HomeMy WebLinkAbout94-00271
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PETITION .'OR PROBATE Rnd GRANT OF I,ETTERS
EslaW of. .1ohannefl 'I'. IJ0!lfK~!1_______ No, ~ I - q '-1- .:< 7/
also know" as ___.________________.________ To:
----..--.-------.--.--- Rcglstcr of W!lIs}or thc d
__.____.____ _________, Dl'cl'used, County of CW1.JCr an In the
Social Seellr/ty No, ___12S-34-83f~_____ COnll110nwcultlt of Pennsylvania
The pelltlon of thc undcrsigued rcspcctfully rcprcscnts tllllt:
Your petltloner(s), who IS/llrC 18 YCllrs of 118C or oldcr IInthc cxccul.UL-_.
In thc IlIsl will of thc IIbovc dccedent, dilled _ Octolxn: 3L.
und codlcll(s) dated --.-----------.N/A
named
, 19-21-
(\lllte rclcyunl drl'lIlmllll\l:c~, c,g, rCllundnlloll, tlcnlh or C.IIeCUlor, CIC,)
Decendent was domlcllcd Ul dcuth III CwnlJCrlancl _ CounlY, Pennsylvania, with
h is last fumlly. or principal rcsldcnce IIt__\!ll....EnQh'lJiood, Cm"lis1e (North Midd]eton 'fWp)
CUmber1a~a~ounty,_Pennsylvanla __
(Ihl SHcct, Ilumber und 11I11l1cipalllY)
Decendent, then -r S~. YCllrs of agc, dlcd Febru~':Y...~_._, 19 94 _I
at Carlisle llosPlt'llL Carlisle, PA .
Except as follows, deccdcnt did notmurry, wus nOI divorccd and did not havc a child born or adopted
after execullon of the will offercd forprobule; wus not lhc vlcllm of II killing and was never adjudicated
Incompetenl: N/A __. ,
Decendent at dealh own cd propcrty with cstimatcd valucs as follows:
(If domiciled In Pa,) All pcrsonal propcrty
(If not domiciled In 1'11,) Personal propcrty in Pcnnsylvania
(If not domicil cd In Pa.) Pcrsonal propcrty in County
Valuc of real cstatc In Pennsylvania
situated as follows:
$ 1,000.00
$
$
$
WHEREFORE, petltloncr(s) rcspectfully
presented herewith and thc grant of lellers
theron.
requcst{s) the probate of the last will and codlcll(s)
'I'estan-entarv
(1e.llnm<ntarYI ndmlnlS!,nllnn <,La,; admlnlmallon d,b,n,<,l,a,)
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Agatha .1. Jansen
911 8n01a Rood
Carlisle, PA 17013
OATH OF PERSONAl, REPRESENTATIVE
COMMONWEAI,TH Oft' PENNSYLVANIA } I:lS
COUNTY Of' __ Cumber] and
Thc petltloncr(s) abovc-namcd swcar(s) or affirm(s) thut the stutcmcnts In thc foregoing pctltlon are
truc and correct to the best of thc knowlcdgc and bellcf of petltloner(s) and that as personal represen-
tutlvc(s) of the abovc decedcnt pet11Ioner(s) will wclland truly administer the estate according 10 law,
Sworn 10 or uffirmcd .and subscribed _ (.\~~,v ,\. );. O'v~
before mClhls 2ill-------~2~,~~ AQatli1.), .1ansen'
~_.;, "ell' ----I} 1.9 ~ 1/ ~U_ Eno]a HQ.'ld
J. ",:{LV(Q./~_~,'::L__f/.-,__ L" ;Y~lislD, P^ ] 7011
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No 21 . 94 - 271
.
. Estate of
JOHANNES T. JANSEN
I Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH ?:.!.o- _ 19~, In consideration of the petition on
the reverse side hereof, sRtlsfactory proof having been presented before me,
IT IS DECREED that the Instrument(s) dated October 3, 1991
described therein be admitted to probate and flied ofrecord as the last w\1l of ,TohannNl 'P: .1An~An
and Lellers Tcsti.1l1Pntary
are hereby granted to Agatha J, .1an~~._
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FEES
Probllte, Lellers, Etc. ",... . ,. S
Short Cerllflcatesl2 ), . , . , , . , .' S
Renunciation '...,,,""""" S
X-Pages S 36,00
JCP TO ~,uu
TAL _ S lili.gg
Plied ."".. .tMRCH. 2.1.. .199A , . , . , . . , . ,
~J:.. Shuqhart, Jr. 19373
ATTORNIlY (Sup, Cl. (,0, No,)
28 s, pitt Street, Cnr1isle, PA 17013
ADDRIlSS
(?l'1l 249-8300
PHONIl
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LAST WILL AND TESTAMENT OF
JOHANNES T. JANSEN
I, Johannas T. Jansen, of North Middleton Township,
Cumberland County, Pennsylvania, deolare this to be my last will
and Testament and revoke all Wills and COdioils previously made
by me,
ITEM Il I direct that my just debts, funsral expenses, and
the expenses of the administration of my estate, inoluding any
state, federal or other death taxes payable beclluse of my death,
shall be paid from my residuary estate as soon as practioable
after my decease, as a part of the expense of the administration
of my estate.
ITEM II: I devise and bequeath all of my estate of every
nature and wherever situate unto my wife, Agatha J. Jansen,
provided she shall survive me by thirty (30) days.
ITEM III: Should my said wife, Agatha J. Jansen, predecease
me or die on or before the thirtieth day fallowing my death, I
make the following specific bequests:
A. Unto my son, Robert J, Jansen, Mediterranean sofa,
two (2) Dutch chairs, two-channel stereo system, the yellow gold
18 kt 1 ct diamond brilliant aut Eternity ring and white gold
14 kt .400 at emerald cut diamond ring, provided he shall survive
me by thirty (30) days.
B. Unto my 80n, Peter T. Jansen, the Dutch blanket
ohest, Dutch olock, four-ohannel
stereo, ,~r~tem, and any~~o)))
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items of family jewelry, not otherwise specifically bequeathed,
to bo selected by my said Ron, provided he shall survive me by
thirty (30) days.
c. Unto Dana Baker, my son Peter's fiancee, the large
blue oval out sapphire ring, yellow gold 18 kt .250 ot brilliant
out diamond ring, yellow gold 18 kt wedding ring, yellow gold 14
kt blue sapphire necklaoe, and Bernina Sewing maching, provided
she shall survive me by thirty (30) days.
D. Unto Joke Jansen, my wife's oldest sister, the
18 kt yellow gold ring with single pearl, provided she shall
survive me by thirty (30) days.'
E. Unto Netty van stein, my wife's second oldest
sister, the yellow gold 14 kt .400 ot. brilliant cut tulip ring,
provided she shall survive me by thirty (30) days.
F. Unto Mieke Jaarsma, my wife's third oldest sister,
the yellow gold 14 kt amethyst and diamond ring, provided she
shall survive me by thirty (30) days.
G. Unto Anneke van Eeuwijk, my wife's youngest sister,
the yellow gold 14 kt sapphire ring, provided she shall survive
me by thirty (30) days.
H. Unto Veronique Jansen, Joke Jansen's daughter, the
yellow 14 kt gold necklace with single diamond cross, provided
she shall survive me by thirty (30) days.
I. Unto Saskia van Stein, Netty van stein's oldest
daughter, the yellow 14 kt gold emerald and diamond ring,
provided she survives me by thirty (30) days.
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J. Unto Susan van stein, Netty van stein's second
daughter, the yellow kt gold necklace with amethyst and diamond
pendant, provided she shall survive me by thirty (30) days.
K. Unto Nathalie Jaarsma, Mieke Jaarsma's daughter,
the yellow 14 kt gold nec~lace with flat gold crOBS, provided she
shall survive me by thirty (30) days.
L. Unto Ada Den Hartog, the Delfts Blue China,
provided she shall survive me by thirty (30) days.
M. Unto Irene Cromer, the Copper Candleholder
(20 inches) with candle (18 inches), provided she survives me by
thirty (30) days.
N. Unto my two SOliS, Robert J. Jansen and Peter T.
Jansen, all of my remaining clothing, personal effects, jewelry,
household furniture and furnishings, tools and equipment, books,
records and tapes, vehicles and other tangible personal property
of like nature, to be divided between them in as nearly equal
shares as possible as they shall agree, provided they, or either
of them, shall survive me by thirty (30) days. Should either of
my said sons predecease me or die on or before the thirtieth day
following my death, his share shall lapse and be added to the
share for my other son. Should my said sons be otherwise unable
to agree upon a division of tangible personal property between
them, it shall occur on the basis of alternating selection, my
eldest son, ~obert, to have the first selection,
ITEM IV: Should my said wife, Agatha J. Jansen, predecease
me or die on or befor.e the thirtieth day following my death, I
bequeath the sum of Twenty
Thousand ($2_0,.096.00) Dollars unt~'
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Trustee hereinafter named, IN TRUST, for the fOllowinq uses and
purposes and subjeot to the terms and oonditions hereinafter set
forth.
A. My Trustee shall expend upon my wife's mother,
Mrs. J. M. van Eeuwijk streng, for her health and medioal oare,
support and maintenanoe in reasonable oomfort so much of the
income and principal as my Trustee shall deem necessary, during
her lifetime. My Trustee shall have sole and absolute discretion
in determining whether such expenditures are reasonably
nocessary. My Trustee shall take into oonsideration all other
income and other resources available to the said life benefioiary
and shall expend inoome and principal for her benefit only to the
extent reasonably necessary to provide for her health and medical
oare, support and maintenance in x'easonable comfort. Any inoome
of the trust not so expended shall be paid in convenient
installments, not less frequently than quarter annually, in equal
shares unto my hereinafter named remainder beneficiaries.
B, Upon the death of my said wife's mother,
Mrs, J. M. van Eeuwijk streng, my Trustee shall pay Dver,
transfer, convey and distribute the then remaining principal and
inoome of the trust, discharged of trust, in equal shares unto my
two sons, Robert J. Jansen and Peter T. Jansen, Provided,
however, that should either of my said sons be deceased at the
time of the death of the life beneficiary, his share shall be
distributed to his issue, per stirpes, living on such date, and
in default of such then living issue, his share shall be added to
the share fer my other son or his then living issue.
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ITEM. V: Should my said wife Agatha J. Jansen predeoease me
or die on or before the thirtieth day fOllowing my death, I
bequeath the sum of Fifty Thousand ($50,000.00) Dollars unto my
Trustee hereinafter named, IN TRUST, for the following uses and
purposes and BUbject to the terms and conditions hereinafter set
forth:
A. My Trustee shall expend upon my two sons, Robert J.
Jansen and Peter T. Jansen, for their health and medioal oare,
support, maintenance in reasonable comfort and education so muoh
of the income and principal as my Trustee shall deem neoessary.
My Trustee shall take into consideration all other income and
other resources available to the said beneficiaries and shall
expend the income and principal for their benefit only to the
extent reasonably necessary to provide for their health and
medical oare, support, maintenance and reasonable comfort and
education. My Trustee shall have sole and absolute disoretion in
determining whether such expenditures are reasonably necessary.
Any inoome of the trust not so expended shall be paid in
oonvenient installments not less frequently than quarter annually
in equal shares unto my said sons.
B. When my youngest living son shall attain the age of
thirty (30) years, my Trustee shall pay over, transfer, convey
and distribute the then remaining principal and aocumulated
income of the Trust, discharged of trust, in equal shares unto my
two sons, Robert J. Jansen and Peter T. Jansen, provided,
however, that should ei thar of my said sons be deoeased at the
time of the death of distribution,
hiC'fl?a", shall be.dCr/7ted
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to his issue, per stirpes, living on such date, and in default of
suoh then living issue, his share shall be added to the share of
my other son or his then living issue.
ITEM VI: Should my said wife, Agatha J. Jansen, predecease
me, I devise our home and real property at 911 Enola Road,
Carlisle, North Middleton Township, Cumberland County,
Pennsylvania in equal sh~res unto my two sons, Robert J. Jansen
and Peter T. Jansen, provided, however, that the share of either.
of my said sons who predeceases me or dies on or before the
thirtieth day following my death shall be distributed to his
issue, per stirpes, living on the thirty-first day following my
death and in default of such then living issue, such share shall
be added to the share for my other son or his then living issue.
Provided further, that should either of my said sonp be residing
as a resident of the aforesaid household at the date of my death,
he shall be entitled to reside in the said household for a period
of two (2) years from the date of my death, upon payment of
taxes, insurance, utilities and general maintenance of the
household and property, reasonable wear and tear excepted,
without being required to pay any sum of rental to my other said
son, the right to partition to be postponed during such period of
possession.
ITEM VII: Should my said wife, Agatha J. Jansen, predecease
me or die on or before the thirty-first day following my death, I
devise and bequeath the rest, residue and remainder of my estate
of every nature and wherever situate in equal shares unto my two
sons, Robert J. Jansen and Peter T.
fn~,n;; provided,
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that the share of either of my said sons who predecease. maor
dies on or before the thirtieth day following my death .hall be
distributed to his issue, per stirpes, living on the thirty-first
day following my death and in default of suoh then living issue,
such Bhare shall be added to the share for my other son or hi.
then living issue.
ITEM VIII: I appoint Farmers Trust Company of Carlisle,
Pennsylvania, Trustee of the trusts created in Items IV and V
hereof.
ITEM IX: The following provisions shall apply to the Trusts
oreated under Items TV and V hereof, and to each share thereof:
A. PAYMENTS TO DISABLED BENEFICIARY. In oase the
inoome or any disoretionary payments of prinoipal beoome payable
to a minor, or to a person under. legal disability or to a per~on
not adjudioated inoompetent, but who, by reason of illness or
mental or physioal disability, is in the opinion of my Trustee
unable properly to administer such amounts, then suoh amounts
shall be paid out by my 'l'rustee in such of the following ways as
the Trustee shall deem best:
(1) Directly to such benefioiary;
(2) To the legally appointed guardian of such
beneficiary;
(3) To some relative or friend, exoept the
natural parent of any grandchild or issue of
any deceased son of mine, for the support,
health ann medioal care, and education of
such beneficiary; or ~I
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(4) By my Trustee, using suoh amounts directly
for suoh beneficiary'~ Rupport, health and
meQical care, anQ eQucation.
B. SPENDTHRIFT PROVISION. No beneficial intorest
under the Trusts, whether in income or prinoipal, shall be
subject to anticipation, assignment, pledge, sale or transfer in
any manner, nor shall any beneficiary have the power to
anticipate, encumber or charge such interest, nor shall such
interest, while in the possession of my Trustee, be liable for or
subject to the debts, contraots, obligations, liabilities or
torts of any beneficiary.
C. UNDISTRIBUTED INCOME. Any income, acorued or
undistributed at the termination of any estate or interest, shall
be paid by my Trustee as income to the persons entitled to the
next successive interest in the same proportions in which they
take such interest.
D. COMMON FUND. For convenience of administration
and investment, my Trustee is authorized to hold the several
shares of the TruRt as a common fund, dividing the income,
proportionately among them, to assign undivided interests to
the several shares and to make joint investments of the funds
belonging to my Trustee. For such purposes and insofar as may be
practicable, the Trustee may consolidate any separate share of
the Trusts with any other trust or trusts created by me or any
member of my family by will or agreement, and may hold,
administer and invest the several trusts as one or more common
fund or funds and make joint or severe- ~~~.t'i')bUtiOns..of ~~
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and principal thereof, whiohever my Trustee shall deem advisable.
ITEM Xl All fiduciaries acting under this Will, whether or
not namen heroin, shall have the following powera in addition to
those vested in them by the oommon law, by statute or by the
other provisions hereof, all of which shall be exercised in a
fiduciary oapacity, primarily in the interests of the
beneficiaries, applioable to all property, including property
held for minorlol, whet.her principal or income, exercisable without
oourt approval and effective until aotual distribution of all
property:
A. To retain and to hold any securities or other
property, real, personal or mixed, inoluding stock of my
corporate Trustee or an nffiliata, received from my estate
without regard to any principle of diversifioation or risk.
B. To invest and reinvest in all forms of property,
including stocks, bonds, funds and other securities, whether
operated by my corporate Trustee, its ~ffiliate or others,
without restriction to investments authorized for Pennsylvania
fiduciaries, as they shall deem proper without regard to any
principle of diversification or risk.
C. To sell at public or private sale, to exchange, or
to lease for any period of time any real or personal property,
and to give options for sales, exchanges or leases for such
prices and upon suoh terms and conditions as they shall deem
proper.
D.
To hold property in the name of the Trust oreated
in the name of my Trustee; ~i~~t deSignati~~
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hereunder, or
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any fiduoiary oapaoity, or in the na~e of a nominee, or
unregistered.
E. To allooate reoeipts and expenses to prinoipal or
inooma, or partly to eaoh, as they from time to time, in their
sole disoretion, shall think proper.
F. To vote in person or by proxy all seourities, and
to beoome a party to any stookholders' agreements deemed
advisable by them in oonneotion with suoh seourities.
G. To borrow money from any person or institution,
inoluding my oorporate Trustee or an affiliate, upon their bond
or promissory note, and to seoure the repayment thereof by
mortgaging, oreating a seo~rity interest in, pledging, or
otherwise enoumberi,ng any or all real or personal property as
they, in their sole disoretion, shall ohoose without regard to
the dispositive provisions of this Will.
H. To make any divisions or distributions required
hereunder, wholly or in part, in kind or in oash, and to make
nun-prorata distributions of assets in kind.
I. To exeroise any eleotion or privilege given by the
Federal tax and other tax laws, inoluding without limiting the
foregoing, the joinder with my said wife in filing inoome tax
returns, the eleotion of the alternate valuation for Federal
Estate tax purposes, the eleotion to olaim items of deduotion for
estate tax or for inoome tax purposes, and to make or not to make
equitable adjustments or apportionments for the exeroise or
nonexercise of any Auch election or privilege.
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J. Only after the deaths of either or both of lilY Baid
sons and should the principal of the Trust created hereunder be
or become too small so aD to make establishment or continuance
thereof inadvisable, my corporate Trustee, in its sole
disoretion, may make immediato distribution of the then remaining
balanoe of the principal and accumulated income outright to the
benefioiaries ther.eof in the same proportions in which they are
then entitled to share~, or portions of shares, of the Trust. If
any such beneficiary has not then attained the age of twenty-one
(21) years, my corporate Trustee may distribute such
beneficiary's share, or portion thereof, to the legally appointed
trustee of such beneficiary under Items IV(B) and/or V(BI hereof,
or may appoint and pay such share, or portion thereof, to a
custodian for such beneficiary under the Uniform Gifts to Minora
Act of any state, without further obligation or responsibility
for such distribution so paid. Upon such termination, the rights
of all persons who might otherwise have a successive interest
therein shall cease.
K. To compromise any claim or controversy.
ITEM XI: I appoint my wife, Agatha J. Jansen, Executrix of
,this my last will and Testament. Should my said wife fail to
qualify or cease to act as Executrix, I appoint my two sons,
Robert J. Jansen and Peter T. Jansen, Executors of this my last
Will and Testament.
ITEM XII: I direct that my Trustee and personal
representatives, as well as their suocessors, shall not be
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent I Sohannes T. Jansen
Date of Deathl
Febru~x..JA, 1994
Admin, No. 21-271 of 1994
Will No,
'ro the Register!
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to
the following benefic.laries of the above-captioned estate on
April 8, 1994 I
Name
Robert J. Jansen
Address
911 Bnola Road, Carlisle, PA IJU13
Peter T. Jansen
10807 Gambril Drive, No. 21, Manassas, VA 22110
Agatha .1. Jansen
911 Enola Road, Carlisle, PA 17013
NDtice has now been' given to all persons entitled thereto under
Rule 5.6(a) except
Datel April 8, 1994
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Name Dale F. Shughart, Jr.
Address 28 S. Pitt St., P.O. Box 208
Carlisle, PA 17013
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Telephone(711 249-8300
Capacity:
Personal Representative
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represent.ative
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NOTICE OF 9ENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF Cumberland , PENNSYLVANIA
In re Estate of Johannes T. Jansen
No. 21-271 of 1994
TOI Robert J. Jansen
911 Enola Road
Carlisle, PA 17013
, deceased,
(beneficiar.y)
(address)
Please take notice 01 the death of decedent and the grant of
letters to the person~l representative(s) named below, You may have
a beneficial interest in the estate as followSI
Date of death Feb~y 14. _1994
place of death Carlisle. PA 17011
County of grant of original letters Cumberland
Decedent died x
testat.e
intestate,
A copy of the will x is
is not attached.
Name(s)/ address(es) and telephone number(s) of all personal
representatives appointed
Name
Address
Telephone
Aqatha J. Jansen
911 Enola Road. Carlisle, PA 17013
249-1530
. '
'"
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF Cumberland , PENNSYLVANIA
In re Estate of Johannes T. Jansen
, deceased,
No. 21-271
of J:..994
TOI
Agatha J. Jansen
(beneficiary)
911 Enola Road (address)
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below. You may have
a beneficial interest in the estate as follows I
You are the sole beneficiary under your husband's Will. There are no
other heirs to his Estate.
(if additional space is needed, use back of page)
, Name of decedent Johannes T. Jansen
Last known address 911 Enola Road, Carlisle, PA
of decedent
Date of death February 14. 1994
Place of death Carlis le , PA 17013
County of grant of original letters Cumberland
Decedent. died x testata intestate,
A copy of the will x is
is not att.ached.
Name(s), addresB(es) and telephone number(s) of all personal
representatives appo1.nted
Name
Address
Telaphone
Aqatha J. Jansen
911 Enola Road. Carlisle. PA 17013
249-1530
Inventory of the real and personal estate of
JOIIANNF."l T" .JAN~I;:N t
deoeased
RFAL PROPEIm'
None.
PERSONAL PROPERT'i
t. Clothing and personal effects.
2. 1984 Volvo 760 Turbo Diesel sedan, valued in accordance
with attached appraisal of 1\I11ron Boltz, Manager,
Earl B. !:.ehnan.
3. Savings Account #022-303475,
FanrersTrust Carpany (Statement attached).
Principal
Interest
50. O'
1,500. 00
1,733 82
372
4. 1,713.0788 shares, Carlisle Co., Inc.,
Camon, NYSE
57,174. 00
Total personal property
60, 461. 54
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COMMONWIALTH 011 'INNSYLVANIA l
COUNTY 0. CUM.I.LAND J
III
Agatha J. Jansen
._._._______>___.__n _.~ ___>______.._~ -~_._. -.-.. - ...-.. .
sworn,_____. according to law, dopoles end "VI th.tS h.,__...iJ!_J:.~_lL______..__,..__ ---
]';xe,Q.U.tdlt________...___. 01 tho Estete 01 __J:Qhanne.a..:L-J.a~n..-------..._.-.-
l.t. 01 ________d.l>lorthd MJdd1eton Town.sh_~E..,__..___", Cumb.rl.nd County, P." d.o....d .nd th.t the
within Is an Inv.ntery made by ..fflll.tha..J.__Jaflfll'n -.. --.- .--_..,-, tho ..ld_..E:Keautrix___ ----"
01 the entire ell.te 01 laid deoedent, conllltlng 01 ell the perlonal prop~rty end r..1 estnt., lXoept r..1 ..t.te ouhlde
Ihe Commonw..lth 01 Pennlylvonla, nnd that the Ilguru oppollte each Item el the Inv.ntorv repr..ent lt'l lelr v.lu.
eI 01 the dete 01 decedent's death, a.~cJ;:.4 ~, '2s~
and lublorlbed belore me,
being dulV
19.. 94
.___..Agi\tl.1iLJ.._J.illlilQO
h...", , Ad..I.I,t,.",
_ _....Jl J1 EnQ!."..B.9<lL '.. ,...____ __d_" ___......
Car1is1c,PA 17013
..-------- ----------_.---,~---_.-....------- .~
Add""
Date 01 D..th __JJ____
DIY
Apr i l_____._.,_,__,~..i..___~___..____ ___"_'__'
M.nth YII'
INSTRUCTIONS
I, ,~n Inventory mUlt be flied within three monthl alter appoln1m.nt of plrlon.1 ,eprll.nt.tlve,
2, A luppl.ment Inventory mull be lIIed within thlrtv deYI 01 dllcovory 01 .ddltlon.1 ....h,
], Addltlonel Iheets may be attached 81 to plrlonalty or realtv
4, S.. A,tlcle IV, Flduclarl.. Aot 011949.
P.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
cOM~~~l~~tl-l~01(~~'Wa~ANIA (TO BE FILED IN DUPLICATE
IiARRISR~~1i,~~\j12l-O'" WITH REGISTER OF WILLS COUNTYCOOE
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OECEOENrS COMPLETE AOORESS
Jansen, Johannes T. 911 Enola Road
Carlisle, PA 17013
.
nEV~ HOO E)(" (11~81)
POR DATeS OF DEATH APUR 11'0" CHICKHIAE
IP A srOUSAL
POVERTY CREOIT IS CLAIMID
F11.E NUMBER
C P ALL CORRESPONDENCE AND CONFIDEHTlAL TAX INFORMATION SHOULD BE DIRECTED TO:
R ~ NAME COMPLETE MAILINO ADORESS
R D Dale F, Shu hart Jr, Es, Fowler. Addams, Shughart & Rundle
~ ~ TELEPIiONENUMBEA 28 South Pitt ~'et, ::1
- T 717 249.8300 Carlisle PA 17013
1, R.oJ EstAt. (Schedul. A) (I) None
2, Stock8lnd Bonds (Sch.dulo B) (2) 57 , 174 , 00
3. Clo80ly Held Stock/Partnorshlp Inlorost (Schodulo C) (3) None
4. Mortgagetl and Nolos Rocolvablo (Schedule D) (4) None
5, Cash, Bank Deposits & Mlscellan8<lus Personsl Property (5) 3 , 287 , 54
(Schedule E)
I, Jointly Owned Property (Schedulo F)
7. Translors (Schedule G) (Schedule L)
I, TotoJ Gross Assats (Iotalllnes 1-7)
8, Funoral Ewpen...., Admnlstratlve Cosls, Mlscellan8<lus
Ewpsn80ll (Schedule H)
10, Debls, Mortgage Uabllltles, liens (Schedule I)
11. TotoJ Deductions (tolalllnes 9 & 10)
12. Nst VoJue of EBtel. (line B mnus IIn. 11)
13, Charltabl. .nd Gov.rnmental Bequosts (Schedul. J)
14. Nst Valuo Sub ocl to Tax line 12 mnus IIn. 13)
15. Amount of line 14taxabl. at B% rato
(InclucW valuos Irom Schodule K or Schsdul. M,)
18, Amounl 01 line 141w<able at 15% ral.
(Include values from Schedul. K or Schodule M.)
17. Principal lax duo (Add tax Irom line 15 and from IIn.1B,)
11, Crodlls/Sp Poverty Prior Payments Discount
+ 2,517.87 + 132.52
18. Illlno 18 Is g,.ator than IIn. 17, .nt.r tho dlff.r.nc. on IIn. 19, This Is tho OVERPAYMENT.
IXI 0 ICheck hera " you ara raquaaUng I refund 01 your ovarpayment.1
20, If line 171a greal.r Ihan line lB, .ntor Iho diff.renc. on IIn. 20, This Is lho TAX DUE,
A, Entor lhe Int.rost on tho balance due on IIn. 20A.
B, Entpr the total of IIno 20 and 20A on IIn. 20B, This Is Iho BALANCE DUE.
Maka Check Pa able 10: R let.r 01 Willa A nt
. . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO Re,CHfCK MATH ~ ~
Un~" plnaltlll oj ptrJury, I dlcllr. that I hlVI lumln,d thl, /llurn, including accompanying loh.dulu and II.tlm,nU, and to thl bul of my knowl'dge and blli,t, 1llllru.,
eOll.oland compl'll, 1 d,cllnlhlt all ,,,'utl'l has bun ,.pOllld Itl'UI mllrklt Villi". O.clar.tlon of p,.p.", other thin thl p",ona' r.p"~.nl.Uv.I' baud on ,UlnformtUon 01
which pr.p.,., hit tny knowlldge.
I
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SOCIAL 9ECtJRITYNUMBER
195.34.8325
X 1. Original Return
Cumberland
o 3.
05,
04.
[]]I,
Ou.
07.
o B,
Umtod Estate
FuM. Inter..t Compromse
(lor datos 01 death aff.r 12-12,82)
Docodont Malntalnod a Uvlng Trust
(Attach a copy 01 Trust)
Docodent Died Testato
(Attach copy 01 Will)
R
E
C
A
p
I
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U
L
A
b
N
(8)
(7)
NO,riE\,
None
(9)
13,636,00
(10)
2,652.45
(15)
44,173,09
~
21- 94. 271
VEAR
IIUMBER
Rsmalnder Roturn
(lor dat.. of dealh prior to 12"13-82)
Fed.ral Estat. Tax
Return R.qulrod
Total Numbol 01 Sal. Deposit Bowes
'1
(8)
60 , 461. 54
(11)_
(12)
(13)
(14)
)( ,06 II
16,288.45
44,173.09
None
44,173,09
2,650,39
0,00 X.15a
0,00
(18)
c
o
M
C
T
A
b
N
Intarest
SIGNATURE Of PF.RSON RESPONSIBLE FOR FILING RETURN ADDRESS
q~~ .\, ~~
9i"i . Enoiii' R~iid"".'''''''''''' ...... ........ _...
carii~jie" 'PA" "i'7bi"j...... _.. ........ ........ _...
ADDRESS
f?"!~~!.,.. ~?A~~!'.,.. ~~.l!g\l!l.r:~.~. .~~!lA~~............
28 South Pitt Street
Ciiri i~jie ~. 'PA" DbY:i...... -......................
SIONATUAE OF P~ER OTHER THAN REPRE ENTAT1VE
o(pt2(. k5/~~.
Copyright (c) 18il1 lorm 101lwl,. only Clnl" Pilei SOftWArI, Inc,
(17)
2 ,650.39
(lB)
(19)
2,650,39
0.00
(20)
(20A)
(20B)
0,00
0,00
0.00
DATE
S-~-9~
DATE
()5!r'l
Form 1600 (A.v, 1 Hill
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I~ST WILL AND TESTAMENT OF
JOHANNES T. JANSEN
I, Johannes T. Jansen, of North Middleton Township,
Cumberland County, Pennsylvania, deolare this to be my last Will
and Testament and revoke all Wills and Codioils previously made
by me,
ITEM I: I direot that my just debts, funer'al expenses, and
the expenses of the administration of my estate, inoluding any
state, federal or other death taxes payable because of my death,
shall be paid from my residuary estate as soon as practioable
after my decease, as a part of the expense of the administration
of my estate.
ITEM II: I devise and bequeath all of my estate of every
nature and wherever situate unto my wife, Agatha J. Jansen,
provided she shall survive me by thirty (30) days.
ITEM III: Should my said wife, Agatha J. Jansen, predeoease
me or die on or before the thirtieth day following my death, I
make the fOllowing specific bequests:
11. Unto my son, Robert J. Jansen, Mediterranean sofa,
two (2) Dutch chairs, two-channel stereo system, the yellow gold
18 kt 1 ct diamond brilliant cut Eternity ring and white gold
14 kt .400 ct emerald cut diamond ring, provided he shall survive
me by thirty (30) days,
B. Unto my son, Peter T. Jansen, the Dutch blanket
chest, Dutch clock, four-channel
stereo, ~~_)tern,
(, ' ,
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tlnd any two (2)
...- ('-~/)
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items of family jewelry, not otherwise specifically bequeathed,
to be selected by my said son, provided he shall survive me by
thirty (30) days.
C. Unto Dana Baker, my son Peter's fianoee, the large
blue oval out sapphire ring, yellow gold 18 kt .250 ot brilliant
out diamond ring / yellow gold 18 kt wedding ring, yellow gold 14
kt blue sapphire necklace/ and Bernina sewing roaching, provided
she shall survive me by thirty (30) days.
D. unto Joke Jansen, my wife's oldest ,sister, the
18 kt yellow gold ring with single pearl, provided she shall
survive me by thirty (30) days.
E. unto Netty van stein, my wife's second oldest
sister, the yellow gold 14 kt .400 ct. brilliant cut tulip ring,
provided she shall survive me by thirty (30) days.
F. Unto I!ieke Jaarsma / my wife's third oldest sister,
the yellow gold 14 kt amethyst and diamond ring, provided she
shall survive me by thirty (30) days.
G. Unto Anneke van Eeuwijk, my wife'S youngest sister,
the yellow gold 14 kt sapphire ring, provided she shall survive
me by thirty (30) days.
II. Unto veronique Jansen, Joke Jansen's daughter, the
yellow 14 kt gold necklace with single diamond cross, provided
she shall survive me by thirty (30) days.
I. Unto Saskia van stein, Netty van stein's oldest
daughter, the yellow 14 kt gold emerald and diamond ring,
provided she survives me by thirty (30) days.
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J. Unto Susan van stein, Netty van steinls seoond
daughter, the yellow kt gold neoklace with amethyst and diamond
pendant, provided she shall survive me by thirty (30) days.
K. Unto Nathalie Jaarsma, Mieke Jaarsma's daughter,
the yellow 14 kt gold necklace with flat gold oross, provided she
shall survive me by thirty (30) days.
L. Unto Ada Den Hartog, the Delfts Blue China,
provided she shall survive me by thirty (30) days.
M. Unto Irene Cromer, the Copper Candleholder
(20 inches) with candle (18 inches), provided she survives me by
thirty (30) days.
N. Unto my two sons, Robert J. Jansen and Peter T.
Jansen, all of my remaining clothing, personal effects, jewelry,
household furniture and furnishings, tools and equipment, books,
reoords and tapes, vehicles and other tangible personal property
of like nature, to be divided between them in as nearly equal
shares as possible as they shall agree, provided they, or either
of them, shall survive me by thirty (30) days. Should either of
my said sons predecease me or die on or before the thirtieth day
following my death, his share shall lapse and be added to the
share for my other son. Should my said sons be otherwise unable
to agree upon a division ~f tangible personal property between
them, it shall occur on the basis of alternating selection, my
eldest son, Robert, to have the first selection.
ITEM IV: Should my said wife, Agatha J. Jansen, predecease
me or die on or before the thirtieth day following my death, I
bequeath the sum of Twenty 'fhousand
($~~~~,OO) Dollars u~~o ~
(;;..' ,-..- ( //
) " !e',........., ( ')' !.....i,~
I' -
Trustee hereinafter named, IN TRUST, for the following uses and
purposes and subjeot to the terms and oonditions hereinafter set
forth.
A. My Trustee shall expend upon my wife's mother,
Mrs. J. M. van Eeuwijk streng, for her health and medical care,
support and maintenance in reasonable comfort so much of the
income and principal as my Trustee shall deem necessary, during
her lifetime. My Trustee shall have sole and absolute discretion
in determining whether such expenditures are reasonably
necessary. My Trustee shall take into oonsideration all other
inoome and other resources available to the said life beneficiary
and shall expend income and principal for her benefit only to the
extent reasonably necessary to provide for her health and medical
care, support and maintenance in reasonable comfort. Any income
of the trust not so expended shall be paid in convenient
installments, not less frequently than quarter annually, in equal
shares unto my hereinafter named remainder beneficiaries.
B. Upon the death of my said wife1s mother,
Mrs. J. M. van Eeuwijk streng, my Trustee shall pay over,
transfer, convey and distribute the then remaining principal and
income of the trust, dischar.ged of trust, in equal shares unto my
two sons, Robert J, Jansen and Peter T. Jansen. Provided,
however, that should either of my said sons be deceased at the
time of the death of the life beneficiary, his shar.e shall be
distributed to his issue, per stirpes, living on such date, and
in default of such then living issue, his share shall be added to
the share for my other son or his then livJ~~ issue.
,,-- / '
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ITEM V: Should my said wlfe Agatha J. Jansen predecease me
or die on or before the thirtieth day following my death, I
bequeath the sum of Fifty Thousand (050,000.00) Dollars unto my
Trustee hereinafter named, IN TRUST, for the following uses and
purposes and subject to the terms and conditions hereinafter set
forth:
A. My Trustee shall expend upon my two sons, Robert J.
JansAn and Peter T. Jansen, for their health and medical care,
support, maintenance in reasonable comfort and eduoation so much
of the income and prinoipal as my Trustee shall deem necessary.
My Trustee shall take into consideration all other income and
other resouroes available to the said benefioiaries and shall
expend the income and principal for their benefit only to the
extent reasonably necessary to provide for their health and
medical care, support, maintenance and reasonable comfort and
education. My Trustee Dhall have sole and absolute discretion in
determining whether such expenditures are reasonably necessary.
Any inoome of the trust not so expended shall bo paid in
oonvenient installments not less frequently than quarter annually
in equal shares unto my said sons.
B. When my youngest living son shall attain the age of
thirty (30) years, my Trustee shall pay over, transfer, convey
and distribute the then remaining principal and accumulated
income of the Trust, discharged of trust, in equal shares unto my
two sons, Robert J. Jansen and Peter T, Jansen, provided,
however, that should either of my said SOilS be deceased at the
time of the death of distribution,
hiss~~ry shall be
(,;'1 Z
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distributed
('/)
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to his issue, per stirpes, living on such date, and in default of
suoh then living issue, his share shall be added to the share of
my other son or his then living issue.
ITEM VII Should my said wife, Agatha J. Jansen, predeoease
me, I devise our home and real property at 911 Enola Road,
Ca~lisle, North Middleton Township, Cumberland County,
Pennsylvania in equal shares unto my two sons, Robert J. Jansen
and Peter T. Jansen, provided, however, that the share of either
of my said sons who predeceases me or dies on or before the
thirtieth day following my death shall be distributed to his
issue, per stirpes, living on the thirtY-first day following my
death and in default of such then living issue, such share shall
be added to the share for my other son or his then living issue.
Provided further, that should either of my said sons be residing
as a resident of the aforesaid household at the date of my death,
he shall be entitled to reside in the said household for a period
of two (2) years from the date of my death, upon payment of
taxes, insurance, utilities and general maintenance of the
household and pr.operty, reasonable wear and tear excepted,
without being required to pay any sum of rental to my other said
son, the right to partition to be postponed during such period of
possession.
ITEM VII: Should my said wife, Agatha J. Jansen, predecease
me or die on or before the thirty-first day following my death, I
devise and bequeath the rest, residue and remainder of my estate
of every nature and wherever situate in equal shares unto my two
sons, Robert J. Jansen and Peter T.
can~~J provided,
0' t?,L,_,- 7-
I
howev'7J
C-/ /
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/ -
that the share of either of my said sons who pr.edeceasea me or
dies on or befcre the thirtieth day fOllcwing my death shall be
distributed to his issue, per stirpes, living on tho thirty-first
day following my doath and in default of such then living issue,
such share shall be added to the share for my other son or his
then living issue.
ITEM VIII: I appoint Farmers Trust Company of carlisle,
Pennsylvania, Trustee of the trusts cr~ated in Items IV and V
hereof.
ITEM IX: The following provisions shall apply to the Trusts
created under Items IV and V hereof, and to each share thereof:
A. PAYMENTS TO DISABLED BENEFICIARY. In case the
income or any discretionary payments of principal become payable
to a minor, or to a person under legal disability or to a person
not adjudicated incompetent, but who, by reason of illness or
mental or physical disability, is in the opinion of my Trustee
unable properly to administer such amounts, then such amounts
shall be paid out by my Trustee in such of the following ways as
the Trustee shall deem best:
(1) Directly to such beneficiary;
(2) To the legally appointed guardian of such
beneficiary;
(3) To some relative or friend, except the
natural parent of any grandchild or issue of
any deceased son of mine, for the support,
health and medical care, and education of
such beneficiary;
(-,,/)
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(4) By my Trustee, using such amounts directly
for such beneficiary's support, health and
medical care, and education.
B. SPENDTHRIFT PROVISION. No beneficial interest
under the Trusts, whether in income or principal, shall be
subject to anticipation, assignment, pledge, sale or transfer in
any manner, nor shall any beneHciary have the power to
anticipate, encumber or charge such interest, nor shall such
interest, while in the possession of my Trustee, be liable for or
subject to the debts, contracts, obligations, liabilities or
torts of any beneficiary.
C. UNDISTRIBUTED INCOME. Any income, accrued or
undistributed at the termination of any estate or interest, shall
be paid by my Trustee as income to the persons entitled to the
next successive interest in the same proportions in which they
take such interest.
D. COMMON FUND. For convenience of administration
and investment, my Trustee is authoriz~d to hold the several
shares of the Trust as a common fund, dividing the income
proportionately among them, to assign undivided interests to
the several shares and to make joint investments of the funds
belonging to my Trustee. For such purposes and insofar as may be
practicable, the ~'rustee may consolidate any separate share of
the Trusts with any other trust or trusts created by me or any
member of my family by will or agreement, and may hold,
administer and invest the several trusts as one or more common
fund or funds and make joint or severt~/~~tf)butiO:;-.O(~~
f~~-"-"" L ;r-,...~
l /
(4) By my Trustee, using such amounts directly
for such beneficiary's support, heelth and
medical care, and education.
B. SPENDTHRIFT PROVISION. No beneficial interest
under the Trusts, whether in income or principal, shall be
subject to anticipation, assignment, pledge, sale or transfer in
any manner, nor shall any beneficiary have the power to
anticipate, encumber or charge such interest, nor shall such
interest, while in the possession of my Trustee, be liable for or
subject to the debts, contracts, obligations, liabilities or
torts of any beneficiary.
C. UNDISTRIBUTED INCOME. Any income, accrued or
undistributed at the termination of any estate or interest, shall
be paid by my Truste.e as income to the persons entitled to the
next successive interest in the same proportions in which they
take such interest.
D. COMMON FUND. For convenience of. administration
and investment, my Trustee is authorized to hold the several
shares of the Trust as a oommon fund, dividing the income
proportionately among them, to assign undivided interests to
the several shares and to make joint investments of the funds
belonging to my Trustee. For such purposes and insofar as may be
practicable, the Trustee may consolidate any separate share of
the Trusts with any other trust or trusts created by me or any
member of my family by will or agreement, and may hold,
administer and invest the several trusts as one or more common
fund or funds and make joint or
severe ~~,t'rJbutionsHo(~~/9j
- 1-""~ L-"...... y Yt.--..~
f' /'
and prinoipal thereof, whichever my Trustee shall deem advisable.
ITEM X, All fiduoiaries acting under this will, whether or
not named herein, shall have the following powers in addition to
, those vested in them by the oommon law, by statute or by the
other provisions hereof, all of which shall be exercised in a
fiduciary capacity, primarily in the interests of the
benef j,ciaries, applicable to all property, including property
held for minors, whether principal or income, exercisable without
court approval and effective until actual distribution of all
property:
A. To retain and to hold any securities or other
property, real, personal or mixed, including stock of my
corporate Trustee or an affiliate, received from my estate
without regard to any principle of diversification or risk.
B. To invest and reinvest in all forms of property,
inoluding stocks, bonds, funds and other securities, whether
operated by my corporate Trustee, its affiliate or others,
without restriction to investments authorized for Pennsylvania
fiduciaries, as they shall deem proper without regard to any
principle of diversification or risk.
C. To sell at public or private sale, to exchange, or
to lease for any period of time any real or personal property,
and to give options for sales, exchanges or leases for such
prices and upon such terms and conditions as they shall deem
proper.
D.
To hold property in the name of the Trust created
in the name of my Trustees ~it ~t designatio~o~
( C'-~l~-.-- 7- Q~
/
hereunder, or
any fiduoiary oapaoity, or in the name of a nomineo, or
unregistered.
E. To allocate reoeipts and expensos to prinoipal or
inoome, or partly to eaoh, as they from time to time, in their
sole disoretion, shall think proper.
F. To vote in person or by proxy all securities, and
to become a party to any stockholders' agreements deemed
advisable by them in connection with such securities.
G. To borrow money from any person or institution,
including my corporate Trustee or an affiliate, upon their bond
or promissory note, and to secure the repayment thereof by
mortgaging, creating a security intereet in, pledging, or
otherwise encumbering any or all real or personal property as
they, in their sole discretion, ohall choose without r(1gard to
the dispositive provisions of this Will.
H. To make any divisions or distributions required
hereunder, wholly or in part, in kind or in cash, and to make
non-prorata distributions of assets in kind.
I. To exercise any election or privilege given by the
Federal tax and other tax laws, including without limiting the
foregoing, the joinder with my said wife in filing income tax
returns, the election of the alternate valuation for Federal
Estate tax purposes, the election to claim items of deduction for
estate t~x or for income tax purposes, and to make or not to make
equitable adjustments or apportionments for the exercise or
nonexercise of any such election or privilege,
C-, //
u-1-~ C
I
'1-
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~//'
.~
J. Only after the deaths of either or both of my said
sons and should the prinoipal of the Trust oreated hereunder be
or beoome too small so as to make establishment or oontinuanoe
thereof inadvisable, my oorporate Trustee, in its sole
disoretion, may make immediate distribution of the then remaininq
balanoe of the prinoipal and aooumulated inoome outright to the
benefioiaries thereof in the same proportions in whioh they are
then entitled to shares, or portions of shares, of the Trust. If
any such beneficiary has not then attained the age of twenty-one
(21) years, my oorporate Trustee may distribute such
benefioiary's ahare, or portion thereof, to the legally appointed
trustee of such benefioiary under Items IV(B) and/or V(B) hereof,
or may appoint and pay suoh share, or portion thereof, to a
oustodian for such beneficiary under the Uniform Gifts to Minors
Act of any state, without further obligation or responsibility
for suoh distribution so paid. Upon such termination, the riqhts
of all persons who might otherwise have a successive interest
therein shall cease.
K. To compromise any claim or controversy.
ITEM XI: I appoint my wtfe, Agatha J. Jansen, Exeoutrix of
this my last will and Testament. Should my said wife fail to
qualify or oease to act as Executrix, I appoint my two sons,
Robert J. Jansen and Petel' T. Jansen, Executors of this my last
Will and Testament.
ITEM XII: I direct that my Trustee and personal
representatives, as well as their suooessors, shall not be
cL
j/
'1"
....:.."
i
,
I
,
I
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.---.........-..,.....,....-. ,"'-
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t:.-
RIIV-11147 ElC AFP (10-93*
COI'IOIl\lUL I" Of PEHHlVLVANU
OlPARlHENI OF REVENUE
RURUU OF INDIVIDUAL TANEI
HPI. lIUDI
HARRlllURQ, PA 1712..0601
/1{-- /11- 10
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF OEDUCTIONS, ANO ASSESSHENT OF TAX
ACN 101
DATI 09-15-94
DATI OF DIATH 02-14-94 m~T~O. CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO yOUR ACCOUNT, SUIHIT THE UPPER PORTION OF THIS PORN HITH YOUR TAX
PAY"ENT TO THE REBUTER OF WILLS, HAXE CHECK PAyABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT Tal
DALE F SHUAHART JR ESQ
FOWLER ETAL
28 S PITT ST
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
1-
Anunt R..I Ued
-
CUT ALONG THXS LINE .. RETAXN LOWER PORTION FOR YOUR RECORDS ~
iiiV: i54""" iinFP' "iiii:93T"tliific3i"-ciF"'iNliiififAiici"YAx-A'lijiil A'iliiiiitl'f;-ALt"OWANCi-oR'---..mm.._...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAlC
JOHANNES T PILE NO. 21 94"0271 ACN 101
ESTATE OF JANSEN
,
07-13-94
DATI
TAX RETURN WAS, (X I ACCEPTED AS FILED
C I CHANGED
RESERVATION CONCERNXhO FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF Rr.TURN BASED aNI ORIGINAL RETURN
1. R..l ..bt.. ~ :;h;dule A) II I
2. Stock. .nd lond. (Sohedule II C21
5, Clo.ely Held Stock/Pertner.hlp Inl.re.t (Sohedule CI (51
~, "orto.se./Notel Recelveble CSch.dul. 01 C~I
S, Ce.h/lonk Depollh/Hho. P.rIOMI Property (Sohedule EI (II
6. Jointly Owned Prop.rty CSchedul. II C61
7. Trenlf.rl (Sch.dule 01 (71
8. Tot.l A..etl
~.,(:oo
57.174.00
.00
.00
3,28Lli .
.00
.00
(81
',i,!
60,461. 54
, APPROVED DIlDUCTlONS AND ElCEMPTlONSI
9. Funer.l ENpenl.I/A4nlnlltretlve COlt.1
"hoell_ou. ENp.nl.. CSohedule HI ('I 13,636.00
10. Debh/Hortlleoe LIIlbIUUe./Lhnl ISohedule II 1101 2,652.45
11. Totel Deduction. (Ill
12, Net Vel"" of TeN Return 1121
15, Cherlteble/Oovern..nbl aeque.1I (Schedule JI IUI
l~, Net Velue of Eobb Subject to TeN ll~ I
NOTE: If In ......m.nt wa. i..uld pr.viau.ly, lin.. 14, 111 Ind/or 16 and 17 will
refl.ot figur.. that inolud. ~h. tot.l of ~ return. .......d to dlt..
ASSESSMENT OF TAlCl
11. AlIOunt of Line I~ +aNebh et 6Yo nle ClII 44,173.09 X,06 . 2,650.39
16. A.ounl of L Ine l~ +aNebh et l&Yo rite 116 I . 00 X, 11 . . 00
17. Prlnolpll TeN Due (17) 2,650.39
TAlC CREDITS I
PAY"ENT
DATE
'I,
16,288,45
44,173,09
,00
44, 173. 09
RECEIPT
NUNIER
DISCOUNT It I
INTEREST (-I
A"OUNT PAID
05-05-94
886041
132.52
2,517.87
TOTAL TAlC CREDIT
BALANCE OF TAlC DUE
INTBRI8T
TOTAL DUE
2,650,39
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVER'E
FOR CALCULATION OF ADDITIONAL INTERE'T.
( IF TOTAL DUE IS LESS THAN el, NO PAYHENT rs REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAV IE DUI
A REFUND, SEE REVERSE SIDE OF THIS FORll POR INSTRUCTIONS,)
"
,
"
, ,
"
R!IIRYATION. E.toto. .f dooodint. d~lng on or bofor. DoolObor 12, 19'1 .. If on~ futuro Int.r..t In tho o.t.to I. tron.f.rr.d
In pa.....ion or .nJoVMnt to elll. I (coll.t,,..O btntflol.rl.. of thl dtCMen' aU,r thl tl{plr.Uon of My ..t.t. 'or
l1f. or for v..r., thl C~~.lth her.by .kPr...lv r...rv.. thl rllht to Ippr..I. and ...... tr,n'f." InherltlnGl T'.I'
It the 1twful ell.. . (Cloll...rl1) nt. on InV IUOh future In'tr.'''
:,
I
P\lR1lOI( Of'
NOTICE I To fulftll thl requlrl.."t. of S.otlon ZI~O of the InherltlnGe end E,t.t. TIM Aot, Act 2Z of 1991. 72 P.'.
Iootlon 21~0.
Plmtl!,
R!fUND (CRll
\i
:i D'J!iCTlON.,
i
IDIlIN
ISTRITlYf
, I CORRl!CTI DNS I
DISCOUNT'
INTlR!'!,
DelICh thl top portion of thll Notlo, .nd cub.lt with your Ply..nt to the AI,I,.,,. of Will. prlnt.d on thl r.v.r.. .Id.,
--Nell. chook or 0"', ordor p"lblo to' REaISTER aF MILLS, AaENT
All plv..nts rlc.llltd ,hill fir.' b. .ppUId to ,"'lInt"... which ..., be due ..Hh anv rOl.I~r IPPll.d to thl hiM.
A r.fund of . t'M cr.dlt, which wa. not r.~.ttd on the 'IK Rlturn, ..v bl reque.tld bV oOlplltlng In ".ppllcltlon
'or RI'1oM of Plnnlvl","I. Inherltancl II\d E.tltl Till" (AEY~UU)' ApPl101tJon. .rl '''.Ilable .t till O"ICII
of thl Rlgllt.r of tHl1., MY of the 2J R.vlnU4I DlItrlct O"ICII, or by c.ll1111 thl 'JHlcl.l Z4~hour
anl..lrlnl IIr"lc. nueblr. 'or for.. ord.rlnll In Penn.vlv.nll 1"100~S6Z~Z050, outsldl Ptnnul"."I. Ind
within l~II Hlrrlsburg Irl, (717) 7'7.a09~, TOOl (717) 77Z~ZZSZ (HI.rlnt IlPllrld Onlv).
Any plrtv In Interllt not ..thfl.d with thl appr.I....nt, alloM,"ol or dllllloWlnol of deduction., or ......Mnt
0' 'IM (Includlnl dl.count or Int.,..t) .. .hown on thl. No'lc~ IU.t obJlct wlthl~ .Iwtv (60) d.v. of rlcllpt of
thll NoUal bVI
....written protll' to thl PA Dlptrt"nt of re.".nut, Bo.rd 0' APPllll, DEPr. 211021, H.rrhburl, PA 17U.~lOZ1, OR
.....Iectlon to hi'" thl ..tt.r dlt.r.lned .t IUdlt 0' the acrount of thl Plr.on.1 repr..lnt.tlvl, OR
.....ppul to tht Orphan.' Court.
Feotutl .rror. dllaa".r.d on thl. ........nt .hould bt Iddr"'erl In wrlttnt tal PA Dtplrtaent of R.venue,
lur.1U 0' Indt~ldu.1 T'w", ATTNI Pa.t A.......nt RI"II" Unit, DEPT. 280601, H.rrl.burg, PA 17128~O'OI
Phone (717) 7'7~6S0', SI. p.g. 3 of the bookl.t "Inltructlon. for Inhlrltanal ,.w Rlturn 'or I R..Ident
Dtoedlnt" (REY-IS01) far In .wpllnltlon 0' ~lnl.trltl".ly corr.ct.bl. Irror..
If toy tlX due II plld within thrH (1) c.llhdtr INM1th. "fter the d'''ldtnt'. d..th, . fI,,1 percant (1:<) dluount of
the taw Plld 11 alloNtd.
Jnt.r..t II ohlrlld blglnnlng with flr.t dlw of ~11nquenow, or nlnt (9) aont~. end ani (1) dlY 'r~ thl dlt. of
d..th, to thl dlt, of plv..nt. 'IKII which b.e... delinquent blfora Jenuarv 1, 1982 bltr Inter..t .t thl rat. of
11M (6K) p.rc.nt p.r annu. a.lout_ted .t . dlllv r.t. of .000164. All t.w.. whlah ble... delinquent on and .ftlr
Januer~ 1, l'U will bllr Inter..t .t . nt. which will vlry frol Clllnder Vllr to Olhodtr Vllr with thlt ratl
aMounOld by tha PA o.,tlrtMnt of Ravll'lUI. The applJotbla lnter..t rat.. 'or 1982 through 1994 ""
Yo!!! Inter'lt R.t. DIllv Int"..t Fletor ~ Jnter..t Rlt. D.II~ Int.r..t F.otor
1911 20:( .010541 19" IIX ,111m
19U 16X .IIO~JI 1911 9X ,111m
I9I~ lIIi .nlSII 1911-1991 IIX .110m
1915 ISX ,IIIS56 1992 9X .llom
I99Hffi IX .110192
....Intlrllt I. cIloul.t.d .. follow. I
IKTERElT . .ALANCE aF TAX UNPAID X NUKlER OF DAV. DELINQUENT X DAILV INTEREST FACTOR
....An~ NoUc. llIued Ifter the t.w beC'OIt. de1Jnqu4K\t Mill l'aU.ot 1M Inttr..t o.loulltlon to flU"" (11) dII~'
bevond thl dtta of the ........"t. If Plvant 11 1161 1ft" thl lnter..t coeput.Uon d.t. .hown on the
NoUn, ItddIUonl1 lntor..t .ult be ctlaullted.