HomeMy WebLinkAbout95-00437
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PETITION FOR PROBATE and GRANT OF Lt;11t;RS
Eslatt at I.IlCV E. Adnms No. -2J., '15 - ~3 7
also known IU To:
Realstcr of WUls for the
INcrlUtd County of Cllmbe rlnnd In the
Social Security No. 1 70-50-09~8 . . Commonwealth of pennsylvania
The petltlon of the undcrslllled respeclfuUy reprcsenU lhat:
Your petltloner(s), who blare 18 years of aae or older an lhe execul or
In the last will ofthe above decedenl, dated October 27
and codlcil(s) dated
named
. 19...21-
(Iwe rdevanl draurul&nCa, e... rfound.doD. death or execulor. cte.)
County, PCIlIISylvanla, with
^ t. 219
Oecendenl was domiciled at death In Cumberland
h PT last femUy or principal re:ldencc at 824 I.isburn Rond
I.ower Allen Townshi
(UJllUect, .umber lIld mWlClpallty)
Decendent, then 94 years of age, dled . Mav 19 , 19 95
at Harri;:ahur~ Hoapitnl. Har.risburg. Dnupllln County I PA .
Except as foUows, decedent dld not marry, was not dlvor~ and dld not have a child bom or adopted
after ellecutlon of the wlU offered for probate; was not the victim of a IdIIIns and was never adJudlcated
Incompetent: no exceotion
Dccendent at death oWlied properlY with estimated values as foUows:
(If domiciled In PL) All personal properlY
(If not domiciled 1a PL) Personal propertY In PCIlIISylvanla
(If not domiciled In I'L) Personal propertY In County
Value of real estate In Pennsylvania
situated as foUows:
s
s
s
s
201,000.
-0-
-0-
None
.
WHEREFORE, petltloner(s) rcspeclfuDy reciiicit(s} 'the" probate' .of' the-mt' WiD"Uid"CodJCiI(sj"
presented herewith and the grant of leller< Testnmentnrv
(1tsW1lmtaly; admlolJlntlOll C.'.L; admlnl"'OIIoa d.b.....LL)
theron.
I~
11
I~
and Trust Compnny
~
Dnuphin Deposit Ban
By:~L--
e I Keck
AqqiRtnnt Vire Preqident
f1nrl 'l'rIlClt' nffic-pr
P.O. Box 2961
Hnrrisburl?. PA
4N
17105
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } as
COUNTY OF ----G.!.!n,:,,"rlfi:1d
The r-etltloner($) above-named swrar(s) or af/1nn(s) that the statements In the foregoing petition are
true and correct 10 the best of lhe Icnowledae and beUef of petltloner(s) and that as personal represcn-
tatlvc(s) of the above decedeat pcI!tloner(s) will weU and trUly administer the estate accordlna to law.
DnuPhi~' osit Bank nnd Tru~~ yompnny
Sworn to ,?r afflm:ed _.and subscribed { BY: _ L- //...... 4Lv I' r-rr ~
before me !hi: . r,.. _ day of 1(0 crt L. Kl!c'k.'" ..
, -Il~"~ 19-22-- Assistant Vice President nnd i
"n11~".jJ.\, y~ ;;IjU"Y./~~ Trust Officer ~
/.5'-,3,?- ;;r M~~. ,ewJ.S R~glsitl ~
". ..
No.
21-95-437
Estate of
, Deceased
Lucv E. AdnmH
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW June 6th. 19 95 , In consIderation of the petition on
the reverse Ilde hereof, satisfactory proof b.tv1na been presented before me,
rr IS DECREED that the Instrument(l) dafrd October 27th.1993 '
desc:rlbed therein be admitted to probate and rued of record as the last will u'f
, Lucy E. J\d!lT1S
and !.cum Testaoentary
are hereby granted to Dauphin Deposit Bank and Trust Cannany C/O Robert
L. Keck, Asst. Vice President /Trust Officer
-
FEES
m4J/Uf.. C, ('/&.f;'4{ 1);, ,j ;t,J('U~ /t? fl~(/;~
/1 lloalM' I WIllII' 'f/L ;I ""7". '7T'
(/ M"ary oc. Lewis '
Nenl S. West, Esquire (032485)
McNees, Wnllnce & Nurick
A Tl'OIlNEY (Sup'.?- L~.. No.)
100 Pine Street, Harrisburg, PA 17108-1166
ADDRESS
(717) 237-5220
PHONE
270.00
Probate, Letters, Etc, '0"" 0 .. S
9.00
Shorl CertIficates( 3) ....... ... S
Renunc:iatfoD 00'" o. 0.'...... S
X-Pages (5)
JCP
S 15.00
:J.uu
TOTAL _ t
FIled . ,'. .~!Jne;. ~/.l.~~~......,.. .~:?'.~~.
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Mailed Letters and Order to Executor
I
on 6-6-95.
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LUCY E. ADAMS
.
I, LUCY E. ADAMS, of Cumberland County, pennaylvania, declare thia to be
my will and hereby revoke all prior wille and codicile made by me.
1. Pereonaltv. I bequeath euch iteme of my tangible pereonal
property ae are epecifically itemized on a liet, if any, in my handwriting,
eigned and dated by me at the end thereof, and attached to thie my Will, to
the pereone named therein to receive euch iteme. I bequeath my two figurine
pi~turee which are now located in my living room to my eon, Dalton L. Hoffmen,
if he eurvivee me. I bequeath all the reet of my tangible pereonal property
not ueed in bueineee or for the production of income, including without
limitation furniture, furniehinge, clothing, jewelry, objecte of art and
decoration, and the like, and any motor vehiclee which I own, together with
the ineurance thereon, to euch pereon or pereone ae my executor may in my
executor'e eole diecretion, determine, after my death.
2. sDecific Beoueete. I bequeath the eum of Three Thoueand Dollare
($3,000.00) to each grandchild of mine who survives me, with eaid ohare
dietributed outright to each ouch grandchild. I bequoath the oum of One
Thoueand Dollare ($1,000.00) to Grace United Methodiot Church, preoently
located at 313 Herman Avenue, Lemoyne, Pennoylvania.
3. Reeidue. I bequeath, devioe, and appoint all the reet of my
property, of whatever nature and wherever oituated, including property over
which I hold a power of ,appointment, ao followo. euch property ohall be
divided into one ohare equal to oixty percont (60') and one ehare equal to
forty percent (40'), with the firot ehare (60') diotributed to my Bon, A.
Gerald Hoffman, if he eurvivee me, and the eecond share (40') distributed to
my eon, Dalton L. Hoffman, if he survivee me. If A. Gerald Hoffman shall fail
to eurvive me, but hie wife survivee me, then his ohare shall be distributed
to hie wife. If A. Gerald Hoffman and his wife both fail to survive me but
leave ieeue of A. Gerald Hoffman who do survive me, or if Dalton L. Hoffman
.hall fall to .urvlve me but leave. la.ue who do .urvlve me, then the .hare of
the dec.a.ed child of mine who left 1..u. who eurvlv. m. ehall b. dletribut.d
per .tlrpe. to the 1..ue of auch decea..d child.
4. survlval. If any beneficlary .hould die within .ixty (60) day.
.ft.r me, then he .hall b. d.em.d to have pr.d.c....d m. for all purpoe.e of
this wl11.
5. Soendthrlft Claue.. No int.r..t (wh.th.r in incom. or prlncipal,
whether or not. remalnder int.r..t, and wh.th.r veet.d or contingent) of any
beneficiary h.reunder shell b. eubject to anticip.tlon, pl.dg., .eeignm.nt,
..le or tranef.r ln any mann.r, nor ehall any ben.ficl.ry h.v. power in .ny
m.nn.r to charg. or encumber hle eald int.r.et, nor eh.ll the e.id lnt.r.et of
.ny b.nefici.ry be 11able or subject in .ny m.nner while in the poeeeeeion of
my fiduci.riee for .ny li.bility of such b.n.fici.ry, wh.ther euch ll.billty
.rie.. from hie d.bte, contracte, torte, or oth.r engag.m.nte of any typ..
6. Facilitv of PaYment for Minors or Incomcetente. Any amounts or
....t. which .r. p.y.bl. or dletrlbut.bl..to . minor or lncomp.tent hereunder
m.y, at the di.cretion of my fiduclariee, b. p.ld or dietrlbuted to the p.rent
or guardian of .uch mlnor or incompetent, to the per eon with whom such minor
or lncompet.nt r..ide., to a truet exietlng eol.ly or prim.rily for the
b.n.flt of .uch minor or lncompet.nt, or dlr.ctly to such minor or
lncompetent, or m.y be .pplied for the uee or b.nefit of such mlnor or
incompet.nt.
7. Power.. In addition to such other pow.re .nd dutlee .e may be
gr.nted el..where hereln or whlch may be gr.nted by l.w, my flducl.riee
h.r.und.r .h.ll h.ve the following powere .nd dutiee, without the neceeelty of
notlce to or con.ent of .ny court, but eubject to .ny .ppllc.ble requlr.m.nte
of ordin.ry due c.r. .nd loy.lty.
(a) To ret.in .11 or any part of my pror..rty, re.l or
per.on.l, in the form ln whlch it may be held be the tlme of lte
r.c.lpt, lncluding .ny cloe.ly held bueineee in which I have an
int.r.et, a. long .e in the exerclee of thelr diecretion it m.y b.
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(g) In dividing or distributing any property, real or
per80nal, includ8d herein, to divide or distribute in ca8h, in
kind, or partly in ca8h and partly in kind.
(h) without limitation of power8 e18ewhere granted
therein, to hold, manage and develop any real e8tate which may be
held by them at any time, to mortgagD any such property in such
amount8 and on euch terms a8 they may deem advisable, to lease any
such property for such term or terms and upon such conditions and
rentals as they may desm advisable, whsther or not the term of any
such lea8e ehall excssd ths period psrmitted by law or the
probable period of rstention under this instrument I to make
repaire, replacement8 and improvemsnts, etructural or otherwise,
in connection with any euch property, to abandon any such property
which they may deem to be worthleee or not of eufficient value to
warrant keeping or protecting, and to permit any such property to
be lost by tax sale or any other procsedings.
(i) To smploy euch brokers, banke, cU8todians, investment
couneel, attornsye, accountante, and othsr agsnte, and to delegate
advisable eo to do, notwithetanding that said property may not be
of a character authorized by law.
(b) To invest and reinvest any funds held hereunder in any
property, real or personal, including, but not by way of
limitation, bonds, preferrsd stocks, common stocks and othsr
securitiss of domestic or forsign corporations or investment
trusts, mortgages or mortgage psrticipations, mutual funds with or
without salss or redemption chargss, and common trust funds, even
though such property would not be considered appropriate or legal
for a fiduciary apart from this provision.
(c) To s.ll, convey, exchange, partition, give options to
buy or lease upon, or otherwise dispose of any property, real or
personal, at the time held by thsm, at public or private sale or
otherwise, for cash or other con8ideration or on credit, and upon
8uch term8 and for such pric8 a8 they may determine, and to convsy
8uch property free of all tru8ts.
(d) To borrow money from any per80n, including any
fiduciary hereunder, for any purpo8e in connection with the
administration hereof, to execute promi88ory notes or other
obligation8 for amounts so borrowsd, to 8Scure the payment8 of
such amounts by mortgags8 or plsdge8 of any property, real or
per8onal, which may be held hersunder.
(e) To make secured 10an8 or un8ecured 10an8 if to any
issue of mine or to a trust e8tabliehed by or the e8tate of any
issue of mine, in such amounte, upon 8uch terme, at 8uch ratee of
interest, and to 8uch pereon8, firme, or corporation8 as they may
deem advieable.
(f) To renew or extend the time for payment of any
obligation, eecured or unsecured, payable to or by them as
fiduciaries, for as long a period or periode of tims and on such
terme, ae they may determine, and to adju8t, eettle, and arbitrate
claime or demande in favor of or again8t them.
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to them euch dutiee, righte and powere ae they may determine, and
for euch periode ae they think fit.
(j) To regieter any aecuritiee at any time in their own
namee, in their namee ae fiduciary, or in the namee of nomineee
indicating the truet character of the securities sO rsgietered.
(k) With respect to any securities forming a part of ths
trust, to vots ur.n any proposition or election at any meeting of
the corporation ssuing such securities, and to grant proxiea,
discretionary or otherwiae, to vote at any such meeting I to join
or become a par~y to any reorganization, readjustment, merger,
voting trust, consolidation or exchange, and to deposit any auch
securities with any committee, depository, trustee or otherwise,
snd to payout of the assets held hereunder, any fees, expenees
and assessments incurred in connection therewith, to exercise
conversion, subscription or other rights, and to recoive or hold
any new securities issued ae a reeult of any such reorganization,
readjustment, merger, voting truet, coneolidation, exchange or
exercise of conversion, eubecription or other righte and generally
to take all action with respect to any such eecuritiee ae could be
taken by the absolute owner thereof.
(1) To engage in sales, leaees, loane, and other
transactions with any trust establiehed by me, even if they ere
fiduciaries or beneficiaries thereof.
(m) To exercise all elections which they may have with
reapect to income, gift, estate, inheritance and other taxes,
inclUding without limitation execution to deduct expenses in
computing one tax or another to payor to defer payment of any
tax, in all evente without their being bound to require
contribution from any other pereon.
(n) To operate, own, or develop any busineee or property
held hereunder in any form, including without limitation sole
proprietorehip, limited or general partnerehip, corporation,
association, tenancy in common, condominium, or any other, whether
or not they have reetricted or no management righte, ae they in
their discretion think best.
8. ~. I direct that all estate, inheritance, and eucceeeion
taxee that may be assessed in consequence of my death, of whatever nature and
by whatever jurisdiction imposed, other than generation-ekipping taxee, shall
be paid out of the principal of my general estate to the same effect as if
said taxes were expenses of administration I provided, however that my
executor(s) may in the discretion of my executor(e) reque.t that any portion
or all of .aid taxes (to be paid out of the principal of my general e.tate)
shall instead be paid out of the princip.l of any trust e.t.bli.hed by me, to
the extent exprs..ly authorized undsr the terms of s.id tru.t.
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9. Fiduciariee. I appoint ae executor hereunder Dauphin Depoeit Bank
and Truet Company, or ita aucce..or. My executor .hall .erve a. guardian of
the property of any minor beneticiariee hereunder, under any in.trument ot
tru.t executed by me, under any policiee at ineurance on my lite, and in any
other .ituation in which the power to make auch appointment exi.te under the
law. of Penn.ylvania. My executor .hall be compan.ated in accordance with it.
.tandard .chedule ot charge. in ettect from time to time during the period ot
it. .ervice..
10. Gender. Unleee the context indicatee otherwise, any use of the
ma.culine gender herein ehall aleo include the feminine gender.
11. Forteiture. If any beneticiary under thie documont, whether
.pacifically named herein or otherwiee, challengee the validity or entorcea-
bility of thie my will or of my truet created by me or the dieposition of
assets set forth herein, and is unsuccessful in such challenge, said benefici-
ary ehall relinquieh and forfeit any and all right, title and interest in and
to all property di.tributable pureuant hereto and any assets or sharee other-
wi.e di.tributable to euch benefiCiary, and same shall be distributed as if
.uch beneficiary had failed to .urvive and tailed to leave issue who eurvive
h.reunder.
IN WITNESS WHEREOF, I, LUCY E. ADAMS, herewith set my hand to thie, my
l..t Will, typewritten on eix (6) sheets of paper including the self-proving
atte.tation chuee and signatures of witneeses, this 2711x day of October,
1993.
Witnes.ed.
t"<i!J f (,Jl~~J
LU E. AD S
residing at \130 (10(<0("'( ;.9,.,{lpt(,J.J ft"'1f,!)ll,,fA nO!j
residing at/f:/ /l;1tt:J2i~ Y>h111;#/ /Y4-.:J;L
residing at 484/, ;'~'rQ~.1 '])f.V." mt.l~,/v.....,...~h."'91I'A 1"':t:)~S
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...,..,"'-".._'-......,...~"
R!V-1547 !X AFP (12"95*
COtItDHWEALTH OF PfNHSYLVAHIA
DfPARTHENT OF REVEHUE:
BUREAU OF INDIVIDUAL TAXEI
DtPT. U06Dl
HARAISIURG, PA 17UI.D6G1
I!J-;H~J.
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT DF TAX
ACN 101
DATE 02-12-96
FIL! NO.
05-19-95 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO VOUR ACCOUNT, SUBHIT THE UPPER PORTIDN OF TNIS FORH WITH VOUR TAX
PAVHENT TO THE REOISTER OF WILLS. HAXE CHECK PAVABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
ROBERT L KECK
DAUPHIN DEPOSIT BK & TR
213 HARKET ST
HBO PA 17105
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
....ount H..! U.d
CUT ALONG THIS LIN! ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:isW"Ex-iiFii-n'Z";'9!;"nloTicE--oi'-YliHEiiii'ANcE-TAx-jiPPRjiisEHfii:r;-iiLi:owANcE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ADAMS LUCY E FILE NO. 21 95-0437 ACN 101 DATE 02-12-96
TAX RETURN WAS. I XI ACCEPTED AS FILED
I I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAIS!D VALUE OF RETURN BASED ON. ORIOINAL RETURN
1. R..l E.t.t. IS.hodul. Al III
2. Stock. and Bond. ISoh.dul. BI 121
3. Clo..ly Held stock/Partnarahlp Int.r..t (Schedule CJ (3)
4. Hartg.geI/Not.. Receivable (Sch.dul. 0) (4)
S. C..h/Bank Depolita'Hila. Par.onal Property (Sch.dul. EJ ei)
6. JointlY Dwnod Prop.rty ISohodul. FI 161
7. Tranaf.r. (Schedule OJ (7)
8. Total A...t.
.00
173.9B4.58
.00
.00
36.801.00
.00
.00
lei
210,785.58
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. F....r.l E........../Ado. Co.to/Hho. EKpon... t5chodul. HI 191 14,457.93
10. Debto/Hortooge LhbUIU../Llon. IS.h.dul. 1) nOI 1.542.96
11. Total DoducUon. 1111
12. Net Value of TaM Return (2)
15. Charitable/Covarnllent.l B.quaat. (Schedule J) (15)
it.. Nat Valu. of Ed.t. Subjaot to Tax nit)
NOTEI I~ an assassment was issuad previOUSly, lines 14, 15 and~or 16, 17 and 18 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAXI
15. AltOUnt of Llna 14 at Spou.al rat. nSJ
16. Aaount of Llna 14 taxable at Llneal/CI... A rat. (16J
17. A.ount of Lln. 14 taxable at Collat.ral/CI... 8 rata (17)
18. p,.lnclpal Tax Due
16.nnn 89
194.784.69
1.000.00
193,784.69
.00 X,OO.
193,784.69 x.06.
.00 X .15.
ual
.00
11,627.08
.00
11,627. 08
TAX CREDITS.
PAVHENT
DATE
08-17-95
11-02-95
RECEIPT
HOIIBER
AA048129
AA082286
D15ClUlT 1+1
INTEREST I-I
525.00
.00
AHOUHT PAID
9,975.00
1,127.08
TOTAL TAX CREDIT
BALANCE OF TAX DU!
INTEREST
TOTAL DUE
11,627.08
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATIDN DF ADDITIONAL INTEREST.
I IF TOTAL DOE 15 LESS THAN '1, NO PAVHENT 15 REQUIRED.
IF TOTAL DUE 15 REFLECTED AS A "CREDIT" (CRI, VOU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
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C:'
RESERVATJO'h EIt.t.. 0' decedent. dyIng on or be'or. Dee....r 11, 1911 -- 1f eny future Intlr..t In the ..t.ta h tr,,".rrltd
In po.....lon or .,Joyeent to Cl... . (coll.t.r.l) ~'lDl.rl.. 0' the decedent .ft.r the .xplration of en, ..tat. 'or
11'. or 'or y..r., the eo..on....lth tMr.,v axpr...h re..rv.. the rlaht to epprall. end ...... trenlfar Inherlt~. fix..
.t the llMful CI... I (collat.r.l) rat. an env .uch future lnt.r..t.
PIIlPOSE DF
NOTICEI To fulfIll the ,.....lr....,h a' Section 1140 of the Inherlt~a Met E.t.t. Tax kt, Aot II of 1"1. '1r P.I.
s.ctlon 2140.
PAVMIEHT. Detach the tap portion 0' thh HaUc. Met IUbIIIt wIth your p.pent to the R.ght.r of NUll prlntltd an the rever.. .Ide.
...tWt. chKk or' .....v ord.r p.y.tlla tal REGISTER OF MILLS, AOEHT
AU p'YHnh rH.lved IhIll flnt be eppl1ltd to MY Int.r..t which -V btI dull with MY r...lndlr IIPPUed to the tax.
REFl>>ID (OIh A r.fund 0' . tax c,..It, which .... not reque.tltd on the Ta. R.turn, ..y ~ reque.t. by cDllplaUng en "Appl1caUon
for Aaflnt of P.......vlvenla InhlrltllnC' Met [.t.t. Tax" (REV-ISIS). AppllcaUon. are .v.UMiI. .t the Office
of the Attl.tar of Will., eny of the lS A.venue DI.trlot Dffle.., or bv c'lllng the epeel.1 14-hour
en...."lng ..rvlcl nuebar. 'or' 'or.. ordering. In Penn.vlvani. 1.100-562-2050, out.ld. Penn.ylvenl. and
within locII Herrlaburll .r.. &717) 717-1094, TIlDl (717) nz"zzsl I....rlng 1.llred Onllt).
OBJECTIONS I Any party In Int.r..t not ..thfled with the apprahMlnt, .UIMtInC. or dl..l1ow~. of deduction., or .........,t
of to: (Including dlacount or Int.ra.U a. Ihown an thh HaUc. ...t obJ.ct wlthln .blY (60) day. of rK.lpt of
thh HatlCI bl
AlIItIN
IITRAllV'!
CORRE:CTI OMS I
"'written prata.t to the PA Depart...,t of AIV__, Ioard of Appea", Dlpt. 2110Zl, Herr'laburll, PA 17121"1021, DR
....IHtlon to hlv, thl .att.r det.relned It audit of the KCCU\t of \hi personal r.,r..ant.tlv., DR
--appaal to thl Orphan.' Court.
FIC~l .rrar. dl.cav'r~ an thl. ......eant .hould ~ addr...ed In writing tal PA D,plrteant of A.v~,
lur."" of Indlvldu.l TlxlI, ATTNI Palt A.....l4I1t Revl... Unlt, Dlpt, "0601, 1f"r'hbUrlh PA 17121.0601
Phone (717) 717.6505. ... p-ve S a' the bookllt "Instruction. fa,.. InMrltanc. Ta. A.turn '0,.. . Allle.."t
Decadent.. (REV"1501l for an Ixplanatlon of ad.lnl.tr.tlv.l~ carraotlbl. .rror..
01 SCOLIf1' I
If MY "11 due h p.ld withIn th,.... U) calam.r __u" 1ft.,.. the decadent'. dllth, . fly. percent CS:() dlacowtt of
the to: p.ld 11 allowed.
Int.r..t Is ctMIrged betlmlna with fir" d.y of dellnquMCy, or nine 19) ....th. Md one (1) d.y frM the dalh of
dI.th, to thl data of PI)"Hnt. Tax.. which bee.. delinquent be'are JlnUlry 1, nlz lM.r Int.r..t .t thl r.t. of
.hI (.x) pa"'cant per .... calculated .t a d8lb ,.ate of .000164. All tax.. which bee... delinquent on Met Ift.r
January 1, 1.., will ba.r Int.rllt .t a r.t. which ..111 VlN fr_ c.l""r y..,.. to c.l.....r Yllr ..Ith thIIt nt.
announced by the PA o.plrtaent of R.venue. The appllcabl. Int.r..t ratl' 'or 191Z thrOUGh 1996 .r'l
INTEREST I
!!!! Int.r..t R.t. DailY Int.r..t Factor !!!! ~t..!!!!! Dallv Int.r..t Factor
I... rDX .000541 1'17 .X .000247
1915 In .ODOU. 1'''-1''1 \IX .000501
19M \IX .00DSGl I... ox aOODZ47
1915 I$X .001556 199]41994 n .000ltz
1916 lOX .000274 1"5"1'" ox .OOoz,U
."Int.r..t 11 CIIC1.l1.ted .. fal11*11
IHlEIIE8T . BALAHCE OF TAll UNPAID X N\I1lBER OF DAYS DELI"QUEHT X DAILY IHTEIlEBT FACTOR
"-Any Hotlc. I..uad ,'t.r the t.x bacoaa. delInquent wIll reflaot ~ Int.r..t c.lculltlon to flftean (IS) day.
beyond the data of the ...........t. If P'YHnt II ... .ft.,.. the int.,.." coaputatlon dIIt. shown on the
Notlc., additional Int.r..t au.t be calculated.
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Proposed Distrihution of Beneficiary
PRINCIPAL
Receipts:
Per Inventory Filed or Balance of Prior Account
This Account
210,785.58
13B.06
Net Gain (or Loss) on Sales or Other Disposition/Principal
3,607.40
--..........-..........
214,531.04
Less Disbursements: Debts of Decedent
Funeral Expenses
Administration Expenses
Federal/State Taxes
Fees & Commissions
Family Exemption
1,219.94
1, 242 .11
1,446.84
11,102.08
11,800.00
0.00
26,810.97
Balance before Distributions
Distributions to 8sneficiaries
......-............-----........-....................
187,720.07
22,000.00
Principal Balance on Hand
.....-.....-..............
165,720.07
For Information:
Investments Made
Changes in Investment Holdings
INCOME
Receipts: Per Prior Account Filed
This Account
Page
16
3
3
4-5
6
6
6-7
7
7-B
9
10
0.00
9,021.82 11-13
Net Gain (or Loss) on Sales or Other Disposition/Income
0.00
.........................-..
9,021.82
Less Disbursements
411.20
Balance Before Distribution
Distributions to Beneficiaries
....................-....
8,610.62
0.00
Income Balance on Hand
........-............-....
8,610.62
For Information:
lnvestments Made
Changes in Investment Holdings
Combined Balance on Hand. 174,330.69
-2-
14
15
RECEIPTS OF PRINCIPAL
Description
Fiduciary
Acquisition
Valua
Assets listed in the Inventory
and Appraisement as Filed
210,785.58
Cash:
1995-07-21 Dean Witter Select Hun Tr Unit
Insd PA Series 4 - Dividend
138.06
--..-....-... 210,923.64
--------....--..
Total Receipts of Principal
210,923.64
-3.
.' '
CAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS/PRINCIPAL
Cain Loss
1995-06-30 651.466 sharas AARP Income
Fund CNHA & U.S. Tressury Fund
Net Proceeds 9,890.17
Fid. Acq. Value 9,804.56 86.21 0.00
1995-07-03 2,500 shares Dean Witter U.S.
Covernment Sec Trust
Net Proceeds 22,313.45
Fid. Acq. Value 22,250.00 63.45 0.00
1995-07-03 26 shares Dean Witter Select
Hun Tr Unit Insd PA Series 4
Net Proceeds 25,455.56
Fid. Acq. Value 25,532.78 0.00 17 .22
1995-08-09 3,618.318 shares Putmam
American Covernment Income
Fund Class A
Net Proceeds 30,538.60
Fid. Acq. Value 30,538.60 0.00 0.00
1995-08-30 $10,000 Citicorp Hortgages
Secs Inc Remic Pass Thru
Certificate Series 1992.14
Series Class A-5 7.5% due
08/25/2021
Net Proceeds 9,875.00
Fid. Acq. Value 10,018.75 0.00 143.75
1995-08-30 $5,000 Lancaster County PA
Hospital Authority Masonic
Home Project 6.6% due 10/01/97
Net Proceeds 5,122.45
Fid. Acq. Value 5,212.35 0.00 89.90
-4-
1995-08-30 $10,000 Philadelphia PA Gas
Works Revenue Bonds Eleventh
Series C 6.7\ due 01/01/97
Net Procseds 10,144,20
Fid. Acq. Value 10,329.25 0.00 185.05
1995-08-30 1,112 shares Pennsylvania
Power & Light Co.
Net Proceeds 24,235.22
Fid. Acq. Value 20,224.50 4,010.72 0,00
1995-10-03 1,634 units Dauphin Deposit
U.S. Government Fixed Income
Fund
Net Proceeds 16,682.07
Fid. Acq. Value 16,683.29 0,00 1.22
1995-10-03 2,207 units Fixed Income
Collective Investment Fund
Net Proceeds 23,033.83
Fid, Acq. Value 23,089.67 0.00 55.84
1995-11-08 $10,010 Hel10n Bank
Certificate of Deposit 6.83\
due 03/14/96
Net Proceeds 10,010,00
Fid. Acq. Value 10,010.00 0.00 0.00
Total Gains and Losses/Principal
Less Loss
4,160.38
552.98
552.98
Net Galn
3,607.40
-5-
1,219.94
DISBURSEMENTS OF PRINCIPAL
Debts of Decedent:
1995-06-22 Bell Atlantic - Telephone
Expense
12.95
1995-06-22 Elizabeth Knouse - Hair Care
10.00
1995-06-22 Fairview Professional Pharmacy
- Medical Expense
9.10
1995-07-21 Dauphin Deposit Bank and Trust
Co. - Trustee's fee for Lucy
Adams TIA
281.89
1995-09-22 The Wood at Cedar Run - Rent
906.00
Funeral Expenses:
1995-06-22 Rolling Graen Memorial Park -
Burial Fees
210.00
1995-07-06 Rolling Green Cemetery Co. -
Dste Scroll
90.00
1995-07-13 A. Gerald Hoffman -
Reimbursement for Pastor John,
Flowers, Comfort Inn. and
Phone Call
345.59
1995-07-20 A. Gerald Hoffman -
Reimbursement for Funeral
Expenses
12.95
1995-08-22 Dalton Hoffman, M.D. -
Reimbursement for Funeral
Expense
583.57
1,242.11
Administration Expenses:
1995-06-06 Cumberland County Register of
Wills - Cost of Probate and
Three Short Certificates
299.00
1995-06-12 Cumberland Law Journal - Cost
of Advartising and Proof of
Publication
40.00
1995-06-22 Irwin R. Brandt - Appraisal
Fee
25.00
-6-
PRINCIPAL BALANCE ON HAND
Cash:
Currsnt
Value
02/29/96
Fiduciary
Acquisition
Value
-...-..-..-......-
Uninvested
Capital Reserve Account
20.07
165,200.00
20.07
165,200.00
Sundry Assets:
Jewelry
500.00
500.00
-----......---.. ..-.---..-----
165,720.07 165,720.07
-10-
1995-07-27 Capital Reserve Account 17.83
1995-08-01 Capital Reserve Account 318.10
1995.08-25 $10,000 Citlcorp Mortgage Sees 62.50
Inc Remic Paas Thru
Certificate Series 1992-14
Series Clasa A-5 7.5' due
08/25/2021
1995-08-30 $10,000 Citicorp Mortgagea 60.42
Secs Inc Remic Pass Thru
Certificate Series 1992-14
Series Class A-5 7.5' due
08/25/2021
1995.08-30 $5,000 Lancaster County PA 92.58
Hospital Authority Masonic
Home Project 6.6' due 10/01/97
1995.08-30 $10,000 Philadelphia PA Gas 109.81
Works Revenue Bonds Eleventh
Series C 6.7\ due 01/01/97
1995-09-01 Capital Reserve Account 446.01
1995-09-18 $10,010 Mellon Bank 218.40
Certificate of Deposit 6.83\
due 03/14/96
1995-10-02 Cspita1 Reserve Account 639.14
1995-11-01 Capital Reserve Account 867.64
1995-11-08 $10,010 Mellon Bank 93.07
Certificate of Deposit 6.83\
due 03/14/96
1995-12-01 Capital Reserve Account 859.36
1996-01-02 Capital Reserve Account 847.20
1996-02-01 Capital Reserve Account 947.40
.....--................ 6,569.74
Other:
1995-07-05 Fixed Income Collective 128.90
Investment Fund
1995-07-06 Dauphin Dsposit U.S. 84.34
Government Fixed Income Fund
1995.07-21 Received from Compsny @.4175 464.26
per share peyab1e 7/1/95 recd
7/3/95
-12-
1995-07-21 Dauphin Doposit U.S. 90.39
Government Fixed Incomo Fund
1995.07-21 Fixed Income Collective 134.29
Investment Fund
1995-08-02 Dauphin Deposit U.S. 85.38
Government Fixed Income Fund
1995-08-02 Fixed Income Collective 131.44
Investment Fund
1995.09-05 Fixed Income Collective 130.49
Investment Fund
1995-09-06 Dauphin Deposit U.S. 85.53
Government Fixed Income Fund
1995-10-03 Dauphin Deposit U.S. 82.90
Government Fixed Income Fund
1995-10-03 Fixed Income Collective 125.27
Investment Fund ..--..--............- 1,543.19
......----......--..
Total Receipts of Income 9,021.82
-.\-
-13-
DISBURSEMENTS OF INCOME
1995-07-05 Dauphin Deposit Bank and Trust 47.66
Co. - Commiss ion
1995-10-04 Dauphin Deposit Bank and Trust 230.18
Co. - Commission
1996-01-08 Dauphin Deposit Bank and Trust 133.36
Co. - Commiss ion ..-.--...-----
411.20
..--------.--..
Total Disbursaments of Income
411.20
-14-
INCOME BALANCE ON llANO
Cash:
Current
Value
02/29/96
Fiduciary
Acquisition
Value
..--.-..--.
--.---......--..
Uninvested
Capital Reserve Account
10.62
8,600.00
10.62
8,600.00
............. --.....-----.
8,610.62 8,610.62
. -
AFFIDAVIT
Dauphin Deposit Bnnk nnd Trust Compnny, Executor under the Lnst
Will nnd Testnment of LUCY E. ADAMS, decensed, hereby declares under
oath thnt it has fully nnd fnithfully dischnrged the duties of
its office; thnt the foregoing Account is true nnd correct nnd
fully discloses nil significant trnnsnctions occurring during the
nccounting peried; thnt nil known clnims ageinst the Estnte have been
pnid in full; that, to its knowledge, there nre no claims now
outstanding ngninst the Estnte: thnt nil tnxes presently due from
the Estate have been paid: and thnt more thnn four months have elapaed
since the first complete advertisement of the granting of lettera in
this Estate.
/ 2 L.- ILvA I'j-CI f "l1- h
Dauphin Deposit Bank and Trust Company
Subscribed and sworn to by
Robert L. Reck
befo~~ this .;;~ day
/dSY 0 ~ , 199~
y~~
, Notnry Public
.-/
Nalarial S.al
Mary Ann And.rson, Notary Publlo
Harrisburg, Dauphin County
My Cammlaslon e'plras Oct. 30. 1998
Mnmtlr>f, """"""""ria Assoc:iIlIIOo of NoImm
.17.
Proof of Publication of Notite in The Patriot and The Evening News
and The Sunday Patriot-News
UndflF ..\d No. yr, t\PPf"O'of'd M.)' 1ft. I~.
Commonwtnlth of Ptnn~"lvonia,} .
Co'm'" of nnlll'hlll'"
.....................t:lJ!;l.lE\~.LJ!!?r..r;.!?t:-:........................,........,belnll' dul)' sworn according to law, deposes and says:
Asst. Controller
That he Is the ............................of THE PATRIOT - :\E\\'S CO,. a corporation orl1anlzed and existing
under the laws of the Commonwealth of Penns)'lvanla. with Its principal office and place of business at
812 to 818 Market Street, In the City of Harrlqhurll', COllnty of Dauphin. State of Pennsylvania, owner
and publisher of THE PATRIOT and THF. EVESING NEWS and the SUNDAY PATRIOT. NEWS
newspapers of general clrculatloo, printed and pUblished st 812 to 818 Msrket Street, In the City.
County and Slate aforesaid: that THE PATRIOT and TilE EVENING NEWS and the SUNDAY
PATRIOT. NEWS were established March 4th, 1854. snd Februar)' 15th, 1917 and September 18th,
1049, respectively, and all ha\'e been continuously published ever since:
That the printed notice or publication which Is securel)' attached hereto la exactly as printed and
bl h h 15th, 22nd, and 29th
pu lshed In their rell'Ular editions and Issues w Ich appeared on t e ..........................................................
....,...~.~~~....C?f.....~~.~,~...!.~.~.?.:.....................................................,...........................................................................
That Delther 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 publication
are true: and
That he has peraonal knowledge of the facts aforesaid and Is duly authorized and empowered to
verify this statement on hehalf of The Patriot-News Co. aforqsald by virtue and purauant to a resolu.
tlon unanimously passed and adopted severally by the st?2olders a,nd board of directors of the said
Company and subsequently duly rl!l:orded In the office for t e~,ordJlr ~e~d~ ~d for said Count)'
of Dauphin In MI",.lIao,oul Book "M". Volum. II. P... 3! 7. [.Cc:. fyC{)l'0/,.t--...,
Sworn to and subscr, fore m thl.... .....day of
.....J. 199 -/./ -u.4~
~r~' '. ........ ...~~~-::. .
Torry L flu...". Nolary Pwb"<: Notary Public
HanOSlluoQ. DJUjlIoo CoUO'f
~ ).~r',",""_6.,'998,, .............................
$'iai~ffii~lOlAdVii'tising Costs
Dauphin Deposit Dank & Trust, Attn: Robert Keck
'iliii::r'fs'bur:Cj';' ""'pK':' '.'..'1'7.1.0'5'...."......."...........
.........................".......................................,............,..
To THE PATRlOT.NEWS CO., Dr.
For publishing the notice or publlcat!nn attached hereto on the
157.6B
above stated dates - $........................,...
Probating same $............r~~..:.~~.
Total $............................
Estate Nollces
IM.tUTO.'1 NOTICI
Letttf'. ,..tom.n'aty In the enA,e ope
LUCY E ADAMS,lal. of Lower Allin TownshIp,
cumbtrlimd County, P'Mlylvonla. Myln; betn
oronltcllo tt\t und,nl,Met all per~. btitng In.
deb:.d to laid e.tottwlll PitoN moke ""'Im.nt
at oftc.. and all pet'1On1 haYlnv Clol m. will PfeMnt
the 10m. withoUt delaY to:
DAU,HIN D...OIITIANKANDTRUIT
COM'ANY. ..KVttr
,,~Mot1l.tlh'Mt
Horrbburt. "'''''IYtv'IIn'' ,"II
0"'01
HIli I. Wed. ...........'"
MeN", waltocll H..-.
1M '1M ItrMt
11,0. ".11" ...11&1
HorrldMl..........m
....
)"
Publisher's Receipt for Advertising Costs
THE PATRIOT-NF.WS CO., publisher of TilE PATRIOT one! THF. F.VENING NF.WS and the
SUNDAY PATRIOT-NEWS, newspapers of general circulation. hel'eb)' acknowledll'e receipt of the
aforeaald notice and publication costa and certifies that the some have been duly paid.
TIlE PATRIOT.NF.WS CO.
By
."....".".......,..,...,.............",....................................,.....
.
PROOF OF PUBLICATION OF NOTICE
IN CUMIIERLANI> LA W .JOUI~NAL
(Under Act No. 5117. approved May 16. 1929). P. L.17114
STATE OF PENNSYLVANIA :
ss.
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire. Edilor of the Cumberland Law Journal, of the County
and SllIte aforesaid, being duly swom. according to law, deposes and says that the Cumberland
Law Journal, a legal periodicul published in the Borough of Carlisle in Ihe County and State
aforesaid, was established January 2, 1952. am] designated by the locul courts as the official
legal periodical for the publication of all legal notices, and hus. since January 2, 1952, been
regularly issued weekly In the said County, and thallhe printed notice or publication attached
hereto is exactly the same as was printed in the regular editions and issues of the said
Cumberland Law Journal on the following dates,
viz:
JUNE 23. 30. JULY 7. 1995
Affiant further deposes that he is authorized to verify this statement by the Cumberland
. Law Journal. a legal periodical of general circulation. and that he is not interested is Ihe subject
matter of the aforesaid notice or advertisement. and Ihat all allegations in the foregoing
statements as to time, place and character of publication are true.
Mimi, LUGY E.t dec'd.
Late of Lower All.n TownShIp
Ex..utor: Dauphln DoPOOII B;"'k
and Tru.l Company. 213 Market
~~"8:: Harr1aburg. P.nosYlvanJa
Attorney.: N.U S. We.t. Eaqulre.
McN... Wallace '" Nunck 100
PIne Street. P.O. Box 1166' Har
n.burg. PA 17106,1166,' .
-,lJJJ;{lL__
Rhger M. MOI'gel1thal, Editor
I
f
I
I
SWORN TO AND SUBSCRIBED before me this
07 day of JUL Y , 1995
. -,
j; ('J '
c:~~' ai', (j ";J",J,{{L('t({:U
No ry
NOTARIAL SEAL
TERESA J. BURKHOlDER, NOlary Public
Ca~i~e, Cumberland County. Pa.
My Commlsslon Expires Feb. 12, 1996
I
I
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REGISTER OP WILLS OP CUMUEllI,AND COUNTY
REPORT OP STATUS OP ADMINISTRATION
(Por Resldcnt Decedcnts Dying After July I, 1984)
ESTATE NO. 21-95 - 04E-.
Name of Deeedent:_..__.
Social Security Account No.:
Lucy E. Adams
170-50-0988
Da(e of Death:
5/19/95
Name of Personal Rcpresentallve(s):
Dauphin Deposit Bank and Trust Company
Capacity
(check one)
Executor
Administrator
x
Administrator c.t.a.
Administrator d.b.n.
Is the administration of the estate complete?
(")(")
c gNo ~ ::lJ::O
3 -, ~
C"
l{' , "
'" ~~ ~
Q
one):~" !;:~ . t"
-
- -..
:';x 0 '~; {~,
':
;!".:1 :::; t'
(,:. '!'
(. .- Ii>
~~ "~-' ...,
~ -
-.J
Yes
x
If "yes", how was the administration ended? (check
By court accounting
fly account stated to parties In Interest
Old the parlles relcase the
personal representative?
Other (explain)
Tolal amount paid to date to creditors and for funeral and
administrative expense
Total value of distributions to date to beneficiaries
$ 14,457.93
.
If admlnlstrallon is not complete, estimated value of assets
stili In administration
NOTE: This status report Is due no later than the due date for flUng the Pennsylvania
Inherllance Tall Relurn or, If no Inheritance Tax Relum Is required, nine (9) months
after the date of dealh; If Ihe administration of the estate has not been concluded,
a summary report shall be flied annually thereafter until the administration Is complete.
Is correct to the
I certify under penalty of perjury that the foregoing Information
best of my knowledge, Information and belief.
Dauphin Deposit
JiYr--/~7 .
/
Date:
6-5
Bank and Trust Company
Ue.,. /h,,' /J' 71,
" Personal Representallve
, Attorncy for Estate
1996
, -
v
~
CW'.l.f lCATJl1fLlll..1tl1.[J CJUJtiUEIl.RlllJl_5...L(Il)
Nome of Decedent: __Ll1cy._E._,Adoms_______..____.___._____.__
Date of Death: JIU._ll,_1Jl9~ _____.
Will No.
To the Register:
Admin. No. _Oll!l.3l....l2Ll9.95
I certify that the notice of beneficial interest required by Rule 5.6 (a) of
the Orphans' Court Rules was served on or by mall to the following beneficiaries
of the sbove-captioned Estate on J.ul.y..Jj. 1995
Nanle
Address
A. Gerald lIoffman
1,08B Powers Drive, Las Cruces, NM 8BOOl
Dalton J.. Hoffman
484 Hobll Avenue, Sutte ?6, Comarillo, CA 93010
Grace United Hethodist Church 313 Uen."n Ilvenue, Lemoyne, PA 17043-1997
Hichael P. 1I0ffman 9165 Eves Drive, Roswell, GA 30076
Gerald Lee Hoffman
9471 Peaceful Drive, Sanebel, FL 33957
103 Skyline Drive, Hechanicsburg, PA 17055
1098 W. 1100 N.. Orena. UT 84057
1098 W. 1100 N.. Oreno, UT 84057
665 N. 600 W. 118, Provo, Ut 84601
659 N. 600 W. tiS, Provo, UT 84601
Grace ElaIne D'Asostino
Tara BUBlunan
Tracy lIoffmnn
Trina Wnrden
Tammy 1I0kanson
Notice hOB now been givon to n11 persons entItled thereto under Rule 5.6
(a) except,
NO EXCEPTIO~.._._
fi.a, I l.&.'--
Dat.e:__ljl---'-' I _::!::! L
By: ~-:? )1~ 1411/' "t-r't
SiguAture: Robort I.. Keck Assistant Vice
PresJ,lent and Trust Officer
Name:
Dnuphln Deposit Bank and Trust Company
Adell'ellS:
P.O. Box 2961, Harrisburg, FA 17L05-2961
Telephone: (717) 255-21/.8
Cnpncity:__L_ Perll(lIIo1 Repl'esentative
___, Counsel (01. Personal Representative
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D AA 048129 COMMONWEALTH OF PENNSYLVANIA
NO. DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
arYlltJI_,....,
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RECEIVED FROM,
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ACN
ASSESSMENT Ii'
CONTROL ~
NUMBER
AMOUNT
DAUPHIN DEPOSIT BK & TR CO
lul
'~.'1/:l.UU
P.O. BOX 2961
HARR I SBURG PA 1710:5
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ESTATE INfORMATION,
~ filE NUMBER
gel -199:5-0437
EJ NAME Of DECEDENT
II DATE Of PAYMENT
m POSTMARK E
COUNTY
SSN 170-:50-0988
(fIRSTI 1M I)
.
CU BERLAND
DATE Of DEATH
REGISTER OF WILLS
m TOTAL AMOUNT PAID .9.9715.00
CW
RECEIVED BY );':ri'!-(t' (. ,l'rwu
.;~ SIONATUjI 1 ~. , . .
. f' '/ .:.oC /)-'. ,,/
11ARY C. LEWIS ,':".~
REGISTER OF WILLS
REMARKS
DAUPHIN DEPOSIT BK & TR CO.
SEAL
CHECKII M-037772
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ESTATE OF LUCY E. ADAMS
DETACH AND RETAIN THIS PORTION FOR YOUR RECORDS
1300036555
PENNSYLVANIA INHERITANCE TAX PAID
TO REGISTER OF WILLS. AGENT - PAYMENT
ON ACCOUNT TO RECEIVE DISCOUNT -
PA NO. 2195-0437
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No. M-037772
OATE 8/17/95
r
REMITTANCE AMOUNT )
INCOME \.'d 'I PRlNb\~L I
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2. SupplomonloJ Roturn
4.. Futuro Intorost Compromloo
(lor datos of d08th attor 12-12.02)
[E] 6. Docodanl Died To.lala [E] 7. Docodenl MDinlolnod a Uvlog Tru.1
AnDCh co 01 Will Anach a co of Trust)
C P AU CORRESPONOENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
R ~ NA~E COMPI.ETEMAII.INGAODRESS
R D Robert L. Keck Dnuphin Deposit Bnnk nnd Trust Compnny
~ ~ TELEPHONENUMaER 213 Market Street
- T 717 255-2148 Hnrrisbur PA 17105
1. RoDi Eatale (5chedulo A) (1) None
2. Slack. and Bond. (Schedulo B) (2) 173.984.58
3. Clo.ely Hold Slock/Partne",hlp Inlero.1 (Schadulo C) (3) None
4. Mongago. and Nole. Rocelvablo (Schadulo D) (4) None
5. Cash. Bank Dopo.it. & MI.cellanoou. Personal Propar:y (Sch, E) (5) 36.801.00
8. JolnUy Owned Propony (Schodulo F) (6) None
7. Tren,'or. (Schodule G) (Schedulo L) (7) None
8. Tolol Gross A..olS (IOIDi Une. 1-7)
9. Funeral Expenses. Admlnlslratlvo Costs, Miscellaneous
Expen.os (Schodulo H)
10. Debl.. Mangago UabIIlUe.. Uon. (Schedule I)
11. Tolal Doductloo' (10101 Une. 9 & 10)
12. Nel Value 0' E.I.le (Uno 6 mlnu. Uno 11)
13. Charltablo and Governmental Bequosts (Schodule J)
14. Net Value Sub ec1 to Tax Une 12 minus Uno 13)
15. Spousal Transfers (for dates of death attor 6"30-94)
Soo Instructlonsfor Appllcablo Porcentage on page 2.
(Include valuos from Schodulo K or Schedule M,)
18. Amount of Uno 14 taxablo at eo" rale
(Includo vDiuo. Irom 5chedula K or Schedule M,)
17. Amount or Une 141axoblo at 16% ralo
(lncludo values from Schedulo K or Schedule M,)
16. Principal IS)( duo (Add IS)( Iram Una 15, 16 and 17,)
19.Crodlls/Sp Poverty Prior Payments Discount Inlorost
0.00. 9.975.00 . 525.00 0.00
20. II Une 191s greator than Uno 18, entor tho dlfferenco on Uno 20, This Is the OVERPAYMENT.
~ 0 ICheck here It you are requesUng . refund of your overpaymentl
21. U Uno 181s groater than Une 19, entor the difference on Une 21, ThIs is the TAX DUE.
A. Enter the Interest on tho balanco due on Uno 21A.
B. Enla' Iho lollll 01 Uno 21 end 21A on Uno 21B, ThI.I'lhe BALANCE DUE.
Make Check Pa able to: Re later of WIlts. A ent
~ ~ BE SURE TO ANSWER AU OUESTlONS ON PAGE 2 ANn TO RECHECK MATH <II <II
Una., p.n""I.. at p.'lury,I a.tlAr.ln'll have ....mln.a Inl' r.turn,lntlualngattampanYlng atnlaul.. ana .lallmlnU, and 10 lit. b.11 at my IInawl.dg. ana b.lI.t, 11 II uu.,
con.cland complll., I alcla,. tltat all,..I..tal. It.. b..n "po,t.d at lru. marhtvalu., O.cll.,allon 01 p,.p..r., ollt., titan the plrlonal ,.pr"'Matlv," ba..d on alllnlo,matlon 01
whlclt p,.p..,.r h.. any knowledg..
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C R C
K 0 K
P S
FOR OATE!lOF OEAnt AFTER 17131fll' CHECK HERE
IF A !JPOUDAl
P RTV r. T I, r. Al
FILE NUMBER
"EV~ 1500 EX '11-94'
/~- -35' - :.l..
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COUNTVCOOE
c.
21-95-01.37
YEAR
NUMUER
cO"'~F,~"t.~A~W1Mfl1,'1!ll'~~AN'A
0' r, 'I""
ItAnRISOU 0,' A 11121-0801
D
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DECEDENTS NAME ILAST, FIRST, AND ~IODLE INITIAL I
Adams Luc
E,
DEC[OENT!I COMPI.ETE ADDRESS
824 Lisburn Rond
Cnmp III 11, PA
AMOUNT RECEIVED {SEE INSTRUCTIONS)
0.00
Romalnder Roturn
(lor dale. 01 doalh prtor to 12-13-62)
Foderal Estate Tax Return Requirod
Total Number of Safe Depollit BoICOS
(8)
210,785,58
1I0CIAI. SECURITYNU~nER
170-50-0988
DATE OF DEATH
05/19/1995
DATE OF BIRTH
12/29/1900
(11)
(12)
(13)
14
16.000.89
194.784.69
1.000.00
193 784.69
Cau",y Cumberland
(IF APPI.ICADLE)5URVIVINQ SPOUSE'S NAME{lAST,FIR5T AND MIDDLE INITIAL) SOCIAL 5ECURITYNUMDEA
X I. Original RolUrn
4. Umlled Estela
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0.00
05.
6.
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(8)
14.457.93
(16)
193.784.69 X ,06-
0,00
0,00 X .16-
(10)
1.542.96
(15)
0.00 X
11,627,08
(16)
11.627.08
T
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P
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(17)
(19)
(20)
10.500.00
0.00
(21)
(2IA)
(2IB)
1.127.08
0,00
1.127,08
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
J --:7 ' I!. ,....Iy + TlJ ~!I..'!e~_l_,!_~!,'p'g~_l_~_~!,.,!~_:,_,!g.:.r.r:~~.!=..~~!".p.~!,y_.__~1'_ecuto~
~~. /~, ... \ rrv \ 213 Market Street. Hnrrisbur . Ph 17105 ~v
THER THAN REPRESENTATIVE ADORESS DATE
_....-.........~_..._._-_.__.._--.._--_.__..._---._--
Fo,m1500 tRev, 7-1141
CopyIlG"tIC)1111l4Ia,m 10ItW"" onlv CP5Yltlml,lnc.
.
.
Act 1#48 01 1994 provides lor the reduction 01 the tax rates Imposed on the net velue 01 translers to or lor
the use 01 the spouse. The rates 8S prescrfbed by the statute will be:
-3% (.03) will be sppllcable lor estatas 01 decedents dying on or after 711/94 and belore 1/1/96
-2% (.02) will be applicable lor estatas 01 decedents dying on or after 111/96 and belore 111197
-1% (.01) will be applicable lor estates 01 decedents dying on or after 111/97 and belore 1/1/98
-Spousal translers occurrfng on or after 1/1/98 will be exempt lrom Inherllance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedent make I transter and:
L retalnlheusaorlncomeo'lhepropenytr8nsferred,. . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . .. X
b. relaln Ihe right to deaJgnale who ahell uae Ihe properly translerred or lIS Inoome. . , . . . . . . . . . . . . . . . . . " X
.. retalnareverslonarylnteres~or. . . . ,.. . .. . . . , . ,. ... . ..... ... . .... . . . . . .. . . ... X
d. recelvelhepromlseforllfeofellherpeymenls,benenIsOrCare?.,.. ,.,.................. .... X
2. II dealh oeourred on or before December 12, 1982, did decedent wtlhln two ye8lll preceding dealh
transfer properly wtlhout receiVing adequate consldarallon? II daalh occurred aher December 12,
1982, did decedenl tranafer propeny whhln one year 01 dealh wtlhout receMng adequale
cons/deration? . . . , . . . . . . . . . . . , . . . , . . . . . . , . . . . . . . , . . . . . , . . . . . . . . . . . . , . . X
3. Dlddecedentownan'lntruBlta~bankaccountathlsorherdealh?,........................... X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Capyrigh1lc) 1114 lorm soHwa,. onlV CPSr1tlm,,'nc.
Fa,," 1500 IRlv. ,....,
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Q[
LUCY E. ADAMS
I, LUCY E. ADAMS, ot cumberland County, Penneylvania, declare this to be
my will and hereby revoke all prior wille and codicils made by me.
1. personaltv. I bequeath such items at my tanqible personal
property as are sp8citically itemized on a liet, it any, in my handwriting,
signed and dated by me at the end thereof, and attached to this my Will, to
the persons named therein to receive such items. I bequeath my two tigurine
pictures which are now located in my living room to my son, Dalton L. Hotfman,
it he survives me. I bequeath all the rest of my tangible personal property
not used in business or tor the production of income, including without
limitation furniture, furnishings, clothing, jewelry, objects of art and
decoration, and the like, and any motor vehicles which I own, together with
the insurance thereon, to such person or parsons as my executor may in my
executor's sole discretion, determine, after my death.
2. SDecitic Beauests. I bequeath the sum ot Three Thousand Dollars
($3,000.00) to each grandchild of mine who survives me, with said share
distributed outright to each euch grandchild. I bequeath the eum ot One
Thousand Dollars ($1,000.00) to Grace United Methodist Church, presently
locatsd at 313 Herman Avenue, Lemoyne, Pennsylvania.
3. Residue. I bequeath, devise, and appoint all the rest ot my
property, of whatever nature and wherever situated, including property over
which I hold a power ot ,appointment, as tollows. such property shall be
divided into one share equal to sixty percent (60\) and one share equal to
torty percent (40\), with the first share (60\) distributed to my son, A.
Gerald Hotfman, it he survives me, and the second share (40\) distributed to
my eon, Dalton L. Hottman, it he survives me. It A. Gerald Hottman shall tail
to eurvive me, but his wite survives me, then his share shall be distributed
to his wite. If A. Gerald Hoffman and his wife both fail to survive me but
leave iesue of A. Gerald Hoffman who do survive me, or if Dalton L. Hoffman
.
.
'-,.-..-.--- --------
.hall tail to .urvlve m. but l..v.. i..ue who do 8urvlve me, then the .hare ot
the deceased child ot mine who lett issue who survive me shall be distributed
per stirpes to the issue ot such deceased child.
4. Survival. It any beneticiary should die within sixty (60) days
atter me, thsn he ahall be dasmed to have prsdsceased me tor all purposes ot
thia will.
5. SDendthritt Clsos.. No interest (whether in income or principal,
whether or not a remainder intereat, and whsthsr vested or contingent) ot any
beneticiary hereunder shall be eubject to antiCipation, pledge, assignmsnt,
sale or transter in any manner, nor shall any beneticiery have powsr in any
manner to charge or encumber his said intereet, nor shall ths said intsrest at
any beneticiary be liable or subject in any manner while in the possession ot
my tiduciaries tor any liability ot such bensticiary, whethsr such liability
ariees trom his dSbts, contracts, torts, or other engagemente ot any type.
6. Facilitv of Pavment lor Minors or rncomcetents. Any amounts or
assets which are payable or distributabls to a minor or incompetent hereunder
may, at the discretion ot my tiduciaries, be paid or distributed to the parent
or guardian ot such minor or incompetent, to ths person with whom such minor
or incompetent rseides, to a trust eXisting solely or primarily for the
benetit ot Such minor or incompetent, or directly to such minor or
incompetent, or may be applied for the Use or benefit of Such minor or
incompetent.
7. Powers. In addition to such other powere and duties as may be
granted elsewhere herein or which may be granted by law, my fiduciaries
hereunder shall have the following powers and duties, without the necessity ot
notice to or consent of any court, but SUbject to any applicable rsquirements
of ordinary due care and loyalty,
la) To retain all or any part of my property, real or
personal, in the torm in which it may be held at the time of its
receipt, inClUding any closely held business in which I have an
interest, as long ae in the exercise of their discretion it may be
- 2 -
\
adviaable ao to do, notwithatandinq that said property may not be
ot . character authorized by law.
(b) To invest and reinvest any funds held hereunder in any
property, real or personal, incLuding, but not by way of
limitation, bonds, preferrsd atocks, common stocks and other
securities of domestic or forsiqn corporations or investment
trusts, mortgages or mortgage partiCipations, mutual funde with or
without salss or redemption charges, and common trust funds, even
though such property would not be considered appropriate or legal
for a fiduciary apart from this provision.
(c) To ssll, convey, exchange, partition, give options to
buy or leeee upon, or otherwise dispose of any propsrty, real or
personal, at the tims held by them, at public or private sale or
otherwise, for cash or other consideration or on credit, and upon
such terme and for such price as they may determine, and to convey
such property free of all trusts.
(d) To borrow money from sny person, including any
fidUciary hereunder, for any purpose in connection with the
administration hereOf, to execute promissory notes or other
obligatione for amounts so borrowed, to secure the payments of
such amounts by mortqages or plsdges of any property, real or
psrsonal, which may be held hersunder.
(e) To make secured loans or unsscured loana if to any
issue of mine or to a trust established by or the estate of any
i.Bue ot mine, in such amounts, upon such terms, at such rates of
interest, and to such persone, firms, or corporations as they may
deem advisable.
(f) To renew or extend the time for payment of any
obligation, SRcured or unsecured, payable to or by them as
fiduciariee, for as long a psriod or periOds of time and on euch
terme, as they may determine, and to adjust, settle, and arbitrate
clsims or demandB in favor of or against them.
(q) In dividing or distributing any property, real or
psrsonal, included herein, to divide or distribUte in cash, in
kind, or partly in cash and partly in kind.
(h) Without limitation of POwsrB elBswhere granted
therein, to hold, manage and develop any real estate which may be
held by them at any tims, to mortgage any such property in such
amOUntB and on such terms as they may deem adviBable, to lease any
Buch property for such term or tsrms and upon such conditions and
rentala as they may deem advisable, whether or not the term of any
such lBasB Bhall excBed the period permitted by law or the
probable period of retention under thie instrument; to make
repair_, replacements and improvements, structural or otherwise,
in connection with any such property, to abandon any such property
which thsy may deem to be worthless or not of sufficient value to
warrant keeping or protscting, and to permit any such property to
be lost by tax ssle or any other proceedings.
(i) To smploy such brokers, banks, custOdians, investment
counsel, attorneys, accountants, and other agents, and to delegate
- 3 -
.
to them such dutie., rights and powers .a they may determine, and
for .uch p.riod. aa they think fit.
(j) To regi.ter any aacuritie. at any time in their own
name., in their name. aa fiduciary, or in the name. of nominee.
indicating the truat character of the .ecurities eo regietered.
(k) With reepect to any eecuritiee forming a part of the
tru.t, to vote upon any propo.ition or election at any meeting of
the corporation ieeuing .uch .acuritia., and to grant proxie.,
di.cretionary or otherwi.a, to vote at any .uch maetingl to join
or become a party to any raorganization, readju.tment, merger,
voting tru.t, coneolidation or exchange, and to depoeit any such
.ecurities with any committee, depoeitory, truetee or otherwise,
and to pay OUt of the aeeata held hereunder, any fees, expenses
and a.sessmanta incurred in connection therewith, to exercise
conversion, subscription or other rights, and to receive or hold
any naw sacuritie. iaauad ae a rasult of any auch reorganization,
readjustment, marger, voting trust, consolidation, exchange or
exercise of conversion, subscription or other rights and generally
to take all action with respect to any such securities as could be
taken by the absolute owner thereof.
(1) To engsge in sales, leaeee, loens, and other
traneactions with any trust established by me, even if they are
fiduciaries or beneficiariee thereof.
(m) To exercise all elections which they may have with
respect to income, gift, estate, inheritance and other taxes,
including without limitation execution to deduct expenses in
computing one tax or another to payor to defer payment of any
tax, in all events without their being bound to rsquire
contribution from any other person.
(n) To operate, own, or davelop any business or propsrty
held hsreunder in any form, including without limitation sole
propristorship, limitsd or general partnership, corporation,
association, tenancy in common, condominium, or any other, whether
or not they have restricted or no managsmsnt rights, as they in
thsir discretion think best.
8. IAxgA. I direct that all estate, inheritance, and succession
taxe. that may be assessed in consequence of my death, of whatevsr nature and
by whatever jurisdiction imposed, other than generation-skipping taxes, shall
be paid out of the principal of my general estate to the same effect ae if
aaid taxea were expensee of administration I provided, however that my
exacutor(a) may in tha discretion of my executor(s) request that any portion
or all of eaid taxes (to be paid out of the principal of my general estate)
shall inatead be paid out of the principal of any trust established by me, to
tha extant exprassly authorized undar the terms of said trust.
- 4 -
.'
9. FiduciarleB. I appoint a. executor hereunder Dauphin DepoBit Bank
and Trust Company, or its BucceSBor, My executor shall serve &D guardian of
the property of any minor benefieiariea hereund.r, under any in.trum.nt of
tru.t executed by me, under any policie. of in.urance on my life, and in any
other eituation in which the pow.r to make euch appointment .xi.t. und.r the
law. of P.nn.ylvania. My .xecutor .hall be comp.n.at.d in accordance with its
.tandard .chedule of charq.s in eff.ct from time to time durinq the p.riod of
it. s.rvic...
10. O.nd.r. Unl.es the contsxt indicat.s oth.rwis., any us. of the
m..eulin. q.nd.r h.r.in shall also includ. the feminine q.nder.
11. Forfeiture. If any beneficiary under this document, whether
.pecifically named herein or otherwi.e, ehallenqe. the validity or enforcea-
bility of thi. my will or of my trust created by me or the disposition of
ase.ts e.t forth hsrsin, and is unsuccessful in such chall.nqe, said bensfici-
ary ehall r.linquish and forfeit any and all riqht, title and inter.st in and
to all property distributable p~rsuant hereto and any ass.te or ehar.e oth.r-
wis. dietributabl. to euch b.n.ficiary, and sam. shall be distribut.d as if
.uch ben.ficiary had fail.d to eurvive and failed to leave iasue who survive
hereunder.
IN WITNESS WHEREOF, I, LUCY E. ADAMS, hsrewith set my hand to thie, my
last Will, typ.writt.n on eix (6) she.ts of paper includinq the self-provinq
att..tation claus. and siqnatur.. of witn....., this ~7~day of Octob.r,
1993.
Witn....d.
1',,-<: '-' f r::.'L~:
LUCl( E. AD~S
reaidinq at \1;;0 "~.}l!a<",.f IJ." f.;t,-";,, ('t',,(,:J...L ,!,~ .'-;0:3
- / ,(c/ /.' '-//' ,/ , ,1..
r.aidinq at /fIcif ~t)ldUh~ffAY~ ,)11'/ /$.3.;L
residinq at 4t'4 t. :,rc-f.,r",,-I .".,~. tn",.Iv....,.~},...7.;P/I f70::S"
- 5 -
'.
COMMONWEALTH or PENNSYLVANIA
COUNTY OF DAUPHIN
SS.
LUCY B. ADAKS (th. t..tatrix)
/'"Ii../;:j -Yd~ I and (th. witn.....),
~am.. are I(9;n-;'d to tit. tor.g nt duly .worn,
.ach h.r.by d.clar.. to the und.r.i .d t..tatrix .ign.d
and .x.cut.d the in.trum.nt a. h.r la.t will in the pr...nc. ot the witn.....
and that .h. had .ign.d willingly, and that .h. .x.cut.d it a. h.r tr.. and
voluntary act tor the purpo... th.r.in .xpr....d, and that .ach ot the
witn....., in the pr.s.nc. and h.aring ot the testatrix, signsd the will as
witne.. and that to the bsst at his knowledge the te.tatrix wa. at that time
eight..n year. at age or older, ot .ound mind and under no con.traint or undue
influenc..
WITNESS'
TESTATRIX,
f. /': l.,' ~., 0..\ ",_.."I::,.~
Lll~ E. ADAI4S
.......' -'
{},.,..~l.u..-' (. lnM((T'-r......
WITNESS.
()uf4~;L
WITNESS,
Subscribsd and 8worn to b8tor8
and
8ub8crib8d and 8worn b8tor8 m8
, the witness..,
~
c
(S E A L)
NOTARIAL SEAL
JENNIE E. ROW, 1l~1ary Public
Hanlslxlrg, PA Oauphrn County
MyCormUSlonfxplres.bn.19,1537
- 6 -
'''l'
REV.,IDit EX. (tit.UI
Co"r.'<<\lrc~~{\''\l.F.W~fIY'''' ::c~~ii~
eSTATe OF FiLe NUMBER
Lucy E. Adams SS# 170-50-0988 05/19/1995 21-95-0437
(Prop.rty lalnlly-ownad with Right 01 Survivorship mUat be ellaoloaad on Sohadul. F) All ...1 .atal. ahould b. raportad .t rolr marlt.t valu.
which la dannad .. tha prlc. at whloh property _uld b. ..ohangad b.twaan a willing buyar and a willing a.llar, n.lthar b.lng oompallad to
b or ..11. both havln raaaonabla knawl allh. rslavant racla.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATli
TOTAL Also onlor on IIno 1. Roc ltulatlon
(II mare space 10 ooodad. Insen .ddltlonDlsh""lII of aame size,)
Copytlghljcl11114 to,m lottw.,. only CPSYIllml.lnc,
s
0.00
Fo,," 1600 Schedull AIR...., 12.151
AEV - 1&03 EX + 14all'
cO"\1.~11rt~"l~bW~~f>>"NI'
ESTATE OF
SCHEDULE B
STOCKS AND BONDS
SS# 170-50-0988
FlU! NUMBER
21-95-0437
Lucy E. Adama
05/19/1995
oln -awned with RI ht of Survlvorahl muat be dlaolaaed on Sohadul. F.
DESCRIPTION
VALUE AT DATE
OF DEATH
9,804.56
All .
ITEM
NUMBER
1
10
651.466 shares AARP Income
Fund GNMA & U.S. Treasury
Fund
2
$10,000 Citicorp Mortgage
Secs Inc Remic Pass Thru
Certificate Series 1992-14
Series Class A-5 7.5% due
08/25/2021
10,01.8.75
3
1,634 units Dauphin Deposit
U.S. Government Fixed Income
Fund
16,683.29
4
26 shares Dean Witter Select
Mun Tr Unit Insd PA Series 4
25,532.78
5
2,500 shares Dean Witter
U.S. Government Sec Trust
22,250.00
6
2,207 units Fixed Income
Collective Investment Fund
23,089.67
7
$5,000 Lnncaster County PA
Hospital Authority Masonic
Home Project 6.6% due
10/01/97
Accrued Interest
44.00
5,212.35
8
3,618.318 shares Putnam
American Government Income
Fund Class A
30,538.60
9
1,112 shares Pennsylvnnia
Power & Light Co.
20,224.50
$10,000 Philadelphia PA Gas
Works Revenue Bonds Eleventh
Series C 6.7% due 01/01/97
Accrued Interest
10,329.25
256.83
. .
TOTAL Also enter on IIno 2. Roes ltulatfon
(II moro .paco Is noeded. loSOft eddl1loneJ sheets of '8100 sl%o,)
Capyrlllfttlcltlt1l4 fa,," .aU......'. ani)' CP5)"I.,"..ln~
S 173 984.58
Fa,," 1500 Schedule 8IA.v. 4-1111
REV.. '506 EX . 11..821
SCHEDULE C
CLOSELY HELD STOCK,
PARTNERSHIP AND PROPRIETORSHIP
Please Print or e
FIll! NUMBER
21-95-0437
COM~!1!l,'I(I\I'A'lT,t1 PI: P'\lm~~.hYA"'A
"'Rhlb'ENt'iill'c!'Eb'l,tl'f"
ESTATe OF
Lucy E. Adams
55# 170-50-0988
05/19/1995
__ C-t or C-2 mual be _hod for..eIl bualn... Intarut D1tha doc_t, ather \hIUla
Il1!M
NUMBER
rtolDraII .
DESCRIPTlOll
VALUE AT
DATe OF DEATH
TOTAL A190 enle, an line 3. Roc lrutadan
(II mare space Is needed.fnsen addlUanalsheets or same a1za,)
ClIp)'f'laht(clll1M form loltwaflllnly CPSVltlml.lnc.
s
Form 1500 Schedull C tAlv, :1,,112)
0.00
REV.. 1101 EX . (1....1
COM:I.\l\lrt'E~~'b"t.F.W,WbYANIA
I!STATI! OF
SCHEDULE D
MORTGAGES AND NOTES
RECEIVABLE
Please Prtnt or .
flU! NUMBER
21-95-0437
Lucy E. Adams
5511 170-50-0988
05/19/1995
All 01 -ownod wIIh tII. RI
ITI!M
NUMBER
of Survlvarah mua' be dlacloMd on Sc:hodul. F.
DI!SCRIPTlON
YAWl! AT DATI!
OF Dl!Allf
TOTAL Also .nl.r on IIn. 4. Roca llulallon
(II mor. apac:e I. n..d.d, 1...11 addlllonal ah..ta 01 aamo Ilz.,)
COPyrlGht(C) 1114 for", lo'twar. onlyCPSYlteml,lnc.
s
0.00
Fo,", 1500 Schedul. 0 IRe. '''II)
REV - 110' EX + (2"'71
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELlANEOUS
PERSONAL PROPERTY
cO"'\1,\(\lrt~~{\''It~~JbY''''
ESTATE OF
,
""..</"-
Fla..o Flint or 0
FlU! NUMBER
21-95-0437
Lucy E. Adams
55" 170-50-0988
05/19/1995
All
ITEM
NUMBER
I
aln -owned wlnl RI ht 01 Survlvarahl mUlt be dlacloaed an Sohedule
DESCRIPTION
Capital Blue Cross/Blue
Shield - Refund of Unearned
Security 65 Premium
2
Dauphin Deposit Bank and
Trust Co. - Checking Account
#10421912
Accrued Interest
3
Tangible Personal Proporty _
Sold At Public Auction
4
Ladies 18K White Gold
Diamond Ring
5
Lucy E. Adams - Cash Found
In Appartment
6
Lucy E. Adems Trust .
Capital Reserve Account
7
$10,010 Mellon Bank
Certificate of Deposit 6.83'
due 03/14/96
Accrued Interest
8
Musselman Funeral Home Ine
Refund under Agteement for
Pre-Arranged Funeral
9
Patriot News Company _
Refund on Unused Newspaper
SubSCription
10
The Woods At Cedar Run _
Refund of Security Deposit
TOTAL Also enler on line e, RoclI ltulatlon
(Anach addlUon&l B 1/Z' X". shoets II more spaco Is noedod.)
Copynghtlcltgg4 rOt," .oftwa,. only CPSYlt.m.,lnc,
VALUE AT DATE
OF DEATH
228.20
1,501.63
1.93
844. 70
500.00
159.52
16,401.93
10,010.00
123.44
5,017.75
9.90
2,002.00
'0'," 1600 Sch.dul. e IA.y, 2-17)
S 36 801. 00
.
/
D
Dauphin Deposit Bank
and Trust Company
MAIN OFFICE: 2.3 MARKET STREET. HARRISBURG, PENNSYl.VAN.... 17.01
7.7.2&5-212.
Decedent Confirmation
Name: Lucy E. Adams
Social Security No.: 110-50-0988
Date of Death (000): 05/19/95
Account No.
0010421912
----------- ------------------------ ------------------------
Type
Date Opened
or Issued
Checking
------- ------------------------ ------------------------
03/01/93
---- ----------------- -------------
Date Closed
or Matured
Date of Death
Balance $1,501.63
------------------------ ------------------------ ------------------------
PLUS
Date of Death
Accrued Int. $1.93
----------- ----------- --
Joint O.'/l'1ers
(if any) None
------------------------ ------------------------ ------------------------
Date of Joint
o.vnership
------------------------ ------------------------ ------------------------
- ------------------------ ------------------------
Special Conments: N/A
Additional tntaraatton aVAtlabl. at 120.00 p.r hour. On. hour .tnt.u..
Date Prepared: June 16, 1995 Prepared by: Cheryl A. Bowers
CUstomer Management Information Dept. (CMI)
Page 1 of 2
Telephone No. (111) 255-2054
For. 00-020-218 (REV 7/93)
IRWIN R. BRANDT
"DEALER IN FINE JEWELRY"
3802 Bonnybrook Road
Harrlaburg, PA 17109
Appolntmont Onlv
(717) 545-7849
r
~3. Lucy S. Adams. ~sta~e
L- 6 June 1995
ITEM NO,
DESCRIPTION
TOTAL
1. ladies 191~ w!:i te :-:>lc. ._ :.:?mon:: rin,; I'I:!. ,,1 3 rows s,crOS3.
The center row cont~ins~wo (2) 0 ~:s. each, clarity is
I-4, color l. the ~nd 0 noint~r is cl?rity of 3I-2, color
7.. rhe zec'1nc two brt:1Lllt cut round ti.ie.:nonc.: are 12 pt ,
each, 3I-l clp.rity, color J. The center brilliant cut
ro!:,nd d:!.<;,::Ionc. is 30 ?oin t3. ::lis die.:nor:d i:l heo.V'J '{li th
inclusions and s bad chin in one corner, I-4 clarity,
L color. There are two t2) rows of 1 pt e~ch In each
side of center dis::Ion::'s.with 9 stones eecll row.
rotal diaoonc. weight of 102 ?ointa or lct. 2 p~e.
Value $ ;Du.OC
)ue to the fluctuation in th~ ~ricea of metals end gem
stones. the above fi;ures represent our best s~ti:ne.teof
c~rrent values. Also besed or. the S?ot price of gold this
date 3 384.00. The dismonds were not removed from the
mounting, but are estimated weight.
~h:i~
'"
o
li!;
mi'"
Ih!~
:;J ~~
e;tJQ
U~'"
a 0:
'" ~o
:i
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1'10
..~
I~
'" .
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... .
~ ...
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.., \0
.. '"
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o U 0 tf
\Q ::s lQ .::!
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..
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.
III
..
..
tit
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R
~
o
..
fI
..
..
.
'"
'"
...
.
o
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...
..
1>1 ...
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.... u...
> III ..
III 0 III
UJ .... :E
'"
In ........ t>..
tr'GJUCU
A.... ... A
'5~tJ:i
'" >.o!l1
.... lU -; IU
cu c:I O.&J
-:::i~lil
i~~~
>. M .... t:)
GI
R I
:i . I I
'"
I ' . .
:a:UU
lIi~..;x
x~~x
:i....Mc,;
..
..
, .
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...
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o
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ljp 4)'"
... ... GI
tU t:rl to.&J
U A U c:I
.... .....1'4 t-t
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'j ~'j :i
.. ..
G1'" .. I!
URU:O
o!l m m'm
'i .&J 0 ...
o lU up."
.. ... R
t:)UJM I
l. I I .
...
Jcnu~
, . , ,
C)tn....p."
..
I
el
...
..
GI
..
GI
~ W t.1 S'
.... .... 0'....
... R'"
oR U ... 0
:u lU .&J > lU
... oR ... III oR
3:U""'U
1>1'" 8.... ..
A rd cu 0 Il'I
.... t:I Q 0 cu
... 0 ,Q R
U en CLI W....
cu ... 'M 111 WI
oR GI III III :0
uc.tn!1.D1
I I t I I
t;!~~~~
Ollo"'''''''
. ..__...___.~__ ~.______~. _~._........._#,,,,,,~, "'.~ ,"0. -
REV- no, EX + tn....1
cOMrN\lilrt-.~~..;.tl.W,WtY.NIA
E5TAll! OF
Lucy E. Adama
SCHEDULE F
JOINTLV-OWNED PROPERTY
SS# 170-50-0988
05/19/1995
Joint tenanl(a):
NAME
ADDRESS
A.
B.
C.
JolnUy-owned property:
FILE NUMBER
21-95-0437
RELATIONSHIP TO DECEDENT
ITEM LETll!R DAll! TOTAL VALUE DECO'S DOUAR VALUE OF
FOR MADE DESCRIPTION OF PROPERTY
NUMBER JOINT OF ASSET " INT. OECEDENT INTEREST
TENANT JOINT
TOTAL tAl.. enter on line 8. Recaol1Ulationl 0.00
(II more apace Is needad.ln.ert addltionalaheelS of same .Izo,)
Copyrlohtlcl1,IlI4 torm lo,twl'. only CPSYltlm"lnc.
Form 1600 Sch.dul. F (A.v. 12..131
REV - 1110 EX + IZ.I"
cO"::'\l\l~~4\'ltlrW,WhY'N'A
ESTAll! OF
SCHEDULE G
TRANSFERS
PleuD Prlnt or 8
FiLe NUMBER
21-95.0437
Lucv E. Adams SS# 170-50-0988 05/19/1995
THIS SCHEDULE MUST BE COMPI..ETl!D AND FILED IF THE ANSWER TO ANY OF THE QUESTlDNS ON PAGE 215 YES.
ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DECO'S DOLlAR VALUE OF
NUMBER r'I~~fo~::I".tr:~:~:::~~.~:~:':ri::"I~;.r OF ASSET ""INT, DECEDENT INTEREST
1 Revocable Truse A8reement By
and Beeween Lucy E. Adams.
Seeelor and Dauphin Deposie
Bank and Truse Company,
Truseee Daeed March 10, 1993
2 Assees Reporeed on Schedule
Band Ieems 6 and 7 of Schedule
E
,
,
,
TOTAl. CAlso .nlor on IIn. 7, Recaol\1Jlalionl S 0.00
(II mar. apac. la n..d.d, Insert addlUonal sh..ta 01 aame size,)
Copy"ght(C) 1114 'arm 10UWVI onlv CPSVlllml.lnCo
Form 1600 Schldult G IAev. Z.I1)
.
REV - 1111 EX . 17-")
SCHEDULE H
FUNERAL EXPENSES,
ADM1NISmATIVE COSTS AND
MISCELLANEOUS EXPENSES
cOM~NqJl1~IiJ'.'I1H Qf, PWJttV.l.YANIA
''iltolb'ENlb\!'tl!b'iiN\''''
eSTATE OF
Luc E.
ITEM
NUMBER
A.
B.
c.
Adams
SS# 170.50.0988
05 19 1995
DESCRIPTION
1
Funeral expen...:
A. Gerald Hoffman
Reimbursement for Pastor
John, Flowers, Comfort
Inn and Phone Calls
(see continustion schedule nttached)
Total of Continuation Schedule(s)
PI.... Prtnt or
FIll! NUMBER
21.95.0437
AMOUNT
345.59
896.52
9,300.00
1.
AdmlnlatraUve Coats:
Persooal Represenlatlve Convnlsslons Dauphin Deposit Bank and Trust Co.
SOcial Securl1y Numbero! Persooal Represenlatlve:
Vear Conrnl..lona paid
2.
AIIarney Fees
McNees. Wsllace & Nurick
3.
Family Exemption
Clalmenl
Address of Clwmant al decedenfs death
5treel Addra..
City
5tale
Zip Code
Relatiooshlp
4.
Probate Fees
Cumberland County Register of Wills
I
Mlle.lIaneoua expenses:
Cumberland County Register
of Wills . 1 Short
Certificate
2
Pntriot News Compsny . Cost
of Advertising snd Proof of
publication
3
Cumberland Law Journal .
Cost of Advertising and
Proof of publication
4
Hsar's Auction - Commission
on Sale of Personal Proper.ty
(see continuation schedule attached)
Total of Continuation Schedule(s)
TOTAL Also enter on line 9. Reea ttulation
(If more aplCI Is needed. In.ert IddttJona' sheets of ..me alII.)
COIIY'10"I(C) 111114 10'," saHw." only CPSYltlllll, Inc.
- '---~'-'_.__.._--'
--..-.
F'.
2,500.00
0.00
299.00
3.00
158.68
40.00
211.20
703.94
S 14457.93
Fa"" 1600 SCII.dull Htnlv, 7-11'
~.J 1 ~_ rrt,
~.:- ,
,
.
.
Estate of: Lucy E. Adams
ITEM
#
-{~.
SS# 170-50-0988
05/19/1995
CONTINUATION SCHEDULE
Coneinustion of Schedule H-A
DESCRIPTION
AMOUNT
2
Dalton Hoffman, HD .
Reimbursement for Funeral
Expenses
583.57
3
A. Gerald Hoffman - Reimbursement
For Funeral Expenses
12.95
4
Rolling Green Cemetery Ca. -
Funeral Expense
.90.00
5
Rolling Green Memorial Park
- Opening and Closing Fee
For Burial
210.00
....------.......--
896.52
-.,-~, -
.- ::b..-.:..\
.
.
Eutate of: Lucy E. Adams SS# 170-50-0988 05/19/1995
CONTINUATION SCHEDULE
Continuation of Schedule H-C
ITEM DESCRIPTION
#
AMOUNT
5 Irwin R. Brandt - Appraisal
of Ring
25.00
6 HcNees, Wallace & Nurick _
Legal Costs
51.96
7 Cumberland County Register
of Wills - Reserve for Filing
500.00
8 Dauphin Deposit Bank and Trust
Company - Trustee's Fee
126.98
---..-.-.....
703.94
'-,
~\~>-:::.""._'~-<'.''''''---''-~'''*':-_li__''--'_'-c''H''''..~
.
SCHEDULE N
SPOUSAL POVERTY CREDIT
REV-Itl.' [XI'-\l21
I. 210 785,58
2. 0.00
3. 0,00
4. 0.00
5. 0.00
0.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX 0lV1510N (AVAILABLE FOR DECEDENTS DYING AFTER 1:v:II19tl
ESTAlC OF FILE NUMBER
Lucy E. Adams ss~ 170-50.0988 05/19/1995 21-95.0437
This ISChodulo must bo complotod and flIod II you chockod tho spousoJ povortY cradil box on tho cover uhool.
-ALe OOF EA
1. Taxablo Assets totollrom lino 8 (cavar shoot) . . . , . . ,
..".,..,....,..,.".. .
2. Insuranco Procoods on Ulo of Qocodon1. . . . . . . . , , .
"..,.,.......,.,.,... .
3. RoUromentBonolllS"..,..".,.,."",.,.,.,.",.......,.,..,.,
4. JolntAaaolSwlthSpouaa.".".,..""",.."..".,.........."..
5. PA LonoryWlnolog.. . . . . , , . . . . . , . . . . . , . . , , . . , . . . . . . . . , , . , , , , , , .
5a. Othor Nontaxablo Asseta: Uat (Mach aohodula II necessary). . . . , , , , . . . .. 5a.
5b.
5..
5d.
5. SUBTOTAL (Uno. 5a, b, c. d), . . . . . .
,.......................... I....
5.
0.00
210 785.58
Y. TotIllGraaaAsllolS(Addlln..1thru5~..,..,..,...,..,....,..,.....".,...... 7.
8. TatlllAc1UllI UablllUaa, . . . . . . . . . . . . , . . . , . . , . . . , , . . . . . . . . . , . . . . , , , . . . ., 8.
9. Not VllIuo of EsToto (SubtrllC1l1no 81rom 1100 7) . . . . , . . , . , . . . , , . . . , . . . . . . . . , . , . . , . .
IIl1no 91. groatorthan $200,000 - STOP. Tho ostatol. not ollglblo to clDlm tho crodlt. II not. .0nUnuo to P8I\ II, 9. 210.785.58
PART II -CALCULATION OF JOINT EXEMPTION INCOME - (Attach cople8 of F8derallndlvlduallncome
Tax Returns for decedent and 8 DUSe.
I. TAX YEAR: 1992 :z. TAX YEAR:
la. 0.00 :la.
lb. 0.00 :lb.
10. 0.00 2c.
ld. 0 . 00 2d.
Ie. 0.00 2e.
11. 0 . 00 21.
4b. Avorogo Joint Exomption In..me . . . . . , . . . . . . . . . , . . , , . . . . , , , . , , , , . , , .
IIl1no 4(b) I. gro.tor than $40,000 - STOP. Tho o.tata I. not ollglblo to clDlm tho Clodlt. II not, continuo to pan III.
PART III-CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT
ESTATES
'"como:
a. Spouse.........,.......,..,...
b. Decadont........,..............
c. Jolnt.....,..,...",."..,..,..
d. Tax Exomptlncamo. . . , , , , , , , . . , , . , , ,
e. Othor Income nOlllalod obava. . , . . , , . , , . . ,
I. Tollll.""""",...".""""
4. Avorago JoInt Exomption Incomo Calculation
4.. Add Joint Exemption Incomo from abovo:
(If) 0.00
+(21)
0.00 +(3f)
1. Insert amount 01 taxablo transfors 10 sPOUSO or $100.000, whichever Is less. ,
,........,.. .
2. Multiply by crodlt porcontago (...Inatructlan.) , . , , , . . . , , . , . , , , , , . . , , , , , . . , ,
3. This Is tho amounlaltho Roaldonl Spauslll Povorty Crodll, Includ. thl. figuro
In1hecaJcuIBUonortolalcredltsonlln010ofthocovershoel.. , ., ..,. . ".. . . . . , , , ,
4. For Nonrosldonts, enler tho ratio 01 tho decadent's gross ostale In PA 10 the valuo aflho
decedont'sgrossostalo..,. .., . , , , . , , . .. . , ., , ., .... . "" . , . , , ..
5. Multiply IIno 3 by IIno 4 ond ontor tho tatlll haro, Thl.l. tho amount 01 tha Nanro.ldant Spoualll
Poverty Credll, Include this figure In tho calculation or tOlal credils on flno 10 01 lhe cover shoot.
COPyright (c11U4 fOl," aoftwltI only CPSylt.IlII, Inc,
0.00
1993 3.
0.00 3a.
o . 00 3b.
0.00 3c.
O. 00 3d.
0.00 3a.
0,00 31.
TAX YEAR: 1994
0.00
0,00
0,00
0.00
0.00
0,00
0.00
0.00
.;- 3 )
0.00
.
.
I. 0.00
:z. 6.00%
3. 0.00
4. 0.00
5. 0,00
Sell.dull (R...., HUt
'...
, ,2. /- q,j -l/37 c
Invento/y 01 the real and personal 15tate of
I.UCY E. A1iAMS
deceased
(SEE ATTACHED SCHEDULE)
210 785 58
.
.
. -- _.. .-..
.
eOMMONWEALTH OF PENNS'tLVANIA .
eOUHT't OF C:UMlIElU.A.ND
}
II:
Dauphin llepo>>l.t IIl1nk und Trust Comlllll nnd Hobert I" Keck. Asst. Vice PreH./Tr\lHt O(flcer
.nd .ub.crlb.d b.ron m.,
l~ I ,,95
. ,d~/J(,t:P~~<k~:l//
b.lng duly sworn .cco,dlng to law, d.pos" .nd .ays that t h.Y lire
Exzecutors or the Est". or (,\ICY E. Adnms
lat. 0' 824 l.ishurn Road. tlnner Allen Townshi n Cumb.r1and C4unty, P.., decuud and th.. the
DauphlJl llepoHlt BlinK b I rust Compllny nnd .
wlthln la .n Inv.ntory mad. by Rohert L. KeCK. ,nre , the ..Id hxecutors
. a' th. .ntln .stat. a' .ald d.e.d.nt, can listing or all the p.non.1 p,ap.-rty .nd rut a~.te, exe.pt ,ul ....t. ou..ld.
th. C4mmonwulth 0' p.nn.ylv.ni., and that the flgu," opposlt. ueh Item 0' the Invantary r.ptlunt it's ,.Ir ...Iu.
II 0' the dat. 0' d.eadent'. duth.
Dnuphin Deposit IInnk llnd Trust Compnny,
EX~of the Estnte of Lucy E. Adnms
BY~ ~ L-~11'-'1 't-p
t;;;i.. .~
Robert 1.. Keck, Asst. Vice preol~i~~~Trust
Sworn
McNees, Wllllllce &
100 Pine Street,
Nurick
Hnrrisburg, PA
Add.....
1710l
Oat. 0' O.ath
Notan"l Soal
MAry Ann And.lSon, Notary Public
Harrisburg. O;tuphln County
My Commission e.pirus Ocl, 30. 199B
~Pflf'l~\",:-o."...~.rv;ntM",~rio!i
19
O'Y
Hny
M.ol!a
1995
Y..,
IH5nUC-nOHS
I. An Inv.ntory must b. m.d within th,.. month. .ft.r .ppalntm.nt 0' p.nanal ",p,,,.nt.tI.,..
2. A .uppl.m.nt In.,.ntary mud b. m.d within thiny d.'P a' dlsea.,.ry 0' .dditlan.1 u.....
3. AddItional .h..n may b. ....eh.d IS to p.noulty or ,ulty
4. S.. MlcI.IV, Rduel."" Act or 1949.
.
.
li'
" !-<
0:
0
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;'., K
..
I '"
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<II
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....
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.
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'- ~
INVENTORY
Estate of:
Date of Death:
County:
Lucy E. Adams
May 19, 1995
Cumberland
Stocks/Lis ted:
---........----.....--.....................................----.-----......
11 651.466 shares AARP Income Fund CNMA & U.S.
Treasury Fund
12 1,634 units Dauphin Deposit U.S. Government Fixed
Income Fund
13 26 shares Dean Witter Select Mun Tr Unit Insd PA
Series 4
14 2,500 shares Dean Witter U.S. Government Sec Trust
15 2,207 units Fixed Income Collective Investment Fund
16 3,618.318 shares Putnam American Government Income
Fund Class A
17 1,112 shares Pennsylvania Power & Light Co.
Subtotal
Bonds:
18 $10,OOD Citicorp Mortgage Secs Inc Remic Pass Thru
Certificate Series 1992-14 Series Class A-5 7.5%
due 08/25/2021
19 $5,000 Lancaster County PA Hospital Authority
Masonic Home Project 6.6% due 10/01/97
Accrued Interest
20
$10,000 Philadelphia PA Gas Works Revenue Bonds
Eleventh Series C 6.7% due 01/01/97
Accrued Interest
Subtotal
Total Inventory
-2-
9,804.56
16,683.29
25,532.78
22,250.00
23,089.67
30,538.60
20,224.50
...-......-----....
148,123.40
10,018.75
5,212.35
44.00
10,329.25
256.83
25,861.18
210,785.58
--
cO"'~P/.'xt.~w\\-Or.l\ttJt!il.l-~'NI'
HARRISR5~t,~A ~\z8.0601
h- -lot, -.;l,
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WilLS
21
-c
FOR DATESOF DEATH AFTER 12/]1/91 CHECK HERE
IF" SPOUSAL
OV I AIM
FILE NUMBER
REV * 1500 EX . (7.g.,
CAB
H P L
E P 0
C R C
K 0 K
P S
o
E
C
E
o
E
N
T
DECEDENT'S NAME (UST. FIRST, AND MIDDLE INITIAL)
HOLL CHARLES J.
COUNTY CODE
DECEDENY'SCOMPLETE ADDRESS
355 HUNTERS ROAD
NEIIVI Ll.E , PA 172/,1
'SOCIAL SECURITY NUMBER
717-12-7802
DATE OF DEATH
03/02/1996
CATEOF BIRTH
0/,/05/1919
CUMBf:RLAND
County
96
0/,37
NUMBER
YEAR
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST,FIRST AND MIDDLE INITIAL)
HOLL EMMA
X 1. Original Return
4. limited Estate
AMOUNT RECEIVED (SEE INSTRUCTIONS)
395/,77.66
RemaInder Retur"
(for dales 01 dealh prior to 12-13-82)
Federal Estate Tax Return Required
Total Number of Safe Deposit BOkes
SOCIAL SECURITY NUMBER
173.28.B63/,
2. Supplemental Relurn
X 41. Future Interest Compromise
liar dates 01 death eher 12.12.82)
[ID I. Decedent Died Testate ~ 7. Decedent Mainlained a Living Trus'
(Atta.h .0 01 Willi (Atta.h a '0 01 Trustl
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
[K] 5.
o 8.
R
E
C
A
P
I
T
U
L
A
T
I
o
N
COMPLETE MAILING ADDRESS
UNIVEST PLAZA
BROAD (, MAIN STS.
SOUDERTON PA 189611
None
None
None
None
2,246.16
None
1,005,177 .43
(8)
C P
o 0 NAME
R N
R 0 UNION NATIONAL BANK (, TRUST CO.
E E
5 N TELEPHONE NUMBER
- T 215 721- 2444
1. Real Eslata (S.hadule A) 1
2. Slo.ks and Bonds (S.hadule B) (2)
3. Closely Hald Sto.k/Partnershlp Interest (S.hedule C) (3)
4. Mortgages and Notas Re.elvable (S.hedule D) (4)
5. Cash, Bank Ceposits & Miscellaneous Personal Property (5ch, E) (5)
6. Jointly Owned Property (S.hedule F) (6)
7. Translers (S.hedula G) (S.hadula L) (7)
8. Total Gross Assets (cotalUnes 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous
Expenses (Schedule H)
10. Debts. Mortgage Liabilities, Liens (Schedule I)
11. Tolal Deductions holal Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Une 11)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Sub'ect to Tax (Line 12 minus Line 13)
15. Spousal Transfers (for dales of death art'r 6-30-94)
Se8 Instructions for Applicable Percenlage on page 2,
(Include values from Schedule K or Schedule M.)
16. Amount of Line 141axable aI6-'_ rate
(Include valueslrom Schedule K or Schedule M.)
17. Amount of Line 14 taxable at 15-/_ rale
(Include values from Schedule K or Schedule M.)
18. Principal tax due (Add talC from Line 15. 16 and 17.)
19. Credits/Sp Poverty Prior Payments Discount
0.00+ 46,000.00 + 2,1,21.05
20. If Line 1915 greater than Line 18. enler the difference on Une 20. This is the OVERPAYMENT.
~ D IChlck here If you are requesting a refund of your overpayment.l
21. If Line 1815 greater Ihan Line 19. enter Ihe difference on Line 21. This Is the TAX DUE.
A. Enter thelntere!t on the balance due on Line 21A.
B. Enter Ihe tolal 01 Line 21 and 21A on Line 21B, This Is tha BALANCE DUE.
Make ChIck P. abl. to: RI Ist.r of Wills. A ent
. . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
IIfplln&luo perury, eel'.' It IIv..umnedI 'felurn,lncudnglccomp'nyI'l9SC II utes. slal_menls,_ lothe SiD my nowedg.. II ,I strue.
co"ecland complele, dltCl.rethatall ,..t.sl.te hIS been reported.t true market v.lue. Oecl.r.tlonot pr.par.rothe, th.ln the perSOnAl represenl.llvels blsed on .11 Information at
which prep.'.r hIS 111)' knowledge.
(9)
18,148.19
(10)
4.797.71,
(11)
(12)
(13)
(14)
(15)
138,061.25 X 07.'
(16)
B/,6 ,1'16 ,1,1 X ,06 ,
T
A
X
C
o
M
P
U
T
A
T
I
o
N
(17)
0.00 X ,15'
(18)
Inlerest
(19)
(20)
(21)
(21A)
(21B)
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
UNION NATIONAL BANK (, TRUST CO.
UNIVEST PLAZA, BROAD & MAIN STS
SOUDERTOff: .PA" .iS9'64.. ..,..', "'.,......,, .",..
SOUDER, ROSENBERCER, BRICKER, BUSCHMAN (, MAZA
114-120 EAST BROAD STREET
SOUDERTOfi:"PA' .iS96.';- -" ---- -.. --,., -.. -.'" --- -.
C:;2~ r<.SO"L--~
Copyright (c) 1994 torm sOftWII. only CPSystems, Inc.
I ,007 ,423.59
22,945.93
984,477.66
984477.66
0.00
50 ,78/,.98
0.00
50.78/,.98
48,1,21.05
0.00
2,363.93
0.00
2 ,363.93
DATE
1115'/'7 t,
DATE
II
Form lR.v.1-9~)-
REY.1510EX+ (2-871
courH~~~4\,~,WhY.HI.
ESTATE OF
SCHEDULE G
TRANSFERS
Pleoso Print or T .
FILE NUMBER
21 - 96 - 0/.37
CHARLES J. HOLL SSfl 717-12-7802 03/02/1996
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON PAGE 2 IS YES.
ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBER InclUde name 01 Ihe transf.'.e, Ihelr OF ASSET .1. INT. DECEDENT INTEREST
f.t.llanshl~ia dllC.d.nt dateo' transf.r,
A ON 10/19/95 DECEDENT CREATED A . 'RUST \11TH
UNION NATIONAL BANK & TRUST CO. m- SOUDERTO
AS TRUSTEE (SEE ATTACHED COPY 0 . TRUST ACRE :MENT) .
ASSETS IN TRUST AS OF DATE OF D :ATH ARE AS 'OLLO\lS :
COMMON STOCK
1 200 SHS A T & T CORP, CUSIP
11001957109 12,650.00 100.001. 12,1:';0.00
2 200 SHS DU PONT DE NEMOURS EI
CO, CUSIP #263534109 15,693.75 100.001. 15,693.75
ACCRUED DIVIDEND - ITEM #2 10/..00 100.001. 10/..00
3 200 SHS GENERAL ELECTRIC CO,
CUSIP fl369604103 15,368.75 00.001. 15,368.75
4 200 SHS MERCK & CO INC, CUSIP
11589331107 13,/.75.00 100.001. 13 ,/.75.00
5 200 SHS NATIONSBANK CORP. ,
CUSIP #638585109 15,062.50 100.001. 15,062.50
ACCRUED DIVIDEND - ITEM #5 116.00 00.001. 116.00
6 200 SHS TEXACO INC, CUSIP
CUSIP #881694103 15,906.25 00.001. 15,906.25
ACCRUED DIVIDEND - ITEM #6 160.00 100.001. 160.00
FEDERATED INCOME FUNDS
7 2,520.064 SHS FEDERATED GNMA
TRUST fl16, CUSIP fl314184102 28,275.91 100.001. 28,275.91
ACCRUED DIVIDEND - ITF~ fl7 167.90 100. 001. 167.90
8 1,625.222 SHS FEDERATED INCOME
TRUST #36, CUSIP #314199100 16,67/..78 ~00.001. 16,67/..78
ACCRUED DIVIDEND - ITEM #8 90.88 100.001. 90.88
U.S. GOVERNMENT NOTES & BONDS
9 25,000 U.S. TREASURY NOTES 4.37 1.
8/15/96, CUSIP #912827L75 2/,,921. 88 ~00.001. 2/.,921.88
ACCRUED INTEREST - ITEM #9 1.8.08 LOO.OO1. /.8.08
10 25,000 U.S. TREASURY NOTES 5.50 1.
11/15/98, CUSlP 11912827V7/. 25,097.66 100.001. 25,097.66
ACCRUED INTEREST - ITEM #10 /.07.97 100.001. 1.07.97
Total of Continuation Schedulo( ) 820 956.12
TOTAL (Also onter on line 7. Recapitulation) 1 005,177 ./.3
(If motO spacD is needed, insert addilionalsheots of same sizo.)
Copyright (e) 1994lorm sallwa,. only CPSysl.ms, Inc.
Fafm 1500 Sch.dule G (Rey. 2-87)
Estate of: CHARLES J. HOLL
Soc Sec #: 717-12-7802
Date of Death: 03/02/1996
Continuation of Schedule G
(Transfers)
Item Description of Proporty
II
Exclusion Total Value
of Asset
Decds Doller Val of
X Int Decds Interest
B TRANSFERS - WITHIN ONE YEAR OF DEATH
I GIFrS IIERE MADE ON 12/8/95
TO THE FOLLOWING CHILDREN
AND GRANDCHILDREN:
KAREN BROIINE 3,000.00 10,000.00 100.00X 7,000.00
JOHN BROIINE 3,000.00 10,000.00 100.00X 7,000.00
MICHAEL BROWNE 3,000.00 10,000.00 100.00X 7,000.00
COLLEEN BROWNE 3,000.00 10,000.00 100.00X 7,000.00
GLENNA DIMMIG 3,000.00 10,000.00 100.00X 7,000.00
RICHARD DIMMIG 3,000.00 10,000.00 100.00X 7,000.00
JASON DIMMIG 3,000.00 10,000.00 100.00X 7,000.00
JANNA DIMMIG 3,000.00 10,000.00 100.00X 7,000.00
MARINDA BAILEY 3,000.00 10,000.00 100.00X 7,000.00
ROBERT BAILEY III 3,000.00 10,000.00 100.00X 7,000.00
2 771.05 ACRE FARM LOCATED IN
CUMBERLAND COUNTY - GIFTED
TO GORDON & AMY HOLL (SON &
DAUGHTER-IN-LAII) ON 7/15/95 6,000.00 1,050,000.00 50.00X 519,000.00
------_..-..----
820,956.12
REV. 1511EX . (7-88)
ESTATE OF
CO"l1.i11lm4\,U~}'bY'N"
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pl.... Print or T .
FILE NUMBER
21 . 96 . 01.37
B.
1.
2.
3.
CHARLES J. HOLL
ITEM
NUMBER
A.
SS
717-12-7802
03 02 1996
DESCRIPTION
AMOUNT
1
Fun.ral Exp.n"'l
HUFF & LAKJER FUNERAL HOME - FUNERAL EXPENSES
4,981. 55
2
EMMA HOLL - REIMBURSEMENT FOR FUNERAL LUNCHEON
3,297.64
3
AMY HOLL - REIMBURSEMENT FOR MINISTER TRAVEL
EXPENSES FOR FUNERAL
20.00
Admlnlatratl.o Coatll
Parsanal Rapra.antatl.e Commission. UNION NATIONAL BANK & TRUST CO.
So.lal Sa.urity Number of Parsanal Repre.entatlva: 23 -1171580
Year Commissions paid 1996
3,000.00
AUorney Fees
SOUDER, ROSENBERGER, BRICKER, BUSCHMAN & MAZA
3,000.00
Family Exemption
Claimant EMMA HOLL
Address of Claimant a' decedent's death
Straa. Address 355 HUNTERS ROAD
City NEWVILLE
Ralatlon.hip I/IFE
3,500.00
Slale PA Zip Coda 17241
4. Probate Fees
1
Miscellaneous Exp.n"sl
CLERK OF ORPHANS' COURT COST TO FILE FINAL ACCOUNT
31.0.00
C.
2
3
CLERK OF ORPHANS' COURT ORDER TO SATISFY AI/ARDS
1..00
NOTARY PUBLIC - AFFIDAVITS
5.00
TOTAL (AI.o entar on line 9. Ra.a hulatlon)
(II maro ap..ols noaded, Inaart oddltlonalsheeta of lame al...)
Copy rig hi (e) 1994 form loflw.r. only CP:JYlt.ms, Inc.
$ 18 148.19
Form 1500Sehedule H(R..... 7.88)
REV. 1512 EX' (1-93)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
COM~Ni~rrr.~{\Wt\v~r1Y'NI'
ESTATE OF
CHARLES J. HOLL ssg 717-12-7802 03/02/1996
ITEM
NUMBER
1
1ST AMERICAN HOME CARE
2/19/96-2/23/96
DESCRIPTION
PERSONAL CARE FROM
2
PRESByrERIAN HOMES, INC. - ROOM & BOARD
3
GREEN RIDGE VILLAGE - MEDICAL INSURANCE
I.
TREASURER, MONTGOMERY COUNTY - 1996 PERSONAL
PROPERTY TAX
5
CARLISLE HOSPITAL - MEDICAL EXPENSE
Pl.... Print 01 .
FILE NUMBER
21 - 96 - 0/.37
AMOUNT
870.75
1,302.33
1,380.00
528.66
716.00
S I. 797.74
TOTAL (Also .nlar on lin. 10, Ro.. itulaliool
(II mor. spac.ls needed, Insert add~Jonal sheets of same size.)
Copyrl9hl (e111l94 'orm loftwar. only CPSy.terns, Inc,
Form 15DOSehftful.I(R.".1-93l
REV.. 151:1 EX + (t.ll)
--.---"-..-.... ...-
co..rH'm~{\~~/hYAHIA
ESTATE OF
SCHEDULE J
BENEFICIARIES
SS
717-12-7802
03 02 1996
CHARLES J. HOLL
ITEM
NUMBER
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
1
A. Taxable aequests:
UNION NATIONAL BANK & TRUST COMPANY
OF SOUDERTON, TRUSTEE FDO EMMA HOLL
WIFE
(TRUST)
UPON DEATH OF EMMA HOLL:
KAREN J. BROWNE
474 KURT DRIVE
BLUE DELL, PA 19420
DAUGIITER
GLENNA G. DIMMIG
RD 3, PO BOX 3836
MOHNTON, PA 19540
DAUGIITER
JANICE E. BAILEY
785 BOEHM'S CHURCH RD.
BLUE BELL, PA 19422
DAUGIITER
NAME AND ADDRESS OF BENEFICIARY
a, Charitable and Governmental aequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also anlar on line 13. Ra.. ~ul.lion)
(If more spaclls n..ded, Insert additional sheets of same size,)
Copyright (c) 1U. farm lIDltw.r. anty CPSysl.m, Inc.
FILE NUMBER
21 . 96 - 0437
AMOUNT OR
SHARE OF ESTATE
ENTIRE RESIDUE
IN TRUST, PER
TRUST AGREEMENT
ITEM SECOND
ONE-THIRD OF
RESIDUE
ONE-THIRD OF
RES IDUE
ONE-THIRD OF
RESIDUE
AMOUNT OR
SHARE OF ESTATE
$
FOfm 1500 SchMlul. J (Re-v, t.&7)
0.00
REV-1514Ex. (10.94)
SCHEDULE K
LIFE ESTATE/ANNUITYI
TERM CERTAIN
CO"~Nil~{\'~,NhY'N"
ESTATE OF FILE NUMBER
CHARLES J. HOll SSn 717-12-7802 03/02/1996 21 - 96 - 0437
This schedule Is to be used for all single life, joint or successive Ide e~tales and term certain calculalions. For dales of death aher 12-31.61 and
before 5-1-89. actuarlallaclors lor slngleh'e calculations can be found in Revenue Booklet (REV-1501S). For dates of d.ath on or aher 5.1.89
actuarial lactors can be found In IRS Publicalion II 1457 ACluarial Values, Alpha Volume.
The Instrument creating the Iii. Interes' Is a: (Pie... .ttach . capy of In.trum.nt)
.D Will
([] Intervivos Oeed of T~ Other
, LIFE ESTATE INTEREST CALCULATION
Pr...nt Ag.
Namala) 01 L1f. T.nanll.) Oat. 01 Birth (N.orast Blrthdo ) T.rm of v.o.. L1/. Ealat. la Payabl.
EMMA HOll
08 10 15
Term of Vears
81
Term of Vears
Term of Vears
Term 01 Vears
1. Volua of Fund from which Ua E..al.(sl Is payabl., , ,
2. Actuarial Factor per appropriate Table , , , . , . , , ,
Inler..1 Tabla rala - 0 3 1/2% 0 6% 0 to'/,
3. Valua of U. Estat. (L1n. 1 x L1n. 2) ,
395,471.66
0.34910
[K) Variable Rate
6.6 '/,
138,061. 25
Namol.) of Annultonlla)
ANNUITY INTEREST CALCULATION
Pres.nt Age
Oot. 01 Birth (N BI hd ) Term 01 V.o.. Annuity la Payabl.
..r.st rt I
Term 01 Vears
Term 01 Vears
Term of Years
Term 01 Vears
1. Vatu. 01 Fund from which annuity Is payable, , .
0.00
2. Check appropriate block below and enter corresponding (number) In column , . .
Fr.quan.y 01 payout..O W..kly (52) OIli-w..kly (26) O_Monthly (12)
o Ouarterly (4) OS.mi-Annually (2)-0 Annually (1) -0 Olh.r ( )
3. Amount of payout per period , , . , . . . .
0.00
4. Aggregate Annual payment. line 2 II line 3 .
0.00
5. Annuity Factor (see Instruclions)
Interesl Table rale - 0 3 1/2./. D 6.'. 0 10./. D Variable Rale
0.0 %,
0.0000
6. Adjustment Factor (see Inslructions). . . . . . . . . . , , . . . , .
7. Value of Annuity - II using 3 1/2.'.,6.,.. 10.'. or if variable rate and poriod payout is at end of period.
calculation Is: line 4 llLfneSxLln.' . . . . ... . , .. ,.. _. . , , ,
It using variable rale and period payout is at beginning of period. calculalion Is:
(Lln.4 x L1n. 5 x Lln. 6) + Lln.3.. , , , " ""','"
0.0000
0.00
0.00
HOTE: The values 01 the funds which create the above luture Interesls must be reported as part or Ihe Estate Assets. line 1 through line 7.
Th. Resulling life/Annuity Inter.st{s) should be reported al the appropriale tall rate on Lines 13. 15. 16 and 17 as requir.d.
Copy,lghl(e:) 1995 formtoftw.reonlyCPSySI.ms,lnc. Form 1500 Schedule K (Ae'lI. 10.94)
o
REV. 164' EXfI10-V4)
CO"~N\lt1nm4\,Wo~~~'NI'
SCHEDULE M
FUTURE INTEREST COMPROMISE
FILE NUMBER
21 - 96 - 01,37
ESTATE OF
CHARLES J. HOLL SS~ 717-12-7802 03 02 1996
Thl. ..h.dul.l. .pproprl.t. only lor E.,.,.. 0' d.c.d.nl. dying .1I.r D...mb.r 12, 1982.
This schedule Is 10 be used lor allluture Inlerests where the rale 01 lax which will be applicable when the luture Interest vesls In
assesslon and en 0 menl cannol be established with certain
Thelnstrumenl creallng lheluture lntereslls:
Will
X Tru.t
(Pl.... .U.ch .opy 01 Inllrum.nl)
Oth.r
I. B.n.llcl.rl..
NAME OF DATE OF AGE TO
BENEFICIARY RELATIONSHIP BIRTH NEAREST BIRTHDAY
1. KAREN J. 8ROWNE DAUGHTER 08 09 1,7 1,9
Z. GLENNA C. DIMMIG DAUGHTER 10 20 1,9 46
3. JANICE E. BAILEY DAUGHTER 12 19 1,5 50
4.
5.
II. For decedents dying on or aher July 1. 1994, il a surviving spouse exercised or Intends 10 exercise one ollhe following wilhln 9
monlhs 01 lhe decedenl's death. check lhe approprlale box and supply a copy of the document In which lhe surviving spouse
ell.relses such withdrawal right
Unllmlt.d rl ht or wlthdr.w.1 Llmlt.d rl ht 01 wlthdr.w.1
III. Explan.tlon 0' Camproml.. Olf... (II mora .p...I. n..d.d. atta.h add.ionalS,S X 11- ,heel.)
Emma Hol1 is the income beneficiary of a trust valued at $395,477.66.
Based on her age, modest lifestyle, and our understanding that she has
sufficient income and assets to support her, we consider the invasion of
principal to be highly unlikely. Tho remainder, at tho death of Emma Hol1,
is to be distributed equally to the three daughters.
Value of Fund
Life Estate Factor (6.67.)
$395,1,71.66
.3/,910
Value of Life Estate
$138,061. 25
Remainder - taxable at 67.
$257,1,16.41
IV. Summary of Compromise Offer:
1. Amount 01 Future Interest. _ . , . , , . . , , , . . , , . . . . . . . . . . . S
2. Value 01 Line 1 exempt from lax as amounl passing 10 charrU.s, etc. . .
(also Include as part ollolal shown on Line 13 of Cover Sheel)
3. Value 01 Line 1 passing 10 spouse al approprlale lax rate , . . , ,
Ch..k 1 BI..k 0 &',c" 0 3',c" rn O',c,
(also Include as part of total shown on line 1S of Cover Sheet)
4. Valuo of Line 1 Taxable at Lineal Rate . . , , . , . . . . . . . , .
(also Inc:ude as part of lolal shown on Line 16 of Cover Sheet)
5. Value of line 1 Taxable at Collateral Rale . . , . . . , . . , . . .
(also Include as part of total shown on line 1701 Cover Sheet)
6. Total Value 01 Future Inleresl (sum of Lines 2 lhru S must equal line 1)
Copyright (e) 1995 tormsollw.r.only CPSy.tems, Inc.
Form 1500 Sehfilule M IRev. 10-V4)
REV. '649 EX. (8/S5)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT OECEDENT
ESTATE OF FII. Numbar
CHARLES J. HaLL SSO 717-12-7802 03/02/1996 21 - 96 . 0437
PART A: Enter the d.scriptian and value of alllnle,est5, both taxable and non.taxable. regardless allocation and nel 01 deductions,
which ass 10 the dec.dent's survivin souse b will, Inleslac ,0 eralion at law, or otherwise.
Oescrl tion 01 items
UNION NATIONAL BANK & TRUST COMPANY OF SOUDERTON,
TRUSTEE FOR CHARLES HaLL TRUST FBO EMMA HaLL, WITH
REMAINDER TO DAUCHTERS - KAREN BROWNE, GLENNA DIMMIG,
AND JANICE BAILEY (SEE SCHEDULE K FOR APPORTIONMENT
VALUE TO WIFE AND SCHEDULE M FOR VALUE TO DAUGHTERS)
SCHEDULE 0
TRANSFERS TO SURVIVING SPOUSE
It.mil
1
Amount
395,477.66
Pan A Tolal: Enler lhe lotal here and In the spouse's -Amount Recelv.d- block on Page 1 395 ,477.66
Election To Subject Property To Tax Under Section 2113(A) As A Taxable Transfer By This Decedent.
11 a trust or similar arrangemenl meets Ihe requirement 01 Section 2113(A), and:
a. The trust or similar arrangement Is listed on Schedule O. and
b. The value of thetrusl or sImilar arrangement is entered In whole or pan as an asset on Schedule O.
then the transteror's personal representative may specifically Identify the trust (all or a fractional portion or percentage) 10 be Included In the election
to have such trust or similar property Ireated as a taxable transfer In this estate, If less than the entire value 01 the lrust or similar property Is Included
as a taxable transfer on Schedule O. the personal representative shall be considered to have made the electlon only as to a fraction of the trust or
similar arrangement. The numerator of this fraction Is equal to the amount of thelrust or similar arrangement included as a taxable asset on Schedule O.
The denominator Is equal 10 the lotal value of the trust or similar arrangement.
ELECTION,Do you .Ia.' und.r Saollon 2t13(A) 10 tr..1 .. ataxabla Iranl'ar In Ihla .alata aU or a portion at a Irult or almUar ."ang.mant
cr.aled for the lole UII 01 thl. d.ced.nt'. surviving spoua. during the surviving spouse', entlr. IIf.tlme?
YES [[] NO 0 Slgnltur. Dal. II M'1 t-
Not.: If the election a 11.1 to more than one trust or Imlll' arran eme"t. then a.e .,ate co of dule 0 must be.1 ned and fll.d.
Part B: Enter the description and value of allinlerests, both laxable and non.laxable, regardless of location and net at deductions,
which ass to the decedent's survivin souse for which a Section 2113(A) election is beln made,
Oescrl tlon at items
UNION NATIONAL BANK & TRUST COMPANY OF SOUDERTON,
TRUSTEE FOR CHARLES HOLL TRUST F80 EMMA HOLL, WITH
REMAINDER TO DAUGHTERS - KAREN BROWNE, GLENNA DIMMIG,
AND JANICE BAILEY (SEE SCHEDULE K FOR APPORTIONMENT
VALUE TO WIFE AND SCHEDULE M FOR VALUE TO DAUGHTERS)
Itamll
I
Amount
395 ,t,17. 66
Part B Total (s.e Instructions)
395,t,77.66
Copyright (c) 1995 'otm loflw,f. only CPSyst8ml, Inc:.
Form 1500 Sehedul. 0 (R.v. 8-95)