HomeMy WebLinkAbout04-0868Estate of Anna J. Umholtz
also known as.
Social Security No. 162 -07- 88 ~ 6 Deceased.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut r ix
in the last will of the above decedent, dated Octobt~r 9
and codicil(s) dated
PETITION FOR PROBATE and GRANT OF LETTERS
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
named
.21Z0_2
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 1901 Chatham Drive
Lower Alien township
(list street, number and muncipality)
Decendent,,then 85--yearsofage, died August 27 2004
at Colonlal Park Care Cent:er, Lower Paxton Twp.
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopte~
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $.. 10,000.00
(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: $ 1 O0,000, O0
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
pre~ented herewith and the grant of letters_ testamentary
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
Nancy L. Conrad
70 Runyon Road
Hummelstown, PA l'/U3b
OATH OF PERSONAL REPRESENTAtiVE
COMMONWEALTH OF PENNSYLVANIA 3
COUNTY OF CUMBERLAND j~ ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the k~owledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
~r~.~is ~ ~ __ day of /
~2004 /
No.,~d_=_~_t]' - ~
Estate of Anna J. Umholtz , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NO~%~J~X
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described thegn be admitt~l~o probate and filed of record as the last will of
and Letters '~'-l}-Ag'~o~ ~-~'~ ~ t3
are hereby granted to
2 0 0 4 ., in consideration of the petition on
FEES
Probate, Letters, Etc .......... $~z.~_._._._._._._~.
Short Certificates( ) .......... $ Q'
TOTAL
Filed ..(~..'Z.~'~-~..~ ..................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
REGISTER OF WILLS OF C~.mbef/an,~ COUNTY
OATH OF SUBSCRIBING WITNESS
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that. .~<- ]9! /4/'$a $ present and saw
the testat f ~ .~ , sign the same and that ~ ~ ~' signed as a witness at the
request of restart ;~, in h~f _ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or ~ffoirm,~e[l and subscribed before /~
me I~his o~,D ° ~ - ~
REGISTER OF WILLS OF
· (Address)
(Name)
(Address)
Cum ~e ~'/a, nca' COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(,ea-¢~) a subscriber hereto, (each) b ' '
emg duly qualified according to law, depose(s) and sity(s). {hat
.. ~5~ e_~ )$ familiar with the signature of
c~
testa~ of (one of the subscribing witnesses to) the will presented herewith ~d
codicil
that ~ ~ ~ believes the signature on the will is in the handwriting of
to the best of. ~ knowledge and belief.
Swor~ to or ~f~r~d and subscribed before ~~
me t$is ~ da ff r ~
{5~~~ (Address)
(Name)
(Address)
105 805 REV 0/86
This is to certify that the inforrnation here given is correctly copied from an original certificate of death duly filed with me as
l~ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for pem~anent filing.
WAFINING: It is ifle§al to duplicate this ¢oplt blt photostat or pho~ograph.
Fee for this certificate, $2.00
? 10530173
NO.
COMMONWEALTH OF PENNSYLVANIA
c-
--2t--O4--
DEPAR NT OF HEALTH · VITAL
Local Registrar
AUG 3 0 2004
Date
~ CERTIFICATE OF DEATH ~'J
~.~1te
1901 ~'. .......... ~~syiv~ia ~
Ko~r
LAST WILL AND TESTAMENT
ANNA J. UMHOLTZ
I, ANNA J. UMHOLTZ, of 1901 Chatham Drive, Ca~np Hill,
(Tov~ship of Lower Allen), Cumberland County, Pennsylvania, make,
publish and declare this as and for my Last Will and Testament, hereby
revoking all other Wills and Codicils heretofore made by me.
FIRST: I direct that all inheritance, estate, transfer, succession
and death taxes, as well as my just debts and funeral expenses, of any kind
whatsoever, which may be payable by reason of my death, shall be paid
out of the principal of my estate as the same can conveniently be done.
SECOND: I give, devise and bequeath all the rest, residue
and remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
~ together with any insurance policies thereon, in equal shares, unto my
children, RICHARD P. UMHOLTZ, of Omaha, Nebraska, NANCy L.
CONRAD, of Hummelstown, Pennsylvania, DONNA L. NEWHOUSE,
of Mechanicsburg, Pennsylvania, and JUSTINA E. MCGOVERN, of
Haddonfield, New Jersey, per stirpes.
THIRD: In addition to all powers granted to them by la,v and
by other provisions of this Will, I give the fiduciaries acting hereunder the
following powers, applicable to all property, exercisable without court
approval and effective until actual distribution of all property:
(A) To sell at public or private sale, or to lease, for any period
of time, any real or personal property and to give options for sales, ex-
changes or leases, for such prices and upon such terms (including credit,
with or xvithout security) or conditions as are deemed proper. This
includes the power to give legally sufficient instruments for transfer of the
property and to receive the proceeds of any disposition.
(B) To partition, subdivide, or improve real estate and to
enter into agreements concerning the partition, subdivision, improvement,
zoning or manageinent of real estate and to impose or extinguish restric-
tions on real estate.
(C) To compromise any claiin or controversy and to abandon
any property which is of little or no value.
(D) To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, ~vithout restriction to
investments authorized for Pennsylvania fiduciaries, as are deemed proper,
without regard any principle of diversification, risk or productivity.
to
(E) To exercise any option, right or privilege granted in
insurance policies or in other investments.
(F) To exercise any election or privilege given by the Federal
and other tax laws, including, but not necessarily being limited to, personal
income, gift and estate or inheritance tax laws.
(G) To make distributions to my herein named beneficiaries
2
in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order to
pay debts, taxes, or estate or trust administration expenses, to protect or
improve any property held under my will, and for investment purposes.
(I) To select a mode of payment under any qualified retire-
merit plan (pension plan, profit sharing plan, employee stock o~qmrship
plan, or any other type of qualified plan) to the extent provided for by the
plan or the law.
FOURTH: I nominate and appoint NANCY L. CONRAD,
Executrix, of this, my Last Will and Testament. In the event of the death,
resignation or inability to serve for any reason whatsoever of NANCY L.
CONRAD, I nominate and appoint DONNA L. NEWHOUSE, Executrix,
of this my Last Will and Testament. I direct that my Executrix and her
successors shall not be required to post security or a bond for the
performance of her duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this q day of
October, 2002.
(SEAL)
3
Signed, sealed, published and declared by the above-named
Testatrix as and for her Last Will and Testament in our presence, who, at
her request, in her presence and in the presence of each other, have
hereunto subscribed omc names as attesting witnesses.
Address Name
Address Name ' ~L
4
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
NAME OF DECEDENT: Anna J. Umholtz
Date of Death:
August 27, 2004
Will No. 2004-00868 Estate No. 21-04-0868
To the Register:
I hereby certify that Notice of Beneficial Interest required
by Rule 5.6(a) of the Orphans Court Rules was served or mailed to
the following beneficiaries of the above-captioned Estate on
September 28, 2004.
Nancy L. Conrad Daughter
Justina E. McGovern Daughter
Donna L. Newhouse Daughter
Richard P. Umholtz Son
70 Runyon Road
Hummelstown, PA 17036
250 Meadow Drive
Haddonfield, NJ 08033
11 Argali Road
Mechanicsburg, PA 17055
17113 Shirley Street
Omaha, NE 68130
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except: NONE
Date: September 28, 2004
Andrew C. Sheely,
PA ID NO 62469
P.O. Box 95
127 S. Market Street
Mechanicsburg, PA 17055
717-697-7050
Counsel for Personal Representative,
Nancy L. Conrad, Executrix
Estate of Anna J. Umholtz
Name of Decedent: ~
Date of Death: 12/10/1995
_CERTIFICATION OF NOTICE UNDER RULE 5.61a)
Will No. 2004-00858
Admin. No. 21-04~0858
To the Register:
I certif7 that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 10/12/2004
:
Name Address
Mary R. Mowers
7 Burke Drive
PA 17257
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
no exceptions
Date: 10/18/2004
Capacity:
ig~ture
Name: Joel R. Zulli~qer
Address: 14 North Main Street, Suite 200
Chambersburq PA 17201
Telephone(264) - 6029
· X
Personal Representative
Counsel for Personal
Representative
Tel¢?t~one: (717) 097-7050
ANDREW C. SHEELY
AqWORNEY AT LAW
127 South Market Street
P.O Box 95
Meclnanic~t~urg, Permsylwmia 17055
F,~x: (717} 007 7005
November 24, 2004
Office of the Register of Wills
Glenda Farner-Strasbaugh, Register of Wills
Cumberland County Courthouse
Carlisle, PA 17103
RE: Estate of Anna J. Umholtz
Estate No. 21-04-0868
Date of Death: August 27,
2004
Dear Register of Wills:
I represent the Estate of Anna J. Umboltz. Enclosed is a
check made payable to "Register of Wills - Agent" in the amount of
$2,500.00, same constituting a prepayment on account of
Pennsylvania inheritance taxes in the above-captioned estate.
Your time and consideration in this matter is greatly
appreciated. Please forward a receipt of this payment to me as is
your standard custom.
ACS/bmk
Enclosure
c: Nancy L. Conrad,
Hand Delivered
Executrix
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128 0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 0O4666
SHEELY ANDREW C ESQ
PO BOX 95
MECHANICSBURG, PA 17055
fold
ESTATE INFORMATION: SSN: 162-07-8816
FILE NUMBER: 2104-0868
DECEDENT NAME: UMHOLTZ ANNA J
DATE OF PAYMENT: 11/24/2004
POSTMARK DATE: 11/24/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 08/27/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 :¢2,500.00
TOTAL AMOUNT PAID:
$2,500.00
REMARKS:
SEAL
CHECK# 1001
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~E', '-GC EX ,}.:lC
N,A,P b '
REV-1500
*' COMMONWEALTH OF
PENNSYLVANIA
'&Ili.. DEPARTMENT OF REVENUE
DEPT 280601
,. HARRISBURG, PA 17128-DE01
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 04
00868
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DECEDEiH'~; NAh,lE (LAST. FIRST, AND MIDD;~E INITIAL)
UMHOLTZ, ANNA J.
SOCIAL SECURITY NUMBER
162-07-8816
THIS RETURN MUST BE FILED iN DUPUCA.1E WITH lHE
REGISTER OF WILLS
DATE OF DEMH {MM-DD-YEAR) DATE OF BIRTH (MM-OD-YEAR)
08/27/04.. _.. I 02/27/1[1.
(IF AFP:Ji";A5,.,E': SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
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o [~ D,'cpjpnr Oierl Testate {AI1i'.ch CCpy' a' 'Nil::
o 9 ~i!'gg:icn Proceeds Received
D2.Supplel11entalReturn
o 4a. Future Interest Compromise ((iaw Of J;,~tl o'ler 12-12-(2)
o 7. Decedenl Maintained a Living Trust IAt:~r~ copy ~,TM[)
o 10. Spousal PoverlyCredit r:;":t1 r;fdr;l:r t,d\'If'n~ 12_31.91 a~d f.l-~~'i
o 3. Remainder R~t:.Jm c, ,j,,"'!, prim I" 12-1 ,->iil
o 5. Federal Esta:e T8x Rf~turn ,"<equ:rAd
B. Tot.i'lI Number ofS:"fp IIp;J(lStt 30xe,i
o 11. Eitictio:1to lit IJwlel Sec. G113(A)itt"vl,S~r"
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THIS SECTION MUST BE COMPLETEP, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAM~ COMPLETE MAILING ADDRESS
ANDRloW C SHEELY, ESQUIR~_.__ ANDREW C SHEELY, ATTORNEY AT LAW
FIRI,1NA'h",'"p""" 127 SOUTH MARKET STREET
ANDRloW C. SHEELY, ATTORNEY AT LAW PO BOX 95
(ECEPH('NeNUI~8ER- MECHANICSBURG, PA 17055
(717) 697.7050 .-
"
Rea::st::J!e I,S2heduleA)
(1)
(2)
(3)
(4)
(5)
115,900.00
:2 SI0C~:; 81\(j Bonds (Schedule B)
n
3 CICSr.,'1 ;--'p:d C::>r:\QmtiDf\, Parti"ll'\rsl"lip Of :;,ole-Proprietorship
r,10't'~3q;:.S P. ~0~PS Receivable (Schedule Dj
2,709 68
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Cesn :lank D8posits & Miscellaneous Personal Property
ISd1e.bl''=-)
6,097.24
(6)
6 JrJillr:" O\~":,ecl P~operty (Scnedule F)
O;f:!~<lr"le6:li:ngRequeS[ed
~f
01
..rr:'~
htef- /i\.'c:sl"m"fe.rs & Misce.ll,aneOlJ5 Nor,-Probate Property
(-ScheJ:;:'" C;nrU
(7)
124,706,92
10t<l1 Gross Assets (lata! L:nes 1-7)
(8)
10,00995
13,946.92
(11)
23,956,87
100,750 05
~j hj~,FH;;1 tjpenses &. Admir)istra(ive Costs Schedule H)
(9)
(10)
10 Det)!, ,~,i ::"',,'~edel1~. Morlgage Liabilities, & Liens (Schedule I)
11 Total Deductions (total Lines9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13 Ch"r:'3:Jls Jilt: Governmental Bequests/Sf,e 9113 Trusts for which 8fl election. to tax has I"\ot ae€1"\
rl1;.,dp. (Sr;hpd;:le J:
(13)
14 Net Value Subject to Tax (Une 12 m'lnus line 13)
(14) _______ .._"..."_100,~50,05... .
SEE INSTRUCTIONS ON F EVERSE SIDE FOR APPUCABLE RATES
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15. /\m;-;L:'I: if jrle 14 18xable at the spousal lax
r;:,\I:')[ ;Tc,nslerStmrier See 911'0 (a)(1.2)
x.D
(15) __~_______""
100,75005 x 0 45
(16)
._~,,'i3322.
1 ti An1l)~~lt (If Une 14 laxable at lineal rate
x.12
(17)
1? f\m,~t~ll "f !.i19 14 ~ax(lb;e at sibling mle
x 15
(18)
18. P\[~1~'L 11 d ~irle 14 taxable at colla(eral ral',
19 Tax rue
(19) ___"..____"_._..._~~~.;lJ5..
REQUESTING A REFUND OF AN OVERPAYMENT
2CO
CHECK HERE IF YOU AR
> > BI; SURE TO ANSWER ALL. QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
m~OONORTH HANQVEB5TREEIm ____
CITY CAR LlSU:
TSTATE~A ----
Tax Payments and Credits:
1. Tax Due (Pagp 1lill8 19)
2. Credits/PaymPlits
A. Spousal Poverty Credit
B. Phor PaynH'1ts
C. Discoul't
(1)
_ 2500JJO
_131.28
(2)
Total Credits (A + B + C )
3 !nteresVP8n8!~Y if <ltlpllCabl8
D. II~terest
E. Penalty
Total interesUPenalty ( 0 + E ) (3)
4. :f Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 line 20 to request a refund (4)
5 :f Lllie 1 + lln" 3 i:'l greater than Une 2. enter the difference. This IS the TAX DUE.
(5)
A. E.nter the jJ'lerest on tile tax due.
(5A)
(5B)
8, Enter the lc ta: of line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
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l ZIP
17013
4,533.~~~.
2,631:5'
1,9021 i
1,902:"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
2
Old decedent make a transfel and:
a retalll the use or income of the property transferred;..
" ~etalr the right to designale who shall use the property transferred or Its income:,
retal!l a reversionary Inten:!st; or.....
rl il"ceive the promise for lifE. of either payments, benefits or care? ..
:f death occurred after December 12, 1982, did decedent transfer property within one year of death
v'lithout receiving adequate c(Jrlsideration?.
D:d decedent own an "in trusl for" or payable upon death bank account or security at his or her death?..
D:cJ decedent own an IndivldL:al Retirement Account annuity, or other non-probate property which
(~I)I~tai:1s a beneficiary deslgnltion?
3
4
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.......0
....0
o
...........0
o
Yes
No
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IKI
IKI
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT M; PART OF THE RETURN.
Under pBnalties Df p?fiur". I GAclare that I have examined this rslur'l, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is tllJe correct
lnd [cm~l*
Declaration of pre parer Iyherth,m the personal representative is bissd on all information of which preparer has any knowledge
S!G~AT~~S;ONS~,FO~E;;L i-CX
ADDRESS Cd.f-
_[\Janey L Conrad, ExeeJrix, 70 Run 01\ Roacl,Hummelstown, PA 17036
SIGN RE OF PRE PARER ~ER TH E IVE
A 0 S5
Andrew C Sh"ely, Attorney, 127 S. Morke reet, P.O. Box 95, Mechaniesburg, PA 17055
O,ITE
Ma -eh :5 . 2005
DinE
March3.2005
For dales of death Cl or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net vaiue of transfers to orfor Ihe use of the sllrvlving :,;pcJuse is 3%
[72 PS, ~9i16 (.1) (' ,1) ';i))
For dates of death ';(1 or after January 1, 1995, file tax rate imposed on the net value of transfers to or for tile use of the surviving sDOuse is OJ'~ [it: PS, ~911b~ai (11)
The statute does ilC:U:smnill a transfer to a survlvin~ spouse from tax, and the statutory requirements for disclosure of assets and fliing a tax relu~n ,FE: s\I:1 appkabie eve::
the surviving SpOUSE is 11')8 only beneficiary
For dates of death 1::'1 or after Juiy 1 2000
The tax rate imposEd 011 1/18 ,'lei value of lransfers fre;.m a deceased child twenty-one years of age or younger at death to or for the use of a :'Ii' lural p(1~e'1t an adcplive par,n
or a stepparent Of the \~,-:ild is 0% [72 P,S, s9116(a)(t2)]
The tax frlte ,'Illpose i 1]'1 t'1€ :1e( vaiue of transfers to or for lhe use of tile decedent's lineal beneficiaries IS 4,5%, excep! as noted HI 72 PS, ~911GI12) P L F S 09: 161,1)(1);,
The tax rate :m,ODs!'d '):-i liw net value of trans1ers '0 or for the use of the decedent's siblings is 12% [72 P,S ~9116(a)(1.3)] A sibling is di,~:led u"d.-;r Sl3cFoil 9182 as ci
Indlvlduai who has 2,j :eas\ one parent in common with the decedent. whether by blood or adoption.
I:=JEV.15U?I:X+ (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
I>NNI>.T UMHOLTZ 21-04-0868
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
1901 CHATHAM DRIVE, CAMP HILL,
LOWER ALLEN TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA, 17011
(SEE ATTACHED SETTLEMENT SHEET)
115,900.00
115,900.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
\
,
I A:"'Seltlement Statement u.s. Department of Housing
""""
and Urban Development ,r
OMB No. 2502-0265
B. Tvoe of Loan
10 FHA 2.0 FmHA 3. 0 Cony. Voins 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number
4.0 VA 5.0 Cony. Ins. 34139 BIXLER 10603298
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "(p.D.C.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
D. NAME OF BORROWER: Steven K. Bixler
ADDRESS OF BORROWER: 710 Quaker Circle, ApI 2. Lewisberry, P A 17339
E. NAME OF SELLER: Anna J. Umholtz Estate
ADDRESS OF SELLER: c/o Andrew C. Sheely, 127 S. Market St., Mechanicsburg, PA 17055
F. NAME OF LENDER: M&T MORTGAGE CORPORATION
ADDRESS OF LENDER: 2270 Erin Court, Lancaster, PA 17604
G. PROPERTY 1901 Chatham Dr.
LOCATION: Camp Hill. PA 17011
H. SETTLEMENT AGENT: SHUMAKER WILLIAMS, P.c.
3425 SIMPSON FERRY ROAD, CAMP HILL, PA 17011
PLACE OF SETTLEMENT: 3425 SIMPSON FERRY ROAD, CAMP HILL, PA 17011
I. SETTI.EMENT DATE:
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
1 OO.GRf'l"-S AMOUNT DUE FROM BORROWER 400.GROSS AMO T DUE TO SELLER
101.C""-"t ooJ" nnce II < 000.00 401 '<01'0 "n" 115900;;"
IO"'.O~r""n"I""ro""erhl 401 .P~onnol --
I /l3.Settlem"nt ch"'T'yes to borrower (lin 140m , 4'2 <J 1403.
104. 404. -
105. 40<. ----
Ad;ustments for item" nairllw ",...n...r in advance A' ,t'" for item" ....<>jA b\l s..lI"'r in advan --
106.Cit,,/town taxe" to 406 Citv/t"'~ 'oxeo to _.~-_..-
tD7.Cn"n'" tax"s 12/6/2004'" 21'11'004 27.4 1407.Cnuntv to<eo I ?/</'004 tn 12/3112004 - _ 27.84
lO8.Assessments to 408.A"'::""ssments to
109.School Taxes 12/6/2004 tn 6/30/2005 '24.44 409. School Taxes 12/6/2004 tn 6/30/200 <2444
1 I Cl.'-:ewPf 12/6/2004 to 1 2/" /2olJ. -;:<6 4100,,,,.. 12/6/2004 to 121'1/2004 6.56
III Ren"e 12/6/2004 to 12/31120(\, 12.6< 41' >>pf"se 12/<11004 to 12/31/2004 ~
112. to 412 '0
120.GROSS AMOUNT DUE FROM BORROWER ~ 119,954.01 420.GROSS AMOUNT DUE TO SELLER ~ 116,471.50
200.AMOUNTS PAID BY OR IN BEHALF OF BORROWER SOD. REDUCTIONS IN AMOUNT DUE TO SELLER
20] .Denosit or earnest mone" 'MOM 501.Excess denosit {"ee instructions'
202.pnnf'i""<l1 <lmnunt of new Jnan{s\ -;-;;;-'0000 1<0' 0 t'l~ent ch'faeo to ,eHenline 140m -;;;~-;- ,.
203.Existino-loan{s' taken subiect to 501 Existino loan(~' t~ken subiect to .--
204. 504.Pavoff of first mortp"ap"e loan
50S.P~voff of second mortp"ap"e loan ------
205.
206.Princinal amount of seller financinp" 506.Princinal amount of seHer financinp" .-----
~---
207. 507.
208. 508. ---
209. 509. --
209a 509a
209b 509b
Adjustments for items unpaid by seller Adjustments for items unpaid by seller .-
21 , 'neo to 510.Cit,,/t^wn taxes to
211.Couotv tnes to I "11.Cn"ntu t"yes to
212.Assessments to 512. Assessments to
213. to 1<1' to ---
214. to 514. to -~~
215. >c 515. 'n
216. to 516. '0 -
217. tn 5P. '0 --
218. to 1<1'. to
219. to 519. to
220.TOTALAMOUNTS PAID ~ 120,377.00 520. TOTAL REDUCTIONS IN ~ 9,481.34
BY OR IN BEHALF OF BORROWER AMOUNT DUE SELLER
300.CASH AT SETTLEMENT FROMTO BORROWER 600. CASH AT SETILEMENT TO/FROM SELLER
301.Gross amount due from borrower (line 120) 119954.01 601.0ross amount due to seller lIine 420) 116 A7I.50
302.Less amounts naid bv/for borrower nine 220l 120377.00 602.Less reductions in amount due seller nine 520 9481.34
303.CASH 0 From IXI To BORROWER ~ 422.99 603.CASH IXITo o From SELLER ~ 106,990. I 6
, NOv-ll9-04 05: 22PM FROU-Palton Pi ctu '"S
717 795 8263
7-921 P.005/007 F-!48
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IF YOU HAVE ANY Ques nO S CONCERNING THIS REFUND,
PLEAse CALL us TOLL fRE_ AT '-800-523-5800.
T-921 P,006/007 F-848
MRP Health Care
Options.
~
E ,TATE OF ANNA J UMHOLTZ
CHATHAM DR
HILL PA 17011 5917
PAYEE: ESTATE OF ANNA J UMHOLTZ
INSURED
KEG ACCOUNT NUM
086 0220011861
CHECK AMOUNT
***********166.50
CHECK DESCRIPTION
YOUR ACCOUNT IS CANCELLED. THE REFUND CHECK BELOW
REPRESENTS MONTHLY PAYMENTS PAID BEYOND THE
CANCELLATION DATE.
!=arm T-258.7 Ptim.d in U S.;\.
PLE,o,SE DETACH CHECK BiLOW AND CASH PROM,."L."
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DEPARTMENT OF TRANSPORTATION
CERTIFICATE OF TITLE FOR A VEHICLE
983161551001014-001
80DYTYPE
DD'
SEAT CAP
"l2 BUICK
YEAR MAKE Of' VEHICLE
I OH I ~~~~:~,~!ll
PAIORTlTLriSTATE
I UNLADEN WEIGHT I GVWR
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03S~3"l1 0
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V!:'HICLE IDENTIFICATION NUMBER
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1<'10<'198
DATE PA TITLED
OAT~OFISSUE
GCWR
TITLE BRANDS
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ODOMETER STATUS
(l~ /l,CT\.JA~MILfI\Gj':
1 ~ MIU':AGE E:XCEEPS THE MECHANICAL
LI~rr~
2-;NOT'THEAtTUA~MILEAGE
3,. NOT THE ACTUAL M1!J'flGE.OQOMEn,R
TAMPERINGVERIFIEO'
4 ~ EXEMPT FROM ODOMETllfl DISCLOSURE
OWNERSHIP
WITH
RIGHTS
OF
SURVIVORSHIP
REGISTERED OWNEfI($)
FIRST LIEN FAVOR OF
SECOND LIEN FAYOFl OF;
_,TITLEBAAND$
A ~AN7IQlJr::VEHICLE
C ~ CLASSIC VEHICLE
o ~ COU.ECTIBlE VEHICLE
F ~OU"OFCOUNTAY
G ~ ORIGINAl.l Y MFGO. FOA Neill-OS
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X ~ ISlWAS ATAXI
J UMHOLTZ
CHATHAM DR
HILL PA 17011
IUDE LOCAL 5~2 015 4
\\ a setOmllelnr.older ls listed upon aalisfaclion of the first lien, the firs!
J;" f A q ~ ~ Il6I1holder must forward this Tille to the Bure<lu of Motor Vehicles Il/ilh It'>'il
- V ~..- aI)p'QpnatetOlmll.Miee
FIAST LIEN RELEASeD
DATE
BY-rfja~ ~ ,J~~ cj. ~NREL"SED
AUTHQRt2EO REPRESE Tl , I ~
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IUOS LOCAL 542 DIS 4
878 S RIVER RD
HALIFAX PA 11032
BY
AUTHOAIZEDR.EPRESENTATIVE
BRADLEY L
I cerlily as of lhe date at issue, tile <>f\\ci",ll&cords ot Ille Pennsylvania Oepartmarlt
of Transportation retlecrlhat theperaon(s) or company naml1dhllr 111n Is the lawJulOWr1l1r
oj tnesaic ~etIk;la.
FEB-23-05 02:37PM FROM-Pallon Piclures
717 795 8263
T-826 P.004/004 F-708
f4fl
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Stam Farm Mutual Automobile Insu.r.ance Co~y
one Slate Farm Dr
eoneortJvr7lePA 79339
6110 5570
94240-5-0
mirtOlTZ, ANNA J
1901 CHATHAM DR
CAMP HILL PA 17011-5917
AGENT
Al ROMERO
25 EAST MAIN STAEET
HUMMELSTOWN, PA 17036-1616
1".III...III"""II",",I.I.I,I.""III...III.....illllllll
(717)566-8209
DEe OB, 2004
RE: Policy Number:
Refund Amount:
622 7408-830-381
"'''87.92
The attached refund is a result of the termination of your policy.
If you have any questions, please contact your State Farm agent.
Policyholder SeNice
134-67i'S.1 Rev. 07-01-2002 (Olb0101bl
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- If.[) Stak! Farm Mutual Aldomobfte Insurance Company
- Concordville PA 19339
BANK OF AMERICA. NA
CUSTOMER CO/'lNIiCTION
A~'r.A DEKAL.B CN'N GA
5f-127Mll .
113926079P
.
378
POliCY NUMeeR 622740&630.381
OATE DEe 08, 2004
94240-5-0
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~ PAYTa"'E 6110 5 570
...~ """""OF UMHOLTZ, ANNA J
~~ 1901 CHATHAM DR
~ CAMP HIll PA 17011-5917
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$ .....87.92
-e:IGHlY-aeVEN ~D'UfOO lJOI..1.ARS....
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.REV""EX."""W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ANNA J. UMHOLTZ
SCHEDULE F
JOINTL Y.OWNED PROPERTY
FILE NUMB~l_. 04- 08 6 8
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
Nancy Conrad
70 Runyon Road
Hummelstown, PA 17036
Daughter
8.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY . %0' DATE OF DEATH
ITEM FOR JOINT MAOE Include name offinancial institutioo and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT deed for joinUy-held real estate VAlUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
09/14 / 0 PNC BANK
Checking Account #5140065466
Anna J. Umholtz! Nancy Conrad, Jt. Ten $4,503.78 50% $2,251.8~1
A. 2/01/0 PA Central Federal Credit Union
Account #37743-014
Anna J. Umholtz/Nancy Conrad, Jt. Ten $ 7,690.70 50% $3,845.l!,
TOTAL (Also enter on line 6, Recapitulation) $ 6,097.24
(If more spaoe is needed, insert additional sheets of the same size)
SEP~26-2004 23:57
PNCBRNK
412 768 3458
P.01/01
GPNCBAN<
September 27, 2004
Andrew Sheely
Attorney at Law
127 S Market St.
P 0 BOll 95
Mechanicsburg, PA 17055
R.E: Estate of Anna J Umholtz (Deceased)
SSN: 162-07-8816
DOD: 08-27-2004
scp
Dear Mr. Sheely:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account #5140065466 Established 09- 14-2000
ANNA J UMHOLTZ
NANCY CONRAD
DOD balance: $4,503. 78 Non interest bearing account
Please note that this office only provides date of death balances for deposit aCCOllllts
(IRAs, CDs, Checking and Savings accounts). We do not process any filllUlcial
tl'ansactioDll or provide statements. If you need assistance with lIny of these items,
please call1-888.PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
t,.J" ~ - -:1.
~
Erica L Schlegel
1-800-762-1775
P7-PFSC-04-F
500 Firs, Ave.
PitlSburahPA 15219
Member FDIC
TOTRL P.01
. -~."\., //
, ,/
"-~.."'-.
PA Central
MAIN - 959 East Park lJrlh;
Harrisburg, PA 17111
BRANCH - 25 West .J\bill {Hi" r
Shiremansrown, PA I7U 1 J
BRANCH - 5137 J()nt'~IO\\11 I ';ld
Harrlsburg, PA 17112
FEDERAL CREDIT UNION
www.pacenrralfcu.com
800.356.3875
FAX 717.564-1503
November 15, 2004
Andrew C. Sheely
Attorney At Law
127 South Market Street
P.O. Box 95
Mechanicsburg, P A 17055
RE: Estate of Anna J. Umholtz, deceased
Date of Death: 8/27/04
Account Number: 37743-014
Dear Mr. Sheely:
She had a share/savings account with P A Central Federal CTedit Union. The balance of
the account as of August 27, 2004 was $7,690.70. The account was opened February 1,
2003 and was in the name of Anna J. Umholtz and/or Nancy L. Conrad. The account was
closed on September 23, 2004.
If you have any further questions or concerns, please do not hesitate to contact me at 1-
800-356-3875, extension 120.
Sincerely,
Ivl~lt K ~)MJL
Michelle R. Houck
Member Products Specialist
REV-1~.;~1 EX+ \,2_9c,i) ,
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
21-04-0868
(If more space is needed, insert additional sheets of the same size)
AlilOllNT
1. $5,586.50
2. 250.00
3. 318.00
4. 190.00
C()MIv',(:~,,\'\lEALTH OF PENNSYLVANIA
IW-;[f~,TANCE TAX RETURN
F'\:::;:;;!DENT DECEDENT
ANNA J. UMHOLTZ
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A FUNERAL EXPENSES:
1
MUSSELMAN FUNERAL HOME
DONATION TO CHURCH WOMAN'S GROUP - FUNERAL SERVICES
STEPHENSON'S FLOWERS
NANCY CONRAD - MEAL/FOOD REIMBURSEMENT
B ADMINISTRATIVE COSTS:
1 Persanal Representative's Commissions
Name of Personal Representative(s) NANCY L. CONRAD, EXECUTRIX
Social Security Number(s)/EIN Number of Personal Representalive(s)
Street Address 70 RUNYAN ROAD
HUMMELSTOWN, PA 17036
City State ~Zip
Year(s) Commission Paid:
2 Attorney Fees ANDREW C. SHEELY, ESQUIRE, PER AGREEMENT
3 Family Exemption: (If decedent's address is not lhe same as claimant's, attach explanation)
Claimant
Street Address
City State ~Zip
Relationship of Claimant to Decedent
4 probate Fees CUMBERLAND COUNTY REGISTER OF WILLS
LEGAL ADVERTISING - CUMBERLAND COUNTY LAW JOURNAL
Accountant's Fees PATRIOT NEWS
5.
G Tax Return Preparer's Fees
,
7 !
!
FILING FEES FOR INHERITANCE TAX RETURNS
I
I
~ Reserves to conclude administration of Estate,
taxes, preparation/mailing, Accounting
and copy charges of necessary Fiduciary Returns
TOTAL (Also enter on line 9, Recapitulation) I
$ O. OC
$ 2525.0C
$ 263.0C
75.0('
187.4=
$ 15.00
$ 600.0C
.___~~,009,C;:'5
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-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Receipt Date:
Receipt Time:
Receipt No.:
9/23/2004
10:52:47
1037893
UMHOLTZ ANNA J
Estate File No. :
Paid By Remarks:
2004-00868
NANCY CONRAD
JA
________________________ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION FOR PROBA
EXTRA PAGES
SHORT CERTIFICATE
JCP FEE
Check# 4521
Total Received.........
235.00
9.00
9.00
10.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
$263.00
$263.00
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16, 1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Shannon D. BiIlhime, being duly sworn according to law, deposes and says:
That she is a Staff Accountant with The Patriot News Co., a corporation organized and existing under the
laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market
Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-
News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market
Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established
March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published
in their regular daily andlor Sunday/ Metro editions which appeared on the 5th, 12th and 19th day(s) of October
2004. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and
that all of the allegations of this statement as to the time, place and character of publication are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this
statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed
and adopted severally by the stockholders and board of directors of the said Company and subsequently duly
recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M",
Volume 14, Page 317.
PUBLICATION
COpy
Sworn to and subscribed before me
NOTARIAl SEAL
Terry l. Russell, Nol
M.mb,r I Pennsylvania A"Oell
Estate Notices .
ANDREW C. SHEELY
ATTORNEY AT LAW
127 SOUTH MARKET STREET
P.O. BOX 95
MECHANICSBURG, PA. 17055
EXlCUTRIX'S NOTICI _
Leiter. Te.farMntary on' the E.tate of
ANNA J. UMHOLTZ, late of tIM Town.hlp
of Low~ Atlen, Cumberland County, Penn.
sylvania. ho..... bHn granted to the under-
signed. All perlOM knowlne tlMm..lv.. to
bit Irn:t.bted to .ald E.tate will make pay.
ment Immediately and tl\o.e hovlll8 claim.
will present them for .ettlement to:
Nancy L. CfIIrad, aqcutrlx
C/O AndNW C. SIl..ly, .",ulre
127 hutll Market......t
'.0. lox"
Mechanlctbul'9, 'A 1700
(717)"'''-7OQ
Statement of Advertising Costs
To THE PATRIOT-NEWS CO.
For publishing the notice or publication attached
hereto on the above stated dates 187.45
Publisher's Receipt for Advertising Cost
The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
been duly paid.
By....................................................................
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013
October 22,2004
Cwnberland Law Journal is published every Friday by the Cwnberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cwnberland County and the legal newspaper for publication of legal notices.
TO:
Andrew C. Sheely, ESQUIRE
RE:
AnnaJ. Umholtz, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cwnberland Law Journal.
---------------------------------------------------------------------
---------------------------------------------------------------------
Advertisement inserted on follo~ng dates:
October 8, 15, 22, 2004
Advertising Cost
$ 75.00
Proof of Publication
$ 0.00
Second Proof Request
$ 0.00
Payment Received
$ 75.00
Total Amount Due
$
0.00
---------
---------
Payment received October 5. 2004
by Beckv H. MorgenthallExecutive Director
REV-1S12EX'p-9ij
~.
SCHEDULE)
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMm~WEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
21-04-0868
FILE NUMBER
ANNA J. UMHOLTZ
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
$ 195.38
100.00
43.32
53.18
196.96
243.30
274.43
40.78
63.60
1. State Farm Insurance (home owner's ins.)
2. Craig Sierak - lawn care
3. Health South
4. Verizon (8/27/04 - 12/6/04)
5. PPL (8/27/04 - 12/6/04)
6 .
(8/27/04 - 12/6/04)
PA AM Water
7. UGI (8/27/04 - 12/6/04)
8. Boyd E. Diller, Inc.. - trash
9. UGI/repairs to stove
10. John Baumgardner, misc. house repair to prepare homE for
final settlement (painting, trim repairs) 988.00
11. R.D. Strwser - plumbing repairs
110.00
12. Richard Umholtz - reimbursement for misc.
home improvements
154.77
13. State Farm Insurance
63.98
14. Comcast Cable - final bill
129.17
15. Mary Haring - large item trash removal
195.00
16. Holy Spirit Hospital
350.00
17. West Shore EMS
145.21
18. Metro Med Services
92.50
19.
Settlement charges associated
including commissions, taxes,
fees per Settlement Sheet)
with sale of real estcte,
sewer, refuse and rec< rding
9,481.34
20. Chuck Bricker commission on sale of personal property
310.50
21. Sudden Death Pest Control
715.50
TOTAL (Also enter on line 10, Recapitulation) $ 1 3 , 9 4 6 . 92
(If more space is needed, insert additional sheets of the same size)
NOV-09-04 05:22PM FROM-Patton Plcturl'
m 791 8m
T-921 P.OOI/OOT F-149
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~
~ CHUCK BRICKER AlICTIOIll SERVICES .HC 1p39
~. :,ae~~~g.~~RG. pA .7050 Duto 1&r..:t,d)i.:5k"="'/",,,,,,,
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.'1 'J
.' i.:.c:-;;:S:1/~,'i..d', ___.--.J $ 6;v...,,:~:- '.
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~. ':O'll.'ll.2HS': 500"'1:.:1851311' HdC(
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REV.'~13EX+(1-97)~.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RES!DENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
ANNA J. UMHOLTZ
FILE NUMBER21_0 4 -08 6 8
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
L TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1.
NANCY L. CONRAD Daughter 25 % of Rest,
70 Runyon Road Residue and
Hummelstown, P A 17036 Remainder
RICHARD p, UMHOLTZ Son 25 % of Rest,
17113 Shirley Street Residue and
Omaha, NE 68130 Remainder
DONNA L. NEWHOUSE Daughter 25 % of Rest,
11 Argali Road Residue and
Mechanicsburg, P A 17055 Remainder
JUSTINA E. MCGOVERN Daughter 25 % of Rest,
250 Meadow Drive Residue and
Haddonfield, NJ 08033 Remainder
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 addillonal sheets at the same size)
.-
..
J
LAST WILL AND TESTAMENT
OF
ANNA]. UMHOLTZ
I, ANNA]. UMHOLTZ, of 1901 Chatham Drive, Camp Hill,
(Township of Lower Allen), Cumberland County, Pennsylvania, make,
publish and declare this as and for my Last Will and Testament, hereby
revoking all other Wills and Codicils heretofore made by me.
EIRS't: 1 direct that all inheritance, estate, transfer, succession
and death taxes, as well as my just debts and funeral expenses, of any kind
whatsoever, 'Which may be payable by reason of my death, shall be paid
out of the principal of my estate as the same can conveniently be done.
~: r give, devise a.nd bequeath all the rest, residue
and remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, in equal shares, unto my
children, RICHARD P. UMHOLTZ, of Omaha, Nebraska, NANCY L
CONRAD, of Hummelstown, Pennsylvania, DONNA L. NEWHOUSE,
of Mechanicsburg, Pennsylvania, and ]USTINA E. MCGOVERN, of
Haddonfield, New Jersey, per stirpes.
Il:l.llU2: In addition to all powers granted to them by law and
by other provisions of this Will, I give the fiduciaries acting hereunder t.he
following powers, applicable to all property, exercisable without court
approval and effective until actual distribution of all property:
(A) To sell at public or private sale, or to lease, for any period
of time, any real or personal property and to give options for sales, ex-
changes or leases, for such prices and upon such terms (including credit,
with or without security) or conditions as are deemed proper. This
includes the power to give legally sufficient instruments for transfer of the
property and to receive the proceeds of any disposition.
(B) To partition, subdivide, or improve real estate and to
enter into agreements concerning the partition, subdivision, improvement,
zoning or management of real estate and to impose or extinguish restric-
tions on real estate.
(C) To compromise any claim or controversy and to abandon
any property which is of little or no value.
(D) To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without restriction to
invesunents authorized for Pennsylvania fiduciaries, as are deemed proper,
without regard to any principle of diversification, risk or productivity.
(E) To exercise any option, right or privilege granted in
insurance policies or in other investments.
(F) To exercise any election or privilege given by the Federal
and other tax laws, including, but not necessarily being limited to, personal
income, gift and estate or inheritance tax laws.
(G) To make distributions to my herein named beneficiaries
2
"
in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order to
pay debts, taxes, or estate or trust administration expenses, to protect or
improve any property held under my will, and for investment purposes.
(I) To select a mode of payment wlder any qualified retire-
ment plan (pension plan, profit sharing plan, employee stock ovvnership
plan, or any other type of qualified plan) to the extent provided for by the
plan or the law.
FOURTH: I nominate and appoint NANCY 1. CONRAD,
Executrix, of this, my Last Will and Testament. In the event of the death,
resignation or inability to serve for any reason whatsoever of NANCY 1.
CONRAD, I nominate and appoint DONNA 1. NEWHOUSE, Executrix,
of this my Last Will and Testament. I direct that my Executrix and her
successors shall not be required to post security or a bond for the
performance of her duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this q day of
October, 2002.
~ ~.~ (SEAL)
ANNA}. UMHOLTZ .
3
.~
Signed, sealed, published and declared by the above-named
Testatrix as and for her Last Will and Testament in our presence, who, at
her request, in her presence and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
I(L>J~/\~, (l....,jl.ll~.llill jkt.J ~
Address Name
//:2 N.30'f'lrs/.: I!I!-Inn/-;/!, fit 170/1 cJ!~!L..YJ. o...",)(j-
Address Name
4
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11.96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHEELY ANDREW C ESQ
PO BOX 95
MECHANICSBURG, PA 17055
-fold
ESTATE INFORMATION: SSN: 162-07-8816
FILE NUMBER: 2104-0868
DECEDENT NAME: UMHOLTZ ANNA J
DATE OF PAYMENT: 03/03/2005
POSTMARK DATE: 03/03/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/27/2004
NO. CD 005014
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,902.17
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1.902.17
REMARKS:
CHECK# 29
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
BUREAU OF INDIVIDUAI':TA1lES~::
INtERITANCE TAX DIVISIDH'-- 'J',
PO BQX 280601
HARRISBURG PA 171Z8-0601
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
2'1il' W\V ryO P/''''II.2: t.2
\;;.,!j fI,-.f L __. f
CI rr!/ ~.C-
,__t.Pf\ \."jj
~:~R~W M~i'~~~;~JfYRT
PO BOX 95
MECHANICSBURG PA 17055
05-16-2005
UMHOLTZ
08-27-2004
21 04-0868
CUMBERLAND
101
A.aunt R...i tted
*
REV-1547 EX AFP (03-05)
ANNA
J
(91
1101
I CHANGED
III
(21
(31
(<II
(51
(61
(7)
115,900.00
.00
.00
.00
2.709.68
6.097.24
.00
(81
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WIllS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
Ur-"i!I:,.yt.\W.'l"1f!~1.'mI'tm.W.IWl!A\"t'4MM.m.l'll\fllTftM!m'~.YC[W4MM.1IW'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF UMHOLTZ ANNA J FILE NO. 21 04-0868 ACN 101 DATE 05-16-2005
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect ~igures that include the tatal ~ ALL returns assessed to date.
ASSESSMENT OF TAX:
1.5. Mount of Line 11ft .t Spousal. rate (15)
16. A~nt 01 Line 14 tBx~lB .t Lineal/Class A rat. (16)
17. Amount of Lin. 1<1 et Sibling ....t. 117l
18. A~unt of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
TAX RETURN WAS: (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partne~ship Interest (Schedule Cl
4. Mortgages/Notes Receivable (Schedule Dl
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedul. FI
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral ExPenses/Adm. Costs/Misc. ExPenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts
14. Net Value of Estate Subject to Tax
NOTE:
10,009.95
13.946.92
(111
1121
(131
11<11
(Schedul. .II
.00
100,750.05
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
NOTE; To insure proper
credit to your account,
submit the upper portion
of this for. with your
tax paynent.
124,706.92
?~ Qli6 R7
100,750.05
.00
100,750.05
1191=
.00
4,533.75
.00
.00
4,533.75
'PAY CR T'"
f ,., AHlMIT PAID
DATE IIUNBER INTEREST/PEN PAID (-I
11-24-2004 CD004666 131. 58 2,500.00
03-03-2005 CD005014 .00 1,902.17
TOTAL TAX CREDIT 4,533.75
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. I
.. ~
o .
..
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Umholtz, Anna J.
Date of Death:
August 27, 2004
Estate No.:
21-04-0868
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 B.C No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. lfthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes ~J No.l]l
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 IX! No 0
Date:
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Cl of the Orphans' Court and may be
attached to this report. Q.
6. 2005 .
June
Andrew C. Sheely, Esquire
Name
127 S. Market St.,
Mechanicsburg, PA
Address
P.O. Box 95
17055
717-697-7050
c ;
Telephone No.
Capacity: 0 Personal Representative
1!J Counsel for personal representative
vc1