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HomeMy WebLinkAbout01-0562 PETITION FOR PROBATE and GRANT OF LETTERS ~\ -0\- Slo~ No. To: Register of Wille; for the a Cumoeri an . ... . Deceased. County of In the Social Security No. 16,,-22-2~l:U 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 rix in the last will of the above decedent, dated December 7 and codicil(s) dated Estate of MARY C. ROGERS also known as named , 19Z1L- Decendent was domiciled at death in Cumberl and h er last family or principal residence at 180T Letchworth Camp Hill (list street. number and muncipality) (,;;,;) Decendent, then 74 years of age, died June 6 ~ 2001 , at Heal th South. Lower Allen Twp., Cumberland County . 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 incompete~t: Decendent at death owned property with estimated values as follows: . (If domiciled in Pa.) All personal property $ 10,000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 90.000.00 situated as follows: 1807 Letchworth Drive r::lmp Hi'1) rllmnprl ::Inti rnnnty WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Tes tamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ,.,... ~ l;;;- c,l{\D~ :gODtt.j ~ I / ~ I :~ I (\(- ~T' -g.g t-l0o A I II O~ o;S".:::: 3ct u..... ~o 1ii c:: tlO in IJ u,-,-l j( (\ 0 LJJ{\ flr5 G/r\D If 00uJ fJe.j OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLAND ARY \ Co - d '3 (~--' ! D No. 21 - 01 -: 562 Estate of MARY C. ROGERS , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW J U N E 14, t9: 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated DpC'pmher7 t 1978 described therein be admitted to probate and filed of record as the last will of Mary C. Ro ger s \ and Letters Testamentary are hereby granted to Cindy A .Sowers CINDY ROGERS njkja CINDY SOWERS FEES Probate, Letters, Etc. ......... $ 200.00 Short Certificates( 1)).. . . . . . . .. $ 30 00 Renunciation ................ $ RENUNCIATION $ 5.00 X-PAGE 3.UU J~P JUNE 14,T?~AL - $ 5.00 Filed ............ .-.... .... . ... .,. 24-3..Q0 Michael V . Brown , Esquire (PA LD. 79984) 27 N. Wg~~ ~~up. Ct. 1.0. No.) P.O. Box 1284, Harrisburg, PA 17108-1284 ADDRESS (717) 234-3282 PHONE Mailed letters to attorney on 6-14-01 ? LAST WILL AND TESTAMENT OF MARY C. ROGERS I, MARY C. ROGERS, of 1807 Letchworth Drive, Camp Hill, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, declare and publish this as my Last Will and Testament, revoking all prior Wills. FIRST: I direct that the expenses of my last illness and funeral shall be paid from my estate. 1. I direct my Executor to payout of my estate the cost of the perpetual care and maintenance of the burial plot in which I shall be buried, should arrangements for same not have been concluded and paid for prior to my death, and also the cost of an appropriate tombstone. SECOND: I give and bequeath to my husband, GEORGE E. ROGERS, any automobiles, household and personal effects and other tangible personal property of like nature, which I may own at the time of my death, providing he survives me by ten (10) days. 1. If my husband, GEORGE E. ROGERS, does not so survive me, I give and bequeath my tangible personal property, in equal shares, to my daughters, DONNA LIDDICK, BONNIE ROGERS, and CINDY ROGERS, or to the survivors or survivor of them. THIRD: All the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and wheresoever situate, I give, devise and bequeath unto my husband, GEORGE E. ROGERS, providing he survives me by thirty (30) days. 1. If my husband, GEORGE E. ROGERS, predeceases me or does not survive me by thirty (30) days, I give, devise and bequeath the residue of my estate to my three children, in equal shares. FOURTH: All Federal, State and other death taxes that may be assessed because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this my Will, shall be paid from the principal of my residuary estate as part of the expense of administration of my estate. FIFTH: I nominate, constitute and appoint my husband, GEORGE E. ROGERS, Executor of this my Will. 1. In the event that my husband, GEORGE E. ROGERS, fails to serve or to continue to serve as Executor, I designate and appoint my three children, DONNA LIDDICK, BONNIE ROGERS, and CINDY ROGERS, as substitute or successor Executrixes. . , " .... SIXTH: My Executor shall have power to compromise claims and controversies; to sell at public or private sale any real or per- sonal property, and to make distribution of my estate in cash or in kind. 1. My Executor shall not be required to furnish a bond in any jurisdiction in which he may act, and if bond is nevertheless required, it shall be without surety. I~WITNESS WHEREOF, I have hereunto set my hand and seal this ?tIf day of Noue~be~, 1978, at the end hereof, composed in all of two (2) pages. ~~ .:/~ ~'.) , ;' ,'~/ 0 A"~1' C' ~~/' #-71./ A ~ Mary C. R ers ~I (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, MARY C. ROGERS, as and for her Last Will and Testament in the presence of us, who, at her request, in her presence and in the presence of each other, all being present at the same time, have hereunto set our hands as witnesses. Name dilJ If' IJkJ ~-jj6f'Yl,)0 /)a'1/~ A /1 / ," / . ~/.. - //)/' L/' f~? / /C;,?[- ''f' v - ,.fB==:=:=:i.b ! Address 1~24,;f1 tf' ~~y W///, /~- /'~ v/ ~-'Y1A' 'A~~ /<(' ( 7/ Name Address Name Address 21 - 01 - 562 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS (each) a subscribing witness to law, depose(s) and say(s) that codicil e will presented herewith, (ea~oeing duly qualified according to /' present and saw Sworn to or affirme me this ./' / ----- signed as a witness at the the presence of each other) (in the presence of the the testat , sign the same and that request of testat_ in h ce and other subscribing witness(es)). nd subscribed before day of 19_ ~e) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ~ Vl vtO.. J- 'lddtvt Jt>O NNI'&- N\{)~ S-- (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they familiar with the signature of Mary C. Ro gers x~ testa! rix of (one of the subscribing witnesses to) the will that they presented herewith and codicil believes the signature on the will is in the handwriting of MARY C. ROGERS to the best of their knowledge and belief. ~ . ~ l~ CLEWIS lit (1ddress) ~ ~c.. ~-L '~_ (Name~~.y---l. ()A. Jlf/) '[/lIf e. )i6. th. 17/1 I (Address) 21 - 01 - 562 RENUNCIATION In Re Estate of MARY C. ROGERS deceased. To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned.Y OYl Vl ~ L; rid "\ ct i. j)o N N /E.. /VI o(J-, ~ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Cindy A Sowers WITNESS hand this day of June ~l' 2001 ~~A- :D ~'1 ~ AS~~~~ 1;;Dv)vLVM~rtd (Addless) ;f~. ~()O *e. . J7/1/ ~~~~ :;? _ (Signature) -.lX)NNJ'lz MO ~~ :b\J~ 6f2'F ',,", fl. ~.- f-JC./ (Address) W~J' f 0-'-7(( ( (Signature) (Address) f- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Mary C. Rogers, Deceased June 6, 2001 Will No. 2001-00562 Admin. No. 21-01-0562 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) ofthe Orphans' Court was served on or mailed to the following beneficiaries of the above-captioned estate on September 27, 2001: Name Address Cindy A. Sowers Donna Liddick Bonnie L. Morris 121 Vine Street, Harrisburg, PA 17104 400 Bonnymeade Avenue, Harrisburg, PAl 7111 5506 Grouse Drive, Harrisburg, P A 17111 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: (NONE) Date: September 27,2001 ELLIOTT REIHNER SIEDZIKOWSKI EGAN & BALABAN By: ichael . Brown, Esquire 27 N. Front Street P.O. Box 1284 Harrisburg, PA 17108-1284 (717) 234-3282 (voice) (717) 233-4264 (facsimile) Capacity: _ Personal Representative l Counsel for personal representative G:\B&B\CLlENTS\954\BENEF1CI.CER I~~IMUI *. :", COMMONWE.o\lTHOF , , PENNSYlVANIA . DEPARTMENT OF REVENUE DEPT, 280601 ..;. HARRISBURG. PA 1712B-C601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OF~ICIAL IJSE Oi"ll y c / (p- ;2 ~c. -I () FILE NUMBER 41_010562 cMriccu 'tEAR - ~ - - I- Z UJ Cl IJJ U IJJ Cl OECEOENTS NAME (lAST, FIRST, AND MlOOLE INITIAL) ROGERS, MARY C. OATE OF OEATH IMM-OQ-YEAR) OATE OF BIRTH (MM-oO.YEARI 06-06~2001 04-30-1927 SOCIAL SECURITY NUMBER 162 - 22 - 2583 (IF APPlICABLE) SURVIVING spouses NAME (LAST. FIRST. ANO MIOOLE INITIAL) THIS RETURN MUST BE RLEO IH.OUPUCA TE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ... % W " % o .. " w '" '" o o []I 1. 0rigiiIat ~lm1 0 2. Supplementaf Return 0 3. Remainder Return fcWt d tIaIJI pntJIlD 12.13-82) o 4.Umited~tale D4a.FutlJrelnterestCompromiselclallddtalhallw,2.,2-121 o 5. Federal Estate Tax Relum Required G9 6. Decedent Died Testate (ADdlcopyalVMI 0 7. Oetedent Maintained a lMng TNSlfr'DXll<:opyalTIU$l) .0- 8. Total Number of Safe Deposit Boxes o 9. UllgatlooProceedsReWit<l 0 10.SpousaJP"""YCtedil(dood_......12~1~1...,.,"" 0 11._10 la.under Sec. 9113(A) """'''''01 :.:tHIS .sECJiOI'(lii,ilST:BE:COMI'LETEDi"'Llj;CORRESP.oNDEN~E Af/D:CONFlDENTIALJAX INFORMATION SHOULD BE DIRECTED ,TO: j NAME ' COMPLETE MAlUNG AOQRESS Michael V. Brown, Esquire 27 N. Front Street FlRMNMtE~_) . P.O. Box 1284 Elliott Reihner Stedzikowsk1 E an & Balaba Harrisb r PA 17108-1284 TELEPHONE NUMBER u g, 717-234-3282 w ~ct) ",,, ..0 00 ",,,,, .... .. '" 1. Real Estate (SchecklIe A) (1) 79,900.00 nit,. .oFFICIAL USE .oNLY -0- ::;(,. Kl :u . CD 2. Stocks.and Bonds (Schedule B) (2) :::l 0' (! e:r' 3. Closety Held Corporalion. Partnership or SoIe.Proprietorship (3) -0- (I ..,., f'T1 (4) -0- 00 4, Mortgages & Notes Receivable (Schedule D) I 5. Cash. Bank Deposits & MisceUaneous Personal Property (5) 15,756.88 00 Z (Schedule E) -10 0 (6) -0- "J 6. Jcli!1IIY Owned Properly (Schedule F) "".,.. !;{ o 50parale !3l11ing Requested " ~ W ...J 7. Inter-Vrvos Transfers & MisceBaneous Non-Probate Property (7) 24,007.30 => t: (Schedule G or L) 0. B. Tolaf Gross Asset> (1l>taIli1es 1-7) (B) 119_664.18 <l; U 9. F....eraI 8cpenses & Adninislritive Cosls (Schedule H) (9) 6,636.20 UJ 0:: 10. Oebl$ of Oecedent. Mong;1ge Uabililies. & liens (Schedule Q (10) 15,253.78 11. Total Oeductlons (1oIaI Lines 9 & 10) (11) _21J?89.98 12. Net Value of Estate (li1e 8 rnir<Js Line 11) (12) 97,774.2f) . -O- J 13. Charitable and Go>.."nent;l Beques1s/Sec 9113 Trusts forwllich an _10 tax has not been (13) made (ScheOuIe J) 14. Net Value Subject to Tax (li1e 12 minus Line 13) (14) 97.774.20 SEE IHSTRtJCT10NS ON REVERSE SlOE FOR APPUCABLE RATES Z 15. AmolnIdUne14_atlhespousa!tax 0 -0,.. -0- ~ rale, or _ UI1der See. 9116 (aXU) l.O_ (15) 97,774.2'0 45 (16) 4 ,39'9-:84 I-' 16. AmountofUne 14_atinealra.. x.O_ => -0- -0- 0. 11, _dUne 14_atsiblingra.. :x .12 (17) :E 0 18. Amoonl of Line 14 _ at coIaleIal rate -O- x .15 (18) 0 U X 19. Tax Due 119) .4 ,'399.84 ~ 20.0 t :-. '> > BE SURE TO ANSWER ALL QUESTIONS .oN REVERSE SlOE AND RECHECK MATH < < ' 'ecedent's Complete Address: HREETAOORESS 1807 Letchworth Drive :ITY Camp Hill I STATE PA I ZIP 'ax Payments and Credits: Tax Due (Page 1 line 19) Credits/Payments A. Spousal Poverty Credil B. Plio< Payments C. Discounl (1) 4,399.84 -0- -u- -0- TolalCredits(A+B+C) (2) -0- InlerestlPenally if appHcable D.lnteresl i E. Penalty -0_ -0- TotallnteresllPenalty ( 0 + E ) I. KUne 2 is greater than Une 1 + line 3, enter Ihe difference. This is Ihe OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (3) (4) (5] -0- i. Kline 1 + Une 3 is greater than lile 2, enter !he diffOfence. This is Ihe TAX DUE. A Enter Ihe interest on Ihe tax due. (SA) B. Enter the total of Une S + SA This is Ihe BALANCE DUE. (s!l.l- Make Check Payable to: REGISTER OF WILLS, AGENT -0- 4,399.84 -0- 4,399.84 ~~_~..",.~~~&_..~ _: ~ ~..;r.r,+-........~~~~~........... l:i y-....... ~ .~~~- ~~~.~~ - .... -"......~;1~..~.~~~''t::~~~~ PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent male a transfer and: Yes a. retain the use or income of the property transferred;......................................................,...................h.............. 0 b. retaij:! the right to designate who shall use the property transferred or its income; ....h...................h................. 0 c. retain a reversiolla.ry.interest. or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12,1982, dId decedent transfer property within one year of death without receiving adequate consideration? ...........,................_...................................................................._............ 0 3. Did decedent own an 'n trust for" or payable upon dealh bank account or security at his or her death? .............. 0 4. Did decedenl own an Individual RetiremenlAccoun, annuity, or olher non-probate property which conlains a benelida<y designation? ........................................................................................................................ G9 No rn ~ ~ o o G9 o 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 preoaIIies olpeljl$y, t dedare lhatl have eX3mi'ted tis reUn. indudit1g accompanying schedules and stalemetlts, and 10 !he bestot my knowledge and beief, it is true, correct and ccmpIe\e. DedataIiondptepamoUteflhanlhe~~isbasedonaJilrorm:alionof'M1ichpreparerhasilf'f'lkoc:1wledge_ SIGNATURE OF P/:RSON RESPONSIBl OR RUNG RETURN , I-Ct/J'/L) ADDRESS PA 17104 2 Harrisburg, PA 17108-1284 ~~~f!""~~~'C-~~~............_.~~~~1"~~~~~- ~~,1~ - ,... -dt;'-r '" -,-......,........~_..~~;p.T.~~V~:~ Fa-dales 01 death on a- after July 1, 1994 and before Janua<y 1, 1995. Ihelax rate imposed on Ihe nel value 0I1ransfets to a- for Ihe use of the SUl'living spouse is 3% [72 P.S. 59116 (a) (1.1) (i)~ For dales 01 death on or after Januart 1, 1995. the lax rate imposed an !he net value of transfers to or for Ihe use of Ihe SUNiving spouse is 0% [72 P.S. 5g116 (a) (1.1) (u)]. The statute does not exemol a transfOf to a surviving spouse from lax. and Ihe slaMo<y requirements for disclosure of assels and IifIl19 a lax return are stiU applicable even ~ the SUl'living spouse is tile only benetida<y. For dates of dealh on or after July 1, 2000: The lax rate imposed on Ihe net value 01 :roosfer.; from a deceased ~iild ~enty-one years of age or younger at death 10 or for !he use 01 a natural paren, an adoptive parent or a stepparent 01 Ihe child is 0', [72 P.S. ~9116(aX1.211. The lax rale imposed on Ihe nel 'Ialoo of transfers 10 or lor Ihe use of the decedents lineal beneficiaries is 4.5%. except as noted in n P.S. 59116(1.2) [72 P.S. 5g116(aX1)1. The lax rale imposed on Ihe net value of transfers 10 or for Ihe use of Ihe decedents siblings is 12% [72 P.S. S9116{aX1.3)~ A sibling is defined, under Section 9102. as an individual who has at least one parent in common wilh Ihe decedenl, 'Nhelher by blood or adoption. ;. REV.1502 EJC. 112-85) '* COMMONWfAUH OF ,eNNSYlVANIA INHERITANCE T,U ROORH RfSIOEHT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Mary C. Rogers, Deceased FlU NUMBER 21-01-0562 (Property jointly-owned with Right of Survivorship must b. disdos.d on Schedule F) All reol .sfQt. should b. reported at fair morxet vol which Is d.fined as the price at which property would b. exchanged between a willing buyer and a willing sell.r, neither being comp.IJ~~ to buy or sen. both having reasonc::Jbl. knowledge of the relevont facts. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 1807 Letchworth Drive, Camp Hill, Cumberland County, FA (Decedent took title by operation of law due to death of spouse, George E."Rogers on January 4, 1998) Property LD. No. 13-23-054 7-299 79,900.00 ~. 79,900.00 "'.,"''''.,''''''* COMMQNVV€..AlTH Of ~NNSYt.V,\NtA INHEfUTMICE TAX RETURN RESIOENT OEC~[\ENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Mary C. Rogers, deceased FilE NUMBER 21-01-0562 ESTATE OF Inc!ude /he proceeds of Jjligalion and lIe dale ltIe ~~o.eds were received by Ihe estate. AU property joinUy-owned with the right of survivorship must be disclose<:! on SChedule F. ITEM NUMBER 1, 2. 3. DESCRIPTION ~SECU Bank - Savings Acct. 0162222583 1998 Ford Taurus SE Sedan 4'd VIN: 1FAFP5ZS8WGZ30134 Allfirst Checking: 72435674 VALUE AT DATE OF DE."H 5.99 9 , 135 . 00 6,615.89 TnT,., I~!....... o"t<u "" lin...: PPf:;;ciiulaticnl I s 15,756.88 REV.IS10 EX+ \2.lJ71 "'..~~.~ ,......\-..\ . . ..~:..o.. _"-,='::t- SCHEDULE G TRANSFERS COMMONWE~LTH OF PENNs,nV,t,NI,.l. INHERITANCE TAX ItET\JRN RESIDENT DECEDENt PLEASE PRINT OR TYPE ESTATE OF FILE NUMBER Mary C. Rogers, Deceased 21"':01-0562 THIS SCHEDULE MUST BE COMPlETt:D AND FILED IFTHE ANSWER TO ANY OFTHE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHe::'T IS YES. I _ I r I DECO. DOLLAR V,.l.WE '~ DES,RlPTlON OF PROPERTY EXCLUSION OTAl VALUE i '" OF DECEDEW.s ~UM8ER Include nome of ~he IrcnJerl1e.1he;r re1c:tionship 10 decede~nt: dole Qf Irorufer" I OF ASSET lINT INTERES'. I 1 AlIFirst IRA CD 87006167277524 Transferee - Cindy SOwers-- Daughter Transfer Date - 06-06~2002 23646.70 100 23,646.70 2 Al1First IRA CD 87000026723002p Transferee - Cindy SOwers-- Daughter Transfer Date - 06-06-2002 360.60 100 360.60 I \ I I I I o .. TOTAL (Also ~nler online 7. Rel:QoiIVlclion) S 24,007.30 (fr more "lpo.ce'1 ,,~ded. inu!rt addiliOflol mHn 0; ~ome size.) "".'''''''''"W COMMONWEALTH Of PWNSYL VANIA JNHERlTANCE TAX RETuRN RESIOENr DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Mary C. Rogers, Deceased FILE NUMBER 21-01~0562 Debts of decedent must be reported on Schedule l ITEM NUMBER DESCRIPTION AMOUNT A. FYNffi\L EXPENSES: 1- Eberly's Hill Church of God- Funeral Lunch 100.00 2. Geigle Funeral Home - Cremation & Mennrial Services 1,434.20 .. . . B. ADMINISTRA TlVE COSTS: 1. Personal Represenla~'s Commissklns Name of Personal Representative (5) Social SealriIy Nutnhe<js) I EIN Number of P"""""I Representltive(s) S...t Address CRy Stlle Zip Year{s} Commission Paid: 2- Attomey Fees 4,600.00 3. Family Exempoon: (If decedent's address is not the same as dainanfs. atfadl explanation) Claimant Sb"e<!! Address " City Slate Zip Relatiollship of Claimaot to Decedent 4. Probate F... 243.00 5. Aa:oootanrs Fees 6. Tax Return Preparer's Fees 259.00 7. - TOTAL lA.1so enter on fine 9, Rec-.;pitulation) $ 6,636.20 - - - .. - (If fOOrp. soaca lS needed. Insert addihollaf sheets or the sane sIze) .(V-I3I~f)l_I"'JI ~~~ ~~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS COMMO"'wt...UH OF "NNSl\VAo"'IA INHtlf'1.4N<;f tu lInUIlH USICENT OtC~DE"" ESTATE OF Mary C. Rogers, Deceased Please Print or Type FilE NUMBER 21-01-0562 ITEM NUMBER AMOUNT DESCRIPTION 1. 2. 3. 4 . 5. 6. 7. 8. 9. 10. 11. 12._ 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. Dauphin Deposit lfank & Trust Go. -- Mortgage Int. ~eal Estate Settle~ent Charges PSECU Visa: 162222583 Beacon Medical Group: 3748200 Siegeloaum, Gunder & Lacey Gastroenterology -rogema-OO Physicians of Rehaoilitation-Industrial & Spine Medicine, P.C. Associated Cardiologists - rogema_Ol West Shore EMS: 9069268A Healthsouth Renao. of Mechanicsourg: 400023 Cardiovascular Surgical Institute:2l633-1-l Alstate: 077064317 06/12 Verizon: 7171613760 Holy Spirit Hospital: 16854465 Susquehanna Internal Medicine : 5064 fuffit Pease & Lim Associates :-162222583- Pennsyl vania American Water Co. 24-1167743-4 PPL Utilities: 14520-71001 Penn State Milton Hershey Medical Center 162222583 AllFirst: Checking Fee PPL Utilities Lauren Miller - Lawn Care Donna Liddick - Lawn Care PennDOT - Title Transfer Pennsylvania American Water Co. 24-1167743-4 UGI Utilities West Shore EMS: 9069268A Daily Eye Associates 381.69 8,005.40 4,373.15 95.21 63.06 22.77 309.82 64 .51 76.76 313.31 9.87 46.71 31.19 667.69 38.00 10.35 18.01 275.00 8.50 50.51 105.00 81. 52 58.50 48.99 ~.94 71. 32 20.00 TOTAL {Also enter on line 10. Recapitulation) IS 15,253.78 (If more space is needed. inserl additional she-et~ of sCJm~ :ize.) 1l~.1)13 lX.. (1..1) . CO_ONWU>Ult 0' ,t",HST\Y.l.Hl.l. lHHl'llIT"'ItCJ T,lX Un.:I... USIOll"l'l)lCtl)nl, SCHEDULE J BENEFICIARIES Mary C. Rogers, Deceased FILE NU.\\BER 21-01-0562 ESTA TE OF ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESiATE A. T cxable 8o!GlJesls: I. 2. Cind.:\r Sowers 121 Vine Street Harriso.urg, PA 17104 Donna Liddick 400 Bonnymeade Ave Harrisburg; PAl7nI Daughter 1/3 Daughter 1/3 3. Bonnie L. M:>rris 5506 Grouse Drive . Harrisburg , PA 11111 Daughter 1/3 .-.~ '.....- :; ."> >'.'TEM. NUMBER' :fiJ-~ NAME AND ADDRESS OF BENEFICIARY I AMOUNT'OR SHARE OF ESTATE L B. Charitable end Governmental Be9uesh: 1. -, -, TOTAL CHAR!7.:.3l.'S ;..NC GCVE~NMen~l 8E'::;UESTS {AJJa IMler on line 13, Rec::!=iruic:ionj is fIF more spGca i: needl1d, insert additiiOnai :hel1h of :ame :i:u I LAST WILL AND TESTAMENT OF MARY C. ROGERS I, MARY C. ROGERS, of 1807 Letchworth Drive, camp Hill, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, declare and publish this as my Last Will and Testament, revoking all prior Wills. FIRST: I direct that the expenses of my last illness and funeral shall be paid from my estate. f:. '( 1. I direct my Executor to payout of my estate the cost of the perpetual care and maintenance of the burial plot in which I shall be buried, should arrangements for same not have been concluded and paid for prior to my death, and also the cost of an ". appropriate tombstone. SECOND: I give and bequeath to my husband, ,GEORGE E. ROGERS, any automobiles, household and personal effects and other tangible personal property of like nature, which I may own at the time of my death, providing he survives me by ten (10) days. 1. If my husband, ,GEORGE' E. ROGERS, does not so survive me, I give and bequeath my tangible personal property, in equal shares, to my daughters, DONNA LIDDICK, BONNIE ROGERS, and CINDY .ROGERS, or to the survivors or survivor of them. THIRD: All the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and wheresoever situate, I give, devise and bequeath unto my husband, GEORGE E. ROGERS, providing he survives me by thirty (30) days. 1. If my husband, GEORGE E. ROGERS, predeceases me or does not survive me by thirty (30) days, I give, devise and bequeath the residue of my estate to my three children, in equal shares. FOURTH: All Federal, State and other death taxes that may be assessed because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this' my Will, shall be paid from the principal of my residuary estate as part of the expense of administration of my estate. FIFTH: I nominate, constitute and appoint my husband, GEORGE E. ROGERS, Executor of this my Will. 1. In the event that my husband, GEORGE E. ROGERS, fails to serve or to continue to serve as Executor, I designate and appoint my three children, DONNA LIDDICK, BONNIE ROGERS, and CINDY ROGERS, as substitute or successor Executrixes. SIXTH: My Executor shall have power to compromise claims and controversies; to sell at public or private sale any real or per- sonal property, and to make distribution of my estate in cash or in kind. 1. My Executor shall not be required to furnish a bond in any jurisdiction in which he may act, and if bond is nevertheless required, it shall be without surety. ~WITNESS WHEREOF, I have hereunto set my hand. and. seal this day of ~, 1978, at the end hereof, composed in all 0 two (2) pages. ;(J~ ~ ..:) . o~ e.j~ "';f/A--e/ Mary C. . ers / (S~) ~ i' ~; SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, MARY C. ROGERS, as and for her Last Will and Testament in the presence of us, who, .at her request, in her presence and in the presence of each other , .all being present at the same time, have heEeunto set our hands as witnesses. ~; v , Name /14; ((./JkJ Name ';f:,-lift,f~' )17 1J.,.lA~.J Name /~l' If j/' It Address 1~,;11 Address .!1/p?/' X/;'/:l1, ~ , Address ~;~A~J/,/f {;,~ .~. ".,. ,'''' ,;~ ~ t' i~> COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712B-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BROWN MICHAEL V ESQ 27 NORTH FRONT STREET POBOX 1284 HARRISBURG, PA 17108-1284 ___nn_ told ESTATE INFORMATION: SSN: 162-22-2583 FILE NUMBER: 2101-0562 DECEDENT NAME: ROGERS MARY C DATE OF PAYMENT: 02/08/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/06/2001 NO. CD 000837 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,399.84 I I I I I I I I TOTAL AMOUNT PAID: $4,399.84 REMARKS: CINDY A SOWERS C/O MICHAEL V BROWN ESQUIRE CHECK#1025 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. lEWIS REGISTER OF WillS "'v /6 -c54S6 - /6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG, 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 MICHAEL V BROWN ELLIOTT ETAL PO BOX 1284 HBG '02 f\PF( 1 2 ESQ P 1 :'-)3 L,. PlAl,QJY,108 ~ 0 158 04~08-2002 ROGERS 06-06-2001 21 01-0562 CUMBERLAND 101 RfY-15it7 EX AFP (01- 02) MARY C Amount Remitted (1) (2) (3) (4) (S) (6) (1) (9) ClO} CHANGED 79,900.00 .00 .00 .00 15,756.88 .00 24,007.30 (8) 6,636.20 15,253.78 Cl1) Cl2} Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax 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-1547 EX AFP (Ol~02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ROGERS MARY C FILE NO. 21 01~0562 ACN 101 DATE 04-08-2002 T AX RETURN WAS: (X) ACCEPTED AS F I LED * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 119,664.18 Cl3} Cl4} 21.889.98 97,774.20 .00 97,774.20 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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. 10. 11. 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return 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 (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 97,774.20 X 045 = 4,399.84 .00 X 12 .00 .00 X 15 . DO Cl9}= 4,399.84 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02~08-2002 CDOO0837 .00 4,399.84 TOTAL TAX CREDIT 4,399.84 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 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.} RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Com.onwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTI ONS : DISCOUNT, PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF MILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, 8ureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, HarriSburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-ISOI) for an explanation of administratively correctable errorS4 If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1. 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. I. . Name of Decedent: Date of Death: Estate No.: Will No.: (t V l~.)~ C I STATUS REPORT UNDER RULE 6.12 Mary C. Rogers June 6, 2001 2001-00562 PA File No.21-01-0562 Pursuant to Rule 6.12 ofthe 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 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? 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Date: June 4, 2003 N ,~" ,,:--:' .-- E:: UI I "?'" :s J ~,:;~: cI: ~~ l""') p ELLIOTT REIHNER SIEDZIKOWSKI EGAN & BALABA By: " ./ ichael V. rown, Esquire Pa. LD. #. 9984 27 N. Front Street P.O. Box 1284 Harrisburg, PAl 71 08-1282 717-234-3282 717-233-4264 (facsimile) mvb@erse.com , ~ -' ,U - }.: ..~.~ == ~Jc Capacity: Personal Representative X Counsel for personal representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 .- . Date: 5/07/2003 ROGERS CINDY 121 VINE STREET HARRISBURG, PA 17104 RE: Estate of ROGERS MARY C File Number: 2001-00562 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: 6/06/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: JFile Counsel Judge