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Home My WebLink About01-0388 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Percy N. Dorwart No. 21-01-388 also known as Percy Ner Dorwart I Deceased Social Security No. 207 -07 -9095 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) [;I A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the Decedent, dated September 27, 1996 and codicil(s) dated November 14.1996 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: [;I B. Grant of Letters of Administration (c.I.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 100 Mount Allen Drive, Mechanicsburq, Upper Allen Township (list street, number and municipality) Decedent, then~ years of age, died April 9. 2001, at Mechanicsburq, Cumberland County (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ............................................... $ 432,000.00 (If not domiciled in PA) Personal property in Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ (If not domiciled in PA) Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Value of real estate in Pennsylvania ........................................................... $ 190.000.00 Total ........................................................................... $ 622.000.00 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Robert J. Dorwart P.O. Box 990 Lancaster, Ohio 43130 Form RW-1 Page 1 of:2 (Dauphin County - Rev. 9/92) /~- ~~y~ c.., y Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner(s) will well and truly administer the estate accordin to I dC3Y of Sworn to and affirmed and subscribed before me this 17th APRIL 200j.. "n)C2L<-y' c2" 'fi-U4~/U,,-J/20 ~ DECREE OF REGISTER Estate of Percy N. Dorwart also known as Percy Ner Dorwart Social Security No: 207-07-9095 Deceased No. 21-01-388 Date of Death: Aoril 9. 2001 AND NOW, APRIL 18 ,2001, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters. Testamentary 0 of Administration (c.I.a.; d.b.n.c.t; pendente Ine; durante absentia; durante minontate) are hereby granted to Robert J. Dorwart n the above estate and that the instrument(s), if any, dated Seotember 27. 1996 and November 14. 1996 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters.. . . . . . . . . . . ., . . .. . . . . . . . . . Short Certificates...(6)....... Renunciation................. . Affidavit ( )................. Extra Pages ( )............ Codicil......................... . JCP Fee........................ Inventory & Tax Forms... Other.......................... .. TOTAL............... . Form RW-l Page 2 012 (Dauphin County - Rev. 9/92) :257767 _1 $ 410.00 )-;,'7:uu./ 0 Z ~'-"'(A' / "' '(' / /t? C./ J,' " '-<! ;0.; ,7 /! / /~ i egister of Wilis $ 18.00 $ $ $ 6.00 $ 10.50 $ 5.00 $ $ ~ 4~ ~~~-Y ~~4)/v I ~o/2h Attorney: P. Daniel Altland, Esquire 1.0. No: 25438 Address: 3401 North Front Street Harrisburg, PA 17110-0950 717-232-5000 L( - I 1- ([) { $ 449.50 Telephone: DATE FILED: 1 (I')XiJ'i RE\' 'i(XI> rhis is to cenir\' due the information here given is correctly copied from an original certificate of death duly flIed with me as Lxal Registrar.' The original certificate will be forwarded (0 the State Vital Records Office for permanent tIling. WARNING: It is illegal to duplicate this copy by photostat or photograph, Fee f()r this certifIcate. $2.00 ~~jj;/;;." 4jilf~\\_~J1Ltik~:~ /.,I'.~ '\. / ...../1' n-' 1./ ~'/ . "'\A~ I,'~I "..~~~ /~~/.; \~\ (~c::.! ':~ " :ii:~ \... c..".); '.. j, -i "~ \\*~."-.'.r;/*~ \~ a~/ . . ~ " \~'~,~ //~tt --!lIrJI - ,- ~ ~<';;ll~ "",:." ENl \'l,'l'~ "///O/II1IJII P 7296260 No. 21-01-388 ~~R~ APR 1 1 2001 Date COMMONWEALTH Of PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ,~ 2/87 NAME Of DECEDENT \fdSl MIll<lle. L...., P~ey N~ VO~waAt SEX 2. Male. I. AGE (last Bo<lhaavl UNDER' VEAR ManIlla Days UNDER I 01<< Houfa "'inul" 8lRTHPv.cE ,C4y;,r.<! Stale Of Fcretgn Counuy) 86 HeVt~-wbwr.g, PA . .5, ..COUNTY OF OEA1H . ~ Cumb~land ..... .. DECEDENT'S USUAl OCCUfWlOH ~ (~=:'.:!'~~::~:'i' ~ llL Saie..6man "... DECEDENT'S MAlUNG AOORESS (Sl'''', c.y~. su., ZiP Codel 100 Mount Allen V~~ve. Me.chan~e.6bwr.g,PA 17055 v,. k. Me.ehan~c..6bwr.g KINO OF BUSINESS/INDUSTRV WAS DECEDENT EVER IN U S. ARMED~ v.. 0 12, Conoeo DECEDENT'S ACTUAl AESIOENCE (See lIlSltUClIOna on OIher Sldel STAlE FILE NUIoI8ER SOCiAl SECURIT\' NUMBER DATE OF DEATH ,McnoI1, Da~, ._, .. 4-9-2001 3. 207 07 - 9095 :="YIO RACE - AmencaIIlncli.In. 8/eck, White. etc:. (SpecIy) 10. wh~te. SURVIVING SPOUSE I" "".. go"'lTldlO8O namel 1.. He.O .... dKecllInIlMd in 1711, Coun PA Did dec:edeI1l Cumb~land ~7 170.0 ~'*.::'':::oI MOTHER'S NAME ,Frs!. Mdate, MaKlen SuIOam8) Phoebe. P~~ce. cilylboro 17.. &.Ie II. INFORMANT'S NAME (T ypelPrinl) . MJr.6. CeVtole. V. S aM. METHOD OF OlSl'08lTIOH 8urieI 0 C......llonXJ ~ 110m StalaO OIlIer (Spec:iIy' ACTING AS SUCH ...... 24-2tI_ be ~ad by DATe PRONOUNCED DEAD (Moo"'. Day. 'r9at1 ~-~~, // 2.. 101, 2S. ,.., - () ? -0 I 27. MIlT I; Ent'" lIle CliMases. mjurias Of comptocal""" whith caused.he dealh 00 noc antar the ITlOde o' "YinQ. such as cardiac 0' 'esplralory arrasl. shocI< 0' heart la,luta I." onty one c:auw on aacl\ _ .-oIAT! CAUU (f.... c-.... 01 condol_ .-.Iong '" .....)- ~ III condiIiona it...,. -.g 10 IlIIlYladiale _. E-. UIIDEJIL'IlNO CAUSe (OIMaM or ....v ...~- ,-.long on....., LAST I : 1 d. DUE 10 (OR AS A CONSEOuENCE Of): MS I'M AUTOPSY PERfORMED? WERE AU1OP$Y FINOIHG$ ,vuU\8t.E PRIOR 10 COMPlETION OF CAUSE OF DERH1 DATe OF INJURY (Monlll. Dav. Year) IooIAHNER Of DEATH 6- o o Halural Hom_ o o o Att_ Pendong In_'gallon ...0 v.. 0 No~ s...cide CO<Jld noc be delenn.ned IlL 21b, n. ::EIIJIAUJ IChacl< only onel 'ceRTlI'Y/NG PHYSICIAN IPh~ COftoly'ng cause 01 de.'" whet' anllll'er pnySlC"'" has pronounced <!e;,I" ana comple\e<lltem 23) To..._oI"'yknow....cIa.d\occ__"'~e.uMi.'.ndm.nna'...IlI'",. """"""""'" ..,."".,..,."",."., "PRONOUNCING AND CERTIFYING PHYSICIAH (Ph~" tIOll\ ;llono,,,>c.ng oeath and c"",IV""l 10 cause of deathl To Ibe belli 0' my kl'Owe.dQft, death OCCU,,.ed at the &line. date. and place. and due to tN cauM(a) and m.nner .. 'lated. 'MEDICAL EXAMINER/CORONER On the baais of e"sminatlon and/or invesligalion, in my opinion. dealh occumld allhe lime, date, and place, and due 10 Ihe cause(.land 1. manner as .tat~.,., .,.'.' ,. . . , . -..", , , . . , ., " '" , .' ,.........'.'.', , "'<>os....", - - ~~ ~ , 7 - (.. ~l/~I/( I ~ Me.c.ha.n~e.6bwr.g (MonII\, Day. 't'aarl 2310. 2Jc. Wf\S CASE REFERRED TO LlEDlCAL ~'NERlCORONEfI? .....~rf/ H- I Aporo"imare '_~n : 0.- and daatll I I I NoD PART 1/: Othe, signi/lc:anl ooncIIiana concribullng ID claalll, buI _ resutlin9 in lIle llIlCIarlying ca.- given in FWrr I. TILlE Of INJURY INJURV I(I WORK? DESCRIBE HOW INJURV OCCURRED, v.. 0 NoD o .. " .. . f_ . LAST WILL AND TESTAMENT OF PERCY N. DORWART I , PERCY N. DORWART, of Fairview Township, York county, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last will and Testament, hereby revoking and making void any and all wills by me heretofore made. FIRST: I order and direct that all of my just debts and funeral expenses be paid by my hereinafter named Executrix as soon after my death as may be found convenient. SECOND: All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death I give, devise and bequeath to my wife, CATHERINE E. DORWART, providing she shall survive me for a period of thirty (30) days. THIRD: In the event that my said wife, CATHERINE E. DORWART, should predecease me, or in the event that she does not survive me for a period of thirty (30) days, then I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal 21-01-388 and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death as follows: A. Ninety-five (95) percent of the residue of my estate shall be given to my six children, ROBERT J. DORWART, CAROLE DORWART SPAHR, KATHLEEN DORWART SNYDER, ALAN R. DORWART, ELAINE DORWART GARMAN, AND JAMES P. DORWART, in equal shares, per stirpes. B. Five (5) percent of the residue of my estate shall . , , . be given to JOHN P. VORIS of 309 Pinewood Drive, Shiremanstown, Cumberland County, Pennsylvania, 17011. FOURTH: I hereby nominate, constitute and appoint my said wife, CATHERINE E. DORWART, as Executrix of this, my Last Will and Testament, and I do direct that no bond shall be required of such Executrix hereunder. My said Executrix shall have full power at her discretion to do any and all things necessary for the complete administration of my estate, including the power to sell at public or private sale and without order of Court, any real or personal property belonging to my estate, and to compound, compromise or otherwise to settle or adjust any and all claims, charges, debts and demands, whatsoever, against or in favor of my estate, as fully as I could do if living. In the event that my wife, CATHERINE E. DORWART, does not survive me or fails to qualify, then I nominate, constitute and appoint my son, ROBERT J. DORWART, as the alternate Executor. Said alternate Executor shall have all of the powers, privileges, duties and immunities as hereinbefore more fully set forth for my original Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal to 7}) f'J I and Testament, this) 7 -day of J1f'''''~~' 1996. c>~ 11/ IY~~ Percy N. If'Drwart (SEAL) this my Last will Signed, sealed, published and declared by the above named Testator as and for his Last will and Testament, in the presence of us, who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses. ...- FIRST CODICIL TO THE LAST WILL AND TESTAMENT PERCY N. DORWART 21-01-388 I , PERCY N. DORWART, of Fairview Township, York county, Pennsylvania, being of sound mind and memory, do make, publish and declare this to be the First Codicil to my Last will and Testament dated the 27th day of September, 1996. FIRST: I hereby add a paragraph to my Last will and Testament dated the 27th day of September, 1996, which paragraph shall be numbered FIFTH and shall read as follows: FIFTH: I direct that my remains be cremated. SECOND: In every other respect I hereby confirm and republish my Last will and Testament dated the 27th day of September, 1996. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this codicil to my Last Will and Testament dated the 27th day of September, 1996, this If!!!- day of rVDVfh1Bt1-; 1996. c?~41' BOi~ Percy . Dorwart (SEAL) Signed, sealed, published and declared by the above named Testator as and for the first Codicil to his Last will and Testament dated the 27th day of September, 1996, in the presence of us, who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses. ~D- ~. " . ~.1'- If) l~ ~. (~ -- 21-01-388 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of testat_ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS CAROL D SPAHR and ROBERT J DORWART (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of PERCY N DORWART codicil testat~ of (<me{)oo{)dntX~REiogx~m6XX<<) th9and will presented herewith and codicil that they believes the signature on the will is in the handwriting of PERCY N DORWART to the best of their _ knowledge and belief. /1 '(f) i; f ./ Sworn to or affirmed and subscribed before L (~q4..0 '4fl/t me this 17th day of /--J( QJTle) (j) . APRIL. "__ ~2001 7/3 ~ ;;;/"';~v' ;!//VI----f '>>12ul (tjf~'(~f<wWz.#u~eo/.?cuP 1_ f/,<<'9 Addr.,ess) 7-?# n/ 7 3 -5/ '/ Register I P-tA/Iy.,l~ - ~ j&rJ'z;A-11 v fame! . . ,# .I./J /lA-1 '1 c ~/f'.A'"~) t7l( 't J I) c:J (Address) E CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Percy N. Dorwart Date of Death: April 9. 2001 Will No. Admin. No. 2001-00388 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 May 1 L 2001 : Name Address Robert J. Dorwart P.O. Box 990. 2280 Hamburg Road. Lancaster. OH 43130 Carole D. Spahr 763 Glen Arden Drive. Lewisberry. P A 19339 Elaine L. Garman 7490 Allentown Boulevard. Harrisburg. PAl 7112 James P. Dorwart 1375 Old OuakerRoad. Etters. PA 17319 Kathleen D. Snyder 1401 Princeton Road. Mechancisburg. P A 17050 Alan R. Dorwart 204 South Second Street. Wormleysburg. PA 17043 John P. Voris 541 Lexington Avenue. Mechancisburg. P A 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except. Date: May 11.-2001 Q~' I '\ ~ ,~..-------_._--''''-'~. .~.~ (J . if' ~o if.... D. . i -,"~ "L(.), C~ Signature P. Daniel Altland. Esquire. Esquire Name 3401 North Front Street Harrisburg. P A 17110 Address (717) 232-5000 Telephone Capacity: _ Personal Representative ~ Counsel for Personal Representative :260278 _1 RfV-l500E~(l>OOl REV-1500 '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPl 2.60601 HARRISBURG, PA 1712S-OS01 = INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z UJ C UJ U UJ C lECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DORWART, PERCY N. lATE OF DEATH (MM-DD.YEAR) 04-09-2001 c. /. G.__ .. .<=2.",1.. i.....t FILE NUMBER gL-.f2L __3-e'?' COUNTY CODE yEAR NUMBER SOCIAL SECURITY NUMBER 207 07 9095 DATE OF BIRTH (MM.DD.YEAR) 08-27-1914 IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A '" , I I!J 1. Original Return ~ 0 4. Limited Estate ~ I!J 6. Oetedent Died Testate \Al\actl~yofWill) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (elate cf dealll after 12-12-82) o 7. Decedent Maintained a Living Trust (AMch copy cfTJ\Jst) o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-M) THIS RETURN MUST BE FILEO IN OUPLICA TE WITH THE REGISTER OF WILLS SOCIAL Sl:L.:UKII r NUMtll:t<. o 3. Remainder Return (dale of cleath pricr 10 12-1:)-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AtmdI Sch 0\ ... Z Uj o z o .. '" Uj 0: 0: o " THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: . NAME COMPLETE MAILING ADORESS P. Daniel Altland 3401 North Front Street FIRM NAME,,,,,,,,,,,,,,, Mette, Evans & Woodside P.O. Box 5950 TELEPHONE NUMBER (717) 232-5000 Harrisburg, PA 17110-0950 SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES z o ~ I- :::l a. :!E o U g 5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a){i .2} z o ~ :::l I- a: <( (J UJ " 1. Real Estate (5cnedule A) 2. Stocks and Bonds {Schedule B) 3 Closely Held Corporation, partnersnip or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) 5. Casn, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule r) o Separate Billing Requested (1) (2) (3) (4) (5) $13,340.00 (6) 567,308.59 6. Amount of Line 14 taxable at lineal rate 302,017 .90 298,167.02 (7) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G orL) 8 Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11 Total Deductions (total Lines 9 & 10) 12. Net Value of Estate {Une Bm\nus Line 11) (9) (10) (8) 7.088.62 9,269.36 (11) (12) (131 613,524.92 16.357.98 597,166.94 (14) 597,166.94 x..O_ (151 x.O~ (16) 25.528.89 x.12 (17) x ,15 (18) $4,478.75 (19) $30.007.64 13. Charitable and Govemmental Bequests/See 9113 trusts for which an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line i2 minus Line 13-) 7. Amount of Line 14 taxable at sibling rate 00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE AND RECHECK MATH < < ",.. $29,858.35 8_ Amount of Line 14 taxable at collateral rate 9 Tax Due Decedent's Complete Address: STREET ADDRESS 100 Mount Allen Drive CITY Mechanicsburg I STATE PA I ZIP 17055 Tax Payments and Credits: 1. Tax Due (Pagel Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 30,007.64 1,500.38 Tolal Credits ( A + B + C ) (2) 1, 500.38 3. InleresUPenal1y if applicable D. Interest E. Penally TolallnteresUPenal1y ( D + E ) (3) 4. If Line 2 is grealer than Line 1 + Line 3, enler the difference. This is lho OVERPAYMENT. Check box on Pagel Line 2Q 10 requesl a refund (4) A. Enter the interest on the tax due. (5) (5A) 28,507.26 5. If Line 1 + Line 3 ~ greaterlhan Line 2, enter the difference. This is \11< TAX DUE. B. Enter the total of Line 5 + 5A. This is Ihl BALANCE DUE. (5B) Make Check Payable Ie REGISTER OF WILLS, AGENT 28.')07.26 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 [XJ b. retain the right to designate who shall use the property transferred or its income; ....................................... .". 0 [Xl c. retain a reversionary interest; or............ .................. ..................................................... ................................. 0 [XJ d. receive the promise for life of either payments, benefits or care? ...... .................................................... 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death wi1hout receiving adequate consideration? ................ .......................h 0 Ga 3. Did decedent own an "in Irust for' or payable upcn death bank account or securily at his or her death? .............. 0 [XJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..................... ............................h................................... ... .m........................ 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, Under penalties of periury, J declare that J have examined Ihis return, including accompanying schedules and statements, and Ie the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other th the rsonal representative is based on ail information of preparer has any knowledge ADDRES 43130 SIGNATURE OF;R\lEP / ADDRESS o DATE ( r' -(:./ P.O. Box 5950. Harrisburg, PA 17110-0950 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to ( r for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)l. 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 SL viving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and mlng a tax return are stm applicable ENen if the surviving spouse is the only beneficiary. For dates of death on or after July 1.. 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)J. The tax rate impcsed on the net value of transfers to or for the use of Ihe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1 )1. The tax rate imposed on !he nel value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. """''''','',0\1,,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER PERCY N. DORWART All real property owned solely or as a tenant in common must be reported at fair market valut. Fair market value is defined as the price at which property would be exct\ange<l between a willing buyer and a willing seller, neither being compelled 10 buy or sell, both having reasonable knowledge of the televant facts. Real property which is jointly-owned with rIght of 5uNivorshln mus~ be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH $13,340.00 Lot No. 2 Park Drive, Newberry Township, York County; Plan Book "FF", Page 463, value determined by assessed value which is 100% of market value .._.~._ TOTAL (Also enteron line 1, Recapitulation). $ 13.340.00 (If more space is needed, insert additional sheets of the same size) eB<"W8<'''''''I''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER PERCY N. DORWART All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. VALUE AT DATE OF DEATH 2. 3. 4. 5. 6. 7. Mortgage from Thomas Dorwart and Barbara Dorwart dated April 2, 1993 in face amount of $25,000.00 payable in 120 monthly payments of $316.69 including interest at 9% per annum, maturity October 15, 2003, covering Lot Block 7 Green Acres Addition Number Six, Unit Three, Citrus County, Florida, Book 1007, Page 346 20, $5,588.57 $10,184.70 $27,426.63 $15,157.02 $87,418.02 $62,036.60 $94,206.36 Unpaid BalancE Installment Agreement of Sale by David Lewis.Lehman dated July 20, 1994 in the face amount of $23,900.00 payable $305.00 monthly including interest at 9% per annum, maturity June 20, 2004 covering 355 Cragmoor Road, York Haven, Pennsylvania Unpaid Balance Mortgage from Alvin L. Fisher and Joan P. Fisher dated October 29, 1992 in face amount of $50,000.00 payable $524.00 monthly including interest at 9% per annum, maturity October 29, 2006 covering 111.5 acres in Clymer and Chatham Townships, Tioga County, Pennsylvania recorded in Book 576, Page 832 Unpaid Balance Installment Agreement of Sale by John E. Neff and Grace Bonnie Neff dated October 2, 1984 in the face amount of $43,000.00 payable $405.32 monthly including interest at 10% per annum, maturity December 20, 2004 covering 117 Walton Street, Lernoyne, Pennsylvania Unpaid Balance Installment Agreement of Sale by JoAnn Nguyen and Trung Q. Nguyen dated October 2, 1996 in the face amount of $95,000.00 payable $795.00 monthly including interest at 8% per annum, maturity October 2, 2016 covering 80 Park Drive, Newberry Township, York County, Pennsylvania Unpaid Balance Installment Agreement of Sale by Marion A. Stone and Michael Stone dated September 11, 1996 in the face amount of $71,000.00 payable $500.00 monthly, with interest at 6% per annum, maturity May 1, 2017, covering 4.5 acres in Warrington Township, York County, Pennsylvania Unpaid Balance Mortgage from Bonnie L. Holtry dated April 3, 2000, in the face amount of $95,000.00 payable $697.08 monthly including interest at 8% per annum, maturity April 3, 2005, covering Lot 3 of Plan Book "FF", Page 463, known as 2195 York Road, Dover, York County, Pennsylvania, Book 1395, Page 1661 Unpaid Balance TOTAL (Also enler on line 4, Recapitulation)_ $ 302,017.90 (If more space IS needed, Insert additional sheets of the same slle) """"'''''''''''<l. CQYMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER PERCY N. DORWART lnclude the proceeds of litig" tion and the date the proceeds were received by the estate All property jointly-owned with the right of sUlvlvorship must be disclosed on Schedule F. 2. 3. DESCRIPTION Allfirst Bank Checking Account No. 0019512856 Allfirst Bank Money Fund Alternative Account No. 0098185675 Allfirst Bank Certificate of Deposit Account No. 80000002294234 VALUE AT DATE OF DEATH $6,353.33 45,483.66 ITEM NUMBER 1. 11,247.03 5. 6. Ameritas Investment Corp. AIM Funds; 5026058247 Evergreen Funds; 821-5358411322 Alger; 770730497 89,480.00 125,040.00 20,563.00 4. TOTAL (Also enter on line 5, RecaPltulation)..J $ 298. 167 . 02 (If more space is needed, insert additional sheets of the same size) """""'"""". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER PERCY N. DORWART Debts of decedent must be reported 01 Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: L Cremation Society of PA $155.00 2. Messiah Village for videocassette of memorial service and food for after memorial service 119.92 3. Larry Snyder, flowers for memorial service 144. 16 4. William Spahr, reimbursement for minister, organist and clothing 205.04 B ADMINISTRATIVE COSTS: 1. Personal Representative 5 Commissions Name of Personal Representative (5) Social Security Numoer(s} I EIN Number 01 Personal Reptesentative{s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees to Mette, Evans & Woodside 6,000.00 3. Family E empriOl1: (If decedent 5 address is not the same as claimant s, attach explanation) Claimant Stree\Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 449.50 5. Accountant s Fees 6. Tax Return Preparers Fees 7. Filing fee for Inheritance Tax Return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 7,088.62 (If more space is needed, insert additional sheets of the same size) ""'''"'''1''''''. COMMONWEA.LTH OF PENNSYlVI\NlA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF PERCY N. DORWART FILE NUMBER Include unreimbursed me, tal expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. DESCRIPTION AMOUNT $3,398.00 30.00 615.00 3.25 47.06 3,967.05 1,209.00 PA Department of Revenue, 2000 Income Tax Dr. Dalbey, balance of account for medical care Spangler Associates, preparation of 2000 tax returns Quantum Imaging, balance of bill not paid by insurance Debra Popp, Tax Collector Messiah Village, room and board through March 30, 2001 Messiah Village, room and board final bill TOTAL (Also enteron line 10, Recapitulation) $ 9,269.36 ..J {If more space IS needed, Illsert addltlonal sheets of the same sIZe) REV-1513 EX+ (9-0 '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT :sa ...I:'J BENEFICIARIES ESTATE OF FILE NUMBER PERCY N. DORWART NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (aj (1.2)] 1. Robert J. Dorwart Box 990, 2280 Hamburg Road Lancaster, OH 43130 2. Carole D. Spahr 763 Glen Arden Drive Lewisberry, PA 11339 3. Elaine L. Garman 7490 Allentown Boulevard Harrisburg, FA 17112 4. James P. Dorwart 1375 Old Quaker Road Etters, PA 17319 5. Kathleen D. Snyder 1401 Princet.on Road Mechanicsburg, FA 17050 6. Alan R. Dorwart 204 South Second Street Wormleysburgr PA 17043 7. John P. Voris 541 Lexington Avenue Mechanicsburg, FA 17055 RElATIONSHIP TO DECEDENT Do Not UstTrustee(s) NUMBER I AMOUNT OR SHARE OF ESTATE 1/6 of 95% 1/6 of 95% 1/6 of 95% 1/6 of 95% 1/6 of 95% 1/6 of 95% 5% of 100% ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-15110 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. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If mOfe space is needed. insert additional sheets af the same siz.e) LAST WILL AND TESTAMENT OF PERCY N. DORWART I, PERCY N. DORWART, of Fairview Township, York County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last will and Testament, hereby revoking and making void any and all wills by me heretofore made. FIRST: I order and direct that all of my just debts and funeral expenses be paid by my hereinafter named Executrix as soon after my death as may be found convenient. SECOND: All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death I give, devise and bequeath to my wife, CATHERINE E. DORWART, providing she shall survive me for a period of thirty (30) days. THIRD: In the event that my said wife, CATHERINE E. DORWART, should predecease me, or in the event that she does not survive me for a period of thirty (30) days, then I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death as follows: A. Ninety-five (95) percent of the residue of my estate shall be given to my six children, ROBERT J. DORWART, CAROLE DORWART SPAHR, KATHLEEN DORWART SNYDER, ALAN R. DORWART, ELAINE DORWART GARMAN, AND JAMES P. DORWART, in equal shares, per stirpes. B. Five (5) percent of the residue of my estate shall be given to JOHN P. VORIS of 309 Pinewood Drive, Shiremanstown, Cumberland County, pennsylvania, 17011. FOURTH: I hereby nominate, constitute and appoint my said wife, CATHERINE E. DORWART, as Executrix of this, my Last will and Testament, and I do direct that no bond shall be required of such Executrix hereunder. My said Executrix shall have full power at her discretion to do any and all things necessary for the complete administration of my estate, including the power to sell at public or private sale and without order of Court, any real or personal property belonging to my estate, and to compound, compromise or otherwise to settle or adjust any and all claims, charges, debts and demands, whatsoever, against or in favor of my estate, as fully as I could do if living. In the event that my wife, CATHERINE E. DORWART, does not survive me or fails to qualify, then I nominate, constitute and appoint my son, ROBERT J. DORWART, as the alternate Executor. Said alternate Executor shall have all of the powers, privileges, duties and immunities as hereinbefore more fully set forth for my original Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal to .p; f'J J this my Last will and Testament, this) 7 -day of J1fP""l:.f~, 1996. C>~ 11- p~ (SEAL) Percy N. rwart signed, sealed, published and declared by the above named Testator as and for his Last will and Testament, in the presence of us, who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses. ~ FIRST CODICIL TO THE LAST WILL AND TESTAMENT PERCY N. DORWART I, PERCY N. DORWART, of Fairview Township, York County, Pennsylvania, being of sound mind and memory, do make, publish and declare this to be the First Codicil to my Last will and Testament dated the 27th day of September, 1996. FIRST: I hereby add a paragraph to my Last will and Testament dated the 27th day of September, 1996, which paragraph shall be numbered FIFTH and shall read as follows: FIFTH: I direct that my remains be cremated. SECOND: In every other respect I hereby confirm and republish my Last Will and Testament dated the 27th day of September, 1996. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this Codicil to my Last Will and Testament dated the 27th day of September, 1996, this !<(!!! day of rVD'fth1Btf, 1996. G?1118",~ Percy . Dorwart (SEAL) Signed, sealed, published and declared by the above named Testator as and for the first Codicil to his Last will and Testament dated the 27th day of september, 1996, in the presence of us, who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses. C);~ D- I / . ~~:t rr)L'- ~~_C --- ~ -}:; .[d I : ~/l~. . . " ~ ~ ~ rJJz ~ ~ o ~ 0 s~~~ ~ O~~ID~l:"" o ~~'"'" ~~~~\O< oa 8 (I) ~ ~ ~.. W:2~~~~ Z~Z.~o? .~ 'Cii ~ tz. ,..:. ~ t-:.(f)o..""....,,-.(I) r:."'\ ~ ~ 0 ~. ~ ~~z ~. ~~.~~ ~ ~~ ~ ~ :T C3 t'- o r.n ~ ~ TO~ U'1 ~6 ~~ ~ ~ t5. ~5~~ %%;~ Q Qo';::!.l~ %%\~ ~~g~ \\~~ ~; \~ - ~- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG. PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 496716 REV.1162 EX (11-96) RECEIVED FROM: I" ACN ASSESSMENT CONTROL NUMBER AMOUNT P DANIEL ATLAND ESQUIRE 340l NonTH rRON1 5TR[[7 r 0 DD \' 59'::',(1 101 $28.507.26 ~ j~~RR I ~;BUPG. r'?) l' l 1 ()., 09:::'0 --- FOLD HERE FOLD HERE - ESTATE INFORMATION: I FILE NUMBER 2.l -'~2t=j() 1 ~-()3fJtJ SEJN ,::"'07-- 07---9095 NAME OF DECEDENT (LAST) DUt:.~t..Jj.4F:' T PC RC Y f\j (FIRST) (MI) DATE OF PAYMENT 6 I .. J ./ ;:' oJ 0 1 I (,., I , .. "l (~l 1 (2 / L~' i)() 1 y~ ..."'....!if .... POSTMARK DATE COUNTY :~: LJ r-~! E~ E~ R L _ ~~!\J [) .. TOTAL AMOUNT PAID . s ~~? ~:J ,~.~~: -.~. ~:;~~ 6 r.,'t ':1 F< \1 DATE OF DEATH it /'./:?.' 20C' j REMARKS ~,C t.~ L" f-=- /fJ ~:-I I)~~f\J I EL~ {\ 'rL-.f:;~"..;L) ESll~.j I F~~t::' C! -iE Cr. # (lor?,? SEAL RECEIVED BY REGISTER OF WILLS ~ METTE, EVANS & WOODSIDE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW HOWELL C. METTE ROBERT MOORE CHARLES B. ZWALLY PETER J. RESSLER LLOYD R. PERSUN CRAIG A. STONE JAMES A. ULSH DANIEL L. SULLIVAN STEVEN D. SNYDER CHRISTOPHER C. CONNER JEFFREY A. ERNICO KATHRYN L. SIMPSON P. DANIEL ALTLAND ANDREW H. DOWLING MICHAEL D. REED PAULAJ. LEICHT GARY J. HElM DAVID A. FITZSIMONS GUY P. BENEVENTANO THOMAS F. SMIDA 3401 NORTH FRONT STREET P.O. BOX 5950 HARRISBURG. PA 17110-0950 TELEPHONE (717) 232-5000 FAX (717) 236-1816 JOHN F. Y ANINEK* VICKY ANN TRIMMER TIMOTHY A. HOY KATHLEEN DOYLE Y ANINEK JAMES M. STRONG BRY AN S. MEGARY* JENNIFER A. Y ANKANICH RANDALL G. HURST* SUSAN D. ANDERSON OF COUNSEL JAMES W. EVANS IRS NO. 23-1985005 *MARYLAND BAR http://www.mette.com June 12, 2001 Via Certified Mail Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 1 70 13 Re: Estate of Percy N. Dorwart SSN: 207-07-9095 10972-1 Dear Sir/Madam: Enclosed for filing are duplicates of the Inheritance Tax Return, and a check in the amount of $28,507.26 in payment of the tax due. We have also enclosed a check in the amount of $15.00 for your filing fee for the Inheritance Tax Return. Please contact the undersigned with any questions. Very truly yours, METTE, EVANS & WOODSIDE /' ' /\ /1 C;; h.J~ LkL~ k/ '-...... -._~ P. Daniel Altland PDA:ml Enclosures cc: Robert J. Dorwart, Executor :263068 1 / [:'d J/h-- (I 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 P DANIEL ALTLAND METTE ETAL PO BOX 5950 HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-30-2001 DORWART 04-09-2001 21 01-0388 CUMBERLAND 101 I ~~* REV-1547 EX AFP (12-00) PERCY N Amount Remitted PA 17110 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 ~ ifE"v=is4j-iY-AFP--ri"2-:oo1--N(ffiCE-oF-.rNHiifiTANCE-YAirAPPRAisiifENT~--Aii-oWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DORWART PERCY N FILE NO. 21 01-0388 ACN 101 DATE 07-30-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (IS) 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 = .00 567,308.59 X 045 = 25,528.89 .00 X 12 = .00 29,858.35 X 15 = 4,478.75 (19)= 30,007.64 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) S. 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) (S) (6) (7) 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) 13.340.00 .00 .00 302.017.90 298.167.02 .00 .00 (8) 7,088.62 9.269.36 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 613,524.92 16.31)7 98 597,166.94 .00 597,166.94 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-12-2001 AA496716 1,500.38 28,507.26 TOTAL TAX CREDIT 30,007.64 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.) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. fL / V~~/ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Percy N. Dorwart Date of Death: April 9. 2001 Will No. Admin. No. 2001-00388 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. Date: ~~ l,{ .i"1 ,5, 2- 002..- r>f . C;. (: .) 01.,-,;/' att'~;':... / Signature P. Daniel Altland Name (Please type or print) 3401 North Front Street Harris burf!. P A 17110 Address 717 -232-5000 Telephone Capacity: _ Personal Representative ~ Counsel for Personal Representative :299860 _1