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PETITION ron 1>>lumATE und GltANT 0... I.I~TTEnS
No, __PlL-:::55.:.j,p..1 .3
To:
:, KENNE'I'II H. WllI'l'g
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____________ ,_____________ _ Hosl,lor or Will, 1111 Iho
l84M26M50671J"t'l'lIwd, COIIIII)' or __CumborJ.ancL In Ihe
SIId,,1 St"'II'/I)' Nil, _______ COllllllonwollhh or I'onll'ylvllnlll
Tho I'ollllon 01' Iho IIndo"lsnod ""I'OClrllll)' 101"0'0111' 111111:
Your I'elllloner(,), whll h/me IN YOllrs ur IIse III older IIn Ihe eXOClI1
In .he las. will Ill' Ihe abllve dec,'delll, dIlled
and codldl(s) dilled
rix
JulY 26
nUlIled
,IIJJ!L
I'HUe IrleHlIll !;h!;Ulll\lnU(C'\, t.tt. 1C'llIl1lchulon. death uf t\ttlllur, C'le..
Decendent was domiciled 01 dealh in Cumberland COli illY, I'ennsylvaula, with
h is 1~~1~li~.or.ll~~'JtPJhre~~~~~I~lMechanicsburg I>orough, P/\
111\1 'Ired. number and munclllalil)')
Dccenden.,ll)en 59 yeors of age died April 27 ,1995
01 Harrisburg Hospital, HarrJ.sburg, 1'1\
ExecI'I os follows, decedent did nOllllarry. was nol divorced and did nol hove 0 child born or adopled
afler execution of the will offered for probate; wus nollhe vlcllm of 0 killing and was never adjudicated
Incompelenl:
Decendenl 01 dealh owned property wllh estimated vollies os follows:
(If domiciled in 1'0.) All personal property $ _'J. 00>0, ..,
(If nOI domiciled In 1'0.) Personal property in Pennsylvania $
(If nol domiciled in Po.) Personal property in COllnty $
Vallie of real eSlale In Pennsylvania $
sllualed os follows:
WHEREFORE, pelltloner(.) respeelfull)' reqllest~) tl~ Rfob~e of the lust will and eodlell(s)
presenled herewllh and .he grant of leller. es a en ary
(1C'110mC'I1UlI)'; admlnl\lrOllon c.I.a.: admlnhlradon d.h.n.c.l.a.)
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Martha C. White
2338 S. Market Street
Mechanicsburq, PA 17055
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } 88
COUNTY OF r"mh"rl "nn
The petltioner(s) above-named swear(s) or affirm(s) Ihat Ihe statements in the foregoing petition ore
true and eurreel to Ihe beS! of the knowledse and belief of pelltioner(s) and Ihal os personal represen-
tUlive(s) of the above decedent pelltloner(s) will wellund truly adminisler Ihe eSlale'aeeordlng to low.
~ ~L.. L.. \..l)~ ,.sr.
Sworn 10 or affirmi~T~nd sllbscribed
before me .l1lli day I'
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RY C. LEWIS
R('R;S(('r
s
No. 21 . 95 - 613
.'-;Stlltc of
KENNB'I'II H. WIII'I'B
I I)cccll8cd
I)ECREE 01<' PROBATE AND GRANT 01<' LETTERS
AND NOW AUGUST 16. 19~, In consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED Ihat the Instrumenl(s) doted July 26, 1982
described therein be admllled to probate and filed of record oS the lost will of
Kenneth R. White
Testamentary
MARTHA c. WHITE
and Lellers
ore hereby granted to
711"'1 df!, '"~) f".1iJn(ffi~ .
Real"er 01 Will. '0" (j
MARY C. LEWIS
FEES
$ 25.00
Probate. Lellers, Etc. .,. . . . , , .
Short Certlneates( 1 ~.. .. . .. ... $ 36.00
RelUlRclat.ion .........,."... $
X-~age, j.UU
JCP $ 5.00
TOTAL _ $ 6Q 99
Filed . ~.,.. ~~.~~~T. .1.~ I. ,l.~~?,.. .",....
Timothy M. Anstine, 44879
A1TORNEY tSup, CI, I,D, No,)
Box 737, camp Hill, PA 17001-0737
ADDRESS
737-3405
PHONE
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Mailed letters and order to attorney on 8-16-95.
21 - 95 - 613
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IDust Bill uub ffit1l1umtut
OF
KENNETH R, WHITE
I, KENNETH R. WHITE of Mechanicsburg, Cumberland County,
Pennsylvania, do make, publish and declare this to be my
Last Will and Testament, hereby revoking all previous
Wills and Codicils heretofore made by me.
FIRST: I order my Executrix or Executor hereinafter
named to pay all my debts and funeral expenses as soon after
my death as reasonably possible.
SECOND: I give, devise and bequeath, all the rest, residue
and remainder of my estate, of whatsoever kind and wheresoever
situated to my wife, Martha C. White.
THIRD: Should my wife, Martha C. White, predecease me or
fail to survive me by thirty (30) days, then I give, devise
and bequeath, all the rest, residue and remainder of my estate,
of whatsoever kind and wheresoever situated as follows: Seventy
five (75%) percent of my entire estate, I give, devise and
bequeath to Trudy Strasbaugh of Dillsburg, Pennsylvania. The
remaining Twenty-five (25%) percent of my estate, I give,
devise and bequeath to my son, Kenneth R. White, Jr.
FOURTH: Should my son, Kenneth R. White, Jr., be under
the age of eighteen (18) years at the time of my death, I hereby
direct that Trudy Strasbaugh be appointed guardian of the estate
dd minor, K~n"h f2;;~~.
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FIFTH: I hereby appoint my wife, Martha C. White, as
Executrix of this my Last Will and Testament. Should my wife
predecease me or fail to qualify as Executrix, I appoint the
C.C.N.B, N.A. of New Cumberland, Pennsylvania, as contingent
Executor of this my Last Will and Testament.
SIXTH: I direct that my Executrix, Executor and/or
Guardian shall not be required to give bond for the faithful
performance of their duties in any juriadiction.
SEVENTH: I hereby declare it to be my express desire that
the Executrix or Executor of this my Last Will and Testament,
employ the law firm of Mancke, Lightman & Wagner of Harrisburg,
Dauphin County, Pennsylvania, for legal advice and assistance
in the probating of and carrying out of the provisions of my
Last Will and Testament, they having an intimate knowledge
of my affairs, views and wishes respecting many matters
that may arise in the probate of this instrument, the
administration of my estate and the execution of the powers
therein mentioned.
IN WITNESS WHEREOF,
to this my Last Will and
1982.
I have hereunto set my hand and seal
Testament, 7 :.:(. day of ~
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, en~k~~ ~'{t (SEAL)
This instrument consisting of two (2) typewritten pages,each
bearing the signature of the above-named, KENNETH R. WHITE,
was by him on the date hereof, signed, published and declared
by him to be his Last Will and Testament, in our presence, who
at his request, and in his presence and in the presence of
each other, we believing him to be of sound and disposing
nd and memo have hereunto subscribed our names as witnesses.
.
r..iding "4-'.1~2 tl;"kdl';d~"e if '3
residing at.J:<~1 Mr.ufc;(i,;<J.O~.. / 171 'i
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21 . 95 - 613
REGISTER 01" WII.LS m' COUNTY
OATH 01" SUBSCRIBING WITNESS
----- ,
codicil /~
(each) a subscribing .,!\,Itness to the will pre.euled herewith, (sach) being duly quallned according to
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law, depo.c(s) and say(snhat " / presenl and saw
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the tesla' , sign Ihe some and thaI '>/ signed as a witness at thc
request of testa' in "-- PJcsC-;;ee and (Iilthc presence of each other) (in thc presence of the
other subscribing witness(esll,../' . ---__...
Sworn to or arnrmed arid;:bscrlbed before ~
me this'/ day of (Name) "-
19_
(Address)
Register
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t~ ':" REGISTER OF WILLS OF c.w.AS~M::PCOUNTY
~u; ~ ~TH OF NON.SUBSCRIBING WITNESS
.::r~N Le.~ ])~/~Re-.s ;: k'RIJ/J1;;-/2
(each) 0 subscriber hereto, (each) being duly quallned according 10 law, deposc(s) and say(s) that
familiar with the slgnalUre of J:~\,.aJ er,-\ 'R. W 1-1 \ ~
codicil
will
that
presented herewllh and
codicil
believes the slgnalure on the will is In the handwriting of
testa~ of (one of the subscribing wllnesses to) the
_\<E\JNe:Tl-\ 'R, Wrl \~
10 the best of
knowledge and belief.
Sworn to or arnrmed
me this
d subscribed before
day of
19
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. (Nan;e) 1.....,. A ' r
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.tftc. /J (Address)
U::Z M~<" ?!' ~
(Name)~ ~
t:,.3t e>f,t~...,?f}~t>' 6/,.& rf1 /7'IJ):;J...r-
(Add,ess)
CERTIFICATION OF NOTICE UNDER RULE 5.6(8)
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Date of Death:
Kenneth R. White
April 27, 1995
2195 - 0613
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Name of Decedent:
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Will No.
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To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
September 7, 1995.
Martha C. White
2338 S. Market street
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except: None
Date: September 7, 1995
SAWIS, GUIDO,
SHUFF &
MASLAND
2t09 Market Slmct
Camp Hili. PA
.JJWQ., ..quir.
POBOX 737
CAMP HILL, PA 17001-0737
Telephone: 717//737-3405
Counsel for Personal Representative
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
eO"~f,l'i~'th!~'If,'iMJj;llJlANIA (TO BE FILED IN DUPL/CA TE
HAAAIS86r.kv.e'l9Ii;.OOOI WITH REGISTER OF WILLS r.OUN'VCOOE
OEe'OEN"O NA"E 'IAOI, "AOr. ANa "'aDLE INIIIALI OECEOENI'O CO"PLE'E AOOAES'
WIIITE KENNETH R. 2338 S, Ma,'kot Stroot
OOCIAL..CUAIIYNU".EA OAlEO'OIAIH OA.. 0' 0/1"" Mochanlcsbura, PA 17055
184.26.5067 01/27/95 06/18/35
Yf'AR
FOR OA'E5 OF DEAl.. AFrER tllJ1111CHECkHEnE
IF A SPOUSAL
FILE NUMBER
21.95.0613
Counl Curnbor land
0' APPLlCABLEI.UAVIVINa SPOUSE'. NA"E ,IASUIAsr AND "'DOLE IN"'AL) SOCIAL SECUAlIv NU"BEA
Whlto Martha C. 164.30.3151
to X " Original ROlurn 2, Supplomonlal Ro'urn
~ b X 4, L1mi1od E.lalo 40, FUluro Inlo,o" Compromi.o
E C (10' do,o. 0' doa'h a"or lZ.1Z.8Z)
~ ~ ~ [ID I, Docodonl Dlod Tesla'o 0 7. Oocodonl Malnlolnod 0 Living T,u.1
(Anoch ce 01 Will) (Altach 0 co 0' Tru.t!
C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
o 0 NA"E Ca"PLErE "A1L1Na ADDRESS
ft " Tlmoth M. AnstIne Es. Saldls, GuIdo, Shuff & Masland
~ Ii rELEPHONE NU"SER 2109 Market Street
T 717 737.3405 Carn Hill PA 17011
1. Rool ESlalo (Schodulo A) 1
2. Slock. ond Bond. (Schodu" B) (2)
3, Clo,oly Hold SlockIPortnorshlp Inloro,l (Schodu" C) (3)
4. Mongogo, and NOles Rocolvablo (Schedulo D) (4)
I. Ca,h, Bonk Dopo.lI. & MI.collonoou. Porsonal Proporty (Sch, E) (I)
I. Jolnlly Ownod Property (Schodulo F) (6)
7. Tron,'o.. (Schodulo G) (Schedulo L) (7)
8, TOlol Gross Assots (lolal Llno. 1-7)
9. Funeral ElC'penses. Admlnlstralive Costs, Miscellaneous
Exponses (Schodulo H)
10. Dobt" Mongags L1ablllllo" Lions (Schodulo I)
11. TOlal Doductlon. (total Lines 9 & 10)
12. N.I Voluo of E.'al. (L1n. 8 minus Llno III
13. Charitablo and Govornmontal B.quo... (Schodulo J)
14. N.I Valuo Sub ocllo Tax CLln. lZ mlnu. Lln. 13)
15, Spousal Tran.f... Clor dales 01 doa'h a"" 6.30.94)
See lnstrucllons for Applicable PerCenlage on page 2.
(lncludo values 'rom Schodulo K or Schodulo 1.1,)
16. Amount of line 14 lalC'able at 6'1. rale
(lncludo valuo, 'rom Sch.dul. K 0' SChodu'o 1.1,)
17. Amount of line 14lalC'able at 15'1. rale
Cfnclude values from Schedule K or Schedule M.)
18, Principal lax duo (Add lax 'rom Llno 15, 16 and 17,)
19. CredilsJSp Poverty Prior Payments DiSCount
(793.34) + 39.67
20. II L1no 191s groa'''lhan Llno 18, onlor Ih. diffo,onco on Lln. ZOo Thl.ls 'ho OVERPAYMENT.
m 0 Chock ho,. II ou a,o ro uoolln 0 ,,'und of our avo' mont.
21, I,tlno 181s gro.'or Ihan L1no 19, onlor Iho dillo,onco on Llno ZI. Thl, Is Iho TAX DUE.
A. Enter the Interest on the balance due on line 2 t A.
B, Enlor thololal 01 L1no ZI and ZM on Llno ZIB. Thl. i'lho BALANCE DUE,
Mak. Chock Pa obi. Ie: Ro 101., 01 Willa, A ont
· · BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
O'PO""", PO'""" oc '01. 0"0" I m'IKn, "" "''''ompo",,,,.. uso ""0"'"",0 '0' 0 II. my""w go, 'ol,IIIX1'..,
""roc, 0"" compto,o. d..lo,o'h.I.1I 'OO''''xlo ho. boo" 'opo"" 01 II.. ...,.., ..,.., 0"'''0110" of ",'po,,, o'h" Ih.n Iho po,,,,,,, ,0",,,,",.11.0',,,_ 0" 0111"'0''''110" of
~hlch prepar.t h" any tnowl<<fge.
AMOUNT RECEIVED (SEE lHSTRUCJlOHSl
Remainder R.lurn
(for dato, el dealh prior 10 lZ-13-82)
Fede,al ESlal. Taw Allum Required
Toral Number 0' Safe Deposit Boxes
01,
o 8,
-
3 ,012.56
u
C
A
P
I
T
U
L
r
o
N
10.500.00
(8)
13,512.56
(9)
10,106.71
(10)
29,850.53
(11)
(12)
(13)
(14)
39 , 957.24
(26,444.68)
(26 444.68)
(15)
0.00 X
=
0.00
~
(16)
(26,44/..68)< ,06 =
0.00
(17)
0.00 X ,15 =
0.00
C
o
M
C
T
A
T
o
N
(18)
0.00
inlerest
(19)
(20)
(753.67 )
0.00
(21)
(21A)
(21B).
(753.67)
. 0,00
(753.6?)
SIQNATURE OF PERSON RESPONSIBLE FOR FllINQ RETURN Martha C. Whi te
2338 S. Market Street
Mecli;';ii~sbu':----PA'- .i7cfs5.... - '--" ---.... __....
'JlVE Saldls, GUido, Shuff & Masland
2109 Market Stroot
Garn" iiiii" 'p;: "i7Cfii """ '" - "'" "'" ..___.._
DATE
'/'2 lfl9 /-
DATE
1(1-1/( ~
Form 1~ (Rev, l.g.)
r;
~
NUMSER
Act '48 011984 provldH lor Ih. reduc1lon ollh. tax r,'e. Impo.ed on Ihe n.' v.ru. of Ir.n.',,. 10 or lor
the ut. ollh. epou... Th. r.'" .. ",lIerlbed by Ihe .lalul. will be:
e3% (,03) will be applicable lor ,,'ala. 01 decedenl. dying on or alt.r 7/1/94 and belor. 1/1/118
e2% (,02) will be appllcabl. lor e,'al.. 01 decedenl. dying on or alter 1/1/98 end belor. 1/1/97
e1% (.01) will be appllcabla lor e,'al.. 01 decedenl. dying on or alter 1I1/97 and belor. 1/1/118
eSpousaltransl.,. oceu"'ng on or after 1/1/118 will be exempllrom Inher/laneetax.
PLEASE ANSWER THE FOLLOWING GUESTIONS
BY PLACING A MARK (Xl IN THE APPROPRIATE BLOCKS.
1. Old docod.nl mak. I IIln,'or Ind:
YES NO
10 rl..lntheuslorlncolneofth.proPlrtytrlns'.rred,..... ....., .........................
b, ,llIln tho ,Ighllo d.slgnol. who sholl USI tho prop.rty Ir"ns'"rr"d 0' hs Inco,"" ' , , , , , , , , , , . , , , , , , , , ,
c. ""In I reversionary Inl.,.st; or . . , . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . " . . . . . . . .
d. rlcllve the promfs. for lit. 0' either plyrnenls, benefits Dr clre? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Z. II d.llh accurr.d on or bolo" D.c.mbor 12, 1982, did d.cedent whhln Iwo Y.I,. p"codlng d.lth
IIlns1e, p,operty wlthoUI "c.lvlng Id.qulle consldorlUon? II d.llh occurrod Ihor Doc.mbor 12,
1982, did d.c.d.nll'lns'or prop.rty wllhln one Y.lr or dlalh whhoUI "celvlng Idequale
consideration? . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Old docodent own In 'Intrusllo,' bank ICcount II his 0' he, dealh? " '" . , " ", , , , , . , , , , , , , ,.",
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES.
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Copyright (c:) 1814 form Ia'tw.r. only CPSylltms, Inc.
Form 1500 (Rev. 7.84)
x
x
X
X
X
X
-"'_.".~"~~74r...~.;tt.,..........,
lli~igt DiU Nlt~ m~Bbtm.eltt
Q!:
KENNEnl R, WHITE
i
I, KENNETH R. WIIITE of Mechanicsburg, Cumberlnnd County,
Penneylvania, do make, publish and declare this to be my
Last Will nnd Testament, hareby revoking 011 previous
Wills nnd Codicils heretofore mode by me.
FIRST: larder my Executrix or Executor hereinefter
nsmed to pny 011 my debts and funernl,expenses os soon sfter
my death as reasonsbly possible.
SECOND: I give, devise and bequeath, all the rest, residue
and remainder of my estate, of whatsoever kind and wheresoever
situated to my wife, Martha C. White.
THIRD: Should my wife, Martha C, White, predecease me or
fnil to survive me by thirty (30) days, then I,give, devise
and bequeath, nIl the rest, residue nnd remainder of my estate,
of whatsoever kind nnd wheresoever situated as follows. Seventy
,
. ;five (757.) percent of my entire estate, I give, devise and
.
~bequeath to Trudy Strnsbaugh of Dillsburg, Pennsylvania. The
remaining Twenty-five (257.) percent of my estate, I give,
devise and"bequeath to my son, Kenneth R. White, Jr.
FOL~TH. Should my son, Kenneth R, White, Jr., ba under
the age of eighteen (18) years at the time of my death, I hereby
direct that Trudy Strasbnugh be appointed guardian of the estate
.'
." .<=<, ,~".<, Z>'T~
.--------'-.
FIFTlll' I hereby eppoint my wife,
Executrix of this my Last Will snd Testament.
prsdecesse me or fail to qualify os Executrix,
C.C.N.B. N,A. of New Cumberland, Pennsylvania,
Executor of this my Last Will
SIXTH. I direct that my
and Testament.
Guardisn sholl not ba
~~,
"
Executrix, Executor andho
~. ~ .'.1!
required to give bond for the fait
. "V\'f
;,t,
:"~.1:
performance of thair duties in any juriodiction.
SEVENTH. I hereby declare it to ba my express des~rea
"', foCi
. "~j
the Executrix or Executor of this my Last Will and Testamentt/
;T~
employ the low firm of Mancke, Lightmen [, Wegner of Harrisli!-,rg :
.....
, '.14
Dsuphin County, Pennsylvania, for legal advice and assistsnce
of my affairs,
thst may srise
,:
.
of the provisions of' my!.
:.\;~.. \
sn intimste knOWledge.'i
. ,.lilt,
views end wishes respecting many matters ;'\' , '
,1
in the probate of this instr,ment;'"the
in the probsting of end carrying out
Last Will and Testament, they having
.'
,\
adminiatration of my
therein mentioned.
~
.1
estate and the execution of the powers
'.
.to this my Last
1982.
,;. !.-'i
set my hand and seal ..'-
~(; day of ~ .
;
IN WITNESS
WIlEREOF,
.
Will and
I hove hereunto
Testament, th
SEAL
This instrument consisting of two (2) typewritten pages,each
bearing the signature of the above-named, KENNETH R. WHITE,
was by him on the date hereof, signed, published and declared
by him to be hia Last Will and Testament, in our presence, who
at hia requeat, and in hie preaence and ln the preeence of
each other, we believing him to be of sound and disposing
nd and memo heve hereunto subscribed our names as witnesses.
residing at4r.151 E!j~dI't/4Jf]!
7JJ~ residing at..JtfVJ ~'I ~c;ff,jJ.Og'/ "t7,
RIV. '101 Ex + 14.111
co..tl.m~g.fYhYANIA
ISTATI O~
SCHEDULE B
STOCKS AND BONDS
KENNETH R. WHITE SSO 184.26.5067
OS/27/95
~ILI NUMUIl
21.95.0613
(All ,ropotty olnlly-owned w"h Illghl 01 SUlYlvorahl
ITEM
NUMBER
mUll be dll.looed on S.hedul. F,)
DESCRIPTION
VALUE AT DATE
OF DEATH
The following sharas ora all common stock:
1
2
3
I,
5
16 sharas Albamar1a Corporation
32 shares Ethyl Corporation
3 sharas Tredegar Industries
10 sharas First Colony Corporation
90 shares Dauphin Daposit Corporation
13.75
10.687
22,687
22,25
24.00
220.00
342.00
68.06
222.50
2,160.00
TOTAL (AI.o .nler en line 2, R..o "uJaticn)
(If more .poco I. noodod, In.on oddlllonal.haots ol.ome .Izo.)
Copyright (c) 1tH form .oftw.,. only CPSYllemt,lrc.
.
3 012.56
"IV 0 11011. + (tol7/
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCI!LLANEOUS
PERSONAL PROPERTY
Pie... Print a' T
',L. N MIIR
21.95.0613
COMtf.m__,NbYA~IA
..TATI 0'
KENNETH R. WHITE ssg 18~.26.5067
OS/27/95
All . o/nl
ITEM
NUMBER
own'" wllh RI hi 0/ IUIVI.orahl mUa' be dla.'oa'" on S.hadul. '1
DESCRIPTION
VALUE AT DATE
OF DEATH
1
2
3
4
5
6
1950 Ford fire truck 0 actual solo price
1939 Ford convertIblo - actuol 0010 prico
1965 Chevrolot Impala - actual sa10 price
1974 Cadillac limouoine - actual sale price
CMC truck parts - actual sale prico
1989 Chevrolot Caprice . transfarrod to wife
1,000.00
4,000.00
400.00
500.00
100.00
4,500.00
TOTAL (Also anla, on /In. 5, Raea 11u1a11on)
(Allach addnlonal8112" . 110 shills ff more spac.ls n.eded.)
Copyrlllhl(c) 18t4 tOtmtottw.,.onttCPSYSltml,lne.
I
I
i.
1'-
I.
I
i'
S 10 500.00
Form 1500 Schedul. E (""',2.07)
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
RIV. 1111 EX , (7.18)
co"rH\lil~~MhY'HI'
.STATI O~
Pi.... Prlnl 01 .
~IL. NUMBlR
21-95-0613
184-26-5067 05 27 95
DESCRIPTION
KENNETH R. WHITE SS
ITEM
NUMBlR
A. Fun...1 Exponl..'
II.
AMOUNT
1
2
Malpazzi Funoral Home
Gingrich Memorialo, Inc.
4,040.00
385.00
1,
Admlnlltratlv. COlIto'
Personal R.pr.sentatlve Commissions
Social SICUr\ty Numb" of P.rsonal Reprosenlallvl:
Y'lrCo~s~nspa~
2.
Said is , Guido, Shuff & Masland
2,000.00
Attorney F..s
3.
3,500.00
Family Exell1>tIon
Clalmanl Mortha C. White
Addr.ss of ClalrTllnt at dlcedent's death
SUIII Address 2338 S. Market
c~ MechanicsburR
Relationship \I if e
Streot
Slall ~ Zip Code 17055
4,
Register of \li11s
69.00
Probate Fe.s
C, Mlle.nln..ul Exp.n....
1
2
3
Cumborland Low Journal - legal ads
Patriot-News Co. - legal ado
Regioter of \/illo - filing feoo
40.00
62.71
10.00
. 10 106.71
TOTAL (Also enler on line 9. Rece hulatlonl
(II mal. ,p,c,', nooded, tn..rt addUlonal .heel<. at..m. .b.,)
Copyrfghl(c) '"4 form IOlIwlI. only CPSyst'mI,lne.
F.... 15OO0c""'''' HI..... 7-81)
fr;
'"
1.'
'\
I,
f_,
~;-
MALPEZZI FUNERAL HOME
o Markel Plaze Wev
Mechenlcaburg, P^ 170&&
MICH^EL J, M^LPEZZI
Ownel
Telephone 717.097.4090
Fax 7170897.2414
~
May 15, 1995
Martha C White
2336 S. Market st.
Meohaniosburg" PA 17055
I sinoerely appreoiate the confidence you have plaoed in me
and will oontinue to assist you in every way I can. Please
feel free to contaot me if you haye any questions in regard
to this statement.
The Funeral for Kenneth R. White Sr. on May 1, 1995
-----------------------------------------------------------------
SELECTED SERVICES OF FUNERAL DIRECTOR AND STAFF:
Automotive Equipment . . . . . . . . . .
FUNERAL HOME SERVICE CHARGES . . . . . .
SELECTED MERCHANDISE:
20 Ga. Non Proteotive
Guardian Vault . . . .
2465.00
$
$
----------
2465.00
. . . . . . .
. . . . . $
$
675.00
590.00
. . . . . . .
. . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . ., ....... $
CASH ADVANCES & ACCOMMODATIONS:
Cemetery Equipment . . . . . .
Certified Copies . . . . . . .
3930.00
TOTAL DUE
$ 70.00
$ 40.00
----------
$ 110.00
----------
$ 4040.00
----------
$ 4040.00
. . . . . . . .
. . . . . . . .
TOTAL CASH ADVANCES AND SPECIAL CHARGES
TOTAL FUNERAL EXPENSE
..IV. 1111 EX. (1.IJ)
co"~m~{\WJl,"~JhYANIA
STATIO'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Pi.... P,lnt of .
,tLI HUMBlR
21.95.0613
KENNETH R, WHITE
SSO 184.26.5067 OS/27/95
ITlM
HUMBlR
DESCRIPTION
AMOUNT
1
2
3
4
5
Harrisburg Hospital
Harrisburg Hospital
PA Neurological Associates
Moffitt, Pease & Lim Associates
A. Z. Ritzman Associetes
25,565.71
3,045.82
585.00
610.00
44.00
TOTAL (Also .nlor on II.. 10, R.ca nulallon)
(If more space is n..ded, Inslrt addiUonal Shelts of same Slzl.\
Copyrfght (c:) 1H4 form aoftw.,. only CPSystems, Inc:.
. 29 850.53
F..m 15DOS<:hedu", I (ROY, f-13)
..: ~~!!f~~t,H,~~,,~:tt:'teJ:~'b~~~#:(~#.~~~~~~~1X~l~~f~i-~~t;il~~tf~.~~~~"i4Yi:':t;:Z$~~~~li~~t~':
t^....I"'L IlLI\Lltt b':.ILfo\ IIU~I'Ir^L
'"0'/1 ""11I
~. 1.~A I IDI.JON
, I FORNEY
. "--.10,.", nclal Counlllol
717/782-6468
WHITE, KENNETH R eR
ACCl 953048694 PT lYPE~
SOC SEC NU ~IB426'067
ADMITTED 041~~'2195 DSCH 04/27/95
INPArIENT DOCTOR 18890
STMTS 0 M STMT.DATE 05/0B/95
Accr BALS PTBAL
CURR BAL 25545.71
OPEN BAL 25565.71
TRANSACTION DESCRIPTION CODE
PATIENT AIR TRANSFER 0112000
...... END OF REPORT ......
INIWmy
CONTI~AC r FI~EQ
FC A GUAR NUM
GUARANTUR
DATE 11/11/95 TIHE 09: 12
AMTj)ATE
lE~ 717-766-46'5
I(ENNf::IH R WHLTE
2338 SHARKEY Sl
MECHANICSBURG PA
170~)5
CHG DATE
01/04/'15
INS
INS AMT
ACC r 1IJ lAb
~5545.11
2.1556-5-:.-7
PT AM'!
~!0. 00'-
prU-J' ~
-t"^'"
"-H'~
v-. HI-. 0-
vf "F'T"'-O'
:),I'IT vS
0""
-I""'"
.LIJ"~ .
Th.-, 1.4 -
~
.,,1I"'~w.)
" -..~
~,. CAPITAL HEALTH SYSTEM
~~ t7 S. MARKET S~UARE I P.O OOX 8700
,~, HARRlSOURG, PA t7105'8700
I<CNr,ICTII n ~llIl 'rl:
'23313 S MnnKr,r GT
11c'CIIAN I r.SrIUnr. PA 170':0:;
JLlne 2:'1, 1995
l~nTlI,NT Nr\MCZ: Kr,NNr;rll n ~IIIITe::
FACH NO: 325484
ACCOUNT NO.. 161201, 1
[IAn: OF sr;:rw 1 Cft 04/;;>~:/9~',
13AI.AW:~ DUIZ: '/;3045. ')2
r,f)r:ATION: 1H30 -. I!m
Dcal' I<ENNr:TII n WlIlTr:
f1a/""I'lsLJLlI"g Hospital apIII'eclat!?!:; ye,ul' c:ontlnuc'd LI~,E' of' Its racl 1 itlcs.
~Jl? .:!/""l? w/""i t I ng th I s 1 eUrJ/"" 1:0 1 nt you know tht! GbltUS 0 r your account
with us.
Our rec:ol'ds Indicate that YOUI' bi\li\ncl? of !/:3045.0:? is no\'l due fell'
services render'~d. I"le,:vJt! do either or the Following wl1:hln the neHt
15 days.
1. Pay thD balancl?
and mal I to.
dLle b\' checl:, 01' c:hal'ge cal'd (",ee belol1)
IIAnnIS8URO HOSPITAL
P. O. [lOX 2853
I~Rn18DURG, PA. 17101
C{.,~h pfi~'nH:~nt. r;houlcf bi.' lfIfU:!{,' ~t tlu:' c.:F.lGhit...'.....E. CI,..rir-e
11ond,~y..,"rld"Y 0'00 f).M. . 4")0 1".1'1.
:<'. PIp",!,." c"ll'Jf)I~F FOr(l~r'( (~l 7j7..782-~~45811ith any
questions Or to provide InGLI/""ancD Inro/""matlon.
MOI1Uo'l\"-FI'i d.-.y ~,: 00 A. M. .. 4 '00 1".11.
Oinj:l.~r~ly,
JANt'" rOrlNr:y
C/""od It <lI1tJ Co 1 101: I: I rm DL!pa/""l:mrm t
I <<L1thDI"; H: you t.o clwl"'gr,. ~'____.___
Vi s.";l-!..- '")1'" "".)-:Jl:orr::"Jr"d__._
ACcollnt Nun,hC'r _____, _._._..___ Good ThrLI....__..
Au I:h(]l''' i znd :iiIJn..\tIJrrJ__....____.__._".._..___._.__
f',"int I\Jtllllr"___.___. .w__ ._...._..__~~~_~__.~,~_ ..,.___,.,~_u
161';:01,1
VttA. M.mbl, 01 VOluntary Hotph"t or Am.ne., Inc._
, ."-.,.',
,-'
I I'n HllllillLlllill:,lI f1!>lilll
11,11" f" I I,V II"'" llfllll",!, 11111,\ I
1111\ I tl\>ll-hl' I' :d.1 liP!.
11.'1110)"114',1'0 1,'1-'-,.\
II l .',1 if "~I 'Iii I
IIIJ IU :. jt,H_~'t/,I'Jn')
",IlL,.,'
Accounl No,
wh Ill',H' 1-1 !
Amount OUI
~ I t\~,.. l'J I
1~"'nlll~t;h r~ Wh 1 I; I!
C/o Timuthy nn.Linl!
nl(~)'J l'Ia','llo1; nt",'uot, I,tux ~/3~1
Camp Ilill, PIl 17~1l'l1..(;)7;rl
Dill Amounl Ene/clod
10/83/'J\)
Pi\"t;il~nt:; "I,-'\tll(~:
Kl,nnui.h f~ Wh i h' IF HIB WIlB (llVE~I, CUlIl'I :"El-IT
DILLINO OPFICE HOURD 91lM aPM
Pleaso rDmo....o and lulurn Ihls portion Willi your paymonl
0'./2'1/9 :; Cf, Kr~nnoth 'J'Jr.!b'f Initii\l Cun~)L\l t~'\1;J.c)n 1'1 J ',;l'/./ Inj.~'l
FJ5/J~II'Ji lldjll;>l;m~nt
WJ/H:/') . Pi\}'h\('fl L.-Tt\i\ nh Vou
09/1,Y'J j P"\'1ment--Th ,,' n~t YOll
O)."U wi. :1. tD 11i 11 call llJi
(a'I/1~J,/'J :; C!;) I(enn()l:;h ~ '3'.~j:!af~ Gu IJs~~q uunt H"spitill Cil '137.1 130.0 130.0.
r19/HY9 ; P,':\ym(,~nt;~RTh c."\ nit. YDll f.). 0
09/12/'~ ' Paynu~nt-Thci.n~t YI)L1 0.0'
~1',/23/'~ ; Cti) Kenne'l;h ( ":l5819 P'rc) fet:; lo.i Ollt;'\ 1 Componc;.~n'l; ',:37 to l 1',11.01 :L ',el. fJ I
0',/25/9 j eta I<enne";h ~ ';')~:;(31 ') P'rofuG\5ial1c.'\l Component ,,37. 1'.0.0 1',11.13 "
f.)9/1E!/9 ; Pc;,\ymt.-nt"'Th I':\n~t YOll 0.0 )
09/12/9j P"ynllmt-Thanl,: YOLl el.01
pirt;ien1; dcce,':\setl 4-[:7- )
PLEABE CRLL m:PICE IMMEDIATELY TO DISCUSS YOUR RCCOUNT
PLEASE RETAIN THIS PORTION OF
STATEMWT FOR YOUR RECORDS
PAY THfS AMOUNT ~
~~f)t',.. m 'l
, '<<Account Anal a/a
Insuranco Balanco
paUont Balanco
Tolal
fJ.~J1
~jL\5.. (!) 1
Current
E'.01
11.0
30.60
fJ.m
0.0
61.90
11.01
0. FJ 1
91,120
11.lill
11.0P.
120 + PATIENT t
_ 0. 0 :llALANCE
~,U~.. 0 IAMOUNT DUE
MO......I'rt'.I'I.:,\SE & 1.11\1 ,\SSOCI,\TES,INC,
IIMMI NllllTlIl'IUlNT S'IIII'HT
\\'IlIlMI.E\'SlIllllll,I'A 171~1.\
TAS III M2.\.IKfo.In~
1'..111,'". .v"III~" /" 1',1 I'rI'I"""" 17171 7.II.K,\I ~
t.KIIII.24K,1I2~7 /"11' 171717.\I.".I~'1
GEORGE R, MOFFITT, JR, M,O.
WILLIAM E. PEASE, M,O.
HENG F, L1t~, M.O,
ARTHUI1 J. MULLER, D.O.
FELIX GUTIERREZ, MO
PAUL A PICCINI, M,O,
CLAUDE FANELLI, M,O.
THACH N. NGUVEN, M,O,
JOHN P. ZORNOSA, 1.1 O.
ROBERT G BAIL V, M,O,
DAVID (\, PAWLUSH, MO,
.------.__.-
_. __~~~~n~ ~o~
PaU.nt BallnCI Ou.
.__...~_. .-.
. h I t!<~.:-_Q!
01'1
610.00
,--_..-.', .,'
Amount Enclol.d
. _____.__ ._'__..n.'._.
Kenneth R White
2338 5 Marlr,et St."eet
)EV21 /85
_..n~_ u
MOko chuCks pavablu 10:
MOFFITT, PEASE & LIM ASSOCIATES,INC,
Mechenlc5burg.PA 1705~
Please romovo and roturn Ihls portion with your paymont
SEE REVERSE FOR PAVMENT INFORMATION
I 83010 Ekg Interpreta t I on 81 Report IJ 427.5 30.00 ,~O. 00
04/22/85 I 83010 EI<g Interpretation 81 Report 0 427.5 120.00 1;),0.00
04/24/85 b 8330726 Echocardlogram 20 I nterp 81 r~e 427.5 225.00 225.00
04/24/85 b 8332026 Doppler Echo Reading Interp 81 427.5 175.00 \'I~~. 00
04/24/85 b 8332526 Doppler Color Flow Velocity M 427. ::. 60.00 E;O.OO
L:OFFITT. PEASE & L1M ASSOCIATES, INC,
'000 NORTH FRONT STREET
WORMLEVSBURG, PA 17043
TAX ID '23.1864722
PIUlnt Nlml:
Kenneth R White
PAY THIS AMOUNT -..
610.00
.-----.,-------.
PLEASE RETAIN THIS PORnON OF
STATEMENT FOR YOUR RECORDS
31-60 61.90
91.120
120.
Account Anll III
Insurlnce Balance
Pallent Balance
Tolll
Current
0.00 0.00 0.00 0.00 0.00
610.00 0.00 0.00 L 0.00 0.00
------...----- ----.--.----.---- --------- -----.--- .----- ---.- ---
I
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RIV-1547 IX AFP (12-95_
CDHHOHWUlflt or PfNHI'IIVAHIA
brPAtI'N:N' Of "rY(HU(
IUI(AU or INDIVIDUAL 1'.[1
DO'. "'''1
flAJtlIIlLMG, P. 1111......
ACN 101
NOIICE OF INIIERITANCE TAM
A~~RAISE"ENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT Of TAM
DATI 05-06-96
FILE NO.
DATI OF DIATH 04-27-95 CDUNTY CUMBERLAND
NOTE I TO INSURE ~RO~ER CREDIT TO YOUR ACCOUNT. SUBHIT TltE U~~ER ~ORnDN Of TillS FORH WITH YOUR TAM
~AYHENT TO THE REOISTER Of WillS. NAKE CHECK ~AYABLE TO "REOISTER Of WILLS. AOENT"
REMIT PAYMENT TO:
TIMDTHY M ANSTINE ESQ
SAIDIS ETAL
2109 MARKET ST
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
A_aunt Re.Uted
CUT ALONO THIS LINE .. RETAIN LOWER PORTlDN FOR YOUR RECORDS .....
iiEV: i5c,-;-iix--AFi.--rrz-:9si""iioYicii--o,,"'iiiHiiiiii'AiicE-YAx-iippiiiiiiiiiii€NT~--Ai:l-owAiicE-oii------------ _____
DISALLDWANCE DF DEDUCTIDNS AND ASSESSHENT DF TAX
ESTATE DF WHITE KENNETH R FILE ND. 21 95-0613 ACN 101 DATE 05-06-96
TAM RETURN WAS I I X I ACCEPTED AS FILED
RESERVATIDN CDNCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED DN: DRIGINAL RETURN
1. Rool Eotot. ISchodulo AI III
2. stock. and Bond. (Schedule I) (2)
5. Clo..ly H.ld Stock/Pertner.hip Inter..t (Sch.dule C) (5)
4. "ortg.g..IHot.. Rec.lvable (Seh.dul. 0) (4)
5. Ceah/Bank a.Po.lt.IHI.e. Per.on.l Prop.rty (Schedule E) (5)
6, ~olntly awned Property (Schedul. F) (6)
7. Tran.fer. (Schedul. Q) (7)
8, Totel A...t.
I CIIANOED
,00
3,012,56
.00
.00
10,500,00
,00
,00
181
13.512.56
APPRDVED DEDUCTIONS AND EXEHPTIONS:
9. Fun.rel Expen.../AdR. Co.t./Hilc. Exp.n... (Schedul. H) (9)
10. Deb/Hodg.go lioblUUo./Llon. 'Schodulo Xl 1101 29,850,53
11. Tot.l Deduotion. (11)
12. N.t V.lue of rex Return (12)
15. Charlteble/Gov.rnMentel aequ..t. (Schedul. J) (15)
14. N.t Velu. of E.tete Subjeot to Tex (14)
NDTE: I~ an asseslment wal iSIUBd prBviDully, linel 14/ 15 and/or 16, 17 and 18
rB~lBct ~igurBs that include the total o~ ~ rB~urnl aSIBllBd to date.
ASSESSHENT OF TAX:
15. AMount of Lln. 14 .t Spau..l r.t. ns)
16. A.ount of Line 14 tax.bl. .t Line.l/Cl... A rete (16)
17. A.ount of Line 14 t.x.bl. at Coll.terel/Cl... B r.t. (17)
18. Princlp.l Tax Due
TAX CREDITS:
PAYHENT
DATE
10.106.71
~q.QIi7 ::t4
26.444.68-
.00
26.444,68-
wUl
.00
.00
,00
M'OO.
M .06.
M .15.
U81
.00
.00
.00
.00
RECEIPT
NUHDER
DISCOUNT 1+1
INTEREST I-I
AHDUNT PAID
· IF PAID AFTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX VUE
INTEREST
TDTAL DUE
.00
,00
.00
.00
\
IF TOTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRl. YOU HAY BE DUE
A REfUND, SEE REVERSE SIDE Of THIS fDRN fOR INSTRUCTIONS. I
~~ ~ :1):0
1';" t?!. ~
t .) ~ r'
L' ,J t"
~ .,
i I "
0\
\. , -.
.-
~-' ;? "'0 ;:: ~:~
N Vi
::J i:. e 9-
;:l- N
RESERVATION, Eltat.. of dec~t. dvlng on or bafor. Oaca.ba,. 12, 1982 -- .f any future Int.r..t In thl ..tat. I, tran,'arred
In po.....lon or enJoyaent to Cl... . (col1,t,r,.' ~fJcl.rl.. of thl dlcldant .ft.r thl expiration Df any ..tat. for
11'. or for v..r., thl Co.-onw..lth hareby Ixpr...lv ral.rv.. the rlDht to appral.. and ...... tranl'.r Inherltancl 'axI'
at th. lawful CI... I (col1at.ra.) rat. on any such future Int.r..t.
PURPOSE OF
NOTICE. To fulfill thl nqulr...ntl of Saction 214D of thl Inh,rltancl end E,tat, Ta. Act, Act 2Z of 1991. 72 P.S.
Sactlon 2140.
PAYMENT. Dltach thl top portion of thl, Hotlcl and ,ub.lt with yoor ply..nt to thl Rlgl,tar of Will, printed on thl rav.r.. ,Ida.
nHaI chick or RIllY ardu plyabl. tal REGISTER OF MILLS, AGENT
All p.,.ent. r.c.lved .h.ll flr.t be applied to eny lnt.r..t Which .ay ba due with any r...lnd.r appli.d to the t.x.
REFUND CCAJI A r.fund of a t.x cr.dlt, which was not r.qu..t.d on tha T.x R.turn, aay b. raqu..t.d by co.pl.tlng an RAppllc.tlon
for R.fund of Penn.ylv..,la Inh.rltanc. Bnd Est.t. TaxR CREV-UUJ. Appllclltiona .r. av.llabl. at the Office
of the R.gi.t.r of Will., any of the 23 R.vanu. Dlatrlct Dfflc... or by calling the .p.clal Z~-hour
an.~rlng ..rvlce nu-bar. for for.. ord.rlngl In P.nn.ylvanla 1-100-362-2050, outald. p.nn.ylvenl. and
within local Harrl.burg .r.. C717) 717-109~, TDDI C717) 77Z-Z252 CHaarlng I.palr.d Only).
DIJECTIONSI Any party in Intar..t not ..tl.fl.d with the .ppr.I....nt, .llowanc. or dl..llowanc. of d.ductlon., or ........nt
of tax Clncludlng dl.count or Int.r..t) a. ahown on thl. Notlc. au.t object wIthin .Ixty C60) day. of r.c.lpt of
thh Notic. b~l
--wrltt.n prota.t to tha PA D.p.rt.ant of R.vanu., loard of App..l., D.pt. ZI10ZI, H.rrl.burg, PA 17121-1021,
nal.ction to hay. the ..ttar dahraln.d at .udlt of the account of tha parsona1 rapru.ntat1v., OR
--app.a1 to the Orphan.' Court.
OR
.
AD"IN
ISTRATlVE
CORRECTIONS. Faatu.1 arror. dl.covlr.d on thl. ........nt .hould b. .ddr....d In writing tOI PA D.p.rta.nt of R.v.nul,
Bur..u of Indlvldu.1 Tl'lx", ATTNI Po.t A.......nt R.vl.w Unit, D.pt. 210601, tt.rrhburg, PA 17121-0601
Phon. C717) 717-6505. S.. paa. 3 of the bookl.t Rln.tructlon. for Inh.rltanc. T.x R.turn for. R..ld.nt
D.cadantR CREV-150J) for an .xplanaUon of ad.lnhtnUv.h correct.bla err'lra.
If any tax dua 1. paid withIn thr.. C3) c.landar eonth. aftar the d.cadant'. d.ath. a flv. parc.nt C5~J dl.count of
the t.x paid I. al10wad.
I
DISCDUHT I
INTEREST I
lnt.r..t I' charg.d b.glnnlng with flr.t d.~ of dellnqulncy, or nlna C9) aooth. and onl Cl) day fro. the d.t. 0'
de.th, to th. d.ta of p.yaant. Tax.. which b.c... d.llnquant b.for. Janu.ry 1, 191Z b.ar Int.r..t .t the rat. of
.Ix C6~) parcant p.r .nnue calculatad at . dally rata of .DODI6~. All t.x.. which b.ca.. d.llnqu.nt on and .ftar
Janu.ry 1, 1912 will b..r Int.r..t at . r.t. which will vary fro. c.l.nd.r y..r to caland.r y..r wIth that rata
announc.d by thl PA Dap.rt.ant of Ra...lnu.. Th. appllcabl. Int.ra.t r.t.. for 191Z through 1996 .r"
~ Intan,t Rata Dalh Interut Factor ~ Int.nlt Rat. D.lly Int.r..t F.ctor
1912 ZD~ .OOD5~1 1917 .~ . .000247
1913 I'X .00008 1918-1991 llX .oonol
I'" \IX .DOnOI 1992 OX .OOOZ~7
1915 13X .00n56 1993-1994 7X .000192
1916 I'X .ODOZ7~ 1995-1996 'X .00OZ~7
nlntarut I. celcul.t.d .. fallowlI
INTEREST a BALANCE OF TAX UNPAID X "UNBER OF DAYS DELINQUENT X OAILY INTEREST FACTOR
--Any Notice I..u.d .ft.r the t.x b.co... d.llnquent wIll r.fl.ct an Intar..t c.lculatlon to flft.en CIS) d.~.
beyond thl d.ta of tha ........nt. If p.y.ant Is ..d. after the Int.rut coaput.tJon d.t. .hown on the
Notlca, additional Int.,...t .u.t be calcul.tad.
I. RECBIPTS or PRINCIPAL
A. cash
1. Proceeds from sale of fire truck
2. Proceeds from sale of Ford vehicle
3. Proceeds from sale of Cheyrolet yehicle
4. Proceeds from sale of 1974 Cadillac
5. Proceeds from sale of GMC truck parts
6. J.C. Taylor Auto insurance refund
sub-total:
B. Personal Property
1.
1989 Chevrolet Caprice
Sub-total:
c. Stock and Bonds
1.
2.
3.
4.
5.
6.
7.
Dauphin Deposit dividend
Ethyl Corporation dividend
Dean Witter Reynolds sale of stock
Abbemarle Corp. dividend
First Colony Corporate dividend
Tredegan Industries dividend
Dean Witter Reynolds dividend
TOTAL RECEIPTS OF PRINCIPAL:
$1,000.00
4,000.00
400.00
500.00
100.00
37.00
$4.500.00
$ 22.50
4.00
3,176.70
.80
1. 00
.18
22.50
$6,037.00
$4,500.00
$3,227.68
$13.764.68
II. DISBURSEMENTS or PRINCIPAL
A. Administratiye Expenses
1.
2.
3.
4.
5.
Patriot-News Advertising
Cumberland Law Journal
Cumberland County Register of Wille
Cumberland County Register of Wille
Saidie, Guido, Shuff & Masland
sub-total:
$ 62.00
40.00
69.00
10.00
2.500.00
$2,681. 71
B. Debts of Decedent
1.
2.
Pa Neurological Associates
Harrisburg/Polyclinic Hospital
Sub-total:
200.00
3.500.00
TOTAL DISBURSEMENTS OF PRINCIPAL:
$3,700.00
$6.381. 71
-,- :_'~~t~~~'~~t~~N_~~'~'~,~ti;;;;;~'f,):~i:~.l~"~~'~Ii.'i~j:~~~-ii~~~~;-\;,7'ft>~'~iJ~f~,!!l7!;
III. DISTRIBUTION OF PRINCIPAL
A. In-kind Distribution:
1. 1989 Chevrolet Caprice to Martha White $4,500.00
B. Amount Remaining:
1.
Pursuant to Will of Kenneth White,
distribution to Martha White
$2.882.97
TOTAL DISBURSEMENTS
TOTAL RECEIPTS OF PRINCIPAL
DISTRIBUTION
$7,382.97
$13,764.68
$13.764.68
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lRD/lulle 30, 1992117858
REGlSTlm OF WILLS
Cumberland County Courlhouse
One Courlhouse Square
Carlisle, PA 17013
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To:
Personal Representative
Counsel: 'rIMuuh "I. ,,1~61 1141!;, 1!;5Q"
RE: Estate or KENNETH H, WHITE ,Deceased, Late or
MECHANICSBURG BOHOUGIl
Estate No.: 21- 1995 - 613
Date or Decedent's Death: 4 . 27 - 9 5
Pursuant to Rule 6.12, the above named personal reprcsentalive or the above nallled attorney, if
applicable, within two (2) years of the decedent's death. and annually thereafter unlil administration is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6.12, in
substantially the prcscribed form, showing the date by which Ihe personal reprcsentative, or attorney. as
applicable, reasonably believcs administration will be completed. The purpose of this Notice is to advise
you that unless the requisite StalUs Report is filed with the Regisler of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to determine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, if any.
Accordingly, if the requisiteStalUs Report is not filed by 6-10 ,19~1 you arc hereby
advised that a request will be submitted to the Coun in accOldance with Rule 6.12,
Date: 5-28-97
Distribution to Estate File
STATUS REPOHT UNDER RULE 6.l~
Date of Death:
/-<-Crv~Jl, /?, w!V.::b...
4. 7~, '"IS-
Name of Decedent:
Will No.
Admin. No. OJI-/99S-fJJ/3
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 ~hether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the pe~nal representative file a final
account with the Court? Yes No .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached 0 this report.
Date:
7nu; ;lq, 199"7--
.,
Sign
John,..."'...J. D-eilt ,Esq.
Name (Please type 0 print)
;210 W, M9-. sh--e.J ~~L.
Address -
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Te 1. No.
Capacity:
Personal Representative
~counsel for personal
representative
(MAH: rmf/ AM3)