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HomeMy WebLinkAbout04-0972 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Martin H. Rodgers No. 2. l (.' ~ --- ~i ct' [ '2- Also known as To: , Deceased. Register of Wills for the Social Security No. 167-32-9199 County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your petitioner(s) who is/are 18 years of age or older, applies for Letters of Administration on the estate of the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 109 "A" Street, P.O. Box 174, Plainfield, PA 17081. Decedent who was 87 years of age, died October 9, 2004 at Carlisle Regional Medical Center, Carlisle, PA 17013. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $~-~ z, o o (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,, .. o ~ Situated as follows: P0~vo e, II~ .,,~,....~ ~o5.-, cc.:< Itl Petitioner after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Ronald T. Rodgers Son 717 Ravenwood Dr., Smithville, NJ 08205 Robert V. Rodgers Son 7325 John Hopkins Ct., Raleigh, NC 27616 Marty Ann Rodgers Daughter 59 West Main Street, Newville, PA 17241 THEREFORE, petitioner(s) respectfully request(s) the grarf(~ff, d~rterq of administration in the appropriate form to the undersigned. ~/ ~ Ronald T. Rodgers 717 RavenwoodDr. Smithville, NJ 08205 Page 1 of 2 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) ) ss COUNTY OF CUMBERLAND . ) The petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the - above decedent petitioner(s) will well and truly administer the estate according to law. ~ ..: Sworn to or affirmed aid subscribed Before me this t, Sth rla~'~ ~, i/// ~egister~' !~ i x ( ^ · r , , ,, , , t ?; .... ~ ' i'~ ~Y', ,1 No.' 'z~_ ('q- Estate of MARTIN H. RODGERS, Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW, October 1~,, 2004, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that RONALD T. RODGERS is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to RONALD T. RODGERS in the estate of MARTIN H. RODGERS Letters of Administration ........ $ 2 9 ~ ~ ~ Sho~ Ce~ificate(s) ............... $ t~ c ~ Attorney (Sup. Ct. I.D. No.) Renunciation ................ .~....$ I (..(. ff TOTALJ(~ $ ~c'~ Address Filed ................................ 200 '2~ ', c~ Phone Page 2 pr2 CERTIFICATE OF DEATH 87 ~ { Martin H. Rodgers Hale 167 32 -- 9199 *'October 9~ 2004 ~ 8-18-1917 ~tlantic City,NJ ,.~.,,.,.~l ~o~,,~, Cumberland Carlisle Carlisle Medical Center 109 A Street P.O. Box 174 u~ ,~.s,,,. Pennsylvania Pla~nfzeld, PA 17081 ~ ~ 2004 -~ ~ J~,~enn.~y]vania Crematory ~.~ Harrisburg, PA 17tOg RENUNCIATION In Re Estate of Martin H. Rodgers To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Marty Ann Rodgers, a daughter of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s)that Letters of Administration be issued to Ronald T. Rodgers. WITNESS my hand this day of October, 2004. · ny Ann ,Rodt~ 59 West Main Street Newville, Pennsylvania RENUNCIATION In Re Estate of Martin H. Rodgers To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Robert V. Rodgers, a son of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Ronald T. Rodgers. WITNESS my hand this day of October, 2004. bert V. Rodgers /// ~ 7325 John Hopkins Court Raleigh, NC 27616 PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY Harrisburg, Pcnusylvania In tim Matter of the Estate of: Martin H. Rodgers KNOW ALL MEN BY THESE PRESENTS, that Ronald T. Rodgers as Administrator o£ the Estate of Martiu H. Rodgers and Pem~sylvania National Mutual Casualty- Insurance Compauy, a Pennsylvmfia Corporation, of Harrisburg, Peonsyh,ania, as Sure .ty, are held and fimdy bound tmto Orphans Court of Cumberhmd County the in tl~e fidl and just sum of One Hundred Thousand DOLLARS, ($100~000 ) for the payment of which, well and truly to be made, we bind ourselves, our heirs, execulors,, admiuistrators, successors and assigns, jointly and severally firlnlv by these preseols. Sealed with our seals, and daled this 26th day of Octobcr. 2004. WHEREAS, Ronald T. Rodgers , bas beeu, or is about to be, appointed Administrator of the estate of Martin H. Rodgers , by llle Orl)hans Court of Cumberlaml County. NOW. THEREFORE, the condition of this obligation is such, that if the Adminstrator said shall well and truly discharge the duties of said trust according to law, then this obligation is void, othenvise to remaiu in full force aud effect, Ronald T. Rodgers PENNSY~NIA NATIONAL b.,IUTUAL CAS~Y~NSURAN~E QDMP~4~Y eg{y ott, Attoruey-h,- =] 7 ...... Form 78-168 PENNSYLVANIA NATIONAL MU'I'UAL CASUALTY INSURANCE COMPANY Harrisburg, Pennsylvania POWER OF ATTORNEY Know' All Men By these Presents, That PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania, does hereby make, constitute and appoint PATRICIA K. ARBEGAST, DAVID W. HOPCRAFT AND JEFFREY L. SCOTT, ALL OF CARLISLE, PENNSYLVANIA (EACH) its true and lawful Attorney(s)-in-Fact to make, execute, seal and deliver for and on its behalf as surety as its act and deed: ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING EXCEEDS THE SUM OF SEVEN HUNDRED FIFTY THOUSAND DOLLARS ($750,000.00) ........................................ ALL POWER AND AUTHORITY HEREBY CONFERRED SHALL HEREBY EXPIRE AND TERMINATE WITHOUT NOTI~ AT MIDNIGHT OF THE 30TM DAY OF SEPTEMBER 2005, AS RESPECTS EXECUTION SUBSEQUENT THERETO. And the execution of such bonds in pursuance of these presents shall be as binding upon said Company as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its office in Harrisburg Pennsylvania, ill their own proper persons. This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on October 24, 1973 at Harrisburg, Pennsylvania, which resolution is shown on the reverse side hereof and is now in full force and eft In Witness Whereof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these presents to be signed and its corporate seal to be affixed on SEPTEMBER 18, 2002 PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPA :-..:..--- Kenneth R. Shutts, Executive Vice-President, Secretary & General Coun Commonwealth of Pennsylvania, County of Dauphin ss: On SEPTEMBER 18, 2002, before me appeared Kenneth R. Shut~s to me personally known, who being by me duly sworn, did say that he resides in tile Commonwealth of Pennsylvania, that he is Executive Vice-President, Secretary & General Counsel of PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, That he is the individual described in and who executed the preceding instrument, and that tile seal affixed on said instrmnent is the corporate seal of said Company, and that said instrument ;vas signed and sealed on behalf of said Company by authority and direction of said Company, and the said office acknowledged said instrument to be the free act and deed of said Company. Nota~ Public Commonwealth of Pennsylvania, County of Dauphin ss: Notarial Seal Greer, Vice President, Surety & Fidelity of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania, do hereby ce~ify that the above and foregoing is a tr;~c and co~ec~ copy ora Power of Attorney, executed by the said Company, which is still in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the corporate~~a~~b~r 2 6 ~ h, ~ )C v ~ FCsfden( 'Surety~ Fi~ 78-I 90 (Rev 05/02) CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Martin H. Rodgers Date of Death: October 9, 2004 Will No. Admin. No. 21-04-0972 To the Register: I certify that notice of (beneficial Interest) estate administration 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: November 2, 2004. Name Address Ronald T. Rodgers 717 Ravenwood Dr., Smithville, NJ 08205 Robert V. Rodgers 7325 John Hopkins Ct., Raleigh, NC 27616 Marty Ann Rodgers 59 West Main Street, Newville, PA 17241 Notice has now been given to all persons entitled thereto under Rule 5.6)a) except NO EXCEPTIONS Date: 11/2/04 ~,~_._~ "'~--~ Signature Name: Robert G. Fray Address: 5 South Hanover Street Carlisle, Pennsylvania 1701 ~ Capacity: Personal Representative X Counsel for Personal Representative REV-1162 EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2806O1 HARRISBURG, PA 17128-O601 PENNSYLVAN IA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004785 RODGERS RONALD T 717 RAVENWOOD DRIVE SMITHVILLE, NJ 08205 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 ~;9,000.00 ESTATE INFORMATION: SSN: 167-32-9199 FILE NUMBER: 2104-0972 DECEDENT NAME: RODGERS MARTIN H DATE OF PAYMENT: 12/30/2004 POSTMARK DATE: 1 2/30/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/09/2004 TOTAL AMOUNT PAID: $9,000.00 REMARKS: R T RODGERS CHECK# 113 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: MARTIN H RODGERS Deceased Court File No: 21-2004-972 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. S3532(b)(2). CITICORP CREDIT SERVICES INC. 1) Claimant's name: C/O BALOGH BECKER L TO, 4150 OLSON MEMORIAL 2) Claimant's address: HWY #200 MINNEAPOLIS, MN 55422 866-234-0513 3) Creditor listed below is the owner and holder of a claim in the amount of $ 4827.28 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: PO BOX 174109 A ST PLAINFIELD, PA 17081 6) Date of Death: 10/09/04 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by Dated: JAN 2 8 2005 On behalf of the claimant, I do solemnly declare and perjury that they Information and representa i ns to the best of my knowledge, information a elie Chelsea A. Whitley/Angela M. H ary Ellen eeman/Chad Bolinske/Thersia Lee, Attorney-in-Fact Written notice of claim was given to Personal Representative and/or his/her counsel as stated below: RONALD T RODGERS Name 717 RAVENWOOD DR Address SMITHVILLE, NJ 82051 City/State/Zip I Date not~frr!a~~ 6 J {t-~ IN RE ESTATE OF: MARTIN H RODGERS AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part ofhislher duties. 3. The Decedent purchased merchandise in the amount of $ 4827.28 account number 5491130330633454 evidenced by 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. By: Att eys-in-Fa t: Chelsea A. Whitley _ Angela M. Horn _ Michael D. Johnson Mary Ellen Weeman_ Thersia O. Lee Chad 1. Bolinske L 4150 Olson Memorial Highway, Suite 200 Minneapolis, MN 55422-4811 Further your affiant sayeth not Subscribed and sworn before me This dli day of ~.. ,2005. No 1--. rt () 1 217 REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER COUNTY CODE 167 -32-9199 OFFICIAL USE ONLY 21-04-0972 YEAR NUMBER SOCIAL SECURITY NUMBER SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <( .-. ~ a.. :!: o u >< <( .-. 15. Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec.9116 (a)(1.2) t- Z W o w u w o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Martin H Rod ers DATE OF DEATH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE DATE OF BIRTH (MM-DD-YEAR) REGISTER OF WILLS SOCIAL SECURITY NUMBER UJ ~ ~V) x: a::: x: 00..0 UJoo :I:a:::..J Oa..al a.. <1: o 2. Supplemental Return 04a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) 010. Spousal Poverty Credit (date of death between 12-31-91 and 1.1-95) o 3. Remainder Return (dale of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 011. Election to tax under Sec. 9113(A) (Attach Sch 0) OFFICIAL USE ONLY r"',,,,) o (~? r.,.) t. .., '-'" I , i o 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Allach copy of Will) 09. litigation Proceeds Received THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Robert G. Fre 5 South Hanover Street FIRM NAME (If Applicable) Carlisle, PA 17013 5,070 620 4,205 (8) 25,597 12,600 (11 ) (12) (13) (14) 10/9/2004 8/18/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) t- Z W o z o a.. (J) w 0::: 0::: o U 171,000 52,945 233,840 717-243-5838 1. Real Estate (Schedule A) (1 ) (2) (3) NONE (4) NONE 11. TOTAL DEDUCTIONS (total Lines 9 & 10) 38,197 195,643 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) 14 Net Value Subject to Tax (line 12 minus Line 13) 195,643 195,643 X .045 (15) 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) (5) z o i= <( ...J ~ t- ii: <( u w 0::: 6. Jointly Owned Property (Schedule F) Dseparate Billing Requested (6) x .0 (16) 8,804 16. Amount of Line 14 taxable at lineal rate 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property (Schedule G or L) (7) x .15 (18) 19. Tax Due (19) 8,804 20.0 CHECKHERE: IF'YOU:~~E;:REQU~STING'AlR.t:tY.Np;9f,~N.!PVF4f{PAYNlt;NJ- > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 8. TOTAL GROSS ASSETS (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) :10) x .12 (17) 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 217 o Martin H Rodgers 167-32-9199 d C dd ece ents amp ete A ress: STREET ADDRESS 109 "A" Street P.O. Box 174 CITY I STATE !ZIP Plainfield PA 17081 Tax Payments and Credits: 1. 2. Tax Due (Page 1 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 8.804 9,000 450 Total Credits ( A + B + C ) (2) 9,450 3. Interest/Penalty if applicable D. Interest E. Penalty 4. Total Interest/Penalty ( D + E) If 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 (3) (4) (5) (SA) (5B) :>~:~:~:>~:~~>>::::::~:t~){:tt~{){{{{))>>{{:::>>>{:::::~:::~:::::~::~::::~~~:~~~:~:~~~~g:~::~~;t~~(~:::fg:;;~~::::Zg~~:03:::::g~::~:/7'~:~~':::~:~~:0:::::{>:>>>?::::)?n:::~<>>>n>>t>::~:::~:> 646 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. ..................... .................... .................... .................... ........................................ ...................... ..................... PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "XU IN THE APPROPRIATE BLOCKS d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12,1982,did decedent transfer p without receiving adequate consideration? . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank acc 4. Did decedent own an Individual Retirement Account, annuity or oth contains a beneficiary designation? . . . . . . . . . . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST I ~~ \) - / ~ Yes No D 0 D 0 D 0 D [K] D 0 [KJ D 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or . . . . . . . . . . . . . D [K] RT OF THE RETURN. belief, it is true, DATE 08205 DATE ADDRESS 5 South Hanover Street Carlise 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 for the use of the surviving spouse is 3% [72 P .S. Section 9116 (a)(1.1 lei)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(1, 1 )(ii)]. The statute does not exempt 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-one 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. Section 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%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 9116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Section 9116(a)(1.3)] .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, AT REV-1502 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Martin H RodQers 21-04-0972 ALL REAL PROPERTY OWNED SOLELY OR AS A TENANT IN COMMON MUST BE REPORTED AT FAIR MARKET VALUE. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. REAL PROPERTY WHICH IS JOINTLY-OWNED WITH RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM NUMBER 1. 2. DESCRIPTION House and lot of ground, 59 West Main Street, Newville, Pennsylvania. See Appraisal House and lot of ground, 109 A Street, Planfield, Pennsylvania. See HUD-1 statement VALUE AT DATE OF DEATH 71,000 100,000 TOTAL (Also enter on line 1 Recaoitulation)$ (If more space is needed, insert additional sheets of the same size) 171 000 217 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Martin H Rodqers FILE NUMBER 21-04-0972 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 10,578.495 shares of Federated Kaufmann Fund K, ave. value of 10/8 and 10/11/04 VALUE AT DATE OF DEATH 52,945 TOTAL (Also enter on line 2 Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 52 945 AT REV-150B EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Martin H RodQers FilE NUMBER 21-04-0972 Include the proceeds of litigation and the date the proceeds were received by the estate. ALL PROPERTY JOINTL Y.OWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM NUMBER 1. 2. 3. 4. 5. DESCRIPTION VALUE AT DATE OF DEATH M&T Bank acct. no. 43447 1985 Chevrolet Cavalier, mileage in excess of 100,000 miles Real Estate tax proration (see HUD-1 settlement statement attached) Insurance premium refund Trash hauling refund 3,992 375 203 469 31 TOTAL (Also enter on line 5. Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 5,070 217 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Martin H Rodqers 21-04-0972 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Marty Ann Rodgers 59 West Main Street Newvile, PA 17241 Daughter B. C. JOINTL V-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST NUMBER 1. A. 1993 Buick Century 1,240 50.00% 620 TOTAL (Also enter on line 6. Recaoitulation) $ 620 (If more space is needed, insert additional sheets of the same size) 217 REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER ESTATE OF Martin H Rodqers This 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. 21-04-0972 DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER TRANSFER. ATTACH A copy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPliCABLE) VALUE 1. Dreyfus Founders Growth Fund F, 436.89 shares, Marty Rodgers 4,205 100.00% 4,205 named as beneficiary; ave. closing price for 10/8 and 10/11/04 TOTAL (Also enter on line 7 Recapitulation) $ 4205 (If more space is needed, insert additional sheets of the same size) 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Martin H Rodqers 21-04-0972 ITEM NUMBER A. 1. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Ronald T. Rodqers Social Security Number(s) I ErN Number of Personal Representative(s) 155-40-0405 Street Address 717 Ravenwood Drive City Smithville State NJ Zip 08205 Year(s) Commission Paid: 2005 8,000 Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4,000 City Relationship of Claimant to Decedent State Zip Probate Fees 303 Accountant's Fees Tax Return Preparer's Fees Real estate repairs 4,548 Administrator's Bond 460 Short Certificates 18 Expenses of sale of real estate (see HUD-1 settlement statement attached) 7,362 Expenses of maintaining real estate held for sale 852 Final medical bill 31 Automobile title transfer 23 TOTAL (Also enter on line 9 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 25597 REV-1512 EX+ (12-03) 217 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Martin H Rodgers SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-04-0972 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. DESCRIPTION Mortgage on 59 West Main Street, Newville AT&T Universal Card Sprint VALUE AT DATE OF DEATH 7,694 4,827 79 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12,600 217 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF M rf H R d FILE NUMBER a In o loers 21-04-0972 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 outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Ronald T. Rodgers 717 Ravenwood Drive Smithville, NJ 08205 Son 1/3 of residue 2. Robert V. Rodgers 7325 John Hopkins Court Raleigh, NC 27616 ~ Son 1/3 of residue 3. Marty Ann Rodgers 59 West Main Street Newville, PA 17241 Daughter 1/3 of residue 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 PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV~1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ~... . Kelley Blue Book " ' THE TRUSTED RESOURCE . 'thJl.tllIi ( )\ 'J 17- , ""5, , ',' \, ,~~" f'~" f.') I'>~ t t~,ll,,")r " ,1..:. ~,' t: o;.h~) '\., .~,~ l ~ "~ -=... '~"_.-=;":1e: ':' advertisement .~'. ~ I3L..1IC:::K: ~ @!e: VOl I pay Everyone R~ gets the GM Employee Discount. -'-~ _. Offer ends August 1. ~,l -t - la At partidpating dealers only. W la we. ~'~e'~ Nota(~nt more. I ~ _ >>~c:Jt"hele,foJ,lIII)re ~__::t':" ~-:_-: ~~A~;:~-_-'~~'~~C"'\~<"i _'{"""""~. -p.... -..,>0 ::._.~,_;~ .-!;; .A.~::;\.;~ ~ U SED CARS o Quick Dealer Price Quote 0 Search Used Car Listings List Your Car for Sale REVIEWS & RATINGS ADVICE FINANCING & INSURANCE BLUE BOOK7t PRIVATE PARTY REPORT Pennsylvania · August 2, 2005 1993 Buick Century Special Sedan 40 .~ . . Search Listinas for This Car List Your Car For Sale Online Quick New Car Price Quote Free CARFAX Record Check Auto Loans from 4.990/0 APR Insurance Quote Print "For Sale" Sign Payment Calculator Engine: V6 3.3 Liter Trans: Automatic Drive: FWD Mileage: 100,000 Equipment Air Conditioning Power Steering Power Door Locks AM/FM Stereo Dual Power Seats Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. This vehicle has a clean title history , the paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. There should be little or no rust on this vehicle. The tires match and have substantial tread wear left. A "goodll vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category . Private Party Value Search Local Listinas I List This Car for Sale $1,240 Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold liAs Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle1s actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars Lock In Auto Loan Rates As Low As 4.99% APR .i r'~~g, ILl. BLUE BOOK (LASSIFIEDS~ Search Used em li~ting5 QUickly browse through over 600,000 used vehicle listings to find exactly the car or truck you want. (@). E3LJ I C::I<: ~.;:r~........ . >>, Click.here for- mOle Kelley Blue Book THE TRUSTED RESOURCE kbh.COIIt ( h ,,;:1..5' \ rlo~ i r...;'} {' it" r,r ~- \.t fA _ .....L.., 'i \. \.,.,,>, 'KJake-a:test:id~~:~-->~' . Pr4:'produl:lion ITlooal :zrown. J\t:tual pl<<luclion rnodt!! ma:)' ..~ry_ Ay_b~ Y1'~ I~" ~0004. ShD'''tl ....'~h ll'nJiI~ble! SI7.Jr1 P.!Icka(1e- It; Quick Dealer Price Quote 0 Search Used Car Listings List Your Car for Sale REVIEWS & RATINGS ADVICE FINANCING & INSURANCE USED CARS BLUE BOOK1t. PRIVATE PARTY REPORT Pennsylvania · August 2, 2005 1985 Chevrolet Cavalier Sedan 40 BLUE BOOK (LASSIFIEDS~ S[;rj[(h Used (or listing) Engine: 4-Cyl. 2.0 Liter Trans: Automatic Drive: FWD Mileage: 110,000 Search Listinas for This Car List Your Car For Sale Online Quick New Car Price Quote Free CARFAX Record Check Auto Loans from 4.990/0 APR Insurance Quote Print "For Sale" Sign Payment Calculator Quickly browse through over 600,000 used vehicle listings to find exactly the car or truck you want. Air Conditioning Power Steering AM/FM Stereo ,"CeAII-New ,'2005 Cobalt: Coupe Sedan 5S Supercharged Equipment Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history , the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Private Party Value Search Local Listinos I List This Car for Sale $375 Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. And a dealer: Take a test drive.. Go>> Get a Used Car Trade-In Value ~... .~ 1 cobalt Get Invoice & MSRP on New Cars Lock In Auto Loan Rates As Low As 4.99% APR ->......~; Copyright @ 2005 by Kelley Blue Book Co., All Rights Reserved. Jul-Aug 2005 Edition. The specific information required to determine the value for this particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition or other particular circumstances pertinent to this particular vehicle or the transaction or the parties to the transaction. This report is intended for the individual use of the --. ~.-- A. Settlement Statement U.S. Department of Housing and Urban Development ~ ,r OMB No. 2502.()265 B. Type of Loan 1.0 FHA 2.0 FmHA 4. 0 VA 5. Qg Conv. Ins. C. NOTE: This form is furnished to give you a statement of actual seUlement costs. Amounts paid to and by the settlement agent are shown. Items marked "p.a.c" were paid outside of closing; they are shown here for informational purposes and are not included in the totals. D. NAME.ANDADDRESS OF BORROWER:Neil C. Darhower HeatherJ. Rutz 860 Opossum Lake Road, Carlisle, PA 17013 860 Opossum Lake Road, Carlisle, PA 17013 Estate of Martin H. Rodgers 109 A Street, Plainfield, PA 17081 3. 0 Conv. Unins File Number P140-154/Darhower Loan Number 101611695 Mortgage Insurance Case Number E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: . Countrywlde'!Ho"".;Loans;lnc. 1210 Norlhbrook'Dnve, #300/Trevose, PA 19053 G. PROPERTY LOCATION: 109 A Street Plainfield, PA 17081 H. SETTLEMENT AGENT: PLACE OF SETTLEMENT: TIN: O'Brien, Baric & Scherer 19 West South Street, Carlisle, PA 17013 25-1708515 . "' I. SETTLEMENT DATE: OS/27/2005 RESCISSION DATE: J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price $92 000.00 401. Contract Sales Price $92 000.00 102. Personal Property 402. Personal property 103. Settlements charges to borrower: 403. (from line 1400) $4,253.15 104. 404. 105. 405. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 106. City/town taxes to 406. City/town Taxes 10 107. County Taxes OS/27/2005 to 01/01/2006 $112.20 407. County Taxes OS/27/2005 to 01/01/2006 $112.20 108. Assessments OS/27/2005 to 07/01/2005 $91.08 408. Assessments OS/27/2005 to 07/01/2005 $91.08 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER: $96,456.43 420. GROSS AMOUNT DUE TO SELLER: $92,203.28 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money $1,000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) $89,240.00 502. SelUement charges to sener (line 1400) $7,361.86 203. Exisllng loao(s) taken subject to 503. Existing loan(s) taken subfeclto 204. 504. Payoff of first mortgage loan 205. 50S. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 210. City/town taxes to 510. Cltyllown taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR $90,240.00 520. TOTAL REDUCTIONS $7,361.86 BORROWER: IN AMOUNT DUE TO SELLER: 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER 301. Gross amount due from borrower (line 120) $96,456.43 601. Gross amount due to seller (line 420) $92,203.28 302. Less amount paid by/for borrower (line 220) $90,240.00 602. Less reductions in amt. due seller (line 520) $7,361.86 303. CASH ( 00 FROM) ( 0 TO ) BORROWER: $6,216.43 603. CASH ( 0 FROM) ( 00 TO ) SELLER: $84,841.42 ... HUD-1 (3-86) - RESPA, HB 4305.2 PAGE 1 L. ..J.1 (Rev. 3186) OMS No. 2502-0265 700: TOTAL SALES/BROKER'S COMMISSION PAID FROM PAID FROM BASED ON PRICE $92,000.00 @ 6 .~ = $5,520. 00 BORROWER'S SELLER'S FUNDS FUNDS DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: AT AT 701. $2,735.00 to BH Agency SETTLEMENT SETTLEMENT 702. $2,785.00 10 Re/Max Sterling 703. Commission paid al 8elllemenl $5,520.00 704. 800 ITEMS PAYABLE IN CONNECTION WITH lOAN' 801. loan orIglnallon fee % 802. loan discounl % 803. AppraIsal fee 10: Central Penn Appraisals, Inc. $310.00 804. Credit report to: Countrywide Home Loans, Inc. $35.00 605. Lender'llnlpection lee 806. Mortgaga Insurance application fee 10 807. AlSumpllon lea 808. Flood Check Fee to Landsafe Flood $26.00 809. Document Preparation Fee to Lender $400.00 8tO. 811. 900 ITEMS REQUIRED BVLENDER TO BE PAID IN ADVANCE' 901. Interesl from OS/27/2005 to 05/31/2005 @ $13. 45/day $67.2S 902. MorIgage Insurance premium lor mos. 10 903. Hazard Insurance premium for yr.. 10 904. Flood Insurance premium lor yrs.to 905. SETTLEMENT CHARGES 1000. RESERVES DEPOSITED WITH lENDER: tOOl. H8ZBrd insurance 3.00 months @l t002. Mortgege insurance 1.00 monlhs <m 1003. Cily property taxes months <m 1004. County property laxes 5.00 months @ 1005. Annual BllIIssmenls months@ 1006. Flood insurance months @ 1007. School taxes 13.00 monlhs @ 1006. months@ 1009. Escrow Ad' ustment $77.00 $25.42 per month $70.65 per monlh per monlh $15.40 permonlh per monlh per monlh $76. 82permonlh per month $76.26 $70.65 $998.66 ($112.42) 1101. Salllamanl or closing laa 10 1 t 02. Abslract or tille seerch 10 1103. Tille exemination 10 1104. TiUelnsurance binder to 1105. Documenl preparallon 10 1106. Nolary leaalo Cash 1107. Attomey's rees 10 includes above items Numbers: 1106. Tille Insurance 10 O'Brien, Baric' Scherer (includes above items Numbers: 1101-1105 1107-1111 1109.lendet"s coverage 1110. Owner's cover. e $810.75 '1". Ends 1100 1300 #900 1112. Insured Closing Ltr. 1113. O'Brien, Baric' Scherer (Overnight Fee) AND TRANSFER CHARGES' $10.00 $89,240.00 $92,000.00 1201. Recording fees: Deed $38.50 ; Mortgage $68.50 ; Relesses $107.00 t202. City/counly lax/stamps: Deed $920.00; MorIgage $920.00 1203.5Ialelax/slamps: Daed $920. 00; MorIgage $920.00 1204. Assignment or Mortgage recording $27.00 1205. 1300 ADDITIONAL SETTLEMENT CHARGES' -., 1301. Survey 10 1302. Pesllnspection 10 1303. BIS Home Inspection Service (home inspltermite insp.) $235.00 1304. Cumberland County Tax Claim Bureau ('04 school bill) $921.86 1305. 1306. 1307. 1400. TOTAL SETTLEMENT CHARGES $4,253.15 $7,361.86 I have carefully reviewed the HUD-1 Settlement Statement and 10 the best of my knowledge and belief, it is a true and accurate statement of ail receipts and disbursements made on my account or by me in this Iransaction. I further certify Ihat I have received a copy of the HUD-1 Settleme t Statement. Bo_~ #~ Neil C. Darhower Date: -fp)j~., ;;:x c>! ~ 1 Date: ~~ .5- ".r-Seller or Dale: -z 7-~ Agent: Rodger T. Rodgers Bonawer. IMh f) ~ fHeather J. Ru \..cr The HUD-1 Settlement Statement which I have prepared Is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed In accordance with this statement. Date: Settlement Agent: .~ 08Ie:S:--)27 Las- Robert L. O'Brien WARNING: It il a crime to knowingly make false statements to the Uniled States on this or any other similar form. Penallles upon conviction can include a fine Bnd imprison- ment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Drey/Founders:Growth;F (FRGRX) (FUND) U.S. Dollar Date Price High Low Volume 10/8/04 9.62 n/a n/a n/a No Splits Get another quote any day after 1/2/1970 1/2/1970 Date: 10/8/04 [ OoJ Symbol: Copyright @ 1998-2004 BigCharts.com Inc. Historical and current end-ot-day data provided by FT Interactive Data. :2 I'vbnth (Daily) @8igCharts.co rn ( /) . 1\ ( J~ ~V'J 10.00 Q -;*C': ...'" 1 ~_, 9.50 1 mo 2mo 3mo 6mo 1 yr 3yr 5yr Copyright @ 2004 Dow Jones & Company, Inc. All Rights Reserved Drey/Founders:Growth;F (FRGRX) (FUND) U.S. Dollar Date Price High Low Volume 10/11/04 9.63 n/a n/a n/a No Splits Get another quote any day after 1/2/1970 1/2/1970 Symbol: Date: 10/11/04 Copyright @ 1998-2004 BigCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. :2 I'vbnth (Daily) (?t8igCharts.co m /...... / vV~f- 10.00 13.75 9.50 1 mo 2mo 3mo 6mo 1 yr 3yr 5yr Copyright @ 2004 Dow Jones & Company, Inc. All Rights Reserved Federated Kaufmann;K (KAUFX) (FUND) U.S. Dollar Date Price High Low Volume 10/8/04 5 n/a n/a n/a No Splits Get another quote any day after 1/2/1970 1/2/1970 [ Go J Symbol: Date: 10/8/04 Copyright @ 1998-2004 BigCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. 2 rvbnth (Daily) @8igCharts.com J ~.2 ^ {~. 1 .....r....". It ''"'\ jv 5. (I ..1 'vI . ~J 4.9 1 mo 2mo 3mo 6mo 1 yr 3yr 5yr Copyright @ 2004 Dow Jones & Company, Inc. All Rights Reserved Federated Kaufmann;K (KAUFX) (FUND) U.S. Dollar Date Price High Low Volume 10/11/04 5.01 n/a n/a n/a No Splits Get another quote any day after 1/2/1970 1/2/1970 Symbol: Date: 10/11/04 Copyright @ 1998-2004 BigCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. 2 I'vbnth (Daily) @.IBigCharts.c(I rn C' .-, --'. ..;j /- ~j J~ .r ..........1 ) '...., I'J --)........ . \l" C" --, __I. L. 5.1 5.0 1 mo 2mo 3mo 6mo 1 yr 3yr 5yr Copyright @ 2004 Dow Jones & Company, Inc. All Rights Reserved ----& .. Nnv 09 04 10:27a p. 1 m M&fBank 499 Mitchel1 Road. MiIIsboro. DE 19966 Mail Code DE.MB-J2 Phone (RSg) 502-4349 Fax (302) 934-2955 November 9. 2004 Fax: 717-243-6441 Frey &Tiley Attorney At La,,\! 5 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of: Martin H Rod2ers Social Security: 167-32-9199 Date of Death: October 9. 2004 Dear Sir or Madam: Per your inquiry dated November 2, 2004, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account ACCOUnl Number 434477 Ownership (Names of) Marfin H Rodgers Opening Dale 9/1/67 Closed 10/27/04 Balance on Date of Death 53,991.89 A ccrued Interest $ 0.00 Total $3,991.89 Please be advised, there was no safe deposit box found for the above decedent. For further aceount information, regarding owoel'Ship, closures and/or reimbursement of funds, etc., please call the High Street Carlisle OtTace # 717-240-4536. Sincerely, ~""'7 tY&p- Nancy Clagett Records Management 04-24-2006 RODGERS 10-09-2004 21 04-0972 CUMBERLAND 101 APPEAL DATE: 06-23-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REv:is47-Ex-AFp-coj:osj-NoTlcE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARTIN H FILE NO. 21 04-0972 ACN 101 ~UREAU OF INDIVIW1(l;-1AX~~ (f;:\CC :NHERITANCE TAX DIVISION"/ ': ',-' :, \ '0 BOX 280601 . . ., IARRIS8URG PA 17128-06h-j COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 20Gb ~PR 24 p~ 3~ 59 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CLERK OF ROBERT r-,~~f~~\5~~~PA FREY & ffi~V~1 5 S HANOVER ST CARLISLE PA 17013 ESTATE OF RODGERS REV-1547 EX AFP (06-05) MARTIN H TAX RETURN WAS: (X) ACCEPTED AS FILED DATE 04-24-2006 ) 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) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 171,000.00 52.945.00 .00 .00 5.070.00 620.00 4,205.00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 25,597.00 12.600.00 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 233,840.00 38.197 00 195,643.00 .00 195,643.00 14. 15 and/or 16. 17. 18 and 19 will returns assessed to date. NOTE: If an assessment was issued previously. lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = 195,643.00 X 045= .00 X 12 = .00 X 15 = (19)= + DATE 12-30-2004 NUMBER CD004785 INTEREST/PEN PAID (-) 440.20 AMOUNT PAID 9,000.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 8,804.00 .00 .00 8,804.00 9,440.20 636.20CR .00 636.20CR * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D Jl. 1"I~r'.."."" .......... .........-..-- ---- -- -..-- --_.- --- ----------- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) ROBERT G FREY FREY 8 TILEY 5 S HANOVER ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-22-2006 RODGERS 10-09-2004 21 04-0972 CUMBERLAND 101 MARTIN H Amount Remitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF RODGERS MARTIN H FILE NO.21 04-0972 ACN 101 DATE 05-22-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-17-2006 PRINCIPAL TAX DUE: 8,804.00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-30-2004 CD004785 440.20 9,000.00 05-05-2006 REFUND .00 636.20- TOTAL TAX CREDIT 8,804.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IE IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR', YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. , v-{{ CUmberland County - Register at Wl1IS One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013-3385 RE: Estate of RODGERS MARTIN H File Number: 2004-00972 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 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 is due by: 10/09/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbau~ Clerk of the Orphans' Court cc: File Personal Representative(s) ~ Cumberland County - ~egister Of Wllls One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 RODGERS RONALD T 717 RAVENWOOD DRIVE SMITHVILLE, NJ 08205 RE: Estate of RODGERS MARTIN H File Number: 2004-00972 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. 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 is due by: 10/09/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Martin H. Rodl:er Date of Death: October 9. 2004 Will No. Admin. No. 21-04-0972 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 tile a fmal account with the Court? Yes () No (X ) (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 ( X) No ( ) (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be fIled with the Clerk of the Orphans' Court and may be attached to this report. ~J \ ~ . . . ature Date: September 29.2006 Robert G. Fr~y 5 South Hanover Street Carlisle. Pa 17013 (717) 243-5838 Vd "OJ Gl'~1Idj8v~n8 ltin08 S,N'tHdtiO jO >1tB18 LE :" WV Z- 1JO 900l Capacity: ( ) Personal Representative ( X) Counsel for Personal Representative c.... '.1' i ~n '...f' , (\;r:-'JLi ) \ lit,/\ ::..) b':.jl\,F '-, :10 381.:1:10 0308083b ~