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Home My WebLink About04-0519PETITION FOR PROBATE and GRANT OF LETTERS of' Elma E. Bohner Estate also known as Deceased. Social Security No. 169-34-948'0 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ors in the last will of the above decedent, dated June 18, 2003 and codicil(s) dated None To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 100 Mount Allan Driva.. Mechanicsburg, Pennsylvania 17055. (list street, number and muncipality) Decendent, then 98 years of age, died May 18, 2004 , , 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: Messiah Village, Upper Allen Township, Cumberland County Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 300 ~ 000.00 (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 {testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Pamela Ramsey 1752 Olmsted Way Camp Hill, PA 17011 Joseph D. Kerwin, Esq. 4245 Route 209 Elizabethville~ PA 17023 OATH OF-PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF 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 agxihtruly administej~he estate according to law. b~eSw°rn t° °r affirmed and subscribed '"/~/~,~lme this ~x-~e</ -J~eegisterday of [[ ' Estate Of Elma E. Bohner , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NO~~-/'~'-~ ,,1~ ~C~., in consideration of the petition on the reverse side,/h/ereof, satisfactory proof havi~/fe.n, presented before me, IT IS DECREED that the instrument(s) datedX--~d-~~-'~/'o? ~-'~ described therein be admitted to probate and fil/t~'/of record as the last will of and Letters -7~-~7--,'9-.Zz2~-~-,'97-,a-~' c/ FEES Probate, Letters, Etc .......... $¢~-.~'r'?-o"T9 Short Certificates( ) .......... $ at~Sn ................ $ $ TOTAL ~ Filed ~.~ .... ~~ ........... Joseph D. Kerw±n, Esq. #52658 ATTORNEY (Sup. Ct. I.D. No.) 4265 Route 209, El±zabethv-ille, PA 17023 ADDRESS (717) 362-3215 PHONE He,islet Wills Cou W, Pe s¥1¥8 i8 OATH OF SUBSCRIBING WITNESS Estate of Elma E. Bohner also known as Deceased Terrence J. Kerwin (each) a subscribing witness to the [] codicil(s) []will(s) presented herewith, (each) being duly qualified according to law deposes and says that they were present and saw the above Testatrix sign the same and that they signed as a witness at the request of Testatrix in her presence and [2 in the presence of each other [] in the presence of the other subscribing witness(es). Terrence J. Ker~ Millersburg, PA 17061 Sworn to or affirmed and subscribed before me this 2nd day of June, 2004 My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) Form RW-2 (Dauphin County - Rev, 9/92) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Tina L. Lloyd, Notary Public Washington Twp., Dauphin County My Commission Expires Sept. 13, 2005 Member, Pennsylvania Association of Notades NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of Instrument(s) at time of notarization. Register of Wills of Cumberland County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estateof ~'-~-f)'~ fi--. bO/'//f/~ Also known as , Deceased (each) a subscribing witness to the __codicil(s) \/will(s) presented herewith, (each) being duly qualified according to the law deposes and says that they were present and saw the above Testatrix sign the same and that they signed as a witness a the request of Testatrix in her presence and .__~in the presence of each other__ the other subscribing witness(es). Sworn to or affirmed and subscribed before me this day of _./ ,tt~ ,20 'Register /~,~ /yL~/~'c~,,i Signature/~~~ in the presence of hJ~, i~; to certify that the information here given is correctly copied fi'om an original certificate of dealh duly l.ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permm~cm ![1 :~i_' WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 Local Regisu'ar COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH -- I ~' I --'~-- ~'~" GREGORy M. KERWIN T£RRENCE J. KERWlN JOSEPH D. KERWIN HOLLY MCCLURE KERWlN aTtORNEYS At LAW LAST WILL AND TESTAMENT OF ELMA E. BOHNER I, ELMA E. BOHNER, currently of 355 South Sporting Hill Road, Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Co-Executors to pay all my legally enforceable debts, funeral expenses, administration expenses, and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. SECOND: I give, devise and bequeath all of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death in equal shares as follows: One-Ninth (1/9) of my estate shall pass to KERMIT BOHNER of Pillow, Pennsylvania. In the event KERMIT BOHNER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this,-iay Last W~I~, and Testament. C_ One-Ninth (1/9) of my estate shall pass to QUENTIN C. WEAVER of 405 Drew Street, Swarthmore, Pennsylvania. In the event QUENTIN C. Page 1 of 4 Pages (SEAL) ELMA E. BOItNER GREGORY M, KERW~N TERRENCE J. KERW~N JOSEPH D. KERWIN HOLLY McCLuF~E KERW~N ATTORNEYS aT LaW WEAVER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to JOANNE WEAVER of 5600 Moreland Court, Mechanicsburg, Pennsylvania. In the event JOANNE WEAVER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to SUZANNE WEAVER of 39 Broomall Lane, Glen Mills, Pennsylvania. In the event SUZANNE WEAVER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to PAMELA RAMSEY of 505 Ninth Street, New Cumberland, Pennsylvania. In the event PAMELA RAMSEY predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to MARSHALL DEAN of 410 Mumper Lane, Dillsburg, Pennsylvania. In the event MARSHALL DEAN predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. Page 2 of 4 Pages ~ ,~ ..... (SEAL) ELMA E. BOHNER One-Ninth (1/9) of my estate shall pass to RALPH SItADLE of Elizabethville, Pennsylvania. In the event RALPH SI-lADLE predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to DALE ERDMAN of 930 South 31st Street, Camp Hill, Pennsylvania. In the event DALE ERDMAN predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to LaRUE SNYDER of 2008 Lincoln Street, Camp Hill, Pennsylvania. In the event LaRUE SNYDER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. THIRD: I nominate, constitute and appoint my niece, PAMELA RAMSEY, and JOSEPH D. KERWlN, as Co-Executors of this, my Last Will and Testament, authorizing and empowering them to sell and convey any and all real estate of which I may die seized and possessed. Page 3 of 4 Pages ELMA E. BOHNER (SEAL) GREGORY m. KERWIN TERRENCE J. KERWIN JOSEPH D. KERWIN HOLLY MCCLURE KERWIN A'['TORNEY$ AT LAW GREGORY M. KERWIN TERRENCE J. KERWIN JOSEPH D. KERWIN HOLLY MCCLURE KERWIN ATTORNEYS AT law I further direct that my Co-Executors or personal representative shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF, I, ELMA E. BOHNER, have hereunto set my hand and seal, to this my Last Will and Testament, this 18th day of June, 2003. SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, ELMA E. BOI-INER, as and for her Last Will and Testament, in the presence of us, who at her request and in the presence of each other, have ~,~nto set our names as f, Page 4 D:~JDK~TLL~WlLL'~BOHNER. EEB ELMA E. BOI-INER (SEAJ.) CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Elma E. Bohner Date of Death: May 18, 2004 Estate Proceedings No.: 2004-00519 To the Register: I certify that notice of estate 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 June 22, 2004. Mr. Kermit Bohner P.O. Box 91 Pillow, PA 17080 Mr. Quentin C. Weaver 535 Gradyville Road, V103 Newtown Square, PA 19073 Mr. Ralph Shadle P.O. Box 566 Elizabethville, PA 17023 Ms. Joanne Weaver 5600 Moreland Court Mechanicsburg, PA 17055 Ms. Suzanne Weaver 39 Broomall Lane Glen Mills, PA 19342 Mr. Dale Erdman 930 South 31st Street Camp Hill, PA 17011 Ms. Pamela Ramsey Mr. Marshall Dean Ms. LaRue Snyder 1754 Olmsted Way 410 Mumper Lane 2008 Lincoln Street Camp Hill, PA 17011 Dillsburg, PA 17019 Camp Hill, PA 17011 t t4o under Rule 5.6(a) except: NONE Notice has now been given to all persons entitled Date: June 22~ 2004 ! Signature: D. KERWIN, ESQUIRE Address: 4~45 Route 209 ~' ~lizabethville, PA 17023 -~ Telephone': (717) 362-3215 Capacity: ~ X Personal Representative X Counsel for Personal Representative COMMON~cJ~.TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 21 2004 00519 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Bohner, Elma E. .~ 169-34-9480 m DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) o THIS RETURN MUST eE FILED IN DUPLICATE WITH THE ,9. 05/18/2004 03/08/1906 ~ REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [] 1, Original Return [] 2 Supplemental Return ] 3. Remainder Return (date of death pdor to 12-13-82) ] [] 4a. Compromise (da · o death after Estate [] 6. DecedentDiedTestate(Attachcopy [] 7. DecedentMaintainedaLivingTmst(Atta¢h [] g. Litigation Proceeds Received Joseph D Kerwin IRM NAME (If applicable) Kerwin & Kerwin ELEPHONENUMBER 717/362-3215 copy of Trust) [] 10. Spousal Poverty Credit (date of fleath between 12-31-91 and 1-14t51 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) [] 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes [] 1 1.Election to tax under Sec. 9113(A) (Attach Sch O) .~OMPLETE MAILING ADDRESS 4245 Route 209 Elizabethville, PA 17023-9765 (1) O ne~.r N 0 (2) 61,771.92!; (3) Non? (4) None' (5) 305,346.6 l~! (6) None (7) None (9) 41,837.74 (10) 19,132.09 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) (8) 367,118.53 (11) 60,969.83 (12) 306, 148.70 (13) (14) 306,148.70 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 1&Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) x .00 (15) 16.Amount of Line 14 taxable at lineal rate x .045 (16) 17.Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 306,148.70 19. Tax Due 20, [-I ' · " ' ' '' ,e · · -., x .12 (17) x .15 (18) (19) 45,922.31 45,922.31 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1800 EX (Rev. 6-00) ~ecedent's Complete Address: ISTREET ADDRESS 355 South Sporting Hill Road CITY Mechanicsburg I STATE PA IZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penaltyif applicable D. Interest E. Penalty (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) (4) 4. IfLine2isgreaterthanLinel+Line3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5E) Make Check Payable to: REGISTER OF WILL$, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; .................................................................................. r'-I b. retain the fight to designate who shall use the property transferred or its income; .................................... c. retain a reversionary interest; or ....................................... . ...... d. receive the promise for life of either payments, benefits or care? .............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... [] 45,922.31 0.00 0.00 45,922.31 45,922.31 BLOCKS No 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 prepedy 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. UnOer penalties of peljury, I declare that I have examined this return, including accompanying scheUules and statements, al~0 to the best of my knOwledge and belie[ it is tree, correct and complete DocfamUon of Pa~ DATE SIGN,[TURI Josep~ For date: surviv{n ~ouse is 3% [72 P.S. §9118 (a) ('1. t) (i)]. For dates of death on or after January 1, 1905, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 0% I72 P.S. §91 '18 (a) (1.'1) (ii)l. lhe statute does not exempt a transfer to s 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 alter 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)1. 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. Ramse-v /~ I ~'~ t/ 752 Olmsted Way ~ ~. ~ CampHill, PA 17011 ~ ~THERTHANRERRESENTATIVE ADDRESS ~J4z~ab~o~)~t?]?o~0~P~' 17023 ?F'7, J 4245 Route 209 / J~ ~IIe, PA 17023-9765 of er 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 SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERffANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bohner, Elma E. FILE NUMBER 21 -2004-00519 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE 0 DEATH 1 U.S. Savings Bonds - see attached list 17,771.20 2 Vanguard Wellington Fund 29.25 20,738.25 3 PPL Corp 46.82 14,046.00 4 PPL Corp 46.81 ~ 9,216.47 TOTAL (Also enter on line 2, Recapitulation) 61,771.92 SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY C O MMONV~FCAI.TH OF PENNSY[.VAJ~IA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bohner, Elma E. FILE NUMBER 21 -2004- 00519 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. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 2 3 4 5 6 Certificate of Deposit No. 1112351626 at Community Banks Certificate of Deposit No. 1245796931 at Community Banks Certificate of Deposit No. 301072354 at Mid Penn Bank Certificate of Deposit No. 302071523 at Mid Penn Bank Account No. 5080073711 at PNC Bank Account No. 5003648825 at PNC Bank 49,780.63 44,724.65 49,312.69 38,543.48 26,531.89 96,453.27 TOTAL (Also enter on Line 5, Recapitulation) 305,346.61 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADIVINISIRATNE COSTS ESTATE OF Bohner, Elma E. FILE NUMBER 21 -2004- 00519 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. l 2 FUNERAL EXPENSES: Hoover Funeral Homes, Inc. ADMINISTRATIVE COSTS: Personal Representative's Commissions Pamela Ramsey Joseph D. Kerwin, Esq. Social Secudty Number(s) / EIN Number of Personal Representative(s): Street Address ]752 Olmsted Way City CampHill State PA Zip 17011 Year(s) Commission paid Attorney's Fees Kerwin & Kerwin Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Register of Wills State Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Notary fees Register of Wills - Short Certificates Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 4,678.00 18,355.93 18,355.93 304.00 10.00 9.00 124.88 41,837.74 ~t~dul~ H Funsal ~ & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bohner, Elma E. FILE NUMBER 21 -2004- 00519 Cumberland Law Journal - Advertisement of Estate Upper Dauphin Sentinel - Advertisement of Estate U.S. Postmaster - certified mail 75.00 45.00 4.88 Page 2 of Schedule H SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVAJqlA INHERITAJ~JCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bohner, Elms E. FILE NUMBER 21 -2004-00519 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 Messiah Village - nursing home care Pa. Department of Revenue Pharmerica Verizon PNC Bank - check printing fee Pamela Ramsey, Power of Attorney fees 9,020.00 11.00 545.29 7.00 48.80 9,500.00 TOTAL (Also enter on Line 10, Recapitulation) 19,132.09 SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES ESTATE OF Bohner, Elma E. FILE NUMBER 21 -2004- 00519 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Kermit Bohner, P.O. Box 91, Pillow, PA 17080 1/9th of estate 2 Quentin C. Weaver, 535 Gradyville Road, V103, Newtown Square, PA 1/9th of estate 19073 3 Joanne Weaver, 5600 Moreland Court, Mechanicsburg, PA 17055 l/9th of estate 4 Suzanne Weaver, 39 Broomall Lane, Glen Mills, PA 19342 1/9th of estate 5 Pamela Ramsey, 1752 Olmsted Way, Camp Hill, PA 170ll l/9th of estate 6 Marshall Dean, 410 Mumper Lane, Dillsburg, PA 17019 1/9th of estate 7 Ralph Shadle, P.O. Box 566, Elizabethville, PA 17023 l/9th of estate See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet ~[o NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DiSTRiBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET SCHEDULE J BENEFICIARIES continued RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT AMOUNT OR SHARE ~ Net List Trustee(s) OF ESTATE [include outdght spousal distributions, and transfers under 1. ['AY, ABLE DISTRIBUTIONS Sec. 9116(a)(1.2)] 8 Dale Erdman, 930 South 31st Street, Camp Hill, PA 17011 l/9th of estate 9 LaRue Snyder, 2008 Lincoln Street, Camp Hill, PA 17011 1/gth of estate COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bohncr, Elma E. FILE NUMBER 21 -2004-00519 Page 2 of Schedule J LAST WILL AND TESTAMENT OF ELMA E. BOHNER I, ELMA E. BOIINER, currently of 355 South Sporting Hill Road, Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Co-Executors to pay all my legally enforceable debts, funeral expenses, administration expenses, and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient a~er my decease. iS.F~ZD]~: I give, devise and bequeath all of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death in equal shares as follows: Page i of 4 Pages A. One-Ninth (1/9) of my estate shall pass to KERMIT BOHNER of Pillow, Pennsylvania. In the event KERMIT BOHNER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this,Jify'Last W,..ilt and Testament. B. One-Ninth (1/9) of my estate shall pass to QUENTIN C. WEAVER of 405 Drew Street, Swarthmore, Pennsylvania. In the event QUENTIN C. _. (SEAL) ELMA E. BOHNER ~VEAVER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shalI pass to JOANNE WEAVER of 5600 Moreland Court, Mechanicsburg, Pennsylvania. In the event JOANNE WEAVER predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to SUZANNE WEAVER of 39 Broomall Lane, Glen Mills, Pennsylvania. In the event SUZANNE WEAVER predeceases me, I direct that his sham of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to PAMELA RAMSEY of 505 Ninth Street, New Cumberland, Pennsylvania. In the event PAMELA RAMSEY predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to MARSI~IALL DEAN of 410 Mumper Lane, Dillsburg, Pennsylvania. In the event MARSHALL DEAN predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. Page 2 of 4 Pages ELMA E. BOHNER (SEAL) One-Ninth (1/9) of my estate shall pass to RALPH S~LE of Elizabethville, Pennsylvania. In the event RALPH SHADLE predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to DALE ERDMAN of 930 South 31st Street, Camp Hill, Pennsylvania. In the event DALE ERDMAN predeceases me, I direct that his share of my estate shall pass in equal shares to those beneficiaries who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. One-Ninth (1/9) of my estate shall pass to LaRUE SNYDER of 2008 Lincoln Street, Camp Hill, Pennsylvania. In the event LaRUE SNYDER predeceases me, I direct that his share of my estate shall pass in equaI shares to those beneficiar/es who survive me in this numbered Paragraph SECOND of this, my Last Will and Testament. TEIIR1).: I nominate, constitute and appoint my niece, PAMELA RAMSEY, and JOSEPH D. KERWlN, as Co-Executors of this, my Last Will and Testament, authorizing and empowering them to sell and convey any and all real estate of which I may die seized and >ossessed. Page 3 of 4 Pages ELMA E. BOHNER (SEAL) I further direct that my Co-Executors or personal representative shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF, I, EL1VIA E. BOHNER, have hereunto set my hand and seal, to this my Last Will and Testament, this 18th day of June, 2003. SIGNED, SEALED, PUBLISHED : and DECLARED by the above- : named Testatrix, ELMA E. : BOHNER, as and for her : Last Will and Testament, in : the presence of us, who at : her request and in the : presence of each other, have : Page 4 of 4 P~ ELMA E. BOHNER (SEAL) Banks ACCOUNT NUMBER{S) TYPE OF ACCOUNT DATE OPENED PRINCIPAL BALANCE ACCRUED INTEREST TILL DATE OF DEATH BALANCE AT DATE OF DEATH MATURITY DATE ACCOUNT OWNERSHIP NAMES OF JOINT OWNER- SHIP,IF ANY DATE JOINT OWNER- SHIP WAS ESTABLISHED ADDITIONAL INFOPJ4ATION INTEREST PJ~TE SIGNATURE DATE P.O. Box 350 . Millersburg, PA 17061 · Phone 1-800-331-8362 Mo~gage Center: (717) 69D2133 Trust Division: (717) 692-2133 4098 Derry Street Harrisburg PA 17111 (717) 558-2144 2615 N. Front Street Harrisburg PA 17110 (717) 233-7380 4622 Carlisle Pike ~hanicsburg PA ~7050 (717) 761-2480 001 Petem Mtn. Road Dauphin PA 17018 (717) 921-8899 Other Offices: Road, PO Box 205 OaJmatia PA 17017 (570) 758-2721 2 E Main Street zabethville PA 17023 (717) 362-8147 550 Main Street Lykens PA 17048 (717) 453-7185 545 E Grand Avenue fower Cfty PA 17980 (717) 647-2157 7-9 E Main Street Tremont PA 17981 (570) 695-3358 MID PENN www. midpennbank, com June 24, 2004 Kerwin & Kerwin 4245 Route 209 Elizabethville, PA. 17023 Attention: Joseph D. Kerwin Re: Estate ofElma E. Bohner Date of Death: May 18, 2004 SSN: 169-34-9480 Dear Mr. Ker~vin: In response to your recent letter requesting information on the accounts of Elma E. Bohner, we have researched our files and enclosed is the necessary data: Account#: 301072354 - Certificate of Deposit Original Issue Date: April 17, 1989 Maturity Date: April 17, 2007 Account Name: Elma E. Bohner Balance DOD: $49,213.88 Balance Accrued Interest DOD: $98.81 Total DOD Balance: $49,312.69 Joint Ownership Name: N/A Account #: 302071523 - Certificate of Deposit Original Issue Date: January 16, 1990 Maturity Date: January 16, 2005 Account Name: Elma E. Bohner Balance DOD: $37,870.61 Balance Accrued Interest DOD: $672.87 Total DOD Balance: $38,543.48 Joint Ownership Name: N/A If you have any questions, please call me at 717-692-2133 ~:,;' ",'~[~ ~: Sincerely, ; ~7.- ,: - ' Beverly S. Hand ember FDIC Since 1868 PNCBAN September 9, 2004 Joseph D. Kerwin 4245 Route 209 Elizabeth, PA 17023 Estate of EIma E. Bohner, deceased SSN: ] 69-34-9480 DOD: $/15/2004 Dear Mr. Kcrwin: In response to your request for Date of Death balances for tile customer noted above, our records show the following: Checking Account Account #$080073711 Established 09/09/1993 ELMA E BOHNER DOD balance: $26,$28.87 + $0.00 accrued interest Savings Account Account #5003645825 Established 06/19/2001 ELMA E BOHNER DOD balance: $96,413,76 + $6.32 accrued latexes! Please note that tl~s office only provides daw of death balances for deposi~ accounts (IRA$. CD$, Checking and Savings accounts), We do not process/ny fil~a~cial transaeflolts OF provide statements. If you need essis~nee with any of these items, please call I-$88-PNC-BA_~-K (1-858-762=2265) or ~op by your local PNC Bank branch or'rice. Sincerely, Rachelle Well~ 1-800-762-1775 PT-PFSC-0~-F 500 f'~t Ave. PittebuTgh PA 15219 Member FDIC TOTAL P.Oi KERWIN & KERW]N ATTORNEYS AT LAW 4245 ROUTE 2O9 ELIZABETHVILLE, PA 17023 (717) 362-3215 (717) 896-9089 FAX (717) 362-4459 E-maih kkl@eplx.net Please Reply To: ~ EL1ZABETHVILLE OFFICE ~ HARRISBURG OFFICE GOVERNORS' ROW 27 NORTH FRONT STREET HARRISBURG, PA 17101 (717) 238-4765 FAX (717) 238-8455 PATRICK E. KERW]N (1913-1987) GREGORYM. KERW1N - TERRENCE J. KERWIN - JOSEPH D. KE R~fflN - HOLLY McCLURE KERWIN September 13, 2004 Register of Wills of Cumberland County Cumberland County Courthouse South Hanover Street Carlisle, PA 17013 Re: Estate of Elma E. Bohner Estate File No.: 2004-00519 Dear Sir or Madam: Please find enclosed herewith for filing in your office the Inheritance Tax Return and the Inventory for the above-captioned estate. Would you kindly time-stamp the enclosed copies and return them to me in the enclosed self- addressed, stamped envelope. Also enclosed is a check in the amount of $45,922.31 representing the inheritance tax due. JDK:tll Enclosures Thank you for your assistance. Very JOST D. KERW1N Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Bohner, Elma E. also known as , Deceased Pamela Ramsey No. 21 -2004- 00519 Date of Death 5/18/2004 Social Security No. 169-34-9480 Joseph D. Kerwin, Esq. The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/VVe verify that the statements made in this Inventory are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Joseph D Kerwin I.D. No.: 52658 Signature: Jo¥(q~lS. Kerwin, Esq. Signature: /1 Address: 4245 Route 209 Elizabethville, PA 17023-9765 Address: 1752 Olmsted Way Camp Hill, PA 17011 Telephone: 717/362-3215 Personal Property U.S. Savings Bonds - see attached list Vanguard Wellington Fund PPL Corp Telephone: 717-761-3131 Dated: 17;771.20 2 [8.25 14,046.00 PPL Corp 9,216.47 Certificate of Deposit No. 1112351626 at Community Banks 49,780.63 Certificate of Deposit No. 1245796931 at Community Banks 44,724.65 Certificate of Deposit No. 301072354 at Mid Penn Bank 49,312.69 Certificate of Deposit No. 302071523 at Mid Penn Bank 38,543.48 Account No. 5080073711 at PNC Bank 26,531.89 Account No. 5003648825 at PNC Bank 96,453.27 (Attach additional sheets if necessary) Total Personal Property and Real Estate $367,118.53 Register of Wills of Cumberland County, Pennsylvania Estate of Bohner, Elma E. also known as INVENTORY continued , Deceased No. 21 - 2004- 00519 Date of Death 5/18/2004 Social Security No. 169-34-9480 Total Personal Property $367,118.53 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 0O4378 KERWIN JOSEPH D 27 NORTH FRONT STREET HARRISBURG, PA 17101 ........ fold ESTATE INFORMATION: SSN: 169-34-9480 FILE NUMBER: 2104-051 9 DECEDENT NAME: BOHNER ELMA E DATE OF PAYMENT: 09/14/2004 POSTMARK DATE: 09/13/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/18/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $45,922.31 REMARKS: TOTAL AMOUNT PAID: $45,922.31 SEAL CHECK# 1006 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION po BOX 28D601 HARRTSBURG, PA 17118-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JOSEPH D KERWIN KERWIN & KERWIN 4245 RTE 209 ELIZABETHVILLE PA 1702~ BATE 11-15-Z004 ESTATE OF BOHNER ELMA E BATE OF BEATH 05-18-2004 FILE NUHBER 21 04-0519 COUNTY CUMBERLAND ACN 101 Amount RmmAtted [ MAKE CHECK PAYABLE AND REMIT PAYMENT 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 (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOHNER ELHA E FILE NO. 21 04-0519 ACN 101 DATE 11-15-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a*a (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Per*narship Zn~eras~ (Schedule C) ($) 4. Not,gages/No,es Receivable (Schedule D) (4) 5. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) ($) 6. Jo{ntly Owned Propmr~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs{H/sc. Expenses (Schedule H) (9) 10. Debts/Mortgage L{ab{l{~{ms/L{mns (Schedule I) (10) 11. To,al Deduc~/ons 12. Net Value of Tax Re~urn 611771.91 .00 $05~$46.61 .00 .00 NOTE: To {nsure proper cred{~ to your account, subm{{ {he upper port{on .00 of {h{s form wi{h your tax payment. .0O (8) 367,118.53 41,857.74 19a132.09 (11) (12) 60.969.83 $06,148.7§ 15. 14. NOTE: Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) Ne~ Value of Ese:ate Subjac~ ~:o Tax Zf an assessment was issued previously, lines 14, 15 and/or ASSESSMENT OF TAX: 15. Amount of L{ne 14 a~ Spousal ra~e 16. Amoun~ of LLnm 14 ~axable a~ LLneal/Class A rate 17. Amoun* of L/ne 14 at S/bling ra~m 18. Amoun~ of L/ne 14 ~axable a~ Collateral/Class B ra*e 19. Pr/nc{pal Tax Due: TAX CREB]TS= PAYMENT I RECEIPT DATE NUHBER 09-15-2004 CB004578 .00 reflect figures that include the total of ALL returns assessed to date. D~SCOUNT (+) INTEREST/PEN PAID (-) (15) . O0 (14) $06,1~8.70 16, 17, 18 and 19 will 45,922.$1 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 45,922.$1 45,922.31 TOTAL TAX CREBZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 45,922.51.00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) AMOUNT pAID (is) .00 x O0 = (16) .00 x 045= (17) . O0 x 12 = (18) $06,148.70 x 15 = (19)= RESERVATION: Estates of decedents dying on or before December 12, 19BI -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the CoaaoneaaLth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laafuL Class D (colLaterat) rata on any such futura interest. PURPOSE OF NOTICE: To ~ulfill the requirements of Section Z1~0 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit, ahich was not requested on the Tax Return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available online at wee.revenue.state.pa-us, any Register of Hills or Revenue District Office, or from tho Department's Z~-hour ansaering service for forms orders: L-800-56Z-ZO50; services for taxpayers eith special hearing and/or speaking needs: 1-BOO-~7-5OZO (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisaant, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You amy object by filing a protest online at eea.boardofappeaLs.stata-pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from tho Board of Appeals websita. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box ZBIOZL, Harrisburg, PA 17LZB-LOZL. Petitions amy not bm faxad. D) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTH: Post Assessment Review Unit, P.O. Sox Z80601, Harrisburg, PA LTLZB-O60L Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (5) calendar months after the dacedant's death, a five percent (eX) discount of the tax paid is allowed. PENALTY: The lex tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January LB, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months end one (1) day from the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 198Z bear interest at the rate of six (DX) percent par annum calculated at a daily rate of .00016~. AIL taxes which became delinquent on and after January 1, 19BI will bear interest at a rate ehich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1aDZ through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor. ~ 20Z ~ ~"~"~'8-1991 llZ .000501 ~ 9Z .O00Z~7 1955 16Z ,000~38 199Z 9Z .O00Z~7 ZOOZ 62 .O0016~ 19B~ 1LZ .000501 L99~-L99~ 7Z .00019Z Z00~ 5Z .000137 1985 I~Z .000356 1995-1996 9~ .000Z~7 ZO0~ ~Z °000110 1986 IOZ .O00ZT~ 1999 7Z .00019Z 1987 IOZ .O00ZT~ ZOO0 7Z .O00XeZ --Interest is calculated as follows: XNTEREST = BALANCE OF TAX UNPA/D X NUIJBER OF DAYS DELTNQUENT X DAXLY TNTERBST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must bm calculated. ST A TUS REPORT UNDER RULE 6.12 Name of Decedent: ELMA E. BOHNER Date of Death: May 18, 2004 Estate No.: 2004-00519 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes_X___ No___ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Yes b. account is : c. in interest? Yes Did the personal representative file a final account with the Court? No _X_ The separate Orphans' Court No. (if any) for the personal representatives' Did the personal representative state an account informally to the parties _X_ No d. Copies of receipts, releases, join ers and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' 0 rt and may be attached to this report. CJ cry Date: 08/26/05 , , 0- C'-..l JO EPH D. KERWIN, ESQUIRE 42 5 ROUTE 209 ELIZABETHVILLE, PA 17023-9765 (717) 362-3215 (',j - L'.- (') L!~ <,-) r--:-':) C"-l (-) c;~ ( 0".. () Capacity: ___ Personal Representative --~j .-l,,'': _x_ Counsel for personal representati ve c4 RW-27