HomeMy WebLinkAbout03-0907PETITION FOR PROBATE and GRANT OF LETTERS
Estate of LAURA H. RASMUSSEN No.
also known as To:
Register of Wills for the
Deceased. County of CUMBERLAND in the
Social Security No. 057-10-1456' Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut RICHARD J. SIMEONEnamed
in the last will of the above decedent, dated APRIL 17 ,l~ ? 001
and codicil(s) dated RENUNCIATION DATED OCTOBER RTH ?f~i]R TH FAVO_R OF
MANUFACTURERS AND TRADER.R WRIT.RI C~t3MPAM~r "M b T _n_a_kLK"(FOPMEP~Y ALLFIRCT
TRUST COMPANY DF PA_. N_A_)
(state reJm~nt circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in CUMBERLAND County, Pennsylvania, with
hER last family or principal residence at 107 MAY DR. APT. 4, CAMP HILL~ PA. 17011
(list street, number and muncipality)
Decendent, then 92 years of age, died OCTOBER 3 ,~9 9n03 ,
atM__ESSIAH VILLAGE. 100 MT. ALT.EM DRIVE: MEgT-TAMTIq.RRT_T~_~. p_A_ 17055
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:
$ 1,212,105.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters. TESTAMENTARY
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
MANUFACTURERS AND TRADERS TRUST COMPA~
T-TARRT.gBtTR~; pa !71_0! '7
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
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 an, fl)truly administer the estate according to law.
Sworn to or affirmed and subscribed //////
befor.e roe this ~7~ day of
No. o~/- o.3 - q O"l
Estate of LAURA H. RA.qMILqgEN , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW { ~0PeA.~-~ .:~!. N)~oaaa, in consideration of the petition on
the reverse side hereof, satisfactory proof having been pre~ented before me,
IT IS DECREED that the instrument(s) dated APRIL 17, 2001
described therein be admitted to probate and fried of record as the last will of LAURA H. RASMUSSEN
and Letters TI~.,qTAME. NTARY
are hereby granted to. MANUFACTURERS AND TRADERS TRUST COMPANY, SUCCESSOR TO
ALLFIRST TRUST COMPANY OF PENNSYLVANIA, N.A.
FEES
Probate, Letters, Etc .......... $ 865.00
Short Certificates(19 .......... $. 30.00
5.00
Renunciation ................ $.
WILL 4-PAGES $ 12.00
JCP ~3~ $, 10.00
Filed ~ TOTAL 922.00
"~O'= BV-' Z~5~ ................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
Oath of Personal Representative
Commonwealth of Pennsylvania
Coun~ of DAUPHIN
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and tha~s personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate acc~,e~/n~ to law/"'
Sworn to or affirmed and subscribed ~ ~-~
before me thi.~/~ day of "
~or the I~egi~m/
Estate of ),ATlPA l-l PAqM!l$SEl~l
Social Security No: DgT-1 0-1/+56
.ow, 2-oo
Date of Death: OrTOB~'P 3. 2003
Deceased
, ~ , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IS DECREED that Letters [~ Testamentary .~ Of Administration
IT
(c.t.a.; d.b.n.c. La.; pendente lite; durante absentia; durante minoritate)
are hereby granted to ~"~(~'~,k~C~,C..."~kbg,~'J~
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $ ~)5 .00
Short Certificate(s) ..... $ ~ , O0
Renunciation ........ $ ,~ . 0 0
Affidavbs ( ~ .....
Register of ~T~iils d (F 0 ~
Attorney: u~o A t~'~'~ A T~"tT~I'~ ~'%XT
I.D. No: 06340
Address: 301 MARKET STREET, P.O. BOX 109
LEMOYNE, PA 17043-0109
Te{e~hone: 717-761-4540
Extra Pages ( ) .... $ J C)--- 0 0
Codici) ......... $
TOTAL ......... $ 0/o~
PreDated by the Penn=vivaRia Bar Association
Copyright (c) 1996 form software only CPSystem=, Inc.
;or~ RW-1 (mgl)
Estate of LAURA H. RUSMUSSEN
Also known as
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
, No.
, Deceased
The undersigned, Richard John Simeone, Nephew, Named Executor of the above-
(Relationship) (Capacity)
named decedent, hereby renounces the right to administer the estate and respectfully requests that
Letters Testamentary be issued to Manufacturers and Traders Trust Company "M&T BANK",
(Formerly AIIfirst Trust Company of PA, N.A.)
WITNESS my hand this
~ dayof ~)~(-'~¢__. t" , 2003.
%
Richard~Joh~L_S~meone
18 Gloucester Avenue
Gloucester, Mass. 01930-2527
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, $2.00
P 9 G 4 8 2 0 0 OCT 0 8
Local Registrar
No. Date
COMMONWEALTH OF PENNSYLVANI EPARTMENT OF HEALTH · VITAL RECORDS
CERTIFk.,-JE OF DEATH
,. Laura H.. Rasmussen ,. Female ,. 057 -- 10 -- 1456 ,. Oot~ 3, 2003
· ,- 9 : ; ,. 9-1-11 ,. NYC, NY
~ CITY. BO~O. TWP Of 0E~TH ZFAClLrTY N~U~E (11 nc~ ~. ~*~e ~,e~ ~n~ r~t(oe, W~S DECEDENT OF H~SI~,41C OR~GIN? ~RACE - anw~c~ k'~4n. B1~k. Wh~. Mc.
· .~15t
;5~ Cumberland . Upper Allen Twp.l" ~$]4k ~'C~n,5~ '-~'~'~'" I,t White
~ :,,, Executive Sec. h,,. Trans, oft Co. I,,. I,,12t.~
~ 100 Mt. Allen Drive ~c,t,~ ,,..u,, Pennsvlvanj.~
Mechanicsburg, PA 17055 ~
,~.c~ C%~nherland ,,.~ ~k~ ~a,~,p H~ ] ] ~-> ....
Joseph A. Rasmussen ,,. M. Prances ~_..rl
~. Rev. ~c~ffi a. 8~me ~.18 Glouc~ter bye., ~m~st~, ~ 01930
~ ,,. 012755-L ~s-~ ~, 1903 ~t St, ~, PA 17011
~(~XC~E~ . ,
Mi~ ~ ~ ~PE~S6N ~PCETED C~ ~
~:~:,~ax .min,I l .... ~o,, .... tigal~n, in my opinion, de.th ...... d at ,~ lira. dat.. and pi .....
· ~ ~-- ~ ......................................
005284-1/3/20/2001/HAJ/RJ M/102792
· ast ill aah ¢stamCnt
OF
LAURA H. RASMUSSEN
I, LAURA H. RASMUSSEN, of the Borough of Camp Hill, Cumberland County,
Pennsylvania, do make, publish and declare this to be my Last Will and Testament,
hereby revoking and making void any and all former Wills made by me.
ITEM I: DEBTS.
I direct that all my debts and funeral expenses, including my gravemarker, and all
expenses of my last illness that my estate is obligated to pay shall be paid from my residuary
estate as a part of the expense of the administration of my estate.
ITEM II: PAYMENT OF TAXES.
All federal, state and other taxes payable because of my death, with respect to
property forming my gross estate for tax purposes, whether or not passing under this Will,
including any interest or penalty imposed in connection with such tax shall be considered a
part of the expense of the administration of my estate and shall be paid from that part of my
residuary estate passing pursuant to ITEM III. hereof without apportionment or right of
reimbursement. All such taxes on present or future interest shall be paid at such time or
times as my personal representative may think proper, regardless of whether such taxes are
then due. I further direct that any and all such taxes shall be paid from and deducted from
005284-1/3/20/2001/HAJ/RJM/102792
my residuary estate prior to the calculation of the shares of the residuary beneficiaries, so
that each residuary beneficiary, charitable or not, shall bear a portion of the burden of such
taxes.
ITEM III: TANGIBLE PERSONAL PROPERTY.
1. I give and bequeath all my tangible personal property in my
apartment to my closest friend, BETTY HOLLAND, any my nephew,
RICHARD JOHN SIMEONE, to be divided by them as they agree.
2. Should BETTY HOLLAND predecease me and RICHARD
JOHN SIMEONE survive me, all of my tangible personal property in my
apartment shall go to my nephew, RICHARD JOHN SIMEONE, and his
then living issue, per stirpes.
3. Should my nephew, RICHARD JOHN SIMEONE,
predecease me and BETTY HOLLAND survives me, BETTY
HOLLAND shall divide all of my tangible personal property in my
apartment among herself and those of my nephew's three (3) children,
MATTHEW JOHN SIMEONE, MARK ANDREW SIMEONE and
HONOR CHRISTINE SIMEONE, who survive me.
4. Should neither BETTY HOLLAND nor RICHARD JOHN
SIMEONE survive me, all of said items shall go to those of the above
three (3) children of RICHARD JOHN SIMEONE who survive me.
2
005284-113/20/200 I/HAJ/RJ MI102792
ITEM IV. RESIDUE.
I give devise and bequeath the rest, residue and remainder of my estate as follows:
1. 33.333% to my nephew, RICHARD JOHN SIMEONE, and
his then living issue, per stirpes
2. 33.333% to my friend, BETTY HOLLAND provided she
survives me. Should she fail to survive me, this gift shall be added to and
distributed as part of 1. of this ITEM IV.
3. 11.111% to MATTHEW JOHN SIMEONE and his then
living issue, per stirpes.
4. 11.111% to MARK ANDREW SIMEONE and his then
living issue, per stirpes.
~ .11.111% to HONOR CHRISTINE SIMEONE and her then
living issue per stirpes.
ITEM V. PERSONAL REPRESENTATIVE.
I name, constitute and appoint my nephew, RICHARD JOHN SI1V~DNE, to be
Executor of this my Will. If he fails to qualify as Executor or fails to complete the
administration of my estate, I appoint ALLFIRST TRUST COMPANY OF PA, N.A.,
Executor.
-3-
,005284-,1/3/20/2001/HAJ/RJM/102792
ITEM VI. BOND.
No personal representative shall be required to post bond or enter security in any
jurisdiction.
IN WITNESS WHEREOF, I hereunto set my hand and seal this
,2001.
,/7~ day of
LAURA H. RASMUSSEN
Signed, sealed, published and declared by the above-named Testatrix, as and for
her Last Will and Testament, in the presence of use, who at her request, in her presence
and in the presence of each other have hereunto subscribed our names as witnesses.
-4-
005284-,1/3/20/2001/HAJ/RJ M/102792
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA ·
· SS.
COUNTY OF CUMBERLAND ·
We, LAURA H. RASMUSSEN,
and ~ r'~. --.,.,.. ~ , the Testatrix ~and the witnesses,
respectively, whose names are stg~ed to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will and that she had signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness
and that to the best of his/her knowledge the Testatrix was at that time eighteen years of
age or older, of sound mind and under no constraint or undue influence.
LAURA H. RASMUSSEN
Witness
Sworn to or affirmed to and subscribed to before me by LAURA H.
RASMUSSEN, Testatrix, and
and ~-~~
, x~i~nesses, ~is '
t~.,,., _;.,.~_~,.. ,2001.-~'~ \ ~ a'~ day of
NOTARIAL SEAL
DIANNE LENIG, Nolary Public
Lemoyne Borough Cumberland Co.
,,,My Commission Exptres Dec. 21, 2001
Notary Public
LAST WILL and TESTAMENT
of
LAURA H. RASMUSSEN
JOHNSON, DUFFLE, STEWART
& WEIDNER
ATTORNEYS AT LAW
LEMOYNE, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No:
LAURA H. RASMUSSEN
October 3, 2003
21-03-0907
To the Register:
I certify that notice of estate administration as required by Rule 5.6(a) of the
Orphan's Court Rules was served on or mailed to the following testate and intestate
beneficiaries of the above-captioned estate on November 14, 2003.
Name Address
The Reverend Richard John Simeone
18 Gloucester Avenue
Gloucester, MA 01930-2527
Betty Holland
c/o Sue Decker
772 Lancaster Avenue
Enola, PA 17025
Matthew John Simeone
Mark Andrew Simeone
Honor Christine Simeone
181 Ramblewood Road
Moorestown, New Jersey 08057
9 Bertram Street
Beverly, MA 01915
44 Euclid Avenue
Stamford, CT 06902
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
NONE
Date: November 14, 2003
SteWart &
~son, Duffle, Weidner
Address 301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
(717) 761-4540
Personal Representative
X Counsel for personal representative
Telephone
Capacity:
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 O03399
M & T TRUST COMPANY SUCCESSOR
213 MARKET STREET
HARRISBURG, PA 17101
........ foJd
ESTATE INFORMATION: SSN: 057-10-1456
FILE NUMBER: 2103-0907
DECEDENT NAME: RASMUSSEN LAURA H
DATE OF PAYMENT: 12/31/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 10/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $145,350.00
TOTAL AMOUNT PAID:
$145,350.00
REMARKS: M &TINVESTMENTGROUP
SEAL
CHECK# 400039189
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Register of Wills of
CUMBE~
INVENTORY
County, Pennsylvania
Estate of Laura H. Rasmussen
also known as
No. 2003-00907
DateofDeath 10/03/2003
,Deceased SocialSecur~ No. 057-10-1456
Successor to Allfirst Trust Company of PA,
Manufacturers and Traders Trust Company,
NA
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 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 Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Johnson, Duffle, Stewart & Weidner
Name of
Attorney: Horace A. Johnson, Esquire
I.D. No.: 06340
Address: 301 Market Street
Lemo:~ne, PA 17043
Telephone: 717/761-4540
Personal Representatiy~anufacturers and Traders Trust
Company, S~GY;fesse~-hto All.fi. rst Tyust Company
Sign~,~re.'~//~ l~ ) /,/~///~////i///~,_.f~ PA, Nm
Address: 213 Market Street
Harrisburg, PA 17101
Telephone: 717/255-2109
Dated:
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Value
Total: 1,237,532.82
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (199Z)
Estate of:
Date of Death:
County:
INVENTORY
Laura H. Rasmussen
10/03/2003
Cumberland
CASH:
$100,000 M&T Bank Certificate
of Deposit 2.33% due
04/05/06 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Interest
$15,000 Emigrant Savings Bank
Certificate of Deposit 5.12%
due 4/05/04 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Interest
$15,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 12/23/03 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Interest
$25,000 PNC Bank Certificate
of Deposit 4.97% due
08/02/04 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Interest
$25,000 PNC Bank Certificate
of Deposit 5.81% due 5/15/05
- Received from Laura H.
Rasmussen Trust dtd 4/22/03
Accrued Interest
$30,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 11/30/04 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Interest
Bank of New York - Replacement
check payable 6/1/02 for
Cash Payment in Lieu of
Fractional Share
Distribution, Class A/B
100,000.00
6.39
15,000.00
6.33
15,000.00
6.09
25,000.00
10.21
25,000.00
79.58
30,000.00
12.18
4.61
Estate of:
Date of Death:
County:
Laura H. Rasmussen
10/03/2003
Cumberland
Camp Hill Plaza Apartments -
Return of Security Deposit
Cash found in home
Emigrant Savings Bank -
Uncashed Interest Check on
Certificate of Deposit from
September
Greenpoint Bank - Uncashed
Interest Checks on
Certificates of Deposit from
March and September
Highmark Blue Shield -
Reimbursement of Overpayment
Highmark Blue Shield - Medical
Reimbursement
Manufacturers and Traders Bank
Checking Account %70366268 -
Date of Death Balance
Accrued Interest
MTB Money Market-Inst I-FD
%420 - Received from Laura
H. Rasmussen Trust -
Principal Cash as of Date of
Death
MTB Money Market-Inst I-FD
#420 - Received from Laura
H. Rasmussen Trust dtd
4/22/03 - Income Cash as of
Date of Death
Accrued Interest
PNC Bank Checking Account
%51-4016-8545 - Date of
Death Value
Accrued Interest
Return of Capital Tax Exempt
Secs Trust
Verizon Lehigh Valley - Refund
100.00
32.60
63.25
314.58
5.03
64.96
23,189.16
0.97
117, 686.60
822.74
6.59
25,583.15
2.58
1,643.85
1.78
379,643.23
2
Estate of:
Date of Death:
County:
Laura H. Rssmussen
10/03/2003
Cumberland
PERSONAL PROPERTY:
Household Effects - Appraised
Value for Items taken in Kind
Household Effects - Sales
Price of Remaining Items
STOCKS/LISTED:
2 shares Agere Systems
Incorporated Class A
67 shares Agere Systems
Incorporated Class B
6,426 shares Allied Irish Bks Plc
Spons ADR - Received from
Laura H. Rasmussen Trust dtd
4/22/03
60 shares AT&T Corporation
Accrued Dividend
96 shares AT&T Wireless Services
Incorporated
21 shares Avaya Incorporated -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
664 shares Bellsouth Corporation -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
1,640 shares BP Amoco PLC Sponsored
ADR - Received from Laura H.
Rasmussen Trust dtd 4/22/03
1,300 shares Brown Shoe Inc. New -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
97 shares Comcast Corporation
Class A New
1,469 shares Delaware Group Income
Fds Inc. Delchester-A 924 -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
3,036.00
392.45
6.74
214.74
188,281.80
1,263.30
14.25
831.84
228.90
16,397.48
71,340.00
43,459.00
3,144.74
4,539.21
3,428.45
Estate of:
Date of Death:
County:
Laura H. Rasmussen
10/03/2003
Cumberland
2,057 shares Dreyfus Premier St Mun
Bond Fund PA Ser CL A - Received
from Laura H. Rasmussen
Trust dtd 4/22/03
3,127 shares Eaton Vance PA
Municipals Fd-B - Received
from Laura H. Rasmussen
Trust dtd 4/22/03
4,367 shares Federated PA Muni
Income Fd-A %311 - Received
from Laura H. Rasmussen
Trust dtd 4/22/03
4,577.614 shares Franklin High Yield Tax
Free Income Fd-a - Received
from Laura H. Rasmussen
Trust dtd 4/22/03
1,600 shares Hershey Foods
Corporation - Received from
Laura H. Rasmussen Trust dtd
4/22/03
256 shares Lucent Technologies
Inc. - Received from Laura
H. Rasmussen Trust dtd
4/22/03
96 shares Midas Group Inc. -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
1,333 shares Nuveen Municipal Value
Fund - Received from Laura
H. Rasmussen Trust dtd
4/22/03
2,334 shares Nuveen Select Tax Free
Inc Port 2 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
10 shares Pennsylvania Insd Mun
Inc. Tr UT 63 26 Mul M -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
Accrued Interest
32,788.58
31,864.13
51,050.23
47,744.51
119,312.00
569.60
1,239.84
12,176.96
30,913.83
2,772.10
40.60
Estate of:
Date of Death:
County:
Laura H. Rasmussen
10/03/2003
Cumberland
576 shares PepsiAmericas Inc. -
Received from Laura H.
Rasmussen Trust dtd 4/22/03
2,577 shares Putnam PA Tax Exempt
Income Fund - Received from
Laura H. Rasmussen Trust dtd
4/22/03
1,143 shares Smith Barney Capital &
Income Fd B - Received from
Laura H. Rasmussen Trust dtd
4/22/03
15 shares Tax Exempt Secs Tr Ut
Natl Tr 200 - Received from
Laura H. Rasmussen Trust dtd
4/22/03
Accrued Dividend
5,404 shares Tyco International Ltd
- Received from Laura H.
Rasmussen Trust dtd 4/22/03
Accrued Dividend
618 shares Verizon Communications
- Received from Laura H.
Rasmussen Trust dtd 4/22/03
8,608.32
23,373.39
16,299.18
10,362. O0
12.00
114, 618.84
67.55
20, 925.48
TOTAL RECEIPTS OF PRINCIPAL ...............
854,461.14
1,237,532.82
5
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 004116
M & T TRUST COMPANY SUCCESSOR
213 MARKET STREET
HARRISBURG, PA 17101
........ fold
ESTATE INFORMATION: SSN: 057-10-1456
FILE NUMBER: 2103-0907
DECEDENT NAME: RASMUSSEN LAURA H
DATE OF PAYMENT: 07/02/2004
POSTMARK DATE: 07/02/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 1 0/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $21,006.85
TOTAL AMOUNT PAID:
$21,006.85
REMARKS:
SEAL
CHECK//288370267-2
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
COUNTY CODE
-- 03 00907
YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ RASMUSSEN, LAURA H
Z 057 -10-1456
LM DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS I~TtJRN MUST BE FILED IN DUPUCATE WITH THE
"' 10/03/2003 9/1/1911 REGISTER OF WILLS
Ill (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ OD
z
Z
IX I I. Odginal Return
~']4. Limited Estate
~'-] 6. Decedent Died Testate (Attach copy of Will)
[~9. Litigation Proceeds Received
L~ 2. Supplemental Return ~ 3, Remainder Return (date of death prior to 12-13-82)
[--~ 4a. Future Interest Compromise (date of death after 12-12-82) [-~ 5, Federal Estate Tax Ratum Required
r'~7. Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total Number of Safe Deposit Boxes
[~ I0. Spousal Poverty Credit (date of dealh between 12-31-91 and 1-1-95) E~ 11. Election to tax under Sec. 9113(A){Altach Sch O)
NAME
RUTH ANN McMILLEN
FIRM NAME (IfApplicable)
MANUFACTtTRERS AND TRADERS TRUST CO.
TELEPHONE NUMBER
717-255-2109
COMPLETE MAILING ADDRESS
213 MARKET STREET
HARRISBURG, PA 17101
1, Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership orSole-Propdetorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
6. Jify 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)
! 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
0.00
5,475.~1~.;
0.O0
0o00
56,913.29
0.00
1,179,643.92
(8)
OFFICIAL USE ONLY
1,242,032.82
72,762.19
9,224.95
(11)
81,987.14
1,160,045.68
0.00
(12)
(13)
4. Net Value Subject to Tax (Line 12 minus Line 13) (14)
1,160,045.68
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) 0.0 0 x .00 (15)
6. Amount of Line 14 taxable at lineal rate 0.00 x .04,5 (16)
17. Amount of Line 14 taxable at sibling rate 0.0 0
x .12 (17)
18. Amount of Line 14 taxable at collateral rate 1,160,045.68 x .15 (18)
19. Tax Due (19)
0.00
0.00
0.00
174,006.85
174,006.85
2W4645 1000
Decedent's Complete Address:
tS ~ ~t=~- ~ ADDRESS
MECHANICSBURG
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
0.00
145,350.00
7,650.00
0.00
0.00
ISTATE
IZlP
17055
174,006.85
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
153,000.00
0.00
21,006.85
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
A. Enter the interest on the tax due.
(5A).
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Pa to: REGISTER OF WILLS, A GENT
(5B)
21,006.85
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; ....................... E~ [~
b. retain the right to designate who shall use the property transferred or its income; ......... ~ [~
c. retain a reversionary interest; or ................................ ~ ~--~
d. receive the promise for life of either payments, benefits or care? ................. ~--~ j~
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 secudty at his or her death? E~] F~
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'~jof perjury, I declare that ~ have examined this return, including accompanying schedules and statements, and to he best of belief, ibis true. correct and complete.
Declaration~ef p~feparer o~i' titan the personal,~'epr~sentative is bejt~=d on all information of which preparer has any knowledge, my knowledge and
SIGNATUJ~E OF PER~'ON RESPONSIBLE F~R I~IGJ:~N ~/'~/'~ ~ VICE PRI~SI
II
HARRISBURG, PA 17101
~OR~//THOMSON FASTTAX 9711
RICHMOND, VA 23236
FARRAR CT SUITE 110
//~~_DATE
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. § 9916 (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 exem pt 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 im posed 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.
2w4646 1.o0o
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
RASMUSSEN, LAURA H 2!-03-00907
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
1. AT&T CORP OFDEATH
1,263.30
CUSIP: 001957505
Shares/Par: 60
Exchange: NYSE
COMNEW
Div: 0.2375 Ex: 09/26/2003 Rec:
Accrued Income
AT&T WIRELESS SVCS INC
CUSIP: 00209A106
Shares/Par: 96
Exchange: NYSE
AGERE SYS INC
CUSIP: 00845V100
Shares/Par: 2
Exchange: NYSE
AGERE SYS INC
CUSIP: 00845V209
Shares/Par: 67
Exchange: NYSE
CL B
COMCAST CORP NEW
CUSIP: 200300101
Shares/Par: 97
Exchange: NASDAQ
CL A
09/30/2003 Pay:
11/o3/2oo3
TOTAL (Also enter on line 2, Recapitulation) $
14.25
831.84
6.74
214.74
3,144.74
5,475.61
2W4696 3000 (If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
~:$¥ATE OF FILE NUMBER
RASMUSSEN, LAURA H 2~-03-00907
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
NUMBEF DESCRIPTION
1. CASH FOUND IN DEU,:mENT'S HOME
2
3
4
5
6
7
8
9
10
11
12
13
HIGHMARK BLUE SHIELD
REIMED-RSEMENT OF OVERPAYMENT
HIGHMARK BLUE SHIELD
MEDICAL REIMBURSEMENT
VERIZON LEHIGH VALLEY - REFUND
CAM1= HILL PLAZA ASSOC.
RETURN OF SECURITY DEPOSIT
PNC BANK CHECKING ACCOUNT #51-4016-8545
BALANCE AT DATE OF DEATH
INTEREST ACCRUED TO DATE OF DEATH
M&T BANK CHECKING ACCOUNT
#70366268
DATE OF DEATH BALANCE
INTEREST ACCRUED TO DATE OF DEATH
THE BANK OF NEW YORK
RELACEMENT CHECK FOR CASH
PAYMENT IN LIEU OF FRACTIONAL SHARE DISTRIBUTION, CLASS A/B
INTERNAL REVENUE SERVICE CENTER
REFUND DUE FROM DECEDENT'S FINAL
INCOME TAX RETURN - 2003
HAAR'S AUCTION INC.
VALUE REPORTED ON TAX RETURN
IS GROSS SALES PRICE AFTER IN KIND DISTRIBUTION.
HOUSEHOLD EFFECTS:
APPRAISED VALUE $4527.00
LESS DISTRIBUTED IN KIND ($3036.00)
REMAINING ITEMS VALUED AT $1491.00
SOLD AT AUCTION FOR $ 392.45
PERSONAL PROPERTY LOCATED AT
107 MAY DRIVE, APT. 4,
TOTAL (Also enter on line 5, Recapitulation)
VALUE AT DATE
OF DEATH
32.60
5.03
64.96
1.78
100.00
25,583.15
2.58
23,189.16
0.97
4.61
4,500.00
392.45
3,036.00
56,913.29
2W46AO 2.000 (If more space is needed, insert additional sheets of the same size)
Estate of= RASMUSSEN, LAURA H
Schedule E -- Cash, Bank Deposits & Misc. Personal Property
Page 2
2~}-03-00907
Item Value at
No. Description Date of Death
13
CAMP HILL, PA 17011
ITEMS DISTRIBUTED IN KIND ARE
REPORTED AT APPRAISED VALUE:
(COPY ATTACHED) ($3036.00)
TOTAL. (Carry forward to main schedule) ...... 0.00
REV-1510 EX + (1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATEPROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RASMUSSEN, LAURA H 2~-03-00907
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.
~S~I~ON OF PROPER~ % OF
I~M INCLU~ THE NAME OF ME T~FEREE, THEIR RE~TIONSHIP TO DATE OF DEATH DECD'S EXCLUSION
~CE~D~E ~ OF T~FER A~ACH A COPY OF THE TAXABLE VALUE
NUM BEF ~ED FOR ~ ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1. ON APRIL 22, 2003, ~ 0.00 100.00 0.00 0.00
DECEDENT CREATED THE LAURA H.
RASMUSSEN REVOCABLE TRUST,
WITH ALLFIRST TRUST CO. (NOW
MANUFACTURERS AND TRADERS
TRUST CO.), AS TRUSTEE. THE
DECEDENT RETAINED THE RIGHT TO
INCOME FOR LIFE AND THE RIGHT,
BY INSTRUMENT IN WRITING, TO
MODIFY, ALTER, AMEND, OR TO
REVOKE THE TRUST IN WHOLE OR
IN PART AT ANY TIME DURING HIS
LIFE.
UPON DEATH OF THE DECEDENT,
THE TRUST WILL TERMINATE AND
ALL ASSETS, WHETHER PRINCIPAL
OR INCOME, SHALL BE
DISTRIBUTED TO THE EXECUTOR(S)
OF HER ESTATE TO BE
DISTRIBUTED AS PART OF THE
ASSETS OF THE DECEDENT'S
ESTATE. (COPY OF TRUST
AGREEMENT ATTACHED, THERETO.)
ON THE DATE OF THE DECEDENT'S
DEATH, THE FOLLOWING ASSETS
WERE HELD IN THE TRUST (SEE
CONTINUATION SCHEDULE G):
2 $100,000 M&T BANK CERTIFICATE 100,000.00 100.00 0.00 100,000.00
OF DEPOSIT ~ 2.33% DUE
04/05/06
#31003914462939
3 INTEREST ACCRUED TO DATE OF 6.39 100.00 0.00 6.39
'DEATH ON ABOVE CERTIFICATE OF
DEPOSIT
4 $15,000 EMIGRANT SAVINGS BANK 15,000.00 100.00 0.00 15,000.00
CERTIFICATE OF DEPOSIT ~ 5.12%
DUE 04/05/04 #02-5152427-8
5 INTEREST ACCRUED TO DATE OF 6.33 100.00 0.00 6.33
Total from continuation pages .... 1,064,631.20
TOTAL{Alsoenteronline7, R~apitulation):$
1,179,643.92
(If more space is needed, insert additional sheets of same size.)
2W46AF 2.000
Estate of: RASMUSSEN, LAURA H
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item
No. Description
Date of death % of Decd's Exclusion
Value of asset Interest (If applicable)
Page 2
21-03-00907
Taxable Value
5 DEATH ON ABOVE CERTIFICATE OF
DEPOSIT
$15,000 GREENPOINT BANK
CERTIFICATE OF DEPOSIT ~ 4.93%
DUE 12/23/03 #6510580977
INTEREST ACCRUED TO DATE OF
DEATH ON ABOVE CERTIFICATE OF
DEPOSIT
$30,000 GREENPOINT BANK
CERTIFICATE OF DEPOSIT @ 4.93%
DUE 11/30/04 #6510500553
INTEREST ACCRUED TO DATE OF
DEATH ON ABOVE CERTIFICATE OF
DEPOSIT
10
$25,000 PNC BANK CERTIFICATE
OF DEPOSIT @4.97% DUE 08/02/04
#31300186870
11
INTEREST ACCRUED TO DATE OF
DEATH ON ABOVE CERTIFICATE OF
DEPOSIT
12
$25,000 PNC BANK CERTIFICATE
OF DEPOSIT @5.81% DUE 5/15/05
#31600161717
13 INTEREST ACCRUED TO DATE OF
DEATH
14 EMIGRANT SAVINGS BANK
UNCASHED INTEREST CHECK ON
CERTIFICATE OF DEPOSIT FROM
SEPTEMBER
15
GREENPOINT BANK
UNCASHED INTEREST CHECKS ON
CERTIFICATES OF DEPOSIT FROM
MARCH AND SEPTEMBER
MARCH $125.86
15,000.00 100.00 0.00
6.09 100.00 0.00
30,000.00 100.00 0.00
12.18 100.00 0.00
25,000.00 100.00 0.00
10.21 100.00 0.00
25,000.00 100.00 0.00
79.58 100.00 0.00
15,000.00
6.09
30,000.00
12.18
25,000.00
10.21
25,000.00
79.58
63.25 100.00 0.00 63.25
314.58 100.00 0.00
314.58
Estate of: RASMUSSEN, LAURA H
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item
No.
Description
Date of death % of Decd's Exclusion
Value of asset Interest (If applicable)
Page 3
2~-03-00907
Taxable Value
SEPTEMBER $125.84
SEPTEMBER $ 62.88
16
MTB MONEY MARKET-INSTR I-FD
#420
PRINCIPAL CASH AS OF DATE OF
DEATH
17 MTB MONEY MARKET-INSTR I-FD
#420
INCOME CASH AS OF DATE OF
DEATH
18 INTEREST ACCRUED TO DATE OF
DEATH
19 RETURN OF CAPITAL
TAX EXEMPT SECS TRUST
20 ALLIED IRISH BKS P L C
CUSIP: 019228402
Shares/Par: 6426
Exchange: NYSE
SPON ADR ORD
21 AVAYA INC
CUSIP: 053499109
Shares/Par: 21
Exchange: NYSE
22
BELLSOUTH CORP
CUSIP: 079860102
Shares/Par: 664
Exchange: NYSE
23
BP PLC
CUSIP: 055622104
Shares/Par: 1640
Exchange: NYSE
24 BROWN SHOE INC NEW
CUSIP: 115736100
Shares/Par: 1300
Exchange: NYSE
117,686.60 100.00 0.00
822.74 100.00 0.00
6.59 100.00 0.00
1,643.85 100.00 0.00
188,281.80 100.00 0.00
228.90 100.00 0.00
16,397.48 100.00 0.00
71,340.00 100.00 0.00
43,459.00 100.00 0.00
117,686.60
822.74
6.59
1,643.85
188,281.80
228.90
16,397.48
71,340.00
43,459.00
Estate of: RASMUSSEN, LAURA H
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item
Description
Date of death % of Decd's Exclusion
Value of asset Interest (If appllcable)
Page 4
2]-03-00907
Taxable Value
25
DELAWARE GROUP INCOME FDS INC
CUSIP: 245908207
Shares/Par: 1469
Exchange: NASDAQ
DELCHEST A
26
DREYFUS PREMIER ST MUN BD FD
CUSIP: 26202D649
Shares/Par: 2057
Exchange: NASDAQ
PA SER CL A
27
EATON VANCE MUNS TR
CUSIP: 27826L504
Shares/Par: 3127
Exchange: NASDAQ
PA MUNS CL B
28
FEDERATED MUN SECS INCOME TR
CUSIP: 313923708
Shares/Par: 4367
Exchange: NASDAQ
PA MUN INCM A
29 FRANKLIN TAX FREE TR
CUSIP: 354723702
Shares/Par: 4577.614
Exchange: NASDAQ
HI YLD T/F A
30 HERSHEY FOODS CORP
CUSIP: 427866108
Shares/Par: 1600
Exchange: NYSE
31
LUCENT TECHNOLOGIES INC
CUSIP: 549463107
Shares/Par: 256
Exchange: NYSE
32
MIDAS GROUP INC
CUSIP: 595626102
Shares/Par: 96
4,539.21 100.00 0.00
32,788.58 100.00 0.00
31,864.13 100.00 0.00
51,050.23 100.00 0.00
47,744.51 100.00 0.00
119,312.00 100.00 0.00
569.60 100.00 0.00
1,239.84 100.00 0.00
4,539.21
32,788.58
31,864.13
51,050.23
47,744.51
119,312.00
569.60
1,239.84
Estate of=
Item
No.
RASMUSSEN, LAURA H
Schedule G -- Inter-vivos Transfers
Description
Date of death
Value of asset
& Misc. Non-probate Property
% of Decd's Exclusion
Interest (If applicable)
Page 5
2.~-03-00907
Taxable Value
33
34
35
Exchange: NYSE
NUVEEN MUNVALUE FD INC
CUSIP= 670928100
Shares/Par: 1333
Exchange: NYSE
NUVEEN SELECT TAX FREE INCM PT
CUSIP= 67063C106
Shares/Par= 2334
Exchange= NYSE
PENNSYLVANIA INSD MUN INC TR
CUSIP: 708839485
Shares/Par: 10
Exchange= OTC
UT 63 26 MUL M
Carryover & Daily Interest=
40.60
36 Accrued Income
37
38
39
40
PEPSIAMERICAS INC
CUSIP= 71343P200
Shares/Par= 576
Exchange= NYSE
COM
PUTNAM PA TAX EXEMPT
CUSIP: 746852102
Shares/Par= 2577
Exchange= NASDAQ
SH BEN INT
INCOME FD
SMITH BARNEY INCOME FUNDS
CUSIP: 83181A203
Shares/Par= 1143
Exchange= NASDAQ
SB CAP&INCM B
TAX EXEMPT SECS TR
CUSIP= 876942467
Shares/Par= 15
Exchanqe= OTC
12,176.96
100.00 0.00
30,913.83 100.00 0.00
2,772.10
40.60
100.00 0.00
100.00 0.00
8,608.32 100.00 0.00
23,373.39
16,299.18
100.00 0.00
100.00 0.00
10,362.00 100.00 0.00
12,176.96
30,913.83
2,772.10
40.60
8,608.32
23,373.39
16,299.18
10,362.00
Estate of: RASMUSSEN, LAURA H
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item
No.
Description
Date of death % of Decd's Exclusion
Value of asset Interest (If applicable)
Page 6
2~-03-00907
Taxable Value
UT NATL TR 200
Carryover & Daily Interest:
12.00
41 Accrued Income
42 TYCO INTL LTD NEW
CUSIP: 902124106
Shares/Par: 5404
Exchange: NYSE
Div: 0.0125 Ex: 09/29/2003
Rec: 10/01/2003 Pay:
11/01/2003
43 Accrued Income
44 VERIZON COMM1/NICATIONS
CUSIP: 92343V104
Shares/Par: 618
Exchange: NYSE
12.00 100.00 0.00 12.00
114,618.84 100.00 0.00
114,618.84
67.55 100.00 0.00 67.55
20,925.48 100.00 0.00
20,925.48
TOTAL. (Carry forward to main schedule) ...... 1,064,631.20
REV-1511 EX + (1-97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RASMUSSEN, LAURA H 2~-03-00907
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
2
5.
6.
7.
FUNERAL EXPENSES:
MT. OLIVET CEMETERY
GRAVE OPENING EXPENSE
MYERS-HARNER FUNERAL HOME,
1903 MARKET STREET
P.O. BOX 291
CAMP HILL, PA 17011
FUNERAL EXPENSE
DESCRIPTION
INC.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) See Schedule &ttached
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State __ Zip
Year(s) Commission Paid:
Attorney Fees Name: HORACE A. JO~]:NSON, ESQ.
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
Accountant's Fees
Tax Return Preparer's Fees
REGISTER OF WILLS
CUMBERLAND COUNTY
SWORN IN FEE
REGISTER OF WILLS
CUMBERLAND COUNTY
4 SHORT CERTIFICATES
State ~ Zip
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
1,363.00
7,783.00
36,630.49
24,420.32
0.00
922.00
0.00
0.00
15.00
PPL UTILITIES
TWO NORTH NINTH STREET
ALLENTOWN, PA 18101
Total from continuation pages ....
12.00
21.41
1,594.97
72,762.19
2W46AG 2.000 (If more space is needed, insert additional sheets of same size)
Estate of= RASMUSSEN, LAURA H
Schedule H, Part B -- Administrative Costs
Item
No.
Description
10
11
12
13
14
15
16
FINAL ELECTRIC BILL FOR DECEDENT'S APT.
10.37
11.04
VITERRA
SUITE 300
7406 FULLERTON STREET
JACKSONVILLE, FL 32256
FINAL UTILITY PAYMENT
AT&T
PO BOX 8212
AURORA, IL 60572-8212
FINAL TELEPHONE BILL FOR DECEDENT
HOBBIE AUCTIONEERS
901 N. 2ND STREET
HARRISBURG,PA 17102
APPRAISAL OF PERSONAL PROPERTY
HAAR'S AUCTION INC.
COMMISSION ON SALE OF HOUSEHOLD ITEMS
REPORTED ON SCHEDULE F #2
RICHARD J. SIMONE
18 GLOUCESTER AVE
GLOUCESTER, MA 01930-2527
REIMBURSEMENT FOR RENTAL COST OF
U-HAUL TO CLEAR APARTMENT.
EDMUND G. MYERS, ESQ.
JOHNSON, DUFFIE, STEWART & WEIDNER
PO BOX 109---301 MARKET STREET
LEMOYNE, PA 17043-0109
REIMBURSEMENT FOR ADVERTISING NOTICES
IN THE PATROIT NEWS & THE CUMBERLAND LAW JOURNAL
$15,000 GREENPOINT BANK CTF OF DEPOSIT 4.93%
DUE 12/23/03 - PENALTY FOR EARLY REDEMPTION
Page 2
2~-03-00907
Amount
67.82
8.47
200.00
98.11
289.02
205.68
15.97
TOTAL. (Carry forward to main schedule) ...... 885.07
Estate of: RASMUSSEN, LAURA H
Schedule H, Part B -- Administrative Costs
Item
Description
17
$30,000 GREEATPOINT BANK CTF OF DEPOSIT 4.93%
DUE 11/30/04 - PENALTY FOR EARLY REDEMPTION
18
RESERVE FOR FILING COSTS -
ESTIMATED
Page 3
24-03-00907
Amount
9.90
700.00
TOTAL. (Carry forward to main schedule) ...... 709.90
Estate of= RASMUSSEN, LAURA H
Schedule H, Part B -- Personal representatives~ Commissions
Item
No.
Description
Name: MANUFACTURERS & TRADERS TRUST CO.
Social security number:
Address: ATTN: RUTH ANN McMILLEN, AVP
213 MARKET STREET
HARRISBURG, PA 17101
Year (s) commissions paid:
Page 2
2~-03-00907
Amount
36,630.49
TOTAL. (Carry forward to main schedule) ...... 36,630.49
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RASMUSSEN, LAURA H 21-03-00907
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
Include unreimbursed medical expenses.
ITEM
NUMBEF
DESCRIPTION
MESSIAH VILLAGE
FISCAL SERVICE DEPARTMENT
1000 MT. ALLEN DRIVE
MECHANICSBURG, PA 17055-6100
NURSING HOME
PAID 11/10/2003 $5774.50
PAID 11/26/2003 $382.00
PAID 03/22/2004 $ 68.00
(PREVIOUSLY BILLED TO MEDICARE)
VERIZON LEHIGH VALLEY
PO BOX 28000
LEHIGH VALLEY, PA 180002-8000
TELEPHONE SERVICES TO DECEDENT
PP&L
TWO NORTH NINTH STREET
ALLENTOWN, PA 18101
ELECTRICAL SERVICES TO DECEDENT
VITERRA
SUITE 300
7406 FULLERTON STREET
JACKSONVILLE, FL 32256
UTILITY SERVICES TO DECEDENT
CAMP HILL PLAZA APARTMENTS
121 NOVEMBER DRIVE
CAMP HILL, PA 17011
RENT DUE ON DECEDENT'S APARTMENT
M&T TRUST CO.
HARRISBURG, PA
INCOME FEE DUE ON DECEDENT'S TRUST
AT DATE OF DEATH
PA DEPARTMENT OF REVENIIE
BALANCE DUE ON DECEDENT'S FINAL
STATE INCOME TAX RETURN - 2003
TOTAL (Also enter on line 10, Recapitulation) $
AMOUNT
6,224.50
47.64
10.06
24.40
1,482.83
947.52
488.00
9,224.95
2W46AH 2.000 (If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
RASMUSSEN, LAURA H
NUMBER
k
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLEDISTRIBUTIONS[includeoutrights~usaldistributions, andtransfer~
underSec. 9116(a)(1.2)]
1617 THOMPSON LANE
MECHANICSBURG, PA 17055-6729
SIMEONE, RICHARD J
18 GLOUCESTER AVENUE
GLOUCESTER, MA 01930-2527
SIMEONE, MARK ANDREW
9 BERTRAM STREET
BEVERLY, MA 01915
SIMEONE, MATTHEW JOHN
181 RAMBLEWOOD ROAD
MOORESTOWN, NJ 08057
SIMEONE, HONOR CHRISTINE
970 HOPE STREET
APT #4H
STAMFORD, CT 06907
2~ -03-00907
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FRIEND
NEPHEW
GREAT NEPHEW
GREAT NEPHEW
GREAT NIECE
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NONITAXABLE 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 Il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$ 0.00
2W46AI 1.000 (If more space is needed, insert additional sheets of the same size)
ESTATE OF RUTH H. RASMUSSEN ]DOD: 10/03/2003
',~,CCT' #1~)347~ (~S~ATE) ~ ! -- --
PENNSYLVANIA CALCULATION: i FR END
CALCULATIO~N OF ESI'ATE RES D_UE
NEPHEW
HONOR
CHRIST NE
SIMONE
33.333% 33.333% ~ 11.111%i, 11.111% 11.111%
DATE OF DEATH _ ~' . -- - ~ ---- .,- ~ _
GROSS ESTATE + '1,242,03282 '
~UNERAL EXPENSES (SCH. J_ISART A) ~ ($9,146.00) ~?
ADMI~STRATIO~EXPENS~S (SCH. J,', PART B) ~ ($63,-,~.20)-' - '
D~(SCH. ~PART 1) ($9,224.95)~ '
~CIFIC~UEST OIE REAL ESTATE $0 ~ -
~PECIF~QUEST ~F TANG~S I ($303~ ~.485 0
J · J '~ ~ . U
SOLD/DISTRIBUTED ($294~34) $147 17 $14-7;~
CASH BEQUESTS $0.00
LIFE INSURANCE (SCH. D) $0.00
JOINT PROPERTY (SCH. E, PART II) ~ $0.00"
ANNUITY (SCH. I) ' ' $0.00-
CHARITABLE DISTRIBUTIONS (SCH. O) $0.00 ~
FEDERAL ESTATE TAXES
PENNSYLVANIA ESTATE TAXES _
RESIDUE_ _
$128,523.93
PA TAX @ .15 $128,523.93
SCHEDULE J EXPLANATION OF DISTRIBUTION PER WILL - PA
ESTATE of LAURA H. RASMUSSEN
RICHARD J. SIMONE
18 GLOUCESTER AVENUE
GLOUCESTER, MA 01930-2527
BETTY HOLLAND
1617 THOMPSON LANE
MECHANICSBURG, PA 17055-6729
MATTHEW JOHN SIMEONE
181 RAMBLEWOOD ROAD
MOORESTOWN, NJ 08057
MARK ANDREW SIMEONE
9 BERTRAM STREET
BEVERLY, MA 01915
HONOR CHRISTINE SIMONE
970 HOPE STREET APT ~4H
STAMFORD, CT 06907
NEPHEW
FRIEND
GREAT
NEPHEW
GREAT
NEPHEW
GREAT
NIECE
33.333% SHARE OF RESIDUE PER
ITEM IV (1) OF THE WILL
TANGIBLE PERSONAL PROPERTY AS PER
ITEM III (1) OF THE WILL
DISTRIBUTED IN KIND
DISTRIBUTED NET SALES PRICE
33.333% SHARE OF RESIDUE PER ITEM IV (2)
OF THE WILL
TANGIBLE PERSONAL PROPERTY AS PER
ITEM III (1) OF THE WILL
DISTRIBUTED NET SALES PRICE
NET SALES PRICE
11.111% SHARE OF RESIDUE PER ITEM IV (3)
OF THE WILL
11.111% SHARE OF RESIDUE PER ITEM IV (4)
OF THE WILL
11.111% SHARE OF RESIDUE PER ITEM IV (5)
OF THE WILL
$551.00
$147.17
$2,485.00
$147.17
DEPARTMENT OF; ~"VENU E
BUREAU O¢ iNDIVIDuAL TA~E$
DEPT. 280601
HARRISBURG, PA 1712~-0601
RECEIVED FROM:
-~EI~T~YLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAl. RECEIPT
I~EV-I 1 ~2 EX(11-96)
NO. CD 003399
M & T TRUST COMPANY SUCCESSOR
213 MARKET STREET
HARRISBURG, PA 17101
ESTATE INFORMATION: SSN: o57-1o-14s6
FILE NUMBER: 2103-0907--~~-~~
DECEDENT NAME: RASMUSSEN LAURA H
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
1 2/31/2003
00/O0/0000
'CUMBERLAND
1 0/03/2.003
ACN
ASSESSMENT
CONTROL
NUMBER
101
AMOUNT
45,350.00
REMARKS:
TOTAL AMOUNT PAID:
M & T INVESTMENT GROUP
45,350.00
CHECK# 400039189
SEAL ..........
INITIALS: AC
RECEIVED BY:
'""DONNA M. OTTo
DEPUTY REGISTER' OF WILLS
TAXPAYER
his is to certify that the information ~--~e given is correctly copied trom a. original '"xtificate of dcad~ duly filed whh me as
Local Registrar. The original certificat. J1 be forwarded to t'hc State Vital Records ]ce for perr,;ane,~t filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 984.8188
No.
'a Regisu'ar
OCT 0 8 200
Date
COMMONWEALTH OF PENNSYLVANI EPARTMENT OF HEALTH * VITAL RECORDS
CERTIFI~.,~TE OF DEATH
,. Laura H.. Rasmussen ,. Female1~' 057 -- 10 -- 1456 IL October 3, 2003
: ~ ,. 9-1-11 NYC, NY [] ~ is~,j[]
~00 NE. ~ Drive ~CTU~ ,7..m,. P~ylV~ia ~ ,~..0 ~.. ' '
~~, PA 17055
,.. Joseph A. ~s~s~
~. ~v. Ric~ J. S~e ~.18 Glouc~ter Ave., ~ou~st~, ~ 01930
~m c,~O ~.~..O ~0-03 ~. Olivet ~t~
n. ,,b. 012755-L ~ers-~m~ ~, 1903 ~t St, ~, PA 17011
m' '~- Ira.
,,.
,r~)~ a
~]*O~ .O .O ~. 0
REGIST~'SSIG~/ANDNUM~/ ~/~ ,
7172312636
Register of Wills of CUMBERLAND County, PennsylvaK
Certificate of Grant of Letters
WHEREAS, on the 31st
dated April 17th 2001
No. 2003-00907 PA NO. 21-03-0907
ESTATE OF ~RASMUSSEN LAURA H
Late of
Deceased
~AMp HILL BOROUGH
Social Security No. 057-10-1456
day of October
200_~3 an instrumei
was admitted to probate as the last will of RASMUSSEN LAURA H
(i~.'~., ~.~.~,
late of CAMP HILL BOROUG~
, CUMBERLAND County, who died on the
3rd day of October ~00~ and,
W~EREAs, a true copy of the will as probated &s annexed hereto.
THEREFORE, i, DONNA M. OTTO _, Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day 9ranted Letters TESTAMENTARY
to M & T TRUST COMPANY SUCCESSOR and TO.ALLFIRST TRUST CO OF PA N A
who hav____~e duly qualified as Executor(rix)
and ha?_~e agreed to administer the estate accordin9 to law, all of which fully
appears of record in my Office at CUMBEP~ COUNTy COURT MOUSE,
CARLISLE, PEAT~SYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 3!s_~_~t day of October 2003.
**NOTE** ALL NAMES /~BO~E APPEAR (LAST, FIRST, MIDDLE)
OF
LAURA H. RASMUSSEN
I, LAURA H. RASMUSSEN, of the Borough of Camp Hill, Cumberland County,
Pennsylvania, do make, publish and declare this to be my Last Will ahd Testament,
hereby revoking and making void any and all former Wills made by me.
ITEM I: DEBTS.
i direct that all my debts and 5aneral expenses, includ~g my gravemarker, and all
expenses of my last illness that my estate is obligated to pay shall be paid from my residuary
estate as a part of the expense of the administration of my estate.
ITEM II: PAYMENT OF TAXES.
All federal state and other taxes payable because of my death, with respect *.c,
property forming my goss estate for tax purposes, whether or not passing under this W~I2,
including any interest or penalty, imposed in connection with such tax shall be considered a
part of the expense of the administration of my estate and shall be paid fi'om that part of my
residum?- estate passing pursuant to ITEM III. hereof without apportionment or right of
reimbursement. All such taxes on present or furore interest shall be paid at such time or
times as my personal representative may tl-fink proper, regardless of whether such taxes are
;hen &ie. I 5.~er direct rlaat any and ail such taxes shall k,e paid ~om and dednc;ed fi'oxz=
that each residuary beneficia% charitable or not, shall bear a portion of the burden of such
taxes.
ITEM III: TANGIBLE PERSONAL PROPERTY.
1. I give and bequeath all my tangible personal property in my
apartment to my closest friend, BETTY HOLLM'qD, any my nephew,
RICI-LM~D JOHN SIMEONE, to be divided by them as they agree.
2. Should BETTY HOLLAND predecease me and RICHARD
JOHN SIMEONE survive me, all of my tan~ble personal property in my
apartment shall go to my nephew, RICHARD JOHN SIMEONE, and his
then living issue, per stirpes.
3. Should my nephew, RICHARD JOHN SIMEONE,
predecease me and BETTY HOLLAND survives me, BETTY
HOLLAND shall divide all of my tan~ble personal property in my
apartment among herself and those of my nephew's three (3) children,
MATTHEW JOHN SIMEONE, MARK ANDREW SIMEONE and
HONOR CHRISTINE SIMEONE, who survive me.
4. Should neither BETTY HOLLAND nor RICHARD JOHN
SIMEONE survive me, all of said items shall go to those of the above
three (3) children of RICHARD JOHN SIMEONE who survive me.
2
ITEM iV. RFqrDrr~
I give devise and bequeath the rest, residue and remainder of my estate as follows:
1. 33.333% to my nephew, RICHARD JOHN SIMEONE, and
his then living issue, per stirpes
2. 33.333% to my friend, BETTY HOLLAND provided she
survives me. Should she fail to survive me, this gift shall be added to and
distributed as part of 1. of this ITEM IV.
3. 11.111% to MATT~W JOHN SIMEONE .and his then
living issue, per stirpes.
4. 11.111% to MARK ANDREW SIMEONE and his then
living issue, per stirpes.
~ .11.111% to HONOR CHRISTINE SIMEONE and her then
living issue per stirpes.
ITEM V. PERSONAL REPRESENTATIVE.
I name, constitute and appoint my nephew, RICHARD JOHN SI1V~DNE, to be
Executor of this my Will. If he fails to qualify as Executor or fails to complete the
administration of my estate, I appoint ALLFIRST TRUST COMPANY OF PA, N.A.,
Executor.
-3-
iTEM VI. BOND.
No personal representative shall be required to post bond or enter security in any
jurisdiction.
IN WITNESS WHEREOF, I hereunto set,my hand and seal this
~,2{,7 ,2001.
,/7q~q day of
~ /~, ~.~.,..~,..~.,..v~..~__~_SEAL)
LAURA H. RASMUSSEN
Signed, sealed, published and declared by the above-named Testatrix, as and for
her Last Will and Testament, in the presence of use, who at her request, in her presence
and in the presence of each other have hereunto subscribed our names as wimesses.
-4-
Ae F[DA v lit
COMMONWEALTH OF PENNSYLVANIA ·
· SS.
COLrNTY OF CUMBERLAND ·
We, LAURA H. RASMUSSEN,
and
~,,?~ ~..~.,~e.-~-)~,~ , the Testatrix and the xvimesses,
respectively, whose names are si~ed to the a~ached or foregoing instrument, being first
duly sworn, do hereby declare to fl~e undersigned authofiW that the Testatrix si~ed and
executed the instrument as her Last Will and that she had signed willingly and that she
executed it as her ~ee and voluntaw act for the pu~oses therein expressed, and that each
of the wimesses, in the presence and hearing of the Testa~Sx, si~ed ~e Will as witness
and that to the best of iris/her ~owledge the Testatrix was at that time eighteen years of
age or older, of sound mind and ~der no cons~aint or undue i~uence.
LA~ H. ~SMUSSEN
Wire. ss
SWorn to or affim~ed to and subscribed to before me by LAURA H.
RASMUSSEN, Testatrix, and ~.~_..._,_~-x~'a.. ~-r-..,----v-~,
and ~t',, ~ ....,~ ~ ~ ~4.~ , W~nesses, ~s ~ ~ ~k~ day of
~--~.~, ~ .L ,2001.~Z
Notaw Public Q~ % '
NOTARIAL SEAL
DIANNE LENI6, Notary Public
tLemoyne Borough Cumberland Co.
Commission Expires Dec. 21,2001
-5-
Reply to:
901 N. 2'd Street
Harrisburg, PA 17102
(717) 233-0115
Fax: (717) 230-8996
HOBBt£ AUCTIONEERS
William W. Hobbie
AU 2591L
8 N. Market Street
Duncannon, PA 17020
(717) 834-5655
October 25, 2003
Mrs. Ruth Ann McMillen
M&T Bank, Trust Department
PO Box 2961
Harrisburg, PA 17105-9968
Re.'
Estate of Laura H. Rasmussen, Deceased
107 May Drive, Apt. 4
Camp Hill, PA 17011
Dear Mrs. McMiilen:
Pursuant to your request, on October 24, 2003, I inspected certain items of the Estate of Laura H.
Rasmussen,. Deceased, located at 107 May Drive, Apt. 4, Camp I-r_dl, PA 17011.
Based on my experience as an auctioneer for over twelve years and an antique dealer for over
twenty-five years, it is my opinion that the value for estate evaluation purposes of the inspected
items is as follows:
Livin~ Room:
Machine oriental, approx. 5' x 4'
........................................... $25.00
(2) Upholstered love seats
................................................. 20.00
Upholstered couch
....................................................... 20.00
(3) Upholstered chairs
.................................................... 15.00
(2) Mahogany end tables
.................................................. 20.00
Three-piece stack tables, mahogany
........................................... 25.00
Various knick-knacks and stuffed animals ..................................... 10.00
Pair table lamps ,,
- ' ........................................................ z0.00
Fancy tray table .......................
50.00
Mahogany four-drawer server ...................
75.00
Contents of top: Lamp, candle holder, miscellaneous ......................... 20.00
C ' e',-I - .,..I , 1
onten~s o~ urawers: Can,~y, piasac figures, oaoer napldns
..................................................
Mrs. Ruth Ann McMillen
M&T Bank, Trust Departmem
October 25, 2003
Page Two
Oil on canvas, impressionist style, approx. 3' x 2', signed E. Kraske .................. 50.00
Zenith TV and modernist stand
............................................. 25.00
Contents: Personal ..................................................... -0-
Duncan Phyfe round1 amp table ............................................. 30.00
Glass table light ......................................................... 10.00
(4) Porcelain pieces ....................................................... 5.00
Three-drawer bookcase
................................................... 30.00
Contents: Books, figures, fan
............................................ 5.00
Contents of drawers: View master ....................................... 10.00
Miscellaneous storage and Christmas items ................. 5.00
Sony tape player, stand, and tapes ............................................ 5.00
Seth Thomas mahogany mantle clock
........................................ 50.00
Mahogany glass-door bookcase
............................................. 95.00
Contents of(4) shelves: Souvenir figurines, including (1) Royal Doulton and
(1) newer Hummel fi~mnfne, and wooden figures, etc ...... 75.00
(2) Brass butterflies and flowers
.............................................. 5.00
(2) Fashion prints with fabric
............................................... 20.00
Small newer marble top table
............................................... 15.00
Closet: Clothes
Records and books
................................................ 5.00
Box, personal : ................................................... -0-
Balance of items in Living Room
............................................. 5.00
Storaee Room:
(4) Boxes bedding ........................................................ 5.00
Hoover vacuum
.......................................... 5.00
(4) Shelves miscellaneous storat, e books oames
~ ' ,~ - ' ............... 5.00
Metal cabinet and miscellaneous storage of household, pottery (McCoy, cracked), tin, etc
........................................ 10.00
Metal cabinet with doors
5.0O
Contents of door: Cookware, liquor, miscellaneous.., i iiiiiiiiii ii i iii
5.00
Contents of drawer: Tools, parts .......................................... 5.00
Contents of sheMng: Approx. (! 6) pieces porcelain and miscellaneous glass ........ 20.00
(3) Boxes (2 empty) Yarn
.................................................. 1.00
Exercycle ........................ 2 ....... : .............................. 5.00
Household clearing tools, card table, (4) ~olding chau-s, and balance of items ~ Storage Room
...................................... !0.00
l~s. Ruth Arm McMillen
M&T Bank, Trust Department
October 25, 2003
Page Three
Dinin____,g_,o Area:
Newer china closet ...................................................... 40.00
Contents: Approx. (19) Lladro child figurines .............................. 570.00
(3) pieces Smben glass (One not signed) .......................... 150.00
(1) Lalique rooster, signed ..................................... 50.00
(6) Miscellaneous pieces ....................................... 10.00
(6) Small souvenir glass pieces .................................. 10.00
Contents of drawers: Teak stands ........................................ 10.00
Plastic and plate stands 1.00
Baskets and miscellaneous ............................. 10.00
Floor lamp .............................................................. 5.00
Walnut table and (4) chairs ................................................ 75.00
Sideboard ............................................................ 100.00
Contents: Approx. (13) cups and saucers .................................. 30.00
(3) Flower fi=m.tres (Coalport and Royal Doulton) 30.00
Souvenir spoons and miscellaneous glass .......................... 10.00
Approx. (12) newer Oriental souvenir items ........................ 20.00
Contents of drawers: Linens, pla~emats, miscellaneous ........................ 25.00
Approx. (56) pieces International Sterling (broken set) ...... 400.00
Various silverplate and miscellaneous .................... 40.00
Set Franciscan china ................................. 40.00
Miscellaneous porcelain, ~ass, trays and storage ............ 10.00'
_Art glass vase .......................................................... 10.00
Metal cart with photos and miscellaneous ...................................... 5.00
"Goebel". dog ........................................................ 10.00
TV trays " 5.00
(2) Needlepoint pictures 5.00
Kitchen:
Formica table and (2) chairs ................................................. 1.00
Upper cabinets: Everyday china, stemware, bar glasses ........................... 30.00
Counter tops: Black & Decker toaster oven .................................... 5.00
Miscellaneous glass and plastic items .............................. 5.00
Lower cabinets and drawers: Usual pots and pans, household storage, utensils,
cleaning supplies ................................. 20.00
Hoover washine machine
Balance of items in Kitchen ................................................. 5.00
Pantie: Food and storage -0-
Mrs. Ruth Ann McMfillen
M&T Bank, Trust Department
October 25, 2003
Page Four
Bed Room #1:
Dresser with mirror
Top:
........................................................ 5.00
(4) Silver souvenir bracelets ........................................ 40.00
(2) Mosaic pins, earrings, miscellaneous costume jewelry .................. 30.00.
(3) 14K gold rings (red, blue gems, and peats) ........................ 180.00
(2) Cocktail rings ................................................ 90.00
(1) American Indian silver and turquoise ting ........................... 25.00
(2) 14K gold rings (amethyst and gold) .............................. 100.00
(1) Tennis bracelet (clear and red gems) .............................. 100.00
(1) Gold cocktail ting ............................................. 40.00 .
Balance costume jewelry .......................................... 50.00
Silk scarves
Personal storage, some costume jewelry .................................... 10.00
Clothes and miscellaneous storage, wallets scarves ............................ : 5.00
Mahogany side table ..................................................... 10.00
Contents: Radio, ak freshener, miscellaneous ................................ 1.00
Boston-style rocker ...................................................... 20.00
Upholstered chak and ottoman .............................................. 5.00
Single bed
Smaller Governor W'mthrop-style desk ...................................... 125.00
Drawers: Personal storage .............................................. -0-
Top: Usual personal and stationery items ............ . ................... 5.00
Bookcase: Royal Doulton figure ......................................... 40.00
Miscellaneous porcelain and figures .............................. 20.00
Metal file cabinet and personal papers ........................................ 10.00
Desk, 'typewriter, personal items .................... ' ........................ 10.00
Floor lamp 5.00
(2) Desk chairs on rollers
................................................... 5.00
Walker, bedside table and ointments .......................................... 1.00
Gold fancy bracelet
...................................................... 75.00
(2) Silver rings with amethyst and glass ....................................... 50.00
Miscellaneous costume jewela-y ............................................. 50.00
Gorham cry. stal snowflake ................................................. 25.00
Early military medals (circa 1900) ........................................... 75.00
(2) 14K gold rings ..................... : ................................. 50.00
Jewelry box with (5) drawers full better costume jeweh-y ......................... 100.00
(3) Silver dollars, early dog tag, St. Christopher medals ........................... 50.00
Small lot £orei~_~ coins ..................................................... 5.00
Mrs. Ruth Ann McMillen
M&T Bank, Trust Department
October 25, 2003
Page Five
Closet #1:
Closet #2:
Clothes .......................... 0-
Various stylish hats ............................... 5.00
Clothes
Bath Room:
Towels, sheets, etc ........................................................ 5.00
Personal and household storage ........................... : .................. ~0-
Wire chair
Balance: Personal ~
Balance ofitems in Bath Room ................................ : ......... 5.00
Bath Room #2:
Towels and sheets
...................................................... 5.00
Balance: Personal and household storage ................. ' ' -0-
Linen Closet:
Luggage (5 pieces) ....................................................... 5.00
Blankets, fan, miscellaneous storage ......................................... 10.00
(3) Table leaves
Empty boxes
Bed Room #2:
Oak side by side secretary desk
............................................ 400.00
Contents: Books and miscellaneous
....................................... 5.00
Miscellaneous paper storage .....................................
Lamp,
small
painting
tnorvam) ............................................. 10.00
Sewing machine .......................................................... 5.00'
Upholstered chair and ottoman
......... : .................................... 5.00
Side table and stuffed bear and iron
........................................... 5.00
Pull out bed ............................................................. -O-
Stuffed animals
....................................................... ,. .oo
............................. 5.00
Contents: Miscellaneous storage ....... ' ......................... 5.00
Top: Lamp, tray, miscellaneous
......................................... 10.00
Closet: Clothes
(8) Fancy ladies hats ........................................... 30.00
Balance of items in_ Bed Room #2
............................................ 5.00
Mrs. Ruth Ann McI~fillen
M&T Bank, Trust Departmem
October 25, 2003
Page Six
Hall:
Bookcase and books
...................................................... 5.00
Total $4,527.00'
If you have any questions, please don't hesitate to call me.
service in this matter.
Sincerely, /~J~/
William W. Hobbie
Hobbie Auctioneers
Thank you for allowing me to be of
REVOCABLE TRUST AGREE1V[ENT
THIS REVOCABLE TRUST AGREEMENT is made .%"~' 0~ay of
~ ~:~ /'--- , 2003, by and between Laura H. Rasmussen of Cumberland County,
Pennsylvania, herein called the "Settlor," and Allfirst Trust Company of Pennsylvania, N.A.
herein called the "Trustee," or its successors or assigns by purchase, merger, consolidation, or
otherwise.
In consideration of the covenants and mutual promises herein contained, the Settlor
and the Trustee hereby agree as follows:
ARTICLE I. Trust Propert?-; Name
A. The Settlor does hereby transfer, assign, convey and deliver to the Trustee
the sum of one dollar ($1.00) and the property described in Schedule A attached hereto, the
receipt of which is ac 'knowledged by the Trustee.
B. ~M! real and personal property heretofore or hereafter received by the
Trustee shall form a part of the trust estate, and shall be herein referred to as, the "trust
estate".
A_RTICLE II. Payment of Trust Income and Principal to Settlor
During the lifetime of the Settlor, the Trustee shall pay from time to time, to or for
the benefit of the Settlor such sums from the net income or principal of the Trust as the
Settlor (or the Settlor's duly appointed attorney-in-fact) may request in writing or otherwise.
Any income not distributed on an annual basis shah be added to principal.
A~P.T!CLE Ii!. Withdrawal of Trust Principal
A. During the Settlor's lifetime, the Trustee shah have the power and authority
· hereunder to make payments of net income or principal for the Settlor's heaith, maintenance,
comfort or support, and the Trustee may make any such payments to or for the benefit of the
Settlor, or to the individual who is, in the sole judgment of the Trustee, in proper charge
of the Settlor, whether with or without a court order; and in eveQ- such event payments ma3,
be made, received and applied without the necessity of any accounting to, qualification in, or
approvai of any cou~. and any such payments made in ~ood faith shall be deemed proper and
B. The Settlor shall have r. he po~.ver and authori~, upon ~'ri~en notice to the
Trustee, to Withdraw any pa~ or aii of the principal of the trust estate, so that the trust estate
may be terminated in whole or in part in the sole and absolute discretion of the Settlor.
O;3tional Provision for Spouse:
The Settlor directs that the following paragraph (initial one)
shall
all not
be a part of this Agreement:
C. Whenever, in the sole and absolute opinion of the Trustee, the Settlor shall be
incapable of exercising the foregoing power of withdrawal, the Trustee in its sole and absolute
discretion may make payments of the net income or principal for the Settlor's spouse's health,
maintenance, or support, and the Trustee may make any such payments to or for the benefit
of the Settlor's spouse, or to the individual who is, in the sole judgment of the Trustee, in
proper charge of the Settlor's spouse, whether with or without a court order; and in every
such event payments may be made, received and applied without the necessity of any
accounting to, qualification in, or approval of any court, and any such payments made in good
faith shall be deemed proper and shall constitute a complete release and acquittance of the
Trustee therefor.
ARTICLE IV. Payment of Taxes and Expenses
Upon the death of the Settlor, the Trustee, after consultation with the Personal
Representative of the Settlor's estate, may pay from the trust estate:
A. To the proper taxing authorities for the account of the Settlor's estate:
1. All income taxes payable with respect to income received by the
Settlor prior t'o the Settlor's death, or payable by the Settlor's estate after the Setflor's death,
2. .MI estate and inheritance taxes (including any interest and penalties
thereon not caused by negligent delay) payable with respect to all property, included in the
Settlor's gross estate, whether or not such property constitutes a part of the trust estate, and
3. All unpaid gift taxes on any gifts made by or attributed to the Settlor
during the Settlor's lifetime;
B. All debts, claims, funeral expenses, and administration expenses (including
commissions and legal fees) which, in the sole and exclusive judgment of the Trustee, properly
are payable by and duly chargeable against., the Settio?s probate estate or the trust estate:
c' All o~h..~ ~ '- ...... ~*~
~' ~'~, : .......(other than as
provided M paragraph A above) and/or penalties not caused by negligent delay which the
Trustee, in its sole and exclusive ~udgment, shah deem to be proper[y payable by or on behaff
of the Seffior's probate estate or by the trust estate.
.~TICLE V. Balance of the Trust Estate
~ of the balance of the trust estate then remaMMg M the hands of the Trustee after
any payments described in the foregoMg Article ~ and McludMg a~ additions thereto sha~
be paid over and distributed to:
A. ~y one or more of such persons and co~orations, MeludMg the Seffior's.
estate or creditors or to the creditors of the Se~lor's estate, as by last wffi and testament the
Se~lor effectively may appoMt, includMg gffis ~ trust; provided, however, that no exercise of
such power of appo~tment sha~ be effective unless reference thereto shaB be made M a valid
wffi executed by the Se~lor, specffiea~y mentioning th~ Agreement and expressly ~tendhg to
exerebe such power. The Trustee may determine that such 'power was not exercised ff withM
s~ (6) months of the date of the death of the SeRlor the Trustee shaB not have received a copy
of a will duly admi~ed to probate exereisMg such power.
B. ~ of such share not so effectively appoMted shaB be paid over to the
Seffior's Estate.
~TICLE ~I. AdmM~trative Prov~ions for Trust
A. No Bond. The Trustee of each trust created hereunder shaR sem, e as such at
aB ~es without bond.
B. .Succession. Any successor or substitute Trustee hereunder shaB have all the
rights, powem, discretion, dufi~ and responsibffities grant~ to or imposed upon the Trustee
named herein~ provide, however, that any successor or substitute Trustee sha~ have no
ob~gafion to Mquire Mto, nor any ~abffiW for, the prior admM~afion of any trust.
C. No Court Sure,sion. None of the rests hereM created shaB be
admM~tered under the dkection or ju~dicfion of any coup. If any trust hereunder
nonetheless is subject to the jurisdiction of any court, such jurisdiction shah extend only to the
particular ma~er considered, and sha~ termMate upon conclusion of the proeeedMg.
B Other ~ot~ of Beneficiam.,. ~Vherever ,h~ T ...... h .....~ ~ ~ -
~a~ ~ave me
power to pay over and distribute to or for ~he benefit of anYbeneficia~ sUch amounts as h ~ts
sole and absolute discretion the Trustee may or shall deem to be necessa~, reasonable or
desirable, the Trustee may, but shall not be required to, ~quire ~to or ~vestigate any other
income or resources then available to such beneficial.
E. Life Insurance Proceeds. The Trustee shall determ~e what para of afl life
insurance proceeds or other death benefits, ff any, payable to it sha~ be made a para of any
trust. The Trustee sha~ not be ob~gated to prosecute any action to eollect such payments
unless it ~ ~demnffied ~ the manner and ~ an amount satishctoO~ to it or unless it sha~
determine that the other assets of the trust are sufficient to pay a~ expeases of prosecu~g
such action.
F. Corporate Trustee Holds Assets. The co,orate Trustee sha~ reta~ custody
of a~ assets of any trust hereunder created, and any ~dividual Trustee sha~ be excused from
any ~abffiq~ on account thereo~
G. Compensation of Co,orate Trustee The corporate Trustee shall be en~tled
to compensation hereunder for its normal management se~ices as calc~ated under the
corporate Tmstee's schedule of fees pub~shed from time to time. The corporate Trustee shall
also be entitled to reasonable additional compensation from the prMcipal of the trust for
se~ices other than those related to normal trust adminis~tion, such as Mves~ga~ons
rela~g to d~crefiona~ payments of Mcome or prMcipal. A copy of the corporate T~stee's
current fee schedule is a~ached as Schedffie B hereto.
G. No A~oo~onment of Income. ~ythMg to the contra~ hereM
no~ithstandMg, the Senior dkects that on the death of any pe~on theretofore en~tled to
receive Mcome hereunder, no appo~onment sh~ be made thereof, and all acc~ed and
und~buted Mcome shah be paid to the beneficiao,, or ratably to the beneficiaries, next
entitled to rece~.e the Mcome or prMcipal of the trust.
H. Actual Notice. Unffi the Trustee shah receive actual notice of any b~h, death
or other event on which the right to receive any payment an~or distribution of Mcome and/or
prMcipal may depend, the Trustee sha~ not be Hable to any beneficia~ of the t~st for
payments or distributions theretofore made M good faith.
indemnification. SeUior shah [ndemnh~; and hold Tmastee, its dh-ectors,
officers, employees, agents, shareholders, representatives, parent, affiliates and subsidiaries
harmless from any and aH claims, losses, costs, expenses, fees, charges, damages, liabilities,
actions, causes of action, or any other sums whatsoever, charged to, incurred or paid by
Trustee in connection with, related to, or arising from, directly or indirectly, this Agreement,
or by reason of any other actions, contracts or agreements entered into by Trustee in
connection herewith; save and except this indemnification shah not apply to claims where
gross negligence is proven.
ARTICLE VII. Powers of Trustee
In addition to ail powers, authorities and discretion granted to it by common law,
statute or under any rule of court, the Settlor hereby expressly authorizes and empowers the
Trustee in its sole and absolute discretion to:
A. retain the securities of the corporate Trustee hereunder (or any parent,
sucCessor or Subsidia~:~ Co~p0mtion thereof) and to invest and reinvest in real or leasehold
property, tangible or intangible personal property, common trust funds, mutual funds,
common stocks, preferred stocks, bonds, and debentures, all as the Trustee may consider
advisabie or proper, without application to, or the approval of, any- court and without being
restricted as to the character of any investment by any statute or rule of law or court
governing the investment of trust funds;
B. invest and reinvest income and principal in securities of, or other interests in,
a no-load, open end management t3~pe investment company, or investment trust registered
under the provisions of the federal Investment Company Act of 1940 that does not impose a
contingent deferred sales charge or distribution charge on that investment, and the Trustee
shall have such power even ff a corporate Trustee serving hereunder or an afl.fflate of such
corporate fiduciary' provides services as investment advisor or manager, sponsor, distributor,
custodian, transfer agent, registrar, or similar related ser~Sces to the investment company or
investment trust and receives reasonable compensation for those services;
C. sell, lease (irrespective of the possible termination of the trus0, improve,
partition, mortgage, exchange or otherwise dispose of any and ail property' at any time
forming a part of the trust, in such manner, for such purposes and upon such terms as the
Trustee ma.;, deem ad;4sable;
..... ~ ......... ~ respect to ~ ~.~ .... ~ ~:~
securities held by it, for a~y pu~ose, a~d to t~ke any other action which the Trustee may
deem neeessa~ or proper in eon~ection therewith, pa~eipate ~ any voting trust, merger or
reorgan~ation and to hoid investments ~ the name of a nom~ee;
E. make divisions or dis~ibufions of the assets of any t~st ~ money or ~ ~d,
or pauly ~ money and pauly ~ ~nd, and to cause any pa~ of any such trust to be composed
of prope~ different ~ ~d from any other para; except as othem4se here~ spech~eaHy
provided, the judgment and any determination of the Trustee ~ connection therewith,
includ~g values assi~ed to various assets, shall be bind~g and conclusive on all persons
interested there.;
F. borrow or advance money for any purpose connected with the protection,
prese~ation or improvement of the tms~ and create one or more mortgages on, or pledges of,
any pa~ or a~ of the prope~ Mcluded M such trust, Whenever the Trustee shall deem the
~:~. same ~iB judgment advhable;
G. pay, comprom~e, compound, extend, mod~, renew, adjustt ~figate, submit
to arbitration, se~ or release any claims or demands of the trust agahst others or of others
agahst such trust as the Trustee shall deem adv~able and to make any payments h
connection therewith;
H. execute, ac~owledge and de~er any and aH ~struments ~ writ~g which
the Trustee may deem ad. able to car~ out any of the powem described hereM, McludMg
the power to Mdicate any di~sion or d~tfibufion of any trot by deeds or other wrings ~r
Mstmments recorded among the pubhc records of any jur~dicfion where any such prope~
may be located. No pa~ to any such Ms.merit M wring si~ed by the Trustee shall be
bound to see to the app~cafion by the Trustee of any money or other prope~ paid and
de~-ered to it pumuant to the terms of such Mstrument;
I. exerc~e, or consent to the exercise of, any tax options or elections aRowed by
any federal, state or local tax law;
J. retain agents such as accountants, aRomeys, health advisors, and real ~tate
agents or other ad. om to assist ~ the admM~tration of the Trust and to pay them from
Trust assets.
Ci~eck one bqx,
I~ Al! ~nvestment decisions shall_ be made ia the sole and absolute
discretion of the Trustee and its discretion pursuant to the provers hereinabove conferred
upon it shall be binding and conclusive upon all persons, beneficiaries or remaindermen.
[] No changes shall be made in the investments constituting the trust
without the consent of the Settlor during the term of the Settlor's life, unless at the time the
consent be required, the Settlor be so ill' or incapacitated as to be unable to signify approval
or disapproval, or unless the Settlor's whereabouts be unknown, or the Settlor be not
readily accessible, in any of such events the Trustee may take such action as it deems
advisable without obtaining such consent. The decision of the Trustee in respect to the
necessity7 for dispensing with the consent of the Settlor, because of the existence of such
circumstances, shall be conclusive and binding upon all persons interested in the trust and
all persons dealing with it.
.~RTtCLE VIII. Additional Trust Property
Subject to the acceptance of the Trustee, the Settlor and/or any other person may a~
any time deposit with, or transfer, devise, bequeath or appoint to the Trustee additional
proper(y to be held, administered and ultimately distributed hereunder as a part of the trust
estate.
)~RTICLE IX. Revocation and Modification
The Settlor hereby reserves the right and power at any time and from time to time
during the Set, lot's lifetime to revoke the trust hereby created in whole or in part, and to
modify or amend in any respect any of the terms and provisions hereof, including the power
to withdraw any or all property from the trust estate and to remove the Trustee and appoint a
successor Trustee (such removal to be effective upon receipt by the Trustee of the successor
Trustee's written acceptance of such appointment) by written notice delivered to the Trustee,
without the consent of any other person and without notice to any person other than the
Trustee; provided that the obligations of the Trustee shah not be increased nor its
compensation reduced without its consent.
The Settlor certifies (I) that the Taxpayer identification Number shown on this
Agreement is correct and (2) that the Settlor is not subject to backup withholding either
because the Settlor has not been notified that it is subject to backup withholding as a result of
a failure to report all interest or dividends or the Internal Revenue Service has notified the
Settlor that it is no longer subject to backup withholding. (NOTE: strike item (2) if the
Settlor has been notified that it is subject to backup withholding and has not received a notice
from internal Revenue Service that backup withholding has terminated.)
ARTICLE X1. Acceptance by Trustee
The Trustee hereby accepts the trusts herein created, and agrees to serve as Trustee
hereunder.
ARTICLE XII. Terms
A. Throughout this Trust Agreement, when the context or circumstances so
require, references to the sin~qflar number shall include the plural and vice versa, and
references to any gender shall include any other gender.
B. The headings used herein are for convenience only and do not affect or
modify the provisions of this Trust Agreement.
C. This Trust Agreement, and all of its terms, conditions, provisions and
limitations, shall be construed in accordance with the laws of the [State]
[Commonwealth].
PN ~[TNESS 'v~REOF, the Senior and the Trustee have hereunto set their hands
and aff'Lxed their seals, respectively, the day and year first above mentioned.
) ,~.: /
. ..? .,., /;i~, ~,/:~......, ~?,~
.. ,:..._,., . / :; - ~
wiTNEss:-'~- :,
' '' ' ~ ,? : ,' ,' .:;'"-T--?', · fi,'-'/. ~
:"' ' .... K:~d. - ,,-~ (Sea~)
',_...--i-:~ - ; i. b*.>->:-"~-',.. ':'::"*
Settlor's Telephone No.
Settlorls Sigmi~re
Laura H. Rasmussen, Settlor
~ettlo r' s IN ame
Settlor's Taxpayer I.D. No. Settlor's Address:
%/3 ,,~. >, e.,:>~ _~
ALI~IRST TRUST COM~.~_ANY,'~ / /
ATTEST'_--' · OF.~EN~SYI4*O. Nk~,F~. :/Ill
Bradley) C~A~ CF~ - Vice ~resideat
/
213 ~arket Street
I-!arri.qhur~; Pennqvlvania 17101
IF REAL PROPERTY IS A PORTION OF Tlqqr~ TRUST, THIS AGREEMENT _MUST BE
NOTA_RIZED.
Register of Wills of
CUMBERLAND
SUPPLI!R, II!iNTAL
INVENTORY
County, Pennsylvania
Estate of Laura H. Rasmussen
also known as
, Deceased
No. 2003-00907
Date of Death 10/03/2003
Social Security No. 057 - 10 - 1456
M?nufacturers and Traders Trust Company, Successor to Allfirst Trust Company of PA, NA
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 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 Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Johnson, Duffle, Stewart & Weidner
Name of
Attorney: Horace A. Johnson, Esquire
I.D. No.: 06340
PersonaI Representativ~e/~ufacturers and Traders Trust
Company, Succe~/~r J~r-Allfiirst Tr~st.Company of
Signature: ~ ~ )~ ~~f/~f~_ PA' NA
Signature: & TBUST oFRC~
Address: 301 Market Street Address: 213 Market Street
Telephone:
Lemoyne, PA 17043
717/761-4540
Harrisburg, PA 17101
Telephone: 717/255-2109
Dated: ,
CASH:
Internal Revenue
Decedent's Final
Description
Service Center - Refund due
Income Tax Return - 2003
(Attach additional sheets if necessary)
from
Value
· 4,500.00
Total: 4,500.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory,
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc, Form #RW-7 (199Z)
July 14, 2004
Attorneys At Law
PO BOX 1166
100 Pine St
Harrisburg, PA 17108-1166
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
(717) 787-3930
FAX (717) 772-0412
Dear SidMadam:
Re:
Estate of John Andrew Utzman
File Number 2103-0907
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before 01/02/05. Because Section 2136
(d) of the 1995 Act allows for .only one extra period of six (6) months, no additional extension(s) will be
granted that would exceed the maximum time permitted.
~mce[e]y, :-.
. .
Claudia Maffe~, S~sor
Document Pro~g Uni~
Inheritance TaxD~n"
BUREAU OF 1NDIV'rDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
REV-15~i7 EX AFP C01-05)
RUTH ANN MCMILLEN
M & T TRUST CO
215 MARKET ST
HBG
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
COUNTY
ACH
08-$0-200~
RASMUSSEN LAURA
10-05-2005
21~'~'~ 0907.
CU_I~B~ L AN:]I~
· ] ',
PA 17101
HAKE CHECK PAYABLE'.AND RF~ZT PAyHENT TO:
REOISTER OF 'q~L:Ls -"
CUMBERLAND CO::COURT~OUSE
CARLISLE, PA 17015--
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTXON FOR YOUR RECORDS
REV-I$&7 EX AFP [01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT~ ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF RASMUSSEN LAURA H FZLE NO. 21 05-0907 ACM 101 DATE 08-$0-200~
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORTGZNAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
~. ClosaZy HaZd Stock/Partnership Znterest (ScheduZa C) (3)
~. Mortgages/Notes Receivable (Schedule D) (~)
$. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly O~ned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Expanses/Ada. Costs/Misc. Expanses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10)
11. Total Deduc~ ions
Ne~ Value of Tax Return
5~75.61
.00
56~915.29
.00
.00 NOTE: To insure proper
credit to your account,
submit the upper portion
.00 of this form ~ith your
tax payment.
1~179~6~$.92
(8) 1,2~2,052.8Z
72,762.19
13.
NOTE:
9,22q.95
(11) 81.987.1~
(12) 1,160,0~5.68
.00
1,160,0~5.68
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13)
Nat Value of Estate Subject to Tax (lq)
If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17,
reflect figures that lnclude the total of ALL returns assessed to date.
ASSESSMENT OF TAX: 15. Amount of L/ne lq at Spousal rate
16. Amount of L/ne lq taxable at Lineal/Class A rate
17. Amount of Line 1~ at Sibling rata
18. Amount of Line 1~ taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDZTS:
PAYMENT RECEZP[ D~COUNT (+)
DATE
12-:~1-Z005
NUHBER
CD005599
CDO0~ll6
07-02-200~
INTEREST/PEN PAZD (-)
7,650.00
.00
18 and 19 Nlll
(1.5) .00 X O0 : .00
(16) .00 X Oq5 = .00
(17) . O0 x 12 = . O0
(18) 1,160,0r+5-68 x 15 = 17~,006.85
(19)~ 17q,006.85
AHOUNT PAZD
lq5,$50.00
21,006.85
TOTAL TAX CREDZT 17~,006.85
BALANCE OF TAX DUEI .00
~NTEREST AND PEN. I .00
TOTAL DUE J .00
( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT 1S REOUZRED.
1F TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)
ZF PA/D AFTER DATE INDZCATED, SEE REVERSE
FOR CALCULATZON OF ADD/TZONAL /NTEREST.
RESERVATION:
Estates of decedents dying on or before December 1Z, 19az -- 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 far
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the Iawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST=
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1313). Applications are available at the Office
of the Regi';ter of #ills, any of the Z3 Revenue District Offices, or by calling the special 24-hour
answering service for fores ordering: 1-BOO-362-ZO50; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board eT Appeals, Dept. ZSiOZ1, Harrisburg, PA lT1ZS-lOZ1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. la0601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lBO1) for an explanation of administratively correctable errors.
If any tax due is paid within three [5) calendar months after the decadant's death, a five percent (SZ) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day fram the date of
death, to the data of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2004 are:
Interest Daily Interest Daily Interest Bally
Year Rate Factor Year Rate Factor Year Rate Factor
~'~ 20X .000548 1-~8-1991 llZ .000301 ~'~ 9Z .000247
1983 16Z .000438 1992 9X .000247 ZOOZ 6Z .000164
1984 llZ .000301 1993-1994 72 .O0019Z 2003 5Z .000137
1985 15Z .000356 1995-1998 9Z .000247 2004 42 .000110
1986 102 .000274 1999 7Z .000192
1987 lOZ .000Z74 ZOO0 72 .O0019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELING)UENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: LAURA H. RASMUSSEN
Date of Death: OCTOBER 3, 2003
Will No. 2003-00907
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, 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 X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: 6 MONTHS
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
c. Did the personal representative state an account informally to the
parties of interest? Yes No
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.
Date: Sep ~t~nber 28,.2004~
EDMUND G. MYEgRS
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
BUREAU OF /NDZVZDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 171Z8-0601
CONNONNEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF DETERHZNATZON AND
ASSESSHENT OF PENNSYLVANZA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
R/¥-~85 EX AFP ¢0~,-05)
RUTH ANN MCHZLLEN
M & T TRUST CO
215 HARKET ST
HBG
DATE 08-$O-ZOOq
ESTATE OF RASHUSSEN
DATE OF DEATH 10,~4~c..Z005
FZLE NUMBER Z1~3~090~
COUNTY CUI~,~RLAND
ACN 20~!i
LAURA
Amount:. Rmmi~m~l
PA 17101
HAKE CHECK PAYABLE'AND R~ZT PAYHENT TO:
RESZSTER OF
CUH~ERLAND CO COURT HOUSE
CARLZSLE, PA 17013
NOTE: To insure prope~ credi~ ~o your account, submi~ ihs upper portion of ~his form wi~h your tax payment.
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR FZLES
REV-483 EX AFP (01-03) ~ NOTZCE OF DETERNZNATZON AND ASSESSHENT
OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN
ESTATE OF RASHUSSEN LAURA H FZLE N0.21 03-0907 ACN 201 DATE 08-30-200q
ESTATE TAX DETERHZNATZON
1. C~edi~ Fo~ S~ate Death Taxes as Verified Zl~3Zl.~6
Pennsylvania Znhe~i~ance Tax Assessed
CExclud~ng Discoun~ and/o~ Znte~est)
3. Znhe~i~ance Tax Assessed by O~he~ S~a~es .00
o~ Te~i~o~ies of ~he United S~ates
(Excluding Discount and/o~ Zn~e~est)
R. To~al /nhe~i~ance Tax Assessed
5. Pennsylvania Es~a~e Tax Due .00
TAX CREDZTS:
166~$56.85
166~56.85
PAYMENT RECEZPT DZSCOUNT (+)
DATE NUMBER ZNTEREST/PEN PAZD C-) AMOUNT PAZD
TOTAL TAX CREDZT .00
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE . O0
~ZF PATD AFTER THZS DATE~ SEE REVERSE SZDE (ZF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS RE~UZRED
FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU HAY BE
DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR TNSTRUCTZONS.)
PURPOSE OF
NOTICE:
PAYMENT:
To fulfill the requirements of Section ZlqO (b) of the Inheritance and Estate Tax Act, Act Z$ of ZOO0.
(7Z P.S. Section 91qO).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF HILLS, AGENT.
REFUND (CR): A refund of a tax credit may bo requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1513). Applications ara available at the Office of the Register of NiXXs,
any of the Z3 Revenue District Offices or from the Department's lq-hour ensnaring service for forms ordering:
1-BOO-36Z-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-~7-50Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied with the assessment of tax as sheen on this notice may object aithin
sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021,
--eXacting to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
XSTRATIVE
CORRECTIONS:
Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTR: Post Assessment Reviea Unit, Dept. Z80601, Harrisburg, PA 17126-0601,
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
OR
PENALTY:
INTEREST:
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in tho same manner and in the tho same time period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Fedora1 Estate Tax
return becomes delinquent at the expiration of nine (09) months from the date of death.
For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return
becomes delinquent at the expiration of eighteen (18) months from the date of death.
Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6g) percent per annum
calculated at a daily rate of .00016q. All taxes ahich became delinquent on or after January l, 198Z mill bear
interest at a rate mhich mill vary from calendar year to calendar year with that rate announced by the PA
Department of Revenue. The applicable interest rates for 1982 through ZOOq ara:
Interest Daily Interest Daily Interest Daily
Yea._._r Rate Factor Yoa.._.r Rate Factor Yea~ Rate Factor
1982 lOX .0005fi8 1988-1991 11X .000301 2001 9Z .O00Zfi7
1983 16Z .000fi58 199Z 9Z .OOOZq7 ZOO2 6Z .00016q
198~ llZ .000501 1993-199fi 7Z .OOOleZ 2003 5Z .000157
1985 132 .000356 1995-1998 92 .OOOZq7 ZO0~ qZ .000110
1986 IOZ .O00Z7q 1999 7Z .00019Z
1986 IOZ .OOOZ7~ ZOOO 82 .OOOZ19
--Interest is calculated as folloas:
XNTBREST= BALANCE OF TAX UNPAID X NUtIBER OF DAYS DEL'rNQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shoan on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: LAURA H. RASMUSSEN
Date of Death: OCTOBER 3.2003
Will No. 2003-00907
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, 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
x
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: 3 MONTHS
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
c.
parties of interest?
Did the personal representative state an account informally to the
Yes No
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.
E~~Jt
JOHNSON, DUFFIE, STEW ART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, P A 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
Date: March 4, 2005
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE
ESTATE OF
DA TE OF DEATH
FILE NUMBER
COUNTY
ACN
'*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
REY-756 EX Al'P 112-1141
03-14-2005
RASMUSSEN
10-03-2003
21 03-0907
CUMBERLAND
202
LAURA H
RUTH ANRMCMILLEN
M S T TRUST CO
213 MARKET ST
HBG PA 17101
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLEJ PA 17013
NOTE: To insure proper credit to your accountJ subllit the upper portion of this forll with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~
REV=736--EX--AFP--Coi:.-oir----.i-NOficE--OFDETE-RMiNATiCfti-AND-AS-SESS-MENT------------------------ ----
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ..
ESTATE OF RASMUSSEN
LAURA
H FILE NO.2l 03-0907
ACN 202
DATE 03-14-2005
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
21J32l.46
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
l66J356.85
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
166.356.85
5. Pennsylvania Estate Tax Due
.00
6. Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
7. Additional Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
-IF PAID AFTER THIS DATEJ SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $lJ NO PAYMENT IS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDI~' (CR)J YOU MAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
r;i;
STATUS REPORT UNDER RULE 6.12
Name of Decedent: LAURA H. RASMUSSEN
Date of Death: OCTOBER 3,2003
Will No. 2003-00907
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion ofthe administration of the above-captioned estate:
1. State whether administration of the Estate is complete:
Yes
No
x
2. Ifthe answer is No, state when the personal representative reasonably
believes that the administration will be complete: 6 MONTHS
3. Ifthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
c.
parties of interest?
Did the personal representative state an account informally to the
Yes No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached
to this report.
C1-
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EDMUND G. MYERS
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, P A 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
Date: July 5,2005
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2003-00907
ESTATE OF LAURA H. RASMUSSEN, DECEASED
--------------------------------------
--------------------------------------
FIRST AND FINAL ACCOUNT OF
Manufacturers and Traders Trust Company, Executor
================================================================================
Date of Death:
October 3, 2003
Date of Executor's Appointment:
October 31, 2003
Date of First Advertisement of Letters:
CUmberland Law Journal
Patriot News
December 5, 12 and 19, 2004
December 30, January 6 and 13,
2005
Accounting for the Period:
October 3, 2003 to
June 8, 2005
================================================================================
Purpose of Account: Manufacturers and Traders Trust Company, Executor, offers
this account to acquaint interested parties with the transactions that have
occurred during this administration.
It is important that the account be
additional information or questions
carefully examined.
or objections can be
Requests for
discussed with~::~
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Manufacturers and Traders
213 Market Street
Harrisburg, PA 17101
(717) 255-2109
Trust Company
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Horace A. Johnson, Esquire
Johnson, Duffie, Stewart & Weidner
301 Market Street
Lemoyne, PA 17043
(717) 761-4540
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SUMMARY OF ACCOUNT
Estate of Laura H. Rasmussen, Deceased
For Period of 10/03/2003 through 06/08/2005
proposed Distributions
to Beneficiaries
PRINCIPAL
Receipts:
Per Inventory Filed 3-7
Subsequent 7
Principal Receipts
Net Gain (or Loss) on Sales
or Other Disposition
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administration Expenses
Federal and State Taxes
Fees and Commissions
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
For Information:
Investments Made
Cha~ges in Investment Holdings
INCOME
Receipts:
This Account
Net Gain (or Loss) on Sales
or Other Disposition
Less Disbursements
Balance Before Distribution
Distributions to Beneficiaries
Income Balance on Hand
COMBINED BALANCE ON HAND
Page
32-33
8-11
12
12
12 13
14
14
15
16
17-22
23-27
28-29
30
31
2
Current
Value
Fiduciary
Acquisition
Value
490,951.83 490,951.83
====;========== ===============
10,064.95
9,146.00
2,627.07
216,990.12
61,050.81
1,242,032.82
564.79
20,756.51
1,263,354.12
299,878.95
963,475.17
480,751.32
482,723.85
21,577.76
0.00
21,577.76
1,475.68
20,102.08
11,874.10
8,227.98
490,951. 83
======>==========
RECEIPTS OF PRINCIPAL
ASSETS LISTED IN THE INVENTORY
AND APPRAISEMENT AS FILED
CASH:
$100,000 M&T Bank Certificate
of Deposit 2.33% due 4/5/06 -
Received from Laura H.
Rasmussen Trust dated 4/22/03
Accrued Interest
$15,000 Emigrant Savings Bank
Certificate of Deposit 5.12%
due 4/5/04 - Received from
Laura H. Rasmussen Trust dated
4/22/03
Accrued Interest
$15,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 12/23/03 - Received from
Laura H. Rasmussen Trust dated
4/22/03
Accrued Interest
$25,000 PNC Bank Certificate
of Deposit 4.97% due 8/2/04 -
Received from Laura H.
Rasmussen Trust dated 4/22/03
Accrued Interest
$25,000 PNC Bank Certificate
of Deposit 5.81% due 5/15/05 -
Received from Laura H.
Rasmussen Trust dated 4/22/03
Accrued Interest
$30,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 11/30/04 - Received from
Laura H. Rasmussen Trust dated
4/22/03
Accrued Interest'
Bank of New York - Replacement
check payable 6/1/02 for Cash
payment in Lieu of Fractional
Share Distribution Class A/B
3
100,000.00
6.39
15,000.00
6.33
15,000.00
6.09
25,000.00
10.21
25,000.00
79.58
30,000.00
12.18
4.61
Fiduciary
Acquisition
Value
Camp Hill Plaza Apartments -
Return of Security Deposit
Cash found in home
Emigrant Savings Bank -
Uncashed Interest Check from
Certificate of Deposit from
September
Greenpoint Bank - Uncashed
Interest Checks from
Certificates of Deposit from
March and September
Highmark Blue Shield - Medical
Reimbursement
Highmark Blue Shield -
Reimbursement of Overpayment
Internal Revenue Service -
Refund due from Decedent's
Final Income Tax Return - 2003
Manufacturers and Traders Bank
Checking Account #70366268 -
Date of Death Balance
Accrued Interest
MTB Money Market-lust I-Fund
#420 - Received from Laura H.
Rasmussen Trust - Principal
Cash as of Date of Death
MTB Money Market-Inst I-Fund
#420 - Received from Laura H.
Rasmussen Trust - Income Cash
as of Date of Death
Accrued Interest
PNC Bank Checking Account
#51-4016-8545 - Date of Death
Value
Accrued Interest
Return of Capital Tax Exempt
Sees Trust
Verizon Lehigh Valley - Refund
4
100.00
32.60
63.25
314.58
64.96
5.03
4,500.00
23,189.16
0.97
117,686.60
822.74
6.59
25,583.15
2.58
1,643.85
1. 78
384,143.23
PERSONAL PROPERTY:
Household Effects - Appraised
Value for Items taken in Kind
Household Effects - Sales
Price of Remaining Items
STOCKS/LISTED:
2 shares Agere Systems
Incorporated Class A
67 shares Agere Systems
Incorporated Class B
6,426 shares Allied Irish Bks PIc
Spons ADS - Received from
Laura H. Rasmussen Trust
dated 4/22/03
60 shares AT&T Corporation
Accrued Dividend
96 shares AT&T Wireless Services,
Incorporated
21 shares Avaya, Incorporated -
Received from Laura H.
Rasmussen Trust dated 4/22/03
664 shares Bellsouth Corporation -
Received from Laura H.
Rasmussen Trust dated 4/22/03
1,640 shares BP Amoco PLC Sponsored
ADR - Received from Laura H.
Rasmussen Trust dated 4/22/03
1,300 shares Brown Shoe, Inc. New -
Received from Laura H.
Rasmussen Trust dated 4/22/03
97 shares Comcast Corporation
Class A New
1,469 shares Delaware Group Income
Funds, Inc. Delchester-A #24 -
Received from Laura H.
Rasmussen Trust dated 4/22/03
2,057 shares Dreyfus Premier St Mun
Bond Fund PA Ser CI A -
Received from Laura H.
Rasmussen Trust dated 4/22/03
5
3,036.00
392.45
6.74
214.74
188,281. 80
1,263.30
14.25
831.84
228.90
16,397.48
71,340.00
43,459.00
3,144.74
4,539.21
32,788.58
3,428.45
3,127 shares Eaton Vance PA
Municipals Fund-B - Received
from Laura H. Rasmussen Trust
dated 4/22/03
4,367 shares Federated PA Muni
Income Fund-A #311 - Received
from Laura H. Rasmussen Trust
dated 4/22/03
4,577.614 shares Franklin High Yield Tax
Free Income Fd-A - Received
from Laura H. Rasmussen Trust
dated 4/22/03
1,600 shares Hershey Foods Corp -
Received from Laura H.
Rasmussen Trust dated 4/22/03
256 shares Lucent Technologies}
Inc. - Received from Laura H.
Rasmussen Trust dated 4/22/03
96 shares Midas Group, Inc. -
Received from Laura H.
Rasmussen Trust dated 4/22/03
1,333 shares Nuveen Municipal Value
Fund - Received from Laura H.
Rasmussen Trust dated 4/22/03
2,334 shares Nuveen select Tax Free
lne Port 2 - Received from
Laura H. Rasmussen Trust dated
4/22/03
10 shares Pennsylvania lnsd Mun
Inc Tr UT 63 26 Mul M -
Received from Laura H.
Rasmussen Trust dated 4/22/03
Accrued Interest
576 shares PepsiAmericas Inc. -
Received from Laura H.
Rasmussen Trust dated 4/22/03
2,577 shares Putnam PA Tax Exempt
Income Fund - Received from
Laura H. Rasmussen Trust dated
4/22/03
1,143 shares Smith Barney Capital &
Income Fund B - Received from
Laura H. Rasmussen Trust dated
4/22/03
6
31,864.13
51,050.23
47,744.51
119,312.00
569.60
1,239.84
12,176.96
30,913.83
2,772.10
40.60
8,608.32
23,373.39
16,299.18
12/06/04
15 shares Tax Exempt Secs Tr Ut
Natl Tr 200 - Received from
Laura H. Rasmussen Trust dated
4/22/03
Accrued Dividend
10,362.00
12.00
5,404 shares Tyco International 114,618.84
Ltd - Received from Laura H.
Rasmussen Trust dated 4/22/03
Accrued Dividend 67.55
618 shares Verizon Communications - 20,925.48
Received from Laura H.
Rasmussen Trust dated 4/22/03
SUBSEQUENT PRINCIPAL RECEIPTS:
Pharmerica - Refund of Credit
Balance
564.79
TOTAL RECEIPTS OF PRINCIPAL...... ... ... ...
7
854,461.14
564.79
1,242,597.61
===============
11/19/03
11/28/03
11/28/03
11/28/03
12/03/03
12/03/03
12/03/03
12/03/03
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL
Gain
$100,000 M&T Bank Certificate
of Deposit 2.33% due 4/5/06
Net Proceeds
Fid. Acq. Value
100,000.00
100,000.00
0.00
$15,000 Emigrant Savings Bank
Certificate of Deposit 5.12%
due 4/5/04
Net Proceeds
Fid. Acq. Value
15,000.00
15,000.00
0.00
$25,000 PNC Bank Certificate
of Deposit 4.97% due 8/2/04
Net Proceeds
Fid. Acq. Value
25,000.00
25,000.00
0.00
$25,000 PNC Bank Certificate
of Deposit 5.81% due 5/15/05
Net Proceeds
Fid. Acq. Value
25,000.00
25,000.00
0.00
1,469 shares Delaware Group Income
Funds, Inc. Delchester-A #24
Net Proceeds
Fid. Acq. Value
4,642.04
4,539.21
102.83
2/057 shares Dreyfus Premier St Mun
Bond Fund PA Ser Cl A
Net Proceeds
Fid. Acq. Value
3,127 shares Eaton Vance PA
Municipals Fund-B
Net Proceeds
Fid. Acq. Value
32,768.01
32,788.58
32,051. 75
31,864.13
187.62
4,367 shares Federated PA Muni
Income Fund-A #311
Net proceeds
Fid. Acq. Value
51,137.57
51,050.23
87.34
8
Loss
20.57
12/03/03 4,577.614 shares Franklin High Yield Tax
Free Income Fd-A
Net proceeds 48,202.28
Fid. Acq. Value 47,744.51 457.77
12/03/03 2,577 shares Putnam PA Tax Exempt
Income Fund
Net Proceeds 23,373.39
Fid. Acq. Value 23,373.39 0.00
12/03/03 1,143 shares Smith Barney capital &
Income Fund B
Net Proceeds 17,007.84
Fid. Acq. Value 16,299.18 708.66
12/05/03 6,426 shares Allied Irish Bks PIc
Spans ADS
Net Proceeds 189,686.62
Fid. Acq. Value 188,281. 80 1,404.82
12/05/03 60 shares AT&T Corporation
Net Proceeds 1,208.34
Fid. Acq. Value 1,263.30 54.96
12/05/03 96 shares AT&T Wireless Services,
Incorporated
Net Proceeds 693.08
Fid. Acq. Value 831.84 138.76
12/05/03 21 shares Avaya, Incorporated
Net Proceeds 294.40
Fid. Acq. Value 228.90 65.50
12/05/03 664 shares Bellsouth Corporation
Net Proceeds 17,395.98
Fid. Acq. value 16,397.48 998.50
12/05/03 1,640 shares BP Amoco PLC Sponsored ADR
Net Proceeds 70,254.30
Fid. Acq. Value 71,340.00 1,085.70
12/05/03 1,300 shares Brown Shoe f Inc. New
Net Proceeds 45,523.86
Fid. Acq. Value 43,459.00 2,064.86
9
12/05/03 97 shares Comcast Corporation
Class A New
Net Proceeds 3,020.43
Fid. Acq. Value 3,144.74 124.31
12/05/03 1,600 shares Hershey Foods Corp
Net Proceeds 123,898.19
Fid. Acq. Value 119,312.00 4,586.19
12/05/03 256 shares Lucent Technologies, Inc.
Net Proceeds 793.56
Fid. Acq. Value 569.60 223.96
12/05/03 96 shares Midas Group, Inc.
Net Proceeds 1,452.41
Fid. Acq. Value 1,239.84 212.57
12/05/03 1,333 shares Nuveen Municipal Value
Fund
Net Proceeds 12,143.05
Fid. Acq. Value 12,176.96 33.91
12/05/03 576 shares PepsiAmericas Inc.
Net Proceeds 9,192.52
Fid. Acq. Value 8,608.32 584.20
12/05/03 5,404 shares Tyco International Ltd
Net Proceeds 126,393.62
Fid. Acq. Value 114,618.84 11,774.78
12/05/03 618 shares Verizon Communications
Net Proceeds 20,201.47
Fid. Acq. Value 20,925.48 724.01
12/08/03 10 shares Pennsylvania Insd Mun
rnc Tr UT 63 26 Mul M
Net Proceeds 2,742.00
Fid. Acq. Value 2,772.10 30.10
12/10/03 Household Effects - Sales
Price of Remaining Items
Net Proceeds 392.45
Fid. Acq. Value 392.45 0.00
10
12/11/03
$15,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 12/23/03
Net Proceeds
Fid. Acq. Value
15,000.00
15,000.00
12/11/03
$30,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 11/30/04
Net Proceeds
Fid. Acq. Value
30,000.00
30,000.00
12/11/03
2,334 shares Nuveen Select Tax Free
Inc Port 2
Net Proceeds
Fid. Acq. Value
30,667.31
30,913.83
01/12/04
2 shares Agere Systems
Incorporated Class A
Net Proceeds
Fid. Acq. Value
6.63
6.74
01/12/04
67 shares Agere Systems
Incorporated Class B
Net proceeds
Fid. Acq. Value
209.70
214.74
01/26/04
15 shares Tax Exempt Secs Tr Ut
Natl Tr 200
Net Proceeds
Fid. Acq. Value
10,122.90
10,362.00
TOTAL GAINS AND LOSSES/PRINCIPAL.. .........
LESS LOSS... . . . . . . . . . . . . . . . . . . . . . . . . . .
NET GAIN OR LOSS. . . . . . . . . . . . . . . . . . . . . . . . . . .
11
0.00
0.00
23,459.60
2,703.09
20,756.51
===============
246.52
0.11
5.04
239.10
2,703.09
n/10/03
n/10/03
n/10/03
n/10/03
n/20/03
n/26/03
12/03/03
03/22/04
04/09/04
01/31/05
n/10/03
11/13103
n/10/03
n/13/03
n/13/03
DISBURSEMENTS OF PRINCIPAL
DEBTS OF DECEDENT
Messiah Village - Nursing
Home Expense
PP&L - Utility Expense
Verizon Lehigh Valley -
Telephone Expense
Viterra - Utility Expense
Camp Hill Plaza Apartments -
Rent due on Decedent's Apartment
Messiah Village - Nursing
Home Expense
Manufacturers and Traders
Trust Company - Income Fee
due on Trust at Date of Death
Messiah Village - Nursing
Horne Expense
Pennsylvania Dept of Revenue -
2003 Personal Income Tax -
Balance Due
Holy Spirit Hospital -
Medical Expense
5,774.50
10.06
47.64
24.40
1,482.83
382.00
947.52
68.00
488.00
840.00
FUNERAL EXPENSES
TOTAL DEBTS OF DECEDENT... ... ..... ..................
Myers-Harner Funeral Home,
Inc. - Funeral Expense
Mt. Olivet Cemetery - Grave
Opening Expense
7,783.00
1,363.00
ADMINISTRATION EXPENSES
TOTAL FUNERAL EXPENSES.... ...... ..... .... ...........
Hobbie Auctioneers -
Appraisal of Personal Property
cumberland County Register of Wills -
Sworn in Fee
Cumberland County Register of Wills -
probate Fees
12
200.00
15.00
922.00
10,064.95
9,146.00
1l/24/03
12/10/03
12/11/03
12/11/03
12/18/03
12/18/03
12/30/03
01/22/04
02/05/04
04/06/04
04/07/04
OS/27/04
07/01/04
07/01/04
07/06/04
PP&L - Utility Expense
11.04
Haar's Auction - Commission
on Sale of Household Effects
98.11
$15,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 12/23/03 - Penalty for
Early Redemption
15.97
$30,000 Greenpoint Bank
Certificate of Deposit 4.93%
due 11/30/04 - Penalty for
Early Redemption
9.90
PP&L - Utility Expense
10.37
Viterra - Utility Expense
67.82
AT&T - Telephone Expense
8.47
Cumherland County Register of wills -
2 Short Certificates
6.00
Edmund G. Myers, Esquire -
Reimbursement for Cost of Advertising
Proof of Publication in the Patriot
News and The cumherland Law Journal
205.68
Richard J. Simeone -
Reimbursement for Rental Cost
of U-Haul to clear apartment
289.02
Cumherland County Register of Wills -
2 Short Certificates
6.00
Cumherland County Register of Wills -
Cost of Filing Inventory
25.00
Cumherland County Register of Wills -
Cost of Filing Pennsylvania
Inheritance Tax Return
15.00
cumherland County Register of Wills -
Cost of Filing Supplemental Inventory
10.00
Susan Rodrigo - Reimbursement
of Postage for mailing Form
706 Federal Estate Tax Return
via Registered Mail
11. 69
RESERVES:
Cumherland County Register of Wills -
Account Filing Fee
700.00
TOTAL ADMINISTRATION EXPENSES...... ..... ... .........
13
2,627.07
12/26/03
07/01/04
07/01/04
01/06/05
01/06/05
09/17/04
FEDERAL AND STATE TAXES
cumberland County Register of wills -
Pennsylvania Inheritance Tax
Payment
cumberland County Register of Wills -
Pennsylvania Inheritance Tax -
Balance Due
us Treasury - Federal Estate Tax
Internal Revenue Service -
Fiduciary Income Tax for year
ending 9/30/04
pennsylvania Dept of Revenue -
Fiduciary Income Tax for
year ending 9/30/04
145,350.00
21,006.85
44,297.27
5,387.00
949.00
FEES AND COMMISSIONS
TOTAL FEDERAL AND STATE TAXES...... ....... ... .,. ....
Johnson, Duffie, Stewart &
Weidner - One Half of Attorney Fee
RESERVES:
Johnson, Duffie, Stewart &
Weidner - Balance of Attorney Fee
Manufacturers and Traders
Trust Company - Executor's Fee
12,210.22
12,210.10
36,630.49
TOTAL FEES AND COMMISSIONS.... ..... ... ..............
TOTAL DISBURSEMENTS OF PRINCIPAL.. ..... ..... ... .....
14
216,990.12
61,050.81
299,878.95
--------------
--------------
Betty Holland
12/31/03
04/07/04
12/20/04
Honor Christine Simeone
12/20/04
Mark Andrew Simeone
12/20/04
Matthew John Simeone
12/20/04
Richard J. Simeone
12/31/03
04/07/04
12/20/04
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
Distribution - Share of
Proceeds from sale of
Household Effects as per Item
III (1) of the will
Household Effects - Appraised
Value - Distributed in Kind as
per Item III (1) of the Will
Advance Distribution
Advance Distribution
Advance Distribution
Advance Distribution
Distribution - Share of
Proceeds from sale of
Household Effects as per Item
III (1) of the Will
Household Effects - Appraised
Value - Distributed in Kind as
per Item III (1) of the Will
Advance Distribution
147.17
2,485.00
159,140.32
147.17
551.00
159,140.32
TOTAL DISTRIBUTIONS TO BENEFICIARIES. . . . . .
15
161,772.49
53,046.78
53,046.78
53,046.78
159,838.49
480,751.32
==============
PRINCIPAL BALANCE ON HAND
Description
Current Value Fiduciary
Acquisition
or as Noted Value
MTB Money Market-Inst I-Fund #420
482,723.85 482,723.85
482,723.85 482,723.85
=~====:======== ===============
16
CHANGES IN INVESTMENT HOLDINGS - PRINCIPAL
$100,000 M&T Bank Certificate
of Deposit 2.33% due 4/S/06
10/03/03
11/19/03
inventoried
redeemed
$lS,OOO Emigrant Savings
Bank Certificate of Deposit
5.12% due 4/5/04
10/03/03
11/28/03
inventoried
redeemed
$lS,OOO Greenpoint Bank Certificate
of Deposit 4.93% due 12/23/03
10/03/03
12/11/03
inventoried
redeemed
$25,000 PNC Bank Certificate of
Deposit 4.97% due 8/2/04
10/03/03
11/28/03
inventoried
redeemed
$2S,000 PNC Bank Certificate
of Deposit 5.81% due 5/1S/0S
10/03/03
11/28/03
inventoried
redeemed
17
Cost
100,000.00
(100,000.00)
0.00
===========~===
lS,OOO.OO
(lS,OOO.OO)
0.00
--------------
--------------
15,000.00
(15,000.00)
0.00
--------------
--------------
2S,000.00
(25,000.00)
0.00
==========::::===
25,000.00
(2S,000.00)
0.00
--------------
--------------
$30,000 Greenpoint Bank Certificate
of Deposit 4.93% due 11/30/04
10/03/03
12/11/03
inventoried
redeemed
30,000.00
(30,000.00)
0.00
================
Agere Systems Incorporated Class A
10/03/03
01/12/04
2 shares inventoried
(2)shares sold
6.74
(6.74)
o
0.00
--------------
--------------
==============
Agere Systems Incorporated Class B
10/03/03
01/12/04
67 shares inventoried
(67) shares sold
214 . 74
(214.74)
o
0.00
--------------
--------------
==============
Allied Irish Bks PIc Spons ADS
10/03/03
12/05/03
6,426 shares inventoried
(6,426)shares sold
188,281. 80
(188,281. 80)
o
0.00
:::=============
===============
AT&T Corporation
10/03/03
12/05/03
60 shares inventoried
(60)shares sold
1,263.30
(1,263.30)
o
0.00
--------------
--------------
--------------
--------------
AT&T Wireless Services, Incorporated
10/03/03
12/05/03
96 shares inventoried
(96)shares sold
831. 84
(831. 84)
o
0.00
e======:::======
===============
Avaya, Incorporated
10/03/03
12/05/03
21 shares inventoried
(21) shares sold
228.90
(228.90)
o
0.00
=======::::======
==============
18
Bellsouth Corporation
10/03/03
12/05/03
664 shares inventoried
(664)shares sold
16,397.48
(16,397.48)
o
0.00
===============
BP Amoco PLC Sponsored ADR
10/03/03
12/05/03
1,640 shares inventoried
(1,640)shares sold
71,340.00
(71,340.00)
o
0.00
--------------
--------------
==============
Brown Shoe, Inc. New
10/03/03
12/05/03
1,300 shares inventoried
(1,300)shares sold
43,459.00
(43,459.00)
o
0.00
--------------
--------------
================
Comcast Corporation Class A New
10/03/03
12/05/03
97 shares inventoried
(97)shares sold
3,144.74
(3,144.74)
o
0.00
--------------
--------------
--------------
--------------
Delaware Group Income
Funds, Inc. Delchester-A #24
10/03/03
12/03/03
1,469 shares inventoried
(1,469)shares sold
4,539.21
(4,539.21)
o
0.00
--------------
--------------
--------------
--------------
Dreyfus Premier St Mun
Bond Fund PA Ser Cl A
10/03/03
12/03/03
2,057 shares inventoried
(2,057)shares sold
32,788.58
(32,788.58)
o
0.00
==============
--------------
--------------
Eaton Vance PA Municipals Fund-B
10/03/03
12/03/03
3,127 shares inventoried
(3,127)shares sold
31,864.13
(31,864.13)
o
0.00
===============
--------------
--------------
19
Federated PA Muni Income Fund-A #311
10/03/03
12/03/03
4,367 shares inventoried
(4,367)shares sold
51,050.23
(51,050.23)
o
0.00
--------------
--------------
==============
Franklin High Yield
Tax Free Income Fd-A
10/03/03
12/03/03
4,577.614 shares inventoried
(4,577.614)shares sold
47,744.51
(47,744.51)
o
0.00
--------------
--------------
===============
Hershey Foods Corp
10/03/03
12/05/03
1,600 shares inventoried
(1,600)shares sold
119,312.00
(119,312.00)
o
0.00
="======::=======
==============
Household Effects
10/03/03
04/07/04
04/07/04
inventoried
distributed in kind
distributed in kind
3,036.00
(2,485.00)
(551. 00)
0.00
===============
Household Effects
10/03/03
12/10/03
inventoried
sold
392.45
(392 .45)
0.00
--------------
--------------
Lucent Technologies, Inc.
10/03/03
12/05/03
256 shares inventoried
(256)shares sold
569.60
(569.60)
o
0.00
===============
=======::::======
Midas Group, Inc.
10/03/03
12/05/03
96 shares inventoried
(96)shares sold
1,239.84
(1,239.84)
o
0.00
--------------
--------------
--------------
--------------
20
Nuveen Municipal Value Fund
10/03/03
12/05/03
1,333 shares inventoried
(1,333)shares sold
12,176.96
(12,176.96)
o
0.00
--------------
--------------
================
Nuveen Select Tax Free Inc Port 2
10/03/03
12/11/03
2,334 shares inventoried
(2,334)shares sold
30,913.83
(30,913.83)
o
0.00
--------------
--------------
================
Pennsylvania losd Mun
Ine Tr UT 63 26 Mul M
10/03/03
12/08/03
10 shares inventoried
(lO)shares sold
2,772.10
(2,772.10)
o
0.00
--------------
--------------
================
PepsiAmericas Inc.
10/03/03
12/05/03
576 shares inventoried
(576)shares sold
8,608.32
(8,608.32)
o
0.00
--------------
--------------
================
Putnam PA Tax Exempt Income Fund
10/03/03
12/03/03
2,577 shares inventoried
(2,577)shares sold
23,373.39
(23,373.39)
o
0.00
--------------
--------------
==============
Smith Barney Capital & Income Fund B
10/03/03
12/03/03
1,143 shares inventoried
(1,143)shares sold
16,299.18
(16,299.18)
o
0.00
:=======:=======
:===============
Tax Exempt Sees Tr Ut Natl Tr 200
10/03/03
01/26/04
15 shares inventoried
(15)shares sold
10,362.00
(10, 362.00)
o
0.00
===============
--------------
--------------
21
Tyeo International Ltd
10/03/03
12/05/03
5,404 shares inventoried
(5,404)shares sold
114,618.84
(114,618.84)
o
0.00
--------------
--------------
==============
Verizon Communications
10/03/03
12/05/03
618 shares inventoried
(618)shares sold
20,925.48
(20,925.48)
o
0.00
--------------
--------------
================
22
RECEIPTS OF INCOME
DIVIDENDS
BP Amoco PLC Sponsored ADR
12(08(03
Hershey Foods Corp
12/14/03
TOTAL DIVIDEND INCOME. ." .................
INTEREST
$100,000 M&T Bank Certificate
of Deposit 2.33% due 4/5/06
11(19/03
01/07/04
01/07/04
Interest due for November
Interest due 4(5/06
82.98
197.89
191.50
$15,000 Emigrant Savings Bank
Certificate of Deposit 5.12% due 4(5(04
11/10(03
$15,000 Greenpoint Bank Certificate
of Deposit 4.93% due 12/23/03
11/10/03
12/08/03
12(11/03
56.79
60.84
14.17
$25,000 PNC Bank Certificate
of Deposit 4.97% due 8(2/04
11/28/03
02/06(04
21. 63
105.53
23
710.12
632.00
1,342.12
==============
472.37
59.03
131. 80
127.16
$25,000 PNC Bank Certificate
of Deposit 5.81% due 5/15/05
11/28/03
02/06/04
02/06/04
due 10/15/03
due 11/17/03
$30,000 Greenpoint Bank Certificate
of Deposit 4.93% due 11/30/04
11/10/03
12/08/03
12/11/03
Delaware Group Income Funds,
Inc. Delchester-A #24
11/25/03
12/08/03
Dreyfus Premier St Mun
Bond Fund PA Ser Cl A
11/04/03
12/03/03
Eaton Vance PA Municipals Fund-B
11/20/03
12/22/03
Federated PA Muni Income Fund-A #311
11/04/03
12/01/03
Franklin High Yield
Tax Free Income Fd-A
11/25/03
12/26/03
71.48
39.80
123 .36
113.66
121. 76
28.37
26.11
20.87
102.79
108.90
99.00
70.56
192.15
192.15
124.27
92.02
24
234.64
263.79
46.98
211.69
169.56
384.30
216.29
Manufacturers and Traders Bank
Checking Account #70366268
01/07/04
01/07/04
01/07/04
01/07/04
Interest due 10/21/03
Interest due 11/21/03
Interest due 12/19/03
Interest due 12/30/03
1. 03
1. 99
1. 81
0.65
MTB Money Market-Inst I-Fund #420
12/01/03
01/02/04
02/02/04
03/01/04
04/01/04
05/03/04
06/01/04
07/01/04
08/02/04
09/01/04
10/01/04
11/01/04
12/01/04
01/03/05
02/01/05
03/01/05
04/01/05
05/03/05
06/01/05
62.75
598.65
609.59
580.90
623 . 29
589.54
611.10
627.34
758.29
892.36
994.98
1,144.24
1,232.30
1,204.40
881. 06
876.78
1,052.09
1,089.08
1,188.57
12/01/03
Nuveen Municipal Value Fund
12/01/03
Nuveen Select Tax Free Inc Port 2
Pennsylvania Insd Mun
Inc Tr UT 63 26 Mul M
11/25/03
12/08/03
11. 50
0.60
25
5.48
15,617.31
53.32
13 6.54
12.10
PNC Bank Checking Account #51-4016-8545
02/06/04
02/06/04
02/06/04
02/06/04
Interest from 9/11 - 10/9/03
Interest from 10/10 - 11/6/03
Interest from 11/7 - 12/9/03
Interest from 12/10 - 2/4/04
Putnam PA Tax Exempt Income Fund
12/02/03
Smith Barney Capital & Income Fund B
01/27/04
01/27/04
01/27/04
01/27/04
Dividend due 9/26/03
Dividend due 10/31/03
Dividend due 11/28/03
Dividend due 12/26/03
Tax Exempt Sees Tr Ut Natl Tr 200
12/15/03
01/08/04
01/15/04
01/26/04
0.42
2.91
3.47
5.88
55.32
55.51
55.70
0.56
51.75
12.00
51. 90
25.80
TOTAL INTEREST INCOME......... ..... .......
OTHER INCOME
Received from Laura H. Rasmussen Trust
12/03/03
Return of Capital Tax Exempt
See
Dividend on Eaton Vance PA Mun
Fund B 9/16 - 10/15/03
Dividend on Delaware Group
Delchester A 9/23 - 10/22/03
Dividend on Franklin High
Yield Inc. Fund 9/23 - 10/20/03
Dividend on Putnam PA Tax
Exempt Inc Fund 9/29 - 10/27/03
Dividend on Dreyfus Premier St
Mun Bond Fund 10/1 - 31/03
Dividend on MTB Money Market-
Inst I-Fund #420 10/1-31/03
Dividend on Tax Exempt Sees Tr
due 10/15/03
Dividend on Eaton Vance PA
10/16 - 11/17/03
12/03/03
12/03/03
12/03/03
12/03/03
12/03/03
12/03/03
12/03/03
12/03/03
26
258.00
119.40
27.67
226.50
71.79
102.99
61. 52
48.75
30.47
12.68
83.44
167.09
141.45
18,547.02
===============
12/03/03
Dividend on Franklin
High-Yield 10/21 - 11/20/03
Dividend on Delaware Group
Delchester 10/23 - 11/17/03
Dividend on PA Insured Muns
Inc Tr due 10/25/03
Dividend on Putnam Tax Exempt
10/28 - 11/28/03
Interest on MTB Money Market
11/1 - 30/03
Dividend on Verizon
Communications due 11/3/03
Dividend on BellSouth Corp due
11/3/03
Dividend on Nuveen Select Tax
Free Fund due 11/3/03
Dividend on Nuveen Municipal
Value Fund due 11/3/03
Dividend on Tax Exempt See due
11/15/03
73 .09
12/03/03
6.94
12/03/03
11. 50
12/05/03
15.36
12/05/03
14.38
12/03/03
237.93
12/03/03
152.72
12/03/03
136.54
12/03/03
53.32
12/03/03
39.75
TOTAL OTHER INCOME.... ....... .... .........
TOTAL RECEIPTS OF INCOME.. ...... ....... ...
27
1,688.62
1,688.62
==============
21,577.76
===============
12/01/03
12/03/03
12/03/03
12/08/03
01/02/04
02/02/04
03/01/04
04/01/04
05/03/04
06/01/04
07/01/04
08/02/04
09/01/04
10/01/04
11/01/04
12/01/04
01/03/05
DISBURSEMENTS OF INCOME
Manufacturers and Traders
Trust Company - Commission
62.98
Laura H. Rasmussen Trust -
Fee collected on Trust for
10/4 & 10/5/03
67.68
Laura H. Rasmussen Trust -
Fee collected on Trust for
10/5 - 11/15/03
203.48
BP Amoco PLC Sponsored ADR -
Foreign Tax Withheld
70.52
Manufacturers and Traders
Trust Company - Commission
148.84
Manufacturers and Traders
Trust Company - Commission
74.35
Manufacturers and Traders
Trust Company - Commission
58.38
Manufacturers and Traders
Trust Company - Commission
34.85
Manufacturers and Traders
Trust Company - Commission
37.39
Manufacturers and Traders
Trust Company - Commission
35.37
Manufacturers and Traders
Trust Company - Commission
36.67
Manufacturers and Traders
Trust Company - Commission
37.64
Manufacturers and Traders
Trust Company - Commission
45.49
Manufacturers and Traders
Trust Company - Commission
53.54
Manufacturers and Traders
Trust Company - Commission
59.70
Manufacturers and Traders
Trust Company - Commission
68.65
Manufacturers and Traders
Trust Company - Commission
73.94
28
02/01/05 Manufacturers and Traders 72.26
Trust Company - Commission
03/01/05 Manufacturers and Traders 52.87
Trust Company - Commission
04/01/05 Manufacturers and Traders 52.61
Trust Company - Commission
05/02/05 Manufacturers and Traders 63.13
Trust Company - Commission
06/01/05 Manufacturers and Traders 65.34
Trust Company - Commission
TOTAL DISBURSEMENTS OF INCOME. ....... .... ......
29
1,475.68
===:::===========
Betty Holland
12/20/04
Honor Christine Simeone
12/20/04
Mark Andrew Simeone
12/20/04
Matthew John simeone
12/20/04
Richard J. Simeone
12/20/04
DISTRIBUTIONS OF INCOME TO BENEFICIARIES
Advance Distribution
Advance Distribution
Advance Distribution
Advance Distribution
Advance Distribution
TOTAL DISTRIBUTIONS TO BENEFICIARIES. .....
30
3,958.04
1,319.34
1,319.34
1,319.34
3,958.04
11,874.10
::::==============
INCOME BALANCE ON HAND
Current Value
Fiduciary
Acquisition
Value
Description or as Noted
MTB Money Market-Inst I-Fund #420 8,227.98
8,227.98
8,227.98 8,227.98
=============== ===============
31
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Current Value
or as Noted
Fiduciary
Acquisition
Value
Richard J. Simeone -
33.333% Share of Residue as
per Item IV (1) of the Will
Principal:
Cash
160,907.94
160,907.94
Income:
Cash
2,742.66
2,742.66
163,650.60 163,650.60
-------------- --------------
-------------- --------------
Betty Holland -
33.333% Share of Residue as
per Item IV (2) of the Will
Principal:
Cash
160,907.94
160,907.94
Income:
Cash
2,742.66
2,742.66
163,650.60 163,650.60
-------------- --------------
-------------- --------------
Matthew John Simeone -
11.111% Share of Residue as
per Item IV (3) of the Will
Principal:
Cash
53,635.99
53,635.99
Income:
Cash
914.22
914.22
54,550.21 54,550.21
==~======~==== ==============
32
Mark Andrew Simeone -
11.111% Share of Residue as
per Item IV (4) of the Will
Principal:
Cash
Income:
Cash
Honor Christine Simeone -
11.111% Share of Residue as
per Item IV (5) of the Will
Principal:
Cash
Income:
Cash
53,635.99
53,635.99
914.22
914.22
54,550.21 54,550.21
============== ==============
53,635.99
53,635.99
914.22
914.22
54,550.21 54,550.21
490,951.83 490,951.83
============== ==============
33
AFFIDAVIT
Manufacturers and Traders Trust Company, Executor under the Last will
and Testament of LAURA H. RASMUSSEN, deceased, hereby declares under oath that
it has fully and faithfully discharged the duties of its office; that the
foregoing 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, to its knowledge, there are no
claims now outstanding against the Estate; that all taxes presently due from the
Estate have been paid; and that more than four months have elapsed since the
first complete advertisement of the granting of letters in this Estate.
AS$T, VICE PRESID~NT
. 11lUS'T OffICE<<
Subscribed and sworn to
before me this
/
. .tpu-./YYI )AA-
day
of
2005.
~ ~,yJ/~
Notary Public
COMMONWEALTH OF PENNSYLVANIA
NoIarIaI Seal
Deanna L WeiII5, NoIary P1JJIic
Qly Of Ha!rillbUIg. 0lli4Jhil COIrty
My CanmisalOl1 Elcplre8 Dee. 6, :!(J06
M6m~I', P.n",ytll&"!,a AsSOCiation Of Notartes
34
1JJast lIill an~ wcstamcut
...... .- '~01
;(.1" iJj; ~'-l' ,
OF
LAURA H. RASMUSSEN
I, LAURA.. H. RASMUSSEN, of the Borough of Camp Hill, Cumberland County,
Pennsylvania, do make, publish and declare this to be my Last Will and Testament,
hereby revoking and making void any and all former Wills made by me.
ITEM I:
DEBTS.
I direct that all my debts and filneral eA-penses, includLTIg my gravemarker, and an
expenses of my last illness that my estate is obligated to pay shall be paid from my residuary
estate as a part of the expense of the administration of my estate.
ITEM II:
PAYMENT OF TAXES.
Ail federal, state and other ta.xes payable because of my death, with respect to
property forming my gross estate for ta.x purposes, whether or not passing under tIns Will,
including any interest or penalty imposed in connection with such tax shall be considered a
part of the expense of the administration of my estate and shall be paid from that part of my
residuary estate passing pursuant to ITEM III. hereof without appOliionment or right of
reimbursement. All such taxes on present or future interest shall be paid at such time or
times as my personal representative may think proper, regardless of whether such taxes are
then due. I further direct that any and all such taxes shall be paid from and deducted from
."'.
_I ,.""
I :l1aI each :;:esiduary ~>;;=-1~=:'::~2:'-->
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_,-.i.'___~"",~,__ _"-
shall bez.:.- 2. pCI1:icIl '::( tll~ b::rCleIl <::::: SU':~1 j
taxes.
ITEM III: TA.NGIBLE PERSONAL PROPERTY.
I. I give and bequeath all my tangible personal property in my
apartment to my closest friend, BETTY HOLLAND, any my nephew,
RICHARD JOHN SIMEONE, to be divided by them as they agree.
2. Should BETTY HOLLAND predecease me and RICIL4.RD
JOHN SIMEONE survive me, all of my tangible personal propeliy in my
apartment shall go to my nephew, RICHARD JOHN SIMEONE, and his
then living issue, per stirpes.
3. Should my nephew, RICHARD JOHN SIMEONE,
predecease me and BETTY HOLLAND survives me, BETTY
HOLLAND shall divide all of my tangible personal propeliy in my
apmiment among herself and those of my nephew's three (3) children,
l\1ATTHEW JOHN SIMEONE, MARK ANDREW SIMEONE and
HONOR CHRISTINE SIMEONE, who survive me.
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4. Should neither BETTY HOLLAND nor RICHARD JOHN
SIMEONE survive me, all of said items shall go to those of the above
three (3) children of RICHARD JOHN SIMEONE who survive me.
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I give devise and. bequeath the rest, residue and renlainder of ll1Y estate as 1"o110\v5:
1. 33.333% to my nephew, RICHARD JOHN SIMEONE, and
his then living issue, per stirpes
2. 33.333% to my friend, BETTY HOLLAND provided she
survIves me. Should she fail to survive me, this gift shall be added to and
distributed as pali of 1. of this ITEM IV.
3. 11.111 % to MATTHEW JOHN SIMEONE and his then
living issue, per stirpes.
4. 11.111 % to MARK ANDREW SIMEONE and his then
living issue, per stirpes.
, .11.111 % to HONOR CHRISTINE SIMEONE and her then
living issue per stirpes.
ITEM V.
PERSONAL REPRESENTATIVE.
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I name, constitute and appoint my nephew, RICHARD JOHN SIMDNE, to be
Executor of this my Will. If he fails to qualifY as Executor or fails to complete the
administration of my estate, I appoint ALLFIRST TRUST COMPANY OF PA, N.A.,
Executor.
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ITEM 'VI. BOND,
No personal representative shall be required to post bond or enter security in any
jurisdiction.
IN WITNESS WHEREOF; I hereunto set my hand and seal this
./1 r
L.JO/U:t./
.7\ '
{ 1
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J7#' day of
,2001.
d~.. 1/ '~-4:1~' (SEAL)
LAURA H. RASMUSSEN
Signed, sealed, published and declared by the above-named Testatlix, as and for
her Last Will and TestaIl1ent, in the presence of use, who at her request, in her presence
and in the presence of each other have hereunto subscribed our names as witnesses,
-4-
AFFIDAVIT
COMMO"N'WEALTH OF PEN;.'-fSYLV~"'-Nl:A
ss.
COUNTYOFCUMBEP~~~D
We, LAURA H. RASMUSSEN, ~'''''''''''"'--'- ..;;-"" .'~"--"~---~",
and "4:S",~~.,il. s::::;.. ....c-.. --cf-''--'..J the Testatrix'-and the witnesses,
respectively, whose names are sigited to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will and that she had signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed, and that each
of the witrlesses, in the presence and hearing of the Testatrix, signed the Will as wimess
and that to the best of his/her knowledge the Testatrix was at that time eighteen years of
age or older, of sound mind and under no constraint or undue influence.
,L? . If7
j..4.1-(~ ~ "dt~/1 ~ ' - - -- n ':!l ~
LAURAH~
Wimess
Sworn to or affinned to md subscribed to before me by LAURA H.
RASMUSSEN, Testatrix, and ~,-",-,--,_,~, "::,;....J,"'----.~
arld .""'t..'SJ'r..,.-,-,..S:~~ \:;CI.. __...-c-... _.).;_j , witnesses, this ., -\ 1..\"\ day of
C:'--""'~'" L ,2001.'''::'
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I NOTARIAL SEAL i
I DIANNE LENIG, Notary Public
I Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA ORPHANS' COURT DIVISION
NO. 21-20b3,-O0907
IN THE ESTATE OF LAURA H. RASMUSSEN
LATE OF UPPER ALLEN TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED
CERTIFICATION OF NOTICE TO BENEFICIARIES PURSUANT TO
CUMBERLAND COUNTY ORPHANS' COURT RULE 6.3-1
The undersigned certifies that written Notices of the time of presentation of the First and
Final Account and Statement of Proposed Distribution of M&T Investment Group, Executor of
the Estate of laura H. Rasmussen, have been given at least twenty (20) days prior to the date
fixed for confirmation in accordance with and required by Section 3305 of the Pennsylvania
Estate and Fiduciary Code.
Date: ~ /'Z, ].-0#"
Johnson, Duffie, Stewart & Weidner
By ~);~
Edmund G. M}1 rs
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: LAURA H. RASMUSSEN
Date of Death: OCTOBER 3. 2003
Will No. 2003-00907
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, 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. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X
No
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is: NO. 21-2003-00907
c.
parties of interest?
Did the personal representative state an account informally to the
Yes No
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.
Date: October 26, 2005
E&i~~
JOHNSON, DUFFIE, STEW ART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, P A 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
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OF COUNSEL
HORACE A. JOHNSON
F. LEE SHIPMAN
BRUCE) GROSSMAN"
':'admitted in NY only
)ERRY R. DUFFIE
RICliARD W STEWART
C. ROY WEIDNER. JR.
EDMU",D G. MYERS
DAVID W. DELLCE
)OHN A STATLER
)EFFERSON ). SHIPMAN
RALPH H. WRIGHT. JR
MARK C. DUFFIE
)OHN R. NINOSKY
MICHAEL). CASSIDY
MELISSA PEEL GREEVY
ROBERT M. WALKER
WADE D. MAI\LEY
LAW OFFICES
JOHNSON
DUFFIE
\\'1;l'I'I'''''~ 0. : \ 1 I
\1\11 ill\\," Id',\\ ""Ill
October 26,2005
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Laura H. Rasmussen
Date of Death: October 3, 2003
Your File No.. 21-2003-00907
Our File No. 5284-1
Dear Register:
Enclosed for filing please find the final Status Report for the above referenced Estate. Should you have
any questions, please feel free to contact the undersigned.
Very truly yours,
~SONI ~UFFIE, STEWART & WEIDNER
~.W~
Dana Wieseman
Estate Administration Paralegal
Ene.
cc: RuthAnn McMillian
:261643
301 MARKET STREET P.O. BOX 109 LEMOYNE. PENNSYLVANIA 17043-0109
WWWjDSWCOM 717.761.4540 FAX: 717.761.3015 MAIL@jDSWCOM
JOHNSON, DUFFIE, STEWART & WEIDNER, P.C.