HomeMy WebLinkAbout04-0658 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Mary R. Homart ~_~/
NO.
also known as To:
Register of Wills for the
· Deceased. County of .Cumberland
SociaI Security No. 184-38-8272 in the
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 or named
in the last wilt of the above decedent, dated. M~v ~1. 20
and codicil(s) dated ~ - ,
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at deathin Cumberland
County, Pennsylvania, with
h last family or principal residence at · ~
32 i - 'r'v .......... ~ic ur PA 170 5
(list street, number and muncipality)
Decendent, then. 91 years of age, died Ju'ly 1 r 2004
at Bethany Villaqe - , t~
Except as follows, decedent did not marry, was not divorced and did not have a child horn 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 $1 2 0,0 0 0
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania
situated as follows: ~ $-
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
..~
George T. Homan
4050 Mountain View Road
Mechanicsburq, PA 17050
OATH OF· PERSONAL REPRESENTATIVE
COMMONWEALT,]-I OF pENNSYLVANIA
COUNTY or t' u tcoaA }
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 person~ represen-
tative(s) of the above decedent petitioner(s) will well~ truly administ~the estate according to law.
Sworn to or affirmed ~d subscribed ~[~~~
before~ this [~ , day of [ /'
eg, 'er
Estate Of Mary R. Homan ., Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~ - -~ -- O~-~
st will of
."~0-- , in consideration of the petition on
FEES
Probate, Letters, Etc .......... $. 235.00
Short Certificates( )..- ....... $
'°°"
$. I0.o~
TOTAL -.--- ~Q~]{' Ob.
Filed .... .~ r. ~ .~...' .=7.9° ~.-. '"
~avid w. Knauer~ Esq- 21592
ATTORNEY (Sup. Cz. I.D. No.)
411-A E. Main St.~ Machanicsburg
ADDRESS
717-795-7790
PHONE
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 5/31/2006
HOMAN GEORGE T
4050 MOUNTAIN VIEW ROAD
MECK~ICSBURG, PA 17050
RE: Estate of HOMAN MARY R
File Number: 2004-00658
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS I COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent1s death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing lS due by:
7/01/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~~
U
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
egi ter of giII5 of umherIanl ountl,
Estate of ~J4
Also known as /
OATH OF NON-SUBSCRIBING WITNESS
,Deceased
}ach) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
(~ familiar with the signature of /L(F.2~,~ ~_ ~//.,Z:~ ,testattg~:xof
(one of the subscribing witnesses to) the codicil/will p[esented herewith and that ~ % believes
the signature on the codicil/will is in the handwriting of ~ /1_ ~ ~ 0 Pt.C-~49
to the best of k,~' knowledge and belief.
(Name)
(Address) /~-~'1! .1~ ~]~~, '/
l
Sworn to or affirmed.and subscribed
Before me this ll--~ day0f
-,.~'~&k~ ,20 C-->~l- ~ame)~ ~f/~
For the Re~ste~- - - ~q~o ~/~
~~ (Address)
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 10599488
No,
ocal Registrar
,u n 72004
Date
91 v-
Cumberland
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
Sales
325 Wesley Drive
Mechanicsburg, PA 17055
' : Dec 9,1912
MechantcsburS
George Clifford Reed
Geoz T. Homan
6, 2004
010338-L
Female 184- 38 -- 8272 ~ July i, 2004
Priscilla Krumrine
4050 Mountain View Mechantcsburg, PA 17050
County Memorial Park State College, PA 16801
Koch Funeral Home, State College, PA 16801
JUN 0 2 2004
LAST WILL AND TESTAMENT
OF
MARY R. HOMAN
KNOW ALL MEN BY THESE PRESENTS, That I, MARY R. HOMAN, of the
Township of Lower Allen, County of Cumberland, and Commonwealth of Pennsylvania,
do make, publish, and declare this instrument to be my Last Will and Testament, hereby
revoking and making void any and all former Wills by me at any time heretofore made.
FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses
and costs of administration as soon as conveniently may be done after my death. I
further direct the Executor hereof to pay all inheritance, estate, transfer and succession
taxes which may be levied or assessed upon any property which is included as part of
my gross estate for the purpose of any such tax.
SECOND: I give and bequeath unto the following grandchildren the sum of
$1,000 each:
A)
B)
C)
D)
E)
F)
Kimberly A. Homan
Kathryn E. Emrich
Jeffrey A. Homan
Kenneth B. Homan
Michael D. Homan
Morgan W. Homan
I have not given and bequeathed any gift and bequest to Nicholas A. Homan because
on the date of the execution of this my Last Will and Testament, he still owes me the
sum of $27,000, being the balance of my loan to him. However, if he should repay me
-1-
the $27,000 balance on my loan to him, I give and bequeath unto him the sum of
$1,000. In the event that he does not repay the aforesaid balance of my loan to him,
then in that event, I give and bequeath unto his sister, Kimberly A. Homan, an
additional gift and bequest of $1,000 or the combined total of $2,000.
THIRD: I give and bequeath unto St. Paul's Lutheran Church of Pine Grove,
Pennsylvania, the sum of $5,000.
FOURTH: I direct that in addition to the advertisement of my death in the
Cumberland Legal Reporter and The Sentinel that my death also be advertised in the
Center County Legal Reporter and the Center Daily Times.
FIFTH: I give, devise and bequeath all the rest, residue and remainder of my
estate in equal shares, share and share alike, to my Sons, GEORGE T. HOMAN,
EDWARD W. HOMAN, and MICHAEL R. HOMAN, perstirpes, provided that they are
living on the date of my death. In the event that one or more of my sons are not living
on the date of my death, then in that event the share of my son who has predeceased
me shall be given, devised and bequeathed as hereinafter set forth in paragraph SIXTH
of this my Last Will and Testament.
SIXTH: In the event that one or more of my aforesaid sons have died prior to
the date of my death, I give, devise and bequeath the share of the rest, residue and
remainder of my estate that my son who has predeceased would have received but for
his death to his widow, to wit; GEORGE T. HOMAN whose wife is DEBRA A. HOMAN
-2-
and EDWARD W. HOMAN, whose wife is BARBARA E. HOMAN, and MICHAEL R.
HOMAN, whose wife is DARLA J. HOMAN, per stirpes.
SEVENTH: I appoint my Son, GEORGE T. HOMAN, to be Executor of this my
Last Will and Testament. In the event that he predeceases me or is unable or unwilling
to be my Executor of this my Last Will and Testament, then in that event I appoint my
Son, EDWARD W. HOMAN, as the successor or contingent Executor of this my Last
Will and Testament. In the event that my son, EDWARD W. HOMAN, predeceases me
or is unable or unwilling to be my Executor, then in that event I appoint my Son,
MICHAEL R. HOMAN, to be my Executor of this my Last Will and Testament, and I do
hereby give to the Executor hereof full power, discretion and authority at any time or
times to sell, at private or public sale, mortgage, lease, pledge, exchange or otherwise
deal with or dispose of the property comprising my estate as deemed best, to settle and
compound any and all claims in favor of or against my estate as deemed best and, for
any of the foregoing purposes, to make, execute and deliver any and all deeds,
mortgages, contracts, leases, bills of sale or other instruments necessary or desirable
therefor.
LASTLY: I direct that no fiduciary appointed by this, my Last Will and Testament,
shall be required to give bond and that if, notwithstanding this direction, any bond is
required by any law, statute or rule of court, no surety shall be required thereon.
-3-
IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and
Testament, consisting of four (4) typewritten pages on the margin of which (except this
page) I have affixed my initials this 3rd day of May, A.D. 2002.
MARY R. HOMAN "
Signed, sealed, published and declared by MARY R. HOMAN, the above-named
Testatrix, as and for her Last Will and Testament, in the presence of us, and each of us,
who at her request, and in her presence, and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
I~th Myers
Amy Kn~
-4-
County of Cumberland
Commonwealth of Pennsylvania
SS.
ACKNOWLEDGMENT AND AFFIDAVIT
We, MARY R. HOMAN, the testatrix, and the undersigned witnesses to the Will,
the attached or foregoing instrument, having been qualified according to law do depose
and say:
(a)that I, the testatrix, do hereby acknowledge that I signed the instrument as my
Will, that I signed it willingly and as my free and voluntary act for the
purposes therein expressed; and
(b)that we, the witnesses, were present and saw the testatrix sign the instrument
as her last Will, that she signed it willingly and as her free and voluntary
act for purposes therein expressed; that each of us in the hearing and
sight of the testatrix signed the Will as a witness and that to the best of our
knowledge the testatrix was at that time 18 or more years of age, of sound
mind and under no constraint or undue influence.
Sworn to or affirmed before me by MARY R. HOMAN, testatrix, and Beth Myers
and Amy Knauer, witnesses, this 3rd day of May, 2002.
MARY R. HOMAN '
By: David W. Kn~u~r
Attorney I.D. #21582
Beth Myers ' / --------
Amy K~
-5-
CERTIFICATION OF NOTICE UNDER RULE 5.6(~)
Name of Decedem: Plfd~ ~j~ ~.
Date of Death: ,~q$--"{ 1/ ~OOC/
Will No. ,;)-oC~/-oo~,T~
Admin. No.
To the Register:
I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries Of the above-captioned estate on
Name Addre_s_s
b(~.,~,~.~.7 f~ hi':',~.~ 3 ,o,q,~./.~ P/d4cc: ,O~T~C .~/~-T~mo{?C--, /a~,. 0.1237
t(t=/v,¥6-r/¢ 8-
/'4/ T, ec.~Kct ~ E-
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: 0c.7' t ~ ~oo'-/
/
Signature
Telephone ('7l
Capacity: ~ Personal Representative
Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 10/05/2004
KNAUER DAVID W
41lA E MAIN ST
MECHANICSBURG, PA 17055
RE: Estate of HOMAN MARY R
File Number: 2004-00658
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS, COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 10/24/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Personal Representative(s)
Judge
Sincerely,
ENDA FARNER ~
Clerk of the Orphans, Court
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 10/05/2004
HOMAN GEORGE T
4050 MOUNTAIN VIEW ROAD
MECHANICSBURG, PA 17050
RE: Estate of HOMAN MARY R
File Number: 2004-00658
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPH3~NS, COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 10/24/2004
Your prompt attention to this matter will be appreciated.
Thank You.
CC:
File
Counsel
Judge
Sincerely,
ENDA FARNER ~
Clerk of the Orphans' Court
CERTIFICATION OF NOTICE UNDER RULE 5.6(a~
To the Register:
I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) ofjcl~e Qrphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ('~t ~.,t~., I~, ~
-.
Name Address
Notice has now been given to ail persons entitled thereto under Rule 5.6(a)except
Date:
Signature
Name
Address
Capacity: __ Personal Representative
/~Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96l
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOMAN GEORGE T
4050 MOUNTAIN VIEW ROAD
MECHANICSBURG, PA 17050
-------- told
EST A TE INFORMATION: SSN: 184-38-8272
FILE NUMBER: 2104-0658
DECEDENT NAME: HOMAN MARY R
DATE OF PAYMENT: 02/18/2005
POSTMARK DATE: 02/18/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/01/2004
NO. CD 004970
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,008.73
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 118
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
$9,008.73
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
lllV-'MIOlXlMlll
I . --\P0
'* COMMONWEALTIlOF
PENNSYl.VANIA
DEPARTMENT OF REVENUE
DEPT. 280101
HARRISBURG! PA 1712f.Ol101
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NU_
2'\ _ 04 0658
CiiimCiiiE -_- - iiiiER- - -
SOCIAL SECURITY N_
184-38-8272
..
Z
III
la
~
Q
oeceDENT'S _ (WIT. FIRST, NIl MlDlILE INITlAl)
Mary R. Homan
DATE OF DEATH (Mt.Il)D.VEAR) DATE OF BIRTH (MM-Do-YEAR)
07/01/201M 12/09/1912
(IF APPlICABLE) SlRVMNG SI'OUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl.)
THIS RETURN MUST BE FILED IN DllPUCATE WITH TIE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
''''',
III
[!] 1.0l1g1nal1lollln
04.UmIIed*
[!] 6. DecedenlDied Toolale_..,ofWlj
09. lilgalon""-<is ~
o 3. Remainder floMn I"'". _... .,"~
o 5. Federal E$lale Ta. Retum RoqIirad
..L 6. TOIII Nlxnbor of Sale 00p>sIt a-
D 11.E_ntotaxunderSac.9113(A)_...ot
o 2. Supplamantal Rel1.m
o 48. Future Interest Compromise (dall of dIIlh.. 12.12..t2)
o 7. Decodenl Malnlailad a Living Trust ~..."." of ''''''l
o 10. Spousal Poverty Cred~ (_ Q' deIIIt bttwMn 12.31"11nd 1.1-951
I
= e T. Homan
FIRMN 1'_1
COMl'lETE MAILING ADORESS
George T. Homan
4050 Mountain VIew Rold
Mechanlcsburg, PA 17050
B
(71r) 732-5530
~
E
i
1. Rea ESIlIe (SdleduleA) (1)
2 Slocks and Bonds (Sdledulo B) (2)
3. Closo~ Hold Corpolllllon, Partnorsllip or Solo.ProplIoIOIIhIp (3)
4. Mo~s & -. RoceIvabio (SchadiM D) (4)
5. Cash, Bank Dopooi1s & lhoononeous Porsooal property (5)
(Schedule E)
6. Jo~Uy Ownad Propolty (Scheduio F) (6)
o Soporale Billing Roquootod
7. Inlor.Vlvos Transfers & MIsoollanoous Non.Probate Propor1y (7)
(Schaduio G Of l)
6. TotaIGnll._ (1oIa1LInos H)
9. Funeral Expenses & Adml~otrallve CoSIS (SchediM H) (9)
10. Oobls of Oooodont, Mortgaga Lio~nlles, & Lions (Schedulol) (10)
11. TDlalDoduoflOlll (totalLlnOl 9 & 10)
12. Hot Va. of E.1aIo (lilo 6 minus Line 11)
13. Charitablo end GoYommonlal Boquests/Sac 9113 Trusts for which an olootion 10 II' has nol boon
modo (Schadula J)
14. Hot Val... Subjoct to Ta (Line 12 "*'uslile 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
15. Amotrlt of Line 1418llabloallho spoulSll tax
ralo, Of translars undor Sac. 9116 (a)(12)
0.00
36.231.68
0.00
0.00
25,774.02
OFFICIAL USE ONLV
,
.~"l
~'::J
2,188.07
c,
151,885.76
..t~._~,._.__':;:"2. ,i
C:)
(8)
10,885.58
0,00
218,079.11
(11)
(12)
(13)
10,881.11
205,193.93
5.000.00
(14)
200.193.13
~
~
A.
~
U
~
'.0_ (15)
~m____200,1!l3.93 '.O~ (18)
9,008.73
18. Amounl of Uno 141axabl. al nnoal raIe
17. Amount of Line 14 I8llabio al sibling rat.
18. Amourt of Uno 14 _ al_,81 rate
. .12 (17)
. .15 (18)
(18)
9.008.13
19. Ta Due
'"..."....". ....~
Decedent's Complete Address:
I~~~"M
CITY Meehan/csbu
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. CredittlPaymtnts
A. Spousal Povally Credl
B. Prior Payments
C.DISCOI.rlt
j
I STATEpA
\ ZIP 17055
(1)
9.008.73
Total Credits (A' B'C) (2)
0.00
3. InterastIPenalty If applicable
D. Intem!
E. Panally
Totallnl.r.sllP.nalty ( D . E )
4.. If Li"" 21s gr.alerthan Un. 1 + Une 3, enter the dllf.rence. This is the OVERPAYMENT.
Check box on PIllf 1 Line 20 to request I refund
(3)
(4)
(5)
(SA)
0.00
0.00
9,008.73
5. If Lln. 1 + Lin. 31s grelter than Un. 2, enter 111. dlff.rence. Th~ is the TAX DUE.
A. Enter the interest on lI1e tax due.
B. Ent.r the lotal of Una 5 + SA. This is th. BALANCE DUe. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
r~'::,':,x~r;:l. '--I~l:', i~~.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer end: Yes No
a. reteln the use or Income of lhe property transf.""d;...................................................................................... 0 Iil
b. retain th. right to d.slgnat. who shall use th. property transf.rred 01 its Incoma;........................................... 0 Iil
c. retain a rev.rslonary Inter.s~ Of.......................................................................................................... .............. 0 Iil
d. receive the promise fo! life of .ither paym.nts, ben.~ts or care? ................................................................... 0 Iil
2. ~ d.ath occurred an., December 12, 1982, did decedent transf.r property ..lI1in on. y.ar of deall1
withoul rece~ng adequate consideration? ......................................................................................................... 0 Iil
3. Did decedent own an -., trust for' or payable upon death bank account or security at his or her death?.............. 0 !iI
4. Did d.cedenl own an Individual R.tirem.nt Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... !iI 0
IF THE ANSWER TO ANY OF THE ABOVE QUESnONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
U:'lder pen.... of perjury,! dtelare 'lilt [have examined this return, tncludlng Icco""lnylng schedules and statements, and 10 the belt of my knowledge and berte', ~ is true, correct
end ~.
OtdIratIcn at prepnr other thtn !he peraonII rlprttenlltlYl is bold on aIIlnfonnlaon of which preplrer hal In\, knowledge,
SIG E OF PERSON RESPQN ISLE FOR FILING RETURN DATE
---------- H:JL.-IiJ. JooS--
,
9,008.73
ORE
'toS-o l'1o<<,.,T'T/N lJa:<,J RD. H€CI-f~~Jl~ Pt;,
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE '-I-'--'-'
I 70 S'CJ
DATE
ADDRESS
II IIJrr~ II lIUtl'. \i'} ;'~;-toiW; .!~;(.;1;f~~#i,~I~lL&_~
~or dates of d.ath on or after July 1, 1994 and bef~ Jenual)' 1, 1995, th. tax rate impos.d on the n.1 valu. of transfers to or for the us. of the surviving spouse Is 3%
172 ?S. ~9116 (a) (1.1) (I)].
For dates of death on or after January 1, 1995, 111. tax rat. imposed on th. net valu. of transfers to or for 111. use of the surviving spouse is 0% 172 P.S. ~9116 (a) (1.1) (UlI.
The statute does nat ...mol a lransf.r to a survl~ng spouse from tex, end the staMory requlrem.nts for disclosure of ass.ts and fiilng a tax retum are stII1 applicable even ff
Ill. surviving spouse Is the ony ben.ficiery.
For dales of deall1 on or after July 1, 2000:
The tax rsle Imposed on the net VIIlue of transf.rs !rom e deceased child twenty-on. years of age or young.r el death to or for 111. use of a natural parent, .n edopUve pet8llt,
or a stepparent of !he child Is 0% 172 P S. ~9116(a)(1.2)J.
The tax rate Imposed on Ihe net VllIu. of trensf.rs to or for the use ofth. deced.nt's iln.al ben.ficlerles Is 4.5%, .xcept as noted In ?2 P.S. ~9116(1.2) [72 P.S. ~9116(e)(1)J.
The tax rat. Imposed on th. net valu. of translers 10 or for the us. of 111. deced.nt's siblings is 12% [72 P.S. ~9116(aX1.3)1. A sibling is d.fined, under Sectk>n 9102 as an
indlviou~ who has at I.ast one parent In common with th. decedent, wheth.r by blood or adoption. '
ReV.,.03 ex. 16.9'-*,
COMMON\oVEALTH OF PENNSYLVANIA
INHERITANce TAX RETURN
ReSIDENT DeceDeNT
SCHEDULE 8
STOCKS & BONDS
ESTATE OF
Mary R. Homan
FILE NUMBER
21-04-0658
All proporty Jolotly-owneel wtt~ right of ....Iv...hlp .....t bt dl.clOHd on Scheelull F.
ITEM
NUMBER
I
DESCRIPTION
VAlUE AT DATE
OF DEATH
2.
3.
89 Shrs of MeUife Common @35.78
74 Shrs of Sears Roebuck & Co. @37.89
1622.499 Shrs of Columbia Acom Fund Select Fund Cia6s C @ 18.64 July 1, NAV
3,184.42
2,803.86
30,243.38
TOTAL (~so enter on lioe 2, Recap;t'i.'oo) S
(If more space Is needed, Insert additional sheets of the same size)
36,231.66
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. S: Historical Prices for SEARS ROEBUCK - Yahoo! Finance
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PRICES
Date Open High Low Close Volume Adj
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2-Jul-04 37.79 37.82 36.40 36.84 3.137.600 36.43
C1-Jul-OY ~ 38.303l<~~ 37.47 ~2.348.oo0 37.52
30-Jun-04 38.00 38.97 .45 37.76 3.889,800 37.54
29-Jun-04 38.42 38.43 37.43 38.26 2,708,500 38.04
28-Jun-04 39.26 39.33 38.58 38.63 1,931,400 38.41
25-Jun-04 39.66 39,69 39.25 39.25 2,403,300 39,02
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11/12/2004
MetLife
Statement of Trust Interests
Februa<y.2000
At the time MetLife demutualizes, you will be allocated shares of MetLrte, Inc. Common Stock, which will be held for you in the MetLife Policyholder Trust
The number of Trust Interests you own is equal to the number of shares of MetLife, Inc. Common Stock held for you in the Trust
This Statement of Trust Interests tells you how many Trust Interests you will own at the time MetUfe demutualizes (in other words, how many
shares of MetLile, Inc, Common Stock will be allocated to you and held for you in the Trust).
If you want to buy more shares of MetLife, Inc. Common Stock to be held for you in the Trust, you should use the form printed below to submit
a Purchase Instruction. You are only eligible to purchase additional shares if you are being allocated less than 1,000 shares. Stock can be
purchased through the Purc~ase and Sale Program on the first trading day following the 90th day afler the date MetLife's demutualizalion
becomes eHecflve. Purchase Instructions received before the purchase program begins will not be processed until the commencement 01 the
purchase program. If you want to sell the shares of MetUfe, Inc. Common Stock held for you in the Trust, you should use the form printed on
the reverse side of this page to submit a Setllnstruction. Stock held In the trust can be sold afler the IPO distribution Is completed, which
should be no more than 30 days after the plan etteclive date, Sell Instructions received before the sale program begins will not be processed
unlll the commencement 01 the sale program, All such purchases and sales will be on a commission-free basis.
-
-
-
-
-
AUTO .._........ '~DIGIT 17013
HARY _ _N
1 ALLIANCE D_ APT 30.
CARLISLE PA 17013-4135
1,..111"'111.... ..1\..11..1..\ ...11..11..1.1.1..1.,.11.,1..11
Sl
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...
Plaase be sure the correct address appears in
lhe window 01 Ihe envelope " you are
submltllng a Purchase or Sale Instruction.
The attached instruction card identifies the
correct address lor each Iype 01 transaction.
LL2
N5.692
PLEASE RETAIN FOR YOUR RECORDS
Name
/lA_V R HCIlWI
R.laln this number lor
luture relerenca
.. Inve.tor 10
e067 07" 1147
Number 01 Tru.t Intereat. 119
Sequence Number "0034257711
PLEASE READ THE IMPORTANT INFORMATION ON THE BACK OF THIS FORM AND IN THE ENCLOSED BROCHURE
Use ONLY if a transaction is requested. Unless you wish to Inlllatea transaction, no acllon Is required.
PURCHASE INSTRUCTION Change ot address:
!lOb7 0758 ],].iI?
(See reverse side to SELL)
IlARV R _N
ChaseMellon Shareholder Services
PO Box 382200
Pittsburgh PA 15250-8200
Sianature' {if adrlres.o; beino chancedl
Make check, In U.S. dollars, payable 10:
Metlife Purcbase Program
Amount Enclosed
1",11.1,1,.,1.1.1.1,11...1..1...1.111".11...11...11".1...11
~
Please be sure this address appears in the
envelope window for Purctlases ONLY!
Minimum investment $250. 00 (except as I
described in the enclosed brochure)::::J
0000101 102 80b7075!lll47 b
LL2 N5'692
4. '"...llVV ~ .1. LlldH\;t:
Y~hoo! My Yil1mtl MiH
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PRICES
Dale Open High Low Close Volume Adj
Close"
6-Jul-04 35.35 35.59 35.26 35.41 1,140,100 34.99
2-Jul-04 35.72 35. 5.47 35.52 680,600 35.10
~ ~ 36.2~.s:7P 35.30 ~ 1 ,326,800 35.24
30-Jun-04 35.70 35.97 35.43 35.85 1,288,100 35.42
29-Jun-04 35.51 35.72 35.41 35.60 924,600 35.17
28-Jun-04 35.72 35.94 35.47 35.51 944,900 35.09
25-Jun-04 35.50 35.69 35.16 35.52 2,281,900 35.10
24-Jun-04 35.34 35.72 35.30 35.49 1,381,900 35.07
23-Jun-04 35.48 35.49 35.09 35.43 1,374,900 35.01
" Close price ~djusled for dividends and splits.
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REV-1S08EX+(6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Mary R. Homan
FILE NUMBER
21-04-0658
lndude the proceeds of litigation and the date the proceeds were received by the estate.
All property Jolntly..owned with right of lurvlvorshlp must b, dl.clOled on Schedule F.
ITEM
NUMBER
DESCRIPTlON
Prepaid Burial Expenses - VauK, Marker and Property
VAlUE AT DATE
OF DEATH
2 AllianceBemslein Capital Resv
2,322.50
8,451.52
15,000.00
3 Payment received for a quK claim deed to her grandfathe~s abandoned property (right-aI-way)
TOTAL (Also enler on line 5, Recapilulation) $
(If more space is needed, insert additional sheets of the same size)
25,774.02
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Deed
MADE the 3rd
day of
September
in the )car T\\o Thousand Foll\' (2110-l).
IlllWI I-N:
GEORGE HOMAN, !x<:eutor ot'111e btalc of MARY REED HOMAN, parl~ "I'
the lirs\ IXlrl.
(,RANTOR
-AN D-
GRD PARTNERSHIP. 265 Blue COllrse Drile. C I. State College. PeJlns) ilani~L
pC\r\~ 01' the second pmt.
(j RA N Tl:J.
WIT\ESSETI-I. I'hat inl'lJIlsidmltion ol'FIFTEEN THOUSAND AND OOilOO
DOLLARS ($ 15,OO(l.OO). in hand p.lid. the re<:eipt \\her<::ol' is hc'ITb\ :I<::knol\ kdgc'lL the s:lid
(ir.lll\o[' do h<::rcby remis<:. rekase and quit <:Iaimto tl1<: "lid Ciranl<:e.
ALL that certain l11esslIC1(!.e. \cnelllent C1lld tract or hnd situate in f'erguson To\\nship. Centre
County. l'enn:iyhani,l. being designated as the property orthe Krul11rine lleirs by property suney
l1f Scott Tudor. Registered Professional Land Surveyor No. 0423] I-F. dated May 17.2004.
BEGINNING at an imn pin on the western right of way of U.S. Route 322 (North Atherton
Street) at the intersection with lands now or formerly of Bobubhai L. and Kaneh,mben B. Pall'\:
thence ,1long the common boundary of lands of Patel and now or formerly ofearll!. and .loan L
elmk and the lands herein conveyed. South 67 degrees 29 minutes 41 seconds West. a distance
of 336.0R lCel to a point: thence on a eliI've to the left with a radius of 50 li:et. a chord bearing of
SOllth ::0 degrees 52 minutes 03 seconds West. n chord distance of 43.61 feet and a length of
4:'.13 ICl't to " pin 011 thc northcr right OeWa) ofOrlnndo Avellue. a 50 foot right of way: thence
,dong the right of\\ay of()rlando ^\cnlle on a curve to the len with a radius 01'200 kc\. a chord
bC'<1ring of North 69 degrees m~ minutes.t5 seconds Wes\. H chord clist<1nee 01' 63.29 i'c:".t aJld"
length \,r 63.:'6 \'cetlo n pin <1t tl1l' inkrsection 01' unkllll\\ n bnds: thence along. the CO\11n1\1n
b\1undary \lith lInklllm n lands. North II deg.rces 45 minutes () 1 seconds Ens\. ,\ distance of 46.
2X [\:etto a pin al the intersection \\ith lands JlO\\ or formerly ofRonnlcl I!. and Joan E. Clark and
n()\\ or forlllerh bnds of/\rthur P. and ^udrv J. Buch.:r: thence along the comll1on boundary of
. '" ..... ..
lands 0 r Bucher and Brewneer Renlty and lnnds now or formerly of Orvis M. Poonn,lI1 Tract I.
:--;orth 67 degrees 30 minutes 07 seconds East. a distance of 388.22 feet to an iron piJl on thl'
\\esterly rig.ht of way of U.S. Route 322: thence along the right 01'\\'<1) ofll.S. Rouk 322. Sllulh
Ie) (kgrees 57 minutes 53 seconds East. a distance: of 50 1celto a pin. the point or beginning
Containing 20.830 square feet.
BEING the residuc ol'the Adam Krllmrine Eslate. the said /\d<1m Krumrine having died and his
\\ ill being pwb<1ted Jul) 13. 1932 leli to survive him t\\O daughters. Katie Krumrine Reed and
M,lry Knllmine (lamer.! he said K<1tie Krumrine Reed died and !en to suni\ e her Mar) Reed
Ilon1<ln. The ",id Mary Krllmrinc (,arneI' died and Ict\ to stll'\i\'c lwr ^d,\l11 Krumrine (i,m1CT. hl'l
\)nl\ S"Il. \lhll <1\-'0 h<1vinl!. died \ell to sllr\'i\ e him his son Charles William (,amer ,lIld a qC!,
. ,
d.\ugh\er Ikll\ ('<1rbriek \\ho S11:111 COJl\'l') their interests tll the Gr<1ntee herein by decds to be
recorded lonlcmporancullsly herc\\ith. (ieorge 110111nn is the \.:\cclltor urthe Estate uCMary Rced
I h'l1lan. \\11l1 died 2004.
l'NOF:R AND SUBJECT, NEVERTHELESS, to all e.v:istil1Q.easements. conditions. rcstricti\'ns
:Jnd e()('c:n:mts of rc:cord.
r-;~~.-::-T(5:C-8~OAJ \'cL~ /0 vt1z...
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. " ';;";'" 1" '''1",,;-..t('1 ~ -5 - 0
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f ,."_.,,,,~.:-' ..'. . --..-- if'
L?-<:._.:::..~~~~~!~~lldent ler
AND lh,' said liranlor will QUIT CLAIM nnd reiL-ase the property hereby conveyed.
IN WITNESS WHEREOF. said Cirantm does hereby hereunto set his handss nnd senlss. the dn:
~\I1d : e,11' lirsl ~\bt)\'e-\\rillen.
\,',01,,1 ;lIld ,1;.'1,\,'''.',1111 Ilk PI'l'~l'lll'l' (\1
1/
..../ j~~o---__
George lIt m\l1. ["eeutor
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COliN IY 01 CENTRE )
011 lhis. the _3rd day 01' September . 2()()4. berore me a NolaI': Public. thl'
undersigned onieer. personally appeared lieorge 1101lWll. kilOl1 n to me or satisl(lclOril: pro\ c'l1
\d be lll,' person \\h()se n.lI\\e is subscribed 10 the \\ ilhin instrument. ,\I1d aekn()\\lcdged tklt he
l'\,'c'ull'd the same fell' lhe purpose therein conlained.
IN WITNESS WHEREOF. I have hcreunlD selm)' hand and oflicial seal.
r~~;X~~t~~t~~~-~l
t J!'~'erl ~;f;!t;;'~G, r,~;\:",rf."..r~; t
t ~'~'.'<; J'~'.~'.":?'~':.;;:>-'~'.:'; ,,-,> ," ~,:'. ~:
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Notal' 'ublic (/
Ivl: Commission ["pires:
REV.1S09 EX+ (&-98)
..
COMMON~TH CIF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Mary R. Homan
FILE NUMBER
21-04-0658
If In 1.lIt wu mid. Joint within on. Y.lr of thl dlC.dlfltl, dltl of dlath. It mutt be "'portld on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO OECEDENT
A. George T. Homan
4050 Mountain View Road
Mechanlcsburg, PA 17050
Son
B
Edward W. Homan
C.
Michael R. Homan
489 Rock Road
Slate College, PA 16803
Son
227 Hillcrest Avenue
State College, PA 16803
Son
JOINTLY.OWNED PROPERTY:
LmER DATE DESCRIPTION OF PROPERTY %Of DATE. Of DEATH
ITEM FOR JOINT MAIle INClUDE JrfAME Of FINANC\Al.INSTITUTION AND BANK ACCOUNT NUMBER OR SINILAR DATE. Of DEATH DECD'S ""UEOf
NUMBER TalANT JOlNT IDENTIFYING NUMBER. AnACH DEED FOR JDINn.V.HELD REAl. ESTATE. VALUE OF ofoSSET INn.REST DECEDENT'S INTEREST
1. A. 04/24/1997 M & T 8ank Checl<ing Aceount# 13611311 3,897.52 50 1,948.76
2. abe 04127/1990 PA State Employees Crell" Union Account # 184-3U272 Reg. Sheres 848.85 25 212.21
3. abe 04/27/1990 PA State Employees Crell" Union Account # 184-38-8272 Checking Acet 105.61 25 26.40
4. abe 04127/1990 PA State Employees Crad" Union Account # 184-38-8272 Money Market 2.80 25 0.70
TOTAL (Also enter on line 6, Recapitulation) $ 2,188.07
(If more &p8ct Is needed. Insertlddtlonar sheets of the same Ilze)
!:1 M&I'Bank
STATEMENT PERIOO
PACE
1 OF 1
ACCOUNT NO. .. ACCOUNT TVPE
1361139 CLASSIC CHECKING
JUL.03-AUG.03,2004
00 2 04345H Il 021
1654
GEORGE THOMAN
4050 MOUNTAIN VIEW RD
MECHANICSBURG PA 17050
STONMIlllE
ACCOUNT SUMMARY
A
OS S I
OTIlER A TI S
NO. AIlOUMT
CIl C S PA 0
NO. ANOUNT
NO.
I TER ST
A ANt
3,.97.52
o
0.00
1,276.07
ACCOUNT ACTIVITY
,
A
PT
T
07-03- aEGINNING aALANCE
07-06-04 AARP HEALTH CARE PRE"IUM
07-01-04 IlDAG'S CATERING SERVICE 8142380824
07-08-04 CENTRE CDUNTV MEH 5621 814-237-41
07-08-04 CHECK NU"BER 0630
07-14-04 CENTRE COUNTV "Ell 5621 8142374108
07-16-04 CHECK NUN8ER 0631
07-26-04 SPACE MART SELF STORACE STATE CDLL
148 . 75
571.68
935.00
150.0
480.00
281.00
55.12
t3,897.52
3,748.77
3,177.19
2,092.19
l,b12.19
1,331.19
1,276.07
ENDING BALANCE
n,276.07
CHECKS PAID SUIlIlARV
630 07- 08- 04
150.00
631 07-16- 04
281.00
FOR QUESTIONS ABOUT VDUR ACCOUNT CALL 1-800-724-2440.
DO VOU HAVE "LESS-THAN-PERFECT" CREDIT DR ARE YOU SELF-EHPLDVED?
"IT'S ALTERNATIVE LENDING IlDRTGAGES ARE DESIGNED FOR THOSE:
. WITH HIGH HONTHLV BILLS.
. WHO HAVE DIFFICULTV DOCUMENTING THEIR INtONE.
NOW AVAILAaLE IN NEW YORK, PENNSYLVANIA, MARYLAND, VIRGINIA AND WASHINGTON DC.
TO FIND OUT "ORE, CALL US AT 1-800-436-0798. "&T IS AN EQUAL HOUSING LENDER.
LOO6A (903)
2033 0002
5042 Y
FINANOA~ll-
TRUST CORP
STATEMENT OF ACCOw~S
001361139
STATEMENT PERIOD
FROM THROUGH
4-24-97 5-04-97 0
PAGE 1 OF 1
x
MARY R HOMAN
GEORGE THOMAN
770 S HANOVER ST APT 308
CARLISLE PA 17013
o ENCLOSURES
5
1111111111111111111111111.1
CHECK PLUS ACCOUNT
....,,=-..0:..."'_ _" _____._____n
PREVIOUS DEPOSITS/ CHECKS!
STATEMENT BALANCE CREDITS 2 DEBITS
.00 1,045.82
ACCOUNT: 001361139
SERVICE
o FEES
.00 .00
~
ENDING
BALANCE
1,045.82
INTEREST PAID THIS YEAR
ACCOUNT/INTEREST INFORMATION
.50 FED TAX WITHHELD THIS YEAR
.00
DATE
ACTIVITY DESCRIPTION REFERENCE
BEGINNING BALANCE
IT
INTER
ENDING BALANCE
.00301706790
DEPOSITS! CHECKS/
CREDITS DEBITS BALANCE
'" .----._ . ..........-...-----...-...-...-----ciOJ
1,045.32 .---.-- 1.0~
.scr ......--......- 1,045.82
1,045.82
,
,
\ ***
ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM
ANNUAL PERCENTAGE YIELD EARNED
AVERAGE DAILY COLLECTED BALANCE
INTEREST EARNED
4-24-97 THROUGH
1.76%
950.29
.50
5-04-97 ***
C'~,!':l/~ 7JtV~'iI/
DIRECT FINANCIAL TRUST COMPANY, NOBLE BOULEVARD OFFICE
INQUIRIES TO: NOBLE BLOULEVARD & SOUTH WEST STREET
CARLISLE, PA 17013
TELEPHONE: 717-243-3212
PSECt;
111111111
PO 6ax 67013 (717) 234-8464 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
webslte . http://www.psecu.com
Pell",yl,"m" SI"le Employees Credit Umol1
VISA
PAGE
1
0184XXXXXX .08/25/04
0.00
0.00
.. .... NUl! M'It.\1II<T AfolOlIlT lH<C\.08ID
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1,"111,"111,",1,1,11","1,1",11"11"1"1,1,1,11,,,,,1,11
MARY R HOMAN
4050 MOUNTAIN VIEW RD
MECHANICSBURG PA 17050-2134
'Mly waste time & money on writing checks al"1d paling
postage>
n l"" or. going 10 moIco pl' Yillo poymont uoIng 0 PSECU
c~ock,1og 1"" onlln. bonIcIng ond tono_ _ YIoo poymonll
Or, eel uo.. (800) 237-7328 no_d. 01 (717) 234-848410
Howlollurv. Ao 1110 m,"" 0""., onlof 44. Uoton to Iho ooloctlon
and Io8ow .,. m.~IonI, (Vou'll need your eccounl numb.-
ond PIN hendy.)
Eithtlr Way ~ No eo.t, Quick I. E..y. Avallabl. 2""ho&;~. o.yl
3090184388272
TO REPORT A LOST OR STOL!;:N CARD' CALL OUR BUSINeSS NUMBERS USTEO ATl1iE TOP OF EACH STATEMENT PAGE
FROM 7 /oM . 6 PM MONDAY 10 FRIDAY AND ,IN. 10 12 PM SA1IJRDAY, OTHERWISE CALI. .....66&6878
."...~ ~~tr:.'t:~... Mn.wrMR, ...Q.,.:4...;t.."...
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0184XXXXXX 07/31/04 08/25/04 6500.00 0.00
~BEFORE 1
DETACHING HERE T
.A~~.
0.00 6500.00
ADDITIONAL JOINT OWNERS.
ItICHAEL R HOltAN
EDWARD W HOltAN
ID 09 VISA LOAN
POST TRAN REFERENCE
DESCRIPTION
AItOUNT
YTD FINANCE CHARGE, YEAR TO DATE
0.00
:~.""
~
0.00
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0.00
+- ~~' ~ -+ ::...~i).rr~~L:':+
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1RANiSAC'OON
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'1.'100%
12.'100%
0.82500%
1.07500%
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
02010002
2009823
PSECr4t,
" IIIIH"
P.O. Box 67013 (717) 234-B484 (Hanisburg)
Harrisburg, PA 17106-7013 (BOO) 237.732B (Nationwide)
webslte - h"p://www.psecu.com
I
Pellmylvolllo 5101<- Employee, Cred'l UIIIOIl
USE YOUR PSECU VISA FOR
BACK TO SCHOOL PURCHASES.
MARY R HOMAN
JOINT ONNER
QEORGE THOMAN
PAGE 2
1~:~~l~~l ~ . .
: ... ",:-::', :::::C' ,:':'::,:::,::','_:':,:,:':'--:,'::::::'::,':::':,';::-';;:::.;,'f::':
I. . '. POST EFF 1I~$CRtPnON . .' . '.
: . trill ..'111> 01. REGOLAR SHARES bEGINNING BALANCE .
I 0706PAYI1ENT; DIRECT DEPOSIT MET LIFE .
TYPE, ANNUITYPAY ID, 9039565104
WITHDRAWAL DIRECT DEPOSIT I1ET LIFE 3319.45- 343.35
om' "PAy~::~,U:~~riE:':~;~::l04. .' . .... '. ........ 0.'5 849.30
A~NUAl PERCENTA~ YIELD EARNEl!O .15% FROI1 07/01/04 THltOUGH 01/31104 .
BASED ON AVERAGE DAILY BALANCE OF 1,491. 32 . .
ENDING BALANCE 349.30
DIVIDEND YTD, YEAR TO DATE 17,33
., ".'.
. . At!OUNT
..'.. ...
BALANCE
.' .41L 85
4163.30
0712
0731
I
I
I
I
,
\
l : ,ilIJ~Q",:W.;;;..j=.raill:.;;;=:~.liI'#_'=..;;..=III..=.=;;;;J;;;;:;;,.=;;;'==:;:;';;;;::;;;;;==:....,f;:;;;=!lII!.1Ir<l!;=.=~~ai~~*=:w,.~wai.,.=:;..illlll=
\ '.' '. POST. eFf l!ESCRIPTIQN '. . At!QI,lNT' B"LANG!::
n.oi . ". III 04 MllNEVHANl!lER BEGINNING BALANC!:: .. '105.61
0731 PAYI1ENi, DIVIDENti 0.250~ 0.02 105.63
L ANNUAL PERCENTAGE YIELD EARNED 0.22% FRat! 07/01/04 THROUGH 07/31/04
BASED ON AVERAGE DAILY BALANCE OF 105.61
' -~7"1" ''''''''''''fHt!. IALANCE .' --.". .---- .- lQ5U ."
\ ... . 1llVIPENP YTD, YEAR TO PATE 0.14 .
~;:::,:;:;~>,~~.:~';~:.:...:~..:;.i..'_.......~.*.*..~.~~=.==~=.~=~~...lil,==-~=..=*........'....,.......==..=.
I .~~~~ EFF ~~S~~I~~~~~t!ARKET BEGINNING BALANCE A"OUNT BAL~~~~
0706 DIVIDENP RATE CHANGEP FRat! 1.33% TO 1.83%
.... 0712. <, "!llVI.PENP RATE CHANGEll FROH 1.83% TO
'. ..... '.' 0719 ... .:. tlIVtDENP. RATe CHANG.Ell FROM 1.79% TO
. tU1...' EH~IHG JAlAN<:E .', . .... .... .
tiIVIDEND YTD. YEAR TO DATE
~==..=============================:===============.================...============
... ANNUAL PERCENTAGE RATE 12.900% ... PERIODIC RATE (DAILY) .035342%
02020002 2009824
REV-1S10 EX_ 16-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE Of
Mary R. Homan
FILE NUMBER
21-04-0658
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAMe Of THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXClUSION TAXABlE
NUMBER THE DATE OF TRANSFER. AITACtl ACOPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IFAPPUCASLE} VALUE
1. AXA Equitable Invesbnenl Annuity - This contract was purchased on 9/16/02 124,898.79 50 62,449.40
with George T. Homan (her son) as the annuitant.
2, Metlife Annuity ID # 000829276R8 89,436.36 100 89,436.36
100
100
100
TOTAL (Also enter on line 7 Recapitulation) $ 151,885.76
(If more space is needed. insert additional sheets of the same size)
\'~urrABLE M~""__", /~S';
~~ \ ;~\MULATOR ~~_
P.O. BOX 1547, SECAUCUS, NEW JERSEY 07096-1547 .'0."'"
fit
Quarterly Account Review
Statement Period:
April 01, 2004- June 30, 2004
3C2635893
003373302 AT 0 517 .'AUTO T30 9301 17050 3
1...111...11111..1.1,1111...1.1.1111..11..1..1.1.1.11.....1.II
Mary R Homan / George THoman
4050 Mountainview Rd
Mechanicsburg PA 17050-2134
Contract Number: 302 635 893
Contract Type: Equitable
Accumulator" (NQ)
GMDB Election: Greater of Roll up or Ratchet
Contract Date: September 16, 2002
Contract Owner: Mary R Homan / George THoman
Annuitant Name: George THoman
Effective on or about September 7, 2004, subject to regulatory approval, The Equitable Life Assurance Society of
the United States will change its name to AXA Equitable Life Insurance Company. The name change has no impact
on the terms and conditions of y'QW policy or contract. If you have any questions, contact your financial
professional. GE-29026 Now you can be notified bye-mail whenever your Annuity Quarterly Statement becomes
available online. Visit www.equitable.com. enroll for online access to your annuity contract and sign up for
Electronic Delivery.
Quarter
Account Activity Summary 4/1/2004-6/30/2004
if(~..Y~JM11!lil\:.\It",{IRm~~:'1i~';!jj;:Jl1;;jjf;ij';';!jlJjiji:;i:;iil!!JI1~.~i~gj~1;~;i;.!!
~~*~ ROO
Requested Withdrawals ($10,000.00)
1i.;_.IIM~::I~gl'-l~~~~r~:f:~]1;fit:~r~~~::;:i!~ili:ili:li~mji~I:::::i,;~!i~i;jili[f~1!~i:ili:~:i.i::~m:~8r;i:1m:!:rifd8:~~iili:~~ill:
Variable Investment Option Results ($411.29)
Guaranteed Interest Option Interest $280.87
Year-To-Date
1/1/2004-6/30/2004
Since Purchase
9/16/2002-6/30/2004
$0,00
($10,000.00)
$118,988.63
($10,000,00)
Your Account Allocation
Your Account Value is currently invested among the asset classes
below. Totals may not be exact due to rounding. To review your
investment strategy, contact your registered representative
IIIlIII 39% Large Company Stocks
~ 26% Domestic Bonds
G::J 31 % Guaranteed.Fixed
o 4% High Yield Bonds
For Assistance. Contact:
Your Financial Professional:
David Smith
/l\XA Advisors, LLC
Suite 426b
315 S AllenStreeL__._. _
State College PA 16801 _.
814-234-4414
You can obtain current account information,
including balances and "nit values, any time you
wish.
. Call our TOPS voice response system
1-888-909-7770, or
. Visit our Website: www.equitable.com and
click on EQAccess
If you want to speak to one of our Customer
Service Representatives please call 800-769-7771
8.30 - 5:30 ET Monday - Friday
=-
-
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-
-
-
..
-
-
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~
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0033733 00SS397
Page 1 of 4
Please review this statement and retain it with your Accumulator papers. Financial information Continued on Revelse Side
IIAXA EQUITABLE
~...
- .
J .. 0
.
......~ co ....~
~o"..u",c."
ACCUMULATOR
P.O. BOX 1547, SECAUCl!S, NEW JERSEY 07096-1547
3C2 635 a93
003394701 AT 0292 "AUTO T6 C 9401 17050 0
1".111",11',",1.1.11"...1.1,"11..11..(..1.1.(.1111,..1.11
George THoman
4050 Mountainview Rd
Mechanicsburg PA 17050-2134
e
Quarterly Account Review
Statement Period:
July 01, 2004-September 30,2004
Contract Number: 302 635893
Contract Type: Accumulator (NQI
GMDB Election: Greater of Roll up or Ratchet
Contract Date: September 16, 2002
Contract Owner: George THoman
Annuitant Name: George THoman
Great Newsl On October 25, 2004, AXA Equitable will expand your investment choices by adding six Enterprise
variable investment options to your current investment option line-up, The options are: EQ/Enterprise Equity,
EQ/Enterprise Equity Income, EQ/Enterprise Growth, EQ/Enterprise Growth and Income, EQ/Enterprise Small
Company Growth and EQ/Enterprise Small Company Value, For a prospectus containing more information .. .
including investment objectives, risks, charges and expenses, call your financial professional. GE-29728(B\ (8104)
Quarter Year- To-Date Since Purchase
1/1/2004-9/30/2004 1/1/2004-913012004 9/1612002-9/30/2004
Account Activity Summary
iI~~q~I)!l~i9.il!i:~:;.{.~!;!:j~'!';.:;;i!i,;i,!;j!!'i! "
Contributions
Requeste~ l/Vit~dr~wa.l.s .. ...... .
;:.iil?lul!illli!'i~ll!I!~J:!;BiQ!~lii:)i.!:;;!I: i1,!: O,1!i'
Variable Investment Option Results
Guaranteed Interest Option Interest
iii;ii;i~I!U~~;,7!U';!
$0.00
$0.00
";:::,:;~:r,}';:::::;
..............:.:::;;"
"""""'.;,,;.,.:.:
$0.00
($10,000.00)
$118,988.63
($10,000.00)
........."
.;,,::,:' ;':),;;" ::::::;:::;:::H~N:
:-,,:,,;,;<,;':"';". ......'..,..-.....b
($1,044.59)
($51.30)
~li..t.:I.i'..liv:lqlii>;;;:!,i;liili!ii::lji!i!!lii.l~rllir.~.I~!;;J
Your Account Allocation
Your Account Value is currently invested among the asset classes
below. Totals may not be ..ael due to rounding."o review your
investment stl<lte)lY, contact your registered representative.
. 36% Large Company Stocks
~ 27% DomestiC Bonds
~ 31 % Guaranteed~Fixed
o 4% High Yield Bonds
00339470056321
For Assistance, Contact:
Your Financial Professional:
David Smith
AM Advisors, LLC
Suite 426b
315 S Allen Street
State College PA 16801
814-234-4414
You can obtain current account Information,
including balances and unit values, any time you
wish.
. Call our TOPS voice response system
1-888-909-7770, or
. Visit our Website www a.a-eqUltable.com and
click on EQAccess
If you want to speak to one of our ellstomer
Service Representatives please call 800-789-7771
8:30 - 5:30 ET Monday - Friday
Please review this statement and retain it with your Accumul~tor papers. Financial informa.tion Continued on Re'lerw Side
..
Iii
~
-
-
Iii
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III
-
iii
-
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Pa~€ i of 4
REV.'511 EX. 112'99*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAl EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mary R. Homan
FILE NUMBER
21-04-0658
Debts of decedent mull be reported on Schedule L
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
,.
FUNERAL EXPENSES:
Koch Funeral Homan
Haag's Catering
Centre County Memorial Park
Osiris Holding of PA
Rev. Robert Rohlbaugh
Prepaid Vau~ - Marker- Property
6,426.50
571.58
935.00
480.00
150.00
2,322.50
2.
3.
4.
5.
6.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
_State
Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
. Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(It more space is needed, insert additional sheets of the same size)
10,88558
REV.1513W(!>OO) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mary R. Homan
FILE NUMBER
21-04-0658
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under
Sec. 9116 (0)(1.211
1 Michael D. Homan 227 Hillcrest Avenue Stale College, PA 15803 Grandson 1,000.00
2 Morgan W. Homan 227 Hillcrest Avenue Slate College, PA 15803 Grandson 1,000.00
3 Kenneth B. Homan 141 Treasure Lake DuBois, PA 15801 Grandson 1,000.00
4 Jeffrey A. Homan 116 Wesley Olive Mechanicsburg, PA 17055 Grandson 1,000.00
5 Kathryn E. Emrich 450 Roman Court York, PA 17404 Granddaughter 1,000.00
6 Kimberly A. Homan 3 Paula Place Apartment 3C Baltimore. MD 21237 Granddaughter 2,000.00
7 Michael R. Homan 227 Hillcrest Avenue State College, PA 15803 Son 43,581.51
8 Edward W. Homan 489 Rock Road Slate College. PA 16803 Son 43,581.51
9 George T. Homan 4050 Mountain View Road, Mechanicsburg, PA 17050 Son 106,030.91
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH lB, AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Saint Paul's Lutheran Church P.O. Box 2000 Pine Grove Mills, PA 16868 5,000.00
TOTAL OF PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-I500 COVER SHEET $ 5,000.00
(If more space is needed. insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
MARY R. HOMAN
KNOW ALL MEN BY THESE PRESENTS, That I, MARY R. HOMAN, of the
Township of Lower Allen, County of Cumberland. and Commonwealth of Pennsylvania,
do make, publish, and declare this instrument to be my Last Will and Testament, hereby
revoking and making void any and all former Wills by me at any time heretofore made.
FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses
and costs of administration as soon as conveniently may be done after my death. I
further direct the Executor hereof to pay all inheritance, estate, transfer and succession
taxes which may be levied or assessed upon any property which Is Included as part of
my gross estate for the purpose of any such tax.
SECOND: I give and bequeath unto the following grandchildren the sum of
$1,000 each:
A) Kimberly A. Homan
B) Kathryn E. Emrich
C) Jeffrey A. Homan
D) Kenneth B. Homan
E) Michael D. Homan
F) Morgan W. Homan
, have not given and bequeathed any gift and bequest to Nicholas A. Homan because
on the date of the execution of this my Last Will and Testament. he stili owes me the
sum of $27,000, being the balance of my loan to him. However, if he should repay me
. 1 .
'/I)f? I(
the $27,000 balance on my loan to him, I give and bequeath unto him the sum of
$1,000. In the event that he does not repay the aforesaid balance of my loan to him,
then in that event, I give and bequeath unto his sister, Kimberly A. Homan, an
additional gift and bequest of $1,000 or the combined total of $2,000.
THIRD: I give and bequeath unto SI. Paul's Lutheran Church of Pine Grove,
Pennsylvania, the sum of $5,000.
FOURTH: I direct that in addition to the advertisement of my death in the
Cumberland Legal Reporter and The Sentinel that my death also be advertised In the
Center County Legal Reporter and the Center Daily Times.
FIFTH: I give, devise and bequeath all the rest, residue and remainder of my
estate in equal shares, share and share alike, to my Sons, GEORGE T. HOMAN,
EDWARD W. HOMAN, and MICHAEL R. HOMAN, ~ slimes. provided that they are
living on the date of my death. In the event that one or more of my sons are not living
on the date of my death, then in that event the share of my son who has predeceased
me shall be given, devised and bequeathed as hereinafter set forth in paragraph StXTH
of this my Last Will and Testament.
SIXTH: in the event that one or more of my aforesaid sons have died prior to
the date of my death, I give, devise and bequeath the share of the rest, residue and
remainder of my estate that my son who has predeceased would have received but for
his death to his widow, to wit; GEORGE T. HOMAN whose wife Is DEBRA A. HOMAN
-2-
m f/f II
and EDWARD W. HOMAN, whose wife is BARBARA E. HOMAN, and MICHAEL R.
HOMAN, whose wife is DARLA J. HOMAN, ~ stiroes.
SEVENTH: I appoint my Son, GEORGE T. HOMAN, to be Executor of this my
Last Will and Testament. In the event that he predeceases me or is unable or unwilling
to be my Executor of this my Last Will and Testament, then in that event I appoint my
Son, EDWARD W. HOMAN, as the successor or contingent Executor of this my Last
Will and Testament. In the event that my son, EDWARD W. HOMAN, predeceases me
or is unable or unwilling to be my Executor, then in that event I appoint my Son,
MICHAEL R. HOMAN. to be my Executor of this my Last Will and Testament, and I do
hereby give to the Executor hereof full power, discretion and authority at any time or
times to sell, at private or public sale, mortgage, lease, pledge, exchange or otherwise
deal with or dispose of the property comprising my estate as deemed best, to settle and
compound any and all claims in favor of or against my estate as deemed best and, for
any of the foregoing purposes, to make, execute and deliver any and all deeds,
mortgages, contracts, Jeases. bills of sale or other Instruments necessary or desirable
therefor.
LASTLY: I direct that no fiduciary appointed by this. my Last Will and Testament,
shall be required to give bond and that if, notwithstanding this direction, any bond is
required by any law, statute or rule of court, no surety shall be required thereon.
-3-
J?-J ~ If
IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and
Testament. consisting of four (4) typewritten pages on the margin of which (except this
page) I have affixed my initials this 3rd day of May, A.D. 2002.
mmo~Af~.r.~,
Signed, sealed, published and declared by MARY R. HOMAN, the above-named
Testatrix, as and for her Last Will and Testament, in the presence of us, and each of us,
who at her request, and in her presence, and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
~~~..
seth Myers
Amy Knauer
'-<-V
.4.
County of Cumberland
Commonwealth of Pennsylvania
ss,
ACKNOWLEDGMENT AND AFFIDAVIT
We, MARY R. HOMAN, the testatrix, and the undersigned witnesses to the Will,
the attached or foregoing Instrument, having been qualified according to law do depose
and say:
(a)thatl, the testatrix, do hereby acknowledge that I signed the instrument as my
Will, that I signed it willingly and as my free and voluntary act for the
purposes therein expressed; and
(b)that we, the witnesses, were present and saw the testatrix sign the instrument
as her last Will, that she signed it willingly and as her free and voluntary
act for purposes therein expressed; that each of us in the hearing and
sight of the testatrix signed the Will as a witness and thetto the best of our
knowledge the testatrix was at that time 18 or more years of age, of sound
mind and under no constraint or undue Influence.
Sworn to or affirmed before me by MARY R. HOMAN, testatrix, and Beth Myers
and Amy Knauer, witnesses, this 3rd day of May, 2002,
171~ 1?~Q~
MARYR.HOMAN .
~ '
,. " . -, .
/Seth M~ers -~~
~~1~
Attorney I.D. #21582
- 5-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Marv R. Homan
Date of Death: 07/01/2004
Will No.: 21-04-0658
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiaries of
the above-captioned estate on 07-14-2004
Name
George T. Homan
Edward W. Homan
Michael R. Homan
Kimberly A. Homan
Kathrvn E. Emrich
Jeffrey A. Homan
Kenneth B. Homan
Michael D. Homan
Moraan W. Homan
Address
4050 Mt. View Road, Mechanicsbura, PA 17050
489 Rock Road, State Colleae. PA 16803
227 Hillcrest Avenue. State Colleae. PA 16803
3 Paula Place, Apartment 3C. Baltimore. MD21237
450 Roman Court. York, PA 17404
116 Wesley Drive. Mechanicsbura. PA 17055
141 Treasure Lake. DuBois. PA 15801
227 Hillcrest Avenue. State Colleoe. PA 16803
227 Hillcrest Avenue. State Colleoe, PA 16803
Notice has now been given to all persons entitled thereto under Rule 5.6 (a)
except Non
Date: March 18. 2005
>-
David W. Knauer
411 A E. Main Street
Mechanicsbura, PA 17055
Telephone: (717) 795-7790
Capacity: _ Personal Representative
-L Counsel for personal
representative
06-20-2005
HOMAN
07-01-2004
21 04-0658
CUMBERLAND
101
APPEAL DATE: 08-19-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REy:is47-Ex-AFP-io3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEHENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY R FILE NO. 21 04-0658 ACN 101
BUREAU OF INDIVIDUA~ TAXES
INHERITANCE TAX DIVISIDM
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
p ::1
v.._.,~ I j
I,' I. ~I
'il ," 0'+
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
O~~' ,.,,,,,
Ht....I--:;,.:..'\;\1 ;:;
GEORGE !Tl!llOHAN
4050 MOUNTAIN VIEW RD
MECHANICSBURG PA 17050
ESTATE OF
HOMAN
*'
REV-1547 EX AFP (06-05)
MARY
R
TAX RETURN WAS: I X) ACCEPTED AS FILED
DATE 06-20-2005
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule DJ
S. C.sh/Bank Deposits/Hisc. Personal Property (Schedule E)
6. .Jointly Owned Property (Schedul. f)
7. Transfers (Schedule G)
8. Total Assets
11)
(2)
(3)
(4)
(5)
(6)
(7)
.00
36.231. 66
.00
.00
25.774.02
2.188.07
151,885.76
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. ExP8nses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
110)
10,885.58
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. ~unt of Line 14 at Spousal rat. (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rat. (17)
18. Anount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
S:
NOTE:
+
DATE
02-18-2005
_BER
CD004970
INTEREST/PEN PAID 1-)
.00
.00
Ill)
112)
113)
114)
.00 X
200,193.93 X
.00 X
.00 X
AHDUNT PAID
9,008.73
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
00 =
045 =
12 =
15 =
119)=
NOTE: To insure proper
credit to your account,
submit the upper portion
of this for. with your
tax P.y....,t.
216,079.51
1 n .RRIi IiR
205,193.93
5,000.00
200,193.93
.00
9,008.73
.00
.00
9,008.73
9,008.73
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YDU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
-
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/31/2006
KNAUER DAVID W
411A E MAIN ST
MECHANICSBURG, PA 17055
RE: Estate of HOMAN MARY R
File Number: 2004-00658
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
7/01/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
Gl~/!f':!r~
Clerk of the Orphans' Court
cc: File
Personal Representative(s)