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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AN D MIDDLE INITIAL)
Doelker Mary J.
DATE OF DEATH (MM~ OD-YEAR) DATE OF BIRTH (MM -OD-YEAR)
OFFICIAL USE ONLY
FILE NUMBER
21-04-0328
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
172 -24- 7903
THIS RE'TURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECUR{TY N UMBER
4. Limited Estate · FutucelntarestCompromlse(dateofdeathafter 1Z-1Z-BZ)
__ 6. Decedent Died Testate Decedent Maintained a Living Trust 0
(Attach copy of Will) (Attach copy of Trust)
[~ 9. LitlgatlonProceedsReceived [~]10. SpousalPovertyCredlt
(date of death between 12-31-91 and 1-1
NAME
James D. Bosar Esquire
FIRM NAME 0f APplicable)
TELEPHONE NUMBER
717/737- 876[
3.
Remainder
~rior to 12-13-8Z)
11. Etectlon to tm< under Sec. 9113(A)
(Attach Sch O)
COMPLETE MAILING ADDRESS
One West Main Street
Shiremanstown, PA 17011
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Propemy (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9}
10. Debts of Decedent, Mortgage Liabi[ities, & Liens (Schedule l) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1) 82,677.00
(2) 4,993.80
None
16,925~01
3,491.78
None
7,155.66
None
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFFICIAL USE ONLY
(8) 108,087.59
(11) 7,15S.66
(12) 100,931.93
(13~
(14) 100,931.93
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
X .0 0 (15) 0.00
0.00 X .0 45 (16) 0.00
17,674.93 X .12 (17) 2,120.99
83,257.00 x .15 (18) 12,488.55
19. Tax Due (19) 14,609.54
.~ Copyright (c) Z000 form software only The Lackner Group. ~nc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STRE~ ADDRESS
17 North High Street
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
13,846.82
728.78
(1)
Total Credits ( A + B + C ) (2)
3. Interesl/Penalty if appricable 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 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (gA)
B. Enter the total of Line 5 + gA. 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 No
a. retain the use or income of the property transferred; ......................... ~'~ r~
b. retain the right 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 paymenta,~benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ ~']
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. ~] []
4. Did decedent own an individual Retirement Account, annuity, or other non-probate proper[./
which contains a beneficiary designation? ................................ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
14,609.54
14,575.60
0.00
0.00
33.94
0.00
33.94
[OFPERSONRESPONSIBLEFORI NGRETURN Gerald f. Hale DATE
201 N. 34th Street
Hill, PA 17011
:NTAT[VE
James D. Bogar Esquire DATE
One West Main Street
-- -~ i~¥~'s-~ ~{: - }X ' - iVOii- .................... LL [~.i, (,0
For dates of death on 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% ;. 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 0%
[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 JuJy 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
parenL an adoptive parent, or a stepparent of the child is 0% [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 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(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.
Copyright {c) ;~000 form software only The Lackner Group, [nc. Form REV- 1500 EX (Rev. 6-00)
REV-150ZEX*(1-97}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF
Mary J. Doelker SS# 172-24-7903
SCHEDULE A
REAL ESTATE
03/14,/2004
FILE NUMBER
21-04-0328
All real property owned solely or aa a tenant in common must be reposed ~ ~ir mark~ value. Fair market value is defined as the price
at which property would be exchanged be~een a willing buyer and a willing seller, neither being compelled m buy or sell, both having reasonable
knowledge of the relevant ~cts. Real property which is joi~l~owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
i Ali that certain piece or parcel of real estate having erected
thereon a - dwelling house being known and numbered as 17 North
Eigh Street, Shiremanstown, Cumberland County, Pennsylvania. ThE
property was Carl K. Doelker and Mary J. Doelker, husband and
wife, by Deed dated October 14, 1974 and recorded October 16,
1974 in the Cumberland County Recorder of Deeds Office, a copy o~
said Deed being attached hereto an~ incorporated herein. The
said Carl K. Doelker died November 7, 1987, whereupon full and
complete title became vested solely in Mary J. Doelker, the
Decedent herein. The above-described real estate was conveyed tc
Brenda K. Stifling, pursuant to Clause SECOND, of the Last Will
and Testament of Mary J. Doelker. A copy of the Deed conveying
said real estate is incorporated herein. It is respectfully
suggested that the fair market value of the real estate is as
follows: $78,740.00 (county assessed value-in effect as of the
date of death) x 1.05 (common level ratio factor-in effect as of
the date of death) - 82,677.00.
TOTAL (Also enter on line 1, Recapitulation)
82,677.00
82,677.00
(if more space is needed, insert additional sheets of the same size)
Copyright{c) 1996 form sof*~ware only CPSystetns, lnc, Form REV-1502 EX (Rev. 1-97)
FEF~SIMPLE DEED--Typewriter
· r eumre,
14th d'aF o! October In the year o! our Lor~ One
?'ho.aand ~It~¢ Illtndred t~sd Seventy-Four (.1974)
~[~tlllE~ll KATHRYN Ir. WOLFE, widow, of the Borough of Shiremanstown,
Cutnberland County, Pennsylvania, Grantor, Party
-AND-
CARL K. DOELI~ER and MARY $. IX)ELK. ER, his wife, of
the City of Harrisburg, Dauphin County, Pennsylvania, Grantees, Parties
the s.,n o! Twenty-five thousand nine hundred fifty ($25,950. 00) ............
~[[ that certain tract of land situate in the Borough of Shiremanstown, County
BEGINNING at a point at the southeast corner of the intersection of High Street
and Froht Street; thence in an easterly direction along High Street and Front
Street; thence in an easterly, direction along the southern line of said Front Street
a distance of one hundred fifty (150) feet, more 6r less, to a point in the llne of
lands now or late of Ray E. WoLfe;thence in a southerly direction along the line
of other lands now or late of Bay E. Wolfe, a distance of fifty (50) feet to a point;
thence in a westerly direction a distance of one hundred fifty (150) feet, more or
less, to a point in the eastern line of aforementioned High Street; thence in a
northerly direction along the eastern line of said High Street a distance of fifty
(50) feet to a point, the place of BEGINNING.
HAVING thereon erected a one and one-half story single brick dwelling, said
premises being known and numbered as 17 N. High Street, Shiremanstown, Pa.
BEING the same premises which Ray g. Wolfe, single man, by his deed dated
the 4th day of December, 1953, and which deed is recorded in the Office of the
Recorder of Deeds in and for Curaberland County, Pennsylvania, in Deed Book
"N", Volume 15, Page 63, granted and conveyed unto Clifton C. Wolfe and
Kathryn Ir. WoLfe, his wife. The said Clifton C. Wolfe died on l~ay 25, 1974
whereupon title became ~sted in Kathryn V. Wolfe, his wife, the Grantor herein.
Dist. Cumb. Co., P,'
,~R,~ 7..~
use and beko~ o] the said part ies of tl~ second Fart, their heirs and a~siDns
she THE ~AID party of the first part, her
,tssi~ns, that she the teid party of the first part, her
heirs and astt~ns~ against the s~id p~r~ o] tbs first part and he r h~irs and aFainst all
' 'E'"A'"'T"'H"~- -Y- 'N'..X.~ ....w...Q .L~. F E ...
........................................................................
........................................................................
........................................................................
........................................................................
........................................................................ (BELL)
........................................................................ (BE,IL)
........................................................................
........................................................................
........................................................................ (8EALI
........................................................................ (8I~L~
aooD/ 25 ~aG£ 236
o]]~oer, i~rsonall~ ap~r~d ........ ~.~.~.~..~.~.~ .................................................................................
.f/-O.T.~: ~~ ~.. ~... ". ..........
~rur~ In the Office for ~9~d~ng of Deed~, ~o~gages, etc., in and
Tax Parcel No. 37-23-0555-182
THIS INDENTURE,
MADE THE
BETWEEN
and
day of June, two thousand four (2004)
GERALD J. H~LE, Executor of the'Last Will and
Testament of MARY J. DOELKER, late of Borough
of Shiremanstow~, Cumberland County, Pennsyl-
vania, party of the first part,
BRENDA K. STIRLING, of Carlisle, Cumberland
County, Pennsylvania, party of the second
part:
TN'~'~R.~,A~, the said MARY J. DOELKER by her Last Will and Testament,
duly proved and recorded in the Cumberland County Register of
Wills Office, Pennsylvania, in Docket Book 21-04-0328, Letters
Testamentary being issued on April 6, 2004, provided, in perti-
nent part, as follows:
EC~: I devise and bequeath real estate owned by
me, same being known and numbered as 17 North High Street,
Shiremanstown, Pennsylvania, and all my household goods and other
tangible personal property maintained therein, excepting, how-
ever, cash, securities, stocks, bonds, bank accounts (including
certificates of deposit) and other like or similar items, to my
niece, BPd~NDA K. STIRLING, of 24 Eastwood Drive, Carlisle,
Pennsylvania. Should my niece, BRENDA K. STIRLING, predecease
me, I direct that the real estate specifically devised and
bequeathed herein, be and become a part of my residuary estate to
be distributed as set forth hereinbelow.
FIFTH: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all prop-
erty, exercisable without court approval and effective until
actual distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it...
EIGHTH: I nominate and appoint GERALD J. HALE,
Executor of this, my Last Will and Testament...
NOW THIS INDENTURE WITNESSET~, that the said party of the first
part, by virtue o~ the power and authority aforesaid, in said
Will contained, and in consideration of the sum of One Dollar
($1.00) to him paid by the said party of the second part, at and
before the ensealing and delivery of these presents, the receipt
whereof is hereby acknowledged, has granted, bargained, sold and
conveyed, and does hereby grant, bargain, sell and convey to the
said party of the second part, her heirs and assigns forever:
ALL THAT CERTAIN tract of land situate in the Borough of
Shiremanstown, Cumberland County, Pennsylvania, more particularly
bounded and described as follows, to wit:
BEGII~NING at a point at the southeast corner of the intersection
of high Street and Front Street; thence in an easterly direction
along High Street and Front Street; thence in an easterly
direction along the southern line of said Front Street a distance
of one hundred fifty (150) feet, more or less, to a point in the
line of lands now or late of Ray E. Wolfe; thence in a southerly
direction along the line of other lands now or late of Ray E.
Wolfe, a distance of fifty (50) feet to a point; thence in a
westerly direction a distance of one hundred fifty (150) feet,
more or less, to a point in the eastern line of aforementioned
High Street; thence in a northerly direction along the eastern
line of said High Street a distance of fifty (50) feet to a
point, the place of BEGINNING.
HAVING THEREON ERECTED a one and one-half story single brick
dwelling, said premises being known and numbered as 17 N. High
Street, Shiremanstown, Pennsylvania.
BEING the same premises which Kathryn V. Wolfe, widow, by deed
dated October 14, 1974 and recorded October 16, 1974 in the
Cumberland County Recorder of Deeds Office in Deed Book
Volume 25, Page 235, granted and conveyed unto Carl K. Doelker
and Mary J. Doelker, husband and wife. The said Carl K. Doelker
died November 7, 1987 whereupon full and complete title to the
within described real estate became vested solely in Mary J.
Doelker. The said Mary J. Doelker died March i4, 2004.
TOGETHER with all and singular the rights, liberties, privileges,
hereditaments and appurtenances whatsoever thereunto belonging or
in anywise appertaining, and the reversions and remainders,
rents, issues and profits thereof, and all the estate, right,
title, interest, property, claim and demand whatsoever of the
said Mary J. Doelker at and immediately before the time of her
decease, in law or equity or otherwise howsoever, of, in, to or
out of the same:
TO HAVE AND TO HOLD the said granted premises to the said party
of the second part, her heirs and assigns forever.
AND the said party of the first part, does covenant, promise,
grant and agree, to and with the said party of the second part,
her heirs and assigns, by these presents, that the said party of
the first part, has not done, committed, or knowingly or
willingly suffered to be done, any act, matter or thing what-
soever, whereby the premises aforesaid, or any part thereof, is,
are, shall or may be charged or encumbered, in title, charge or
estate, or otherwise howsoever.
IN WITNESS WHEREOF, the said party of the first part has here-
unto set his hand and seal the day and year above written.
Signed,
COMMONWEALTH OF PEI%rNSYLVANIA
Sealed and Delivered
of
COUNTY OF CUI~BERLA_ND
· GERALD J. H~E ~'-e~'
: SS.
(SEAL)
On this, the 1044'- day of June, 2004, before me, the under-
signed officer, personally appeared GEPJkLD j. HALE, known to me
(or satisfactorily proven) to be the person described in the
foregoing instrument, and acknowledged that he executed the same
in the capacity therein stated and for the purposes therein
contained.
seal.
IN WITNESS WI~EREOF,
I hereunto set my hand and official~~i~
No tary Public I 101~81~L
My Co~i s s i on E~ ~ res ~HI~E~AN~N BOR~ CUMB~ ~.~
L~ CO~ISS 0N ~ A~IL ~. 2005
CERTIFICATE OF RESIDENCE
I do hereby certify that the precise residence-and complete
post office address of the within named grantee is 24 Eastwood
Drive, Carlisle, Pennsylvania 17013.*
2004
Attorney four' the Estate of
Mary J. Doelker (N.T.S.)
COM~ONWEALTH OF PENNSYLVANIA :
: SS.
COUI~TY OF CUlW/BERLAND :
RECORDED on this day of
2004, in the Recorder's Office of the said County, in
Deed Book , Page
Given under my hand and the seal of the said office,
the date above written.
*PLEASE RETURN TO:
JAMES D. BOGAR, ESQUIRE
ONE WEST MAIN STREET
SHIREMANSTOWN, PA 17011.
., Recorder.
COMMONWEALTH OFPENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
Mary J. Doelker SS# 172-24-7903 03/14/2004
All property jointly-owned with right of survivo~hip mu~ be disclosed on Schedule F.
FILE NUMBER
21-04-0328
ITEM VALUEATDATE
NUMBER DESCRIPTION UNITVALUE
OF DEATH
1 United States Savings Bonds, Series H, see attached 2,000.00
copies of bonds
2 United States Savings Bonds, Series SN and E, as listed 2,993.80
on attached Receipt
TOTAL(A~oenteronlineZ, Recap~ul~on) 4,993.80
(If more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form software only CPSy~tems, [nc. Form REV-1503 EX (Rev. 1-97)
Branch ID: BP174192
ESTATE OF MA/~Y J.
C/O JAMEs D. BOGA~R,
ONE W. MAIN STREET
SHIREMANSTOWN, PA
Serial Number
DOELKER
ESQUIRE
17011
51-6554197
Redemption Date: 04/27/2004
Transaction Number: 345844
Teller ID: rohxxxte
101057198-S] SN
101057197-SN SN
101057196-SN SN
101057199-SN SN
!101057200-SN SN
101057201-SN SN
I01057202-SN SN
6418304123-E E
6418304122-E E
6418304121-E E
120-E E
6418304119-E E
6418304118-E E
6418304117-E E
6418304116-E E
6418304115-E E
!6418304114-E E
6418304113-E E
6418304112-E E
6418304111-E E
07/1968 $20.25 $125.43
25 03/1968 20.25 136.04
10/1967 20.25 133.80
12/1968 20.25 115.45
25 05/1989 20.25 114.12
25 02/1970 20.25 116.4~
25 06/1970 20.25 118.45
25 11/1971 18.75 107.61
06/1971 18.75 108.20
25 04/1971 18.75 107.85
25 03/1971 18.75 107.85
25 01/1971 18.75 107.55
25 11/1970 18.75 120.94
09/1970 18.75 120.94
06/1970 18.75 119.25
25 02/1970 18.75 118.59
25 09/1969 18.75 116.27
25 05/1969 18.75 119.85
25 12/1968 18.75 118.53
07/1968 18.75 115.39
$145.68
156.29
154.05
135.70
134.37
136.71
138.70
126.36
126.95
126.60
126.60
126.30
139.69
139.69
138.00
137.34
135.02
138.60
137.28
134.14
FIAP~RISBURG(S!MPSON FERRy)
5032 Simpson Ferry Road Mechan
2004
Mechanicsburg, PA 17055
717-766-6800
Page t Of 2
Savings Bond
ESTATE OF MARY J. DOELKER
Redemption Receipt ~
Redemption Date:
51-6554197
04/27/2004
Transaction Number: 345844
Serial Number Series Denom
Issue Interest
Date Issue Price Earned Value
I 6418304110-E
E6418304124-E E
$25 03/1968 $18.75 112.53 131.28
25 10/1967 18.75 109.70 128.45
Total number of bonds redeemed: 22
Customer Signature
Total I ToZal I Total
PriceI Interest Value
$423.00 $2,570.80 $2,993.80
EAP~ISBURG(SIMPSON FERRY)
5032 Simpson Ferry Road Mechan
2004
Mechanicsburg, PA 17055
717-766-6800
Page 2 Of 2
0052.3097008i~31
Di292b996H
:ST" - :, ~
iqO0 6 2~ 2~ ?q 5~1'
D12926995H
l~29Z6794
D1292699~H
REV- 1508 ~X + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
REEIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
Mary J. Doelker SS~/ 172-24-7903 03/14/2004 21-04-0328
Include the proceeds of litigation and the date the proceeds were received by the estate, All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
t
2
3
4
5
DESCRIPTION
Cash found in decedent's home
Allstate Insurance - Homeowner's Insurance Premium Refund
Comcast Cable - Cable Bill Refund
Commonwealth of Pennsylvania - Rent Rebate
Postmark Credit Union - Savings Account No. 7063, date of death
balance $12,745.49, accrued interest $0.00
United States Treasury - 2003 Federal Personal Income Tax Refund
Contents of home and personal property - Value as listed on
attached appraisal
VALUE AT DATE
OF DEATH
3,000.00
122.00
50.45
123.07
12,745.49
304.00
580.00
TOTAL (Also enter on line 5, RecapitulatJon'~ ~ 16,925.01
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Farm REV- 1508 EX (Rev, 1-97)
, ,POSTMnnH
VC REOI T UNION
April I6, 2004
James D. Bogar
Attorney at Law
One West Main Street
Shiremanstown, PA 17011
Re: Estate of Mary $. Doelker
S.S. # 195-074697
Account # 7063
Dear James D. Bogar:
The account of Mary J. Doelker with Postmark Credit Union was owned since September 7,
1988 and she was sole owner.
Interest (dividends) is paid on the last day of the month for accounts.
The following is an account status on March 14, 2004.
Type Opened Balance 03/I4/2004 Interest Rate
Savings 9/07/1988 $12,745.49 0.80%
There are no beneficiaries and no safety deposit boxes on the account at Postmark Credit Union.
This should provide the information for you to handle the estate. If you have any questions please
call.
Very truly yours,
Bonnie Sommer
Member Services
2630 - ng~escoL~n ~ccd · Hcrr,sburg, PA · ~7! ~0-3660
, /oC ? 19
Re:
James D. Bogar, Attorney
One West Main Street
Shiremanstown, PA 17011
William G. Rowe, Appraiser
211 Old Stone House Rd,
Carlisle, PA 17013
Estate of Mary J. Doelker
Pemonal Property Appraisal
17 North High Street
Shiremanstown, PA 17011
Date: May18,2004
LINDEN HALL ANTIQUES
2tl OLD STONE HOUSE ROAD
CARLISLE, PA 17013
717-249-1978
LIVING ROOM
T.V. - old model
Sofa / chair - worn - no value
Recliner
Prints
2-t~er stand
Music center - no value
Wall clock
Lamps
Miscellaneous household
BEDROOM
Bedroom set
Miscellaneous household
Lamps
Ladder
Knick knacks
BEDROOM
Single bed
Small chest
Stand
Chair
Knick knacks
KITCHEN
Pots / pans
Glassware
Small appliances
Dishes
Flatware
Miscellaneous kitchen wares
$15.00
$0,00
$10.00
$10.00
$15.00
$0.00
$15.00
$5.00
$5.00
$125.00
$10.00
$5.00
$5.00
$10.00
$15,00
$10.00
$5,00
$5,00
$10.00
$15.00
$5,00
$15.00
$10.00
$10.00
$10.00
Doelker Appraisal 1 5/18/2004
BASEMENT
Shelving
Cabinets
Table / chairs
Miscellaneous kitchen items
Miscellaneous tools
Exercise equipment - no value
Stools
Heater
Work benches
ATTIC
Rugs
Lamps
Cedar chest
Bedding
Miscellaneous household
Sewing stand
SHED
Miscellaneous garden tools
$10.00
$5.00
$10.00
$10.00
$15.00
$0.00
$10.00
$5,00
$25.00
$10.00
$5~00
$85.00
$10,00
$10.00
$15.00
$15.00
TOTAL $580.00
William G. Rowe
Doelker Appraisal 2 5/18/2004
REV- 150s EX + (1-97)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary J. Doelker SS~/ 172-24-7903 03/14/2004
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
21-04-0328
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.Gerald J. Hale Brother
201 N. 34th Street
Camp Hill, PA 17011
JOINTLY-OWNED PROPERTY:
L~ ~ ~ ~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM =OR JOINT MADE Include name of flnartcial Institution and bank
account number or simllarldentlfylng rlumber. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Att~chdeedforJolntly-heldrealestate. VALUE OF ASSET INTEREST DECEDENT'SINTERE~
A 10/01/84 ~itizens Bank - Checking 6,983.55 50.00~. 3,491.78
%ccount No. 6100715612,
~ate of death balance
$6,983.55, accrued interest
$o.00
TOTAL (Also enter on line 6, Recapitulation) $ 3,491.78
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1509 EX (Rev.
CITIZENS BANK
525 William Penn Place
Suite 153-2510
Pittsburgh, PA 15219
May 3, 2004
JAMES D BOGAR
ONE WEST MAIN STREET
SHIREMANSTOWN, PA 170I 1
Estate of MARY J DOELKER
Date of Death: Mar 14, 2004
SSN: 195-07-4697
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of his/her date of death.
For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please
call 1-888-999-6884.
Sincerely,
Robert Roos
Operations Services
CITIZENS BANK
Account Numb er 6100715612
Account Title MARY DOELKER OR GERALD HALE
Date Opened 10/1/84
Account Type Checking
Principal Balance as of DOD $6983.55
Interest from Last Posting to DOD
Account Balance as of DOD $6983.55
YTD Interest to DOD $ .00
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
ESTATE OF
Mary J. Doelker SS~/ 172-24-7903
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
03/14/2004
FILE NUMBER
21-04-0328
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1
2
3
4
5
FUNERAL EXPENSES:
Gingrtch Memorials - Monument Lettering
Perkins Family Restaurant - Funeral Luncheon
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number{s) / E[N Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees James D. Bogar Esquire
Family Exemption: (if decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Cit'/ State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Linden Hall Antiques - Personal Property Appraisal
Pennsylvania American Water Company - Water Bill-Final
PPL - Electric Bill-Final
Recorder of Deeds - Recording Deed and Statement of Value
RESERVES: Costs to conclude administration of Estate including
filing fee for PA Inheritance Tax Return, Inventory and First &
Final Account; preparation of Personal and Fiduciary Income Tax
Returns
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation) $
90.00
154.27
5,185.00
241.50
65.00
12.10
33.34
39.50
850.00
484.95
7,155.66
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software onJy CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: Mary J. Doelker
Soc Sec #: 172-24-7903
Date of Death: 03/14/2004
Item Description
Continuation of Schedule H-B7
(Other Administrative Costs)
Amount
6 Robert Stirling - Lawn Care
7 UGI Corp Holding Co - Gas Bill-Final
8 Verizon - Telephone Bill-Final
175.00
290.50
19.45
484.95
ESTATE OF
Mary J. Doelker SS~/ 172-24-7903
NUMBER
2
3
4
II.
SCHEDULE J
BENEFICIARIES
03/14/200~,-
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spo~al distributions, and
t~nsfers under S~, 91
Gerald J. Hale
201 N. 34th Street
Camp Hill, PA 17011
Harold R. Hale
800 Wood Street, Apt. 302
Harrisburg, PA 17113
Irene M. Hale
1021 South Progress Avenue
Harrisburg, PA 17111
Brenda K. Stirlfng
24 Eastwood Drive
Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Brother
Brother
Sister
Niece
FILE NUMBER
21-04-0328
AMOUNT OR SHARE
OF ESTATE
One-third
(1/3) of rest,
residue and
remainder
One-third
(1/3) of rest,
residue and
remainder
One-third
(1/3) of rest,
residue and
remainder
Specific
bequest of
real estate
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF FART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
$ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lmckner Group, [nc. Form REV- 1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
MARY J. DOELKER
I, MARY J. DOELKER, of Shiremanstown, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I direct the payment of all my just debts and
funeral expenses, including my grave marker and all expenses of
my last illness, shall be paid from my residuary estate as soon
as practical after my decease as a part of the expenses of the
administration of my estate.
SECOND: I devise and bequeath real estate owned by me,
same being known and numbered as 17 North High Street, Shiremans-
town, Pennsylvania, and all my household goods and other tangible
personal property maintained therein, excepting, however, cash,
securities, stocks, bonds, bank accounts (including certificates
of deposit) and other like or similar items, to my niece, BRENDA
K. STIRLING, of 24 Eastwood Drive, Carlisle, Pennsylvania.
Should my niece, BRENDA K. STIRLING, predecease me, I direct that
the real estate specifically devised and bequeathed herein, be
and become a part of my residuary estate to be distributed as set
forth hereinbelow.
THIRD: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, as follows:
(A) One-fourth (1/4) thereof to my deceased husband's
sister, G.
sylvania.
MARIE HANDLEY, of 2729 Banks Street, Penbrook, Penn-
(B) One-fourth (1/4) thereof to my sister, IRENE M.
HALE, of 1021 South Progress Avenue, Apt. R-5, Harrisburg,
Pennsylvania.
(C) One-fourth (1/4) thereof to my brother, HAROLD R.
HALE, of Apartment 302, 800 Wood Street, Steelton, Pennsylvania.
(D) One-fourth (1/4) thereof to my brother, GERALD J.
HALE, of 201 North 34th Street, Camp Hill, Pennsylvania.
FOURTh: Should any of the individuals named in Clause
THIRD hereinabove predecease me, I direct that their share under
this, my Last Will and Testament, be divided evenly among or
between the surviving residuary beneficiaries as set forth
herein.
PIFT~: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or condi-
tions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
SIXT~: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SEVENT~: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
EI~T~: I nominate and appoint GERALD J. HALE, Execu-
tor of this, my Last Will and Testament. In the event of the
death, resignation or inability to serve for any reason whatso-
ever of the said GERALD J. HALE, I nominate and appoint BRENDA K.
STIRLING, Executrix of this, my Last Will and Testament. I
direct that my Executor or Executrix, and their successors, shall
not be required to post security or a bond for the performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this.3~ day of
~.~ , 1998.
MARY J. DOELKER
(SEAL)
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the pres-
ence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
Address
4
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of Mary J. Doelker
No. 21-04- 0328
Date of Death 03/14/2004
, Deceased Social Security No. 172-24-7903
Gerald J. Hale,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that raise statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
A~orney:
I.D. No.:
James D. Bo~ar Esquire
19475
Ce~'ald 3.
Signature:
Address: One West Main Street
Address: 201 N, 34th Street
Shiremanstown, PA 17011
Camp Hill, PA 17011
Telephone: 717/737-8761
Description
Telephone: 717/737-1403
Dated:
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total: 104,595.81
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Penr~ylva.la Bar Association
CopyHght (c) 1996 form software ortly CPSystems, Inc. Form#RW-7 {199Z)
Estate of:
Date of Death:
County:
Mary J. Doelker
03/14/2004
Cumberland
INVENTORY
CASH:
Allstate Insurance -
Homeowner's Insurance
Premium Refund
Cash found in decedent's home
Comcast Cable - Cable Bill
Refund
Commonwealth of Pennsylvania
Rent Rebate
Postmark Credit Union -
Savings Account No. 7063,
date of death balance
$12,745.49, accrued interest
$0.00
United States Treasury - 2003
Federal Personal Income Tax
Refund
PERSONAL PROPERTY:
Contents of home and personal
property - Value as listed
on attached appraisal
122.00
3,000.00
50.45
123.07
12,745.49
304.00
580.00
16,345.01
580.00
-1-
BONDS:
United States Savings Bends,
Series H, see attached
copies of bonds
United States Savings Bonds,
Series SN and E, as listed
on attached Receipt
REAL ESTATE/PA:
Ail that certain piece or
parcel of real estate having
erected thereon a - dwelling
house being known and
numbered as 17 North High
Street, Shiremanstown,
Cumberland County,
Pennsylvania. The property
was Carl K. Doelker and Mary
3. Doelker, husband and
wife, by Deed dated October
14, 1974 and recorded
October 16, 1974 in the
Cumberland County Recorder
of Deeds Office, a copy of
said Deed being attached
hereto and incorporated
herein. The said Carl K.
Doelker died November 7,
1987, whereupon full and
complete title became vested
solely in Mary J. Doelker,
the Decedent herein. The
above-described real estate
was conveyed to Brenda K.
Stirling, pursuant to Clause
SECOND, of the Last Will and
Testament of Mary 3.
Doelker. A copy of the Deed
conveying said real estate
is incorporated herein. It
is respectfully suggested
that the fair market value
of the real estate is as
2,000.00
2,993.80
82,677.00
4,993.80
-2-
follows: $78,740.00 (county
assessed value-in effect as
of the date of death) x 1.05
(common level ratio
factor-in effect as of the
date of death) - 82,677.00.
82,677.00
TOTAL RECEIPTS OF PRINCIPAL ...............
104,595.81
-3-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
BUREAU OFINDIVlDUAL TAXES
DEPT280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1162 EX(11 96)
NO. CD 00464O
BOGAR JAMES D
1 W MAIN STREET
SHIREMANSTOWN, PA
17011
ESTATE INFORMATION: SSN: 195-07-4697
FILE NUMBER: 2104- 0328
DECEDENT NAME: DOELKER MARY J
DATE OF PAYMENT: 11 / 17/2004
POSTMARK DATE: 11/17/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/14/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $33.94
TOTAL AMOUNT PAID:
$33.94
REMARKS:
SEAL
CHECK# 1009
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Estate of
also known as
Register of Wills of Cumberland
PETITION FOR GRANT OF
Mary J. Doelker
Gerald J. Hale
County, Pennsylvania
LETTERS
, Deceased Social Security No. 19:.5- 07-4697
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 06/09/1998 and codicil(s) dated 02/25/2004
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
N/A
B. Grant of Letters of Administration _-~ :~: .~ ~ T,
(c.t.a.; d.b.n.c.t.a; pendente lite; duran~'absentia; ~,rante r~itlbrltate)
Petitioner(s) after a proper search has/have asceRained that Decedent left no Will and was survived by the following spouse (if any) and
heirs: ~
Name Relationship Resic~e'hce
(COMPLy_ I1-- IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 17 North High Street,
Borough of Shiremanstown, Shiremanstown, PA 17011, PA
(list street, number, and municipality)
Decedent, then 89 years of age, died 03/14/2004 at Holy Spirit Hospital,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
Camp Hill, PA
(Location)
$ 15,500.00
$
$
$ 78,000.00
situated as follows: 17 North High Street, Shiremanstown, PA 17011
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the appropriate form to the undersi~lned:
Signatw_e.
Typedorprintednameandresidence
Gerald J. Hale
201 N. 34th Street, Camp Hill, PA 17011
Prepared by the Pennsylvania Sar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the e a~e~according to law.-.
Sworn to or affirmed and subscribed
before me thi~ day of
/
~- Forth~,~egister _ . -4~ --
No.
Estate of Mary J. Doelker
Social Security No: 195-07-4697
AND NOW, ~-~ ~
Date of Death: 03/14/2004
Deceased
,~'~)/-~Z', in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters F'~ Testamentary r~ of Administration
(c.t.a.; d.b.n.c.t,a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Gerald J. Hale
in the above estate and that the instrument(s) dated 06/09/1998 02/25/2004
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $
Short Certificate(s) ..... $
Affidavits ( ) ....
Extra Pages ( ) ....
Codicil ........... $
JCP Fee .......... $
Inventory .......... $
/ -- ~'" Regi~er of_,Wills ' .<. /"~ --
Attorney: James D. Bo~ar, Esquire
I.D. No: 19475
Address: One West Main Street
Shiremanstown, PA 17011
Telephone: 717/737-8761
Other ........... $
TOTAL ......... $ ~['~"'~" ~4:~
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
Estate of
also known as
Register of Wills of Cumberland
OATH OF SUBSCRIBING
Mary J. Doelker
County, Pennsylvania
WITNESS
, Deceased
James D. Bo~ar
(each) a subscribing witness to the ~ codicil(s) j--~ will(s) presented herewith, (each) being duly qualified according to law
depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as
a witness at the request of Testator(rix) in his/her/their presence and r'~ in the presence of each other [-~ in the presence of the
other subscribing witness(es).
(Signature)
J~eeS D og r
0 Wes~ ~'grstreet
Shiremanstown, PA 17011
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this ! ~ day
Notary Public
My Commission Expires:
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission.)
This document was accepted for
Probate on April 2, 2004 at 9:59am.
See Petition and Oath of Personal
Rep._~,
NOTARIAL SEAL I
BONNIE L. WILLIAMS, NOTARY PUBLIC I
SHIREMANSTOWN BORO., CUMBERLAND CO.I
MY COMMISSION EXPIRES APRIL ]8, 2005J
NOTE: To be taken by officer authorized to administer oaths.
Please have present the original or copy of instrument(s)
at time of notarization.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-2 (1991)
Register of Wills of Ctm]berland County, Pennsylvania
OATH OF SUBSCRIBING WITNESS
Estate of Mary J. Doelker No. r~/-~f~)~;~- ~~
also known as
, Deceased
Ray D. McClenahen Evelyn M. McClenahen
(each) a subscribing witness to the ~ codicil(s) r'--] will(s) presented herewith, (each) being duly qualified according to law
depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as
a witness at the request of Testator(rix) in his/her/their presence and r~ in the presence of each other [~ in the presence of the
other subscribing witness(es).
(Signature) /J Say D. McClenahen
~054 Irene Drive
Harrisburg, PA 17112
(Address)
(Sign~,tu're) ~2 'Ev~'lyn M. 'M~Cl%nahen
5054 Irene Drive
Harrisburg, PA 17112
(Address)
Sworn to or affirmed and subscribed
before me this 3 I,.~- day
Notary Public
My Commission Expires:
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission.)
This document was accepted for
Probate on April 2, 2004 at 9:59am.
See Petition and Oath of Personal
Rep. V-L7---.
NOTARIAL SEAL |
· BONNIE L. WILLIAMS, NOTARY PUBLIC !
>HIREMANSTOWN BORO., CUMBERLAND CO.I
.MY COMMISSION EXPIRES APRIL 18, 2005_l
NOTE: To be taken by officer authorized to administer oaths.
Please have present the original or copy of instrument(s)
at time of notarization.
Prepared by the Pennsylvania Bar Association
Copyright (c~ 1996 form software only CPSystems, Inc. Form #RW-2 (1991)
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRmING V~TfNESS
codicil
subscribing witness to the will pre~ented herewith, (each) being d~y
say(s) that
to
pre~ent and saw
the testat , sign same and that
request of testat in pre~ence and (in the presence of
ether subscribing wimess(es)).
signed ~ a wime~s at the
ether) (in the pr~ence of the
Sworn to or affh'med and subscribed
me this day of
20
(Name)
(Address)
)(,4 ddra.~~
REGISTER OF WILLS OF Cant~Xana COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Gerald J. Hale
(lg~h) a subscriber hereto, ~ being duly qumlified ac:ording to law, degese(s) and say(s)
he is farJH= wik5 the si~-~ ..... of M~ J. ~elker
ccdidl
[hat he be~eves the siznature on ~e will is in ~e h~dwfifing
M&ry d. Doelker
to the bes: of his knowledge and be!/ef. .~ --
me this ~/~ da7 of 201 N. 34th~st. (~me)
~~ 20 04 C~ Hill, PA 17011
hVame)
/.4 ddroms )
This document was accepted for
Probate on April 2, 2004 at 9:59am.
See Petition and Oath of Personal
Rep.~L~
an certificate of death du~Y
~05 REV 9/$6
This is to certify that the information here given is correctly copied from original
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
p 10039933
Local Registrar
1YPE~PRINT
PERMANENT
Bt ACK INK
89
¥r$
F DEATH
Cumberland
COMMONWEALTH OF PENNSYLVANIA ' DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH .....
Iker
ACTUAL
.ES,t~.CE Cumberland
ShiremanstOwn. Pennsylvania 17011
Chester G. Hale
Gerald J. Hale
[-] 18, 2004
~on~L,o~ [] :D-O12662"L
,/es, spec~ Cu~n
Rican etc.
iremanstown
Pearl C. Major
~chanicsburg Cemetery
White
17011
Mechanicsburg, Pa. 17055
year)
NoEl
This document was accepted for
Probate on April 2, 2004 at 9:59am.
See Petition and Oath of Personal
Rep. VT.
LAST WILL AND TESTAMF''T' '
This document was accepted for
OF Probate on April 2, 2004 at 9:59am.
See Petition and Oath of Personal
MARY J. DOELKER Rep.__~-~-.
I, MARY J. DOELKER, of shiremanstown, cumberland
county, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I direct the payment of all my just debts and
funeral expenses, including my grave marker and all expenses of
my last illness, shall be paid from my residuary estate as soon
as practical after my decease as a part of the expenses of the
administration of my estate.
SECOND: I devise and bequeath real estate owned by me,
same being known and numbered as 17 North High Street, shiremans-
town, Pennsylvania, and all my household goods and other tangible
personal property maintained therein, excepting, however, cash,
securities, stocks, bonds, bank accounts (including certificates
of deposit) and other like or similar items, to my niece, BRENDA
K. STIRLING, of 24 Eastwood Drive, Carlisle, Pennsylvania.
Should my niece, BRENDA K. STIRLING, predecease me, I direct that
the real estate specifically devised and bequeathed herein, be
and become a part of my residuary estate to be distributed as set
forth hereinbelow.
THIRD: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, as follows:
(A) One-fourth (1/4) thereof to my deceased husband's
sister, G. MARIE HANDLEY, of 2729 Banks Street, Penbrook, Penn-
sylvania. (B) One-fourth (1/4) thereof to my sister, IRENE M.
HALE, of 1021 South Progress Avenue, Apt. R-5, Harrisburg,
Pennsylvania.
(C) One-fourth (1/4) thereof to my brother, HAROLD R.
HALE, of Apartment 302, 800 Wood Street, Steelton, Pennsylvania.
(D) One-fourth (1/4) thereof to my brother, GERALD J-
HALE, of 201 North 34th Street, Camp Hill, Pennsylvania.
FOURTH: Should any of the individuals named in Clause
THIRD hereinabove predecease me, I direct that their share under
this, my Last Will and Testament, be divided evenly among or
between the surviving residuary beneficiaries as set forth
herein. FIFTH: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or condi-
tions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws. (G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
SIXTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SEVENTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
EIGHTH: I nominate and appoint GERALD J. HALE, Execu-
tor of this, my Last Will and Testament. In the event of the
death, resignation or inability to serve for any reason whatso-
ever of the said GERALD J. HALE, I nominate and appoint BRENDA K.
STIRLING, Executrix of this, my Last Will and Testament. I
direct that my Executor or Executrix, and their successors, shall
3
not be required to post security or a bond for the performance of
their duties in any jurisdiction-
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this ~ day of
1998.
M~RYO.~
signed, sealed, published and declared by the above-
amed Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the pres-
ence of each other, have hereunto subscribed our names as
attesting witnesses-
Address
[ress
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Mary J. Doelker
Date of Death: March 14, 2004
Will No. 21-04-0328
To the Register:
Admin. No.
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
April 8, 2004:
Name
Address
Gerald J. Hale
Irene M. Hale
Harold R. Hale
Brenda K. Stirling
201 N. 34th Street
Camp Hill, PA 17011
1021 South Progress Ave.
Apt. R-5
Harrisburg, PA 17111
800 Wood Street, Apt. 302
Steelton, PA 17113
24 Eastwood Drive
Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except:
None
Date:
Capacity:
~es D. ~ a , Esquire
One West ~a~°~t~eet
Shiremanstown, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
JAMES D. BOGAR
JENNIFER B. HIPP*
*Also admitted to New Jersey Bar
JAMES D. BOGAR
ATTORNEY AT LAW
ONE WEST MAIN STREET
SHIREMANSTOWN, PENNSYLVANIA 17011
e-mall mall@bogarlaw.com
June 9, 2004
TELEPHONE
(717) 737-876!
FACSIMILE
(717) 737-2086
Direct e-mall Jbogar/}bogarlaw. com
VIA HAND DELIVERY
Glenda Farmer Strasbaugh
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE:
The Estate of Mary J. Doelker
No. 21-04-0328
Date of Death: March 14, 2004
Dear Ms. Strasbaugh:
I represent the Estate of Mary J. Doelker. Enclosed is a
check made payable to the Register of Wills in the amount of
$13,846.82, same constituting a prepayment at discount on account
of Pennsylvania Inheritance Taxes in the above-captioned estate.
The prepayment is determined as follows: $83,257.00 multiplied
by 15% or $12,488.55, plus $17,392.09 multiplied by 12% or
$2,087.05, totaling $14,575.60, less discount in the amount of 5%
or $728.78, resulting in payment of $13,846.82. Please provide
me with the appropriate receipt in this matter.
Your time and consideration in this matter are greatly
appreciated.
EYS~tr~ly yours, ~ ~
· B~A_R
JDB/blw
Enclosure
cc: Gerald J. Hale, Executor
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 004024
BOGAR JAMES D
1 W MAIN STREET
SHIREMANSTOWN, PA
17011
........ fold
ESTATE INFORMATION: SSN: 195-07-4697
FILE NUMBER: 2104-0328
DECEDENT NAME: DOELKER MARY J
DATE OF PAYMENT: 06/09/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/14/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $13,846.82
REMARKS:
TOTAL AMOUNT PAID:
$13,846.82
SEAL
CHECK# 1 O02
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INOI~~(!J;l:i-#~~i~HCt CF
INHERITANCE TAlC DIlJI~'" ,
PO BOX 280601 ,<,....
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ZQ05 JMJ 24- ,C,;; f}: 18
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-25-2005
DOElKER
03-14-2004
21 04-0328
CUMBERLAND
101
CLEF:;<
OP,pH":N~
JAMESCJl!!:80GI\R "ESQ
1 W MAIN ST
SHIREMANSTOWN PA 17011
*'
REV-15~7 EX AFP (l!-O~)
MARY
J
A.aunt Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HDUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
RW :r~i,".Ex..K"p..rll1":6!'.Nlii"i'cE.oF.liMER.i'i'ANCE.i"Al!.APPRAYsEii'€N'~..Kr.i.oliliicE.i1R.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOELKER MARY J FILE NO. 21 04-0328 ACN 101 DATE 01-25-2005
TAX RETURN WAS: (X I ACCEPTED AS FILED
I CHANGED
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line l~ at Spousal rat. (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of line 14 at Sibling rate (17)
18. Allount of Line 14 t.xable at ColletereI/Class 8 rate (18)
19. Principal Tax Due
.00 X 00 = .00
.00 X 045 = .00
17 ,674.93 X 12 = 2,120.99
B3,257.00 X 15 = 12,488.55
1191= 14,609.54
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule AJ
2. stocks and Bonds (Schedule BJ
3. Closely Held stock/Partnership Interest (Schedule CJ
4. Hortgages/Notes Receivable (Schedule DJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
III
(21
(31
I~J
(51
(61
171
82.677.00
4.993.80
.00
.00
16.925.01
3.491.78
.00
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule l)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
{91
llOI
7,155.66
.00
1111
ll21
ll31
ll41
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with yo~r
tax payment.
108,087.59
7.1<;<; 66
100,931. 93
.00
100,931.93
TAX C D1T9:
P 'NUMBER "-' AMOUNT PAID
DATE INTEREST/PEN PAID (-I
06-09-2004 CD004024 728.78 13,846.82
11-17-2004 CD004640 .00 33.94
TOTAL TAX CREDIT 14,609.54
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A '~REOIT" ICRI, YDU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I ,J
S"'-
<:j..
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Mary J. Doelker
Date of Death: March 14, 2004
Will No.
21-04-0328
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes XX 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.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No XX
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 XX No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to ~his report.
Da te: 3/4/05
James D. B r, Esquire
Name (Please, type or print)
One West Maln St.
Shiremanstown, PA 17011
Address
(717) 737-8761
Te 1. No.
~" '.
-.. -.,
Capacity: Personal Representative
(MAH:rmf/AM3)
x Counsel for personal
representative ~