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Will
PETITION FOR PRODA TE and GRANT OF LETTERS
WI/I
Estate . .l4l~~~~1l . J::, . P.t,t; . . . . . . . . . . . . I . . . . . . . . . . . .
No... .il./. :-:1'f.-;.9.~... ............
also known as . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..................................................
To: Register 01 WPlmPilnd
Countyol~ Ihl'
. Commonwealth 01 Pennsylvania
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . Deceased.
Social SecurIty No. .. .1.li2.,22.,.0292 . . . . . . . . . . . . . . . . . .
The pellllon 01 the undersigned respectlully represenlslhal:
Your pelllloner(s) Is/are 18 years 01 age and the execut . Qt'll. . . . .. . . . . .. . . ... named In the last wl11 01 the
above decedent, dated. . .May. 22~. . . . . . . . . . . . . 19.81. . and codlcil(s) dal~d . ..NGne. . . . . . . . . . . . . . . . . . . . .
...................................................................................................
........................................................................................,..........
(Slate ,.Ievant chcum.tanc.., e,g, R.nunclallon, death ol..ecutor. etc,)
Decedent was domiciled al dealh In CumbeI land County, Pennsylvania, with her. . last lamll)'
or principal residence at ..31.1 E. .Burd Street,. Shippensturg, . Cuml:e.dand. County, . Pennsylvania.
...................................................................................................
Wst IlrHt. number and municipality)
Decedent, then. .66. . years 01 age, died .. .November .12,. . . . .. . . . . .. . . . . . . . . . . . . . . . .. . ... 19. 9li. . ,
at .. .313. E.. .Burd. S.tl:eet,. Shippeosburg, .P". .17257..........................:..... ...........
Except aslollows, decedent did not marry, was nol divorced and did nol have a child born or adopted alter
execution ollhe wtll ollered lor probate, was not the victim 01 a killing and was never adJudlcaled Incom.
petent ...... NQne. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.)
(II not domiciled In Pa.)
(11 not domiciled In Pa.)
Value 01 real estate In Pennsylvania
situaled aslollows: .............................,...................................
$ Y.C! ~ WO:W
$............
$............
$............
All personal properly
Personal properly in Pennsylvania
Personal property in Counly
WHEREFORE, petilloner(s) respecllully requesl Ihe probate 01 the last will and codlcll(s! presented here.
with Ihe grant ollollers . . . . Iestamental:Y . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . .. . . .. . . . . . : . . . . . .. thereon.
(Testamentary, adminlltratlon c.t.a., admlnlshallon d.b,n.c.t.a)
~J 411 Slon,'ure<O)ondRe,ldence(,1
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................................................................................... ................
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OATH OF PERSONAL REPRESENTATIVE
COMMOMWEALTHOFPENNSYLVANIA l SS
COUNTY OF . . . CV~~~R)'NlQ . . . . . . (
The pelllloner(s) above named, swear(s) or afflrm(s) that Ihe slelementsln Ihe loregolng pellllon afe true
and correct 10 the besl 01 the knowledge and beUel 01 pelllloner(s) and that as personal representallvels) 01
Iheabove pelllloner(s) will well and truly admlnlsler Ihe eslale ac:J.~ I,aw.
Sworn to or affirmed and sub. '~~"'" .. ;.y'.............................
scribed belore me this. ) ~!May 01 ~~':': . . <f:. Uf.#.~. . . . . . . . . . . . . . . . . . . . . . . .
NO~~,v> " 1,9 . .. . . . .. . .. . .. . .. . . .. .. . . .. .. . .. . .. . . .. . . .. . . .. .. .
.. . . ..,....... (0.... . . .:." . ..
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W."', ................................... ..............
. RY C. LEWIS
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ESlaleoUU. ~J:\'I.Le-~n .E, .Q~J:..... .... . .... .............. Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW. .... .~QV~f'lJl.EJ~ .?~............. 19. .9~. ,Inconsldefallonolthepellllonon thereverasslde
hereol, sallslactory prool having been presented before me, IT IS DECREED that the Instrument(s) daled
. . May. .22, .198;1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . .
described therein be admlUed 10 probate and Illed 01 record as the last wtll 01 . .I<!\~l)lel!l1. E.. .Qt~. . . . .. . . . . . .
...................................................................................................
and letters. . . .TestalOOntary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . '" . . . . I I . . ... .
are hereby granled 10 . .John. I... .Qtt . and. J.aan. E.. Yarner. . . . . . . . . .. . . . , . . . . . . .. . . . . . . . .. . . . . . . . . . . . .
.....................:.............................................................................
...............................................................(J........:......~~........
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Documonts Allached: Register of Wills
OalhofSubscrlblngWllness(s) 0 MARY C. LEWIS.
Oath of Non.subscrlblng Witness(s) 0
Oalh 01 Wllness(s) 10 mark 0
Renunclallon(s) 0
Letters Test. $ 70.00
3 Sh. Cert. 9.00
X-Page 3.00
JCP 5.00
.. .H.. Anthony . Adams.!' .Es'lu'l.t'e .t2Sli02.). . . ..
ATIORNEY (l:iup. Ct. I. D. No.)
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ADDRESS
TOTAL
532-3270
............................................
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COMUONWEALTH OF PENNSYLVANIA. DI!PAATMIHT 0' ttlA.LTH' YITAL RECOROI
CERTIFICATE OF DEATH
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21 - 94 - 986
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LAST WILL AND TESTAMENT
I, KATHLEEN E. OTT, being of sound mind, memory and underetanding, do make,
publieh, and declsre thie my Last Will and Testament, hereby rovoking all prior wills
and codicile made at any time before by me.
FIRST. I direct that all my funeral expenses be paid os eoon ae practicsble
after my death.
SECOND. I give and bequeath my Antique Light and Blood Stone ring to my daughter,
KATHY A. JARDINE.
THIRD. I give and bequeath my Mllrble Top bureau and Black Onyx ring to my daughter,
JOAN E. VARNER.
FOURTH. The reet and residue of my eatote I give, devise, and bequeath to my
children, JOHN 1. OTT, JOAN E. VARNER, MICHAEL L. OTT, and KATHY A. JARDINE, to share
and share alike per etirpes.
FIFTH.
I nominate and appoint JOHN I. OTT and JOAN E. VARNER ae the executors
of this, my Laat Will and Teetament.
IN WITNESS WHEREOF, I, KATHLEEN E. OTT, to this my Last Will and Testament, set
my hand and seal this ~ day of Mlly, 1981.
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(SEAL)
Sworn to and subscribed,
declared and published by
KATHLEEN E. OTT,
os her Last Will and Testament,
and eo done in the presence,
of we the witnesses, who
sign at her requeet, and in
her preeence and in the presence
of each other.
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COMMONWEALTIl OF PENNSYLVANIA:
: S S
COUNTY OF
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I, Knthleen E. Ott, the teetatrix whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge
that I signed and executed the instrument as my Laet Will; that I signed it
willingly; and that I signed it os my free and voluntary act for the purposes
therein expreseed. , ) , ';VJ
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Sworn or affirmed to snd acknowledged
before me, by Kathleen E. Ott, the
testatrix, the.<,c dsy of
May, 1981.
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NcJlIry Pub I c ~mnlU;N. UOTAnr 1'I1nrrc
My Conn. ExpirW~TlPEI1SilU!W. ~'O~7;,~)JlI' ~
, 'tulJDERLAlrD counrr
' 2tt COXMIGSIOl1 EXPInIlS UAY 1'1
COMMONWEALTII OF PENNSYLVANIA: .1996
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COUNTY OF
We, -':I. 1\..A\...tM-< 1\~a.\N\c.. and Co..rW\c...c,. ~the witneaees
whose nsmes are signe~ tb the foregoing instrument being duly qualified sccording
to law, do depose and soy that we were preeent and saw teetatrix sign and execute
the instrument ae her Laet Will; that she signed willingly and that she executed
it as her free and voluntary oct for the purposes therein expressed; that each of
ue in the hearing and slgnt of the testatrix signed the will as witnessee; snd
that to the best of our knowledge the testatrix was at tho time eighteen (18) or
more years of age and of sound mind and under no constraint or undue influence.
~\. \ ('()at\A0
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this , day of
and subecribed
and
, witnesses,
Mny. 1981.
before
Sworn or affirmed to
me by
Notary Public
My Comm. expires:
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21 - 94 - 986
REGISTER OF WILLS OF C' (, VIi' ~)"-rl(_.O COUNTY
OATH OF SUBSCRIBING WITNESS
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(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that h.t' '" Ir. "'. +- present and saw
L."J n ." ~ \ p,' ..l t lfti-
the testat I' ,,'( , sign the same and that I-\(d signed as a witness at the
request of testa' I " v In" p r presence and (In the presence of each other) (In the presence of the
other subscribing wltness(es)).
Sworn 10 or affirmed and subscribed before L(-~ ~,
me Ihls 18TH day of ~--
NOVEMBER . ,}~,.J!.4 ,,)e, p. VI" c;( f"'''~ ~Lk.-. Q, 17,)'57
?,IA(ff ({ ~;~ :"..Cfd12J-r:t':t;~. (AkdreSS) '--U
,-, '" ~ .' : , Register .', I
\, I ' MARY C. LEWIS (Name)
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(Address)
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~~GlffiR OF WILLS OF C' \J. IM-~ (ci)COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (eUc
.s,h:o ; s
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leslet ~ I Y of (one
c.,l-c-,
of the subscribing witnesses to) the
elng duly qualified according to law, depose(s) and say(s) Ihal
familiar with the signature of K c, 'II, /A" to'! ~ D1(
eodldl
will
presented herewith and
codicil'
believes the signature on the will 15 in the handwriting of
that
Wo.-\\A'PP",,1 ('c, ()~d
10 the best of '^'" r knowledge and belief. /
Sworn to or affirmed and subscribed before ':7<<1,/; 4; ~'71 ((-((; ("
me Ihls 18TH day of ' / (Ume) G ( I 0
NOVEMB R 9 94 (~~? K ,r';\c~.,L(.... ~,<.,<I) 0' I'sr.} rCt,
J (Address) I I ')0 ( '3
(Name)
(Address)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
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I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphan's Court Rules was served on or mailed
to the fOllowing beneficiaries of the above captioned estate on
September 26, 1994
Date of Death:
November 12, 1994
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Name of Decedent:
Kathleen E. ott
~
Will No: 1994-00986 Pa File No.: 2194-0986
~
To the Registerl
Name
Address
143 South side Drive
Newville, PA 17241
313 E. Burd street
Shippensburg, PA 17257
Joan E. Varner
John I. ott
Michael L. ott
Kathy A. Jardine
Deceased
687 Barnstable Road
Carlisle, PA 17013
Notice has now been given to all persons entitled thereto
under Rule 5.6(a) except: None.
Date: 12/22/94
~ ~"'''''"., ~--:::'
H. Anthony !J!IlmlJJ_ squ re
128 E. King street
Shippensburg, PA 17257
Telephone: 532-3270
Counsel for Personal
Representative
Jv 500,"+ I"'" ./ JlC,l/ I J .JiJ./ 1-l\'i \ 'ORD"JII0'DI"'H,.mRI2/311~ICHIC~IQII<.
. .~. I~J ~ ::r.o' .:. ~ . INHElmANCE~T1x RETURN ~o~m~u~::DI"S CLAIMID 0
'1:"}~".:.!' RESIDENT DECEDENT 'Ill NUMUR
tClMMOtlWI"'tlOIPI"tl5YlVA"1A (TO BE FILED IN DUPLICATE ,"/ (:JtJ r:/'7?~
' . D"A'b~WWJ:'IYltlUI WITH REGISTER OF WILLS) >< (: I'
IlAIlltISlUIIO.'" 11121 0601 COUNTY CODE YEAR NUMBER
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ID.\ll1lrliUII' /D.\Irll1111lW-
162-22-0292 Lu" 1 ~-<J4 17-4_77 t""
rn 1. O'lglnal R.'u,n 0 2. Supplom,n'al R,'urn
o A. lImll.d Ettate [J Aa. Future Inlero.' Compromhe
(I., do'.. of dO.lh aftor 12.12.821
016. Doc,d,nl DI,d Tolla" 0 7. Doc,d,n' Maln'aln,d a living T,u.1
A!I.ch c. .f Will) Altach c. of T,u"1
ALL CORRISPONDINCI AND CONfIDENTlAL.TAX I fO AT ON SOLD BI DIRECTID,TOI.~' ....i'..\'. ..;.
U~E MAILING ADD.
03.
05.
R.malnd.r Return
(f., do'.. of d,.,h p,larl. 12.13.821
Fedoral Ellalo To.
R.lu,n R.qul,.d
_ 8. T.lal Numb" of Safo Dopo.IIBo.o.
H. Anthony Adams. Esquire
mUImFInlUlUh
128 E. King Street
Shippensburg, PA 17257'
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I. R.al E1'o'. (Sch.dulo A) ( I)
2. Slack. and Bond. (Schedulo BI ( 21
3. Clo..ly H.ld S'ock/Pa'lno"hlp 'nl"o.I(Schodul. C) (3)
4. MO'lgag.. and No'o. Rocolvahl. (Sch.dul. DI ( 4)
5. Ca.h. Bank Depo'lI. & Mlltollan.ou. Po "anal P,op"lyl 51 2 .064.88
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6. Jolnlly Owned P,op"ly (Schodulo fl ( 61 22,971.82
7. T,onal".(Sch.dulo G) ISch.dul.LJ ( 7) 0.00
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9. fun"al hp.n..., Admlnhl,allvo Ca.II, Mlltollan.ou. (91 7.327.62
E.p.n," (Sch.dulo HI
10. Dobl', MO'lgag, L1ablllll.., L1.n. (Sch.dulo II (101
11. Talal Doducllon.('a'allln.. 9 & 10)
12. No' Valu. of E,la'. (IIno B mlnu.lI"o III
13. CharUable and Governmental Oeque'lI t5chedure J)
lA. Net Value Sub _clio Ta~ line 12 rnlnulUne 13)
15. Amount or IIn. 14 ta~obl. 01 6% rate
tlnclud. valu.. rrom Sch.dule K or Schedule M.I
16. Amounl of IIn. 1.4 IUKabr. 01 15lfb 101,
(Includ. value. from Schedule K or Sch,dul. M.I
17. P,lnclpalla. du.(Add 'a. f,.m IIn. 15 and f,om IIn. 16.)
10. Credll. Spou.al Poverty Credll Prior Payment. Discount
+ 1.000.00 + 50.00
I~. If IIn, IB h g"a'o, Ihan IIno 17, on'e, II.. dllfe"nc. an IIn. 19. Thl. 1.11,. OVERPAYMENT.
IiIO...I't'lI":II!'II'...'..I......ll..IJ..riJl'IlfiI1hilt.i.rnrrrrnn..lOlll....'..,llii'lilfiJI1.
(18)
(19)
~.
,
'"
'1J
-
'-I
O'l
(BI 25.036.70
,1' 7
~ 1"11(/1. I},
7,327.62
17,709.08
,.
20. If IIn, 17 h g"olo, ,han IIn. I B, 'n'" Ih. dill".n" an IIno 20. Thl. h Ih. TAX DUE.
A. Enler the Int.re.t on the balance due on line 20A.
B. En'" Ih. 10101 of IIn. 20 and 20A on IIn. 20B, Thl. I. Iho BALANCE DUE.
Make Chock Payablo to, Rogl.I" of Will., Agont
I. .... ....... BISURI TO ANSWER ALL QUllrlONS ON REVU" SIDE AND TO,RECIlECK MATH...........'~: l/l"\lr"'~'
Undlt p.naltl.. 0' p.tIUty. , d.ch". .holl hove ..amln.d .hlt relurn, Indudln actompan)'lng .ch"du II and ,'o'.m,nll. ond 10 . e b..r 0' my .nowl. O' an "'.
II Is tru.. cou.d and tOmplele. I dedare thaI all real 81101. hal b.. lIe t morllll value. O.c1alallon 0' p"pare, other than Ih. p.rsonol "pr...nloll... II
oled on olllnfotmollan of which p"po"r hal any .nawl.do..
rornnmnllrollllJlrllll11l1lllnllUI" AGGII ..3,J r . '~"f'f"""
~"I""I"a( ,II {hI/of
rfAUIOIllu-m.\ffJlIJmm.\I/lir AGGIIll f"
.. ,-.,- . t1-L-tu L--
0.00
I;
~-
(,
:Oc;;
p;:>
0.00
(II)
(12)
113)
(14
(15112.,709.08
".06.
17.709.08' .
1,OIi7.'i4
1,050.00
17 'i4
12.54
(161
".15. ,
117)
Inter..'
120)
(20A)
(20B)
DAn
DATI
.
COMMONWEAL TIt or rENNSVL VANIA
INIlERlTANCE TAX 1IF.1UIIN
nEslUENT IJECEUEN r
.
EliT AT E UF
. Kathleen E. Ott
C^" PIOP."y lollllly onn.d v.llh ,i;~1iiiil,~iB,j;~iw1cif,ill,.~!~iil;;;iiicill~iti~~I"I.~:::I:L-....._~~..
ITEM
NUMB En
IlI:lIEIJIILIi ......
I:A!l1l ANIJ MISCr:l.l,AN"UUS
I'EI\SUNAL "I\Uf'lm rv
.... ~~~~'::. .;~r-::_.....__
!"Ill: ~UMUEn
lI!:sellll'IIUN
VALUE AT
DATE OF DEAllI
---...--
1.
Dauph~n Deposit Checking
Acct. # 97442097
1,254.31
2.
Miscellaneous Cash
60.57
750.00
3.
1988 ~~e Aries
r
,
I
i
..
f
;
r
1 urAL (A"" ""I., "r~~lIn G. 11.0.1'11111.110111
S 2 064 88
'" 'tint. '1IIlt. I. n..dH l"tI,. Iddl!'n"lt .h.... or .11tI1 .Int
lllil "'~~4i;;.* .i
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IIY.I509 IX. 17.111
SCHEDULE "'" I
JOINTLY-OWNED PROPERTY
-- _____d______._, ,u'--FiLiNUMiiEii
COMMONWfAltU 0' 'IHUIYlVAHIA
lHItUItAHCI 'A' ./'U.1t
_"IDIHt DlerD Hf
mATIO'--
K"thlppn 1=:. On
Jolnl 'ononll.l.
NAME
A. Joan E. Varner
... _ _~_h.________.__._. _.____
_ .___.____. .A!l.l~R.!!Jt._. .. _. ,....._.... ,J!lLo\T10NSHIP TO DECEDENT
143 South Side Street daughter
Newville, PA 17241
Jolnlly.ownod p.oporty.
.'__0'_-
LEnER DATI
ITEM FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBE' JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
.
1. A 1988 Dauphin Deposit Savings Acct. 45,.9/.3.64 50% 22,971. 82
Acct. #49-38-7-0741-1
-
TOTAL IAI.o onlor on IIno 6, Rocapltulallan) S 77.971 82
III more 'pac. 11 n..cI.d in,,,' additional .h.." o( ,ome II,.,
m"llOF
Kathleen E. ott
ITEM
NUMBER
1.'1-111111""'11
". '. "..,..."'.....,,'."....."'._i
t!j;~
(OMMOI'weAIIIIOI ",ltllnVAUlA
UUlllIIlI^"cr ,^x IIfllllllU
IIUlbUU O(((OUII
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.o P,lnl or TV 0
mrnUMli
DESCRIPTION
AMOUNT
A. Funoral Expon....
1.
2.
3.
4.
B.
A.
C.
1.
2.
3.
A.
5.
6.
7.
8.
I.
Fogelsanger-Bricker Funeral Home
Cumberland Valley Memorial Garden
South Newton Township Fire Dept. (Bldg. Rental fOL Memorial
service)
Food Supplies (served at Memorial Service)
Ad,nlnl..rall.o co.lI.
Perianal RlfJrtnlnlallva Commlnlonl
Sodal So.u,lIy Numbor 01 ro"onal Rop,o.onloll.ol
Voar Commllllon. pold
90.19
5,082.50
550.00
100.00
2.
Allornoy foo. - H. Anthony Adams, Esqul,re
1,.000.00
.'
3. family E~ompllon
Clolmanl Rolallon.hlp
Add,o.. of Clylmonl nl doudonl'. doalh
Slrool Addro..
Clly 51010
Zip Cado
Probalo foo. - Register of Inlls
102.00
Mloc.llan~ouo, Exponu.. .
Borough of Shippensbure (water final)
arner Cable (Final bill)
nited Telephone
107.07
63.94
47.73
91.88
91.51
.
ASCO (final bill)
enelec (final bill)
"
. ,
.'
:', .
.:.' I ~
TOJAL (Aha .nlor on IIno 9. R..opllulallan'
IIf mar. opac. 10 no.dod. In.o,' addlllonal 01000'0 of oamo 01.../
S 7327.62
. ,. ._..",..~.._""_..~-....-.,...,......,.~-.,.,,.. ".~. -. .._"-''',-~.,-
.. '"'" '"ij l
'1~~f~ SCIIEDULE .1
CO",,,u')U'fI'''"nU'''''"''I''''"IA BENEflCIAlllES
IUlII....ttUI"..IllJ.1I
'!llClllllt!!.~I'II!.'.'.1_::':"'_"~R._" .._.. ~---":;\-:r.--r;;=-' U.l.--.-~___z=
ESTATE OF . -- - - ,---- ,- - _m'____ -- -,.. - ,--,- --- rlt:E'NUMDER
-."'...-'"
-,-=.~.....,...>
, -
. ~:~.-.'. _:_....,.;,....~.,;.",.,..._""~.."'-.: ...........,..-.rI'j.
Kathleen E. O.~_ '.______.__ _......____,_,.___,_,.,_...,.
ITEM
lIUMDER
lIAME ^,W ADDItESS or ummCIAlty
RELAJlONSIIIP
AMOUNJOR
SIIARE OF ESTATE
I.
A. TOAubl. BetlUIIlIl
Joan E. Varner
143 South Side Drive
Newville, PA 17241
John I. Ott
313 E. Burd Street
Shippensburg, PA 17257
Kathy A. Jardine
687 Barnstable Road
Carlisle, PA 17013
---..------.---
(MId
1/3
2.
Child
1/3
3.
Child
1/3
ITEM
NUMBER
lIAME AlW ADDRESS OF DENEFICIARV
AMOUNT OR
SHARE OF ESTATE
B. Challlubl. and GO'l.,nmanlol b'llu""1
I.
TOJAL CIIIIRIT^BIr: ^I~D GOVERHMtNI^l Br:aUESTS l^lto 0/11., on 1;,,0 IJ. Roc.pllur'llon' S
-li'-;;;';;;-;;';;;i';-';~-.~J;j;'i;;;;;'~ddlii;;;~i-~I~~'.il or lam. "1')
i"
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.
....;"
.
-..
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-- - - - - ------ - -- - ---- - -- -_ __ .__ 0_._ _ _ ___ _ ___ _ __ _ ___ ____
.j....",'
0," '. ,'A' A" ,"022'817 COMMONWEALTH OF PENNSYLVANIA
NO. , , ' DIPARTMINT O. RIVINUI
OFPlCIAL RECEIPT.' PENNSYLVANIA INHERITANCE AND ESTATE TAX
, (
'*'
!._.,t,
"
,..'\lllt! 1Jl1~.t41
RECEIVED fROM.
&
ACN
ASSESSMENT I!'
CONTROL iii
NUMBER
AMOUNT
ADAMS H ~NTHONY
,
le8 EKING ST
101
.1,000.00
"
SHIPPENSBURG PA 178~7
- fOtD HUf tOtD HI"
ESTATE INfORMATION.
t:'I fiLE NUMBER
Y 81-1994-0986
t:'I NAME OF DECEDENT (LAST)
~ OTT KATHLEEN E
II DATE Of PAYMENT
II POSTMARK DATE
COUNTY
SSN 168-88-0898
(fiRST) Mil
CUMBERLAND
OATE Of DEATH
m TOTAL AMOUNT PAID .1 ,000. 00
RECEIVED B~ ~ (J. yG . J'
Y/-Lf I{~'_NAIURE ~
~R OF WILLS ~~SrS~ERL~F aILLS
-..----- - --------.,.-.,~-----.----.--.....:...... -.-- -,-- ----- -- - -..---;-r------ r--
i;j, ' . " "1,";; :..., ,'<
.
A
REMARKS
JOHN OTT ~ JOAN VARNER
SEAL
.'
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,
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,
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-~. '.,
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" .... ..- -.,,~.., '-''''
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tf . . . ·
--- ----...----.---------- -- - ._--- --- ------- --- - --------
"",,,,5 ~,~~,lf~(p , , ,
~(,:i.;..,:,;,',<,.-.,-\f-;..;. ):-,,',:,;';<',' -> .'
D'Nd~A-9229Q,7 COMMOND~~~~~T~r R~~~:YLVANIA
(;i~,i~1I1:"~I' .' '.,OFflCIALRECEIPT. I'ENNSYLVANIA INHERITANCE AND ESTATETAX
6'01(,
C)j-~i ·
~
RECEIVED FROM:
&
ACN
ASSESSMENT I!I
CONTROL I:lI
NUMBER
AMOUNT
ADAMS H ANTHONY
leB E KJNB ST
101
.1S.II".
SHJPPENSBURB PA 17ee7
'OIDHUf
ESTATE INfORMI\T10N,
~ fiLE NUMBER
~ el-1994-09S11
~ NAME Of DECEDENT (LAST)
~ OTT KATHLEEN E
., DATE Of PAYMENT
Iii 03/01l/ge
EI POSTMARK DATE
COUNTY
SSN ll1e-ee-oege
(fIRSTI (Mil
I
I
-I
I
CUMBERLAND
DATE Of DEATH
m TOTAL AMOUNT PAID
.le.elf
SK
REMARKS
JOHN J OTT & JOAN E. VARNER
SEAL
" (./
RECEIVED BY ~ -" ",' ,. , '.'
O-"GNAIURE , ",\ +
MARY C. LEWJS 1'.-- tle", 'I'" '\
REBJSTER OF WJLLS '
CHECK" le
REGISTER OF WILLS
~~-----~~--~~----~---------------------~-~7--~~---
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REV 1547 EX AFP (12"94*
AllH OF PEHHSYLVANIA
P'AHtENf Of REVE:1fJE
BUREAU OF INDIVIOUAL TAMES
Df:PT. Zl0601
HARRISBURG, PA 11121aQ6Dl
It!- ). 'I y- /0
NOTICE OF INHERITANCE TAX
APPRAISENEN1. ALLOWANCE OR DISALLOWANCE
OF DEOUCTIONS AND ASSESSNEHT OF TAX
ACN 101
DATE 05-08-95
FILE NO.
OF DEATH 11"12"94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBNIT THE UPPER PORTION OF TNIS FDRN WITH YOUR TAX
PAYNENT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
H ANTHONY ADAMS ESQ
128 EKING ST
SHIPPEN5BURG PA 17257
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AltOUht R..Uted
,yO'/"
/
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR VOUR RECORDS ~
iiiii=iii47"ix"liFP"iiZ':94T"iiilYici""ciTYNHiiiii'ANCi"Ylix-jiJijiii'A"fsiif€ii'i'";-m."ciiiAifci"jjFimmm"mm"
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF OTT KATHLEEN E FILE NO. 21 94-0986 ACN 101 DATE 05-08-95
APPROVED DEDUCTIONS AND EXEMPTIONS:
7, lt27 . 62
9. Funaral Expans../Ad.. Ca.t.'Hllo. Expan... (Sch.dul. H) (9)
10. Debt./Martvage llabiliti../Llana (Schedule IJ (10) .00
11. Total Deduction. 111)
12. H.t Value of TIK R.turn (12)
13. Charitabla/Covarnlllnt.l Bequa.h (Sch.dul. ,,1) (15)
14. Nat Valu. of Eat.t. Subjeot to TaM: (14)
NOTE: If an assessment was issued previously, lines 14. 15 end'or 16. 17 and 18 will
reflect figures that include ths total of ~ returns aBleBBed to date.
ASSESSMENT OF TAX:
15. AMount of Lina 14 at Spou..l rat. (IS)
16. AMount of Lin. 14 t.xabl. .t Lin..l/Cl... A r.t. (16)
17. AMount of Lln. 14 t.xabl. .t Coll.tar.l/CI... 8 rat. (17)
18. Prlnolpal Tax Du.
TAX CREDITS:
PAYNENT
DATE
02-10-95
03-02-95
TAK RETURN WASI C X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Ra.l EIt.t. (Sch.dul. A) (1)
2. Stock. and Bond. (Schadul. 8) (2)
5. Clo..ly H.ld Stock/Partnar.hlp Intar..t ISchadul. C) IS)
4. Hortaage./Note. Rec.lyabl. (Schedul. D) (4)
s. C..h/Bank D.po.ita/Hl.c. p.r.on.l Proparty (Schedul. E) (5)
6. ~olntly Own.d Prop.rty (Schedul. f) (6)
7. fran.f.r. eSchedul. Q) (7)
8. Tot.l A...t.
RECEIPT
NUNBER
AA022817
AA022907
DISCOUNT
INTEREST
c.)
C-)
52.63
.00
CHANGED
on
c: -:' \0
~~' <./,
,._ .00
, .00 s;;
.00 -<
.00 ..h
2.064.88
22.971.82 ~..
-t1' ..00 ,'...
.}.....:.- un W
.00
17,709.08
.00
X .03.
X .06.
x .15.
(1BI
ANOUNT PAID
1,000.00
12.54
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER OATE INDICATED, SEE REVERSE
FOR CALCULATION OF AODITIONAL INTEREST.
:;)
:Dr:,
(I ,.,
I
Vi n
~.
25,036.70
7,3" 6?
17,709.08
.00
17,'109.08
.00
1,062.54
.00
1,062.54
1.065.17
2.63CR
.00
2.63CR
IF TOTAL DUE IS LESS THAN '1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRI, YOU NAY BE DUE
A REFUNO. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Kathleen E. Ott
Date of Death: 11-24-94
Will No. Admin. No. 1994-00986
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 X 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 followingl
a. Did the personal representative file a final
account with the Court? Yes No X
b. The aeparate 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.
Date I 11-15-96
~ (6)~~
Signat.ure
-.
o'r]
'"
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-
~.
r.:;-:
H. Anthonv Adams. Kqouire
Name (Please type or print)
128 E. Kin~ Street. Shiooensburg. PA 17257
Address
( 71~ 532-3270
Te 1. No.
",
co
-
Personal Representative
Counsel for personal
representative
Capacity:
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@
X
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CfmH I rm'f / ^'g~
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