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Home My WebLink About01-0819 Estate of' fir") lA/ /1 r- d 1l/1. also known as PETITION FOR PROBATE and GRANT OF LETTERS V.0 ~emu'fA No. To: 21-01-819 Register of Wlls for the . Deceased. County of e.dh->h.,w14nd in the Social Security No. / (Q 1~ ..2 1- 600 / 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 ~al-'I in the last will of the above decedent, dated '-=?/iJ t2 ~ <;?;~~ 2.d.. and codicil(s) dated 7)ec.ernh~---"Y ~,S! 1'11'7"" WI/i""-' narn~2f- e, ypcufr'l- . 8. V1Io &(2 mil tJinamed , 19Eb- de r..e..a..9 e~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in h is last family or principal residence at 4//(1/) T iNP, r' I (list street, number and muncipality) - .....- Decendent, then 9/ at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: years of age, died (l "J v6l- .-S ,~oo/ 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: $ ,g~. 000, <'0 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~ '" ~ \I) u = \I) :9~ "'~ \I).... c.:\I) = ,,=,0 C"';:: cd "';:: ~\I) ~Q.. \I) '- ~o 0; = 00 Cii / ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTlI OF PENNSYLVANIA I S8 COUNTY OF (I // ;.-y, .6.e/y /'a n d. J 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 beli f petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and t ly aZ'nister the esta cording to law. . ") Sworn to or affirmed and lJ'l before me this 4th ciQ' S t. !a l:: ~ ~ /7- -'I' - IY No. 21-01-819 Estate of HOWARD M WOLGEMlJTH , Deceased DECREE OF PROBATE AND GRANT OF LETTERS and Letters are hereby granted to AND NOW SEPTEMBER 5 xWJOO 1 ,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 JANUARY 22. 1982 described therein be admitted to probate and filed of record as the last will of HOWARD M WOLGEMUTH TESTAMENTARY o DALE WOLGEMUTH and JUDITH WOLGEMlJTH HAMTT.1'ON ~'Y (J )f:/'i'''''' ,elf j A1n.c-<v i glster 0 Wills I / FEES Probate, Letters, Etc. ......... Short Certificates( ).......... x-page.s . RenuncIatIOn ................ JCP $ $ $ $ TOTAL _ $ 93.00 ~;E.~'J;'~~.E;~. ~... .4QOJ. ......... . . .. . 70.00 9.00 9.00 5.00 ATTORNEY (Sup. Ct. 1.0. No.) ADDRESS Filed PHONE lNARNING: IT IS ILLEGAL TO ALTER THIS COpy OR TO DUIF'UCATE BY PHOTOSTAT OR PHOTOGRAPH. : 0 i 1(' iI !I: \ , 01 f N J " I ,ii, IHI 1\11 W,N I ~L VI L ) j' ~ l~:; II EI: I~; lIAF: ::E;: II le l I orl r F Df:J\ TH 'I " CERT. NO. T 4 9 6 0 2 2 4 I t "/ , '~,;.' / ill ~,_ '\.. . .t! 1/::- ~\\ ~~l \, -.1 f; :;~ /~~Ji ?* I')," ~~,! !~ i~~;>7'~, ~':j \; ... .""~],,,,,.,,,~ * ">:. ~,;' ~ rMI' ~ ~'~~:.~ :~ r', August 6, 2001 Date of Issue of This Certification ~', ~~~' ~!.. Howard 21-01-819 M. Wolgeauth Name of Decedent ___ Sec_~_~~~~_~_~_~__ ___ Social Secunty No __ _~~_~9_-=-24~_~0~01~ _ _________ Date of Death August 5, 2001 January 21,1910 Mt. Joy, Lancaster County, Pennsylvania Date of Birth -~_____'______ _______ Birthplace .._____.~ _ n _ .______.~_______~_______ Place of Death Messiah Village ~ Cumberland County Upper Allen Twp. - ,-,"', f\':Hl C,rv, norougll (11 -:-C,"'bl'if:' Pennsylvania Race. Wh it e BIC Missionary ----- Armed Forces? (Yes or No)_ Messiah Village,P.O. Box 2015 Mechanicsburg No Occupation_________ Widowed Decedent's ____n~_______ Mailing Address Mrs. Judith C. Hamilton Informant --------___________________:....._______ Funeral Director Name and Address of Funeral Establishment Mantal Status PA ------"------,--"----~-~- Sl Cif, "C"A' State Scott D. Brenneman, FD Cocklin Funeral Home,Inc., 30 N. Chestnut Street, D11lsburg, PA 17019 Part I: Immediate Cause Congestive Heart Failure Interval Between Onset and Death ;a) ---~ -- ---------_________L_~.___ (bJ_ Renal Failure - "".__._.__._--_._-_._..__._-----..._-------_.~-_.~---- -----,..,-----_._--~-_._,._------~-. ---+--- (e) -- ---_..._--------.._~---~._._--""--_._-- ------------- ----- ---._-----.._--------~-------~.._- Part II (d) ~ _ _ _ .~__~_________.____,,__ Other Significant Conditions 1 1 1 __--L______~ Manner of Death ;~XX Describe how Injury occurred: Natural Homicide Pendinq Investigation Could not be Determined [-1 ~J Accident SUicide L. Lynne Britton, MD Name and Title of Certfier ___ __________________~ Messiah Village 100 Mt. Allen Drive, Mechanicsburg, PA Address ~ 1 76~0., 0.0_, Coroner, ME) -------.-..------.-...---.------.--...---.-----------..._-~-.._---_..._._-_._----~._--- 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 Fleca,ds Office lor permanent IIII~~",,"?:: ~ 676~~",,",'_ August 6, 2001 153 Logan Road, Dillsburg, PA 17019 f.,' , ..::.-1-7::.'"";::-~.-._------~-~ 21-01-819 WILL OF HOWARD M. WOLGEMUTH I, the undersigned, HOWARD M. WOLGEMUTH, of Cumberland County, Pennsylvania, being of sound mind and disposing memory, realizing the uncertainty of this life, but with confidence in God and trust in His Son, my Lord and Savior, Jesus Christ, who died for my sins upon the cross and rose again to justify me and give me eternal life, do hereby make, publish and declare this to be my last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses, including the cost of a headstone and the inscription thereon, be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate, inheritance and succeSSlon taxes that may be assessed in consequence of my death, of whatso- ever nature and by whatsoever jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property incl udable in my taxable estate whether or not passing under thi s Will shall be free and clear thereof. III. I bequeath to my wife, Pearl B. Wolgemuth, all tangible personal property which I own at my death and all the rest of m~l property, of whatever nature and wheresoever situate, including property over which I hold a power of appointment. IV. If my wife, Pearl B. Wolgemuth, does not survive me, I devise and bequeath all my property that would have otherwise passed under Paragraph III above, equally unto my two children, o. Dale Wolgemuth and Judith Wolgemuth Hamilton. If either of ~,t~, (~~\{ ~ " /",' . ,/ j '. - ,; .,. _ . J, )" ~~~~/l them predecease me, his or her share shall pass on to his or her issue per stirpes. V. I appoint my wife, Pearl B. Wolgemuth, Executrix of this my Will. In the event that she fails to qualify or ceases to act as Executrix, I then appoint my two children, o. Dale Wolgemuth and Judith Wolgemuth Hamilton, Co-Executors, or the survivor of them as sole Executor of this my Will. I further direct that no bond be required by my personal representatives for the faithfull performance of his or her duties in any jurisdiction. IN WITNESS WHEREOF, I, HOWARD M. WOLGEMUTH, herewith set my hand to this my last Will, typewritten on two (2) sheets of paper incl uding the atvs~ation cl ause and signatures of witnesses, this 22~day of r~ . 1982. ~j~' 7F7 (SEAL) Signed by Howard M. Wolgemuth, by him declared to be his Will in our presence, who have hereunto subscribed our names as witnesses in his presence and at his request, this ~;~tday of ~~~- , 1982. ~ ct. 1:.5~ Q~ ,. ~1%~ residing at ~ I Pit residing at ~ ~~ ~ I!A -2- ~"""\. .~. ":r-;\: ~ r ,~- . l I', '''.' ,:.~} .:!" '.: ,~,.~~,..~I !\fl(' ~ It. ~\ .i.,.).. . ~", '" ,~. '1!il~:; COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF WE, -pO t' is E. B~-r'f" and Q a, \ E:. \I ee.. +e \ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator, Howard M. Wolgemuth, sign and execute the instrument as his last Will; that Howard M. Wolgemuth, signed it willingly and that Howard M. vlolgemuth executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator, Howard M. Wolgemuth, signed the Will as witnesses; and that to the best of our knowledge, the Testator, Howard M. Wolgemuth, was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~t. I:>"y-olo:. E. 6a..,..... &~ , WITNESS Q~t,.~ c ~r \ IS. t:.'e.e~- ,W NESS SWORN TO and acknowledged before me by the above-named ~4 ~ witnesses this ;2;2- day of hnwcnt V ,1982. I SEAL /) ~,~~~~~~,// /' / ---. -3- ;(1. }. : . .;.~ .:'. ,,,: ...... [J,... '.'. .,.....J q ,;:, t\.~ . ~~." '" :~ #i' . .... ..'f~' ., " <'lo 4 . ~ ~~. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF I, HOWARD M. WOLGEMUTH, whose name is signed to the attached or foregoing statement, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instru- ment as my last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. /// ~-L!/ '~'i ~r?' HO~M. WO~ MUT. - "( SWORN TO and acknowledged before me by HOWARD M. WOLGEMUTH, the Testator, this ;~ day of :Jq/1l/C/I)I , 1982. SEAL -4- 'iI< ;.;;;~".. ."., ..'I.!,...""'...'..... '. ";r':dJ ~r CERTIFICATION OF NOTICE UNDER Rl1l.E 5.6(itl Name ofOecedene ~ Date of Death: H 0 \..oj A t'2. '!:) 1Yl, Lu \;;)L ~~ V)'\ \K)'~ 07-0$""_01 Will No. .:<o~, - 'O\l K,'( Admin. No. :LI_ ~ I - 0 g I 'i To the Register: I certify that noliee of (benefkia/ Inte....t) ....te admjnJstraUnn requked by Rule 5.6(a) of the O<phan" Court Rule, w", ..,,, ved on 0' mailed 10 tbe following benefieiade, of Ibe abo,e'eaptioned e'tale on _. II _ ~ _ <:> I : Na.~ O. ~A~~ Addre~ W Q I... c;.,~ WI \A )\"'\ ~ I C f"f\, i-i- R.:~ (VI 6 c. ~ A )'.I I c:. S e "^ y( '-. . '- ~. ']) l~' \"'\ "- -- t:::.- L( S' '^ 1M "" '''' D -<:.. "D. \..(... S It __I\. "- PI+- , fA (7~S~ 17~' 'i W. H A ~1'-'"T\;)1o( NOlk, has now been gi"n 10 all pee'on, enblled Iherelo unde, Rule 5.6(a) excepI_ .~ j{~~f... Date' N~v <' ~~\)~ 'J<< Signature Name Q, j) A I... ~_1-J \) I- G-t- M tAl') ~ Address ~S:/ ~ I!Y\ , I...~ J€.~ t1\ ~ (...r\ PH' , <:. S; Il v.. t\. G:. , P .p,. ~ 7 ~ S' $"' - Telephone a (7) _7" ,,- "3;:) \) C. Capacity: ~ Personal Representative _Counsel for personal repreSentative COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX(11-96) PENNSYL VANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WOLGEMUTH 0 DALE 2510 MILL ROAD MECHAN/CSBURG, PA 17055 ---.---- told ESTATE INFORMATION: SSN: 169-24-6001 FILE NUMBER: 21-2001_ 0819 DECEDENT NAME: WOLGEMUTH HOWARD M DA TE OF PAYMENT: 11/05/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/05/2001 TOTAL AMOUNT PAID: REMARKS: DALE 0 WOLGEMUTH CHECK#128 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS NO. CD 000480 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,350.00 I I I I I I I I $1,350.00 MARY C. LEWIS REGISTER OF WILLS -\ '\) ~l --'I <t. r f' ' ..;, \::>tJ I ~: M I '( \.,J IV) ~"..- o iA ~ M "4 .J J J' i y d ) ") 11 \) -., ,-3 \lr 0 0 7- ~ ,) .J \..., .~ (j) C:!. ~ ,j) ~ \..-1 ../ f \1, \J) ? (~< V n ILl C) \"- d - ~ ~ lj., VI ~ e \'\ ~ '\ ,,y .J 1: t' ~ :J rl \) \.11 J J ~ <t, \) -- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: WOLGEMUTH 0 DALE 2510 MILL ROAD MECHANICSBURG, PA 17055 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 1 69-24-6001 FILE NUMBER: 21-2001- 0819 DECEDENT NAME: WOLGEMUTH HOWARD M DATE OF PAYMENT: 12/03/2001 POSTMARK DATE: 11/30/2001 COUNTY: CUMBERLAND DATE OF DEATH: 08/05/2001 REMARKS: 0 DALE WOLGEMUTH CHECK#130 SEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: INITIALS: CW RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 000592 MARY C. LEWIS REGISTER OF WILLS AMOUNT $174.38 $174.38 I /",}l , I II ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~~\.IJ Pr~ Date of Death: og' - ()S"- 0 I Will No. ~~~ 1- O\)~\9 M. W \),- C-~ "M-,^~ \-T Admin. No. -;2.1- 01- C~I'l 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 >< No 2. If the answer is No, state when the personal representative reas9nably believes that the administration will be complete:", N LA , 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 ')(, . N I 'A b. The separate Orphans' Court No. (if any) for the personal representative's account is: ~ /...p,. 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. ~1l~0 ~~ O.S>At-~ vJ\)I.-(j.E;M-,^~ 'A Name (Please type or print-) ~s'I::l ('v'Il,.." ~ fY\. ~~ PI~ l c.s 13~ 1\..(;.. PA- 17~ S-~ Address J Date: ,( II / 1. ~ / ?t Ot;L ( ( ......... c r- If) N B: !,; '%C Jc.... .I ,) M I '~~".':i ~~ 2 lJ-.. ~,"I (l) '..0 cs:: a>= 00 Capacity: <1 :.. I (:,~i 't'.. c...J c:::::I (71() "I ~ C. - '3~ 0 (. Tel. No. (j . ::1) QQ) Q)a: a: p ~personal Representative f: 7- b::..v.~ Q It.. Counsel for personal representative (MAH:rmf/AM3) r ! i I ! ft i i , ! \ (; ~ i ~ \ \ \ \ \ \ ..m_~ .--~' -, -J .,_: (;( . ' ( j .,~., . . - '\.I Q ~~ Q 0 G:;I ',? - :.CV ~, vi' '. h '" > L' '. "". ,ll" f I-~ ~ m ~ f ~~Im. 3:" ~;j c(:i Co diij iit,j 't ",. ""to. :i, C' 1",- ," :) '.." 0, (f) a> a: 0: ~ VJ ~ ~~ ~ ~ \) ~ ~\j VJ t- ''-J (' ~ ~ ~~ ~ "- () 1'- '" ~1~ V \.~ ~ .~ 1"\ ~ V, - \'\.I, \- 1Q V VI ~ ~ - ~ ~ ~ :) V \~ \:.J QL r- '<:j . - ........ E: If'\ I c..:J CJ 'l ." ?,.- m ',,_ .0 ...-. s:: .- - Ci,)::; 50 is :::: - - - '. ~ ~- - .-:: -:: ~ ~ "- "1 ~ ::::: ~ ~- ::::::: ~ ::::::: - ... ....::: .,.., .;:) "':1 1":1 ..... I ~::~ () 1'-- .,." ~ .~ \'\( ~ ~ ~ ~ t ~ .' ~L/.. /1 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 8lATE :I,,::;ESTATE OF ~DATE OF DEATH FILE NUMBER P 2 rJNTY 01-21-2002 WOLGEMUTH 08-05-2001 21 01-0819 CUMBERLAND 101 PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4-j-E3f-AFP--fi'2-:o0Y-NO'TicE--OF-YtiHERiTANCi-'TAX-APPRAiSEMENY-,--AL:rOWANCi-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HOWARD M FILE NO. 21 01-0819 ACN 101 ReCOf uc ..... ReUj::tf; . o DALE WOLGEMUTH 2510 MILL RD MECHANICSBURG '02 JAN 25 PA 17055 ClerK CUmberi3.r;c' ESTATE OF WOLGEMUTH TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets Allount Rellitted ( ) CHANGED ~ /f.- ~)v REV-1547 EX AFP 112-001 HOWARD M DATE 01-21-2002 (1) .00 NOTE: To insure proper I (2) .00 credit to your account, I (3) .00 subllit the upper portion I (4) 16.751. 00 of this forll with your i (S) 13.563.00 tax paYllent. I 17.579.00 I (6) (7) .00 (8) 47,893.00 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 I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: lS. Allount of line 14 at Spousal rate (lS) 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 TAX CREDITS: PAYMENT DATE 11-05-2001 11-30-2001 NOTE: RECEIPT NUMBER CD000480 CD000592 DISCouNT (+J INTEREST/PEN PAID (-) 71. 05 .00 12,439.00 .00 (11) (12) (13) (14) (9) (10) 1~.43c) 00 35,454.00 .00 35,454.00 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 35,454.00 X 045 = .00 X 12 = .00 X 15 = (19)= AMOUNT PAID 1,350.00 174.38 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 1,595.43 .00 .00 1,595.43 1,595.43 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV.l500 EX . (,.97) w ~ lIl::$1/) Ull:lIl: Wll.U :rOO UIl:J A-lll A- <( z o j: ~~ 1-':) Q. :I o (,) REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH F PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITiAl) use a blank block to separate words t- Z W o W o W C l.)JoL<T''Mu-~k 1'7 FUNUiiiR ;1. / COUNTY CODE M SOCiAl SECURITY NUMBER DATE OF DEATH I-t 0 \.N A R.. \) DATE OF BIRTH o I I ".2- I I I 9 0 1& '1--:Lt.{-c, 00 ( 6<{lo~/-:L\JO (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST,;:; 7~INITIAl) SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ;2 ( I 0 f'f\ \ (..'- (2.") f'^ E. '- \..l. ~ \{ I c..s' f!. IJ'. R. c:- ae; .I ,.. ."...,. . (1) (2) (3) (4) (5) (6) (7) ::l :;.. cr ....,t'" '(11 '. t.:-- UT G~~!.{ ~=L~ o (7 (') (l <1 YEAR NUMBER I &,75/ ~'6i 0 I '3 I ~ ~ 3 .J:O:.:; 0 /7,57900 (9) (10) (8) 11-, l-f-s '1 00 ~ 1. Original Return 0 2. Supplemental Retum 0 3. Remainder Return (dateDldeathpriorto 12-13-82) o 4. Limited Estate 0 4a. Future Interest Compromise (date 01 death after 12-12-82) 0 5. Federal Estate Tax Retum Required o 6. Decedent Died Testate (Attach copy 01 Will) 0 7. Decedent Maintained a Living Trust (Attach copy ofTr"SI) _ 8. Total Number of Safe Deposit Boxes o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95) 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING AODRESS 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 Subjectto Tax (Line 12 minus Line 13) 15. Amount of line 14 taxable at the spousal tax rate , , See instructions on reverse side for applicable percentage 16. Amount of line 14 ta9ble -:2./ L1 /" J I at~rate I-f, ') "7", ..:l ~, "1 ~ \. 17. Amount of line 14 taxable at 15% rate 19. (11) (12) (13) (14) x .0 (15) ~ W Q Z o A- I/) W II: II: o U Q. l) A(..~ FIRM NAME (II Applicable) W \) '- G- ~ ~ ,^r"\1-\ G -+ E: c.. ~""'() fl..... 00 P6: 04 416) .15 (17) (18) 17 \J <{< Cl C"'J I W x x :g N en CP V.i 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation.Partnership or Sole-Proprietorship z o 5 :::) !:: D. c( o w Q: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1'7) t..{ 7,c:t '1 3.0 0 / 1-, 4 3 ~ . 3-<,t{S--L(.b o 0 o 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 18. Tax Due '3 5, L{ S-- L( 0 0 I SCf~ 43 , J,~9<.L(5 IQ N\\~,- Jl 1'f\E;('\-l.~t\I<::~eV\a.c;....J PA- {70~< ADDRESS I;.z... $ '>- M N. ''-' '"1l1l- "'J)k'_$t!."f'.,~ e~ 1.7~(9 DATE A I -L-11 'O? ~ 0 ( DATE , 11--;'-7- ~, Decedent's Complete Address: . STREET ADDRESS ~/t..( ('f\ f::'lr;; I f'rI.. VI I.- L- A G- ~ p\J. (l,~"" (Zt') I( CITY f'f\ ~ c.~ ~ +\ I r.::.S ,a,^ ~ C- I STATE P p..- I ZIP / 7, "''$"S'" Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount .:!. ~(".:3 "'J. (1) I ~ Cf ~. i.f"3. /:3 5"'0. 00 "7 I. o~ Total Credits (A + B + C) (2) /41(,<)' 3. Interest/Penalty if applicable D. Interest E. Penalty _. -e_ ..Jh,J Total Interest/Penalty (0 + E) (3) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 line 19 to request a refund (4) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 17 Lf. '3 (' ._~"mL_".rn~~.._l J~.~~__,J~~_:~~~~,~rablj to'~l~~~IER OF ~~~.:~ AG:1~.LJ1L__JI~IUltL.mj_,~ PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; .............................................................0 b. retain the right to designate who shall use the property transferred or its income; ................ 0 c. retain a reversionary interest; or............................................................................................. 0 d. receive the promise for life of either payments, benefits or care? .........................................0 2. If death occurred on or before December 12,1982, did decedent within two years preceding death transfer property without receiving adequate consideration? 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 "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?.... 0 .1 7 tf, 3 t No m [g ~ ~ 1XI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN 72 P.S. ~9116(a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995. 72 P.S. ~9116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt 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 JANUARY 1, 1995 - Please answer the following question by placing an "x" in the appropriate space. Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire lifetime? Yes 0 No IZl If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(ies). Enter the value of the trust on Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule 0 in order to make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(ies). 'REV-1507 'EX+ (1-97) SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF w V L. G- C: MiA.."" ~ H \) -....J PI fL") M, FILE NUMBER -;2.-1- 0/- 00 ~{9 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Ai 'J '\ f R E:'- E. '\ V A ~ '- e 5'" ~ E..ruc.. \ l'J;..t W \l L G-~ vv\ \A. ~ 11 d-~O IV\ \1,1,.. ~~A~ M E:<'-~ A 1'\ (CS VS v... fl-r;.., P p, / (p 7$'0, ~~ / 1"7 Q ~'$""' TOTAL (Also enter on line 4, Recapitulation) $ / "_ 7!: / (If more space is needed, insert additional sheets of the same size) ~EV.l508 EX _11.9'7) :* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF cJ 01.. Cr (;. M \I,.~ ~ ) \~ ~ W f\ It. ~ N\. FILE NUMBER :Zl-o(- 01\:) '1 ('1 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. DESCRIPTION VALUE AT DATE OF DEATH c..~ ~<.t:.;:.J \--{ G- if:1 c....c... ~.......ti ~' Y'f\ (l-\.. ~ \-l 13 A ;.1 (<- ~ S'<: (-: \.1- ff fi. ({.Il L... ~ t\-') '(Y\ ~.~ 1--' f') H (<;;,..) /J I,A R. C. ,/ P Pr A k. e; 21.1.- O\JO -~'551 p p. a.. 1<- I.....J ~-( /1 0 ~(' ))~~ vAL..v-.~ 8 059,/:3 I x: HI'"':' {;.. A.~,.....- -::S:::"H.. q M ~ '3.'3~ -;1.. ((?. l P PI . D ~ J.. I-l E 1<. ~ '- E...,.. f (. p S ~ $ 5' 5"o~, 00 ~ TOTAL (Also enter on line 5, Recapitulation) $ / 3 ~ 1: t:, :3, '::>0 (If more space is needed, insert additional sheets of the same size) REv.t509 EX .,t.9,> .,. SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LJ a L <r <:J" \A '"' 'r': t4 \) vJ po, yt'\) m, FILE NUMBER ;LI-()l-OO ~ I q If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. 0, '9AL..~ WOLrJ-fMi},:,~ B. J\...''"$:>-I W. H ~M\ \...~~1'~ ~S'/o f'A1l..'- (2.\::.1 f'(\G'-.\-"'~""Ic..S€V-~c:.) pp:... 170$"~ 4 s;: v-'M VV\ ,~ '0 ~ j) I L- (... ~ ~ ',~ It G- P ~ J ~'<JH b A v-c..~"'c.~ c. . JOINTLY-OWNED PROPERTY: LETTER ITEM FOR JOINT NUMBER TENANT DATE DESCRIPTION OF PROPERTY MADE Include name of financial institution and bank account number Of similar identifying number. Atlach JOINT deed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET %OF DECO'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A~(!,/qqCf SLl'5G....'-"-~f-\lAH+.\p.. V~'-'."G;--{ rC,^ I?-. l"l $" \... p....-; ((; ,fJ.''-L... (2.., C ~ t('.. p ~~, '.,,1... P P-r , 70 ( I ..J 5p....vllJG--S rr,!~-:Jj;. ~7~'l. !2- U:r v......... '/-. R- ;;: ~ po, IZE: S 1..{1 &, {;2.. '3'{ '3:g ~ / ~ ~-S7, 4;< ~, ~r-g ,QQ9 $~f't-~ C \-" ~'- 1'- dl c:;:.. ~ I c.. * '3' i, 1- 5 lA A tU: 'D fl- A 'f---< 1-- q '18,77 "3'$'1/3 q '1'1. ~~ "'2. fA 11. / '1 'i 1 :cH,.... U~..('5 '-r ~ t-\ C..:~ rv'. ~ :;;; , ot- 0"-' ~r.r\:\J~ 1?-4,ctt 3~ I~ 4I,(P& TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1{~7 q REV.1511EX "(1.g7J ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 1. 8. 1. 2. 3. 4. 5. 6. 7. ~, '1, la, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT W 0 L. G-~ M vV""\' f1 H ~\.JJ A (l.. ":) M. FILE NUMBER pL.i- 0(- o~,(11 .. DESCRIPTION FUNERAL EXPENSES: 1\\ ~)) \ f\ ~ V \ ~ i- P, ?- t - N-- \. ~ l.- S N 'IT;> ~ IG-S F'1.-...v,J lit.- S"OO.QO ~'37, ~v ~O.~O h~ H~,(;.\,,-,,-I""i'-.s C>:l c: j<::' L I N f" "'" )-.1 (.R,. J\ '- H~ "^- ~ '3 ::) r-< . c:::: ir\ ~ ":.~(--l~ ~, J) \L-L- '> ev...n..C- P (),.. (70 I 9 .J ~<o v. O~ , ADMINISTRATIVE COSTS: Personal Representative's Commissions /" 0 N. (C Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attomey Fees H'"':ll-l(e, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant f-..( ~ 1-.\ '- Street Address City Relationship of Claimant to Decedent State Zip AMOUNT ~ ').'67, ~o Accountant's Fees f-4. <);.t f. Probate Fees q '3. <)" Tax Retum Preparer's Fees ({I::. \J C~'" ( ~ (,.\ r;.. ~~.<... f:.Y<:- Po"", G- O-') C ',J. 'IY\ r3 \;. R-l... P\ 1'-\~ L p..."" ":J cv- /1. ~ (J. L- ~'-fl3E:.IZ",,"'( ~I/e C~('\..L-\r'-<c P-A 17'~13 '..J -' b') '\ ~ ~ oS" E }.\"""" I t{ c l- - L E:.C:- p, '- f. 0, 15 0 "l( 13 0 c ~ R.. '- , ~ (... t P A I 7~ 11 J .J (.""11-1{\\... Pr:..'IfY-.f.t(~~ N\E;SSIr;:.,~ V(~\"'A("~ .p~ a~-+ ;L':)/$" ME;c..o\-\A-\J\CSa...../'aC-j p~ 17--S'$" '"\\) P ~ '" ~ '{Y\ \; ~ \ t. po, - 9 (4 v.-(/... ) R. ~ -r \I- l"'-\ "\:> J ~,,:--\rv E'"'J.. f t:c t-I ~ E r "F\'t-\p\L- PA.~I'fY'..~},r- M \ 5C (L-L-A t( t,1;:)V--" TOTAL (Also enter on line 9, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) tfo"'3. 'l~ ~, o~ ({. l-s S7"3, 0 0 ~ ( I$'"/ ( bZ-~-5. 7::; ) It 139. c:l,;) J ~:"'."'~., . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF lJJ 0 L (j- E. (Y\ \)\ ~ y+ , )-\7', \..".1 A a... ~ r'v\. FILE NUMBER a-I- 0 1-00 ft \q NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1. TAXABLE DISTRIBUTIONS (include outright spousal distributions) REIJ\ TIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 1. 0, '1:J t:a. L. ~ W C:ll..... Go e V'r\ [)..'"""'\"" ~ -;2.. S I (':) rY\ \ L l.... f2.. 3> .. N..€,C.t-\A't--$<::':; Gv.-f2-C-.I pfl )7Q$"~ .5:' ~ +l. 11) 7"l-r.- ')., ::T v-~ l",""~ W, t-+ A W\ I ,-"\0 iJ L.( S u-.,ff'. 'M \ ~ .-~ re... P""-- (-?r,::,("l 1) I,-I.....S g/.A. I<.. '- .. r ) "D ~ '" c:.~'""r elL /1. 77-7,- --r-~\..~L ~ '" ;2 (. V - I :$'" ~~ L. 11'\ ( I (" 5~ 451.{ ,- ENTER DOLIJ\R AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II.. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ~,.,.~.~.",.~.,. ..'.-..... /- ~..;~....., \.. . . ;. ~ : : tOt -, ;'.... ... ._,.;:. .,,,,,,t\ v '/ ~ , - ;':\:$ . ~.. t......-. ,,~t . ,-- I ' ,,~...' ,':(, , '\, .~.t-t.t::.t~c1\"'~'.^ .6 r ..--k '\~ \. ..., Js..;' ,..,~ '. ;'^"... ",,;,.., ~~.., t'Ofo~ "1' Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2001-00819 PA No. 21-01-0819 ESTATE OF WOLGEMUTH HOWARD M (LA::i'l', r'.1.K::i'l', M.1.lJlJLl::!;) Late of UPPER ALLEN TOWNSHIP CUMt;l::!;KLANlJ CUU.N'l'Y, Deceased Social Security~No~ 169.24-6001 day of September 1:'-;: ,;~, 2001 an instrument WHEREAS, on the 5th dated January 22nd 1982 was admitted to probate as the last will of WOLGEMUTH HOWARD M (LA::i'l', r'.1.K::i'l', M.1.lJlJLl::!;) late of UPPER ALLEN TOWNSHIP CUMBERLAND County, who died on the 5th day of August 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to WOLGEMUTH 0 DALE and HAMILTON JUDITH WOLGEMUTH who have duly qualified as Executor (rix) and have agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 5th day of September 2001. ~// r'e~ffERrsf4!Jrtifin":Y * * NOTE * * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) WILL OF HOWARD M. WOLGEMUTH I, the undersigned, HOWARD M. WOLGE~1UTH, of Cumber l~nd County, Pennsylvania, being of sound mind and disposing memory, realizing the uncertainty of this life, but with confidence in God and trust in His Son, my Lord and savior, Jesus Christ, who died for my sins 1 ' '.' "_'" L.t.. "~.. ~ i upon the cross anq ~ose again to justify me and give me eternal life, do hereby make, publish and declare this to be my last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. .1 direct that all my just debts and funeral expenses, including the cost of a headstone and the inscription thereon, be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatso- ever nature and by whatsoever jurisdiction imposed, shall be paid out of the principa"i of my general estate to the same effect fiS if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. I ~equeath to my wife, Pearl B. Wolgemuth, all tangible persona~:ptoperty which I own at my death and all the rest of my property, of whatever nature and wheresoever situate, including property over which I hold a power of appointment. IV. If my wife, Pearl B. Wolgemuth, does not survive me, I devise and bequeath all my property that would have otherwise passed under Paragraph III above, equally unto my two children, O. Dale Wolgemuth and Judith Wolgemuth Hamilton. If either of ;f2,( ~,. o ~ \{ /&:~O~~~~/l '~'i :,1 j 1 1 I i '1 them predecease me, his or her share shall pass on to his or her issue per stirpes. v. I appoint my wife, Pearl B. Wolgemuth, Executrix of this my Will. In the event that she fails to qualify or ceases to act as Executrix, I then appoint my two children, o. Dale Wolgemuth and . I.~'- ' Judith WOfgemuth Hamilton, Co-Executors, or the survivor of them as sole ~xecutor of this my Will. t ,:,.' , .' , "'. r further direct that no bond be required by my personal representati ves for the faithfull performance of his or~ her,l~pt.:it,~,~<, .;1;C {~/~ ~~\.,~ ~H_}~;,l,,,,, .in' any jurisdiction., IN WITNESS WHEREOF, I, HOWARD M. WOLGEMUTH, herewith set my hand to this my last,Will, typewritten on two (2) sheets of paper including the at clause and signatures of witnesses, this 22.~day of 1982. .~~ (SEAL) Signed by Howard M. Wolgemuth, by him declared to be his Will in our presence, who have hereunto subscribed our names' as witnesses in his presence and at his request ,this ~j.tUtday of ~~ , 1982. ~ ct.I:'SdAAJ Q,& e. ~1 %~ residing at ~, P-A- residing at ~ k~, Q~ .:.... " i.' ~ ' ,1': -2- COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF WE, ~O t' \ s E . B~-r.... and Q d' \ E:. \I e.e-+e \" the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that .wewere present and saw the Testator, Howard M. Wolgemuth, sign and.lexecute the instrument as his last Will; that Howard M. Wolgemuth,' signed it willingly and that Howard M. Wolgemuth executed it ,1.a~.>.his fre,e i'1nd volun~ary,.~ctt~~~i"':t-.he..purp'oses.;\>t;n.efeiql',expr::essed; that each pf us in the hear ing and sight of the Testator, Howard M. Wolgemuth, signed the Will as witnesses; and that to the best of our knowledge, the Testator, Howard H. Wolgemuth, was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~t. b"l""'''' e.. &a.'t''r &~ ,. WITNESS Q..J2 t,. ~ C ~r \ E... \::.'e:.e~-', W NESS ~ it '..;; ~ t." ;+..:.,~:~ ~ '. ~1o ;'1',) i .'~!:..y-~ r .f.. -'...:..~. SWORN TO and acknowledged before me bY'~1;~~..?:boy~~named witnesses this ;22~ day of J;;nt./dXV!", 1'982. I . 'I SEAL"". I -3- COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF t 1" I, HOWARD M. WOLGEMUTH, whose name is signed to the attached or foregoing statement, having been duly qualified according to . :~-.Jo' '., _' \' ji, , ; ~ ,,' -~ . law, do hereby aCknowle,dg,e that Isign~d and executedth~i,~,na1;ru.."", ment as my last Will~.. th~tL+,S~ . ,naJv.>"ij~,4~t.~ba;t;~~+ ._":,,." _.. :, ,'I,_:~.:.i~':',':;:;'~~~'!~"'_r<tth11..~~~. _ - _.,-~l:~~~:f\'~~;;e~~~-;~'>~f~?-;~.f;<~:;u:",":/';\~~:~'-~" ,,<~':,si,qned;:.it . as, my,fre~'~\ao.4;ii,,~9Jt$ " <>:r.,>the<'purposes therein , ;,~.~ /":,i. .', -, .;. .', ".; .':.. ~ - '.. > >:. - -, '. -, :t..4~.:; expressed. .' "11;-,- ;. ' ,/ SWORN TO and acknowledged before me by HOWARD M. WOLGEMUTH, the Testator, this l~ day of CfinUdl' V , 1982. y I SEAL .'\ S .. ' ~..( . -4- .' Mellon Bank PERSONAL BANKING STATEMENT DIRECT INQUIRIES TOI MELLON BANK NA 0 COMMONWEALT~ REGION MECHANICSBU~ GIANT 255 CUMBERLAND PKWY MECHANICSBURG PA 17055-5677 717-795-7652 111.111 mlllll..I.I..I.I...I.III......II.I.I....II.I.I.I..I.1 HOWARD M WOLGEMUTH PEARL B WOLGEMUTH 614 MESSIAH VLG PO BOX 2015 MECHANICS BURG PA 17055-2015 00250 0809 312-000-5537 {AGE 1 OF ~. ~TATEMENT ~ROM 08/03/01 3 THRU 09/05/01 GET CONNECTED TO ONLINE BILL PAYING AND DISCOVER THE FAST AND CONVENIENT WAY TO PAY YOUR BILLS. SIGN UP TODAY AND YOU CAN ENJOY 6 MONTHS FREE ONLINE BILL PAYING (WHEN YOU HAVE A MELLON CHECK OR ATM CARD). VISIT WWW.MELLON.~OM/SPECIAL OFFER FOR COMPLETE DETAILS. RELATIONSHIP SUMMARY DEPOSIT ACCOUNTS CHECKING HITH INTEREST TOTAL BALANCE 7.899.62 7,899.62 LOAN ACCOUNTS OUTSTANDING CHECKING WITH INTEREST ACCOUNT 312-000-5537 OPENING BALANCE AS OF 08/03/01 TOTAL DEPOSITS AND OTHER ADDITIONS INCLUDING INTEREST CREDITED THIS PERIOD TOTAL CHECKS AND OTHER HITHDRAHALS INCLUDING FEES AND CHARGES THIS PERIOD CLOSING BALANCE AS OF 09/05/01 7.449.73 +611.94 -162.05 7,899.62 AVERAGE ACCOUNT BALANCE AVERAGE COLLECTED BALANCE FOR ANNUAL PERCENTAGE YIELD EARNED YOUR ANNUAL PERCENTAGE YIELD EARNED FOR THIS STATEMENT PERIOD IS 0.26% 7.921.51 7.921.51 DATE POSTED 08/0:5/01 DESCRIPTION OPENING BALANCE MISC AUTOMATED CRED us TREASURY 303 3031036030SOC SEC 169246001A SSA DEPOSITS AND OTHER ADDITIONS CHECKS ~ AND OTHER HITHDRAHALS DAILY BALANCE 7.449.73 -~ 8.059.73 610.00 08/08/01 CHECK. 3760 . 162.05 7.897.68 09/05/01 INTEREST CREDIT SERVICE CHARGE 09/05/01 CLOSING BALANCE 1.94 .00. 7.899.62 7.899.62 12.1501 . YOUR MONTHLY SERVICE CHARGE (SHOHN TO THE RIGHT) HAS BEEN HAlVED THIS MONTH BECAUSE YOU MET THE AVERAGE DAILY BALANCE REQUIREMENT IN YOUR CHECKING ACCOUNT. .' SUSQUEHANNA '~ALLEY FEDERAL CREDIT UNION 1213 SLATE HILL ROAD CAMP HILL, PA 17011-8035 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 HOWARD M WOLGEMUTH O. DALE WOLGEMUTH 4 SUMMIT DRIVE DILLSBURG, PA 17019 TRAN POST TRANSACTION DATE DATE DESCRIPTION 08/01 08/01 08/16 08/29 08/29 08/31 08/01 08/01 08/07 08/13 08/15 08/16 08/18 08/21 08/22 08/31 Memberl: Social Security I: Statement Date: Pagel: Ma il Code: 3782 169-2X-XXXX 08/31/2001 1 YTD TAXABLE DIV: $47.05 YTD TAXABLE INT: $.00 YTD FINANCE CHG: $.00 TRAN FEE AMOUNT AMOUNT FINANCE LOAN CHARGE PRINCIPAL BALANCE ------------------------------ ----------- -------- --------- ---------- ----------- Type: 00 - REGULAR SHARES - 00 PREVIOUS BALANCE 2785.72 08/01 Deposit 46826.62 --::~ 49612.34 08/16 Transfer Withdrawal 3500.00- I 46112.34 08/29 Transfer Withdrawal 17537.00-/ 28575.34 Transfer Withdrawal To MBI 990 Acct: 40 08/29 Transfer Withdrawal 17537.00- / 11038.34 Transfer Withdrawal To MBI 1241 Acct: 00 Type: 40 - SHARE DRAFT - 40 08/01 Deposit 08/07 Share Withdrawal 08/13 Iteml- 66 Tracel- 17025850 08/15 Iteml- 68 Tracel- 11011400 08/16 Transfer Deposit 08/18 Deposit 08/21 Iteml- 67 Tracel- 21024150 08/22 Iteml- 69 Tracel- 17087~60 NEW BALANCE 11038.34 i']. v 444.24 ,/ 50.00- 500.00- :/ 237.50- ,/ 3500.00 ,/ 389.86 22 . 86 - ,/ Q978 . 00:::,..("" PREVIOUS BALANCE 2554.53 --~ 2998. 77 2948.77 2448.77 2211.27 5711.27 6101.13 6078.27 1100.27 NEW BALANCE 1100.27 f:,l y Item. Amount Cleared Items This Period NOTE: An .. indicates a skip in sequence. Item. Amount Item. Amount Amount Item. -------- ----------- -------- ----------- -------- ----------- -------- ----------- 66 500.00 67 22.86 68 237.50 69 4978.00 Description Summary Count Dcbitf: C;-edits -------------------- Share Draft Items ATM Transactions EFT Transactions Electronic Checks Voice Transactions Other Withdrawals Other Deposits Balance Forward: Net Change: New Balance: 4 o o o o 1 3 5738.36 .00 .00 .00 .00 50.00 .00 .00 .00 .00 .00 4334.10 2,554.53 1,454.26- 1,100.27 If you had a Christmas Club for this year, you will receive your check in a few weeks. If not you can use your Credit Union Visa for your extra Holiday expenses this year and open a Christmas Club for next year to provide the extra cash you will need. 0800456