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PETITION FOR PROBATE and GRANT OF LETTERS
d)/-f:JJ.t- II~
Estate of Ila ry 1I.
also known as
No.
To:
Register of Wills for the
Deceased. COUnty of Cnmhprl "nn in the
Social Security No. ? n, - 1 h - h 71 ~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitloner(s), who Is/are 18 years orage or older an the execut nr
In the last will of the above decedent, dated November 13,
and codlcil(s) dated N / A
r3.E'tl:ie:merE:
named
,19--2L-
(Slate relevant circumstances, e.g. renuncialion, death of exeCUlor, elc.)
Decedent w.~ domlcilcd at dcath in "'"mi;>orl ~'lQ County, Pennsylvania, with
h il r last family or principal residence at
Rnl N U~nn\TP~ q~rpo~ r~rli~lp. Ppnn~ylv~ni~ 17n11
(Carl isle. Borough) i1iststrcet. number. Twp. or Born.1
Decedent. then HR )'earsofage,died November 1], ,1993
at en1 N J.f~nnHQr c::...,....PQ!- r~rl;Ql(:J. Pll 17n11 .
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: N/ A
Decedent at death owned propcrty with e~timated values as follows:
(If domiciled In Pa.) All personal property $ 60 . 000 . 00
(If not domiciled In Pa.j Personal property In Pennsylvania $
(If not domiciled in Pa.) Personal property In County $
Value of real estate In Pennsylvania $
situated as follows:
WHEREFORE, petltloner(s) respectfully
presemed herewith and the gram of letters
theron.
request{s) the probate of the last will and cOdicil{s)
TOEt3FRQRtary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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Ilieelete'.IA, P.'. 17957
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF CUMBERLAND
The petitioner{s) above.~amed swear{s) or affjrm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner{s) and that as personal represen-
tative{s) of the above decedenl petitioner(s) will well tr Iy a, mlnl~ according to law.
Sworn . V~..e I'l
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MAR
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OF .
MARY H. PARTHEMORE
I, Mary H. Parthemore, of the Borough of Carlisle,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound mind, memory and understanding, do hereby publish and
declare this to be my Last Will and Testament, hereby revoking
and declaring null and void any and all Wills and Codicils
heretofore written by me.
ITEM I. I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be convenient to
the proper administration of my estate.
ITEM II. I give, devise and bequeath unto my son, John A.
Parthemore, Jr., my household goods, automobile, Clothing,
jewelry and similar items of tangible personal property.
ITEM III. I direct that all inheritance and estate taxes be
paid on all the rest, residue and remainder of my estate from the
residue of my estate prior to further distribution.
ITEM IV. I give, devise and bequeath 50% of the rest,
residue and remainder of my estate to Church of God Homer Inc.,
located in Carlisle, Pennsylvania. This is an unrestricted gift
and the funds may be used in whatever manner the corporate
officials feel appropriate.
ITEM V.
I then giver devise and bequeath the remaining 50%
of the rest, residue and remainder of my estate unto Dauphin
Deposit Trust Company, Trustee under an Agreement of Trust
dated JUly 31, 1974. Dauphin Deposit Trust Company shall not be
required to post bond for their services as Trustee.
RE1i.J500 EXt {I!.Ql1
20. If line 17 i. greater thon line 18, enter the difference on line 20, Thi. i. the TAX DUE.
A. Enter the infer". on the balance due on lin. 20A.
B, Enle' .he 10101 of Hne 20 and 20A on line 20B. Thi. i. Ihe BALANCE DUE.
Mako Chock Payablo fa, Rogl.!o, 01 Will., Agont
.. BE SURE TO' ANSWER AU QUESTIONS ON REVERS! SIDE AND TO RECHECK MATH.. "')
Under penohie. of pet jury. I declare thot I hove examined (hi, return, indudin9 accompanying uhldul., and 'taltmenf., and to the b..t of my Ilnawf.dgt and be!c.f,
tt I, Ir ., carred and compl.,.. I declore that ail reol eltole has been r.portelf at f,ve morht 'Value, O.darolion ot preparer other ,han IhI ~AOnol r9prt..ntatllLte I.
bo. ft 0 Informalion of pr po,..r ha. any ~~owl.dg..
I .. R R R N f - UR AOOREW- ' ~.~ :-;
J -.4. ~a 235 ~I. Iligh Street. ~iddletovn. PA 17057 ~" /idy,/
ADDRESS .
'jl~8 S. Baltimore St.. Dillsburg. PA 17o~9 2jhy/.t/~Q'
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COMMONWEALTll OF PENNSYlVANIA
DEPARTMENT Of REVENUE
DEPT. 280601
HARRIS8URG, PA 171?8.0601
M ,AN MI
PARTIlEMORE,
FOR OATIS 0' DIATH AfTlR 12/31191 CHICK HIRI
" A SPOUSAL
POVIRn CRIDIT IS CLAIMID 0 .
fill HUM!!R
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
21
COUNTY CODE
94
YEAR
0112
NUMBE~ .
IliA
MARY Il.
801 N. Ilanover Street
Carlisle. PA 17013
o IAL CURtT NUMBER
DA E OF DEA~ DATE Of BIRTH
201-16-6715
11/11/93
07/23/190
ounl
rn 1. Original Return
o 2, Supplemenlal Relurn
o 3. Remainder Return
(fa, dale. 01 dealh prior 10 12.13.B2)
o 5. Fede,al E.lale Tax .
Return Required
_8. Tolal Numbor of Safe Deposit Box..
o 4. limited Estale 0 40, Future Inlerest Compromfse
(far dale. of dealh oker 12.12.82)
Ga 6. Decedent Died Testate 0 7. Decedent Maintained a living Trust
(Altach copy of Willi (Allach copy of TrUll)
Att COIlRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAM . C M lETE MArLING ADDRESS
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,.;.,
.' ';,~':f~,;,-;:;i;t-!')'~~'~:':Yi~~~4,1~~
Jane M. Alexander
TElEPHONE NUMBER
Es u ire
( 717 I
432-4514
148 South Baltimore
P O. Box 421
Dillsbur.g. peP701~_.
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Street
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I. Real E.lale (Schedule AI ( 1) 0.00
0.00
2. Slack. and Bond. (Schedule B) ( 21
3, Cla.ely Held Slock/Portne"hip 'nle,ell (Schedule CJ (31 0 . 00
4. Mortgoge. ond Nale. Receivable (Schedule D) ( 41 0 . 00
5, Co.h, Bank Oepo.il. & MilCeUoneaUl Pe.,onal Praperty( 5) ---fin., ~ q R 77
(Schedule EI
6. Joinlly Owned P,operty (Schedule FI ( 6) 0 . 00
7. Tron.fe" (Schedule G) (Schedule II (7) 391 . 769 . 22
8. Total GrC?u ASlals (total lines 1.7)
9. Funeral Expenses, Administrative COSh, Miscellaneous ( 91
Expen.e. (Schedule H)
10. Debl., Mortgage liabililie., lieOl(Schedule I) (10)
11, T 0101 Deduction. (10101 line. ,,& 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmenlal Boque'b (Schedulfll J)
14. Net Value Subject to Tax (line 12 minu~ line 13)
15. Amount of line 1.4 taxable at 6% role
(Include valu.. f,am Schedule K a, Schedule M.I
16. Amount of line 14 taxable at 15% rate
(Include valuel from Schedule K or Schedule M,I
17. Principal tax due (Add tax from line '5 and from line 16.1
18. Credill Spouiol Poverty Credil Prior Paymcnh DilCount
+ ..21-.-3.25- + ,-1. ,,125_. -
19. If line 18 il greater than line 17. enler the difference on line 19. Thi. j. ihe OVERPAYMENT.
aO.":T:!'J~"".'.I_'.i'I'."I'.I"'lII<lill'I!.'.IQrtr:'I':lr.'I-I"rl_'1Ll~I'I''''.lII'h'''I.
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(121 440 H7 98
(13) _23 533.a..~
(IA) 416-.-6./1] 99
(151 --..1.li.LQ.!Lh.2L.._>< ,06.. 25 . 001. 04
(161
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(17) .~.hQQl.04
Interest
(1 B)
(19)
(201 _
(20A) _
(20B)
2.501.04
0.00
2.5l1LJ)4
IIV.lJIO U. VoUI
COMMONWIALIH O' PENNSYlVANIA
IHHI!IITAHCf tAlIUURH
.UIDEN'DECIDEN,
SCHEDULE "G"
TRANSFERS
UTATI 0'
fiLl NUMIER
MARY H. PARTHEMORE
THII SCHEDULE MUst IE COM'LETED AND fiLED If THE AIISWER TO ANY Of THE QUmlONI ON THE IMI5I SIDE Of THI COVER SHIET II YU.
IteM . TOTAL VAlUE DECO, DOLlAR VALUE
DUCRIPTION Of PROPERTY EXCLUSION ,! OP DECEDENT'S
NUMIER 0' ASSET INTERIIt
PRINCIPAL
Cash $ 86.45
Navigator Fund 1,300.00
Accrued interest . 1. 51
$5,000 Dauphin Deposit Bank and Trust
3.8% Certificate of Deposit, due
11/30/94 . 5,000.00
Accrued interest 6.25
$10,000 Harris Savings Certificate of
Deposit, due 1/8/94 10,000.00
Accrued interest 10.41
$1,000 Agway Inc. Sub. Deb 7.5% due
7/1/2003 1,000.00
Accrued interest 27.33
89 shares Mellon Bank Corp., Pfd.,
Series B, Conv. 6.75% 2,408.56
Accrued interest 37.55
4,158 shares Dauphin Deposit Corp. 104,989.50
207 shares Harsco Corp. 8,564.63
Accrued dividend 72.45
196 shares Delaware Group Fund 3,682.84
10,213 units Fixed Income Collective
Investment Fund 112,040.63
Accrued income 606.53
12,267 units Municipal Bond Fund 141,288.55
Ac.crued income 619.36
.
INCOME
Cash 84.68
Navigator Fund 200.00
Less: Trustee's fee -258.01
TOTAllAl.. ..... ..I.. 7. It< 1391 769.22
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SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
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COMMONWEAltH OF PENNSYlVANIA
INHERITANCE TA.X RETURN
RESIDENT DECEDENT
ATE OF
MARY
. ITEM
NUMBER
A.
F E
Pllall Print or T I
UMBER
2194-0112
H. PARTHEMORE
DESCRIPTION
1.
Funaral Explnlll'
Gilbert W. Parthemore Funeral Home, Inc. -
Gingrich Memorials - engraving
B.
Admlnlltratlve COIlII
John A. Parthemore, Jr.
1.
Penonol Representative Comml..lon.
Social Security Number 01 Personal Repr.sentative,
Vear Comml..lon. paid 1994
2.
Attorney Fee.
Jane M. Alexander, Esquire
3,
Family Exemption
Claimant
None Claimed
Relation.hip
Add".. 01 Claimant at decedent'. death
Street Add".. _.
City __
Stat.
Zip Code
Probate Fe.. Register of ~lil.ls - petition for Probate $ 11
Short Certificates $ 6 Extra Pages $ 3 JCP Fee $
MllcllIanloul Explnlll'
Cumberland [,aw Journal - advertis ing Executor's Notic
The Sentinel - advertising Executor's Notice
Register of Wills - filing Inventory and Inheritance
Tax Return
Register of Wills - Filing Estate Release
Leslie K. Neidig - notary fees on Estate Release
and Inventory
TOTAL 1"1'0 enter on line 9. Recapitulation)
(If mOrllpaCI II nlldld, lnllrt addltlonallhlltl of saml 1111.)
AMOUNT
7,672.34
60.00
None claimed
3,000.00
129.00
40.00
62.12
25.00
10.00
10.00
S 11.008.46
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Inventory of the real and personal estate of
MARY H. PARTHEMORE
deceased
1. Dauphin Deposit Bank and Trust Company Checking Account
#0067407757
2. Dauphin Deposit Bank and Trust Company Certificate of Deposit
. #.8000409054
3. Church of God Home Resident's Fund - closing of PCA account
4. Church of God Home, Inc. - refund of fee
5. Church of God Le Tort Manor - refund for housing
6. Refund from York Newspaper Company subscription
7. Capital Blue Cross refund
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TOTAL
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,
1,006 78
5,006 25
2 09
1 82 75
52,41 36
17 32
305 22
60,59 .77
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~IIIlltANRx YORK
}
II:
John A. ParthellJ.~. Jr.
being duly ,"wnrn eccording to lew, dopo.e. end ,ey' thet he ; s t-ho
Executor of the Estate of Mary H. Parthemore
lote of --1!QJ;.9.Y..9-IL9L_CilX.l.i.S.lJL.____ , Cumberland County, Pa., decea.ed and thet the
within i. an inventory mede by .1nl,n. p~ rt-h",'1lOJ:e ,-,1r , the .aid Rypr-111-nr
of the entire e.tate of seid dacedent, con.istlng of all the pe..onal pro".rty and real estate, e.eept rea' estete ouhlde
the Commonwealth of Penn.ylvania, and that the figures oppo.ite eaeh item of the Inventory represont It's 'ltlr vlt'ue
as of the date of decedent's death.
SWORN and subscribed before me,
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235 West High Street
Middletown, PA 17057
Add....
Dltte of Deeth
11
Month
93
v...,
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal rep:esentotlve.
2. A supplement inventory must be filed within thirty dey. of di.covery of Itdditiona'ltllah.
3. Additional sheets may be altached as to personalty or realty
4. See Article IV, Fiduciaries Act of /949.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF e"'IlII-'~NI:k YORK
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Jo.htLA.......fAr..t.beroore.,...J.t:..... ............ ._...........
being duly ..---S.WOUl..........._ .ccordlng to I.w, deposes .nd s.ys that h..
is Exec!,!.t.Cl..r_.._.. .._............... ..... 01 the Estete 01 .._r-1~.!Y. H. Pilrthemore
I.t. 01 _ll.o..t:ough. of. Carl isle .' ___......___, Cumberl.nd County, P.., d.c....d .nd th.t tho
wlihin II .~~ri?rn~~r~1,\l.~g~y .._ ...... him_....... ....._ _ _..__, the I.id E')(~C'''t",.
of tho entire..tato of s.id decode nt, consisting 01 .11 the porson.1 proporty .nd r..1 ost.to, ..copt reel ..t.to ouhldo
tho Commonwo.lth of P.nnlylv.ni., .nd th.t the figuros opposito e.ch itom of tho Inv.ntory ropro..nt It's f.lr v.lul
.. of tho d.to of docodent's de.th ,
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Middletown, PA 17057
Add,,"
O.to of Oeeth .__~l___....__.._._........._.._......!.l..._........___ 93
Day Month Vu,
INSTRUCTIONS
I. An inventory must be filed within three months after .ppointment of person. I represent.tivo.
2. A supplement inventory must bo filed within thirty d.ys 01 discovery of .ddition.1 ....h.
3. Addition.l,h..h m.y b. .tt.ched as to p.rson.lty or re.lty
4. Soo ArtlclolV, Fiduci.ries Act of 1949,
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REV-1547 EX AFP UO~93*
CCltlDM!:ALTH OF PENNSYLVANIA
IlEPARTlEHI 1IF Rf'IEMJf:
IURUU 1IF INDIVIIIUOL IAlCES
OEPT. IID'Dl
HARRIlIURG, PA 17121-06Dl
jot'
NOTICE OF INNERITANCE TAX
APPRAISENENT, ALLOWANCE OR OISALLOWANCE
OF OEDUCTIONS, ANa ASSESSNENT OF TAR
ACN
DATE 10-03-94
101
C/
FILE NO.
DAT! OF DEATH 11-13-92 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAR
PAVNENT TO THE REGISTER OF WILLS. NAKE CHECR PAVABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
JANE M ALEXANDER ESQ
148 S BALTIMORE ST
PO BOX 421
DILLSBURG PA 17019
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ADOUnt Rooittod
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
. REWiS47"EX--Aj:ji-nci:93T"iloTicE'-oF-i:NHEiiii'AiicE-TAx-APPiiA-iiiEifEilT~'-Ai.i-oiiAiicE-oli-----"----------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF PARTHEMORE MARY H FILE NO. 21 94-0112 ACN 101 DATE 10-03-94
TAR RETURN WAS. t X I ACCEPTED AS FILED
I I CHANGED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL AND 1 SUPPLEMENTAL
1. Rool Eltoto lSc:hodulo Al III
2. Stock I ond Boncll tSchodulo BI 121
S. Clalol>> Held Stock/Portnorohip IntorOlt ISohlldulo Cl tSl
4. HartgogollNat.1 Roeoivobl. tSchoclulo DI 141
5. Calh/Bonk Dopaoitl/Nilo. Porlanol Praport>> ISchodulo EI 151
6. Jaintl>> _ Pr_rl>> ISchedulo Fl t61
7. Tronlfo.. ISchodul. Gl 17l
I. Total A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expen.../Ad.lnt,trat!vl COlt"
"1Ic.l1~. Ex,en.., (Schedule H)
10. DobtllHartgogo Lloblllti.I/Lionl ISchodulo II
11. Tatol Deduction.
12. Het Vllue of To. Roturn
15. Choritoblo/DavoNWMtol ~otl ISchedul. Jl
14. Not Volue of Elloto SUbjoet to TIK
NOTE:
If .n ........nt w.. issu.d pr.viau.ly, lin..
refl.ct figur.. th.t includ. the tatal af ALL
ASSESSMENT OF TAX: -
15. _t .f Uno 14 tIKoblo ot 6~ ..to U51
16. _t of Uno 14 tIKoblo ot 15~ rot. t16 I
17. Principal To. Duo
TAX CREDITS:
PAYHENT
DATE
RECEIPT
_ER
DISCOUNT Col
INTEREST I-I
02-10-94
05-25-94
06-22-94
855896
886112
886205
871.78-
91. SO-
lI. 68-
INTEREST IS CHARGED FROM 06-23-94 TO 10-18-94
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM..
o IF PAlO un. DATE INDICATED. SEE REVEIlSE
fOR CALCULATION Of ADDITIDIW. INTEREST.
(l~J
,00
,00
. DO ':;~
.00
63.443.77
.00
391.769.22
-- 181
455.212.99
11,033.46
1.141. 55
1111
1121
1151
1141
14, 15 and/ar 16 and 17 will
r.turns ass.s.ed ta dete.
191
nOI
418.093.99 X.06 .
.00 R.15 .
U7l
ANOlJNT PAID
21,375.00
2.501.04
84.60
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
12,175.01
443.037.98
24.943.99
418,093.99
25.085.64
.00
25.085.64
22,985.68
2.099.96
47.58
2,147.54
I IF faTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED.
IF faTAL DUE IS REFLECTED AS A "CREDIT" ICRI. VDU HAV BE DUE
A REFlIGl. SEE REVEIlSE SIDE OF THIS FOIll FDR INSTRUCTIONS. I
j /Lf- rlf -'I fOR DATES OF DEATH AmR 12/31/91 CHECK HIRE
INHERITANCE TAX RETURN ~o~W~ug:~DIT IS CLAIMED 0
RESIDENT DECEDENT FILl NUMBER
(TO BE FILED IN DUPLICATE
_._. _ I,V'!~ REGISTER OF WILLS) COUNTlc~DE 9~EAR 0112 NUM8ER
MI DENT" COMPLETf A.ODRU5
REV.l~l)Ofh (1'.911
~':!IV
11' \:,~., 'r\
. .{"/I'
COMMONWfAlltl or I'tt11~SYlVM~IA
DtPAIITMWl Of R[VfNUr
DtPT. ~lln601
ttUIlIUUIlG. PA 111~8.0t1!.
15
~
PAR'rIlEMORE,
MUR
201-16-6715
fMRY
II.
r-'T~I
.11~11/93 107/23/1905
6iJ 2. Svpplemenlol Rolvrn
801 N. Hanover Street
Carlisle, PA 17013
Co,", Cumberland
l!!
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-:00:
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o I. Original Rolvrn
o 3. Remolnder Relvrn
(lor dole. of deolh prior 10 12.13.B2}
o 5, federal EIlole To,
Return Required
_ B, TOlol Nvmbe, 01 Sole OepoIl180...
o A, limited e,lalo
o .40. Future Inler.I' Compromise
(for dale. 01 deolh oftor 12.12.821
o 6. Decedont Died TOllate rJ 7, Decedent Maintained 0 living TruI'
(Alfoch copy 01 Willi (Alloch copy 01 T..IlI
ALL CORRESPONDENCE AND- CONFiDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
N M Jane M. Alexand:::-"'~S~'Ui:qC6~~E~~~:OtA~D'~:ltimore
I II N M' '_ P. O. Box 421
Dillsburg, PA 17019
717-1- 432-4514 ()()
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Street
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( 8) 2 845 . 00
1. Real E.lole (Schodvle A) ( 11
2. Slock. and Bond. ISchedvlo B) ( 21
3, Clo.ely Held Slock/Porlno"hip Inloro" (Schedvle CI (3)
4, Mortgage. and Noto, Roceivoble (Schodvlo 01 ( 4)
5. Ca5h~ Bank Deposih & Mi5cellaneous Personal Properly( 5)
(Scnedvle EI
6. Jolnlly Owned Proporty ISchedvlo fl
7, Tronde" (Schedvlo GllScnedvle LI
8. Total Gran Anels (IQlallines '.71
9. funeral Expenses, Administrollve Cosh, Miscellaneous I 9)
EKpe"o. ISchedvle HI
10, DeblS, Mortgage lIobllllle., lie" ISchodvle I)
I', TOlol oeduclions (IOIOI fin.. 9 & 10)
12. Net Value of Estaht (line 8 minus line III
13. Charitable and Governmenlal BequtlSh ISchedule Jl
14. Ner Value Subjoa 10 Tax (line 12 minus line 131
15. Amount of line 14 taxable 01 6% rolo
(Include values from Schedule K or Schedule M,l
16. Amount of line 104 loxable at 15% rol"
IInclude values from Schedule K or Schedule M.)
17. Principal lax due (Add lox from line 15 and from line 16,1
18. Credill Spou~ol Poverty Credil Prior Paymen!s DilCount Inlerost
- + -...-.-- + ---
19. If line 18 is grealer than line 17, enter Ihe djfference on line 19, This is the OVERPAYMENT.
aD
20. If line 17 il greal.r thon line 1 S, enler Ihe difference on line 20. This il the TAX DUE.
A. Enl'r the interell on the bolonce dve on Iln. 20A.
8, Enfer Ih. 10101 of lin. 20 and 20A on line 20B. This i'lhe BALANCE DUE,
Moh..~_~~!.k P~yo~~~~~~t_.f..!.! WlIII0gent
. . BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH....
Und.r p.nolli., of pClljvry, I d.~t"~7;. Iholltl;;.-;;;;i-;';.~r,i';;~.~cl;~, inctvding accomponying uhodu!el ond Ilol.menll, and 10 the bill of my knowltdg. and b.li.f.
Illllfve, ( fflel Q"d complett. I Ihot 011 "0111"01 hOI bun repOrllJd otlrue morhl \'olve. Declaration of preporer alher Ihon th, ".rsanolr.prellntat;...t il
bo..d on 01 inf "'Oliff' f W " an)' lo.no..... . de..,'. ,
I NA U N" ~Nil I -., -.iDOf(Sr ~ DAU ~ / t///
. 'Pa emo ,Ji -. 235 \~. High Street, Uiddletown, PA 17057 ((j/'t.T
-~H' ~~;~(~ S. Baltimore St., Dillsburg, PA ~~~19 ~~~/f~
0.00
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0.00
n nn
2,845.00
z
o
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0.00
o 00
( 61
I 71
25.00
0.00
25.00
(10)
(111
(121
(13)
(141
(15) --.--.-l-,4-l{h-oe-.--x ,06"
0.00
2,820.00
1.410.00
1..410.00
84.60
0.00
(16)
~ .15"
z
o
~
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...
:E
o
v
)(
0(
...
84.60
0.00
(17)
(18)
(191
0.00
Check hure if you ore requesting 0 refund of YOlJf overpayment.
84.60
0.00
84.60
(20)
120AI
(208)
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COMMONWfAlTH Of PENN~nV"'Nl.
INHfNl'A.NCE 'AIC ItffUIIN
IIfSIO[~'~f.E!~__._.,__
ESTATE OF
MARY H. PARTIlEMORE
ITEM
NUMBER
A. Fun.ral Exp.n.."
1.
IltY,IS"'.. ;1,811
B.
4,
C.
1.
2.
3,
4,
5.,
6,
7,
8,
SCHEDULE H 1
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS. EXPENSES PI.a.. Print or Typ.
L' LE NUMBER
21-94-0112
DESCRIPTION
AMOUNT
1.
Admlnl.tratlv. Ca.h,
Porsonal Ropro..nlatlvo Commlllion.
Social Security Numbor of Porsonol Ropr..ontatlvo:
Yoar Commi"ion, paid
2,
Attornoy Fo..
3,
Family Exomption
Claimant
Addro" of Claimant at docodont', dooth
Stroot Addro"
City
Zip Codo
Rolotlon.~ip
Stolo
Proboto Fo..
MI.c.llan.ou. Exp.n...,
Register of Wills - filing supplemental Inheritance
Tax Return and Inventory
25.90
TOTA~ (AI.o ....r on IIn. 9, Rocapltulotlon)
(If mar. .poc. " n..d.d, In..rt addlllonal .huts of .am. ,....,
$
2500
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Mary H. Parthemore
Date of Death: November 11, 1993
will No. 21-1994-0112
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
. d. Copies of receipts, releasesr 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.
Date: 12/19/96
co e!(
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a:
Jane M. Alecander
N me (Please type or print)
148 S. Baltimore Street
Address Dillsburq, PA 17019
(717 I 432-4~14
Tel. No.
Capacity:
Personal Representative
X Counsel for personal
representative
(HAH I rmf/ AM3 )
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(
)1ELEASE
Jr., The Church of God Home, Inc., Carlisle, Pennsylvania and
KNOW ALL MEN BY THESE PRESENTS, that John A. Parthemore,
Dauphin Deposit and Trust Company, Trustee, being all the
beneficiaries named in the Last Will and Testament dated November
13, 1992 of Mary H. Parthemore, who died November 11, 1993, do
hereby aCknowledge that we have had and received of and from John
A. Parthemore, Jr., Executor, of the Estate of the said Mary H.
Parthemore, deceased, our full and respective distributive share
as set forth in the First and Final Account as provided to us.
WHEREFORE, we do, by these presents, remise, release,
quit-claim and forever discharge the said John A. Parthemore,
Jr., Executor, of the duties of the trust imposed and from all
,.
demands whatsoever for or by reason thereof.
actions, suits, payments, accounts, reCkonings, claims and
IN WITNESS ~ have hereunto set
this ~y of ~ ~Afu../ 1996.
WITNESS:
my hand and seal.
~A/A~ / /b'T
~O..'~ r; ~ .i?~
r~d I~'O
J n A. part~~more ,00' '~
. J.,')
Church of God Home r Inc .);ii(:
~~~~
I ~JU(n Xc} IOJ/cur--
I . .a' -/;// /.
I ;;X-~'1'(~::t(//~/ !
I ' "..... ... I -.........
I
Dauphin Deposit Bank and Trust
Company, Trustee by:
du.{ 1)}a.~.A>y
Sue Mauery
COMMONWEALTH OF PENNSYLVANIA
.
.
COUNTY OF
('1'17
On this, the I 9 .H day of rdJt ua!:!i. , l:9'9'O, before
me, the undersigned officer, a Notary PubliC, personally appeared'
John A. Parthemore, Jr. known to me (or satisfactorily proven) to
be the person whose name is subscribed to the within instrument
and acknowledged that he executed the same for the purpose
therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial
seal.
: SSe
Notarial Seal
Danlse L, On, Notary PubIlo
WOOdbury Bol'O, BedrOrd Coun!v
My Commission ExpIres Aug, 24, (_
Marmer, ~Associiiiii~
COMMONWEALTH OF PENNSYLVANIA
~I1IA 1" tJft
Notary PUblic
:
COUNTY OF , ~ :
On this, the /'1 -'V day of ~C)O.o' J/'JVL./ ,1996, before
me, the undersigne~icer, a Notary Public, personally appeared
Dauphin Deposit Bank and Trust Company, Trustee by Sue Mauery
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument and acknowledged that
she executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial
,..1. ...,... Ji Ji .c/
Grace A, Gordon, Notary Public
Harrisburg, Dauphin Coon
My Commlsslori Expires Sept. 2~ 2000 fUL.t (J . ()/, IlVl
Member,Pennsylvan~AssocIatlonolNOlJrles Notary Public .
: SSe
COMMONWEALTH OF PENNSYLVANIA
.
.
, COUNTY OF
I On this, the'~ 'day of. i) e=~"b.",e.. , 1996, before
me, the undersigne~icer, a Notary Public, personally appeared
The Church of God Home, Inc. by
known to me (or satiSfactorily proven) to be the person whose
name is subscribed to the within instrument and acknowledged that
he executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial
seal. ~
'--;:;-L 1/. 1t:/ti.
Notary Public
: SSe
NOTARIAL SEAL
THOllAS A HAlllLTON, NOTARY PUBLIC
CARUSLE BORO. CUr.!8ERl.lIIO C(\UNTY PA
, MY COMMISSION ExPIRES JULY 7. 1997