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
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15. Amount of Line 14 taxable at the spousal tax
rate ,or transfers under Sec.9116 (a)(1.2)
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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
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x: a::: x:
00..0
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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
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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)
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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)
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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
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( )\ 'J 17- , ""5, , ',' \, ,~~" f'~" f.') I'>~ t t~,ll,,")r
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-'-~ _. Offer ends August 1.
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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
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REVIEWS & RATINGS ADVICE FINANCING & INSURANCE
BLUE BOOK7t PRIVATE PARTY REPORT
Pennsylvania · August 2, 2005
1993 Buick Century Special Sedan 40
.~
. .
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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.
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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
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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.
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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
(
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. 1\ (
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Q -;*C':
...'" 1 ~_,
9.50
1 mo 2mo 3mo 6mo 1 yr 3yr 5yr
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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
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4.9
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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
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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
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