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HomeMy WebLinkAbout07-17-15 J 1505614134 Ex�o3,a,�F�, R EV-1500 OFFlCIPL USE ONLT Bureau oflntlivitlualTaxes CountyCotle Year File Numper Po eox zaosoi INHERITANCE TAX RETURN Harrisbum,PA i�128-0601 RESIDENT DECEDENT 2 1 1 5 0 0 9 4 ENTER DECEDENT INFORMATION BEIOW Social Secp�ity Numbe� pa�e of Deat� MMDDYVYV Dale 0/Birth MMDOTYYT 0 1 1 8 2 0 1 5 � 3 0 4 1 9 3 7 Decedenl's Las�Name SuKx Decetlenfs First Name MI W A R R E N D A V I D R (If Applicable)En[er Surviving Spovse's Informalion Below Spouse's Last Name Suffix Spouse's First Name MI S T I N T Z C ll M E L E A N 0 R L THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FIL�IN APPFOPRIATE OVALS BEIOW Q 1.Original ReWm � 2 Supplemental Retum � 3.Remaintler ReWm(tlate of death Prior[0 12-03-82) � 4.AgricWture Exemption � 5. FUNre Interest Compromise(tla�e o( � 6 Fetleral Estate Tax Retum Requiretl (aeleoitlealhonaaker]-0-2011) deathaXerl2-12-82) Q 1. DeceEent Oletl Testate � 8. Decetlent Ma'mtainetl e Living Trust _ 9.Tatel Num�ar of Sa/a�eposit Boxes (AtlaohoopyotwllJ (qnecpwpyolWstJ � 1Q�i�igation Pmceetls Receivetl � 11. Noo-Probate Trenskree ReNrn � 12. Deterra4Election olSpousal Trus�s (Schetlule F antl G Assels only) ❑ 13. Business Asse�s ❑X 14.Spouse is Sole Beneficiary (No tmsl Involvetl) CORRESPON�ENT-THIS SECTION MUST BE COMPLETED.pLL CORRESPONOENCE ANO CONFIDENTIAL TA%INFORMAiION SHOIILO BE DIRECTED T0: Name DaY�ime TelepM1one Num�er C H R I S T A M A P L I N 7 1 7 5 4 1 5 5 5 0 First Line af Address B 4 5 S I R T H 0 M A S C 0 U R T Second Line of Atltlress suzTE 12 Ciry or Post OKce Slate ZIP Cotle H A R R I S B U R G P A 1 7 1 0 9 correspontlenPse-malladtlress: CHRISTA@JANBROWNLAW.COM REGI3IEROF WRLS�ON�Y c �., A a' REGISiEROFWILLSUSEONLY � � � � � �RTE FILED MMODYYYY � _ p m s � r N A � :. r �, —io _ z m � m m '._ � ,: .00 �. 7 ' > o ��-oatir.q�os�tv -^ '' F � �,., � c� _� ' r m — 2 4� O PLEASE USE ORIGINAL FORM ONLY v '� Sitle 1 I Ifllll IIIII IIIII IIIII IIIII IIIII IIIII IIII)IIIII IIIII IIII I�II / L 1505614134 1505614134 J ` r , �l J 1505614234 REV-1500 EX(FI) Decetlenfs Social Security Number oxeaeorsrvame�. DAVID R • WARREN REGAPITULATION 1. Reai Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. • a. sm�ks a�a eo�as fscnea�ie s� . _ _ . . . . . . . . . . . . . . _ . . . . . . _ . _ _ _ . z. 1 6 4 9 2 0 . 9 0 3. Closely HeIC Corporation,Partnership or Sole-Pmprietorship(Schedule C) . . . . . 3. • 4. Motlgages antl Noles Receivable(Schetlule�) . . . . . . . . . . . . . . . . . . . . . . 4. • 5. Cash, Bank Oepasits antl Miscellaneous Personal PropeRy(Schetlule E). . . . . . . 5. L 7 $ 6 4 . � 5 6. Join�ty Owned Property(Schedule F) ❑ Separate Billing ReQuestetl . . . . . . . 6. � • � � 1. Inte�-Vivos Trensfe�s 8 Miscellaneous N¢n�-Pmbate Pmperty (Schetluie G) u Separate eiuing Req�estee . . . . . . . z 3 2 9 7 7 6 , 0 0 s. ror�i c.oss nssea¢o�ai u�es i m�ouyn�� . . . . . . . . . . . e. 5 L 2 2 6 1 . 6 5 9. Funeral Expenses antl ntlm�m�is�rative Cosis�Schetlule H) . . . . . . . . . . . . . . . . . . 9. 2 7 4 6 6 . 9 7 10. Debts o/Decetlen�,Motlgage Liabilities, antl Liens(Schetlule I) . . . . . . . . . . . . . 10. 1 0 5 6 . 9 3 i t 7otal oeauctions(totai�ines s ana iol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �t 2 8 5 2 3 . 9 0 12. Net Value o�ESWte(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 8 3 7 3 7 . 7 $ 13. Charitable antl Govemmental Bequestsl5ec 9113 Tmsts for which an election b tax has not been matle(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. � . 0 0 ia. NeNaiueSubjecttoiax(�inei2minus�inet3) . . . ia. 4 8 3 7 3 7 . 7 5 TAX CALCULATION�SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount ot Line t4 taxa�le at�he spousal tax rate,or [ransfers untler Sec.9116 (a)(t2)x.o _ 4 8 3 7 3 7 . 7 5 �5. 0 . 0 � 16. Amount ot Line 14 taxable atlinealrate X. _ . i6. 0 • � 0 1]. Amount ol Llne 14 taxable at sibling rate %.12 � . 0 0 1I. 0 . � � 18. Amount of Line 1a taxable a�rAllateral rale X.15 • 18. � • � � 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . 19. � . 0 � 20. FILL IN THE OVAL IF VOU ARE RE�l1ESTING A REFUND OF AN OVERPAVMENT ❑X Un�er penaNes ot perl�ry.I tleclare I M1ave e�amineJ t�ls reW m.'mcWJing accomDanying sc�e0ules an�stetemenis,antl lo iM1e bes�of my knowle�Be and Eelie[ il is Vue,cortM an0 complete.Declera�ion of preparer o1M1er IM1an IM1e person responsUle lor Iliing tM1e reW m Is base0 on all inlormabon ot wM1icM1 D�eparer pas any knowleUge. SIGNayu E F PERSON RES N51 LE R F ING RETURN OATE l`.l��iaiva, �� �i�- x � ���5�- nooaEss 211 MORE DR • � HARRISBURG PA 17112 51 URE 0 PRE RE THER H M f�it5 N RESPONSIBLE FOR FlLING THE RETURN ORTE �-�� �� �A �RESS � 8 SI45 R THOMAS CO RT, SUITE 12 HARRISBIJRG PA 17109 I II�III IIIII IIIII IIIII IIIIIIIIII IIIII IIIII II�II II�II I�II IIII Side 2 L 1505614234 15�5614234 � REV45�0 E% (Fp Page 3 File Number DecedenYs Complete Address: 2� is oosa DECEDENTSNAME DAVID R. WARREN STREET ADDRESS 2100 BENT CREEK BOULEVARD CUMBERLAND COUNTY GITV $TATE 21P MECHANICSBURG PA 77050 Tax Payments and Credits: �. Tax Due(Psge 2,Line 19) (7) 0.00 2. CreditslPaymenis A.Prior Payments 67,400.00 B.Discounl 0.00 (See insimdionsJ 7o�al Credits(n*B� (2) 67,400.00 3. Inleres� (3) 4. If Line 2 is grea�er ihan Line 1 +Line 3,en�er�he diRerence.This is ihe OVERPAYMENT. Fill in oval on Page 3,Line YO to requesl a refuntl. (4) 67,400.00 fl If Llne t +Llne 31s greater Ihan Llne 2,enler ihe 41Herenca.T�is Is Ihe TAX DUE. (6) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Oidtlecedenimakeatrareferand�. Yes No a. re�ainlheuseorincomeo�ihepmpetlYtransferred .. ......_. ...... ...... ❑ � b. retainlherighttodesignatewhoshallusethepropertylransfenetlorilsinCome ..... ..... ❑ ❑X c. retainareversionaryinterest ......... _.._.. ._.. _.. ..... ❑ � d. receive�hepromisebrlifeoleilherpaymenis benefilsorcare� ..._ _... .__ ❑ ❑X 2. If deat�occuRetl afler�ec.12.1982,tlid decedent irans(er pmpeny within one year of tleath withoutreceivingadequateconsitleration� ........... ................ ..._._..... .... ❑ ❑X 3. �Iddecedenlownan'lnims�for"orpaya�laupondealhbankaccoun�orsecurryalhisorherdee�h� __. ❑ � 4. Ditl tlecetlentown an intlividual reliremen�accoun�,annuiry or ol�er non-probate propetly,which conlainsabeneficiarydesignation7...._ ...._... .......... . .. .. ............. ._......._ x❑ ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOII MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Por tlates of tleath on or aiterJury 1, 1994,ana before Jan. 1, 1995,ihe t�rate imposetl on ihe net value ai Vansfers to or for ihe use oi the surviving spouse is 3 percent�72 P.S.§9116(a)(1.1)(i)I. For dates o/death on or aHer Jan. 1, 1995,the tax rate imposetl on�he net value of iransfers to or for Ihe use of ihe surviving spouse is 0 percent [72 P.S.§911fi(a)(1.1)(ii)].The staWte does no�exemp�a transier�o a surviving spouse from tax,and the statutory requirements for tlisclosure of asse6 antl filing a tax reNrn are s�ill applicable even if�he surviving spouse is Ihe only bene5ciary. For dates of dea�h on or afler July 1, 2000: • The lax rate imposed on the net value of fransfers fiom a deceased child 21 years of age or younger al tleath to or for the use of a naWral parent,an adoptive parenl or a step-parent of the chlld Is 0 percent[72 P.S. §9116(e)(1.2)]. • The Ux rate imposetl on ihe net value oi transiers to or for ihe use of the tlecetlenTs lineal beneficiaries is 4.5 percent,except as noted in(72 P.S.§9116(a)(1)�. • The tax rate imposed on ihe ne�value of iransfers m or for ihe use of the tlecedenYs siblings is 12 percent[72 P.S. §9116(a)(1.3)I�A sibling is defined, untler Section 9102,as an individual who has al leasl one parent in common with the decedent,whether by blood or atloption. aev��soa ex��e��z) pennsylvania SCHEDULE B oEanarmEul or reEVEuuE iu�ERirnNCE.nxaEruaN STOCKS 8i BONDS aEsioENroECEOErv* ESTATE OF FILE NUMBER DAVID R. WARREN 21 15 0094 All property joinlly ownetl wi[h righl oi survivorship must be tlisclosetl on Schetlule F. ITEM VAW E AT DATE NUMBER DESCRIPTION OF DEATH 1. UFinancial Group�, Brinker Capital Brokerege Account#649-910880 164,920.90 Consisting of the following: Fidelity Spartan 500 Index FD Advantage Class (FUSVX); 64.712 shs @$71.57/sh =$4,631.44 Pidelity Intermedia[e Muni Income (FLTMX); 3,151.037 shs @ $10.67/sh = $33,621.56 Aston/River Road Independent Value N (ARNX); 141213 shs @ $10.44/sh = $1,47426 Avenue Credit Strategies Investor(ACSAX)�, 378 409 shs @$10.68/sh =$4,041.41 Columbia Dividend Opportunity CL A(INUTX); 457.865 shs @$9.54/sh = 54,368A3 Columbia Select LRG Cap Growth Class A(ELGAX); 412.154 shs @ $1720/sh = $7,089.05 Delaware Value FD CL A(DDVPJO:. 319226 shs @ $18.13/sh = $5,787.57 Doubleline Total RT Bond FD CL N (DLTNX); 941.587 shs @ $11.07Ish = $10,423.37 Driehaus Event Driven Funtl (DEVDX)�, 151.605 shs @ $10.08/sh = $1,528.18 Driehaus Active Income Fund (LCMAX)�, 319.477 shs @$10.41/sh = $3,32576 Forward EM Corporate Debt Fund Investor(FFXRX)�, 448.843 shs @ $8.63/sh - $3,873.52 JP Morgan Strategic Income Opport A (JSOAX); 140.638 shs @ $11.68/sh = $1,642.65 LM BW Absalute RTRN Opportunities CL A(LROAX); 132.834 shs @ $12.59/sh = $1,672.38 MFS International Value Fund CL A(MGIAX)�, 166.380 shs @ $33.45/sh = $5,565.41 Northern Intermetl Tax Exempt Funtl (NOITX)�, 2,890.302 shs @ $10.83/sh = $31,301.97 T Rowe Price Growth Stock Advisor CL (TRSAX); 115.338 shs @$5023/sh =$5,793.43 Ridgeworth Mid Cap Value Equity CL I (SMVTX); 524.449 shs @ $13.181sh = $6,91224 Rivernorth Core Opportunity FD CL R (RNCOX); 633.601 shs @ $12.02/sh = 57,615.68 Riverpark Strategic Income Funtl Retail (RSIVX); 261.816 shs @ $10.06/sh = $2,835.07 Riverpark Short Term High Yield Retail (RPHYX); 332742 shs @$9.89/sh = $3,290.82 T Rowe Price Intl Stock AdviSor CL (PAITX)�, 244.040 shs @ $15.56Ish = $3,79726 TCW Relative Value Dividend Apprec CL N (TGIGX) 338.752 shs @ $17.12/sh = $5,799.43 Touchstone Focused Class A TFOAX � TOTAL(Also enteron Line 2,Recapilulation) S 164 920.90 If more space is neetletl, insert addi[ional shee[s of the same size Continuation of REV-1500 Inheritance Tax Return Resident Decedent DAVID R.WARREN 21 15 0094 DecetlenCs Name Page 1 File Numbe� Schedule B -Stocks 8 Bonds ITEM VA W E AT DATE NUMBER DESCRIPTION OF�EATH 137.500 shs @ $3526/sh = $4,84825 Wasatch Frontier Emerging Small Co's (WAFMX)�, 1,207201 shs @ $3.05/sh = $3,681.96 SUBTOTALSCHEDULEB GRANDTOTALSCHEDULEB �AIsoenleronLine2,Recapimlalion) 5 164,920.90 REV4548 E%�(OB-02) pennsylvania SCHEDULE E oePaarmeN*orr+eve»ue CASH, BANK DEPOSITS & MISC. wneartnrvce*aer�maN aEsioErvroECEOErvr PERSONAL PROPERTY ESTATE OF: FILE NUMBER: DAVID R. WARREN 21 15 0094 Inclutle roe pmceetls of litigation antl Ihe tlate[he Omceetls were receiveE by the es�a�e. All property loin[ly owned with�ight of survivorship must be tllsclose0 on Sc�eEule F. ITEM VALUE AT DATE NUMBER OESCRIPTION OF DEATH 1. ROBC Limited Partnership�, The Bridges at Bent Creek refund 1,874.00 2. PNC Bank Checking Account#51-1301-8998 6,819.00 3. IRS; LLS. Dept of Treasury; 2014 income tax refund 3,828.00 4. Final Pension payment 1,387.69 5. PA Department of Revenue; 2014 income tax refund 465.00 6. UFinancial Group; Brinker Capital Brokerage Account#649-910880; cash account 3,197.06 TOTAL�AIsoenleronLine5,RecapiNlalion) S 1756475 If more space is needed use addltional sheets of paper of[he same size. aev-isia ex.�oe-ae� pennsylvania SCHEDULE G oeaaa.Mer+.oraever.u= INTER•VIVOSTRANSFERSAND u+r+eairarvcernxReruRr+ MISC. NON•PROBATE PROPERTY aEsioEnroECEOErvr ESTATE OF FILE NUMBER DAVID R. WARREN 21 15 0094 This schetlule mus[be mmple[etl antl�iletl il ihe answer to any of Questlons 1lhmugh 4 on page Nae a(Ne ftEV�1500 is yes. OESCftIPTION Of PROPERTV ITEM irvc�uoENExunEo�rHErau+srEqEE.*xeaaEunor+sxiarooECEOEHrnNo DATEOFDEATH YOFDEC�'S EXCLUSION TA%ABLE NUMBER .Heon*eoFrau+srea.nnnanrovvorr„eoEeeroAveues*a*c VAWEOFASSET WTEREST i��wa�c.�a VAWE 1. UFinancial Group; Brinker Capital 329,776.00 100.00 0.00 329,776.00 Traditional IRA�, Account#649-426113 Beneficiary= Eleanor J. Stintzcum, spouse TOTAL (Also enteron Line 7,Recapilulalion) f 329 776.00 II more sDace is neetletl,use a0tlitional sM1ee6 0l paper ol Ne same size. REKt511 EX*(0&13) pennsylvania SCHEDULE H oePaArMeHroraeveHue FUNERALEXPENSESAND irvrvEeirarvceravaeruarv ADMINISTRATIVECOSTS aEsioENroECEOErvr ESTATE OF FILE NUMBER DAVID R. WARREN 21 15 0094 �xeEenYs Eebis must Ee reported on Sch¢dule 1. ITEM NUMBER DESCRIPTION AMOUNT q, FUNERALEXPENSES: t Hetrick-Bitner Funeral Home�, funeral expenses 10,633.37 2. Gabriellas; funeral luncheon 357.18 3. Spring Hill Cemetery; Grave opening 730.00 4. Stephenson's Flowers &Giks�, flowers 268.80 5. EBY Graniteworks�, gravemarker 1,070.00 B. ADMINISTRATIVE WSTS: 1. PersonalRepresenla�iveCommissions�. Neme(S�olPersonalRepresen�6live�s� sVeeeaaaress CAy S�ate ZIP Vear(s)Commiesion Paid p. nnamey F�s: Jan L. 8rown 8 Associates 10,24523 3, FamityExemptiort�l(Gecedenfsatltlressisnol�hesameasdaimanfs,allachexplanation) Glaimanl SlreetACdress Ciry SWte ZIP Relalionship ol Claimant lo Decetlen� 4. proba�eFees�. Register of Wills, Cumbedand Counry 510.50 5 acmun�amFees Parks &Company 355.00 6. raRaewmPreparerFees Alan J. Ceperich, CPA 600.00 2014 &final individual income tax retum 7. Cumberland Law Journal; legal ativertising 75.00 8. The Sentinel; legal advertising 243.64 9. Gregory R. Reed, Esq., guardiaq final guardian's fees 1,625.00 10. Gregory R. Reed, Esq., attorney fees 61875 11. Orphan's Court; Petition to Withdraw-guardianship 40.00 12. Orphan's Court; Motions for Transcripts 80.00 13. Transcripts wsts 14.50 TOTAL(Also enteron Line 9,Recapitulation) b p7 466.97 II mare space is neetled,use aGdi�ional shee6 0(paper ol Ne same size. REV-1512 EXr(12-021 pennsylvania SCHEDULE I oEanA�MEnroraEvcNUE DEBTSOFDECEDENT� iNneairaHceraxaeroev MORTGAGE LIABILITIES& LIENS REsioENroECEOErvr ESTATE OF FILE NUMBER DAVID R. WARREN 21 15 0094 Repotl tlebts incurreG by the tlecetlent prior to death Ihal remained unpaitl atthe date of tleath,induding unreimbursetl mMical expenses. ITEM VA W E AT DATE NUMBER DESCRIPTION OF OEATH 1. Pinnacle Health; outstanding hospital/medical bills 960.01 2. Check 1629; written predeath; cleared postdeath 90.00 3. Alert Pharmacy; outstanding medical bill 6.92 TOTAL�AIsoen�eronLinelO,RecapiNlation) E � 056.93 If more space is neetle4 insetl additional s�eets of lhe same size. aev-i s+s ew�m.�o� pennsylvania SCHEDULE J oePnR.Me�.oF at�eH�e BENEFICIARIES INHE0.ITANCEiPXREiURN RESI�ENiDECEOENi ESTATE OF: FILE NUMBER: DAVID R. WARREN 21 15 0094 RElATIONSHIPTODECEDENT HMOUNTORSHARE NUMBER NAME ANO A�DRESS OF PERSON(S)RECEIVING PROPERTY Do Not ListTruatee�e) OF ESTATE � TAXABLEDISTRIBUTIONS pnduaeouhighlspousaltlisiribWionsanOVanslersunaer Sec.911A(aj�t2}� t Eleanor L Stinizcum Spousal 2116 Sycamore Drive 100%of estate Harrisburg, PA 17112 EMER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-0500 COVER SHEET,AS APPROPRIATE. ❑, NON-TAXABLE DISTRIBUTIONS'. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN'. 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBl1TI0N5'. 1. 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE�ISTRIBUTIONS ON LINE 13 OF REV4500 WVER SHEET. S 0.00 If more space is needed,use addiiional sheets of Daper of ihe same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid wi[hin three calendar months of the decedenTs date of death: 67,400.00 Discount: 0.00 InterestTable Year Days Delinquent Balance Due Interest this time periotl this year this period . Before 1981 � . 1982 1983 1984 1985 1986 1987 1988through 1991 . . 1992 1993 through 1994 . . �.. 1995 through 1998 . . 7999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011through 2015 _ . . TOTALS �� '� Penalty Calculation If the decedenYs date of death was on or before Mamh 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: ATTACHMENT TO REV-1500 ESTATE OF FILE NUMBER DAVID R. WARREN 21 IS 0094 Elea�or L. Stintzc�m is the sole beneficiary, Executrix, and surviving spouse of David R. Warren. Eleanor L. Stintzcum and David R. Wanen had a commo� law mar�iage. However,the Last Will and Testament of David R. Warren dated May 26. 2014 and executed by Gregory R. Reed, Guardian purs�ant to an Order of Court in the guardiunship matter, File No. 145-OG2011 in Ihe Court of Common Pleas of Dauphin County, Pennsylvania, Orphans' Court Division, seems [o mistakenly list Eleanor L. Stintzcum as "friend". Therefore, although Eleanor L. S[intzcum is the surviving spouse of David R. Warren.a 3 mon[h prepaymcnt was made to preserve the s�bstantial prepayment diseount if Eleanor L. Stintzcum is challenged as being the surviving spouse of David R. Warren. A refund of this prepayment is respectfulty requested. Attached to this Inheritance "Pax Keturn are eopies of the followi�g documents to suppott and show that Eleanor L. Stintzcum and David R. Warre�had a common law mazriage and tha[ Eleanor L. Stintzcum is the surviving spouse of decedent 1. Dea�h Cenificate listing Eleanor Stintzcum as Wife; 2. File stamped Petitio� for Appointment of Emergency and Permanent Plenary Guardians of the Person and Estate of David Warren which provides under paragraphs 2 and 26 that David R. WaRen is the common law husband of Eleanor L. Stintzcum 3. Tra�script from emerge�cy guacdianship hea�ing held on 12/22/20l 1 in which the Court s[ates on Page 19: "�Chere's no question ei[her[hat [here was a common law marriage,...": 4. Transcript from permanent guardianship hearing held on 1/20/2012; 5. F.melope daced 6/25!15 addressed to "Eleanor Warren"; 6. E�velope dated 12/17/2008 addressed to "Mr. a�d Mrs. David Warren"; 7. Emelope dated 12/19/201 ] addressed [o " Mr. and Mrs. llave Warren"; 8. Pictures celebrating their murriage; 9. Obituary listing decedent as the husband of Gleanor Stintzcum for 37 years; 10. Family/Social history listed on a report signed by Dr. AngstadG M.D. (medical information redacted); 1 l. 3 cards for 3 of decedent and Eleanor Stintzcmn's pets that died; 12. Fcc rcccipt from thc Humanc SocicTy for David Eleznor R. Warren for a deceased pet they owned; 13. Letter from Dr. Tyndall. M.D. 14. Letter from decedenYs bcother and sisrer-in-law dated 3/4/2015; and 15. February 2015 and Maroh 2015 Brinke�Capital statemen[s fo� decedenPs IRA listed on Scliedule G showing transfers to spouse as Eleanor Stintzcum was the beneficiary of the IRA account. LAST WILL AND TCSTAMENT OF DAVID R WARREN KNOW ALL MEN BY THESE PRESENTS, That I, DAVID R. WARRHN, curtendy of the Hampden Township, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and 1'estament, hereby revoking and making void any and all former Wills by me at any time heretofore made. FIRST—I direct the Exewtrix or Executor hereof to pay all myjust debts, funeral expenses and costs of administration as soon as conveniently may be done after my death. 1 further direct the Executrix or Executor hereof to pay as part of the expense of administering my estate all inheritance, esta[e, [ransfer and succession taxes which may be levied or assessed upon any property which is included as part of my gross estate for the purpose of any such tax. SECOND—I give, devise and bcqueath all the rest, residue and remainder of my estate, both real and personal, ro my friend, ELEANOR L. STINTZCUM, on the condition that s� �.� � =� �� survives me. - o �, "' � _-� :.� o ��.� _'-' , a_ : » THIRD — If my said friend, ELEANOR L. STINTZCUM, fails to survive irie�then`�' ive; �� , devise and bequeath all the res[, residue and remainder of my cstate, both real and personai,z--ias .: -�i - �� follows: `" � '��, �� .� � � a) Fifty percent(50°/a) thereof to my friend, TRACI ANN ST[NTZCUM; b) Tw'enty-five percent (25%) thereof to my friend, APRIL L. STMTZCUM; and c) Twenry-five percent (25%)thereof to my brother, ALAN K. WARREN. FOURTH— I appoint my friend, ELEANOR L. STINTZCOM. the Executri� of this, my Last Will and TestamenL In Ihe e��ent of the death, resignation, renunciation or inability o(my said friend, ELEANOR L. STINTZCUM, ro serve as my [xecutrix, then 1 hereby appoim the � ��)�� � F� `�:S�L 1 DRW N'-I W-2 puardian of my estate, GREGORY R. REED, [squire, the Esecutor o(this, my Last Will and Testament. I do hereby give to �he Esecutrix or Execwor hereof full power, discretion and awhority at any time or times to sell,at private or public sale, mongage, lease, pledge, exchange or otherw�ise deal with or dispose of�he propeny comprising my estate upon such terms as deemed best, to settle and compound any and all claims in favor of or against my estate as deemed best and, for any of the Ioregoing purposes, to make,execute and delivery any and all deeds, mongages,contracts, leases, bills of sale or other instruments necessary or desirable �here(ore. LASTLY - 1 direct that no fiduciary appointed by this, my Last Will and Testament, shall be required to give Bond and tha� if, notw�ithstanding this direction, any Bond is required by any law, statute or rule of court, no Sure�y shall be required thereon. IN WITNESS WHEREOF, the Coun o(Common Pleas o(Dauphin Counry, Pennsylvania, Orphans' Coun Di��ision, has approved the execution of this Will on behalf of DAVID R. WARREN, the iestator, pursuam to its Order o(Court dated May 6, 2014, and directed GREGORY R. REED, ESQUIRE,guardian o(the Estate of the Testator to execute this W ill on behal(of ihe testator this �����day of May, A.D. 2014. � � / [ � / �4(����9;L'>!l (1� -�' t r ( AL) DAVID R. WARREN, Gregory R. Reed, Gu rdian Signed, sealed, published and declared by the above named GR[GORY R. REED, ESQUIR6, on behalf of DAVID R. WARREN. as and for his Last Will, in the presence of us and each o(us, ���ho, at the request and in the presence of the Guardian and in the presence of each other, ha��e hereu� subs 'bed our ames as �eitnesses thereto the da�� and year last above Hritten. / Residingat �� S'lad.� �n�( �i'�vr �`/'���_d / �y J Il � � �• ! �` �. �� ResidinE at �/// .Y'ud l{`: !l: - �/�� � 7 5-� L q � ���. ` C�/ ��r l� SSZ ACKNO�NLEDGMENT COMMONWEALTH O� PENNSYLVANIA ss COUNTY OF DAUPHIN "7 We, GREGORY R. REED, L-SQUIRE, Guardian for David R. Warren, the testator, and [-ynidre..G � I� . 1�ry and �ac��e� � � .�i� , the wimesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby dedare ro the undersigned authoriry that the Guardian si@ned and execured the instrument as Ihe testator's Last Will pursuant [o that certain Order of the Dauphin Counq� Court of Common Pleas, Orphans' Court Division, dated the 6`h day of May, 2014, that the Guardian signed willingly and executed it at the direction of such Order for the purposes therein expressed; that each subscribing wimess in the hearing and sight of the Guardian signed the Will as a witness. ���`�'i�.���9�. l2r� s�f<=�.�k �� DAVID R. WARREN by G e ory R. Reed, G �rdian ` � �; ,1�.� �J f'-� itn ss Witness ,� Subscribed, swom ro and acknowlcdged before mc by GREGORY R. RGLD, Guardian of the Estate of Da`v�id R. Warren, the testator, pursuant to Court Order and subscr'�ibed and s�aom to beforemebY ryl•ad�ee�. �. ��y and RQC�f.� � . /✓'N i 999 the wimesses, this �E�� day of�, 2014. �pyip�x,Fµ�x or vemmvnHu / MOTNNlSELL �/"/'��� _ ./ �!' �p�aK° N �aq� Public SVMTNtAT0VM5MF.mWUPW 9CpOtR1LY CoimY�+o^ MCNEES WALL4CE 8 NURICK LLC By: Scott Alan Mitchell Attomey ID No. 76124 570 Lausch Lane Lancaster,PA 17607 Phone: (717) 581-3713 Facsimile:(717)260-1633 E-maiC smitchell@mwn.com IN RE: . IN THE COURT OF COMMON PLEAS . DAUPHIN COUNN, PENNSYLVANIA DAVID WARREN, . . ORPHANS' COURT DIVISION AN ALLEGED INCAPACITATED PERSON . . NO. PETITION FOR APPOINTMENT OF EMERGENCY AND PERMANENT PLENARY GUARDIANS OF THE PERSON AND ESTATE OF DAVID WARREN TO THE HONORABLE JUDGES OF THE SAID COURT: The Petition of Eleanor L Stintzcum and Traci Ann Stintzcum, by and through their counsel, McNees Waliace 8 Nurick LLC, respectfully represents the following: 1 . The Petitioners are Eleanor L. Stintzcum and Traci Ann Stin�cum, mother and daughter("Pelitioners"), adult individuals residing at 2116 Sycamore Drive, Harrisburg, Pennsylvania 17112. 2. The alleged incapacitated person is David Warren ("David"), who has been the common law husband and companion of Petitioner Eleanor L. Stintzcum and the stepfather of Petitioner Traci Ann Stintzcum for approximalely thirty-three (33) years. 1 I L..i.�_W �'.I`.4''j� . �A525]13.1 "C u..-,. � . . �.:i.l CLERI:(.�.��.�,_._. :�: , .. � 3. David is sevenry-four years of age, having been born on March 4, 1937. 4. David has suffered from the effects of old age and dementia tor a number ot years and has steadily and markedly declined in cognitive functioning and memory for approximately the last five years. 5. More recently, Petitioners have observed that David is unable to manage his personal, financial, medical, etc. matters without prompting from Petitioners. For example, David does not change his clothes or bathe unless encouraged to do so. � 6. As will be averred further below regarding the emergency basis for this Petition, Petitioners also have observed that as David's dementia has progressed, he has become more prone to violence and threats of violence. For example, upon being prompted by Petitioners involving his personal care, David frequently is resistant to help, even becoming physically threatening and antagonistic. 7. Also, since David's doctor arranged for David's dnver's license to be revoked within the past year, David regularly and forcibly demands his car keys, even calling Petitioner Eleanor L Stintzcum names, swearing at her, has attempting to swing at or hit her, and even at times threatening to kill her. 8. David is under the care and treatment of Mamfa Verma, M.D., of Pennsylvania Neurosurgery and Neuroscience Institute, Inc., Bloom Outpatient Center, 4310 Londonderry Road, Suite 202 Harrisburg, PA 17109, James A. Tyndall, M.D., of Internists of Central PA, Lid., 108 Lowther Street, Lemoyne, PA 17043, Christopher Royer, Psy.D., 3314 Market Street, Suite 200, Camp Hill, PA 17011. 9. Attached hereto as Exhibit A and incorporated herein by reference is a Deposition of Individual Qualified to Render Opinion as to Incapacitation, which has been completed and verifed by Mamta Verma, M.D. of Pennsylvania Neurosurgery and Neuroscience Institute, Inc. 7he deposition questionnaire is being presented to the Court in lieu of a formal deposition transcript. 10. . As noted in the deposition, Dr. Vertna last saw David on November 29, 2011. 11. Dr. Verma's deposition confirms that David suffers from moderate dementia and is totally unable to manage his finances and meet essential requirements for his physical health and safety. 12. On November 9, 2011, David was examined by Christopher Royer, Psy.D., and Dr. Royer determined that David has at least a moderate level of dementia at this time, does not appear to have capacity to make decisions in his own best interest, and requires twenty-four hour supervision in order to maintain his health and safety and the safety of those around him. A copy of Dr. Royers report is attached hereto as Exhibit B and incorporated herein by reference. 13. Because of David's mental and physiral condition, it is believed and therefore averred by Petitioner that David is an incapacitated person within the meaning of Chapter 55, Subchapter A, Section 5501 of the Probate, Estates, and Fiduciaries Code, in that his ability to receive and evaluate information effectively and communicate decisions in any way is impaired to such a significant extent that he is partially, or totally, unabie to manage his financial resources and to meet essential requiremen[s for his physical health and safety. 14. David's current income consists of approximately $3,734 per month, consisting of the following: Social Security -- $1,358.00; pension -- $1,382.17; and IRA distributions and miscellaneous stock dividends — $993.83. 7 5. David's current assets consist of the following: Stocks (valued as of November 20, 2011): Verizon-2,900shares $ 107,996. AT&T— 155 shares $ 4,533. Frontier— 1,128 shares $ g,g82, Comcast-484share5 $ 10,265. Wells Fargo — Stock Porttolio $ 195,007. Prudential— 100 shares $ 4,853. IRAs: Wachovia $ 4,156. Prudential Annuities $ 74,352. Discovery Classic $ 6,665. C D: Belco Credit Union $ 13,000. Life Insurance: Prudential Death Beneft $ 68,000. TOTAL ASSETS: � 16. David has no natural-born children and has no prior marriages. David has no living parents but has the following siblings: Alan Warren 985A Forge Rd Carlisle, PA 17015 Richard Warren 961 East Ave Box 86 State Line, PA 17263 Chades Warren 534 North 5th St McConnellsburg, Pq 17233 17. David has not previously executed a power of attorney, and he currenlly lacks the capacity to execute a power of attorney, which has led to Petitioner filing this Petition. 18. Petitioner is not aware of any advance health care directive or healthcare power of attorney of David. 19. Due to the condition set forth above, David is totally unable to manage or even appreciate the signifcance of his financial affairs, property, and business and to make and communicate any decisions relating thereto, including the ability to communicate his need for assistance in these areas. 20. Due to the severity of the condition set forth above, David lacks the ability to make or communicate any responsible decisions concerning his persona and is unable to attend to his personal safety or to keep himself properly nourished, hydrated, and medicated, or to communicate to others his need for assistance in these areas. 21. Due to the severity of the diagnosed conditions set forth above, the assistance of other persons or services would not enable David to participate in the making of any decisions concerning his estate or person. 22. �The severity of the diagnosed conditions of David requires that a plenary guardian be appoinled to manage the estate of David. Said guardian should be appointed to manage and handle all aspects of his estate, specifically including, but not limited to: all issues relating to his cash, checks in any bank or savings account held in his name, stocks and bonds, personal property, real estate, life and other insurance of which he may be a beneficiary, entitlement to any government or non-government benefit plans, federal, state, and local taxes, trust accounts of which he may be a beneficiary, claims made or to be made on his behalf or against him, fhe execution of documents, the entry into contract affecting him and the payment of reasonable compensation or costs to provide services to him. 23. Less restrictive alternatives, other than the appointment of a plenary guardian of his estate, have been considered but determined not to be viable alternatives. Petitioner therefore believes [hat the best interests of David and his estate are no[ being provided for at this time and will not be provided for absent the appointment of a guardian of his estate. 24. The severiry of David's condition, as stated above, mandafes that a plenary guardian of his person be appointed to handle all issues relating to the person of David, specifically including, but not limited to: his living arrangements, his medical and neurological care, the administration of inedication to him and the employment and discharge of physicians, psychiatrists, dentists, nurses, therapists, and other professionals for his physical and neurological treatment and care. 25. Less restrictive alternatives, other than the appointment of a plenary guardian of his person, have been attempted but determined not lo be viable alternatives. Petitioner therefore believes that ihe best interests of David and his person are not being provided for at this time and will not be provided for absent the appointment of a guardian of his person. 26. The proposed guardians of the person and estate of David are i) David's common law wife and companion of approximatety thirty-three (33) years, Eleanor L. Stintzcum, Petitioner, and 2) David's stepdaughter, Traci Ann Stintzcum, Petitioner. 27. Whereas both Petitioners live with David, and in light of Petitioner Eleanor L. Stintzcum's age, Petitioners believe that it is appropriate for both of them to be appointed as Co-Guardians of David. 28. The Petitioners are qualified individuals pursuant to 20 Pa.C.S.A. § 5511(�. The proposed guardians do not have any interest adverse to David, and a copy of an acceptance to serve as guardian of David's estate and person is attached hereto and incorporaled herein by reference. 29. No other Court has ever assumed jurisdiction in any proceeding to determine the capacity of David, nor has a guardian already been appointed for him. 30. David was a member of the armed services of the United States from 1956 to 1959, but is not receiving any benefits from the United Slates Veterans' Administretion or its successor. 31. The Petition seeks both a permanent guardianship under 20 Pa.C.S.A. § 5511 and, for the reasons set forth below, an emergency guardianship under 20 Pa.C.S.A. § 5513, to remain in effect until a full guardianship ran be ordered by the Court. 32. In accordance with recommendations of David's doctors, Petitioners are urgently seeking placement for David in a local personal care facility. 33. As noted above, Petitioners have observed more recently that as David's dementia has progressed, he has become more hostile and violent and has made threats of physical harm to Petitioners as they try to provide him with care and discuss receiving care in a facility. 34. Additionally, more recently, Petitioners have observed David talking to himself and making statements that he should kill himself. � 35. Dr. Verma has examined David most recently on November 29, 2011, and she has recommended to Petitioners that lhey seek immediate placement for David in a local personal care facility as a result of his progressive dementia. As a result of this recommendation, David's violence and hostility has increased further. 36. On Saturday, December 17, 2011, David physically attacked Petitioner Eleanor L Stintzcum in their home and tried to choke her. Petitioner Traci Ann Stinhcum immediately commanded David to stop and attempted to ca11911 for assistance. 37. Upon Petitioner Traci Ann Stintzcum ariempting to call 911, David ran towards Traci, knocked her to the Floor, and began to physically assault her, resulting in multiple bruises to her back and hand and a mild concussion. 38. Shortly after the aforementioned incident, the Lower Paxton police arrived and arranged for David to be taken by ambulance to the emergency room. The police made an official report of the event under report number 20111217M0035. Petitioners do not yet have a copy of the report. 39. Also, Crisis Intervention was called, but they were unwilling to become involved due to David's dementia diagnosis. 40, While David was in the emergency room, Petitioners attempted to locate immediate placement for David in a local personal care facility. However, although Arden Court had availability for placement, they were unwilling to admit David without a valid guardianship or power of attorney in place. 41. As a result of not being able to be admitted to Arden Court for lack of a guardianship or valid power of attomey, David was released from the emergency room to retum home. 42. The emergency room doctor gave David Ativan in an attempt to calm him, which was successful. However, the doctor only gave Petitioners five (5) additional Ativan tablets upon releasing David from the emergency room, and so it is critical that a guardianship be in place so that Petitioners can arrange for David's immediate placement in a personal care facility and authorize appropriate medical care and medications for David's dementia. Otherwise, the aforementioned attack likely will be repeated — perhaps with more dire results. 43. Petitioners continue to be in contact with personal care facilities about placement for David, and as is the nature of the personal care industry, availabiliry changes on a daily and even hourly basis depending upon deaths, discharges, admissions, etc., of existing or new residents. 44. For those facilities that currently have indicated a willingness to admil David upon availability, they have advised Petitioners that they cannot admit David without a valid guardianship or power of attorney in place. 45. As is customary in the personal care industry, if a prospective resident fails to accept an available admission—or if admission is denied because of lack of a guardianship or power of attorney—the available admission is offered to the neut prospective resident on the facility's waiting list. 46. Thus, as a result of the foregoing, and whereas Petitioners could be notified of availability on a momenPs notice — thus requiring an immediate decision or otherwise losing the availability to another prospective resident, it is critical that Petitioners have a valid guardianship in place by the time a facility advises Petitioners of availabiliry. 47. Additionally, as demonstreted by the events of December 17, 2011, David needs immediate medical care, medications, etc., and yet Petitioners are without legal authority to address David's medical care — and third parties are unwilling to provide care to David apart irom a guardianship or valid power of attomey. 48. Additionally, awaiting a permanent hearing with twenty (20) days' notice not only will jeopardize placement (which Petitioners anticipate being available any day), but having David remain at home and being given twenty (20) days' notice of a hearing likely will result in a repeat ot the above assault. 49. As a result of the above examples and Petitioners' daily observations of David's inability to care for himself, Petitioners are seeking an emergency guardianship in that they believe that waiting approximately thirty days for a non-emergency guardianship hearing will jeopardize David's health and safely in that David needs immediate care, placement, and assistance, and yet Petitioners have no legal authority to act for him. 50. Due to the emergency nature of the circumstances, it is requested that this Court waive the requirement that twenty (20) days' notice of the hearing on the Petition for Appointment of an Emergency Guardian be given to David and that instead only twenty-four (24) hours' notice be given to him along with service of the Citation. 51. The Petitioners believe and therefore aver that because of David's present physical and mental condition, including his progressive dementia and demonstrated hostility and violence, induding the events of December 17, 2011, his presence in court would be detrimental to his welfare. � WHEREFORE, Petitioners, Eleanor L. Stintzcum and Traci Ann Stintzcum, pray that this Honorable Court (i) award a Citation directed to David Warreq the alleged incapacitated person, and to such other persons as the Court may direct, with twenty-four (24) hours' notice and service thereof to be given to him, to show cause why he should not be adjudged to be an incapacitated person and why Eleanor L. Stintzcum and Traci Ann Stintzcum should not be appointed emergency plenary guardians of his person and estate, with such emergency guardianship to be in effect for a period of no less than seventy-two (72) hours from the date of this Court's decree; and (ii) award a Citation directed to David Warren, the alleged incapacitated person, and to such other persons as the Court may direct, to show cause why he should not be adjudged to be an incapaci[ated person and why Eleanor L. Stintrcum and Traci Ann Stintrcum should not be appointed permanent plenary guardians of his person and estate. Respectfully submitted McNees Wallace & Nurick LLC Scott A Mitche Sup. Ct. Atty. ID #76124 Elizabeth P. Mullaugh Sup. Ct. Atty. ID#76397 Attorneys for Petitioner McNees Wallace & Nurick LLC 570 Lausch Lane, Suite 200 Lanraster, PA 17601 (717) 587-3713 VERIFICATION The Undersigned hereby verify that the statements made in the foregoing document are true and correct to the best of our knowledge, infortnation and belief. We understand that false sGtements herein are made subject to penatties of 18 Pa.C.S.A. Section 4964, relating to unswom falsification to authorities. C-Cy�/irtr7l � Eleanor L. Stintzcum _ � T a Ann Stintrcum Dated: I ?,' � 9 'a01 � , � � � E � �' . � ' � � � � � _ � , �� � �� � _ .., -� � :• �, � _ , e _ I � �' - � � � _ � � � � ' � � 'L _+ i �' � _ f � _ I < .-+ _ A \ � � I � � I �II I I / / / �i. ,47 --- � . � I�"I< l� 1;1. I:� � `aAiS`' �_.��a.� ►illlilllill�l`1Ij S�RTE ���F P� RZE3 pEC I?."08 *_� RYOJNT ��_��E �0.59 ni:z aooszass-o; C j I — � � �..�� �.. . i �� N _ I � � r _ � � � � — � � ��' � - � � � � _ � _ ' � �3 � ° � ° xi , � p � a � ; J � I . � '� . 2 �'1 y . '- �' Ci . � _ _ �9 � ' � � _ � ' u. a�' � � . I �� n a�> � , �'3�� � ..�� N � i �3m r..m, ,� :y� �, ,' . i` s � � j ,,: i � 'r"�. �.. I ��� i _ Ii . ,... , �_ . � �.z ,. , _� � �,,< - ; � ,; a�., , . :.JF', f . � � � �� � _3.�. {�� ��' `� '.}-, .-;�. ' ,Zn- ,`; I .', ' � :'�� ,> � a � � � � � . ✓ ........ ......... ..,,�.,. _ ..a.,� ..a��o�� a wuua�y uy me ruouc vpm�on. Page 1 ot 1 David R.Warren �!"�� Davitl R.Warren Davitl Raymond"Bud"Warren, 77, o(Harrisburg. PA passetl away Suntlay, January ;,� 16,2015 a(The Bridges at Benl Creek,Mechanicsburg, PA. Born Maroh 4, 1937 in Chambersburg, PA, David was the son of the late David Speer and Elva Pead (Hammers)Warren. He was the husDantl of �.p Eleanor(Jenkins) S�inizcum for 37 years. Davitl was a Veteran serving in ihe Uni�ed States Army. Upon his Honorable Discharge he began working for AT&T w�ere he was a cable splicer an0 iater retired from ',4��Verizon where he was a technician installing micmwave lowers. Davitl enjoyed raising and showing �' ��dogs. He was wetl known thmughout Ihe neighborhood as the Dog Walker. He was a man o(many talents and skills.He had ihe abiliry to look at and fix just about anything. He enjoyetl yard work, electrical/plumbing antl building with his hands. In atltlition to his wife, David is survived by three bro�hers, Richard Warren of State Line, PA.Charles Warren of McConnellsburg, PA and Alan Warren of Carlisle, PA; severai nieces antl nephews. Frientls may wll 11:OOAM-12:00 PM, Thurstlay, January 22, 2015 a��he Hetrick-Bitner Puneral Home, 3125 Walnut SL, Harrisburg, PA. The graveside service will be 1:00 PM, Friday,January 23,2015 at the Spring Hiil Cemetery Shippensburg, PA. In lieu of flowers, the family suggesis memorial contributions may be made to the Wountled Warrior Project at P.O. Boa 758517 Topeka, Kansas 66675. The Hetrick-Bitner Funeral Home has been enlrusted with ihe arrangements. To s0are online condolences please visi�www.HetrickBi�neccom Funeral Home Hetrick-Bitner Fune21 Home,Inc. 3125 Wainut S�reet Harrisburg, PA 17109 (71�)545-3774 Published in Public Opinion on Jan. 21,1015 http://www.legacy.com/obituari es/publi copi n iononl ine/obituary-pri nt.aspx?n=davi d-r-warre... 2/5/2015 i � � � � �1 � � � � �1 � i � ,, � � > 'o A ,2 � r E O T a - � H = � rn � n �a m N O 3 � ,a c ol � a q ` � p�p � � R �) U L y O C A o 'o C � y " Q � � _ � n � q � y a a r s � E '! as+ T � � r � O � � L m � � g r .« y _ Y a A on 3 > > d �u > ' � °' � _ . y c E i v I 0 � V � � � � � �� � 1 . L L d j L� � ,� 3 n �\', s � _ 9 q T .0 /�� N - c H O � 3 LX F 3 J � ' � _ # .. 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Pner M.Bneq M.D. Pavick Ralnmemy,M.0 Dean L.Le�men,PAL Michazl L.Gluck,M.D. V.MarNa Kapoor,M.D. Viiuysh¢e Kurtur,PAL lemes A.Tyndall,M D. PreNeesh VisweneNen,M.D. Melissa Brndmf,PAC LawrenccB.Zimmeeman,M.D Alanl.Sweeney,M.D. YaheSheh,PC-C Carle l.Denm,M.D. Roxma Vargu,M.D. Hewar Seyed,CRNP DuminicMinrchi,DO. HartyS.Sahi,M.D Wrndy Scheenrn,M.D. NARRISVIEW PROFESSIONAL CENTER-108 LOWI'l1ER ST-LEMOYNE,PA 100l7-(]1'i��141366-Frs(]I])]9H]33 March 4,3015 To Whom I[Mey Conccm: This is in reference ro Ne relationship between Devid Werren and Eleanor Stinlzcum. AlYwugh Ney were�wl oRicially martied.�hey resided toge�AaforgeeterN�30years. Thtyfunctio�rcdaaawuplewiNdivisionoflaborandrtsponsibiliticsconsistmtwi�hamartiegc. During pcnods of illncu(of cithn member of the cauple)the oNer memUer wu very much invoWed in dccisian making and cert. Aphough Ihcy hed �w"rcal children"�ogclher Ney did shert ihe responsibili�ies af caring for�heir childrtn(show dogs). 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E B a AaN =�a.�n eu. _S� Eo„E.,� „s a_F , gaq_ sr�;_�e5a cE E - e � E3Tqem . � 5 0 € ' ^ ee3"orcodgrvm v�_� "a� s n �e a°.°1i G_ EU. -8r es4a = «mEa� � m' �3E`� 8�� � &2� . >� E 3�oNmo�pE�3°E"���a€ � �`s" e B s =__� <� gAmo�o_o`€sE�o���>"v9AAa��„ -o� �w g� °�v- �Av;s„�._"N° - a6 _ __ �E �Eea;�@ ,_ s�aY -_ „_�m__u Jan L. Brown & Associates ATTORNEYS AND COUNSELOAS AT LAR' Jnu L. BaowN.Fcpi_ixe BaF,,uon B ICeru,�rtr.�cn�rss�sravr JnrQUFuve A. Ke�t.v.Fspoier I�oirH A.BAeusoi e annusisrxrrrvF,�ssisr oN1 Cuxisr,�M. Aei.m.rsoeiu'- Mci issn L. S,�in�.i.een�rsvsrANr Karnenne Y.K�urz.�ecni.,�ssisr�v. July I5, 2015 o � co u� � m � m w � c � o v m s � r N � Kcgisterof Wills � r l-- �-' �„ r�n Cumberland County Courchouse � � �^� � , v` - One Courihouse Square " '� -, -4 -n � -; o :i 3 t T Carlisle, PA 170li - _ ��� < . � � � � � ti rm Re: Estate of David R. Warren '� -� �' � � � Eeta[e No. 2015-00094 Czecutrix: Eleanor L. Stintzcum I'o Whom It May Concern: Enclosed please find the following for fili�g for the above referenced Estate: 1. An original and two copies of the ]nheritance Tax Return. 2. An original and one copy of thc Inventory. Please time stamp and return our 51e copy of the Inheritance Tax Return and Inventory in the enclosed envelope. Sincerely, �`— Christa M. Aplin Enclosures cc: Eleano� L. Stintzcum. Execuhix Olde English Gap • 845 Sir Thomas Court • Suitc 12 • Harrisburg PA U109 Telephonepl7)541-Si50 • Fax(717)541A2'_3 • HmuII�.ILBaswcg�jenbmwnl¢w.com • www,jenbrow�lawwm