HomeMy WebLinkAbout10-24-07
--.J
15056041114
REV-1500 EX (06-05)
OFFICIAL USE ONLY
County Code Year
File Number
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~ \ {j.Q
b~llc
Date of Birth
194-66-1239
06122006
06081968
Decedent's Last Name
Suffix
Decedent's First Name
MI
ROHRER
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
MELISSA
M
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
W 1. Original Return 0
D 4. Limited Estate D
2. Supplemental Return
D
D
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
W 6. Decedent Died Testate D
(Attach Copy of Will)
D 9. Litigation Proceeds Received 0
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
8. Total Number of Safe Deposit Boxes
o
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
STEPHEN D. TILEY
Firm Name (If Applicable)
717-243-5838
REGISTER OF WILLS USE ONLY
FREY & TILEY
First line of address
5 SOUTH HANOVER STREET
Second line of address
'-"'i
,-" '\
City or Post Office
State
ZIP Code
DATEFIL.
:- --',
CARLISLE
PA
17013
--J
,
" I
C,)
---I
ROAD, NEWVILLE, PA 17241
&~
D.TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041114
15056041114
--.J
--.J
15056042115
REV-1500 EX
Decedent's Name: MELISSA M ROHRER
RECAPITULATION
1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . .
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . .
6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . .
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) DSeparate Billing Requested. . . . . . . .
8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
194-66-1239
Decedent's Social Security Number
1.
2. NONE
3. NONE
4.
5.
6.
7. NONE
8.
9.
102000.00
0.00
14434.00
1. 00
116435.00
16116.00
9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . .. 13.
14. Net Value Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . .. 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O 0
16. Amount of Line 14 taxable
at lineal rate X .0 ~
17. Amount of Line 14
taxable at sibling rate X . 12
18. Amount of Line 14 taxable
at collateral rate X . 1 5
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042115
15.
16.
17.
18.
15056042115
101938.00
118054.00
-1619.00
0.00
-1619.00
0.00
0.00
0.00
0.00
0.00
D
--.J
REV-1500EX Page 3 194-66-1239
Decedent's Complete Address:
File Number
DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER
MELISSA M ROHRER 194-66-1239
STREET ADDRESS
8 CEDAR STREET
CITY II STATE I,ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
0.00
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
0.00
A. Enter the interest on the tax due.
(5A)
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . ., 0
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0
o
D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No
o
o
o
o
o
o
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for
the use of the surviving spouse is three (3) percent [72 P .S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
zero (0) percent [72 P .S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory
requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for
the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P .S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half
(4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling
is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
217
REV-1502 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Melissa M. Rohrer 21-06-0576
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right ohurvivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
8 Cedar Street
Newville, PA 17241
Two Story Single Family Residence
Assessment: $85,890
Common Level Ratio published June 2006: 87.8%
Market Value implied by the assessment: $97,824.61
Property was sold February 23, 2007 for $102,000, subject to seller contributions for
purchaser's closing costs. Those contributions and other expenses of seller are listed
in Schedule 1-1 of this Return.
See copy of settlement sheet, attached.
102,000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
102,000
MB
A'o.
0 NO. 2502-0265 .,"r
A. B. 'TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING 110 URBAN DEVELOPMENT tOFHA 2.QFmHA 3. !mCONV. UNINS. 4. OVA 5.0CONV. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT AA501.00103 3001062258
a. MORTGAGE INS CASE NUMBEP~
C. NOTE: This form is furnished to give you a statement of ac:tual settlement costs. Amounts paid to and by the settlement agent afll shown.
Ilems merked "[pOer ;,efll paid outside the closing; they are shown here for Informalional pUlpOses and elll not included in the 1o/8/s.
1.0 3Ill8 IAAS07.Qll1ln.JOFCIMSOT.m'D:lI481
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADORESS OF LENDER:
Patnc:k Jones and Eslll!.. of Melissa M. Rohrer Aegis Wholesala Corporation
Mercetles S. Jones. husband and wife PO Box 7739
8 Cedar 51. Springfield, OH 45501-7139
NewvUle, PA 17241
G. PROPERlY LOCATION: H. SETiLEMENT AGENT: I, SETTLEMENT DATE:
8 Cedar SL SUNSET SETTL.eMENT SERVICES, LLC
Newvllle, PA 17241 Februlll}' 23, 2001
Cumberiand CountY, PeMsylvania PLACE OF SETTLEMENT
341 Science Park Rd., Sle. 205 C1
Slate College, PA 16803
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SElLER:
101. Contract Sales Price 102,000.00 401. Contract Sales Price 102,000.00
102. Personal ProntlrN 402. Penlonal Pro""mt
1 03. Selllement Chaltlas to 80rrtlWllr lUna 1400 3.881.82 "'03.
104. "'04.
105. 405.
AtlIUstments For Ilems Peld s.- SeHer In advanca Adlustments For Items Paid 811 SeVer in advancs
106. CllvlTown Taxes to 406. CllvlTown Taxes to
101. CountvTaxes to 407. Caunlv Taxes to
108. Schoal 02123101 to 07/01/07 394.51 408. Schoal 02123101 to 07/01/07 394.51
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 106,276.33 420. GROSS AMOUNT DUE TO SELLER , 02,394.51
200. AMOUNTS PAlO BY OR IN BEHALF OF BORROWER: 600. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Oeaasll or amest money 500.DO 501. Exr:ess DenosU lSee Instrucllons)
202. Prlnctoal Amount of New Loan/s\ 102.000.00 502. Settlement Chames to Seller Ii ne 1400j 9,820.66
203. Exlsllno loan s taken sub'ectlo 503. ExisUn" loan 51 taken 5ui'ilect to
204. 504. PlMIIf First Mortgage 10 Nationstar Mortgage, LLCJ 79,312.13
205. ~O5. "'"'olf 5acand lIIIart<la""
206. 506.
207. 501. -COellOSlt disb.as ""'ceeds\-
208. 508.
209. SeDer Concession 3.589.34 509. Seller Concession 3,589.34
Adfuslments For Items iJiiiIa/d BV SellIN AdfUSlments For Ilems UntJl!/d Bv Seller
210. CIlvIT own Taxes to 510. CllvlTown Taxes 10
211. ClluntllTaxes 01/01/01 to 02123101 54.42 511. CounlvTaxes 01/01107 10 02JZ3J07 54.42
212. School to 512. School ID
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. I 519.
220. TOTAL PAID BYIFOR BORROWER 106,143.76 520. TOTAL REDUCTlON.AMOUNT DUE SELLER 92.m.15
300. CASH AT SETTLEMENT FROPilITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. GIllIS Amount Oue From Borrower IUne 120 I 106.216.33 601. Gross Amount Oue To Seller (Une 420\ I 102.394.51
302. Less Amount Paid BvlFor Borrower IUne 220) I( 106,143.76 602. Less Reductions Due Seller (LIne 520) I( 92.m.15
303. CASH ( X FROM){ TO) BORROWER I 132.57 603. CASH ( X TO.I ( FROM) SELLER I 9,617.36
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Basad on Prica $ @ % 6,120.00 PAlO FROM PAlO FROM
OiYfsion of Commission (line 700) as Follows: aORRCWS1l'S sel.lER'S
701. S 3.085.00 . to Ceoturv 21 - A Better Way F\lNOS AT FUNOS "T
702. S 3 035.00 10 Dawn & Associates SrnLElAENT SE'TTLEMENT
703. Commission Paid at Set1lemenl 6,120.00
704. Transaction Fee 10 Dawn and Associates 195.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Onaloallon Fee % to
802. Loan Discount % to
803. Appraisal Fee 10 Bob Sloner. Appra sar 300.00
804. Admin 10 Aeels Wholesale Corporation 598.50
805. Credit Report to American Advantage Mortgage Services. LLC 14.16
806. Precess!no Fee to American Advantaee MortClaCle Services LLC 650.00
807. Broker Fee to American Advantage Mortgage l:iervtces. LLC 850.00
806. oocument Pl1lo
809. Broker Fea Aegis Wholesale Corporation
810.
811. Yield Spread Prem Pd by Lender American Advantage Mortgage Services, LLC pac L 5765.00
eoo.lTEMs REQU/RElSY LENDER TO BE PAID IN ADVANCE
901. Interest From 02123107 to 03l01J07 @ $ 17.815100Jday ( 6 days 6.3750%) 108.89
I 902. Mortoaoe Insurance Premium for 12 months to
903. Hazard Insurance Premium for 1.0 vears 10
904.
90s.
1000. RESERVES DEPOSITED WITH LENDER
1001. HIIZBItf Insurance 3.000 months 5 43.75 oer month 131.25
1002. MolIo""e Insurance months S 82.45 oer month
1003. CllvlTown Taxes months S oer month
1004. Countv Taxes 2.000 months S 31.23 gar month 56.72
1005. School 9.000 months @ $ 93.75 per month 843.75
1006. mon\he @ S per month
100'7: months (QI 5 oer month
1008. Ano-ale Adluslment months (Ill $ Qer month -404.34
1100. TITl.E CHARGES
1101.. Settlemenl orCles/no Fee 10
1102. Abstract ar Tille Search to
1103. WIre "'ee to SUNSET SETTLEMENT SERVICES. LLC 20.00
1104. ~ress Man Fee 10 SUNSET SETTLEMENT SERVICES. LLC 65.00
1105. Document Praoarallon 10
1106. Tax CertJL/en Letlers to SUNSET SETTLEMENT SERVICES. LLC 75.00
1107. Attorney's Fees tc
Includes above item numbers: I
1108. Tille In"t1ranCll to United General Tille In=nce Comoanv 868.75
flnc/Udes &bOIll! Item numbers: j
1109. Lenders Coverage $ 102.000.00 868.75
1110. OWner's Coverage S
1111. END. 100.300.900 to SUNl>t: I SeRVICES, u..c 1110.00
1112. Closing Proteetlon !.alter to United General nUe Insurance Company 3Q.OO
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recardlno Fees: Deed $ 50.00; Mortgage S 89.00; Releases S 139.00
1202. CIlV/CounlV. ax/Slamos: Deed 1.020.00' MarlQalle 510.00 510.00
1203. State Tax/Slamos: Deed 1.020.00; Mllrtoaoe 510.00 510.00
1204. TPI' Recordlnos
1205- TPP RecordIngs
1300. ADDITIONAl. SETTLEMENT CHARGES
1301. .SurVev 10 II
1302. Pest InSllBdlon 10 / I' II
1303. ProoertvTaxes- cd \hru '07 JI/
1304. 2007 CounIvTaxes-EST. to Beltv L Hockensmith. Tax Collector H Ilf" 28.2~..Q35~24 374.80
1305. See adem' dlsb. exhibit \0 /1 If! I AI' 325.00 150.00
1400. TOTAl. SETTLEMENT CHARGES fEnter IIn Unes 103, Secllon J and 502. Secdoi1 K'flt 1/ I \..// ...-'"'\ 3,881.82 9.820.66
// I /!~->-' / /
SUNSET SETTLEME!ll15ERVICES. LLC, SelUemenl A ent
Pag.:!.
9
(MSG7~1031 AAS07.o0103 I A61
HUD-1, Page 3 J
Borrower (5): Patrick Jones and Mercedes S. Jones,
husband and wife
8 Cedar Sl
Newville, PA 17241
lender: Aegis Wholesale Corporation
Settlement Agent SUNSET SETILEMENT SERVICES, LLC
(814)272-4169
Place of Settlement: 341 Science Park Rd., Ste. 205 C1
State College, FA 16803
Settlement Oate: FebruaIy 23, 2007
Property location: 8 Cedar Sl
Newville, PA 17241
Cumberland County, Pennsylvania
Seller(s): Estate of Melissa M. Rohrer
Additional Disbursements
PayeelDescrlptlon
Advance Look
Home/Pest Inspection
Escrow-Sunset Settlement, LLC
Escrow-Final Water & Sewer
Total Additional Disbursements shown on Line 1305
NotelRef No.
Borrower
325.00
Seller
150.00
$
325.00 $
150.00
Seller Loan Payoff Demils
Payoff First Mortgage
Loan Payoff
Total Additional Interest
Late Fee
to Nationstar Mortgage, LLC
Re: 243819792
79,275.37 As of 02126/07
37.36 2 days @ 1B.680000Per Diem
30.69 Included in Total Payoff amount if payoff is received after 03/15/07
Totall.oanPayoff
79,312.73
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and
accurate state t of all receipts and disbursements made on my account or by me in this transaction. I further certify
that I ha77~PY of the HUD-1 Settlement Statement.
g~ ;,#~ \
trick Jones / ),1'lC,k1.---ucrJ
WARNING: It Is a crime to knowingly make false statements to the United States on thIs or amJ sImIlar fonn. Penalties upon convlctlon can
Include a fine and Imprisonment. For details see: Titlll1B U.S. Code Sec:tlon 1001 and Sec:tlon 1010.
(MS07-00103.PFtl/MS07-o0103/46)
217
REV-1507 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MELISSA M. ROHRER
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21-06-00576
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Claim Against William Stanley based upon unsecurred personal loan in the amount of
$20,000. William Stanley was the former live-in boyfriend of the decedent. The decedent's
checking account shows a $20,000 transfer to William Stanley which was to have been a
loan related to William Stanley's purchase and operation of a pizza restaurant. That
business failed and the loan is deemed uncollectable.
o
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o
217
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MELISSA M. ROHRER
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ITEM
NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All DroDertv iointlv-owned with riaht of survivorshiD must be disclosed on Schedule F.
FILE NUMBER
21-06-00576
DESCRIPTION
Adams County National Bank account number 9120955
See letter dated July 11, 2006, attached
Accrued interest to date of death
VALUE AT DATE
OF DEATH
762
1
2
Orrstown Bank checking account number 108006363
See letter dated September 8, 2006, attached
550
3
Miscellaneous Household Furnishings distributed to Adam F. Rohrer
No listing, estimated value:
500
4
Miscellaneous Household Furnishings distributed to Robert S. Hostler
No listing, estimated value:
500
5 Cash in wallet
6 U.S. Treasury - Refund
7 U.S. Treasury - Refund
8 U.S. Treasury - Refund
9 Refund - PA Virtual Charter School
10 Refund - Safe Auto
11 Refund - First Premium Bank
12 Refund - Homeowners Loan Corp
13 Refund - Waste Management
14 Sale of 1984 Dodge Truck
15 Sale of 2001 Volkswagen Turbo Bug
4
27
19
5,564
96
160
7
490
54
200
5,500
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
14,434
~ ADAMS COUNlY
NATIONAL BANK
July 31,2006
Frey & Tiley
Attorneys at Law
5 South Hanover Street
Carlisle, P A 17013
Re: Estate of Melissa M. Rohrer
Dear Mr. Tiley:
The following information is being provided as per your request:
Acct. Type Account No. Account Accrued Ownership Date Opened Date Joint
Principal on Interest
D.O.D. to
D.O.D.
Checking 2187531 $2.14 $00.00 Jt. wi Adam 7-19-04 7-19-04
Rohrer
Savings 9120955 $761.87 $.77 Individual 3-25-03 NIA
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5116.
Sincerely,
'-OJ Mrf~
Lois Kime
Deposit Services
..~
ORRSTOWN
BANK
September 18, 2006
TO: Stephen D. Tiley ,
Frey & Tiley
5 S. Hanover $t
Carlisle, PA 17013
FROM: Andrew G. Ott
Customer Service Officer
Orrstown Bank
22 S. Hanover St
Carlisle, PA 17013
RE: ESTATE OF MELISSA M. ROHRER
DATE OF DEATH: JUNE 12, 2006
IT IS HERE:BY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKING ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
108006363
MELlSSAM. ROHRER November 14. 2002 $550.47
SA VINGSACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
CERTIFICATES OF DEPOSIT
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
PO Box 250 . Shippensburg, PA 17257 . (717) 532-6114 · (717) 532-4143 Fax. WW\Nnrrdn,^1I"l Mn'\
217
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
MELISSA M. ROHRER
FILE NUMBER
21-06-00576
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Adam F. Rohrer
17 East Louther Street
Carlisle, PA 703
Step-Son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST
NUMBER DECEDENT'S INTEREST
1. A. 7/19/04 Adams County National Bank account no.: 2187531 2 50.00% 1
0
2. A. 11/30/05 1999 Mitsubishi Automobile VIN: 4A3AK44YXXE120873 0
Title No.: 62279824502 RO See copy of title attached. 0
This vehile was abandoned to an impound company that had 0
towed it and stored it. The car was abandoned for storage 0
fees. 0 50.00% 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 6 Recaoitulation' $ 1
(If more space is needed, insert additional sheets of the same size)
?"- ADAMS COlJNlY
NATIONAL BANK
July 31, 2006
Frey & Tiley
Attorneys at Law
5 South Hanover Street
Carlisle, P A 17013
Re: Estate of Melissa M. Rohrer
Dear Mr. Tiley:
The following information is being provided as per your request:
Acc1. Type Account No. Account Accrued Ownership Date Opened Date Joint
Principal on Interest
D.O.D. to
D.O.D.
Checking 2187531 $2.14 $00.00 J1. wi Adam 7-19-04 7-19-04
Rohrer
Savings 9120955 $761.87 $.77 Individual 3-25-03 NIA
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. lfyou need any additional information, please contact me at (717)339-5116.
Sincerely,
r/l M rf~
Lois Kime
Deposit Services
16
I' q It
.0 I 5".1il
I _
prfJ.(rY
If)- Y' r p
frj1fV
~;r'
If a co-purchaser other than your spouse is listed and you wantlhe tnle to
be listed as 'Joint Tenants With Right of Survivorship' tOn dealh of one
owner, 1IIIe goes 10 surviving owner.) CHECK HERE O...Olh!lrwiSl/;lti~;;title
will be issued as 'Tenants in Common' tOncleath)f one~er~~Imere.f'Ol
deceased owner goes 10 hislher heirs or estate);J..:.,J ;:::.::;'.,: .':::::~'}::;:j.:1\
1ST UEN DATE: ~ IF NO UEN.6HEC~'&.
DAV
VEAR
SIGNATUA:E OF PERSON ADMINISTERING OATH
1ST UENHOLDER
STREET
N
<.D
Ul
(Jl
~
OJ
w
N
CITY
IF THIS IS AN ELT. CHECK HERE 0
NOTE: FIN REOUIRED
2ND UEN DATE:
STATE
FINANCIAL
INSTITUTION NO.
The undelallilned nereby tNlCel applicatiOn lor Certllicale 01 Tille to the vetlide described
above. .~ 10 "" .ncumtl,.ncn and other Ieg.1 daims ..t tanh h....
2ND UENHOLDER
STREET
SIGNATURE: OF APPUCAN'T OR AUTHOfUZEO SIGNER
STATE
FINANCIAL
INSTITUTION NO.
CITY
SIGNATURE OF co-APPUCANTfTlTLE OF AUTHORIZED SIGNER
IF THIS IS AN ELT, CHECK HERE D
NOTE: FIN REQUIRED
217
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
MELISSA M. ROHRER
21-06-00576
ITEM
NUMBER
A.
1.
B.
1.
2.
3.
4.
5.
6.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
Egger Funeral Home
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Joyce Ann Anderson
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 1484 Center Road
City Newville State PA Zip 17241
Year(s) Commission Paid: 2007
Attorney Fees (Frey & Tiley)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Robert S. Hostler
Street Address 44 Marsh Drive
City Carlisle
Relationship of Claimant to Decedent Son
*** Robert S. Hostler resided with the decedent, and then remained in the house until he needed to vacate
Probate Fees the house as the house needed to be sold to cover expenses. It anticipated that there
will be insufficient assets with which to satisfy the Family Exemption in full.
(Frey & Tiley)
State PA
Zip 17013
Accountant's Fees
7. Reserve to File Account
Tax Return Preparer's Fees
(Frey & Tiley)
8. Filing Fee - Inheritance Tax Return
9. Cumberland Law Journal - Advertising
10. The Sentinel - Advertising
TOTAL (Also enter on line 9 Recaoitulation $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
7,597
1,500
3,000
3,500
112
None
None
180
15
75
137
16 116
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT D EDENT
ESTATE OF
MELISSA M. ROHRER
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-06-00576
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Miscellaneous Expenses -- See Schedule 1-1 , attached
101,938
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
101,938
ESTATE OF: ROHRER, MELISSA M.
FILE NO.: 21-06-00576
SCHEDULE "1-1"
DISBURSEMENTS
Date
2006
20-Jul Automatic Debit to Orrstown Checking Account
Difference between DOD balance and closing balance 126.20
20-Jul First Premier Bank 64.23
20-Jul Comcast Cable 69.50
20-Jul Embarq (Sprint) 44.67
20-Jul PP&L 140.64
20-Jul State Farm Insurance 134.13
20-Jul Betty L. Hockensmith - Tax Collector 1,124.96
10-Aug Centex Home Equity - Mortgage Payments 1,258.47
12-Sep N ationstar - Mortgage Payment 613.89
12-Sep Newville Water & Sewer Authority 335.40
12-Sep PP&L 224.21
l8-Sep State Farm Insurance 71.66
18-0ct Nationstar - Mortgage Payment 644.58
19-0ct State Farm Insurance 44.82
I-Nov Nationstar - Mortgage Payment 613.89
14-Nov State Farm Insurance 38.83
9-Dec c.A. Caple - Auctioneer 951.50
9-Dec N ationstar - Mortgage Payment 675.27
Schedule "I-I" - Estate of Melissa M. Rohrer
Page 1
ESTATE OF: ROHRER, MELISSA M.
FILE NO.: 21-06-00576
SCHEDULE "1-1"
DISBURSEMENTS
Date
11- Dec Frey & Tiley - Reimburse for Short Certificates 12.00
21- Dec PP&L (voided then cleared) 46.36
21- Dec State Farm Insurance 38.83
21- Dec N ationstar - Mortgage Payment 613.89
2007
2-Jan PP&L 46.36
25-Jan State Farm Insurance 38.83
25-J an PP&L 21.87
25-Jan Newville Water and Sewer Authority 136.41
25-J an N ationstar Mortgage 613.89
25-Jan Kough's Oil Service 631. 92
25-Jan Joyce A. Anderson - Misc. Supplies and landfill (cleaning, paint
locks, film and developing) 203.52
23-Feb Expenses associated with sale of 8 Cedar Street, Newville, PA:
Realtor's Commission to Centry 21/ Dawn & Associates 6,120.00
Contribution to Buyer's Closing Costs 0.00
Wire Fee and Overnight Fee to Sunset Settlement Services 85.00
Realty Transfer Tax 1,020.00
Escrow for Final Water and Sewer Bill 150.00
School Tax Pro-Ration (394.51)
County & Municipal Tax Pro-Ration 54.42
Payoff First Mortgage to Nationstar Mortgage, LLC 79,312.73
27-Feb Egger Funeral Home 5,597.05
Schedule "I -I" - Estate of Melissa M. Rohrer
Page 2
ESTATE OF: ROHRER, MELISSA M.
FILE NO.: 21-06-00576
SCHEDULE "1-1"
DISBURSEMENTS
Date
27-Feb PP&L 18.12
27-Feb Kough's Oil Services 345.00
27-Feb Cumbo Valley Endo. Center 34.19
27-Feb Hoover's Plumbing & Heating 70.00
14- Mar Newville Water & Sewer Authority 10.26
14-Mar PP&L 29.42
26- Mar Refund - State Farm Insurance (45.62)
ll-Apr Refund - Nationstar Mortgage (18.68)
24- May Refund - United States Treasury (30.00)
101,938.11
Schedule "I-I" - Estate of Melissa M. Rohrer
Page 3
217
REV-1513 EX'" (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
MELISSA M. ROHRER
21-06-00576
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1 Trust for: Adam F. Rohrer, 17 East Louther Street, Carlisle, PA 17013 Step-son 50%
2 Trust for: Robert S. Hostler, 44 Marsh Drive, Carlisle, PA 17013 Son 50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TEST AMENT
OF
MELISSA M. ROHRER
I, Melissa M. Rohrer, a resident of 1484 Center Road, Newville, Cumberland County,
Commonwealth of Pennsylvania 17241, do hereby make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making void any and all Wills and Codicils by me at
anytime heretofore made.
FIRST
. I direct the payment of my just debts and funeral expenses as soon after my death as may
be convenient. '.' . .
I direct that all federal and Pennsylvania estate taxes, Pennsylvania inheritance taxes, and
generation-skipping transfer tax payable as a result of my death, not limited to taxes attributable to
property passing under this Will, shall be paid by my Executor from my residuary estate. I direct
my Executor not to seek reimbursement for any tax so paid from any beneficiary under this Will,
heir of mine, or other transferee of property included in my gross estate. I make this direction
knowing that the Pennsylvania inheritance tax rate for my stepson is presently greater than the rate
for my son.
SECOND
I declare that I am the widow of Gerald F. Rohrer. I had one child prior to my marriage to
Gerald F. Rohrer, to wit: Robert S. Hostler, a son born January 7, 1988. My deceased husband
had a son born prior to our marriage, to wit: Adam F. Rohrer, born December 17, 1988. Although
not adopted by me, I have always considered my stepson Adam F. Rohrer like a son to me and, as
nearly as possible, I desire that he be treated equally with my son Robert S. Hostler.
THIRD
All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever
the same may be situate, I give, devise and bequeath, in equal shares, per stirpes and not per capita,
unto such of my children and my stepson Adam F. Rohrer as shall survive me by ninety (90) days,
but should any of them fail to so survive me then the share such deceased child or said stepson of
mine would have received shall pass to such of his or her issue as shall survive me by a period of
ninety (90) days, per stirpes, and if there be no such issue the same shall lapse and be added to the
remaining share or shares; Provided However, that if any child of mine or my said stepson, or any
issue of any child or said stepson, shall be under twenty-one (21) years of age at my death, the
share of my residuary estate that that child or said stepson or issue shall be entitled to shall instead
pass in trust as set forth in paragraph five (5) of this Will. At the present time I have one child, as
aforementioned, and therefore, at the present time my estate would be divided into two shares, one
for my son Robert S. Hostler and one for my stepson Adam F. Rohrer.
In the event that neither my said stepson nor any child shall survive me by the aforesaid
period of ninety (90) days, nor the issue of any of them survive me, I give, devise and bequeath all
the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same
may be situate, to my sister Joyce Ann Anderson.
FOURTH
Should any child of mine survive me who is less than twenty-one (21) years of age, and
'. my sister Joyce Ann Anderson, as Guardian of the person of such child of mine.
FIFTII
~ Should any person less than twenty-one (21) years of age be entitled to a distribution out of
the residuary of my estate pursuant to Paragraph Third herein, I direct such share shall be paid to
my sister Joyce Ann Anderson, as Trustee and Guardian of the estate of such person, but if she
should decline, cease or be unable to act as such, then in such event, I nominate, constitute and
appoint my brother-in-law, Eugene Rohrer, as altemate or successor Trustee and Guardian of the
estate of such person. I further direct that no said Trustee or Guardian shall be required to post any
bond to secure the faithful performance of his or her or its duties in the Commonwealth of
Pennsylvania or in any other jurisdiction, and I authorize and direct said Trustee or Guardian of the
estate of such person to recei ve and to invest said distribution and to pay so much of the income
arising thereon together with so much of the principal thereof as in its opinion is necessary or
Last Will and Testament of Melissa M. Rohrer
Page 1 of 3
desirable to be expended for the proper maintenance, support and education of such person, and
upon such person attaining twenty-one (21) years of age, to pay the then remaining principal
together with any undistributed income to such person. It is my intention that a separate
guardianship estate or trust be established for each such person less than twenty-one (21) years of
age who is entitled to a distribution out of the residuary of my estate.
SIXTH
Any and aU payment or payments of any sum or sums, whether in cash or in kind and
whether for principal or income, payable to any said child or children, shall be made upon the sole
receipt of the respective individual to whom the payment is made, and free from anticipation,
alienation, assignment, attachment and pledge, and free from control by the creditors of any such
beneficiary. All shares of principal and income herein given shall be free from anticipation,
assignment, pledge or obligations of any beneficiary, and shall not be subject to any execution or
attachments.
SEVENTH
I hereby nominate, constitute and appoint my sister Joyce Ann Anderson as Executrix of
this my Last Will and Testament. In the event of the renunciation, death, resignation or inability to
act for any reason whatsoever of my said sister Joyce Ann Anderson, I nominate, constitute and
appoint my brother-in-law, Eugene Rohrer" as Executor of this my Last Will and Testament. I
further direct that no bond or other security shall be required of any Executor or Executrix
appointed in this Will for the performance of his, her or its duties in any jurisdiction in which he,
she or it may be called upon to act. The terms Executor or Executrix may be used interchangeably
in this Will and shall refer to any Executor or Executrix appointed in this will, or any other
Administrator appointed by a court of competent jurisdiction.
EIGHTH
In addition to, and not in limitation of, the powers conferred by law or by other provisions
of this Will, my Executrix shall have the following powers, each of which may be exercised from
time to time by my Executrix in her sole discretion:
(a) To retain in the form received, and to sell either at public or private sale, or to
distribute in kind, any real or personal property.
(b) To manage both real and personal property.
(c) To invest and reinvest in all forms of property, notwithstanding the fact that any or
all of the investments made are of a character or size which but for this expressed
authority would not be considered proper for an Executrix.
(d) To exercise any option or rights arising from the ownership of investments.
(e) To compromise claims without court approval and without the consent of any
beneficiary .
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament, written on three (3) pages (including notary page), this 25th day of February, 2002.
~~~EAL)
issa M. Rohrer
Signed, sealed, published, and declared by Melissa M. Rohrer, the Testatrix above named, as
and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the
presence of each other, have hereunto subscribed our names as attesting witnesses.
~AJ 70
~/::St A~~
Last Will and Testament of Melissa M. Rohrer
Page 2 of 3
..~.-....---.--_...--.......-..-..,... ......~....-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss:
We, Melissa M. Rohrer, the Testatrix in, and
and , the witnesses, to the Last Will and Testament, the
attached or foregoing instrument, who have signed the instrument, having been duly qualified
according to law do depose and say:
a. that I, the Testatrix, do hereby acknowledge that I signed and executed the instrument
as my Last Will and Testament, that I signed it willingly and as my free and voluntary
act for the purposes therein expressed; and .
b. that we, the witnesses, were present and saw the Testatrix. sign and execute the
instrument as her Last Will and Testament, that she signed it willingly and executed it
as her free and voluntary act for the purposes therein expressed; that each of us in the
hearing and sight of the Testatrix signed the Last Will and Testament as a witness and
that to the best of our knowledge the Testatrix was at that time eighteen (18) or more
years of age, of sound mind and under no constraint or undue influence.
~'1~
~..f)/ 7~
/ L
/~.;'.
~ i N6l A. ~
Subscribed, sworn to and acknowledged before me by the Testatrix and the witnesses
above-named, this 25th day of February, 2002.
~~--d .
SJ
Notary Public
NOTARIAL&EAL
ROBERT G. fREf,MOlARY PUBUC
CARWSLE, CUM81!RUlND COUNTY. PA
MY COMMISSION EltPRIRES JUNE 3. 2002
Last Will and Testament of Melissa M. Rohrer
Page 3 of 3