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Home My WebLink About04-1024 PETITION FOR P~ROBAT~ and GRANT OF LETTERS also known as To: Register of Wills for the ~_ , Deceased. County of(_~v~[~v:,~-lr',,~J in the Social Security No. i~L~r)~©~(rY] . Commonwealth o f ~ennsyl~,ania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of are or older an the execut~ ~ named in the last will of the above decedent, dated ~¥ ~'xL'k~C~7'- ~ ~ , 19 and codicil(s) dated (slate relevant circumstances, e.g. renunciation, death of executor, etc.) Deg.endent was domiciled at death in ('SLq~q~lCT\ctvk~_ Count?, Pennsylvarlia with h~( tast family or principal residence at ~l O.X,C'c,.%J ~',J~ (list street, number and muncipality) Decendent rheA_ ~ ~ years of age, died (~x(' ~k-!,/~> ~ ~C~) ,'I9-_ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent 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: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE - COMMONWEAIGTH OF PENNSYLVANIA ~ ss COUNTY OF. {-~1)~13 ~4:~L?VN/t~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to ttte best of the knowledge and belief of petitioner(s) and that as personal represen- _ retire(s) of the above decedcat petitioner(s) will well and~tjmly administer the esta~ according to law. Sworn to or affirmed and subscribed ~/~~~ before me this ~ day of [ ~ Estate0f L~rEL~ i-lESL~q~ f~qO~TO/2._~? ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DEC~ED that the inst~ment(s) dated described therein be admitted to probate and filed of record as the l~t will of and Letters ~e hereby granted to FEES Probate, Letters, Etc .......... Short Certificates(g) .......... $ ~ 0 A~ORNEY (Sup. Ct. I.D. No.) TOTAL Filed ................................... PHONE WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. 5773622 Evelyn Heller Mortorff Female October 20, 2004 7-3-1916 Menallen Township, Adams County, Pem~sylvmfia 301 Oxford Road, Cumberland County, South Middleton Township White Laborer No Widowed 301 Oxford Road, Gardners, PA 17324 Joyce Sheaffer M. Lee Dugan Dugan Funeral Home, Inc, Bendersville, PA 17306 Chest trauma. Motor vehicle crash Belted passenger, vehicle turned into path of oncoming vehicle Michael L. Noms, Coroner 6375 Basehore Road Suite #1, Mechanicsburg, PA 17050 0 -0i o October 23. 2004 , 124 Rice Avenue, Big%iMlle, PA 17307 OATH OF NON-SUBSCRIBT~NG W~TNESS Estate of ~ Also Imoxxm as , Deceased each) a subscriber hereto, (each) being duly qualified according to law. de.p~e(s) and say(s) that ~.-~z~ ....... '-~ -odicil/will nresented herewith and that ~_~beheve~ (one of the subscribing -~xqmesses to) mc ~- r the si~atare on the codicil/will is in the handy, tiring of_ to the best of ~ lmowledge and belief. (Address) Sworn to or affirmed a..nd~Fbscribed Before me this __~) T ~ da~',~f (~ /' 3~x~.~~ (Address) / LAST WILL %ND T:~oTAM~NT OF EVELYN H. MORTORFF I, ~velyn H. Mortorff of R.D. 2 Gardners, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. IT~ I: I direct that all my just debts and funeral ex- penses~ including my ~revemarker and ill expense~ of my last ill- ness, shall be paid from my residuary estate as soon as practicable after my decease as a part of th~ administration of my estate. IT~ II: ! devise and becu~a,~h all of ;,~ estate of every n~ture %nd wherevsr situate to my husband George C. i'.Iortorff~ provid- ing he shall survive me by thirty dams. IT~'~ III: ~hould my husband ~eorge C. [~lortorff, ~.red a=~ me or die on or before the thirtieth day following my death. I devise and beou~ath all of my estate of evsry nature and wherever situate to my issue ~er stirpes living on the thirty-first day followinK my death. [~ly household goods and personal effects, and other tangible personalty of like nature (not including cash or securitiest, together with ~ny existing insurance thereon, to be divided by ssiection of the children, providing all a~ree, and .~s to property about which ther~ ~s nc unanimous agreement, I direct my eldest son to distribute said property among my i~;sue as h~ deems best. ..~ IV: Ail federal, state and other death taxes payable b~ecause of my death, with respect to the property forming my gross estate for tax purposes, whether or not ~assing under this will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and sh~ll be r>aid out of the principal of my estate without a~portionment or right of reimbursamsnt. Page -2- IT 54 V: I ~ppoint my husband, George C. Mortorff executor of this my last will. Should my husband, Gaorge C. Mortorff, fail to ~ualify or cease to act as executor, I appoint mM son Leonard Mortor~I, executor of this my last will. IT~[ VI: I direct that my executor or his successors shall not be r~euired to give bond for the faithful performance of their duties in any jurisdiction. IN WITNE3S WHEREOF, I have hereunto set my hand this 2_ y /~ d~y of ~/~ i~ _, ~ The preceding instrument, consisting of this and one other typewritten paKe, each identified by the signature of the testatrix was on the day and date thereof signed, published ~nd declared by by Evelyn H. Mortorff, the testatrix therein named, as and for her last will in the bresence of us, who, at her reouest, in her presence, and in the presance of each other have subscribed our names as witnesses h~reto. residing at ~ ~ ~_ , CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ~~VP\L)(1 'Me\\Cy \ltOY1-t'l-tt Date ofDeath: I () ~ dO - O-j Will No. ;;C[)l-) - () '\ Dd '--\ Admin. No. 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 11 -I q ~ Olf ~;) -,-0 c) : ~ Address lfOf$).yc\'\\I\C1YThvN- 'PO. Bux d8to Y($~Y: ~v;yqs' ~ '\ )3);), l CWPYl T '0IrV1i\yr -9+' \ (} q \)1 Y\O b-ovt:. 12d. I J() yr\rY'Y~ I 9A '\) 3;) lJ . jD~\rf) ~\\e0*~Y ?hI Ox.\lJ{c:t Qc\ \::s-0,vc\neY:\:K3\. \i'2,.:;lL) f\~Ylf' ~ {\i\CXThyff \S)q ln~p(JLQ CCJllY1-I'Mi\'{\n:\)IJh0 mD,..')\QD\ (b'fb\ 'M()'lYuW Illl E:.I \~\\:yC'.st-t)r' lRv\i3l.Q Po. lib!'] !Lt\1Y\.Q-H/l 1\'t"03-1tv jY )q(j.S ~S1eY'Dr Notice has now been given to all persons entitled thereto under Rule 5.6(a) except CkY \\ ') ~ '?'A \ '1013. Date: -Z - 1 / DS LA /lS S Signature \,0 C::) i."''') Name ~"\(Ly 'L t=. 'KJ L) \ Q. Y Address 15,') ,x,u+Y7 t-b'llbVCY Jt. ro.Y'\(.sl-e PY+ 1)[ )~ ;- ('.'-, Telephone ({II) d~11 ~ W DJ 0 , t.: Capacity: _ Personal Representative / +-counsel for personal representative '-',.,j Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717)240-6345 Date: 02/01/2005 BAYLEY MARK F 155 S HANOVER ST CARLISLE, PA 17013 RE: Estate of MORTORFF EVELYN HELLER File Number: 2004-01024 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 02/20/2005 Your prompt attention to this matter will be appreciated. Thank You. S~' GLENDA ,=~ Clerk of the Orphans' Court cc: File Personal Representative(s) Judge Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 02/01/2005 MORTORFF LEONARD G PO BOX 286 YORK SPRINGS, PA 17372 RE: Estate of MORTORFF EVELYN HELLER File Number: 2004-01024 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 02/20/2005 Your prompt attention to this matter will be appreciated. Thank You. ~~~ GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court cc: File Counsel Judge IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: Estate of Evelyn Mortorff, .J "....., r-:-.:. <:-'-) (....0" - --~ : No. 21-04-1024 '--":::: ;-,1 : [-~J ) ,.OJ ----.-. -~~l .::-) - ! 'r-j PETITION FOR APPROVAL OF SETTLEMENT 1. Your Petitioner, Leonard G. Mortorff, the personal representative of the Estate, herein requests that the Honorable Court confirm and grant settlement of litigation in this matter, which has been initiated by the Estate. 2. On October 20, 2004, Evelyn Mortortoffwas killed in a motor vehicle accident. At the time of her death she was widowed and with issue, as more fully setout herein. 3. Leonard G. Mortorffwas appointed the administrator of the estate of Evelyn Heller Mortorff on November 10, 2004, by Glenda Farner Strasbaugh, the Register of Wills of Cumberland County. Exhibit "A". 4. The respondent Ethel Weaver is covered by a policy of automobile liability insurance in the amount of $1 00,000.00. Said policy was issued by the Liberty Mutual Insurance Company. 5. Liberty Mutual Insurance Company has agreed to pay ninety fiver percent (95%) policy amount of $95,000.00, as the result of the death of Evelyn Heller Mortorff. 6. At the time of the death, UIM/UI coverage in the amount of $25,000.00 was available through the Liberty Mutual Insurance Companies and Liberty Mutual Insurance Company has agreed to pay the full $25,000.00 for the wrongful death action of Evelyn Heller Mortorff. 7. At the time of the death, UIM/UI coverage in the amount of $25,000.00 was available ~ through the Liberty Mutual Insurance Companies and Liberty Mutual Insurance Company has agreed to pay $75,000.00 for the wrongful death action of Evelyn Heller Mortorff. 8. All sums set forth above constitute damages on account of personal injury/wrongful death, arising from the occurrence, within the meaning of S 104 (a) (2) of the Internal Revenue Code of 1986, as amended. 9. Counsel requests counsel fees in the amount of $64,350.00 dollars which represents full and fair compensation. for his representation of Petitioner and the Estate, and which is the amount prescribed by the fee agreement, being 33% of the Gross Recovery (see Exhibit B). 10. Petitioner requested from the Department of Revenue allocation approval of the gross proceeds of the settlement including the costs and attorney's fees as follows: (a) Wrongful death claim $97.500.00. (b) Survival claim $97.500.00 11. The requested allocation has been approved with amendments by the Department of Revenue, as evidenced by the hereto attached letter. (Exhibit C) 12. Pursuant to the wrongful death statute (42 Pa. Cons. Stat. Ann. Section 8301), the beneficiaries of the wrongful death action, and the portion of their interest are as follows, before attorney fees and costs: Leonard G. Mortoff - $19,500.00 Loren Mortorff - $19,500.00 Eugene Mortorff - $19,500.00 Joyce Sheaffer - $19,500.00 13. The heirs which are grandchildren are taking an equal allocation, per stirpes under the S urvi vor Action. 14. All of the heirs have been apprised of the settlement and concur in the same. Exhibits "D-I" 15. The purpose of the aforementioned allocation has been designed to treat all the heirs equally while minimizing the tax liability of the estate. WHEREFORE, Petitioner respectfully requests that she be permitted to enter into the settlement recited above and that the Court enter an Order of Distribution as follows: (a) To: Rominger & Whare $64,350.00 for counsel fees, to be subtracted equally from the wrongful death action and survivor claim. (b) Wrongful death claim: The remaining balance of $52, 260.00 shall be paid as follows: Leonard Mortorff: $13,065.00 Loren Mortorff: $13,065.00 Eugene Mortorff: $13,065.00 Joyce Sheaffer: $13,065.00 (c) Survival claim $78,390.00 to the estate with direct payments subtracted out as follows: Kenneth Treaster: $6,532.50 Carol Morrow: $6,532.50 Datej{/1 -<- (9- L (j (} , . Respectfully submitted, ROMINGER & WHARE .........,o'Jt) /- Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, P A 17013 (71 7) 241-6070 Supreme Court ID # 81924 Attorney for Petitioners IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: Estate of Evelyn Mortorff, : No. 21-04-1024 VERIFICATION I hereby swear or affirm that the Foregoing is true and correct to the best of my knowledge and/or information and belief. This is made subject to the penalties of 18 Pa.C.S S4904 relating to unsworn falsification to authorities. Date: ~7 <. Iy LCt7(/" ~ Respectfully submitted, ROMINGER & WHARE Kar::? &;"minge-;:ESq~ire 155 South Hanover Street Carlisle, P A 17013 (717) 241-6070 Supreme Court ID # 81924 Attorney for Petitioners REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2004-01024 PA No. 21-04- 1024 Es ta te Of: MORTORFF EVEL YN HELLER (Last, First, Middle) Late Of: SOUTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 184-05-0369 WHEREAS, on the 10th day of November 2004 an instrument dated. October 27th 1975 was admitted to probate as the last will of MORTORFF EVEL YN HELLER (Last, First, Middle) la te of SOUTH MIDDLETON TOWNSHIP, CUMBERLAND County, who died on the 20th day of October 2004 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: MORTORFF LEONARD G who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 10th day of November 2004. i~U,tCULFeLV thCllht cultw rA j j Register of Wills U peA if/If/ 1rL4W) ~ J]0~ ;r h~lu~ ~ 1 * *NOTE* * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) POWER OF ATTORNEY AND CONTINGENCY FEE AGREEMENT I, Leonard Mortorff, Executor of the Estate of Evelyn H. Mortorff, the undersigned, hereinafter called "Client" hereby retains, appoints, and nominates ROMINGER, BAYLEY & WHARE LAW 0 FFICES, its mem bers and associates, hereinafter called "attorney" to represent Client as legal counsel for all purposes in connection with the death of Evelyn H. Mortorff after an automobile accident that occurred around or about October 20,2004. Client and attorney hereby agree as follows: 1. Initial Evaluation - Attorney will undertake an initial investigation and evaluate the merits of this case. No attorney fee will be charged for attorney work in connection with the evaluation. Client shall provide in advance a retainer of 0 to be used for the purposes of paying the costs associated \vith the initial investigation. Attorney will review the pertinent records and will advise the Client concerning the probable merits of the case. If the initial evaluation of the merits of the claim is favorable, attorney will advance the costs of prosecuting the case. These costs shall be repaid by Client as specified in paragraph 5 below. Attorney reserves the right to terminate the Agreement after the initial evaluation if the case is determined not to have merit, at which time any balance remaining in the trust account after payment of expenses shall be returned to Client. 2. Attorney Fees - In payment for the services performed by the attorney, Client hereby agrees that attorneys' fees shall be paid as follows: (a) Prior to the filing of a Complaint or a request for arbitration, payment for services shall be thirty-three (33%) percent contingency fee on the total amount paid in settlement of the claim; and (b) If a Complaint is filed or arbitration is requested, payment for services shall be thirty-three (33%) percent contingency fee on the total amount paid by either settlement or verdict. In the event of a settlement in the form of a structured settlement, it is agreed that attorney fees shall be paid according to the above terms based on the cost of the structured settlement to the settling party(s). It is further understood and agreed that the amount to be paid as the attorney fees on the structured settlement shall be paid on a lump sum basis at the time the structured settlement is entered into by the Client. Lx~:6ll ~? 3. Settlement - No settlement of this case may be made without the Client's prior approval. 4. Distribution of Proceeds - Client further agrees that from the proceeds of any recovery, whether by settlement, judgment or otherwise, the attorney may deduct the attorneys fees to which it is entitled, together with all costs and expenses which have been advanced or remain unpaid; and Client further agrees that the attorney may deduct the amount of all unpaid bills for professional services and make disbursements of such funds directly to the creditors involved. 5. Cost Advance - Attorney shall have the authority to make advances and to incur such costs as the attorney determines necessary in the processing of the Client's case. Such advances and costs include but are not limited to: (a) Fees for physicians, psychologists, accountants and other experts which attorney deems necessary to assist in handling of Client's case; (b) Copying charges, travel expenses, court costs, deposition expenses, long distance telephone calls, postage. In the event of a monetary recovery, Client agrees to reimburse attorney for the above- referenced expenses incurred. After the attorneys fees are deducted from the settlement and/or verdict, the expenses shall be repaid to attorney out of the remaining balance of the settlement and/or verdict. If Client rejects a settlement offer that attorney believes is reasonable and equitable under the circumstances, Client agree to be responsible for any and all out-of-pocket expenses incurred during the pursuit of their claim, irrespective of a monetary recovery. 6. Withdrawal - If, during the pursuit of this case, the attorney determines that, under the existing circumstances, it is not feasible or practicable to prosecute this case, upon notification to the Client of such facts, the attorney may withdraw from representation under this agreement. Client agrees to execute all documents and take all steps requested by attorney that are necessary to facilitate the \vithdraw of representation. 7. Appeal - If the Client authorizes an appeal of this case, the attorneys' fees shall be increased by 10% more than the fee set forth above to cover the additional work involved in handling of the appeal. 8. Fee Division - In the event that Client was referred to Rominger, Bayley & Whare Law Offices by a referring attorney, Client does not object to the division of the attorneys fees being charged to the Client between the attorney and the referring attorney. Client understands that she will not pay any additional fee as a result of the division of the fee between attorney and referring attorney. 9. Termination of Agreement by Client - In the event that the Client seeks legal representation elsewhere regarding the incident described herein and after the instant fee agreement is executed, Client agrees to immediately reimburse attorney for all expenses incurred to date. Moreover, for the work performed by the attorney up to the date of separation of attorney and Client, Client agrees that, in the event of an ultimate monetary recovery, attorney is entitled to reasonable compensation (quantum merit) from any verdict or settlement. 10. Arbitration - Any dispute between the attorney and the Client shall be resolved by arbitration. The arbitrators shall be members of the Pennsylvania Bar Association. The attorney shall select one arbitrator. The Client shall select one arbitrator. The two arbitrators shall select a third arbitrator. The arbitrators shall, by majority vote, establish all rules pertaining to the arbitration, including determining how the cost of arbitration shall be paid. If the dispute is not resolved, the rules of the American Arbitration Association in effect at the time shall apply and control. 11. Termination - This agreement applies only to the attorney's pursuit of the claim sped fied above. This agreement terminates upon the final distri buti on of proceeds recovered on behalf of the Client through verdict, settlement or otherwise, if not terminated before such time. In the event Client desires additional services performed by attorney, whether related to the above-described incident or not, the fees and costs to be charged by the attorney in the event representation is undertaken, is subject to other agreement. I have read the above agreement and understand and agree to its terms. T~e~ are no . /. ,votlher ..a greements between the parties hereto. This agreement is entered into this,_ -~ .LAay of VLb0. , 2004. ~~ht/ L , ?lk:A ~/1!'{ Leonard Mortorff, Executor of the Estate of Evelyn H. Mortorff APPROVED AND ACCEPTED BY: uuf5 );/1/0'1 Date . _ _~?/16/200~.~4~ 717-783-3467 INHERITANCE TAX PAGE 01/01 WEB AOOkESS WWW.state.Da.US 8lmEAu OF lNOtVlDUAL TAXES INHERITANCE TAX DMSION Po 50)( 280601 HARR.ISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE June 16, 2006 . Karl E. Rominger, Esq. Rominger & Whare 155 S. Hanover St. Carlisle, PA 17013 Re: Estate of Evelyn Mortorff File Number: 2104-1024 Court Number: CCP Cumberland Co. No, 21-04..1024 Dear Mr. Rominger: The Department of Revenue has received the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the Petition, the decedent died as a result of a motor vehicle accident. Decedent's wrongful death beneficiaries are her four adult issue. Please be advised that, based upon these facts, our additional correspondence concerning the grandchildren of the decedent, the settlement and for inheritance tax purposes only, this Department has no objedion to the allocation of the proceeds based on our correspondence. The estate has agreed to revise the petition and supply the court with the revised petition allocating the net proceeds of this action, $52,260 to the wrongful death claim and $78.390 to the survival claim. Proceeds of a survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa. C.S.A. ~8302~ 72 P.S. ~~9106, 9107. Costs and fees must be deduded in the same percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Departmenfs position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or requires anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the Department may take in any other proposed distribution of proceeds of a wrongful death/survival action. Sincerely, ~.lU~ Holly A. McClintock Trust Valuation Specialist // L!... /j ~~'.6/C PHONE: 717-787-'794 · FAX: 717-783-3%7 · EMAll: hmccLintoc@state.oa.us MEMORANDUM OF UNDERSTANDING AND WAIVER QF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to determine what percentage of the award is to be allocated to a Wrongful Death Action and what percentage of the award is to be allocated to the Survivors' Action. The purpose of this allocation is to prevent some or all of the monies from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would occur before settlement of the Estate and result in direct payments to the heirs in the forms of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlement, T am releasing the Executor of the Estate from any claim I, or the Estate, may have against him for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. '-", , Date:---5-\ \ ~ \a~ \ -~dd)~i2 9(l1 Kenneth Treaster, Jr. L / t If})' /1 LX fCz 'b I MEMORANDUM OF UNDERSTANDING AND WAIVER OF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to determine what percentage of the award is to be allocated to a Wrongful Death Action and what percentage of the award is to be allocated to the Survivors' Action. The purpose of this allocatiotl is to prevent some or all of the monies from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would occur before settlement of the Estate and result in direct payments to the heirs in the form of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlement, I am releasing the Executor of the Estate from fu'y claim I, or the Estate, may have against him for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. Date: 5 -lu, Ol.n ~~rJL-A- ~wn..0 Carol Morrow Zx)vhi( II c j) C MEMORANDUM OF UNDERSTANDING AND WAIVER OF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to determine what percentage of the award is to be allocated to a Wrongful Death Action and what percentage of the award is to be allocated to the Survivors' Action. The purpose of this allocation is to prevent some or all of the monies from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would Occur before settlement of the Estate and result in direct payments to the heirs in the forms of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlement, I am releasing the Executor of the Estate from any claim I, or the Estate, may have against him for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. Date: i) 7 t:/.,U {/' j'- ...:.> ~ ~()O(~ n ;U \ I . './ I JOY~f:;'. c l.h1!P'/?_, V f ><' JL{h) ( I IF fi MEMORANDUM OF UNDERSTANDING AND WAIVER OF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to detern1ine what percentage of the award is to be allocated to a Wrongful Death Action and 'Hhat percentage c.fthe ;~~v/a~d is to be al1ccated to the SUL,,'ivOfS' A..ction. The purpose of this allocation is to prevent some or all of the monies from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would occur before settlement of the Estate and result in direct payments to the heirs in the forms of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlement, I arn releasing the Executor of the Estate from any claim I, or the Estate, may have against him for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. Date: ~ 7 8' CJ (;;. ~A- ,//~ Loren Mortorff "." - . ( -( I' /" fi j- 'X Jei )Q i b MEMORANDUM OF UNDERSTANDING AND WAIVER OF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to determine what percentage of the award is to be allocated to a Wrongful Death Action and what percentage of the award is to be allocated to the Survivors' Action. The purpose of this al1ocatioi1 is to prcverit some or all of the m.Qni~s from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would occur before settlement of the Estate and result in direct payments to the heirs in the form of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlement, I am reieasing ihe Executor of the Estate from any ~laim I, or the Estate, lllay hav~ against hilil for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. Date: S--/'9 /ZC<b I t ~~ ugene Mortorff ?)( fL,b(t )/ JI /1 MEMORANDUM OF UNDERSTANDING AND WAIVER OF PRESENCE AT CONFIRMATION HEARING The Executor for the Estate of Evelyn Mortorff has pursued litigation as a result of the auto accident which occurred in this case. The Executor has been successful in negotiating settlements which total One Hundred Ninety-Five Thousand ($195,000.00) Dollars which are payable to the Estate. It is the Executor's opinion and the opinion of the litigator's counsel that this settlement is appropriate and proper under the circumstance. Further, the Executor will be contacting the Pennsylvania Department of Revenue to determine what percentage of the award is to be allocated to a Wrongful Death Action and what percentage of the award is to be allocated to the Survivors' Action. The purpose of this allocation is to prevent some or all of the monies from being taxed as a part of the Estate. Therefore, the Executor will attempt to remove the maximum percentage from Estate taxation for the benefit of all of the heirs. The percentage attributable to a Survival Action would be placed with the remainder of the monies in the Estate and distributed at the time that the Estate is finalized. The percentage attributable to the Wrongful Death Action will be distributed to the heirs in the same percentages and allocations as they would receive under the Estate, but said distribution would occur before settlement of the Estate and result in direct payments to the heirs in the forms of advances. The proceeds would be divided equally one-fifth to each of the four (4) surviving children, and one-tenth each to the two (2) grandchildren whose mother predeceased their grandmother. WAIVER OF PRESENCE AT CONFIRMATION HEARING I agree that I have read and understand the Memorandum of Understanding and that I consent to the above settlement and waive my presence at any Court Hearing on the confirmation of this matter. Further, I realize that by ratifying this settlenlent, I am releasing the Executor of the Estate from any claim I, or the Estate, may have against him for purposes of the settlement to be confirmed. I also understand and agree that further estate administration must occur and a final accounting or family agreement will still need to be executed and approved at a later date. Date: s- / eLD~ I f ~#4/- Leon rd Mortorff 2i~k'bl[ /f Z /1 ~ v IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA 1 IN RE: Estate of Evelyn Mortorff, : No. 21-04-1024 FINAL ORDER AND NOW, to wit this the ~ day :r lLJ)~ , 2006, it is hereby ordered that the settlement in the amount of One Hundred Ninety Five Thousand ($195,000.00) Dollars is granted. The proceeds are to be distributed as follows: (a) Half of the $195,000.00 of the settlement, less one half of the attorneys fees and expenses shall be distributed to the estate. The remaining half of $195,000.00 shall be split per stirpes between the heirs; four heirs being children to Evelyn Mortorff get one fifth (1/5) and two heirs being grandchildren to Evelyn Mortorff get one tenth (1/10), in amounts as more fully set out in the Petition filed in this matter. (b) An amount of$64,350.00 will be paid to Rominger & Whare for their hours of work involved in the case, and as agreed to by the parties. Said fee to be allocated appropriately between the survivor action and the wrongful death action. (c) All sums set forth above constitute damages on account of personal injury/wrongful death, arising from the occurrence, within the meaning of ~ 104 (a) (2) of the Internal Revenue Code of 1986, as amended. It is further recognized that the allocation of the award of $52,260.00 for Wrongful Death and $78,390.00 for a Survival Action has been approved by the Pennsylvania Department of Revenue and entered as an exhibit to the petition. (d) Further, nothing in this approval is meant to be construed as a limitation on any other cause of action available, and/or as to any party, except as to those actions and parties released by the agreements attached to the petition. (e) Further, the Court authorizes the administrator and administratrix of the estate to bind the estate by signing the releases attached to the petition, and to extinguish any and all survival claims and wrongful death claims as appropriate. ,...., " \'"J By the Court, I'F'\'\.~ 0i;flL Z ""'! I! \ q? \;,~ JvJ ., . , '~., a ..i ",1 . V 'V ..-" J. \. ' .'-\ I '1- ""i~'\\ \' \~1':~.}1 ,"\ ~\' V\.......i-J \-...'j\.,JU'J,-,-'-J ...) .Jv.... (:/' L:umoer.Lana county - RegIErErur VVlLU:i One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-634~ Date: 9/14/2006 BAYLEY MARK F 64 SOUTH PITT STREET CARLISLE, PA 17013 RE: Estate of MORTORFF EVELYN HELLER File Number: 2004-01024 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: 10/20/2006 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, ~a=~ Clerk of the Orphans' Court cc: File Personal Representative(s) ~ cumberland. County ~-- Register or WlLLS One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 MORTORFF LEONARD G PO BOX 286 YORK SPRINGS, PA 17372 RE: Estate of MORTORFF EVELYN HELLER File Number: 2004-01024 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: 10/20/2006 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, G~~~ Clerk of the Orphans' Court cc: File Counsel ~ U_i c:) - L_;_ - LL_ (.--) C) Lc~j c.:} [J._'-: C) c) I L' L::": u - Register of Wills of Cumberland CoWlty STATUS REPORT UNDER RULE 6.12 Name of Decedent: b.f2-1 LI t/J flel/.e-r Mot+lJr.-/!- I Date of Death: Or:f{) b er d0 ::J.oo'-f Estate No.: daJL/- O/odLj. 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: CJ M c.E f-- g::: ,r.: _),-_J L-h--OC- o C) C:J ~~~~ (.):c t-: O-cc 0:-" o"""-~ :J (.) c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and nmy be attached to this report Date: 9j;n /0& :c a... co N 0- I..LJ (/) ...0 = = "" 1. State whether administration of the estate is complete: Yes 0 No % 2. If the answer is No, state when the p~ representative reasonably believes that the administration will be complete: '-LI:fl.r p nA....h.I r I ~ . I J. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 0 No 0 :; Signature ... Kt:lfj ~ ROMi I/1qtr, ~,Jir-L Name ld1Zs ~fl7!:r/I7~' (-;/7) dLll- (/07{) Telephone No. Capacity: 0 Personal Representative ~ounsel for personal representative ~ ROMINGER & WHARE Attorneys at Law Karl E. Rominger Michael J. Whare Michael O. Palermo, Jr Leslie A. T Qmeo* * Also admitted ii New Jersey September 27,2006 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013 RE: Estate of Evelyn Heller Mortorff 2004-01024 Dear Register: Enclosed please find the completed Status Report that we received f<t the above referenced matter. Should you have any questions, please do not hesitate to contact the office. Sincerely, Karl E. Rominger, Esquirtl KERltlp Enclosure fi9 .~.:5 ;g ClIO . :) 3".:. ;- ,--. "",.. m -rc' -",,:; ;g "'~ UJ /'.. C.::) 0 c)o~ r-.:J c- ~~ .::5 --j :g 155 South Hanover Street, Carlisle, PelUlSylvania 17013 · Tel: (717) 241-6070 · Fax: (717) 241-6878 www.ron:tingerlaw.com ADVOCACY · ADVICE · ANSWERS ~ c:..> ~ en (.I') rTJ -0 N co ::2 --Ii.. --'j I'i ~1 E; i~.:~c~; n'i C') C) c-) -1 2-~ ( ) f'r"J N ~ ... #' .) - ---I 15056041125 REV-1500 EX (06-05) PA Department of Revenue*, Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisbu PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number Date of Birth 184050369 10202 004 07031916 MORTORFF EVELYN MI H Decedent's Last Name Suffix Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW !XI 1. Original Return o 4. Limited Estate !XI o 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes K A R L E . ROM I N G E R , E S QUI R E 717 241 607 0 Firm Name (If Applicable) REGIST~~ OF WILLS USi: ONLY ROMINGER & WHARE ~() ."... First line of address 1 5 5 SOUTH HANOVER S T R E E T ! r.....:; Second line of address -0 City or Post Office State ZIP Code --'.-: ;'"0 -j)Al'E FILED .. CARLISLE PA 17013 - ill Correspondent's e-mail address:karl@rOminQer.com Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. D ration of pre rer other than the personal presentative is based on all information of which preparer has any knowledge. SIGNATURE OF PER ON L 0 F ADDRESS /DO 7'J V ~ ({J_ . P.:>>( 23&, }cw..k 5J{lV"'~s SIGN OF PREPARER OTHER THAN 'REPRESENTATIVE' , ---...... A J73"7'2. DATE ;2 u/2-f/40-e-", ~ JS~;;- /ICr/7~V(V ),)) C4l--J/St Pd /7t1/~ ;' , PL SE uSE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 --' ~ IJIJ. 1 ......~Il.~.".j""'i!m!"~..~lk.;fI",J;I"..."'~""""~"'.~I!I._..l\'\'~~'~tlIfj~!I/1I11~~~~ -..J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name EVELYN H. MORTORFF RECAPITULATION 184050369 1. Real estate (Schedule A) 1. 2. Stocks and Bonds (Schedule B) 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous N,Q!1;Probate Property (Schedule G) U Separate Billing Requested. . . . . .. 7. 164210.36 8. Total Gross Assets (total Lines 1-7) 8. 1 6 4 2 1 O. 3 6 .......................... . .1 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 6 0 6 2 O. 0 6 ............... . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 3 5 6. 6 0 $V 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 6 0 9 7 6. 6 6 12. Net Value of Estate (Line 8 minus Line 11) .........................12. 1 0 3 2 3 3. 7 0 Iv 13. Charitable and Govemmental Bequests/See 9113 Trus~s for which an election to tax has not been made (Schedule::!) ................. . 13. .- 1 0 3 2 3 3. 7 0 14. Net Vallie Subject to Tax (Line 12 minus Line 13) .................. 1~ TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ... transfers under Sec. 9116 o . 0 0 o . 0 0 (a)(1.2) X.O _ 15. 16. Amount of Line 14 taxable 1 0 3 2 3 3 . 7 0 4 6 4 5 . 5 2 at lineal rate X .04L 16. 17. Amount of Line 14 taxable o . 0 0 o. 0 0 at sibling rate X. 12 17. 18. Amount of Line 14 taxable o . 0 0 o. 0 0 at collateral rate X .15 18. 19. Tax Due . . . . . . . . . . . . . . . . . 19. 4 6 4 5 . 5 2 ............ . ................. . 20. FILL IN THE OVAL IF YOttARE REQUESTING A REFUND OF AN OVERPAYMENT o :.: . '. Side2 L 15056042126 15056042126 -..J ~ REV-1500 EX Page 3 OQcedent~s Complete Address: File Number o 0 DEGEDENT'S"NAME EVELYN H. MORTORFF STREET ADDRESS 301 Oxford Road CITY I STATE I ZIP Gardners PA 17324 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 4,645.52 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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) 0.00 0.00 4,645.52 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. 4,645.52 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...................................................................... D D b. retain the right to designate who shall use the property transferred or its income; ............................... D D c. retain a reversionary interest; or ................................................................................................ D D d. receive the promise for life of either payments, benefits or care? ....................................................... D D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... D D 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... D D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. D D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a)(1.1) (i)]. 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 zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-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 zero (0) percent [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~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. REV-1502 EX + (6-98) .'W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER EVELYN H. MORTORFF 0 0 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 orooertv which is iointlY-owned with riaht of survivorshio must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (6-98) '.. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1504 EX + (6-98) ',. SCHEDULE C CLOSEL Y.HELD CORPORATION, PARTNERSHIP OR SOLE.PROPRIETORSHIP COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER o 0 ESTATE OF EVELYN H. MORTORFF Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1505 EX + (6-98) '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 State Zip Code State of Incorporation Date of Incorporation Total Number of Shareholders Business Reporting Year 1. Name of Corporation Address City 2. Federal Employer I.D. Number 3. Type of Business ProducUService 4. I STOCK TYPE TOTAl NUMBER OF PAR VAlUE NUMBER OF SHARES VAlUE OF THE I 'IJ .Votina SHARES OUTSTANDING OWNED BY THE DECEDENT DECEDENT'S STOCK Common $ Preferred $ Provide all rights and restrictions pertaining to each class of stock, 5. Was the decedent employed by the Corporation?, , . , . , , , . . , , . , , , , , , . , . . . . . . , , , , , , , , , , , ,DYes 0 No If yes, Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? ,."""",....""",................. 0 Yes 0 No If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? ............... 0 Yes 0 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years if the date of death was prior to 12-31~2? DYes 0 No If yes, 0 Transfer 0 Sale Number of Shares Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder's agreement in effect atthe time of the decedent's death? . . . . . . . . . . . . 0 Yes 0 No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? ................................................. 0 Yes 0 No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? .....,.................. 0 Yes 0 No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . . . . . . . . . . . . .. 0 Yes 0 No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. (If more space is needed, insert additional sheets of the same size) REV-1506 EX'" (9-00) ,',. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT ESTATE OF EVELYN H, MORTORFF FILE NUMBER o 0 1 , Name of Partnership Address Date Business Commenced Business Reporting Year ~ ~ 2, Federal Employer 1.0, Number 3, Type of Business Product/Service 4, Decedent was a 0 General 0 Limited partner. If decedent was a limited partner, provide initial investment $ Zip Code 5, PERCENT PERCENT BALANCE OF PARTNER NAME OF INCOME OF OWNERSHIP CAPITAL ACCOUNT A. B. C, D. 6, Value of the decedent's interest $ 7, Was the Partnership indebted to the decedent? ......."""................... 0 Yes 0 No If yes, provide amount of indebtedness $ 8, Was there life insurance payable to the partnership upon the death of the decedent? ........ 0 Yes 0 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy g, Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12 -31-82? DYes 0 No If yes, 0 Transfer 0 Sale Percentage transferred/sold Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales, 10, Was there a written partnership agreement in effect atthe time of the decedent's death? . . . . . . . 0 Yes 0 No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? ...................,.............. 0 Yes 0 No If yes, provide a copy of the agreement of sale, etc, 12, Was the partnership dissolved or liquidated after the decedent's death? ..,.............. 0 Yes 0 No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received, 13, Was the decedent related to any of the partners? .............."................ 0 Yes 0 No If yes, explain 14, Did the partnership have an interest in other corporations or partnerships? . . . . . . . . . . . . . . . . 0 Yes 0 No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE A. Detailed calculations used in the valuation of the decedent's partnership interest. B, Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C, If the partnership owned real estate, submit a list showing the complete addressles and estimated fair market value/s. If real estate appraisals have been secured, attach copies, 0, Any other information relating to the valuation of the decedent's partnership interest. REV-1507 EX'+ (6-98) 'W CPMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) ...... COMMONWEALTH OF PENNSYLVANIA . INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 117,000.00 Survivor Action 2. Death Benefit from Nationwide 15,000.00 3. Funeral Benefit from Nationwide 2,500.00 4. Personal property-Furniture and household items 1,957.75 5. Initial Cash Deposit 132.90 6. Proceeds from sale of car 1,000.00 7. PNC Deposit 26,619.71 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 164210.36 REV-1509'EX + (6-98) . taLt. ..~ SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 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 JOINTL Y.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 V-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) . taLt. ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H. MORTORFF SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY FILE NUMBER o 0 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. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OFTRANSFER ATTACH A COP\' OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPUCABlE) VALUE 1. TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) .... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H. MORTORFF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER o 0 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Dugan Funeral Home 6,672.50 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Leonard Mortorff 8,318.28 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 301 Oxford Road City Gardners State P A Zip 17324 Year(s) Commission Paid: 1 2. Attorney Fees Administration/6863.28/Litigation/3861 0.00 45,473.28 3. Family Exemption: (If decedenfs address is not the same as claimanfs. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 156.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 60620.06 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) ... SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H. MORTORFF FILE NUMBER o 0 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Keystone Podiatric Medical VALUE AT DATE OF DEATH 4.12 2 Family Home Medical 8.19 3 Carl E. Ocker, Auctioneer 125.00 4 Sentinel and Cumberland Law Journal 219.29 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 356.60 REV-1513 EX +.(9~~_ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H MORTORFF SCHEDULE J BENEFICIARIES RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE L TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions, and transfers under Sec. 9116 (a) (12)] 1. Kenneth J. Treaster, Jr. Lineal 15,549.10 2. Carol Morrow Lineal 15,549.10 3. Leonard Mortorff Lineal 18,033.20 4. Loren Mortorff Lineal 18,033.20 5. Eugene Mortorff Lineal 18,033.20 6. Joyce Sheaffer Lineal 18,033.20 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ FILE NUMBER o 0 (If more space is needed, insert additional sheets of the same size) REV-1514 EX + (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EVELYN H. MORTORFF SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev.1500 Cover Sheet FILE NUMBER o 0 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. D Will D Intervivos Deed of Trust D Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH UFE ESTATE IS PAYABlE D Life or DTerm of Years D Life or D Term of Years D Life or DTerm of Years D Life or D Term of Years D Life or DTerm of Years 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Actuarial factor per appropriate table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest table rate - 031/2% 06% 010% OVariable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ANNUITY INTEREST CALCULATION NAME~)OFLFEANNUITANT~) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE D Life or D Term of Years D Life or D Term of Years D Life or D Term of Years D Life or D Term of Years 1. Value of fund from which annuity is payable .......................................... $ 2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . . . . . . . . . . Frequency of payout - D Weekly (52) D Bi-weekly (26) D Monthly (12) D Quarterly (4) D Semi-annually (2) D Annually (1) D Other ( ) 3. Amount of payout per period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor (see instructions) Interest table rate - D 31/2% D 6% 010% D Variable Rate % 6. Adjustment Factor (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity -If using 31/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ...........................$ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, insert additional sheets of the same size) REV-1644 EX + (3-04) *' INHERIT ANCE TAX SCHEDULE L COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT INHERITANCE TAX RETURN 0 0 RESIDENT DECEDENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER I. ESTATE OF MORTORFF, EVELYN H. (Last Name) (First Name) (Middle Initial) This schedule is appropriate only for estates of decedents dying on or before December 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal. II. REMAINDER PREPAYMENT: A. Election to prepay filed with the Register of Wills on (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income or Annuitant(s) of election or annuity is payable C. Assets: Complete Schedule L-1 1. Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . . . . . $ 3. Closely Held Stock/Partnership. . . . . . . . . . . . . . . $ 4. Mortgages and Notes. . . . . . . . . . . . . . . . . . . . . . . $ 5. Cash/Misc. Personal Property . . . . . . . . . . . . . . . . $ 6. Total from Schedule L-1 ....................................................$ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities. . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Unpaid Bequests. . . . . . . . . . . . . . . . . . . . . . . . . . $ 3. Value of Un includable Assets . . . . . . . . . . . . . . . . $ 4. Total from Schedule L-2 ....................................................$ E. Total Value of trust assets (Line C-6 minus Line 0-4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ F. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . G. Taxable Remainder value (Line E x Line F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ (Also enter on Line 7, Recapitulation) III. INVASION OF CORPUS: A. Invasion of corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income or Annuitant(s) corpus or annuity is payable consumed C. Corpus consumed ........................................................... $ D. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . E. Taxable value of corpus consumed (Line C x Line D) ................................$ (Also enter on Line 7, Recapitulation) REV-164!l EX + (3-84) INHERITANCE TAX SCHEDULE L-l COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT ELECTION INHERITANCE TAX RETURN -ASSETS- FilE NUMBER 0 0 RESIDENT DECEDENT I. Estate of MORTORFF EVELYN H. (Last Name) (First Name) (Middle Initial) II. Item No. Description Value A. Real Estate (please describe) Total value of real estate $ (include on Section II, line C- 1 on Schedule Ll B. Stocks and Bonds (please list) Total value of stocks and bonds $ (include on Section II, Line C-2 on Schedule Ll C. Closely Held Stock/Partnership (attach Schedule C-1 and/or C-2) (please list) Total value of Closely Held/Partnership $ (include on Section II, line C-3 on Schedule Ll D. Mortgages and Notes (please list) Total value of Mortgages and Notes $ (include on Section II, line C-4 on Schedule Ll E. Cash and Miscellaneous Personal Property (please list) Total value of Cash/Misc. Pers. Property $ (include on Section II line C-5 on Schedule l\ III. TOTAL (Also enter on Section II, line C-6 on Schedule L) $ (If more space is needed, attach additional 81/2 x 11 sheets.) REV-1646 EX + (3-84) INHERITANCE TAX '* SCHEDULE L-2 COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT ELECTION INHERITANCE TAX RETURN -CREDITS- FilE NUMBER 0 0 RESIDENT DECEDENT I. Estate of MORTORFF EVELYN H. (Last Name) (First Name) (Middle Initial) II. Item No. Description Amount A. Unpaid Liabilities Claimed against Original Estate, and payable from assets reported on Schedule L- 1 (please list) Total unpaid liabilities $ (include on Section II, Line 0-1 on Schedule L) B. Unpaid Bequests payable from assets reported on Schedule L- 1 (please list) Total unpaid bequests $ (include on Section II, Line 0-2 on Schedule Ll C. Value of assets reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are not included for tax purposes or that do not form a part of the trust. Computation as follows: Total unincludable assets $ (include on Section II, Line 0-3 on Schedule Ll III. TOTAL (Also enter on Section II, Line 0-4 on Schedule L) $ (If more space is needed, attach additional 8'/2 x 11 sheets.) ~,.''''.~'(* SCHEDULE M FUTURE INTEREST COMPROMISE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Check Box 4a on Rev-1500 Cover Sheet FILE NUMBER ESTATE OF EVELYN H. MORTORFF 0 0 This Schedule is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. o Will 0 Trust 0 Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY 1. 2. 3. 4. 5. II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. o Unlimited right of withdrawal o Limited right of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest ................................................. .$ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) ......$ 3. Value of Line 1 passing to spouse at appropriate tax rate Check One o 6%, o 3%, 00% ............... .$ (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check One o 6%, o 4.5% ..................... .$ (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) ......$ 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) ......$ 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) .................... .$ (If more space is needed, insert additional sheets of the same size) R~V-1648'EX (11-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION (AVAILAB..E FOR DATES OF DEATH 01/01/92 to 12/31/94) ESTATE OF FILE NUMBER EVELYN H. MORTORFF 0 0 This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet. SCHEDULE N SPOUSAL POVERTY CREDIT PART I - CALCULATION OF GROSS ESTATE 1. Taxable Assets total from line 8 (cover sheet) . . 1. 164210.36 2. Insurance Proceeds on Life of Decedent ..... 2. 3. Retirement Benefits ........ 3. 4. Joint Assets with Spouse 4. 5. PA Lottery Winnings ............ 5. 6a. Other Nontaxable Assets: List (Attach schedule if necessary) .. 6a. 6b. 6c. 6d. 6. SUBTOTAL (Lines 6a, b, c, d) .... 6. 7. Total Gross Assets (Add lines 1 thru 6) .......................................... 7. 164210.36 8. 9. Total Actual Liabilities. ............................... ........................ Net Value of Estate (Subtract line 8 from line 7) ............................... Iff 9' t th $200 000 STOP Th st te' t f 'bl t cla'm th 8. 9. 164,210.36 . . PARTII CALCULATION OF JOINT EXEMPTION INCOME (Attach caples of Federallndlvlduallncorne Tax Return for decedent and spouse) dt Ifn t ntn etop rtII a. Spouse 1a. 2. TAX YEAR: 19 3. TAX YEAR: 19 2a. 3a. 2b. 3b. 2c. 3c. 2d. 3d. 2e. 3e. 2f. 3f. Income: 1. TAX YEAR: 19 b. Decedent 1b. c. Joint.... 1c. d. Tax Exempt Income..... 1 d. e. Other Income not listed above ............ ........ 1e. f. Total................................. 1 f. 4. Average Joint Exemption Income Calculation 4a. Add Joint Exemption Income from above: (1f) + (2f) + (3f) (+3) 4b. Average Joint Exemption Income ...................................................................................................... If line 4(b) is greater then $40,000 - STOP. The estate is not eligible to claim the credit. If not, continue to Part III. PART III CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT ESTATES 1. Insert amount of taxable transfers to spouse or $100,000, whichever is less ....... 1. 2. Multiply by credit percentage (see instructions) . ................ ..................... .................... 3. This is the amount of the Resident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet. ................................................... 4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate. ...................... ........................................................ 5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Inctude this figure in the calculation of total credits on line 18 of the cover sheet 2. 3. 4. 5. REV-164g'EX + (6-98) '* SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER EVELYN H. MORTORFF 0 0 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or sim- ilar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivin souse under a Section 9113 A trust or similar arran ement. Description Value Part A Total $ Part B: Enter the descri tio" and value of all interests included in Part A for which the Section 9113 A election to tax is bein made. Description Value Part B Total (If more space is needed, insert additional sheets of the same size) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: Discount: 0.00 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 1988 throuah 1991 1992 1993 throuah 1994 1995 throuah 1998 1999 2000 2001 2002 2003 2004 2005 2006 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: 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 MORTORFF LEONARD G PO BOX 286 YORK SPRINGS, PA 17372 ____un fold ESTATE INFORMATION: SSN: 184-05-0369 FILE NUMBER: 2104-1024 DECEDENT NAME: MORTORFF EVELYN HELLER DATE OF PAYMENT: 05/02/2007 POSTMARK DATE: 05/02/2007 COUNTY: CUMBERLAND DA TE OF DEATH: 10/20/2004 NO. CD 008110 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,645.52 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECPT TO A TTY CHECK# 7 SEAL INITIALS: MW RECEIVED BY: REGISTER OF WILLS $4,645.52 GLENDA FARNER STRASBAUGH REGISTER OF WILLS .\ 1 V' '"', . , FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF EVELYN MORTORFF (File No. 21-04-1024) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Evelyn Mortorff, late of Gardners, Cumberland County, Pennsylvania, deceased, died testate on October 20,2004, having first made her Last will and Testament, which was duly executed on October 27, 1975, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania. WHEREAS, the said Evelyn MortortT, by the aforesaid Last Will and Testament, named Leonard Mortorff, as Executor of said Last Will and Testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of real and personal property; to a total value of$164,210.36 as set forth in the attached schedule and Inheritance Tax Return, which is attached hereto and made a part hereof, and marked Exhibits "A" and "B" respectively. WHEREAS, the debts and deductions, including the payment of inheritance tax in the said ~s.plte, amount to $67,756.16, leaving a balance for distribution of $9'8,454.20. Q C',~, --.... ~ ,- (-) -,' WHEREAS, the balance for distribution as shown in the said Inheritance Tax RetUt'rl-ilarkCf4;as -:' +" Exhibit "A" has been distributed as herein indicated in accordance with the terms oftheLas~sWill aa4 ~,_.J " _...... Testament of the said decedent; C,) NOW, THEREFORE, KNOW YE, that I, Joyce Sheaffer, the heir under the Last Will and 1..':) Testament of the said decedent, and being that person entitled to inherit under said Last Will and Testament, do hereby acknowledge that I have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and .\ 1 devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and' effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that I will contribute my share ofthe estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~~ Witness II daYOf~ Joycel'::t0 . Jt #~ l& "'U~~"'.l,\l!!l!\~..') ~-~:V'itM ~ ., Fi!hi.lI .f. Slnod.)Q ~ ~h~."l-:-..cI.~~4 ,"!b~ t_~.~ !~ ,:~~~..;.~ t~~;d~~!:~2!~ ~ :~~~~ -: :~~:~,_:,':~,~~,~~: :~~._ _~~-_ ~ ~ .' I devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense .and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing ofthis agreement, I do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this I 7 day of ~ 2~lt)~ ~ A- mtJU.~LJ Wltnes Carol Morrow NcJIIIIaI- tQlnw....~=~ r~.~~J8n.1t,2OOi ~ 1 . I COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND On this, the / Z day of ~ ' 2007, before me, a notary public, the undersigned officer, personally appeared C Morrow (known to me or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WIlNESS WHEREOF, I hereunto set my hand and official seal. ~0.~ N tary Public NoIInIISeII I<Irh W. s..nn.m.n. NcUry Public NcwIh MIddIMlln ~~ County MrCommllaIon Jan. 19.2008 FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF EVELYN MORTORFF (File No. 21-04-1024) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Evelyn Mortorff, late of Gardners, Cumberland County, Pennsylvania, deceased, died testate on October 20,2004, having first made her Last will and Testament, which was duly executed on October 27, 1975, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania WHEREAS, the said Evelyn Mortorff, by the aforesaid Last Will and Testament, named Leonard Mortorff, as Executor of said Last Will and Testament; WHEREAS, letters testamentaIy on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor hereinafter called personal representative~ WHEREAS, the said personal repr~sentative has gathered the assets of the estate of the said decedent and the assets consist of real and personal property~ to a total value of$164,210.36 as set forth in the attached schedule and Inheritance Tax Return, which is attached hereto and made a part hereof, and marked Exhibits "A" and "B" respectively. WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $65,756.16, leaving a balance for distribution of $98,454.20 WHEREAS, the balance for distribution as shown in the said Inheritance Tax Return marked as Exhibit" A" has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said decedent~ NOW, THEREFORE, KNOW YE, that I, Loren I. Mortorff, the heir under the Last Will and Testament of the said decedent, and being that person entitled to inherit under said Last Will and Testament, do hereby acknowledge that I have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and .' devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day~ AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this I 7 day of -4 2007. *1# ~ ~~ 1 ess , ~ '. COMMONWEAL TH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND On this, the J7 day of fV7IUA.- ,2007, before me, a notary public, the undersigned officer, personally ap~rtorff (known to me or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. &~,;; t? g~ Notary Public . " F AMIL Y SETTLEMENT AND FINAL RELEASE IN ESTATE OF EVELYN MORTORFF (File No. 21-04-1024) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Evelyn Mortorff, late of Gardners, Cumberland County, Pennsylvania, deceased, died testate on October 20, 2004, having first made her Last will and Testament, which was duly executed on October 27, 1975, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania WHEREAS, the said Evelyn Mortorff, by the aforesaid Last Will and Testament, named Leonard Mortorff, as Executor of said Last Will and Testament; WHEREAS, letters testament8l)' on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of real and personal property; to a total value of $164,21 0.36 as set forth in the attached schedule and Inheritance Tax Return, which is attached hereto and made a part hereof, and marked Exhibits "A" and "B" respectively. WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $67,756.16, leaving a balance for distribution of $98,454.20. WHEREAS, the balance for distribution as shown in the said Inheritance Tax Return marked as Exhibit "A" has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said decedent; NOW, THEREFORE, KNOW YE, that I, Eugene Mortorff, the heir under the Last Will and Testament of the said decedent, and being that person entitled to inherit under said Last Will and Testament, do hereby acknowledge that I have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate ofthe said decedent after the signing ofthis agreement, I do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day Of~ ~~ ~rt~riI~ .' . . COMMONWEAL TH OF PENNSYL VANIA COUNTY OF -CUMBERLAND . M-a..~~ On this, the [o? day nf V"Aa..~ ,2007, before me, a notary public, the undersigned officer, personally appeared Eu ene Mortorff(known to me or satisfactorily proven) to be the person whose name is. subscribed to the within instrument,. and acknowledged that she executed the same for the purposes therein contained. : SS. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~ NOTARIAL SEAl VICKY L KNOTT, ~~ Public Berwick Twp., Al'ams County ExpIres March 13, 3J08 FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF EVELYN MORTORFF (File No. 21-04-1024) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Evelyn Mortorff, late of Gardners, Cumberland County, Pennsylvania, deceased, died testate on October 20,2004, having first made her Last will and Testament, which was duly executed on October 27, 1975, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania WHEREAS, the said Evelyn Mortorff, by the aforesaid Last Will and Testament, named Leonard Mortorff, as Executor of said Last Will and Testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of real and personal property; to a total value of $164,21 0.36 as set forth in the attached schedule and Inheritance Tax Return, which is attached hereto and made a part hereof, and marked Exhibits "A" and "B" respectively. WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $67,756.16, leaving a balance for distribution of $98,454.20. WHEREAS, the balance for distribution as shown in the said Inheritance Tax Return marked as Exhibit "A" has been distributed as herein indicated in accordance with the terms ofthe Last Will and Testament of the said decedent; NOW, THEREFORE, KNOW YE, that I, Kenneth Treaster, the heir under the Last Will and Testament of the said decedent, and being that person entitled to inherit under said Last Will and Testament, do hereby acknowledge that I have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and ." . devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. 2007~~~ Witnes ' IN WITNESS WHEREOF, I have hereunto set my hand and seal this Ist'day of $Jf- ~(lm M-~-J:; Kenneth Treaster '. . . ' COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND On this, the } sty of JY)a~ ,2007, before me, a notary public, the undersigned officer, personally appeared K eth Treaster (known to me or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. IOIJBP tl. ~~ Notary Public COMMONWEALTH OF P NoIariaI Seal Brooke A. BInger, Notary Public Carlisle Soro, Cumberland County My Commission Expires Aug. 11, 2010 Member Pennsylvania AsSociation of Notaries .. FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF EVELYN MORTORFF (File No. 21-04-1024) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Evelyn Mortorff, late of Gardners, Cumberland County, Pennsylvania, deceased, died testate on October 20, 2004, having first made her Last will and Testament, which was duly executed on October 27, 1975, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania WHEREAS, the said Evelyn Mortorff, by the aforesaid Last Will and Testament, named Leonard Mortorff, as Executor of said Last Will and Testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania,. to the said Executor hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist ofreal and personal property; to a total value of$164,210.36 as set forth in the attached schedule and Inheritance Tax Return, which is attached hereto and made a part hereof, and marked Exhibits "A" and "B" respectively. WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $65,756.16, leaving a balance for distribution of $98,454.20 WHEREAS, the balance for distribution as shown in the said Inheritance Tax Return marked as Exhibit "A" has been distributed as herein indicated in accordance with the terms ofthe Last Will and Testament of the said decedent; NOW, THEREFORE, KNOW YE, that I, Leonard Mortorff, the heir under the Last Will and Testament of the said decedent, and being that person entitled to inherit under said Last Will and Testament, do hereby acknowledge that I have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to me by the said Last Will and Testament, the amount due me under said Last Will and Testament, which amount I have received this day; AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as ifthey had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal representative, Leonard Mortorff, his heirs, executors, and administrators and assigns, or and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the state of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement and final release. ~,t. tf IN WITNESS WHEREOF, I have hereunto set my hand and seal this ( - day of ~ 2007. ~p~A- tness . ~JJM!r~/ Leonard Mortorff . ~- . , . COMMONWEAL TH OF PENNSYL VANIA : SS. COUNTY OF CUMBERLAND : On this, the ~ day of m.~ ' 2007, before me, a notary public, the undersigned officer, personally appeared Leo d Mortorff (known to me or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. blldJlJ tl. ~ Notary Public . COMMONWEAlTH OF PENNSYLVANIA NotaiaI Seal Brooke A BInger, Notary Public Cac1lsle BolO, CumbeI1ancI County My CommIssion Expkes Aug. 11,2010 Member. Pennsylvania Association of Notaries .::- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE , " :-N1;l1,I,CEOF INHERITANCE TAX APPRAISEME~T, ALLOWANCE OR DISALLOWANCE OF DEDuctIONS AND ASSESSMENT OF TAX DATE 07-09-2007 ESTATE OF MORTORFF EVEL YN H DATE OF DEATH 10-20-2004 FILE NUMBER 21 04-1024 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 09-07-2007 ( See reverse side under Objections) Amount Remittedl 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-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MORTORFF EVELYN H FILE NO. 21 04-1024 ACN 101 DATE 07-09-2007 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 7nnl I ill' 13 -........ \.,o',_r_ f::lL"? 36 n /":, OF;:~'I-'i CI" KARL E ROMINGER ESQ ROMINGER & WHARE 155 S HANOVER ST CARLISLE PA 17013 REV-1547 EX AFP (06-05) TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 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) S. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: .00 .00 .00 .00 164,210.36 .00 .00 (S) (l) (Z) (3) (4) (S) (6) (7) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 164,210.36 60,620.06 9. 10. 11- 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) Debts/Mortgage Liabilities/Liens (Schedule I) (10) Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax 60.976.66 103,233.70 .00 103,233.70 If an assessment was issued previoUSlY, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of Ahh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate lS. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: NOTE: 356.60 (11 ) OZ} Cl3} 04} OS} Cl6} 07} ClS} .00 X 00 .00 103,233.70 X 045 = 4,645.52 .00 X 12 .00 .00 X 15 .00 Cl9}= 4,645.52 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-02-2007 CD008ll0 .00 4,645.52 BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-03-2007 TOTAL TAX CREDIT 4,645.52 BALANCE OF TAX DUE .00 INTEREST AND PEN. 554.05 TOTAL DUE 554.05 * 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 DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT,2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX! 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BA YLEY MARK F 17 WEST SOUTH STREET CARLISLE, PA 17013 ____uu fold ~. ESTATE INFORMATION: SSN: 184-05-0369 FilE NUMBER: 2104-1024 DECEDENT NAME: MORTORFF EVELYN HELLER . DATE OF PAYMENT: 10/24/2007 POSTMARK DATE: 10/22/2007 I COUNTY: CUMBERLAND DATE OF DEATH: 10/20/2004 NO. CD 008848 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $554.05 1 I I I I I I I . TOTAL AMOUNT PAID: $5'54.05 REMARKS: RECEIPT TO ATTORNEY CHECK# 4668' 'SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS BUREA~01' 'LECTIONS & TAXPA ERVlCES PO B 281041 HARRISBURG PA 17128-1041 COMMONWEAL TH OF PENNSYL VANIA DEPARTMENT OF REVENUE Inheritance Tax Liability Delinquencv Notification REV -8661'0 AFP (06-06) KARL E ROMINGER ESQ ROMINGER & WHARE 155 S HANOVER ST CARLISLE PA 17013 Notice Date: Estate of: MORTORFF SSN: Date of Death: File Number: Date of Assessment: ACN: 10/15/2007 EVELYN H 184-05-0369 10-20-2004 21 04-1024 07-09-2007 101 Our records indicate a delinquent inheritance tax liability for the above estate. Outlined below is a summary of our records. Additional interest is calculated and included in the balance to fifteen (15) days from the date of this notice. TAX INTEREST PENALTY CREDIT BALANCE 4,645.52 554.05 4,645.52 554.05 "-.--..' -:~:: -; The Inheritance and Estate Tax Act mandates the filing of a tax return and payment df all!::: outstanding liabilities by a personal representative of the estate or a transferee within ninewonths of the decedent's death. . --~ To avoid further action including additional costs and interest, the above amountj.due mus~be paid within 15 days from the date of this notice. Please detach and return the lower portion with yaur your payment to the Register of Wills of the county indicated. Make check or money order payable to "Register of Wills, Agent". If the above balance due has been paid recently, please disregard this notice. If you have any questions regarding this notice, please contact: Harrisburg Call Center (717) 783-3000 TDD# 1-800-447-3020 (Service for taxpayers with special hearing and/or speaking needs) --~._-------_._---------------------------------------------------------------------------------------------------------------------------------------------------------------------.-------------------------------------------------- PLEASE RETURN THIS PORTION WITH YOUR PAYMENT TO THE REGISTER OF WILLS LISTED BELOW Estate of: MORTORFF SSN: Date of Death: File Number: Date of Assessment: ACN: EVELYN H 184-05-0369 10-20-2004 21 04-1024 07-09-2007 101 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 <6 ~ ,..:. ....\ ''', I,.. \..... (..\ ..~. i,.} i..} I.L\ l") = _. - "::::. - t .- -- ..:::- ,M - - =- - ~ -- - ::- ::- - ~ -- -- -- ::- o() ()::>~ ~(I)cr iii () ~ a>o_ ~ 3.. ~ ""0 '="0- ~g() ~(/)O .;(.(1)5 z CJ):z ~~ ~ iO~(I) ..J> (I) ce. -' ~ o (I) ..J> ..... ()) ~'. .z. -. ~ (/) n ~\ n<-' 0.,.... (. -,J .: :""-1 :g -- ::- := ::- ~.. ()~~ ~ (J'I a. -. (/) :) ~oco ~ $, ~ "'O'="go ~:t):> . '::) ~ (I) 'UlO<s ~<(') '" CD _' O)....e,. a. 9! ~ ~<a -l9l- o ..... e".) o 0 uNITED6'~ ;. 0 N. ~ '1.-'1 ~ 0 {:; ~ \r \\)i ~%g\'~~~.l ONO" rnN. . ....N.s:..~ . -.lo~", . 00 ol/l ~-.I ~ In Re: Estate of MORTOR1!"F EVELYN HE ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-01024 ,-. ) NOTICE OF FAILURE TO FILE STATUS REPORT " , --.1 Personal Representative: MORTORFF LEONARD G Counsel for Personal Representative: BAYLEY MARK F 1,_ :> (: .-; Date of Decedent's Death: 10120/2004 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Comt Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. lfthe required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to detem:~nc whether sanctions should be imposed upon the delinquent personal representative or counsd for the delinquent personal representative. . ( (c -'1'" . Ii ~\;:1.'?"zl'let(j . IJ !~t"' .'"' I Date: 10/31/2007 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File In Re: Estate of MORTORFF EVELYN BE ORPHANS' COURT DIVISION COURT OF COMMON PLEAS Or- CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-01024 NOTICE OF FAILURE TO FILE STATUS REPORT ) J ) ---...J Personal Representative: MORTORFF LEONARD G Counsel for Personal Representative: BAYLEY MARK F Date of Decedent's Death: 10/20/2004 (" ~.) f' ' The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~. .A-~' (9' wi,.a' ' ., . t~ItI'{.i!"L/ ...._ (4P.L~. .' . Date: 10/31/2007 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File Pa. G.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF l>-U\A \c) 0,,-\0. (\{;t coJfJf~,~piNkitL+~'NiA Name of Decedent: t-Vf' \u '(\ - \ Date of Death: \D \;:}D \dDD~ \ I {'-rID r-\- Dr+t- c~; I (': " . \.,'; '~ T File Number: dObL\ - ()\DdY:. Pursuant to Pa. O.c. Rule 6.12, 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 0 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 fo !lowing: a. Did the personal representative file a final account with the Court? . . . . . .. yay cs 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: n\h \ C. Did the personal representative state an account informally to the parties in interest? ............................... ~Y es 0 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. ~ c:: ~ "'\ ,"". Dale ~~ CJ. d-t:.A..) L. \ s,g"L",,, Fa", 'h:' ,on' Capacity: DPersonal Representative )1 COlillsel .., 1. \DS S ~D4.Q{ ~-\- Address ~(!.r\\~\-€... Th \lCJ\~ D r\) dUct-loDI 0 Telephone ~ r:. -' .' ,.- -- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX OIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Dc(Y'\Rflq; rf~~'RITANCE TAX . '~"-'\'i,-',-j~1A';'~~NT OF ACCOUNT ,-,-j ,. --'.- '* REV-1607 EX AFP (03-05) KARL E ROMINGER ESQ ROMINGER & WHARE 155 S HANOVER ST CARLISLE CLERK OF ORr\! ". ~ ,,~. r"~l' IRT 1',[,>-\t< .) '---):_'-,~,.~ CU~ . GA. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-26-2007 MORTORFF 10-20-2004 21 04-1024 CUMBERLAND 101 EVELYN H 2007 DEe = 5 AM": 42 Amount Remit ted 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 MORTORFF EVELYN H FILE NO. 21 04-1024 ACN 101 DATE 11-26-2007 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: 10-05-2007 PRINCIPAL TAX DUE: 4,645.52 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-02-2007 CDo0811 0 .00 4,645.52 10-22-2007 CDo08848 554.05- 554.05 TOTAL TAX CREDIT 4,645.52 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 " 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. ) ~