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Home My WebLink About94-01003 ~. ,.~, : " "'h- ,.t ~ -- ~'::_~, -~ '~'-~,~/!~:~~~;-~~ - .,,-'''it , ':'_\ ~ ':;! :~>.: .. ~. . ; " , PETITION FOR PROBATE and GRANT OF LETTERS CONNIE M. CONKLIN No, d2/- 9'1 - 100.3 To: Estate oJ also known as Reglsler or Wills ror Ihe , /)~"''J!''etl. COlllllY or CUMBERLAND III Ihe Social Security No. 207 - 07 - fib 1!1 Conullonweallh or Pennsylvania The pellllon or Ihe ullderslgned respeelrlllly represents Ihal: Your pelllloller(s), who Is/ure 18 years or nge or oldc.r IIJ1Ihl' exe~lJ) OR named In the lasl will orlhe above decedent. dOled OCTUBtR JO, 1!l91 ,19_ and eodlell(5) dOled ('laiC Itlc~\'11I11 CIrC1IIIU1IUU:C!i. (.g, renunclatloll, tlcalh ur c\CClllor, eIC.) Deeendent was domiciled al dealh In CUMBERLAND CounlY, !'~!1!!5)'lvanl'!.l~lh h...EL- 1051 ramily or principal residence 01 XSl!KlCl[NlaW.l(l'I<llWCX8lClOn:KSJ)UIa;X~lIwNllHX. 1700 Market st. Camp Hill.pa. (I'" slreel, nlllnbcr nru.lltlllnclJlRlh)') Deeendelll,lhen 8B yenr5 or age, died NOVEMBER 9, ,19 94 111 . Uxeepl as roilow5, deeedenl did nolmarry, 11'05 nol divorced and did nol hnve n child born or adopted arter execullon or Ihe will orrered ror probnle; was nollhe vlellm or a killing and was never adjudlealed Ineompelenl: Dccendelll 01 dealh owned properlY wllh eSllmaled values as rollow5: 3392.93 (lr domiciled In Pa.) All per50nal properly S (lr nol domiciled In 1'0.) Per50nal properly In Pennsylvania S (lr not domiciled In 1'0.) Personal properlY In CounlY S Value or real eslale In Pennsylvania S sltualed 05 roilows: WHEREFORE, pelllloner(s) re5peelrllily [fm!l:~tI.1Nth~Rnrobale or Ihe la51 will and eodlell(s) pre5enled herewllh and the grnnt or leller. I t:'IIIME III Y (tC\tRl11clllnry; ndmlnlmntlol1 c.l.n.; ndmlnlsUntlon d.b,n.c.l.a.) theron. 'g Ii .,,- 'ct "'8 'SI." ~.il "'o. 'g'O i iii tl:Azy. f: C~ 185 CENTRAL VIEW RD KILLSBURG PA 17019 OA TH OF PERSONAL REPRESENTATIVE COMMONWEALTH m'IJENNSYLVANIA } 88 COUNTY OJ" CUMBERLAND Sworn 10 or arrlrmed and subscribed before me thl. 23rd. dag or 'j~}(JI1,+ Q.. ~~~~,~r 19----L MAR'\' C. I..EW IS", . Hell/sler J v....~ -r.c, ,,",Cll>-'-t,, 'I -f).1/9 - Itj. I ..... ~fiiil/i:-{~~"r,:>{;'fi._;";d..;:4{t.."-'-"" ~ I .c~ ~c.:>, " The pelltloner(5) above-named 5wear(.) or afrlrm(5) Ihalthe Slalemenls In Ihe roregolng petition arc Irue and correCI to Ihe be51 or Ihe knowledge and beller or pelltloner(s) and Ihal 05 personal represen- lallve(s) or Ihe above decedenl pelltloner(5) will wen and Iruly admlnl.ler the e.lale according to law. {/~d+ L r:~ '" 0;;' ~ ;; ~ ..... ,,~ JZ .\ .. ""';.-',;;-::'-." . .- -' --~-'~~'"'' No, 21-94-1003 Estate of CONNIE M. CONKLIN . Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NOVE~IBER 29 19...J.L, In conslderallon or the petition on the reverse side hereor, sallsraclory proor having been presenled berore me, IT IS DECREED thatlhe Instrument(s) daled OCTOBER 30, 1991 described therein be admitted 10 probate and med or record as the last 11'111 or CONNIE M. CONKLIN It:'IIIMtNIARY PHILLIP L. CONKLIN and Letters arc hereby granted to FEES P b L E S 25.00.. ro ale, ellers, tc.. .. , . . . .. Shorl Certlneales(3) ........., S q .nn Renunciation ................ $ . X-Pages S 12.00 JCP 5.00 TOTAL _ S 51.88 Filed .,."" :'. MOY,f;b1!:ier.. 2.9 "l!l.U" 'm~ ('" ~.w..:., no..p P, S) ........b.. o Resl'le, ot wlIIl " MARY C. LEWIS PETER B FOSTER ESQ NO. 15357 ATTORNEY (Sup, CI. 1.0. No,) 121 SOUTH STREET ADDRESS HARRISBURG PA 17101 (717) 234 _ rbl~ff I,') 1- r'~ , . r:J e-- I'~ , , . i'.! c;: 4;'1" (e p-, .,' S ij U Hl(16tllnf:V...- ("I'DA THIS ct"TlflC"'1 U 001 WARNING: IT 15 ILLEGAl. TO AI. TEn THIS COPV OR TO DUPLICATE BV PHOTOSTAT on PllOTOGRAPtt. CO....ONW.ALTtt OF PENNSYLVANIA DEPARTMENT OF UEAlTH VITAL f1EconOS ~. L ~~l --' ~ SOK .:r- Social Security No. .)../) 7 - /J 7 - t. ~ 1 , Date of Death /U 9/ It tv Date of Birth 1-<. - 1:4. . ~S- Birthplace 'fJLG_, At . Place of Death <_ -I,. -' ItN 'pi- B-1" L~ (!'t{. {{ _.../ / &."-,d v/- LL Pennsvlvanla J J ~ ,.e111I,NI'TlI 7 f c."lfll, Cl1t,"TfijfOUO)'" '_1'~ f Race tJ,1,.z; Occupation (J .t2. , _I Armed Forces? (Yes or No) /t Decedent's / ..1 / L '" / /' .4- Mailing Address 7/J II Ji'L-L.l...tJ1 V-I {lJh_I~J /V-n' / ]V&< Nllml>>t . a"... ' ellrf' 'OWfl . SIIlI -,&' 'l CERT. NO. 2438036 Name of Decedent ~L"'<-L l' .~ filiI 11- I.{ - tv 0"1 olluIII 01 Thlt C.'III.c....OI1 / /1/ '.."Jet.. Informant Name and Address f Funeral Establishment / .~"-- Funeral Director {L 7; Y.;, a I (}fl-"".,I 'I.1L-( / This Is to certify that the Information here given Is correctly copied from an original certificate of death duly flied with me as Local Registrar. The original certlllcate will be forwarded to the State Vital Records Office for permanent filing. .. ~ Part I: Immediate Ca~ (a) i!Z vi ({ -f." J).J (b) .{L If 7- I' (c) (d) Part II: Other Significant Conditions Manner of Death: Natural ~ Homicide 0 Accident 0 Pending Investigation 0 Suicide 0 Could not be Determined 0 ~ek Name and Title of ce~ Addross ,-/.1 7 ~ - , _ /1- "1' fi'y 0.'1 f\1o(""d l"'I Loul n~,tl'.' t.L Interval Between Onset and Death Dascrlbe how Injury occurred: (M,D.. 0,0., Coroner, M,E,) - ( n.22... u"., ""0"""01 VlllIl PfCOfl11 O'.llItINo ..,,' , L'.,: ~jl'rrl.'l'Ji\l",~'","" 1/1U4 [ '! ., .IU'hl T- CII,.lJo'pUgtl, TO*'llhlp ': f!.":' : : ~ ~,,: ,',~1~;;::'~' .',;. " ',' , " I: .', ,V':.:' ',.i.i.'. ,. '.e, ,:::':';:." '.< :,:, '. I,:. '. ',,',::':.',:': ..::'. . , '...:, i";:.. '::':>:. : i '::.:._:-.""",'.:, ,;.-.-: ...>.,::'.,:i .... .'..' ...,' ;.:::-. i:;':;-'?""'..::'.' .-:-,c' ,.,..,,:,'. ::' ,..... " };i:ii~'\;:-:-:"~/; 'i.-.:' '!_,-<, ~ ,:,.,j" . ..,\.;. ~:,~\~i~i~H~ :;'~::;."~')'.. :.- '.~:,,~i';:..::,';.,:u . ':( ':.,~...,..'. 't,';::' , ."'" ;' ,i. '.,'.,' ::.,: <0:: :;..,.: .::.. . :,\":;", ;:;,C'>;.>, ';:":;;,::,' ,.;",;'.- :,- ~:l:t~,:' ,', .:. -,;'; ~~;d).. :::h'~:{:7;;}; ,'.."... .:;;.J;'L:;.; .:- ,.,,;-~q',:, :\~.~:. ...' ':,',;; ,i-;'.:,;';, ""'.">:.,.. ,i :,";'" ..'. '.,,"/,,-':.'. :.;, -.,;",:",. '.':.;" ",;, ..' , ,,'., ." '.' ' . ",.;..'.:'i... '-'{','F,;' ::,....! .;::' ':i'i': .',:, ...';."'>..: ,,:: J-:: ,.:->:'.':.;' ."', . .'- :;',.:,: ." '. . . ..- .'<: ..;:;,:',:~ .-:,/,' :.., .,-;- ',. . ' .... :',/. ~ ',': ;:, ';, :'. }'c.,; "':~ :'., ;.,c., .... >U:.. .'_.:u ,.:.:. t~t{~t,:::",)~y:.: :'"~~(..,.::. :.... ,. :' ,.', . ' ~ '~: ;~i,~~ ., i', ::-.,,r)3 ';;: L." ,',,'.' :;::;\i ,~>:',. , , :<>..' .' ,;,:.~~';)~\ f::,:', .,' ';:';.:',- '. ,. ';> ,--';.~;';.: .~:;;\ ;;'; , : ,;.,~~::. ":;-";-"~,. '. .' ',; ",., /: l,_ ii'l ;:: '/;;>J\~~::; '.;;.:.. ;.':'~;:a.u''''\''::;::" . ~t", <" '.' :~lC',: ",'( ',c, .~", ., ~ '., :j"'f"" . ci dd :. .. ... . . - . . u h; ". . ....... . . -,-_ ._,_" _. .,H<_ . .. ,,-'j .. ...-.; 0_ ",.' , r . -.-.- '.':' . ,j;",>., ';' f-; ", . ~~io-.~~ .. ~,k'-'" ~,,~- """,n EOM/October 8, 1991/10512 , . 3Ea5t Jrlill altb IT"t5talutut or COIlllIII H. CONKLIN I, CONNIII H. CONKLIN, of the Borough of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any ~ime heretofore made by me. ARTICLB I I direct the payment of all my legal debts, and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and whatever jurisdiction imposed, shall be paid from my Residuary Estate as part of the expense of the administration of my Estate. ARTICLE II I give and bequeath my automobile, household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my son, PHILLIP L. CONKLIN, if he survives me. ARTICLE III I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate unto my son, PHILLIP L. CONKLIN, provided that should he predecease me, I give, devise and bequeath the same unto his then- living issue, per stirpes, by representation. --y- - - -.'. /'-; '<j,-' :r~' ~~ .-"" ,'l" 'f,~ ~ ~ ~' , t' ~ ; ~- #i t. , ~ ~. , ';. f! EO,M/<><:tojler 8, 1991/10512 ARTICLB IV In the event that any beneficiary of my will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, I give, devise and bequeath such share unto DAUPHIN DBPOSIT BANK AND TRUST COMPANY, pennsylvania, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in Trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training) without regard to his or her ability to provide for such support or education or to make payment for these purposes, without further responsibility, to such beneficiary or to any person taking care of such beneficiary. When such beneficiary shall reach the age of twenty-one (21) years, Trustee shall distribute the then-remaining principal and any income accumulated thereon unto such beneficiary absolutely, and the Trust as to that beneficiary shall terminate. In the event any beneficiary dies before receiving his or her final distribution hereunder, such beneficiary's Trust shall terminate and the balance of principal and income shall be paid over to my then-living issue per stirpes by representation. ARTICLE V During the time any portion of my Estate remains in Trust, the same shall not be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over income and principal as hereinbefore determined to the parties designated, as their interest may appear, without regard to any attempted anticipation, pledge or assignment by any beneficiary, and without regard to any claims thereto or ----......,..",.-"'""'!"'r~--,. If EOM/OclOb~r 8, 1991/10512 , , attempted levy, attachment, seizure or other process, provided that if any such levy or seizure, or other process, shall be authorized by law or specific order of any Court having jurisdiction, Trustee shall not be liable to any beneficiary for violation hereof by reason of the same. ARTICLE VI If at any time during the continuance of any Trust created hereunder, the Trustee in its sole and absolute discretion determines that the size of any individual Trust account has become so small as to be impractical to continue to hold in Trust and uneconomical to continue to administer as a Trust, then in such circumstances, the Trustee may without further authorization distribute the balance of the principal and income in such Trust account to the beneficiary then-entitled to the income therefrom, and upon such distribution the Trustee shall be released from further obligation with respect to that account and shall not be subject to any claim from any person who may have had a future interest in such Trust account had it been continued in Trust. ARTICLE VII I name, constitute and appoint my son, PHILLIP L. CONKLIN, Executor of this my Last will and Testament. In the event my son, PHILLIP L. CONKLIN, fails to qualify or ceases to so act, I name, constitute and appoint my grandson, MICHAEL K. CONKLIN, alternate Executor to complete the administration of my Estate. IH WITNESS WHEREOP, I have hereunto set my hand and seal, this 36lL day of OJ:;~ ' 1991. {21g>>)1Aj"Y>?, ~)~iJJ..-.~ (SEAL) connIe M. conkltn . EG~/~b~ 8, 1991/10512 siqned, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~J'Mrv ~~/~~~k"' .f~-" E~tdIOcto!ler 8, 1991/10512 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND We, CONNIE H. CONKLIN, LUJ~IINO~. MV8~-\ and R~L1>1t H WiIGl~T, Jt the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~J'I/OJ'1'7~Ag~: Conn e M. Con 1 n ~/t41J~ Witness ~/#~ w t s r and acknowledged before me by Connie H. subscribed and sworn to before me by , and l?A lPI~' ~ W(( IC,Hr, jft d., of (1.b;~ ;~ ( /). /l 'IJ:,::' ~ NOTARIAL SEAL ~<Vl '-!!t. ~L'v-<.l GINA M. ALOISIO, Not.ry Public ' Notary PUblic WiIIlamspnrl. lycomlng Counlv. Pa, I/ri Commlnlon bplr.. 00<:. 28, 1992 Subscribed, sworn to Conklin, Testatrix, and l\)MunD ~ M\leRS witnesses, this ~b-\l.. ~ ,': '1 01 Q .....~.l . ~1! ......,...,.". r ~,.,' , ,,- '0' . ~' .. :'~' :,:) .~"} .~ " .,).~ ;..' rt') I) .' . ~ :... 0 () . ~ .... I 8 '* ra. . ~ 0 :I: ...-' I el -... ~ ~ " . ~, ,-,..,-.. , . ., ,0 ." .~,"',. ., -.. -~.: ',d .',::" "9:1) Jtt.~.. "C' ,), .,~ .',-':'" ../;1) ...;:; ,'. ~::: t.~ (.'f {I.. '.. ,A..."I --'::)0. ,.~;" 115 r~~ 'bf .. .~lE ~ c ~ ~Id . . <IS ~ z ,~.. ~. ,~ ~ :c o .~ , :,\.-, ~'-"cL.:;'" ~~)Y).ri.f~fo}J'!';:J<:":~";';' "~~'\ ,~!!'-"'{,,"'" iltl~,o.'~'l;~:~!:ci~;'~/:,J~:~~;';~,'::', RUGuld..j. .,.. of Rl'Ui:ill" t'i \,Iills CERTIFICATION OF NOTICE UNDER RULE 5.6/a) '95 I1n~ 21 /19 :<16 Name of Decedent: Conn 1 e M. Conklin Clen. .AJUII Date of Dellth: November 9. 1994 Cumbol' 11\1 'rl., PA Will No. 1994-01003 Admin. No. 2194-1003 To the RegisLerr I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphllns' Court :Hules was served on or mailed to the following beneficiaries of the above-captioned estate on March 17. 1994 : Name Address Phillip I.. Conklin, 185 Central View Road, lli1lsburR, PA 17019 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: March 20, 1995 ~~.~ Signature Name Peter B. Foster Addressl21 South Street lIorrlsburll, I'A 17101 Telephone/717) 234-9321 Capacity: Personal Representative x Counsel for personal representative l~ -...........-. . . . . . ~_. t'" ~,. /4 -,;JL/7 -) '-I ... t: . U'i.tsoo Ix. 1\1 qt) 'OR DATil 0' DIATHAnU uta",. CHICKItII .. A I'OU.AL 'OYII" CIIDIT II CLAIMID 0 ;iii- HUM'" ~,? \I INIlliRITANCE TAX RETURN '~:.rif..;,t' RESIDENT DECEDENT COMMOtlW\.",' 01 ....""Y1VAI,,. (TO BE FILED IN DUPLICATE DI,AII MlUl or II\VruUf 1I..",f.l:& ~~u\~ 11060' WITH REGISTER OF WILLS) ~_ _._.___l-_~______.._~_~ ._______. -+~~~_.. -- -- oruonwrn11lfli^mlll!r. Al101limilrmlflAII- 15 ~ a ~ ~~~ o~'" ~ 115 ~a oz u2 I. R.ol E,'ol. IS,h.dul. AI I 1) 2, Slo'~. and Bond. (Sch.dul. 01 I 2) 3. Cia Illy 1l.ld SlocUPollnenhlp Inl.r.'1 IS,h.dul. q I 3) ~, Morlgog.. and Nol.. R.,.lvobl. (Sch.dul. 01 I ~) 5, Co.h, Oon~ O.po"" & Miltollon.ou. P."onol Plop.rlyl 51 6112. 91 IS'h.dul. E) 6. Jolnlly Own.d Prop.'ly IS,h.dul. FI I 6) 7. Tron.'." IS,h.dul. GIISch.dul. l) I 7) 8, Tolol Gran Ami. ('olollln.. 1.7) 9. Fune,al bpenle., Admlnlst,atlve Call', MI.eellaneau. ( 9) hp.n... (Sch.dul. II) 10, O.b". MOllgog. lIoblllll.., lI.n. ISch.dul. I) (10) 11, Tolol O.du,lIon. I'o'ollln.. 9 & 10) 12. N., Volu. 0' E.,o'. (IIn. 8 mlnu.lln. 111 13. Ch~rllable and Gavernmenlal Oequellt (Sdlodul. J) \4, N.I Volu. Sub.d 'a Tax (IIn. 12 mlllu,lIn. 1J) 1 S. Amount of Illle U tn..nhle ot 6% ,a In (Includ. value I fran1 Selledule K 0' Schodule M.) 16. ^n1ounl 01 line 14 loxoblo at 15% rot_ (Indud. volu.. from Sch.dul. K or S,hodul. M.) 17, Principal 10. du.(Add 10. from IIn. IS and from IIn. 16.) 18. Credit, Spoulal Povarty Cradil I'llo,l'aymenlt ----.--- + ----- + 19. IIl1n. 181. gr.ol.r Ihon IIn. 17, .n'.r Ih. dlll...n,. on IIn. 19, Thl.I.lh. OVERPAYMENT. aD 20. If IIn. 17 II Or.ol., Ihan IIn" 19, onl., Ihe dUlerence on IIn. 20. Thb h the TAX DUE. A. Enler lhe Inlerl11 011 1110 lJalanca duo on line 20A. 8. Enl.r ,h. 10101 of IIn. 20 and 20A on IIn. 20B. Thll I. Ih. BALANCE DUE, Mo_~. Che<~ royobl. t., R.g,!'.' .f Will., Ag.nt .. "III SURE TO ^NSWER ^IL QUESTIONS ON RIVERSIIIOI AND TO RICHICK MATH.. iij~c1or penaltl... a' p8ri~;y,-rci;~r(J'. 111Dllli~j~~'~lCu;-nTr;';~fli;i, lelllln, Includln;p accompanying Ichedule. and .Iallmenll, and to Ihe belt of my howledoe anlJ b.ii, It 11 true, carrod and complele. I d.c1me 'hal nil 'rnl"ln'" 1,,1' luren "po,'e 01 true marlt,t valu.. Oeclarallon of pr.por.r olhe, than Ih. p.rtonal '.p'.lenlallvlt baled on allln'o,mallon 0' w"kh Ilfll,IOIflr hn' ony lnowlndll'l. IillIrnUlrorPUlbfTimot1!iill JOr/IUNa OI1U;;r--.- AubHll D'''. ~ - ..P. {~,,~ 185 Contral Viow Road. Dlllsbur!1t PA 17019 j/ I / 9.5" Fil,1;t~I{(llillirlil H mmmlAlr"r-------AiiDllU D'''-'- - . _~..:____m__=__________.~21 South Streot, IInrrisburll, PA 17101 1/31/95 z o j I z o ~ !5 ill o u g .;;, - COUNty CODE fJl"lD[)lIUI C(LI YEAR 100,,3 HUMIU' Conklin, Connie.. H. !&lAflIWIII IIl1Mlli-=- '--.rllAlI or DrAlIr--- DIo1fmT! 207-07-6619 11/9/94 12/23/05 .._------.----" ---.-. . ~- .--.-.-.-..---- Ild 1. Orlolnol R.I"rn I J 7. SUf'f'I.m.nlol R.'urn 185 Central View nood Ili118burll. I'A 17019 c_, [14, [J 6. lImll.d Ellulo o 3. Remalnd.r R.lurn (fa, dol.. of d.oth prior 10 12.13-8, o 5. f.d.ral E,'ol. Tax R.'urn R.qulr.d _ 8. Totol Numb.r 0' Sof. 0.1'0.11 Bo.. LJ 4u. futu,. Inl.'.11 Comp,oml.. (lor dot.. 0' d.olh oft.r 12.12.82) Deudelll Oled Toltnle I] 7. aeeedent MaintaIned a living Tru'l Allo,h 'a of WillI (Alloch copy 01 Tru.') ALL CORRIIPONDINCI Allll (;O~lrnIENn^L TAX INfORMATION SHOULD.I DIR.aID TOil i ""'\:,i,j,l, llAMe--- ---.-- -- - COMPlUf MAILING ADDIIUS I I'hillip Conklin 185 Central View Road mffflllllfflUMIlI------ IJi11 Sburll. I'A 17019 /.!...'_:"!~;C':"_'~ I 717 432-9222 8789.18 ( 8) 6112.91 1333.28 (15) Ill) (121 (13) (141 )( .06. 10,122.46 - 4,009.55 o o n (16) )( ,15. o (17) o Ol1eaunl Int.'.lt o o o (18) (19) c: t()t~ lord I dU tHo Hit .ds"" (I to LInd 0' VaUI OVl!If1uvnwnl (20) 120A) (20B) n o .... - .~~ 00- 'R sO; .0 J!l - .~t; 0.. .,..8 i'.;"~ 00 rp " . do::J , -, m ~m ~ I... 'l'.;n l(ii ,~~ ~1. ~ ,UV':JO. '~. 11..111 *' COMMONWlAlI~ O"'IINIYLVANIA INHUIIAN '!AI I'URN UIIDIH DICED Nt IsTAT. oji Connie H. Conklin - ~_.~_._--- IPlOp.rty '.Inlly..wn.d with Right., Survlv...hlp mu.1 b. dl"I...d .n Sch.dul. FI All ,..1..1.,. .h.uld b. ,.p.,t.d .1,.1, m.r~.t v.lv. whIch I. d.lln.d a.th'I"lc. 01 whIch pr.p.rly w.uld b. ..ch.ng.d b.lwun a willing buy.r and a wllllng..II." n.lth., b.lng c.mp.lI.d t. bu a, ..II, b.lh having '....nabl. ~n.wl.dg. .'Ih. lOl.van' 'ach, ITEM NUMBER SCHEDULE A REAL ESTATE L_ FilE NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. None TOTAL AI.o .nl.,.n IIn. I, R.co IIuloUon (1/ mo,. 'poc. Is n..ri.ri, 'n.." oririmonol .h..I, 0' ,om. 01...) $ 'j . [ i i ;\ !, ; . "Y' 15011.. ,..... ~...t. ~~ COMMONWIA~1t 0' "~N'llYANIA IN~\\',ltiN~ID\~hlm TATI 0' Connie M. Conklin SCHEDULE B STOCKS AND BONDS 'Ill NuMB R (All p,opo,Iy 'olnlly.ownod wllh RighI 01 Survivorship mud bo dl,clolod on Schodulo ',1 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. None TOTAL Al,o onlor on IIno 2, Roco lIulollon (II mo,o 'poco 11 noodod, In.o,' odditlono' ,hoo', 01 .omo alIO.) s ~I".~"'~'~ * COMJ;\?,:1':,I~U~,~' t'IW,\~\l"NI' 'IiIlIDINI Otc1DINT ISlATI 0' Connie M. Conklin eSch.eI"te C-1 It C-2 mUI' It, attach... f.r lach ltulln''''"I".., .f the ".e.d,,,,, ....., than a "."I'forthlp.1 SCHEDULE C CLOSELY HELD STOCK, PARTNERSHIP AND PROPRIETORSHIP ITEM NUMBER DESCRIPTION 1, None PI.a.. PrInt ar l' . Fill NUMBER VALUE AT DATI OF DEATH II' more 'poce II n..d.d, Inll" oddil/on./ .h..,. 0' .om. JiIO.' TOTAL Al,a .nler an IIn. 3. R.ca Itulallon $ _ n, ~-~~,~~fK~~~"wrtartip4~,,-';'i;.~3hi-,,:{,,',-~gL\~.t~4J~J',-;'.!:.j:-t;m.."..}f.tffll:~:'i~,,~~~,.'tiH/"l" ';'<.~, ;.., 1I~.1I0S fl. 1"'1 -!~~ COMMQUWfAl1tt 0' PfUulnVANIA IHUUIfAt'CE tAX IUIUIIU USIDfNt DfCfDfNt SCHEDULE C.l CLOSELY HELD CORPORATE STOCK INFORMATION REPORT PI.as. T . ar Print Tho lollowllln 11110"';011011 mu.t be .ubmltted with .hls schedule: ' ' ESTATE OF Connie M. Conklin FILE NUMBER A. Delalled descrlpllan .hawlng Ihe melhod 01 campulollon ullllnd In the voluallon ollhe deCldenl', .Iock. B. Compl.le copl.. 01 financial .Iolemenlt or compl.t. copl.. 0' Ihe federal To" R.lurn. (Federol Form 1120) for the year of d.alh and A preceding yeon. C. Slatemenl 01 dividend. paid each y.or. USI those declared and unpaid. D. UIt nom.. 0' oU/cen, .olarl.., bonus.. and any olhlf benefllt r.celv.d from Corporation. E. If the Company owned real ..101., .vbmlt 0 Iisl .howlng Ih. compl,'e address/.. and ..lImal.d Fair Marht Valv.I..1f R.ol E.lat. Appral.al. have betn "cured, plea.. attach copl... f. lht principal .tockholden 01 dale of dea.h, numb" of Ihor.. held, and relollonlhlp to dlCed.nt. G. Any olher Informallon rei olive 10 tho valvallon of lhe deced.nt', Inlerelt. 1. Nom. of Corpolotlon Stre'l Add,." None State of Inc. Dol. of Inc. Clly Slale Zip Code Tolal Number of Shorehalden Federal I, D, Number ISame A. Federal Farm 11201 3. Type of Bulin." BUllne" Reporllng V.ar 10 2. Product ~, STOCK TYPE TOTAL' SHARES OUTSTANDING PAR VALUE . SHARES OWNED BY DECEDENT Common Pr.ferred Pravld. all right. and r..lrletlan. pertaining to each cia.. of .tack. S, Was decedenl employed by Ihe Carparallon' CI Ye. 0 No II Y'" POllllon Annual Salary S Tim. Oevaled 10 bUllne" 6, Was Ihe Carporallan Indebled 10 the decedenl' 0 Ye. 0 No II y", provide amount of Indebledn... S 7. Wa. there life In.uronce payable 10 ,he corporallon upon dealh of decedenl' 0 Ve. 0 No If y", Calh Surrender Value: S Ne' Proceeds Payable: S Owner of Polley Old Ih. d.cedent lell or Iron.fer .tock of Ihlt company within one y.ar ~or 10 dealh If ,he dol. 0' dealh wal on or oher 12/13/92 or wllhln Iwa yeo" IIlhe dale 0' dealh wo. prior 10 12/13/82' 0 Y.. U No If yesl 0 Tran.f.r OSole I of Sharll Trand"ee or Purcha..r Can.ldllallon S Dol. Anach a ..parole .heet for additional transl.r. and/or 101... Old ,he corporation hove on Inler"lln oth.r corporations or parlnenhlp.' 0 v.. 0 No If Y'" reporl the neceuary In'armal/on on a .eparate .h..l, Including Sch.dule "C.I" or "C.2" for each Inlerlll. 10. Was there a written .har.holder'. agreemenlln .lIeel at Ih.Ume of lhe dec.denl'. dealh' OV" 0 No If Y'" provide a copy of lhe agr..m.nt. 11. Was Ihe decedenl" .Iack .old' 0 Ye. 0 No If ye., provide a copy of ,he agreem.nt 01 101., elc. B. 9, 12. Wo. the corporation dluolv.d or liquidated ofter the d.cedenl', dealht 0 Vel 0 No If yes, provld. a breakdown of IIquldallon dil.rlbullonl, elc. Allach a ..parole .h..,. I i. ! i i_;C, oj....: \ Ily.uGtntlltll ~\i~ COMMONWEAltH or PfNNSYlVANIA INHERUANce 'AIC UIUIIN .UIOtN' OfCfOfH' SCHEDULE C-2 PARTNERSHIP INTEREST REPORT PI.a.. T . or Print FILE NUMBER ESTATE OF Connie M. Conklin The /ollowlng In/otmatlon must be submitted with this schedl!le: A, Detailed demlpllon .howlng tho melhod of compulallon ullll..d In Ihe valuallan of the docedont'l Interelt. 8. Complete copln of IInanclal'latomonl. or comploto coplol of Iho Fedoral To. Rolurnl (Form 1065) lor the year of dealh and 4 preceding years, Including a balanco .hoel for Iho yoar of doath, C. If tho Company ownod Real Eltato. lurnllh 0 IIltlhowlng Ihe camploto addroulel and o.lImaled Fair Markot Valuols. If Real Ellato Apprallall have boen .ocurod, ploalo a!lach capln, O. Any olher Informallon rolallvo to tho valuallon of Iho docedont'. Intore.t. ,,' 1. Name 01 Partnership None Fedorall. O. Numbor (AI por Form 1065) Dolo 8ullno.. Cammonced Addrell 8ullno.. Activity 2. Oocodent wal a oGonoral oUmltod part nor. If decodont wal a IImltod partnor, provldo Inltlallnvnlment $ 3. PARTNER'S NAMES ,., or INCOME ,., or OWNERS NIP SALARY BALANCE or CAPITAL ACCOUNT A. I. C, D. r 4. Elllmated Value of decedent'llntere.t: S 5. Wa. the partnership Indobted 10 the docodont' DVn DNa If yel, provide amount of Indoblednell $ 6. Wal there life Inluronco payablo to tho partnorshlp upon tho doath 01 Iho decodonl' oVn DNa If ye., Calh Surrender Valull $ Nol procoodl payable. S Owner 01 Polley. 7. Wal there a wrl!lon partnership agreomont In elfoct atlho limo of Iho docodent'l death' DVn DNa If ye., a!lach copy of agroomont. 8. Old the partnorshlp have an Intereltln any othor partnorshlp. or corpora lion.' oVel DNo If ye., report tho necouary Informallan on a ..parato .hoot, Including Schedulo "C. I" or "C.2" for each Inlorelt. 9. Old the docodonl'.Intoro.tIn the partnorshlp change In the yoar bolore d"Jth If tho dolo of doath wal an or alter 12113182 or If death accurrod prior to 12113182 In Ihelalttwo yoars' DVn DNa If ye., e.plaln. 10. Wallhe docodont relatod to any 01 the other partners' DVel DNo If ye., explain. 11. Wal the partnership dluolvod or IIquldatod afler decodenl'. dealh' DVn DNa If yel, report all tho relatod Inform allan, Including capln of the Solei Agreomont andlor SoUlemonl Shoot. 12, Wal the decedont'. partnorshlp Intoreltlold' oVel DNa If ye., provldo a copy 01 tho agroemnt of 1010, ele, " l .........-...... ~ . ' "'1ltol'" (7.," ~ COM~t?,"r.I:UH.~' t'r.H'~~'HI' lS"OIH~ otciDtW/ ISTAlI 0. Connio M. Conklin SCHEDULE D MORTGAGES AND NOTES RECEIVABLI P'.o,. Prlnl or l' . .ILI NUMIIR CAn In.,."" 1.'nlly.ewn,1I with the ."h' .f lurvl.."h1p mUlt b. dlnl..... .n Ich,lIul. P.I ITEM NUMIIR Nono t' DESCRIPTION (It more 'poco 11 n..d.d, Inllr! oddiliono/,hlll, o/,om. 11.1.) VALUI AT DATI o' DEATH s ~, ~1_"lt$I~~.\':~~;Ulo;l",",."''''''_-_'''-''-''~~''''_ "~i ~~~~, ~__~_~'."~->>wtN~"'~ ~ \1 'i-.' ..~ .,~ . . I \:-[ . ;j. ~ ~ Ii ~ .;; ...,.11011.. t1"1J , . '* SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY COMMONW\AlIH 0' 'INNIYlVANIA INHIII AHClIAX InUIH ..IIDIHt Dtc,nlHT tSTATE Of . Connie H. Conklin (All ".,.,.. .....lly......... with lhe ."hl .f Survlw"hlp mu" ... ..I.ct..... ... Sch.",,!. '1 ITIM NUMBER 1. 2. 3. 4. DESCRIPTION Cash in checking sccount at Dauphin Deposit Bank, Camp 11111. PA Benefits from P!,nnsylvanin State Retirement Fund Benefits from Penn Treaty Insurance Company, 3440 Lehigh Street. Allentown, PA 18105 Benefits from Commonwealth Retirement Board TOTAL Allo .nt.r on IIn. 5, R.eo (A"ach addlllonaI8~" x 11" tM.tllf more .pac.l. n..d,d,) ~-~~~\~.~;i.!"..!<.,..:....;c.~~,r.~"_. '._j,''''''';''';';'''--'~'''''''''.''"9''''''''''''''''~''~-'~''''''''''-''' VALUE AT DATE OP DEATH $3201. 07 67.00 2650.00 194.84 S6,112.91 t' ~ 1 ~ t ~ ~ B. " f , # ~; , , ~. , { t , , ! \ t t i , } , "'....~. ..~,., .'L '" .'li !1~1~...,ll""1 . COMMONweAllH 0' PfNN'YlVANIA INHf.nAHCI tAli InUIN oISIDIH! DICIDIHr SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OP Connie H. Conklin Fill NUMBER JoIn' 'ononl(ll' __'___"~ .____.__.__~..u__.__ NAME ADDRESS RELATIONSHIP TO DECEDENT A. None C. Jolntly..wnod propo"VI ITEMER LmER DATE POR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET 'If> INT, DECEDENr's INTEREST TENANT JOINT 1, , TOTAL (Abo .nlor on IIn. 6, Rocopllulollon) S (If mOrl .pac. is n..d.d in.,,' ar:JrJiIlono' ,h.." o( .om. lin) ,> t ~* " ~~ IIV,1510 I" 11.1'1 .' . '* SCHEDULE G TRANSFERS PLEASE PRINT OR TYPE Fill NifMiEr-~-----'~ r' eOMMONW'AllI' D' P1NNV"VANIA INHnllANel 'AX "" IN ___~ ..~=~.!!!~~.::L~~!~.~=,:=-.:-=:;:.;c;==,,-,-_----:-- ~---==- IITATI OF Connie M. Conklin ~ 'HIIICHIDULl MUST III COMPLITID AND 'ILlD IF 'HI ANIWER '0 ANY OF 'HI QUISTlONI ON 'HI IIVERII 1101 0' 'HI COVER IHIIT II YEI. --' -- -------.---------- .- ---omLAR VAWi- IlfM DUCRlPlION Of PROPERlY TOTAL VALUI DECO, EXCLUSION '"' Of DECEDENT'S NUMIER 'II("" nOlM oIlh, 'tDtl""H, lite" r.lofiondtip'o dim.,.', da', 01 Irand.,. Of ASSET INT, INTERUT None , TOTAL IAllO ,"t., on IIn,7. RlconUylotlon' S I" ,"or. .pon II n..d,d, H..." additional .1...,. oI.om. ,',..' I i ! ,. " f J J t ~'1~ 1 '-"~ . IIVUIl .... '.111 ITEM NUMBER A. I, B. 2, 3. * COMMOHWIAL1'H 0' 'INNSYlVANIA INHERItANCe 'AX tnUIH .tIIDEN' OrclDIHT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. P,lnt 0' T . Connie M. Conklin DESCRIPTION AMOUNT Fun.,al bp.n.... Funeral expense at Neill Funeral 1I0me Dural expenses at Rolling Green $1213.00 1241.18 I. Admlnl.trotlv. CO.tll Pononol R.pr.s.nlallve Commlulons Social S.curlty Numbor 01 Pononol R.pr.s.nlall..1 Y.ar Commissions paid Allornl)' Fo.s 250.00 Family Exompllon Clalmanl Addross 01 Clalmanl al d.c.d.nl'. doalh Slre.1 Address R.lallanshlp Sial. Zip Cod. City .4. Probalo FOil C. MI.c.llan.ou. Exp.n.... 1. 2, 3, .4. S. 6. 7. 0, 25.00 TOTAL (Also .nl., on IIn. 9, R.capllulallon) (limo,. .pac. I. n..d.d. In..rt additional oh..t. of .am. .1...1 $ 8189. 18 '""1.""l.......~,#!I.~..~..'....~"...,.."b.:.,.".....C.'..'I"'....~'+'J".,~av_._.',.t"""''''',~,'-''''''''' ~-",,,"'" J \ ,_?"""",,""",',"'>\"." ,,;,''<W'''\.:1'ttM! . NY-lUl.... P."I ,g~~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L1ABLlTIES AND LIENS PI.a.. Print or T . rLE NUMBER COMMQNWUllH Of PltIU',,"....I. IHHflltAHCI tAl InuI", .UlblHI blClblHI ISTATE Of Connie M. Conklin ITEM NUMBER DESCRIPTION AMOUNT 1. Attorney's fees paid to Attorney Edmind G. Myers $ 225.00 1108.28 Housing expense at Leader Nursing Home TOTAL (Alto .nl.. on IIn. 10, Rocopllulollon) (II more 'poco " n..d.d, InlOrl oddillono' ,h..I, ot,om. II..,) $1333.28 It V 1111 lit ''''I ~~ (0"''''''011'1'1....''.. or 'hllli"VAtl!A INHU""'uCt ,.... ..IUI,. IIIIOINI CIUDIN! SCHEDULE J BENEFICIARIES ESTATE OF Connie M. Conklin FILE NUMBER ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP A. Ta.abl. Bequllhl 1. Phillip L, Conklin 185 Central View Rood Dillsburg, PA 17019 Son ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY '8. Chartlable and Go....rnm.ntal B.que,tsl 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUEST5lAllo .nl.. on lin. 13. R.copllulotlon) S (If more .poc. Is n..d.d, In..rt additional .h.... of .am. .111) ;o"~,",^, <'.,;,.,,- .,,' ,- "-"''(.,;.,t1'_, ;'_':'. \. AMOUNT OR SHARE OF ESTAU 100% AMOUNT OR SHARE OF ESTATE . .f~,UUfl.l)9JI ,,~.,'~,..~- -.V'W' COMMOUWfAlllf O. P[WHiUYAHIA INtlUnANCf 'AX RUUJlN Rf510fm PICfOftH SCHEDULE K LIFE ESTATE/ANNUITY/ TERM CERTAIN ESTATE OF FILE NUMBER Connie H. Conklin Thl. .ch.dul. I. 10 b. u..d lor oll.lI;gl. III., lolnt o~ -,uc~oIlIY. III. ..101.. o~d I.rm c.rloln colculallan.. For dol.. of d.olh altor 12.31.61 and b.foro 5.1.89, aeluarlol faelors for .Ingl. lIro colculallon. can b. lound In R.y.nuo OookloIIREV.15010), Far dolo. of d.alh on or alt.r 5.1.89 aCluarlal "'clors can b. found In IRS Publica lion , lA57 Aeluarlal Valu.., Alpha Volum., Th. In.lrum.nl cr.allng Ih. III. Inl.r..II. or (PI.a.. allach a cop V of In.trum.ntl o Will D Inl.rylya. O..d of Tru'l D Olh.r l-J 0, '''' \l \'>1.:1 (. f\ e,l'(, \ 'LIFE ESTATE INTEREST CALCULATION ' Nomoi.) of LIfo Ton.ntl'l Oato .f Birth Pr...nt Ag. INoar..t Blrthd'yl T.rm of V,an L1f. E.,o'. II Pavabl. o lIfo or D Torm of Voars o lIfo or D Torm of Vo.rs o Lifo or D Torm .1 Yoars D lIfo .r D Torm 01 V.ors 1. Valu. of Fund from which L1f. E.IUIO(.) I. payabl.,..................................,...................... S 2, Aeluarlal Foelor por .'!Pproprlal.labl. ......................................................................... Inl.r..t Tobl. ral. . U 3Y,% [I 6% 0 10% [] Varlabl. Ralo % 3, Valu. of LIf. E.lol. (L1n. 1 )( L1no 21...................................................,...................... S ANNUITY INTEREST CALCULATION Namol'l 01 Annultontl'l Oato of Birth Pr...nt Au. (Noor..t Blrthdoyl T.rm of Vear. Annultv II Pavabl. D Lifo or D hrm of Vo.rs D lIfo or D Torm of Yoars o Lifo or D hrm .f Yoars D lIfo or D Term 01 Yoars 1. Valu. of Fund from which annuity I. p_ayabl. ........................,....,................................... S 2, Fr.qu.ncy of payoul . [] W.okly 0 Ol.w..kly D Monlhly o Quart.rly lJ Soml.Annually 0 Annually 0 Olhor 3, Amounl 01 payaul p.r porlod.....................................,...........................,..................... A. Annual paymonl .".. """.""",.,... .,. ,......', "'.'",,, ".,... .,...'.' ......', "'" '" ,........ "...., ....... ...., 5. Annully faelor ('00 In'lrUellon.) Inl.r.'1 Tobl. ralo. 0 3Y,% [16% 0 10% D Vorl obi. Ral. % 6, Adju'lmonl Faelor I... Inslrucllon.) ......,..,..............................,............,..........,.............. 7, Valu. of Annuity. If u.lng 3Y,%, 6%, 10% or If yarlublo ral. and porlod payaull. at .nd of p.rlad, calculollon Is: L1n. 4 x L1n.5 )( L1n. 6........,....,...................,...................... If u.lng varlablo ral. and p.rlad "a you I I. 01 b.glnnlng of c.rlad, calculallon Is: (L1n. 4 )( L1n. 5 x L1n. 61 + L n. 3. NOTE. Th. yalu.. of Ih. fund. which ".01. tho aboy. fulur. Inl.ro.h mu.1 b. r.porlod a. part of Ih. E.lat. AII.I., L1n. 1 through L1no 7, Th. R..ultlng L1folAnnully Inl.ro'II.).hould b. r.porl.d at tho approprlato tax ral. on L1n.. 13, 15 and 16 a. r.qulr.d, . _ly.I&44 U.13....1 . . COMMONWEALTH O. PENNSYLVANIA INHeRITANCE TAX ReTURN n!SIOENT DECEDENT INHERITANCE TAX SCHEDULE "L" REMAINDER PREPAYMENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER I. Eslale of Connie M. Conk] in llal' Nom_' (Flnt Nom_' (Mlddl. Initlall Thl. .ch.dul. I. opproprlol. only (or ."01.. 01 d.ced.n'. dying on .r b.f.r. O.c.mb.r 12, 1982. Thl. .ch.dulo I. to bo u.od lor 011 romolnd.r rolurn. whon on olocllon 10 propoy hot boon fIIod undor .ho proyl.lon. 01 S.cllon 714 .f 'h. Inh.rllonc. and e,'ol. Tax Acl .f 1961 or to ropor"ho Inyo.lon 01 Iru., prlnclpol. R.malnder Prepaymenh None A. Eloellon 10 propoy fIIod with Iho Rogl.tor 01 Will. on (olfoch copy of olocllon) B. Nomo(.) 01 L110 Tonont(.) 0010 01 Birth or Annulton'(.} II. lDolO1 Ago on dolo 01 oloellon Term of years Income or annuity I. poyablo C. A..o'" Complolo Schodulo l.1 1. Roal E.la'e S 2. Slack. and Bond. S 3. Closoly Held Stock/Partnorshlp S 4. Mortgogos and Nolo. S 5. Co.hIMlse. Porsanal Proporty S 6. Talal Irom Schedulo l.1 S O. Cr.dlt" Complol. Sch.dul. l.2 t. Unpaid llabllllle. 2. Unpaid Bequosl. 3. Value 01 Unlncludablo A..ol. 4. Tolal Irom Schodulo l.2 E~ Talal yaluo of tru.t 0"01' (llno C.6 mlnu. L1no 0.4) F. Romalndor Fodor (soo Table I <>r Tablo II In In'lrudlon Booklol) G. Taxablo Romalnder yalu. (line E x L1no F) AI.a onlor on L1no 7, Roca Itulallon S S S S S S III. Inva.lan of Corpu.. A. Inya.lon 01 corpus \--lOt0'i:. (Monlh. Day, V.ar) B. Namo(.) 01 llfo T onan.(.) or Annultanl(') Dolo 01 Birth Ago on dolo corpus consumed Term of years income or annully I. payablo C. Corpus can.umod O. Romalndor faclor ('00 Tablo I or Tablo 11 in In,"ucllon Booklol) E, T a..ablo yaluo of carpu. con.umod (L1no C x lino 0) (AI.a onlor on L1no 7. Rocapltulallon) S S . arV.I641 IX. 111.16) INHERITANCE TAX . . ~j~ SCHEDULE M COMMONWEAlTH Of PENNSYLVANIA INttERI1ANCE TAX RflURN FUTURE INTEREST COMPROMISE filE NUMBER RESIDENT DECEDUH .. . -.-.- .. - _. -- I, E.lal. af Connie M. Conklin (Lal' Name) (flnl Nom.) IMlddl. 1.111011 - Thl. Ichldull II appraprlatl anly far Ellat.. af dlCldlnt. dying all.. Dlclmb.. 12, 1982. Thl. .ch.dul. I. la b. u..d far all lulur. Inl.,.'" wh.r. ,h. ral. of 10. which will b. appllcabll wh.n ,hi lulu,. Inl.r..1 v..I. fn pall.llfan and .nlaym.nl cannal b. .,Iabll.h.d wllh cerlalnly, II. Olnlflelar'" NAME SEX AGE ON DATE OF RELA lIONSHIP ~Mal. DATE OF BIRTH BENEFICIARY or DECEDENT'S DEATH F hmal. 1, 2. 3. 4. S. III. Explanatlan af Campramlll Of/In None , , IV, Summary af Compromll. Of/.n 1. Value of Fulure Int.re.h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S 2. Amount of Une 1 EliCsmpl from Tax ....... I . . . . . . . . . . . . . . . . . . . . . . . . . . . S (aha .nl.r on lIn. 13 R.capllulallon) 3. Amounl al lIn. 1 Ta.a~l. 01 0% Ral. . . . . . . , . , , , . . . . , . . , . . . , , . . . . . , . . . $ (al.o .ntlr an lIn. 15 T a. Ca~ulallonl 4. Amaunl 01 lIn. 1 Ta.a~l. al 15 Ral.. . , . . . . , . ,. . . . . . . . . . . . . . . . . . . . . . $----- 101.0 .nllr an lInl 16, To. Campulallanl (If mar. .pac. I. n..d.d, attach addlllanal 8Y, . 11 H .h..1I1 - . . . . ,.- '...... ._ ,,_,'-_ _"_ .__ ~v___..._. _,_ <__, _.._' , ~..._' ~" ' , , i q Ii C2. STATUS REPORT UNDER RULE 6.12 Name of Decedent l Connie M. Conklin Date of Deathl November q. lQQ& Will No. Admin. No. 1994-01003 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate is completel Yes No x 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete l within two months 3. If the answer to No. 1 is Yes, state the followingl a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date l Nov. II, 1996 ~~,~ Signature " to In \\J Peter B. Foster Name (Please type or print) (~IC . 0: .. '.'J p, ~! .:i uu Capacity: Personal Representative Counsel for personal representative r~ c;-' -. .oA -.;~ C 121 South Street. IIsrrishllrp. Pn. 17101 Address , , , N ~ ,",- ~2 ( 717 ) 234-9321 Tel. No. n (MAHI rmf/AH3) > .."._-~~.., '-'''' I... 'I II l Ii J i . -ComP"III;mI , and'or 2 lor .dditionM UIYlclI. -CompIltllllml3, .".nd .b. -Print your nImIlnd .dd,... on the ',vers, ollhlt form 10 thlt WI Cln ,"um thl, canl,o ~u, -Anld'l ttVt torm 10 the!tant of lhe fnIIlplece. or on lhe bltk It IpICI don not pormll. -Wrll.'R.tum Rapt R<<IIJIft'~lon the mlilpIece below lhI.rtldl nLWnbe,. -The Return Receipt wtllhow 10 Whom1he Irtldl Wit dtllvt'.d andthl date dIltnrMt. I allO wish 10 racalv. tho lollowlng a.rvlc.a (for an .xlra I..): 1, Cl Addr....a.. Addr... 2, Cl A..,.ct.d D.llvary Con.ull po.lmo.t.r for I.., 4a, r1Icl. Numb.r 2- 32-11R'.3-0/~ 4b, S.rvlce Typ. CI Aegl.l.rad ",(cartlned CI expra.. Mall b In.ured CI A.'um AoaIIpt lor Merd1ancl.. CI COO 7. D.I.,/ O,"v.ry --t;:.-C:;( 8, Addr...ee'. Addr... (Only /I rDqua.ted and lee I. paid) l I: j; UI 1 .l! ! I 3. ArtIcle Addr...ed 10: PG;T~ 13. ~T~ E-SQ. III OIJlA.:n1-.s. r: I-I1r-RRI5B~ti, PA, /7/01 . " 6. Aocalved By: (prtnt Name) I 8. Signature: (Addra..ae or Agent) JI X C I PS Fonm 3811, Dacambar 1994 r 0, .. ~""''''''Il.. j..,l;"*~'''''..I''''6~~i'~\~~,h4~;,!+;~rr4 Z 332 11113 OJ,2 " . ".,' . , \ j I ,. . , " ~..., 'l \ I" .. .. 4<- , .l . I "I"'''' I < I , ,.-,. POIlage , f' , ..:1 /:......(.. > ....- " " ':1 CertjfiOdFee Spod~ Del..ry F.. Rastlidftd Oehoery Fee on ~ Relum Receipl Showing 10 .... ~&D'I.Oe""ered a IloUn Rect.,o Shoomg ~ v.l1m, .q; OJIt. & Mtesw', Ati'eu ~ TOTALP....ge&F... (") Postm.rtF. or Olle l~ le I ',," 'I t ;. A . "I t: ~ .... ..,. ,* .~ " , l,_ " , " ..." " $ -:' .J t' . / ",' t . . t. ,- . , f~~ "." ..---. -.,-..- 11' ~':- i ... ~.._- ---.".---:-.'l't~_l:I ,- r.. --~.. i - -. .,... - - ..... ....... _._~- . ". I f I UNITED STATES POSTAl SERVICE . I , Flrll.cl..1 Mall r POltaga & Faol Paid , USPS I Pormll No,a.IO 111111 .. I I . , I I I I ,02 , · Print your name, address, and ZIP Code In this box. A liN: \), "LlA.1\J A- 'R~~. Of WI U-S \ cOUR-rrhru.s~ \SQ.. CfrRLISLE, Pf.\./1DI3 I , , i ""11",III"'"'I"/I"'I",I,r,I/'III'""'",'II"ltI ... :;1. Ii . . . ", d _ v. .,., "l" tAl.' . .. 1_ 1... 't. ,', " .~ ,. !,.. 1.,1' f.' , l, .,1\ , . '.:N t~''';f !:. .-~,. ) "i, '. I{ , '" . 4' -k ". r ,; '1., t ~ ~.\ . 4 "',., .~ ,.... '.. ,. . - .. ,'., .. ',. . . ," I .. , ... , , ,.;. , ,j ~' ",'. 0\ \' ~,' r .' , . 'f ..... -~ . ... ..--." -~. t.. - ,~. ""-.,...__..~" -W" ", -.....--_.. i --~ , ~---...A J . . 0. , \ ~ , I 'I " . I . , . . ~'~._, I I \: . i\ 7;' t' it -'t. ;if ; . f ;~ , " . . DEe 2 7 199!l\ ~t JRD/June 3D, 1992/17858 In Re: Estate of CUllNlE M. O:NKf,IN Late of CAMP HILL OOruJGH ORPHANS' COURT DIVISION, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 2hl994-l003 No. 1994_01003 NanCE OF FAILURE TO FILE Sl'A11JS REPORT AND REQUEST TO CONOUer A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: PE'l'ER F\:STER, ESQ., Date of Decedent's Death: 11-9-l994 Date of Delinquency Notice: 10..4-l999 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notilles the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal rcprescntalive nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or lis Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, Bursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on I -4d999 , 19_, and that the ten (10) day nOlice to file the StalUs Report has expired. Accordingly, In accordance with Rule 6.12 the Court Is hereby notified of such delinquency and the undersigned requesls that a Court conduct a hearing to determine whether sanctions should be Imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 12-27-1999 \...1rv~~ ~ ,~ pv..-V ~p.1:i.y Mary C, ewls, eglster of Wills Distribution: Personal Representative Counsel for Personal Representative Estate File A HElIIUNG IS SCHEDULED run );; w1 3 ~ 11'1' r? : 3.& ooum'fU,M NO. J. IF THE STATUS flIo~rom' 1s FILED PRIOR 'lU THE IlEARING DATE, .,,, """""'"""" "" """"'w>. /'Ill ~ ~UFF'En,p.J. IN 'lllE HEMING --'!'\-- "---",.'~' ,. ._'~."----_._-.-.-" ","'.".....- ,--..<" " . o ~ ~ i J, i/:. ~ STATUS REPORT UNDER RULE 6.12 Name of Decedentl (DlJ~'t.. k.(c)U~\..'11\J Date of Deaths \Jlh.J~tv\"'~ 'it\. ct'l Lt Will No. Admin. No. ~ql.f- D(001:> Pursuant to Rule 6.l2 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate is complete I Yes No ')( 2. If the answer is No, state when the personal representative ~easonably believes that the administration will be completes w \~ ,it,., l:"\,uD ).(d....:tJ.J.s.- T i ,It n;.:i '1.... "r. ,I.:,,', :1;', '~.,r,: ,,"n ;'l ;~ ~:'~ ',: 3. If the answer to No. 1 is Yes, state the followings a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account iSI c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. q ~<:( - N ;>[1.: o.!!l - '.' w~ ~ r; ~:l ;-.. "'..> C., ~:;. N ,'1 I <c '.. ~ J~ W l'..l e.i1 w ~iif ~ ~~ a:D: ~~~( Signature ~~ '0, ~'7-~ Name (Please type or print) l ;),. \ c;.l) ~ ~. \;i ~~U~G PA. Address l l"llol ('llll ~~-Ct'~\ Tel. No. :;"..1 .'.~ ~?~! : i~\j ~!J' :i,(. Ii ~.? ,"1li ~. Da te I ~ M. .J-t '1-0 lX) CapacitYI Personal Representative " Counsel for personal representative (MAHsrmf/AH3) . ~.._.----~,- ,'- --.-. .~'..'--i\".----""--~------'--"-_.~'--'-------'_."-'~.."~. " . of ~ f, f , ~ ~ " . ., c... STATUS REPORT UNDER RULE 6.12 Name of Decedent: Connie M. Conklin November 9, 1994 Date of Deathl Will No. Admin. No. 1994-0l003 Pursuant to Rule Court Rules, I report the the administration of the 6.12 of the Supreme Court Orphans' following with respect to completion of above-captioned estate: State whether administration of the estate is complete I Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be completel within six months 1. 3. If the answer to No. 1 is Yes, state the followingl a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~o d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date:Octo~r 9,2000 ~0,~ Signature Peter n. Foster Name (Please type or print) 12l South St., Harrisburg, PA l7101 Address ...; r, . 1, . CJ ~- ,.- f3 !., ~; f; d:'- - ....:: :~ ::; (.)u ;:'''> p ( 717) 234-932l Te 1. No. Capacity: Personal Representative Counsel for personal representative X (MAH:rmf/AH3) ...,....~ .:o..:t~...~._- -.. *~ " f, i f' ;''1 IT, t . 1 i' , K ~. :~ , , ,~ , f. l , e,V/ STATUS REPORT UNDER RULE 6.l2 Name of Decedent: Connie M. Conklin Date of Deathl November 9. 1994 Will No. Admin. No. 1994-01003 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is completel Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete I within six months 3. If the answer to No. 1 is Yes, state the following I a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: October 17. 2002 ~ 'e.- ~-c. Signature Pp-tAr R. FnRter Name (Please type or print) 121 South St.. Hsrrisburg, PA 17101 Address ,',' p (7171 234-9321 Tel, No. - " ' ~ -' Capacity: Personal Representative Counsel for personal representative X (MAH: rmf/ AM3) --.._._._._~-..~'_...~. . ._.....,__.._..'''_-'''''~~~,.......'''..-u--.._..". ~ ! , cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone I (717) 240-6345 . ' Datel 10/08/2002 PHILLIP L. CONKLIN 185 CENTRAL VIEW ROAD DILLSBURG, PA 17019 REI Estate of CONKLIN CONNIE M File Number: 1994-01003 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within,.two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/09/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~ JJtI2t4 (4L 44: ~ lolARY C. LEWIS 4~tl~- REGISTER OF WILLS -7 ~ cc: /File Counsel Judge 7" _~?s:~:~~~i..~" ,. '~n. . Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone I (717) 240-6345 Datel 10/10/2005 PHILLIP L. CONKLIN 185 CENTRAL VIEW ROAD DILLSBURG, PA 17019 REI Estate of CONKLIN CONNIE M File Number: 1994-01003 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/09/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, o~=!:~~t REGISTER OF WILLS CCI File Counsel Judge .. " L-C:r .. CUmbsrland'County - Regi~ter Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Datel 10/10/2005 FOSTER PETER B 121 SOUTH ST. HARRISBURG, PA 17101 RE: Estate of CONKLIN CONNIE M File Number I 1994-01003 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 11/09/2005 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge Sincerely, ~~;IJ;~Lt!t GLENDA FP~ER STRASBAUGH REGISTER OF WILLS ", .. ~~1""""."o-",-"<,,,, . .~~~""--"___""~"'" ""'~'-~ <' . ' \-r/ ~-; ~ ";:, , 4:r'. I'\'~' ""r ['It ',~ ~".., ~, Cumberland County . Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone I (717) 240-6345 Datel 12/01/2004 . FOSTER PETER B 121 SOUTH ST. HARRISBURG, PA 17101 REI Estate of CONKLIN CONNIE M File Number I 1994-01003 Dear Sir/Madam I It has come to my attention that you have not'filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/09/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~, GLENDA FARNER STRASBAUGH REGISTER OF WILLS CC I File Personal Representative(s) JUdge . " ..