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Home My WebLink About01-0039 ( c/ I ~ c?tJtJ - JI) REV-T500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTK OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 01 0039 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Bock, Howard M. 195-07-4101 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 12/29/00 07/17/1906 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK r Original Return ~o Supplemental Return 8 (date of death prior to 12-1:3-82) APPRO- 4. Umited Estate 4a. Future Interest Compromise 5.~tteral Estate Tax Return Required (date of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 6. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach acopyofTrust) BLOCKS 9. Litigation Proceeds Received 10. Spousal PO\Jerty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 and 1-1-95) (Attach Set"! 0) }fill$'~~M!.!gj'IlI$Qpw!@j~p;;I\!i!iQQIj!l!1$!1P~~jij;;9~!lijj$@,AAtAXI~!l9RMA:tIdN$@!!!iP!$Q,i'i~dt~QT9i NAME COMPLETE MAILING ADDRESS COR- Richard C. Snelbaker 44 West Main Street RE- FIRM NAME (If Applicable) Mechanicsburg, PA 17055 SPON DENT Snelbaker, Brermeman & Spare, P.C. TELEPHONE NUMBER 717-697-8528 None OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3,213.88 3. Closely Held Corpora.tion, Partnership Of Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 51,173.08 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) None RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) None ..... 6. Total Gross Assets (total Lines 1-7) (8) 54,386.96 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 3,933.10 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,534.51 11. Total Deductions (total Lines 9 & 10) (11) 5,467.61 12. Net Value of Estate (Line 8 minus Una 11) (12) 48,919.35 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 48,919.35 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amountof Line 14taxableatthe spollsal tax rate, or transfers under Sec. 9116(a}(1.2) X.O (15) - TAX 16. Amountof Line 14 taxable at lineal rate 0.00 X .0 45 (16) 0.00 48,919.35 - COMPU- 17. Amountof Line 14 taxable at sibling rate X .12 (17) 5,870.32 TATION 18. Amount of Line 14taxable at collateral rate 0.00 x.15 (18) 0.00 19. Tax Due (19) 5,870.32 20. ~ !~~K\lg!l.EIl?YQi)'.@iI!$'flIffiJi!1$JiN$i*ij~NPdl\'#~~!!!"AMittl . > > BE SURe TO .ANSWER' ALL QUESTIONS ON: PAGE 2 'AND flECHECK Mil. TH~< o PA15001 NTF 29755 Copyright 2000 GreatlandlNelco lP - Forms SoHwam Only PA REV-1500 EX (6-00) Decedent's Com lete Address: STREET ADDRESS West Shore Health & Rehab Center Page 2 770 P lar Church Rd, E. pennsboro CITY STATE PA ZIP 17011 Hill Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 6. Prior Payments C. Discou nt (1) 5,870.32 4,500.00 225.00 Total Credits (A + B + C) (2) 4,725.00 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 1,145.32 (SA) 0.00 (56) 1,145.32 Total Interest/Penalty (0 + E) 4. \f 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 + Une 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 + 5A. This is the BALANCE DUE. MaI<e Check Payable to: REGISTER OF WILLS, AGENT .i\i....~.t~~~.~~~~!~~...fA~~gtt~!i~8...~U~~f;8~g~~!tk2;~8...~~...;1~1;:.:l~:.+~~~~~~8~~IRY~~t8bk~...:.. 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'? ... 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. Yes No ~ I 8 ~ 2. o o Under penalties at perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best at my knowledge and bellet, it is true, correct and complete. Declaration of preparer other than the personal representative is baseo an Intormation of which preparer has anv knowledQe. SIGNATURE OF PER ON RESPONSI6L FOR FILING RETURN DATE tU / ADORES See S SIGNA )..00/ DATE q -<I- f - 0 , Main Street, Mechanicsburg, PA 17055 ':'.':::".:-.:::'.':"".:'.:'.:'.:'.:"'>:':":.:'.".,:':'::'.:':::',.':".:',.:.:.,...:.:.:':::':::'::',:.:".:'..:..:'.,::,:':':'.:":':'.:'.::,.,:::,::>,:,::'.:':::,.,:::,:::,.:,:'.,:,::"'::,:;'::,.:,:: :::,:":::':'::"::::,::::::,::,,,:,::,:,,:,,:,::::,:::,,:':"::::::':,,:::::,:,:,:::::::::::::,:::::,:,::,:,:::,:,:::::,,:,,::,::::":::::,:,:::::,:":,::,::::::,,,,,::::,:,:::,':':::':':',:,:,:,:,::'::: ',',:,':'::,:,"::'::::,::',''::::"::':':"::'::"'::::"::::::':::':':""::":':,:::,:,:,::::,:,:,:,,::::::,,:,:,::::,,::':':'" :':.,.,-,-,.:::-:.:.:-:.:.,.:-,.,.,-.::.:.:.:.:-:.,.,-"::--.,::,,:,,,:-:-,,;-,-,:-:.-.::':':"':':-..-,.:-:'::.:::-:.,.::...:-:.-,:...:::..:.::..:-:-,.:-:.,.,.,.,.:':':':-"'-:-:':"-"-::::-:':':-:-":': -:":',.::::::.,.:.:-:.,:.,,",:::.':':::-:':'::.:':',.-.::::':':':'::':,-,::,.-:::-":,:-",:,-,-,-::,,,::::,:,,:,'.:.-':'-.:':,':''':-:':':-:-'''':''':':':::':-:':':-:-'''''''::':':.:.:-,.,-:-,.,.:.:.: .:.,.,-:-,.,-:.::,.:.:.:-:.:-:-:.:-:":".,:::,:,:"-:,:,,-.-.:,,,,.-,.,:-..-:.:._,.,.,.,,:.-,,':':,-,'-'-' F:~-r-'d~t;S'-o td'ea::th"~-ri"'o/~f't~ /Jt;-i;; -; ,-1' !l94- a.'n'-(j '-bef'~-;-;;"J~~'~-~~-;;;' :"-:-"'9-95: . th'~'-ta~ -r~t;'irri P o'~~cro~ ."t"h'e"~'e't' ~~l iu';;' ort'~~'~'~'f;~S"-t~'-'~'~': f'~/t'h';'~s'~'-~' fth-;;'~'~'~:;;i'~r~'g"sp'~~'~eis'3.;i~" . [72 P.S. B 9116(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 0% [72 P.S. B 9116 (a) (l.l}{ii)]. The statute rlnp.>'l nnt p.lIp.mpt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still app licable even if the surviving s!3ol..lse is the only beneficiary. For dates of death on orafterJuly 1, 2000: The tax rate imposed on the net value of transfers from a deceased cl1ild twenty-one years of age {If youf1ger at death to or for tile use of 11. natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S.B9116(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. B 9116(1.2) [72 P.S.€9116(a}(tll. The tax rate imposed on the ne1 value 01 transfers to orfor the use of the decedent's siblings is 12% {72 P.S, B 9116(a)(1.3)]. Asibling 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 Copyright 2000 Greatland/Nelco lP- Forms Software Only Estate of: Howard M. Bock 21-01-0039 The following person(s) are signing the return as representative(s) of the estate: Margaret A. Bock 1112 Columbus Avenue Apartment 3 Lemoyne, PA 17043-1723 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Howard M. Bock SCHEDULE B STOCKS & BONDS FILE NUMBER 21-01-0039 All property Jointly-owned with right of survivorshIp must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 John Hanc=k Financial Services, Inc., 63 shares of ccmron st=k valued @ 37.125 per share. St=k is held in the name of Doris Bock deceased wife of Decedent. Doris Bock pre-deceased decedent on July 6, 2000 and residue of her estate passed to Decedent 2,338.88 2 MetLife, 25 shares of corrm:m st=k valued @ 35.00 per share 875.00 \ TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,213.88 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Howard M. Bock SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-01-0039 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jolntlv-owned with rIght of survivorshIp must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Mellon Bank, checking account #162-162-5340 13,397.09 2 Mellon Bank, money market account #260-070-3819 34,566.03 3 Mans Ring, appraised value 300.00 4 Old Arrerican Insurance Corrpany, hospital benefits, policy #AM26149 385.56 5 Capital Blue Cross, refund of premium on health plan #195074101 314.62 6 West Shore Health & Rehab Center, refund of prepaid medical care 1,940.78 7 United States Treasury, refund on 2000 personal incane tax return 269.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 51,173.08 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Neice, Inc. *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH Of PENNsYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-01-0383 ESTATE OF Sheehan, Angela P. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: I Parthmore Funeral Home, funeral bill. 2,986.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Stale Year(s} Commission paid Attorney's Fees Dale F. Shughart, Jr. (estimated) Zip 6,5 10.00 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Zip Stale 243.00 4. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Register of Wills, Short Certificates. 9.00 2 Chuck Bricker, appraisal fee. 50.00 Total of Continuation SChedule(s} TOTAL (Also enter on line 9, Recapitulation) 9,404.87 19,202.87 REV-1 .11 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Howard M. Bock SCHEDULE. H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-01-0039 Debts of decedent must be reported on Schedule L ITEM NO. DESCRIPTION A FUNERAL EXPENSES; AMOUNT 1 Rolling Green Cemetery ConlJany, inscription on marker 135.00 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 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 3,000.00 0.00 4. Probate Fees 80.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 Register of Wills, filing fee for Inheritance Tax Return 15.00 8 Register of Wills, short certificates 18.00 9 Cumberland law Journal, advertising Executrix notice 75.00 10 Patriot-News, advertising Executrix notice nO.l0 11 Reserve for filing fee, accounting fees and other costs associated with the administration of Decedent's Estate 500.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,933.10 7 CPA11 NT'F 10911 Copyright Forms Software Only, 1997 Ne1co, Inc, REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Howard M. Bock Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-01-0039 DESCRIPTION AMOUNT 1 PharMerica, account payable, prescriptions 1,534.51 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 1,534.51 Copyright Forms Software Only, 1997 Nelco, Inc, REV""!-513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Howard M Bock No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Margaret A. Bock 1112 Columbus Avenue Apartment 3 Lemoyne, PA 17043-1723 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) Sister 21-01-0039 AMOUNT OR SHARE OF ESTATE 48,919.35 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 CPA13 NTF 10913 TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ Copyright Forms So11ware Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) 0.00 .~ (' d "'" ~ "s;, ''t-.., ~ '" \ . ~:::~:: LAW OFFICES SNELE:lAKER. BRENNEMAN 8: SPARE -~....~--~-" 21-01-39 LAST WILL AND TESTAMENT I, HOWARD M. BOCK, of the Township of East Pennsboro, 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 anytime 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 sister, namely, MARGARET A BOCK, absolutely and in fee simple, if she survives me by as many as sixty (6U) days. THIRD. If my said sister, MARGARET A BOCK, does not survive me by as many as sixty (60) days, then and in that event, I order and direct that my residuary estate be converted into cash as soon as practical and the net balance thereof be distributed and disposed of in the following manner: A I give and bequeath a sum of money equal to five per centum (5%) of my net residuary estate unto THE PRESBYTERIAN CHURCH at Mechanicsburg, Pennsylvania, absolutely. B. I give and bequeath forty-seven and five-tenths per centum (47.5%) of my net residuary estate unto the AMERICAN CANCER SOCIETY through its office serving the West Shore area of Cumberland County, Pennsylvania, to be used only for projects or programs in said County of Cumberland. C. I give and bequeath forty-seven and five-tenths per centum (47.5%) of my net residuary estate unto the AMERICAN HEART ASSOCIATION through its office serving the West Shore area of Cumberland County, Pennsylvania, to be used only for projects and programs in said County of Cumberland. LASTLY. I nominate, constitute and appoint my sister, namely, MARGARET A. BOCK, to be the Executrix of this, my Last Will and Testament, but if for any reason she should fail to qualify as such Executrix or cease so to serve, then and in that event, I nominate, constitute and appoint RICHARD C. SNELBAKER to be the Executor hereof, each and both to serve without bond or other security as a condition of qualification hereunder. IN WITNESS WHEREOF, I, HOWARD M. BOCK, have hereunto set my hand and seal to this my Last Will and Testament, which consists of two (2) typewritten pages to each of which I have affixed my signature this /IA day of October, A.D., Two Thousand (2000). 1;~()-Vf/~'~J?!; 1/LL/~. ," HOWARD M. BOCK (SEAL) The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by HOWARD M. BOCK, 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 e ch oth ave subscribed our names as witnesses hereto. ~ LAW OFFICES SNELBAKER. 8RE['Jt~EMAN &. SPARE ~g.~r- -2- COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. ) We, HOWARD M. BOCK, RICHARD C. SNELBAKER and JANE J. COONEY, the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of his or her knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. /7~Z:~rr~ /)/LL ator 2-~tf1s' (~A~_ Cl Subscribed, sworn to and acknowledged before me by HOWARD M. BOCK, the Testator, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J. COONEY, the witnesses, this 11th day of 0('mb<2i<:: ,2000. ~ Oi(\&(e -1< .~cQC1S Notary Public lllIndJa K. =. ~ PublIc Mal:ll8nIc8llum BolO. Clo,ibo.ltllld CounIY My CommIssTon ExpIres Nov. 22, 200'3 '.ll"'nhf.'lr De"'~"" ... .~ -; ~ _~ ~"'.- .,'_':',__ .... ~.,..,~ "". LAW OFFICES SNELBAKER, BRENNEMAN & SPARE PETITION FOR PROBATE and GRANT OF LETTERS ~/- 0/- 39 HOWARD M. BOCK Estate of also known as No. To: Register of Wtlls for the . Deceased. County of umberland in the Social Security No. 195-07-4101 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 11 and codicil(s) dated None named ,:lI' 2000 (state relevant circumstances, 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 WEst Shore Health & RehahilitAtion c'pnter, 770 Poplar Church Road, Camp Hill. PA 17011 (East Pennsboro Township). (list street, number and muncipality) Decendent, then 94 years of age, died December 29, at East Pennsboro To~~ship. 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: ~ 2000 I , Unestimated $ $ $ $ None 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.t.a.; administration d.b.n.c.t.a.) theron. ~ '" 'V' u ~ <1.1 -o~ .- '" "'~ <1.1 ... 0::<1.1 ~ -00 ~.;: ctS"= ~<1.1 ~a., <1.1..... BO ell ~ Oll en ~t~t'~ 1109 Columbus Avenue (Apt. 7) ~ T.pmoy-op, FA 1706.i OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I S'"' COUNTY OF' CUMBERLAND J ~::) Sworn to or affirmed a..nd SUbscri.bed{ before me this 8.f!A., day of January ~ .~ {}. ~ ~I. (i,a. .5{;.~-;-;ll , 1/ Reglste /6 -- c1 (J() '- /7 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. 7iJ~~a.~ Mar aret A. Bock ~ 0Ci' ::s l::l - l:: ~ ~ No~ 21-01-39 Estate of HOWARD M. BOCK , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 9th ~-2ilill, 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 Oc tober 11, 2000 described therein be admitted to probate and filed of record as the last will of Howard M. Bock and Letters Tes tamentary are hereby granted to Margaret A. Bock FEES Probate, Letters, Etc. ......... $ 60.00 Short Certificates(3) . . . . . . . . " $ 9.00 ~~.~~:r.~.r~~.... $ 6.00 JCP $ 5.00 TOTAL _ $ 80.00 Filed .J:~P..w'f. .~t;Q.1. .~Q9~. . . . . . . . . . .. . . {! Jc'i , (! a' ~.,L (I. /-- YZl2k.t. i ~ jkOu:.) p1_> ., . ,..t. L./UA.,;)/ Ufli.{uJ o Register of Wills AKE & SPARE, P. C. B (717) 697-8528 PHONE MAILED LETTERS TO ATTORNEY JANUARY 9, 2001 21-01-39 ['his is to certifY that the information here given is correctly copi~d from an original c~rtific~te of death duly filed with Local Registrar. The original certificate will be forwarded to the State VItal Records Office fot permanent hllJlg. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~-~ ,'.'''1///'''''" \l"~~"mJ!F itl----__ 1"'$-7 ~4'~"\ !/~/~- '\\~\ :~I ". \~~ ~c::.1 '-'>>,. "_~ ~t-)i\ ,.fi~', . ,i:b.$ \*~_.>-,/*~ ~ a..\ - /"-~,,, ~rA~ . /~" -",.___ '11ljj;----{t.-\:; ",/ ---',_";,, EN1 \\ "",1' ""##IIIIIJJ ~7?Z~~ Local Registrar P 7022887 JAN 0 2 ZOGl No. Date ; 43 Aev 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH 1. Howard M. Bock SEX a. male STAlE Fill: NUMBER SOCIAL SeCURIT't' NUM8ER oATEOF~7n;:-O;-::;;~'-- NAME OF DECEDENT (f ',~sfM'~~- -- -..----.---- AGE (last Bwttoaayl UNDER '\ YEAR MonI"- D-V- 3. 195 - 07 4101 .. Dec. 29, 2000 94 U>IOER I DAY HourII Mw.ut.. 8IRTHP\..Aa !C,ty ovod P\..ACE OF 1)EJ(JH IC'r>ec1& oNy Of'e -- .;ee ,(1SlrUCI~ on ort-el ':lldet Stale ex F CflltlQ!l COUNfV) HOSPITAL: Harrisburg,Pa 1""",...,0 ERIOutPI'oe", 0 7. ... FACU.JT"f NAME I" nollf'lSl'hJl1On ~W~e su~ and l'll.ImD81'l =",,)0 v.. $. COUNTY OF DEATH RACE - Amencan IncUn, sa.ck, Whit.. etc. t_l .. Cumberland OECEOEHT'S USU,,\L OCCUPATfON (~~~~o;;:.::~;rr . HL Foreman II1..~isburg Steel CO OECEDENT'S MAILING ADDRESS ~rHt. CIlyI1Own. Stale. ZrpCooel DECEDENT'S ACTUAL RESIDENCE ISH IflSIrucllOnl on othef SIde) White SURVIVING SPOUSE (II ..,.. gn.oe maQlln namel ro .-p. 770 Poplar Church Rd. l~amp Hill, Pa. 17011 17b. Cou !lid - Me.. Cumberland -' ",,-0 :;"''''':':''':'::01 MOTHER'S NAME \fll~. Mtd<1kt. Malden Sulname) 1t. Ma ie A. mFORMANl'S ""'lUNG ADDRESS (&reec. Cltyf1'oo.Nn, State. lip COde) 2.1109 Columbus Ave. Lemo PLACE OF DISPOSITION. Name 01 CemetefY, Cr.m.rory 01 Othef Plac4t ....-.. 221>. the tin' 01 my knowledge. death occurred.a' 1he tlmtl. dale and place Slated Ul8 and T cite) 2,.Roll1n Green Mem. P IWAE ....0 ADDRESS OF FACIl'ty ~Bselman Funeral LICENse NUMBER Cumb CO. P . FRHEA'S NAME (Firs.. MlCldIe. la51) \.. Phili L. aHF()fU.IANT'S NAME (T ypNPnnl) Margaret A. Bock METHOD OF OISPOS1llOH _1Xl C.._ 0 0Ih001_ Bock Sr. Lemo e P _. IME Of OEATH ::L:L- oATE PRONOUNCED DeAD (M()(llfl. Day. Year) a.. Cf ... 25. /)<Z,v ;J. 1, ;l, OcJV 27. MAT I: Enl., me diuase., injuries or cornpkaflonS which caused !he dealh 00 nol enter the mode of dyitw;l, such as cardiac or I.spllato')' allest, shOck Of MaR tailuI. list only one cause on each hne 23b. 230. MS CASE REFERRED TO MEDICAL EXA~INERlCORONEA? ....0 No~ 4ltUL ~ f'>?D DUE 10 lOR AS A CONSEOUENCE On :!S. I~:llmal. I incWVIII befWMn . onset and dIIath PAR'f ": t::llhef sigrnr'lcanl: condiIioM eoncnbuting to death, but ~#a__~PMITI DUE 10 lOA AS A CONSEQUENCE Of): DUE 10 lOR AS ACONSEOUENCE OF)" d WERE AUTOPSY FINOfNGS WANNER OF DEATH A""Il.ASLE PRIOR TO COMPlETtON OF CA.USE ~ 0 OF OEAJ'H7 Hal....." HomICide -...,,. 0 Pending lrwnllgahon 0 Nog V.. 0 No 0 s..cido 0 Coutd noc be determined 0 DATE OF INJURY (Monto. Day. Year) TIME OF INJ RY INJURY IiI 'NOAK1 DESCRIBE HOW' INJURY OCCURREO. _ 0 NoD aa.. 210, can"'ER ICt':ec1I. onr, one\ aCERTlFYlNG PHYSlCIAN IPhySIClClo CetlllYlng cause 01 death wtlen af'QIhe+> phYSIC.an has p1onounced deal" ana compleled Item 231 To Ihe .... of my knowtedo-. death oceLlned due 10 Ih. UUM(S) and mannar .. ...ted. . 21. 3011. 3Gb. PlACE OF NURV. At hOme. tatm, Sl'"', tactOr;. otfic. building. .-c_ ,Spec.f.,) 300. Y. 3OC. .UEDICAl EXAMINERlCORONER 0... the b.-i. of examination and/or inveStfgation, in my opinion, death occul'fed at the time, date, and place. and due to the causeCs) and manner .. st,ted.. . 31.. REGISTRAR'S SIGNATUAE AND NUMBEA ~~~ I~/ I~/ /1 :JOt. SIGNRURE AND TITLE OF CERTIFIER ~ 31b. LICENSE NUMBER o 31.. j1f tJ&J I tJ'i L r ~ 31"- NAME AND ADDRESS OF PERSON WHO COMPlElED CAUSE 0; DEATH (\1em 271 Type Of Print /~ H'" ",r" Ie). c,.."." "1..j',....II., o ' /./"w--S If' H/; '" 32. Z:-Iof-~ /h){ 4 I}" / _ OAT E HlEO IMooth Day 7" 3' / () 7.- f~/ I .PRONOUNCING AND CERTIF'YING PHYSICIAN IPhVS'ClCIn bOlt! >lIO(lOUrlCln~ Oedth and ~el1rlylflg 10 cause 01 dealtll loth. ~t ot my know)edge, death oc:cuneclJlt Iha 1Jme, .ale, ..net plac;e,..nd due to the UUM(a) and manne,.. ataled.. /6- O2oo-/y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN RICHARD C SNELBAKER SNELBAKER ETAL 44 W MAIN ST MECHANICSBURG PA 17055 11-05-2001 BOCK 12-29-2000 21 01-0039 CUMBERLAND 101 Allount Rellitted *' REY-1547 EX AFP <12-001 HOWARD M 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 =i54-j-Ex-AFP--fI2-=ooY-NoYicE--oF-YNHEififAifcE-YA'x-A-PPRA-isEMENT-:--Ar:rOWAifcE-O-i----------- - ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOCK HOWARD M FILE NO. 21 01-0039 ACN 101 DATE 11-05-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED 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 ( ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 3,213.88 .00 .00 51.173.08 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: PAYMENT DATE 03-07-2001 NOTE: RECEIPT NUMBER AA478119 DISCOUNT (+) INTEREST/PEN PAID (-) 236.84 INTEREST IS CHARGED THROUGH 11-20-2001 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM (9) (10) 3,933.10 1.534.51 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 54,386.96 ';.467 61 48,919.35 .00 48,919.35 14, 15 and/or 1&, 17, 18 and 19 will returns assessed to date. .00 X 00 - .00 X 045 = 48,919.35 X 12 = .00 X 15 = (19)= AMOUNT PAID 4,500.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 5,870.32 .00 5,870.32 4,736.84 1,133.48 14.56 1,148.04 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) \. /(.-,:"200 ,- /-Z/ BUREAU OF INDIVIDUAL tAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-l'G7 EX AFP {Gl-GZI RICHARD C SNELBAKER SNELBAKER ETAL 44 W MAIN ST MECHANICSBURG APH -1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-11-2002 BOCK 12-29-2000 21 01-0039 CUMBERLAND 101 HOWARD M '02 2 :l\7 Allount Rellitted t> ~ PA l^Q~5: 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 forI! with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6'ifj-ix--AFP-foY:02y------.*.-iNHERiYANC'E--YAX-STATEHENY-OF-ACCouiiT--...------------------ --- ESTATE OF BOCK HOWARD M FILE NO.21 01-0039 ACN 101 DATE 03-11-2002 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 5,870.32 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-07-2001 AA478119 236.84 4,500.00 09-25-2001 CDOO0302 .00 1,145.32 02-25-2002 REFUND .00 11 .84- TOTAL TAX CREDIT 5,870.32 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) J (;- ~ 6V /JlI BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT <;~ C '* REV-1687 U iFP (12-00> Recorcej of Register of ~jVllls DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-19-2001 BOCK 12-29-2000 21 01-0039 CUMBERLAND 101 HOWARD M '01 NOV 26 All:4 7 RICHARD C SNELBAKER SNELBAKER ETAL Cierk.(" ... r:ourt 44 W MAIN ST -. ....... ~ MECHANICSBURG a.~9~ Co., PA 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 RECORDS ~ REV =i60j-EY-AFP-fi"2-.:ooY------...--iNHEiiITANCE-yiY-STAfEHENY-O,:-iccou'Nf--...--------------------- ESTATE OF BOCK HOWARD M FILE NO,21 01-0039 ACN 101 DATE 11-19-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001 P R I N C I PAL TAX DUE: ........................................................................................................................................................................................................................... 5,870.32 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-07-2001 AA478119 236.84 4,500.00 09-25-2001 CDOO0302 .00 1,145.32 TOTAL TAX CREDIT 5.882.16 BALANCE OF TAX DUE 11 .84CR INTEREST AND PEN. .00 III IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 11 .84CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A '"CREDIT'" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 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 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 u______ fold ESTATE INFORMATION: SSN: 195-07-4101 FILE NUMBER: 21-2001- 0039 DECEDENT NAME: BOCK HOWARD M DA TE OF PAYMENT: 09/25/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/29/2000 NO. CD 000302 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,145.32 I I I I I I I I TOTAL AMOUNT PAID: $1,145.32 REMARKS: MARGARET A BOCK C/O RICHARD C SNELBAKER CHECK# 104 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS t-- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Howard M. Bock, Deceased Date of Death: December 29,2000 No. 2001-00039 PA No. 2101-0039 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 10, 2001: Name Address Margaret A. Bock 1109 Columbus Avenue (Apt. 7) Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: January 10, 2001 ichard C. Snelbaker 44 West Main Street Mechanicsburg, P A 17055-0318 (717) 697-8528 (Y l-- STATUS REPORT UNDER RULE 6.12 Name of Decedent: Howard M. Bock Date of Death: December 29. 2000 Will No. 21-01-0039 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 re~resentative file a final account with the Court? Yes No . 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 Cerk of the Orphans' Court and may be a- he this report. Date: 3/1/02 J Si "'-I Richard C. Sne1baker Name (Please type or print) 44 West Main Street Mechanicsburg. PA 17055 Address c. ,-. r:J (--,...... C2 z:. N P "'< i-' .) ::-:. :. .-6 ... "...... -'~ ( 717) 6 9 7 -8 5 28 Tel. No. Capacity: Personal Representative X Counsel for personal representative (MAH:rmf/AM3) LAW OFFICES SNELBAKER. BRENNEMAN & SPARE RECEIPT AND RELEASE WHEREAS, Howard M. Bock, late of East Pennsboro Township, County of Cumberland and Commonwealth of Pennsylvania, died on December 29, 2000, having first made his Last Will and Testament in writing probated before the Register of Wills of said Cumberland County on January 9, 2001, and Letters Testamentary were issued on the same date to Margaret A. Bock, 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, Margaret A. Bock, 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 1 provisions of said Will, and I do hereby acknowledge that I, this day have, had and received of and from Margaret A. Bock, Executrix of the Estate of Howard M. Bock, 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 Howard M. Bock, Deceased. NOW, THEREFORE, I, the said Margaret A. Bock, do by these presents, remise, release, quit-claim and forever discharge the said Margaret A. Bock, 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 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE 2 LAW OFFICES SNELBAKER. BRENNEMAN 8: SPARE concerning 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 Margaret A. Bock, 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 27th day of February 2002. w~ -- ~ J1r.~a..~ Margaret A. Bock (SEAL) 3 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) On this the 27th day of February 2002, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Margaret A. Bock, 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. ~Pnd.m-KsJ~ Notary Public Not8riaI Seal Sandl'8 K. ShoWers. Notary PubtIC MechaJ1IcSburg Bora. cUmberland County My Commission expires Nov. 22. 2003 i . .,<""'.;-,"'- r '.~...... ~~.'" ".' ~."., - .0" " 4 ESTATE NO. 21.01-0039 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY MARGARET A. BOCK, EXECUTRIX OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF HOWARD M. BOCK, DECEASED, LATE OF EAST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Margaret A. Bock, Executrix as aforesaid and Accountant herein, avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: December 29, 2000 January 9, 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 The Accountant charges herself with the receipt of the following items of Decedent's Personalty valued as of the date of Decedent's death: 1. John Hancock Financial Services, Inc., 63 shares of common stock valued at $37.125 per share 2. MetLife, 25 shares of common stock valued at $35.00 per share 3. Mellon Bank, checking account #162-62-5340 4. Mellon Bank, money market account #260-070.3819 5. Mans Ring, appraised value 6. Old American Insurance Company, hospital benefits, policy #AM26149 7. Capital Blue Cross, refund of premium on health plan #195074101 8. West Shore Health & Rehab Center, refund on prepaid medical care 9. United States Treasury, refund on 2000 personal income tax return 10. Penn Mutual, life insurance policy #2519795 11. Penn Mutual, life insurance policy #2388730 12. MetLife, life insurance policy #124944255 13. United Fidelity Life Insurance, life insurance policy 14. Prudential Insurance Co., life insurance proceeds from Employee Group plan at Harsco Corp. 15. John Hancock Financial Services, Inc., gain on sale of securities TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Page 1 $ 2,338.88 875.00 13,397.09 34,566.03 300.00 385.56 314.62 1,940.78 269.00 4,002.06 2,670.43 1,915.88 2,579.39 2,500.00 34.67 $ 68,089.39 PERSONAL TV - PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from Decedent's Personalty Account: 1. Register of Wills, Agent, estimated payment on Inheritance Tax 2. Rolling Green Cemetery, marker inscription 3. PharMerica, prescriptions 4. Register of Wills, Agent, Inheritance Tax 5. Register of Wills, filing fee for Inheritance Tax return 6. Register of Wills, additional probate fee 7. MetLife, loss on sale of securities 8. Snelbaker, Brenneman & Spare, P.C., attorney services 9. Snelbaker, Brenneman & Spare, P.C., costs advanced: a. Register of Wills, probate fee b. Cumberland Law Journal, advertising Executor's notice c. Patriot-News, advertising Executor's notice d. Register of Wills, short certificates 10. Reserve for filing fees, accounting fees and other costs associated with the administration of Decedent's Estate TOTAL, PERSONAL TV, PRINCIPAL ACCOUNT, CREDITS: PERSONAL TV - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the following income from the investment of Personalty Principal: 1. Orrstown Bank, estate account #108-005537, interest 2. John Hancock, dividends 3. Mellon Bank, checking account #162-62.5340, interest 4. Mellon Bank, money market account # 260.070-3819, interest TOTAL, PERSONAL TV, INCOME ACCOUNT, DEBITS: PERSONAL TV - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Personalty Principal Account: TOTAL, PERSONAL TV, INCOME ACCOUNT, CREDITS: REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with the receipt of Decedent's Real Estate as follows: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Page 2 $ 4,500.00 135.00 1,534.51 1,145.32 15.00 55.00 95.32 3,000.00 283.10 80.00 75.00 110.10 18.00 1,000.00 $ 11 ,763.25 $ 63.40 19.53 45.19 124.22 252.34 $ $ NONE $ NONE $ NONE $ NONE LAW OFFICES SNELBAKER. BRENNEMAN & SPARE REAL ESTATE. PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from Real Estate Principal Account: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: $ NONE $ NONE REAL ESTATE - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the income from the investment of Real Estate Principal Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: $ NONE $ NONE REAL ESTATE - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: $ NONE $ NONE Page 3 . . . RECAPITU LA TION PERSONAL TV: PRINCIPAL ACCOUNT: Debits $ 68,089.39 Credits $ 11 ,763.25 Balance $ 56,326.14 INCOME ACCOUNT: Debits $ 252.34 Credits $ NONE Balance $ 252.34 TOTAL PERSONALTY $ 56,578.48 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: $ 56,578.48 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE , Page 4 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE STATEMENT or PROPOSED DISTRIBUTION Margaret A. Bock, Executrix and Accountant herein, proposes to distribute the balance of the Estate of Howard M. Bock, Deceased, to wit: $56,578.48 in accordance with the Last Will and Testament of said Decedent as follows: 1. Margaret A. Bock a. Mans Ring, retained in kind b. 100% of residue TOTAL FOR DISTRIBUTION: Page 5 $ 300.00 56,278.48 $ 56,578.48 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Margaret A. Bock, 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 Howard M. Bock, 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 First and Final Account and Statement of Proposed Distribution are true and correct to the best of her knowledge, information and belief. /Jt~r~; ~ Executrix and Accountant Sworn to and subscribed before me this 27t? day of Febru~~ J 2002 dO'l~->I W~ Notary Public ' -i 1- NOtariB' seal pubfiC sandra K. ShOW9~ C<lUfI1Y. MeC!:\61'~xp\res NOV. 22. ~ My COmtnlSS_,_.- ~ .' ,.'.......~ ~. LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Page 6 C/) m )> r- nn x'- 1'10 n ~U) .z P"I ...r 0,,", ...~ f11 ::0 ~ () "tl 0 Z "Tl m 0 0 )> )> r= (f) c en -i s: m ~ m z -i m m Z ...~ n:;! s: 0 Qj~ ru~ )> "Tl -I ruo c o~ uJ-u 00 .......CO m ,m ::I "'~ ~~ m . ru~ """0 n)JJ z aJ 0)> ClS: ,'m -n ..g fI1 oITl ,".J~ 0 '0 0 ...... ::0 ...... '" -i I~ 0 :D ru r 0 f1J 0-; '-" $: 0 1> 0 0 ",. i )> 0 Z () 0 ,.,~ '::J -I 0 t::1 0 .... ;J~ 0 0 - v~ Lt.) Z " ~ 3 - W (1 Z " 1'~ 55 <1 en U'1 .::! f C' '..1 .t::' I-" ....:) .;......,. ~ :..:s ,r.> U1 fiJ .4:' I'" m ., .. .- r 4- D UJ :!: :s D >-< D ;'1: fl 1-; rn (fl <- :0 tIl S '" ,..., l~j --'..I .">01 -~ >-; G'J .13 n 1'1 I r1 D 'TJ -1 Xl D t:J n .... -.J ,,:) cn U! :IJ m s::: )> :IJ @ I ::tI m o m < m o "T1 ::tI o s: :IJ -I m 0 0 ~ m < r )> ::0 3m )> zo~ m~o s::: 0 cOm)> G3 ~ c s:::Z(f)o .... Z OJ:d(f)z (0 -I moS::: -i -0 ::Dr!;2 )> m. 5 -I ::0 0 l<< ~ )> ;:- ". s: ... . .. 0 (.II tJI c 0 0 Z 0 0 -I . 0 ....., 0 0 ~ <:) :r rn :0 rn :rOIXlOO )>mc:mo ~~filj;~ Ciilj5)>~o aloC:s:z cOJom:2: ill~"T1zm - z-i)> "tl coC; )> c:"Tl:r: 6JJo c:m"Tl )>~"tl 'zm -fCZ ~m1i5 m -< (/) r- < )> Z ); ::::. N '" 6 OJ ~ z 0 :t m ." :0 ." ::j - )>"0 0 zm - (")Z )> mZ r- )>(/) z-< :0 O~ m m)> 0 (/)Z -4- m )>)> - -4 "tJ m -I -4 )> >< Z 0 )> )> ~ -J ex> ~ ...... CD on m ::: '" '" m x cO 9 c. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J 55: Margaret A. Bock according to law, deposes and says that She is the Executrix of the Estate of Howard M. Bock late of _~~~~~en_nsbo!:.~__,!,~w~ship _ , Cumberland County, Pa., deceased and that the within is an inventory made by Margaret A. Bock __ _ ., the said Executrix of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. being duly !'\WOY'n Sworn and subscribed before me, 27th Day of February fJA.l~" J!. ~bh :;:~ 2002 h?/~a,-r$~ Executor - Adminjst~tork E t. Margaret A. !:lOC, xecu rlX 1112 Columbus Avenue, Apt. #3 Notarial Seat SBndr8 K. ShoWers, Notary PublIC ~ Boro. CUmberland CountY My CommissiOn expires Nov. 22, 2003 ; ~ .. ~ .. t. ......h~, r"l_.-_,.",,,..~__M' ",,-'~^ Lemoyne, PA 17043-1723 Address Date of De;'lfh 29th Day December Month 2000 Year INSTRUCTIONS I. An in'lentory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. 0. .rl ;::: tI) s:::: ~ '0 0 ""tl >- (l) E-< tI) <II ?f ..... w '" ~ c:l:: ..... ro 0 III W "" (l) ~ Q) Q.. ..... 0 0 U tl 0 V) (l) .0 II) ~ 0 C C'I W c:l:: W Cl tI) III (l) ! :c s:::: ~ - .... Q.. Q. (j Z ..... ...I U. . s:::: III ro u. ...I -< 0 -D (l) Q. .0 W 0 "" w , 0... >- .-f I > c:l:: 0 (l) "- Z co ~ .. s:::: ~ Z 0 tI) c (I) C :::I V') Z . ro 0 ci c:l:: :E: ~ U . A Z W -< ~ 0 Q.. '0 ""tl ~ c '0 ro III ~ - L: ro ~ 0 0 CIl ;::: ::r: ..Q ""tl ~ 0 CIl E tl 0 .rl .. III :::I u: 0 p:; ...J U = Inventory of the real and personal estate of HOWARD M. BOCK, Deceased PERSONALTY: 1 John Hancock Financial Services, Inc., 63 shares of common stock valued at $37.125 per share 2 MetLife, 25 shares of common stock valued at $35.00 per share 3 Mellon Bank, checking account #162-62-5340 4 Mellon Bank, money market account #260-070-3819 5 Mans Ring, appraised value 6 Old American Insurance Company, hospital benefits, policy #AM26149 7 Capital Blue Cross, refund of premium on health plan #195074101 8 West Shore Health & Rehab Center, refund on prepaid medical care 9 United States Treasury, refund on 2000 personal income tax return TOTAL PERSONALTY: REAL ESTATE: Decedent owned no Real Estate at the time of his death TOTAL PERSONALTY AND REAL ESTATE: -+ '-J ~ ~, f=j ~.~:; - }:: ":)~ :5 '....,..... .~-~. Page 1 ~Ou( - 57 .. /-~ $ 2,338.88 875.00 13,397.09 34,566.03 300.00 385.56 314.62 1,940.78 269.00 $ 54,386.96 0.00 $ 54,386.96