HomeMy WebLinkAbout02-0240PETITION FOR PROBATE and GRANT... ,..., LETTERS
also known as
Deceased.
Social Security No. i Dt 7_. '-{ ~ - ~ '20 ¥~.o
To:
Register of Wills for the
County of 6'om/~'n ~.~_ t.~ r>
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(a~), who is/a.r.e 18 years of age or older an the executO&
in the last wilt of the above decedent, dated '/~C,6, o; t- i0 ~
and codicil(s) dated
in the
named
,19q~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~_d)~/OP-~ C. tg'~ County, Pennsylvania, with
last family orprincipal residence at ate,$ ff,o~,/NO c~cte
(list street, number and muncipality)
Decendent, then 7 ?~ years of age, died '~C(" ~:1~ ~'~-g/<. 9 , ~ ~.OO l,
at
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:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ i ~ ~L~ c~
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ qt7tp: Zt./b,, oo
situated as follows: r'rli, rl.~ ~g- z~(- o-? ~3 - ! g.~
r'~ -z'z> 2_ z- z y - a, 76;3' - ~' ~
WHEREFORE, petitioner(s) respectfully request(s) the Ityobate of the last will and codicil(s)
presented herewith and the grant of letters 7"~g' r-,~/~ ~-.'-w r,,~ ,,..~.'
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ]~ ss
COUNTY OF ~=cm~/~e/, t_8,~a U
The petitioner(s) above-narned 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 ~ '?'/.~-~,~q~/-//~;~-~ ~
before me this l st_ day of ~ '~ ~ - , ~ ~'
- /- / --7 ' Registe~t ~ ~
17'-O3-(a
No. 2]-02-240
Estate Of /--///c. ~b,a/ /_, {t,J~- ,~ t' 7__, , Dece~ed
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIL 4
the .reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ,/-fO~Z-' 0"7'- /d'~ //;/~ L7
described therein be admitted to probate and filed of record as the last will of //-'///
and Letters '/~ g 7-/q No (~.',~
are hereby granted to ~/C.//~OC/~_ ~ {-~t,2~ j~
2002, in consideration of the petition on
FEES
Probate, Letters, Etc .......... $ 340.00
Short Certificates( ) .......... $ 6.00
- a e.s. 6.00
:~uficmtxon ................ $. -
JCP $. 5.00
TOTAL ~ $. 357.00
Filed . A.P. RIL..4,. 200.2 ..................
~ ~e ~, ~.~ ~ss
PHONE
his is to certi6/that the information here given is correctly copied from an original certificate of death duly filed with me as
Local R.egistrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~qling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
~ '1 Local ~egi~rar
P 7 9 0 2 7 8 9
No. ~ Date
21-02-240
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Hilda L. Wertz ,.Female ,. 192 -- 14 -- 6346 ,.December 9_z 2001
~ s. 09/27/1923 . n.~ L]
South Middleton ,. Ckmlberland Crossings ,"~'~'~'~ m. White
D~CEDENT'S USUAL
KIND OF BUSINE SS¢~NDUSTR¥
903 Spring Circle
Mechanicsburg, PA. 17055
Chester R. Lyter
Michael T. Wertz
,,. Annie Feeser
I~,. 1612 'l~'ir~lle Road~ Carlisle, PA. 17013
r'--"",--' o,, i=.=-,----c-.,,--
~,,..December 14, 2001 J,,.. St John's Cemetery J,,,Mechanicsburq, PA. 17055
t~CE.SE.UUSE. .~U,E,*,,O,~S~OFr-~O.m, Mai zzi FuneralHome--
J ..... 0116~7-L J.~. 8 Martk~ei,P2a~,za ~ay, Mechanicsburq, PA 17055
I
~e~ ~ m 1~ ~~ ............................
~ I i~ 0 P'~ ..... ~"" ~ I I
stated .... ' ' . i ..................... LJ j
LL_L~,
Last Will
of
HILDA L. WERTZ
21-02-240
I, HILDA L. WERTZ, of Mechanicsburg, Cumberland County, Pennsylvania,
make this Will and revoke all of my prior wills and codicils.
Article One
My Family
I am not now married.
The names of my children are:
DENNIS C. WERTZ
MICHAEL T. WERTZ
JAN R. HATALLA
SANDRA K BARCLAY
All references to my children in my will are to these children, as well as any
children subsequently born to me, or legally adopted by me.
Page 1
Article Two
Distribution of My Property
Section 1. Pour-Over to My Living Trust
All of my property of whatever nature and kind, wherever situated, shall be
distributed to my revocable living trust. The name of my trust is:
HILDA L. WERTZ and MICHAEL T. WERTZ, Trustees,
or their successors in trust, under the HILDA L. WERTZ
FAMILY LIVING TRUST, dated August 10, 1998, and
any amendments thereto.
Section 2. Alternate Disposition
If my revocable living trust is not in effect at my death for any reason
whatsoever, then all of my property shall be disposed of under the terms of
my revocable living trust as if it were in full force and effect on the date of
my death.
Article Three
Powers of My Personal Representative
My personal representative shall have the power to perform all acts reasonably
necessary to administer my estate, as well as any powers set forth in the
statutes in the State of Pennsylvania relating to the powers of fiduciaries.
Page 2
Article Four
Payment of Expenses and Taxes
and Tax Elections
Section 1. Cooperating with the Trustee of My Living Trust
I direct my personal representative to consult with the Trustee of my revocable
living trust to determine whether any expense or tax shall be paid from my
trust or from my probate estate.
Section 2. Tax Elections
My personal representative, in its sole and absolute discretion, may exercise
any available elections with regard to any state or federal tax laws.
My personal representative shall not be liable to any person for decisions made
in good faith under this Section.
Section 3. Apportionment
All expenses and claims and all estate, inheritance, and death taxes, excluding
any generation-skipping transfer tax, resulting from my death and which are
incurred as a result of property passing under the terms of my revocable living
trust or through my probate estate shall be paid without apportionment and
without reimbursement from any person. However, expenses and claims, and
all estate, inheritance, and death taxes assessed with regard to property passing
outside of my revocable living trust or outside of my probate estate, but
included in my gross estate for federal estate tax purposes, shall be chargeable
against the persons receiving such property.
Page 3
Article Five
Appointment of My Personal Representative
I appoint MICHAEL T. WERTZ to be my personal representative.
If MICHAEL T. WERTZ cannot act, or is unwilling to act, I appoint
DENNIS C. WERTZ as my successor personal representative.
I direct that my personal representatives not be required to furnish bond,
surety, or other security.
I have initialed all of the pages of this Will, and have signed it on August 10,
1998.
HILDA L. WERTZ ~
The foregoing Will was, on the day and year written above, published and
declared by HILDA L. WERTZ in our presence to be her Will. We, in her
presence and at her request, and in the presence of each other, have attested
the same and have signed our names as attesting witnesses and have initialed
each page.
We declare that at the time of our attestation of this Will, HILDA L. WERTZ
was, according to our best knowledge and belief, of sound mind and memory
and under no undue duress or constraint.
Address:
Page 4
Address'
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
)
)
SS.
We, HILDA L. WERTZ, , and
the Testatrix and the witnesse~,
respectively, whose names are signed to the foregoing Will, having been
sworn, declared to the undersigned officer that the Testatrix, in the presence
of witnesses, signed the instrument as her last Will, that she signed, and that
each of the witnesses, in the presence of the Testatrix and in the presence of
each other, signed the Will as a witness.
HILDA L. WERTZ
WITNESS
Subscribed and sworn before me by HILDA L. WERTZ, the Testatrix, and
by and
, the witnesses, on August 10, 1998.
Notary Public
My commission expires:
Page 5
IN RE: ESTATE OF HILDA L. WERTZ,
Deceased
IN THE OFFICE OF THE REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-02- O~J-JFO
ORDER OF REGISTER
AND NOW, this q'Tt+ day of ---~/~1 L ., 2002, upon consideration of the Petition for
Probate of Lost Will, specifically including the photocopy of the proposed Will to be probated, the Affidavits
of Thomas J. Ahrens, Esquire, dated February 15, 2002, and Michael T. Wertz, dated February 14 and
March 7, 2002, together with Oaths of Subscribing Witnesses of Debra M. Lacy, dated January 23, 2002,
and Samuel S. Lindenberg, dated February 13, 2002, it is hereby ordered that the photocopy of the Last Will
and Testament of Hilda L. Wertz, dated August 10, 1998, shall be admitted to probate upon filing of a
Petition for Letters Testamentary by the named Executor and Administration of the Oath of Personal
Representatives to said Executor, and Letters Testamentary shall thereupon be granted to said Executor.
In light of the above-described Petition, together with the Affidavits and the Consents attached, a
hearing with respect to the Petition is waived.
MARy ~.~LE~/I~S
Register of Wills
21-02-240
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
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 the same and that signed as a witness at the
request of testat__ in h__ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
(Name)
(Address)
Register
(Name)
.~: , ~ ' ' (Address)
(~) a subscriber hereto, (each) being duly qualified according t% law, depos~s),and say(s) that
/~ familiar with the signature of .~/&3~ ~ ~~ ,
co~
testa~,~ of (one of the subscribing witnesses to) the ~}~[~ presented herewith and
codicil
that ~//c/4~ E c ~ ~Z ~ believes the signature on the will is in the handwriting of
to the best of ~??.-~ knowledge and belief.
Sworn to or %f~,r~ed and subscribed before
me this day of
fName~ i
(Address)
(Name)
(Address)
21-02-240
w,i i s
OATH OF SUBSCRIBING WITNESS.
(each) a subscribing witness to the
law, depose(s) and say(s) that
codicil
will presented herewith, (each) being duly qualified according to
present and saw
the testat. , sign the same and that signed as a witness at the
request of testat.__ in h__ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19
Register
(Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF ~ ~-~ COUNTY
TH OF NON-SUBSCRIBING WITNESS
(each} a subsc, riber hereto, (each) being duly qflglified according to law, depose(s) and say(s) that
'~'O'//,e /9 familiar with the signature of"/L//~ZV7 ~" /Y~r~Yr'7-- ,
codicil
testat__ of (one of the subscribing witnesses to) the ~'~presented herewith and
codicil
that ,D/-/~_ believes the signature on the will is in the handwriting of
to the best of .A,/E~ knowledge and belief.
to e,o e
me this ~ 1st ~ day of ~ , tmamo ~ , ~_ ,
', February~ ~2oo2 12ti C
~~~~ ~~~~Register (AddressJ
(Namej
(.4 ddress)
21-02-240
IN RE:
Estate of
Hilda L. Wertz
Deceased
iN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
PETITION FOR PROBATE OF LOST WILL
TO THE HONORABLE MARY C. LEWIS, REGISTER OF WILLS AND CLERK OF
ORPHANS' COURT:
Your Petitioner, Michael T. Wertz, respectfully represent that:
1. Your Petitioner is Michael T. Wertz, who resides at 1612 Trindle Road,
Carlisle, Pennsylvania. He is an adult individual and is named as Executor in the Last
Will and Testament ofHilda L. Wertz, which Last Will and Testament is dated
August 10, 1998 and was prepared in the law offices of Robert J. Kreidler, Esquire of
Harrisburg, Pennsylvania.
2. Hilda L. Wertz was born on September 27, 1923 and departed this life on
December 9, 2001, while living at 903 Spring Circle, Mechanicsburg, Cumberland
County, Pennsylvania. The said Hilda L. Wertz was widowed at the time of her death.
3. Hilda L. Wertz is survived by four adult children. They are: Dennis C.
Wertz, Michael T. Wertz, Jan R. Hatalla, and Sandra K. Barclay.
4. On August 10, 1998, in the law offices of Robert J. Kreidler, the decedent
executed her Last Will and Testament, which is a pour-over will, along with a
Revocable Living Trust. The original Trust and a copy of her will were placed in an
Estate Planning binder and given to the deceased.
5. The aforesaid will stated that the entirety of her property of whatever
nature and kind, wherever situated, shall be distributed to her revocable living trust.
6. Her trust, named HILDA L. WERTZ and MICHAEL T. WERTZ,
Trustees, or their successors in trust, under the HILDA L. WERTZ FAMILY
LIViNG TRUST, dated August 10, 1998, and any amendments thereto, is still in
force.
7. After the death ofHilda L. Wertz, a search for the original will was
performed by the 4 children of the deceased, and by Attorney David Haller of the
Law Offices of Robert J. Kreidler, and all of them were unable to find the original.
Petitioner believes and therefore avers that the aforesaid will attached hereto, as Exhibit
"A" was unrevoked and in full force and effect at the time of the decedents death.
Therefore, Petitioner respectfully requests that the copy of the Last Will and Testament of
Hilda L. Wertz dated August 10, 1998 and filed in the decedents Estate Planning binder
be accepted for probate as the Last Will and Testament ofHilda L. Wertz.
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF CUMBERLAND }
SS:
Personally appeared before me, a Notary Public, in and for said Commonwealth
and County, Michael T. Wertz, who being duly sworn according to law, deposes and says
that the facts set forth in the foregoing Petition are true and correct insofar as affiant has
personal knowledge thereof, and are otherwise true and correct according to his
information and belief.
Michael T. V~en~
Sworn to and subscribed before
me this ! ~ r'
day of ~"4{~,'~£-
A.D., 2002.
Notary Public '
My Commission Expires:
(SEAL)
Last Will
of
HILDA L. WERTZ
I, HILDA L. WERTZ, of Mechanicsburg, Cumberland County, Pennsylvania,
make this Will and revoke all of my prior wills and codicils.
Article One
My Family
I am not now married.
The names of my children are:
DENNIS C. WERTZ
MICHAEL T. WERTZ
JAN R. HATALLA
SANDRA K BARCLAY
Ail references to my children in my will are to these children, as well as any
children subsequently born to me, or legally adopted by me.
COPY
Page 1
Article Two
Distribution of My Property
Section 1. Pour-Over to My Living Trust
All of my property of whatever nature and kind, wherever situated, shall be
distributed to my revocable living trust. The name of my trust is:
HILDA L. WERTZ and MICHAEL T. WERTZ, Trustees,
or their successors in trust, under the HILDA L. WERTZ
FAMILY LIVING TRUST, dated August 10, 1998, and
any amendments thereto.
Section 2. Alternate Disposition
If my revocable living trust is not in effect at my death for any reason
whatsoever, then all of my property shall be disposed of under the terms of
my revocable living trust as if it were in full force and effect on the date of
my death.
Article Three
Powers of My Personal Representative
My personal representative shall have the power to perform all acts reasonably
necessary to administer my estate, as well as any powers set forth in the
statutes in the State of Pennsylvania relating to the powers of fiduciaries.
Page 2
Article Four
Payment of Expenses and Taxes
and Tax Elections
Section 1. Cooperating with the Trustee of My Living Trust
I direct my personal representative to consult with the Trustee of my revocable
living trust to determine whether any expense or tax shall be paid from my
trust or from my probate estate.
Section 2. Tax Elections
My personal representative, in its sole and absolute discretion, may exercise
any available elections with regard to any state or federal tax laws.
My personal representative shall not be liable to any persofl for decisions made
in good faith under this Section.
Section 3. Apportionment
All expenses and claims and all estate, inheritance, and death taxes, excluding
any generation-skipping transfer tax, resulting from my death and which are
incurred as a result of property passing under the terms of my revocable living
trust or through my probate estate shall be paid without apportionment and
without reimbursement from any person. However, expenses and claims, and
all estate, inheritance, and death taxes assessed with regard to property passing
outside of my revocable living trust or outside of my probate estate, but
included in my gross estate for federal estate tax purposes, shall be chargeable
against the persons receiving such property.
Page 3
Article Five
Appointment of My Personal Representative
I appoint MICHAEL T. WERTZ to be my personal representative.
If MICHAEL T. WERTZ cannot act, or is unwilling to act, I appoint
DENNIS C. WERTZ as my successor personal representative.
I direct that my personal representatives not be required to furnish bond,
surety, or other security.
I have initialed all of the pages of this Will, and have signed it on August 10,
1998.
HILDA L. WERTZ
The foregoing Will was, on the day and year written above, published and
declared by HILDA L. WERTZ in our presence to be her Will. We, in her
presence and at her request, and in the presence of each other, have attested
the same and have signed our names as attesting witnesses and have initialed
each page.
We declare that at the time of our attestation of this Will, HILDA L. WERTZ
was, according to our best knowledge and belief, of sound mind and memory
and under no undue duress or constraint.
'~~'~WITNESS [ '"'
Address:
Page 4
~¥V]'~NESS ' ~
Address:
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
We, HILDA L. WERTZ, , and_
, the Testatrix and the witnesses,
respectively, whose names are signed to the foregoing Will, having been
sworn, declared to the undersigned officer that the Testatrix, in the presence
of witnesses, signed the instrument as her last Will, that she signed, and that
each of the witnesses, in the presence of the Testatrix and in the presence of
each other, signed the Will as a witness.
HILDA L. WERTZ ~
WITNESS
Subscribed and sworn before me by HILDA L. WERTZ, the Testatrix, and
by and
, the witnesses, on August 10, 1998.
Notary Public
My commission expires:
Page 5
21-02-240
IN RE: Estate of
Hilda L. Wertz
Deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
AFFIDAVIT IN SUPPORT OF PETITION
BEFORE ME, the undersigned officer, personally appeared Michael T. Wertz
(DEPONENT), who, being duly sworn according to law, and intending to be legally
bound, depose and say that he has no knowledge that his mother ever received the
original will prepared by attorney Robert J. Kreidler on August 10, 1998.
That he is co-trustee with Hilda L. Wertz on the HILDA L. WERTZ FAM1LY
LIVING TRUST, dated August 10, 1998.
That he assumed the original Last Will and Testament of his mother, Hilda L.
Wertz was located in her Estate Planning Binder.
That the Estate Planning Binder ofHilda L. Wertz was given to Ahrens Law
Offices, P.C. for the purpose of administering the Estate ofHilda L. Wertz.
That he was informed by Ahrens Law Offices, P.C. that the Last Will and
Testament ofHilda L. Wertz located in her Estate Planning Binder was a copy of the
original.
That a search of the remaining property ofHilda L. Wertz was performed, and the
original will could not be located.
That at a meeting at Ahrens Law Offices, P.C., on January 28, 2002, attended by
the four (4) children ofHilda L. Wertz, an inquiry was made as to the whereabouts of
their mothers last will. None of the children were aware of the location of the original
will, or of their mother destroying the will prepared by attorney Robert Kreidler on
August 10, 1998.
That he has no knowledge of his mother, Hilda L. Wertz, destroying the original
will.
Sworn and subscribed before me, this 14th
I- NOT~ ~ I
/ MY OOMMt$~ION EXI'IRE~ MAY ~. 2oo5
/ -/' -l~lichael T.
day of February ,2002.
[ Notary bub~i-c
21-02-240
IN RE: Estate of
Hilda L. Wertz
Deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
AFFIDAVIT IN SUPPORT OF PETITION
BEFORE ME, the undersigned officer, personally appeared Thomas J. Ahrens
(DEPONENT), who, being duly sworn according to law, and intending to be legally
bound, depose and say that he is in possession of the original Living Trust prepared for
Hilda L. Wertz by Attorney Robert J. Kreidler on August 10, 1998.
That the Estate Planning Portfolio binder ofHilda L. Wertz contained the original
Living Trust document dated August 10, 1998.
That the Estate Planning Portfolio binder was supplied by the family ofHilda L.
Wertz to Ahrens Law Offices, P.C. for the purpose of administrating the estate of Hilda
L. Wertz.
That the Living Trust document contains the original signatures ofHilda L. Wertz
the trustmaker, and ofHilda L. Wertz and Michael T. Wertz, the Trustees.
That the signatures were notarized by Robert J. Kreidler.
That a copy of the Last Will and Testament ofHilda L. Wertz with blueback from
the office of Attorney Robert J. Kreidler was filed in the Estate Planning Binder.
That the copy of the Last Will and Testament ofHilda L. Wertz attached to the
"OATH OF SUBSCRIBING WITNESS" forms is the file copy from the law office of
Robert J. Kreidler, provided by Attorney David Haller.
Sworn and subscribed before me, this
Thom/s J. Ahrens, Esq.
/ $ day of ~~, 2002.
Notary Public
Notarial Seal
Patdcia A. Staub, Notary Public
Hampden Twp., Cumberland County
My Commission Expires May 2, 2005
Member, Pennsylvania Association of Notaries
21-02-240
IN RE: Estate of
Hilda L. Wertz
Deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
AFFIDAVIT IN SUPPORT OF PETITION
BEFORE ME, the undersigned officer, personally appeared Michael T. Wertz
(DEPONENT), who, being duly sworn according to law, and intending to be legally
bound, depose and say that to his knowledge neither he nor any of his family has ever
seen the original will and it is his belief that the original will was kept by Robert J.
Kreidler, Esquire, and that the Estate Planning package that comained an original
Revocable Living Trust, and copy of the Last Will were the only documents delivered to
the deceased, Hilda L. Wertz.
Sworn and subscribed before me, this 7th
day of March, 2002.
iv Notary Public
OATH OF SUBSCRIBING WITNESS
Estate of Hilda L. Wertz
also known as
, Deceased
No. 21-02-240
Samuel S. Lindenber~l
(each) a subscribing witness to the[~ codicil(s) I~ will(s) presented herewith, (each) duly qualified according to
law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and
that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence ar~) in the
presence of each other I~ in the presence of the other subscribing witness(es).
124 Woodland Dr.
Harrisbur~l PA 17110
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this I ~ ~'~ day of
N ?~'~rY Public
M~/Commission Expires: ~ - Z~ -
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE:
To be taken by officer authorized to administer oaths. Please have
present the original or copy of instrument(s) at time of notarization.
RW-2
OATH OF SUBSCRIBING WITNESS
Estate of Hilda L. Wertz
also known as
., Deceased
No. 21-02-240
Debra M. Leac¥
(each) a subscribing witness to thel~l codicil(s) I~1 will(s) presented herewith, (each) duly qualified according to
law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and
that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence an~ in the
presence of each other I~ in the presence of the other subscribing witness(es). , /
A_OL ( ig.
517 S. Juniata St 044
Lewistown,
(Address)
(Signature)
(Address)
Sworn to or affirmed ancl subscribed
before me this ,~ ~ l~/ day of
.., /.
Not--~ry Public
My Commission Expires:
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
RW-2
NOTE: To be taken by officer authorized to administer oaths. Please have
present the original or copy of instrument(s) at time of notarization.
Notarial Seal
Linda K. McCarl, Notary Public
Lewistown Boro, Mifflin County
My Commission Expires Sept. 21,2002
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDiViDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0OO931
WERTZ MICHAEL T
1612 TRINDLE ROAD
CARLISLE, PA 17013
ESTATE INFORMATION: SSN: 192-14-6346
=ILE NUMBER: 2102-0240
DECEDENT NAME: WERTZ HILDA
DATE OF PAYMENT: 03/06/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/09/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $28,100.00
I
TOTAL AMOUNT PAID:
$28,100.00
REMARKS: MICHAELTWERTZ
SEAL
CHECK# 118
INITIALS: VZ
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
JERRY R. DUFFLE
RICHARD X~'. STEXY,/ART
C. ROY WEIDNER, JR
EDMUND G. MYERS
DAVID xy,/. DELUCE
RALPH H. "X/RIGHT, IR.
DAVID I. LANZA
MARK C. DUFFIE
KEIRSTEN XY,/ALSH DAVIDSO~I
MICHAEL J. CASSIDY
ROBERT M. WALKER
LAW OFFICES
JOHNSON, DUFFLE, STEWART 8' WEIDNER
A Professional Corporation
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
W'EBSITE: www.j&sw.com
TELEPHONE 717-761-4540
FACSIMILE 717 - 761 - 3015
E-MAIL mail~jdsw.com
March 25, 2002
HOKACE A. IOHNSON
OF COUNSEL
WRITER'S EXT. NO. 24
E-MAIL rhw@jdsw.com
Vicki Zuna
Office of the Register of Wills
County of Cumberland
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Lost Will - Hilda L. Wertz
Dear Vicki:
Enclosed is an Order of the Register of Wills admitting a photocopy of the Last Will and
Testament of the above-named decedent to probate. We have reviewed the Petition for
Probate of Lost Will filed by Michael T. Wertz, together with the supporting Affidavits and Oaths
of Subscribing Witnesses, and are of the opinion that the presumption of revocation by physical
act does not arise, and the contents and due execution of the Will have been established.
Accordingly, the enclosed original and copies of the Order may be signed.
We are also enclosing the original Affidavits given by Michael L. Wertz and Thomas J.
Ahrens, Esquire and the original Oaths of the two subscribing witnesses, which should all be
placed in the file.
Very truly yours,
j O H N SOJ~k, D U F F I E.,SSE~'/~R..T-~ WEIDNER
Ralph ~, Wright, .
RHW:Iar:156220
Enclosures
IN RE: ESTATE OF HILDA L. WERTZ,
Deceased
· IN THE OFFICE OF THE REGISTER OF WILLS OF
· CUMBERLAND COUNTY, PENNSYLVANIA
ORDER OF REGISTER
AND NOW, this~ '-i-~ day of '/~)/'~/L-- , 2002, upon consideration of the Petition for
Probate of Lost Will, specifically including the photocopy of the proposed Will to be probated, the Affidavits
of Thomas J. Ahrens, Esquire, dated February 15, 2002, and Michael T. Wertz, dated February 14 and
March 7, 2002, together with Oaths of Subscribing Witnesses of Debra M. Lacy, dated January 23, 2002,
and Samuel S. Lindenberg, dated February 13, 2002, it is hereby ordered that the photocopy of the Last Will
and Testament of Hilda L. Wertz, dated August 10, 1998, shall be admitted to probate upon filing of a
Petition for Letters Testamentary by the named Executor and Administration of the Oath of Personal
Representatives to said Executor, and Letters Testamentary shall thereupon be granted to said Executor.
In light of the above-described Petition, together with the Affidavits and the Consents attached, a
hearing with respect to the Petition is waived.
MARY
Register of
CERTIFICATION OF NOTICE UNDER RULE $.a(a)
Name of Decedent: /-//,' 'D/q L.
Date of Death: [Z~ ?~ 2.~L) /
WillNo. 2(_.70~- t~g~t? Admin. No. 2/ - OZ - OL~'O
To the Register:
I certify that notice of (beneficial interest) ~smte administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~-~ ~c7~ .
Name Address
~,~ao.- 1:. Oac~-rz. /'&/z rk,,.,~ ~,,~ d,~.t/.~, P,~
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name
Telephone
Capacity:
Personal Representative
~Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 02 0240
COUNTYCODE YEAR NUMBER
OO
a.
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Wertz, Hilda L
12/09/2001 09/27/1923
~0F APPL~A~LE'~-SURVlVING SPOUSE'S NAME ( LAST. FIRST AND MIDDI~F iNi'r~AL)
SOCIAL SECURITY NUMBER
192-14-6346
THIS RETURN MUST BE FILED IN DUPLICATE W~TH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdor to 12-13-82)
[] 4. Limited Estate [] 4a Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required
12-12-82)
[] 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)
.... !2-3!;9~ and
NAME
Thomas J. Ahrens
FIRM NAME (If applicable)
Ahrens Law Offices, P.C.
TELEPHONE NUMBER
717/697-1800
COMPLETE MAILING ADDRESS
552! Carlisle Pike
Mechanicsburg, PA 17055
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)
442,000.00
204.36
None
None
46,707.41
None
170,556.07
28,020.77
8,041.85
(8)
659,467.84
(11) 36,062.62
12. Net Value of Estate (Line 8 minus Line 11) (12) 623,405.22
, ~.. ,.,ha, ,t=u,e and e',~ctic, n t~ tax, ,o,, ,,o, be~.,,
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 623,405.22
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
1§.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
623,405.22 x .045 (16) 28,053.23
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. []
x .12 (17)
x .15 (18)
(19)
28,053.23
: ;: >> BE SURE TO ~,SW~R ~ ~ES~ONS ~N REVERSE S DE AND RECHECK MA~H <<
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
REET ADDRESS 903 Spring Circle
STATE l ZIP
Mechanicsburg i PA / 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
28,100.00
1,402.66
Total Credits (A + B + C)
(1) 28,053.23
(2) 29,502.66
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 the OVERPAYMENT. (4) 1,449.43
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. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0o00
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 .................................................................................................................. [==J
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 retum, 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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
~IG~ATU~E OF PERSON RESPON~/F6R FILING RETURN
ADDRESS DATE
1612 Trindle Road ~'/o~ ~/DO~
Carlisle, PA 17013
ADDRESS DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
5521 Carlisle Pike
PA 17055 g' -g, 7- 0%--.
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 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 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
SCHEDULE A
REAL ESTATE
Wertz, Hilda L
ESTATE OF FILE NUMBER
21 - 02 - 0240
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which properly would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or se , both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule Fo
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
DEATH
1 310 Wertz Avenue/900 Spring Circle, Mechanicsburg, PA 17055, Duplex house on property with a tax 140,000.00
ID of 22-24-0783-126
2
901 & 900 Spring Circle, Mechanicsburg, PA, Duplex house on property with the tax ID of
22-24-0783-099
915 & 917 Spring Circle, Mechanicsburg, PA, Duplex house on property with the tax ID of
22-24-0783-093
TOTAL (Also enter on Line 1, Recapitulation)
160,000.00
142,000.00
442,000.00
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wertz, Hilda L 21 - 02 - 0240
All propert3t jointl¥-ownod with right of survivorship must bo dis¢lo$od on $¢hodulo F.
VALUE AT DATE OF
DEATH
ITEM
NUMBER
1
DESCRIPTION
Roadway Corporation Stock, account # 3004896339
UNIT VALUE
- '34.06
204.36
TOTAL (Also enter on line 2, Recapitulation)
204.36
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Hilda L
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONALPROPERTY
FILE NUMBER
2 ! - 02 - 0240
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
DESCRIPTION
ITEM
NUMBER
!
2
3
4
5
6
7
8
9
Waypoint Bank checking account # 1800025637, Hilda L. Wertz is owner
Long Term Care claim check
NB Liebman refund
Patriot News refund
Verizon refund
December rent checks
ELCA Charitable girl annuity dividend
Roadway stock dividend
Landlord insurance refund
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
1,183194
43,114.64
50.00
10.40
1.13
1,085.00
730.00
0.30
532.00
46,707.41
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Hilda L
SCHEDULE G
INTER-VIVOS TRANSFERS &
FILE NUMBER
21 - 02 - 0240
ITEM
NUMBER
This schedule must be completed and filed if the answer to any of questions 1 throu
DESCRIPTION OF PROPERTY
DATE OF DEATH
Include the name of the transferee, their relationship to decedent and the date of transfer,
Attach a copy of the deed for real estate. VALUE OF ASSET
New England Financial account # 4VB 121273, Hilda L.
Wertz Living Trust dated 8/10/98
Waypoint Bank account # 0100355320, Hilda L. Wertz
Living Trust account
169,116.36
1,439.71
Ih 4 on page 2
%OF
DECD'S EXCLUSION
IF APPLICABLE)
INTEREST
100%
100%
TOTAL (Also enter on line 7, Recapitulation)
,s yes.
TAXABLE VALUE
169,116.36
1,439.71
170,556.07
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Wertz, Hilda L
FILE NUMBER
21 - 02 - 0240
Debts of decedent must be reported on Schedule I.
DESCRIPTION
ITEM
NUMBER
A.
1
2
FUNERAL EXPENSES:
Malpezzi Funeral Home
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Add ress
City State Zip
Year(s) Commission paid
Attorney's Fees Ahrens Law Offices, P.C. -- Thomas J. Ahrens
Family Exemption: (if decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Add ress
City
Relationship of Claimant to Decedent
Probate Fees Cumberland County
State Zip
Accountant's Fees
Tax Return Preparer's Fees Padden, Guerrinn| & Assoc|atcs
Other Administrative Costs
Estate notices in The Sentinel, and the Cumberland Law Journal
Filing fee for PA Inheritance Tax Return
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
8,335.00
16,000.00
357.00
225.00
152.63
15.00
2,936.14
28,020.77
Schedule H
Funeral Expenses &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN Administrative Costs continued
RESIDENT DECEDENT
ESTATE OF
Wertz, Hilda L
FILE NUMBER
21 - 02 - 0240
Selling costs for 917 Spring Circle, Mechanicsburg, PA
Selling costs for 310 Wertz Avenue, Mechanicsburg, PA
Selling costs for 901/903 Spring Circle, Mechanicsburg, PA
Cost of maintaining 917 Spring Circle until date of sale
Cost of maintaining 901/903 Spring Circle until date of sale
Cost of maintaining 310 Wertz Avenue until date of sale
Page 2 of Schedule H
1,565.00
204.00
204.00
535.00
62.00
366.14
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Wertz, Hilda L 21 - 02 - 0240
Include unreimbursed medical expenses.
ITEM
NUMBER
4
5
6
7
8
9
10
11
12
13
14
DESCRIPTION
Chargeback and bank charge on bounced check deposited into Waypoint account # 01000355320 prior to
date o£ death
Knouse Concrete - rental property bill for work completed prior to DOD
Monroe Township sewer bills for rental property,
October 1 - December 9
Security deposits on rental properties - held in escrow
DBA Orthopaedic Institute
Andrews & Patel Medical Office
Pinnacle Health Hospital
West Shore EMS - ambulance
Apria Healthcare - oxveen
Cumberland Crossings - final nursing home bill
HealthSouth
Physicians Of Rehab
Quantum Imaging
Wilson St. Internal Medicine
TOTAL (Also enter on Line 10, Recapitulation)
AMOUNT
51%o
2,000.00
886.35
2,685.00
16.98
75.17
811.39
88.35
53.12
596.44
235.90
27.77
39.76
15.62
8,041.85
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Hilda L
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 - 02 - 0240
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
HILDA g. WERTZ FAMILY LIVING TRUST, dated August 10, 1998
1612 Trindle Road, Carlisle, PA 17013
RELATIONSHIP TO
DECEDENT
___ Do Not List Trunteei'.s)
Trust
AMOUNT OR SHARE
OF ESTATE
100%
II.
Enter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover sheet
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
/:7- '-/7 -
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DIV/SION
DEPT. Z80601
HARRISBURG, PA 17128-0601
CONHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHER/TANCE TAX
APPRAISEMENT) ALLOWANCE OR D/SALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'0;2 JUL-~)
THOMAS d AHRENS
AHRENS LAW OFFICES
55Z1 CARLISLE PIKE
MECHANICS8UR6 PA
REV-la4? EX AFP (DI-D2)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-08-2002
WERTZ
1Z-O9-ZO0!
21 02-0240
CUMBERLAND
101
Aaoun'1' Remit'Icad
HILDA
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF WERTZ HILDA F:ILE NO. 21 02-0240 ACN 101 DATE 07-08-2002
TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVAT:ION CONCERN:lNG FUTURE :INTEREST - SEE REVERSE
APPRA:ISED 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)
r~. Mortgages/Notes Receivable (Schedule D) (~)
$. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S)
6. Jointly O~ned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCT:IONS AND EXENPTZONS:
9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) (9)
10. Dabts/Hortgega Liabilities/Liens (Schedule [) (10)
11. Total Deductions
12. Nat Value of Tax Return
442~000.00
Z04.$6
.00
.00
~6~707.41
.00
NOTE: To insure proper
credit to your account,
subai~ the upper portion
of this form ~ith your
tax payment.
28,020.77
8,041.85
(11)
(z~) 623,405.ZZ
13.
lq.
NOTE:
ASSESSMENT OF TAX:
15. Amount of Line 1~ at Spousal rata
16. Amount of Line 1~ taxable at Lineal/Class A rate
17. Amount of Line 1~ at Sibling rate
18. Amount of Line 1~ taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYHENT RECEIPT D/SCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-)
O$-06-ZOOZ CDO009~! 1,40Z.66
(Is). .00 x O0 = .00
(z6) 625,405.22 x 045= 28,053.23
(17) .00 X 12 = .00
(~8). .00 x 15 = .00
(~9]= 28,053.2:5
AMOUNT PAID
Z8,100.00
TOTAL TAX CRED:IT
BALANCE OF TAX DUEJ
:INTEREST AND PEN.
TOTAL BUE
Charitable/governmental Bequests; Nonielected 911:5 Trusts (Schedule J) (13) .00
Nat Value of Estate Subject to Tax (lr+) 6Z$,405.ZZ
:i'l: an assessment was issued previously, Lines 14, 15 and/or 16, 17, 18 and 19
reflect ~igures that include the total of ALL returns assessed to date.
IF PAID AFTER DATE IND/CATED, SEE REVERSE
FOR CALCULATION OF ADDIT/ONAL INTEREST.
Z9,502.66
1,449.43CR I
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
170~556.07
(8) 659,467.84
BUREAU OF 'rND'rV'rDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMON~iEALTH OF PENNSYLVAN'rA
DEPARTMENT OF REVENUE
'rNHERZTANCE TAX
STATEHENT OF ACCOUNT
RE¥-IiB7 EX AFP (01-02)
THOMAS J AHRENS
AHRENS LAN OFFICES
5521 CARLISLE PIKE,',
MECHANICSBURG "PR17055
DATE 08-05-2002
ESTATE OF HERTZ
DATE OF DEATH 12-09-2001
FXLE NUMBER 210Z-OZqO
COUNTY CUHBERLAND
ACN 101
Aeoun~ Remitted
HILDA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, submit the upper port/on of this form with your tax payment.
CUT ALONG TH'rS LINE ~ RETA'rN LO#ER PORT?ON FOR YOUR RECORDS -~
REV-1607 EX AFP (01-0Z)
##~ INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF WERTZ HTLDA FILE NO. Z1 OZ-OZqO ACN 101 DATE 08-05-2002
TH'rS STATEMENT TS PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACH TN THE NAMED ESTATE. SHOIfN BELO#
TS A SUMMARY OF THE PRTNC*rpAL TAX DUE,, APPLTCATTON OF ALL PAYMENTS,, THE CURRENT BALANCE,, AND, 'rF APpLTCABLE,
A PROJECTED 'rNTEREST FTGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 07-01-2002
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
28,053.25
PAYMENT RECEIPT DZSCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
1,q02.66
05-06-Z002
07-16-2002
CD000951
REFUND
.00
28,100.00
1,qq9.q$-
ZF PAXD AFTER THXS DATE, SEE REVERSE
SIDE FOR CALCULATZON OF ADD/TZONAL XNTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQU/RED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT'
TOTAL TAX CREDIT
28,053.23
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THTS FORM FOR TNSTRUCTZONS. )
REGISTER OF WILLS OF CUMBERLAND COUNTY
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF Hilda L. Wertz
* NO. 2002-00240
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.: 2002-0240
Hilda L. Wertz
December 9, 2001
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:
Did the personal representative file a final account with the Court?
Yes No X
bo
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
Date:
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.
Signature
Thomas J. Ahrens, J.D.
Name (Please type or print)
5521 Carlisle Pike
Mechanicsburg, PA 17050
Address
(717)697-1800
Telephone No.
Capacity:
X
__ Personal Representative
__ Counsel for personal
Representative