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Home My WebLink About02-0939 PETITION FOR PROBATE and GRANT OF LETTERS H-e/ en F Le'm~r No. ~ I -0 .:l - q.ag To: Estate of also known as Register of Will~ for ~he I. I Deceased. County of ( UM h#;. .tn/ in the Social Security No. t'1'O !){ 4QC; i 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 executoJ<. in the last will of the above decedent, dated I - {.." and codicil(s) dated named , 19-5-+ (lis! street. number and muncipality) Decendent, then 9 I years of age, died f) C I. be,.. / I , ,We :2 f)C '2" at 5A...."'4 --r;;c-l.,-\ I 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 was domiciled at death in h r:;tZ. last family or principal residence at 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: $ /9A/..3- - $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration c.t.a.; administration d.b.D.c.t.a.) 3: ~ u ~ ~ ~3 ~~ "'~ ~ -00 C:':= (II'';:: 3~ ~~ :;0 " ~ ., <ii JPh)'~ E lRhwlli r ~y_ ~~ ~"./e'/~ (.j~~'. , , 1M" ),U) ~"l ) c;::; ~#MJ l/4,tJ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLAND 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) an that as personal Tepresen- tative(s) of the above decedent petitioner(s) will well d truly ad~ste estate according to law Sworn to OT am,'Tmed and SUbSCrib, ed { C" ,/ '" before me this ,18th day of ~' ~~~ ! 11- '5-~ No. .:21- Oel-Q3Q Estate of HEr~EN F r~EHMER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTOBER 21, 2002 lff_. 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 1-6-1997 described therein be admitted to probate and filed of record as the last will of HELEN F LEHMER and Letters TESTAMENTARY are hereby granted to JAMES E LEHMER FEES Probate, Letters, Etc, ",.."., $ 25.00 Short Certificates( )..,....,.. $ 3.00 Renunciation ."."""".... $ 5 . 0 0 extra pages $ 9.00 TOTAtP_ $ ~.uu . 10-21-2002 47.00 Flle'lnai'Ie'd' 1:'0' 'exec' '1 0'':2'1 :'700'2' ATTORNEY (Sup. Ct. LD, No.) ADDRESS PHONE .! HI05.805 REV ')/1;6 This is to certify that the information here given is correcdy copied from an original certificate of death duly filed w' Local R,gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent t\ling. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. No. Local Fee for this certificate, $2.00 p 8607035 I date 1I105.143_2Ia1 COMMONWeALTH Of PENNSYLVANIA. DePARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYl'tlfllttIll "' PfflUAtI~U' B1.ACKlml: ~ll"~ ............. ..... - Helen F. Lehmer -...... ....... I ....- -- SEll Female I. .1. ~lQw"_ PUaOFDERHlOoD S-"'f"...g"eo......1 tIlSf'fIlU.: NeWville, Penosylvan 0 SWlfU_R -- 198 _ 01_ 4951 ....''Ik~r . 2 H_OFCECEDENTIf-'~l_ .. '~~~..."usu.:..""""-': . .-~lmm' " . OECEDENrSW..INGAIlIIfE..$o....~SIIM.lip~ 1,000 West South Street Carhsle, Pa. 17013 ...... WIPolI ~VEAlH US.AAIolEOFOfICESl _.o,..,d o L_ COIlHlYOFOEAlti Cumbel1and 81 y... , ACl-RVNoUElIlROl_...._...eoc""'_I Sara Todd Nursing Home ~ Insur.ance t.iNlfW.1lPillJI;._ -........- ~ ". .. 'A1llER'aMJ.I4E,-.....~l... ,"'..... ""~ """'" ...- 00__ n...~__ Cumberland - - MO' -....., 1"lIIII.d'!:.-:'::: UOTtiER"SIWEIFf...I.bta.........s........ Grace Marquart 1la.O .............. .. .a .. iw0AUANr5N.UlElT~ Fred McCalister James E. Lehmer ... ............Mi~ - ~'" .~- ~nicsburg;.Pa.17055 ~ 8 o ~ ~ , ............."!I'_o<Ip.___......""'linla._...,~_..s. ',""" ." ..... .. . VJ.J.CI,'A.'fY/~ RJ lIE IlIll..PAClNOlJr4CED[EAO~Oay,'lIiI;jI' Ilil{ " October 10 J JliJ(J;;! U.HllTI: ~""""'.Injur\u.-""""",,,"""""_'l>>lM.1h OI>"",_"'_ol~.$.::l\u~"""Slli<-""'t&<,....._.-,Idon, liIo<ll*l__..._.... ."-...~c:.--., Slate Hill Cemetery ~OCAIIOIt.~....lip~ Camp Hill, pa 11 " ~ , ~ .. l.E1"11OPClf'DISl'OSIhOM O 8uIIUtilX~O - - ". SIaIWtIflEOF~SE ". ICENSENUUllEft FD-012755-L ANO~':rr~ Home, Inc. 37 ~asfM8in Street Mechani llCEH!lEHUMIleR M"ESlGHEO RN5J7i/J.? L 7'" r REFEI\REOlO:D' ., NoPT . Pa 1705 DE ~i {)IlA n (J<V DUElDjOftAS-"CONSEOlIfNCEOF): . fl.L-il~fjit-\f.1'l\\ 1)t;M.E.NTt~_____ 1:- ::::::::;::---_~_=__=_- =.:..~~S WoHHEflOf'OEATH ~~r eot.Wl~vrCUi5i: OFDERli1 1::w..;~. :-....... I ....~ ~~-*"--W1na1O I!'ll---...-......Ynli-.. .~ '- f- i' c 'A-~j 1~ . ""...... .......,,"""'" OESCAlIlli..:lWIN.IlIAYOCCUJIfIEfl _0 ~ Ilil X -- ~ Poonding~"'" o [J [l ~OI'.muAY-A1_...,...._~_ ... ~....~ -"'~- .. 0 NoD -. g.- O o - .p""'iIlU"C"lCi"HD(:IIlTlfYlNQI'tIY$ICI4"~_;>o"""""".ngdol"'_~"'C_""."."'l '..IlI._...oay....._g.._""....~..I..._....IO._p1..:...not_.......'"....'.'.....m..ll~~...~~~ ..",,.....,,... C"'lIo:I_...~._ no.. ~a.. CEJnIf!EAlCtl.d.......an.t .CfA'V.VIllGPHyatelAHIPh._~_.._"......_,""...c.........."'''''"'''''''''-f..........,o''m.......~''''';r~1 T.. Q.. ~.,gj...... ........... ......"'''0....-.:1...10........01(.1''''''............1..... ,. ,,_.., ......., -............. ~ ."'flllC..IO:..~ERlCOROf,lEII On Ill_ b.....,I....mln.....n..nd/DlIn.....Ig..olGn. lAm'..pInIoM,.......otl:utte<:l "'......Ir....d.I...RdplK. . andd...l.. Ih. ".""'.1_ 11.......,.......I~:ed............'n.... ................,..... ......................,..,............................... ~-_...-. ~ ,,> d..U_~; . ~~b,,'*__ o O.Q"E~U.Lb...Dooy. ....O-o+48S4'.-L !~:/ll-/o," IoHD NlOREUCf I'f.llSOO'MCGOIW\'ElP1;MHE t1F~:m m.i 21HllMDtI"lllll W~Lt...1 AYI1 -So ~Ht..l f t' - .t'\2.l sel--i/V0 ,...tl,J e1\i-L-l..}t.E 11ul.3> FUPlUDf*.DO\l_' ~(!)t;robelf!. i;;{ 0<.17-84-..' , iJ ... 1..:1./~11;21 021 - 0 - q 3~ LAST WILL AND TESTAMEl,T OF HELEN F. LEHMER I, HELEN F. LEHMER, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania, being of and disposing mind, memory and understanding, do make, publis and declare this my Last Will and Testament, hereby revoking making void any and all prior Wills by me at any time heretof made. 1. I direct the payment of all my just debts and tuneral expenses as soon after my decease as the same can be conveni y done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my three (3) chil to wit, LARRY E. LEHMER, JANES E. LEID1ER and JEANNE L. SCIDvAR share and share alike, per stirpes. en, , -1- LASTLY, I nominate, constitute and appoint my son, LARRY E. LEIDffiR, Executor of this my Last Will and Testament, and in the event that my said son should predecease me, or should he be unable or unwilling to serve in such capacity f any reason, then in such event I nominate, constitute and ap nt my son, JAMES E. LEHMER, Executor of this my Last 1'1111 and Te ament, and in the event that my said son should also predecease me, should he be unable or unwilling to serve in such capacity fo any reason, then in such event, I nominate, constitute and appoi my daughter, JEANNE L. SC~lARTZ, Executrix of this my Last Will d Testament, and in all instances, I direct that my said person , representatives be excused from posting bond or other securit for the faithful performance of their duties in any jurisdict n. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~Ihk. day of January, A. D., 1997. +.~ (SEAL) Helen F. Lehmer -2- Signed, sealed, published and deolared by the above named, HELEN F. LEHMER, as and for her Last Will and Testamen in the presenoe of us, who have subsoribed our names hereto a witnesses, at the request of said testatrix, in her presenoe d in the presenoe of eaoh other. r -3- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, HELEN F. LEHI'lER , the testst rix 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 Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by HELEN F. LEHMER , the testatI'ix , this fo-jL day of ,TAn"",.y , A. D., 1997. ~, -:}, ;t;, ~AA"Dhj 8eaI He1en_ F. L erf2- ....!!ft~~NlIi: A ~_fobI.fl.~ COMMONWEALTH OF PENNSYLVANIA ) ) SS. "**8lIf f.>:~~~~~~N'!y ,/. .",<:,:~;';.;:,:j0718.;pitG!;Nov. 6.19>>' COUNTY OF CUMBERLAND . r_"'~'~i~:!3{27G~r;,;::-(~,::"'.-.:S We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , HELEN F. T.F:HMTm , sign and exe- cute the instrument as :lIIIbe/her Last Will and Testament; that the said testat rix , HELEN F. LEHMER , executed it as m./her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix , signed the Will as witnesses; and that to the best of our knowledge, the testat rix was, at the time, eighteen (18) or more years of age, 0' '0""' "'"': '"' "",., "" 0"(2 '"0"" 00 ""'"' ,.fl"".o'. Sworn and B~cribed to bef me this b day of January 1997. fl1~ If Q ~/ll!' -4- RENUNCIATION cll- O.;L - <134 In Re Estate of HELEN F LEHMER deceas To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned LARRY E LEHMER, SON the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Lett be issued to JAMES E LEHMER WITNESS hand this day of ,19 L- (Signature) /,/ ff/7/o.) (Signature) (Addres,) (Signature) (Addres,) v- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Helen F. Lehmer Date of Death: October 10, 2002 Will No. Admin. No. 21-02-0939 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 December 21, 2002: Name Address Larry E. Lehmer 2722 Rosegarden Blvd., Mechanicsburg, PA 17055 105 North Street, Rear 106, Harrisburg, PA 17101 112 Lawrence Lane, Carlisle, PA 17103 James E. Lehmer Jeanne L. Schwartz Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: December 21,2002 ~~~~ CHARLES E. SHIELDS, III .~ 6 Clouser Road r Mechanicsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Representative REV-1500EX i6-001 " o 1';- 95- g O=FICIAc_ IJS' DN'_' / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPl 280601 HARRISBURG, PA 17128-0601 REV,.1 SOlD INHERITANCE TAX RETURN RESIDENT DECEDENT YEAR NUMBER w ..., ",$cn u"'''' wo.u ,,00 u"'... 0." 0. '" FILE NUMBER ~.L - -!?.:z. 0 Q. !l 3 9_ COUNTY CODE ~ Z IJJ C IIJ (.) IJJ C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) lEHtnEIf, H€UiN F. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) /0 -10 _ 2.002 I::J.. - 3/ -1'120 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL) ,v/A SOCIAL SECURITY NUMBER /9-e - 01 ~'lSI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [RI1. Original Return o 4. limited Estate ~ 6. Decedent Died Testate {Attach copy 01 Will) D 9. Litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (date of death aller 12-12-82) o 7. Decedent Maintained a Living Trust (Allach copy o/Trust) o 10. Spousal Poverty Credit (dale o/death between 12-31.91 and "'-95) o 3. Remainder Return (date o/death prklrto 12.13-82) o 5. Federal Estate Tax Return Required () 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sell 0) ..., z w c z o 0. .. W '" '" o u lNE, ,:n EO,I, JO; COMPLETE MAILING ADDRESS (p CL.OltS ~ ,eD. f}?EC-f//l1IJ lesB f.,{1f'6-, PA- /70$"S NAME (!/ftl-;et.€S R: SIf/E/..D5 7f[: FIRM NAME (If Applicable) TELEPHONE NUMBER 7/7- 76>(p -0;z09 z o ~ :;) ~ ii: 00( (.) IJJ D:: (l) 0 OFFICIAL USE ONLY (2) 0 (3) 0 (4) 0 (5) 1 9 77/. /3 (6) D (7) 0 (".c ~/c.) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoIe~Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Il'Iter-Vi~os Trans1ers & Miscellaneous Non~Probate Property (Schedule G or l) 8. Total Gross Assets (1otal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) {B) ~ '1, 77/- /3 1 ~ Jilf..39 t '-1.2; '1$.3.9S- (9) (10) l' 5~1{)~.3t.1 D o o (1l) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !c( I-' :;) D.. :ii: o (.) ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x ,oD- (15) x,o~ (16) x .12 (17) x .15 (1B) (19) o o () D o o o o o 16. Amoun1 of Une 14 taxable allineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 10.0 CHECK HERE IF YOU ARE REQUESTING A REFUtlO OF Atl OVERPAYMENT '. ,".., ~,~,@iL%l!RS:rQA1!IIll!llS!!A1J.,r."'....nONS -"-"'RSEmJ;,AI!Ip.RI:C!-I!'~ MATlt<<.. Decedent's Complete Address: > STREET ADDRESS / tJ()(7 UJut $c,~ .streeT CITY CIII'/i sit! I STATE ;/l;f- I ZIP /70/3 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pnor Payments C. Discount (1) tJ (9 o t? Total Credits (A + B + C ) (2) o 3. InteresUPenally if applicable D. Interest E. Penaily D t) (3) (4) (5) (5A) 4. TolallnleresUPenally ( D + E ) If Line 21s greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of line 5 + 5A. This is the BALANCE DUE. () o o o o (5B) Make Check Payable to: REGISTER OF WILLS, AGENT ~~t",\"'\liJc~.,l!i~~UI~.1itl!li.!!I!J. ~..,..Liil!I,!,..", ".~TI.Q ..n ..' .... .'11.i1IY1L'1f. m.... II. Tt.il\Q~.~.I~ ~~~lt~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income o!the property transferred;................................................:......................................... 0 b. retain the nght to designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or................,.....................................................................................................,.... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred aner December 12, 1982, did decedent transfer property within one year of death without receivin9 adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........".... 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............."......................................................................................................... 0 No ~ ~ ,l&J )Sl ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, meC#41///CSB/(I(!G, tdA /7oS$" TIVE 1"11- /7DsS DATE g- I 03 DATE :? /. Os ~~""..-1~?c~~~"";~~;:;';~..,.,."~1~:...~~~~"""~,~~'1~:}~;~-:::~,.'!~~~'~~,,~::?~,'T.',i~:~,~~,,}".';:":7,~(::",~.:"-'re.,.' '-~:!':"'1:":/~:"';:\~~\" ':"l-:"",,! _ ".>~y~,:r~..."~l~,,,,j':'t'lW!~"-~, '!I-~'f~ 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. 99116 (a) (1.1) (i)]. For dates of death on or aner January 1, 1995, the tax rate Imposed on the net value of transfers to or for the use of the sUIViving spouse is 0% [12 P.S. 99116 (a) (1.1) (ii)]. 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 aner 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. 99116(a)(1.2)J. The lax rate imposed on the net value of transfers to or for the use o/the decedent's lineal beneficianes is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. 99116(a)(1)\. The tax rate imposed on the net value of transfers to orlor the use of the decedent's siblings is 12% [12 P.S. s9116{a)(1.3)]. A sibiing is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~l"EX''':''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EST ATE OF SCHEDULE E CASH,BANK DEPOSITS, & 'MISC. PERSONAL PROPERTY FILE NUMBER L E" fU1E'1t, HG'tEIV r: ,:;1.1- 02 - 7J? Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned wfth the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. .2. 3. DESCRIPTION /I'I(J lid//( ehul(;~ Iffd'. All), so7 Po 9';:3 't(, (set kw q&chu?) myars /7lAual #oHfe fl,-r/4,eI -hllutZl €.SM'P~ ~ Refund Aetn(( ::z:nsur: &. *" becule/lf /lMle tlu)a;: fJ/'IJfert, 61 /Jny .'Xv65~ Sad, t(S 1Mf/5ehPlcI hrr/J'Sh21S ~/ ~ p~ !lr/(;; ~ Oe:-hkr t/ .2~tJt? ;,; ;tl/ef/Rrl2,,{tJh ';r e/lle/'/j &. SurAl, ~<<e( IJ/e~/';al f!ome.. VALUE AT DATE OF DEATH 71' ';?,73".7' ~ o o,;z{., ~o f& 9",37 TOTAL (Also enter on line 5, Recapitulation) lit more space is needed, insert additional sheets of the same size) $ 9 77 f. /3 / GPNCBAN< . February 19,2003 Charles E Shields, II! Attorney at Law 6 Clouser Rd Mechanicsburg, P A 170.55 sop R'" Estate of Helen F Lehmer (Deceased) SSN. 198-01-4951 DOD: 10-10-2002 Dear Mr. Shields, Please note our new address lit t.he bottom of this letter: In response to your request for Date of Death balances for the customer noted above, our records show the f(,Howing: Checking Account Account#5070092396 Established 12-04-1987 l-lELEN F LEHMER DOD balance: $2.736.76 Non interest beanng account The decedent did not maintain any safe deposit box at PNC Bank. Please note that this office only provides date of death balances for depOSIt accoW1ts (IR!~s, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with a.'1ji of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~ :/. ~A_ Erica L Schlegel PNC Decedent Reporting Firstside Center 500 First Ave, 4111 PI elF PittsburghPA 15219-3128 1-800-762-1775 Member FDIC TOTAL F'.cn .REV,''''''.,:,'''. COMMONWEALTH OF PENNSYLVANIA INHERlTANCE TAX RETURN RESIDENT DECEDENT SCHEDULEG INTER.VIVOS TRANSFERS & Mise. NON.PROBATE PROPERTY ESTATE OF L€J..{mIF~, HIFUi7V F. , FILE NUMBER ;2..1- &>.2 - 93<t ITEM NUMBER 1 This schedule must be completed and filed if the answerta any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDe THE NAME OF THETRANSFEREI<, THEIR RELATlONSHIPTO DECEDENT ,fJoIOTHE DATE OF TRANSFER. AnACH.AC~ OftHEOEEOfORREALESI""TE. TI(1"'AI.srGIIl~ &>~ PIFRSOIII/I-{."TY T<> .;TGIfWItIE SClfi1lAl(1rz 1A117l1/A/ P,VIP Y~A!! or l).D.;). ("J)ECElJENTS '];)/~U6H7ee) ;; . C!J>LollEt> IV f Go 7ANb d. 13t{~€/ftt e. ,<(C:CLlAlI9( CHA"e 7). e/f/Zj) 7/f~lE $ ~ (!H/f-/RS (-ro7.tfL <:/F7S-L.E$~ ~..?N' ~~"'''P''''D) DATE OF DEATH VALUE OF ASSET ~ 1 S7>. "D ,.. .?20."'" ,- ..;jst>.~o 'if .;;s: Of) %OF DECO'S INTEREST It)Oj';, //)0.7;, II!>Oh /0";;' EXCLUSION IFAf'PlICAllU:) TAXABLE VALUE ,- ISD.6D .. ra- y 2Sl>. In> '" -<'$.<>0 -p- -6- - ,p- -0- TOTAL (Also enteron line 7, Recapitulation) $ (~more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-991 . ~ SCHEDUIJE iN FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF r-z:J LEfI/Ilc:;,..., /I ~...E1'I r:. :J.I-oz - 9~9 ITEM NUMBER A. Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: rnytrS rUlle-rttl !-/DI1/e .James R. c:;.;"dH'd, Funer",j NA& myers .r:<tne-r..1 1I~;Jfe -' oi,,'~,,'Y ~e. :/. 3. >I, .f /J1ed,ttn/cshwr{j (!3t>>/c fWnu.a1 fi-4 -a:IJ) me.I'>IDr;al.s, "f meek"m""s),,,~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2. Name of Personal Representative(s) ':Ji+mES Er. LEHmER Social Security Number(s)JE1N Number of Persona) Representative(s) ' S Street Address '21 ~:l RD:;~GIUtbeN -e,LV.D. City lY1 EcH /}N1 C.s IOu R Go- State ~ Zip 1.0 s.s- Year(s) Commission Paid: ~oo.3 Attorney Fees C h tt.rles R. ~;e/d.s 1lL 3. Family Exemption: {ll decedent's address is not the same as claimant's, attach explanation} Claimant NONE Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees aM<i or~;n...1 15S4e &of sl..,.t c....rt; F,'ccd-e.s 5. Accountant's Fees 6. 7. ~. 1. 10, fl. Tax Return Preparer's Fees :r c.......t ~r",d<:bi /I) +l i/(. 1'>lo../< lYl~ics- \'\1..,:\ ~c.... p/"ep. of <!..I05e-o....r ID'fO I ~. I A-a'u..rfr'i.jn(j '".\ Cu.....'ou-\......c;\ 4.w .JOI.I.rnal A-dverti ~ i "j 1M HCl.rris b\M',j ~'tr; b t rtle:h-o- We 5C 141/'; IIfXPllnt'7 fe..h"'.) hl/"J -:r" he,.j """,,ee -1A,J" Jfelzml 1/ "tl; h'NI"/ ;J,.."i",./e Pee ~ ~tI'rkf 1'e~, C!erlJ /IM,I/ ,t-s,.$ TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 1', ,O.:l,-,t>O !'fS",olJ , ~~o.69 ". f? 7. 00 f/6S:/3 1&,73.9Y 1\/ D/IJ€ , l{.7.lJO ,. ,"0.00 " 7S,OO ,. gS.2'9 l' 13/./w " /O,dO ~ 1 j-; tJt} :)f,70 -;0 T/U $ ~7'/.J: 39 sckr/ ; I(. ~./ ;;:;5T t>F c,~-?I~, IIe:Z-E7iI.F. :2I-~z-'7..3'7 /3. &r'Y;'!I_dlll"-~ h1_~~~~J1!.44t@ I. ~ ~ ~~) li'/7. PO - - .------ ___~~___.____.___.__ m" _ _.__.,_....._.____,__ "___,_, _ James Lehmer 2722 Rose Garden Blvd. Mechanicsburg, PA 17055 James R. Gingrich Memorials 5243 SimDson Ferrv Road Mechanicsbura. PA 17055 (717) 766-5622 Invoice 125138 2/26/2003 ._ .~.~~.: Contraet Date Family Name Salesman. Ron Colvin Lehmer 1 Cemetery Inscription Order Total: Payments: $95.00 $0.00 Balance Due: f1{ Afmance charge 0/ I 1/2% per month (18% annually) will be added after 30 days 1-/) 110,5 (~ de FlEv.1512EX*{1.97i ,..,; ...J>" ."'" , SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS N€"LE711 r: Z/-o2- '1..37 COMMONWEALTH OF PENNSYLVANIA IHHERITANCE TAX RE1URN RESIDENT DECEDENT ESTATE OF FILE NUMBER L€#/J/EJe , Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. 1 77-7.77 :;. S,IUAII,4. 7b.1:>D /Jf€7HM!/;Ifi ~E "* (-X- 7h/s fJaf/Hv;1 w's /Jul'e JeJbre ~ &I.D-"/' HbI<Jeyu:, fie. c.heU< eI/~ /1bf cJ~r:Me dec.u/uff 11C!t!PI07t l(n:hl a./fer #f d. P. P":) ~E;:lm.tat(~.sEh1ENr 7P ""IE7!-/Y/}/E Sa#Jt//M?TZ T'i>/f /J/fY/HB'iJf- PP/f Gj,cr FiM /J/lt116E '" .:<, . liS :5. 'f ,- :516, . aO 'I .<II, 8"/1.7/ 5H/e'~H /p.t)J) mE/H~R/.4L /lIiIIYE 7>Gl!3///?G/h/;BtI~SE/?I'~r I9/UGD /t> ~#. :2'>. f7. w. TOTAL (Also enteron line 10, Recapitulation) $ "I-.2,]lS 3, qS- (If more space is needed, insert additional sheets of the same size) "'.';'''''''.'''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES FILE NUMBER ESTATE OF L.G"II/11U(, H€La./ r NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (Include outnght spousal dlstnbutlons) RELATIONSHIP TO DECEDENT Do Not List Trusteets) 1. J;mes F. LehJ1JV 27:?2 iPo.seprrtten' ~/V'/. /J/ec-hll'llcsfful'<!, ;J,4 /;1p ~ $e." <<. 4t/'/"f E: Le~/11l!r /0$ 40rrA c.5f: /f'e4r /()~ , lIuw's/;;o"/,;7/1 17/ pI .J'. :;e~ II/Ie L. JahHlpr!2 1/2 L4lt1re'lce /',u1e &/f-s/e,,,v// /,//i?.g :5P" :SO" 2/- 02 - ?3~ AMOUNT OR SHARE OF ESTATE Y3 j3 ;/.3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON.TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. 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) LAST WILL AND TESTA~rT OF HELEN F. LEHMER ~ J - D;L -C13CI I, HELEN F. LEHMER, of the Township of Upper-Allen, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my three (3) children, to wit, LARRY E. LEHMER, JA~mS E. LEID1ER and JEAIlliE L. SCilliARTZ, share and share alike, per stirpes. -1- LASTLY; I nominate, constitute and appoint my son, LARRY E. LEHHER, Executor of this my Last Will and TestallEnt, and in the event that my said son should predecease me, or should he be unable or unwilling to serve in such capacity for any reason, then in such event I nominate, constitute and appoint my son, JAHES E. LEBMER, Executor of this my Last Will and Testament, and in the event that my said son should also predecease me, or should he be unable or unwilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my daughter, JEANNE L. SCHWARTZ, Executrix of this my Last Will and Testament, and in all instances, I direct that my said personal , representatives be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~~- day of January, A. D., 1997. ~+.~~ Helen F. Lehmer (SEAL; -2- Signed, sealed, published and declared by the above named, HELEN F. LEHMER, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. ~ ,,0 -3- /Q- f5--Y ~ BUREAU OF INDIVIDUAL INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 TAXES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX lIEV-lS1i7D:AF'P " CHARLES E SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 'f-J_, l,_.I c :"':Jj DATE ESTATE OF DATE OF DEATH FILE NUMBER " 'CPmlTY ACN 09-22-2003 LEHMER 10-10-2002 21 02-0939 CUMBERLAND 101 HELEN F -~) Amount Remitted ,', MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIM LOWER PORTION FOR YOUR RECORDS ..... RE-Y:is4TEX-AFP--eoY:03'j--iioYjCE-ii"'-YJijjER-jTiNCE-YAJTAPPRA-jSEHEii:r-:--ALi-owiifcriiri---------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LEHMER HELEN F FILE NO. 21 02-0939 ACN 101 DATE 09-22 003 TAX RETURN WAS: (Xl ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate [Schedule Al (1) 2. Stocks and Bonds (Schedule Bl (2) 3. Closely Held stock/Partnership Interest (Schedule Cl (~) 4. Hortgages/Notes Recei~able (Schedule D) (4) 5. Cash/Bank Depos1ts/"1sc. Personal Property (Schedule E) (5) 6. Jointly Owned P~ope~ty (Schedule F) (6) 7. T~an$fe~$ (Schedule Gl (7J 8. Total Assets 10. ll. 12. 13. 14. Debts/"ortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax R8tu~n (9) (10) .00 NOTE: To insu p~ope~ .00 credi t to YOU ccolAnt. .00 submit the up portion .00 of this form h you~ 9.771.13 tax pay..nt. .00 .00 (8) 9,77 13 8,748.39 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm~ Costs/Misc. Expenses (Schedule H) Cha~ltable/GovernMental Bequests; Non-elected 9113 T~usts (Schedule JJ 42.953.95 0]) (2) (3) (4) 41,9 Net Value of Estate Subject to Tax 41,9 NOTE: If an assess..nt was issued previously, lines 14, 15 and/or 16, 17, 18 and 1 reflect figures thet include the total of !hh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal ~ate 16. Amount of Line 14 taxable at Lineal/Class A ~ate 17. Amount of Line 14 at Sibling ~ate Amount of Line 14 taxable at Collate~al/Class B ~at. will (15) (16) 0]) (18) .00 X .00 X .00 X .00 X 00 045 = 12 15 Tax Due (19)= 00 00 .00 .00 .00 IPT NUHBER CO (+J INTEREST/PEN PAID (-) A"OUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE o o o o * IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST~ ( IF TOTAL DUE IS LESS THAN tl. NO PAY"ENT IS REQUIRE IF TOTAL DUE IS REFLECTeD AS A "CREDIT" <CRJ, YOU H BE DUE A REFUND. see REVERSE SIDe OF THIS FORM FOR INSTRUC NS~) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION ::J.-/- 0:(- 93'1 ESTATE OF HELEN F. LEHMER, DECEASED u*AN INSOLVENT ESTATE*** FIRST AND FINAL ACCOUNT INCLUDING PROPOSED DISTRIBUTION OF JAMES E. LEHMER EXECllTOR --------------------------------------------------- Date of Death: October 10, 2002 Letters Granted: October 21, 2002 Dates of Publishing Notices in the The Patriot News December 31,2002, January 7 & 2003 Dates of Publishing Notices in the Cumberland Law Journal January 3, 10, 17,2003 Covering the Period: October 10, 2002 to September 30, 2003 --------------------------------------------------- Purpose of the Account: James E. Lehmer, Executor, offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicate the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with James E. Lehmer, c/o Charles E. Shields, III, 6 Clous Road, Mechanicsburg, PA 17055. PROPOSED SCHEDULE OF DISTRIBUTION Class 3: Pennsylvania Department of Welfare Class 6: Pennsylvania Department of Welfare $22,278.72 claimed: $19,539.99 claimed to be paid -0- to be paid -0- JAMES E. LEHMER, Executor of the Estate of HELEN F. LEHMER., deceased, hereby declares under oath that he has fully and faithfully discharged the duties of his office, that foregoing First an Final Account is true and correct and fully discloses all the significant transactions occurring during the accounting period; that all claims now outstanding . st the Esta~~and at all taxes present due from the Estate have been paid. I' ( E.LEHMER Sworn and subscribed to before me this O?M day of HM~ A.D. 2003 '/' ./ ~Ar~~//~~ Notary Public NOTARIAL SEAL Chal1es E. Shields. III. Notary Pubfic Monroe 1Wp. Cumberland Coun~J My CommiSSion Ellpiros June 20. 2004 5 LAST WILL AND TESTAMEaiT OF HELEN F. LEHMER ..oJ) - D.2 -Cj,3C I, HELEN F. LEHMER, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking a making void any and all prior Wills by me at any time heretof made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveni ly done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my three (3) chi' en, to wit, LARRY E. LEHMER, JANES E. LEH!1ER and JEAnNE L. scm.. , share and share alike, per stirpes. -1- LASTLY, I nominate, constitute and appoint my son, LARRY E. LEm1ER, Executor or this my Last Will and Testament, and in the event that my said son should predecease me, or should he be unable or unwilling to serve in such capacity ro any reason, then in such event I nominate, constitute and app nt my son, 3A}ffiS E. LEHMER, Executor or this my Last Will and Te ament, and in the event that my said son should also predecease me, should he be unable or unwilling to serve in such capacity ro any reason, then in such event, I nominate, constitute and appoin my daughter, 3EANNE L. SCHWARTZ, Executrix of this my Last Will d Testament, and in all instances, I direct that my said person , representatives be excused rrom posting bond or other securit ror the raithful perrormance or their duties in any jurisdict n. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~-rh_ day or 3anuary, A. D., 1997. +.~~ Helen F. Lehmer (SEAL) -2~ i I co l' - co il j~~lg!i~ ...~Gj 1(11 E'- 2lils'j~~I{ i. ~iIJ!i~ I( "1 ~ ~ II.!!) i ~ tjll"Wl ~!I~lfll~ ~iillh j ll.tI"6IZ; '8 -"If~' i Ii JlJ~ji I'8Jhi,!ti! = J~t ~II.( "' ~ "' - 0 .... t r1P '" - 9~ ct p; w-, "-J t.t- x~ <5 (,; ~ k: ""- "'>- a: 4i "':::. ::> ~ It) i::uO~ ui~ III ~ s~..", "'ex: rJl I ~ ::,. ~ C -0 . WQ -c~5 ~~ z ~ () ~ ~ 00'- <I: <> , - 0. 3' <( I '" ~:;O! J: () :t ~ .... .,-.. 0 W " ~ \ -= Q..:: ::E ll.. \~ :0 -0- ~ \\\ 3'-:; \: '0 :> \'- ~ C>~g~ VI '-.l U) ~-e;; V'j "0 - C)- \ . E. () 0 t g". & 't.s"i 0 Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/03/2004 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 RE: Estate of LEHMER HELEN F File Number: 2002-00939 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: 10/10/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, FARNER STP~ASB~GH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen F. Lehmer Date of Death: 10-10-02 Will No. Admin. No. 21-02-0939 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. ~hether administration of the estate is complete: Yes_~_ No_ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes_~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: Sept. 9, 2004 ~~ ~~~y Signature Charles E. Shields, III, Esc~ire Name (Please type or print) ~ { _, J 1: ~ ...... ~ 6 Clouser Road, Mechanicsburg, PA 17055 ~ '-'-, ',~] Address (717) 766-0209 · ZF -" ' .a:~,:i 0[ ~ t0. Tel. No. : I [ I Capacity: __Personal Representative ~ ~: : ~ I :::J X Counsel for personal representative (MAH: rmf/AM3 )