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HomeMy WebLinkAbout02-1111PETITION FOR GRANT OF LETTERS -- r Estate of (T~'~'~~~ F' l~~-t'~-`~'~~ -~ No. n~ ~ - Dom. - L/I also known as ,Deceased Social Security No. l ~~~ yy ~1~~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for (COMPLETE "A" OR "B" BELOW:) ^ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut named in the Last Will of the Decedent, dated and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence ~i9h~~~T~ /('/~S .l/A ~,TN ...t,Vla~ N~~~ S .1'it~'~T/Ix fJ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in residence at County, Pennsylvania, with his/her last family or principal ~!~ I ~~/1 ~ 3~~~3~ tusi areei, nwnoer anu mwnapanry~ _ Decedent, then ~~ years of age, died AC~YM/~f~ L ?"L , at /r/~,E'l if'L~ ,~~~.~~~L ~/~JZC'/~'~ r!'Pi9~'~~' (Location) Decedent at death owned property with estimated values as follows: _ _ rfdomiciled in PA All ersonal roe 2C~ ~~~~'~ `'~' (~ ) p P P rty ......................................... $ (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ ~C'l. L'~-. Total ..../..~.........../.~ ...............1.~..~.......................~.1.........../.Y......................................... $ ~' rr~~'~ D~~ Real Estate situated as follows: ~~L' ~5'~~~~ /~G"~~~ ~(J [-~/~`u~~' ~'~ Wherefore, P ~ (s) respe tfully qu t(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appro ate to the u ers' ned: S' natur Typed or printed name and residence ' Q/1 ~~ ~~i~A.Z~ 5 t~~/ ~' uf~.f aB/ sr ~1i9f>r ~/~33C, ~~ RW-7 1`~- - tu`-~- - l~ Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of Dauphin The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~ Sworn to and affirmFd and subscribed before me this 9th day of DECEMBER "1_ "--_ -0`~" DECREE OF REGISTER Estate of t-° ~~~~~ ~~ }~~~~'~'P~ "'~' Deceased No. ~ ~ ' Q~ " ~~ ~ also known as Social Security No: 1~~' ~~ ~~~~ Date of Death: ~~~'~~~~~~ ~> ~ ~OZ AND NOW, DECEMBER 9 , 2 0 0 2 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ^ Testamentary ^ of Administration (c.t.a., d.b.n.c.t.; pendente liter durante absentia; durante minoritate) are hereby granted to ~~~.r~ ~D~31~.T~ in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... $ 2 0 0. 0 0 Short Certificate(s) ............... $ 12.0 0 Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( ) .............. $ Codicil ................................. $ JCP Fee ................................. $ 10.0 0 Inventory & Tax Forms ............. $ bond 15.00 Other ...................................... $ TOTAL $ 237.00 Attorney: I.D. No: ~G' ~~~ Address: ~~33~ ~~~'~/~~~ f~ ~'/~i/l~ 1~. %~~ eft- /7~.-~r Telephone: 7~~' ~~~ ~ ~~~~ admin waited for letters 1~~TE FILED: ~~'~ 12-9-2002 12-9-2002 RW-7A .~.. I !b :i i'. "e ?: ' 9i1' :l :3ilf I1 ~~E?'*= -iCi.'^ !S COt't't'CIl~% CO!?ItC~ fi~ITl diR i'I1~IRd~ C1,1C1tU::~il' t)~ Ci: :ji 1~=j 1 .'. S;i. 1:~ .,t C31 1'; .- _ ._. c +';l; "t' ~<it'.~'tit!'L3zL~ TO C~1C ~C:2tt: ~' iC~la ~iCC,T~$ ~~t~7li iC :~li ; ~ra'~H~.'Ig+I~~: t S illegal to d~s~l3cate tt~iS Co~Y try photostat o1' pl~oto~~~ s, -- ::, ~~, ~r +~ ~ . F ~ DEC t~ 5 2002 ~ 8645480 ~-•~~r~ ~~~~~~ a3 Rev zie7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH I AME OF DECEDENT If usr. Middle. ;asl SEX SGCtAI SECURITY NUMBER DATE OF OEATM,MCnm. Day. 'rear) I (,t:oRGF r RH(N: ~~~~~ ~ :. le 7. ~lg - Yy _82oy ..`i~cer.,be~ z. zooz +GE (Lass Bmhaay) UNDERtVEAR UNOERtI~AY DATE OF BIRTH 81RTHPLACE;CM and PIACE OF DEATHlC1+ecM avy one--.ee:nsuvclArnrm wnei sore/ Months • Days Howe • At~wea Mpnm Day real ~talea ACregn Counuyl HOSPIUL OTHER: ~ 15s3 mLa~'c~l Z / ~ ~ , Inpalwd ® EWOulpauam ^ DOA ^ Hony ^ RasWnu AJ SpecMl LJ L) Q Yn. _ ~ a. 7. h r a 4 N. • r (XINTY OF DE/ITM CfTY, t~.lRO. TWP OF DEATH FACILRV NAME III not ~w~twwn, gwe street antl numuer, OF HISPANIC ORIGIN7 VNS D ECEDEN~T RACE -Amercan IMian, &eca, While. etc. .gyp ,.O n °~ me~' ~/ ~~ •`~ r C1 ~ • S ~C ~ I°t IG ~ 7 No IrJ vw LJ tl yea. sWCdy Cuban. Puerto Rican, ac. Maalcur lSpacM) l . DECEDENT'S USUAL OCCUPRKNI Ku_•D OF eUSINESS/INDUSTRV WAS DECEDENT EVERM DECEDENT'S EDUCATION MARITAL STATUS-Married N M i d W d d SURVIVING SPOUSE s is (Give wrw d work dare dwuy rmat otwwkrrtq Me:dnd use resredl L.f,/jf Sly/~$ ~~. U.S. ARMED fOFICES? Yes^ No® ever arr , i owe e , S m est ade com tea Elemen /Secondary CoWgs Diwrced($peCM) i :v a. grve mau,en nxnel s~~t 3,. - p•/t r~7r~sov , Ot2) Ilaw 5.1 2 9 l • ~l ' tm. tx. 1 r.ir a l.,e~- ,7.1 ,s. I ECEDENT'SMAILING ADDRESS (Slreel.CM/bwn. SUw. Lp, .net DECEDENT'S ^Ya aac.dra tivedm n.p °nnSyl~Gnrc. Dia ,ic l • p •77 1 3 S Uvr~Jt Nose Ic00"G~ . . . . AcruAL ,Ta. Slm. RESIDENCE -~ ~•a•nl ~1 I !~,~1 r s. ( G.r• I. S lQ rtI J 7DI 3 - /See elslruCLMa Nve et e _ /~ un caner swat l m. County ~ V r" b e ~ l~-~ ~ lownsnipi , 7d.® wahin xfual limas of ` 4 Y S ~l° caylboro t +THER'S NAME (Fu ,MbWe. Last) MOTHER'S NAME IFust. M:dd4.MadnSwname) ~R ta.~c~or4e F. FZ~•A~~x..-t ,a. G_r r es t II rFORMANT'S ME (TyperPmg I NfORMANT'S ING ADDRESS ISbeel. Cifylfown, SWe. Zip Cod e) d.. Ed.wc.rd ~obb•@ xgb. 58S! sou~aw 'f 1 ~' r4r.ss .• F/on~l~- 3a 33 A~ETHOD OF DISPOSITION GATE OF DISPOSITION PLACE OF DISPOSRION-Name of CemNery,Cnmatory LOCRIO -CirylTown, Stue, Ztp Cad Burin ^ Cnmalicn ® Removal hom Slate ^ (Moran, Day War) a OlM( Plxe t.ortelion^ OlnarlSpacMt - ^ `}{G ~A /702 8 %l 'f /l.. :, b. ~ 6 i. r / x,e. v, :,d. c... e SIGNATURE ~ fUNERAL SERVICE LICENSEE OR PERSON ACTING AS SUCH LICENSE NUMBER NAME AND ADORE FACIUTYW. v e . m.^AQ/ w/ n a9, Z G , ' 1ta. '~~s. ..GG- _ xb .S-O/3,$~Jr' 2 - ~ xx<.ZOO/ :Y11~..rk 'f. tlc.ri': i u~ /^'9 i7io3 CumpMta Aems 23a< my when anlryirtg To lna Deat of my AnowNdga. dash all a, dale and place slated. LICENSE NUMBER L L ( DATE SIGNED Mash Day year/ p~ ~yaa:Mn n nd avaiMDle at bme of dmh to f ISgnewre and Tale/ ~ ~ O J 7 / ~ J }' . , ) Z ' L ^ ~ ~ dam. c•mry arise o ~ xa.. x7D. xx. c u.,ms 2e~28 must W completed try IME OF DEATH GATE PRONOUNCED DEAD IMonm. Day. Pearl WAS CASE REFERRED TO MEDICAL E%AMINERICORONER7 K I. ' ^ a L Yea L No p,rsprt who pronounces dam. ` L ~~v ~ I J P ~ I j- ~ M ~ _ . M. x5. 2a. x y. PART I: Emer Iha diseases. injuries cr compacataau which cruses the dash Do rid solar IM mod of dying, Such as cardiac or respiratory anesL shock p. near laaure r Appro:unate PART 11: OIMr signilicad crorldawns conpibwirg to darn, ow ~ mlerval bNween nd nsumng in uw tWadyirg cruse 9rven n PART 1. Usl Dory oru cruse on each Frr. t onset sod dam IA•MEDIATE CAUSE (Fuuu I a..eaae w pramawn pL! (, /"V v N A ~' Y~ M. ~ a G i~ M DUE TO (OFi AS A COHSE WENCE OR: t S,rKNMMey Hal cwtditiona D. t .ury, Nailing W immediate DUE TO (t7H AS A CONSEQUENCE OFD: l _ c.•,•se. Enlar UNDERLYING ~ CAUSE IDrsease w nryry c. - a. a evDa,ed events Ol/E TO 1(Xi AS A CONSEQUENCE OFI: I ~c uarq n seam) LAST d. N aS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY IWURV AT WORK7 DESCRIBE HOW INJURY OCCURRED. P. RFORMED7 AVAILABLE PRIOR TD (Mmm. Day. Pearl COMPLETION Of CAUSE ^ OF DEATN7 Natwal ~ Homicitle Y ^ N ^ .,..dm ^ PerWirg Mveatigatwn ^ ~ o es ]d. ]00- M. 7llt. ]ed. w ^ No ® Vea ^ No wu~Me ^ Could rot Da OeNrmmed ^ PUCE OF INJUPV - AI home, hrm, areal, tadory, ollics LOCATION ISDeet. C:rylTOwn, Stale) Ouaainq, etc. ISpecavl x. •. xeb. 19. 70e. _ Cr RTIFIER ICnece oniy anal d! 23 SIGNATURE AND TITL 7 I~ ~~ 1em 1 'CERTtFY1NG PHYSICIAN IPhysican cwelyu,g causetl seam when caner phvskan rtes porwunced deem arts compiete To 11N neat of my knowNdge, dam xcumed dw b me cause(al and manner as stated ..................................................... ^ ~ • 7, 0. ~ to cause of dealnl ndcMA a ln A P • LICENSE NUM R DATE SIGNED (Moron. Day. year) ( 2 2 ~ (~ ~` ~ J 7 r ~ L ~ ' y g nysCan Dnln ~+~nouriCaxJ aea a N I 'PRONOUNCING AND CERTIfVING PHYSICI death occurred at ilia Ilene, date, and place, and dw to 1M uuxta) and manner as stated .......................... - To the beet of my EnowNdge 71d 71e , , NAME AND ADDRESS l3F PERSON W NO COMPLETED CAUSE OF DEATH (Item 271 Type q(~int I ~ ~ ~ r Qr "J .7 'MEDICAL EXAMINER/CORONER On the basis of easminslion and/or investigation, in m y opinion, death occurred at the time, date, and place, and due to the cause(s) and ^ r ~ r/ /1 / ~~Z ~'~'~ ~ CX ~'~ r ~~ ~-3 / y j '1 Z .......................................................... manner as stated .............................. O ,. ~ ~ c- ~ 3 ~a ]x. REGISTRAR'S SIGNATURE AND NUMBER /////~ ~-~//y 1~/ ~ /~ DATE FILED (MOnm. Day Pearl •'7 BOND NO. ~~om III ~er~ ~p ~~je~e ~re~er~t~ ~' ~ ' ° ~- - r r r r bat i~c~ ~'dd ~ ~ 1J ~~ h i~ [ S ~.5'r S ~7 ~ x~ ~" S-F- ___ ....~~ ~ ~G(~ d~ ..L~y5ui25t~, c~ o~_i r~y,N,C' ~cc< Su ~~ ~-y A Are[~held an/d firmly bound unto the CommonwealW of Pennsylvania in the sum of_ ~`,,2.1t~_ TY-l.~i~cl1' ~ S /x 1 y ?~-X.{:~ ~~~ `. DOLLARS, to be paid to the said Commonwealth, to which payment, well and truly to be made, we bind ourselves, jointly and severally, for and in the whole, our Heirs, Executors and Administrators, firmly by These Presents. Sealed with our Seals, dated the. ~ ~ __. __.r._day of~~~rh ~ P~ in the year of our Lord ~~ GCS v ~v1 GL{ $ f]`ic,es _~~,~ ~TGU U_~ ~tije QConDftion of ~tJis ®6Cigation i~c much That if the above bounden ~ ~~ ~ ~ ~ v p h ~ ~ ----- /~' ----n-AdministraTo~^ of all and singular the Goods, Chattels and Credits of.._~~? _~ ~'~ E~ ~ K ~? ~~2 fj ~q ` % ~ // deceased, do make, or cause to be made, a true and perfect INVENTORY of all and singular the Goods, Chattels and Credits of the said deceased, which have come, or shall come, to the hands, possession or knowl- edge of_._-__ ~ ~~/ ~e ~ a~{j r c the said__._.L?_s>s'~_...~_._ S3~?-~?;c or into the hands and possession of any other person or persons, for_.___.__~_L~._.__and the same so make, do exhibit, or cause to be exhibited, into the Register's Office, in the County of Lebanon, within// 30 days from the date hereof, and the same goods, Chattels and Credits of the said deceased, at the time of~[1~~,__ ____-..death, which at any~t^ime after sh^a~ll come t~ the hands or possession of the said --- or into the -hands and possession of any other person or persons, for__.._.._~!.~ do well and truly ad- minister according to law and further do make, or cause to be made, a just and true account of i~.~caid administration, within one year from the date hereof, or when thereunto legally required, and all the rest and residue of the said Goods, Chattels and Credits which shalt be found remaining upon the said Administrator's account, the same being first examined and allowed by the Orphans' Court of the County having jurisdiction, shall deliver and pay unto such person or persons as the said Orphans' Court, by their decree of Sentence, pursuant to law, shall limit and appoint; and shall well and truly comply with the LAWS OF THIS COM- hIONWEALTH relating to Collateral Inheritances, and if it shall hereafter appear that any Last Will and "Testament was made by the said deceased and the same shall be proved according to law, if the said____..._ ~=-d~,~~e ~~hh ~°e ;~ bung hereunto required, do surrender the said Letters of mi trati n int the egis is Office aforesaid, then this OBLIGATION to be void-otherwise to r~ ' ull fo e. i ~eateD anD (bereD to tl~e ~ .-- . ~ i ~~ ncc of sseL ~ ~~ %~~~' SEAL l ~~`~ { 1wSURRtiG~ ~ l-~ lo• o• ~~'K~c` s~eL s~ii ~ ~ ~~ Set"ei~v`E e Selective Insurance Company of America 40 Wantage Avenue Branchville, New Jersey 07890 973-948-3000 POWER OF ATTpg~y KNOW ALL MEN BY THESE PRESENTS: That the Selective Insurance Company of America, a New Jersey cor- poration having its principal office in Branchville, State of New Jersey, pursuant to Article VII, Section 13 of the By- Laws of said Company, to wit: "The Chairman of the Boazd, President, any Vice Presidents or the Secretary may, from time to time, appoint actor- neys in fact, and agents to act for and on behalf of the Company and they may give such appointee such authority, as his/her certificate of authority may prescribe, to sign with the Company's name and seal with the Company's seal, bonds, recognizances, contracts of indemnity and other writings obligatory in the nature of a bond, recognizance or conditional undertaking, and any of said Officers may, at any time, remove any such appointee and revoke the power and authority given him/her. does hereby make, constitute and appoint PATRICK FREER, DENISE M. EICEMAN, ROBERT P. HORN, VICHI E. JOHNSON its true and lawful Attorney-in-fact, to make, execute, seal and deliver for and on its behalf, and as its act and deed, bonds, undertakings, recognizances, contracts of indemnity, or other writin s obli atory in the nature of a bond sub- ject to the following limltauons: NO ONE BOND TO EXCEED ONE MILLION DOLLARS ($1,000,000.00) and to bind the Selective Insurance Company of America thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Selective Insurance Company of America, and all the acts of said Attorney are hereby ratified and confirmed. IN WITNESS WHEREOF, the Selective Insurance Company of America has caused these presents to be signed: ~ by its Vice President and its corporate seal to the hereto affixed this ~ MAY , 19 98 19TH _ day of o ~~E C0~1P w Selective Insuran e m ~ qy` w ~ ~ >~ ~ `" BY: ~~ ~ State of New Jersey ~ . ' F.F. Gre,~~,!Jr,> wide '~ W County of Sussex U ~~~ y ~2 926 ~ ~a On this 19TH day of 1 N n MAY 98 19 before the subscribet~ No li and For the County of Sussex duly commissioned and qualified, came F.F. Graver, Jr. of the Selective Insurance C\ an to ° e'^' Jersey in to be the officer described herein, and who executed the preceding instrument, and he acknowledged the execution o e same~ad bei me y me duly sworn deposed and said char he is an officer of said Company aforesaid; that the seal affixed ro the preceding instrument is the core 'd Company, and the said corporate sea! and his signature as officer were duly affixed and subscribed to rttc said instrument by the authority and direction of the Company; that Article VII, Section 13 of the By-Laws of said Company is now in force. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal at Branchville, New Jersry this ~ E• C Hq day of MAY 98 19 ~•~ // ~BF 19TH JUDITH E. CHAM$ERLAIN G~~~ hq~~ l ' NOTARY PUBLIC OF N$®~~- to Pubp~OTARY The power of attorney is signed and sey fa~~ I~ ~~' any ~e authority o he ollowBg'Res ut' ado red by the Board of Directors of Selective Insurance Company of Amenca at a meeting c d and d the 6th of February 1987, to wit: "RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of a facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements thereof on powers of attorney for the execution of bonds, recognizances, contracts of indemnity and other writings obligatory in the nature of a bond, recognizance or conditional undertaking......." I, Patricia A. Fulkrod, Assistant Secretary of the Selective Insurance Company of America, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by said Company which is still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company ac B c vt New Jersey this ~ r -t- day of ~-,r~~2~s~~_I~- o0 ' ~ ~~~ ~ The RED border on t~8-f~cA rtM~ document has a security VOID background pattern. If it is not RED and the word VOID is visible: this is not a certified copy ~S phonesus aeLarya r ,~o on. ~.~ .,,.,... C,'~ CERTIFICATION OF NOTICE UNDER RULE 5 6 (a) Name of Decedent: George F. Rhinehart III Date of Death: December 2, 2002 Will No. 21-02-1111 To the Register: Admin. No. I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 18, 2003: Name Address Matt Dobbie 45054 Fox Pointe Drive Canton, MI 48187 Suzanne Dobbie 4169 Nantucket Drive Mechanicsburg PA 17050 Mischelle White 2120 Fremont Street Rockford, IL 61103 Eddie Dobbie 15851 SW 281St. Street Miami, FL 33033 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except Date: /? ~ D3 Linus E. Fenicle, Esquire Reager & Adler, PC 2331 Market Street Camp Hill, PA 1701 i (717)763-1383 Counsel for Personal Representative CUivIF3ERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of RHINEHART, GEORGE F. ,III No. 21 02 1111 also known as Deceased Date of Death 12/2/02 Social Security No. 198448209 Personal Representative(s) of the above Estate, deceased, verify 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 Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal ive: ~v i Name of Attorney: LINUS E. FENICLE I.D. No.: 20944 Address: 2331 MARKET STREET CAMP HILL PA 17011 Telephone: 717-763-1383 Description Stocks & Bonds Closely-Held Corporation, Partnership or Sole-Proprietorship Mortgages & Notes Receivable Cash, Bank Deposits, & Misc. Personal Property ORRSTOWN BANK SAVINGS ACCOUNT 1985 PORCHE 944 Dated l ~ ~ ~ ~ ~ b Value 0.01 1,500.00 Total 95,000.01 (Attach Additional Sheets if necessary) ~ NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory RHINEHART, GEORGE F. ,III 21 02 1111 Pa e 1 Description of Inventory . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 II -I Ol- \.p REV..1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV.1500EX"(6-00) DECEDENT'S NAME (LAST, FJRST, AND MIDDLE INJTJAL) I- Z W C W CJ W C RHINEHART, GEORGE F. , III DATE OF DEATH (MM-OO-Year) DATE OF BIRTH (MM-DD-Year) 12/02/2002 03/27/1953 {IF APPLICABLE} SURVlVlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE lNITIAL) NONE Ul ~ X:ii~ U&U ~a:9 u..., ?;: [R] 1. Original Return o 4. limited Estate o 6. Decedent Died Testate (AttachCOjlyofWdl) o 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12.ll-52) o 7. Decedent Maintained a living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of delllh between 12-31-\11 am! 1-1-9S) OFFICIAL USE ONlY FILE NUMBER 2 1 - 0 2 1 1 1 CCijji'w-coor --YEA~ - -'iMffiER-- SOCIAL SECURITY NUMBER 198-44-8209 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3, Remainder Retum (daICofdeathprklrto 12.13-82) o 5. Federal Estate Tax Re1Um Required ~ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AtlacllScll0) .... :z J!j :z o .. ., Ul '" '" o u COMPLETE MAILING ADDRESS 2331 MARKET STREE1 NAME LINUS E. FENICLE FIRM NAME (If Applicable) REAGER & ADLER, P.C. TELEPHONE NUMBER 717-763-1383 CAMP HILL (1) (2) (3) (4) (5) z o ~ ..J :J l- ii: <( CJ w a: 1. Real Eslale (Schedule AI 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jolnlly Owned Property (Schedule F) o Separate Billing ReQuested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. CharItable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (6) (7) (9) (10) 14. Net Value Subjec1to Tax (Line 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I- :J Do :E o CJ ~ I- 15, Amount ofUne 14 taxable at the spousal tax rate, or transfer.; under Sec. 9116 (a)(1.2) 16. Amount of Une 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due X_(15) X_(16) X .12 (17) X .15 (18) (19) 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C 1...' : 93,000.00 I=-; I I I 2,000.01 i I \ i PA 17011 OFFICIAL USE ONL yU (8) 95,000.01 28,536.23 75,843.44 (11) (12) (13) 104,379.67 -9,379.66 (14) -9,379.66 dd Decedent's.Complete A ress: STREEHOORESS 138 BURNTHOUSE ROAD CITY CARLISLE. I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount Total Credits (A + 8 + C) (2) 3. InteresUPenalty It applicable D.lnterest E. Penalty 4. TotallnteresUPenalty ( 0 + E ) 11 Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. (3) 5. (4) (5) (5A) (58) to: REGISTER OF WILLS, AGENT A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; ........................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 c, retain a reversionary interest; or ........,............................................................................................. 0 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................... ............................................... 0 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .......................... ............................................................................. lZl lZl lZl lZl lZl lZl lZl o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. , including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correcl and complete. . based 011 all information ofwhich preparer has any knowledge. ;j.E . eta. 0:3 ~/1-p E ADDRESS For dates of death on or after July 1. 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or forthe use of the surviving spouse is 3% [72 PS. ~9116 (a) (1.1) (ill For dates of death on or after January 1. 1995. the tax rate imposed on the net value of fransfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (Ii)]. The statule does not exemot a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twentY-{)f1e years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(I.2)]. The tax rate imposed on the net value oftranslers 10 orforthe use of the decedent's lineal beneficiaries is 4.5%. except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(I)J. The tax rate imposed on the net value of transfers to orforthe use ofthe decedent's siblings is 12% [72 P.S. !j9116(a)(I.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ",v,w,,,,:,,m. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER RHINEHART GEORGE F III 21 02 1111 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compeUed to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jOintly-owned with right of survivorshin must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 138 BURNTHOUSE ROAD, CARLISLE. PA 17013 VALUE AT DATE OF DEATH 93,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 93,000.00 REY'WOE'.'''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF RHINEHART GEORGE F . III FILE NUMBER 21 02 1111 Include 1he proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION ORRSTOWN BANK SAVINGS ACCOUNT no joke - account was depleted to cover overdraft checks VALUE AT DATE OF DEATH 0.01 2. 1985 PORCHE 944 sold for this value. Kelley Blue Book indicated it was worthless - see attached 1,500.00 3. 1991 CHRYSLER LEBARON sold for this value. Kelley Blue Book indicated it was worthless - see attached 500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, 'nsert additional sheets of the same size) 2,000.01 "'''''".,,'''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF RHINEHART GEORGE F. . III FILE NUMBER 21 02 1111 Tl1is schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM tNCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEOENTANDTf-IEDATEOFTRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACHACOPVOFTHEOEEDFORREAlESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) 1. LIFE INSURANCE. TRUSTMARK 25,963.70 O. 2. ING 401(K) 13,210.55 O. TOTAL (Also enter on line 7, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) '''''''EX''''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF RHINEHART GEORGE F . III FILE NUMBER 21 02 1111 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. KIMMEL FUNERAL HOME 3,694.1D 2. OBITUARY 39.60 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City Slate Zip Year(s) Commission Paid: 2. Attorney Fees REAGER & ADLER, P.C. 1,7DD.DD 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 237.DO 5. Accountanfs Fees 6. Tax Return Preparer's Fees H.R BLOCK - 2D02 TAX RETURN PREPARATION 138.DD 7. CUMBERLAND LAW JOURNAL 75.DD 8. THE SENTINEL 9. REAL ESTATE COMMISSION 6,51 D.DD 1D. REMAX REALTY PROCESSING FEE 125.DD 11. OVERNIGHT, WIRE AND NOTARY FEES - SALE OF HOME 38.5D 12. TRANSFER TAX 93D.DD 13. RECORDING FEES - POAAND SATISFACTION PIECES 71.DD 14. LAWN SERVICE 2DD. DD 15. SELLER ASSISTANCE 3,DDD.DD 16. FIDUCIARY BOND - SELECTIVE INSURANCE 7DD.DD 17. TITLE SEARCH TO SATISFY OLD MORTGAGES 5D.DD 18. CARLISLE SENTINEL - YARD SALE AD 1D.DD TOTAL (Also enter on line 9, Recapitulation) $ 28,536.23 (If more space Is needed, insert additionai sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent RHINEHART, GEORGE F. , III 21 02 1111 PaQe 1 Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION AMOUNT 19. 20. 21. 22. 23. BRETZ CARPET - purchase carpet for sale of home LEONARD WALTERS - home repairs, cleaning, grass culling & materials for sale of DAVID SHEIBLEY -trash removal from home EXECUTOR TRAVEL, LODGING & CAR RENTAL EXPENSES HOME DEPOT - home repair supplies 2,800.00 1,420.00 1,700.00 2,370.74 77 .29 2,650.00 SUBTOTAL SCHEDULE H-BT 11,018.03 ,ev"""."",. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF RHINEHART GEORGE F. . III SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. DESCRIPTION COUNTRYWIDE FUNDING -1ST MORTGAGE PAYOFF MADISON FIRST - 2ND MORTGAGE PAYOFF CENTRAL PENN MEDICAL GROUP EMERGENCY COUNTRYWIDE FUNDING - November, 2002 - May, 2003 PP&L - November, 2002 through June, 2003 MBNA HOUSEHOLD BANK PROVIDIAN COMCAST CABLE RISK MANAGEMENT ALTERNATIVES (SEARS) CULLIGAN MASLAND ASSOCIATES CAPITAL ONE CARLISLE REGIONAL MEDICAL CENTER SPRINT PCS SPRINT - 717-245-8573 FILE NUMBER 21 02 1111 AMOUNT 57,667.60 4,746.02 180.00 5,966.14 707.55 460.77 1,300.00 196.23 1,862.07 113.81 129.16 1,926.28 50.00 292.87 141.84 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 75,843.44 Continuation of REV.1500 Inheritance Tax Return Resident Decedent RHINEHART, GEORGE F. , III 21 02 1111 Paqe 2 Schedule J . Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16. SPRINT. 717-245-0927 60.65 17. HOLY SPIRIT HOSPITAL 42.45 SUBTOTAL SCHEDULE I 103.10 GRAND TOTAL SCHEDULE I $ 75,843.44 REV-1513EX"9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ,OT 'C "' ?1 O? 1111 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS !include oubight spousal disbibutions, and transfe", under Sec. 9116 lal 11.2)] 1. EDDIE DOBBIE BROTHER 15851 SW 281ST STREET MIAMI, FL 33033 2 SUZANNE DOBBIE NIECE 4169 NANTUCKET DRIVE MECHANICSBURG, PA 17050 3_ MICHELLE WHITE NIECE 2120 FREMONT STREET ROCKFORD, IL 61103 4_ MATT DOBBIE NEPHEW 45054 FOX POINTE DRIVE CANTON, MI 48187 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PARTIl- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (11 more space IS needed, Insert addilional sheels of the same size) Kelley Blue Book Used Car Values . KeIIq'" Book . TIre Trusted ~: Blue Book IlIhIrll'et W"kh Enter your email to get the latest I Le S''1 NewCarPril;lJlg! Blue Book Private Party Report Build a Car lm;utl_ Pennsylvania' September 3, 2003 QUllllty Ratings Ow_hi!> Co$t My Car's Val.... used Car Retail 1985 Porsche 944 Coupe 20 Free Prlc;e Quote Buy II wed Car $ell Your Car MotorcycleS Flriilnl;lJlg Insurance Lemon Clueck Wenantles Car RevIews Car PnlYlews Decision GuideS Advice I Free~.I~.j Abo\It kill) Home, Engine: 4-Cyl. 2,5 Liter Trans: 5 Speed Manual Drive: Rear Wheel Drive Mileage: 92,000 BUUJ'lLew-Car ];lJD'. <LlJsef:Lcar LisLYQur Ca.r:foJ:Sale...Qj1Jjn~ free LemQn...Cbe~ AutQ...l,oans .from _3.99% APB lnsuranceQuote Warran.t:Y QJJote Pri n.L" FoU~ale".slgj1 Payment Calculator Sell.y:oW" car..(m_~BaYJ"10J;Qf~ Equipment Air Conditioning Power Steering AM/FM Stereo Cassette Alloy Wheels Consumer Rated Condition: Poor "Poor" condition means that the vehicle has severe mechanical and/or cosmetic defects and may be in questionable running condition. The vehicle may have problems that cannot be readily fixed such as a damaged frame or a rusted-through body. A vehicle with a branded title (salvage, flood, etc.) or unsubstantiated mileage should be considered "poor" because of potential problems and should be independently appraised to determine its value. Private Party Value (no value) Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of cars in this category varies greatly. Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Get the latest ElIue Book Ilf~Wb?c" ~~--.t(3_1J~~~ Car Irg.de~nVQIJ..l.~ y~tJnyoice~MS.RP _Q[LN~w.---CaLs ~e_t.A per!:;QOJQPersorl_AulQ.L.lli3!1 Page I of2 Run a CAR Lemon No fl::nter'y'DU maID VEtil ra,E HIST Kelley Blue Book Used Car Values - New Car Pril;ing Sllikla Car 1~ Qllllllty RatlIllJ$ Ow_hip Cost Used Car Retail Free Pric<! ~ B..., a Used Car Sell Yaur Car MotorcycleS Flnanl;ing Insurance L_on Check 1 WlJrTantleS Car IlA!vIew$ Car Pn!Ylolw$ DedsiGn Guides Advice Free Newsletter Abclu: I Keller.... ... TIte Trusted Resoutce 1<bI>.""," Blue Book WJ.rill'lt Wfl0sh Enter your email to get the latest I Blue Book Private Party Report Pennsylvania. September 3, 2003 1991 Chrysler LeBaron Sedan 40 Buy -<l1\l~\Nc.a r BuU Used Car List YO\1LCar For Sal~DlinE:!. Fr~Lemon Check AuJ:lLLoanUIQ!11 3.99%.APR InsurancE:!..Quote Wi'lrranty.Quote print "FoLSale"Slgn Pa'Lment Cal.culator SellYoJJI car~n~BID' Motors Engine: V6 3.0 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 88,000 Equipment Air Conditioning Power Steering Tilt Wheel Cruise Control AM/FM Stereo Cassette Consumer Rated Condition: Poor "Poor" condition means that the vehicle has severe mechanical and/or cosmetic defects and may be in questionable running condition. The vehicle may have problems that cannot be readily fixed such as a damaged frame or a rusted-through body. A vehicle with a branded title (salvage, flood, etc.) or unsubstantiated mileage should be considered" poor" because of potential problems and should be independently appraised to determine its value. Private Party Value (no value) Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of cars in this category varies greatly. Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Get the I.test Blue B<lok JII",*"I W_ Get _ aJl?ed _ ~MIn~de-l D-Value Q~t~I1VOj~81--.f'1S&P QD Ne_w~a.ts Page I of2 Lg Sill Havs. ... DR1V E -~ Hun -1 UNlFORM SETfLEMENT STATEi\IENT OMS Approval No. 2502-0265 A. U.S. DEPARTMENT OF HOUS]NG AND URBAN DEVELOPMENT SETTLEMENT $1' A TEMENT B. TYPE OF LOAN 6. File Number: 7. Loan Number: I. FHA 2. FmHA 350270 3. Cony. Unins. 4. VA 5. Cony. Ins. 8. Mortgage Insurance Case Number C. NOTE, This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for infonnational purposes and are not included in the totals. NOTE: TIN - Tax"'~ er's Identification Number D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: Matthew W. Windomaker Estate of Geroge F. Rhinehart Arlington Capi tal Mortgage Sally J. Windomaker Two Greenwood Square 28 Mill Street #1 138 Burnthouse Road Suite 200 Mt. Holly Springs, PA 17065 Carlisle, PA 17013 Bensalem, PA 19020 05-6133416 G. PROPERTY LOCATION: H. SET'TLEMENT AGENT NAME, ADDRESS AND TIN 138 Burnthouse Road PA RealEstate Settlement Service Carlisle, PA 17013 10 West Pomfret Street Carlisle PA 17013 PLACE OF SETTLEMENT I. SETTLEMENT DATE Parcel # 08-09-0523-063 10 West Pomfret Street 06/30/2003 Carlisle PA 17013 J. SU1\'1:\1ARY or BORROWER'S TRANSACTION 100, GROSS AMOUNT DUE FROJ\.I BORROWER: 10 I. Contract sales "rice 93 000. 00 102. Persona] ro ert " I 03. Settl~menl charrres to borrower Line 140m 3 806. 46 104. 105. Ad'llstrnents for items aid b seller in advance 106. CiMtown taxes 107. Countv taxes 06/30/2003-12/31/2003 94.35 108. Assessments 109. School Taxes6 30 03-6 30/03 2.55 110. III. 112. 120. GROSS AMOUNT DUE FROM BORROWER 96 903.36 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 20]. Dennsit or earnest money 202. Princinal amount ofncw loan's 93 000.00 203. Existin ]o,lIl(sl taken subiect to 204. 205. 206. 207. 208. 209. Sellers Assistance 3 000.00 Adiustments for items unnaid bv seller 210. Cit"/town taxes 21 [. Count" taxes 212. Assessments 213. 214. 215. 216. 217. 218. 219. 220. TOTAL PA[D BY/FOR BORROWER 96 000.00 300. CASH AT SETI'LEMENT FROM/TO BORROWER 301. Gross amount due from borrower Line 120 302. Less amount aid b Itor borrower Line 220 303. CASH FROM BORROWER 96 903.36 96 000.00 903.36. K. SUMi\'IARY OF SEL!...ER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contmct snles mice 93 000.00 402. Personal nronertv 403. 404. 405. Ad'ustments for items nnid bv seller in advance 406. Citv/town taxes 407. Count" taxes 06/30/2003 -12 / 31 / 2 003 408. Assessments 409. School Taxes6/30 03-6/30/03 410. 41l. 4]2. 420. GROSS AMOUNT DUE TO SELLER 94.35 2.55 93 096.90 500. REDUCTIONS IN AMOUNT DUE TO SELLER, 50 l. Excess de"osit 502. Settlement charl."!es to seller (Line 1400 503. Existin{> loan's' taken subiect to 504. Pavoffoffirst mortoa'e loan Countr wide 505. Pavoffofsecond mortoaae 103n Madison First 506. 507. 508. 509. Sellers Assistance Adjustments for items unnaid bv seller 5] O. City/town taxes 51]. Count" tuxes 5[2. Assessments 513. 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 7 874.50 57 667.60 4 746.02 3 000.00 73288.12 600. CASH AT SETTLEMENT FROMrrO SELLER 601. Gross amount due to seller Line 420 602. Less reduction in amount due seller Line 520 603. CASH TO SELLER 93 096.90 73 288.12 19 808.78 SELLER'S STATEMENT The information contain~'d in Blocks E, G, H, and [ and on line 401 (or, ifline 401 is asterisked, line 403 and 404) is important tax information and is being fumished to the Internal Revenuc Service (see Seller Certification). If you are required to tile:J. rcturn, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS detennines that it h:J.s not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxp:J.yer identification number, you may be subject to civil or criminal penalties imposed by law. Under ~nalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. (Seller's Signature) Estate of Geroge F. Rhinehart (Seller's Signature) i&'> EASY SOFr, Inc. 200] Previ L. SETTLEMENT CHARGES 700. TOTALSALES/BROKER's COMMISSION based on orice S 93 000.00 @ 7.000% PAID FROM PAID FROM Division of Commission nine 700 as follows: BORROWER'S SELLER'S 701.$ 3 745.00 to Re Max Realtv Associates Inc. FUNDS AT FUNDS AT 702. $ 2 765.00 to Re Max Sterlina Realtv SETTLEMENT SETTLEMENT 703. Commission naid at Settlement 6 510.00 704. processina Service Fee to Re/Max Rea!tv Associates 125.00 800. ITEMS PA YAHLE IN CONNECTION WITH LOAN SO l. Loan Oril!in:ltion Fee S 802. Loan Discount S 803. Aoornisal Fee to 804. Credit renort to 805. Lender's Insnection Fee 806. A lication Fee to ACMe :S350.00 POC 807. Homeowne r to Millville Mutual (5385.00 POCl 808. Tax Related Service Fee to ACMe 100.00 809. Document prenaration Fee to ACMC 395.00 g[O. Flood Cerification Fee to ACMC 21.00 811. Courier Fee to ACMe 42.00 812.0verniaht Fees to PA Real Estate Settlement Services 15.50 15.50 813. Wire Transfer Fee to PA Real Estate Settlement Services - 5.00 15.00 900. ITEMS REOUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 06/30/2003-06 30/2003 @ SlS.180 ner dav 15.18 902. Mort .aQe Insuranc~ Premium for 903. Hazard insurance Premium for 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1 DOl. Hazard insurance '2 month(s) @ S32.08 ner month 64.16 1002. Mortyaye insurance 1003. Cit Pronertv Taxes 1004, County Prooertv "Laxes 7 month sl @ $15.62 Der month 109.34 1005. Annual assessments 1006. School Taxes 14 month(s @ s79.41 ner month 1 111.74 ]007. - 1008. Aggregate Accountin . Adiustment -205.21 1100. TITLE CHARGES ] 10 I. Settlement or closinl! fee to ] 102. Abstract or title search 10 ] ] OJ. Title Examination to I ] 04. Tit]e insurnnce binder 10 [ 105. Document oreoaration to [ 106. Notarv fees to Ann B. Sensenich 8.00 8.00 1107. Attome 's fees to inc]ud~s line numbers: ,.,",..,~,. ~.... - -;,<,.~.-;/,"., ' .. ] 108. Tille Insurance to CTIC/PA Real Estate Settlement Services 816.75 1 includes line numbers: 1101-1105 ". " J ]09. Lender's covern 'e $ 93000 . 00 1110. Owner's covera 'e $ 93000.00 1111. Endorsements: 100 300 8.1 150.00 ! 112. Conestooa Title Insurance Comnanv CPL 35.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin" fees: Deed $ 38.50 Mort a e$ 64.50 ReleaseS 103.00 1202. Cit Icn! taxlstam s: Deed S 930.00 Morteace$ 930.00 1203. State tax/stamos: Deed $ 930.00 Mortea(!e S 930.00 1204. 12 Two Satisfaction Pieces to Recorder of Deeds 54.00 1205. POA to Recorder of Deeds 17.00 1300. ADDITIONAL: SETTLEMENT CHARGES 1301. Survey to ] 302. Pest insoection to to HomeChek 50.00 1303. Lawn Service Fee to Seth Pomorev 200.00 1304. Water test to HomeChek 40.00 1305. 1306, 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J llnd 502 Section K\ 3 806.46 7 874.50 CER r1FICATION: 1 have carefully reVIewed the HUD.! Settlement Statement and to the best 01 my knowledge and beltef. It IS a true and accurate statement ot all receIpts and disbursements mad n account orby me in this transaction. [further certify that I received a copy of the HUD-I Settlement Statement. Seller M/ .W~ Mat hew W. Windomaker Seller Borrower Sally J. Windomaker The HUD-! Senlcmc111 Statement which I h:lVe prepared is a true anr.! accurate account of the funds dl U 'ed or!o be disbursed by the undersigned as part of the settlement of this t,nsacti~ . ~~~y? ~~ 06/30/2003 Settlement Agent PA RealEstate Settlement Services Date WARNING: [t is a crime!o knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a line and imprisonment. For Jetails see: Title 18 U.S. Code Section 1001 and Section 1010. it) EASY SOFT. Inc. 2001 Previ ~~ /- ~o i ~ BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE rnx DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% 1FV c01-OS1 DATE 10-27-2003 ESTATE OF RHINEHART III GEORGE F DATE OF DEATH 12-02-2002 FILE NUMBER 21 02-1111 LINUS E FENICLE COUNTY CUMBERLAND REAGER & ADLER ACN 101 2331 MARKET ST Amount Remitted CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CUT ALONG THIS LINE ~ CARLISLE, PA 17013 --------------- _ RETAIN LOWER PORTION FOR YOUR ------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENTCOALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RHINEHART III GEORGE F FILE N0. 21 02-1111 ACN 101 DATE 10-27-2003 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) 2. Stocks and Bonds (Schedule B) (1) 93,000 00 NOTE: To insure proper 3. Closely Held Stock/Partnership Interest (Schedule C) (2) .0 0 credit to your account, 4. Mortgages/Notes Receivable (Schedule D) (3) .00 submit the u pper portion 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 of this fora with your 6. Jointly Owned Property (Schedule F) 2,000 O1 tax payment. 7. Transfers (Schedule G) (6) .00 8. Total Assets (71 .00 APPROVED DEDUCTIONS AND EXEMPTIONS: ($) 95,000.01 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 28,536.23 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions (10)- 75.843 44 12. Net Value of Tax Return (11) 7 04 ~7g (,7 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts [Schedule J) (12) 9,3 79.66 - 14. Net Value of Estate Subject to Tax (13) .00 NOTE: if an assessment was issued (14) 9,379.66- reflect figures that includeptheltotal~oflALL returnsaassessed~to7date,and 19 will ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate (15) .00 X 00 = .00 17. Amount of Line 14 at Sibling rate (16) • 00 X 045 = . 00 18. Amount of Line 14 taxable at Collateral/Class B rate (lg) .00 X 12 _ .00 19. Principal Tax Due X 15 = .00 rax cREa=rs: c19)= . 00 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT .00 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 A REFUND. SEE RFVFRCF crnR: ..~ r..~.. ___.. ___ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: George F. Rhinehart, III Date of Death: 12/02/2002 Will No.: 21-02-1111 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: First and Final Account to be heard on November 23, 2004 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No B. The separate Orphans' Court No. (if any) for the personal representative's account is: C. Did the personal representative state an account informally to the parties in interest? Yes No ~i D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of ~e Orphans' Court and may be ~->'~ attached to this report. /~ ~ Date: Novem~r /~ --~ 2004 ' :' 5-~ l~us E. Fenicle, squire Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISION THE ESTATE OF GEORGE F. RHINEHART,III : ESTATE NO. 21-02-111 ! ESTATE OF GEORGE F. RHINEHART, III LATE OF CARLISLE BORO FIRST AND FINAL ACCOLrNT OF THE EXECUTOR, EDDIE DOBBIE AND PROPOSED SCHEDULE OF DISTRIBUTION Date of Death: December 2, 2002 Letters Granted: December 9, 2002 First Complete Advertisement of Grant of Letters: February 28, 2003 Accounting Period: December 9, 2002 to July 11, 2004 Purpose of this Account: The Administrator offers this First and Final Account to acquaint interested parties with the transactions that have occurred during its administration of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Linus E. Fenicle, Esquire -, ~ Reager & Adler, P.C. ~? ~ 2331 Market Street -~ Camp Hill, PA 17011 ~ (717) 763-1383 Eddie Dobbie, Administrator ~ 15851 SW 281st Street Miami, FL 33303 (305) 498-0201 IN RE: : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY : ORPHAN'S COURT DIVISION THE ESTATE OF GEORGE F. RHINEHART,LII : : ESTATE NO. 21-02-1111 NOTICE THE FIRST AND FINAL ACCOUNT FOR THE ESTATE OF GEORGE RHINEHART WAS FILED WITH THE CUMBERLAND COUNTY ORPHAN'S COURT ON ~Q-~(~-~( ~ , 2004. THE ACCOUNT WILL BE PRESENTED TO THE ORPHAN'S COURT FOR AUDIT ON NOVEMBER 23, 2004 AT 9:00 AM IN THE CLERK OF THE ORPHAN'S COURT, CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA 17013. ANY OBJECTIONS TO THIS ACCOUNTING MUST BE MADE BY NOVEMBER 23, 2004 AT 9:00 A.M. AND SHALL BE FILED WITH THE CLERK OF THE ORPHAN'S COURT, CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PENNSYLVANIA 17013. RECEIPT FOR PAYMENT Cumberland County - Register Of Wills Receipt Date 9/18/2003 Hanover and Hiqh Street Receipt Time 12:34:12 Carlisle, PA 17013 Receipt No. 1034099 RHINEHART GEORGE F III File Number 2002-01111 Remarks REAGER ET AL/CASH PD BY E FOX JA ................ Distribution Of Receipt ........................ 'Yransaction Description Payment Amount Payee Name INSOLVENT RETURN 10.00 CUMBERLAND COUNTY GENERAL FUN iNVENTORY 13.00 CUMBERLAND COUNTY GENEP~AL FUN Check# 15239 I10.00 ('hecl<If 15239/CASH .13 00 'l'otal Received ......... 23 00 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Lori Saylor, Classified Advertising Manager of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following dates, viz ¥ Copy of Notice of Publication Letters Testamentary for ~ the. Estate of GEORGE: . F. RHINEHART. ilI Who February 14, 21 & 28, 2003 o. , Affiant further deposes that he is not interested in the subject matter of the aforesaid notice or ~,~! advertisement, and that all allegations in the foregoing statement as to time, place and character ,HlII,PA1701t'~ of publication are true. February 28, 2003 Sworn to and subscribed before me this 28th day of February ,2003. Notary Public My commission expires: NOTARIAL SEAL SHIRLEY O. DURNIN, Notaq/Public Cmitsle I~oro.. Cum,b~.d~nd Count~ M~ Commission Exp._J~ AL!Cf 9, 2003 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approvcd May 16, 1929), P. L. 1784 STATE OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : Lisa Marie Co,ne, Esquire, Editor of the CumbcHand Law Journal, of the County and State aforesaid, being duly sworn, according to law, dcposcs and says that thc Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid. was established January 2, I952, and designated by the local courts as thc official legal periodical for the publication of all legal noticcs, and has, since January 2, 1952, bccn regularly issued weekly in thc said County, and that the printcd notice or publication attached hcrcto is exactly the same as was printed in thc regular editions and issues of thc said Cumberland Law Journal on the following dates, viz: February 21,28, March 7, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumbcrland Law Journal, a legal periodical of general circulation, and that he is not intercstcd in the subject matter of the aforesaid notice or advertisement, and that all allegations m the foregoing statements as to time, place and character of publication are tree.  is~ Marie Coync, ~ditor ~lneh~t, George F., m, dec'd, SWORN TO AND SUBSCRIBED before mc this ~te of ~e CI~ of C~llsle. Executor: Eddie Dobble. 7 day of February, 2003 Attorneys: Llnus E. Fenlcle, Es- quire, Reager &Adler. P.C., 2331 Market Street. Camp Hill, pA ~ ~ ~ 17011, (717) 763-1383. . . ESTATE OF GEORGE F. RHINEHART, III CUMBERLAND COUNTY FILE NO. 21-02-1111 RECAPITULATION Real Property $93,000.00 Receipts o£ Principal 29,058.57 Personal Property 3,191.50 $120,963.71 $125,250.07 Expenses of Administration $33,921.69 Debts of Decedent 78,747.57 Legal Fees & Filing Fees to complete Estate 1,131.00 ($113,800.26) ($113,800.26) $11,449.81 ESTATE OF GEORGE F. R14INEI-IART~ IH CUMBERLAND COUNTY FILE NO. 21-02-1111 REAL PROPERTY 138 Burnthouse Road Carlisle, PA 17013 - Contract Sales Price $93,000.00 $93,000.00 ESTATE OF GEORGE F. RHINEHART, 1II CUMBERLAND COUNTY FILE NO. 21-02-1111 RECEIPTS OF PRINCIPAL TrustMark Life Insurance Policy -Estate was beneficiary $25,929.00 AFLAC Insurance Payoff 850.00 Refund of 2003 County/Township taxes 94.35 Refund of 2003/2004 School Taxes 2.55 Refund of Homeowner's Insurance 527.00 Refund of Escrow Account 1,620.96 Refund of Auto Expenses 34.70 Orrstown Bank - Savings Account .01 $29,058.57 $29,058.57 ESTATE OF GEORGE F. RHINEHART, CUMBERLAND COUNTY FILE NO. 21-02-111! CASH, BANK DEPOSITS & PERSONAL PROPERTY 1985 Porsche 944 - Sales Price $2,310.00 1991 Chrysler LaBaron - Sales Price 500.00 Sale of Pool 200.00 Refund of Airline Ticket 181.50 ~3,191.50 $3,191.50 ESTATE OF GEORGE F. RHINEHART, I1! CUMBERLAND COUNTY FILE NO. 21-02-111! DEBTS OF DECEDENT Countrywide Funding - 1st Mortgage Payoff $57,667.60 Madison First - 2na Mortgage Payoff 4,746.02 Home Equity Loan Payoff 5,725.48 Central Penn Medical Group Emergency 180.00 Countrywide Funding - Mortgage Payments 11/02 - 05/03 5,957.14 PP&L - 11/02 to 06/03 Providian 707.55 Culligan 1,300.00 Masland Associates 113.81 Capital One 129.16 984.54 Carlisle Regional Medical Center 50.00 Holy Spirit Hospital 42.45 Capitol Tax Collection 19.54 Nationwide - Homeowners Insurance 74.00 Orrstown Bank - to cover NSF to Fitzpatrick Plumbing 653.15 Debt Recovery Services 51.56 Household Credit Services 345.57 $78,747.57 $78,747.57 ESTATE OF GEORGE F. RHINEHART, II! CUMBERLAND COUNTY FILE NO. 21-02-1111 EXPENSES OF ADMINISTRATION Kimmel Funeral Home $3,694.10 Kimmel Funeral Home - Death Certificates 30.00 Obituary 39.60 Cumberland County Register of Wills 237.00 H&R Block - 2002 Tax Return Preparation 138.00 Cumberland Law Journal 75.00 The Sentinel 71.33 Fiduciary Bond - Selective Insurance Company 700.00 Yard Sale Ad - Carlisle Sentinel 10.00 Real Estate Commission to ReMax 6,510.00 ReMax Realty Processing Fee 125.00 Overnight Wire and Notary Fees - Sale of Home 38.50 1% Transfer Tax 930.00 Recording Fees - Sale o£Home 71.00 Lawn Service 200.00 Notary fee for sale of home 8.00 Seller help for home sale 3,000.00 Printout for Checking 274.00 Overdraft Charges 123.71 Administrator's Commission 3,600.00 Bretz Carpet - Pumhase carpet to sell home 2,800.00 Leonard Walters - Home repairs, cleaning & reimburse for home repair materials 1,420.00 David Sheibley - Trash removal 1,700.00 Executor Travel, lodging & car rental 1,421.74 Home Depot - Home repair & supplies 77.29 Betty Dobbie - Title search 50.00 Countrywide - Pay by phone 9.00 Reager & Adler, P.C. 3,728.41 Other Miscellaneous Fees 2,840.01 $33,921.69 $33,921.69 IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISION THE ESTATE OF GEORGE F. RHINEHART,III : ESTATE NO. 21-02-1111 ESTATE OF GEORGE F. ~/~HART, III By: ~'~~ Eddie Dobbie, Administrator IN THE STATE OF FLORIDA COtmT¥ OFmi- Eddie Dobbie, being duly affirmed according to law deposes and says that he is the Administrator of the Estate of George F. Rhinehart, III and that the said Account is just and true to the best of his knowledge and belief and the Grant of Letters and the First and Complete Advertisement thereof occurred more than four months before filing of the Account and that the Decedent was not adjudicated incompetent. ~/~ Eddie Dobbie, Administrator Sworn to ~an~ubscribed before me this /~'~ dayof ~ ,2004 Notary Public IN RE: : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY : ORPHAN'S COURT DIVISION THE ESTATE OF GEORGE F. RH1NEHART, III : : ESTATE NO. 21-02-1111 PROPOSED SCHEDULE OF DISTRIBUTION The balance remaining for distribution, according to the First and Final Account is, $11,449.81. The administrator proposes to distribute the balance according to the Laws of Intestacy, 20 Pa. C.S.A. § 2103. The Administrator of thc estate is Eddie Dobbie, half-brother of the deceased. George F. Rhinehart, III, deceased, had no children. The mother of George F. Rhinchart, III was Mary Rhinehart. Mary Rhinchart had four (4) children, George F. Rhinchart, III, Eddie Dobbic, Harold Dobbie, and Nancy Rhinehart. The father of George F. Rhinehart, III, George Rhinehart Jr., is also deceased. George F. Rhinehart, Jr. had two (2) children, Nancy Rhinehart and George F. Rhinchart, II]. Harold G. Dobbie died on December 26, 1979 leaving to survive three (3) children, Suzanne Dobbie, Michelle White, and Matthew Dobbie. Eddie Dobbie has never had any contact with Nancy Rhinehart but had a recollection at one point that she lived in Eastern Pennsylvania. A search was done for individuals with any resemblance to the name Nancy Rhinehart in the entire state of Pennsylvania. The only one that could be located was a N. A. Rhinehart of 720 North Lincoln Avenue, Jersey Shore, PA 17740. A letter was sent to her on March 24, 2003 to which no response was ever received. A copy of that letter is attached to this First and Final Account. Accordingly, the Administrator was not able to locate or find Nancy Rhinehart. Under the provisions of the Intestacy Laws, 20 Pa.C.S.A § 2103(3), if no parent survives the decedent, then the distribution is to the issue of each of the decedent's parents. The issue of the decedent's parents are Eddie Dobbie, Harold G. Dobbie, deceased, and Nancy Rhinehart. All attempts at locating Nancy Rhinehart have been unsuccessful. Distribution of the balance, would therefore, according to the laws of Intestacy, be one-half(lA) to Eddie Dobbie and one-sixth (1/6) each to Suzanne Dobbie, Michelle White, and Matthew Dobbie, adult children of Harold G. Dobbie, deceased. The balance as set forth in the First and Final Account is $11,449.81 and therefore, each of the above-name individuals would receive the following amounts: 1. Eddie Dobbie - $5,724.91 2. Suzanne Dobbie - $1,908.30 3. Michelle White - $1,908.30 4. Matthew Dobbie - $1,908.30 Linus E. Fenicle Sup. Ct. ID# 20944 Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 (ph) (717) 730-7366 (fx) Dated: October 22, 2004 REAGER & ADLER, PC ATTORNEYS AND COUNSELORS AT LAW 2331 MARKET STREET CAMP I-t~LL, PENNSYLVANIA 17011-,16,12 717-763~1383 TE LEFAX 717-730-7366 WEBSITE: ReagerAdrerPC com THEODORE A. ADLER + THOMAS O. WILLIAMS DAVID W. REAGER SUSAN H. CONFAIR CHARLES E, ZALESKI JOANNE HARRISON CLOUGH LINUS E. FENICLE SUSAN J. SMITH DEBRA DENISON CANTOR DOUGLAS LEHMAN Writer's E-Mail A0dress: reagerp¢~epix not ,' Certilied Civil '-rial Specialist March 24, 2003 ¥ N.A. Rhinchart 720 N. Lincoln Avenue Jersey Shore, PA 17740 RE: Estate of George Rhinehart Our File No. 02-965 Dear N.A. RhiRchart: This finn has beer retained to rcprcsent the Estate oF©corec Rhinchart, Ill. We arc trying to locate a missing heir by the name of Nancy RhiRclaart who ,,','as thc daughter oF George Francis Rhinchart, Jr. who resided in Florida at thc time of his death iR April, 2000. Please contact this office should you bclicve you arc xvho we al'¢ looking For. Vcryfi~, yours,/- LEF/mdz IN RE: : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISION THE ESTATE OF GEORGE F. RI-IINEHART,III ESTATE NO. 21-02-1111 CERTIFICATE OF SERVICE I hereby certify that on the date set forth below a tree and correct copy of the First and Final Account of Eddie Dobbie, Administrator for the Estate of George F. Rhinehart, III was served on the following persons via U.S. First Class Mail, Postage Prepaid: Eddie Dobbie 15851 SW 28Pt Street Miami, FL 33033 Suzanne Dobbie 4169 Nantucket Drive Mechanicsburg, PA 17050 Michelle White 2120 Fremont Street Rockford, IL 61103 Matt Dobbie 1727 Washington Blvd. Birmingham, MI 48009 R A Ea P.C. By: L'~nus E. Fenicle, ~s~uire Sup. Ct. ID # 20944 Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 1701 717-763-1383 (ph) 717-730-7366 (fx) Dated: /~/~'/~'~ Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/10/2004 FENICLE LINUS E ESQ REAGER & ADLER PC 231 MARKET STREET 1265 CAMP HILL, PA 17011 RE: Estate of RHINEHART GEORGE F III File Number: 2002-01111 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/02/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, // GLENDA FARNER STRAin'UGH REGISTER OF WILLS cc: File Personal Representative(s) Judge I hereby certify that written notice of ' ' ,~ii ,~ ~ - this Ac~coum, ~nd o! ~e date, ~ ~ ~ ~t~ ~ ~ ~' ~ ~en give~: · e~ ~ ~ ~ to ev~ othe~ kn~n ~ ~ ~ ~ ~e ~ c~i~, the ~ ~ ~r~ ~ ~ ~ ~st d~ to ~e ~ ~ ~ ~ ~ ~n ~ ~ ~countant to h~e ~ ~ ~ ~ in ~ ~ate ~ ~, ~ ~ ~ of STATUS REPORT UNDER RULE 6.12 Name of Decedent: George F. Rhinehart, III Date of Death: 12/2/2002 Will No. 21-02-1111 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1.State whether administration of the estate is complete: Yes X No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court ? Yes X No ~ b. The separate Orphans' Court No. (if any ) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest ? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed~with th~ Clerk of the Orphans' Court and may be attached to this/r~/oft. Date: 12/13/2004 Signature Linus E. Fenicle Name (Please type or print ) 2331 Market Street CamD Hill PA 17011 Address cDcr~ ~ (717) 7631383 ~_~ _~ -- cc~::~ Tel. No. ~-:'C 'z, .'-:J.~'~- a.. Ox: craC~ ~2: Capacity · Personal Representative E~c"~: t:_,¢~' ~'' ~ c.~ c.~_~t.~ X Counsel for personal c__:,~ ~::~._~ ~:~ representative