Loading...
HomeMy WebLinkAbout04-0363PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Social Security No. 26,~- q2 ~ 8i~)eceased' Register of Wills for the County of Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executon~/t0.f~o cica r tea ) named in the last will of the above decedent, dated and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C'orrlher']a~d County, Pennsylvania, with his last family or principal residence at 6g' l~o,~F;a I~t-;ve ; 5hi?,t~onx~t~ ~ PA (list street, number and muncipality) D~e~cend, e_nt.,, then '73 years of age, died at~ac~o .ql~'~ff~ojq C~rOuQH.-u~ Ho~pi~l ; 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: ~-~: L~ixe Decendent 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 situated as follows: WHEREFORE, petitioner(s) respectfully r, eque, st(s) the probate of the last will ~d codicil(s) presented herewith and the grant of letters ~ ,5~/,ote .~r~ ! y~ theron. (testamentary; adn~nistration c.t.a.; administra$/.on d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~x.~,-c,~ .~.,~ The petitioner(s) above-named swear(s) or affirm(s) that thc statements in thc foregoing petition arc truc and correct to thc best of thc knowledge and belief of petitioner(s) and that as personal represen- tative(s) of thc above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed bef~e,.rne [his J ~ day of REGISTER OF WIL~$'-OI~---~ COUNTY OATH OF SUBSCRIBI~ codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat. ~ , sign~ signed as a witness at the reqUest of testat, in h presence and ~ ~presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of (Name) 19 ~ (Address) Register (Name) (Address) REGISTER OF WILLS OF ~"~lec//q OATH OF N~.ON-SUBSCRIBING WlTN~S (~h) a subscriber hereto, (each) being duly qualified according to law, d~Ose_(s) ~ say(si'that f5 familiar with the signature of testat ~t~ of (one of the subscribing witnesses to) the presented herewith and that /4%::' to the best of ~ t.~ codicil believes the signature on the will is in the handwriting of knowledge and belief. (Name) (Name) Sworn to or affirmed and subscribed before me this I ~ day of (Address) hereby certify that the foregoing is a true and correct copy of an original record that is 6n file in Hackettstown~ NJ Dated at Washington Borough: 3-15-04 Signed: Linda L, Hendershot, RMC/CMC, Registrar Barbara E. Van Why, Deputy Registrar c 'C STATE FILE NUMBER kEG-lB NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES AUG 03 CERTIFICATE OF DEATH :s 1~ la. Legal Name of Decedent (First. Middle, Last) ~ Joseph F. Doerwang ~ lb. Also Known As (AKA}, If Any (First, Middle, Last) 2. Sex 3. Social Security Number ~' ~ ~ M .262-42-8159 '6 ~t~ 4a. Age-LastBidhday 4b. UnderlYear 4c. UnderlDay 5. Dateo~Birth(M~Dy/Yr) 6. Birthplace (City & State/Foreign Country) ~ '~ 73 Years Months Days Hours Mi..te~ 09--10--1930 The Bronx, NY ~ 7a. Residence-State 7b. County 7c. Mu, ,;...;:.,.;ity/City PA Cumberland Shippensburq '~ 7d. Street and Number 7e. Apt. No. 7f. Zip Code 7g. Inside City Limits? ~. 65 Rustic Drive N/A 17257 ~Yes DEe  ~. aa. Ever in US Armed Forces? ~i~Yes E]No I-IUnk 9. Marital Status at Time of Death ' 10. Surviving Spouse Name r~ ~ b, lfyes, NameofWar: Korean War []NeverMarrled ~Divorced (Ifwife, name pdor to first mardage) ~ []Married I-Iw d°Wed N/A ' '6 ~ O~ c. War Service Dates (From/To): 1950-1954 E]Marded but Separated DUnk.own ~ ~j ~. Father's Name (First, Middle, Last) 12. Mother's Name Prior 1o First Marriage (First, Middle. Last) ~ Edward Doerwang Catherine Adler ~ 13a. Name of Informant 13b. Relationship to Decedent ~ Michael Doerwang Son  13c. Mailing Address (Street and Number, City. State, Zip Code) z 15 East Church Street, Washington, NJ 07882 --~14. Method of Disposigo~ 15, Place of Disposition (Name of cemetery, cremato/% other place) " ~"~Buda~ I-IDonation St Ann Catholic Cemetery >- OCremafion [] Entombment rn [] Removal from State 16. Location-City, Town and State 0 []Other(Specify): Hampton, NJ 08827 ~ '~ ~ 17. Name and Complete Address of Funeral Facility  ~. )eVoe Funeral Service,Inc.136W.Washington Ave,Washington,NJ 0788 ~ 18. Signature of F.Ji,~,5~ ~D t~tor// ~.~ ,~ ~' ¢, ~_~,j~/ 19. NJ Li ..... I~ber0 4 5 '5 20. Dec, Cabal I=duca[io.- 21. Decedent of H spanic Odgin? 22. Decedent Race - Check one or more boxes to indicate what race ~>. 14JHighest degree or level of school Check one or more boxes that the decedent considered himself/herself to be. ~_ j~ f~ completed at time of death, best describe if decedent i$ [~W hire ~>' .~ ~O []Grade 8 or less Spanish/Hispanic/Latino.[]Black or Afdcan American OGrade 9-12; no diploma Check "No" box if decedent is not Spanish/Hispanic/l_atino. []American Indian or Alaska Native ~ []High school graduate or GED~No. Not Spanish/Hispanic/ (Enrofledorpdncipaltribe) o [~Some college credit, no degree Latino []Asian indian []Filipino i--IKorean ~ ~ r-lAssociate degree (AA, AS) EYes, Mexican, Mexican •Chinese E]Japanese []Vietnamese ~ ,C~ []Bachelor's degree (BA, AB, BS) American, Chicano '~ []Olher Asian (Specify) ~ .~ I []Master's degree (MA, MS, MEd, []Yes, Puedo Rican []Native Hawaiian []Guamanian or Chamorro MSW) []Yes, Cuban []Samoan ~ ~ E]Ooctorale (PhD, EdD) or []Yes. Other Spanish/Hispanic/ ~ Professional degree (MD, DDS, JD) Lafino (Specify): []O~her Pacific Islander (Specify) ~ E]Other (Specify) ~E 23. Occupation of Decedonl (Type of work done most of life, even if retired) 24. Kind of Business/Industry z Lab Technician Chemical 25. Name and Address of Last Employer Englehard Corporation, Edison, NJ 08820 FOR STATE ITEMS 26-3g MUST BE COMPLETED BY PERSON 26. Date P. ronou.nced Dead (Mc/Day/Yr) 27. Time Pronounced Dead USE ONLY WHO PRONOUNCES OR CERTIFIES DEATH ~J 1 ~ /(~ Y ~ J~'~ ~M [~PM Place of 28. SignatureofPer~Pron~jngD~eath(IfotherthanCertifier) 29. L, ..... Number 30. D{t'Signed(Mo/Day/Yr) Accident Cross Class If D~.ath Occurred in a Hospital: ', if Death Occun-ed Somewhere Other Than a HospRaL 1~ patient []Emergency Room or Outpatienl I I-IDecedenrs Home []Other (Specify): ,. USE OF DEATH Immediate Cause ' (Enter chain °f eventS (diseases injuries, or complications) that directly caused death ~'nterval Between 36a. PART I -- final di .......... diti .... I--.... Ring in death. Sub- ~'~ ~'/~$ ~ ' n,' sequent¥listconditi .... ' (.~"~-'~kv"~ ~c~7'~- ~,~,lO. LIJ if any, leading to lhe --1 Enter the UNDERLYING Received ,~ CAUSE (di ....... inury c. ~_.1~1~ i ~ forLimb O hat nitiated the events Dueto(orasa~onse(~uenceoD: Only ~ .... Iting in death) LAST. d. ~_~J.~ (.~O'%-~,v'~> l ~... ~--~ ~______~c. ~.~{~.~.."~ ] ~ 36b. PART II - Enter other significant conditions contributing to death but not resulting in 137. Was an Autopsy 38. Were Aulopsy Findings >' underlying cause given in PART I. rn Performed? [ Available to Complete Cause ~Yes fqNo of Death? ~ { DYes ~l~  39. Date of I~ury (Mo/Day/Yr) 40, Time of Injury I-lAM 41. Place of Injury (e.g., home, construction site, restaurant) 42. njury at Work? U.I --I [~PM []Yes []No D. 43a. Location of injury (Number and Street, Zip Code) 43b. Municipality ~ 43c. County 43d. State o ¢.~44. Describe How injury Occurred [4J 45. If Transporfatio, Injury: Contains O I-]Passenger J-~Other (specify): Amendment I--46. Manner of Death 47. Did Decedent 48. Did Tobacco Use 49. If Female: ~tatural []Pending Have Diabetes?Contribute to Death? f-INot pregnant within past year []Suicide [-ICould not be ~NNos I-lYes j~robably []Pregnant at time of death []Unknown if p~e~i,~.,i within the past year 50. Certifier (Check onfy one): ~1. Name, Address and Zip Code of Certifier . / ~ ~ H5119 55. S. ignalu~e~f Loc~'~egi~rar 56 Dis dc No 57 Date R ?ttecai-FiiWNumber INSTRUCTIONS Distribution: JOSEPH F. DOERWANG ~ JOSEPH F. DOERWANG, residing at 26 Beethoven Avenue, in the Borough of Washington, County of Warren and State of New Jersey, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all other Wills or Codicils heretofore made by me: FIRST: I order and direct that all of my just debts and funeral expenses be paid as soon after my death as can conveniently be done. SECOND: I give, devise and bequeath a~l the rest, residue and remainder of my estate, both real and personal, to my children, PAUL JUDE DOERWANG and MICHAEL THADDEUS DOERWANG, to be theirs absolutely and forever, share and share alike. If either of my aforesaid ch~dren should predecease me leaving issue, then I direct that the share of my deceased child go to said issue. If either of my aforesaid children should predecease me leaving no issue, then I d~ect that the share of my deceased child go to my surviving son. THIRD: If my said Grandchildren are minors when this clause of my will becomes effective, and if my said grandchildren should not be 21 years of age at the time of my decease, I appoint my surviving Son as Trustee of the property of my said Grandchildren, he to serve without bond or other security in any jurisdiction, and to have f~ power and authority to expend both the corpus and the income of the property which he shall hold as such guardian and trustee for the maintenance, welfare and education o~ my said grandchildren. FOURTH: I hereby constitute and appoint my Sons, PAUL JUDE DOERWANG and MICHAEL THADDEUS DOERWANG Co-Fiduciaries of this my Will. If either of my Sons should die before I do, or if either of my Sons and I should die in a common catastrophe or as a result of same, and if either of my Sons having s~rvived me shall for any reason fa~ to qualify or having qualified shall fail to act as Fiduciary, I then d~ect that my s~viving Son act as sole Fiduciary. No bond or other security sha~l be required of either of said persons in any jurisdiction for the faithful performance of the~ duties. I empower my said Fiduciaries to se~ any real estate or any part thereof or interest therein of which I may die seized, either at public or private sale, at such t~me and upon such terms and for such purpose as to said Fiduciaries shall seem proper and to execute and deliver proper conveyances for the same in law. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~day of NOVEMBER, in the Year of O~ Lord, One Thousand Nine Hundred and Eighty -eight. ~ ~OSEPH F. Do~R~~ SIGNED, SEALED, PUBLISHED & DECLARED by the Testator, JOSEPH F. DOERWANG, to be his Last Will and Testament, in om presence and in the presence of each of us, we being present at the same t~me and we at his request, and in ~ presence and in the presence of each o~her, have h~reunto signed our names Residing i~~ CERTIFICATION OF NOTICE UNDER RULES 5.6(a) Name of Decedent: Date of Death: Will No: Joseph F. Doerwant March 14, 2004 21-04-0363 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Col~rt Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April t/~ , 2004: Paul J. Doerwang 76 South Lincoln Avenue Washington, NJ 07882 Michael T. Doerwang 15 East Church Street Washington, NJ 07882 '"ID Notice has now been given to all person~ept: No exceptions. Date: April ~_, 2004 J //Yaylor'P. Andrews, Esquire ~ 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 w <( ~!::en U~~ wQ..u J:og U~ltl Q.. <( 21 -04 COUNTY CODE YEAR -0363 NUMBER 1_::: r ) t- Z W Q W (,) W Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Doerwan , Jose h F. DATE OF DEATH (MM-DD-VY) DATE OF BIRTH (MM-DD-YY) 03-14-2004 09-10-1930 (IF APPLICABLE) SURVIVING SPOUSE'S NAME N/A SOCIAL SECURITY NUMBER 262-42-8159 THIS MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ,."., '-'..,.... $0.00 $0.00 $0.00 $0.00 $0.00 1. Original Return 0 2. Supplemental Return 4. Limited Estate 0 4a. Future interest Compromise 6. Decedent Died Testate 0 7. Decedent had Living Trust o 3. Remainder Return o 5. Fed. Est. Tax Return Req'd 8. Total number of SOB's I- Z W C Z o Q.. en w ~ ~ o U COMPLETE MAILING ADDRESS: NAME: Taylor P. Andrews, Esquire FIRM NAME: Andrews & Johnson TELEPHONE NUMBER 717243-0123 Taylor P. Andrews, Esq. Andrews & Johnson 78 W. Pomfret St. Carlisle, P A 17013 z o ~ S ::>> t- o: < (,) W 0:: (1 ) (2) (3) (4) (5) (6) $0.00 $2,263.80 OFF~CIAL USE O. Y 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3.Closely Held Corporation, Partnership or Sole-Prop. 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administration Costs (Sch H) 10. Debts of Decedent, Mortgage liabilities, & Liens 11. Total Deductions (total lines 9&10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amnt of Line 14 taxable at the spousal 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 19. Tax Due 20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT $0.00 $35,771.32 $4,855.54 (7) (9) (10) (8) $42,890.66 $12,678.67 $33,314.29 (11) $45,992.96 (12) ($3,102.31) z o j:: ~ ::I Q.. :E o o >< ~ x.O_ x.045 x.12 x.15 (15) (16) (17) (18) (19) $0 $0 $0 Decedent's Complete Address: STREET ADDRESS 65 Rustic Dr. CITY STATE ZIP Shippensburg PA 17257 . Tax Payments and Credits: 1. Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discounts Total Credits (A+B+C) 3. Interest/Penalty if applicable D. Interest E. Penalty 4. TotallnterestlPentalty (D+E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1 ) (2) (3) (4) (5) (5A) (5B) $0.00 $0.00 $0.00 $0.00 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 transerred or its income: c. retain a reversionary interest: or d. retain the promise for life of either payments 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 property which contains a beneficiary disignation? D D D D D D D ~ ~ ~ ~ ~ ~ ~ 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 pe~ury, I declare that I have examined this r m, i uding accompanying schedules and statements, and to the best of my knowledge and belief, it is tru&, correct and complete. ., Washington, NJ 07882 DATE ;;J. - ~f-o~ DATE 2 - '2lr -cf) > 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% [72P.S. Sec. 9116(a)(1.1)(I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value oftransfersto or for the use of the surviving spouse is 0% [72 P.S. Sec. 9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deseased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. Sec. 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1). 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. Sec.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. Mellon Investor Services P.O. Box 3333 South Hackensack, NJ 07606 January 31,2005 ~ Mellon JOSEPH F DOERW ANG ATTN TAYLOR P ANDREWS 78 W POMFRET ST CARLISLE PA 17013 1~=';;~__i~T_L~, ~~. - H i Account Key 'jDOERW ANG- : :JOSEFOOOO I 't IInvestor m..#_."~.Q?}~?3.7~Q~0 Control 1[200501310002931 I Number i I .._ ." " __ ..... . ......._ Dear Sir or Madam: Thank you for contacting Mellon Investor Services regarding the above referenced MetLife, Inc. common stock account. Please be advised that as 03/14/04 was not a business day we are unable to provide you with the closing price as of that date. We are enclosing the closing price of the stock as of the nearest working days: DATE 2004-03-12 2004-03-15 2004-03-16 CLOSING PRICE $ 34.3000 $ 34.0100 $ 34.1600 As per your request we have also sent in the legal transfer instructions and the instruction for sale of stock which you will receive under a seperate cover. If you have any additional questions or concerns, please call our Customer Service Center at 1-800-649- 3593. You may also access your MetLife, Inc. common stock account on the Internet at https://vault.melloninvestor.com/isd. Sincerely, Mellon Investor Services . SCHEDULE B STOCKS AND BONDS ESTATE OF FILE NUMBER Doerwang, Joseph F. 21-04-0363 ITEM NUMBER All property jointly-owned with Right of Survivorship must be disclosed on Schedule F DESCRIPTION VALUE AT DATE OF DEATH 66 shares Metlife @ $34.3 per share $2,263.80 TOTAL (also on line 2, Recapitulation) $2,263.80 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Joseph F. Doerwang Include the proceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with Right of Survivorship must be disclosed on Schedule F DESCRIPTION VALUE AT DATE OF DEATH 21-04-0363 ITEM NUMBER Manufactured double-wide home at 65 Rustic Dr., Southampton Township, Shippensburg Post Office, P A 17259 as per agreement of sale in arms length transaction to unrelated party. $32,900.00 2 1995 GMC pick-up truck - high mileage [175,000] - sale price to unrelated buyer $300.00 3 Miscellaneous furnishings - proceeds of sale Kenny's Auction House $2,444.00 4 M&C (Menlo Park) FCU account 250-RG $127.32 TOTAL (also on line 5, Recapitulation) $35,771.32 A. "onn Approved OMB NO U.(t.UOl B. TYPE or LOAN I. 0 rmHA a. 0 CONV. UNINS. i. 0 CONV. INS. I", ~1Ul NUIIlDe,,: i 8. MONace IDaldD~e Cue Num.ber: SETTLEMENT STATEMENT U. S. DEPARTMENT or HOUSING AND URBAN DEVELOPMENT 1.0 rHA '.0 VA .. ... ~WIlbe...: C. NOTE: Thu form U furlli.hed 10 sive you a '1Glemenl of aclual ,el/lemenl co.'" Amounl. paid 10 and by Ihe .eltlemenl agenl ore .hown. lIe"" /fIMked "(p.o.c.)" were paid o,,,"ide Ihe clo.ing; Ihey are .hown here for informalional p..rpo.e. and ore nol included in Ibe 101GI.. D. NAME OF BORROWER: JOHN G. CRIDER AND BARBARA N. CRIDER E. NAME or SELLER: JOSEPH DOERWANG ESTATE F. NAME OF LENDER: G. PROPERTY LOCATI0N: H. SETTLEMENT AGENT: 65 RUSTIC DRIVE SHIPPENSBURG, PA 17257 HALE REAL ESTATE I. SETTLEMENT DATE: PLACE or SETTLtIlENT: 14 WEST KING STREET SHIPPENSBURG, PA 17257 .. SUMMARY or BORROWER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORR0 Jl'ER: 101. Cootr.....I.. prl.. 32 .900.00 102. PertonaJ property 103. Settlement ~bUle. to borrower (line 14(0) 104. 10&. .4/iilJllmenl.l (or ileml paid by WIer in adwnce to to 236. 71 to 213. 21'. 21&. 216. 217. 218. 219. 220. TOTAL PAID BY/FOR BORROWER 500.00 300. CASH A T SETTLEMENT FROM/TO BORROWER 301. GIoao........II. due from bo......./Iine 120) JJ, 1JlI. 11 301. Lea _OWl" paid lIT/lor bono_ /line 220) ( 5UU. UU) 303. CASH ( EI FROM) (( I TO) BORROWER 32,638.71 :;;Z";~ $~ '-j ~~ JANUARY 6, 2005 K. SUMMARY 01' SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract ....e. priee ~., ann nn 402. 'enoDal property 403. 404. 40i. AdilJllmenl.l (or ileml mid by oeUer in advance 406. CitYltown lase. '0 401. Coun.y.....Ol/07/05 to 12/11~ 7'lR 71 408. A...umentl . to 409. 410. 411. 412. 420. GROSS AMOUNT DUE TO SELLER 33, 13B. 71 500. REDIICTIONS TN AMnllNT DltE TO SELLER: &01. Esee.. cteftoalt (let imtructiOl'UJ i02. SdU.mant .b'. e. to oelle1r mne 14001 1 974.00 &03. E_f_I--loan I taken suhled to &0'" ..-ft.1f of flni mori8:..e lout 28,067.82 &06. .....off 0' -.......ct mo.....e 10." &08 &01. 808. i09. AmlJltmenl.l (or ite"" IJIIIlIJid bv IelIer 510. ctb'/toWll &uel to ill. Coulltytue. 01/01/04 to 12/31/04 1l1.Q7 &12. ~....eDtl to i13. SCHOOL 07/01/04 - 07/30-05 477.44 i14. i1i. i18.. &11'. i18. il'. 520. TOTAL REDUCTION AMOUNT DUE SELLER 30,631.23 600. CASH A T SETTLEMENT TO/FROM SELLER 801. GIO. _OWl' due to -. /line 420) 33,138.71 801. Lea6 nduetiou III _OWl' duo .0.. (line 520) IllO,631.23 I 603. CASH ( It! TO) (0 FROM) SELLER 2,507.48 ~~ HUD-I (5-76) It;~ ;. ~~~ -2- L. SETTLEMENT CHARGES 700. TOTAl. SALES/BROKER '5 COMMTSSION ba..cd on price '32,900 @6 % 1 ,~/4.( UPAlD FROM PAlD FROM /Jivi.ion of Commillion lUne 700) a. follow$: BORROWER'S SELLER'S TOt. . '0 HALE REAL ESTATE FUNDS AT FUNDS AT' to SETTLEMENT SETTLEMENT T02. . 703. Commission paid at Settlement 1,~/4.UU 704. 800. ITEMS PA Y ABLE IN CONNECTION WTTH LOAN 801. Loan OriDnatioD Fee ,. 802. Loan Discount ,. 803. A......raisal Fee '0 804. Credit ReDort '0 805. Lender's Inspection Fee 806. Mort.....e Insurance Application Fee to 8',.. Assumntion ".ee 808. 809. 810. 811. 900. l1'EMS RfXlU1RED BY LEJliDER TO BE PAID IN ADVANCE 901. Interest trom '0 .. /day ~02. Morta.lIle Insurance Premium for months to 903. Hazard Insurance Premium for . years to 904. years to 905. /000. RESERVES DEPOSITED WITH LENDl':R 1001. Hazard insurance month. . . per month 1001. Mortcaae insurance months" . per month 1003. City property taxes months" . per month 1004. County property taxes months. . per month 1005. An~ual useuments months. . per month 1006. month. . . per month lOOT. months. . per month 1008. months. . per month 1100. TTTLE CHARGES 110t. Settlement or claDnC fee '0 1102. Ahstraet or tiUe search '0 1103. Title examination '0 1104. Tttle insurance binder '0 1100. Document preparation '0 1106. Notary fees to 1107. Attorney's fees to (inducIe. above ileml number., ) 1108. Title insurance to '- (includes abofle item. numbe", 1109. Lender'. cover..e . 1110. Owner'. coverqe . 1111. 1112. I 1113. I I /200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Reeol.UnR fees: Deed' ; Mortp&e . ; Rele... . 1202. City Icount)- tax/stamp.: Deed' ; Monaace . 1293. State tax/st Imps: Deed' ; Monpae . 120-4. 120&. 1300. A1JlJlTIONAL SETTLEMENT CHARGES 1301. SUl'Vey to 1302. Pest in.pect ion '0 1303. 1304. ]305. 1400. TOTAL SJ<;TnEMJ<;NT CHARGES (enler onlin.. 103 Section J and 502 Section KJ 1,974.00 HUD-l (5-76) NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION M & C (Menlo Park) FCU C/O Engelhard Corporation 101 Wood Avenue South Iselin NJ 08830 732-205-5199 ~250 100023 Social Security No. Please report address corrections using the form on the other side of this statement. Send ADDRESS CHANGES ONLY to: M&C (Menlo Park) Fed. Credit Union PO Box 12 Iselin, NJ 08830 JOSEPH F DOERWANG 65 RUST! C DRIVE SHIPPENSBURG PA 17257 626 Please report account discrepencies to Lori Joyner, Supervisory Committee Chair at 732-205-5002. Thank you! 1'11111...1..1.1.1.1.1...11.1...1..1.11.....11.11...1.1.1,1.11 Statement Period Transaction T t I Account Payments I FINANCE: Account ransac Ion . . Date Acllvlty Advances CHARGE I Balance Page: 1 -.......- 010104 .. 033104 10104 Beginning Balance 10104 DIVIDEND 0.32 A dividend of $0.32 will be posted on 4/01/04 APYE for Dividend Period 1/01/04 Through 3/31/04 is 1.01% 127.00 127.32 -------------------------------------------------------_._----------------------- The FINANCE CHARGE is computed by multiplying the unpaid balance(s) by the (daily) periodic rate (at the equivalent ANNUAL PERCENT- . ~E) applied to the unpaid loan SH - RG ."-.../,ance(s) at the time of the loan pay- ment for the period that balance(s) was outstanding; balance(s) change each time new amounts are advanced or payments lUA mRdA or crAdit!': nivAn. New DIvidends I Year-To-Date ANNUAL Periodic IdentificatIOn Balance Credited FINANCE PERCENTAGE I rate % This Year CHARGE RATE (Daily) 127.32 0.32 Kenny's Auction 4401 PHILADELPHIA AVENUE . CHAMBERSBURG. PA 17201 . (717) 264-6578 Consignment Check-In (\/\ " ._ i . ^ Name:~Jej. LJoe-rtl!o- (\i Address: /_5 1:: \ L I /1 U t~-^Si-- ; '.3 I I. J . 1 j > .- Wi1Sn IIlJ{171 IJ" e {S4.(j () 7 2~ J.. Phone: q 08 - (p fq - 'I ol7,~ Lot Number: . t.fb1 Taken In By: }.J T () -- Description of Items Consigned: t . - ~~~~ ("(", s. 0 to "( Ct:L .S,C<.) I b t2.d r() [i)",,, 'S e--L 2. f) I k. s .t-c-<:.~ ~ I Bon .~ 'SJ~t' tL.;e S ;;L l i '?l h ~ s . . ,) . I(l/n (\IQ~s '~ii) Cot-fer' !-c::;,ble t<oU -tv,) d.e::>K IC..k.C.l~- I I r 'Yl /1lcA ~ <,hrp I n r'\ -f-c,," bLe tc oed c.-,k~~ l \~ \J-.e. l L..:. * L;~. c' In., ~. s t='o \ d Q~a t; bed. ') , -'. / .., J lC()~!l rkl.."" c~L.r: A"'?( I commission you to auction the items above to the highes1 bidder by public auction. I certify that I am the owner of the above listed goods and have good title and the right to sell. I' understand that I will receive a check in the mail once my items have been sold only if the total sale exceeds the $75 minimum pick up/commission fee (if my items total less than $75, I will receive no payment " and be billed for the diff~rence) I also understand that I will be charged for <l. \ ~ ,.::0 Sc\. \ ..- disposal of any items that fail to sell. . f- h..L. b"Oi.-J's a.00lA.:.-\::...\ ~~<:.. Special Instructions: ~\ \ I)'^"~ ~t I~ [n. lh:'7"I--\r-es S I 0, n "soJ.Q \ I I '1 ~.-.... , ., f.) C I Commission Fee: .J.....). Ofii? '". Date: ,o( I v D I () LL. .,. \ -,' m,' · . \ ,- /; f';' , i. / Seller's SigRature: it...>'. /' ,:J.... --) \--.,r- Thank you for using Kenny's Aucti services. We are proud to be serving this community for over 20 years! Please keep this receipt. Should you have any questions, please call us at 717-264-6578. ?, '2-0 '-" -- d({!/2 = $ 7t1tJ.- 1.(3/ . /# ,4 wdf' &1 ~7 ~bl!i!ilJ _@ = $ 35" .- '/ -@ 9 BUYER ITEM 11 ... 13/ BUYER -r ITEM ~/n;~~. .h1...!'"~/ ~ ~ _@ = $ 6,{'.- 13 BUYER 1..(5/ .:2 - {;n('/ Zd~ ~ ~ 2, @ Jt7tJO = $ -/0 . ITEM .s9' 15 BUYER ITEM d. - ~tf ~ / )~ 2-@ 5't)() = $ /0. HEET # .3 ' t),l)7> SHEET TOTAL $ ,;"lJ..c;y. DQ I 3 ,~ _@ = $ I (l . - IUYER ~~4f' ~JV = $0100.- RUNNING TOTAL $ 2 ~~:ER~7;FiM LOT # '/) 1{; '( @ ;2/ LI '\ if -c4o-u r $ _?25:- 4 BUYER 77 {~L~t..(->C ITEM LOT # h lfl1 @ = $ 7.50 ,,'- . 6 BUYER ,;20 Z _ ITEM /.h;-v~~ ~ ~ )bl!fJL1j _@ = $ 3S · - 8 BUYER /,.57 J-kTYJ ,13~4L z;.j~ = $ 6'5'. - ITEM LOT # '1.6 '1 @ 10 BUYER ITEM Od ~ ~-@ 1,;(3 ~cu/7 = $ iI.-- 12 BUYER ~eck~ tlJj' ITEM LOT # b Lt6 7 @ = $ 9(1.-- /61 14 BUYER ITEM = $ 5'.- 16 BUYER = $ ~GC} . . -' ..- .. 0'* 210-+ 8,80 .. + 1'3540+ 2 , 4' L~ 4 . * 2,44<'.':< 35'% 855'4 1,580-6:;; _ o.,;c SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Doerwamz. Joseoh F. 21-04-0363 if an asset was made joint within one year of the decedent's death, it must be reported on Schedule G Surviving Joint Tenant (s): NAME ADDRESS RELATIONSHIP TO DECEDENT A Michael T. Doerwang B C 18 E. Church St., Washington, NJ 07882 Son Jointlv-owned property: LETTER FOR DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF TOTAL V AWE OF DECD'S % INT. DOLLAR VALUE OF DECEDENTS ITEM NUMBER JOINT TENANT INSTITUTION AND BANK ACCOUNT NUMBER OR ASSET INTEREST SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE 1 A 11-Jun-96 Orrstown Bank - checking $6,332.37 50% $3,166.19 account #689661 2A 26-Jun-96 Orrstown Bank - checking $3,378.70 50% $1,689.35 account #34445 TOTAL (also on line 6, Recapitulation) $4,855.54 ~~ ORRSTOWN BANK TO: Andrew & Johnson Attorneys at law 78 West Pomfret Street Carlisle, PA 17013 FROM: ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Joseph F Doerwang DATE OF DEATH: March 14, 2004 DECEASED IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOllOWING ACCOUNTS WITH ORRSTOWN BANK: (3) CHECKING ACCOUNTS DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST 689661 Joseph F Doerwang 6/11/96 6,332.30 .07 Michael T Doerwang SAVINGS ACCOUNT DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST 34445 Joseph F Doerwang 6/26/96 3,378.70 2.40 Michael T Doerwang CERTIFICATES OF DEPOSIT DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST (1 ) 5/4/ 04 By Timothea Customer Service Operator P.O. BOX 250 . SHIPPENSBURG. PA 17257 TEL. (717) 532-6114 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES FILE NUMBER ESTATE OF 21-04-0363 Doerwang, Joseph F. ITEM NUMBER A. 1 2 3 B. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT Funeral Expenses: DeVoe Funeral Home, Washington, NJ Primrose Path Florists St. Ann's Catholic Church, Hampton, NJ - for burial costs Administrative Costs: Personal Representive Commissions Name of Personal Representative(s) Social Security Number of Personal Representative: Street Address: $4,000.00 $146.10 $1,550.00 Zip: City: State: Year(s) commissions paid: Attorney fees to Andrews & Johnson Family Exemption Claimant Street: City: State & Zip Relationship of Claimant to Decedent: Probate Fees to Register of Wills Accountant Fees to Patricia Rosendale, CPA Tax Return Preparer's Fees Lot rent for decedent's empty home Electricity for decedent's empty home Gas for decedent's empty home Water for decedent's empty home Insurance for decedent's empty home Repairs of water leak at decedent's empty home Bank charges - estate account Kenny's Auction - commission on sale of personalty Real estate taxes $2,000.00 $129.00 $200.00 $2,100.00 $159.75 $131.53 $493.87 $297.60 $103.99 $18.99 $855.40 $492.44 TOTAL (also on line 9, Recapitulation) $12,678.67 SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER Doerwang, Joseph F. 21-04-0363 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Medical bills $934.64 2 JR's Auto service - auto repairs due at death $122.96 3 Sprint $57.08 4 AT&T - cell phone $13.71 5 Capital One - account 4305722346204228 $1,331.91 6 Bank One - account 5466759990063338 $1,619.53 7 Purchase money installment loan [secured by mobile home] due to Waypoint bank $29,234.46 TOTAL (also on line 10, Recapitulation) $33,314.29 t'lWayl=tqiflJ January 3,2005 Andrews & Johnson Attorneys at Law 78 West Pomfret Street Carlisle P A 17013 Re: Estate of Joseph F Doerwang Dear Mr. Andrews Weare writing in response to your faxed request for information regarding that above customer account. The account is a mobile home installment loan and was held solely by the deceased. The principal balance as of the date of death was $29,234.46, with the interest balance being $121.75 for a total of$29,356.21 as of March 14,2004. Please note that this figure is not a payoff as of the date of death. We hope that this satisfies your needs, however should you have other questions, please feel free to contact the Loan Servicing Department at (800) 554-5472, extension 2100. Respectfully, I" . ~hOY\'i-~ch Shannon L Deatrich Loan Servicing Team Leader WaypointBank P.O. Box 1711. HARRISBURG. PENNSYlVANIA 17105-1711 Toll Free 1-866-WAVPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER D J hF 21 040363 oerwan, oseot - - ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributioos, and transfers W1der Sec. 9 I 16(aXl.2)] 1 Paul Jude Doerwang, 76 S. Lincoln Ave., Son 1/2 Washington, NJ 07882 2 Michael Thaddeus Doerwang Son 1/2 15 E. Church St., Washington, NJ 07882 II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. Charitable and Governmental Bequests: TOT AL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0 ~. .q ~ s: ~ a lad. aua ol (~nmeuf JOSEPH F. VOERWANG .. ~:i , "J ' :the JOSEPH F. VOERWANG, ~e6iding at 26 Beethoven Avenue, ~n Bo~oug h 06 Wa..6 hing-to n, . Coun-ty 06 WaJVte.n a.nd s-tate. 06 New J eJL.6 ey, being 06 .6ound a.nd cU..6po.6ing mind, me.mo~y a.nd undVl..6.ta.nding, do h~eby ma.ke., b!:l !l.evofU-ng publi-6h a.nd de.c1.aJc.e. -th.Lo -to be. my La..6-t W-ill a.nd Te6.ta.ment, h~e a.ny a.nd a.U o-theJt WLU.6 OIL CocUUL6 heJtetonolLe. ma.de. by me.: .:t6 a.nd FIRST: I olLdeJt a.nd cLiJc.e.c;t -that a.U 06 my ju.6:t deb , rz;tl!:l be 6unvz.a..t e.xpen6e6 be. pdid a..6 .6oon a.6.teJt my death a..6 c.a.n c.onve.~e done.. . !l.eJ>idue SECONV: I give., de.vi.6 e. a.nd be.que.ath a.U .the !l.eAt, ,J"en PAUL a.nd lLe.mdindeJt 06 my e6-tate., bo.th ~eai. a.nd pVl..6onai., .to my c.hilwLo , fJ;.:telY a.nd JUVE VOERWANG a.nd MICHAEL THAVVEUS VOERWANG,to be. .the>>cA a.b.60 .. , d!!.en .6 hou1.d 6 olLe.veJt, .6ha.tte. a.nd .6ha.tte. ilike.. 16 e..U:heJt 06 my a.nolLe6a..i.d c.hll . dec.eM ed plLe.de.c.e.a..6 e. me. te.a.ving i.6.6 ue., .the.n I cLiJc.e.c;t .that .the. .6 ~e 06 my u.ed p!l.e.de.c.e.a..6 e. c.hil.d go .to .6did i.6.6ue.. In e..U:heJt 06 my a.601Le6did c.hil.dJLe.n .6 ho d c.hild go me. te.a.ving no i.6.6ue., .the.n I cLiJc.e.c;t :that :the. .6 ha.tte. 06 my de.c.eM e -to my .6U1Lviving .6on. tfI),h c..e.a.u.6 e. THIRV: 16 my .6did GILa.ndc.hil.dlLe.n aJte. minoM whe.n u.ed not be 06 my w.i.i1. be.c.ome6 e.66e.c.tive., a.nd i6 my .6did glLa.ndc.hil.dJr.en .6ho , ing So n M 21 ye.a.JL6 06 a.ge. at :the. time. 06 my de.c.e.a..6e., I a.ppoin.:t my .6uJLV~v without bond TILu..6.te.e. 06 .the. plLopeJt:ty 06 my .6did GILa.ndc.hildILe.n, he..to .6~ve . . :th .... :.,.' ,. J: ~ .,. : d:t ha. [.. 0 0 ow~ a.nd a.uthoM:ty OIL 0 eJt .6e.C.WlAA,.y ~n a.ny jU/l.,{,6u-l.l:AA..on, a.n 0 ve. nlUA- P d , he.6 ha.U hot .toe.xpe.nd bo.th .the. C.OlLpu..6 a.nd .the. inc.ome. 06 .the. plLopeJdy whic.h [ duC.a;UO}t 0 u a..6 .6uc.h gu.aJr..cUa.n a.l'I.d btu..6:te.e. 60~ -the. mdin-te.na.nc.e., we..tnaJLe a.nd e my .6a.id gMndc.hil.dlLe.n. FOURTH: I h~e.by C.OM.tli.u.te. and appoin-t my SOM, PAUL JUVE VOERWANG and MICHAEL THAVDEUS VOERWANG Co-Fidu~e.6 06 -th..Lo my Will. 16 e);th~ 06 my SOM .6hou.td die. be.6o~e. I do, o~ i6 U:th~ 06 my SOn6 and I .6hou.td die. in a c.ommon c.ata.6:tJtophe. o~ a.6 a ~e.6uR..:t 06 .6a.me., and i6 e);th~ 06 my SOM having .6Mvive.d me. .6ha.ll .oO~ any ~e.Mon .om to quili6Y o~ having quili'Me.d .6ha.U 6a-U :to ad M Fiduu~y, I :then cLiJc.e.d :that my .6Mviving Son ad M .60.te. Fiduc.iaJr.y. No bond o~ o-th~ .6e.c.MUy .6ha11. be. ~e.qtWte.d 06 eA..:th~ 06 .6a.id pVl..60M in any juJU.6dic;t[on 60~ -the. 6aLth6lLi p~60~anc.e. 06 -thw ciu;t{.u. I e.mpow~ my .6a.id FiduuaJU..u to .6e.U any ~e.a..e. u-tate. o~ any paJL:t :th~e.06 o~ in.:t~ut :th~un 06 whic.h I may die. .6uze.d, U:th~ at pubLic. o~ p~vate. .6ai.e., at .6uc.h time. and upon .6uc.h -t~ and 60~ .6uc.h pMpO.6e. M -to .6a.id Fiduu~e.6 .6ha11. .6e.e.m p~op~ and :to e.xe.c.ute. and de.Uv~ pJr.op~ c.onve.yanc.u ioJr. :the. .6a.me. in .taw. IN WITNESS WHEREOF, I have. h~e.un.:to .6e.:t. my hand and .6e.ai. -th..Lo :l#da.y 06 NOVEMBER, in -the. Ye.~ 06 OM LOJr.d, One. Thou.6and N.i.ne. Hun~e.d and Ug h:t.y - ug h:t.. ),t1PH~: b~ ~ SIGNEV, SEALED, PUBLISHEV & VECLAREV by :the. Tu-tato~, JOSEPH F. VOERWANG, :to be. h..Lo La.6:t W-ill and Tu-ta.me.n.:t, in OM pJr.e.6e.nc.e. and in -the. p~Ue.}tc.e. 06 e.ac.h 06 u.6, we. bung pJr.e.6e.n.:t at the. .6a.me. time. and we. at h..Lo Jr.e.quu-t, and in h..Lo pJr.e.6e.nc.e. and in :the. pJr.uenc.e. 06 e.ac.h oth~, have hVLe.un.:tO .6igned OWL na.me.6 ~? ..------~ ~ i -----.\ Re.oidirtJg at .:.: ,;/~ M T ~ '/ '~j Re6~Mn9 ~~~ vO (" WELTMAN, WEINBERG & REIS CO., L.P.A. A TTORNEYS AT LAW 175 South Third Street, Suite 900 Columbus, Ohio 43215 800.325.9965 614.801.2710 www.weltman.com BURLINGTON, NJ 609.914.0437 CHlCAGO,IL 847.940.9812 CINCINNA n, OH 513.723.2200 CLEVELAND,OH 216.685.1000 DETROIT, MI 248.362.6100 PHILADELPHIA, PA 215.599.1500 PITTSBURGH, PA 412.434.7955 March 10,2005 Cumberland, Register Of Wills One Courthouse Square Carlisle, PA 017013 f".) Re: Estate of Joseph F Doerwang Case No. 21-2004-363 Our Client: Mobile Consultants, Inc. Account No. 31829 Balance Due: $27,988.26 Our File No. 4051422 i~) rv ,) Dear Clerk of Courts: This law firm represents Mobile Consultants, Inc. in connection with ils claim which we wish to file on our client's behalf into Ihe eslate of Joseph F Doerwang, deceased. Enclosed is our check in the amount of $1 0.00 which we undersland is the filing fee for this claim. Our client's claim is based upon its account number 31829 in the amount of $27,988.26. As oflhe date of this letter, this is the amount due. Included with this letter is the claim form which we wish to present to this court and which we are forwarding to the attorney and/or fiduciary of this estate. It would be appreciated if all correspondence and disbursements with respect to this matter be forwarded to our office and to the attention of the undersigned. Additionally, it would be appreciated if any notices of any hearings also be forwarded to the undersigned. Thank you for'your cooperation in this matter. Sincerely Yours, ~~u STEPHANIE SLAUGHTER Aulhorized agent for the claimant SSL:sek Enclosures cc: Paul Jude Doerwang Taylor P Andrews WWR#405l422 CLAIM FORM FOR COMPANY OR ORGANIZATION STATE OF NEW JERSEY COUNTY OF CUMBERLAND, REGISTER OF WILLS CASE NO. 21-2004-363 ) The undersigned, _STEPHANIE SLAUGHTER Authorized agent for Claimant, herewith presents and files their claim against the Estate of Joseph F Doerwanq I deceased, for and on account of the following described indebtedness owing by said Estate of Claimant, viz: For a an installment loan with Mobile Consultants, Inc., Account No. 31829 Balance Due: $27,988.26(As of the date of this claim, this is the amount due.) STATE OF OHIO COUNTY OF FRANKLIN Before me, the undersigned authority in and for said County in said State, personally appeared STEPHANIE SLAUGHTER Authorized agent for the claimant, who being first duly sworn, says that (s)he is Authorized Aqent for Mobile Consultants, Inc., the claimant, and that (s)he has full and complete knowledge of the correctness of the above claim against the Estate of Joseph F Doerwanq , deceased, and the amount claimed is justly due (or to become due), and after allowing all proper credits. ~.~ ~~tv Authorized Agent for the Claimant 175 South Third Street, Suite 900 Columbus, Ohio 43215 20cb . Subscribed and sworn to ",'," c, CO"~ I o+!, '" ~y( !A ~~ ?t., _ Notary Public \""" I I ,\ V I" ,,-;, ~~,.I..e.!J ~', '0'" \\ II '.g , -...../:...."...I/;:.:~~'.. -~&~- - :~; ..'---\\..' =*, \ : : i i*: :. <Jl'" f : .........~..... ..:;:~...~ '''''''' ...a.: , ,1, ~"""""O"~' " .. 0'" " ",",, ~,\\\ SEBRINA l. KEHOE Notary Public, State of Ohio My Commission Expires 01-17-07 WWR # 4051422 STATEMENT OF ACCOUNTS FOR: Mobile Consultants, Inc. DECEDENT'S NAME: Joseph F Doerwang ADDRESS: 76 S. Lincoln Ave CSZ: Washin~ton, NT 07682 SSN: 262-42-8159 DOD: 03/14/04 ACCOUNT #: 31829 BALANCE DUE: _$27,988.26 EXHIBIT A )1# ~ \'1'\\2: 4\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX Or BUREAU OF INDIVIDUiiiTAXSS. , CnUn!iJIERITANCE TAX DIVISION' .; .. 'v n ox Z80601 ,; } r-'("\ H., ISBURG PA 171Z8-0601 7nnr 'Ii' '{ ')0 ,",'J ,,,. L I ."oJ (,," '- 1-11 <.' ... DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN c: EPi: (iF ORDI '^ \J' JQ' 0r;t ,;-.,.. I Mnl v \.)~}'J ri ! TAYLOR jiUi\RDREWS<ESgi ANDREWS & JOHNSON 78 W POMFRET ST CARLISLE PA 17013 05-23-2005 DOERWANG 03-14-2004 21 04-0363 CUMBERLAND 101 *' REV-1547 EX AFP (03-05) JOSEPH F hount Re.ittecl MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 1t~V-~Il,."ft.l'Wm~'tI!1.mtm.W'.!MfI!RW4M!'t.m.~'II\fJt~mMMT~.'lrC[!lV4M!'t.r.rr.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DOERWANG JOSEPH F FILE NO. 21 04-0363 ACN 101 DATE 05-23-2005 TAX RETURN WAS: I X I ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R8.1 Estate (Schedul. A) 2. stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property ISchedule F) 7. Transfers (Schedule S) 8. Total Assets (1) (2) 131 (4) IS) 161 171 .00 2.263.80 .00 .00 35.771. 32 4.855.54 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral ExPenses/Ad.. Costs/Misc. Expenses [Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. N.t Value of Tax Return 13. Ch.ritabl./Gov.r~ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 (10) 12,678.67 33.314.29 1111 1121 1131 1141 NOTE: To insure proper credit to your account, sub.i t the upper port ion of this form with your tax pay_nt. 42,890.66 41;.99:> 96 3,102.31- .00 3,102.31- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~1gures that include the total o~ ALL ASSESSMENT OF TAX: 15. ~ount of Line 14 at Spousal rate (15) 16. ~t of Line 14 taxable .t Lineal/Class A rat. (16) 17. Amount of Lin. 14 at Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due TAX CRE S: rAY" '.J AMOUNT PAID DATE NUHBER INTEREST/PEN PAID 1-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = 1191= .00 .00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 DOERWANG PAUL JUDE 76 SOUTH LINCOLN AVE WASHINGTON, NJ 07882 RE: Estate of DOERWANG JOSEPH F File Number: 2004-00363 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/14/2006 Please feel free to contact this office with any questions you may 'have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel f1 Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 DOERWANG MICHAEL THADDEUS 15 EAST CHURCH ST WASHINGTON, NJ 07882 RE: Estate of DOERWANG JOSEPH F File Number: 2004-00363 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/14/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, G~~~ Clerk of the Orphans' Court cc: File Counsel V"Y cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 MCNEW MICHAEL A 1042 WILLOWBROOK DRIVE CHAMBERS BURG , PA 17201 RE: Estate of RIGGINS MARGARET R File Number: 2004-00358 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/04/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel VY IN RE: ESTATE OF JOSEPH F. DOERWANG DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0363 FIRST AND FINAL ACCOUNT OF PAUL J. DOERWANG AND MICHAEL T. DOERWANG EXECUTORS OF THE ESTATE OF JOSEPH F. DOERWANG LATE OF SOUTHHAMPTON TOWNSHIP,CUMBERLAND COUNTY, PENNSYLVANIA Date of death: letters Granted: Advertisement of letters: The News Chronicle: Cumbo Law Journal: ACCOUNT STATED AS FINAL March 14, 2004 April 15, 2004 March 29. April 5, 12, 2005 April 1, 8, 15, 2005 Purpose of Account: Paul J. Doerwang and Michael T. Doerwang offer this account to inform interested parties of the transactions that have occured during this administration. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Ta lor P. Andrews, Es .78 W. Pomfret St., Carlisle, Pa. 17013. Phone 717-243-0123 PRINCIPAL Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries Principal Balance Remaining SUMMARY & INDEX Paae No. 2 3 3 $37,907.80 $44,166.13 ($6,258.33) $0.00 ($6,258.33) INCOME Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries Income Balance Remaining 4 4 $0.00 $0.00 $0.00 $0.00 4 $0.00 COMBI~ED BALANCE REMAINING ($6.258.33) . I \ 1 8 \ 'U '" .-. Page 1 PRINCIPAL RECEIPTS (Value as of Date of Receipt unless otherwise indicated) 66 shares Metlife @ $34.3 per share Manufactured double-wide home at 65 Rustic Dr., Southampton Township, Shippensburg Post Office, P A 17259 as per agreement of sale in arms length transaction to unrelated party. 1995 GMC pick-up truck - high mileage [175,000J - sale price to unrelated buyer Miscellaneous furnishings - proceeds of sale Kenny's Auction House Total Receipts of Principal Page 2 Amount $2,263.80 $32,900.00 $300.00 $2,444.00 $37,907.80 PRINCIPAL DISBURSEMENTS Purchase money installment loan [secured by mobile home] due to Waypoint bank: Funeral Expenses: De V oe Funeral Home, Washington, NJ Primrose Path Florists St. Ann's Catholic Church, Hampton, NJ - for burial costs Administration Expenses: Attorney fees to Andrews & Johnson Hale Real Estate - broker's fee for selling double-wide Lot rent for decedent's empty home Electricity for decedent's empty home Gas for decedent's empty home Water for decedent's empty home Insurance for decedent's empty home Repairs of water leak at decedent's empty home Bank charges - estate account Kenny's Auction - commission on sale of personalty Real estate taxes Patricia Rosendale, CPA - tax preperation Register of Wills - filing fees The News-Chronicle -legal advertising Cumberland Law Journal - legal advertising Unpaid Claims [general creditors] = Capital One account - $1,331.91 Bank One account - $1,658.81 TOTAL DISBURSEMENTS OF PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES None TOTAL DISTRIBUTION OF PRINCIPAL TO BENEFICIARIES Page 3 I $29,234.46 $4,000.00 $146.10 $1,550.00 $2,000.00 $1,974.00 $2,100.00 $159.75 $131.53 $493.87 $297.60 $103.99 $18.99 $855.40 $492.44 $175.00 $257.00 $101.00 $75.00 $44,166.13 $0.00 INCOME RECEIPTS None Total Receipts of Income None INCOME DISBURSEMENTS Total Disbursements of Income to Beneficiaries Page 4 $0.00 $0.00 $0.00 COMMONWEALTH OF PENNSYLVANIA COUNTY OF Paul J. Doerwang ,being duly sworn according to law, deposes and says that the Account as stated is true and correct, and that the Grant of Letters and the first complete advertisement thereof occurred more than four (4) months before the filing of the Account. ~~o~ ul J. Doerw?l:' j .....-- Sworn and subscribed to before me this i.3 day of ~"). d DO<.o SUSAN FUM~}\kzq QAWr PIIJUC Of NEW J~V ~~ J2I2a/200; COMMONWEALTH OF PENNSYLVANIA COUNTY OF Michael T. Doerwang ,being duly sworn according to law, deposes and says that the Account as stated is true and correct, and that the Grant of Letters and the first complete advertisement thereof occurred an four (4) months before the filing of the Account. Michael T. Doerwang Sworn and subscribed to before me. this J~ day of ~0 d{)tJ/P ~'Y) ~~~ SUSAN FLEMING NOr~~ PUSUc OF NEW J&SIV Com~n ~ B2/afJJ'm - IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JOSEPH F. DOERWANG DECEASED ORPHANS' COURT DIVISION NO. 21-04-0363 NOTICE OF FILING ACCOUNT NOTICE IS HEREBY GWEN that Paul J. Doerwang and Michael T. Doerwang, Executors of the Last Will and Testament of Joseph F. Doerwang, Deceased, has this date filed the First and Final Account in the above-captioned Estate in the Office ofthe Register of Wills in and for Cumberland County, Pennsylvania, where the same are filed as public records and may be inspected. There is no schedule of proposed distribution because the estate is insolvant. YOU ARE FURTHER NOTIFIED that any exceptions or objections to said Account must be filed in writing at the Office of the Register of Wills aforesaid prior to the confirmation of said Account, scheduled as set forth below. UNLESS written exceptions or objections are filed prior thereto, said Account will be presented to the above-captioned Court in Courtroom No. I of the Cumberland County Courthouse, Carlisle, Pennsylvania, at 9:30 o'clock A.M. prevailing time, on Tuesday, June 20, 2006, at which time said Account will be confirmed. ANDREWS & JOHNSON Date of Notice: Y. -(8 ,. d~ By: ax r P. Andrews, Esq. tomeys for the Estate of Joseph F. Doerwang TO: Weltman, Winberg & Reis Co., L.P.A. Attn: Allen J. Reis, Esquire 175 South Third Street Suite 900 Columbus, OH 43215 Estate Information Services, Inc. ATTN: NATASHA McDANIEL 5330 East Main Street, Suite 2001 Davis Professional Building Columbus,OH 43213 r , ",~":"",''':'...W''.'-~'''''''''''F''''''''''''''''"",~""",,, ....... .~~~""''''''' _ '0 <i5 0 t:::o~ g> CD :J .C - m c :.=~ 0 ~ C Q.t'U?:- r::: 0. 0 Q) ~ .... E.~ 0) <D a:: '- (!) .- t.'l .c"O - 0:;; <<J ~ '::~=.9c:oo~ o CD.9 >92 ~O (tl mE"O~~ij) .0 .2-<1> (t)>~": O-jUetSQ)qsO CS .m.t:~..c:i ~~~Zj.~~o ....J::. CD .. I (IJ ~-.oO ct "'0 .e ~i1~lj I~ f~iisiZZ~ };. 8 ~ . ~ ~ s.~ ~ !~ig~~c!o l.~.c ~!-~ ~j.ffi -= ~~ 0 (I)~.~.c ~ v Z ,c:C J:x..I ~ 0 t:G Z r:u 8 0 Z 0 0 :> 00 'J) ... - tJZt!) Z ~ ~ ~ r:r... tJ~Z =j~s~ ,c:C ,c:C O~~~~ ::r:: t!)~ P-l ....:lZt:G ~<~<9 rz:I M ,c:C~r:u ~~ p..~ U) 1..0 Z~O ~ 0 ....N 0 M HP::;C1 'J)Z~~R I-J 0 ~r:u ~~ti)~t-4 I 0 - ~ ~ Q.I:aD. r:r... ~ 008 =~~U 0 0 z Q<~ I ~ -...:I rz:I ~ I-JrzJ Z 8 N 8 ,c:C -< ,c:C U)...:Itt: 8 - t:G:>tJ U) 0 H,.:tH rz:I Z ~P-l::E ~..~ Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 :S<:;5.e.p~ F' !1e1vJa",,; :3 - I V: - ZLJO 1 J-( -OC{- -()~') Date of Death: Estate 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 0 No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: g - (- O~ 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 0 No 0 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 0 No 0 Date: Telephone No. "7.... (.;_:~ t Capacity: 0 Personal Representative ~ Counsel for personal representative {l) Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: 1 'J .;!, e p h ,C'. i::J 0 t" r W Cl '" .5 Date of Death: 3- J'i - Ci.f 2 1- o'i - 0:'\4 ; Estate 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 ofthe estate is complete: Yes 0 No Ul 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: U 1"1 {' ~ yo- l' c, \ v1 )( lfthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed wi t Clerk of the Orphans' Court and may be attached to this report. Date: l.\ .,13- u ~ M l C l-'\ Co ~ \ T. D 'C ~ r W " .., j Name 15. E. Chl..ll--ch st. Address VV c'.5 J, ; (l 5 r Q (l I ,oJ ]'" 0 1 ~~ :l 90~ ~(o~ --'-I .11.2 Telephone No. Capacity: ~ersonal Representative o Counsel for personal representative i ~\ ~.'t\\Jv' ' > Z ;x:! >0 ()<'>-l~ ~~~drrJ ~~~~~ ~~'i:lzcn tv' 0 tr1 e'i:l>3Vl~ 6 :t'>'- ............~>-lO ~ C! uq-' :I: C;:;~>Z ~:Ecn o Z ci"3'9~ g.;:C'~ g- ::;'I~.3(jr~ ~5rl ~\ ~ ~5'5ifi. ~~i ~ ~ii all!) ?1~i!~l~~ ~il~~i:7~ Qc;~~~~~~ ~::7C5'::r1'%5 OlnCD!>> ~....- ......~<(/) CD-cr \,) !p~ia.3m a; Q.< (f)'<51ll0 i Q.O ::q;<+~::- ~ >>> 9'-10 :::3> :.: a. ::r (") -, 'll -, - '" (l) ;;.;. 3 ~ ;jj ('0 () '2. ::1l :.?(l.l1:l::l~o~= ::l!!;o-'~!:;CD~ v; -" I"-f> j-" co 0 ::;:; -.-;: ~ ;s"O H;l>' nc ::r:t"i :J:>l (Ij~ t"i. 80 . 0 [Ij O::tl O:E: [Ij;J:>l ::tlZ :E:G) :J:>l Z:J:>l G)Z d I I I l z o tIj (J) 8 :J:>l 8 tIj o >-tj ~ o (J) tIj "0 ::r: >-tj . N -' I o .1:>0 I o W 0'1 W d o [Ij ::tl :E: :J:>l Z r\ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/20/2007 ANDREWS TAYLOR P 78 W POMFRET STREET CARLISLE, PA 17013 RE: Estate of DOERWANG JOSEPH F File Number: 2004-00363 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/14/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, &,,~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) rrl Cumberland County - Register Of Wills One Courthouse Square Carlisle! PA 17013 Phone: (717) 240-6345 Date: 2/20/2007 DOERWANG PAUL JUDE 76 SOUTH LINCOLN AVE WASHINGTONt NJ 07882 RE: Estate of DOERWANG JOSEPH F File Number: 2004-00363 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULESt NO. 103 SUPREME COURT RULES DOCKET NO. 1t for decedents dying on or after July 1t 1992t the personal representative or his counsel! within two (2) years of the decedent's deatht shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/14/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report! please disregard this notice. Sincerely! ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/20/2007 DOERWANG MICHAEL THADDEUS 15 EAST CHURCH ST WASHINGTON, NJ 07882 RE: Estate of DOERWANG JOSEPH F File Number: 2004-00363 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/14/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ ~ f' Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel o Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ev (.tA.~ 1Lr I o.~ COUNTY, PENNSYLVANIA Name of Decedent: 5~s~pL, F. (1u~9 r Date of Death: :5 -I <f - or- File Number: 'Joe 'f - 00 ~3 Pursuant to Pa. O.C. Rule 6.12, 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: . . . . . '. . . . . . . . . . . . . . . J!fl...Yes 0 No 2. lfthe 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 DNo 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. DYes DNo 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. Date 3 .... Co ~o" () I . -, ! i f _. . ! l .. I oj ~ Capacity: DPersonal Representative }VCounsel -ro.{(c, Po. A-AJr~;; ( t.:s i. Nameof:;iFiIi~:FormR, -.. fref 5,f- Address G(" {,51 -( P 4- 17~ / ~ , '1/7 ;;ziJ>-e>(Z~ Telephone Form RW-JO rev. JO.J3.06 j