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HomeMy WebLinkAbout01-0030 c.. REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 ..200 ~ DEPARTMENT OF REVENUE jt:,- -s DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0030 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Hoke, Rodqer E. 192-30-0273 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 12/26/00 02/14/1934 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Hoke, Leah, J. 3. Remainder Return CHECK r Original Return ~' Supplemental Return ~ (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12~12-:82) PRIATE 6. Decedent Died Testate 7. DecedentMalntalnedaLlvlng Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will} (Attachacopyof Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credlt<date of deatl"\ betwE!\'!r1 0 11. Election to tax untler Sec. 91 13(A) 12-31-91 and 1-1-95) (Attach Seh 0) tll\$:$:~NM\!$T'I;ll$$Ql\iI!1~j$U!PtAliW$Qljt!Il$RQjljpll~.QQNffli~I\ffIAlntAXIf.ll@ijMArlQi!$Ilq!lu\\llijpli'il$q;jjlbmm NAME COMPLETE MAILING ADDRESS COR- Richard e. Snelbaker 44 West Main Street RE- FIRM NAME (If Applicable) Mechanicsburg , PA 17055 SPON DENT Snelbaker, Brenneman & , p.e. TELEPHONE NUMBER 717-697-8528 None QFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 2,088.91 0 f'ln,<p.lv Held Corporation, Partnership or So ie-Proprietorship. (3) None I 4. Mortgages & Notes F. ,edule 0) (4) None 5. Cash, Bank Deposits ,~ Miscellaneous Personal Property (Schedulr.; f (5) 4,234.80 6. Jointly Owned Property tScheaull:: - " 0 Separate Billing Requested (e' None -~ RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) None 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 15,285.10 None (11) (12) (13) 6,323.71 15,285.10 (8,961.39) None (14) (8,961.39) TAX COMPU- TATION SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 0.00 X.O 0 (15) 16. Amountof Line 14taxableat lirlealrate 0.00 X.a ~ (16) 17. Amountofline14taxableatsiblingrate 0.00 x.12 (17) 18. Amounto1line 14taxableatcollateralrate 0.00 X .15 (18) 19. Tax Due (19) 20. 0 l.eHi:pK\'l"'R.Eillt'#)Q'ME!W;$ill!,~~iR~l'ltiQf#I'l'd~l!!'!AYMEfffl 0.00 0.00 0.00 0.00 0.00 .. ..... """"/@El!,$jjlle:T&#iii$,W~#@@i:lE!tti&N$g@!"i;&Eil#iiiti,fflEG8EOK'MAThlii~",."",.""",,"'" o PA15001 NTF 29755 Copyright 2000 GreatlandlNelcc LP - FcrmsSoftware Only PA REV-1500 EX (6-00) D d 'C I Page 2 ece ent s omolete Address: STREET ADDRESS 110 Woods Drive CITY I STATE I ZIP Mechanicsburo PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit S. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ~C~X~~R!~!~I~Ag~6~~6!i!~~~~~~;6~~~~~~2i!~x~ (3) 0.00 (4) (5) 0.00 (SA) 0.00 (58) 0.00 "X" '::>}~{:}:{:}:{::::\/:::::}:{:::::}}::}}/}\\:/:::}::::::.;j}::::::,=::::::':::::::::::::::::::}:::::\?:::::: .;.;.:-,.;-:-:.,.:.;.,.:.;-:.:.,.::..:.:::...;.,.,.;.;.,.;';';';':-";':';';-";-'-;-'-:-":-:"""-'-:::'.-.,::;,..,.,:....:-;.,.;.:-:...;.:-;.;.;.;.;.:.;.;.;-:.:.:-..;.." INTHEAPPROPRIATESLoCKS.. . Yes No ~ I B ~ 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 income; c. retain a reversionary interest; or. . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12,1982, 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 Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . 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 perjury, I declare that I have examined this r~turn, including accompanying schedules and stat~me.nts, and to t~e best <?f my knowledge and behef, it IS true, correct and complete. Declaration of preparer other than the personal representative IS based on information of which preparer has any knowledqe. SIGNA RE OF PERSON RESP NSI8LE FOR FILING RETURN OAT 101 .0 ~ e attached PARER OTHER THAN REPRESENTATIVE DATE 9 O!~ bl A 44 West Main Street, Mechanicsburg, PA 17055 (72P.S. !i9116(a)(1.1)(i)). For dates of death on or after January 1,1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 00;., [72 P.S. Ii 9116(a)(1.1)(ii)]. The statute no!'!!': nnt ",-,,,mnt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 00;., (72 P.S.!i9116(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.!i 9116(1.2) 172 P.S. i 9116(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. Ii 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 CoPyri9ht 2000 GreatlandfNelco LP - Forms Software Only Estate of: Rodger E. Hoke 21-2001-0030 The following person(s) are signing the return as representative(s} of the estate: Hoke, Leah J. 110 Wcxx:ls Drive Mechanicsburg, PA 17050 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rodqer E. Hoke SCHEDULE A REAL ESTATE FILE NUMBER 21-2001-0030 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 property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH All real estate in which the Decedent had an interest was owned with his wife, Leah J.Hoke, as Tenants by the Entireties; therefore, no real estate is reported on this schedule. TOTAL (Also ehter on line 1, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 7 CPA21 NTF 10904 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rcrlqer E. Hoke SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0030 All property Jointly-owned with right 01 survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 MetLife, 33 shares of common stock 1,118.91 2 CUmberland Valley Cooperative Association, 97 shares prefe=ed stock 970.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space ;s needed, insert additional sheets of the same size) 2,088.91 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Rodqer E. Hoke 21-2001-0030 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with rlaht of survivorship must be disclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 Land O'Lakes, Inc., equity reserve account #2010206, redemption of shares 3,734.80 2 1975 Yam3ha rrotorbike 50.00 3 1971 Honda i"btorbike 50.00 4 1973 Yamah motorbike 50.00 5 1976 Yam3ha Motorbike 50.00 6 1979 Cadillac 100.00 7 1980 Chevrolet 200.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets 01 the same size) 4,234.80 7 CPA81 NTF 1090S Copyright Forms Software Only, ,997 Nelco, Inc. REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rcxiqer E. Hoke SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0030 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION A. FUNERAL EXPENSES: AMOUNT None B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative{s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State 0.00 Zip Year{s} Commission Paid: 2. Attorney Fees Narre: Richard C. Snelbaker 3. Family Exemption: (If dec8ck 'S is not the same as claimant's, attach explanation) Claimant Street Address City State Z:r Relationship 01 Claimant to Decedent 15,000.00 0.00 4. Probate Fees 81.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 Register of Wills, filing fee for spousal Inheritance Tax Return 10.00 8 Register of Wills, short certificates 9.00 9 Patriot-News, advertising Executrix notice 110.10 10 Cumberland Law Journal, advertising Executrix notice 75.00 TOTAL (Also enter on line 9, Recapitulation) $ (\1 more space is needed, Insert additional sheets 01 the same size) 15,285.10 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVAN]A ]NHER]TANCE TAX RETURN RES]DENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Rodoer E. Hoke No. NAME AND ADDRESS OF PERSON(S) RECE]V]NG PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Hoke, Leah J. 110 Woods Drive Mechanicsburg, PA 17050 F]LE NUMBER RELAT]ONSH]P TO DECEDENT Do Not List Trustee(s) Surviving spouse 21-2001-0030 AMOUNT OR SHARE OF ESTATE 0.00 ENTER DOLLAR AMTS. FOR D]STR]BS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPR]ATE ON REV 1500 COVER SHEET II. NON-TAXABLE D]STR]BUT]ONS: A. SPOUSAL D]STR]BUT]ONS UNDER SECTION 9113 FOR WHICH AN ELECT]ON TO TAX]S NOT BE]NG MADE None B. CHAR]TABLE AND GOVERNMENTAL D]STR]BUT]ONS None 7 CPA13 NTF 10913 TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE D]STR]BUT]ONS ON LINE 13 OF REV 1500 COVER SHEET $ Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) 0.00 ". "~ ~ LAW OFFICES SNELBAKER. McCALEB 8: ELICKER LAST WILL AND TESTAMENT I,RODGER E. HOKE, of the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated unto my wife, LEAH J. HOKE, absolutely and in fee simple, if she survives me. THIRD. If my wife, LEAH J. HOKE, should not survive me, and if all of my children have attained the age of twenty-two (22) years at the time of my death, then and in that event I give, devise and bequeath my entire Estate in equal shares unto my said children, share and share alike, absolutely and in fee simple. Should any of my said children predecease me and leave lawful issue to survive them, I order and direct that the share or part of my Estate which such deceased child or children would have received hereunder had he, she or they survived me shall be distributed unto the issue of such deceased child or children per stirpes, said issue taking his, her or their deceased ancestor's or ancestors' share or shares hereunder by representation and not per capita. If, however, any of my said children are under the age of twenty-two (22) years at the time of my death and should they be otherwise entitled to receive my entire estate under the provisions of the paragraph immediately preceding hereinabove, then and in that event, I give, devise and bequeath my entire said Estate unto DAUPHIN LAW OFJI'ICES SNELBA"ER. MCCALEB a ELICKER DEPOSIT BANK AND TRUST COMPANY of Harrisburg, Pennsylvania, as my Trustee, in trust, nevertheless, to hold, invest and re-invest the same, to collect the income, and after paying all expenses incident to the management of said trust, to use and apply as much of the net in- come and principal thereof as may be necessary in the sole discretion of my Trustee for the support, maintenance, care and education of such of my children as may be under the age of twenty-two (22) years, it being my will and intention to provide for each child who has not attained such age and who may be dependent and unemancipated ~y reason of disability Dr full time attendance in a school) at the effective time hereof with the same or simiiar advantages and benefits during his or her dependency which I have provided to my older child or children together with the privilege of acquiring a college or other post-high school education; and upon the youngest of my children attaining the age of twenty-two (22) years, I order and direct that the balance of principal and any accumulation of income remaining in the hands of the Trustee be distributed in equal shares unto my said children, share and share alike. It is my express will ahd considered thought that my said Trustee should terminate any benefits under the foregoing trust for any child under the age of twenty-two (22) years who has by his or her personal conduct become independent, completed formal education or otherwise demonstrated his or her lack of dependency upon the funds under the management and control of the said Trustee. In addition to the foregoing directions and general discretion vested in my said Trustee, the marriage of said children or their persistent display of lack of personal initiative and industry shall be considered by my said Trustee as sufficient cause to discontinue the discretionary distribution provided hereinabove. It is my further express instruction and direction that all discretionary payments hereinabove provided shall cease for each of my said children upon the attainment by each said child of age twenty- ~ two (22) years, thus making available the balance of said trust for use in the purposes set forth above for my younger child,or children. LASTLY. I nominate, constitute and appoint my wife, LEAH J. HOKE, to be the Executrix of this, my Last Will and Testament, but if for any reason she shall fail to qualify as such Executrix or cease SO to serve, then I nominate, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY of Harrisburg, Pennsylvania, to serve in her place, each to serve without bond. IN WITNESS WHEREOF, I, RODGER E. HOKE, have hereunto set my hand and seal to this, my Last Will and Testament which consists of three (3) typewritten pages to each of which I have affixed my signature this ;2., day of C1C~ A.D., One Thousand Nine Hundred Seventy-seven (1977). )/,~ / , /L--1~ -' ?' ~h-4 (SEAL) The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by RODGERE. HOKE, the Testator therein named, as and for his Last Will and Testament; in the presence of us, who, at his request, in his presence, and in the presence of each o/th.~e~r~ have names as witnesses hereto. ~ /.-" /-:--.c?t.?L~.,b_ subscribed our //. ~ Zlf-, "" /f" Ic& C~ p /.<,.2/ LAW OFFICES SNELBAKER. t1cCALEB 8: ELICKe:R PETITION FOR PROBATE and GRANT OF LETTERS ~ 1- C I - 30 RODGER E. HOKE No. To: Estate of also known as Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 192-30-0273 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 Oc tober 25. and codicil(s) dated None named ,19~ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or-principal residence at Woods Drive. Sil ver Spring Township (Mechanicsburg, 17050), Pennsylvania (list street, number and muncipality) Decendent, then 66 years of age, died December 26, ,~~ 2000 , at Silver Spring Township, Cumberland County, Pennsylvania 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: None Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: Unestimated $ $ $ $ None* * All real estate owned by decedent and Leah J. Hoke as tenants by the entireties. WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.La.; administration d.b.n.c.La.) theron. '" v u " '"' ]3 '"' ... 0<::'"' " -00 ".;::: ~.= 3~ '"' "'- ;'0 '" " "" C/i ~~.L1 4, tI-d-<-= eah J(. oKe 110 Woods Drive Mechanicsburg. PA 17050 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I S" COUNTY OF CUMBERLAND J ~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn t,o or affirme~ and ,SUbscrib;{d cr1t A -2- ~L-- ~ before me this? day of eaha. Hoke ~ .Januarb ~~ 2000 ~ '-rY)::vurf f;: ,bu./UJ \eLt. fI. . ..J1{;liv<4 ~ S I' ,~ Register ~ /10-- ). OJ - 5--' N 21-01-30 o. Estate of RODGER E. HOKE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 8th 219 200 ~ 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 October 25. 1977 described therein be admitted to probate and filed of record as the last will of Rodger E. Hoke and Letters Testamentary are hereby granted to Leah J. Hoke '~L". ~~ 'J~~.1 . ea u&J5?1 I)o/'~ Register of Wills SNELB ER E .. ''J & SPARE, P. C. Probate, Letters, Etc. ......... $ Short Certificates~ 0) . . . . . . . . .. $ ~EfC.'l;~. rG~.~.... $ JCP $ TOTAL _ $ Filed . ,J.~UARY .S.t.Q,. ?QQL . . . . .. . . . .. . 40.00 30.00 6.00 5.00 81.00 B FEES ne a.e A RN Y (Sup. Ct. J.D. No.) 44 West Main Street Mechanicsburg. PA 17055-0318 ADDRESS (717) 697-8528 PHONE ..__...J .. -' ..., "0 .- " MAILED LETTERS TO ATTORNEY JANUARY 8th, 2001 21-01-30 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Richard C. Sne1baker ~ 0fa1X1) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that he was present and saw Rodger E. Hoke the testat tor , sign the same and that he request of testator in h ; R presence and (in the pr other subscribing witness(es)). signed as a witness at the other) (in the presence of the ar . ne a er 44 West ~~~treet Mprn;m; f'snnrg. PA 17055-0318 (Address) Sworn to or affirmed and subscribed before me this f! ~ day of January ~2000 ~nCUi!J(' ,,t'.I/'u, ro~ (I fJ. .!Af;)r?lLw~~ Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS Leah J. Hoke and Richard C. Sne1baker (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that each is familiar with the signature of Rodger E. Hoke ooototk will presented herewith and 00Cli0{}{ believes the signature on the will is in the handwriting of the testat~ of (>> that each Rodger E. Hoke to the best of -.their _ knowledge and belief. January ~t'1 km x~ 'j!V_ / fl.1). Sworn to or affirmed and subwibed before d~ ~ ~ me this g: u.. day of Lea. J .("~'*~ . 110 Woods Drlve,'~ec~anlcsburg, PA 17050 JOO 2000 ~ -tI!{~Q'I'"1f ~ -=_ -:~7'ir~ddr"S) Register _~ Richar~~. ~nelbaker 44 West Main Stre~~ Mechanicsburg, PA 17055-0318 (Address) 21-01-30 ,hat the information here given is correctly copied from an original certificate of dearh duly filed with me as he original certiflcate will be forwarded to the State Vital Records Offlce for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. If this certiticate, $2,00 p 6987736 No, -t . Ilk 0 "1 ~dA 'L- /-; ,( JJ Local Rtgistrar ~ ~~ndR/t.. ::< ~ of-L) C/~ , Date NAME OF DECEDENl jF Ir$l ~.M(Jle, Las!) -~~"""-"""=---'-=---=-'-'=:"':=--==-='""'="'-.S'EX Rodger E. Hoke COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH H105 .4,JAev 2187 TYP(iPRINT IN PtAMANENT BLACK INK I. AGE HaS! BlI'1hlJay) .. UNDER 1 YEAR Montha Oav- UNDER f 0;';;- Hours ! Winul.. .. CIlY. 8OAO. TWP OF OE"TH Silver Spring BJRTHPUCE JCJI' iI(;(J PlACE OF DEATH (C"ed. OI"ly ope -- ">etI ,n$lfuctoOlli Ol1l,lftoet s...,., SlaleOl rCleognCounlly) HOSPITAL Highspire, 1np.ilIIltflIO ERiOutpau.nI 0 7. Pennsi(!y.erJ' ... FACtllTY NAME (II M[,n!ol'MI(JO. gIve streel ami nurnOftfl =ltirlO 66 v,. .. COUNTY OF De,(fH Cumberland ... ... DECEDENl"S USUAL OCCUPATIQt.I (G,veloind 01 WOI'k dooe dlJllng rnoIlI of -... ".' "f1I'ffl\~f"" I 1'. 11~ DECEDENT'S MAILING ADDRESS {Stt.... C.ry~. ~. Zrp Codel 110 Woods Drive Mechanicsburg, Pa. 17050 Male STATE FilE ~lJM8EA SOCIAL SECURIT"/' NU\4BER ,. 192 _ 30_ DATE OF DEATH ,Mcmtl. Oa~. ~I 0273.. December 26, 2000 RACE. Ameoc:an indian. Baack. WtwI., .-c (Spec,..,.) White 1.. MARITAL STATUS. Man" SURVIVING SPOfJSE N.~M.rr..a.W~. (ll~..74maotklnNtn.1 ~ced(SpeClt~1 Married 1S. Leah J. Wise Silver Spring .." II. F"RHER'S NAME (fnt. MoOdIe Last) 11_ INFORMANT'S NAME (T r'p8iPnflll Harry Leah J. Hoke l1d.O ~~.'::OI UOTHER'S NAUE if"st MIdOle. MaIdeoSYInam8) II. Mary Herman INFORMANT'S MAILING ADDRESS ISlr.... CIl)oITown. sw., Zip Codel 'lID 110 Woods Drive Mechanicsburg, Pa. 17050 PLACE OF OISPOSJfIOH. ~ of C.lMlflt)1. Cf.mauxy LOCATtON. CityllOwn, Stal., Zip Code '" ""*-- Rolling Green Memorial Park 1Th. Counry :l1c. Jan 3, 2001 LICeNSE NUMBER FD-012662-L DATE PAONQVNCEDDEAD IMOfIttl. Dav. Year) December 26, 2000 24. M 25. :11. NItT I: Enlerlt\e di......, Injun.SOI' comp!K;;Jihonswhich caused Itle (lealh Do not .nl.'IM l1\Odeol d'l',nQ, such as '~,dlaCQf re:;pt'alory 0111.$1. Shock oftieart 'adur. t ~I only one C;JiUY on each Ii~ gClJhIC/ (tAV\Ur DUE lO{OAAS ACONSEOUENCE Of)~--~------ b~__~~_~__~.__ DUE 10 (00 AS A CONSEOUENCE Ofl: c.------ooEmtOOASACQNSEQUe-NCEon--. . WERE AUTOPSY FINDINGS -""'LABlE PRtOR TO CQUPtETK)N OF CAUSE OF OERH7 MANNER Of DEATH DATf. OF INJURY IMlXllhOav. Veafl Ha.lura' 0< At:t:idenl [J Su~'" [J ".,-. 2'''. Camp Hill, Pennsylvania 17011 NAME AND ADDRESS OF FACILITY '3<. Myers Funeral Home. Inc. 37 East Main Street Mechanlcsburg. Pa 17055 LICENSE NUMBER DAlE SIGNEO (MonIh. Dav. ......1 23b. 23c. WlS CASE REFERRED TO MEDICAl EXAMlNERlCORONER7 ,... 0 NoO< ... I "'9PtQ~jm.a : ~ betwMn : onMt and de.'" i f pAII'J II: 0Ihlar SlGAllk:ant cord&ior\a conlrltMAing 10 dIN...., but noI"'SUIhnlIinlhil~cauM,,",en....PARTI I : I , --'-- TIME Of INJURY INJURY AI WOAKl DESCRIBE HOW INJURY OCCUAAfD Pending Il'lveSI'9a1IOR [J [] o ~~CE OF INJURY. AI homa.la,:C:;eel. loJ.CIOfy, offic. buikJing. etc. ISpoc~vl 3Qo. JOd. LOC.QION (Str... C.rylTown Slatel Hom~... No L:X y..o NoD< Cou6d not be dele"n",ed 1... 28b. CERTifiER ICt'eck (lI"lt'l' one) 'CEATIFYJJrtG PHYSK:IAH (Phf~ldll Ct'1l1ly'l\g C.,)U5e ul <}edlh ...her ..ln~Jlhe' I-ltl,,::.M.:'iUl h.lS PIQ(IOI.J/Y,;;ed liedlh .;.,1.0 LQml-lh:led lIem ;\31 To the ~.t of m., knawlold9., d.alh oc:curnod due Wt m. cause(sl<l"" m...n., a. slaled. ... :5 8 ~ o o ~ ~ Z . PRONOUNCING AND CERTifYING PHVStClAN tf'hV'WCldf'l t~)ll' ;)';"'uurll;orlfl <.led'" dl,d .:;e'l<ly.nq CO<;duSff/fl dedltll To 'h. bn,1 01 m., knowl.dgfll, d.ath oc:cuued .11he lima, d..le. aOft pl<l'., and due to lh. c<lu..tllllnQ manner a. sl.led 'MEQICAL EXAMINER/CORONER On the- b..i. of e:..min.Uon IIndlor invesligalion, 1R my opinion, dltalh oCf;uued althlt lime, dat~, and plac;;e, and due to the cause(a) and manner a. statN,.. . . .. . . '. . . . .. .. .. ......... . . '" REGiSTR~)SIGNATLJRE AND NUMBER ~---~ ---~---~-----_._. '" <- L.&L~ _ 0 NoD M. JOe. "". SIGNATURE AND TITLE OF CERTifiER o ". WlA lLTc y'\t r LICENSE NU"""" OllJESKiNEDt"""'/t-' - [] ''-L-MDQ:nII.Lf>:~_____ "d_ L~l?_l (,{ ,________ NAME AND ADDRESS Of iiE-RSON WHO COMf>lETEOC..wSE fsi otAJ (lIemU1TypeQl"Pnnl i . '. u --r:..) /.Ji) "', _ I-- I S 0_ . 11. ~ ('; I [J 5:1.::;l tV. (,0'./'7 -yt'.) ... \.V()( /II J ~ ,/5 bl' (!J I ~ ..j DATE FllED~Mo(\lll Oa.,. ,",ail .-... / ,.,.j)aCt? /n /"1-;(:) -} if"', )6(,/(,1 c;.?'j / nu/3 ./ / (, -c:2CY'~ -0) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 RICHARD C SNELBAKER SNELBAKER ETAL 44 W MAIN ST MECHANICSBURG NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER :l19 COUNTY ACN '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REY-736 EX AFP (OI-02l '02 !\I' \"{ - 1 03-25-2002 HOKE 12-26-2000 21 01-0030 CUMBERLAND 202 RODGER E Allount Rellitted , L."~, PA 17~~nh. MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV =736-El(-AFP--COr--02i-----..-NOficE-OF--DETERMiifATicfti-AND-AS-SESSMENy------------------------- --- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF HOKE RODGER E FILE NO.21 01-0030 ACN 202 DATE 03-25-2002 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) /6' -c.2oo -I.S-' ~ RICHARD C SNELBAKER SNELBAKER HAL 44 W MAIN ST MECHANICSBURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-4BS EX AFP <l2-DDI 11-05-2001 HOKE 12-26-2000 21 01-0030 CUMBERLAND 201 RODGER E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ Rifv:48ji-EX--AFP--fi2~-OO)-----.-i-NO-ficE--OF--DETE-RMIN-ATIO-N-AN-D-AS-sESSttENir---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF HOKE RODGER E FILE NO.21 01-0030 ACN 201 DATE 11-05-2001 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ /b-c::JOO -6--" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RICHARD C SNELBAKER SNELBAKER ETAL 44 W MAIN ST MECHANICS BURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-05-2001 HOKE 12-26-2000 21 01-0030 CUMBERLAND 101 _ REY-1547 EX AFP <l2-DDI RODGER E Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4'-EXAFP-fi'2=ooY-NoYicE--oF-INHEififANCE-TAx-"A-pPR'AisEMENT-,--Ati-OWANCE-OR'------------ -- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HOKE RODGER E FILE NO. 21 01-0030 ACN 101 DATE 11-05-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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. 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 2,088.91 .00 .00 4,234.80 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage 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) (10) 15,285.10 .00 NOTE: .00 .00 .00 .00 X 00 = X 045 = X 12 = X 15 = NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 6,323. 71 (1lJ (12) (13) (14) ] 5 .2BIi ] 0 8,961.39- .00 8,961.39- (19)= .00 .00 .00 .00 .00 . PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Rodger E. Hoke, Deceased Date of Death: December 26, 2000 No. 2001-00030 PA No. 2101-0030 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 or about January 12, 2001: Name Address Leah J. Hoke 110 East Woods Drive Mechanicsburg, P A 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: January 9,2001 lchard C. Snelbaker 44 West Main Street Mechanicsburg, PA 17055-0318 (717) 697-8528 :-;) ,. ": ;'"' fY/ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Rodger E. Hoke Date of Death: 12/26/2000 Will No. 21-01-0030 Admin. No. 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. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, ~tate the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes - X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the :::::O~~jI:~Phans' Court and may ~,report. J "''''.t :? ~ , ". r ~ ~.~ Richard C. Sne1baker Name (Please type or print) 44 West Main Street Mechanicsburg, PA 17055 Address ( 717) 697-8528 Tel. No. Capacity: Personal Representative X Counsel for personal representative (MAH:rmf/AM3) LAW OFFICES SNELBAKER. BRENNEMAN & SPARE RECEIPT AND RELEASE 021- Of-3D ------ (2" WHEREAS, Rodger E. Hoke, late of Silver Spring Township, County of Cumberland and Commonwealth of Pennsylvania, died on December 26, 2000, having first made his Last Will and Testament in writing probated before the Register of Wills of said Cumberland County on January 8, 2001, and Letters Testamentary were issued on the same date to Leah J. Hoke, the Executrix named in the Last Will and Testament of said Decedent; and WHEREAS, said Executrix has entered upon and completed her administration of said Decedent's Estate as set forth in her First and Final Account attached hereto, and intends to distribute the net balance of the assets of said Estate to the person named in the Statement of Proposed Distribution also attached hereto, both of said documents being incorporated herein by reference thereto; and NOW KNOW ALL MEN BY THESE PRESENTS, that I, Leah J. Hoke, being the principal legatee and distributee named in the Will of said Decedent and the person entitled to share in the residuary distribution of the Estate of said Decedent, do hereby declare and say that I, have examined the attached Account and Statement of Proposed Distribution, and find the same to be true and correct, and in strict accordance with the terms and provisions 1 of said Will, and we do hereby acknowledge that I this day have, had and received of and from Leah J. Hoke, the Executrix of the Estate of Rodger E. Hoke, the cash, personalty and/or real estate set opposite my name in the above Statement of Proposed Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purports and dividends which were due, owing and payable and belonging to me by any means whatsoever, for or on account of my full share, part or dividend of the Estate of Rodger E. Hoke, Deceased. NOW, THEREFORE, I, the said Leah J. Hoke, do by these presents, remise, release, quit-claim and forever discharge the said Leah J. Hoke, her heirs, executors and administrators, of and from my said shares or dividends of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents. AND, desiring to avoid the delay and expense of the settlement of said Estate by filing the foregoing Account of said administration in the Office of the Register of Wills of said Cumberland County and by having the balance in the hands of the Executrix, as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, I do hereby agree that the foregoing Account and Statement concerning LAW OFFICES SNELBAKER. BRENNEMAN & SPARE 2 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE the matter of settlement may be recorded with the same effect upon me as if the same had been reported upon by said Court, in a decree of distribution made on such proposed Statement of Distribution by the said Court of Common Pleas - Orphans' Court Division. AND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that I, the said Leah J. Hoke, do hereby agree that if any debts or demands other than those included in the above referenced First and Final Account, as hereinbefore set forth, shall be hereafter recovered against the Estate of said Decedent and be legally payable out of the same, that I will return to the said Executrix such amounts thereof as may be necessary to pay such debts or demands. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 'l-\t~\ day of tt1ev-g- WITNESSED BY: 2002. 0.- V I\.. (' 1..oJ. U /~ -/! 1- rf~ te'a . ~7e (SEAL) cr-. (1 3 LAW OFFICES SNELBAKER. BRENNEMAN Be SPARE COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) On this the I L1+h day of m~ 2002, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Leah J. Hoke, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. d:o jlJ;ill. ,J< ~'1~ Notary Public Notarial Seal Sandra K Showers, Notary PubIfc Mechanlcsbllf9 Bora, Cumberland County My CommiSSIon Expires Nov. 22, 2003 Member, ~~"f~'f"Ji,',~fll~~"'''''~'!>;~'"''' "',<f I\~;,."',\,~l":'.""'i 4 ESTATE NO. 21-01-0030 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY LEAH J. HOKE, EXECUTRIX OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF RODGER E. HOKE, DECEASED, LATE OF SILVER SPRING TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Leah J. Hoke, Executrix as aforesaid and Accountant herein, avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: December 26, 2000 January 8,2001 DATES EXECUTOR NOTICE ADVERTISED: Cumberland Law Journal Patriot-News January 19, 26, February 2,2001 January 16, 23, 30, 2001 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT DEBITS "T"he Accountant charges herself with the receipt of the following items of Decedent's Personalty valued as of the date of Decedent's death: 1. MetLife, 33 shares of common stock valued at $33.90 per share 2. Cumberland Valley Cooperative Association, 97 shares preferred stock 3. Land O'Lakes, Inc., equity reserve account #2010206, redemption value 4. 1975 Yamaha motorbike 5. 1971 Honda motorbike 6. 1973 Yamaha motorbike 7. 1976 Yamaha motorbike 8. 1979 Cadillac 9. 1980 Chevrolet TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: PERSONALTY - PRINCIPAL ACCOUNT CREDITS LAW OFFICES SNELBAKER. BRENNEMAN 8: SPARE he Accountant claims credit for the payment of the following items from Decedent's Personalty Account: 1. Greenawalt & Company, P.C., conference fee on Federal Return 2. Register of Wills, filing fee for Inheritance Tax Return 3. Snelbaker, Brenneman & Spare, P.C., reimbursement for following costs: a. Register of Wills, probate fee b. Register of Wills, short certificates c. Cumberland Law Journal, advertising Executrix notice 4. Register of Wills, filing fee for Inventory and Final Accounting 5. Snelbaker, Brenneman & Spare, P.C., costs advanced: a. Register of Wills, short certificates b. Register of Wills, certified copy of Will Page 1 81.00 6.00 75.00 $ 1,118.91 970.00 3,734.80 50.00 50.00 50.00 50.00 100.00 200.00 $ 6,323.71 $ 110.00 10.00 162.00 38.00 118.10 6.00 2.00 I c. Patriot. News, advertising Executrix notice 110.10 TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: $ 438.10 PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the following income from the investment of Personalty Principal: 1. Orrstown Bank, interest on estate account # 108005526 $ 0.18 TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: $ 0.18 PERSONALTY - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Personalty Principal Account: $ NONE TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: $ NONE REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with the receipt of Decedent's Real Estate as follows: $ NONE TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: $ NONE REAL ESTATE - PRINCIPAL ACCOUNT CREDITS Irhe Accountant claims credit for the payment of the following items from Real Estate Principal Account: $ NONE TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: $ NONE REAL ESTATE - INCOME ACCOUNT DEBITS he Accountant charges herself with the receipt of the income from the investment of Real Estate Principal Account: $ NONE TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: $ NONE REAL ESTATE - INCOME ACCOUNT CREDITS he Accountant claims credit for the payment of the following items from the Real Estate Income Account: $ NONE TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: $ NONE LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Page 2 RECAPITULATION PERSONALTY: PRINCIPAL ACCOUNT: Debits $ 6,323.71 Credits $ 438.10 Balance $ 5,885.61 INCOME ACCOUNT: Debits $ 0.18 Credits $ NONE Balance $ 0.18 TOTAL PERSONALTY $ 5,885.79 REAL ESTATE: PRINCIPAL ACCOUNT: Debits $ NONE Credits $ NONE Balance $ NONE INCOME ACCOUNT: Debits $ NONE Credits $ NONE Balance $ NONE TOTAL REAL ESTATE: $ NONE TOTAL FOR DISTRIBUTION: $ 5,885.79 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Page 3 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE STATEMENT OF PROPOSED DISTRIBUTION Leah J. Hoke, Executrix and Accountant herein, proposes to distribute the balance of the Estate of Rodger E. Hoke, Deceased, to wit: $5,885.79 in accordance with the Last Will and Testament of said Decedent as follows: 1. Leah J. Hoke 100% of residue Advance Distribution 1/29/01 Advance Distribution 2/28/01 MetLife, 33 shares of common stock, retained in kind 1975 Yamaha, 1971 Honda, 1973 and 1976 Yamaha Motorbikes, in kind 1979 Cadillac and 1980 Chevrolet, in kind Cash TOTAL FOR DISTRIBUTION: Page 4 $ 500.00 3,734.80 1,118.91 200.00 300.00 32.08 $ 5,885.79 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE 'I COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Leah J. Hoke, being duly sworn according to law deposes and says: that she is the Executrix of the Estate and under the Last Will and Testament of Rodger E. Hoke, Deceased, and the Accountant herein; that there are no unpaid creditors or claimants of said Estate; that there are no persons interested in the distribution of said Estate other than as stated in the foregoing Statement of Proposed Distribution; and that the facts set forth in the foreqoing hrst and Final Account and Statement of Proposed D:stribl!tion are true and correct to the best of her knowledge, information and belief. d~Jc -/-!C~ '. Leah i Hoke Executrix and Accountant Sworn to and subscribed before me this \4th day of t\\cu.o- 2002 ~GV1~~~ Notary Public ''tV~,~" ,0.: ~.~...... Sandra K. Showers, Notary PubliC , Mechank:sl:>urQ Boto, ,?umberland county" ; My CorTvnission ExpIres Nov. 22, 200. I _J Member, PennS'.,~im~t~ .l\~(':.....,;:-,}ic:~, of (\,!"C~ari::~(-; Page 5 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J ss: Leah J. Hok8 being duly RWO rn according to law I deposes and says that::fle is t he Exec ut rj x of the Estate of ROrlgA r R H Ok-A late of Silve.:r~.ruLT.Qw..ns.bj,p-__. I Cumberland County, Pa., deceased and that the within is an inventory made by Leah J. Hoke ., the said Executrix of the entire estate of said decedent, consisting of all the personal propdrty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, X1l9 2002 ~an~/~ I~=~;::-I Meet Boro, CumberI8nd ' My~",,"res Nov. ~~ ~"Amf")cr Oc"""c.n..4q.......i.., I\~,...,..-..:....."';......... ...' !\.....4.,.",,;"''":. Date of Death 26th Day ~,,-If ~ -rlrb- '-- . ,~utor - Administrator Leah J. Hoke 110 East Woods Drive MechaQicsb'lrg. P{\. 17055 Address December Month 2000 Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal represen~Uve. 2. A supplement inventory must be filed within thirty days of discovery of additional asseij. . 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. '0 (Yl o >- I- W ~ I- W -< a.. I- o V) W ~ W J: 0.. l- LL. -J o -< z o Q V) z ffi -< a.. . W H <D bO '0 o Q:; ~ o t- Z W > Z -J LL -< 0 W ~ <D ~ 0, ::r: o z ci "'-' '.~J-; ;>:" . u . OM ..c: u:J s:::: ~ o 8 bO s:::: OM H 0- CI) H <D > rl OM CI) " QI ... <ll Gl U Gl Q H <D GI ~ l:J'}g III rl a.. <D s:::: CI) III 0.. >- - C :J o U " C III -.: Gl ..Q E :J U ~ . .. U '0 H co ..c: () OM Q:; - o ." ..! u: ~ o o = Gl ... III -J Inventory of the real and personal estate of RODGER E. HOKE, Deceased PERSONALTY: 1. MetLife, 33 shares of common stock valued at $33.90 per share 2. Cumberland Valley Cooperative Association, 97 shares preferred stock 3. Land O'Lakes, Inc., equity reserve account #2010206, redemption value 4. 1975 Yamaha motorbike 5. 1971 Honda motorbike 6. 1973 Yamaha motorbike 7. 1976 Yamaha motorbike 8. 1979 Cadillac 9. 1980 Chevrolet TOTAL PERSONALTY: $ 1,118.91 970.00 3,734.80 50.00 50.00 50.00 50.00 100.00 200.00 6,323.71 $ REAL ESTATE: All Real Estate in which Decedent had an interest was owned with his wife, Leah J. Hoke, as Tenants by the Entireties. $ 0.00 TOTAL PERSONALTY AND REAL ESTATE: $ 6,323.71 Page 1 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ma-rlC,^ € S;c '^- '-0 J t:Z- r ~b .., ~ 1 WilINo.: Ft.e,~ ~o 0 /- ~o I Date of Death: DO 30 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Comi Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 1&1 No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal ~esentative file a final account with the Court? Yes _ No lCl b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal ~resentative state an account informally to the parties in interest? Y es ~ No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date:Mi..,'~D:(" ~ S ~ Signature ('') c.. ~c. I Name s.. ~Dw---e-r {' ..' G'L{J ~ ~ ~ ~~~~ Pk (;6J 0 '117 (,q, lq~V Telephone No. .i.-..,...... Capacity: ~ Personal Representative o Counsel for personal representative vJ