HomeMy WebLinkAbout96-00138
PETITION "'OR IlROBA TE and GRANT 01: LETfERS
E..,a/I' IIf _c/~_L Qca ~~ No. _J.J.:9'./ 31
als<I k<l<lll'/I as Zl-- To:
Re~i'ler or Will5 ror I\le
, IJ.orcaIl'd. CounlY or ~ in Ihe ClMBERLAND
S<I,.;al SCI'urit.\' Nil. --i-u:-;t. - C; :Ill Comnlllnweahh or Penn'ylyania
The pelilionor Ihe under,i~ned re'peelfulll' repre,enl' Ihal: .
\'ollr pelilioner(,), "ho is/me IN year, of a~e Ilr older anlhe exeeul.LU~
inlhe la'l "ill Ill' Ihe ahme den'denl, daled _~..:.-_d'P'
and cndidl(,) daled
r:f,?
,19
('lalt" Ielr\anl drnlll1\l,lIIn.'\, r,lI. h'llund:llinn. llc;llh uf ("rnllnr, ('le.J
Oecendenl wa, dllmkiled al deollh in _C~ ~CQUnIY' Penn~yIYania, with
h--t.4l ~la'l ram ill: or yrindpj! residence al -IIJL!..:.A. . tiLL~ t: fJ.;:r
_~~'--'+DI/ -Co J .
(11\1 \111.'1:1, l1umh"r .mJ 11111111.'111;1111)1
))ecendem Ihen 'i 1.. yem or age, diC~>V' /"1-- , 19 f/ ~ ,
~~ JH.
nI E\Cepl a' I' . ~":vdecedenidid nol m ry, wa, nol divorced and did nol havc a child born or adoPled
afler e\eculiln or Ihe "ill off red ror probale; wa' nollhe ,'klim or a killing and was neyer adjudiealed
incompelem:
))ecendenl al death .'''n d prnperty "ilh cMin1nICd ""Iue, a' rollow,:
(II' ,10m idled in Pa,) All per,onal property
(II' nol dllll1idled in I'a.) I'er,onal property in l'enllSylS'Unia
(II nOI domidlcd in I'a.) I'er,onal property in Coumy
Value of real c'lillC ill l'enn'l'lvani:~ d . ~
,ilualcd a, 1'0110"': -I.LQ~1-11---~~
----fi!'o =<..Jf&.<u''''~ 6.A... - . P ./ i-
f
s
s
s
C s ~ OOO,M)
. ::.
~ "'f2ft eI,,~
WHEREFORE, pelitioner(,) re'peclfully requ~1'J~ pro!'iLe or the la,l will and codieil(s)
pre,emed here"ith and Ihe gran I of leller,_--1: HJ!aiZ""~
' 1l.."lilmCnliU~; iHJr1\1l11\1r Ilm l:.t.iI.; adminim.lllon d.h.n.t.l.a.)
thCIUII.
,
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-OS-l-/..(.L I ALU~J/I'.., ,'(',/.
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_l2JLc./xvlh'-L''!''':J- . Pa J70n-
OATH 0... IlERSONAL REPRESENTATIVE
CO!\l!\lONWEAI.T11 OF I'ENNSYI.V ANIA }
COlJ~n' OF CU1BBf\LA.'lD ~>l
---
The pelitiuller(') "bu'e'lIamed ,\Seill(') or affirm(,) lhal Ihe 'lmemelll' illlhe roregoing pelilion are
trlle ,11,,1 curr<cllu Ihe he'l uf Ih,' k:UllSlcdge "nd helieI' of pelilioller(,) and Ihal as personal represen.
10Ili....I'1 uf Ihe ,,"u'e ""<ellelll peliliuner(,) will "ell "nd truly "dl1lini'ler Ihe e,lme aefording to law.
s~ II h' ur affirmed "",I ,,,h,crihed j ciJ/t11;': '~L:'/;(I1'Jl~P&r0 ~
~cfu ' lI1e Ihi, ---~!} - --- sl'l '~ . ~
~ _~i'i;L ---,-- 9 - -- - ~
_.lii2;~6. (M.(~jJJ - ~~,tf ~__Y;&~'-~~L;""/ I
/5- 85-1 O'\ARY l:. LE.WI::;' R~ - -- ~
... .
..
Di OF ~VANIA)
)55:
OF CUMBERLAND. )
I, CHARLES E. JACOBS , the testat or , whose name is signed
the attached or foregoing inst:runent, having been duly qualified accordiJ1g to law,
hereby acl<nowledge that I signed and executed the insttunent as Ill)' Last Will and
estament; that I signed it willingly; and that I sipled it as Ill)' free and voluntary
t and deed for the purposes therein expressed.
Sworn and affirmed to and acl<nowleclged before me, the 28th clay of
December , A. D., 19-1!!L.
~'IH OF PENNSYLVANIA)
)55:
)
~tai'&<~/7
My ('rr.rn; " S ion Expir
NOTARIAL SEAL
IWlY S, ROBINSOll. NOTARY PIJIlLlC
HECHANICSBURG BOAO. CUCllRI.AlI1l CO.
My C...t..lon Exptre. Sept. 21. 1991
(SEAL)
OF CUMBERLAND
We, the undersisned,
and
J. ROBERT STAUFFER
, the witnesses whose names are signed to the attached or
oregoiIlg inst:runent, being duly qualified according to law, do depose and say that
were present and saw the testat or CHARLES E. JACOBS.
ign and execute the instnJDent as his/i1elr Last Hill and Testament; that the said
tat or CHARLES E. JACOBS .' signed the same willingly and
t the said CHARLES E. JACOBS , executed it as his/_ free and
luntary act for the purposes therein expressed: that each of us, in the hearing and
ight of the testat or ,signed the Will as witnesses; and that to the best of our
ledge the testat or ,was, at the time, 18 or uore years of age; of sauro mind;
d under no constraint, duress or \J1'ldue 1u
rn and subscribed to before me
2lll:h clay of December
, 1988 .
IWlY S. ROelNSQll, NOTARY P\J!I.1C
HECHANICSBURG BOAO. CIMIlERLAND CO.
My Cooal..lon E.plro. Sept. 21. 1991
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUM'ERLAND
}
II:
HARlE H HANSFtEJ.D & BWI.AU J ATKINSON
b.lng duly qualified .ccordlng to I.w, d.pos.1 .nd s.y<<thet they arc lhe
execlIlric<!fI of tho Estet. of Charlefl E. Jacobs
t.over Al t<!" TvI"
I... of _ __ , Cumberland County, Pe" d.c.es.d end th.. tho
Ithl I 1 t d b Harie H. HansU<!td & Belltnh J. Atkinson th Id l!xcculricefl
w n. en nven ory m., y , . Ie
of tho .ntir. .stet. of .eld d.c.d.nt, consisting of ell tho p.rsonal pro".rty end rul ..te", exc.pt rul ...... outsld.
tho Commonwealth of P.nn.ylvenie, end th.. tho figur.. opposlt. each It.m of tho Inv.ntory r.pr...nt It'. felr velu.
II of tho det, of d.c.d.nt's death.
~'Y II
19 9"
~~~n~~
Eneut., . Alm'nht,.t.,
'I1..-eJ. <L Qzj....~
Belllah J.OAlkinson ...
4201 Gettysburg Road
Camp Iii II PA 170 tt
Add....
.~~~
and subscrlb.d b.for. m.,
Notarial Soal
Gordoa V. Hamilton. Notary Public
Lower Allon Twp., Cumberland CounlV
~Y Commission E'plras Aug. 27, 199B
MC!T(Io)r.~AssociaQ1of_
of Duth
DIY
January
M..th
1996
.
Det.
v..,
INSTRUCTIONS
I. An Inventory must b. fil.d within three month. after appointment of p.rsonel r.pr...ntetive.
2. A .uppl.m.nt inventory must be filed within thirty daY' of di.covery of edditlonal e...ts.
3. Additional shoots may b. attach.d e. to personalty or rulty
4. S.. Articl. IV, Flduciari.. Act of 1949,
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Inventory 01 the real and personal estate 01
Charlcs F.. Jacobs
deceased
1.
Thrce (3) Single Fa.ily Dwellings:
3803 Rosemonl Avc.
1101 Pri.rose Ave.
~lOlA Primrose Avc.
$88,000. 0
2.
Personal Properly
14,746. 0
Tolal
102,746. 0
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20. If lint 19 is gr.ater thon lint 18, .nt., the diK.,."c. on lint 20. This is ,h. OVERPAYMENT.
ElO
21. If lint 18 is g,.al.r than lint 19, .nt., thl diff,r,nu on lint 21. This ilth. TAX DUE.
A. En'., the int,rell on ,h. balance due on lint 21A.
B. Enl., ,h. 10101 of lin, 21 and 21A on lint 218. This is the BALANCE DUE.
Malle Ch.eI, Payable to: R.ght., of WIII'1 Ag,nt
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH <l( <l(
Und.r penalti.. of perjury. I d.dol. .hot I have 'llomined this ,.Iur", including accompanying sch.dul.. and .tot.menh. and to the b.., of my knowledg. and beli.I,
ill. Iru., corr.el and campi.,.. I dldor. thot 011 no1 '''01. has b..n '.port.d at fru. marke' valu.. D.c1aration of pr'par., oth.r .han th. pltlonal '.pr.s.ntativ. i~
bOled on 011 information of which preparer hat any knowledge.
'''''(tJyrl gh..:t~N A'll('r~W 10' ""~",..'::'N.hI .!}j~ OAll /
. ,'H. H, I '.\"iiif 'Cr. t s b IO!!! /9t,
,. HI. O' E _ IH t_UENUIIVE AOOln DATi' ,
. t513 Cedar Cliff Dr., Camp Qi11, PA 17011 /~$I'~
~
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'*'
'5-},'~)-'--1
FOR OATIS OF DIATH AnlR 12/31/91 CHICKHIRI
IF A SPOUSAL
POVIl" CRlDIT IS CLAIMID 0
fILl NUMIIR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
COMMONWeAUH 0' '(NNSYLVANIA
D!,.UTMENT 0' '!V!NUe
DOT. 2.0601
HAUISlUIO. ,... 17121.Q601
ON' NAM (lAI. fIRS . AND MIDOIIINI IAq
96
YEAR
0138
NUMBER
21
COUNTY CODE
OICfOENT'S M'U I ADDIE
8
lil
hl
..
C S CIIAR!.J'S
SOCIAL SlCU_lfY NUMln
187-16-5394
DAIl 0' IllTH
t/26/t897
IIOIA PrlmroHr AvO'.
Camp 1I1tt, PA t70t1
COIIIlI II n
AMOUNt IICIIYID I'll INU_UCTIONSI
N/A
03.
05.
".
DAll 0' DIAIM
1/12/%
II' AH\l(AIUII",I'r,YIMQ liJOUU I ....."'IIl.II. "'" "NO "',OOlI'N,fIAU
N/A
N/A
[) 1. O,iglnal R.'urn
o 2. Suppl.m.ntal Return
Remainder Return
(la, da.., al d.alh priar la 12.13.821
Federal Ellal. Tax Return R.quir.d
::i8
....
..z
82
o A. limited Eliot. 0 "a. Future Inl.rll' Campramil'
Ifar da.., al d.a,h ah.. 12.12.82)
[J 6, DlCeden' Di.d Tlllal. 0 7. D.Cld.nl Maintain.d a living Trull
(AICach capy al Will) IAllach c.py al TIUlI)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DlREClED TO.
N..... COM'UTt MAllINO ADDIlS
Harl" H. HanHfJ"ld 4201 C;"llysbllr& Road
"L1'HON'NUM'" r.alUp 11111, "(1)(')7011
761-6176 Co ,- .r
"il
_8, Talal Numb., of Saf. D.palit BouI
z
'"
;::
:5
~
u
OM
..
1. R.al E,'a.. 15ch.dul. Al (I) 88.000.00
2. Slack. and Band, (Sch.dul. 8) ( 2) -0-
3. Clol.ly H.ld SloclJPartnlfshlp Inlerllt (Sch.dul. q (3) -0-
... Mortgages and NOles Receivable (Sch.dule DI (. I -0-
5. COlh, Bonk D.palitl & MilCll/an.aul Penanal Prop.rty (5) 14.746.50
(5ch.dul. E) -0-
6. Joln'ly Own.d P,ap.rty ISchtdul. F) (6)
7. Tran,l", 15ch.dul. G)ISch.dul. LI (7) -0-
8. Talal Gran Au." ('alaflinll 1.7) 22,203.06
9. Fun.ral Ex~.nlel. Administraliv. COliS, Miscellaneau, (9)
Exp.n"l ( chedul. H)
10. D.b", Mortgage liabililill, liens (Sch.dule I) (10) -O-
11, Total Deductions (tolallin'l 9 & 10)
12. N., Valu. of Ellate (line 8 minuI lint 11)
13, Charitable and Gav.rnm.ntol a.quel" (Schedul. J)
U. N.t Valu. Subject 10 Tax (lin. 12 minut lint 13)
15. Spoulal Trani"" (for datil of d.ath ah., 6.30.9..)
S.. Inltruetiant for Ar.plicable Percentage on R.ver" (IS)
Sid.. (Indud. value, rom Sch.dule K or Sch.dul. M.) 76,5/.3.44
16. Amount af lint U 'axabl, 01 6% role (16)
(Indud. valulS from Sch.dul. K or Schedul. M.)
17. Amount of lint U laxable 01 15% rote (171
(Indud. valulS from Schedule K or Sch.dul. M.I
18, Principal lox due (Add lax from lin.. 15, 16 and 17.1
19, Credits Spaulal Payerty Credit Prior Paymentl Dilcaunt
+ +
(191
1201
c.
-,
_J
(8)
102.746.50
(11)
(121
(13)
(141
22,203.06
80,543.44
4,000.00
76,543.44
X.__
)( .06 :I
4,592.6t
)( .15 :I
z
2
...
c
...
E
:II
..
u
:o!
...
1181
4,592.61
Inlerll'
Ch~(k here if you orc fcquc\ling a refund of your overpayment.
121)
121A)
1218)
4,592.6t
4,592.61
A, ~TTLEMENT STATEMENT
U.S. DEPARTMENT OF HOUSING
AHO URBAN DEVELOPMENT
ONB NO, 2502'0265
......
,r
B, TYPE OF LOAN
" II FHA 2. [ I FmHA 3. IXI Cony, Unll. 6. FILE NUMBER 7, LOAN NUMBER 8, I40RTGAGE INS CASE NUMBER
4, II VA 5. [ I Cony. Inl, Ka
C. NOTE:Thll form t. furnished to glv, you I Itlttment of actual lettl~nt COltS. Amounts paid to and by the .ettlement agent
ar. shown. Itenw Nrked II[POC]" wert paid outside the Closing: they ar. shown her. for Intormltlonll purpoII' end are
not Included In the tOUlI, 4,2 05'95 (7/Ka)
O. NAME AND ADDRESS OF BORROWER E, NAME AND ADDRESS OF SELLER F. NAME AND ADDRESS OF LENDER
THE PRIMROSE ASSOCIATES
CHARLES E. JACOBS ESTATE
FUL TON BANK
G. PROPERTY LOCATIOH
3803 ROSEI4ONT AV/l101 PRIMROSE
CAMP HILL, PA 17011
LOWER ALLEN TWP CUMBERLAND CO
H, SETTLEMENT AGENT 23 2386065
LEON HALLER ESC AGENT/PURCELL KRUG HALLER
PLACE OF SETTLEMENT
FUL TON BANK
CAMP HILL PA 17011
I, SETTLEMENT OATE
September 16, 1996
J. SUMMARY OF BORROWER'S TRANSACTION
112,
120. GROSS AMOUNT OUE FRON BORROWER
412,
97,900,21 420. GROSS AMOUNT DUE TO SELLER
89,049,71
219. 519.
220. TOTAL PAlO dY/FOR BORROWER 82,800.00 520, TOTAL REDUCTION AMOUNT DUE SELLER 923.00
300, CASH AT S.TTLEMENT FRON/TO BORROWER 600. CASH AT SETTLEMEHT TO/FRON SELLER
301, Grosl An" Due from Borrower Illne 120) 97,900,21 601, Gross Amount OUI to Seller Illne 420) 89,049.71
302, Le.. Amt Paid trot/for Borrower 11Ine 220) 82,800.00) 602. LISI Reductions OUI SIller Illne 520) 923,00)
303, CASH (X) FRON I TO ORROWER 15,100,21 603, CASH (XI TO [ I FRON SELLER 88,126.71
The U"Kf.rllgnfl:t hlr. led; ef.p of. cDl'f1)leted copy of pages 1&2 of this statement & any IttlchmenU referred to her,ln.
SELLER
CHARLES E. JACOBS ESTATE
y:;.,.uJl-Ji'j ()H,~ ~.~
HUD.l (3'86) RESPA,
HB 4305.2
SELLER
'.
-
.
SETTLEKENT STATEKENT PACE 2
L, SETTLEKENT CKARCES
~ ~ PAID FROM PAID FROM
, BDRROlIER'S SELLER'S
..... -. <:~~?:.:~T FUNDS AT
...., ."~..,
~
704~
I ~-..~-- , nnnn , -..- -,;;0; nnnn'
~~
~ --. .. .", Tn. ....
..;-~ <~j
. ,.,.;,-=. ~ -..-
-== ....
...-n
Bl',
900, ITEKS REQUIRED BY LENDER TO BE PAID IN ADVANCE
I --.-;;;;;;:- ~.v. ..
~.,.. ".
... '.~.~--.;;-
905,
--urc
~ ..... ~. ~.,.
~.,.. o . - .:.;;.--;;;.;;;,,;-
~
[;-=--.= ~. ~.,.
~.,.. . . ;....--~~.
~
100B,
-.~ '-';;-
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.= ".
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-=-.~
itiiR = 'n.,,,n,.,,. ~ ,no nn
,
,. -. ~.nu .." 'D 'orDnu 'O'.T
""'=
....-.-.....
~'3'rl ..... n-';-';;'. ,. <n . 1lli" --..--nn ==-
. ~
~-= , . ..n,or
11205, ::!Q[
I"'i'ii
1* ".
I ..;-
....,-
1305. See Exhlbl t of Additional Dlsburs....nts 4,00 B,OC
1400, TOTAL SETTLEKENT CHARCES CEnter On Lines 103, Section J and 502, Section Kl B,B50,50 923.0C
By signing page 1 at this statement, the signatories acknowledge receipt of a completed copy of page 2 of this 2 page statement.
(7/KDI
Certified to be . true copy
L HALLER ESC ACENT/PURCELL KRUG HALLER
Settlement Agent
. ,
,
AGREEMENT
0~--\I......h. JnT/",!
THIS AGREEMENT MADE ON l~ ...< 3 . 19 ~BEr.:E.EN /'r 1"- ~' t. f..) nla,';' ,.:':, d,,1
:1'-'1"-'" '." .r "F -., 1_ /.'./ '" ..t1......I.".~.~
?.. ~_... " ,". .f _.~ ._'''' '.' '
, , L
PHONE 1-:, 7\ (.. '17; .) 'f I ( ',HEREAFTER CAllED THE SellERS AND G 10....) '-> A..A'" I''; , \
~C .-,' T' 5 h ~ i Ii ) , HEREAFTER CALLED THE AUCTIONEER
BOTH PARTIES AGREE THAT THE AUCTIONEER Will CONDUCT A PUBLIC AUCTION OF PERSONAL AND OTHER PROPERTY OF THE
SEllERS AND THE AUCTIONEER Will USE HIS PROFESSIONAL SKILLS, KNOWLEDGE AND EXPERIENCE TO THE BEST ADVANTAGE OF BOTl-
PARTIES IN PREPARING FOR AND CONDUCTING THE AUCTION.'
, THE ~~~dN I~ TO ~E HELD ON .. . 19 'l ('-
AT 0 - . .' , '1 "Ij,: fIt" (/0 I / (LOCATION)
IF THE AUCTION IS POSTPONED FOR ANY REASON B~YONtn THEil"PARTY'S, 0 TRPL\ TH~UCTION WILL TAKE PLACE AT A LATEF
DATE AGREEABLE TO BOTH PARTIES. \ i >,J.,.., I
THE SEllER HEREBY AGREES TO TURN OVER AND DEUVER TO THE AucTIONEER TH'l:' ITE 5 LISTED BELOW TO BE SOLD AT PUBLIC
~UCTlON: \J'
~ ~ '
, '-e....... ,h, \ ,':)(.....,0,.-')0 ) '('c..( ~.d4<rf'"
, '1.0 u ( 1:0-:.>
o SEE AlTACHED SHEET~
NO iTEM SHAU BE SOLD PRIOR TO OR WITHDRAWN FROM THE AUCTION EXCEPT BY MUTUAL AGREEMENT OF BOTH THE SelLER ANt
AUCTIONEER. .. .
_ IT IS AGREED THAT AU GOODS Will BE SOLD TO THE HIGHEST BIDDER EXCEPT THOSE ITEMS SPECIFIED IN WRITING BY THE SELLER TC
HAVE A RESERVE BID. THE SELLERS AGREE THAT THE AUCTIONEER'S FEES (AS LISTED BelOW) WILL BE DEDUCTED FROM THE GROSS Rf
CEIPTS OF SAID AUCTION. THE AUCTIONEER AGREES TO TURN OVER THE NET PROCEEDS OF THE AUCTION TO THE SEUERS WITHIN A RE.t
SONABLE TIME AFTER THE AUCTION, ALONG WITH SALE RECEIPTS AND RECORDS. THE SELLERS AGREE THAT ALL AUCTION FEES & E>
PENSES, AS LISTED BELOW. WILL BE DEDUCTED FROM THE AUCTION PROCEEDS BEFORE RECEIPT OF PAYMENT AND SATISFACTION C
ANY LIENS OR ENCUMBRANCES. .
PROFESSIONAL FEES
PROMOTIONAL EXPENSES:
)
AUCTIONEER
PERSONAL PROPERTY ....................
REAL ESTATE ...............................
CAPITAL GOODS.......................... ..)
OTHER
;)570
,
:.2. '?"
.)
OTHER EXPENSES:
, j
,-... ,
r
.
I
I
I
!.,
i
I
CLERK. ........... ............ '0' ... .... ............... .... .... ../
CASHIER ..............................:.....,................ ,)
OTHER PERSONNEL:
FOOD VENDOR:
THE SEllERS AFFIRM THAT THEY HAVE GOOD TITlE AND RIGHT IO'SEll SAID PROPERTY AND THAT THE PROPE IS FREE OF ALL Er
CUMBRANCES AND LIENS EXCEPT AS FOLLOWS: ' ' '. P~OXIMATE
.
.!!EM. MORTGAGE OR LIEN HOLDER U AID BALANCE
"
"
......7
c I.Jo.J.c. ~, 'Il" ,~;. ,,',
u.~,. ,'J\ r;. t ,(v.../
. I AUCTIONEER SIGNATUR~
o LICENSED AND BONDED IN FAVOR OF THE STATE -
-"'< "J _ LICENSE /I ,: ./ " .- ,_
~ " (
t! .;' 1- , '.
I ,..../~~/.#-\ .,. II , I~ It,"-",,"""'",-
SEllER'SIGNATU~E" , '
SELLER'S COpy
.,' .1 .
<..1 ''ShlER'sfcNATURE
. -.'
.
'."1'1 J .
",
\.
CONSIGNOR'S NAME
j\( (. f: ',-
Jc,( '/ ~C {7/.
LOT #
ADDRESS
RECEIVED BY;
PHONE
ZIP CODE
DATE
UU'''"'' DESCRIPTION OF CONSIGNED ITEMS OU'NIIIY DESCRIPTION OF CONSIGNED ITEMS
':'
SHEET II.
OF_TOTAL SHEETS
SETTLEMENT
r;(f]. <:
....$
I herebv commission you to HII the Items lisled aboYe & on the at-
tached sheet. to the hlghest biddof by publiC autton. I certlly thai
I am the owner 0' (he above lisled Ilems and have good title and the
riQhllO aellltwnn. I C8l'bIV thai the Items IlSled are free from all In.
cumbran:el. I DOree 10 accept all re'~bIIlly for providing QOOd
bile and for doIlWtry 01 hUe 10 the IUdU1w. It is agreed IMllho
consq'ee is not respons.ble 'or the loss 01 any .Iem duo 10 fife, theil,
datMQe, elc I understand thai a "\ commfSslOfl
WlI be ded.cted horn tho gross sales of my lImns
TOTAL CONSIGNOR SALES
EXPENSES:
..., .-
,.-' -' % COMMISSION
N2(; .bY
$ ,
S
$
TOTAL EXPENSES
.;....
.
$
/11-' .
Y c"(, l .
V J. {.'/. 7 I
Conslgnor SlQl\1turo
CHECK NO.
NET PAYABLE TO CONSIGNOR
CONSIGNOR'S SETnEMENT COPY
',..1JlllhP'''''
~.'::":~
- %{i-
(OMMONWtALfH 0' ,eNNSYLVANIA
INHllUTANCl TAX UTU.N
USIDlNT DlClDlNT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
t
0138
CHARLES E. JACOBS
ITEM
NUMBER
AMOUNT
DESCRIPTION
1,
A. Funeral Expen...:
2.
3.
Hyers Funeral Bo.e
Brother v.. Jones - Funcral Scrvicc
Ricc He.orial Works - Headstone Engraving
$ 4.405.00
100.00
75.00
1.
B. Admlnl.tratlve Ca.'a:
2.500.00
2.
3.
4.
C.
1.
2.
3.
4.
S.
6.
7.
8.
Persanal R.presentalive Commissions - Harie H.
Social S.eurity Number 01 Personal Representative:
1996
Hansfield _
191-74-0117
Year Commissions paid
Allarney Fe.. - J. Robert Stauffer Esq.
Professional Fees - Charles F. Sullivan CPA-Preparation of PA
Inheritance Tax Return
185.00
2.500.00
Family Exemplian
Claimant
Relationship
Addre.. 01 Claimanl at deeedenl's dealh
Slreel Addrell
Qy ~~e
Zip Code
Probate Fe.. Register of Vills
97.00
Mlse.llan.au. Expens..:
Patriot-News 63.40. Cumberland Law Journal 60.00 -Advertising
123.40
Erie Ins. Group. - Liability Insurancc
33.00
Associated Prods. - Toilel for sale
114.50
R.Y. Fager Co. - Water Heater for ltOl Primrosc
188.84
Settle.ent Costs on Sale of Real Eslale
923.00
Robert T. Sholly. Gladc's Auction-Commission on R.E. Sale
1.760.00
Robert T. Sholly, Glade's Auction-Commission of Sale of Persona
Property
3.686.63
Wayne Hansfield - Haintenance
27.00
TOTAL (Also enter an line 9. Reeapitulalianl
5 l6.718.37
(If mare space I. n..ded. In.ert addltlanal.he... af same .1.e,1
'1'4-.."0."....
-!:@;!-
COMMC)HWIALf'H 0' PlNNSYlYAHIA
INHlllTAHCI TAl _ITUIN
_lltDINT DlelDINT
PAGE - 2
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE com AND
MISCELLANEOUS EXPENSES
Ploa.. Print or T 0
21
96
CHARLES E. JACOBS
ITEM
NUMBER
DESCRIPTION
1.
A. Funoral Exponloll
1.
B. Admlnlltratlvo Callll
Ponanal Represontall.. Commissions Beulah Atkinson
Social Socurity Numbor 01 Pononal Roprellntati..: 17 1
Voor Commissions paid
28
0939
2, Anornoy foil
3,
4,
C.
1,
2.
3,
4,
5.
6.
7,
8.
Family Exomption
Claimant
Address 01 Claimant at docedonl's deolh
St..ot Address
Relationship
City
Slate
Zip Code
Probate FOil
Mlscollanooul ExponseSl
Donald Atkinson - Haintenancc, Rcpairs & Cleanup
Hary Ann Prior, Trcas.-R.Estate Taxes ($464.92+1,108.36-1,019.5 )
Pri.rosc Associatcs - Rental Refund
Hellon Bank - Bank Service Charges
Utilities - PP&L $254.56, PA we $389.77, LA Tvp.$594.00-30.13
Bcll Atlantic $31.20, Fucl Oil $156.00
Charlcs F. Sullivan, CPA - Preparation of 1996 Fiduciary Inc.
Tax Rcturns
TOTAL (Also enler on line 9, Rocopitulollon)
(II mar. IpOCO Is n..dod, Insert oddjtlonalsh..ts 0' lam. II..,)
0138
AMOUNT
2,500.00
359.26
553.70
156.33
20.00
1,395.40
500.00
s
5,484.69
\.......:-+-.;.,-~.~~,-"--"'"".,,":...~ ."._~".,-.'" ',\ .:.-"
.
ISTATI O'
CHARLES E. JACOBS
ITEM
NUMIlER
1l~.~tIHh(1.f11
1,
2.
3.
4.
ITEM
NUMIlER
~
(OMMOtfWIALfM Of ptNNln'll,.'A
.....IIfAHCI tAl UNI..
........ -,
SCHEDULE J
BENEFICIARIES
fiLE NUMIlER
21
96
0138
NAME AND ADDRESS OF IlENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
A. T a.ablt Btqutlll:
$7,000.00
+ 201 of Residua.
Beulah J. Atkinson
951 w. Trindle Road
Mechanicsburg, PA 17055
Daughter
Marie M. Mansfield
4201 Gettysburg Road
Camp Bill, PA 17011
Daughter
5.000.00
+ 201 of Residua
Dorothy M. Hiller
91 Deer Lane
Carlisle, PA 17013
Daughter
500.00
+ 201 of Residua
George Jacobs
886 Cedars Road
Levisberry, PA 17339
Son
201 of Residual
NAME AND ADDRESS OF IlENEFICIARY
AMOUNT OR
SHARE OF ESTATE
8. Charitable and Gonrnm.nlol B.quI.'I:
$4,000.00
1.
Mountain Bible Brethern Church
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o tnlor on lint 13, RtCopaula.ionl
(If more .pace II n..d.d, In..rt additional .h.... of lame .1..)
S 4,000.00
'.
. ' .
QoMlN\olEAL'IH OF PE1tlSYLVANIA)
)ss:
CXlNIY OF CUMBERLAND, )
I, CIWlLES E. JACOBS , the testat or , whose name is signed
o the attached or foregoing inst:runent, having been duly qualified according to law,
o hereby ackn::lwledge that I signed and executed the inst:runent as my Last Will and
estament; that I s:1gned it willingly; and that I s4;:ned it as my free and voluntary
ct and deed far the purposes therein expressed.
Sworn and affirmed to and ackr10wledged before me, the 28th day of
December , A. D., 19~.
l'm'lWEAL'IH OF PENNSYLVANIA)
)55:
JUNIY OF CUMBERLAND )
We, the undersigned, J. ROBERT STAUFFER and
JOHN M E"AKIN , the witnesses whose names are signed to the attached or
Jregoing inst:runent, being cIuly qualified according to law, do depose and say that
! were present and saw the testat or CHARLES E. JACOBS.
ign and execute the instzunent as his/hm- Last 'yill and Testament; that the said
CHARLES E. JACOBS ., signed the same willingly and
:lat the said CHARLES E. JACOBS , executed it as his/_ free and
)luntary act for the purposes therein expressed; that each of us, in the heariIlg and
ight of the testator ,signed the Will as witnesses; and that to the best of our
:xMledge the testat or ,was, at the time, 18 or tl'Dre years of age; of sOlJ1'ld mind;
1d under no constraint, duress or lu
~~~~A/?
My Crr.m~ "sion ExpiI
NOTARIAl. SEAl.
MARY S. RQ11NSOll. NOTARY PUIlLlC
IEClWlICS8UIlG BOAO. ~RlAlID CO.
"1 Co.ol..lon Explrl. Sept. 21. 1991
(SEAL)
. .
10m and subscribed to before me
28th day of December
o
,
, Comnission:~~ires:
MARY S. R081HSOlI. NOTARY PIJ8l.1C
IEClWllCS8U1lG BOAO. CIIlBERlAlID CO.
"1 Co.otuton Earl". Sept. 21, 1991
/5-,f'5 - 'I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAMES
INHERITANC[ TAK DIVISION
DEPT. uoua
HARRlsaURe. PA 111ll.0.01
G
NOTICE Of INHERITANCE TAM
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSHENT OF TAM
MARIE M MANSFIELD
4201 GETTYSBURG RD
CAHP HILL PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
17011
02-03-97
JACOBS
01-12-96
21 96-0138
CUMBERLAND
101
Anount R...tttad
*'
'(,.n.I"," III-hi
CHARLES
E
MAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiE'y:is4i-EX'AFP'ii'F9&T"iioYicEuo"uiNHEiiifAiicE-YAiniPPRiiisEifiiir;-,U.DiwAiicE-iili-----------mu.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JACOBS CHARLES E FILE NO. 21 96-0138 ACN 101 DATE 02-03-97
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSHENT OF TAX:
15. Allount of Lln. 14 at Spou.al rat. (15)
16. Aaount of Lin. 14 taxable at Lin..l/CI... A r.t. (16)
17. A.ount of Lin. 14 t.xabl. at Collateral/CII.' B r.t. (17)
la, Principal Tlx Due
TAX CREDITS:
PAYHENT
DATE
10-15-96
TAX RETURN WAS I I X) ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rool Estoto ISchodule Al III
2. stock I and Bondi (Schedull 8) (2)
3. Cloa.ly Held stock/Partnership Int.rl.t (Schadul. C) (3)
4. Hort;lgl.IHot.. Receivable (Schadull OJ 141
5. Cash/Bank DIPolltl'Hllc, Parlonal Property ISchedule EJ 151
6, Jointly awnod Property ISchodulo fl 16)
7. Transfers ISchedule GJ 171
&. Total Allet.
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expanse./Ad". Co.te/HlIc. Expenu. ISchedule HI C91
10. Dobt./Hortgogo Llebllltlo./Llon. ISchodulo II elOI
11, Totel Doductl.ns
12. Het Value of Tax Return
13. Charitable/Govern"ental Baquast. ISchedule JI
14, Not Veluo .f Estoto Subjoct to To.
NOTE:
RECEIPT
NUHBER
AA146841
DISCOUNT
INTEREST
etl
e-)
3,40-
I CHANOED
88.000.00
.00
,00
.00
14,746.50
.00
.00
18)
22.203.06
.00
elll
llZI
1131
1141
.00
76.543.44
,00
M .00.
M ,06.
M .15.
IUI
AHOUNT PAID
4.592,61
INTEREST IS CHARGED FROM 10-16-96 TO 02-11-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST,
NOTEr To insure proper
credit to your account,
.ub.it the upper portion
of this for" with your
tax pay"ant.
102,746.50
n.'o~ 06
80,543.44
4,000.00
76.543.44
.00
4,592.61
.00
4.592,61
4.589,21
3,40
.10
3.50
I If TOTAL DUE IS LESS THAN 'I. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REfUND, SEE REVERSE SIDE Of TNIS fDRH fOR INSTRUCTIONS. I
00 :o~
~~ ~ ~~ ~
c
"
..." ...
.. Gl 'I
I ,. ,
w
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, ~ .- ..
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OJ
RESERVATlON. E,"'" of dlcedent. dYing on or blfor. D.c.~r 12, .9., .. I' any future Int.r..t In thl ....t. I. tranl'lrred
In po.....lon or enJoy.."t to CI... . Icol1,t,r.l) bln'flcl"I.. of t~ dlc.dlnt .'t,r thl ..plr'llon of ~y ....t. 'or
l1f. or 'or y..r., the COaaonM..lth hlt'by ,.pr..,lv r...rv.. thl right to ,ppr,I,. ~ ...... tran,'.r Inherlt~. ,....
It thl l'~'ul el... I Icol1,t,r,l' r.t. on any such future Int.r..t.
PIIRPOSt Of'
NOTICE I
PAMH',
RUUNDICAh
a_ACTIONS I
'OftIN
tln'lIVE
CQlmfCTlOHSI
DJSCCUnl
P[HlL TV.
INTEAUT I
To fulfill the 'Iqulr..,ntl 0' Slctlon '140 0' thl Inhtrltanct and E,t,t, ,.. Act, Act It of 1'91. 72 P.S.
Section l1U.
Detlch the top portion of thl, Hotlcl and .~It with your p.y..nt to the RI,l,t,r 0' VIII, printed on the r.var.. .Ida.
........ check or ItOMV ord.r pa'ubl. tal REGISTER OF MILLS, ADENT
All pa,.ent. r.calv.d shall flr.t be appll.d to any Int.r.st which .ay ba due with any r...lndlr appllld to thl t...
A r.fund of . t.. cr.dlt, which w.. not r.qu.st.d on thl T.. Rlturn, "V b. r.que.tld by coaplatlng In "application
for R.fund of P.nn,ylvlnl. Inherltanc. ~ Estat. TI." (REY.1S1S). Appllc.tlon. ar. ,vlllabla at thl Offlc.
of thl A.gl,t.r of Wills, anv of thl ZS R.venu. District O,flc.., or bv calling the sp.cl.l Z~.hour
ansWlrlng 'Irvlc. nuaber. for for.. orderlngl In P.nn.vlvanl. 1.800.S62.Z050, out,ldl PennsVlvanla and
within loc.l Hlrrl.burg .r.. (711) 181.809~, TOO' Cl1l) llZ.ZZ52 (H.arlng J.palr.d Only).
Anv party In Int.r..t not .atlsfl.d with thl .ppr.ls"lnt, allowanc. or dl.allowance 0' dlductlon., or as'ls~t
of ta. (Including discount Dr Int.rlst) ,. shown on thl. Notlc. au.t obJ.ct within .Ixty (60) day. of r.c,lpt af
thll Hotlc. bYI
".wrlttan prot..t to thl PA a.part.ant 0' R.v.nue, laird 0' App..ls, alpt. Z81021, Harrisburg, PA I11ZI-I0ZI, OR
".lleetlon to h.v. thl .att.r d.t.r.lned .t audit 0' the .ccount 0' thl p.r.on.1 r.prlsantatlv., OR
...,,1.1 to the Orphan.' Court.
feetu.l IrtOr. dlscav.rld an thl. .......ant should b. .ddr....d In writing tal pa a.p.rt'.nt 0' AIVanu.,
aut.au a' Indlvldu.l T...., ATTNI Po.t a......ant R.vl.w unit, alpt. Z80601, H.rrl.burg, PA 11Il.-0601
Phone (711) 7.'-6505. SII p.g. 5 0' thl bookl.t "In.tructlon, 'Dr Inh.rltanc. T.. Alturn 'or a A..ldant
Dee.d.nt" (REV.ISOI) 'or an ..plan.tlon of Idalnl.tr.tlv.ly corr.ctabl. .rror..
I' any t.. ~ I. P.ld within thr.. (3) cal.nd.r aonth. .ft.r the d.c.dant'. d..th, . flv. p.rcant cst) discount 0'
the tax p.ld II .llow.d.
ThI ISX t.. .-na.ty non-p.rtlclp.tlon panllty I. c~t.d on tha tot'l of the t.. and Int.r..t .....s.d, and not
P.ld ba'or. Janu.ry I., 1996, the 'Ir,t d.V ,'t.r the .nd of thl t.. lan..ty p.rlod. This non-participation
pan.lty I. app..labl. In thl .... .annar and In thl the .... tl.. p.rlod .. you would apPI.1 thl t.. and Intlr..t
th.t h.. blan .......d .. Indlc.t.d on thl. notlcl.
Int.r..t I. ch.rg.d baalnnlng with 'Ir.t d.y 0' d.llnquency, or nln. C9J .unth. and one CI) d.y fro. thl dati a'
d..th, to thl d.t. 0' p.y.ant. T.... which b.c... d.llnqu.nt b,'or. Janu.ry I, 19.2 b..r Int.r..t at tha r.t. of
.1. (6X) p.rcant p.r annua c.lcul.t.d .t . d.llv r.t. 0' .0001'~. All t.... which blc... d.llnquent on and ,'t.r
Janu.ry I, 19.1 will b..r Int.ra.t .t . r.ta which will vary fro. c.l.ndar y..r to clland.r y..r with that r.ta
ennouncld by the Pi alp.rtaant 0' Rlvenue. Th. IPPllcabl. Intlrlst rat.. 'or 19.Z through 1991 .r'l
'!!!! Jnt.n.t A.tl O.lh Intarllt f.ctor !!!!' Intarllt .... a.llv Int.,...t F.ctor
1.1l lOX .0005,.. 191' 'X .0002"
1911 lOX .OOOU' .....1"1 lIX .GOGSOI
19.' lIX .000301 1992 9X .0002"
I9IS UX .00035' 1993.1994 7X .GOO192
19.. I'X .0002" Ins-I'" 'X .OOOZ'"
"Intarllt II calculat.d .. 'ollowu
INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
".Any Notice Issued .ftar thl tax blcaae. d.lInquent will nfl.ct an Interllt c.lcul.tlon to 'lftlan CIS) day.
beyond the dlt. 0' thl ,s...s.ant. I' p.y.ant Is .ad. "t.r the Intlr.st coaputlttan data shown on the
Notlcl, addltlon.1 tnt.r.st lU.t b. c.lcullt.d.
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uI ~"~,~uJ .~n~n, ~UI IJ -. II" ',t ~eq."'a '~Dleq JO uo auJAp '~UIpI'.p 10 ....~.3
INOU,g1S3I
Recer,!':i: :., ;.:; of
Rer;'r,~,;: ,! Wills
'97 FES 10 P2 :21
Clair.
Cumb..;r,,, i~
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Co., PA
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IMt8Ch tM top portion 0' th1l Notice .nd __It with your paYHnt .... paylb18 to tN ,... Md Midra..
printed on tN rever.. .Sde.
-- If REllDEHT Q[CEDDfT ..a check or ...y or.r pantll' tal REGISTER OF WILLS, AGENT I
-- If tal-RESIDENT II(CEIlOfT ..... chedt or ...y or.r p.yltbla tal CotltONWEALTH OF PENNSYLVANIA.
AU pa,..,h rKtllved ..U tMi .",lIed flr.t to MY Int.ralt ....Ich ..y be .. with MY r_lnder ..lied to tM tIX.
REf\ICD (ellI A rah.nd 0' a tIX cr.eUt, ....Ich .... not r....ted on the Tax A.tum, ..y be r....ted by cOllphUng In
-AppUcatlon far Rlf\rId 0' ~1Y1YW'l11 Inheritance end E.t.t. T..- (REV-ISiS). application. ar. lWtIl1lbl. .t
the O'flce of the R..I.t.r of Will., any 0' the ZS Revenue DI.trlat O'flc.. or 'roe the o.p.rt8ent'. 24-hour
an....r1nt1 .."Ice ,...rs 'or 'or.. orderIng I In PennlylvBnI. 1-100-162-2050, outllde PII"Il"I,Y!VW1"
Md wIthin 10CII1 HIIrrltbur. Ir.. (717) 717-1094, fDO' (717) nz-un (HuIrlng I.alred only).
REPLY TOt Que.Uon. r...rcUna .rrora conhlned on thl. noUce should bra Mtdr...ed tOI PI DepartMnt 0' RlIVenue, lureau
of IncUvldual ,...., ATTNI Po.t A.........t R...,I... LnJt, Dept. 210601, "'rrl*,rl, PA 17121-0601, phoM
(717) 717-6505.
DISCCUfTI
If W!Y t.. due 11 paId withIn thr.. (S) c.lendar aonth. aft.r the cS.c.....t". dMth, a flva pareant (5%) dhcCM'lt
of the t.. ,.Id .. IUOMId.
PENAL TVI
n. 15% tax ....tv non-participation panel ty .. coaputed on ttw tot. I 0' the tu: and Intlrllt ......ed, Md not
"Id ba'ora .J.nu.ry II, 1996, the first day aft.r the and 0' the tax __.ty period.
INTEREST I
Int.ra.t It chtrgad baglmlna wIth 'Ir.t dliy of deUnquancy, or nIne (.) aonth. and ana (1) day 'rOIl the data of
....th, to the data a' Plv-1t. T.... ....Ich bacaM delinquent ba'on Januery 1, ...2 t.ar Int.r..t at the nt. 0'
.he (6%) pare,"t par .... calculated at . dally rat. a' .000164. All tax.. ....Ich bee.. dellnquent on end aftar
~ry 1, 1..2 will balr Intara.t at a r.ta which will v.ry 'rOIl calendar y.ar to calandar year with that rata
announced by the PA Dap.rt.ant 0' R.vanua. The IPPllcabl. Int.r..t r.t.. 'or 1"2 through 1997 .r'l
Yllr Interllt Rata DtIl1y Intar..t Factor
Intlr..t R.t.
a.lly Intara.t Factor
V.ar
UIl zox . GODS" 1917 9X ,OOOZ4?
Ins 16X .00001 1911&1991 lIX .000101
1914 lIX .nnn I"Z 9X .000247
1915 IIX ,000556 199'-1994 n .OGOI,Z
1914 lOX .Oao274 1995-.997 9X .OOOZ~?
--Intarut I. calcul.ted a. fol1ow.1
IH1'EIIElIT . IAL&JICE OF TAX UllPUD X KUKlER OF DAYI DELI"QUEHT X DAILY IwrEREST FACTOR
....
.....Any Notlaa III...ad .ft.r the tu becoM. delinquent ..Ill nfl.ct an Intarut calcuhtlan to flft..., ns) day.
beyond the data 0' the ..........t. If PlYMnt h Ada aft.r the Intar..t COIIPUtaUon data shown on the
Notlea, additional Intar..t au.t be calculated.
STATUS REPORT UNDER RULE 6,12
Namo of Decedent:
Charles E Jacobs
Dato of Death: January 12, 1996
Will No. Admin, No, 21-1996-0138
Pursuant to Rulo 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:
I. State whether administration of tho estato 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. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: April 28, 1998
1)(It~, .~( fJ(;;'t~ a,AJ" L J ()f/e.~"
Signature
Marie M Mansfie]d
Name (type or print)
Beu]ah J Atkinson
co ~<;(
'5~ N ::J~
N 0
lUg; a.. .J .~
~>
C~ l.i .;r
I ~~
"0 ,.
",1> ~ II
ot; .:
......... ' 1",)
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~ .~ s::
a: a: ll)-
uO
4201 Gettysburg Rd Camp Hill PA 17011
Address
717761-6]76
Telephone No,
Capacity:
X
Personal Representative
Counsel for personal
representative