HomeMy WebLinkAbout95-00620
.J.-:TIT.ON a:<m .J.umATE und GnANT ()Io' 1.E'."I'EnS
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S"dlll S",'/lr;II' N", (2.'(,>,5::1 "-1..?"P" _.. ._. Cllll1mllnwenllh Ill' I'ennsylvllnlll
The 11~lhlllllllf Ihe m"k"l"n~d tL"pe"lflllly fepl~,,-mS 111111:
YIlIIr p~llllllner(s), Whllls/llre IN )'~Il" Ill' ""~ m Illd~r Ilnlh~ execIII~l'"
Inlh~ hl\t will Ill' Ih~ Ilhll,," d~c,'d~m, dlll~d ~.3._.E.1
Ilnd clldldl(s) dIlled
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(,uue rdc\allt \:itl:IlIll\IlUh:"'''' 1.'.11. u'ullllchulnn, lkillh Ill' C\l~lIlnr, cole.)
I)~celld~nl WIlS domiciled al dealh in (!l"/~t1.~l>_ COllnly".Pennsylvllnlll. with
h I~ last rllmlly or prindpul r~shJence UI '7,;1 Cl_ ~>, iM~^,o _, b uti:
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D~cendent. en' Sg ,19 9;-
at1'p"3 '.- ~.B. r. ,
Excepl as follows. d~cedcnl did nOl marry. wus not ',livO/ced nnd did n I hllve a child born or adopted
Ilfler execllllon of Ihe ,"ill orrered for probllle; WIlS nOllhe vlellm or II killing and was never adjudlcaled
inconlpclcnl:
Dec~ndpntlll dcmh owned p/OperlY wilh cSllmllled vallles liS rollows:
(lrdomkiled in I'll,) All personlll properlY
(II' nOI domiciled in I'u,) PcrsonalproperlY In Pennsylvania
(II' not domiciled in Po,) l'ersonulproperlY In Count)'
Vulue of real C"~HI1C in Pennsylvania
shuatcd as follows:
$ -11 ~7JO . 4'ZJ
$
$
$
WHEREFORE. pelilloner(s) respeclfully re lIesl s) Ihe probulc of Ihc lasl will and codlcll(s)
presellled hcrcwlth und the gram or Iellers -./(
Iheron,
tlL"IOHllI.'IlHlf)'; udminl\lnHion 1.'.1.11.; administration d.h.n.c.l.a.)
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OATH OF PEnSONAL REPRESENTATIVE
COMMONWEAI.TH OF I>ENNSYI.VANIA }::IS
COU NT\' OF ClMlERLAND
The pelillonerls) ahm'c.nam~t1 ,,;carl\) or affirmls) Ihallhe stalClnelllS in Ihe roregolng pelltion are
trlle and eUl~eet IUlhe hest uf Ihe "1uwledge and hellcf of pClilloner(s) and Ihul as personal represen-
1111;",'1\) uf lhe ahm'c deccdent pelitioner(s) will well and Irnly adminisler Ihe eSlale aecO/ding 10 law,
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Swnrll It' or affirhll:d and ,lJh.....:rihC.t1.~... --:~. _."".~~....r::::..,-_~c::~~_ ~
hefore 111~ Ihis _ ./~~'/'_ tlay 9i, ...:~ ~'
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15-5tJ-/.;;:l, t*IarY C.LeW 1I('~iJl('r <:!.
No. 21-95-620
Estate of
WILLIAM K. BlEGEN
I Deceased
DECREE OF PROBATE ANI> GnANT OF I"ETTERS
AND NOW August 16th 19~, In consideration of the petition on
Ihe reversc side hereof, sallsraetory proof having been presented berore me.
IT IS DECREED thai the Instrumenl(s) dated Februarv 21,1995.
described therein be admitted to probatc and filed of rceord as the last will of
w~,';am ~ Q;a~on
and Letters _ Test_ntary
lire hereby granted to Jacqueline R. Biegen
, ~ t1 ~Cgif:~, jJjfi)Jtlf~jJ~
Mary C. LeWis
FEES
Probate, Letters. Etc, "..,.".
Short Certlficates( ]) " , , , . . , , .
Renunciation,..",'..,",. ..
x-pages
25.00
3.00
$
$
$
$ 12.00
TOTAL _ $ 45.00
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ATrOR!oII!Y (SUp, CI, I,D. !oIo,)
ADDRESS
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LAST WILL AND TESTAMENT
OF
WILLIAM K. BlEGEN
I, WILLIAM K. BlEGEN, Social Security Number 083-36-1325, of the
commonwealth of pennsylvania, declare that this is my LAST WILL AND
TESTAMENT and I revoke all other wills and codicils previously made by
me.
FIRST I I appoint my Wife, JACQUELINE R. BlEGEN, as my personal
Representative concerning this Will, If she is unable or fails to
serve, I then appoint my daughter, VERONICA C. BlEGEN to serve as my
personal Representative.
a. I request that my Personal Representative be permitted to
serve without bond or surety thereon and without the intervention of
any court, except as required by law, I direct that my Personal
Representative act in unsupervised administration so as to administer
my estate with a minimum of court supervision. If it becomes necessary
to have ancillary administration of my estate in any jurisdiction where
my Personal Representative is unable or does not desire to qualify as
ancillary legal representative, I appoint as such ancillary legal
representative such individual or corporation as my Personal
Representative shall designate, in writing.
b. I direct my Personal Representative to pay the expenses
of my last illness, the expenses of a funeral appropriate to my station
in life and custom of living (including a suitable monument or marker
for my grave), and written charitable pledges which I have made. I
grant my personal Representative the power to extend or renew any debt
for such time as my personal Representative shall deem appropriate.
c, All estate, inheritance, succession and other death taxes
with respect to all property passing under this my will shall be paid
from and borne by the principal of my residuary estate, without regard
to reimbursement, as if such taxes were administration expenses. My
Personal Representative may pay such taxes at any time deemed
advisable, whether or not then due and payable.
d. My Personal Representative is requested to settle my
estate as soon after my death as may be practicable, and to payor
deliver every legacy or bequest to my beneficiaries without waiting any
time that may be believed to be customary in probate matters.
~,,-~~~
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PAGE 1 ..(? M 01/!
OF 4 PAGES ~ -fU-!.!=:- ..fill.-
e, I have served in the Armed Forces of the United States,
Therefore, I direct my Personal Representative to consult with a Legal
Assistance Attorney at the nearest military installation and with the
Department of Veterans Affairs and the Social Security Administration
to ascertain if there are any benefits to which my family members are
entitled by virtue of my military service.
f. I may leave a letter of intent with the executed copy of
this will for the purpose of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. I request, but do not require, that my Personal
.Representative honor my wishes therein expressed,
SECOND: I give, devise and bequeath, absolutely and forever, all
of my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my Wife,
JACQUELINE R, BlEGEN, as her sole and absolute property if she shall
survive me.
THIRD: In the event that my Wife, JACQUELINE R. BlEGEN shall not
survive me, to my daughter, VICTORIA T, BlEGEN, I give my collection of
model trains.
POURTH: In the event that my Wife, JACQUELINE R. BlEGEN shall not
survive me, I give, devise and bequeath, absolutely and forever, all of
the rest, residue and remainder of my estate and property of which I
may be seized or possessed, or to which I may be entitled, at the time
of my death, wherever situated or of whatever nature, be it real,
personal, or mixed, to my daughter, VERONICA C. BlEGEN as her sole and
absolute property if she shall survive me,
PIPTH: If there is a complete failure of takers under the
preceding paragraphs, the property undisposed of shall be distributed
to the heirs of my Wife, JACQUELINE R. BlEGEN, the identity of such
heirs to be determined at the time of my death, pursuant to the
Statutes of Descent and Distribution in effect, in the state of my
domicile, at the time of my death.
SIXTH: Except as otherwise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not. Insofar as I
have failed to provide in this Will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake, Except for the specific bequest mentioned in
Paragraph THIRD of this Will, I make no other provision for my
daughter, VICTORIA T. BlEGEN.
,~~~"'~~,
PAGE 2
OP 4 PAGES
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SEVENTH I ^ny beneficiary who faila to aurvive until thirty (30)
daya after my death ahall be deemed to have predeceaaed me, and the
gift to that beneficiary shall be disposed of accordingly.
EIGHTH: The term "Personal Repreaentative" as uaed in this will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such a fiduciary.
NINTH: In addition to any powers granted by the laws of the state
in which this Will is probated, I hereby authorize and empower the
fiduciaries named in this Will, to the extent of the discretion herein
granted, to sell, exchange, convey, transfer, asaign, mortgage, pledge,
,lease or rent the whole or any part of my real or personal estate, to
invest, reinvest, or retain investments of my estate, to perform all
acts and to execute all documents which my fiduciaries may deem
necessary or proper in regard to my property, If any of my fiduciaries
elect to receive compensation for services, such compensation will be
that allowed by law.
TENTH: If any part of this Will shall be invalid, illegal, or
inoperative for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Personal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this Will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania,
this 21st day of February, 1995, set my hand and seal to
this my LAST WILL AND TESTAMENT, consisting of 4 typewritten pages,
each page bearing my handwritten signature,
,~,- ~~~ (SEAL)
~'LxAir K. BIEGEN L:::::::.
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PAGE 3 {} h 0,/1 0dJ
OF 4 PAGES ~ ~ f#+-
'1'he foregoing inotrument waD, at Carliale Uarracka, Pennaylvania,
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OF &.J.IJ~; '119-
/ 701..3
thio 210t. day of February, 1995, oigned, aealed, publiahed and declared
by WILLIAM It, BlEGEN, t.he t.eatator, t.o be hia LAST WILL AND TBSTAMBNT
in the preaence of all of us at. one t.ime, and at. t.he aame t.ime we, at.
hia requeat and in hia preaence and in the preaence of each ot.her, have
hereunt.o aubacribed our namea aa at.t.eat.ing wit.neaaea, and we do so
verily believe t.hat. t.he said test.at.or ia of sound and dispoaing mind
and memory at. t.he date hereof,
C;Jlil?<- /vh__ ~IJ
OF &/h/'-Lo /J! OF ~fA. /71J1}
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PAGE 4 ~J1 17 .. CinJ
OF 4 PAGES ~ Jl::i:f21... ~
COMMONWEALTH OF PBNNSYLVANIA
COUNTY OF CUMBBRLAND
ACKNOWLEDGMENT
I, WILLIAM K, BlEGEN, testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law, do hereby acknowledge that I signed and executed the instrument
as my Last Will; that I signed it willinglYI and that I signed it as my
free and voluntary act for the purposes therein expressed.
~~ ~,~
LIAM K. GE '
(SEAL)
AFFIDAVIT
We, Gs-hFe. G-c7:)R. GtF , 1'nA~_'N<. \{\\Q...S , and
~o~~ ' the witnesses, sign our names to this
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his Last Will; that the testator signed willingly and
executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witness; and that to the best of our
knowledge the testator was at that time 18 or more years of age, of
sound mind and under no constraint or undue influencen,J m.11
-&1--, JJ~~\~\'5'_V\e fu\2.~ ~
Witness U 'W-[tness Witry!!ss
Subscribed, sworn to and acknowledged before me by WILLIAM K.
BlEGEN, the testator, and subscribed and sworn to before me by
t;.s~ GI:-r:::;:.~tf , :u:\.~\1V\\L f\u\h 'J , and
.J ilaA-l!l.I!p,r , the witnesses, this 21st day of February,
1995.
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NO'l" I:'UBL'if;
My Commission E
. [:.:..(:61 SPAt
KIm C, Guyor,'lolmy Publlo
Cnrllsll" Bora. CurnbOllnnd County
My Comml..lon Explro. Nov, 10, 1997
,-"\I1'uU(,I"'&nnsylvJlIIJ " . bOno NOW1OS
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D ~o, AA 048148" . COMMON::~~~,~:.~:~:YLVAN~~
":~Iltll' "'J 'OPPlCIAL RICIIPT . PENNSYLVANIA INHIRITANCE AND ESTATI TAX
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RECEIVED FROM,
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ASSESSMENT f!'
CONTROL ...
NUMBER
AMOUNT
JACQUELINE R BlEGEN
sea RIDGEWOOD DRIVE
101
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MECHANICSBURG PA 170~~
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ESTATE INFORMATION,
B FilE NUMBER
. , II NAME OF DECEOENT
11 OArE OF ~
m POSTMAR
COUNTY
(lASrl
OATE OF D H
JACQUELINE R BlEGEN
m TOTAL AMOUNT PAID
."'.00
REMARKS
REGISTER OF WILLS
SEAL
CHECK* 1315
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
<OMMOHW\'~" '" "\,""1""" (TO BE FILED IN DUPLICATE
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IlAU"fJ b, ~"I'll' 01>0' WITH REGISTER OF WILLS) (OUNlY COOl .;I. I Y1AR' NUMIU
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Efl. O,lglnol R,'urn D 2, Suppl.m.nlol R"urn rJ 3, R.molndOl R.lu,n
(la, datil a' d.olh p,lor 10 12,\3,821
o .c, L1mlt.d Ellat. 0 AD. Futur. Inl.'I.l Comproml.. 0 5. hd.ral Ellal. Tal R,turn R.qulr.d
(la, dol.. 01 d.olh oltOl 12.12.921
o 6. DIC.d.nt DI,d r"lal, 0 7. O,tld.nf Malnlaln.d a living TrUll
(Allo,h ,opy 01 Willi (Allo,h ,opy 01 T,ulll
iAWCORRUPONOINCI AND CONplOINnAL TAIUNPORMAnON SHOULD BI OIRICTlOTOI' in Oil-" ;''',tik. ij~1 "!i;#;.~"ft ,Ii
COJlU'l MAIl! A 0 .n"P\'
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20. If L1n. 191, Or.at.r Ihan lIn. 18. .nl.r the dIfference an L1n. 20. Thl.1t the OVERPAYMENT,
1110
21. If L1n. 18 It gr.al.r than lIn. 19, .nt.r the dlffer.nc. an L1n. 21. Thl, I, the TAX DUE.
A. Enler th.lnt.r"t on the balance due on Line 21A.
B, Enl" Ih. 10101 of lIn. 21 and 21A on lIn. 21B, Thl.l. tho BALANCE DUE,
Malee Ch.cle Payabl. '01 R.gl.t.r of Willi, Ag.nt
~"''[t.il''!,,'''i'''~ii'k ,.. BUURUO ANSWER ALL QUEmONS ON REVERSE 5101 AND TO RICHICK.MATHK: i;, , .
Und.r p.nolll" of perjury. I d.dar. Ihat I have exomlned thl. return. Including accompanying .chedul.. and ,'atement" and 10 the b..t of my knowl.dg. and bellef,
It It Iru.. corred and compl.'e. I d.dore Ihot 011 rial ..Iale hat been r.partler at Irue marklt value. Declaration of pre parer olh.r than the p.nonal rep,...ntatlve II
baled on all Information of whIch preparer hat any knowl.dg..
S19_ II! O. '(RWN R(~NS1Il( 'O~I!!.NO R\TURN ADDRUS OAt(
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2, Sto,k, and Bond. IS,h.dul. B) ( 21
3, Clollly H.ld Slo,~'Portn,"hlp In"lOIt IS,h.dul. C) (3)
4, MOlIoog.. and No'" R.col.obl. (S,h.dul. 01 ( 4 I
5. Calh, Bank Oepollh & Mlscellan,oul Penonal Properly ( 5 )
(S,h.dul. E)
6, Jolnlly Own.d Prop.rty (S,h.dul. FI (61
7. T,on,'... (S,h.dul. GI(S,h.dul. L) (71
8. Talal Gro.. A..." (10101 lIn.. 1.7)
9. funeral Exp.n.... Admlnlllratlve Colli. Mltcellaneoul ( 9 )
bp.n... (S,h.dul. H)
10, D.b". Mortgog. Uoblllll.., lI.n. (S,h.dul. II (101
11. T 0101 D.ductlon. (10101 Un.. 9 & 10)
12. Net Value of E.tate (line 8 mlnul line 11)
13. Charitable and Governmenlal Bequ.." (Schedule J)
14. Nel Valu. Sub eet 10 Tax lint 12 mlnull1ne 13)
15. Spoulal Trand.,. (for dal.. of d.ath aher 6.30.94)
5.. Inllruetlon. for Ar,pllcable Percentage on Rev.r.. 1151
Sid.. (Include valu.. rom Schedule K or Sch.dule M.)
16, Amount a' Un. 14 loxobl. 01 6% rol. (16)
(Include valu.. from Sch.dule K or Sch.dule M.I
17, Amounl of Un. 14 loxobl. 01 15% rol. (17)
Ilnclude valu.. from Schldule K or Sch.dule M.)
10, P,lnclpollox duo (Add lox I,om Un.. 15, 16 and 17,)
19. Credit. Spoulal Povlrty Credit Prior Paymlnll
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(2181
Act .48 of 1994 provld.. for the r.ductlon of the tox rot.. Impo..d on the n.t valu. of tran".r. to or for
the u.. of the .pou... Th. rat.. a. pr.lCrlb.d by the .tatut. will bel
. 3~ (.03) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 7/1194 and b.for. 1/1/96
. 2~ (.02) will b. applleabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1 'Ill (.01) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.altran".r. oecurrlng on or aft., 1/1198 will b. .xempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK k) IN THE APPROPRIATE BLOCKS.
YES NO
1, Old decedent make a transfor and:
o. retain the use Of Income of the property transferred, .......................................................
b, retain the right to deslgnoto who shall use the property transferred or Its Income, ..,....,.......
c. fetaln a reversionary interest; or ...................................................................................
d, recetve the promise for life of either payments, benefits or care' ..................,...................,
2. If deoth occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration' If death occurred after
December 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideration' ................. ........ "'.... .........,.. II....'. ...... ..... ..... to n... ..................... on
3. Old decedent own an 'In trust for' bank account at his or her deathi........,........,..........,......,..
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1/
,;/'
to'
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,
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I[Y.llQ) U. 14.1&1
*
COMMONWIAltH 0' PfNNiYLYANIA
'NHlllIANCf 'A' "I'IU"N
IUIOIHl DICtO Nt
SCHEDULE B
STOCKS AND BONDS
/J'//'Al'f K. S,iT"- AI
(All p,opolly lolnllv.ownod with Right 01 Survlvo,"hlp mull bo dllcl.,od on Schodulo ,,)
ITEM
NUMBER DESCRIPTION
1.
tI SIM
.,.;..,,1. nUII~
.~ JI.J''1frC ,o!:t'N~'~
VALUE AT DATE
OF DEATH
'1(.J'JT.
TOTAL Allo enter on line 2, Reeo Itulotlo"
(II more space ;, ""ded, insert additional ,h..f, o( lame ,in.'
S f'lt: :r. ,11)
}
,
r
.
""11111'.1''''
.. ,
;',
H~:
"'f:'1'
.-.---,
, .
.
5CHIDULI H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Ploa.. P,lnl 0' Ty 0
COMMONWIAUtt m "t~N'.IY"'HIA
IHtU'!fANC' 'AI urUIH
IUIPINI ~ICIDrN'
1.//,;"., k. -;) ~tA/
ITEM
NUMBER
Cily
4, Probato Foo.
C, MI.eollanoou. Expon....
"
2,
3,
4.
5,
6,
7,
8.
A,
1.
B.
"
2,
3.
AMOUNT
DESCRIPTION
Funoral Expon.ut
'f\-.1!l, .......
Admlnl.tratlv. co.t..
POllonal Rop",.ontatlvo Comml..lon.
Social Socurlty Numbor of Pellonal Ropro.onlolivo:
Voar Camml..lon. paid
Allornoy Foo.
Family Exomptlon
Claimant
Add",.. of Claimant at docodont'. doath
51"'01 Add",,,
Rolalion.hlp
51010 Zip Codo
J'- "0
7~' .
TOTAL (AI.o onlor on IIno 9, Rocapltulalion)
Ilf more .pae. I. n..dod. In.." additional .h..1I af .om. .1.0,)
s r~'" f. c!f)
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,
CERTIFICATION OF NOTICE UNDEn nULF. 5.6(a)
Name of Decedent I AId t,A)~1 k' ~'t--r;"6'N
Date of Deathl ..P~ ~I;I 9\-
Will No. ..2/- 9 }- -c,,/l [) Admin. No.
To the Register.
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on'or mailed to
the following beneficiaries of the above-captioned estate on
I
~
:f((I~lItr/.'""c- /!. I?....-r-t~
Address
:i".a~ k',]>~~wot')"?\ "[:w. /I:~/ ~/?<os~r-
SU/l.UI""""'I ~""~
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Datel ~ #~ !l'~
~~~~~7--
Name
Address
'11:)
.1!8
Telephone(
F: ~r,' f:l T' Capacity:
Personal Representative
,.1
Counsel for personal
representative
~J
~
I
(/
"
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
/.), /J/~ ;,'"
.
*', "2~-~F,II/
Date of Death: "P:;J -:r...ly ~.;-
will No. ~/- 9',--c,,;/f)
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 wbether 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 personal 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 to this report.
Vrl
1!"
~ ';-.~
,/, ~ I
~~~ -1, ~7-"-
S na cure
,.. - "'z
J.lfl'(,J","'-/,A/I!:- ^ _6E/V
"'n:) Name (Please type or print)
:1:) 7,.:J'C? ",f,lU"...,,,,,2> ~ ;f.'1!j,,/lII"!.lM~_f3
Address / ~,.. ,
Date: /~-'" j>'r
(;;': Ll'! El
r'-:'
"L.':'
.'
_1,
(7i VI 7'3.:1 f?3F:;>
Tel. No.
'Capacity:
',I
~ Personal Representative
Counsel for personal
representative
(MAH: rmf/ AM3)
I{)' ~ () - I~
REV-1547 EX ~FP 112094*
CO',"OHWUltH or PU4NIYLVAHIA
DlPA'UttlH' Of' Rtyu....:
IURfAU or INDIVIDUAL ,aXll
D(pf. r,u'l
fWtAIIIURO, Pi 17.,..OUl
~CN 101
NOTICE Of IHIIUITANtE TAM
AfP~AISEHENT, ALLOWANCE D~ DISALLOWANCE
Of DEDUCTIONS AHD ASSESSHEHT OF TAM
D~T! 11-20-95
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiifli:ii;4i-Ex-iiFP-(i'2=94Y"iiiificE--IiF-YNHEiiii'iiNci-TAinipPRAisEHiii'r;-,U.i."liiiiiNCi-ijli--m---mu--u
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BlEGEN WILLIAM K FILE NO. 21 95-0620 ACN 101 DATE 11-20-95
4,628.00
4.G7R nn
50,00
.00
50,00
will
, DO
3,00
.00
3,00
3,15
,15CR
.00
,15CR
. IF PAID AFTE~ DATE INDICATED, SEE REVERSE
FO~ CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS TIlAN .1. NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TillS FORM FOR INSTRUCTIDNS,I
FILE NO.
D~T! OF DEATH 07-22-95 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPU PD~TlOH OF TillS FO~H WITN YOU~ TAM
PAYHENT TO THE REDISTE~ OF WILLS. HAKE CIIECK PAYABLE TO "~EDISTE~ Of WILLS, AGEHT"
REMIT PAYMENT TOI
JACQUELINE R BlEGEN
823 RIDGEWOOD DR
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
A.ount R..ltt.d
TAlC RETURN WAS, I X I ACCEPTED AS FILED
I I CHAHGED
RESERVATION CONCERNINO FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Eot.t. ISc~dul. Al ell
2. Stocke and Bond. (Schedul. B) (2)
3. Clo..ly Held Stock/Partner.hip Inta,...t (Schedul. C) (5)
... Karla_g.I/Not.. Rac.ivabl. (Schadul. D) (4)
S. CaahlBank Oapoalt.'Hlao. par.onel Property (Schedule E) (5)
6, JolntI~ Owned Prop.rt~ ISc~dul. FI t61
7, Tronof.ro ISchedul. GI 171
a. Total A...t.
,00
4,628,00
,00
.00
,00
, DO
,DO
IBI
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funa,.al EMP.n.../A~. Co.t.,"llo. ExPen... .Schedule H) (9)
10. D.btoIMortg.g. LleblIltl.o/Llon. IScheduI. II 1101 .00
11. Tot.I Deduction. 1111
12. Net Vel... of T.x R.turn U21
15. CharUabla/Gov.rNlantal Bequ..t. ISchedul. J) (15)
I~, Net V.I... of Eot.t. Subj.ct to T.x tl~1
NOTE: If an aDDeDDment waD iDDued previDUD1Y, linBD 14, 15 end/or 16, 17 end lB
reflect figureD that include the total of ~ returnD aDDeDDed to date.
ASSESSMENT OF TAX:
15. _unt of Ll... I~ .t Spou..I r.t. USI
16. A-ount of Line 14 taxable .t Lin.aI/Cl... A ~.t. (16)
17. ~t of Line 14 taxable at Coll.t.~.l/Cl... B ~.t. (17)
11. P~lncip.l Tax Due
4.578.00
,OOM'OO.
50.00 K.06.
,00 M ,15.
lIB)
TAX CREDITS:
PAYHENT
DATE
08-22-95
DISCOIRlT e.1
INTEREST I-I
,15
RECEIPT
HUIlBER
AA048148
AIlOUHT PAID
3.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
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,:
~; 1
"
1,1
"
_I
REIDYATlO'h htatn of decedent. dying on or tJ.'or. DecMber 11, 1911 .. if MY future Intand In tM ..t.t. it tr""'.rred
ln po'Hnlon or ..,jo~t to Cl.n . (coUatar.l) banaUolarl.. 0' tM ~t a'hr tM ..,lraUon 0' .", ..t.t. for
Uta or 'or 'Hr., the C.........lth tMr., ..,r...b r...rv.. tM right to IIPPra... .. ...... tr"'.'.r InhrlrU.... TUl..
at the l..ful ClI.. I (coU.t....U rat. on MY wch 'utur. lnt.r..t.
PIIlPOSE OF
NanCEI To fu1l111 the raqulr..."h 0' SeoUon 2140 0' the Inhlrltanc. " [.t.t. Tax Act, Act 21 0' 1"1. 72 P.I.
SecUon 2140.
PAvtEKTl DatKh the top parUon of \hit NoUc. and aubalt with your p.~t to the _....t.r of WUb printed on the ravar.. aide.
--ftlka chec:k or ...., order ",.1. tal REGISTER OF MILLS, "DElfT
AU ,lYNnta rec'lved ahall Urat tJ. ..-lIed to WI)' Intar..t .....Ich M' tJ. We with WI' r"'lndlr 1IPP1Iad to the tu.
REF\ICD (CRh A rahnt 0' a tax credlt, which "'.. not raqua.._ on the Tax A.tum, .., be reque.ted by cOllplaUng an "Appllc.Uon
'or AafwMt of P.......rlVMI. InlMrltanc. and E.tata T.... (REV-1SU). Appl1ceUon..ra .vaU_Ia at the Office
of the A-Vlst.r of WIU., Wlr of the U Aavanua D"trlct OfUc.., or by O8ll1ng the ItPKlal 24.hour
Wlaw.rlng ..rvlc. nu.ber. for 'ora. orderlngl In Pann.rlv.nla 1.IOO.S6Z.Z050, out,ld. Penn.rlv.nl. and
wlthln IOCIII Harrhbura ar.a (717) 787-1094, TDD. (7l7J nZ-2U2 (Hearing 1..lred Dnb).
OUCTlDHSI Anr p.rty In Int.r..t not uU.fI_ ",Ith the IIPPr.l.....t, .Uow.nc. or dlnUowwte. 0' deductlona, or ..........t
of tax (lnoludlno dlllCOUftt or Int.r..t) .. shown on thl. NotlCI auat object ..Ithln .bty (60) .y. 0' rKelpt of
this NoUn bYI
.....rltten prata.t to the PA Dap.rt.wlt of A."....., IoaMl of Appe..., Dept. 281021, Harrhburg, PA 17121-1021, OR
"alectlon to have the ..Uar deteralnecl .t audlt of t.ha KCOW\t of the personal repr..entatlv., OR
-......1 to tho OrphWla. Court.
....IN
ISTRATlYE
CORRECTIONS I
FlIOtual error. dlscov.red on this .........,t Ihould be addr...ed In wrltlno tOI Pi Dlpnt...,t 0' R.venue,
lur.", 0' Individual Tax.., ATTHI po.t A.....aant R.vl... Unit, Dept. 210601, 'tarrlaburg, PA 1712'-0601
Phone (717) 7'7-6505. s.. paoa S 0' the bookl.t ~In.tructlon. 'Dr Inharlt~. Ta. R.turn 'Dr. A..ldant
Dacadant~ (REV-1501) 'or an explanation 0' ~Inl.tr.tlv.lr correctabl. .rror..
If WI)' tu duo h p.ld ",Ithln thr.. (5) c.lander aonth. .,tar the decadent.. death, a IIv. p.rcent (S:U discount of
the tax paid 1a .Uowd.
Int.r..t It charged beglmlna ..Ith flnt daw 0' dal1~w. or nino (9) ..,th. Bnd ana (1) da)' 'r.. the data 0'
dnth, to the data of p.~t. Tu.. .....Ich bacMa delinquent tJ.'or. January 1, 1912 bur Int.rnt at the r.t. of
.Ix (IX) parcent par ..... O8lcul.ted .t . dalh nt. 0' .000164. AU tax.. which bec.Ma daillnquant on and .,tar
January 1, 19.2 ..Ill baar Int.r..t at . r.t. which will verw 'r.. calendar y.ar to c.landar )'ear with thet r.t.
announced by tho PA Dap.rtaant of A.vanua. Tho IPPllcabl. Int.r..t r.t.. for 191Z through 1"5 .r'l
DISCOUNT I
INTERESTI
~ [ntar..t R.t. Dally Int.r..t Factor :2!r Int.ra.t AlIt. D.lt>> Inter..t FlHltor
1912 ..X .0DD54I 1917 n .00020
1913 16% .000451 U&4.1991 IlX .000501
1... 11X .000501 199' n .00020
1985 15% .000556 l"S-I994 n .000192
1... lOX .000274 1995 n .000247
--Int.r..t I. c.lcul.ted .. 'ollow.1
INTEREST . BALANCE OF TAX UNPAID X HUKlER OF DAYS DELINQUENT X DAILY INTEREBT FACTOR
--An)' Notlc. IsIUed aftar the tu becOllO. dal1ncp.Mlt will raUlIOt ., Int.r..t c.lcul.tlon to flftHn US) d.u
tJ.yond the d.ta of the .....MOnt. If pa,..,t Is .... .It.r tho Int.r..t CDllPUtatlon data "*'" on the
NoUc., additional Int.r..t ....t IMI calcul.ted.