HomeMy WebLinkAbout01-0071
21-01-71
LAST WILL AND TESTAMENT OF DOROTHY F. HERSH~~N
I, DOROTHY F. HERSHMAN, of North Middleton Township,
Cumberland County, Pennsylvania, declare this instrument to be
my Last Will and Testament, in manner and form following:
1. I hereby expressly revoke all Wills and Codicils
heretofore made by me.
2. I hereby direct my Executor to pay all my just debts,
funeral and administrative expenses out of my estate, as soon
as practicable after my death.
3. Should my son, Larry R. Hershman, survive me for a
period of thirty days following my death, I devise and bequeath
the remainder of my estate to Larry R. Hershman.
4. Should my son, Larry R. Hershman, predecease me or die
on or before the thirtieth day following my death, I direct that
my estate be settled and administered in accordance with the
provisions hereinafter set forth:
A. I forgive and declare discharged all debts,
owed to me by any person or organization, specifically
the debt owed by the Westshoremen, Inc.
B. I direct that the remainder of my estate be
divided into six equal shares, which I devise and
bequeath as follows:
(1) One share thereof to the First Lutheran
Church of Carlisle, Pennsylvania, to be used for
the maintenance of its buildings and grounds.
(2) One share to my sister, Louise Martin,
of 63 North West Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
(3) One share to my sister, Leonora Stake, of
154 North Hanover Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
(4) One share to my sister, Melva Weary, of
925 West Louther Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
- 1 -
(5) One share to my nephew, Dr. Ronald
McGowan, of 302 Hillside Road, Johnson City,
Tenn., or to his heirs if he predeceases me.
(6) One share to be divided four ways, as
follows:
(a) One portion thereof to my
sister-in-law, Helen Farrow, of 913 East
Brandon Drive, Chambersburg, Pennsylvania,
or to her heirs if she predeceases me.
(b) One portion thereof to my nephew,
James Farrow, of Pittman, New Jersey, or to
his heirs if he predeceases me.
(c) One portion thereof to my niece,
Daine Farrow Behot, of Burlington, New Jersey,
or to her heirs if she predeceases me.
(d) One portion thereof to my nephew,
Danny Farrow, of Chambersburg, Pennsylvania,
or to his heirs if he predeceases me.
6. I nominate and appoint Farmers Trust Company, Carlisle,
Pennsylvania, Trustee of the share of any beneficiary who may be
a minor. The income and/or principal of said trust may be
accumulated or expended for the maintenance, education and
support of such beneficiary as my Trustee in its sole discretion
may determine; and my Trustee, in the expenditure of income
and/or principal for such purposes, may, at its discretion,
apply the same directly without the intervention of a guardian
or pay the same to any person having the care or control of said
beneficiary or with whom the beneficiary resides, without duty
on the part of the Trustee to supervise or inquire into the
application of the funds by any person to whom any payment is
so made. The balance of such income and/or principal shall be
paid to such beneficiary upon reaching majority, or to such
beneficiary's estate in the event of death prior thereto.
7. I nominate and appoint my son, Larry R. Hershman, as
Executor of this my Last Will and Testament~ and as substitute
Executor I nominate and appoint Roger M. Morgenthal, Esq..
8. I direct that my personal representative and Trustee,
as well as their successors, shall not be required to file bond
or security in any jurisdiction.
- 2 -
"
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 5 r ~'f
day 0 f Ot Ll;~-v{~, , 19 79 .
~~
';'j' _// .~7 // I
~ D;i:~t{?9 /' He~~h~~;;~7,.,,~j
( SEAL)
WITNESS:
'/T2h IL (h~1J'~
/ I
'qc,,, Ie) L~-,,~t,l
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, Dorothy F. Hershman, Testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last will; that I signed it
willingly; and that I signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by
Dorothy F. Hershman, Testatrix, this J rll-1 day of Jk.Ci'/'VJ......~{-l~
1979.
c~
\"" rJ
/; ~ i!."//~;> -. I
Testatrlx
v
. "':~"/ (7 j r i/;" ,1 r:-' /"/ ';77." ../
==8 ~. :~
, .--; GL--~,-~ --,- C .
Notary
J I ,-
f (,~y'}-~~
.~~
- 3 -
~
COMMONWEALTH OF PENNSYLVANIA
5S.
COUNTY OF CUMBERLAND
We, Roger M. Morgenthal and Tom H. Bietsch, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix, Dorothy F. Hershman, sign and
execute the instrument as her Last Will; that she signed will-
ingly and that she executed it as her free and voluntary act for
the purposes therein expressed; that both of us in the hearing
and sight of the Testatrix signed the will as witnesses; and
that to the best of our knowledge the Testatrix was at that time
18 or more years of age, of sound mind and under no constraint
or undue influence.
Sworn or affirmed to and subscribed to before me by Roger
M. Morgenthal and Tom H. Bietsch, witnesses, this JrA day of
~~~ ,1979.
.~. ;1__ /21//7 j(~.
i tness '
\'~t,v~ IJ
Witness
,'J 1
},.; T' Ii
.J.'-.() /;L"~,L,i
'-,
~.~~ ~~<~
0' Notary
~
- "'-.
(~ .
~~ ~~.......~
,'" -.' J,~"
- 4 -
REV-1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0071
COUNTY CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
HERSHMAN , OOROTHY F. 182-2207781
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
01/03/01 04/30/1915 WITH THE REGISTER OF WILLS
(IF APPcICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I SOCIAL SECURITY NUMBER
~ B 3. Remainder Return
CHECK 1. Original Return ~' Supplemental Return (date of death prior to 12-13-82)
APPRO- 4. Umited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
~ateof death after 12-12-82)
PRIATE 6. Decedent Died Testate 7. ecedent Maintained a living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach a copy of Trust)
BLOCKS 9. litigation Proceeds Received 10. Spousal Poverty Credit(date of death between 0 11. Election to tax under Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
tIli$~IH\ijQ$til~qQMl'iU11j;\piAlitQQijijtl~!'itl~!lij:;QliIfitii!!fllA4rAXiij!@RMAfjQjij$l!Qj;jilPm!ilj!i~p~tQi
NAME COMPLETE MAILING ADDRESS
COR- Roger M. Morgenthal, Esquire 95 Alexander Spring Road
RE- FIRM NAME (If Applicable) Suite 3
SPON
DENT FISHMAN & IDRGENTHAL Carlisle, PA 17013
TELEPHONE NUMBER
717-249-6333
134,000~bo OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) 26,982.50
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 50,024.53
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) 0.00
8. Total Gross Assets (total Lines 1-7) (8) 211,007.03
9. Funeral Expenses & Administrative Costs (Schedule H)(9) 18,679.54
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 93,105.31
11. Total Deductlona (total Unes 9 & 10) (11) 111,784.85
12. Net Value of Estate (Line 8 minus Une 11) (12) 99,222.18
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 Une 13) (14) 99,222.18
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, ortranslers under Sec. 9116(a)(1.2) X .0 (15)
TAX 16. Amount of line 14 taxable at linea! rate 99,222.18 X .0 ~ (16) 4,465.00
0.00 - 0.00
COMPU- 17. Amount of Line 14 taxable at sibling rate X .12 (17)
TATION 18. Amount of line 14 taxable at collateral rate 0.00 X .15 (18) 0.00
19. Tax Due (19) 4,465.00
20. 0 ICH~KjjEflEIl!VQl!AlleReQ!lElrt!@@R~NDt;WAtjQveR~AYMeNTil
Ib -cUJ3- ~
c
. >>BE SURE TO 'ANSWER ALL .QUESTfONS ON 'PAGE 2 ANC.RECHECK MATH<< ..
o PA15001
NTF 29755
Copyright 2000 Greatland/Ne!co LP- Forms Software Only
Estate of: WROTHY F. HERSHMAN
SUMMARY OF ALLOCATIONS TO BENEFICIARIES
Taxable at lineal rate
Larry R. Hershman
99.222.18
21-2001-0071
PA REV-1500 EX (6-00)
Page 2
Decedent's Complete Address:
STREET ADDRESS
906 Harrisburg Pike
CITY 'I STATE I ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
4,465.00
4,000.00
200.00
Total Credits (A + 8 + C)
(2)
4,200.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
(3) 0.00
(4)
(5) 265.00
(SA) 0.00
(58) 265.00
TotallnterestiPenalty (D + E)
4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund
5. If Une 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Une 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
~t~~~~!~~!~~YA~~8rr8!i~a8G~~yj8~~~~~tx8i~d!~;1~;;i~~~~R~!~g'~iRY~~tg2~~{
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, 1962, did decedent transfer property within one year of death
without receiving adequate consideration?, . . . . . . , . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0
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 return, including accompanying schedules and statements, and to the best of my
knowledge a ellet, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of
which re a r as an knowled e.
SIGNATU PE E PONSIBL OR FiLING RETURN DATE
Yes No
~ I
B ~
~
ADDR S
See Sch e attached
SI~~ 1tl;:~~ OT~ REPRESENTATiVE
~~
95 Alexander Spring Road, Suite 3, Carlisle, PA
DATE
S-/Jojo/
17013
/:)):::?/:::t?)J:):}{@:/:):(U/U{})}}}}}))}})\\\\())\\()))\,)::((U\::::/::::(:::=,j:::j:}@}}/:////U\)\\)\\\}}\:::?:}),(y/}///:\\tt})\\\)::)}\}))\\)/}:?(:))}:Y-':):?:U::::,}("
For dates' of cleai'h on or'after July 1, 1994'and befor'e'Janli,iry '1', "995, the tax rate'i'mposed 'on' tile' net value of'transf'ers't'o or {or the 'use'of th'e'surviving spouse
is 3%
[72 P.S.1i 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. Ii 9116 (a) (1.1) (ii)].
The statute <in.." 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 0% [72 P.S. !i9116(a)(1.2)).
The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. Ii 9116(1.2) [72 P.S. i 9116(aX1)].
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(aX1.3)]. 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
Copyright 2000 Greatland/Neico LP - Forms Software Only
Estate of: DOROTHY F. HERSHMAN
21-2001-0071
The follOVling person (s) are signing the return as representative (s) of the estate:
Larry R. Hershman
906 Harrisburg Pike
Carlisle, PA 17013
LAST WILL AND TESTAMENT OF DOROTHY F. HERSHf~N
I, DOROTHY F. HERSHMAN, of North Middleton Township,
Cumberland County, Pennsylvania, declare this instrument to be
my Last Will and Testament, in manner and form following:
1. I hereby expressly revoke all wills and Codicils
heretofore made by me.
2. I hereby direct my Executor to pay all my just debts,
funeral and administrative expenses out of my estate, as soon
as practicable after my death.
3. Should my son, Larry R. Hershman, survive me for a
period of thirty days following my death, I devise and bequeath
the remainder of my estate to Larry R. Hershman.
4. Should my son, Larry R. Hershman, predecease me or die
on or before the thirtieth day fOllowing my death, I direct that
~
I
my estate be settled and administered in accordance with the
provisions hereinafter set forth:
A. I forgive and declare discharged all debts,
owed to me by any person or organization, specifically
the debt owed by the Nestshoremen, Inc.
B. I direct that the remainder of my estate be
divided into six equal shares, which I devise and
bequeath as follows:
(1) One share thereof to the First Lutheran
Church of Carlisle, Pennsylvania, to be used for
the maintenance of its buildings and grounds.
(2) One share to my sister, Louise Martin,
of 63 North West Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
(3) One share to my sister, Leonora Stake, of
154 North Hanover Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
(4) One share to my sister, Melva Weary, of
925 West Louther Street, Carlisle, Pennsylvania,
or to her heirs if she predeceases me.
- 1 -
(5) One share to my nephew, Dr. Ronald
McGowan, of 302 Hillside Road, Johnson City,
Tenn., or to his heirs if he predeceases me.
~
I
I
I
~
I
!
(6) One share to be divided four ways, as
follows:
(alOne portion thereof to my
sister-in-law, Helen Farrow, of 913 East
Brandon Drive, Chambershurg, Pennsylvania,
or to her heirs if she predeceases me.
(bl One portion thereof to my nephew,
James Farrow, of Pittman, New Jersey, or to
his heirs if he predeceases me.
(c) One portion thereof to my niece,
Daine Farrow Behot, of Burlington, New Jersey,
or to her heirs if she predeceases me.
6.
(d) One portion thereof to my nephew,
Danny Farrow, of Chambersburg, Pennsylvania,
or to his heirs if he predeceases me.
r nominate and appoint Farmers Trust Company, Carlisle,
I
i
I
I
i
~
~
I
I
Pennsylvania, Trustee of the share of any beneficiary who may be
a minor. The income and/or principal of said trust may be
accumulated or expended for the maintenance, education and
support of such beneficiary as my Trustee in its sole discretion
may determine: and my Trustee, in the expenditure of income
and/or principal for such purposes, may, at its discretion,
apply the same directly without the intervention of a guardian
or pay the same to any person having the care or control of said
beneficiary or with whom the beneficiary resides, without duty
on the part of the Trustee to supervise or inquire into the
application of the funds by any person to whom any payment is
so made. The balance of such income and/or principal shall be
paid to such beneficiary upon reaching majority, or to such
beneficiary.s estate in the event of death prior thereto.
7. I nominate and appoint my son, Larry R. Hershman, as
Executor of this my Last Will and Testament: and as substitute
Executor I nominate and appoint Roger M. Morgenthal, Esq..
8. I direct that my personal representative and Trustee,
as well as their successors, shall not be required to file bond
or security in any jurisdiction.
~
- 2 -
II
I
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this "5 r.f
day of f).~...... , 1979.
?J (1-"'/41. JY. ft ,1?h~_....I (SEAL)
Dorot F. Hers man
WITNESS:
11t~ IL /h61l~
i ~J \~',-i....Ll.
I
I
I
I COMMONWEALTH OF PENNSYLVANIA
il
Ii COUNTY OF CUMBERLANO
"
Ii
SS.
I, Dorothy F. Hershman, Testatrix, whose name is signed to
the at.tached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act
!I for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by
Dorothy F. Hershman, Testatrix, this 1....1 day of ~(L...__{"",-
1979.
r. . ...,~<< .,
\ -~ -/ . .
/,'.) A ~~t~trl~" t'L,f--l ~r?~_../
vi
~ ..~/~
_~~C.
Notary
.'f t IIrr E. H~DT7' "R. NOTP.RY PI 18111";
I :- I :'-nln1v Cnrli:.!('!, P.\
" '," ("r",:::;i~:1 r::""ir~::; Jc:munry 27, 1983
I
Ii
- 3 -
COMMONWEALTH OF PENNSYLVANIA
58.
COUNTY OF CUMBERLAND
We, Roger M. Morgenthal and Torn H. Bietsch, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix, Dorothy F. Hershman, siqn and
execute the instrument as her Last Will: that she signed will-
ingly and that she executed it as her free and voluntary act for
the purposes therein expressed: that both of us in the hearing
and sight of the Testatrix signed the Will as witnesses I and
that to the best of our knowledge the Testatrix was at that time
18 or more years of age, of sound mind and under no constraint
or undue influence.
Sworn or
M. Morgenthal
D.UL"'.'~
affirmed to and subscribed to before me by
and Tom H. Bietach, witnesses, this 3rA
, 1979.
Roger
day of
'~f!:; JUt/},~
~lJ~J
Witness
~~ -r ~J~~_~
-J Nota;;
J/,; 'I'T f'. HFRTZU'R, ~J()TAnY PI !RUt::
CUoilb::;r1C1nd County Carlisle, Pr\
tAl' Commi,,;on Expires January 27, ) 983
- 4 -
REV-15jl2 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOROTHY F. HERSHMAN
SCHEDULE A
REAL ESTATE
FILE NUMBER
21-2001-0071
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 01 survivorship must be disclosed on Schedule F.
ITEM
NO. DESCRIPTION
VALUE AT DATE
OF DEATH
1 Real Estate Premises 906 Harrisburg Pike, Carlisle, CUmberland
County, Pennsylvania, appraised by Diversified Appraisal
Services
134,000.00
TOTAL (Also enter on line 1, Reo.ollul.tion] $
(If more space is needed, insert additional sheets of the same size)
134,000.00
7 CPA21 NTF 10904
Copyright Forms Software Only, 1997 Nelco, Inc.
APPRAISAL CERTIFICATION
I hereby certifY that upon application for valuation by:
THE ESTATE OF DOROTHY F. HERSHMAN
the undersigned personally inspected the following described property:
All that certain piece or parcel of land situate in the Township of North
Middleton, Cumberland County, Pennsylvania, bounded and described as follows:
Beginning at a point in the northern line of State Highway Route #11, the said
State Highway leading from Carlisle to Harrisburg, the said point of beginning being the
southeast comer of Lot No. 1 on the hereinafter mentioned Plan of Lots; thence
northwardly along Lot No.1, a distance of 300 feet to a point in line of Lot No. 13 on
said hereinafter mentioned Plan of Lots; thence eastwardly along Lot No. 13 a distance of
100 feet to a point, a comer of Lot No.3 on said Plan of Lots and now 'or formerly owned
by Harold H. Neusbaum; thence southwardly along the lot of the said Neusbaum, a
distance of 300 feet to a point in the northern line of said State Highway; thence
westwardly along said State Highway, a distance of 100 feet to a point, the place of
beginning.
To the best of my knowledge and belief the statements contained in this report are
true and correct, and that neither the employment to make this appraisal nor the
compensation is contingent upon the value reported, and that in my opinion the Market
Value as ofJanuary 3,2001 is:
ONE HUNDRED AND THIRTY-FOUR THOUSAND DOLLARS
$134,000
The property was appraised as a whole, subject to the contingent and limiting
conditions outlined herein.
3
rY~~
Larry E. Foote
Certified General Appraiser
GA-000014-L
REV-1 ~03 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOROTHY F. HERSHMAN
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-2001-0071
All property Joln~y-owned wlth right of survivorship must be disclosed on Schedule F.
ITEM
NO. DESCRIPTION
VALUE AT DATE
OF DEATH
1 Cornrron Stock of Keystone Financial, Inc., 1255 shares, valued at
$21. 50 pel share by merger consideration as set forth in
attached letter.
26,982.50
2 100 shares of common stock of KiptJater Mines Limited, worthless
0.00
3 28 shares of cornrron stock of 'IMA (Television Manufacturers of
America Co.), worthless
0.00
4 210 shares of ccmnon stock of Keystone Research and Developnent
Corp. After inquiries and attempts to contact this local
company, it is considered worthless.
0.00
TOTAL (Also enter on line 2, Raceoilulelion) $
(If more space is needed, insert additional sheets of the same size)
26,982.50
7 CPA31 NTF 10905
Copyright Forms Software Only, 1997 Nelco, Inc.
"'.'W"""'''''''''''''H".no.l_.u".....,..@
NOTICE TO FORMER KEYSTONE FINANCIAL, INC. SHAREHOLDERS
)~
(
",l
"
,
On October 6, 2000, Keystone Financial, Inc. combined with M&T Bank Corporation.
You have been deemed not to have made an election in the combination and your shares have
been designated as "Non-Election Shares" because either (i) your Election Form and Letter of
Transmittal, properly completed and accompanied by all required documents, was not received
by the Exchange Agent by 5:00 p.m. Eastern time on September 20, 2000, or (ii) you did not
make an election on that form. Therefore, the merger consideration to which you are entitled
consists @ in cash for each share of Keystone common stock you held immediately prior
to the combination.
If you already have sent in the certificate(s) representing your shares of Keystone
common stock, you will be receiving your merger consideration shortly. If you have NOT sent in
your certificate(s), then in order for you to receive your merger consideration you must complete
and return the enclosed Letter of Transmittal, together with the certificate(s), in accordance with
the instructions contained in the Letter of Transmittal.
Until the certificate(s) representing your shares of Keystone common stock are properly
surrendered to the Exchange Agent, such certificate(s) shall only be deemed to represent a right
to receive the merger consideration upon surrender. No interest will be paid or will accrue on the
merger consideration payable to you.
We appreciate your prompt completion and delivery of the enclosed Letter of Transmittal
together with the certificate(s) representing your shares of Keystone common stock. When
sending your materials by mail, please use registered mail, properly insured, with return receipt
requested. If you already have returned your certificate( s), there is nothing else you need to do at
this time.
If you have any further questions, please contact EquiServe at 1-800-730-4001 or M&T
Bank at 1-716-842-5445.
EquiServe Trust Company
Exchange Agent
Private Client Group
~ Merrill Lynch
214 Senate Avenue. Suite 501
P.O. Box 0810
Camp Hill, Pennsylvania 17001-0810
7179754600
8009370735
Fishman and Morgenthal
Attn: Roger Morgenthal
95 Alexander Spring Road, Suite 3
Carlisle, PA 17013-9137
February 28, 200 I
Re: Estate of Dorothy F. Hershman
Dear Mr. Morgenthal:
Following is research conducted on the three stock certificates that were found in Mrs. Hershman's safe
deposit box.
I.) 28 shares TMA (Television Manufacturers of America Co.). Company was adjudicated bankrupt
07/28/1972. Stock has no value. (Source: Annual Guide to Stocks published by Financial
Information, Inc. Jersey City, NJ.)
2.) 100 shares Kipwater Mines Ltd. Charter cancelled for failure to file reports and pay taxes in 1969.
Stock has no value. (Source: Annual Guide to Slocks published by Financial Information, Inc. Jersey
City, NJ.)
3.) 2 JO shares Keystone Research and Development Corp. No information was available. As the
certificate indicates company was incorporated in Pennsylvania, you might call the Corporation
Bureau in the PA Department of State to see if they can provide any details about this company.
We are providing this information at no cost. Please don't hesitate to contact us if you have additional
questions.
Sii',cen;IY, ~'~ 1 I
\ J 0J1lt. -II"
- ,tl,.,l.,t. ...' '.f>' l
~. .-
V;;ogmia G. W I /'
Assistant Vice President
Sr. Financial Consultant
VGW/crt
enclosures:
Copies of Stock Certificates
cc: Larry Hershman, Executor
REV-150e EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOROTHY F. HERSHMAN
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-2001-0071
Include proceeds of litigation & date proceeds were received by the estate. All prOD. lolntlv-owned with rlaht of survlvorshlc must be disclosed on Sch. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 Household goods, personal property CL'"ld other furnishings,
appraised by Linden Hall Antiques
2,085.00
2 Investment Account #872-30748, Merrill Lynch, Camp Hill, PA
28,900.90
3 Certificate of Depcsit #247412060993415
4 Checking Account #417963, M&T Bank, Carlisle, PA
15,272.39
3,766.24
TOTAL (Also enter on line 5. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
50,024.53
7 CPA81 NTF 10908
Copyright Forms Software Only, 1997 Nelco, Inc.
LINDEN HALL ANTIQUES
211 OLD STONE HOUSE ROAD
CARLISLE. PA 17013
717-249-1978
January 23, 2001
TO: Roger M. Morgenthal
Attorney
95 Alexander Spring Road
Carlisle, Pa. 17013
FROM: William G. Rowe
Appraiser
211 OLd Stone House Road
Carlisle, Pa. 17013
RE: Estate of Dorothy F. Hershman
906 Harrisburg Pike
Carlisle,Pa. 17013
DINING ROOM
Display Case
Collectibles
Table W/4 Chairs
China
Lenox Bowl
Angels
Blue Willow Plate
Cups/Saucers
Set Noritake dishes
Stemware
Glassware
Modern Collectibles
Linens
Fostoria
Pictures
$ 65.00
35.00
350.00
10.00
15.00
10.00
15.00
20.00
30.00
15.00
25.00
15.00
10.00
30.00
10.00
PAGE 2
GARAGE
Electric Mobility Cart
Walker Etc.
Porch Patio Furniture
$ 250.00
15.00
35.00
LIVING ROOM
Pair Recliners
2 Hitchcock Chairs
Desk
Mirror
Lamp
Pair Lampstands
2 Pc. Sofa
Coffee Table
Knick Knacks
Lamp (Broken)
Lamp
Console T V
Wall Hangings
End Stand , 2 DWr
Lamp Table
Books
Organ
Lamp
Royal Doulton Figurines
Brass Candlesticks
90.00
50.00
65.00
10.00
10.00
100.00
35.00
10.00
40.00
o
15.00
55.00
20.00
50.00
30.00
10.00
25.00
20.00
100.00
60.00
HALLWAY
Bookcase
Books
Floor Lamp
Settee
Knick Knacks
Mirror
20.00
15.00
10.00
50.00
10.00
20.00
PAGE 3
BEDROOM
Single Bed
Recliner/Ottoman
End table
Portable T V
Vanity Bench
Rocker
Lamp
2 Small Stands
Chest
Knick Knacks
TOTAL
\.....- '
$ 25.00
60.00
10.00
20.00
25.00
15.00
5.00
5.00
30.00
15.00
$2085.00
William G. Rowe
--,-0
F_N'
Reference 10: 137639
First Union National Bank
Atto: Account Verifications
POBox 40028
Roanoke V A 24022-73 13
February 14,2001
FISHMAN & MORGENTHAL
95 ALEXANDER SPRING ROAD SUITE 3
CARLISLE, PA 17013-9137
SUBJECT: Verification I Confirmation of Account and Balance Information provided for:
DOROTHY F HERSHMAN (SSN# 182-22-7781)
Date of Death: January 31, 2001
Denosit Account Information
Account
Type
Account
Number
Date of Death
Balance
Average
Balance.
Date
Opened
Maturity Interest Accrued YTD Date
Date Rate Interest Interest Paid Closed
CERTIFICATE OF DEPOSIT 247412060993415
LEGAL TITLE, DOROTHY F. HERSHMAN
$15,272.39
1219/1999
$59.39
$79.52
2/512001
.. Due to system limitatIOns. we can only provide a twelve month average balance on depository accounts.
. Date of death balance does not include accrued interest.
.. If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were
made during {~a time period.
/
~ I It.
Signature of Depository Re_
February 14,2001
Date
Drema Rubinoff
Depository Representative
Servicenter Associate
Title
(540)563-7323
Phone Number
abs; at
FEB 2 0 200\
1'J'r':<2
STMT
ACTION
PROD CODE DDA
CURR CODE
ACTN POST EFFECTIVE
TRACE ID
* 01/03
CO
STFD 1
96 OP EBRN
COlD
ACCT
THF TRANSACTION STMT FORMAT 01/01/30 12.38.52
MS 50852 ACTION COMPLETE
-
417963 SHORT NAME HERSHMAN DOROTH
PAGE 2 SEARCH FROM 100/12/05 THRU 101/01/18
CHECK NUMBER TRAN AMOUNT D/C BALANCE
DESCRIPTION ,-; . ~ ~
201.00 C ~766.24.--:
031036034087166 US TREASURY 303 SOC SEC - -
5191 529.00 D 3,237.24
0021114818 CHECK NUMBER 5191
5192
0022512238 CHECK NUMBER 5192
5193
0022743112 CHECK NUMBER 5193
310.00
D
2,927 .24
* 01/03
01/09
01/18
76.00
D
2,851. 24
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO ..-STSM
Wt ~ I (J~c..
()fl-,
STMT
ACTION
PROD CODE DDA
CURR CODE
ACTN POST EFFECTIVE
TRACE ID
* 12/05
CO
STFD 1
96 OP EBRN
COID
ACCT
THF TRANSACTION STMT FORMAT 01/01/30 12.38.49
MS 50852 ACTION COMPLETE
* 12/27
417963 SHORT NAME HERSHMAN DOROTH
PAGE 1 SEARCH FROM 100/12/05 THRU 101/01/18
CHECK NUMBER TRAN AMOUNT D/C BALANCE
DESCRIPTION
5186
0041535496 CHECK NUMBER 5186
5185
0041900512 CHECK NUMBER 5185
5188
0022866412 CHECK NUMBER 5188
5187
0022866414 CHECK NUMBER 5187
5184
0022866413 CHECK NUMBER 5184
5190
0021704554 CHECK NUMBER 5190
5189
0022834938 CHECK NUMBER
220.00
D
5,409.93
* 12/11
300.00
D
5,109.93
* 12/19
760.00
D
4,349.93
* 12/19
540.00
D
3,809.93
* 12/19
530.00
D
3,279.93
660.00
D
2,619.93
* 12/28
223.60
D
2,396.33
5189
1,168.91
121736152897662 US TREASURY 312 CIVIL SERV
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO ..-STSM
* 01/02
C
3,565.24
S5 tW"
o , ~1
vl r.'~ V'
Private Client Group
~ Merrill Lynch
214 Senate Avenue
Suite 501
P.O. Box 0810
Camp Hill. Pennsylvania 17001-0810
7179754600
800 937 0735
January 22,2001
Roger M. Morgenthal, Esq.
Fishman & Morgenthal
95 Alexander Spring Road, Suite 2
Carlisle, P A 17013
Re: Estate of Dorothy F. Hershman
872-30748
Dear Mr. Morgenthal:
Enclosed are date of death (01/03/2001) values for the Dorothy F. Hershman Estate. Her
account was opened November 30, 1981.
Don't hesitate to call if you need further details or have any questions.
S;'~'l'\' (i/ ciJf,
cf)\...'K-c! \0=-/
Virginia G. Walter
Assistant Vice President
Sr. Financial Consultant
VGW/crt
cc: Larry Hershman
P.O. Box 202
Carlisle, PA 17013
'JAN 23 :iII!1
. ,
Estate of Dorothy F. Hershman
Date of Death Values
January 3, 2001
Price Market . Accrued .
Security Quantity . 01103/01 Value Interest Total
Cash .30 .30
Money Fund
ML Banking Advantage 849 1.00 849.00 849.00
Certificate of Deposit
Providian Nat'l Bank 10,000 99.340 9,934.00 129.50 10,063.50
6.30% 10/21/2002
MBNA America Bk 10,000 98.907 9890.70 102.40 9,993.10
5.05% 10/22/2001
Equity
PPL Corp. 195 41.00 7,995.00 7,995.00
Total 28,669.00 231.90 28,900.90
FlEV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
OOROTHY F. HERSHlVlAN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE HUMBER
21-2001-0071
Debts of decedent must be _orted on Schedule I.
ITEM
NO.
A.
.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
1 Hoffman-Roth Funeral Halle, Inc.
8,025.00
2 George's Flowers, funeral floral arrangements
132.50
3 Westrninister Cemetery, footstone
695.00
4 sunnyside Restaurant, j;X)st-funeral reception
630.73
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Represent.tive(s)
Social Security Number(s)/EIN No. of Personal Represent.tive(s)
Street Address
City Slate
0.00
Zip
Year(s) Commission Paid:
2.
3.
Attorney Fee. Name: Fishman & !1:Jrgenthal
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant SEE NEXT PAGE
Street Address
City St.te Zip
Relationship of Claimant to Decedent
4,500.00
0.00
4.
Probate Fees
261.00
5.
Accountant's Fees
0.00
6.
Tax Return Preparer's Fees
0.00
See Schedule attached
Total frcm continuation page (s)
4,435.31
TOTAL (Also enter on line 9. Rec.oitUl.tionl $
(If more space is needed, insert additional sheets of the same size)
18,679.54
7 CPA11 NTF 10911
Copyright Forms Software Only, 1997 Neico, Ii'lC.
Estate of: OOROTHY F. HERSHMAN
SOJEDUlE H, PART B -- Administrative Costs
Item
No.
Description
7 Family Exemption Clain1ant:
FAMILY EXEMPTION
Larry R. Hershman, son
906 Harrisburg Pike, Carlisle, PA 17013
8 Register of Wills, Additional short certificates
9 cumberland Law Journal, Advertising Letters
10 The Sentinel. Advertising Letters
11 Diversified Appraisal Services, Real Estate Appraisal
12 Linden Hall Antiques, Appraisal of Personal Property
13 Register of Wills, filing inheritance tax return
14 Larry Hershman, reserve for closing expenses
15 Register of Wills, Reserve for Accounting
TOTAL. (carry forward to main schedule) . . . . . .
Page 2
21-2001-0071
Am::>unt
3,500.00
9.00
75.00
101. 31
250.00
85.00
15.00
200.00
200.00
4,435.31
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOROTHY F. HERSHMAN
Include unreimbursed medical eXlJenses.
ITEM
NO. DESCRIPTION
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21-2001-0071
AMOUNT
1 Decedent's check #5191, wri tt2l1 before but cleared after death
529.00
2 Decedent's check #5192, written before but cleared after death
310.00
3 Decedent's check #5193, written before but cleared after death
76.00
4 M&T Bank, check order invoice
9.18
5 Shipley Oil, fuel bill
345.54
6 Merck Medeo, rredicine bill
12.00
7 CP02, OXygen machine bill
52.95
8 The Sentinel, ad placed by decedent
16.97
9 Dottie Lewis, care giver, statement
770.00
10 United States Treasury, incorre tax
642.00
11 PA Dept of Revenue, income tax
298.00
12 The Patriot-News, ad placed by decedent
14.00
13 Judgrrent Note dated March 13, 1985, entered to No. 97-6035 Civil
Term, Prothonotary's Office of CUmberland County, in favor of
Larry R. Hershman
15,000.00
14 Judgment Note dated October 30, 1992, entered to No. 97-6037
Civil Term in CUmberland County Prothonotary's Office, in favor
of Larry R. Hershman
75,029.67
7 CPA12 NTF 10912
TOTAL (Also enter on line 10, Recaoitulation) $
(If more space is needed, insert additional sheets of the same size)
93,105.31
Copyright Forms Software Only, 1997 Nelco, Inc.
c\wpSI\ATR
fiLE COpy
LARRY R. HERSHMAN,
Iw. 97. (PO 37 ~ r fl--
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
v.
DOCKET NO: 3854 CIVIL 1992
JUDGMENT NOTE
DOROTHY M. HERSHMAN,
Defendant
CIVIL ACTION - LAW
AGREEMENT TO REVIVE
The undersigned, DOROTHY M. HERSHMAN, hereby agrees that the judgment .entered
on March 13, 1985 in the Office of the Prothonotary of Cumberland County Pennsylvania to No.
3854 Civil 1992 be revived and the lien continued and authorizes the Prothonotary to enter and
index a judgment of revival in the amount of $75,029.67 plus costs.
Date:
10 (21/'17
":;" -~.. / ( ./
// .: t : .f"'/.' ( / .f /~J, ; /1/ r,~ ..1.../'-' '"
DOROT,HY/M~ HERSHMAN, Defendant
COMMONWEALTH OF PENNSYLVANIA
; ss
I
II
I,
:1
il
COUNTY OF CUMBERLAND
On this, the d-.-1\;;:t1-.. day of 1) ~ , 1997, .before me, a Notary Public, in
and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared
DOROTHY M. HERSHMAN, known to me (or satisfactorily proven) to be the person whose name
is subscribed to the within instrument, and acknowledged that he/she executed the same for the
purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~~\)~
Notarv Put)
NOTARIAL SEAL
PATRICIA O. OL Y ARNIK, NotaJy Public
Hampden Twp., Cumberland County, PA
My Convnission Expires Augusl 27, 2001
II
, ,
~ubgmtnt <!ttrtifirat.e
*'
( -..
',' ~
, . >
-. , ,....- ~~~
'cI~ --R. 1~/
i/s .
c!)#UJ-t;I'1- 7n. l./f~
Common Pleas of Cumberland County, Carlisle, Pennsylvania
~ 1tr>:Q..
No, 38~+ CU~
f)d-. 10
199:J..
19.!l2 Judgment entered for
$ 7 s: OJ. 9. 'lDated
.
(O/3P,/92- Time//:'IJ-I1M,
Payable
-....
Tax and entry paid bY':~'
$ f- s-o
*~L.WdhL~
. pfOlhonotary
/
RETURN THIS PAPER WHEN THE JUDGMENT IS SATISFIED.
, .
1uJ. '3 r~i ~ 199;;..
Amount: $75.029.67
Date: October 50 1992
DEMANDJ11DGMENT NOTE
FOR VALUE RECEIVED, DOROTHY M. HERSHMAN ("Obligor"), the
undersigned promises to pay to the order of LARRY R. HERSHMAN ("Obligee"), P. O.
Box 202, Carlisle, PA 17013, Seventy-Five Thousand Twenty-Nine and 67/100 Dollars,
$75,029.67, as follows: On Demand with interest from default only at the rate of Twelve
Per Cent (12%) per annum.
The undersigned hereby empowers any Prothonotary, Clerk or Attorney of any Court
of Record within the United States or elsewhere to appear for the undersigned and, with
or without declaration, to confess judgment at any time or times, against each, any or all of
the undersigned and in favor of the holder hereof for the above sum, plus interest thereon
from thee date hereof, with costs of suit and an attorney's commission of 15% for collection.
The undersigned hereby releases all errors and expressly waives all rights to any stay of
execution, sequestration of rents and exemption of any property from levy and sale on
execution under any law or rule of court now in force or hereafter enacted. All of the
foregoing promises are the joint and several promises of the undersigned and shall bind the
undersigned, heirs, personal representatives, successors and assigns. The undersigned and
all endorsers waive protest, demand and notice of non-payment of this Notice. Obligor
further agrees that any property, real, personal or mixed may be sold through a Writ of
Execution and further hereby waives and releases all relief from any and all appraisements,
stay or exemption being of any State now in force or which are passed hereafter.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 30th day of
October. 1992.
WITNESS:
r(Z'j' n~ n~I~~~
(.. '.J /
'LI f77. ..x/I J ,-,.-
Dorot y M. Hershman
g~
-=
"
-
L'-'
,_:~
"
~ .:,. t.-O
r-o
, ,
EXPLANATION OF RIGHTS
FOR CONFESSION OF JUDGMENT
A I clearly and specifically understand that by signing a Note dated the 30th day
of October. 1992, in the amount of Seventy-Five Thousand Twenty-Nine and 67/100
($75,029.67) Dollars, payable to Larry R. Hershman which contains a Confession of
Judgment clause:
1. I will authorize the Prothonotary or any attorney of any Court of
Record to enter judgment against me and in favor of Larry R. Hershman which will give her
a lien upon any real estate which I may own, including my home; and
2. I will give up the right to any notice or opportunity to be heard prior
to the entry of this judgment on the records of the court; and
3. I will agree that Larry R. Hershman can enter judgment without any
proof of non-payment or other default on my part; and
4. I will subject all of my property, both personal property and real estate,
to execution and Sheriffs sale, pursuant to this judgment, prior to proof of non-payment or
other default on my part; and
5. I will be unable to challenge this judgment should Larry R. Hershman
enter it, except by a proceeding to open or strike the judgment; and such a proceeding will
result in attorney's fees and costs which I will have to pay.
B. I know and understand that it is the confession of Judgment clause in the
above described Note which gives Larry R. Hershman the rights enumerated in sub-
paragraphs one through five of paragraph A above.
IF I DO NOT SIGN A NOTE WHICH CONTAINS A CONFESSION OF JUDGMENT
CLAUSE, I UNDERSTAND THAT I WOULD HAVE THE FOLLOWING:
1.
judgment; and
The right to have notice and an opportunity to be heard prior to
2. The right to have the burden of proving default rest upon Larry R.
Hershman before my property can be exposed to execution; and
3. The right to avoid the additional expense of attorney's fees and costs
incident to opening or striking off a confessed judgment.
4. Fully and completely understanding these rights I have prior to signing
the above described Note, and clearly aware that these rights will be given up, waived,
relinquished and abandoned if I sign the Notes, I nevertheless freely and voluntarily choose
to sign the note, my intention being to give up, waive, relinquish and abandon my known
, .
rights (as described in paragraph B above) and subject myself to the circumstances described
in paragraph A above.
WITNESS:
I HA VB READ THIS ENTIRE FORM AND
I FULLY UNDERSTAND ITS CONTENTS
~~ ful\~
'21/~ (L~ (/7l. 1ItP/ud?71-€'A j
,vOlothy M. Hershman
AFFIDAVIT OF INCOME
The undersigned, being first duly sworn or affirmed, does hereby certify that his
income on the date of execution hereof, exceeds $10,000 per year.
IN WITNESS WHEREOF, I have hereunto set my hand and seal the 30th day of
October. 1992.
tC)~ , rJ -+ Lf ';n"J. -XA., /~, Nv'
;
Sworn to and subscribed before
me this 30th day of
October, 1992.
Notary Public
My Commission Expires:
CERTIFICATE OF RESIDENCE
C I' J t'f!' J -., () JJ
I certify that my current residence is: P. 0, l3oIC?. 0 L.J <\ r 151e/ I
"-
{'~.\d AI' :r.:n Y4\vA-rD <<"-->t--
,/ ,
"\wp51\ATR
, .
rILE COpy
LARRY R. HERSHMAN,
110. '1'1. (; 03'; G.,;d I ~
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET NO: 734 CIVIL 1985 .
JUDGMENT NOTE -
Plaintiff
v.
DOROTHY M. HERSHMAN,
Defendant
CIVIL ACTION - LAW
A GREEMENT TO REVIVE
The undersigned, DOROTHY M. HERSHMAN, hereby agrees that the judgment entered
on March 13, 1985 in the Office of the Prothonotary of Cumberland County Pennsylvania to No.
734 Civil 1985 be revived and the lien continued and authorizes the Prothonotary to enter and
index a judgment of revival in the amount of $15,000.00 plus costs.
Date:
/0/21/17
\...., ~. ,)' I ;
:.I h .. /-",,- ':....::', /_ '/iLd..-j . -
M. HERSHMAN, Defendant
COMMONWEALTH OF PENNSYLVANIA
: ss
I
II
"
"
I
II
COUNTY OF CUMBERLAND
On this, the d--G\J:;t., day of ()I~~ ,1997, before me, a Notary Public, in
and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared
DOROTHY M. HERSHMAN, known to me (or satisfactorily proven) to be the person whose name
is subscribed to the within instrument, and acknowledged that he/she executed the same for the
purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
,
VC0~~~~Y~~I~
NOTARIAL SEAL
PATRICIA O. OI.YAIINIK, Notal'/ Public
Hampden Twp., Cumberland CQUllIy, PI\
loIy C~ II,",,' f.lJ9Jf. Z7, 1001
.
.u..............J1~!;.9.h..... _...u........ ............. !f.B.S.
~...h_.Q!9'...R~~~.Q.........__.n..........uu......_.....~_.._.___no__............ .fI.r ...tw. _.1"'0- ,rornlse t.
.., .. ... ..... of .!-!~.~ !;Y....~,....tl!?~~h!!l.<i!n......... ... ..._...............u....................... ....-............................ ..... .........
...f.;i..fj;~.gn..1.hQ."l>.and..and... 9.P 1;1,.9.9....:: ::-.::::::-.::::-.::::.7.::::-.::::-:::::-.::::.7.::::.7.::;::::::-.::::::::::::....... ::;:.::;:. 0<"'"
''2
without def.lu,lon. v.lu. f,J..et'lv~. wll" Int.,.., front ...._._.de.faul.tuon~y:..n..n_..............._u.... .t ~ nl" of .1...n ~r Uftl. 1M'
aMUm. A,.. 'ur""u ...J...... do ""'"''' ,"""",1,. Ind 'rYtP_e, In" A"OI'ntY of In., Court of Recorda of ...n'....lv.n'.. or .l"whet.. 10 .ppe"
ftI .nd 10 etll., JudO'""'" '0.1'''' ..me... ,.... .". .bo". sum, \1'" or w'",our decl.ntion. with COIl. of lull. r.lu~ '" ."01'1. without ,tl'" of
..-.clition. .nd wi", ny, pH un'. Idded tor coU~tI", 'Hi: and ............ allO w-'vo ~ '....' of Inquhltlon l:Ift In" r.., "t.t. th.. "'" ~ kvlcd
upoI'I to collKt this nol.. IlId 4f "'.reo., II'OI"n"'ll, condemn th. ,am. and author". the Prolhonotlry '0 e"ler UPOfI ",e FI. FA. ..Jt\Y:... 'lid
""""'ary cOftdil'tn~tlon. end ....A.... 'urth.r 09r.. 'aid ."a'. m.J" bIl' laId on e Fl. FlA... .nd _.1"'00" ".r.b., walvlt' .nd r.I.." .11 ren", from .ny
.Ni ." &t)IH'a1u"\4!f,t, "tay or t'U"",Uon \.~ of an., Sl.lt. now 11'1 force. or her.."., fo be p"SH.
,.1~J-Q.QQ.,..Q.9..
..........u.................. ...... ....00........... ............ ................... ...00.......... .._ ......_........n_.......... ..... ........... ..U" ..........-
............_............. ....H.'un.." n............... _.... .... _........ ..... ........ .n...n..,,, .... n... ...un. ........ u... ........ ....n.. .......... '''''''.''.'
WITNESSES.:
" " ----, / .
.4LJ~~~~M~?r~r~iiil*~.i?U,~- ......IS.."
...... ...... ..._........_........._...._... ._.. ... ................ ... _ .... ..(S...II
........_....:._......_. ...... ...._..... ....u...._
........U._...h............_n_.n........_.........nn_.._........n__..tSHl)
I hereby certify [hat the precise rrsidenct of the JUdgO\(,1\l Crl'ditor in (hi~ Judgnu'nt j,,, _~.:._~:__~~~__~p_~!__
-. ~~r..U.liiJ..eJ.. PA. ._DO.U...... "'-'" ..--. .... ..-...--~~--.1/t;.=-==- .--... -. '" -...
....._...~~.....~~~-~.._....._...._..
Artorne;'~.--
, .
~
."
'..-'''''ilJo<.;;ll'
:""'-\\, ",I ':;~\i.~i:
3mtu!
(!l~rtifitZtt~
. .
,.... ~~:'_::~,!f . i:
I 3 ilAR' 85
92(,{,
:uU9.00 -- 1
u C O. 5 0 2
too 9.50 rOlL _ ~ of Cumberland County,
~/(,.~
~
~ m.1/-e/'~
Carlisle, Pennsylvania
No. 73'1
7)it;:
~
19 tc
19K Judgment entered for
00 .3-/" A' ~ a, If
$/..<;;OtJO. Dated bS Timet.aIM.
(JJ~ de/~
3~/3
Payable
Tax and entry paid by ;;i../J
s7'.~
Z:7~<~ [. N-RUN
Prothonotary IJP
RETURN THIS PAPER WHEN THE JUDGMENT IS SATISFIED.
, .
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
DOROTHY F. HERSHMAN
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Larry R. Hershman
906 Harrisburg Pike
Carlisle, PA 17013
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not Uat Trustee(s)
Son
21-2001-0071
AMOUNT OR
SHARE OF ESTATE
99,222.18
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 $
0.00
Copyright Forms Software Only, 1997 Nelco. Inc.
(If more space is needed, insert additional sheets of the same size)
Register of Wills of CUMBERLAND County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of DOROTHY F. HERSHMAN
also known as DOROTHY M. HERSHMAN
No. 21-01-71
, Deceased
Social Security No. 182 - 22 - 7781
LARRY R. HERSHMAN
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[K] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 12/03/1979 and codicil(s) dated None
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
NONE
o B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I
Name
Relationship
Residence
-,
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND
County, Pennsylvania with his/her last family
or principal residence at 906 HARRISBURG PIKE, NORTH MIDDLETON TOWNSHIP
(list street, number, and municipality)
Decedent. then ~years of age, died 01/03/2001 at CARLISLE HOSPITAL, PA
(Location)
Decedent 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
30,000.00
$
$
$
$
150,000.00
situated as follows:
906 HARRISBURG PIKE, CARLISLE, PA 17013
T ed or rinted name and residence
LARRY R. HERSHMAN, 906 HARRISBURG PIKE
P.O. BOX 202, CARLISLE, PA 17013
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
/ b -- c:; [73 - ~
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLAND
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: and that, as personal reRresentative(s) of
the Decedent, Petitioner(s) will well and truly administer the es te acc06to lit. . I J
Sworn to or affirmed and subscribed , ,c1LuA 1~ tJLu.J.{f}1IJf11\
'-tA~Ry,jR. HERSHMAN 1
before me this ~ day of \...;
, \
i, i'
f'"
'. I '
.'
JANUARY 2000
~l' //Y(~/~b' ~(,IdLv'/2c/ */7
I / For the 'Heglster
No. 21-01- 71
Estate of DOROTHY F. HERSHMAN
Deceased
Social Security No: 182 - 22 - 7781 Date of Death: 01/03/2001
AND NOW,
JANUARY 1 7
, 2000 ,in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters []] Testamentary 0 Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
LARRY R. HERSHMAN
in the above estate and that the instrument(s) dated
12/03/1979
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters. . . . . . .
$
235.00
.o/p~/(l-!f/~~NjL/ A2l <V/,//Xu/
( I' egister of Wills I
Short Certificate(s) .
$
12.00
Renunciation.
$
Attorney:
ROGER M. MORGENTfLt\L
Affidavits (
$
1.0. No:
17143
FISHMAN & MORGENTHAL
95 ALEXANDER SPRING ROAD
SUITE 3
CARLISLE, PA 17013
Extra Pages ( ) .
$
9.00
Address:
Codicil. .
$
JCP Fee.
$
5.00
Telephone: 717/249-6333
Wtl-Le/ LcpG/ ~Ac-/Z~ ~'0
Inventory.
$
Other . .
$
TOTAL. . . . . . . .. $ 261.00
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
j u ).('HJ)
t(t,\ ')/Kh d I fil d . h
T:1is is to certify that the information here given is correctly copied from an original ce~tificate of death uBi- 1 e WIt
L~\cal Registrar. The original certificate will be forwarded to the State Vital Records OffICe for permanent lIng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
me as
Fee for this certificate, $2.00
,f,OIIIIIII"',,,,,,,,,,.,,
IIII~ ~\\" OF PEM"'"
""I~~. .. .... ~cr~
l~.. -. .'. - ~\
!~_......,....\
~~" .. , ~~
i c,...)(~', J:b~
~ *' , ,..,"~ * ~
\. <::'2 '.o-cc~ - - - ~l
'\. ~ - . ~l
~ ~p "-.<v..,~l
'....--.:IMENl \)\ ",1,1
--""'''''''''111111/1''
a--- ~- ~~~~
Local Registrar
p 6947622
JAN'
4 2001
Date
No.
21-01-71
~ :)
H105,144 Aev. 1/91
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
PElPAINT
IN
~M"'NENT
....CKINK
M
Hershman
SEX
2, Female
STATE FILE NUMBER
SOCIAL SECURITY NUMBER
CI
3.
182-22-7781
DATE OF OEATH (Month. Day. Yearl
January 3, 2001
UNDER 1 DAY
HOUrs Minute.
OATE OF BIRTH BIRTHPLACE (City and PLACE OF OEATH (Check only one - see instructions on other Side)
(Month. Day, Year) Stale or Foreign Counlry) HOSPITAL:
Roxbury, PA Inpatient ~
7, a..
FACILITY NAME (II nollnstllulion. gIve streel and numbet)
~;='fY) 0
RACE. American Indian, Black, While. ete
(SpecIfy) Wh i te
Ie,
10.
DECEDENT'S USUAL OCCUPATION
(~;V.:o<;~l~:r,f.~r~d::u~r:~r~or
. 11.. Secretary llb. State
OECEDENT'S MAILING AODRESS (Street C.tylTown, State, Zip Code)
906 Harrisburg Pike,
Carlisle, PA 17013
WAS DECEOENT EVER IN
U.S. ARMED FORCES?
YesO No~
MARITAL STATUS. Married
Never Married. WidOwed,
Divorced (SpecIfy)
Widowed
SURVIVING SPOUSE
(If WIfe. give ma.den name)
12,
OECEOENT'S
ACTUAL
RESIOENCE
(See instructions
on other side)
17.. Stale
PA
Did
decedenl
live in a
township? 17d.O :h:;~:7\i~V: of
MOTHER'S NAME (Firs1- Middle. Maiden Surname) Mary Bell
17e. GO Yes. decedentlived In
North Middleton
rw~
17b. Coun
City/boro
James W. Farrow
liCENSE NUMBER
010343-L
HI.
INFORMANT'S MAILING i'OORESS (Street. "iI)'lTown. State. ZIp ~e)
20b 906 Harrlsburg P1Ke, Carllsle, PA 17013
PLACE OF OISPOSITION. Name of Cemetery, Crematory LOCATION. CityfTown. State, Zip Code
or Other Pt8C41
le, Westminster Cemetery 21d. Carlisle, PA 17013
NAME AND ADDRESS OF FACiliTY Hof fman-Roth Funeral Home
22c. 219 N. Hanover S Carlisle PA 17013
LICENSE NUMBER DATE SIGNED
(Month. Day. Year)
1a.
INFORMANT'S NAME (Type/PMt)
. Larry R. Hershman
METHOD OF DISPOSITION
Burial :iJ Cremation 0
Other (Specdy
DATE PRONOUNCEO DEAD (Month, Day, Year)
24. 10: 35 A'M. 25. January j, 2001
27. PART I: Enter the d;.eases. injurie. or complications which caused the death. 00 not enter tile mode of dying, such as cardiac or respiratory arr..t, shOCk Or heart failure.
Lilt only one c.use on each tine.
23b. 23c.
WAS CASE REFERREO TO MEOICAL EXAMINER/CORONER?
Yes~
NoD
b.
Probable Pneumonia
OUE 10 (OR AS A CONSEOUENCE OF);
Chronic Obstructive Pulmonar
OUE 10 (OR AS A CONSEOUENCE OF):
2$.
. Approxim.te
: interval between
lonset and de.th
PART II:
Other significant COnditions contributing to death, but
not resulting in the underlying cau,e given in PART I
Disease
Hx. Anemia & PVD
Status Post Fractured Hip with
OUE 10 (OR AS A CONSEOUENCE OF):
d.
WERE AUTOPSY FINOINGS
""AILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
Natural
~
o
o
Homicide
o
o 30.. 30b. M. 3Oc.
o ~~;'~~~~~'::'f;t home. farm, street, lactory, office
30..
Yes
Coroner
MANNER OF OEATH
O,l(fE OF INJURY
(Monlh. Day. Year)
TIME OF INJURY
INJURY AT WORK?
OESCRIBE HOW INJURY OCCURRED.
NO~
Yes 0
No 0
Accident
Pending InvestigetiOn
2... 21b,
CERTIFIER (Ctlec~ only ooe)
'CERTIFYING PHYSICIAN (PhystCian certifying cause 01 dellth when another phy$iClan has pronounced death and completed Item 23\
To thel:le8t of my knowl~, cteeth occurrecl due to the c.uM(.) and m.nner aa .t.ted. . . . . . , . . . , . . . . , . . . , . . . , . . . , . .. . . , . . , . . , . , . , . . . . . . , , .
Suicide
21.
Could not be determined
SIGNATUR
. PRONOUNCING AND CERTIFYINO PHYSICIAN (PhysiCian both pronouncing dealtl and certifying 10 cause 01 dealh)
To the I:Ie8t of my knowled~. death oceufT8(l at the time, date, and plllCe, and due to the eau88(a) .nd manner as .tated. . . . . . . , . . , , , . . . . . . . . , . ' . ,
D 31
L1CENS NUM ER DATE SIGNED (Month, Day. Year)
o 31c. 31d. January 4, 2001
NAME AND AOORESS OF PERSON WHO COMPLETED CAUSE OF OEATH
(Item 27) Type or Prinl Michael L. Norris, Coroner
6375 Basehore Road, Suite #1
Mechanicsburg, Pa. 17050
32.
DATE FILED (Month, Day. Yea',
34. <.1u\ . t dGD '\
'MEDICAL EXAMINER/COAONER
On the ba.l. ofaxamlnatlon and/or Investlvatlon. In my opinion. death occurred at the time, date, and place. and due to the causa(.) and
mannar aa atated.. . , . . . . , . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31..
REGISTRAR'S SIGNATURE AND N
~ \ ~l \ 101
of-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: DOROTHY F. HERSHMAN. a/kla DOROTHY M. HERSHMAN
Date of Death: JANUARY 3. 2001
Estate No.: 21-01-0071
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on JANUARY 12. 2001
Name Address
LARRY R. HERSHMAN P.O. BOX 202, CARLISLE. PA 17012
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
NONE
Date:
JANUARY 12. 2001
~vu,.~
Signature
;......-
FISHMAN & MORGENTHAL
Name Roaer M. Moraenthal . Esauire . #17143
Address 95 Alexander Sorina Road. Suite 3
Carlisle, PA 17013
Telephone (717) 249-6333
Capacity:
_ Personal Representative
-L Counsel for Personal Representative
CI/
STATUS REPORT UNDER RULE 6.12
Name of Decedent: DOROTHY F. HERSHMAN, a/kla DOROTHY M. HERSHMAN
Date of Death:
1/3/01
No. 2001-00071
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: xx Yes _No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to NO.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes ~ No
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? xx Yes _ No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of Orphan's Court and
may be attached to this report. ~
2/11/02 0crA.. l(}. -ml1(dial;>>lJ
Ign ure
Date:
\.::)
SALZMANN, DePAULlS, FISHMAN & MORGENTHAL, P.C.
Name (please type or print) Roger M. MorQenthal. ESQuire, #17143
95 Alexander SprinQ Road. Suite 3.
Address
Carlislet PA 17013
CIty, Sta e, Zip
(717~ 249-6333
T elep one Number
Capacity: _ Personal Representative
-1L Counsel for Personal Representative
:~~~
C..J
c'
c.::o
Lw
:....t.....
~)
"-'1
d.:
\::--J_,. -g
p ,~) ::::;
,.; '" ,.-:::
- "'--
1&- f}.[:; -- 6(
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
~..J/ ,
/L?
*'
REV-1'D7 EX AFP (12-00>
ROGER M MORGENTHAL ESQ
FISHMAN & MORGENTHAL
95 ALEXANDER SPG RD 3
CARLISLE PA 17013'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-20-2001
HERSHMAN
01-03-2001
21 01-0071
CUMBERLAND
101
DOROTHY
F
AlIOunt Remitted
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, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=ir;o-j-i-X--AFP--fi'2-.:oo'"r------...--iNHERITANCE--YAX-STA-fEMENT-O-F'-Accoutif--...---------------------
ESTATE OF HERSHMAN DOROTHY F FILE NO. 21 01-0071 ACN 101 DATE 08-20-2001
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: 07-02-2001
PR I NC I PAL TAX DU E : ...........................................................................................................................................................................................................................
4,465.00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-26-2001 AA478204 210.53 4,000.00
05-30-2001 AA496656 .00 265.00
08-06-2001 REFUND .00 10.53-
TOTAL TAX CREDIT 4,465.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDITwW (CRl,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
~ ?6-C2o.3-C:V
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG I 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
07-09-2001
HERSHMAN
01-03-2001
21 01-0071
CUMBERLAND
101
ROGER M MORGENTHAL ESQ
FISHMAN 8 MORGENTHAL
95 ALEXANDER SPG RD 3
CARLISLE PA 17B13
c;i
C/
REY-l!i~7 EX AFP (12-00>
DOROTHY
F
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=is47-i:X-AFP--fi'2':oiir-NO,.-ici--OF-YNHEifiTAifCE-YAX-APPRAisi:..iENT~--Ai.i-oWAiicE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HERSHMAN DOROTHY F FILE NO. 21 01-0071 ACN 101 DATE 07-09-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
134,000.00
26,982.50
.00
.00
50,024.53
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
211,007.03
(11)
(12)
(13)
(14)
111.784 85
99,222.18
.00
99,222.18
(9)
(10)
18,679.54
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect ~igures 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:
.00 X 00 = .00
99,222.18 X 045 = 4,465.00
.00 X 12 = .00
.00 X 15 = .00
(19)= 4,465.00
93,105.31
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-26-2001 AA478204 210.53 4,000.00
05-30-2001 AA496656 .00 265.00
TOTAL TAX CREDIT 4,475.53
BALANCE OF TAX DUE 10.53CR
INTEREST AND PEN. .00
TOTAL DUE 10.53CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE
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.)
CD
i ~
x
ill
N
(0
>
ill
a::
><
<
J-
W
J-
<<
_J-
zen
<(W
>0
..JZ
><
en
zW
zO
wZ
c.<
J-
a:
W
J:
Z
<(
Z
<(
>
--l CJ)
>- W
~W~
Z::>I-
WZ...J
o.W~
LL>:)
oWe
LC_
ILL~ <(
~oe a.
<(I-Z "
WZu:....CJ
~Wo~gs
Z~:)gco
~0:~C\J5Q
o::::<(w~o:
00.[[0.0:
u~~~~
~
o
N
(X)
~
~
<(
<(
d
Z
o
(!)
o
cO
C\J
r::
I-
Z
~
o
~
<(
t-
a..
-
w
(.)
w
a:
..J
<t
-
(.)
-
LL
LL
o
I-
Z
WOCI
Z~((W
OU)l-lIl
<(U)z~
WO~
~uz
<(
:iE
o
II:
LL
C
W
>
W
o
W
II: L
~-,
, ,
'_I
t" ).
.7
Vt
,..''''~
, I
L:J rr;
.. ,"i
jo-....'{
z Co>,
~
L tD
,I er:
01 :=J
!X in ~...:...
W en r~J
:[ :::;~? :
t.... l.j t;j
cr: a; _J
.:I >~ Ln
~~~ T ~~ ~.~
~ 2? :::; ~
..J c> L_ Cj
UJ
a::
UJ
:J:
g
f2
, .
[~'"
,,"",
(I
r=OZ ~~
I ~ (>
i= Co:;.
<(
~ ~
a: C>
O"~'
~ o:'u
- W
W co ,,"',</
I- 3'.J
<(z
UJ ~ ~
ffi W u:::
:J:
g
f2
I
I
~_------L
I~
~
.,.,...;
m
t"-...
~ ......
.1
'..
ru
ell I='
en
t:1) 0:
~
(J"l
U)
">,,~-,,.....~-~-. .,.....~.~'
Li.~
;...~
-,
r---
.~
....;
t."'"
~6
~~7.:t
Z
I-CI
z.-
wL
oX
~Uj
LU ry
O;~~i
LL.......
o
W
~
<(
z
~)
fU
I- ",
aJ,..o
~ ru
~:
a. 0':;
LL
o
LU
I-
<(
o
. :r
.
~?
'--:(
:........'
'"
'-..;
,',",
,--,
.:=-
~o
<(0
~.>
0: ',-'
<(
~
I-
en
o
a.
W
;1.1
~:
=i
~Lj
Z
::>
o
u
~~,
~ ~~ ~-;
\~~~.
'~
l~:.j
C.:t
'~?i
r:;]
1
'_~.J
o
<(
a.
I-
z
~
o
~
<(
....J
<(
I-
o
I-
>- ,'.:'"
CD '- l,..;J
fa~! ~~;
>
w
o
W
((
(/)
--l
--l
S
u..
o
a:
UJ
~
(/)
<!J
UJ
a:
T
"-1.
~_.
,)
~r:
~iJ
..;.
,,,<
"..../
Z
".' < ::r.
~,~
<r
C> v.
r' r
.,.,.j
....'
I r':r r-::
I- j~) I
<( ..
~.,-< U)
LL :::s:::
o CI
w <(
I- ~
<( W
o ((
L...';
L_)
....J
<(
W
U)
~.:---""'~~-~~ ~,..-.. --';-"--~~,..~... ... ...-~--
<D
i:
x
<(
I-
W
I-
<(<(
-I-
zen
<(w
>0
...Jz
><(
en
zW
zU
wZ
D..<(
!::
a:
w
J:
z
<{
z
<{
>
-.J (J)
>- w
C/) ><
zw<(
z::>....
wz...J
a...w<(
LL>::)
oWe
a:_
ILL:::: <{
~oe a...
<{I-~ -
wz ..-<9
sw~~~
z~::)asco
Oa:<(C\J5:Q
~~~t~
Ow::)w<{
uomOI
<..0
Lt)
<'0
<.0
01
..q
<(
<(
o
z
o
<0
o
00
C\J
r:::.
l-
n.
-
w
(.)
W
0:
..J
<(
-
(.)
-
LL
LL
o
I-
d]-.Ja:
z~~w
o(J)l-a)
<((J)z~
wa=>
~oz
<(
:2:
o
a:
u..
c
w
>
W
u
w
a: L
I-
Z
=>
a
~
<(
_.~,c;it;,,- - ...," .""-.-....~~.,.,....._-.__~_....,._., ~...'~..-.....:.lIoO...
o
(:'
U1
..(J
f'J
tit
..-f
-.
. )
......
0
tr
I.!) f1)
:E ",.
I;-
~ . )
0:: ,y ['"
......
W Q.
8 W
0
Ct cr <r
l.oJ CL
...J 0
<r .....~
...
I <! uJ
t-- ::<: Cf) ..J
Z W ill
W ..J UJ ~
t!l tI ~ .
-.....
n:: r--t ~
0 tf) --,
_..,.J ....l..
~.' [I'- m u
'~~l~~~.-~..-;o.~-~;a_, .;r~~-..;"'--"-:?:"-:;;;::_'~.~:-;~
I
~,,?.c'.:":--:.~ - .":,
UJ
II
UJ
:c
g
2
'::J
<r
U~~
,,,~_ ..;l. ; ~ J '.1,
~:..lr. \0 .\\
...~",.. ,l:f! 1\
_.J
j
, .
1--1
3
"..
o
~
a..
}-!
.'.. Z
:'f,~
' 'O~' f 1 ~
~
<(
-.J
<(
I-
a
I-
(f)
-.J
-.J
~
LL
o
a:
w
~
(f)
CJ
w
cr:
~'&~' ~
o g ~i
W.i!... t.A...
>
W
o
W
a:
~
--\
CD ,
t.... I
["
;
ru
ru ;
j 1
[u i='
CJ)
ll) a:
....... ~
;?': LL
/;"\
L:.J
l.J) "r
.... :
}~.
r-- 0
....~""-t ~....-~
i=' w...
z ~ CJ) 0
0 ' " <{ Q .---1 -, C';
-'
i= i....1 2- :;~ I .-} d: ".110"
<( t:1 <I ~:)
~ -I I- .~ nJ ...J j"t!
..... ,-
a: c,.. z E' I- ", c: ......,. ,
w z
0 0 I w lU :,,,,\-,
". W .." I- "r' I
u. ftJ w vJ ~ f'l) <{ () ~1~ I- (::-
~ a: u C!" >- 0 ....... <{
w w <{ w ~.
co .,....., 0 LJ a... U") ~ c. :.:J 0 --.,
w a:
I- ~ ru LL LL <{ >- lJ LL
<( ::> 0 0 ~ I- 0
I- z w W I- Z W
W ~ I- CJ) ::> I-
m -.J <{ <{ 0 0 <{
w u: z 0 a... U 0
,1J
=,
1::J
"
'j
JJ
,
;r:;
,~
I:
r-
w
er:
C)
:E:
I i
""*--
.:-.
;U;
CI~
;,jj
t..:,
':)
0:
....J
L~j
,. "
l,_,.J
(J)
:::c::
a:
<(
~
w
a:
-.J
<(
W
(J)