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Home My WebLink About80-00568 :' '~..':':',.-., .::1 -~ i';'f::.' :-..~~-..:, -:" ~,\ -, d, .. " ,:"><:,~\,,-..,,. ~~tt"'~:):, f.1'...d'li.... ":1 ~~.t.~~~:h: ':l: - 11~ts ~f!jj..., ~r-"'.:'>'.."; ~f~~~s;:~:,: . . i!i~",.",....... ~~#,~;Y2f<~<.:.::.: I'.;""".... ij11' ~\.);~,l:~:~:,::_ : ~ ," 'I.:, ,:,' ) -~ .~. " ..... .' ;., " .,' fl) r.Q lJ') '.. . .. >t ~ ~ ~ .. I ~ ~ I - 0 0 . . o-'l t!l ~ Z ~ g , , 3 o 00 "1 . ',- "',N\, ..... o ". - III - III ~, . o :Z Ge!D 568 No. 21-80 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY In the Estate of David G. O'Hara , deceased. To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania. Petltloner(~) Is ~ the execut or named In the Last Will and Testament of David G. O'Hara dated February 19, 1974 Decedent was a citizen of the United States and a resident of Lemoyne ~ (Borough), Cumberland County, Commonwealth of Pennsylvania. Decedent died on Monday the 25th day of August A.D, 19~,ln the County of Dauphin ,State of Pennsylvania at the age of ~ years. Decedent has (~ been married and tiiiI; (has not) had children born to him (ffilt) since the ex- ecution of the above described Will. Decedent was possessed of personal property to the value of approximatelv 820.000.00 and of real estate to the value of ~-,ft- .:2~ () Co 0 ' as near as can be ascertained; said real estate situated as follows 130 Hunnne1 Avenue , T,p-moynp., Cumberl;lnn County. Pennsvlvania Therefore, your petltloner(~ respectfully apply(ies) for the probate of the said Last Will and Testa- ment and for Letters Testamentary theron. Dated Septemher 1. 1980 (~ ~ "'. \w*~-,~.~ Name and address Robert D. O'Hara of Petltloner(s) 130 Hunnnel Avenue Lemoyne, PA 17043 COMMONWEALTH OF PENNSYLVANIA t COUNTY OF CUMBERLAND j Robert D. O'Hara ss named in above application, being duly sworn statements set forth in this petition are true to the best of Sworn to and subscribed before according to law say(s) that the his knowledge and belief, ~tember 3. ~-(},. 1980 ,~ r ~ n . \ 0.- .~ ~(J-"---l:..0\ v--'> .e' L~ Robert D. O'Hara Filed: September 4, 1980 ~ Shaffer, Calkins & Balaban 223 North Front Street, P.O. Box 1188 Harrisburg, PA 17108 I Attorney Loudon L. Campbell .:</-,f-ti-56? //-//S--,3 .':,/<;; LAST 'II ILL AND TESTAMENT I, DAVID G. O'HARA, of the Borough of Lemoyne, County of Cmnberland and COll\l1l:lnwealth of Pennsylvania, do make, publish and declare this to be my Last Will and Testalllent, hereby revoldng and making void any and all Wills by me at any time heretofore made. I. I direct the payment of my just debts and funeral expenses as soon after my decease as may be convenient to my Executor hereinafter nallled. II. I hereby grant and bequeath all of my estate wherever situate, both real and personal, to my Wife, CATHARII~E L. O'HARA. III. In the eTent that my Wife, CATHARINE L. O'HARA, should predecease me, I grant and bequeath the following: The Sum of One Thousand Dollars to JOHN A. 0' HARA, JR. - Grandson The Sum of One Toousand Dollars to PAUL D. O' HARA - Grandson The Sum of One Thousand Dollars to MICHAEL L. O' f'.ARA - Grandson The Sum of One Thousand Dollars to DANIEL D. O'}l.ARA - Grandson The Sum of One Thousand Dollars to '!ERRY L. 0' HARA - Grandson The Sum of One Toousand Dollars to TlDl1AS R. O' HARA - Grandson The Sum of One Thousand Dollars to SUSAN A. SHANDELMIFR - Granddaughter The Sum of One Thousand Dollars to CATHARINF. T. MCKEE - Grandniece IV. I grant and bequeath the residue of my estate in equal shares to my Children, ROBERT D. O'HkRA, BRUCE L. O'HkRA, JOHN A. O'HARA, and JEAN O'HARA SHANDELMIER. V. I hereby nominate, constitute and, appoint ROBERT D. O'HARA Executor of this, my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this JL day of February, 1974 A.D. 1:, a,'l~~;; /J 611-~ (SEAL) Signed, sealed, published and declared by the abaTe nallled testator as and for his Last ~lill and Testame'nt, in the presence of us, who at his request, in his presence, and in the presence of each other, have her.mnto subscribed our names as Witnesses. 2/:;., , ./:.1 (!? L~t- I aM J 7Jr t&kfJ' OATH OF PERSONAL REPRESENTATIVE MONWEALTH OF PENNSYLVANIA ss: me, the Register for the Probalc of Wills and granting of Letters of Administration in and for the who, being duly , do depose and say that as of the last Will and Te deceased truly administer the goods and chattels, rights and credits of said dec e provisions of the law relating to Transfer Inheritances, and subscribed before me. / / Register Ol .....f 11 ..!ol g P=l . ~ .s ~ 'i ~ ~ os :;:l on p.. ~ ~ DECREE day of ,A.D.,19_, th\as probated and late of , Cumberland coun~ ennsylvania, were granted to W' ess my hand and official seal the day alld year aforesaid. \ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Rcgistcr for thc Probate of Wills and granting of Lelters of Administration in and for the County of Cumberland, personally came Robert D. O'Hara who, being duly sworn I do es depose and say that as Executor of thc last Will and Testament of David G. O'Hara deceased he will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances, Sworn and subscribed before me. ~ . September 3 A,D., 19Jill.- ____.3:..r~+~.~V'~ Robert D. O'Har Register ;.,; 0: ;~ CD: : os ." : ~ ...... : Q) l~ ~; u.. M: 1-1: CD' Q): 0 ~l '"'; ~j Q): 'J) CD; ~\ .:.: +I: ~ --l g 0<: \0; Q): ~ Ill: --l o~ ~ U)i I .: .... , 0: ": .... v: +I: - .~ CD; S ",: s: E-t: 1\ I ,...: ~; .-I: >: = <'1\ <: .~ 1II: d "" 'tl M' 011:: ~ CD: CQ 0 CD .... '"': .: Z 0 ~ " .s ~ ~ 11 0 .s 'g ~ - .~ '" I'<< Z ril '" DECREE Be it remcmbered that on the 4th day of September ,A.D.,19~, there was probated and recorded the last Will and Testament of David G. O'Hara late of 130 Hummel Avenue, Lemoyne , Cumbcrland County, Pennsylvania, Robert D. O'Hara Deceased. Lclters Testamentary were granted to Witness my hand and official scal the day and year aforesaid. 8S~; ~ (!,~ ~ Regist~r Inv.nlory of Ih. r.ol and p.rsonol .slol. of DAVID G. O'HARA deceased, Real Estate: I 130 Hummel Avenue, Lemoyne, Pennsylvania 17043 Personal Propertv: 364 Shares Dauphin Deposit Corporation 1163B75 U.S. Savings Bonds POD to Catharine O'Hara ($25.00) (Total of 81 bonds) U.S. Savings Bonds C20869756l2B ($100.00) U.S. ~avinbs Bondo 0209036283 n ($500.00) Dauphin Deposit Bank - Certificate of Deposit CD 012-1-18001 for $10,000.00 West Shore Savings & Loan - Certificate of Deposit OSPC l5B 1376, Certif ODDS for $6,100.00 Certificate of Deposit OSPC 2/2 749 (Two separate certificates in the amounts of $500.00 and $2,000.00 issued under one number) Passbook Savings Account OS-286 1973 Dodge Sedan B25064693, Serial No. LH4l-C3R-3l566l ~liscellaneous Household Items and Furniture: Zenith 24" Color Console TV Set - 10 years old Brown Recliner Chair Lazy-Boy Recliner Chair - Gold Fabric 8 Maple Dining Chairs Drop-leaf Breakfast Table Small Drop-leaf End Table Unfinished Plywood Wardrobe Necchi Sewing Machine Bos ton Rocker Electrolux Vacuum Cleaner Bench Grinder 36' Extension Ladder - Very old and worn 20' Aluminum Extension Ladder 12' Extension Ladder Miscellaneous Hand Tools & Garden Tools Miscellaneous Personal Effects and Clothing Jewelry: 10K Y.G. Amethyst Birthstone Ring Y.G.F. Gruen Veri-thin Pocket Watch, Engraved DGO with YGF Waldemar and YGF Knife l4K Y.G. Tie Tac with Amethyst Gold Plated Watch Chain wiRed Stone Key-wind Pocket Watch (not in operating condition) 24,000 00 12,012 00 4,734 56 77 12 385 60 I I , 10,5711 59 6,3601 91 2,5661 31 399 71 1,000 00 50 00 10 00 25 00 40 00 10 00 5 00 15 00 75 00 25 00 100 00 25 00 15 00 20 00 15 00 75 00 50 00 $ 50.00 25.00 15.00 10.00 25.00 125 00 $ 62,78 80 COMMONWEAlTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 5$: Robert D. O'Hara ~._---_._-_._. -.-------- ---' .-.--.-.- ._-- ..----. boing duly sworn ~ ___ according to law, depo..' and .ay. that h. .----~~~-----.---.-~.-.- _.__-Ex~ec'!tQ-~--- .p _ ~ .. of tho E.tet. of JllYid_G_._O:ll.llr~(l-~-' lato of 130 Hummel Avenue. Lemovne ~ ___, Cumberland County, Po., docoa.od and that tho within i. an inventory made by ~.~. _ _~_ hitn ~ ~_'~_~ .- - -'~' .--, tho .aid_~c~-tor -- of tho ontiro e.tato of .aid decodont, con.i.ting of all the personal prop.rty and roal o.tato, oxcopt real estate oulsid. the Commonwoalth of ponn.ylvania, and that tho figure. oppo.ito oach itom of tho Invontory ropro.ont it'. fair valuo a. of tho dato of docodont'. doath. ::D~j.g. ~nd .ub.cribod be foro me, ~~~B>~~--"~ -- ,/~_'='- _J':&' ,,1 ~s;l. Av' e- . .-----..-. -..--- --. .--.,-.---'- . - a ~.~"-^- lLt3-0 dLf, ~l ,',;.,~' :i. .Lt.:, ~t,;' ". :':..:,IIC halll!j',ur:,:, l}'h;~~lln Co., Pa. My Cvmnl,~5Iun bpilfS Au.;t. 15, 198~. ter&<>";e>. 12. / 7 0 <{.3 ~ ---- ~_.'J'--~/--- Addrell Date of Death _----..22---~_--~-----...J.~gust--~ Day Month 1980 Yotr INSTRUCTIONS I. An inventory mu.t be filed within throe month. aHer appointmont of personal repre.entativefl co 2. A .upplement inventory mu.t bo filed within thirty day. of di.covery of additional a".t.. ~~ 3. Additional .heels may be attached a. to personalty or realty g;6 ;0", 4. See Articlo IV, Fiduciarie. Act of 1949. ';~ "'> o- n"': .::.(,., , n "11(':> -;'.~ III I ~ ! ~ \ , '1 \ \ . ..; >- III 0 ~ w I ~ ~ J ~ '< .. w "'I '" \ Q. I- ...., ~ u 0 Vl 0 t 0 w '" w ~I c ~\ I- :I: Q. 01 .. I- ...J LL Z LL ...J <( 0 ~ Q. W 0 <( w ~" .;.. \ > z '" ~ 'I ",1 ~ - I, Z 0 c c " .; I' - Vl Z .... 0 '" >, u \ z II w <( ~\ ~ .... Q. I -0 c i .. i\ : - -.: 0 0 -" ." \1 '" E - ~ .. " ...J U u: ,-,----- cD ",'" c:> fTlfTl ",n B ._0 ~..,::o ...... -.0 ,,,fTl N -nO . . JJ ,~.!o .-:-r'I ~.." .31 -' ,., N :---, :.:. , :? r::: .REV-CCQ (I-aD) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT AFFIDAVIT OF FIDUCIARY (Instructions on Reye..e Side) *' -- Eslole of David G. O'Hara Dote of Death August 25. 1980 Lost Address 130 HUIJlIIle1 Avenue Social Securit)" No. 716-09-6604 Lemovne. ICITY) PA 17043 Bureau File No. County File No. .) / 'II " ;/ J t;" .. (STA TI;.) (Z:PI 1. Decedent died: ( ) Intestate (without 0 will) (X ) Testalc (leaving 0 lost will--copy attached) 2. Is the filing of 0 Federal Estate Tax Return required for this estate? 3, ( X) Executar/~ ( ) Administrator/Administratrix Yes_ No X Nome Rnhprr n ntl1~y~ Address 130 Hummel Avenue Lemoyne. PA 17043 (CITYI (STATE) (ZIP) 4. All correspondence should be moiled to ( X) Attorney ( ) Fiduciary. 5. If on attorney is representing thc estate, indicate: Nome Loudon L. Campbell. Esquire Address 223 North FIO~nt Street. P.O. Box 1188 / Harrisbur2. PA (CITY) (STt.TE) 17108 ('ZIP) List all safe deposit boxes registered in the decedent's individual namehor jointly with, or as an agent or deputy of another, or in decedent's individual nome with right of occess by anat er os agent or deputy. Include the nome and address of the bonk or other institution where the safe deposit box is located, the nome :s) in whic, the box is registered and the relationship of the joint holders to the decedent. NAME AHD ADDRESS OF BANK DR OTHER INSTITUTION IN WHICH DECEOENT MAINTAINED A SAFE OEPOSIT BOX NAME OR NAMES IN WHiCH SAFE OEPOSIT BOX IS REGISTERED RELATIOHSNIP OF JOINT HOLOERS TO DECEOENT Dauphin Deposit Bank & Trust Company David G. O'Hara or 301 Market Street. Lemoyne, PA 17043 Robert D. O'Hara Son Under penalties of perjury, I declare Ihatl hove eXDmined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete. 11- 115 - 3 ,~ ~-lt.c.t<-\J0 ~-v-___ SIGNATURE OF F'OUCIARY ,'1' /tiff ,/ DATE Page 2 REV~!51 u.eo) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY * (Instructions on Reverse Side) Estate of David G. O'Hara ESTIMATED DEPARTMENT ITEM DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL YJ 27 Dauphin Deposit Checking Account #65172485 $ 3,205.63 28 Medicare & Travelers Insurance Medical Expense Reimbursement 468.67 29 Death Benefit from Pennsylvania Railroad Voluntary Relief Department 1,252.30 30 Medical Expense Reimbursements from Travelers Insurance 7.98 31 Cash-on-hand in wallet of David G. O'Hara 15.50 32 u. S. Treasury Railroad Retirement Employee Death Benefit 869.70 33 Medical Expense Reimbursement from Medicare 32.00 , I I , i ~ ~ , I i TOTAL THIS PAGE ~ 5,851. 78) iff. c.o'f. S-,s- ~ I i ! QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material pari of his estate without receiving valuable and adequate consideration? (Answer "Ves" or "No".) NO 2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Ves" or "No",) ~ 3. If the answer to one or two above is "Ves" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy of death certificate, c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer, d. All other information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in posse5sion or enjoyment at or after his/her death? (Answer "Ves" or "No".) NO a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power at disposition? (Answer "Ves" or "No".) NO b. What was the transferee's age at time of decedent's death? 5. Did decedent in his/her lifetime malle any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Ves" or "No".) NO b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Ves" or "No".) NO 6. If the answer to five b. above is "Ves," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Ves" or "No".) NO 8. Did decedent, at any time, transfer property, the bmeficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Ves" or "No".) NO 9. If the answer to eight above is "Ves," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer liVes" or "No".) NO REV-4S3 EX. (3.80) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIAR!ES * Estate of David G. O'Hara (Instructions on Reverse Side) BENEFICIARIES AND ADDRESSES RELATIONSHIP John A. O'Hara, Jr. 3920 Emig School Rd., Dover, PA Paul D. O'Hara 326E Barker Circle, West Chester Michael L. O'Hara Grandson 7315 Grandson PA 19380 Grandson R. D. #2, Boiling Springs, PA 17 07 Daniel D. O'Hara Grandson 643 Hummel Ave., Lemoyne, PA 17 43 Grandson E. Trindle Road, Mechanicsb rg, PA 17055 Thomas R. O'Hara Grandson P.O. Box 107, Landisbur.g, Granddaughter Susan A. Shandelmier 99 Hagues Mill Rd., Ambler, PA 1 Catharine T. McKee 1635 P Street N.W., Washington, Robert D. 0' ara 130 Hummel Avenue, Lemoyne, PA Bruce L. O'Hara 5249 E. Trindle Road, Mechanicsb John A. O'Hara 715 E. Wind in Hill Rd., Mechani Jean O. Shandelmier 130 Hummel Avenue, Lemoyne, PA 7043 Grandneice 20036 Son 7043 Son The above beneficiaries are living at this time except for the following: NAME Bruce L. O'Hara (Share passes to Daniel D. O'Hara, O'Hara and Thomas R. O'Hara as above) SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH Yes 01/11/47 $1 000.00 Yes 01/22/48 $1,000.00 Yes 01 17 49 $1,000.00 Yes 10/01/48 $1,000.00 + 8-1/3% of Yes 02/18/50 of Yes 06 27 52 $1,000.00 + 8-1/3% of residue Yes 04 02 53 $1,000.00 Yes 11/23/40 $1 000.00 Yes 09/28/20 No idue Yes 04/19/24 25% of residue Yes 11/30/26 25% of residue DATE OF DEATH 09/26/78 REV...'S4 (1-80) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTL Y OWNED PROPERTY . (Instructions on Reverse Side) Estate of David G. O'Hara P TOTAL E VALUE OF DEPARTMENT ITEM R NO. DESCRIPTION MARKET c DECEDENT'S VALUATION VALUE E INTEREST IOfficial Use Only) ~ NONE . . - TOTAL THIS PAGE NONE f\I ~."' Jl'M?, V INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be included, List real estate first. 1, Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property as indicated in the instructions for Schedule "6". Include the name, address and relationship to the decedent of the co.owner (s) and the date the joint ownership was established. 2, Indicate the total market value of the jointly owned property. 3. Indicate the percentage of the decedent's interest. 4, Indicate the market value of the decedent's interest. c "" " n > r.1 > ... > 0 0 " </l :::; :::; Z 0 n e u -l Z ... Z t"" r.1 r.1 ~ Z ;:0 > 0 - 0 t"" Z Z r.1 -l r.1 -l Z P P -l -< </l r.1 - </l Z 0 'Il 0 -l ,- P 'T1 ., ;:l: ~ , ~ 0 ...::' 'T1 '- ~ ;.'':'' - 'T1 ,:-.)",- 0 5 :--. ,~ Z E. ~ ", " ~hu > c ~n r r. r- ~z c: 6~ ~ :;:'" Vl w' l......-..J -' :> -'" t'1 Ci- 0::(.'1 = Ow 0 0- :z 'co uc.:J ~:::: Z UJW 0 .=> !( ",'" t'O ~'-' '-' -< -< ~ r.1 r.1 > > ;:l: ;xl REV.51B Fa (70801 ~~ "__",~..,4..' NOTICE OF FILING OF APPRAISEMENT COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELO OPERATIONS Robert D. O'Hara 130 Hummel Ave. Lemoyne, PA 17043 RE: Estate of County of File No. 0::1'''; n (1 n' l-f~Y'~ Cumberland 21-80-0568 Dear Mr. O'Hara: You are hereby notified that the 0,.,; giD~l appraisement in the estate of D~v;d r. ()'H",.." has been filed in the office of the Register of Wills of Cumberland County on March 13 , 19.81.. Said appraisement reflects the following valuations: Real Estate Personal Property Jointly Owned Transfers Total 22.162.51 44,607.55 ,. nOnF~ none 66,770.06 As to such tax that is paid within three months from date of death, 0 five (5%) percent discount is allowable. As to any tax that remains unpoid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest otthe rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961,72 P.S. 2485-1001, P.L. 373. Date March 13. 1981 Signed .-ft/17'ft'il Jilfr<,;7 DHd) Titl e Chief Appraiser NOTE: This is not a bill. ~ ~ cz: ~ ..: <>: ~ ~ ~ Il-o '0 '" >- >- @ ~ '" M <Il ~ ~ ;:> '" ...l ~ ~ ..: '" ~ l!"I C'1 - ..J U ~ ~ U Z ~ - 0 ~ ~ - 0 ~ ci ~ ~ ~ 0 ... 0 '" z ci <Il '" >- ... ci - ~ ~ z z ... ... ~ z :l ci - ci fS cz: 15 ~ ~ ~ z :E z Q u ~ z - ~ ~ 8 0 S'; '" - ~ Q Il-o ...l ..-.... :. ~-REy,1162EX : '. ~ . COMMONWEALTH OF PENNSYLVANIA . 4 NO . DEPARTMENT OF REVENUE .' .K 29404 OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX I " . , II = ij __r ~ ~- ""'---__""____w_ ~A - 83.02 '1 M "PAID IN FULL" ;; I ---- - - - - -- - - -. - - - - - - - - - -- - -- - - - - - - -- -- ....--.. TAX AT 6% TAX AT 15% RECEIVED FROM ltobert D. O'Hara TAXAT_~D ,I 223 It Front: st Box 1188 ESTATE TAX ADDRESS Harrhbur PA 17108 TOTAL TAX CREDIT '--E"fTATEINFCiAMATiCiN7--- DA TE OF DEATH FILE NUMBER 21-80-568 A 11 6 1981 LESS DISCOUNT PLUS % INTEREST (FROM TO_I DATE OF PAYMENT NAME OF DECEDENT m m TOTAL AMOUNT PAID COUNTY l________ _______ ?OSTMARK DATE REMARKS SEAL RECEIVED BY REGISTER OF WILLS Inventory of the real and personal eslo'e of David G. O'Hara deceo.ed. Amount listed on Inventory submitted October 27, 1980 Supplemental Inventory Personal Property: Dauphin Deposit Checking Account #65172485 Medicare & Travelers Insurance Medical Expense Reimbursement Death Benefit from Pennsylvania Railroad Voluntary Relief Department }~dica1 Expense Reimbursements from Travelers Insurance Cash-an-hand in wallet of David G. O'Hara U.S. Treasury Railroad Retirement Employee Death Benefit Medical Expense Reimbursement from Medicare Total Supplemental Inventory REVISED INVENTORY TOTAL $62,787 80 3,205 63 468 67 l,m 13_~ 7, 98 I, 151'50 869 70 32 00 5,851 78 $68,639 58 COMMONWEALTH Of PENNSYLVANIA COUNTY Of CUMBERLAND 55: Robert D. 0' Hara __._ ,_.__" ~ ____.~_ n_._ ,___,__" ..u.._._ .___ O. __ ._- -..---- ..--.-. ._- , .'__ according to law, doposos and says that ho .....___.-J_s---.- --..-.---- _ . .___ _ _ of tho Estato of _--Yavi~.~'Hara_._-- b. d I sworn o'"g u y ______ Executor lato of 130 Hummel Avenue, Lemoyne _, Cumborland County, Pa., docoased and that the within is an inventory mad" by him___ __---- ._- -- .--. ---, the said_ Ex.ecutor of the entire eshte of said decodont, consisting of all tho personal prop.rty and real oshte, e.cept real eshte outside the Commonwealth of Pennsylvania, and that the figures opposite oach itom of tho Inventory ropresent it's fair value as of the dato of decedent's death. -.-.-.----------- _._~--- - . S..orn to and subscribed before me, pc\,~~;~,/wc~- n'_ _J3JL Hu]Jlllle_LAy.ejlue------ '- '-;l"-'H~ /'/, ~.k.A.. A <Ji-:' f k 1980- Lemoyne, PA 17043 SON OM K. eRB, Notary Public Harrisbur!:i, Dauphin Co,. Pa. My CommissiOn Expires Sept. G, 1982 . ----..--. --------- Addr." Date of Doath 25 August 1980 --_.----~.._-------------------------_._- _____.__._ __n_______u.,__.________ Month Yur Oay INSTRUCTIONS I. An inventory must be filed within three months after appointmont of personal representativo. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may b. attached as to personally o~ really 4. See Article IV, Fiduciaries Act of 1949. < \ .\ l>j . oj ~ --...... I C' on ~ g ~' I<l -0 ~ >- '" " . ~ w m H ~ M ~ I- ~ I .. M 'I) ~ w < m . " " a.. I- ~I J u .0 ~ 0 " " 0 w VI C <Xl '" ~ ,.. '" w ~ ~I '" .. " ~ I- J: a.. u. . a.. m c Z I- -' .. <To CJ ~ < 0 0 I u. -' CJ, a.. ~ '" ~ "- , H W 0 < w l >. ~ ..l p., > IX 'tl . "6 ,j g; z ....1 - <Xl Z 0 c " (;) ~I " ~ " 0 1\ '" VI Z 0 0 '" ~I U 4 'tl Z w < <:> .... " a.. ~ ." 0 c H .. !\ - -.: , 0 " -" ." ... \: ~ E - ..!! 0 '" " 0 -' U u:: CZl t:~., ~'-" go: , ltJ=~ .~ , ~L: U4 , (4.. ~ , . . (:;., C --- . i~l~ ...;::.: 1...:IJ" N [~r. C-,t.- :> 0::.-1 o:m = '" O(::j Z Ow Uw :::r.:.", ~Q; 0 00'= ui=> fO ....'-' U REV.455 (l.BO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHER'TANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS File No. , ; -, '. .,/ \'/ \i Estate of David G. O'Hara Date of Death August 25, 1980 WHEN CLAIMING THE FAMilY EXEMPTION, COMPLETE THE FOllOWING: Robert D. O'Hara Claimant Jean O. Shandelmier Relationship to Decedent Son Daughter Claimant's Address 130 Hummel Avenue, Lemoyne, Pennsylvania 17043 ITEM NO. 12 13 14 15 16 17 18 19 20 21 DATE 1 9/12/80 9/12/80 9/16/80 9/26/80 9/26/80 0/20/80 0/20/80 0/21/80 0/24/80 0/25/80 1/03/80 1/06/80 1 80 1/1'1/80 NAME OF PAYEE Musselman Funeral Home U.G. I. Cor . PP&L Holy Spirit Hosp. Rad. Assocs. Register of lnlls U. G. I. Corp. Ra mond C. Grandon M.D. Borou h Cumberland Law Journal PP&L Thomas J. D'Angelo Riverton Consolidated Water Co. Rehab Medicine Associates Register of Wills U.G.I. Cor. Gin rich Memorials of Mechb Communit Ph sicians Inc. West Shore Times Loudon L. Campbell, Esquire Robert D. O'Hara Executor REMARKS AMOUNT "family exemption" Funeral ex enses $ 2 Utilit bill Utili t bill Pa ment for x-ra s Letters Test. & Short Certificates Utility bill Doctor's bill Sewer R a Le al Advertisin Utility bill Real estate appraisal Utili ty bill Medical bill Filin fee - Inventor O. 0 3.00 4.66 47.00 1. 98 13.33 2,500.00 Utility bill Lettering Monument Balance due on Invoice dated 8/5/80 Estate Advertisement Attorney Fees Miscellaneous Administrative Exnens TOTAL THIS PAGE ~, 773,45 I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. ~l .~~ ~ //1./, \~~ .. ,-.t~, l/='. 8_ . Ii^ /IY/6<.J , SIGNATURE OF ATTORNEY/FIDUCIARY DATE OFFICIAL USE ONLY 1113.1~ I DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ AT t,.,;. /5 PERCENT. 1,-,~ .$ - d-.s-:..:;I DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption, In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. C "tl " (") > t"1 >- :s >- 0 0 " '" " Z Cl (") c: " .., Z ~ Z t"" t"1 r:1 ;>; Z >- s:> - s:> t"" ;;:l Z z Z rrJ -I rrJ .., s:> -I t'l - s:> -< [Jl <Jl Z 0 [Jl 0 .., ,- I s:> "'1 "'1 ;;:l '. ~ ~ r:' 0 .' oJ ':.. ~ ~ ~:G 6 "'1 "'1 1.1. n .. r-- 4:~~~ Z , =:"1: - ~l:; H.. J >- wl.; :> l.C/::: t"" (.:,..... c Ow c: 0:: "'~I :z 'c:> Oc "":I: rn Uw "':::> rrJ ~o: 0 :::U 0 ~ <.) z -<: -<: ::; t"1 rrJ ~ > >- ;;:l ;;:l I I INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. :OMMONWEALTH OF PENNSYLVANIA :>EPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT '* .Ai' 3 /) 3;:U//J'&:tIru~~..r_. , (/ hcf..L , I .' , t.......<f...:r. /' ,: I.'.f r-' .~ '1.-"../., "'Y' ESTATE ,1:/ ,. / ,. -u'", '///_.U~._/"J /1",)/ I, /, . ' t' i..I i / .~ . v:/>l"-f? __</ (... /'1:,.vj,,-r- COUNTY FILE NO: j/- /tJ- I, (. .(7 , , OATE iO: ~~/ ~I~~d./".J;./ . / ,/~id,t:. / //l~':? '''''.' , , ~'II (". '/_ (";, FILE NO. c;// - ",~'l . :)V ,( COUNTY !54'//i-it~,bt.A<,d- DATE OF DEATH /l('<-1("'J~ ~2 - /;J..!tJ /I / I ......:. ,~/(;"'t Appraised Value 01 Estate: Aeal Estate Personal Property .'. , .,' - , $ ./.-{ /frj. .:j I + ~/1./ ,/17. ~/:J- Jointly Held PropertvlTransfers + Total Approved Deductions $1.. t ?>)t/ ,; r; 71''/3 -L/::J 1 Total Gross Estate Clear Value of Estate $ 5!/ q '/fr I/o / , Less: Approved Charitable Exemptions Claar Value 01 Estata Subject to Tax $ ')(; 111 (;, / Amount Taxable @ 6% Rate $ 57. ':';1&: I~/ , tax due $ -..: ,; 7 / ) 'I /5rJ {J-O $,j{.j'j 1/ Amount Taxable @ 15% Rate 1.'-11) (,'-() tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE * * * * * * A five percent discount totaling $ will be granted if the Inheritance Tax is paid bV Less Credits: DATE OF PAYMENT " 11- /1- (,() AMOUNT PAID $ ;. ,/,.1,-/,/ + _~ I ,:J L....1 DISCOUNT $/Y/3'1 - INTEREST TAX CREDIT $ = ~..' /i I $,--. if .,I ~ 11 + = + = Interest accrues at the rate of six (6) percent per annum on the unpaid balance of Inheritanca Tax from 10 date of payment. Interest due if paid by is BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ ~. i).A tj i::"',:~; .: : ../ ? J ).... :t(fi<J J See Information on Reverse Side lOt. ~'1Z "".tot APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDEIH COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS DATE Hay 5. 1981 APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made far cll1sent to the transfer of the fallowing securities of a Pennsylvania Corporation or a National Banking Association located in Pennsylvania: (a) 364 (b) Dauphin Deposit Corporation (c).collll1lOn-sto~" (NOTE: In describing securities enter in (a), ab Ole, either the number of shares of stack or the lace amount 01 registered bonds, in (b), the name 01 the issuing company and in (c) the class 01 stack or the stated interest rate and mafurity date of registered bonds.) ISSUED ON May 14, 197.9.--, and having a TOTAL MARKET VA-LUE OF S...12.,.017 (Oat.) as 01 the date 01 death of the decedent.--D""irl r. O'H"r" (Nome of Decedent) . on-Augll~t 2~, jQ80 (Date of death) who was lote of l1n Hltmm~ 1 A\1t:l1n1l~ (Sheet and Humber) l.~p (Pest Office) Cum~and Pennsylvania (County) (State) The securities are registered as lollows:--J)a>,Li-d~-Ila-r-a (Namo or nomes in which certificotes ore registered) XI~mms:m>/"'W0R) EXECUTOR ) PORlitrt D n''J.1~T'::l l1n Hllmmp1 ;,mp IT,em~ PA (Nome) (Address) NAME OF APPLICANT _Loudon 1 r"mpbe11. Faq COUNTY FILE NUMBER-2l=_80-~68 ADDRESS OF APPLICANT BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS AP'PLICA TlON. IT WILL NOT CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONS~NT TO TRANSFER SECURITIES DA TE t:Jn t- II. /fr:fl I hereby consent to the Iransfer of the above securities noW registered in the name 01 th: :I~id . Decedent and waive the filing 01 a certilicate certilying to the poyment of the transler inheritance tax to which .the property 01 said Decedent is made subject pursuant to the provisions 01 the Act 01 June 20, 1919, P.L. 521, as amended and the Act 01 June 15, 1961. P.L. 373, as amended. This is also in accordance with the provisions of the Act 01 April 9, 1929. P.L. 343. This Consent to Transler the herein described property operates only in reference to the estate 01 the above-named Dccedent. *~ Signed ahe Secretary 01 Revenue By .~~~ (Cc:unty) ~ -"'"' 1"'"'\ c:J) -.)0 -.;)7,8 ESTATE SETTLEMENT AGREEMENT This Agreement is made the 18th day of Hay , 1981, by and among Robert D. O'Hara, Executor of the estate of David G. O'Hara, Deceased, (hereinafter referred to as Executor), and John A. O'Hara, Jean O. Shande1mier, Daniel D. O'Hara, Terry L. O'Hara, Thomas R. O'Hara, and Robert D. O'Hara, as residuary beneficiaries of the said estate (herein collectively referred to as the beneficiaries). In accordance with their desire that the administration of the estate of David G. O'Hara be terminated without the expense and delay of a court accounting, the parties hereto, in consideration of the mutual covenants herein expressed, and intending to be legally bound hereby, agree that: 1. The estate of David G. O'Hara, who died August 25, 1980, is now in the process of administration, Letters Testamentary having been duly granted to the Executor by the Register of Wills of Cumberland County on September 4, 1980. 2. Under the provisions of Item IV of the decedent's will, his residuary estate was given to the following beneficiaries in the fractional shares set forth opposite their names: John A. O'Hara 25% Jean O. Shandelmier 25% Robert D. O'Hara 25% Daniel D. O'Hara 8-1/3% Terry L. O'Hara 8-1/3% Thomas R. O'Hara 8-1/3% 3. The parties acknowledge that the Executor has received the assets and made the payments set forth in the First and Final Account of the Executor, a copy of which is attached hereto as Exhibit A and made a part hereof, and the parties approve the said Account in its entirety. l"Q '0'" L...d\ UtJ r;lOC U V -'. 4. The parties hereto agree that the remaining balance of the estate assets shall be distributed as set forth in the Schedule of Distribution, a copy of which is attached hereto as Exhibit B and made a part hereof, including distributions of all legacies and devises as therein set forth, without intending to limit the rights or remedies of the Executor, the parties further agree to indemnify the Executor and save the Executor harmless against all liability, loss and expense (including, but not limited to, costs and counsel fe~s) which the Executor may incur, whether due to the Executor's negligence or otherwise, as a result of making the above-described distributions without a court audit. 5. The beneficiaries authorize the Executor to reserve from the above-mentioned balance, assets having an aggregate value of $ NONE as reflected in the Schedule of Distribution. Following their receipt of the Estate Tax Closing Letter and any estate tax deficiency that may be assessed and any other proper expenses or liabilities of the estate of which the Executor shall have received notice by that time, or which may otherwise be payable, the Executor shall distri- bute to the beneficiaries, in the proportion of their interests as set forth in Paragraph 2 above, and without further accounting, the balance then remaining. Such distribution will also include any funds received by the Executor subsequent to the date to which the attached Account is stated. Should any proper liabilities of the estate, whether for taxes or otherwise, arise or come to the attention of the Executor or any of the other parties thereafter, the beneficiaries agree to be jointly and severally liable therefor. 6. The parties, and each of them, hereby forever fully release, compromise, settle and discharge any and all claims, demands, action or causes of action, legal or equitable, absolute or contingent, vested or hereafter to accrue, which any of L ')L~' l.Uu but: JUb them may have against any other party hereto or against the estate of D~vid G, O'Hara deceased, or the Executor thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said estate, or growing out of or relating to any act of the Executor in his administration of said estate, even if attributable to negligence, and agree that any period for the limitation of actions for the collection of any erroneous distribution or distributions shall commence only at such time as the Executor shall have obtained actual knowledge of such erroneous distribution or distributions and that in no event shall the period for collection of any erroneous distribution or distributions be less than two years after the actual discovery thereof by the Executor. 7. The parties agree to execute such additional releases as the Executor may submit to them in order to confirm their discharge from any further liability to the parties in connection with the said estate. 8. This Agreement may be executed in multiple counterparts and, when so executed, shall be binding upon all the parties, and their respective heirs, next- of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals th7~day and year first above written. Q.l.-u.&- ~ . ~/tfl-A- (SEAL) Robert D.. O'Hara, Executor & Beneficiary /1 ' I /. / [. ~/r-y.)~ W. ~#~.-v- (SEAL) .John A. O'Hara, Beneficiary / (SEAL) Jean O. Shande1mier, Beneficiary (SEAL) Daniel D. O'Hara, Beneficiary (SEAL) Terry L. O'Hara, Beneficiary (SEAL) t..J1..:\ .iUu I ;.uC ,,:,Ub Thomas R. O'Hara, Beneficiary '""", ~. them may have against any other party hereto or against the estate of Dllv1d G, O'Hara deceased, or the Executor thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said estate, or growing out of or relating to any act of the Executor in his administration of said estate, even if attributable to negligence, and agree that any period for the limit1tion of actions for the collection of any erroneous distribution or distributions shall commence only at such time as the Executor shall have obtained actual knowledge of such erroneous distribution or distributions and that in no event shall the period for collection of any erroneous distribution or distributions be less than two years after the actual discovery thereof by the Executor. 7. The parties agree to execute such additional releases as the Executor may submit to them in order to confirm their discharge from any further liability to the parties in connection with the said estate. 8. This Agreement may be executed in multiple counterparts and, when so executed, shall be binding upon all the parties, and their respective heirs, next- Of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. Q~l..u,-!- ~ . ~~/~ (SEAL) Robert D. O'Hara, Executor & BenefiCiary I John A. O'Hara, "neficiary tte.JjL,~L~ ean O. Shandelmier, Beneficiary (SEAL) EAL) Daniel D. O'Hara, Beneficiary (SEAL) L o./t.!\ J.Uv' :;~c JUt, Terry L. O'Hara, Beneficiary (SEAL) Thomas R. O'Hara, Beneficiary (SEAL) ,-.., them may have against any other party hereto or against the estate of D~v1d G. O'Hara deceased, or the Executor thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said estate, or growing out of or relating to any act of the Executor in his administration of said estate, even if attributable to negligence, and agree that any period for the limitation of actions for the collection of any erroneouS distribution or distributions shall commence only at such time as the Executor shall have obtained actual knowledge of such erroneous distribution or distributions and that in no event shall the period for collection of any erroneous distribution or distributions be less than two years after the actual discovery thereof by the Executor. submit to them in order to confirm their discharge from any further liability to 7. The parties agree to execute such additional releases as the Executor may the parties in connection with the said estate. 8. This Agreement may be executed in multiple counterparts aod, when so executed, shall be binding upon all the parties, and their respective heirs, next- of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. . Q.l-'--'^-'~ ~ . C:::-'-:-If.~ (SEAL) Robert D. O'Hara, Executor & Beneficiary (SEAL) John A. O'Hara, Beneficiary (SEAL) Jean O. Shande1mier, Beneficiary (' .0(, ."f ~r2~<L_~L- ~J .0/", ~~(SEAL) Daniel D. O'Hara, Beneficiary (SEAL) Terry L. O'Hara, Beneficiary (SEAL) . . ':J.' LJ L w:";; .1.UL. r ;....., - Thomas R. O'Hara, Beneficiary . .' .. -. them may have against any other party hereto or against the estate of D~vid q, O'Hara deceased, or the Executor thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said estate, or growing out of or relating to any act of the Executor in his administration of said estate, even if attributable to negligence, and agree that any period for the limitation of actions for the collection of any erroneous distribution or distributions shall commence only at such time as the Executor shall have obtained actual knowledge of such erroneous distribution or distributions and that in no event shall the period for collection of any erroneous distribution or distributions be less than two years after the actual discovery thereof by the Executor. 7. The parties agree to execute such additional releases as the Executor may submit to them in order to confirm their discharge from any further liability to the parties in connection with the said estate. 8. This Agreement may be executed in multiple counterparts and, when so executed, shall be binding upon all the parties, and their respective heirs, next- of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. . C~~_~~ ~. &:#~ (SEAL) Robert D. O'Hara, Executor & Beneficiary (SEAL) John A. O'Hara, Beneficiary (SEAL) Jean O. Shandelmier, Beneficiary (SEAL) Daniel D. -"'" (SEAL) L .,:, .tU,--' :;"L ~il (SEAL) Thomas R. O'Hara, Beneficiary .-, them may have against any other party hereto or against the estate of D~v1d G, O'I~ra deceased, or the Executor thereof, by reason of any matter, cause or thing growing out of or relating to any property or assets of the said estate, or growing out of or relating to any act of the Executor in his administration of said estate, even if attributable to negligence, and agree that any period for the limitation of actions for the collection of any erroneouS distribution or distributions shall I i commence only at such time as the Executor shall have obtained actual knowledge of such erroneous distribution or distributions and that in no event shall the period for collection of any erroneous distribution or distributions be less than two years after the actual discovery thereof by the Executor. 7. The parties agree to execute such additional releases as the Executor may submit to them in order to confirm their discharge from any further liability to the parties in connection with the said estate. 8. This Agreement may be executed in multiple counterparts and, when so executed, shall be binding upon all the parties, and their respective heirs, next- of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. ,Q.J:.-...,,-&- ~ . ~/-?,,,"^- (SEAL) Robert D. O'Hara, Executor & Beneficiary (SEAL) John A. O'Hara, Beneficiary (SEAL) Jean O. Shande1mier, Beneficiary (SEAL) Daniel D. O'Hara, Beneficiary (SEAL) Terry L. O'Hara, Beneficiary L d 108 r :;vL ';:.L;:; //J ~ () (;',,'/1.'" ;J'/.:t'?/I;t?<?' . /' /;:>-:"1(1, Thomas R. O'Hara, Beneficiary (SEAL) " ESTATE OF DAVID G. O'HARA, DECEASED ACCOUNT 1. ASSETS 1. Transfer from Dauphin Deposit Checking Account 2. Hedical Expense Reimbursements 3. Penna. R.R. Vol. Relief Dept. - Death Benefit 4. Dauphin Deposit Corp. - Dividend 5. West Shore Savings & Loan - Interest 6. Washington National Insurance Co. - Life Ins. Policy 7. Dauphin Deposit Bank & Trust Co. - Interest on C.D. 12-18001 8. Travelers Insurance Co. - Hed. Expense Reimbursement 9. Cash from David G. O'Hara - Wallet 10. Travelers Insurance Co. - Hed. Expense Reimbursement 11. U.S. Treasury - R.R. Retired Empl. Death Benefit 17. U.S. Treasury - Redemption of Savings Bonds 13. Hedicare - Hed. Expense Reimbursement 14. Refund on Inventory Filing Fee - Register of Wills 15. Travelers Insurance Co. - Hedical Expense Reimbursement 16. Hedicare - Hedical Expense Reimbursement 17. Travelers Insurance Co. - Hedical Expense Reimbursement 18. Pa. Blue Shield - ~~dical Expense Reimbursement 19. Corom. of Penna. - Tax Rebate on Property Tax 20. Pa. Blue Shield - Hedical Expense Reimbursement 21. Dauphin Deposit Corp. - Dividend 22. Jean O. Shandelmier - Sale of Real Estate 23. Travelers Insurance Co. - Hedical Expense Reimbursement 24. Pa. Blue Shield - ~edical Expense Reimbursement 25. Susan A. Shandelmier - Sale of 73 Dodge Sedan 26. U.S. F. & G. Co. - Refund on Auto Insurance Cancellation 27. Cash - Sale of Personal Effects 28. West Shore Savings & Loan - Redemption of C.D. l5-B-1732 29. West Shore Savings & Loan - Interest on C.D. l5-B-1732 30. West Shore Savings & Loan - Redemption of C.D. l5-B-1376 31. West Shore Savings & Loan - Interest on C.D. l5-B-1376 32. Dauphin Deposit Corp. - Dividend 33. Dauphin Deposit Bank & Trust Co. - C.D. 12-22473 34. Dauphin Deposit Bank & Trust Co. - Interest on C.D. 12-22473 35. 364 Shares of Dauphin Deposit Corp. at $33.00 per Share GROSS ASSETS II. DEDUCTIONS 1. Husselman Funeral Home 2. Holy Spirit Hospital Rad. Assoc. 3. Robert D. O'Hara Letters Testamentary - 33.00 Short Certificates(lO)-lO.OO 4. West Shore Savings & Loan Assn. - C.D. 5. Raymond C. Grandon, H.D. 6. Lemoyne Borough - Sewer Rental 7. Cumberland Law Journal - Legal Advertisement Exhibit "A" $ 3,205.63 468.67 1,252.30 236.60 330.25 156.60 748.38 6.40 15.50 1.58 869.70 5,220.58 32.00 2.00 14.40 296.00 96.00 62.32 15.00 74.00 236.60 22,162.51 81.00 6.30 1,000.00 123.00 680.00 3,000.00 170.37 6,100.00 318.12 236.60 HI,OOO.OO . 575.66 12,012.00 $69;806.07 2,382.65 53.00 43.00 9.67 416.00 15.75 18.00 ~ 8. Thomas J. D'Angelo - Real Estate Appraisal 9. Rehab Medicine Assoes. 10. Register of Wills - Filing of Inventory 11. Gingrich Memorials of Mechanicsburg - Lettering Monument 12. Community Physicians Inc. 13. Register of Wills - Pa. Inheritance Tax 14. Loudon L. Campbell - Attorney's Fee 15. John A. O'Hara - Reimbursement for Auto Insp. & Repairs 16. Register of Wills - Filing Fee - Supplemental Inventory 17. Register of Wills - Filing Fee - Inheritance Tax 18. U.S.F. & G. Co. - Auto Insurance 19. Carol A. Luta - 1980 Lemoyne Boro. Taxes 20. Register of Wills - Balance of Pa. Inheritance Tax 21. IRS - Amended 1040 22. U.S. Fiduciary Income Tax Return 23. Pennsylvania Fiduciary Income Tax Return 100.00 50.00 5.00 47.00 1.9B 3,445,43 2,500.00 40.28 3.00 6.00 229.00 71. 99 3.02 19B.00 119.00 33.Bl TOTAL DEDUCTIONS $ 9,791.5B III. SPECIFIC BEQUESTS 1. John A. O'Hara, Jr. 2. Paul D. O'Hara 3. Michael L. O'Hara 4. Terry L. O'Hara 5. Thomas R. O'Hara 6. Susan A. Shandelmier 7. Daniel D. O'Hara 8. Catharine T. McKee $ 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 $ 8,000.00 TOTAL SPECIFIC BEQUESTS IV. DISTRIBUTIONS TO RESIDUARY BENEFICIARIES 1. John A. O'Hara, 122 Shares of Dauphin Deposit Corp. at $33.00 per share $ 4,026.00 2. Robert D. O'Hara, 120 Shares of Dauphin Deposit Corp. at $33.00 per share 3,960.00 3. Jean O. Shandelmier, 122 Shares of Dauphin Deposit Corp. at $33.00 per share 4,026.00 TOTAL DISTRIBUTIONS TO RESIDUARY BENEFICIARIES $12,012.00 -'. <. u ,. L.;... L..' t;" e); u..ll1; C)l~' a::t2 c,,, <.:>'" ~a: -I. " r"" a.. u c'. ~'I(.';, :7:0 .rj;" -r...i <l...J "'0' .ow '0> a:"'Z ::> 'ju u N N ~ F>