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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEAlTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG A 17128-0601
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INrTlAL) use a blank block to separate words
FilE NUMBER
21
Gaughen, Lorena G.
DATE OF BIRTH
February 15, 1907
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
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0: 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (dale of death prior to 12-13-82)
o 4.limiled Estate 0 4a. Future Interest Compromise ldaleoldealhEJfter12-12-62} 0 5. Federal Estate Tax Return Required
Q 6. DecedentDied Testate (Allach copy of Wi I) 0 7. Decedent Maintained a living Trust (Allach copy ofTrust) _ 8. Total Number of Safe Deposit Boxes
o 9. litigation Proceeds Received 0 10. Spousal Poverty Credit (daleo/death belwelll112.31-91 and 1-1-95) 0 11. Election to tax under Sec. 9113(A) {Allac:h Sc:h O}
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADORESS
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Patricia Armstrong, Esquire
FIRM NAME (1IAppliceble)
THOMAS, THOMAS, ARMSTRONG & NIESEN
255-7627
212 Locust Street
P.O. Box 9500
Harrisburg, PA 17108-9500
I. Real Estate (Schedule A) (I)
2. Slocks and Bonds (Schedule B) (2)
3. Closely Held Corporation'partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5, Cash, Bank Deposits & Miscellaneous Personal Property (5)
Z (Schedule E)
0 6, Jointly Owned Property (Schedule Fl (6)
j 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
:J (Schedule G or l)
!::: 8, Total Gross Assets (tolal Lines 1-7)
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<( 9, Funeral Expenses & Administrative Costs (Schedule H) (9)
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~ 10. Debts of Decedent. Mortgage Liabilities, & liens (Schedule I) (10)
11, Total Deductions (total Lines 9 & 10)
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268,168 54
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37,988 67
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306,157
(8)
18,573 24
2,570 54
(II)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
6,255 60
20,400 00
26,655 60
21,143
285,013
10,000
275,013
78
43
00
12, Net Value of Estate (Line 8 minus line 11)
13, Charitable and Governmental Bequests/See 9113 Trusts for which all election to tax has not been
14. Net Value Subject to Tax (Une 12 minus line 13)
43
15, Amount of line 14 taxable -0-
Z at the spousal tax rate
0 See instructions on reverse i efor Ie cenl e
i= 16, Amount ofline 14 taxable 139,013 43
~;! 'I ~ 4.5 % rate x .06
"':) 17. Amount of line 14 taxable 136,000 00
G. x .15
:IE al15%rate
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U 18. Tax Due
19 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Under penallles of perjury, I declare !hat I have examined this return, Including acrompanylng schedules and 5talemenls, and to the besl of my knowledge and belief, it is true, correct
and complete. Declaration of preparer other
than the D8rsonal r'eDresentaliva is based on all informaoon of which Or'eD8rer has anv krlowledoe.
SIGNATURE OF PERSON ONSIBLE FOR FILING RETURN ADDRESS
C Jill U-t~l WRZ-
SIG ATURE OF PREPARER OTHER THAN R ADDRESS
P.O. Box 9500, Harrisburg, PA 17108
DATE
U/!1/O/
DATE ' t
Decedent s ComDlete Address:
STREET ADDRESS Manor Care
1700 Market Street
CITY I SlATE PA I ZIP
Camp Hill 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 18)
2. Credits/Payments
A. Spousal Poverty Credit
(1)
8. Prior Payments
C. Discount
22,500.00
1,184.21
Total Credits (A + 8 + C ) (2)
23,684.21
3. InteresUPenalty if applicable
D.lnterest
E. Penalty
TotallnteresUPenalty (D + E) (3)
4. If line 2 is greater than line 1 + line 3, enter the differenoe. This is the OVERPAYMENT.
Check box on Page 1 Line 19 to request a refund (4)
5. If line 1 + line 3 is greater than line 2, enter the differenoe. Tliis is the TAX DUE, (5) 2,971.39
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This Is the BALANCE DUE. (58) 2,971.39
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PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN X IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ..... ................ ...... 0 []I
b. retain the right to designate who shall use the property transferred or its income;............... 0 []I
c. retain a reversionary interest; or. ................ ............... ................. ............................0 ~
d. receive the promise for life of either payments, benefits or care? .......................................0 IJi
2. If death occurred on or before December 12,1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .... ..~(~...................,... ............. ..........0 0
3. Did decedent own an "in trust for" or payable upon death bank account or security
at his or her death? . ........................ ............... ........................... ..........0 ~
4. Did decedent own an individuai retirement account, annuity, or other non-probate property?... 0 []I
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
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72 P.S. 99116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net vaiue of transfers to or for the use of the
surviving spouse from 6% to 3% for dales of dealh on or after July 1, 1994 and before January 1, 1995.
72 P.S. 99116 (a) (1.1) (ii) provided for the reduction ofthe rale imposed on Ihe net value of Iransfers to or for the use of the
surviving spouse from 3% to D% for dates of death on or after January 1, 1995. The statute does not exemot a transfer to a surviVing
spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving
spouse is the oniy benefiCiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995 - Please answer the following question by piacing an "x" in the
appropriate space.
Did the decedent create a trust or similar arrangement which is solely for the surviving spouse s benefit for his or her entire
lifetime? Yes 0 No [ID
If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the dealh of the second
spouse, al which time il will be fully taxable at the rate(s) appiicabie to the remainder beneficiary(ies). Enter the vaiue of the trust on
Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule 0 in order to
make the election available under Seclion 9113. If the eiection is made, the trust or similar arrangement is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate,
and the remainder is taxed at the rate(s} applicable to the remainder beneficiary(ies). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or
similar arrangement between the surviving spouse and the remainder beneficiary(ies).
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Lorena G. Gaughen
FILE NUMBER
2001-0027
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 compeKetI to buy or sen, both having reasonable knowledge of the relevant facts. Real property which Is Jointly-owned with
right of
survlvorshln must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
None
TOTAL (Also enter on line 1, Recapitulation) $
<If more space is needed, insert additional sheets of the same size)
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COMMONWEAllH or PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Lorena G. Gaughen
FilE NUMBER
2001-0027
All property Jolntly-owned with right of survivorshIp must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
PNC (Combined Trust Porffollo)
VALUE AT DATE
OF DEATH
$268,168.54
TOTAL (Also enteron line 2, Recapitulation) $ 268,168.54
(If more space is needed, insert addITional sheets of the same size)
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COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
2001.0027
Lorena G. Gaughen
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate, All proPflfty JOllltly~ned with the right of survivorshiP musl be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
DESCRIPTION
PNC Checking Account
PNC - Trust Cash
E.L. Gaughen (Spouse) Trust Payment
Peoples Benefit
Peoples Benefit
Patriot News Refund
IRS Tax Refunds
PA Tax Refunds
Blue Cross/Blue Shield Refund
Blue Cross/Blue Shield Refund
VALUE AT DATE
OF DEATH
$18,959.72
14,508.43
631.80
220.00
17.39
67.05
2,606.00
440.00
401.90
136.38
TOTAL (Also enteron line 5, Recapitulation) $ 37,988.67
(If more space is needed, insert additional sheets of the same size)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RES\DEN1 DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FI~E NUMBER
Lorena G. Gaughen
2001-0027
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERA~ EXPENSES:
1. Myers Funeral Home 6,795.00
Catholic Cemetaries 625.00
Post Funeral Wake 1,146.61
B. ADMINISTRATIVE COSTS:
1. Personal Representative So Cmnmissoos 6,000.0
Name of Personal Representative (s) Patricia Armstrong Morgan
Social Security Number(sj {EIN Number of Personal Representa\\ve(s}
Street Address 514 Orchard Drive
City Lemoyne State PA Zip 17043
Year(s) Commission Paid:
2. Attorney fees 3,000.0
3. Family Exemption: (If decedent 5 address is not the same as claimant s, attach explanation)
Claimant
Street Address
City State Zip
Relationship 01 Claimant to Decedent
4. Probate Fees 506.6
5. Accountant s Fees
500.0
6. Tax Return Preparers Fees
7.
TOTA~ (Also enteron line 9, Recapitulation) $ 18,573.24
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(If more space 's needed, Insert add,tlonal sheets of the same sIZe)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE 1M RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE HUMBER
Lorena G. Gaughen
2001-0027
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
100.00
529.39
953.07
66.06
627.02
295.00
2.
Conner Riech Assoc.
NeighborCare Pharmacy
Manor Care
Manor Care
Thomas, Thomas, Armstrong & Niesen (pre 000)
Robert Daub - Accountant (2000 Inc. taxes)
1.
3.
4.
5.
TOTAL (Also enter on line 10, Recapitulation) $ 2,570.54
(If more space is needed, insert additional sheets of the same size)
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
2001-0027
Lorena G. Gaughen
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. See Attached List
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. Good Shephard Church 10,000.00
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 10,000.00
(If more space is needed, insert additional sheets of the same size)
Name Address Relationship Amount
Gloria A. Dillree 2208 Logan Street, Camp Hill, PA 17011 Friend $75,000
Richard L. Rickert 2208 Logan Street, Camp Hill, PA 17011 Friend $25,000
Beverly Stone 15 King's Arms, Mechanicsburg, PA 17055 Friend $ 2,000
Kathryn Armstrong 3600 Logan Street, Camp Hill, PA 17011 Friend $ 5,000
Susan Marlene Shank and 153 Glendale Street, Carlisle, PA 17013 Niece and her $ 5,000
Dennis Shank husband
153 Glendale Street, Carlisle, PA 17013
Kirby Shank 45 Chestnut Street, Telford, PA 18969 Great Nephew $ 2,000
Kyra Shank 45 Chestnut Street, Telford, Pa 18969 Great Great $ 2,000
Niece
Christopher Shank 420 West Union Street, 3,d Floor Great Nephew $ 2,000
West Chester, PA 19382
Todd Shank 153 Glendale Street, Carlisle, PA 17013 Great Nephew $ 2,000
Phyllis Shanahan 4855 Grover Street, Omaha, NE 68106 Cousin $ 5,000
Suzanne Palkovic 5 Chrisma Drive, Camp Hill, PA 17011 Niece $ 3,000
Alex Jeffrey Palkovic 5 Chrisma Drive, Camp Hill, PA 17011 Great Nephew $ 500
Katelyn Elizabeth Palkovic 5 Chrisma Drive, Camp Hill, PA 17011 Great Niece $ 500
Thomas Gaughen P.O. Box 686, Camp Hill, PA 17001-0686 Son Residue
Kevin Gaughen P.O. Box 686, Camp Hill, PA 17001-0686 Grandson $15,000
Grant Gaughen P.O. Box 686, Camp Hill, PA 17001-0686 Grandson $15,000
Porsha Gaughen P.O. Box 686, Camp Hill, PA 17001-0686 Granddaughter $15,000
Warren Gaughen P.O. Box 686, Camp Hill, PA 17001-0686 Grandson $15,000
Doris & 128 Minnich Road Cousin $ 2,000
J. Richard Washinger Chambersburg, PA 17201
Susan Grobaski 05505 Denise Road Niece $ 3,000
Boyne Falls, MI 49713-9729
Martin Shanahan 261 E. 3"' Street, Wahoo, NE 68066 Cousin $ 2,000
LAST WILL AND TESTAMENT OF
LORENA G. GAUGHEN
I, Lorena G. Gaughen, of Country Meadows, Mechanicsburg, Pennsylvania, being
of sound and disposing mind, memory and understanding, do hereby make, publish, and
declare this as and for my last will and testament, hereby revoking any and all prior wills,
and any and all codicils thereto, by me at any time heretofore made.
FIRST: I direct the payment of the just, reasonable and lawful expenses of my last
illness and funeral from my estate as soon after my death as conveniently may be done.
SECOND: Except as I may have otherwise provided in a memorandum signed by
me and accompanying this willi give my tangible personal property (excluding inter alia,
any cash, stocks or monies in Trust) to my son, Thomas W. Gaughen, if he survives me
by sixty (60) days.
THIRD: 1 give and bequeath the following:
a) The sum of $5,000 jointly to my niece, Susan Marlene Shank and her
husband Dennis Shank, per stirpes and an additional $2000 for each of their three children,
per stirpes and $2,000 in Trust for and to their granddaughter Kyea.
b) The sum of $75,000 to my very good and faithful friend Gloria Dillree.
c) The sum of $25,000 to my good friend Rich Rickert.
d) The sum of $2,000 to my good friend Beverly Stone.
e) The sum of $5,000 to my good and faithful friend Kathryn Armstrong.
f) The sum of $5,000 to my husband's cousin Phyllis Shanahan.
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October 8, 1998
g) The sum of $3,000 to my niece Susan Palkovic and an additional $500 in
Trust for and to each of her two children.
h) The sum of $15,000 each to my grandchildren Kevin, Grant, Porsha and
Warren Gaughen.
i) The sum of $2,000 to my friends Doris and Dick Washinger of Chambersburg,
PA.
j) The sum of $3,000 to my niece Susan Grabowski.
k) The sum of $2,000 to Martin Shanahan.
I) The sum of $10,000 to Good Shepherd Church, Camp Hill, Pennsylvania.
I recognize that after my residuary pays all the taxes associated with these
bequests, as well as the costs of administrating my estate, there may be virtually no
residuary. However, my son Tom will receive the balance of all monies from the estate of
my husband, Eldon L. Gaughen.
FOURTH: All the rest, residue and remainder of my property wheresoever and
whatsoever, I give, devise and bequeath to my son, Thomas W. Gaughen, if he survives
me by sixty (60) days. If he does not survive me, then I give, devise and bequeath the
remainder to my grandchildren under the terms of paragraph SIXTH. I also exercise any
power of appointment I may have under any document and provide for any monies or
property to be given to my son, Thomas W. Gaughen.
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October 8, 1998
FIFTH: If my son, Thomas W. Gaughen, does not survive me by sixty (60) days, I
give, devise, and bequeath all the rest, residue, and remainder of my estate in equal shares
to my grandchildren, Kevin, Grant, Porsha and Warren Gaughen, per stirpes.
If any of my grandchildren are a beneficiary under this paragraph FIFTH or under
paragraph THIRD and have not reached age thirty (30) at the lime of my death then that
part of my estate passing to them shall be held in Trust as hereinafter set forth.
If my son, Thomas W. Gaughen, disclaims any portion of my estate passing to him
under Paragraphs SECOND and FOURTH hereof, said disclaimed portion shall pass under
this Paragraph FIFTH.
SIXTH: If any of the beneficiaries are under age thirty (30) when they take under
the terms provided herein then the monies passing to them shall be held in Trust by Patricia
Armstrong Morgan and Gloria Dillree as Co-Trustees (hereinafter collectively referred to
as "Trustee"), for the benefit of such beneficiary or beneficiaries, and so much of the
income therefrom and so much of the corpus thereof as may from time to time be deemed
to be necessary in the sole discretion of my Trustees shall be used, paid and applied for
the support, health, comfort, maintenance and education of such beneficiary or
beneficiaries. The Trustee shall from time to time add to the corpus any surplus income.
As each beneficiary attains the age of thirty (30) years, the fund then held for his or her
benefit shall be paid and distributed to such beneficiary or beneficiaries but if such person
shall die prior thereto, the balance shall be distributed to his or her executor or
administrator.
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October 8, 1998
SEVENTH: My Executor shall, in his absolute discretion, determine any available
elections under the Internal Revenue Code of 1986 or that are in effect at the time of my
death.
EIGHTH: I direct that neither the Trustees, nor any Executor/Executrix, or other
fiduciary named, nominated, or appointed in this, my last will and testament, shall be
required to post any bond or give any security of any type for any purpose whatsoever, any
law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the
contrary notwithstanding.
NINTH: My Executor/Executrix or other fiduciary named, nominated or appointed
in this my last will and testament and their successors shall have the following powers (if
applicable) in addition to those vested in them by law or by other provisions of this will or
any trust agreement, to be exercised by them in their absolute discretion, which powers
shall be applicable to all property held by them, effective without the order of any court and
until the actual distribution of all such property:
A. To retain, as investments of my estate or trust, any or all assets of my estate,
real, personal, or mixed, without regard to any principal of diversification, and to purchase
and acquire real or personal property, and to hold any or all of such real and personal
property retained or acquired without making the same productive of income;
B. To permit any beneficiary to occupy any real estate retained or acquired
upon such terms and conditions as my fiduciary shall deem proper;
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October 8, 1998
c. To invest and reinvest at discretion without restriction to so called "legal
investments." with the specific right to invest in common and preferred stocks, and in such
common trust, diversified, money market and mutual funds as they deem appropriate;
D. To sell. to grant options for the sale of, or otherwise convert any real or
personal property or interest therein. at public or private sale, for such prices, at such time.
in such manner and upon such terms as they may think proper. and to execute and deliver
good and sufficient conveyances, assignments and transfers thereof without liability of any
purchaser to see to the application of the purchase money;
E. To compromise and arbitrate claims by or against my estate or any trust
created hereunder;
F. To make distributions in cash or kind. or partly in each at valuations fixed by
my Executor and Trustee at the time of distribution;
G. To join in any recapitalization. merger, reorganization or voting trust plan
affecting investments; to deposit securities under agreement; to subscribe for stock and
bond privileges; and generally to exercise all rights of security holders;
H. To manage. operate, repair, alter or improve real estate or other property, and
to lease real estate and other property upon such terms and for such period as my
Executor and Trustee deem advisable even for more than five years and beyond the
duration of any trust;
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October 8, 1998
I. To deduct administration expenses upon either the federal estate tax return
or fiduciary income tax return, with or without adjustment between principal and income,
as my Executor shall determine;
J. To associate with them in the absence of a corporate fiduciary, an
accountant, custodian and investment advisor, and their agents and to compensate such
accountant, custodian and investment advisor, and agents out of principal or income or
both as my Executor or Trustee shall determine, such compensation to be a reduction to
the compensation of my Executor or Trustee;
K. To carry out the terms of any agreement I may have entered into to sell all
or any part of any property or any interest I may own in any business at the time of my
death;
L. To execute and deliver any written instruments that they may deem
advisable to carry out any power, duty, or discretion granted to them, and all persons shall
be fully protected in relying upon their power to execute every such instrument and no one
shall be obligated to see to the application by them of any money or property received by
them pursuant to the execution and delivery of any such instrument;
M. Any Executor or Trustee may delegate any or all of hislher powers, duties and
discretions to any other Executor or Trustee by an instrument in writing and may revoke
such delegation at will in the same manner. In this regard, the Executor of my estate shall
have full authority to change the Trustee named herein to any corporate Trustee of their
choosing, so long as this power does not constitute a general power of appointment or
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October 8, 1998
result in the imposition of additional taxes, in which case, said authority is rescinded or
limited so as to preclude such inclusion;
N. To do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate; and
O. To make any election provided for in the Internal Revenue Code with respect
to all or any part of my estate qualifying for any such election.
TENTH: Not withstanding any other provision hereof, the Trustee, may, in its sole
and absolute discretion, at any time terminate any or all Trust created hereunder if in the
judgment of such Trustee the value thereof is insufficient to warrant the cost and
inconveniences of continued administration, or if, in its judgment continued administration
is otherwise impractical. Upon such termination the entire balance remaining shall be paid
over to the current income beneficiary, then in equal shares to all income beneficiaries
(whether or not then receiving income in equal shares). In making such a judgment, such
Trustee need not consider the interest of remaindermen or succeeding income
beneficiaries and their respective interest in the Trust shall cease upon such determination
by such Trustee.
ELEVENTH: My Executor and Trustee shall pay all estate, inheritance and other
death taxes, together with interest and penalties, which shall be payable with respect to
property or interests subject to taxation by reason of my death and whether passing under
my will or any codicil, or otherwise, including jointly held and other non-testamentary
property. My Executor and Trustee shall pay the same out of the principal of the residuary
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October 8, 1998
unless otherwise required by law. Trustee may advance to my Executor from the principal
of the Trust such amount as may be required by my Executor for the payment of such
taxes. Notwithstanding the foregoing, I authorize my Executor to exercise any options
available in determining, minimizing and paying taxes of my estate as my Executor may
at his sole discretion deem appropriate.
TWELFTH: Any and all payment or payments of any sum or sums, whether in cash
or in kind and whether of principal or income, payable to any beneficiary, shall be free
from anticipation, alienation, assignment, attachment, and pledge, and free from control by
the creditors of any such beneficiary.
THIRTEENTH: I appoint Patricia Armstrong Morgan as Executrix of this, my last will
and testament, but should she for any reason fail to qualify as such Executrix, or having
qualified fail to serve as such Executrix, then I nominate, constitute, and appoint my son,
Thomas W. Gaughen, as my Executor of this, my last will and testament. I understand that
I may choose anyone to act in this latter capacity and have voluntarily requested that
Patricia Armstrong Morgan be named Executrix. I intend that any Executor/Executrix or
Trustee serving hereunder be compensated for their services in addition to any other
monies they may receive.
FOURTEENTH: Words used in the singular may be read to include the plural or the
plural may be read as the singular. Similarly, the masculine form may be read to include
the feminine and neuter; the feminine may be read to include the masculine and neuter;
and the neuter may be read to include the masculine and feminine.
-8-
October 8, 1998
FIFTEENTH: Finally, all references in this will to issue shall include natural born
children as well as adopted children.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will
and testament, consisting of nine (9) typewritten pages, this 8th day of October, 1998.
c1~j~
Signed, sealed, published, and declared by the above named Testatrix, Lorena G.
Gaughen, as and for her last will and testament, in the sight and presence of uS"who, at
hislher request, in hislher sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
(/'~~~d~
AddressZiZ- 6xvs+ -sJ. t-/e4. .b\ J 7/D&
Address S-o::: s~.w Sf {A~Li<I<L M
I J
-9-
October 8, 1998
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
We, Lorena G. Gaughen, the Testatrix and the witnesses, respectively, whose
names are signed to the Last Will and Testament, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and Testament that she had signed willingly, and that she executed it as her free
and voluntary act for the purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the will as witness and that to the best
of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older,
of sound mind and under no constraint or undue influence.
('
Subscribed, sworn to and acknowledged before me by Lorena G. Gaughen,
Testatrix, and subscribed and sworn to before me by fame-Ia Il. WOS'SOf) and
~TOh(} fl. fj !WfnOU..... , this 8th day of October, 1998.
~~
Notary Public
My Commission Expires:
F:\ClIENT5IMfSC\GAUGHEMWllLS\2'VVflL.WPD
Notarial Seal
Rhonda Heffelling"', Notary PubIio
Harrisburg. Dauphin Cout:'tV
My Commission Expires March 13. 2000
Member. Pennsyl1lania AssociaUon of Notaries
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
Lorena G. GauQhen
No.
21-01-207
also known as
Sue GauQhen
, Deceased
Social Security No. 201-16-4933
Petitioner(s), who is/are 18 years of age or older, applv(ies) for:
(COMPLETE "A" OR "B" BELOW:)
[;I
A Probate and Grant of Letters and aver that Pet:itione'(s) is the ex:EnJtrix nama:! in the Last Will of the Docedent dated
October 8, 1998 and codicil(s) dated
State relevant circumstances. e.g., renunciation, death of executor, etc.
Except: as fOIb.tvs, D:o:dent:do not many, was notdi\.aced, and do not have a dlitt born or adoplEd afterexe:utbn of1t-e clocunenls<::llren:d 1iJr pobate; was
not the victim of a killing and was never adjudicated incompetent:
[;I
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner{s) after a pq:H g:m:;h ~aoca1aina::l that!JEo:dalt left no Will and was survi\,a:l by the fdbtving spouse (If any) and
heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
County, Pennsylvania, with her last family or prindpal residence at
(l c~&~s L..vv. C....o-t-- 4g?Jl e I (......t(le.
(list street, number and municipality) ~a.e" IVJ~ \l.cl "<'<"\e c..1.i......t:\..iV'l c S '() u..'-' 9...-
Decedent, then~ years of age, died February 10, 2001, at Manor Care Health Services. 1700MarketStreet.CamoHiII.PA 17011 \7c:;:;,
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property . . . . . . . . . . . . . . . . . . . . .. $ 290,000.00
(If not domiciled in PAl Personal property in Pennsylvania ..... $
(If not domiciled in PAl Personal property in County . . . . . . . . .. $
Value of real estate in Pennsylvania ............................. $
Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 290,000.00
Real Estate situated as follows: N/A
Wherelbre, Petitioner(s) respectfully request(s) 1t-e probate of1t-e last Will and Codicil(s) presentEd with this Petition and the grant of letters in the appropriate
form to the undersigned:
T
Patricia Armstrong Morgan
514 Orchard Drive
Lemo ne PA 17043
Form RW-1 Pag", 1 of:2 (Dauphin County) ~ Rev. 9/92
/6 -02Ic:2 - b
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLAND
TIle Petitioner{s) al:x::M3-narra::l S\M3Elr(s) and affirrn(s) that "the statEments in "the foregoing Petition are true and cx:>rrect
to "the best of "the knowledge and belief of Petitioner{s) and that as personal representative(s) of"the I:JEo::dent Petitioner(s) will
vvell and truly administer the estate according to lavv.
Svvorn to and affirmed and subscribed ~~uC/
before me this 21st day of
Q.~u
{J/Ul K
()
FEBRUARY
2001
~I () >j2/L/4_'~~hJ) /7t ~ ~.7"
No.
21-01-207
Estate of
Lorena G. Gauqhen
Deceased
Social Security No.
201-16-49
Date of Death: Februarv 10. 2001
AND NOW. FEBRUARY 22 .2001, in consideration ofthe Petition on the reverse side hereon,
satisfactory proof having been presented before me,
IT IS DECREED that Letters J'Testamentary ijbo{xA.1dmmi:st~~
xJl\XXIl{~:K1e.t:x:lxlxlma:Je~Il{~mi:Il{CllliIlIaac
are hereby granted to Patricia Armstronq Morqan. e/ktB rBtrioiQ ^rmatr8n~
in the above estate and that the instrument(s) dated October 8. 1998
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters......................... .$
270.00
\~/.//)1:;:.t~/~!z;""j) ~e) .q~J,71
. eglster of Wills
Short Certificate(s) ...(3).$ 9.00
Renunciation......... ...... $
Affidavit ( ) ................ $
Extra Pages ( ) ...........$
Cod i c i I .......................... $
JCP Fee............... .........$
27.00
5.00
Attorney: Patricia Armstronq. Esquire
1.0. No: 23725
Address: 212 Locust Street. P.O. Box 9500
Harrisbun:l, PA 17108-9500
Telephone: (71 7) 255-7627
Inventory............ ..........$
Other........................... $
TOTAL.. .. .. .. .. .. ... $
311. 00
Form RW-1 Page 2 of 2 (Dauphin County) - Rev. 9/92
HlOS.80" REV {)/86
This is to certify that the information here given is correctly copied fron: an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fillllg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Fee for this certificate, $2.00
Local Registrar
p
7176563
rEg 1 3 7001
Date
;43_ 21117
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
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1lECEIlENT'.IoWUNG_aalSlr"'~_2iD~
4837 East Trindle Road
Mechanicsburg,Pa 17055
CGIIogo
('''.$+)
_SlllrUS._
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31..
LAST WILL AND TESTAMENT OF
LORENA G. GAUGHEN
I, Lorena G. Gaughen, of Country Meadows, Mechanicsburg, Pennsylvania, being
of sound and disposing mind, memory and understanding, do hereby make, publish, and
declare this as and for my last will and testament, hereby revoking any and all prior wills,
and any and all codicils thereto, by me at any time heretofore made.
FIRST: I direct the payment of the just, reasonable and lawful expenses of my last
illness and funeral from my estate as soon after my death as conveniently may be done.
SECOND: Except as I may have otherwise provided in a memorandum signed by
me and accompanying this willi give my tangible personal property (excluding inter alia,
any cash, stocks or monies in Trust) to my son, Thomas W. Gaughen, if he survives me
by sixty (60) days.
THIRD: I give and bequeath the following:
a) The sum of $5,000 jointly to my niece, Susan Marlene Shank and her
husband Dennis Shank, per stirpes and an additional $2000 for each of their three children,
per stirpes and $2,000 in Trust for and to their granddaughter Kyea.
b) The sum of $75,000 to my very good and faithful friend Gloria Dillree.
c) The sum of $25,000 to my good friend Rich Rickert.
d) The sum of $2,000 to my good friend Beverly Stone.
e) The sum of $5,000 to my good and faithful friend Kathryn Armstrong.
f) The sum of $5,000 to my husband's cousin Phyllis Shanahan.
-1-
October 8, 1998
g) The sum of $3,000 to my niece Susan Palkovic and an additional $500 in
Trust for and to each of her two children.
h) The sum of $15,000 each to my grandchildren Kevin, Grant, Porsha and
Warren Gaughen.
i) The sum of $2,000 to my friends Doris and Dick Washinger of Chambersburg,
PA.
j) The sum of $3,000 to my niece Susan Grabowski.
k) The sum of $2,000 to Martin Shanahan.
I) The sum of $10,000 to Good Shepherd Church, Camp Hill, Pennsylvania.
I recognize that after my residuary pays all the taxes associated with these
bequests, as well as the costs of administrating my estate, there may be virtually no
residuary. However, my son Tom will receive the balance of all monies from the estate of
my husband, Eldon L. Gaughen.
FOURTH: All the rest, residue and remainder of my property wheresoever and
whatsoever, I give, devise and bequeath to my son, Thomas W. Gaughen, if he survives
me by sixty (60) days. If he does not survive me, then I give, devise and bequeath the
remainder to my grandchildren under the terms of paragraph SIXTH. I also exercise any
power of appointment I may have under any document and provide for any monies or
property to be given to my son, Thomas W. Gaughen.
~
-2-
October 8, 1998
FIFTH: If my son, Thomas W. Gaughen, does not survive me by sixty (60) days, I
give, devise, and bequeath all the rest, residue, and remainder of my estate in equal shares
to my grandchildren, Kevin, Grant, Porsha and Warren Gaughen, per stirpes.
If any of my grandchildren are a beneficiary under this paragraph FIFTH or under
paragraph THIRD and have not reached age thirty (30) at the time of my death then that
part of my estate passing to them shall be held in Trust as hereinafter set forth.
If my son, Thomas W. Gaughen, disclaims any portion of my estate passing to him
under Paragraphs SECOND and FOURTH hereof, said disclaimed portion shall pass under
this Paragraph FIFTH.
SIXTH: If any of the beneficiaries are under age thirty (30) when they take under
the terms provided herein then the monies passing to them shall be held in Trust by Patricia
Armstrong Morgan and Gloria Dillree as Co-Trustees (hereinafter collectively referred to
as "Trustee"), for the benefit of such beneficiary or beneficiaries, and so much of the
income therefrom and so much of the corpus thereof as may from time to time be deemed
to be necessary in the sole discretion of my Trustees shall be used, paid and applied for
the support, health, comfort, maintenance and education of such beneficiary or
beneficiaries. The Trustee shall from time to time add to the corpus any surplus income.
As each beneficiary attains the age of thirty (30) years, the fund then held for his or her
benefit shall be paid and distributed to such beneficiary or beneficiaries but if such person
shall die prior thereto, the balance shall be distributed to his or her executor or
administrator.
-3-
October 8, 1998
SEVENTH: My Executor shall, in his absolute discretion, determine any available
elections under the Internal Revenue Code of 1986 or that are in effect at the time of my
death.
EIGHTH: I direct that neither the Trustees, nor any Executor/Executrix, or other
fiduciary named, nominated, or appointed in this, my last will and testament, shall be
required to post any bond or give any security of any type for any purpose whatsoever, any
law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the
contrary notwithstanding.
NINTH: My Executor/Executrix or other fiduciary named, nominated or appointed
in this my last will and testament and their successors shall have the following powers (if
applicable) in addition to those vested in them by law or by other provisions of this will or
any trust agreement, to be exercised by them in their absolute discretion, which powers
shall be applicable to all property held by them, effective without the order of any court and
until the actual distribution of all such property:
A. To retain, as investments of my estate or trust, any or all assets of my estate,
real, personal, or mixed, without regard to any principal of diversification, and to purchase
and acquire real or personal property, and to hold any or all of such real and personal
property retained or acquired without making the same productive of income;
B. To permit any beneficiary to occupy any real estate retained or acquired
upon such terms and conditions as my fiduciary shall deem proper;
-4-
October 8, 1998
C. To invest and reinvest at discretion without restriction to so called "legal
investments," with the specific right to invest in common and preferred stocks, and in such
common trust, diversified, money market and mutual funds as they deem appropriate;
D. To sell, to grant options for the sale of, or otherwise convert any real or
personal property or interest therein, at public or private sale, for such prices, at such time,
in such manner and upon such terms as they may think proper, and to execute and deliver
good and sufficient conveyances, assignments and transfers thereof without liability of any
purchaser to see to the application of the purchase money;
E. To compromise and arbitrate claims by or against my estate or any trust
created hereunder;
F. To make distributions in cash or kind, or partly in each at valuations fixed by
my Executor and Trustee at the time of distribution;
G. To join in any recapitalization, merger, reorganization or voting trust plan
affecting investments; to deposit securities under agreement; to subscribe for stock and
bond privileges; and generally to exercise all rights of security holders;
H. To manage, operate, repair, alter or improve real estate or other property, and
to lease real estate and other property upon such terms and for such period as my
Executor and Trustee deem advisable even for more than five years and beyond the
duration of any trust;
-5-
October 8, 1998
I. To deduct administration expenses upon either the federal estate tax return
or fiduciary income tax return, with or without adjustment between principal and income,
as my Executor shall determine;
J. To associate with them in the absence of a corporate fiduciary, an
accountant, custodian and investment advisor, and their agents and to compensate such
accountant, custodian and investment advisor, and agents out of principal or income or
both as my Executor or Trustee shall determine, such compensation to be a reduction to
the compensation of my Executor or Trustee;
K. To carry out the terms of any agreement I may have entered into to sell all
or any part of any property or any interest I may own in any business at the time of my
death;
L. To execute and deliver any written instruments that they may deem
advisable to carry out any power, duty, or discretion granted to them, and all persons shall
be fully protected in relying upon their power to execute every such instrument and no one
shall be obligated to see to the application by them of any money or property received by
them pursuant to the execution and delivery of any such instrument;
M. Any Executor or Trustee may delegate any or all of his/her powers, duties and
discretions to any other Executor or Trustee by an instrument in writing and may revoke
such delegation at will in the same manner. In this regard, the Executor of my estate shall
have full authority to change the Trustee named herein to any corporate Trustee of their
choosing, so long as this power does not constitute a general power of appointment or
-6-
October 8, 1998
result in the imposition of additional taxes, in which case, said authority is rescinded or
limited so as to preclude such inclusion;
N. To do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate; and
O. To make any election provided for in the Internal Revenue Code with respect
to all or any part of my estate qualifying for any such election.
TENTH: Not withstanding any other provision hereof, the Trustee, may, in its sole
and absolute discretion, at any time terminate any or all Trust created hereunder if in the
judgment of such Trustee the value thereof is insufficient to warrant the cost and
inconveniences of continued administration, or if, in its judgment continued administration
is otherwise impractical. Upon such termination the entire balance remaining shall be paid
over to the current income beneficiary, then in equal shares to all income beneficiaries
(whether or not then receiving income in equal shares). In making such a judgment, such
Trustee need not consider the interest of remaindermen or succe~ding income
beneficiaries and their respective interest in the Trust shall cease upon such determination
by such Trustee.
ELEVENTH: My Executor and Trustee shall pay all estate, inheritance and other
death taxes, together with interest and penalties, which shall be payable with respect to
property or interests subject to taxation by reason of my death and whether passing under
my will or any codicil, or otherwise, including jointly held and other non-testamentary
property. My Executor and Trustee shall pay the same out of the principal of the residuary
-7-
October 8, 1998
unless otherwise required by law. Trustee may advance to my Executor from the principal
of the Trust such amount as may be required by my Executor for the payment of such
taxes. Notwithstanding the foregoing, I authorize my Executor to exercise any options
available in determining, minimizing and paying taxes of my estate as my Executor may
at his sole discretion deem appropriate.
TWELFTH: Any and all payment or payments of any sum or sums, whether in cash
or in kind and whether of principal or income, payable to any beneficiary, shall be free
from anticipation, alienation, assignment, attachment, and pledge, and free from control by
the creditors of any such beneficiary.
THIRTEENTH: I appoint Patricia Armstrong Morgan as Executrix of this, my last will
and testament, but should she for any reason fail to qualify as such Executrix, or having
qualified fail to serve as such Executrix, then I nominate, constitute, and appoint my son,
Thomas W. Gaughen, as my Executor of this, my last will and testament. I understand that
I may choose anyone to act in this latter capacity and have voluntarily requested that
Patricia Armstrong Morgan be named Executrix. I intend that any Executor/Executrix or
Trustee serving hereunder be compensated for their services in addition to any other
monies they may receive.
FOURTEENTH: Words used in the singular may be read to include the plural or the
plural may be read as the singular. Similarly, the masculine form may be read to include
the feminine and neuter; the feminine may be read to include the masculine and neuter;
and the neuter may be read to include the masculine and feminine.
-8-
October 8, 1998
FIFTEENTH: Finally, all references in this will to issue shall include natural born
children as well as adopted children.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will
and testament, consisting of nine (9) typewritten pages, this 8th day of October, 1998.
J1~j~
Signed, sealed, published, and declared by the above named Testatrix, Lorena G.
Gaughen, as and for her last will and testament, in the sight and presence of us, who, at
his/her request, in his/her sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
,?/~
)/:iJd ~
I
Address 2/2.. Locusf 5+. ~t:4. 84 17 loB
Address S-o$" s~.w Sf (AteL'5/~ t7;/
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-9-
October 8, 1998
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
We, Lorena G. Gaughen, the Testatrix and the witnesses, respectively, whose
names are signed to the Last Will and Testament, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and Testament that she had signed willingly, and that she executed it as her free
and voluntary act for the purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the will as witness and that to the best
of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older,
of sound mind and under no constraint or undue influence.
./
t/~~
Subscribed, sworn to and acknowledged before me by Lorena G.
Testatrix, and subscribed and sworn to before me by Pamela II. WtJs..SVt)
IohfJ Ii. A /2ClfYJOrCA-.
Gaughen,
and
, this 8th day of October, 1998.
~Ii~
My Commission Expires:
Notarial Seal
Rhonda Heffelfinger, Notary PubUo
Harrisburg. Dauphin Coulity ,
My Commission Expires March 1S. 2000
Member. Pennsylvania Association of Notaries
F.ICLlENTSIMISCIGAUGHENIWILLS\2WILL.WPD
:Jlomas. :Jlomas. A7JW1ls!!I"I{)7/u/ & ~sen
:lItlorneys arul Counsellors al Law
SUITE 500
212 LOCUST STREET
P. O. Box 9500
HARR[SBURG, PA [7[08-9500
www.ttanlaw.com
PATRTCIA ARMSTRONG
FIRM (7[7) 255-7600
CHARLES E. THOMAS
(1913 - 1998)
DiITct Dial: (717) 255-7627
E-Mail: parmstrongril:ttanlaw.com
FAX (717) 236-8278
May 7,2001
Mary C. Lewis
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
In re: Estate of Lorena G. Gaughen
Late of Cumberland County
Date of Death: February 10, 2001
County File No.: 2001:ot)2=l. OJ D 7
Dear Ms. Lewis:
Enclosed is a check in the amount of $22,500 for payment during the discount period on
the above referenced estate.
If you have any questions, please contact the undersigned.
Very truly yours,
THOMAS, THOMAS, ARMSTRONG & NIESEN
By <~:i~u~
Enclosures
F :\CLI ENTS\MISC\GAUGHEN\Probate\01 0507. wpd
E
---
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Lorena G. Gauahen
Date of Death:
Februarv 10. 2001
\.;'
Will No. 2001-~;2 0,
Admin. No.
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above--captioned estate on March 7,
2001:
Name
Address
Gloria A. Dillree
Richard L. Rickert
2208 Logan Street, Camp Hill, PA 17011
2208 Logan Street, Camp Hill, PA 17011
Beverly Stone
15 King's Arms, Mechanicsburg, PA 17055
Kathryn Armstrong
3600 Logan Street, Camp Hill, PA 17011
153 Glendale Street, Carlisle, PA 17013
Susan Marlene Shank
Dennis Shank
153 Glendale Street, Carlisle, PA 17013
Kirby Shank
45 Chestnut Street, Telford, PA 18969
Kyra Shank
45 Chestnut Street, Telford, PA 18969
Christopher Shank
420 West Union Street, 3rd Floor,
West Chester, P A 19382
Todd Shank
153 Glendale Street, Carlisle, PA 17013
Phyllis Shanahan
4855 Grover Street, Omaha, Nebraska 68106
Suzanne Palkovic
5 Chrisma Drive, Camp Hill, PA 17011
5 Chrisma Drive, Camp Hill, PA 17011
Alex Jeffrey Palkovic
Katelyn Elizabeth Palkovic
5 Chrisma Drive, Camp Hill, PA 17011
Thomas Gaughen
P.O. Box 686, Camp Hill, PA 17001-0686
Kevin Gaughen
P.O. Box 686, Camp Hill, PA 17001-0686
Grant Gaughen
P.O. Box 686, Camp Hill, PA 17001-0686
Porsha Gaughen
P.O. Box 686, Camp Hill, PA 17001-0686
Warren Gaughen
P.O. Box 686, Camp Hill, PA 17001-0686
Doris & J. Richard Washinger
128 Minnich Road, Chambersburg, PA 17201
Susan Grobaski
05505 Denise Road, Boyne Falls, MI 49713-9729
!) '" .-.
Martin Shanahan
261 E. 3rd Street, Wahoo, Nebraska 68066
Good Shepherd Catholic Church
3435',Trindle Road, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
N/A
Date:
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Name Patricia Armstrong. Esquire
Address 212 Locust Street, P.O. Box 9500
Harrisburq, PA 17108-9500
Telephone (717) 255-7600
Capacity: Personal Representative
X Counsel for personal
representative
Adopted April 30, 1992, to apply to decedents dying on or after July 1, 1992.
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:JJ;l[)malJ9 :JJ;l[)malJ9 AlIW1llJ!1l"I[)7/u/ & ~lJtBn
:Jlttonuu/s ami Counsellors at kw
SUITE 500
212 LOCUST STREET
P. O. Box 9500
HARRISBURG, PA J7108-9500
www.ttanlaw.com
PATRICIA ARMSTRONG
Direct Dial: (717) 255-7627
E-Mail: parmstrong@ttanlaw.com
FIRM (717) 255-7600
FAX (717) 236-8278
CHARLES E. THOMAS
(1913 - 1998)
June 19, 2001
Ms. Mary C. Lewis
Cumberland County Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
In re: Estate of Lorena G. Gaughen
Date of Death: February 10, 2001
Social Security Number: 201-16-4933
File Number: 2001-0027 ;)1)1
PA Number: 21-2001-060
Dear Ms. Lewis:
Would you kindly acknowledge receipt by dating and stamping the attached copy of this letter.
Enclosed in duplicate is the Pennsylvania Inheritance Tax Return (Schedules A, B, E, H, I, and J)
together with the following:
1 . Copy of decedent's will dated October 8, 1998;
2. A check in the amount of $2,971.39 payable to the Register of Wills for the Inheritance
Taxes due;
3. There is no Federal Estate Tax Return; and
4. A check in the amount of $15.00 to cover the cost of filing the Return.
Very truly yours,
Enclosure
F :\CLl ENTS\MISC\GAUGHEN\Probate\01 0619RegofWiIIs. wpd
THOMAS, THOMAS, ARMSTRONG & NIESEN
By 77::rr~ Q~] Iv
~i~ia Armstrong d
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT~ ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
PATRICIA ARMSTRONG ESQ
THOMAS ETAl
PO BOX 9500
HBG PA ~rl08
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-30-2001
GAUGHEN
02-10-2001
21 01-0207
CUMBERLAND
101
5;*
REY-ISO EX AFP Cl2-DDl
LORENA
G
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=is'4;-EX-AFP--n2:iioY-NOTicE--Oi=-YNHEifiTANCE-YAX-APPRAiSEMENT,--AL1-oWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GAUGH EN LORENA G FILE NO. 21 01-0207 ACN 101 DATE 07-30-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ 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
.00 X 00 = .00
139~013.43 X 045 = 6~255.60
.00 X 12 = .00
136,000.00 X 15 = 20,400.00
(19)= 26,655.60
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)
.00
268,168.54
.00
.00
37,988.67
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
18,573.24
2.570.54
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
306,157.21
21.143 18
285,013.43
10~000.00
275,013.43
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-08-2001 AA496566 1~184.21 22,500.00
06-19-2001 AA496747 .00 2,971.39
TOTAL TAX CREDIT 26~655.60
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU MAY BE DUE
A DC'C'IINn ~I=I= RI=UFRSI' SIDE OF THIS FORM FOR INSTRUCTIONS.)
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE EST ATE. IF EST ATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
/,/.
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/ <------'
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Lorena G. Gaughen
Date of Death:
02/10/01
Will No.:
Admin. No.:
21-207-2001
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, state the following:
A. Did the personal representative file a final account with the court?
Yes
No
x
B. The separate Orphans' Court No. (if any) for the personal representative's account
IS:
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 Clerk of the Orphans' Court and may be attached to this report.
ceiL~ )~''f
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Date:
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Patricia Armstrong
Name (Please type or print)
-
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212 Locust Street Suite 500, Harrisburg, P A 17101
Address
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(717) 255-7627
Telephone No.
Capacity:
Personal Representative
X Counsel for Personal Representative
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