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HomeMy WebLinkAbout03-1046PETITION Estate of Karl W. Rot:z also known as FOR PROBATE and GRANT OF LETTERS To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania Social Security No. Deceased. 194-26-682']. The petition of the undersigned respectfully represents that: Your petitioner(x), who is/amc 18 years of age or older an the execut rix in the last wilt of the above decedent, dated January 25 and codicil(s) dated none in the named ,19 95 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 1003 Newburg Road, Shippensburg? Sout:hamp t:on Townsh-ip (list street, number and muncipality) Decendent, then 69 years of age, died December 1, 2003 ,X~ , at Chambersburg Hosp±t:al, Chambersburg, PA 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: none 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: 5,555 WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) t e s t ament ary (testamentary; administration cma.; administration d.b.n.c.t.a.) Pauline M. Rotz ~ 1003 Newburg Road Shippensburg, PA 17257 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF CUMBERLAND ) SS 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 represen- tative(s) of the above decedent petitioner(s) will well and, truly administer the estate according to law. ~._/ ," /-') .. . Sworn to or affirmed and subscribed blffore me this l~4z~q day of Pauline M. Rotz No. Estate Of Karl W. Rotz , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~,~)~ 0~mJ)-~L ~3 ~06 ~ ~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated January 25, 1995 described therein be admitted to probate and filed of record as the last will of Karl W. Rotz ; and Letters Testamentary Pauline M. Rotz are hereby granted to FEES Probate, Letters, Etc .......... Short Certificates( ) .......... R~,~,W~ ~.'V.~.. ~.. TOTAL m~a ~:.~:. g~,3. Register of Wid d ' 0 ~4~ Jerry A. Weigle, Esquire #01624 ATTORNEY(Sup. Ct.I.D. No.) WEIGLE & ASSOCIATES, P.C. 126 East King Street ADDRESS Shippensburg, PA 17257 717-532-7388 PHONE LAST WiLL AND TESTAMENT I, KARL W. ROTZ, of 1003 Newburg Road, Shippensburg, Southampton Township, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved wife, PAULINE M. ROTZ, absolutely. THIRD. In the event my said wife should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate to my children and grandchildren, on a per stirpes distribution basis, as follows: A. B. C. ONE SHARE to my son, LARRY E. ROTZ, on a per stirpes basis. ONE SHARE to my daughter, BRENDA K. ROTZ, on a per stirpes basis. ONE SHARE to be divided equally between the children of my deceased son, TERRY L. ROTZ, as follows: 1. ONE THIRD OF ONE SHARE to my granddaughter, TAWNYA B. ROTZ, on a per stirpes basis. 2. ONE THIRD OF ONE SHARE to my granddaughter, LERISSA C. ROTZ, on a per stirpes basis. 3. ONE THIRD OF ONE SHARE to my grandson, MATTHEW K. ROTZ, on a per stirpes basis. (SEAL) MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA. 17257 FOURTH. In the event that any beneficiary of this my Last Will and Testament is under the age of eighteen (18) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise, DEBORAH ROTZ, of 150 Middle Spring Road, Shippensburg, Pennsylvania, AS GUARDIAN, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the age of eighteen (18) years, with the following powers in addition to those presently given by law: The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; Be The power to expend the principal, within the discretion of the said Guardian, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; Ce The power to sell any and all real estate, within the discretion of the said Guardian; De The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of eighteen (18) years, without the necessity of a formal adjudication of the Guardian's account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; Fe In the event the above-mentioned Guardian is unable to accept the Guardianship, I then name, constitute and appoint BRENDA K. ROTZ, of Chambersburg, Franklin County, Pennsylvania, as Guardian, with the same powers hereinbefore stated. FIFTH. I nominate, constitute and appoint my wife, PAULINE M. ROTZ, to be the - 2 - MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA. 17257 Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint LARRY E. ROTZ and BRENDA K. ROTZ, or the survivor thereof, to be the Executors of this my Last Will and Testament. SIXTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, KARL W. ROTZ, have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this~S day of (SEAL) This instrument was by the Testator, KARL W. ROTZ, on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in his presence and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. - 3 - MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA. 77257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : I, KARL W. ROTZ, the Testator whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by KAR~W. ROTZ, the Testator, of ', ~,{,~,~ , 995~ NOTARIAL SEAL mappendxxg, PA Cumbemnd County My Commleskm Expires July 31, 1968 - 4- MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw KARL W. ROTZ, Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before ~me by ¢i~nesses, this ~w~ day'of _ -5 - MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA. 17257 KARL W. ROTZ MARK, WEIGLE AND PERKINS ATTORNEYS AT LAW I 15 EAST KINg STREET SHIPPENSBURG, PA. WEIGLE & ASSOCIATES, P.C. * ATTORNEYS AT LAW 126 EAST KING ST~.EET, SHIPPENSBURG, PA 17257-1397 · TELEPHONE: (717) 532-7388 FAX: (717) 532-6552 IN RE: ESTATE OF KARL W. ROTZ, : late of the Township of Southampton, Cumberland County, Pennsylvania, deceased IN TItE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NUMBER 21-03-1046 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a} Name of Decedent: Karl W. Rotz Date of Death: December 1, 2003 Will No. 21-03-1046 To the Register: 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- captio:ned estate, on December 29, 2003: Pauline M. Rotz 1003 Newburg Road Shippensburg, PA 17257 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE. December 29, 2003 Signature Name: Address: Telephone: Capacity: Jerry A. Weigle, Es Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 (717) 532-7388 Personal Representative X Counsel for Personal Representative WEIGLE & ASSOCIATES, P.C.-- ATTORNEYS AT LAW --126 EAST KING STREET --SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN X OFFICIAL USE ONLY FILE NUMBER 2 1 - 0 3 1046 R ES I D E N T D E C E D E N T cou cooE .u BE, DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Rotz, Karl W. 194 - 26 - 6821 D~EOFD~TH(MM-DD-YEAR) D~EOFBI~H(MM-DD-Y~R) 12-01-2003 10-22-1934 (IF APPLICABLE) SU~IVING SPOUSE'S NME (LAS~ FIRS~ AND MIDDLE INITIAL) Rotz, Pauline M. --12. Supplemental Return --] 4a. Future interest Compromise (,~ate of death a~t~r 12-12-82} E~7. Decedent Maintained a Living Trust (^ttach copy of Tmst) E]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-g5) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS E~ 3. Remainde..r Return (data of death p~'to 12-13-82) ~'-~ 5. Tax Return Required Federal Estate 8. Total Number of Safe Deposit Boxes "--]11. Election to tax under Sec. 9113(A) (~=Sch O) ~-~1, Odginal Return r--] 4, Limited Estate r--~ 6. Decedent Died Testate (A~ch copy of WiW) ---]9. Litigation Proceeds Received NAME Jerry A. Weigle, Esquire FIRM NAME 0fA~p,caUe)WEiGLE &ASSOCIATES, P.C. COMPLETE MAILING ADDRESS 126 East ~±~ Sh±~pe~sSur§, TELEPHONE NUMBER 717-532-7388 5,581.80 (8) (11) (12) (13) 13,077.74 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 (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 Liabilities, & Liens (Schedule I) (10) 11, Total Deductions (total Lines 9 & 10) 12, Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) x .0 .. (15) 14. 15. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 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 x .0 __ (16) Street PA 17257 OFFICIAI~ '~USE ONLY 5,581.80 13,077.74 (7,495.94) NONE - INSOLVENT 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20. ~] Deced~nt's Complete Address: STREET ADDRESS 1003 Newburg Road Cl~Y Shippensburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty STATE PA (1) Total Credits ( A +. B + C ) (2) Total Interest/Penalty ( D + E ) (3) 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) (5A) (5B) A. Enter the interest on the tax due. ZiP 17257 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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 either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 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 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. Under penalties of perjury, 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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN, A~URE OF PERSON RESPONSIBLE FOR..FJt, ING RETURN DATE ADDRESS 1003 Newburg Road, Shippensburg, PA' 17257 Pauline M. SIGNATURE OF PREPARER OTHER THAN REPR[ IVE DATE Jerry A. Weigle, Esquire Z--lO,-Oq 126 East King Street~ Shippensburg~ PA 17257 For dates of death on or after July 1, 1994 and ~ January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of 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 retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 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(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. §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. RE¥-1508 EX+ COMMONWEALTH OF PENNSYLVANIA INFIERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDUL'E E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Type FILE NUMBER Karl W. Rotz (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) 21-03-1046 iTEM NUMBER me DESCRIPTION M & T Passbook Savings Account #1217357 Accrued interest to date of death State Employees' Retirement System - death benefit TOTAL (Also enter on line 5, Recapitulation) S VALUE AT DATE OF DEATH 5,558.88 2.84 20.08 5,581.80 (Attach additional 8~" x 11" sheets if more space is needed.} REV-1511 EX+ J7-88J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or Type ESTATE OF ITEM NUMBER Be Bo C. 1. 2. 3. 4. 5. 6. 7. 8. Karl W. Rotz DESCRIPTION JFILE NUMBER 21-03-1046 FuneralExpenses: Fogelsanger-Bricker Funeral Home Cleversburg United Methodist Church - funeral reception Parklawns Memorial Gardens Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid Attor,ey Fees Weigle & Associates, P.C. Spouse Family Exemption Claimant Pauline M. Rotz Relationship Address of Claimant at decedent's death Street Address 1003 Newburg Road City Shippensburg State PA Zip Code 17257 Register of Wills, Cumberland County - Letters Letters Testamentary Testamentary - filing Insolvent PA Probate Fees Testamentary and Short Certificates Miscellaneous Expenses: Cumberland Law Journal - advertising News Chronicle - advertising Letters Register of Wills, Cumberland County Inheritance Tax Return AMOUNT 7,495.80 541.19 1,060.00 250.00 3,500.00 53.00 75.00 92.75 10.00 TOTAL (Also enter on line 9, Recapitulation) $ 13,077.74 (If more space is needed, insert additional sheets of same size.) REV-1513 EX+ (2-87) ~ COMMONWEALTH OF PIt:NNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Karl W. Rotz 21-03-1046 ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE A. Taxable Bequests: 1. Not relevant as estate is insolvent. ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) ' $ (If more space is needed, insert additional sheets of same size) 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 ,JAN 2 0 200 Phone (888) 5024349 F ax (302) 934-2955 January 16, 2004 Weigle & Associates, P.C. Attorneys At Law 126 East King Street Shippensburg, PA 17257-1397 Re: Estate of Karl W Rotz Social Security: 194-26-6821 Date of Death: December 1, 2003 Dear Sir or Madam: Per your inquiry dated December 28, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 97480088 Ownership (Names Karl W Rotz Pauline M Rotz Opening Date 01/28/80 Balance on Date of Death $1,887. 72 Accrued Interest $ 0.00 2. Type of Account Sm,ings Account Account Number 21000001217357 O,vnership (Names Karl W Rot-. Opening Date 03/28/83 Balance on Date of Death $5,558.88 Accrued Interest $ 2.84 Total For further account information, closures and/or reimbursement of fimds please call the King Street Office at #717-532-4132. Please be advised, there ~vas no safe deposit box found for the above decedent. Records Management LAST WiLL AND TESTAMENT I, KARL W. ROTZ, of 1003 Newburg Road, Shippensburg, Southampton Township, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved wife, PAULINE M. ROTZ, absolutely. THIRD. In the event my said wife should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate to my children and grandchildren, on a per stirpes distribution basis, as follows: A. B. C. ONE SHARE to my son, LARRY E. ROTZ, on a per stirpes basis. ONE SHARE to my daughter, BRENDA K. ROTZ, on a per stirpes basis. ONE SHARE to be divided equally between the children of my deceased son, TERRY L. ROTZ, as follows: 1. ONE THIRD OF ONE SHARE to my granddaughter, TAWNYA B. ROTZ, on a per stirpes basis. 2. ONE THIRD OF ONE SHARE to my granddaughter, LERISSA C. ROTZ, on a per stirpes basis. 3. ONE THIRD OF ONE SHARE to my grandson, MATTHEW K. ROTZ, on a per stirpes basis. (SE~) MARK, WEIGLE AND PERKINS --ATTORNEYS AT LAW -- 126 EAST KING STREET --SHIPPENSBURG, PA. 17257 FOURTH. In the event that any beneficiary of this my Last Will and Testament is under the age of eighteen (18) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise, DEBORAH ROTZ, of 150 Middle Spring Road, Shippensburg, Pennsylvania, AS GUARDIAN, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the age of eighteen (18) years, with the following powers in addition to those presently given by law: me The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiarY; Be The power to expend the principal, within the discretion of the said Guardian, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both~ undergraduate and graduate), trade, business or technical school education, of the said beneficiary; Ce The power to sell any and all real estate, within the discretion of the said Guardian; De The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of eighteen (18) years, without the necessity of a formal adjudication of the Guardian's account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; gj The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; Fe In the event the above-mentioned Guardian is unable to accept the Guardianship, I then name, constitute and appoint BRENDA K. ROTZ, of Chambersburg, Franklin County, Pennsylvania, as Guardian, with the same powers hereinbefore stated. FIFTH. I nominate, constitute and appoint my wife, PAULINE M. ROTZ, to be the - 2 - MARK, WEIGLE AND PERKINS --ATTORNEYS AT LAW -- 126 EAST KING STREET --SHIPPENSBURG, PA. 17257 Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint LARRY E. ROTZ and BRENDA K. ROTZ, or the survivor thereof, to be the Executors of this my Last Will and Testament. SIXTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, KARL W. ROTZ, have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this~ day of (SgAn) This instrument was by the Testator, KARL W. ROTZ, on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in his presence and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. - 3 - MARK, WEIGLE AND PERKINS --ATTORNEYS AT LAW -- 126 EAST KING STREET --SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : I, KARL W. ROTZ, the Testator whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by KAR~W. ROTZ, the Testator, this ~.~ay of~~~ , 7995. ~ fh-- \7 I II -4- MARK, WEIGLE AND PERKINS --ATTORNEYS AT LAW -- 126 EAST KING STREET --SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : the witnesses whose names are signed to the foregoing 'instrument, being duly qualified according to law, do depose and say that we were present and saw KARL W. ROTZ, Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before .me by i :.esses, -5- MARK, WEIGLE AND PERKINS --ATTORNEYS AT LAW -- 126 EAST KING STREET --SHIPPENSBURG, PA. 17257 REGISTER OF WILLS, CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 Name of Decedent: Karl W. Rotz Date of Death: 12/01/2003 Will No. 21-03-1046 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 x No__ Insolvent PA Inheritance Tax Return was filed and approved. 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 X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may b:ttached to this ~ ~o~t. Jerry A. We~gle, Esquire Name (Please type or prznt) WEIGLE & ASSOCIATES,~P.C. 126 East King Street Address Shippensburg, PA 17257 (717) 532-7388 Tel. No. Capacity: Personal Representative (MAH: tm f/AM3) X Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 180601 HARRISBURG, PA 17118-0601 COMNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15~7 EX AFP (01-03) KARL W · ~ APR 14 Ag:E;I JERRY A WEIGLE ESQ WEIGLE & ASSOCS 126 E KING ST C.?~ SHIPPENSBURG [~T~7257 DATE Oq-12-200q ESTATE OF ROTZ DATE OF DEATH 11-01-2005 FILE NUMBER 21 05-10q6 COUNTY CUMBERLAND ACN 101 f Amount Remitted CUT ALONG THIS LINE MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LOWER PORTION FOR YOUR RECORDS ~ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ROTZ KARL W FILE NO. 21 05-10q6 ACN 101 DATE Oq-12-ZOOq TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule [) (10) 11. Total Deductions 12. Net Value of Tax Return 5z581 .80 O0 O0 NOTE: To insure proper O0 credit to your account, O0 submit the upper portion 00 of this form with your tax payment. O0 13,077.7q (a) 5,581.80 .00 (11) 13.077.7q (lZ) 7,q95.9q- 13. lq. NOTE: ASSESSNENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Estate Subject to Tax (iq) If an assessment was issued previous/y, lines 14, 15 and/er 16, 17, .O0 7,q95.9q- 18 and 19 will reflect figures that include the total of ALL returns assessed to date. (15) .00 x O0 = .00 (16) .00 x Oq5 = .00 (17) . O0 x 12 : . O0 (18) .00 x 15 : .00 (19)= . O0 AMOUNT PA/D IF PAID AFTER DATE /NDZCATED, SEE REVERSE FOR CALCULATION OF ADD/TZONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR)) YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 12, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes et the lawful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, which wes not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-36Z-ZOSO~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, ar assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17118-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. IH0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of th* tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period es you would appeal the tax end interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19AZ will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~- 1991 111 .000301 1983 161 .000438 1992 97, .000147 1984 111 .000301 1993-1994 71 .000191 1985 131 .000356 1995-1998 9Z .000147 1986 101 .000174 1999 71 .000191 1987 IDZ .000174 ZOO0 71 .000191 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAZD Interest Daily Year Rate Factor ~ 9Z .000247 2002 6Z .000164 Z003 5Z .000137 2004 4Z .000110 X NUNBER OF DAYS DELINOUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculatlon to fifteen (15) days beyond tho date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.