HomeMy WebLinkAbout01-0657
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of f'"red /)/):A,. P J.J H60vR-f No. 021-0 J - t:,$j
also known as To:
Register of Wills for the
County of in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
, Deceased.
Social Security No. j 8''' 0:5 7 I 2.. t.JJ
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last will of the above decedent, dated 0 q / I 7 / 1C}(o ~
and codicil(s) dated J d / I) 4 / i q })q { {
( I
named
,19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in
h last family or principal residence at
In'-doll t. k'Fl -!nfOYl.J h..:;p
(list street, number and muncipality)
De~endent, then H years of age, died . ) ic '1 7 , ~...) t>o "
at l:.uilVl~r/(1 .-..(') (Y'[l ~ \' III'. q,f .
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:
$ 35.000.00
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron.
"*
(testamentary; administration c. t.a.; administration d. b. n.C. La.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
{~LUV~~~
Sworn to or affirmed and subscribed
before me this 10th day of
7l11"f C. i.;~~ ~".pl! <:,y~~2Q.QL
I gister
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No. 21-01-657
Estate of
FREOONIA R. HOOVER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JULY 11 ~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 Sept. 17,1968 COCICIL DATED: NOV.9,1984
described therein be admitted to probate and filed of record as the last will of
FREDONIA R. HOOVER
TESTAMENTARY
BARRY LEE HOOVER
and Letters
are hereby granted to
7Yll},,4 Q..~.v-<.. llJ,.,.. P.8.~
. _ Re~ster of Wills
FEES
Probate, Letters, Etc. .........
Short Certificates( 1) . . . . . . . . . .
~iiW~fion ................
Codicil
JCP
$ 70.00
$ 3.00
$ 6.00_
$ 10,50
5.00
TOTAL _ $ 94.50
Filed .... .~X. n.,.~QQJ... . .... . . . . . . . . .
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
:1
__ . ~ ^ oJJ \ Il )
HIOS.80S REV ~/B(l
This is to .certify that t~e. inform~:ion he~e given is correctly copiS,d from an original certificate of death duly filed with me as
Local RegIstrar. The ongmal certificate wIll be forwarded to the'''~tate Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photC?stat or photograph.
21-01-657
Fee for this certificate, $2.00
p
7431501
No.
~~Lx~'~
JUL 0 9 2001
Date
,143 FWt. 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
. SWfFU_
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. isbJrg, . PA ::- 0 f_ 0 0Q4 0 .--J:=-- ~
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CUmberlarrl Crossings ---
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""" DECEDENT EVE~" DECEilEKr$EDUCRION . """",,,-sWUs'._
u.s._DFOACElI1 ___
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...._..Jiiddlesex
_ OF DECEDEHTtf... _. c-.
t. Fredonia R. Hoover
AGE Cl- _ UNDE~ ,_
- Do,o
s. 89 v,..
COUNTY OF DERH
UNDE~ 1 ow
-!-
.
.
CUmber larrl Co.
..
Middlesex Twp.
DECEllENT"S_~ ICINDOF
. _al____
~te......--I
1~ ,
1lECBlEMT'S___........~._1Ip~
, l.a1gsdorf Way
... Carlisle, PA 17013
---,..._.~
1 W~lliam Blyler
~-(T~ Hoover
MElMlOOI'
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,...
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1:;i-=--~YHo
. __SPOUSE
..----
..
PA 17070
PUCE 01'
.00... _
Rolling Green Cemetery Allen Twp. ,PA 17011
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AMD_CWIlOClUTY
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UCENSE..-.. __
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DUE 10I0Il AS A COO&OUENCE Of):
No
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OR'E OF IMJUIlY
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CODICIL TO
LAST WILL AND TESTAMENT
OF
FREDONIA R. HOOVER
I, FREDONIA R. HOOVER, of New Cumberland, Cumberland County,
Pennsylvania, declare this to be the sole Codicil to my Last Will
dated September 17, 1968.
I - I bequeath my opal ring with diamonds unto my granddaughte ,
Monique Rigling.
II - In all other respects, I hereby ratify, confirm and
republish my Last Will dated September 17, 1968, together with this
sole codicil as and for my Last Will.
~ITNESS WHEREOF, I have hereunto set my hand and seal on this,
the! . day ofr~~~L1.) , 1984.
I .
~~R~
redonia R.'Ho6 er
(SEAL)
Signed, published and declared on the date thereof by the above named
Fredonia R. Hoover as and for the sole codicil to her Last Will dated
September 17, 1968, in the presence of us, who, at her request, in her
presence, and in the presence of each other, have hereunto subscribed
our names as witnesses hereto.
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Nam;e '-. " I,,/J
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Name
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Address
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ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011
CO~~10NWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
WE, the undersigned, the testatrix and the witnesses, respectively,
whose names are signed to the foregoing instrument, being first duly
sworn, do hereby declare to the undersigned avt~ority that the testatrix
signed and executed the instrument as h~r ;f2~f:CW!1!O and Testament and
that she signed willingly (or ,..,.illingly dlrected another to sign for
her), and that she executed it as her free will anq voluntary act for
the purposes therein expressed, ana that each of the witnesses, in the
presence and hearing. of the testatrix signed the will as wi tnesse's and
that to the best of their knowledge the testatrix was at that time
eighteen yearsbf age or olderl of sound mind, and under no constraint
or undue influence.
l;vJ~?II~
." Testatrlx
v1i tness
~Jd A~~L~
. W tness . .
and
day
Subsc:-ibed,. sworn to and acknowledged.'befo:-e me by the. test~tr.:i.,..x,
subscrlbed ahp sworn to before me by both wltnesses,-thls )?~
of ~~() , 198L. .
~. )f!u~~1
Notary u131ic""
BAReARA N. KINN. 0I0T,(Ry PUBliC . .
r~MP Hlll BORO. CUMBERLAND COUNTY
M"( CCMMISSION EXPIRES APR. 22. 19'85
r.ie:nbcr, Pennsylvania Association of Notaries
ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET. CAMP HILL, PA 17011
LAST WILL AND TESTAMENT
OF
FREDONIA R. HOOVER
I, FREDONIA R. HOOVER, of New Cumberland, Cumberland County,
Pennsylvania, declare this to be my Last will and Testament,
hereby revoking any will previously made by me.
I - I devise and bequeath all of my estate of whatever
nature and wheresoever situate to my husband, Jesse H. Hoover,
providing he survives me by thirty (30) days.
II - Should my said husband fail to be living on the
thirty-first (31st) day following my death, then I devise and
bequeath all of my estate of whatever nature and wheresoever
situate unto my son, Barry Lee Hoover, per stirpes.
III - I appoint James K. Arnold, Esquire, of Camp Hill,
Pennsylvania, guardian of any property which passes either under
this will or otherwise to a minor and with respect to which I am
authorized to appoint a guardian and have not otherwise specifi-
cally done so. It is my intention to appoint my said guardian,
James K. Arnold, Esquire, as guardian in all of the instances
where I am authorized by law or permitted to do so. Such guardian
shall have the power to use principal as well as income from time
to time for the minoris education, support and welfare without
further responsibility to the minor or minors or to any person
taking care of the minor or minors. It is my intention that the
foregoing powers may be exercised by the guardian without prior
court approval. The said guardianship shall terminate as to each
beneficiary when he or she reaches the age of 21 years, at which
time his or her share of the principal and any accumulated income
shall be distributed to him or her absolutely. The interest of
the beneficiary or beneficiaries hereunder shall not be subject to
ARNOLD 8: SLlKE
anticipation or to voluntary or involuntary alienation.
UTORNEYS AT LAW
Page 1
2109 IIARKET STREIT
CA.MP HILL. PINNSYLVA,NIA
IV - All taxes that may be assessed in consequence of
my death of whatever nature and by whatever jurisdiction imposed
shall be considered a part of the expense of the administration
of my estate and my personal representative or representatives
shall have the absolute power in his or her discretion to pay the
same at once whether or not the law under which they are imposed
permits the postponement of all or part of them to a later time.
v - I appoint my husband, Jesse H. Hoover, Executor of
this, my Last Will and Testament. Should my said husband fail to
qualify or cease to act as such, then I appoint my son, Barry Lee
Hoover, Executor of this, my Last Will and Testament. Should my
said son fail to qualify or cease to act as such, then I appoint
the said James K. Arnold, Esquire, Executor of this, my Last Will
and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on
this, the
17rll
day of ~e.MA6R , 1968.
~ - ~;J), I
~v'. ~-,~
Fredon a R. Hoover
(SEAL)
Signed, sealed, published and declared by FREDONIA R. HOOVER, Tes-
tatrix therein named, on this and one (I) other sheet of paper as
and for her Last Will and Testament in our presence, who, in her
presence, at her request and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
~)/tU _ Pa.
Address
ARNOLD III SL.lKE
~~,A.
Address
ATTORNEYS AT ~AW
2109 IIARKET STREET
CAIIP HILL. PENNSYLVANIA
Page 2
21-01-657
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_
Register
(Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
DEBRA S. HOOVER AND BARRY L.HooVER
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
WE ARE familiar with the signature of FREIX)N'IA R. HOOVER
~
will
testat-RIX- of (one of the subscribing witnesses to) the
presented herewith and
~
believes the signature on the will is in the handwriting of
that
WE
FREIX>NIA R. HOOVER
to the best of
knowledge and belief.
THEIR
Sworn to or affirmed and subscribed before
me this 10th day of
nUN ~~
/Y1Q.1 e,~j p~PE. ..
Regl er
D1tf:-~Jf::::;-
(Name) . Il
q (p {l a r 0 I PI t:LL ~ Ne0 lVJY\bJ ({(1J( cA...
. . (Address) ~f~
.]3o,-"ri L, 1fc;?c:/C/'<2 r
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CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Fr.u::Jon:a- R, ffc/c?I)~1
Date of Death: 01 ) {y // ~r7 r
Will No.: :::J.Ij'dl-CJCJ6~? Admin No.:
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 (57//010/ :
Nam~
Address
".
tn()n i?; u-e.... f< 1,3 t I ~
b~ Upp~r Y~t-.k IR.~/
f1J.e.w If#pe/ P&- / ~93g
q ~ ~17; rCJ( cP I ~-C" ~~
f~n~/7->7~-7~~
Pew CurrJ:.~r-Id? n4/ Par" 1,/t?7L?
ph/.1f7-t2- #::' ~~-
7tfll--e?3~
J3t2-rry /,..... -if6'tt?o.p r
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: /c:lI9/C?1
47 ~, 1ho'U..(>~------C {;,k-- ,;:b,A '\
Slgnatur -r -------y
ErP -r' ry L.. -fltC?([? (I t<? r
Name
Capacity:
~r:;? r~r6>! P/C12-C-e.-. rJeW CVI'Y) f,;e.r-{a~
Address / ~, i >-,?77c:
71 >-7 '7 r.f- '72r{l::2
/Telephone
~ Personal Representative
D Counsel for personal representative
REV-1500~X (6.00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY (...,
/ ~ - ;('1 3 ~;;~__~___
FILE NUMBER
.2L-OL __~57
COUNTY CODE YEAR NUMBER
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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W
(,)
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
FRt::O
SOCIAL SECURITY NUMBER
18~-05 -7/2.0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
DATE OF DEATH (MM-DD-YEAR)
07- 1-0 10-ll.rll
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
o 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date o/death after 12-12-82)
D 7. Decedent Maintained a Living Trust (AttachcopyofTrust)
D 10. Spousal Poverty Credit (date of death betwwn 12-31.91 and 1-1-95)
o 3. Remainder Return {date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (AttachSch OJ
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NAME,
COMPLETE MAILING ADDRESS
q(p (!.-fIJeOL PUf<!..E
NE W ClAfVl6Ete.LI'/-^-J{j PIl J/C'70
FIRM NAME (If Applicable)
2.
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
OFFICIAL USE ONLY
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1)
(2)
(3)
(4)
(5)
952.1-01
2g/31?,,23
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(8)
37 2'04.24
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
q 4-S 0
5 t &'t/ .110
,
5:rlgyo
2),,;) ("tLJ,YLj
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
(12)
(13)
12. Net Value of Estate (Line 8 minus line 11)
13. Charitable and Governmental 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)
,~.:< (oly,t<-{
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x,O_ (15)
(" I y. R-L x o 'is (16)
llYLDt (01
3;;).
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
x ,12 (17)
x ,15 (18)
18. Amount of line 14 taxable at collateral rate
19. Tax Due
(19)
I :--1l.,,1-1r.1
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
CITY
ZIP
1'70
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditsJPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) ~ ~{,lLJ{
Total Credits (A + B + C ) (2)
..,-
3.
InteresUPenalty if applicable
D.lnterest
E. Penalty
. in~
.' tcy
4.
TotallnteresUPenalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 line 20 to request a refund
(3)
(4)
(5)
(5A)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
<oy_
\ Y (o;;? ~ I
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
IF- . ~]1I1i111~1111IJlm1 "--!!I;'i\'11 -- !II nlll1l11~ --
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 ~
~. ;:::~ :h~e:;~~i:~:~s:~t:~::;:~shaHuset~~~r~~erty transferred or its income;. ...............................: B ~
d. receive the promise for life of either payments, benefits or care? ........ .............. 0 IBr
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .. . ............. .......................... ........ D I&J
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. .... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.... ................ ................
"I
.....0 C2'l
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 perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other than the personal representativ eisbasedon all information of which preparerhas any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
O~loJ/O"L
, ,
e.. e..
SIGN!lT~RE OF PREIJAR R OTHER THAN REPRESENTATIVE
bJ!..Llu-,L ~
ADDRESS
q& ~/"I()I f/6.ce tJd..w D"I^,borlc.v>(f fA
II!lIIilL-~U W.1Il1 :U__I__ilL I mlll_ "~.."_, _IIIiIL~... -Ll1I ~.Il!lJlllrJIIILU.llUIlll_1
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)l.
po 70
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot 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 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)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(111.
The tax rate imposed on the net 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.
~'OO"'.(197~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF .
Hoo LIE (2 flZe OotUlA I<
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
Lufhera.!) Bro+hUhOOd Fund-A (54)
LuH-QraV\ t>ro+t-.uhood ru.lI\d - Pr (55)
?.
2(P &Lfl. ~g
I 12 S.35
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ 2 ~ ~13 ,L '3>
I
REV'''",.I'~'')..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
1-100 V E- rc.
('(<6- OON I fl
f2.
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
PNC. 6AiUV- 1U4 CItF-~k.JN& ACJ2T SD-ODCfCj-S8YJ
QS2..I.01
TOTAL (Also enter on line 5, Recapitulation) $ CJ 5 2../ _ 0 I
(If more space is needed, insert additional sheets of the same size)
REV-'5'3,EX+ (9-00*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
NUMBER
I
RELATIONSHIP TO OECEDENT
NAME AND ADDRESS OF PERSON IS) RECEIVING PROPERTY 00 Not L1slTruslee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 la) 11.2)]
f3t:Jt<.P--Y L- /-foo 1/ E It.. So 10
C)(p Ct4e.OL PUtt! E-
N P--w L.U(YH6e.~LA-NO P4 I/o 70
1.
AMOUNT OR SHARE
OF ESTATE
j(
32-(Pt4,6'4
loa /0
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS 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
,.
TOTAL OF PART Il- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert addltlonal sheets of the same size)
REV-1511 EX+ (12-99) .
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
1--/60 V ~ R... F 12..6 00 N I A
FILE NUMBER
I<
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
L
B, ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/E1N Number of Personal Representative(s)
Street Address
City State _ Zip
Year(s) Commission Paid:
2, Attorney Fees
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Cill State __ Zip
Relationship of Claimant to Decedent
4, Probate Fees Cum6E,z(A/V!) CWNtJ, R~G;.stF-1( of 0, LL.\
'R-E-C!.C/pT tb /02. /q, Qtj.50
5, Accountant's Fees
6, Tax Return Preparer's Fees
7,
TOTAL (Also enter on line 9, Recapitulation) $ qtj 51)
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
RtV.1512EX.(1-971
ESTATE OF
-~
"
n., .
~ :-
SCHEDULE)
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
H DO V E tZ 1212. E 00 N / A
1<-
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
L.
2;>.
L{.
5.
DESCRIPTION
,
C. Um6 E.e LAN 0 CR..OSSIN b.!: RcneE-mEN r COfnm.
CU.m,5F-I<LffN 0 Ctz.O's'S/lV6-5 R.e 7; te.E me tV T COMVI'\L.(Y[ [-I-y
Ptu:. r<. T P hA-R..Vhllc.lj S€-(2..UI LI2.. J:-YIJ ~
.
CA /2. LI S L. E Trn A b/ t\JG. AS,S oc..
Qobev"t C, CAtr<.ytd -r:C.
AMOUNT
5 oCiQ. (? 5
5'- 00
II. *1
I q I
ILI-IO
TOTAL (Also enleron line 10, Recapllulation) $ 5 I gLj. q 0
(If mare space IS needed, Insert additional sheets of the same size)
DEBRA S. HOOVER
717 774-7282
96 CAROL PLACE
NEW CUMBERLAND, PA 17670
. -;"
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1319
s
BARRY L HOOVER
DEBRA S. HOOVER
717 774--7282
96 CAROL PLACE
NEW CUMBERLAND, PA 17070
.'
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BARRY L HOOVER
DEBRA S, HOOVER
717 774-7282 1
96 CAROL PLACE 1/ .! -., .:;.- ~
-7 '/ "/
NEW CUMBERLAND, PA 17070 -' 8,o,L FOA 0
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CHECK HEAElf TAx OEOUCT:etE ITE\I
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For added security, the
account number no longer
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PNC Bank. N.A. 040
Ct:nlr:t)PA
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BARRY L HOOVER
DEBRA S. HOOVER
"
717774-7282 - ~ 7: ~,::)
96 CAROL PLACE ~ ,--
, , NEW CUMB.E~LAND, PA 17070 !l,foL fOfl 0
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DEBRA S. HOOVER
717 n~7282 1\
96 CAROL PLACE ' ~ .J..)l.~':r-r~;;'c;1
NEW CUMBERLAND, PA 17070 ./' j/l>M-.?CII'O
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Catlral P A
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For added security, the -- - -
account number no longer
appears on this copy.
J.SSESSMENT
31Ll NO. C 2
';.,u 'f~M
2001-02 PERSONAL TAX NOTICE .. SCHOOL
SOUTH MIDDLETON SCHOOL DISTRICT
lUKE ~:'EC~S ~~O.E1L:. ~o:
,... ." . -, ..... .. , ,-,
MI OLifllNG ~IS ?~Iaa I
JULY-AUG 31
SEPT-OCT 31
AFTER OCT
I
j) /..LL/3 LAST DATE FOR EXONERATION
CAl'-ec13: 12/01/01
-rr- C?-;L---u UNPAID BY 05/15/02 TAXES
7/ WILL BE TURNED OVER TO
;/~~~~;' DELINQUENT COLLECTOR.
17070 ACCT # 040-0009978
ROBERT C CAIRNS TAX COLLECTOR
20 BUCKTHORN DRIVE
CARLISLE PA 17013-4303
PHONE (717) 249 1453
SCH pic
--1,0 ".P
seH RES
lO".p
SCH acc
1 a....? 9 7 0 . 0 ..-1
,
.,
9.80 :
10.00
11.00,
I
.,
4.90:
5.00,
5.50'
HOOVER, FREDONIA
C/O BARRY HOOVER
96 CAROL PLACE
NEW CUMBERLAND PA
DATE
.. JULY 1 2001
~. MON TUE WED 9:30-5:30
CLOSED SEPT 17 THRU 28
CLOSED DEC 20 THRU JAN 01
AFTER JAN 01 OPEN MON & WED
3511
'~,?
1,l1 ....?
DISCOUNT
FACE
PENALTY
"~J" r~. "~
::1.\, ;?'l:l$ ~"'O\JHT .
\.. U.70/
~ 5:'ml'
16.50
IF~Q&l.DlSlu.mlJl": IIKtDS~A.Sr.Ullltll ADCIlUSia: EltVELOPE....I""'OU"CllIIIISo.
JOB TITLE: FULLY RETIRED
DEADLINE TO CORRECT OR APPEAL JOB TITLE IS 90 DAYS FROM DATE OF BILL
CALL 240-6365 OR 697-0371 EXT 6365 OR 532-7286 EXT 6365.
I": T . :"1) I, L"(
:-[;',:IJ; ,::':1
. :c:
','J."
.
::: 1 '3 r~ 1:1 j;'j:, 8 i" I. T [ ,-; I) e:: A/ _ ,
O'
.0
AMOUNT
24.67-11
,-.:. 04
...'..J. I
3 . 44., I
7 .0,:., I
7.0 v.;
I I; ,: T :=' H,~ P ~ A C Y '3;: ;.;., ./ ., , 11'\ I:
DESCRIPTION
~0i21/01 Payment-Ihank You
"';/28/01 Paym~nt-Than~ YOI)
.. ACrrVITY FOR HOOVER, FMEOONIA
JlieS 01 6476139 480 POTASSIUM CHl0R 2
J'. OS 01 6529214 30 PReVACIO 30 ~G
t6 01 6529240 6 PHE~EPGAN 25~G SU
.1 I
":1 1.:37
Y T D F rr~
I I
.. .~-~.:~_...-
;t;,;~-:~--:~.
C H A R lirE
~''''"o'';''''''''''''l r."."'......"'.....""""'l rot".",. '''''''.;'1
49.71 + 17.44 + .00 =
fTEM TOTAL
II
2~.57-
. IJ rJ
'25.04-
-HOO\lF
. ,';),;]
01
'H
o l
3. l.j 4
. (: IJ
7.00
7.00
. ,) 0
.00
17.44
LEG E r~ D
Fl R MONTH
. .
d
7(/?/~(
I I I
( 3 2c)
(.....'.'....m....."."'..l
_ 49.71
=
17.44
67.15
07/09/01
07/09/01
Adj~M~di~~~;-w~it~of. -..
Plan Payment,1029750
Questions? Call (717) 249-2482
MAKE CHECKS PAYABLE TO:
PROVIDER/
P~ACTICE NAME Patient Accounting Services
107/17/01
,',,;".\ -EMENT DATE
083658-00
CARLISLE IMAGING ASSO
I DATE CF LAS"!"
PA'fMENT
11 .43-
7.66-
)/~N
~
13J-!.
0.00 0.00 0.00 0.00
OVER:HI AYS OVER 90 AYS
7:::1A,\lS.4.CT10NS AFTeR THE CLCS;NG ],..l,j'"E 'N!!..:" ~.??=..':.,~ C,'l '(C!~'R ,\i;::;~7 :;-...l,7::,i::.'r
;~.
101/01-07/06
\ 0'/n7/2001
120 DAYS
.00
Balance Forward:
MONTHLY ROOM CHARGE
PR PRIVATE IN
For: FREDONIA R. HOOVER
90 DAYS
60 DAYS
4,262.85 4,262.85
888.00 5,150.85
5,099.85- 51.00
d
111-8
30 DAYS
CURRENT
.00
.00
CUMBERLAND CROSSINGS RETIREMENT COMMUNITY
.00
':.1.00
TOTAL
DUE
.~
;/8
;--
RECEIPT FOR PAYMENT
===================
Cumberland County - Register Of Wills
Hanover and High StreeE
Carlisle, PA 17013
Receipt Date
Receipt Time
Rece~pt No.
7/11/2001
09:05:58
1026191
HOOVER FREDONIA R
File Number 2001-00657
Remarks BARRY L. HOOVER
PB
------------------------ Distribution Of Receipt ------------------------
Transaction Description Payment Amount Payee Name
PETITION FOR PROBA
SHORT CERTIFICATE
CODICIL
EXTRA PAGES
JCP FEE
70.00
3.00
10.50
6.00
5.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
Check# 1310
Total Received...... ...
$94.50
$94.50
../
~~,
CUMBER~~R~~~~SINGS
CUM8ERLA~D CROSSINGS RETIREMENT COMMUNITY
1 LONGSDO~F WAY
CARWSLE, PA 17013
'-717.245-9941
F~EDONIA R. HeQVER
lJlHmy 1 r,J:. J.ILlCJlI[I.:
'i'11 clH:'i'n.. r"U'ICI':
NL~ CUMD~RLAND. PA 110/0
DATE
i
I; {, I.: :3/.: () 01.
!or,/OI--0{,!:;l0
~O/l/ 1 ~l/i:~()Ol
O"I:;rO!:,OOl.
'06;:)O!.:OO t
()/)/~.\(}/~~()()1
i)b/:JO/200 .1.
06/:"O/;:~()O:l.
:)(,/:;rO/2001
t7/01.!OI
I
I
I
I
I
I
,
!
120 OAYS
.00
I" ""., 1"1':1': 1I1'l1,lll\ R. HQDVI::F
11.1.....':'
- DETACH AND RETURN UPPER PORTION WITH ReMITTANCE -
DESCRIPTION
I:~i14."/ jill'l(~ (.I ~'(:)r'"u~,..d ~
r>I'~ FIn: VA l'E IN
MOm HI.Y f\UIl~1 CI"'l'im:'I"
TRANSPDRTATION/CNA
:1. IHilJR LAtlllR GI-'I1~I,r.)":
r::.~18URI~ f'lIlJlJING
I~I':AI. HHmAI<fi:
OXYGEN lUOING 2S'
MIU!..'!' '.JPI::r.
,
1 nXYI.'lE'j'j ~IAHAI. GANNU!..A
'61';(~ V~I:::l~HU;I~ ~I,I'; ~11!JoP- Ju Iy)
P fTJD
~-4f:-/3/1
7/ if3/tJ/
I'l~n n<HIr:JHJA 1,_ HtJrJVER
eo DAYS
.<l0
eo DAYS
. (H)
30 DAYS
.00
DEBIT
411'J9l..~;:~3
IL, IW'l. 00
:\,~;i ..00
~';~~~" 4.t~
:I.0.7E1
:2:.. ;39
1(;'" :':~7
:1." :"1
~~:; " I"
'33 "). PO
STATEMENT
DAiE I
06I:cN/":O():I. I
I TOT~ A~T. ,D~E I
; oil j ,..61:'.. d.';' I
~ gJ'i. ~ (~
5 D'?'1 ' ~
C~E~IT
BALANCE
I~ '.I "1 r; 1. '. ~.~~:;.,~
I~/(il "~~t~i
.(}()
I, :I.Bc..OO
I, ~,~()O .O()
) 'J ~~;~7 " 'I/.I
I ~ ~':~:21:::1 ~ ?i:~
I ,~?::'fJ . 1.);1.
~,,;::!::;t,.. DB
I, ~ "~~~:;/,, 0 9
I " ;~ ll:;'~ _ f.) !:i
SOQ9.'l.l
1.:1.1. '-1.1
CURRENT
4 t '26(~ ..1:)\:;
CUMBERLAND CROSSINGS RETIREMENT COMMUNITY
.'
.
----~
TOTAL
DUE
.,. 4,262.es
$i:R? If,)"
I . 1-.." .
Bal~n~iForward: 4,791.25 ,791.25
06/2~i/2001 PR '~''pRIVATE IN 4,791.25- .00
06/,01-06/30 MONIHl.;;Y,f ~OOM CHARGE 4, 18~;.00 ,185.00
(>6/19/20'01 TRANSPORT~TION/CNA 15.00 ,200.00
1 HOUR LABOR CHARGE
06/3012001 ENSURE PUDDING '..... ~ . 22.44 ,222.44
C 6/:<0/2001 HEALTHSHAKE 10.78 ,233.22
06/3012001 OXYGEN TUBING ~C'''' 3.39 ,236.61
",,'
06/:<0/2001 AtlULT WIPES 19.27 ,255.88
06/:10/2001 OXYGEN NASAL CANNULA 1.21 ,257.09
06/30/2001 PREFILLEtl HUMIFIER BLTS 5..76 ,262.85
,
I for': FRElIONIA R. HOOVER 111-B
120 DAYS 90 DAYS 60 DAYS :30 DAYS CURRENT TOTAL ~
I .00 .00 .00 .00 4,262..85 DUE 4,262.85
CUMBERLAND CROSSINGS RETIREMENT COMMUNITY
,_.
." -
Checking Accolmt Statement
~.PNCBAN<
.\nollnl nnl11h~r: 50.()lJ99-5848 ~ continued
For the period 07/12/2001 to 08109/2001
FREDONIA R HOOVER DECO
Primary account number: 50-0099-5848
Page 2 of 2
1::' For 24-hour customer service:
Call: '.aaa.PNC.8ANK
Activity Detail
Deposits and Other Additions
:It!!
Amount Description
19.00 Direct Deposit. Soc See
t"S Tre;1SlilY 303 1:31OI.'KdiD
There was 1 Deposit or Other Addition
totaling $19.00.
'17"11.
Other Deductions
CII,!
Amount
Description
Olitst;1ndin~ Item Clo.se
"'itllllr:lwal Tel (HOO!)ll iO~ f)~19
There were 2 Other Deductions totaling
$9,521.01.
- III
.()()
9,j:!I.01
(t;- III
Daily Balance Detail
[,!e
Balance
~1.j(J';!.O I
Dale
OJ,'ll)
B,Jlance
~),j:!Ull
Date
()711~)
8.JI.Jnce
.on
('7' 12
Want a Quick, Easy and Convenient Way to Apply for a Loan?
[,Ilg Oil tu the Loau Ct'lIter tOllay. The Ln,lll Ct'tHer off...,!".:; oulilll' acn~ss ru a variery of loau programs. The site is secured with a
] :~h It'n'lol' l'1lt"ryptioll ;'lud, hest uf all. pHI C'ollht hare yuur loan derisioll ill a lJl;tUer of lIlinlltes! Cn tu
v.ww.pncbank.com/offcrs/luan/ aud dlt'ck otlt our special offer.
---. --'--_.-----_.~-~----_._.._--_._.-. .._---~- .-.-.-.--
-
Checking Accotmt Statement
I':\C lJ.lllk
G. PNCBAN<
Primary account number: 50-0099.5848
Page 1 of 2
For tI,. p.riod 07/12/2001 to 08/09/2001
<
Number of enclosures: 0
,
FREDoNIA R HOOVER DECD
cia BARRY L HOOVER
96 CAROL PL
NEW CUMBERLAND PA 17070-1101
~ For 24-hollr customer service or
ctlrrent rates: Call1.S88-PNC-8ANK
l8J Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
g Visit liS at www.pncbank.com
'=">
I TOO terminal: ,'-800-531-1648
For he:!! 111<:;" lI1\(laIH.,j dl~n'~ onIv
Important Account Information
Consumer Electronic Funds Transfer Disclosure Statement
I )111' n'yjsed policy 011 fraudulent Use o( your CUl\5UH\Cr Check Card (ur ~on-PIN plln:hases surpasses protections m<lllllared by
'~dl'Ld regularion. Quite silllply, PNC I'tank Consumer Check Cardholders .ue liable for $0 uf Non-PI~ purchases thai are
'('\l'rminetl by Us to be unaHlhor1-J.t'I\. whether mall.... in Pl'r.SOIl, nVI'r rhe phone, nr ontlw \\"ol"1d \Viele \"el>. For additiull~ll
J ll'lJllllatioll, please re\"it~,,, the enclos....d COtlSlIllll'r Electronic Funds Tr;msfer Disclusure Sr:1t....lIlelll.
Get With Our Program. The PNC Bank Student Plan.
I Ll'..... ~~ child going to college? "'hy 110t tl'lllhem about 1Ile PNC Bank Stud....nt Plan account? Any college studellt is eligihle fur
I i lis account, which fc;uurcs a checking accoullt, free PNC B,mk check card and a li'ee savings account. l>!us, th....re's 24-l\onr, 7-day
.1l'''t'SS to allY of our more thall3100 PL\iC Bank ...\T~'I5 allllAccollllt Link ~ll pllcbatlk.colll. Best of::1l1, not only will your child havt"
r (Jlln'lliellt access to their accollllts, you rail link the accollnt (0 yours (or easy cash tr"nsf~rs. CaB 1~888-P~C.BANK or stop b~'
Y1HII" local branch orfice roday to open an account.
Checking Account Summary
A...:count number: 5Q-0099-5848 Account link ~ number: 0184057126
Fredonia R Hoover Deed
Balance Summary
Beginning
balance
9,50~.0 I
Deposits and
other additions
El.OO
Checks and other
deductions
0,521.01
Ending
balance
Please see the Activity Detail section for
additional information.
.00
Average monthly
balance
2,~U5.5j
Charges
and fees
.00
Transaction Summary
Checks paidl
withdrawal s
Bank card/POS Account Information
transactions assistance calis
Teller
transactions
o
o
1
Total ATM
transactions
PNC Bank MAC
A TM transactions
Other MAC A TM
transactions
Other ATM
transactions
o
o
o
o
As of 08/09, a total of $21.51 in interest was
earned this year.
Interest Summary
Annual P'lM'Cel\tage
Yield Earned (APYE)
0.007.
Number of days
In Interest period
Average collected
balance for APYE
Interest Earned
this period
o
.00
.00
___m ----~.--~-_._____=__-=::=..===;;d
.~.
UJIHERAN
BROlHERHOOD
SECURmES CORI?
615 Founh Avenue South
Minneapolis. MN 55415
Family of Funds Statement
;i
Investor Number:
FFS-360361
Social Security No. or Tax!D: 184-05-7126
~
1",111",111,,,1,,,111,,,,,,11,,,1111,,,,,,111,1,,,11,,1,,,11
FREDONIA RUll-l HOOVER TOO
96 CAROL PL
NEWCUMBERLND PA 17070-1101
Statement Period:
APR 1 - JUN 30, 2001
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Your LB Famuy of Funds Statement is mailed folJowtng tbe
quarters ending .'tfarch.june, September & December.
Registered Representative:
FREDERICK NEVE~\l&'1 JR
3425 5L\1P50N FERRY RD
c.-I..\IP Hill. P.\ 17011-6405
(717) 730-9611 (/;7 >-c:; 3c::c,- /7.:',"'''''')
Do you want to benefit from the recent ta.x law changes? Lutheran Brothe~ood can help inform you
of the changes and how to use them to your advantage! Your LBSe regIstered represemative can help
or visit our website at www.luthbro.com or call 1-800-990-6290 for the 2001 Ta.'( Law Summary.
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: : i Account Summary
06/30/01 06/30/01
...--
03/30/01
06/30/01
,
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RlHD HAME (HUMBER)
ACCT HUMBER
MARKET VALUE
MARKET VALUE
i
93.9%
6.1%
$26,647.88
$1,725.35
LB Fund - A ( 54)
LB Income Fund - A ( 55)
7467865
7467865
$25,557.03
$12,851.59
$38,408.62
$22.23
$8.40
100.0%
$28,373.23
Total
Account Earnings Summary
Year-to-Date
Sbort.Term Long-Term
B!lI!li!lm mDIla mDm
TOTAL
RIND NAME (HUMBER)
ACCT HUMBER
LB Fund - A ( 54)
LB Income Fund - A ( 55)
7467865
7467865
$0.00
$412.12
$0.00
$0.00
$0.00
$412.12
$0.00
$0.00
Total
$412 .12
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To speak with a customer service associate
Monday - Friday 7 a.m. - 9 p.m. CST
Saturday 9 a.m. - 1 p.m. CST
Call; 1-8<JO.99<J.{5290
Investor Access Online:
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24-hour-a-day Automated Service Line:
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IIII~IIII~~I II
lU'Ldt,_..,_IItI'''.,.-'I.__1
0: WTHERAN
L . BROTHERHOOD
:;,. SECURfTlES CORL'
625 Fourth Avenue South
Minneapolis. MN 55415
Family of Funds Statement
Inves{Qf Number:
FFS-360361
APR 1 - JUN 3D, 2001
Statement Period:
Page 2 of 3
Transaction Summary
C<mfinn TraM
EiiJI ED
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fUND:
OWNER:
ACCOUNT:
fUND:
OWNER:
ACCOUNT:
04/27
04/30
0;/29
0;/31
06/27
06/29
.~ "
,-.;
;:
TRANSACTION
Transaction Trade Shares Per
mt!lImll!l:Ii E!DI
SHARES
Cumukltive
TRANSACTION
lB fUND - A
fREOONIA RUTH HOOVER TOO
54-7457865
Beginning Balance
No tj.msactions this period
Ending Balance
1,198,73;
1,198.735
TRANSfER ON'DEATH BENEfiCIARY - pEn CAPITA
BARRY L HOOVER
SSN: 169-44-;986
Birthdate: 1952-01-22
LB INCOME fUND - A
fREDONIA RUTH HOOVER TOO
55-7457865
04/27
04/23
0;/29
0;/23
06/27
06/22
Begirming Balance
Withdrawal Payment -ACH
Income Reinvest $ .04
Withdrawal Payment -Am
Income Reinvest $ .04
Withdrawal Payment -ACH
Income Reinvest $ .04
439 A30
7,1;8
44L 001
;,119
437,870
3,020
1,;08,403
1,068,973
1,076,131
63;, 130
640,249
202,379
20;,399
205.399
$3,700,00
$60,34
$3,700,00
$43,0;
$3,700,00
$2;,61
$8A2
$8A3
$8,39
$8,41
$8,4;
$8A8
Ending Balance
BARRY L HOOVER
SSN: 169-44-;986
Birthdate: 19;2-01-22
Primary
1IIIIm~~IUI~~1 .
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOOVER BARRY LEE
96 CAROL PLACE
NEW CUMBERLAND, PA 17070
_dhU_ fold
ESTATE INFORMATION: SSN: 184-05-7126
FILE NUMBER: 2101-0657
DECEDENT NAME: HOOVER FREDONIA R
DATE OF PAYMENT: 04/09/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/07/2001
NO. CD 001044
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,468.31
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TOTAL AMOUNT PAID:
$1,468.31
REMARKS: BARRY l HOOVER
CHECK# 1015
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. lEWIS
REGISTER OF WILLS
Val
STATUS REPORT UNDER RULE 6.12
Name of Decedent: F,..e.A?7n(d" R. tf('7,e?u-e-1'
Date of Death: 07fe;:7fd- 0/'/'/
Will No. ;;LJ'- ttJ(-{J,t:;-7 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 wpether administration of the estate is complete:
Yes V 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
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 No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Ui
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Signat.u
73a r0~ !-. I:iC/&(I~ I
Name (P ease type or print)
16 CG?r~1 P!cP ("'!~ .^!~\N a,~~('-lcF' J
Address /J nq
~ce,
Da te: tJ L-f it r;-j L?;;-
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(717) //4- ~&~
Te 1. No.
Capacity: ~personal Representative
,~
g;
Counsel for personal
representative
(MAH:rmf/AM3)
/6 -c;;)J'/~-o-
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
BARRY L HOOVER
96 CAROL PL
NEW CUMBERLAND
'0'"
L.
24
:l5
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-20-2002
HOOVER
07-07-2001
21 01-0657
CUMBERLAND
101
'*
REY-1547 EX AFP 101-02'
FREDONIA
R
Allount Rellitted
\fA: 17070
Ct',lf,;
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-EX-AFP--foY=oZY-NOYiCE--OF-YNHEifiTANCE-YAX-A"ppRA"isEMENT-,--Ail-oWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOOVER FREDONIA R FILE NO. 21 01-0657 ACN 101 DATE 05-20-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 1&, 17, 18 and 19 will
re~lect ~igures that include the total of !bb returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
.00 X 00 = .00
32,614.84 X 045 = L467.67
.00 X 12 = .00
.00 X 15 = .00
(9)= L467 . 67
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
U)
(2)
(3)
(4)
(5)
(6)
(7)
.00
28,373.23
.00
.00
9,521.01
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12" Net Value of Tax Return
13" Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
94.50
5.184.90
Ul)
(2)
(13)
(4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
37,894.24
5.279.40
32,614.84
.00
32,614.84
TAY CREDITS:
, .... ,~. ,,~-~.. . l+} AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-09-2002 CDOOI044 .48- L468.31
TOTAL TAX CREDIT 1,467.83
BALANCE OF TAX DUE .16CR
INTEREST AND PEN. .00
TOTAL DUE .16CR
. 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.)