HomeMy WebLinkAbout01-10-06 (2)
- -
REV.1500EX (b-OO)
REV-1500
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
o
W
U
w
o
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Deardorf, Robert L.
DATE OF DEATH (MM-DD-YEAR)
04/18/05
DATE OF BIRTH (MM-DD-YEAR)
OS/22/14
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
w
f-
:.::~l/)
un:::.::
wll-U
:r:oo
un::-'
1l-1Il
Il-
ot
~ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (AUach copy 01 Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 death aile, 12.12.82)
o 7. Decedent Maintained a Living Trust (Attach cOPyofTrustJ
o 10. Spousal Poverty Credit (date 01 death between 12.31.91 and 1.1.95)
o
FILE NUMBER
21 05
0391
COUNTY CODE YEAR
NUMBER
SOCIAL SECURITY NUMBER
207-07-6137
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dale 01 death prrorto 12.13.82)
o 5. Federal Estate Tax Return Required
.0. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AUach Sch 0)
f-
Z
W
C
Z
o
ll-
l/)
W
n::
n::
o
u
';rHIS'SECTION.:M t1SiT{BE(CQIlliRI.!ETED;tAt;L.:iCQRRE~f10NJ)ENCEi~NDic::.(jNFIPENTIAt'1tAXiIN F'ORMATIONSHOtlIJO!BE'OIRECtEt)i:rq:'
NAME COMPLETE MAILING ADDRESS
Carl G. Wass 3631 North Front Street
FIRM NAME (If Applicable) Ha risb 9 P A 17110
Caldwell & Kearns, P.C. r ur,
TELEPHONE NUMBER
(717) 232-7661
z
o
<
..J
::>
I-
a::
<
u
w
0:::
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
(6)
(1)
(2)
(3)
(4)
(5)
427,335.63
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens(Schedule I)
11. Total Deductions (total Lines 9 & 10)
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)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-
::>
c..
~
o
u
><
~
15. Amount of Line 14 taxable atlhe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O ~ (15)
16. Amount of Line 14 taxable at lineal rate
x .0 (16)
17. Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
.___.____________~~?L~?t3:7! x .15 (18)
(19)
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
>>BE'SURET0iANSWER,Al:I..fQUESTIOJilSONREVERSE"SIDE;ANORECHECKMATH < <
80,000.00
(
c:>
17,076.07
w'
,
--'
(8)
45,066.79
1,133.00
(11)
(12)
(13)
524,411.70
46,199.79
478,211.91
182,945.20
(14)
295,266.71
(17)
44,290.01
44,290.01
Rt.
, .
Decedent's Complete Address:
STREET ADDRESS
812 Market Street
CITY
Lemoyne
STATE
PA
ZIP
17043
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
44,290.01
40,000.00
2,105.26
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C) (2)
42,105.26
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 20 to request a refund (4)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
2,184.75
A. Enter the interest on the tax due.
(SA)
(5B)
2,184.75
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
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 [Kl
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [Kl
c. retain a reversionary interest; or.......................................................................................................................... 0 [Kl
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [Kl
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? ........................................................................................................................ 0 [Kl
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 return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaralion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
?Jii-:;d"J11=;~~:ET:N _~~ .____
1063 Pebble Mechanicsbur , PA 17050 10 Claystone Road, York, PA 17404
. . ..-___.__._.._..._.__.__".___.._,_._'_~__m___..._ ___'_'_"'_~~_._mm.____.___ "_~_._._._m________m.__.__....__....... ...~___.,__...__..~_.._._ _..... __ __'_..... .___.._._....."..__..
SIGNATURE OF PREPARER ER THAN EPRESENTATIVE
._....~
- .~~,~~._----
DATE
...... 11~.iQ~___
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. 99116 (a) (1.1) (i)].
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. 99116 (a) (1.1) (ii)].
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 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. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)J.
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. 99116(a)(1.3)J. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
FILE NUMBER
21-05-0391
All real property owned solely or as a tenant in common must be reported at fair market value, Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Two-unit residential dwelling, known as 812 Market Street, Borough of Lemoyne, Cumberland
County, For Title see: Cumberland County Deed Book B-25, page 519, deed dated February
23,1972. Co-owners, Irma May Deardorff, spouse (died June 4,1977) and Gladys Lillian
Deardorff (died December 31, 1995) predeceased the decedent who acquired complete
ownership by right of survivorship.
Appraised Value
80,000.00
(Deed - Exhibit #1 )
(Appraisal - Exhibit #2)
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
80,000.00
REV-1508 EX+ (6-98) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISe.
PERSONAL PROPERTY
ESTATE OF
Deardon, Robert L.
FILE NUMBER
21-05-0391
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Cash located within home of the decedent
12,506.44
2. M & T Bank, checking account #277-294-78-4222 (Exhibit #3)
3. Morgan Stanley Dean Witter Account #410-040913-049 (Exhibit #4)
41,124.71
5. Oppenheimer & Co., Inc. Account #A09-0004282-RR-127 (Exhibit #5)
35,998.94
7,000.00
177,296.03
59,607.28
4,913.13
11,478.37
60,152.76
4. 1999 Buick Century 4-door sedan (received upon sale)
6. Putnam Investments, Oppenheimer & Co., Inc. Account #B 18-1207076137BBB (Exhibit #6)
7. Putnam Investments, Oppenheimer & Co., Inc. Account #A 15-160044630957 (Exhibit #7)
8. Duff & Phelps Utility/Corporate Bond-valued as of 3/31/05 - 876.8808 shares @ 13.0900/share (Exhibit #8)
9. Allstate Annuity Contract #GA 18417901 (Exhibit #9)
10. Personal belongings, collectables and other miscellaneous personal property within home of decedent-
proceeds of sales thereof by Chuck Bricker, Auctioneer (Exhibit #1 0) 15,294.25
11. Proceeds of sale - miscellaneous coins and paper money 1,588.00
12. Private sale of miscellaneous personal property 237.13
13. Capitol Blue Cross - health insurance refund 104.00
14. Allstate Insurance Company - auto insurance refund 19.34
15. Allstate Insurance Company - homeowners insurance refund 15.25
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
427,335.63
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-05-0391
SURVIVING JOINT TENANT(S) NAME
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
RELATIONSHIP TO DECEDENT
A. Darrell Williams
B. Linda Williams
C.
Donald R. Shover, Sr.
D. Donald R. Shover, Jr.
JOINTLY-OWNED PROPERTY:
ADDRESS
10 Claystone Road, York, PA 17404
10 Claystone Road, York, PA 17404
Church of God Retirement Community
801 N. Hanover Street, Carlisle, PA 17013
Friend
Friend
Friend
1063 Pebble Court, Mechanicsburg, PA 17050
Friend
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCDUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 09/02/03 Oppenheimer & Co., Inc. Account #A09-0030014 31,228.21 1/3 10,409.40
B. 09/02/03 Oppenheimer & Co., Inc. Account #A09-0030014 (Exhibit #11)
2. C. 03/02/95 Central PA Conference, United Methodist Church, Investment Certificate 20,000.00 1/3 6,666.67
D. 03/02/95 Central PA Conference, United Methodist Church, Investment Certificate
(Exhibit #12)
TOTAL (Also enter on line 6, Recapitulation) $ 17,076.07
(If more space is needed, insert additional 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
Deardorf, Robert L.
FILE NUMBER
21-05-0391
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Darrell Williams, Co-Executor, NOTE: 2nd Executor
Social Security Number(s)/EIN Number of Personal Representative(s) 211-34-8614
Street Address 10 Claystone Road
8,566.00
City York
Year(s) Commission Paid: 2006
State PA
Zip 17404
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
.Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8,566.00
REV-1511 EX+ (12099).
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
FILE NUMBER
21-05-0391
Debts 01 decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Donald R. Shover, Jr. Co-Executor, NOTE: 2nd Exec.
Social Security Number(s)/EIN Number of Personal Representative(s) 206-32-1290
Street Address 1063 Pebble Court
City Mechanicsburg
Year(s) Commission Paid: 2006
State P A
Zip 17050
2.
Attorney Fees Carl G. Wass, Caldwell & Kearns, P.C.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4.
Probate Fees Register of Wills
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. The Patriot-News - Legal Advertisement
8. Cumberland Law Journal - Legal Advertisement
9. Robert R. Jones & Associates - Real Estate Appraisal
10. Register of Wills - Additional Short Certificates
11. Verizon - telephone service at dwelling during clean-up
12. PPL Utilities - electric service at dwelling during clean-up
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
8,566.00
17,882.00
464.00
256.80
75.00
450.00
12.00
120.87
109.48
$
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
(continued)
13. Allstate Insurance Company - auto insurance 49.16
14. Allstate Insurance Company - homeowner's insurance 94.84
15. P A American Water Company - water service to dwelling 90.00
16. Postmaster - Lemoyne - stamps 37.00
17. Faith Nicola - 2005-06 School Real Estate Tax 829.15
18. Musselman's Funeral Home - additional death certificate 25.00
19. Lemoyne Borough - sewer rental 60.00
20. Robert Haring - trash removal 162.50
21. Reimbursement of travel expense to co-Executor, Darrell Williams 885.27
22. Reimbursement of travel expense and supplies to co-Executor, Donald R. Shover, Jr. 331.72
23. (RESERVED - Federal & State Income Taxes) 6,000.00
TOTAL (Also enter on line 9, Recapitulation) $45,066.79
REV-1512 EX. (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
FILE NUMBER
22-05-0391
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Figi's, Inc. - charge account debt
19.65
2.
Bank Card Services - credit card balance
120.09
3.
Verizon - telephone charges
66.31
4.
PPL Electric Utilities - electricity charges
96.00
5.
Borough of Lemoyne - water & sewer charges
70.06
6.
Comcast Cable - final TV cable bill
27.70
7.
PA American Water Company - water services
27.68
8.
Eshenaurs Fuels, Inc. - heating oil bill
273.33
9.
Faith Nicola - 2005 County/Borough real estate taxes
370.69
10.
Luff Lawn Mower Repair - bill for repair services
61.49
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,133.00
REV-1513 EX+ (9-00)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-05-0391
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Malcolm G. Wakefield, Jr. & Lucille Wakefield, 3 Waverly Drive,
Hummelstown, PA 17036 (3% tangible property & residue) Nephew 9,000.30
2. George R. Severine, 1247 Danielle Drive, Frederick, MD 21703 (3%
tangible property & residue) Nephew 9,000.30
3. David N. Severine, 342 Abby Terrace, Drexel Hill, PA 19026 (3% tangible
property & residue) Nephew 9,000.30
4. Patricia McConegly & John McConegly, 138 Jonathan Drive, Canonsburg,
PA 15317-3041 (3% tangible property & residue) Niece/Nephew 9,000.30
5. Lucinda Wakefield, 111 Hallmark Street, Hershey, PA 17033 (3% tangible
property & residue) Niece 9,000.30
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
1. Calvary United Methodist Church, 700 Market Street, Lemoyne, PA 17043 (20% tangible property &
residue) 76,227.12
2. Zembo Temple, 2801 N. 3rd Street, Harrisburg, PA 17110 (8% tangible property & residue) 30,490.88
3. Masonic Village at Elizabethtown, c/o William L. Kingsbury, Esquire, Montgomery, McCracken, Walker
& Rhoads, LLP, 123 South Broad Street, Philadelphia, PA 19109 (8% tangible property & residue) 30,490.88
TOTAL OF PART 11- 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)
REV-1513 EX+ (9-00)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
SCHEDULE J
BENEFICIARIES
(continued)
FILE NUMBER
21-05-0391
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
6. Darrell Williams & Linda Williams, 10 Claystone Road, York, PA 17404
(15% tangible property & residue) Friends 45,001.54
7. Reverend Richard Feeser & Ruth Feeser, 5 N. 25th Street, Penbrook, PA
17103 (22% tangible property) Friends 66,002.24
8. Reverend Richard Feeser & Ruth Feeser (real estate) Friends 80,000.00
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
4. American Red Cross, PA Cap. Region, 1804 N. 6th Street, Harrisburg, PA 17102 (2% tangible property
& residue) 7,622.72
5. Salvation Army, Inc., clo Richard D. Allen, Assistant Corporate Secretary, The Salvation Army, Legal
Department, 440 West Nyack Road, PO Box C-635, West Nyack, NY 10994-1739 (2% tangible
property & residue) 7,622.72
TOTAL OF PART 11- 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)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
SCHEDULE J
BENEFICIARIES
(continued)
FILE NUMBER
21-05-0391
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
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
6. American Heart Association, c/o Colleen M. Marshall, Bequest Administrator, PO Box 8835, Camp Hill
PA, 17001-8835 (2% tangible property & residue) 7,622.72
7. PA Association for the Blind, 90 E. Shady Lane, Enola, PA 17025 (2% tangible property & residue) 7,622.72
8. Bethesda Mission, 611 Reily Street, Harrisburg, PA 17102 (2% tangible property & residue) 7,622.72
9. American Cancer Society, c/o Vicki J. Harbin, Legacy Paralegal, Pennsylvania Division, Inc., Route 422
TOTAL OF PART 11- 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)
REV-1513 EX+ 19-00)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Deardorf, Robert L.
SCHEDULE J
BENEFICIARIES
(continued)
FILE NUMBER
21-05-0391
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
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
and Sipe Avenue, PO Box 897, Hershey, PA 17033-0897 (2% tangible property & residue) 7,622.72
TOTAL OF PART 11- 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)
---.....
~
\
~
\
~
:"
..' .;....
WILL OF ROBERT 1. DEARDORF
I, ROBERT 1. DEARDORF, of the Borough of Lemoyne, Cumberland County,
Pennsylvania, declare this to be my will and revoke all prior wJls and Codicils.
FIRST: Tangible Personal Properly.
I direct that my Executor shall, as promptly as possible after my death, arrange
with a reputable auctioneer of his choice for the public sale of all tangible personal
property owned by me at my death subject to the limitation that such sale shall not be
conducted horn my final place of residence or horn any real property I may own at the
time of my death, but instead it shall be conducted horn the auction house of the
auctioneer or such other similar location as may be determined by my Executor. The net
proceeds horn such sale and the insurance proceeds, if any, on such property shall be
divided among the following persons in the following manner:
(a) Three percent to my nephew, MALCOLM G. WAKEFIELD, JR., and his
wife, LUCILLE WAKEFIELD (or the survivor of them), of Hummelstown,
Pennsylvania.
(b) Three percent to my nephew, GEORGE R. SEVERINE, of Baltimore,
Maryland.
(c) Three percent to my nephew, DAVID N. SEVERINE, of Drexel Hill,
Pennsylvania.
(d) Three percent to my niece, PATRICIA McCONEGLY, and her husband,
JOHN McCONEGLY, (or the survivor of them), of McMurray, Pennsylvania.
(e) Three percent to my niece, LUCINDA WAKEFIELD, of Camp HJl,
Pennsylvania.
F:\L WORK\WILLS\G 1 0220 1 G.WPD
----
)
(
'"
~
l
~
"
t--.j, J.
(f) Fifteen percent to my friend, DARRELL WILLIAMS, and his wife, LINDA
WILLIAMS (or the survivor of them), of York, Pennsylvania.
(g) Twenty-two percent to my friend, REV. RICHARD FEESER, and his wife,
RUTH FEESER (or the survivor of them) of Penbrook, Pennsylvania.
(h) Twenty percent to my church, CALVARY UNITED METHODIST
CHURCH, 7th and Market Streets, Lemoyne, Pennsylvania, or its duly constituted
successor, if any.
(i) Eight percent to the ZEMBO TEMPLE, 2801 North Third Street,
Harrisburg, Pennsylvania, for the specific benefit of any children's hospital or burn center
regularly supported by the charitable efforts of the said ZEMBO TEMPLE.
(j) Eight percent to the MASONIC HOMES, ElizabethtoWTI, Pennsylvania.
(k) Two percent to the PENNSYLVANIA CAPITAL REGION CHAPTER OF
THE AMERICAN RED CROSS, 1804 North Sixth Street, Harrisburg, Pennsylvania.
(1) Two percent to the SALVATION ARMY, INC.
(m) Two percent to the AMERICAN HEART ASSOCIATION, PA
AFFILIATE, CAPITAL REGION DIVISION, Wormleysburg, Pennsylvania.
(n) Two percent to the PENNSYLVANIA ASSOCIATION FOR THE
BLIND, 2843 North Front Street, Harrisburg, Pennsylvania.
(0) Two percent to BETHESDA MISSION, 611 Reily Street, Harrisburg,
Pennsylvania.
F :\L WORK\WILLS\G 10220 1 G, WPD
- 2 -
\)
\
\
")
\
"
~
"-
,.' ,"
....J.
(p) Two percent to the AMERICAN CANCER SOCIETY, CUMBERLAND
COUNTY UNIT, 117 North Hanover Street, Carlisle, Pennsylvania.
Should any of the individual beneficiaries named in this Paragraph FIRST fail to
survive my death by thirty days, the gift to such benefiCiary shall lapse, and such lapsed
gift shall be divided pro rata among the remaining beneficiaries. should both of any of
the paired beneficiaries named in this Paragraph FIRST fail to survive my death by thirty
days, the gift to such pair shall lapse, and such lapsed gift shall be divided pro rata among
the remaining beneficiaries.
SECOND: Specific Gift of Real Estate.
I give my real estate known and numbered as 812 Market Street, Lemoyne,
Cumberland County, Pennsylvania, to my friend, REV. RICHARD FEESER, and his
wife, RUTH FEESER (or the survivor of them) of Newport, Pennsylvania, provided they
or either of them survive my death by thirty days, and in default thereof, this gift shall
lapse and pass instead as a part of the residue of my estate. It is my specific direction that
all costs and expenses associated with the gift of this real estate to Rev. Feeser and/or his
wife shall be paid by my estate as a cost or expense of administration and that it shall not
be necessary for Rev. Feeser and/or his wife to incur any cost or expense to receive this
gift.
THIRD: ~.
I give the residue of my estate to be divided among the following persons in the
following manner:
(a) Three percent to my nephew, MALCOLM G. WAKEFIELD, JR., and his
wife, LUCILLE WAKEFIELD (or the survivor of them).
F:\LWORK\WILLS\G 10220 I G.WPD
- 3 -
'--
~
\
~
[
~
"
"-4
(b) Three percent to my nephew, GEORGE R. SEVERINE.
(c) Three percent to my nephew, DAVID N. SEVERINE.
(d) Three percent to my niece, PATRICIA McCONEGLY, and her husband,
JOHN McCONEGLY, (or the survivor of them).
(e) Three percent to my niece, LUCINDA WAKEFIELD.
(f) Fifteen percent to my friend, DARRELL WILLIAMS, and his wife, LINDA
WILLIAMS (or the survivor of them).
(g) Twenty-two percent to my friend, REV. RICHARD FEESER, and his wife,
RUTH FEESER (or the survivor of them).
(h) Twenty percent to my church, CALVARY UNITED METHODIST
CHURCH, 7th and Market Streets, Lemoyne, Pennsylvania, or its duly constituted
(i) Eight percent to the ZEMBO TEMPLE, 2801 North Third Street,
Harrisburg, Pennsylvania, for the specific benefit of any chJdren's hospital or bum center
regularly supported by the charitable efforts of the said ZEMBO TEMPLE.
(j) Eight percent to the MASONIC HOMES, Elizabethtown, Pennsylvania.
(k) Two percent to the PENNSYLVANIA CAPITAL REGION CHAPTER
OF THE AMERICAN RED CROSS, 1804 North Sixth Street, Harrisburg,
Pennsylvania.
(1) Two percent to the SALVATION ARMY, INC.
F :\L WORK\WILLS\G 10220 1 G. WPD
- 4-
'-
~
\
(
.~
\
~
~
(m) Two percent to the AMERICAN HEART ASSOCIATION, PA
AFFILIATE, CAPITAL REGION DIVISION, Wormleysburg, Pennsylvania.
(n) Two percent to the PENNSYLVANIA ASSOCIATION FOR THE
BLIND, 2843 North Front Street, Harrisburg, Pennsylvania.
(0) Two percent to BETHESDA MISSION, 611 Reily Street, Harrisburg,
Pennsylvania.
(p) Two percent to the AMERICAN CANCER SOCIETY, CUMBERLAND
COUNTY UNIT, 117 North Hanover Street, Carlisle, Pennsylvania.
should any of the individual beneficiaries named in this Paragraph THIRD fail to
survive my death by thirty days, the gift to such beneficiary shall lapse, and such lapsed
gift shall be divided pro rata among the remaining beneficiaries. Should both of any of
the paired beneficiaries named in this Paragraph THIRD fail to survive my death by thirty
days, the gift to such pair shall lapse, and such lapsed gift shall be divided pro rata among
the remaining beneficiaries.
FOURTH: Spendthrift Provision.
Until distributed, no gift or beneficial interest shall be subject to anticipation or to
voluntary or involuntary alienation.
FOURTH: Death Taxes.
(a) All death taxes (and interest and penalties thereon) imposed upon any property
whether or not passing under my will and upon proceeds of insurance on my life shall be
paid out of my residuary estate.
F ,\L WORK\WILLS\G 10220 I G. WPD
- 5 -
""""'"
"'"
v
(
\
(
''''-.
~
........
FIFTH: ..Administrative Powers.
My Executor shall have the following powers in addition to those conferred by law
until all property is distributed:
(a) To retain any real or personal property in the form received and to sell it at
public or private sale.
(b) To manage real estate.
(c) To purchase all forms of property without being confined to so-called legal
investments and without regard for the principle of diversification.
(d) To exercise any option or rights arising from ownership of investments.
(e) To compromise claims without order of court or consent of any legatee.
(f) To distribute in cash or in kind.
(g) To employ accountants, agents, investment counsel, brokers, bank or trust
company to perform services for and at the expense of my estate and to carry or register
investments in the name of the nominee of such agent, broker, bank or trust company.
The expenses and charges for such services shall be charged against principal or income or
partly against each as my Executor may determine. My Executor is expressly relieved of
any liability or responsibility whatsoever for any act or failure to act by, or for following
the advice of, such accountants, agents, investment counsel, brokers, bank or trust
company, so long as my Executor exercises due care in their selection. The fact that an
Executor may be a member, shareholder or employee of any accounting, investment or
brokerage firm, agent, or bank or trust company so employed shall not be deemed a
conflict of interest. Any compensation paid pursuant to this subparagraph shall not affect
F :\L WORK\WILLS\G I0220 I G, WPD
- 6 -
o
\
~
(
'-
"-'
,
.-
in any manner the amount of or the right of my Executor to receive commissions as a
fiduciary.
(h) With respect to the interest vesting in a beneficiary who, in the opinion of my
Executor, is incapacitated by reason of age (other than minority) or illness (mental or
physical) when such interest vests in him or her: to hold the interest during his or her
incapacity and to invest the interest and all accumulations thereon; to apply so much of
the income and principal as my Executor deems advisable for such beneficiary's benefit for
any reason without considering other funds available to him or her; and to deliver the
balance of principal and income to the beneficiary at such time as he or he gains capacity.
In addition, my Executor shall have the right at any time to pay the entire interest to the
guardian of the estate of the incapacitated beneficiary to hold for his or her benefit. The
receipt of a guardian or such other person as may be selected by my Executor to receive a
distribution under this subparagraph shall be a full and complete discharge to my
Executor.
SIXTH: Definitions.
(a) The word "Executor" when used herein shall include all genders and the singular
and plural as the context may require. "Executor" shall also include the term "Co-
executor. "
(b) Paragraph headings in this will are for reference only and shall not affect the
meaning, construction or effect of this Will.
SEVENTH: Power of Appointment.
I decline to exercise any power of appointment given to me under any Will, Codicil
or Deed of Trust.
F:\L WORK\WILLS\G 10220 1 G. WPD
- 7 -
..
.....
I
..
EIGHTH: Executor.
I appoint DONALD R. SHOVER, JR., of Mechanicsburg, Pennsylvania, and
DARRELL WILLIAMS, Co-executors. If either of them fails to qualify or ceases to act
for any reason, I direct that the survivor alone shall serve as Executor. My Executor shall
not be required to post security in any jurisdiction.
~N WI1NESS WHEREOF, I have hereunto set my hand this .5- day of
~.~,2001.
/1;~ 1.
ROBERT 1. DEARDORF
The preceding instrument, consisting of this and seven other typewritten pages,
each identified by the signature of the testator, was on the date thereof signed, published,
and declared by ROBERT 1. DEARDORF, the testator therein named, as and for his
last will, in the presence of us, who at his request, in his presence, and in the presence of
each other, have subscribed our names as witnesses hereto.
~~~
' EORGE . VAUGHN, III
k,8d~
"
DIANE B. JENKINS
F :\LWORK\WILLS\G 10220 1 G. WPD
- 8 -
.. '
~
COMMONWEALTH OF PENNSYLVANIA
""'" '. ".
COUNTY OF CUMBERLAND
)
( SS.:
)
I, ROBERT L. DEARDORF, being the testator whose name is signed to the
foregoing instrument, having been duly qualified according to law, do hereby acknowledge
that I signed and executed the foregoing instrument 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.
Sworn or affirmed to and acknowledged
be!off me by the testator named abov
L day of 71..(7(/.-e---r1'Lt~ , 200
;;) J
,~U4d Uur
Notary public
NOTARIAL SEAL I
Frances T. Vaughn. Notary Public I
Hampden Twp., Cumberland County
My Comml88!o~ Exp~~apt 15,2003 J
COMMONWEALTH OF PENNSYLVANIA
)
( SS.:
)
COUNTY OF CUMBERLAND
WE, GEORGE A. VAUGHN, III, and DIANE B. JENKINS, the witnesses
whose names are signed to the foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw the testator sign and execute the
instrument as his last will; that he signed it willingly; that he 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 signed the will as witnesses; and that to the best of our knowledge, the
testator was at the time eighteen or more years o~r age of s. ound mind, and under no
constraint or undue influence, ,~~
EOR~UGHN, III
~& g dL-K-'.J
DIANE B. JE1<fKINS
Sworn or affirmed tOl-pnd acknowledged
before me this 6-1'~y of
/( /yc.'---&-J",-b-,,7'1 , 2001.
? ..'
~h4~cPA' 1 /kUAr/
Notary Public '
NOTARIAL SEAL
Frances T. Vaughn, Notary Public
Hampden Twp., Cumberland County
My Commission Explrs(j Sept. 15, 2003
F :\L WORK\WILLS\G 10220 I G.WPD
J~N-01-2005 01 :34AM
>k'l
,~"-"'.~ .~~~~
,~.~ ...,.~~,~
'.;,'1..\'3>f....,:~
'";~~~tl
, . ,. "'';1
.: '_'~:'~i ~;.~~~>~\~~
'~'1~~!
" _-r. ':;r:'_~.'
..~'4'. '~~
~:~~~ti.~ijt4
. .,.J".., ~(;!
';J~;~.~:~1;;~?;~~:~
{,~~~
,~..,;~~ 1
't'.' . .:. .\~i
~ ..' )
...
"
r}~~;}
_ L':~~' ". .
FROM-
P003/004
T-787
F-231
r.
:I.I-cT--W....ranlll n......~:hr.f'1. .....na-ACI. J"P~lIt.a. RI~\.
. "_Qt". 1.1..101. J--... I..-li...... r..
,1_.:,"
I
. .J
j
j
I
f
~fJt~
11Beeb~
MADE THM' 23:?../2..",c- dau of . ~ /~~~~ (n ~ke 3/4Ia,..
of our Lartl 0"6 tllOU6a.nd ni..e kU'Idred _J~'.,<"..-.; 7-- <'.;':',7' ~ /Y7..;1..) t:7
CETJVEEN GLADYS LU:.x.'I&'1 DEAUDORFf,' antl ROBERT L. DEARDORFF (brother' .and &1...t:..r)
. Li;~y~e~ Cumberland County, PennsYl.vania, here:Lnafcer cal.J.ed
~~~
'''.,~ mt
;:"~~J
i:
I
I
i
I
J
I.
!
J
I'
l
I
.!
'j
~
J'
1
his 'Wl-fe, all of Lellloyno,Cull1berl,and Counq, Pennsylvani... here::Lnaft:er cal1ed
Gntntor 6 .
and
CL.\DYS LILLI^'-... D~ARDOltPF and HOB~RT L. PI~AlU>ORFp <::Ind J;R.'iA MAY DBARD01U'.e,
WITNESSETH, t/lat in cc.t'/.8iderr.ltiou of
'.Q;,.Cl\ ~d ,00/1.00 ($1.00)
. in'hand paitl.tJ~6 receipt toJU17:cof.is hereby acknowledged. the lIaid grantors do
.'a.tod conv('u ~'?thc <laid gra?uce s. their heirs and assi.gns ae joi.nt tenant:s
. ..ur.....ivorshtp 'and nat as t:eQaAt:$ :Ln common.
Gnuctee s :
DollarB,
h.e-rebu orant
....it:h right of
.
"J
.t., .. ~:.
AL~ tha~.cert4in partaE a lot situate formerly in East Pennsboro Township, now
.Lc~~e."."!".~re.:."particu1.ar1Y .do;osignal:e.d and de.scr:lbed as 'fol.low,s,
BeLRG tWQnty-~ive (25) feet: ofx of t:ha western side of Lot: No. 38, :In a plan of
lots .kn~..... P1.a.R No_ 3, 'Nortit Rivert:on, Pa.. said plan ,.1.s raco:':'ded in tit.. Re-
c:orde,r'lO office for Cul11berland County. Pennsylvania. in Dl-lod Book "J". Vol.. 4,
Pag":'40.
I
!
I
I
I
I
'1
j
,
!
,
I
.1
,
,
~
'BEGINNx,r.lG.at a po1.nt:-1.10 feet '.reom the southwest COrner of Dale Avenue; thencn in
, a .Bouc'herl,y di-rec:tJ.on a10ng the eastern side of Lot No. 39, 120 feet: to all a1ley;
thence a10ng sai.d alJ.ey in an easter1y direction 25 feet; thence in a nor~erly
direction. 120 feet. to ~arket St:rect; thence in a Westorly d:Lrect:Lon, 25 teet to _
t:ha p~ace of. BEGINlfI:NG.
, , .
UEINdt..t.;~c same prQm:l."oas wh:lch Jenn:le Maude DeardOrff and Irv:ln P. Deardorff by
the:Lrdeod dnt:ed ~by 2, 1.946. and recorded :Ln t:he Off::Lce of t.h~ Recorder of Deeds
in .and ror Cumberland Count:y, Pc:nnsy1van1.a, :Lu Deed Book "En. Volume 13, t"age 406,
gr......t:ed n....d conveyed' u-nto Gladys l..:tl.J.ian Dea.rdorff and Robert L. Deardorff. brot:her
and ..1.ac;er.
,:'.'
I:T is the-intent of tIds dee4 to continuo. ehe pr~or joi.nt cenaney with rigfit of
surv:Lvorship r!i>J.ationsh:tp between ehe or1.ginal. grantees but to also. a!1d the n_
il.. Irma ~~. Deardorff'. wi.fa 'of Robert: L. Deardorff to the deed for the purpose of
cro":Cing a tenancy b,y t:he ent1.retios as betWeen Robert ~. De'ardorff and I:nna May
.ne'ardorff . BaLd t:enaricy. by' :eni:ireU.es t:o 'equal. one.,.half interest :tn said property
,and s..id eenancy by tlle eneir~ti.es to be cons:1dcr..d as a jo;Lnt tenant wit:h r1.ll.ht
..of survJ.vorship an.dnot: as a tenant: in common wil:h G1adys Lil llan , Deardorff.
.n-i.s is a conveyance of
'. wife.. and is' PAc subject;-
, ~V)~ .....t~.... . .
.~E;E~ :.~,~
~:: <:; ~'I <:'1
'-lo.OI-:J". ~
~~~~~~J~
i!~~;~'B .. .'
g~3 ~
,,- ~\ :C'
_::~~~:':"
'1
,'. ~.'
a one-half :Loterest: in real elOtate by a hUlOhand to hi.s
.to PennsyJ.vania ReaLty Transfer Tax.
EXHIBIT
j
~ .
8p~-):2':'r/'CE 5i9
'1
JUN-01-2005 01 :34AM
FROM-
T-787
P.004/004
F-231
. . ".\. ~
1',"--
':'}~?'~,,:"'"
:~~5~:~:": '. .,.
t.:;'." ..
..,~;~. .
.:.Jtr..,._ ~~.~... ....._ .......
..~'.': '..~,'
AND thl; .0.14 ~l!o,.s 'llet"ebu eovcmaDt clfld 007ee
wiUwarrcznt . . gcnera11y
that ekey . .
tlllt P1'Opcrtu hcrebll 'eonvc.y<!d.
.~~
~
.,
.- .::: ".~
~
IN WI'l'NMSS WHIi:Rfi:OF. _ill ora/ntor' 8 have "eTcflnt() lid thc.ir' lU2'MS 4'1Cl ./tC"tI'>i
t"e dalJ' and ~-,. If,..,. G.botJs tDrittcm. ,. ~/ -.' . . /' - . C""'-,
~. . ~. /.(. ,>:/'[2": '-~:.,.._.,~t!_~..-
~i...".b. ......1.. .....1l.'..1Io_e2o '-'--=~rr..~~~""-"-~------' ........
In th..~rr.rn..,e or . G1adys L1.i:11.:I.an Deardorff .-;'
.) ;~~.~ -, :'.~:t.' ;--;-~/--"V.-_'c --I {-~.'~~~ll' -7! /7-----~.
.......:.."...---.-...-......--.-..-......-..-..--....-.- ~.=Ri..Gi '" T.7nfrn - -, L{.7,?""- l,-~
._.....:.._....___.._......:..~_.:~:_._....~_...___._.._. .._~_...~.::~~~.~~~~.__~.=~~r:f:==::=-.~..~:~~::~~: ~.
. ,~
~'.~
..'
'..
Sb.,-ts.ol
} IJ.~ .
CcmnlJt 01 . Cunlb..r1~nd.".. . ?
. On'th4tI. tl&o:,~. o?f!~.<'7-:da'll O/%~~~ "I< -<;:/
tAe'.".'7U/.er.,gn.d o6kfn-. f)en-.ollJ/qppearecl GJ.adye 1.1111.an. Deardorff
Deardorff. .
.Pen...~yJ.van1.a
. ~f) ,? ~ l1efo.." ....".
"
and Robe~1: L.
se,g.of'.
r..nDWn eo'~ (o'r';'a.tilJltACtOrlly prD'I1eft)eO lJe the perscnJs whose __e s are BltlJBcribe.l to tIle
within instru~a.ncl'a.ckniolUledged' tho.t the.y e;l:ecuted Bo.me for the purposes therein
oo...tamed. - , " .
INW17'NE~S':WHEREOF. 1 hens_to ltd ~,,~~-o~.i4la /7:..5:.~;;' I:':"'~::"':~-"',___'
:..........-<:::...('.:~~./-'.7m....----.mJ~.s..F...~:-~:..:.~At). ,
~=-. ..1.
EUZ.\HLr;.... b. SPOTlS. ttoy^~V ~..~. Ie ~~ g _ . _ ~ \. . -;
~~"~.~:.~;~~~:.:-----Cli~:;:~:-:~.~~:s~~~~~~~f~~~~.'::T. /
}... ".
,"".
; . ':'~ . ~ :.:..'
County of
. On t1~~~,~,;;. _.. . ,.
.... ,-1." ,., ';-" . '. ;.. .' - : ..
. .~ ...~~~,.91!.~"".. P-'.II/~UJ/,.-pp~~r"-'
,:, (., ", . '-'. . ::'"": .... ..:~> l ~'.!
d41I of
. .
. ~9
. b,eforome.
1m.oWft to me (0,. -tlaf-forilv 'P'YX1eft) to be the perecm
within i"'Wr4-_t. end. GCkmnIIledoed tll.Qt
oonta.i.ned,:";' .'" ., ......', ',"'. .....
.IN ~/TNESS. ~.WH.~REOF. I' 1&",r"o,".to Bet -'II 1I4nd and official Bcal.
whose ........." BubBcribed to the
e:x:ecuted B4-e /0'1' the p..rpOBCS thc-rei..
. ~.~ .'.
............__._.~.....~......................._--,.-_._---_._____.__.__._______._.r__p._...:...._...~.,~
,~':
I., :
Title 01 Officer.
, . Ida AsnJby t1#!rtify thd . the preciee ~enc" ~M _plste' post oOles ad(lreBB
ofthewitA_~grtl.ftte.'... :32 North 81:h Sl:reect Lemoyne. p~nna. 17043
;:;i -:J ~
19 7"Z-
_._~~~_._-_.__......,...,..
Atto'T7WtY /0'1' _.nn_dJ.f,,-.t~~___.__._____...__........... .
/'l. ';-..G~
.'.t~25P>ACE .' 5~.O
\
\.
------- -'._'~
i
I
,
i
i
.,
1
.____:---:-:-..._..>-_.....1
,. . . .... .
,.......~... .....~::-."';:'"7""~.-;~.~~~,~~:~=..,.....~.~..'!->..\ '~.:"_" .--::-='.'~:"'''-:----'
. . .~:.
Robert R. Jones Appraisers
APPRAISAL OF
A SMALL RESIDENTIAL JNCOME PROPERTY
L 0 CAT ION : 812 Market Street
Lemoyne
PA
17043
CLIENT
: Caldwell & Kearns
3631 N. Front Street Harrisburg, PA 171101553
AS OF DATE
: April 18, 2005
A P P R A I S E R : Christopher M. Jones, SRA
EXHIBIT
Robert R. Jones Appraisers
I
'2
05060119
I
Robert R. Jones Appraisers
7800 Allentown Boulevard
Harrisburg, PA 17112
Tax 10 #25-157-6961
Caldwell & Kearns
3631 N. Front Street Harrisburg, PA 171101553
In accordance with your request, I have personally
inspected and appraised the property located at:
812 Market Street
Lemoyne
PA
17043
The purpose of the appraisal was to estimate the market
value of the property, as improved, in unencumbered fee
simple title of ownership.
The subject property consists of:
7 Rooms
2 Bedrooms
2.0 Bath(s)
The Traditional style residence contains
Gross Living Area.
It is my opinion that the estimated market value of the
property as of April 18, 2005 is $ 80,000
1,542 square feet of
The above information has been automatically extracted
from the appraisal and inserted in this cover page.
Respectfully submitted,
/J -.. IV~
L/i-//
Christopher M. Jonl'lt, SRA
/
/
Robert R. Jones Appraisers
rlJM&TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
August 22, 2005
Caldwell & Kearns
Attorneys At Law
3631 North Front Street
Harrisburg, Pennsylvania 17110-1533
Re: Estate or Robert L Deardorf
Social Security: 207-07-6137
Date of Death: Avril 18, 2005
Dear Sir or Madam:
Per your inquiry dated August 09, 2005, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
27729478
Ownership (Names oj)
Erma M Deardorf*
Robert L Deardorf*
Donald R Shover Jr, POA
Opening Date
08/28/64 Closed 07/14/05
Balance on Date of Death
$41,092.16
Accrued Interest
$ 32.55
Total
$41,124.71
-
Please be advised, there was no safe deposit box found for the above decedent.
We provide the date of death account balance on Retail Accounts, Checking, Savings, and Certificate of Deposit Accounts.
For information on the Annuity Account, please contact Renee George at 717-731-4841. This information was obtained by
contacting the Branch of Record.
*For further account information, regarding ownership and any changes, closures and/or reimbursement of funds,
etc., please call the West Shore Plaza Office # 717-255-2271.
Sincerely,
~-0"~~%{1
Nancy Clagett
Records Management
EXHIBIT
I
'3
I
-
.
-I )> r Z
0 3 .00 0)
- c
!. CD 3
.... c.:
)> C')" )> (I)
(') ~
::J en 0
(') en
0 - m. -
r:: Z en
::J () TI (I)
- TI c ()
< ::J
!. 0 a. C
8- "'"
r:: ::+
CD )> '<
3
CD
....
C')"
~ ~
OJ ......
0
I
0
~
0
co
......
CJ.)
I
Z 0
~
C co
3 :::D
C" 0
(I) C"
"'" (I)
0 ;:$.
I\:) -
.j:>. c r
en (0
I\:) ...... ::J C
VJ (0 ::+
i:x> ~ en (I)
VJ I\:) 0)
"'"
c.
0
~
c
0)
-
"tI (I)
... 0
cr
CD -
'0 C
CD (I)
...
III 0)
::r -
III ::J"
...
CD <
0
::l 0)
~ c
...
~ 0)
-
...... 0 o'
0
-...J "'" ::J
~ 0
en ......
~
......
i(1
0
0
en
<
0)
c
(I)
0
::J
0
-EIt -ffl -ffl ~
(,.) ...... I\:) ......
U1 ...... .j:>. 00
Co a Co i\)
co -...J ...... 0
ClO (0 (0
Co N ~ 0
oI:lo I\:) I\:) en
EXHIBIT
I 14
Account Information System Output
for CAROL SUE PARTILLA
FH 410 040913 049 000 ILAF 02/02/04 END PLAN 517651975
ACTION VALUE DSC/TAX/STRF PRICE SHARES INTERIM BAL
12/31/04 DIV 33.70 1. 00 33.700 24913.290
01/03/05 DIV 3.51 1. 00 3.510 24916.800
01/03/05 BOT DIR 167.45 1. 00 167.450 25084.250
01/31/05 DIV 34.33 1. 00 34.330 25118.580
02/28/05 DIV 37.54 1. 00 37.540 25156.120
03/10/05 DIV 14.01 1. 00 14.010 25170.130
03/10/05 SEL BOOK 305.00 1. 00 305.000 24865.130
03/21/05 DIV 15.59 1. 00 15.590 24880.720
03/21/05 BOT DIR 100.00 1. 00 100.000 24980.720
03/31/05 DIV 14.61 1. 00 14.610 24995.330
03/31/05 SEL BOOK 75.61 1. 00 75.610 24919.720
04/28/05 DIV 44.05 1. 00 44.050 24963.770
04/28/05 SEL BOOK 150.00 1. 00 150.000 24813.770
04/29/05 DIV 1. 63 1. 00 1. 630 24815.400
05/16/05 DIV 28.12 1. 00 28.120 24843.520
05/16/05 SEL BOOK 24843.52 1. 00 24843.520 0.000
TOTAL SHARES 0.000
Morgan Stanley Dean Witter Confidential Data - not an official statement
Page 1 of 1
Tuesday, July 19,2005
3:31 pm
D9892
07/19/2005
4:28
Page 1
Date 04/18/05
Symbol IFABX
Use Page Up, Page Down, i, ~
Frequency
Date
04/18/2005
04/15/2005
04/14/2005
04/13/2005
04/12/2005
04/11/2005
04/08/2005
04/07/2005
04/06/2005
04/05/2005
04/04/2005
04/01/2005
03/31/2005
03/30/2005
03/29/2005
03/28/2005
03/25/2005
03/24/2005
03/23/2005
03/22/2005
NAV
17.760
17.760
17.930
18.060
18.140
18.120
18.100
18.190
18.130
18.060
17.990
18.030
18.060
18.000
17.890
17.960
17.980
17.960
18.020
AMERICAN FUNDS INC (B)
OPr
17.760
17.760
17.930
18.060
18.140
18.120
18.100
18.190
18.130
18.060
17.990
18.030
18.060
18.000
17.890
17.960
(Daily)
17.980
17.960
18.020
Page: Document Name: Oppenheimer & Co. Inc.
A09-0004282 RR=127 ROBERT L DEARDORF PAGE: 1
DATE- 04/19/05 812 MARKET STREET TEL # 717-737-7739
TD OPEN O.OODR
TDBL 0.00 MKT VAL 177,296 EQUITY 177,296 TYP - 1 0.00
SDBL 0.00 HSE-EXCS 115,223 CASH-AVL 0 TYP-2 0.00
MFUND 18.14 HSE-CALL o BUY-POWR 0 TYP-9 0.00
CS/EQ 0.00 FDL-CALL o SMA-BAL 0 OTHER 0.00
*** HOLDINGS IN ACCOUNT ***
LONG/SHORT S E CUR I T Y
*** TYPE 1 ***
18.140 ADVANTAGE PRIMARY
1,760 NUVEEN PFD & CONV
FD 2
CASH DIV REC 04/15/05
7,969.330 EATON VANCE INCM
DES C RIP T ION
PRICE
MKT VAL
LIQ CWPXX
INC CfT JQC
*
1.000
12.570
18.14
22,123.20
7,244.748
.093 PAY 05/02/05 $163.68
FD BO 5509 EBIBX * 10.960
REINVEST CODES (D/S/L)
OPPENHEIMER CHAMPION I 5511 OCHBX * 9.360
REINVEST CODES (D/S/L)
87,343.85
CCC
67,810.84
CCC
UNPRICED ITEMS
o
PRICED ITEMS VALUE
177,296.03
NEXT (N) PREV (P) PAGE # ACCT (/ACCT) MFUND (MF) END (E)
EXHIBIT
j
1#5
Name: mooninm - Date: 04/20/2005 Time: 07:28:52
PUTNAM INVESTMENTS
Search
Account List
BIN Number:
TaxlD:
Registration:
207-07-6137
ROBERT L DEARDORF
812 MARKET ST
LEMOYNE PA 17043-1517
lID Account Detail
Transaction History
CDSC Simulator
Distributions
Prices
Unissued Shares:
9,319.562
Issued Shares:
Total Shares:
Escrow Shares:
a3Q,OOO
10,154.562
N/A
Print Friendly
Get the lates:: if'fo
{.tt
\~~'l
Market Value:
MTD Accrued:
$59,607.28
$0.00
otal:
$59,607.28
MORNINGSTAR@
RESEARCH
Fund/Account: B18-1207076137BB8
PUTNAM HIGH YIELD ADVANTAGE FUND CLASS-B
Cusip: 74678J203
Available Shares:
Available Account Balance:
As of 04/19/2005
Distribution Options:
SWP:
PAC/AlP/SIP:
Account Type:
Network Level:
Check Writing:
Last Maintenance Date:
Check_HisJQry
ROA:
LOI:
Pending Trades:
CosJ...6.asIsHis.tory
CDSC Lot History
9,319.562
$54,705.83
Non-networked
No
N/A
Yes
No
No
This value may not reflect any pending trades or accrued dividends, and is based on previous business day':
price.
Note: Information that is not available for this account is noted as "N/A" below
Uncollected Shares: 0.000 Dealer/Branch/Rep: 94144/A09/127 MOONIN
Div:CAsH
CG: CAsH
No
No
Individual
~.lcH: JnfDrma:lOn on:
Pdrticipatmg
Companies
'-",-
EXHIBIT
I
16
Statements
PUTNAM INVESTMENTS
Search
Account List
BIN Number:
Tax ID:
Registration:
207-07-6137
ROBERT L DEARDORF
812 MARKET ST
LEMOYNE PA 17043-1517
m Account Detail
Transaction History
CDSC Simulator
Distributions
Prices
Unissued Shares:
827.127
Issued Shares:
Total Shares:
0.000
827.127
N/A
Escrow Shares:
Print Friendly
Get the lates~ info
.
.Ijl' j
\',f
Market Value:
MTD Accrued:
$4,913.13
$0.00
otal:
$4,913.13
MORNINGSTAR@
RESEARCH
Fund/Account: A15-1060044630957
PUTNAM HIGH YIELD ADVANTAGE FUND CLASS-A
Cusip: 74678J104
Available Shares:
Available Account Balance:
As of 04/19/2005
Distribution Options:
SWP:
PAC/AlP/SIP:
Account Type:
Network Level:
Check Writing:
Last Maintenance Date:
C.heck.Histo.ry
ROA:
LOI:
Pending Trades:
CQst6as.isHlstQry
827.127
$4,913.13
Non-networked
No
N/A
Yes
No
No
This value may not reflect any pending trades or accrued dividends, and is based on previous business day':
price.
Note: Information that is not available for this account is noted as "N/A" below
Uncollected Shares: 0.000 Dealer/Branch/Rep: 94144/A09/127 MOONIN
Div: cASH
CG: CASH
No
No
Individual
r"1cre !nfDrma:-lon Dn:
Particip~tJrq~
Cornpanies
VlsJtthe....
BUSIN.E55 BUIL.:OliN G .
.CENJ:ER
EXHIBIT
'7
Statements
DUFF & PHELPS UTILITY & CORPORATE BOND
DIVIDEND ~EINVESTHENT AND CASH PURCHASE PLAN
STATEMENT OF ACCOUNT
The Bank of New York, Administrator
P.O. Box 1958
Newark, NJ 07101-9774
SEQ#
01
000213
ROBERT L DEARDORF
812 MARKET ST
LEHOYNE PA 17043-1517
Answers to many questions and requests are
available by visiting The Bank of Now York's
wobslte at: http://stockbny.com or
Emall at:Sharoownors@bankofny.com
1-800-432-8224
Company Number
Account Number
Record Date
Payment Date
3077
0000065805
07/15/05
07/29/05
Next Anticipated Inves1ment Date MONTHL Y
CURRENT DIVIDEND PURCHASE INFORMATION
Plan Record Date Posi1ion
Held By You In Certificate Form Held By Plan
Administrator
Rate
Gross Dollars
Paid
Service
Fees
Tax
Withheld
Nel Dollars
Reinvested
Total
o
901. 9322
901. 9322
.08500
76.66
.00
.00
76.66
YEAR- TO-DATE TRANSACTIONS
Transaction Date Transaction Description Transaction Dollars Price per Share Transaction Shares Total Shares Held By Administrator
BALANCE FORWARD 848.4410
01/31/05 INCOME REINVESTMENT 127.37 13.7180 9.2849 857.7259
02/28/05 INCOME REINVESTMENT 128.16 13.7750 9.3038 867.0297
03/31/05 INCOME REINVESTMENT 128.95 13.0900 9.8511 8'16.8808
04/29/05 INCOME REINVESTMENT 129.78 13.1800 9.8468 886.7276
05/31/05 INCOME REINVESTMENT 130.62 13.4615 9.7032 896.4308
06/30/05 INCOME REINVESTMENT 76.20 13.8510 5.5014 901.9322
07/28/05 REINVESTMENT TRANSFER .00 .0000 901.9322 .0000
07/29/05 INCOME REINVESTMENT 76.66 14.1075 5.4340 5.4340
IF YOl HAVE ANY QUESTIONS REGARDING YOUR AC COUNT, PLEASE CALL OUR NVESTOR R LATIONS
DEPA~~ ME NT OR VISIT OUR WEBSITE. REMINDER: TO FURTHER EX PEDIlE YOU R TRANSACT ON
REQUE T, PLEASE USE THE TEAR OFF STUB ATTAC HED BELOW.
YEAR-TO-DATE SUMMARY
GROSS DIVIDENDS I TAXES WITHHELD I CASH CONTRIBUTIONS I SERVICE FEES I TOTAL FUNDS INVESTED I ADDITIONAL INCOME I FAIR MARKET VALUE
797.74 I .001 .00 I .00 I 797.74 I .00 I 76.66
.. DETACH HERE .
TRANSACTION REQUEST FORM - PLEASE KEEP THIS FORM FOR FUTURE REQUESTS
D
D
Sell Plan Shares (Enter Number of Whole shares)
If "All' is entered, Participation in the plan will be OTIIIIJ
terminated. Shares will be sold subject to the
Terms and Conditions Detailed in the Plan.
Issue Plan Shares (Enter Number of Whole shares)
If "All" is entered, Participation in the pI'l' will be
terminated. A certificate will be issued in
Registered holder(s) name.
D
CertifICate Transaction -
Marlr fhis box and
complete the other side
of form. Do not Sign
the CertiflCate(s)
EXHIBIT
I
18
Address Change
Mark this box and complete
the other side of form
D
L
$100.00 MINIMUM PAYMENT
$5,000.00 MAXIMUM PER MONTH
D
Optional Cash Contribution Amount Enclosed
- All Payments must be In U.S. Dollars
Drawn on a U.S. Bank and Payable to
The Bank of New York.
DATE
~LL REQUESTS MUST SIGNATURE
BE SIGNED BY ALL
:EGISTERED OWNERS
~M)\Kt:""NtfMARKlNGS BELOW THIS LINE)
3077
1002
0000065805
4
00000010000
9/16/2005 3: 12
PAGE 002/002
Fax Server
~
Allstate.
Allstate Life Insurance Company
PO Box 80469
Lincoln NE 68501-0469
Telephone: 1-800-755-5275
Fax: 1-847402-5313
ROBERT L DEARDORF
812 MARKET ST 2ND FL
LEMOYNE PA 17043-1517
September 16, 2005
Your Representative.
RENEE L GEORGE
M & T SECURITIES, INC.
1200 MARKET STREET
LEMOYNE PA 17043-1417
(717)731-4841
AlIstatell) Preferred Performance
Statement Date 04118/05 To 04118/05 For Annuity #GA18417901
YOUR ANNUITY VALlIE AS OF 04/18105 IS:
$ 61),152.76
Beginning Account Balance 04/18/05 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,152.76
Interest Earned 04/18/05 thru 04/18105 .............................................. $ .00
Ending Account Balance 04/18/05
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,152.76
Current
Rate
Fund
Value
4.75%
$ 60,152.76
New effective annual rates for each Guarantee Period Account will be determined when the current guarantee expires.
If you have any questions concerning your annuity, please contact your representative at your financial instiution.
EXHIBIT
I
B15TEOQN.N01
19
&l#&.WJ"'615TfI)Q\81tJrElXlNlllllUU
BRICKERS AUCTION
Buy & Sell on Commission - Complete Sale Service
93 Texaco Rd., Mechanicsburg, PA 17055 766-5785
Personal Property of /'!2..... CJ f3 '7 ,?., [) E.. fL).. b {.f E-5
Address ~'2- MK~ L~HuYfJF fl-'
Sold At Public Sale A- US s- 20 6 S-
Outstanding
Total Sale
/C, 7 .,
8 ~D. /S
~k () 7~-
Total Checks
Total Cash
Cash After Payout
Expenses
Auctioneer & Clerks
Adv. Cost
Property Fee
Sale Setup or Help
Total Expenses
r
8 G. 0 r /..>'. C J<5
/ & g -5V
([)2e;, 2~ty
)2)T1L t;;
bJ-(j, oD
EXHIBIT
I
1#10
Thank You For ~F!!IF!!r.tinn Chur.k Rrir.kF!!r Allr.tionF!!F!!r /l, .t::taff
BRICKERS AUCTION
Complete Auction Service
Auction - Wednesday Evenings
766-5785
/~-L()T
Chuck Bricker, Auctioneer
TOTAL SALE /
/: /)!~ }'~~
6- ~/ 2/5D
CLEA~ )) I i () (j I r) u
COMM.
No r /1 L_L- S OL~~
--~--
BRICKERS AUCTION
Complete Auction Service
Auction - Wednesday Evenings
766-5785
Chuck Bricker, Auctioneer
TOTAL SALE
COMM.
)) -LDT
(UD
CLEAR.
BRICKERS AUCTION
Complete Auction Service
Auction - Wednesday Evenings
766-5785
COMM.
D --LCr;
BRICKERS AUCTION
Complete Auction Service /jjy ~.t, A 0 \
Auction - Wednesday Evenings - v ~ ~ ""\--
766-5785
Chuck Bricker, Auctioneer
TOTAL SALE
COMM.
OZ- ~ l, S'0
7/~o
/~(),OO
CLEAR.
OPPENHEIME~
Oppenheimer & Co. Inc.
1015 Mumma Road
Wormleysburg, PA 17043
800-722-2294
Member of All Principal Exchanges
July 19, 2005
Carl Wass, Esquire
Caldwell & Kearns
3631 N. Front Street
Harrisburg, Pa. 17110-1533
RE: Estate of Robert L. Deardorf
Account A09-0030014
Dear Carl:
On September 5, 2003 Mr. Deardorf gave me a $20,000 check
and set up the account jointly with Darrell and Linda Williams.
It was meant as a gift in appreciation of the assistance which
Darrell and his wife provided. The account was technically
opened on 9-2-03.
Please call me if you need any additional information.
Sincerely,
!.'V\ ~ Vv\ ~
Marc Moonin
Vice President - Investments
MM/dsd
EXHIBIT
I '11
......
"~ll"
o
Q)
00
o:l
0...
C'
t'il
E .::E
Eo<e:
=Uo
CI1otJ<:"l
= lo. t"-
.8 Q) 0
~E:g
o'lii 0
~~t:!
Q)O
= Q,N
.8 Q,;:
....00
~ .... l::
1:<0
'r;; "0 "0
~~E
.:: == 'C
Q-!io..
.8 ~ 'g
~<fr
"t ~
o
~
'<t
......
o
o
C')
o
o
d,
o
<e:
;.;
Q)
.0
E
;:s
Z
i:
;:s
o
(,)
(,)
<e:
<=
'2
o
~~
u-
'-'tlo
~2t
<t:
.....
Ig~~~.~ g 81
iO g ~ ~ 0 ~
I N NI
. g,
I en
,
0000 g I
"'O"'O"'O"'O(li ~
I~.~.~.~> ~.
I~ ~ ~ ~~! "Oil
1~!:3 ~!:3:S
'"" 1-0 '"' 1-0 '"0 E
'>->->->-2 ~
It:: t:: ;.. ;;:. 0 8
88J:J:~ ~
~~g'if::gef-~
I~ ~ g ~ g 0 ~II.
N~'o:::t"~'V~~ N -;'
- N '"
<<)N
on
I" g ~
~~ 8 :2
I~ ~ -a' ~ .g ~ ~'
10 >- -0: 0 ~ ~ ~I
8 ~~~ 2:~~1
-o:~u~o.s-o:
~~~~~~~
II- a:l >- >- >-~.>:J
00
o
c::
~ ~
00 ...,
::;:~r:=:E-
;$OOO","~
:S~~~~
-_<E-
~...l","00<1e
~::lQ Eo..dl", ~
...l~...l~","":'
...l...lE-a::Z~
~~~~~~
<:SO:::::","'::
Q...lC::oo...l=
;x:
a:l
<t:
~
00
'D
0;
o
C'"\
r.f
0-. '<t
C> '<t
C'"\ vi
'<t I'-
00
00'
N
'D I'-
0-. N
N
'<t
00
~ ";!.
o 00
I'- ~
N
o 0
o 0
'" 0
00 C>
r-:
I'- '<t
I'- '<!:
N '"
'" I'-
-
C'"\
Q
.....
CI
:J
>-
~
~z ~
"'" "'-'
...l 0
.....< <r:
;;.. E-
oo~~ ~
ooQOCl ;;..
QZU"'"ooQ
z~~=e<r:
~... oo~
"'QC'"\<~'<t
...lZ",U...'<!:
<","<'l~>",
~ ,'" ","I'-
E-~;!.~Zo
~~-<r:
::;:0 U::;:
a:l
....l
U
a::
~
.....00
OE-
;x:
;x:
~
U
00
Ie
~
Q
l"l
N
~
o
e:
"0
:;
o
.c
'"
"0
e:
10
<n
'Vi
'"
0;;
e:
10
e:
10
<II
.c
8
-0
~i
~8
._ u
",10
~o
oU
e.~
~~
~.~
f-J!
~~
<lie.
e: e.
1!l0
<11-0
~]
8~
~ ~
0:J
~~
eo
B"E
~8
B~
<no;;
ro .u
~fE
",0
.c<ll
.c
-0 ~
~~
IO~
t: ~
~~
"'~
1010
;:1;;
o '"
e::;::
.::c
~E
~<II
:J.c
.c~
~g
~~
=c
~o
<II~
.c~
8-0
<II:;
> 0
<II.c
=Vl
~6
<II'"
~;:,;:
5:Q ~
O..c .-
~?;'E
10",0
",<IIlj
g~<(
<II:J .
l: ~ E
BEiO::
.0<11
V'!'::5
::)-0_
, <110
g.s VI
c:~"E
." -g 8
.sc:~
]~~
~Q)fE
a.~o
e:.c <II
~.s f3
.c<ll.c
~~
~ ~ 'i
10 -0 '"
:=~E
c";o .E
~~g
~uu
'3: ro ~
"01t::::
<11"0 <II
~Gg
E"'",
~~ :t:
g ~ B
~-g::6
~~.E
~.~ c:
-o~o
e:IOe.
10 E :J
"'~-o
.~~~
......- Q)
'ij) Q) ~
o.c <II
o..f-.c
l"l
It'l
cO
....
a,
aO
N
l"l
N
~
'<t
00
~
<>
Q
I'-
N
....
N
cO
N
"i
....
l"l
...l
<
E-
O
E-
r/)
~
....l
....l
o
Q
r/)
;:J
'1- \
CENTRAL PENNSYLVANIA CONFERENCE
THE UNITED METHODIST CHURCH
303 MULBERRY DRIVE / P.O. BOX 2053 / MECHANICSBURG, PA 17055-2053 / TELEPHONE (717) 766-5275
May 9, 2005
Attorney Carl G. Wass
3631 N. Front Street
Harrisburg PAl 711 0
Dear Attorney Wass,
This letter is in reference to an investment account that ROBERT L. DEARDORF had
with the Central Pennsylvania Conference Committee on Loans.
Mr. Deardorffirst invested money in the amount ofTen Thousand Dollars ($10,000.00)
on October 31, 1986. He then added another Ten Thousand Dollars ($10,000.00) on July
6, 1992. On March 2,1995, Mr. Deardorfpresented both of those certificates to us,
requesting that a new certificate be prepared, adding the names of Mr. Donald R. Shover
Sr., and Mr. Donald R. Shover, Jr. That investment account, in the amount of Twenty
Thousand Dollars ($20,000.00), is now in our loan fund. A copy of his request for that
change and the new certificate is enclosed for your information.
If you need additional information please feel free to contact me.
Sincerely,
~)w. ;U~
~rs.) Zedna M. Haverstock
TREASURER-COMPTROLLER
Enclosure
EXHIBIT
I
'12
COUNCIL ON FINANCE AND ADMINISTRATION
..
No.11688
9005. Arlington Ave., Room #119, Harrisburg, Pa. 17109
MARCH 29, 19~
On demand we promise to pay to the order
ROBERT L. DEARDORF
AND/OR DONALD R. SHOVER, SR. AND/OR DONALD R. SHOVER, JR.
*>'<**TWENTY THOUSAND AND---------------- -------------NO / 100-----------------:-Oollars
of
$$20,900.00.
Without defalcation. or stay of execution, for value received, with interest at5...-5lL%, per annum, wah'lng Inquisi-
tion and exemption laws, llnd confess judgment for ab:)\"e sum without offset, with interest and costs of suit, and
with five percent for collection fees. There is a 1 % penalty on all monies not left in the fund for a period of one
year.
THE CENTRA. L PENNSYLV A.~""IA. CONFERENCE COMMITT. EE ON LOANS 1'.
.., ~: THE 'UNITED METHODIST CHURCH ~, t' /
< ') h_; I (i .. -- ( . f f . /,' 'i
Attest: Y.J~~ -.. ft--v~ '-_~v_.J-~: /......'. .A.. p...-e ,/
(~) TREASURER CHAlRPERSON OF THE COMMIT'rEE ON LOANS