HomeMy WebLinkAbout94-00681
21-94-0681
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CO"'UOHWULTt. OF PENNSYLVANIA' DEPARTMEHT 0' HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
A
UeWalt , Male - 0:'-. 0;)
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. July 16, 1994
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PIlODADI.E HYOCAIlDIAL INFARCTION
o..-lOUI~.Na(Jl'1
IIYPERTENSIVE CARDIOVASCULAR DISEASE
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1.....'11'''''.,.. Michael L. Norria,coronor
~ 405 Fa1rw~y Dr va
,.. .. HochanlcBbur Pa. 17055
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r..\Sl' WI LI, fIND TF'..S'I'!\MENT
I, ),loyd ^. D3\~alt, tl resident of tho Borough of Camp HUl, Cl.I11berland
County, Pennsylvania, baing of sound and disposing mind, memory and undarstand-
ing, do make, publish and doclaro this as and for my last Will and Tastanant,
horoby rovoking and lnaking null and void any and all Wills and Tastamanto, or
wri.tings in thp. nature thcroof, by me at any time horetoforc made.
1. I naninate, constitute ond appoint my wife, Sara K. Dewalt, to ba
Executrb< of this, my last Will and Tastarront. Should a substitute or successor
ba required, I nr.rnini'\te, mnRt-:itnteand nppo.int. fiR Executor my son, Michael Lloyd
Dewalt. I direct that neither my said wife nor my said son shall be required
to give bond for the faithful perfonnance of her or his duties homunder in this
or ony other jurisdiction, and that if, not\'lithstanding this direction, any bond
is required by any law, statute or rule of court, no surety be required thereon.
II. I give, devise and bequeath all of my property and estate, of whatso-
ever kind and wheresoever situate, of which I shall die seized or possessed, or
of which I shall ba entitled to dispose at tho time of my death, to my wife,
Sara K. Dewalt, tho same to be hers absolutely, providing my said wife survives
me by a period of sixty (60) days.
III. Should my said \~ife, Sara K. D3walt not survive Ire by a period of
sixty (60) days, then I direct that all of my property and estate, of \~hatso-
ever kind and wheresoever situate, of \~hich I shall die seized or possessed, or
of which I shall ba entitled to di13poso at the time of my death, 00 disposed of
in tho follO\~ing manner.
^. Certain items of tangible personal property as set forth in a separate
signed rremorandun, \'Ihich I may place \'lith my Will, shall pass to the persons
designated therein.
B. ^l.1. sharn[1 of stocl: in lIMP, Inc., ~lhich I may stHl possess at the time
of my death, I give and bequeath as follows:
1. One-third (1/3) of such sha=es of stock to my grandson, Mi.chael
Steven Dewalt, the sarro to be his absolutely.
2. Tho remaining t\'lO-thirds (2/3) to Dauphin Deposit Bank mld Trust
Carpany, Harrisburg, Pennsylvania, or its successor corporation, in trust
nevertheless, one-half (1/2) of said shares to be held for the benefit of
my greatgrandson, Jeremy lIndrew Stone, and one-half (1/2) of said shares
to be held for the benefit of my greatgranddaughter, Athena Lynn
Stone.
My trustee shall accumulate all dividends and incane fran all
said shares of stock until each of my sa.ill greatgrandchi1dren reaches
the age of thirty (30) years, at which t.ime the shares of stock and
all accumulated incane fran said shares held for each such great grand-
child shall be va.ill over to such great grandchild and that greatgrand-
child's separate tI"'Jst shall tenninate.
My trustee shall have the authority to invest the dividends and
incane fran said shares of stock in any investment considered legal
for fiduciaries under the l8\~ of the COl111Ol1wealth of Fe.,nsY.Lvania,
and specifically is authorized to invest in any carmon trust fund
administered by the trustee.
Notwithstanding the instruction contained hereinabove for the
trustee to accumulate all incane until such tinY.! as each beneficiary
reaches the age of thirty (30) years, I nevertheless authorize and
direct my trustee to pay fran accumulated incane, and if that prove
inSUfficient, to pay [ran the principal, such Sulls, and at such times,
as my trustee may deem necessary or appropriate, for the college or
graduate school education of each such beneficiary.
Should either of my said great grandchildren die prior to full
distribution to them hereunder, the balance remaining in such de-
ceased great grandchild 's separate trust shall be paid over to my son,
Michael Lloyd Dewalt.
C. All the rest, residue and remainder of my property and estate, of
I/hatsoever kind and wheresoever situate, of which I shall die seized or
possessed, or of which I shall be entitled to dispose at the t.ime of my
death, I give, devise and bequeath to my son, Michael Lloyd Dewalt. If
my said son decides to dispose of my hane at 3110 Dickinson Avenue, Clll11?
Hill, Pennsylvania, rather than retain it for his CMn use, I direct that
he, as my EKecutor, have an appraisal made of such property by a profes-
sional real estate appraiser to determine the fair market value of said
property, and I direct that the said property be first offered at the
appraised fair market value to my grandson, Michael Steven Dewalt. Should
my said grandson, Michael Steven Del~alt, decline to purchase the property
at the appraised fair markot valuo, my Exocutor lIIay, ilfl he wishes,
either keop tho property or dlsposo of it on tl~ open n~ket.
IN WITNESS W1lEREXlF, 1 hava har.ounto sot lilY hand and seal to this, lilY last
WIll. and Tostaroont, this /I? IJ day of January, 1986.
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1/ ~~, l.. . , (~al)
I Lloyd A. Dewalt
SIGNED, SEALED, PUBLISHED lIND DEX:LAREDby Lloyd A. Dev/alt, the above named
Testator, as and for his last Will and Tostamont, in our presence, who, in his
presence, at his request, and in the presence of each other, have hereunto sub-
scribed our names as attesting witnesses.
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!\'){~ )87 ~,,~ fI.LJt1 PA f7r.Jlt
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lIddrdss
ACKNOWLEDGIENT
C<M1:JNWEALTH OF PENNSYLVlINIA,
COlINI'Y OF CUMI3ERLlIND
I, Lloyd A. Dewalt, vlhose narre is signed to the attached or foregoing in-
strunent, having been duly qualified according to law, do horeby acknO\~ledge
that I signed and executed the instrunont as my Last lUll, that I signed it
willingly; and that I signed it as my freo and voluntary act for the purposes
therein expressed.
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Lloyd A.
. ,
/i..' ..e'I/--d"'ClL-.
Dewalt
5\~orn or affirmod to and ackncMledged before me by Lloyd A. Dewalt, the
Tostator, this ~ day of January, 1986.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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o 40. fulure 'ole roll Compromise
(for dalo. of doo,h ollor 12.12.82)
[J]'6; Decedent Died T..tale 0 7. Decode"1 Malnlalned a living Trull
(Alloch cop of WillI (Alloch co of Trull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
HAM M UTE MAiliNG ADORES:.
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I. Rool E.lo'o (Schodule AI ( I) "):}""o>-<.'
2. Slacks and Bond. (Schodule BI ( 2) JLL.!f-L1: " .'
3. Clo.oly Hold Slock/Portno,.hlp In'oro.1 (Schedulo C) I 31 --2J:&~
4. Mor'BoBo, and Nole. Recelvoblo (Schodule D) ( 4) ...:..:1Jar~L-...-
S. Co.h, Bank Depo.il. & Mlltollanoou. Pe,.onol Property( 5) .)\ 'V~, <-
(Scnedule E)
6. Joln'ly Ownod Property (Schedule F)
7. Tran.fe,. (Schodule G) (Schodule l)
8. To'al Grall Anol. (10101 line. 1.7)
9. Funeral Expense., Admlnlstrollv. Co.f., Mhcellaneou. (9) 11 ').~ 9}. J tJ
Expon... (Schodulo H)
10. Dobl., Mortgage lIobill,'o., lien. (Schedule I)
11. Tolal Deduction. (10'01 line. 9 & 10)
12. Ne' Value of E.lole(line 8 minu.llne 11)
13. Charilabl. and Governmental Bequesh (Schedule J)
14. Nel Value Sub oct 10 Tax (IIno 12 mlnu.llne 131
15. Amount of line 14 loxobl. at 6% rale
(Include values from Schedule K Dr Schedule M.)
16. Amount of line 14 taxable at 15% rala
(Include value. from Schedule K or Schedule M.I
17. Prine/poi 'a. due (Add lox from IIno 15 and from IIno 16,)
19. C",dil. Spousal Paver'y Cradll Prior Payments
+ +
19. If line 181s greater than line 17, enter ,he difference on line 19. This is the OVERPAYMENT.
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(CMMONWUlTH 01 PfNN!lYlVANIA
DEPARTMENT Of REVENUE
DEn 780601
HA_"RISlURO. PA 17128.0601
M . ,A M
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1. Original Relurn
II
fOR DATES Of DIAIH AfTlR 12/31/91 CHICK HIRI
If A SPOUSAL
POVIRTT CREDIT IS CLAIMID 0
flU NUMBER
COUNIY CODE._ ~ I
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Supplemental Relurn [J 3. Remainder Rei urn
I'or dolo. 01 doa,h prlorto 12.13.82)
o 5. federal E.tole Tax
Relurn Required
_ 8. Total Number of Safe Deposit Boxe.
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(20B) /) 1 ,c:.." <.-..
20. If line 171s grealer thon line 18, enfer the difference on line 20. This h the TAX DUE.
A. Enter thlt Interest on the balance due on line 20A.
B. Enlor ,ho 10101 of line 20 and 20A on line 20B, Thl. " 'ho BALANCE DUE.
Mak. Chock Payabl. fa, Rogl,l.r of Will., Ag.nf
...... BI SURI TO AtlSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.......
Under penaltle. of perlury, I declor. Iholl hove examined Ihls rllurn, Including occompanylng ache'dul.s and slalemenll. and 10 the be.t of my knowledge ond belief,
It is true, correel and complet.. I declare lhat 011 ,eol ..tot. has been reporled ollrue markot volve. Declaration of preporer other thon the personal representative Is
based on 011 Information of which preparer hos any knowledge.
SIGNATultf OF PUSON RUPONSlllE fOR flUNO RETURN ADOIUS!:! DATE
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JiGNAlURf Of fRfPARfR OrRER THAN REPRESENTATIVE
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plea.e PrInt or Type
FILE NUMBER
J
COMMONWfAUH OF P(NNSYlVANIA
INHllnANCI TAX .nUIN
IUIDINT DlelDINT
ESTATE OF
je....'ltl C(, !liIU' {jj.{
(All prop.rty loln,ty.own.d wllh th Right of Survlvonhlp mUI' b. dllClo..d on Sch.dule FI
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
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TOTAL AI.o enter an line 5, Reca
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(Attach additional 8\01," X 11" ,h,.flll mora 'pac. I, nlled.d.1
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CERTIFICATION OF NOTICE UNDER RULE 5 f6'ia I
Name of
:::::~nt~A~~:t7;/; 1 r:ti- D~~I/~~p
0' i' I
Admin. No. I 9'Q'l. -
dO r-? I
Date of
Will No.
.' ,
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court 'Rules was served on'or mailed to
the following beneficiaries of the above-captioned estate on
:
Name
",- "'^-<L Ie
a fl..l-l/ "j r-
Address
311t! ru/k~~. ~(~
. r)rlll
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: I//:I,'.{ / tfl-/
( I
.5 IJ<A""",,,,, 16. ilu:t,.,.. /1..e.:z,
Signature
Name .$4 fl.,. ~ k Dc W 7=\ '-.,-
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AddresssllO (), c../<IIvSO!\/ Ave,
c' A fV\ P H,'l- l.- PE Il/ /VA
(? /I II
Telephonei'll?) '7('I_.:l q I ~
Capacity: V- Personal Representative
Counsel for personal
representative
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -411I
iiEV:istWi'lf-AFji-Coif:9Cjr-ilcii'-icnWYHHEiiii'ANCn:'AiC"iippRiiisEHEilT-,--AL'LOWAiicrnilimnnmm--n
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
LLOYD A FILE NO. 21 94-0681 AC~nOl
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\ REV-1547 EX AFP (08-94*
CO""OHW(AL m OF PENNSYLVANIA
DEPART"EHT Of REVENUE
BUREAU or INDIVIDUAL fAlCES .
atpy. Z80601
ttARRISBURC, PA 171Z8-0601
/1/. .1:.}/- {.>
ACN 101
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF OEDUCTIDNS AND ASSESSHENT DF TAM
DATE 12-19-94
FILE NO.
07-16-94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCDUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAYHEHT TO THE REGISTER OF WIllS. HAME CHECM PAYABLE TD "REOISTER OF WILLS, AGENT"
REMIT PAVMENT TO:
SARA K DEWAL T
3110 DICKINSON
CAMP HILL
AVE
PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
Anount Ra"Hi.d
ESTATE OF
DEWALT
(!, ~,r.
HOUSE
TAM RETURN WAS. I X I ACCEPTED AS FILED
DA:i? 12-19-94
mn
en 0
RESERVATION CDNCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL
1. R..l Eat.t. (Schedule AI
2. stocks and Bond. (Schadul. 8)
S. Clo..ly Hald stock/Partnership Int.r.at (Schedul. CJ
4. Hartg.ga./Not.. Receivable (Schedule OJ
S. Ca.h/Bank Deposita/Hi,c. Paraonal Property (Schedule EJ
6. Jointly Owned Property ISch.dul. F)
7. Transfara (Schedule OJ
8. Tot.l A..at.
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11)
(2)
131
141
151
161
171
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(8)
APPRDVED DEDUCTIONS AND EXEMPTIONS:
7,391.20
9. Funa,..l E)(pan.aa/Ad... Coata/Hhc. E)(pan... (Schedule to (9)
10. D.bt./Hortgaga Llabll1U../LJen. (Schedul. I) ClO) .00
11. Total DaducUon. 111)
12. Net V.lu. of T.x Return (12)
13. Ch.,.it.ble/GoYern~.nt.l Bequ..t. ISchedul. J) (13)
14. N.t V.lu. of E.t.t. Subj.ot to T.K (14)
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 .t Spou..l rat. (15)
16. Anount of Lin. 14 taxable at Lin.al/Cla.. A r.t. (16)
17. Anount of Lin. 14 t.xabl. at Collat.ral/Cl... 8 rate (17)
18. Principal Tax Du.
.00
.00
.00
M.03,
M .06,
M .15.
!l81
TAX CREDITS:
PAYHENT
DATE
RECEIPT
HUHBER
OISCOUNT 1+)
INTEREST I-I
AHDUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION DF ADDITIDNAL INTEREST.
1.455.00
7,~gl ?n
5,936.20-
.00
5.936,20-
will
.00
.00
.00
.00
.00
.00
.00
. DO
I IF TDTAL DUE 1S LESS THAN f1, ND PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
RESERVATIoN1 E.tat.. of dec.dent. dvlng on or b.'or. D.c.eb.r 12, 1982 -- I' any future Int.r..t In the ..t.te I. tran.f.rr.d
In po.....lon or anJoy.ent to CI... I Icolllt.ral) b.n.'lcllrl.. 0' tha decad.nt a't.r the a.plr.tlan a' any ..tat. 'or
Ilf. or for v..r., the Coa.anw..lth h.rebv ..pr...ly r...rv.. the right to .ppr.I.. and ...... tran.,.r IRh.rltlnc. T....
at tha lawful Cia.. I Ccollat.ral) rata an anv .uch futura I"tara.t.
PURPOSE OF
NOTICE I To fulfill thl requlre'.nt. of Sactlon 2140 of tha Inherltanca end Estata Ta. Act, Act 22 0' 1991. 72 P.S.
S.ctlon 2140.
PAYMENT I
D.tach the top portIon of thl. Notlca and .ubalt with your p.va.nt to the R.gI.t.r 0' Will. prlntad on the ravlr.1 .Id..
--"ak. chick Dr .onav order p.y.bl. tal REGISTER OF MILLS, AGENT
All p.y..nt. racllv.d .hall flr.t be appll.d to any I"t.r..t whIch a.y b. due with any ra..lnd.r appll.d to thl t...
REFUND (CR). A r.'und of at.. cradlt, ~hlch wa. not r.qu..t.d on thl T.. Rlturn, ..v b. rlqul.t.d bv coapl.tlng an "ApplIcation
for Refund 0' P.nn'Ylvanla Inh.rltanc. and E.t.t. Ta." IREV-l!l!). Application. .r. .v.ll.bl. .t the Of,lc.
of the R.gI.t.r of Will., any of the 2! R.v.nue DI.trlct O"lcI', or by c.lllng the ,plcl.1 2~ahour
an.w.rlng ..rvlc. nuab.r. 'or for.. orderlngl In P.nnsvlv.nla 1-800a362-lD50, out.ld. P.nn'vlvanl. and
withIn local Harrl.burg .r.a (717) 787-.094, TDD' (717) 77Z-ZZS2 IH..rlng lap.lr.d Onlv).
OBJECTIONS1 Any party In Int.r..t not .atl.fl.d with the .ppr.I....nt, allow.nc. or dl..llowanc. of d.ductlon., or ........nt
of ta. Clncludlng dl.count or Int.r..t) a. .hown on thl. Notlc. .u.t obJ.ct within .I.tv (60) d.y. 0' r.c.lpt of
this Notice bV1
--wrlttln prot..t to the PA D.parta."t of R,vlnu., Bo.rd 0' App..", DEPT. l81021, tlarrlsburg, PA 17128-1021, OR
--.Iectlon to h.vI thl a.tt.r d.t.r.ln.d at .udlt of the account 0' the p.r.on.1 r.pr...ntatlv., OR
--appeal to the Orph.n.' Court.
AD"IN
ISTRAT1\IE
CoRRECTIoNSI
Factu.l Irrar. dl.cov.r.d on 'hi. ........nt .hould ba addr....d In writing tal PA D.p.rta.nt Q' Rlv.nu.,
Bureau of Indlvldu.l Ta..., ATTNI PD" A.......nt R.vl.w Unit, DEPT. 180601, Itarrlsburg, PA 17118-0601
Phon. (717) 787-6S05. s.. p.g. 3 of the bookl.t "In.tructlon. for Inh.rltanc. Ta. Raturn for a RI.ld.nt
n,clden'" (REV-1501) for an ..planatlon of adalnl.'ratlvalv corract.bl. arror..
DISCOUNr,
INTEREST,
If any ,.. due I. p.ld wl'hln thra. (3) caland.r aooth. a' tar 'ha d.cld.nt'. da.th, a flv. p.rc.nt (S~) dl.count 0'
thl ta. p.ld I. .llowed.
Intlr..t I, ch.rg.d beglnnlna with flr.t d.~ of d.llnquency, or nln. (91 _onth. and ana Cl) dav 'roa the d.tl 0'
d..th, to the data of p,yaant. Ta... whIch bee... dallnqu.nt b.fore Janu.ry I, 1981 b..r Int.r..t .t thl rlt. Q'
,I. (6~) parcant p.r .nnua calcul.t.d .t . daIlY rat. of .000164. All ta.a. which b.cB.. dllJnqu.nt on and .'t.r
January 1, 1982 wIll b..r Int.r..t at a ratl which wIll vary fro. clland.r y..r to c.l.ndar v..r wIth that rata
announc.d by the PA D.part..n' 0' AaVlnue. Thl appllcabl. Int.r..t rat.. for 1982 through 1994 ar"
!!!!: Jnt.r..t Aat. D.llv Jnt.rnt Factor !!!!' Intar..t Rat. D.lly Intarnt Factar
1911 2DX .DDD5U 1986 laiC .ODDZ7~
1915 16iC .000411 1917 .~ .DDD2U
1984 Il~ .DOUDl 1918-1991 IU .DDUDl
1915 UX .DOU56 1992 .. .DDDZ47
1993-1994 n .DDDI9l
1995 .~ .DDD2U
--lnt.ra.t I. c.lcul.t.d a. follow..
IHTEREST . BALAHCE OF TAX UHPAID X HUHBER OF DAYS DELIHQUEHT X DAILY IHTEREST FACTOR
--Any Not Ie. I"uld a,tlr tha ta. b.coa.. dlllnqu.nt will refllct an Int.r..t calculation '0 'Ift..n (15) d.~.
blvond thl dati 0' the ........nt. l' pay..nt I. ..d. .'t.r 'h. Int.r..t coaput.tlon data .hown on the
Hotlcl, .ddltlon.l Int.ra.t lU.t be calculatad.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: .,-1'1,.') ....i!..- 0." /),1.11 ',"'iJI';;
Date of Death: v~v...5' I (,'. / f/ ,!~
Will No. ,').. I - 1'/14 - (0 S"j Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No 11
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:.
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, 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.
Da te : (J~ A:J ' I 'i I q 9 (,"
\" flAA./ ;:; I)P /1.//11. (J T.-
Signat.ure
Cl
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UID: '0
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t'
Sara K. Dawalt
Name (Please type or print)
3110 Dickinson Avenue
Camp Hill, PA 17011
Address
.J
.. t:
~:J
UU
( 7f , I "? {, I - , '1/ <(-
Tel. No.
Capacity:
X Personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)