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Home My WebLink About97-00735 ",,' "" :):: '~''-' l!, ,:,~' '~ .... -... '- ',' \:'" ,''1 "~: ~:' ". -, ,. '," '~- ". .,','-1'. , , ,;'f i~~' . ":'\,~J .", ,J. t('. -- -".,.....tc)- r~~{;('~: ,~:....i "',J,lo.,..,,,..;" ~%~ "C:- tli" ?!~{H'~1;}:~HtS0~'::~ , ;}t::;.:f.':,;~" )r~' ~ . "" t, ~ . '~H.,;.,t'(,:;: ,;,:;.::,-r~,:}. ',"!., .- :,:: .,',:.j;," ',,' .J{~,.t , '",:',', -"-',~,- .. '1,\1 3 'si. . . ... i ..;,). -- .Qt ,.' .' .", c',,' .' ....... '0: G) .. D ... ......."'.. "11.I x:;.... .. z ::...~ ~ '.12 15 -.;l()/- PETITION FOR PROBATE and GRANT OF LETTERS ~ ~ 1~97-lV'35. Eslale of R i ch"rn W also known as Blnch",r No. To: Register of Wills for the . Dcccased. County of Cumber land in Social Security No. 166- 12- 0:;206 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), 'it~ is/arc 18 years of uge or older un the executrix in the lust will of the above decedcut, dated .T"nna ry '31 and codicil(s) datcd thc named , 19-9-5-- (state relevant dn:nnlstanccs, c.g. renunciation, death of executor, CIC.) Deeendent was domiciled at death in r.llmh"rl "nn h i!i last family or principal residence at County, Pcnnsylvania, with . g L (list street, number and nlunciplI!ity) Decendent, then Ilt; years of age, died August 27,1997 , at ~ha.rhClTn I c:: {""hni ("'Q. Ah7 Vnrk "Rn~n r:Pt-t-y~hllrg 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 kiiling and was never adjudicated incompetent: n{")n~ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ ~ t;. n n n n n (If not domieiled in Pa.) Personal property in Pennsylvania $ (If not domieiled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 201 F,,,,,t Rnrn Str",et. Shippensburq. Pef1nS~7J ,;Tan; ~. C'l1mh~r' ~nn .....nnnt-y WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and eodieil(s) t",,,t,,m,,,nt,,ry (tcSUllnClllary; administration c.I.a.; administration d.b.n.c.La.) ~ ~ . u c . "'~ .;;;~ u_ '"'u c ",0 c':; (\I':; ~. ~o. U~ 30 ;;; c '" Vi yrff~L~~ A~ .f~~ t;7t;t; P"pp"r Ring" W"y C9RCOrG, CA 04521 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 S' COUNTY OF C"lmbgrhRQ ]' " The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition arc true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. S worn to o. r affilJ!l"d and s. ubscribed ~ 1( a~/?l/7H.2. ~~ ~ before me this ~ day of c;-=--::; '--~ ." '1:'e~_c-"j~9 Bonn;o <:: Rnh;ncnn g .{~WIM.4.J.L --'1~ ~ V R~~lr ~ . ,--_.-.....-~._....._-.. _.'~ No. ~-lqq'1-0'7.3s.. Estate of RH'HIIRn W RT.Or.HER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW !':"ph'mh"r ~ 19~, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated .hn'lary '31, 1 QQ<=; described therein be admitted to probate and riled of record as the last will of , o;~pa~a M Rl0~h~~ and Letters T'ilstamllRtilry are hereby granted to 'Rnnn; p ~ 'Rnhi n c:nn '-1I}Vlv~~ .Y.tUJil ~ i.- Vrc!fIWAtlf Register of Wills RY C I,EWIS FEES Probate, Letters, Etc. ......... $ Short Certificates(ii) . . . . . . . . .. $ Renunciation ................ $ JCP $ TOTAL _ $ SEPTEMBER 5 I 115,00 1~:88 Forest N. Myers, #18064 ATIORNEY (Sup. Ct. I.D. No.) 5.00 l.'lJ..00 117 P~rk pl~ce West ADDRESS Shippensburg, PA 17257 ...... 1997 Filed ................................... PHONE (717) 532-9046 aCJ c :-" '.r. -_I -" LETTERS AND ORDER MAnED '1'0 A'l"l'ORNEY I .~ -u .1. ,-./ c::: 1111" I', II! lL'III!'. 111\ ,il I("~J'I LlI 11!11 Ii", Illt,.!,II.I[;,'I. Ii II H' "II ~', Ill.d \ \ II ill. 11\ , .'>11",[1" ,., ,j',HL ,ltd\' liled 'I !', [fll,IIII'lll lillng. willi lilt' ,I'. ~ " I '. , I "i' ; ! ! ~ ; Iii i" (lIl\',II,!.,1 :,. tl \1,11 WARNING: It IS illegal to duplicate this copy by pilatO'. I'" or photograph. I, j ,[ <II //!~'i/4!OL <" ':l' ,';~\11i or pit-------, ,,"~\"" "41', /'i<<~.~\ ::e' " ~:I lCl :".. -; ~w .., .. z,.,: \ . ,.. ,. -7- .' #>..- \ <?:' ...~)I .0;..0 .....-...:-/ '..'1-9{ "<-,,r,_ "'>._;IIiN1 ~\,,-,"" -::":i!!::}!.!.!~' (Y3Cf. /P7:7 11,,'. 4435528 \~... 2"1 COMMnNWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH ~AME OIl OiECIOl!(l' I". ....,.,. ~., .., .Male ""1'<\1""'''''''' iOCl.~ M:C\J~'T'f "IlV~UI OKlEC'~(.T"I.i".r"'I',.. _. ,.166 - 12 5206 t. August 27. 1991 I. RiCHARD W. BLOCHER ~ .1l(1~1Il~ UNtit!IIIYlN! - "" uHOl!lIllV1r .......ll.I...... 1lIU~!I:...._ PVoC. 01 Ol!R..'C..... """'....-_.....". 1.'"''''_''''''' on...".,,,.....,,.c...""',\ lO(l$l'ltoL Bendersville.PA 1__0 !~....O , .AC/UTY """'€ I~ ""'..........,.., govoo...... Vrd'.....!lI<. Shepard's Choice Hospice '0 Wh ile ~UJW""NO'>I'QU<,( .....,...,.....- ,SZ",C 85 y,. cou~rrOf~.. nAC'~_...._.l\OOC<I._."" "~_"'l Adams Gettysbut'g KINO 1\1 S ~NOIJ!T~" l.I~'IIT"'~!WU&'U.""'" /1....1o?i......,,_ ~ o..o.:.dl'>oec#yl 1'.""'1 ",Widowet' Ih,O ....,___ltI OlCEOOlT'!UW.....OCCIlN;tOff (d'::;:.~~:::3.~ " Pdntet' ft,.idel Pdnting Hous OIECl!OiENn"""""'OolOClW:H~....c~liIMl'llCodoI Of;Cl!OlNT'1 ""'~ A!SlOf:NCE ""- ~-- .. - MOO -' 11~,~ :"'-:::-':::d IoIOTHo[II'.,.,.,l.IEjf..,l.I_.U_s...'...., " Alicr. G. Wert 'Nfonl.l......T'So,U..LlIoIllAOOl<(u"""'.c....--.~r'llCOIo1 5755 Peppet't'idge Way. Concot'd. CA 9452] PUoCIOl'OtSPOSlTlOf'l.N""'OI~""C'_"", ~oc.ulON.~s<....rClc.o.>> ",Ot'*"*- hippensburg, Cumbo 201 East But'd Stt'eet ,.sh ippensburg. PA 17257 "'JI1f:A"......IoIt:I'..,l.I_~ II John C. Blochet' 'NFOfIltAHT-S""""'IfI_"'"I Bonnie S. Robinson lo<CIl<OOOl'SI'OSlT .....XJ~D "*-" Cumberland Shippensburg ..,- Ct. ,PA ~_ rin Hill Cemeter " .00 LICE'"5lN\J>Mlrl1l 011776-L 17257 CooIpIole_:r:lMIIiIVf_~ ~.__._.._.. ~_.._, "_I""--~~ ----~ zf /517 WA Mt~E'!AR(DlOl.I(OIC.ll...UllIN(M:OOOfO'Rl ' _0 .4f J'<lIIT.:OI..........,...__.........-.;"'_ea.o ""'~..__o,.no.__..I'lVf1, _Dl.CI'IC.&Ull"... -.- ,..-.g..-..- 1""""'-. 1"-- ,-""- , "'" --- I:' ~...,,~IlI_ _r._UMOIIlU'INQ CAUUlo.-O"",,, --- .~..-........, T1UECI''''I.lUAY tMXIRYIltWOll.' OUCRIlIlIfON'""UfIVtXCll"""O _SAN~Y l't1ll'0RUI!l)t wtR..AUTOPlIV'INDtNQS ........~'" COUl'I.ITIOHOfCAIlU: "''''''" .........N(ROl'~H OAJEQf'l""Ultl' (""",,.c.._l ~ o o o o DPI,.O.CEOl',""unv.",_'."".,,_,._,OlIl<.l.I. -""O....,~..., - -- --~ ..... - _ 0 ...0 - 0 ~V .. 0 ~)1 *- - UJIIT_lIlcr.;oo:r-._ .ClJllTWT_"'""!CIAM(PO\...,..~.:-"'_...........,..."".oc.........po~_......<,...po..OO"-1). T.N_.....-...............-.....................)__.._".......,..........,.......... lOCAT\OH~... c....-_ ~., """".....~""'.....- .... " .~A/rlOCIJIIT.,..,tfO~y~AH(P",""..~I,.,I>'"....,....;"'l_...,<...o/yo>Q"'<......"'_..1 T..._.....--......___"'...._._,_,........._IrIN........)........ftftW._"".. ...DlCALDAUIt/tIllCOAONlfI JI.~":' ~::~I.~~.~~~~~I~~~~~.ln ",.,.~.n.~:~~~~ ~~~~~ ~~~~ ~'~..~~I;: .'~.~~;: ~.~~~~~;;~~~~~I.~~ 0 "' , ]'11)- ~~ i ::: ..:?I - Iqcl"7- d'l 35 ',j: i: :!i:: ":: it, ! ::1 ;; no r. -';".i ;;fl.:' ,;.,,';;' , ! i :: Ii : ~ ' ,- " , ,i '! :1 t:il;i ;I" :1; " !,~jiL , 'i!., 'j,,:!' "T ,II" 'ii' j,: !. :1 'i' i'" ,:::' ii: it:'; :.,i, :ii: " ::' , ii: ,I' :r ;i:i -,, ':f , : ~ I '."!,: I: , ,ill' :,'1 ';, ;j ro'; L:. ~, ! .J _'I ";'_1 ::U Git, CU.- ; ("', 0:: rIJ ~ '" Joi. , ~ % ::t= ~ ~ ~ u ~~ % 0 ~ < << ~ ... ~ " ..\~ ~ :z; '" u ;;: ~ U H '" " Z << " ;3: 'd :<: "" 0 ' - . . " < 0 ;3 ~ .... ~ ~ ... -tll ... z " tIl tIl ~ rIJ " 0 < '" 0:: ~ ~ % ~ ... :I: ~ % 0 ..: r:f ~ 0 0 u Q H 0:: .- " * * LAST WILL AND TESTAMENT * * I, RICHARD W. BLOCHER, of Shippensburg Township, Cumberland Counl'/, Pennsylvania, revoke my prior wills and declare this to be my Last Will: FIRST: PAYMENT OF EXPENSES. I direct that the expenses of my last illness and funeral be paid from my estate as soon as may conveniently be done. SECOND: SPECIFIC BEOUESTS: A. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.00) DOLLARS to my grandson, GEOFFREY ROBINSON; B. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.001 DOLLARS to my grandson, MICHAEL ROBINSON; and C. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.00) DOLLARS to my grandson, BRYAN ROBINSON. THIRD: BEOUEST. I give, devise and bequeath the residue of my estate, real or personal, tangible or intangible, together with all insurance policies thereon unto my daughter, BONNIE ROBINSON, provided she shall survive me by thirty (301 days, per stirpes. EIDJ.!l.TIt RESIDUE OF EST ATE. I give, devise and bequeath all the rest, residue and remainder of my estate unto my daughter, BONNIE ROBINSON, provided she shall survive me by thirty (301 days, per stirpes. BEIlt PROTECTIVE PROVISION. To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be (il assignable to a beneficiary or (iil available to anyone having a claim against a beneficiary. SIXTH: DEATH TAXES. All federal, estate and other death taxes payable on the property forming my gross estate, whether or not it passes under this will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment for federal estate tax purposes. SEVENTH: MANAGEMENT PROVISIONS. I authorize my Executrix, as follows: A. Retain/lnvest: To retain and to invest ill all forms of real estate and personal property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations imposed by law on investments by executors or any principle of law concerning investment diversification; B. Compromise: To compromise claims and to abandon any property which, in my Executrix's opinion, is of little or no value; C. Borrow: To borrow from and to sell property to my daughter or others, and to pledge property as security for repayment of any funds borrowed; D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales of leases; E. Capital Changes: To join in any merger, reorganization, voting.trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. Distribute: To distribute in kind and to allocate specific assets among the beneficiaries (including any custodian hereunder) in such proportions as my Trustee may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all property at any time held by my Executrix or my Trustee and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law aod shall be exercisable without court authorization. EIGHTH: EXECUTOR. I appoint my daughter, BONNIE ROBINSON, Executrix of my Will. In the event of the death, resignation, renunciation or inability of my daughter to act as Executrix, I appoint MELLON BANK, its successors and assigns, Executor of this, my Will. Neither my Executrix, nor any successor shall be required to give bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal this.lln. day of JANUARY, 1995. l~ " r:tr %tf/lf} tv I:U::r^f,1; ~ ASEAU Richard W. Blocher, Testator In our presence, the above.named Testator signed this and declared it to be his will, and now, at his request and in his presence and in the presence of each other, we sign as witnesses: ,/ltt~v/ ;l-~ 6- CC~'- ~+b~ , COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF FRANKLIN I, RICHARD W. BLOCHER, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the purposes therein expressed. /. y(p-t, unr! tv y),Wv-i/ Richard W, Blocher, Testator ,~~,,:.:;:;_;,;_;;.,,:,:._:"~,~tJ~$~;';:~W;j~'i;,.R;'>j..;>i~i\,.;.ri,r:;:~~;'" ..'J..:,"'" ., ~ ..''"-,.... We, RICHARD W. BLOCHER, the Testator in and the undersigned witnesses to the Will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (al that 1, the Testator, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (bl that we, the witnesses, were present and saw the Testator sign and execute the instrument as his Will, that he signed it willingly and executed it as his free 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 Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. '7 /!:f1.~?j{jiJ1/f jrJ J'flJJ(~ Richard W, Blocher, Testator ~;'.O~~ Witnes{ p. ~fW-~ . Witness Subscribed, sworn to or affirmed, and acknowledged before me by the above.named Testator and by the witnesses whose names appear on this 31st day of JANUARY, 1995. NotFIriC'l' Seal Foresl N. My.'; "IotillY Public SO\~l'\amplon T>".U l=ranklin County MI' COfi'{llIS~"I'.JI' (.:,c,pI'~ Qec. 11, 1997 I. .. ',I.e. ry. Name of Decedent: RICHARD W. BLOCHER Date of Death: AUGUST 27, 1997 Will No.c2I-Q7 - 7.35' Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.61al of the Drphans' Court Rules was served on or mailed to the following beneficiaries of the above. captioned estate on September 1 O. 1997 NmIm Address Bonnie S. Robinson Brian Robinson Michael Robinson Geoffrey Robinson 5755 Pepperridge Way, Concord, CA 94521 5755 Pepperridge Way, Concord, CA 94521 2963 Wrangler Street, Las Vegas, NV 89102 1919 Sierra Drive, Fredricksburg, VA 22405 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except - ",=-+-,,-,2s-- Signature Date: 9 -'::l - 9" 0', Forest N. Myers, Esquire 137 Park Place West Shippensburg, PA 17257 (7171532.9046 I": c: ('.) Capacity:_ Personal Representative ,- L.o.- U_I , .-XX- Counsel for Personal Representative r- <.:" ..=::5 iJCi :" "~\';a\,,,~'ii:.>,,..~}~" . ;~~~f""'HWii'iI\-:o;,*",...,:.(.,r."""f'~'':'"'l'''J''',:A'''~'--''''' --., .' .. ri.'-i.. 2-1 j17 - 735- Name of Decedent: RICHARD W. BLOCHER Date of Death: AUGUST 27,1997 Will No. 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 of the estate is complete: Yes No XXX 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: March 6, 1997 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 anyl for the personal representative's account is: u, (....' c. Did the personal representative state an account informally to the parties in interest? Yes _ No_ N d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. C\.. I.'.' ""J !"- , I "- r"~""'''~'''''''''.''''''~ ...,..."........~.~~. ", 0.- ,- 0: Date: ~ ~-~l ':+-N~ Signature FOREST N. MYERS, Esquire 137 Park Place West Shippensburg, PA 17257 (717) 532.9046 Capacity:_ Personal Representative XX- Counsel for Personal Representative 0', ~' ) c N ~ rO- 1.!.1 ~ r-u 9' ..;.- .:; (~I'--: .JV /5-;).01 -,) ,I[V-Iloo"-I'-.'I INHERITANCE TAX RETURN ~~~~.r~~~~~Fuk~~g6'$~tlll"'JI191 RESIDENT DECEDENT POVERlY CREDIT IS CLAIMEOO COMMONWEALn'O'PENNSVLVAN'A (TO BE FILED IN DUPLICATE FILE NUMBER OEPARTMENTO' nEVENUE 21 1997 "AnR'sg~~~.':~~~:,,-O'01 WITH REGISTER OF WILLS) COUN-rY CODE VEAR DECEDENrS NAME (LAST. FIRST. AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS Blocher, Richard W 201 East Burd Street DECEDENT SOCIAL 3ECURIlY NUMSER DATE OF DEATH DATE OF BIRTH Shippensburg, PA 17257 166-12-5206 08/27/97 06/19/1912 Counl C\Jn1b:rland (IF APPLlCAO"lsunVIVINo SPOUSE'S NAMEILAST. SOCIAL SECURllY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) FIRST AND MIDDLE INITIAL) o 40. Futuro Inlorost Compromiso (for dates of death aftcr 12-12-02) l3 6. Docedont Died Tostata 0 7. Decodent Malntainod a Uvlng Trust (Aftech copy 01 Will) (Aftach copy 01 TrusI) "Alll!iIl:Ol\l\eSllPNDE:NCE!iillNdidONf:IDENTll'itliirAlCillleOI\MATION ,SHOI.I(O,BeiOiREC'TEO,TO:/::i,:i:',i,',:-: NAME COMPLETE MAILING ADDRESS Forest N rs 137 Park Place West TELEPHONE NUMBER shippensburg, PA 17257 717 532-9046 1. Real Eslale (Schedule A) 2. Stecks and Bonds (Schedule S) 3. Closely Held Stock/Partnership Interest (Sch. C) 4. Mortgages end Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) o. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (Schedule L) e. Tetal Gross Assels (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) 10_ Debts, Mortgage Liabilities. Uens (Schedule I) 11. Tolal Deduclions (Iolal Lines 9 & 10) 12. Nel Value of Estate (Une 8 minus Une 11) 13. Charitable and Governmental Bequests (Schedule J) 14_ Net Value Subject to Tax (Line 12 minus Une 13) 15. Spousal Transfers (fOf dales of death alter 6-30-94). See Instructions lor Applicable Percentage on Page 2. (Include va!ullS trom Schedule Kaf Schedule M.l 16. Amount 01 Une 14 taxable at 6% rate (Include values from Schedule K or Schedule M.) 17. Amount of Une 14 taxable at 15% rate (Include values from Schedule K or Schedule M.) 1e. Principal lax due (Add tax from Unes 15, 16 and 17_) 19. Credits Spousal Poverty Credit Prior Payments Discount + + IS'Z..c= 20. If L e 191s greater Ihan Line 16. enter the dlllerence on Une 20_ This Is the OVERPAYMENT. !~!' .1Cri~~ki'ijBr'$\Jjt o'U1I~f~!~.'hu~~.r"I~!:rifuna!:QfC'our,i~v.e';;":tymentuliiiiii:i:!i!:!HiH':i1@iHi 21. If Line 10 Is greater than Line 19, enterthe difference on Une 21. This Is the TAX DUE. A. Entar the interest on tho balance duo on Line 21A. S_ Enter lhe total 01 Line 21 and 21A on Une 21 B. This Is the SALANCE DUE. Make Check Payable to: ReglsteT 01 Wills, Agent Ililllllllil!ilII!II!ill,I!lllill\lIiillllilllHi!I!:iI!I!liil!11:..m!\I:..I\BESI.IRIl!;tO!~5WEI\:~tiIQ(jESTlON$IONII1AGEI2AND'TOIRECHECKilMA'THlf'!lo+?lli'!ioIiiI!Ii1!ii,,!!lllliii!iiildi!iiHi!i!!I!Hiiilllillli!iliiill!iii'! Undor penalties 0 pOflury, I doclaro that I have oxamined this roturn, neluding accompanying schedules and statements, and to the best 01 my knowledge and bellof, it is true, correct and complete. I declaro that all renl ostato has boon reported at true m<lrket value. Declaration 01 preparer othor than tho personal reprosontative Is based on all Information of which proparer has any knowlodgo. SIGNATURE OF ERSON RESPONSIS R FILING RETURN ADDRESS ~ "".c~See Schedule attached 1. Original Return CHECK APPRO- PRIATE BLOCKS o 4. Umlted Estate CORRES- PONDENT RECAPIT - ULATION TAX COMPUTA- TION C:- 0735 NUMBER 3. Romaindor Return (lot datosol dealhpnorlo 12-13-82) o 5_ Federel Eslale Tax Relurn Required .QQ O. Total Numbor of Sefe Deposit Soxes : :: : I: i: I : i i! n; I : Ii::! ~ I:::! I: ~: Ii!:: Ii i i: i:\l: i:: II I 11 n!!:!:! i: i Ii: Ii!! i!l! ! I (1) (2) (3 ) (4) (5) None None None None 69,989.00 (6 ) (7) None None (0 ) 69,989.00 (9 ) 9,413.00 (10) 5.00 (11) (12) (13) 9,418.00 60, 571. 00 None 60,571.00 3,634.00 0.00 3,634.00 Interest .... \ 'B 2. - -6-,.e& (19) (20) (21) (21A) (21B) '3%)... 3,/5:34.66 0.00 ~ . '~4 OQ '!~ 1- DATE 10- 9-g~ SIONATURE OF PREPARER OTH ~...., A15001 NTF 6619 ADDRESS 137 Park place West Shippensburg, PA 17257 DATE \1.:>-9-9, Copyright Forms Soltware Only, 1994 Nelco, Inc. N94PA001 . Estate of: Richard W Blocher 21-1997-0735 The follCMing peroon(s) are signing the return as representative(s) of the estate: Bonnie S Robinson 5755 Pepperidge Way Concord, CA 94521 .-- ~~~~1'1,_";l"......",H;o"'~"""""'~''''''"I'.''F'''.''' .w.,.._....~..~".' ....; ,.._...~....'''',,"',._-. ~.. ..".~.. m__.,.,....., REV-1508I;X.(2-81) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY PIOB:lO Print or T po FILE NUMBER 21-1997-0735 must bo dlsclosod on Schodul. F) DESCRIPTION VALUE AT DATE OF DEATH 1 PNC Bank, Certificate of Deposit #21001057155 4, 580 . 00 accrued interest 11.00 2 Dauphin Deposit Bank, Certificate of Deposit #814-523925 40,000.00 accrued interest to date of death 1,842.00 3 Insurance payrrent, nursing hare insurance 480.00 4 Wells Fargo Bank 0.00 Wells Extra Savings #6439702150 17,679.00 accrued interest 4.00 Checking Account #0435033899 1, 856 . 00 CUstom Access Checking #0173483472 3,537.00 $ 69,989.00 TOTAL (Also entor on line 5, Rocapitulation) (Atlach additional B 1/2" x 11" shOOIS if moro spaco Is noodod.) PA15D81 NTF 1215 Copyright Forml Software Only, 1994 Nelco, Inc. N94PA081 ,), , r I.' I . . REV-l&t'EX.(1..U) COMMONWEALTH Or- PENNSYLVANIA INttERlTANCE TAX nETURN RESIDENT DeCEDENT ESTATE DF Richard W Blocher ITEM ND. A. Fun.r.1 Exp.ns.s: SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES DESCRIPTIDN 1 Fogelsanger-Bricker FUneral Hare B. AdmlnlstraUvo Costs: Personal Roprosentative Commissions Social Security Numbor 01 Porsonal Ropresontativo: Yoar Commissions paid 1. 2. Atlorney Foes Narre: Forest N Myers 3. Family exemption Claimant Address of Claimant at decedont's death Slreel Address City 4. Probate Fees c. Miscellaneous Expenses: Relailonshlp State Zip Code 1 Probate fees, Register of Wills 2 advertising, Cumberland County Law Journal 3 Register of Wills, filing fees inheritance tax return 4 News Chronicle, advertiserrent Ploa.o Print or Typo FILE NUMBER 21-1997-0735 AMDUNT 6,393.00 0.00 2,750.00 0.00 0.00 141. 00 60.00 15.00 54.00 9,413.00_ PA15111 NTF"" Copyright Forml Software Only, 1994 Nelco, Inc. N94PA111 TOTAL (Also onler on Uno 9. Recapitulation) $ (II moro spaco Is noodod, Insert addlllonal sheots 01 same size.) f" ." REV-1$13 EX. (2"11) COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE DF SCHEDULE J BENEFICIARIES FILE NUMBER Richard W Blocher ITEM NO. 21-1997-0735 AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARV RELATIONSHIP A. TnMoblo Doquonla: 1 Bonnie S Robinson 5755 Pepperidge Way Concord, CA 94521 2 Michael J Robinson 2963 Wrangler St lita Vegas, NV 89102 3 Geoffrey Robinson 1919 Siera Dr FredricksWrg, VA 22405 4 Brian D Robinson 5755 Pepperidge Way Concor.cl, CA 94521 daughter 45, 571. 00 grandson 5,000.00 grandson 5,000.00 grandson 5,000.00 ITEM NO. AMDUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARV B, Chorllablo and Govornmontel Boque.ts: None TDTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enler on line 13, RecapllulaUon) (II moro space Is needed, Insort addlllonal shoets 01 samo size) $ PA15131 NTF 122M ~'I'A""",ii,.l3l:l";:(~,,f.":",;:WI<.;~':':':'(J.I;.Q-:i"'C'~'''' '-'-\"';~'", ~.,",'":,,_,;;,,., ..:.\".-...,u('~....,\,., '''. 0.00 i I I I i I ! l II II .1 II b r r I ** LAST WILL AND TESTAMENT ** I, RICHARD W. BLOCHER, of Shippensburg Township, Cumberland County, Pennsylvania, revoke my prior wills and declare this to be my Last Will: FIRST: PAYMENT OF EXPENSES. I direct that the expenses of my last illness and funeral be paid from my estate as soon as may conveniently be done. SECOND: SPECIFIC BEQUESTS: A. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.001 DOLLARS to my grandson, GEOFFREY ROBINSON; B. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.001 DOLLARS to my grandson, MICHAEL ROBINSON; and C. I give, devise and bequeath the sum of FIVE THOUSAND ($5,000.001 DOLLARS to my grandson, BRYAN ROBINSON. , l 1 :\ . I I r ; THIRD: BEQUEST. I give, devise and bequeath the residue of my estate, real or personal, tangible or intangible, together with all insurance policies thereon unto my daughter, BONNIE ROBINSON, provided she shall survive me by thirty (30) days, per stirpes. FOURTH: RESIDUE OF ESTATE. I give, devise and bequeath all the rest, residue and remainder of my estate unto my daughter, BONNIE ROBINSON, provided she shall survive me by thirty (301 days, per stirpes. FIFTH: PROTECTIVE PROVISION. To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be IiI assignable to a beneficiary or Iiil available to anyone having a claim against a beneficiary. , I. " SIXTH: DEATH TAXES. All federal. estate and other death taxes payable on the property forming my gross estate, whether or not it passes under this will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment for federal estate tax purposes. \ \ .~- ~~j!;.:;;;,;ii~:"~;'~''':'''M;'''''''''''!J"".r<1~'';'''''i':,;-'':~:"'~"1'j" ..',....., I .- ,i.._.-:-,,, "', \ SEVENTH: MANAGEMENT PROVISIONS. I authorize my Executrix, as follows: A. Retain/Invest: To retain and to invest in all forms of real estate and personal property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations imposed by law on investments by executors or any principle of law concerning investment diversification; B. Compromise: To compromise claims and to abandon any property which, in my Executrix's opinion, is of little or no value; C. Borrow: To borrow from and to sell property to my daughter or others, and to pledge property as security for repayment of any funds borrowed; D. Sell/lease: To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales of leases; E. Capital Changes: To join in any merger, reorganization, voting.trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. Distribute: To distribute in kind and to allocate specific assets among the beneficiaries (including any custodian hereunderl in such proportions as my Trustee may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all property at any time held by my Executrix or my Trustee and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without court authorization. EIGHTH: EXECUTOR. I appoint my daughter, BONNIE ROBINSON, Executrix of my Will. In the event of the death, resignation, renunciation or inability of my daughter to act as Executrix, I appoint MEllON BANK, its successors and assigns, Executor of this, my Will. Neither my Executrix, nor any successor shall be required to give bond. , -d;'...','-,;; ".' .".,....,.,..,....,<;, ,.-."'",~,, I I' f" IN WITNESS WHEREOF, I have hereunto set my hand and seal this -Ua day of JANUARY, 1995. ",IS", AtVlrJ l1J /rJ .L-trr~ A -<SEALI Richard W. BlochBr, Testator In our presence, the above.named Testator signed this and declared it to be his will, and now, at his request and in his presence and in the presence of each other, we sign as witnesses: .1t;~?d~- 6, CCUU\ ~tJoJ1 I COMMONWEALTH OF PENNSYLVANIA COUNTY OF FRANKLIN :SS I, RICHARD W. BLOCHER, having been duly qualified according to law, acknowledge that 1 signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the purpDses therein expressed. .,1. 0tf.h UJ-t.,J tv yJflvc).vJ-v' Richard W. Blocher, Testator Dauphin Deposit Bank and Trust Company W. I:AI1.Ml:llS n,\S" . "HU\'lI;\St\ ~ 1l,\SK or I'rNN''i\'l\'.\SL\ Illll'I'\'.ll SOLIlI,H &. Co., INt:. EMiTl',llN MOllltLHi! SU{\,It:I'.S, Isc. RECEIVED OCT - 8 1997 October 6, 1997 Law Omce Forest N. Myers 137 Park Place West Shippensburg, P A 17257 LAW OFFICE FOREST N. MYERS Re: Estate of SSN DOD Richard W. Blocher t6G.12.5206 August 27, 1997 Dear Mr. Myers: Thank you for your request concerning date of death balance information for all accounts held by Mr. Blocher. The enclosed listing is for any accounts which may have been held at Dauphin Deposit Bank, Farmers Bank, Valleybank, and Bank of Pennsylvania. We are happy to supply this information to you. Also, if additional information, research, or file copies are needed, they can be provided for a service charge of $20.00 per hour (one hour minimum) and .25 per copy. If you have any further questions, please call me at (717) 255-2054. Sincerely, Q~.~ Cheryl A. Bowers Customer Management Information Department cab 1'.0. Box 2961 . l-IAIUUSIIURG, I'A 17105-2961 TEI.EPHONE 717 255-2121 . http://w\\'w.anytimcbank.coll1 '''1 ",,'H" """""-;' n.",~. ,,,,, T.,...' rr."'"'''''' .,,,,ll.!,.,,,"'" <:-"..,1.,,'" ('fl ,,,,. .,rf' ..."lv;1hrif''', l"\' Fir....! t,~~.r\,'.,".1 n"""nrf'\ P"."l>'lVo""'\'~"'~'" ","_ P~,...,,,, "'~".~'''r.'i'-'' .,.c.... ',.! Decedent confirmation Name Social security NO Date of Death Richard W. Blocher 166-12-5206 AUgust 27,1997 Description Account Account Account Account No. 8140523925 Account Type Certificate ofOeposit Date Opened or Issued 10/10/96 Date Closed or Matured 11/10/97 (Maturity) Date of Death Balance $41,842.32 PLUS PLUS PLUS PLUS Date of Death Accrued Int. $105.63 Joint Owners (If any) None Date of Joint Ownership Special Comments: N/A Date Prepared: October 6, 1997 Prepared by: Cheryl A. Bowers (Rev 8/26/97) page: 2 '.;'.'.,~~ ".c',' .:~.,,; .:./'" . . 412 76 P,01/01 SEP-24-1997 14:53 \ONe IIlnk. N.A. Phlluurgl1. PA I~~M PNCIn'I< elF Decedent RtpOrting 'rwo me Plaza, 33rd Flcot' Pittsburgh, Pa 15222 PNCBANK S&ptlllTb&r 24, 1997 Foreat N Myerl!l 137 Park Place West: Shippenl5bUrg, Pa 17257 Rlt: Estate of Richard W Blocher, Deceased SSN 166-12-5206 roo 08/27/97 Dear Mr Myars, Please find the date Of death inforllllltion you have requeetffd listed below. Establiehed 11/09/94 o.:tiricate of Dllposlt 121001057155 Richard W Blocher IlOD Balance $ 4,580.34 + 11.36 accrued interel!lt. P1ea8Q fax me a copy of the death or short certifieat\t at 412 762-7149. Sincerely, Qdl'YM. ~ Donna Borman 1-800-762-1775 13 09-24-1997 02:28PM 412 76 TOTAL P .01 P.01 ~,;;.~ ; ,,'lo ~\":'; ooT-08-91 WED 11:06 EAST PORTLAND ope 658 FAX NO. 225 4283 P. 02 JIiAIBIL WELLS FARGO =W 0p0tIII0n0 _ OA !ll22iH31& October 8, 1997 FomtN. Meyers 137 Ptrlt PL West Shlppembmg. PCIII\. 17237 R.c: Estrte of Richard W. Blocher Dear: Mr. Meyers In n:llpOn$eIO your J.l\cr~~lvod OIl October 7. 1m. PI.... b. ioformed ofth. following informe1ioll: Accoll.D~ Type! Wills Enr8 sav1llll" Account Nl1DIber: 6439702150. Opened 5-6-97. Balance.. 0(8-2.7-97: 517,679.16 Accrued Interest as ot 8-27-97: 54.07 A_unt hold ill Single Ownership. Riclmrd W Blocller, Owner. Bonnie S. Robinson, P.O.A. Correllt Status: CIO$ed Acconnt T1P": Regolar Checking Afeonllt !'lumber: 0435033899, Opened 5-6-97. Bllllnee .. of 802M?: $1,8SS.92 NOD Interest bearing a_not. Aec>unt held in Single Ownership: Richard W Blocller, O""'er. BonDle S Robluson, P.O.A. Carrellt StalaSl C10lled AeeOant Type: Coltb'" ~ Checldng Acconnt Nnmber. 0173<182472, Opeaed 12-18-96. BalaDcc at or8-27-97: $3,536.57 NnD mtemt bellriDl acooaDt. Aomant beld ill Slug'" Ownership: Wehard W Blocher, Owner. Bonole S RoblnsoD, P.O. A. Current Slatas: Opetl If we can be of my further wistnnce, please do not hesitate to coDlaCt us at (503)72 1-5252.. Sincerely, r ~) sS~~_iP~fl Operations Officer SHB/sk f'ru1\C(lOl\HOC)'ClCCIt'lItIct 10-08-1997 03:02PM 225 4283 P.02 ~~;~ (~f} i '\ t.} <~Cbl# -"INn .-I - .c :IE en ~ .... (.) In a:: - u.. * * * * * * * * * * * * * * * * * * * * * * * * * * * * '/j * ,IE- ~ * * "" * * ~ * * >< * * .,. * * '" * * * * Z * * * * ~ * * Z:l I:"-- * * ;a V'l * * N * * l' * * ::> ~ ~ * * ~ Q) 01(. * ....o~~:: * * :Il " oil * * ., i;l '" * .. ...,; - ';j * * :i: ~..c * * ~ ~ en * * '"' ... c:: * * ....,I ltJ tU * * ~ p..* * ~ l' .e- * : < M rJl: * ...:i- i< " !fl o .c:: 'g 8 ~ :1:' <:r M -:: Ul 6 ~;; = =000('-= ..... U ::s.- = ~""'.s~ ~ o g!:l "= ... 't: 0 " -:: OJ 0 c;;: ti..oC,)~= '6b S g ~ :: ~8ou-= ,.--- ,.- . -'-~~~:~~'~~'~~~'~~:;....~._.__..__._-~--~._~;-_._. ~';;f.;Ji;~i~~~i};':'~'~'i\t"~:S .""';'~":"":'j:',';', ~~ &., .# -. ~.. .... . \ /- \-.., i , , i , ,I ( ,/ . LAW DFFICES FOREST N. MYERS/ TRUST ACCOUNT REGISTER OF WILLS - CUMBERLAND COUNTY a 1- 97 - 7 3 2)- 10/9/97 7812 r 3.452.00 /0-//-'17 Trusls Richard Blocher 21-1997-00735 3,452.00 ;.~ '. . r (, , .' j .. , " e . " , t- o ;'t, '. ..i: ." ,\ .... -'" 0{ . , ) ,r.. '\ r,; ;; .~". \ .. . ..) .~ , ~1 ,i. " :.) " " 'n J" . 1 .~ ~~-r' I-"~l. . ,', f, )J'" ,. '" ~.. .'" ,.f i I. .1 ;:;,'" " ,1 , , ( ..--~ .-...I --~- '~ - ~ ..... ;-"; ~......__..~ '\ . I ' .},.. i.. '. "'. . /' ,!',)~ -:"",\;~ .~..-. -. .../..--.- -::z ..' -",,' .r-' .~..,:- \. ) \ I"'"" ...-'. "~" '\ """'I / \ / LAW OFFICES FOREST N. MYERS/TRUST ACCOUNT REGISTER OF WILLS - CIJMBERLAND COUNTY Trusts Richard Blocher 21-1997-00735 .- ! I '--'Y"'-'-'~'---'- ~_. .... - ./v'tQ 1019/97 02/ f 7- '7 3~ '. \ '. . -; --'. -. ~ .-.-.....- . -..')---'.- ---.__w__ ;'~f-~: . .1' ~...~:- 7813 15.00 15.00 /i('- ./ ..J' >1 '\~ .. "d .' i. ; , ., , , ,.,f::', , < .- 1\ " ~\ f' 1. .~ '. . "4' \," .\ '~. .. <{ ., ~ .r".. ) ". ,{ . ,~-~..}? 1'.... 'r. , . , . . : i' '~,. . ... _ r-. ~ "',,;', '\~} .~. j. y~' \ '" q;r \ (, ..- " . .~ ~-~. \' ",'I ! , rt\ -.- ,t "",",;,. -r.... '. . : (; ~ '1- ~- ...! ...'1- /:-...<,;~ . ':1/:J) .:11 " . ',"""!" """ ,!,"'<'\1 ..... - ,.",....'." ",. . ',..' , , , ., 01" tN' . ~ . / 1--- I , J ! j I I I I I I I I I I . 'U-_~_-'r--"~"'-"-- COMMONW[AUH OF PENNSYLVANIA OEPAHTMENT OF REVENUE. BUREAU OF INDIVIDUAL TAXES D[flT 280001 HARRISOLJflG. PA 171280601 '*~' )1 .. . NO. AA 242338 AEV,"52 EX /".95) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: I ACN ASSESSMENT CONTROL NUMBER AMOUNT FOREST N MYERS EQUIRE tOt $3,452.00 137 PARK PLACE WEST SHIPPENSBURG. PA 17257 FOLOHERE FOlD HERE - ESTATE INFORMATION: FilE NUMBER 21-1997-0735 SSN 166-12-5206 NAME OF DECEDENT (LAST I (FlRSTI (MI) BLOCHER RICHARD W DATE OF PAYMENT 10/14/1997 POSTMARK DATE 10/10/1997 COUNTY CUMBERLAND DATE OF DEATH 8/27/1997 REMARKS FOREST N MYERS TOTAL AMOUNT PAID $3,452.00 5K /'" - / '/.1(.' '- ; r RECEIVED BY / / t< '1. '" ( /. ../....'./ :/-,/ MARY c. LEWIS/ !I,: -I-. REGISTER'CIF WILLS.::./"/JJ..../ .{J'f'j. . ," ,/ SEAtHECKII 7812 r~[Cii:-;'EP OF WILL.S >:lc~~-----:-------- --- -~.._-- ------- ---- -.- --- .--. ---. ~::-:----_._----- ----.,..---~.;r---~~ . . .. r " "-'.rr~' . ~~::_~..-:----:-:--~~ ~ ,...4--'~" .--.:;..... COMMDNWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE /5'.-c70I-3 BUREAU OF INOIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURC, PA \7128.0601 /. e-..... NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALLDWANCE OF OEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE DF DEATH FILE NUMBER COUNTY ACN 01-27-98 BLOCHER 08-27-97 21 97-0735 CUMBERLAND 101 FOREST N MYERS 137 PARK PLACE SHIPPENSBURG WEST PA 17257 AMount ReMitt.d * In-lid"." lit.,,, RICHARD W MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ rfEV:iS4i-EiCAFP-niif:97Y-iiiiricnWYtiHEiiiTANCn'-"ic-APPRAisEMiiii'~--ALLciwANcnjR-----_.---------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BLOCHER RICHARD W FILE NO. 21 97-0735 ACN 101 DATE 01-27-98 If an assessmBnt was issued previously, lines 14, IS and/or 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 1S. AMount of Line 14 at Spousal rat. (15) 16. Amount of Line 14 taxable at Line.l/Cle.. A rat. (16) 17. AMount of Line 14 taxable at Collet.ral/Class 8 rat. (17) 18. Principal Tax Due TAX RETURN WAS: (X I ACCEPTED AS FILED RESERVATIDN CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.al Estate (Schedule Al 2. stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule Cl 4. Mortgagas/Notes Receivable (S~h.dul. OJ 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIDNS: 9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortga;. Liabilities/Liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts 14. Not Voluo of Estoto Subjoct to Tox NOTE: TAX CREDITS: PAYHENT DATE 10-10-97 RECEIPT NUHBER AA242338 DISCOUNT (tl INTEREST/PEN PAID (-I 181.6B ( ) CHANGED ll) (2) (31 (41 (51 (61 (7) .00 .00 .00 .00 69.989.00 .00 .00 (81 NOTE: To insure proper credit to your account, subnit tha upper portion of this forn with your tax paYMent. 69,989.00 9,418 nn 60,571.00 .00 60,571.00 .00 3,634.00 .00 3,634.00 3,633.68 .32 .00 .32 . IF PAID 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" (CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I (91 IlOI 9,413.00 5.00 (11) (121 (131 (141 (Schedule J) .00 X .00= 60,571.00 X .06= .00 X .15= (181 AHDUNT PAID 3,452.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE RESERVATION: E.t.t.. of dec.dent. dying on or before Dcacub.r 12, 1982 u if any future lnt.r..t in the ..tate 11 tran.farred In po.....lon or enjoyaent to Cl... B (collataral) banaficlaria. of the d.cadant aft.r the e~piratlon of any ..tate for life or for y.ar., the Co.-onw.alth her.by .~pre..ly r...rv.. the right to apprai.. and a...s. tran.fe" Inheritance Ta~.. at the lawful Cia.. B (collat.ral) rat. on any .uch future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN ISTRA TIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fuiflll the r.quir...nt. of Saction 2140 of the Inh.rltanc. and E.tate Ta~ Act, Act 21 of 1995. (12 P.S. S.ctlon 9140). Detach the top portion of thh NoUc. and sub.1t with your paYllent to the Reght.,. of Wills printed on the r.v.r.. lid.. --Make ch.ck or lIoney order payable to: REGISTER OF HILLS, AGENT A refund of a ta~ cr.dit, which was not rClque.tQd on the Tax R.turn, aay be requested by cOllp1eting an "Application for Refund of P.nn.ylvanla Inh.rltanc. and E.tat. Tax" (REV-1313). Applications ar. av.llabl. at the Offlc. of the Regl.ter of Wills, any of the 23 Rev.nue District OfficD', or by calling the sp.clal 24-hour an.warlng servlc. nu.ber. for foras ordering: In Pennsylvania 1-800-362"2050, out,ld. PennsYlvania and withIn local HarriSburg ar.. (717) 787-8094, TOOt (711) 712-2252 (H.arlng Iapalred Only). Any party in Intere.t not ..tlsfled with the apprals...nt, allowanc. or dilallowanc. of deductions, or .,s....ent of ta~ (Including discount or inter..t) as shown on this Notlc. aust object within sixty (60) day. of r.c.ipt of this Notic. by: . --written prote.t to the PA Departaant of Revenu., Board of App.als, Dapt. 281021, Harrisburg, Pi -"election to have the .atter d.t.r.lned at .udlt of the .ccount of the parson.l r.pr...nt.tiv., --.pp.a1 to the Orphans' Court. OR 11121-1021, OR FactulII .rror, discov.r.d on thh a..assaent should b. addr.ssed In wrIting to: Pi D.part.ent of R.venue, Bureau of Individual Taxa., ATTN: Post A.......nt R.vlew Unit, D.pt. 280601, HarriSburg, PA 17128-0601 Phone (717) 187-6505. Se. page 5 of the book1at "Instruction. for Inheritanc. Ta~ Return for a R..ldent Dec.dent" (REV"1501) for an .xplanation of ad.lnistr.tlv.1y corr.ctab1. error.. If any t.x dUG I. paid within thr.. (3) c.l.ndar .onth. after the deced.nt'. death, . flv. perc.nt (5~) dl.count of the ta~ p.ld i. allowed. The 15:% t.~ a.nub flon"parUclpaUQn pen.lty Is co.put.d on the total of the t.x and Inter..t .....sed, and not paid before January 18, 1996, the first d.y aft.,. tha and of tha ta~ ..na.ty period. Thl. non-participation p.n.lty 11 app..1able In the .... aanner and in the the s... ti.. p.rlod as you would .ppea1 the t.xand Inter..t th.t ha. bun ....ss.d a. Indicatad on this notice. Int.r..t I. ch.rg.d beginning with first d.y of d.llnquency, or nln. (9) 80nth. and on. (1) day frail the d.t. ~f d.ath, to the d.t. of pay..nt. Taxe. which b.c... dellnqu.nt b.fore January 1, L982 bear int.r..t at the r.t. of .i~ (6%) perc.nt p.r annua ca1cul.ted .t 8 dally r.t. of .000164. All tax.. which b.ca.. d.llnqu.nt on .nd .ft.r J.nu.ry 1, 1982 will be.r int.rest .t . rate which will vary fro. c.1.ndftr y.ar to caland.r y.ar with that r.te announc.d by tha PA n.part..nt of R.venu.. Th. .pp1Icabl. Int.r.st r.t.. for 198Z through 1991 are: '!.!!r Int.r..t Rata Dally Inter..t Factor ~ Inter..t Rate Dally Inter..t F.ctor 1982 20% .000541 1981 91: .000241 1983 16% .000435 1981-1991 11% .000301 19&4 11% .000501 1992 9% .000247 1915 13% .000356 1993-1994 n .000L92 1986 10:% .000274 1995~1998 9% .000241 ....Int.r..t 11 c.LculatCld D' foUo..s: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ".Any Notice i..ued .ft.r the ta~ b.co... d.linqu.nt will r.fl.ct an inter..t c.lcul.tlon to flft..n (15) days b.yond the d.te of the ..I.....nt. If pay..nt 1. .ad. .ft.r the int.r..t coaput.tlon date .hown on the Notic., .dditlon.l Int.rost aust b. c.1cul.t.d. '.;";t<-.,_;""_'~ ., STATUS REPORT UNDER RULE 6.12 Name of Decedent:~..e.d W ~~ht'r Date of Death: A[)~u,lJ-t ..;;'7... /997 Will No. ,.;/- 191') -()73~- 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: CJ 1. State whether administration of the estate is complete: Yes V No__ ~-'6 Signature h) res. L tJ IY~ US N~me (P lease t pe or print) I 1:J7 Parl PiaN: \.1('6-t. {)JlIoneJl.s~UJCY ! Address I . (L /'125 7 I I (~71 53~-qo4v I Tel. No. , I ! I I i- 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 informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: '}. ~~9 -.. . .-) " . Capacity: Personal Representative ~ounsel for personal representative (MAH:rmf/AM3)