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Home My WebLink About01-0499 Estate of Ruth R. Freecn:al1 also known as PETITION FOR PROBATE and GRANT OF LETTERS ~J-O 1- L/9CJ No. To: Register of Wills for the . Deceased. County of CUmberland in the Social Security No. 204-01-1903 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rixes in the last will of the above decedent, dated Septanber 29 and codicil(s) dated named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h pr last family or principal residence at 4810 East Trindle Road S.Yl1pJ !l1:^-1 ( l~echanicsburg, PA 17055 - (list street, number and muncipality) Decendent, then 85 years of age, died Hay 7, 2001 , ~OOOQ{, at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 4810 East Tril-idle Road, Mechanicsburq, $ 220,000 $ $ $ 150,000 PA 17055 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testarnentary (testamentary; administration c.La.; administration d.b.n.c.La.) - '" Q:) u s:: CI,) :"9~ '" '-' CI,) .... Cl::CI,) s:: -00 Q.= ~..:: 3~ CI,)<+- 50 ~ s:: bl) Ci'5 Chery . La"1tz lS90 LanIDS I Gap Road Y~d;;; ~~=\'~ :Robin F. Cole 1370 S\vope Drive Boiling Springs. FA 17007 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l ss COUNTY OF ClJI-1BERLZ\ND J The petitioner(s) above-named swear(s) or affirm(s) that the stat ments in the foregoing petition are true and correct to the best of the knowledge and belief of peti'o r(s) and t a rsonal represen- tative(s) of the above decedent petitioner(s) will well and trulYi min' ter the estate a cording to law. ~ ~. ~ ~ - ~ ~ ~ It:, -~3~-3 ~o. 21-2001- 499 Estate of Ruth H.. Freedman , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW i,lay 22;, 2001 ~ ,in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Septe"TIber 29, 1998 described therein be admitted to probate and filed of record as the last will of RuLli R. Freec1r.nan and Letters Testar.lentary are hereby granted to Chel:y1 F. Lentz and Robin F. Cole FEES Probate, Letters, Etc. ......... $ 30_5. 00 Short Certificates~) . . . . . . . . .. $ 18 . O~ ReRHReiAl;OiI . r;r/~. f.d,~:'O. . . .. $ 9. 00 JCP $ 5.00 TOTAL _ $ 337.00 Filed . May . 22nd, . 2001. .. . .. . . . .. . . .. . . ATTORNEY (Sup. Ct. I.D. No.) 212 N. 3rd St., P.o. Box 11993 ADDRESS Harrisburg, FA 17108-1998 PHONE (717) 233-7691 MAILED LETTERS 'TO ATI'ORNEY l h ,', IS to certify that the information here given is correctly copied frum an original certificate of death duly tiled with me as Lh":! Registrar.' The original certificate will be forwarded to the State \' Ital Records Office for permanent tIling. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. /.;liit~1\roF'pI7~~ .{,\\~ \.'" -----~----~f,f ::-~ i' ~/'/ '\~ \. ,~~( "'~\~~ (~ ~ / ','-, ',,' , \~ ~ I~~; - :"1. :~~ ~ c.,..)'", .'j -6. ('! ~ \\*~.'.)*f \~\,' /~l ,":.~"" ,/~" -:..--f/;I;;-----i't-.~ l -~"!" EN1 \\,~",#' ~ ~L~e~r Fee for this certitlcate. $2.00 P 7298166 MAY 1 0 ZOO1 Date ITEM 1# 8 b ., SHOULD READ AS FOLtO\'i~ {tJ/Yltd C"1l i IT;tJD 21-2001-499 44 Rev 1/91 ~ ,/?( ~:Z::F PENNSVLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) N Freedman SEX 2. Female SWE FILE NUMBER SOCIAL SECURITY NUMBER Bent Creek D.la'E OF DEATH (Monlh, OlIy, Year) 4. May 7 J 2001 $.204-01-1903 UNDER 1 OJ<< DATE OF BIRTH BIRTHPLACE (Clly and PlACE OF DEATH (Check only one see inSlructions on other SIde) Hours Minutes (Monlh, Day, Year) Slate or Foreign Country) HOSPITAL: Apr. 27 J 1916 est Fairview, P Inp.llent 0 EAlOUtpatlenl 0 DOA 0 ~ ~ k FACILITY NAME (If not inslrtulion, give street and number) ~~fY) KJ Ie. RACE. American Indian, Black, WMa, ate (SWWite 10. DECEDENT'S USUAL OCCUPATION (:--~~:O~u~r:::l!r:ff . 11a~lerk :val Supply Depot DECEDENT'S MAILING ADDRESS (Street, CilylTown, Stale, Zip Code) DECEDENT'S ACTUAL RESIDENCE (See instructlOlls on other SJda) College 2 (1'" or 5+) MARITAL STATUS. Merried Newr Marriad, Widowed, DIvorced (Speclly) W.idaYed SURVMNG SPOUSE (II wile, give maiden name) LICENSE NUMBER zKP 013163 L Did decedent "'Ie loa CUmberland township? 17d.0 ~~;.~=7:~:or ~N~~SI'~f1hde" Sur nama) 1 . INFORMANT'l!. MAlLltlGtDORESS (Street. ColylTClV{n. SIal" Zip C<>9a) .890 .LamO s Gap Rd. ,LYleCl1aIllcsburg, ,PA17050 PlACE OF DISPOSITION - Name 01 Cemetery. Crematory LOCATION. CityfTown, State, Zip Code or Other Place ./ Rolling Green Cemetery Lower Allen Twp., PA 17011 . 21e. 21d. NAME AND ADORESS OF FACILITY fU...:LlO.1.l ~ fua:allbrallc C:en. Stv .324 H.Imel. AveoD:!u.:~r~- LICENSE NUMBER ORE SIGNED (Month, Day, Year) 17C)'L Yas. decedenllived in 1 Silver Spring twp 2100 Bent Creek Blvd. 1..Mechanicsburg,PA 17050 FATHER'S NAME (fvSl, MoCldIe. Ljames Foster Roddy 1.. INFOAMANT'SNAME(Ty!>8iPlln'theryl F. Lentz 17.. State 17b. Count cily/boro, 238. 9=:: ;=.=::~ by TIME OF DEATH Aprx. DATE PRONOUNCED DEAD (Month, Day, YBar) -.~ 24. 8:00 P. M 25. May 7. 2001 - 27. PART I: Enter the diIaaMs, injuries or complications which caused the death. Do not enter the mode of dying. such as cardiac or respir.tory arrest, shock or heart lallure. ~~ LiIl only one causa on each line -...TE CAUSE (Fonal dioease Of condition = raoulling'" death)_ ~ ~ Sequentially liaI condtloons ,:1111 any, leading to Immediate .__, Enter UNOEALYING ,,_ CAUSE (Oioaase Of injUry .--1heI initialed events .'areeulting in dealh) LAST H ertensive Cardiovascular Disease DUE TO (OR AS A CONSE<jlUENCE OF): 23b. 2$0. WAS CASE REFERRED TO MED,SAL EXAMINEAICORONER? Yes IJIl. 26. I Approximate : interval between : onsel and death i NoD PART II: Other significant conditions <:onIrlbutlng to death, but not resul1ing In the underlying cause given In PART I. Aortic Stenosis Atrial Fib DUE TO (OR AS A CONSEQUENCE OF): DUE TO (OR AS A CONSEQUENCE OF): :.- MS AN AUTOPSY ._ PERFORMED? ~ ..- ~~ d WERE AUTOPSY FINDINGS A\AILA8lE PRIOR TO COMPLETION OF CAUSE OF DEATH? MANNER OF DEATH DATE OF INJURY (Month. Day, Veal) TIME OF INJURY INJURY I\r WORK? DESCRIBE HOW INJURY OCCURRED. Natural ~ [J [] Homicide o o o Ye.O NoD -...0 No~ Yes 0 No 0 Accident Pending Il\Y8SIigatlOn Coroner ... 21b. C8ITlI'IER (Checl< only or'8) .CERTIFYING PHYSICIAN (Physician certifyong cause 01 death when anolll..r physIC..n has pfOnounced dealh and completed lIem 23) To'" bea1 of my knowledge. claathOCCunH _tothe cauH(.,and mannar aaatatecl. . ........ ., ........ .. . ...... . .. . ... ...', SuIcide 21. Could not be determined -=- ~ . PRONOUNCING AND ~TlfYlHG PHYIIClAN (PhYIIICian bolh pronouncing death and <*1iIying 10 cause 01 death) - To ItII bIet 01 my knowIeclge, ctMlIl occumd .11he lime, da... and place, and due to ItII C8uae(elend _ aa ."Ied.. . . . . . . . , . . . . . . , . . . . . . . . . ~ ~ 'MEDlCAL EXAIoUNERlCORONEA ~ On the baalaof examination and/or Inveatlgatlon, In my opinion, dealh occurrlld at the tlma, d.... end place, and due 10 the cauae(a) and __.....tlld........ ............... ..... .........,..... .... ................ ......... ........... ........ ....... -=31e. REGISTRAR'S SIGNATURE AND NUMBER 33. I~/I~I/I/I ~ 32. DATE FILED (Mon Day. ~/() ~/ 34. . . ... 11I()tst lIill Ctnb ([Le~tnm~nt OF RUTH R. FREEDMAN I, RUTH R. FREEDMAN, of 4810 East Trindle Road, Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament hereby revoking all prior Wills and Codicils. ITEM I. I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM II. I glve, devise and bequeath my engagement and wedding rings to my daughter, CHERYL F. LENTZ. ITEM III. I give, devise and bequeath two white gold diamond rings to my daughter, ROBIN F. COLE; one with 12 small diamonds, the other wi th a diamond in the center surrounded by smaller diamonds. ITEM IV. It is my specific desire to treat my children as fairly as possible. Therefore, I direct my children should equally divide a~y remaining rings and other miscellaneous jewelry, which their father had given me, knowing that he would be very pleased by their acts. ITEM V. I give, devise and bequeath the sum of Two Thousand Five Hundred Dollars ($2,500.00) to the following: a. My grandson, FRANK E. LENT Z , IV; b. My grandson, JOSHUA F. LENTZ; c. My granddaughter, ASHLEY T. LENTZ; and d. My grandson, BRADLEY H. LENTZ. I. .' ITEM VI. I give, devise and bequeath the rest, residue and remainder of my estate, of every nature and wherever situate, in the following manner: a. one-half to my daughter, CHERYL F. LENTZ, or her issue per stirpes; and b. one-half to my daughter, ROBIN F. COLE, or her issue per stirpes. ITEM VII. I nominate and appoint my daughters, CHERYL F. LENTZ and ROBIN F. COLE, as Co-Executor's of this my Last Will. ITEM VIII. I direct that my Executrix shall not be required to give bond for the faithful performance of her duties in any jurisdiction. ITEM IX. I direct that all taxes due at my death or as a consequence of my death shall be paid from my residuary estate. IN WITNESS WHE.RE..~., OF.. J. I . have h~reunto set my hand and seal this :,<,,911 day Of'./;Z:::~ ' 1998. the /// // ()~ fee /It It;: (~~C#/JA../ RUTH R. FREEDMAN / , 00"" , 'i. J . .(', . , ,,~ II I f\( vt ',_.~ WITNESS " ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN J'---' We flt}\ +; ~\.. ( i ( 1: (t, \ \"(\,,,'\ r -'___> ,1 ...,\' \ l/ ' '{ ;-"-."'" .../ , the testatrix and witnesses, respectively, whose names are signed to the forgoing instrument, being first duly sworn, do hereby declare that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of the witnesses' knowledge, the testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. . EEDMA f I ',' i' \ (, - J ,,~--", ",I \ ",' ' , ,~ \' ) 1 )I ufrft. '1< 'Irs (U~J~. " Ir"'!""/1 /' J !, f 'r~~" I)', -t-- /'1 ( I,t'f-"t)(j 11\ ( i(),f'-, ',,(I (:/Ji lJ,/Lf.,L/" 1-11 y (/ \ ;1-) I) jI.// '/ ! j, i / J J " ! J~.' - /1" ,( '" I' I 'l---"" WITNESS / /nJetrt/JL J ~ /-6-01 7-< tV) I) Q. NlS t- ~ $ h ~~s. i va I;) t} /1IQ- WITN ' , 6000 Linglestown Road P.O. Box 6656 Harrisburg, PA 17112 ~/,//f .? ' ,/../' .. .' ~ / ~ lry! ?- 1. '-Ie> " ATTORNEY .. .. . On this, the f\ " ~1 d ,~ r:\j: t ' day of () f \,' ) ]/ / ,,~.~ \ I 'v, ,I' I fl' /) \UAJ{ , 1998 before a Notary Public, the undersigned officer, personally appeared, Marion E. MacIntyre, Esquire, known to me or satisfactorily proven to be a member of the Bar of the Supreme Court of Pennsylvania, and certified that she was personally present when the foregoing acknowledgement and affidavi t were signed by the testatrix and witnesses. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. ,1.(: j ()~ .J/\ ^ jj!-t..AI~ i i NOTARY !_ ) · )AL ;' ... -:: . \~;/ '-. PUBLIC NOTARIAL SEAL , KRISTlE L. SHIRK Cltv of HarriSburg' ~~~ry PUblic ==~,t~~pmISS!On E)(~' Q Phm County ---,.--., ~,,' Ir_~.!v.'_~V}?L~~~2.._, CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Ruth R. Freednan Date of Death: IJ1ay 7, 2001 Will No. Admin. No. 2001...00499 To the Register: I certify that notice of (beneficial interest) 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 I'Jay 25, 2001 : Name Address See attached sheet. Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: Nay 25, 2001 ~~ --- Signature Name Thcrnas S. Beckley, Esquire Address 212 N. 3rd St., P.o. Box 11998 Harrisburg, PA 17108-1998 Telephone ( ) (717) 233-7691 Capacity: _ Personal Representative ~Counsel for personal representative Certification of Notice Under Rule 5.6 (a) -- Attachrrent Oleryl F. Lentz 1890 Lambs' Gap Road Mechanicsburg, PA 17055 Frank E. Ientz, IV 1890 Lambs' Gap Road H.echanicsburg, PA 17055 Joshua F. Lentz 1890 Lambs' Gap Road Mechanicsburg, PA 17055 Ashley T. Lentz 1890 Lambs' Gap Road Nechanicsburg, PA 17055 Bradley H. Lentz 1890 Lambs' Gap Road lvJ.echanicsburg, PA 17055 Robin F. Cole 1370 SWope Drive Boiling Springs, PA 17007 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Freedman, Ruth R. No. 21 - 01 - 00499 Date of Death 517/2001 also known as , Deceased Social Security No. 204-01-1903 Cheryl Lentz ~--- ------- ---_._---~._. _._--- The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Thomas S.13eckley Personal Represen. talive ~ / -h / Signature: ~ ~ ,) Cheryl Lentz I.D. No.: 77040 Signature: 212 North Third Street Post Office Box 11998 Harrisburg, PAl 71 08 Telephone: ((717)) 233-7691 Address: Address: 1890 Lamb's Gap Road Mechanicsburg, PA 17055 Telephone: (717) 732-5545 -. --- - Dated: Personal Property: Motorola Corp. Stock 196.80 Pepsico Stock 224.70 Total Return Trust (TRFCX) 1,130.88 13,284.00 4,157.41 Waypoint Stock Vanguard Wellesley Income Fund Certificate of Deposit (First Union #247412056316702) Including Accrued Interest of $25.93 2,115.21 Certificate of Deposit (First Union #247412056316701) I(nduding Accrued Interest of $25.93) 2,115.21 First Union Savings Accunt (#1010041727221) qU1l1:J !,":l'r) . ''''.- 281.13 First Union Checking Account (#8474) LF.: Z d 9- 833 lO. 6,491.70 300.00 Federal Tax Refund Waypoint Stock Dividend ~.}U 102.00 Nationwide Automobile Insurance Refund '""'-_)'8~j 24.50 (Attach additional sheets if necessary) Total $281,237.35 "\ Members First Savings Account (#152381-00) (Including Accrued Interest of $.29) Members First Certificate of Deposit (#152381-59) (Including Accrued Interest of$1.82) Members First Certificate of Deposit (#152381-71) (Including Accrued Interest of $7.88) Members First Certificate of Deposit (#152381-72) (Including Accrued Interest of $1.37) Members First Certificate of Deposit (#152381-77) (Including Accrued Interest of $11.81) Members First Certificate of Deposit (#152381-75) (Including Accrued Interest of $8.15) Members First Certificate of Deposit (#152381-76) (Including Accrued Interest of $8.15) Members First Certificate of Deposit (#152381-79) (Including Accrued Interest of$11.58) Members First Certificate of Deposit (#152381-80) (Including Accrued Interest of $14.66) Members First Certificate of Deposit (# 1523 81-82) (Including Accrued Interest of $1 0.92) Members First Certificate of Deposit (#152381-84) (Including Accrued Interest of$17.53) Members First Certificate of Deposit (# 152381-85) (Including Accrued Interest of$17.56) Waypoint Bank Certificate of Deposit (#1800013065) (Including Accrued Interest of$53.14) Refund - Merck-Medco Rx Services Refund - County Taxes Refund - School Taxes Refund - Sewerffrash Miscellaneous personalty (see attached) subtotal, Personal Property: Real Estate: 4810 East Trindle Road Mechanicsburg, P A 17055 subtotal, Real Estate: 620.4 7 1,853.14 7,532.21 1,348.86 11,311.31 7,916.46 7,913.77 11,598.97 14,145.34 10,601.68 15,516.25 15,542.12 2,736.92 8.00 245.32 459.23 14.76 1,449.00 $141,237.35 140,000.00 $140,000.00 , ESTATE OF RUTH FREEDMAN LOCATION rrEM DISPOSITION VALUE Kitchen Table and two chairs Auction $25.00 Dishes Audion $25.00 Toaster Auction $5.00 Pots/pans Auction $20.00 Utensils Auction $10.00 Microwave oven Family $20.00 Stove. Refrigerator, Dish washer Sold with house Inc'l in sale Uving room Sofa Family $25.00 2 Wino backed chairs Family $50.00 Coffee table Family $25.00 Television Family $25.00 Recliner chair Family $25.00 End tables and lamps Family $25.00 Bedroom 1 Single bed with frame Family $25.00 2 Dressers Family $50.00 Night stand with lamp Family $10.00 Clock radio Auction $10.00 Sittingfoom Hutch Family $25.00 Rocking chair Family $10.00 Dry sink Family $50.00 Lamps Auction $25.00 End tables and lamps Family $25.00 Bedroom 2 Single bed with frame Family $25.00 2 Dressers Auction $100.00 Lamps Auction $2.00 Television Family $2.00 Basement Washer and dryer Sold with house Inc'l in sale 2 Chairs Auction $10.00 Dining foom Table and chairs Sold with house Inc'l in sale Cabinet Sold with house Inc'l in sate Personal Clothing Given to Salvation Army $0.00 Weddino rings Family $500.00 Costume jewlery Auction $100.00 Various wall hanaings (pictures) Auction $100.00 2 telePhones Given to Salvation Army $0.00 Books Given to Salvation Army $0.00 Family photographs Family $0.00 VCR (broken) Trash $0.00 Small stero Given to Salvalion Army $0.00 Video tapes Given 10 Salvalion Army $0.00 Audio tapes Given to Salvation Army $0.00 Sheets and towels Given to Salvation Army $0.00 Gold bangle bracelet Family $100.00 TOTAL $1,449.00 '\. /6-D2~ ~>-0 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 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN THOMAS S BECKLEY ESQ BECKLEY & MADDEN PO BOX 11998 HBG 1 \) 3 P A {l;i! il 08 05-13-2002 FREEDMAN 05-07-2001 21 01-0499 CUMBERLAND 101 * REV-1547 EX AFP (01-02> RUTH R Amount Remitted 140,000.00 18,993.79 .00 .00 122,243.56 31,969.08 6,266.46 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 (1) (2) (3) (4) (5) (6) (7) (9) (10) 40,088.81 1.742.51 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. (8) 319,472.89 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: is4"j-iX--AFP--(cff=02j--Ncffici--OF-'rNHiifiTANCi-y-A"X-APPRA-isiifENY-,--Aii-oWANci-ifri----------- - - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FREEDMAN RUTH R FILE NO. 21 01-0499 ACN 101 DATE 05-13-2002 TAX RETURN WAS: (')() ACCEPTED AS FILED CHANGED SEE ATTACHED NOTICE 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 41.831 32 277,641.57 .00 277,641.57 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: 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 = .00 277,641.57 X 045 = 12,493.87 .00 X 12 = .00 .00 X 15 = .00 (19)= 12,493.87 . ". ....'" . n.........' , l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08 01 2001 CDOOOII0 624.69 17,000.00 TOTAL TAX CREDIT 17,624.69 BALANCE OF TAX DUE 5,130.82CR INTEREST AND PEN. .00 TOTAL DUE 5,130.82CR . 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.) 'v /:; - ~-23J -.3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-1607 EX AFP (01-02> ,,()2 -1 THOMAS S BECKLEY ESQ BECKLEY & MADDEN PO BOX 11998 HBG PA 11\1;08 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-03-2002 FREEDMAN 05-07-2001 21 01-0499 CUMBERLAND 101 RUTH R Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 NOTE: To insure proper credit to your account1 submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV: i 6rfj-Ex--AFP--((ff:021-------...-iNif€iiiYANcE--;:Ax-Sy"irfEME-ti;:-OF-AC-Couiff--.-i.---------------- - - - -- ESTATE OF FREEDMAN RUTH R FILE NO.21 01-0499 ACN 101 DATE 06-03-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYMENTS 1 THE CURRENT BALANCE1 AND1 IF APPLICABLE1 A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-13-2002 P R I N C I PAL TAX DU E : ........................................................................................................................................................................................................................... 121493.87 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-01-2001 CDOOOII0 624.69 171000.00 05-17-2002 REFUND .00 51130.82- TOTAL TAX CREDIT 121493.87 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE1 SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "'CREDIT"' (CRJ1 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS S BECKLEY ESQUIRE POBOX 11998 HARRISBURG, PA 17108 -------- fold ESTATE INFORMATION: SSN: 204-01-1 903 FILE NUMBER: 21-2001- 0499 DECEDENT NAME: FREEDMAN RUTH R DA TE OF PAYMENT: 08/02/2001 POSTMARK DATE: 08/01/2001 COUNTY: CUMBERLAND DATE OF DEATH: 05/07/2001 NO. CD 000110 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $17,000.00 I I I I I I I I TOTAL AMOUNT PAID: $17,000.00 REMARKS: CHERL Y F LENTZ C/O THOMAS S BECKLEY ESQUIRE CHECK#1013 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS , ~ v o o~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ruth R. Freedman Date of Death: Nay 7, 2001 Will No.: 2001-00499 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 [ill No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Dale: 4/16/03 -s ~ ~ ~ Signature Thanas S. Beckley, Esquire Name Beckley & Hadden 212 N. 3rd St., P.O. Box 11998 Harrisburg, PA 17108-1998 Address (717) 233-7691 Telephone No. Capacity: 0 Personal Representative I19 Counsel for personal representative , .. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/09/2003 CHERYL F LENTZ 1890 LAMBS'GAP ROAD MECHANICSBURG, PA 17050 RE: Estate of FREEDMAN RUTH R File Number: 2001-00499 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 5/07/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: ./File Counsel Judge 1'tEV.1SOOEX (&MJ oe COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY /6-~3d-:3 w .... lil:::!U) u""" w..u ,,00 u"'.... ..., .. .. FILE NUMBER 2 1 0 1 INHERITANCE TAX RETURN RESIDENT DECEDENT YEAR NUMBER 9 9 004 COUNTYCOOE I- Z W Q W o W Q DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) F'REELM\N, RUTH R. DATE OF DEATH (MM-OO-YEAR) DATE OF BIRTH (MM-DD-YEAR) May 7, 2001 April 27, 1916 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 204 01 - 1903 THIS RETURN MUST BE FILED IN DUPliCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER rn 1. Original Return o 4. limited Estate 06. Decedent Died Testate (AllachcopyofWill) D 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise Idate of death after 12.12-82) o 7. Decedent Maintained a Living Trust (Attach copy o.fTrust) o 10. Spousal Poverty Credit (date Of death ootween 12.31-91 and 1-1.95) o 3. Remainder Return Idale of ~ath poor 10 12.13-82) o 5. Federal Estate Tax Return ReqUired o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) IAttacl1SchOi .... Z W o Z o .. ., W '" '" o u Seilf'M'O$'l'llI!'cOr.-PL.ETEJ); ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Thoma S Beck1 COMPLETE MAILING ADDRESS S ey Esquire ., 212 North Third Street FIRM NA~~t"fe'l & Madden Post Office Box 11998 TELEPHONE NUMBER Harrisburg, PA 17108-1998 (717) 233-7691 ~ z o ~ ::) l- ii: 00( o w c::: 1, Real Estale (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) o Separate Billing Requested 7. Inter.ViIJOS Transfers & Miscellaneous Non-Probate Property (Schedule G or L) B. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I} 11. Total Deductions (total Lines 9 & 10) (1) (2) (3) (4) (5) 140.000.00 18,993.79 - ..... ::::: (r.. :::s ~,; ?i "'J: .,., ,.,., 0:0 t 0\ 122,243.56 31,969.08 'v N (..j 00 (6) (7) 6,266.46 (6) 319,472.89 - (9) (10) 40,088.81 1,742.51 12. Net Value of Estate (Line B minus Line 11) 13. Charitable and GOlJemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (11) 41,831.32 (12) 277 ,641 ~7 (13) (14) 277 ,641.57 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES z o !;( I-' ::l D. ::E o o ~ 15. Amoul'\t of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.O_ (15) x.o~ (16) 12.493.87 x .12 (17) x .15 (16) (19) 16. Amount of line 14 taxable at lineal rate 277 . 641. ~7 17. Amount of line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due 20,0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT . > > BE SURE TO ~SWER ALL QUESnONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 4810 East Trindle Road CITY Mechanicsburg I STATE PA I ZIP 17055 Tax Payments and Credits: 1, Tax Due (Page 1 Una 19) 2, CreditslPayments A, Spousal Poverty Credn B, Prior Payments C, Discount (1) 17,000.00 624.69 Total Credits (A+ B+ C) (2) 17,624.69 3, Interest'Penally if applicable NfA 0, Interest E, Penalty TotallnteresUPenally ( 0 + E ) (3) 4, If Line 21s greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 12,493.87 5,130.82 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5) (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT ,.~~~",l.~"''->'''. ,.~~~j';.<-Jr.<1: ~\,'l<~.....~~"J. -~ , '. 4 . ~~;'i.'~~~~,.~{E~.i.\'f.!~-~":':i':"'i2~\'f'~~~~.Jf-.- --~.:] PLEASE ANSWER THE FOLLOWI~G QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; .......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 c, retain a reversionary interest; or...............................................................,.......................................................... 0 d, receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred afier December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideratio.n? .............................................................................................................. 0 3, Did decedent own an 'in trust fo~ or payable upon death bank account or securily 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? .....:.......................................... .................. ................................ No [29 [Xl []I []I [XI IXI ......lXI 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties 01 pe~ury, I declare that 1 have examined this return, induding 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 all information of which pre parer has any knowledge SIGNATURE OF PER 1 Lentz, Executrix ADDRESS 1890 Lamb's Gap SIGNATURE OF P Mechanicsburg, PA RESENTATIVE 17055 DATE ~ l);( Thomas S. Beckley, Esquire ADDRESS 212 North Third Street. P.O, Box 11998, Harri:sbur~: PA 17108~1998 ~~'~_::;M~'~~.r- ~. "'"'-""";oi .~,.-..---~~--:e;-~~~~T&~~~'y~I!!.~.1-..::1f~:h:m.!1J.~__~~:~im;f~~)~1 IQC:I:I 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 or for the use of the surviving spouse is 3% [72 P,S. ~9116 (a) (1.1) (i)). For dates of death on or afier January 1, 1995, the tax rate imposed on the net value of.transfers to or for the use of the survivin9 spouse is 0% [72 P,S. ~9116 (a) (1.1) (ii)), The statute does not exeniDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or afier 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)). The tax rate imposed on the net value of transfers to or forthe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P,S, ~9116(1.2) [72 P.S, ~9116(a)(1)), The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% 172 P,S. ~9116(a)(1.3)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. '* Schedule A Real Estate COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. FILE NUMBER 21 - 01 - 00499 All real prope'W owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wilfing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION : VALUE AT DATE OF , DEATH 140,000.00 I .4810 East rrindle Road lMechanicsburg, PA 17055 Schedule A TOTAL $140,000.00 ," ., ":::"TAT<^c:'~ _, - .......u.-...,',~... 1- ~;;-'TT II~JllI\:"C l::/:1A."O,,"S L-tap TO-At ~.6II!./I!!I"!"H(C:~g, cn'AMI~!=:I~r! !lI11lI;P~ on ~r'CD 411.101. OO:l. 00 r.!Il"'.l.... .f.____l_~n.. '''ft. ,,,",.... I~" ~,,- P.AO-:;, I!! 0.000 - ~AII; l='~C~~ ,aO~~OWER'o ~\.JNt:SA" SeTrI.G.Ve.f\,;T PAIO'ROM SE~LI!!:R'S Fl.-'NCe A" SfiTT;..EM!I\,'T i .,.,,~ to. In ~ c..,.....W1I..lbl'l aaid.., S.I""......I'>\ .n, ~TE'" .AV'~I. '''O'~.:.,nN W T" ,o~~ I ::: ~::: ~::=,:',,, ".. I A!'I~ ....._.....1 ~"'. ~tl..-..Il.=t"'..It.... : ,.. Mor!:.o-ae.. In MClr'l:l2ac7el!: t:n~:"!r'':'1::.ed.. Unl.:..rn.:Lted.. :!:t;Q :ne. ~1\ Lll 275.00 .18 ec L" ~~ Lx:l. U. ..1\ ~P.O.C.~ 2.327.50 .uver 3C>t:o.OC ::!;s.cc 9Q.IJO 4'C.CO .lO~.OO ItJ.... 24 '1:)....... ,.,. 115~.:!.:;4 I I., I,":."':"~nt. 1\QenQ"{.L t.1:.d.. "',.. 80..26 ull 45.22 Ll\ \ B6~. OJ u. 1..5. ge...j .1.I!;G.oe I .\~ o~ i ..(lO 1151 . '1 -1'0.00 Q 35.00 77.00 700.00 ",OO.CO 21i,'7!! If'I"!:J ::: 2a.5'- ~:' .' Lean "OOt:! !~ Io!! K.V81::.1Lt.e. .... Cililh III ,.......!Itate .;....,........ 1\d'Anav ~ ~,,=d. .133 oOO,QO ~~o~ooc.oo ~ 68~.75 I., Kalv,t:Lte a.'t.tJ.&rN'!In1: 1W~ :t..'t:d., I,., 0" d. ft.~1.1bJ..; J:! loI'a,:,:;l.cnll.1 ="~~e. "'n \u:~ne" ---1~M -1J,Ol I ;~~~ ~~:;:::~,::~.:.m". f ~!lO" , '~:"lfl ADD(na"'-lA' ~1l.'M"""I!Mr::N'T C:HlI.An~~ ~.o.l Rt.,.._ I ;::: ::~';',::.. :: :~:::: 1)0.1 ~.II.d'" It' ":I'~:" 1---12CL1Ql':I" t"l"".,tvlT\,o."o, ill... E"'t;'.I!I~~ 8to...'l1o ,-::~: nOVERrojM~N't. ~.n("H~'CllNG A,fo..!O "'IU..Nl.\\:F-~ C::i~'~J:'lt; __..,.41"", ....... I:U'....4. ~,. 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I ~ -:~.~. ,,,.~,o..'" ..,- J I'IH'l '''I'v'lrl'NT..tVa.. ~.GJ1 (":o,,"I..U,...... 1'1'"2 !f;~n!:]oQ!!,'l"." -"~~ "Ill! ~:~ ~'I.l!. s.: 111_ ~.~1!L03 ...oJ.> 2J4 7' '!I ,'s. ~~7 '1~ H;~ I ~nn :ilQ1 "'1I~ I Tp'l'AL PAlO BVIFpR ..O"=~ ~ eA,.BH A'T" !iI~"'" '!:1'.1~ TO I!OP\A. \lVP..n. COO" .~""., .," "om,,::::: :";,. '~~' I r.......'llUnelJ..'..'ul,l"'.....tf .a o' :to.. 01 c.AsH e~!,)M JIii.;<'!tt'llCWE" I ~~ ' :~~ :::;:~~~~:~~~,~E~:"~:~;;j~;c:.~ J..::..S.O.3 ''',000,001 14$:3"00.$2 1'3 QOO.OO ia(J2 1......r"'rl"...~I...,!t"......'..fIll1'\6!~O. 14C."7~D.3~ :".'l.~S.O$ ,JC3 :1..L 3~c. e.:2 eo:.'! CA~\.;,.O SE. L'P"'N .13$, '04.20 Tl~lIlEx"r\}~'" "~~ltnlHlld 5)'.!llom PrlrlltHI O:lmS/~:'l7. t.'- \4:32 JtU.V.l"H.:D~l ()(8~) . Schedule B Stocks & Bonds COMMONWEAL T1-t OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. : FILE NUMBER 21 - 01 - 00499 All property jointly-owned with Right of Survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH I Motorola Corp. Stock 196.80 2 Pepsico Stock 224.70 3 ITotal Return Trust (TRFCX) 1,130.88 4 'Waypoint Stock 13,284.00 5 'Vanguard Wellesley Income Fund 4,157.41 Schedule B TOTAL $18,993.79 ESTATE OF '* Schedule E Cash, Bank Deposits, & Misc. Personal Property I FILE NUMBER I 21-01-00499 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT - --- - -----..------- Freedman, Ruth R. DESCRIPTION Certificate of Deposit (First Union #247412056316702) Including Accrued Interest of$25.93 2 Certificate of Deposit (First Union #247412056316701) I(ncluding Accrued Interest of $25.93) First Union Savings Accunt (#1010041727221) IFirst Union Checking Acconnt (#8474) IFederal Tax Refund Waypoint Stock Dividend Nationwide Automobile Insurance Refund 3 4 5 6 7 8 Members First Savings Acconnt (#152381-00) (Including Accrued Interest of $.29) Members First Certificate of Deposit (#152381-59) (Including Accrued Interest of $1.82) Members First Certificate of Deposit (#152381-71) (Including Accrued Interest of $7.88) IMembers First Certificate of Deposit (# 152381-72) I(lncluding Accrued Interest of $1.37) 'Members First Certificate of Deposit (#152381-77) {Including Accrued Interest of$11.81) Members First Certificate of Deposit (#152381-75) (Including Accrued Interest of $8.15) Members First Certificate of Deposit (#152381-76) {Including Accrued Interest of $8.15) 'Members First Certificate of Deposit (# 152381-79) (Including Accrued Interest of $11.58) Members First Certificate of Deposit (#152381-80) (Including Accrued Interest of $14.66) Members First Certificate of Deposit (#152381-82) I(Including Accrued Interest of$IO.92) 9 10 11 12 13 14 ] 5 16 17 VALUE AT DATE OF DEATH 2,115.21 2,115.21 281.13 6,491.70 300.00 102.00 24.50 620.47 1,853.14 7,532.21 1,348.86 11,311.31 7,916.46 7,913.77 11,598.97 14,145.34 10,601.68 Schedule E TOTAL $122,243.56 ESTATE OF '*' Schedule E Cash, Bank Deposits, & Misc. Personal Property continued FILE NUMBER 21 - 01 - 00499 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlY-<lwned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 18 19 20 21 22 0' -, 24 25 COMMONWEALTH OF PENNSYLVANIA INHERITANCETA,XRETURN RESIDENT DECEDENT Freedman, Ruth R. DESCRIPTION Members First Certificate of Deposit (#152381-84) (Including Accrued Interest of$17.53) Members First Certificate of Deposit (#152381-85) (Including Accrued Interest of$17.56) !Waypoint Bank Certificate of Deposit (#1800013065) '(Including Accrued Interest of$53.14) Refund - Merck-Medco Rx Services 'Refund - COllntv Taxes Refund - School Taxes Refund - Sewerrrrash Miscellaneous personalty (see attached) VALUE AT DATE OF DEATH 15,516.25 15,542.12 2,736.92 8.00 245.32 459.23 14.76 1,449.00 page 2 of schedule E ESTATE OF RUTH FREEDMAN LOCATION ITEM DISPOSITION VALUE Kitchen Table and \we chairs Auction $25.00 Dishes Auction $25.00 Toaster Auction $5.00 Pots/oans Auction $20.00 Utensils Auction $10.00 Microwave oven Familv $20.00 Stove, RefrtOerator, Dish washer Sold with house Inc'l in sale Uving room Sofa Familv $25.00 2 Wino backed chairs Family $50.00 Coffee table Familv $25.00 Television Family $25.00 Recliner chair Family $25.00 End tables and lamps Family $25.00 Bedroom 1 SinGle bed with frame Family $25.00 2 Dressers Familv $50.00 Niaht stand with lamo FamilY $10.00 Clock radio Auction $10.00 Sittinaroom Hutch Family $25.00 Rockino chair FamilY $10.00 DIY sink FamilY $50.00 LamriS" Auction $25.00 End tables and lamos Family $25.00 Bedroom 2 Single bed with frame FamilY $25.00 2 Dressers Auction $100.00 Lamps Auction $2.00 Television Family $2.00 Basement Washer and drYer Sold with house Inc'l in sale 2 Chairs Auction $10.00 Dining room Table and chairs Sold with house Inc" in sale Cabinet Sold with house Inc'1 in sale Personal Clothing Given to Salvation Annv $0.00 Weddino rinos Familv $500.00 Costume iewlelY Auction $100.00 Various wall hanoi",,!; loictures) Auction $100.00 2 teleol1ones Given to Salvation Annv $0.00 Books Given to Salvation Anny $0.00 Family DhotooraDhs Family $0.00 VCR (broken) Trash $0.00 Small stero Given to Salvation Ann" $0.00 VllIeo ta""-~ Given to Salvation Annv $0.00 Audio taces Given to Salvation Annv $0.00 Sheets and towels Given to Salvation Armv $0.00 Gold banole bracelet Family $100.00 TOTAL $1,449.00 *' Schedule F Jointly-Owned Property COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. FILE NUMBER 21 - 01 - 00499 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A Cheryl Lentz ADDRESS RELATIONSHIP TO DECEDENT B Robin Cole 1890 Lamb's Gap Road Mechanicsburg, P A 17055 1370 Swope Drive Boiling Springs, P A 17007 1890 Lamb's Gap Road Mechanicsburg, P A 17055 Daughter Daughter C Frank E. Lentz, IV Grandson JOINTLY OWNED PROPERTY Letter Date Description of Property %of Date of Death Item for Joint Made Include name of financial institution and bank account number Date of Death Deed's Value of Number Tenant Joint or similar identifying number. Attach deed for jointly-held real Value of Asset Interest Decedent's Interest __ estate.__________ _____________n -.--- - - ------- A,B 5/4/2000 Members First Certificate of Deposit (#152381-81) 5,568.17 33%, 1,837.50 (Including Accrued Interest of $6.03) 2 C 10/5/2000 Members First Certificate of Deposit (#152381-83) 520.511 50%1 260.26 (Including Accrued Interest of $.59) 3 A,B 3/4/98 IMembers First Savings Account (#174321-00) 52.441 33%1 17.31 l(lncluding Accrued Interest of $.02) 4 A,B 3/4/98 !Members First Certificate of Deposit (#174321-40) 10,376.26 33% 3,424.17 (Including Accrued Interest of $1 0.04) 5 A,B 3/2712000 Members First Certificate of Deposit (#174321-43) 1,765.53 33% 582.62 (Including Accrued Interest of $1.61) 6 F 6/2/98 Members First Savings Account (#176281-00) 52.441 50% 26.22 '(Including Accrued Interest of $.02) 7 F 612198 Members First Certificate of Deposit (# 176281-40) 6,660.63 50% 3,330.32 (Including Accrued Interest of$6.65) I 8 F 11/4/98 Members First Certificate of Deposit (#176281-41) 570.61 50% 285.31 I(lncluding Accrued Interest of $.57) 9 D 6/2/98 iMembers First Savings Account (#176282-00) 52.44' 50%1 26.22 (Including Accrued Interest of$.02) i 10 D 612198 Members First Certificate of Deposit (#176282-40) 6,660.63 50%1 3,330.32 (Including Accrued Interest of$6.65) , 11 D 1114/98 IMembers First Certicate of Deposit (#176282-41) 570.61 50% 285.31 (Including Accrued Interest of $.57) Schedule F TOTAL 1 31,969.08 I '* Schedule F COMMONWEALTH OF PENNSYLVANIA Jointly-Owned Property INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Freedman, Ruth R. 21 - 01 - 00499 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. ------..-- --------.-- JOINTLY OWNED PROPERTY Letter Date Description of Property %of Date of Death Item for Joint Made Include name of financial institution and bank account number Date of Death Deed's Value of Number Tenant Joint or similar identifying number. Attach deed for jointly-held real Value of Asset Interest Decedent's Interest estate. 12 E 6/2/98 !Members First Savings Account (#176285-00) 52.44' 50%i 26.22 l(Including Accrued Interest of $.02) 13 E 6/2/98 'Members First Certificate of Deposit (#176285-40) 6,660.63' 50% 3,330.32 (Including Accrued Interest of $6.65) 14 E 11/4/98 Members First Certificate of Deposit (#176285-41) 570.61 50% 285.31 (Including Accrued Interest of$.57) 15 E 1/20/99 Members First Certificate of Deposit (# 176285-42) 1,122.13! 50% 561.07 (Including Accrued Interest of $.93) , 16 C 6/2/98 'Members First Savings Account (#176286) 52.44 50%, 26.22 '(Including Accrued Interest of $.02) 17 A,B 4/14/98 Members First Certificate of Deposit (#174321-42) 7,470.99' 50% 3,735.50 (Including Accrued Interest of$6.83) ] 8 C 5/29/98 'Vanguard STAR Fund (85.951 shares@ $17.18 per 1,476.64 SO%i 738.32 share) 19 A,B 2/27/98 Vanguard Wellington Fund (264.624 shares@$28.89 7,644.99 33%1 2,522.85 per share) 20 C 9/17/99 Waypoint Bank Cetificate of Deposit (#1800012962) 1,090.061 50% 545.03 (Including Accrued Interest of$19.69) 1 21 A 12/15/99 115 Shares Waypoint Bank 1,237.05 50%, 618.53 12 A,B 2/5/96 1033.106 Shares of Templeton Growth Fund - Class C 18,709.55 33%1 6,174.15 !(Account #201-61732) , page 2 of schedule F Estate of Ruth R. Freedman Surviving Joint Tenant's Name. D Ashley T. Lentz E Joshua F. Lentz F Bradley H. Lentz SCHEDULE F (Continued) JOINTLY OWNED PROPERTY Address 1890 Lamb's Gap Road Mechanicsburg, P A 17055 1890 Lamb's Gap Road Mechanicsburg, P A 17055 1890 Lamb's Gap Road Mechanicsburg, P A 17055 21-01-00499 Relationship to Decedent Granddaughter Grandson Grandson '* Schedule G Inter-Vivos Transfers & Misc. Non-Probate Property I I FILE NUMBER , 21 - 01 - 00499 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. This schedule must be completed and filed if the answer to a~of !J!Iestion 1 through 4 on the reverse side of REV-1500 COVER SHEET is y.es. - ___________n_________ __on - - - - ------rn-- - I __ _____u__, - ITEM DESCRIPTION OF PROPERTY DATE OF DEATH I % OF I Include Ihe nama of the transferee, their relationship to decedent and the date of transfer I DECO'S i EXCLUSION I TAXABLE VALUE NUMBER Attach a copy of the deed for real eslate. VALUE OF ASSET! INTEREST' (IF APPLICABLE) Lutheran Brotherhood Flexible Premium Deferred Arumity 6,266.46 100% 6,266.46 (Policy Number B3143786) Schedule G TOTAL $6,266.46 *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES Musselman Funeral Home 2 Open Grave i 3 !Flowers 4 funeral Luncheon 5 Schedule H Funeral Expens:s & Mninislrative Costs I FILE NUMBER u 21-01-00499 DESCRIPTION B. ADMINISTRATIVE COSTS Personal Representative's Commissions Cheryl Lentz and Robin Cole Social Security Number{s) I EIN Number of Personal Representative(s): Street Address 1890 Lamb's Gap Road City Mechanicsburg State P A Year(s) Commissions paid Zip 17055 2 Beckley & Madden Attorney Fees 3. Family Exemption (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State ZI P Code 4 City Relationship of Claimant to Decedent Probate Fees Probate Fee 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs The Patriot-News The Cumberland Law Journal iDeath Certificates :Moving expenses from Nursing Home Pennsylvania Power and Electric Company Schedule H TOTAL AMOUNT 7,540.00 760.00 208.00 380.98 none 13,000.00 none 337.00 167.10 75.00 37.00 225.00 160.66 40,088.81 *' Schedule H Funeral ExpenSES & MninislratiYe Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. !Pennsylvania-American Water Company 'IShiPley Energy ,Lawn Maintenance !Repairs to Furnace jNationwide Insurance Hampden Township (water/sewer) Register of Wills (Short Certificates) Telephone Tolls Postage 'Photocopy Charges Estimated Closing Costs Real Estate Transfer Tax Notary Fees County Taxes Repairs to Furnace jRepairs to House in anticipation of sale of real estate !Kenneth Waggoner - Repairs to Chimney !Filing Fee - Inheritance Tax Return and Inventory I FILE NUMBER I 21-01-00499 98.89 158.49 210.00 301.95 2]9.00 210.00 12.00 1.71 65.00 200.00 2,000.00 700.00 8.00 407.03 1,500.00 10,000.00 1,075.00 31.00 page 2 of schedule H *' Schedule I Debts of Decedent, Mortgage Liabilities, & Liens COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. I FILE NUMBER 21 - 01 - 00499 ITEM DESCRIPTION AMOUNT NUMBER I Susquehanna Internal Medicine 133.83 2 Moffit Vascular Group 17.75 3 Comfort Care 57.45 4 Holy Spirit Hospital 9.18 5 Occupation Tax 9.80 6 Bridges At Bent Creek 61.65 7 Moffit, Peas & Lim 27.73 8 Kathryn Fetrow (real estate taxes) 1,125.12 9 200 I Estimated Income Tax 300.00 Schedule I TOTAL $1,742.51 '. Schedule J Beneficiaries COMMONWEALTH OF PENNSYlVANlA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. FILE NUMBER 21 - 01 - 00499 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do.NQtLislIruste.e!J.l I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Chery I Lentz 1890 Lamb's Gap Road Mechanicsburg, Pennsylvania 17055 , IDaughter 2 Robin Cole 1370 Swope Drive Boiling Springs, Pennsylvania 17007 I IDaughter I 3 Frank E. Lentz, IV 1890 Lamb's Gap Road Mechanicsburg, Pennsylvania 17055 Grandson I IGranddaughter 4 Ashely T. Lentz 1890 Lamb's Gap Road Mechanicsburg, Pennsylvania 17055 5 Joshua F. Lentz 1890 Lamb's Gap Road Mechanicsburg, Pennsylvania 17055 Grandson Ener dollar amounts for distributions sho~n ab~IJE3_9~__!~rl~~_!~J~r<?ug~._17, ~s appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Schedule J TOTAL AMOUNT OR SHARE OF ESTATE :50% or residue i50% of residue 2,500.00 2,500.00 2,500.00 '. Schedule J Beneficiaries continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Freedman, Ruth R. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 6 Bradley H. Lentz 1890 Lamb's Gap Road Mechanicsburg, Pennsylvania 17055 FILE NUMBER 21 - 01 - 00499 RELATIONSHIP TO DECEDENT Do Not List Trulltee(s) AMOUNT OR SHARE OF ESTATE Grandson 2,500.00 page 2 of schedule J 11lttst lIill ttnb @p,Stnmput OF RUTH R. FREEDMAN I, RUTH R. FREEDMAN, of 4810 East Trindle Road, Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament hereby revoking all prior Wills and Codicils. ITEM I. I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM II. I give, devise and bequeath my engagement and wedding rings to my daughter, CHERYL F. LENTZ. ITEM III. I give, devise and bequeath two white gold diamond rings to my daughter, ROBIN F. COLE; one with 12 small diamonds, the other with a diamond in the center surrounded by smaller diamonds. ITEM IV. It is my specific desire to treat my children as fairly as possible. Therefore, I direct my children should equally divide any remaining rings and other miscellaneous jewelry, ,which their father had given me, knowing that he would be very pleased by their acts. ITEM V. I give, devise and bequeath the sum of Two Thousand Five Hundred Dollars ($2,500.00) to the following: a. My grandson, FRANK E. LENTZ, IV; b. My grandson, JOSHUA F. LENTZ; c. My granddaughter, ASHLEY T. LENTZ; and d. My grandson, BRADLEY H. LENTZ. ITEM VI. I give, devise and bequeath the rest, residue and remainder of my estate, of every nature and wherever situate, in the following manner: a. one-half to my daughter, CHERYL F. LENTZ, or her issue per stirpes; and b. one-half to my daughter, ROBIN F. COLE, or her issue ITEM VII. per stirpes. I nominate and appoint my daughters, CHERYL F. LENTZ and ROBIN F. COLE, as Co-Executor's of this my Last Will. ITEM VIII. I direct that my Executrix shall not be required to give bond for the faithful performance of her duties in any jurisdiction. ITEM IX. I direct that all taxes due at my death or as a consequence of my death shall be paid from my residuary estate. I~ WITNESS WHE~have h:reunto set my hand and seal this the ;,f-iflf day of( z:::~ ' 1998. ~ 1i:fi<'R</dc#~ RUTH R. F EDMA // / ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN /") , ~ r;J . We ~ 1){\1.. k t(epciYIAf) t(rIS+IP L. Sln\ftc ~ , the testatrix and witnesses, respectively, whose names are signed to the forgoing instrument, being first duly sworn, do hereby declare that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of the witnesses' knowledge, the testatrix was at' the time eighteen years of age or older, of sound mind and under no constraint or undue influence. 0nqi..iA~, J ~7 j?-6r 1< no IJ (!. N'6 t-- I?{ Sh~f~< ~ /)1) Vl It>. - WITN ' 6000 Linglestown Road P.O. Box 6656 Harrisburg, PA 17112 On this, the '.1 ('r\i'\ c~ /1 day of (lR ."("I/"{),, t, ( r-. " If . I" \ I '. . -..'" / \...{ I v I 1998 before a Notary Public, the undersigned officer, personally appeared, Marion E. MacIntyre, Esquire, known to me or satisfactorily proven to be a member of the Bar of the Supreme Court of Pennsylvania, and certified that she was personally present when the foregoing acknowledgement and affidavit were signed by the testatrix and witnesses. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. , I' , , {(' " II ( I . I '" I j \ . I \/ \ . 'h/ ( ( Y.JJ'ft /') I~))( 1)/, .i, NOTARY' P,uBLIC I NOTARIAL SEAL KRISTlE l. SHIRK N CIty Of HarriSburg' 0 otary PUblic My C!'rnrnissron ev~. aUDhm County - ----.. --:., !~~_~~~y_~, 1999 ---