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Home My WebLink About02-0591Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Gloria A. Dillree Rickert No. Z.~ ~ 02• ,,, g~_ also known as Gloria A. Dillree Deceased Social Security No. 198-18-9852 Petkioner(sl. who is~aze 7 B years d age a rider, applylies) for_ (COMPLETE'A° OR'B° BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executor named in the Last Will of the Decedent, dated Aril 11 1997 State relevant drwmstmces, e.g., renundation, death of executor, etc. Except as follows, Decedent did not marry, 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 Administration (d.b.n.c.t.e.: pendentel¢e; durance absentia; durante minodtate) Petitioner(s) after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) and Decedent, then 79 years of age, died June 18, 2002, at Holy Spirit Hospital, C~ mp Hill, PA 17011 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property .................................................. . (It not domiciled in PA) Personal property in Pennsylvania ................................ . (If not domiciled in PA) Personal property In County .................................... . Value of real estate in Pennsylvania ................................................................ . Total ............................................................................... Real Estate 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 undersigned: re n ,~ Typed or printed name and residence Form FiW-1 Page 1 of 2 (Dauphin Counryl - qev. 9I9T $ 115,000 $ 115,000 i~- ~z-I Richard L. Rickert 2208 Logan Street Camp Hill, PA 17011 Decedent was dot~iciled at death in Cu erland County, Pennsylv nia It he last family or principal residence at 2208 Logan Street, Camp Hill. PA 17011 / ~ !1 Q ~ ~ lyZ-~.Z- ~ ~ l ~ ~~ Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 represe tative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to I f Sworn to and affirmed and subscribed before me this ~hth day of C JUNE- , 2002 ~ l~~ ~ - ~ C ~~ ~~ .- t ' R ire;, I LL S , . / ~,~ ~~ No. ®~ - C.~;~ ~~ 1 Estate of Gloria A Dillree Rickert a/k~a Gloria A Dillree _ Deceased Social Security No: 198-18-9852 Date of Death: June 18 2002 AND NOW, 7 THE 26 _, 2002, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters JB(Testamentary ^ of Administration d.b.n.c.t.; pendente IRe; durante absentia: durante minordate are hereby granted to Richard L. Rickert in the above estate and that the instrument(s) dated April 11 1997 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters Short Certificate(s)..5. Renunciation ................ Affidavit ( ) ................ Extra Pages ( ).......... Codicil ......................... JCP Fee ....................... Inventory Other...... $ 235.00 ~'f~'e~c~i' ~ ~ 1~ ~, „~~U,('j'C,'.~ ~~t-< - Y C L S Register of Wills $ 15.00 $ 18.00 $ 5.00 Attorney: Patricia Armstrong $ I.D. No: 23725 ,,,,,,,,,,,,,,,,, $ Address: 212 Locust Street, Suite 500__ Harrisburg PA 17101 TOTAL ................ $ 273.00 Telephone: 717/255-7600 FILED 6-26-02 MAILED TO A'ITY 6-26-02 Form RW-1 Page 2 of 2 (Dauphin County) -Rev. 9192 IIn~3i~ KF~'a8r, This is to cer~ifv that the information here given is correetly copied from an original certificate of death dilly filed with me as Local Registrar.-1•he original certificate will be forwarded to the Stare Vital Records Office for per(ranent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fce for this crrtiticaTe, $2.00 _ P_8384453 Nr. s. La R.r. ve7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ~ iJ ti ~ Zouz i Tate NAME OF DECEDENTIFrsr. Makaa. Taal SEX SOCIAL SECURITY NUMBER DATE OF OEAIN,MCrun. pay, hYl +• r ~ } ,rt _ 2• Fc-~na1P ~- 198 - 18 - 9852 a~~t1 } ~~ {-,~/-~ AGE (loY Brllway) UNDER, YEAR UNDER 1 DAY OATS OF BIRTH BIi,TNPUCE IC.N a q PUCE OF OERN ICMcM rsry nne-- ,ta.nslrucbcvg m.Xnei styl MoNM ( Days Nava . Mirwlq !Moron. Day. '4erl Slalsa fuagn CdwarYl OTHER: __ _..___.__. __.. -___--.. HOSPITAL Y 1`y, InpalyM lLT ERIOuIPinaa ^ DOA ^ ~ ^I OIMr ^ Ras-0tnu lJ IS ~y ) ^ '. s. e. Jan 28 23 ,. Hazelton, Pa W Y .., • 000HTY OF DERV CRY, BORO. TWP Of DEATH FACILITY NAME pI Ml nvawan, tyre weal ano nanonr WAS DECEDEM OF HISPANIC ORIGIN] - --- RACE ~ Amancan Indan, &ack, WAAa, alt ~ ' No Q{ Yb ^ X yao. spocry CuMn, tSDacryl C rland b St Pennsboro ) MoXKirf,PwnoRK~rl.«e. ian e ' pECEDENT'S USUAL OCCUPRION KIND OF BUSINESSnNDUSTRY WAS DE E NT VERW O EOENT'$ EDUCATION MATUTAL STRUS•MnrW ----- - SURVIVING SPOUSE (Gna Yrddwap dory owng rtnY U.S. ARMED FORCES] EMman ~ adec ad Coaa l l5oconda a Nevn Martyd. Widowed, Drvacad (SIYeeM to waa. pr•mawnnamal d rArpinp sN; do nd use reWed) Jack u en ~~ ~ ~ Yss^ No ary ry p 10,21 ,,aayyl 12 Married Richard Rickert • ,,.. Bookkee .r tor ea „D. ,:. ,,. ,.. ,~. DECEDENT'S MAILING ADDRESS 15urIa,.Cryttorm, Stay,Iq Cooel DECEDENT'S Pa ,7c ^ Yp aec.aaliro0 ~n 2208 Logan Street RESIDENCE 17e. Sao . ; . d~.c.d.rll dndmnard.l Camp Hill, Pa 17011 1$teninuc~` b l d ~""~ Camp Hill g] `w:" x~" ~~ °°""""'"T ,6. er an ,ie.conn Ctun nd. Y al cry _-__---__- __._ _... ___- FATHER'S NAMEIFas,, Mario. lash ( MOTHER'S NAME IFrsl. Mdd4. Maaen SunMy Adam Scarcella , Jennie. Orlando ,,. INFORMANT'S NAME (IypYRnl) , INFORMANT'S MAILING ADDRESS ISraal, CrylFOwn. Sala. Zp Cafe) k 2208 Logan Street Camp Hill, Pa 17011 206 :a. . METHOD OF DISPOSITION . GATE OF DISPOSITION PUCE OF DISPOSITION • Nang aComolery, Crematory JLOCRgN ~ Ciry/Twm, Slala. Ip Coda Bllnal 1~l~ Cnmalfon ^ Removes Yen Slalar^ IMaXO, Day, Yaarl a Olen Plxe • „°;""°"^ °'"'r'SPOCry' ^ „D.7une 21 2002 „<. Rolling C>1-een Cc-~r>Ft__~_r RUBE OFF FOR PERSON ACTING AS SUCH LICENSE NUMBER NAME ANOADORE55 OF FACILITY Hill, Pa ,ne. _ „D. 011654-L „c r.rs-}~rn?r FUn~ral_Home IncCamp Hill, Pa 1701 plat lyaq y dy..d•am uccoaaJ allM lxna, dais era psu slalsd LICENSE NUMBER ORE SIGNED aamt2L{only n Gel blM Datl elm YrowN - - ~__ ~~~ plryarctan b na avadaON tl ume of daa1D b (Srprwnaa and IYy1 (MpW.OaY. Year) c.nay caua.a0oam. Itilu~l,C~f~ ~~~GISSGjZ-- 1~I1) ~.)Z`~'-~ 3 L f~IIL ly.. 7 L~c L. ~. ne. ,x. -- - - _ __ pours 2426 muM M complolad by TIME OF DERH DRE PRONOUNCED OEAD1MOnm. Day, Yeaq WAS CASE REFERRED TO MEDICAL EXAMINEWCORONERi prvaon rln promwlcaa wa01. - ~ Vat ^ No^ 2a. ~~~ l~ A M. ,S. _~Vllt" ~~~, ZV~~_ -- - - - - - 27. PART I: EMOr IM dsoaaos, m(wies a congacalgry wlntD posed IM daalp. Do not anlsr IM moon of dyvg, such as cardac or rasprralary arysl, slncp a Man laduro. I Appro:uryla PART IL ONar srgndkaM auWl4ona ranoaXAkp b danA. Dul LW orry one cause an oaU Yno. ~ nlana OaMNn na nwpVq n mo urW ~lryg ulna gran n PRAT I. • I onset and d•aln pYlYED1ATE CAUSE (Fwl C /f ~/ _ daeaso a caldeal ~ '' { ~~ I 1 eaupilq a dNml -. a. ~ . pU ~q (Ofi~SACON ~~ ` L ! ~ L y/ ~ ~ ~ ~ Sotpwnl46y Yet raasions D. - ~ `L ~/L~(.!/ ~ ~J- ~,/ r ~ ~~ ~ a~~ y f /V "t/V'"r- 1/'~-`~` _ __ it arty, Nadinq b arunadyle DUE 70 (OI(AS A CONSEQUENCE OF): 1 ullae. Emn UNOERLYINO ~ CAUSE (Daauoa aFKy c. - mal aMUleo owns DUE TOIOR AS A CONSEQUENCE OF): 1 rmpvq n deaml LAST r d. _ _ _ - WAS AN AUTOPSY WERE AUT OPSY FINDI NGS MANNER OF DEATH GATE OF INJURY TIME OF INJURY INJU RY R WORK] PEAFORME07 AWIUBLE PR10R 10 (MOnm, Oay. Year) COMPLETION OF CAUSE ~ ^ OF OEO'N7 Nalwal Homcao AccaaN ^ PandVq Imoslgalion ^ ,oa. ~Iro. r-s~ Wt ^ No y I ~ Yp ^ Flo ^ Suicide ^ Could rwt Do delnmmed ^ PUCE OF INJURY •,U Inrty, lar m, suer, / aulan9, alt. ISpecarl IM. 2eD. ,9. ,da. CERTIFIER 1Cnxr ary onel 'CERTIFYING PHYSICIAN IPDysa:ran cnaryvq cause tl oeam wean analrer DDrsa:an Ms porwt,nced deem arw com{Yeled Item 2]I ^ To Ily Wt of my Yrlowlod9a. daa1D occurred dw b W cauae(al and manner as tWM ................... ....... .. .... ............... ...... 'PRONOUNCING AND CERTIFYING PHYSICIAN IPDyscan Dom :Xawuncrg deem and cMAyvey ro cause d deaml ^ To No li*tt of my anowMdga, OeaN occwrad a, Na aura, dale, and Dlaco, and dw la IM ctuselU and manner at tlalrW .......................... 'MEDICAL E%AMINEAtCOAONER ' On Iha basin of etaminatlon andlor Inves,lgalion, In my opinion, daa,p occurred a, IDe Ilme, dale, an d place, and due,o the causelt) and ^ manner as a,a,od .... .................... ... ........ ... .. ..... .. .. .. ...... ......... ... ..... ..... ... ...... ..... ... ,ta. RE RAR'S SIGNATURE AND ~ MAR _ _ I ' / t / / ., .~~;~' l,: ----- ----~a- L~xai Regisn'ar Yp ^ No ^ a. ue. _ -- _-.. _ _ _ ..LOCATION (Spew. CryRuw~. Salal. ISE NUMBER DATE SIGNED Mwvn y, Yaarl :AND ADDRESS OF PERSON wN0 COMPLE 1 ED CAUSE OF DEATH 27 Type a Pnnl ~,ober•£ b. Kvsz~oS~M•n. - nn Uay rear r FLLEDIMp ^ / /! 1 LAST WILL AND TESTAMENT ,2~-oa-59 t GLORIA A. DILLREE of 2208 Logan Street, Camp Hill PA 17011, being of sound mind, memory and understanding and considering the uncertainty of life, do hereby make, publish and declare this to be my Last Will and Testament; hereby making null and void all prior wills and codicils thereto, by me heretofore made. FIRST I direct that all my debts, including the expenses of my last illness, and funeral expenses be paid as soon after my death as may conveniently be done. SECOND I give, devise and bequeath all the tangible personal property owned by me at the time of my death, together with all insurance policies thereon, to RICHARD L. RICKERT, my husband, provided that he survives me by thirty (30) days. THIRD I give and bequeath to the following individuals the following amounts: To YVONNE MIELE, the sum of SIX THOUSAND FIVE HUNDRED ($6,500.00) DOLLARS. To JASON MIELE, the sum of SIX THOUSAND FIVE HUNDRED ($6,500.00) DOLLARS. To JACELYN MIELE, the sum of TWO THOUSAND FIVE HUNDRED ($2,500.00) DOLLARS. To SUSAN C. MOSTERT, the sum of SIX THOUSAND FIVE HUNDRED ($6,500.00) DOLLARS. To ROSE OLANDER, the sum of FOUR THOUSAND ($4,000.00) DOLLARS. To BRIGETTE RICKERT, the sum of TWO THOUSAND ($2,000.00) DOLLARS. To SPENCER RICKERT, the sum of TWO THOUSAND ($2,000.00) DOLLARS. FOURTH I give, devise and bequeath the rest, residue and remainder to RICHARD L. RICKERT, my husband, provided that he survives me. In the event that RICHARD L. RICKERT, my husband, fails to survive me, I give, devise and bequeath the rest, residue and remainder of my estate: To YVONNE MIELE, a fifteen (15%) percent share. To JASON MIELE, a fifteen (15%) percent share. To JACELYN MIELE, a nine and one hundred sixty-six thousandths (9.166%) percent share. To SUSAN C. MOSTERT, fifteen (15%) percent share. To ROSE OLANDER, a nine and one hundred sixty-six thousandths (9.166%) percent share. To BRIGETTE RICKERT, a nine and one hundred sixty- six thousandths (9.166%) percent share. To SPENCER RICKERT, a nine and one hundred sixty-six thousandths (9.166%) percent share. To BRETT M. RICKERT, a nine and one hundred sixty-six thousandths (9.166%) percent share. 2 To SCOTT L. RICKERT, a nine and one hundred sixty-six thousandths (9.166%) percent share. FIFTH I nominate, constitute and appoint RICHARD L. RICKERT, as Executor of this my Last Will and Testament. In the event that he does not survive me, or if he renounces, resigns, or is otherwise unable to act as Executor, I nominate, constitute and appoint JOSEPH SCARCELLA, as Executor of this my Last Will and Testament. In the event that he does not survive me, or if he renounces, resigns, or is otherwise unable to act as Executor, I nominate, constitute and appoint FRANK OLANDER, as Executor of this my Last Will and Testament. I hereby relieve my Executor from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able to do so by law. IN WITNESS WHEREOF, I, GLORIA A. DILLREE, have to this my Last Will and Testament, consisting of three (3) pages, set my hand and seal this 11th day of Apr i 1 , 97. ~ ,,, .r C~' ,7(/J~ GLORIA A. DILLREE SIGNED, SEALED, PUBLISHED and DECLARED by GLORIA A. DILLREE, the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses. 4' ~° 7 3 COMMONWEALTH OF PENNSYLVANIA :SS. COUNTY OF SCHUYLKILL . I, GLORIA A. DILLREE, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it as my free and voluntary act and for the purposes therein expressed. Sworn to or affixed and acknowledged before me, by GLORIA A. DILLREE, the Testatrix, this 1 lth day of April, 1997. ~ r r c t!~ rat-Gtr _ ~f ~''.~~~~..1'/ LORIA A. DILLREE ,~~~ JO .JON ,ESQUIRE A ber of the Bar of the Highest Court of Pennsylvania ut vs~ o ~wox>roxit~wttlsnttumn noc COMMONWEALTH OF PENNSYLVANIA :SS. COUNTY OF SCHUYLKILL -~ I ~L.,9i'. / ~,,.. J U~~~ r~, ~~'~`'' ,one of the witnesses, whose name is signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that I was present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that the Testatrix signed willingly and executed as her free and voluntary act for the purposes therein expressed; that each subscribing witness in hearing and sight of the Testatrix signed the will as a witness; and that to the best of my knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to and affirmed to and subscribed to before me by ,~-~ ~~. ~~~,..~ ,Witness, this 11th day of April, 1997. )) l Witness ~.- ,~.,-. JO NE SQUIRE A er of the Bar of the Highest Court of Pennsylvania ut iroio:~wo~o~uc~waisnnu+axr Doc COMMONWEALTH OF PENNSYLVANIA :SS. COUNTY OF SCHUYLKILL I, JOSEPH H. JONES, one of the witnesses, whose name is signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that I was present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that the Testatrix signed willingly and executed as her free and voluntary act for the purposes therein expressed; that each subscribing witness in hearing and sight of the Testatrix signed the will as a witness; and that to the best of my knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn ~o and affirmed to and subscribed to before me by r ~i ~._` ~ ~!~~ff` ,Witness, this 11th day of April, 1997. s ,, ,~; ~; J ~ . JO S, WITNESS A ember of the Bar of the Highest Court of Pennsylvania ~r 4 ~f ,,~'/ = ~ r, ,~ J , NOTARY PUBLIC ! n~c ~~ ai vs~ro~woxrnDtm~wnlswnuixTr.DOc COMMONWEALTH OF PENNSYLVANIA COUNTY OF SCHUYLKILL On this, the 11th day of April, 1997, before me, the undersigned officer, personally appeared JOSEPH H. JONES, ESQUIRE, known to me or satisfactorily proven to be a member of the bar of the Highest Court of Pennsylvania, and certified that he was personally present when the foregoing acknowledgement and affidavit were signed by the Testatrix and witness. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~ r n OTARY PUBLIC '~ ~ M am ~ue~ic r~. ~~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Gloria A. Dillree, a/k/a Gloria A. Dillree Rickert Date of Death: June 18, 2002 Will No. 2002-00591 Admin. No. To the Register: I certify that notice of beneficial interest 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 July 18, 2002: Name Address City, State Zip Richard L. Rickert 2208 Logan Street Camp Hill, PA 17011 Susan C. Mostert 17422 Cambridge Grove Drive Huntersville, NC 28078 Spencer Rickert 4 Cromwell Court Mechanicsburg, PA 17055 Scott L. Rickert 4 Cromwell Court Mechanicsburg, PA 17055 Brent M. Rickert 4 Cromwell Court Mechanicsburg, PA 17055 Jason Miele 244 Dana Street Wilkes-Barre, PA 18702 Jacelyn Miele 244 Dana Street Wilkes-Barre, PA 18702 Yvonne Miele 244 Dana Street Wilkes-Barre, PA 18702 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A F Date: '~ ' ' z ~ ~' LL ~` ~ .r~: ~'c~~ ~., `~-. ~-~-~ - :Signature Name Patricia Armstrong, Esquire Address 212 Locust Street, P.O. Box 9500 Harrisburg, PA 17108-9500 Telephone (717) 255-7600 Capacity: Personal Representative X Counsel for personal representative Adopted April 30, 1992, to apply to decedents dying on or after July 1, 1992. F:\CLIENTS\MISC\D I LLRE E\Probate\CE RT5.6A.wpd COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER NO. CD 002124 ARMSTRONG PATRICIA 212 LOCUST STREET P O BOX 9500 HARRISBURG, PA 17108-9500 fold ESTATE INFORMATION: Ssrv: iss-~a-ss52 FILE NUMBER: 2102-0591 DECEDENT NAME: DILLREE GLORIA A DATE OF PAYMENT: 02/04/2003 POSTMARK DATE: 02/03/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/ 1 8/2002 REV-1162 EX(11-961 AMOUNT 101 ~ 53,390.00 TOTAL AMOUNT PAID: REMARKS: RICHARD L RICKERT CHECK#501 SEAL INITIALS: VZ RECEIVED BY DONNA M. OTTO 53,390.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS ,.. , 'C\--f;'\ I( . J-. ~ REV-I500EX(6-UOI *' COMMONWEALTH OF . ' PENNSYLVANIA , .!lIii., DEPARTMENT OF REVENUE DEPl 280601 , HARRISBURG, PA 17128-0601 w >- ::.::~CI.l 0"'''' w"o ",00 0"'''' .... .. '" ll-l;}-I REV-1500 INHERITANCE TAX RETURN ~~NUMBER RESIDENT DECEDENT ~- 0 ONl. 2 o 0 5 9 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Dillree, Gloria A., d/b/a Gloria A. Dillree Rickert I- Z W o W U W o DATE OF DEATH (MM-DD-YEAR) 06/18/2002 SOCIAL SECURITY NUMBER 198 - 18 - 9852 DATE OF BIRTH (MM-DD.YEAR) 01/28/1923 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Richard L Rickert >- z w '" z 0 FIRM NAME (If Applicable) .. '" THOMAS, THOMAS, ARMSTRONG & NIESEN w '" '" TELEPHONE NUMBER 717-255-7600 0 0 1. Real Estate (Schedule A) (1) None 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) $64,210.66 Z (Schedule E) 0 None 6. Jointly Owned Property (Schedule F) (6) ~ D Separate Billing Requested None ::::l 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) I- (Schedule G or L) c: c:( 8. Total Gross Assets (total Lines 1-7) U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) $16,444.70 w a:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 00 1. Original Retum o 4. Limited Estate IX 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received 1369 o 2. Supplemental Retum o 4a. Future Interest Compromise (d~\e o/dealh ~f1er 12.12.82) o 7. Decedent Maintained a Living Trust (Atlacl1copyofTrusl) o 10. Spousal Poverty Credit (date o/death between 12-31-91 and 1-1.95) o 3. Remainder Return (dale of daalh prior to 12-13-(2) o 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) {Attach Sch 0) I")i. '.iSt: ONL $64,210.66 (8) (11) $ 16,444.70 (12) $ 47,765.96 (13) -0- (14) $ 47,765.96 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax $ 23,765.96 -0- rate, or transfers under Sec. 9116 (a)(1.2) ~..._.___ x.O ~"'~ (15) $ 2,000.00 __x.O~ $ 90.00 16. Amount of Line 14 taxable at lineal rate (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) $ 22,000.00 $ 3,300.00 18. Amount of Line 14 taxable at collateral rate -------.- x.15 (18) (19) $ 3,390.00 19. Tax Due z o !;;: I-' ::::l 0.. ::!; o u g CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT - Decedent's Complete Address: STREET ADDRESS 2208 Logan Street CITY Camp Hill I STATE PA I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $ 3,390.00 Total Credits (A + 8 + C ) (2) 3. InteresUPenalty if applicable D.lnterest E. Penalty TotallnteresUPenalty ( D + 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. ThIs is the TAX DUE. $ 3,390.00 A. Enter the interest on the tax due. (5) (SA) 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT $ 3,390.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS .................. --l IKJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;................ ......................... b. retain the right to designate who shall use the property transferred or its inceme; ................... c. retain a reversionary interest; or............ ............................... ................. ....... ................. d. receive the promise for life of either payments, benefits or care? ....................... 2. If death occurred after December 12, 1962, did decedent transfer property within one year of death without receiving adequate consideration? ................ ......................... .................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 4. Did decedent own an Individual RetirementAccount, annuity, or other non-probate property which contains a beneficiary designation? ..................... .................. Yes o ........0 ............0 o o o No IKI I!I I!I IKJ ~ [!I Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of pre parer olherlhan the personal represenlative is based on all i nformalionofwhichpreparerhasanyknowledge. SIGNAT~::?:~Z~~OA:'~._ ADDRESS 2208 Logan Street, Camp Hill, PA 17011 DATE /-.:-:rO-.. 0:; SI~~ h~;;~or~H&~:RESENTA~IVE ADDRESS V. 212 Locust Street, P.O. Box 9500, Harrisburg, PA 17108-9500 DATE /-3(-{J~.~ 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 (al (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)l. 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 slepparent of the child is 0% [72 P.S. 99116(a)(I.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries is 4.5%, except as noted in 72 P.S. 99116(1.2) {72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(I.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-150B EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Gloria A. Dillree Rickert, alkJa Gloria A. Dillree FILE NUMBER 2002-00591 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned wIth right of survlvorst\lp. must be- dlsclo$td on Sched\lle F. ITEM NUMBER DESCRIPTION 1. Waypoint Bank Checking Account. #310002795 P.O. Box 1711 Harrisburg, PA 17105-1711 VALUE AT DATE OF DEATH $64,210.66 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) $64,210.66 REV-1511 EX+ (12-99) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Gloria A. Dillree Rickert, a/kJa Gloria A. DUlree FILE NUMBER 2002-00591 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers-Harner Funeral Home $6,668.00 Obituary 180.00 Rolling Green Cemetary 1,330.00 Knights of Columbus - Post Funeral 1,493.70 ADMINISTRATIVE COSTS: Waived B. 1. Personal Representative's Commissions Richard L. Rickert Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Slreel Address 2208 Logan Street City Camp Hill Slale ~Zip 17011 Year(s) Commission Paid: 2. Attorney Fees 3,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Richard Rickert 3,500.00 Street Address 2208 Logan Street City Camo Hill Slale~Zip 17011 Relationship of Claimant to Decedent Spouse 4. Probate Fees 273.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enler on line 9, Recapitulalion) $ 16,444.70 (If more space is needed, insert additional sheets of the same size) " ~ LAST WILL AND TESTAMENT 2.'-02.-591 GLORIA A. DlLLREE of2208 Logan Street, Camp Hill PA 17011, being of sound mind, memory and understanding and considering the uncertainty of life, do hereby make, publish and declare this to be my Last Will and Testament; hereby making null and void all prior wills and codicils thereto, by me heretofore made. FIRST I direct that all my debts, including the expenses of my last illness, and funeral expenses be paid as soon after my death as may conveniently be done. SECOND I give, devise and bequeath all the tangible personal property owned by me at the time of my death, together with all insurance policies thereon, to RICHARD L. RICKERT, my husband, provided that he survives me by thirty (30) days. THIRD I give and bequeath to the following individuals the following amounts: To YVONNE MIELE, the sum of SIX THOUSAND, . . .._n._...~_ . FIVE HUNDRED ($6,500.00) DOLLARS. To JASON MIELE, the sum of SIX THOUSAND FIVE HUNDRED ($6,500.00) DOLLARS. To JACEL YN MIELE, the sum of TWO THOUSAND FIVE HUNDRED ($2,500.00) DOLLARS. To SUSAN C. MOSTERT, the sum of SIX THOUSAND FIVE HUNDRED ($6,500.00) DOLLARS. I j~ll X To ROSE OLANDER, the sum of FOUR TIIOUSAND ($4,000.00) DOLLARS. Y-.. To BRIGETTE RICKERT, the sum of TWO TIIOUSAND ($2,000.00) DOLLARS. To SPENCER RICKERT, the sum of TWO rnOUSAND ($2,000.00) DOLLARS. FOURTH I give, devise and bequeath the rest, residue and remainder to RICHARD L. RICKERT, my husband, provided that he survives me. In the event that RICHARD L. RICKERT, my husband, fails to survive me, I give, devise and bequeath the rest, residue and remainder of my estate: , To YVONNE MIELE, a fifteen (15%) percent share. To JASON MIELE, a fifteen (15%) percent share. To JACEL YN MIELE, a nine and one hundred sixty-six thousandths (9.166%) percent share. To SUSAN C. MOSTERT, fifteen (15%) percent share. To ROSE OLANDER, a nine and one hundred sixty-six ~. . .- ." ..-.-- thousandths (9.166%) percent share. To BRIGETTE RICKERT, a nine and one hundred sixty- six thousandths (9.166%) percent share. To SPENCER RICKERT, a nine and one hundred sixty-six thousandths (9.166%) percent share. To BRETT M. RICKERT, a nine and one hundred sixty-six thousandths (9.166%) percent share. 2 ;~'':!.;r:~;,;i;:. To SCOTT L. RICKERT, a nine and one hoodred sixty-six thousandths (9.166%) percent share. FIFI'H I nominate, constitute and appoint RICHARD L. RICKERT, as Executor of this my Last Will and Testament. In the event that he does not survive me, or ifhe renoooces, resigns, or is otherwise unable to act as Executor, I nominate, constitute and appoint JOSEPH SCARCELLA, as Executor of this my Last Will and Testament. In the event that he does not survive me, or if he renounces, resigns, or is otherwise unable to act as Executor, I nominate, constitute and appoint FRANK OLANDER. as Executor of this my Last Will and Testament. I hereby relieve my Executor from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able to do so by law. IN WITNESS WHEREOF, I, GLORIA A. DlLLREE, have to this my Last Will and Testament, consisting of three (3) pages, set my hand and seal thiS~~t~ .daY of APr_i~H L d ;J ~I~-.------=,;."" /GLORIA A. DlLLREE SIGNED, SEALED, PUBLISHED and DECLARED by GLORIA A. DlLLREE, the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the - presence of each other, all being present at the same time, have hereooto subscribed our names as witnesses. - ~??~ 3 _.. -.---.' .Lo....:;,.2:;;.~\"'~\:,;,'i.J;'if.,.,,~~,.". .",'.... . . '.' ......, "'J~Jj~UIWIf ll., '~":t-'''f;l'l'' -r......;" . ..~~~' ~ ~' ,-","~,.."...,..-. COMMONWEALTH OF PENN8YLV ANIA COUNIY OF SCIRJYLKILL :88. . . I, GLORIA A. DILLREE, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it as my free and voluntary act and for the purposes therein expressed, Sworn to or affixed and acknowledged before me, by GLORIA A. DILLREE, the Testatrix, this 11th day of April, 1997, ht~~ 1l8~/ GLORIA A. DILLREE < J~~O~llIRE A ber of the Bar of the Highest Court of Pennsylvania - COMMONWEALTH OF PENNSYLVANIA COUNTY OF SCHUYLKILL :ss. . . I, ~ t1. ~ . one of the witnesses, whose name is signed to the attached or foregoing instrument, being dilly qualified according to law, do depose and say that I was present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that the Testatrix signed willingly and executed as her free and voluntary act for the purposes therein expressed; that each subscribing witness in hearing and sight of the Testatrix signed the will as a witness; and that to the best of my knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to and affirmed to and subscribed to before me by ~ tl.?~ . Witness, this lIth day of April, 1997. ~ti,/~ Witness ~/~~ ( JO NE SQUIRE _ A er 0 the Bar of the Highest Court of Pennsylvania "",.:....... . '. . . . . .' ..... - '""'~-'1f~?f'",:;liE(ri,1"='''w~.=' ~." :SS. COMMONWEALTH OF PENNSYLVANIA COUNTY OF SCHUYLKILL . . t I, JOSEPH H. JONES, one of the witnesses, whose name is signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that I was present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that the Testatrix signed willingly and executed as her free and voluntary act for the purposes therein expressed; that each subscribing witness in hearing and sight of the Testatrix signed the will as a witness; and that to the best of my knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn .0 and affirmed to and subscribed to before me by , Witness, this 11 th day of April, 1997. ~~ r J . JO S, WITNESS A ember of the Bar of the Highest Court of Pennsylvania ~!llrd I!mJ NOTARY PUBLIC ~\ \ ~~~~a~ i `~' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 PATRICIA ARMSTRONG THOMAS ETAL PO BOX 9500 HBG PA COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% ~FP (01-03) DATE 03-31-2003 ESTATE OF DILLREE-RICKERT GLORIA DATE OF DEATH 06-18-2002 FILE NUMBER 21 02-0591 COUNTY CUMBERLAND ESQ ACN 101 Amount Remitted 17108 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _____________________ -------------------------- ---------------------------------------------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DILLREE-RICKERT GLORIA A FILE N0. 21 02-0591 ACN 101 DATE 03-31-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 00 NOTE: To insure proper 1. Real Estate (Schedule A) (1) . 00 credit to your account, 2. Stocks and Bonds (Schedule B) (2) . 0 0 submit the upper portion 3 Closely Held Stock/Partnership Interest (Schedule C) (3) . . 4 Mortgages/Notes Receivable (Schedule D) (4) .00 of this fore with your . 5 Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 64,210.66 tax payment. . 6 Jointly Owned Property (Schedule F) (6) .00 . 7. Transfers (Schedule G) (7) .00 210 .66 64 8. Total Assets (8) , APPROVED DEDUCTIONS AND EXEMPTIONS: 16,444.70 9 Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) . 10. Debts/Mortgage Liabilities/Liens (Schedule I) [ 10) .00 44 70 11. Total Deductions (11) . 16.4 47,765.96 12. Net Value of Tax Return (12) .00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) [13) 47,7 65.9 6 14. Net Value of Estate Subject to Tax (14) NOTE: if an assessment was issued previously, lines f ALL 14, ret 15 andior 16, 17, 18 and 19 will urns assessed to date. reflect figures that include the total o ASSESS MENT OF TAX: 23,765.96 X 00 _ .00 - 15. Amount of Line 14 at Spousal rate (15) 04 00 000 2 5 = 90 .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) X . , 1 2 00 (17) t .00 X -_ . 17. e Amount of Line 14 at Sibling ra 15 00 000 22 = 3,300.00 teral/Class B rate (18) ll t C X . , 18. a o Amount of Line 14 taxable a 390.00 3 19. Principal Tax Due (19 , )= DATE -03-20 /PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT 3,390.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. pFREFUND.DSEEIREVERSECSIDEAOFATHISEFORM FOR)INSTRUCTIONS,DUE PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 O Name of Decedent: Gloria A. Dillree, a/k/a Gloria D. Rickert Date of Death: 06/18/02 Will No.: Did the personal representative state an account informally to the parties in 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: 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: If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes interest? Yes B. The separate Orphans' Court No. (if any) for the personal representative's account is: C. D Admin. No.: 2002-00591 No X No N/A Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and maybe attached to this report. Date: March 31, 2003 :. 'e ,~. ,L- ignature Patricia Armstrong Name (Please type or print) 212 Locust Street, Suite 500, Hamsburg, PA 17101 Address (717)255-7627 Telephone No. (MAH:rmt/AM3) Capacity: Personal Representative X Counsel for Personal Representative R.W. - 27