HomeMy WebLinkAbout02-0242PETITION FOR PROBATE and GRANT OF LETTERS
also known as To:
Deceased.
Social Security No. ~) ~- 0 '7 ~ ~:gt'O
21-02-242
Register of Wills for the
County of Ol, ttll ~ eO. k4t~r3
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), x~ ho is/are 18 years of age or older antthe executO rd
in the last wilt of the above decedent, dated }B~4,-/ 1'5
in the
named
,19 ~l
{state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~lxh~el~.k,~wO County, Pennsylvania, with
h ~ ~/oB; 1..; ~c~last fa~ily2g P R. t~c.-~°r l~rincipal resi~ncew/,., atl~oc,ltegz_ C~e~ m e-e.y 0 a~ 0 t
at
{list street, number and muncipality)
Decendent, then ~' ~ years of age, died ~="g~)d-~ll,. ~.c[ , l,~oo ;7._..,
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 $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
request(s) the probate, of the last will and codicil(s)
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALIH OF PENNSYLVANIA
COUNTY OF ~c~t ~eC_ka~ t) f
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,__an,d subscribed
,before me this _. ~'15~ ' __ day of
//~., .,t~.'~ ~.....~. /~.. ~.~,~x~. . _~ /
/- ~' f~,/--- 7 ' ' ~Regi~er
/ 7- "'/7- g
NO. 21-02-242
Estate Of T~EnMA U HOLLENBAUGH , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH7 :S~ 2002. 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 If/kY 13. 1981
described therein be admitted to probate and filed of record as the last will of
THELMA U HOLLENBAUGH ;
and Letters TESTAMENTARY
are hereby granted to RONALD L HOLLENBAUGH
FEES
Probate, Letters, Etc .......... $ 235.00
Short Certificates( ) .......... $ 15.00
6.OO
RXe-P ag.e S.
nuncaauon ................
JCP $ 5.00
TOTAL __ $ 261.00
Filed ..... .i~..R.C.B.. 7.,..2.Q Q .2 ...............
- ,~ - ! c-'? .... /' - -' /
/ R.R. stet of Wills
A'I-FORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8047103
No.
21-02-242
Loc~egist
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
,. ~elma V. Hollen~u
,", ~ -- u, -- ~o~u I' ~eDruary 2 , ~2
~ ,. ....... ~ ~ I
~ I~. ~ ~ ~. ~.-, wnl to
,,.. clerical ,,,.
b,. [,,. 12[ widow ,,.
16 Cre~ery Drive I~,u~
~iling Springs, PA 17~7
=~~ ~rnau ,,. Viola (unknot)
R .,,~-m.. .. -- . D~,.s~,~..c~.~.z~'
~~g..ollen=uKn '~,~',,~ ~ l~_gre~ery Drive. Boilino Sorin~. PA 17~7
~0 ~ ~,.0 C ..... ~ I.~,~.~ .... c,,~ I~,c~,..~
,~0 ~,~m OLFebruary 27, 2002 LGreenwo~ C~etery Mncaster, PA
~m //m/~.~/ 1,,. 014404-L I~encrai PA Cra. Sty., 3125 Walnut St., PA
LAST WILL AND TESTAMENT OF
THELMA V. HOLLENBAUGH
I, Thelma V. Hollenbaugh, of the Borough of Carlisle,
Cumberland County, Pennsylvania, declare this to be my Last Will
and Testament and revoke all Wills and Codicils previously made
by me.
ITEM I: I direct that all my just debts and funeral
expenses, including all expenses of my last illness, 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 bequeath any automobiles or motor vehicles
I may own at my death, my personal effects, household goods, and
other tangible personal property of like nature (not including
cash or securities), together with any existing insurance thereon,
to my son, Ronald L. Hollenbaugh. I direct that any of the fore-
going articles not selected by my said son shall be sold at public
or private sale by my personal respresentative(s), and I further
direct that the net proceeds thereof shall be administered and
distributed as a part of the residue of my estate.
ITEM III: I devise and bequeath the residue of my estate
of every nature and wherever situate to my son, Ronald L.
Hollenbaugh. Should my said son predecease me, I devise and
bequeath the residue of my estate to his issue, per stirpes,
surviving me.
ITEM IV: I appoint Dauphin Deposit Bank and Trust
Company, of Harrisburg, Pennsylvania, guardian of any property
which passes, either under this Will or otherwise, to a minor and
with respect to which I am authorized to appoint a guardian and
have not otherwise specifically done so, provided that this
~`r
aX>pointment of a guardian shall not supersede the right of any
fiduciary in its discretion to distribute a share where possible
to the minor or to another for the minor's benefit. Such guardian
shall have the power to use principal, as well as income, from
time to time for the minor's support, health and medical care,
and education (including college education, both undergraduate
and graduate), or to make payment for these purposes, without
further obligation or responsibility to see to the proper expendi-
ture thereof, directly to the minor or to the minor's parent or
to any person taking care of the minor.
ITEM V: All Federal, State and other death taxes payable
because of my death, with respect to the property forming my gross
estate for tax purposes, whether passing under this Will or other-
wise, including any interest or penalty imposed in connection with
such tax, shall be considered a part of the expense of the adminis-
tration of my estate and shall be paid out of the principal of
my residuary estate without apportionment or right of reimburse-
ment, provided that any or all claims, taxes and expenses in
connection with the settlement of my estate may be paid from the
assets of that certain Trust created by me with Dauphin Deposit
Bank and Trust Company, of Harrisburg, Pennsylvania, on April 22,
1981, including any alterations or amendments thereto, or any other
trust which may hereafter be substituted therefor, as provided
therein.
ITEM VI: I appoint my son, Ronald L. Hollenbaugh,
Executor of this my last Will. Should my said son fail. to qualify
or cease to act as Executor, I appoint Dauphin Deposit Bank and
'T'rust Company, of Harrisburg, Pennsylvania, Executor of this my
Last Will.
ITEM VII: I direct that all fiduciaries acting under
this Will, whether or not named herein, 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 and seal,
this /~3 `~' day of May, 1981 .
~;,,~~L~il~,.y~,., i" • :s~C'-C-~~,.~.c..G :z.cc-~y~~..,, (SEAL ]
J
The preceding instrument, consisting of this and two (2)
other typewritten pages, each identified by the signature of the
Testatrix, was on the date thereof, signed, published and declared
b,y Thelma V. Hollenbaugh, 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.
,~
,-,
~~
21-02-242
Register of Wills of Cumberland County
Oath of Non-Subscribing Witness
'~'(~ %~e ~3~ '[', k_) t~ tO d) LJ c,[:Subscriber hereto, being duly qualified
according to law, deposes and says that she is familiar with the signature of Thelma V.
Hollenbaugh, testatrix of the Last Will and Testament of Thelma V. Hollenbaugh,
executed May 13, 1981, and that she believes the signature on the will is in the
handwriting of Thelma V. Hollenbaugh to the best of her\knowledge and be
Sworn to and Subscribed before me this
ief.
Address
Address
ff--/~(-' day of ~
2002.
Register,6f Wil~? × ' y
Of Cumberland County
21-02-242
Register of Wills of Cumberland County
Oath of Subscribing Witness
John B. Fowler, a subscribing witness to the Last Will and Testament of Thelma
V. Hollenbaugh, executed May 13, 1981, being duly qualified according to law, deposes
and says that he was present, saw and heard the testatrix, Thelma V. Hollenbaugh, sign
and declare the same to be her last will and that he signed as a witness to the same at the
request of the testatrix in her presence and in the presence of the other subscribing
witness.
hn }~.-Fowl~r -
Address
Sworn to and Subscribed before me this 6th day of
2002.
Reg~sterJf Wills
Of Cumberland County
¢OMMONWEALIH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
COUNTY COOE YEAR NUMBER
I-
Z
14,1
LM
LIJ
14.1
I-
:Z
Z
o
n~
n,
o
(,3
o
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[-b~, ~ V.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR
02/25/2002 10/23/1919
SOCIAL SECURITY NUMBER
333-07-23t0 -
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[~1. Odginal Return
r-j4. Limited Estate
["-~ 6. Decedent Died Testate (^~c~ copy of willl
r--] 9. Litigation Proceeds Received
r--~ 2. Supplemental Return
[~4a. Future Interest Compromme (date of death after 12.12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of Trust)
[~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
r--] 3. Remainder Retum (date o1 death p~tor to 12-13,82)
[~]5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[~11, Election to tax under Sec, 9113(A) (Attach Sch O)
NAME
FIRM NAME (If/~oplk;able)
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
3O6 ~rflsor ?]ace
Mama-gie, PA 18062
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) (8)
[~ 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) ,~241,O~
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) $ 661.67
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
$ 9,971.55
$162,161.10
(8)
(11)
(12)
$ 172,132.65
$ 4~902.69
$167:220.°~
$167,229.96
i'--X3FFICIAL::I~ISE ONLY
!
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
$167,229.96
x .0_ (15)
x .04.5 (16)
x .12 (17)
x .15 (18)
(19)
20. []
$ 7,525.35
$ 7,525'35
$ 7,525.35
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
Decedent's Complete Address:
STREETADDRESS
STATE PA
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
$376.27
ZIP 17007
(1) $ 7,525.35
Total Credits (A + B + C ) (2) $376.27
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.
A. Enter the interest on the tax due.
(5) $ 7,149.0~
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $ 7;149.08
Make Check Payable to: REGISTER OF WILLS, AGENT
IF THE ANSWER
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; ............................................ [] []
d. retain a reversionary interest; or ..................................................................................................... : .................... [] []
d. receive the premise for life of either payments, benefits or care? ...................................................................... [] []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [] []
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 pemonal representative is based on all information of which preparer has any knowledge.
SIGNATUEE OF PERSON RESPONSIBLE FOR FILING RETURN,
ADDR~:S$ ~'~
16 (~ Road ~oilir~ S~r~
OF
P^ 17007
DATE
51712OO2
DATE
5/7/2002
308 ~ P]~e 18062
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 RS. §9116 (a) (1.1) (ii)].
The statute does not exemDt 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,
O
or a stepparent of the child is 0K [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 RS. §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. .
REV-1508 EX * 0-91 ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
/he]ma V. H011edzs3~ 2002-(D242
Include the proceeds of litigation and the date the proceeds were received by the estate. All propen'y jointly.owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2.
3.
4.
Pre.id Mneral Expenses -- Westmimter Ce~b~y
Blue (Zkoss/S%ield Pe6.rd
~ Refu~
(tmckirg A~o~t; AllFirst 435-7387-8
$2,645.00
337.35
490.75
6,498.45
TOTAL (Also enter on line 5, Recapitulation) $ 9,971_.55
(If more space is needed, insert additional sheets of the same size)
REV. 510 E.X * 0-97) ~
COMNIONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
~ v. P~l~a~m~b 2002-(D242
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
ITEM ~HCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER, DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OF THE DEED FOR REAL ESTATE.
NUMBER VALUE OF ASSET INTEREST
1. ~le Tcust M~0 Pcrmld Holl~ $162,161.10 100% $162,161.10
TOTAL (Also enter on line 7, Recapitulation) $ 162~161.10
(If more space is needed, insert additional sheets of the same size)
RE~/-1511 EX+ (12-99) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
/hel~8 V. Fb~l~
ITEM
NUMBER
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
5.
6.
7.
Debts of decedent must be reported on Schedule
DESCRIPTION
FUNERAL EXPENSES:
Erial
Restar~t hrr_hs~- ~ida
Fanily M~tir~
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
__ Zip
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
State__Zip
TOTAL (Also enter on line 9, Recapitulation
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$ 87.35
$ 75.oo
$ 4,241.02
$ 261.00
$ 275.00
R£V-1512 IiX * (1-97) ~~
COMMONWEALTH OF PENNSYLVANIA
INHERtrANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
2032~2
Include unreimbursed medical expenses.
ITEM
NUMBER
5.
(5.
DESCRIPTION
~ei~hbor Care ~y
Allfirst ~mk ~
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insed additional sheets of the same size)
AMOUNT
$ 661.67
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
II.
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outdghi spousal distributions)
RELATIONSHIP TO DECEDENT
DO Not List Trustee(s)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE~
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
AMOUNT OR SHARE
OF ESTATE
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
LAST WILL AND TESTAMENT OF
THELMA V. HOLLENBAUGH
I, Thelma V. Hollenbaugh, of the Borough of Carlisle,
Gumberland County, Pennsylvania, declare this to be my Last Will
and Testament and revoke all Wills and Codicils previously made
by me.
ITEM I: I direct that all my just debts and funeral
expenses, including all expenses of my last illness, 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 bequeath any automobiles or motor vehicles
I may own at my death, my personal effects, household goods, and
other tangible personal property of like nature (not including
cash or securities), together with any existing insurance thereon,
to my son, Ronald L. Hollenbaugh. I direct that any of the fore-
going articles not selected by my said son shall be sold at public
or private sale by my personal respresentative(s), and I further
direct that the net proceeds thereof shall be administered and
distributed as a part of the residue of my estate.
ITEM III: I devise and bequeath the residue of my estate
of every nature and wherever situate to my son, Ronald L.
Hollenbaugh. Should my said son predecease me, I devise and
bequeath the residue of my estate to his issue, per stirpes,
surviving me.
ITEM IV: I appoint Dauphin Deposit Bank and Trust
Company, of Harrisburg, Pennsylvania, Guardian of any property
which passes, either under this Will or otherwise, to a minor and
with respect to which I am authorized to appoint a guardian and
have not otherwise specifically done so, provided that this
appointment of a guardian shall not supersede the right of any
fiduciary in its discretion to distribute a share where possible
to the minor or to another for the minor's benefit. Such guardian
shall have the power to use principal, as well as income, from
time to time for the minor's support, health and medical care,
and education (including college education, both undergraduate
and graduate), or to make payment for these purposes, without
further obligation or responsibility to see to the proper expendi-
ture thereof, directly to the minor or to the minor's parent or
to any person taking care of the minor.
ITEM V: Ail Federal, State and other death taxes payable
because of my death, with respect to the property forming my gross
estate for tax purposes, whether passing under this Will or other-
wise, including any interest or penalty ~mposed in connection with
such tax, shall be considered a part of the expense of the adminis-
tration of my estate and shall be paid out of the principal of
my residuary estate without apportionment or right of reimburse-
ment, provided that any or all claims, taxes and expenses in
connection with the settlement of my estate may be paid from the
assets of that certain Trust created by me with Dauphin Deposit
Bank and Trust Company, of Harrisburg, Pennsylvania, on April 22,
1981, including'any alterations or amendments thereto, or any other
trust which may hereafter be substituted therefor, as provided
therein.
ITEM VI: I appoint my son, Ronald L. Hollenbaugh,
Executor of this my last Will. Should my said son fail to qualify
or cease to act as Executor, I appoint Dauphin Deposit Bank and
Trust Company, of Harrisburg, Pennsylvania, Executor of this my
last Will.
ITEM VII: I direct that all fiduciaries acting under
this Will, whether or not named herein, 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 and seal,
this /~ ~day of May, 1981.
The preceding instrument, consisting of this and two (2)
other typewritten pages, each identified by the signature of the
Testatrix, was on the date thereof, signed, published and declared
by Thelma V. Hollenbaugh, the Testatrix therein named, as and for
her last Will, in the presence of us, whq, at her request, in her
presence, and in the presence of each other, have subscribed our
names as witnesses hereto.
82/27/2882 15:01 7172498637 ALLFIRST 0ARL MAIN PAGE 03/09
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. ~ t~'. ,~.~t~¢~;;.~",~' ~ ..?~.',~ ::,,'~:,;. ~.. "~ ~.... :..~ ,'.,.~ "~.. ~.' ...~......'~:~.+~,.~ · ..~, .. .. ~.,.....~ . ~ ..,....
.... . ~".'.~'"'." .:"~"':' '~ :~."*'"r'.'..'~'; ',"'j' . · ~ · .... .. ',"..::'"~' ... , .~:.'
REVOCABLE TRUST 'AGREEmeNT
THIS REVOCABLE AGREEMENT OF TRUST, executed in duplicate
this 22nd day of April, 1981, between THELMA V. HOLL~'NBAUG~, of
113 Mlllside Drive, Carlisle, Pennsylvania ~7015, hereinafter called
the "Settlor", and DAUPHIN DEPOSIT BANK'AND TRUST COMPANY~ of 213
~arket Street, Harrisburg, Pennsylvania 17105, hereinafter called
the "Trustee'!, WITNESSETH: '
1. Trust Property. The Settlor does hereby assign, transfer
and deliver the property listed in the schedule(s) attached hereto
and made a part hereof, to have and to hold much property and any
otb'er property of any kind which the Trustee may. pursuamt to any
of the provisions hereof, at 'any time hereafter hold or acquire
(all of such property being hereinafter collectively referred to
as the "trust estate"), IN TRUST, for the uses and purposes and
upon the terms and conditions hereinafter set forth.
2. Dlspositive Provisions. The Trustee shall hold, manage,
invest and reinvest the trust estate, and shall collect and receive
the income therefrom and shall dispose of the net income and
principal as follows:
(a) During the lifetime of the Settlor, the Trustee shall
Day so much of the net income from the trust estate in convenient
installments to the Settlor, or otherwise, as she may from t~me
to time direct in writing, and the Trustee shall also pay to her
such part or all of the principal of the trust estate as she shall
'request in writin~ from time to time. If at any time the Settlor
is under a legal disability, or by reason of illness or mental or
physical disability is, in the opinion of the Trustee, unable
properly to manage her affaErs, the Trustee shall use so much of
the net income and such part or all of the principal of the trust
estate in Such manner as it deems necessary' o~ advisable iCom'time
to 'time fo~ the support, health and medical care, and maintenance
in reasonable comfort of the Settlor. Any income not SO paid Or
02/27/2882 1§:81 7172498637 ALLFIRST CARL MAIN PAGE
:,.," -' !',...-,..' ..... ~z'~. :'~..'.'.~! ~.~' ~,., ,~' ~.,~,,~ %,'.~.', ~ ..... .~,'~ :. ,~',.~:~ .~...j,'~.%~.~< '~;.,..~'~.~.~. ' ,. '.,,.' . .'..' "
,' .: . . " · ' . ' .' . . ' . ' .. . .'...'. '.':'.' .'..'.z~ '~::"?: '.?C::~' : i?¥,'"'.'":'.'.'~'"~,..~r'.~,'~-
expended shall be accumulated and added to the principal of the
trust estate.
(b) Upon the death of the Settlor, this Trust shall
terminate, and the then remaining principal and any accumulated
or undistributed income therefrom shall be paid over, .conveyed and
distributed, discharged of the truer, to the Settlor's son,
Ronald L. H011enbaugh, provided that if he shall, not be then living,
the same shall be paid over, conveyed and distributed, discharged
of the trust, to his then living issue, per stirpes.
5. Payments to ~ino~s. If any principal of the trust estate
shall become distributable to a minor, the Trustee may in its
absolute discretion either pay over such principal and any accumu-
lated or undistributed income therefrom at any time ~O the guardian
of the property of such minor, or reta~ the same for such minor,
IN S~PARATE TRUST, during his or her minority. In case of such
retention, the Trustee may use and apply so much of the net income
and prinoipal as it deems necessam¥ o~ advisable from time to time
for the support, health and medical care, and education (inCluding
college education, both undergraduate and graduate) of such mino~,
o~ may make payment for these purposes, without further obligation
or responsibility to see to the proper expenditure thereof, directly
to such minor or to such minor's parent or to any person taking
care of such minor.
&. Tax Provisions. Upon the death of the settlor, the Trustee
shall have the power to make such expenditures out of the trust
estate as the Truste~, in its sole discretion, shall consider
necessary or desirable in order to facilitate the settlement of
the Settlor's estate. ~n exercising such power, the Trustee ~ay
pay, in whole or in part, any or all of the following items: 'the
expenses of the Settlor's last illness a~d burial; her debts; her
-2-
02/2?/2002 l§:B1 ?172490637 ALLFIRST OARL MAIN PAGE 05/09
"-~%~...~%~7~'~?-~ ~'~. :.: .. ~..,~'.,.',,. ~..;- ~.,. .. -~..~.~...-~'~.~'~ . ... ..~.. .~.~ .., . .... ,~.. .,~_~.._~2.~.,:~ ~...~.~.~..~..'~.,,~~~~?~.?.'.:.A~z.~_.j. . ...~-~ ~.~.~*'.'.*.
income taxes; the Federal, State and other death taxes on any or
all property included in her gross estate for taxpurposes; and
all othe~ items in connection with the settlement of her estate.
Any such items may be paid directly by the Trustee or the funds
for their payment may be transferred by the Trustee to'the Settlor'$
personal representative(s), and neither such personal representa_'
tire(s) nor any beneficiary of the Settlor's estate shall be
required to reimburse the Trustee for any funds so paid or trans-
ferred.
5. Spendthrift Provision. No beneficial interest under this
Trust, whether in principal or income, shall be subject to antici-
pation, assignment, pledge, sale or transfer in any manner, nor
shall any beneficiary have the power to anticipate, .encumber or
charge such interest, nor shall such interest, while in the posses-
sion of the Trustee, be liable for or subject to the debts,
contracts, obligations, liabilities or torts of any beneficiary.
6. Trustee's Powers. The Trustee shall have the following
powers in addition to those v~sted in the Trustee by the common
law, by statute or by the other provisions hereof, all of which
shall be exercised in a fiduciary capacity, primarily in the
interests of the beneficiaries, applicable to ail property, includ-
ing property held for minors, whether principal or income, exercis-
able without court approval and effective until actual distribution
of all property:
(a) To retain and to hold any property received from
'Settlor or any person, including stock of the Trustee, without
regard to any principle cf diversification or risk.
(b) To invest and reinvest in all forms of property,
including stocks, bonds, funds and other securities, whether
operated by the Trustee or.others, without restriction to invest-
ments authorized for Pennsylvania. fiduciaries, as the Trustee shall
-5-
82/27/2002 15:01 7172498637 ALLFIRST CARL MAIN PAGE 0G/09
deem proper, without regard to any principle oF diversification
or risk.
(c) To sell at public or private sale or to exchange any
property, and to give options for sales or exchanges, for such
prices and upon such terms or conditions as the Trustee shall deem
proper.
(d) To hold property in the name 'of the trust estate, or
in the name of the Trustee without designation.of any fiduciary
capacity, or in the name of a nominee or unregistered.
(e) 'To a~locate receipts and expenses to'principal or
income or partly to each as the Trustee from time to time, in its
sole discretion, shall think proper.
(f) To vote in person or by proxy all securities belonging
to the trust estate, and to become a party to any stockholders,
agreements deemed advisable by the Trustee in connection with such
securities.
(g) To borrow money from any person or institution,
including the Trustee, upon the bond or promissory note of the
Trustee, and to secure the repayment thereof by mortgaging, creating
a security interest in, or pledging or otherwise encumbering any
Dart or all of the trust estate.
(h) To make any division or distribution required here-
under, wholly or in part, in kind or in cash; and to make non-
prorate distribution of assets in kind.
(i) To compromise any claim or controversy.
?. Additional Property: The Settlor or any person shall have
the right at any time and from time to time, with the consent of
the Trustee, to assign, transfer and deliver any other property
of.any kind to the Trustee, and such other property sh~ll be held,
administered' and disposed of by the Trustee in accordance with the
provisions of this Agreement without the execution of any further
-4-
02/27/2002 15:01 7172498637 ALLFIRST CARL MAIN PAGE 07/89
instrument or declaration.
8. Accoun~%ng ~ Trustee. The Trustee shall render to the
Settlor quarter-annually, o~ at such other intervals as the Settlor
and the Trustee ~ay from time to time agree, statements of aCcount.
showing in detail receiptS., disbursements' and dlstrfbut%ons of both
principal and %ncome of the t~ust estate, and all %nvestment trans-
actions.
9. GomDensatiOn of Trustee. The T~ustee' shall be entitled.
to receive as compensation for its services hereunder comm~ssions
at the rate of one-quarter of one percent per annum, computed
annually on the market value of all securities and'othe~ Property
held in the principal account of the trust estate, plus commissions
at the rate of four percent per annum, computed quarterly ~n the
gross income Of the trust estate, all of which commissions shall
be paid quarterly and charged to income. The Trustee shall also
be ~eimbursed for all necesssar¥ and reasonable expenses incurred
in the management and protection of ~he trust estate. There shall
be no further compensation due the ~rustee at the termination of
this T~ust.
10. Resignation of and Successor Trustee. The Trustee may
resign at any time upon w~tten notice given 'to the Settlor. A
successor trustee may be appointed by the Settlor during her life-
time, or, if she shall be incapable of making such aDp°intment,
by any court having jurisdiction over this Trust. Any successor
trustee thus appointed, or if the Trustee shall merge with or be
consolidated with another corporate fiduciary, such corporate'
fiduciary shall succeed to all of the duties and to all of the
powers, including discretionary powers, herein granted to the .
Trustee.
11. Power of Amendment and Revocation. The Settlor shall have
the right at any time and from time to time during her lifetime
-5-
02/27/2002 15:61 717249BG3,7 , ALLFIRST CAK% MAIN PAGE BB/09
~:.' ".','~,Q.'.." '. ,. '..': ".',. "..:..t -f r"~.~J"~.'"?h~ :."~ '~' ". t?'~," °'' "~".%~ -'~'.{ ~',.':,... "' ' '.,~., ~,,: ". .... ' ' ' ": .'. ..' ' ,
by instrument in w~iting delivered to the Trustee to alte~, amend
o~ revoke thi~ A~eement~ eithe~ tn whole o~ in part, p~ovided,
however, that if altered or'amended, the dgti~s, powers and
responsibilities of the T~ustee shall not be substantially changed
withou~ its consent. In cas~ of mevocation, the t~ust estate, o~
that pa~t thereof as to which this Agreement may be revoked, shall
be ~edelive~ed by the T~ustee to the Se~tlo~ o~ in accordance with
he~ written directions.
12. Situs. This T~ust is established and accepted by the
T~ustee under the law~ of'the Commonwealth of Pennsylvania, and
all questions concerning its validity, construction and administ~a-
tion shall be determined under such laws.
IN WITNESS WHEREOF, the Settlo~ has hereunto set her hand and
seal, and the Trustee has caused this Agreement to b~ executed by
its duly authorized officers and its corporate seal to'be hereunto
affixed, the day and year first above w~i'tten.
Thelma V. HollenbaughCJ
..[SEAL]
DAUPHIN D£POSIT BANK AND. TRUST COMPANY
02/27/2802 15:01 7172498637 ALLFIRsT I~ARL HATN PAGE 09/89
',,'f"i',,,.: ~',.. ,. '-. .... ':~ ' .... '' : '" "'" ..... ~ '" '"" "'~'"'"'"' "" ........ '
~,~,~'~...,,"~:i:':i'.~.;r~:. ~; . -', ".-"., ": ,. · ........ . , , ' , ' '~ · , ~ ' '" /', "~:'"""t. 77
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF.CUMBERLAND
On this, the 3~ day of May, 1981, before me, the under-
signed officer, personally appeared Thelma V. Hollenbaugh, known
to me (or satisfactorily proven) to be the person whose name is
subscribed to the foregoing T~ust AGreement, and a~knoW!edged that
she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
· ' ~N~ L ~R~;,~ P~I~
~rll$1~ Cum~rla~ Cocsn~ ~
C051MONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
On this, the ~-~ day of May, 1981, .before me, the under-
signed office~, personally appeared Thomas W. Walker, who acknowl-
edged himself to be a vice P~esident of Dauphin Deposit Bank and
Trust Company, and that he as such Vice P~esident, beinG authorized
to do ~o. executed the foregoing Trust Agreement for the purposes
therein contained by.signing the name of the corporation by
himself as Vice PPesident.
IN WITNeSs WHEREOF, I hereunto set my hand and official
seal.
Joseph T. Nanovic, Esquire 308 Windsor Place Macungie, PA 18062
Phone: 610-966-0621 Fax: 610-966-6266 email: jnanovic~msn.com
May 7, 2002
Mary C. Lewis
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Thelma V. Hollenbaugh, deceased
No: 2002-00242
Dear Ms. Lewis:
Enclosed for filing, please find the following:
1. Two copies of REV-1500, Inheritance Tax Retum for a Resident Decedent for
Thelma V. Hollenbaugh, deceased;
2. Two copies of the Last Will and Testament of Thelma V. Hollenbaugh
executed May 13, 1981;
3. Two copies of a Revocable Trust Agreement executed by Thelma V.
Hollenbaugh on April 22, 1981; and
4. The Estate of Thelma V. Hollenbaugh check number 109 in the amount of
$7,149.08, the sum due and payable for the Pennsylvania Inheritance Tax.
If you have any questions, please contact me by any of the numbers listed above.
,.~e~y truly yours,
~e~vic
mnc.
cc: R. Hollenbaugh
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HAIRRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001158
HOLLENBAUGH RONALD L
16 CREAMERY DRIVE
BOILING SPRINGS, PA 17007
........ fold
ESTATE INFORMATION: SSN: 203-07-2310
FILE NUMBER: 21 02-0242
DECEDENT NAME: HOLLENBAUGH THELMA U
DATE OF PAYMENT: 05/09/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/25/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $7,149.08
TOTAL AMOUNT PAID:
$7,149.08
REMARKS: RONALD LHOLLENBAUGH
SEAL
CHECK//109
INITIALS: CW
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Date of Death:
Will No. Admin. No. 20024X)242
To the Register:
I certify that notice of (beneficial interest) estate admm~straUon reqmred by Rule 5.6(a) of the Orphan Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 3/19/3302 :
Name Address
Ronald L. Poll~l~L'h 16 ~ ~ fi0ilirg S~r~s, PA 17007
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Sz
~::'~ N Josq:h T. Nsrmvic
Address 308 ~i_~ Place
Ymmrgie, PA 18(Yo2
Telephone ( 610 9(:6--062].
Capacity: Personal Representative
Counsel for personal representative
BUREAU OF ZNDZVZDUAL TAXES
ZNHE:RXTANCE TAX DIVTSION
DEPT. 280601
HARRXSBURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
"02 UUL-t
dOSEPH T NANOVZC ESQ
508 WZNDSOR PL
MACUNGZE PA ~.~062
DATE 06-24-2002
ESTATE OF HOLLENBAUGH
DATE OF DEATH 02-25-2002
FZLE NUHBER 21 02-0242
COUNTY CUHBERLAND
ACN 101
Amount
REV-1547 EX AFP (01-02)
THELHA U
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGTSTER OF WZLLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:3
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-0:~) NOTTCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF HOLLENBAUGH THELHA U F]:LE NO. 21 02-0242 ACN 101 DATE 06-24-2002
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVAT]:ON CONCERNZNG FUTURE /NTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORZ$ZNAL RETURN
1 Reel Estate (Schedule A)
E Stocks end Bonds (Schedule B)
3 Closely Held Stock/Partnership Znteras~ (Schedule C)
Nor~gagas/No~es Receivable (Schedule D)
$ Cash/Bank Deposi~s/N1sc. Personal Propar~y (Schedule E)
6 Joln~ly O~ned Propar~y (Schedule F)
7 Transfers (Schedule G)
8 To~el Assa~s
APPROVED DEDUCTZONS AND EXEHPTZONS:
9 Funeral Expenses/Ad.. Cos~s/Hisc. Expenses (Sch®dula H)
10 Dab~s/Nor~gega Liabilities/Liens (Schedule [)
11 Total Deductions
12 Nat Value of Tax Return
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
9z971.55
O0
162~161.10
(8)
4,241.02
(lO) 661.67
O0 NOTE: To insure proper
O0 credi~ ~o your account,
O0 submi~ ~ha upper pore/on
O0 of ~his form ~i~h your
tax payment.
NOTE:
172,1:32.65
(11) ~ .902.~9
(12) 167,229.96
Charitable/Governmental Bequests; Non-elec~ed 9113 Trusts (Schedule J) (13)
Nat Value of Es~e~a Subjec~ ~o Tax (14)
Zf an assessment ~as lssued previously, lines 1~, 15 and/or 16, 17,
reflect flgures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun~ of Line 14 et Spousal ra~e
16. Amoun~ of Line 14 taxable mt Lineal/Class A ra~e
17. Amoun~ of Line 14 et Sibling ra~a
18. Amoun~ of Line 14 ~exeble at Collateral/Class B ra~a
19. Principal Tax Due
TAX CREDZTS:
PAYmeNT RECEZPT DISCOUNT (+)
DATE NUNBER ZNTEREST/PEN PAID (-)
05-09-Z002 CD001158 :376.27
.00
167,229.96
1F PAID AFTER DATE ZNDICATED, SEE REVERSE
FOR CALCULATION OF ADDZTZONAL INTEREST.
18 and 19 #ill
(15) .00 X O0 = .00
(16) 167,229.96 x 045 = 7,525.:35
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= 7,525.35
AHOUNT PAZD
7,149.08
TOTAL TAX CREDZT J
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
7,525.:35
.00
.00
.00
( XF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
FIRST AND FINAL ACCOUNT OF
Ronald L. Hollenbaugh, Executor
For
ESTATE of Thelma V. Hollenbaugh, Deceased
Date of Death:
Date of Executor's Appointment:
First Complete Advertisement of
Grant of Letters:
Accounting for the Period:
Gross Estate:
February 25, 2002
March 4, 2002
March 19, 2002
February 25, 2002 to
August 28, 2003
$172,132.65 * See Notes.
Purpose of Account: Ronald L. Hollenbaugh, Executor, offers this account to acquaint
interested parties with the transactions that have occurred during his administration.
The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for additional
information or questions or objections can be discussed with:
Joseph T. Nanovic, Esquire
308 Windsor Place
Macungie, PA 18062
610-966-0621
Summary of Account
Page Current
Value
Fiduciary
Acquisition Value
Proposed Distribution to Beneficiaries
Principal
Receipts
Net Gain (or Loss) on Sales or Other
Disposition
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administration Expenses
Federal & State Taxes
Fees & Commissions
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
For Information:
Non-probate assets
Solvency of Estate
Income
Receipts
Less Disbursements
Balance before Distributions
Distributions to Beneficiaries
Income Balance on Hand
Combined Balance on Hand
5
3
4
4
4
4
4
5
5
5
4&5
5
5
5
5
5
5
$00.00
$12,223.33
$o0.oo
$661.67
$3,542.67
$8O5.35
$7,149.08
$00.00
$64.56 (-$2185.44)
$oo.o0
$64.56 (-2185.44)
$00.00
$00.00
$00.00
$oo.oo
$oo.oo
$64.56 (-2185.44)
-2-
Receipts of Principal
Assets Listed in Inventory
(Valued as of Date of Death)
Fiduciary Acquisition
Value
Cash:
Allfirst Bank - checking account
$ 6,498.45 $ 6,498.45
Prepaid Funeral Expenses -
Westminster Cemetery
$ 2,645.00
Total Inventory
$ 2,645.00
$ 9,143.45
· Note: Non-Probate Property in the form of a Revocable Trust FBO Ronald L.
Hollenbaugh totaled $162,161.10.
Receipts Subsequent to Inventory
(Valued When Received)
3/12/02 Capital Blue Cross Premium Refund $337.35
3/22/02 Allfirst interest 1.78
3/27/02 ManorCare Refund 490.75
$ 829.88
5/7/02
R.L. Hollenbaugh, Loan proceeds
for payment of inheritance tax and
other fees
Total Receipts of Principal
$ 2,250.00
$12,223.33
Gains and Losses on Sales or Other Dispositions
NONE
3/11/02
3/11/02
3/11/02
3/11/02
3/20/02
Disbursements of Principal
Debts of Decedent
CVS Pharmacy,
prescriptions $ 459.95
West Shore Ambulance,
services 63.00
NeighborCare,
prescriptions 56.72
Healthdrive Dental Group
Dental Services 75.00
Allfirst, check order 7.00
661.67
-3-
9/7/1999
3/11/02
4/20/02
4/20/02
4/20/02
4/27/02
Funeral Expenses
Westminster Cemetery,
Prepaid items
Westminster Cemetery,
Saturday Burial; certs.
Wayne Noss Flowers
Giant Market, food at home
Bon Ton, gift for speaker
Sunnyside Restaurant,
funeral luncheon
$ 2,645.00
160.00
50.88
212.12
24.99
449.68
$ 3,542.67
3/11/02
3/11/02
4/4/02
4/4/02
8/28/03
Administrative Expenses
R.L. Hollenbaugh, 261.00
reimbursement, probate fees
Greenawalt & Co., tax services 275.00
The Sentinel, Adv. Of Letters 87.35
Cumberland Law Joumal,
Adv. Of Letters 75.00
Clerk of Orphans' Court
Account fees
107.00
$ 698.35
$ lO7.00
5/7/2002
Federal and State Taxes
Pennsylvania Inheritance
Taxes $ 7,149.08
$ 7,149.08
Fees and Commissions
NONE
Total Disbursements of Principal
$12,158.77
Balance before Distribution
Ronald L. Hollenbaugh, sole beneficiary of the Estate, lent the Estate, as noted
hereinabove, the sum of $2250. After payment of all taxes and other bills, except for
repayment of the loan, there is a balance of $64.56. The Estate will return that sum to
Mr. Hollenbaugh. The Estate is insolvent with an outstanding debt to Mr. Hollenbaugh
in the amount of $2,185.44.
-4-
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
Note. Ronald L. Hollenbaugh is the sole beneficiary of the Estate. Non-probate property
in the form of a revocable trust FBO Ronald L. Hollenbaugh totaled $162,161.10.
The Estate became insolvent upon the payment of the Pennsylvania State Inheritance
Tax; the Estate borrowed $2,250.00 from Ronald L. Hollenbaugh to complete the
payment of said taxes.
Therefore them was no Distribution of Principal to the sole beneficiary of the Estate --
Ronald L. Hollenbaugh.
Principal Balance on Hand
The Estate is insolvent. There is a balance orS 64.56 in the Estate consisting of the
remainder of the funds borrowed from Ronald L. Hollenbaugh.
Information Schedules: Income
There are no information schedules regarding income. There was no income. All
transactions of this Estate are as listed above.
Proposed Distribution to Beneficiaries
Note. Of the funds borrowed from Ronald L. Hollenbaugh, there is a remainder of
$ 64.56 in the Estate checking account. That remainder will be returned/distributed to the
Estate's sole beneficiary, Ronald L. Hollenbaugh in partial repayment of the loan. The
Estate has a negative balance of-$2185.44.
RONALD L. HOLLENBAUGH, Executor under the Last Will and Testament of
Thelma V. Hollenbaugh, deceased, hereby declares under penalties of perjury that he
has fully and faithfully discharged the duties of his office; that the foregoing First and
Final Account is true and correct and fully discloses all significant transactions occurring
during the accounting period; that all known claims against the Estate have been paid in
full; that the first complete advertisement of the grant of letters was more than four
months from the date the account was filed; that, to his knowledge, there are no claims
now outstanding against the Estate; and that all taxes presently due from the estate have
been paid. He understands that false statements herein are made subject to the penalties
of 18 Pa. C.S.A. 4904 relating to unswom falsification to authorities.
RONALD L. HOLL-ENBAUGH~utor
-5-
FLRST A~D FTN4L ~ ~
Rmald L. P~llmbm~Sb' Exe~u~
For
t~TA~E of 2~_lrra V. Poller~zmgh, ~
~ T. b~qovic, ~re
~rdsor P]~e
PaCU~e, pA 18/:2
STATUS REPORT UNDER RULE 6.12
Name of Decedent: l]'~]ma V. Poll~ha ~a
Date of Death: Fakruary 25, 2002
_ Admin. No.: 2002-(D242
Will No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Kules, 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 No F']
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
Date: 2/15/06.
If the _answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yesxx No [~]
b. The separate Orphan~' Court No. (if any) for the personal representative's
accotmt is: _~-00242
c. Did the personal representative state an account informally to the parties
in interest? Yes ~ No [-] Provi_ckq formal accamt and 10/14/2003 hzca~t
c. Copies of receipts, releases, joinders and approval of fonnal or
informal accounts may be filed with the Clerk of the. Orph_an~' Court
and may be attached to ·
Nme
.qZZla 6t 83:1
308 Wirdsor Place
IvL~__ ~ie; PA 1R~?
Address
610-9ffo-(Y~l
Telephone No.
Capacity:
[-'] Personal Representative
~-] Counsel for personal representative