HomeMy WebLinkAbout94-00698
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PETITION FOR PIWUA TE and GHANT OF I. ETTERS
Eslate of lJ"rJ +~ '( I k't' / / CJC- No. ~/-91 - to9'i
also k"ow" us Tn:
R~BIsI~r of Wills for Ih~
I [)(IC('O.wtl. County of In lhe
Sodol Se('II,/I)' No. J. 0 1../ 0 I 'h<J !:>-<j Conllllonw~nhh of I'~nnsyl\'ania
Th~ r~lillon of Ih~ uud~rsiBn~d r~sr~clfully r~pr~'~nl' Ihlll:
Your p~lhion~r(s). who I,/nr~ 18 y~nrs or aB~ or ~~~~llh~ eX~CUI....... _
in Ih~ la'l will of Ih~ IIbo\'~ d~c~d~l1I. dlll~d -B..,--1 of " ,
nud eodidl(s) dlll~d
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hUlIc rdc\'11I1l drcIlIIUlIlII''f.'li, e.~. rClIlllldullull. lll'lllh III" C\,-'l,'ulnr. eIC.}
D~cend~nl WIIS domlcil~d III d~l1Ih lu t!.... '" /., ~..- f 4.....0 C9UlllY, I'ennsylvnuhlywllh_
h Q.~Yf; prlnd~)tsid~nccal =::f1,-"~LU:;;'ik/../ !Jd'..c.Jr-~ I~J I~
(ii'l 'lll'Cl. lHullher "nd Illlllldrlllil)') I
q r 'ellrs of IIg~, dl~d ,/ er t...S- / ' 19 <71.(
nl <> (...>4- c.>- ~e ~.&1,'f:/f'{~ ~I .
Exc~pl ns follow" d~c~d~11I did nol marr ,wa, nOI divore~d IInd did nOI have a child born or ndopl~d
nft~r ex~culion of Ih~ will orr~r~d for probate: WII' nOllhe vlclim of II killing aud wns never ndjodlcaled
Incomrelenl:
Dec~ndenl nl dealh owned rropcllY whh eSlhnaled valucs "' follow,:
(If domicllcd in I'n.) All p~rsonnl ProrellY $ 2 . 00 0
(If nol domiciled in I'n.) I'ersonlll prorerly in I'enn'ylvanla $
(If nol domiciled in I'a.) I'er,onal proP~IIY in Coul1ly $
Vnlue of renl estale In I'enn'ylvanill $
shualed as follows:
WHEREFORE, r~lhioner(s) resr~clfull)'
presenled herewhh and Ih~ grum of lell~rs
lheron.
. Ihe Insl will and codlcll(s)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH 01' I'ENNSYI.VANIA }' ::1::1
COUNTY OF ~.I:lBERLAND
..Jc) H'
of-
The rClitlon~r(') nbol'c.nllmcJ ,w~lIr(') or affirm(s) lhlll lh~ slal~m~l1Is In Ihe for~golng relhlon arc
Irue and correcllO Ihe be'l of Ihe knowledge llnd belieI' of relitloller(s) lInd 111111 liS rersonlll rerre,en-
lallve(s) or the lIbove decedel1l relilioner(s) will wellmll lru lIdminlSler Ihe e'llIIe ~IW.
Sworn 10 or affirmed lInd subscribed {' ~ '"
before me lhis 10 tlL_ dllY or ~'
~ ~.'~~_p~._P8S~~-!t~ ~
. 'O.~ ~
No. 21-94-698
Estate of
DOROTHY
I. KELLER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW AUGUST 11 19~, in considernlion of Ihe pClhion on
thc rcverse side hercof, salisfaclory (lroof having been (lresenled before me,
IT IS DECREED Ihal the inslrumenl(s) dllled july 9, 1965
described therein bc udmilled to probule nnd flied of record as Ihe lasl will of
DOROTHY I. KELLER
nnd Lellers TESTAMENTARY
nre hereby srnnled to RA YMOND C. KELLER
'n1oa C'... 'P.......'. n~ P.8.\).~
R'sl..<< or WII(.
FEES
Probnte. Lellers, Ele. ......... $ 25. 00
Shorl Certlfienles(3) .. .. .. . '" $ 9 . 0 0
;~n~~~~~n ................ :~
TOTAL _ $ 42.00
Flied .... ..W.C1\l.E!'f. ,U.(. .~~.~4.........
AlTORNEY (Sup. CI. 1.0. No.)
ADDRESS
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This i!t IU n:nH)' Ih.lIl1u: inlllflluciul1 hefl' ~i\'l'" i~ (Olin II)' u'pitd "UII1 .lIlllli~ill.d u'lIilililll' olllt-.lIl,' dill)' filc:l! wllh
1.00';al Ht.'gislrJr. Thl'llrigill.a1 n'r1ilimll' will hl' ftlrwilrdt.d Itl dll' SI.lll' Vit.d Ht'lonl, (Hlllt. lur P"'III1>llltlll fllill,L:
WARNING: Ills lIIegollo duplicate this copy by photoslat or photograph.
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2420118
f.Uti 8 1991
No.
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DJIL'
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT Of HEALTH' VITALAEconos
CERTIFICATE OF DEATH
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Auguot 9, 1994
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LAST WILL AND TESTAMENT
I, DOROTHY I. KELLER, sometimes known aa DAROTHY I. KELLER,
of the Dorough of Carlisle, cumberland County, Pennsylvania,
being of sound and disposing mind and memory, do hereby make,
publish and declare this to be my Last Will and Testament,
hereby revoking any and all former Wills or Codicils by me made.
1.
I give, devise and bequeath all of my estate, both real
snd personal property,unto my husband, RAYMOND R. KELLER,
absolutely, and I hereby appoint my said husband as Executor
of my estate.
2.
In the event my said husbsnd shall predecease or fail to
survive me, then I give and devise my estate in the following
manner:
(a) I give, devise and bequeath all of my estate unto'
my children, RAYMOND C. KELLER AND RODERT G. KELLER, in equal
shares, sbsolutely.
(b) I hereby appoint the said RAYMOND C. KELLER as Executor
of my estate under this second paragraph of my Last Will and
Testament, however, if the ssid Raymond C. Keller shall be
unable or unwilling to serve, then I appoint the said ROBERT
G. KELLER as Executor of my estate.
(c) If the said Raymond C. Keller shall fail to survive
me and he shall not be survived by any issue, then I direct
that his share in my estate is given and devised as follows:
One half (~) thereof unto the wife of Raymond C. Keller, JANE
G. KELLER, and the remaining one half (~) thereof unto ROBERT
G. KELLER.
WILLIAM F. MARl80N
ATTORN" AT LAW
CMLI.U. ,"'.
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IN WITNESS WHEREOF 1 have hereunto set my hand and seal
this 9th day of July, 1965.
(SEAL)
, ~t"\./(SEAL)
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testatrix, Dorothy 1. Keller, as and for her Last Will and
Testament, in the presence of us, who have hereunto subscribed
our names at her request as witnesses thereto, in the presence
of said Testatrix and of each
WILLIAM F. MARTSON
ATTO"NEY AT LAW
CA"LIILE. ,A.
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I FOR DATIS OF DEATH A"ER 12/31191 CHECK HUE
INHERITANCE TAX RETURN ~o~m)yug~DIT ISCLAIMED fL____
j RESIDENT DECEDENT FlU NUMBER
COMMO"WlAll" OJ """''''''''A (TO BE FILED IN DUPLICATE _) I ", Lf- . I .., , '
DI,.UtMWT Of 1l('lo'lNUI I H EGISTER OF LL) lJ c, (~
"ml,~Jn, ~~oWlll ObOl W T R WI S COUNTY COQE YEAR !:,,~MBER
OICIDIN 'N.MIH"Li'~t'DMIIJDIIIN'tl"'~120 +~ " I Dt(~th.~O~;':;IXI;;'(J J+crn1f!. .
iOC'AI ,,~(ff,h-,,-.,--, ..---- ..Ii 0; OIAl" ED~I 0""1" At'2.. WA-lNU+".. (Eo.f{;,-w, ~R...J
2..0'1- CJ '-: "'ll..5'1 tJ&-tlt.-1'1 1:l-o,)-02.c,.",<-.C.t..'2;j-~~:-l7.._'" 0/1-. 1701
,,' ~::::,::O~'" ...., n'" ','" :"'_~:~'~~'~'~,__ :~'" ":"" "u~~'''~_ f AMOU~I"'~"~O "" ":~:,CI~O~~ __ ,_ ___", _____
~ 1. Original Relu,n 0 2. Supplemental Relurn [] 3. Remainder Return
(for doll. of death prior 10 12.' 3.821
o 5. Federol EIlote To... Relurn Required
'(\ I~OO o. 11_~~1
21. If line 181s greoler thon line 19, anler Ih. differencI on Line 21. Thill. the TAX DUE.
A. Enler Ih. Inl.rl.1 on the balance due on line 21A.
8. Ent.r Ihe 10101 of line 21 and 21A on line 218. This Is Ihe BALANCE DUE,
Make ChICle Payable to: Regl.t.r of Will., Agent
>- ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH <II( <II(
Under p.nahi.. of perlury, I declare Ihall ha~e examined Ihls r"lurn, Including ottomponying schedules and slotemenh, and to Ihe bllt of m)' ~no.....ledge and belief,
.1 Is true, correct and complete. I declare thot all real estate has been reporled allrue market ...alue. Declaration of preporer olher than the personal r.pr.sentati.... Is
based on all Information of which pre arer hal on ~nowledge. .
;lO"A "'ON ""0""'" Of l1u'" Cf~";;- lA.J J..o....f fh. /70.!J OA"rll,lq7
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Ifor doles 01 death ah.r 12.12.821
Decedent Died Te,'ate 0 7, Decedent Maintained 0 Li...ing Trull
IAuoch cop)' 01 Willi (Allach copy of TruIll
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
"A~AV /lt6V1J d. Vi: LLf:12- COM"q';A~OAOD~. L dv+Lu:...., .sl-
ttU'1'40N! NUMtU II')
2... YCJ- I Lf S-{) UIJ.. L,S L e t"/J 1/0/3
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_ e. Tolol Numb.r of Sof. Depolit 80.....
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1. Real Ellole IS,h.dule AI (I )
2. 510,1\ and Bond. IS,h.dule B) 1 2 I
3. Closely Held Sloc~/Porlnenhlp Inler..' (Schedul. q 13 J
A. Mottgag.. and Not'I R.cel~able (Sch.dul. OJ ( A )
5. Cash. Bonk D,polits & Misc.llan,oul Persanal Prop.rly ( 5 )
(S,hedul. EI
6. Jointly O.....n.d Prop.rly (Schedule fl ( 6 )
7. Tron,l", (S,h.dul. GIIS,h.dule LI 17)
e. Tolal Gran An'II (10101 Lines 1.7)
9. Fun.ral E..pensel, Admlnistrati.... COliS, Miscellaneous (9)
bp.nses (Schedul. H)
10. D.bh, Morlgage liabilities, liens ISch.dul. I) (10)
11. Tolal Deductions (Iotalllnes 9 & 101
12. NIl Value of Ellol. (lin. 8 rnlnUlline 11)
13. Chorilabl. and Go....rnm.ntal B.queslS ISch.dul. J)
lA, Nel Valu. Subl.ctlo Tox (lIn. 12 minus Line 13)
15. Spoulol Transfers liar dates af death after 6-30.9041
S.. Instructions for Applicable Percenloge on R.....n. 115)
Sid.. (Include ...alues from Sch.dule K or Schedule M.)
16. Amount of Line 14 lallobl. 01 6% tate (16)
(Include ...alues from Schedule K or Schedule M.I
17. Amount of line 1A ta..oble 01 15% role (17)
(Include ...olues from Schedul. K or Schedule M.)
18. Princlpalla.. due (Add lox from lines 15, 16 and 17.1
19. Credits Spoulal Poyerl)' Credit Prior Paym.nlS
A/eMe..
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LCi 'i I. ,()
1 B I
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112)
113)
(lA)
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20, If line 19 Is greoler than line 18, .nter th. diff.r.nc. on line 20. Thh Is th. OVEAPA YMENT.
aD
Check hero If you aro requosting a rofund of your overpayment.
/vV'le-
121)
121AI
121B)
I/tINttE.
';rv.l!Oln.l.hl I ~
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COM,l,\ONW[A\TH Of PfNNnlV...N....
INHfllltANCf tAlC "[TURN
IUIO(Nt OI(IO[NT _
ESTATE OF .,
OW" +.{" 1
SCHEDULE B
STOCKS AND BONDS
l
FILE NUMBER
l/1Y-I1t.1r-
VELLt:,r.>
IAII proporty lolnlly.own.d wllh Right of Su,uluo"hlp mUlt b. dlnlolld on Sch.dulo F.)
ITEM
NUMB~R DESCRIPTION
l.
VALUE AT DATE
OF DEATH
4YoShA.res
r: w
Wdd I weJl-fi
7110. 72..
TOTAL Allo Inler on line 2, ReeD lIulation
(II more 'POCt ;s n..d.el, Insert additional.heeh of 10m. lile.)
S
700.7z..
~~I4;~-h't:~;~_r~,:;-J,.~~_~;p~~;:;i;;.::';f_i:\.i.;,:.-;:;.,:,7<";:";:";"J'";Xl;J!/;'i.:1j.";:::;_;.~;;~~..;,,,,"-t~"f"i~":"__~ ;;',-~_'-"_'; i" ,.'i";-,,:.:....t~
'1 '0 '~'.I to. ,;"1
1 SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploalo Print ar Typo
FILE NUMBER
2.1&J1.(-~t1r-
9....~.~
'l:~W~
cO....MONwfAllH Of p(NNnIVANIA
lNHlll1ANCI tAX UtURN
RI"OINt DICIOINt
ESTATE OF
iAi'I;'-~.p"'Y~ln~Y~W~d ~1I~h~RI.hl .f lulfVI.."hIP'::~' ~'~:d ~ S'h'dUI'~1
ITEM
NUMBER
VALUE AT
DATE OF DEATH
DESCRIPTION
I
2.
,
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FA-f2.mEltS
~'- ~ 'oJ r./ Y.J
thaI' (,1;'.( J
-rn.l's -{- d..,-
Uu..~ If-1 /~,'J
{ Y.!, LIJ(" Shle fJ
eM. (.. /J.c.d
/..f t ?t 3
~ 3. 2 tJ
.3'(..~~
~ 1'.J.t.ur C .vS5
Nt,j~II.'IIJI'(f\,:? .
.,
s "1 Z 3, -, (
(Atlr.'\ ".' ,.: ,...: c;.," )C 11" ,hll'l if more .poc. II "..did.)
I.
I
thlSHI', I'".
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I SCHEDULE H
L FUNERAL EXPENSES,
ADMINISTRATIVE COSTS A.ND
MISCEllANEOUS EXPENSES
_._ __ _ . _ _ un __
Plea.e Print or Type
F E NUMBER
,-1~'1. at1t
(OMMQUW!Alltt Of f1tm!.Y1...AWA
INI1f1l1TAUCI T.'" IOURU
'!!.IDU41 DIClDfUl
ESTATE OF
DO(Lo.f-h
ITEM
NUMBER
A.
1.
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
B.
ICI5LLt:/2.
DESCRIPTION
AMOUNT
Funeral Expen.e..
)./-01-1- M ^ I'J -I?u/{ - f-u N v.~~ I
u..n L I!. L e.. Nl e,,,\(.> rI 1.1 - H-1"1o (J .s tr., IJ e
I
IflJ !:.C r' 0-"1 :)")1
, ~,(3.2.3
I 3 ".00
I.
Admlnlltratlve Calli.
Personal Repre.entollve Commissions
Social Securlly Number of Personal Representallve:
Year Comml..lons paid
2.
Allorney Feel
3.
Family e.empllon
Claimant
Addre.. 01 Claimant 01 decedenl's death
Stroot Addre..
City
State
Zip Code
RelationshIp
Probate Fees
Mllcellaneoul Expense"
Newspl:l-pee. - 5-f!;(l/...'N~1 hi II
..5, he"'/- {let-?,I- I c:.Jlfe.. - t!. v m" c"
TOTAL (Also enler on IIn. 9, Recopllulollon)
(If more Ipace II needed, Insert oddltlonallheell of lame llze.)
S
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LAST WILL AND TESTAMENT
I, DOROTHY 1. KELLER, some times known as DAROTHY I. KELLEI
of the Dorough of Carlisle, CUmberland County, Pennsylvania,
being of sound and disposing mind and memory, do hereby make,
publish and declare this to be m~ Last Will and Te~tament,
hereby revoking any and all former Wills or Codicils by me made
1.
I give, devise and bequeath all of my estate, both real
and personal property,unto my husband, RAYMOND R. KELLER,
absolutely, and I hereby appoint my said husband as Executor
of my .estate.
2.
In the event my said husband shall predecease or fail to
'.' ,
survive me, then I give and dev~s~ my estate in the following
manner:
(a) I give, devise and bequeath all of my estate unto'
my children, RAYMOND C. KELLSR AND ROBERT G. KELLER, in equal
shares, absolutely.
(b) I hereby appoint the said RAYl>IOND C. KELLER as ExecUt(
of my estate under this second paragraph of 'my Last Will and
Testament, however, if the said Raymond C. Keller shall be
unable or unwilling to serve, then I appoint the said RODERT
G. KELLER as Executor of my estate.
(c) If the said Raymond C. Keller shall fail to survive
me and he shall not be survived by any issue, then I direct
that his share in my estate is given and devised as follows:
One half (~) thereof unto the wife of Raymond C. Keller, JANE
G. KELLER. and the remaining one half (~) thereof unto ROBERT
G. KELLER.
\
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IN WITNESS WHEREOF I have hereunto set my hand and seal
this 9th day of July, 1965.
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SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
,
Testatrix, Dorothy I. Keller, as and for her Last Will and
Testament, in the presence of us, who have hereunto subscribec
our names at her request as witnesses thereto, in the presenct
of said Testatrix and of each
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6-171-e,
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAMES
INHERitANCE TAM DIVISION
DEPT. 21060 I
HARRISIURG, PA 1'lrl-0601
NDTICE aF INNERITANCE TAM
APPRAISENENT, ALLDWANCE OR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSNENT OF TAM
RAYMOND C KELLER
905 W LoUTHER ST
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
PA 17013
07-07-97
KELLER
08-05-94
21 94-0698
CUHBERLANo
101
AMOunt R..t U.d
c~
*'
,.,.lIdU'UltI.,,.
DOROTHY
I
HAKE CHECK PAYABLE AND REMIT PAYHENT Tol
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONO THIS LINE . RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiE'y:is'4j-ix-"iip-ioY:97riiii'fici--ciF--liiiiiiiifANci-T'AX-iippRiiisiN€N,.-,--"Li:ciiiANCi-iirim-------m----
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF KELLER DOROTHY I FILE NO. 21 94-0698 ACN 101 DATE 07-07-97
TAM RETURN WAS, I X I ACCEPTED AS FILED
RESERVATION CONCERNINO FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Eat.t. (Schedul. Al (l)
2. stock. ."d Bondi (Schedule 8) (2)
3. CIDa.ly Hlld stock/Partner.hip Int.r..t (Sch.dule CJ (3)
4. Hortg'DI./Not.. Receivabl. (Schedull OJ (4)
s. C..h/Blnk Dapoalta/Hlac. Plrsonal Property (Schedul. EJ U)
6. Jointly Owned Property (Schedul. FJ (6)
7. Traneflra (Sch.dul. OJ (7)
8. Tobl A...t.
APPROVED DEDUCTIONS AND EXEHPTIONSI
9. Funaral EXPln.../Ad.. Co.t./Hllc. E~p.n... (Sch.dull H) (9)
10. Dlbt./Hortaaga ll.biliUa./Uan. (Schedula U nO)
11. Total Deduction.
12. Hat Valua of Tax Raturn
15. Charit.bla/Govarn~antal Baqua.t. (Schadula J)
14. Hat Valua of E.t.te Subjeot to Tax
I CHANGED
.00
700.72
.00
.00
923.71
.00
.00
(81
1,991.90
.00
1111
1121
1151
1l~1
NOTEI To insure proper
credit to your account,
sub.it tha upper portion
of thia for. with your
tax pay.ent.
1,624.43
1.991 90
367.47-
.00
367.47-
NOTEI
14, lS and/Dr 16, 17 and 18 will
raturns aBBelsed to date.
If an aBBeBBment was iBsued previoUB1Y, linBs
reflect figures that include the tDtal of abh
ASSESSHENT OF TAXI
15. ~ount of LIna 14 at Spou.al rata
16. A.ount of LIna 14 taxabla at Llne.l/Cla.. A rata
17. A.ount of Line 14 taxabla at Collataral/Cla.. 8 rat.
18. Principal rax Due
Ilil
1161
1171
TAX CREDITS I
PAYNENT
DATE
RECEIPT
HUI1BER
DISCOUNT 1+'
INTEREST/PEN PAID 1-)
.00 M .03.
.00 X.06.
.00 X .15.
1181
A/tOUHT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATIDN DF ADDITIDNAL INTEREST.
IF TOTAL DUE IS LESS TNAN tl, ND PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF TNIS FORN FDR INSTRUCTIDNS.I
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RESERVATION. E...t.. 01 decad~t. dVlng on O~ ~'or. Dec..ber 12, 1911 .. If any lutur. Int.r..t In the ....ta I, transf.rrad
In po.....lon Dr '"Jov.~t to Cl... I (col1.t.r.l) beneflclarl.. of the dec.d~t .,t.r the I.plrallon of any ....t. for
11'. Dr 'or v..r., thl Co..onw..lth h.rabv l.pr..'IV ral.rv.. the rlDht to apprl's, ~ ...... tran.',,, lnn-rltlnCa 'IX"
at the l",'ul Cia.. I (col18""I1) ,..t. on any IUch 'utur. Interut.
.........., II'
NOTICE. To fulfill the raqulraaent. of Slctlon Z14D of the Inherlt~. ~ E,t,t, ,.. Act, Act 21 of 1995. (72 P.I.
Section ,140).
PAvttEHT. D.tKh the top porUon of this Hotlu Met lubIIlt with vour p.)*II..... to the Rllllh.,,. of Wills prlnhd on thl ,..Vlrs. IIde.
...... chedr; 01" ~v a"d.,. PIV"'.' tal REGISTER OF MILLS, AGENT
RUUND (CAI. A refund of . tlx credit, which "I' not nquutad on thtl hie Aaturn, .'V ba nquut.d bv CMP..tlng ., "Appllc.tlon
far R.fund of P.nnsvlv~l. Inh.rltanc. ~ Est.t. T.M" (REY-ISI3). Applications .r. av.llebla at the Dfflc.
of the A.,l.t.r 0' Willi, anv of the 23 R.vlnue Dlltrlct Dfflc.., or bv c.llln, tho SPICIII 24-hour
answering 'Irvlc. nu.berl 'or far.. ardlrlngl In Plnn.vlvanl. 1-800-362-2050, out.ld. Penn.vlv.,l. ~
within lacll Hlrrl.burg Irl' (717) 787-8094, TDa. (717) 772-2252 (Hllrlna lapllrld Onlv).
alJECTlOHSI Anv p.rtv In Intlr..t not ..U.fled with thl IPpr.Is..ent, .UOWencl a,. dlsaUOWMCI of deduction., a,. ......Mnt
of t.. (Inducting discount a,. Int.r..t) .. .hown on this Hatlu .u.t abJ.ct within .htv (60) d.V' 0' rlc.lpt of
thl. Notice bv.
--written prot..t to the PA Dep.rt..nt of A.venue, Baird of Applals, Dept. 281021, Hlrrl.bura, PA 17121-1021, OR
--.l.ctlon to h.vI the a.tt.r dot.raln.d .t audit of the account 0' the p....ontII npr..ent.Uv., OR
--1ppI.I to the Orph.,.- Court.
AI>>UM
ISTAATlVE
CORRECTIONS.
Foctu.l .rrar. dl.cav.r.d on thl. .......ant .hould be Iddrl..ed In writing tal PA D.plrtaont of A.venue,
Bur.au a' Indlvldu.l T...., ATTNI po.t A......ent A.vlew unit, Dept. Z80601, Harrl.burg, PA 171ZI-0601
Phone (717) 717-6S0S. S.. p.g. S of the bookl.t "In.tructlon. for Inha,.ltanc. Ta. Alturn 'ar a A.lldont
Doc~t. (REV-1S01) far en 'Mplanatlon of ~Inl.tr.tlv.lv corractabl. .rror..
If any t.M due Is p.ld within thr.. (3) c.landar aonth. Iftlr thai dlcedent'. dtlth, I flv. porcant cs'n discount af
the t.. paid I. allaw.d.
The ISX t.M .-ne.ty non-partlclp.tlon penllty I. co~ted on the tat.l of tho tlM and Int.r..t ......ed, and not
p.ld b.for. Janu.rv 18, 1996, the 'Ir.t dav a,t.,. the .nd of the t'M .an..tv p.rlod. Thl. non-plrtlclpatlon
penelty It ltppI.labl. In the .... .llt'IMr IInd In the; thl .... U.. p.rlod .. you WOYld ~.I the; tn end Int.rllt
that h.. bMn .......d .. Indlc.t.d on thl. noUc..
Dtsaun .
PENAL TV.
JNTEREST.
Jnt.r..t It charg.d b.glnnlng with flnt d.v 0' d.Unquttncv, 0,. nln. (9) .onth. IInd ani (1) dlY fr_ thl d.t. of
d.ath, to the data 0' p.v...,t. r.M" which bec... d.Unquent b.for. JMUarv 1, 1982 beer Int.r..t .t the nta 0'
.IM (6~) plrcant p.r annul calcul.t.d .t . d.lly r.t. of .000164. All ta.a. which blc... d.llnquent an and .,tlr
January 1, 1'8% will b'lr Int.r..t .t . r.t. whIch .,111 v.ry fro. cllendar Yllr to c.lendar y.a,. with that r.t.
announclel bv thl PA Dopartaont of AlvlnUI. Th. .ppllcabl. Int.....t r.t.. for 191Z through 1997 .r.,
!.!!! Jnter..t R.t. D.lly Int.r..t Factor :!!!! Jnbr.at R.t. D.lly Jnloreat Factor
1911 2DX .aaOS48 1917 'X .0aaZ47
1915 16X . aaG438 1911-1991 IIX .0aa3Gl
1914 IIX .oaosol 199. OX .OaaZ47
1915 ISX .ooosn 1993-1994 7X .ooanz
1916 lOX .Oaa%74 1995-1997 OX .00aU7
--lnt.r.n h c.lcullt.d .. 'ollowlJ
INTEREBT . BALANCE OF TAX UNPAID X NUnBER OF OAY8 CELINQUEHT X DAILY INTEREBT FACTOR
_.Any Hatlc. 1..uad .ft.r the tax b.c~. d.llnquent .,111 r.fl.at an Int.r..t c.lcul.tlon to flft.en (15) d.y.
b.yond the data of the ........nt. If p.y..nt Is aiel. Ift.r ths Int.r..t cooput.Uan datI .hown on the
Notlc., .ddltJor.1 Int.rast .u.t b. calcul.t.d.
STATUS REPORT UNDER RULE 6.12
Name of Decedent I ::fn~i 0J/~
Date of Deathl
Will No. 1.. I - C('i-bt-?r 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 estatel
1.
Stat~hether administration of the estate is complete I
Yes No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
3. If the answer to No. 1 is Yes, state the followingl
a. Did the personal repr~ntative file a final
account with the Court? Yes No ~~-
b. The separate Orphans' Court No. (if any) for
the personal representative's account iSI
. c. Did the personal representative s~n
account informally to the parties in interest? Yes 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 at hed to this report.
Date:
Wel "o~.
VI ., n'.'''''-r;UJn::>
pre, 'nl::>
Signat.ur
YAfM~~ ~ .veJ/~
Name ( lease ype or print)
qos- W /...ov/e.er!;f
Address ~L , ':. t.. €-- Pit- 17~/)
( ) /71 2. '{q - III \'0
Te I. No .
9Z: 6\1 8- OSII S'6.
"1"/ "
JO '.
Personal Representative
Counsel for personal
representative
"jU
"0 )08
Capacity:
(MAHlrmf/AM3)
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CLAIK NO. 942011
DESCRIPTION OF CHECK
DATE PAID OB/22/94
\.... TYPE OF CLAIK/NAKE OF INSURED DEATH CLIIIK ON DOROTHY KELLER
NIIKE OF PAYEE
RAYKOND KELLER
KAIL TO
0/407
905 W LOUTHER STREET
CARLISLE PA 17013
POLICY NO.
I 6737026B
I 6737026B
ACCOUNT NAKE
DEATH BENEFITS INDUSTRIAL LIFE
DEATH BENEFITS INDUSTRIAL LIFE DIV ADD
AKOUNT
500.00
117.07
TOTAL ........
617.07
ADDRESS OF PAYEE
SOCIAL SECURITY NUKBER
OF PAYEE
,
"-,
, '
~r: -tri--W ..;..-.
"'1/1, /1' '"
," .,ii 1';jl;1l
1I.,i' III :11 I
',.111. ';:
BALTIMORE LIFE
10075 RED RUN BOULEVARD
OWINGS MILLS. MARYLAND 21117.4071
Ia.,oa
"iiI
RAYMOND KELLER
llo\rE 00/22/'.1/.
" r
0/'107
905 W LOUTHER
CARLISLE PA
DEA"fH
r
$617.07
STREET
17013
~
p~035?Op ~053~o?qBq~ ~BOO~5~?BP
AE01002P
PRU TRADITIONAL PLAN
50352602
DOROTHY I KELLER
, RAYMOND C KELLER
905 W LOUTHER ST
CARLISLE PA 17013
PRIMARY (LIFE)
SERVICED BY 950 P 00
FEMALE PAID UP
BORN 12-02-02
ISSUE AGE 64
AE01- 01
RHO CAMO Z AS OF 08-17-94
RES STATE 39 PREMIUM
OWNER
DIVD OPT
POLICY KIND
POLICY DATE
INITIAL AMOUNT
INSURED
PUA ISSUE DATE
L88 00-00-00
01-23-67
750"
SETTLE OPTION LUMP S
BENE RAYMOND C KELLER SON
TYPE 11 ORD
FOR ADDITIONAL PRIMARY INFORMATION, HIT PF2 KEY
ENTER NEW KEYWORD/ E TO END POL H OR DEPRESS ENTER KEY FOR MENU
KEY HSELECT DATA
AE01020P APPROXIMATE
PRU TRADITIONAL PLAN
50352602 DOROTHY I KELLER
PAID UP
DIVIDENDS
OPTION - PUA
LAST ANNIV DIVD
LAST DIVD EARNED YEAR
POLICY VALUES AS OF 08-18-94 AE01- 01
RHO CAMO Z AS OF 08-17-94
POLICY DATE 01-23-67
SERVICED BY 950
LOAN VALUES
INTEREST RATE
35.72 AVAILABLE LOAN
1994 EXCL DIVDS
INCL DIVDS
5.00
679.78
2,212.38
PUA (FACE VALUE)
CSV PUA
I
,
I
1,691.37.....
1,561.31
INCR IN CASH VALUE (AS OF 01-23-95) 3.75
TOTAL CASH SURRENDER VALUE (EXCL TERMINATION DIVD) 2,253.93
FOR ADDITIONAL POLICY VALUE DATA, HIT PF2 KEY
ENTER NEW KEYWORD/ E TO END POL H OR DEPRESS ENTER KEY FOR MENU
KEY HSELECT DATA
'j
,.
!"
,"'". "'. ,.~.
CalJllnl D1UCCro88
l>cnl18ylvanla D1ucShlchl
, liARRlSOURO. M. 17171
aC-eM frUelR
191305
ESTATE OF DOROTHY KELLER
C/O RAYHOND C KELLER
905 W LOUTHER ST
CARLISLE PA 17013-1727
AGREEHENT NUHBER
204018059
......................... EXPLANATION OF REFUND .........................
PERIOD OF REFUND
FROM l 09/01/94
TOI 10/01/94
REFUND REASONl CANCELLED DECEASED
TOTAL REFUND AMOUNT I
REFUND AMOUNT I
.93.20
t93.20
TYPE OF COVERAGE I
SECUR lTV 65
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==- WUULWUI< I H
::==- COHPORATfON
111849 1541 - OS7
UR.QI; Ml. tlrJE M).
11/01/94 12/01/94
"'0010 I'AY'AIIU
9222-26688
~- 51IAAUtl.lD
0.15
RAft
48
PAY $7,20**********
TO niE
8f!OER
,...111...111...,.."..11....111.,.1..1.11..1111...."1../1..,
DOROTHY I KELLER
X RAYMOND C KELLER
. 905 WEST LOUTIIER ST
CARLISLE PA 17013-1727
CONSECUTIVE
COMMON STOCK
DIVIDEND NO. 330
PA~Ar
Tho Fn. National _ 01 Chlcooo
on
Fn. Chicago TruIt Con.,II1JI 01 New \\It
FIr1I ChlclIgo TIUI/ Con..-nv 01 New \\It'
- DlaburaIno AoonI .
11 . d.lwJ oc L. J.
{jlM. U V ~~G~
'II CIlIa If lOIII/U II " UDI PUNC1/ our,
Cj 30000?0 ~ 51, 111' Q
1541
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70.23221710
030000701641
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D;,'. August 24, 1904
No.
IIUII.rolllr Dorothy IDle Keller
n. Raymond C. Keller
905 West Louthor St.
Carlisle, PA 17013
.'
l'mreu.iunal Sc~IL't.
]
$ 2395.00
Jf.dlitlel and l!qulrmclll
CIU.Lel
Inlcflnenl Rf(cplIKh:
2660.00
040.00
Tolnl'A'
:& 599!i.00
, .
..
"
CARLISLE MEMORIAL SERVICE, INC,
41 S. Bedford Street
CARLISLE, PENNSYLVANIA 17013
o N~((J) 0 (l~~ ~J
0428
(717) 243.5480
....
Mr. n~ond O. Kollor,
905 \~. Louthor st.
Oorlielo, PA. 1701;
Decombcr 1, 1994
OJI'DMlA OfUA NO
94-120 Kollor
.............
Harlin D. Hontzor
'.R....I
1iiIm~ ~illl.t'.Wl~ESCA1ifTio~,f~~tia ;mt.'PRlc:'B:~/; "t1ihtAM'ouNii1-1!'
~~~ ~...t1..~~~;;j.":~._.,....._...._".,..........-t4"'.l'LI.tw-.~.t~t..:..'''-'j,.~ ~!~~'."'<"":'J"""'~' .....1f~\4W...-:~4',
Inecription placod on Kollor momorial in I1t. Zion
oomotory for Dorothy I. Kollor. 31;7. 00
DO~~_I'1~~kLEn
~1
~ (\)\~i
\V\
ORIGINAL
~cy&w!
PlllXU'f*' (1\.iiii'1..~_'lt"l.o..ftOlIrCUINll.""