HomeMy WebLinkAbout96-00152
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PETITION FOR PROBATE and GRANT OF LETTERS
No. :J./ - ,qql.t - /5:l.
To:
Bwwof Carl Ravmond Adams
also known as
Regisler of Wills for the
Deceased. County of ('limn....' ''',Q in the
Social Security No. 200-24-062R Commonwealth of Pennsylvania
The pelition of Ihe undersigned respectfully represents that:
Your pelitioner(s), who Is/arc 18 years of age or older an the execut .. i y
In the last will of Ihe above decedenl, daled AUQust 17 I
and codicil(s) daled
named
, 19-6!L
(MaIC relevant circnmSlanCt5, e.g. renunciallon. dealh of c"4t!:ulor. cle.)
~ecendent was domiciled at death in cu~befland County, Pennsylvania, with
h s lasl family or principal residence at 13 E m Street I Carlisle, PA
g01(O 0 r: C 1lRi-l Hf=
(list stretl, number and muncipalil)')
. . .
Dcccndenlj then 63 'years of aJle, died M"..,.h F;. ,19 96
at CarlisJ.e Hospi t{ll.l_~arl1s1e I PA .
Except as. follows, decedent did not marry, was nOI divorced and did nol have a child born or adopted
arter execution of the will offered for probate; was notlhe victim of a killing and was never adjudicaled
incompetent:
Decendenl at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property S 10.000.00
(If not domiciled in Pa.) . Personal properiy in Pennsylvania S
(If not domiciled in Pa.) Personal property in County S
Value of real estate in Pennsylvania S 20.000.00
situaled as follows: 134 Elm Street. C1lrl j"I...
FA 1 701 ~
WHEREFORE, petitioner(s) respectfully request(s) Ihe probale of the last will and codicil(s)
presented herewith and Ihe grant of lellers testamentary
Iheron.
(1e5lamCnlary: adminimation c.I,a.: administration d.b.n.c.l.a.)
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~21"te~ti~~"street
Albany. CA 94706
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OJ. PENNSYLVANIA } ss
COUNTY OF ___CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) thatlhe statemenlS in Ihe foregoing petition are
true and correct to tile best of the knowledge and belief of elitioner(s) and that as Ilersonal represen-
tative(s) of the ahove decedem pi~i1io~er(s) will~ll~nd ~IY_ a~~te.r)he eSI~te al:eording to law.
Sworn to or affirmed. and s ubs':ribed { ,f{. <. U . / .
before me this _l.1j;b <lay of ~nllY M. ~Ilams ~.
MARr'H ~~~~M1..-) .' / ~
/J.IA f J::
~C. LEWIS "!tr1.l.~er ~
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LAST Il'IU. AND TKSrAm;NT O~' CArlL IlAnlOND ADMIS
KNO~' A1.L ~IKN IlY TIIKSK I'nKSKNl'S, That I, Carl Raymond Adams,
of tho norouah of Curllllto, Cuml,ol'la'lll County, Ponnsylvania, boing
;
of 1I0unl! mincl, 1II0011ory Rllll IInllo I'll talllli nl:, do mako, publish and declare
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thill my Lall\; ~'ill ancl To II tlllllo nt , hOl'ohy rovoking and making void any
arul aJ 1 h'illll IIr 1110 01. ullY 1.11111' ho,'oloro,'o made.
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ITEM J. 1 I:ivo, c1ovJso alW hequoath all of my property,
who ther the 11011I0 ho rOllt, 1IO"IIonll I or mixod, aol! whorosoevor 5i tuato,
to my lIistor, Nancy M. Adams.
ITK~I 2. 1 al'poJnt my sistor, Nancy ~l. Adams, to be the
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Exocutrlx of lilY olltato.
IN Il'ITNESS IWErlEOF, I have executed this my Last 1\'111 and
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Tostamont, conllistin/t of ono typowritton pago, by affixing my signature
and my soal to 111111I0, this {7 day or H.I'.1/.L.d , 1960.
(l ") ,i/ ,} I
""1 ( k~ 1 A't/("I((, / /:!i2tlJ-1tA-.j
(SEAL)
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Tho wrltlnlt containod on this one shoet was signed and soalod
hy tho abovo nomoll Cn rl Raymond Adams, and by him PUblished and declared
all and fOl' his LOll t "'ill onel Tos tamont in tho presence of us, who here-
unto suhscrihod our namos as
and in tho prosonco of onch
witnossos, a~is roquost, in his presence,
othor, tho~ day of--11}J.~I.III.A"'" ,
1960.
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UNITED STATES FIDELITY AND GUARANTY COMPANY
POWER OF AITORNEY
NO. 106331
..
KNOW IIU. MEN BY TIIESE PRESENTS: ThaI UNITED STII ns nOEUlY ANO GUIIRIINlY COMPIINY. a ,o"",...i.. .rp.izcd aod ..illi.,
Wider It..law. ohbt SLalc of Muylud aDd ......i.. ill priacipal office" Ibe CII)' of Uahimort, ill tbe Slale of Marylaad. doc. btrtb)' Wllhlute aDd tppoilll
Richard A. Neidcrcr
orlhecityor Carlisle ,Staleof Pennsylvania ilJINCudl.wfuIAllomcyCl)-iDoFact.uchilllbci,nparalc
clflKiry lImon IbaD Olt i. umed above. to ai,. its ume U I\Il'tfy 10, aad 10 exccute,.al ud IckDowlcdlt aD)' &ad aU boack. uadcnakiDl1. coDlractJ ud olber
MiacI iUlrumCDlJ ialb, Ulun thereof 01 bcbalrorthe Compaay iD ill bulisell of palUltCiDI tile fid.lu)' orpenocu: JUIIlDlCtia,lbc pcrformuc. or coetracts;
&lid ute...i_1 or paraDacci., bold. ud UDdcnakjDI' requirtd or pcrmiacd ia "Y adioDS or procccdia.. allowed by la....
ID WilDts' Whereof. 1M uid UNITED STAres FIDEun"' AND OUARAl'ilY COMPANY hu ClUlCd lbi. iDJINmlDllO be ...Ied wilt. iu corporalc suJ.
duly llte.ed bylbe .i.lWUrtS orhsSCD.ior Vice Pmidtlt &ad AJlilWll Secretuy.lbi. 8th da)' or January . A.D. 19 93.
UNlTEO STII ns FIDELITY IINO GUIIRIINlY COMPIINY
(Sipcd) BY"'~ ..
(Sipcd) BY........~.. Q.......... ;\.:~:.r.~:~.. ~~:'~.:
,~ AlIlSlaDt SecMary
-.:;1...)
\<.:.,
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Oolhi. 8th day.r January .,..0.1993 .bcr......pcnoaall~..n'lc Robert J. Lamendola
S.ai., Vi" P...id..,.rtb. UNlTEDSTllns FIDELITY Al'lt\G\JIIRMTICOMPIINYUcI, Paul D. ~ims .IIui.....
S.'Rtary or said C.mplD)'. wi.b bo,b or...bom 1 am ~\IiYacquai.l.d. ...... bci.81oY'"" k~.,.lIy duly aw."" Ill"""" ,bey. lb. said Robe r t J.
Lamendola aad Paul D\.tsims ....z \. ....R RlpcC'ivelYllio! ~br Vi" PRlid....od ,be IIui....' S.'Rlary .r
(be said UNITED STATES ROElIn' ANQ.~..\ltA'Nn' COMPAt<N. ~~ralioa delCribed ia a.Q~ fo'~~.ecuted Ibe rortloiq Powcror Allomcy: tballbey
eacb kAt.".lbc aul of...id corporalioa; IUlI~ lCal affixed 10 pid rO~~'orAnomey wu sucb corpq~)llf.lballl was ~ alTUlcd by order orllle Board of Directofl
or....d corporw:loa. IoDd Ihallbe)' .iped Ibeir aamts IbtrCto br\Ii.~ ~r as Seaior Vice pres,df'iI"'alt Allillaal Sccrrlaly. rurccllvcly. orllle Compaay.
MyConuniui..cxptRllb. 11th daY!.a.V1lirChll'~"95.
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r~ (SiPC~) ... 1<\frl14:,,(\E..r.t!~.~
~~ . .. \1...1'-: NOTIIRVPUOUC
ni. rower lor ADOntC)' i'lfIDted uader aad.br ~~~~)' ortbe rolloWlag Resolulioas adopled by Ibe Board or Dirrcto~ orlbe UNITED STATES
noarrv ANti GUARllt.TI COMPANY.. ScptcmW'i4, 1992:
RESOLVED.IW il cOlacclioa with lbe fidelity aDd lW'et)' ilsunace bwileSl ortbe COmplD)'. all hoads. uDdenakiap. coatracts aDd otber iaANmcDtJ
RlaliDllo J.Iid bUliDell ma)' be siped. uecUlcd. ud ackDowledled by pCDOU or tDlItiu appoialed u ADome)1I).ia.Facl punuaallo a Power of Anorae)' iuued ia
accorduKe with lheae RIOIUliollJ. Said Powertl) of Anome)' ror aad oa bebalr orlbe COmpaD)' ma)' aad .hall be executcd ia lbe IWI'IC aDd oa bebalf orlhe COmpaD)'.
tilber by lbe Cbail1TWl, or llIe PrllideDl. or aD E.Il.ecutlve Vice Pre.idcDI, or a SeElior Vice PreSldeG(. or a Vicc Prnideal or aa AuilWlI Vice Presidcllt. joiDtI)' wilb tbe
ScCftlaty or aa AuillaDl Secftlary. uDder lheir Rlpectivt dclllalJioDI. The ",ulure or IUcb offiura ma)' be tDl"vcd. pnaled or lilbolnpbed. ne lilnatW'C or eacb
orllle rORloiq officcl'l &lid lbe lCal orlbe COmpaDY ma)' be atrUled b)' racsimile 10 aay Power or Alloncy or 10 aa)' "nificlJe relaLilllbeRlo appoiatiq
ADomcy{.)oia.Facl ror purpo.u ooly or cuculiDI &lid annlla; boad. aad uDdutauass aad ocber wnllap oblilaJory iD Ibe natW'C Ibertor. aad. ualell subltqueDtI)'
Rvok.cd ud subject 10 aay Iinuwioa'lCl ronb IbeRia, al)' lueb Power or ADome)' or cenlfil:ale bunas sucb racllrNle "paNre or rauimile "al thall be valid ud
biDdiDI UpoD tbe Compuy ud aay IUcb power 10 ueculed aad unified b)' Iueb racaimile .ipaJurt aDd facllmile Hal .hall be valid aad biadiaa upol Ibe CompaD)'
witb rapccllO aa)' boDd oruDdcrtalria,lo wtucb il is validl)' attacbed.
RESOLVED. tbal Auomty(.)oiD-Facl .hall bave Ibe power aDd aUlbonty. UDlcss IUblCqueally revoked aad. ia aD)' cue, subjeello Ibe terms &lid limiwioal
orlbe Powtr or Anol'1MY iuucd 10 tbem. 10 execute aad deliver oa bebalr orlbe Compaa)' aDd 10 anacb Ibe 5Cal orlhe Co"",aay 10 aay aDd all boDCh ud uadenakiap.
ud olllerwriliDl' oblipLoty illlbe UlUrc tberrof, &ad aa)' such taANmcal elltculed b)' sucb AlloneY(')-Ia.Facl .baI1 be u biDdias upoa lbe Corqsu)' u ir.ipcd by
aD Executiw Officer aad aelled &lid aacucd 10 by Ibe Sccrelary or lbe Compaa)'.
L Paul D. Sims ... IIui.... S'CRtary .fIb, UNlTEO STllns F10EUlY IINO GUIIJV.NlY COMPIINY.
do b.nbycenify lhallbe rOnlOia.i. .INe exurpl from Ibe Ruolutioa orlbe u.id Co~aa)' II adopted by its 80am orOtrrclol'lOa ~plembcr 24.1992 aad tballbi.
Rtaolutioa ia ia full rorce aad ,rrect.
1.lbe uadel'lip,d Auillaal Secretary oflbe UNITED STA 'ffiS F1DELfTY ANO GUARAN1Y COMPANY do bereb)' ctnif)' lballhe rOnlcial Power or
ADoney i. i. full rorte ud effecl ud!au Dol bin ftvokcd. 1t
I. T,"imo.y WIl....r.1 b.ve bm..,.... my ba.d aod 'b. ,..1.11 . m~TA ns FIOELllY ANO Gl'ARIINlY COMPIINY .. thi. day
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~ 1. "J! AlstltallSn:rellry
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STII n; or MIIRYLIINO)
55:
BIlL TIMORE CllY
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of
CARL RAYMOND ADAMS,
, deceased,
No. 152
of 1996
TOI
Nancy M. Adams
(beneficiary)
(address)
P. O. Box 1330
Pleasanton, CA 94566
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:
YOU ARE THE SOLE HEIR TO THE ESTATE OF CARL RAYMOND ADAMS, DECEASED,
PURSUANT TO HIS LAST WILL AND TESTAMENT DULY PROBATED.
(if additional space is needed, use back of page)
Name of decedent
Carl Ravmond Adams
Last known address
134 Elm Street, Carlisle, PA
of decedent
Date of death March 6, 1996
Place of death Carlisle Hosoital, Carlisle, PA
County of grant of original letters Cumberland
Decedent died
intestate.
x
testate
A copy of the will -z-- is
is not attached.
Name(s), address(es) and telephone nurnber(s) of all personal
representatives appointed
Name
Address Telephone
P. O. Box 1330, Pleasanton, CA 94566 (510) 244-1624
Nancy M. Adams
Name(s), address (es) and telephone number(s) of all counsel
Telephone
Name Address
Dale F. Shughart, Jr. 28 S. pitt st., P.O. Box 208
Car s e, PA 17013
249-8300
Additional information may be obtained from the undersigned.
Date March 19, 1996
Signature
Name uale F. Shughart, Jr.
Address 28 S. pitt st., P.o. Box 208
carlisle, PA 17013
.. Telephone ( 7171 249-8300
capacity: personal Representative
y Counsel for personal
representative
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of
CARL RAYMOND ADAMS,
, deceased,
No. 152
of 1996
TOI
Sara E. Mowery
C/O Nancy MOW~~Y
44 Casielli Avenue
San Francisco, CA 94111
(beneficiary)
(address)
.
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:
The attached will of Carl Raymond Adams leaves his entire estate to his
sister, Nancy M. Adams. The Will has been probated and you are not an helr. If
Mr. Adams had died without a Will, you would have been entltled to a l/~ share as
(if additional space is needed, use back of page)sole survlvlng lssue of
Mr. Adams' sister, Helen.
Name of decedent
Carl Ravmond Adams
Last known address
134 Elm Street, Carlisle, PA
of decedent
Date of death March 6, 1996
Place of death Carl isle Hosoital, Carlisle, PA
County of grant of original letters Cumberland
Decedent died x testate intestate.
A copy of the will -K-- is
is not attached.
Name(s), address(es) and telephone number(s) of all personal
representatives appointed
Name
Address Telephone
P. O. Box 1330, Pleasanton, CA 94566 (510) 244-1624
Nancy M. Adams
.
, ,
- ~_._.-
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF
CUMBERLAND, PENNSYLVANIA
The attached Will of Carl Raymond Adams leaves his entire estate to his
sister, Nanc M. Adams. The will has been' robated and ou are not an heir. If
Mr. Adams ad dled wlthout a Will, you would have been entitled to a 1 10 share as
(if additional space is needed, use back of page) surviving issue of
Mr. Adams' brother, Glenn.
In re Estate of
, deceased,
CARL RAYMOND ADAMS,
No. 152
of 1996
TO:
Glenn A. Adams, Jr.
(beneficiary)
(address)
22 Holly Street
Mt. Holly springs, PA 17065
.
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:
Name of decedent
Carl Ravmond Adams
Last known address
134 Elm Street, Carlisle, PA
of decedent
Date of death March 6, 1996
Place of death carlisle Hosoital, carlisle , PA
County of grant of original letters Cumberland
Decedent died x testate intestate.
A copy of the will -K-- is
is not attached.
Narne(s), addressees) and telephone nurnber(s) of all personal
representatives appointed
Name
Address Telephone
P. O. Box 1330, Pleasanton, CA 94566 (510) 244-1624
Nancy M. Adams
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Name(s), address(es) and telephone number(s) of all counsel
Name Address
Telephone
(717) 249-8300
Dale F. Shughart, Jr. 28 S. Pitt St., P.O. 80x 208
Carlisle, PA 17013
Additional information may be obtained from the undersigned.
Date March 19, 1996
Signature
Name llale F. Shughart, Jr.
Address 28 S. Pitt St., P.O. Box 208
Carlisle, PA 17013
~ Telephone (717) 249-8300
Capacity: Personal Representative
y Counsel for personal
representative
~""~"~'<'--""" m",~"""~,~__.__"u~'..>.._n_",
,
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
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b.lng duly slIorn occordlng to law, d.polol o..d soys that fl.o is the
Executrix 0' tho Estoto of Carl R. Adams
lot. of _.bQJ;'ough_of_Carliale,_____ , Cumborlond County, Po., d.ceas.d ond that tho
withIn Is on Inventory mado by ._ ___, tho sold Executrix
of tho ontiro ost.to 0' soid d.cod.nt, consisting of .11 tho p.rson.1 prol'.rty .nd rool .stoto, ..c.pt r..1 .,t.t. ouhld.
tho Commonw.olth 0' P.nnsylvonl., and that th. liguros opposite ooch It.m of tho Invontory r.prount It's faIr volu.
os of th. do to of d.c.d.nt's d.oth. ~/
'~ /; /
SlIom ond subscribod bo'or. m., .'f. ;?!2({ ,'" ,-;J.:(v.'f!&:',/c.-:!/ ~~,~
,. 1/ xecu'or . ~tor F/
Nancy M. Adams
921 Cer ito Street
l'lancyJl--.1\dams
_Oc;.tober 7. 19 96
~,~ ~"1& -/
NOTAIIIAl. SEAl. CJ
BONNIE L. COnE. NOTARY I'UIK.lC
101IO OF lIT HOlLY SPIIHGS, CtJlIBERlJJlO CO.
IIY COMIIISSION EXPI~S OCT06[R 17, ligS
I
Albany, CA 94706
Add,...
Dot. of Death
6th
Doy
Yur
March
Month
1996
INSTRUCTIONS
I. An Inv.ntory must b. flIod withIn three months oft.r appolntm.nt of p.rson.1 repr.senlotiv..
2. A supplem.nt Inventory must bo flIod within thirty d.ys of discov.ry of .ddition.1 ....ts.
3. Additional sho.ts m.y bo attached .s to p.rsonalty or roalty
4. So. Articlo IV, Fiducl.rlos Act 0'1949.
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PERSONAL PROPERTY
1. Cash on hand.
2. clothing and personal effects.
3. Cedar Chest, mission desk with chair,
Roseville baskets, two cut glass bowls,
sterling teaspoons, digital clock, value
based upon appraisal of Ben E. Rowe, attached.
4. Miscellaneous household goods sold by executor,
value based upon actual sale price.
5. Household goods and furnishings sold at
public auction, value based upon actual sale price. 4,132.90
6. Firearms, value based upon appraisal of
Dewalts Gun Room, attached.
7. 1994 Mercury Sable LS sedan, value based
upon appraisal of Kirk M. Wise, general
manager, Family Ford Mercury, attached.
8. U.S. Treasury, 1995 income tax refund.
9. Patriot News Company, unexpired pension
checks on hand and deposited.
10. Patriot News company, reissuance of payment for
expired uncashed pension checks.
11. Base share account #390000, West Shore
Teacher's Federal Credit Union.
principal -
Accrued interest -
12. Checking Account #4000017,
Principal -
Accrued interest -
13. savings Account #1-149821,
Farmers Trust Company
Principal -
Accrued interest -
14. One $75 Series EE, U.S. Savings Bond
#K-0-100-136-678EE, issued February 3, 1993
15. Accordia, refund on executor's bond.
16. Pennsylvania Blue Shield/Blue Cross,
major medical reimbursements
17. National Wildlife Federation, subscription refund.
18. Royal Insurance, auto insurance refund.
Inventory of the real and personal estate of
CARL R. ADAMS, Deceased
REAL PROPERTY
Lot improved with two-story frame attached
dwelling house situate in the Borough of
Carlisle, Cumberland county, Pennsylvania,
known as 134 Elm street, Carlisle, PA 17013.
NON PROBATE
Life Insurance
1. West Shore Teachers FCU
2. Metropolitan Life Insurance Company
TOTAL PERSONAL PROPERTY
50,000.00
318.00
o
210.00
555.00
2,400.00
9,935.00
273.00
1,150.00
5,750.00
5,473.78
29.69
12,338.62
0.00
18,704.77
137.46
43.50
10.00
12,512.60
15.48
65.07
3,822.11
5,032.88
132,909.86
". ....~.....~...... -----..........---......
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IS-Clf:'
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cO..~Fm'rN~'lfFP.llM!i1b~ANI.
HARRIS8~~liJ.'.ffi 121....,
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
FOR OATES OF DEATH AFTER '213'19' CHECK HERE
IF A SPOUSAL
P Y R CR OITISC AIM 0
FilE NUMDER
REV.. t500EX .(7.14)
CAB
H ~ l
ERg
Co K
K P 5
21-96-lit-
YEAR
NUUBER
2. Supplemonlal Return
4a. Futuro IntereSI Compromise
(lor dale' 01 dealh alter 12-12-82)
[]] 6. Dccedent Died Testate D 7. Decedenl Maintained a living Trusl
(Attach co of Will) (Anach a cop 01 Tru,l)
C P All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD DE DIRECTED TO:
2 2 NAUE COUPLETE MAILING ADDRESS
R 0 Dale F. Shu hart Jr. Fowler. Addams, Shughart (, Rundle
~ ~ TelEPHONE NUMBER 28 South Pitt Street
- T 717 249-8300 Carlisle PA 17013
1. Real E,la'e ISchedule A) 1 50,000.00
2. S,ocks and Bonds (Schedule D) (2)
3. Clo'ely Held SlocklPartnership Inlere,' (Schedule C) (3)
4. Mortgage, and Noles Receivable (Schedule D) (4)
5. Cash, Bank Depo'~' & Mi,cellaneou, Personal Property (Sch, E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Tren,fers (Schedule G) (Schedule l) (7)
8. Total Gross Assols (tolal Lines 1-7)
9. Funeral Exp.nses. Adminislrative Costs. Miscellaneous
Expenses (Schedule H)
10. Debls, Mortgage llabil~ies, lien, (Schedule r)
11. Tola' Deduc'ions (1ola' Line, 9 & 10)
12. Nel Value of Esla'e (line 8 minu, line 1')
13, Charitable and Governmen..' Bequests (Schedule J)
14. Nel Valu. Sub cl'o Tax (Lin. 12 minus line 13)
15. Spousal Tran,f.rs (for dares 01 dealh alter 6-30-94)
Sit Instrucltons for Applicable Percentage on page 2.
(fntlud. valulS from Sch.dul. K or Sch.dul. M,)
16. Amounl of line 14 taxable al 6'/, rate
(fntlud. va'ulS from Schedule K or Schedule M,)
17. Amounl of line 14 taxable at 1S'/. rate
(Include values from Schedule K or Schctdul~ M.)
18. Principal lax due (Add lax from line 15, '6 and 17,)
19. CreditslSp Pover1y Prior Payments Discount
+ 8,000.00 + ',21.05
20. If line 191, g"aler Ihan Line '8, onlo"he dlllerence on Line 20, This is Ihe OVERPAYMENT.
~ D ICheck here II you Ire requesting I refund 01 your overpaymentl
21. If line t81s greater than line 19. enter the difference on lin~ 21. This is tho TAX DUE.
A. Entll lhelnt.resl on tho balance duo on line 21A
B. Enter Ih. 10'.1 01 Line 21 and 21A on line 2'B, This is 'he DAlANCE DUE.
Mako Check pa able 10: Re iste, of Wills. A ent
~ ~ DE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
Under peNllles 01 pe'lury.1 dlKla,ethat I haye e.amlned thl' '.t!Un.lncludlng accom~nylng schedul.sand .l"e~nt.. and to Ihe best 01 my knowledge and belief. It I. true.
COffeet andcompltt!.l dKlarelhatall ,o,ll..lal. hit bHn,.pofted allrue mlf...1 value. DlKla'ltlon at pt'~I" other thin Ihe pellOnal ,.presentlllvels blled on IlIlnlOlmlllonof
which pt'p"er h any knowledg..
(- SICN.W EOFPERSONRESPONS ,~EFORIIlINCRE1.UR/l Nancy M. Adams
'-- .. . : I c J 1921 Cerr! to Street
I; ,,/}I 'l/~' i:'., ,'^yb~;,..:.cii..9i..i66................................
SI REOF Wr OIH RT .N~ IVE ~~.~~;~.~~~~.~;~~.~~~~.~~~~.~~.~..~~~.~~~............
I Carlisle, PA 17013
D
E
C
E
D
E
N
T
DECEDENT'S NAME (LAST. FIRST. AHD MIDDLE INITIAL)
Adams Carl R.
COUNTY CODE
DECEDENT'S COMPLETE ADDRESS
134 Elm Street
Carlisle, PA 17013
OATE OF BIRTH
12/03/32
DATE OF DEATH
03/06/96
soctAL SECURITY NUMBER
200-24-0628
Cumberland
Count
R.mainder Relurn
(for da'ts of d.arh prior 1012-13-82)
Federal Estato Tax Return Requited
Tolal Number of Safe Depo'~ Doxe'
OF APPLICABLE)SURVIVlNG SPOUSE'S NAME (lAST .FIRST AND MIDDLE INITIAL)
SOCIAL SECURITYNUMDER
AMOUNT RECEIVED (SEE INSTRUCTIONS)
X 1. Original ReMn
4. llmiled E5Ia..
o 5.
o 8.
R
E
C
A
P
I
T
U
l
A
T
o
N
74,054.87
(8)
124 ,051..87
(9)
29 , 291.18
(10)
11,619.91
40.911. 09
83,143.78
(11)
(12)
(13)
(14)
83 143.78
(15)
0.00
0.00 X
=
(16)
0.00
o . 00 X ,06 =
T
A
X
C
o
M
P
U
T
A
T
I
o
N
12".71.57
(17)
83,143.78X ,'5 =
(18)
12 ,1.71.57
Inloresl
(19)
(20)
8,421.05
0.00
(21)
(21A)
(21D)
'. ,050.52
0.00
'.,050,52
~
~
flzs!f/
SALES COMPARISON APPROACH
In arriving at this conclusion of the value of the
subject property, the appraiser made a survey of properties
that have sold in the area of the subject property.
Consideration was given and adjustments were made on
each comparable sale as to time of sale, size, location, as
well as all other factors that might affect value. A resume
of some of the sales considered by the appraiser is as
follows:
SALE NO. 1
Location:
Date of Sale:
Sale Price:
Size:
Unit Price:
140 Elm Street, Carlisle,
September 15, 1995.
$52,500
1,332 sq. ft.
$39.41 per sq. ft.
Pa.
SALE NO. 2
Location: 138 Elm Street, CarliSle, Pa.
Date of Sale: October 26, 1995.
Sale Price: $56,500
Size: 1,232 sq. ft.
Unit Price: $45.86 per sq. ft.
SALE NO. 3
Location: 130 Elm Street, Carlisle. Pa.
Date of Sale: June 21, 1994.
Sale Price: $61,900
Size: 1,368 sq. ft.
Unit Price: $45.25 per sq. ft.
The appraiser, in addition to the sales listed, also
considered several additional sales in arriving at his final
opinion of value. After making all of the .necessary
adjustments, it is the appraiser's considered opinion that
the indicated value of the subject property by the Sales
Comparison Approach is $50,000.
7
CERTIFICATE OF APPRAISAL
Your appraiser hereby certifies that:
1. I have no present or contemplated future interest in the
sUbject property.
2. I have no personal interest or bias with respect to the
subject matter of this appraisal report or the parties
involved. My findings are not based on the employment to
make the appraisal, the compensation expected, a requested
minimum valuation, a specific valuation, or the approval of
a loan.
IImrnr
J. To
of fact
analyses,
based, are
the best of my knowledge and
contained in this appraisal
opinions, and conclusions
true and correct.
belief, the statements
report, upon which the
expressed herein are
o
4. This appraisal report sets forth all of the limiting
conditions (imposed by the terms of my assignment or by the
undersigned) affecting the analyses, opinions, and
conclusions contained in this report.
5. This appraisal report has been made in conformity with
and is sUbject to the requirements of the Code of
Professional Ethics and Standards of Professional Conduct of
the National Association of Real Estate Appraisers.
6. No one other
conclusions, and
set forth in this
than the undersigned prepared the analyses,
opinions concerning real estate that are
appraisal report.
~:~
Chief Appraiser
t..
10
COMPARABLE NO 2
138 Elm St.
Carlisle
Same street
$ 56
$45.86 CZl
Courthouse & MLS
OESCnIPT~ ".'5"""1"''''_
$ 4 5.25
Courthouse
OE SCRIP liON
COMPARABLE NO 3
130 Elm St.
Carlisle
Same street
$ 61
lZl
& MLS
I O"IS AdIUSltntn!
,
,
,
2 000
None
6-21-94
Similar
25' x 100'
Similar
Wood
106 ears
Su erior
rofJI .edrms. Baths
2.000
(1,000)
7 . 3 1
I 368 Sq H ;
Oil hot wtr.
None
Encl. porch,
balcon .
Typical for
the re ion.
None
Unheated rm.
on first fl
Porch
I 000
Porch atio
500
Si ilar
Si ilar
Oil FHA
Similar
Porch, balcdny,
stor. bld :
,
.
,
,
I
.\
,
Similar
Similar
Similar
Similar
s
I 000
12 000
1 000
6 500
~ew roo f
.
~
r...us
None
S 40 500
50 000
sales are acce table
of value of 50 000.
-------~----_...
."...
..._---_._-~-_.__._.._.__._._._-----_.__.__.....-
. -----.....-.. ~---'--- .-------
-- -.._. -- ------..___ h.__ _ _._.~_.______.___
.----.--------
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-.----.--- --.-----------------..-- ,.~ -..---.-- - ------------.--------
.n --~.----__..___h..______._ __..__._.____..
lJ 5 I=QRMS INC ;tCENTRAL SO. GRAFTON, MA 01519 044(j I 800 12~ 95dJ. t 8J!J 4.11
('i ri
BILL ROWE. AU 1538L
EN . AU 1092L
08 . AU 2276L
R. D. 4, Box 353 · Carlisle, P A
249.2677 249.1978
Auction Is Action Call uROWE"For Satisfaction
May 21, 1996
TO:
Dale Shughart
28 South Pitt
Carlisle, Pat
Jr.
Street
17013
COPY: Nancy Adams
Executrix
FROM: Benny E. Rowe
Auctioneer/Appraiser
2505 Ritner Highway
Carlisle, Pat 17013
REF: Carl Raymond Adams Estate Appraisal, 134 Elm Street,
Carlisle, Pa..Current Market Value.
Cedar Chest
Cogar Wargrobe
Mission Oak Desk w/Chair
Roseville Basket
2 Cut Glass Bowls
Sterling Teaspoons
Digital Clock
.'IOR Zeai tit
.VCR Zenith
Tit Color
O;lk Buffet
dlt:l.fferese
~loor Model Victrola
Fleer "e~el Radio
Hise. Small ~ool~
t2' Alumiflum-Laeeer
$ 55.00
6!i.OO
110.00
15.00
15.00
10.00
5.00
'0 no
25.00
7S 00
B5-.-().()
45.00.
125.00
i~A-IlO
1 0....00
JS.O.o.
2 H9ild
4 Head
C'onC!nl~- 7.on;"h
\ l' e vv\s /J V\ed Ol.\[
we~-e.. 'SoIA by
Q,).-ecAA1OR \\-
Df70
TOTAL
$705.00
Cri. ~
~
c
(
INVENTORY & APPRAISAL
OF FIREARM COLLECTION
OF CARL R. ADAMS, DECEASED
. 'DATE. OF .DEATII: .' MARCil 6,. l0996
ID'INDGlm
1. Smith & Wesson revolver Model lO ! .38 caliber $lOO .00.
2. Smith & Wesson seni-auto Model 6906 ! 9 mm $300.00.
RnLES
1. Remington rifle Model 700 ! caliber .270 $350.00.
2. Remington rifle Model 700 ! caliber 30-06 $350.00.
3. Remington rifle Model 700 ! caliber 22-250 $350.00.
4. Savage rifle Model 840 ! caliber .222 S200.00.
:,nJl"'-lr'lS
1. Ithica SKB double barrel sootgun! Model lOO (12 gal $300.00.
2. Ithica " " " $300.00.
3. K-MARl' double barrel sootgun! 12 ga $l50.00.
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FARMERS m
TRUST _
April 3, 1996
Fowler, Addams, Shuchart . Rundle
PO Box 208
28 South Pitt Street
Carlisle, PA 17013-0208
Re: Estate of Carl R Adams SSN 200-24-0628
Date of Death: March 6, 1996
Dear Mr Shuchart, Jr:
In answer to your request concernlnc accounts owned, either
separately or Jointly, by the above referenced decedent and the
balance in each account as of the date of death, we have checked
our records and are submittinc the followinc information in
duplicate. We succest that you file one of these letters attached
to the Pennsylvania Inventory forms (RCC)to substantiate the
balance you report.
Note that we have shown the correct reclstration for each account.
Also, interest accrued to the date of death, if any, is listed as
a separate ficure.
Checklnc account 8400017 was orieinally opened 9/1/67 or before.
The account was titled In Carl R Adams' name alone. The balance as
of 3/6/96 was $12,338.62. The account was non-interest bearlnc.
Savlncs account 81-149821 was oricinally opened 3/23/68. The
account was titled In Carl R Adams' name alone. The balance as of
3/6/96 was $18,704.77 plus $137.46 accrued interest for a total of
$18,842.23. The account was carnine 2.80' interest at the time of
death.
We have no record of a safe deposit box in the decedents name.
Sincerely,
h~.0')\.y'>.<;"CA"~
Karen Tomassone
Supervisor Customer Service
One Wl'Slliigh Slfl'eIP.O. Box 220 Carlisle, Pennsylvania 17013 (717) 243-3212
'\
.'
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
REV .1511 EX . (7."1
CO"'r._{\,U~]hYAHIA
ESTATE OF
Carl R.
ITEM
NUMBER
A.
B.
c.
1
2
3
4
5
6
7
8
9
lO
11
12
l3
14
l5
Adams
SS 200-24-0628
03 06 96
DESCRIPTION
1
2
Funlral Expln...'
Hoffman-Roth Funeral Home, funeral bill.
Carlisle Memerial Services, menument.
1.
Admlnl.traUvl co.t.,
Personal R.presentativI Convnissions
Social Security Number of Personal Rfpresentative:
Vea, Convrissions paid
2.
Attorney Fe.s
Fowler, Addams, Shughart & Rundle
(Statements attached)
3.
Family Exemption
Claimant
Add,..s 01 Claimant at docld.nt's d..th
SU"I Addllss
City
Slat.
Zip Cod.
R.lationship
4.
Pro bat. Fees
Register of Wills
Mlscellan.ous Exp.n....
H&R Block, prepare tax returns.
Dauphin Oil, fuel oil.
UGI, gas (9.65; 9.88j 6.60; 42.02; 9.00j 10.00)
PP&L,elec(18.03;16.l3;32.30;37.00;20.65j7,42j6.45;50.
Carlisle Borough, sewer & water
(80.93j256.17;l8.94j23.68;11.82;11.82j50.00.
United Telephone Co., phone (57.59; 42.37
Register of Wills, short certificates
Register of Wills, filing inventory and
inheritance tax return.
Cumberland Law Journal, advertise Letters.
The Sentinel, advertise Letters.
Commonwealth of PA, automobile registration.
UPS, overnight mell.
L&M Heating, repair water heater,
Jones Plumbing, plumbing repairs.
Richard Beaston, carpentry, ropalrs and new lock.
Total of Continuation Schedule(s)
TOTAL (Also .nler on fin. 9, R.c. ~ulalion)
(If more spice Is needed, Insert additional sheets of same Ilze.)
,..._......."..\ ,Gill' ...._............. ....... ,.~.,...._ 1_
""'_7_ --. -, "'-, ~~~r"",..',..,~
\--_.~..''''~'~~~.4~~.,;:-"......_''.
~.................
Pi.... Print or T I
FILE NUMBER
21-96-156
AMOUNT
6,671.00
440.00
8,325.00
3l5.00
81.00
171. 63
87.l5
187.98
453.36
99.98
18.00
25.00
60.00
74.71
24.00
8.00
74.20
869.45
143.89
11 l61. 83
S 29 291.l8
.
.
;',--" t".> c' '.
,;.....-,.--...-. -"-- ",
_....,..-"..........,~..... .
..~'...- .-'
Estate of: Carl R. Adams
Soc Sec I: 200-24.0628
Date of Death: 03/06/96
Item
I
Continuation of Schedule H-C
(Miscellaneous Expenses)
Amount
Dsscdption
110.00
16
17
USF&G, surety bond.
Gilbert's Pest Control, termite
trentment
Postmaster, certified mnil.
Darlene Moyer, 1996 county nnd borough
real estste tnxes
Cspital Tax Collection Burenu,
personal taxes.
Bonnie Coyle, notary fees
Nancy M. Adams, reimbursement of air
travel expenses (2 round trip from
California to Pennsylvania).
Nancy M. Adams, reimbursement of
out-of-pocket expenses for postage,
auto expense and long distance
telephone calls.
Benny E. Rowe, appraisal of
household goods.
Benny E. Rowe, auctioneer's commission
Jay Cayman, trash hauling
Lube N Co, automobile service,
inspection and repairs to pass
inspection.
Mailboxes, Inc., shipping personal
property (furniture, personal effects,
financial records and documents) to
executor/beneficiary in California.
Darlene Moyer, 1996-97 school district
real estate tax.
Donegal Mutual, fire insurance.
Jonea & Associates, processing
medical insurance claims.
Century 2l, Brenneman, realtor
commission (estimated).
Recorder of Deeds, realty transfer tax
(estimated) .
Reserve for Accounting and prepnrlng
fiduciary income tnx returns.
11,161. 83
..............
500.00
919.55
2.52
l8
19
20
21
22
1,064.00
23
24
50.00
l,445.90
500.00
25
26
27
28
1,340.77
29
30
3l
3,000.00
32
33
34
l86.84
9.90
20.00
304.l8
388.13
435.04
135.00
250.00
500.00
.'........~..._""
... ...~.. ,........ "'t:l._ ,
,
FOWLER, ADDAMS, SHUGHART & RUNDLE
ATTORNEYS AT LAW
P.O. BOX 208
28 SOUTH PITT STREET
CARLISLE, PENNSYLVANIA 170 T 3.0208
JOHN I. 'OWLEft, III
WILLIAM A. ADDAMS
MICHAU R. RUNDLE
.rrclAL CDUNItL
DALE ,. IHUGHA"T. JR.
TElEPltONE 17171 248,0300
FAX 17171248.0164
'OWLER. ADDAM' . .HUQHAftT
1117....121
0' COUHIU
HOHO"AIU DALE ,. IHUGHAftT
11114'111"
September 25, 1996
Nancy M. Adams, Executrix
Estate of Carl R. Adams
TO: FOWLER, ADDAMS, SHUGHART & RUNDLE (S)
Professional services rendered as follows:
5/29/96 - Letter to client. .5
6/03/96 - Office conference with Nancy; prepare
statement of reimbursable expenses;
pay estimated tax. 1.0
6/06/96 - Review message from Nancy; telephone
conference with Berkheimer and message
for Nancy; review proposed Agreement. .9
6/06/96 Telephone conference with Nancy and
Larry Foote and Marjorie Berkheimer;
fax to Foote and letter to client. 1.0
6/10/96 Telephone conference with Nancy. .3
6/12/96 Recorder's Receipt for estimated tax; and
letter to client. .2
6/17/96 Checks to client. .1
6/18/96 Review and compiling information; letter
to client, CV Nephrology and RWC. 1.0
6/21/96 Updating inheritance return;
telephone conferences with Nancy, Larry
Foote, Sollenberger's and Register of
Wills. 1.5
6/24/96 Office conference with Nancy and final
preparation of expense itemization. 1.0
6/27/96 Review and organize information from
Nancy. .5
6/28/96 Check mail at Elm Street. .2
7/02/96 - Balance checkbook and statement savings. .3
7/03/96 Review file; balance bank statements
and letter to client. .6
7/05/96 Bill from Yellow Breeches; letter to
Yellow Breeches and Jones; review file. .5
7/08/96 Deposit Rowe check; letter to client. .2
7/10/96 Review information received; letter to
Jones, client and providers. 1.7
,I
.,.........._....;f~........
.; ...;..~.;.;." ...;.:..-,.....i!~.t:. ".
7/10/96 _ Telephone conference with McDowell
Insurance and letter to McDowell.
_ Information from Jones; letter to Jones
and Nancy; pay sewer and water bill.
_ Check to PP&L; letter from Berkheimer;
letter to Berkheimer and client.
7/30/96 -.Review bank statements; pay Blue Mountain;
and letter to client.
_ Telephone bill to Nancy.
_ Telephone conference with Nancy.
_ Pay school district tax and letter to
client.
8/06/96 _ statements from Blue Cross/Blue Shield
deposit check and letter to Nancy and
Jones.
8/13/96. _ Information from Homeowner's insurance
and auto; letter to client and deposit
check.
8/20/96 _ Carlisle Hospital bill and check from
Blue cross/Blue Shield, deposit and issue
check; letter to client and Jones.
8/23/96 _ Report from Berkheimer; letter and
bill to Nancy,
Balance accounts with bank statements
and letter to client.
Telephone conference with Nancy.
Report from realtor.
Telephone conference with Joan Jones;
letter to client.
9/24/96 _ Telephone conference with Nancy,
9/25/96 _ Final preparation of Inheritance Tax
estimate and Inventory; letter to Nancy, 4.~
...... .."
. .
FOWLER, ADDAMS, SHUGHART & RUNDLE
September 25, 1996
Pa&e 2
7/23/96
7/29/96
7/31/96
8/03/96
8/05/96
8/29/96
9/01/96
9/18/96
9/19/96
Total hours -
Total fee at $125/hr.
NOTE: Estimated fee to complete administration and
distribution of Estate.
Total fees to date and estimated fee.
.2
.5
.5
.5
.1
.2
.1
.3
.6
.6
.2
.2
.2
.1
.2
.2
20.20
$2,525.00
1.000.00
$8,325.00
r--if
.".
FOWLER, ADDAMS, SJlUGIIART & RUNDLE
ATTORNEYS AT LAW
P.O. BOX 208
28 SOUTH PITT STREET
CARLISLE. PENNSYLVANIA 17013-0208
JOHN I. 'OWUR. III
WILLIAM A. ADDA'"
...CHAIL ft. RUNDLE
TELEPHONE 17171 241.8300
FAX 17171 241.8164
'OWLUI. ADDA'" . IHUOH"RT
11t7l.'IIJI
'PlCIAL COUHUL
DALE Po IHUaHART. JR.
0' COUHIlL
HOHOR"I\.I DALI Po SHuaHART
May 28, 1996
Nancy H. Adams, Executrix
Estate of Carl R. Adams, deceased
TO: FOWLER, ADDAMS, SHUGHART & RUNDLE (S)
RE: Estate of Carl R. Adams
Professional services rendered as follows:
Cash advances:
Postmaster, certified mail letter to DPW
2.52
Fees: Dale F. Shughart, Jr.
03/11/96 - Office conference with client; preparation
of probate petition and bond; conference
with insurance agent Dick Neiderer. 3.5
03/12/96 - Office conference with client. .3
03/13/96 - Review and compile documents. 2.5
03/14/96 - Office conference with client; to
Farmers Trust company with client; SS4 to
IRS various telephone conversations. 3.0
03/15/96 - Recording 00214; brief office conference
with client; letter to client. 1. 5
03/18/96 - Organization of client's records and
various correspondence. 2.5
03/19/96 - Hailing complete correspondence and
organization of file; notices to
Beneficial Interest and cover letter. 2.0
03/20/96 - Telephone conference with client. .2
03/21/96 - Obtaining value of U.S. savings Bonds;
telephone conference with Jones & Assoc.;
review of tax returns; letter to client. .8
03/22/96 - Review of correspondence; letter to client. .5
03/25/96 - Filing W-9; check to UGI; letter to client;
telephone conference with client; letter to
Glenn and Carol. .9
03/27/96 - Check to PP&L; letter to National
Geographic and client. .2
FOWLER, ADDAMS, SHUGHART & RUNDLE
Ma, 28, 1996
Pqe2
03/28/96 - Letter from cli~nt and Teacher's CUi
letter to Teacher's CU and Patriot News;
message from Glenn; second letter to
client.
04/02/96 - Letter to Jones, client and American
Express; deposit checks.
04/04/96 - correspondence to client, Carlisle
Hospital and Jones & Assoc.
04/10/96 - Review medical information; letter to
Jones & Assoc.; C.V. Nephrology and
client; review of proof of publication
from CIJ.
04/15/96 - Review hospital bill; letters to client
and Jones & Assoc.; deposit insurance
proceeds.
04/16/96 - Review letter from Jones & Assoc.; deposit
tax refund.
04/22/96 - Telephone conference with Mrs. Polk at
BS/BC; letters to Jones & Assoc.,
Berkheimer and client (2); review sentinel
proof of publication; telephone conference
with client.
04/24/96 - Office conference with client; compiling
medical bills.
04/25/96 - Final sorting of medical bills and
cancelled checks; letters to Jones & Assoc.;
Blue Mountain Anesthesia and client.
04/26/96 - Review information from Carlisle Hospital
and BS/BC; telephone conference with
Jeff Gilbert; letter to Jones & Assoc.
and client.
04/29/96 - Telephone conferences with client,
Marjorie Berkheimer, and Ben Rowe.
04/30/96 - Review of information from Gilbert,
BS/BC and Berkheimer; letters to client,
Berkheimer, Jones & Assoc and PA Department
of Welfare (certified).
05/01/96 - Review bank statement and contract
with Gilbert; telephone conference with
Richard Beaston.
05/03/96 - Telephone conference with DPW.
05/13/96 - Review medical information and corres-
pondence; letters to clients and Jones &
Assoc.
05/15/96 - Office conference with client; letter to
Jones.
t'
.9
.6
.5
.6
.6
.1
1.0
1.5
1.0
1.0
.5
2.2
.5
.1
1.5
.7
I'
f:
I
I:
roi
l
h
,,,.,
,.
1.5
...
_. ,
-
-
-
LAST 'fILL AND TESTAl>IENT OF CARL RAYMOND ADAMS
,
KNOW ALL MEN BY THESE PRESENTS, That I, Carl Raymond Adams,
...
of the Borough of Carlisle, Cumberland County, Pennsylvania, being
of sound mind, memory an~ ,understanding, do make, publish and declare
this my Last Will and Testament, hereby rovoking and making void any.
and all Wills by me at any time heretofore made.
ITEM 1. I give, devise and bequeath all of my property,
whether the same be real, personal or mixod, and wheresoever situate,
to my s1ste~, Nancy M. Adams.
ITEM 2. I appo~nt my sister, Nancy M. Adams,' to pe the
Executrix of my estate.
IN WITNESS WHEREOF, I have executed this my Last Will and
Testament, consisting of one typewritten page, by affixing my signature
. 'and my seal to same, this 17 day of fl Al,t "t..d , 1960.
tJ..'fJ.': Rr-O"fU('>-KJ):;; I!~W'-!J
(SEAL)
The writing contained on .this one sheet was signed and sealed
by the above named Carl Raymond Adams, and by him published and declared
as and for his Last Will and Testamont in the presence of us, who here-
unto subscribed our names as
witnesses, a~is request, in
other, the~ day of .
his presence,
and in the presence of each
1960.
~~\r., .()~'v'\'d',,,,, /~
(;) ~
\.J.:j;d-l~" }!, "7.//,,,,:,,
I
J
..r--------------------- ._-.--_.
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- - - - - - - - --- - - -- _. -- _. ~-- -- - - - - - - - - -,- ~ - - -,-
j ...,
~
.---..- -, ..~.._....
,
-- --- --- ~- -- - - - - _.- - - --
RECEIVED FROM,
&
ACN
ASSESSMENT fl'
CONTROL ~
NUMBER
AMOUNT
SHUGHART DALE F JR
28 S PITT STREET
101 18,000.00 :
CARLISLE, PA 17013
ESTAT! INfOIlMAT10N.
!IIINMR
II 21-1996-01~2 SBN 200-24-0628
!II NAME F DECEDENT (lAST) (FIRST) (Mil
~ ADAMS CARL RAYMOND
I E P"YMfN
'r
B POSTMARK l>>JE
COUNTY
m TOTAL AMOUNT PAID 18,000.00
.. VZ
C I'
\.. . \."jI
RECEIVED BY ! /I., /: tltM.:tl /'?i/
MARY C. LEWIS ,_ '%t/.'1U /y(/, .
REGISTER OF WILLS I
REMARKS
NANCY MADAMS
C/O DALE F SHUGHART
CHECK" 3~
JR ESe
SEAL
REGISTER OF WILLS
"
i
\ -.
~. .
~'
:<
"
. '
- ..- ,.--,.
-~.... "R
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....
11
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/5- fl/) - 1
COHHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERltAHCE fAX DIVISION
DtPT. 1I0Ul
HARRISIURC, Pi 11121.0601
NOTICE OF INHERITANtE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DALE F SHUGHART JR
FOWLER ETAL
28 S PITT ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-03-97
ADAHS
03-06-96
21 96"0152
CUHBERLAND
101
Anount Re.itt.d
c..-
~*
11"1"'11 l" IIt.tll
CARL
R
MAKE CHECK PAYABLE AND REHIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiiv: iSiii"EX"AFii "nF96T"iioYicEnOFniNHEiiii'AiicE"YAX"A"P PRiiisEHiiir;",\L.i."OWANCE"b"Ii"--"m"--mm-
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF ADAMS CARL R FILE NO. 21 96-0152 ACN 101 DATE 02-03-97
If an assessment was issued previously, lines 14, IS and/or 16, 17 and 18
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Anount of Line 14 at Spou..l rat. (15)
16. A.ount of Lin. 14 taxable at Lin.al/CI... A rat. (16)
17. A.ount of Line 14 ta.abl. at Coll.t.ral/Clals B r.t. (17)
18. Principal Tax Du.
TAX CREDITS:
PAYMENT
DATE
06-03"96
10-14"96
TAX RETURN WAS I I X I AtCEPTEO AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, Rool Eatoto ISchodulo Al III
2. Stocka and Bonda ISchodulo BI C21
3. Closely Held stock/Partnership Int.r..t (Schedul. C) (3)
4. Hortg.gal/Hota. Raceivable (Schadule DJ (4)
5. Ca.h/Bank Deposita/Hilc. Pa'lonal Property (Schedule E) IS)
6. Jointly Owned Property (Schedule F. 16J
7. Trenlferl ISchedule GJ 17J
e. Totel Alletl
APPROVED DEDUCTIONS AND EXEHPTIONS:
.. Funerel E~penlel/Ad.. COlts/Hisc. E~p.n.e. (Schedule HJ 19J
10, Oabta/Mortgago Llobllltlo./Llon. ISchodulo II 1101
11. Tot.l Deduction.
12. Net Velue of T.. Return
15. Chariteble/Covern.entel aaque.t. ISchedule JJ
14. Net V.lu. of Elt.te Subject to Tax
NOTE I
RECEIPT
NUMBER
AA1l2893
AA146842
OIStOUNT C+I
INTEREST C-I
421,05
,00
I CHANGED
50.000,00
,00
,00
,00
74.054,87
,00
,00
IBI
29,291.18
11.619,91
1111
n21
CUI
n41
,00 X .00.
,00 X ,06.
83.143,78 x.lS.
nel
AMOUNT PAlO
8,000,00
4,050,52
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTEs To inlure proper
credit to your account,
lub.it tha upper portion
of thil for. with your
tax pay.ant.
124.054,87
4n.911 n9
83.143.78
,00
83,143,78
will
.00
.00
12.471,57
12.471.57
12,471.57
.00
.00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS TNAN tl, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "tREOn" CCRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
AUERYAHONI
PURPOSE Of'
HOHCll
PAYtlEHTI
REFUND tCA) I
alJECTIONSI
AIlHtN
ISTAAlIVE
CORAfCTIOHSI
DISCCk.JtTl
PENALTY,
INTEREST t
00 ~ :0:0
em (1)~
:3 ..:
c ~. ! (~
-n
,,, It,
~ CD .,
I
\..oJ
"_
:u~
}.~
...:....
~.'.
(Ii 2.
B
o
i..J
00
[sh... a' d.udln" dying on ar btIfon O.ullbtlr 12, 1912 ~- If MY fu'ur. In'.r..' In 'M ...... 11 'r,"".rr"
In po.....lon or enJoy..n. '0 CII" I l~oll,'.r.l) bM,'I~I.rl.. of th4 d.~.den' .f..r ,h. I.plr.tlon 0' en, ....t.
II" or 'or y..r., th4 C~onwe.I'h h4rlby ..pr...I, r...rv.. thl right to ,ppr.I,. end I"'" tren,'.r Inherl'ancl
.t thl lewful CI... I l~oll".r.l) rlt. on any .u~h 'utur. Int.rlst.
'.r
Tlu.
To 'ulflll tM r.qulr...nts 0' S.~tlon ZI~O 0' thl Inh.rltanc. and Est.tl T.. Act, Act ZZ 0' 1991. 7l P.S.
Sactlon '140.
Det.ch th4 top portion 0' this Notlcl and sub.lt with your p.y.,nt to thl A.glst.r 0' Will. prlntld on the rlv.r.. ,Id..
--M.... chltk or 110M' ord.r parlbl. tal REGISTER 0.' MILLS, AGENT
All p.yaent. rlc.lvld shill 'Irst b. appll.d to any Int.rlst ~hleh ..y b. dul with any r'lllnder appll.d '0 th4 tl..
A r.fund 0' I taM credit, which WI. not rlqu.stld on thl 'a. R.turn, .., bl rlquestad by coaplltlna an -Appllc.tlon
'or A.,und 0' Pann.,lvenll InhlrltlnCl and Elt.ta T..- (REV-ISIS). Appllcltlonl Ir. Iv,lllbl. at the O"lc.
0' thl A.,I.t.r 0' Wills, any 0' the 2S R.v~. Dlltrlct a"lc.l, or by cllllng the Ip.el.1 Z'-hour
InIWlrlng l.rvlcl nu.b.r. 'or 'or.. ord.rlngl In P.nnsylvanl. 1~'00~S6l-2050, outsld. Pennsylvanl. and
within loc.1 H.rrl.burg .r.. (717) 717~1094, TOO' (717) 772-Z2SZ (H..rlng lap'lred Onl,).
Any p.rty In Int.rllt not l.tl,'I.d with the .ppr.ls...nt, .Ilo~anc. or dls.llowanc. of d.ductlon., or ......-.nt
of ta. (Including dl.count or Int.r..t) .. shown on thl. Notlc. .u.t obJ.ct within ,I.ty (60) d.y. 0' rec.lpt of
this Notlc. by!
--written prot..t to the PA D.part..nt of Ravlnu., lo.rd of App..I., D.pt. 2110ZI, Harrl.bur" PA 17121~IOZ1, OR
--.Iactlon to h.v. thl ,.tt.r d.t.r.lned .t .udlt a' the .ccaunt of the p.r.onal r.pr..en..tlv., OR
--app,11 to the Orphln." Court.
FaetUtI .rror. dl.cav.r.d on thl. I.....,.nt .hould b. .delr",ld In writing tal PA a.p.rt,."t of ..venu.,
IurllU of Indlvldu.l T...., ATTNI Pa.t A......ant R.vllw unit, a.pt. l10601, H.rrl.bur" PA 17Il.~0601
Phon. (717) 7.'.6505. S.. pI,. 5 a' the bookl.t -In.tructlon. far Inh.rltlnc. T.. R"urn far. R..ldant
Oac:ldlnt- (R[V~lsO)) far In .IlPlanlUon of .dIIlnls.r.Uv.h carrlctabl. .rrar..
If an, ta. due I. p.ld wIthin thrl. eS) c.l.nd.r .anth. .ft.r the d.c.dent". d..'h, . flv. parelnt Cs~) dl.count a'
the t.. p.ld It .llowed.
The Is~ ta. a.nt.ty non-p.rtlelp.tlon pen.lty I. eaaput.d on the tatll a' the t.. and In'.r..t ......IeI, and not
p.ld bafor. Janulry II, 1'96, the flr.t day af'.r the end 0' thl t.. .-n..ty p.rlad. Thl. non~p.rtlclp.tlon
panllty I. .pp..labl. In the .... .ann.r and In the thl .1.. .1.. p.rlad .. YOU would .pp..l the t.. and Intar..t
th.t hi' blan .......d .. Indlc.t.d on thl. notlc..
In..r..t I. ch.r,.d blQlnnlno with 'Ir.t d.y of d'llnqu.ncy, or nine (91 eonth. and one (I) d.y 'rot the d.t. a'
d..th, to the data of p.yaent. """ which bac... dellnqu.nt b.for. Januar, I, 1"Z b..r Int.r..t .t thl r.t. of
.1. C6~) p.rcent p.r ~ cllcul.t.d .t . d.lly r.ta 0' .DDOI64. All t,"" which b.c... d.llnquent on and .f'.r
Januery I, 19', wIll b..r Int.r..t .t . r.t. which will v.ry fro. c.llnd.r v..r to c.landar y..r with th.t r.t.
ennounc.d b, the PA Dlp.rt'ent a' R.v.nue. 'h. Ippllcabll In'lre.t r.ta. 'or I,., through 199' .rll
!!.!! Interllt R.t. a.llv Inter..t F.ctor !!!r- In'.r..t R.t. D.llv In'.rllt Flc'ar
1911 ZOX .0005" 191' 'Z .OOUU
1913 16Z .000lt1l I9I'~1991 llX .000101
19l~ IIZ .000101 199Z .Z .0002"
1985 UZ .000556 1995~I99lt 'Z .000192
nil lOX .000l7lt 199s~1997 'Z .00Ult'
....Intar..t I. calculat.d .. 'aUa..t
INTEREST . BALAnCE OF TAX unPAID X nUnBER OF DAYS DELInqUENT X DAILY InTEREST FACTOR
-~&n, Natlcl I..u.d .f'.r the t.. b.ca'.. d.llnqu.nt will r.fl.ct an In'lr..t cllculatlon to flft.an (IS) d.V'
beyond the d... of thl .......ant. If p.yaant I. ..d. "t.r thl In..r..t co~t.tlan dlt. ,hown on thl
Notlc., addltlon'l Intlr..t au.t ba c.lcul.t.d.
r.II1LU>IlATAF1LMOSPfTALllOC\,...m.I'ldo
er.e.t.1WUIt,.,t.2.......
.........C121IWOUUI'M
ALLEGED INCAPACITATED PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
96. / ~-,:;l.
ORPHANS' COURT
INRE:
CARL R, ADAMS
CITATION
WE COMMAND, you that laying aside all business and excuses whatsoever, you be and
appear in your proper person before the Honorable Judges of the Common Pleas Court, Orphans'
Coun Division at a session of the said Coun there to be held. for the County of Cumberland to show
cause why Carl R, Adams should not be adjudged an incapacitated person and a guardian of his
person and of his estate appointed,
A hearing upon said citation is to be conducted on the 'iJ U day of
Ov,',C' . 1996, at?: 30 o'clock L,M" in Coun Room No, ~ of the
I
Cumberland County Coun House, Carlisle, Pennsylvania, at which ,time all interested parties may
be heard,
Written notice of said Petition and hearing shall be given in large type and in simple
language to the alleged incapacitated person, The notice shall indicate the purpose and seriousness
of the proceeding and the rights that can be lost as a result of the proceeding, It shall include the
date, time and place of the hearing and an explanation of all rights, including the right to request the
appointment of counsel and to have counsel appointed if the Coun deems it appropriate and the right
to have such counsel paid for if it cannot be afforded, A copy of the Petition shall be attached,
Personal service shllll be made on the alleged incapacitated person, and the contents and tenns of
the Petition shall be explained to the maximum extent possible in language and tenns the individual
is most likely to understand, Service shall be no less than twenty (20) days in advance of the
hearing, In addition, notice of the Petition and hearing shall be given by cenilied mail to all persons
residing with in the Commonwealth who are sui juris and would be entitled to share in the estate of
the alleged incapacitated person if he died intestate at that time, and to the person or institution
providing residential services to the alleged incapacitated person,
Witness my hand and official seal of office at Carlisle, Pennsylvania this ~of/ day of
1.,1, ,1996.
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INRE:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL V ANlA
ORPHANS' COURT DIVISION
96. JS~
CARL R, ADAMS
ALLEGED INCAPACITATED PERSON
ORPHANS' COURT
{\\ ORDER
AND NOW, this Kday of ~996, upon consideration of the within Petition
and upon motion of MARTS ON, DEARDORFF, WILLIAMS & OTTO, attorneys for Carlisle
Hospital, Petitioner herein, a citation is hereby awarded to the Petitioner and directed to Carl R,
I
Adams, an alleged incapacitated person, to show cause why he should not be adjudged an
incapacitated person and a guardian of his person and of his estate appointed, A".'. 0
A hearing upon said citation is to be conducted on the 8ft\. day of Pr P''''^'
, 1996, at q', ~O o'clock k ,m., in Court Room No,;' of the Cumberland County Court
House, Carlisle, Pennsylvania. at which time all interested parties may be heard,
Written notice of said Petition and hearing shall be given in large type and in simple
language to the alleged incapacitated person, The notice shall indicate the purpose and seriousness
of the proceeding and the rights that can be lost as a result of the proceeding, It shall include the
date, time and place of the hearing and an explanation of all rights, including the right to request the
appointment of counsel and to have counsel appointed if the Court deems it appropriate and the right
to have such counsel paid for if it cannot be afforded, A copy of the Petition shall be attached,
Personal service shall be made on the alleged incapacitated person, and the contents and tenns of
the Petition shall be explained to the maximum extent possible in language and tenns the individual
is most likely to understand. Service shall be no less than twenty (20) days in advance of the
hearing, In addition, notice of the Petition and hearing shall be given by certified mail to all persons
residing within the Commonwealth who are sui juris and would be entitled to share in the estate of
the alleged incapacitated person if he died intestate at that time, and to the person or institution
providing residential services to the alleged incapacitated person,
BY THE COURT,
1.
\
INRE:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
CARL R, ADAMS
ALLEGED INCAPACITATED PERSON
ORPHANS' COURT
96-
PETITION FOR ADnmICATION OF INCAPACITY AND
APPOINTMENT OF GUARDIANS FOR HIS PERSON AND ESTATE
TO THE HONORABLE, THE JUDGES OF SAID COURT:
The Petition of Carlisle Hospital, by its attorneys, MARTSON, DEARDORFF, WILLIAMS
& OlTO, is made in accordance with 20 Pa. C,S,A, ~5511(e) and respectfully represents as follows:
I, Petitioner, Carlisle Hospital, is a Pennsylvania nonprofit corporation with a place of
business at 246 Parker Street, Carlisle, Cumberland County, Pennsylvania 17013, Petitioner has
been providing health care and counseling to the alleged incapacitated person since November 26,
1995 and is interested in his welfare,
2, The alleged incapacitated person is Carl R, Adams, a 63 year old adult individual
born on December 3, 1932,
3, The alleged incapacitated person resides at 131 Elm Street, Carlisle, Cumberland
County, Pennsylvania 17013,
4, On or about November 26, 1995, the alleged incapacitated was admitted to Carlisle
Hospital, The diagnosis for Mr, Adams was renal failure, diabetes, and esophagitis, Mr, Adams is
also legally blind,
5, The alleged incapacitated persons' spouse and parents are deceased, The alleged
incapacitated person has three living siblings, Meryl Adams, Gene Bender and Nancy Adams, all
of whom reside in the state of California,
6, The alleged incapacitated person has a nephew, Glenn Adams and a niece, Carol
Wickard, both of whom reside in Cumberland County, Pennsylvania. Mr, Adams and Mrs, Wickard
have declined to act as guardian for the alleged incapacitated person,
7, The Petitioners know of no other relatives of the alleged incapacitated person,
8, No person or institution is providing residential services to the alleged incapacitated
person, The alleged incapacitated person is currently an inpatient at Carlisle Hospital, Prior to onset
on illness to the present degree, he resided at his above referenced Elm Street home,
9, The guardianship is sought because the ability of the alleged incapacitated person to
receive and evaluate infonnation effectively and communicate decisions is impaired to such a
significant extent that he is totally unable to manage his medical condition to meet essential
requirements for his physical health and safety, and is totally unable to manage his financial
resources,
10, Mr, Adams consistently refuses most medically necessary medications, frequently
refuses meals or eats little and refuses to restart nutritional IV, Such actions jeopardize Mr, Adams'
life and illustrate his inability to comprehend and evaluate infonnation in order to make infonned
and rational decisions, In addition, Mr, Adams refuses physical therapy, rehabilitation, personal care
or to engage in discharge planning,
II, Steps were taken to find less restrictive alternatives to guardianship, however, these
steps have failed, Petitioner believes that until his most recent hospitalization, the alleged
incapacitated person was handling his own affairs with the assistance of others, However, Mr,
Adams condition is such that he now requires constant supervision and care, Petitioner is not aware
of any durable general powers of attorney, trusts or other advance directives in existence, The
alleged incapacitated person lacks sufficient capacity to appoint an attorney-in-fact, For these
reasons, Petitioner respectfully submits that there is no less restrictive alternative to plenary
guardianship of the person and of the estate,
12, The specific areas of incapacity over which it is requested that the guardians be
assigned powers are the management of all aspects of the physical care and well-being of the alleged
incapacitated person, as to the guardian of the person, and the management of all financial resources
and property in the alleged incapacitated person's estate, as to the guardian of the estate,
13, Petitioner suggests that Capitol-Public Guardianship Agency, P,O, Box 1113, Camp
Hill, Pennsylvania, owned and operated by Ann Thorek, be appointed plenary guardian of the person
and estate of the alleged incapacitated person. The qualifications of the proposed guardian is that
it is familiar with arranging care for those incapable of doing so for themselves and also of handling
financial matters for such persons in a fiduciary capacity.
14, The proposed guardians have no interests adverse to the alleged incapacitated person,
15, Based upon infonnation provided, the gross value of the alleged incapacitated
person's estate is estimated to be $50,000,00, though no appraisals have been conducted,
16. The alleged incapacitated person's annual net income from all sources is unknown,
17, No other court has assumed jurisdiction in any proceeding to detennine the capacity
of the alleged incapacitated person and no other Court or other body has appointed a limited or
,
plenary guardian for the alleged incapacitated person or his eSlate to the best of the knowledge and
infonnation of the Petitioners,
18. The written consent and statement of the proposed guardian of the person and estate,
as required by C,C,O,C,R, 14,2-2, is attached hereto and marked as Exhibit "A,"
WHEREFORE, Petitioners pray this Honorable Court, pursuant to the provisions of Chapter
SS of the Probate, Estates and Fiddciaries Code \:0 Pa, C,S.A. ~SSOI, et seq.), to award and issue
a Citation directed to the alleged incapacitated person, the said Carl R. Adams with notice thereof
to his presumptive adult heirs and to such other persons as the Court may direct, to show cause why
the said Carl Adams should not be adjudged an incapacitated person and a plenary guardian of his
person and of his estate appointed,
Attorneys for Petitioners
Respectfully submitted,
MARTS ON, DEARDORFF, WILLIAMS & OTIO
By ~~. D~/I
W, Darren Powell, Esquire
Ten East High Street
Carlisle, PA 17013
(717) 243-3341
Date: 2 -\ (, . 'Ie.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Carl R. Adams
Date of Death: March 6. 1996
Estate
xWiH No. 21-96-1- - 151-
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State 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 v
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 repo t.
Date:
April 28, 1997
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Capacity:
Personal Representative
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Dale F. Shul!hart. Jr.. Esauire
Name (Please type or print)
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a:
35 East Hil!h Street. Suite 201
Address
Carlisle, PA 17013
(717) 241-4311
Tel. No.
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Counsel for personal
representative
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