HomeMy WebLinkAbout95-00801
PETITION FOR PRonATE and GRANT OF LETTERS
No, (). I - I q q 5 - <is 0 I
To:
Estate of Richard A. lIo1sberg
also known as
Reglsler of Wills for Ihe
Deceased, COlllllY of CU~lImlll,ANIJ In Ihe
Social Security No, 19 Ii -14 - 3 Ii f 5 Commonweahh of Pennsylvania
The pelitlon of Ihe undersigned respectfully represenls thai:
Your pelitloner(s). who Is/arc 18 years of age or older an Ihe exeeut 0 r
In the last will of the above deeedelll, daled October 2
and codlell(s) dated
named
,19~
(Illite relevant clrcllmSIIlRCC5, e.,. renunciation, denlll or e,cCUlor t ctc.)
Deeendent was domiciled at death In Cumberland
h ; " last family or principal residence at 4114 Rosement
Allen Township
(lbt streel, number Bnd munclplllhy)
Decendent,thell 73 ,yearsofage,died , October 20 ,19 95
M Universitv HOsPltal, Hershey Medlcal Center, Hershey, PA ,
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the wIll offered for probate; was not the victim of a killing and was never adjudicated
Incompflent: None.
Decendent at deatt. owned property with estlmaled values as follows:
(If domiciled in Pn.) All personal property S 1 "000. 00
(If not domiciled in Po.) Personal property In Pennsylvania S
(If not domiciled In Po,) Personal property In County S
Value of real estnte in Pinnsyl\'llnla S l B , U U U . U U
situated lIS follows' 4 14 Kosemont Avenue, Lower Allen '!oWIll,hlp,
Cumberland County (Deed BOOK J-j4, rage b~~l 11/3 Interest)
County, Pennsylvania, with
AvenUe, Lower
WHEREFORE, petltloner(s) respectfully
presented herewith and the grant of leners
theron,
request(s) the probate of the last will nnd codlcil(s)
testamentary
ttcSlDmenlary; admlnhtrallon C.I.II.; o.dmlnlsmulon d.b.n.c.t.II.)
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Scot R. lIolsberg
4114 Kosemont Avenue
Camp Hill, PA 17011
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }::IS
COUNTY OF ~illJLE;BJ!AND
Sworn to or affirmed and SUb'.C;i.bed {
before me lhis 24t1L._ d:\j50f\
"~~ '3.721/i'l ({)
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R CLEWiS ^:; egls!er
/6- &'.3- ~ ' pf fLLC'I-
The petluonc,"is) above-named swe~r(s) or arlirm(s) that the statements in the foregoing petition are
true and c.:>,reet to the best of the knolYledge nnd belief of pethloner(s) and that os personal represen-
tatlve(s) of the above decedent pethlon~r(s) will well and Iruly administer the estate according to law.
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No 21-95"801
.
EsIDle of
RICHMD A. 1I0LSBERG
, Deceased
DECREE OF PRODA TE AND GRANT OF LETTERS
AND NOW OCTOBER 26 19...Jli.,., In consideration of the petltfDn on
the reverse side hereof. satfsfactory proof having been presented before me,
IT IS DECREED that the Instrumenlls) dated October 2. 1989
de.lcrlbed therein be admllled 10 probate and /lied of record ILl the flLlt will of
Richard A. Holsbero
and Lellers Tes tamen ta rv
are hereby granted to Scot R. Holsberg
MARY C.
'--{ltr'li Y (1, ~1I~.....tI--'-fJ ".J../t'fn,,_~lUuJ
LEWI, . "R Il<rorwuls iJ<Jf1/dy.-
FEES
Probate. Lellers, Etc. ......... S 60.00
Short Certlficates(8) .... , . . . " S-fi-:-B&
1;r2g8~ftn ................ $ .
JCP S 5.00
TOTAL _ S 110.00
Filed ..9~'t?'~~'~1'~~.t. .f.~?~..... I I...
Norman P. Hetrick, Rsq. '(66884)
ATTORNEY (Sup, Ct. I,D, N...)
10 S. Market Sq., Suite 500
P.o. Box 1265. Harrisbura PA 17108
ADDRESS
l 717) 236-9581
PHONE
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LETTERS AND ORDER MAILED TO ATTORNEY OCTOBER 27th, 1995.
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FIFTlh If either of my sons shall have predeceased me,
the share that otherwise would be distributed to the prede-
I i ceased son of mine shall pass instead to the issue of the
I: predeceased son who survive me, per stirpes and not per
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I i SIXTH: I f a son of mine predeceases me leaving no
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,; issue or if no issue of such son survive me, the share which
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issue shall instead be distributed to my surviving son.
SEVENTH: I nominate, constitute and appoint my son,
SCOT R. HOLSBERG as the Executor of this my Will. Should he
be unwilling to serve or should he be unable to serve for
any reason, then I nominate, constitute and appoint my son,
KURT K. HOLSBERG as Executor of this my Will.
EIGHTH: I confer on my Executor and successor Executor
in addition to those powers granted by law, the following
powers to be exercised in a prudent manner and applicable to
all property constituting a part of my Estate:
A. Power to Invest: To retain and to invest in all
forms of real and personal property, regardless of any
limitations imposed by law on investments by fiduciar-
ies, to exercise all the rights ordinarily belonging to
the owner of or investor in such property, to register
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investments in the name of a nominee and to keep such
property in such good order and repair as they deem
expedient.
B.
Power to Sell, Lease, Mortgage, etc. To sell at
public or private sale, to exchange, to mortgage, to
lease or to extinguish any mortgage, lease or loan for
any period or periods of time, to repair, alter and
improve any real or personal property upon such terms
as to cash, credit or options as they in their sole
discretion may deem appropriate and to do all things
necessary or ordinary in achieving these ends, without
liability on the part of any third party to see to the
application of the funds given therefor.
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C. Power to Borrow, Pledqe and Compromise. To borrow
money from any source or sources, to pledge any assets
as security therefor and to compromise claims.
D. Power re Administratj,ve Expenses. To treat adminis-
trative expenses either as income tax or as estate tax
deductions, without regard to whether the expenses were
paid from principal or income, and without requiring
reimbursement.
E. Power to Distribute, Allocate and Value. To make
distributions in cash or in kind or partly in each, to
allocate property to persons entitled thereto and to
fix the value of property.
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NINTH:
Any Trustee, Guardian, Executor, their succes-
in this my Will or during the administration of my estate,
shall be excused from posting bond in all jurisdictions
regardless of any law or rule of court to the contrary.
TENTH: All gifts of any kind herein made shall be
delivered directly to the beneficiaries free from anticipa-
tion, alienation, assignment, attachment, and pledge, and
free from control by the creditors of any such beneficiary.
Such gifts shall not be subject to the assignment or antici-
pation or pledge by the beneficiary, or to execution, attach-
ment, or any other process for the enforcement of judgments
or claims of any sort against them.
ELEVENTH: All inheritance, estate, succession or trans-
fer taxes, whether State, Federal or otherwise, or any other
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tax in the nature thereof, which may be payable by reason of
my death, shall not be apportioned but shall be paid, togeth-
er with any interest or penalties, out of my residuary es-
tate as if such taxes were administration expenses.
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SIGNED, SEALED, PUBLISHED and DECLARED by the above-
named Testator, RICHARD A. HOLSBERG, as and for his Last
:1 will and Testament, in the sight and presence of us, who, at
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II his request, in his sight and presence, and in the sight and
I presence of each other, all being present at the same time
iI have hereunto set our hands as witnesses.
II
I' Name J!; df.lA/l( ci-;/N1111/1
Residing at \7/tl'f to! /tlt/~urt'P/ t!4.
pJ4/!H ~f .,.J;/
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Name
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Residing at .2.178' ~ f)A..
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Residing at '1l(:r !l/~";:kd /1.;.
d~IJJ.,A. 12. (7(('2
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I COMMONNEALTH OF PENNSYLVANIA
i COUNTY OF
SS
I, RICHARD A. HOLSBERG, Testator, whose name is signed
to the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I
I' signed it willingly; and that I signed it as my free and
I voluntary act for the purposes therein expressed.
~~UI- /.6~ T
RICHARD A. 1I0LSBERG
Sworn or affirmed to and acknowledged before me,
by RICHARD A. HOLSBERG, the Testator,
this (""il.{c{ day of October, 1989.
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My Commission Expires:
HOJAR'IAL SE L /'
JOYCE E, fOHL, NOIIIY Public
H.rrlsburg, O.uphln County, Pa,
M, ~"''''''''on Expire. Sopl, 21, 1992
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F' to':-o \ 'A' -A' :':, -082531 COMMONWEALTH :P' PENNSYLVANIA
NO. . , _ . DlI'AIlTMINT OP RIVINUI .
, _'-" , , .! O.fICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
<'IY.t~IIII'"'' ~ .
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RECEIVED FROM:
D
ACN
ASSESSMENT '!'
CONTROL ...
NUMBER
AMOUNT
HETRICK NORMAN P EBCI
10 S MARKET SQUARE BUTJ E ~O
POBOX S2h:5
HARRISBURG. PA 1710B-S2h:5
Jul
.Jb;;:t."/",d
101.0"'"
ESTATE INfORMATION,
~ fll NUMBER
III 21-1995-0S01
~ NAME Of DECEDENT IIAST)
~ HOLSBERG RICHARD A
m DATE Of PAYMENT
m POSTMARK DATE
COUNTY
BBN 196-14-361:5
(fiRST) IMI
m TOTAL AMOUNT PAID
$lh3.73
VZ
REMARKS
SCOT R HOLSBERG
CIO NORMAN P HETRICK
CHECKlI SOlO
ESQUIRE
REGISTER OF WILLS
RECEIVED BY / 1/./,/,.; l. .
"SIONAl'lU ..-
.....;/1. i
MARY C. LEWIS
REGISTER OF WILLS
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SEAL
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INVENTORY
Estate of:
Data of Daath:
County:
Richard A. Holsberg
10/20/1995
Cumberland
CASH:
Coreststes HDmilton Bank _
Statement Savings Account
No. 6398002553.
8.97
.........--...
8.97
PERSONAL PROPERTY:
....e...__.._._...
Isaac H. DDutrich Trust .
Corestatea Hamilton Bank
Account No. 04.15096.00,
decedent is a one. twelfth
beneficiary of the trust.
Total principal
balance: $317,927.35
Plus accrued
interest: 129.02
$318,056.37
26,504.70
Personalty. Household goods,
furnishings and personal
property.
500.00
Pontiac Crand Am Sedan. 1986,
value per N,A,D.A. Official
Older Used Car Cuido (9/95 .
12/95) .
1,600.00
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28,604; 70
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
FILE HUMBER
Fon OA'UOF ClATltAFlER 12/3"" CHECK HERE
IF A !IPOU!AL
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co...~p,t'~~W,\\'ll/.fI\,'t:'ll'b~.NIA
H'R",oR5~k\l.em",OIO'
1995.00801
COUNTY COOE
OlCEDENTS COMPLETE ADOAUS
4114 Rosemont Avenue
Camp Hill, PA 17011
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OEClOEHrs NAME (LAST, fiRST, AND MIDDLE INITIALI
Holsber Richard A,
SOCIAlSECUAlTYHUMOER
196-14.3615
DAT[ OF DE A'"
10/20/1995
OAT[ OF BIRTH
06/18/1922
Cou"l,
Cumberland
(IF APPL1CADLEIsunVIVlHQ SPOUSE'S NAME ILAST,FlRST AND MIDDLE INITIAL!
lIolsber Muriel 5,
X I. Ortglnal Roturn
4. Urnlod Eol.,o
SOCIAL SECURITY NUMBER
201.16.1140
Y[An
NUMOER
2. Supplomonlal Roturn
4.0 Futuro Inlorest Compromiso
(lor dolo, 01 doolh .her 12-12-B2)
[]] e. Docodenl Died Too'.'o 0 7, Docodonl Malnlalnod . Uvlng Truol
Anoeh co of Will (Anaeh 0 co o!Trust
All. CORRESPOHDENCE AND COHFIDENTIAL TAX IHFORMATIDH SHOULD BE DIRECTED TO:
AMOUtH RECEIVED (SEE: INSTRUCTIONSI
0.00
Aomalnder Return
(lor doloo of do.'h prtor 10 12.13.B2)
Foderal Eelolo Till< Roturn Roqulred
Tolal Number of S.fo Depoall Bo.ea
05,
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COMPLETE MAILlNO ADDRESS
Hetrick, Zaleski & Pierce,
10 S. Market Sq" P,O. Box
lIarrisbur PA 17108.1265
(11
(2)
(3)
(4)
(B)
(e)
(7)
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RR N NAME
D Norman p, lie trick Es ,
& fi 'ELEPHONE NUMBER
- T 717 236.9581
1. Rolli ES1ol. (Schodulo A)
2. Slocks and Bonds (Schedulo B)
3, Cloeely Hold Sloek/Portnorshlp Inlorool (Schodulo C)
4, MoMgagos and Noloa Rocolvoblo (Schedulo D)
5. Cosh. Bonk DopoollS & Mlscollanoouo Poroonol PropeMy (Seh. E)
e, Jointly OWned PropoMy (Schodulo F)
7. Tronlfero (Schodulo G) (Schodulo L)
e. TOllll Groos AGlOlo (Iolal Unoal-7)
8. Funeral Elcpensos, Admlnlstratlvo Costs, Mlscollanoous
Expon,ol (Schodulo H)
10. Dobl., MoMgogo U.biIIUo., Uen. (Schedulo I)
11. Tolal DodueDonl (Iolal Unol 0 & 10)
12. Nel Valuo 01 Ellalo (Uno B mlnul Uno 11)
13. Chorllable and Governmenlal Boquooll (Schedule J)
14. Not Value Sub oct 10 Tax Uno 12 minus Uno 1:J
15, SpoUlal Tranlloro (lor doloo 01 doalh ahor 5.30.04)
500 Instructions lor Applicable Porcontago on pago 2.
(Includo v.luollrom Schodulo K or Schedulo M.)
lB. Amounl 01 Uno 141axablo 015% ralo
(Include valuollrom Schedulo K or Sehedulo M.)
17. Amounl of Uno 141axoblo OIIC% rolo
(Includo voluel from Schedulo K or Schodulo M.)
lB, Principal lax duo (Add lax Irom Uno lC, 10 and 17.)
IB,Crodllo/Sp PoveMy Prior Poymenl!J Dlscounl
+ 163,73 + 8.62
20. II Uno 1910 groolor Ihan Uno 10, onler Iho dlNeroneo on Uno 20. ThIII,lho OVERPAYMENT.
~ 0 IChlck he'elf you a,. reque.Ung I refund of your overpaymentl
21. II UnolB '" gre.'or Ihan UnolB, onlor Iho dlfforonco on Uno 21, This lItho TAX DUE.
A. Enlor tho f"lorost on tho balanco duo an Uno 21A.
B, Enlor Ihototlll 01 Uno 21 .nd 21A on Uno 21B. Thill. Iho BAlANCE DUE.
Mako Ch.ck Po abloto: R. lotor or Willa, A nt
~ ~ BE SURE TO AHSWER All. aUESTIDHS ON PAGE 2 AHD TO RECHECK MATH .. ..
Unll., pln.III" at p"lury, I d.elA,.III.11 h.v. ...mtn.1I Unl "llj,n, ,nChldlllll,cc.omp.nYl"IIIC:Il'dullI,nd 1t&I.m,nt',.nd 10 Ih. bill at my '"owIICl'g. ,nCl' b....f. 11'1 till',
corr.el'nd co",,,I,I..1 d,cLa,.III,I.II'III'II.I. h.. bun npolt.d.1 'ru. "',,'h' v.hll. O,cyrltIO" 01 p"p.'" olh., thl" the p.raonll"p''''l'Iutl''.'1 bA..d on 1111"'0""1110" 01
whlchpl.pl",hUII'I,'nowt.dg,.
44.01
28.613.67
25,338.33
.0.
(e)
(9)
10 , 251. 70
(10)
40,871,82
(111
(12)
(13)
14
(16)
0,00 x
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(18)
2,872,49 X .OB.
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(17)
0,00 X ,IC,
(Ie)
Inlotosl
(19)
(211)
(21)
(2tA)
(2IB)
SIGNATURE OF PEASON AE PON&IBLE FOA FILINQ RETURN Scot R. Holsberg
4114 Rosemont Ave.
c-;'.ni..iiii i.'--PA- - -i joii........ ...... -. - -. ...... -..
lIetrick, Zaleski & Pierce, P,C,
!9..~ ,. ."!'!!"!<_'!~ .~.q". _P.., 9... _~~?<_ .H~.~..............
IInrrlsbur PA 17108 -1265
p.e.
1265
53 , 996,01
51,123,52
2,872.49
2 872 .49
0.00
172,35
0,00
172,35
172,35
0.00
0,00
0.00
0.00
DATE
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DATE
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SCHEDULE F
JOINTLy-oWNED PROPERTY
ESTAT1! OF
Richard A, IlDlsberp;
Jolnl tlnanl(o):
55# 196-14-3615
10/20/1995
FILE NUM8ER
1995-00801
A.
HAME
SCDt R. HDlaberg
ADDRESS
4114 RDsemDnt Ave.
Camp Hill, PA 17011
RELATIOHSHIP TO DECEDENT
SDn
B.
Kurt K. HDlsberg
5340 RepechD Dr.
San DiegD, CA 92124
SDn
c.
Jointly-owned proporty:
LETT1!R DAT1!
ITEM FOR MAOE DESCRIPTION OF PROPERTY TOTAL VAWE DECO'S OOu.AR VALUE OF
NUMBER JOINT OF ASSET " INT. JECEDENTINTEREST
T1!NANT JOINT
1 A 10/01/93 CDrestates HamiltDn Bank - 10,00 50.00\ 5.00
SeniDr Citizen Checking
ACCDunt ND. 63-01032-4,
Dwned jDintly with son,
SCDt R. HDlsberg.
2 A,B 01/18/90 HDuse and lot - 4114 76,000.00 33.33\ 25,333.33
Rosemont Avenue, LDwer
Allen TDwnship, Cumberland
CDunty, Pennsylvania, Dwned
jDintly with SDns, Kurt K.
HD1sberg and SCDt R.
HDlsberg. Deed BDDk J-34,
Page 693, Value per
appraisal Df Karen Smith,
C,M, DDtweiler,
TOTAL 'Also entor Dn IIno 6, RoclollullUonl S 25 338,33
(II molO spaco Is neodod, Insort addlUonaJ shoets 01 semo silO,)
CoPyflghllcIIU4Io,," '011..,. only CP5y.I.",., Inc.
Fo,,,, 1500 Sch.dlll. F (R..... 1:1-111
AEV... tllD U. CI-IFI
cO"lI.\l\lrt.."l~'Ilg1j,'Q~~'N"
ESTATE OF
SCHEDULE G
TRANSFERS
Ple_ Prtn' or e
FILE NUMBER
1995-00801
Richard A. HolaberR SS# 196-14.3615 10/20/1995
TIllS SCH~UIJ! MUST BE COMPLETED AHD FILED IF TIlE AHSWER TO ANY OF TIlE OUESTlOHS OH PAGE 2 IS V1!S,
ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DECO'S DOLlAR VALUE OF
NUMBER Inc."'de nllne 0' Ihellen,"'U, th.lr OF ASSET %INT, DECEDENT INTEREST
'elal,onlh, tadeudln' dlle.'IlIn,I."
1 Lincoln National Life 0.00 0.00 0.00
Inaurance Co. - Annuity
Contract No. 710571,
beneficiaries are the
decedent's sons, Kurt K.
Holsberg and Scot R.
Holsberg. Contract cashed
in by decedent on September
13, 1994, per letter of
Lincoln National.
.
TOTAL (Also onler on IIno 7, ReclPllullUonl . 0.00
(II more spice III needed, InDGr1 IIIddiUonallhoets or lame size.)
COPyrlllht(c)"'" fo,m I.n...r. ani,. CPS,."I"".lnc.
Fo,m 1500 Bc.h.dule Q IAIV. 2-1')
AIY.. tI" IX. 11-"1
ca"I':.\11ft'E'i~~~W~/hYANI.
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILl! NUMBER
1995.00801
Richard A.
ITEM
NUMBER
Halabar
5511 196-14.3615
10 20 1995
NAME AND ADDRESS OF 8ENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
1
A, Taxlble Bequests:
Kurt K. Ha1sbarg
5340 Rapacho Dr.
Apt. Y.I06
San Diego, CA 92124
Son
50. of residue
2
Scot R. Holsberg
4114 Rosemont Avenue
Camp Hill, PA 17011
Son
50. of res1due
3
Barbara H. Long
2674 N. Riviera Dr.
White Bear Lake, HN 55110
Sister
$8,000.00 *
*The estate is insolvent I therefore, the de edent's sister shallot
receive the decedent's bequest to her.
ITEM
NUMBER
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF 8ENEFICIARY
8. Chlm.ble and Governmental Bequel1S:
TOTAL CHARITA8LE AND GOVERNMENTAL BEOUESTS Also enlar on IIno 13, Ree. lIullllon
(II maro spoco Is n..dod, In.." addlUonoleh..lo 01 ooma alzo.)
Cap'f'lght leI ,gU 'a,m .aIlWA'. a"ly CP5)'.'ellll, I"Co
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Fa,m 1500 Schedul. J (R..... 2-")
LAST WILL AND TESTAMENT
OF
RICHARD A. HOLSBERG
I, RICHARD A. HOLSBERG, of Lower Allen Township,
Cumberland County, Pennsylvania, d~clare this to be my Last
Will and hereby revoke all prior wills and codicils made by
me.
FIRST: I direct that all my just debts and funeral
expenses be paid out of my estate as soon as practicable
after my death.
SECOND: I give, devise and bequeath $8,000.00 to my
sister,.BARBARA H. LONG.
THIRD: I give, devise and bequeath all my household
goods and personal effects to my sons, KURT K. HOLSBERG and
SCOT R. HOLSBERG, in equal shares, share and share alike,
particular items to be allocated among them as they decide.
JI
~~
FOURTH: All the rest, residue and remainder of my
estate, of whatever nature and wherever situate, I give,
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devise and bequeath to my sons, KURT K. HOLSBERG and SCOT R.
HOLSBERG, in equal shares, share and share alike.
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FIFTH: If either of my sons shall have predeceased me,
the share that otherwise would be distributed to the prede-
ceased son of mine shall pass instead to the issue of the
predeceased son who survive me, per stirpes and not per
capita.
SIXTH: If a son of mine predeceases me leaving no
issue or if no issue of such son survive me, the share which
would be otherwise distributed to such son or such son's
issue shall instead be distributed to my surviving son.
SEVENTH: I nominate, constitute and appoint my son,
SCOT R. HOLSBERG as the Executor of this my will. Should he
be unwilling to serve or should he be unable to serve for
any reason, then I nominate, constitute and appoint my son,
KURT K. HOLSBERG as Executor of this my Will.
EIGHTH: I confer on my Executor and successor Executor
in addition to those powers granted by law, the following
powers to be exercised in a prudent manner and applicable tc
all property constituting a part of my Estate:
A. Power to Invest: To retain and to invest ir. all
forms of real and personal property, regardless of any
limitations imposed by law on investments by fiduciar-
ies, to exercise all the rights ordinarily belonging to
the owner of or investor in such property, to register
2
investments in the name of a nominee and to keep such
property in such good order and repair as they deem
expedient.
B. Power to Sell, Lease, Mortgage, etc. To sell at
public or private sale, to exchange, to mortgage, to
lease or to extinguish any mortgage, lease or loan for
any period or periods of time, to repair, alter and
improve any real or personal property upon such terms
as to cash, credit or options as they in their sole
discretion may deem appropriate and to do all things
necessary or ordinary in achieving these ends, without
liability on the part of any third party to see to the
application of the funds given therefor.
C. Power to Borrow, Pledge and Compromise. To borrow
money from any source or sources, to pledge any assets
as security therefor and to compromise claims.
D. Power re Administrative Expenses. To treat adminis-
trative expenses either as income tax or as estate tax
deductions, without regard to whether the expenses were
paid from principal or income, and without requiring
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reimbursement.
E.
Power to Distribute, Allocate and Value. To make
distributions in cash or in kind or partly in each, to
allocate property to persons entitled thereto and to
fiy. the value of property.
3
COMMONWEALTH OF PENNSYLVANIA
SS
COUNT\' OF
We, /.1Im),!4- .4 Ill/l/lr.J
and ,4~/.u".." P MIJ.
signed to the attached or foregoing instrument, being duly
,
(j)Ol1o~ 1'1\, t3,,1'\ t~
, the witnesses whose names are
qualified according to law, do depose and say that we were
present and saw the Testator, RICHARD A HOLSBERG, sign and
execute the instrument as his Last Will; that he signed
willingly and that he executed it as his fr=e and voluntary
act for the purposes therein expressed; that each of us in
the hearing and sight of the Testator signed the will as
witnesses; and that to the best of our knowledge the Tl::ste-
tor, was at the time 18 or more years of age, of sound mind
and under no constraint or undue influence.
1); /tl.MIIt. IJ tll4h/U'
Sworn or affirmed to and subscribed to before me by
l.II' ...., /f 1/-' t
/11/1.l.!)('!._,~ ~,.__.n/.J...:..' /".'!,L..r...<IL.. -.I..~a-/..,.t:.. I
.1;-' \J' <LI '; '" .,..,(7'
anCl/;.;fL.1..III{l." L I,;,' /, (> , witnesses this ,'.' -=-." day
,
of October, 1989.
,.,,,, )
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. "....:_,'..:. /:"
1/: ,,f I I / ~. .' L.. ,.....
Notary ,Public
'J ,." ./ /.
. or." . ...- -',t ,. I
r... ~ '~j. T- ,.
I HDI ARIAI lEAL
JOYCE E. 'OHI, tlclary Publ~
Hdftj,burg. O.l.Iphin Counfy. P..
My Commiuian hpires. Srpl. 21, 1992
8 Ilf;l...-:..~;~l/
_"-':. .' '-l ... .
My Commission Expires:
Dividend Reinvestment and Stock Purchneo Plnn
Cumulntlve Statement
FULTON FINA~CI'l C'~P OIV qSINV pLAt.
Fu.lton~millls
DIVIDEND REINVESTMENT DEPARTMENT
PO DOX 321S lANCASTER, PENNSYlVANIA 17604
1-800.616.0m
Opllonal Ca8h Contrlbullon,
Tax 1.0. Of 50CIII Sac. No
1'ij-,,7-C5S1
Account Numbe,
7H5004
Pie... UID rlver.e Ilde lor wlthdrawal.ltom )'DUI .ccounl Ind
Chick Ihl box below. P/81110 advl., add'e" chang.. below.
o Change. Noted on Reve..e S.de.
M.ke Chocks Payable To:
FULTON a~NK
Mell This Portion To:
Ana
.:o~.t -: "'::t_;ry.~'l;
..11' ;OH "J~jr IV.
C~/~ H:LL, p~ 1?~11
FULTON eANK
Olvldend Relnvlllmanl DepartmBnt
P,O. Box 3215
LBnelller, PA 17504.3215
Amounl 01 ChBek $
T..lo Of Social IKuflly No. ,\ceou,,1 Humber
195-07-0551 7~~5004 FLLr.'~ Flt.AIICI\l CORP OIV ~EINV PUN
Etf.a!vt rranNdIon Oew1ptlOn P,lc:WRate "';';' 8hlf" Ttlll ',j Tot&IShatn
Dal, . T,anllctlOO
:; E u I1IN II\"' ~AU'lC: 2.87et
_1/1:; OIV J1I C!~T SliS 2. \I v.170
~1I15 .HV eN PLA'I SHS O.~ 0} 0.170
U 1/,7 SH~ II!'; PUilCHUEO :;.3.' 19.4~~2 +0.1734 3.052
J4/15 on C~ C'!ilT ~HS 2.'51 0.170
04/15 OIV 011 PLAN :JH~ r}. '; , 0.170
04/40 5U~I1E. PU.C~H;) :;.41 ~IJ.0517 +0.1701 3.2221
OblC," STCC" CIV/PLIT C.l':O +0.3222 3.544~
o 7/1~ vIV J;~ C!:tT StiS ,. 0 ~ 0.17:1
07/15 OIV Or. .. L,\~ ~H:i 0.60) 0.170
il7/b Sn~.H~ ?IHCOS~,) '.60 1':.0000 +0.2033 3.747t
1 iJ/l 5 HV ~,. C:~ T iH; 1.i)~ 0.17.1
1 il/1 5 ;JIV C~. PLA ~j SH~ (J. '\ 4 G.17\)
10/1/1 .)11"" :;~ f'JIlC'i\H~ 3.7 J ~~.500a +11.1644 3.912
'h.~.VouNowOwn -' ,i!.,'.__.'"._:."", I!ji' .,J.t, ;l~...'l .;;...to;....~.,I~~; ..~fl.'.'.'.
Sha,.. Held Dr You . Plln Sha,n . TOIII Shlfn Owned
Hald B~ Agent
~U~A ,; nCL;J."~
1. '11 2
DlvldDnd RelnvOItmDnt nnd Slack Purchase Plan
Cumulellve Stntemenl
PU.lton~~~d'
OIVIOENO REINVESTMENT OEPARTMENT
PO eox 3215 lANCASTER. PENNSYlVANIA 17604
1.800.626.0m
fuVtst Bill tittw ili.:est~m.ent
OF
EOOA E. HOLSBERG
I, EOOA E. HOLSBERG, of the Borough of Cmrp Hill, Cunberland
County, Permsylvania, being of sound and disposing mL'1d, memJry and
understanding, do hereby make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making void any and all
Wills by me at any time heretofore made.
ITEM 1.
I order and direct my Executor, hereinafter named,
to pay all my just debts, funeral expenses and inheritance taxes as
soon as may conveniently be done after my decease.
lTE11 2.
All the rest, residue and remainder of my estate,"' .
real, personal and mixed, of whatsoever kind and wheresoever situate,
I give, devise and bequeath unto my daughter, BARBARA H. LONG, and my
son, RIClIARD A. HOLSBERG, share and share alike.
lASTLY, I hereby naninate, constitute and appoint Carl B.
Stoner, Jr., Esquire of Harrisburg, Permsylvania, to be the Executor
of this my Last Will and Testament.
IN Wl'INESS WHEREOF, I, EOOA E. HOLSBERG, have hereunto set
my hand and seal, this I~yof O("ic.)~lr ,A.D./Cfro.
SIGNED, SEALED, PUBLISHED AND
DECUIRED by the above-named
Testatrix as and for her Last
Will and Testament, in the
presence of us, who at her
request and in her presence
and in the presence of each
other, have hereunto subscribed
our names as witnesses thereto
the day and year aforesaid.
/2
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'T....I_~ P 1-Id~/~~
Edna E. ii01Sberg ~
1/,,('1'"1 Jltlr~/ ~ '
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residing at
residing at
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V"'\: "IALTDA
WtsT SUORt SALts Om,t
3310 M"...rr Sntn
CAMrllru. r" 17011
17171761.1910
r.17GI.530"
EAST SUORe SALts OmCt
5137 ()rrormllubl,
11A1l"''''0, r. 1711 Z
(717) 652.7260
fu G5Z.0ZGI
EXOClmVt Omct
3310 MnlnSntLT
CAMrlluJ..r" 17011
(7171761.1010
"DL71I'17U'II MAA.U 7iIL.OmUL\'Cc.....&vCC 11164"
Nonnan p, Hetrick, Esquire
P. 0, Box 1265
10 S, Market Square
Harrisburg, P A 17108-1265
October 30, 1995
RE: 4114 Rosemont Avenue
Camp Hill, PA 17011
Richard A" Kurt K. and Scoll Ho1sberg
Dear Mr. Hetrick:
In response to your request, I have completed a Comparative Market Analysis on the
above-referenced property. In its plesent condition, with no repairs and/or improvements,
the property is valued at approximately $76,000.
If you need the supporting documentation, please call me at 761-1910,
Cordially,
'1A
Karen Smith, OR!
cc: Scoll Holsberg
KSlkig
RFr.~l"J::O
OCT 3 1 1995
HETRI(,K ZilLESKI & PIERCE
MORTGAGt DRORtllAGt
17171 761.Hl10
RtLOCATlON & CORlllR.\Tt SI:RllCts .
(711) 7eil.1 UU
SLTTLL\ltm.
t717) 71i1.1!)10
Rtm.\u & rROIUTV MANAGf..\ttm
(717) 7lil.CiIiUi
6
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This jDeed~
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l.on!onotl,oll,'/lIId"ill'/llI/1drr,llllld HI..!,lInOI,
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UCIIARO A, 1I0LSBERG, ..d KURT R, IIGLSBERG, ..d SCGT _..... :!
R. 1l0LSBERO, It the C.anh If C..buh"d. C......"..lth It '..",yhuh, ::
GRAHTEES, "
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RICIIAIO A. "GLGSrRO, I Itfttl. .'., If thl C...ty It
C....lu.llth ., Pln"Iylvlnt., GRANTOR.
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c!\1l
THAT CERTAtH I.t It pl.cl or gflund It lUll. In Llv" All.. T.uft~
ship, C..buh"d C"uh, Pulltyhnt., bUfldld nd dncrlbld " hlhu., h
viII
BEGINNING .1 . p.lnl .n Ihl ..rlh.r. II.. .r R.I....I 8Ir..I, 1.ld
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Iho IIl1do"lllIed officer, po"ollallv
kllown to mo, (or latulaelorilv
flCoven) to bo the pe"on WIIOIO lIame ."bleribed 10 Iho ,villlin Inllmment, and
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R;cord~d on lhil '?-'-\, tlav o( ~'\. .I1,''1.h~iiy ~:':"~:l.t{
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Recordorl Offlco ollhe laid COllllly in Deed Book.J fl'o/ILmo 1l{ PaJo '" q i
GI~on .indor my hand and tho Ital of the laid Off/co, Iho dato abovo wrmon,
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"n- UNCOLN NATIONAL
UFE INSURANCE CD.
.".,d LINCOLN NATIONAL CORP~RfTION I \ I I \
Annull"nl's N,'me:_..:J?1o\iLtI~D1s.Dl!..Lt'-_-
Institulion/ Agency:
ANNUl I Y SERVICE REQUEST
Cash Transactions
1/(J51 \
T,lX J.D."; Jq lD- )~ -3& 15.
COIltr,lel #;
INSTRUCTIONS: Complele Seclion I, 2, Qll3, Seclions 4, 5, and 7 musl always be compleled,
I, SECIlONI-PAR~L~JTHDRAv.:AL.1 S.EcnON~-IRATll{\NSFER . ,
I request a withdrawal be m.lde (rom Ow Account Valull
of my annuity contract as specified below. I understand
thai If Ihis amount exceeds the free wlthdr,l\\',,1 provision
allowed in the contract, there may be 01 pl'lltllty charge
that is deducted from the remaining Account Value.
As indicated in tlw .lttaclll'd ilCCl'ptilllce Il.tlef, pll'ilSl'
transfer 1}~J of Ol}' II~^ annuity 10;
Name:
Street:
City, St"le, Zip;
o Amount equal to $
o 10% of Accounl Value
o Cumulali\'e Inlerest
o Other
! SECIlO~(Rm:'~~/~SII SURR~D1m _ '~ __.;
)\: I hereby request immedlale cancellation of Ihe LNL
ilnnuity contr,let. Pleilse lorward the Surrender Value
proceeds as Indic"led below. (The Conlract must be
relurned along with Ihis cancellation reques!.)
1 realize that the withdrawaf of funds from my annuity conlr.lel may cw.lte t.lx.lble income and thllt I have the option of
ha\'ing Federallnco",e Tax withheld or not withheld nn my withdrawoll. I "Iso reolJi,e Ih"l withdrawals ",.llie prior 10
age 591/: may incur an additional t.1X penalty of up to 10%.
o YES, I want 10 have Income T,lX withheld fromlhese fUllds al
)( NO.1 do not wish 10 have Income Tax wllhheld althls tlllle,
II.'
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The effeclive d.,te of this request will be the dale the form is received in the Admlnistrati\'e Office of Lincoln Nalional
Lifelnsur" 'Co polny. ,,\-.._. f) ~1Ao\'ll' '''1-1
Oaled al u...fuL2ULl-S'(- Ull till' ------cL-1~1. f -:l#f;C 19 ~,
Owner: '. rJ ~~1 Agent/Witne,,: '1., VJtLIIJI/r7t~
Joint Owner: Aflenl/Witlle,,;::r
IHOI Suuth Meyers Iluad . O.lkbrnuk Terr,lCe,llIlnuis hOIHI-<;21.' . (70H) ')11>,0045
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RE: ESTATE OF
RICHARD A. HOLSBERG
IN THE COURT OF COMMON PLEAS
CUMBERlAND COUNTY,
PENNSYLVANIA,
ORPHANS COURT DIVISION
NO, 1995-00801
DISCLAIMER
WHEREAS, Richard A. Holsberg, of Lower Allen Township, Cumberland County,
died testate on October 20, 1995 ('Testator"); and
WHEREAS, Testators Last Will and Testament dated October 2, 1989, was
admitted into probate by the Register of Wills of Cumberland County on October 26,
1995, and filed at est8te file number 1995-00801 (the "Will"); and
WHEREAS, Letters Testamentary thereon have been granted to Scot R. Holsberg
as Executor, by the Register of Wills of Cumberland County; and
WHEREAS, under Paragraph second of the decedeDt's Will, Testator gave eight
thousand dollars ($8,000) unto his sister, Barbara H, Long, a copy of said Will which is
attached hereto and made a part hereof as Exhibit "A"i and
WHEREAS, Barbara H. Long desires to disclaim and renounce completely any.
and all right, title and interest she may have or Will have in the specific bequest under
the Will or any kind of interest whatsoever in the Will.
NOW, THEREFORE, Barbara H. Long hereby irrevocably and without
qualification in accordance with the provisions of Section 2518 of the Internal Revenue
Code of 1986 and Section 6201 of the Pennsylvania Probate, Estates and Fiduciaries
Code, 20 Pa Cons. Stat. Ann. Section 6201 et.sell,. does completely disclaim and
renounce and refuse to accept any and all right, title and interest conferred or attempted
to be conferred to her by virtue of said rights created under the Will.
I 8 H...
IN WITNESS WHEREOF, Barbara H. Long has set her hand and seal this
of MCMe..k.. . 19Z'k,.
Witness:/Jr I~, ~J\w IhWrtMd'-' 1)..;(p-n:J
Barbar8 H. Long
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LAST WILL AND TESTAMENT
OF
RICHARD A. HOLSBERG
I, RICHARD A. 1I0LSBERG, of Lower Allen Township,
Cumberland County, Pennsylvania, declare this to be my Last
Will and hereby revoke all prior wills and codicils made by
me.
FIRST: I direct that all my just debts and funeral
expenses be paid out of my estate as soon as practicable
after my death.
SECOND: I give, devise and bequeath $8,000.00 to my
sister, BARBARA H. LONG.
THIRD: I give, devise and bequeath all my household
goods and personal effects to my sons, KURT K. HOLSBERG and
SCOT R. HOLSBERG, in equal shares, share and share alike,
particular items to be allocated among them as they decide.
FOURTH: All the rest, residue and remainder of my
estate, of whatever nature and wherever situate, I give,
devise and bequeath to my sons, KURT K. HOLSBERG and SCOT R.
HOLSBERG, in equal shares, share and share alike.
~~-, l'-"''''''''_~-~(,.;,,,,~-,..,,,,,,,",,,,~,,,_,,-,,.j,,,-~.~;~~.;'j,_,-_.,^i; .H',;"":':'A,;t-...\,-:;-.,-"",-~",,""""";:-<'~-*"<"'-"'--,""",,_..,- ..
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FIFTH: If either of my sons shall have predeceased me,
the share that otherwise would be distributed to the prede-
ceased son of mine shall pass instead to the issue of the
predeceased son who survive me, per stirpes and not per
capita.
SIXTH: If a son of mine predeceases me leaving no
issue or if no issue of such son survive me, the share which
would be otherwise distributed to such son or such son's
issue shall instead be distributed to my surviving son.
SEVENTH: I nominate, constitute and appoint my son,
SCOT R. HOLSBERG as the Executor of this my will. Should he
be unwilling to serve or should he be unable to serve for
any reason, then I nominate, constitute and appoint my son,
KURT K. HOLSBERG as Executor of this my Will.
EIGHTH: I confer on my Executor and successor Executor
in addition to those powers granted by law, the following
powers to be exercised in a prudent manner and applicable tc
all property constituting a part of my Estate:
A. Power to Invest: To retain and to invest in all
forms of real and personal property, regardless of any
limitations imposed by law on investments by fiduciar-
ies, to exercise all the rights ordinarily belonging to
the owner of or investor in such property, to register
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investments in the name of a nominee and to keep such
property in such good order and repair as they deem
expedient.
B. Power to Sell, Lease, Mortgage, etc. To sell at
public or private sale, to exchange, to mortgage, to
lease or to extinguish any mortgage, lease or loan for
any period or periods of time, to repair, alter and
improve any real or personal property upon such terms
as to cash, credit or options as they in their sole
discretion may deem appropriate and to do all things
necessary or ordinary in achieving these ends, without
liability on the part of any third party to see to the
application of the funds given therefor.
C. Power to Borrow, Pledge and compromise. To borrow
money from any source or sources, to pledge any assets
as security therefor and to compromise claims.
D. Power re Administrative Expenses. To treat adminis-
trative expenses either as income tax or as estate tax
deductions, without regard to whether the expenses were
paid from principal or income, and without requiring
reimbursement.
Power to Distribute, Allocate and Value. To make
distributions in cash or in kind or partly in each, to
allocate property to persons entitled thereto and to
fix the value of property.
3
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SIGNED, SEALED, PUBLISHED and DECLARED by the above-
named Testator, RICHARD A. HOLSBERG, as and for his Last
Will and Testament, in the sight and presence of us, who, at
his request,. in his sight and presence, and in the sight and
presence of each other, all being present at the same time
have hereunto set our hands as witnesses.
. --
Name /1/ tY.lA /1( tf {II 1-1/1/4
Name
fJ~~/jjl~~
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N~. t>>-p.;b
Residing at fl-iN III! ".III:wn,../t:'4.
'pJ,'tt~ ~. J,4
Residing at .278' ~ f)A..
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Residing at Y'I:r 1tI,fw'7:::1:d /.t.
d.....wJ,,-1 { 12.
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COMMomiEALTH OF PENNSYLVANIA I
I SS
COUNTY OF I
I, RICHARD A. HOLSBERG, Testator, whose name is signed
to the attached or foregoing instrument, having been duly
. qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will, that I
signed it willingly, and that I signed it as my free and
voluntary act for the purposes therein expressed.
--r=;? D4k-Ul- . M~ T
RICHARD A. HOLSBERG .
,Sworn or affirmod to and acknowledged before me,
by RICHARD A. HOLSBERG, the Testator,
,N d
this(~/' ~ day of October, 1989.
.._,
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/-Nqt:ary
(/',. "
-." .''J' h '
." -r:-':~-;;,_/
Public'
(SEAL)
My Commission Expiresl
. I~"~ .' j
'NOIARIAL SEAL
JOYCE E. rOHL. HO"ry Publl.
Hmhburg, O.uphin County. P.,
My .CDmmln'o_ hpires Sept, 21. 1992
c.U-Hft.1..-':':- <~37
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF
We, II\AO,'A /) 7111)I/~J (j)oY\'NAo 1'1\. ~e.1'\ [.::::,
and ,4~tU.lov P M"-L , the witnesses whose names arc
signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw the Testator, RICHARD A HOLSBERG, sign and
execute the instrument as his Last Will; that he signed
willingly and that he executed it as his fr~e and voluntary
act for the purposes therein expressed; that each of us in
the hearing and sight of the Testator signed the Will as
witnesses; and that to the best of our knowledge the Tcsta-
tor, was at the time 18 or more years of age, of sound mind
and under no constraint or undue influence.
I) It 1471 /u '
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Sworn or affirmed to and
ljj.""
I /I.i.L ~ (.~. \..
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and/;;.;,fL.\..lllt~ I _
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of October, 1989.
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subscribed to before me by
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day
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Notary .Public
My Commission Expires:
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!{ -I' ,e t 7'~ -'tc).. I..~
HOIARIAI SEAL
JOYCE E, f OHI, lIolory Publlt
Hllltisburg, Oluphin (ounly. P_.
My Commission E..pire, Sept. '1. 1992
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ATTDftHIlV. AT LAW
10 SOU"" MAnMllT Sa""".
pon O,."C& Dax 12811 ;
H"'R....nURO, PaHN.vLvANIA 17100.12a8
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REV-1547 EX AFP 112-95~
CDHMOHWUL HI Of PO"SVL VANIA
DlPAAIHlHl OF A[vtNUE
IUREAU Of INDIVIDUAL "XEI
DtPI. '10601
HARRUIUAC, PA 17U.~06Dl
ESTATE OF HOLS8ERG RICHAR FILE NO.
DATE OF DEATH 10-ZO-95 COUNTY CUMBERLAND
HaTE, TO IHSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT THE UPPER PDRTIOH OF THIS FORH WITH YOUR TAK
PAYHEHT TO THE REOISTER OF WILLS, HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AOEHT"
REMIT PAYMENT TO:
HOT ICE OF INHERITAHCE TAK
APPRAISEHEHT, ALLOWANCE OR DISALLOWAHCE
OF DEDUCTIDHS AHD ASSESSHEHT OF TAK
ACN
101
DATE
04-22-96
NORMAN P HETRICK ESQ
10 S MARKET SQ
PO BOX 1265
HBG PA 17108
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.Dunt R..ttt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiE"v:i54i-ExnAFji-nz:9f;"i-iiiIYici--or?-i-NHEiiifANcE-YAx-iipjiiiiiisEiiiii,.-;-ALi:oiiANCE-iiJi'-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOLSBERG RICHARD A FILE NO. Zl 95-0801 ACN 101 DATE 04-22-96
TAK RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..I E.t.t. (Schedule A) ell
Z. stock. and Bond. (Schedul. I) 12.
3. Clo..ly H.ld stock/Partnership lntar..t (Sch_dul. CJ IS)
~. "or-tvagaa/Not.. Receivable (Schedul. OJ 14.
5. C..h/BIM\k DapoIUa/Hhc. 'a,.lon.l Property (Sch.dule E) IS)
6. Jointly Owned Property (Schedule F) (6)
7. Tranafara (Schedule OJ 171
8. Tot.l A...t.
I CHAHOED
,00
44,01
,00
,00
Z8,613.67
Z5,338.33
,00
(BI
53,996.01
APPROVED DEDUCTIONS AND EXEMPTIONSz
10,251.70
9. Funaral Expan.../AdII. COlh/"hc. EMPan... (Schedul. HI ('I)
10. Dobh/Hortgogo LhblllUu/Llona (Schodule II llOI 40,871 .82
11. Total Deduction. (11)
12. N.t Valu. of Tax R.turn (lZ)
15. Charitabla/Govern..nt.l Baqu..t. (Schedule J) (15)
14. H.t Value of E.t.t. Subject to TaM (14)
NOTEz I~ an a.....m.nt was 1..u.d pr.v1Du.ly, 11n.. 14, 15 and~or 16, 17 and 18 will
re~lact ~1gur.. that include the total of ~ ra~urn. a..e..ad to date.
ASSESSMENT OF TAXI
1&. A.aunt of Lina 14 at Spou..l rat. (IS)
16. A.aunt of Lin. 14 taxabl. at Lin..I/Ct... A rat. (16)
17. A.aunt of Lin. 14 taxabl. at Collateral/Ct... Brat. (17)
18. Principal Tax Dua
TAX CREDITSz
PAYHEHT
DATE
01-19-96
0;1.1:>3 0;:>
2,87Z.49
.00
Z,87Z.49
.00
2,872.49
.00
X,OO.
K ,06.
X ,15.
nel
,00
17Z,35
,00
17Z.35
RECEIPT
NUHBER
AA08Z531
DISCOUNT
IHTEREST
Itl
I-I
8.6Z
AHOUHT PAID
163.73
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
172,35
,00
,00
,00
. IF PAID AFTER DATE IHDICATED, SEE REVERSE
FOR CALCULATIOH OF ADDITIOHAL IHTEREST,
IF TOTAL DUE IS lESS THAH '1, HO PAYHEHT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE
A REFUHD. SEE REVERSE SIDE OF THIS FORH FOR IHSTRUCTIOHS,I
,
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RESERVATION I [Ita'" 0' decadent, dvlno on or before o.c.~r 12, .9.2 -~ If env future lnt.r..t In the I' tat. I, trBn"'rr~
In po.....lon or anJov-.nt to el... . (coll.taral) beneflcl,rl.. of the dlcadent .,t.r thl ..plratlon of any ..tat. for
llf. or 'or y..t., thl C~.lth hereby ..pr...lv r...rvI, the right to Ippr.... end ...... trenl,.r Inn.rlt~. ,....
.t the l~'ul Cl... . (co111'eral) rat. on eny luch future Int.r..t.
PURPOU Of
HOTICEI To ful,111 thl rlqulra-.ntt of S.ctlon 214D of the Inherltancl end Elt.t. T.. Act, Act 22 0' 1991. 72 P.S.
Section 2140.
PI'mEN'.
Detach the top portion 0' thlt Hotle. end Iub.lt with your p'r-ent to the RIgl,'ar of Will, printed on thl r.ver.. tide.
--H.... check or ItOfMY order plyabl. tal REGISTER OF MILLS, AGENT
AU paynnt. recllv" shall flnt be .,lIed to ...y Int.r..t which .ay be w. ..lth ...y r..al"'" .,lIed to thll bx.
REFUND (CAli A r.fund of . t.1f cr'dlt, which .... not nqu..bd on thll 'all: Return, .a., bit r.que.ted by cOllpI.tlng IIn "Application
for Aafund of Penn..,lv...l. Inherltanc. end E.t.t. 'IX" (REY-1515J. Appllc.tlon. .r. .vall~l. at thll O"lcI
0' the R.ght.r 0' NUll, an., 0' the 25 Ravlnue Olltrlct O"lc.., or b., caUlna the .peel.1 2'-hour
....~rlng ..rvlc. nuabar. for for.. ordarlngl In Penn..,lv...le 1-100-562-2050, out.lde Penn.ylv...la ~
..Ithln local Harrlsbur. .t.a (717) 717-IOM, TOO. (711) nt-2t5t (....rlng llIp.lred OnlY).
OIJ(CTIDHS, An., p'rty In Int.r..t not ..tl.'I.d ..Ith the appral..aent, .llowanc. or dl..llo.....c. 0' d'ductlon., or ......eent
0' t'll: (Including dl.count or lnt.r..t) .. .hown on thl. Hotlc. .u.t object ..Ithln .Ixty (60) da.,. 0' racalpt of
thh HoUc. b.,.
ADMIN
ISTRATlVE
CORRECTIONS I
--..rlttan prot..t to the PA O.p.rt..nt 0' R'v,nu., Bo.rd of App.al., D.pt. 211021, Ilarrl.burg, PA 17121-1021, OR
--llactlon to have the ..tt.r d.t.raln.d at .udlt 0' thl account 0' tha p.r.on.1 rapt...ntatlv., OR
--app..l to tha Orphan,' Court.
DISCOUNT,
Factual .rror. dl.cov.r'd on thl. ......~~t .hould ba .ddr....d In wrltln. tal PA O.p.rtaent of R.v~,
Burlau of Indlvldu.l TaMl', ATTN, POIt A.......nt Ravl... Unit, D.pt. Zl0601, Ilerrhbur., PA 17121-0601
Phon. (717) 717-6505. Saa p.,. 5 of the bookl.t "In.tructlon. for Inhlrltancl T.. Alturn for. A..ld.nt
Dlud.,..t" (MY-ISO!) for... ..pl..,eUon 0' am.lnhtraUv.av corract~l. arror..
I' .,..., t.. due I. p.ld within thra. (3) c.l.nd.r lonth. .,t.r the d.c.dant". d..th, . flv. p.rcent (5%) dl.count of
the tax paid I. allowad.
Int.r..t I. charg.d b..lnnlng ..Ith flr.t dey 0' dallnquenc." or nlna (,) .unth. Bnd ana (1) da., froa thl data 0'
death, to the data 0' pa.,aant. Taxa. which bee... dallnquent b.for. January I, 1'.2 ba.t Int.ra.t .t thll rat. 0'
.1_ 16%) p.rcant p.r ~ calculatad at a dally r.t. 0' .000164. All t.x.. which b.c... dallnquent on ~ .,t.r
Januar., I, 1'1' ..Ill ba.r Intar..t .t . rat. which ..111 v.ry fro. c.l.ndar y.ar to calandar y..r with th.t r.t.
~.d by thl PA D.partaant 0' Revanue. Tha appllcabla Intera.t rate. 'or 1'1' through 1996 aral
INTEREST.
~ tntera" Rata Dalh Intar..t Factor ~ Int.rllt Rata DaUy lntar..t Factor
I'U ..~ .0005U 1917 9~ .0002'7
1915 16;( .ooonl 1'11-1991 Il~ .GOUOl
1'14 Il~ .Oaosal 1992 9~ .0002"
1'15 IU .000556 1995-ltfl 7~ .0001'2
1.16 lD~ .000274 1995-1996 OX .0002"
"-lnt.r..t I. calculated .. follow..
IHTEREST . BALANCE OF TAX UNPAID X NUnDER OF DAYS DELIHQUENT X DAILY IHTEREST FACTOR
uAny Hotlca I..uad aft.r tha t.. bacOll" d.Unquant will raflact an Intar..t calculation to flft.an CIS) dlY'
ba.,ond thl dltl of tha .......ant. I' p..,..nt I. .ada a,t.r tha Int.r..t coaput.tlon data .hown on thl
Notice, addltlon.l Int.rllt .....t ba celculatld.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Richard A. 1101sbetl]
Date of Death: October 20, 1995
Will No.
1995-00801
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:
1. State whether administration otthe 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:
J. 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 X
b. The separate Orphans' Court No. (if any) for
the perDonal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No X
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' C,ourt and may be attached to this report.
~~
S a ure
Date:
q-M._.~
.
L.
Norman P. Hetrick, Esquire
Name (Please type or print)
213 Hai:ket Street:, P.O. BOx 1248
Harrisburg, PA 17108-1248
Address
,';
'j"
( 717) 237~
Tel. No.
c~ ~ -:~
..:) Li
Ot.)
Capacity:
Personal Representative
_~_.Counsel for personal
representative
(MAH:rmt/AMJ)
RW-27