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Home My WebLink About02-0082PETITION FOR PROBATE and GRANT OF LETTERS Estate of BETTY J. ROHRBACH also known as .., Deceased. Social Security No. 196-14-2314 No. 21-02-82 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioners, who are 18 years of age or older and the Executors named in the last will of the above decedent, dated August 16, 2000 and codicil(s) dated N/A Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 344 Male Lane Carhsle PA 17013 Decedent, then 76 years of age, died December 21, 2001 at Holy Spirit Hospital, Camp Hill~ Cumberland County, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property With estimated values as follows: $ (If domiciled in Pa.) All personal property $85,000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioners respectfully request the probate of the last will presented herewith and t~,rant of. letters.~, sta~~;on. 7037 Terrann Drive _~isburg, PA 1. 7112 629 "B" Street Enola, PA 17025 5700Wertzville Road Enola, PA 17025 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND ) The petitioners above-named swear or affirm that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioners and that as personal representatives of the above decedent petitioners will well and truly administer th~, e~.,~c~°~_dlnlg ~.~t~ d d subscribed - Sworn to or affirme au bef~e me this _~day of /NA2~E . ,2002 NO. 21-02-82 Estate of Betty J. Rohrbach, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 24, ,2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated August 16, 2000 described therein be admitted to probate and filed of record as the last will of Betty J. Rohrbach; and Letters Testamentary are hereby granted to Georgia Lee Kohr, Linda Lou Still, and Debra Sue Boyer. l~egil~er of Wills " ' ' - FEES Probate, Letters, Etc ............$ 200.00 Short Certificate(s) .............$ 39.00 ~..F~T~..EC~...2 $ 6. O0 JCP $ 5.00 TOTAL $ 250.00 Filed ...... .J..A..N..U...A3...Y....2..4.,....2.0.0..2 ....................... HANFT & KNIGHT, P.C. Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, PA 17103-9142 (717) 249-5373 ATTORNEY PICKED UP LETTERS F: \User Folder\Finn Docs\EstatesX2593 - 1 pet ition test, wpd 1-28-02 his is to c~rtify 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 7886595 No. 21-02-82 Local Registrar DEC 2 ~' 0 2001 Date :43 Re,. z, a7 COMMONWEALTH OF PENNS'I~LVANIA ' DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Betty' 5an~ Rohrbach Female ,. 196 -- ,1 314 ' ' ' I ............ ' ........ ~N~ ~H ~ ~.~p~ [F~ ( .~ ) ' 0 0 ~ ~N~. Camp Hill B r ' I ~~ ' ~ite C~berland ~agt Penn,boro T~ OLq ~e~e~T-HOS~T~ ,. ' ' ' ........ i.Wr ll2. I~ I 1,4. .~u~w~ ilS. ~. C~/Tovm. 344 Maple Lane Carlisle, Pa. 17013 ~Tu~ ~7..s~. Penna. I~"~' ,~.~Cumberland William Crone ~ORMANT'S NAME Georgia L. Kohr I,,- Mary Sargant I~. 7037 TerrannDrmve, harrisburg, a. ill '%~'t~O~T~ONI I~E~ ~, ~ - ~ ~C~T~,~. C ...... V Dec. 27,2001 I .......... ,,, Harrisburg Cemetery ,,, Harrisburg, Penna, 17105 IL~ENSENU~ER I~E~O~OFF~,~ t~ fl. zna ~creec' ~. ~ ~t/~-~ u~. Neumyer Funeral Home, Inc. Harrisburg, Pa. 17 when cendying NMnl 24-26 rnu~ be co~3lm~:l by E ~.1~, AI'~H ~ A [O/~RONOUHC E O OEAD (Monm. Day. Ye~_~) -"'"""'""~'-"' il ,dO ~ · .. I-. DE~Ehr~F::'t:K°'::;zl. ~_.~.~.. . L-~ ~ ., d,-~z~o /~ ~0~e ~4AS CA~E RE~* ?O MEDicAL EXAMiNER~O~NER? 21-02-82 WILL OF BETTY J. ROHRBACH I, BETTY J. ROHRBACH, of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and revoke any Will previously made by me. ITEM I. I bequeath my Fleetwood mobile home and my personal property located therein to my son, RONALD A. ROHRBACH, for his use during his life, or until said interest is terminated under the conditions provided for hereinafter. Upon the death of my son, RONALD A. ROHRBACH, or upon the termination of his life estate as provided for hereinafter, I direct that my executors hereinafter named sell said mobile home and distribute the proceeds as part of my residuary estate under ITEM II. of this my last Will. I direct that my son, RONALD A. ROHRBACH, make the lot payments where my mobile home is located, pay all utilities, maintain insurance on said mobile home, pay taxes on said mobile home, and provide routine maintenance to mobile home. My son may not allow anybody to live in the mobile home with him except for a wife or a female companion. My son may not move the mobile home from the lot where it is located at the date of my death. Should my son not comply with all of the requirements set forth hereinbefore, his life estate will be terminated and my executors are authorized to sell the mobile home and my personal property located therein and distribute the proceeds as part of my residuary estate under ITEM II. of this my last Will. My son shall not be required to give bond for the safekeeping of such property. Page 1 of 3 Pages ITEM II. I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to those of my seven (7) children who are living at the date of my death. Should any of my children not be living at the date of my death, I devise and bequeath his or her share of my estate in equal shares to those of my children who are living at the date of my death. ITEM III. I appoint my daughters, GEORGIA LEE KOHR, LINDA LOU STILL, and DEBRA SUE BOYER, executors of this my last Will. ITEM IV. I direct that my executors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this 16th day of August, 2000. Betty~J~Jach~ The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testatrix, was on the date thereof signed, published and declared by Betty J. Rohrbach, the testatrix therein named, as and for her last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF PERRY ) We, Betty J. Rohrbach, Bonnie K. Burd and Cynthia M. Lindsay, the testatrix and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the Will as witness and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Betty J. R?~. ~h, ~l'~statrix Bonnie K. Burd, Witness C~thia M. Lin'~.~y, Witness Subscribed, sworn to and acknowledged before me by Betty J. Rohrbach, the testatrix, and subscribed and sworn to before me by Bonnie K. Burd and Cynthia M. Lindsay, witnesses, this 16th day of August, 2000. (SEAL) SIGNED Page 3 of 3 Pages Notarial Seal [ Elizabeth R Quigley, Notary Publ c _Bloomfield Bom, Perry County [_~_¥ Gornrnla$1on Expires May 29, 2004 M~mber, ~nnsylvanta Association of Notaries Name of Decedent: Date of Death: Will No. 21-02-0082 To the Register: F:\User Folder~Firm Docs\EstatesX2593-1 certification notice.wlxt CERTII~ICATION OF NOTICE UNDER RULE 5.6(a) BETTY J. ROHRBACH December 21,2001 I certify that notice of beneficial interest 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 February 7, 2002: Name Ronald A. Rohrbach Georgia L. Kohr Cheryl K. Deibler Linda L. Still Janis R. Donmoyer Debra S. Boyer Address 344 Maple Lane, Carlisle, PA 17013 7037 Terann Drive, Harrisburg, PA 17112 Lot 166 Tyler Street, Grantville, PA 17028 5700 Wertzville Road, Enola, PA 17025 11 "B" Glenwood Drive, Camp Hill, PA 17011 629 "B" Street, Enola, PA 17025 Notice has not been given to all persons entitled thereto unde~Rule 5.6(a) except: N/A Date: 2-{'~to'- /~ ~.,~~/~ - / Michhel J. Hanft, Esqutfre t/ Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013-9142 Telephone (717) 249-5373 Capacity: Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2806O1 HARRISBURG. PA 17128-0601 ~NAME (LAST, FIRST, AND MIDDLE INITIAL) Rohrbach, Betty J. REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT z z OFFICIAL USE ONLY 1'7- I~ILE NUMBER ~ 21 02 00082 ~ YEAR NUMBER SOCIAL SECURITY NUMBER 196-14-2314 DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-OD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 12/21/2001 01/29/1924 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdo;'to 12-13-82) ] 4a. Future Interest Compromise (dale of death after 12-12-82) [] 7. Decedent Maintained a Living Trust (Attach copy of Trust) [] 10. Spousal Poverty Credit (date of death be[ween 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 12-31-91 and 1-1-95 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL qAME [] 5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS TAX INFORMATION SHOULD BE DIRECTED TO: 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013 None None OFFICIAL USE ONLY (11) (12) (13) Michael J. Hanft, Esquire FIRM NAME (If applicable) Hanft & Knight, P.e. FELEPHONE NUMBER 717/249-5373 None 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested (6) 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 Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 92,594.79 None None 10,870.57 4,170.65 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) 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) (8), 92,594.79 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 19. Tax Due 15,041.22 20. 77,553.57 (14) 77,553.57 x .00 (15) 77,553.57 x .045 (16) x .12 (17) x .15 (18) 3,489.91 (19) [] 3,489.91 ~BE ~dRE ~ATff~ Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) 'Decedent's Complete Address: ISTREETADDRESS 344 Maple Lane CiTY Carlisle STATE PA ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 17013 3,489.91 InterestJPenalty if applicable D. Interest E. Penalty 13.16 Total Credits (A + B + C) (2) 0.00 13.16 3,503.07 3,503.07 Total InteresfJPenalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, (4) Check box on Page 1 Line 20 to request a refund 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. (5A) 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 No a. retain the use or income of the property transferred; ......................................................................... 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 ether a ments benefits or car ? ................................................. PY , e 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate cons derat 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 property which contains a beneficiary desionat on'~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of penury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, con'ect and complete, Declaratic:. preparer other than the personal representative is based on all information of which preparer has any know~edge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Georg Lee Kohr ' . eor~):.._ r . ~_ ~'~,'~ 7037TerannDnve /. / / ~A~ ~ ~~ ~ Ha~isb~g, PA 17112 ~ ~ ~ Lin~ L. St~, DATE ~..~. ~ ~~ 5700 We~ville Road ~;~~~THE~--~[~NTATlyE ADDRESS Enola, mA 17025 /0--/~-~. 'v'icnael J' V~ ~~~ ~r~?~ °~[~nue' Suite 106 /0 {;T~ For dates of death on or a~er July 1, 1994 and before Janua~ 1, 1995 the tax rate im osed on t sum~wng spouse is 3% ~2 P.S. {9116 (a) (1.1) (i)] , P he net value of transfers to or for the use of ~e For dates of death on or aaer Janua~ 1, 1995, ~e tax rate imposed on the net value of transfers to or for the use of the sumiving spouse is 0% [72 P.S. {9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a sumiving spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax return are still appli~ble even if the sumiving spouse is the only beneficial. For dates of death on or a~er July 1, 2000: The tax rate imposed on the net value o[ kansfers frbm a deceased child ~enty-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 0% [72 P.S. ~9116 (a) (1.2)]. The tax rate imposed on ~e net value o[ ¢ansfers to or for the use of the decedent's lineal beneficia~es is 4.5%, except as noted in 72 P.S. {9116 ~.2) ~2 P.S. {9~ ~6 (a) (~)]. 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. ADDITIONAL Personal Representatives Rohrbach, Betty J. SS# 196-14-2314 12/21/2001 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. 3 Name Debra S. Boyer Address 629 "B" Street City, State, Zip Enola Date ~- /~4~ --~¢~- PA 17025 4 Signature Name Address: City, State, Zip Date 5 Signature Name Address: City, State, Zip Date 6 Signature Name Address: City, State, Zip Date Signature Name Address: City, State, Zip Date COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESE)ENT DECEDENT ESTATE OF Rohrbach, Betty J. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 02 - 00082 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 1 2 3 4 5 6 7 8 9 10 I1 12 13 DESCRIPTION Check from Pension Trust of Bethlehem Steel Corporation and Subsidiary Companies 2000 Fleetwood Mobile Home, VIN No. PAFLY22A847398SC13 1978 Bass Boat and 1978 Boat Trailer, (VIN No. 217484) Certificate of Deposit with Allftrst Bank, Account No. 80000002219602 PNC Bank Checking Account No. 5140110992 Miscellaneous Personal Property Automobile - 1995 Toyota Corolla, VIN No. 2T 1AE09B4SC 121844 Refund from OneBeacon Insurance for overpayment, Policy No. OPZ608624 V MetLife Investor ID No. 8062 4623 3237 MetLife for Policy No. 632670153 M John Hancock Life Insurance Company Policy No. M08839570 MetLife Policy No. 944901874 M Income Tax refund check from IRS, check No. 2304 76499519 ~ AT DATE OF DEATH 22.00 45,410.00 2,500.00 30,039.00 1,496.77 5,000.00 3,300.00 39.16 1,242.32 1,226.31 1,761.23 488.00 70.00 TOTAL (Also enter on Line 5, Recapitulation) 92,594.79 SCI-IEI~I P H FUNERAl. EXPENSES & ADMINLS'TRA'[1VE (X)Sm COMMONWEALTH OF PENNSYLVANIA k'NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rohrbach, Betty J. FILE NUMBER 21 - 02 - 00082 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Johne E. Neumyer Funeral Home, Inc., 1334 North 2nd Street, Harrisburg, PA 17102 2 Brachendorf Memorials, Inc., 213 ! Herr Street, Harrisburg, PA 17103 - Gravemarker ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid - Attorney's Fees Hanft & Knight, P.C. -- Michael J. Hanft, Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills - to open Estate Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Fee to The Sentinel to advertise Letters Testamentary Fee to Cumberland Law Journal to advertise Letters Testamentary Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 6,726.40 1,189.00 2,500.00 250.00 126.23 75.00 3.94 10,870.57 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rohrbach, Betty J. SchedubH FILE NUMBER 21 02-00082 Fee to Postmaster to send certified mail to Department of Public Welfare 3.94 Page 2 of Schedule H COMMONWEALTH OF PEN NSY1.VAN IA ~HERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rohrbach, Betty J. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 02 - 00082 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION OneBeacon Insurance, Policy No. OPZ6-08624 V - Auto Insurance 6 7 8 9 10 11 12 13 14 2 3 4 5 Mobilehome Insurance Bill, Policy No. 0 01 859023 - Mobile Home Insurance Automobile Loan through Allfirst Bank, Account No. 20000000069618 Pinnacle Health Medical Services, Account No. 202323 Fee to t~ansfer ownership of the 2000 Fleetwood Mobile Home Quantum Imaging, Account No. 069427493 Lawrence Cox and James Blacksmith One Beacon Moffitt Heart and Vascular Group Allfirst Bank Allstate Beacon Insurance Mid Penn Urology, Inc., Account No. 36158 ~' Apria Healthcare, Inc., Account No. ROHOAJF TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 56.00 29.00 3,583.93 49.60 22.50 30.56 8.39 56.00 5.10 171.31 76.50 59.16 1.37 21.23 4,170.65 I~EV-1513 EX~. (g-O0) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rohrbach, Betty J. FILE NUMBER 21-02 00082 SCHEDULE J BENEFICIARIES RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT I~', Nh! tlmt Trt,atut, t OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Ronald A. Rohrbach 344 Maple Lane son 1/6 residue of estate Carlisle, Pennsylvania 17013 2 Georgia L. Kohr daughter I/6 residue of estate 7037 Terann Drive Harrisburg, Pennsylvania 17112 3 Cheryl K. Deibler daughter 1/6 residue of estate Lot 166 Tyler Street Granville, Pennsylvania 17028 4 Linda L. Still 5700 Wertzville Road daughter 1/6 residue of estate Enola, Pennsylvania 17025 See Continuation Schedule(s) attached 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVEr~ SHEET SCHEDULE J BENEFICIARIES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rohrbach, Betty J. 21 - 02 - 00082 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE [include outdght spousal distributions, and transfers under I, rAY, ABLE DISTRIBUTIONS Sec. 9116(a)(1.2)] 5 Janis R. Donmoyer daughter 1/6 residue o£estate 1 ! "B" Glenwood Drive Camp Hill, Pennsylvania 17011 6 Debra S. Boyer daughter 1/6 residue of estate 629 "B" Street Enola, Pennsylvania 17025 Page 2, of Schedule J WILL OF BETTY J. ROHRBACH I, BETTY J. ROHRBACH, of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and revoke any Will previously made by me. ITEM I. I bequeath my Fleetwood mobile home and my personal property located therein to my son, RONALD A. ROHRBACH, for his use during his life, or until said interest is terminated under the conditions provided for hereinafter. Upon the death of my son, RONALD A. ROHRBACH, or upon the termination of his life estate as provided for hereinafter, I direct that my executors hereinafter named sell said mobile home and distribute the proceeds as part of my residuary estate under ITEM II. of this my last Will. I direct that my son, RONALD A. ROHRBACH, make the lot payments where my mobile home is located, pay all utilities, maintain insurance on said mobile home, pay taxes on said mobile home, and provide routine maintenance to mo§lie home. My son may not allow anybody to live in the mobile home with him except for a wife or a female companion. My son may not move the mobile home from the lot where it is located at the date of my death. Should my son not comply with all of the requirements set forth hereinbefore, his life estate will be terminated and my executors are authorized to sell the mobile home and my personal property located therein and distribute the proceeds as part of my residuary estate under ITEM II. of this my last Will. My son shall not be required to give bond for the safekeeping of such property. Page 1 of 3 Pages ITEM II. I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to those of my seven (7) children who are living at the date of my death. Should any of my children not be living at the date of my death, I devise and bequeath his or her share of my estate in equal shares to those of my children who are living at the date of my death. ITEM III. I appoint my daughters, GEORGIA LEE KOHR, LINDA LOU STILL, and DEBRA SUE BOYER, executors of this my last Will. ITEM IV. I direct that my executors shall not be required to give bond for the faithful performance of, their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this 16th day of August, 2000. The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testatrix, was on the date~thereof signed, published and declared by Betty J. Rohrbach, the testatrix therein named, as and for her last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF PERRY ) We, Betty J. Rohrbach, Bonnie K. Burd and Cynthia M. Lindsay, the testatrix and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the Will as witness and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Betty j. R~, ~h, ?~estatrix ~ Bonnie K. Burd, Witness C~thia M. Lindsa/y,'Witness ~ Subscribed, sworn to and acknowledged before me by Betty J. Rohrbach, the testatrix, and subscribed and sworn to before me by Bonnie K. Burd and Cynthia M. Lindsay, witnesses, this 16~h day of August, 2000. Page 3 of 3 Pages (SEAL) SIGNED Notarial Seal Elizabeth R Qulgley, Notary Public BlOomfield Bom, Perry County ~Commls$1on Expires May 29, 2004 MereSt, Pennsylvania Association of Notades COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001722 HANFT MICHAEL J 19 BROOKWOOD AVENUE SUITE 1 O6 CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 196-14-2314 FILE NUMBER: 2102-0082 DECEDENT NAME: ROHRBACH BETTY J DATE OF PAYMENT: 1 O/14/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/21/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,503.07 TOTAL AMOUNT PAID: ~3,503.07 REMARKS' MICHAELJ HANFTESQUIRE SEAL CHECK# 1284 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: BETTY J. ROHRBACH Date of Death: December 21,2001 Admin. No. 21-02-00082 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: State whether administration of the estate is complete: Yes X 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: ao is: c. Yes X No Did the personal representative file a final account with the Court? Yes __ No X The separate Orphans' Court No. (if any) for the personal representative's account Did the personal representative state an account informally to the parties in interest? d. Copies of receipts, releases, j oinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: January7,2003 Respectfully submitted, HANFT & KNIGHT, P.C. Mi~squire~'~~-'- Attorney ID No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 (717) 249-5373 Counsel for personal representative F:\User FoldexkFirm Docs~EstatesX2593-1 .statusxpt.wpd