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Home My WebLink About01-0267 _J Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Elsie M. Ludwig also known as No. :1J,-OI-~~ 7 , Deceased Social Security No. 181-42 - 8481 June L. Lingle Petitioner(s), who isIare 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix named in the last Will of the Decedent, dated 01/03/1968 and codici~s) dated None 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: n/a D 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 haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with hislher last family or principal residence at 112 Miller Street, East Pennsboro Township (list street, number, and municipality) Decedent, then ~years of age, died 02/22/2001 at Lower Allen Township, Cumberland Co., PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania 168,000.00 $ $ $ $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and CodiciKs) presented with this Petition and the grant of letters in the a riate form to the undersi ned: T ed or rinted name and residence June L. Lingle, 112 Miller Street P. O. Box 2, Summerda1e, PA 17093 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. !~ -d2/& -7n Form RW-1 (1991) J 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(s) and that. as personal representative(s) of the Decedent. Petitioner(s) will well and truly administer the estate according to law. ~~~ Ju . Lingle c:7 Sworn to or affirmed and subscribed before me this ~liay of 2001 ~ ~ No. 21-2001-267 Estateof Elsie M. Ludwig Deceased Social Security No: 181-42 - 8481 Date of Death: 02/22/2001 March 9th AND NOW, 2001 ,in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [!] Testamentary D Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to June L. Lingle in the above estate and that the instrument(s) dated 01/03/1968 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Short Certificate(s). 5 $ 235.00 15.00 $ ~ ~.x:~~~.~ / Register of Wills ary c. Lewis . REgister of Wills Letters. . . . . . . Renunciation. $ Affidavits ( $ Extra Pages ( -01. $ Codicil. $ JCP Fee. $ Inventory. $ Other $ Attorney: James D. Bogar, Esquire 1.0. No: PA 19475 -0- Address: One West Main Street Shiremanstown, PA 17011 5.00 Telephone: 717/737 - 8761 MAIL LETTERS AND ORDER 'TO ATTORNEY TOTAL. . . . . . . .. $ 255.00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems,lnc. Form RW-1 (1991) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS / / codicil / (each) a subscribing witness to the will presented herewith, (each)peing duly qualified according to law, depose(s) and say(s) that " present and saw the test at , sign the same and that / signed as a witness at the request of test at in h presence and (in the),resence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before // me this day oC / 19---.L- ,/.1" (Name) (Address) ;Register / (Name) (Address) j' 21-2001-267 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS June L. Linqle and Roy G. Linqle (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of Elsie M. Ludwiq }QOmEiXx testat-Li:1L of (<mCxHfiotb:eo,ud:>6~>>itK~~xt:0) the will presented herewith and mdicilx that they believes the signature on the will is in the handwriting of Elsie M. Ludwig to the best of the ir knowledge and belief. Sworn to or affirmed and subscribed before me this 8th Marc PA 17093 Mary Lewis Regis'er of wills u... LJ~ j (Addre~S/ Register/Jj4i ~' v;:r:.-0 - ;;;t;z:,- ?1foy G. Llng1e ( d amej 112 Miller St., Summerdale, PA 17093 (Address) [1': IS to certify that [he information here given is correcdy copied froIll an original certificate of death duly filed with me as )<.. I Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. Fee f()f this cenitlcate, $2.00 p 7194398 ;l- :2 7 -(J ( Date 21-2001-267 H105. lOR... 2/87 COMMONWEALTH Of PENNSYlVANIA. DEPARTMENT Of HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPE/PRINT IN PERMANENT BLACK INK 1. AGE (La.. Bon""aYI UNDER 1 YEAR Mon<ha Days SlAT[ filE ~UMe[n ElS~':-~~~~;-~~d:;~ ~--------~-=~=~-~~--:~em~le ~J;:;~~CUR:tj~;BER UNlJER 1 DAY DATE OF IIlRTH -Bifi'iHPLAcE :e., .rod PlACE Of' DEATH ,C"€C. "'Y "'.... ..... .,.,,,,,,,....,., Oil "''''', ,..... Houfa : ..._u';,.. ,.M()(lln Dav '(esfI 3taleOill rCH~IC}flCOUnIlY) HOSPt~--- - ------ : InpalMN"t 0 ERlOutpauflnI 0 . k fACILITY NAME (line,)! ,n!.l'f\JII()fl. give SUN' an() r"JmQefI February22~OOl DECEDENT'S USUAL OCCUPATION (Give k.IIld of WWOIk <.lOne dulll1g'1'105I oIrrJ~maker'el"ed I Mechanicsburg, PA k. KIND OF BUSINESS/INDUSTRY NAME OF DeCEDENT tf 1,;-M"lddia. LaSl) 93 ..... ~:;oIy,O 5. COUNTY Of DE>>H Cumberland RACE. AmeflcMllndt.n. Black, While. "Ie ,Spoc,"", Whi te ~ .... . l1a. I1b. DECEDENT'S MAILING AOORESS (5......... CoIyllOwn. SIaIe. L.., Cod<!l 112 Miller Street 1~ummerdale, PA 17093 FATHER'S NAME If.... Moddle. LaSlI DECEDENT'S ACTUAL RESIDENCE (See ."sJrucllOOS on DlOe' side) MARITAL STATUS. Manoed Nav... M;Ufl4ld, WMiowed. DlVOfced (Specify) Wido~<.l~___ 15. 17<.K1 'fn. __nc ijvec:tin Eas t Pennsboro SURIIIIIING SPOUSE llf ......e. give malCJen namu) Own Home N/A -------- '- 1lb. Counry Cumberland 17d.O ::==0' C!,,!~ MOTHEA'S NAME lFII'So1 M.octe. Malden SuIO.iffiO) .... Z ~ w :rl o ... o w ~ Z 11. INFORMANT'S NAME (T YpotP....1 ~. June L. Lingle METHOD Of' OISPOSIT~ O ~ C.ama._ 0 RamovallJom s.a.ao 00naCJ0n 01.... (Spealyl . 21.. James Masimer 19. A nes Blessing INFORMANT'S MAILING ADOAESS 151,..... C'lyflown, SIMIe. L'fJ C<Xle' ~. 112 Miller Street, Summerdale, PA 17093 PLACE OF DISPOSITION. N..... of Cematel'/. C,ematory LOCATION - CllylTown, S,a.e, Zip Code 01 0lh8f PIM:. 21<. Hummelstown Cemetery 21!'-lIummelstg,Wn._.J>A 17036 NAMEANDAOOA.ESSOFFAC'~ITY Tre{z-&- Bowse_-r_--~F~~(;ral Ho _ Inc. 22<114 West Mall1 Street Hummelstown,_PL_rZtnL LICENSE N3BER DATE SIGNED ~--- " (Moodl. Day, Veal) 23b. 1<- {j DoL IP35 - L 23c~:l-_~~~__:!O 0 I WAS CASE REfERRED TO MEDICAL EX.....INERlCORONER1 ~~~~ Vo.O NoIkV M 25 b 21. MAT I: Enter the (11581.5.5, injUries Of comphCal-.>05 wllKh caused Ule cJealh 00 noc 8018' IhtillIlOCfe 01 l1ying, such as c 4i4ac Of respIratory iI""!f.I. :iIlock Of htlil.tlalJuu. ll" onry ON cause on eac.h line (Ol'l~(~. C llettvf {;.:;(t('~ DUETO(OAASACONS~~ ( __41 fJ.e ~ IeNt1 ~r DUE TO (OA AS A CONSEOUENCE OF)' 26. I AppfO.llrnille : tlllervaJ be",,"" I onsec ~ dealh I : PART II: Other Slglllrtcafll cOfldi1.ons contnbulNlg 10 <Mioil'h, but ,t not reSU~N19 111 the under1y\ng CiI) grwn. PARll e Ur:4J ,f' lC ~. ( uve _&~llF,/f ~N:r'-~ ~CE.cr '" dt4}t ~~~i7L_n I : DUE TO (OA AS A CONSEOUENCE OF) Yes 0 No~ ~ o o OAT E OF INJUFty (Monlh. Day. 'l'eafl TIME Of' INJuRV INJURY AT WORK? DESCRIBE HOW INJURY OCCuAREO WERE ..UTOPS'" FINDINGS "\llULAalE PRIOR TO COMPLETION Of' CAUSE OF DEATH? MANNER OF OEATH Homac;ide o o o ~E OF INJURY. "'hom.. 1..~.O::;.el. laOllf'/, ollie. bulkJiOQ. 4tlC. ,Specll..-) JOe, o NoD PendU1g InveSliqahon No bY .... 3Oc. 2... 211I>. aRTlFIEA (C~eck ani.,. Q(W!I .CERTIFYING PHYSICIAN IPt!VStCotan c.".hfyUlQ cause d ~alh ....he'l..lf\Olhe. ph..-s.c.anh4S PfOtlOtJnced dedi,.. ano COfnpl"'lt!d Item lJ) To the be., o. my know&edge. death occuned dlMlo Ih. cause($) and manne. .. stated SuICide Could noI be determined . PRONOUNCING AND CERTifYING PHYSICIAN (Phvs.c.an tx)lh ~Oflw(lClng Wdlt1 andce'lIlylO(j 10 cause ot deal'" To the bHt o' my knowledgft, de~th occurred,t lJ\e time. d~l..,and place..nd due 10 the C.use(I).nd manner.a Itated., 'UEDICAL EXAMINER/CORONER ~~~~~,b::;:t::=~min.tion andJo, in'Vt!sligation, in my opinion, death occurred al the lime, date, and place, and due to Ihe cause(s) IInd [J 31a REGISTRARSS'GNATUREANDNUMBER"J-! . ~ fL 11 /J~ . ~.zI2. ~ I~J ~>!si-[ttjlt- '. (Lt~lL~m_---- r~ ~Q l-- 3-CX'! 'b. d.. 0 F7 LAST WILL AND TESTAMENT OF ELSIE M. LUDWIG KNOW ALL MEN BY THESE PRESENTS t THAT, I t ELSIE M. LUDWIG, Widow, of Hummelstown, Dauphin County, Pennsylvania, being of sound mind and disposing memory, do make, publish and declare the following instrument as and for my last Will and Testament, and I do hereby revoke any and all wills by me at anytime heretofore made. ITEM I. I direct my executrix hereinafter named to pay my just debts and funeral expenses as soon after my decease as may be practicable. ITEM II. I give and bequeath unto the United Church of Christ of Hummelstown, Pennsylvania the sum of Five Hundred ($500.00) Dollars. The said money to be used by the church officers as they deem fit and proper. ITEM III. All the rest, residue and remainder of my estate, real property, personal property and mixed, I give, devise and bequeath unto my daughter, June L. Lingle, absolutely. ITEM IV. I appoint my said daughter, June L. Lingle, executrix of this my last Will and Testament. IN WITNESS WHEREOF, seal this __3 r-d day of se~ ~~ hf a~d --{} /). / / ~ -'}/ .{><\?.--u/ ) I 1 Els~e M. Ludw~g (SEAL) WITNESSES: 7JLa-<.-o U. k~ ~ / ' . LJ ;(;Af.a..~'t""-f ? '0'" I /_ f"f) a t 1\,!..fL-'L~~ / \,-",~ V" ~ at ~k;'{ c_ / ' residing residing CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Elsie M. Ludwig Date of Death: February 22, 2001 Will No. 2001-00267 Admin. No. 21-01-2001 To the Register: I certify that notice of estate administration 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 19, , 2001: Name Address United Church of Christ 104 East Main street Hummelstown, PA 17036 112 Miller street P. o. Box 2 Summerdale, PA 17093 June L. Lingle Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Bo a , Esquire One West Ma' street Shiremanstown, PA 17011 (717) 737-8761 capacity: Personal Representative X Counsel for Personal Representative Date: 3 /19 / 0 1 -- FOLD HERE ~ - ~"~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 - '-.... PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 49 S 626 REV-1162 EX (11-96) RECEIVED FROM: r BOGAR JAMES D 1 W MAIN STREET SHIREMANSTOWN, PA 1701i ESTATE INFORMATION: I FILE NUMBER 21-2001--0267 SSN 1 a 1 -- <-I ~:: f><'.i U L NAME OF DECEDENT (LAST) (FIRST) (MI) LUDWIG ELSIE M DATE OF PAYMENT 5/22/2001 POSTMARK DATE 0/00/0000 COUNTY CUMBERLAND DATE OF DEATH 2/22/2001 - REMARKS JAMES BOGAR ESQU IRE:. CHECK" 12 SEAL REGISTER OF WILLS ACN ASSESSMENT CONTROL NUMBER " . ~ TOTAL AMOUNT PAID ./ ,,,-//,.- ! / RECEIVED BY" ,'i,!1 / (/ , ['IA':>'y' C. c" SiJ I .~_:. ~"~:r:-t.::l -:. f< J>)f L-Jlt.,~ AMOUNT 'I FOLD HERE ".-r""" ,./.:' /.' [(I ,,' :t' . v // ' ",/:".11 ,d:J/-r.../ ,/ . .,.'" ;r'\ "/"..LL, ,/ ), '-77',./,r.:/.'-1- c/ .~-_.. /./....-? /~-c:J/ 6 - 7 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'v BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JAMES D BOGAR ESQ 1 W MAIN ST SHIREMANSTOWN PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-02-2001 LUDWIG 02-22-2001 21 01-0267 CUMBERLAND 101 c;f- c /' REV-1547 EX AFP el2-00) ELSIE M 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 :is4j-Ex--AFP-(i2:oo-f-No'~ficE-oF-INHEifi;:AircE-TAx-APPRAisEiiENT~--A[i-oWANCE-ifR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LUDWIG ELSIE M FILE NO. 21 01-0267 ACN 101 DATE 07-02-2001 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 TAX CREDITS: .00 X 00 = .00 198,272.33 X 045 = 8,922.25 .00 X 12 = .00 .00 X 15 = .00 Cl9)= 8,922.25 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 .00 .00 .00 211,638.07 .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) ClO) 12,256.37 609.37 Cl1) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 211,638.07 12.865 74 198,772.33 500.00 198,272.33 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-22-2001 AA496626 446.11 8,476.14 TOTAL TAX CREDIT 8,922.25 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 REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) - C!r/ ) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Elsie M. Ludwig Date of Death: February 22, 2001 Will No. 21-2001-0267 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. I f 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 Cerk of the Orphans' Court and may be attached to this report. Oat e : rJ. .' & '-0)... James D. r, Esquire Name (Please. type or print) One West Maln St. Shiremanstown, FA 17011 Address ('Y' . .j In '-1::1 l.;..J i...:.... (717) 737-8761 Te 1. No. rr 0J P - ...1<......{ ..: r:: ;:i) ~ "'~I"~ .....~ Capacity: Personal Representative x Counsel for personal representative (MAH:rmf/AM3) /6-0:2/6- 7 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2:80601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) Ludwi Elsie M. DATE OF DEATH (MM-DO-YEAR) FILE NUMBER , l/ OFFICIAL USE ONLY 21-01-0267 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 181-42 - 8481 THIS RETURN MUST BE RlED IN DUPUCATEWlTH THE NUMBER REGISTER OF WILLS SIAL U I VN o o None Karie None None 211,638.07 None None 12,256.37 609.37 .0 0 .0 45 .12 .15 3 dateo delIIth . RemalnderReturn prior to 12-13-82) S. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election Iota unclef Sec. 9113{A) (Attach Sch 0) .DlRECr$;TO,1i!% TELEPHONE NUMBER One West Main Street Shiremanstown, PA 17011 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Lions (Schedule I) (10) 11. Totallleductions (total Lines 9 & 10) 12. Net Valu. 01 Es_ (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for whM:h an election to tax has not been made (Schedule J) 14. Net Value Sub eel to Tax (Line 12 minus Line 13) Copyright (e) 2000 form software only The Lackner Group,lnc. 02 22 2001 LIAL UVIVI s 0 OLE IA X 1. Original Return 4. limited Est.te X 6. Decedent Died Testate 7. (Attach copy Df Will) o 9. litigation Proceeds Received D 10. 1tTHISSEcnON MUS'tBE:eOMP NAME James D. Bo ar Es uire FIRM NAME (If Apptleable) (1) (2) (3) OFFICIAL USE ONLY (8) 211,638.07 (11) 12.865.74 (12) 198,772.33 (13) 500.00 (14) 198,272.33 (15) (16) (17) (18) (19) 0.00 8,922.25 0.00 0.00 8,922.25 R E C A P I T U L A T I o N (4) (5) (6) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unde, Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rato 198,272.33 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. x X X X FonnREV-1SOO EX (Rev. 6-00) '- Decedent's Complete Address: STREET ADDRESS 112 Miller Street CITY I STATE I ZIP Summerda1e PA 17093 Tax Payments and Credits: 1. Tax Due (pago 1 Line 19) 2. CredilslPaymonlS A. Spousal Poverty Credk B. Prior Payments C. Discount (1) 8,922.25 0.00 446.11 Total Credits ( A + B + C) (2) 446.11 3. InterestlPenalty K applicable D. Intefest E. Penalty TotallnlorestlPenalty ( D + E) (3) 4. If line 2 is greater than line 1 + line 3. enter the difference. This is tho OVERPAYMENT. Check box on PlI!lo 1 line 20 to roquost a rolund (4) 5. If Line 1 + Line 3 is greater than Line 2. enter 1he difference. This is the TAX DUE. (s) A. Enter tho interest on tho tax due. (SA) 8. Enter tho total of Line 5 + SA. This is tho BALANCE DUE. (58) Mako Check Payable to: REGISTER OF WILLS, AGENT ii!il!!]ll]llll]!l]]]J!!]!!!!!!!!ll]!1]!1!i!]iillll!l!1IIIll!!li!!lll!lllJI!!I!ll!l!ll!l]!!]IJ!]!II!I!l!ll!!!!I!I!!!lm!III!!llli!II!II!I!IIIII!lmmm~m~Wl[llilll[!!!1!!!!mm~mm~mmUUm~mmm!mmmum.llmml!lll l!lll!II!!!IImllllllImml!llmm~lll\ll!mmli!mmmm!!!I~!!m!II!I\lll!!!\l!l!!!!\!l!!\\\ll\!ll!!!l!llll 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; . . , . . . . . . . . . . . . ~ ~~x b. retain the right to designate who shaH use the property transferred or its income; . c. retain a reversionary intere5t; or. . . . . . . . . . , . . . . . . . . . . . . . . . d. receive the promise for fife of either payments. benefits or care? . . . . . . . . . 2. H death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? , . . . . . . . . .. .................. 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 Individual Retirement Account, annuity, or other non-probate property which contains a benefICiary designation? ................................0 IF THE ANSWER TO Am OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 0.00 8,476.14 0.00 8,476.14 []J []J []J Under penalties of perjury, I deClare that I have ex.mlned this return, Including accompanyIng schedules and statements, and to the best of my knowledge and belief, It Is true, correct and complete. Declaration of preparer other than the personal representative Is based on alllnforrnatlon of which preparer has any knowledge. SIGNATU OF PERSON RESPON$IB~E FOR FILING RETURN June L. Lingle 112 Miller Street ---S~erd;;ie~--PA---i709-j------------------------ James D. Bogar Esquire One West Main Street - - -ShJ.r-emaristow; - FA - - iiaif - - -. - - - - - - - - - - - - - - -- DATE OS/21/2001 DATE OS/21/2001 For dates of death on or r uly 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3"!o (72 . 9116 (a)(1.1) (I)t For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% {7'2 P .S. 9116 (a) (1.1) {in}. The statute does not exempt a transfer to a surviving spouse trom 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 benefJCiary. 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 foe the use of a natural parent. an adoptive parent. or a stepparent 01 tho child is O"!o [72 P.S. 9116 (a) (1.2)t TM tax rate imposed on the net "Ialue of transfers to offor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. 9116( 1.2) [72 P.S. 9116(aXl)]. The tax rate imposed on the net "Ialue of transfers to or for the use of the decedent's siblings is 12"10 [72 P.S. 9116(aX1,J)]. 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. CopyrIght (c) ZOOO form software only The Lackner Group, Inc. Form REV-fSOO EX (Rev. 8-00) REV~1508 EX +(1.97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE Of fiLE NUMBER Elsie M. Ludwig SSlf 181-42-8481 02/22/2001 21-01-0267 Incklde the proceeds oIlitigalion and the date the proceeds we.. received by the estate. All propefty jointly-ow..... with the right of survivorship must be dlaCloMd on ScMcIule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Al1first Financial Inc. - CD Account No. 80000002219323, date of 28,045.39 death balance $28,013.13, accrued interest $32.26 2 Allfirst Financial Inc. - CD Account No. 80000002219323, date of death balance $50,500.00, accrued interest $117.88 50,617.88 3 Allfirst Financial Inc. - 1999 Back Interest - adjustment for error made by Allfirst concerning interest payments 67.05 4 Al1first Financial Inc. - 2000 Back Interest - adjustment for error made by Allfirst concerning interest payments 261. 03 5 Capital Blue Cross/PA Blue Shield - Refund 212.30 6 Fulton Bank - Checking Account No. 1600-42176, date of death balance $1,102.11 1,102.11 7 Fulton Bank - Money Market Account No. 9900-49288, date of death balance $36,596.30, accrued interest $10.95 36,607.25 8 Fulton Bank - CD Account No. 022-0122587, date of death balance $13,000.00, accrued interest $32.95 13,032.95 9 Fulton Bank - CD Account No. 022-0132259, date of death balance $44,041.57, accrued interest $1,331.46 45,373.03 10 Fulton Bank - CD Account No. 163-0071776, date of death balance $34,654.85, accrued interest $1,655.23 36,310.08 11 PA Department of Revenue - Refund 9.00 TOTAL (Also enter on line 5. Recap~ulation) S 211,638.07 (If more space is needed. insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 ex (Rev. 1 ~97) FUlton Bank P.O. BOX 4887 . LANCASTER, PA 17604 People dedicated to your success, * (717)291-2589 WWW.FULTONBANK.COM 1-800-FULTON-4 March 26,2001 James D. Bogar One West Main St. Shiremanstown, PA 17011 Dear Mr. Bogar: RE: Elsie M. Ludwig, deceased February 22, 2001 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking #1600-42176, open 5/1/73, balance $1,102.11, Power of Attorney June L. Lingle. Money Market #9900-49288, open 1/4/83, balance $36,596.30 and accrued interest $10.95; paying 3,64%, Power of Attorney June L. Lingle. CD #022-0122587, open 2/7/00, matures 3/7/02, balance $13,000 and accrued interest $32.95; paying 6.16%, in her name only. CD #022-0132259, open 9/12/00, matures 3/12/02, balance $44,041.57 and accrued interest $1,331.46; paying 6.67%, Power of Attorney June L. Lingle. CD #163-0071776, open 3110/99, matures 9110/01, balance /' $34,654.85 and accrued interest $1,655.23, in her name only. 'J' .~ '-:-"'l< /' . . <:>~:.,ifyouha~aiiy further questions, please do not hesitate to contact me. /;'~<::>:'~i,;; -'-/f/ '(; /'?[ I"L~' 4<., '--.; /, i:J. ,,:)- 'r~~~J~.:, ...~ '-"~.~2>,; "/,( <() c.;,_. .:",~.:::;:.) ", . .,..,. /;., ''l:l.' '"J' -:':>0 C:::.,. ~?.. ~,-, ,.,,...,,,, ./ " <,.f) :/ " Very truly yours, ChuJ/)U~r?--.J~ Christine Putt Smith Credit Confirmation Processor .-..... ~._- /' ....../:, V,"" --'"'}. 03/26/01 16:13 ~1 302 934 2955 James D. Bogar Attorney At Law 1 West Main Street ShiremanstoWD, P A 17011 'CIS Re: Estate of ElsieM Ludwif! Social Securitv: 181-42-8481 Date of Death: Februarv 22.2001 Dear Sir or Madam: iI!1 0021003 II alffirst A111lrs1 Financial Quler N-A. PO Box 900 Millboro. DE 19966 March 26, 2001 Per your inquiry dated March 19.2001 please be advised thai at 1IIe time of death, the above.named decedent had on deposit with this bank the foUowing: I. Type of Account Account Number Ownership (Names oj) Opening Date Rollover Account InitioJly Opened on Balance on Date of Death Accrued Interest Total 2. Type of Accounl Account Number Ownership (Names oj) Opening Dote Rollover Account Initiol1y Opened on Balance on Dote of Death Accrued Interest TotoJ Certificate ufDeposit 81JOO1)()()2219323 Elsie M Ludwig 09/14199 11/10/97 $28,013.13 $ 32.26 $28,045.39 Certificate ofDeposii 87008141241532 Elsie M Ludwig 09/08/98 08/08197 $50,500.00 S 117.88 $50,61788 03/26/01 16:13 OUl 302 934 2955 -CIS _Jl!I.lli~003 _ 77:i. '-rdou "'" In&Iude ""l' ace_In which 1M dI=sed 11IO)' _ be... Il.rted... Power 01 Atlomzy, C_ DjUlrilonn Trfm4or. Il<pru.../Qttw Paye., or r,.,.,. under. Wrll/enAgrc._ For jut1her account tnformatlon, clo.ruru andIOI' reimbuI'femsnt ojjuntb refit' to be/OlJ branch: IlUMMJ!LSTOWN OFFICE & EAST MAIN STREET BUMMELSTOWN, PA 17036 717-566-4003 Sincerely, REV-1511 EX +(1.97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYlVANIA IHHERlTANCETK/. RETURN RESIDENT DECEDENT ESTATE OF Elsie M. Ludwig SSfF 181-42-8481 02/22/2001 Debla ol_ must ... reported on Schedule I. FILE NUMBER 21-01-0267 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Hoss's Steak & Seafood - Funeral meal 297.37 2 Trefz & Bowser Funeral Home - Funeral expense 6,815.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's ConYl'lissions Name of Personal Representativo(s) Social Security Number(s) I EIN Number of Personal Representativo(s) 51100' Address City Stale Zip - Year(s) Commission Paid: 2- Attorney's Fees James D. Bogar Esquire 4,375.00 3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 255.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 H&R Block - Preparation of 1999 and 2000 Amended Personal Income 64.00 Tax Returns 2 RESERVES: Costs to conclude administration of Estate including 450.00 filing fee for PA Inheritance Tax Return and Inventory, First and Final Account and preparation of Fiduciary Income Tax Returns TOTAL (Also enter on line 9. Recap~ulation) $ 12,256.37 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems. Inc. Fo,", REV-1Sll EX (Rev. 1.971 REV-1S1Z EX +(1-97) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elsie M. Ludwig SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSil 181-42-8481 02/22/2001 FILE NUMBER 21-01-0267 Include unrelmburud medical .",___ ITEM NUMBER 1 DESCRIPTION Alert Pharmacy - Final bill AMOUNT 549.37 2 PA Department of Revenue - 2000 Personal Income Tax (Amended Return) 7.00 3 PA Department of Revenue - 1999 Personal Income Tax (Amended Return) 2.00 4 U.S. Treasury 2000 Personal Income Tax (Amended Return) 40.00 5 U.S. Treasury - 1999 Personal Income Tax (Amended Return) 11. 00 TOTAL (Also enter on line 10. Recapnulation) $ 609.37 (tt more space is needed, insert additional sheets of the same size) Copyright (f:) 1996 form softWare only CP$ystems, Inc. Form REV-151Z EX (Re.... 1-97) RI!V-1513 EX .(9-00) SCHEDULE J BENEFICIARIES COtollMONWEALTH OF PENNSYLVANIA INHERlT ANCE T.x RETURN RESIDENT DECEDENT ESTATE OF Elsie M. Ludwh SSfI 181-42-8481 02/22/2001 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS l'nd....outrlght_,...."...,ons.."" transfMSunder See. 9116(aX1.2)J 1 June L. Lingle 112 Miller Street Summerda1e, PA 17093 "".... Do Not List Truotee(.) Daughter FILE NUMBER 21-01-0267 AMO~~~~;A~ARE Rest. ' res idue and remainder of Estate ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS' A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS United Church of Christ - Specific Bequest 500.00 500.00 TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) CopyrIght {c) 2000 form software only The Lackner Group, Inc. Fo.m REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT OF ELSIE M. LUDWIG KNOW ALL MEN BY THESE PRESENl'S, THAT, I, ELSIE M. LUDWIG, Widow, of Hummelstown, Dauphin County, Pennsylvania, being of sound mind and disposing memory, do make, publish and declare the following instrument as and for my last Will and Testament, and I do hereby revoke any and all wills by me at anytime heretofore made. ITEM I. I direct my executrix hereinafter named to pay my just debts and funeral expenses as soon after my decease as may be practicable. ITEM II. I give and bequeath unto the United Church of Christ of Hummelstown, Pennsylvania the sum of Five Hundred ($500.00) Dollars. The said money to be used by the church officers as they deem fit and proper. ITEM III. All the rest, residue and remainder of my estate, real property, personal property and mixed, I give, devise and bequeath unto my daughter, June L. Lingle, absolutely. ITEM IV. I appoint my said daughter, June L. Lingle, executrix of this my last Will and Testament. seal IN WJ~~ WHEREOF'Fhereunto this day of '^^1 se~ ~~ ~~ a~d " ( ,-_-l f ((~--..w l/lj'-r/L,,,hr--'(j (SEAL) Elsie M. Ludwi' vi WITNESSES: 1J~L/. ~ Jrlf~~-r-iJ ~J!.J residing at /~ ,W at y/~wk;I.R. / ' residing