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HomeMy WebLinkAbout95-00926 ft\~\~{~~~::" ." ,~\' '.,,,', ~ f." ,:,' , . " : -- ; ~:" ;" , , .' ; c~ -";':;: " l.t . _ ',. " \, ~:;"(>:\'_ ,'~,V': '<:, ';'q .. ';' :".-: -':\ i,I; ':;~~'!'L:\::,;~:i,i.,,;:,-, :,' ...: ;'", '. ,-,::"i: :, -'''-, \ ::. ,,' - -,.-,;.::', :.-: ; ,': '..- '. -- " ,., ,';'- :".;'-: ...:i",,:' .'~',-;-, ,;,,:., :-,':'~, _,:: ",,'-\;': ;,:>:;:.>., : ," '.i:,;'.',.-:--;;: :,', :. ,'C: c,,_ '.. ~,:;-~ :-:,:::::-::~.::::,;:jc*~:':; '. ..,;<~:, j;,:-> "'.. /;.:,,;,.., ':::;.:;.. ,::,;:-:" ",,; ,y, :~i:::;. Jrj,,: ",,:-,.:! : ' ,,-;:>. ',' ",' -,' ,::-~:-,::': "j-:f",":"',, ':-: .': '" ,,", ,', " ," :, ,- , ':- '. '..' '" ,c" ',," _ "" ,,-,. ."- .::; - i; ,':':~' ,:, :;:-:;::/.~:::; :'. ,:': : - ,,', ,: F; I: ::,,-,:>, ": ';.;:,:;-,:;:::;>, i;'::: :'>:d ,''''.': ":." :;,,;, " ._:.:,',<;~~',: ,i;. ?' ..' .. '-"-;':''-:'i-'", --. .. i '::' ". q: , ,c,' :,- ,'r. :,:".,.:., ,,' ". '" ::, ',:,,,,;,: ";;.. -:;;',,;-: ':: .. ? ' .. .' -\-',/: F.-'" ' .- " . ;: .. "V,i':~ 'L"";:J ~';':,-.:'" :.: ;"', -';,' . ; ;,c'!,,:. :rS;','f .,'" ,;'. :i;!~r~: ";~:~"::'\', : ~ 1,1 :" ';". ~~;1{ .. I' ';;" ~~ ,.: ,.,..,. t~~l}~r:~ ,'; " -;~{j,.;,-:<, :'" ~~:~/ F~;:/ ~:::~ ,i~ .,- ',' :. ,~ . . <...,.' ," ::;T, ~.:r~_~;~ ~;i , ?! .it. .-.< :.":3; '\" " ,. .riP,- PETITION FOlt pnOUATE I1l1d GnANT 0... LETTEltS .;< J~95 - 'tc?- ie_____ IMall' oI __Celesta E. si/1l11Ol1l3 al.m kill""" "' _Celesta .Iwclyn sinmona No. 10: ____~___. Ill'~i'll" of Will, fI" Iho ______.____.. . Ilt'''"'II,,'tI, l'olllll)' of . Cunbcrland._. III SO..;III SI,..",;I.\' No, ,..184-12-3666 l'Olllllloll\\ollllh of 1'01l1l,yl'lIl1ll1 Tile perllloll of Ihe IIl1do"i~II",1 ,,"p"',III1I1)' "'I""''''III' Ihal: Your pClhl{lfIcr(tO, \\110 i\/Dr IK )"CUI!ol of 1Il!1' HI ohl,', 1111 thl.' l'\l.....lllor In Ihe hili will nf Ihe IIhnve de,edonl. dlllo<l __Hay.19, IIn<l eodldl(" lhno<l ---None--... __ __ _________..__ nlllno<l "..___________.11)77_ 1\IUlC,' It'll'\illll ,"irnlll1\lilll\'l'\, ,...., Il'lllIlIl.:lalitlll, tkilllllll"\l'(llllll. CIL',) l>ecellJlenl WII' dnmlcilod III <loalllln ..CUIIb&t"land---- ...____._____Collnl)'. l'enn,yl'lInlll, wllh her hili rlllllil)' or prlndplll ",Idonco aI "I_South LocuBt_Point--Road,_Mon~.,. Jlhip,-LHcchaniCBbuJ:9_Post_officc,_.17055) ('o..-hQrland-County,-PA (Ihl \IIl"'I, IIlllllh,', illlllllllllldp"llI)1 l>eelJldenl, Iholl_72__ YOll" of IIge. <liell..NoveuDcr...28 .11).95_, III ItA,..,. 1 Ahucg Iln"l"'ital,_lIarrisburg,.PA__ __ ___________ . EX,"pIII' follnw,. d"edolll did nolmllrr)', WII' 1101 <li""rce<lllml did IInl have II child born or IIdopled ufler execollon of Ihe will offorod for pmbale; wa' nOllho vicllm of a killill~ IIl1d WII' IIOvor udjlldlcalod lncnmpelelll: _No_exception ._____ Deoclldonllll delllh owned p'opOrl)' wllh e'llmaled vallles as follows: (If dOllllclled In I'll.) All pmonal pmporl)' $ Undetermined .J (If nol domiciled In I'll,) I'emllllll pmpcrl)' In l'enns)'Il'lInlll $ (If nol domiciled In I'll,) I'ersolllll pmporl)' In COllnl)' $, Vulue of real esllne In l'enn,)'Il'anlll $-NonD sllualed liS follows: WHEREFORE, pelllloner()j respcclfull)' roquell(s) Ihe Ilmhlllo nf Ihe 111'1 will lUlllxmxlliiDl(x) prCleflled berewllh IInd Ihe grulllof lellers_Testamentary (IL'\llIlIWlllllJ)": 1Ullllini\tlillitlll L',t.il.: lulmlni'II,lIitll1 LI,h,II,l:,I,ll.) Iheroll, t "'- 'ot ~g C':: ~'- -:;;i 1l~ ao [ Vi /.) /), - _~~~~!:.?:.-~_u~t2~~:f~.;~~.L!~2r~;J\ _ &,00,1>1 M._SimoclnS,...Jr. --l-SOuth-Locust-Point-Road---- _Mechanicsburg,.....l'A.J.7055__ OATH OF PEltSONAL ItEl'ltESENTATIVE COMMONWEALTII ()Jo' PENNSYLVANIA }:l:l COUNTY OF LUlBERLJIND The pelllloller(llllhol'e'"llllled ,wear(,) or IIffirlll(l) Ihllllho '1IIIClllelll' inlhe furogoillg pelllloll lire Irlle ulld cor reel 10 Ihe hOIl of Ihc kllllwledge ulld heliof of 1'011l101lerlx)lIlId Ihlll "' pemlllal rcpresen- IUllvc(Jd of Ihe uhow deccdolll POliliouor(w will wcll '~llllrllIY 1I<IlIIllIi,ler Ihe eslnle IIceurdillg 10 hIII'. , . I' .,~ Sworn 10 or umrmcd Ulld II,h.\Cribo<l 1-_.,::a:...:~.--.-/.2~'!'?'-" ,~a.1:/-2) (" beforc lIIe Ihl, __Il:h-__ dll)' of ~___SaIooc~.M._SimJDns,_Jr. '-~' llecetLN' :::r;------- 1'195_. q _____ _u__... _...... a ~~~y.K.u.~pJg.f!.'!!.^Q if'-"-"-"~----------- ~ aryc . LeW1S UI'J.:i.\I(" ~________._.___._~___.__ :s: IS 7;1-::1.. Ihc 21-95-926 ~ ~ '~~'L --,.... . ~- !,,; - '"y .,~ -- L. ~ '-\- ",' ':';":<.' :,,; LAST WILL AND TESTAMENT I, CELESTA E. SIMMONS, of the Township of Monroe. County of Cumberland and State of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my last Will and Testament, hereby revoking and making void all former wills, codicils and other testamentary dispositions by me at any time hereto- fore made. 1. I direct my Executor, hereinafter named, to pay as soon as prac- ticable after my decease all my just debts and the expenses of my last illness and burial. 2. I give, devise and bequeath all of my estate - real, personal and mixed - unto my husband, Samuel M. Simmons, Jr., absolutely. 3. Should my said husband predecease me, then and in that event I give, devise and bequeath all of my said estate unto my son, Samuel M. Simmons, III. 4. I nominate, constitute and appoint my husband, Samuel M. Simmons, Jr., executor of this my last Will and Testament. Should my said husband fail to qualify or cease to act as executor, I hereby appoint my son, Samuel M. Simmons, III, executor of this my last Will. IN WITNESS WHEREOF, I, CELESTA E. SIMMONS, the Testatrix, have hereunto set my hand and seal to this my last Will and Testament on this /9~'day of 17,] , 1977. ~'/ .--c:e::(..4J, Z- P ---L:. r ... ......---. (SEAL) Signed, sealed, published and declared by the above named Celesta E. Simmons as and for her last Will and Testament in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. O~"r. .-S, '-<~'(/I {," ~_.~ r>1( ~ J' . ., t", '7 / t( OOl'ICE OF n~EFJCIAL INTERFSl' IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTi' OF CUMBERLAND , PENNSYLVANIA In re Estate of Celesta E. Simmons, a/k/a Celesta Evelyn Simmons, deceased, No. 21-95-926 of Cumberland County, PA TO: Samuel M. Simmons, Jr. (beneficiary) 1 SOuth Locust Point Road Mechanicsburg, PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate as follows: Entire Probate Estate All property owned in joint names as tenants by entireties (if additional space is needed, use back of page) Name of decedent Celesta E. Simmons, a/k/a Celesta Evelyn Simmons Last known address 1 South Locust Point Road of decedent Mechanicsburg, PA 17055 Date of death November 28, 1995 Place of death Harrisburg Hospital, Harrisburg, PA County of grant of original letters Cumberland Decedent died X testate. intestate. A copy of the Will X is attached. is not attached. Name(s) , address (es) and telephone number(s) of all personal representatives appointed Name Address Telephone Samuel M. Simmons, Jr. 1 South Locust Point Road (717) 766-3375 Mechanicsburg, PA 17055 ..' Name(S), address(es) and telephone number(s) of sll counsel Telephone Address ~ William L. Sunday (717) 766-9622 . 39 West Main Street-ste 1 Mechanicsburg, PA 17055-6230 Additional information may be obtained from the undersigned. Date February I"! 1996 Si9nature/1U~...," ../ ~W7" Name William L. Sunday Address 39 West Main Street - ste 1 Mechanicsburg, PA 17055-6230 Telephone (717) 766-9622 Capacity: personal Representatives X counsel for personal representatives ,; 4 _ : j IOl'ICE OF BareFICIAL IN'l'mEST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA In re Estate of Celesta E. Simmons, a/k/a Celesta Evelyn Simmons, deceased, No. 21-95-926 of Cumberland County, PA TO: Samuel M. Simmons, III (beneficiary) 72 SOuth Locust Point Road Mechanicsburg, PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate as follows: one (1) Certificate of Deposit issued in names of Celesta E. Simmons and Samuel M. Simmons, III, b PNC Bank on Au ust I, 1994 Six 6 U.S. Savln s Bonds Ser es EE ssued in 'oint names as above if addit onal space is needed, use back of page Name of decedent Celesta E. Simmons, a/k/a Celesta Evelyn Simmons Last known address 1 SOuth Locust Point Road of decedent Mechanicsburg, PA 17055 Date of death November 28, 1995 Place of death Harrisburg Hospital, Harrisburg, PA County of grant of original letters Cumberland Decedent died X testate. intestate. II copy of the will X is attached. Name(s), addressees) and telephone representatives appointed is not attached. number(s) of all personal Name Address Telephone Samuel M. Simmons, Jr. 1 south Locust Point Road (717) 766-3375 Mechanicsburg, PII 17055 . - .. ----.---.......-..-.- -.... :.---. Name(s), address(es) and telephone number(s) of all counsel ~ Address Telephone William L. Sunday 39 West Main Street-Ste 1 (717) 766-9622 Mechanicsburg, PA 17055-6230 Additional Date February 13 , information may be obtained from the undersigned. Signature .~ "'/....L,.".~1' Name William L. Sunday 1996 Address 39 West Main Street - Ste 1 Mechanicsburg, PA 17055-6230 Telephone (717) 766-9622 Capacity: Personal Representatives X Counsel for personal representatives " J NOTICE OF BmEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA In re Estate of Celesta E. Simmons, a/k/a Celesta Evelyn Simmons, deceased, No. 21-95-926 of Cumberland County, PA TO: Samuel M. Simmons, IV (beneficiary) c/o Samuel M. Simmons, III, parent 72 South Locust Point Road Mechanicsburg, PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate as follows: One (1) U.S. Savings Bond Series EE issued in names of Celesta E. Simmons or Samuel M. Simmons IV on May 26, 1987 (if additional space is needed, use back of page) Name of decedent Celesta E. Simmons, a/k/a Celesta Evelyn Simmons Last known address 1 South Locust Point Road of decedent Mechanicsburg, PA 17055 Date of death November 28, 1995 Place of death Harrisburg Hospital, Harrisburg, PA County of grant of original letters Cumberland Decedent died X testate. intestate. A copy of the Will X is attached. Name(s), address (es) and telephone representatives appointed is not attached. number(s) of all personal Name Address Telephone Samuel M. Simmons, Jr. 1 South Locust Point Road (717) 766-3375 Mechanicsburg, PA 17055 , , I' , ' . . ..... ,- Name(a), address(es) and telephone number(a) of all counsel Telephone Address (717) 766-9622 Name - 39 West Main street-Ste 1 William L. sunday Mechanicsburg, PA 17055-6230 Additional information may be obtained from the undersigned. Date Februarv IS. 1996 Signature :&~....,~ '/:"'["7' Name william L. Sunday Address 39 West Main Street - ste 1 Mechanicsburg, PA 17055-6230 Telephone (717) 766-9622 capacity: personal Representatives X counsel for personal representatives " .. ~.. ~.. ... .. .~. -0 . , --I~f~j~.E!;~!t!~~~f'J\\:~~j. RECEIVED FROM, I ACN ASSESSMENT Ii' CONTROL ~ NUMBER AMOUNT SUNDAY WILLIAM L 39 W MAIN STREET 101 ..,,'tl:!.bl MECHANICSaURG, PA 17055 'OtDHftl_ ESTATE INFORMATION, 1:1 FilE NUMBER Y 21-1995-0926 1:1 NAME OF DECEDENT (lAST) ~ SIMMONS CELESTA E II DATE OF PAYMENT EJ POSTMARK COUNTY SSN 104-12-3666 (FIRST) IMII CUMBERLAND DATE OF DEATH REMARKS m TOTAL AMOUNT PAID $942.67 CW SEAL SAMUEL M SIMMONS JR CIO WILLIAM L SUNDAY ESQ CHECK" I REGISTER OF WI LLS (\ .. RECEIVED BY ~f:A., , \./ '/"(/"1' ,.r.:..J MARY C. LEWIS 'I)/.y", A.'/" r. REGISTER OF WILLS .' " ' ---- .' -_..-._.~_.~--.--.......;......~ -'~,-.. ...~.. ,. . COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND III SllInuol M. Sirllllons, Jr. baing duly swor!) . according 10 low, dopa... and ..y. Ihol ho ill the Executor 01 Iho E".lo 01 ColQ.s"il-.!,._ Si"mon~_.. ._ __~..._.____.._... 1010 01 U' Monroe Township .., Cumborlond Counly, Po.. doc.o.od and Ihot Ih. within Is on inv.nlory m.d. by !lim ._, Ih. ..Id_ _1':.xes:!JtQr _n"_'" 01 Iho onliro o"oto 01 .old d.cod.nl, con.lstlng 01 olllho p...onal prop.rly and r..1 ..1010, oxcopl rool ..1010 ouhld. Ih. Commonw.ollh 01 P.nn.ylvonl., and Ih.' Ih. IIgur.. 01'1'0.11. o.ch lI.m 01 Ih. Inv.nlory r.pro..nl 11'. 1.lr voluo .. 01 Ih. d.lo 01 d.c.d.nl'. d..lh. ^j19ust , 27 1911iL_ /, .ff . /.,/ ""t~('/",;,,! ~ ,-'-.,r /h~1<N~.f//;:/t..~-:!-"',:!.:.c:.-..~.9L.. .. . Samuel M. E..,ul., .lNINlolslflltOK Sinmons, Jr. Swor.fi.-t2..- .nd .ub.crlb.d b.loro m., 1 5.., Lqcl!st!.'o,i~!;..Il.~d I. Nr ,t'I," SUdl Chl1rli n V. . ,;.m.L':r., NJ!;'lIY l'u~'iC . Mocniln~:;lll."U uo~..." r.L:n~!,I~!' - ',j CO,unl{ My COlllltll5~IOI1 E.P.Il~'~' 10, lUl.10 Mcrri>t1f, PL'fll'lSy1""Jrll..lfo~ltJJn ot NotanuS Dol. 01 O.olh .,_. .,... 2..81<.IL. ...._, ____...._, __._.lio'y~.!!lQer::....___.. O.Y Month j . f:1..ech~!l.!csbu~!_.R.~ 170?~_.. .. ___u_ ..._ Add,... 1~95 Vu, INSTRUCTIONS I. An Inv.nlory mu.1 bo llI.d wllhln Ihr.. monlh. .1I0r appolnlm.nl 01 p.rsonol roprOl.nlotlv.. 2. A .upplomonl Inv.nlory mu.1 bo m.d wilhln Ihlrly d.y. 01 dlscov.ry 01 addition. I ....h. 3. Additlon.l .h..h may b. o"och.d a. 10 p.rsonolly or r.ally 4. S.. Artlcl. IV, Flducl.rl.. Acl 01 1949. ~ i ..,; w .. ~ ~ ffi ~ 1 " II a.. VI u 0 Vl II .. 8 w . C '" ~ IX w c.l " .. ~ a.. -' LL .,; a.. E Z ..J ~ 0 ~, a.. 0 LL :I: W 0 <( ~ t- <( > Z IX Z 0 c ~ c " II) Z ~ U 0 IX Z W <( ... a.. " c - " "l: 0 II -" "0 ... II E - .. 0 " " it 0 ..J U CD ,;2/-95-//.21.,' Inventory of the real and porsonal ostale of celesta-E.-51mmons-------- ____. deceased o. ____..... ...__.______4. ----.--.- .' _._,.~. ._.~_m+ _n._'_".'___" . PERSONAL INVENTORY 1. Interest Checking account .50-7ooB-4943 in PNC Bank Balance date of death Accrued interest date of death 2. Contents of Safe Deposit Box owned in separate namo of Decedent Ladies SOli tare Diamond Ring - 10 pt. Man's Stick pin Variety of Wedding bands and Stone ring old chain Ladies closed face pocket watch pin Wrist watch (broken) 3. Household GoOds and Furniture Oak kitchen cabinet Refdgerator Electdc stove Automatic washer and dryer Round oak table Color Portsble TV Color Console TV (Old) Cedar chest Recliners 2 lamp stands 3 pc bedroom suite Refdgerator Asst. dishes, pots/pans 4. Ladies 5 stone ring 5. Ladies 2 stone ring 6. Ladies 40 stone ring 7. Premium Refund - AAA Life Insurance Company Accidental Death Policy f" '.J ~-~. TarAL PERSONAL INVENTORY L~ r,_ f"'... r-.j n ~-:] f"CL u: "; fh ~tJ uu I 2601 71 95 4B 00 25 00 20 00 10 00 75 00 No V lue No V lue 400 00 100 00 50 00 200 00 200 00 50 00 25 00 75 00 25 00 25 00 150 00 200 00 100 00 300 00 400 00 300 00 25 09 $ 5405 75 R(Y. UOO U. l,Q"1 ~ ..""" blg:~ :c09 U~aI c ~tJ )5- 702-;J..., INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 'OA OATIS 0' DIATH AnER 12/31191 CHICK HERI I' A SPOUSAL ~ P()VIATYCA!~IT IS ~C!Alr,U~D~ I). flU NUMBER 21 >- ffi fil ... w o ,;,>- wffi "'''' "'z 8~ z o 5 => t: !:c ... w '" z o fi 0- .. ~ :II o ... COUNTY CODE 95 926 YEAR NUMB!R tUClOIUl!l (O"'NIfI AIlOIIU 1 South Locust Point Road Monroe Township Mcchanicsburg, PA 17055 -. e"'~'r.C;;_h~HWil ",,,"uel;o,,,,..-- All property owned as tenants ___~_ by~.~entireties [J 3. Remainder Return . (for dole' 01 death prior 10 12.13.B21 b(] 5. federal hlale To. Return Required LB. Tolal Number of Sa'e Depo,il Bo.., (SI -22l0L56 1111 1121 1131 1141 5405.75 16695.81 o 16695.81 COMMONW(....\lH Of pfNI4!oVlYAt~I" DIP....RlM(Nl Of IHY(NU( orPl 210601 H~~IIISlUR~!_~~ 1'_1_1~.:.Q~_' DI(IlJINt'!i NAM( IlAn, 'IU ,A"O MIOOlllt~IIIAll Simmons, Celesta E. =;~:;,~~u;~~6 ~-J::::::'~l:-~t::':("~~- l" "'''1(101111 IU'WIW,toQ 'I'OUU I ".....1111'1 "Ul ...0 "'llt>r, ..11,rl', !IOCIA' !I1l:G"'" n\n;,.a1 I Simmons, Samuel M. .J~__ ~~187-15i~6oo4~ !Xl 1. Original Return (J 2. Supplemental Relurn o 4. limited Estale rJ .10. future Inleres' Compromhe (for doles of death ofter 12.12.82) 0Cl6. Decedent Died Teslale [J 7. Decedent Moinlained 0 Living TrUll (Anoch cop)' of Willi (Anoch copy of T'USI) ALLCORRISPONDENCE AND CONFIDENTIAL TAlC INFORMAnON SHOULD BE DIRECTED TO. NAM( (OM'LIU MAlIlUO AODIIU William L. Sunda 39 West Main Street - Ste 1 HU'HON( NUMIU 717 766-9622 Mechanicsburg, PA 17055-6230 1. Real E.lote (Schedule A) 2. Stocks and Bonds tSchedule B) 3. Clolely Held Sloc~/Portnenhlp Inleres' (Schedule C) 4. MOr1gog.. and Noles Receivable (Schedule D) 5. Cosh. Bank Deposils & Miscellaneou. Penonol Proper'y (Sthodulo EI 6. Joinlly Owned Property (Schedule f) 7, Tran.lon(Sthodulo GllSthodulo II 8. Tolol Gran Anell (tolalllne. 1.71 9. funeral Expen"., Administrative CoSlI, Mlscelloneou, Ex pen". (Schedule HI 10. Oebll, MOr1goge lIobililies, liens (Schedule I) 11. Tolol Dedudlons (10101 lines 9 & 101 12. Nel Value of Eslole (line 8 minus line 11) 13. Choriloble and Gove,nmentol Bequesls (Schedule JI lA. Net Value Subjecllo ToxlLlne 12 minus line 131 15. Spousal Tronl'e,. (for doles of death after 6.30.9.41 5.. In,trucllons for Ar,pllcoble Percenloge on Revene Side. (Indude values rom Schedule K or Schedule M.) 16. Amoun' of line 14 loltoble at 6% role (Indude voluII from Schedule K or Schedule M.) 17. Amoun' of line 1.4 to.able at 15% rote (Indude va lUll from Schedule K or Schedule M.) 18. Principal tOIt due IAdd lox from lIn.. 15, 16 and 17.1 19. C"dill Spousal Poverty Credil Prior Paymenls DIscounl + ..st42..6.7_ +_49~.61_ - (1)_0 (2) 0 13) 0 141 0 (5) 5405.75 16) 10157.81 171 _6538.00 (9) -B.311.69 1101 8..60 (151 None_TaJH!ple~_a_ ~ ~_.,O_. (161 __t66~~..Bl______._. ,06 . (171 o x .IS . __0 --1001..7.5 -.0 (101 lOOt. 75 992.28 1191 120) 21. If Line 18is greoler ,hon line 19, enler Ihe difference on line 21. This Is Ihe TAX DUE. A. Enler theln'erest on ,he bolonce due on line 21A. 8. Enler the tolol of line 21 and 21A on line 218. Thi' I. ,he BALANCE DUE. Make ChICk Payable tal Reghter of Wllh, Agent 121) ___----9..47 f21AI ___0_ 1210) ___--9~47 Inle'"' :l 0- 20. If line 191s greoler Ihon line 18, enler the difference on Line 20. This is Ihe OVERPAYMENT. aD Chode horo if you 010 rlJqulJsling a rofund of your o\l'lJfpaymont. ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH aOI( aOI( Under penollies of perjufY, I declare Ihal I hove lIlComined this relurn, Including accompanying "hedules and Ilalemenh, and 10 the besl of my ~nowledge and belief. ills true, correct and complete. I declare that all rool estate has btlen lepollecf at true mafkel valuo. Declorolion of preparer other than the penonal representative Is baled on all Information of which pfeparer has any ~nowledge. !lICiNA1UI' Of PfR!lON IIU'OU!l"_. fOil 'lUNG IIfTUIlN Aoi.l~n~fsoufh"-Locust[joint^ Road-~ DAn "~iJ'f1r"r~?t;'i . ,,, ;,f.N.ftf~ui)-.<>";,,,~~C~:~~C~b~~/A~r055_--~_---_u-~ _, ~m.t~~-_1u/7- ___ '.~. _ t1ec:amcsgurg, J;~ 7055-6239 ~ .~--- AIJ9USr.;Z--1996, <>. ~_ll9lJ.!"!:_ 017 _1~~~6~ '. .' Act '48 of 1994 provIde. for the reduction of ,he tax ra'e. Impo.ed on 'he ne' value of Iran.fer. to or for the u.e of ,he .pou.e. The rate. a. pre.crlbed by the .Ialule will bel e 3% (.03) will be appllcoble for e.lole. 01 decedenl. dyIng on or after 711/94 and before 1/1/96 · 2% (.02) will be applicable for e.'a'e. 01 decedenll dying on or after 111/96 and before 1/1/97 · 1% (.01) will be applicable for e.lale. of decedenl. dyIng on or after 1/1/97 and before 1/1/98 e Spou.al Iran.fer. occurring an or after 1/1/98 will be exempl from Inheritance lax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (..-) IN THE APPROPRIATE BLOCKS. * u.s. Series EE Bonds in name of decedent 1 Old decedent make a transler and: and son and grandson and found in joint Safe . Deposit Box in names of decedent and her husba d a. retain ,he use or Income 01 ,he property tronslerred, ....................................................... *x YES NO b. retain the right to deslgna'e who shall use the property 'ranslerred or its Income. ............... *x c. re'aln a reversionary Interest; or ................................................................................... *x Ii j I I d. receive the promise lor IIle 01 either payments, benellts or care9 ....................................... 2. IF death occurred an or beFore December 12, 1982, did decedent within Iwo years preceding death transFer property without receiving adequate conslderatlon9 II death occurred after December 12, 1982, did decedent transler property within one year of death without receiving adequate consideration'. ....... ................................. ...................... .......... ...... .................... x 3. Old decedent own an 'In trust For' bank account at his or her death9...................................... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FII~~IT AS PART OF THE RETURN. 1! . 9). v.' L7. [8' ./', ::1\' '\ ill ~ " t ! . , ; " IfY:150J U + 1".U) ,,~:~'9l\ ...\~.u; COMMONWfAl'tt Of '[NN'YlVANIA. INHfIIIl1ANCt "". .(tURN .UIDfH' DICIOfHl SCHEDULE A REAL ESTATE I i , I I i i I ESTATE OF FILE NUMBER Celesta E. SilTlllOns 21-95-926 (Prop.rty lolntly-owned with Right of Survivorship mUll b. dlulo..d on Sch.dule F) All ,,01 ..Iat. should b. ,.port.d at 'air morlt" valu. which I, d,flned 01 the prlcl at which prop.rty would b. .achang.d b,twI.n 0 willinG buy., and a willing ..II." nelth., being compelled to buy or ..U, both havl",p.alo"~bl. Ic~owl.dg. 0' the ,.I,von' 'actl. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. See Item 11 Schedule F - Jointly OWned Property o _ T~~~LJAh~ ~n~~r ~" I~~! I, .Rec~pl~ulotion) (II more 'pace is need.d. in.e,t oddi';ono/ ,he.II 0' some lin.) s 0 " IIIY.)'SOJ III + ..-161 ~j;& COMMONWUl1H 0' PumimV,tNIA INHUIIANC( IAlIll1UIIH IIUIOEN' DEClDENI SCHEDULE B STOCKS AND BONDS I ESTATE OF FlU NUMBER Celesta E. Simmons 21-95-926 (All properly lolnlly-owned with RighI 01 Survlvonhlp mUll be dluloud on Schedule F.) ITEM NUMBER DESCRIPTION I. See Items 1 and 2 on Schedule G T~ansfe~s VALUE AT DATE OF DEATH o 2 See Items 6, 7, 10 and 13 A on Schedule F - Jointly-owned prope~ty o " TOTAL Allo enler on line 2# Reco ltulallon lIt more 'pace i, nlud.d, in,.,' odditional .h..l. o/.ome lin.} s 0 1I1"'OII'tlll'l ~~..~~j- (l)MM(,lIIW' All II Uf f'ltlH!l'I\I~II'A lNIIIIU1ANn 'AX .UUIN .___... __, '~.SUll!~'.~(tt~!N' _ __ .__-.. ES1ATIOf- ._-- SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY .. _.. Ploo.o. ~ri~1 or lyl'o,... . filE NUMBER .____n___._ . Cele.s.ta.~. Sin11lOI)s..._.__.. . . u u.. .. . ... .._._mn'.__.___ 21".95".926._______.._n_.._ t~~I_ ~_~~P!I!" 1!1~!I~'?~.,:,!~~~!~~~Dhl_~!!~!..v_I_~!.!'~T_~~..~~~!!~~~(~ Qn_Sch~ul. !J___ __+_ .__ ._. .-----.--- ---.----- -- .-- ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. DESCRIPTION VALUE AT DATE OF DEATH __. ___.__ .__._ ________ __. ......~___.._..~~.._._ _._____h..._.n.__._u.___ _~______..~._.___. --.--_.~._- .- .--- Interest Checking account 150-7008-4943 in PNC Bank Balance date of death Accrued interest to date of death 2601. 71 .95 Contents of Safe Deposit Boxowned in separate name of Decedent Ladies Soli tare Diamond Ring - 10 pt. Man's stick Pin Variety of Wedding bands and Stone ring Old chain Ladies closed face pocket watch Pin wrist watch (broken) See Appraisal attached lIousehold Goods and Furniture Oak Kitchen cabinet Refrigerator Electric stove Automatic washer and dryer Round oak table Color Portable TV Color Console TV (Old) Cedar chest Recliners 2 lamp stands 3 pc bedroom suite Refrigerator Asst. dishes, pots/pans 48.00 25.00 20.00 10.00 75.00 No Value No Value 400.00 100.00 50.00 200.00 200.00 50.00 25.00 75.00 25.00 25.00 150.00 200.00 100.00 Total @ appraisal $ 1600.00 See Appraisal attached Ladies 5 stone ring ) Ladies 2 stone ring ) Ladies 40 stone ring ) 1600.00 300.00 Valued at appraisal attached 400.00 300.00 Premium Refund - AM Life Insurance Company Accidental Death Policy 25.09 _______ _________________o.____.~._____~_.__'____ -------.--.--...---.-. _!C?TAL (Ah~~~_o-".!i!~~!_ Rocoeilulollon) L--5405.75 1^lInch uddilionol BY." IC 11" "leeh if mOJe ,PQt. II needed.) IIYU!""., 1""' ,tttlj. COMMOtlWI"'ITIt Of """"I'o''''IIIA 'UllunAUCI tAl .nUIU4 .. "OfUJ D(CIVWI SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OF Celest~ E. Si~~..._.._...___. ,_.. _.-------- - ----IF'LENUMDER 21-95-926 ..~ n__~.___..__.__..._'____.. ___.____n.___________________ Joint '.nontlt)1 NAME -----.---- A. Samuel M. Simmons, Jr. _ ___~_I\l!.ll!E~L_ 1 South Locust Point !load Mechanicsburg, PA 17055 .__ ._._ RElMICl~SHI~_ TO DECEDEI!!.-. lIusband B. Samuel M. Simmons III 72 South Locust Point !load Mechanicsburg, PA 17055 c, Samuel M. Simmons IV 72 South Locust Point Road Mechanicsburg, PA 17055 Jolntly.own.d property, ITEM NUMBER LE"ER FOR JOINT TENANT A 1/1/79 Savings Account #50-3000-1927 in PNC Bank Balance date of Death 15563.78 Accrued Interest to D/D 7.02 1/1/60 Interest Checking Account #50-7oo8-49B6 in PNC Bank Balance on date of Death 6408.34 Accrued Interest to D/D 4.37 1/1/79 Passbook Savings Account #50-3000-4929 in PNC Bank Balance date of Death 30542.62 Accrued Interest to D/D 27.66 8/20/85 Money Market Account # 50-3012-3776 in PNC Oank Balance on date of Death 35786.89 Accrued Interest to % 55.94 8/25/9~ Certificate of Deposit # 21001012439 (formerly #182129) issued by PNC Oank on 8/25/94 Balance date of Death 10000.00 Accrued Interest to D/D 134.13 1994 One (1) $10000. U.S. Treasury Note, 6.25% in names of decedent and spouse Value date of Death 10050.00 Accrued interest date of Death 152.82 DATE MADE JOINT DESCRIPTION OF PROPERTY TOTAL VALUE OF ASSET 1. 2. A 3. A 4. A 5. A SA. A Son Grandson DECD'S DOLLAR VALUE OF % INT. DECEDENT'S INTEREST 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% (II mar" 'poce i, nuded inuit' odd/lionul tllfl,,,II of lome lize) TOTAL (Aha enter on line 6, Recopilulallon) 50% -~-_._--_._-~-------------- Exempt - Husband and Wife Account Exempt - Husband and Wife Account Exempt - lIusband and Wife Account Exempt - Husband and Wife Account Exempt - Husband and Wife joint owners Exempt - Husband and Wife joint owners s o IfVIW)fI"III"J 2. ~~ SCHEDULE F COMMO"W""1l O. "",,,,,v'"'' JOINTLY-OWNED PROPERTY INI:~;:~Af~~fD'f~"f~:~~RN ___ (CXNrINUE01-_.___._~___~_ .______.____ ESTATE OF I FILE NUMBER Celesta_Jh silT!!!Q!ls 21-95-926-_ Jolnllenant(I)1 NAME A,Samuel M. Simmons, Jr. ADDRESS 1 South Locust Point Road Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT lIusband B.Samuel M. Simmons, III 72 South Locust Point Road Mechanicsburg, PA 17055 Son c.Samuel M. Simmons IV 72 South Locust Point Road Mechanicsburg, PA 17055 Grandson Jointly-owned property. ITEM LEnER DATE FOR TOTAL VALUE DECO'S DOLLAR VALUE OF NUMB'EI JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT IlROOGIrr FORWlIRD 0 6. A See Oat 1680 shs Right Aid corporatior under Common Stock, issued in nan~s descd!.: of Samuel M. Simmons, Jr. and tion of Mrs. Celesta E. Simmons as fol Propert\ lows: Shares Date 10 May 8, 1972 100 Aug 27, 1974 100 Oct 8,1974 70 Jan 19, 1981 140 Jan 17,1983 420 Jan 16, 1984 "An July 8, 1991 1'-680 shs @ $28.3125 47565.00 50% Exempt-Husband a Wife OWners 7. A 1/28/85 oneIl) $500. U.S. Savings Bond Series EE dated Jan. 28, 1985 in names of Celesta E. SimmonE or Samuel M. Simmons, Jr. foun in joint Safe Deposit Box rented in names of Samuel M. Simmons, Jr. and Celesta E. Simmons 532.80 50% Exempt - lIusband Wife OWners 8. A 1982 Lincoln Sdn. 1750.00 50% Exempt - Husband Wife OWners 9. A 1988 Lincoln Sdn. 5000.00 50% Exempt - Husband J~H_lL-~ nd and and and ClIRRIED FORWlIRD IIlur~_IS o (II more 'pace i, "..a.cJ in,." ocJcJj/ionol ,h..h 0' lame Ii,.) "\lISll9UI\IIt.1 COMl,IO'.....I...\lIt(lt "tm\'\"'''''l'''' ,twl"t,,'j(II.... _I'\l"~ 'n'IlI'~1 Olttl'ltll 3. SCHEDULE F JOINTLY-OWNED PROPERTY __.___ . (cxmINUEDL~_._ . .J FI_~E~;.;~;;~___ ESTATE OF CELESTA M. SIMMONS Joint '.non'(,), NAME A. Samuel M. siii1iiOnii;-Jr.-'''.-- ADDRESS 'r'-soutfi~i.ociiit--Point "'if6ad"- ,-~"-~-. Mechanicsburg, PA 17055 RElATIONSHIP TO DECEDENT "-Husband --,..--- B. Samuel M. Simmons, III 72 South Locust Point Road Mechanicsburg, PA 17055 Son C. Samuel M. Simmons, IV 72 South Locust Point Road Mechanicsburg, PA 17055 Grandson Jolntly.own.d prop.rty' ITEM NUMBEI LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY TOTAL VALUE OF ASSET DECO'S DOLLAR VALUE OF % INT. DECEDENT'S INTEREST ll. A. BROUGHT FORWARD 7/13/72 1225 !tis El:pity Q:o...th of Jllra:ia:l In:: , Va. O:::::p., 0:Ima1, R3r 1(:. Valte Q'1 d:lOO cf t\'lat:h *W::rt:hl.ees* "'tare dwge::l 5/l/16 to Dive:sifia:l a:o.th O:::::p 'ohich \as di.s9:llva:l b/ l/ ~ ~ All those three (3) Certain tracts of land situate in the Township of Monroe, County of Cumberland and State of Pennsylvania which Samuel M. Simmons, Jr. and Celesta E. Sirrmons, his wife, by Deed dated March 20, 1973 and recorded in the Recorder's Office in and for said Cumberland County in Deed Book "L", Vol. 25, Page 141 granted and conveyed unto Samuel M. Sirrmons, Jr. and Celesta E. Sirrmons, his wife (decedent). o lI. 10. A. 9Jt E.xa1p:-H.B:En:J arrl Wife joint 000I'a:S Excepting and reserving those five (5) parcels of land con- veyed by Samuel M. Sinrnons, J and Celesta E. Sinrnons, his wife, as follows: CARRIED FORWARD --- Xlil~K)(~IIDIKlI>l( 5 o (If more space is nueded inuul additional sheets 0' sumu siID) 5. _Iii I\CW Il. 111M SCHEDULE F JOINTLY-OWNED PROPERTY (crm'INUED ) ... .. ~~ ~1~El~~;:'~;~___..__ (0"''''0'''\0101 "IH. 0' "tn"II""';I" j'mtlIUt.nlu'I!U.'j l"lUltt'Dl(lt'I"" ESTATE OF Celesta M. simmons J.ln' 'onan'l.)' A. NAME -.'- Samuel M. Simmons, Jr. _._ _______ .... _.~DDRE_S~_.. _...._._ _._Jl_ElATlON~!l_I!'!QJl.E_c:.~DENL 1 South Locust Point Road Husband Mechanicsburg, PA 17055 B. Samuel M. Simmons, III 72 South Locust Point Road Mechanicsburg, PA 17055 C. Samuel M. Simmons, IV 72 South Locust Point Road Mechancisburg, PA 17055 Jolntlv.own.d prop.rtYl ITEM NUMBE LETTER FOR JOINT TENANT DESCRIPTION OF PROPERTY DATE MADE JOINT )I. 14. 15. e Dates der iption BROUGHT FORWARD ertificate of Deposit No. 21001012436 issued by PNC ok, N.A. on 8/1/94 in names f Celesta E. Simmons and amuel M. Simmons III Balance on date of Death Accrued Interest to 0/0 ix (6) $1000. U.S. Savings nds, Series EE, issued in ames of Celesta E. Simmons r Samuel M. Simmons, III found in Safe Deposit Box of amuel M. Simmons, Jr. and elesta E. Simmons. 8/1/94 B. B. Des 16. Date 1000. Sept. 15, 1986 1000. Sept. 15, 1986 1000. Oct. 20, 1986 1000. Oct. 20, 1986 1000. Oct. 20, 1986 1000. May 26, 1987 5/26/87 e (1) $1000. U.S. Savings nd, Series EE, in names of elesta E. Simmons or Samuel Simmons, IV in Safe posit Box C. TOTAL VALUE OF ASSET 2??oo.00 315.61 970.00 970.00 970.00 970.00 970.00 844.00 844.00 Son Grandson DECD'S DOLLAR VALUE OF % INT. DECEDENT'S INTEREST o 50% 50% $1??oo.00 157.81 100% See Item 1 100% Schedule G 100% Transfers 100% 100% 100% 100% See Item 2 Sch. G. TOTAL IAho .nl.r on IIn. 6. R.Cop;lulali.n) S 10157.81 -- ---------.- (II more space js needed inser' additiunol shoe's 01 same size) R[V.ISla [h 1'.811 . SCHEDULE G TRANSFERS COMMONWfAlH1Of PfNNSYlV.ANIA INHUIlANel TAX _nUIN ItESIDENf DICIDINT PLEASE PRINr OR TYPE ESTATE OF Celesta E. Simmons FILE NUMBER 21-95-926 THIS SCHEDULE MUST SE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPIION Of PROPERTY EXClUSION TorAI VAlUE DE~D. 8PgE~~~t~V.\ NUMBER Inc~u~~_n~_m.._ 01 ,h.'tonl'''.., lh.lr ,.totlOtUh,p to dftAdent, dol. 01 'fOnsl.,. Of ASSET INT. INTE~E$T_. 1- Six (6) $1000. U.S. Savin9s Bonds, Serie EE, in names of Celesta E. Simmons or Samuel M. Simmons, III (her son) in Saf Deposit Box of Samuel M. Simmons, Jr. an Celesta E. Simmons, parents of transfer FACE DATE $1000. Sept. 15, 1986 970.00 100% $970.00 $1000. Sept. 15, 1986 970.00 100% 970.00 $1000. Oct. 20, 1986 970.00 100% 970.00 $1000. Oct. 20, 1986 970.00 100% 970.00 $1000. Oct. 20, 1986 970.00 100% 970.00 $1000. May 20, 1987 844.00 100% 844.00 2. One (1) $1000. U.S. Savings Bond, Series EE, in names of Celesta E. Simmons or Samuel M. Simmons IV, (her grandson) in Safe Deposit Box of Samuel M. Simmons, Jr and Celesta E. Simmons, grandparents of transferee. $1000. May 26, 1987 844.00 100% 844.00 ~-_..._- _._~-------~--~--_._-~~_._-~.--_.~ .........._.~---..- _.__._.~-..".... _ ~~__. ..._ m___..>-..... _ _. .._. _.,...____~__."..._...____ --~_..".- ---.-...-"--------..----~-...-----....____.. _____~___.__._______.'~~~~J~.rKt .~!e!~.~_~".It.!,_~It(_ap_II.~~~II!"J_ ~__~~~_~.~~~____.. ,,, mor. space is needed, in.." odditional .,...Is ollome IIr..' JlVllIIUt p.11J II~:'~'~I\ ""!U'~ COMMONWEAltH OF PlNN,nVA.NIA INIUIIIIA.NCf: 'A. IInUIIN IIUIOIN' OlcrOftH SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Ploa.o Prln' or Typo I fiLE NUMBER 21-95-926 ESTATE Of Celesta E. Simmons ITEM NUMBER DESCRIPTION AMOUNT A. Funoral bponll" B. 4. C. 1. 2, 3. 4. 5. 6. 7. 8. I. Malpezzi Funeral Home $ 7846.00 1. Admlnl,'rallvo Co.'" Personal Repre,en'atlve Camml..lan, Social Security Number or Personal Repre,enlotlve, Yea, Camml..lan, paid 2. Alla'ney Fee, 270.00 3. Family Exemption Clalman' Add,e.. or Clalman' a' deceden", dealh Sl,ee' Add,e.. City Stale Zip Code Relatlan,hlp P,oba'e F.., 45.00 Ml.collanoau. bpon,", Register of Wills - (1) Short certificate 3.00 40.00 52.04 1.65 3.00 2.00 Return 25.00 25.00 cumberland Law Journal - Executor's Notice The sentinel - Executor's Notice Postmaster - certificates of Mailing Register of wills - (1) Short certificate Register of wills - Certified copy of will Register of wills - Filing Inventory and PA Inh Tax Chuck Bricker Auctioneer Appraisal Household goods TOTAL (Also onl., an IIn. 9, Recapltulatlonl (II more .paco I. noedod, Inllrl addlllonal .hool. of .amo .111.) 5 8312.69 RKV.I,U [)h 17.U) COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Celesta E. Simmons SCHEDULE "I" DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE NUMBER 21-95-926 ITEM NUMBER DESCRIPTION AMOUNT 1. Harrisburg Hospital - Account Payable 12/8/94 $ 8.80 TOTAL IAllo enter on line 10, Recepltuletlon) . 8.80 flf tll,,"t '1lIHll I' 1\I'lIlt"I!ln,,," /1l1<lllllln..1 dlllll" nl 'limn ,jllll "v HIlII. 11.,', ,,~'~:9~ ,,,,Uu. CO.....(ll.....I..lltlOltlt.hHn,l.lll. IIolH..lIAIolU'UIl1U.... '''IDIIol'DIUOllol' SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Celesta E. Simmons 21-95-926 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. To.able Bequlu": 1. Samuel M. Simmons, J. r. 1 South Locust Point Road Mechanicsburg, PA 17055 Ilusband Entire Probate Estate and all joint property in names of De- cedent and Husband. 2. Samuel M. Simmons, III 72 South Locust Point Road Mechaniceburg, PA 17055 Son $2??oo. Certifi- cate of Deposit having taxable value of $1??oo. in joint names of Dececlent and son with accruecl interest of 157.18 and Series Bonds listed in Sch G. Item 1 3. Samuel M. Simmons IV 72 South Locust Point Road Mechaniceburg, PA 17055 Grandson Series EE Bond listed in Sch G Item 2 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B, Charitable and Govornmental BuquG''': 1. None None TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o onlo, on IIno 13, Rocop;'ula,lan) S None IIf more Ipan II n..d.d, Inurt addltlonal.h..ts of lame lb.) . STATUS REPORT UNDER RULE 6.12 Name of Decedent: Celesta E. sinmons Date of Deathl Novenber 28, 1995 Wi 11 No. 21-95-926 Admin. No. Q", Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X 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. Date: October.;:,l~1999 .?'..J0....J{" ~~~"" Signature ~ William L. Sunday Name (Please type or print) 39 West Main Street Mechanicsburg, PA 17055-6230 Address ( 717) 766-9622 Te l. No. Capacity: Personal Representative Counsel for personal representative X (MAH:rmf/AM3) FIIHILY SETI'LIlMml' AGREIlMml' 21-95-926 TIlE FIRST I\ND FINAL Aaxun' OF SI\H\JEL H. SUIlOOS, JR., EXEX:l1l'a{ UNDER TlIB LJ\ST WILL I\ND TESTIIHml' OF CELESTA B. SIfoIIlOOS, LATE OF TIlE TaoINSIIIP OF foamOR, CXXBl'Y OF l:D1IlERLI\ND, I\ND 8rATE OF PmNSlCLVANIA, OOCEI\SED, I\ND RELBI\SB OF TlIB DISTlUIlUl'EE lH>ER TlIB WILL OF SAID DeCEDml' IIBRETO A'ITAClIED. Date of Death: Novenber 28, 1995 Dates Letters Advertised: CUnberland Law Journal - Dece,L..r 22, 29, 1995 and January 5, 1996 'l'I1e Sentinel - Decerrber 15, 22 and 29, 1995 PERSOOJ\LiY PRINCIPAL Aaxun' DEDITS Accountant charges himself with the Personal Property set forth in the Inventory filed in the Office of Register of Wills in and for CUlt>erland County in the amolD'lt of: Accountant also charges himself with the following: $ 5405.75 1996 Jan 20 Samuel M. Simmone, Jr. - Direct payment of funeral expenses to Malpezzi Funeral Home 7846.00 1998 Jan 20 Samuel M. Simmons, Jr. - Advance to settle estate 2018.50 20 Estate of Celesta E. Simmons - Transfer from Personalty Income Account to Personalty Principal Account 2.58 'lUJ'M. PERSOOALTY PRINCIPAL Aaxun' DEDITS S 15272.83 PERSCW\LTY PRINCIPAL Acaun' CUlDITS ACCXlUIltant asks credit for the following: 1996 Jan 20 Malpezzi Funeral Home - Direct payment by samuel M. simmons, Jr., surviving spouse, to Funeral Home $ 7846.00 Feb 21 Register of Wills, Agent - PA Inheritance Tax PA Inh. Tax $992.28 Less Discount 49.61 942.67 Aug 27 Chuck Bricker - Appraisal Fee 25.00 27 Register of Wills - Filing PA Inheritance Tax Return and Inventory 25.00 27 Register of Wills, Agent - Balance of PA Inheritance Tax 9.47 27 William L. Sunday, Esquire - Reimburse COsts Advanced: Register of wills - Probate Fee $45.00 Register of wills - 2 Short Cert. 6.00 CUmberland Law Journal - Notice 40.00 The Sentinel - Notice 52.04 Postmaster - certificates of Mailing 1.65 Register of wills - Certified Copy of will 2.00 146.69 1998 Jan 21 William L. Sunday, Esquire - Attorney's Fee 3500.00 roTAL PEIl.SCWU.TY PRINCIPAL ACXXXJNr CREDITS S 12494.83 . 1995 p~r..rr Il<<n1B ^lXXUn' RIlC8IP'l'S ^CCOUntant charges himself wi!:h !:he following: Dec 18 PNC Bank - Interest to closing ACCOunt '50-7008-4943 IDrM. PERscIw.Tr Il<<nIB ^a:nm RIlC8IP.rs $ 2.58 $ 2.~ PERscIw.Tr lNCX>>ts ^lXXUn' BXPmIDInlRBs ^CCOUntant lIBks credit for !:he following: 1998 Jan 20 Estate of Celesta E. Simmons _ Transfer to Personalty Principal Account $ 2.58 IDrM. PERscIw.Tr Il<<n1B ^lXXUn' BXPmIDlWREs S 2.5!;! ADYJ\NCEHI!NTS 1/20/98 Samuel M. Simmons, Jr. Contente of Safe Deposit Box in separate name of decedent - In kind $ 178.00 2600.00 Household Goods and Furniture - In kind iUl'AL ADVIINCmIPNTS S 2n8.oo R&:APrrorJ\Tlm p~~: Principal Account Debits Credits $ 15272.83 12494.83 Ilalance $ 2778.00 Income Account Receipts Expendituree $ 2.58 2.58 o Balance LESS: . Advancements $ $ o 2778.00 2778.00 o Total Distributable Estate BALllNCE IN IIANDS OF ACXXXlNTAm.'S FOR DIS'IRIllUTlm S RELEJlSE WllmEI\S, Celesta E. Silll11Ons, died NovenVer 28, 1995 leaving a Last Will and Testament dated May 19, 1977, wherein and whel:"eby she gave, devised and bequeathed her estate, aftel:" the payment of hel:" just debts and funeral expenses, unto her husband, Samuel M. Silll11Ons, JI:"., absolutely: and MlmEI\S, she further provided that in predeceased her, she gave, devised and bequeathed Samuel M. Silll11Ons, III: and M~, her husband, Samuel M. Silll11Ons, Jr, survived the Testatrix, the estate is distdbutable to her surviving husband, Samuel M. Silll11Ons, JI:". the event her husband her estate to her son, t<<M JQDo/ ALL Mm BY TIIESE PRESENl'S, that I Samuel M. Sinmons, JI:"., the sole legatee, devisee and distdbutee of the estate of said decedent, and the only person entitled to shal:"e in the distdbution of said estate, do hereby declare and say that I have examined the foregoing Account and find the same to be true and correct and in strict accordance with the terms and provisions of said Will, and do hel:"eby acknowledge that I, l,ave had and received of and from Samuel M. Sinmons, Jr., Personal Represuntative of the Estate of Celesta E. Silll11Ons, the items set opposite my name as advancements in the above stated Account in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purparts and dividends which were due, owing, payable and belonging to me, by any means whatsoever, for 01:" on account of my full share, part or dividend of the estate of the said decedent and all interest accrued thel:"eon. t<<M T1~, I Samuel M. Sinmons, Jr., the sole legatee, devisee and distdbutee of the Estate of Celesta E. Sinmons, deceased, do by these presents remise, release, quit-claim and forever discharge the said Samuel M. Sinmons, Jr., his heirs, executors and administrators, of and from my said shares or dividends of said estate afol:"esaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, 01:" of any other act, matteI:", cause or thing whatsoever, from the beginning of the world to the day and date of these said presents. AND, desiring to avoid the delaying and expense of the settlement of the said estate by filing the foregoing Account of said administration in the Office of the Clerk of the Orphans' Court of said County, and by having the balance in the hands of the Executor, as shown by said Account, distributed by an auditor appointed by the Orphans' Court Division, of the COUl:"t of COfTIT1On Pleas of Cumberland County, I do hereby agree that the foregoing statement concerning the manner of settlement may be recorded with the same effect upon me as if the same had been reported by the said Court of Oommon Pleas -- Orphans' Court Division. , , . __~ __-_-. ';"0. - -- . ~IW~~U I on ~:~~~II~I "" on ftS~J.s_O ,a ftS - ~ r--- =oC>~ - = 3 I (I)~ \0 f!j ~ ~ m ~ IIll 18\ l? ,~ r:!> '" ~ ~~ii oEo FOI '''-" -'111 Q.~.r. ~ ... - ~ = = C .l1,~ ~ ~ U) ~ ~~ ~ .!!! .a s ~ ; ::: ftS - .c ~U)~~[:l i [:l iiimm~~ ~ ~i~llh~~~ .... ~ ~[:l "'~~~ D NO. Me 146665... COMMON:':~~:T~: .~:~:YLVANIA "~I"''' OffiCIAL RICI'''' . ,.NNIYLVANIA INHIRITANCI AND ESTATI TAX '* RECEIVED FROM: I ACN ASSESSMENT I!'I CONTROL IiII NUMBER AMOUNT SUNOAV WILLIAM L 39 W MAIN STR~r.T 101 .".47 MECHAN I CSllUHG. I'A 1 .,O~~ lOtOHflf ESTATE INFORMATION, ~ FILE NUMB R li1 a 1-19?~-09[!b 1:1 NAME Of DECEDEN LA ~ SIMMONS CELrrOTA E ~ DATE OF PAYMENT ~ /27 II POSTMARK DATE COUNTY BSN 104-12-3666 I MI CUMBERLAND DATE Of DEATH SEAL SAMUEL M SIMMONS C/O WII.L1AI1 L SUNI1AY ESO CHECKII " m TOTAL AMOUNT PAID .9.'17 REMARKS REGISTER OF WI LLS vz ), . ("0..' RECEIVED BY '~-aA...\ ~f'''(A~ ,:'",\ (lON/. . MARY C. LEWI S . ", //<'I' ;"'~ j}/~''';-t- REGISTER OF WILLS f .."" ,_.._ ~._._ ._n. _~ .~__ ___ __ _ "."__ __ __ __. -- --. - - j"" -;--,.- -".-i ...- ,.._~ .' "" . ! ~, " , " "---- , , --._~--:-:-..~.M.~~.'- ...... .~:. I . HAKE CHECK PAYABLE AND REHIT PAYHENT TOI REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ii{v:is4'rEX-iii:'p--niF96riiiiYicniF-YtiHEifii'ANCin"liinipjiiiA'isEifiiii'-;-iii.i.-liiiANCriili----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX CELESTA E FILE NO. Zl 95-09Z6 ACN 101 TAX RETURN WAS' I I ACCEPTEe AS FILEe C XI CHANGEe SEE APPROVED DEDUCTIONS AND EXEHPTIONS: 5,405.75 ,. Fun.ral Expan.../Ad.. COlta/HiIC. Expans.. (Schedul. HJ C91 10. Oabh/Hodgag. Llab111U../Llanl CSchadula Il no) .00 11. Tot.l Deduction. (11 ) 12. Hat Valu. of rax Raturn (12) 13. Ch.,.Uabla/Govarn..nt.l a.qu.lt. (Sch.dula J) n5) 14. Hat Valu. of E.t.t. Subjact to rax (14) NOTE: If an assassment was issued previouslY, lines 14, IS and/or 16, 17 and 18 will reflect figures that include the total of !hh returns assessed to date. ASSESSHENT OF TAX: 15. A.aunt of Lina 14 at Spou..l ,.at. (15) 16. A~unt of Lina 14 t.xabla at Lin..I/CI... A r.t. (16) 17. Aaount of Line 14 t.xabla at Coll.t.ral/CI... 8 ,.at. (17) 18. Principal rax Due TAX CREDITS: PAYHENT eATE OZ-ZZ-96 08-Z7-96 IS 7J.;1 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE 11/ BUREAU eF INDIVIDUAL TAXES INtERITAHCE fAX DiVISION DEPf. 180601 HARRISBURG, PA 17UI"D6DI HeTICE eF INHERITANCE TAX APPRAISEHENT, ALLeWANCE OR DISALLeWANCE eF eEDUCTIeNS ANe ASSESSHEHT OF TAX WILLIAM L SUNDAY STE 1 39 W HAIN ST MECHANICSBURG DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 11-25-96 SIMMONS 11-28-95 ZI 95-0926 CUMBERLAND 101 AMount R..itt.d PA 17055-1819 ESTATE OF SIMMONS RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN 8ASED ON: ORIGINAL RETURN 1. Re.1 E.t.te (Schedule AJ 2. stock. ~d Bond. (Schedule BJ 3. Clo..ly Held Stock/P.rtner.hip Intere.t (Schedule CJ 4. Hortg.g../Note. Receiv.ble (Schedule DJ s. C..h/Bank Depolit./Hi.c. Perlon.l Property (Schedule EJ ,. Jointly Owned Property (Schedule fJ 7. Tran.fer. (Schedule OJ 8. Tot.l AI..t. III 121 131 141 (5) 161 C71 .eO . ee .Oe .ee 5.4e5.75 10.157.81 6 .538. DO leI .00 16,695.81 .00 X'OO. X.06. X .15. Ilel RECEIPT NUHBER AAllZ538 AA146665 eIsceUNT INTEREST AHOUNT PAID Itl c.) 49.61 .00 94Z.67 9.47 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE *' ....IJ4'...,'II'-t41 CELESTA E DATE ATTACHED 11-25-96 NOTICE NOTEI To in.ure proper credit to your .ccount, .ub.it the upper portion of thl. for. with your bx pay".nt. ZZ ,101. 56 Ii .t.nc; 71i 16,695.81 .eO 16,695.81 .00 l,eel.75 .00 1, Del. 75 1,001. 75 .00 .eO .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION eF ADDITIeNAL INTEREST. I IF TOTAL eUE IS LESS THAN fl, NO PAYHENT IS REQUIRED. IF TeTAL DUE IS REFLECTEe AS A "CREDIT" (CRI, yeU HAY BE DUE A REFUND. SEE REVERSE SIeE OF THIS FORH FeR INSTRUCTIeNS.1 RESERVATION I E.t.t.. 0' dec~t. d_lng on Dr be'or. Dec.-ber II, 1"2 .. I' ~v 'utur. Int.r..t In ~ ..t.t. I. tr~.f.rr~ In po.....lon Dr ~Jor-ent to (I... . (collat.,.I) b~flcl.,I.. of t~ decedent .ft.r t~ .xpl,.tlon 0' ~v ..t.t. 'or II'. or for v..r., t~ (~.Ith ~r.bv ..pr...lv r...rv.. tn. right to .,pr.I.. Bnd ...... tr~.f.r Inherlt~. T.... .t the l.wful el... . Ccoll_t.r.l) ,.1. on ~v such 'utur. Int.r..t. ........ OF NOllCEr To fu1fll1 tM ,aqul,,",,t. 0' Section 21'0 of tM Inherltanc. Met Estlta T.. Act, Act ZI. of 1991. 71. P.I. SecUon 2140. DetKh the top port1on of this NoUn and .....It with your p.ya",t to thl R.ght.r 0' Will. prlntad on t~ r.vlr.. .Ida. ---"aka chack Dr aonay ord.r p.vebl. tOI REGISTER OF MILLS, AGENT All p.yaent. rac.lvad .hall flr.t b. appll.d to InV Int.r..t whIch a.y be due ~Ith any r...lnd.r applied to thl ta.. RU1JrfD CCRU A r.'und 0' a ta. cr.dlt, which ~.. not r......t.d on the hll R.turn, ..y b. r.qulllhd b_ coapl.Ung an "AppllcaUon for R.fund 0' pann.ylvanla Inherltanc. Bnd E.tat. T.... (REY-IlI1). application. .r. av.llahll .t thl a'flc. 0' thl Raght., 0' Wllh, .,,_ 0' thl z:s R.vanu. District afflc.., or bv ulllng thl .pacl.1 U-hour ."....rlng ..rvlc. nuabar. for 'Dr.. ord.rlnal In Pann'vlvanl. 1-'00-162-2050, out. Ida Pann.vlvanl. and ~Ithln loc.1 Harrlsbur. .ra. (7171 717-8DM, TOO' (7171 77Z"ZZ5Z (H..rlng 1..lred Only,. PA'nEXT. OIJECTIDHSI Anv p.rtv In Int.r..t not ..tl.fl.d ~Ith thl ,ppral...ant, .llo..anc. or dl.allo..anc. of daductlon., or ......aent 0' till (Including dl.count or Int.r..t) I' Ihown on thl. Notlc. au.t obJ.ct ..Ithln .llltv 1'0' d.v. 0' r.c.lpt 0' thl. NoUc. bYI --..rlttan prot..t to thl PA D.,lrtaent of R.v.nu., lo.rd of App..I., a.pt. 2alOll, Harrl.burg, PA 17111-1021, OR --alactlon to h.v. tha ..tt.r dat.ralned .t audit of thl account of th. p.r.onal r.,r..ent.tlv., OR --BrP..I to the Orph.".' Court. ADMIN IITRAllVE CORAECTJOH1I DISCOUNTI Factu.1 .rror. dl.cov.r.d on thl. ........nt .hould b. addr....d In ~rltln. tal Pi O.p.rt..nt of R.v.nu., lur..u of Indlvldu.1 T...., AnNI Po.t A......'"t R.vl... Unit, D.pt. 110601, ...rr!lburg, PA 171"60601 Phona 17171 7.766S0S. s.. p... 5 of th. bookl.t "In.tructlon. for Inherltanc. r.. R.turn 'or. A..ld,"t Decedent.. CREY-150)) 'or an ..plan.tlon of .d_lnl.tratlv.lv corr.ctabl. .rror.. If anv t.. due I. p.ld ~Ithln thr.. (1) c.land.r aonth. .'t.r th. d.c.d.nt'. d..th, . 'Iv. percent C5~) dl.count 0' the tax p.ld It .llow.d. PENALTVI ThI 15~ t.1l .-na.ty non-p.rtlclp.tlon pan.lty I. coaputed on th. tot.1 of thl t.. and Int.r..t ......Id, and not p.ld ba'ara Janu.ry 16, 1996, thl first d.V ,'hr th. .nd 0' thl t.. un..tv period. Thlt non6p.rtlcJpatlon penalty h .....Iabl. In thl .... 'IIl'WMIr end In thl; tM .... tI.. periOd III YOU MOUld .,..1 thl t.1l ... Int.r..t that h.. bean ......ad .. Indlc.ted on thl. notlc.. INTEREST I Int.r..t I. char.ed b.glnnlng with 'Ir.t d.y of d.llnquancv, or nine C91 ~th. and one CI) dav froe thl d.t. 0' death, to the d.t. of p'V.-nt. T.... which b.c..a d.llnquant bafor. Januarv ), 19a2 b..r Int.r..t .t thl ,.t. of .1. C6XI parcent par ~ c.lcul.ted .t . d.llv r.t. 0' .000164. All t.... which bac... d.llnquant on and .ft.r Janu.ry 1, 1911 ..III ba.r Int.r..t .t . rat. which ..III v.rv froe c'land.r v..r to caland.r v..r with th.t rata announcld bv the PA DIP.rtaant of R.vanu.. Th. appllcabl. Int.r..t r.t.. 'or 1911 thro~gh 1996 .r.. !!!! In,.,..t A.t. D.IIY Tnt.r..t f.ctor I!!! Int.r..t Aat, O.IIY Int.r..t factor 1911 'OX .OOOSU 1967 OX .000lU 1911 lOX .0DDUa 191161991 lIX .000101 "" IIX .000101 1992 OX .aaOlU 1915 ISX .0aU!t6 1991-1'" 1X .aOOltz ".. lOX .DaOU' 19956199' OX .0OOlU --Int.r..t .. c.lcul.tad .. fallONII INTEREST . BALANCE eF TAX UNPAID X NUNBER DF eAYB DELINQUENT X DAILY INTEREST FACTOR --Anv Hatlc. I..ued .ft.r thl tax bacoaa. delInquent ..III r.fl.ct ~ Int.r..t calcul.tlon to fl't.an CIS' dav. bavond tM etat. of the ......""t. If P'Vllnt Is ... .ft., thl Int.n.t coapul.tlon d.t. shown on thl Hatlc., .odltlonal Int.r..t lU.t be c.lcul.t~. 1(;-7')'} _" .1 .~ COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSVLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN c... '* BUREAU OF INDIVIDUAL TAMES ".€.Rl1AH'E t'" DIVISION DCP1. IIUD 1 HARRlllURG, pa. l1Ula06Dl In.'''''''' ,n.tU DATE 05-19-97 ESTATE OF SIMMONS CELESTA E DATE OF DEATH 1l-ZB-95 FILE NUMBER Z1 95-09Z6 COUNTY CUMBERLAND WILLIAM L SUNDAY ACN Z01 STE 1 l A.ount R..1 U.d ] 39 W MAIN ST MECHANICSBURG PA 17055 MAKE CHECK PAVABLE AND REMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NeTE. To In.ur. prop.r cr.dlt to your .ccount. .ub.lt t~o upp.r portion of thl. for. with your to. poy.ont. CUT ALONG TMIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES .... .-i;'.....n;._"'~;i,-._.;;'..1ffi.,."...fi..";r;".."'..."';o;.-..iff....._.............------.. OF PENNSVLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF SIMMONS CELEST A E FILE NO.Z1 95-09Z6 ACN ZOl DATE 05-19-97 ESTATE TAX DETERMINATION 1. Credit For State Oaath Ta~es as Verified 95Z .14 Z. Pennsylvania Inharitanca Ta~ Assessad (E~cluding Discount and/or Interest) .eO 3. Inheritanca Ta~ Assessad by Other States or Territories of the United States (E~cluding Discount end/or Interast) 4. Total Inheritanca Ts~ Assessad 5. psnnsy1venie Estata Tax Due TAX CREDITS I PAVMENT DATE AMOUNT PAID RECEIPT NUMBER DISCOUNT 1+) INTERESTIPEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 _IF PAID AFTER THIS eAlE, SEE REVERSE SIDE IIF TOTAL DUE IS LESS THAN tl, NO PAY"ENT IS REQUIRED FeR CALCULAlIeN eF ADDITIONAL INTEREST. IF TOTAL DUF. IS REFLECTEe AS A "CREen" ICR), yoU ""Y BE DUE A REFUNO. SEE REVERSE SIeE eF THIS FeR" FeR INSTRUCTIONS.) .00 95Z.14 .00 PORPOSE OF NOTlCEI PAYrtENTI nr; .- .-.~ " , If" ..., .::.' '" To fulfill the raquln""" 0' s.ctlon nt' CbJ of the Inherlbnee Bnd htat. '.11 Act, Act ZI of .995. 17Z P.S. s.ctlon 'IU). P.tlch the top portion of thl. Hotlcl ~ ,ubalt with your p.y.~t to thl Rlgl,t.r 0' t.v.r.. IIda. a~ H~. check or .onay order payable tal ,> J Willi prlntld.an , \..'? .ho REDISTER OF MILLS, AGENT. REfUND (CRJ. A r.'lond of I talC credit ..y ba requ..ttd by cHPlaUnu Ian ....ppUutlon for A.fund of P.,.."vl"....a InfMrltlll"tCl wtd Est.t, 'IX" (REV-Un), Appllcetlon. .r. Iva"MI.. at the Offlc. of 'hi; RlgSI,ar of WUh, ...y of the ZI A.v~ DI.trlct o"lc.. or fto. the aIP.rt.ent"s Z4-hour ....w.rlng ..rvlcl nuabar. for 'or.. orderlngl In P~.ylv...l. l-IOQ-S6Z-2D50, out,lda Pannlylvenl. and within 10cIl HarriSburg .r.. C117' 7.7-1094, TODt (711) nt-llSZ CH..rlng 1..lrad OnlY). OIJECTlONS, AOftIH- ISIR"lIVE CORRECTIONS, PENALTY I INf[AEST. Any p.rty In Int.r..t not ..tl.,lad with tha .......ent 0' tax .. .hown on thl. not Ie. ..y obJ.et within .I.ty (60) d.y. 0' rae.lpt 0' thl. Notle. bYI --wrlttan prot..t to the PA Depart.ent 0' A.venue, loard 0' App..I., C.pt. Zal021, H.rrl.burg, PA 17121-1021, OR --.I.ctlng to have thl .attat d.tar.lnad .t .udlt 0' thl p.r.onal r.pr...ntatlv., OR --appa.1 to thl Orphan.' Court. factual .rrot. dl.cov.rad on thl. .......ent .hould be addr....d In writing tal PA Dep.rtaant 0' Aavanul, lura.u 0' [ndlvldu.1 T.x.., ATTN. Po.t A.......nt A.vl.w unit, D.pt. Z10601, H.rrl.burg. PA 17121-0601, Phone (717) 717-6505. S.. page 5 0' the bookl.t Rln.tructlon. 'or Inh.rltanc. T.. Aaturn for. A..ldant O.c.dantR IREV-lS01) for an ..planatlon 0' .dalnl.tratlv.ly corr.ctabl. .rror.. Th. 15% tax aana.ty non-p.rtlclp.tlon p.n.lty I. c~t.d on the tot.1 a' thl ta. and Intar..t .......d, and not p.ld be'ore Janu.ry )1, l'~', thl 'Ir.t dey .ft.r thl .nd 0' the t.. aan..ty p.rlod. Thl. nan-p.rtlclp.tlon pen.lty I. app.alabl. In the .... .ann.r and In the the .... tl.. p.rlod .. YOU would app..1 the t.. and Int.r..t that hit hlan .......d.. Inelleat.d on thh notlu. for dat.. a' d..th on or .ft.r 10-]-'1, P.nn.ylvanla [.tat. Ta. ba..d on the f.d.ral E.tat, T.. r.turn becOll. d.llnquent .t the Ixplr.tlon 0' nine 10') eonth. fro. the data of d..th. For dat.. a' d.ath prior to 10-]-'1, Pann.ylvanl. Eatat. T.x b..ad an thl Fed.ral E.t.t. Ta. raturn bacOll. d.llnquent et the a.plr.tlon 0' Ilght..n III) lonth. 'roe th. dat. of d.ath. T.... Which bee... dallnquent ba'or. January 1, l'IZ baar Int.r..t It the rat. of .1. C6~) p.re.nt p.r annul calculatad .t a dally rat. 0' .00016~. All t.... which b.c... d.llnqu.nt an or .,t.r Janu.ry 1, l'IZ will b..r Int.r..t .t . rata which will v.ry 'rol cel.nd.r y..r to c.landar y..r with th.t r.ta announc.d by thl PA o.p.rtaent 0' A.vanua. ThI appllcabl. Int.r..t r.t.. for 1912 through 1991 .r'l V..r [ntar..t A.ta O.lly Int.r..t factor Vear Int.rut R.t. O.lly Intare.t Factor 191Z 'OX .OODSU 19&7 .~ .0002l117 1'85 \6~ .000~]a 19&&-1991 IU .oonol .9.' m .oonol 199Z .. .000ZlII7 1915 U~ .000556 199]-19'" 7X .00019Z 191' lOX .000274 1"5-1997 .~ .000247 ulnt.re.t .. c.lculltad II 'allow.. INTEREST . BALANCE eF TAX UNPAID X NUnBER DF DAYS DELINQUENT X DAILY INTEREST FACTDR uAny Notice IliUM .fhr thl tl. b.c:o... d.llnquent will nfllct an Int.r..t calculation to '1ft.." CIS) days beyond thl data of thl ......lInt. I' payaant I, .ed. .,tar the Int.r..t eoaputatlon a.t. .hown on the Notice, ~Itlonal inter..t au.t b. c.lculatMt. /_-) 7.',{"{ BUREAU ef INeIVIDUAL TAXES J..tERl1AHC[ lAM. DIVISION DEPt. UQ6DI HARR1SlURG, pA 111,..0.D\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION ANO ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN C-. * PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) rrJ .. . . ' . ~ '''l c."\ ,- . TOTAL TAX CREDIT .00 ., BALANCE OF TAX DUE .00 (..-:: ',"' 2. :j INTEREST AND PEN. .00 '.)0 TOTAL DUE .00 In."tn'" III.UI 05-26-91 SIMMONS 11-28-95 21 95-0926 CUMBERLAND 202 AMount A..utlKl CELESTA E ] WILLIAM L SUNDAY STE 1 39 W MAIN ST MECHANICSBURG PA 11055 [ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 11013 NOTEI To in.ur. proper cr.dit to yoUr ..count, .ubolt tho uPp.r portion of thl. foro with yoUr t.. p.yoent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES .... ;W:,,.._,,._,;,--,,;-:.,r----,n;;m.-,,-;,,,,,,,-,,,";;'-''';-'i'';;;'';,y-------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER MM ,,,.,, " """," """" "" ..-" "-",, ..', '" ..,,,,-,,-,, ESTATE TAX DETERMINATION ,. 'C"" ,.C ,.... ,..., ,.... ., ,.c",., .,' 2. Pennsylvania Inharitance Tax Assassed 952.14 (Excluding Discount and/or Interast) 3. Inheritance Tax Assessad bY othar States .00 or Territorias of the Unitad states (Excluding Discount and/or Intarest) .. ,..., ,",.c...",. ,.. ......., ",.,. ,. ,.,".",.",. ,..... ,.. ". ," 6. Amount of Pennsylvenie Estata Tax PreviouslY Assassed ...., ." ,.,.c.. ,..... ,.. ,..'C" ... ,. ..',....., ,."".",..,. ,..... ,.. ,.. ... TAX CREDITS I _If PAle AFTER THIS DATE, SEE REVERSE SIDE l1f TOTAL DUE IS LESS THAll n, NO PAYHENT IS REQUIREe fDR CALCULATION Of ADDITIDNAL INTEREST. If TeTAL DUE IS REfLECTEe AS A "CREelT" ICRI. YDU HAY BE eUE A REfUND. SEE REVERSE SIeE Of THIS feRH fDR INSTRUCTIDNS.) PIIll'OSL IIf HOrJct. To fulfill the r..,I,..-nh of SKHon 2US (b) of tM Inher1tBnCa Md Estat. "1Il Act, Act U of I"S. (72 P.I. 'HUon '."S), PAvttDfT. DetKh U. top portion of \hit Notlc. ~ SlMIt with your .-,...,t to the Aqllta.. 0' NUll ,.rlnt.d on ,.... r.vI,.. .... -- twl. cMck or MMy order plvMlI. 101 REOIBTER OF MILLS, AGENT. REfUlD <<CR J I " ,.,Pond of . tl. credit ..y be tlql,..ted by capl.tlng WI "application 'or Rd\RI of p.""..,lvWll. JnhlrUWlCI Md hl.t. hlll- (R[V.aU). Application. '1" .".11_1. It tM Offln of tM R........ of WUh, any 0' the ZJ R.,,~ D.lttle' Offlc.. or fro. t~ o.partaentt, ".hou.. ~....rlna ..,vlcl ~r. 'or lor.. ordering, In P~'yl".,I. 1.100.)62-2050, out,lda Penn.,l","._ and within lOCal Harrl.burg '1'" (717) 7'7..a~, TOOl (711) 71Z-llSZ C....rlng t..,..tH Onh). OIJECTJDHSI Any p'rt, In Int.,... not I.tl.fled with the ......-.ot of ... .. shown on thl, notle. .., object withIn .ll1ltv (60) diY' of r~.lpt of thl, Notle. b~1 ....rIU.... proh.t to tM PA o.p.rt.....t 0' A.v.,..,., loerd of App..h, Dept. 1111Oll, H.,.,.laburll, PI. 17UI-Ull, OR ....Iectlng to h.v. the ..tt.r d.t.r.lned .t ItUdIt of the ".r.on'l repr..."htl"., OR "'~I to tn. DrphM,' COUtt ADHIN- IITHATlVE CORRECTIONSI f.clu.. .r,.o,.. dl.cov.r.d on thl. .........,1 .hould b. add,....ed In ..rltlng 101 PI. o.Pltt...,t 0' R.v.nus, lut.", 0' lnellvldull ,...., AnNI Post A......tnl A.vl... Unit, Depl, laUOl, ".trhburg, PI, 17U..06D1, PhaM (717) 7n.nOS, S.. p.g. 5 0' the bookl.t ''In'lructlon. 'or roherltlnC' rIll R.lurn for. Auldent D.cedent" (REy-nO!) 'or en 'llphnlUon 0' ItdIilnhtntlv.iy corr.elebb Irror., PrHAL tV, ThI 15~ tax ~.t~ non.p.rtlcIPlllon p.n.lt~ I. co~t.d on thl totll 0' tl~ till end Int.r..t .......d, and not P.ld bI'or. Jenuery I', 1996, the 'Ir.t d.~ .fllr thl end a' the tlx ..,...t~ p.rlod. rhl. non.p.rtlelp.tlon p~.lt~ I. appe.11b1e In the .... lanner end In the the .... tl.. period I' ~DU would Ipp..1 the tlX and Int.r..t thllt hII. bI." ......ed .. Indlc.tlMt on thlt noUce. INTEREST, Additional P~.~lv",l. Eat.t. T'1l ......Id .. . r..ult of . thing. on tM redlr.1 E.t.t. 'ax ela.lng h"lr blc:DMI dellnquent .t the Ixplt.tlon of one CI) ~th 'rol thl dlt. thl IIMI noUcI 0' the lner.... In Flder'l E.t.t. 'ax I. recllvld. rail.. Which bee... d.llnquent bI'orl Janulry I, I'IZ b..,. Intlr..t .t thl r'll of .111 (6~) p.reent p.r ~ e.lcul.tld .1 . dll1~ nil of .000164. All t.... Which bee... delinquent on or .ftlr Jsnuar~ I, 1911 ..111 b..r Inl.r..t .t . till ...,Ich ..Ill very fro. celilnder ~..r to e.lender y..r ..lth th.t rill ~MI bV thl PA Deplrl-.nl 0' Alv.,..,.. rhl sppllcabll Inllr..t r.tl. for 19., through 1991 Ir.1 !!!! Inler..1 Alii D.lly Inllr..t Feclor !!!!' Int.r"l A.t. D.11v Inl.t..1 rKtor 1911 ..~ ,000541 1911 n .000141 I'U lOX .DODOI 1'11"1991 IU .000501 I'" II~ .DDOSDI 1991 .. .GOOl41 I'U U. .000J56 I99J.1994 1X .DOoln I... lax .OGO"" 1995.1991 .. .000l41 ....Int.r..t It Cllculllld .. 'allow" INTEREST . BALANCE OF TAX UNPAID X NUnSER OF DAYS DELINQUENT X eAILY INTEREST FACTeR .-Anv Nollc. I..ued .'llr the tB. bec~. delinquent ..III reflect 8n Int.t'.1 clleul.tlon to ,1,t.In 115) d.v. berond the date of the ........,t. If P'Plnt II .... aft.r the Inl.r..t Co.putlt1on det. lhown on thl Hot Ie., addltlonsl Int.r..t .u.t b. eelcul.'.d. FAMILY SE'l'l'L91Fm' ArnEIlMENl' 21-95-926 TIlE FIRST AND FINAL ACXXlUn' OF SJ\MUEL H. SIMHOOS, JR., BXBCI1lat lH>ER TIlE LAST WILL AND TESTAMFm' OF CELESTA E. SIHI'lCNS, LATE OF TIlE 'roWNSIIIP OF HamOB, cxun'l1 OF CUlBERLAND, AND STATE OF PENNSYLVANIA, IlfX:P..ASED, AND RELEASE OF '11IE DISTlUIIl1l'EE UNDER TIlE WILL OF SAID 0fX:EDIlNl' IIERETO A'rl'Aamo. Date of Death: NovenDer 28, 1995 Dates Lettera Advertised: CUaberland Law Journal - llec:eober 22, 29, 1995 and January 5, 1996 TIle Sentinel - Dec.",L..c 15, 22 and 29, 1995 ":" PERSaW.TY PlUNCIPAL ACXXXNl' DEBITS Accountant charges himself with the Personal Property set forth in the Inventory filed in the Office of Register of wills in and for Clmberland County in the amount of: Accountant also charges himself with the following : $ 5405.75 1996 Jan 20 Samuel M. Simmons, Jr. - Direct payment of funeral expenses to Malpezzi Funeral Home 7846.00 1998 Jan 20 samuel M. Simmons, Jr. - Advance to settle estate 2018.50 20 Estate of Celesta E. Simmons - Transfer from Personalty Income Account to Personalty Principal Account 2.58 'lUJ'AL PERSCWILTlt' PRINCIPAL ACXXlUn' DEBITS S 15272.83 P~Tl1 INCDm ACXXllNl' RECEIPTS Accountant chargee himaelf with the following: 1995 Dee 18 PNC Bank - Interest to closing Account 150-7008-4943 $ 2.58 TOl'AL PERSaW.Tl1 INCnlE Aocam R&:BIPTS s 2.58 P~Tl1 INCDlE ACXXllNl' BXPENDI'l'URES Accountant asks credit for the following: 1998 Jan 20 Estate of Celesta E. Simmons - Transfer to Personalty Principal Account $ 2.58 TOl'AL PERSaW.Tl1 INCnlE Aocam EXPENDITURES S 2.58 IUU.EJ\SR W1IERE11S, Celesta E. Sinmons, died Novenber 28, 1995 leaving a Last Will and Testament dated May 19, 1977, wherein and whereby she gave, devised and bequeathed her eatate, after the payment of her just debts and funeral expenses, unto her husband, Samuel M. Simmons, Jr., absolutely; and W1IERE11S, she further provided that in the event her husband predeceased her, she gave, devised and bequeathed her estate to her son, Samuel M. Simmons, III; and WIIEREAS, her husband, Samuel M. Sinmons, Jr, survived the Testatrix, the estate is distributable to her surviving husband, Samuel M. Sinmons, Jr. fOol ~ ALL Mm BY TIIESB PRESENTS, that I Samuel M. Sinmons, Jr., the sole legatee, devisee and distributee of the estate of said decedent, and the only person entitled to share in the distribution of said estate, do hereby declare and say that I have examined the foregoing Account and find the same to be true and correct and in strict accordance with the terms and provisions of said Will, and do hereby acknowledge that I, <lave had and received of and from Samuel M. Simmons, Jr., Personal Repre~~ntative of the Estate of Celesta E. Sinmons, the items set opposite my name as advancements in the above stated Account in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purparts and dividends which were due, owing, payable and belonging to me, by any means whatsoever, for or on account of my full share, part or dividend of the estate of the said decedent and all interest accrued thereon. fOol T1~, I Samuel M. Simmons, Jr., the sole legatee, devisee and distributee of the Estate of Celesta E. Simmons, deceased, do by these presents remise, release, qUit-claim and forever discharge the said Samuel M. Sinmons, Jr., his heirs, executors and administrators, of and from my said shares or dividends of said estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any other act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these said presents. AND, desiring to avoid the delaying and expense of the settlement of the said estate by filing the foregoing Account of said administration in the Office of the Clerk of the Orphans' Court of said County, and by having the balance in the hancls of the Executor, as shown by said Account, distributed by an auditor appointed by the Orphans' Court Division, of the Court of COllI1'On Pleas of Cumberland County, I do hereby agree that the foregoing statement concerning the manner of settlement may be recorded with the same effect upon me as if the same had been reported by the said Court of COmmon pleas -- Orphans' Court Division. AND, in consideration of the aforesaid settlement being made without the aid of said Court of Common Pleas - orphans' Court Division, that I, Samuel M. Simmons, Jr., do hereby agree that if any debts or demands other than those included within The First and Final Account of the said Samuel M. Simmons, Jr., Executor, of the F~tate of Celesta E. Simmons, deceased, as hereinbefore set forth, shall be hereafter recovered against the Estate of said decedent and be legally payable out of the same, that I, Samuel M. Simmons, Jr., shall return to said P.xecutor such amounts thereof as may be necessary to pay such debts or demands. IN wrmESS WIlEREDF, I have hereunto set my hand and seal this ;l'/"-" day of cPr:-1"'IJ~,J , 1999. . I /h-J' }O~();/ /-1 ('--Ji', I',",,} q I , SIlmuel M. S mmons, Jr. ,/1 STATE OF PENNSYLVANIA : . . ss. COUNTY OF CUMBERLAND : Before me, the subscriber, a Notary Public in and for said State and county, personally appeared, Samuel M. Simmons, Jr., and in due form of law acknowledged the foregoing Release to be his act and deed and desired that the same might be recorded as such. WITNESS my hand and notarial seal 1999. thi~ day Ofa/"~.h k) l;tl181 hl:.,1 ChlU'vn hJ!lf'loro, tlol/IIY Pt/lhe Moctltln.'~trlll'l i\o'u Gt.IlI11urlilllll Count, 1.4.,. COlllflli',Illl'">fl ht'III'!; ''',1'( \0. ;'1)1.);) , Member, Pennsylvnnla A!.soCIolliOtl cl Ncl.lltCfi