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HomeMy WebLinkAbout03-0973Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of ROMA M. SNYDER Deceased Social Security No. 198-30-0246 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of the Decedent, dated MAY' ]4, 1954 and codicil(s) dated State relevant circumstances, e.g. renunciation, death of Executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in residence at CUMBERLAND County, Pennsylvania, with her last family or principal Manor Care, Borough of Camp Hill (List street, number and municipality) Decedent, then 88 years of age, died September 6, 2003 at Manor Care (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ..................................................................... $ (If not domiciled in PA) Personal property in Pennsylvania ..................................... $ (If not domiciled in PA) Personal property in County .................................................... $ Value of real estate in Pennsylvania ...................................................................................................................... $ Total ......................................................................................................... $ 90,000.00 None 90,000.00 Real Estate situated as follows: Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence ISUSAN K. SELLER 900 ACRI ROAD MECHANICSBURG, PA 17050 WILL OF ROlq~ M. SN~DER I, ROMA M. SI~¥DER, of the Borough of Lemoyne, Cumberland County, and State of Pennsylvania, declare this to be my last will and revoke and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give and bequeath the sum of One Thousand ($1,000) Dollars to each of the following of my grandchildren who are alive on the day of my death: LINDA RUTLEDGE, LESLIE BROWN, THOMAS RUTLEDGE, STEPHANIE SEILER, JEFFREY SEILER, MARTIN SNYDER, AMY SNYDER, LORRAINE SNYDER, PETER BEAM, and LESLEY BEAM. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate to such of my issue, per stirpes, as survive my death by sixty (60) days. ITEM IV. Should any person entitled to a share of my estate not have attained the age of twenty-three (23) years at the time for distribution to him or her, I devise and bequeath the share of such any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any person to my hereinafter named trustee, IN SEPARATE TRUSTS, to hold, manage, invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereon as my trustee thinks proper for the comfortable support, maintenance, health, welfare, and education of the person without regard to the person's parent's ability to provide such support or education, or to make payment for such purposes, without further responsibility, directly to such person or directly to such person's parent, or directly to any person taking care of such person. Any principal or income not so applied shall be ~distributed to such person when he or she attains the age of twenty- three (23) years, or if he or she dies prior thereto, to his or her personal representative. ITEM V. I appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY trustee of the trust or trusts created by this my last will. In addition to the other powers and authorities granted to my trustee by Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee the following special powers and authorities: A. To retain any or all of the assets of my estate, real or personal (including any stock or securities of any corporate fiduciaries), without any regard to any principle of diversification, risk, or productivity; B. To invest and re-invest in all forms of property without restriction to investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper, without regard to any principle of diversification, risk or productivity; C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my trustee deems proper and in the best interests of the beneficiary or beneficiaries of said trusts; D. To allocate receipts and expenses to principal or income or partly to each as my trustee from time to time deems proper in its sole discretion; E. To compromise any claim or controversy; F. To exercise any option, right, or privilege granted in insurance policies or in other investments; G. My trustee may accumulate the income from this trust during the term thereof but may, from time to time, distribute from current income or from accumulated income or from principal such amounts as my trustee, in its sole discretion, deems advisable for the education, welfare, and comfort of the trust beneficiary. ITEM VI. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary alienation. ITEM VII. I direct that my corporate fidicuaries shall receive compensation for the performance of its functions hereunder in accordance with its standard schedule of fees in effect from time to time during the period over which its services are performed. ITEM VIII. I appoint my daughter, SUSAN SEILER, executrix of this my last will. Should the said Susan Seiler predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my daughter, BARBARA BEAM, executrix of this my last will. I designate these daughters to serve as executrix of my will not because they are any more competent or loved than any of my other children, but because their service will be more convenient because they live in the area where my estate will have to be administered. ITEM IX. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand andseal this !~ ~ day of ~ , 1984. ROMA/~ S~I~D : 4 The preceding instrument, consisting of this and FOUR other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published and declared by ROMA M. SNYDER, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 5 COMMONWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing 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 acknow- ledged before me by the testatrix named above this /~*~ day of F'~7 , 1984 NotarsF Public lYNN K~ND£R, N0~am/Cublic Lemoyne, Cumberland Co., Pa. N~' Commission Expires Aug. 6, 1984 COMMONWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY OF CUMBERLAND ) WE, SAMUEL L. ANDES and GEORGE A. VAUGHN, III, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and acknowledged before me th /¥~day of ~.; , is 1984. otaryr Publ ~¢i~N ~I~D£~, ~o~rg ~ubll~ I.~moyneo Cumberland Co., ~¥ ~ommission Expire~ ^u§. 6, 1984 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed Before me this ,~1 ~ day of ,2003. SUSANd~EILER No. ,..~[- C)'~ Hq--'( .~ Estate of Social Security No: ROMA M. SNYDER , Deceased 198-30-0246 Date of Death: September 6, 2003 ANDNOW, ~O¥~r',~'~' c~4, ,2003, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate are hereby granted to SUSAN K. SELLER in the above estate and that the instrument(s) dated MAY 14, 1984 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. FEES Letters ........................... Short Certificate(s) Renunciation .............. Affidavit ( ) .................. Extra Pages (E} ....... Codicil ............................ JCP Fee ....................... Inventory ...................... Other .............................. TOTAL ......... $ I.D. No: 20558 Attorney: EDMUND G. MYERS Address: Johnson, Duffle, Stewart & Weidner, 301 Market Street, P.O. Box 109, Lemoyne, PA 17043- Telephone: 717-761-4540 ATTORNEYS AT LAW 5~5 I~OHTH T'W'EI, FTH STRIg]gT P. 0. BOX A-1O~ LEMOYNE~ PE~SY~VANIA 17043 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ROMA M. SNYDER Date of Death: September 6, 2003 Will No.: 21-03-00973 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-captioned estate on Barbara H. Beam Susan Seiler Any Haskell Chester H. Snyder Martin Snyder Name Address 5207 Meadowbrook Dr., Mechanicsburg, PA 17050 900 Acri Road, Mechanicsburg, PA 17050 2805 Live Oak Court, Cummings, GA 30041 7240 Glasgow Circle, Conway, SC 29527 4420 Grove Drive, Acworth, GA 30101 Jeffrey Seiler 610 Lee Place, Frederick, MD 21702 Thomas Rutledge 870 Crab Orchard Dr., Roswell, GA 30076 Mrs. Lesley Messer 2708 Beehnon Way, Raleigh, NC 27603 Dr. Linda Delbridge 572 Rockrose Court, Incline Village, NV 89451 Lori Curia 2213 Spring Fern Court, Apex, NC 27502 Mrs. Lesley Brown 2026 Woodcrest Dr., Winter Park, FL 32792 Peter Beam 5630 Major Way, Sacramento, CA 95841 Stephanie Hanlon 1266 Bridgewater Dr., West Chester, PA 19380 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Name Edmund (~. Myers Esq. Johnson, Duffie, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Capacity: X Personal Representative Counsel for personal representative OFFiCI,~L US~ ONL ~~ 0OMMONWE,LTHO~PENNS~,V,N,, INHERITANCE TAX RETURN :F2E"UM~;ER '"' DEPARTMENT OF REVENUE OE,~.~oo0~ RESIDENT DECEDENT 21 03 00973 HARR SBURG, PA i7128-0601 DEcEDENT'S NAME iEAsTi FIRST AND ~DDL~iN-mALi : COUNTY CODE YEA~R NUMBER _ . SOCIAL SECUR~Y NUMBE~ SNYDER, ROMA M. I DATE 0F DEATH(M~:DD:~EAR) ! DA:rE OF: BIR~'H (MM-DD:YEAR) Il 98-30-0246 09/06/2003 10/30/1914 i rNm RETURN MUST BE F~LED ~N DU.UCATE W~TH rile REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SoCiAl- sEcURITY NUMBER : [] i~ °riginalReturn [] 2. Supplemental Retur~ BI ~ Remainder Return (date of death priorto 12-13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) ................ 12-31-91 and 1-~ ~J EDMUND G. MYERS ~iRM NAM~ilfappli~_.able, 301 MARKET ST. JOHNSON, DUFFIE, STEWART & WEIDNER P.O. BOX 109 TELEPHONE NUMBER - i LEMOYNE, PA 17043-0109 717/761-4540 : 1. Real Estate (Schedule A) (1) (,. ~ ~,,k J~, ~ 4_, 2. Stocks and Bonds (Schedule B) (2) -, ,~'~o~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) Nor~'. 4. Mortgages & Notes Receivable (Schedule D) (4) ~o~'''¥'' c:~ : 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 92,767.0r.4) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 59,694. %8 [] Separate Billing Requested ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 70,455 (Schedule G or L) ' - 8. Total Gross Assets (total Lines 1-7) (8) 222,9]7.42 . 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 9,30 !. 75 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,563.35 tl. Total Deductions(total Lines 9 & 10) (11) ]0,865. ]0 12. Net Value of Estate(Line 8 minus Line 11) (12) 2 ] 2,052.32 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax(Line 12 minus Line 13) (14) 2 ] 2,052.32 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 212,052.32 x .045 (16) 9,542.35 17. Amount of Line 14 taxable at sibling rate (17) x .12 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 9,542.35 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) De'cedent's Complete Address: STREET ADDRESS Manor Care 1700 Market Street CITY Camp Hill ' STATE PA ZIP 1701 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) (1) 9,542.35 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is th~OVERPAYMENT. (4) 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 theTAX DUE. (5) 9,5 4 2.3 5 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 9,542,35 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 fe of either payments, benef ts or care'?. ........................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate cons derat on? ................................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ....... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benef c ary des gnat on?. ............................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of 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 preparer other than the personal representative is based on all informat on of which preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE OF~Rg-ON~ Mechanicsburg,, PA 17 050 ED/VJ~D~ G. MYERS P O BOX 109 ' - ~};! <,'~Oflc,/'-t'4'/~O"v'~ ............. L~'~0YNE, PA... 17043-0109 ,:~//~ (~.? For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. :}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exempta 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 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, ROMA M. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER . 21 - 03 - 00973 Include the proceeds of litigation and the date the proceeds were received by the estate~,ll property jointly-owned with the right of survivorsh,p must be disclosed on schedule F. ITEM NUMBER ! DESCRIPTION Waypoint Bank- Certificate of Deposii N0. 3134] ~7~ Date of death balance, plus accrued interest. Waypoint Bank - Certificate of Deposit No. 516019977 Date of death balance, plus accrued interest. Miscellaneous personal items at ManorCare TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 15,011.95 77,655.09 100.00 92,767.04 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY RELATIONSHIP TO DECEDENT Daughter ESTATE OF SNYDER, ROMA M. FILE NUMBER / 21 - 03 - 00973 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G, SURVIVING JOINT TENANT(S) NAME ADDRESS A Barbara H_Beam ~5207 MeadowbrookDr. Mechanicsburg, PA 17050 B Susan K. Seiler 900 Acri Road Daughter Mechanicsburg, PA 17050 JOINTLY OWNED PROPERTY: ~ ' ~ DESCRIPTION OF PROPERTY ITEM [ LETTER ' DATE Include name offinancial institution and bank account numberi DATE OF DEATH / D~cODF,S / DAIv~,LOL~EDc~FATH NUMBER.IFORTENANTJOINT, JOINTMADE lestatel°r similar .... identifying number.. Attach deed for jointly-held real VALUE OF ASSET :!INTI:I~I: qT/ .~ ,.,~CEDENT S INTEREST'-m , 1 A l 1/06/1996 ~ M&T Bank- Certificate of Deposit - ~0,~53.881 50% 25,126.94 No. 31003914495633 2 ~ B Date of death balance, plus accrued i interest. 02/02/1998: M&T Bank - Checking Account No. 47186623 ! Date of death balance, plus accrued interest. 69,135.67 50% 34,567.84 TOTAL (Also enter on line 6, Recapitulation) 59,694.78 ,,~ SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS& ,N,ER~TANCE TAX RE*URN MISC. NON'PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER SNYDER, ROMA M. 21 - 03 - 00973 lhis schedule must be completed and filed if tho answer to any of questio~ns 1 throu~gh 4 on page 2 is yes. ITEM : DESCRIPTION OF PROPERTY the date of transfer DATE OF DEATH % OF Include the name of the transferee, their relationship to decedent and NUMBER : Attach a copy of the deed for real estate. IVALUE OF ASSETi DECD'S EXCLUSION TAXABLE VALUE INTEREST i 0F APPLICABLE) I Southwestern Life Insurance Company ~i,993.357 - Annuity - Contract Number: 0006563580 Beneficiaries: Barbara Beam, Susan Seiler and Chester H. Snyder, daughters and son. Southwestern Life Insurance Company Annuity - Contract Number: 0006304600 Beneficiaries: Barbara Beam, Susan Seiler and Chester H. Snyder, Daughters and Son. 31,993.35 38,462.25 38,462.25 TOTAL (Also enter on line 7, Recapitulation) 70,455.60 COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H ' FUNERAL--S& ADMINISTRATNE COSTS ESTATE OF SNYDER, ROMA M. FILE NUMBER ! 21 - 03 - 00973 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 B. FUNERAL EXPENSES: Musselman Funeral Home Bixler's/Royer's Flowers - funeral flowers Trinity Lutheran Church - funeral service/funeral lunch Rolling Green Cemetery - cemetery charges Premier Catering - funeral lunch Barbara Beam - reimbursement for items purchased for funeral lunch. ADMINISTRATIVE COSTS: Personal Representative's Commissions Susan Seller, Executri-.~ '~ ""~' ~'~;~ ,: , of Personal Representative(s): · Street Address 900 Acri Road City Mechanicsburg, State PA Zip 17050 Year(s) Commission paid Attorney's Fees Johnson, Duffle, Stewart & Weidner Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Register of Wills - Cumberland County Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Joumal- legal advertisement The Patriot-News - legal advertisement Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 2,763.15 200.30 500.00 485.00 517.00 240.00 500.00 3,500.00 234.00 75.00 109.30 178.00 9,301.75 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SchedtleH AdminMmive Cosls conlinued SNYDER, ROMA M. i FILE NUMBER - 21 - 03 - 00973 Register of Wills - file Inventory & Inheritance Tax Remm 25.00 Reserve for close-out costs Register of Wills - short certificate 150.00 3.00 Page 2 of Schedule H .~ = SCHEDULE I ~ DEBTS OF DECEDENT, MORTGAGE OOMMONWEA'THOERENNSYLVAN,^ LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF : : :~ : :=~ :: : : ~ SNYDER, ROMA M. FILE NUMBER ~ 21 - 03 - 00973 Include unreimbursed medical expenses. ITEM NUMBER ! 2 4 7 i DESCRIPTION Neighborcare Pharmacy ~ decedent's account ManorCare - 9/1/2003 - 9/6/2003 - room charge East Pennsboro Ambulance Service - decedent's account balance Dr. H. S. Fineburg - balance of visit charges not covered by insurance Quantum Imaging - decedent's account balance not covered by insurance Mobile X-ray Imaging, Inc. - decedent's account balance not covered by insurance Milton S. Hershey Physician Group - balance not covered by insurance TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 74.24 1,127.75 82.50 112.91 1.78 73.33 90.84 1,563.35 REV,-1513 EX+ ~9-00) ,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, ROMA M. NUMBER I. ] i SCHEDULE J I BENEFICIARIES I FILE NUMBER 21 - 03 - 00973 RELATIONSHIP TO NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY i DECEDENT -- ~ D~h[ot List~'rustee(s) TAXABLE DISTRIBUTIONS (include outright spousal distributions) , Linda Rutledge Delbridge [ Granddaughter 572 Rockrose Court Incline Village, NV 89451 Lesley Rutledge Brown 2026 Woodcrest Dr. Winter Park, FL 32792 Thomas Rutledge 870 Crab Orchard Drive Roswell, GA 30076 Granddaughter Grandson 4 Stephanie Seiler Hanlon 1266 Bridgewater Dr. West Chester, PA 19380 Granddaughter AMOUNT OR SHARE OF ESTATE $1,000.00 cash bequest. $1,000.00 cash bequest. $1,000.00 cash bequest. $1,000.00 cash bequest. II. See Continuation Schedule(s) attached , Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she t NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT i BEING MADE :B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN i RESIDENT DECEDENT ESTATE OF SNYDER, ROMA M. FILE NUMBER 21 - 03 - 00973 NUMBER RELATIONSHIP TO ~ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT ! AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE i-~I~:'TDIDI ITIr~MO [include outright spousal distributions, and transfers u~d~r 7 .......... · -~-,',.~..~J,'~o Sec. 9116(a)(1.2)] Jeffi'ey Seiler Grandson : $1,000.00 cash 610 Lee Place ' bequest. Frederick, MD 21702 Martin Snyder 4420 Grove Drive Acworth, GA 30101 Amy Snyder Haskell 2805 Live Oak Court Cummings, GA 30041 Lorraine Snyder Curia 2213 Spring Fern Court Apex, NC 27502 Peter Beam 5630 Major Way Sacramento, CA 95841 Grandson Granddaughter Granddaughter Grandson $1,000.00 cash bequest. $1,000.00 cash bequest. $1,000.00 cash bequest. $1,000.00 cash bequest. 10 11 Lesley Beam Messer 2708 Beelmon Way Raleigh, NC 27603 Barbara H. Beam 5207 Meadowbrook Dr. Mechanicsburg, PA 17050 Grandson Daughter $1,000.00 cash bequest. One-fourth residue. 12 13 14 Susan Seiler 900 Acri Road Mechanisburg, PA 17050 Chester H. Snyder 7240 Glasgow Circle Conway, SC 29527 Children of deceased daughter Corinne May Snyder Johanos - deceased December 18,2001: Thomas Rutledge - 870 Crab Orchard Dr. Roswell, GA 30076 Daughter Grandson Grandson One-fourth residue. One-fourth residue. One-twelfth residue. Page 2 of Schedule J · ' SCHEDULE J COMMONWEALTHINHERITANCE OF TAX PENNSYLVANIA RETURN BENEFICIARIES continued RESIDENT DECEDENT L ESTATE OF SNYDER, ROMA M. FILE NUMBER . [ 21 - 03 - 00973 RELATIONSHIP TO NUMBER , NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT I DO Not List Trustee(s) [include 0utright spousai distributionS, and transfers under t TAXABLE DISTRIBUTIONS Sec. 9116(a)(1.2)] 16 gesley Rutledge Brown Granddaughter 2026 Woodcrest Drive Winter Park, FL 32792 17 Linda Rutledge Delbridge 572 Rockrose Court Incline Village, NV 89451 Granddaughter AMOUNT OR SHARE OF ESTATE One-twelfth residue· One-twelfth residue. Page 3 of Schedule J Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of SNYDER, ROMA M. also known as , Deceased No. 21-03-00973 Date of Death 9/6/2003 SocialSecurity No. 198-30-0246 Susan Seiler, Executrix The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unswom falsification to authorities. Attorney: I.D. No.: Personal Representative Susan Seiler, Executrix " 20558 Signature: Address: 301 MARKET ST. P. O. BOX 109 LEMOYNE, PA 17043-0109 Telephone: 717/761-4540 Personal Property Signature: Address: 900 Acri Road Mechanicsburg,, PA 17050 Telephone: (717) 732-5237 Dated: o'~_ j~_O Waypoint Bank - Certificate of Deposit No. 3134152746 Date of death balance, plus accrued interest. 15,011.95 Waypoint Bank - Certificate of Deposit No. 516019977 Date of death balance, plus accrued interest. 77,655.09 Miscellaneous personal items at ManorCare 100.00 Wt "oD p:Je!!oqul.qf3 Total Personal Property $92,767.04 (Attach additional sheets if necessary) Total Personal property and Real Estate $92,767.04 Ct. IMONWEALTH OF PENNSYLVANIA F ~ART~'IENT OF REVENUE ,.,OREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003594 MYERS EDMUND G 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043 ........ fold 'ESTATE INFORMATION: SSN: 198-30-0246 FILE NUMBER: 21 03-0973 DECEDENT NAME: SNYDER ROMA M DATE OF PAYMENT: 02/23/2004 POSTMARK DATE: 02/20/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $9,542.35 !REMARKS: · . CHECK//113 SEAL TOTAL AMOUNT PAID: 99,542.35 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRTSBURG, PA 17118-0601 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEMENT, ALLOHANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-I~I7 EX AFP ¢01-05) EDHUND G MYERS JOHNSON ETAL PO BOX 109 LEHOYNE A9:51 DATE 0r*-12-Z004 ESTATE OF SNYDER DATE OF DEATH 09-06-2003 FZLE NUHBER 21 03-0973 COUNTY CUHBERLAND ACN 101 Aeoun'lc Rem'i 'l:'tad ROMA HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS L/NE I1~ RETA'rN LONER PORTTON FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTZCE OF TNHERZTANCE TAX APPRA'rSEHENT, ALLONANCE OR DTSALLONANCE OF DEDUCT'rONS AND ASSESSHENT OF TAX ESTATE OF SNYDER ROHA HFZLE NO. 21 03-0973 ACN 101 DATE 0r*-11-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVAT'rON CONCERN'rNG FUTURE 'rNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rea/ Es~a*e (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) 3. Closely Held S~ock/Par~nershAp Zn~eres~ (Schedule C) (3) q. Mor~gegas/No~as Receivable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Jo/n~ly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) B. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Costs/MAsc. Expenses (Schedule H) (9) 10. Dab,s/Mortgage L/ab/IAi/es/Liens (Schedule I) (10) 11. To,al Deduc~/ons 12. Na~ Value of Tax Re~urn 9Z~767 Or, 59 z69r* 78 70zr.55.60 (8) O0 NOTE: To lnsure proper O0 cradA* ~o your accoun*, O0 subeA~ ~ha upper portion O0 of ~his form wASh your ~ax payment. 222,917. r*2 9,301.75 1,563.35 (11) ID .8(,5. ]§ (12) 212,052.32 15. NOTE: Cheri~able/govarnean*el Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0 Ne'l: Value of Es~a~e Sub~ec~: ~:o Tax (lq) 212,052.32 Tf an assessment was issued prev~.ously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. DISCOUNT {+J INTEREST/PEN PAZD (-) .0O (15) .00 x O0 = .00 (16) 212,052.32 X Or*5 = 9,5r.2.35 (17) .00 x 12 = .00 (lB) .00 x 15 = .00 (19)= 9,5r*2.35 AMOUNT PAID TOTAL TAX CREDZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ASSESSHENT OF TAX: 15. Amoun'~ of L/ne lq a~ Spousal ra~e 16. Aaoun~ of Line lq ~exabla a* Lineal/Class A ra~a 17. Amoun~ of LAne lq e~ Sibling ra~e 18. Aeoun~ of L/ne lq ~axabla a~ Collateral/Class B ra~e 19. PrincApal Tax Due TAX CREDTTS: PAYMENT ) RECETPT DATE NUMBER 02-20-200q CD00359r* IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 9,542.35 .00 .00 .00 ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REIIUZRED. 'rF TOTAL DUE TS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE REFUND. SEE REVERSE Si'DE OF THIS FORM FOR TNSTRUCTI'ONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1Z, 19BI -- 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 Commonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (TZ P.S. Section 91fi0). Detach the top port[on of this Notice and submit with your payment to the Register of Mills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications ara available at the Office of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z0`-hour answering service for forms ordering: 1-800-56Z-ZO50; services for taxpayers with special hearing and / or speaking needs: 1-800-0`0`7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloaance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA l?lZB-lOZ1, 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 Rev[aw Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated an 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 I, 1982 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000160`. All taxes which became delinquent an and after January 1, 198Z will bear interest et a rata 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 ZOO0` are: Interest Daily Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year Rate Factor 1982 20Z .00050`8 ~)'~%- 1991 llZ .000301 ~ 92 .00020`7 1985 16Z .0000,58 1992 9Z .00020`7 ZOOZ 67. .000160` 1980` 112 .000301 1993-1990` 72 .000192 2005 52 .000157 1965 13Z .000556 1995-1998 97. .00020`7 2000` 0`Z . go0110 1986 IOZ .000 Z70` 1999 77. . O 00192 1987 lOZ .000Z70` 2:000 7Z .OOglgZ --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ROMA M. SNYDER Date of Death: September 6, 2003 Will No.: 21-03-00973 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 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 The separate Orphans' Court No. (if any) for the personal representative's account is:. Did the personal representative state an account informally to the parties in interest? Yes X No 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. Signature Edmund G. Myers, Attorney Johnson, Duffle, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne, PA 17043-0109 Address ,(717) 761-4540 Telephone No. Capacity: Personal Representative X Counsel for Personal Representative