HomeMy WebLinkAbout01-0713
Register of Wills of CUMBERLANI{;ounty I Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
Page M. Lentz
No.
21-01-713
also known as
, Deceased
Social Security No.
226-03-2639
"CIlIlOtlC.(.). who 1./s.e 1 fl yes.. of age or older. applylie.i for
(COMPLETE "A" OR "B" BELOW:)
'U
A. Probate and Grant of Letters and aver that Petitioner(s) is~ the execut or
Decedent, dated June 16, 1989 and codicil(s) dated nonp
named in the Last Will of the
State ,elev8f1t circumstances, e.g., renunciation. death of execulOf. ete
Except 'asfolwws, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incompetent:
[J
B. Grant of letters of Administration
~c.t.a., d.b.n.c.t.8.: pendente hte; durltfHe absentls; durante mi"oritafe)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name
Relationship
Residence
Decedent was domiciled at death in CUmberland County, Pennsylvania, with his/her last family or prinCipal
residence at ~~n R.1ngp \1; 11 oC)P. 210 BiC) Sprinry Rd., NQ~7illQ, l?.A 17241
(list sueCI, numbel and f1lUnfclpahty)
Decedent, then RE;
years of age, died Julv 21. 2001
,19_, at
Green Ridge Village
(Lucatio,,)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property .............................. $ ~O, 000.00
(If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ............................................... $
Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10 000 00
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Typed or printed name and residence
~
PO Box 11
Rossville, PA 17358
RW-7
/~ -~~7- 7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of rnMB?RLAND
The Petitioner(s) above-named swear(s) and affirm(si 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 representative( of the Decedent,
Petitioner(s) will well and truly administer the estate according to law.
day of
Sworn to and affirmed and subscribed
before me this
1st
John R
AUQUSt, 2001 19___
~~~/~~~/Jt}/ /~e'Y'
DECREE OF REGISTER
Estate of
Faqe M. Lentz
Deceased
No. 21-01-713
also known as
Social Security No: 226-03-2639
Date of Death:
July 21, 2001
AND NOW, August ~ 2001 , 19_, in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that LettersXJ Testamentary 0 of Administration
(c.t,n.; d.ll-fl_r:f.; fltmdnnle Ilt~; dUf,iUIW atJst!llfw; tJUWUlt.' n'NmmliJIt.')
are hereby granted to
John R. Lentz
in the above estate and that the instrument(s), if any, dated June 16, 1989
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Short Certificate(s).......... $
Renunciation.................. $
Affidavit ()................. $
Extra Pages ( )............ $
Codicil.......................... $
JCP Fee........................ $
Inventory & Tax Forms... $
Other............................ $
6.00
>;?Jr(J~:J~~~,)Atu4<~
Re ster of Wills
Letters........................... $
40 00
6.00
5.00
Attorney:
1.0. No:
Address:
John A. Roe
07109
?t;?O T"lr'lPhnp Rnj
TOTAL................ $
57.00
Harrisburg, FA 1 711 0
Telephone: 717/f..71-9870
DATE FILED: August 1, 2001
RW-7a
1105.80'\ REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
t:2-v ~ ~~
Local Registrar
Fee for this certificate, $2.00
p
7618656
JUL 2 4 20m
Date
21-01-713
:43 Rev. '2Jft7
COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (for.. Middle. LMI'
t.
SEX
8IRTHI'LACE (Coly aIlCl
SlaIe 01 fcreogn COUIl/IYl
~ID
RACE. A-.nlndien.lIIKk. While. ..
~
Wh.<.te
SUfMV1NG SPOUSE
II ... grwe...- ........
CilyIlIaf
a.
,~
'---~
:_lIIICIdNlIl
I
,
I
PART I: 0lIlet ~ ..........-......10........ bul
not r--.g in IIle UIIdeIIying_ __InPART l.
~~ tni~
DUE 10 (OR AS A CONSEQUENCE Of):
MANNER OF OEAa"H
DATE OF INJURY
(........ Day. ....,
TIWE OF INJURY
INJUAV III WOAK1 DESCRIBE HOW lNJURV 0CCUflfIE0.
No~
.........
AccidenI
Suicide
o
o
--
PMlding~
o
o
o PlACE OF 'NJUflY . AI /loIne. 1_.11'''. IKfary. oIflt;. ....
buiIdIIlg. eIC.lSpeoIvI
3OIt.
_ D NoD
CotAdnotlllt__
34.
:ta.
csrrnJIlCNc:koriy CMI
"Cl!llTFYlIIClI PHYSICIAN (PhYK*l C8ItIIylng cause d dea1h ..tlerl MlOlher physoc... has pronounc:ecl deall> ana Cllmplll8CJ nem 231
TO........oI""'II-'-Ige.___.......theCMIM(.land__'........................................................... ..
2t.
~
~ .PfIONOtINClNQ AHOCERrIl'YING",Y1lICJAN,~ llolh llflYlOUllClrlO oelllh and clI1I/ylno 10_01 deallll
;I To........ 01 "'Y~, -- -- lit.......... dele. and piece. ..... _ to .... CauM(.I.nd maMa'.. aIaIacI.. . . . . . . . . . . . . . . . . . . . . . . . .
0.51 "MEDICAL. EXAMINI!RlCOROHER
OIlthelNllle CII..amlnatlon anellOI' Inveatl1lAtlon.ln my opinion. "eath occurred at the lime. "ate, and place, and due to the ceu..'s) and
l:L=-~~~......................................~,;~;;...1
~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Page M. Lentz
Date of Death:
July 21, 2001
Will No.
2001-00713
Admin. No.
To the Register:
I certify that Notice of estate administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on/or mailed to the following beneficiaries of the above-
captioned Estate on August 8, 2001.
NAME
ADDRESS
Linda Lentz
Richard Lentz
John R. Lentz
Kristina Mujica
P. O. Box 85, Paonia, CO 81428
31 Wilmington Way, The Woodlands, TX 77384
P. O. Box 11, Rossville, PA 17358
2 South Howard Street, Smyrna, DE 19977
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
William K. Lentz, who is deceased.
Date:
August 8. 2001
a
~~
. . oe, Esq.
Attorney I. D. #07109
2520 Doehne Road
Harrisburg, PA 17110-9622
717/671-9870
Capacity :
x
Personal Representative
Counsel for Personal Representative
\Rule 5.6(a)
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No. 01-00713
FIRST AND FINAL ACCOUNT OF
JOHN R. LENTZ, Executor
for the
ESTATE OF PAGE M. LENTZ, Deceased
Date of Death:
Date of Executor Appointment:
Accounting for the Period:
July 21, 2001
August 2, 2001
8/02/01 to 6/15/02
PURPOSE OF ACCOUNT: JOHN R. LENTZ, Executor for the ESTATE OF PAGE M.
LENTZ, offers this Account to acquaint interested parties with the transactions that have occurred
during this administration.
This Account also indicates the distribution of the Estate.
It is important that the Account be carefully examined. Requests for additional information or
questions or objections can be discussed with:
John A. Roe, Esquire
Attorney for the Estate of PAGE M. LENTZ
2520 Doehne Road
Harrisburg, PA 17110-9622
717/671-9870
ESTATE OF PAGE M. LENTZ
RECEIPTS
CASH/STOCKS/BONDS
(Transfer from Decedents checking account)
Beginning Balance
GNMA dividend
checking account interest
PHEAA Refund
Presbyterian Homes Refund
GNMA Certificate #0758681
10/9/01 checking account interest
10/30/01 checking account interest
11/30/01 checking account interest
12/30/01 checking account interest
2/2/02 checking account interest
3/10/02 checking account interest
4/2/02 checking account interest
5/2/02 checking account interest
5/2/02 PA Income Tax refund
5/22/02 Federal Income tax refund
5/22/02 GNMA check
8/9/01
8/14/01
8/14/01
9/8/01
9/24/01
8,337.69
12.50
3.33
298.69
1,523.30
358.87
4.92
3.88
2.85
2.40
2.18
2.33
2.10
2.27
350.00
2,000.00
15.00
Total
$12,922.31
ESTATE OF PAGE M. LENTZ
DEBTS OF DECEDENT
8/14/01 John A. Roe, Esq. (Reimburse probate fee)
8/14/01 PSERS (refund retirement payment)
8/14/01 John Lentz (reimburse cremation and reception)
8/14/01 Cont. Care Rx (prescriptions drugs)
9/13/01 Tristan Associates
10/10101 John Roe, Esq. (partial attorney's fee)
10/10101 John A. Lentz (reimbursement of travel & misc. expenses)
10/30101 Register of Wills, Agent (balance due - Inheritance tax)
11/5/01 Register of Wills (Inheritance Tax filing fee)
11/5/01 John A. Roe, Esq. (Partial attorney's fee)
3/28/02 St. Clair & Associates (income tax preparation)
John A. Roe, Esq. (Final attorney's fee)
Register of Wills (filing fee for Releases and Accounting)
TOTAL
57.00
198.25
1,393.97
303.31
30.00
1,000.00
400.00
194.07
25.00
1,962.50
150.00
1,125.00
28.00
6,867.10
PAGE M. LENTZ INTERVIVOS TRUSTS
PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES
4 Funded Revocable Trusts Dated 8/20/91
See attached letters from Waddell & Reed and Vanguard
John R. Lentz (Son)
Waddell & Reed Advisors
Wellesley Income Fund
18,722.66
43,557.41
Richard H. Lentz (Son)
Waddell & Reed Advisors
Wellesley Income Fund
18,722.66
43,557.39
Linda P. Lentz (Daughter)
Waddell & Reed Advisors
Wellesley Income Fund
18,722.66
43,591.47
Kristina L. Mujica (Grand-daughter)
Waddell & Reed Advisors
Wellesley Income Fund
18,722.78
43,564.39
Total Principal Distribution to Beneficiaries
$249,161.42
Each beneficiary paid their share of Pennsylvania Inheritance Tax.
John R. Lentz
Richard H. Lentz
Kristina L. Mujica
Linda P. Lentz
$2,662.47
$2,662.47
$2,662.78
$2,663.93
ESTATE OF PAGE M. LENTZ
SUMMARY
Total Receipts & Income
Total Debts of Decedent
BALANCE ON HAND (Estate Checking Account)
$12,922.31
6,867.10
$6,055.21
RELEASE
KNOW ALL MEN BY THESE PRESENTS, that I, RICHARD HENRY LENTZ,
of The Woodlands, Texas, one of the beneficiaries of PAGE M. LENTZ, deceased, late of
Newville, Cumberland County, Pennsylvania, who died testate on July 21, 2001 and whose Last
Will and Testament dated June 16, 1989 was duly probated in the Office of the Register of Wills
of Cumberland County, Pennsylvania on August 2,2001 and recorded to No. 21-01-0713, DO
HEREBY:
1. Acknowledge the receipt of the sum of ONE THOUSAND FIVE
HUNDRED THIRTEEN and 80/100 ($1,513.80) which represents final payment of the bequest
in paragraph No.3. b. of said Will which provides as follows:
"3. b. One share to my son, RICHARD HENRY LENTZ
of DeSoto, Texas, per stirpes."
2. Release and forever discharge John R. Lentz, Executor of the ESTATE OF
PAGE M. LENTZ, her heirs and assigns, and the Estate of Page M. Lentz, deceased, of the
aforesaid payment and of and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever.
3 . In consideration of the fmal distribution to the undersigned of the property
described above, the undersigned agrees to pay the Estate any amount up to the value of the said
property distributed that may be necessary in the future to discharge any liabilities of the Estate.
This instrument shall be legally binding upon the successors and assigns of Richard
Henry Lentz.
day of
IN WITNESS WHEREOF, I have hereunto set my hand and seal this /7 rll
Jrv~~ , 2002
WITNESS:
B@' ~.J+-
~JI~(~~
Richard Henry Lentz.
RELEASE
KNOW ALL MEN BY THESE PRESENTS, that I, KRISTINA BROSS LENIZ
PLEASANTON MUJICA, of Smyrna, Delaware, one of the beneficiaries of PAGE M. LENIZ,
deceased, late of Newville, Cumberland County, Pennsylvania, who died testate on July 21,2001
and whose Last Will and Testament dated June 16, 1989 was duly probated in the Office of the
Register of Wills of Cumberland County, Pennsylvania on August 2, 2001 and recorded to No.
21-01-0713, DO HEREBY:
1. Acknowledge the receipt of the sum of ONE THOUSAND FIVE
HUNDRED THffiTEEN AND 80/100 ($1,513.80) which represents fmal payment of the bequest
in paragraph No.3. d. of said Will which provides as follows:
"3. d. One share to be divided equally between my
granddaughter, KRISTINA BROSS LENTZ
PLEASANTON, of Dover, Delaware, and my
grandson, WILLIAM KARL LENTZ, of Addison,
New York, share and share, per stirpes." (William
Karl Lentz died, vesting his interest in Kristina Bross
Lentz Pleasanton Mujica.)
2. Release and forever discharge John R. Lentz, Executor of the ESTATE OF
PAfJE M. LENTZ, her heirs and assigns, and the Estate of Page M. Lentz, deceased, of the
aforesaid payment and of and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever.
3. In consideration of the fmal distribution to the undersigned of the property
described above, the undersigned agrees to pay the Estate any amount up to the value of the said
property distributed that may be necessary in the future to discharge any liabilities of the Estate.
This instrument shall be legally binding upon the successors and assigns of Kristina
Bross Lentz Pleasanton Mujica.
~ WITNESS WHEREOF, I have hereunto set my hand and seal this IF"
day of , 2002
WITNrt -!l
-
RELEASE
KNOW ALL MEN BY THESE PRESENTS, that I, JOHN ROBERT LENTZ, of
Rossville, Cumberland County, Pennsylvania, one of the beneficiaries of PAGE M. LENTZ,
deceased, late of Newville, Cumberland County, Pennsylvania, who died testate on July 21, 2001
and whose Last Will and Testament dated June 16, 1989 was duly probated in the Office of the
Register of Wills of Cumberland County, Pennsylvania on August 2, 2001 and recorded to No.
21-01-0713, DO HEREBY:
1. Acknowledge the receipt of the sum of ONE THOUSAND FIVE
HUNDRED THIRTEEN and 80/100 ($1,513.80) which represents final payment of the bequest
in paragraph No.3. c. of said Will which provides as follows:
"3. c. One share to my son, JOHN ROBERT LENTZ, of
Rossville, Pennsylvania, per stirpes."
2. Release and forever discharge John R. Lentz, Executor of the ESTATE OF
PAGE M. LEN1Z, her heirs and assigns, and the Estate of Page M. Lentz, deceased, of the
aforesaid payment and of and from all actions, suits; payments, accounts, reckonings, claims and
demands whatsoever.
3. In consideration of the fmal distribution to the undersigned of the property
described above, the undersigned agrees to pay the Estate any amount up to the value of the said
property distributed that may be necessary in the future to discharge any liabilities of the Estate.
This instrument shall be legally binding upon the successors and assigns of John
Robert Lentz.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ..S -/)
day of ~ (/ y/e , 2002
WITNESS:
~~ww
RELEASE
KNOW ALL MEN BY THESE PRESENTS, that I, LINDA PAGE LENTZ, of
Paonia, Colorato, one of the beneficiaries of PAGE M. LENTZ, deceased, late of Newville,
Cumberland County, Pennsylvania, who died testate on July 21, 2001 and whose Last Will and
Testament dated June 16, 1989 was duly probated in the Office of the Register of Wills of
Cumberland County, Pennsylvania on August 2, 2001 and recorded to No. 21-01-0713, DO
HEREBY:
1. Acknowledge the receipt of the sum of ONE THOUSAND FIVE
HUNDRED THIRTEEN and 80/100 ($1,513.80) which represents final payment of the bequest
in paragraph No.3. a. of said Will which provides as follows:
"3. a. One share to my daughter, LINDA PAGE LENTZ
of Pontiac, Michigan, per stirpes."
2. Release and forever discharge John R. Lentz, Executor afthe ESTATE OF
PAGE M. LENIZ, her heirs and assigns, and the Estate of Page M. Lentz, deceased, of the
aforesaid payment and of and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever.
3. In consideration of the final distribution to the undersigned of the property
described above, the undersigned agrees to pay the Estate any amount up to the value of the said
property distributed that may be necessary in the future to discharge any liabilities of the Estate.
This instrument shall be legally binding upon the successors and assigns of Linda
Page Lentz.
~ IN WITNESS WHEREOF, I have hereunto set my hand and seal this l<f!'h
day of -VJ..,Yl. Q . , 2002
WITNESS:
~l' WUltL'Ju
/,~}
~/2 J7
, (/~~/ F
Linda Page tz
Register of Wills of CUMBERLAND County, Pennsylvania
INVENTORY
Page M. Lentz
No,
21-01-0713
Estate of
also known as
Date of Death 7/21/2001
, Deceased
Social Security No. ??n-01-2639
Personal Representative(s) of the above Estal:. ;:~:~asc-j. verify that the items appearing in the following inventory ir: -iC-= ::.
of the personal assets wherever siwoce and a, :.' ~".e real estate in thd Commonwealth of Pennsylvanli3 of said Dece-:;~-:. :-::
the valuation placed opposite each item of sc;:: - :-:ntv., represents its fair value as of the date of the Decedent's d~=~:;. =..:
that Decedent owned no real est3te outside o' :;-~ ::.-mn-.:;nwealth of Pennsylvania except that which appears in a n1en-: '3;-;;:_-
at the end of this inventory. I/We ve:ify that .,;-.,-= ,::0::18,""-::nts made in this Inventory are true and correct. i/We under5~:-':; :-::
false statements herein are mad6 subjec\. to :-~ ::-3;oE>i:,es of 18 Pa. C.S. Section 4904 relating to unsworn falsii!: ::..:- ':
authorities.
AddreSS:
07109
2520 Doehne Road
Namp. of
Attorney:
John A. Roe
I.D. No.:
Harrisburg, PA 1711 0
Telephone :__J,j.71fi11- -QR70
Des.: ~:: ~.~.r,
Value
Waypoint Bank
Account 700000518
14,017,96
GNMA Certificate No. 07586818
348.31
:...1
Total: 14,366.27
(Attach Additional Sheets if necessary i
NOTE: The Memorandum of real estate outside the C::--cmorh'.ea:th of Pennsylvania may. at the election of the personal represerl~iH .~
the value of each item. but such figures should lie: C-:: :;*ler.oed IIno the tOlal of the Inventory.
RW-8
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
ROE JOHN A ESQ
2520 DOEHNE ROAD
HARRISBURG, PA 17110
_n_n__ fold
ESTATE INFORMATION: SSN: 226-03-2639
FILE NUMBER: 21 - 2001 - 071 3
DECEDENT NAME: LENTZ PAGE M
DA TE OF PAYMENT: 10/19/2001
POSTMARK DATE: 10/18/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2001
NO. CD 000403
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,662.78
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: WADDELL & REED FUND FAMILIES
C/O JOHN A ROE ESQUIRE
CHECK# 20752969
SEAL
INITIALS: PB
RECEIVED BY:
REGISTER OF WILLS
$2,662.78
MARY C. LEWIS
REGISTER OF WILLS
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
ROE JOHN A ESQ
2520 DOEHNE ROAD
HARRISBURG, PA 17110
-------- fold
ESTATE INFORMATION: SSN: 226-03-2639
FILE NUMBER: 21-2001- 0713
DECEDENT NAME: LENTZ PAGE M
DA TE OF PAYMENT: 10/19/2001
POSTMARK DATE: 10/18/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2001
NO. CD 000404
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,663.93
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: LINDA LENTZ
C/O JOHN A ROE ESQUIRE
CHECK# 699
SEAL
INITIALS: PB
RECEIVED BY:
REGISTER OF WILLS
$2,663.93
MARY C. LEWIS
REGISTER OF WILLS
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
ROE JOHN A ESQ
2520 DOEHNE ROAD
HARRISBURG, PA 17110
-------- fold
ESTATE INFORMATION: SSN: 226-03-2639
FILE NUMBER: 21-2001- 0713
DECEDENT NAME: LENTZ PAGE M
DA TE OF PAYMENT: 10/19/2001
POSTMARK DATE: 10/18/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2001
NO. CD 000405
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,662.47
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: RICHARD H LENTZ
C/O JOHN A ROE ESQUIRE
CHECK# 1027
SEAL
INITIALS: PB
RECEIVED BY:
$2,662.47
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
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
ROE JOHN A ESQ
2520 DOEHNE ROAD
HARRISBURG, PA 17110
-------- fold
ESTATE INFORMATION: SSN: 226-03-2639
FILE NUMBER: 21-2001- 0713
DECEDENT NAME: LENTZ PAGE M
DA TE OF PAYMENT: 10/19/2001
POSTMARK DATE: 10/18/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2001
NO. CD 000406
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,662.47
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JOHN LENTZ
C/O JOHN A ROE ESQUIRE
CHECK#1030
SEAL
INITIALS: PB
RECEIVED BY:
$2,662.47
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
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
ROE JOHN A ESQ
2520 DOEHNE ROAD
HARRISBURG, PA 17110
_u__u_ fold
ESTATE INFORMATION: SSN: 226-03-2639
FILE NUMBER: 21 - 2001 - 071 3
DECEDENT NAME: LENTZ PAGE M
DATE OF PAYMENT: 11/02/2001
POSTMARK DATE: 11/01/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2001
NO. CD 000473
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $194.07
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JOHN LENTZ
C/O JOHN A ROE ESQUIRE
CHECK# 101
SEAL
INITIALS: PB
RECEIVED BY:
REGISTER OF WILLS
$194.07
MARY C. LEWIS
REGISTER OF WILLS
/ & ~ c:J el7 -- V
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT1 ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
Recorc:~;'.'1
RegiE,:'sc
of
,,'.'\.... DATE
N\ll~::' ESTATE OF
DATE OF DEATH
P\2 'OF7ILE NUMBER
. COUNTY
ACN
12-31-2001
LENTZ
07-21-2001
21 01-0713
CUMBERLAND
101
.02 JI\N-4
JOHN A ROE ESQ
2520 DOEHNE RD
HBG
*5~
REV-15~7 EX AFP 02-DD)
PAGE
M
PA 1711~terk>'
Cll1nber;anc
AlIOunt Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4'j-ix-AFP--fi"Z-:ooi--NOiici--OF-YNHiifiTANCi-YAirAPPRAisiii'ENT~--Ar:rOWANCi-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LENTZ PAGE M FILE NO. 21 01-0713 ACN 101 DATE 12-31-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rate (15)
16. A.ount 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
CR TS:
PAY NT
DATE
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. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule El
6. Jointly Owned Property (Schedule Fl
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
348.31
.00
.00
16,113.86
.00
249,161.42
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage 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)
(10)
121772.49
.00
(11)
(12)
(13)
(14)
NOTE:
.00 X 00 =
2521851.10 X 045=
.00 X 12 =
.00 X 15 =
R CEIP
NUHBER
*** SUMMARY 0
SCOUNT (+)
INTEREST/PEN PAID (-)
ALL 05 PAYMENTS
560.62
101845.72
AMOUNT PAID
**
11-01-2001
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
(19)=
NOTE: To insure proper
credit to your accountl
submit the upper portion
of this forll with your
tax pay..ent.
2651623.59
12.772 49
2521851.10
.00
2521851.10
.00
111378.30
.00
.00
111378.30
111406.34
28.04CR
.00
28.04CR
. IF PAID AFTER DATE INDICATED 1 SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDITn (CR) 1 YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
&v
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE
STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL
COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Pa~e M. Lentz
Date of Death:
July 21 2001
Will No. 21 01-00713
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 ---X- No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes ---X- 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 of interest?
Yes ---X- No
d.
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the orp4:;y ~ :is report.
Signature
Date: June 25. 2002
'';.'''1
John A. Roe, Esq.
2520 Doehne Road
Harrisburg, PA 17110
717/671-9870
0:l
~
Capacity: Personal Representative
X Counsel for personal representative
-
.~...I' .__....
REV-1500EX(6-00i
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPl 280601
HARRISBURG, PA 17128-0601
1(" -;).1-7 - 7
REV-1500
OFFICIAL USE ONLY
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FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
21
- 01
00713
COUNTY CODE
YEAR
NUMBER
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W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lentz, Page M.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
07/21/2001 07/01/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
226 - 03
- 2639
[:::J 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (AltachcopyofWill)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy 01 Trus!)
o 10. Spousal Poverty Credit (date ofdealh between 12-31-91 and 1-1-95)
o 3. Remainder Return (date of death prior!o 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Altacl1 Sch 0)
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NAME hn
Jo A. Roe, esq.
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
2520 Doehne Road
HarriSburg, PA 17110
TELEPHONE NUMBER
717/671-9870
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
348.31
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
16,113.86
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(8)
266,623.59
(6)
(7)
249,161.42
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
12,772.49
o
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(11) 12,772.49
(12) 252,851.10
(13) 0
(14) 252,851.10
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)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
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D.
::i:
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15. Amount of Line 14 taxable al the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
'.0_(15)
252,651.10
, 0 4S-- (16)
, .12 (17)
, .15 (18)
11.378.30
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 141axable at collateral rate
19. Tax Due
(19)
1 94.07
200
CHECK HERE IF YOU ARE REQUESTING A REFUNO OF AN OVERPAYMENT
REV.'~'EX"'.97I..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Page M. Lentz
FILE NUMBER
21-01-0113
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
1.
2.
3.
4.
5.
6.
DESCRIPTION
Waypoint Bank
Checking Account 700000518
Interest 7/19
Interest 8/14
Interest 9/14
GNMA Interest
Interest
7/19
8/14
VALUE AT DATE
OF DEATH
14,017.96
10.69
3.33
4.92
13.22
12.50
298.69
1,523.30
198.25
31.00
PHEAA Refund
Presbyterian Homes Refund
PSERS Retirement
Social Security
TOTAL (Also enteron line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16,113.86
REV.1510EX+(1.97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Page M. Lentz
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
FILE NUMBER
21-01-0713
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDETKE NAME OF TKETRANSFEREE,TKEIR RElATIONSKIPTODECEDENTAND THE DATE OF TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OF HIE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLICABl.E\
NUMBER
1.
4 Funded Revocable Trusts Dated 8/20/91
See attached letters from Waddell & Reed and Vangu rd
1. John R. Lentz (Son)
Waddell & Reed Advisors 18,722.66
Wellesley Income Fund 43,557.41
2. Richard H. Lentz (Son)
Waddell & Reed Advisors 18,722.66
Wellesley Income Fund 43,557.39
3. Linda P. Lentz (Daughter)
Waddell & Reed Advisors 18,722.66
Wellesley Income Fund 43,591.47
4. Kristina L. Mujica (Grand-daughter)
Waddell & Reed Advisors 18,722.78
Wellesley Income Fund 43,564.39
TOTAL (Also enter on line 7. Recapitulation) $ 249,161.42
(If more space is needed, insert additional sheets of the same size)
REV'''.'lEX'''''',.
COMMONWEALTH OF PENNSYLVAN'A
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Page M. Lentz
FILE NUMBER
21-01-0713
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Cremation Society of PA 1,080.00
2. Funeral Reception 313.97
B. ADMINISTRATIVE COSTS: reimbursement of travel & misc. expenses 400.00
1. Personal Representative's ~
Name of Personal Representative (s) John R. Lentz
Social Security Numbe~s)1 EIN Number of Personal Representative(s)
Street Address POBox 11
City Rossville. PA State pA Zip 17358
Yea~s) Commission Paid:
2. Attorney Fees 4,500.00
3. Family Exemption: (If decedenfs address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 57.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7. Market Sq. Presbyterian Church 200.00
8. PSERS (reimburse retirement payment) 198.25
9. Cont. Care Rx (prescription drugs) 382.61
10. Presbyterian Homes 5,307.35
11. Tristan Associates .30.00
12. Cont. Care Rx (prescription drugs) 303.31
TOTAL (Also enter on line 9, Recapitulation) $ 12,772.49
(If more space IS needed, Insert additional sheets of the same size)
REV-1513EX.f1.97)
..
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLV~NIA
INHERIl rlNCE TAX HETURN
RESIDENT DECEDENT
ESTATE OF
Page M. Lentz
FILE NUMBER
21-01-0713
NUMBER
I.
4.
NAME AND "ODRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTONS (include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
I.
Linda P. Lentz
P. O. Box 85.
Paonia, CO 81428
1/4 share
daughter
2.
Richard H. Lentz
31 Wilmington Way
The Woodlands, TX 77384
son
1/4 share
I
3.1
John R. Lentz
P. O. Box 11
Rossville, P A 17358
son
1/4 share
Kristina L. Mujica
2 South Howard Street
Smyrna, DE 19977
grand-daughter
1/4 share
ENTER DOLLAR ;MOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, .AS'PPROPRIA TE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTR:BUTIONS:
A. SPOUSAL DISTRIEJTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEI~3 MADE
I.
B. CHARITABLE AND 30VERNMENT AL DISTRIBUTIONS
I.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 celER SHEET $
(If more space is needed, insert additional sheets of the same size)
SECURITY HOLDER REMITTANCE HISTORY
08/10/01 14: 2S: 30
REM2
00004316CD
07586818SF
07586818SF
.82742637
8.50000
003791
226-03-2639
POOL NUMBER
HOLDER NUMBER
CERT. NUMBER
PRO-RATA SHARE
SEC. INT. RATE
ISSUER NUMBER
TIN/SSN
FINAL PMT IND
FINAL PMT DTE
------- PAYEE NAME
AND ADDRESS -------
PAGE M. LENTZ
203 MESSIA~ VILLAGE
POBOX 2015
l"lECHANICSBURG
FOREIGN COUNTRY IND
l-'A 170,,5
JUN, 2001
959388
07/06/01
REPORTING MONTH
CHECK NUMBER
CHECK ISSUE DATE
VOID INDICATOR
FROM-PAYEE 91936
REPL. CK. DATE
REPL. CK. NUM.
COMBINED CK. IND Y
UNUSED FUNDS IND
------------- REMITTANCE
SCHED. PRIN
SCHED. INT
ADD'L PRIN
ADJUSTMENT
WITHHOLD AMT
TOTAL CASH
ENDING CERT BAL
9.71
2.79
. C 2
.00
=:X 3
1~ .32
384.31
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"VI Way~qi!lt
LOOK FOR U5. WE'LL GET YOU THERE.
08/10/2001
JOHN ALEXi\NDER ROE
2520 DOEHNE RD
HARRlSBURG PA 17110
The information which you requested on the account(s) of PAGE LENTZ ESTATE
(Social Security Number 226-03-263Q) is/are as follows:
Account l<'Jrnber
Class of Account
Date Opeo,d
Principal Balance
Accrued lr:terest
Balance ar !)ate 0:'
Death
Account e,'.vne,.shp SOLE
Name of .ic.;int
Owner, if any
700000518
CHECKING
02/27/81
14017.96
140] 7.96
Date Own;rship
Was Estab)ished
Account 1\umber
Class of Account
Date Opened
Principal Balance
Accrued lnterest
Bal~~':'e 31 Dare of
Death
Account Ownership
Name of Joint
Owner, if ::n)
Dale Own;rship
Was Established
Additional
Information
Requested
PLEASE COMPLETE W-9
Si{;;/'cl2:Innr:
KATH/You1<JO?
SEN10R SERV1CES REP.
PO. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711
Toll FrEE 1-866-WAYPOINT (1-866-929-7646) . wwwwaypointbank.com
T~guardJRoUP.
ESTATE OF PAGEM LENTZ
ATTN JO~ R. LENTZ
PO BOX 11
ROSSVILLE P A 17358-0011
October 4, 2001
...... -~""""--' -.."-'....-...-.-
Welbsley Income Fund bv
09875803145
09875803284
09875803336
09875303433
Dear Mr. Lentz:
We areresFonding to a request for the values of the above referenced accounts. Please
convey our sincere condolences to the family of Page M. Lentz for their loss. Since the date
requested of July 21, 2001 was not a clliy of business, we are providing me values as of
July 20, 2001. On that day, the number of shares, the price per share, and the value of each
account were as follows:
Page M. Lentz TR
UA 08-20-1991
Funded Trust
FBO Richard Henry Lentz
. Fund Name
09875803145
Wellesley Income Fund Inv
Price
~.
Shares
2,097.130
$20.77
$43,557.39
Page M. Lentz TR
UA 08-20.1991
Funded Trust
, FBO John Robert Lentz
Fund Name
09875803284
Wellesley Income Fund Inv
Shares
Price
Value
2,097.131
$20.77
$43,557.41
Vanguard Voyager Service
Post Office Box 2600, Valley Forge, Pennsylvania 19482-2600
8o<:>-z84"'7245 . www.vanguard.com
Page M. Lentz TR
UA 08-20-1991
Funded Trust
FRO Linda Page Lentz
Fund Name
09875803336
Wellesley Income Fund Inv
Shares
Price
Value
2,098.771
$2lJ.77
$43,591.47
Page M. Lentz TR
UA 08-20-1991
Funded Trust
FRO Kristina L. Mujica
Fund Name
09875803433
Wellesley Income Fund Inv
Shares
Price
Value
2,097.467
$20.77
$43,564.39
If you have any questions, please contact your Voyager Service Team at 1-800-284-72-\5.
Voyager's business hours are Monday through Friday from 8 a.m. to 10 p.m. and
S:lturday from 9 a.m. to 4 p.m., Eastern Time. One of 0"0.11' dedicated Voyager Associates
will be pleased to assist you.
Sincerely,
--Ik' ~
Kari Blake
Voyager Service Communication Associate
40009071
.-OWADDEll
~~!7}2.
..
6300 Lamar Avenue
Post Office Box 29217
Shawnee Mission, KS 66201.9217
August 10, 2001
John Alexander Roe
2520 Doehne Road
Harrisburg, PA 17110-9622
Re: Estate of Page M Lentz
Date of death: July 21,2001
Dear Mr. Roe:
In response to your request for infol1nation regarding the accounts of Page 1'.1 LeDlz and the date of death
values we are prc.iding this information.
Account 21449889, registered Page 1'.1 Lentz TR for Kristina \1 Lentz had 3044.355 shares of Waddell &
Reed Advisors Core In\"estment fund at 86.15 per share.
Account 21449947; registered Page 1'.1 Lentz TR for Richard H Lentz had 3044.335 shares of Waddell &
Reed Advisors Core Investment fund at 86.15 per share.
Account 21449897; registered Page 1.1 Lentz TR for Linda P Lentz had 3044.335 shares of Waddell &
Reed Advisors Core Im"estment fund at 86.15 per share.
Account 21449913; registered Page 1'.1 Lentz TR for John R Lentz had 3044.335 shares of Waddell & Reed
Advisors Core Investment fund at $6.15 per share.
Each oIuIe above accounts received a March 15,2001 dhidend of$18.57 and was paid out to the
decedent. There has been no accrued interest on the accounts
If you have any questions concerning the above, or if this office "an be of further seIvice please do not
hesitate to contact us again.
8lrn;erely,
W/ IV Q
/, n, ^
~~hlr~~
Client Services Division
Waddell & Reed Services Company
A:WILLSl:revocabl.tst
FUNDED REVOCABLE TRUST
KNOW ALL MEN BY THESE PRESENTS, that I, the undersigned, do
hereby declare that (1) the monies delivered herewith, the amount
of which is referred to on the attached form(s) and/or (2) certain
outstanding shares, the numb~r or dollar value of which is referred
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to on the attached form(s), and/or (3) certain outstanding units of
limited partnership, the number or original cost of which is
referred to in the attached form(s), to be held in trust by me
under this FUTlded Revocable Trust. Having directed that s'tid
assets be utilized to acquire shares of capital stock of one or
more of the mutual funds or securities designated by me, in the
manner specified on said attached forms, and having directed that
the shares and/or units so acquired be registered in my name as
Trustee for JOHN ROBERT LENTZ, as Beneficiary, whose address is
Post Office Box 11, Rcssville, Pennsylvania, 17358, under this
Funded Revocable Trust, I do hereby further declare that the terms
and conditions upon which I shall hold said shares and/or units and
any additional shares and/or units acquired by me, as Trustee
hereunder, from whatever source, including shares and/or units
acquired by way of subsequent purchases, transfers, or exchanges
into an account in the name of this Trust, shall be as follows:
( 1)
During
my
lifetime
all
cash
dividends
or
distributions are to be paid to me individually for my
own personal account and use; provided, however, that any
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additional shares of stock issued to me by way of a stock
dividend or reinvestment of dividends or distributions
upon shares and/or units held hereunder shall become part
of and be subject to this Trust.
(2) Upon my death the title to any shares and/or units
subject hereto and the right to any subsequent dividends
or distributions shall be vested in the Beneficiary
hereunder. The record date for the payment of dividends
or distributions, rather than the date of declaration of
the dividend or distribution, shall, ,.-ith reference to my
death, determine whether any particular dividend or
distribution shall be payable to my estate.
(3) During my lifetime, I reserve the right, as Trustee,
to vote, sell, redeem, exchange, transfer or otherwise
deal in or with the shares and/or units subject hereto,
but upon any sale or redemption of said shares and/or
units or iiny part thereof, the Trust hereby declared
shall terminate as to the shares and/or units sold or
redeemed, and I shall be entitled to retain the proceeds
of sale or redemption for my own personal account and
use.
(4) I reserve the right at any time to change the
Beneficiary or revoke this Trust, but it is understood
that no change of Beneficiary, and no revocation of this
Trust, except by death of the Benef iciary , shall be
,
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effective as to the funds and/or stocks for any purpose
unless written notice thereof in such form as the funds
and/or stocks shall prescribe is delivered to its
respective transfer agent at such transfer agent's
respective current address.
The decease of the
Beneficiary before my death shall operate as a revocation
of this Trust, and in sllch event the Beneficiary shall be
divested of all interest in the shares and/or units held
hereunder.
(5) In the event this Trust shall be ~evoked or
otherwise terminated, said shares and/or units and all
rights and privileges hereunder shall belong to and be
exercised by me in my individual capacity.
(6) The funds,
partnerships,
or companies,
their
respective transfer agents, or persons affiliated with
the transfer agents, and their respective officers,
directors, employees, and representatives shall nut be
liable for the validity or existence of any Trust created
by me; and any payment or other consideration made or
given by the funds, partnerships, or companies to me as
Trustee or otherwise, in connection with said sharos
and/or units or any dividends or distributions thereon
shall, to the extent of such payment fully release and
discharge the funds, partnerships, or companies from
liability with respect to said shares and/or units or any
dividends or distributions thereon. I acknowledge that
none of the persons referenced in this paragraph has
rendered legal advice regarding this Funded Revocable
Trust, and that I have utilized my own judgment or sought.
independent legal assistance in regard to this Trust.
WITNESS:
,-\
,-;..,;;7./ .0' ,A--C: /.~
/i;;; z.~'l-//)O!/'b,&/<::l J
/
;,- :\>_~ --::. 1\ ;
-'
,.4.:.--:'---
PAGE M. LENTZ
'/
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Date:
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LAST Wl,L AND TESTAl1ENT OF PAGE M. LENTZ
I, PAGE M. LENTZ, of Nm-lberry Township, York County, Pennsylvania,
bE!ing of sound and disposing mind, mGmory and understanding, do make, utter and
publish this my Last Will and Test::lnllent, he'c'eby revoking all former Wills by mle
h"l'etofore made.
1. I order and direct that all my just debts and funeral expenses be
fully paid and satisfied by my EXE.cutor, hereinafter named, as soon as may be
convenient after my decease.
2. I give, devise and bequeath all the rest, residue and remainder of
my eS La te ,n~al, PB1"SOoul anJ IId.xed, t'{ wlw L:.HH.l.VCr IIU Lure LlIHl \Y'lIel:e~oeVet.
situate, of which I shall diE! seized and possessed, or to which I shall be
entitled at the time of my decease, to my husband, PAUL S. LENTZ.
3. In the event that my said husband, PAUL S. LENTZ, should predecease
me, or should we die in a common dIsaste.r, I give and bequeath tertain personaL
e,ffect's, in such way and proportions as are set forth in a Hemorandum which I
shaLL leave wiLli Lhis 11IY Last Hill dlld '1\~!c)L:Jl\It~Ill:.
^"ll t'll(' n~~t.. r{'::i(h1(~ :llHi r011l;,linrlcl' or ;ny r,<::'I";:I.1:0, rl';lJ. !'0xsoll,'11
Blld ;ni.xed, of whatsoever nature and wheresoever situa'te, of which I shall die
sei?ed and possessed, or t.') whicll I shall be E:ntitled at "the time of my decease,
I give, devise and bequeath in four (~) equal shares as follows:
A. One share to my daughter, LINDA PAGE LENTZ, of
Pontiac, Michigan, per stirpes.
B. One share to my son, RICHARD HENRY LENTZ, of
DeSoto, Texas, par stirpes.
C. One share to my son, JOHN ROBERT LENTZ, of Rossville,
Pcnnsylvania~ per stJ_rpes.
D. One share to by divided equally between my granddaughter,
,
KRISTINA BROSS LENTZ ?LEASANTON, of Dover, Delaware,
and my grandson, WILLI1\11 KARL LENTZ, of Addison, New York,
sh.'lI."O lInd shnre. pel" sLil:llC.s.
4. I nominate, constitute and appoint my said husband. PAUL S. LENTZ.
Executor of this my Last Will and Testament and Guardian of the Estates of any
minor beneficiaries, to serve without bond of any type whatsoever.
In the event that my said husba:1d, FAUL S. LENTZ, 51,ould predecease
me.. or be unable to se.rve for any re.;:,scn wh;).t.'::~o'~.ver, I nominete, ::onsti tute and
appoint my said Bon, JOT-IN HOBERTLENT7., Excc,,!:or or I:his my Last Will and
Tes\:,ament and (juClr,LLan of the Esl<.i.l',es of Bny IllLlLOl: beneficia.-ries, Lo serve
wi thcut bond of any type ,;.;hatsocV81=.
In thc event that my said son, JOHN ROBERT LENTZ, should predecease
me, or be unable to serve for any reason 'olhatsoF:.ver, I norninatc:;, constitute arid
appoint my said daughter, LINDA FAGE LENTZ, Executor of this my Last \hll and
Testament an(1 Guard"lall o~ the Estates of any nlinor beneficiaries, to serve
without bond of any type whatsoever.
In the e-vent that my said daughter, LINDA PAGE LENTZ, should
predecease me, or be unable to serve for any reason 'i'.:natsoever, I nominate,
constitute and appoint m./ said son, EICHARD HENRY LENTZ, Executor of -this my Las'c
\..J:i.ll nod Te::;tarnent: A.ncl Guardian ot l:h<:~ Es"l:<:lh;s of ::my minor hene:f:i ciaries I to
Sc.L'Ve HiLhoul bond of any tyP€! what:soevcJ:.
IN \'JIT~JESS \-IHEREOF, I haV2 to th:!.s myL!-lst \.!i11 and Tes'::.;;!me~lt,c s~t my
hancI ar.d seal at the end he-(80f t1>i.5 / {, tl; clay of ::S?tL-v--L-- , 1989.
I I '(Y2, V' ill I ;:(ce'--,~-
//1' I'M;l\ 1_1_ LENTZ (SEAL)
The preceding instrument, consisting of t1....O pages J was 0;-;' th(~ date
th2reof signed, published, and declared by PAGE M. LENTZ, the teE'tatrix, herein
na::1lCc1, as and for he.r Last Will and Tes tament) in the presence of us. who) at her
request, in her pr~sence, and in the presence of each other, have subscribed our
names as witnesses hereto.
1.9/. .,<!.~.
j' jHit ' s. -#
jrv.' ztfcld_7' 'li:J{'./-G'2''[;
H.' .tness (
John A. Roe, Esquire
101 North Front Street
Harrisburg, PA 17101
ACKNOWLEDGKENT ,\NIl ,<,f'FID'\VIT
COMHONW1':i\T,TH OF PENNSy'LVANTA )
) :3:..-i:
COUNTY OF DAUPHIN f:jc )
II ^ l C'it,<'AL-c.---
On this ~ day of ~-
Roe, Brenda J. Pascotti, testatrix and the
, 1989, we, PAGE K. LENTZ, John A.
witnesses, respectively, whose names
arc signed to the foregoing instrulOent, being f:i.L.::: duly sworn, do 'hereby declurc
1:0 Llltl LIndo I":., ignnd f,lU/:,horll.y I:Jw/: I;ho l:().'.IL,'lI~I'I:[ S I p,nnrl find OXOCIlI;orl tho
instrument as her Last Hill and Testament and that she signed Hillingly, and that
she executed it as her free and voluntary ac.t tor the purposes therein expressed,
and that e"ch of the Hitnesses, in the presence and hearing of the testatrix,
signed the Will as Hitnesses and that to the best of his/her knowledge the
t'ostatrix Has at that time eighteen years of age or older, of sound mind and
u:"lder no constrElilYt or undue infl.uence. _-
/....;.> I ~--
; I ' (" >(.") I' JI(, /. '1,/' ,I,
/0 ,) (:;1':^1,1
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/,"-/ ri\G.f.~Ku~_~ (SEAL)
/ W ,t~?? /7 ' _,
/?-./I }t..)V!--1<.d.<(/.., -tt.!.&-i9J'ML)
11 tness
Subscribed, sworn to, and acknowledged before me by PAGE K. LENTZ,
Testatrix, John A. Roe, and Brenda J. ll;lSt:oLtl, \>Illnesses, this;L day of
Et~.
, 1989.
)0/1 ("":;<G"'~'-'''- C'J::' !S-L(: ",.,t;
. Nota Public
._.... ..----.J-
---~--.'.,...~..,.". i.gyr.,..qlAl. SeAL
JANICE: I.:" " . . "JTARY PUBLIC
HARRISB,".. ,'.'HIN COUNTY
IN r.OMMISSICi ",:,',:1ES OCT, S, \992