HomeMy WebLinkAbout04-1081Estate of
also known as
Register of Wills of CU mE ^ND County, Pennsylvania
PETITION FOR GRANT OF LETrERS
A. Burton Hoff No..r [
Petitioner(s), who is/are 18 years of age or older, apE~l'/(les) for:
(COMPLETE 'A' or 'B' BELOW:)
, Deceased
Social Security No. ,,
] A. Probate and Grant of Letters Tectamentmy and aver that Petitioner(s) is/am the execut, or
the Decedent, dated ] 1/27/2000 and codicil(s) dated .
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Oecedaot did not many, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Axlministrstion
(c.ta.; d.b.n.c.ta; pendente tlte; durant~a~ntia; dur.ante minoritate)
Pe6tioner(s) after a proper search has/have ascertained that Decadent Jeff no Will and was survived by the fol~wing spouse (if an),) and
heirs:
I Name Relationship
(COMPLETE IN ALL CASES:) Attach additional sheets if necesser/.
Decedent was domiciiad at death in Camp Hi]] Borough, Cumberland
County, Pennsylvania with his/her last family
or principal residence at 3.06 North 21st Street, Camp Hill, PA 17011
(list street, number, and municipality)
Decedent, then 87 years of age, died November 9, 2004 at '306 North 21 st Street, Camp Hill, Cumberland County, PA
(Loce~on)
Decedent at death owned propert7 with estimated values as follows:
(if domiciled in PA) All personal pmpedy
(If not domiciled in PA) Personal property in Pennsylvania
(If not domk:iiad in PA) Personal properS' 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 with this Petition and the grant of
letters in the appropriate form to the unders~ned:
S~nature
Michael B. Hoff
TTped or printed name and residonce
19 Byers Road
Liverpool, PA 17045
Oath of Personal Representative
Commonwee~th et' Penrmylvanla
County of
The Petitioner(s) above-named swea~(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) cf
the Decedent, Pet~ioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed Michael B. Hoff
before me th/s ~.~) day cf
19 Byers Road
For the ~ ~J
17045
Estate of A. Burton Hoff
Social Security No: 172-01-6705 Date of Death: November 9, 2004
AND NOW, this day of , 2004
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
iT IS DECREED that Letters [] Testamentary [] Of Administration
, in consideratio[~;~
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante abser~ia; durente mineritate)
are hereby granted to Michael B. Hoff
in the above estate and that the instrument(s) dated November 27, 2000
described in the Petition be admitted to probate and tiled of record as the last Will of Decedent.
FEES
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... $
Codicil ........... $
JCP Fee .......... $
Inventory .......... $
Ottmr ........... $
I.D. No: 83993
Address: 2109 Market Stxeet
Camp Hill, PA 17011
Telephone: (717) 737-3405
TOTAL .........
Prepared by t he Peni~ylvanl& Ba~ A~x:latJ~n Copyrlght (c) 1996 form ~ftware only CPSystems, Inc. Form RW- ~ (1~J1)
his is to certify that the intbrmation here given is correctly copied from an original certificate of death duly filed with me as
l,ocal Registrar. The original certificate will be forwarded to the Statc Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fcc for this certificate, $2.00
P 10687631
No.
Local Registrar
NOV ] 1 2004
Date
CERTIFICATE OF DEATH
August Burton Hoff
87
Aug.
Camp Hill
306 North 21st Street ~S,~E
Camp Hill, PA 17011
(Coroner)
=, ~le :. 172-01-6705 - 4. November 9, 2004
Camp Hill, PA ~
W. Hoff
Michael B. Hoff
November ll,
5:00 A u q. Novembe~ 9, 2004
Occlusive Coronary Artery Disease
Fahey
Cremation Sociel
Pemmsylvenia Crematory Harrisburg, PA
Services, Inc., Harrisburg, PA 17109
~
17109
November 1~, 2004
Michael L. Norris, Coroner
6375 Basehore Road, Suite #1
Mechanicsburg, Pa. 17050
SAIDIS
LAST WILL AND TESTAMENT
OF
A. BURTON HOFF
I, A. BURTON HOFF, of Camp Hill, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made
by me.
FIRST
I direct the payment of my just debts and expenses of my last illness and funeral from my
estate as soon after my death as conveniently may be done.
Further, I authorize my personal representative to expend funds from my estate, in such
amount as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
SECOND
I give, devise and bequeath my house known as 306 North 21st Street, Camp Hill,
Pennsylvania to my granddaughter, ALLISON H. DICK.
THIRD
I give, devise and bequeath all the rest, residue and remainder of my estate to my beloved
son, MICHAEL B. HOFF, absolutely and in fee simple if he survives me by thirty (30) days.
1
'1
FOURTH
In the event that my son, MICHAEL B. HOFF, fails to survive me by thirty (30) days,
then I give, devise and bequeath all the mst, residue and remainder of my estate in equal shares
unto my daughter-in-law, SUSIE HOFF.
FIFTH
I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate
passing under this Will or otherwise shall be paid out of the principal of my residuary estate.
SIXTH
In addition to the powers conferred by law, I authorize any personal representative acting
under this instrument, in his/her absolute discretion:
A. To retain in the form received, or to sell either at public or private
sale any real or personal property;
B. To exercise any options to subscribe for stocks, bonds, or other
investments;
C. To join in any plan of lease, mortgage, consolidation, exchange,
reorganization or foreclosure of any corporation in which my estate or any trust
may holdstocks, bonds or other securities;
D. To sell, transfer, convey, mortgage, pledge, lease or exchange any
property, real or personal, which at any time may form part of my estate, for the
payment of debts or taxes, or for any purpose of administration or distribution,
for such prices and upon such terms as my personal representative, in his/her
SAIDIS
sole discretion, may deem wise, and to execute and deliver deeds of conveyance
or transfer thereof;
E. To make settlements and compromises on such terms as my personal
representative in his/her sole discretion may deem wise without the necessity of
obtaining any court approval thereof;
F. To make distribution hereunder either in cash or kind, as my personal
representative in his/her discretion may deem wise.
SEVENTH
I do hereby nominate, constitute and appoint my son, MICHAEL B. HOFF to act as
Executor of this my Last Will and Testament. Provided, however, that if he is unwilling or
unable to act as Executor, I direct the duties of Executrix be performed by his wife, SUSIE
HOFF.
EIGHTH
I direct that no personal representative, guardian, trustee or other fiduciary appointed
under this instrument shall be required to give bond for the faithful performance of their duties in
any jurisdiction.
IN WITNESS WHEREOF, I, A. BURTON HOFF, have hereunto set my hand and seal
to this my Last Will and Testament, consisting of five (5) typewritten pages, the first two (2) of
which bear my initials in the margin for identification, this~7 ~ay of November, 2000.
A. BURTON HOFF
3
SAIDIS
SHUFF, ItDWI~R
& LINDSAY
Camp HI~ PA
Signed, sealed, published and declared by the above-named A. BURTON HOFF,
Testator, as and for his Last Will and Testament in the presence of us, who have hereunto
subscribed our names at his request as witnesses thereto, in the presence of said Testator and of
each other.
ADDRESS
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
We, A. BURTON HOFF, c~-/- and , the Testator and wimesses,
respectively whose names are signed to the foregoing or attached instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testator signed and executed the
instrument as his Last Will and Testament and that he signed willingly and that he executed as
his free and voluntary act for the purposes therein expressed, and that each of the wimesses, in
the presence and hearing of the Testator signed the Will as witnesses and that to the best of their
4
knowledge the Testator was at the time eighteen (18) or more years of age, of sound mind and
under no constraint or undue influence.
A. BURT~)N HOFF ~
7 - Wit~ess Xx
Subscribed, sworn to and acknowledged before me by A. BURTON HOFF, the Testator,
and subscribed to and sworn or affirmed to before me by-John ~", ,~;I,~ and/¥aet,,
witnesses, thisoT'/~ay of November, 2000. ~/M~~/
_...-qNotary Public
Notadal Seal
Sallie Osman, Notary Public
Carlisle Bom Cumberland County
My CommiSsion Expires Mar, 29, 2004
5
Name of Decedent:
Date of Death:
Will No. 2004-01081
To the Register:
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
A. Burton Hoff
November 9, 2004
Admin. No. 21-04-1081
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 December ~-[ ,2004.
Name
Michael B. Hoff
Allison H. Dick
Address
19 Byers Road, Liverpool, PA 17045
306 North 21st Street, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
none
Date:
Thomas E. Flower, Esquire
SAIDIS, SHUFF, FLOWER & LINDSAY
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
Capacity:
Personal Representative
X Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOFF MICHAEL B
19 BYERS ROAD
LIVERPOOL, PA 17045
----- fold
ESTATE INFORMATION: SSN: 172-01-6705
FILE NUMBER: 2104-1081
DECEDENT NAME: HOFF A BURTON
DATE OF PAYMENT: 01/31/2005
POSTMARK DATE: 01/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 11/09/2004
NO. CD 004904
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$5,000.00
REMARKS:
CHECK# 5860
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
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
HOFF MICHAEL B
1 9 BYERS ROAD
LIVERPOOL, PA 17045
unun fold
ESTATE INFORMATION: SSN: 172-01-6705
FILE NUMBER: 2104-1081
DECEDENT NAME: HOFF A BURTON
DATE OF PAYMENT: 03/14/2005
POSTMARK DATE: 03/14/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 11/09/2004
NO. CD 005050
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,501.33
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$4,501.33
REMARKS:
CHECK# 5889
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV-15{J(l EX (6-00)
f\J. A ,P,b
REV-1500
'* COMMONWEALTH OF
. PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 04
1081
COUNTY CODE YEAR
NUMBER
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C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
HOFF, A. BURTON
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-YEAR)
08/07/1917
DATE OF DEATH (MM-DD-YEAR)
11/09/2004
THIS RETURN MUST BE FILEO IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITiAl)
~ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (AlIachcopyofWII)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dale of death af\e( 12-1Z-62)
D 7. Decedent Maintained a living Trust (AlIachcopyofTrust)
D 10. Spousal Poverty Credit (daleofdealhbalw&en 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior to 12-1H2)
D 5. Federal Estate Tax Return Required
1.- 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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COMPLETE MAILING ADDRESS
2109 MARKET STREET
CAMP HILL, PA 17011
NAME
THOMAS E. FLOWER
FIRM NAME (If Applicable)
SAlOIS, SHUFF, FLOWER & LINDSAY
TELEPHONE NUMBER
(717) 737-34D5
(1)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an electioo to tax has not been
made {Schedule J)
(11) 4,959.35
(12) 142,235.13
(13) 0.00
(14) 142,235.13
12,848.16
33,363.00
(6)
89,189.99
(7)
11,793.33
,',)
j"'''-J
,,~ ,~,~"~"~~,~~~"~,~~,--~,-,-,,'
(9)
(10)
(8)
4,959.35
147,194.48
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
'.0_ (15)
142,235.13 '.0 ~ (16)
6,400.58
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14laxable at sibling rate
'.12 (17)
x .15 (18)
18. Amount of line 14 taxable at collateral rate
19. Tax Due
(19)
20. [RJ
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
\r
Decedent's Complete Address:
STREET ADDRESS
306 N. 21 st Street
CITY Camp Hill I STATE I ZIP 17011
PA
(1)
"L{tJO ( .."6"
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credns/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
9,501.33
~",.(~
Total Credits (A+ B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
q 7~c.f. tf'Y
,
0.00
Sf ~b~. lfo
A. Enter the interest on the tax due.
(5)
(5A)
(5B)
to: REGISTER OF WILLS, AGENT
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income; ............................................ D
c. retain a reversionary interest; or......... .................................................................................................... ........... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................................... ........... .............................. ~
No
[KI
[KI
[KI
[KI
[KI
[KI
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,
FILING RETURN
DATE
3 -2
Under penalties of perjury. I declare that I have el(8mined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Daclaration of preparer other than Ihe personal representative Is based on all info rmation of which preparerhas any knowledge.
SIGNATURE OF P
~'
ADDRESS U
19 Byers Road, Liverpool, PA 17045
SI~E~NTATIVE
ADDRESS
Saidis, Shuff, Flower & Lindsay, 2109 Market St., Camp Hill, PA 17011
DATE
]-H.-t>~
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (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 survivin9 spouse is 0% [72 P.S. 99116 (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 0% [72 P.S. 99116(0)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2} [72 P.S. 99116(a)(I)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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-1503 EX+ (6-9'.
COMMONVllEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
HOFF, A. BURTON
FILE NUMBER
21-04-1081
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
,.
DESCRIPTION
312 shares Verizon common stock@41.18
VALUE AT DATE
OF DEATH
12,848.16
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
.
12,848.16
REV-l'OB EX+ (6-9B) ..
COMMONI/v'EALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
HOFF, A. BURTON
FILE NUMBER
21-04-1081
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
US SAVINGS BONDS (see attached list and value calculator)
VALUE AT DATE
OF DEATH
3 coins in safe deposit box
30,492.00
2,755.00
116.00
2 1998 Chevy Cavalier Sedan, 12,000 miles
4
TOTAL (Also enter on line 5, Recapitulation) $
(If more space IS needed, insert additional sheets of the same size)
33,363.00
REV-1509 EX+ 16-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
HOFF, A. BURTON
FILE NUMBER
21-04-1081
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 Michael B. Hoff
19 Byers Rd., Liverpool, PA 17045
son
B.
C.
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MAO' INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HElD REAL ESTATE. VAlUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 07/01/2002 PNC 8ank c1d #31300213179 13,404.16 50 6,702.08
2. A. 08/15/2002 PNC Bank c1d #31500231349 20,085.40 50 10,042.70
3. A. 05/16/2002 PNC Bank c1d #31400228058 50,351.96 50 25,175.98
4. A. 12/19/1997 PNC Bank checkin9 acct. #4140029393 42,844.86 50 21,422.43
5. A. 01/28/1963 Belea Communny Credit Union savings acct #029490 5,815.26 50 2,857.63
6. A. 01128/1963 Belea Community Credit Unioin checking acct. #029490 322.88 50 161.44
7. A. 11/07/1994 Commerce Bank, time deposit savings #9030 20,942.67 50 10,471.34
.
8. A. 01/10/2000 Commerce Bank, time deposit savings#24278 24,712.78 50 12,356.39
.
TOTAL (Also enter on line 6, Recapitulation) $ 89,189.99
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX_ 16-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
A. Burton Hoff
FILE NUMBER
21-04-1081
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 NAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTO DfCEDENTAND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IFAPPLlCASLEl VALUE
1. Allstate/Glenbrook Advantage Plus Annuity, contract # GA 16614426 11,793.33 100 11,793.33
1
,
......
.
I
.
" " , ..
"C""7
TOTAL (Also en1er on line 7 Recapitulation) $ 11,793.33
(If more space IS needed, insert additional sheets of the same size)
REV.1511 EX. 112'991.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
HOFF, A. BURTON
FILE NUMBER
21-04-1081
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
,.
B. ADMINISTRATIVE COSTS:
,. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representalive(s)
Street Address
City Slate Zip
Year{s) Commission Paid:
2. Attorney Fees 4,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City Slate .Zip
Relationship of Claimant to Decedent
4. Probate Fees 136.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Patriot News, publish estate notice 248.35
8. Cumberland Law Journal, publish estate notice 75.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
4,959.35
REV-1513 "" (9-00) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
HOFF, A. BURTON
FILE NUMBER
21-04-1081
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.211 100.00 '
1 MICHAEL B. HOFF, 19 Byers Rd., Liverpool, PA 17045 son
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
%
(If more space is needed, insert additional sheets of the same size)
SAIDlS
SHUffi. JiDWER
&Ul''ilJSAY
~>AT.IAW
2109 Market Street
Camp HlIl, PA
LAST WILL AND TESTAMENT
OF
A. BURTON HOFF
I, A. BURTON HOFF, of Camp Hill, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made
by me.
FIRST
I direct the payment of my just debts and expenses of my last illness and funeral from my
estate as soon after my death as conveniently may be done.
Further, I authorize my personal representative to expend funds from my estate, in such
amount as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
SECOND
I give, devise and bequeath my house known as 306 North 21st Street, Camp Hill,
Pennsylvania to my granddaughter, ALLISON H. DICK.
TIDRD
I give, devise and bequeath all the rest, residue and remainder of my estate to my beloved
son, MICHAEL B. HOFF, absolutely and in fee simple if he survives me by thirty (30) days.
1
fi (!;PH
SAIDIS
SHl.J!'!i &WER
&~uSAY
ATlOItNMoAT-lAW
2109 Market Street
Camp IDII, PA
FOURTH
In the event that my son, MICHAEL B. HOFF, fails to survive me by thirty (30) days,
then I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares
unto my daughter-in-law, SUSIE HOFF.
FIFTH
I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate
passing under this Will or otherwise shall be paid out of the principal of my residuary estate.
SIXTH
In addition to the powers conferred by law, I authorize any personal representative acting
under this instrument, in his/her absolute discretion:
A. To retain in the form received, or to sell either at public or private
sale any real or personal property;
B. To exercise any options to subscribe for stocks, bonds, or other
investments;
C. To join in any plan of lease, mortgage, consolidation, exchange,
reorganization or foreclosure of any corporation in which my estate or any trust
may hold stocks, bonds or other securities;
D. To sell, transfer, convey, mortgage, pledge, lease or exchange any
property, real or personal, which at any time may form part of my estate, for the
payment of debts or taxes, or for any purpose of administration or distribution,
for such prices and upon such terms as my personal representative, in his/her
2
f)(3/1
SAIDIS
S~!!OWER
&UNUSAY
AITOIlNEYSoAT.IAW
2109 Market Street
Camp HlII, PA
sole discretion, may deem wise, and to execute and deliver deeds of conveyance
or transfer thereof;
E. To make settlements and compromises on such terms as my personal
representative in his/her sole discretion may deem wise without the necessity of
obtaining any court approval thereof;
F. To make distribution hereunder either in cash or kind, as my personal
representative in his/her discretion may deem wise.
SEVENTH
I do hereby nominate, constitnte and appoint my son, MICHAEL B. HOFF to act as
Executor of this my Last Will and Testament. Provided, however, that if he is unwilling or
unable to act as Executor, I direct the duties of Executrix be performed by his wife, SUSIE
HOFF.
EIGHTH
I direct that no personal representative, guardian, trustee or other fiduciary appointed
under this instrument shall be required to give bond for the faithful performance of their duties in
any jurisdiction.
IN WITNESS WHEREOF, I, A. BURTON HOFF, have hereunto set my hand and seal
to this my Last Will and Testament, consisting of five (5) typewritten pages, the first two (2) of
11>
which bear my initials in the margin for identification, this~7 day of November, 2000.
C;. 13~ f/4J
A. BURTON HOFF
3
fl {3 Ii
SAlOIS
S~!!OWER
& LIl'luSAY
IJlOIIlIE1'SoANAW
2109 Market Street
Camp HlII, PA
Signed, sealed, published and declared by the above-named A. BURTON HOFF,
Testator, as and for his Last Will and Testament in the presence of us, who have hereunto
subscribed our names at his request as witnesses thereto, in the presence of said Testator and of
each other.
~. {? ~
IF
!/t1J]
=p;;:; ~
t1t11Wf /1-<>> ,N.
ADDRESS
ADDRESS
aMI (j{jJ / I
\k
COMMONWEALTH OF PENNSYL V ANlA
ss.
COUNTY OF CUMBERLAND
-!.VYJfJ;[ .51tJ<~ .,1,~ :.~~ "VI
We, A. BURTON HOFF, ~' and ~
S. N ael
, the Testator and witnesses,
respectively whose names are signed to the foregoing or attached instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testator signed and executed the
instrument as his Last Will and Testament and that he signed willingly and that he executed as
his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testator signed the Will as witnesses and that to the best of their
4
API!
.
SAIDIS
S~!!DWER
&UNUSAY
AlIUIlNffiMT>uW
2109 Market Street
CampHill,PA
knowledge the Testator was at the time eighteen (18) or more years of age, of sound mind and
under no constraint or undue influence.
(1, 1:Jr~ l~
A. BURTON HOFF
i. 51
w
Subscribed, sworn to and acknowledged before me by A. BURTON HOFF, the Testator,
and subscribed to and sworn or affmned to before me byJohll [". ,c;JiJ:t> and /("'h',
witnesses, this0l7 Tfay of November, 2000. / /
,~
S-N6")
,
otary Public
Notarial Seal .
Sallie Osman, Notary Public
Carlisle Bora. curryberland County
My Commission Expires Mar. 29, 2004
5
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Date
11-Nov-04
10-Nov-04
09-Nov-Q4
08-Nov-04
Open High Low
41.4 41.84
41.45 41.59
41.18 41.5
41.15 41.22
Close
41.23 41.64
41.17 41.17
40.86 41.27
40.85 41.1
Volume Adj. Close'
7793700 41 .24
5846200 40.77
6018400 40.87
5576400 40.7
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Kelley Blue Book - Private Party Pricing Report - Chevrolet, Cavalier
Page I of2
_~I!-~
BLUE BOOK PRIVATE PARTY REPOn
Pennsylvania' March 17, 2005
1998 Chevrolet Cavalier Sedan 40
Search ListinQs for This Car
List Your Car For Sale Online
Quick New Car Price Quote
Free CARFAX Record Check
Auto Loans from 4.25% APR
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Payment Calculator
Engine: 4-Cyl. 2.2 Liter
Trans: Automatic
Drive: Front Wheel Drive
Mileage: 12,000
Equipment
Air Conditioning
Power Steering
AM/FM Stereo
Dual Front Air Bags
ABS (4-Wheel)
Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects. This vehicle has a
clean title historv , the paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. There should be little or no rust on this
vehicle. The tires match and have substantial tread wear left. A "good" vehicle will
need some reconditioning to be sold at retail. Most consumer owned vehicles fall into
this category.
Private Party Value Search Local ListinQs for This Car $2,755
Private Party Value is what a buyer can expect to pay when buying a used car from a
private party. The Private Party Value assumes the vehicle is sold "As Is" and carries
no warranty (other than the continuing factory warranty). The final sale price may
vary depending on the vehicle's actual condition and local market conditions. This
value may also be used to derive Fair Market Value for insurance and vehicle donation
purposes.
Get a Used Car Trade~In Value
Get Invoice & MSRP on New Cars
Get a Person to Person Auto Loan
BLUE BDDK I
SeQlth Used {
Qu ickly bro~
600,000 USE
to find exac1
you want.
adv
Page --L ol__L__
SAFE DEPOSIT BOX INVENTORY
INSTRUCTIONS
(1) Cash: Report tatal only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are
to be designated by name of company, certificate number, date of certificate, name in which stock is registered,
and number of shares and dass of stock.
(3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered
and type af ownership, i.e., jaintly held, payable on death, ete.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name af depasitor, number of book, last date appearing in
book, name 01 bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness, List and describe as
lully as possible.
(8) All other contents.
ITEM
NO.
ITEM DESCRIPTION
~/tJfm
1<1 ~)'f r-27
II
UH~ MffCil. _:it 'tJ 30 !f/I7/
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''fif),D019 Get It DV2.2~dS-
~ '2b/J1J'lJ ucd# ) S-e.o2~1 sl.J
I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY,
Sl~ SIGNATURE
PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW;
--rHI9I..at~ G-. J:" /0 UJeV'
CHECK APPROPRIATE BOX:
D Executor(trix) DAdministrator(trix)
o Estate Representative 0 Joint owner of sofe deposit box
NOTE: Attach additional 8%" x 11" sheet (5) if necessary or use duplicates of this page of form.
PRINT TITLE
~41
M JL)(..e..( l.l"G
REV.4115EX+{l.Q2)
~iJ.
SAFE DEPOSIT BOX
INVENTORY
COMMONWEALTH OF PENNSYlVMHA
DEPARTMENT Of REVENUE
INHI1RlTANCE TAX DIVISION
DEPT,2110601
HARRISBURG, PA 17128.0601 Please Print or Type
MUST BE COMPLETED BY REPRESENTATlYE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS lOCATED AND RETURNED TO ABOVE ADDRESS
COUNTY CODE FILE NUMBER SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER
)..
DECEDENT'S NAME (LAST, fiRST, MIDDLE) DATE OF DEATH
I~f..{, AIA.GuST f5'-lI2..ToAJ )J-q-OLJ
ADDRESS OF ECEDENT (STREET) , f . /II I
&1 . }$I- fr'/ /1
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSI
(NAME)
---!HrJ ......+S C. Ft-ou/{-t'L. . C-<; dl..
,
(STREET ADDRESS)
2 (0"1 Mqp-/v,{ ~-t;
(STATE)
(CITY)
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(STATE} (ZIP CODE)
( 70 I}
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b. (NAME)
(RELATIONSHIP)
(STREET ADDRESS)
(CITY)
{STATE)
JZIP CODE)
c. (NAME)
(RELATIONSHIP)
(STREET ADDRESS)
(CITY)
(STATE)
(ZIP CODE}
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAME)
13 !/tV k
ISTREET::JJO I M /llLte{
. NAME OF PERSON MAKING LAST ENTR
A, i3t,\orfoP'J. I~'
DATE qu;ONTRACT TO RENT BOX
~-llD-"1>
NAME AND ADDRESS OF PERSONIS) HAVING ACCESS TO BOX
a. (NAME)
A, g("Lr~tJ
(STREET ADDRESS}
c,{.
(STATE) (ZIP CODE)
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b. (NAME)
(STREET ADDRESS}
(CITY)
(STATE)
(ZIP CODE) (CITY)
(STATE)
(ZIP CODE)
NAME AND TITLE OF EMPLOYE TAKING THE INVENTORY
"dR.V\. *,ne..Tt~s .(, I' It!~
WAS A WILL IN THE BOX? ~ ONO If yes, a._ D1ide 91 will: t.1
-11.1> f'ar-=.J-r- wl/..1- l.(fA"> 1!..PM.Q.v~ :h;t'"" 100""
- "'"Ii:"" tCcime and add'ress of personal represent alive, If named In the will /-
INAMEIM(~~ Ifr#
(STREET ADDRESS) /"j)
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c. Name and address of attorney, if any )
(NAME)
.--yr.,'-O-w..J:/.f, 'C I P {01N~
'^-L<41
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(STATE)
fJ/i
(ZIP CODE)
17tltfS
(STREET ADDRESS)
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101M "I
"hSTATE) (ZIP CODE)
rrl- n~ (/
D & S COINS
" .
, .
224 FOURTH STREET
NEW CUMBERLAND, PA. 17070
(717) 774-4182
Customer's
Order No.
SOLD TO M (I<. €..
DATE
110 rF
rzJrg lot 19_
,
ADDRESS
SALESMAN
TERMS
CASH CHARGE C.O.D. PAID OUT RETD. MDSE. RECD. ON ACCT.
aUAN. DESCRIPTION PRICE AMOUNT
\qO'S- <; Ji:J: ~ 17rtJ vf i- 11r" -
1 fin 1/. -- TJ J. . --
6-tJ ff-IFi< /hs 4<-
ALL Claims and Returned Goods MUST be accompanied By This Bill
SIGNATURE
JRN-fP-200:> 17:41
I.'NCRRNK
o PNCBAN<
January 3, 2005
Saidis, Shuff, Flower & Lindsay
Attn: Thomas E Flower
2109 Market St.
Camp Hill, PA 1701 I
RE: Estate of A BlUton Hoff (Deceased)
SSN. 172-01.6705
DOD: 11-09-2004
Dear Mr. Flowcr:
412 7GB 34Sn
p.m
/scp
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account #31300213 I 79
A BURTON HOFF
MICHAEL B HOFF
DOD balance: $13,308.08 + $96.08 accrued interest
Account #3 I 500231349
A BURTON HOFF
MICHAEL B HOFF
DOD balance: $20,076.49 + $8.91 accrued interest
Account #31400228058
A BURTON HOFF
MICHAEL B HOFF
DOD balance: $50,318.97 + $32.99 accrued intcrest
Checking Account
Account #5140029393
A BURTON HOFF
MICHAEL B HOFF
DOD balance: $42,84174 + $3.12 accrued interest
Page I of2
Established 07-01-2001
Established 08-15-2002
Established 05-16-2002
Established 12-19-1997
JRN-,P~-?f10S 17: 42
PNCBnNK
412 758 3458
F1.VJ;2
The decedent maintained Investment Account # 1914143 7 for further infonnation please
call 1-800-762-6111.
The decedent did not maintain any safe deposit box Or loans with PNC Dank.
Please note that tbis office only provides date of death balances for deposit acrounts
(IRAs, CDs, Checking and Savings accounts). We do not procell any tin.ncial
transactions or provide st.tements. If you need assistance with any of these items,
please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
~'J.~
Erica L Schlegel
1-800-762-1775
P7-PFSC-04-F
500 First A vc.
Pittsburgh P A 15219
Member FDIC
Page 2 of2
n nn
Belco Community Credit Union
3500 Trindle Road
Camp Hill, P A 17011
Re: Estate of A. Burton Hoff
Date of Death: November 9,2004
Social Security No. 172-01-6705
Dear SirlMadam:
The following is a complete record of the above decedent's accounts as of November 9, 2004,
decedent's date of death. If the decedent had a safe deposit box, indicate number
Balance on Date of Death
Account No.
Type of
Account
PJ.~LL,-,~p(11
fult:\t\c,e
Accrued
Interest
Names on
Account (All
Owners)
e
Date
Opened
~(i J'>jJJ(rOr
Si ature of Official
Date:~
Title:QW([)f)IC ~(VICPlJ ie.pr~vrhf{\e
Commerce
DEe 28 2oo.Bank
December 27, 2004
Saidis, Shuff, Flower & Lindsay
2109 Market St
Camp Hill, PA 17011
RE: Estate of: A Burton Hoff
Social Security #: 172-01-6705
Date of Death: November 9, 2004
Dear Sirs:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Time Deposit
Account #: 9030
Date Opened: 11/7/94
Primary Owner: August B Hoff
Secondary Owner: Michael B Hoff
Date of Death Balance: $20,942.67
Accrued Interest: $0
Principal Balance: $20,942.67
Type: Time Deposit
Account #: 24278
Date Opened: 1/10/00
Primary Owner: August B Hoff
Secondary Owner: Michael B Hoff
Date of Death Balance: $24,743.99
Accrued Interest: $31.21
Principal Balance: $24,712.78
Commerce Bank / Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
Commerce
_Bank
If there are any questions or additional information that
is needed, please feel free to contact me at (717) 795-7118
ext. 3151.
Sincerely,
L0u.rndn.. cr Mo~~
Wanda J Morris
elF Team Leader
Commerce Bank I Harrisburg, N.A.
PO. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
//
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/
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/
3/25/2005 2:03
PAGE 002/002
Fax Server
Ails/me Life I_once CompQJ'l)'
Life andAnnuIiy ClaimS
P.O. Box 94212
Palatine, IL 60094-4212
~
Allstate.
YoU'1'I;l in gobd hands.
VIa FacsimUe (7171 737-3407
March 25, 2005
ThODUlS E. Flower
Law Offices
Saidis, Shuff, Flower, and LindsaY
Re:
Contract No:
Alden Burton Hoff
GA16614426
Dear Mr. Flower:
We have been requested to complete Internal Revenue Service (IRS) Fonn 712 with regard to the
referenced contract.
The purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or
with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract).
The contract referenced was an annuity contract, which is not reportable on IRS form 712.
The foIIowing information is provided regarding the value of the annuity and other data as of the date
specified:
Date of Death: November 9, 2004
Annuity Value as of Date of Death: $11,793.33
Cost Basis: $11,558.20
Named Beneficiary: Michael B. Hoff
"The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, or need further assistance, please contact the Customer Care Unit at 1-877-499-
6418.
Sincerely,
Donna Rivera
Claim Representative
Overnight Addre..: 544 Lakeview Paikway, Vernon Hills, lL 60061
Toll Free Fax: 1-866-635-4523
06-20-2005
HOFF
11-09-2004
21 04-1081
CUMBERLAND
101
APPEAL DATE: 08-19-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS -
REY:is4'-Ex-AFp-co3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
A B FILE NO. 21 04-1081 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
1 -!
: I
i: 55
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
ORPH/',i'!
THOMAS IC:Ift:OWER
SAIDIS ETAL
2109 MARKET ST
CAMP HILL
PA 17011
ESTATE OF
HOFF
*'
REV-1547 EX AFP (06-05)
A
B
TAX RETURN WAS: (X) ACCEPTED AS FILED
DATE 06-20-2005
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule A)
2. Stocks and Bands ISchedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule DJ
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Tot.1 Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
12.848.16
.00
.00
33.363.00
89.189.99
11. 793.33
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral ExPens.s/A~. Costs/Hlsc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule Il
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule ~)
14. Net Value of Estate Subject to Tax
(9)
(10)
4,959.35
I~ an assessment was issued previOUSlY, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rat. (15)
16. A~unt of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. A.ount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
CR TS:
NOTE:
T
.
INTEREST/PEN PAID 1-)
263.16
.00
DATE
01-31-2005
03-14-2005
HUHBER
CD004904
CD005050
.00
Ill)
(12)
(13)
(14)
.00 X
142,235.13 X
.00 X
.00 X
AMOUNT PAID
5,000.00
4,501.33
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
00 =
045 =
12 =
15 =
(19)=
NOTE: To insure proper
credi t to your account I
sub.it the upper portion
of this forn with your
tax payment.
147,194.48
4.91;9 31;
142,235.13
.00
142,235.13
.00
6,400.58
.00
.00
6,400.58
9,764.49
3,363.91CR
.00
3,363.91CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS.)
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
STATUS REPORT UNDER RULE 6.12
Name of Decedent: A. Burton Hoff
Date of Death: November 9, 2004
Will No. 2004-01081 Admin. No. 21-04-1081
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the estate is complete: Yes X No_
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court? Yes_;
No X.
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes X; No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report.
i.i__
CDate:
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I.D. No. 83993
SAIDIS, SHUFF, FLOWER & LINDSAY
2109 Market Street
Camp Hill, P A 17011
(717) 737-3405
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/30/2006
FLOWER THOMAS E
2109 MARKET STREET
CAMP HILL, PA 17011
RE: Estate of HOFF A BURTON
File Number: 2004-01081
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: 11/09/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~ Yl' ~f~AjJ
~.~~v
_7
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/30/2006
HOFF MICHAEL B
19 BYERS ROAD
LIVERPOOL, PA 17045
RE: Estate of HOFF A BURTON
File Number: 2004-01081
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 I 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: 11/09/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report" please disregard
this notice.
Sincerely,
~~AJ~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
j
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: R UR.1lJkJ If '
Date ofDeath / 1/-1/ )'JiJ'f
Estate No.: de c tf ,... () 10 ?I
f--'
f-I-o F'J-
Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following
with respect to completion ofthe administration of the above-captioned estate:
1. State whejXer administration of the estate is complete:
Yes [Q/ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. Ifthe answer to No.1 is Yes, state the following:
a. Did the person<:!!e~entative file a final account with the Court?
Yes 0 No ll.Y
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: /J/ fr
I
c. Did the person~nyresentative state an account informally to the parties in
interest? Yes 1LJ" No 0
c. Copies ofreceipts, releases, joinders and approval of fomlal or infomlal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date:#
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Signature
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Name r-- /
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Addr ss
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Telep one No.
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Capacity: 0 P~nal Representative
~unsel for personal representative
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LUmDer..lana Louncy - Kt:::JJ.bL...CL VL rY.l..l..l.u
One Courthouse Square
Carlisle, PA 17013
Phone: (71 7) 24 0 -. 6345
t(Q)lPV
Date: 10/30/2006
FLOWER THOMAS E
2109 MARKET STREET
CAMP HILL, PA 17011
RE: Estate of HOFF A BURTON
File Number: 2004-01081
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 lS due by: 11/09/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Z:~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc:
File
Personal
\ U .'::1 \j v\lr~18
1\ I('(Y\ C' \\\.i1r.\d'uQ
J):\ i\)',) ',):1 ~ \' CJ
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Representat"l v~~(s')
I 2 :ZI t-id S - AON SOal
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
# l I / ,.., r-
Name of Decedent: i I 1.' (::L~ 6, 7?, {A R'(Y-.I Iii) ~ r
Date of Death: /1- 9 - 0 'I
Estate No.: 200 t.j - 0 10 ~(
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:
J. State whether administration of the estate is complete:
Yes l8r No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did tbe personal representative file a final account with the Court?
Yes 0 No ~
b. The separate Orpbans' Court No. (ifany) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes ~ No 0
c. Copies of receipts, releases, joinders and approval of fomlal or infomlal
accounts may be filed with the Clerk ofthe Orphans' Court and may be
attached to this report.
Date: 11- {, -D b
:7;?/~~ 8 . I~
SIgnature
M (c-If .--Tee "3 - /-fOFr-
Name
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Address ~ /.I.c..-e l'cbC- jJ If - / A:1 V S
(//7) 'T7/~- 377'"-;)
Telephone No.
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Capacity: 0 Personal Representative
o Counsel for personal representative
<:Pi
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
of CU
No. 2004- 01081 PA No. 21- 04- 1081
Estate of: AUGUST BURTON HOFF
O D 9� (First,Middle,Last)
V alk/a: A BURTON HOFF
Late Of: CAMP HILL BOROUGH
CUMBERLAND COUNTY
Deceased
1750 Social Security No:
WHEREAS, on the 23rd day of June 2015 an instrument dated
November 27th 2000 was admitted to probate as the last will of
AUGUST BURTON HOFF
(First,Middle,Lastl
a/k/a A BURTON HOFF
late of CAMP HILL BOROUGH, CUMBERLAND County,
who died on the 9th day of November 2004 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, LISA M. GRAYSON, ESQ. , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters of ADMINISTRATION C.T.A. to:
SUSIE HOFF
who has duly qualified as ADMINISTRATOR(RIX) C.T.A.
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYL VA NIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
a
of my office on the 23rd day of June 2015.
eglster o i is
C) t-- Deputy
11.1 —j CD
C.) lL C�
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N S LU
Ct) a- CS]
p O
v 11s �
tsl.� L_.�'�"'*NOTE*'- ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland COUNTY,PENNSYLVANIA
Petitioner(s)named below, who is/are 18 years of age or older, apply(ies)for Letters as specified below, and in
support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropriate form:
Decedent's Information
Name: August Burton Hoff File No: ��,.�\1o�g
a/k/a: A • Burton Hoff (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 11/9/2004 Age at death: 8 7
Decedent was domiciled at death in Cumberland County, Pennsylvania (State) with his/her last
principal residence at 306 North 21st St 17011 Camp Hill Borough Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedentdiedat 306 North 21st St 17011 Camp Hill Borough Cumberland PA
Street address,Post Office and Zip Code City,Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania................................All personal property $ 1 . 00
If not domiciled in Pennsylvania.............................Personal property in Pennsylvania $
If not domiciled in Pennsylvania.............................Personal property in County $
Value of real estate in Pennsylvania.............................................................. $
TOTAL ESTIMATED VALUE.... $ 1 . 00
Real estate in Pennsylvania situated at:
(Attach additional sheets,ifnecessary) Street address,Post Office and Zip Code City,Township or Borough County
❑ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated and Codicil(s)
thereto dated *Fxarutpr, Mirhael R. Hnff, rlieri nn 5/7/Pnl,S, I ettprs n Arim initratinn are h-eing
requested to finalize the estate.
State relevant circumstances(e.g.renunciation,death of executor,etc.)
Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced,was not a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(g),and did not have a child born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
❑ NO EXCEPTIONS ❑EXCEPTIONS
® B. Petition for Grant of Letters of Administration(If applicable) d • b • n - C - t • a
ata.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate
If Administration,ea.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
® NO EXCEPTIONS ❑EXCEPTIONS
i�
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following sp�se(if any)an�irs(atfgcl=
additional sheets, if necessary): C r"D C-)
rn C— 7
_T
Name Relationship Address n
DIED MAY 7, 2015 R`� - M
-�
Michael B • Hoff son
c� _0
c� C>
c
7 ►-+ r- M
►-r cn Q
Form RW-oz rev.1011 Uzo11 Page 1 O 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTYOF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
19 Byers Road
Susie Hoff Liverpool PA 17045
t:1 Fri
The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to the best of-the kRow"ledge and belief-3 t-D
of Petitioner(s)and that,as Personal Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the est`aa avwr,d* g to+�sy.
Sworn to or"affir ted and subsci gibed before
Date
;- 4
me this Clay of — Date t�
By: Date F--+ C3 a
For the.neglsier Date
BOND Required: U YES ® NO To the Register of Wills:,
FEES: Please enter my appearanc by my signature below:
Letters. . . . . . . . . . . . . . . . . . . . . . . $ Attorney i P
( � )Short Certificates(s) . . . . . .
( )Renunciation(s). . . . . . . . . . ,
( )Codicil(s) . . . . . . . . . . . . . .
( )
Affidavit(s). . . . . . . . . . . . . ':.
Bond Printed Name: David. Stone , Esquire
Commission . . . . . . . . . . . . . . . . . . . . Supreme Court
ID Number: 39785
Other . . .
. . . . . . . . . Firm Name: Stone LaFaver & Shekletski
. . . " " " Address: 414 Bridge Street
. . . . . . . . . P . O . Box E
. . . . . . . . . New Cumberland PA '17070
. . . . . . . . . Phone: 717-?74-?435
I . . . . . . . . Fax: ?1?-??4-3869
Automation Fee . . . . . . . . . . . . . . . . . Email: dstonea@stonelaw • net
JCS Fee . . . . . . . . . . . . . . . . . . . . . . .
TOTAL . . . . . . . . . . . . . . . . . . . . . .$
DECREE OF THE REGISTER
Estateof August Burton Hoff File No: �-, C) —In-
a/k/a:
AND NOW, ��I Sin 1 in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Letters- o f- A d m i n i_s t r a t i o n
d • b • n • e • t • a are hereby granted to S u s i e H o f f
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))of De-'edent.
6&�Q ryi Aatp�4)
Register of Wills p�
Form RW-02 rev./0/Il/201/ f Page 2 Of 2