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..
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THEREFORE, petitioner(s) respectfully request(s) the gram of letters of administration in the
appropriate form to the undersigned.
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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
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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
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, '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.
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.... 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
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I fill NUMB.R
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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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
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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
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761-3459
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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
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( 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
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OAff
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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_
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I~V.U1U" 12.1T!
L
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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
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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.
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