HomeMy WebLinkAbout04-0685Estate of
also known as
Register of Wills of County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Paul Loutzenhiser, a.k.a.
Paul D. Loutzenhiser
No. 21- Oq-
, Deceased Social Security No. 202-36-5947
(COMPLETE "A- OR -e- BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or named in the Last Will of the
Decedent, dated 5-12-2004 and codicil(s) dated
Except as follows, Decedent did not merry, was not divorced, and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence J
Decedent was domiciled at death in Cumberland County, Pennsylvani~~, with his/her last family or principal
residence at 621 Tower Road, Enola, PA 1 /UZ5
Decedent, then 57 years of age, died July 1 7 ,2004 at Erie, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personar 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 ............................................... $ ~',-~O
Total .................................................... $ //.~.
Real Estate stuated as fo own: 621 Tower Road, Enola, PA 1 7025
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of ~etters in the
appropriate form to the undersigned:
Signature Typed or printed name and residence
Forestview Skilled Nursing Ctr.
Timothy Loutzenhiser
7!!~ ~rubb Rcz~, ~
Oath of Personal Representative '
Commonwealth of Pennsylvania
County of
The Petitioner(s) above*named swear(s) and 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 representative(s) of the Decedent,
Petitioner(s) Will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
before me this ~:~;~'¢~ day of
DECREE OF REGISTER
Est.eof
also known as
Deceased
Social Security No:')-O?-- ~o- ~qq'"~ Date of Death:"-'l- I"1 -(3L[
AND NOW, ---~,.~,~.x/ o~.~--k , 20 (_~ in consideration of the Petition
on the reverse side hereon, s~tisfactory proof having been presented before me,
IT IS DECREED that Letters [~ Testamentary [] of Administration
are hereby granted to / ~ ~(~-\~_~, ~O~( Q~V.-~-.L~J~._ .
in the above estate and that the instrument(s), if any, dated ~- )b.-Oq
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ...........................
Short Certificate(s) ..........
Renunciation ..................
Affidavit ( ) .................
Extra Pages ( ) ............
Codicil ..........................
JCP Fee ........................
Inventory & Tax Forms...
Other ............................
TOTAL ................ $ c>~.'-~-~. -cS~O
Attorney:. Michael F. Brown, Esq.
I.D. No: 24898
Address: 2080 Linglestown Rd., Suite 201
Harrisburg, PA 17110
Telephone: (717) 540-9170
DATE FILED: ~ - ~ - gq
his is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
'3'220313
Charles Hardester
State Registrar
JUL 1 9
Date
0
COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH" VITAL RECORDS ~ ~i
CERTIFICATE OF DEATH ~ ~
Lo~tze~hiser ,. Male 3. 202 -- 36 --5947
'. Paul D.
Erie
621 '[~:~er Road
,,. Enola~ PA 17025
,,. Calvin Loutzenhiser
,~ Mr. Tim Loutzenhis~N
7/19/2CX)4
ILT 7/% , -
J'. July 11.2004
Millcreek ,.Fom~ Skzll~ N~szng ~nter ,~'*' ,~ ~ite
~1~ ~ ' ' ~'~ ~ ..... ' ~' -- '
J~ 7116 Gmbb Ro~, Erie, PA 16~6
~-~ L~-C~.~.~
~ie Cr~to~ ,,~. Erie, Pe~sylvania 16~2
2004
JUL 1 9 209~
LAST WILL AND TESTAMENT
OF
Paul Loutzenhiser
I, Paul Loutzenhiser, Enola,
Pennsylvania, revoke my prior wills and
last will:
Cumb~lan~ Coun~ky,
declare this to be my
Debts and Funeral ~.~.enses: My lawful debts and the expenses
of my last illness, funeral and burial shall be paid out of my/ '
estate.
II.
Personal and Household Effects: With the exception of the
specific items noted below, I give all my articles of personal or
household use, together with all insurance relating thereto to
Timothy Loutzenhiser, if he survives me by thirty days. f~__--
III. Real Estate: I give my real estate located at 621 Tower
Road, Enola, Pennsylvania, to Timothy Loutzenhiser.
IV. Residuar~5 Estate: I give the residue of my estate, real and
personal to my son, Tmothy Loutzenhiser, if he survives me by
thirty days.
V. Protective Provision: No interest in income or principal shall
be assignable by, or available to anyone having a claim against,
a beneficiary before actual payment to the beneficiary.
VI. Death Taxes: Any federal, state and other death taxes payable
on the property forming my gross estate for tax purposes, whether
or not it passes under this will, shall be paid out of the
principal of my probate estate just as if they were my debts, and
none of those taxes shall be charged against any beneficiarN. _ ~
VII. Manaqement Provisions: I authorize my executor:
A. To retain and to invest in all forms of real and
personal property, including common trust funds regardless
of any limitations imposed by law on investments by
executors or trustees, or any principle of law concerning
investment diversification;
B. To compromise claims and to abandon any property
in my executor's opinion, is of little or no value;
C. To borrow from, and to sell property and to
property as security for
which,
pledge
repayment of any funds borrowed;
D. To sell at public
lease for any period of
and to give options for sales or leases;
or private sale, to exchange or to
time, any real or personal property,
E. To join in any merger, reorganization,
or other concerted action of security
delegate discretionary duties with respect
voting-trust plan
holders, and to
thereto;
F. To use administrative or other expenses of my estate as
income tax or estate tax deductions and to value my estate
for tax purposes by any optional method permitted by the law
in force when I die, without requiring adjustments between
income and principal for any resulting effect on income or
estate taxes; and J /~/
G. To distribute in kind and to allocate specific assets
among the beneficiaries in such proportions as my executor
may think best, so long as the total market value of any
beneficiary's share is not affected by such allocation.
IX. Executor and Truste~: I appoint my son, Timothy
executor of my will. He is to serve as without
Loutzenhiser,
bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this /~ day of ~04, at the end hereof,
composed in all of ~_____ pa~. ~
SIGNED, SE~?.mD, PUBLISHED AND DECLARED by the above named
Testator as and for his Last Will and Testament in the presence
of us, who, at his request, in his presence and in the presence
of each other, all being present at the same time, have hereunto
set our hands as witnesses.
~7~ddress
STATE OF PENNSYLVANIA :
: SS.
COUNTY OF DAUPHIN :
I, Paul Loutzenhiser, having been duly qualified according to
law, acknowledge that I signed the foregoing instrument as my
will, and that I signed it as my free and voluntary act for the
purposes therein expressed.
We, having been duly qualified according to law, depose and
say that we were present and saw Paul Loutzenhiser sign the
foregoing instrument as his will; that he signed it as his free
and voluntary act for the purposes therein expressed; that each
of us in his sight and hearing and at his request signed the will
as witnesses; and that to the best of our knowledge he was at
that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Subscribed, sworn to or affirmed,
and acknowledged before me by the
above-named testator and by the
witnesses whose names appear
opposite on ~ I'~-- ,2004
LP~A A, CONWAY, NOTARY PU et.~C~..~ /
~SQUEHANNA ~, ~UPHIN CO
COMMISSION BPIRES ~ARCH
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURGr PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1162 EXt11
NO. CD 004511
fold
BROWN MICHAEL V ESQ
27 NORTH FRONT STREET
P O BOX 1284
HARRISBURG, PA 17108-1284
ESTATE INFORMATION: SSN: 202-36 5947
FILE NUMBER: 2104-0685
DECEDENT NAME: LOUTZENHISER PAUL
DATE OF PAYMENT: 1 O/18/2004
POSTMARK DATE: 10/15/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $5,000.00
REMARKS:
TOTAL AMOUNT PAID:
$5,000.00
SEAL
CHECK//1592
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
QUINN'BUSECK.LEEMHUIS.TOOHEY & KROTO.INC.
Attorneys At Law
2222 West Grandview Boulevard, Erie, PA 16506-4508 Phone: 814-833-2222 FAX: 814-833-6753
Kevin M. Monahan
kmonahan(~luinnfirm.c om
October 14, 2004
Cumberland County - Register of Wills
Hanover and High Street
Carlisle, PA 17013
Estate of Paul D. Loutzenhiser
No. 2004-00685
Inheritance Tax Prepayment
Dear Sir/Madam:
Enclosed please find a check in the amount of $5,000 representing the inheritance tax
prepayment for the Estate of Paul D. Loutzenhiser.
Should you have any questions, please do not hesitate to give me a call. ~-' ~'
Very truly yours,
QUINN, BUSECK, LEEMHUIS, TOOHEY &
KROTO, 1NC.
Kevin M. Monahan
KMM:akn
Enclosure
Document#228766, vl
Customer: This senqce area is provided for your internal use
and convenience. Service must be marked on airbill.
FedEx Service:
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~ PRIORITY OVERNIGHT MON
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N.r.. , ~"~gO~i\Ph... 814 833-2222
C~mpnyQUlNN L~W FIRM
AddFes~ 2222 W (~RANDVI~W 8LVD
c~/ERIE stare PA
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In the Court of Common Pleas of Cumberland County, Pennsylvania
IN RE:
ORPHANS' COURT DIVISION
Estate of Paul D. Loutzenhiser
NO. 21-04--685
Certification of Notice Under Rule 5.6(a)
Name of Decedent: Paul D. Loutzenhiser
Date of Death: 0711712004
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served
on or mailed to the following beneficiaries of the above-captioned estate on 1012612004
Name Address
Timothy Loutzenhiser 7116 Crubb Road, Erie, PA 16506
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except.
Date: October 26, 2004
Signature
Name: Kevin M. Monahan
Address: 2222 W. Grandview Blvd.
Erier PA 16506
Telephone: (814) 833-2222
Capacity:
X
Personal Representative
Counsel for Personal Representative
1N THE MATTER OF
THE ESTATE OF
PAUL D. LOUTZENHISER,
deceased
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
NO. ~g$ OF 2004
To the Clerk of Courts:
APPEARANCE
Please enter my appearance as attorney for the Estate of Paul D. Loutzenhiser,
deceased.
Respectfully submitted,
QUINN, BUSECK, LEEMHUIS, TOOHEY &
KROTO, INC.
Kevin M. Monahan
2222 West Grandview Boulevard
Erie, PA 16506-4509
(814) 833-2222
QUINN.BUSECK.LEEMHUIS.TOOHEY & KROTO'INC.
Attorneys At Law
2222 West Grandview Boulevard, Erie, PA 16506-4508 Phone: 814-833-2222 FAX: 814-833-6753
Lisa L. Masi
Estate Paralegal
Imasi@quinnfinn.com
March 7,2005
Register of Wills
Cumberland County Courthouse
Hanover and High Streets
Carlisle, PA 17013
RE: Estate or Paul D. Loutzenhiser
21-04-0685
Dear Register:
Enclosed please find the original Inheritance tax return and Inventory (in duplicate) regar~ihg the
above-referenced estate. You will see that $122.19 oftax is due. I have enclosed a check in that
amount, as well as a check for $25.00 to cover the filing fee.
Please send both receipts to my attention at the Quinn Law Firm. Thank you.
Very truly yours,
QUINN, BUSECK, LEEMHUIS, TOOHEY &
KROTO, INC. "
!ltia~1f/;WJ
<Lisa . Masi
By
Estate Paralegal
Enclosures
---
---
---
---
---
--.-
-.0_
-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MONAHAN KEVIN M, ESQ
2222 WEST GRANDVIEW BOULEVARD
ERIE, PA 16506-4509
-- fold
ESTATE INFORMATION: SSN: 202-36-5947
FILE NUMBER: 2104-0685
DECEDENT NAME: lOUTZENHISER PAUL
DATE OF PAYMENT: 03/10/2005
POSTMARK DATE: 03/07/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2004
NO. CD 005044
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $122.19
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$122.19
REMARKS:
CHECK# 254989
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
"
REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE
Hanover and High Streets
Carlisle, PA 17013
.
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
REV-1500 EX + (6-00)
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COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME(LAST, FIRST, AND MIDDLE INITIAL)
Loutzenhiser Paul D.
DATE OF DEATH (MM-DD-YEAR)
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
202-36-5947
THIS RETURN MUST BE FILED IN DUPUCATEWITH THE
\Y--
Copyright(c) 2000 form software only The Lackner Group, Inc.
DATE OF BIRTH (MM-DD-YEAR)
07/17/2004 02/11/1947
IF APPLICABLE SURVIVING SPOUSE'S NAME LAST, FIRST,AND MIDDLE INITIAL
NUMBER
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
X 1. Original Return
4. Limited Estate
X 6. Decedent Died Testate
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12- 12-82)
7. Decedent Maintained a Living Trust 0
(Attach copy of Trust)
(Attach copy of Will)
D 9. litigation Proceeds Received
3. date of death
. Remarnder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit D 11. Election to tax under Sec. 9113(A)
(date of death between 12-31-91 and 1-1-95) (Attach Sch 0)
. THIS $l!:<:'fIQN'MtlSt: BE~Q~f'Lrmll, Al.l. co Rl!$~~I;jENCE'& 'cp . f'IP~ . At.i'rAllc(fl:F:liIlMA'tIOt($I-(OIlLI);alatiIBEcrl:o',.Oj . .
NAME COMPLETE MAILING ADDRESS
Kevin M. Monahan
FIRM NAME{lf Appllcable)
Quinn Law Firm
TELEPHONE NUMBER
2222 West Grandview Boulevard
Erie, PA 16506
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8 4 833-2
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFFICIALUS'E ONLY
-0-
(8) 151,604.87
(11) 31. 930.52
(lZ) 119,674.35
(13)
(14) 119,674.35
(15)
(16)
(17)
(18)
(19)
0.00
5,385.35
0.00
0.00
5,385.35
(1)
(Z)
(3)
130,000.00
None
None
(4)
(5)
None
13,282.54
(6)
8,322.33
12,167.73
19,762.79
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate 119,674.35
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
ZOo
x
X
X
X
o 0
.0 45
.12
.15
Fotm REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
621 Tower Road
CITY I STATE I ZIP
Eno1a PA 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5,000.00
263.16
Total Credits ( A + B + C) (2)
5,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WillS, AGENT
5,385.35
0.00
122.19
0.00
122.19
{:::'m::m::'~:t:~~~~:!~~~:!~~:::~~~::~~tt!~!~~~:!~~~!~~i~:~~m~~::~t~~!:!~~!:~~:!!,:~:!1
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or.
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
:~~m~~:~::~~~!~!~~!~:I~~~:!~t~~~:~mm'::""
No
~~
Yes
[]]
D
[RJ
[RJ
D
D
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
~r~
SIGNATURE OF PREPARER OTHER THAN R
Timothy Loutzenhiser
7116 Grubb Road
-----------------------------------------------------
Erie, PA 16506
Quinn Law Firm
2222 West Grandview Boulevard
-- -E'::i~- -1>1.- --i6-S06- - -- - --- -- --- -- --- -- - -- --- --- ---
DATE
...-
3- 7- OS
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. 9116 (a)(1.1)(i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (iO]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000;
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV- 1502 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Paul D. Loutzenhiser SS# 202-36-5947 07/17/2004 21-04-0685
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledge of the relevant facts. Real property which is jOintly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
1 Real Estate located at 621 Tower Road, Enola, PA - East Pennsborc 130,000.00
Twp., Cumberland County
Cumberland County Deed Book 263, Page 4696; see attached
Exhibit No. 1
SCHEDULE A
REAL ESTATE
TOTAL (Also enter on line 1, Recapitulation) $ 130,000.00
(If more. space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHER1TANCETIV< RETURN
RESIDENT DECEDENT
ESTATE OF
Paul D. Loutzenhiser
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
SS1ft 202-36-5947
07/17/2004
FILE NUMBER
21-04-0685
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
Credit to estate for real estate taxes paid in advance of real
estate closing
VALUE AT DATE
OF DEATH
1,140.35
2
Federal income tax refund
856.00
3
Geico - car insurance refund
229.78
4
Nationwide homeowner's insurance refund
48.00
5
Waypoint Bank - refund of escrowed funds from real estate closing
208.41
6
1981 Yamaha motorcycle - valued as per sale price
600.00
7
1999 Pontiac Firebird TransAm vehicle - valued as per appraisal
9,200.00
8
Personal property located in decedent's residence
1,000.00
TOTAL (Also enter on line 5, Recapitulation) $ 13 ,282.54
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
REV- 1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETIV< RETURN
RESIDENT DECEDENT
ESTATE OF
Paul D. Loutzenhiser
SCHEDULE F
JOINTLY-OWNED PROPERTY
SSfI 202-36-5947
07/17/2004
FILE NUMBER
21-04-0685
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
A.
SURVIVING JOINT TENANT(S) NAME
Timothy Loutzenhiser
ADDRESS
7116 Grubb Road
16506,
RELATIONSHIP TO DECEDENT
son
B.
c.
JOINTLY-OWNED PROPERTY,
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial Institution and bank DATE OF DEATH DECO'S VALUE OF
account number or similar identifying number.
NUMBER TENANT JOINT Attach deed for Jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 07/13/98 Waypoint Bank Checking 16,644.67 50.00% 8,322.33
Account No. 900038894 -
joint with decedent's son,
Timothy Loutzenhiser
TOTAL (Also enter on line 6, Recapitulation) $ 8,322.33
(If more space is needed insert additional sheets of the same sjze)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1509 EX (Rev. 1-97)
REV-1510 EX +(1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Paul D. Loutzenhiser
07/17/2004
FILE NUMBER
21-04-0685
SSfj 202-36-5947
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM
NUMBER
1
DESCRIPTION OF PROPERTY
RELA t~8~M~I~ t~'b~~~5~~TT~JJ~~~lfAET~E6F t~X~RSFER.
ATTACH ACOPYOFTHE DEED FOR REAL ESTATE.
Commerce Bank Checking
Account No. 032032765 -
account was made joint on
June 5, 2004, with son,
Timothy Loutzenhiser; see
attached Exhibit No. 2
DATE OF DEATH
VALUE OF ASSET
47.97
2
Steel Seven Credit Union
Account - account closed on
July 15, 2004, funds
transferred to decedent's
son, Timothy Loutzenhiser;
see attached Exhibit No. 3
1,212.65
3
U.S. Savings Bonds redeemed
within a year of decedent's
death - joint with
decedent's son, Timothy
Loutzenhiser; bonds
redeemed 7/1/04; gift of
cash
1,203.64
% OF
DECD'S
INTEREST
100.00%
EXCLUSION
(IF APPLICABLE)
47.97
100.00%
1,212.65
100.00%
1,203.64
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same si2e)
Copyright (cl 1996 form software only CPSystems, Inc.
TAXABLE VALUE
0.00
0.00
0.00
0.00
Form REV-1510 EX (Rev. 1-97)
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Paul D. Loutzenhiser
SSIf 202 - 36 - 5947
07/17/2004
FILE NUMBER
21-04-0685
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES,
Funeral Expenses: soloist, priest, memorial, church
300.00
2
Office of Catholic Charities - grave marker
1,495.00
1.
ADMINISTRATIVE COSTS,
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attorney's Fees Quinn Law Firm
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4,450.00
City
Relationship of Claimant to Decedent
State
Zip
4.
Register of Wills
272.00
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Capital Area Abstractors, LLP - express mail charge
20.00
2
Capital Area Abstractors - tax certification fee
12.00
3
Cumberland County Law Journal - estate advertising
75.00
4
Dave Wevodau - painting inside decedent's home to prepare it for
sale
1,500.00
5
Dillburg Septic, Excavating & Paving, Inc. - clean septic system
at decedent's residence to prepare it for sale
175.00
Total of Continuation Schedu1e(s)
3,868.73
TOTAL (Also enter on line 9, Recapitulation) $ 12,167.73
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, tnc. Form REV-1511 EX (Rev. 1~97)
Estate of: Paul D. Loutzenhiser
Soc Sec #: 202-36-5947
Date of Death: 07/17/2004
Continuation of Schedule H-B2
(Attorney's Fees)
Item
#
Description
Amount
1
Quinn Law Firm
legal fees
450.00
2
Quinn Law Firm
legal fees
4,000.00
4,450.00
Estate of: Paul D. Loutzenhiser
Soc Sec #: 202-36-5947
Date of Death: 07/17/2004
Item
#
Continuation of Schedule H-B7
(Other Administrative Costs)
Description
Amount
6
East Pennsboro Township - final sewer bill
46.50
7
HCTC - health coverage payment
62.81
8
Homespec Inspection Protection radon treatment at decedent's
residence to prepare it for sale
635.00
9
Jensens - repair to decedent's Firebird TransAm
75.00
10
water bill
21.34
PA American water
11
water bill
12.11
PA American water
12
water bill
20.00
PA American water
13
Pennsylvania Power and Light - electric bill
35.31
14
Quinn Law Firm - costs advanced - i.e.: telephone charges, fax
fees, postage, copies
20.25
15
Quinn Law Firm - costs advanced - i.e.: telephone charges, fax
fees, postage, copies
33.96
16
Recorder of Deeds - transfer tax on sale of 621 Tower Road,
Enola, PA
1,300.00
17
REGISTER OF WILLS
short certificates
15.00
18
filing fee - Inheritance tax return and
25.00
REGISTER OF WILLS
Inventory
19
Timothy Loutzenhiser - for mileage regarding
estate affairs; 716 miles @.375 per mile
643.50
Reimbursement to
travel to manage
20
Sylvester's Services, Inc. - dumpster return and garbage removal
to prepare decedent's residence for sale
521.08
21
122.63
The Sentinel - estate advertising
22
78.19
Timothy Loutzenhizer - reimbursement for miscellaneous expense
23
UHaul - bill for moving services
173.88
24
Verizon Telephone - phone bill
25.85
Estate of: Paul D. Loutzenhiser
Soc See #: 202-36-5947
Date of Death: 07/17/2004
Continuation of Schedule H-B7
(Other Administrative Costs)
Item
II
Description
Amount
25
Verizon Telephone - phone bill
1.32
3,868.73
REV-1512 EX +(1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Paul D. Loutzenhiser
FILE NUMBER
21-04-0685
SS!! 202-36-5947
07/17/2004
Include un reimbursed medieal expenses.
ITEM
NUMBER
1 Bank One credit card
DESCRIPTION
AMOUNT
340.42
2
East Pennsboro Township Tax Collector - 2004-05 school taxes
1,482.50
3
Federal Express Mailing fee - for recording quitclaim deed in
Cumberland County
10.96
4
Forestview Nursing Facility - nursing home bill
600.00
5
HCTC - health coverage payment
187.19
6
Lafayette Life - life insurance premium; checking outstanding at
death
173.01
7
MBNA Credit Card
7,963.14
8
PA American water - water bill
13 .85
9
Pennsylvania Power and Light - electric bill
63.94
10
Recorder of Deeds
file quitclaim deed
38.50
11
Verizon Telephone
phone bill
16.51
12
Waypoint Bank Home Equity Loan No. 0907007264 - one-half of joint
home equity loan with decedent's son, Timothy Loutzenhiser
1,471. 06
13
Waypoint Bank, formerly Harris Savings - one-half of joint
mortgage on 621 Tower Road property; one-half payoff as of date
of death, plus satisfaction fee
7,401. 71
TOTAL (Also enter on line 10, Recapitulation) $ 19,762.79
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV-1513 EX + (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Paul D. Loutzenhiser
SSfI 202-36-5947
07/17/2004
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and
transfers under Sec. 9116{a)(1.2)]
Timothy Loutzenhiser
7116 Grubb Road
Erie, PA 16506
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
1
Son
FILE NUMBER
21-04-0685
AMOUNT OR SHARE
OF ESTATE
100% of
residue
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON- TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software oniy The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
2("":
--- tr>
~f'
';.~ I ;
fu~-,
7'}
'~.'.,
Eo
.-
N
N
'\
d
.p..
~..:O
.4J (to
{i) ()
{~Q 0
.'~~~ :'1
',;) J''l.':>
"'-~ (' ,~.
Paul Loutzenhiser
Paul
Enola,
."") ~
'"":'.;,') -"
Cumb:~{lan~
~"- i,"]
(';')
I,
Loutzenhiser,
,~,
CouRty,
Pennsylvania, revoke my prior wills and declare this to be my
last will:
I. Debts and Funeral Expenses: My lawful debts and the expenses
my last illness, funeral and burial shall be paid out of my'fp L
of
estate.
II. Personal and Household Effects: With the exception of the
specific items noted below, I give all my articles of personal or
household use, together with all insurance relating thereto to
Timothy Loutzenhiser, if he survives me by thirty days.
~J)L-
III. Real Estate: I give my real estate located at 621 Tower
Road, Enola, Pennsylvania, to Timothy Loutzenhiser.
IV. Residuary Estate: I give the residue of my estate, real and
personal to my son, Tmothy Loutzenhiser, if he survives me by
thirty days.
V. Protective Provision: No interest in income or principal shall
be assignable by, or available to anyone having a claim against,
a beneficiary before actual payment to the beneficiary.
VI. Death Taxes: Any federal, state and other death taxes payable
on the property forming my gross estate for tax purposes, whether
or not it passes under this will, shall be paid out of the
principal of my probate estate just as if they were my debts, and
none
of those taxes shall be charged against any benefici~~ ~
VII. Manaqement Provisions: I authorize my executor:
A. To retain and to invest in all forms of real and
personal property, including common trust funds regardless
of any limitations imposed by law on investments by
executors or trustees, or any principle of law concerning
investment diversification;
B. To compromise claims and to abandon any property which,
in my executor's opinion, is of little or no value;
C. To borrow from, and to sell property and to pledge
property as security for repayment of any funds borrowed;
D. To sell at public or private sale, to exchange or to
lease for any period of time, any real or personal property,
and to give options for sales or leases;
E. To join in any merger, reorganization, voting-trust plan
or other concerted action of security holders, and to
delegate discretionary duties with respect thereto;
F. To use administrative or other expenses of my estate as
income tax or estate tax deductions and to value my estate
for tax purposes by any optional method permitted by the law
in force when I die, without requiring adjustments between
income and principal for any resulting effect on income or
estate taxes; and
ijL
G. To distribute in kind and to allocate specific assets
among the beneficiaries in such proportions as my executor
may think best, so long as the total market value of any
beneficiary's share is not affected by such allocation.
IX.
Executor and Trustee;
I appoint my son,
Timothy
Loutzenhiser, executor of my will. He is to serve as without
bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this /.;2.
d,y of ;(::3 '7/-lTIo4'
all of ~ pa .
at the end hereof,
7 ;7<--
composed in
~ ou1 Lout.enhi.
,
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testator as and for his Last Will and Testament in the presence
of us, who, at his request, in his presence and in the presence
of each other, all being present at the same time, have hereunto
set our hands as witnesses.
'Yf!)3 (. ~~k (1). rpt-'so~
~ (;) t"d
- \ft-"7~ddrerr ~.t t~
t'"~,3.JC ~~~ e ~cd.
~--..:.?7.K /;?>~drerr ~-d! 4= ~
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2004.00685 PA No. 21.04-0685
Estate Of: LOUTZENHISER PAUL
{Last First Middle;
a/k/a:
Late Of:
LOUTZENHISER PAUL D
EAST PENNSBORO TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Securi ty No: 202-36-5947
WHEREAS, on the 22nd day of July 2004 an instrument dated
May 12th 2004 was admitted to probate as the last will of
LOUTZENHISER PAUL
(Last Filsr. MirJdlel
a/k/a LOUTZENHISER PAUL D
la te of EAST PENNSBORO TOWNSHIP, CUMBERLAND Count V,
who died on the 17th day of July 2004 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH
for CUMBERLAND County, in the Commonwealth of
certify that I have this day granted Letters
LOUTZENHISER TIMOTHY
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
Register of wills
Pennsylvania, hereby
TESTAMENTARY to:
in and
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 22nd day of Ju)y 2004.
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
......
OMB NO. 2502-0265 'r
A B. TYPE OF LOAN;
U.S. DEPARTMENT OF HOUSING & URBAN DEVElOPMENT 1_0FHA 2_0FmHA 3 OCONV, UN INS 'OVA S(R]CONV.INS
6. FILE NUMBER: 17_ LOAN NUMBER
SETTLEMENT STATEMENT 2004080015
8 MORTGAGE INS CASE NUMBER:
C _ NOTE This form is furnished to give you a statement of actual settlement costs. Amounts paid /0 and by the settlement agent are shown.
Items marked "(POC)" were paid outside Ihe closing; they are shown here (orinformalionaJ purposes and are not included in Ihe totals
'" 31B8 \20040aoo15PFDI2004D80GI5i15)
D NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER
JasonWEstrightand Timothy loutzenhiser, Executor Wachovia Mortgage Corporation
Christme M.Estright Paul D. Loutzenhiser '\ J€fferson SquaT€!
521 Tower Road 7116 Grubb Road Waterbury,CT 06706
Enola, PA 17025 Erie, PA 16506
G. PROPERTY LOCATION H. SETTLEMENT AGENT 20-0417209 I. SETTLEMENT DATE:
621 Tower Road Capital Area Abstfactms, LlP
Enola, PA 17025 October 12, 2004
CumberlandCounty,Pennsylvania PLACE OF SETTLEMENT
621 Tower Road, East Permsboro 4999 Jonestown Road , Suile202
Township. Cumberland County.
Enola, Pennsylvania Harrisburg, PA 17109
J, SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101 Contrac\ Sales Price 130,000.00 401. Contract Sales Price I 130,000,00
102 Personal Pro e 402, Personal PrcioertV-
103 Settlement Char;;es to Borrower (Line 1400 4,166,83 402..
10' 404
105 I 405
A~stmenls For lIems Paid B;;seller in advanw Ad'ustmunts For Items Paid B SeJlerin advance
106 Counl fTownshi 10(13/04 " 01(01105 80.26 406. CounlVfrownsh"io' 10/13/04 to 01(01/05 ! 80.26
107 SchoolTaxes 10/13/04 10 07/01/05 1,060,09 407 SchoolTaxes 10113f04 to 07101105 1,060.09
108 Assessments 10 408. Assessments 10 I
109 409
110 410,
111 , 411.
112 '12
120 GROS$ AMOUNT DUE FRQMBORROWER ! 135.307,18 420 GROSS AMOUNT DUE TO SELLER I 131,140.35
200 AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500 REDUCTIONS IN AMOUNT DUE TO SELLER:
2Q1, De osit or earnest !1iQI'€ 1,00000 501 Excess De osit See Instructions
202 Pnn~1 Amount of New Loan s 117,000.00 502 SettlementCharaesto Selle--;tline 14001 2,881.00
203 Existin loan s takensub'eclto 503. Existin loan s taken subec\ to
204 , 504. Payoff of first Mortgage 10 Harris Savings 13,500.00
205 505 pa off of second Mort a e
206 506 De osit letaineo b seller I 1,00000
207 507.
208 508 I
209 509.
Adustments For Items Un aidB Seller MiUstments For Items Un aidB Seller
210 Cou"ilNrrownship I, 510 Coun fTownshi 10
211 SchoolTaxes 10 511 SchoolTaxes 10
212 Assessments 10 512 Assessments 10
213 513
214 514 .
215, 515
216 516
217 517
218 518
219 , 519. ,
220 TOTAL PAID BY/FOR BORROWER , 118,00000 520 TOTAL REDUCTION AMOUNT DUE SELLER ! 17,381.00
I
300. CASH AT SETILEMENT FROMfTO BORROWER: 600. CASH AT SETILEMENT TO/FROM SELLER:
301. Gross AmOUnt Due From Borrower line 1201 135,30718 601 Gross Amount Due To Seller line 420 131,14035
302 Less Amount Paid By/For Borrower (line 220) ( 118,000,00) 6C2 less Reductions Due Seller (line 520) l 17,381.00
30J CASH ( X FROM) ( TO) BORROWER ! 17,307.18 603 CASH(X TO){ FROM) SELLER , 113,759.35
The undersigned hereby acknowiedge receipt of a completed copy 01 pages 1&2 of this statement & any attachments referred to herein.
Borrower / .,--."
\
'l{~:~
0:, V'\' Ei(,.,'fU , ;.71:\ ~.
'q \', ' ,-:J,I:\ ,----LYu"' ,
~\1 M.E~'\
v
Seller
T'lTll)\h}' \.::>ulzenllise' Exe~ul('r for the Estate of
pauID,Loutze~--'-
TOTAL COMMISSION Based on Price
D'vislOn of Comm'ssion line 700) as Follows
S "
$ t,
Commission Paid at Settlement
$
L. SETTLEMENT CHARGES
(Q) 0.0000%
~~o.
701
702
703
704
800. ITEMS PAYABLE IN CONNECTION WITH lOAN
801 Loan 011 ination Fee 1,0000 % to Wachovia Mort a e
802 Loan Discount % to
803 Appraisal Fee to
804 Credit Report 10 WachoviaMortgage
805 Tax Service Fee to First American Real Estate Tax Service
806 Flood Certification Fee to Wachovia Morlqa e
807 ProcessmgFee to WachoviaMortgage
808 Application Fee 10 Wachovia Mortgage
809 Doc Transmission 10 Wachovia Mortgage
810 MERS Fee to Wachovia Mortgage
811 PIW Fee to FNMA to Wachovia Mortgage
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901 InlerestFrom 10/12/04 to 11/01/04 @ $ 19,230000/day ( 20 days
902 Mort a e Insurance Premium for months to
903 Haz.anJ Insurance Premium for 1,0 ears to
904
905
1000
1001
1002
1003
1004.
1005
1005
1007
1008 A re ate Ad'ustment
1100 TITLE CHARGES
1101 Settlement or Closinq Fee
1102 Courier Fee
1103 Wire Transfer Fee
1104 Tax Certification Fee
1105 Document Pre aration
1106 Nota Fees
1107. Attorney's Fees
includes above item numbers
1108 Title Insurance
includes above ilem numbers
Lender's Coverage
Qwner'sCoverage
100,300 & 900 Endorsements
ClOSing Service letter
"
8,000
5000
9000
months $
months .$
months $
months @ $
months @ $
months $
months
months
$
$1170.00 POC blender
%)
27.50 er
month
month
month
month
month
month
month
month
"
8.56 per
123.54 er
20.71 per
"
"
"
t,
to Ca ital Area Abstractors, llP
to Cailal Area Abstractors Settlemenl Account
to Capital Area Abstractors, llP
to
to
t,
Dorothea R Butkus
to landAmencala
ersTille
1109
1110
1111
1112
1113
1200.
1201
1202
1203
1204.
1205
1300. ADDITIONAL SETTLEMENT CHARGES
1301 Survey
1302 Pest Ins ection
1303 East Pennsboro Townshi - Tras
1304 Pa Amencan Waler Co
1305 See addit'l disb. exhibit
1400. TOTAL SETTLEMENT CHARGES
$ 117,000,00
$ 130,000.00
to Capital Area Abstractors, LLP
\0 land America lawyers Tille
GOVERNMENT RECORDING AND TRANSFER CHARGES
Recording Fees: Deed .$ 38,50: Mortgage $ 60.50:
Cit fCount Tax/Slam s Deed 1,300,00' Mort a e
Stale Tax/Stamps Revenue Slam s 1,300.00: Mort a e
2004-05 School Taxes 10 East Pennsboro Townshi Tax Collector
Releases $
#0912-2990-016
to
t,
to East Pennsboro Townshi
to Pa American Water Co
to
(Enter on Lines 103, Section J and 502, Section K
By "g'
"'g rage 1 01 tn" statement, tne >Ignalor;e. ~ol;nowte~ge rece'pl 01 a complel.~ CUPY 01 page 2 of [r", two ;~Ib,e~~~( L\ QjQ.-._p &'1 .tl ~.cl:,L
Capital Arealtbstractors,llP
Settlement Agent
Certified to be a true copy
PAID HlOM
BORROWER'S
FUNOSAr
SETTLEMENT
1500
7800
800
30000
6000
2500
395
50.00
384.60
8250
58.48
617.70
186.39
-383,54
2000
2000
12.00
100875
150,00
3500
10500
1,30000
2000
4,166.83
(200405001512004060015115)
P~ge 2
PAID FROM
SEllER'S
FUNl)~ AT
SElTLEMENT
1200
1,30000
1,482.50'+
46,50,
200
2000
2,88100
ADDITIONAL DISBURSEMENTS EXHIBIT'
Borrower: Jason W. Estright and Christine M. Estright
Seller: Timothy Loutzenhiser, Executor for the Estate of Paul D. Loutzenhiser
Lender: Wachovia Mortgage Corporation 1 Jefferson Square Waterbury, CT 06706
Settlement Agent: Capital Area Abstractors, LLP
(717)920-9179
Place of Settlement: 4999 Jonestown Road" Suite 202
Harrisburg, PA 17109
Settlement Date: October 12, 2004
Property Location: 621 Tower Road
Enola, PA 17025
Cumberland County, Pennsylvania
621 Tower Road, East Pennsboro
Township, Cumberland County,
Enola, Pennsylvania
PA YEE/DESCRIPTlON
NOTE/REF NO
BORROWER
SELLER
Capital Area Abstractors, LLP
Express Mail for Mortgage P/O
Capital Area Abstractors, LLP
Express Mail Fee for Loan Pack
20.00
20.00
Total Additional Disbursements shown on Line 1305
$
20.00
$
20.00
(20040B0015.PFD/20040B0015/15)
Commerce
_Bank
November 19, 2004
The Quinn Law Firm
2222 W Grandview Blvd
Erie, PA 16506-4508
RE: Estate of: Paul D Loutzenhiser
Social Security #: 202-36-5947
Date of Death: July 17, 2004
Dear Sirs:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Checking
Account #: 032032765
Date Opened: 10/14/92
Date Closed: 7/26/04
Primary Owner: Paul D Loutzenhiser
Secondary Owner: Timothy P Loutzenhiser
Date of Death Balance: $47.97)
Accrued Interest: $0 \~
Principal Balance: $47.97 \
The above account became joint on 6/5/04.
Commerce Bank I Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
Commerce
_Bank
If there are any questions or additional information that
is needed, please feel free to contact me at (717) 795-7118
ext. 3151.
Sincerely,
Wup,,6C\.. ~ ~~
Wanda J Morris
elF Team Leader
Commerce Bank I Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001.8599
4051 EXECUTIVE PARK DRIVE . HARRISBURG, PA 17111
1-800-322-8792 . \-717-561-9969 FAX. 1-800-278-3357 Audio Response. www,steelsevcn,org
November 8, 2004
Quinn, Buseck, Leemhuis, Toohey & Kroto, Inc.
2222 West Grandview Boulevard
Erie, P A 16506-4508
Attn: Lisa Masi
RE: Paul D. Loutsenhiser
Dear Lisa:
f
This share account was closed on July 15,2004 in the amount of$1212.65. If you need any
further information you may contact us at 1-800-322-8792, Monday -Friday 8:30-4:15.
T;:i~ 1JoJL
Robin Haehnlen
EXHIBIT
Ofji I ~
:Il~"'1;
G. Kenneth Griffin, Jr
Presid("nl
Eric J
VicePreside/J1
Daniel [) Minnich
hcnslIru
y"
Secrefnl}
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Paul D. Loutzenhiser
No. 21-04-0685
also known as
Date of Death 07/17/2004
, Deceased Social Security No. 202-36-5947
Timothy Loutzenhiser,
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. INVe understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Kevin M. Monahan
Personal Representative _ ~~
Signature: ~r I
Timothy Loutzenhiser
1.0. No.'
41246
Signature:
Address:
2222 West Grandview Boulevard
Address:
7116 Grubb Road
Erie, PA 16506
Erie, PA 16506
Telephone, 814/833 - 2222
OY\^-;\ \:' . .~W'\(.L
ho\bJ,y Y0bl,c
Telephone, 814/836 - 7038
31,/05
Dated:
I~V'
/\MY K. NEWARA. NOTARY PUBLIC
ERIE, ERIE COUNTY. PENNSYLVANIA
MY COMMISSION EXPIRES OCT. 10. 2005
1---.
Description
Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
143,282.54
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.
0'.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form#RW-7 (1992)
Estate of:
Date of Death:
County:
INVENTORY
Paul D. Loutzenhiser
07/17/2004
Cumberland
CASH:
Credit to estate for real
estate taxes paid in advance
of real estate closing
1,140.35
Federal income tax refund
856.00
Geiea - car insurance refund
229.78
Nationwide homeowner's
insurance refund
48.00
Waypoint Bank - refund of
escrowed funds from real
estate closing
208.41
2,482.54
PERSONAL PROPERTY:
1981 Yamaha motorcycle
valued as per sale price
600.00
1999 Pontiac Firebird TransAm
vehicle - valued as per
appraisal
9,200.00
Personal property located in
decedent's residence
1,000.00
10,800.00
-1-
REAL ESTATE/PA:
Real Estate located at 621
Tower Road, Enola, PA - East
Pennsboro Twp., Cumberland
County
130,000.00
TOTAL RECEIPTS OF PRINCIPAL... ...... ... ...
-2-
130,000.00
143,282.54
BUREAU OF INDIVIOUAL',TAllEI[
INHERITANCE TAX DIVISIOJt","
PO BOX ZSD6Dl >e...
HARRISBURG PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
Znn.t,'{\\! 0(j
Je" rL, LV
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
Prl12: 40
05-23-2005
LOUTZENHISER
07-17-200<0
21 0<0-0685
CUMBERLAND
101
AlIOunt R..l tted
C'E",'!I
; '"'c-
,- !,,\
ORD' 'V. H'
,-j ;;:,,\:.,)
KEVIN MCl!liIAKAII
QUINN LAW FIRM
2222 W GRANDVIEW
ERIE
BLVD
PA 16506
'*
REV-1547 EX AFP (03-051
PAUL
D
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 ....
IUV-"MC,."ft.m.'l'\t.!~'1l'tl1.'lMn'l!t.W.!MftItrt'Ilr<<!'t.m.l'WltlTft"'~.ycr.WIlAW.Ilft'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LOUTZENHISER PAUL D FILE NO. 21 0<0-0685 ACN 101 DATE 05-23-2005
TAX RETURN WAS: I X I ACCEPTED AS FILED
I CHANGED
I~ an assess.ent was issued previously. lines 14. 15 and/or 16. 17. 18 and
r~lect ~igures that include the total ~ abb returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 .t Spousal rate (IS)
16. ADDUnt of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 .t Sibling rat. (17)
18. AlIOunt of Line 14 tax.ble at Colleteral/Class Brat. (18)
19. Principel Tax Due
X D S:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estat. (Schadul. A)
2. Stocks and Bonds (Schedule 8J
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
s. Cash/Bank Deposits/Kisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedule 8)
8. Total Assets
III
(2)
131
(41
151
161
(71
130,000.00
.00
.00
.00
13.282.54
8.3ZZ.33
.00
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funerel Expenses/Adm. Costs/Kisc. Expenses (Schedule H)
10. DebtslKortg.ge Liabilities/Liens (Schedule I)
11. Total D8ductions
12. Net V.lue of Tax R.turn
13. Chariteble/Governnental Bequests; NOn-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
191
1101
12,167.73
19.762.79
1111
1121
1131
1141
NOTE:
.00 X
119,67<0.35 X
.00 X
.00 X
00 =
0<05 =
12 =
15 =
1191=
DATE
10-15-200<0
03-07-2005
AHOUNT PAID
5,000.00
122.19
NUMBER
CDOO<0511
CD0050<O<O
INTEREST/PEN PAID (-I
263.16
.00
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
NOTE; To insure proper
credit to your account,
submit the upper portion
of this for. with your
tax P8YlNll'lt.
151,60<0.87
~1 .9~O I:i?
119,67<0.35
.00
119,67<0.35
19 will
.00
5,385.35
.00
.00
5,385.35
5,385.35
.00
.00
.00
I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REIlUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORH FOR INSTRUCTIONS.I
IN THE OFFICE OF 'lEE c::LrnK OF RIDJRDS
CUMBERLAND COUN'IY, PENNSYLVANIA
RB3ISTER OF WII.J..S DIVISION
STAWS REPORT UNDER RULE 6.12
Name of Decedent:
PAUL D. LOUTZENHISER
Date of Death:
July 17, 2004
will No.: a\ -0\.\ - ~~S
Register File No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' court Rules, I report
the following with respect to ccmpletion of the administration of the above-
captioned estate:
1. State whether administration of the estate is CC1ll'lete. Yes X No
2. If the answer to i1 is No, state when the personal
representative reasonably believes that the administration
will be complete:
3. If the answer to 11 is Yes, state the folla.dng:
(a) Did the personal representative file a final
account with the Coort?
Yes
No X
(b) The separate Orphans' Court docket number (if any)
for the personal representative's account is:
(c) Did the personal representative state all acca.mt
informally to the parties in interest?
Yes X No
(d) Copies of receipts, releases, joinders and
approvals of formal or informal accounts ooy be
filed with the Clerk of the Orphans' Court and
may be attached to this report.
Date:
June 2, 2005
Ifw<~-- A A~
KeVln M. Mtnab~,/~squire
2222 W. Grandview Blvd.
Erie, PA 16506
( ~14) ~jj-nn
Personal Representative
X Coul1sel
Signature:
Name :
Address:
Telephone:
Capacity:
~