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HomeMy WebLinkAbout97-00553 \ I, ) j I I \ I I. I '0. DATI$0' DIATH Anll12/31/91 CHICK HII. J:i~ INHER'TANCE TAX RETURN ~o~:::~U~:~DIT IICLAIMID I I .... RESIDENT DECEDENT PILI HUM'" COMMONWEAltH Of ''',"SY,V.,.,A I (TO BE FILED IN DUPLICATE 2 H7-IIIIJ ' __!I~:.~;'fJ:r~~~:~::~, . .. ... WITH REGISTER OF WILLS) COUNTY COOf . V:AR NUMBeR &i~;;~~~~';: AND MIOOII INllt:;;:i-:~ ""~:--1~.97[~;~;~~~;;;" 19181~':::r'[(c~~a~r(1~j:9~1;Ue':~~1'::A7~~1~7~ojlo~3r' ~~~~-c~!u-I.n-'b' erllllld _169-_18-1.l'17 April 10, I · (If U'\i('41,tl ~U~~IVI'lCJ "Olll' \ U_Io\' II"'" 11~'1 .WI Mlllllll "1'1'.11 ~(I~IM H(UIlIIY ~1(!Mllf" "MOU~I' REfflVff) ISft Ilj\IA\J( TlnN~) tKl 1, Original Return ( I 2, SupplllnUltltul Return [ ] 3. Rllmaindor Relurn llor dol." 01 death prior 10 12.1 J.821 [ I 4, limited htole I I 4C1 fulure 1"/tHO" Comprombe [') 5. Federal E"at, Tal( Relurn Required (for dotlll Qf death (liter 1'1.12,82) [".] 6. Oecedenl Oi.d Te_lale [ I 7, Decedenl Mulnlulned Cl Uving Trull ___ 8 Total Number of Safe Oepolit Box.. (A!loch copy of Willi (A!lo(h copy of Trulll ALL CORI.SPONDENee ANifco"NPIOiNTIALTAJ(iN.ORMATION SHOULlfl. DIRiclio-,oi---'-"" ,-" ~,-----~_. ... ._--~----_. NAM' D~~othY M. ~~9t~tter - ----. -17E7'OMS~~;~0~:nov~- ;;-r~~;,--~~~"~~-' HL1Hiofi'NUM"" - . - --- --:_:].Carlisle, PA 17013 ..-.-...... J.~111-.-I-c,lr!:t"811It, ____.,.___ _'~=~=_',.'-...~.=_ ,,_ ...--..~__ .,._==~=,_...,.~._=o=__..~_.,=_,_'"~~ . >- >- IE SURE-TOAj.jSWERALLQUES![~NS,()~RE~~~HIDE.~~D TO RECHECk MATI~. -c.. Under ponaltle5 of perjury, I declare Ihatl have examined Ihi, return, including occompany'ing IChodulel and ,Ialomenh, and 10 ths bOlt of my knowledge and ulllel, It II Irue, correct and complete. I declar. Ihot 011 real ollate ho~ been reponed (II !ruo mor~ot ...olue Declaration of proparer olher Ihan ,he per10nol ruprelentati.... II baled on all Information of which preparer hat any knuwledge, 510NATlJA[ Of PEASON 1tE".s"jiONSIBLi-fOR"fi'iiiJo-,if:Tljli'N . '--AooR~55 _..._/J:L)--H:~{./ . UAf Of P fPAAE~ OHlER ItlAN AEPRfSfNfAIIVf ...~.."? :/ ~. REV.l!100 U. (1.9.11 ~ i:S~ ulm , m III 11l " ~i ,," uf " 12 5 ! .. 1, Real E"ate (Schedule AI ( 1 I 2, Stock. and Bond. ISch,dule 8) (2 1 3, Clo.ely Held SlockfPo,'n."hlp Inte,e" (Schedule q (31 . 4. Mortgages and Nolel Recel...able (Schedul. DI 14 ) 5. Cash. Bank Oepotill & MIsc.llan.ous Perianal Prop.rty 15 I (Schedule E) 6, Jointly Owned Property (Schedule fl 7, Tronlle.. (Schedule O) (Schedul. l) 8. Total Gran Aue" llotallln" 1.71 860..50. 9. Funeral Ellpensel, Admlnlltrotlve Cas", Mllullaneoul (q) _._'.u,,"_ _._,_.___.._._~__._,~...'.,. hp.nUl (Sch.dule HI 10. O.bu, Mortgage Llabllilie" lien I (Schedul. IJ 11. Total O.ducti(.ons (lolaIUn., 9 & 10) 12. Net Value of Estal.(Une 9 minus Lln. 11) 13. Charitable and Go...ernmental BequII" (Schedule JI 1.1. Net Value Subjec;tt~. Tall J~~~!J.~~r:~~.~ln. 13l.__..__~,~_~_.~____. lS. Spousal Tranderlllor date, of d.ath after 6.30-94) Se. I",tructlons for Applkable Perc.ntag. on R....eru (IS) Side. (Include valuII frorn Schedul. K or Schedule M.l 16. Amount of Lln. 14 taxable at 6% ral. (Include ...alues from Schedul. K or Schedule M.) 17. Amount;)f line 14 taxable al 15% rate (Include valu., frornSchedule K or Schedule M.l 19, Prlnclpaltall~ue (Add tOK from Un.. 15, 16 and 17.1 19, Credits Spoulal Pov.rl)' Crodil Prior Parmenh 168.0.4 (191 (20) 164.94 7.70. ~~02 .96 (6) ( 71 6302.0.6 ( 81 (101_,_.... ._._,__.._.._..._,.____ (111 __________~~9_'!.l! 5441.56 (121 .-.--_ '-"__ 4393.25 (131.. ..____... (141.._.__.--___ __,}D48.31 .._-~- )(, ---_.- (16) '__ _)( ,06 III W) 10.48.31 )( .15 III 157.24 " ~ ~ . " u S (181 1~7.2" Dhcounf Inler"'1 3.10 + + 20. If line 1911 grealer than Une 18, .nl.r Ihe difference on Line 20. Thh II th. OVERPAYMENT, iii F. Cht'Ck Ill'H' If you (Ilj> rl'qul'~lu'~J U refund of your ovelpClynwllf 21. If line 18 il grealer than line 19, enter !he difference on Line 21. Thil i, Ihe TAX DUE. A. Enter Itl. inlerlll 011 ttle balance duo on line 21 A 8. Entlr I"etolol of line 21 and 21A on Lin. 218, Thil il Ih. BALANCE DUE. Ma~. C~.'c~. Poy!'~.~!_~~.I_~~'I~t_!'..~!..~IIl.~_I\.fI.nt 1211 (21,0.1 I2'BI ClAH 770S. Hanover St., Box 45, Carlisle, PA 17013 A[lOR! ~s 5 S. Hanover St., Carlisle, I'A 17013 I Y ,1998 .,1/ , 1998 A nril o;rr- April !W'J.'IOI');(''''1 '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH Of P1!NNSVLVANIA INHERITARCE ToK RETURR EITATE OF Vera M. Erdman FILE NUMBER 21-97-553 Include tilt procoedt.f litigation and tilt data tilt proceeds were rtlCOlv8d bV tho ..tale All properly jointly........ with tho rig," ot aurviolo"hlp mu.t lit dllclolad on Schadufa F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Cash In room 42.52 2,'. August 6, 1997, Refund from Chapel Pointe 923.00 3. Date of death balance in checking account at Financial Trust Co. 182.24 4. August 27, 1998, Refund of insurance from J. C. Penney 8.90 5. August 28, 1998, Insurance benefits from Federal Employee's Group IAfe 3796.79 6. January 21, 1998 lump sum benefit from Federal Office of Personnel Management 592.61 7. Restitution ordered in U.S. v. l,awrence White and James Massella 20.00 8. Anticipated federal tax refund 736.00 TOTAL (Also 8nler on line 6, Recapltuletlon) . (If more space Is needed, Insert eddltlonal sheets of lhe same SIZ8) 6302.06 . ;"t~".-;r'" _,' f<.- " ;'J 'IOV''''''~(''''. COMMoRWEAlTH OF PENRSYIVARIA INHERITANCE ToX RETURR SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Vera M. Erdman FILE NUMBER 21-97-553 Debts of decedent mUlt be rapurttd on Schldulll. ITEM NUMBER DESCRIPTION A, FUNERAL EXPENSES: 1. Hoffman Roth Funeral Home AMOUNT 260.00 e. ADMINISTRATIVE COSTS: 1. Parsonal RapAlsel\~IiVI'1 Commlss~nl Name of P9I1Onal Rap_n~tivelll Social Sac\JiIty Numoor(l) I EIN Numoor of Pa""nal Rapra.entativ'(I) _ Slr8etMdrass C~ -S~I. Zip Yoart.) CommO$~n Paid: 2, Altomey F... Frey &. Tiley 500.00 3, F.ml~ Ex.mption: (1Idacodenr. .ddr..... nollhe same a. c~lmanr., attach e.~anetio") C~lmanl Slr8etAddrass C~ Slate Zip Re~tion.hlp 01 C~lmant to DO<O<Ient 4, Probate F... Filing fee to Recorder of Deeds for Small Estate Petition 21. 00 . 5, Acoountenf. F... 6, Tal R.lum Praparel. Faes 7, August 15, 1997, Payment to Carlisle Hospital 25.00 8. January 23, 1998, Cash to Register of Wllls for copies 2.50 9. February 18, 1998, Cash to Register of Wills for certified copy 2.00 10. Checks cleared after death 50.00 TOTAL (Also enler on line 9, Recapilulallon) $ 860.50 (If more Space Is needed, insert addlllonal.heal. 6f the game size) ~. fI.l ..;l ~ Il< Z IN Z 0 Q Z . .... 0>- ~ ~ !=I .. "" :sE-< PfI.l . :sZ ~ ~ ~E-<1 . !2 i oP iil<cn ~ ~ ~.~ ~ u8 fI.l Q:s :i liiliiu I<oQ E-<P:: Sfl.l.,j I=lirN ~j:s p::fI.l ~ p::...:I1l< lh ~(; pf-< O...:lQ ..~~~~ ~p::~ 0...:1 ~ 1<o~6 U!;: =~~i2 o~~ &.I.... zcn+, U >- ZU ol<oi l&o S gO fu ~pcn < !=I 0 ., ~ f-<UZ == ~ ~ 1I<ffi ~o Il< ll< ~ IN REI ES1'ATE OF VERA M. ERDMAN IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA ORrHANS' COURT DIVISION NO. CIVil, TERM f~TITION FPR DISTRIBUTION OF SMALL ESTATE (Pursuant to 20 Pa. C.S.A. !i3t02l TO THE HONORABLE, THE JUDGES OF THE SAID COURT: The Petition of Dorothy Hostetler, respectfully states as follows: I. Vera M. Erdman (Decedent) died on April 10, 1997, domiciled in the Borough of Carlisle (770 South Hanover Street), Cumberland County, Pennsylvania. A true and correct copy of her Death Certificate is auached hereto as Exhibit" A." 2. Petitioneris Dorothy Hostetler, an adult individual of the Borough of Carlisle (770 South Hanover Street), Cumberland County, Pennsylvania, and is a legatee of the Decedent. 3. There is no family relationship between the Decedent and the Petitioner but rather they were friends and acquaintances, both being residents of The Alliance Home of Carlisle, PA, Inc.. now known as Chapel Pointe at Carlisle. 4. Decedent died testate leaving a Will dated February 17, 1996, the original of which is attached to this Petition as Exhibit "B" and is incorporated herein by reference thereto as if fully set forth herein. 5 . Decedent died of natural causes, as can be seen from the Death Certificate auached as Exhibit "A." Therefore, Decedent's Last Will and Testament leaves (at paragraph Third (All the entire estate 80% to The Alliance Home, its successors and assigns, and 20% to her personal representative in lieu of compensation for her fiduciary duties, Paragraph Fifth of the Last Will and Testament appoints Dorothy Hostetler, the Petitioner, as Executrix and paragraph Sixth waives the entry of security. 6. Petitioner docs not intend to file said Last Will and Testament for probate as this is a small estate with three small assets, 7. Decedent's sole assets at death were a checking account at Farmers Trust Company, Carlisle, Pennsylvania, having a balance of approximately $132.24 (net of checks cleared after dent h), n credit bnlnnce lit The Allillnce Home (now known as Chllpe,1 Pointe lit Carlisle) of 939.46, IInd 'I life insurance policy with the Pedel'lll Employees Group Life Insurance Pl'Ogl'llm paynble to her estate in the IImount of $3,750,00, In addition, the Dec\~dent was entitled to cel1ain denth benefits as a re,mlt of being a World War \I Vetel'lln however those henefits were paid directly to the Hoffman-Roth Funeral Home of Cllrllsle, Pennsylvania, I'lli' services rendered, 8. To the best of the knowledge, Inforllllltioll and belleI' of your Petitioner, all final bills of the Decedent have been paid, except for a $260,()O outstllnding balance due Hoffman-Roth Funeral Home, Carlisle, Pennsylvania, for holding of the hody pending its donation, S'IJeciflcally, The Alliance Home (now Chllpel Pointe at Carlisle) hus been satisfied by medical assistance payments IInd the funeral home, except for $260,00, has been paid by Veteran's benefits, 9, A, Decedent was one of sevcn children, the snle survivor of which is Mr, Arthur Y. Erdmlln of 205 Church Road, Cherry Hill. New Jersey 08002. The Decedent's Intcstate heirs also included certain nieces and nephews however her surviving brother does not know their whereabouts. The Decedent's surviving brother has represented to counsel for Petitioner that he is in accord with the Decedent's Will and has no interest In her estllte. B. Pa. 0, Ct. R. 5,6 requires that a Notice of Beneficiallntcrest in Estate be sent to the intestate heirs of a Decedent within three months of the grant of lellers, however, this Petition is for distribution of a small estnte without the grant of letters, C, 20 PII. C.S,A, ~3102, providing for settlement of small estatcs on Petition, provides thatlhe Court may direct distribution "with such notice as the COUl'l shall direct." D. Your Petitioner requests an Order for Distribution waiving notice to any individuals or entities, 10. Your Petitioner and The Allillnce Home of Carlisle, PA, Inc" now known as Chnpel Pointe lit Carlisle, lire the only parties interested in the above estate as beneficiaries, heirs or claimants, and therefore no notice is required to any other pnrty, For purposes of waiving notice, The Alliance Home of Carlisle, PA, Inc" now known as Chapel Pointe at Carlisle, has joined in this Petition. II. Petitioner files this Petition pursuant to 20 Pn, C,SA ~3102, WHEREFORE, Petitioner requests your Honorable Court to enter a Decree ordering that the Estate of Vera M, Erdman, Deceased, be awarded 80% to The Alliance Homc of Carlisle, PA, Ine.. now known as Chapel Pointc at Carlisle, and 20% to Dorothy Hostetter, without notice to Y.E.BlFICAnON I. Dorothy Hogtettel', depoge nnd sny Ihnlll1m Ihe Pelilloner In Ihe nbove mntter: nnd thnt the facts sel forth In the foregoing Pelltlon for Dlslribullon of Smnll EsHM, are Irue and correct bllsed partly upon pergonn\ knowledge nnd Ihe I'ernnlnder upon information and belief; I understand thlll this Verification is made subject to penalties of 18 Pn. C,S.A. ~ 4904, relllling 10 unsworn falsiftcnlion to authorities. Dated: ?(,C..;Ck ,;( t( I 'N ? j}.(J/t(d;ly )11, ;.kddtZe Dorothy H(f!;tetter YERIFICATION I, Stephen D. Tiley, depose nnd say Ihatlam counsel for the Pelltioner in the nbove matter; and that the facts sel forth at paragraph nine (9) of the foregoing Petition for Distribut.ion of Small Estate are true and correct based partly upon personal knowledge nnd the remainder upon information nnd belief; I understnnd that this Verification Is made subject to penalties of 18 Pa. C.S.A. ~ 4904, relating to unsworn falsification to authorities. Dllted:1 (M- r/f; I f7? ~&A ... /-. ,7 -) Steph . Tiley / YJRlFICATlON The Alliance Home of Carlisle, PA, Inc.. t/d/b/a Chapel pointe at Carlisle, by Wesley L. Bard , deposes and Sl\YS that it is a legatee in the above matter; and that the facts set forth in the foregolog Petition for Distribution of Small Estate are tme IInd correct based partly upon personal koowledge and the remainder upon information and belief; I understand Ihlllthis Verification Is made subject to pennlties of 18 Pa. c.S.A. ~ 4904, relating to unsworn fnlslfication to nuthorities. Date~~2~ / fY7 ~ '~INl ~lIn '" )1.1\"1.':'.1' "(,hi.. h tll n'l'I~f\' that 'tlll' IllfOrll\;\!ioll IWIT Id\'t'll h lIIIH'id',' (['PII.t! rllJ!1\ ,HI (l1-i!',lllal \VlliliLI\(' pi dVillh ;1111)' Ilh,d wid, IlII' il'i l.ocalltcgi'Hrar.'Tlw original iTnilh;Il(' \\'1111\1' !(lI\\'dldnllll dll' \1;11(' Vil.lI HI'(lll-,I.. {lOlcl' tIll !,('1'I1I;1I11'1l1 filin!'" WARNING: It Is IIlogAllo dupllcllto this l:Opy by photostat or photograph, he hll lhh L'l'ltllhale, ),~,()() Illill'''''''''''',,; ;,,,,,"Z~\1 II Of PEt:'"" ';'#h' ~//"",. .... "~\' " ~ .~ (L~.. ~"_ ,/~)) \ i'f<>', - ~"'/I "-34'" i ~,,-'t',,~, '%.'I"fNl~' 111(11 '%:lI/!.!l11!JJ1!1JJJ-' ~~. ~tu.~t"~~, ((!l',t! Hl'nl~II,1I 4157586 NIB IU9'( No, ( lal~' H1Q\U:)RlhliIJ COMMONWEALTH OFPENN6VlVANIA. DEPARTMENT OF HEALTH. YI'tAl AECORDS CERTIFICATE OF DEATH 'IU.lEo'otCfOf~lTl". 1,1"," ,loIll ,ran "tl ~li"'''1I SE~ i,iClAI. ~ICUIl(N /IU"'IE~ Fornolo 169 - 18 (ur!O'Of,,'",I,t~{"'''''1 April 10, 1997 .. VerR H. ~o ",. ..""...Y( ErdmAn (,t~1I1YI-UI - . UI;()tf\10,lV ~61'I~tl( ."ni"LlCI.C.,A<"" "<lIo<' r~- JlIl'y'~ 30~11ql Sh~~"~ki,\t;~pl^1 I _.l1______ CI 'lC~ ny .,.....! 1" O(",~.,.,,(In q',~ Vr-.111'<1 ".-~.... =""IC:l 78 '" COU~ YOl' ..011 5/1 Curl isle White Cumberlnnd u " .. ',,~-::.:7'.'%r::~:r:' I Clnrk I Gov('rnmenl OICIDl"T'hl"II.WtQMlOfl"SI$lt...C""""""SlIIII;;C;:;;;l-OIC~~ ChApel Poinlc at Cnrlifllc ~~~~NG[ ~."r>1 770 South \lanovor St. ,s..""....:'''''. "''''1 II Carlisle. 'A 1701J___ ,,"'.'~,,~; (~~5~- _Gllmherlnlld '_N~...I 1,.rt:J:~:::Ol Uf~'1~""A"'I"'.IoI"''''l.''i l,I()i;;ifr~~lu.lfl"" l,l'kJif 1oI....'~~..r.1 Charles t,. f.rdrnan !J. Claire Haurer . '" WAN' N.."'!IT!....~''''I IN'OOMAli!''!",''IIINl!lOOAf.SIlI?'t_.Ci,I\","_,..._I>(lCl109l I I \' 17013 Dorothy Hosletter 191'- 770 SOllth IinnovM :-it.. LRr lH e, A loIf: lion '(1OIi IlAI[ilTlil9ii\iSifi(';;;'-.._--~. ~\"CI(JIO"f'Q'l11()/I'~I"",,,,c..,",.,,,C'''"''''~1 I AIO"'':'c:",i1l;Nft,SoM','.eo.M ""'-'00,....1_0 Rlm'''lOl''''''!lI.,.LJ _ ,...,.-.ml).,_. ~OI""~I..,. "'....I'lf-fr_________________.._._.____._U April 11, 1997 ll11mnnHy Gifts Rogitltry I Phllnltclphln. PA , .ll, ~v . C~~ ',NO U~H 1~-.]0i;(N'>f~mr--- I -~l,l.oNa.oollr:llS ,AC,llltv 0 mlln- 0 IInernl Homo ~ ".In ...9!.~748 ~~lu,__212....N Hanovor St. C~rl191e PA 17013 101,.. ,1...1."""'.l9'I.,.ll~',.:<I~r"lt"".I,m._nlll.MpI..."..~ \~E'I~fN\JlIU~ 0 113,..0 _. f. ~~~"'"~.~ - r;;:::~~~~1:li.I~-~-:2f}:m~;~~ ------ W'~:;:r'I=~!;!~:.-CHCAIEUl,l.~<< '~~;:I-?) ___ - 'IP"" ..pr [' . ~ ___lL._~_).~U2_D!,I t~_.!:L.:J.Q__L~__, ___ _.J "'.'_"'''...1''1'''''''"'("'''P<<.''''''1~~''~'.'''''I'~.'-'''''" r"".,ot;;; 1'1 ""''''M 1,"''IlI''''~'' 1'''''<.'''''''l1'''1.''..1 1''''''O'fu.III''''' lAI'I'<...."11 '''III'~: OI"'9'kNl/~_'~IO"'iII~.CM ...~.,...."..o'U'"'"". "/ &=": '">l,......If>q...,..~"'_.......'AJlIfl ,-4.f.wfi!dlfif-4'Kf</~ci//.2t JI.n.-fU!)J___: --~/... -cg---:J"-~.c:..:.. ~-i1-((. I :.=-O~':;;'i4i~<d~> . n ... nnn; -- -- fJU(IOi0il~.i~-{;'::,i4<;i'(~,;rIH,i "'I. _ ....._______._______.__..-.__..__..."_,_..._.. _. ".,..t,. wI...~~UIOl'.l'I'fOl'K1S !,I..NN 1'l000fMH n.____~___ o~iiOriNiiiiiy-._.- hllf ,1' 'N.jURY ]HJVR~~I\\OAIO llUI;IIIH~I"'-JlJIlYOCc:Ullll.D """11J,'U~II()11TO ,I,l""'~' !)l, "''''I C()lol'~f1~OICA\lU Nl"".1 ~ ""f'~<II CI ;.,,~:,C~,,~,:'~I....:~-- ~:: ___~: ____ ___:::,:":~~~:::., i~ ~Oi:":'='~::.-~:!~:':: '::~;,:"'5 "E'~i- ";;; ......... '~:~~~~t:yy:~~:;~~~;;~;=~r~:;~~,~~;; ;~:~~:~:;t:~';:.;';;,~~:,;~ :.' ;i~~~~-'"''':''' "~,, '.'" ~"..., '<It" '" ~ '- ~ ;.../J ~~rrf~~ . ~A" : ,( ~-J:J A~'::tr,.U;7l),,---;I--;-.-'. '~IlOIlO\J,.C'HQ.,..tlOU"'~INO~"Y~.Cll..IH,..:,'"t''' ,'."'," "J"".,'I. ",I>""r"'I'" .",'n,~'I~,..I.' ... :Ii (1nI ...7...... r"/ ~'tI. I ....~Y.::) T'I"'_t.t""."'l"'''''''t.4'''~'''W.'''''ltl~IU'''',~''. fM411",l""~u'I~'~'U"'''II'~'I''''""lln,(''.d i I I!.\.,,/"V .._.,..!IL~~.r:._..Q~._____ I .J.!. ..t_'7.t_,7~ .._. 'jA"~ "WAO()I'I'~()lI ~tf'lIOI;l'\>ttOC{)l,l~ttitIOC. ~'" ["~",~lllll>'t",~rl"( 4-~p ~-~'~''''~h ~" _. 'WIOICAI, .U"'INUICOM"I~ f"""" rt:... , j r ~~~~:lb~:I~:I::.~I"'II~H~"'<>II"'''II<Jfjln" '" m~"4'","r'. ~tll~ n~~~"..'tl(l~t "mt, 'HI," 1"'101'01_ ,nd '("'lot'.. '.""IU ~",I 1.1, t/:{ ~ c:~;/t! .' ~~ '" ~h.. tt&' ::~"'"'~!!:;1\~!~~~!~____ __ _~=_ ~-I-~j~(i_-- ,\~""'_":;'~~1t;:~~\qq;"U.r. ~1,!OOf!.U~I!fE$ 1'f~SlIlY ~_.. ,'......"..__1 . 1,._Ll_,dIo:__"~_,_~_~,,~_,___ C"rlisle ",-- lXHIIIT 'W' "i loll t ~ ~ . ~~ ' I g $ . . loIl"'- .~ :S . .... III 'i ~ ~ ~ fI< og~~ 0 . :r:: iJ :l;" 0< ~l:"~~ ~ ~~~ ig ,~~ ~ Q 141 " I" I .. . ' . f ~.- '. I, VERA M. ERDMAN, of The Alliance Home, 770 S. Hanover Street, Carliele, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. FIRST: I direct that the cost of my funeral and burial be limited as contained in my written instructions entitled, "Pre- amble To My Will." SECOND: I bequeath my household goods, jewelry and my tan- gible personal property to The Alliance Home, its SUccessors and assigns. THIRD: A) If my death shall be the result of illness and no accident insurance benefits are received by my estate, the residue of my estate shall be distributed in the fOllowing propor- tionsl- (1) An 80% share to The Alliance Home, its successors and assigns; (2) A 20% share to my personal representative in lieu of compensation for her fiduciary services. B) If my death shall be the result of an accident and accidental insurance benefits are received by my estate, the residue of my estate shall be distributed in the following pro- portions:- (1) A 10% share to each of the fOllowing, to wit, TRUTH FOR ISRAEL, PATHWAYS INTERNATIONAL, 69th STREET ALLIANCE CHURCH, JAMES and MARJORY WEIGANT (as tenants by the entireties), NEIL and GILDA ALTMAN (as tenants by the entireties), BARBARA DONOVAN, and my personal representative in lieu of compensation for her fiduciary services; (2) A 20% share to The Alliance Home; (3) A 5% share to each of the following, to wit, ROSE GARRO and DEBORAH CLARK. ro., f~-"1 """Hf8l.T "B" FOUR1'HI I direct that all taxes that may be assessed tn consequence of my death. of 'whatever nature and by whatever jurisdiction imposed. shall be paid from my residuary estate as a part of the expenses of the administration of my estate. FIFTH: I appoint DOROTHY HOSTETTER, Executrix of this my Last Wi 11. SIXTH: My Executrix sh..ll have the following powers in addition to those vested in her by law and by other provisions of my Will, applicable to all property wliether principal or income, and effective until actual distribution of all propertYI (a) To retain any or all of the assets of my estate, rsal or personal, without regard to any principle of diversification, riSk or prOductivity; (b) To invest in all forms of property, including stock r common trust funds and mortgage investment funds, wi thout restr iction to 1 nvestments authori zed for PennsYlvania fiduciaries as they deem proper, without regard to any principle of diversification, riSk or productivity; (c) To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property for such price or prices and upon such terms or conditions as they deem proper. SEVEN1'HI I direct that my Executrix shall not be required to enter security in any jurisdiction in which she may be requi red to act. IN WITNESS WHEREOF, I have hereunto set my hand and seal to - 2 - EX~lIS'T "1;" , ';. ' " thiB my Lut Will and Testament this 17:d. A.O., 1996. day at' "..e.~ '7// "M/I LJ ;/ ~~nl'~ . (SEAL) Signed, Sealed, PUblished and Declar.ed by VERA M. ERDMAN, the above-named Testatrix, as and for her Last Will and Testament, in the prssenceof us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses: ~ 71). h~J (I" JI-^L- OF 'J '7 (! ,S #tt,frc::J U elL sl(-' ~ hcvtq tvt..ct c. S -,~\~,~o--- , OF , '70 S, 0ctf'<'(.~'~-r: C"u.l',.J., Pc.. , , OF - 3 - r_HI8IT "8" 1'Y .2'1/ 'I IURIAU Of INDIVIDUAL TAMES IIH!RIIAllCt IRK DIYIIIIIH DEPl. /1.... ...."..., flA HUlr'''1 COHHONNIALTH OF PINNIYLVANIA DIPARTMINT OF RIVIMUI c *' NOTICE OF IHHERITANCE TAM APPRAISE"ENT. ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AHD ASSESS"EHT Of TAM ....lt4' II AI, fH.." DOROTHY M HOSTETTER 770 S HANOVER ST BOX 45 CARLISLE PA 17013 DATI ISTATI 01' DATI OF DEATH FILl NUHlER COUNTY ACN VERA 07-27-1998 ERDMAN 04-10-1997 21 97-0553 CUMBERLAND 101 r----AiOOUntRe.1 ft"--'l ....=- MAKE CHECK PAYABLE AND RIMIT PAYMENT Tal REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG TMIS LINI .. RITAIN LONI!R PORTION FOR YOUR RICORDS ~ iiiWU'4rix-AFP--C09"::97TNii;'-icr-O;-iiiHiiiifANCi-;:A'X-APpjjA-iiiiiiiiiT~--AirojjAi"ci-'br"--""---------- DISALLOWANCE OF DI!DUCTIONS AND ASSESSMENT OF TAX VERA M FILE NO. 21 97-0553 ACN 101 ISTATE OF ERDMAN TAM RETUIIH liAS I I X) ACCEPTED AS FILED RESERVATION CONCIRNINO FUTURE INTI!REST - SI!E REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..I E.tet. (Schedul. A) 2. Stook. end Bond. (Sonodul. B) S. Clo..ly Hold Stoo~/P.rtnorahlp Int.r..t (Soh.dul. C) ~. Hort_.IHot.. Roo.IY...l. (Sohedul. D) 5. C.ah/11nk Depollt./H110. ParlDnal Property (Schedule E) 6. Jointly Own" Property (Sohedul. FI 7. Tran.fe,.. (Sohedule Q) I. Totel A...ta DATE 07"27-1998 I 1 CHAHClED III (2) 131 (~I (5) (61 (7) .00 .00 .00 .00 6.302.06 .00 .00 (I) NOTE I To insure P"'-'" ored,1t to Your MCOI.I'\t, .ublllt tho upper pOrUon of thia forll with Your tex P.y_t. 6.302.06 APPROVED DI!DUCTIONS AND EXIMPTIONSI 9. Funeral Expen.../A~. Co.t.IH110. EKPln... (Sohedul. H) (9) 10. Dobta/Horto_ U...lllU.a/Uon. (Sohodul. I) (10) .00 11. Totel Doduotlon. (11) 12. Het Vel... of T.x R.turn 112) 15. Chorlt...l./Gov.rnoont.l B.quoata, Hen-.l.ot.d 9115 Tru.ta (Sohodul. Jl (15) 1~. Hot Vel... of E.tet. Subj.ot to rex (1~) NOTII If.n ........nt w.. i..u.d pr.v10u.ly, l1n.. 14, 15 and/or 16, 17 and 11 w111 refl.ct f1gur.. th.t 1nclud. the tot.l of ~ r.turn. .......d to dat.. ASSISSMENT OF TAXI 1&. Aoount of L1no 1~ et Spou.el r.t. US) 16. Aoount of Llno l~ t.....l. et Uno.l/Cla.. A reto (6) 17. Aeount of Llno I~ t.....l. .t Collet.r.l/Clea. Brat. 1171 11. Prlncipel T.x Duo TAX CREDITS I ~A~'HEHT DATE 03-31-1 98 04-01-1998 07-20-1998 860.50 A'~ lin 5.441. 56 4.393.25 1,048.31 .00 M .00. .00 M .06. 1, 048.ll M .15. (11) .00 .00 157.24 157.24 RECEI~T NUttBER AA269903 AA269907 REFUND DISCD\lNT (+) IHTEREST/~EN ~AID I-I 3.11- .00 .00 AHOUNT PAID 164.75 3.29 7.69- · IF ~AID AFTER DATE IHDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTI!REST AND PIN. TOTAL DUE 157.24 .00 .00 .00 I IF TOTAL, DUE IS I.E$S THAH U. NO PAV"EHT IS REllUIRED. If TOTAL DUE 1$ REfLECTED AS A "C.EDIT" ICR). VDU HAV BE DUE A REFUHD. SEE REVERSE SIDE OF THIS fDRH FOR INSnUCTJON~.' M. REIOVATlDHl P\JRPOSE 01' MOTlCEI PA\1tENTl REFUND (CA)l 0\ it l5 \17 f"" l~e co N ,. ~ ,\1 i-,)} ~~ @(\) ~ '\9 0:0:: (l}. 0 E".t., of ~tI d~ing on or bofor. o.c..r 12, 1'12 ~~ H .o~ future tntlrl.t in the ..t.t. h tnn,f.rred in po.....ion or .nJo~t to Cl.,. . (col1.t,ral) beneflcl,rl.. of the decldent .ft.r the IMplr.tton of ...~..t.t. for I1f. or for ~..r., ttw C-.onw..lth hl".by l!Cpr...h' r.,.rv.. tM rIght to IIPPrlhl n ...... tr...,f.r Inhlr1tano. hK.. .t the l",ful Cl... . (ooU.t,r.l) rltl on illY such futurl lntlr..t. TO fulfUI thl requlrlHllh of SeoUon 2140 of the InherJtMOI and Est_t_ TalC Aat, AClt 1:1 of 1995. (72 P.S. s.<ltlon '140). o.tloh the top portion of thh Notlal and .utIIIlt Nlth your payunt to tM R.gilt.r 0' NUll prlntltd on thl r.vlr.. ,1d1. ........ ell**. or ItOnIY orcktr pllyltbl. tOI REGISTER OF MILLS, AGENT A rlflM1d of . t.1C crldIt, which Nil' not r.qu..ted on thl TIIIC Return, ..y bel requesteet by a"pl.Ung IIn "Applioltion for R.fund of Penn,y1v.,le Inhurltttn<ll .nd E.tata TaK" (REYM13l]), AppllcDUon. are IveHabl. .t the Offlc. of the Regllt'r of WUlI, Iny of thl 25 A.vtflUtl Dhtrlct Offlc.a, or by cllllng thl .p.clel 2~~hout .......rlng ..rvlc. nuablr. for for.. orderlngl In Penn'Ylv~nla IM800M36Z.Z0S0, outside Penn.ylvAnia tnd lillthln local Harthhurl erea (711) 787-8094, TDDI (717) 77Z.2252 (Hillring l.p.ir.d Only). OIJECTlOHSl Any p.rty In intere" not .aU.fI.d with the appr.he..nt, allowance nt dlsllllow8OC1 of dIckKltlon" or ......Mnt of teK (Including di.count or intere.tl a. .hown on thia Notice eust object within .llCty (60) d.y. of receipt of thh NoUc. by: AbMlN ISTRolTlYE CORRECTIONSI DISCOUNT I ,.PENAl TVI INTEREST I .Mlilrlttan prot..t to the PA D.part.ent of Revenue, 80ftI'd of App.al., Dept. 281021, Harri.burg, Pol 11128~1021, OR, uel.cUon to MV. the .atter d.hr.lned at ludlt of the Iccount of the p.r.onal rapr..ent.Uve, OR .~~.1 to the Orphan,' Court. Factu.1 .rror. diJco",.red on this ........nt .hould b. IKIdre...d In writing tOI Pol Dep.rt.ent of Ravlftl.M, IurelU of IndivIdual Taxe., ATTNI Po.t A......lnt R.",i.., Unit, D.pt. 280601, Harti~burg, PA 11121~0601 Phone (717) 787~6505. S.. page 5 of the bookl.t "In.tructlon. fer Inheritance Tax R.turn for. A..ldlnt o.cedlnt" (REVMI501) for In .KplanatJon of .dlini.trativelY corr.ctable arror.. If ,,"y tall'due Is paid within thrae 151 callnd.r .onth. after the decedent', de.th, I flv. percant (5:0 CliJcount of the tlK p.ld 11 allowed. The ISX tax ..nuty non~partlclp.tlon p.nalty h c..,.ut.d on thl total of thl talC and intare.t ......ed, and not paid blf(lr. January 111, 1996, tM Hnt d.y,fter tM end of thlll taK lItnuty periOd. This non-participation penalty it ~labh In thlll .... HMlr end In the the .... tI.. p.r lod .. you would eppa.l the; tax and Intar..t tt.t hII, bun .......d a. IneUc.t.d on this nettlc.. Inhr..t h chlir..dtNitlnnlng Nith flr.t d.y of delinquency, or nine (9) IM)nth. and one (1) d.y frOll the d.t. of dlath, to the OIte of pay.."t. TalC.. MIlich bee... d.llnquent. before Januaty I, 1982 tMar Inter." at thl rate of ,Ix (6X) percent .pt/r IN'lIllM calculat.d It a d.lly rata of .0001614. All taKIt Mhlch b.c... delinquent on and .Uer January 1, 198Z will Mar Intar..t .t . ra" which tlflll vary frOll calendar year to calendi,r ye.r with thlt r.te MnOUnC.d by the PA Depart..nt af Aavenua, ThI appliCable inter..t rat.. for 1912 through 1996 ar.; U!!: Inter..t Rete DaUy lnt.re.t hctor :!!!r lnter..t R.ta DaUy Inter..t Feotor 1982 20:< .000548 1.81 9% .000247 1913 16:< ,000458 1988-1991 11% .000301 1984 11:< ,000301 19.2 9% .000247 1915 13% ,000356 1'"3.1994 1% .000192 I'" 10% ,000214 1995~1998 9% .000247 ~.lnt."'lt I. calculat.d .. follow'l INTEREST . BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR hAoY Notlc. luuad .ft.r the t.x beaOR' dellnqu.mt will r.flect an Int.r..t cI'lculoUon to flftun (15) day. beyond tha d.t. of the .......-nt. If ply.ant It .ad. after the Inter..t COllPut.Uon data .hoNn en tha Notio., additional Int.ra.t .u.t ba colaul.tad, /5 ,;{41- Y '*' COMMONWIALTH OF PINNSVLVANIA DEPARTMINT OF RIVINUI 1:NHEUTANCE TAlC STATEMENT OF ACCOUNT \ C/ BUReAU OF SMOSVIOUAL TAMES INHI!~IIA"c:r IAK DIYIIIOIl IllPT. z...11 HARMt81URO, ?A 111Z,~"Ol "",..,.....111'''' 08-03-1998 ERDMAN 04-10-1997 21 97 - 0553 CUMBERLAND 101 VERA M DOROtHV M HOSTETTER 770 S HANOVER ST BOX 45 CARLISLE PA 17013 DATI 1ST ATE OF DATE OF DIA TH FILl NUIGlER COUNTY ACN -A~ount R!._lttod- MAKI CHECK PAVABLE AND RIMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 MOTE. To Inau.- proper or~lt to ~our ..oaunt. .u.-It the upper portion of thl. f... with ~our t.x p_~nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiiV' :i60"f'iX'AiiP'i'O:Fi'ff'--'-'...'iNHE'RiTAiiCE-TAX-sTATiMENT'OF-ACCOUNT--.-.ii---"- ----.-..... -.,. ESTATE OF ERDMAN VERA M FILE NO.21 97-0553 ACN 101 DATI 08-03-1998 THIS STATEMENT SS PROVIDED TO ADVISE Of THE CURRENT STATUS OF THE STATED ACM IN THE NANED ESTATE. SHOMN BELUM IS A SUMMARY Of THE PRINCIPAL TAX DUE. APPLICATION Of ALL PAYMENTS. THE CURRENT BALANCE. AND. If APPLICABLE. A ROJEC IN RTf RE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT. 07-20-1998 157.24 - PRINCIPAL TAX DUE, PAYMENTS (TAX CREDITS). AMOUNT PAID 164.75 3.29 7.69- PAYMENT DATE 03- 31-1998 04-01-1998 07-20-199,8,., RECEIPT NUMBER AA269903 r,~A269907 ,-:REFUND DISCOUNT (+) INTEREST/PEN PAID (-) 3.11- .00 .00 i;-'. '-!'l N ~~ <,,1 (~i IP r- 0: 1. ;~ T~ ,~8 cO p, TOTAL TAX CREDIT 8ALANCI OF TAX DUI INTEREST AND PEN. TOTAL DUE 157.24 .00 .00 ,00 . If PAID AfTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( If TOTAL DUE IS LESS THAN .1. MO PAYMENT IS REQUIRED. If TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORM fOR INSTAllCTlONS. ) PA_. I i I i I I I I ,I I I I ...- '.... top ...tlon of ttolo NoU.. ..... ....It with l/OU' ""_t _ puolllo to tho _ .... odcIro.. prlntfJd on ttM rlYerlN .1.. " 1lI!IIIIl'NT III!CEIlEIIT ..... _ 0' _. 0''', .._I. tll IIElltaTlII OF 1IILLS, AllI",. "!IOH.IIUIIlEN' IlEmlI!IIT """. _ II' _. 0'.' p....I. to, COltlOIllI~ALTH OF PElINsYLVAIlJA. MfUIII (Clh A ,.efunc:l af . taJI aredlt, whloh .... not r.....ted on the hie ..turn, ..~ bIi r.....tM b~ OCIIIPI.tlntl en "_UoeUon for "fund of Pennerlven.. Int.rlt_. ... Eltet. T~ (fEV-U1S). AppUOIUont .r. IIY8Ulbl. .t thellUoe of the ......t.r of .Unl, MY of ttMt U Revenue Dhtdot Of' 1011 or fr. the ..........t.. ,....... M....I"I MrvlC* nu.ber. for forti. orderl"81 In hnn'~lVfW'll. 1-100-)62-2150, GlIb'. Pem.~h..d. .,.. t1Jtt!ln 10011 "'rrllburl Ir.. (117) 7.,..aOM, TOOl (111) 712-22&2 (""rlne 1..1,.. onh'). RIItlV Ta, ....tion. r...rd.", error. cont.lned on thh nottc. thould bet -*fr....d tOI PA o.,.rtllrlnt 0' h~, Iu,..., of JndlvldUll 'IIC.., AnHI Put A.......,.t Rlvl.., UnJt, Dlpt. Z""I, KI,,.hbur., PA 17121.....1, phoN Cl17) 711-6115. DJSICOIMh If My tmc .... II ,.Jd within thr.. (5) ~lend1r IIOf1th, ,ft.r the ......t.. dMth,. five ,..rOWlt (Q) dJMaw1t of the tax ..Id II ,UOMed. _lTV. IHTIlIIIT . The lSX t.M ....ty non"pertlal,.Uon P4lNlty II CHputed an the tot.1 of tht tlx .., Int."..t .....Hd_ ... not ,.ld bIIfqr. JwMry II, 1"', u.. flr.t dIly .ft'r the ... of the t.x .....ty period. Int.rtt.t .. on.rlld -.Innlng ..ith flr.t My of delinquency, or nIne ('l IIOftth. end on. (1l dIIy frClll the det. Of death, to the det. of p.~t. TaMla .....Jah __ dlUnquent before .......ry 1_ 1912 blar Int.r..t .t the rlt. of .IM (6Xl "rOWlt per .... ..Iaulllt" .t . d.lly r.t. of .100164. AU tlllC" ......toh bIafIM _11nquent on ..., .ft.r """'"y 1, 191' ..111 OMr Int.r..t .t . r.t. whloh ..111 VII')' frOll o.llnder lfHr to OIllendlr YMr WlttI tMt ,..te ~ by th8 PA ~rt-.nt of AIYInUI, ThI eppllolbl. Int.r..t ".t.. far 191' thrOUlh 1991 .r'l V.., Int.r..t Alt. hlh' Int.r..t Faator V..r Inter...t AIlt. Dllh Int'I'I.t F..tor l..r rox . .0054a 1M' ,~ ,"1147 1..5 lOX ...."JI l"a~1991 ll~ ....SOI 19M ll~ .""31~ 199. ,~ ...,,'" I.... ISX ....S56 1993-1994 ,~ ..OU,. I'" 1I~ . ..1274 1995~1991 ,~ ."0147 -"Int."..t 1. Glloul.ted .. follow. I IIl'I'IIIIT . IALAllCE OF TAX UNPAID X HUIIIER OF DAYS DELINqUENT X DAILY IIlTIIIlIT FWfOII uAny MoUo. 1.1UId .ft.r t.... t.)( beG.... MlInquent ..Ill refleat ... Int.r..t Hloul.t1on to fHt... UI) .YII 1M,... tht det. of the ...........t. If P'nllnt h ... .ft., ttM Int'nlt a.-put.Uon dlt. IIhowl on u- Notl.., ~Itlonel Int.r..t au.t be calcul.ted,