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HomeMy WebLinkAbout03-0285 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Vgills for the ., Deceased. County of/_~a,,-~,,,zcrm~.c~,do in the Social Securit. v No. / ? /--.3,:P ~ ~ ¢,~,,~ .~ 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 t~ P.... named in the last will of the above decedent, dated ~, ZP,:~--,:._ /~'~'_q-- ,19__ and codicil(s) dated (state relevam circumslances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~"~,:~',"/~ ,:--~-./"-> Q.ounty, Pennsylvania, with h ~ last family or principal residence at (list street, number and muncipality} Decendent, then ~ ~ years of age, died ~ ~ ~ 0 ., ~2o0~ , at_~w~ C~~ ~~ ~ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: __~~ ~ ~ ~ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Y",:~'-.SY",,)- theron. (testamentary; adminislration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -/ COUNTY OF _/?&/,-~,.~,c.o~L__/./,-~ f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedem petitioner(s) will well and truly administer the estate according to law. before me this . ,~1~5~. ___ __ day of ,4/// ' ,,~ ~' No. Estate Of OAN~T L RICKROOE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 2 ? 2003 ~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 12-6-1985 described therein be admitted to probate and filed of record as the last will of JANET L RICKRODE ; and Letters TESTAMENTARY are hereby granted to 3AMES A R!CKRO-nE --( ' O~ . Register of Wills FEES Probate, Letters, Etc .......... $ 25.00 Short Certificates( ) .......... $ 15.00. ATTORNEY (Sup. Ct. I.D. No.) ~~~ .e..x.t.r.a..~f99.~.. s 9. oo jcp $ ]0.00 ADD.SS TOTAL , $ 59.00 4-2-2003 Filed ................................... PHONE mailed to exec 4-2-2003 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS '~'~'~ codicil '~" ' (each) a subscribing witness"~he will presented herewith, (each) bC~duly qualified according to law, depose(s) and say(s) that "",.~~ present and saw the testat , sign the same and that "~ signed itness at the request of testat in h presence and (~~sence of each other) (in the presence of the other subscri~n~ Sworn to or affirmed an~ubscribe~e me this _ day o~ ~ame) Register (NamO (Address) REGISTER OF WILLS OF OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that I AM familiar with the signature of .1ANET L R_~CKRODE , codicil testatRIX of (one of the subscribing witnesses to) the will presented herewith and codicil that I believes the signature on the will is in the handwriting of JANET L RICKRODE to the best of MY knowledge and belief. Sworn to or affirmed and subscribed before me this ~.~- day of (Nat~~ O...a,6bL . ~o0 5___ ~ ~c'73 (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS ....... codicil (each) a subscribing witn~s~t<~ the--" will presented hereWi~,~fea~being'~~ duly qualified according to liiiii~iils~)~iT~ Ssljisiiiltame an;r:~eantce and (in the prescriber 9f e~~i other subscribing witness(es)). Sworn to or affirmed and s~ me this ~day (Name) 19 Register ~ · (Name) (Address) REGISTER OV WILLS OV COUNTY OATH NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s] and say(s) that ~ ~ familiar with the signature of~~~~~ , codicil testat~ of (one of the subscribing witnesses to) the ~ presented herewith and that ~ believes the signature on the~ id~c/~ the handwriting of to the best of ~ knowledge and belief. Sworn to or affirmed and subscribed before me this . ~% day of//'--~/~ ~ ~Name) ~'~ ~- ~ ~ ~% ~ ~~ ~ ~ (Address)~ - ~" ~ ~et~er ~ (Name) ~ (Address) This is to certify that the information here given is correctly copied from an original certificate of death duly filed With me as I,ocal 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. ~ --- ' L~,~¥Registrar -- // No. ~ Date .los ;~=n,, ~? COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS ~,~,,, CERTIFICATE OF DEATH '- ' .......... Fmle I" 171 -- ~ -- ~9 ,.~rch 26,. 2~3 66 I--i' I--i~ ,,~ ~t~ Pecan ,, Distribcti~ I,,. I,,. 12 I ,. ~rri~ ,tJ~ 328 FOrth St. ~st Fai~iew, PA 17025 ~M~c~ ~ Z~ ~ 1~28 Forth St., West Fairview, PA 17025 ~ ~fl ~G ~[,~rch 28,~ 2~3 I Rolling Green C~te~ ~ Hill, PA 17011 --- 17- .,.,_:::17. -- ~ _ ~ I~T~m~ ~&~'~'~"~'~'~'~'~""~"~'"~"'"~ 0 . ~cql ~.~,'~+~,'+~ ..... ' ........................................ . .~m~ -~ 9,'~+ O. ~Us~e Pg. ~'~ of JANET L. RICKRODE ,R - o3 g.5 I. JANET L. RICKRODE, presently of Harrisburg, Dauphin County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking and making void all Wills, Codicils or Writings in the nature thereof by me at any time heretofore made. ITEM I. I direct that the payment of my debts and the ex- penses of my last illness and funeral shall be paid from my estate as an administrative expense as soon after my death as conveniently may be done. ITEM II. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever juris- diction imposed, shall be paid as part of the expenses of the ad- ministration of my estate. ITEM III. All the rest, residue and remainder of my estate, real, oersonal and mixed, of whatever nature and wheresoever situate, of which I shall die seized, or to which I may be entitled, or over which I shall possess any power of appointment by Will at the time of my decease, whether acquired before or after the execu- tion of this, my Will, to my husband, JAMES A. RICKRODE, absolutely ~JANET L. RICKRODE and in fee simple. ITEM IV. Should my said husband die before me, or so nearly at the same time so that it cannot be determined which one of us survives, or in the event that my said husband and I shall perish at the same time in a common disaster, or in the event of my said husband's death within thirty (30) days after my death, then the said devise and bequest of my residuary estate shall lapse or be divested and I give such property as follows: A. All jewelry to my granddaughter, COURTNEY L. ZINK; B. All the rest, residue and remainder to be divided equally, per stirpes, among my children, MICHAEL ZINK and CATHY BRANDT, and my husband's daughter, WANDA K. LERCH. One-third share to each. ITEM V. I appoint my Executor guardian of any minor children with power (1) to hold for minors all property payable by law to a guardian appointed by my Will; (2) after considering the minor's wishes, to retain tangible personal property or de- liver it to the person standing in the place of a minor's parent, without bond; (3) to invest the balance of the minor's property and all accumulated income without the restriction to investments authorized for fiduciarieS; and (4) to use income and principal for the minor's maintenance and education, either directly or by payment to any person selected to disburse it whose receipt shall be a complete acquittance therefor. All unexpended principal and income shall be paid to the minor at majority. For purposes of this Will, majority shall be the age of eighteen (18). My gusrdians may, in discharge of all duties hereunder, pay any minor's share deemed impractical of administration to the person standing in place of the minor's parent or deposit it in an interest-bearing account in the minor's name. ITEM VI. No interest of any beneficiary under this Will or any Codicil hereto shall be subject to anticipation or voluntary or involuntary alienation. ITEM VII. I appoint my husband, JAMESA. RICKRODE, Executor of this my Last Will and Testament. In the event of the incapacity of my said husband, or his refusal to act as my Executor, or should my said husband resign as my Executor, I appoint RICHARD STELTZER, alternate Executor. Should he not act as alternate Executor, I appoint MICHAEL ZINK, alternate Executor with the same powers and duties. ITEM VIII. I hereby give full power and authority to my Executor or alternate Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my estate; to sell and dispose of any or all of my estate, real or personal or both, for such prices and upon such terms of credit or otherwise, and in such manner as my said Executor or alternate Executor deems best, without an Order of Court, at private sale if he sees Page 3 of 4 Pages ~ ! , - L. RIC OOE (SEAL) fit, and to furnish and deliver to the purchaser or purchasers all necessary or proper deeds and other instruments of convey- ance and transfer thereof. ITEM IX. I request that no bond or other security shall be required of any Executor or alternate Executor acting here- under for the faithful performance of his duties, any law of any state or jurisdiction to the contrary notwithstanding. IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will and Testament consisting of this and three (3) other pages, at the end of which I have also set my hand and affixed my seal for greater security and better identification, this ~ day of~-~ ~ ~~~.~/~,~ . , 1985. Page 4 of 4 Pages ~~.~ o~.~(SEAL) T L. RICKRODE We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto set our hands and seals the day and year above-written, and we certify that at the time of ,~xecution thereof, said Testatrix was of sound and disposing mind nd memor~y. , ~ ~ ~ /~ ~ Re si~ing at ~-~ ~f~ ,~~~~' , '. ', ill o£ JANET L. RICKRODE LAW OFFICES GILBERT E. PE-I-RINA 228 HOCKERSVILLE ROAD P. O. BOX 323 HERSHEY, PENNSYLVANIA 17033 Name of D~edent: ~ ~ ~ ~ / ~ (~ f ff/~ Date of Dea~: Y~ ~ C ~ ~ ~ ~ ~ O O ~ WillNo. ,~,1,.' Og -O ZS~ Admin. No. ~-~- OO Z~ To ~e Register: I ceffify ~m notice of (~fic~ ~) ~ a~ini~trafion required by Rule 5,6(a) of ~e 0~h~s' Cou~ Rules was se~ on or mailed to the following beneficiaries of the above-captioned estate on ~p, ] 2md Zoo ,~ : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: .,?;~.~,e- ...... ! 2. : '7_003 . Signature./~d"~)'~"~'~ '-~ Address II 2 6 Co, ' tm Z '"?' ::; ct. Telephone t8C3), Z ':]-L ~ 011~ '.:. --~ Capacity: ~ Personal Representative ~ P~2 o a, ~ Counsel for personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by thc decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of ~(x.~ ~ ~ L_, ~, c_ ~ c o CJ e. , deceased, Estate No. Z-C2T)3 - OO 7_ ~'.~ (Name and Address) TO: k~'o.r'~ e~ fiat R,c--]'cC~d.q-. ii Z o {_~ Co=Jo_ .... ~...~ ............. / Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent , died on the dayof "V~ o.~- oA ,2003 ,at Co ,r~o- la -~ cJ County, Pennsylvania. J( The Decedent died testate (with a Will); or The Decedent died intestate (without a Will). The personal representative of the Decedent is (name, address and telephone number). ,~.2 ~ 8' / If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the .0~trges for duplication. Date: (.o'- J2 Signature~7~, Address // ? Capacity: Personal Representative Counsel for personal representative STATUS REPORT UNDER RULE 6.12 NameofDecedent: ~-,.x~ o_.3,_ . /._, (~,c/< Date of Death: t~ae cA 2. ~, j 7. oo3 Will No.: ?_ I - Og - o 7_. 51S Admin. No.:'7~3,.S- Pursuant to Rule 6.12 of'the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No 2. If the answer is No, state when the personal represjentativ~ reasonably believes that the administration will be complete: / 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No [~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal re..~presentative state an account informally to the parties in interest? Yes LI No c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. / ..,.,Signature Name ': ~ Address '~ ~u : Telephone No. Capacity: E] ?ersonal Representative FI Counsel for personal representative COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE Harrisburg District Office; Lobby, Strawberry Square, Harrisburg, PA 17128-0 Phone: (717) 783-1405 FAX: (717) 783-4447 Web: www.revenue.state.pa.us October 13, 2004 ESTATE OF: JANE L RICKRODE DATE OF DEATH: 03-26-2003 FILE NUMBER: 21 03-0285/2004-28 (Please remit top portion with your payment) REV- 1 500 PENNSYLVANIA DEPARTMENT OF REVENUE OE.T. 280 0 INHERITANCE TAX RETURN F,LE.UM.ER 21 _ 03 0285 .^RR SBURG. P^ RESIDENT DECEDENT . cooE DECEDENTS NAME (LAST, 'FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Rickrode, Janet L. i 171-30-6489 i~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH {MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE a.I 03/26/2003 09/16/1936 t,1 REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER C3 Rickrode, James A. 194-28-8574 ,,, J--] 1. Original Return [] 2. Supplemental Retum [] 3. Remainder Retum (date of death pdor to 12-13-82) ~" ~ ~ [] 4. Limited Estate 0 ~ [] 4a. Future Interest Compromise (date of death after 12-12..82) ,,, ~ [] 5. Federal Estate Tax Retum Required :3:~0 m~ [] 6. Decedenl Died Testate (A~ch copy of Will) [] 7. Decedent Maintained a Living Trust (Attach copy of Trust) C~ 8. Total Number of Safe Deposit Boxes < [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of dealh between 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A)(Attach Sch ~. THIS 8,ECTION MUST BE COMPLy: ~ t:D. ALL CORRESPONDENCE AND CONtqDENTIAL TAX INFOR".~.TION SHOULD BE DIRECTED TO: ~ NAME ~ COMPLETE MAILING ADDRESS z James A. Rickrode o ~ 1130 La Costa Lane a. FIRM NAME (IfApplicable) ~ Winter Haven, FL = / 33881 O TELEPHONE NUMBER o (863) 292-0117 1. Real Estate (schedule A) (1) O.OO, 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 15,841.43 (Schedule E) O 6. Jointly Owned Properly (Schedule F) (6) 0.00 .~ Separate Billing Requested ..~ ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0.00 I-'- (Schedule G or L) ~ 8. Total Gross Assets (total Lines 1-7) (8) 15,84'1.4~ UJ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 7,399.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)(10) 8,418.71 11. Total Deductions (total Lines 9 & 10) (11) 15,817.71 12. Net Value of Estate (Line 8 minus Line 11) (12) 24.02 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J} 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 24.02 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES ~ 15. Amount of Line 14 taxable at lhe spousal tax ~"i rale, or Iransfers under Sec. 9116 (a)(1.2) _ .0 ~)~ (15) 0.00  16. Amount of Line 14 taxable at lineal rate x .0 (16) 0.00 O~ 17. Amount of Line 14 taxable at sibling rate x .12 (17) 0.00 (.,) 18. Amount of Line 14 taxable at collateral rate - __ x .15 (18) 0.00  19. Tax Due (19} 0.00 > · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < :)ec~dent's Complete Address: STREETADDRESS MCHS Carlisle 940 Walnut Bottom Road C~TYCarlisle J STATEpA J Z~P 1 7103 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) O.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0.O0 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) O.OO A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] 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 cons derat on? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty 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 GUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. DeclBra'd(N'l o~ I:Xl~oarer olher than Ihe pe~:xtal representative is based o~ ~ inftN'ma[x~n of which IxBparer has any SlGNA,T,U~E OF' PERSON RESPONSIBLE FOR'~F~ING RETURN DATE 1(.~1:) La Costa_Lane Winter Haven, FL. 33881 I~IAT~RE ~)-I:: P~EPARER OT~IER 'I:HAN ~FPR-ESE~:rlVE bATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. §9116 (a) (1.1) (ii)]. The statute does not exem~)t a transfer to a surviving spouse fi.om 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 neal 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 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an indMdual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) II r ,~ SCHEDULE E COMMONWEALTH OFPENNSYLVANIA ICASH, BANK DEPOSITS, &/VIIS(;. INHERITANCEREsiDENT DECEDENTTAX RETURN I PERSONAL PROPERTY ESTATE OF FILE NUMBER Rickrode. Janet L. 21-03-0285 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property Jointly-owned wilfl right of suwivorshlp must be disclosed on Scbedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking Account 15,256.43 2. Jewelry 200.00 3. Table, Bedside Small 20.00 4. Telephone 10.00 5. Clock Radio 10.00 6. Chest of Drawers 20.00 7. Clothes 50.00 8. Pictures 25.00 9. Computor 200.00 10. Computor Desk 50.00 TOTAL (Also enter on line 5, Recapitulation) $ 15,841.43 (If more space is needed, insert additional sheets of the same size) INI'~RIT, M~CE~ DEC~DENTTAXRETURN , MORTGAGE LIABILITIES, & UENS ~AI'E ~ ' ~ N~R Rickrode, Janet I. 21-03-07_~5 VALUE AT DATE 1. Pa. Dept of Revenue (taxes 2002) 573.00 2. Pa. Dept of Revenue (laxes 2003) 55.52 3. HanJsfleld Nursing Home, Harrisburg, PA. 5,843.45 4. MCI-IS Cadisle Nursing Home 525.00 5. Kramer Medical 100.00 6. West Shore EMS Transport Services 108.65 7. Dr. Goodman & Ass Harrisburg, Pa. 72.48 8. Carlisle Hospita 401.00 9. Surgical Phy (nursing home visits) 19.36 10. Dr Broestein Harrisburg, pA 141.10 11. East Shore Surgical 39.07 12. Communily Life Team EMS 347.00 13. Apda Healthcare 7.24 14. Dr. Rob eri Kantor Harrisburg,PA 119.33 15. Associated Cardiologists Mechanicsburg, PA 62.04 16. Vascular Associates Camp Hill, PA. 4.47 TOTAL (.Nsoenler on line 10, Rnmp~.' d=~,~n) $ 8,418.71 Attachment Sch H item number 3. Janet RJckrode needed to be in an assisted living care facility, under Doctors orders because the care that she required at the time was more than I could supply. At this time pdor to her death she was located at Hardsfield Nursing Home in Harrisburg. She was transported from here to the Hospital and when released Hardsfield refused to take her back because she was going to need full nursing care. At this time she was transferred to · MCHS Carlisle. She was only here for a very short time and she was taken back to the hospital where she passed. REV-1513 EX* SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFI(:IARIE$ INHERITANCE TAX RETURN RESIDENT DECEDENT ~'~ATE OF ~LE Sec 9116 (a) Janes A. Rickrode 1130 La C(~a ~ W~ ~n, FL ~1 Spouse 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18, AS AJ:~TE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART #- ENTER TOTAL NON-TAXABt. E DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ 0.00 JANET L. RI~'KRODE I. JANET L. RICERODE, presently of Harrisburg, Dauphin County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking and making void all Wills, Codicils or Writings in the nature thereof by me at any time heretofore made. IT~ I. I direct that the payment of my debts and the ex- penses of my last illness ~nd funeral shall be paid from my estate as an administrative expense as soon after my death as conveniently may be done. ITEM II. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever juris- diction imposed, shall be paid as part of the expenses of the ad- ministration of my estate. IT~ III. All the rest, residue and remainder of my estate, real, ~ersonal and mixed, of whatever nature and wheresoever situate, of which I shall die seized, or to which I may be entitled, or over which I shall possess any power of appointment by Will at the time of my decease, whether acquired before or after the execu- tion of this, my Will, to my husband, JAMES A. RICKRODE, absolutely Page 1 of 4 Pages ~~ ~~~ (SEAL) and ~n fee simple. ~rT]~ IV. Should ~y said husband die before me, or so nearly at ~e s~e time so ~at ~t c~ot be dete~ed ~ch one of us s~[v~s, o~ ~ ~e even~ ~at my said husb~d ~d I shall peri~ at ~e s~e t~e ~ a co~on ~ster, or ~ the event of ~ said husbsBd's dea~ wi~ ~r~ (~) days after ~ dea~, ~en the said devise ~d bequest of my ~esidua~ estate s~ll lapse or he ~vested ~d I ~ve such proper~ as follows: A. ~1 jewel~ to my ~d~$~er, CO~~ L. ZIE; B. ~1 ~e rest, residue ~d rema~der to be ~vided equ~ly, per stiles, ~o~ ~ chil~en, ~C~L Z~ ~d CA~ B~T, ~d my husb~d's da~ter, ~A K. ~. ~e-~rd ~e to each. ~ V. I appo~t ~ ~ecutor ~~ of ~y m~or chil~en wi~ power (~) to hold for ~ors all proper~ payable by law to a ~ar~ appointed by ~ ~i11; (2) after considering ~e m~or's wishes, to re~ t~ible personal proper~ or de- liver it to ~e person st~g in ~e place of a ~or's parent, wi~out bond; (3) to ~vest ~e b~ce of ~e ~nor's proper~ ~d all acc~ated income wi~out the restriction to investments authorized for fiduciaries; ~d (4) to use income ~d principal for the ~or's mainten~ce ~d education, either ~rectly or by pa~ent to ~y person selected to ~sb~se it whose receipt shall be a complete acquitt~ce ~erefor. ~1 ~e~ended principal ~d income sh~l be paid to ~e ~or a~ majori~. For pu~oses of Page 2 o~ ~ ~ges ~~ ~~~EAL~ ~T L' RIC~0DE ~ ~ ~ this Will, m~jority shall be the age of eighteen (18). My gumrdians may, in discharge of all duties hereunder, pay any minor's share deemed impractical of administration to the person standing in place of the minor's parent or deposit it in an interest-bearing account in the minor's name. IT~ WI. No interest of any beneficiary under this Will or any Codicil hereto shall be subject to anticipation or voluntary or involuntary alienation. ITEM VII. I appoint my husband, JAMES A. RICERODE, Executor of this my Last Will and Testament. In the event of the incapacity of my said husband, or his refusal to act as my Executor, or should my said husband resign as my Executor, I .appoint RICHARD STELTZER, alternate Executor. Should he not act as alternate Executor, I appoint MICH~. ZINK, alternate Executor with the same powers and duties. ITEM ~III. I hereby give full power and authority to my ~ecutor or alternate Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my estate; to sell and dispose of any or all of my estate, real or personal or both, for such prices and upon such terms of credit or otherwise, and in such manner as my said Executor or alternate Executor deems best, without an Order of Court, at private sale if he sees L. RIC ODW. _(S AL) fit, and to furnish and deliver to the purchaser or purchasers all necessary or proper deeds snd other inst~ments of convey- ance and transfer thereof. ITEM IX. I request that no bond or other security shall be required of any Executor or alternate Executor acting here- under for the faithful performance of his duties, any law of any state or jurisdiction to the contrary notwithstanding. IN WITNESS ~HEREOF, I have set my hand and seal to this my Last Will and Testsment consisting of this and three (3) other pages, at the end of which I have also set my hand and affixed my and' better identification, this ~ day seal for greater security We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published ~nd declared by the above- n~med Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request a_nd in her presence, and in the presence of each other, have hereunto set our hands and seals the day and year above-written, and we certify that at the time of y x~decution thereof, said Testatrix was of so~nd and disposing mind ~r~ Resi~ing at ~ ' JRD/June 30, 1992/17858 Date: February 03, 2005 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF James Rickrode 1130 La Costa Lane WinterHavenFL,33881 RE: Estate of Janet L. Rickrode File Number: 21-03-0285 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) 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 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 will become delinquent on: 03/26/2005 Your prompt attention to this matter will be appreciated. Thank you. Sincerely, ~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Judge Counsel JI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVlDU"I;::"fI;IXES INHERITANCE TAX DIYISION'..-\jv' PO BOX 280601 HARRIS8URG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15~7 EX AFP 112-D~) iR:-;......... JAMES A,-RICkRODE 1130 LA "COSTA LN WINTER HAVEN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-21-2005 RICKRODE 03-26-2003 21 03-0285 CUMBERLAND 101 JANE L Allount Relli tted FL 33881 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 411 RE-V'=U4"'-!X--AFP--CDY:6J1--No;--IciroF-INHER"fflN-ci-"tAi.A-pFlRA-IsIMiN'~.ALtowlNCE-oR-_._-_.__._._. -_. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RICKRODE JANE L FILE NO. 21 03-0285 ACN 101 DATE 02-21-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedula D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 15.841.43 .00 .00 (8) NOTE: To insure proper credit to your account. submit the upper portion of this forll with your tax paYll8nt. 15.841. 43 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governll8ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 7.399.00 8.418.71 (11) (12) (13) (14) 15.817 71 24.02 .00 24.02 I~ an assessment was issued previoUSly. lines 14. IS and/or 16. 17. 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: lS. Amount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due C D TS: NOTE: 24.02 .00 .00 .00 X 00 = X 045 = X 12 = X 15 = (19)= .00 .00 .00 .00 .00 DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 4, TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS_l Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 .:MIVY7 L '€:ClGlePDv- Estate No.: J-Zfo-OY ~//'03- ~2-f?~ Date of Death: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: - Yes ~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe answer to No. I is Yes, state the following: a. Did ~ersonal representative file a final account with the Court? Yes n.. No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes $- No 0 c. Copies of receipts, releases, joinders and approval offorma! or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. _ .0 Dale~(2-I!~ ~S' , ... t?4/~-/~ 19nature - VR/nLS /J /?C~~/.Je:r- Name . _,I t.w.' Address _ / W I "..-""'~ #~ .::z 9 l- -0// 7 Telephone No. 3.3U/ Capacity: ~onal Representative o Counsel for personal representative .~J