Loading...
HomeMy WebLinkAbout94-00153 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Deceased. Social Security No. \ C/{, ' \0 - o,'il5! c; No. ~/.9J/;- IS?> To: Register of Wills for the County of CUi"\SI;RLflND in the Commonwealth of Pennsylvania Estate of ?RUL E:. 1>rRR. also known as The petition of the undersigned respeetfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl ~ for letters of administration on the estale of (d.b.n.j pendente lite; durante absentia; durante minoril3lc) the above decedent. 'Decendent was domiciled at death in CUt'\~bRlRN']) Coumy, Pennsylvania, with It is last family or principal residence at \0'\ NeVI:t'\BI'I:: -PP,iV':) CAI'C\~ HilL \l~\\. (list street, number and municipality) Deeende~ttthen 1(. years of age, died FI$RuFIRY 'i- ,19 9"1- at lo'! ~t>\)r/f\~~ 1>Ri ~I:. \ Cfl('(\P 1-\:, \ Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: Neill'" $ g \ CDe $ $ $ Petitioner_ after a proper search h"---'- ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: . Name Relationship Residenee w C Iti I-IIL.L YR. \lOll . RIVE) fI1EC~l'I)liCS\WRG . "or;s {Y'l1tIlA!;"L 1;:. 1:lERR THoN\R~ E. 1>rnR.. 11 . c. t-l i..c THEREFORE, petitioner(s) respectfully request(s) the gram of letters of administration in the appropriate form to the undersigned. I "'- '~i " 1l.g ..- ~~ l>'_ so ! iii ~~. tuJu'l ~L t.~-AM- RENUNCIATION OF RIGHT OF ADMINISTER Before the Register of Wills of Cumberland County. In the matter of the Estate of: Derr, Paul E., Deceased : To the Honorable Mary C. Lewis, Register of Wills of CUmberland County: The undersigned, .I'!~ , and, as such, entitled under Sect10n obate, Estates and Fiduciaries Code, to administer the estate of Derr, Paul E., who died on February 4, 1994, intestate, having his last family or principal residence at Camp Hill Borough, in the County of Cumberland, State of Pennsylvania, hereby renounce my riqht to administer the estate of said decedent. Witness my hand, this J./ ~" day of February, A.D. 1994. Signed in the presence of: t~ J)"F ..~1 ('~ ^ '/).",t9-i. t4 ,J\.LO--'~ tJ--W\ w~ c , c RENUNCIATION OF RIGHT OF ADMINISTER Bafore the Register of Wills of Cumberland County. In the matter of the Estate of: Derr, Paul E., Deceased To the Honorable Mary C. Lewis, Register of Wills of Cumberland county: The undersiqned, ..J. ~)0...utJ\-.IYL.t..a.<...Q , and, as such, entitled under Section 3155(b) of the Probate, Estates and Fiduciaries Code, to administer the estate of Derr, Paul E., who died on February 4, 1994, intestate, having his last family or . principal residence at Camp Hill Borough, in the County of Cumberland, state of Pennsylvania, hereby renounce my riqht to administer the estate of said decedent. . -1J,... Witness my hand, this.~l day of February, A.D. 1994. Siqned in the presenca of: ,j. )f 0 Q _ 'k)...vtJL (")(") :u c: G ~ :u ? (',~ ," -. ~ I \Q , - ~ c. r, , .". ~ " ,..,,,,;,,,,, >,.'.,... .. , 'COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUM.ERLAND } II: Micha..l E. nerr b.lng duly sworn .ccordlng to I.w, doposos .nd s.ys that h. is the co;"administrator of tho Estato of Paul E. Derr ItI. of _91!!!\lLl:!.L1.t----.... ..--------.... , Cumborl.nd County, P.., d.ceu.d .nd that the within Is .n Inventory mode by " hiin ., tho sold co-administrato of the .ntlre uhte of seid decedont. consisting of .11 tho ponon.1 prop.rty .nd ruluhto, .xcept rOil est.te ouhlde tho Commonwe.lth of Pennsylv.ni., .nd th.t tho figures opposito uch itom of the Inventory represont It's f.i. v.luo u of the d.te of decedent'. dOlth. .nd subscribod before me, ~-VV\, Michael E.E~~~t.~d~~~~~istrator 6 Ridd,.. Rnan Camp Hill, PA 17011 19 Addreu Otlo of Duth 04 02 Month V..r 1994 D.y INSTRUCTIONS I. An Inventory must be filed within throo months .fter .ppointment of porson.1 repre..ntotive. 2. A supplemont invontory must be filod within thirty doys of discovery of odditionol ....h. 3. Addition.1 sheeh moy be .tt..hed II to person.lty or re.lty 4. See Article IV, Fiduci.ries Act of 1949. )- .,; . ... w ~ ~ '" l- e W < . ... ... u e 0 III . .. CII .. ~ W '" W ... Q . ... e J: ... ... .; ... i.t :: ... ... u. e>:. ... 0 ... < 0 ... ... CII= u. l>: :l: W 0 < w i- r > z '" 9 p c Z 0 Q E ~ I - III Z ", II 0 '" < j UI ... z 1 w ... ... c ::> - ~ ~ J 0 ~ ~ . JJ ... ... . E ~ : -; ~ " ... U it: . " 'i ..... ... .....1IancII VIIuI ..... NIl. DIM .... I_ III.lla GalII4tl_ 01. .... B_ IaOD . L iIII .. ....1_ III.lla GDInII~ n. ....1_ 11I.00 Gall.... 0111II .... I_ III.lla ~1_1. - ....1_ III.lla CDlIllllllllB .. ....1_ III.lla qa(- -411 - ....1_ 11I.OII """""VII. n.. .... . Bond 11I.00 aat1401l114l! OIno .... I_ 11I.00 aatmlllD4& cano .... 1 Bond as. nM. !I._ " lIII7lI .... 1 Bond as.oo 02Ill7I804a2II lIII7lI .... 1 Bond I2S.DG ..)0. I IlIe lltnD .... e Bond III.lla a2IS4CIlIlIE OInt ....1_ III.lla aII34OI14Gl11 llSI11 . .... e Bond III.lla 02IlSItIInDI! tBI11 .... 1 Bond 11I.OII aBI7844IIIE .,,1 .... 1 Bond IZI.Da ........, IlInt , ....1_ III.Da 4.'1~ llI/'l ....I!- III.IllI aza......... lIIIIZ ....1_ III.IllI CBI1411l44Cl! lMI7Z ....e_ III.110 ....41.. 11Im .... 1 Bond 1II.lla. GIlIMImlllllll lIIIIZ .... I_ I2I.DD QlCMttll_-.z 11m ....I!- III.IllI CBlllal121! lIIIIZ ....I! Bond 1II.IllI'~1_ CNI13 ....1_ III.IllI ~11114l! CII/73 ....1_ III.IllI CII1.... CII/73 ....1_ III.IllI QlI_IIl.- 1I/J3 ....I!- III.IllI Ql14II11111. OIn4 ....I!- III.IllI CII114144l11llB lII/14 " .' ....I! _ III.IllIQlI_ lIII14 ....11- III.IllI CIIIllh_ lIII14 .... I_ IBJD .. II 11114 ....11- .. GIIU...Ul88IiIi 0l/7II ....1I11anc1 1II.IllI- ClIImI ....11IancI III.IllI aarr...... CIIIIlI ....I!- III.IllI QIQa7_ lIIm ....I!- ... ""11fn_ lams ....11- 1II.IllI___I. IlItJ1I ....I!- ....~ CIII7lI ....11- III.IllI QallJIMI7l! CIIIIlI ....1_ III.IllI CII1l111lBr1! lIIm ....1!1IancI III.IllI aIllIlllllllllll 11111I ....11_ III.IllI all__ lIlI1l' 411III1 _ IIS.lIII all....../! 11Im .... I_ III.IllI aIlnnllll7l! tIII11 .... 1 IJanlI III.IllI all'-1e tIII11 .... e Bond III.IllI QIII ,11II. lam ....11- as.oo I'IM . II 01111 ....I!- .... . rr,tWIIli CIII7lI .....11- -.ao -,_ CIIIIlI .....I!- III.IllI QIt, ... tIII1I .....I!- as.oo ~ t. lams .....11- IaOQ .(81J ~ IInI .....I!- as.oo ~. lIII1I ....11- III.IllI CllllMrm_ lIII1I ....I! IIancI as.oo ': ..,. tIII7I .... e_ III.IllI caIOIlIIIn! lams .... e_ ea.oo aar48me IJIlI .... Ell_ IlID.DlI uml_ - .... Ell IIancI IlID.DlI Ll814111l1E1l - .... B!_ IIO.OlI UmllnEll - .... Ell 1IancI. IlID.DlI .- III OWl .... Ell IIoncl IIO.OlI I ..... 11I/11I ....EIl_ IIO.OlI Llllllll4llll!l! 1_ TOTAL h,llClO.DO r '~V.1500 ox. t2.871 , 19. If I;no 181. g,oall' than I;no 17. onlo, Iho d;ffo,onco on nno 19. Thl, i. tho OVERPAYMENT. aD 20. Illino 17 I. g,oato, Ihan nno 18. onlo, tho d;ffo,onco on nno 20. Thi.l. tho TAX DUE. A. Ent.r the in..relt on thl balanc. due on lint 20A.. B. Enlo' Iho latal 01 lIno 20 ond 20A on IIno 20B. Th;. i. tho BALANCE DUE. Make Chock Payablo 101 Rogl.t., 01 Will.. Agont ::~ .;. ..t> . .,~. ." ...... SUIlTO ANSWEI AU QUESTIONS ON 1lIVIIII;S'DI:AHDTQ:JIlIQIICX.MAnI......:...~,,,.\l:I!\lI,'~$.,,,. . . Und.r plnclll.. of P.rfUryl , dldor. that t have .aamin,d Ihi. r.tu,n. induding accompanying ;ch.dul.. and Ile'.m.nt., and to the b... of "'y k~. oftd be1ief. III. trut, (arred and compl.,.. t declar. that all reol ..tot. hen bit" '.port.d 01 true mark.t vol".. D.claration of pr.potef' othtr then the penOftol repreuntollll. Is bal.d on alllnfonno'ion of which pr.par., hot ony kftOwl.dg.. IIGNArUl1 0' '(liON RUPONll1U fOl flUNG IErUIN "DDlfU . 6 Riddle Road, Camp Hill, PA 17011-6021 v "DDIUS 355 North 21st Street, Camp Hill, PA 17011 z o 1= ~ :) .. :IE o u )( ~ ~Ab I fill NUMB.R INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ~ fil III .. COMMONWEALTH o. peNNSYLVANIA DE'ARTMENT Of REVENUE POST OffiCE lOX 8321 HAUISIURO, PA 11105.1327 M A.. tNI All DERR, PAUL E. A I M DA cou~lv CODE N' M 109 November Drive, Apartment Camp Hill, PA 17011 94 YEAR 0153 NUMBER ,AN MI A f 0 A H 196-10-9885 2/4/1994 11/8/1917 o 2. Supplomenlal Rolurn Cumberland CO"'"1 ~ :.:-'" u"'" ....u :1:00 u..... ..ID .. C 29 1. O,lglnal ROlu,n o 4. L1mllod E.,o'o o 3. Romolndo, Rolurn (for dolo. 01 dooth pria, 10 12.13.821 o S. Fodorol E.lalo To. Return Required CL B. TOlol Numbo,of Safo Dopo';1 Bo.o, o 40. Future Inlerlll CompromlsD Ifo, dol.. of doolh oho, 12- I 2.B21 o 6. Decedent Died Testate 0 7. Decedent Maintained a living Trust (Allach copy 01 Willi (Anoch co y of Trulll ALL.CORResPONDENC/! AND CONFIDENrfAL TAX INFORMAnON.SIIOULD BE DIRECTED TO. NAM M MAlLIN A E Herbert G. Rupp, Jr. Rupp and Meikle II M The Wagner Building, Suite 303 355 North 21s~~reet Cam Hill, PA!; r701b ~i .... "z 82 -i'~ ' .' \ :': . ".;, . -;. ',~ ; ^,\ 'c:~:',{:,"> 761-3459 ~..;~ z o 1= :5 :). 0- iL i5 ... .. 1. Roal ElIalO (Schodule A) ( I I 2. Slock. and Bond. (Schedule BI ( 2) 3. Closoly Hold SlocktPartno"hlp Inlo'OII (Schodule q (3) 4. Mortgage. and Nolo. Rece;,oble ISchodulo 0) ( 4) S. Cash, Bank Deposits & Miscellaneous Personal Property( 5) (Schodulo E) 6. Joinlly Ownod P,operty (Schedule FI 7. T,ansf... (Schodule G) (Schodulo l) 8. Total Gron An... ('0101 lines 1.7) 9. Funeral bpln,.., Administrative COIU, MilcoHaneoul ( 9) Expon.o. (Schodul. HI 10. Dob". Mortgago UabiUtlo.. lion. (Schodulo I) (101 11. Talol Oeductlon.llolal Uno. 9 & 10) 12. N., Valu. of E.lalO (Iin. 8 m;nu.l;no 11) 13. Charitable and Governmental Bequelu (Schedule J) 14. N., Valuo Subioct 10 Tax (Uno 12 m;nu. Uno 131 15. AlIount 01 Uno 14 taxablo 01 6% ralo (Indudo ,aluo. 110m Schedulo K 0' Schodulo M.) 16. Amount of IIn. IA laxabl. 01 15% '010 (Indudo valuo. I,om Sch.dulo K 0' Schodulo M.) 17. Principal lax duo (Add lax from ';no 15 and Irom lino 16.) 18. Creditl Prior Paymlntl Dilcount -0- + 769.11 (181 (191 769.11 -0- -0- 5.098.20 -0- -0- "1.9'7 41 ~ .- -"..-1- ;.., ,." I.,JI ( 6) (7) -0- -0- 13,720.82 746.33 I BI1l7 ,015.61 (111 14,467.15 (12) 102.548.46 (13) -0- (IA 102,548.46 X .06_ -0- (IS) -0- 102,548.46 X .15_ 15,382.26 (161 (17) 15,382.26 Interlll -0- Check here If \lOIJ mt' requesting 0 rcfund of YOUf oV('fpcvmcni (20) (20AI 1208) 14.613.1'5 _n_ 14.613.1'i DAn S" "l'~~ OAff ~ SCHEDULE B STOCKS'1WJ4 BONDS ... 11ving18anclI VIIulI 1IIItIlHII. IlII8 .... & IIand ..00 aaIlI4I14E 0111II .... & IIand ..00 1\1 I J4I! - .... & IIand ..00 QI:IlP8.7IlII& 1111II _& IIand ..00 QZIIIIMIIrIII 0I11l1 _&1Iand ..00 1121011'.'& - _&1Iand as.oo Q2411II1_ - lien. & Bond ..00 112'11 irE - _&1Iand ..00 0ZII2I573.. 11/11 81111I E Bond ..00 02474Ol172141! OIno .... E IIand 121.00 Q24a71'lI3III! Cl:II1O .... E Bond . 12ll.oo rtMQ .]u.... 11 ~! ClIlI1lI .... E Bond 121.00 02&CI7ISIlM32E ClIlI1lI . .... E IIand ..00 Oa11 R.IlE lana ....E Bond 12Il.oo CI2UCOm8E OIm _Eiland ...00 1I2U4CII14l1E CICII7. . _EBond 12Il.oo ""QJ4_ lB/7' .... & IIand 121.00 a2mI442SIE lB/7' .... & Bond 121.00 ~.. !~a 111111 , _ EBond ..00 . .. '117' _Eiland ..00 n '0IMIAa lIII7Z _Eiland as.oo QIIII.4II144C11! !W7Z _Eiland as.oo Q!IlIIIh4... 111M _Eiland ..00 QIlO4I7I\IlIBI! arm .... E IIand as.oa <l!CM14lt2JE 11m _Eiland as.oo Q5III._ 112m _Eiland as.oo ClI1111711ll211111! CMm _Eiland as.oo llIlIII71'lII4l! 11III73 _Eiland as.oo ClIlll1l1e. 11 arm _Eiland as.oo ClIll_ 11/73 _Eiland as.oo ClIl'4SI1IlD1E 01"4 _Eiland as.oo ClIl174144all11 ClCll74 .... E IIand as.oo ClIl'lI2lIIII784II 11II74 IleItec: E IIand as.oo ClIl2IIl,_ lB/74 .... E IIand I2SJXJ .."M 1& 11"4 .... E IIand ea.oo ~.fU'1IQI: OIns ....E IIand . -.00 QIl2I. fI ll3mI _Eiland ..00 ll8IIlI774CIIIE lI5tnI .... E Rond ..00 QIIIIZl7C44IE 0IImI _E8ond ..00 GaNSUI1. lem; ....E IIand -.00 a......'.jlll 1117S _Eiland ea.oo 'lIOeI4OIlMlIl CICII78 8elIIIE Bood ..00 QlIIII3I1Il171! lIIII7I ....E IIand ea.oo OIll1llS.lI2I7E lIIII7I ....EIIand ea.oo QIlIlIllll2&lE 11/11I ....EIIand I2LlIO QIl4Dll81l11E 0lIT7 8IItII Eiland 121.00 QIl........c t1NT7 lIIIIIIE IIand ea.oo QIlI171llZ77l! tMT7 ....E IIand ..00 QIl.....E fJIIT7 lIIIIIIE IIand ea.oo CJII1. ,... '11/77 .... & IIand ea.oo .& l1T .e 01/11I lIIIIII & IIand ea.oo n ."... CICII78 lIIIIIIE IIand ..00 - 1-, lIIII7I _&Bond ea.oo a.... .. 111/11I _Eiland ..00 QIQI,. ... .11I7I _Eiland ..00 0111'" t.4E .1I7S _Eiland ea.oo QlD.1D2211E ll3trI _ E IIand ..00 CIllDtn.... lBI7I _E IIand ea.oo -r ...4& 111M _Eiland as.oo CIIIIIl1I11171! 101711 ....l!1Illnd 121.00 0IS74211711l! ,:rm .... liE IIand 110.IIII Llml~ llWlI .... liE IIand 110.IIII LlI743l1lEE III8lI .... liE IIand 110.IIII Ll777lll711iE lIMO .... liE 1Iand. 11II.00 I .- lNMZ _1iE1Iand 110.IIII I GInU... 111/fJ2 _IiEDond 110.IIII LU I71I41lEE ll111Z TOTAL II .IOlI.OO Cremation Society of Pennsylvania for crematory charges Cedar Lawn Cemetery Grave Opening 260.00 Stone Cutting 65.00 ,l8Ullat ,. SCHEDULE H FUNERAL EXPENSES,. ADMINI51'RAnvl com AND MISCELLANEOUS EXPENSES . _IlWIAlIHO'I ""HI_I. IHHIIIWfCI wanuAN a..tDIH'DICIDIH' DER.R, PAUL E. ITEM NUMBER A. Pun.rel Exp.n.... DESCRlmON I. 2. B. Aclmlnlatretlv. Coat.. Michael E. Derr ",.onol Rap....ntotlve Commlllionl :r: 165-38-1567 Sodol S.curity Number of ",.onol Ja~~~.~oIlwll De r r YeorCommlllionl paid tint. "~i~38-1503 I. z. Allamey Fill Rupp and Meikle 3. Family Exemption - None ..' Claimant Ralationlhlp Add.... of Calmant at deced.nt'l d.oth 5',", Add.... - Cty Stat. AMOUNT 809.00 325.00 2,840,00 2,840.00 5,680.00 5,680.00 Zip Cod. Proboll Fee. (SEE SCHEDULE ATTACHED) 256.00 MI...llanlOu. bp.n.... <l. c:. I. 2- 3. <l. 5. 6. 7. 8. (SEE SCHEDULE ATTACHED) 970.62 TOTAL (Alia .nter on lin. 9. Racapitulatlonl 513,710.82 (If mar. .pa.. I. n..d.d, In..1t addlllonal .hoe.. of .am. oIu.1 SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF: DERR, PAUL E. FILE NUMBER: 21-94-0153 ITEM NUMBER DESCRIPTION Camp Hill Plaza Apartments - Rent for February, 1994 Ann M. Markley, Tax Collector School Taxes for 1993 - 1994 P.P. &L. - Electric service for 7/21/93 through 2/23/94 Manheim Township - School Tax 1. 2. 3. 4. TOTAL AMOUNT 520.00 16.50 166.33 43.50 746.33 t_ l:~~,~.:,.,),,,.;,. I~V.U1U" 12.1T! L . C(U.\MONwrAUH 0' "NNlnVAHIA INHII"ANCI 'AX liNIN IUIDIN' DKIDIN' SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER DERR, PAUL E. 21-94-0153 ITEM NUMBER AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP A. Taxable S.qullts: 1. (SEE SCHEDULE ATTACHED) ITEM NUMBER AMOUNT OR SHARE OF ESTATI NAME AND ADDRESS OF BENEFICIARY 8. Charitabl. and Gov,rnm,ntal Bequests: I. TOTAL CHARITABtE AND GOVERNMENTAL BEQUESTS (AI.o onlo' on lino 13. Ro<opitolotion) (If mo,. .pac. I, n...d.d, InNrt odditlonal ..h.." of lorn. ,11.1 S -0- SCHEDULE J BENEFICIARIES ESTATE OF: DERR, PAUL E. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 1. A. Taxable Bequests: 2. 3. 4. 5. G. 7. 8. 9. Michael E. Derr Nephew 6 Riddle Road Camp Hill, PA 17011-6021 Thomas E. Derr Nephew 248 Indian Creek Drive Mechanicsburg, PA 17055-2526 S. Lee Darr Niece P.O. Box 261 Elizabethtown, PA 17022 Jonina Dupler Niece 11 Deer Lane Elizabethtown, PA 17022 Luana Kelly Niece 155 East Park street, Apartment 6 Elizabethtown, PA 17022 Krist~ Stickell Grandniece 651 North 73 Terrace HWD, Florida 33024 Barry Derr Grandnephew 201 Plantation Road Martinez, Georgia 30907 Kathy Murphy Grandniece 5184 Oak Spring Drive Grovetown, Georgia 30813 Laura Green Grandniece 518 Hardy Drive Grovetown, Georgia 30813 FILE NUMBER: 21-94-0153 AMOUNT OR SHARE OF ESTATE one-seventh one-seventh one-seventh one-seventh one-seventh one-seventh one-twenty-first one-twenty-first one-twenty-first '1' ;.~-~---~---~_._-~---------------~-~~~. ~ ,.ii~I!f':."'. . 'p' ",ij:~~~e' ~;-f'mI.':~~i'~l'i~ . .' NWE'f<"r > . ~NNSY 'f<' IA'W"~i'l,i..,...... )' . ft. '\ .' \ ,.," f!It,~'" '~f.\ """"", . " ~.l"~";'m't~~V'I~''';j'~{i'';.J[~'''\'';' ,..1f,,,,.Ct\,, ...,\,., "/' )..._. .~'..~, t. ~','-'n"""'llh""'''.\;tI{'''\~L.'I('~'~'\ ,Ji';, :L:I!,,~\ '" ; f . T\. , . ."':o"1>;;.\I)!,fr"\'~/;;,'ti',..-:;~ll', r.11i":';uE'AD1MINT,:O':~INOI~}i~I,;,.l",~jJ\l:~I,~t.;!\\..;,\)'~if:\j!~,":"~\;"f!~,\,::i'~!,\,/,,~ !":#:'~~~~~~' . ~'"" ;~'ter(l it~:'':ii':;'"'' ,.:J\ ,t\'".-;~,:r>~':'I~~'~'~~~;~J!!':~';'o.(,I,;;,"::J:':rf;:, 0\","')",1',41;0, :l~',',j;;f~Ah~:i::~,t',l;,(,~J:: \, ':"'~",~.~t;.: ,~:\l;e: ~ . ~~\.~!fIlll'j'9r.i'}I"'~,~ ~C!!n:i!!i,,~,Jtmy.~lil~',,~~~~,!~l')l.~~;~t!!),~tr^!~I~~;;,~;;d~! ACN ASSESSMENT P!'I CONTROL ... NUMBER & AMOUNT RECEIVED FROM: MICHAEL E DERR 6 RIDDLE AD ---ro 1 'I',pi.bJ":'. i~ CAMP HILL PA 17011 ESTATE INFORMATION, I!:'I FilE t~UMBER 1II 21-1994-0153 E1 AME Foe DENT lAST) DERR PAUL E 11 DA f 0 A:~ENT EI P STMARK OAT UNTY 100.'00 CUMBERLAND A A SSN 196-10-988:5 (FIRST} (Mil , qt.. m TOTAL AMOUNT PAID .14,613.15 6G REMARKS MICHAEL E. DERA AND THOMAS E. DERR CHECK" 16 REGISTER OF WILLS RECEtVED BY j.'", I ,.-/'~(( I"; / /JI/;). : "5IGNA:,~ ,;. - .' I' MARV C. LEW 16 i".( ,i:.t..~ j J:tij, REGISTER OF WfLI.S' T {f . . SEAL - - _.- ---- -- ., ---, -- -. .__ __ _ _ ___ ____ .,.._ __.__ _ u.'._ __ _.-- -.... -- ..-- -- _.- - -- - - -:-.-, \ 191 cO REV-1547 EX AFP 110-93. COHHONWEALTH OF PENNSYLVANIA DEPARTHENT Of REVENUE IUREAU OF INDIVIDUAL TAXES DfPT. 210&01 HARRISBURG, PA 17121-0601 . NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ACN 101 DATE 09-06-94 FILE NO. 02-04-94 COUNTY CUMBERLAND NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX PAYHEHT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT TO: HERBERT GRUPP JR WAGNER BLDG STE 303 355 N 21ST ST CAMP HILL PA 17011 REGfSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AMOunt ReMitt.d CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiEV:is4j-iiC"Ai:ii-iiij:93riioT"ici--OF-i-NHiiiiTANCE-T"AX-iiPPR7iisEHEiiT~--ALi.-DWANcE-ijR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DERR PAUL E FILE NO. 21 94-0153 ACN 101 DATE 09-06-94 TAX RETURN HASI (X I ACCEPTED AS FILED ( I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BAseD ON: ORIGINAL RETURN 1. Rool Eototo (Schodulo Al (II 2. Stocko end Bondo (Schodulo BI (21 S. Cloooly Hold Stock/Portnorohip Intoroot (Schodulo C) (51 4. Mortgag../Not.. Receivable (Schedule DJ (4) 5. ~.ah/Bank Deposita/HiIC. Perlonal Property (Schedul. E) (5) 6. Jointly Dwnod Proporty (Schodulo FI 161 7. Tren.foro (Schedulo GI (71 8. Tot.1 A...te .00 5.098.20 .00 .00 111.917.41 .00 .00 (81 117,015.61 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expen.e./AdMinlstrative Co.t., Hloco11enoouo Expan... (Schodulo HI 191 13 , 720.82 10. DebhlltodO""o L1obllitloo/L1eno (Schedulo II nOI 746.33 11. TotoL Doductlono nl) 12. Not Voiue of Tox Roturn (121 IS. Charitoblo/Oovornoontol Boquooto (Schedulo JI (IS) 14. Not Volue of Eototo Subject to Tox (141 'NOTE: I~.n ........nt was i..ued pr.viou.ly, lin.. 14, 15 and/or 16 .nd 17 will refl.ct figural that inc1ud. the total of ~ r.turn. a......d to dat.. 14,467.15 102,548.46 .00 102,548.46 ASSESSMENT OF TAX: 15. Aoount of Line 14 toxoblo at 6% roto 16. Aoount of Line 14 toxoblo ot 15% roto 17. Principol Tox Duo TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+1 DATE NUHBER INTEREST (-I (151 1161 .00 X.06 . 102.548.46 X.15 . (171 .00 15,382.27 15,382.26 AHOUNT PAID 05-04-94 886030 769.11 14,613.15 .J TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 15.382.26 .00 .00 .00 a If PAID AfTn DATE INDICATED, SEE REVEISE fOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN n, NO PAYIlENT IS REQUIRED, If TOTAL DUE IS REfLECTED AS A "tREOIY" (CRI, YDU HAY IE DUE A REFIIID. SEE REVERSE SIDE OF TNIS FOIIIt fOR INSTRUCTIONS. I on c 0--.. ,~,., ,:.,:" , , "'.J RESERVATrOHr E.t,t.. of d'c~"'h d~ln" on or be'o"e o.c..t)I,. 12, 1982 ... If ....y future Int.,...t in the ..ht. 11 tten'f.rrld In pa.....lon or enJoy,."t to Cl... II (colhte,.eU b..,.flcl.,.l.. of t.,. dec.dent .fh,. the IxplrlUon of ....y ..tat. for U,. or for )I.'''', thICo-.onw..lth hereblt I.pr...ly t...,...... tM right to apprlln and ...... tranlfe,. InhlrHanu TIIlI. at the laNful Cl.., B (collltl,.el) ~.t. on ony .uch future Int.,...t. PURPOSE OF NOTICEs To fulfIll the nqulr..lIlb of SlcUon ZlteD of the IntM,.UMCI Ind E.t,t, rIll Act, Act 22 of 1991. 72 P.S. Section ZlttG. PAVMENTs aetab! the top purtlon of thh Notlc..Md ~1t..lth your pIYlent to the Rltllltl,. of WUla printed on the re....r'l .Ide. ....M.k. check or lIOhIy order plyabllll to: REGISTER OF MILLS, ACENT All Plyant. recelYld IhlU flr.t b. applied to any Int.,...t which 'Iy b, dill IIlth Iny ,....lnd1r appUed to the t.lC'. REFUND (CR): A r"uncI of I tllC' cr.eUt, which .... not r.....t.d on thII Tax R.turn, .,,~ be rlquast.d by cOIIpleUng an "applicatiOn for R.fund of PMn'Ylvanll InhIlritanc:. end E.tltl TllC''' (REY~nlJ). olppUcaUonl Ir. av.Uabl. .t thI Dfflc. of the Rlllht.r of WIU., any of the 25 Revenu. Dlatrlct OffiCII, 01" by caUlng the 'PICI.I 24~hour ..,....rlng IIrvicI nullban for forll ord.l'inGI In P.,.,.ylv..,tl 1~IDD~562~205~, outsld. P.nn.ylvanl. and within loc.l HarriSburg .r.. (717) 787-1094, TDD' (717) 772-2252 (....rlng I"llred Only). OIJECTtON$~ Any p.ri'Y In intlr..t not IIthflld 'with tn. appr.h.....t, II11Ollenc. or dlllUOllenctl of dlIducUon., Ol".........,t of tllC' UnclucUng dhc:ount or Int_rllt) ., Ihown on thlt NotlcI lIU.t obj~t within .bty (60) din of nc.lpt of thh Notle. by~ AIl!IIN IST..mw: CORRECTIClHSz --..rltt.., prot..t to the PA OtiPlrt.."t of R.vlnUl, IoIIrd of app..h, DEPT. ZlUll, Hlrrlsburg, PA 17121-1021, ~-.IICtlon to hili" the .att.r <Ietllrllned at audit of thl 'CCClU'lt of thI Plnonl! rapruent.Uv., OR -";'.....~ to the Orphan,' Court. OR DIstolIfTz hctull .rrors dllcov....d on this .ss.....,t should bI ~n"ld In ..rlUnt tOI PA o.,."t..nt of R.venue, Bur... of Indlvldull TllC"', ATTHI Po.t ...........t Revl... Unit, DEPT. 210611, Hlrrll1burg, PA 1712.~0601 Phone (717) 717-6505. $.. PetIt.:S of th6 bookl.t "In.tructlon. for Inhe..ltMC;. TllC R.tu"n for. R..ldlnt Dee.dant" (REY-UOU for en upl..-wUon of 8dllnlttr.Uv.b correct_I. .rror.. If MY tllC dIM 11 PI1d within thr'l (5) cllend11r IIOnth. .ft... the dlCltdwlt". dI.th, I five Plirc",t (SX) dll4*lnt of thI tllC plld Is 'Uowed. INlDEST I Int.r..t I, chIItltld beglMlnl ..Ith flr.t dew of dlUhlIUenCW, or nine (9) IIOnth. Ind OM (1) dey fr-oa the dati of dUth, to the dlte of paYNnt. Taxe. which blAH dlllnqlJWlt before Jlnutiry I, 1'12 bea.. Intlr.r;t at the r.te of ,he (6):) "rcent "r ~ calculated at . d,lh rata af .00l1M. All taxII Mhlch bee... delinquent on Ind aftllr .......ry 1, I'll 11I111 bear lnt.,...t It . ".t. Which 11I111 v.~ froe calendllr tlMr to cal""'r w'lr IIIlth that ,..t. ltInOIl.nCecI bw the PA o.p.rt....t of Revenue. The IppllCllbI. Int.rllt nt.. for 1'12 thraugh 1994 ar" !!!! Intlrllt Rat. DaUy Int.rllt r.ctar ~ Inter..t Rat. Uallr Intlrllt Factor Itll IIX .OOOSU ".. au . 000274 1911 lOt .000411 1'17 tX .000247 I'" IIX .IJQUOl 1"'~1"1 IIX .ODOSOI 19U Ill< .DODS" 1"1 tX .000247 1"1~ltM n .0001'2 --Int.,...t 11 CltlCUlatad .. fol1011" IIlTEIEIT . IAUllCE OF TAX UllPAID X IMIIEII OF DAYIl DELlHQUEIIT X DAILY IIlTEIEIT FACTOII ."Anw Hot1~ I...... aft.r the talC --.. CleUrMIUII\t tl111 ,..Uect an Int.,..tt c'lculaUon to fifteen US) deya ba)JGnd the data of the ..........t. If PQMnt II .... enar tN lnt.r..t COlP\oltatlon d.ta "*'" on ihe Notl~, "-Itl~l Int.r..t IUlt be calculated. Estate of Paul E. Derr, Deceased .. Summarv of Account Estate No: 21-94-0153 Pages Proposed Distribution to Beneficiaries 12' 13 prinoipal Receipts Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Taxes . Fees & commissions 'it.. 5 , 6 $ 128,729.61 7 $ 834.91 7 809.00 8 1,008.24 9 14,641.15 10 4,090.00 $ 21,383.30 $107,346.31 11 916.01 12 $106,430.30 11 Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand For Information: Investments Made Inoo.. Receipts Income Balance on Hand Combined Balance on Hand Re.erve Administration Expenses Reserved to Pay 9 Taxes Reserved to Pay Fees and Commissions Reserved to Pay Distribution Balance for Distribution to Beneficiarie. 9 9 Proposed Distribution to Beneficiaries 12' 13 2 12 620.90. 12 526.00 650.00 7,270.00 Q).90 $107,051.20 8,446.00 $ 98,605.20 $ 98,605.20 , Estate of Paul E. Derr, Deceased Estate No: 21-94-0153 BACKGROUND I PAUL B. DBRR, D!CBASBD, ~IRST AND ~IHAL ACCOUNT Paul E. Derr, died intestate on February 4, 1994. He was a resident of 109 November Drive, Apartment No.6, Camp Hill, Cumberland County, Pennsylvania, 17011. He died at the age of 76 years. His CO-Administrators, Michael E. Derr and Thomas E. Derr, file the enclosed First and Final Account stated through October 11, 1994. The decedent died without a will. Letters of Administration to administer his Estate were granted to Michael E. Derr and Thomas E. Derr, CO-Administrators on February 18, 1994. The Co-Administrators, Michael E. Derr and Thomas E. Derr, marshalled the decedent's assets, paid the decedent's funeral expenses and other debts and administration expenses and paid the decedent's inheritance taxes. The Estate has been properly advertised. The Pennsylvania Bureau of Individual Taxes accepted as filed the Decedent's Inheritance Tax Return and said acceptance of the Return is attached hereto and marked Exhibit "A". The Inheritance Tax Return for the decedent's estate is attached and marked Exhibit "B". The Inventory filed on behalf of the decedent's estate is attached and marked Exhibit "C". No questions have arisen with respect to the administration of the Estate. Persons in interest to whom a copy of this First and Final Account was sent are listed on Exhibit "D". A $ 300 federal income tax refund is expected. Interest will be earned on the $ 83,000 certificate of deposit to its date of maturity on November 25, 1994 (interest to October 11, 1994 accrued on this certificate of deposit is $ 1,074.79). These items will be SUbsequently accounted for by the CO-Administrators. 3 , , Estate of Paul E. Derr, Doceased Estate No: 21-94-0153 TUBS May 2, 1994 - Register of Wills, Agent - Pennsylvania Inheritance Taxes May 2, 1994 - Register of Wills, Agent - Filing Inventory and Inheritance Tax Return 14,613.15 28.00 TOTAL TAXES $14,641.15 rBBS AND COHHISSIOHS March 4, 1994 - Rupp and Meikle on Account of Attorneys Fees 2,500.00 May 2,1994 - Rupp and Meikle on Account of Attorneys Fees 1,590.00 TOTAL FEES AND COMMISSIONS $4,090.00 TOTAL DISBURSBMBU'l'S or PRINCIPAL . 21,383.30 ADMINISTRATION EXPENSES RESERVED TO PAY Cedar Lawn Cemetery - Interment of Ashes Gingrich - cuttinq of Gravestone Clerk of Orphan's Court - filing of First and Final Account 115.00 300.00 111.00 TOTAL ADMINISTRATION EXPENSES RESERVED TO PAY 526.00 TAXES RESERVED TO PAY 1994 Federal Income Taxes 650.00 TOTAL TAXES RESERVED TO PAY 650.00 9 . ,ir, I I. , , Estate of Paul E. Derr, Deceased Estate No: 21-94-0153 Kl'bti Stioltall 651 North Seventy-Three Terrace HWD, FL 33024 oash $14,217.31 Barry Darr 588 Hiqh View Circle Grovetown, GA 30813 oash $4,7311.11 Xathy Ilurphy 627 Dennis Drive Martinez, GA 30907 oash $4, 73!1. 12 Laura Grsen 518 Hardy Drive Grovetown, GA 30813 oash $4,7311.12 TOTAL PROPOSBD CASH DISTRIBUTIO. $118,105.20 13 ~~Y.l~47'EX AFP (10093* C-'lTH Of PEHNr'llVAHIA DOARfMEN' Of RfVEHIJE IlItUU DP' INDIVIDUAL TAICES DOT. 110611 HMIIIIItMG, PA 17UI-0601 ACN 101 NOTICE OF INNERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX DATE '09-06-94 'FILE NO. DATI OF DI!ATH 02-04-94 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX PAYHENT TO TNE REOISTER OF WILLS. MAKE CHECK PAVABLE TO "RECISTER OF WILLS, ACENT" REMIT PAYMENT TO: HERBERT GRUPP JR WAGNER BLDG STE 303 355 N 21ST ST CAMP HILL PA 17011 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AIoount Rultted CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ jllv:i54i-EX-AFii-mi:m--HilYii:r-QP-liiHeififi\iitrriix-ii"~Riiisiiriliir-,--iiL.i:owiiNci-iiriu-------------.- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ' ESTATE OF DERR PAUL E FILE NO. 21 94-0153 ACN 101 DATE 09-06-94 If an ........nt w.. i..ued previou.ly, lin.. 14, 15 .nd,or 16 .nd 17 will refl.ct figure. th.t include the total of ALL return. a......d to det.. ASSESSMENT OF TAXI - 11. _t of LIne lit tax"'l. .t 6% r.te II&) 16. _t of LIne lit tax"'l. .t 15% ...t. IUI 17, Pr1ncl..l Tax _ TAX CREDITSI PAI'IIENT DATE TAIl RETURN WAS, I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. RHl Eat.t. ISchedul. Al 2. st_. _ Bond. ISchedul. BI S. Clo..l~ Hold Stock/P.rtnor.hl. Int.r..t ISchodul. CI 4. Hortllllllll.lNot.. R.c.hobl. ISchodul. DI 5. Colh/lonk Dopoo1h/Hho. P.raon.1 Pro..rty ISchodul. EI 6. Jolntl~ Owned Pro..rt~ ISchodul. FI 7. Tr....for. ISchedul. CI e. Tot.l A...t. APPROVED DEDUCTIONS AND EXEMPTIONS I .. Funer.l EKPen.../Aa.lnlatr.ttve Coatal H1.0.ll0n00u' Exo..... ISchodul. NI 10. Debt./Hortgog. L1...1l1tl../LI... ISch.dul. II II. Tot.l Doduotlon. 12. Not V.l... of T.. R.turn IS. Chorlt...l./Cov......t.l Bequo.t. ISchedul. JI 1... ._" ~.1... of E.t.l. SuiJJeui: .t... Tu NOTE I RECEIPT NUIlIER DISCOIIIT 1., INTEREST I-I 05-04-94 8S6030 769.11 · IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. e.<'I{ it3 ~ ,'"A" I I CNANCED III 121 151 litl 151 Iii 171_ .00 5.098.20 .00 .00 111.917.41 .00 .00 III 117,015.61 191 1101 13.720.82 746.33 1111 1121 IISI ;1.U 14.467.15 102,548.46 ,00 ' 102.548.46 .00 X.G' . 102.548.46 X.IS . 1171 .00 15,382.27 15,382.26 AIlOUItT PAID 14.613.15 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 15,382.26 .00 .00 .00 I IF TOTAL DUE IS LESS THAN 'I. NO PAYMENT IS REOUIRED. IF TOTAL DUE IS REFLECTED AS ,. "CaEDIT" ICRI. YOU HAY IE DUE A REFUND. SEE REVERSE SIDE Of THIS FORll FOR INSTRUCTIONS. I REV.I5Oll EX + 11.ln '. ,~~ COMMONWfAlfH OF 'I!NNSYLVANIA DE'ARfMENI' Of REVENUE POST OFFICE lOX 8327 HARRISIURG,'A 1710.5.8327 N' HAM (LA. . IR .AN I !i :n... "'Q "'z 00 , u... z o ~ :E o u )( ,~ INHERITANCE TAX RETURN RESIDENT DECED&NT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) i 5l III CI MID l I I tAli DERR, PAUL E. IAl URI Y NUMB DA f 0 A H 196-10-9885 2/4/1994 $ ~-'" ...'" ...u :z:00 u..... ..... ... C' j1g 1. Original Relurn o 4. Limiled E.tole L H N NUM! R 761-3459 z o ;: ::5 E ... ~ ... ... I. Real Estole (Schedule A) ( 11 2. slock. and Bond. (Schedule B) ( 2) 3. C1o.ely Held slocktPortne"hip 'nlerllt (Schedule C) (3) 4. Mortgage. and Nole. Receiyoble (Schedule D) ( 4) 5. Co.h. Bonk Deposil. & Mi.cellonoou. Pe"onol Property( 5) (Schedule EI 6. Joinlly Owned Property (Schedule F) 7. T,on.le" (Schedule G) (Schedule LI B. TOlol Gross Asse" (Iolollinll 1.7) 9. Funeral Expensls, Administrative COlli, Miscellaneous ( 91 Expen.e. (Schedule H) 10. Deb... Mortgage Liobililie.. Lien. (Schedule II (10) 11. TOlol Deduction. (10101 line. 9 & 10) 12. Net Value 01 Ellole (line 8 minu.line II) 13. Choriloble ond Goyemmentol Boqullt'lschedule J) 14. Nel Value Subfoct 10 Tox (line 12 minus tine 13) 15. A'IIounl 01 line 14 laxoble at 6% rote (Indude yolulI lrom Schedule K 0' sch.dul. M.) 16. Amounl 01 line 14 laxoble 01 15% rolt (Indude yolue. lrom Schedule K 0' sch.dule M.) 17. Principollox due (Add tax from line 15 and Irom line 16.1 16. Credit. Prior PaymentJ Discount -0- + 769.11 161 I 7) (15) (16) U NUMB.I o ,c. , , . cou~tt CODE N' M L A 109 ~ovember Drive, Apartment Camp Hill, PA 17011 A 0 I H 11/8/1917 COlin' 19. .1' lin, 18 is greol.r Ihan lin. 17, 8nter the difference on 'in. 19. This is th. OVERPAYMENT. aD 20. If li~. 17 i. gr.at.r thon line 18, ent.r the diH.r.nc. on lin. 20. This is the TAX DUE. A. Enl.r the int.rll' on .ho balance due on lint 20A. B. Ente, Ihe 10101 01 line 20 and 20A on tine 20B. Thi. is the BALANCE DUE. Moke Check Payoble to. logl.l.. of Will., Agen' '" ':'~., .. ..BE SUU'"' ANSWIII ALL QUESTIONS ON REVllSElSIDI:AHDTO IIDIKXlMlH_ ';I1'..t~"'~'. Uftdtr pMOhi.. of ptri~ry. I d.dar. tha, t hove .aanrined thla return, indudir\g accompanying schedul.. o~d .tatem.",., and to the btst of My k~. and b.U.f, It I. true, corred and compl.t.. I dldara rhot ad tlal Hlot. he" b..n r.pon.d al true mark.t VGI..,.. Oedaration of p"parer other than the ptnDftOl ,.,...ntoti.,. i. baaed Oft all Information of which prepare' hat on, knowltdg', iWCjHArUGIi Of 'UIQN AUPON'"L( fOIt 'lUNG ItfrUItN ADDItUi DAn: $. '" 6 Riddle Road, Camp Hi 11, PA 17011-6021 !5'-l-~'t ,. A DArt o 2. Supplemental Return o 40. Futu,e Inter.at Compromise (for dale. 01 death oke, 12.12.B2) o 6. Cecoden' Died re.tate 0 7. Decedent Maintained a living Trult (Alloch copy of Will) (Alloch copy 01 Trustl ALLCOIRESPONDENCE,AND CONFIDENTIAL TAX INFOlMATlON,SHOULD BE DIIECTED TO. AM MP MAlLIN A R Herbert G. Rupp, Jr. Rupp and Meikle The Wagner Building, Suite 355 North 21st Street Cam Hill, PA 17011 -0- 5.098.20 -0- -0- , 1 T, aT ~ 4] -0- -0- 13,720.82 746.33 -0- 102,548.46 Int.re.. -0- Ch(!ck here ,f you Ofe Icque"fing'c t(!fund of your dvcrpoymt'nt )7i ~<,<('b..i G ~"W 1< 94 YEAR Cumberland o 3. Remainder Return Ilor dote. 01 d.oth priorlO 12.13.B2) o 5. Fedorol Estole Tax Return R.quired 0.... 8. ToloI Number 01 Sole Depo.it Bo.e. 303 ( B) 117,015.61 (11) 14,467.15 (12) 102 , 548.46 (13) -0- (t4) 102,548.46 x .06. -0- x .15. 15,382.26 (17J 15,382.26 (18) (19) 769.11 -0- (20) (20A) (2081 14,(1]3.1'5 0- 14.613.15 355 North 21st Street, Camp Hill, PA 17011 E)(q'~t;- I'B ~ S" -l-qy OO'l108'lt '111.1.0.1. Z8IOI iEIOItlIlt 1111 OO'lIIII _ialllleS Z81m tEil&:8au1 OO'lIIII, _ialllleS Z8IIO :at" Blann OO'lIIII . _1EI111leS CIlI/IO iElwswn 00'lIIII _ialllleS 08/ll0 iallllCtAlll1 00'lIIII _ialllleS 08/ll0 5BlIl101I1IU1 00'lIIII _ialllleS lIUIl !I1lW1l1Zt4llD llO'SZt puogallPlll 1IlI01 lWIll8U1CllCl1C1 00'IZt _allPlll IlIm at,a,..., lIlI'SZt _allllllllll 8lJSlI lIllIIllIUtalIO 00'- _ alOlllll WIllI 1I01ZZCCII11ID OO'SII _ alOlllll lIlIIl .... LJI...IIID OO'SII _ a IOllIlI IWlII i'H IaIIO OO'SII _alllJ08 wm UIl8C ""W) arsa _ alOlllll WID ~ 00'1II _ a IOllIlI WID '"""-.-I.l"...., 00"1II _alllleS Will iIiaIIl "" 00"IZt _ alOlllll UlDI P'1 -IlK) on:II _a...... lJJIIJ SI....1IO 00'1II _alOlllll lJJIIJ BUZlIUIlIIO ana pulllI alOlllll UJfIJ a'~.--M~ ana _ alOlllll UJIII BIOIlIlDtIllO 00'1II _SIOllIlI lUll IIllIIlIlIBUUIll ana _a...... WID iUlIZlIlBlIlO 0Il'IlZt _illOllIlI WID iItIttIlZIaCI ana _S...... WID B8t0101 !IllO, 00'1II _a IOllIlI 1WI1 .'-'''''OIl) OO'SII _a...... 811111 _UU&lDIC DO'SZI _a...... WID .....tIZIIID 00'1II _a...... WID _UlllID 00'1II _ a IIIlWlI WID _Ill ..lIIlD ana _a...... WIG aDltltu.II'JI'CIft' IXI"IIt _alOlllll tUII SIIfI ..,T . ..... _a...... tlllll _1IIIIIllD 00'1II _a...... tlllll' BtItlIlIlIllIIIII 00'1II _a...... .. tll\:ll IIllIIttlttllll 00'1II _a_ tUIG SIaI_11II llG'IIt _a_ 81111 _111I 00'1II _SIIIleS WID -111I 00'1II _a_ WID iMIIlllIIlIIl 00'1II _S_ CUIO _11lIIlIIl ana _a_ ElIZlI azrzmlIl.m ana _a_ wn iIlIlZllllIllllll ana _a...-s WIll IIllIlIImKlIIl ana _a_ wm _ltlllMlD 00'1II _S...... ZUlO iIlItt_UIlIl) 00'1II _S_ WIllI IIftfDIMI . cxrIII. _a...... , um . CXIWI _a_ UIlII ~ ~'(I. ID'8t _a_ IlIIll ~ OO'SII _a_ iUiiii aa.--1XI'IIl$ _ S IOllIlI , IlI\:lI BIOtIlDKlll:O ana _S_ IllIG BElItlIlDKlll:D 00'1II _S_ IllIlII !lUll - . ana _S..,.. . lWIlI azr-....... ana _S...... lWIlI II 'PlP!"{".'" CXI12I _ alOlllll 0lI\:lI iIIaIlllItMD ana _S..... aulG lMZZIOttta:l ana _a_ 11II11 .u..-..u. 0011II _a_ lII/III at. III) aTIII -.- lII/III IIZIINlmIiU 00'1II -.- - BIIIl:I.-m:D IIlI'IIIlt _.- 11/10 _nail OO'SII _.- am 8UWICZD OO'SII _S_ - ib iii. _a_ 11II10 _......- 00'1II 1lUDII..... IIIIlJ ....11IIIII ~ .... ..... , . ..... saNOS ~..Sll;)O.LS e: g'1!lClaH:>S I I i'j '1 "j ,,J d j ''/ J 1 ,. J ~I'a.v.... '*' CIlMMONWWIM 01' "NNIYtVoUIIA INHIlIWlCl TAll .OUIN IIIIDINT DIClDINf SCHEDUU H FUNERAL IXI!I!NIIS,. ADMINlsrRAnvl cam AND MISCELLANEOUS IXPINIIS DERR, PAUL E. ITEM NUMBER , A. Fun.,.,1 Exp.n'.'1 B. A. Co 1. 2. 3. A. $. 6. T, 8. DESCRIPrlON 1. P1_. PrInt or . Cremation Society of Pennsylvania for crematory charges Cedar Lawn Cemetery Grave Opening 260.00 Stone Cutting 65.00 2. I. Admlnl.tratlv. CoIf.1 Michael E. Derr I Co . I 165-38-1567 "-nana' IWp.....nta! ... mm,,, ani '"~ all D ,', omas. , err Sada' S_rity Numb., of P.nanaJ Pille.. .., . . i~38-1503 Year Commls.,ons paid ~n~ p" , 2. AIIDm." FHI Rupp and Meikle 3. fDmily ex.mpllan ,.. Non e Calmant IWlatfanlhlp Add....1 of Cmmant a! d_d...'1 d.ath Stl'Hl Add...u ..... Cty Stat. ZIp Corl- 2,840.00 2,840.00 AMOUNT 809.00 325.00 5,680.00 5,680.00 Ptaball FH. (SEE SCHEDULE ATTACHED) 256.00 MII..llo.Nu. lap.n...1 (SEE SCHEDULE ATTACHED) 970.82 TOTAL (AIID -. on IIn. 9. ilKapItuJallanl $ 13, 170.82 (If ma,. .pa.. il n..d.d, 101.1t _dltlaoal.hull of ,_ IIA.I , 8- 8 '. . SCHEDULE J BENEFICIARIES ESTATE OF: DERR, PAUL E. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 1. A. Taxable Bequests: 2. 3. 4. 5. 6. 7. 8. 9. Michael E. Derr Nephew 6 Riddle Road Camp Hill, PA 17011-6021 Thomas E. Derr Nephew 248 Indian Creek Drive Mechanicsburg, PA 17055-2526 S. Lee Derr Niece P.O. Box 261 Elizabethtown, PA 17022 Jonina Dupler Niece 11 Deer Lane Elizabethtown, PA 17022 Luana Kelly Niece 155 East Park Street, Apartment 6 Elizabethtown, PA 17022 Kristi Stickell Grandniece 651 North 73 Terrace HWD, Florida 33024 Barry Derr Grandnephew 201 Plantation Road Martinez, Georgia 30907 Kathy Murphy Grandniece 5184 Oak Spring Drive Grovetown, Georgia 30813 Laura Green Grandniece 518 Hardy Drive Grovetown, Georgia 30813 8- 13 " FILE NUMBER: 21-94-0153 AMOUNT OR SHARE OF ESTATE one-seventh one-seventh one-seventh one-seventh one-seventh one-seventh one-twenty-first one-twenty-first one-twentY-first Ir",qntory of the real ant! personal estate "I , , PAUL E. DERR ' (SEE ATTACHED SCHEDULE) TOTAL \, ":1:) 'J , L :'('. . :~ ~ tt ~." eJ(~I~I"'" \;.. deceased . ~, . r9,OlS 61 , COMMONWEALTH OF PENNSYl,.AN/A ,. .,. COUNT\' OF CUMBERLAND } , u: r, "'''to Mi"ha"l F.. Derr b.ing duly sworn acc.rding t. law, d.p.... and say. that h. is the co-administrator of tho Estat..f Paul E. Derr I.t. of _CamE..J:!.t1.1..__.__..... ....-..-----.... , Cumb.rland County, Pa., d.c....d and that tho within i.an inv.ntory mad. by . ,him- .... , tho ..id co-administrator of tho .ntir. estat. of said d.c.d.nt, c.n.isting of all tho pers.nal pr.p.rty and rOIl ..tat., exc.pt r.al ..tat. .utsid. tho C.mmonw.alth .f P.nn.ylvania, and that tho figur.. .pp..it. .ach it.m .f tho Inv.nt.ry r.pr...nt it'l fair valu. .. .f tho dat. of d.c.dent'. d.ath. and .ub.crib.d bofor. m., 19 ~Q [, p.QJ1J\ Michael E.E~~~r.~d~~Mr~istrator 6 RiddlP...R.narl Camp Hill, PA 17011 Addr... Date of DOIth 04 Doy 02 Month 1994 V." INSTRUCTIONS I. An inv.nt.ry mUlt be fiI.d within throe m.nthl aft.r app.intm.nt.f p.".n.1 r.pres.ntativ.. 2. A luppl.m.nt inv.nt.ry mu.t b. fiI.d within thirty day. of disc.v.ry .f odditi.n.1 ....ts. 3. Additional Ihoets may be ottach.d .. to p.rl.nolty or r.alty 4. S.. Articl. IV, Fiduciari.. Act .f 1949. >- -.; . ... w . ~ a: ... I W ~ . ... u . 0 . QJ .. e w '" Q '" a: w .... ~ .... . :r ... u. .... .,; .It E .- oJ Z < 0 ~ .... ... .... . u. oJ 1:1; QJ:t W 0 < w i- :1:<( > Z a: r: Z 0 Q E " 'C - '" z t3 I <: a: .. 0 <( () ... III Z w ... ... r: - ~ ~ . - :J ~ . ..0 ... .... l>: . E . . . . " it . oJ U ... '-1.