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HomeMy WebLinkAbout95-0055~ ~ .gti~CAS'~ This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. AUG 16 200T Date H705.1~3 R». R/$7 TYPElr1ENT R/ PERMANENT BLAd(EM( ~!~ f i ? • ~--- Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLININIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH i09Q11 NAME OF NT (FYr. MiCde. La) ~ SE% SOCIAL SECURffY NUMBER DATE OF OERN (Hawn. Daµ'Arr) rna/•1 ,, Y M. ZFemale , 186 - 05 - 1391 aNovember 22, 1994 ADEILar eYllWaA uNOBtIrERI uNDERIDw DREOFtERTN BIRT/IPtncE (CayaAC RACE OF DEATNICM mwdy awr-xaairmucwrear am wN Mar" : °"° HaA t MYrrMa IMCNn.Daµlbr) Johns`~own~" y 81 yr Feb 13 ,1913 a PA T. - ~-r ~~ ^ • ^ oat ^ ~ ^ RrMrpe LJ I ^ COUNTY OF DEQII CRY,SORD. TNT OF GERM FACEJTY NAME PInPI irNe,lion. qve want arrC rwniEer:r NNS DECEDEM OF HISPMNIC ORKiNi7 RAGE-ArMkrrlnrrr, BYCY, NTile. alG w L9 ». ^ n,e., aPae•ycar.rr, (SPen,N Cumberland Lower Allea Twp. 824 Lisburn Road ~•.~b~.«•. White DECEDENT'S USUAL OCCIlPR10N IDNDDF BUSEESS/MDUSTRY a NN9 DECEDENT EVERW DECEDENT'S EDI/C/BpN NARtTAL STRUS-Manr 1 Sl1RVNEq SPOUSE Icm.landawaeaon. mrt r Ne d l d tl ~"` u.S.ARMEOFORC)=97 ~ G NaYwMartM0,1NNPw4 awaeyw.mrrnrr.I ; e m uw r re .l Homem pca er Own Home rI J ~•^ N• E""" m,~y Dl~vroM n`+«¢, Widowec~~ None la 7tR 17. 17. 74 /L OECEDENTSMALEIO ADOpE58 (StreaL CiryTTwm, Stela. ZTCPMI DECEDENT'S ennsy V$a a ]h Ower 9n 17e Ya MN th Str Ca d e E O 824 Lisburn Rd. ~_ a . , ce ar r b RESbEix;E + 1a Camp Hill, PA 17011 cndnr~.dale~ tTw Cumberland ~^•nal na^rwMn`~a,rrl""0ud agwaro. `AT"~or"~man ~a°°"y'L"" MorbE>9'Swad~Fi»mLnMa .M.~drrsarrrn.I to tE. ~~eo'rge offman ~lBiomas ~ neG~teo'f an~cs~urg, PA 17055 METIIDOOf DISP'OSTTIDN ~J ^ DRE OF pSPOSfIbN ("'°'" RACE OF 0ISPOSTTION-Nar dCemrary, Crwrramry ' ` P LOCRI011-CN,Jben,Swe, RSpCab R•~"«n~• ~^ ~wirrrroe ^ 1~$Villtltber 26, 1994 X4 1 - C~Lite Schaefferstown, PA tta t/0. R7a 0. 8E3NiQURE OF SER LICENSEE OR PERSON AS SUCH NAMEAND AODRESSOF ~ ~2-L X37 E. Main St . , Mechanicsburg, PA 17055 a zm CanpNb Malts ady w/r oerryirp Ear al my bpwMAW bYn occvrredrm.IX11e. Nb and Plan rated. LICENSE NUMBER ORE SIIiNEO pM.ld.nrrv.»rNarxm.aarnb carry errreaadL aroTwl lMarr.Dw. Ye.n 77a 7». t7e. Ear SORE rrrl M PemPlaled try OF DEATH DRE LACED DEAD (MpM. Day, lbs) NNS CASE REFER RED TO MEDICAL EIUMMIERICORONERT paraal elraPrrbrawaaa Corn. ~[ /~ ' ~~ Y» ^ Ne~ 21. I M. 73. OY M n.PNNT 1: Erar db diaeeaea, YrNabea CtlmpllcrprN nii irnueCEbaatn. oo nol anarlM nn4dCykq,wM»ardac «r»pwalaryamal. MOelca Mrt laNwe. ~App,minW P11RT E: Olnaf " arVillunl LarSllartperrurrpbdaaN, rE Lir ory erb earw rn earA aa. IiMYal aalvnen nar.rrtlErtlr undNl/arEeaaretlnwrn PARTI. l iaMr arrdear ESMEDMTE CAUSE 1Fwl 1 / ~ A ~~// ~ti ~ ~ , / ~ ltc~rW ~V~ i nFirgndeaer~~ a. ~O U. DUE TO IDR OUENLE EepwraayYaarima D Eery, NaOhq binarbAaN err. EMrUMDERLYMD DUE 70 (OR A OIIE ; CAUSEpirraryay ' c ~ I aIN rOialaC »erb rmaYq n darnl LAST DUE Tp( ACONSEOVENCE OF}. ~ a NMSAN AUTOPSY PERFORNED7 YIERE AUTOPSY PMJOINGS A1aEABlE P1110R TO MANNER OF DERH DATE OFINAIRY TNAE OF WURY IWURY R'NOgKl pESCR1EElpP/IWURY OCCURRED. COMPLETgN aF CAUSE aF DERMT ,a5 Naval ~I H i iC ^ (MCnm. DeY~yea~ an c e ^ YOe ^ No ^ Attrere PsnCarp Nvseyrption ^ rn 'Ab ^ NP W Y» ^ No ^ Surka ^ CaYd nal lr CNNmineC ^ PIACE OF NLIUiiY. AI Mme. Mrm. Kraal. Ixlay, oEke M ~ LOCATION (9reeL Cily/fiwn. Slerol twilbq, Ne. (Spx+lYl 2b. M. ]Ea. 7E1. COITM9ER ICnaea wy arol •C6RE%Bq PNrsE7AN (Pnyscon ardyvg cauy d Ceatn when rgprr pnyaclyl n» announced Ceam arq canglNeC rcem 23) SIGNRt1R OTRt.E OF CE FIER ~~ A TelM beet Mrey lrnwaNdpe, aeatn occurred CUeb dra eaweNfl and rrrrrara etaud ..................................................... ^ I ' ~/ rT 710. ~ 1 ~/ LW 'PRONOUMCiNO AND CERTIFYHJD PHYSICIAN IPn Y~,an Cod, aa+arrKaq deem arts Certil,wnP ro raua d Ceaml LICENSE R/~(,~. DRE $M,NED (Mats. Marl ! ~ ~ ~l TO tM ant M my IrrrwrladEe, C»tlr oceurrW M tM Br. Cab. arts phee. and Cw b the eaufe(e) erW marunr» alale4 ......................... V I 71C. II/ v 714 ' NAME Alb ADDRESS a PERSON WHO COMPLETED CAU 'MEDICAL E7UMINER/CORONER On UIe trb M eaamMetion and/or invests anon, in m opbion, dern CceurreC at tM Time, Cetq and place, and d a to the uueMal snd 9 Y u (It ITT Typap Print , ~ ~~-~ ~ 1~ ~ ~ ^ manmr as n•td .................................................................................................. 7L ~~ t L CCC ~ ? . ~ r Z 'C ' REGISTRAR'SSIGNRURE AND NUMBR DATE FI LED(Mma. y. Yeael L ,r ,~,~,~ 77. ` / u ~~, . _ ._ _ !~' PI+~TITI®N r~~I~ PROLATE ~>~a GId~NT of I.ETTEPt~ Es:a„~ of __ *dorma M. Hoffman lYo. ~L2~~'-' ~~~ -~-~~ also ~?cnox~.r as t _ r~- To: Register of Wilis for the _ Deceased. County cf t'u;rtinerlal3d in the ~ Social Security No. ~ R ~ - 0 5 - ~ 3 91 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your pe:itioner(s), who is/are 18 years of age or older an the execut ors named in the last w?ll of the above decedent, dated December 21 , 19.x_ an:l c0[!scil(s) dated ~nP ~„4T.~~;;,~e;:s~¢ rhP pqt-prp w~.ll zoma tin the c~~~odv andsonrr~l of the __;,_~~7~ co_j~E;, .~1 r~nrpnpnrari~.p - ~%kk.~'t t?~t_r_,_1-0~ ~t€c.m..re~~ ocl-Jos. .~ 4r 1 `y 9'~ -- (state relevant circumstances, e.g. renunciation, death of executor, acJ Decendeni was domiciled at death in _ Cumberland County, Pennsylvania, with h._ er last family orprincipal residence at 824 Lisburn Road, Camp Hill. PA. 17011,. Lower Allen Township {fist street, number and muncipafiry) Decendent, then 81 years of age, died November 22 , 14 94 , at_ B24 Is_sburn Road Camp Hill PA 17011 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted <^.fter execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: no exceptions Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 2 , 5 0 0 . 0 0 (If not domiciled in Pa.) Personal property in Pennsylvania $ ~ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 5 7 , 0 0 0 . 0 0 situated as follows: ~ et County, PF, - Dee Boo , Page an acres situate in Lincoln Township, Somerset County. PA - Deed Book 488, Page 471. WHEREI=ORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented hers:with and the grant of letters testamentary (testamentary; administration e.t.a.; administration d.b.n.c.t.a.) theron. u 1 ~~ _~ C" ° w6~ ~ 1 1 T v ~ Geor e W. Hof an J Mechanics urg, PA 17055 >>?-~J~~44aN x ~ ~~~c~ ~ 19 Teton Drive ___ _ _~;- W!4h~- Fredericksburg, VA 22408 7~3-~tiS-xsU7 (,,. _ ° _S:r3.'C.tt 1 Ann 'RPam i Z 1 ~' -_--- ®ATI~ of PEIZ~ONAY, REPRESENTATIVE ~~ C~~r~l~"~3W~~LTH ®F P~igTNSYI,~At~IA.~ 1 ~s t Ct~'~tJA~'T4' (,~ CUMBERLAND J~ "I'he petitio:ner(s}'~bove-named swear(s) or affirm(s) that tho statements in the foregoing petition are ~~ true end correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- :.. _.~ tative(s} of the above decedent petitioner(s) will well and ruly administer th es ,according to law. Sworn to or affir and subscribed- ~ ~ bpforc nee ~h ~ ~~N d of Geor a W. HQ f _Jr. ~' ~I ~1~1 0 5 ~ ~ti °~~?-, ~ , ~~y- ~ Carol Ann Hoff~~ now ; ~: !iiA~r'.~ L. 1_EI~IS Register ~ E~ Carol Ann Beemiller k i - ,~' _ ~: ~~ ~ i r..,.u.' •, .'. ~ w . ,n`~'IY. 1:. • •Rr.+T°n _~1I. - - _ ~.rXj.i.~C• -M+~+~wt A! t - - .. .. ~~___.. id`. _. \ ~\ ~®0 21 - g5 - 55 ~.S~~~w ET~;i Norma M. Hoffman , ~£C~~S~d IFI, • ,M F..'',tt; ~ ~.,~; ~~ ~;AIVUARY 23, lg 95 , in consideration of the petition on ti,e rCVC_Su sid, ercof, satisfactory proof having beer_ presented before me, iT IS I~1~C~Er''~ that the instrument{s) dated DECEMBER ?1 , 1968 described ;her°in bw adrrtitted to grob2te and filed of record as the last vrill of ~iorma M. Hoffman an(i I,et2ers _ '1•~ ~~a~PeT' ary r:rel-~erec~. ~rzrtedto~George 1;•d. ixoffmanr Jr. , and Carol Ann Hoffman, noY~; Car%1 A:nn Beemiller PEES Probate, Letters, Etc.......... $ 115.00 Short Ccrtificates(~ .......... $ 9.00 Renunciation .....••••••••••• $ 3.00 X-Page $ JCP TOTAL _ $ Filed .... ~~.P~J.AI~`~..?i.>..1995 .......... . _ ` ~- c~ ~._ ~ ~ Lil _ { J - ~ - ~: ~ `~ ~ _.1> ci ~~ :3 U C ~ -'~ '~ ~ C7 Q_ ~ - (Ij ' r~r -~ " F,.k .-r .. ~ ~,~ Register of Wills MARY C. LEWIS Robert I. Boose, II # 3528 ATTORNEY (Sup. Ct. I.D. No.) P. O. Box 344 Somerset, PA 15501 ADDRESS (814) 443-3844 PHONE 'laiiecf l~~~ters and order to attorney on 1-23-95. t: pr ..^m a- aR .,.:e a • c + 's'i2'~•".'£'^ .:ffi!5a"7,^**"'.+»'1'~yys'J'~~ y -. .. __. a .. ,, W+-,""- `l ~' .?ni ,i~<; . ~`'i Z 1- 9 5- 5 5 ~~CI~T~~~ ®~' WI~.I.S OF a~0~,J1`1'I'Y O~'~~I OF ~~J~SC~IBIAIG WIT1~dESS codicil (each) a subscribing v~,tness~t~the will presented herewith law, depos:{s) and sayl;s) that - ~ the testat~ ,sign the same and that`• reouest of tcsta+ in li__ pr nee other subscribing witness(es)). Sworn to or affirmed ~ subscribed before me this ~%/ day of ~__ 19 i ~ Register signed as a witness at the the presence of each other) (in the presence of the (Name) (Name) (Address) I~EGIS7fEI~ OF WALLS OF ~.~~,„.>0~~14>^~t COZJir1TY O~'i'H OF ie10I~1-S'iI~SCRI~ING WI'TNE,.~S ~~ L.. _ 11'1 i ~(e4 c1,..~ ~-w~ ~J _ M i ~~~~' , (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and :say(s) that ~.v~~ familiar with the signature of No"'emu !U' )~~f~~ , codicil festal r' L~ of (on.e of the subscribing witnesses to) the will presented herewith and codicil . that ~ ei< believes the signature on the will is in the handwriting of No,•M~ ~~. z~~ to the best of ~ ~ ~ knowledge and belief. ~ ~ ~ /~~ ~ ~" ''' /,,~v`ti ./. ./G Sevorn to or affirmed and subscribed before ~1 i- ~ ~ ~ 1- ~ K me this 2~TH day of (Name) ,?ANIIARJ' ~, ~ .ro 95 ~. ~ t7 ~j. Sati.,,~rct' ~4 /s37~1 Y C . L E'~d 15 ~ Register 0.ri a. ~ l~ t l l < r (Name) ~sD ~ I Sv~~r ~ ~~+ /~3?~ ) (Adds mss) ~»., '^.+'M:`tt' 't` W ~. ~ ~~'S"' rw..^,""'~r«,.'C..,~L7VL'45,~`1J" ~.*,.., f. :n r~'X'3'?c',~'~' ~;'b ~. .. ~ • being duly qualified according to present and saw i ~_ ~, - i;'< ''< ;~. .t, r' ,~:;~ t ~" r;, '~' f .} e +Y~.r?57~~~._ i ,ti ~, . , k.. a ,w: ~' ~~; x•a i s Y• 1, ~' ,~ "' ~. 'ti - ~. .. b~ - ra." _. Y, !' ~t. i'~ f t' . ~~ i s' . . f ?= ,~r ~"~ f c ,j ,:~ c 9 .~ 1~{{ .l ,- 6 -< j a :. ~~ ~ -~~re4 "'~'°' 3 5 LAST WILL AND TESTAMENT , I, NORMA M. HOFFMAN, of the Village of Sipesville, Lincoln Township, ISomers?t County, Pennsylvania, decle.re this to be my Last Will and revoke any I~IWill previously made by me. i ITEM I: I direct my Executor to cause to be paid as soon as convenient after my death all of my dust debts, the costs of administration of my estate, and the expense of my funeral. ~ ITEM II: I devise and bequeath all. of my estate, real, personal and '.mixed, and wheresoever situate to my husband, GEORGE W. HOFFMAN. ITEM III: Should my husband, George W. Hoffman, predecease me, then I !idevise and bequeath all of my estate, real, personal and mixed, and wheresoever situate, as follows: A. One-half (1/2) thereof to my son, GEORGE W. HOFF'dAN, JR., if he is then living; and should my son, George W. Hoffman, Jr., not then be living, to his issue in equal shares. Should my son, George W. Hoffman, Jr., predecease me without issue, then this share of my estate shall be distributed as part of the share given in clause B of this Item III. B. One-half (1/2) thereof to my daughter, CAROL ANN HOFFMAN, if she is then living; and should my daughter, Carol Ann Hoffman, not then be living, to her issue in equal shares. Should my daughter, Carol Ann Hoffman, predecease me without issue, then this share of my estate shall be distributed as part of th.e share given in clause A of this It~n III. I T_TEM IV: I nominate, constitute and appoint my husband, GEORGE W. F 'HOFFMAN, Executor of this mq Laet Will. Should my husband, George W. Hoffman, fail to qualify or cease to act as Executor, I appoint mq aoa, GEORGE W. HOFFM '~IJP.., and my daughter, CAROL ANN HOFFMAN, or the survivor of them, Executor ;i hereof. I ~~ 1 of 2 d _ •_ 8- i~ ~` / :' I..':. _ ,.~, -~.,. :~' Y ~ , 7~ st ~ r~_ _ _ ,_ ' IN WITNESS WHEREOF, I have hereunto set my hated and sesi this 21st day i; `~of December, 1968. !'`~}) ~ y L~ ~9l ~ ~ t-C~I~CSEAL) Norma M. Hof ~n j Signed, sealed, published and declared by Norma M. Hoffman, the testator (therein named, as and for her Last Hill in the presence of us, *aho, at her request, :in her presence, and in the presence of each other have subscribed our names as ~tidtnesses hereto. ~~ ~i r ~~ ~; Address : ~ ~ (p(,~(~. Address : ~ ..2 ,li /~--! 7<-?„~°'~T.~~-~ ~ . ~1r~~'ytLzy-l ~ !/ ~f . -- Foie neG RECEIVED FROM: H!?i3SE 6~UkIERT I II E£+Q 168 E~,ST t.xi+J I t3N ST P Q HC?X ~~+4 S®1RS~3~3ET PA 15301 ESTATE INFORMATION: i FILE NUMBER S 1-1993-OOg3 SSf~ 1 t36-03-1391 NAME OF DECEDEN' OAST) (FIRST) (MI) H®E~t+!-?td fdCAFiptA M e DATE OF PAYMENT ~ POSTMARK DATE -- - CGUNTY CUP4HERL.i~Pltd DATE OF DEATH 1 ~ ,~~,~~ T REl~AARKS IaECtr?E3E ~. !-IDt=FP3AN,JR. SEAL ~y~CKdfi 1'511%3 ACN ~ A55ESSMENT CONTROL ~ AMOUNT NUMBER 4 1 * } EOID MERE - TOTAL AMOUNT PAID ~~°~ a ®59. S0 RECEIVED 8Y~1 C..r, L g NA URE REf:tSsER OF 1WILLS ~IS~R GILLS ---- - - ~- - _. .. .. ... -....,...-;,.~~-. ..:- .,.: ... ... ..,.. .~ :~'--:..a.T"-+Ana'C~Y+~^'t^^~.~---^,.ee...-.:._ _.,~. _ +~+-.~-~,.^r.,a.e.,- .:Y , . , tip. 'A . ,,}, ~ i, RED- 1500 EX+(7-94) ~ ~ ~ ~ ~ Q V /!~ - /J -,,~ INHERITANCE T AX RETURN COMMONWEALTH hF PEtJNSYLVAN RESIDENT DECEDENT fA DEPARTMENT )F REVENUE (TO BE FILED IN DUPLICATE ` HARRISBURG? A17128-0601 WITH REGISTER OF WILLS) DECEDENT'S NAM F (LAST, FIRST, AND MIDDLE INITIAL) D OFFMAN, PIORMA M. E D E N T A P P C 0 H R E P C R K I A T E C P 0 O R N R D E E S N - T R E C A P I T U L A T I O N SOCIAL SECURITY fJUMBER 186-05-1391 fIF APPLICABLE) SURVIVING! `LAST, FIRSTAND MIDDLE IN ®1. Original Return ^ 4. Limited Estate ® 6. Decedent Died Testate (Attach copy of Will) DATE OF DEATH DATE OF BIRTH 11 22 94 02 13 13 county SE'S NAME SOCIAL SECURITY NUMBER -~_ - - ^ 2. Supplemental Return CUMBERLAND 17011 AMOUNT RECEIVED (SEE INSTRUCTIONS) ^ 4a. Future Interest Compromise (for dates of death after 12-12-82) ® 7. Decedent Maintained a Living Trust (Attach a copy of Trust) NAME OBERT I. BOOSE II TELEPHONE 814 -443-3844 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Neld Stock/Partnership Interest (Schedule C) 4. Mortgages and Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (Schedule L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) 10. Debts, 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 Bequests (Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) 15. pOUSaI Trdnsfr?rc lrnr r1°rn~ ..r ,r,.-.~ _.._ _ _ __ ^ 3. Remainder Return (for dates of death prior to 12-13, 82) ® 5. Federal Estate Tax Return Required 1 . 8. Total Number of Safe Deposit Boxes COMPLETE MAILING ADDRESS DOSE & YOUNG P. C, •O. BOX 344 OMER, PA 15501 ~s~~1y1~ ~lR;?.k`.,~7!~11r~t~ ik7'1~1(~?~2': a :~ ~„' ~iliFl.~rg h ::::::.::.::..::::..:! ~G~I~Gh3trR~°'j::a i9. ~!K1iiSi~l•'ii:;t!iii.H~lilir+.ESE;ilili~l•ilsiiiii~~j~~l;ii'ilililli:a::;..::i;;rs!j'':•r. atY .•;..:..•,• :.....:............::............l...; .....,.1::':.....: :,:ls..::1:;. ; . ;{sts~ll;r':s;l:.l~ill II :pl!!Cf~?~~~'.N€C~Dit~S`iC[~11?I~piliiii'•.iii•:!€i':i`i'€iijii:•jj?ii';;iiii`i~;' ..:. . .::.:..:..:.::.::....................... ..:....::.::.::: FILE NUMBER - "~ I 95 -vc~55 COUNTY CODE YEAR NIIMRFO utceDENT'S COMPLETE ADDRESS 24 LISBURN ROAD AMP HILL, PA (1) ~' 58 uu. (3) (4) - (5 12 560. (6) C/) ~'~ 558, 829. (9)% 12 , 5 4 6 i ~ J~v (1t) 1, 774 /2~ ~ I ~ ,f~ (8) 629 , 889 . (11) 14,320. (12) 615 , 569 . (13) (14) 615 , 569 (Include values from schedule K or S hedule M jge 2~ t t~f x ' - c - 18. Amount of line 14 taxable at 6% rate J (Include values from Schedule K or Schedule M.) (18) 615 , 5 6 9 . x T 3 6 , 9 3 4 . A 17. Amount of line 14 taxable at 15% rat e X (Include values from Schedule K or Schedule M.) (17) x .15 0 18. Principal tax due (Add tax from Lines 15, 16 and 17 ) . M 19• Credits Spousal Poverty Credit Prior Payments P Discount (1 B) 3 6 , 9 3 4 . Interest U + 35,859.+ 1,887.- A 20. If line 19 is greater than tine 18, enter th ce on lin 20 Thi (19) 3 ~ . 7 4 6 e . s is the OVERPAYMENT. T `?~~ ® G)ieck€Ft~irS~I~ ::::::::.::.:::::::E::;:::::;:,:,::::::...:::::::;:::i:,::::•:: © fYttu ere;r:.equestln a re(utltii!` ~~ur~ t~trt3rp~ mend' 20 ( ) 812 . N 21. If line 18 is greater than line 19, enter the difference on line 21 This is the TAX DU . E. A. Enter the interest on the balance due on line 21A (21) . B. Enter the total of line 21 and 21A on ~irle ?1 S. This is the BALANCE DUE (21A) . Make Check Pay3_ble «_~; Register of Wills, Agent (21 B) -+ ~ BE SURE TO ANS,1~Ei~ ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH E- Under penalties of perjury, I declare that ~ i,a~r ev i , am t- ned th+s return, Includln acco correct and complete. I declare t ha! all real estalc has been reposed at true market value. Declaration of preparer g mpanying schedules and statements, and to the best of my knowledge and belle( which preparer has any knowl~ nge. It h true th o er than the personal r SIGNATURE OF PERSONretir>nNSiRLEyORri.;;vGRET epresentative Is ba , , sed on all Irtormatlon of URN ADDRES~•. _ ~I a ~ -- /-~r ; /•-' ~ ~• .. ~ ~~ / ~~: Lr i) ~~ ( ~ / 'Z "'-~C 1 DATE . . ~ SIG RE OF RF _s i' . ~i!'~~;! i tr:~: ~ O1H' HANREPRES TATIVE ADDRESS .~ / ~ _ '~I'/ ~~~~ 219 W, MAIN ST., SOMERSET, PA Copyright Creative Microsystems Inc., Washington, D. C., 1995 15501 DATE _~7~ -~ Act Ac48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: • 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 • 2°'0 (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 19'0 (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS. 1. Did decedent make a transfer and: a. retain the use or income of the property transferred . , b. retain the right to designate who shall use the property transferred or its income . C. retain a reversionary interest or . d. receive the promise for life of either payments, benefits or care? , 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? 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' bank account at his or her death? . . IF ANSWER TO ANY OF THE A80VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Copyright Creative Microsystems Inc., Washington, D. C., 1995 REV- 1F,02 EX+(12-85) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A RESIDENTDECEDEN7 REAL ESTATE ESTATE OF NORMA M. HOFFMAN FILE NUMBER (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estat shou d be reported at fair market value which is defined as the price at which property would be exchanged between a willing buy and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ITEM NO. DESCRIPTION VALUE AT DATE 119.79 ACRES SITUATE IN SOMERSET TOWNSHIP SOMERSET COUNTY OF DEATH ENNSYLVANIA DEED BOOK VOLUME 511, PAGE 350. VALUE PER PPRAISAL OF 7 29 94, 50 000 2 .42 ACRES SITUATE IN LINCOLN TOWNSHIP SOMERSET COUNTY ENNSYLVANIA DEED BOOK VOLUME 488 PAGE 471. VALUE PER ALES AGREEMENT. 8,500 TOTAL (Also enter on line 1, Recapitulation) $ (Ii more space is needed, insert additional sheets of same size.) 5 8 r 5 00 Copyright Creative Microsystems Inc., Washington, D. C., 1995 REV- 15!!3 EX+(4-118) ~:.OMMONWEALTH OF PENNSYLVANIA SCHEDULE B INHERITANCE TAX RETURN RESIDENTDECEDENT STOCKS AND BONDS FSTeTG nc NORMA M. HOFFMAN FILE NUMBER 1995-00055 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM N0. DESCRIPTION VALUE AT DATE ONE OF DEATH TOTAL (Also enter on line (If more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washington, D.C., 1995 REV- 15t?7 EX+(7_ggl ~IIDMMDNWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NORMA M. HOFFMAN SCHEDULE D MORTGAGES AND NOTES RFrl=tveRt ~ Please Print or Type FILE NUMBER AAR-nnn~~ (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM N0. DESCRIPTION ONE TOTAL (Also enter on line (If more space is needed, insert additional sheets of same size.) Copyright Creative Mlerosystems Inc., Washington, D. C., 1995 VALUE AT DATE OF DEATH itulation REV-15,08 EX+(p_87) • COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPER DL... n_ ESTATE OF TY NORMA M. HOFFMAN (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM NO. DESCRIPTION 1 NECKING ACCOUNT - FARMERS TRUST COMPANY CCOUNT # 0011-22762 2 ASH REFUND FROM THE WOODS RETIREMENT HOME 31991 BUICK CENTURY AUTOMOBILE 4 A TEACHERS ASSOCIATI FILE NUMBER _ V , V 1995-00055 ON - PENSION FUND DEATH PA TOTAL (Also enter on line 5, (If more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washington, D.C., 1995 VALUE AT DATE OF DEATH 4,635 1,447 5,950 528 2,560 REV - 159 EX + (12-88) ' , ' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NORMA M. HOFFMAN SCHEDULE F JOINTLY-OWNED PROPERTY Please Print or FILE NUMBER 99R-nnn~~ Joint tenant(s): NAME A. B. C. Jointly-owned property: ITEM LETTER DA FOR MA N0. _ JOINT ADDRESS RELATIONSHIP TO DECEDENT (If more space is needed, insert additional sheets of same size.) V, r,~~aN"ulanon Copyright Creative Microsystems Inc., Washington, D. C., 1995 DOLLAR VALUE OF DECEDENT'S 1 AITCO raT REV- 1510 EX+t2-87) 'COMMONWEALTH OF PENNSYLVANIA SCHEDULE Q INHERITANCE TAX RETURN RESIDENT DECEDENT TRANSFERS ESTATE OF Please Print or NORMA M. HOFFMAN FILE NUMBER 1995-00055 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON PAGE 2 IS YES. ITEM DESCRIPTION OF PROPERTY NO. relationship o decedents d to of transfer. TOTAL VALUE DECE- EXCLUSION DENT'S 1 NTER VI VOS TRUST ESTABLISHED OF ASSET /o OF IN Y DECEDENT DECEMBER 11 1987 558,829 100 558,829 TOTAL (Also enter on line 7, Recapitulation) $ 558 829 (If more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washington, D. C., 1995 REV- 1511 EX+(7-88) GOMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NORMA M. HOFFMAN ITEM NO. A• Funeral Expenses: 1. YERS FUNERAL HOME 2. ALVERSON FUNERAL SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES DESCRIPTION B• Administrative Costs: ~• Personal Representative Commissions Social Security Number of Personal Representative: 2 0 0- 3 2- 5 3 8 3 Year Commissions paid 19 9 5 2• Attorney Fees 3. Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address Clty State 4• Probate Fees C• Miscellaneous Expenses: 1. DVERTISING 2. CCOUNTANT 3. RANSFER FEE ON SALE OF REAL ESTATE 4. EAL ESTATE TAXES 5. ECORDING FEE - DEED OF DISTRIBUTION 6. IDUCIARY FEES Please Print or FILE NUMBER 995-00055 AMOUNT 1,407. 272. 3,500. 000. Code 250. 126. 600. 85. 17. 16. 1, 273. TOTAL (Also enter on line 9, (If more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washington, p. C., 1995 n)~ 12, 5 4 6 . REV- 15,12 EXi (/-93J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NORMA M. HOFFMAN ITEM NO. 1 STERCARD 2'OMERSET NEWSPAPER - EATH 3 ULOW & HOTTLE - ACCO OR 1994 4 RS - 4TH QUARTER FED 5 RS - FEDERAL INCOME SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Please Print or FILE NUMBER 1995-00055 DESCRIPTION ,DVERTISEMENT.OF REAL ESTATE PRIOR TO 'NTING FEES FOR PREPARATION OF 1040 RAL INCOME TAX ESTIMATE AX DUE FOR 1994 FORM 1040 TOTAL (Also enter on line 10, Recapitulatio (It more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washinglon, D.C., 1995 AMOUNT 92 ---_ 76 120 420 1,066 774 REV- 15?3 EX+Ip_87) a 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT `L-PT ~ ~~ w SCHEDULE) BENEFICIARIES OI.. .~ f1_._. ~v~~rl.. Vr NORMA M. HOFFMAN ITEM NO. NAME AND ADDRESS OF BENEFICIARY A Taxable Bequests: EORGE W. HOFFMAN JR. 541 THOMPSON LANE ECHANICSBURG, PA 17055 AROL ANN HOFFMAN BEEMILLER 9 TETON DRIVE REDERICKSBURG, VA 22408 ITEM NO. NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: ,,, Il VI 1yFJb FILE NUMBER 1995-00055 RELATIONSHIP AMOUNT OR SHARE OF ESTATE ON 1/2 SHARE UGHTER 1/2 AMOUNT OR SHARE OF ESTATE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, (Ii more space is needed, insert additional sheets of same size.) Copyright Creative Microsystems Inc., Washington, D. C., 1995 AEv-34B ~X(5-92) PA~JEPARTMENT OF REVENUE FOR REGISTER'S OFFICE USE ONLY ESTATE INFORMATION SHEET County code Year File Number DECEDENT INFORMATION: Enter data as it will appear on all documents submitted to the department. Name (Last) OFFMAN (First) (Middle) NORMA M. Decedent's Social Security Number Date of Death 186-05-1391 Date of Birth 11 22 94 02 13 13 TYPE FILING: Enter chock ()() mark to indicate the nature of the return to be filed with the department. ® Probate Return t' , ~~ ^ Joint Assets Only ^ Estate Tax Onl ~ ~ ' ~ `~"' Y ^ Litigation Purposes (No Other Assets) LETTERS GRANTED: Enter check (X) mark to indicate the nature of the proceedings at the Register of Wills '-' Office. (Attach additional sheets if explanation is necessary.) ~--~ ® Testamentary ^ Administration = ^ No Letters __ ^ Other'(Please Explain) ATTORNEY/CORRESPONDENT Enter all data concerning the attorney or other individual to receive all t INFORMATION: tax information and correspondence. Name (Last) (First) OOSE I I ~ (Middle) Supreme Court f.D. # ROBERT I. 9528 Street Address OOSE AND YOUNG P. C., 166 EAST UNION ST., P.O, BOX 344 City OMERSET ~ State Zip Code Telephone Number PA 15501 814 -443-3844 PERSONAL REPRESENTATIVE Enter all data concerning the personal representative(s) of the estate INFORMATION: authorized by the Register of Wills Executor/Administrator Name (Last) (First) HOFFMAN , JR . (Middle) Social Security Number GEORGE W. 200-32-5383 Street Address 1541 THOMPSON LANE City KECHANICSBURG State Zip Code Telephone Number Co-Executor/Administrator PA 17055 717 -731-9934 Name (Last) (First) 3EEMILLER (Middle) Social Security Number CAROL ANN 207-32-2889 Street Address .9 TETON DRIVE ' City 'REDERICKSBURG State Zip Code Telephone Number Co-Executor/Administrator VA 22408 703 -898-2507 Name (Last} (First) (Middle) Social Security Number Street Address _ _ City State Zip Code Telephone Number 1- _ Copyrlghl Creailve Mltrosystems Inc., Washington, D, C., 1995 RW-146 ~,..I, , INVENTORY _; REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA X WILL Cumberland X gS; NO. 55 ESTATE 19 95 COUNTY OF ~,ffi~$ ~ ~~, ~k~ Attorney of the Estate of Norma M. Hoffman Administrat deceased, being duly sworn according to law, deposes and say s that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsyl- vania of said decedent, that the valuation placed opposite each item of said Inventory represents its pair value as of the date of decedent's death, and that decedent owned no real estate outside of the Commonwealth of Pennsyl- vania except that which appears in a memorandum at the end .of this Inventory. I verify that the statements made in this Inventory are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. ~~_ ~ .~ Robert I. Boose, II, Esq. INVENTORY of the assets of the Estate of Norman M. Hoffman deceased. (Page 1 of ~ pages Inventory) SCHEDULE A 1. 19.79 acres situate in Somerset Township, Somerset County, Pennsylvania $50,000.00 2. 3.42 acres situate in Lincoln Township, Somerset County, Pennsylvania 8,500.00 3. Checking Account Farmers Trust Company 4 635.00 4. Cash Refund from The Woods Retirement Home 1,447.00 5 . 1991 Buick Centuy Ai:' ;r,~,!>i 1 e 5, 950.00 6. PA Teachers. Association Death Payment 528.00 7. Inter vivos trust established by decedent on December 11, 1987 558,829.00 Total Assets 5615,569.00 LAST WILL AND TESTAMENT I, NORMA M. HOFFMAN, of the Village of Sipesville, Lincoln Township, Somerset County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM I: I direct my Executor to cause to be paid as soon as convenient 'after my death all of my just debts, the costs of administration of my estate, and the expense of my funeral. ITEM II: I devise and bequeath all of my estate, real, personal and imixed, and wheresoever situate to my husband, GEORGE W. HOFFMAN. ITEM III: Should my husband, George W. Hoffman, predecease me, then I devise and bequeath all of my estate, real, personal and mixed, and wheresoever situate, as follows: A. One-half (1/2) thereof to my son, GEORGE W. HOFFMAN, JR., if he is then living; and should my son, George W. Hoffman, Jr., not then be living, to his issue in equal shares. Should my son, George W. FIoffman, Jr., predecease me without issue, then this share of my estate shall be distributed as part of the share given in clause B of this Item III. B. One-half (1/2) thereof to my daughter, CAROL ANN HOFFMAN, if she is then living; and should my daughter, Carol Ann Hoffman, not then be living, to her issue in equal shares. Should my daughter, Carol Ann Hoffman, predecease me without issue, then this share of my estate shall be distributed as part of the share given in clause A of this Item III. 'i ITEM IV: I nominate, constitute and appoint my husband, GEORGE W. I~ HOFFMAN, Executor of this my Last Will. Should my husband, George W. Hoffman, fail to qualify or cease to act as Executor, I appoint my son, GEORGE W. HOFFMAN, JR., and my daughter, CAROL ANN HOFFMAN, or the survivor of them, Executor hereof. 1 of 2 II II IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21st day I I~of December, 1968. ~! i )) ~~ ~ ~"~- i l (~~ ~~I :~ f~~ ~ /~ (SEAL) I Norma M. Hoffmani i Signed, sealed, published and declared by Norma M. Hoffman, the testator therein named, as and for her Last Will in the presence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. ~~ ~~ ' f~ //'' ~ Address: ~~~ ~ ~nlrtl>~J:~ Gt,~-ti `~ ~---- -,, ,::, ~ Address: ~ .. ~ i ~.- ., -