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PETITION .'OR PROBATE and GRANT m' LETTERS Hslal>;;'__~bd ~h.~rroubMn_____. No. _011- ~~(),;v also know" as _________.____________ To: .-- Register of Wills for the -- Deceased. Counly of __CJJMBERLAND In the Social SeclJrlty No.. 209-12-68"57 Commonweahh of Pennsylvania The pethlon of Ihe undersigned respeelfully represenls that: Your petitloner(s), who IS/lire 18 years of "8e or older an the exeellUlL_ In the IlIst will of the above dece.lenl, dated _..l3~~~r 1.12L and codlcll(s) dated --..!:lone .______ _ named , 1911L- (\laIC ICleVltllt CirCllllHllIIICC~1 c.g, renunciatloll, dealh uf C'<CClllor. eIC,) Decendent WIIS domiciled lit de"th In Cumberland _ County, Pennsylvaola wilh her last family or prinCipal resldellce lit Camp.Hill Care Center, 46 Erford Road, .CamP Hill, PA 17011 __ (list \trccl, numher (llld lllunclplIllty) Deeendent, then 80 years of 118e, died _~cembeJ,".Jl, , 19 93 at Camp lIill Car!.! Center _. Except as follows, decedent did not marry, was not divorced IInd did not hnve II child born or adopted after execution of the will offered for probllte; WIIS not the victim of II killing and was never adjudicated incompetent: Decendent III death owned property with estlmlltcd vallles as follows: (If domiciled In Pa.) All personal properly (If nol domiciled In Pa.) Personlll properlY in Penllsylvanla (If nol domiciled In Pa,) Personlll properly In County Value of real cst lite In Pennsylvania shuRted as follows: ~ 1 ,999.46 ) L $ WHEREFORE, petitloner(s) respectflllly presented herewith and the grant of Iclters theron. reqllesl(s) the probate of the iast will and codlell(s) test~tary (Ic~talllclltar~': administration c.l,n.; admlnlsuatlon d.h,n,c,t.a.) 11 (<'I) {J (( Y '~.- j~~/ }c'\)',) ('/l-lw' , u D -.2llo....cclurnbiaJMmu , ~.~ CamP HillJ'A 17011 ;'v ~'" u~ a 0 a Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH 010' PI<:NNSYLV ANIA } 1:18 COUNTY 01<' CUflBERLAND The petltloner(s) above. named swear(s) or urnrm(s) Ihnllhe statements In the foregoing petition arc true and correct to the b~M of the knowledge und helieI' of petltioller(s) and that lIS personal represen. talive(s) of the above decedent pclitloner(s) wlllwcll ~t'llrl~lr IIdl~llnisle~,lhT.cslate )lcf;ording to law, . , "1 (.}1'(,',1 ( AJ..), ( Sworn 10 or afflflmd ,and Sllbscnled~' __.___ ___.__ VI J( I I r. .... before n e ~hls .__~_._ dny 01 _ ___._________.______ :. )'0,,,,,., 1~\j?!1E " ( ---;:;'>>1 ~ -- . -- ;;r-----------.-. ~ ';;.Lti..~__ll.-0 ,LIf' '. - 0 ~ M RY LEWIS Renl.\ler ___ __.__. ~ ( /.j -I S() -IL( Thi~ I'" iii t'{'11i1r lhill du' illllJfJlI,llilJIl hl'I(' ,1:iv(,1l b llll'I'I:1I l_lll\(l'd 1111111 ,'f1l1li~:III,d t ('II ifi"ll(' III d('lllh tllIl)' filt'd \\'1111 IOl' il\ 1.(,t'.lIllt,t~islt.H, Tilt, 01 i.ldl1,d I('nifit ,Ill.' will be 1'1' w,lldl,d 1,1 1IIl' "'t,tll' Vi{.11 Hl'uwl\ (1IIilt, 101' Il{'llILlllt'1l1 filillg, , WARNING: It Is 11I8gallo dupllcato Ihls copy by Ilholoslat or photograph. No. /) /:Y7vr-' . (.(~,. .,',.,,") " '~.~<~~~~~.~,,'-:' '..l(~(~.;'_'"il.1JL hl(al'H('g;,\t1l1r // '. !ll'l' fur Ihi\ll'rtifit,Ht., ~,~.oo 2075913 Ole 1 4 1993. ll,/l(' . COMMOIlWEAI TlI o. pnllWYIVAtllA' Oli'AHIMU'H Of' tfEAl.lIl' \'I1AllIlcon06 CEftTlFICATE OF DEATl1 cd)fkTJi7\t;~l;')! \t...,...II'IIJ'~lIU\ .... ~.....__...._.. .-...- ii l" ....--J~.i~:'A~~t~~i:n;,;'n,l.-'llfl1 --'-~;;i::Af:III'~ 1II,Irlll ..I.......... ..........- ~.r~malQ '..2Q9...::'-12 - 6857 J.'_~ (lllII'''(_d i.', ,.' 'L_,~for(l~r!t",I"., ....,.'''''.1'.,1I1.,...~.1 "__.n ... -1 -._L:If _ _~. __'[ .. L~ar.l..1~ l~.~!'~:..... t:~~I_";'~:'O":'~~:[' _~~~~:;~"-'.~':~~[~;- ~:=~~~._~~;':~~..- ~Io'lf "".o\fti 11'/ IlOl1.J ""'m llM!! t \ ,'\011"'"' Ir' ',," .' "., "" 1"1 .' .....A~~(LErIf'jIClf'tl~NJIICOfll\:il"*l ""Cf.""t'.u~ItdIIIl.I...U YlflLft.fl< I 'l' \, . \ \ I ,. I ~ . (, I , '. II..> r.., Y" ( J "I'" 'P<<.t/(....r_~ .Sl...." .....C~,~.b~r~~~~L~D!1tl!2".. j~mP:~~!~~"'!m;;;'\i'T'"!!! 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I () Jt. ~~~~~:n::.'r,"II'o'llon'ndl,,~w"h"I~n,lllnlr 09IIlIQn.I1'llh It':~UIt~~~' 'h~ ::~':~:~~~~::~h~,'~'~'~~~t:~::~ ~~u~.:~_~~_~~ ~L"._~'r~ l~L.--1J:~. t:?'"lL1LS /( i~ I- tl 'ii.i;j"i:iiii1<;;;ijo.7~~~,";'-"------"""'-----" ( '"'' ,,, ?i" ,,,,,, ,,' I, g!./! .:;h~,;..:'.7:=-.............. .!~~~:~..H ~L... ,!/_;J~ - ../...:i,...L.t'L i 17109 ~c 1:""r"4" '''If,'')oI.,nt ,:;:,. ~~~:t~Dt~:~ CAlItI,I',",""" T II . .." ~ Il.. ~"I ,.,...,w ,LAIT , . ~ - "'[Jut i(j,(~ll,;~',.:(i'/j ;', ;1/..'1 ,,:- .. '. " .. LAST WILL AND TESTAMENT OF REBA M. TROUTMAN I, REBA M. TROUTMAN, of the City of Harrisburg, County of Dauphin, and State of Ponnsylvania, baing of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revokjng and making void all former Wills by me at any time heretofore made. ITEM II I direct that my Executor, hereinafter named, shall pay all my just debts and funeral expenses as soon as conveniently may be done ~fter my decease. ITEM II: I give, devise and bequeath all of the residue of my Estate, whether real, personal or mixed, of what- ever kind and wheresoever situate, to the Green Street Church of God, at 1336 Green Street, Harrisburg, Pennsylvania. ITEM III: I nominate, constitute and appoint Robert Deitzel of Harrisburg, Pennsylvania, as the Exeoutor of this, my Last Will and Testament. If Robert Deitzel should be unable or unwilling to serve as Exeoutor for any reason, or should be unable to oontinue as my Exeoutor, I appoint Eugene Harbold of Harrisburg, Pennsylvania, as my Exeoutor. '. . IN WITNESS WHEREOF, I have hereunto set my hand and seal thi's /() ~'1 day of Septembel', 1986. ') ji ~ /. I /,' .1--- t-- /;;' I "-'1." _.'- (I' /' 1:.".. /~~ \ /,') c\ul/-"''U.:JA'L. , Keba .,' Troutman ' The preceding instrument was on the date thereof signed, pub- lished and declared by the said REBA M. TROUTMAN, the Testatrix therein named, as and for her. Last Will in the presence of us, who at her request, in her presence and in the pr~sence of each other, have sub~cribed our names as witnesses hereto. / ~ Residi.J:lg at ~'( 'j) ~, _.::;i(.17t:J// / A" ) ~.v,..{. ~"0u!.1..I Residing at 19 c:l:t--u.u-'tH4f!;'{)~ ~(1( Pa--I;nu>J4d, A t? . / '7<:' 'lefT I' .' -2- 21 - 94 - 02 REGISTER OI~ WILLS 01<' CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Cheryl A. Swartz and Lois A. Fonner, -, ll~ (each) a sUbscrlblnK wilness 10 the will presenled herewilh, (each) being duly qualified according 10 law, depose(s) and say(s) lhnt _~~ey were present and saw Reba M. Troutman Ihe tutal r ix, sign Ihe sallle and thai __ t hey signed as a wilness at the requesl of testal r i x_ In It.~ presence and (ill the presence of each olher) (in the presence of the olher subscribing wilness(es)). V ~tl~l" (;.1, Y':'!:c'-;l (r13- i/' (Name) 412 Ap.2.letree Rd., Camp Hill, PA 17011 vi::-(.~(l/ ~~ess) ~t/~!()i/ I (Name) 19 Lynwood Drive, Palmyra, PA 17078 (Address) Sworn to or afflJ!TIed and subscribed before mC~~J~/ - day of . 192-.2. \~ 1. (~.~C--) Nota Public ~ lt~ NOTAfllAI SIAL FAY l. POTTEIGER. NOlary Public HarriSburg. Dauphin COl/llly My CommissilH' f:'i(lirr.~ ,July 1, 1995 ----..... REGISTER OF WILLS OF COUNTY OATH OF NON.SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, deposc(,s) and say(s) that ~- familiar Wilh thc slgnaturc of codic will teslal_ of (one ~(1he. subscribing wilncsses 10) the ". '..... presented hcrewilh and codicil '~"'" b~l~nature on the will is In the halldwrlllng of // ............ 10 Ihe best of kn~~d bcllcf. ~ Sworn 10 or affirmed angsttb;crlbcd bcforc ~ me this /' /' . day of (NamiJ--.... 19_ thaI ~/ (A ddress) Register (Name) . (Address) " " '. :i, '\ II , " " , I' I , , " ,. 'I " " :,' , ,. , " '. '1 " " I',. , I " I' I' " , " " " 1',' ,.11 ,i , I' , I" I " "t, 'ie, , :' ... ',\', , "i, ,. " ,. " ~ !/ ,1,'; "I 'I q, ': I' , (, )' , , ,,, il: f:, ,. '. ., I .' " , " '.' , .\, 'I' ,I .. : " '!/j' " " i ii' " " '"~ "'., ""I! , " ,. , " .' '1 " " , , ,; , ,. I E..' ,. " ,. , ., L I' I, j; , 1\ "~,I ",,! ,. " " I.; I' I I"; I,' 'I " " , i' , 1\ , f"-", '\:'.:it: , I- ,. ~'l', :;, , I 'all) ? .. , ','I, , .} 'I ,:1' ., (i~ f:~ c:::l '\ ;'. " 'i'.- , r::.e (~l j. I " ! ,. , ,,~l'j :t.:', I, " U 0 I,). Ii , ('1 , , ',', , ftl iij I' "I' d',iU,YJ. ., TJ.'/J ,I:!:J ;i) ..' ,"~ "lj,.., ~..l3 , Cl (,1) , () (~ ~' ~a I' ~~ " " ',',' ,. 1< I' , " >! h, I, , , I' , I' " "!',, i " " " ., ;1' I I' " , '. " " I' 'I, ,. " I' <!" .. I I " " ,'I' '" I, il; ii d' ',. it " " .. " , , ,. " " ,. " ,. {' ., I I. :. .1', ..,' 'I " ,. I' I' ','I ,., t': I ."i , " I' i" ',,1 I', ,. " ,. , ,. ", " " , ,1\ " " " " '"~ " "i' I' I. " " " " " ()I/.- ~ CERTIFICATION OF NOTICE UNDER RULE 5.~. Name of Decedentl .Reba M. Troutman Pate of Death I 12/09/93 WJll No, 199~-00002 __Admin, No. To the Registerl I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court :Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 1/6/94 I Name Address Green street Church of God, 1330 Green street, Harrisburg, PA 17102 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Datel.j/6" IqL( /7c6:ztf)--- SitJ~ ,~; ;~-------_. Name TimLthy W. Romberger, Esquire Address 3631 North Front street Harrisburg, PA 17110 '" \,),1'1 ...;t 1:: .~r. '" " :In':. ,. , I'.: . ,'- I ~~ " 'SI' " ~. pI 08 Telephone( 71)7 232-7661 Capacity I Personal Representative . X Counsel for personal representative !) ;:1 eI.> r,- "U. 1. R.al E.lal. ISch.dul. A) I II __..__________.____________ 2. Slack. and Band. ISch.dul. B) I 2) ____.. 3. Cla..ly H.ld SlocklParlnerlhip Inl.r.'1 ISch.dul. q (31 __ '"___._____ 4. Marlgag.. and Nol.. R.c.lvabl. ISch.dul. 01 ( 4) ________________ 5. Ca.h, Bank D.po.lt. & Mlsc.llon.ou. Penonal Properly( 5) _______1 , 9~7 .2l_____ (Sch.dul. E) 6. Jolnlly Own.d Prop.rly ISch.dul. F) I 6) _ 7. Tra..f." (Sch.dul. 0) IS'h.dul. L} I 7) '_.. 8. TOlal Groll AII.II (Iolallln.. PI 9. Fun.rol Expon"" Admlnlslratlv. COlli, MI".IIanoou. I 91 Exp..... (Sch.dul. H) 10. D.bll, Mongag.L1abllltl.s, LI... ISch.dul. II 1101 _.._,._____ 11. Talal D.ductlo.. (Iolallln.s 9 & 101 12. N.I Valu. 0' Ellal. (IIn. 8 mlnuslln. II) 13, Charltabl. and Gov.rnm.nlal B'qu..ls (Sch.dul. JI 1~, N.I Valu. ~ublocllO Tax Ilin. 12 mlnu.lloo ~3) 15. Amaunl of IIn. 14luxabl. 016% ral. (Includ. volu.. 'rom Sch.dul. K or Sch.~ul. M.I 16. Amounl of IIn. 14 laxabl. 01 15% rato (Includ. valu.s from Sch.dul. K or Sch.dul. M.) 17. Principal lax du.IAdd lax from llno 15 and from 1100 16,} 18, Cr.dlll Spou.al Pov.rly Cr.dlt Prior Paym,," DI"ounl ------------ + ..------ +~---_. 19, II IIn. 13" groal.r Ihan Iin. 17, onl.r Ih. diHor.nco on IIn. 19. Thl.ls Ih. OVERPAYMENT. IiIO 20, II IIn. 17 i. grool.r than IIn. 13, .nl.r Ih. dIH.r.nco on IIn. 20. Thl." th. TAX DUE. A, Enler Ih. Inler..1 on Iho blllaneo duo on IIno 20A, B, Enl.r Ih. 10101 of IIn. 20 and 20A on IIn. 20B, This I. Ih. BALANCE DUE. M.~. Ch"k Payabl. '01 R.gll'" of WillI, Agln' .. II SURI TO ANIWIR AU QUIITIONI ON RIVIR.. SIDI AND TO R.CHICK MATIf... Under p.nolll.. of perjury, I dedar. Ihot I have IKomln,d tnll reI urn, Including accompanying Ichedulel and I!alemenls, and 10 th, bill of my knowledge an b,ll.fl Ill, 'rUI, corr.ct and cample'e. I dlldor. Ihat all "01 "Iale has bien reporled alltue market value, D.darallon of pr.par., olh., than Ih. plnonal "pt..entall", I, brllod 0 IIlnformallon of which p'O~HH r ha any knowledge, !f(lN: , lAjON ill INIf TUA" A01i'iil1r----------- - bAT! __ or. 'I/~ H ~~vr--~i~~lllI11l.?~^ve.,-~.ame...!.~ill,-P^ _17011--,-_ rnr.J,!Jj}jtj...- 3631 N. I'ront st., Harrisburg, PA 17110 Z/lt/rtI . . A!V.tlOO EX+ 111.911 &1 ~ Q I!! ~ie :z:2.. U...al ... <l Ii ~Q oZ U2 z o ~ E ~ z o j:: g ... ~ u g . , t /l/'/S'O-/l{ INHERITANCE TAX RETURN RIlSIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) .0. DATlS O. DIAlH Am. 12/31/91 CHICk HIU If A SPOUSAL POVIRTY CUDIT IS CLAIMID 0 PILI HUM". ~ " ~ ~..:~0.~ COMMONweALTH Of PENNSYlVANIA DEPARTMeNT Of REVENUE om. 2.0601 HARIl;ISBURO, PA 17128.0601 21 COUNTY CODE fNT'S COMPlETE ADDRESS 1994 YEAR 00002 NUMBER ____L , o Troutman, Rem M. OC';IOS~~U1A~~~;:; _ -----r~7:;;~';~--TAT;;;~~;~ IXI 1. Original R.lurn [I 2, Supplomonlal Roturn o 4, Llmlt.d E.lalo [J 40, Fuluro Inloro.1 Compramho (for dol.. of doolh .kor 12.12.821 IX! 6, Docodonl Dl,d Tellalo [] 7. D,cod,nl Mainlalnod a Living TrUll IAllach copy of Willi IAlloch copy of Tru'l) ALL CO.R.SPOND.NCe AND CON'ID'~IAL lAX INPORMATION SHOULD .1 DIRICTID TO, AM [OMPI!T! MAILING ADDRESS Timothy W. Ranberger, Esquire CALDWELl, & KEARNS !l liD'! MIfA ______n____ ------- 3631 North Front street 717 I 232- 7661 Harrisburg, FA 17110 Camp Hill Care Center 46 Erford Rood, Camp !lill, PA 17011 ~ Cumberland - ---- o 3, Romalndor Rolurn Ifor dal., of d.alh prior 10 12.13.82) o 5. Fodoral E.lolo Tax R.lurn R.qulr.d _ 9, Tolal Numb.r of Safo D.pa.1t Boxo. 1,240.84 ( 91 1,987.02 (111 (121 _ 1131 (14) 746.18 746.18 ~O~ -0- (15) __._ ___K .06 a (16)--__________.______K .15 a -0- (17\ -o~ Inleroll Cht,(~ 11l'11' I' VOU (If I' H'III' !>linO II 'UfUlld of VOUf OVt"pIlVllll'nl. 118) (191___ -0- -O~ (201 (20AI ___ (20BI -0- ----_0- -0- -lb_ , I', I . , PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (I"') IN THE APPROPRIATE BLOCKS. .' '. . YIS. NO 1, Did decedent make a transfer and: a. retain the use or Income of the property transferred, ..................,........,......,.... b, retain the right to designate who shall use the property transferred or Its Income, x x c. retain a reversionary Interest or .............,...........,.."...,.....,............".............. x d.' receive the promise for life of either payments, benefits or care? ....................... 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? ,............,......,................,......,.... 3. Old decedent own an 'in trust for' bank account at his or her death?...................... x x x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. . ' . , , , , t. I , RlV.1502 IX+ 112.811. o..,l.o _ . SCHEDULE A COMMONWEAlltl 0' ,ENNlYlVANIA REAL ESTATE d . IN1\~'lbAE~~ED\~~~:mANd"___d ESTATifo'p . :FILB NlJ"MI'iR"' m_.__m~ Troutna,n, Reba. M. .. 21..94-2 dd._d__h.._____ (P,aper1v lalnllv.awned wllh Right 01 Survlvallhlp mull be dl"la.ed on Schedule PI All real e.late .hauld be reported at 101, market valve which II de/lned a. the price at which praper1v would be ..changld betwun a willing bvV" and a willing lOll." nlUh., bllng compelled to louV or lOll, both having ..alanable knawlldgl 01 thl 111.vant lact8, "....____._ _, n,_ .. ..... ...._ ,... --,... ,- .. ITEM NUMBER ,. DESCRIPTION VALUE AT DATE OF DEATH 1. None " .. ,.' , " ,. , i-I. ..' , ,I' ", " , " ;1' , '. "', , . " , , " " , , " ,l' , ,,' ,. ,.,. . ,,, 'j, " H .1 " I " 1-'- " '-, ' ',J " ------ _._-----_..--._._~-_.. ----.-----.'.-------.,. ....-. .. -p-' --.-.- ..... .------.".----.---- -..---.-----. .___.__...______..__u__ _h' h_ d ....__ . "'d TOl'ALI~llalnll' a.nllnl.I,R..apltulatlanl. III ma.. Ipnce /1 nlldld, /01,,1 addillanal shill, 0' laml tI...) . .d.h.... J__.-____._._._ .. . IIV.lj09lJ1tI12.1I1 * ,MMONWUUH 0' PiNNIYlVANIA INH!RITANC! TAX mURN RUIO!Nl O!CIO!NT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATI OP ._-~-- --- I PILI NUMIIR 21-94-2 -- TroutmDn, Reba M. None I, " C. Jaln.tly.awnld praplrtYI ITlM LmlR DATI " TOTAL VALUI DOLlAR VALUI OP POR DICD'S NUMII~ JOINT MADI DISCRIPTION OP PROPERTY OP ASm % INT. DICIDINT'I INTlRIST TENANT JOINT 1, I , , . , " , " , , " ' , ..' , , i . , , .' , , .' , ' , , " , " , , I , , , , " , I ' , " " I , ,I' I' , , ,. . , TOTAL (AI.a Intlr on IInl 6, Rlcapltulatlan) $ " Ii) , " . " " , , , "":, . ') '" ;,i,J~ "'. -,','\ (/I mOil 'pacI I. n..dlr/lnlt" cddltlono/Th.." of IOml Ii..) , RIV.ISle Ii. 1l,811 ~~~ COMMONWfA,L1H (if PENNSYlVAt%\ d .. .. INH~m;,WJli:M":VRN .. ISTATIOP Troutman, Reba M.' OJ', SCHEDULE G TRANSFERS PLEASE PRINT OR TYPE ~ ,,';; ...:" : ,; .--,;:; I ~.,..: Fill NUMBIR . ... -...-.- _ .~_ ._.~u_ __ __...'~.. 21-94-2 . -I' ," __...._,..________... THISSCHIOULI MUST 81 COMPUTIO AND PI LID IPTHI ANSWIR TO ANY OP THI QUISTlONS ON THI RaVlA1I SIOI OPTHI COVIR SHIIT IS VIS, . ITfM" ,,'d', . ~~SCRIPlICl~Of~ROPCR;V d .. .... . ..... ... lCllA~~~L~e.hDecD.DoiiAirVAiuim , eXCLUSION % Of DECEDENT'S NUMBER In<iud. nam. 0' i/,. I,.n.'"", ''',I'ltla''on/hip /0 doctdon/, dal. of ''''''ft, Of ASSEl . .INL. .... ..I!'ll~~~S!. . None ,'. " '. ' ,. il {. " ,. " 'Il, , , ~. " ii " '1-; \, " 'I ,', " Ii! " "" ,',', , ' 1\; t,'.' ,. 1','1. ,. ,," ....-....-- ...~-..-----,,-----~7'C--c-....-....:..-.-.......--.-,...-.. ...:........-- n ..m..;_..... ....,-... '."-j ~--:'._._--~:..:.~--.:.~. ....:._..._._____.__~_..:~.,,,.-"..;-.---~.-~.-.--.--..-.-. _.... Tl?!~L_ (~I~".!~I.~..~Ii~~.7j .R.,,~e!l.u!~.II~nL~..:_..~:....__..'T-. " .' ,," " '. ,III molt.pact'lo n..d.d, inlft' addillonall".." a, 10m. II...) .. '. ' , ,II'! . " ., , . .,V.UIl U.I'.'" ~ SCHEDULE H ~L FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLAN~O.~~ EXPENSES PI.al. !"n' 01 TVp. Lf.lmiiIR Troutman, Reba M. 21-94-2 ---------.-._---~- DESCRIPTION ~1~'9. ." ~~J;ft COMMONWWltl 0' P!NNIVLVAN'^ INHeRITANCe TAX R!lURN RUIO!NT O!C!OeNT ISfAn o. ITEM NUMBER AMOUNT A. Funeral Exp.n..., 1. Woodlawn Memorial Gardens, Headstone and gravemarker 595.00 B. Admlnl,',atlv. COIIlI 1. Perianal Representollve Commllllonl - 12 Social Security Number of Personal Representollve: _ 188 - 4017 1 00.00 Y~or Commllllons paid 1994 2, Attorney Fees - Caldwell & Kearns 350.00 . 3. Family Exemption Claimant __ Relationship II Addrell of Clalmanl at decedent's death St...et Addrell .. City Slate --.:.._ Zip Code 4, Probate Fees 42.00 C. Mllullan.au. Exp.n.." 1. Publication - Cumberland Law Journal 40.00 2, Publication - The Carlisle Sentinel 68.84 3. Caldwell & Kearns - Administrative expenses, Notary, 45.00 postage, etc. 4. 5, 6. 7, 8, TOTAL IAlso enter on line 9, Recapltulatlonl S 1,240.84 I llf more .pac. I. n..d.d, In..rt addltlanallh.." of .am. .1...) " H"I'.1J\)U. !l.111 ~.'~.t ~,U COM"',OtIWIA\H1 0' ,tmunVAt-lIA INHlllfANCI fAlC UfUlN ._~UIO'~N' OleIOlN' SCHEDULE J BENEFICIARIES l. :.== -- UlATE OF Troutman, Reba M. FiLl NUMBIR , 21-94-2 1 A, Ta,able BequI'''' ~-- - AMO'JNT OR . RELATlO~~ SHAR" OF ISTATI N~~~ER NAME AND ADDRm OF BENEFICIARY -_...~_..- -------.-.- .----------- --..-.--------- 1. . ITEM NUM8IR NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARI O' ESTATE B. Charitable and Ga,"rnn,"nlal BequI'IIl 1. Green street Church of God 1330 Green street Harrisburg, PlI 17110 100% /i TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI.a enllr on Itnl 13, Rlcapltulallan). (II mar. spac. Is n..d.d, Inll" addltl.nalsh.... .'sam. silO) $ 746.18 , I c.... ~ C'Il o C'Il (I) a: @l ~ ~ ~~ ~ ~ ;:1 '::~ \!! ~ \J'- 'g ..() '- Cj . \ \ - - " - ~ ~ .. . - (,) = z ~ r1'l - t'- S '" ~ .. ! c r1'l ~ .. i!~ ~ r1'l 0 .. ~ ~ - ~I~~: . c ~ " J '" S!~b ~z ~ 0 '" . ~~:; 0 I II" 'I 0 3 ~;; " b -- ~ ~~j r u '; ~ ~ r:; ~f~ I ~ Ill.. ~ ~Ill ~~ EXHIBIT 11 -.....:..__...~-'" ~....-.LtIL..lf..'r..... "'J"~ , " -...~ - RT.._.... ,-..... -..---- ':" , 1,IIS'I' WILL IIND fN~S'rll~1EN'I' OF !llmll M .~'HOU~ I, ~EBI\ M, TROUTMAN/ of the City of Harrisburi/Cciunty of Dauphin, and State of Pennsylvaniu, being of s6und mind, memory and understanding, do make and publish this, my Last Will and Testament, heraby revoking and. making void all former Wills by me at any time heretofore made. I'rEM II I direct that my Executor, hereinafter " named, shall pay all my just debts and funeral expenses ,as soon as. conveniently may be done after my decease. I'L'E~l II I I give, devise and, bequeath all of the residue of my Estate, whether real, personal or mixed, of ~hat- ever kind and wheresoever situate, to the ~reen Street Church of God, ~t 1336 Green Street, Harrisburg, Pennsylvania, ~B!l I nominate, constitute and appoint Robert Deitzel of Harrisburg, Pennsylvania, as the Executor of this, my Last Will and Testament, If Robert Deitzel should be unable or unWilling to serve as Executor for any reason, or should be un~ble to continue as my Executor, I appoint Eugene Harbold of Harrisburg, Pennsylvania; as my Executor. '" -. ., '"..,-., w " - .....~- seal this IN WITNESS WHEREOF, I have hereunto set my hand and l/' IC. . day of September, 1986. . ..':,...) . /) - .' ;.... , ......,... /'... '. 1~ ,'I .-. 'j " I . - .'r, i; , .(ifeba' ~.T~o~~m~~/." 1.1!--i~,'L. The preceding instrument was on the date thereof signed, pub- lished and declared by the said REBA M.TROUTMAN, the Testatrix therein named, as and for her Last will in the presence of us, who at her request, in her presence and in the presence of each other, have subpcribed our names as witnesses hereto. / I, ,,{ ~/. ~,t.-?u!/U Residing at 'I /9 c~ ~ ~~ .y.Ja..-h--n~44d, A / '7t7 '?? '7 't?' 'I '1 -2- , ()(', t; :'1] I" .... -- , , STATUS REPORT UNDER RULE 6.12 Name of Decedent I Reba Troutman Date of Death I 12/9/93 Will No. 2194-0002 Admin. No. 1994-00002 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 estatel I. State whether administration of the estate is complete I Yes X No 2, If the anSWBr is No, state when the personal representative reasonably believes that the administration will be completel 3, If the answer to No. 1 is Yes, state the following I a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account iSI c. Did the personal representative state an account informally to the parties in interest? Yes X 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 ~ed to this r rt. .,.---- / ..p----/' Datel 7/15/94 >y~?'~ __ ::.----________. gnat. c: Timothy W. Romberger, Esquire Name (Please type or print) 3631 N. Front st., Harrisburg, PA Address 17110 12.17) 232-7661 Tel. No. CapacitYI ___Personal Representative X Counsel for personal representative (MAHlrmflAM3) .t- ,,' REV-1547 EX AFP (10'93~ COMMONWEALTH OF PENNSVlVANIA OEPAATHENT or REVENUE BUREAU Of INDIVIDUAL lAMES DEPT. !IOUl HARRISBURQ, PA 17121-0601 ESTATE OF~ REBA' R" FILE NO. DATIl OF Dr.ATH 12-09-93 COUNTY CUMBERLAND NOTE I TO IHSURE PROPER CREDIT 1'0 YOUR ACCDUNT, SUB HIT THE UPPER PORTION OF THIS FORH HITH YOUR TAR PAYHEHT TO THE REOISTER OF HILLS, HAKE CHECK PAYABLE TO "REaISTER OF HILLS, AaEHT" REMIT PAYMENT TOl NOTICE OF INHERITANCE TAK APPRAISEHENT, ALLOHANCE OR DISALLOHANCE OF OEOUCTIOHS, AND ASSESSHENT OF TAR ACN 101 DATI! 06"20-9~ TIMOTHY W ROMBeRGER ESQ CALDWELL 8 KEARNS 3631 N FRONT ST HBG PA 17110 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 t Alount ROlit ted I CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ iI IV: ii'4"i" iif - APP - i i'ii:m - - NOY i ciS" -OF - IN'iiiiiifANCE - 'fAx "'A-piiii'A"i 9 iH!'Nr;-AL. rowAifcE - cili- -" --- ---- - -" - -"- DISALLOWANce OF DEDUCTIONS AND ASSESSMENT OF TAX UTATE OF TROUTMAN I/EBA M FILE NO.21 94"0002 ACN 101 DATI! 06-20-94 TAR RETURN HAS I I X) ACCEPTED AS FILED I I CHAHaED RESERVATI~N CONCERNING FUTURE INTEREST . SEE REVERS! APPRAISED VALUE OF RETU~N BASED ONI ORIGINAL RETURN 1; Rul Eltoto ISchldulo A) CI) 2, stockl ond Bondi ISohodulo B) (2) s, Clollh Held Stook/Portnorlhlp Intor..t ISohodulo CI IS) 4. HortOlgol/Hotol RloolYoblo ISohldule D) (4) S. Co.h/Bonk Dopollt./Hllo. Por.onll Proplrty ISohodul. E) (5) 6. Jointly O.nod Proplrty I Sohldulo F) (6) 7. Tron.forl (Schodulo a) (7) 8. Totol Alioto 1I .00 ,00 .00 .00 1,987.02 ,00 .00 (8)- 1,987,02 APPROVED DEDUCTIONS AND EXEMPTIONSI 9, Funorol Exponooo/AdllnlotrotlYo Coot II HlIolllonloul Expln.ol (Sohodulo H) (9) 10. Oobh/Hortgogo LlobllIU../Llon. ISohodulo II ClO) 11, Totol Ooduotlonl 12, Hit Voluo of llx Roturn IS. Chorltoblo/aoYlrn.ontol BOoul.tl (Sohldulo J) 14. Hit Voluo of E.toto Subjlot to Tox 1,240,84 ,00 lll) (12) US) (14) 1, 240 84 746 '.18 746.18 ,00 If .n ......m.nt w.. iB.u.d pr.vioU.ly, Un.. 14, 15 .nd/or 16 .nd n will rdfl.ot figur.. th.t includ. the tot.l of ~ r.turn. a......d to dat.. ASSESSMENT OF TAXI IS, Alount of Line 14 to.oblo ot 6% roto 16. Alount of Lln. 14 toxoblo ot 15% roto 17, Prlnclpol Tox Duo TAX CREDITS I PAYHENT DATE NOTEI lIS) 116) .00 R. 06 . .00 R.IS . (17) .00 ,00 .00 RECEIPT NUHBER OISCOUHT (.) INTEREST (.) AMOUHT PAID l TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE .00 ,00 .00 ,00 . IF PAID AFTER DATE INDICATED, SeE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN H, NO PAYHENT IS REQUIRED. .' IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUt,' A REFUND. SEE REVERSE SIDE DF THIS FORH FOR INSTRUCTIONS. I . ReSlRYATIOHI E.t,t.. of decldlnt. dying on or blfor. OlollOlr JZ, I'IZ .. If tnV fut~rl Int.rl.t In the ..t,tl t. trtn.f.rrtd In po.....ton or ,nJov..nt to CII.. I (collet.r.l) bln'flclerll' of th, d,o'd.nt ,ft'r the IMPlretlon of InV I.tet. for Ilfl or for v..r., tn. Co..onw..lth h.r'bV Ixpre..lv r...rvI. thl right to .ppr.I.. .nd ...... trln.f.r InheritInG' Tlx" It the IINful CI... . (colllt.,l1) ret. on .nv .uch 'utur'lnt.r..t. PUlIPOSE Of NOTtCEI To fulfill the requlr...ntl of Slotlon ZUO of the Inh.dt.nc. and fttltl hlC Act, Aot ZZ of 1991. 12 P.'. IlOtlon i!140. PAVMEHTI Dlt.ch thl top portion of thl, Hotlc. .nd .ub,lt with your PIV.lnt to th. R.gl,t.r of Wills prlnt.d on the rever.. ildt. --Kakl chick cr Ion., crdor p","bl" tc. REDISTER OF HILLS, ADENT All PIY.lnts rectlvld 'hlll first bl Ippll.d tu any Inter,.t which ,.v b. due with .ny r..elnd.r Ippllld to the tiM, REFUHD (CAll A rlfund of . t.M cr.dlt, which WI' not r.qul.t.d on tht Tlx Aeturn, .IV b, r.qut.t.d bv oo~lttln, an "Appllcttlon for A.fund of P.m.vlvlnl. Inhlrlttnct Ind E.tltl TlIC" (REY-UUL AppllcltJon. lire IV.Ulbll .t the Offlol of the R.gl,t,r of Will., .ny of the Z5 R.v.nut DI.trlot Offlc.., or bv olllln, the .p.ol,1 Z~-hour answer In, ..rvlc. nutb.r. for for.. ord.rlngl In P.nn'Ylvlnla 1-100-56Z-Z050, cut.ld. Plnn'Ylv,"l. Ind within 10011 H.rrl.burg .r.. (717l 787'809~, TOO. (717) 77Z-ZZ5Z (HI.rlng IIP.lrld Only). OBJECTIONS I Any plrty In Intlr..t not ..tllfl.d with tht .ppr.I....nt, tllowlne. or dl,.llowlnc. of d.duotlon., or ........nt of ttlC (Inoludlng dl.ccunt or Int.rl.t) .. .hown on thl. NotJct IU.t obJ.ct within .ixty (60) dov. of r,cllpt of th1l Notice bYI .-wrltt,n prot..t to the PA D.p.rt..nt of A.v.nu., BClrd of APP'll., DEPT. Z8l021. Hlrrl.burg, PA 171ZI-1021, OR --el.ctlon to h'vI the ..ttlr detlrtlnld at ludlt of tht Icccunt of thl ,..rsonll r.pru.ntttlv., OR --,ppIIl to the Orph.n.' C:lurt. ADltIN IITRATlVE COAllECTlOHS. Flctull error, dlsooy.r.d on thl. I.......nt .hould b. addr....d In writing tal PA D.,lrt..nt of A.v.nue, Bur.ty of Indlvldull Tex.., ATTNI Post A...w...nt Revllw unit, DEPT. 210601, Harrl.burg, PA 17\21-0601 Phone (7171 787-6505. S.. plgl ! of thl book lit "In.tructlon. for Inherltlno, Tlx Rwturn for I A.lldlnt OIe.dlnt" (REY-1501) for .n .lCpl.h.tlon of adllnl.tratlvllv corr.ct.blt .rror.. If any t'M dU4 I. paid within thr.. (3) c.l.ndlr .onth. after the dlc.dtnt'. d..th, . flvl p.rclnt (5~) dl.count of the t'M plld 11 tllow.d. Int.rut It chargld b.glnnll" Nlth flr.t dlY of d.llnqu.ncv, or nlnt (9) lenthl and on. U) dlY 'row the dlb of d..th, to the dati of PIYltot. Tax.. which blc... d'llnqu.nt btforl January I, 1912 bl.r Int.rtlt et the rlt. of .IIC (6X) plrolnt per ennu. CIlculltld .t I dailY r.t. of .OOOI6~. All t'XI. which b.e... d.llnquent on Ind I'ttr Jlnu.rv 1, 1982 will b..r Intlr.st It I rlt. which will vlry frol cal.nd.r y..r to clllndlr y..r with thlt rlt. tnr~.d by the PA O.p,rt..nt 0' Rav.nu.. Tho IPpllcabl. Int.r'lt rat.. for 198Z through 199~ .rll DISCOUNT I INTEREST. '!!!!: Int.rlU R.tt O.lly Int.re.t Fector Y!!r IntlrtDt R,tl O.lly Int.r..t Fletor 1911 ?O~ .000541 1916 10~ ,000276 1915 16~ .000611 1917 O~ .000261 1916 IU .000101 1911-1991 IlX ,000501 1915 IS~ .000156 199! 9~ .000!67 mH996 7~ .00019! --Int.rllt II ollcultt.d .. follow.1 INTERCRT . BALANCE OF TAX UNPAID X NU"IER OF DAVI DELINqUENT X DAILY INTEREST FACTOR .. Any Notlc. ".ued Ifter the tlM b.cOlttI dollnquent will refl.ct In Int.rllt c.1culltlon to. flft"n ell) diva bavond thl date of the ........nt. If pav'tnt It lid. Ifttr tht Intlr"t OOIlpUtlUon dlt. .hewn on the Notlo., IdcUtlonal Interut ...,.t b, cllcullted.