HomeMy WebLinkAbout95-00529
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I)ETITION H)R IJROIIA TE Rod GI{ANT 01' LETTERS
c.Hale "I a."'1B.t':Ilp...!tJ:-~--Ro H-~ No._~j -9...:r - 5::1 i
al.m klwlI't/ as ___________ To:
__~"________ 1{~gi,l~r of Wills for Ihe
~ DI""'II,Il'tI. COIIIllY oI'Cu~Ol:.lI..I,.i3NlL in Ihe
Sodal Srl'lIril.Y No. _q,o_3~o:t_~~~- COnlmollweullh of I'~nnsylvllnlll
The p~lilion of Ihe IlIlder,lgned re,pecll'lIl1y repre,enl' 11\1\1:
YOllr p~lilloner('), \\hol,lI11e IK )'ell" Ill' IIge III older un Ih~ exeell161L
In Ihe IIISI will 011' Ihe IIhow d~eedelll, dilled _m"~---s-,
IInd eodlell(s) IllIed _ -----
nllmed
, 19.Jr:l._
1\lnll' Irlc\,,"1 dJl'llm\lill1~.t:".l'."" '(,lllllldl1llnll.lll'.ltll ul "'\l'",'IIIOI, tl....)
D~eendelll WI" dllllllclled III delllh In _C_lAmJl~B-t.,ilJfD_- Coullly, l'enllsylvllnla, wilh
h__.,- 111'1 I'lImily <It.1'rJllclpnl re,ldenee 111 _6_ p.l-'LN_BJ.h~\l <:. I N (', 1"10 I'lA. ~
_\:,(',.."il\~ vA. 1~')~iJ_\.tJ~'1::-~l:iHlon.o-~
Hi..1 ..lItl't, 1I111ll1ll.." IlIUllllUIlt.:I('liIIiIY)
Deee.lld~I1I,lhen "l!a_ )'ell" nl' nge, di~d ~U.I,L\:.-'C- ,19 "l ('" ,
al__')_W,Al-~Ht!.....tlLC'Lcl-T-.1.R .
Exeepl n, I'ollnw" d~eed~nl did nOlmllrry, 11'11' nol ~ivoreed nnd did nOI hllve II child born or adopled
lIf1er e\~euIIlln of Ihe wlllnl'l'ered for prohllle: WII' 1,,'llhe vlcllmol' n killing a<ld was never adjudlellled
Ineomp~telll:
Deeend~nl 111 dealh owned properl)' wilh eSllmaled val lies 'IS follows:
(If domiciled In Pn.) All pe"onnl properlY
(If nol domiciled in I'll.) Personal properlY in l'enns)'lvanln
(If nOI domiciled in I'n.) I'ersonnlproperl)' in COUIll)'
Vnlue (11' real L'sUllC in PClll1s\'l\'nnia
silualcd as follows: .
$~JSIC;-
$
$
$
.00
WI'IEREFORE, pelitioner(s) re'peell'lIl1)' reqllest(s) Ihe prohnle of Ihe Insl will and eodicll(s)
pre,enled herewilh IInd Ihe grnnlol' lellers__~S'):1.',JY~t.tC::AI?.:'f-
, t1l'''lilllltntllT)'; IHhnilli\lrnllull t.:.1.11.; (ull11lnhlrnllnn d.h.n.t.I.B.)
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LAII1:r,-I~BU.~G:.t- 8-,-__\:1 Q~O-
OATH OF I)ERSONAL REIJRESENTATIVE
COMMONWEA1.TH 0... I'ENNSYLVANIA }::IS
COlINn' 0... ~J!,matJU..f\ t-I"b
The pelili"ne",) nhove.named ""ear(,) '" afn"n(s, Ih'lIlhe 'lnlement' In the foregoing pelltlon lire
IIlle "nd eorreel 10 Ihe he'l of Ihe knowledge and helieI' of pelili"ner(,) nnd thnt as personal represen-
IIl1i"el" of the nho"e "eeedelll petilioner(,) will well and ""Iy ndllllnisl~r the c'tale lIeeording 10 law.
Sw"rn '0 '" allinned IIn" ",h,erihed _~~ .\<-m-Orv- '"
hel',,,e I"e II,'" 11TH 11'1 ,I' 00'
'_d"~~~~~ ' ~
",/ ltcrc.-LEWIS -~RI'~i,I/I'r ~
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No. 21 - 95 - 529
Estate of
MARGARET C. ROHM
. Deceased
DECREE 0..' PROBATE AND GRANT m'LETTERS
'. '
JULY 12. 95
AND NOW 19_. In conslderlltlon of the petition on
the reverse side hereof, slIllsfuelory proof having been prescl1Ied before me.
IT IS DECREED Ihal the Inslrumenl(s) dilled MAY 5. 1989
described therein be udl1lllled 10 probate und filed of record 115 Ihe lasl 11'11I of
MARGARET C , ROHM
TESTAMENTARY
EDWARD E ROHM
and Lellers
, ,. ,
are htreby granled to
'~~(&.il/n~ ~fJ-mI1ti~:h,.
(J R'Bble< or Will. ' r(J
MARY C. LEWIS
, " , ;. , ",FEES
Probate, Lellers. Etc. ......... $ 25.00
Short Cerllneales(4 ) . . . , . . . . .. $ 12.00
Renunellltlon ................ $ 5.00
X-Pages $ 6.00
JCP TOTAL _ $-53jlL
Flied. .,JVI..X. H.. .199.~.........,.....,
ATTORNEY (Sup. CI, I,D. No.1
ADDRESS
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Called Executor,on 7-12-95.
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OF
MARGARET C. ROHM
BE IT REMEMBEREO that I, MARGARET C. ROHM, of 20 Beaver Street, Oillsburg
Borough, York County, Pennsylvania, being of sound mind, memory, and
understanding, do make, publish, and declare this as and for my Last Will and
Testament, hereby revoking and making null and void any and all Wills and
Testaments and writings in the nature thereof by me and any time heretofore
made.
Item 1: I direct that my herei nafter named Executor pay a 11 my just
debts, my funera 1 expenses, and the expenses of the admini stration of my
estate. With this direction, I authorize and empower my Executor to expend for
my funeral expenses and interment such amounts as he may consider necessary and
proper, without regard to any limit that may be prescribed by a court of law.
Item 2: I direct my Executor to pay all inheritance, estate, succession
and legacy taxes of whatsoever nature and kind I to which my estate or the
transfer of any property passing hereunder or otherwise passing by reason of my
demise, may be subject and to charge such taxes against my residuary estate, it
being my intention that none of the aforesaid taxes, either federal or state,
on any property required to be included in my gross estate, under the
provisions of any state or federal law now in force or hereafter enacted, shall
be prorated among the persons interested in my estate to whom such property may
be transferred or to whom any benefit accrues.
Item 3: All the rest, residue, and remainder of my estate, of whatsoever
nature, and wheresoever situate, whether it be real, personal, or mixed
including property over which I have a power of appointment, I give, devise,
and bequeath unto my spouse, KENNETH G. ROHM, provided he survives me for a
period of thirty (3D) days.
Item 4: In the event that my spouse should predecease me, or fail to
survive me for a period of thirty (30) days, I give, devise, and bequeath all
the rest, residue, and remainder of my estate, of whatsoever nature, and
whatsoever situate, to my five children, EDWARD G. ROHM, JEANETTE R. SMITH,
FRANK S. ROHM, SANDRA R. EKLUND, KENNETH G. ROHM, JR.. in equal shares, per
stirpes.
Item 5: In the event that either of my children should predecease me
leaving issue surviving, I give and bequeath the share of such deceased child
to his surviving issue. If any of my children should predecease me without
leaving issue surviving, I give and bequeath the share of such deceased child
to my surviving children.
Item 6: In the event that my spouse should predecease me, I appoint my
daughter, JEANETTE R. SMITH, as guardian of the person of my daughter, Darlene.
Item 7: I nominate, constitute, and appoint, EDWARD G. ROHM and FRANK S.
ROHM to serve as alternate Co-Executors of this my Last Will and Testament.
Item 8: I direct that my hereinbefore name Co-Executors, or their
successors, shall not be required to give bond for the faithful performance of
duties in this or any jurisdiction.
.."
IN WITNESS WHEREOF, I have hereunto set my hand and seal thi s .j day
If 7' · 1989.
of
It:rr/?n'L-
7t.8/~ &." r (~
G R, C. ROH
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i.
The preceding instrument, consisting of this and one (1) other typewritten
page, was on the day and date thereof signed, sealed, published, and declared
by MARGARET C. ROHM, the Testatrix herein named, as and for her Last Will
and Testament, in the presence of us, who, at her request, in her presence, and
in the resen each other, have subscribed our names as witnesses hereto.
Of~~;' PA
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF YORK
SS"
W",.4 ~~ and
the Testatrix and the witnesses, respectively,
~ ose i mes 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 Testament, and that she
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 witnesses, and that to the
best of their knowledge, the Testatrix was at the time eighteen (18) years of
age or older, of sound mind, and under no constraint or undue influence.
We, MARGARET C._ ROHM.
hj ,
SWORN TO AND SUBSCRIBED
BEFORE ME THIs1?~ DAY
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NOr M:iiL SEAL
JAIler s. OOllf,llOTARY PUBLIC
Dn.lSOURO DOROUOH, YORK COUNTY
MY COMMISSION EXPIRE! DCT. ~5, 1m
Member, Penn'yb.nb ASKlcLJllon " u,t:rrJu
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
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Name of Decedent: ml'\\'t.GA('!"ET, r. R..a Ihv\ ..:*
(,,~/<;-9'; Cw, \-.'1'
Date of Death: ' ,-,
Will No. rl/-9<;~~rl9 Admin, No. ~ I-Cf" -~?9
To the Registers
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court 'Rules was served on or mailed to
the following beneficiaries of the above-captioned estate on
7/al/9o:;- I
Name
Address
l,dn.n.nT'T...I <t"""'trtl
(2 n"J SHH>'VVJ"~ q/J2.. Po 1709n
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Lt: W i ~ h , r ry P<>..
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P.en.....d j~' R"HrYl
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k~n...rh /!DJ'h1 tT~
Notice has now been given to all persons entitled thereto under
Rule 5.6 (a) except k~NN F' T II R.oll/f) 3'rL ) 1).)-__ r.;.... )'1"-. ',1'0.1
('"........01('" IL~I'T'1l 1-1-1 rn ,,~() (\r, Nb"l" t' ,(\OLU luV. ~ (.. i r0 W. \114 h ,P is
l-l-~ \ 5 A-UJAU /'Y'l<:l"'~(.4'l' pas'5od r=/wAi .' , '
Datel II-I - 9<;" "'ri..LXAA,.l ~. e~
STgnature '
Name E,l",..,.,....-l ~. I?"HvYI
Address Q(')\ f\h"k "Ill..
L"lI.1(,\i'ih"r~ p~ 170<.11"'\
Telephone('1l1l '1'ilQ -~c:UC)
Capacity:
Personal Representative
Counsel for personal
representative
15 -44--'1
REV -1500
INHERITANCE TAX RETURN FUNUMBEJI
RESIDENT DECEDENT
ItfVw~I1.ll.t)' ~~t.
COMIAONWEAl.~:YlVANlA
DEPAR1~ENT OF REVENUE
OEPU80601
HARR1 R ",, 1
DfCfDfHfSp.WJE(L\ST.rIRST,~UIOOl.E INITIAL) 1M_bin I:1Iclci ~"9..'IlO'1I'
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PsQIfYY1 I/-I'..GA
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DATE Of DEATH
91
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DATEOffllRTlt
tJ Co II '5'lq r:;-
(If APPUCA8lE)MVMHG&POUSHN.WE {lAST,fIRST,N<<JMloo.E H1W.I socw. SECURITY MJABtA
/ :;..18 <II /
THIS RETURN IIIJIT BE FILED 1M IXIPUCATE WITH THE
REGISTER OF WILLS
II!
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.lli3 " OriglnalR.tum 0 2_ Supp\emenIaIR.tum 0 3. R.malnd.r R.tuml...d_......II-t>1l1
o 4_ Limited E.lat. 0 4e, Futumlnleresl Compromise t"'d_...II,,,.n 0 5_ Fed.ml E.lale Tex R.~lm Required
o 6, Deced.nl Died T..lale """h "" dW<) 0 7, Deced.nt Malnlalned I LMng Trull I""'" ...,d TMII _ 8, TOIaI Number 01 S.I. Deposit Bo,..
o 9, Utigelion Proceed. Received 0 10_ S_I pov.rty Cred~ I'" d.... _"-1',91 "" "'"tl, 0 11. EIe<:1Ion 10 la, und.r See. 9113(A) """" ""'"
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULO BE OIRECTED TO:
tw.E CCJAPlETEUAluNQAl)()RE$S
e, 'D Kf<. J IOu^- ~ q rz.
Lflnbl'slou,') POl 170YO
12. N.t Valu. of E.late (L1n. 8 minus LIn.ll)
13, Ch.rilable end Gov.mmenlal Bcque.tslSee9113 Tru.1> lorwh<h en .lectIon 10 la, has nol been
mad. (Schedule J)
14. N8I Valu. Subject to Tn (LIn.12 minus Line 13)
15. AmountolUne14 Ia,eble
at the spousal tax mte I ,
See 1n.lruc:Iion. on mve,.. .Id. lor eppllceble percontag.
16. Amount 01 line 14 taxeble
eI6%ml.
17, Amounl01 lina 14 Ia'.ble
eI15%..1e
" Reel E.late (Schedule A) (1)
2, SloCl<s end Bond. (Schedule B) (2)
3. CIose~ Held CorponlIion,Pertll.llhlp '" Sole-Propnelollhlp (3)
4, Mo!1gIl985 & Nole. Recelveble (Schedule 0) (4)
5, Cosh, Benk O.posl1s & Miscellaneous P.""""I Property (5)
Z (Schedule E)
0 6. JoInUy OWned Property (Schedule F) (6)
5 7, Int.,.VIvos T..nal... & Miscellaneous Non-Probat. Property (7)
::l (Schedule G or L)
I- 8_ Tolal Groll AIIIII (Iolal LIn85'.7)
~
0 9, Fun...1 E,pense. & Admlnlstratlv. COIl> (Schedule H) (9)
W
0:: to_ Oebl> 01 OOCO<lenL Mo!1gIl9. LI.bllille., & Lien. (Schedule I) (10)
11, Total Deduction. (Iolal Lln.. 9 & 10)
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(12)
(13)
.15.:300.00
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(17)
(18)
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> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Undet pllll~tieI 01 perjury, I decln Ulall tLM u.nned thiI return, Irdudlflg ~rng lChedulel n1allliterY*lll.1Ild 10 the bMl 01 my knowledge lI"ld belief, il Is Itue, COOf'Cl a'ld oompIele.
OttdJIralion ClI pl'epa'et other
~1he08rl008InKlrMe!ltltiYflilbls8don~infotmationof'tWhichDl1lO8rfll'hasW1V~
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
I;')
R OTHER THAN REPRESENTATIVE
DATE
I I -I 0 - "17
DATE
I.
C"'/J(!
Tax paymants and Credits:
1. Tax Due (Pagel Une18)
2, CredilslPaymenls
A, Spousal Poverty Credll
8, PrlOI Paymenls
C_ Discounl
(1)
lit, ? :;;
(") I a 0
Tolal Credits ( A . 8 . C ) (21
3, InlerestIPenally If eppllcable
O,lnteresl
E, Penally
(n, '/9
TolallnterestlPenally ( 0 . E) (3)
If line 21s grealer than line 1 . line 3, enter Ihe difference, This Is the OVERPAYMENT,
Cheek box on Plgll Unl18to raqU"t llIlund (4)
If line 1 . line 31s grealerthan line 2, enlerthedifference. This Is Ihe TAX DUE, (5)
A. Enter Ihe Interest on Ihe lax due, (SA) t. , I 9
8, EnlerthelotalofUne5 .5A, Thll Is the BALANCE DUE, (58) A l/7. t..J Z
Maka Chack Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old decedent meke a trenlfer end: Yel
a. relaln tha use or Income of the property transferred: ............................................................. 0
b. relaln Ihe right 10 deslgnete who shalf use the property transferred pr lis Income; ................ 0
c, retain a reversionary Interesl; or.............................................,............................................... 0
d, receive tha promise for life of alther paymanls, benefits or cera? ........................................, 0
2. If death occurrad on or befora December 12, 1982, did decadanl wllhln two yeers
preceding dealh transfer property without receiving adequeta conslderetlon? If deeth occurred
efter December 12,1982, did decedentlrensfer property wilhln one yeer of deelh without
receiving edequale consideration? ...............,......".......,......."",..,......,..............,..,........,..",........ 0
3, Old decedenl own an 'In lrustlo" or peyebla upon death bank eccounl or security
al his or her dealh? ,..,......,.."...."....,......,....""...."...."..,.."..,.'..'......,........,...."..,....,..........",......, 0
4, Old dacedent own an Indlvlduel retirement eccount, annuity, or olher non-probete property?.... 0
4,
5_
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
, , " -: ' 'I :'" 1 "'1' ,"" ,,' I .. 'H , ,: '..' , .' .<," . ,~ " ~ I,' , ,t """ '. .'. .' . : /
72 P,S, ~9116 (a) (1.1) (I) provided lor Iha reduction ollhe tax rele Imposed on Ihe net value of Irenslers to or lor the use of the
surviving spouse Irom 6% to 3% lor detes 01 deeth on or after July 1, 1994 and belore Jenuery 1, 1995,
72 P,S. ~9116 (a) (1.1) (II) provided for Ihe reduction of Iha rete Imposed on Ihe net value of Irensfers 10 or lor Ihe use of the surviving
spouse from 3% to 0% for dales of dealh on or after January 1, 1995, Tha slalula does nol axe mot a transfar to a surviving spousa
from tax. and tha slalulory raqulrements for disclosure of assels and filing a tax ralurn ara stili appllcebla evan If Iha surviving spousa
Is the only benefictary,
FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Pleese an sIVer Ihe following quesllon by placing en "x"ln Ihe
eppropriete spece,
Old the decedent cresta a trust or slmllsr errangement which Is solaly for tha surviving spouse's benefit for his or hsr anUre
IlfsUme? Yes 0 No !5J
If you enswered yes 10 the above question, Ihe tex on Ihe trusl or slmller arrengementls poslponed unlillhe dealh of Ihe second
spouse, 01 which time II will be lully lexeble at the rete(s) applicable 10 Ihe remainder beneficlery(les), Enler Ihe vetue of the lrusl on
Schedule J, Part II, In order to remova Illrom Iha calculation 01 tha lax dua In this estale, You may wish 10 fila Schadule 0 In order to
meke Ihe election evelleble under Section 9113, If Ihe election Is made, Ihe lrusl or slmller errengement Is taxed In the eslale of Ihe
first decadenl spouse, Ihe portion of Ihe Irusl or similar arrangemenl which benefits Ihe surviving spouse Is texed at Ihe zero lex rale,
and Ihe remainder Is lexed at the rete(s) eppllcable 10 Ihe remelnder beneficlary(les), If you choose to make the election, you must
ellech Schedule 0 to a timely. filed tex return, along wilh Schedule(s) K andlor M In order 10 show the epportlonment of Ihe lrust or
slmller arrengemenl between Iha surviving spouse end Ihe remainder beneficlary(les),
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'1'I/E FARllI/mS NATioNAL'UANK
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:., ; TELEI'/I0NE. 7JH76-5312 ~. .',
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MMGARET C ROliM
OR KENNETH e ROHM SR
RO 1 BOX 912
lANU/SDURe PA 170~0
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01 b65205 10
.............................................................................
OLO NUMBER: IbblBb
O~SCR/PT/ON
BALANCE lAST STATEMENT
CIiECK
-------------------------------------------------------------------------------
...............................................................................
SUMMARY:
flCCOUNT
. . . . . NUM BE R. . . . .
UUA 00 0016bZ Ob
PREVIOUS
. .bAlANCE..
305.44
TUTAl
.......DEBITS.....
1 30~.'i4
SERV1C~
. CHARGE.
.00
CH ECK)
UXPAYER / UI
DATE
Obi 29
07117
~ ...............................................................................
UEPOSITS
305.4'1
TOTAL
....CREDITS....
.00
o
/P 0
\ S 0 0
'!{\~' 00
fd \1Jj\P ',}. O~ ,0 ~o
~\Dt\~0~
~U.b\D 00
'0
</)
. \ I \ I \ I \ \ \ \ i ~.. !! In m ! I'l~i! dl Ii
~ ~ ~fs ~ i h a III~"~'~.., I ~H 's
ifilll i' i i~\~i I\~r~~g 1~IJI\jl[i;,hllli\lhtth
II! a I 1: : 1 : : ~ : : i i Z i.:: I I .. ~ .. l J,: a J 1118~
: : & & Ii: i i i 1: ~ ~'Ji ill h} 'H: :II i ,."'~
i \ =1 il 1 i i ~ ~ i 1 \ I 1111 1 'I I i ia IJ\ ; 2[19 iSUs
i : i : 1 i .. i 1: : III 1 v i tall,: ~ I '\"'!!i
. : . : . . . .: . !"'," ".,,! :. [ !ll~
: : li li : : :: :: ::;; : ; : I.: ! tl !:: I I s~
i : Ii Ii 1 : : 1 1, :, i. , 1 ., 1 1 :: .1. ,uu\. \. ~i ",..~
: : .. : : :: :: ",: \. ;. ;. ;. ;. . 1 ..('"
. . . : . . .: ., ...... '"
: : , : '. '. ;.. .. .( !!I
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: , : : . I~
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. ~ . . . . . . . . ~ f\3
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i
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i
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a
l
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r I
r i i t
M.II to
Field Office Inllrucllonl
W SH 006
Dlllv.fY 0' Ihl .u.ch.d ..hick .nd ,,,"m.nt II:
UNCONDITIONAL
Add,..,
BATCH NO. TDt6
Theprudentlal~
FOR INSURANCE SERVICE. OET IN
TOUCH WITH YOUR REPRESENTATIVE
OR THIS OFFICE
CHECK STATEMENT
Th, Pfud.ntll' InturancI Complny or Am.rlu
Cln"ll AII.ntla Opar.tlng Clnl"
P.O. DOM 031
farl Wuhlngton. PA 1103.
CAO CLAIM SUPPORT SRVCS
POBOX 368
FT WASHINGTON PA 19034
DEATH CLAIM
Conl"e, Numb"
042 426 B46
Intur.dlAnnull.n'
MARGARET C RDHM
Chick Numb"
0207 0126964
~UL 27, 1996
WE 110PE WE HAVE BEEN OF HELP TO YOU DURING THIS OIFFICULT TIME.-- THIS CHECK FOR $3,~3~.66 R~PR~SEN1S THE
PROCEEDS FROM THE DEATH CLAIM ON CONTRACT 042 426 B46.
SOURCE OF FUNDS
$2,000.00
$1,766.53
$64,00
$20.03
G;.:~
. . . . . . . . .
FACE AMOUNT OF INSURANCE
ACCUMULATED DIVIDENDS AND INTEREST
TERMINATION DIVIDEND
INTEREST FROM DATE OF DEATH
AMOUNT OF CHECK
. . . . . . . . . . . . . . . . . . . . .
. . . . . . .
. . . . . . . . . .
. . . .
IF THE DECEASEO WAS NAMED AS A BENEFICIARV ON ANV OTHER INSURANCE CONTRACTS', WE SUGGEST THAT A NEW
BENEFICIARV BE NAMEO AS SOON AS POSSIBLE.
SOCIAL SECURITV BENEFITS MAY ALSO BE AVAILABLE. FOR MORE INFORMATION, GET IN TOUCH WITH THE APPROPRIATE
GOVERNMENT OFFICE IN VDUR AREA.
IF WE CAN BE OF ANV ADDITIONAL SERVICE, PLEASE LET US KNOW. ~UST OET IN TOUCH WITH YOUR PRUDENTIAL
REPRESENTATIVE OR THE OFFICE SHOWN ABOVE.
(4K8B6T051B)
(uBI5ROHMI
PLEASE DETACH CHECK - KEEP STATEMENT FOR RECOIIDS
/00......_.. ............-........... ..--.-
'-,' ""j'
, .' ~ ~
:/
I .
- - ----~- ..~--"" ~ _W-_"'N'-'_~~~:~ - ".:;::.- -~ -~.-- ".-" 0-- -.- ~-:":-~~fr~~;-":"'
" "hi':: ..
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-
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALOND THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iii;y:iii4'i-iif-AFP-Hi9-:97riliifici--DFuiNHiifiTiiNCn:"Ain-ppiiAiiiEiiiilT~uAr.LDiiANCi-iiRummu---_---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ROHH HARGARET C FILE NO. 21 95-0529 ACN 101 DATE 02-16-98
TAX RETURN WAS, I I ACCEPTED AS FILED I XI CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Eat.t. (Schedule AJ
2. Stock. ond Bond. (Schedu1. BI
5. Clo..ly Hald stock/Partnership Int.r..t (Schedul. C)
~. Horta.g../Hot.. Receivabl. (Sch.dule D)
5. C..h/Bank Depoaita/Hiec. Parsonal Property (Schedul. E)
6. Jointly Owned Property (Schadul. F)
7. Tranafara (Schedule OJ
B. Total A...t.
APPROVED DEDUCTIONS AND EXEMPTIONSI
5,300.00
9. Funeral Expans..JAd.. Coata'Hl.c. Expen... (Sch.dul. H) (9)
10, D.bt./Hortg.g. Ll.bl11tl../Ll.n. (Sch.du1. II (101 .00
11. Tot.1 D.duatlon. (Ill
12. Hat Value of Tax R.turn (12)
15. Ch.rlt.bl./GoY.r~ent.l 8aqu..tas Non-.lected 9115 Truet. (Schedul. J) (15)
1~, N.t V.1u. of E.t.t. Subj.ot to T.x (1~1
NOTEI If an assessment was iseued previously, lines 14, 15 and/or 16, 17 and 18
raflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAXI
15. A.aunt of Lin- 14 .t Spou..l rata .1S)
16. "ount of Line 14 tax.bla at Llne.l/CI... A r.ta 116)
17. Aeount of Line 14 taxabla at Coll.taral/Cla.. D rata 117)
18. Principal Tax Due
/5- LIt! - 7
BUREAU OF INDIVIDUAL-TAXES
INHERIT~~E TAX DIVISION
;::''IT. U"D601
HARRISIURa, PA 17121-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHEHT OF TAX
EDWARD E ROHH
RR 1 BOX 912
LANDISBURG
DATE:
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-16-98
ROHH
06-15-95
21 95-0529
CUMBERLAND
101
Aaount Reel tt.d
PA 17040
r
(11
(21
(SI
(~I
(51
(6)
(71
.00
.00
.00
.00
2,149.35
.00
.00
(BI
.00 X .00.
.00 X .06.
.00 X ,15.
lllll
TAX CREDITS:
PAYHENT
DATE
11-18-97
DISCOUNT (+1
INTEREST/PEN PAID (-I
.00
RECEIPT
NUltBER
AA242478
AHOUNT PAID
47.42
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
6-
--
In.UdU.,'II'.,U
HARGARET
C
HOTEt To In.ura proper
credit to your account,
.ub.U tha upper portion
of thl. for. with your
ta)( pa)'Hnt.
2.149.35
Iii.~nn nn
3.150.65-
.00
3.150.65-
will
.00
.00
.00
.00
47.42
47.42CR
.00
47.42CR
. IF PAID AFTER DATE INaICATEa, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
1 IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FDR INSTRUCTIONS. 1
..
....
RESERVino... E,..t.. of decedents dyJng on or befon o.cMbe,. 12, I'll -- 1f "'Y future tnt.r..t In the I...t. II tr",,'t,.nd
In po.....1on or enjo~t to C1I" . (colll',r.l) ~'Icl.rl.. of the decedent .,tl,. the expiration of ."y ....te for
11', or for w..r., ~ ~lth her~y expr...ly r.l.rY" the rIght to .",.,1.. ~ ...... tr",,'.r J~rlt~. ,....
.t the l.wful Cl... I (col1".,..1) r.t. on WlV ~ future Int.r..t.
PIIII'ClU OF
NOTICE. To fulfill the requlr''''''1 0' Section 2140 0' the Inherltenc:. Md E,t,t, 'I. Act, Act U of 1995. (71 P.S.
Section 9UO).
PAVltEHTI Detach the top portio" of thl, NoUe. IInd .utM.t .,Ith your Plyqnt to the AIglt'l,. 0' W11" prlnt~ on the rlv.r.. ......
"-"eke cMck or RnIY ord.r pIy-.bll tal REGISTER OF HILLS I AGENT
RUl.MJ (CA) I A r.fund of It.. orMit, which .... not request... on tI'M TI. Rtturn, ..y be r....slH by CDlIpl,Ung WI "AppllCIUon
for R.fund of P~'Ylv."l. Inherltencl end E,t,t, Tlx" (REV.t)lS). Applleltlon. .r. .v.ll~l. at the Dfflc.
of the R..I.tar of WillI, ~v of the ZJ R.v~ al.trlct OfficI', or bv c.lllng the .pecl.l Z4-hour
In.werlng ..rvlc. nu.ber. for 'or.. orderlnal In Penn.Vlv.nla I-IDD-56Z-!D50, out. Ide P8nn.ylvlnl. 8nd
within loc.l "-rrllbur. .ra. (717) 717-1094, TDa, (717) 71Z-2Z52 (H8.rlng lep.lred Only).
OBJECTIONS a Anv p.rty In Int.r..t not ..tl.,led with the IPpral...-nt, allON~' or dl.allowBnC' 0' deduction., or ......-.nt
of tax (Including dl.count or Intsr..t) a. .hown on thl. Hotlc. au.t ObJ.ct within .Ixty (60) d.V' 0' r.calpt of
thl. MoUca bya
--written prot.lt to the PA a.part.ant a' Ravenue, IoIrd of App.als, Dept. ZIIDZl, "-rrl.bur., P' 1712'''1021, OR
n.IKUon to hliv. tM .stt.r dst.ralned at Mldlt 0' the KCount a' the per.an.l reprllenhtlvs, OR
--appe.1 to the Dr~" Court.
AlltlN
ISTAAlIVE
CDRRfCTIDHSr
DISCOlJfTa
Factual .rror. dlscovarld on thl. ....I..-nt should be addr...ed In writing tal PA a.p.rt-.nt a' R.v~,
Bur.eu of Individual Ta.I', ATTNI Po.t A......ent Review unit, Drpt. Z10601, H.rrllbur., PA 171ZI-D601
~ (717) 717-6505, S.. p-a. 5 0' the bookl.t ~ln.trUGtlon. for Inherltanc. TI. A.turn 'or. RI.ldlnt
Dlcldent" (REV-ISOl) 'or In .xpl~tlon 0' edllnl.tr.tlvlly correctlbl. .rror..
I' any t.x due I. paid within thr.. (5) cal~'r .unth. a,t.r the decedent'. death, . 'Iv. p.rcant (5X) dl.count a'
thl tax paid I. allowed,
PENALTY,
ThI IIX tax ,,",.tv non-p.rtlclp.tlon penalty I. coaputed on thl total of the t.x and Int.rl.t ......ed, 8nd not
paid b.for. Jenuarv II, 1996, the flr.t d.y .ft.r the and of the tax .-na.ty period. Thl. non-p.rtlclp.tlon
pan.lty II IIPpe.labll In the .... OMar MIS In the the I'" UII period I' you would applal the t.x and Interllt
that h.. blan .....1Id .. Indlc.tad an thl. not Ie..
INTERESTa
Int.r..t II char'" Nglmlna with first day of deUnquency, or nine (9) aonth. and one (1) dey froll the dIlt. of
death, to the data of PQMnt. T.... which bee.. delinquent bafore January 1, 1912 ba.r Intar..t at tha rat. of
.Ix (6X) parcent per ~ calculated at a d.lly rata of .DD0164. All t.... which bac... delinquent an and aft.r
Janu.ry 1, 19.Z will ~.r Int.r..t .t a rata whIch will v.ry 'rOl c.lendar y.ar to c.l~r y..r with that r.tl
announced by the PA Daplrtaant of R.v~. ThII ~llcabl. Int.r..t ratl' for 19.2 through 199. .r'l
!!!r Intara.t Aat. aally Intar..t Factor !!!! Intara.t Aata nallY Inhra.t Factor
1911 ZOX .DDD!W' 1917 .~ .GlO247
191J lOX .010451 1'''-1991 ll~ ,GlD501
It.. llX .011501 I'" .X .GlDZ47
1985 UX .ODUS6 1'95-1994 n ,DDDI92
I... lOX ,000274 1995-1'" OX .DDDU7
--Interalt I. calculated .. fallow..
INTEREST . BALANCE OF TAX UNPAIO X "UKBEI OF DAYS DELI"QUEHT X DAILY IHTEREST FACTOR
--Any Motlc. I..uad a,tar the ta. baCOII. delinquent wll1 r.flact an Int.rl.t calculation to flftean (lS) day.
beyond tha dltl af tha ......""t. If papant I. ... .ftar the Intan.t c~taUon data shawn an the
Notlc., additional Intar..t au.t be c.lculated.
Mv"nOUI'.j
-
~.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEAL nl 01' PENNSYLVANIA
nEPAATMENTOF AEVENue
BUREAU 01' INDMDUAL TAxe,
PEP!,280001
DECEDENTS NAME
EVIEWED BY
Margaret C. Rohm
Daniel Heck
FILE NUMBER
AeN
2195'()529
101
SCHEDULE ITEM
NO.
E
3
I!llPLANATION 01' CHANGES
The proceed. of lire Inlurane. pollel.. on the life of the deeedent are not subject to tax In
thl decedent'. .,Iat..
ROW
Page 1
RfY.1500 EX+ t7,QAj
~
gl!
~
/5- L/1 '-7 fOR DATl5 O' DlATH AnlR 12/31/91 CHICK HIRI
INHERITANCE TAX RETURN ~o~::~U~:~DITI5CLAIMID 0
RESIDENT DECEDENT flU NUMBER
1~~T~E :&~~T~~ ~~P.}J~tJ)E COU~ fOOE ~~-
OICIOINT'S COMf'HlI A!lDRfU D _ J
GlOV !3it; ::.p;;rN') kq',
/l.J 1 U,.;!)'.;97 1.7CJ.VI
_, ".1
COllnt It. ?,
AMOUN CflYI (Sf( INSTRuctiONS)
Fulur. Inte,.,1 Comproml..
(fa. dol.. of d.o'h all.. 12.12.B2)
peeedenl Maintained 0 living Trull
(Attach cop)' of Trull)
INnAL TAX INPORMAnON SHOULD BE DIRECTEDTOI,..,,,,\,!t'.j:".~\;.:W+N"''\f.1~'j,,.'.ci.
COMmn "'AIlINO ADDIlUS
R.RI ,&" 912-
i '{.(rG
Iii
iii
bl
co
)(1.
04-
Db-
Original Aell"n
Limlt.d r 1'0"
p.c.d.nl DI.d "1101.
IAlla.h 101" 01 Willi
RI PO DI CIA
D CON"
~I
,<'u (-11')
A
ovo
RITJiiO{lJ..Wf.lf.:.f.)-_8. '
..J.J.CLJ-=($21~C?.;jJS;;>~
i
I. R.al h'al. (&.h.dul. AI (1 I
2. &'o.~. and land. la.h.dul. II ( 2 I
J. Clolf', .hld Ilo.~/Polln,"hll' In'''..' (Slh.dul. C) 131
4, MoIIuog.. ond No'" Rml,oltl'I&,lttdul. 01 (41
5. (alht .an~ 0'''01111 & MIIt.llon,oul Peuonal Prop'r1)' (5)
11..'dol. II
b, lolnl', Own.d P"I'.II, lllh.dul. 'I ( b I
7, I,on.l", II.h.dul. 01 (I.h.dul. 11 (71
I, 101010'011 A'If"1'0'01 lIn.. 1.71
9. 'u,,"al bp.".... Admlnl.tratl.... COIlt. Mllc.lIaneou. (9)
hp.nlf' II.h.dul. Itl
10, D.IlIt, MoIIgag. 1I01l1l1l1ll, 1I...IS.h.dul. II (10)
11. 10101 D.d",'oOl I'o'allln.. 9 & 101
\2, N., Value 01 h'o"llln. 8 mlnUllln. 111
13. Charltabl. and Oo...er"m.nlol B'quII" (Sch.dule JI
14, N., Value lulll'<I 10 I"llIn. 12 mlnUllln. 131
15, a'lau.al Trone',,, lIar dol.. of d.alh aft.r 6,30,941
S.. In.tructlon, far Applicable Percentage on A.v.n. (15)
ald., I'ndud. valutl tram S.h.dul. K or S.h.dul. M,)
16, Amaunl ollln. 14 10'0111. 01 6110 ra'. lib)
(Includ. volu.. from Schedul. K or Sch.dul. M.)
11, Amounl of L1n. I.. laltobl. 01 15% ral. (17)
(Includ. .,alu.. from Sch.dul. K or Sch.dul. M.)
18, Principal la' due (Add la, Irom lIn.. IS, 16 and 17.)
19. (r.dlll Spou.al Poverty Cr.dlt Prior Pa)'ments
+ +
20, II lint 191t urea'tt ,han lIn. IB, tn'" ,h. dlll...n" an lIn. 20. Thl.1t ,h. OVERPAYMENT.
IiJO
21, If lIn. 18 ,. 9reol.r than line 19, .nter th, dIFf.r.nce on Lln. 21, Thlll_lhe TAX DUE.
A. Ent.r the Int.rllt on the bolanc, due on L1n. 21 A,
8, En'.. ,h. '0'01 of lIn. 21 and 21A an lIn. 21B. Thlt" ,h. BALANCE DUE.
Mak. Check Pavabl. tal Regl...r o' Wilt., Agent
.., _~ '<1'BISUU1fQfANSWDiAWQUISTIONSONRlVlRSISIDI'AND',TO;RI ICIClMAnt
Un ., peno II.. 0 p.rjury, I .e ore thaI I hove examined thl. return, Including accompanying .chedule. and .tal.m.nl', and 10 the b.1I of my knowl.dg. and b.ll.f,
It It Iru., corr.d and compl.te, I d.c1or. Ihol all real eUol. hat been reported at true morlel value. Oeclarallon of pr.porer olh., than the plnonal ,.pr...ntollv. I.
bOI.d on allln'ormallon of which r. or., hat on)' knowledge.
, HA PIA ON _"POHSIIU ~ '1\I~nU ADORnS DAlf
c.:, (\ u 3-Ll - ~'6
NA UI 0" A II OfHU tHAN RlPRU!N'A'lVf DAn
!
I
g
5,39
NUM8ER
o 3. Remainder Return
(for dol.. of death prior to 12.13.82)
o 5. Federal E.lole TaK A.Iurn R.qulr.d
to
o
{")
o
? I 00 Y . 9 <;"'
()
C)
=5\ D6~ , cr c.,-
(B I
(111
(121
1131
(141
y\(',Y'l-O
vfM<").J)
K._-
K .06.
K .15 iii
(lB)
Ol.c.ount
Intere.t
(19)
(20)
ClweN IWIIl II you nil.' Il'qul.'\Iing a rcfund of your oVl.'rpayrncn', '
(211
(21A)
(2181
7J~""K(~~-:2 ::,1.G~':~
'- ~~ !\J
-.. .~
-::r-...sJ "'-
, -::J-..
Ad '48 of 1994 provld.. for the r.ductlon of the tax rat.. Impo..d on the n.t valu. of transf.r. to or for
the u.. of the .pou... Th. rat.. a. pr..erlb.d by the .tatut. will b.1
. 3% (.03) will b. applleabl. for ..tat.. of d.c.den" dying on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.02) will b. appllcabl. for ..tat.. of d.e.dent. dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.al transf.r. oeeurrlng on or aft.r 1/1/98 will b. .xempt Irom Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS"
YES NO
1. Did decedent make a transfer and:
a. retain the use or Income of the property translerred, .......................................................
b. retain the right to designate who shall use the property transferred or its Income, ...............
c. retain a reversionary interest; or .......................................,...........................................
d. receive the promise for life of either payments, benefits or care' .......................................
2. If death occurred an or before December 12, 1982, did decedent within two years preceding
death transfer I'roperty without receiving adequate consideratloa' If death occurred after
December 12, 1982, did decedent transfer property within one year of death without receiving l(
adequate consideration'.............",........."..,......... t. ,.,....., ..........,....,.. ...... .....,... .......,.. ......
K
3. Did decedent own an 'In trust for' bank account at his or her death'......................................
co
rr) . ~
, 'IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT ,6S PART OF THE RETURN.
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~THOfPENNSYlVANIA
INHl:R1TANCE TAX RETURN
I I
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debla 01 decedent mUlt be reported oa Schedule I.
ITEM
NUMBER
A,
1.
B,
1.
2.
3,
DESCRIPTION
I
AMOUNT !
!
5 :.":i 'l/~I
eoco,oO
FUNERAL EXPENSES:
cF'(f(jf7 tfUf)'l.1l/}cefl jJo/J?'U...
1&W()~ ~,
ADMINISTRATIVE COSTS:
PllflIOIlIl Roprosontallvo'. CommIssions
Neme 01 Personal Repmentallvo(l) Pt"""!. n A-'R a
Soclal Security Numbo~l) 1 EIN Number of PellONll Repmenlellve(l)
slree\Add.... g.,OI l3mi.. ~ J ,
cItyL?lnq;<' hu ~ Slete Cb
Y"~I) CommIssIon Peld:
Attomey Fees
Feml/y exemption: (II decedenre odd.... b not the seme IS delmenre, atl8e11 axptanellon)
Clelmenl
Street Add....
C I Rc H rn
~u-<.l'2...-Or,'ll\'1
'300.00
ZIp 17 ell ()
City
Retallonsl1lp of Clelmenl to Oecedanl
Stale
Zip
4, P~leFees
5, ACCO\Intanra Fees
6. Tax Ratum PreperetJ Fees
7.
TOTAL (Also enter on line 9, RecapltulaUoo) S 5300, 00
(If more lpace Is needed, Insert additlooal sheels of Ihe same size)
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OF
MARGARET C. ROIIM
-'
BE IT REMEMBERED that I, MARGARET C" ROHM, of 20 Beaver Street, Olllsburg
Borough, York County, Pennsyl vania, bei ng of sound mi nd, memory, and
understanding, do make, publish, and declare this as and for my Last Will and
Te~tament, hereby revoking and making null and void any and all Wills and
Testaments and wri t i ngs In the nature thereof by me and any time heretofore
made.
Item 1: I direct that my hereinafter named Executor pay all my just
debts, my funeral expenses, and the expenses of the administration of my
estate. With this direction, I authorize and empower my Executor to expend for
my funeral expenses and Interment such amounts as he may consider necessary and
proper, without regard to any limit that may be prescribed by a court of law.
Item 2: I direct my Executor to pay all Inheritance, estate, succession
and legacy taxes of whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise passing by reason of my
demise, may be subject and to charge such taxes against my residuary estate, it
being my intention that none of the aforesaid taxes, either federal or state,
on any property required to be Included In my gross estate, under the
provisions of any state or federal law now In force or hereafter enacted, shall
be prorated among the persons interested in my estate tp whom such property may
be transferred or to whom any benefit accrues.
Item 3: All the rest, residue, and remainder of my estate, of,whatsoever
nature, and wheresoever situate, whether it be real, personal" or mixed
including property over which I have a power of appointment, I give, devise,
and bequeath unto my spouse, KENNETH G. ROHM. provided he survives me for a
period of thirty (30) days.
Item 4: I n the event tha t my spouse shou 1 d predecease me, or fa 11 to
survive me for a period of thirty (30) days, I give, devise, and bequeath all
the rest. residue, and remainder of my estate, of whatsoever nature, and
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whatsoever situate, to my flve children, EDWARD G. ROHM, JEANETTE R. SMITH,
FRANK S" ROHM, SANDRA R. EKLUND, KENNETH G. ROHM, JR., ln equal shares, per
stlrpes.
Item 5: In the event that either of my children should predecease me
leavlng lssue survlvlng, I glve and bequeath the share of such deceased chlld
to hls surv~vjng If any of my children '~hould, edecease w1thout
,8
em 6: 'In t e event
daughter, JEANETTE R. SMITH, as guardian of the person of my daughter. Darlene.
Item 7: I nomlnate. constltute, and appolnt, EDWARD G. ROHM and FRANK S.
ROHM to serve as alternate Co~Executors of thls my Last Will and Testament.
Item 8: I d1rect that my herelnbefore name Co-Executors, or thelr
successors, shall not be requlred to give bond for the faithful performance of
dutles ln this or any jurisdictlon.
oJ
IN WITNESS WHEREOF, I have hereunto set my hand and seal th1 s ..1 day
)17/ ,1989.
of
The precedlng lnstrument, consisting of thls and one (1) othe~ typewr1tten
page, was on the day and date thereof slgned, sealed. published, and declared
by MARGARET C" ROHM, the Testatrlx herein named, as and for her Last Wlll
and Testament, 1n the presence of us, who, at her request, ln her presence, and
1n the resen each other, have subscr1bed our names as w1tnesses hereto.
of _~ ~~ PA'
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I COMMONwEALTH OF PENNSYLVANIA
If.,
COUNTY OF YORK
SS.
Wvt.1.) ~r~ and
the Testatrix and the witnesses, respectively,
mes are signed to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned authority that ~he Testatrix
signed and executed the'instrument as her Last Will and Testament, and that she
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 witnesses, and that to the
best of their knowledge, the Testatrix was at the time eighteen (18) years of
age or older, of sound mind, and under no constraint or undue influence.
SWORN TO AND SUBSCRIBED
BEFORE ME THIS~ DAY
o ..;lla-t/
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NoTAiiW. SEAl.
JANET s. GORE, 1l0TARY PUBUC
DUSOURG BOROUOIl, YORK COUNTY
MYCOIIMISSlON EXPlRESOCT. 25,Iggo
IItmber,l'ennsylYlnb Association 01 NOlartn
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(QMMONWU,UH Of "NNUlVANIA
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InIDI...I DIClDIHI
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
c. go -<<'S
N~~t'ER NAME AND ADDRESS OF BENEFICIARY
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RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
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ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Seque'h:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o ente, on line 13, Recopltulatlon) S
(If more .pac. II n..ded, Inslrt addltlonal.hllts of .am. 11.11)
1'hb h. Illl.....lit). IIwf duo' infllnn,l!i1l11 1I"'Il' gi\I'11 i", llllll'ld)' tll!,It'd lrolll .111 Ht'~lll;d u'llilil.IIl' 01 t1l'.llh dill)' filtd wilh JIll' J!t
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WARNING: 1111 Illegal 10 duplicate Ihls copy by photoltat or photogreph.
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COMMONWEALTH 0' PENNSYLVANIA' DEPARTMENT OF HULTH' VITAL AtCOADI
CERTIFICATE OF DEATH
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
I Plea.e Print ar Type
FILE NUMBER
'.
COMMONWUlfH OF PENNSYlVANIA
INHUITANCI TAX lnulN
IIIIDINT DICtDINT
ESTATE OF
(All property lolntly-owned with the light of Survlvonhlp mu.t be dr.e1oNd on Schedule ')
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
/,
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Fi(,sr A)llr I L 8cllvl:.
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3S39. s-t.o
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(A"och oddlllonoI8~'" )C 11'" ,hee"I' more .pacel. ne.d.d.)
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND J
UI
being duly eccordlng to I.w, de po... .nd ..y. th.t h.
0' th. Est.t. 0'
I.t. 0' _________._______'__________. ,Cumberl.nd County, 1'... d.c....d'.nd thot the
within I. .n In..ntory m.de by , the Slid
0' the .ntlre .st.t. 0' Slid d.c.dent. con.lstlng 0' .11 the p.rson.1 pro".rty .nd r..1 .st.t., IXC.pt ,001 .st.t. ou..ld.
th. Commonw..lth 0' P.nn.yl..nle, end th.t the figure. oppo.lt. e.ch Item 0' the In..ntory r.p,...nt It'. felr ..Iue
.. 0' the d.te 0' deced.nt'. dooth,
.nd .ub.crlb.d be'or. me,
Eo u)A~D E, RDHI/Yl
Executor.. Adm'nhtr.for
19
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Month
19 QC5'
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Day
INSTRUCTIONS
I. An In.entory mu.t be 'lI.d within throe month. .fter .ppolntment 0' p.rson.1 r.pr...nt.tI...
2. A .uppl.m.nt In..ntory mu.t b. fiI.d within thirty d.y. 0' dl.co..ry of .ddltlon.l ......,
3, Addltlon.1 .h.... m.y b. .tt.ch.d II to person.lty or roolly
4. Se. Artlcl. IV. Flducl.rl.. Act 0' 1949,
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Inventory 01 the real and peraonal estate 01
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deceased
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COMMONWEALTH Of PENNSYlVANIA BUREAU Of I"'DIVIDUAL TAXES/I,
O!PARTMENT Of REVENUE
Dear Register af Wills: I'
Enclosed you will find: Dcheckls) Ddocumen..(s) which were received by the Department of Reve~ueln error, I
These may be proce..ed according to normal procedures, !
!
REMINDER: The POST MARK DATE on envelope a<<ached to any check. enclosed must appear on your i
Officio I Receipt, i
,
Thank you.
OEX5S 19.951
Sincerely,
John Murphy, Chief
Inheritance Tax Division
(717) 787.6201
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
BUREAU Of INDIVIDUAL TAXES
IJKJI1'IMX fAX DIVUIDH
otPT. '11'11
tlARlllllUllG, PA 17111-1601
...'...,..." III.'"
EDWARD E ROHM
RR 1 BOX 912
LANDISBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
03-30-98
ROHK
06-15-95
21 95-0529
CUMBERLAND
101
AlIOUnt R..I ttad
MARGARET C
PA 17040
MAKE CHECK PAYABLE AND RE"IT PAY"ENT Tal
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I To In.ure prop.r credit to your Kcount, __It the upptIr portion of thl. fOMl with your tax p.YMnt.
CUT ALONG THI8 LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iik"'y=Uiiij-ix-AFP-COY=97Fom"...--iiiifiRiTAiicif"TAXoSTAYEHENT-ii"-AifcoiJiiY--iiliir---m-----mo-----
ESTATE OF ROH" "ARGARET C FILE NO" 21 95-0529 ACN 101 DATE 03-30-98
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS OF THE STATED ACN IN THE HAMED ESTATE. SHOWN BELOW
IS A SUHKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESS"ENT OR RECORD ADJUST"ENT, 02-09-98
PRINCIPAL TAX DUE I .00
PAY"ENTS CTAX CREDITS),
PAY"ENT
DATE
11-18-97
03-16-98
RECEIPT
NUMBER
AA242478
REFUND
DISCOUNT C+)
INTEREST/PEN PAID C-)
,00
.00
AMOUNT PAID
47,42
47,42-
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TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN"
TOTAL DUE
.00
.00
,00
.00
a If PAID AfTER THIS DATE, SEE REVERSE
SIDE fOR CALCULATION Of ADDITIONAL INTEREST.
I If TOTAL DUE IS LESS THAN .1,
NO PAYHENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU HAY BE DUE A REf~, SEE- REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
PAYPEHTI
DIItKh the top portion 0' thh Notice WId .-It with wour p.YMf\t .... ,.wllbl. to thl! ,... Met MId,....
printed on V. rever.. .Ide.
If RESlDEHT OECClEHT uk. check or MMW order p.yebl. tal REGISTER OF WILLS, AGENT.
If HOH"AESIDOfT DECEDENT .-. cMck or __w order p.wllbl. tOI CottttONWEAL TH OF PENNSYLVANIA 1
RUUGI (CA)I A rehnl of . tax cr..lt, which .... not r.....tMl on U. Tu: Aaturn, ..wa rlqu..ted h cOllpllUng WI
'"AppUCllt!on for A.hn;I of P.....Qlnnl. Inherltenca ... htat. Tax'" (REV-lSU). AppUcetlon. Ir. 1IVII1111b1. .t
the OffiCII of the A..hter of NUh, ...y of U. U A.v...... Ohtrlet Offl~. or frOfl U. u.p.rtnnt". Z4-hour
.......rlng ."vlc. ""r. fa,. fe,... ordllrlngl In Pw'wtlylv.nla 1-IDO-J62-zaSD, oulllcMi PlfWllYlv...l.
~ within local Harrlabur, .r.. (717) 7.7-1094, TDa. (717) 772"2152 ("*-,.Ing 1~lrld only).
REPLY TDI QUIlI"on. regardIng .rrorl cont'lned on thl. notlc. should be edd,...nd tOI PA Dep.rt....t of AIV"", lur...
of Indlvlul Tax.., ATTN. Po.t A......."t A.vl_ Unit, Dept. 210601, H.,.,.lIbur" PA 17121"0601, phonI
(717) 711..65051
DISCCUfT I
PENALTYI
INmtE:ST I
If .,y tu ell". II p.ld wIthin thr.. (3) c.IMdI,. IMJInth. .ft.r tM decedent". ..th, . flvl ptIrunt (5%) discount
of the tu p.ld II .Uowed.
ThiI 1&% tu ..,..ty non.partlelp.tlon ,....1 tv II cOIIpUtlld on thl tot.l of tha tax and Int.,...t ........, and not
paid tNIfor. .Janu.ry 11, 1996, \hi fl,..t day Ift.r the and of the tax ..,..ty ptI,.lod,
Intlr..t I. cMirged ~1""lng with fI,..t day of delinquency, 0,. "Ina (,) .unth. and OM (1) day frM thre det. of
..th, to thI det. of PIYMnt. Tu.. which bIe-. deUnfIl.*\t tNIfora J.....ry 1, 1'81 air Inbr..t It the ratl of
.IM (6):) percent plr .... CIIlcuhted .t I dally r.tl of .000164. AU tUII which bee.. delinquent on and Ift.r
J~rw I, 1'12 wIll baar Int.r..t It I r.t. which will v.ry froa cll.nder Wllr to cIIMd1r r..,. with that r.t.
~ed br v. PA Oep.rt-.nt of A.v~. ~ ~llclbl. Int.r..t r.t.. for 1'12 through 1991 .r..
V..,. Intlr." Alt. Dlllr Int.rllt Fector
Inbrllt Alt.
D.11v Int.r..t FlOtor
v...
1912 .OX . GaDS" 1'17 n . Gan47
1.llS 1'" .0Gaue 1'11"1"1 11X .GaDSGl
1'" 11X .GaOSGl 1... n . oaOZ47
1"5 15% .GaDSS6 199)"1994 n .OD0192
1... 10% .000274 1995-1991 n .0DOZ47
"'Jnb,...t 1. calcul.ted .. follow'l
IIlTEIlEIIT D BALANCE OF TAX UllPAID X HUKBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
"-Anv Holle. blUld .ft.r ttMI tu bile..... dIIl1nquw1t will reflect.. Inbr." cllcuhtlon to flft..., (5) day.
blvond the clat. of the .....-.nt. If p.~t II ... .ft.r the 1nt.r..t CMPUt.tlon dIIt. shown on the
Natle., addlUOMI Inter..t .,.t tNI c.lcul.tld.
084552093098
ROW621
File No 1995-00529
Decedent ROHM MARGARET C
Date
Filed
7/11/1995
7/12/1995
11/06/1995
10/16/1997
11/19/1997
11/18/1997
cumberland county - Register Of Wills
Page
PA File No 2195-00529
Docket Entries
1 PETITION FOR PROBATE AND GRANT OF LETTERS TESTAMENTARY
OATH OF PERSONAL REPRESENTATIVE
RENUNCIATION
DEATH CERTIFICATE
2 DECREE OF PROBATE AND GRANT OF LETTERS TESTAMENTARY
3 CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
4 STATUS REPORT 6.12 INCOMPLETE
5 INHERITANCE TAX RETURN TAX DOCKET 15 PAGE 44 LINE 7
6 INHERITANCE TAX PYMT
PAID - 47.42 ACN - 101 RECEIPT - 0242478
SHARON C ROHM
2/18/1998 7 REV 1547 NOTICE INH TAX APPRAISEMENT ACN 101
SEE INHERITANCE TAX EXPLANATION OF CHANGES
Docket: 15 Book: Page: 44.00
3/04/1998 8 INSOLVENT INHERITANCE TAX RETURN TAX DKT 15 PAGE 144 LINE 7
INVENTORY
3/04/1998 9 CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
4/03/1998 10 REV 1607 INH TAX STATEMENT OF ACCT ACN 101
TAX DKT 15 PAGE 44 LINE 7
1
JRD/June 30, 1992/17858
In Re: Estate of MAHGARE'I' C" ROHM
Late of WES'I' PENNSBOHO '1'WP
ORl'IIANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-1995-0529
No. 2'.''l'lr;-Or;29
NOTICE OF FAILURE TO FlLE STATUS REPORT AND REQUEST TO
CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RULE
Personal Representative:
EDWARD E" ROHM
Counsel for Personal Representative:
Date of Decedent's Death: JUNE 15, 1995
Date of Delinquency Notice: JUl. Y 23, 1997
The undersigned, Mary C. Lewis, Regisler of Wills. in ae~ordan~e with Rule 6.12, Supreme
Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Commoa Pleas of
Cumberland County, that neither the above named personal represenlallve 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 its Status Report required by Rule 6,12, Supreme Court Orphans' Court Rule and that the requisite
notice, pursuantto Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills
on JUI,Y 23 ,19.2.], and that the tell (10) day notice to file the Status Report has expired.
Accordingly, in accordance with Rule 6.12 the Court is hereby nOlified of such delinquency and the
undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed
upon the delinquent personal representative or counsel for the delinquent personal r presentative.
Date: AUGUS'I' 13, 1997
,lit
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
-
A HEARING IS SCHEDUI.ED FOR fill', t::J~T. :J. .1997. A'1' II: ~fJ A" m '
IN COURTROOM NO" L IF 'I'HE S'I'A'ilGS REPOR'l' ~ FII,EDlpRIOR '1'0 'I'HE HEARING
DA'I'E, 'I'HE HEARING WII.I, AU'1'OMA'1'I AI.I.Y BE CELI,ED.
P.J.
lRD/luDe 30, 1992/17858
REGISTER OF WILLS
Cumberland Counl7 Courlhouse
One Courlhouse Square
Carlisle, PA 17013
NonCE PURSUANT TO RULE 6.11
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
EDWARD E. ROHM
To: Pasonal Representative
Counsel:
RE: &l8le or MARGARE'l' C. ROHM . o-sed, LIIle of
WEST PENNSBORO TWP
&l8le No.: 21-1995-529
Dale of Decedent's Death: JUNE 15, 1995
Pursuant to Rule 6.12, the above named personal representative or the above nl\l1ed attorney, If
applicable, within two (2) years of the decedent's dcath, and annually thCfeafter until administration Is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6.12, In
substantially the prescribed form, showing the date by which the persoaal representative, or attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice Is to advise
you that unless the requisite Status Report Is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register ofWUIs
Is required to notify the Orphans' Court Division, Court of Common Pleas of such dellnqueocy aDd to
request that said Court conduct a hearing to determine whether sanctions should be Iml'O"'llI upl)n the
delinquent personal representative and the delinquent ~nal r~resentatlve'l counsel, If any.
Accordingly, If the requisite Status Report Is not flied by AUG. 6 , 1997, you are bere:by
advised that a request will be submitted to the Court In accordiJlce with Rule 6.12.
Date: JUI,Y 23, 1997 'YnQ,~r. ~,LIA;/1 [;Lf V~l'YlfU.U,J:Jpb:r
Deputy eg ter of WII s l
Distribution to Estate File
;
.t
.-
,-
\
JRD/June 30, 1992/17858
In Re: Estate of MAHGAHI":r C. IOiM
Late of wrST PJo::NNSOORO 'lWP
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.:
21-1995.0529
No,
1995.0529
NanCE OF FAILURE TO FILE STArnS REPORT AND REQUEST TO
CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RULE
Personal Representative:
BrklARD KIHM
Counsel for Personal Representative:
Date of Decedent's Death:
6.15.95
Date of Delinquency Notice:
7.15.98
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme
Court Orphans' Court Rules. hereby notifies the Orphans' Court Division, Court of Common Pleas of
Cumberland County, that neither the above named personal represenlalive 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 Its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite
nollce, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills
on 7.15.98 ,19_, and that the ten (10) day notice to file the Status Report has expired,
Accordingly, In accordance with Rule 6.12 the Court is hereby notified of such delinquency and the
undersigned requests 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: 8.n.98 It)~~gl/.p ~-:-;UIr)/f)1J;tu-_. {), .
Mary C. Lewis, Regist of Wills ~
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
A HEAIUM> IS S~-:r FOH k /iliitf 1Lt1 \ :;0
COURTI<<lCM NO.3. IF 'nil'; 'STA'IUS HBroRT I
AllTCMATICALLY sr; CANCELLrJ:l.
, /;'1'8 AT /.3~ IN
F Lr;O PHIOR TO HEARING DATE, 'lID; WUNG WILL
_........,"'"'..*.....-.,.._.~-,._..,~
.-
'.
lRD/June 30, 1992/17858
REGISTER OF WILLS
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To:
Personal Representative
Counsel:
RE: Estate or MAHGr\RET c. HalM
WEST Prl'lNSOORO 'lWP
Estate No.: 21-1995-0529
Date or Decedent's Denth: 6-15-95
ErMARD 8. ROHM
, Deceased, Late or
Pursuant to Rule 6.12, the above named personal representative or the above named attorney, if
applicable. within two (2) years of the decedent's death, and annually thereafter until administration Is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6.12, in
substantially the prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice Is to advise
you that unless the requisite Status Report Is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
Is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to detennine whether sanctions should be imposed upon the
delinquent persooal representative and the delinquent personal representative's counsel, if any.
Acc:ordlngly, if the requisite Status Report Is not filed by 8-3-98 , 19_, you are hereby
advised that a request will be submitted to the Court In accordance wilh Rule 6.12.
Date: 7-15-98 7JJA)' J JI ~~ - ~nl Yh.u. j).J.
D'~;i{gis~bf~. 1,_ ~
Distribution to Estate File
,
WE. hJ()JJ bwn 70Jd .:;i?u~rqL -r-t';71.fJS ,ha.~ CZ--I
U-XlS ~91I(-Pol. Wf')aT 06 W.{J ({...egoJ
-rh, '5 ~3"tGrtQ.(l iT Ira LJY.- TO fl'l--1Z T/,,,~ ~pil r
TO DO '\0 0 f -In?
aLL- -rILJ; STATUS REPORT UNDER RULE 6,12 T 11''-'..'
(
-
Name of Decedent: YYI1. (~{' 0'1
Date of Death:-'d5 -<tfJCfs
Will No. mS" - 06t5"20,
('. en~l N\
,
Admin. No.
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:
State~ether administration of the estate is complete:
Yes L-" No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
1.
3. If the answer to No, 1 is Yes, state the following:
a. Did the pe~pnal 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 st\~ ~n
account informally to the parties in interest? Yes~No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounls may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
15/0/99
12~
-
...::.i
f.J t~
!)J 1I )(U d !;" )?--J{/Y11
Signat.ure
LCM )lOt:. t:> E. \ R o+t Wl
Name (Please type or print)
\i2J) \ P'f~ '=-to l A(l'h; hU, CO ~ l70li 0
Address '-j
(7ft, 1c;$Q-.39/o
Tel. No.
Capacity: ~personal Representative
Counsel for personal
representative
1;';1
r:
'j'
(MAH: rmf! AM3)