HomeMy WebLinkAbout04-0324The Law Office of
MA I.I. F. Attorney at Law
Certified Elder Law Attorney by the National Elder Law Foundation
2000 Linglestown Road ~ (717) 540-4332
Suite 303 r~x: (717') 540-4313
Harrisburg, PA 17110 .5~)~ .~,~/'~ www. hazenelderlaw, com
April 1, 2004
Register of Wills C~ 2~,' ~ ~
C~berl~d County Co.house 9 r~ ~ ~ ~
One Co~ouse Sq~e m c: -
C~lisle, PA 17013 > ;~ ~
Re: Estate of Nellie Wilhour Troutman
To: The Register of Wills:
Enclosed for filing plebe find ~e ofigin~ ~d ~o copies of the above-referenced
Final I~edmce T~ Retmm well ~ ~ original ~d one copy of a co~esponding
Estate l~o~ation Sheet ~d dea~ ce~ificate. Pleme date-s~p the enclosed copies of
· e I~efimce T~ Re~ ~d ~e Es~te lnfo~ation Sheet ~d re~ ~em to my office
' in ~e enclosed self-ad~essed envelope.
Also enclosed is a check in ~e mo~t of $15.00 representing ~e filing fee.
If you have ~y questions or require ~y addition~ info~ation, please do not
hesitate to contact me.
Sincerely,
Enclos~es
cc: Mimi Sch~ble
-1500
DEPARTuE~ToFREVENUE' INHERITANCE RETU FILENU=ER
Tfoutman~ Nellie~lhour I 7 2 - 2 6 -
DATE OF D~TH (M~B~Y~ ~TE OF BlaH (M~Y~
REGISTER OF WILLS
11 ~8~003. 12/10/1906
~ 6,~entDi~T~ (~ ~ 7.~ent~in~in~a LMngT~(~T~ 8. T~mNum~r~SafeDe~es
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL T~ INFORMA~ON SHOULD BE DIRECTED TO:
~ME [ COMPLETE ~ILmNG ADDRE88
FIRM NAME
Ma~elle F. Hazen~ Esq. ) 2000 Linglestown Read
Sure 303 ' -
Law ~ of Ma~elle F. H~en
TE~PH~.E NUMBER
, ... OFFIC~L USE ONLY
2. S~ and ~n~ (S~ule B) (2)
3. C~e~ He~ Co,omen, Pa~emhip or ~l~Pmpde~hip (3) ........
5. C~, ~nk ~ & M~lbnmus Pe~I Pm~ (5) 800.00
6. Join~ ~ Pm~ (~ule F) (6).
~ lt232.14
8. Toal Gross AS~ ~1Un~ 1-7) (8)
3,822.50
9, Fungi ~ A Ad~ ~ (~u~ H) (9)
~2. N~ Value of Es~ Line 8 minus Line ~) (~2) -2~590.36
~4. H~ Value Sub~ m T~ (Line ~2 mi,us Line ~3) [~4) -2~590.36
SEE IN.RUCTIONS ON ~RSE SIDE FOR ~PUC~LE ~TES
15: A~unt of Line 14 ~ at ~e s~u~l ~
~, or ~n~ und~S~ 9116 (a)(1.2) X ~ (15)
16. A~unt of ~ne t4 ~b~ at lin~l ~ O.00 X .~5 (16) 0.00
17. A~nt~Line14~b~atsibii~ X .12 . (17)
18. AmountofLine1~'~'at~l~l~ - X .15 '(18) "
Dece((ent's Complete Address:
I STREETADORESS
801
N.
Hanover
Street
~ C,ffY Carlisle I STATE PA I ziP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0.00
2. Credifs/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Totel Credits (A + B +C) (2)
3. interest/Penaify if applicebie
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.
Check box on Page I Line 20 to request a refund (4) 0.00
5. If Line 1 + Une 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)
B. Enter the totel of Une 5 + 5A. This is the BALANCE DUE. (5B) 0.00
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 No
a. retain the use or income of the property transferred; ........................................................................... [] []
b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] []
c. retain a reversionary interest; or ...................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ............................................................. [] []
2. If death occurred atter December 12, 1982, did desedent trensfer pmparty within one year of death
without receiving adequate cansideration? ............................................................................................... [] []
3. Did decedent own an 'in trust for' or payable upon death bank account or secuhty at hfs or her death? ................. [] []
4. Did decedent own an Individual Retiremant Account, annuity, or other non-probate proparlY which
contains a beneficiary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ANB FILE IT AS PART OF THE RETURN,
AD'DRESS 137 Leslie Avenue
Merchantville NJ 08109
SIGNATURE OF PR EI~A[~ E R~OTHE~R THAN REPRESENTATIVE .DAT~E
ADDRE~;S 200-O'"~in~/le'sto~,¥1~oad, Suite 303 / /
HarrisburFi PA 17110
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 3%
[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 trensfem fo or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdesure of assets and filing a tax retum are atill applicable even ff
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 ste~oparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate ~mposed on the net value of transfers o or for the use of the decedent s hneal benefic~anes is 4.5%, except es noted n 72 P.S. §9116(1.2) [72 P.S. §9116(a)( )].
The tax rate imsesed on the net value of transfers to or for the use of the decodent's siblines is 12% i72 P.S. 691161a~t1.3tl. A siblino is defined, under Sectico 9102. as an
REV-1508 EX + (6-98)
'=
co..o.vv~,~, or PE.NS~LV^.~ CASH, BANK DEPOSITS, & MISC.
,..E.~r^NCE T*X.~U.. PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Troutman. Nellie Wilhour
include the proceeds of lilJga~on and the date the proceeds ~em received by I~ estate.
All property Jointly-Ovaled with right of sulvivomhip must be disclosed on Schedule F.
ITEbl VALUE AT DATE
NUblBER DESCRIPTION OF DEATH
1. Nursing home personal account 800.0u
)aid directly to funeral home bill
TOTAL (Also enter on line 5, Recapitulation) $ 800.00
REV-150~ EX + (6-98)
.
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Troutman, Nellie Wilhour
if an asset was made Joint witflln one year of the dacedant's date of death, It must be reported on Schadu~ G.
SURVIVING JOINT TENANT(S) NAME ADDRESS ~ELATIONSHIP TO DECEDENT
A. Mimi Schaible 137 Leslie Ave. Granddaughter
Merchantville, NJ 08109
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERS' % OF DA~E OF OEATH
ITEM FOR JOINT MADE INCLUDE NAME OF RNANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR BATE OF DEATH DECD'S VALUE OF
hlUMBER TENANT JOINT IDENTIFYING NUMBER. A~rACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DEDEDENT*S INTERES1
1. A. 2001 Checking Account 864.28 50. 432.14
PNC Bank
Acct. No. 50-0390-1173
TOTAL (Also enter on line 6, Recapitulation} $ 432.1z
REV-151~ EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
~.HEer~^.CE T~X RETUR. ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Troptman. Nellie Wilhour
D~Ms of decedent must be mpofmd on Schedute I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1, Hoffi~an-Roth Funeral Home 3,807.50
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal RepmeantelJve (s) Mimi Schaible
Social Secunty Number(s)/EIN Number of Personal ReprasentatJve(s)
Sheet Address 137 Leslie Ave.
C~ Merchantville State NJ Zip 08109
year(s) Commission Paid:
2. AfforneyFeas Law Office of Marlelle F. Hazen
3. Famiiy Exemplio~: (If decedents address is not the same as claimants, attach explanalJon)
Claimant
S~eet Addreas
City State Zip
Re{a~eaship of Claiment to Decedent
4, proba~ Feea
5. Aceauntent's Fees
6. Tax Retum Preparers Fees
7. Cumberland County Register of Wills Tax Filing Fee 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 3~822.50
-~ SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT O£OEDENT
ESTATE OF FILE NUMBER
Troutma~ . Nellie Wilhour
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER .*ME AND ADDRESS OF PERSON/S) RECE,V,.G PROPERT~Oo.~ L,.T.~.I OF ESTATE
,. TAXABLE DISTRIBUTIONS [i,~c~lg~ ~6 (U~a h(tl~ )~] sal dis~ibu~ons, and tra nsfem under
1. Mimi Schaible Granddaughter 100% Residue
137 Leslie Ave.
Merchantville, NJ 08109
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART Il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING.: It is illegal to duplicate this copy by photostat or photograph.
Fee~for...this certificate, .$2'00:' .... -
P 9-898564 DEC 5 2003
No. ~ Da-re
CERTIFICATE OF DEATH
.~umh, ~ nd ~. i~dl t ~;p. Church of God Home ~[~ ~[~,,~c~. ~ White
C~rland
~ ~ ~-~/~c~9-/~ I~,~. 013144L ' I~. 219 N. Hanover' $~., Carlisle, PA 17013
CONNONNEALTH OF PENNSYLVANZA
BUREAU OF ZNDZVZDUAL TAXES DEPARTNENT OF REVENUE
ZNHERZTANCE TAX DZVZSZON
DEPT. 280601 NOTZCE OF ZNHERZTANCE TAX
HARRZSBURG, PA 17118-0601
APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX REV-1547EXAFP(el-I$)
;:~ DATE 05-2~-2004
ESTATE OF TROUTNAN NELLZE
DATE OF DEATH 11-28-2005
FZLE NUHBER 21 0~-052~
HARZELLE F HAZEN '04 i~i~¥ 24 ~'~ ;!}4 COUNTY CUHBERLAND
ACN 101
STE 303 I Aeoun~ Reei~ad
ZOO0 L~NGLESTONN RD ~,.~
PA
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGZSTER OF NZLLS
CUHBERLAND CO COURT HOUSE
CARLZSLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS
REV-15&7 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR
DZSALLONANCE OF DEDUCT/ONS AND ASSESSNENT OF TAX
ESTATE OF TROUTHAN NELL/E NFZLE NO. 21 04-052~ ACN 101 DATE 05-2~-Z00~
TAX RETURN NAS: (X) ACCEPTED AS FZLED { ) CHANGED
RESERVATZON CONCERNZNG FUTURE /NTEREST - SEE REVERSE
APPRA/SED VALUE OF RETURN BASED ON: ORZGZNAL RETURN
1. Real Es~a~e (Schedule A) (1) .00 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2) .00 credJ~ ~o your account,
$. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) ($) .00 subei~ ~he upper portion
~. Hot,gages/No,es Receivable (Schedule D} (~) .00 of ~his form ~i~h your
5. Cash/Bank Depos~s/N~sc. Personal Proper~y (Schedule E) ($) 800.00 ~ax payment.
6. Jointly O~ned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7) .00
8. To~el Asse~s (8)
APPROVED DEDUCTZONS AND EXENPTZONS: $,822.50
9. Funeral Expenses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9)
10. Debts/Not,gage L~ab~l~ies/Liens (Schedule Z) (10) .00
11. To~el Deduc~/ons (11) ~.~2.50
12 Ne~ Value of Tax Re~urn (12) Z,590.$6-
·
13. Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13)
lq. Ne~ Value of Es~e~e Sub~ec~ ~o Tax (lq) 2,590.56-
NOTE: Zf an assessment ~as lssued previously, 11nes 14, 15 and/er 16, 17, 18 and 19 ~ill
reflect fLgures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX: .00 x O0 .00
15. Amoun~ of L~ne 1~ a~ Spousal ra~e (15) =
16. A,oun~ of Line 1~ ~axeble e~ Lineal/Class A ra~e (16) .00 X Oq5 = .00
17. Amoun~ of Line lq at Sibllng ra~e (17) .00 X ~Z = .00
18. Amoun~ of Line lq ~exable a~ Collateral/Class B rate (18) .00 X 15 = .00
19. Prlncipal Tax Due (19)= .00
TAX CREDZTS:
PAYHENT RECEZPT DZ$COUNT (+) ANOUNT PAZD
DATE NUNBER INTEREST/PEN PA/D (-)
TOTAL TAX CREDZT I .00
BALANCE OF TAX DUEI .00
ZNTEREST AND PEN. I .00
TOTAL DUE I .00
ZF PA/D AFTER DATE TNDZCATED~ SEE REVERSE ( ZF TOTAL DUE TS LESS THAN $1, NO PAYNENT ZS REI~UZRED.
FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR INSTRUCTZONS. )
RESERVATZON: Estates of decedents dying on or before December 11, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the Iawful CIass B (collateraI) rate on any such futura interest.
PURPOSE OF
NOTICE: To fuIfilI the requirements of Section Z140 of tho Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to tho Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
REFUND (CR): A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications ara available at the Office
of tho Register of NJlls, any of the Z$ Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-361-Z050~ services for taxpayers wlth special hearing and ! or
speaking needs: 1-800-447-5010 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraismeant, allowance, or disallowance of deductions, or assessment
of tax [including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17128-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17118-0601
Phone ¢717) 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three [3] calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 1SZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1981 boar interest at the rate of
six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January l, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. Tho applicable interest rates for 1982 through Z004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 201 .000548 1988-1991 11Z .000501 2001 9Z .000247
1983 161 .000438 1991 9X .000247 2002 61 .000164
1984 111 .000301 1993-1994 71 .000192 2003 51 .000137
1985 131 .000356 1995-1998 91 .000247 2004 41 .000110
1986 101 .000274 1999 71 .000191
1987 101 .000274 ZOOO 71 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotice issued after the tax becoeas delinquent will reflect an interest calculation to fifteen (1S) days
beyond the date of the assessesnt. If payment is made after the interest computation date shown on the
Not/ca, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent · Nellie Wilhour Troutman
Date of Death · 11/28/2003
Will No. Admin. No. Estate File 21-04-0324
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 g No ~
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. I is Yes, state the following:
a. Did the personal representative file a final
account with the Court ? Yes ~ No X
b. The separate Orphans' Court No. ( if any ) for
the personal representative's account is'
c. Did the personal representative state an
account informally to the parties in interest ? Yes X No ~
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.
Signat~r~ ~
Marielle F. Hazen, Esquire
Name (Please type or print)
2000 Linglestown Rd., Suite 303
Harrisburq PA 17110
Address
(717) 5404332
.... Tel. No
'~ ~3 Capacity' Personal Representative
17~1 Id [Z d~ 170. X Counsel for personal
representative
FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE
IN
ESTATE OF NELLIE WILHOUR TROUTMAN, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, NELLIE WILHOUR
TROUTMAN, late of Cumberland County, Pennsylvania, deceased, died testate on November 28,
2003, having first made her Last Will and Testament, which was duly executed March 1, 1989.
WHEREAS, Mimi Schaible is the Personal Representative for the Estate of NELLIE
WILHOUR TROUTMAN;
WHEREAS, the said Personal Representative has gathered the assets of the estate of the
decedent and the assets consist of both real property and personal property, to a total value of
$800.00 as set forth in Exhibit A, which is a statement of account of the Personal Representative, and
which is attached hereto and made a part hereof, and marked Exhibit A;
WHEREAS, there is no balance for distribution as shown in the statement marked Exhibit A;
WHEREAS, NELLIE WILHOUR TROUTMAN, by the aforesaid Last Will and Testament,
named her spouse, George H. Troutman, as beneficiary of her Estate, however he predeceased her.
WHEREAS, NELLIE WILHOUR TROUTMAN, by the aforesaid Last Will and Testament,
named her son, Albert C. Troutman, as contingent beneficiary of her Estate, however he predeceased
her.
WHEREAS, NELLIE WILHOUR TROUTMAN, by the aforesaid Last Will and Testament,
named William Troutman, Kenneth Troutman, Kathy Troutman Clark, Kelly Troutman Bates, Mimi
Schaible and Michael Troutman as next contingent beneficiaries of the Last Will and Testament;
NOW THEREFORE, KNOW YE, that we, William Troutman, Kenneth Troutman, Kathy
Troutman Clark, Kelly Troutman Bates, Mimi Schaible and Michael Troutman, being all of the
beneficiaries of the decedent and heirs under the Last Will and Testament of the decedent, and being
those persons entitled to inherit under the Last Will and Testament do hereby, each of us,
acknowledge that we have this day had and received from the aforesaid Personal Representative, in
full satisfaction and payment of all sum or sums of money, legacies, bequests, and devices as are
given, devised and bequeathed to each of us respectively by the Last Will and Testament;
AND, each of us does hereby stipulate that in order to avoid the expense and time involved in
the filing of a formal account and schedule of distribution, we each agree that no account is necessary
and we do hereby agree that we do consent to finalization of the estate without the filing of an
account and schedule of distribution, the same to be with the same force and effect as if it had been
filed and confirrned by the Orphans Court Division of the Court of Common Pleas, Cumberland
County Branch.
THEREFORE, we and each of us do hereby remise, release, quitclaim and forever discharge
the Law Office of Marielle F. Hazen, the Personal Representative, Mimi Schaible and her legal
counsel, Marielle F. Hazen, their heirs, executors, and administrators and assigns, of and from the
estate and from all actions, suits payments, accounts, reckoning, claims, and demands whatsoever for
or by reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the estate
of the decedent.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this / --
day of
~ ,2004.
Witness ~'/ ..... Mimi Schaible
Witness Michael Troutman
Witness William Troutman
Wimess Kenneth Troutman
Witness Kathy Troutman Clark
Witness Kelly Troutman Bates
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF :
On this the t~ g4 day of ~ ,2004 before me, a Notary Public, the
undersigned officer, personally appeared Mimi Schaible (known to me/or satisfactorily proven) to be
the person whose name is subscribed to the within instrument, and acknowledged that she executed
the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Marielle F. Hazen, Notary Public ~"~ota~yPubli~
City of Harrisburg, Dauphin Count3'
My Commission Expires Sept. 23, 2006
IN WITNESS WHEREOF, we have hereunto set our hands and seals this __ day of
., 2004.
Witness Mimi Schaible
Wimess
William Troutman
Witness Kenneth Troutman
Wimess Kathy Troutman Clark
Wimess Kelly Troutman Bates
COMMONWEALTH OF PENNSYLVANIA :
: SS:
cov v .
On this the (~'~ day of (~,~'~0o ,2004 before me, a Notary Public, the
undersigned officer, personally appeared Michael Troutman (known to me or satisfactorily proven)
to be the person whose name is subscribed to the within instrument, and acknowledged that he
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
No~ PublicxJ - ' -
COMMONWEALTH OF PENNSYLVANIA
[" Notarial S~al ]
Jennifer N. Grove, Notary Publk:
Silver Spring .Twp., Cumberland County
My Commission Expires Jan. 28, 20011 J
Member, Pennsylvania Association of Notaries
IN WITNESS WHEREOF, we have hereunto set our hands and seals this ~ day of
~__) [A_V'LD~ ,2004.
Witness Mimi Schaible
Wimess Michael Troutman
Wimess ~ti'i li~m~'~'~-butman/
Witness Kenneth Troutman
Witness Kathy Troutman Clark
Witness Kelly Troutman Bates
COMMON~q~ALTH OF PENNSYLVANIA :
: SS:
On this the ~ day of 3 LLV~ ,2004 before me, a Notary Public, the
undersigned officer, personally appeared William Troutman (known to me/or satisfactorily proven)
to be the person whose name is subscribed to the within insmanent, and acknowledged that he
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARIAL SEAL
APRIL D. SHEAFFER, Notary Public
Carlisle, Cumberland County
My Commission Expires April 23, 2008~
IN WITNESS WHEREOF, we have hereunto set our hands and seals this /~o fg4tay of
~t )~-x// ,2004.
Witness Mimi Schaible
Witness Michael Troutman
Witness William Troutman
Wimess Kenneth Troutman
Wimess Kathy Troutman Clark
Witness Kelly Troutman Bates
COMMONWEALTH OF -..z.~..~., ....~.,
: SS:
On this the l ~0 day of -..~tl,'~ ,2004 before me, a Notary Public, the
undersigned officer, personally appeared Kenneth Troutman (~r,,,~o,,~a4o-me~atisfactorily proven)
to be the person whose name is subscribed to the within instrument, and acknowledged that he
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this /o6 day of
(~f~ ,2004.
Wimess Mimi Schaible
Witness Michael Troutman
Witness William Troutman
W~ei~~'~ -- Kathy Trou~~k
Wimess Kelly Troutman Bates
COMMONWEALTH OF (~oc~ ~-~ :
: SS:
cowry
On this the/o~''~L' ~
day of ,2004 before me, a Notary Public, the
undersigned officer, personally appeared Kathy Troutman Clark (kn~o..~al_to nledor satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and acknowledged that
she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this c~'t'~ day of
~-.~Dt3E.~ ., 2004.
Wimess Mimi Schaible
Witness Michael Troutman
Witness William Troutman
Witness Kenneth Troutman
~ithmill B Kathy.Troutman~~
COMMONWEALTH OF ~-.=,~r~ow. x~s ~A
: SS:
cot TV
.-
On this the D~'t-~ day of ~c)r,D-e._ ,2004 before me, a Notary Public, the
undersigned officer, personally appeared Kelly Troutman Bates (known to me/or satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and acknowledged that
she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
N, ~3~ ~ublic ~
GROSS VALUE OF THE
ESTATE OF NELLIE WILHOUR TROUTMAN
Assets
Cash, Bank Deposits and
Miscellaneous Personal Property $ 800.00
Jointly owned property $ 432.14
TOTAL $1,232.14
Expenses/Distributions
Funeral Expenses (most expenses paid $ 147.11
by life insurance)
Attorney Fees $ 732.00
Probate and Administration fees $ 36.00
Debts:
Income tax $ 955.00
Joint property passes to surviving $ 432.14
Joint owner
TOTAL $2,302.25
TOTAL AMOUNT TO BE DISTRIBUTED $-0-
EXHIBIT A
GIFTS TO BENEFICIARIES
ASSETS:
Assets transferred to Mimi Schaible $78,300.00
In June 2001
Income on Account $ 2,944.33
TOTAL $81,244.33
DEBTS AND EXPENSES:
Funds returned to Nellie $14,400.00
In 2002
Estate Expenses $ 1,963.71
Amount retained for future payment
of tax or other debts $ 1,500.00
TOTAL $17,863.71
NET AMOUNT $63,380.62
Name Share Distribution Amount
Mimi Schaible 1/4th $15,845.15
*Michael Troutman 1/4th $15,845.15
*William Troutman 1/8th $ 7,922.58
*Kenneth Troutman 1/8th $ 7,922.58
*Kathy Troutman Clark 1/8th $ 7,922.58
*Kelly Troutman Bates 1/8th $ 7,922.58
* While the Estate has no money available for distribution, upon receipt of all signatures on the
within Family Settlement Agreement, Mimi Schaible is planning to gift the funds gifted to her by
Nellie Troutman pursuant to the terms of Nellie Troutman's Will.
EXHIBIT A CONTINUED