HomeMy WebLinkAbout03-0394Estate of FREDER I CK
~I~SO /fHO~'H as.
( rant af etter
G. ROUSE, SR.
108-03-9418
Deceased. Social Security No.
Petitioner]~Kwho is a~'K 18 years of age or older, appl ~ for:
~] ~[rII~lal[~ all~ (~ra11~ of ~l~r~ ~l~alIIl~lt~Ir~ and aver that Petitioner(N isX~ the execut or
named in the last will of the above decedent, dated February' 5, 1999
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death t~/'executor, etc.)
Except as follows, decedent did not marry, was not divorced and did not have a child born oradopted afterexecution ofthe will offered for
probate: was not the victim of a killing and was never adjudicated incompetent:
(d.h.n.: pendente lite. d, trante ahse, tia; d, trante minoritate)
Petitioner(s) after a proper search ha ascertained that decedent left no will and was survived by the following spouse (if any) and heirs:
Name Relationship Residence
Decedent was domiciled at death in CUMBERLAND
last family or principal residence at 20 Green Springs Drive,
D.e. cedent, then years of age. died Apr i 1
Decedent 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:
County, Pennsylvania. with h...i S
Mechanicsberg, PA 17050
$ 5,100.00
2003
petitioner(s) respectfully rcqucst(s) thc grant of letters
Testamentary in the appropriate form to the undersigned.
Residence ]
~'~eoerlc~ ~. Rouse,
1279 Woodcock Lane
Kintnersville, PA
Thc petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are ture and correct to the best of the
knowledge and belief of petitioner(s) a nd that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the
estate according to law.
Sworn to or affirmed and subscribed
before me this ~'~ ~ day of
~rederick G. Rouse,
Estate of
so. V
FREDERICK G- ROUSE,
ecree auh
AND NOW /r~/~V ~
hereof, satisfactory proof having been presented before me.
1T IS DECREED that Letters I ~S'FArn ~c~ ,/
/
~l~~. in consideration of the petition on the reverse side
are hereby granted to ~2"~I3EILt'¢J-d ~ "~t~.o~ ~ -~
in the estate of
FEES
Letters ....................... $
Short Certificates ( ) .......... $
Renunciation ................. $
Filing Inventory ............... $
Filing D & D's ................ $
Processing Fee ' $
Other ................ s
TOTAL $
Michael D. Betts, Esquire
ATTORNEY
I.D. ~ 31120
(Sup. Ct. L D. No.)
237 N. York Road
ADDL.F_.SS
Warminster, wa 18974
( -~i- 5 ) 672-3000
PHONE
I05 805 REV 9/86
This is to certify that the information here given is correctly copied fi'om 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 9233192
No.
APR g 7 2003
Date
TYPE/PRINT
BLACK INK
HlO5 =~ Ftev. ~'a? COMMONWEALTH OF PENNSYLVANIA * OEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
,~u~erland ~ gas . . ~ ~,,~.~c~,,. <~) ' '
· mt ~ennsbor ,. Holy Spirit Hospital ~ ..... ~""~'~=' Wh~+~
20 Green Spring DriVe IActuAL ,=..s,,,. PA o. . ~ ' '
Mechanlcsburg, PA 17055 ~%~[~, ~,
,~,.Q ~.~=.~, ~ Mechanicsburg
E Har] y Rouse ,,. Luau Bu~wln
Frederick G. Rouse II
,2b. FD015182
1279 Woodcock Lane, Kintnersville, PA 18930
AVA}L~ Bt £ PRIOR TO
Chalfont, PA 18914
~,~Schneide'~ Funeral Home Hatboro, PA 19040
LAST WILL AND TESTAMENT
OF
FREDERICK G. ROUSE, SR.
I, FREDERICK G. ROUSE, SR. of 372 Hancock Road, Warminster, Bucks County,
Pennsylvania, being of sound mind, memory and understanding do make, publish and
declare this as and for my last Will and Testament hereby revoking and making null and
void any and all Wills previously made by me.
FIRST: I order and direct the payment of all my just debts and funeral expenses as
soon after my decease as may be conveniently possible.
SECOND: I give my the rest of my estate as follows:
1/3 to my son, FREDERICK G. ROUSE, II, if my son FREDERICK G. ROUSE
II, survives me, If my son fails to survive me, then said share shall pass to the issue of
FREDERICK G. ROUSE, H, per stirpes.
2/3 to my son FREDERICK G. ROUSE H as Trustee to hold upon the following
terms:
A. During the lifetime of my wife, WINIFRED ROUSE, should she survive me, to
the extent that benefits are not made available to CATHERINE ROUSE and/or
WlNIFRED ROUSE for basic living expenses, including food and shelter, in Trustees
absolute discretion may distribute from income and principal to or for the benefit of
CATHERINE ROUSE and WlNIFRED ROUSE for their needs other than basic support.
For the purposes of this provision, non-support purchases include, but are not limited to,
dental care, unreimbursed medical expenses, including plastic and reconstructive surgery,
diagnostic work and treatment; rehabilitative training and experimental medical services;
the differential in cost between shelter for a shared and private home or room;
supplemental nursing care; recreation, cultural experiences; outings, travel including
payment for others to accompany my beneficiary; telephone and television, including
cable; reading and educational materials, exercise equipment; and unreimbursed therapy.
Trustee's discretion in making distributions authorized hereunder, is absolute, full and
complete with regard to distributions from the trust estate and shall be binding upon all
interested persons. In addition, trustee may distribute such portion or portions of the
principal and income for it, not otherwise expended, in such proportions as trustee in its
absolute discretion may consider desirable for the health, maintenance and support of my
granddaughter, REBECCA CREELMAN, after considering all resources available to
REBECCA CREELMAN.
B. As this trust is specifically not intended to provide basic support and
maintenance needs for CATHERINE ROUSE and WlNIFRED ROUSE, if they or either
of them are unable to maintain and support themselves fxom their own resources and
sources of income, trustee shah seek such support for CATHERINE ROUSE and
WlNIFRED ROUSE from public sources.
C. The trust has specifically not been created to supplant or replace public
assistance benefits. Trustee should therefore, seek entitlements that are available to
members of the community who are experiencing disabilities that are substantially similar
to those which CATHERINE ROUSE and/or WlNIFRED ROUSE are or may be
experiencing. Trustee shall deny any request made by any agency or governmental entity
requesting disbursement of trust funds to satisfy the needs of either CATHERINE
ROUSE or WlNIFRED ROUSE.
D. Trustee shall take whatever legal steps may be necessary to initiate or continue
any public-assistance for which CATHERINE ROUSE and/or WlNIFRED ROUSE is or
may be eligible. Trustee shall bring such action in any court having jurisdiction over the
matter, to secure a ruling or order that this trust is not available to CATHERINE ROUSE
and/or WlNIFRED ROUSE for support purposes. Any expenses of the Trustee, including
reasonable attorney fees, in connection with matters relating to determination of eligibility
of CATHERINE ROUSE and/or WlNIFRED ROUSE for public support, shall be a
proper charge to the trust.
E. At the time of the death of WlNIFRED ROUSE, the then remaining principal
and any accumulated and undistributed income shall be paid and distributed to
CATHERINE ROUSE and FREDERICK G. ROUSE, II, as follows:
1/4 to FREDERICK G. ROUSE, II
3/4 to CATHERINE ROUSE
In the event that FREDERICK G. ROUSE II does not survive WlNIFRED ROUSE the
share payable to FREDERICK G. ROUSE, II hereunder shall be paid to the issue of
FREDERICK G. ROUSE, II. In the event that CATHERINE ROUSE fails to survive
WlNIFRED ROUSE the share payable to CATHERINE ROUSE shall be paid to
REBECCA CREELMAN, if REBECCA CREELMAN fails to survive WlNIFRED
ROUSE, said share shall be paid to the then-living issue of REBECCA CREELMAN, per
stirpes.
TREATMENT OF UNDISTRIBU~D INCOME
THIRD: All income that is undistributed and accrued at a beneficiaries death shall
be treated as if accrued thereatter.
FOURTH: All federal state and other death taxes payable because of my death,
with respect to property forming my gross estate for tax purposes, whether or not
passing under this Will, including any interest or penalty imposed in connection with such
tax, including jointly held and other non-testamentary property, shall be considered a
part of the expense of the administration of my estate and shall be paid out of the principal
of my residuary estate without apportionment.
Appointment of Executor and Trustee
FIFTH: I nominate, constitute and appoint my son, FREDERICK G. ROUSE, II,
Executor of this, my Last Will. In the event my named Executor fails to qualify or ceases
to act as my Executor, I hereby appoint my granddaughter, REBECCA CREELMAN,
Succeeding Executrix of this my Last Will.
I nominate, constitute and appoint my son, FREDERICK G. ROUSE, II,
and his successors, Trustee. In the event my named Trustee is unable or unwilling to
qualify as my Trustee or having qualified is unable or unwilling to continue to act I appoint
my granddaughter, REBECCA CREELMAN, Trustee.
SIXTH: I direct that my personal representative or Trustee shall not be required
to give bond for the faithful performance of their duties in this or any jurisdiction.
SEVENTH: The interests of the beneficiaries hereunder shall not be subject to
anticipation or voluntary or involuntary alienation until distribution is actually
made.
EIGHTH: My Executor and Trustee and their successors shall have the following
powers in addition to those given to them by law to be exercised by them in their absolute
discretion, which powers shall be applicable to all property held by them, effective without
the order of any court and until actual distribution of all such property:
3
A. To retain any and all investments that may be added to this trust by myself or by
others and to invest in all forms of property (including but not by way of limitation, all
types of stocks and bonds, shares of investment companies and participation in common
trust funds regardless of any limitations imposed by law on an investment by trustees;
B. To invest and reinvest at discretion without the obligation to diversify and
without restriction to so-called 'legal investments", with the specific fight to invest in
stocks, bonds, real estate, including non-income producing residential real estate for the
occupancy of any present income beneficiary or beneficiaries, and in such common trust,
diversified, money market and mutual funds as my executor and trustee deeds appropriate;
C. To sell, grant options for the sale ot~ or otherwise convert any real or personal
property or interest therein, at public or private sale, for such prices and at such times, in
such manner and upon such terms as they may think proper, and to execute and deliver
good and sufficient conveyances, assi~ments and transfers thereof without liability of any
purchaser to see to the application of the purchase money.
D. To borrow money and to secure the repayment thereof by mortgage of real and
personal property, pledge of investments or othenvise, without liability on the part of the
lenders to see to the application thereof.
E. To compromise claim~ by or against my estate or any trust created hereunder;
F. To allocate and distribute different kinds or disproportional shares of property
or undivided interests in property among beneficiaries or trusts, in cash or in kind, or
partly in each.
G. To register investments in the name of a nominee or to hold the same
unregistered in such form that they will pass by delivery.
H. To join any merger, consolidation, reorganization, voting trust plan or other
concerted action of security holders, and to delegate discretionary duties
with respect thereto, and to generally exercise the rights of security holders;
I. To manage, operate, repair, alter or improve real estate or other property, and
to lease real estate and other property upon such terms and for such periods as my
executor and trustee deem advisable even for more than five (5) years and beyond the
duration of the trust.
J. To deduct administration expenses upon either federal estate tax return or
fiduciary income tax return with or without adjustment as between principal and income,
as my executor shall determine;
I~ To join with my wife and file any income tax or giR tax returns that may be
due on my behalf and to pay so much of such taxes as my executor may deem appropriate
and to consent to any gift made by my wife being treated as having been made one-half
(1/2) by me.
L. To associate with them in the absence of a corporate fiduciary, an accountant,
custodian and investment advisor, and other agents and to compensate them from
principal or income or both as my executor shall determine;
M. To permit any present beneficiary to occupy any real estate forming part of the
trust estate without rent or on such other terms and conditions as the trustee shall
determine.
N. To disclaim any interest in property without court approval; and
O. To do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate or trust.
Minors and Incapacitated Beneficiaries
NINTH: If any income or principal shall be payable to any person who shall be a
minor or who shall be incapacitated for any reason, my trustee shall hold such income and
principal during minority or incapacity and shall be entitled to apply such income and
principal to the health, maintenance, support and education of such person during minority
or incapacity without the appointment of any guardian or committee or any authority of
court. My Trustee shall be entitled to make direct application hereunder or to make
application by payment of income and principal to the parent or other person in charge of
such minor or incapacitated person or to his or her guardian or the a custodian under the
Uniform Transfers to Minors Act. Any remaining income and principal to which such
person shall be entitled shall be distributed to such person upon the termination of
minority or incapacity. My trustee as guardian shall have all of the powers given to my
trustee.
Protection of Beneficiaries
TENTH: No income or principal shall be assignable by a beneficiary or available
to anyone having a claim against a beneficiary before actual payment to the beneficiary.
No part of the Trust shall be subject to the claims of any beneficiaries creditors, or
specifically CATHERINE ROUSE'S OR WINIFRED ROUSE'S voluntary or involuntary
creditors for the provision of care and services to them during their lifetime, including
payments for residential care and maintenance by any public entity or private sector.
Under no circumstances can the beneficiary compel a distribution from the trust for
any purpose. Tmstee's discretion in making non-support distributions is final as to all
interested parties, even if my trustee elects to make no distributions at all. Further,
Trustee may be arbitrary and unreasonable. Tmstee's absolute and independent
jud~mnent, rather than any other party's determination is intended to be the criterion of
which distributions are made. No court or any other person should substitute its or their
judgment for the decision or decisions made my Trustee.
Termination of Small or Impractical Trusts
ELEVENTH: Whenever Trustee, in its absolute discretion determines that the size
of any share held in any trust hereunder does not warrant continuing the same in trust, or
its administration would be impractical for any reason, Trustee without further
responsibility:
A. May pay such share to the person entitled at the time to the income from it; or
B. If such person is a minor or in the opinion of Trustee is disabled by advanced
age, illness or other condition, my trustee may pay such share to the parent or other
person in charge of such minor or incapacitated person, or to his or her guardian or to a
custodian under the Uniform Transfers to Minors Act.
Compensation of Fiduciaries
TWELFTH: My children and grandchildren while acting as fiduciaries shall serve
without compensation. Any other individual fiduciary serving hereunder without a
corporate fiduciary shall be entitled to compensation in accordance with the schedule of
compensation of a corporate fiduciary excising fiduciary powers in the jurisdiction in
which I die domiciled.
Interchangability of Language
6
THIRTEENTH: Words used in the singular may be read to include the plural or
the plural may be read as the singular. Similarly, the masculine form may be read to
include the feminine and neuter; the feminine may be read to include the masculine and
neuter; and the neuter may be read to include masculine and feminine.
Headings
FOURTEENTH: The headings used on the various paragraphs of this will are
included for convenience only and shall have no legal si~ificance.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last
Will and Testament, this ~'z~4 day of ~9//r~c.,/' ~/ , 1999.
(SEAL)
Frederick G. 1~o~ es~;'~r./X~'
- TESTATOR
The preceding instrument was on the day and date thereof signed, sealed, published
and declared by FREDERICK G. ROUSE, SR., 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 have subscribed our names as witnesses hereto.
~.~ Address
Witne~
atnes,~;
7
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF BUCKS
I, FREDERICK G. ROUSE, SR. the testator whose name is signed to the attached or foregoing
instrument having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; and that I signed it willingly as my free and voluntary act
for the purposes therein expressed.
Swom to or affirmed and acknowledged before me by FREDERICK G. ROUSE, SR. the
testator, this ~-'r~ day of fr¢~r-~ ~)/ 1999.
FREDERICK G. Rb~SE,-Sl~.-~e~at~r
NOTARIAL SEAL
LI.N. DA J. PRIESTLEY, No~ry Publi~'..~[- ~
warminster Twp., Bucks County
My Commission ~xpires Jan. 2,2~3
We the witnesses whose names are signed to the ~ttached or ~oregoing instrumenL bein~ duly
qualified ~ccordin~ to law~ do depose and say that we were present and saw the testator sign and
e×ecute the instrument as his Last Will; that the testator signed willingly and e×ecuted it ~s his free
and ¥oluntary act for the purposes therein e×pressed; that each subscribing witness in the hearing
and sight of the testator signed the Will as a witness; and that to the best of our knowledge the
testator was at the time 18 or more years of age, of sound mind and under no constraint or undue
influence.
Sworn to or rmed ana subso bed before me by
and ~4't"~ ~ ,P?. (°r,r~,'~,~ , witnesses this
Witness
Notary PU~ (:j
NOTARIAL SEAL
LI.N..DA J. PRIESTLEY, NoI~ Public
wa
arminster Twp., Bucks Countv
My Commission Expires Jan. 2, 2~]03
8
lzt~: O~f 8- ,t~,l £0.
|0 9O!j~O"P~)OJOOe~
Attention: Ann
Register of Wills of Cumberland County
1 Court House Square
Carlisle, PA 17013
MICI-LAEL D. BETTS
ATTORNEY
AT
237 NORTH YO~~r ()~ V~q!~S
WA~INSTER, PA 18974-4515
'03 ~I -8 $0:44
Gtanb~:~c~d Go., FA
May 6, 2003
Re: Estate of FREDERICK G. ROUSE, SR.
(215) 672 - 3000
(215) 672 - 3140 FAX
Dear Ann:
As you may recall, I spoke to you about a week ago concerning this estate. The
decedent, Mr. Frederick G. Rouse, Sr. died on April 25, 2003. His son, Frederick
G. Rouse, II, is the named Executor in the Will of Mr. Frederick G. Rouse, Sr.
Because the Executor resides in Bucks County, he has taken his oath before the Bucks
County Register of Wills.
I have enclosed the following documents pertaining to our Petition for Grant of Letters
Testamentary:
1. Petition for Grant of Letters Testamentary
2. Death Certificate of Frederick G. Rouse, Sr.
3. Estate Information Sheet
4. Original (self-proved) Will of Frederick G. Rouse, Sr. (February 5, 1999)
5. Check in the amount of $ 86.00 representing filing fees for the enclosed
Petition and requested Short Certificates.
I am requesting Five (5) Short Certificates in connection with this Estate.
If you need any additional information or documentation, please feel free to contact me
at my office, listed above.
Sincerely yours,
Michael D. Betts, Esquire
MDB/dsh
Enclosure
SASE
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: FREDERICK G. ROUSE, SK
Date of Death: April 25, 2003
Admin No. c>~ ] - O 3 - ~Q
To The Register:
I hereby certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans Court
Rules was mailed to the following Beneficiaries of the above-captioned estate on June 12, 2003:
NAME ADDRESS
Frederick G. Rouse, Il 1273 Woodcock Lane
Kinmersville, PA 18903
Catherine Rouse
20 Green Spring Drive
Mechanicsbur~, PA
17050
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE
Date: June 12, 2003
Michael D. Betts, Esquire
237 N. York Road
Warminster, PA 18974
Telephone (215) 672-3000
Capacity:
Counsel for Personal Representative
REV- 1500
PENNSYLVANIA
oEP rmm OF aEV UE
a .U0 0 INHERITANCE TAX RETURN
RESIDENT DECEDENT
~, R~ ~ M~ ~)
Rouse, Frederick, G. Sr.
~ DATE OF DEATH (MM.DO-YEAR) ~RTH (MM-DO-YEAR)
W April 25, 2003
0 ~November 01, 1918
UJ 0F APPUC~ SUR'a~N6 &oOUS~ NAME (LAST, FRS1; AND Ug)~E ~nm/d.)
[] Z Suppkm~m Raum
F-] 4. ~ Estate
~ 6. Dec~eM Died Te~ate {.~ ~. ye)
[---] 7. Deceder~ Mak~lned a I.Mng Trust pamrk,mp,/~?flm)
Michael D. Betts, Esquire.
~dONE NU~R
215-672-3000
FILE NUMBER
21 - 03 0394
SOCIAL 8ECURfTY NUMBER
108 -- 03 -- 9418
THI~ RETURM MUST BE FI.ED IN DUPUCATE iMTN 3~.iE
REGISTER OF WILLS
'-']3. Rm~l~nder Return (m~, M ~ i~x lo ,1~4:~.~)
r-'] 5. F~ ~ T~ ~m~
~ 8-T~ ~S~~
~ 11. ~ ~ ~ ~. 9113(A) ~o)
, OOMPLETE MAILING ADDRESS
237 N. York Road
Warminster, PA 18974
1. Peal Estale (Sched~eN (1)
2. S~<ks and eoads (Schedu~ e) (2)
3. ci°sely Held ~, Pmlnefahip or Sole. PmlxWmr~hip (3)
4. Modgages & No~es Recd.(Schedule D) H)
5. Cash, Bank Oo~o~s a ~ pe~o=a prepay (5)
(Schedae E)
0. Jr~o,ny cx~d Prop~y (~ F) (6)
7. Inter-~vos Tramdms & &,flsce~ i~ ~ (7)
(,Schedule (3 or L)
8. To~al 6ro~ M~ (kM Laes 1.7)
9. Furw-a Eqww~ & ~mamm~ Co~ (SctwJ~ H) (9)
10. Debts of Decedeat. klodgage Lai~i]es. & Lans (Sched~ I) (10)
11. To(al D~ (kdal i..~ 9 & 10)
12. NM VaJue of Eatate (Une 8 mkus Une 11)
Cha~aMe and Govemmen~ Bequests/Sec 9113 Tn.~s fro. whi~ an etecikm k) lax has not been
made (8cbeduk j)
14. Net Value Subject to Trax (Une 12 mkws Line 13)
$6,991
(3)
$10,637
$260
(11)
$6,991
$10,896
SEE IN811mGTIO~ ON REVERE ~DE F(X~ A/~Lk~LE RATE~
15. __.A~ount.of Lae 14 taxal31e at Ihe q3omal tax
~me, or ganefem ruder Sec. 91t6 (a)(1.2)
(12)
(13)
(14)
($3,9o5)
($3,905)
$0
16- Amount of Une 14 taxable at liMal rate
17- Anmunt of Lkm 14 taxable at sib&.tg rate
18. Amount of L~e 14 taxable at mti,MmM rale
19. Tax Due
0 (t~
0.045 (1~
.12 (t~ _
0.15 (1~
20. [~~ (19)
D~de~lent's Complete Address:
20 Greens ~_p_0_Rg_Drive
CITY
Mechani~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
$0
Interest/Penalty if applicable Total Credits (A + B + C ) (2)
D. Interest
E, Penalty
Total Interest/Penalty ( D + E ) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page I Line 20 to request a refund (4)
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.
$o
$o
(SB) $0
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:
a. Yes No
retain the use or income of the property transferred; ...................................................................................... E~ []
b. retain the dghI to des gnate who sha I use the properly 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 secudty at his or her death'~ [] []
4. Did decedent own an individual RetirementAccount, 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 SCHE -::~f Q/~ ~'~ E RETURN.
Under penallies of perjury, I declare that I have examined this relum, ~ /
p y ng ules and s~alements, and 1o the best of my kn ~ --
Declaration of preparer other than the personal representative is based on all information of which preparer has an
SIGNA - - y knowledge.
FILING RETURN ' ........... /:~;. ', ....
ADDRESg Frederick ~_ ,-,-
~ ~- ~ouse, II
1279 Woodc ck Lane ~intnersville , PA 18903 -- --
SIGNATURE OF PREPA~E-R~OTHER THAN ~.-pR1ESE ,'rIVE
ADDRESS ' '~'"'""~"~ '"'"' ~: /
/,/z/,""c~ /
2.37 N. York Road, Warminstcr, PA 18974
For dates of death on or after July I 1994 and before January 1 1995 the tax rate ~mposed on the net value of transfers to or ior tSe ~Jse of the surv~vm9 spouse is 3%
[72 P.S. §9116 la) (I.1) (i)].
For dates of death on or after January 1 1995, the
The statute ~ a transfer ~) lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. §9116 la) (1.1) (ii)].
the surviving spouse is the only beneficiary, a surviving spouse from tax. and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
For dates o~ 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 RS. §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 decedenrs 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.
"' '~" I SCHEDULE E
COMUONWE~,T, Or,ENNS¥,VAN~A I CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN !
~EDEN~ PERSONAL PROPERTY
Rouse, Frederick, G. Sr. FILE NUMBER
21 03 0394
Include the proceeds of liligation and lhe date Ihe proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
iTEM
NUMBER
DESCRIPTION VALUE AT DATE
1. OF DEATH
: Savings Account No. 50-040106299
$6,991
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
6,991
*" ;'* I F SCHEDULEH I
COMMONWEALTH OF PENNSYLVANIA I UNERAL EXPENSES &
ESTATE OI;HERITANCE TAX RETURN AD
Rouse, Frederick, G. Sr. FILE NUMBER
21 03 0394
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
1.
2.
3.
4.
DESCRIPTION
FUNERAL EXPENSES: AMOUNT
Schneider Funeral Home
Catholic Cemetaries Office
S[ John Newmann Cemetary
Quakertown Memorials
headstone
$7,403
$900
$3O
$103
5.
6.
7.
8
ADMINISTRATIVE COSTS:
Personal Representative s Commissions
Name of Pemonal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City Slate
Year(s) Commission Paid:
Altorney Fees
Family Exemption: (If decedent s address is nol the same as daimanl s, a~ach explanation)
Claimant
Zip
Street Address
City
Relalionship of Claimant to Decedent
Pmbate Fees
Accountant s Fees
Tax Return Preparers Fees
State ~ Zip
Bank
Investments
return of Social Sec. fund paid after death
return of pension paid after death
$700
$86
$1,026
$389
TOTAL (Also enter on line 9, Recapitulatior $
(If mom space is needed, insert additional sheets of the same size)
10,637
°" :':' /~~
COMMONWEALTH OF PENNSYLVANIA I DEBTS OF DECEDENT,
ESTATE OF
ousc, Fmdcfick~ G. Sr. FILE NUMBER
21 03 0394
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
Spirit Hospital, 503 N. 21st Street, Camp Hill, PA
.Holy Spirit Hospital 503 N. 21st Street, Camp Hill, PA
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$160
$100
260
DEBTS OF DECEDENT,
21 03 0394
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
503 N. 21st Street, Camp Hill, PA
.Holy Spirit Hospital 503 N. 21st Street, Camp Hill, PA
TOTAL (Also enter on line 10,
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$160
$1oo
260
$CH£DULF J
o°.~ONW~T, o~ ~N~V^N~ I BENEFI
CIARIES, N.ER~,NCE T~ ~T.RN ~
RESIDENT DECEDENT I
, reO. Oll. CK, (.j. ~Sr.
21 03 0394
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
l. TAXABLE DISTRIBUTIONS (indude outright spousal distributions) OF ESTATE
1. G. Rouse, II
1279 Woodcock Lane
1/2
PA 18903
Rouse
20 Green Spring Drive
PA 17050
[/2
II.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, 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
1.
TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If mom space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
FREDERICK G. ROUSE, SR.
I, FREDERICK G. ROUSE, SK of 372 Hancock Road, Warminster,-Bucks County,
Pe~m~lvania, being of sound mind, memory and understanding do make, publish and
de.clare this as and for my ihst Will and Testament hereby revoking and making null and
i FIRST: I order and direct the payment of all my just de~ts and timeral e~enses as
[ soon aiier my decease as ~hay be convemeutly possible.
SECOND: I give my the rest of my estate as fbi
// 1/3 to my son, FR.EDERICK . lows.
...... ,x ~j. KOUS.E, II, per stirpes. ~ -- ~um snare shall pass to the issue of
2/3 to my son I~REDERICK G. ROUSE II as Trustee to hold upon the following
A. During the lifetime of my wife, WIN[FRED ROUSE, should she SmMve me, to
term,~ ,. moureuon may distr/bute fro;X~com~ including food and shelter, in Trustees
the ~jx~ent that benefits are not made available to
and Principal to or for the benefit of
CATHERINE ROUSE and t/FIN[FRED ROUSE for their, needs other than basic support.
For the purposes of this prov/sion, non-support purchase '
dental care, tmreimbursed medica~ e~ ·... s include, but are no
~punses, mcIuding plastic an~ ...... ,.mmea to,
diagnostic work and treatment; rehab/litative training and "~,~unstructrve Surgery,
exper/mental medico/services;
:/the &[fFerent/al in cost between shelter for a shared and private home or room;
.
/! supplemental nursing care; recreation .
II cable, reoa; .... _, . ~,aay my ~enenciarv- t,~t~-~.._._ o_, -~,ve~ mcmt~m
//comnl~t ..~.~ __ _ . g stributions auth,,~,~.~ ~ . eimbursed ther
· ~,-. e,~,m~egarato~ ' ' · .... unereunae · apy.
mtere~ __ _ lkqtributions fi~om th,, +--~ . r, ~s absolute
l/ ~ ,ed per~ons In a~la;+;^- ~ ~ [-usx estate and ~,~,,, .... ' .... ~uu
~ · . · ,~,-~,uu, trustee . . ouau oe mndin
]!P ~c~pal and income fo- :'~ . _ may distribute s~ch ..... . g pon. all
i/ · ~.[, not otherwise e,~,.a~.~ :_ _'. pumon.or portions of the
P
-~,,~-,,~u, m saen. pro orhons as trustee in/ts
//absolute discretion may consider desirable fo ,
granddaughter, REBE r the health, main
//~EBECCA '~,, ..... C. CA CREELMAN, ax~er consiaorin _ tenance and SUpport of my
[- ~V~LMAN. ,,,~g all resources available to
[1 . B. As this trust is specifically not inten · .
ii"*~tu are unan~e to mainto;- o--~ - ~ ~,,u wu~II~'RED ROUS~: w.,_ ..
~; sources et;- ...... ~ ~u support taemae/v s _. 4, utaey or either
~,~vv~D ROUSE t~om public sources vv · ~ *or vAiHER/NE ROUSE and
members of the community who are experiencing
to those which CATHERINE ROUSE and/or WINIFRED ROUSE are or may be
experiencing. Trustee shall deny any request made by any agency or governmental entity
requesting disbursement of trust funds to satisfy, the needs of either CATHERINE
ROUSE or WINIFRED ROUSE.
D. Trustee shall take whatever legal steps may be necessary to initiate or continue
anY public-assistance for which CATHERINE ROUSE and/or W/N/FRED ROUSE is or
may be eligible. Trustee shall bring such action in any court having jurisdiction over the
matter, to secure a ruling or order that this trust is not available to CATHEKINE ROUSE
and/or WINIFRED ROUSE for support purposes. Any expenses of the Trustee, including
reasonable attorney fees, in connection with matters relating to determination of eligibility
of CATHERINE ROUSE and/or W/N]FRED ROUSE for public support, shall be a
proper charge to the trust.
E. At the time of the death of WIN/FRED ROUSE, the then remaining principa/
and any accumulated and undistributed income shall be paid and distributed to
CATHERINE ROUSE and FREDERICK G. ROUSE, H, as follows:
3/4 to CATHERINE ROUSE
In the event that FREDERICK G. ROUSE II does not survive WINIFRED ROUSE the
share payable to bREDERICK G. ROUSE, II hereunder shall be paid to the issue of
FREDERICK G. ROUSE, II. In the event that CATHERINE ROUSE fails to survive
WIN/FRED ROUSE the share payable to CATHERINE ROUSE shah be paid to
REBECCA CREELMAN, if REBECCA CREELMAN fails to survive WINfl~RED
ROUSE, said share shall be paid to the then-living issue of REBECCA CREELMAN, per
stirpes.
TREATMENT OF UNDISTRIBUTED INCOM~
THIRD: All income that is undistributed and accrued at a beneficiaries death shall
be treated as if accrued therea~er.
FOURTH: All federal state and other death taxes payable because of my death,
with respect to property forming my gross estate for. tax p~oses, whether or not
'part of the expense of the administration of my estate and
o£my residuary estate without apportionment.
Appointment of Executor and Trustee
F~FTH: I nominate, constitute and appoint my son, FREDERICK G. ROUSE, II,
of this, my Last Wilt In the event my named Executor fails to qualify or ceases
to act as my Executor, I hereby appoint my granddaughter, REBECCA CREELMAN,
Succeeding Executrix of this my Last Will~
I nominate, constitute and appoint my son, FREDERICK G. ROUSE, II,
and his successors, Trustee. In the event my named Trustee is unable or unwilling to
qualify as my Trustee or having qualified is unable or unwilling to continue to act I appoint
my granddaughter, REBECCA CREELMAN, Trustee.
SIXTH: I direct that my personal representative or Trustee shall not be required
to give bond for the faithfifl performance of their duties in this or any jurisdiction.
SEVENTH. ~he mterests ofthe benefices hereunder shall not be subject to
anficipafi°n °r voluntary or involuntary alienation until ~butiOnis actua//y
made.
EIGHTH: My Executor and Trustee and their successors shah have the following
powers in addition to those given to them by law to be exercised by them in their absolute
discretion, which powers shah be applicable to all property held by them, effective without
the order of any court and until actual distribution of all ~ch property:
3
//
//
-.~t- ~ ~x ~ZOCKS &lid r~'lJ~ty (inclu ' ~ [~ b
t~ _ ~ bonds, ~es o ~w~-- ~g but not by ,~ ........ Y myse~or by
//
t t · ~o ~ve~ ~d r~:- ~ ~m~t oy tm~ees;
' vmve~ at
-u~ea 1 · , my OVagafion · .
ti Occuo~c.. -~ ~, mCm~g non :- , ,-m me ~ecffic ~[- ~ -- ---
pro e .- ~ ~ ' '-,' .... ~,-.~,~,,~,:~.~,' ~propfiate-
/p mCb ~er ~d upon mcfi te~ as ~ey ~y t~ ro er ~
mrchaser to see to ~e apP~ca~on of~e P~chase money, y of ~y
D. To bo~ow money ~d to ~c~e ~e r~a~t ~eofb
ersonal prope~, pledge of~ve
//~ders to see to ~e o~_,, .. ~ts or o~e~e -~,[ ..... ~ mO~gage ofre~ and
// E "vgncaUo. meteor ,-.mout ~b~ on ~e Pm of~
/ · To CO~ro~ c~ by or ag~ my estate or ~y tm~ create
]1~__ .. ~i To ~ocate ~d ~ ......... d here~der;
G. To re~er hve~ts h ~e n~e cfa no~ee or to hold ~e
~e~ed h ~ch fo~ ~at ~ey ~ pass by de~. S~e
~,: TO jo~,;~y m~g~, ~n~fio~ reorg~a~o~ vo ':'
~th ~ e~ect ~ereto, ~d to gmer~y ex~o~se ~e n~ts of sec~ holders;
L To ~ag~, operate, rep~, ~t~r or ~rov~ re~ e~m~ or O~r prope~y, ~d
to laase re~ e~ate ~d other prop~ Upon such t~ ~md for mob periods as my
execmor ~d ~ee deem ad--sable ev~ for more ~an ~e (5) ye~s ~d beyond the
d~ation of the trust.
J. To deduct adm/nistration expenses upon either federal estate tax return or
IC To join with my wife and file any income tax or gift tax returns that may be
due on my behalf and to pay so mu_ch of such taxes as my executor may deem appropriate
and to consent to any gilt m~de by my wife being treated as having been made one-half
(1/2) by me.
principal or ~cO :~ :~ ~ ~~~.~. l
M. To pe~t ~y preset b~efic~ to occupy ~y real eaate fo~ an of t [~
tm~ e~ate ~out r~t or on ~ch o~er te~s ~-~ ~-~'~' -- . g p he 'x
determine. ~ ~u uuumuons as me trustee sh~ ,~
N. To disclaim any interest in property without court approval; and
O. To do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate or trust.
Minors and Incapacitated Beneficiaries
NINTH: If any income or principal shall be payable to any person who shall be a
minor or who shall be incapacitated for any reason, my trustee shall hold such income and
principal during minority or incapacity and shall be entitled to apply such income and
principal to the health, maintenance, support and education of such person during minority
or incapacity without the appointment of any guardian or committee or any authority of
cour~t. My Trustee shall be entitled to make direct application hereunder or to make
application by payment of income and principal to the parent or other person in charge o£
such minor or incapacitated person or to his or her guardian or the a custodian under the
Unitbnn Transfers to Minors Act. Any remaining income and principal to which such
person shah be entitled shaft be distributed to such person upon the termination of
minority or incapacity. My trustee as guardian shall have all of the powers given to my
trustee.
Protection of Beneficiaries
eiPal shall be assignable b a b
specifically
CATHERINE ROUSE's OR WINIFRED
ROUSE'S voluntary or involuntary
creditors for the provision of care and services to them during their lifetime, including
payments for residentia/care and maintenance by any pub/ic entity or private sector.
Under no circumstances can the beneficiary compel a distribution fi"om the trust for
.any purpose. Trustee's discretion in -
en if my trustee elects to mai · . /ina/
judgment ~-,- arb rary and Unreaso_At, _ e no distribution ...... as to all
~ , -ataer than any ~,L name. Trustee ...... o at all. Further
~~~_,,tner party's deter~.~..._ ~. aosolute and itld '
.?% ,,,..,.~.: u to Oe the criterion oF
~, ~uld substituto
Termination of Sma/l or/mpractica/Trusts
ELEVENTH: Whenever Trustee, in its abso/ute discretion determines that the Size
.o£any share held in any lxust hereunder does not warrant continuing the same in trust, or
Us admi~stration would
responsibility: be impractica/for any reason, Trustee without/hrther
A. May pay such share to the person entitled at the time to the income fi"om it; or
fl. If such person is a minor or in the
age, il/ness or other condition, opinion O£Trustee is
my trustee may pay disabled by advanced
person in charge of such minor such share to the Parent or other
custodian 'under the or incapacitated Person, or to his or her guardian
Uniform Transfers to Minors Act. or to a
Compensation °f Fiduciaries
~i~tii~=gd;~'~-~ ;~' :~msafl°n in aCCordo,_: ~.u~.~er_without a
_~,.,~ .~ ate aomiciled '' "~,uy'exoisinu ti~:_: ·.ance with flie ~-, : ,
.... """~-Ypowers 1,, ~,~..L.'~?caeaule of
/nterchan. :ai *" '~= JUrisdi~ in
g b'dity of Language
THIRTEENTH: Words used in the singular may be read to include the plural or
the plural may be read as the singular. Similarly, the masculine form may be read to
include the feminine and neuter, the feminine may be read to include the masculine and
neuter; and the neuter may be read to include masculine and feminine.
Headings
FOURTEENTH: The headings used on the various paragraphs of this will are
included for convenience only and shall have no legal significance.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last
Wii/and Testament, this day of _, 1999.
' ~' "'~ ~: (,SEAL)
Vr6derick G. R°Use~'Sr. ''~ ' :"': .: ~
- TESTATOR
The preceding instrument was on the day and date thereof signed, sealed, published
and declared by FREDERICK G. ROUSE, S1L, 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 have subscribed our names as witnesses hereto.
Witness
,?
Witness
Address
Address
Glenda Farner Strasbaugh
Register of Wills &
Clerk of Orphans' Court
Kirk S. Sohonage, Esq
Solicitor
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
OFFICES OF
~egi,ter of Wilt5 anb <lerl~ at toe Off, bans' ~;ourt
~ountp of/gumberlanl~
TO: MICHAEL D BETTS ESQUIRE
237 NORTH YORK ROAD
WARMINISTER PA 18974
Date: JANUARY 26, 2004
MR. BETTS,
I have received the inventory in the Estate of FREDERICK G ROUSE SR. There is a
$10.00 filing fee due.
Please remit to the attention of Anne.
RW 5-8/905M
Personal
FREDERICK G. ROUSE, II
File No.
21-03-0394
Representative(s) of the Estate of FREDERICK G. ROUSEt SR.
, deceased,.
depose and say that the items appearing in the following inventory include all the personal assets wherever situate and all of the
real estate in the Commonwealth of Pennsylvania of said decedent, that the valuation placed opposite e~ch 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.
Michael D. Betts, Esquire
ATTORNEY
I.D. # 31120
(Sup Ct. I.D. No.)
237 S. York Road
ADDRESS
Warminster, PA 18974
(215) 672-3002
PHONE
'g Personal Representative
Signature of Personal Representative
Signature of Personal Representative
Signature of Personal Representative
· Greens ri~
ITEM NO.
1
I DECEDENT~ SOCIAL SECURITY NO.
Drive, Mechanicsburg, PA~ 108 - 03 - 9418
DESCRIPTION
All Inventories Must Be Totaled
PNC Bank Savings Acct. No. 50-040106299
TOTAL:
DOLLAR VALUE
6,991.24
Ii $ 6,991 . 24
BUREAU OF INDIVIDUAL TAXES
I'NHERTTANCE TAX DI'VTSTnN
DEPT. 28060!
HARRISBURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DISALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
Rec?' :' ,: :,iDATE 03-15-200~
F~.~ ." : ~!~ ESTATE OF ROUSE
DATE OF DEATH 0q-25-2003
FILE NUHBER 21 03-039~
'04 MAR 12 P I:Z~DUNTY CUHBERLAND
HICHAEL D BETTS ATTY ESQ ACN 101
237 N YORK RD I Amount Remitted
WARHINSTER PA 18974~~
I
RE¥-15~7 EX AFP
FREDERICK G
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA I?OI3
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 4
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF ROUSE FREDERICK GFILE NO. 21 03-039~ ACN 101 DATE 03-15-200~
TAX RETURN gAS: (X) ACCEPTED AS FILED ( ) CHANCED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schaclula B)
S. Closely Held Stock/Partnarsh/p Interest (Schedule C) ($)
q. Hortgagas/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly O~nad Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
B. Total Assets
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expensas/Ad.. Costs/Nisc. Expanses (Schedule H) (9)
10. Debts/Hortgaga Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Nat Value of Tax Return
6z991.00
O0
O0 NOTE: To insure proper
O0 credit to your account,
O0 submlt the upper portion
O0 of this fora with your
tax payment.
O0
(8)
10,637.00
13.
1~.
NOTE:
6,991.00
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
Charitable~governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Nat Value of Estate Sub~act to Tax (1~,) 3,905.00-
If an assessment .as issued previously, 11nas 14, 15 and/or 16, 17, 18 and 19
.00
.00
.00
.00
.00
.00
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
.00
( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REI~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
reflect flgures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
16. Amount of Line 1~ at Spousal rata (15) .OO X O0 :
16. Amount of Line lq taxable at Lineal/Class A rata (16) .00 X O~S =
17. Amount of LAne 1~ at Sibllng rata (17) .00 X 12 =
18. Amount of LAne 1~ taxabXe at CoXlateral/Class B rata (18) .00 X 15 =
19. Principal Tax Due (19)=
TAX CREDITS:
PAYHENT REC[IPI DXSCOUNT
DATE NUHBER INTEREST/PEN PAID (-)
260.00
(11) ]0.896. OO
(12) 3,905.00-
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collatara1) rate on any such future interest.
To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 91~0).
Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office
of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z~-hour
answering service for fores ordering: 1-800-362-Z050~ services for taxpayers with special hearing and ! or
speaking needs: 1-800-~q7-3020 (TT only).
Any party in interest not satisfied with the appraiseeent, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is alloaed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, end not
paid before January 18, 1996j the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith first day of delinquency, or nine (9) months and one (I) day from the date of
death, to the date of payment. Taxes ehich became delinquent before January 1, 1982 bear interest at the rate of
six (SI) percent per annum calculated at a daily rats of .00016~. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate mhich will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ ere:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor
1982 20Z .0005~8 ~J~'~- 1991 llX .000301
1983 162 .000~58 1992 9Z . O00Z~7
198q 112 .000301 1993-199~ 72 .000191
1985 131 .000356 1995-1998 97. .000247
1986 lOZ .OOOZ7~ 1999 7Z .000191
1987 IOZ .00027~ ZOO0 77. · 000192
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rote Factor
~T~ 91 .0001~7
ZOOZ 67. .00016~
2003 5X .000157
ZO0~ ~Z .000110
X NURBER OF DAYS D£LTNI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after tho tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shomn an the
Notice, additional interest must be calculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/15/2005
BETTS MICHAEL D
237 N YORK ROAD
WARMINISTER, PA 18974
RE: Estate of ROUSE FREDERICK G
File Number: 2003-00394
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. 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:
4/25/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
~
.,.u
. .
o
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
FREDERICK G. ROUSE, SR.
Date of Death:
April 25, 2003
Estate No.:
21-2003-0394
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 iU No 0
2. lfthe answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. lfthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No [3
b. The separate Orphans' Court No. (ifany) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes.IiI No 0
Date:
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be flIed with the Clerk of the Orphans' Court and may be
attached to this report. .
3/18/05 ~~~
Signature Michael D. Betts, Esq.
co
t,()
Mi('h~pl n 'RPt-t-~
Name
237 N. York Road
Warrninste, PA 18974
Address
(215) 672-3002
Telephone No.
Capacity: 0 Personal Representative
.M Counsel for personal representative
[)
j\v
Olumbtrlanll OlountU OOffitt of .Aging
& (!1:ommunitu ~truittll
.2,-n'l - O~/1i{
HUMAN SERVICES BUILDING
16 West High Street, Carlisle, PA 17013
[717] 240-6110 or 697-0371, Ex!. 6110
532-7286, Ext. 6110 Fax: 240-6118
website: WWW.ccD3.net/ae:ine:
e-mail: ae:ine:rmCCP8.net
ANNUAL GUARDIANSHIP REPORT
FOR LEE CRULL
Bruce Barclay
Chmrman
Gmri~i?!hb~~~~
Richard L. RovemIo
Secre[ary
May 26, 2005
Report from Guardian of Person
Cumberland County Office of Aging
Janet Paull, Aging Care Manager 3
TeIl)'L. Barley
Director
On April 29, 2004 Judge Edward E. Guido appointed the Cumberland County Office
of Aging Temporary Guardian of Person for Lee Crull. Following this appointment,
Mr. Crull returned to the Thornwald Home where he had been admitted on April 16,
2005. He was admitted to the Thornwald Home because he could no Ipnger care for
himself. His daughter, Sonya Crull, had been his caregiver but left the area for
several months without making adequate arrangements for his care. His daughter
also had several mental health hospitalizations. On May 13, 2004 the Cumberland
County Office of Aging was appointed permanent Guardian of Person. Mr. Crull .
continues to reside at Thornwald Home.
At the time of his admission, Mr. Crull was diagnosed with dementia, hypertension
and congestive heart failure. No new diagnoses have occurred. ; ,
Mr. Crull has adjusted well to the nursing home. He ambulates well but needs cueing
with most of his activities of daily living. He initially received both occupational and
physical therapy for a prescribed time. He is eating well and has gained weight
since his admission. He enjoys attending activities, but he continues to have periods
of confusion and disorganized speech. He is occasionally exit seeking and therefore
continues to wear a Wanderguard bracelet. Mr. Crull is well like by staff and other
residents.
Several of his brothers and sisters and a nephew have visited the Home and on a
few occasions, with the Agency's permission, have taken him overnight to family
gatherings. On one occasion the daughter visited him and tried to get him to sign
checks until a nurse intervened. The daughter then threatened the nurse promising
to come back and get her. On February 2, 2005 client's daughter again visited him.
She began demanding money and insulting him. She became antagonistic toward
staff and threatened that the nursing home staff and this caseworker would pay for
what we have done. She was escorted from the facility. The Agency gave the home
permission to not allow her on the premises because her visits upset Mr. Crull.
.,..
It is the request of the Cumberland County Office of Aging that the agency retains
Guardianship of Person for Lee Crull. The Thornwald Home has demonstrated an
adequate quality of care for his medical and mental problems. We believe, therefore,
that Mr. Crull should continue to reside in that nursing facility.
<ttumbtrlan~ <ttnunty (@ffttt nf Aging
& <ttnmmunitu ~trUitt5
..21-0 /.j -03q~
HUMAN SERVICES BUILDING
16 West High Street, Carlisle, PA 17013
1717] 240-6110 or 697-0371, Ext. 6110
532-7286, Ext. 6110 Fax: 240-6118
website: www.ccoa.netJat!ine:
e-mail: 3!!in!!(Q)ccoa.net
ANNUAL GUARDAINSHIP REPORT
FOR LEE CRULL
\"~Bruce Barclay
'. Chamllan
Gllt::r.' . Eichelberger
-Vic;e Chairmaf/
RichKtd"L. Rove~no
, Secrefary
TerrY L Barley
DIrector
May 26, 2005
Report from Guardian of Estate
Cumberland County Office of Aging
Janet Paull, Aging Care Manger 3
On April 29, 2004 Judge Edward E. Guido appointed the Cumberland County OHi6e
of Aging temporary Guardian of Estate for Lee Crull. Upon appointment, the Office
of Aging closed the client's checking account at M& T Bank in order to prevent Mr.
Crull's daughter from accessing the account and getting his May Social Security
check. I advised his daughter of this action. We subsequently opened a
guardianship checking account at that same bank. The beginning balance of this
account was $276.05
On May 13, 2004 the Cumberland County Office of Aging was appointed Mr. Crull's
permanent Plenary Guardian of Estate. Following this appointment, the Office of
Aging applied and was accepted as Mr. Crull's Representative Payee for Social
Security. The agency was subsequently accepted as the Fiduciary for Mr. Crull with
the Veterans Administration.
Because we closed the client's account to protect his assets, his Social Security
checks were withheld until we could apply for Representative Payee. The withheld
amount came in August 2004 in one large check. His Civil Service Pension was also
withheld for the same reason but started again when we filed the direct deposit
forms.
Mr. Crull's current income includes Social Security of $218.00, VA Compensation of
$108.00, Federal Civil Service Pension of $915.13 and Public School Employees
Retirement of $90.94 for a monthly net total of $1332.07. The Office of Aging filed
his 2003 and 2004 federal taxes for the purpose of recovering monies withheld.
Mr. Crull resides at Thornwald Home. The cost of his care is currently $1295.99 per
month for room and board. The checking account balance at the end of April 2005
was $3585.70. As of that date, payment for two months were due the Thornwald
Home. Payment was not made until we received notification as to the annual
adjustment in Medical Assistance. Payment was subsequently made in May.
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