HomeMy WebLinkAbout95-00636
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IJETITION HUt IJROUATE und (mANT 01' LE'nlmS
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.__..._.___ ..' .'. II.MI'I.r III Will, I"r 11\.
______.___..._.... . .. 1J""",,"'rI, l'III1I1IY IIf .<:..'.1111 mL..!ImL III Ih.
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YOllr 11.llllolI.rh), ...hll h/lll. IH y.II" IIf nM. III old.r IUllt~OCllbtxXXXXXXXXXXl(vXXIVKOfll
III lh.In\l wlllllf lhe nhuv. d.ced.ol, dlll.d -AprJ..L.15 , 19.1..4-
nml .odlcil(l) dnl.d .rumQ ...-'rhIL..EXllC.ut.dJLlH1Jnad-.io...tluLw.i.ll...-VJ.ck j 0 J.
-11inich=.J.cOQ8._.hQ8-1:QncuncQd~_JUL.o.t.hBl:.-li.i.b.Llng A n f n n ,.,nn Ant
have rono.unCild-inJll'ltlLpLJJ:IInQJl-A......Etillr..-b.r.o.t.hor of dA"Adent.
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(,Iulr ,rleHIll1 dr\'UIII\IUIICC\, ('... rCIIUndl1lhm, ttclllh nr c\e,:tllur, (h.'.)
Oecendent wal dOllllcil.dal d.lllh III Cumberland County, Penllsylvania, with
It er In51 fallllly or prlncipnlmld.llce III ~~~1 ~~r;~vig~,=oa~<,n,j; ;'iMtAt4~ r~
(Ii\l Mlttl, number and 1IIU1\\:I('IIlIII)l)
Decendenl,lhen 64 YCllrs of aMe, died July 4. ,1995
III Blue Ridqe Haven West. Nursinq Home ,
Exeeplas follows, decedel1l did nol marry, WIIS nol divorced and did nOI have a child born or adopted
after execution of the will offered for probale; was notlhe victim of a killing and was never adjudicated
incompetent: None
Deeendent at death owned property with estlmaled values as follows:
(If domiciled in Pa.) All personal property S 2.500 00
(If not domiciled in Pa.) Personal property in Pennsylvania S
(If not domiciled in Pa.) Personal property in County S
Value of real estate in Pennsylvanin S 62 . 000 . 00
situated as follows: 951 WArtzvi 11 A Rd.
Rnnl.R p~ 17n?G
-
WHEREFORE, petitioner(s) respect full)' reqQest(s) rthe prObijle ofdth~ last will and eodicil(s)
presented herewith and the grant of Iclters adm~n s tra t 10n .0. n. C . t . a.
(tCSlamenlnr)': admlnlslnulon c.t.n.; administration d.h.n.c.l.a.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } 85
COUNTY 0... COnmh"r1 Ann
The petitioner(s) above.named swear(s) or affirm(s) thatlhe statements in the foregoing petition arc
true and correct 10 the best of the knowledge and belief of petiti that as personal represen-
tative(s) of the abovc decedent petitioner(s) will n admi Ie estate according to law.
and '"
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MARY C. LEWIS ReJ:;sler ~
No. 21-95-636
Estpte of
Dolores E. Foreman
I I>eccpscd
I>ECREE m' PROnATE ANI> GRANT 01' LETTERS
AND NOW AUGUST 25 19 95 ,In consideration of the petition on
the reverse side hereof. latlsfaclory proof having been presenled before me,
IT IS DIlCRIlEl) Ihat the Instrumenl(s) dated ADd] 15. 1974
described therein be admitted to probale and n1ed of record as the last will of On 1 orA R F. ForAman
and Letters nF AliminiAf-T'Af-inn n n n ,.. .. A
are hereby granted to James A. priar
~
FEES
Probate. Letters. Etc. "".",. S
Short Certlflcates( ),.,..,.... S
Renunciation ,...........,... S
X-PAGES S
TOTAL _ S
~fifd .(\~.11~$T..~~. ..1,m.......... .~ :~~,
total $ 153.00
115.00
15.00
15.UO
I.OUIU,.1(.w.......,. Debra K. Wallet, Esq.
ATTORNEY (Sup. CI.I.D. No.) 23989
24 N. 32nd St.
Camo Hill. Ph l70ll
ADDRESS
(717) 737-l300
3.00
PHONE
MAIL LETTERS AND ORDER TO ATTORNEY ON AUGUST 25, 1995
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8-((o-9S-
21-95-636
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LAST WILL AND TESTAMENT
OF
DOLORESE. FOREMAN
I, DOLORES E. FOREMAN, oC Palmyra, Lebanon County,
Pennsylvania, being oC sound mind, memory and understanding, do make and
publish this my Last Will and Testament, hereby revoking and making void
alllormer Wills by me at any time heretolore made.
ITEM I.
I give, devise and bequeath all ol my estate wheresoever
situated to my beloved husband, Richard Foreman.
ITEM II.
If my said husband lails to survive me, then I give. devise
and bequeath my entire estate to my daughter. Mrs. Vickie J. Minich ol
R. D. #4. Mechanicsburg, Pennsylvania.
ITEM III. I nominate, constitute and appoint as Executor ol this my
Last Will and Testament, my said husband, Richard Foreman. If he be unabl
to act or continue to act as Executor, then I appoint in his place my daughter,
Vickie J. Minich.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
/f-Htday ol tiN IL-, 1974.
Ifl~ t: dfu-..--
The preceding instrument identiCied by the signature ol the Testatrix,
was on the date thereoC signed, published and declared by DOLORES E.
FOREMAN, the Testatrix therein named, as and lor her Last Will, in the
In Re Bllate of
To the Reglller of Wills of
RENUNCIATION
21-9~.1j16
Dolor.OR E. I'oromon
dcccased,
cumberland
COUIllY, Pcnnsylvanla,
The undcralllned Louise Bishop, siscer
the above decedcnt, hereby rcnounec(s) the right !o adminlstcr the estate and respectfully ask(s) that Lellers
dbncta
be Issued to
WITNESS
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James 1'\. Prior
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hand this
day of August If!, 19~,
of
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. (Slsnat_,e)
607 S. Lebanon street
Bryan, Ohio 43506
(Add,ess)
(Sllnal_,e)
(Address)
(Slanat_re)
(Add,...)
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RENUNCIATION
21-95-636
In ReESllleo( Doloros E. F'oromnn
decelsed,
To the Register of Wills of
CumhnrlAnd
County, Pennsylvania.
,
The undersigned dA....,..tr.l', SlUtI', IJ..J,(, Ol"'ll+'lt,r"
of
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the Ibove decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) Ihal Leners
Gl.Io.rJ.t..+.... .
be Issued 10
J'/\"'l.S A .P'-IAf. I brO'il.u of. rkt..t.tk,J ~
WITNESS
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hand.slhls
I~ day of ~...s~ ,J9~.
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(Addre..)
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(Address)
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G1STER OF WILLS OF COUNT-\'
OATH OF SUBSCRIBING WITNESS
Sworn to or afflrme.d and subscribed b
me this i1ay of
19_
Register
) being duly qualified according to
present and saw
codicil
(each) a subscribing witness to the II presented herewith, (e
law, depose(s) and say(s) that
the testa' , sign the same and that
request of testa. In .. presence and
other subscribing witness(es)).
signed lIS a witness at the
rcsence of each other) (in the presence or the
(Name)
(Address)
REGISTER OF WILLS OF ("l1rnh",,.l Rnn COUNTY
OATH OF NON.SUBSCRIBING WITNESS
James A. Priar and Wavne Morris Minich. Jr.
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
Q~<,h nf' ..horn ~ a familiar with the signature of Dolores E. Foreman
00llI1c1t
will
that
o~,...h
,.,OF t-hl'lm
presented herewith and
1l~~
believes the signature on the will is in the handwriting or
testal r ix or ilXlXXDllXJhJlX~tl:l(iHM~X~~ the
Dolores E. Foreman
to the best of h~ a
.
SWOl n to or affirmed and subscribed beror
me this 16th day of (Name)
-/r~I,1'~nOJ lVJ ~ 728 For;O~oa?" ,carlisle, PA l70l3
"! MARY C LEWIS ~ ~~. Q.. .JZ~ ,1J;
(J (Name)
1~A Millers GaD Rd.. Enola, PA
(Address)
l7025
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21-95-636
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WALLET -
24 N, 32... 51rcet'
Camp Hili, ~ 171J1l
L nltjii,.;ne (717) 737.1JOO
AT'TORNEY FOR
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UV.IJOO IX'" (1.9'1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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COMMor~WUUH O' 'INN$y\""NI"
CIPUlMINI O' CC"CNU!
H"UIUOJ:O. ~~o'rJ12l.o60'
ON' NAN 11" , I' . "'hO 'lI100I h. IAU
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FO EMAN DOLORES E.
seCIA, UCU'II" .IUMe.. 01." ':, OIAfH
I 177-24-5102 7/4/95
r't .,"I(.I'llllllhl~1hO II'OUU ,..,.t ,I." It'U ."0 "'001. ,...11.\1
&
FOR DATlS O' DIATH A"IR 12/:1 1/91 CHICK HIRE
If A SPOUSAL
POVlArY CRlDIT IS CLAIMID
FIll NUMIIR
21
COUNTY COOl!
1995
fUR
0636
'4UMU~
I DIN' "w""t'tt "OO'IU
DAn ,~, IIIIH
951 Wertzville RORd
Enola, PA l7025
Ie",,",., ~llmho~l.Anri
"'NOUhT IICII...ID ,SH _hSIlUCiICNSI
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'212131
: seC:A' Heu"" f'.lUMIl'
~ !XJ1. Or'glnal R.IUTn C 2, Suppl.m.nlal R.lurn 03, R.mainder Rllurn
~ (far dol.. of d.alh prior 10 12013.a2l
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Ill..... o A. lImlt.d Ellal. C .aa. FUlure Int.Tlu Compromi.. 05. F.d.ral Eslall To" R.lurn R.quir.d
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="" (far dal.1 of d.ath aft., 12.12.82)
u......
~.. 6il 6. D.Cld.nl DI.d T 11101. C 7. D.Cld.nl Main,ain.d a li...ing TrUll .lL 8. Total Number of Soft D.palil BOXlI
IAllach capy al Will) (Anach copy of TrUll)
ALLCORRESPONDENCECAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO....
,~ .1oM' ICOMmn ...-....UlNO "'ODUSS
~ffi Debra K. Wallet. Esquire 24 N. 32nd Street
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8~ TUIPHONl NUMU" Camp Hill, PA l7011
1. Rial Elfe'. (Sch.dule .AI
2. Slack. and Sondl (Schedult B)
3. C1ol.ly H.ld Slock/Porfn.nhlp Inl.r.I' {Schedule CJ
... Mortgages and Not.. R.cei...able ISchedule D}
5. Calh. Bank D.polill & Mlle.llan.ou. Personal Property
ISch.dul. E)
6. Joinlly Owned Property ISchedule F)
7. Tronsf,,. (Schedul. 0) (Schedul. L)
8, Tolal Gran An." (Iatal Llnel 1.71
9, Fun.ral Exp.nsel, AdmlniUrall~. Cos... Mllc.Han,oul
bpenl'l (Schedul. HI
ht D,bu, Mortgag. liabilillll. lien. (Sch.dul. II
11. Tolal DedUC'llan. {Iofallinll 9 & 101 Ill}
12. N., Volul of E,tal, (line 8 minus line 111 (12)
13. Charitabl, and Go...ernmental B.que'IIISchedvle J) (131
U. N., Valu. Sublect 10 Tax (line 12 mlnullln- 13) (1oll
15. Spousal Tran,f.rs (far d011l of death oft., 6-30.94)
5.. Instruction, for Ar,pllcoble Percentagl on RIYlne (tSI X,_1Il
Sid.. (Includ. va lUll rom 5chedul. K or Schedule M.l
16, Ama""' allln. lJ 'a,abl. a. 6% 'a" (16) 56.693.48 . .06 =
(Include valvlI from Schedule K or Schedule M.I
17. Amount of lint 14 laxobl. 01 15% role (171 )( ,15 a
(Includ. yalu.. from Schedul. K or Sch,dul. M,I
18. Principal lax due (Add tax from lln'l 15, 16 and 17,) (8)
19, Cr.dill Spousal Po...."y Cr.dil Prior Paym.n" Dlscounl Inler.,1
+ + I1q)
20, IF line 19 il gr.al.r Ihon lln. 18, .nler Ih. diff.renCl on line 20. This is Ih. OVERPAYMENT. 1201
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191 l5.824.50
(10) RQ4 ,,,
l6.7l8.65
56.693.48
5Ii fill, 4R
3.401.6l
Check hero if you are requesting a refund of your overpaymont.
3.401.6l
121)
121A)
1218)
3.401.61
21. IF line 18 il grealIT Ihan lIn. 19, .nt.r Ih. diff.rence an lint 21. Thi, illh. TAX DUE.
A. EnlIT Ihe inler..r on Ihe balance due on line 21 A.
8. Enler Ihe /0101 of lIn. 21 and 21A on line 210. This illh. BALANCE DUE.
Make Ch.ck Payabl. tar Regl.t.r of Will., Ag.nt
...1 ,> >- >-'/BE.SURE TO ANSWER ALL QUESTIONS' ON REVERSE SIDE AND TO RECHECK MATH .~ ~ ;.....
Under p.naltl.. of p.rjury, I d.c1ore Ihat I hove examined Ihis relurn, including accompanying schedul'l and I!arem.nll, and 10 th. bell of my knowledge and beuef,
ir il Iru. orred a , I d.c1are Iha' all real ellale has been report.d ollru. markel ...olu., Declaration of pr'porer olh.r Ihon Ih. p.nonal r.pr...nlali.... "
bas n 0 malion of w 'ch pr.pa,.r has any knowledge,
NAlU_ "1 ON.t fO. fIlINQ ~lIU_N ADD_US OMI
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728 For e Road. Carlisle
...oo~us
24 N. 32nd Street. Camp Hill,
PA 17013
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PI\. l7011
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"V,lSD2 t:h 112.151
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C:CMMONWULtH O' PlNNIYLY"H'A
IN"lOtI'Nel u. II'TUIN
tUIDINt DleaD Nt
ISTAU O'
SCHEDULE A
REAL EST A TI:
.1 E NUMBER
DOLORES E. FOREMAN 2l- 5-0636
(ProporlY 'olnlly.ownod with KIVht of Sur.lvo"hlp mUlt bo dl..lolld on Schodull Fl All ,"oll.,otl .hould bl 'IPortld at fair mo,klt .01uI
which II dlflnld al tho prill 01 which proporlY would bl ..chonllld botwlln a wllllnv buy.. and a wllllnv 1111.., nolth.. bllnv complllld
10 bu or 1.11, both hawln . r.asonabl. knowl.d . of the ,.I."ant facti.
VALUE AT OATE
OF OEA TH
1,
Cumberland County, Pennsylvania 17
(Based upon net proceeds from sale
attachedl
$66,788.03
788.03
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A U,S.IJF.I'AIIIM[UI ur IlulJSII~l) nl.d UI10AN UEVfl.OPMtUI OMD No. 2602.02l'i5
r.E1ILEMENI BIAIEMENI Illll,I'flO
SECURED LAND 1...11111111
TRANSFERS, INC. ll, IYI'E OF WAN
3800 Markel Slreel 1 I IIIIA ~I "MilA :Il<I"IJIN.\lIlItm
Camp HIli, PA 17011 '.1 IVA G I I CIlIIV. 11m
fi 1'ltl;flIJMIIf:11 I ' l.llAlIIJlJMUEIl
Phone: 761.7744 l5!J101 0150001139
n MOlll nn eMU': UO.:
0, NotE: lhh~ tOlm 11I11l1111"hnd 10 glvn YOII R "'nlnmlllll (II nclllnl flnlllflll\fllll CURIA ^IIllltJlIllllnlcl In nlul hy lho lolllnlllDlIt nunnl "'" "hown, linin" fTlnlknd
.(I1n.c.)' WRrn ,'Rid oulRhln Ihn clOlillO; IImv RIO flhoWIl hnln Inlllllflllllnllnlln1lHllllnln14 RIllI Rln Ilullnclutfod In Ihn lolnll.
1/. rMMf ANI/ AI/UIlERS or nOllI\OWEIl' (:. U^ME ^'m^D{1I1EGSor r.nlUl- r IlAME AIm AUUI1ESS or LrNUElt
C. Michael Sgrignol i, Jnmen 11. Print', lIilLTia Savinga Bank
1Idminiatrnt:01: d.b.n.c.t.n
or the Eatnte or 2nd & Pine Streeto
IJolorea I' Foremnn lIarriaburg P1I 17101
..
n.I'IIOPEnlY LOCA'IOIJ, II milllrMEIH Alln!I' I. SEI flEMEIH DAlE:
951 Wertzville Road Secured Land Transrers, Inc. 12/20/95
East Pennsboro Township PLACE or SE 11 LEMEIl I :
CUMBERLAND County 3000 Market St. Camp lIill P1\ 17011
J, BUM MARY OF BORROWER'B TRANSACTION: K, sUMMAny OF BELLER'B TRANSACTION:
100. onOBB AMOUNT DUE FROM BORROWER .00 OR099 AMOUNT DUE TO BELLER
101. Contracl Bol05 prieD 73000.00 401 GonlrRcl solos price .00
102. Porsonal properly 4n1 (1nlSol1ol propolly
t03. Selllemenl charges 10 bOIl ower (1lno 1400) 1B45.19 ..,
104. ...
105. 40S.
Adjuslments for 1101118 paid by 601101 In ndvAnco Adjushnonls lor IIams paid by 601l0r In advanco
108. Clly{fown tall I. 4on,Cllyllown laIC I. I
101. County lall 12/20/9510 l2/31/95 1.24 401COUIlly lall ~<!/<!Il/lItllo1<!/ Jl/951 1.24
108. ^"onmonll 10 40ft ^noumonl, I.
109, School 12/28/95'0 06/30196 270.16 "Qq, School 1<!/ <!1l/lItll. UbI JO/9E 270.16
11.. :;ewer: :;;49 .5010 tend 12131 1. 63 4'in'1rewer: :;;119. tlO/q I6!na 12/3 1.63
Ill. 411.
112. 412.
110 OR099 AMOUNT Due FROM BORRoweR 75110.22 410.0n099 AMOUNT DUE TO BELLER 73273,03
,.. AMOUNTS PAID BY OR IN BEHALF OF BORnOWEn ,.. nEOUCTIONR IN AMOUNT OUE TO SELLEn
201. Oeposlt or 00ll1ns1 monoy 2000. CHr ,.ot.Excoss doposll (SOD Inslrucllons)
202. Principal omoun' olllow lonn(s) 35000.00 (;02.8011l0100nl chorgos 10 sollor (1lno 1400) 64115.00
'OJ. ExlRlIng 10nl1(l) tnkon RlIblocl 10 Ml:1 Existing 100n(8) lokon subjocllo
,.. r,n4 !'nyol! 01 nIsi MmtgnglJ Lonn
NONE
?or. r,osVnyoll 01 Socond Morlynun lODfl
?Dn. ,..
;lor. roo,.
,Oft. fiO".
'.0 fiOP.
AdJuBlmonlR lor 110mB unpnld by lollor AdJuslrnonls lor lIoms unpaid by sollor
210. CUylfowlI tu 10 r.lo.CllylfownlnlC I.
211. Counly lox 10 r.1'.Counly lolC 10
2". Anoumonl. 10 r.12.Atlo"rnonl' I.
213. School 10 &13 ochool 10
n4. fil."
?olf-. ."
?lfl ".
"7, r.17.
;"In. fil"
'ID. r.llI
". TOTAL MID BY/FOR DonROWEn 37000.00 "..TOTAL REDUCTIO" AMOUNT DUE SELLER 6485.00
:mo. CASU AT 9ETTLEMEUT FROM on TO BORROWER G..CASIt AT SETTLEMENT TO OR FROM SELLER
MI. 0'08& Amounl duo ftollllJortownr (IIno 120) 75110.22 r,OI.GIOSS nmolllll duo 10 SOliD, (IIno 420) 73273.03
30". loss nmount pnld hv/lor borrowor (11110 220) 37000,00 r.o"lofUI Induction OInouI11 dUlllollor (linn 520) 64115.UU
,., CAB II (lKj fROM) II I TO) OORnOWER 30110.22 ,., CABIt 10<1 TO) II J FROM) BELLER 66708.03
OIlVOI 01 nnllnwnr'. fll(lnnhlln
5nllnt', f.lLlnnhlln
IIUO. t nnY. filM
. ~AllfffiIiJ.l PAIlJ FIIOM
L. SETTLEMENT CIIAnOES 159404
700. TOTAL SALES/BROKER'S COMMIBBION b,..d.n p'I... '/:.lOOO,OO 7,0 nonnOWEn'o BELLEn'a
FUNnB AT FUNDa AT
Dlvlllon 01 Conunlslloll (lhlA 7(0) os 'nllnwft; 'l'otnl: $5L.!.lO.00 BETTLEMEllT BBTTLEMEtlT
701, $ 2530.00 III ,Jack Gauslllm Uealtor ;Y;1.;'Ji,j\)~\'(I'!lJ;;'" W,;t!!';;\';\~1i;..j~~:!Pi)lt'
Uedco '~ I "#il!j"'ll '~'Ptl 'J""-J;.J'~'l ~'r ~.;o~\'< 'Nt'1 ,C
702, $ 2500.00 III /lnnm: . ,f..A.'~ ,,~?;'.' ~"ci"
-f, ''f f~H i :~hl...Jt,..;t<" .l~, '1 .."f ~"{- p." '.. __'..... _~, _.' .S
703. Conllnllllon paid at 00111"'''01\1 5110,00
704, -
800 ITEMB PAYABLE III CONNECTION Willi LOAN
not. Innn Orlglnntlon fnn '" IInn:fil($:.l511, POCr 350,00
802. tunn Ollcount ')l.
..
003 ^rrllnllnl fon In
n04 I:lolllln."olllo
006. l.oruloll hllllocllnn J:nn
000 MOIlgnun InlurnncD ^Ilpllllnllon roo to
no;:-AIIlIlIlllllon 1'00
~~pl. Fee lIa 1.'1'1 Il ($325. POf) - -.._-
noo
ftUl -
8'1.
000. ITEMB REoUlReD BY LENDER TO aE PAID III AnVANce
00 I. Inlofosl horn 12/20/95 1012/31/95 os 6,32/11ny 25,28
902. Morlgago InlwancD Promlum for mn.ln
003. lIozord InStuRIlCn PremlUIT1'Of Vra In
004. VIa. 10
006.
1000. RESERVES DEPOSITED WITU LENDER FOR
lOOt. Hozard Insulonc8 mo,O$ 1100.
1002. MOllgogo Insuronco mO,O$ 1100.
1003, Clly(Town lB' hlO. 0 $ 1100.
1004. Counly lox mo.OS 1010.
1005. Allonmonls mo,O$ Imo, "
1008. mO,O$ Imo.
1007. mo.O$ 1100.
100S, AqqrEScrow mo.O$ 1010. 213.911t r.-;.:' . . ~< ..;;':'
I '00, TITle CUARoES
1101. 801l10monl 0' clollng 10010
1102, Abstracl 0' 11110 soorch 10
1103. TIlle 8xomlllollon 10
1104. Tlllo Insuranco hlnrler 10
1105, Oocumonl prnpnlallon 10 Debra K. Wallet POC (S)
1108, Nota,y loos 10 Cash 5.00 5.00
1107. ^llorneV'1I foos 10
(Includos obovo 110mB No.:) :i1l:iIUW;m . .lW'<\1'i1!Ji r5j;~lt%~\1tq#;Wti~~y'f;
1100, Tlllo Insuronce 10 Secured Land Transfers -
(IncludoB obovo 1I0ms No,:) Ends. 100/300/8.1/BR
1100, Londor', coverogo $ 35.000 . *~
"> . T' "'" '.,f :w. ~~t..-i'~~" '~,~iJ
1110, Owno,', covoroge $ 73,000 J '.,",",',",." ,":" .>; ("""""" ". __ ",.t.".,_~",,,,,.
1111, Mail Fee Secured Land 'l'ransferll 11,00
1112, Disb. Fee Secured Land Transfers 35.00
1113.
1200, GOVERNMENT RECORDmo AND TRANSFER CUAROES
1201, Recording foos: Oood $ 12.00 MOIIUnU. $ 16.00 Mlsc.S 28.00
1202, Clly/counly loK/stomps: Dood S 730.00Morlunu.S 730.00
1203. Slole loK/slomps: DoDd $ 730.00MorIO.uo$ 730,00
1204,
1205,
1300, ADDITIONAL SETTLEMENT CUAnoES
130 l. Survey 10
1302. Post Inspection 10 Paramount Exterm1nat1nq 35.00
1303. nater POC (S)
130<. UV Lioht Real Estate Environmental 570.00
1305.
1400. TOTAL SETTLEMENT CHAnGES (onlor on IInOI 10:) and S02. Socllonl J nnd KI 1845.19 6485.00
II B IJEI'^IIIMI:/H 01: III)lIBIIIll Nil) 1IIIIINIIJEVU.OI'MElH
liEI IIIMINI B1^,EMEfolI
010111 Nil. 2bll21120
rlllJo2
"'ulln, "fII....U".1 "'.11",.11"1'11 IIU.!!t'f',t h,' ~"'"l'mnnl.\llnnl IIl1lhQ "C:"III.'~~ III lul""llltllollIlllnl\'m'II,'l' ollm,,, II' I\I"'WII nn Ihllllun.l Sellln""lhl SIIIlnnllllll,
r.nlll"m"nl ^unlllllfllnhv nl,lInlll-i
''''''NU, 'hn 110M In dllpnllt .ny .mounl. cnlllcl.rt IUf di.blll,fIInnnlln 1I"'ol"III"I'''lIIloU lIr.f:mml <<'" rUlhllJlllV .,,'lIIod In.UIIlUon .nrll" I:lIlIhll1")' ,,,1011111'0 "'"ll1ff!
In II. ClWlllltr:OIlIlI .. .t!fllllulIll
cnnlIIOllullnnlorllt..lVlclI'!rltllltl"ln..r.lin"
"UO CEnTIFICATION OF DUYERS AlID SELLERS
I hnvQ CAIOfull~ ,ovlnwod tho IIUO.1 Snlllo,"onl Slnlrunonl Alld It) Iho hOll oll11V knowloduo and bolh)', III 1Ie.4lJ d RccurRla IlnlolOOll1 01 nlllocolpl. And dl,b"'lomonll
tnlldo on Iny IIccounl bV 100 In 11111 tranlllcUon. I hlllho! cmlll)' Ihall hn....o rocol....od It c~... ,-,olllolOonl Sial monl,
Snllnr'.fillJ",IUln
Snlffu', rlllW ^dclrQII & rllllnn.
Mlluml, In IIn tlllhlll'nll III .r:r.llnl,"r:1\ wllh Ihls "lIlumlllll
r", df]IIl~"lIllI
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COMMONW\"'H ~' ~INN"~ANIA
'HHIII ANCI 'A .nu.
IIIIOINT ole 0.N1
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
l
2l-95-0636
PlIO II Prlnl or T I
DOLORES E. FOREMAN
(All P'8fMrtv lelntlyoewMII with the RIght .f Survl.......hlp mUlt b. dl.c1...d ." Sch.dul. PI
ITEM DESCRIPTION
NUMBER
VALUE AT
DATE Of DEATH
l. Dauphin Deposit
Checking account #54-15624-6
$l,783.59
2. Cash in possession of Decedent
268.00
3. 1986 Ford Crown Victoria (Fair condition.
128,000 miles)
l,OOO.OO
4. Furnishings and misc. personal property - proceeds
from actua1 sale
2,361.85
5. Clothing and misc. personal property donated to
Salvation Army
6. Old coins - based on actual sale
o
7. Social Security check
8. Penn State Medical Center - refund
9. Pennsylvania Tax Rebate
280.00
275.00
35.00
500.00
71.56
49.10
lO. Newspaper and cable refunds
ll. Auto insurance refund
(Attach additional ay," )( I'" sh"'llI more IpOC. Is n..d.d.)
""'Ulltl.111"
mATE O.
,,'!:f~~n
-.!JWi.!
CCMMONWULTH O. 'tNNUWANI"
INHumANCI lAX UTUIfN
UIlOfNI OfCIOENI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
I
I Plea.e Print or Type
I FILE NUMBER
2l-95-0636
AMOUNT
DOLORES E. FOREMAN
ITEM
NUMBER
A. Funeral Expenle.1
B.
4.
C.
1.
2,
3,
4.
5.
6.
7,
8,
DESCRIPTION
1.
Richardson Funeral Home, Inc.
29 South Enola Drive
Enola, PA l7025
S 3,360.00
Rolling Green Cemetery - grave opening, services
l,650.00
Rolling Green Cemetery - marker and installation
l,l32.00
1.
Admlnl.trativo COlli I
Personal Representative Commissians
Soclal Security Number of Personal Represenlatlve:
Vear Commissions paid 1 9 9 6
4,000.00
2,
Allorney Fees - Debra K. Wallet, Esquire
3,600.00
3.
Family Exemption
Clalman'
Address of Clalman' at deceden"s death
Slreel Address
Relalionshlp
City
Slale
Zip Code
Probate Fees
263.00
Mlscellaneoul Expense..
Freeman Real Estate - Appraisal on house
4076 Market Street, Camp Hill, PA l70ll
Real Estate Environmental Service-FHA Water Series
(Outside of closing)
Cleaning supplies - for sale of real estate
250.00
110.00
55.72
Rug Doctor Rents - for sale of real estate 20.99
Arnold Fuel Oil Co. lO l. l3
PP&L (after date of death) 47.26
Payments to cleaning people and workers at yard sale 705.00
(S5.00/hr. )
Patriot News - Ads 24.40
TOTAL (Also enler on line 9. Recapitulation) Sl5, 824.50
(If more space is needed, insert additional sheets of same size.)
'.
-'
"V.'S'llhl""
~:~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABLITlES AND LIENS
PI.all Print .r T .
i FILE NUMBER
i 21-95-0636
CC)WIIOHwUlIM o. '.liN.n...."'..
'H""l'''~1 'A' _nul...
t"IO,""OICIOIHI
ESTATI Of
DOLORES E. FOREMAN
N~W:ER I DESCRIPTION
1, The Milton S. Hershey Medical Center
(balance after insurance)
AMOUNT
21.00
2. East pennsboro Area School Taxes - 1995-l996
534.48
l29.60
173.00
20.03
16.04
3. East Pennsboro Township - sewer
4. AZ Ritzman
5. Bell Telephone
6. PP&L
TOTAL (Also enl.r on line 10. Recapitulolion) 5
(II more 'poce is need"d, insert additional sh"" o( lome sin}
.-~---~-"'._"'-"" . .-..~_.-._~, .,.....
~ ~ ~...... -- '~i~
Rav.IOU IX> 17oI~1
COMMONWEALTH OP PENNSVLVANIA
INHERITANr.E TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "J"
BENEFICIARIES
DOLORES E. FOREMAN
FILE NUMBER
2l-95-0636
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARV
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
1,
A, TI)(lbll B8<lulSts:
Vickie J. Minich (Jones)
35A Miller's Gap Road
Eoola, PA 17025
(deceased 8/29/95)
daughter
100%
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARV
AMOUNT OR
SHARE OF ESTATE
B. Chari tabla and Govarnmental Baquam
1.
None
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also en1l!r on Una 13, Recapitulation)
$
o
. .
..
,:/
LAS'!, WILl.. AND TES'l'AMli:NT
OF
DOLOnES Ii:. FOnlJ:MAN
I, 'DOLOnES E, FOREMAN, oC Palmyra, Lebanon County,
Pennsylvania, being oC sound mind, memory and understanding, do make and
publish this my Last Will and Testamellt, hereby revoking and maktng void
all Cormer Wills by me at any time heretoCore made.
ITEM I.
I give, devise and bequeath all oC my estate wheresoever
sHuated to my beloved husband, Richard Foreman.
ITEM U.
IC my said husband Calls to survive me, then I give, devise
and bequeath my entire estate to my daughter,' Mrs. Vickie J. Minich oC
R. D. //4, Mechanlcsburg, Penllsylvanln.
ITEM III. I nominate, constitute and appoint as Executor oC this my
Last Will and Testament, my said husband, Richard Foreman. . IC ho be unabl
to act or continue to ad as Executor, then I appoint In his place my daughter,
Vickie ,T. Minich.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
lfill'day oC 1/ f'tC Ii..- , 1974.
1fJ~ 0 ,-:jh~_
.
The preceding Instrument identlCied by the slgnatul'e of the Testatdx,
was on the date thereoC signed, published and declared by DOLOnES E.
FOREMAN, the Testatrix therein named, as and Cor her Last Will, in the
. . . ,.
~
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"
pr080neo ot Un, who nt hor 1'oquonl, In hnl' pl'osoneo nnd In tho pI'osoneo ot
oaeh oLhol', havo subscrlbod OUt' nRmon nR wlLnon80R horolo.
1'osldlng nt
I~
~ ,2 IA.<.~~~. rosldlng at
M.~~.- . A~1:tz~. Ii( ,/ 'J l\ .J c;. .
rosiding at
t';
.., ... .... .. ~ .... - .
-. .._.. .--.-. ---.-.-...--" ....-
... - ---. -.-. ..~- .......- .._,.,,~
WALLET DEBORAH K
24 N 32ND ST
& ACN ED
ASSESSMENT AMOUNT
CONTROL
NUMBER '1
.
.Lvi .~,40.L .0.1 .' \ '
c.
RECEIVED FROM,
CAMP HILL, PA 17011
UTATE INfOR.W.TION,
!lIlNUMER
51 21-1995-0636
m NAME Of DECEDENT (lAST)
~ FOREMAN DOLORES E
II DATE Of PAYMENT
EI POSTMARK TE
COUNTY
saN 177-24-:51 02
IfIRST) IMI)
"
CUMBERLAND
DATE 0 DEATH
SEAL
JAMES A PRIAR
C/O DEBORAH K WALLET ESQ
CHECKtI 24
fa TOTAL AMOUNT PAID
-S,',01.61
DO
REMARKS
REGISTER OF WILLS
/I ' '
l ,,; fJt(M1l~ 1~V
/ , I
;,ttV/.)/' -(_
MARY C. LEWIS . r
REGISTER OF WILLS
f
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Inventory 01 the reel and personsl oslato 01
DoloroB B. Forolllnn
decoased
1. Real property - 95l WertzvillB Road, Enola.
cumberland County, PennBylvania l7025
(Based upon net procoeds from sBlo - HUD-1
attached)
2. Dauphin DepoBit
Checking Acct. H54-15624-6
66.788 03
1,783 59
3. Cash in possession of Decedent
268 00
l,OOO 00
4. 1986 Ford Crown Victoria (Fair condition, l28,OOO miles)
5. Furnishings and misc. personal property - proceeds from
actual sale
2,36l 85
6. Clothing and misc. personal property donated to
Salvation Army
o
280 00
275 00
35 00
7. Old coins - based on actual sale
8. Social Security check
9. Penn State Medical Center - refund
lO. Refund from Pennsylvania - Tax Rebate
ll. Newspaper refund, cable refund
500 00
71 56
49 lO
l2. Auto Insurance refund
- '5i!:
- ';";
o(/)
<03 0 ~3 .
o. ~ '8
I:';:
015 "f ..
r'
.j "'0
"t.' ..... ~ Uj
t1' l~)
0", .. ii3
~'g' ~ ~~
a: a: .9!
0
TOTAL
73,4l2 l3
COMMONWIALTH 01' .INNSYLYANIA
COUNTY 01' CUMIIRLAND
III
,lnmOB A. Prlnr
Bworn__.. ___ .ccorellnv 10 I.w, elopo... .nel '.Y' Ihot h. .J.u_AdmilliIlL.rllLor .DUNC'1'^
.___.___..__._ .___.._ .. _ __. 0' Iho E.I.I. 0' ___Uo.lcma-l::._FO.l:QlllAl1_.__
1.1. 0' __. .EIlIIL Ponnebor.o 'I'ownehj P . __ ____ _, Cumborl.nel Counly, P." eI.c....eI .nel Ihot thl
wllhln I..n Invlnlory m.eI. by ........__._......Jl1mD8_A.. l'riAr_ ......._, Ihl ..lei AdmlnlBtrator
0' Ihl Intlr. ..1.1. 0' ..lei ellclellnl, eon.htlnv 0' .11 Ihl p""on.1 proll.rly .nel r..1 ..1.11, .'Clpt r..1 ..t.t. oulllell
thl Commonw..llh 0' P.nn.ylv.nl., .nel Ih.I Iho IIvuro. oppo.lI. o.ch lI.m 0' tho Invlntory rlpro..nt II'. f.lr v.lul
.. of thl eI.I. of ellcleI.nl'. eI..lh. . ".~'=:-J
A.v.MkA. .nel .ub.erlb.eI b.for. m., (/ . ''0 -. ~ .
E..eut., . ""mlnhh.for
bllng eluly
'.
f4
19 <1 "
NOT l!EAl.
leRYF. CXl'm:. NCIIffft F\JllUC
~ lWP, DJlil8VM)OO
Ml'CiOMIIISSIllNEXl'IreJoUNE 17, IIJ!lIl
._ 72 B _E.orge Road
CarliBle, PA l70l3
Addr...
0.11 of OI.Ih
04
07
95
Ooy
Month
v..,
INSTRUCTIONS
I. An Invlntory mull bl fll.eI withIn thr.. month. .ftor .ppolntm.nt of po"on.1 ropr...nhtlvo.
2. A .upplom.nt Invonlory mull bo filoel wllhln Ihlrty eI.y. of ell.eovory of .elelltlon.1 .......
3. Aelelltlonol .hooll moy bo .tt.choel os to por.on.lty or ro.lty
4. S.o Artlcl. IV, Fleluclorlos Act of 1949.
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K. WALLET
24 N, '3200 Slim
Camp Hili. PA noli .
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IN TilE ORPHANS' COURT DIVISION
OF TilE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
;
l;'
{,
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~..
ESTATE OF DOLORES FOREMAN, DECEASED
No. 1995-00636
,
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Ills,;
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15:" OCt "
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~he cl'i1:umtllJ~ses leading up to the execution of this instrument are as follows:
~<
r
APPROVAL OF ACCOUNT, WAIVER, RECEIPT
RELEASE AND AGREEMENT OF INDEMNITY
1. Dolores Foreman died on July 4, 1995, leaving a Will dated April 15. 1974,
naming Richard Foreman, husband, as Executor.
2. Richard Foreman died on February 25, 1989.
3. The Will named Vickie J, Minich, daughter, as alternate Executrix in the event of
Richard Foreman's death or other inability to perfonn the Executor's duties.
4. Vickie J. Minich renounced her right to administer Decedent's Estate and is now
deceased,
5, Subsequent to Vickie J. Minich's renunciation, James A. Priar, brother of
Decedent, was granted Letters of Administration D.B,N,C.T,A. on August 25, 1995.
6. It is the desire of the Administrator of the Vickie J. Minich Estate that the
Foreman Estate be distributed without the fonnality of a court proceeding in order to save
the expense, publicity, and delay incident to such court proceeding, and the Administrator
D.B.N.C.T.A. is willing to make such distribution upon the execution of this instrument.
7, An account of the administration of the Estate of Dolores Foreman has been
prepared by the Administrator D.B.N,C.T,A. A copy is attached hereto.
8, In consideration of the foregoing, the undersigned hereby:
A. Itel1resel1ls nnd wnrrUl1ls thut he hus reud und IInderstunds Ihls Instrument
und tlmt the fuets set forth uhove ure Inte IInd correct to the hesl of his knowledge,
infonnatlon and belief;
B, Declares that he hus examined Ihe uunched IIccount of the IIdminlstratlon of
the Estate and the attached schedule of dlstribulion; that he tinds them to be true and correct
In all particulars; Ihat he accepts and IIl1proves them as if they had heen duly tiled, audited,
adjudicated and continned absolutely by the Orphans' Court Division of the Court of
Common Pleas of Cumberland County, nnd as if the amounts shown liS distributable had
been duly awarded to him;
C. Waives the tiling and auditing of the account of the administration of the
Estate in the Orphans' Court Division of the Court of Common Pleas of Cumberland County,
and agrees that the Orphans' Court Division of the Court of Common Pleas of Cumberland
County may by its decree confinn the account and approve the schedule of distribution;
D. Requests the Administrator D,B.N,C,T.A. to make distribution of the
principal and income in accordance with the schedule of distribution, and cffective upon
delivery to him of the amounts shown as respectively distributable, acknowledges receipt of
such property;
E, Agrees to refund to the Administrator D.B.N,C.T,A. any amount which
may at any time be detennined to have been an erroneous distribution to him, regardless of
the cause of such erroneous distribution, even if attributable to negligence, and agrees that
any period for the limitation of actions for the collection of any erroneous distribution shall
commence only at such time as the Administrator D.B,N.C.T,A. shall have obtained actual
:<
knowlcdgc of such erroncous dlstrlhutlon nnd tlmt In till cvent shnll the period for collcctlon
'/i
of nny crroncous distribution be Icss thnn two YCllrs nftcr thc nctunl dlscovcry thcreof;
F, Absolutely nnd Irrevocnbly remlscs, relcnscs, qultclnlms nnd forcver
dlschnrges Jnmes A, Prinr, Indivldunlly nnd In his cnpncily as Administrator D.B,N.C.T.A"
from any and all actions, suits, pnymcnts, accounts, rcckonlngs, lIabilitlcs, claims and
demands relating In any way to the administration of the Forcman Estate;
G. Agrees to indemnify and hold harmlcss, to the extent of the funds received
by him hereunder, James A, Priar, individually and in his capacity as Administrator
D.B.N.C.T.A., from and against any and all claims, loss, liability or damage (including
legal fees and costs in connection therewith) which he may suffer or to which he may be
subjected by reason of his administration of the Estate, the settlement of his Administrator's
account and the distribution of the assets of the Estate without having the formal approval of
the Orphans' Court Division of the Court of Common Pleas of Cumberland County,
Including, but not limited to, any liability for any federal estate tax, Pennsylvania inheritance
tax or any other death taxes, together with interest and costs incidental thereto, relating in
any way to the Estate; and
H. Declares It to be his intention that this instrument, consisting of three
pages, shall be governed by the law of Pennsylvania and shall be legally binding as an
agreement under seal upon him and upon his heirs, e
W A E MINICH
Administrator of the
Estate of Vicki J, Minich-Jones
ba~
V)H-~
D.~, ;;2-1 ~ qf"
-3-
'~.":!t..1":tY~''!F_~<:-,,.;:'\~t~~~71~-~!~~~,;1~:~~_g~.;,~m.. .'
SUMMARY 01<' ACCOUNT
EiIu.
Cllrrent
Vallie
Fidllciary
Acqllisition
Vallie
Proposed Distribution to
Beneficiary 7 $59,478.76
PRINCIPAL
Receipts 2 -0- $73,537,13
Net Gain/Loss on Sales or 3
Other Dispositions
Less Disbursements
Debts of Decedent 3 310.17
Funeral Expenses 3 1,783.59
Administration Expenses 4 2,263.00
Federal and State Taxes 4 3,451.61
Fees and Commissions 5 7.250.00 15.058.37
Principal Balance on Hand
$58,478.76
INCOME
Receipts
Less Disbursements
Income Balance on Hand
Balance Before Distribution
5
$ 1,000.00
0.00
1,000.00
59,478.76
$59,478.76
Combined Balance on Hand
RI~C";IPTS 01<' I'RINCIPAI,
Assets Usted In Inventory:
(Value as of Dllte of Oellth)
Fiduciary
Acquisition
)lalue
Cash and Bank DeDoslt:
Dauphin Deposit
Checking Account #54-15624-6
Cash in Possession of Decedent
$1,783,59
268,00
$ 2,051.59
Checks Pavable to Decedent:
Social Security Check
275.00
275.00
Tamllble Personal ProDeliy:
1986 Ford Crown Victoria
(Fair condition - 128,000 miles)
1,000,00
FurniShings and miscellaneous
personal property (proceeds from actual sale)
2,361.85
Clothing and miscellaneous personal
property donated to Salvation Anny
-0-
Old coins (based on actual sale)
280,00
3,641.85
Realtv:
951 Wertzville Road
Enola, PA 17025
(Based upon net proceeds from sale)
66,788.03
-1-
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
Real PrODertv:
951 Wertzville Road
Enola, PA 17025
Fiduciary Acquisition Value
Sale - December 28, 1995
$66,788,03
$66.788,03
0,00
TOTAL GAIN
0.00
DffiB~EMENTOFPRlNCWAL
Debts of Decedent:
06/24/95
06/24/95
08/03/95
08/04/95
08/30/95
10/21/95 .
Bell Telephone
A.Z. Ritzman
PP&L
East Pennsboro Township Sewage
PP&L
University Hospitals
20.03
173.00
9.67
80.10
6,37
21.00
$310.17
Funeral Exoenses:
07/07/95
Richardson's Funeral Home
(Partial payment of funeral bill)
1,783.59
-3-
Administration Ellnenses:
08/25/95 Probate Fees - Cumberland County 163,00
Register of Wills
09/13/95 Steve Tobias - Painting 400.00
09/16/95 Debra Wallet - Miscellaneous expenses 19,46
09/25/95 Patriot News - Yard sale ad 12,40
10/02/95 PP&L (After date of death) 10,17
10/07/95 Rug Doctor Rents (For sale of real estate) 20.99
10/07/95 Cleaning supplies 46.17
10/10/95 Cleaning supplies 9.55
10/21/95 East Pennsboro Township Sewage 49.50
10/28/95 Patriot News - Ad for furniture sale 12.00
10/31/95 PP&L 14.35
11/09/95 Karen Priar - Cleaning & yard sale 180.00
11/09/95 Linda & Larry Eslinger - Cleaning & 115.00
yard sale
11/09/95 John & Diane Butina - Cleaning & yard sale 220.00
11/09/95 PaUi-Jo Priar - Cleaning & yard sale 100.00
11/09/95 Billy & Debra Morgan - Cleaning & 65,00
yard sale
11109/95 Marilyn Priar - Cleaning & yard sale 25.00
11109/95 Louise & Lois Bishop - Cleaning & yard sale 400.00
11/21/95 Arnold Fuel Oil Co, 101.13
12/03/95 PP&L 9.37
12/03/95 Real Estate Environmental Service - 110.00
Water testing
12/30/95 Bank Service Charge 6.00
01/09/96 PP&L (Final bill) 13.37
04/04/96 Filing Inheritance Tax Return & Inventory 25.00
/ /96 Reserve - James Priar - postage, mileage, 55.00
parking, long distance, reimbursement
/ /96 Reserve - Filing Fee - Family seulement 50.00
agreement
/ /96 Reserve - Balance of Miscellaneous expenses 30.54
Debra K. Wallet $2,263.00
Federal and State Taxe.~:
04/03/96 PA Inheritance Tax 3,401,61
Reserve - Fiduciary Income Tax 50,00 3,451.61
-4-
Fees Blld COIIIIII'uIOlI,;
10106/11'
IIn:olllnn nonllJaIRlo A/l/ltnl.nl
J>ohm K, Wnllol, IJaq,
JOlllo. A. Ilrlnr, Atlllllnl.,rRlor'. fCll
(Jlon' CnlWII Vlctorln . In"nrtlnl
.nllsli1cllllnllf AtllIIllIl.,mlor'. foo)
7,250,00
250,00
3,000.00
3,000,00
l,OOO,OQ
IlIllln:lt:
RRCruPTS OF INCOME
I'Ne IIl1l1k
CD IlI/NIIIIICd '2/28/11'
$60,000 II) MOW.
IlIloroS"1I AllrU30, 1996
1.000,00 .
TOTAL RECnWTS OIIINCOMIl
1,000,00
J)JSTRIDUTION TO BENEFICIARIES
TO: ESTATE or VICKIE MINICH-JONES
clo Wnyne Minich, Atlrnlnlslrnlor
100%
59,478,76
TOTAL DISTRlDUTION TO BIlNErICIARY:
$59;478.76
JAMES A, PRIAR, Administrator D,B.N.C,T.A. of DOLORES E, FOREMAN,
deceased, hereby declares under oath that he has fully and faithfully discharged the duties of his
office; that the foregoing First and Final Account is true and correct and fully discloses all
significant transactions occurring during the accounting period; that all known claims against
the Estate have been paid in full; that, to his knowledge, there are no claims now outstanding
against the Estate; and that all taxes presently due from the Estate have been paid.
I verify that the statements made in this affidavit are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. ~ 4904 relating to
unsworn falsification to authorities.
{'--Y:H-
JAMES A, PRIAR, Administrator D.B.N.C.T.A.
-6-
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REV-1547 IX AFP (IZ'95)*_.[..,~
[Df'HONWI Al III u' "I """1 VA"I' ACN 101
""'"''''"' ,. "'V".. NOTICE Of INItERITANCE TAR
11M. AU Of IHlllVIllUll lUll A"""AUEHEHT f ALLOWANCE OR DISALLOWANCE
:~:':i,:~~::lr. III"'''' Of DIDUCT!ONI AND AlSESSHENT Of TAR DATE 07-22-96
kaTATI 01' rlllf'rRAN .. FILE NO.
DATI OF DIATH 07-04-9S COUNTY CUMBERLAND
NOT! I TO INIURE rRorER CREDIT TO YOUR ACCOUNT, IUBHIT TIlE urPER PORTION Of TNIS fORIt WITH YOUR TAR
rAYHrNT 10 TIlE RrOlllER Of WILLI, HARE CIIECR PAYABLE TO "REOISTER Of WILLS, AOEIIT"
REMIT PAYMENT TO:
DEBRA K WALLET ESQ
24 N ~2ND ST
CAMP IIILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A..ount R..Hl.d
CUT ALONO THII LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ....
iliV: lait..., .i'l(.;.~p-Clz:nnjii,(ici.-ciF""iNHiil-ifAijci-YAx-iipPRA-iiiii1E"ii'r;-,U,'LOwANci-iili-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
IlITATI OF FOREMAN DOLORES E FILE NO. 21 95-0636 ACN 101 DATE 07-22-96
APPROVED DEDUCTIONS AND EXEMPTIONS I
15.824.50
.. Fun.ral E.pan.../Ad.. Co.t./H1Ie. E.pan,.. CSch.dul. H) (9)
la, Dobh/Hortgogo Lloblllt1../Llona IS.hodulo II 1101 894,15
ll, Totol DoducUona Illl
12. H.t Valua of T.~ R.turn (12)
IS. Charitabl./Govarn.ental Bequa.t, (Schedul. 4) (13)
14. Hat V.lua of EIt.t. SubJect to Tax (14)
NOTEI If an a.....mant was i..uad praviou.ly, linaa 14, 15 and~or 1&, 17 and 18 will
reflact figuraa that include the total of Ahh raturna aaaaaaad to data.
ASSES8MENT OF TAXI
15. A.ount of Lin. 14 .t Spou..l rat. US)
16. A.ount of Lin. 14 t.~.bl. .t Lin..l/tl... A rat. (1&)
17. A.ount of Lin. 14 t.~.bl. .t Coll.t.ral/CI... a rat. (17)
18. Principal T.~ Du.
TAX CREDITS I
PAYHENT
DATE
04-04-9
TAM RETURN WAS' C X I ACCEPTED AS fILED
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED aNI ORIGINAL RETURN
1. RooJ ratoto ISchodulo AI III
2. Stackl and lond. eSohedul. 8) (2)
S. Cla..l~ Held stock/Partnership Int.r..t (Schedule CI (5)
4. "ortglg../Hot.. nlaalYlbl. ISchedul. OJ (4)
J. C..h/lank DIPolita/Hila, P.r.on.l Prop.rty (Schedul, EJ (5)
.. Jointly Owned ProPlrty (Sch.dul. f) (6)
7. Tranlf.". .Sch.dull OJ (7)
8. Tot.1 A...t.
RECEIPT
NUHBER
AA1l2699
DISCOUNT 1+1
INTEREST I-I
,00
I CHANGED
66,788.03
.00
,00
,00
6,624.10
. .00
,DO
181
73,412,13
H.71R 6~
56.693.48
.00
56,693.48
.00 R'OO.
56.693.48 R ,06.
.00 R ,15.
1181
.00
3.401.61
.00
3,401.61
AHOUNT PAID
3,401.61
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
3,401.61
.00
,00
,00
. IF rAID AFTER DATE INDICATED. SEE REVERSE
fOR CALCULATION OF ADDITIONAL INTEREST.
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 REfUND. SEE REVERSE SIDE OF THIS FORH fOR INSTRUCTIONS,I
0\ ,- .(
'J t;'~ In.:
t:~ ...., d
, too. ('.
'.1: -'
.t
" 0\
-
, :j
~ \ ~ .,
~ Ot' .,
?> .~'E
roo:
a: u8
RESERVATION a Elt,t.. 0' decedent. dying on or blfor. O.c.-o.r 12, .9.Z .. l' any future In'.r..t In thl I,'et. I. tran,'.rr.d
In pa......on or IInJovlent to CI... . (coU,t.r.U ben.flal.rl.. of thl cMiudant ,ft.r thl Ixplnt10n of any ..hte for
II'. or for v..r., thl Co..onw..lth heteby axpr...lv r...tVI. the right to .,p,.,I.. ~ ...... tran,'.r Inh.rltancl '1.1.
at the lawful Cl... . (coll.,.r,l) t.t. on any ,uch future Int.r..t.
PURPOSE OF
HOTICEI To fulfill the r.qult...nts of S.ctlon 214D of the Inhadtanea and E.t,t, T.. Act, Act ZZ of 1"1. 72 P.S.
SICtlon 21,.D.
PAvtlfNTI Dallch the top portion of thh Notice and ,ub,1t with your ply.ent to thl R.gl.t.r 0' Wllh ptlntad on the nv.r.. .Ide.
.~"Ilk. chick or ."IV order plyabll tal REGISTER OF MILLS.. AGENT
AU plvunh nCllvad .hall flr.t ba appUad to eny Int.n.t which ..w b. d~ ..lth any r...lndar appUed to thl ta..
REFUND (CR)I A r.fund of . t.. cradlt, ..hlch .... not r.qu..tad on the T.. R.turn, "W ba r.qu..tad bw co.pl.tlng .n "Appllc.tlon
for R.fund of Pann.wlvanla Inh.rltanc. and E.t.,. T.." (REY-15U). Application. .r. .v.llabl. at the Dfflc.
of the R.gI.t.r of Will., any of the 2S R.v.nul DI.trlct Offlc.., or bw c.lllng the ,plclal 24ahour
an.w.rlng ..rvlc. nuabar. for for.. ord.rlngr In P.nn.wlvenl. 1-800-162-Z050, out.ld. P.nn~lvenla and
..Ithln 10c.1 Hlrrl.burg .r.a (111) 717a8094, TOOl (111) 772a2252 CH.arlng Iap.lr.d OnlwJ.
OBJECTIONS I Any p.rtw In Int.r..t not .,thlled with the .ppr.I....nt, .Ilo..anc. or dh.llo..anc. of daductlon., or .......ent
of t.. Clncludlng dl.count or Int.r..t) a. .hown on thl. Notlc. au.t obj.ct within .I.tw C60J daw. of r.c.lpt of
this Notlc. by I
..awrlttan prot..t to tha PA nap.rb.nt of Rav.nua, Bo.rd of App..". n.pt. Za1021. H.rrlsburg, PA 17128"1021, OR
--.Iactlon to he". the ,athr d.tar..ln.d at eudlt of the .ccount of the par.onal rapr..antntlva. OR
....app..l to the Orphan" Court.
AD"IN
15TAATlVE
CORRECTIONS I
factu.l .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tOJ PA nap.rt.ant of Revenu.,
Bur.au of Individual 'a..., ATTNI po.t A.......nt A.vl.w Unit, n.pt. Za0601, Harrl.burg, PA 1712aaD601
Phonl el11) 181-6505. 5.. pIg. 3 of the book"t "In.tructlonl for Inheritance r.. R.turn for. R..ldent
D.c.d.nt" (REYaISOI) for .n ..pl.n.tlon of ad,lnl.tr.tlv.ly corr.ct.bl. .tror..
DISCOUNT,
If any taM due 11 p.ld within thra. (S) cal.nd.r eonth. .ft.r the d.ced.nt'. death, . flv. p.rc.nt C5X) dhco\.W\t of
the t.M paid I. .llo...d.
The 15X taM .~.ty non-p.rtlclp.tlon p.nelty I. co.putad on the total of tha t.. and Int.r..t .......d, and not
paid b.for. Janu.ry la, 1996, tha flr.t d.y after the .nd of the t'M ean..ty p.rlod. Thl. non-p.rtlclp.tlon
pen.lb 11 .pp.alable In the .... .anner and Jn the the .... ti.. perIod a. YOU would app.al the t.. and Int.r..t
thet ha. b.an .......d .. Indlc.t.d on thl. notlc..
PENAL TV J
INTEREST I
Int.r..t I. chlrgld b.glnnlng ..Ith fJr.t dey 0' dellnqu.ncy, or nln. C'J lonth. and on. (1] d.y frol the data of
da.th, to the d.t. of p.y..nt. T..a. which bac..a dallnquant b.fora J~lry 1, 19az ba.r int.r..t at the r.t. of
.IM C6lU perunt par annuli c.lculated at . d.Uy tIIh of .000161,. All ta... which baca.. dell"""ant on and aft.r
Janu.ry 1, 19az will ba.r lnt.r..t .t . rat. which will vary fro. caland.r y.ar to calandar ye.r with thlt rat.
announcad by the PA Dap.rt.ant of Rav.nu.. Tha appllcabl. Int.r..t rat.. for 19aZ through 1996 .r'l
!!!r Intera.t "ate Dallv tnt.ra.t Factor :!!!r Int.re.t Rat. O.llY Intar..t Factor
19a2 ZD~ .000541 19a7 .~ .0DDZ41
1915 ..~ .0004S1 19aa-I991 11:,( .OOUDI
1914 11~ .00UOl 1992 .~ .000241
1915 13:< .00USS6 1993-1994 7X .000192
19a6 10:,( .000Z74 1995-1996 'X .000Z"1
--Inten.t I. calculat.d .. 'ollowlI
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice I..ued aftar the t.. baco... dellnquant ..Ill raU.ct an Intar..t calcul.tlon to flft..n (5) day.
bayond the data of tha ........nt. If ply.ant I. .ad. .,t.r the lntar..t co~ut.tlon data .hown on the
Notlc., Itddlt1on.1 lnter..t w.t ba cllcul.tad.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Dolores E. Foreman
Date of Death: July 4, 1995
will No.
1995-006J6
Admin. No. 2l95-06J6
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 estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
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 informal.ly 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: 5''J"q~
I...OMIla -l'. W~
Signature
0'\
'0 en ':<r -g~
0;> "" 8.
:f"i> ~ 0
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c,'o co I.
"t:.i '_ N I., -0
(1.; u >- .1 ,-.;
o ti :.2 ';'
0':'';' ( . ",
o <V ~ .,.:~
Q)a: - c:
a: ~8
(MAH: rmf/ AMJ)
Debra K. Wallet, Esq.
Name (Please type or print)
24 N. 32nd Street
Camp Hill, PA l70ll
Address
( 71 ~ 7J7-l300
Tel. No.
Capacity: Personal Representative
X Counsel for personal
representative