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Home My WebLink About04-0988PETITION FOR PROBATE and GRANT OF LETTERS Estate of Samuel Amos Souder~ Jr, a/k/a Samuel Amos Souders also known as a/k/a/Samuel Amos Souder cial Security No. NO. 194-07-3596 The petition of the undersigned respectfully represents that: No. 21-04 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Your petitioner(s), who is/are 18 years of age or older and the executors named in the last will of the above decedent, dated April 26~ 2000 and codicil(s) dated N/A (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with the Decedent's last family or principal residence at 42 North High Street Borough of NewviHe Newvill% PA 17241 (list street, number and municipality) Decedent, then 85 years of age, died at Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No Exceptions September 24~ 2004 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: unestimated none 'l~alvin Soudcrr c ' - 150 Crossroad School Road -' '"Newvllle~ PA 17241 ~ ~ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary ~.~~_~stamentary; administration c.t.a.; administration d.b.n.c.t.a.) Erq~t Soudei'- ff Maryanne Souder Pelletier 870 Shippensburg Road g 44 North High Street NewviH% PA 17241 Newvill% PA 17241 ~OATH OF PERSONAL REPRESENTATIVE COMMONWEATIJt OF PENNSYLVANIA COUNTY OF CI~I~IBERLAND The peti~ner(s) a.~ve-nami~d swear(s) or affirm(s) that the statement in the foregoing peition are true and coi'~ect to the best ~ knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this:,qq~:~ay Of ',~c~ ~-~. ~Register No. Estate of Samuel Amos Souder, Jr., a/k/a Samuel Amos Souders, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW Ixh:,oe.-~.~ ~- .: 2004 the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admitted to probate and filed of record as the last will of Samuel Amos Souder, Jr., a/k/a Samuel Amos Souders April 26, 2000 and Letters Testamentary are hereby granted to Calvin Souder, Ernest Souder and Maryanne Souder Pelletier FEES Probate, Letters, Etc. $ [g~. lDO Short Certificates( ) $ ~o oo Total ,$ '~q~ oC~ Filed.... :B. :.]Lx ...o~...~. ................. ' Register of Wills C~. ~ ~io.~:~ Stephen D. Tiley 32318 ATTORNEY (Sup. Ct. I.D. No.) 5 South Hanover Street Carlisle, Pennsylvania 1'/013 ADDRESS (717) 243-5838 PHONE I0$.O05MS REV.(01/03) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. 0526706 C'q No. Charles Hardester State Registrar 0C1' 05 200 Date (%1 .cD -, ,~ CERTIFICATE OF DEATH Samuel Amos Souder z. Malel*.194 --07 --3596 Newville PA ,.,,.~1~ ~,0o~.,~O ~ O Cumberlan4 Newville 42 N. H~gh ~t. New~l~e ~.~m ~te Truck v.~ ~ ~"~ Widow~ 42 North High St. Newville FA 17241 ¢~m~"m) Mary Anne Pelletier ~"~nu~s~,~)PA 17241 LAST WILL AND TESTAMENT OF SAMUEL AMOS SOUDER, JR. A/K/A SAMUEL AMOS SOUDERS I, SAMUEL AMOS SOUDER, JR., also known as, SAMUEL AMOS SOUDERS, of the Borough of Newville (42 North High Street), Cumberland Countv, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills and Codicils heretofore made. FIRST I direct the payment of my just debts and funeral expenses as soon after my death as may be convenient. SECOND I declare that I am now the widower of Anna Mary Souder who died on November 16, 1997, and that I have four (4) living children, to wit: Calvin Souder, 150 Crossroad School Road, Newville, Pennsylvania; Ernest Souder, 870 Shippensburg Road, Newville, Pennsylvania; Richard Souder, 42 North High Street, Newville, Pennsylvania: and Maryanne Souder Pelletier, 44 North High Street, Newville, Pennsylvania. I also have oue deceased child, Robert Souder. who died February 15, 1992 leaving to survive him two (2) children, to wit: Sandy Gall Zimmerman and Bradford Lee Souder. I have no other children living by my wife or otherwise. THIRD ! make the following specific bequests: (a) Whatever tools, rare coins and paper money which I may have at the time of my death, shall be divided into five equal shares, and shall be distributed per stirpes, and not per capita, one share each unto my above-named four children, and one share to be divided equally between the two children of my deceased son. Robert Souder, to wit: Sandy Gail Zimmerman and Bradford Lee Souder, per stirpes and not per capita. (b) To my son, Calvin Souder, I give grandfather's gold watch; my great-granafather's mustache cup: Grandfather Mohler's ceramic pig pen with pig on it; the comer cupboard; and the two (2) white pickle dishes. (c) To my son, Ernest Souder, I give the German stein which he had given to his grandmother; the iron owl bank; grandfather's shaving mug the copper ketde; the blue and white plate with picture of snow scene on it; and the blue and white dishes or cereal bowls. (d) To my son, Richard Souder, I give the red and white Newville pitcher; the glass airplane; and the white hobnail vase from Aunt Flo. (e) To my daughter, Maryanne Souder Pelletier, I give the red plate and the red and white cup and saucer from Grandfather Souder; the camivalware dishes; Anna Mary Souder's mother's red and white plate; thc duck salt and pepper shakers: the china red and white cup and saucer from Anna Mary Soudec's mother; the ccrsmic bS'ds ,.~.'ith onn'¢u which was A :ina M;rt'~i .qouder's mother's; and Anna Mary Souder's tm~ther's bureau, wash stand, trunk, and small ~tand that Anna Mary Souder's father made. FOURTH All the rest, residue and remainder of mv estate, real, person'al and mixed, and wheresoever the same ~nay be situate, I give, devise and beqtieath, in equal shares, per stirpes and not per capita, unto such of my children as shall survive me by ninety (90) days, but should any of them fail to so survive me then the share such deceased child of' mine would have received to such his or her issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such issue the same shall lapse and be added to the remaining share or shares. For purposes of this Will, the word "predecease" shall mean any individual who fails to survive me by ninety (90) days, and the word "survive" shall mean any individual who survives me by at least ninety (90) days. SIXTH I hereby nominate, constitute and appoint my son. Calvin Souder, my son, Ernest Souder, and my daughter, Maryanne Sm:der Pelletier~ or the survivor or st~rvivor:¢ of them, or the successor or successors of them, as Co-Executors of this my Last Will and Festament. I further direct that no bond or other security shall be required ot any Executor or Executrix appointed in this Will for the performance of his or her duties in any jurisdiction in which he or she may be called upon to act. SEVENTH In addition to, and not in limitation of, the powers conferred by law or by other provisions of this Will, my Co-Executors shall have the following powers, each of which may be exercised frown time to time by my Co-Executors in his, her or their sole discretion: (a) To retain in the form received, and to sell either at public or private sale, or to distribute in kind, any real or personal property. (b) To manage both real and personal property. (c) To invest and reinvest in all forms of property, notwithstanding the fact that any or all of the investments made are of a character or size which but for this expressed authority would not be considered proper for an Executrix. (d) To exercise any option or rights arising from the ownership of investments. (c) To compromise claims without court approval and without the consent of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on three (3) pages, this 2. 6 '~' day of April, 2000. ,~:~Jc?-:~ ~.z-z g z~-~ ~ ~,~ .~' ~,~/a' ~ ,~ a (SEAL) Samuel Amos Souder, Jr. Samuel Amos Souders Signed, Sealed, published, and declined by Samuel Amos Souder, Jr., a/k/a Samuel Amos Sourers, the Testator above named, a~ and for h/s Las! Will and Testament, in our presence, who, in his presence, at his request, and m the presence of each other, nave hereunto subscribed our names as attesting witnesses. COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF CUMBERLAND We, Samuel Amos Souder, Jr., a/k/a Samuel Amos Souders, .'~pe/-,6.~ ~ ~3kyand c"~. r./e ,4. m~ (,'2~ , the Testator and the witnesses, respectively, whose names are sigr/ed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned apthority that the Testator signed and executed the instrument as his Last Will and that he had s~gned willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the proposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of their knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ' Samuel Amos Souder, Jr. Samuel Amos Souders _/' / Subscribed, sworn to and acknowledged befbre me by the Testator and the witnesses above- named, this 2,°- day of April, 2000. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Samuel Amos Souder, Jr. Date of Death: September 4, 2004 Will No. To the Register: Admin. No. 21-04-0988 R' I certify that notice .o,f (Beneficial Interest) estate administration required by ule 5.6(a) of the Orphans Court Rules was s.e. rved on or mailed to the following beneficiaries of the above-captioned estate on. November 3, 2004. Name Calvin Souder Ernest Souder Maryanne Souder Pelletier Richard Souder Sandy Gall Zimmerman Bradford Lee Souder 150 Crossroad School Rd., Newville, PA 17241 870 Shippensburg Road, Newville, PA 17241 44 North High Street, Newville, PA 17241 42 North High Street, Newville, PA 17241 306 Oakville Road, Shippensburg, PA 17257 333 Burghers Road, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6)a) except NO EXCEPTIONS Date: 11/4/04 Signat~e Name: Stephen D. Tiley Address: .5 South Hanover Stree~t Carlisle, Pennsylvania 17013 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TILEY STEPHEN D ESQ 5 S HANOVER ST CARLISLE, PA 17013 nn__U fold ESTATE INFORMATION: SSN: 194-07-3596 FILE NUMBER: 2104-0988 DECEDENT NAME: SOUDER SAMUEL AMOS JR DATE OF PAYMENT: 02/10/2005 POSTMARK DATE: 02/10/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2004 NO. CD 004929 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $6.00 I I I I I I I I TOTAL AMOUNT PAID: $6.00 REMARKS: FREY & TILEY CHECK# 5697 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS FREY & TILEY ATTORNEYS-AT-LAW 5 SOUTH HANOVER STREET CARLISLE, PENNSYLVANIA 17013 ROBERT M. FREY OF COUNSEL STEPHEN D. TILEY ROBERT G. FREY TELEPHONE (717) 243-5838 FACSIMILE (717) 243-6441 February 9. 2005 ,..---., , . Commonwealth of Pennsylvania Department of Revenue Bureau of Individual Taxes Inheritance Tax Division P.O. Box 280601 Harrisburg, PA 17128-0601 Re: Samuel Amos Souder, Jr., Deceased File No. 21-04-0988 Dear Sir or Madam: Enclosed please find an inheritance tax return which we have filed for the above referenced decedent's estate. We note that on Schedule "G" we have listed the transfer from the decedent Samuel Souder, to his son, Richard Souder, of Samuel's house and furnishings. That transfer took place in the year 2000. At that time, the house was valued by an independent appraiser at $42,500.00. We have shown that transfer as having a zero valuable taxable in Samuel's estate, even though Samuel continued to reside in the house without a stated rental payment to his son, who also continued to reside in the house. As described at Schedule "G," Richard suffered from physical disabilities as a result of an automobile accident and resided with his parents from 1966 on. While Richard was able to work, his father provided some of his support. His sister, who lives next door, often cooked meals for both of them. We believe that this relationship amounted to support in lieu of rent (or at least one-half of the fair rental value of the house and furnishings) and therefore there should be no value of the transferred assets retained as taxable in Samuel's estate. Should you have any questions, please feel free to contact the undersigned. ~~'. 7;4 Stephen D. Tiley SOT ItIIEnclosure cc: Legatees of the Estate of Samuel Amos Souder, Jr.. c<) ~l.\.~ ~""~l. ,~ Q~,~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 "' ~<.. ~~'i\L 217 REV-1500 EX (6-00) OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-04-0988 COUNTY COOl; YEAR NUMBER ~ z w fa fd o DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Samuel A Souder Jr. DATE OF DEATH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE SOCIAL SECURITY NUMBER 194-07-3596 DATE OF BIRTH (MM-DD-YEAR) 9/24/2004 5/2/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REGISTER OF WILLS SOCIAL SECURITY NUMBER J!! lO:~UI uO::lO: w~g %0::'" ull:1D 4: [K] 1. Original Return o 4. Limited Estate [K] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received 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 Creel. (date of death belween 12-31-91 and 1-1-95) ...Q.. 8. Total Number of Safe Deposit Boxes 011. Election to tax under Sec. 9113(A) (Attach Sch 0) o 3. Remalmer Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Retum Required ~ Z W o Z o Q. r3 It It o o COMPLETE MAILING ADDRESS 5 South Hanover Street Carlisle, PA 17013 717-243-5838 1. Real Estate (Schedule A) (1) NONE (2) NONE (3) NONE (4) NONE OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) ':2 3. Closely Held Corporation, Partnership or Sole-Proprietorship c:) 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) (6) 7,228 370 z o ~ :5 :;) !: Q. c:( fd It 6. Jointly Owned Property (Schedule F) Dseparate Billing Requested 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. TOTAL GROSS ASSETS (total Lines 1-7) (6) 7,598 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 7,469 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) :10) NONE 11. TOTAL DEDUCTIONS (total Lines 9 & 10) 7,469 129 (11) (12) 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) (13) (14) 129 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax Z rate ,or transfers under See.9116 (a)(1.2) x .0 - (15) 0 ~ 16. Amount of Line 14 taxable at lineal rate 128 x .O~ (16) :;) Q. :IE 17. Amount of Line 14 taxable at sibling rate x .12 (17) 0 0 g 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 6 6 217 Samuel A Souder, Jr. 194-07 -3596 Decedent's ComPI ete ress: STREET ADDRESS 42 North Hioh Street CITY 1STATE I~IP Newville PA 17241 Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditsIPayments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 6 Total Credits (A + 8 + C ) (2) 3. InterestlPenalty if applicable D.lnterest E. Penalty TotallnterestlPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT ;"~'~ ;~:i:~i:~' :.:''-':~}S;;,~~~;{tm.~'~~~~1n~~~-$;:!~.~tlr~~~~~~ef~:,,~.~t1![;~.'Jf~~~0~~,:~~~~;:"~:~_i.~'r,-'~-.: ~~~;:,'''.''::!'' 6 6 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . .. b. retain the rightto designate who shall use the property transferred or its income; No D [KJ [KJ [KJ [KJ [KJ Ves [RJ D D o o o .......0 [KJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . 2. d. receive the promise for life of either payments, benefits or care? . . . . . . If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . ., 3. 4. Did decedent own an Individual Retirement Account, annuity or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . ADDRESS Stephen D. Tiley, 5 South Hanover Street, Carlisle, PA 17013 '; ,J,;~;:;;~lat~i(;ii!;,\:.i~~f!i~i,~.~i~:ii~\~~1t~#j~jXttt~l?'(iitc:i\1.~;'i,'.~"~'i;1ii;;"ti~ti",,,,i,j;;.:i.. ..)' . Wi' 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)(1)). For dates of death on orafler 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)(l.l}(li)}. The statute does not exempt a lransfer to a surviving spouse from lax, and the statutory requirements for disclosure of assets and filing a lax return are still applicable even if the surviving spouse is the only ~efiCiary. 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 10 or for the use of a natural parent, an adoptive parent, or a stepparent of the child Is 0%[72 P.S. Sectlon 9116{a){1.2)J. 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 lax rate Imposed on the net value of transfers to or for the use of the decedent's siblings Is 12% [72 P.S. Seclion 9116(a)(1.3)) .A Sibling is defined, under SectIon 9102, as an Individual who has atteast one parent In common with the decedent, whether by blood or adoption. AT REV-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Souder, Samuel A. Jr. FILE NUMBER 21-04-0988 IncIule the proceeds of litigation and the date the proceeds were received by the estate. AU PROPERTY JOINTL y-oWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM NUMBER 1. 2. 3. DESCRIPTION VALUE AT DATE OF DEATH 4. Refund from the Sentinel Tools mentioned at paragraph 3(a) of Will Rare coins and paper money mentioned at paragraph 3(a) of Will (See appraisal by Copenhaver Coin Exchange, attached.) "Calvin" items listed on Rick Foreman, Auctioneer, list attached. Includes items listed at paragraph 3(b) of Will, except ceramic pig pen not found "Ernest" items listed on Rick Foreman, Auctioneer, list attached. Includes items listed at paragraph 3(c), except shaving mug not found "Maryanne" items listed on Rick Foreman, Auctioneer, list attached. Includes items listed at paragraph 3(c) of Will (Items 4,5, and 6 equal $737.00, the amount shown on Auctioneer statement, attached.) Items to Richard Souder described at paragraph 3(d) of Will Burial Fund Account at Farmer's National Bank, and Adams County National Bank 29 25 121 290 5. 257 6. 190 Note: 7. 8. 10 6,306 TOTAL (Also enter on line 5 RecaDitulation $ (If more space is needed, insert additional sheets of the same size) 7228 r-'~-~--'''''-----'-'~~~\ ~ a; $ '\ \ -< ~ " \ \ ,."",...",,_..,_.\ ., \ I.;, '", " tJ:jO c~ () ""<:::1 Cn~ 0 t:l~ ~ t""~ ~~ $ ~~ ~ 0 ~~. 'J> ~ ..... - ~ ~ :::=: +- () ~ ~ 0 p. ~ ..... \0 ~ ~ ":l~N ..... g'O~ 5~~ Q ~~~ -::1'-' ~ ;:;":l~ ~';J.> g. '" ::l g .:o':i(J) NO::::; N\JJO -.l0\~ Rick Foreman Auctioneer,Au 1163L 386 Springfield Rd. Shippensburg, Pa.17257 (717)776-4602 Items for Souder Estate Cals items in cupboard Ernies items in cupboard Mary Anns items in cupboard corner cupboard 4 drawer dresser wash stand blanket chest copper kettle stirrer wooden high chair (broken) sled old trunk small bed stand old record player wooden comode crocks tin box plank bottom rocker strip seat rocker all other wooden chairs Higgins shot gun W.H. shot gun Savage 30-30 Total $15.00 eCA-/'NV' $15.00 ~Ad~ $15. 00 /?'?/1-~Y##~ $200. 00 C.l9-/~'/"'/ $75.00G $50. 00 /?"I~y~A'tL- $25.00 $50.0 $5.00 $15.00 ~/&A'~:sj- $5.00 $35.00 $15.00 -/Y'I~/'M~-.!- $40.00 $20.00 .$5.00 $2.00 L .L./I't!d- $25.00 $1 0.00 $10.00 $20.0 $1 O. 00 ,h?A-AYA-'#~ .e- $75.00 ~,+/,,/'/ $737.00 Richard Foreman Au 1163L ~ ~~/YlUYl.J ,/)t.f. 1/(,3 '- ~ ADAMS COUNlY NATIONAL BANK January 25,2005 Frey & Tiley Attorneys at Law 5 South Hanover Street Carlisle, P A 17013 Re: Estate of Samuel Amos Souder, Jr. Dear Mr. Tiley: The following information is being provided as per your request: Acct. Type Account Account Accrued Ownership Date Date No. Principal on Interest to Account Account D.O.D. D.O.D. Opened Joint Checking 142875 $738.84 $.04 Jt. wi Maryanne 8-2-85 11/20/97 Pelletier C.D. 162597 $6,287.46 $16.84 Irr Burial Fund 7-30-03 NIA Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)338-2171. Sincerely, '17M K ~~ Lois Kime Deposit Services 217 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Samuel A Souder, Jr. 21-04-0988 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. B. C. JOINTLY-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 DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL Y-!iELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrSINTEREST 1. A. Joint checking account Farmer's National Bank (now Adams County National Bank) Acct. No. 14-287-5. Joint with Maryanne Pelletier, 44 North High Street, Newville, PA 17241 739 50.00% 370 Account interest to date of death 0.04 50.00% TOTAL (Also enter on line 6, Recaoitulation\ $ 370 (If more space is needed, insert additional sheets of the same size) ~ ADAMS COUNlY NATIONAL BANK January 25, 2005 Frey & Tiley Attorneys at Law 5 South Hanover Street Carlisle, P A 17013 Re: Estate of Samuel Amos Souder, Jr. Dear Mr. Tiley: The following information is being provided as per your request: Acct. Type Account Account Accrued Ownership Date Date No. Principal on Interest to Account Account D.O.D. D.O.D. Opened Joint Checking 142875 $738.84 $.04 Jt. wi Maryanne 8-2-85 11/20/97 Pelletier C.D. 162597 $6,287.46 $16.84 Irr Burial Fund 7-30-03 NIA Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)338-2171. Sincerely, nMK~ Lois Kime Deposit Services 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 21-04-0988 ESTATE OF Samuel A Souder, Jr. This schedule must be completed and filed ifthe answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. 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 APPlICA8l.E) VALUE 1. Richard L. Souder, son, April 26, 2000, house and furnishings they shared at 42 North Hgh Street transferred to Richard. See deed and gift tax return filed. Have appraised at $42,500.00, by independent appraiser in year 2000. Furnishings valued at $1,200.00. While the decedent continued to reside in the property without paying any stated rent, he paid all expenses associated with the house (utilities and insurance), and most food and household expenses. Richard L. Souder suffered brain injuries in a car accident in 1965, and although able to perform some work, he is physically unstable and has lived with his parents (his mother predeceased his father) ever since his accident. 43,700 100% . TOTAL (Also enter on line 7 Recaoitulation\ $ (If more space is needed, insert additional sheets of the same size) r-:----"-=-'-1 \14-1' '. ./'" . . ~_.. \ ,\~ 1 Tax Parcel No.: 27-20-1754-146 TillS DEED, MADE THE 26th day of April in the year of our Lord two thousand nine (2000). BETWEEN ......... SAMUEL AMOS SOUNDERS, also known as SAMUEL AMOS SOUDER, JlC' widower, of the Borough of Newville (42 North High Street), Cumberland County, Pennsylvania, ~ Grantor, and RICHARD L. SOUDER, single man, of the Borough of Newville (42 North High Street), Cumberland County, Pennsylvania, Gra1ltee, WITNESSETH, that in consideration of One ($1.00) Dollar,in hand paid, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and convey to the said Grantee. his heirs and assigns, ALL THAT CERTAIN piece or parcel of land situate in the North Ward of the Borough of Newville, County of Cumberland and State of Pennsylvania, bounded and described as follows: BEGINNING at a point on North High Street, which point is a corner of lot about to be conveyed to Jennie V. Nelson by the Quincy United Brethren Orphanage and Home; thence westwardly along lot of the said Jennie V. Nelson, one hundred eighty (180) feet, to lot now or formerly of Charles A. Martin; thence Northwardly along lot of said Charles A. Martin, twenty- eight (28) feet, more or less, to a point in line of land of Charles M. Meily, grantor herein; thence Eastwardly along land of the said Charles M. Meily, one hundred eighty (180) feet to a point in said North High Street; thence Southwardly along said North High Street, twenty-eight (28) feet, more or less to a point, the place of BEGINNING; . HAVING erected thereon a two story frame dwelling house known as and numbered 42 North High Street, Newville, PA 17241; BEING the same premises which Charles M. Meily, widower, by deed dated November 8, 1946 and recorded November 8, 1946 in the Office of the Recorder of Deeds in and for Cumberland County, at Carlisle, in Deed Book "I", Volume 13, Page 521, granted and conveyed to Samuel Amos Souders and Anna Mary Souders, husband and wife. The said Anna Mary Souders also known as Anna Mary Souder, having died on November 16, 1997, the entire fee simple title to the above described premises became vested in Samuel Amos Souders, also known as Samuel Amos Souder, by operation of law. THE within conveyance is from father to son and is therefore exempt from all realty transfer tax. AND the said Grantor does hereby covenant and agree that he will warrant SPECIALLY the property hereby conveyed. IN WITNESS WHEREOF, said Grantor has hereunto set his hand and seal the day and year first above written. Signed, Sealed, and Delivered ;'in -.th€ P;63..~nc.s rJf /A :t~ j! II /..~ r, / &r~t<f'.Ji-[..t-y'1-L-~-;/ "'\~A_4Clc~1 (SEAL) Samuel Amos Souders /j/{;'L-n..uti2k{lY"'~-r.-eJ".....'t.c.-t./ .( (SEAL) Samuel Amos Souder, Jr. .' BOOK 2J9 r.',!I10 64 .. .~ c:> ::0 ~, = r-:> -.J ~-, ,- h_ ."!""'I 3: r~ ?'J c.; -:;:-) :',:,) ~~0 ..p. ..-. "''0 ::3 ~~~ ~.: ~~; ,:= ".~1 :.' :::: rn .'_ :~ ~~ ~.:.: I (f)'V -u p Commonwealth of Pennsylvania } ss. County of Cumberland On this, the),r. tf. day of April, 2000, before me, the undersigned officer, personally appeared Samuel Amos Souders, also known as Samuel Amos Souder, Jr., known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. 0D~ N ROBERT G. FREY, NOTARY P\ItIUC CARUSl.E, CUMBERUNO 00UN1'Y. PA IK't COMMISSION ElCPAlRII olUNI3, 2002 I do hereby certify that the precise residence and complete post office address of tli named Grantee, Richard L Souder, is 42 North High Street, Newville, PA 17241. ~ /.{} ~ " ~-tA:.q - 7 1 Stephen D. Tiley, Esquire, N. T.S. Attorney for Grantor COMMONWEALTH OF PENNSYLVANIA }ss. COUNTY OF CUMBERLAND RECORDED on this ;jl day of 'ip,,": \ ,2000, in the Recorder's Office of the said County in Deed Book 'dl ~ ", Page (()~ t' Given under my .hand and seal of the said office, the date above written. ~~ , Recorder ~~~~ ~ ?- ~ ~.:i:~~~;~ih'. " " ..-.. CJ ....~.~~"J.'t.~t ."'~.~:::;. ...., ..:.,.<'._... . "b' '(,0 .:,.;~ !slI',' ~.t"".&;:'\ ., ~ ("i~4"",.;,:<. _, ('~'\~' .' .}or""', :cJl,,/ftr.'t;j~,,~;"~: - '~;~ .I! ;'. 'f r~~~' " ""; "'~.}.l.: "": ,.tI , ~ l~"" i. ;;-.- '.._..~ ..-'t.~'r"{~~ l~ ,~J'~~~~-';; l~\o . ~\;.~" _.~:..,; .../ l' "':~:S'~' .... .~., . -.. .., ,. '".." ~~ ~.~" r1"$J ..'"QI',-" ." n' ~ l,;;,,~~..,.,...:..,,~ . -, 'll1'll"AV{.l;~ " .....1-4Nn~"r"......~. ".. .... .....................,.'l'J 8001( 219 PAtE1065 ''''~r . - ,. . ''''':'""':" i"'A~ FILE Form 709-A United States Short Form Gift Tax Return (Rev. November 2000) Department of the Treasury Internal Revenue SeMee 1 Donors first name and middle initial Samuel A. 4 Address (number, street, and apartment number) 42 North Hiah Street 6 City, state, and ZIP code Newville, PA 17241 8 Did you file any gift tax returns for prior periods? Calendar year _ _~Q99_ _. /2 Donor's last name Souder .. .DYes If "Yes," state when and where earlier retums were filed 9 Name of consenting spouse /t5 ~~/e,( Ol( 6/e;/ OMS No. 1545-0021 3 Donor's SSN 194-07-3596 5 Legal residence Pennsvlvania 7 Citizenship United States [K] No 10 Consenting spouse's social security number N/A Widower NOTE: Do not use this form to report gifts of closely held stock, partnership interests, fractional interests in real estate, or gifts for which the value has been reduced to reflect a valuation discount. Instead, use Form 709. List of Gifts 2,400 4/26/2000 42,500 0 4/26/2000 1,120 (unknown) 43 Misc. 43 43,663 -10,000 33,623 (a) Donee's name and address and description of gift (b) Donor's adjusted basis of ift (e) Date of gift Richard L. Souder 42 North High Street Newville, PA 17241 A) Real estate at 42 North High Street Newville, PA 17241 B) Furnishings at real estate listed at (a) C) Misc. gifts during year: T-shirts, pants, remote SUB-total LESS EXCLUSION NET GIFTS (d) Value at date of gift - ~ I consent to have gifts made by my spouse to third parties during the calendar year considered as made one-half by each of us. :g N/A 8 Consenting s Duse's si nature Date Under penalties of perjury, I declare that I have examined this retum, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than donor) is based on all infonmation of which preparer has any knowledge. Sign Here Paid Preparer's Use Only 717-243-5838 Form 709-A (Rev. 11-2000) SAMUEL AMOS SOUDERS a.k.a Samuel Amos Souder, Jr. 42 North High Street Newville, Pennsylvania 17241 ~6 April2, 2000 Mr. Richard Souder 42 North High Street Newvilie, PA 17241 Dear Richard: By this letter today I gift to you all of the household furnishings situate in the home which we currently share at 42 North High Street, Borough of Newville, Cumberland County, Pennsylvania, which I am today also gifting to .you, except for those items of personal property listed on Exhibit "A" attached hereto. Sincerely yours, A ~~~~kf e~~J~ Samuel Amos Souders .'L-- ;I j' 'J ,.-<J ~ I i..11 ~ /.1 tf.---1.--t ~/L If A Samuel Amos Souder, Jr. r:r--'- SOT/cam THIRD I make the following specific bequests: (a) Whatever tools, rare coins and paper money which I may have at the time of my death, shall be divided into five equal shares, and shall be distributed per stirpes, and not per capita, one share, each unto my above-named four children, and one share to be divided equally between the two children of my deceased son, Robert Souder, to wit: Sandy Gail Zimmerman and Bradford Lee Souder, per stirpes and not per capita. (b) To my son, Calvin Souder, I give grandfather's gold watch; my.'great-grandfather's . . mustache cup; Grandfather Mohler's ceramic pig pen with pig on it; the comer cupboard; and the two (2) white pickle dishes. (c) To my son, Ernest Souder, I give the German stein which he had given to his grandmother; the iron owl bank; grandfather's shaving mug; the copper kettle; the blue and white plate with picture of snow scene on it; and the blue and white dishes or cereal bowls. (d) To my son, Richard Souder, I give the red and white Newville pitcher; the glass airplane; and the white hobnail vase from Aunt Fla. (e) To my daughter, Maryanne Souder Pelletier, I give the red plate and the red and white cup and saucer from Grandfather Souder; the carnivalware dishes; Anna Mary Souder's mother's red and white plate; the duck salt and pepper shakers; the china red and white cup and saucer from Anna Mary Souder's mother; the ceramic birds with mirror which was Anna Mary Souder's mother's; and Anna Mary Souder's mother's bureau, wash stand, trunk, and small stand that Anna Mary Souder's father made. , EXHISIf .,.,.a 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Samuel A Souder, Jr. FILE NUMBER 21-04-0988 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Egger Funeral Home, Inc. 6,210 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees 750 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Richard Souder Street Address 42 North HiQh Street City Newville State PA Zip 17241 Relationship of Claimant to Decedent Son 10 4. Probate Fees 34 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Checks cleared after death, Accl. No. 14-287-5 45 8. Funeral supplies to Dollar General 35 9. Funeral supplies to WalMart 76 10. Final telephone bill 45 11. Newville Water & Sewer Authority 176 12. Comcast 45 13. PP&L 44 TOTAL (Also enter on line 9 Recanitulation $ 7470 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) F. CHARLES EGGER, Supervisor EGGER FUNERAL HOME, INC. 15 Big Spring Avenue NEWVillE, PENNSYLVANIA 17241 717-776-3414 FRANK C. EGGER, Funeral Director October 8, 2004 Funeral Bill for Amos Souder Date of Death September Profesional Services $3,275.00 Newport Stainless Steel Casket $2,520.00 Clergy offering $100.00 Flowers $132.50 Obituary Patriot News $142.82 Honor Guard $40.00 Total $6,210.32 Amount paid ii"om Burial fund $6,305.81 Refund Check $95.49 h"l\e r<{ ( ?at'd r() F"v/f '/ kJ'r~ 217 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Samuel A Souder Jr FILE NUMBER 21-04-0988 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. Calvin Souder 150 Crossroad School Road Newville, PA 17241 Son Specific bequest at 2. Ernest Souder paralJraph 3(b) & 2607 Walnut Bottom Road 1/5 residuary Carlisle, PA 17013 Son Specific bequest at 3. Maryanne Pelletier paragraph 3(c) & 44 North High Street 1/5 residuary Newville, PA 17241 Daughter Specific bequest at 4. Richard Souder paragraph 3(e) & 42 North High Street 1/5 residuary Newville, PA 17241 Son Specific bequest at 5. Sandy Gail Zimmerman paragraph 3(d) & 306 Oakville Road 1/5 residuary Shippensburg, PA 17257 Granddaughter Specific bequest at 6. Bradford Lee Souder paragraph 3(a) & 333 Burgners Road 1/10 of residuary Carlisle, PA 17013 Grandson Specific bequest at paragraph 3(d) & 1/10 of residuary 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) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 SOUDER CALVIN 150 CROSSROAD SCHOOL ROAD NEWVILLE, PA 17241 RE: Estate of SOUDER SAMUEL AMOS JR File Number: 2004-00988 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 adlninistration. This filing is due by: 9/24/2006 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, . If l r;1' ~":I Y.J .. ~~-J /~L IJiMrti'-",j. . Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 PELLETIER MARYANNE SOUDER 44 NORTH HIGH STREET NEWVILLE, PA 17241 RE: Estate of SOUDER SAMUEL AMOS JR File Number: 2004-00988 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: 9/24/2006 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, ""; {~..-. ~- ,J V -. { . '/ l~.#;d'L L . 'UU-U /"" Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 TILEY STEPHEN DOUGLAS FREY & TILEY 5 S HANOVER STREET CARLISLE, PA 17013-3385 RE: Estate of SOUDER SAMUEL AMOS JR File Number: 2004-00988 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 adrninistration. This filing is due by: 9/24/2006 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, b, / . C~ I ~/A./H"#jJ, /uZu,.L1'L U~~Cti:/'J~vvw:-- ~ l..I Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 SOUDER ERNEST 870 SHIPPENSBURG ROAD NEWVILLE, PA 17241 RE: Estate of SOUDER SAMUEL AMOS JR File Number: 2004-00988 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: 9/24/2006 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, t ( ~ . ,Llu fJ i~L lfl~~ j~~7r-' Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel STATUS REPORT UNDER RULE 6.12 Name of Decedent: Samuel L. Souder, Jr. Date of Death: September 24. 2004 Will No. Admin. No. 21-04-0988 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 abov€:-captioned estate: 1. State whether administration of the estate is complete: Yes (X ) No () 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes () 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. Date: September I, 2006 ;#~X; · 7 ":?ignature Stephen D. Tiley 5 South Hanover Street Carlisle, Pa 17013 (717) 243-5838 ("') o ( I 0- W (/) J::> C;) c~ ;:--j .~L o.~ l-- tee =:> ,-" \-1- 0 '_.J 00 '.Le/) 0.:"":-7 , ~<{:' o :r:. u~ Q..., CL cc~ o=:> o Capacity: ( ) Personal Representative .. ..... - :C- o.- ( X) Counsel for Personal Representative r -{'\! >$\ ::: ~ ::=~ l:l'l.... ;;G ,::;, '" m ::= r:: -- c'O ,m ,;:; ~ ~ eY !'C p '?l ::: ~ ~ J::> >$\ :::',:::: t.;.I- ~~ '" ::: ;; ,.,,) ~ ~ 0 .s ~ ,..-, to 0-- ~i .:;:J rf). rrj ~ ~? l-S> 0- o~c: ~ . :;8~ gg~ '00(; ... 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