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Home My WebLink About95-0130a a5 0 ~ r- H105.144 Rm. 1R1 TYPE+-NMIT M RERYANENT BI./1CK RIIC ~l 3 z 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. Auc i s-2oo1 ? ~.- Date Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS (~ 0 2 ~ µ (`. CERTIFICATE OF DEATH ` J (Coroner) - _ _ - S°°E S1I.E NIA.lEq NAME OF DEi'EOEHTIF ~. 1.fia0•. LaeD SECURRY NUMBER DIPS OF DERV 1~. D•Y• 1br) ,. Joan A Yount ,Female a 341-52-8615 ..January 26,1995 AOE ~ uNDO11 vEM uNDER,DAY DREaR eBrrH exRHRnt~lpr•na RACEOP DEIEHI~A°M'ore-r°hvuctlwmonr ea•) J5 Ma°r OM Han MN°w OC~'~.Dh'.~ slw«f«A~Ca~Y) o,HER: 1 9.] ~ Decatur, Illino aw+..^ Ewa.,.wa ^ Do,^ „~ ^ ^ ,)~ j Y" 195 oPDFFH CRY, DERV PACxmHAME(MnC1irYNtlw~,papr+.nea.ne.) wASDEDEDE,rraPHISPANICOap+Nt RACE-Anrkrh+A~n,SIrR,Wlats,•Ee. Cumberland Monroe Pa. Rt.l'74 at Pa 74 ®M.^""''°"'"'`'i°"` e~ Rt ~ . . k•n. Pur1o Rlren,.k. White a ~a~nn~~pp KMIDOF BU8BIE8SMIDlABTgY WAS DECEDENTEYER Mi DECEDENT'S EDUCRION MA,iTAL SDEUB-MnMa 1 SURVMND SPOUSE °10r U.S.AWiED FORCE&9 Nww MNaM WMow•a ' (d tY 111 i ~A p il r M , , •« g r ° Urr,i•a w •. g ve m am rents) C t i M "' ^ "° ® ~Y g r « °N°oitl) a er ng ana er Restaurant o p+) , , , 4 ,~ Never Marrie O[REOFM'S NAB,HD ADpE.9619nest C~riw..n. sex., ZlpC°as) DECEDENT'S 322 Forge Rd. "''~"° pA "°~® "N•°°°°^°a~'~ ~^~+*ti Middleton ~ ° Boiling Springs, PA 17007 r "'°"° ,a ~°P' ° to r„mhPrlanTl rn^.r+~n~r u a • tly~,,,, Ece®e s NAME IF..e MiaM, v.q MOTHER•s NAME(FM, wda.. MrLnSwnrnN H Dean Yount . ,a ,a Elizabeth A Miller . BIFDRNANT'B NAME MP•~~+1 s MALLNB ADDRES819bre, c>ti+w.Ae, sxe•, T+P c°a.) H. Dean Yount 231 North East St. Carlisle PA 17013 MEnaoaPDesPOSeTgN DREOCDisROSrtaH RwcEavDenos)rgH-H.m.ac«n.wr.G«n.ear ~ocaaH-cry~.°.sue..noc°a ^ R.erwu«nsuH^ fMa~M.D•r.~ oM.Pe°°. ~ Dar•n^ oM .rrs°.w ^ 10. Jan. 30, 1995 °. Springville Cemetery .Middleton Tw Cumb Co PA . . . ~~ Eoa "~"~"`""~" ""'"EANDADDR~OF~T`' o man- of uneral H ome 008102 L ,m . M neat r~YM~l~d Btln OrtM mYbpM•°P. MAN °pnund °ttlH l4r.dM~YM Wr°nWE. IICEHSE Isv+r+°.ra re.) r•..«°...~ 1Maw+. D.v. ~e.n rx rrawB xxxw .n°v«+a.wwe°°°°"i0.w,.~r TwEDPDERH prg. DREVRDHOUHDEDDEADna«m.o•x~ 1~wacASEREPERREDroMEDICALEXAMINERlCOR°DNERT „, 8:40 A. M. ,a January 26, 1995 M•3~ N•^ 1h. RIIff F. EneN aw Arr•RH~+r aodlgEplbre wetA Ur•O tlr a.xee. DO ml•neKere moMdayMp,••cArfaNr«enpY•1°ey °nM.Ya i«M°nf°XU°. LIN aYyaM~mrd+wr. - iN PARTp: pMrsipYRCr°m°dlbm eD OOntr~ °i°D4~ . NrvY EMw•n na n•deMp M ter agwyYp Chin qN•n fn PART I. YI®MTIGIME)FYW i°nr1Wb•Ile M° Head In'uries + ' DuEroroRASacaNSEDUENCEOS: ,.,,..,,,,~°,,,,,,~,° ° Blunt Trauma s~r.sgaMnra.e. DuEro(aRASacoHSEOUEHC•Eas: ~ ~e.r,B,DeaYeNB ~~a~«:Mwy e DUE roIOR ASA CONSEQUENCE Of7: . MtleeM)WT ANAUIOPSY MERE AUTOPSY PegdNps MANNER OF DEOH DRE Of 11UURY THE OF INAl11V B1.IURVRWptl(T DESCRIBE HOW INJINr1'000URRED. PERfOM1ED7 AW.ABIE PRIOR ro Pwaw, D•Y ~ , . ~cow~wNaccAQSE NxuN ^ H«N°ia• ^ Aprx. Operator-ejected-two J ^ an. 26, 1995 ~• ~ ®- vehicle intersection Ame.. ~ PwNn I ^ 8:40 A B w ^ ~~ Y.. ^ ~ ^ M collision saga. ^ caunae.aM«meree ^ RADEQPBUURY•umm.,axe,.•..c+•+«xaiw ~ocArloN sx,ctrtw»n.sN+•) a" °i " '"° "` ~P°°" ~ we. ~.. ,,., • Highway t 1 4 , Boili~ Springs , PA ra*sEwN x«+r «~y Sq •ce,T~rBq P„rB,c,AN P I Iy~xCi•n q Ca°• a e.m.n«+ar+oaw OI+Yaa•n nrnon°+.,caa der+•na mw.err~rwb.ra..a.rno~«..eard.»e~wy.na.+.°.,r.w.a ...............~a+w~ananza) ^ ...................... ~,w ~ Coroner mBMe.xa mAr~en °an cenA+roromue.aa°n) LICE •~+•PI•e••,•aBR°nN°eeeenWrM Mr,°m,.xep.°°,°ASarrom.nwyq rea ~nrxwrwMa .......................... ^ >f1a DRESIONED ptagh.Dn. ~1er) ,, Jan. 29,1995 . NAME AND ADDRESS OF PERSON WNOCOMRETED CAUSE OF DERH u El{AIMNEAtCORONER Mrri 27)T rw«P*"Mi h l c ae L. Norris, Coroner oleae°B..Mw•.r~.,wHnw«x,.«'M~Y°Pxao°'°.~"°`a"'a.,"""'"'•a"'•"'a '"a°""°"" 405 Fairway Drive ew+N(•)rW nwnnrrr°hd ............................................... .. ........ ~t~ ..................... ...... ... >n. Mechanicsbur Pa. 17055 REOISTRM'9 sIDNRURE UMBER g ~ ~ ( ~e -~ c i~ DRE FLED (MoriM, !m , Wv) ~. , eu ,~ 0.t. 30 ~ S- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 JOHN B MANCKE ESQ 2233 N FRONT ST HBG PA 17110 *. .:.w REV-1547 E% CFO c09-97) DATE 04-27-98 ESTATE OF YOUNT JOAN q DATE OF DEATH 01-26-95 FILE NUMBER 21 95-0130 COUNTY CUMBERLAND ACN 501 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS 1 -------------- ------------------------------------------------------------------------------- REV-1547 EX AFP (09-971 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF YOUNT JOAN A FILE N0. 21 95-0130 ACN 501 DATE 04-27-98 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN SASED.ON: LITIGATION RETURN 1. Real Estat• (Schedul• A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule Bl (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) l5)_ 70.940.92 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets ~ (81 70,940.92 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule Hl (q) 1,116.77 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) ) .116 77 12. Not Value of Tax Return (121 6 9 , 824.15 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedul• J) (13) .00 14. Net Value of Estat• Subject to Tax (141 69,824.15 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Lfne 14 at Spousal rat• (151 .00 X .00_ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 69,824.15 X . 06. 4, 189.49 17. Amount of Line 14 taxable at Collateral/Class B rats (17) .00 X .1 5. .00 18. Principal Tax Dus (181 4, 189 .49 TAX CREDITS. PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 06-23-97 AA211445 .00 4,189.49 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX TOTAL TAX CREDIT 4,189.49 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF^TOTAL DUE'IS'REFLECTED'AS^A_"CREDIT;; (CR): YOU MAY-BE DUE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION I N H E R I TA N C E TA X DEPT. 280601 STATEMENT OF ACCOUNT HARRISBURG, PA 17128-0601 REV-1607 E% MFR (OS-971 DATE 07-21-97 ESTATE OF YOUNT JOAN A DATE OF DEATH 01-26-95 FILE NUMBER 21 95-0130 JOHN B MANCKE ESQ COUNTY CUMBERLAND 2233 N FRONT ST ACN 101 HBG PA 17110 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONE THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS ~ ----------------------------- --------------------- REV-1607 EX AFP ( 03-97 ) *~(* --------------------------------------------------- INHERITANCE TAX STATEMENT OF ACCOUNT ~(*~ ------- ESTATE OF YOUNT JOAN A FILE N0. 21 95-0130 ACN 101 DATE 07-21-97 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-21-97 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): .00 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 06-23-97 AA211445 .00 4,189.49 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN !1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REFUND. SEE REVERSE STDF OF THTS FORM FOR TNSTRIIrTTONS t 4,189.49 4,189.49CR .00 4,189.49CR COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OIINDIVIDUAL TAXES INHERITANCfTAX DIVISION I N H E R I TA N C E TAX DEPT. 280611 STATEMENT OF ACCOUNT HARRISBURG, pp 17128-0601 REY-I~O7 EM AFD (03-97) JOHN B MANCKE ESQ 1233 N FRONT ST HBG PA 17110 DATE 09-02-97 ESTATE OF MOUNT JOAN A DATE OF DEATH 01-26-95 FILE NUMBER 21 95-0130 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE; To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALOMG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS __~ ___ -------- -------------------------------------------------------------- ------ REV-1601 EX AFP (03-97) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ ----"----"" ESTATE OF MOUNT JOAN A FILE N0. 21 95-0130 ACN 101 DATE 09-02-97 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMM(RV OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-21-97 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 00 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION I N H E R I TA N C E TAX DEPT. 280601 STATEMENT OF ACCOUNT HARRISBURG, PA 17128-0601 REY-1L 07 El( 11FV (OS-971 WILLIAM L ADLER ESp 125 LOCUST ST HBG PA 17101 DATE 09-02-97 ESTATE OF HOFFMAN HELEN F DATE OF DEATH 12-03-95 FILE NUMBER 21 95-0976 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this forn with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (03-97) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT *~[~ -----"" ESTATE OF HOFFMAN HELEN F FILE N0. 21 95-0976 ACN 101 DATE 09-02-97 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-05-96 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 31,619.23 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 02-24-96 AA112555 842.11 16,000.00 04-26-96 AA112785 .00 14,777.17 08-15-97 AA211638 .00 579.38 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ••CREDIT" (CR), TOTAL TAX CREDIT 32,198.66 BALANCE OF TAX DUE 579.43CR INTEREST AND PEN. .00 TOTAL DUE 579.43CR INHERI7/WCE_TAX DIVISION INIiERITANCE TAX lerr~ 5~i! ,aw.. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28D601 HARRISBUtG, PA 17128-0601 JOHN B MANCKE ESp 2233 N FRONT ST HBG PA 17110 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REY-1G 07 EX AFV (OS-977 DATE 04-27-98 ESTATE. OF YOUNT JOAN q DATE OF DEATH 01-26-95 FILE NUMBER 21 95-0130 COUNTY CUMBERLAND ACN 501 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER P_ORTI_ON FOR YOUR RECORDS __~ REV-1607 EX AFP ( 03-97) -~-~-~*xi~ "'"""'""""-'-- --------------------- INHERITANCE TAX STATEMENT OF ACCOUNT ~xx ESTATE OF YOUNT JOAN A FILE N0. 21 95-0130 ACN 501 DATE 04-27-98 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELON IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-20-98 PRINCIPAL TAX DUE :................................................................................. .................................................................................................. 4 , 18 9 .4 9 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-23-97I AA211445 I .00 I 4,189.49 TOTAL TAX CREDIT 4,189.49 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF 70TAL DUE IS LESS THAN S1, NO PAYMENT IS RE@UIRED. IF TOTAL DUE IS REFLECTED AS A ''CREDIT'' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .R I REv:500 c:(+ (7-~dl ~5,.. ~ ~= I GOM~.rONwEAl7H OF PENNSYLVANIA ~ p EPARTMENT OF 3EVENUE SEPT. 280601 ;{i-RR158URG. PA 17128-0601 FA SPOUSALDEATH AFTER 12137191 CHEtX F4E~ INHEsZ1TANCE TAX RETURN ! PovERTY c>xEair Is cLAIMEa ^ 1 RESIDENT DECFDENT t HLE NUMBER (TO BE F~lrD IN DUPt1CATE 21 95 ~' 0130 WITH R~GiSTER OF W11L5) ;COUNTY CODE YEAR NUMBER ;Yount, Joan A. ~ 322 Forge Road y . SOCIAL 52CURITY NUMBER I DATE OF DEATH DATE Of BIRTH BO l 1 l ng Springs , P A 17 ~ 0 7 3.41 -52-8615 f~ (01/26/9 110/23/59 c~nw W IIf ~ry~IG~a1LE1 SURVIVING S-aUSE'3 NAME IIAS?, n113T ANO MIOOIE INITLW ~ SaC1Al SECURIIY NUMBER ~ at~OUNT REC:IYED (SEE iNSTRUClON51 i I ~ 1 . Original Return ^ Z. Suopiemenral Return ^ 3. Remainder Return i+ (for doses of death prior to 12-13-82) W ~ I ~ a Limited Eaore ~ sa. Future Irrtsrost Comoromise ~ 5. Federal Estate Tax Return Required {for dates of death after 12-12-82) `' i a i ~ 6. Decedent Disd Testate ,- 7. Attcch ntrop~ Intamed) a Living Trust _ 8. Total Number of Safe Oeoosit Boxes a I (Attach cony of Wiln ~ of Trust pal'LC:aRRPSPONDENCI:ANQCONF1DEiVTiAL'TA7tINEORMAT101~'St~CUEIYBEDIREt7ED.TO~ .: , ,.~ „,;a.. *~-~''~'' "•~~=r`:... ti Z i N AA~E COMPLETE NAILING ADDRESS =a John B. Mancke, ESQ. 2233 North Fr&~3~ StrE;et ~~ o~ ITeR.EP~ 17NUN234-7051 fiarrisburg, P~ _~-~.711~ / ~ ~a 0 n~ ~ r°.~ 1 . Real Estate (Schedule A) (T) m } Z. Stoda and Bonds (Schedule ii) (2) ~ --' O ~ ~ .,. ~ j 3. Closely Held StoddPattnershio Interest (Schedule C') (3) 0 1, Mortgages and Notes Receivable (Schedule D) (d j .__ -;O J` 5. Cash. Bank Deposits 3 Miscellaneous ?ersanai Property (5 j ; 7 ,_.. ,_„ (Schedule E) '~ ~' ~-i z i ~ b. Jointly Owned Property (Schedule 1 (6 ) { Q j 7. Transfers (Schedule G) (Schedule L) { ~) 7 , 0 6 6.14 a ~ 8. Total Gross Assets (total Lines T-7) 6 , 15 9 . 8 21 (9 ) =' I 9. Funeral Expenses, Administtotive Casts, Miscellaneous (9 ) - i ExQenses (Schedule H) 2, 023.09 lp, pebrs, Mortgage Liabilities, !lens j5cheduie I) (10) (t t) 8, 182.91 1 1 . Torsi Deductions (fora) Lines 9 ~ TO) (t2) -T .116.77 i 12. Net Value of Estate (Line 8 minus Line 11) i 13. Charrtable and Governmental 3eauests (Schedule J) (13) 1 d. Net Value Subject to Tax (Line 12 minus Line 13) (Td) -1 , 116.7 7 15. Spousal Transfer (for dates of death offer 6-30-9d) 0 $ee Instructions for Aoplicoble Percentage on Reverse (15) x.= Sloe. (Include values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at 6% rote (16j x .06 = ~ (Include values from Schedule K ar Schedule M.) 0 i7. Amount of Line ld taxable at 15% rate (1~ x .15 2 (Include values from Schedule K or Schedule M.) a 1 g, principal tax due (Add tax from Lines 15, 16 and 17.J (18) ~ i 19. Credits Spousal Poverty Credit Prior Poyments Discount Interest 0 ~ + + - (TV) 0 x 20. If Lins 19 is greater than Line 18, enter the differotroe on Line 20. This is the OVERPAYMENT. (20) ~ ,~ ~ G 21. If Line 18 is greater than Line 19, enter the difference .on Line 21. Thu is the TAX DUE. (21) ~ A. Enter the interest on the balance due on Lins 21A. (21 A) ~ fl. Enter tfie total of Lins 21 and 21A on Line 21fl. This is the BALANCE DUE. (218) ~ Make Check Poyable to: Register of Wills. Agent ~ }- BESi1RETQ°ANSWER: A1:i~QUESTiON~ ONE RIEVERSESIDEANQ:TC~REtHECKMATiIw:'~~'°' ~;~`~ =-`-~~='i ,;nder penolties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, ::.s true, correct and comQlete. I declare that all real estate hoz been raportsa at true marker value. Dedarotion of preparer other than the personal representative is eased on all information of which prooaror has arty knowledge. ~~ - ' - ' _ - :IGNATURE OF PER ON Rg5PON518U2 FOR fIUNG tE RN a0DRE55 y r/ DATE (~~~'--'2._ ~ !~'~-rt~ 1 ! ~ Cc~i ~ 9t~,s ~~ ~` P~ jr aH ~-% /t ~'t 7 SIGNATURE OF R PARE OTHER AN)gSENT TIVE ADDRESS DATE ~ ` .i~ ~arris~urh,F~~ntl~~rl~et Jonn B. Mancke, Esq. REK~S08 EX. iZ-871 ~,~ ~ SCHEDULE E CASH, BANK DEPOSITS AND CQ/wNAONWEAUH OF PENNSYLVANIA MISCELLANEOUS I INMR~,OENi OECEDENTRN PEit50NAL PROPE~'T`( Pleose Print or Type ESTATE O~ Joan A. Yount rfLE NUMBER 130-21-95 (All property ioiatly-owned witFs rbe Right of Survivenbip must bo disdosud en Scis~dulo F} ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH 1. Cash 5.00 2. V.W. Fox 6, 323.75' 3. Clothing 250.00 4. Furniture Items 250.00 5. Members 1st Federal Credit Union Savings Account No. 1481h1-00 25.14 v 6. Members 1st Federal Credit Union Checking Account No. 148161-11 ( t/ 212.25 TOTAL (Also enter on line 5 Recapitulation) I $ 7 ~ 066 14 (Anach additional 8'fe" x 11" sheen if more space is nssdsd.J iEv.1511 EX. !798) ; SCHEDULE H FtJNERAI EXPENSES, ~~MMONWEAUH OF ?ENNSYLYANtA ~ ADMlNl57RAT1VE COSTS AND I INHERITANCE 'AX 2ETURN MISCEiLANEOUS EXPENSES ~ RESIDENT OECcDENi ~ PfecSe PTint Or Type ESTATE O~ FiI.E NUMBEit Joan A. Yount i 130-21-95 ITEM D EStRf PT10N NUMBER AMOUNT A. Funeral Expenses: ~, ~ Hoffman Rothi: Funeral Home , o, 009.34 `~~ B. 2. C Attorney Fees 3. ~ Famify Exemption ~ Claimant Relationship Address of C?aimant of decedent's death Street Address City State Zip Code Administrative Cos#s: 1. Persona! Representative Commissions _ _ Social Security Number of Personal Representative: Year Commissions paid d. I Probate Fees C. 1. 2. 3. 4. 5. 6. 7. 8. Miscellaneous Expenses: Cumberland Law Journal - Advertise Letters The Sentinel - Advertise Letters 45.00 '~~ 40.0 0 L/ 65.48 / TOTAL (Also enter on line 9, Recapitulation) ~ $ 6 ~ 15 9 . 8 2 {if more space is needed, insert additional sheets of same size.) REV.1312 p[. (1.031 /~q~~~~~ SCHEDULI: I toMMONwEA17f1 Of PENNS1,n,,,,,,,lA DEBTS OF DECEDENT, INHERITANCE TAX 0.ETURN MORTGAGE L1A81UTIES AND L1EN5 RESIDENT OECEDENi I Please Print or Joan A. Yount ~ 130-21-95 (lf more space ;s needed, insert additional sheep ai same size.) eEv,.:st~ Ex. l,2.e71 isi+ ~ ~ ~ SCHEDULE J COMMON WEAIiH OF vENNSYtVANtA B E N E F I C 1 A R! ES tNMERITANtO? TAE RETURN RESIDENT OEG~DENT ESTATE O F fiLE NUMBER Joan A. Yo~snt 130-21-95 NUM ER I NAME AND ADDRESS Of BENEfiCJARY i RELATIONSHIP ~ SHARE OF ESTATE A. Taxaoie Bequests: 1. I Dean Yount 231 North East Street Carlisle, PA 17013 2. Elizabeth Yount 322 Forge Road Boiling Springs, PA 17007 3. Jeanne Yount j Martins Run 11 Martins Run Media, PA 19063 ~.~ ~W ~,5 Father Mother Sister Intestate Heir Intestate Heir Intestate Heir -TOTAL CNARITA$LE AND GOVERNMENTAL $EQUESTS (Also enter on line 13, RecopitUlationy ~ $ I (tf more space is needed, insert additiono~ sheets of same siz:) ITEM NAME AND ADDRESS Of BENEFiC1ARY ~ AMOUNT OR NUMBE3t ! SHARE Of ESTATE i RECEIPT FOR PAYMENT Cumbe rland County - Req inter Of ~niills Hanov er and Hiq~013 eef Carli sle, PA ZZ YOUNT JOAN ALENE File Number 1995-00130 Remarks JEANNE A YOUNT Distribution Of Receipt Receipt Data 2/16/1995 Receipt Time 15:43:17 Receipt No. 1003 999 Trans action Description Payment Amount Payee Name PETIT ION LTRS ADM 18.00 00 12 CUMBERLAND COUNTY GENERAL CUMBERLAND COUNTY GENERAL FUN FUN SHORT CERTIFICATE RENUNCIATION HEIRS . 1 NC ~PT C JCP FEE 5.00 NTR S Fc BUREARECE M D Checks 590 . Total Received........ 345 • 00 345.00 f f c'• . .CO 2X + ~7.9a1 ~ FCR OATES CF OEA7N AFTER 12131 !91 C}iECX HERE t~ ~ INHERITANCE TAX RETURN ~ IaovsR~nruc~E ~ Is cu-,MED ~~'`'' ; RESIDENT DECEDENT . fiLE NUMBER :OMMCNwEALYH OF PENNSYLVANIA (TO BE FILED IN DUPtlCATE ]EPARTMENT OF QEVENUE i 21 95 0130 HARR158URG. ~A06iiza.oeoT WITH REGISTER OF WILLS) ccuNTY cooE YEAR NUMBER iDEC_DENT'S NAME ILAST. FIRST, aN0 MIOOLE iNIt1AU DECDENT'S COMPLETE a00RE55 Yountr Joan A. 322 Forge Road y SOCIAL SECURITY NUMBER ;GATE C>f DEATH DATE Of 31RTM BO l 1 ~ n S 1 n S ~ PA 17007 3 341-52-8615 OI/26/95 10/23/59 cw,,,, ~u~be~rl~an~ ~ ipf ~-KIG~Ll1 SURVrviNa SIOUS!'S n~rE 145T. t111ST .w0 M~nOI! IN1tIAl) ISOCIAL SECURITY NUMBER i AMOUNT iECElVED 15EE INSTRUC7tON5) 1 i L ~ i~ 1. Original Return ~ 2. SupQismental.Rsturn tO reVlOi1S _ 3. Remainder Return ' a :~ , return a~tached (for dates of death prior to 12-13-82) _" ~ ~ 4, limited Estate (~ da. Future lntersst Compromise °~ S. Federo) Estate Tax Return Required _=a - (for dares of death alter 12-12-82) J i " ~ 6. Decedent Oied Testate ^ 7. Decedent Mainroined a living Truer B. Total Number of Sofe ~eoosit Boxes c (Attach copy of `Aril} (Attach copy of Trust) ^ ~ j ALL CORRESPONDENt~ AND CONFIDENTfAL TA7C INFORMATION° SHOt1LQ B~ DIRE{7EQ__ :. . ~ "~~;;, - • - ` a ` NAME COMPLETE MAWtiG ADDRESS ~ "~ =~ John B. Mancke, Esq. I Mancke, Wagner, Here ~ &'~a111y y ~ TELEPHONE NUMBER I 2233 North Front Str~e~ ;° -; i 717) 234-7051 I Harrisburg, PA 171~,Q - 1. Real estate (Schedule A) (1) - ~ Z. Stocks and Bonds (Sdtsduie B) (Z) tx) _ ,.. ~. 3. Closely Held StocxlPartnership Interest (Schedule C) (3) - ,- - ..~,.. ~ d. Mortgages and Notes ReKeivable (Schedule D} (d) f S. Cash, Bank Deposits b Miscellaneous Personal Property (S) 70 r 940.92 _ ~ (Schedu{e E} ~ ~ 6. Jointly Owned Praoerry (Schedule r} (b ) -c ~ ~ 7. Transfers (Schedule G) (Schedule lj (7 } B. Total Gross Assets (total lines i-T) (8 ) ;; ~ 9. Funeral Expenses, Administrative Casts, Miscellaneous (9 ) '~ , Expenses (Schedule N) 10. Debts, Mortgage Liabilities, liens (Schedule I) (10) 1 1. Total Deductions (total lines 4 b 10} (] i) i 12. Net Value of "estate (line B minus Lins 1 T) {1Z) 13. Charitable and Governmenrol 3eaussts (Schedule J) p r e y 10 U S ri e t V a lue (13) 1 d. Net `/alus Subject ro Tax (Clap i 2 minus line 13) - $1 r 116 • 7 7 (la} 6 9. 8 2 4. 1 5 15. SQausal Transfers (for dates of death after 6-30-44) Sse Instructions for Applicable Percentage on Rwerse (15} x._= Side. (Indude values from Schedule K or Sd+edule M.)' 16. Amount of line 1 d taxable at 696 rote { 16) 5 9 , 8 2 4.15 x .06 = 4 , 18 9.4 9 (Indude values from Sdtedule K or Schedule M.) i7. Amount of Line Id taxable at 15% rote (17) x .15 = (Indude Values from Schedule K or Schedule M.) 4,189.49 `a 18. Principal tax due (Add tox from lines 15, 16 and 17.) (18) i 19. Credits Spousal Poverty Credit Prior Payments Discount Interest o ~' + 1191 20. If line 19 is greater than line 18, enter the differenu on line 20. This is the OV9tPA7MENT. (20~ '- ~^ .. 21. If line 18 is greater than Line 19, enter the difhroncs on Line 21. This is the TAX DUE. (21) 4 r 189' 49 A. Enter the interest on the balance due on Line 21A. (21A) e. Enter the total of Lins 21 and 21A on Line 218. This is the BALANCE DUE. (218) Hoke Chedt Payable to: Register of 1Mills. Ageet }- ~- BE SiJRE TO=ANSVYER:'ALL OUE4i10N~ ON. REYE1tSE:SiDEANII TO' RECl!liR:lC ARAItt~: ~~"'~` "`^" > `:~ ;Hoer oenaitiss of penury, I dsdaro that I have exomined tfiis return, including accompanying tdtedules and statements, and to the best of knowlsd a and bshr s .rue, correct and com te. I declare that all real estate has been rsQortad ar a market v lue. oration of rsoarer othw than the p Hai re resentativs ~asea on all information o whids proparor has any knowledge. ::GNAfURE OF PERSON 0.E5P0 IRLE FOR FI N ADDRESS Jean Yount ::GNAtURE Of PREPARER OTHER N 0. ENTAt1VE ADDRESS OATS ___ Harrisburg. PA 17110 w Act #48 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 i/7/96 • 2°/6 (.02) wi11 be applicable for estates of decedents dying on or after 1/T/96 and before 1/1/97 • 1% (.07) 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 i/1/98 will be exempt from inheritance tax. Pl.FASE ANSWER THE FOLLOWING QUESTIONS BY PI.AGNG A CHECK MARK (r) IN THE APPROPRIATE BLOCKS. YES 11~ NO i . Did decedent make a transfer and: a. retain tfie use or income. of tfie property transferred ' i b. retain the right to designate who shall use the property transferred or its .income, ............... I c. retain a reversionary interest; or ................................................................................... `' d. receive tfie promise for life of either payments, benefits or caro$ f 2. If death occurred on or before December 12, 19$2, did decedent within two years preceding death transfer property without receiving. adsqucro considsrationi! If death occurred after December 12, 19$2, did decadent transfer property witfiin one year. of death without receiving adequate considsration$ ......... ............................................... 3. Did decadent own an `in trust for'. bank account at his or her deatfi$ ...................................... IF THE ANSWER TO ANY OF THE ABOVE. QUESTIONS IS .YES, YOU MUST COMPLFfE SCH6,~UteC~r~~-Nr#~t 1T AS PART OF THE RETURN. Vii: 8 t~` ~Z t~ll~' LF. ~I;~..: .n :_w~J ~.~ ~s:: .~~~~y~ REK~S08 EXtfI2.gP) ~~~~~r _~~ . ~ u ~~ CASHr BANK DEPOSITS AND COMMONWEALTH Of PENNSYlVAN1A MISCELLANEOUS INNERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT PIeaSB Print or Type ESTATE OF FILE NUMBER Joan A. Yount 21 95 0130 (All property loiefly-owed with the Right of Surviwrship must be diseieaed oo Seheduie F) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Proceeds from survival action in Estate of Joan A. Yount, deceased, by Jeanne A. Yount, Plaintiff f. Union Quarries, Inc. and Wayne J. Lehman as directed by Court Order dated may 23, 1997, which attached and distributed pursuant to Distribution Sheet attached dated June 22, 1997. 70,940.92 TOTAL (Also enter on line STOTA-L (Aisc enter cn line Recapitulation)~$ 7 0 , 9 40 9 27 0 , 9 40 9 2 (Attach addi6onai 8'~i° x 11" sheets ii more space is needed.) r . ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE 7AX DIVISION DEPT. 260601 HARRISBURG, PA 17128-0601 JOHN B MANCKE ESp 2233 N FRONT ST HBG PA 17110 COMMONWEAL'~H OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ~' -157 E% 4FP IQS-f7) DATE 04-28-97 ESTATE OF YOUNT JOAN A DATE OF DEATH 01-26-95 FILE NUMBER 21 95-0130 COUNTY CUMBERLAND ACN I01 Amount Reaitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS ' CUMBERLAND CO COURT HOUSE. CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LDWER PORTION FOR YOUR RECORDS ~ ------ ----------------------------- REV-1547 EX AFP (03-97) NOTICE OF INHERITANCE -- AX T APPRAISEN~ DISALLOWANCE O NT, ALLOWANCE ------------------- t7R F DEDUCTIONS AND ASSESS ESTATE OF YOUNT JOAN MENT OF TAX A FILE N0. 21 95-0130 ACN 101 DATE 04-28-97 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING .FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds ( Schedule B) .00 NOTE: To insure proper (2) 3. Closely Held Stock/Partnership Interest (Sehedul• C) .00 credit to Your account, (3) 4. Mort yages/Notes Receivable (Schedule D) .00 submit the upper Aortic (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 7 06 6 1 4 of this fore with Your t 6. Jointly Owned P roperty (Schedule F ) , . ax Payment. ( 6) 7. Transfers (Schedule G) . 0 0 8. Total Assets (~) .00 APPROVED DEDUCTIONS AND EXEMPTIONS: ($) 7, 066.14 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 6,1 59.8 Z 10. Debts/Mort~a Liabilities/Liens (Schedule Il (30) 2 02 3 89 _ 11. Total Deductions , 12. Net Value of Tax Return (11) - 8=78 91 13. Charitsbla/Gowrnnental 8egwsts (Schedule J) (12) 1,116.77- 14. Net Value of Estate Subject to Tax (13) .00 NOTE: If an assesswent was issued previously, lines 14, 15 reflect figures that include th andiar 16,-17 and 18 will e total of ALL returns ASSESSNENT OF TAX: assessed to date. 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A r t . 00 X . 00_ . 00 a e (16) 17. Amount of Line 14 taxable at Coll t .00 X .06. ,00 a eral/Class 8 rate (17) 18. Principal Tax Due .D 0 X .15. .0 0 TAX CREDITS: (1B)- _ .00 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) ~ ~ PAID * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF AD02TT(MIA~ TNTFDFCT TOTAL TAX CREDIT .00 BALANCE OF TAX DUE. .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REWIRED. TC TI~Ta1 wt~! Tw w~w• ..~..,__ .- RESERVATION: ;n~ptossessian oar enioyaant to Classf8r(coli~at~eral)2beneficiaries of the redecedent after the °xaitrationt°f ~r°s~tat° for atftherlawfuleClass~8 (olYla erol~ro eon anyresuchyfuturo int rosti~t ~ appraise and assess transfer IN+sritanca Taxes PURPOSE OF NOTICE; To fulfill tM rsquireaents of Section 2140 of the Inheritance and Estate Tax Act, Act 21 of 1995. (72 P. . Section 9140). PAYMENT: Detach tM top Portion of this Notice and subait with your payaent to the Register of Nills printed on the remorse side. --Make check or coney order payable to: REOIST$ft OF NILLS, ADEN? REFUND CCR): A refund of s tax credit, which was not requested on ttw Tax Return, way be regwsted by eoapleting an ^Application for Refurd of Pennsylvania InFnritance and Estate Tax^ (REV-1313). Applications aro available at tM Offlce of the Resistor of Nills, any of ~+° 23 Revenue District Offices, or by calling the special 24-hour answering service nuebers for Toros ordering: In Pemsylvania 1-800-362-2050, outside PemsYlvania and within local Harrisburg area (717) 707-8094, TDDO (717) 772-2252 (Hearing Iapaired Only). OBJECTIONS: ~Yt~r~neludingrdiscount~oriintarest~as shown onsthistNotiuo most objactawithixtY (da~t~YS•ofrraowipt~oft this Notice by: OR --•lectionpt tehavetthe cotter daterainedfateaud ti Hof tho oaccountaof~tfiaPPar28sw:a1 rspras ~tatiwPA 1701280-1021, --appeal to the Orphans' Court. ADMIN ISTRATIVE taent of Revenw, CORRECTIONS: Factual errors discovered on this assessaent should be addressed in writing to: PA Depar Bureau of Individual Texas, ATTN: Post Assesswent Review Unit, Dept. 200601, Harrisburg, PA 17120-0601 Phone (717) 787-6505. See papa 5 of the booklet "Instructions for Inheritance Tax Return for a Rnident Decedent' (REY-1501) for an explanation of adainistrativaly wrrectable errors. DISCOUNT: If any tax due is paid within thrw (3) calendar months after tM decedent's death, a fiw percent CS;U discount of tM tax Paid is allowed. PENALTY: ~' The 151 tex aenesty n°n-Participation penalty is coaputed ~+ the total of the tax and interoat sswssed, and not paid beforo January I8, 1996, the first day sfter;tM end of tM tax aanesty Period. This non-partieipatian penalty is appealable in the sane gamer and in the tM sago tiw period as You would appeal th= tax and interest that has been assessed as indicated on this notice. iming with first deY of delinquency, or nine (9) anths and one (1) day froe tt+e data o4 INTEREST: Interest is Charged bag death, to the datd of pageant- Texas which becaae dalinquNtt beforo JanuerY 1, 1982 boar intarost at the rota o six C6x) pPrcant Par anM+a calculated at a daily rata of .000164. All taxes which beeaee delinquent on and after amouncad~by%tM~PA1DeparteentroftRevemw teTMiaPP111eabi•rinte~st~ramte~srforal%2 throughr1997raro~ that rots Year Interest Rste Daily Intarost Faeto_r Year Intaro~ to Daily Interest Factor .000540 1907 92 .000247 1982 20X ,000430 1900'1991 11L .000301 1983 16X 1992 9iC .000247 1984 11iC .000301 ~ .000192 1985 13X .000356 1993-1994 ,000247 1986 lOiC .000274 1995-1997 92 --Intarost is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUN8ER OF DAYS DELINQUENT X DAILY INTEREST FACTOR -Any Notice issued after tf+e tax bocoaes delinquent will reflect an intarost ealwlation to fifteen C15) days beyond the data of the assessaent. If pageant is aade after the intarost eoaputation date shown on ttw Notice, additional intarost Bust bs calculated. ESTATE OF JOAN A YOUNT, deceased, by JEANNE A YOUNT, Plaintiff v. UNION QUARRIES, INC. and WAYNE J. LEHMAN, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 95,3835 CIVIL TERM CML ACTION -LAW JURY TRIAL DEMANDED AND NOW, this `~i~ day of ~ ,,, ~ t997, upon pefition of the Administratrbc, with a joinder of the beneficiaries of the Estate of Joan A Yount, the settlement with the defendant, is hereby approved as follows: A. The rota! settlement of 5322,000.00 is hereby approved. B. The distribution of 30% of said settlement is hereby approved to be allocated to the survival action and 7096 to the wrongful death action. C. Distribution is approved as outlined in Exhib~ 'H' of this Pesition. By the Caurt, ~- ~ ^~ J. .:,~ ~.. ,a ~ _ v:*i 'Yi10~'1 ~ ~31 L'e J47~ ~~V~ N~iS~4 ta.`~ ~tw~~~L. i 'Ei. ../. l 1 i _3 t~s ~i'i'~ .~'.Wi1 ~di ~Y~•J w'~:1 ~i`~. li~~K'~L. inv.., W-.-.C '~,'3 97 Q ESTATE OF JOAN A. YOUNT, deceased, by JEANNE A YOUNT, Plaintiff v. UNION QUARRIES, INC. and WAYNE J. LEHMAN, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 95--3835 CIVIL TEAM CIVIL ACTION -LAW JURY TRIAL DEMANDED PETt11ON FOR APPROVAL OF SETTLEMENT OF WRONGFUL DEATH~URVNAL ACTION AND NOW tames your Petitloner, Jeanne A. Yount, Administratrbc of the Estate of Joan A. Yount, deceased, through her attorneys, Mancke, Wagner, Hershey & Tully, and f~7es the fdlowing Petition for court approval of wrongful death-survival action as follows: 1. Your Petitioner, Jeanne A. Yount, is the Adminisiratrix of the Estate of Joan A. Yount, having been duly appointed Administratrix of the Estate of Joan A. Yount on February 16, 1995 by Mary C. Lewis, Register of Wills, Cumberiand County. 2. Jeanne A. Yount, Adminisiratroc, resides at 1600 Hagys Ford Road, 10H, Narberth, PA 19072. 3. On January 26, 1995, Joan A. Yount was operating her motor vehide on SR 174 (Boding Springs Road) approaching the intersection of SR 74 (York Road) in Monroe Township, Cumberland County, Pennsylvania, at which time a vehide driven by Wayne J. Lehman, acting as agent, servant or employee of defendant Union Quarries, Inc., collided with the vehide driven by Joan A. Yount, posing fatal injuries to Joan A. Yount 4. As a result of the aforesaid automobile accident, the Estate brought an action which was docketed to the above~aptioned number and term against Union Quarries with negligence of their employee. 5. The Administratrbc employed the law ftmt of Mancice, Wagner, Hershey & Tully to irnestigate the accident, file a claim on behalf of the Estate and negotiate a settlement, if possible, of the above-captioned action. 6. After an extensive investlgaifon, extensive discavery including numerous depositions, and after employing accident reconstructlon experts as well as trafftc signal experts, the defendant has agreed and your Administratra has agreed to a settlement of above-captioned case. A negotiated settlement has been agreed upon in the amount of X322,000.00. 7. The Commonwealth Department of Revenue has been contacted on behalf of the Estate and has agreed to a distnbution of 30% of the total settlement being attributed or allocated to the survival action. A copy of said letter from the Department of Revenue is attached hereto and incorporated herein by reference as Exhibit 'A". 8. The defendant has indicated that no hearing on the Petition is necessary, a copy of said letter is attached hereto and incorporated herein by reference as Exhibit "8". 9. The Estate as represented by the Adminisiratmc, Jeanne A. Yount, and the beneficiaries of the Estate, H. Dean Yount, natural father, and Elizabeth Yount, natural mother,' have further_requested the court to approve this settlement without the necessity of a hearing as evidenced by the consents signed by the - Administratrix and the beneficiaries, which are attached hereto and incorporated herein by reference as Exhibits 'C", 'D" and 'E'. 10. The Estate executed a contingency fee agreement with the law firm of Mancice, Wagner, Hershey ~ Tully, which provided that upon settlement one-thircl shah be paid to the counsel for the Estate. A copy of the Contingency Fee Agreement is attached hereto as Exhibit "F". Costs incurred are outlined in Exhibit "G", which is attached hereto and incorporated herein by reference. 11. The law firm of Manske, Wagner, Hershey & Tully have agreed to accept 2596 plus costs as the fee in this case and no fee wiU be charged by the law firm of Mandce, Wagner, Hershey & Tully for the administration of the Estate. 12. No outstanding medical b~is are due to any party. 13. Petitioner herein requests court approval of the allocation and distribution outlined in Exhibit "H" which is attached hereto and made a part hereof by reference. WHEREFORE, Petitioner prays your Honorable. Court to approve the settlemern of the wrongful death-survival acton in the amount of $322,000.00, allocated with 3096 payable to the Estate through the survival action, with deducilon of the attorney's fees and costs as outlined in Exhibit "G' and further agrees to the 70% being allocated to the wrongful death with the distribution of the wrongful death action being noted in Exhibit °H". Respectfully submitted, MANCKE, WAGNER, HERSHEY, ~& TULLY By - ~T John B. Ma e, Esquire Attorney t.D. .07212 2233 North f=ront Street Harrisburg PA 17110 (717) 2347051 ,~t~ ,~ ~ 1 ~ q ~ Attorney for Plaintiff DATED: ! ` ~~ ~ 97-0505 MAY-?1-199? 15:2'r' FOM DEPT OF REU/CH1EF TQr ' o~nct:. oR ct+t~ couNS~t_ ~ COMMONWEALTH OF PENMSYLVAlvw _' DE~r. 2e1os1 ~ ~ DEPARTMENT OF REvEivUE HARRt38URG. ?A .7129-1061 i ~iay 22, 1P97 John B . k I ~ Blanc ~, esq. Mancke, Tr7agner, EersI~cy and Tully 2293 North Fr`nt Street Harrisburg, P~ 17210 III Re: Inheritance Tax Estate of Joan A. Yo~mt Allc~cation~ of Proceeds B r 1?2~d'r'GJEO P . GJ2/C12 ~' PHCYE 717-7a7-138Q FAX: 717-TTZ-145g Dear Mx . M2eA This is requesting t. I have has no objec~ survival act.. action for P~ 3CtiOn pvrti~ Return and t 2 t Z',13t hesitate to c e: n response to your correspondence of May 6, 1991, t I review the proposed allocation: viewed the allocation. The Depairtment of Revenue on to the allocation of t_hi.rty percent (30~s) to Iris a .and seventy Dercent (70~} to the :wronrsful death asylvania inheritance tax purposes. The survival must be resorted ou a Psnnsylvariia Inheritance Tax appropriate tax Daid.~ his responds to your request_ Please 3o not atact ate if T may be of €urther assistance. V'ezy truly yo%nrs, Vicky ~3na Try *~+~+~~ . Senior ?assistant 'Courise~l cc: Estate Fide ' VAT : j as Exhibit "A" TOTAL P.02 • f ~ f \.~\V ~+a •...v.rr. r } AT I CANEYS AND CV UNSELORB AT LAVM( 2931 NOATH FRONT STRi~T HAARrseuAC. PENNSYLVANIA ilt t0 WILLIAM J_ PETERS CNAALES E WA51l~6IU OENNIS J. B01'JETT1 JOSEPH C. PHi111P5 MICHAiL A. YONSt+OtK THOMAS A. LANG ~AiAELA S. PARA3CANOOLA STF.!•F+EN F. NOOPE SCOTT A. fLEISCHAUER C1NOY J. MURPHY JAMES .+~. cSAAVEA May 14, 1997 Jo hn B , vtanckc, Fsquue MANCKE, WAGiY1t;R, l3ERSHEY & TIJLLY 2233 forth Front Street Harrisburg, Petu~syivania 17110 Dear John: Re: Our File No: 1-1473 Estate of Yount 4. ITalon Quarries TELEPHONE 81 71 238-75 55 FAX 1117) 25E-7750 E~Nw1 AdOrau owlsw@ndreas~at Tlzis will confirm that the above-captioned case has been settled for the sum of 5322,000.40. Although my client and me insurance carrier, PHA, require chat there be court approval of the settlement, these is no t>etd for a hearing on tht Petition for Approval of Settlement. I am enclosing the General Release which I request that you have the representative of the estate slga releasin; Wayt:c J. Lehman. Union Quarries, Inc. and the Pennsylvania ,12anufacittr~crs' Associauoa Insut;ance Company of any further liability with regard to this mamer. Please forward a copy of the Petition for Approval of Settlement along with tlse Court Order approving scitlemcnr, the signed Release and a Praecipe marking the docket settled and discontinued. I thank you for your attention m this rnaner. I will await the closing d , ~**+ *+*a. As soon as I receive all of the closing documents, I will forward the sealetaent check to y~- very tntly mss, CEW:pjc Enclosures Charles E. Wasilefs)a r >~chlblt 'f $" vE~u~lc~-noN I verify that the statemerns made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penaltles of 18 Pa.C.S. $4904, relating to unswom falsification to authorities. .t:~/ G%~%~x%r Dean Yount Dated: ~ ~ ~, / g ~ 7 Exhibit 'C' VEAIFiCAT10N I verify that the statements made in the foregoing document are true and correct. I ur~erstand that false statements herein are made subject to the penalties of t8 Pa.C.S. 84904, relating to unswom falsification to authorities. - Dated: ~ ~! q ~~ ~ Iza Yourn CAS n o E~e,~ Exhibit "D' ~ ~ r i VERIFlCATION I verify that the statements made in the foregoing documern are true and correct. i understand that false statements herein are made subject to the penalties of 18 Pa.C.S. 54904, n~lating to unswom faisii~cation to authorities. l Jea a ourn Dated: Exhibit 'i" LLW OFi1Ci5 Jvtrn a htAncx~ P. RtCKARD WAGNER DavtD E. kIER!SNEY ~YtLL7AM '. TULLY DAV tO R ~ACSC3rl M NCKE, W,4G~lER. HERSHEY ~ TULLY raa rgt7717 seoMr sswettr HARRt58URC. ~ P4 77770 PCWER OF eTTGRNEY A2iD CGDITINCiEliT FE8 a~1G8EEMENT ~pEA ~00E 717 Z. a-071 IQ10W ALL ME~i 3Y TSESE PRESENTS, t313t 2/We ~ ~ , S, flo hereby retain MANGZ{E, AG.YER, HEY & X of HarrisL-urg, Pennsylvania, as my/out attorneys to negotia for as adjustment or to institute for ma/us in my/atir na~ae any legal actions or procgediugs that i.n their judgment are necessa~, ,~.n connection with my/our claim for damages against (~ or anyone else as a result of iri Ties or amages sustained by ma/us on the a'~ day of ~~_, 199,i. I/We agree not to settle or adSust the above cla.i_m or any proceedings based thereon without the written consent og my/our said attorneys. NOW, THEELHE`ORE, in consideration of the services so to be rendera8 by my/our said attorneys, I/we hereby consent, promise and agree to pay to my/our said attorneys far their professional services rendered THZRT°-THI2EE AND ONE-TSIRD (33 1/3~) perce~it of Whatever--~-..(~+rp~. swa is recovered xis---a-.z~~ ' + ~f iCi P ~~Z'SS,'~' ~~~Q~1~ -fTl~~? ~ ~" ~ 'T o'v / .. ~ i--L.~>: -- G'I G311r .7Yi V ~~ 111CLL Uy r~ee~assa~~...ees wed ~~t Leo ailrr~t~.~ a :g s~eis-~ece++te~*. AND NOW, this ) )`day aE , , 199, tha above Contingent Fes Agreement and Poorer of A orney has been read, approved and understood by me/us and the receipt of a copy thereof acKnowladged. The terms set forth are agreeable. (SEAL} (SEAL) (Ss;AL} Exhibit "~"' Attomev Costs 04-03-95 Commonwealth of PA ........................ 8.00 0421-95 John Bickel ...............................500.00 0427-95 Gerald Henneman ..........................617.50 05-30-95 Gerald Henneman .......................... 148.00 06-07-95 Paul Anderson .............................500.00 06-16-95 Gerald Henneman ...........................65.00 06-16-95 Cumberland Law Journal ......................40.00 06-29-95 The Sentinel ...............................65.48 07-i 8-95 Cumberland County Prothonotary ...............45.50 07-18-95 Cumberland County Sheriff ................... 100.00 08-07-95 Cumberland County Sheriff (refund) ............. {x.40 11-08-95 Green Room ...............................50.00 11-13-95 Reprographics .............................. 5.41 12-04-95 Petty Cash .. ............................. i 1.75 12-27-95 PMA .................................... f5.27 01-04-96 Sieve Rickard .............................950.00 01-1796 Central PA Court Reporting ...................100.25 01-24-96 Gerald Henneman ..........................114.00 01-24-96 Gerald Henneman ..........................176.00 02-07-96 Michael Norris ..............................50.00 02 20-96 Central PA Court Reporting ...................420.05 05-21-96 John F. Bickel ............................ 1000.00 07-01-96 Central PA Reporting ........................132.05 12-03-96 Steve RIClcard .............................498.75 02-14-97 Cumberland County Register of WDis .............15.00 02-25-97 Cumberland County Register of WAIs refund ........ x.00 05-02-97 Central PA Court Reporting ................ 220 80 Total .................................. 5 , 696.93 DCH1BiT 'G' Wrongful Death ........................................ $225,400.00 Attomey Fees ... . ....................... 556,350.00 Attomey Costs ........................... 84,187.85 H. Dean Yotmt .......................... 882,431.07. Elizabeth Yount .......................... 882,431.08 Survival .... ............................... 596,600.00 Attomey Fees ........................... 824, ~ 50.00 . . Attomey Costs ........................... 81,509.08 Estate of Joan Yourn ...................... $70,940.92 Total Settlement ........................................ 8322,000.00 Exhibit 'H" ' ~ ' RELEASE OF ALL CLAIMS FOR AND IN CONSIDERATION OF the payment to me/us of the sum of ( $ 3 2 ~ ~ 0 0 0 . 0 Q THREE HUNDRED TWENTY TWO THOUSAND and 00/100---------_ ) valuable consideration, I/we, being of lawful age, have released and discharged, and by these presents do for myself/ourselves m good and y/our heirs, executors, administrators and assigns, release, acquit and forever discharge. THE PMA GROUP UNION UARRIES INC. AND WAYNE J. LEHMAN ana any and all other persons, firms and corporations, whether herein named or referred to or not, of and from any and all actions, causes of action, claims, demands, damages, costs, loss of services, expenses, compensation, and all consequential damage on account of, or in anyway growing out of, any and all known. and unknown personal injuries and death and property damage resulting or to result from accident that occurred on or about the 2 ( day of January 19 9 5 , at or near the intersection of R 174 and SR 74 Monroe Townshi Cumberland Count I/we hereby declare and represent that the injuries sustained may be permanent and progressive and that recovery therefrom is uncertair. and .rdefinita, a::c ir. mak~ry ~ ;is release ar:d a agreed that I/we rely wholly upon my/our own ud g-eea:ent ~= is :;r=derstaod and cf said injuries, and that I/we have not been influencede toe any extent whatever hin making this nreleaseubytany representations or statements regarding said injuries, or regarding any other matters, made by the persons, firms or corporations who are hereby released, or by any person or persons representing him or them, or by any physician or surgeon by him or them employed. I/we understand that this settlement is the compromise of a doubtful and disputed claim, and that the payment is not to be construed as an admission of liability on the part of the perscns, firms and corporations hereby released by whom liability is expressly denied. It is agreed that distribution of the above sum shall be made as follows: This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a mere recital. I/we further state that Z/we have carefully read the foregoing release and k_ZOw the contents thereof, and I/we sign the same as my/our own free act. WITNESS hand and seal this day of 19 IN THE PRESENCE OF Name Address ) AUTION! BEAD BEFORE SIGNING Name Address _. (SEP.L) STATE OF ) County of On this .~ X day of ss. herein, add' who executed tY}e~foregoing instrument and ssion expires: ,- __.....r ~ ~v~i '~ __.. v .. ........ --~t ii ~.~..r...-..~.~. 19~, before me personally appeared _ to me known to be the person(s) described acknowledged that voluntarily executed the same. ~7 ~ ~ JOHN B. MANCKE 1. RICHARD WAGNER DAVID E. HERSHEY WILLIAM T. TULLY LAW OFFICES MANCKE, WAGNER, HERSHEY &TULLY 2233 NORTH FRONT STREET HARRISBURG, pA 17110 AREA CODE 777 234-7051 Estate of Joan A. Yount, deceased, by Jeanne A. Yount v. ' Union r]uarries, Inc. and Wayne J. Lehman Total Receipts .....................................................$322,000.00 Wron I Death Mancke, Wagner, Hershey & Tully: Attorney fees ................................... 556,350.00 Attorney costs ................................. $4,187.85 H. Dean Yount ................................... $82,431.07 Elizabeth Yount .................................. $82,431.08......... $225,400.00 iv I Mancke, Wagner, Hershey & Tully: Attorney fees ................................... $24,150.00 Attorney costs ................................... $1,509.08 Estate of Joan A. Yount ..............570,940.92 minus Inheritance Tax .............. -54,189.49..... $66,751.43 Cumberland County Register of Wills .................... $4,189.49 ......... $96,600,00 AND NOW, this 22nd day of June, 1997, the above Statement of Distribution has been read, understood, approved and the receipt thereof acknowledged. I warrant that my attorney has discussed ail of the elements of my case induding possible verdict at time of trial. I warrant that i enter into the above settlement without threat, mental n:senration, or as a resWt of any coercion. -- It is understood that only the deductions noted above have been made. All outstanding matters will be the responsibility of the undersigned, including any unpaid medical bills resulting from the accident. `~~ Witness Date ~~ 97-0618 H. n Yount ~` ~_~~ r..:,- ,C~