HomeMy WebLinkAbout10-01-12 (2)J 1505610105
REV-1500 EX (az- 11) (FI)
PA Department Of RBVenue PeOnsylvaMa OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX z8o6ot """`"`"~ County Code Year File Number
~ INHERITANCE TAX RETURN
Harrisburg PA 17128-0601 RESIDENT DECEDENT ~\ (~ ~~-~-
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYVIN Date of Birth MMDDYYYY
3/29/2011 01/16/1930
Decedent's Lasl Name Suffix Decedent's First Name MI
LENTZ ARTHUR H
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
Olp i. Original Retum O 2. Supplemental Return O 3. Remainder Return (Date of Death
O 4. Limited Estate m Prior to 12-13-82)
4a. Future Interest Compromise (data of O 5. Federal Estate Tax Return Required
death after 72-12-82)
OD 6. Decedent Died Testate O
(Adach Copy of Will) 7. Decedent Maintained a Living Trust S. Total Number of Safe Deposit Boxes
A
(
ttach Copy of Trust.)
O 9, Litigation Proceeds Received O 10, Spousal Poverty Credit (Date of Death O ii. Election to Tax under Sec
9713(A)
.
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name
Daytime'Telephone Number
DOUGLAS C YOUNG (717) 648-6657
State ZIP Code
PA :17020
N
First Line of Address
114 NORTH HIGH STREET
Second Line of Address
City or Post Office
DUNCANNON
Correspondent's a-mail address: fBlb0yy0Uf1C12
Under penalties of perjury, I declare that I have examinetl this
it Istrue, correct and complete. Declaration or preparer other
FILING RETURN
REGISTER OF WlEkerO3E ONLY
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adules antl 6latemenis, end to the beat of my knowledge end belief,
basetl on all information of which preparer has any knowledge.
DATE
114 NORTH HIGH STREET DUNCANNON PA 17020
P(j'BOX 68, NEW BLOOMFIELD PA 17068
m e:wav ..e~..........~. _______--_-
Side 1
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1505610205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: ARTHUR H LENTZ
RECAPITULATION
1 . Real Estate (Schedule A) ......................................... .... 1. 23,970.00
2 . Stocks and Bonds (Schedule B) ........ . . .......................... ... 2.
3 . Closely Held Coryoration, Partnership or Sole-Proprietorship (Schedule C) .. ... 3.
4 . Mortgages and Notas Receivable (Schedule D) ........................ ... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 12,608.$7
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 600
00
7. Inter-Vivos Transfers d Miscellaneous Non-Probate Property .
(Schedule G) O Separate Billing Requested..... .. , 7.
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 37,17$.$7
9. Funeral Expenses antl Administrative Costs (Schedule H) ................ ... 9. 11,077.13
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10.
11. Total Deductions (total Lines 9 and 10) ............ ................. ... 11. 17,077.73
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 26,101.74
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...................... .. 13.
14. Net Value SubJect to Tax (Line 12 minus Line 13) ...................... .. 14. 26,101.74
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0 45 15,779.74 1g, 710.09
17. Amount of line 14 taxable
at sibling rate X .12 17
18. Amount of Line 14 taxable
at collateral rate X.15 10,322.00 i6. 1,548.30
19. TAX DUE ....................................................... .. 19. 2,258.39
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
O
Sfde 2
L 1505610205
1505610205
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
Flle NamC•r
DECEDENT'S NAME
ARTHUR H LENTZ
STREET ADDRESS
207 EDNA STREET
-CITY _. ..... _ _... ___
VVORMLEYSBURG STATE PA I ZIP 17043
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2, Credits/Payments
A. Prior Payments
B. Discount
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Llne 20 to request a refund.
(1)_ 2,258.39
Total Credits (A + g) (p)
(3)
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,258.39
Make check payable to: REGISTER OF WILLS, AGENT.
_ ,,..
~•:. . ,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
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 ....................................................................................................................... ....... ^
d, receive the promise for life of either payments, benefits or care? ......................................................._...... ....... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................................................................................................ ...... ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ........ ...... ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a benefciary designation? .................................................................................................................. ...... ^ ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995; the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a Vansfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [/2 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent„ except as noted in [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of fhe decedent's siblings is 12 percent [72 iP.S. §9116(a)(1.3)J. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (11-OB)
°"~ ~'~ Pennsylvania
DEPARTMENT DF REVENUE
INHERRANCE TqX RETURN
RESIDENT DECEDENr
SCHEDULE A
REAL ESTATE
ESTATE OF
ARTHUR H LENTZ FILE NUMBER
21/11-0422
All real property owned solely or as a tenant in rnmmon must be reported at fair market value. Fair market value is defned 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 fags.
Real property that is folntlyowned with right of survivorship moat be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common.
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1' LIFE ESTATE AT 1115 STRITES ROAD, MIDDLETOWN PA -SEE SCHEDULE K ATf/\CHED 23,970.00
TOTAL (Also enter on Line 1, Recapitulation.) I; 23,970.00
If more space is needed, insert additional sheets of the same size.
REV-a5o8 E%+ (11aD)
~ ' Pennsylvania SCNEDVLE E
DEPARTMENT OF REVENUE yhJNF BANK DEPOSITS & MISC.
RESIDENTNDECEDENTTURN PERSONAL PROPERTY
ESTATE OF:
ARTHUR H LENTZ FILE NUMBER:
21-11-0422
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survlvorahip must be disclosed on Sr:hedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. M & T BANK CHECKING #000009850851560
893.07
2 M 8 T SAVINGS #015004220421579
49.80
3 CASH ON HAND
544.00
4 2008 FORD F-150 TWO WHEEL DRIVE TRUCK
10,000.00
5 GRANDFATHER CLOCK
75.00
6 HOUSEHOLD AND PERSONAL ITEMS
800.00
7 TOOLS, MOWER & EQUIPMENT
247.00
TOTAL (Also enter on Line 5, Recapitulation) ; I 12,608.87
If more space is needed, use additional sheets of paper of the same size.
REV-1509 EX+ (oi-ao)
~ Pennsylvania
DEPARTMENT OP REVENUE
INHERRANCE TAX RETURN
RES1DENr DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ARTHUR H LENTZ
If an asset became Sointly owned within one year of the decedent's date of death, It must ba_
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS
A• BETTY J GINGRICH 207 EDNA ST, WORMLEYSBURG PA 17043
e.
c.
JOINTLY OWNED PROPERTY:
21-11-0422
ed on Schedule G.
RELATIONSHIP TO DECEDENT
FRIEND
REM
N LETTER
FOR JOM DATE
T MADE DESCRIPTION OF PROPERTY
INCLUDE NAME OF FlNANCIAL INSTIMION AND BANR ACCOUM NUMBER O
TH
DA
UMBER TENANT ]DINT R SIMIIA0.
IDENTIFYING NUMBER. ATTACH DEED FOR JOINRY HELD REAL ESrATE DATE OF DFATH DKEDENT' S
VALUE OF
1.
A• . VALUE OF ASSET INTEREST DKEDENT'S INrEREST
09/18/10 1993 DODGE CAMPER VAN
1,200.00 50 600.00
TOTAL (Also enter on Line 6, Recapitulation) I # 600.00
If more space Is needed, use additional sheets of paper of the same size.
REV4511 EX+ (SO-09)
`_~ ~ "'~ Pennsylvania
DEPAgTMENT OF REVENDE
INHERITANCE Tp% RETDRN
RESIDENT DECEDENT
ESTATE OF
ARTHUR H LENTZ ESTATE
Attorney Fees:
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant '
Street Address
Oty State _
Relationship of Claimant to Decedent
FILE NUMBER
21-11-0422
m Decedent's debts must be reported on Schedule I.
A• I FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Pald:
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
State _ ZIP
2.
3.
4.
5.
6,
~.
8
s
to
11
tz
ZIP
Probate Fees:
Accountant Fees:
Taz Return Preparer Fees:
MEDICAL EXPENSES
SAM'S CLUB
REAL ESTATE EXP FOR LIFE ESTATE COSTS
CAMPER STORAGE
STATE AUTO
DEATH CERTIFICATES
2,621.00
500.00
68.24
315.47
7,425.42
45.00
42.00
60.00
TOTAL (Also enter on Line 9, Recapitulation) I #
11,077.13
If mare space is needed, use additional sheets of paper of the same size.
REV-1513 E%+ (01-10)
~ Pennsylvania
- DEPARTMENT OF REVENUE
INHERRANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE
BENEFICIARIES
ESTATE OF:
FILE NUMBER:
ARTHUR H LENTZ
21-11-0422
NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY
() RELATIONSHIP TO DECEDENT
Do No! List Trustee(s) AMOUNT OR SHARE
OF
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under ESTATE
Sec. 9116 (a) (1.2).] '
1 DOUGLAS C YOUNG GRANDSON RESIDUAL
114 N HIGH ST DUNCANNON PA 17020
2 ALBERTLARGENT FRIEND 247
13 BESSIE LANE MIDDLETOWN PA 17057
3 BETTY J GINGRICH FRIEND 10075
207 EDNA STREET WORMLEYSBURG PA 17043
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH IB OF REV-1500 COVEA SHEET, AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS T
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION i0 TAX IS NOT TAKEN:
1.
8. 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, use additional sheets of paper of the same size.
REV4514 E%+ (409)
pennsylvania SCREDULE K
oennarnervr or nevervuc LIFE ESTATE, ANNUITY
Bureau of lntlividual Taxes &TERM CERTAIN
PO Box zao6oi
Rarrisburg PA t7~z8-o6on (CHECK BOX q ON flEV-15oo COVER SHEET)
ESTATE OF
ARTHUR H LENTZ FILE NUMBER
21-11-0422
This schedule should be used for all single-life, joint or successive life estate and term-certain calculationse. For dates of death prior to 5-1-89,
actuarial factors for single-life calculations can be obtained from the Department of Revenue.
Actuarial factors can be found in 1RS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return.
^ Will ^ Intervivos Deed of Trust ®Other
NAME OF LIFE TENANT DATE OF BIRTH REARESTAftE AT TERM Of YEARS
DATE OF DEATN LIFE ESTATE IS SAYABLE
ARTHUR H LENTZ 01/16/1930 g1 ®Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
1. Value of fund from which life estate is payable ................. . .... . .. . ...... . . . . . . . . .$ 120.000.00
2. Actuarial faROr per appropriate table ...... .
......................................... 0 1 7F
Interest table rate - ®3.5% ^ 6°/a ^ 10°h ^ Variable Rate %
3. Value of life estate (Line 1 muNiplied by Line 2) ....................................$ , _ 23 970 00
NAME. DS LISE ARNUITANT DATE OF BIRTH NEAREST AfJE AT
DATE.DFDEATH TERM DP. YEARS
ANNUITY IS PAYABLE
^ Life or ^ Term of Years
^ Life or ^ Term of Years
~^ Life or ^ Term of Years
^ Life or ^ Term of Years
1. Value of fund from which annuity is payable ....................... . ...................$ _
2. Check appropriate block below and enter corresponding number ,, , , , , , , , , , , , , , , ,
Frequency of payout - ^ Weekly (52) ^ Bi-weekly (28) ^ Monthly (12)
^ Quarterly (4) ^Serni-annually (2) ^ Annually (1) ^ Other ( )
3. Amount of payout per period ........................................................$ _
4. Aggregate annual payment, Line 2 multiplied by Line 3 ................................... _
5. Annuity Factor (see instructions)
Interest table rate - ^ 3.5 % ^ 6 % ^ 10% ^ Variable Rete %,
6. Adjustment Factor (See instructions.) ................................................. _
7. Value of annuity - If using 3.5, 6, or 10%, or if variable rate and period
payout is at end of period, calculation is Line 4 x Line 5 x Line 6 .......... . .... . .. . . . . . . . . .$
If using variable rate and period payout Is at beginning of period, calculation is e
(Line4x Line Sx Llne E)+Line3 ...............................................$_
NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the
tax return. The resulting life or annuity Interest should be reported at the appropriate tax rate on Lines 13 and ].5 through 18 of the return.
If more space is needed, use additional sheets of the same size.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I, Glenda Farner Strasbaugh, Register 1:or the Probate of
Wills and Granting of Letters of Administration in and for
Cumberland County, do hereby certify that on the 1 S` day of
April, 2011, LETTERS Testamentary in common form
were granted by the Register of said County, on the
estate of Arthur H. Lentz ,late of Wormleysburg Borough in said county, deceased, to
Douglas C Youne aka Douglas Young and that same has not since been revoked.
1N TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of said office at CARLISLE, PENNSYLVANIA, this 1st day of Apri12011.
File No. 21-11-0422
PA File No. 21-2011-0422
Date of Death Mazch 29.2011
S.S. No. 200-24-0425
Re ister of Wil
~. Deputy
NOT VALID WITHOUT ORGINAL SIGNATURE AND IMPRESSED SEAL
w
REGISTER OF WILLS Certificate of Grant of Letters
CUMBERLAND COUNTY, PENNSYLVANIA
No. 21-11-0422
ESTATE OF Arthur H. Lentz
a/k/a:
Late Of: Wormlevsbure Borough, Cumberland County,
Deceased
Social Security No. 200-24-0425
WHEREAS, on the 1st day of April, 2011 instrument(s) dated
July ] 0, 2009 was (were) admitted to probate as the last will of Arthiu H. Lentz (a/k/a
late of Wormleysburg Borough, who died on the 29th day of Mazch, 2011, and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, Glenda Farner Strasbaugh, Register of Wills in and for the
County of Cumberland, in the Commonwealth of Pennsylvania, hereby certify that I have
this day granted Letters Testamentazy to Douelas C. Young aka Douglas Young, who has
duly qualified as Executor.
and has agreed to administer the estate according to law, all of which. fully appeazs of
record in my Office at Cumberland County Courthouse, Carlisle, Pennsylvania.
IN TESTIMONY WHEREOF, I have hereunto set my hand acid affixed the seal of
my Office the 1st day of April, 2011.
Register of Wills
Deputy
~ 1~
~ ~, , ~
Last Will and Testament `~ ' ~~-' `~'
~~ -
'~~s,; e
OF ~ ~~; ` `
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ARTHUR H. LENTZ
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I, ARTHUR H. LENTZ, of Middletown, Dauphin County, Pennsylvania, do
make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils by me at any time made.
ITEM I: I direct that all inheritance and estate taxes
becoming due by reason of my death, whether such taxes may be payable by my estate or by any
recipient of any property, shall be paid by the Executor out of the property passing out of the
residue of this Will, as an expense and cost of administration of my estate. The Executor shall
have no duty or obligation to obtain reimbursement for any such tax so paid, even though on
proceeds of insurance or other property not passing under this Will.
ITEM II: I direct the Executor to pay the expenses of my
last illness and funeral expenses from the property passing under this Will as an expense and cost
of administration of my estate.
ITEM III:
I give and bequeath to BETTY JANE
GINGRICH, my grandfather clock and truck.
ITEM IV:
of my tools, lawn mowers and equipment.
I give and bequeath. to ALBERT LARGENT all
ITEM V:
I give, devise and bequeath all the rest, residue
and remainder of my estate, not disposed of in the preceding portiorrs of this Will, to my
grandson, DOUGLAS YOUNG, per stirpes.
ITEM V: In the settlement of my estate, the Executor
shall possess, among others, the following powers:
(a) To retain any investments I may have at my death, including
specifically those consisting of stock of any bank as long as'. the Executor may
deem it advisable to my estate so to do.
(b) To vary investments, when deemed desirable; by the Executor, and
to invest in such bonds, stocks, notes, real estate mortgages or other securities or
in such other property, real or personal, as the Executor shall deem wise, without
being restricted to so-called "legal investments", and without being limited by any
statute or rule of law regarding investments by fiduciazies.
(c) In order to effect a division of the principal o1'my estate or for any
other purpose, including any final distribution, the Executor is authorized to make
said divisions or distributions of the personalty and realty partly or wholly in kind,
and to allocate specific assets among beneficiazies hereunder so long as the total
market value of any share is not affected by such division, distribution or
allocation in kind. Should it appear desirable to partition any real estate, the
Executor is authorized to make, join in and consummate partitions of lands,
voluntazily or involuntazily, including giving of mutual deeds, recognizances or
other obligations, with as wide powers as an individual owner in fee simple.
(d) To sell either at public or private sale and upon such terms and
conditions as the Executor may deem advantageous to the estate, any or all real or
personal estate or interest therein owned by the estate severally or in conjunction
with other persons or acquired after my death by the Executor, and to
consummate said sale or sales by sufficient deeds or other instruments to the
purchaser or purchasers, conveying a fee simple title, free and clear of all trust
and without obligation or liability of the purchaser or purchasers to see to the
application of the purchase money or to make inquiry into the validity of said sale
or sales; also, to make, execute, acknowledge and deliver <my and all deeds,
assignments, options or other writings which may be necessazy or desirable in
carrying out any of the powers conferred upon the Executor in this pazagraph or
elsewhere in my V6'ill.
(e) To mortgage real estate, and to make leases of real estate.
(~ To borrow money from any party, including the Executor, to pay
indebtedness of mine or of my estate, expenses of administration or inheritance,
legacy, estate and other +arxes, and to assign and pledge assets of my estate
therefor.
(g) To pay all costs, taxes, expenses and chazges in connection with
the administration of my estate.
(h) To make distributions of income and of principal to the proper
beneficiaries thereof, during the administration of my estate, with or without court
order, in such manner and in such amounts as my Executor cieems prudent and
appropriate.
(i) To vote any shares of stock which form a part. of the estate, and
otherwise to exercise all the powers incident to the ownership of such stock.
(j) In the discretion of the Executor, to unite with other owners of
similar property in carrying out any pans for the reorganization of any
corporation or company whose securities fonn a part of the a state.
(k) To disclaim any interest in property which woixld devolve to me or
my estate by whatever means, including but not limited to the following means:
as beneficiary under a will, as an appointee under the exercise of a power of
appointment, as a person entitled to take by intestacy, as a donee of an inter vivos
transfer, and as a donee under athird-party beneficiary contract.
(1) To do all other acts in the Executor's judgment deemed necessary
or desirable for the proper and advantageous management, investment and
distribution of the estate.
ITEM VI: Any person who shall have died at the same
time as I shall have, or in a common disaster with me, or under such circumstances that the order
of our deaths cannot be established by proof, or within thirty f30) days of my death. shall be
deemed to have predeceased ine.
ITEM VII: If at any time any beneficiary under the age of
twenty-one (21) years shall be entitled to receive any assets hereunder, the Executor of this Will
shall receive such assets as Custodian under the Pennsylvania Uniform Transfers to Minors Act
for that beneficiary. Such Custodian may receive and administer all assets authorized by law,
and shall have full authority as provided in the Pennsylvania Uniform Transfers to Minors Act to
use such funds in the manner it deems advisable for the best interests of such beneficiary. In
addition, said Custodian shall have all the rights and privileges as to the Custodianship and its
assets as are herein granted to the Executor as to my estate and the assets therein. I also
designate said Custodian as successor Custodian of any property for which I am custodian under
any Uniform Gifts to Minors Act, or Uniform Transfers 1o Minors Act.
ITEM_ VIII: 1 hereby narninete, constitute and appoint my
grandson, DOUGLAS YOiNG, to be the Executor, herein referred to as "Executor". In the
event of his death or his inability or refusal to serve, I nominate, constitute and appoint BETTY
JANE GINGRICH. The Executor is specifically relieved from the duty or obligation of filing
any bond or other security.
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat ar photograph.
'ee for this certificate, $6.00
This is to certify that the information here given i
con'ectly copied from an original Certificate of Deat
duly filed with me as local Registrar. The. origins
celTificate will he tbrwarded to the State Vitt
Records Office for permanent filing.
.awl QQ-Q~•e,l.(:I ~z /3 ~ /ao i~
L,oca] R Tistrar Date Issued
j O
xlm.le Prv IVImB COMMONWEALTH OF PENNSYLVANIA • DEPAIIriENT OF HEALTH .VITAL IiECON03
TYR / %bYf W
Pane xa CERTIFICATE OF DEATH
(See Inetnretlorm erm exempkm oe reveres) sere Fn P wweFN
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STATEMENTPERIOD PAGE
MAR.25-~APR.22,2011 1 OF 3
00 0 06123M NN 017
ARTHUR H LENT2
114 NORTH HIGH ST
DUNCANNON PA 17020
42214
SE'LECTED' AGCO'UNT SUMIMARY
ACCOUNT ACCOUNT INTEREST EARNED MATURITY ENDING
TYPE NUMBER YEAR-TO-DATE GATE BALANEE~
MiT CLASSIC CHECKING N/INTEREST
RELATIONSHIP SAVINGS
TOTAL DEPOSITS
015004220421579
0.02
0.02
893.07
49.80_
942.87
A- ARTHUR H LENT2
M&T CLASSIC CHECKING W~iNTEREST r1TLE "
ACCOUNT N0. 9850851560 NEST SWORE PLAZA
INTEREST EARNED FOR STATEMENT PERIOD 0.00
ACCOUNT SUMMARY
: BEG ING.:
"-BALANCE S. S.
OTHER ADOIT OMS
CHECKS PAI :,,.Q HER
SUBTRACTIONS' :'..CR
INTEREST PD '.ENDI
'' BALANCE
N0. AMOUNT ND. AMOUNT N0. AMOUNT
953.56 3 1,348.46 0 0.00 6 1, 08.96 0.01 893.07
ACCOUNT ACTIVITY
POSTING
DATE
TRANSACTION DESCRIPTION EPQS Sf,
iOTHER ADDITIOIO; ILH CK ir. ER
;SUBTRACTIONS DA Y;.:
BALANCE,
03-25-11 BEGINNING BALANCE 5953.56
03-29-11 DEPOSIT 233.25 1,186.81
04-01-11 US TREASURY 303 XXSOC SEC 1,037.00
04-01-11 TRESSLER - LUTHE PENS PMTS 78.21
04-01-11 FREEDOMBLUE FREEDOMEFT 161.00 2,141.02
04-04-11 In Branch Tr~nsf~r/Nilhdr~w~l 25.00 2,116.02
04-06-11 REVERSE DIRECT DEPOSIT 1,037.00 1,079.02
04-13-11 STATE AUTO COS. E-PAY 71.75 1,007.27
04-18-11 TRESSLER - LUTHE REVERSAL 78.21 ~ 929.06
04-19-11 GOODVILLE MUTUAL INSURANCE 36.00 893.06
04-22-11 INTEREST PAYMENT 0.01 893.07
ENDING BALANCE 5893.07
IAOBA (6/Oa)
Michael and Debbie Bomberger
1130 N. Market St
Duncannon PA 17020
October 17, 2011
Arthur H. Lentz Estate
Douglas Young, Executor
114 High St
Duncannon, PA 17020
The property at 1115 Strites Road, Middletown PA 17057 is owned by us and had a Life Estate on the
deed for the deceased Arthur H. Lentz.
Please find attached a spreadsheet outlining the expenses incurred by us as owners of the property
beginning March 2009.
Total due is $6825.42
Thank you in advance for your attention to this matter.
Michael R. Bomberger
Debbie S. Bomberger
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APARTMENT LEASE AGREEMENT
Page 1 of 3
The Landlords are: Iylr. Arthur Lentz Phone• 737-5777
The Tenant is• ~~. l ~ ~~d6,~ ~ .,.~ ~ ~ Cl.-~.~~
***Only person(s) listed above are to reside at this residence!
~~
Location: ///5 ~/,.;,eC j- ,i~.•~~Q ~~e~/e7`e~.~ ~~ J ''c~ s7"'~ %!; - s3`7;%-:~ ;,~;=,
-see~;t~ ~ .~G v~ _ Y
***Security Deposit is NOT Rena _- __. _ -- -
Monthly Rectal of: $ 6"d d. G ~ Rent Due on the first (1'~ day of each month.
Charges for LateRent: A five dollar late fee is dne for each day after the 5"' of the month
and most be included at time the rent is paid.
***ff rent is not raid by the 15"' of the month the lease will be
eaded and the tenant will be given written notice to move
oat within 15 days.
Term of Lease: Minimum 12 Monffis From To
***Minimnm 60-day move-out wRiTTEN notice regnired prior to
the end of the month that yon intend to move.
Utilities Paid By: RESPONSIBLITIES
(initial)
Water Sewer
Elechic Cable TV
Telephone Renter's Insurance
~~ Building Insurance
Gas
***Landlord is NOT responsible for any accidents occurring on premises!
***Lease is automatically renewed each veer after ezoiration date
.~~
TENANT IS RESPONSIBLE FOR: Page 2 of 3
Contacting utilities immediately to be put into your name
'TT IS YOUR RESPONSIBILITY TO OBTAIN TENANT INSURANCE ON YOUR PERSONAL
BELONGINGS.
Landlord is NOT respoaaibie for eery ks~aes to tenants' property.
~) I~ ONLY people who are on the lease are to be living in the apartmerns.
U:
Keeping apartment; appliances, and area neat and clean
_ Keeping noise level reasonable.
Contact landlord regarding all repairs. NO repairs may be made without Iffidlords' approval.
NO repairs may be deducted from rent (comact landlord immediately)
No waterbeds in aparnneots.
Apartments are
ABSOLUTELY NO PETS ALLOBVEDI f No Pet-Sittine in a~attmentsl (NO CATS!1
No giaing any objects to cabinets, doors, or walls, etc. No stick-oa books to be need.
Ne wallpaper of nay k®d, iadndiag borders, atenciting, etc.
If there is any damage to window screens darin¢ voar occonanev. von wiII be
restwns~le for reolaciaa them before von move oat:
Landlord may inspect the apartment at nay time while tenant is present.
Tenants renting oa the second Boor are responsible for keeping the steps clans at all times.
ABSOLUTELY NO VEHICLES ON THE PROPER THAT ARF NOT IN RUIVNIlVG CONDTTiON
Page 3 of 3
C~;%~~ ~ FINAL APARTMENT CLEANIl~TG CHECKLIST
General: Throughout the entire apartment)
1. Remove ALL trash from apartmeat.
2. Vacuum/Wash all floors. Carnets will be professionally cleaned and cost
will be deducted from your securtity deposit. Teo 1~1D'T' rent a carpet cleaner.
3. Wa1Ls must be free of all nails tacks. marks etc Roles must be speckled and sanded.
4. Clean (washl windows. and blinds or replace blinds with new ones.
5. Replace all burned-out light bulbs.
6. Debris removed from sll aml wiped down iaside and out.
7. All atipliances must be thoroughly washed and oven cleaned
Bathroom:
1. Tub toilet, and basins must be cleaned of all film. soap residue marks etc
2. Clean exhaast fan. and replace arty burned-out i itln~bs
3. Floors must be cleaned and washed un.
K3tehe8:
1. Clean oven. racks, and stove tap of all residue. Replace burner elates if necessary
2. Empty refri~~ar C all racks shelves etc W ah rnrta;de of refrigerator.
3_ Floors nmst be cleaned and washed ~
You must schedule an appointme~ with Landlord for a walk through before handing in keys
~ order to have your security deposit Trailed #o you.
When you move into the apartment, all of the above-mentioned items on the- checklist
Dave been completed. When you move out, the same is expected of ;you.
Uwe have read the checklist, and agree to complete all items prior to returning the keys.
Uwe understand that if ~ese tasks are not completed and/or there is damage tb the apartment,
that charges for cleaning and/or repairs will be deducted from myJour security deposit.
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e s) gesture
Daze: ~ so /m
~~C~'=". ~ ' Y V V
Tenant(s) Signature
Dater, - /cJ