HomeMy WebLinkAbout94-00410
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IJI':T1TION FOR IJRO"ATI~ und GRANT ell<' LETTERS
&/CI(I' of QI:Jtfl.C/<"/tu" .l... (/[1' ~~j!ll':t No, .. .. ...P?l~_9-'1-:-.JftJJ.___
CI/SO klloll'lI CIS "",... u To:
__.m_..'.."" He~lsler of Wills for Ihe
............_...u .. , n,.c,'(/.\'('(/, Couulyof ,C,.,"llnI'Kl,!!.'tQ Iu Ihe
SodClI St"'II/'i/,\' No, ,c..L-(lJ:=/C.'::!;ilJ'i/ COlIIlI\ouwelllth of l'euusylvlIulll
The pelitlou of Ihe uudersigued respeclfully repre,lellls Ihlll:
YOIII' pelltlouer(s). II'hols/arl' lH Yl'ars of IIge 01' older IIl1lhe eXCcUI/.\L".._._'_._._...__I1I1I11Cd
111 the lasl will of thc ahol'l' deCl'dl'UI, dall'd ..u,_.J'.J~tL_..,...I.'..i-_._.__~..____, 19~
IInd l'odlcll(s) dlltedliQd l., . ... ..____ uu....._u,.".____.'u_.________
- ---.--..---. ...- .-.--..--..--..-.---.------<
(~IUll' rl'll'\'HIlI dri.'H1mllllli.'I.'\. l'.~. rcnulldnllllll, dl',llh of I'\Cl'lllOr, cle,)
IJel'l'udeul WIlS dOluldlcd lit delllh lu._.,......,.."c....llod.LU:'/.!:/nd,...u COUl1ly, I'cnl1sylvllnlll, with
11.E.K,.,., lasl faulily or prluciplll rl'sldu)'ee III 3::l!L~!f'~I::!'.:i__.jJJL",,__.tlIJ/, 'l J-.?>
j}Je.c..H"'rf.j~c!.j1, ,}.('0 .. u ._,;"d l '-it<j:.5 ..J,':(;';('t'/...../u!.t~. 7 U' 'JI)
tlhl 'lrcl'l, IIlllllhl'l ulId l1lundllillllY)
lJeeeudeut. II\e~1 ... I'.}... years of IIge, lIil'd., __..._n_...n_Jij'R.LI:.____ cl..L.. 19_? 'I _.
III u.lJobV~.v I..~ i 'J /"/ o~ I';!}j 1,.:.. u. -.---..-.- . ---...-----------,
Fxcepllls follows. dll'cdeUI did UOllllllrry. \\'as UOI dll'orced llulI did uol hlll'l' II child 0011I or IIdoplcd
IIfler l',\eellllol1 of Ihe will ollered for prooule; was l1olthl' I'lcllm of U killing IIl1d \l'IIS nevcr udjlllliculed
incolllpl'tenl: . III (\. " ,,' .,.. ,..,.."".-.,..."-,.---,,.-,,---... .
Deel'udcUI ul dealh oWllcd pl'Opert)' wilh l'sllllluled I'llhll'S liS rollows:
(If domiciled In I'a,) Allpl'rsolllll property
(If 1101 domiciled ill I'a,) l'ersou,llproperty 111 Pel1l1syll'al1iu
(If 1lnl domiciled iul'a,) l'ersol1l1lproperty 111 COUIIIY
Value of real eslale illl'l'l1l1wll'al1la
situall'd as folloll's: ,t] Ir'l, , ....
-'1-1 . /.P
$.~I.t!r?~._
L____
$ .-
$------
WIIEREI'OIW. pl'liliol1er(s) respl'cifully rl'quest(s) Ihe pwollte of the IlIst will lIud eodlell(s)
presel1led herewith al1d Ihl' gral1l of lellcrs,2:.r~Ed":.~.~:Y__________
, (lC'IIUllCIlIHr)'; lIt1mlnhtrntlnn ~,l,il,; lIdmlnlslnlllun d,h.il.c.l.n,)
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.._...___.___..._n____'.__ _ _~_.____._._...___.____.__~___n.
OATH (W PERSONAL REPRESENTATIVE
COMMONWEAI:I'II OJ! I'ENNSYLV ANIA } HH
COlJNn' OJ! ....CU~BJRLffi{L_.___.____._. "
The petilhl1er(s) ahOl'l'.u.lllled swl'ar(s) llluffirlll(s) thullhe stllll'lIIel1ls 111 the foregoing pellllon IIfC
true Umll'UlleCI 10 Ihl' hest ,,1'111<' kl10wledge aud helieI' or 1'l'llllol1l'r(s) IIl1d Will liS !,ersonlll reprcsen-
lutil'l'(s) or Ihl' ahol'l' dm'denl l'elillol1l'l(s) will well alld Irllly adlllil1lsler Ihe eSIIlI(' ueeordln~ 10 IIIII',
'_)
sworn. 10 or 1I..nlrinC'd. and. sllhscr.ihl'd ~.._.t_.~,(:t'L...l"\"~('4C.'/J..Lo.&.1t..<._. _. ~
before IIll' IhiUJ 281 H . dllY (If _ '_ ..u__/,.'........,_.,____."
lHI.~14lfl,Jf-'H\1',,;JI'-Jj0~lw, ,'<~ ..... ..u. .., ..~:=.:::~=-.-~-=::: I
MAR(,c. LEWIS !lcgis/,'/". (j .H._.'_m____ ~
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INHERITANCE TAX RETURN
RESIDENT DeCEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
'/
1. Roal Ellalo (Schodulo AI I II
2, Slack, and Bond. (Schodulo B) I 21 '
3, Clo,oly Hold SIock/Par/northlp Inloro"ISchodulo q I 31
4, Mo'Igago, and Nole. Recolvable ISchodule 01 I 41 .
5, Calh, Bank Oopo.lt. & Mhcollaneou. Po"onal Prope"yl 51 '
ISchodulo Ej
6, Jolnlly Owned Propo'ly ISchodule FI
7, Tranlfo" (Schodule G) (Schodule li
8, Tolol G,on Ane" Ilolalllno. 1.71
9, Funeral Expen.es, Admin"I,allve COlli, Mlscellaneou. ( 9)
Expon... ISchedule H)
10, Oebll, Morlgoge lIablllllel, lions (Schedulo I)
11. T 0101 Oeducllo". 110101 line. 9 & 1 0)
12, Nel Value 01 Ellalolllne 8 mlnu.llno II}
13, Charllablo and Governmenlal BoquO'lIlSchodulo J)
____ 14, Nel Value Sub loci 10 Tax IlIno 12 mlnu.llne 131
15, Amounl of IIno 14 la.ablo 01 6% ralo
Ilncludo value. from Schodulo K or Schodulo M,I
16, Amounl of IIno 14 la.able 01 15% ralo
IIncludo voluOl f,om Schodulo K or Schodulo M,)
17, Principal lox due (Add lax/rom Ilno 15 and from Ilno 16,1
18, C,odll. Spou.ol Pavorly Crodll Prior Paymonl'
""-...------...---- + -,-.... + .
19, If IIno 18l'g,ea'or Ihon IIno 1:', enler Ihe dlffe,onco on IIno 1<', Thl, i.lho OVEAPAYMEI~T,
m[l
20, If IIno 17 I, g,ealer Ihan IIno 18, enler Iho dlfferenco on IIn. 20, Thl, il Iho TAX DUE,
A, Enle' Ihe Inlore.1 on Ihe balanco duo on line 20A.
8, Enlo' Ihe 1010101 Ilno 20 and 20A on IIno 208, Thl, l'lho 8ALANCE DUE,
Mak. Chock Payabl. tOI R.gl.t" of Will., Ag.at
'---==::--.;. U SURI TO ANIWIRALL Q,/E'snoNscONREVF.RSISIDIAND TO REC:HECKcMATH."=-=:-c===
- ~-- -
Undor penaltlel of perjury, I declare IhOl1 have examined Ihh return, IncludIng accompanying ,dl0dulo, Clod stalomonh, and 10 lho bOil 01 m~ knowledge and belief,
1111 true, correel and complete. I declare Ihal 011 real ollale has boon reportod ollruo n1mkol vClluo. DoclorCltlon 01 pr(tflCHor olhor than Ihlt perianal roprelenlallve II
baled on olllnformollon of which preparor hos any knowledge.
fONA~ji[,OFPE~!ON.R(~;;iitE:~~'~:~G~;;~~;~79r~{S~inding Hill Rd.. He~haniclbU~g- fiAf(~~-~;~~;;---
~#t.rfft~;td~ammfiroiW-.J":A'tr,msnn- .. Pa. 17055liAff . __._.____
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'OR DATlSO'DIA'HAnlA 12/31/91 CHICKHIU
If A SPOUSAL
POVIATY CUDI' 15 CLAIMID 0
PILI NUMiii"----------'-.--'-.--
PI No 2194-0410
YEAR NUM8ER
'\
.1;1;-,1'9.
"\"'. \.
;r 'Jr
COMMONWEAltH or PfNNSYl VANIA
DEPARTMENT QI !!VENUE
DEPl. 280601
_. __._..~ HARR!S8URO, PA 11128.0601
1994-00410
COUNTY CODE
- fNi's'cOM'pl-ii'i--A[lDRf'SS-
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," MI
A
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335 Welley Drive, Apt. 323
Mechaniclburg, PI. 17055
MESSIMER, CATHERINE R.
!:;~~;U~'~~~;B _=_~~-=:~~{;~7~~-.r~E50;~~~11 Co.,""
Li 1. Original Relurn 1>:1 2, Supplomonlol Rolurn
r ) 4, Llmltod Ellal. 'I 40, Fuluro Inlo,o.1 Comproml.o
Ifor dOlO' of dualh olio, 12,12.821
II 6, Oecodenl Died Te.lol. II 7, Oocodonl Malnlainod " Living Tru,l
(Alloch copy of Willi IAllach copy of T ru,ll
ALL CORRESPONDINCI AND CONPIDENTIAL TAX iNloR-MATIONSHOULDBE.DIRECrEDTOI--'n.----.
NAM~ --------- ..-.----- w;i;ffii-rTr,iXAiuNOAoo1fss----
CumbwrlllncL .. .________..__._
113, Romaindor Ro'urn
1'0' dole, 01 doolh prio, 10 12.13.821
I 15, Fodoral E,'nlo To.
Rolu,n R.qulrod
._,8, Tolal Numb., 01 Safe Depa.1t Bo.e.
DORIS J. KAUFFMAN
TI[fptlONnruMm----.------u----n----...-.-....- -.-.--- ------
701 E. Winding Hill Rd.
Mechlnic8bur~ h Fa. 17055
~Lll'h=1-.~..6JlI1...
__.~._.__. ..__..__..______ '___ _.. _. __.___ _'n
_._._______.._.._.._____ ___.___.. _..___ .____ _._..__.___m
z
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00
00
00
00
28,726.52
, I
I 61
171
( 8) _.J~.t1.26. ~____
...279.65.._._...._
(IO) n_____'~_~_n.__._._
(II) _.._2..'l.Lll________
(12) _ _.__.___
(13) ...
'_.n' ____.__..n__.___..____,_!.!~.::_:U,446..8+-
(151 un-2B,446.B.7.-nn-..'..X ,06 = ,---l'f'+Oi-.-8-l----.---.-
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1161
x ,15 =
(17)
.1,706.-i 1..-.. -------
Discount
Inter!)lt
(18)
(19) .
Check here if vou nrffrNIUe\tinu (I refund of vour ovorpnymcnl.
1, 7.Q~. El~
(20)
(20AI
120BI .
1,706.81.
_.----.._~----------_._.~_._-~.-~._-- .- ..- _..----
IIV.UI) Ihl).l71
W
COMMONWrALIH o. ,hHUflVMlIA
INHIIIIANCI tAlC IIIUIN
IlItO~'!'91C10IN'
SCHEDULE J
BENEFICIARIES
1
,
I'
+ _ ..+_ ..~.4_+_'+','__""
-
ESTATE OF
MESSIMER/ C~THERJNE R.
FILE NUMBER
1994-00410 P~ NO. 2194-0410
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
._._- ----------_..-_.._.~-+--
AMOUNT OR
SHARE OF 1ST A TE
RELATIONSHIP
1.
A. TaKable Be~uOI": One t'i tth
Lillian Stouffer
801~ S. Market St. Hechdnicsburg, Pa,
17055
2.
Elmer V. Radab~u~h
3031 S W Lucftrne Port St. Lucie, Fl
34953
3.
Doris J. Kauffman
701 E. Winding Htl1 Rd. M~chanicoburg
Pa. 17055
4.
Earl ~. Radabaugh
1223 Bridga St., Nuw eumbBrldnd, Pa.
17070
DlIughter
Son
Daughter
Son
5. Paul F. Messimer, Jr. Step-Son
510 Lewisberry Rd. / Now CJumberland/ Pa,
17076
ITEM
NUMBER
NAME AND ADDRESS OF BENIPICIARY
B, Cha,lIablo and Govornmonlal BoquOIII:
1.
$5/348.01
One t'i fth
$5/348.01
One t'ifth
$5.348101
One fifth
$5.348.01
One fifth
:5/348.02
AMOUNT OR
SHARE Of ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o enle' on IIno 13, Rocapllulallonl S
-----------.----
(II more Ipoce II n..ded, Inll/I ~ddi,l;nallho;j; of la..;;;i;~'--- ----------
,f1IY,I!Oflllt.12.ll1
~~t J SCHEDULEE:l
~ CASH, BANK DEPOSITS AND
COMMONWIAllH m PINNmVANI~ ' MISCELLANEOUS
INHmltrN~'Jtc~mNIN . PERSONAL PROPERTY Plea.e Print or Typ.
ESTATE OF - FILE NUMBER
MESSIMER, CAHTERINE R. NQ 1994-00410 PA NO. 2194-0410
IAII p.....rty lolntly_nld with thl ~llht of Survlvonhlp mu.t bl dlnlolld on Schldull PI
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OP DEATH
$ 2,457.26
120.10
25,000.00
131.17
92.16
63.60
205.75
26.64
555.00
74.84
1. Closing old Checking account to Estate account
2. Deposit Interest check trom CD 53-A31272
3. Transter 3 CD A31273,A31272,A00026C to Estate
chscking account.
4. Interest earned on above deposited
5. State Farm Insurance re~und check.
6. Blue Cross/Blue Shield Retund check.
7. Retund trom Prepaid Funeral trom Musselman
Funeral Home
8. Retund trom Bethany Towers Security Deposit ot
50.00 tess 4 days rent
9/. Value of Log on personal belongings given away
Interest earned cheCking account
Ouote psr telephone Mrs. Baker !ftlY 26
TOTAL (~llo 8ntl/ on IIn. 5, RlcapltulallonL S 28 . 726 . 52
{Allach .ddlilon.1 81\" H 11" .h..i1lf more ,po" It n..dld,1
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r^k~ df '(eia~~--'~;5;;:;~k-J!';~li';i,';_'~ r! ,. I" ".80.B2/313
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CIIY Pi STAll!
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@) Mollon 80';;00":' 00""'" ~"";." """""., ',0"':'-: ':[7716.
li:;.'"):.... II P JJP !;J ~,'fd.Y ' I d":!) i
f.{;~qqoooo~ 881, 2oo?1, HII' . (, \ / ·
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"'~f";""""f'i"'o.a" 'Y',,,,',. "1'''','''-_ _, ."0., .
'."'~ I" , .,....,; '1,0:. ;\!. ' . '1" . ,'~ f ' " . \ '. , ,
' , '\' - f . u ~',,' ,'" II., II' ".:,. , ",.' .t.'
M.!!on Bank, N,A. 60.821313
lfam.bullI. PA 17108
"~~ ~ ."^..~.",.<.,I"""." ...,....".,.,,; " :""'.~,'''''''''','''''' . ,.~,
"":'fo- ""t"P;'.~-,'l~'1"~'~~?p'~rr~"~'T\ :;; , " ",.:...,<,~.l':""':"" '., I .
~r
,r~,~':f\~_7r~,~~""r',f~",)F~,r"C'~"'''f'' ", . -,
04-29-94
to !h.
ordcr
or
r
CATHERINE R MESSIMER
335 WESLEY DR APT 323
MECHANICSBURG PA 17055-3565
130 ~~S120.1000
0000229 ~~~
(I
1I'21,1,~28~1I' l:oH~0082~1: DOt. 281,005811'
Aulhoril.d SIi1\Klura
----- ----
'h''''',_~__,,~____________.. _____..____ _... .
--------.-.-....... ....-...
CATHERINE R, MESSIMER
335 WESLEY OR,. APT, 323
MECHANICSBURG, PA 17055
j(
~ 1931
~ /tJ 19 9~ 1{I.Il/ll!
"
I. $ al'S'57.;l.(..
t;;). ~.bL/ iJM >k~?,~ /~/; 0'0..1.[ a r I
{b Mellon Sa ? '7 T1"
Mcllon8.ntN,,",, ~
Hlrrhburlo p,", ACCOUNT"
~~ C& ~~-?l/~ ~~ .
3 c.. D IS ,S) I tJ J ~(J c-:e. ::-:? .&~
/ 5c)()tJ "t; ED
It-. (/; .., 11? /,,',,/,,7.'.,"". /,1'.
~~,J J>-~~1:j'f)
PayfOlhe
order 01,
\,
....... .-
,..., t" - '\'1: ~.
t:,
Capllal Blue Croes
Pennsylvania Blue Shield
Capital BI~e Cross
Ctl(CI( NUMOOn
,ii'
" ' : HARRISBURG, PA" ,17177 '
.' _I" ,:
1880,84"
"
"1". \.:" HI
RE~UND REASON 1
iI,'1
1,1,.
..: III 'It ,'"
'. '1'."
. I , I I ~ I '. i I I , I , ' I
, i'I}"1
'I'j",'-fl:,'.:' 11',.","
'",,"'."., 1/
, ~ I I I I I ~ ',: l' I 'j 1 1 ' I 1
......................... EXPlANAiION~~F REFUND ..................*......
'./ ',--11"1 01,' ;1 ,,'
,I". "II lilll.'.1 Ill' I, Ii 'I
FROMI 05/0'1/,9.4",:: TOI06/01/94
""j,"''I'" "".1 ';'1
,1';.";;11'1'" 'i/ i,III'
CANCELL:EDDECEI\SE1t: ,,: : 'i ,
" >,",;, "
EST OF CATHERINE MESSIMER
335 WESLEY DR AP.T 323
I'lECHANICSBURG PA 17055-356/i'"
5~
"
'III',:,
'f 1,1:
'AGREEMENT NUMBER
203108088
", .1"
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I),.
"
..,
" ,)
, "
"
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,
, IL./.
"~
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PERIOD OF REFUND
ii"
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......)...,:." ,
:', "'t'..ll"'. ,.,:!..I'
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111.1,11,11 fll' 'j I
:,':",,:.' '",
" I ,
,
II. '
:'
TVPE, OF COVERAGE 1
, S'ECURITV 65
l
REFUND AMOUNT 1
-
1';"'1
$63.60
,
"1"
,,'
TOT At::' REF,UND: AMOUNT 1
'I:)' ") '-:'!ll,'lljll'!I!!
' ," ~ I.', : I; : ~ " I "
IiI' 'IIII.:!I.III..'
I U3.60
l
.' J.~~,I., ,:~~~....l~. , .
,,'.
, ",
"
CNlllllon
rovcr'Claldo
Transaction Codcl
Acccunt Number
IIccclpt Date
Number
"
'"
"
14,1884020('747
414022049 OS/25/94
t63,60
'"
:,
,
,
. : I . ! ' , ~ : ;: r
~'iQ. 0::> ',.
~"""'11';;~ ~~+~~
,:'" ,-, I' ,
,p" , I,t', I) '"
,I,j'
T11'lOJI Rev, (9,<11) L,C, (4N1) PO 3N4
',1
'ill
"
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1"'1
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1l.lV.1Slllhl1.tll
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES PI.al. Print or Tvp.
-I fiLE ~UMBIR
_._~94-00410 Pa N/). 2194-0410
~~
COMMONWIAlTH Of P1NNiYlVANIA
INHIIITANCITAX mUIN
I!SIDINT DICID!Nl
Bro. o.
MESSIMER, CATHERINE R.
ITEM
NUMBER
A. Funeral bp.n"ll
B.
DESCRIPTION
AMOUNT
1.
Funeral WftR prQpaid - 88e Item #7 Schedule E
Money retunded and deposited to E8tate.
1,
Admlnlltratlv. COltll
Personol Reprellnlatlve Commllllonl
Social Security Number of Personol Rep/lllentotlV81
Yeor Commllllonl paid
2. Attorney Feel N A
3, Family Exemption
Claimant Relotlonlhlp
Addrell of Claimant at decedent'l death
Slreet Addrell .
4,
C.
1.
2,
3,
4,
5.
6.
7,
8,
City
Slate
Zip Code
Probate Feel
Regi8ter ot Wills
Mlle.llan,oul bp.nll"
Cumberland Law Journal to advertise E8tate
The Patriot Newa to advertioe Estate
P08tage
Dr. Sullivan tinal bill Not covered by BCaS
Final Telephone Bill at apt.
Final Bethany Towera Billing Food Serv 3/21-4/20/94
TOTAL lAlla enter on line 9, Recapitulation) $
(If mall Ipac. II n..d.d, Inll" additional Ih.... of lam. III'.)
77.00
40.00
45.53
5.50
9.48
13.34
88.80
2"/9.65
~'\<\ '
,\ I
c/
CUMBERLAND LAW dOURNRL
11, ERST HIGH STREET
CRRLlSLE, PR 17013
. June 3. 1994
Cumberland Law Journal is published every Friday by the
Cumberland County Bar Association and is designated by the Court of
Common Pleas as the official legal publication of Cumberland County
and the legal newspaper for publication of legal notices.
TO: Doris J. Kauffman
------------------------------------------------------
RE: Catherine R. Messimer, ESTATE
------------------------------...---------------------
"
Legal advertisemel:ts must be received by Monday Noon. All
legal advertising must be paid in advance, Make all checks payable.
to: Cumberland Law Journal.
====================================~~======================='
Advertisement inserted on following dates:
MAY 20, 27, JUNE 3, 1994
Advertising Cost
$ 40,00
$ 0.00
$ 40.00 c.f: 1/1
....-.............
$ 0,00
---------
---------
Proof of publication
Payment received
Total Amount Due
o 5/1 6 94
Paymentreceived___'"'______. 19_____
by
Note: Your cancelled check will serve as a receipt. However, if you
.', desire a receipted bill please furnish a self-addressed stamped
envelope.
00 . .
Proof of Publication of Notite in The Patriot and The Evening News
~ rr and The Sunday Patriot-News
Undor Ad No, 1181, IIrprol'od ~I.y 1ft, IlI2O,
Com momvealtll of Pennsylvania, }
COlmty of Dal/pllin RR:
Michael Morrow bid I II t I w d and say'
""10....'................,,,...............,,,,,,.......................,,,,,,,,,,.,,,,... 0 nR' U Y 8worn accorc ng 0 a , eposea 8.
Asst. Controller
That he Is the ,,,,,,,,,,,,,,,,,,,,,,,,,,,,of THE PATRIOT - NEWS CO" a corporation organized and existing
under the laws of the Commonwealth of Penns)'lvanla, with Its principal office and place of business at
812 to 818 Marllet Street, In the City of Harrlqburg, County of Dauphin, State of Pennsylvania, owner
and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT. NEWS
newspapers of general circulation, printed and published at 812 to 818 Market Street, In the City,
County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY
PATRIOT-NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th,
1949, respectively, and all have been continuously published ever since;
That the printed notlc~ or publication which Is securely attached hereto Is exactly ss printed and
Metro l'le!Jt 17th, 24th, and 31st
published In their regular!edllfons ano Issues which appeared on the ,,,,,,,,,,,,,,,,,,,,,,,,,,,....,,.,,,,,,,,,,,,,,,,,,,,,,,,
days of May 19j4.
..................",.,.,..............'........0...........,.....,...............,,,,...,............,.,,......,,,....,,.,,,.,,,..........."...".......,.,,,..,..,,,..,.,,,,,,,..,.,,
That neither he nor said Company is Interested In the subject matter of said printed notice or adver.
tlslng, and that all of the allegations of this statement as to the time, place and character of publlcatlon
are true; and
That he has personal knowledge of the facts aforesaid and Is duly authorized and empowered to
verify this statement on behalf of The Patriot-News Co, a oreRald by virtue and purRuant to a resolu-
tion unanimously passed and adopted severally by the s ckhmlde nd board of dlr~ctors of the said
Company and subsequently duly rC\lorded In th~ office f ~. h Ree (~~s in and for sRld Count)'
of Dauphin in :\I1.celllocou, nook "M", Volume 101, Plgc,'/ . ['0 )0t,/1 /' ." ')
Copy of Notice or Publlcatlon """,,",,,"" '" , . ;,?L'\"""""'''''''\''''''':7t.'':'''7t.j;7(.''''''''''''''
Swo to and!subsl:rlb befbre Il)e thJR~J,ti,t.",,,,,,,day of
J 199 '/ y'/-.d .' /Y., / '" J //..'
""""" """" ' , y? I {, {<,<?' C(.
T emma! ~..r0..-:,..(.."i; '''l,~.:>,;\t..r{.....f:hr;(;...(,',:,::,
HOlry L, u!l.lal NotarY Puhlic I NotaT'l/ Public ---,,-
u/lllb g, 7lufihio COUnly )'
AW .~ ~,fl"la9!J" ......,.,......,,,..,.,,,,.,.
~,f'9rr'eyMrtl~~~
Statement 01 ADvertising Costs
BXBCUTAU('I NOTICI
Illot, at Call1,rln. A, Mllllm.r
L.II"ITnlomenloryon Ih. Etlol,OIColh.r.
1M R. Menlmtr, lole 01 Lower AlI'n Townthlp,
Cumbtrlond Counly, Pennlylvonla hoy, bun
gronled 10 III. undtttlllnet1, All !)tltanl knowing
It\fm..lvtllo b.lndebl,d 10 laid Etlale or. re.
(luultd 10 mo~. 1m medial. pavmenl, and lho..
having clalml wltl pre"nl th.m, wlthouldtlov.lor
"Illemenllo:
DorltJ,KollHman
7011. Wlndln, Hili R60d
Mec!\OIIIClbllr,. PA HW
1)p',F.A.~., .~.,....,.~,~M~.~m~,J.l"..",.,.,.., ,.,.,.",..."..,........'".."
Mechanicsburg, PA. 17055
.......",,,,,...,.,,.,,,.,,..,.,,,..,...,....,..,,,,,..,.,,,.....'"",..'....,..
To THE PATRIOT-NEWS CO" Dr,
For publishing the notice or publication attached hereto on the
44.53
above stated dates - $""...".....""",.......
1. 00
Probating same """"'4'g':'~'3""'"
Total .',."".".,..,..".....,...
Publisher's Receipt for Advertising Costs
THE PATRIOT-NEWS CO" l'ub1iRher of THE PATRIOT and THE EVENING NEWS and the
SUNDAY PATRIOT-NEWS, newspapers of general circulation, hel'eby acknowledR'o receIpt of the
aforesaid notice and publication costs and certifies that the same have baen duly paid,
TilE PATRIOT-NI':WS CO,
Ry ,...,'.,..,......,...""".,.,...""",.'"...,.,..,,,,".."",.,.""",."".,..
S,1\k " ,
. @Bell Atlantic
/I (.)
, ,
"/,,
This Information Is required by the Pub/.lc Utility Commission. "Basic"
service Includes the line charge, local, calling and TOUCH TONE service
(If applicable). "Non-Basic" service Includes optional services, other
than TOUCH TONE, such as I.Q. Services, Maintenance agreement for
Inside wire and Gual'dlan and does not Include toll slll'vlces.
. ~'. I',
...,_....-~t1.I"'e~m\limJ.l...1~____".
rage 2 of 11
'J17 795-0193-892 2Y
"'~"
, ,
May 13, 1994
__ ~'H'''11111
Past Due CUI'I'ent Totals
Ba lances Charges
BASIC $12.84 $ -5.34 $7.50
TOLL $1.58 $4.26* $5.84
NON- BASIC $.00 $.00* $.00
TOTALS $14.42 $ -1. 08 $13.34
The following pages provide additional billing details.
* (Inclyd(ls.BeILAliant . " ,\'" ,',' ,~o.~p-!!~~~er(~4)"p'har.ges,)
, '\:~I~:'.",:.hh),'ll~,:t.II. .' 9~ ,
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'::11"1' '::1" I::' '1'::'(',1::' I'll .,
'It, ...... ."1,, ..,1 'I_ .,,1 ""
80.82/313
..__.MI'l ~._J ~,_n___19.9_'f
PAY
I 6~~~~ OF.~~l...l,. ., I:tTJ...rtfi:i".'-~n~_PJI.."_____________n_..________ n .,. -' $1~.g1
! "11:\!R::tt.t:._tL.:J)_db-I,.."f:\.I<.c;._:=-tJ-,!'i~--:::__J 1,,&1>0 _..__________.... __ n,.,,_ _n., DO~~,." ,
@ M,~~~,~~ank
C'_'IUlIlW"I~"&loll
Uurithl1,'^
, '~"'l4IUIllroW"-'~::\i,-
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E:'~1'11t ~~ CIl,.\H.l!il'/i1. 'it 1'l\e.'OSI/l1!'.€
1)UI" J.I<.wp".",,,.,., e)(~c...ffi",
'/0/ e, WII'fOln, 14111 1<...".1
me.c.Il'l,tl '""'bv.c, I PA l'lor,:
V,
FOR EirllJL-_'lr,!/Jlbfl r(tlc;.._'l.17~-'l.$:!lj!1~3.&. 0\ Y
1:0 ~ U008 nl: 881,
DJ~/~?~
~ IJ '. 11.. L/.." ~~~~!._____..___..____
~-(F._.Ll-~-I-~:~-
20071, Hili
,1'000000 ~ ~ ~ 1""
'~-::~f.-:~:~!'!~;'l\lICMW-_"''!.. ~..::'~";~-:.t'!l~I9'Na:::U
11""
....,:~.~e.!'~._~~.."'.;-'.1ll:Wml.:-:..,.~~.AIl~,.,"!,.:.."'*'ea'/,::.~,,~:...
@ Bell Atlantic
'"
.'(
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II ,)L/_ /
cewD~~Y~JUr,.c'JU,Il_,__.
Please make paYment to Bell Atlantil;,:fA
,and return..!1tLi._r2.ilge wi th Y..2Jn:...R.a..y.!llllll1
Due Immodlately
Page 1 of 11
717 795-0193-892 2Y
---~'QJt1
May 13, 1994
--
-
-
-
. ..1...... "11" I.. I 1'1
$13.34
-
Fill In Amount Paid
CATHERINE R tv'CSSIM::R
701 E WINDING HILL RD
/!fCHANICSBURG PA 17055-4995
1.,.111,..111.",1.1..1.1.,1..11.1"1,1...1.1,11.,..,,1/,1..11
$ 00.[]0
P.O. Box 28000
Lehigh Vly PA 18002-8000
,;,..,,,.,,, ....... .".,~":'If,':""""'''.','''".~..:,...u;u.-.u.-.:...~......._....',,, .'..' "';....._~" '..' ".*'".''' '..' '.....~._~,. .... ".,.'",
....,:"~:s ~'~I" ;i)'p..
~q,.H'l. R\/'(t.,. R.l'r\e...:.lms,e.
11)1 e, Word il'/:) .JJ j 1/ 'Rd
/J/CO/l/911';<I ~b".e.5 Pfl ObSS
'.... .._(-~,~'..;".._..l..:u,,~.
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""'." .'
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PAY . .:<if)~<J':,:.
Ii. ,6~m OF 'jje-t:.Iift.Ny._-:- CcJ..~e..~ .... ::~';~,> ~::.. . :::.' ,
I 1:'. u. ~ ~. I r ",:I1:~o.<,::'" ..
. _~._Ul.CL1:J ~ 111-'1__. .. . "'.'.' '. '", . ,
'i7"";;j" ..~ oI'. ........... I'~.." ",
t:'iA II B k ., "d' .... .......... ..... . :, . "
{b Me on an .', ,,:>....~;:''^ :::;-:;". '",',
~~~~""~j". .. ::',;;,>~:,:.:::,~~:-::~,~~,::<, SsrlJTE ~p C'/Jr/l.UJlit!!. ~. mess/me-I!-'
mtl9;.s .5":$:Y"~ #00.:10 ':':,.r.,~?t::Y9;:;:~:~:::-'.:,::;/.J'.A..;~ (), ~JL ex~c~2L-
FOral}:!r/J.1:.~.l4t-I/;1.sS('.nJi:.g., '::" ,'.. ':,:, :-~ ::.':;', ':"~-r../j~r""u,,~- ... ...
11VT!l).~ .: II: o:n':~r:j(j'a:2':~'!:;;a'B4:200? 1, ? ~II'
" . . ',.. ." ......': '~,,,,."'. "" ." "" '... ...
-". - .,..., - "'.....~_.--...~Ice~!~~,:;!.!:_~ ~.....-.: .
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__ J!!.!.~..-,_'f lo.2i 60.82/313
<_ el'o' .." """I
-~._.-----.---.-._-I ,j;; t.!..,,-::..,_ _ J
~o/.
,- /ltJ" _.._,____''___ ._DOLLARS
..
.."..
;/ ',.
(I .',
BETHANY TOWERS
335 WESLEY DRIVE
MECHANICSBURG, PA 17055
RESIDENT'S MONTHLY STATEMENT
.s
APT #323 NAME. . .Messimer, Catherine R,
MONTHLY RENTAL FEE FOR MAY~I', ' . i/cu.r' ___, $ :r9'B.~'6"'" ,",
" " .' ,,~{) ~ ' ""
~.~.....~., / 0 ,,~~- "c:. '~oo._.. . .:ii.1!i?
(-MEALS SERVED BETWEEN 3/21 .;di20--==~:-:>)~=-@-:$' 3. 'JO /'.. -8ii':8~
....."-.... ',.. '-J~- W""""""MM_.~. _:......_--..~"","~
- /?' ,,~~ii.L: :=-,- 0 o-
f C:: G )., rJ1) J..~v~pWI ..
" s' U'1-~~ ~\. PJ-Itf "
. / Ia (0.,/
'~ ("t- :---- WI
~p;.'
~l.~ "'1-"
@$-,-
@ $ ..--,,--
..~. ,~.:
~ ,.'
@ $
'l'OTAL AMOUNT DUE AS OF MAY
1, 1994
~ AtE \,
$ an:bu
-
''''', I ~ .....~" ........' .
",1, "
'.'i''''
'I' ,
. . ','
", ,',
.., .;~ /1 . I
REV-1547 EX AFP (08-94*
COMHOHWfAlTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAMES
DEPT. 210601
HARRISBURO, PA 11111'0601
!STAT! OF MESSIMER CA FILE NO.
DAT! OF DEATH 04-24-94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TD YDUR ACCDUNT. SUBHIT THE UP~~R PORTION OF THIS FORH WITH YOUR TAM
PAYHENT TO THE REGISTER OF WULS, HAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TOI
,((Or;
Q,
NOTICE OF INHERITANCE TAM
APPRAISEHENT. ALLOWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
AON
101
DAT! 11-2B-94
DORIS J KAUFFMAN
701 E WINDING HILL RD
MECHANICS8URG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
f--- ~';ount Ho"ltl~d
CUT ALONO THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: is'4"j" ix"" AFP" -r 08-:94)" .Noi'-ici" -oF" i"NHiifii' ANCii" YA'X" 'A"PPR'A"i s i'lfiNT ~ --Ai. l"oiiANCii. iiri -......."" - - - -"..
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF MESSIMER CATHERINE R FILl! NO. 21 94-0410 AON 101 DAT! 11-28-94
TAK RETURN WAS I (X I ACCEPTEO AS FILED
( ) CHANOED
RESERVATION CONCERNING FUTURE INTEREST - SPoE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. R.ol Eotete ISoh.d"lo Al (ll
2. Stook. ond Bond. (Sohodub 81 (2)
S. Clo.oly ntld SlooL/Portnor.hlp Inloro.t ISohodulo Cl ISl
4. Hortaogo./Noto. R.oolvoblo (Sohodulo DI (4)
5. Co.h/80nk Dopo.II./H1.0. P.r.on.l Proporty (Sohodulo fiJ 151
6. JolntlY Ownod Prop.rty ISohodulo FI (61
7. Tron.f.r. ISoh.dul. 01 (11
a, Totol A..oto
,00
,00
,00
.00
28,726.52
...Q.2.
.00
(8)
28.726,52
APPROVED DEDUCTIONS AND EXEMPTIONS I 279.65
9, Fun.rol Ewpon.o./Ad", Co.t./HI.o, Ewpon... ISoh.dulo HI (9)
10. D.bto/Hortgogo Llob1l1UOI/L1.n. (Soh.dule II (lOI ,00
11. Totel Doduotlon. (111
12. Nott Voluo of T.w Roturn 1121 _
IS. ChorltebloIOo..rn"ontel 800uOlto ISohodulo Jl (151
14, Nott Voluo of E.toto Subjoo~ to T.. (14)
NOTEI If In ft..eBuMBnt WI' i..uld previou.ly, lina. 14/ 15 and/or 16, 17 and 18 will
reflect figure. that includ. the totll of abh r.turn. a.....ed to dlte.
ASSESSMENT OF TAXI
15, Allount of Lino 14 01 Spounl roto 1151
16. Aoount of Llno 14 t.woblo ot Llnool/Clo.. A roto 1161
11. Anount of Llno 14 towoblo ot Collot.rol/Cloo. B rot. (17)
la. Prlnolpol Tow Du.
?7Q ,;.e;
28.446,87
,00
26.446,87
.00 K .00,
28.446.87 K .06,
....:!Q. K ' 1 5,
118)
.00
1,706,81
.00
1,706.81
TAX CREDITS I
PAYHENT
DATE
07-27-94
RECEIPT
NUNBE R
MM886345
DISCOUNT (+1
INTEREST (-I
,00
ANOUNT PAID
1,706,81
TOTAL TAX CREDIT
_ALANCE OF TAX DUE
INTEREST
TOTAL DUE
1.706,81
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS TIIAN H, NO PAYNE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl. YOU NAY 8E DUE
A REFUND. SEE REVfiRSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
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REStRYAYJONI E.t.t.. of decldent. d~lng on or blfor, D.a,'b,' iz, 1982 _4 If tny future 'nt.r..t In thl I.l,t, I, tran'tlrred
In POI....lon or .nJoy..nt to cta.t B 10011,\"al) bln,flcl,rl,. of thl dlCldlnt .ft,r thl .xplr.tlon of anv ..t.to far
11ft or for v..r., the Co..cnw'llth hereby Ixpr...lv r'.lrve. the right to appral.. ,nd ...... tran,'.r Inh'rlttncl Tlx"
at the lawful CII'I B (0011".r.l) rat. on Iny ,ueh lutur. Jottr..t.
PURPOSE OF
NOTICE I
PAIHEHT,
REFUNO (CR),
OlJECllOHS'
AOHIH
ISlRAlIVE
CORRECllOHS,
OISCOU!tT,
IHTERESTI
To fulfill thl requlr...nt. of Slot Ion Z140 of the Inh.rlttno. nod E.tat. Tux Act, Aot ,2 of 1991. 12 P.S,
Stctlon 2140.
~it'oh thl top portion of thl, Hotlcl and lubelt with your pay..nt to th. Rlgl,t,r 0' Will, printed on the rlv.r.. ,Idl,
~-Hlkl chlClk or lIonlY ordlr PIYlbll tal REOISTER OF HILLS, AGEUT
All pIY.lnt. r,c'lvld .hall firlt bl applitd to anv Inttrelt which ",y bt due with anv rl.alndtr IPpll.d to thl t'M,
A r.fund of a tal( credIt, which wal not rtqulltld on thl Tal( R,turn, Ilay bl rtqUllted by co.plltlngln "Application
fcr Rlfund of Ptnnlvlvante Inhlrltanc. and Eltatl Tal(" (RCV'13UI, ApplicatJonl ert ey"lhbll It tht OffiCI
of thl RIghtor cf WIlIt, any of thl 23 RlYlnul Ohtrlct OHlclt. or by cllIUng tht IPlclal Z4-hour
anlwlrlng ..rvlct nUllbtrl fcr fcrn ordering I In P.nnlylvpnla 1-800-36Z-Z050, outlldl Ptnnlvlynnla and
wlt~ln 10cll Ilerrllburg nrll (717) 181-8094, TOOl (717) 77Z-ZZ5Z Wearing Illpalr'd Only),
Any party In Inttr..t not utllUld wHh tht IPprahl..nt, allcwlncl cr dlullowenu 0' dtductlonl, or a.......nt
of t.M (lMludJng discount or Intlr,.tl II Ihown on thh HoUcl .ult obJtct within IIKtv (60) day. 0' rlollpt of
tt'th NoticI bYI
-'wrltt." prote.t to thl PA D.part..,", afR....,lnu., Board 0' ApPlel~, OEPT. Z810ZI. Ilarrhburg, PA 111Z1~I0Z1, OR
utl.otion to ha...,. thl lIeU.r d.'erlllnlld at "udlt of the "ccount of thl rlr.onal r.prutntatlv., OR
-~app.,1 to thlOrPhan.' Court.
Feotu.1 .rrorl dl,covlrld on thl. ........nt .hould bl addr....d In writing tOI PA OIPart..nt of ~Ivlnu."
Bureau of Individual Tax,., AnNI po.t AII..I.lnt Rlyl.w IJnlt, OEPT, Z8060l, tlarrltburg, PA 17128-0601
Phon. (117) 117-6505, S.. page .5 of thl baokltt "tn.truoUon. for Inh.rltancl TIlle Rltu~n far a R..ldlnt
Dlcld.nt" (REY~1501) for an I~planatlon of adllnl.tratl...,.lv aorrlotabl. .rrorl.
If any tlX dUI I. p.ld within thr.. (3) callndar lonth. aft.r thl dlcldlntl. dlath, a flvl Plro.nt (5~) dllcount of
thl tax paAd I. allowld.
Int.r..t I. chargld big Inning with flr.t day of d.llnqu.nny, or nln. (9) .onthl Ind onl (I) uav fro. thl d.t, of
duth, to thl dati of pay..n" TaxII which b.oll.. dlllnqu.nt blfor. January 1, I9U bier Int.rtlt at thl rat. of
lhe 16%) p.rclnt per annul calculatad at I dally rat. of .000164. All tll(lI whIch blCIl.. d.lInqulnt nn 'nd Iftn
January 1, 191Z will b.ar Jntlrl.t at a rat. which will ...,ary fro. callnd"r y.ar to callnUllr Vlar with that ratl
annauno.d by thl PA ~IPart~lnt of Rlvlnul. Th. appllcabl. lnt.rl.t rat.. for 198Z through 1994 arll
Vur Int.ra.t Rat. Dally Inter..t Factor !!!! Inter..t Aat. Dally Intarl.t faotor
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19!2 20~ ,00054! 1916 10~ ,000114
UDl 16~ ,000431 19!1 9~ ,000241
1914 II~ ,000301 1911'1991 11% ,000101
1915 13~ .000356 19qz 9X ,000241
199H9.. 7X ,000192
ulntn..t I. c.leul.t'd lU follow'l
INTEREST. SA LANCE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
-~Any Notlo. IlIu.d after thl tal( bleo... d.lInqUlllMt will reft.et an Interllt ellliulltlcn to flft..n (1!i) day.
b.yond thl dati of the ........nt, If Plv..nt II .,d. afhr thl Inttrllt COlputltlon dlt. .hown on thl
NOtlcI, .ddltlonal Interllt IU.t bl oalculat.d,
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STATUS REPORT UNDER RULE 6.12
.~ I'
Name of. Decedentl Ca the ri ne R. Messimer
Date of Death, April 24 , 1994 Ct. ,
Will No. 199~ 00410 Admin. NO'-2l94-0410
, /1
Pursuant to Rule 6.12 of the Supreme Court orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate I
1. State whether administration of the estate is completel
Yes_"X_ No.__
2. If the anRwer. is No,
repreRentative reasonably believes
completel
Rtate when the personal
that the administration will be
]. If the anRwer. to No.1 is Yes, state the followingl
a. Did the personal representative Hie a final
account with the Court? Yes x No
b. The S(lpilr.ate Orphilns' Court No. (if any) (or
the personal reprBDontatlve's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes_-X.- No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to thIs report.
Date 1 7. ,9 t.. 91
40? -) /,
'. ;;( '., ),r .:l(c'l....~..,1/
igna upe/' /
Na~~rt~l~as~a~~
701 E Winding Hill Rd.
AddressM~'h i b 170
ell1 an cs urg, Pa, 55
J 717) 697-6387
'1'el. No,
CapacitYl x
Personal Representative
Counsel for personal
representative
(MAH I rmflAM])
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