The URL can be used to link to this page

Home My WebLink About04-1175PETITION FOR PROBATE and GRANT OF Estate of'ROBERT H, ROYER also known as Social Security No. Deceased. No. To: LETTERS Register of Wills for the County of ~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated AUiTJST 21 and codicil(s) dated in the named , X~ 2009. (state relevant circumstances, e.g. renunciation, d~ath of executor, etc.) Decendent was domiciled at death in O3l~~ County,~ pennsylvania, with h i.~ last'family or principal residence'at 75 (list street, number and muncipality) Decendent, then 87 years of age, died D~C~I~ER at 75 WEST LAUE~ LANEr ~ TOWNSHIP.. C%~ZLAI~) OOUNTY; PflqNSYLVANIA. 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.) p~rSonal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvani~a situated as follows: 75~ _wE"~-~_ ?~r_n~_ ~-.~_~, _~_~ __q~7~a___.~"wr~ $ 60,000,00 $ $ 166~000.00 WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) q'~.q'PAMk-~PAgt¥ (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) MARY ANN WiI_~IARD 133 CYdRVTN DRYVE. F_n~R_XSL~__mG._-, PA 17112 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF ~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the forcing petitio~re true and correct to the best of the knowledge and belief of petitioner(s) and that as person~ represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~.'~x ~rx~ day of ~ ~~ · ~ 2004 ~ ~ ~., %,% %~ ~eg,ster certify that the information here given is correctly copied froln an original cel'tii]cat~' of death duly filed with me as l<egistrar. The original certificate will be lbrwarded to the State Vital Records Of/ice for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph, Fee for this certificate. $2.00 P 10689014 No, Local Registrar BEC 0 6 2004 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (Ftist, Middle, Last) ~. Robert H. Royer AGE (Last Oi~thday) 87 COUNTY OF DEATH Cumberland DECEDENT'S USUAL OCCUPATION Public Relations DECEDENT'S MAILING ADDRESS 75 West Laueg Lane IACTu^L t~ Camp Hill, Pa 17011 [o. othe, side) SEX I SOCIAL SECURITY NUMBER ~ DATE OF DEATH (Month, Day, Year) zMale Ia. 206 - 10 - 8508'J~.December 3,2004 9,1917 7. Norristown,Pa h. ~.,o.~,,..,[-I oo^D .......o~. [] ...... ~q ~"~'.~ [] CITY, BORO, TWP OF DEATH FACILITY NAME (If not in$1ilulion, give street and number) WA~ECEDENT OF HISPANIC ORIGIN7 ~tampden T~p I.d75 West Lauer Lane · Ir ....... Pu .oR, ..... ,c I,o White PHEAA Y"' [] No [~ t:l,m,nlary/$,co,dary C*3~eg, Div~ced (Specify) . ~a. ~°"'~ 4 .'~'l J.. Widowed ~. ,7.. Stale Pa O~d 17c. [] Ye,, decedent lived in Hampden ,~. co~.t~ Cumberland township? 17d. [] No decedent lived FATHER'S NAME (First, Middle, Last) t~. Jacob G. Roye~ (Type/Print) 2g.. lq~V Ann Williard METHOD OF DISPOSITION DATE OF DISPOSITION MOTHER*S NAME (Feat, Middle, Maiden Surname) ~g. Cora R. Rahn INFORMANT'S MAILING ADDRESS (Street, City/~own, State, Zip Code) J~o,.. 133 Curvin Drive Harrisburg,Pa 17112 IPLACE OF DISPOSITION- Name of Cemetery, Crematory ILOCATIOfl - Cily/~own, Slate, Zip Code or Other Place I ~. Hollinger Crematory Ztd. Mount tlolly Springs Pa Donation [] Burial i i C ...... io~ ~ ....... I Irom State U ( 21a. ethel (Specify) .La S SUCH physician is not available al time of death to caddy cause of death Item~ 24-26 must be cmmpteted by pe[son who pror~unces death. 011654-L , DEAD (Monlh, Day, Year) NAME AND AODRESS OF FACILITY' 1'}03 Market Street /ers-Hamer Funeral HomelncCa[ Pa 17011 LICENSE NUMBER DATE SIGNED [Month. Day. Year) ,..EO,ATECA.SE(F.a, thsease o* c(mdilion a. ~ Enter UNDERLYING CAUSE (Disease or mju~j c WAS AN AUTOPSYI WERE AUTOPSY FINDINGS MANNER OF DEATH PERFORMED?J AVAILABLE PRIOR TO COMPLETION OF CAUSE · Natural Homicide OF DEATH? I Accident~[] Pending Invesligahon Yes [] No Yes [] No [] J Suicide[] Could not be delermmed C:ERTIFIER (Check only one) 'CERTIFYING PHYSICIAN (Physician cer[i~ing cause c~ death when another physician has pronounced death and completed item 23) *MEDICAL EXAMINER/CORONER On the basil of examination and/or investigation, in my opinion, death occucred at the time. date, and place, and due to the causes(~) and WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONER? No~ Approximale PART IhOther significant coliditio~s contrlbuhng to death, bet not resulting in the undedying cause given in p,e~lT L onset and Oeath 3ga 30b M T I pLACE OF INJURY - Al home, farm, slleel, factory, olfice {Streel, State) SIG"ATi 22'5 F'ER6. tIC E NUMBER Item27 Typeo~Pnnt ~ ~. ~[ ~ O ep\wills\ROYERrobert LAST WILL AND TESTAMENT OF ROBERT H. ROYER I, ROBERT H. ROYER, of the Township of Hampden, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, as follows: A. One-third to my daughter, CAROLYN RYAN. B. One-third to my daughter, MARY ANN WILLIARD. C. One-sixth to my grandson, LUKE WILLIARD. D. One-sixth to my granddaughter, CAROLYN RAZO. ITEM III: I appoint my daughter, MARY ANN WILLIARD, Executrix of this my last will. ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. Page 1 of 4 IN WITNESS WHEREOF, I, ROBERT H. ROYER, have hereunto set my hand and seal this ~ day of /~V~F , 2002. ROBERT H. ROYER SIGNED, SEALED, PUBLISHED and DECL~/~ED by ROBERT H. ROYER, the Testator above named, as and for his Last Will and Testament, and in the presence of us, who at his request, in his presence and in the presence of e. ach~ other, have subscribed our names as witnesses. Address Witness \ Address COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : I, ROBERT H. ROYER, the Testator whose name is signed to the at- tached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- Page 2 of 4 ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ROBERT H. ROYER ~ Sworn to or affirmed to and acknowledged before me by ROBERT H. ROYER, the Testator, this ~/ day of ~/_?~s~z~ , 2002. ' Notary ~u'bl / -' COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : [M.yN OTAR I~L SEAL PATRICHI~ L. YO~ER, !,~o!.a~, Public New Cumb,,r!and Boro. Cumberland Co. on Expires Nov. 18, 2002 the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as Page 3 of 4 witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. Witness Sworn to or affirmed to and witnesses, this ~./ day of acknow~ledged before me by and T~. ~--~-~"~.\ ~/'~~ , 2002. Notary P~bli/ NOTARIAL SEAL ?ATF~ICHI^ L, YOTER, Notary Public My Oommi,,~on Explrss Nov. 18, 2002 Page 4 of 4 Estate Of ~:~m'r~H. ~OX~m DECREE OF PROBATE AND , Deceased GRANT OF LETTERS AND NOW ~ ~'x-~x.~ "~.~'~ ,~ ~ll~_2IIDA., in consideration of the,petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated AUGUST 21, 2002 described therein be admitted to probate and filed of record as the last will of ROBERT H. ROYER and Letters WRS~A_MEI~ARY - are heieby granted to ~ ANN ~IARD r ~ FEES Probate, Letters, Etc .......... Short Certificates(~) .......... Renuncia/i0n ...:~ ............ TOTAL Filed ....X."~. ;..'~...'~.; .~..u.~ .................. ATTORNEY (Sup. Ct. I.D. No.) 414 ~ ST~. [~',t; C%lb~RLAND,-PA ADDRESS (717) 774-7435 PHONE 17070 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 WILLIARD MARY ANN 133 CURVIN DRIVE HARRISBURG, PA 17112 ~------- fold ESTATE INFORMATION: SSN: 206-' 0-8508 FILE NUMBER: 2104-1175 DECEDENT NAME: ROYER ROBERT H DATE OF PAYMENT: 03/01/2005 POSTMARK DATE: 03/01/2005 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2004 NO. CD 005002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,000.00 I I I I I I I I TOTAL AMOUNT PAID: $9,000.00 REMARKS: M A WILLIARD CHECK# 1015 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ROBERT H. ROYER Date of Death: 12/3/2004 Will No. 21-04-1175 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules wa~ served on or mailed to the following beneficiaries of the above-captioned estate on Name Address CAROLYN RYAN 314 ELMIRA STREET TROY PA 16947 MARY ANN WilLIARD, EXECUTRiX 133 CURVIN DRIVE HARRISBURG PA 17112 lUKE WilLIARD 2310 HUFFER STREET HARRISBURG PA 17103 CAROLYN RAZO 16 AlEVERA IRVINE CA 92618 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: 2/28/2005 G51}L Signature DAVID H. STONE, ESQUIRE Name: STONE lAFAVER & SHEKlETSKI Address: 414 BRIDGE STREET NEW CUMBERLAND PA 17070 Telephone(717) 7747435 Capacity: X Personai Representative Counsel for Personal Representative uvf COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EXI11-96) RECEIVED FROM, PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WilLIARD MARY ANN 133 CURVIN DRIVE HARRISBURG, PA 17112 ~nn___ fold ESTATE INFORMATION: SSN: 206-10-8508 FILE NUMBER: 2104-1175 DECEDENT NAME: ROYER ROBERT H DATE OF PAYMENT: 09/08/2005 POSTMARK DATE: 09/08/2005 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2004 NO. CD 005780 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $524.73 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: MA WilLIARD CHECK# 1053 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $524.73 GLENDA FARNER STRASBAUGH REGISTER OF WillS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Robert H Royer No. 21 04 1175 , Deceased Date of Death 12/3/2004 Social Security No. 206-1 0-8508 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: David H. Stone, Esquire 1.0 No.: #39785 Address: 414 BridQe Street New Cumberland Telephone: 717-774-7435 personalRepre~ ~ ~WilJiard '" 133 Curvin Drive Harri$fib:~ 17112~ -. '/) '1-4'..{ '-J C'Yl :"] .... Dated -0 :TJ ;. t'l !':'~I (J ~.~~ -';1 !-,"1 :.~; C~J C) --r1 _ -n h IT1 'J-"(~ PA 17070 -; iTl -: ..11 I CO ~ Description Value o 1~00.00 2004 Toyota car sold Clothes sold 250.00 Comcast-refund 3.67 Montour Oil-refund 93.00 Net proceeds on sale of household goods at auction 9,401.00 Property located at 75 W. Lauer St. Hampden Twp. Cumberland County, PA sold to Patricia L. Schuster 185,000.00 Total 277,806.78 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item. but such figures shoukl not be extended into the total of the Inventory. RW-4 Continuation of Inventory Robert H Royer 21 04 1175 Paqe 1 Description of Inventory Description Value PSECU-Cert of Deposit #51 5,000.00 PSECU-Cert. of Dep #56 7,000.00 PSECU-Cert. of Dep. #54 15,000.00 PSECU-Cert. of Deposit #50 20,000.00 3607.45 shares PSECU-Regular Share Acct. #01 @ $1.00 each 3,607.45 Wachovia Bank Savings Club Ace!. #3030090232059 50.01 Wachovia Bank-Checking Acct. 3,705.84 Waypoint Bank-Focus Fifty Checking Acct. 872.45 Waypoint Bank-Savers Advantage Ace!. #450004434 9,496.36 Waypoint Bank-Cert.of Deposit 5,000.00 IRS-refund on decedent's 2004 federal income tax 827.00 Subtotal $ Grand T olal $ 70,559.11 277,806.78 (EV-15ilQ~+(6-001 REV -1500 INHERITANCE TAX. RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W U w C DECEDENT'S NAME (lAST. FIRST, AND MIDDLE INITiAl) OFFICIAl USE ONLY FILE NUMBER 21 -0 4 1 1 75 ""'CciUNiY"COOE -YEAA- - - iiiiiER-- SOCIAL SECURITY NUMBER 2 0 6 - 1 0 - 8 5 0 8 THIS RETURN MUST BE FilED IN Dl!PlICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUM8ER w ~ ",-(I) ","'''' w"'" :rOO ","''''' R;lD "" Ro er Robert H DATE OF DEATH (MM.DD.Year) DATE OF BIRTH (MM-DD.Year) D 3. Remainder Return (dateofdeathpriorto12-13-B2) D 5. Federal Estate Tax Return Required .!.. 8. Total Number of Safe Depo~tBoxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) z o i= <( ..J ::l l- ii: <( u W It: z o i= ~ ::l II.. == o u ~ I- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME (If Ap~<ablel Stone LaFaver & Shekletski TELEPHONE NUMBER 717-774-7435 New Cumberland PA 17070 185,000.0Q.) 3,607.45 12/3/2004 10/9/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) IXJ 1. Original Return o 4. limited Estate [Xl 6. Decedent Died Testate (AttachcopyofWiU) o 9. litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a living Trust (Attach copy 01 Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFI ~~ USE ONl ~ ot..Jt rn (j') s-~ "-'1 ,---------' ~-;:) 6 I 1,-1 CO ~:::J -:' ~f; _' -n = (--") ITl J C~ .... z w o z o .. (I) w '" '" o '" 1. Real Estate (Schedule A) (1) -~ 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) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (Iotallines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (Iotallines g & 10) 12. Net Value of Estate (Line a minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (6) 89,199.33 -ry w o c' (7) 0.00 X _(15) 0.00 222,186.89 X .045 (16) 9,998.41 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 9,998.41 (9) (10) 14. Net Value Subject to Tax (line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (0)(1.2) 2. Slocks and Bonds (Schedule B) (2) (3) (4) (5) (8) 277,806.78 16. Amount of Line 14 taxable at lineal rate 27,555.18 28,064.71 (11) (12) (13) 55,619.89 222,186.89 17. Amount of Line 14 taxable at sibling rate (14) 222,186.89 1 a. Amount of Line 14 taxable at collateral rate 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 19. Tax Due .() ecedent's Comolete Address: STREET ADDRESS 75 West Lauer Lane CITY I STATE I ZIP Camp Hill PA 17011- I Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditsJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,998.41 9.000.00 473.68 Total Credits (A + B + C) (2) 9,473.68 3. InteresUPenalty if applicable D. Interest E. Penalty T otallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT. Check box on Pagel Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 524.73 524.73 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Ves No a. retain the use or income of the property transferred: ........................................................................... 0 IRl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IRl c. retain a reversionary interest; or ...................................................................................................... D lRI d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IRl 2. ff death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................ ............................. ................ ..................... 0 IRl 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 IRl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which conlains a beneficiary designation? ............ ................... ................. ....................................................... 0 IRl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of peijury, I declare thall have exanined this return, including accompanying schedules and statements, and 10 the best of my kooMedge and belief, It is true, correct and complete. Declaration of preparei' other than the personal representaUve is based on all information of which preparer has any knowledge. SIGNATURE Of PERSON RESPONSIBLE FOR FILlN~ RETURN. 117.AVL,?/ ~J7>~ :lA!.-" .I .I J PI h rJ ADDRESS 13 Curvin Drive Harrisbur SIGNATURE 0 DATE ADDRESS PA 17112 DATE ...9~ PA 17070 For dates of death on or after July 1, 1994 and before January 1, 1995, Ihe tax rale imposed on Ihe net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~911fi (a) (1.1) (i)]. Fordates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (Ii)]. The statute does notexemDt a transfer to a surviving spouse from tax, and the slalutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is Ihe only beneficiary. For dates of dealh on or after July 1, 2000: The lax rate imposed on the net value of transfers from a deceased child twenly-one years of age or younger al death to or for the use of a nalural parent, an adoptive parent, or a stepparent of the child is 0% [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 4.5%, 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 Ihe use ofthe decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Seclion 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-96) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rover. Robert. H 21 04 1175 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 nrODertv which Is iointly-owned with rinht of survivorshin must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Properly located at 75 W. Lauer Sl. Hampden Twp. Cumberland County, PA sold to Patricia L. Schuster VALUE AT DATE OF DEATH 185,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 185 000.00 REV-1503 EX + (6-98) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Rover Robert H FILE NUMBER 21 04 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1175 ITEM NUMBER 1 DESCRIPTION 3607.45 shares PSECU-Regular Share Acct. 01 @ $1.00 each VALUE AT DATE OF DEATH 3,607.45 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3607.45 REV-1508 EX + (6-98) * SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rover Robert H FILE NUMBER 21 04 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. 1175 VALUE AT DATE OF DEATH 12,500.00 250.00 3.67 93.00 9,401.00 5,000.00 7,000.00 15,000.00 20,000.00 50.01 3,705.84 872.45 9,496.36 5,000.00 827.00 DESCRIPTION ITEM NUMBER 1. 2004 Toyota car sold 2 Clothes sold 3 Comcast-refund 4 Montour Oil-refund 5 Net proceeds on sale of household 900dS at auction 6 PSECU-Cert of Deposit #51 7 PSECU-Cert. of Dep #56 8 PSECU-Cert. of Dep. #54 9 PSECU-Cert. of Deposit #50 10 Wachovia Bank Savings Club Acc\. #3030090232059 11 Wachovia Bank-Checking Acc\. 12 Waypoint Bank-Focus Fifty Checking Acc\. 13 Waypoint Bank-Savers Advantage Acc\. #450004434 14 Waypoint Bank-Cert. of Deposit 15 IRS-refund on decedent's 2004 federal income tax TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 89199.33 REV-1511 EX + 112-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rover Robert H SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 1175 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers-Harner Funeral Home-funeral expenses 2,578.00 2. Chuck Ryan-Reimb. on catering of funeral dinner 354.96 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number{s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees David H. Stone, Esquire 6,945.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Streel Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 307.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal-advertising grant of letters 75.00 8. The Patriot News Co.-advertising grant of letters 113.61 9. PP&L-electric services from Dec. to July 2005 424.44 10. PAW-water services from Dec. to Aug 2005 160.66 11. Hampden Twp.-trash and sewer from Jan to July 2005 356.50 12. Comcast-cable services from Jan to July 2005 83.03 13. Montour Oil-oil from Jan to July 2005 443.43 14. Travelers Insurance-home insurance 30.00 15. Verizon-telephone service from Dec to July 2005 171.46 16. T-Mobile-telephone service from Jan to July 2005 199.65 17. AT&T-telephone service from Jan to Dece 86.42 18. Duron Paint-paint for house 94.61 TOTAL (Also enler on line 9, Recapitulation) $ 27555.18 (If more space is needed, insert additional sheets of the same size) Royer, Robert, H Decedent's Name Continuation of REV.1500 Inheritance Tax Return Resident Decedent Page 1 21 04 1175 File Number Schedule H. Funeral Expenses & Administrative Costs. B7. ITEM NUMBER AMOUNT 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. DESCRIPTION Home Depot-materials to repair house (window wells, paint, tiles, etc.) Sears-materials to repair stove (hood fan and installation) Oliver Truax-Reimb. on materials for repairs at house Ed Crum-services rendered for installation of electric lines Marie Huder, Treasurer-real estate taxes on property Sovereign Bank-Satisfaction fee on line of credit Oliver Truax-doctor bill due to injury Register of Wills-filing Inheritance Tax Return and Inventory Ehrlich Pest Control-extermination at property Chemlawn-Iawn services at property Settlement costs on sale of property (13,080) less reimb. on taxes ($1,179.81) Reserve for closing expenses 83.34 361.73 300.00 174.00 1,536.12 42.00 100.00 30.00 345.00 59.03 11,900.19 200.00 SUBTOTAL SCHEDULE H.B7 15,131.41 REV-1512 EX + (6-9B) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rover Robert H FILE NUMBER 21 04 1175 Include unreimbursed medicarexpenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1,536.00 1. Link to Care-in home services for December 2. PSECU-VISA card due 23.90 3. Waypoint Bank-line of credit payment 200.00 4. Waypoint Bank-line of credit payoff 26,304.81 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 28064.71 < ,REv.,513EX+I_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ROVAr R ,hort ... ?1 04 117<; 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 [1I1C1ude outright spousal distributions, and transfers under Sec. 9116 <a) (1.2)) 1. Carolyn Ryan Lineal 74,062.29 309 Elmira Street Troy, PA 16947 2. Mary Ann Williard Lineal 74,062.30 133 Curvin Drive Harrisburg, P A 17112 3. Luke Williard Lineal 37,031.15 2310 Hoffer Street, Apt. B Harrisburg, PA 17103 4. Carolyn Razo Lineal 37,031.15 16 Alevera Irvine, CA 92618 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 $ (If more space is needed, insert additional sheets of lhe same size) LAST WILL AND TESTAMENT OF ROBERT H. ROYER I, ROBERT H. ROYER, of the Township of Hampden, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, as follows: A. One-third to my daughter, CAROLYN RYAN. B. One-third to my daughter, MARY ANN WILLIARD. C. One-sixth to my grandson, LUKE WILLIARD. .D. One-sixth to my granddaughter, CAROLYN RAZO. ITEM III: I appoint my daughter, MARY ANN WILLIARD, Executrix of this my last will. ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. Page 1 of 4 IN WITNESS WHEREOF, I, ROBERT H. ROYER, have hereunto set my hand and seal this g.., day of ~VJI , 2002. ~R~ SIGNED, SEALED, PUBLISHED and DECLARED by ROBERT H. ROYER, the Testator above named, as and for his Last Will and Testament, and in the presence of us, who at his request, in his presence and in the presence of each other, have subscribed our names as witnesses. ,. - Ile~UA~ ,~<It Address 0~,,~~.~~\~ Witness ~ hr ~ i\.. A .\?~ Address COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND I, ROBERT H. ROYER, the Testator whose name is signed to the at- tached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- Page 2 of 4 ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the p:~~~......)"e' ,"ec~:~ -f:;:I/~ ~ t ROBERT H. ROYER Sworn to or affirmed to and ROYER, the Testator, this ..J J acknowledged before me by ROBERT H. day of ~J~J~ , 2002. /k,;'1A' Yln', Notary Publ' ," NOTARIAL SEAL PAmlCHIA L YOTER. Nolary Public New Cumberfand Bom. Cumberland Co. My Commi$Mon Expires Nov. 18. 2002 COMMONWEALTH OF PENNSYLVANIA S5: COUNTY OF CUMBERLAND We, ~~""'IJ,.~ and ~"\l.\ l~~\\ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as Page 3 of 4 witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. Witness Sworn to or affirmed to and acknowledged before me by and C" '\.I\.~ 'L. \i:-",,,-~\\ , \).0.,1.1> I~ ~ witnesses, this ~I day of (L~.L A-:f . &1~~; p~~' , 2002. NOTARIAL SEAL PAmlCHIA L YOTER, Notary Public New Cumberland 6010. Cumberland Co. My CommlS31on Expires Nov. 16, 2002 Page 4 of 4 R:EV-4S!i ~X+(9-DOl '*' SAFE DEPOSIT BOX INVENTORY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE: TAX DIVISION DEPT. 260601 HARRISBURG. PA 17128..0601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER (CITY) C4m NAME AND ADDRESS OF PERSON REQUESTING THE OPENING Of THE SAFE OEPOSIT BOX (NAME) M W . \\ J aqDhl) \ la, (STREET NAME)~_ f. ClJ\\.h,",- -U\~ (ZIP COOE) /70 (ZIP CODE) 17 C (STREET NAME) ,or (s(3A (ZIP CODE) 'Ill? , .r (CITY) (STi\E) (ZIP CODE) .Trc~ r4~ I h 94) (RELATION IP) (CITY) (STATE) (ZIP CODE) b. NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NA ) BOX b. (NAME) (STREET ADDRESS) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) (CITY) (STATE) (ZIP CODE) NAME ANO TITLE OF EMPLOYEE TAKING THE INVENTORY ~/ecWhe((J, {,oms WAS A WILL IN THE BOX? 0 YES If yes, a. Date of will: b. Name and address of personal (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. Name and address of attorney, If any (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) SAFE DEPOSIT BOX INVENTORY Page INSTRUCTIONS of (1) Cash: Report total 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 class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, atc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM DESCRIPTION ". I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS C ECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. s( :TURE PERSON RECEIVING COpy OF SAFE DEPOSIT BOX INVENTORY: SIGNATURE xecutor(trix) o Admlnistrator(lriK) o Estate Represerrtalive 0 Joint owner of safe deposit box NOTE: Attach additional 8'"'' x 11" sheet(s) If necessary or use duplicates of this page of form. ll'a Yh3 DATE /8.) lojN PRINT NAME AND CHECK APPROPRIATE BOX BELOW: d re\ded\ROYERESTATESChuster-exdeed PARCEL #10-19-1600-125 DEED THIS INDENTURE made the~~day of ~~ , in the year 2005, between MARY ANN WILLIARD, Executrix of the Last Will and Testament of ROBERT H. ROYER, late of Hampden Township, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- PATRICIA L. SCHUSTER, of the second part, herein after called the Grantee; WHEREAS, the said ROBERT H. ROYER became in his lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in Hampden Township, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on December 3, 2004, having first made his Last Will and Testament in writing dated August 21, 2002, duly probated and registered in the Office of the Register of Wills of Cumberland County on December 27, 2004, wherein and whereby he appointed as Executrix, the said MARY ANN WILLIARD, to whom Letters Testamentary were duly issued by said Register of Wills on December 27, 2004, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills more fully appears; -1- NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of One Hundred Eighty-Five Thousand and NO/100 ($185,000.00) Dollars, which has been paid to her by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, re- leased and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN lot of land situate in the TownShip of Hampden, County of Cumberland, and Commonwealth of Pennsylvania, bounded and described as follows: Lot No. 25 BEGINNING at a point in the easterly line of West Lauer Lane at the dividing line between lots numbered twenty-five (25) and twenty-six (26) on the hereinafter mentioned Plan of Lots; thence in an easterly direction along said dividing line one hundred fifty (150) feet to a point; thence in a northerly direction along the western lines of lots numbered thirty-eight (38) and thirty-nine (39), one hundred five and fifteen hundredths (105.15) feet to a point; thence in a westerly direction along the southerly line of lot number twenty-four (24) on said Plan one hundred fifty (150) feet to West Lauer Lane; thence in a southerly direction along the easterly line of West Lauer Lane, one hundred five and fifteen hundredths (105.15) feet to the place of beginning. BEING Lot No. 25, as shown on the Plan of Lots, Section 1, Point Ridge Farms, Hampden Township, Cumberland County, Pennsylvania, said Plan being recorded in the Cumberland County Recorder's Office in Plan Book 8, Page 2. BEING THE SAME PREMISES WHICH Graymor, Incorporated, a Pennsylvania corporation, by its deed dated December 9, 1960, and recorded December 28, 1960, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book C, Volume 20, Page 69, granted and -2- conveyed unto Robert H. Royer and Dorothy K. Royer, husband and wife. Dorothy K. Royer, died on March 20, 1996, thus vesting title by operation of law in Robert H. Royer, deceased. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of him, the said ROBERT H. ROYER, at and immediately before the time of his decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground above de- scribed, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantees, to and for the only proper use and behoof of the said Grantees, forever. And the said Grantor, for herself and her respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, her heirs and assigns, that she, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, -3- is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above written. . . ~C1nvn..J.V./ J}./ ~ H pl. (SEAL) MARY A WILLIARD, Executrix of the Last Will and Testament of ROBERT H. ROYER COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUJ\\\.u,V \a,~ On this, the ;)~ day of SS: ~~1Jdr , 2005, before me a Notary Public, the undersigned officer, personally appeared MARY ANN WILLIARD, Executrix of the Last Will and Testament of ROBERT H. ROYER, 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 have hereto set my hand and notarial seal. COMMONWEAlTH Of PENNSYlVANIA NOTARIAL SEAl KATHLEEN KEIM. Notary Public N8\I/ Cumberland Boro. Cumbecland Co. My Commission Expires Dec. 5. 2006 I hereby certify that the precise address of the Grantee is 751' )d+- LWA /. f;PArl 1 (!~ Hl'L! / fA I/Olf. _:_~?~~ P"SE l. 11111111 Pennsylvania State Employees (redd Unron ROBERT H ROYER L A c l.:()jtUJ }2[J7 !J ./1 E; f'os .!.- ~ 'J ~ 1..1 tv ~~~ fK. L ()W-J ~is""'.'!:' . .. f- fp{jJff(--T o rf. (CoY Pre r.u. DW. D/ua,) Vl'f~. ..:l~( '(crt \Hr.:=>1' ~c. Harrisburg. PA 17106-7013 (600) 137-7316 (No~Dnwide) website . http://www.psecu.com INTRODUCING VISA PAYROLL TRANS~ER! NO MISSED PAYMENTS OR LATE ~EE5 DUE TO SLOW NAIL OR FORGOTTEN PAYMENTS. CALL PSECU FOR DETAILS. JOIIIT OIMIIER /J:f/f2flox I~~ .. V ffU-()~ ..:: t:J.AL I ;;;.ft-1 ~-'1. . ~~~73~r.tfi~~~_ PAGE 2 W l 'f-kdrQ (PO) U2U2000~ / 7.1Y 5,000, O(} SIO<:Xl.Cl) ZOOr,292 P5Ece UJ"u..::l'::"'a41U.r.'::/b P.O. 110161013 "lJ'I'V'IU \I1UIIDIMYI HarrislJlrt rA 11106-7013 18001237-1328 (NaIanrelde) webtite . htlp:/lwww.psecu.com INTRDDUCING VISA PAYROLL TRANSFER I rP.olI\yl'lIl1lo S"lIe fll'l.I'lY"" [,eUlt Un;oll ND MISSED PAYMENTS DR LATE FEFS DUE TD SLOW HAIL DR FORGDTTEN PAYHENTS. CALL PSECU FOR DETAILS. JotIT ONNEfl ROBERT H ROYER PAGE 3 . '. "..:". .:'x::":(:: ::~t~-:::~~."~:. ;,,: ,y!~~' .'ltr1l',MV', ~~;"';';':;.:Ji:,..l. .:,. .',:;;;':.:~:;i"" :";ll;;.:.:,'W:j;;;"':::l~'~:;~ 020'XXXXXX 11/30/04 t~. .............. :x:.".. .r: '" . .J.J....... .... ;,:::~:~~ti~iit~',:~~ih~;.;~!~~i~.t:~i ;::mi:t::;::'.. 'i;' , " .. ";::> ::t< ,;:j:::,: .:::!::'rJ:::::,,;~&;:~WT,:!L~~W' .;'m:::::::;;:::: .:'i::l""":;""~;~"::'i" :~, .;1" ,,: ,":,:,;'Lu!i: ':"'~"'-;:'VI'" D: ....R..ED. .., 'S"Ili' ........::'.l:l"..I'~~w....I.""" .". "'SIP';;":"::;:':"';'::::':"':':" .:: .m:5 "::;, ;1: "'1: ;'."?'j.. '..;;'''. '.' ,....'f':"~~~~~'''.'r.,~t.~:: n, 1;", ,,::~ ~"" ..." -':'~"";~" :';f:'~P::l:'::"~~r,'~~:::~:~~!,~I~ ...~: ~.!". :':::':'::.::'::::..::... ::'.' 1130 WITHDRAWAL TRANSFER TO SHARE 01 17.34- 5000.00 1130 ENDING BALANCE 5000.00 60 HONTH CERTIFICATE WILL MATURE DN 02/06/08 ::['!i1~~~~!j~!j::;:;i:!::~~~~,~H~T~!~~=~f;~~~~~~~~~';~':;~~I;~~~~;f~~~~:~~~:;:~"';-":, ,.'." ..,: """,,, ,,,,,'~~!('."kr,.~~PTl~.. . .' '.:: :,.: . :: ',': .: ' :, ,.',.:r,'",,,: ,,,,,::;:r.,,tI!Hll.UHT, ,'A~NC",.. , . . .., 'L 110i .... ^.. ID' Sit "36 HONTH CERTIFIClitE BEGINNING BALANCE .... ......... - 150'00.00 ' 1130 PAY"ENT, DIVIDEND 2.570% 31.68 15031 68 ANNUAL PERCENTAGE YIELD EARNED 2.60% FRDM 11/01/04 THROUGH 11/30/04 ::!::::<~~TVi~~~!'+:'~::.:;/!I~!:~~~.~,~~~:~: ,~A,~:.a~:/ :,::::::'::::' ,,,,,: . :,. ':'::,4..:",h'~~;1~~~.;."..":, ~~'J"a.llllJl.lI' ~~ .. .' '.... ..~ti1I.~. ~.:": .,. !t!I!~JWIil . .... .......... . . ." . ,.:,..,~:.:.:x:,.: "1 ~. '''''.''!l"" :." '.''''':'':''.'.' ':," .1::'.' ":"':'S~"~'U.'fFCP1'~FICATE WILL ~TURIl: I1lkllll.2,Vll. ...."" ...:" ",:,,'" "':...>-::., ::::'.. ....... .. ..... DIVIDEND' "TDI' "YEAR TO DATE'" .>... ........... . 353.79.... =~===~a=c=3g___=__~.__.g~__a==3=_m=~s8.__S______~_CSS.==c..a=..~.~&=============== POST EFF B!SCltU'UON AMDUNT BALANCE ,'. 'x'i'" '".,...:a":",'''''~:'''M'''' .. ....11. """"'H CE"'T""IC""- .""":!".,y"",, BALANCE .... ...... .......... '.'.'.' .. . 1".1 ...t _...,... ;::;';;i;;;!:!';~ii!ii!,~~~:"''''.;;;!;!~.~:''~:'''t.'~. f'. III .,.nunl ."'" :";~" '"':'~.:..~':r~.."~~~"1il """ . ..:::~:..::.::;:I'::::::::::il::;::-";'~",' ", ::-:"~, ."~ ",r: ':::.C'. . ...............,.,., ....,........... ......-...... ......"DE"D ....".." .. - -. ..... ......,... .....",....... '.....'.."'''.......,IJ. . .'~ """!llllll"'.y ".".........r...-,~'., .,.......' ""..-&IrO!lWII!......... ...... . . r', ;..""t.."}""",~,,,,,,,~""'I{'.'IfOo'.wl"''''~Itr':'I!' 1I"",t"", .... ;';',:i::i;i';:;;;;;;il;J,:;;;."..,j",i', ,;:" , .......U,... 'I'''-IPNT' ,,' OE' ::"IJfL' ..,..;,.;':':;;~.."" .....:....... ......,.,,;,. i'. -~J:..').':;i::;;;i':~';"""i ,.',.,;,,:~...: .."..... '".:. , ::.:', i",;'i:1!'iii;~~;~;;:l ::'!~:~"~~~:'::"..:~'-:"~ :I".....:..~ : .. ..... .. :JC."~U:'::,:"~:.oI~~.."~-' .......~~.iI' .~.~....".~~~:: ~'''IlIT''''~,:''" ,.'..: ':'. . ..... ......1'1'30.. WITHDRAWAL TRANSFER TD SHARE'''Oz' mm . . ., .... 'Zit:Z8"': io'oiCo'o'''' ..',.., .. 1130 ENDING BALANCE 7000.00 60 HONTH CERTIFICATE WILL MATURE ON 11/18/07 ':':, ':::~';:,:,; .' .., ...u........... ..TD.....v... TO ..ore, . .,,' .""-:::'.' ....,..~.... ... ..... ... . "..... ...,:.. "'[ '" 1'. . '.-: '1""'N:.......:.;~.. .J:.:~"J"I!w:'l . II ,,". . . ..:!::'.: .'1. '. ' .. ,...' '~I.~"*tI!"I(":'-'l,''''. w:' .! J,'.. '.' (~:~;:~{~;G:~ti:;:::rii;:1t1",~~'r;(~~.~="'-'~-.o;..t..~."'..~.~.f~~~ .,:,'~;~~~~~:~~~'~".~,~~~:~~~h:;-:,':":",,: "... ,......... "''''W' ..,!I'D:r~1 "IIVUIIIIJI Iffb,.. VUl 111 ,JiAfI!: " ... ".. '. .. .... 147{ 47,. . .. :: ..'.'." .......1......... .:.:.. ;' ,..!I!!:" "...." .. .... '..1.. .m . . .!....... ..:.'.i.:". ......::.. .. on :::: ::::::.::: ::;:j?::: : .~;.::: . . .'. '. . ;.".,: ;.:::'. . :;i:~ : ~(.,..l:';:';i::i~;:;:::::' ~;":'., .". '.' " .... ...... ... ..... .,."r" ...., .l"l" ;',; ':'::/;~:'i~~.:'::,~,~;:";;~~:",:,,,: ..~: ''': ~. r; ',.:v:..;,;..!":':",. ',',,,: ,:,',:, '......f.... , ..... ..: 2004293 .~. ""'A~c:;~"Fifty Checking _ _ 01 1000813814808 762 30 ~OVIA. I'V.~l::J{ r..1.J,,J.Le. o 16 43,aas -- - 00007531 1 MB 0.30901 MAAO 32 1...111.. I III" ",,11,.," '0111.." ..,,111,',,1," J, '.'..'..11 ROBERT H ROYER 75 WEST LAUR LANE CAMP HILL PA 17011 PB Access Fifty Checking 11/2412004 thru ~ 2/22/2004 Account number. Account owner(s); 1000613614808 ROBERT H ROYER As-count SUmmary ODenll1ll bBlance 11/24 Deposits and olher credits Checks AutomBted Checks Olher withdrawals and sarvice fees Closing blilance 12/22 $2.390.99 1,339,88 + 618.96. 12.71. 246.59 - $2,852.61 ~-Js,a3 u.p -b I?-. 3-0 l.f DejJosits and Other Credits Dare Amounf De.criplilm 11/:30 669.50 AUTOMATED CREDIT PA TREASURY DEPY ANNUITANT 00.10.1236003133041130 PPD MISC 206108508026869 12/01 670.38 AUTOMATED CREDIT UNITED OF OMAHA BENEFIT CK GO. 10. 5470322111 041201 PPO MISG 020613637 lotBI $1~339.88 Checl.s 12/14 2058 354.98 Dafe 12118 Number Total Amount $618.96 Dare 2057 Amoamt 264.00 Oat,. Number Amount NumMr Automated Cbeclts Number 2056 AmQunt 12.71 Dalfl 12/13 Desaiption AUTOMATED CHECK AT&T CONSUMER CHECKPAYMT . / CO.ID.1111111111 041213 ARC Y MiSe 2056 Tetal $12.11 WAGHOVIA BANK, N.A., HAFlRISBURG CAPITOL page 1 ..{ 4 .".l~'SkO~~i~gs"Club Account ~~ 01 3030090232059 752 60 VADIIOVIA 00000306 1 AV 0.278 02 5DG 2 1...111...111"." .11" ./111...1 ROBERT H ROYER 15 WEST LAUR LANE CAMP HILL PA 17~11 o 0 729 I'1V...::l~( 1..LC:/.lC. -- - - Savings Club Account 12/01/2004 thru 12/31/2004 Account number. Account owner(s): 3030090232059 ROBERT H ROYER Account Summary Opening balance 1~1 DePosits and other erecirts Interest paid Other wilhdrawals and service fees OOling balance J2f31 $50.01 50.00 + 0.01 + 100.02 - $0.00 Deposits and Other Cr~dits PB Date 12/06 12IZT Total Amount ~Dn 50.00 TRANSFER FROM CHECKING #1000613614808 0.01 INTEREST FROM 12/0112004 THROUGH 1212712004 $50.01 Interest Number of days this statement period Annual percentage yield earned Interest earned this statement period Interest paid lhis Slatemenl peiiod '''telllst paid this year 26 0.00% $0.00 $'0.01 $0.41 Other Withdrawals and Service Fees ~ - .__..._ Ai!!~r _C?!.~_ 12127 ::~~:mit~:OJPSkACCOONT Total $100.02 - . ()~f> . A-c.c..otJP'T' -rb' p..s~~ 12,. /~7/0'1 AS YOU REQUESTED-YOUR ACCOUNT IS NOWCLOSED, AND THIS IS THE FINAL STATEMENT. IF YOU HAVE ANY QUESTIONS OR WISH ro REOPEN THIS ACCOUNT. CALL US AT SDO-WACHQVIA (800-922-4684), OR CONTACT YOUR WCAL FINANCIAL CENTER. WE APPRECIATE YOUR BUSINESS. WACHOVlA BANK, N.A., CAMP HilL page 1 of 2 HUb. I':!. ~l<ll<l::' 11: ~{HI~ , ~lWaYRqi!'J P.O. Box 171I. Harrisburg. Pennsylvania 1710S-171 ~emDerFOIC ROBERT H ROYER 133 CUR m DR HARRISBURG PA 17112 Cll-71l ENJOY THE WO~OERS WINTER HAS TO OFFER WITH A HOME EOUITY LOAN OR LINE Of CREOIT. WHETHER IT'S fOR GIFTS TRAVEL OR OTHER HOLIDAY ACTIVITIES. LET THE EOUITY IN YOUR HOUSE HELP YOU HANDLE YOUR HOLIDAY SPENDING. *. .. .. - . .. - .. .. -YOUR ACCOUNTS WITH US. ACCOUNT NBR 450004434 400012965 .-YOUR OEPOSITS.- SAVER'S ADVANTAGE FOCUS FIFTY -Total of Your. Deposits., .. .- ACCOUNT TYPE OF ACCOUNT 400012965 FOCUS FIFTY COMBINED STATEMENT DATE 12-20-04 - - - - - * BALANCE 9.497.77 5B8.61 - .10.. D.86.38 AVERAGE BALANCE 791.28 ------------------------------------------------------------------~--------- PREVIOUS BALANCE DEPOSITS WITHDRAWALS CHARGES INTEREST ENDING BALANCE * . . . . - . - - - - - -INTEREST SUMMARV- - INTEREST EARNED FROM 11/21/04 TO 12/20/04 DAYS IN PERIOD INTEREST EARNED ANNUAL PERCENTAGE YIELD EARNED INTEREST PAID THIS YEAR I~TEREST WITHHELD THIS YEAR · - " . . - - . - - - . . - TRANSACTION SUMMARY. TRANSACTION DEPOSITS/ DATE DESCRIPTION CREDITS 11/22 CHECK 973 11/22 CHECK 974 11/22 CHECK 977 11/26 CHECK 978 12/06 CHECK 979 12/09 CHECK 980 12/15 CHECK 981 12/20 SERVICE CHARGE 12/20 INTEREST PAYMENT ..... .09 CHECKS/ DEBlTS....... 422.00 / 337.00" 25.52- 86.08.- --. 200.0~ '- 59.03- " 23.90- .... 1.00--- CONTINUED ON NEXT pAGE 1.743.05 .00 1.153.53 1. 00 .09 588.61 -! - * 29 .09 .14 % 2.55 .00 . . . 8ALANCE 1321.05 984.05 958.53 872.45 672.45 613.42 589.52 588.52 588.61 .00.'02 (~I Customer Service ToII.Free 1-866.WAYPOINT (1-866-929-7646)' In York ArEa 717/815-4500 VWIW.waypointbank.com RUG.l~.~~~~ 11:~(RM VlWayRQi!1$ p.o. Be. 1711. Harrisburg, Ponnsylvanla 17105.1711 Mcm\:l~ FDIC ROBERT H ROYER COMBINEO STATEMENT OATE 12-20-04 FOCUS FIFTY . - . - - -CHECKS PAIO- AMOUNT NO. 422.00 337.00 25.52 86.08 NO. DATE 973 11-22 974 11-22 977*11-22 978 11-26 TYPE OF ACCOUNT SAVER'S ADVANTAGE ACCOUNT 450004434 Oll-71l 400012965 PAGE 2 DATE 979 12-06 980 12-09 981 12-15 - ." AMOUNT 200.00 59.03 23.90 ---------------------------------------------------------------------------- PREVIOUS BALANCE OEPOSITS WITHDRAWALS CHARGES INTEREST ENDING BALANCE " - - - - - - - - - - - -INTEREST SUMMARY- - INTEREST EARNED FROM I1f21f04 TO 12f20104 DAYS IN PERIOD INTEREST EARNED ANNUAL PERCENTAGE YIELD EARNED INTEREST PAID THIS YEAR INTEREST WITHHELD THIS YEAR * - - - - - - - - - - - - . TRANSACTION SUMMARY. TRANSACTION DEPOSITSI DATE DESCRIPTION CREDITS I1f30 ELECTRONIC TRANSACTION 15.12 INTEREST PYMT-CD 002300013381 12103 ELECTRONIC TRANSACTION 148B.00 US TREASURY 303 SOC SEC 12120 INTEREST PAYMENT 1.41 7.993.24 1.503.12 .00 .00 1. 41 9.497.77 29 1.41 .20 % 14 .35 .00 ~ - - - - * CHECKSJ DEBITS BALANCE 8008.36 9496.36 9497.77 11V...=it:J( r.;;J/ J.c::. c\- - " --v ;tce.. OU r'l/'f CL 0 S h/1? ///? 7 /0'1 /~:~: () E ;PtJ.5 I rt- 0 / .l.(....- 'JtJ ot$'&€ 1 &s; 'M-~ Ih ( (}J fin t!J r "f Y . J. OcJl.4 :-.; ...... w i1 cJ!O UI,f IIvftUiC- THANK YOU FOR BANKING AT WAYPOINT BANK fT ~'I ~~ '1 Customer Service lbll-FrEE 1-866-WAYPOINT (I.866-929-7646).. In York Area 717/815-4500 PO~ """'1 www.waypolntbank.com A &-:ttlement Statement U.S. Department of Housing and Urban Development OMS Approval No. 2502-026f S. Type of Loan 1.{ ]FHA 2.[ ]FmHA 4.( ]VA 5.[ IConv.!ns. 3. [ ] conv.unins'16. File Number: I 7. Loan Number: 18. Mortgage Insurance Case Number: 400501458-CB THIS NOTE IS FURNISHED TO GIVE YOU A STATEMENT OF ACTUAL SETTLEMENT COSTS. AMOUNTS PAID TO AND BY THE SETTLEMENT AGENT ARE SHOWN. ITEMS MARKED ~(P.O.C.t WERE PAID OUTSIDE THE CLOSING' THEY ARE SHOWN HERE FOR INFORMATIONAl PURPOSES AND NOT INCLUDED IN THE TOTAlS. ' D. Name and Address of Borrower I E. Name and Address ofS.11er I F. Name and Addnll.. 01 lender PATRICIA L SCHUSTER OF MARY ANN WILLIARD, EXECUTRIX OF THE ESTATE OF ROBERT H. ROYER C. NOTE: ,PA ,PA G. PROPERlY LOCATION 75 WEST LAUER LANE, CAMP HILL, PA 17011 COUNTY: CUMBERLAND PARCELID: 10-19-1600-125 TOWNSHIP: HAMPDEN TOWNSHIP tl SettJemant Agent ECUREO LAND TRANSFERS ~ MECHANICsaURG ps.~ofSettJement 3915 MARKET STREET CAMP HILL, PA I, Settlement DiIte I Dlsburwem....t Dale J. SUMMARY OF BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS 100. Gross Amount Due From Bo~r 400, Gro.. Amount Du. To Seller 101. Purchase Price $185,000.00 401. Purchase Price $185,000.00 102. Personal Property 402. Pel1lonaJ Property 103. SeUlement Charge. 10 Borrower $3,659.25 403. 104. 404. 105. 405. Adjustments For Items Paid By Seller In Advanc:e Adjustmenb For IUm. Paid By Seiler In Advance 106. CitylTown Taxes 406. CitylTown Taxes 107. County Taxes 309.86OO1yrfor09lO1/lJ5 thru 01101106 $103.57 407. County Taxes 309.86OO1yrfor 09101105 thru 01101106 $103.57 108. Assessments 408. Assessments 109. School Taxes 1251.29OO1yr for 09/01105 thru 07/01106 $1,038.74 409. School Taxes 1251.2900/yr for 09101105 thru 07101106 $1,038.74 110. 3rd at! Sewer and Refuse 115.00OOlqlrfOl'09lO1/05 $37.50 410. 3rd air Sewer and Refuse 115.OOOOIqtrfor 09101105 137.50 10101(05 10101105 111. 411. 112. 412. 9/11200510:00:00 AMfa/112005 120. Gross Amount Due from Bo~r I $189,839.06 420. Gross Amount Due To SeN.r I $186,179.81 200. Amounts Paid By Or In Bahalf Of Bo~r 500, Reduction. In Amount Due To Seller 201. Earnest Money $5,000.00 501. Excess deposit 202. Principal Amount of New Loan(s) 502. Settlement Chargas To Sener (line 1400) $13,080.00 203. Existing loan(s) taken subject to 503. ExIsting loan(s) taken Subiect To 204. 504. Payoff of First Mortgage Loan 205. 505. Payoff of Second Mortgage Loan 206. 506. 207. 507. ., " 208. SO,. 209. 509. AdJusbnenb For Items Unpaid By Seller Adjustments For flam. Unpaid By Seller 210. CilylTown Taxes 510. CityfTown Taxes 211. County Taxes 511. County Taxes 212. Assessments 512. Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid ByfFor Borrower 300. Ca.h At Semamant FromITo Borrower 301. Gross Amount Due From Borrower (lIne 120) 302. Less Amounts Paid BylFor Borrower (line 220) $5,000.00 ~O, Total Reduction Amount Due Sellar 600. Cash At Settlement ToIFrom Seller $189,839.06 601. Gross Amounl Due To S.ller (nne 420) $5,000.00 602. Less [)educUOllS In Amt. Due To Seller (line 520) $13,080.00 $186,179.81 $13,080.00 303. Cash [X] From [ ]To Borrower 1184,839.061803. Cash [X] To [ ] From SeU... $173,099.81 400S:X 458 - CB L.. Settlement statement Pagf 700. Total Sales Commission 1850oo.00@6%=11100.oo PlvI.lon of Comml_on (line 700) ~ Follows: Paid FromBon"ower's Paid From Seller's 701. $11100.0010 ERA-NRT, Inc. Funds AI Settlement Flmds At Senterrenl 102. Salling Agent CommIsskm 703. COl'TlITlission paid al settlement $11.100.0 706. Transacllon Fee to ERA-NRT. Inc. $125.0 707. Transacllon Fee to ERA-NRT, Inc. $125.00 800. lt8ms Payable In Connection WIth Loan 601. Loan Origination Fee 602. Loan Dlscount 803. Appraisal Fee 804. Credit Report 005. Lender's Inspection Fee 900. lt8ms Reqplred By Lender To Be Paid In Advance 901. Interest From 902. MOl1gage Insurance Premium for 903. Hazard Insurance Premium for 1000. R.S8lY8S Deposited With Lender 1001. HllZsrd Insurance 1002. Mortgage Insurance 1003. City Property Taxes 1004. County Property Taxes 1100 Title Charges 1101. s.tlIemenl: or Closing Fee 1102. Abstract or Tide Search 1103. "Tille ExaminBtkm 1106. Notary Fees to C~ $2.00 $5.00 1107. Attorney's Fees 1108. TrIIe Insurance to Secured land Transfel$ - Mechanlcsburg $1,283.75 1109. lender's Coverage $ ($) 1110. Owner's coverage $185000.00 ($1283.75) 1116. Wire Fee to Secured Land Transfers. Mechanlcaburg $35.00 1200. Government Recording And rl1lnsfer Charg.. 1201. Recording Fees: Deed $ 38.50; Mortgage $ 1202. CltylCcunly Tax/Stamps 165Q.OQ 1203. Siate Deed Tax $ 1850.00 1205. 1300. AddlUomlll Settlement Charges 1304. Home Inspecllon to South Central PA Home Inspection Co.. Inc. $325..00 1400. Total Settlement Charg.. (Enter On LlPe. 103, Section J And 502, SectIon K) $3,659.25 $13,030.00 , have C8refuUy reviewed the H 0-1 Settlement statement and to the beSt of my knowledge end belief Ills true and accurate stalement of an receipts and dfsbursemenlS on my 8GCOUllt or by me iI\ lhls tf8M8C\\On. , further certify tt1al Il'Iave received 8 copy of the HUD-1 Settlement State t. $38.50 $1,650.00 $1,850.00 .Z?~;nJoe~,..dW P81ncla. us The HUD-1 Senlement Statement wI1ich I have prepared Is a true and aceurafe s ::::::: C. fj. IXI.A 12 0 0' \. a Pri...Q SECURED LAND TRANSFERS - MECHANICSBURG Estate 1. Robert H. Royer wW l~fl.lrnlSlobetlisbuJfled iI\ "".. 91112005 10:00:00 AM ~:'c., <....:.;;, 11-07-2005 ROYER 12-03-2004 21 04-1175 CUMBERLAND 101 APPEAL DATE: 01-06-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 9~!_~~9~~_!~!~-~!~~______~___~~!~!~_~~~~~_~~~!!~~_f~~_y~~~_~~~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ROBERT H FILE NO. 21 04-1175 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 AP~RAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DAVID H STONE STONE HAL 414 BRIDGE ST NEW CUMBERLAND DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ESQ PA 17070 ESTATE OF ROYER REV-1547 EX AFP (06-05) ROBERT H TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 11-07-2005 If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS. . n....'" I I+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-01-2005 '" CD005002 473.68 9,000.00 09-08-2005 "- CD005780 .00 524.73 TOTAL TAX CREDIT 9,998.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .36 TOTAL DUE .36 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets Cl) (2) (3) (4) (5) (6) (7) 185,000.00 3.607.45 .00 .00 89.199.33 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) ClO) 27,555.18 NOTE: 28.064. 71 (11) Cl2) Cl3) Cl4) .00 222,186.89 .00 .00 X 00 = X 045 = X 12 = X 15 = Cl9)= · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 277,806.78 55.619 89 222,186.89 .00 222,186.89 .00 9,998.41 .00 .00 9,998.41 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE nil A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 1<1' STATUS REPORT UNDER RULE 6.12 Name of Decedent: Robert H. Royer Date of Death: December 3, 2004 Will No. 21-04-1175 To the Register: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. Yes X State whether administration of the estate No is complete: 2. If the answer lS 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: N/A (c) Did the personal representative state an account informally to the parties in interest? Yes~ No Date: t.;' - l, Copies of receipts, releases, joinders and of formal or informal accounts may be filed with of the Orphans' Court and may be attached to this /".,:'......,..,.._~:.~:""~l }/ \~SqUire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 (d) approvals the Clerk report. Capacity: Personal Representative X Counsel for Personal Representative vtt es~\rel\ROYERcarolynr IN RE: ESTATE OF ROBERT H. ROYER LATE OF THE TOWNSHIP OF HAMPDEN, CUMBERLAND COUNTY PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-1175 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, CAROLYN RYAN, being one of the beneficiaries under the will of ROBERT H. ROYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROBERT H. ROYER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby walve my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, CAROLYN RYAN, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the d~~~ day of 1>~c.uY) 61'(<- , 2005. ~ .' 7 ,'. Jie~ Q." j Witness f/ COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF 6~AD~olLl.> On this, the C?q ~ day of J)'EQf T" eER- , 2005, before me a Notary Public, the undersigned officer, personally appeared CAROLYN RYAN, 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 have hereunto set my hand and seal the day and year first above written. if' , ' t' C \ } ~\...,--'LJv"'--l... ,. Cu{,\...7c::J Notary Public -2- COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marianne E. Everts. Notary Public Troy Boro. Bradford County My Commission Expires Oct. 12.2008 Member, Pennsylvania Association of Notaries est\rel\ROYERmaryann IN RE: ESTATE OF ROBERT H. ROYER LATE OF THE TOWNSHIP OF HAMPDEN, CUMBERLAND COUNTY PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-1175 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, MARY ANN WILLIARD, being one of the beneficiaries under the will of ROBERT H. ROYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROBERT H. ROYER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby walve my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, MARY ANN WILLIARD, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and asslgns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the (1 Qc. . .. .....-.. '., 1!1 ..'.__H'_-':"~'.. .' . /.-" ''\: ~~~j) ~ day of , 2005. m. a. :b~<t-d MARY ANN WILLIARD COMMONWEALTH OF PENNSYLVANIA: SS: CO UN T Y 0 F Uu,.,f>t Lli\Yv_D On this, the I C1~' day of fuZfLl/\}U./C- , 2005, before me a Notary Public, the undersigned officer, personally appeared MARY ANN WILLIARD, 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 have hereunto set my hand and seal the day and year first above written. '\ z::~ ~}l '-iLL>t!(fL1 Notary Public .~ -2- L TINA M. BURKEY, Notary Public New Cumberland Boro, Cumberland CO. I My Commission Expires April 15, 2009 f. , < est\rel\ROYERluke IN RE: ESTATE OF ROBERT H. ROYER LATE OF THE TOWNSHIP OF HAMPDEN, CUMBERLAND COUNTY PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-1175 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LUKE WILLIARD, being one of the beneficiaries under the will of ROBERT H. ROYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROBERT H. ROYER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution In any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LUKE WILLIARD, do by these presents, remlse, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. --, "7 IN WITNESS WHEREOF, I have hereunto set my hand and seal the &J day of ~\ 1 1)2 (:0 v' he r- 2005. / I (/ i . 1/ i /' i, f;. Witness I -I ! i .-I) JZ / //~'~,,' ..' ' __)' (, I " , . L i .I , ' .;N' ..~~ rJ"1 I, /~ j1 j/ LUKE WILLIARD COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF On this, the '2?) J (teL day of !::wu~~1 , 2005, before me a Notary Public, the undersigned officer, personally appeared LUKE WILLIARD, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ S (jJ\ ;::;14~ !<-D S Aj Notary Public .A .-, ".--'-~".'~"'-'-'~'._W_'->l ! ! ! ] I ____...J ~'...~'~' -2- est\rel\ROYERcarolynrazo IN RE: ESTATE OF ROBERT H. ROYER LATE OF THE TOWNSHIP OF HAMPDEN, CUMBERLAND COUNTY PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-1175 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, CAROLYN RAZO, being one of the beneficiaries under the will of ROBERT H. ROYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROBERT H. ROYER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby walve my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate willlout further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, CAROLYN RAZO, do by these presents, remlse, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, of .JJoc.p.r.,A<.r I have hereunto set my hand and seal the ~~ day , 2005. Witness STATE OF CALIFORNIA SS: COUNTY OF O'Y"l~O----"" On this, the 02.~ day of ~e.k'<?'V$'\~G\lS'"- , 2005, before me a Notary Public, the undersigned officer, personally appeared CAROLYN RAZO, knQ~~Iil -&3 j"C (or satisfactoriJ y 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 have hereunto set my hand and seal the day and year first above written. ~~~~ -2-