HomeMy WebLinkAbout95-00853
PETITION FOIl 1'llOnATE 1I11d GllANT OF I.ETTEHS
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Hlluh' of ~!!:..!.!.ll_~.!...IJ.!!tl!l~L~.l.l.L-__
(11.\0 ""0W" us __
Reglsler of Will, for Ihe
____f /J(t('tlllett!. Count)' of Clllllhprldlltl In the
SlIdtll S"('I/TI/)' Nil, ---.1:.!2.::2lL:2!Jl!L-_ c.:onllllonweahh of Pennsylvania
The pelllion of Ihe IIndersigned Tespeclfnlly rcpresenl' 111111:
Your pelhlonct(s). whols/nre I H )'enTS of age or older nnlhe exeC"1 I I X
in Ihe 1051 will of Ihe above decedem. daled N"y ~'l
nnd codiell(s) daled "',""
named
. 19!..L-
hlllt 'tIt"."' dn'lIrn"ancC'$, f.8. rcnuncialiun. dtlllh ur c"C'c"lOr, ric.)
Decendenl was domiciled al deolh In Cllmh,," Idlld Counly. I'ennsylvonlo, whh
II in last fomily or principal residence at 11 J? Hr.,'}"" ,. Un HI J r Imp 111 1 I. nA
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(USI 'IIttt, nllmber and l11unclpalll)')
Dccenc.lcnt, then ()f) years of ogc, died l~ppt pmhor ?() , 19{')r,
at ""tV gplril IIrmnitil1 .
Excepl os follows, decedenl did nOlmollY. was nol divorced and did nol have a child born or odopled
ofler execullon of Ihe will offered for probale: was nOllhe vlellm of 0 killing nnd was never odJudlcoled
Incompetent: no p.xcpnt i onR
Dccendenl 01 deolh owned properlY with eSllmoled values os follows:
(If domiciled In I'll,) All personal properlY
(If nOI domiciled in 1'0.) Personal properlY In Pcnnsylvnnla
(If nol domiciled in Po.) Personal properlY In Counly
Value of real eslole In Pennsylvania
shuoled os follows: 110111'
$
$
$
$
25.000
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WHEREFORE, pelllloner(s) Tespcclfully
pTesenled herewllh and Ihe gronl of lellers
Iheron.
requesl(s) Ihe probate of Ihe lasl wll1 and codlcll(s)
lontamonlarv
(In1anllmlarYj ndmlnl\U41lon c.l.a.j admlnhtratlun d.b.n.c.t.A.)
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OATH Olf' PERSONAL REPRESENTATIVE
COMMONWEALTH 01: PENNSYI.VANIA } l:lS
COUNTY 01-' ~t!:'lJ.Il~:J'"
The pellllonl'((') Ilbove.nnmed 5wear(s) or affirm(s) Ihot Ihe SlOlements In Ihe foregoing pellllon nre
true and corrCo;1 10 Ihe best or Ihe knowJedte and bellcf of pelllloner(s) and Ihal as personal represen-
totlve(s) of Ihe nbove decedel\l pelhlonel(s) will well ,~nd ITuly ~dm~nJSler Ihe e5lj~e ~ccordlng 10 low,
Sworn 10 or .llnrm.d ,011d su, bSC\'lh.d,~ .f ,..' ) v.~,,/,:, .IJ',-z.t,,'; ~
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[, !lICIIARD COLMAN PETE:tS, of camp lIill, Cumberland
County, Pennsylvania, do herehy make this as and for my Last
\.Jill and Testament, hereby revoking all other wills by me at
any time heretofore made.
FIRST: -- I direct that all my debts, funeral
expenses and necessary expenses of administering my estate, as
well as all estate, transfer, inheritance and succession taxes
payable on account of any devise or bequest herein made be paid
by my executrix, or executor, hereinafter named, as soon after
my death as may be convenient.
SECOND: -- All the rest, residue and remainder of
the property, real and personal of which I shall die seized or
possessed, wherever situate, or over which I shall have at the
time of my death any power of disposition by will or deed, 1
give, devise and bequeath to my wife, DONNA TAYLOR PETERS, her
heirs and assigns, conditioned, however, that in the event of
her death in my lifetime or in the event of her death within the
period of fifteen (15) days after my death, the said devise and
bequest of residue shall lapse and be divested. I authorize
my executor to payout of the income or principal of my estate
the reasonable expenses of the funeral of my wife should she die
within the said period of fifteen days.
TIlIIU): -- Should my wifef DONNA TAYLOR PETERS,
-- )
(page one of my will, ,t::Jf;';.-.C
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predecease me or die within the period of fifteen (15) days
after my death, as hereinabove set forth, then in that event,
I give, devise and bequeath my said residuary estate to my
children, born and to be horn, in equal shares, share and share
alike. Should any of my children, born and to be horn, prede-
cease me, leaving lawful issue to survive me, then the lawful
issue of the deceased child shall take the share that their
parent or ancestor would have taken if living.
,
\~/", 1(,,-', FOURTH: -- Should my wife, DONNA TAYLOR PETEI~S,
~:;t~j~~f:/;7.':;';/,'" f~redece,ase me, or die withi~ the/p~riod of fifteen (15) days .J
(M,' rill'/;: r9 (l ',.. ,V;,~~~:'(:,:'l..'~. s~ r._i ~ttl1f.t:), 7Yf1 7~
1'(1 tr ,< " ,;.t. ""after my,death I appoin~ ~=t!iuh:', ~~ ~..EXEas, and my
':(.1., .,i/ /I..... I ,f ~{j.t"'),!" . -', '~~_ ,_
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sil!t.:er ~~ l~wr Mfta6~lIT"-'P.!$Il\\fl, of H~, !Ii~l.igan, guardians
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,,- I< c." r.i {( I ___
of the persons of my minor children, born or to be born.
',',/ .', ,." .~ \,
(Jj/;.~ ',:L,(/ t'~redecease me, or die within the period of fifteen. (15) ~J:YS
" /' '/. II,/{II-/''>' tJ t;.>~. .!/~"<.t.." /iN\.{ f 1.,,1;,<1 j C '
)~;;_ ;(ti(~)MJ. !:~~.r7,.~:~~~~~ha~ ~~~~::~~r,5"Y/~~:~ d8~e~1l~/~~~; 0
", I (/;1 "", b~ ...r, 11_,1 -, AI~~;&". shall be the guardian of tlie
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FIFTH: --
Shou ld my wife, DONNA TAYLOR PETERS.
estates of my minor children, born or to be born.
SIXTH: -- I nominate, constitute and appoint my
wife, DONNA TAYLOR PETEHS. executrix of this my last will and
testament and direct that she shall not be required to enter
security in any jurisdictIon in \~hI('h she may act for the
faithful performance of her duties as such. Should my wife,
DONNA TAYLOR PETERS, predecense me, refuse to serve, resign or
/' :-), , (,/' ,')
(page two of my will.L.,/.~." (",,~.,,' /1'/"'-; )
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:)
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~! (/", ",,, 1 become incapacitated, or die before the settlement of my estate
~' Ii'';) ,;' .' J as provided in said will and ,testamen,t, in tha,t e~ent 1 nOJDinate,
[..1" ~,!,.iJ". ( , 'I,' 0 ". " I., ',I\, 'I /~,~1:iIJ;./fl~~' (.. ,......,
;il'~'1'ljl'fJ' constitute a~d ap1?oip'~ my rbl:'ot:her , 1<BNWl'1I...JI Pi'!'ERS,. of Hoi:Ly,
F:& 0Jn( '1 " ::I""' f"'''''' r: t.-:z~.J P, t:' (. . -'..(~ /1 l"'- " ., . ..AI' ",,,.,,-,+-,W',I---
1,,' J ,-' ,}. i~~'b':san:-;xecutor ~f th/is";; i:,{~~~rn and t~s'~ament, :A'C'/" .
.' " '. ' i ,I ' ,. ~ .
, "direct that he shall not be required to enter security 1n any
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jurisdiction in which he may act for the faithful performance
of his duties as such.
IN IHTNESS lo1HEREOF, 1 have subscribed my name and
set my seal to this my Last Hill and Testament, contained in
four (4) typewritten sheets of paper, upon each of the fore-
going of which 1 have also written my name, at camp Hill, in the
State of Pennsylvania, this
Z 'i f: day of
,
/.:....i. :~
, A. D.
1.961.
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//<":~/.' /< /' /,
_,-t'!:(:<"Y~:A..-t , ,,"~'':-'t~.'
Richard Colman
)
.,.#-,.r;/r---'.-
".!.~. ~'(~. _c_,
Peters
(SEAL)
instrument consisting of four (4)
pages, was on
The foregoing
., ' /1
this ~ day of
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, 1961, subscribed
on each page and at the end thereof'by RICHARD COLMAN PETERS,
the above named testator, and by him signed, sealed, pub-
(page three of my
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lis hod and declared to be his lAst Will and Testament, in the
presence of UD, and each of UII, who thereupon at his request,
and in his presence, and in the presence of each other, have
hereunto Bubscr ibed out' names as witnesses thereto.
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(page
Invenlory 01 Ihe real and personal eslale 01
RICHARD COLEMAN PETms, D.D,S.
deceased
PATIENT LIST OF 488 DENTAL PATIENTS.
31,120 00
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fOR DAn. Of DlATHNTlR ,~'JI' CHICK HlRE
If A IPOUIAL
POV(RTY CnlDIT 'I CLAIMED
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ITO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
1995
V'[NI
00853
NUMUR
COMMQNW[H..1MOf PlNNSVlVN41A
DIPM1MlNTOf F\lVlNU[
D1PT.~'
HARRISBURG. PA U12'80001
D1C101Hrl HNM Cl....T.flR.T. NiD ....omllNm~1
PETERS, RICHARD COLEMAN
IOClAL II CURl" HUMS1"
21
COUNTY Coor
01 Cl 01 "'" COMl'\ I n HlOMl8'
3122 BRAMARRD
CAMP HILL PA 17011
c...... CUMBERLAND
IOCIA/. .lCURtlY NUMB1" No'QUHl"tclMD 111l1N1",ucnoNII
205-22-0491
199-20-2881
o 3, R.....nd.' R."m
Uotd.... 01 dulll priot 1012-I:l-B2l
o 6. Fed.relE......T..
R."mRequlred
Q.. B, To'" Num>e' oIS.'. Oepoell Bo_
If 1n"Uaa111ll,R\1\1NQ1f'(lU5l'i~ &J61',RRl'TIKlMlXU INnAJ
PETERS, DONNA T,
Q9 I. Origlnel R."m
o ~, Uni1ed E.....
Q9 &,
Docoden'DledTe.t811t
IAtllIChcopyoCWUI)
R ESPO
o 2. supplementlll R ."'m
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48. FUlJrelntarett COflllrtwrill
I'otd.... 01 dulll.l..r \2.12,82l
7. Decedent tvWntalnod I U...ng TN.t
IAtllICh copy 01 TN'S
NFIOE T A INF R
COMPLl.ll M,M.IHG IDORUS
OIR
MCKONLY & ASBURY
PO BOX 1331
HARRISBURG PA 17105
o
EGAN
761-7910
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a:
I, R.eI eo.... (Schedul. AI ( II ----,--
2, StocI<o end Bord.ISchedul. 81 121__----'-----
3, CI..e1y Held S1l>cM'.mer.tjp In..r..IISchedul. CI I 31__. __..n._'__'_
~, M>r1g.g.. and No'" R.celwl>l.ISchedule 0) (41.
6. Ceth. 0... OopOllta &. M.conlneoul Per,Of\III Property I 6l
ISchedule EI
8, JoInUyOW'lOd Property (Schedul. FI
7. TraNfell CSchedule G) (Schedule L)
B. Totlll Gr0l8 AllOts Ctotal Unol 1.7)
9. Funorel E"".""el. Admnl..e.", C..... M.cell.no",. (9)____.-~-13~Z.2
E)pen... (Schedule H)
10. Dlba, MorIQage Uobilili"l UeN CSchodulo n
II, Tollll Ooduc'one (tollll Uno. 9 & 101
12. N.tVoIue 01 E......IUno 9m"" Uno III
13. Charitable and GOYOrMlOntal Beque.alSchedule J)
I~. N.IVelue subl.C\1oTBXIUno 12m"" Uno 13)
16, SpoulDl TroNfere Ifor datal 01 death .fmr &31).941
See InltNCione for ~p*iceble PercentDgo on RewrlO
Skil. (Include wluee hom Schedule K or Schedule M,)
16. Amounl of Uno 14 toxnbI. .16%'."
Unclud. wlu.. '.om Schedul. K ot Schedul. M)
17. Amount 01 Uno 14uuwl>le e116%reta
(Include wZ\JeI from Schedule K Of Schodule M,)
18, Princlpoltaxdu.IAdd"" from Uno. 15. 18.nd 17,)
19. Credits Spouaol povortyCrodit Prior Pe~ntB
.--
31,720.00
(61_
171
(81
31 ,~OO
--~--
697,75
9,834.45
21,885,55
1101_
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(III
1121_
1131
1141
21,885,55
656,57
1161.,_n_,~_;'!..~_~,~,~-55 X .Q~-_
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1161
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1171
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656,57
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Discount
119)
._-- + ______m._ + ..-,.......--.. ..--..----....'
20. If Uno 191' groalar 1henUne 18, enUIr tho difference on Uno 20. T.-.I,the OVERPAVMENT.
1!JJ Check here If you ift r. u..tlng a ,olund of your over ovmont.
21. It Uno 181, greeter than Uno 19, entar 1he difference on Uno 21. Tn' I, tho TAX DUE.
A.. Enter the Inlarelt on the belance due on Une 21A..
B, En"'''''' to'" of Uno 21 and 21A on Uno 21B, Tr-;I I. "'" BALANCE DUE,
Make Check PIYlbl. '0: Regllter 01 Willi. Agent
1201_____--
1211__.._,___n_~5~~~Z-
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12IBI.__..n---..-._E5-~,~2
,. . """, ~BE SURE TO ANSWER ALL QUESTIONS ON REVERSE BIDE ANOTO RECHeCK MATH'" ....
UndO! p.ncI'.. 0' p.rjurv.1 d.el.re""'ll h.'" e""';nod thI. ,e..m.lncluding 8Ccon".n~ng .chodule. end .totonlOn... end to Ill. b..1 01 myknowodg. .nd boli.'.
It 1. IN., cotr.clend corrc>l..., I declorelhol ell r.oI...... he. bo.n .opotted el IN. "",11<.1 wlue, Oeeler..on 0' pr.pe.er olhor thon "'" p.llono1 ,.pre..n"'''' II
bel on oIllntormouon 01 h proparer hOI enykno't'llDdgo.
II AnJlUOfPlHSO [5 KfIlJNQHltlJH" ~OA[S5 BRAMAR .....p HI
.L' 'A..-~I 3122 ROC"". LLPA
SlQ AT A(OfPR OWlRTHN4RlPRlSl"TAnvt. .ADORlliS
MCKONLY & ASBURY
PO BOX 1331 HARRISBURG PA
170'ri' 311 If (,
OAn
';;!/~o/M
17105 ' ...._It'
Act iI'48 of 1994 provides for the reduction of the tax rates Imposed on the net value of trensfers to or for the
use of the spouse. The rates as prescribed by the statute will be:
,
.3% ..031 will be applicable for ellates of decedents dying on or after 711194 and before 1/1/96
.2% (,021 will be applicable fo, ellates of decedents dying on or efter 1/1196 and before 1/1/97
· 1% ..011 will be appllceble for estates of decedents dying on or afte, 1/1197 end befo,e 111/98
· Spousal transfers occur,'ng on or after 1/1/98 will ba exempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK I,..,) IN THE APPROPRIATE BLOCKS,
YES NO
1, Old dscedsnt make e transfer end:
a.
retain the use or Income of the property transferred.
.................................
x
b, retain the right to deslgnam WlO shall usa the property transferred or Its Income, ..,......,. X
c. retain a reversionary Interest or. . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
d. receive the promise for life of either payments. benafits or care? . . . . . , . . . . . . . . . . . . , . . . . . X
2. If death occurred on or before December 12, 1982, did decedent v.lthln tv\o years
preceding death transfer property VIlthout receiving adequam conslde,ation? If death
occurred after December 12, 1982, did decedent transfer property v.lthln one year of
death v.lthout receiving adaquam consideration? . , , . . . . . . . . . . . . . . . . . , . . . , . . . . . . . , . . . . . . .
3, Old decedent OWl an 1n trust for' bank accountat his or her daath? .......,.,..,............ 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,
''''_".1
"[Y.1IOafk .111-"
, coMMQNW11L 1M Df'l NNln YAAIA
IHHE"ITANC[ Tl4Aft[TUftN
ftlllO[NTD[CIDINT
SCHEDULE A
REAL ESTATE
ESTATE Of
RICHARD COLEMAN PETERS
FILE NUMBER
2195-0853
IP,op.,ty lolndy-oN1.d V111h Righi 0' lurvlvollhtp mU'1 b, dllcloud on Ich.dul. FI All '..I....tII.houfd bl r.pon.d.' 'II, milke' valu.
....Ich II dlnnld .. thl price ......Ich proporcy would bo uchlngld b'_In I wiling buy.. Ind I wiling ..11... nllth.. bllng .omplllld
to bu or 1111. bolt! hIVinG ,...on.bl. know.do' of the r.IIVln' ',etl.
1.
DESCRIPTION
PATIENT LIST OF 488 DENTAL PATIENTS.
SALE NOVEMBER 21, 1995. COpy OF SALES AGREEMENT
ATTACHED
VALUE AT DATE
OF DEATH
ITEM
NUMlER
$31,720.00
TOTAL (Also enlDr on lino 1. Recapitulation)
(If more spaco Is noodod. InS01l addi~onal shaoes o( same slzo,}
.
31,720.00
."'--...
ftl""'''''''.I'.''
C~HWrN..1HO'''rHH.YLV~lA
"HlftrT~CE TAX ftr TUftH
T
SCHEDULE H
FUNERAl EXPENSES,
ADMNISTRATIVE COSTS AND
MSCELLANEOUS EXPENSES
Ple..e P,lnl or T e
RICHARD COLEMAN PETERS
ITEM
NUMBER
A.
s,
4,
C.
1.
2.
3.
4,
6,
6,
7.
6.
2195-0853
DESCRIPTION
AMOUNT
1.
2.
3.
4.
5.
Funerel ExpenuI:
NEILL FURNERAL HOME
FLOWERS
CLERGYMAN FEE
FUNERAL LUNCH
MISCELLANEOUS EXPENSE
6,030.00
116.39
100.00
91.31
50.00
1,
Admlnlltredve COlb:
Personel Representative Commissions
Social Security Number oC Personai Representative:
Year Commissions paid
2.
AllDmey Fees
3.
Family Exemption
Clalmanl DONNA TAYLOR PETERlielatlonshlp SPOUSE
Address oC Claimant et decedenrs dealh
StreelAddress 3122 BRAMAR RD
CItyCAMP HILL Stale~ Zip Code 17011
2,000.00
Probale Fees
89.00
Mlcelleneoul Expenlel:
MCKONLY & ASBURY - ESTATE TAX RETURN PREPARATION
650.00
INVENTORY FILING FEE
10.00
TOTAL IAlso enler on line 9, Recapllulatlonl .
9,136.70
III more Ipece II needed, InlOr! eddldonel IhOOb 01 ume Iln.1
""'--.11
"IY.liU(X .12,1,.
COMMONW[AL lH of '[NNln VAAIA
IN""ITAHCI t"""IlU\N
IIIDrNt DIC' DIN'.
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
RICHARD COLEMAN PETERS
2195-0853
ITEM
NUMBER
RELATlONBHlP
AMOUNT OR
BHARE OF EOTATE
NAME AND ADDRESS OF BENEFICIARY
A. T.xable Olqueltl:
1.
DONNA TAYLOR PETERS
3122 BRAMAR RD
CAMP HILL PA 17011
100%
POUSE
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMDUNT OR
OHARE Of EOTATE
B. Charitllble and Gowrrvnental Bequeltl:
1,
TOTAL CHARITABLE AND GDVERNMONTAL BEQUESTS IAllo O"la,onli". 13. Roclljli..lo;onl .
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predecease me or die within the period of fifteen (IS) days
after my death, as hereinabove set forth, then in that event,
1 give, devise and bequeath my said residuary estate to my
\ children, born and to be born, in equal shares, share and share
!
\
alike.
Rhould any of my children, born and to be born, prede-
cease me, leaving lawful issue to survive me, then the lawful
issue of the deceased child shall take the share that their
parent or ancestor would have taken if living,
,F,:.;,..,' . ' , FOURTH: -- Should my wife, DONNA TAYLOR PETERS,
li):/':'j~(,::,';"r.~''';;':l: ''''~redeceas,e me, or die within ,the .period of fifteen (IS) days", 'r.:::
1 ",/'t' (1 /.: (iJ.(( "'- Vi.lkl.,t",/., , _'llr- '. ';a , .tt'/fJ,'<J lj#/
"if I, . ,..:r(., ~"'''afte,r my,death I app~inrt . 1b;''i;''t!~R~" ~~'~~;'l'MEas: and ~y
( ,I. .. tI " "..,1 .y. ""...I,l)~' . _....' '/ . --=' ' I
,( , . ,.. , ".. ,,,. F /1 ~ " '1,- . .. . ' ' . ...-1
.'" ',., SilltBE' i~. ~:i' WtR4= Ii~-fl, of H~, Mi~ld.~, guardians
7/{{J.Nt.a.E~"1A'_' r;ii~' )...' f',l.z{1 )...',>\-,.,.,I.~.r"c. 711 > .(pi( '" ~,tJIC"",,/e#Q-lr.tf,,::;JfIf,'
a;):"W . ,of eh. p,,"on' of my minor ,'ildron, bo= or '0 b. bo=.
'$t (,(~;ff~ '
FIFTH: --
Should my wife, DONNA TAYLOR PETERS,
,"
~.' .'. ~ . .
/;t) '. i I
~I :'. . ",., ..1"':
(~'I." ..
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'./ trIll' I ("t.'..'
~,1 yI~ ~;:';; ..."rl;l,
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lpredecease me, or die \~ithin the p~riod o~ fifteen, (IS) 4fYs ~
(,':IpYl~ /!./...."(,,/u.JI .-t..u ,f/-;Ati-ltJ .I CA
.~ft.er my death~' i~ct, ~hat ~!H! -A.'n."a.ny,-t~ b~ d1a-,uld ,;~ ..
,....<>=I'....,,"!rr-J ' ~~""l!'.w-~S. I.~M_ I~
bj>-llIY, b1!cetbM<, r~~ shall be the guardian of tIie
estates of my minor children, born or to be born,
I' "
7l[;;.u: a~ '[~r.J,U..
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.~ ~..-I , I..-':}
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,,1.7 J! f.t
SIXTH: __ I nominate, constitute and appoint my
wife, DONNA TAYLOR PETERS, executrix of this my last will and
testament and direct that she shall not be required to enter
! ,e,ur"Y in .ny Juri'die'ion in wbieh ,he may ae' for ,be
Should my wife,
faithful performance of her duties as such,
serve, resign or
DONNA TAYLOR PETERS, predecease me, refuse to
'...J
. .
(page two of my will ~j~~ l (,,:':::..,
')
..//,:;'; )
..
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I.
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,
, ~.~ ! ;':' I I .' as provided in said will and t~stamen.", in that ev~nt 1 nominate,
'I. IAn' ",.1'.."" ~ '0' Dulo, l'.i,',I.",.,/( /~,_
i" t"'1~:7- 'I'. .f/t,." constitute a~d appoiJ11: ,mY'j.b~her" lERNSi'1I }of .PEWR8-;- o~ IIltt:l.y.,
:4 . l~'.l.. .~'T_ Jo." l.-.l! llL..,ea-9t..h(} t.'Ul.w ,.Jf (r:""~,1() h~~ ~I T~'/. ~:.'-:: ~ .-.1"- .,:~~v",,~
. /" ,..1'1) 1., "Mii:lhigan, executor of this my last"'~rri and testament, anCl .
",,\.,1'-<11I ~.' ,I ,.I..". .
, "
. '.. ~.) 'j,
; .", . direct that he shall not be required to enter security in any
)[;aMiz;.,.~.<J.
jurisdiction in which he may act for the faithful performance
J~:Z:J"lrr'?~
~l~' . of his duties as such.
f~N'"
become incapacitated, or die before the settlement of my estate
IN IHTNESS \VHEREOF, I have subscribed my name and
set my seal to this my lAst \ViII and Testament, contained in
four (4) typewritten sheets of paper, upon each of the fore-
going of which I have also written my
State of Pennsylvania, this ,:Z fl.;' day
name, at Camp Hill, in the
of
,A-/
'L'~}/
, A. D.
1961.
"j
....
.' // (' ..../.
~ /' /- ,.r .
. .. ~. . . " .
,,'~~;(l,.i.~ (,.'.....:...~,..
Richard Colman
, -,2~~--
-.,t' 4 r.' I <"'~'I
Peters
(SEAL)
pages, was on
The foregoing
~,., :/
this ~ day of
instrument consisting of four (4)
on each page and at the end
).,
/. ~ . .: ,/
.-
,.
thereof' by RICHARD COLMAN PETERS,
, 1961, subscribed
the above named testator, and by him signed, sealed, pub-
(page three of my will
-- "),
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,
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lished and declared to be his lAst Will and Testament, in the
presence of us, and each of us, who thereupon at his request,
and in his presence, and in the presence of each other, have
hereunto subscribed our names au witnesses
;/
,0'//'--
. ,., r' JI /1 .
thereto,
,1
I '
I,", 1.1.';.... t.
(page four
,.~
' ,.-:.
. ~J// ,.~'
of my will "_.4-~~';'~~..~ -;'0/.;(
-
-2
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)~L;'"',;:-)
11/21/95
AGREEMENT, DILL OF SALE AND ASSIGNMENT
AGREEMENT, BILL OF SALE AND ASSIGNMENT dated November 21, 1995, from the
ESTATE OF RICHARD C. PETERS, DDS, deceaoed (hereinafter called the
"Traneferor")~ to PAUL WILLIAMS, DMD, and GINA WILLIAMS, his wife (hereinafter
collectively called the "Transferee").
WHEREAS, the Trsnsferor has agreed to transfer to Transferee its right,
title and interest in and to the patients listed on Exhibit "A" attached
hereto and by reference made a part hereof and records and all goodwill
associated therewith of the Transferor (hereinafter called the "Property") 1
and
WHEREAS, in order that the Transferee shall be in possession of
instrument evidencing transfer to and vesting in the Transferee of the
....
PropertYI
NOW, THEREFORE, THIS AGREEMENT, BILL OF SALE AIID ASSIGNMENT, WITNESSETH
that the Transferor, for and in consideration of the purchase price of Thirty-
One Thousand Seven Hundred Twenty Dollars ($31,720) (calculated by multiplying
4BB patients listed on Exhibit "A" timeD $65), payable $3,172 in cash upon the
execution and delivery hereof and the balance by execution and delivery of
thst Note ol even date drawn in the initial principal oum of $2B,548, does
grant, bargain, sell, BDoign, alien, romine, reloase, convey, transfer, Bot
over and confirm, unto the Transferee, their ouccessorD and assigns, forevor,
the Property and all goodwill associated therewith,
TO HAVE AND TO HOLD the said Property unto the Transferee, their
personal representatives, heirs, successors and assigns, to them and their own
use and behalf forever.
I.
I
,
AND, for the conoideration aforeoaid, the Transferor hereby constituteo
and appoints. the Transferee, their personal representatives, heirs, successors
and aosigns, the true and lawful attorney or attorneys of the Transferor, with
full power of subotitution, for the Transferor and in ito name and otead or
otherwise, by and on behalf of and for the benefit of the Transferee, their
personal repreoontativos, heirs, successors and assigns, to demand and receive
"
~
from time to time any and all of the Property hereby aDsigned, transferred and
conveyed, and to give receipts snd relesses for snd in respect of the ssme end
any part thereof, and from time to time to institute and prosecute in the nsme
of the Transferor or otherwise, for the benefit of the Transferee, their
personal representatives, heirs, successors and assigns, any and all
proceedings at law, in equity or otherwise, which the Transferee, their
personal representatives, heirs, successors and assigns, may deem proper in
order to collect, assert or enforce any claim, rights, or title of any kind in
and to the Property hereby assigned, transferred and conveyed, and to defend
or compromise any and all actions, suits, or proceedings in respect of any of
said property and to do all such acts and things in relation thereto as the
Transferee, their personal representatives, heirs, auccessors or assigns,
,
shall deem desirable; the Transferor hereby declaring that the appointment
made and power hereby granted are coupled with an interest and are and shall
be irrevocable by the Transferor in any manner or for any reason,
AND, for the consideration aforesaid, the Transferor has warranted and
by this Bill of Sale and Assignment does warrant to the Transferee. their
personal representatives, heirs, Buccensors and assigns, that:
(i) Richard C,
Peters, DDS, died testate on September 29, 1995, and his will was duly
probated on November 13, 1995, with the Cumberland County Register of Wills
who appointed Donna Taylor PeterD as the executrix thereunder, who continues
so serving; (ii) it has good and unencumbered title, right and full authority
to sell and transfer the Property hereby assigned, transferred and conveyed,
and will defend the transfers hereby made to Transferee, their personal
representatives, heirs, successors and assigns, against all persons lawfully
claiming said Property; (iii) such Property is free and clear of all liens and
claims, and (iv) that none of the patients included in the Property have
requested Transferor to return or forward his or her records to him or her or
to another provider.
HOWEVER, Transferee does not assume any liability or debt of the
Transferor and Transferor shall indemnify and save Transferee harmless from
- 2 -
.
any loss (including reasonable attorneys' fees) regarding any such liability
or debtt provided however, Transferee shall on end after the date hereof
complY with all applicable laws, rules and regulations regarding the use and
dissemination of the patient records identified on Exhibits A and P hereto,
including without limitation, those pertaining to confidentiality, permitting
access to and providing the original or copies of, such records to patients
and/or their designees, and shall hold Transferor harmless from any loss (to
include reasonable attorneys' fees) for its failure so to do.
AND, for the consideration aforesaid, the Transferor has covenanted and
by this Pill of sale and Assignment does covenant with the Transferee, their
personal representatives, heirs, successors and assigne, that it, the
Transferor, will do, execute and deliver, or will cause to be done, executed
"I.-
and delivered, all such further acts, transfers, assignments and conveyances,
powers of attorney, and assurances, for the better assuring, conveying and
confirming unto the Transferee, their personal representatives, heirs.
successors and assigns, all and singular the Property hereby assigned,
transferred and conveyed as the Transferee, their personal representatives,
heirs, successors or assigns, shall reasonably require.
FURTHER'
(i) Transferor hereby represents and warrants that information
set forth on the patient list constituting the property is accurate, In the
event that Transferee is unable to locate a particular patient at the
specified address, Transferee shall advise Transferor in writing and
Transferor shall have ten (10) days following its receipt of Transferee'S
notice to provide a corrected address to Transferee for such patient and upon
its failure to so do, Transferee shall be credited with a payment of sixty.,
Five Dollars ($65) under the Note of even date, applied against installments
due thereunder in reverse order of maturity, and such credit shall be
augmented by an amount equal to interest at the Note rate on such reduction
from the date Transferee becomes entitled to such credit and extending until
the date of such offset. The foregoing is the sole and exclusive
representation, warranty, covenant or other undertaking of Transferor to
- 3 -
-...:,-",: .: ~
. '
,--
"-,."
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r:
,',
Transferee with regard to the Proporty and all othoro, oxpreoo or implied. are
expressly waived, Thio provioion oets forth tho entire agreement (oral or in
writing) regarding tho oubject mattor hereof and replaceD any prior
diocussions or understandingo, and may be modified hereafter only in writing
signed by the partieo hereto. For example, and not by way of limitation,
Tranoferor makes no representation that the patiento on the patient list will
chose to become patiento of Paul Williams, DMD, or will otherwise respond to
Transferee's communications thereto. Transferee hereby aosumes
unconditionally the risk that a patient lioted on tho patient list has
heretofore or will hereafter select another dentiot to replace Richard c.
,
Petero, DDS, and Transferee ohall have no further duty or obligation to cause,
or to attempt to cause, any such patient to become a patient of Paul Williamo,
,
DMD.
(ii) The parties have agreed on the contento of a letter to be prepared
and sent at Tranoferee's sole expense to the patients at the addreooeo set
froth on Exhibit "A", The envelope shall Hot Tranoferor' 0 addreso ao the
return address, The patient's addreso set forth on the envelope of any letter
not returned as "undeliverable" within thirty (30) daya from mailing, shall be
conclusively preoumed to be correct,
(iB) A oecond patient Hsting is attached hereto ao Exhibit "B" and by
reference made a part hereof, Thio Exhibit listo patiento that had been
treated by Richard C. petero within the time period of eighteen to twenty-four
montho prior to September 25, 1995, but not thereafter. The partieo agree
that the oame letter described above shall also be oent to these patients and
for each patient identified therein who makeo an appointment on or before the
second anniversary of the date hereof with Paul Williams, DMD, for
profeooional oerviceo, Tranoferee ohall pay to Tranoferor the additional oum
of Sixty-Five Dollaro ($651, Tranoferee ohall render a written accounting to
Tranoferor monthly (commencing December 15, 19951 of amounto becoming due
Transferee hereunder and ohall remit payment therewith for the amounts due for
that reporting period.
- 4 -
I,
. ,
(':
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I
REV-1547 EX AFP 112-951.
CO""OHWUllIt or PIHNSVlVANIA
D(PARHUJU or "'(VI NU[
BUill AU Of INDIVIDUAl lurs , . .
DlPt. 110"01
HARRISBURG. PA 1111100611 ~
ESTATE OF P~f:~ Rl'CHAR'6-c~~~~= '
DATE OF DEATH 09-29-95
NOTICE OF INIIERITANCE TAK
APPRAISENENT. ALLOWANCE OR OISALLOWANCE
OF OEOUCTIONS ANO ASSESSNENT OF TAK
ACN 101
FILE NO,
COUNTY
DATE 05-20-96
2l9S70ll53
CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBNIT THE UPPER PDRTION OF THIS FORN WITH YOUR TAK
PAVNENT TO THE REGISTER OF WILLS, NAKE CIlECK PAVABLE TO "REGISTER OF WILLS. AGEN'"
REMIT PAYMENT TO:
REGIS J EGAN
MCKONLY 8 ASBURV
PO BOX 1331
HBG PA 17105
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Alllount R...Uhd
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:isW-EX -AFP-ii'2:ijSY-NOYicE""cW"iNHEiiii'ANCi!-YAX-APPRAisEif€N"-;-ALi:ciwAifci!-iiFi--_mnm ------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
RICHARD C FILE NO. 21 95-0B53 ACN 101
I ACCEPTED AS FILED
SEE
DATE
ATTACHED
05-20-96
ESTATE OF
PETERS
TAK RETURN WAS.
I X 1 CHANGED
NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN SASED ON: ORIGINAL RETURN
1. R..I Eat.t. (Schedule A) III
2. Stock. and Bond. (Schedule OJ (2)
3. Clo..ly Hald stock/Partnership lnt.r..t (Schedule C) (3)
~. Hartg.gal/Hot.. Racelvabl_ {Schedule DJ C4J
5. C..h/Bank Deposita/Hisc. Parlonal Property (Schedule EJ 151
b. Jointly Owned Property (Schedula FJ C&'
7. Tran,far. (Schedul. G) (7)
B. Total Assats
,00
.00
.00
,00
31.720,00
.00
,00
IBI
31.720.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funaral Expans.s/Adn. Costs/Hisc. Expans.s CSch.dula HJ (9)
10. Dabts/Hortgau. Li.bilitias/Liens ISch.dula II elOJ
11. Total D.ductions
12. H.t V.lu. 0' Tax Raturn
13. Charltabl./Gov.rnn.ntal a.qUasts CSch.dula JJ
14. Hat Valua 0' Estat. Subjact to Tax
10,635,00
697.75
1111
1121
1131
1141
11 ,n:o 7;
20.3S7,25
.00
20.3S7,25
will
If an assessment was issued previOUSly, lines 14. 15 and/or 16, 17 and lS
reflect figures that include the total of ALL returns assessed to date,
ASSESSMENT OF TAX:
15. Anount of Lina 14 at Spous.l
16. Anount 0' Lin. 14 taxabla at
17. A.ount of Lina 14 ta.abla .t
18. Principal T.x Dua
TAX CREDITS:
PAVNENT
DATE
03-04-96
NOTE:
rata
Lin..l/Cl.ss A rat.
Coll.taral/Cl... 8 rat.
I1SI
1161
1171
20,387,25
.00
,00
K . DO.
K ,06.
K .15.
I1SI
,00
.00
,00
,00
RECEIPT
NUNBER
AA1l2584
DISCOUNT
INTEREST
Itl
I-I
.00
ANOUNT PAID
656,57
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
656.57
656,57CR
.00
656,57CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
I IF TOTAL DUE IS LESS THAN .1. NO PAYNE NT IS REQUIRED,
If TOTAL DUE IS REFLECTED AS A "CREDIT" eCRI, YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS,)
RESERVATION, [.t.t.. of d.c8dent. dying on or b.'ar. O.c..o.r lZ, 19.Z .. If any future Int.r..t In the ..t.t. I. tr~.f.rr.d
In pa.....lon or enJaye.nt to el... I (coll.t.,el) b.n.flcl_rl.. a' the d.c.dent .ft., the ..plr.tlon of Iny ..t.t. far
11'. or far v..r., thl Coeeanw..lth h.rebv ..pr...ly r...rve. the right to IPprel.. and ...... tran.f.r InhtrltlnC' ,....
.t the I.wful CI... I Icall.t.r.l) r.t. an any .uch future Int.r..t.
PURPOSE OF
NOTICEI To fulfill the r.qulr...nt. of S.etlon Z)40 of the Inh.rlt.ne. and E.t.t. T.. Act, Act ZZ of 1991. 1z P.S,
Sletlon ZlU.
PAYHf:Nh D.tKh the tap portion of thlt Notice and .ub.it with your p.v.ant to tN R.gl.tlr of WIlIt pr Int.d on tN rev".. .Id..
""Ilk' eh.ek or .an.y ard.r puebl_ tal REGISTER OF MILLS, AGENT
All p.y.ent. r.e.lved .hlll flr.t b. .ppll.d to any Inter..t which ..y b. due with any r...lnd.r .pplled to the t...
REfUND (CR)I A refund of . t,. cr.dlt, which w.. not r.qu..t.d on the Ta. R.turn, ..y b, r.qu..tld bV ea.pl.tlng an -Applle.tlon
far R.fund of PIM.ylv~le Inh.rltancl and ht,t. T..- IREY.UlS'. Appllc.Uon. .r. .vall.bl. .t thl Office
of the R.gl.t,r of Will., anv of the 21 R'v,nu. DI.trlet Offlc.., or by c.lllng the .p.cl.1 Z4-hour
an'Mlrlng ..rvlc. nutb.r. for for.. ord.rlng, In P.nn.vlvanl. 1.100-36l-Z0Sa, out.ld. Pennlvlvanl. end
within loell H.rrl.burg .r.. (717) 717-1094, Taal C717' 77Z-2252 CH..rlng lep.lr.d Onlv).
OIJECTIONS' Any p.rty In Int.r..t not I.tl.fl.d with the .ppr.l....nt. allow.nc. or dll.llowanc. of d.ductlonl, or ......aeftt
of t.. (Including dllcount or Int.r'lt) .. .hown on thl. Notlc. IU.t ObJlct within .I.tv (60) d.y. of r.c.lpt of
thh Notice by,
--wrltt.n prot.lt to the PA Dlp.rt..nt of R.v.ou., lo.rd of App..I., O.pt. 211021, H.rrl.burg. PA 17Ill-IOll. OR
--...etlon to h.v. the ..tt.r d.t.r.ln.d .t .udlt of the .ccount of the p.r.on.1 r.pr"'nt.tlv., OR
--.ppe.1 to the Orph~.' Court.
ADHIN
ISTRATlVE
CORRECTIONS I
F.ctu.1 .rror. dl.cov.red on thl. ........nt .hould b. .ddr....d In writing tal PA a.pert..nt of R.v.nut,
lur..u of Indlvldull T...., ATTH. POlt A.......nt R.vl.w Unit, D.pt. l10601, H.rrl.burg. PA 17121-0601
Phon. C717' 717-6S0S. 5.. pIg. 3 of the bookl.t -In.tructlon. for Inh.rllenc. T.. R.turn fa~ . R..ldant
O.eedlnt" (REV-lS01) for an I.pl.netlon 01 .d.lnl.tr.tlv.ly corr.cttbll Irror..
OISCOUNf I
If .nv t.. due I. p.ld within Ihr.. (3) cal.ndar .onth. .ft.r Ih. d.c.dsnt's d..th, . five p.re.nl CS~) dllcount of
the t.. paid I. '1Iow.d.
PENAL TY I
Th. IS~ t.. .en'lty non-plrtleJp.tlon pen.llr II co.pulld on the totll of the taM and Intara.t .......d, and not
p.ld be'or. JanUlry II, 1996, the flr.t day I,t.r Ihe .nd of Ih. te. aen..ty parlod. fhl. non-p.rtlelpatlon
p.n.lty I. .pp.el.bl. In the .... ..nn.r and In the the .... II.. p.rlod I' you would .pp.II the t.. and Int.r..t
th.t hit b.en .......d .. Indlc.hd on Ihlt notlc..
INTEREST I
Int.r..t I. eh.rgld blglnnl", with flr.t day of d.llnqulncv, or nln. (9) .onth. and on. (I) dlY fro. the dll. of
d..th. to the d.ta of p.y..nt. T.... which b.c... d.llnqu.nt b.far. Janulrv 1, 1912 be.r Int.re.t .t Iha r.t. of
.1. 16~' p.rc.nt p.r annul calcullt.d at . d.lly rat. of .000164. All taMI. which b.ca.. d.llnquant on and .ft.r
Janu.ry 1, 191Z will b..r Int.r..t .t . r.C. which will v.ry Ira. eallndlr y..r to c.lend.r v..r with that r.ta
ennounc.d bv the PA D.p.rt..nt 0' Rlv.nue. 'h. IPpllc.hl. lnt.r..t retl' lor 198Z through 1996 .r"
'!!!! Int.r..t Rat. 0111'1 tnt.rut Factor :!!!!r Int.r..t Aat. 0.11'1 Int.,...t Factor
19IIZ zn .OOOSU 1917 .. .000247
1985 16~ .OOOUI 1911-1991 ll~ .000301
1914 1l~ .000301 I99Z .. .000247
19U In .000356 1993-1994 ,. .000192
1916 In .000214 1995-1996 .. .000241
ulnter..t It c'lcul.hd .. 10110""
INTEREST ~ BALANCE or TAX UNPAID X NunBER or DAYS DELINQUENT X DAILY INTEREST rACTDR
.-Anv Hotlc. I..u.d .ft.r the t.. baeo... d.llnqu.nt will r.fl.ct an Inl.r..t calculation to flft.ln CIS) day.
b.yond the d.t. of the I........,t. If Ply.ent I. .ad. Ift.r tha InC.r..t coaput.tlon data .hown on thl
Hot Ie., .ddltlon.t Int.ra.t .u.t b. calcull'.d.
-6
'v ~..
to p
,0 V}
~'~
a: a:
-
. .
I
/ c -J I, / /,/
.J l/'(('.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
BUREAU Of INDIVIDUAL TAXES
INtlUUtlMCt 'All DIVISION
otPf. 110601
IIAAAn.URa, PA 17111.060l
11,..,"111" In.'"
REGIS J EGAN
MCKONLV 8 ASBURV
PO BOX 1331
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-03-96
PETERS
09-29-95
21 95-0853
CUMBERLAND
101
RICHARD
C
AMount R...Ubd
PA 17105
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
HOTEl To insure proper credit to your eccount, sub..lt the upper portion of this for.. with your t._ pay...nt.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-{v:i6iij-EX--AF-p-rOJi=96i-------.M.--iNifiRiifANCif-TAif-STiifEHifNT-iiF-Ac:Couiif--.-..---------------------
ESTATE OF PETERS RICHARD C FILE NO, 21 95-0S53 ACN 101 DATE 06-03-96
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURREHT STATUS Of THE STATED ACH IN THE NAHEP ESTATE. SHOWN BELOW
IS A SUHHARY Of THE PRINCIPAL TAX DUE. APPLICATION Of ALL PAYHENTS. THE CURRENT BALANCE. AND. If APPLICABLE.
A PROJECTED INTEREST fIGURE,
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 05-13-96
PRINCIPAL TAX DUE. ,00
PAYMENTS (TAX CREDITS),
PAVMENT
DATE
03-04-96
05-24-96
RECEIPT
NUMBER
AA1l2584
REFUND
DISCOUNT (+)
INTEREST C-)
,00
.00
AMOUNT PAID
656,57
656,57-
TOTAL TAX CREDIT
.00
,00
.00
.00
SALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
. If PAID AfTER THIS DATE. SEE REVERSE
SIDE fOR CALCULATION Of ADDITIONAL INTEREST.
I If TOTAL DUE IS LESS THAH .1.
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REfLECTED AS A "CREDIT" eCR),
yOU HAY BE DUE A REfUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
N l~ ":l:
~.'j " 'r._
r.'~ ,-
ri ~
N
'01 !;
"
,
, , ,
(, ;) ~ d~
l!)U.
a:'
PAYtt[NTI
Detach the top portion of thl. Hotlel end .ubalt with ~our pa,.'nt ..da plyabl, to thl n... and addr...
prlntad on thl tavar.. .Id..
If RESIOE:HT DECEDENT .,ke chatk or lonay order paYabl. tot REGISTER OF WILLS, AGENT.
If NOH-RESIDENT DECED[HT ..k, thIck or aon.y order Plyable tal COMHONWEAL TH OF PENNSYLVANIA.
All Ply..nt. r.calvld .hall bl applied flr'l to any Intar..t Which '.y ba due with any r...lndar applied to thl t...
REfUND (CR)I A r.fund of I tl. credit, which wa. not r.qu..tad on the 'a. Aeturn, ..y ba rlqul.tld by cOlplatlng an
"ApplicatIon for R.fund of Pann'vlvant, Inherltanca and E.t,t. r.." (REV.l11)), Appllcatlont .t. IVlllabl. at
thl of,lcI of thl R'II.t., of Will., 'ny of thl lJ Ravenu. DI.trlct O"lc.. Dr 'r~ the D.p.rt..~t.. 24.hour
an"..rlng urvlu nullb.r. 'or 'or.. ord.rlngl In P.nn.ylvanl. l.aoo..su.lOSO, outsld. P.nn..,lvenl.
and within lonl H.rrisburg ar.. (1171 787.a094, 100. (717) 71Z.ZZ5Z CHurlng l.p.lr.d onhl.
REPLY TO,
Ou..tlon. r.g.rdlng .rror. cont.ln.d on thl. not Ie. .hould b. .ddr....d tal PA O.pert..nt 0' R.v.nuI, aur..u
0' Indlvldu.l T.n., AnHI Po.t A.......nt R.vl... Unit, D.pt. za0601, Harrisburg, PA 171l1.0601. phon.
(7171 7U-6S0S.
DISCOUNT I
I' en., tl" nu. I. paid within thr.. C)) cal.ndar .onth. a,t.r the d,c'd.nt'. d..th, . 'Iv. p.rc.nt (5~) dl.count
of the t." paid Is allo...d.
PENALTV,
Th. 15~ ta" aan..ty non.partlclpatlon plnalty I. co.putod on thl total of th. ta" .nd Int.r.., .......d, and not
P.ld b.for. Janu.ry II, 1996, 'h. 'Ir.t d.y aft... th. and of 'hI tlM aan..ty p.rlod.
INTEREST,
Intarllt Is charg.d bIg Inning with first day of dlll"qulncy, or nln. C9J .onth. and ana U) day fro. tha data 0'
d.ath, to thl data 0' pay'.nt. 'aM" which b.ca.. d.llnqu.nt b,'or. January I, I"l b..r Int.r..t at tha rat. 0'
.b C6;() parc.nt p.r lI"nUI nlcul.t.d at a dalh rata 0' .000164. All taM" which b.n.. d.lInqu.nt on and a'hr
January 1, 19.1 ..Ill b.ar Int.r..t at a rat. which will vary fro. clII.ndar y..r to c...ndar y..r with th.t rat.
announc'd by the PA D,part.lnt of R.vlnu.. Th. appllcabla Inl.r..t r.t.. for 198Z through 1996 ar.,
Vllr Int.ra.t R.t. Oalh Int","t factor V..,. Int.r..t Rat, Oalh lnt.,...t faclor
1911 10;( .000541 1981 .. .000241
191.s lOX .ODDli3. 191'-1991 11;( .000301
19.~ 1l~ .000301 1992 .~ .ODD2o\1
1985 13;( .000156 1993.1994 '" .000192
1916 lU .OaaZ74 1995-1996 .~ .ODD247
--Int.....t II nlculat.d .. followlI
INTEREST . BALANCE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Notlc. I..uad a'tar the tlM baco... dlllnquant will ra'llct an Inllr..t calcul.llon to flft.ln liS) day.
bayond the data 0' the ........nt. I' p.y..nt I. ..d. a'tar tha Int.r..t co.putatlon dal. .hoNn on tha
Notlc., .ddltlon.1 Int.r..t .u.t b. calculatad.
-'
JRDlJune 30. 1992117858
RlitWiTmt OF WILlA')
CUlllhrrlund Counly Courthouse
One Courlhouse Square
Cllrllsle, PA 17013
NOTICE PURSUANT TO RULE 6,12
PENNSYLV AMA SUPREME COURT ORPHANS' COURT RULES
To:
Personal Representative
Counsel:
DONNA ')'AYI.OR PE'I'ERS
RE: E&tale of 11ICIIAIlD COl.MAN PE'I'ER,!:Deceased, Lale of
CAMP II lid. 1l0llOUGlI
E&tale No,: 21 - 1995 - 8 5 .3
Dale of Decedenl's Death: 9-29-95
Pursuant to Rule 6,12. the above named personal representative or the above named attorney, if
applicable, within two (2) years of the decedent's death, and annually thereafter until administration is
completed, is required to file with the Register of Wills a StalUs Report as required hy Rule 6.12. in
substantially the prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed, The purpose of this Notice is to advise
you that unless the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriale, 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 detennine whether sanctions should be imposed upon the
delinquent personal representalive and the delinquent personal representative's counsel, if any,
Accordingly, if lhe requisite StalUs Report is not filed by 11-10,19,2,7 you are hereby
advised that a request will be submitted to the Court in accordance with Rule 6.12,
Date: 10- 22 -97 "l"~/.L\,q C"XLu~-1-'?-1 lit} VI :WI(l'~ftf'J
Deputy Register of Wills .
Distribution 10 Estate File
~ ..
I'
I,
.I
STATIlS REPORT UNDER RilLE 6.12
Name of
Decedent I g;~ tr. cI /!:; /;V, AN
Deathl ,.6,'ll,.",pt'.<: ;<~I /'1f';;-
, ..
'J
IF
c-7P h)~
Date of
Will No. ,;l" I /9 9 ~- "y> 5'3
Admin. No.
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, I report the [01 lowing with respect to completion of
the administration o[ the ~bove-caplioned estatel
I. State whether administration of the estate is complete I
Yes X No
2. If the answer is No, state when the personal
representative reasonably beiieves that the administration will be
complete I
3. If the answer to No. 1 is Yes, state the followingl
a. Did the personal representalj~ve file a final
account with the Court? Yes No ,IV/H
b, The sepal'a te Ol'pll<lnS' Court No. (i f any) for
the personal representative's account is: A/;I/-+
c, Did the personal representative state an
account informally to the parties in interest? Yes No
;t/ /4-
/t'j A'"
L le-d'J>':i-C ''I'' a,"_~(.((;.L-I__
.f _/1'
t'l,..-L.-" (/'" v 1+// 'J ~ 11'1 7
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 repp7't.
;( < /J. ;\1/4-
Date: /(1/1.7 /'/7'x,k.,...,....) J f'A..;t;;.,J
, Signature
.2)"AlN'" T IlrEtt?5
Name (Please type or print)
$1.:1. /} /I..,,,,,,e ,...' ,o^,,,/,,,
/l1t"c,1'f,v;c", /J",,,,<, ',/'ft / 7o':'-~-
Address I
+... [I",,,,,, r7:':41"",...
~~... S/.t Kilt-''''/i.", [I~,
~ ,-., //'''-hallicuA'''''1,---,.J;l,.
/ 70 ::.-s-
!:Z?1-LZj't' - ?,?f{,'1
1'e I, No,
Capacity:
X Personal Representative
Counsel for personal
representative
717- tyo - tit, '? J