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HomeMy WebLinkAbout95-00579 PETITION rOR PIWBA TE and GRANT OF LETTERS 21-95- .s ?q Eslale 01 Chnr}OlllLDA--Everett also knolVn as N A No. To: Register of Wills for Ihe Deceasrd. CounlY of ClU11berland In the Social Secllrlty No. 196-14-0496 Commonweallh of Pennsylvania The petlllon of Ihe nnderslgned respectfully represenlS Ihat: Your pellllonerif), who Is/IlK' 18 years of oge or older an Ihe execut or In the last will of Ihe above decedenl, dated July 16, and codlcll(s) dated None named ,19~ (slalt' rdr\'""1 t1rcIlIIUlancC',. t.,. ICOlllltllllloll, dealh or t'~t'cutor, tiC.) Decendenl was domiciled at dealh In ClU11berland counlY1PennSYlvanla, with II er last family or principal residence ot rrlS21 ShirleY Ave.. Carl sle. PennSYlvania 17013 (BOrough of Carl sle) (IISIItrt't'I, number and mllnclpnlll)') Decendent Ihcn 71 years of age, died July 161 19 95 at 1521 Shirley Ave., CarliSle, Pennsylvania Borough of Carlis~e) . Excepl os follows, decedent did not marry, was not divorced ond did not have a child born or adopted after execution of the will offered for probnte; was not the victim of 0 killing and was never adjudicated Incompetenl: None Deeendent ot death owned property wllh estlmoled values os follows: (If domiciled In Po.) All personnl properly (If not domiciled In Pn.) Personal property In Pennsylvonlo (If not domiciled In Po.) Personal properlY In County Value of real estate In Penn sylvan In situated os follows: None S Unest1mated S S S WHEREFORE, petltloner(s) respectfully request(s) the probate of the lost will ond codlell(s) presented herewllh and the grant of lellers TestamentarY (1t'llnmcnlluy; ndmlnlllrOllOI1 c.t.n.; admlnlSlnlllon d.b.n.c.t.a.) theron; /J\/A' ~., ~1<t'~J-- ~ H. Eveffii- 1516 Terrace Avenue Carlisle. FA 17013 ?4Q-/;'iR? fhmv>l ?49-19~1 (~'O,.lt) ,j "tl_ '6. 109 "0.2 ~,= ~d: '!1~ =0 ;; 5. Iii OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLAND The petltloner(s) obove-nomcd swenr(s) or nmrm(s) that the stolemenls In Ihe foregoing pellllon ore Irue and correct 10 the best of Ihe knowledge and bell of petltloner(s) ond that os personal represen- totlve(s) of the obove decedent petltioner(s) will well on truly pdmlnisler the estate occordlngto low. omrm11 t ond SUb~~lh~~ 1 I.u \-~ am ere ~ "<,19 ~" ,-- " '''" . I Tit> Mi" ~ Mary C. Lewis ,Relll.rler ()" // :s: No. 21-95 - 579 Estate of Charlotte B. Everett , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW Auaust 7 . 19~, In consideration of the petition on the reverse side hereof, satisfactory proof hovlng been presented before me, IT IS DECREED that the Instrument(s) dated July 16, 1980 described therein be admitted to probate and filed of record os the lost will of Charlotte B. Everett and Letters Testamentarv are hereby granted to William H. Everett l!o1l FEES Probate, Letters, Etc. ......... $ Short CerUneotes( ).......... S Renunciation ................ S , JCP .~ Resl.te, or Will. MARY C. LEWIS Robert R. Black, Esq. (06267) ATTORNEY (Sup. Ct. t.D. No.) 36 S. Hanover st., Carlisle"PA,17013 25.00 3.00 Filed S 5.00 TOTAL ~ S 33.00 .. .~!1~t-.. 7....1. .~~~.~........... PHONE ADDRI!SS 717 - 243-3727 I'J 1:'4. '.=- 0.; .) ~ ;.J l~ - .. ~ .:.: - 0.. - I !5 "" (-. :' J 1_ c:: ~:::> uu d ~~I ~U a: 0: ,,., P' Called attorney on 8-7-95. 21 - 95 - 579 . "'"....... :l..'l~"!"~-~ . ~ ,>) .: ,':/ -il'." ") "J ,;;, " :,'-. -, " -. , , i' " , . ': ~ ' .i.. ','-., '"' ., . ::~ ., ,,1.' " '" ~ , ... , :~ , , u, " uw Ol"l"lca. LANDIS a BLACK CARLISLa, pllNNSVLVANIA LAST WI!.L AND TIlSTAMrm' OF OIARLlJl"ITI B. p.vmurrr I, CHARLOTl'P. B. P.VERE'IT, of the Borough of CarliSle, ClDnberland County, Pennsylvania, declare this to he my Last IVil1 and revoke any Will or Codicil previously made hy me. ITEM I: I direct that all my just debts, funeral expenses and administration expenses, includinp, my grave marker, shall be paid from the assets of my estate as soon as practicahle after my decease. ITEM II: I devise and hequeath the residue of my estate, of every nature and wherever situate, in equal shnres to my t\~O granddaughters, Suzanne H. Everett and Jennifer A. l1verett, or the survivor thereof. I~l III: I direct that all taxes that may he assessed in conse- quence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the ad- ministration of my estate. I~l IV: I nominate and appoint the Farmers Trust C.ompany, Carlisle, Pennsylvania, Trustee of the share and of any property any bene- ficiary who may be a minor. The income and/or principal of said trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my trustee in its discretion may determine; and my trustee, in the expenditure of income and/or principal for such purposes, may, in its discretion, apply the same directly without the intervention of a guardian or pay the same to any person having the care or control of said beneficiary or Idth whom the beneficiary resides, without duty on the part of the trustee to supervise or inquire into application of the funds by any person to whom any payment is so made. The balance of such income and/or principal shall be paid to such beneficiary upon reaching age twenty-one (21), or to such beneficiary's estate in the event of death prior thereto. ITEM V: I appoint William H. Everett f:xecutor of this my Last Will. bond for ITEM VI: I direct that my f:xecutor shall not be required to the fa1thful performance of his duties in any jurisdiction. I have hereunto set my hand this /~~y of give (),Ll~~ WITNESS WHEREOF, ,VPl ,1960. &'~a:Ztt~:~tt The preceding instrument, consisting of this one typC\'ITitten page identified by the signature of the Testatrix, Charlotte B. Everett, was on the day and date thereof signed, published and declared by Charlotte B. Everett, the Testatrix therein named, as and for her Last Will, in the pre- sence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses thereto. 21 - 95 - 579 REGISTER Ol~ WILLS 011 CUMBERLIIND COUNTY OATH OF SUnSCIU8ING WITNESS ESTATE OF CHARIDl'1'E B. EVERETl' Robert R. Black and Edward L. Schoro,p xmIldI (each) 0 subscribing witness to the will (lrcsellled herewith, (eoch) being duly qunllficd occordlngto low, depose(~ and soY(Jlthat t-h"y WP..., prescnt ontl sow Charlotte B. Everett the test at rix , sign Ihe same nnd that they request of testot rix Inl~ presence ond (In the prcscnce of eoch ~. signed as a witncss utthc hcr)~ I-(JJ~ Sworn to or affirmed ond subscribed before me this 1st day of ( om~~' '?i1tubA'(f!:~OI';n bvL.~}ml1iv{J#-bJ' ~~" "'"nnuQt" "t . "'''t"'iillQ. W 17013 OMary Lewis,' RCgiSlc~71-1I~~ ~ - .~ 36 S. Hanover St., Carlisle, flA 17013 (Address) - o !2 ~EG~~rER OF WILLS OF COUNTY :":',~iOATH OI~ NON-SUBSCRIBING WITNESS c... ~, T " -, ;\(~~ch). 0 ~bscrlber,:hereto, (each) cl!..l.g duly qualified o~cordlng 10 100v,...Pe ose(s) ond soy(s) IIl11t .:i:,([' (oQ ::1 \ii fOllllllu~with the SlgnOlUre~of ~ I 00 "'-. codicil tcstot_ of (one of thc subscribing wltlcsscs to t Ie will (lresentcd hcrewith nnd codicil bclievClrt i~gnoturc onlhe will Is In Ihe hUlldwritlllH of believcs the signature of the wil ,pr;.cntcd hCl-Cl!:!lh and thul codicil "'" \1clleves the slguolUrc on lhe will I~ the hondwritlug of " to the best of /OlfudgC nnd bcllcf. Sworn to or offirmed !!Jld subscribed beforc me this L duy of /' 19_ {-':l that testa I ,/ (Nail/C) (Addrcss) Rcgislcr (NUll/C) (Addrcss) Jffy CERTIFICATION OF NOTICE UNDER RULE 5.6 CAl Name of Decedent: Date of Death: Charlotte B. Everett Ju1v 16. 1995 will No. 21-95-0579 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the followin~eneficiaries of the above-captioned estate on Auqust ~. 1995 Admin. No. lilllIm Address Jennifer A. Everett. 4590 Larch Dr.. Act A-162. Harrisburq. PA 17109 Suzanne M. Everett. 311 W. Marshall st.. West Chester. PA 19380 Notice has now been given to all persons entitled thereto under RUle 5.6(a) except None Date: Auq. c1f. 1995 JMa9~~ signature \D "- r:',I .:;, if! - 0_ 0-. I ,,, L<I ::J " ,,' c:: c; l-:': <, -:;.". ~ mIX: ex: t!( :-:0: " Name Robert R. Black. Esq. Address 36 South Hanover Street n Carlisle. PA 17013 Telephone C7171 243-3727 .'J . ...;..~ ag capacity: Personal Representative UU X Counsel for Personal Representative f~V.1500 u,. 17.qAI ~ ..:5'" ...",.. wA.'" ="'9 ug:m ~ ~ - fOR OATIS Of DEATH AnER 12/31/91 CHECKHERI If A SPOUSAL POVERTY CREDIT IS CLAIMEO 0 fiLE NUMBER 21 - 95 - 0579 COUNTY C~OE_, YEAR OIClDENI",OM'tlll ADDIIU 1521 Shirley Avenue Carlisle, PA 17013 CO"", ClU11berland AMOUN1 UCllV(D I~H IN".uClION'1 I:j - II '{ - /c.J.J INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) o 2. Supplemental Return o A. limited Eslal. 0 Aa. Fulur. Inl.r,sl Compromise (lor dole. 0' deolh olter 12.12.82) [?;I 6. Dec.d.nt DI,d T"lal. 0 7. Deced.nl Maintained 0 L1...ing Trus' (Alloch copy of Willi (Alloch copy of Trull) :ALL"ORRE5P'ONDENCE~AND.CONFIDENTIAI.' TAX.INFORMATIONSHOULD,BEDIRECTEDiTO,,~. ,M''''Hll'i'l NAME COMl'lfU MAltiNG AaORn' Robert R. Black, Es 36 South Hanoyer Street 176J~ ffi '" w ... w '" Q:~~, ~ COMMONWEAlTH Of PINNUlVANIA DlPAUMfNT Of RlVINUI Of PT. 180601 HARRIUUIIO. PA 11121.0601 DICIDINT" NAM( lLA . flR . AND MIDDlI INITIAl) Everett, Charlotte B. 'OCIAl UCUltlTY NUMUIt OAt( 0' DIAlH 196-14-0496 7/16/95 I" "'''11(Jl1U1 lU....I.......O 'POUll.I .....MI "...". fl." "''''0 MIIlOI' 1",,11"11 ~ 1. Original Return ....0- wffi "'''' "'= :::~ TfUI'HONE NUMlfl 717 243-3727 = '" S == t: ~ ... w '" 1. Real E.'o'e (Sthedule A) (1 ) 2. Slotk. ond Bond. ISthedule B) ( 2 ) 3, CI...ly Held SlotklPorlne"hlp InlerelllSthedule q (3 ) .c. Mortgages and Not'l Recel...abl. (Schedul. D) (4 ) 5. COlh, Bonk D'poI!h & Mlsc.llaneoul Penonal Properly ( 5 ) 15thedule EI 6. Jolnl1y Own,d Property (S,hedule F) 16 ) 7. Tron.'... (S,hedule GIISthedule L) 17 ) 8. Total Gran Au.1s (Iolallln.. 1.7) 9. Funeral Exp,nlll. Admlnllualive COlta, Mlu:ellan,oul ( 9 ) Exp.nsel (Sch.dule H) 10, Deb... MONsose 1I0blllllel. lIen'ISth,dule I) (10) 11. Tolal Deducllonl (talolllnll 9 & 10) 12. N.I Volu. of Estot. (line 8 minullIn. 11) 13. Chorllabl. and Go....rnm.ntal Bequllta (Sc.,.dule JI U. N.t Valu. Sub.et to Tax (line 12 mlnul L1n. 13) 15. Spoulal Tron,fen (for datil of d.ath after 6.30.941 S.. Inltructlonl for Appllcabi'e Percenlag. on R.....rle (15) Side. (Include volulI from Schedul. K or Schedule M.I 16. Amounl of line 1A laxobl. at 6% roto (16) (Includ. yolu,. from Schedule K or Schedule M.I 17. Amount of lIn. 14 laxoble at 15% ral. (17) (Include ...alulI 'rom Sch.dul. K or Sch.dule M.I 18. Principal tax due (Add lax 'rom lInol 15, 16 and 17.1 19. Credita Spoulal Pa....rly Credil Prior Paymenh z '" ~ 0- == A. .. '" ... Carlisle, PA 0.00 0.00 0.00 0.00 5.610.06 0.00 0.00 6.842.50 767.92 0.00 Dltcounl InlorOlt 03, 05, ..L8, r " " :...nl_- .)~~ 18) 1111 (121 (131 1141 x._- x .06 II x .15 II 118) ~ 0- + + 20. If line 19 II gr.ot.r Ihan lIn. 18, enler Ihe dlff,r,nce on lIno 20. This Illh. OVERPAYMENT. mo (19) 1201 Chock hart! If you oro roquostlng 0 refuod of your overpayment. 21. If lIn. 1811 grealer than lIn. 19. onlor tho diff.rence on lIno 21. Thil h tho TAX DUE. A. Enter the Inloroll on Iho balanco duo on line 21A. B. Enler Ihelolal of lIn. 21 and 21A on line 218. Thll II the BALANCE DUE. Mak. Check Payable tal Register af Will., Agent r,~."'T-r.<, ~?!~!'''t:-r-'. :~,~- Carlisle, PA 17013 Carlisle, PA 17013 (21) (2IA) 121BI NUMBER Remalnd.r Return (for dalll 01 d.olh prior to 12.13.82) Fed.ral Eltol. Tal( Return R.qulr.d Tolol Number of Safe D'POlil BOUI r;,~fI$l:J;t~r,'~;' f.?1:\'t \(:l ~:J? e r- J:, -0 W W <=> '1-. ~~ n 5,610.06 7,610.42 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 U.UU ,', _.:t~';!._-,I.}1');".~'L~., . Act .48 of 1994 provldo. for tho roductlon of tho tax rato. Impo.od on tho not valuo of transfor. to or for tho u.o of tho .pou.o. Tho rato. as prucrlbod by tho .tatuto will bo: o 3% (.03) will bo appllcablo for o.tato. of docodents dying on or aftor 7/1/94 and bofore 1/1/96 o 2% (.02) will bo applicable for o.tato. of decodonts dying on or after 1/1/96 and before 1/1/97 o 1% (.01) will bo appllcablo for o.tato. of docodents dying on or aftor 1/1/97 and boforo 111/98 o Spou.al transfor. occurring on or aftor 1/1/98 will be exempt from Inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (.--) IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedent moke a tran.For and: 0, retain the use or Income of the property transferred, ......................................................: x J b. rotaln the right to designate wha sholl use the property transFerred or Its Income, ............... x x c. retain a reversionary Interest; or ................................................................................... 2. I; : 3. d :i d. rocelve the promise For life aF either payments, beneFits ar core9....................................... IF deoth occurred on or beFore December 12, 1982, did d~cedent wllhin two yeors preceding death transFer praperty without receiving odequote cansldelotlon9 IF deoth accurred oFter December 12, 1982, did decedent tronsFer property within one year of death without receiving adequate consideration'.... .......................,.............. t.......... ,...... ..........,............................ x x X Old decedent own on 'In trust For', bonk occaunt ot his or her deoth9...................................... 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. , ' . 1Ml' WILl. A'ID 1l1,STAMI1NI' OF o IARInnn n. E\If:RI!IT I, OIAlU.OTl11 n, IlVI'JUrrr, of the IlorouRh of CarliSle, Ctlnbnrlond County! Pennsylvnoin, dccloro this to ho 1'1)' J.nst I~ill ond revoke noy l~ill or Cod cil previoosly MBde hy me. ' ITEM I: I direct that 011 1'1)' just debts, funernl expenses ond odministration expenses, includinp. 1'1)' ![rnve marker, shall bn paid fran the nssets of my estnte ns soon as practicahle nfter my decense. ITEM II: I devise nod bequenth the residue of my estnte, of every Mture nnd wherever situate, in equal shares to 1'1)' two grnnddaugbters, SUZBMe fl.. Ilverett nod Jennifer A. Ilverett, or tbe survivor thereof. JTr:lol III: I direct thnt nU tnxes that mny he nssessed in conse- quence of my denth, of whatever nnture nnd by whatever jurisdiction imposed, shnll be pnid from 1'1)' residuary estate os n port of tbe expense of the nd- ministration of my estate. Iml IV: I nominate nod nppeint the Fanners TnlSt Company, Carlisle, Pennsylvnoio, Trustee of the share ond of noy preperty noy bene- ficinry "llo mny bn n minor. The income nod/or principal of said trust mny be aCCUllllloted or expended for the mnintennoce, education nod support of such beneficinry as my trustee in its discretien mny detennine; nod my trustee, in the expenditure of Income nod/or principal for such pUTJlOses, may, in its discretion, apply the same directly without the intervention of a guonlion or pny tbe same to ony person having tbe care or contrel of said beneficiary or with whan the beneficiary resides, without duty en the part of the trustee te supervise or inquire into applicntion of the funds by noy persen to whan ony payment is se made. The bnlonce of such incane ond/or principal shall bn poid to such beneficiary upon reaching ege twenty-one (21), or to such beneficiary's estote in the event of death prior thereto. lHll. .!!!liY : I appoint William H. Everett TIxecutor of this my !.nst ".l, " ;~~;I \ ,.;j; ;;,jl 1~1 ~:'l ~; "J .i l " I ,_l: : iill '):1 ~I '~~ 1ml VI: I direct thnt my r:xeClltor shaU not bn required to give bond rer the faithful perronnnnce of his dutios in nny jurisdictien, 1Jl::o (),JL,~~ W1TN1'.5S 1I1IEnmF, I heve hereunto set my hand this I~ day of .,.__([ ,1980. fL.6~ ~ ~f'f"* aT ottc . !vcrett (SPAL) 11le preceding instlUlllCnt, consisting of this one typewritten page identified by the signature of the Testotrix, Charlotte B. Everett, wos on tbe day ond dote thereof signed, published and declnred by Olarlotte n. Ilvcrett, the Testotrlx therein named, as and for her !.nst Will, in the pre- sence ef us, who, ot her request, in her presence, ond in the presence of each other heve subscribed our nOll1OS as witnesses thereto. U,WO,,.Cl:1 ~(t&<Jr -~:~~ LANDIS. aLACK C"""I'U. ,...""LV.,.14 ~ II\l.Uo,nt 11'71 " ~ SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploa.e Print or 1 e FilE NUMBER 21-95-0579 COMMONweAlTH Of '(NNSYlVANIA INHUITAHCI tAX InUIN IISIDIN' DICIDIN' ESTATE OF Everett, Charlotte B. fAil p,op.,tv lolnllv~n.d wllh Ih. Right 0' Survlvonhlp mud b. dlulo..d on Sch.dul. fJ N~~':ER DESCRIPTION VALUE AT DATE OF DEATH 1,872.95 411.32 547.10 21.27 5.00 25.01 21.87 292.00 500.00 603.56 1,310.00 0.00 1. Checking accoW1t #0005-63471, Parmers Trust Canpany 2. ClU11berland-PerJ:}' Association for Retarded Citizens, wages 3. ClU11ber1and-Perry Association for Retarded Citizens, wages 4. The Sentinel, refund 5. American Expres" refund 6. State Pam Insurance, refW1d premium 7. Sprint, refund 8. Rowe Auctioneers, sale of personal property 9. Donald A. Maurice, sale of 1974 Buick LaSabre autaTOblle 10. Internal Revenue Service, refund 11. Personal property, appraised value. See attached letter 12. The Guarantee Carpanies, life insurance. Total proceeds $9,500.00. See attached statement. Non-taxable life insurance proceeds. 13. The Prudential, life insurance. Total proceeds $2,466.80. See attached statement. Non-taxable life insurance proceeds . 0.00 TOTAL Also ontor an IIno 5. Reea itulatlan S 5,610.08 IAllach additional Bl\" )C 11" ,h..ulf mo', .pac. It n..d.d.) . B~~. ROWE:~~ :~~t OD . AU 2276L R. D. 4, Box 353 · Carlisle, P A 249-2677 249.1978 Auction Is Action Call "ROWE"For Satisfaction August 6, 1995 TO:Wllliam Everett Executor 1521 Shirley Ave. Carlisle, Pa. 17013 FROM: Benny E. Rowe Appraiser/Auctioneer 2505 Ritner Highway Carlisle, Pa. 17013 RE: Charlotte B. Everett Estate, Appraisal 1518 Terrance Ave, Carlisle, Pa. 17013 Chest,4 Drawer, Cherry, Bracket Feet $ 95.00 Dining Room Suite, 7 Pcs.,Table, 4 Chairs, Open Corner Cupboard 7 open Hutch Cupboard 500.00 Bedroom Suite, 5 pcs, Maple Finish Dryer, Electric, Wards Stove, Electric 30", G. E. 535.00 55.00 125.00 ".1 0: -, _ , ) I' . _.~ . ~ _, ...-_..__.. Benny E. Rowe ./ The Guarantee Companies Guarantee Mutual Life Company Guarantee American Life Company 8801 Indian Hills Drive/Omaha, Nebraska 68114 (402) 390-7300 STATEMENT OF PAYMENT CLAIM NO, 14610 POUCY NO, u l-UOUll UlIll-OllOU ,I INSURED &:Vllll:TT, CIIARLUTH 110 CLAIMANT GRUUP INFURMATION - CUHllfiRLAHU-PEHRV ASSUCIATIUN FUR RfiTIIRU&:O CITIZENS IITTN - MICIIELLE IIII!!R 117 N. III1NUI/EIl STIlEfi T CAIlLI~LE, PII 17013 LIFE MiUUNT WILLIAN II. I:V&:IIHT 15111 TI:RRACi III/e. CAIlLISLE,PII 17013 9,:;00.00 i l TUTIIL INSIIRAHCI: MIUUNT * TOTAL AMUUNT PAlO '),500.00 9,500.00 I, S&:UGIoIICK JAMES UF PENN~VLI/AIIIA, INC. I' U UUX 1675 /I11HRISUUIlG, PA 171 05- L/\IJ1l EN 1I1iRRIlHlN APPROVED DY 14021 390-7549 08/10/95 DATE d . 1 PAYEE ~~~'IIM'1\'i&"t~iT-Ml'<l.-~~JI-_~~~l\i~nll_J-- ~ " \ ............-...... Mall to W SHo .Add.." Field arr,,:e Inshuctlon, CAHY 930 O.lInr., 01 Ih. 'lI.chld chic" .nd 'I.t.m.nt I. UNCONDITIONAL BA TCli NO. TO It ThePrudentlal ~ 'OR INGURANCE SEHVICE. GEt IN tOUCH WitH YOUR REPAE5tNTATlVE OR tltlS OFrtCe CHECK STATEMENT th. Prude"'",1 In,u..m:. Cnmpltnr 01 Amellt. eentl., AII'I1',,: Ope""flU CUI., r.o, 80. u 1 Fori W.lh.flu,on, PA 1IOJ4 CAD CLAIM SUPPORT SRVCS POBOX 3DB FT WASIHNGTON PA 19034 DEATH CLAIM COl'li eel Numb.r Inlu'ldIAnnUlt",", Chid, Numb., 0207 0130?72 013 260 176 CHARLOTTE B EVERTT AUG 40 1995 WE HGPE WE HAVE BEEN OF HELP TO YOU DURING THIS DIFFICULT TIME. THIS CHECK FOR $2.4B6.60 REPRESENTS THE PROCEEDS FROM THE DEATH CLAIM ON CONTRACT 013 250 176. SOURCE OF FUNDS $1.000.00 $1,411.12 $30.42 $19.43 $5.03 FACE AMOUNT OF INSURANCE ACCUMULATED DIVIDENDS AND INTEREST TERMINATION DIVIDEND POSTMORTEM DIVIOENO INTEREST FROM OATE OF DEATH AMOUNT OF CHECK $2.466.00 .. .... ........ ........... ....... .......... .......... IF THE DECEASED WAS NAMED AS A BENEFICIARY ON ANY OTHER INSURANCE CONTRACTS, WE SUGGEST THAT A NEW OENEFICIARY BE NAMED AS SOON AS POSSIOLE. SOCIAL SECURITY BENEFITS MAY ALSO OE AVAILABLE. FOR MORE INFORMATION, GET IN TOUCH WITH THE APPROPRIATE GOVERNMENT OFFICE IN YOUR AREA. IF WE CAN BE OF ANY ADDITIONAL SERVICE, PLEASE LET US KNOW. ~UST GET IN TOUCH WITH YOUR PRUDENTIAL REPRESENTATIVE OR THE OFFtCE SHOWN ABOVE. (IKUBTOBle) (..e IBEVER) PLEASE DETACH CHECK - KEEP STATEMENT FOR RECORDS IIY.Ullllt 11.111 . J Ploalo P,lnt or TVpo f 'E NUMBER 21-95-0579 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMONwrAUH OF PENNSYlVANIA INH[RITANCr tAX RftURN RUID[NI DfelDINI E TATE Of Everett, Charlotte B. ITEM NUMBER DESCRIPTION AMOUNT A, Funo,al Exponloll 1. B. 2. 3. Ewing Brothers Funeral Hane 5,405.00 1. Admlnlat,atlvo Callal P.rsonal R.p,.s.ntollvo Commlnlon. Social Socurlty Numbo, of Porsonol Rop,o.ontollvo. Yoor Commlsslonl paid Anornoy Foo. Landis, Black & Schorpp Family Exomption Claimant Add,o.. of Claimant at docodont'. dooth Stroot Addross 1,000.00 Rolollon.hlp City Stoto Zip Codo 4. Probato Foo.: As advanced by Landis, Black & Schorpp Reserve for closing 141.46 125.00 -, C. Mlleollanooul Exponlu, 1. Rowe's Antiques, personal property appraisl Boscov's, final bill 25.00 12.17 2. 3. Borough of Carlisle, final water & sewer bill Pennsylvania Power & LIght Oampany, final electric bill United of PA, final telephone bill 77.76 II. 19.20 26.87 10.00 s. 6. Darlene M:>yur, tax collector, personal taxes 7. a. TOTAL (AI.o onlo, on IIno 9. Rocopltulollon) $ 6,842.50 (If mo,o Ipace II noodod, Inlo,l addltlonallhootl of lamo Ilzo.) UV.IJIIlhl1.UI ESTATE OF ITEM NUMDER 1. 2. 3. 4. 5. 6. 7. B. 9. 10. .. ~jj. l 'SCHI:DULE I J DE8TS OF DECEDENT, MORTGAGE L1A8LITIES AND LIENS PI PIT ~ .__ _ 0010 ~ nt or Vpo FILE NUMDER 21-95-0579 COMMONW'AUIl 0' r""'''lVANIA INHUIU,NCllUIIIUIH l"IOINIOIClOINI EVerett, Charlotte B. DESCRIPTION AMOUNT Gulf Oil Limited Partnership, gas bill , National Health Laboratories, W1paid and unreirnbursed medial expense. Borough of Carlisle, water and sewer bill Thee BonTon, invoice Pennsylvania Power & Light Company, electric bill Yellow Breeches Family Practice, unpaid and unreirnbursed medical expense. J.C. Penney Canpany, invoice Boscov 's, invoice United of PA, telephone bill Yellow Breeches , Family practice, unpaid and unreirnbursed medial expense 72.46 116.50 131. 74 29.09 100.64 12.64 77.29 147.25 59.15 20.96 '. TOTAL IAlso enler on line 10. Recopllulallon) {If mora spac. is na.JoJ, insort additional sh..,s 01 sarno sin.} $ 767.92 .tV.IJUUtI1.111 . COMMONW'AlIH 0' ,tNNnWANlA IHHUIfANCI 'AX InUIH IIIIO'H' o.eIOIH' SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-95-0579 Everett, Charlotte B. ITEM NUMBER RELATIONSHIP AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY 1. A. Taxabl. alqulSlIl Suzanne M. Everett, 166-62-4099 311 West Marshall Street West Chester, PA 19360 Jennifer A. Everett, 173-62-0544 4590 Larch Drive, Apt. A-162 Harrisburg, PA 17109 50% grand-daughter 50% 2. . grand-daughter ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE a. Charitable and Governmental Bequestll 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o .nlor on lin. 13. Rocopllulatlon) S (If more .pace II n..dld, In..rt additional .h.... of .am. .111) . I /.'i-- 9 7 -I'~ REV-1547 EX AFP 1120951*, COHMC)NNUl Ttl OF PENNSYLVANIA DEPAR'"ENT Of REVENUE BUREAU OF INDIVIDUAL lAKES . DEP'. ZlOU) tlARAIIBURG, PA HUe-060l t!- t., ACN 101 NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOWANCE OR OISALLOWANCE OF OEOUCTIONS ANO ASSESSHENT OF TAX DATE 09-30-96 FILE NO. 07-16-95 COUNTY CUMBERLAND NOTE' TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS fOR" WITH YOUR TAX PAYHENT TO THE REOISTER Of WILLS. "AKE CHECK PAYABLE TO "REOISTER Of WILLS, AGENT" REMIT PAYMENT TO: ROBERT R BLACK ESQ 36 S HANOVER ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ."Dunt Re.ltt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... ifiv:is47-EX"AFP-nZ-:9!;"j-iioi'"icnWi"NHEiiifAN"CE-YAin"pjij'iiiiSEHEiir-;"'U.i...OWANCnili-----"..---..------ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF EVERETT CHARLOTTE B FILE NO.21 95-0579 ACN 101 DATE 09-30-96 TAX RETURN WAS, eX) ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Raal Eat.t. (Schedula AJ (1) 2. Stock. and Bonda (Schedule 8) (2) 5. Cloa.ly Hald stock/P.~tn.~.hlp Int.r..t (Schedule C) 15) 4. Harig.g..IHot.. Receivable (Schedule DJ (4) 5. C..h/Bank Depolita/Hilc. Parlonal Property (Schedule E) 15) 6. Jointly Owned Property (Sch.dule f) (6) 7. Tran.fara (Sch.dule OJ (7) 8. Total AII.ta APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.ral Exp.nsa./Ad.. Co.ts/Hllc. Exp.n'" (Schedul. H) (q) 10. D.bt./Hortgaga Liabllitia./Lians (Schadul. I) 110) 11. Total D.ductlon. 12. Hat V.lua of Tax R.turn 15. Charitabla/Gov.rn_.ntal Oaqu..t. (Schedul. J) 14. H.t Value of Eat.t. Subjact to Tax I~ an assossmont wos issuod provious1Y, linos ro~loct ~iguros that inc1udo tho totol o~ ALL ASSESSMENT OF TAX: 15. A.ount of Lina 14 16. A.ount of Lin. 14 17. AMount of Lina 14 18. Principal Tax Due NOTE: .t Spousal t.xabl. at taxabla .t ,..t. Lln..l/Cla.. A ,..t. Collatar.l/Cl... B r.t. 1I5) 1I6l 1I7) TAX CREDITS: PAYHENT DATE RECEIPT NUHBER DISCOUNT I') INTEREST 1-) ) CHANGED .00 .00 .00 .00 5,610.08 .00 .00 eB) 5.610.08 6,842.50 767.92 lIll 1I2) lISI 1I4) 7.~10 42 2.000.34- .00 2,000.34- 14, lS ond~or 16, 17 and 18 will roturns assossod to dote. .00 X .00= .00 X .06= .00 X .15= lIB I .00 .00 .00 .00 AHOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 . If PAID AfTER DATE INDICATED, SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. If TOTAL DUE IS LESS THAN fl. NO PAYHENT IS nEQUIRED. If TOTAL DUE IS REfLECTED AS A "CREon" ICRl, YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS.l . '/J ,... :--l ,:~ Ht. o Po p" L-~ '.' WU.: a: !1..~ ,. 'll :J OU RESERVATION. E,.,t.. of dlcld-nt. dYing on or blfor. Olclab.r lr, 1912 -- If any future Int.r..t In thl ,,'at. S. tran'farrad In po.....lon or enJoy..n. to Cl... I leolbt.,,1) beneflclarlu of thl dacadlnt aftu thl I.plntlo" of any ,,'st. for II'. Dr for v..r., thl Co..onw..lth hlr.by ,.pr...ly rl.lrv.. thl right to .ppr.I.. and ...... tranl'.r Inherltancl ,.... at thl lawful el... I Ceoll",r.l) r.t. on any luch future lnl.r..t. PURPOSE Of NOTICE. To fulfill thl r.qulr...nt. of s.ctJon IlltO of thl InhuUllnu and Est_" rill Act, Act ZZ of .991. 7Z P.S. S.cUon 2140. PiMNTa O.t.ch thl top portion 0' thh Notice Md tubelt with your pIV...,t to thl R.ghtl" of Willa prlntad on thl nVlnl ,Id.. --Hlkl chick or "",y order payabl. tal REGISTER OF MILLS, AOENT All pay.antl rlnh,.d .h.ll Unt b. .ppU.d to .n~ Inhr..t which .'V b. dua with anv r..aiMIt appll.d to the ta.. REFUND eCR). A r.fund of a ta. cradlt. which wa. not raqua.tad on the r.. R.turn. ..v b. rlqu..t.d bv co.pl.tlno an "Appllc.tlon for R.fund of Penn.vlvanla Inh.rltanca and E.t.t. Ta." (REV.ISIS). Application. er. avallabl. at th. Offlc. of the Raglst.r a' WIUI. Iny 0' the ZS R.v.nu. Ohtrlct Offlc... or bv c.Ulng the .p.cI.I t4-hou,. an,w'''lna ..rvlc. nuab.,., 'or 'or., O,.d.,.lnal In P.nn.vlvanla 1.100.56t.t050. out,ld. Penn.vlvanl. and within 10c.1 Harrl.bura araa (717) 717-1094. TDDI (717) 77t-!rS! (H.arlng I.p.lr.d Onlv). OIJECTlONS. AnV p.rty In Int.r..t not ..thll.d with thl apprals"lnt. allowanc. or dlsallowanca of deduction.. or ........nt 0' t.. Uncludlno discount or Intar..U .a .hown on this Nolin .u.t obJ.ct ..lthln .bty (60) dav, 0' r.celpt 0' this Holln bYI ....rltt.n prot..t to the PA D.p.rt..nt of R.v.nuI. loard 0' Appaal.. Dlpt. ZIIOZ1. Harrl.burg. PA 17IZ.-10ZI, nalactlon to have thl ..tllt d.taralnad at ludlt of thl .ccount of the p.r.on.1 rIPrla.ntatlve, OR .-.pp.al to the Orphan.' Court. OR ~ I ADMIN IITRATlVE CORRECTIONS, Faotual .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In ..rltlng tal PA D.part..nt of R.v.nu., Bur..... of Indlvldu.l h..., ATTN. Po.t A.......nt Ravllw Unit, D.pt. Za0601, llarrlsburD. PA 17IZI.0601 Phon. (717) 7.7-6S0S. S.. pag. 5 of thl bookl.t "In.tructlon. for Inh.rltancl 'a. R.turn fa,. . Ra.ld.nt D.c.d.nt" (REV-ISOI) for an IMpllO_tlon of .dalnl.tratlvalv corractabll .rtor.. If anv ta. due I. p.ld within thra. (51 cal.ndar aonth. a'tar the dac.d.nt', d..th, _ flv. p.,.c.nt (S~I dl.count 0' the taM p.ld I. allow.d. , DISCOUNT, PENAL TVI Thl 15~ taK aan..tv non-participation p.n.lt~ I. coaput.d on the tot.1 0' the t.K .nd Int.r.at .......d. and not p.ld b., or. Janu.ry II, 1996, the flr.t day ,'tar the .nd 0' the t.K aan..ty p.rlod. Thl. non.partlclp.tlon panalty I. .ppaalabl. In th. .... .ann.r and Jn the the .... tlea parlod .. YOU would .pp..l the t.. and Int.r..t that ha. ba.n .......d a. Indica tad on thl. notlca. INTEREST. Int.r..t I. charg.d b.glnnlng wJth ,Jr.t day 0' dallnqu.ncy, or nln. (9) eonth. and ana (1) d.y 'roe tha data 0' d.ath, to the data 0' pay..nt. TaK" which bac..a d.llnqu.nt b.for. J.nuary 1, 1911 b.ar Inter..t at the rata of al. C6~) p.rca~t p.r annul calculat.d at a d.llv r.t. 0' .00016'. All t.K.. ~hlch blca.a dallnqu.nt on and .ft.r Janu.ry 1, 198Z will b.ar Jnt.r..t .t a r.t. which wJIl vary froa c.landar y.ar to cal.ndar y..r ..Ith th.t r.ta announced by the PA Departa.nt of RavanuI. 'h. .ppIJc.bla Int.r..t rata. 'or 1982 through 1996 ara, !!.!r Inl."..t Rat. D.lh Intar..t Factor :!!!r Int."..t R.ta DailY Int.r..t Fllctor 1911 20le .0DDS4I 1987 .~ .000247 1911 16~ .ODDU' 1981-1991 11:< .00nOJ 19.4 11:< .OODSOI 199Z .~ .000Z47 19l5 lS~ .000356 1995-1994 ,. .000192 1916 IDle .000274 1995.1996 .~ .000247 ulnt"..t It calculat.d .. follow. 1 INTEREST . SALANeE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Anv Notlca I..u.d aftlr tha taM b.co.a. dallnquant will r.flect an Int.r..t calculation to flft..n C1S1 d.v. bayond tha d.t. of the ........nt. If paya.nt It ..d. aft.r the Inter..t cOllflutallon data .hown on the Hotlc., .ddlllaMl Intar..t ""It b. calcul.l.d. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charlotte B. Everett Date of Death: July 16. 1995 Will No. 21-95-579 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is NO, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account infonnally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of fonnal or infonnal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: lO/lo.f{ qr, ~~u.~ Ro ert R. Black, Esquire 36 South Hanover Street Carlisle, Pennsylvania 17013 (717) 243-3727 Capacity: _ Personal Representative X Counsel for Personal Representative co '0 - /2 .. f" 0_ ". '<l' - I- '"' L,) b Cl U :Z" '11 UJ _.. a:u.. f1' t...... :'Q~ " ~j c -=> C,)C,)