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and expenses of the trust including reasonable compensation of
the trustee. t1y son shall have the right to withdraw the
income from the trust estate at least quarterly, and any income
not withdrawn by him within sixty (60) days of the end of any
calendar year shall be added to the principal and no longer be
subject to withdrawal. The trustee, at its sole and absolute
discretion, may expend from time to time sums of principal which
may be necessary for his support, health and maintenance, includ-
ing but not limited to hospitalization and medical expenses.
Upon the death of my said son, the remaining trust estate shall
be distributed to his then living issue per stirpes, and if he
has no such issue surviving him, including afterborn issue,
then it shall be distributed as follows:
A. 50% to the daughter of my deceased husband
by a former marriage, Christine Shepherd, if living. and if
not to her then living issue.
B. 50% to the Shriners Hospital for Crippled
Children, a corporation.
IV - I appoint Dauphin Deposit Bank and Trust Company,
Harrisburg, Pennsylvania guardian of any property which passes
either under this will or otherwise to a minor or incompetent
and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so. Such guardian
shall have the p01~er to use principal as well as income from
education (including
Page 2
A..OLD, Suaa A n,,:na.
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-......".."
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college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
support and education, or to make payments for these purposes
without further responsibility to the minor or to the minor's
parent or to any person taking care of the minor.
v - The principal and income of the trust hereinabove
created shall be free from anticipation, assignment, pledge or
obligation of any beneficiary and shall not be subject to any
execution or attachment or to voluntary or involuntary aliena-
tion.
VI - The trustee hereinafter named shall have the
following powers and duties in addition to those already vested
in it by law and other provisions of this will:
A. To retain any or all of the assets of this trust,
real or personal, including its own stock, without regard to
any principle of diversification or risk.
B. To invest in all forms of property, including
stock, common trust funds and mortgage investment funds whether
operated by it or others, without restricton to investments
authorized for Pennsylvania fiduciaries, as it deems proper,
without regard to any principle of diversification or risk.
C. To sell at public or private sale, to exchange,
or to lease for any period of time, any real or personal property
and to give options for sales, exchanges or leases, for such
prices and upon such terms or conditions as it deems proper.
D. To allocate receipts and expenses to principal or
or partly to each as it from time to time thinks proper
sole discretion.
income
in its
JA~IIW'~
Page 3
E. To lend to, or purchase from, my executor even
though trustee may also be such executor.
F. To hold property in my name or in its name
without designation of any fiduciary capacity, or in the name
of a nominee or unregistered.
VII - I appoint Dauphin Deposit Bank and Trust Com-
pany, Harrisburg, Pennsylvania, Trustee of the trust hereinabove
created.
VIII - I appoint James K. Arnold, Esq. and my son,
Lovell L. Peterson, Coexecutors of this, my Last Will and
Testament. Should either of my said coexecutors fail to
qualify or cease to act as such, then I appoint the said
Dauphin Deposit Bank and Trust Company to act in this capacity.
None of my personal representatives shall be required to post
bond in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
on this, the
71'H
day of
\lAPllill (
, 1981.
~~4~(SEAL)
e en~. eterson
Page 4
. .
... . . .
Signed, published and declared on the date thereof by the above-named
. HELEN W. PETERSON, as and for the sole codicil to her Last Will dated
January 7, 1981, in the presence of us, who, at her request, in her
presence, and in the presence of each other, have hereunto subscribed
our names as witnesses hereto.
~ Camp Hill, PA
. Name Address
,
~ t. U. jl Landisburq, PA
Name Address
Page 2
ARNOLD Ie SLlKE. ATrOkNtn.AT.t..\W, 1109 MAun STRUT. CAM,mLL.'A nOli
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RECEIVED FROM,
ACN
ASSESSMENT P:'
CONTROL Ii;I
NUMBER
AMOUNT
SLIKE JOHN E
2109 MARKET STREET
101
'6,::166.00
CAMP HILL, PA 17011
fOlD Hfll
ESTATE INfORMATION.
!II IL N R
II 21-1996-0161
!II NAME Of DECEDENT LAST)
~ PETERSON HELEN W
II f PAYMENT
EI POSTMARK lIME
COUNTY
SSN 179-36-1672
(FIRST) (Mil
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CUMBERLAND
DATE Of DEATH
,
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REMARKS
m TOTAL AMOUNT PAID
,~
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JOHN E BLIKE ESQUIRE
'6,eoo.oo
PB
SEAL
CHECK. 1004
,
J<N4 tv ,I
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MARY C. LEWIS '. '1.tV,), "
REGISTER OF WILLS /o.9/Lt-r :
REGISTER OF WILLS
'!~____________________'__~_____~._~__~
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FOR OA'U A. OEA'H AFTER 12/11101 CHECK HERE C. A
IF A SPOUSAL
REV. 1500 EX .0.94)
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COUNTY CODE
C P
o 0 NAME
R N
R D John E. Sl1ko Es uiro
E E
S N TELEPMONE NUUBER
- T 717 737-31,05
1. Rul Estalo(Schodulo A)
2. Slock. and Bond. (Schadulo B)
3. CIoSlIy Hold SlockIPlrtne"hlp Intarl" (Schadull C)
4. Mortglg" Ind Not.. Rocoivlbla (Schodule D) (4)
5. Co.h. Blnk Dopo.its & MisCIU.noou. Parsonal Property (Sch. E) (5)
B. Jointly Owned Property (Schadule F) (e)
7. Tronsfo" (Schadule G) (Schadule Ll (7)
B. Tolal Gross AssolS Itolal Line. 1-7)
9. Funeral Expenses. Administrative Costs. MlSc.llaneous
E,penso.ISchadule H)
10. DobIS. Mortglgo LllbMil" Lien. (Schadulo il
11. Tolal Ooduction.ltolal Lina. 9 & 10)
12. Nol Vlluo 01 E.toll (L1na 8 mnu. Line 11)
13. Char~lble Ind Govornmonlol Boquo.', (Schadulo J)
14. Nol Vlluo Sub' cl to Tn (L1nl 12 mnu. L1no 13)
15. Spousal Trlns!o" (tor dll" 01 doalh Ihar 6-30-94)
St. Instructions for Applic.ble Percentage on page 2.
lInclude values from Schedule K or Sch.dule M.)
'1. Amounl 01 line 14 laKable at 6'1. ,ale
(Include values from Schedule K or Schedule M.)
17. Amount 01 Line 14 taxable 1115'/. rat.
(Include valuts bom Schedule K or Sch.dule M.)
lB. Princip"lt.. duo (Add tl' Irom Line 15, 161nd 17.)
19.Credits/Sp Poverty Prior Payments Discount
+ 6,500.00 + 342.11
20. II Line 19" groltor lhan L1no lB, onlor Iho ddteronco on Une 20 Thi. i. Iho OVERPAYMENT.
~ 0 ICheck hara II you Ira raquaotlng 0 ralund 01 your overpaymant.1
21. If line 18 rs grlatlr than Line 19, enter the diNer.nce on Line 21. This is the TAX DUE.
A. Ent.r 1h. intlr.st on the balance due on line 21A.
B. Enlor lha lolal 01 Lino 21 and 21A on Line 21B Thi." tho BALANCE DUE.
Moka Chock Po obloto, R lotar 01 WlIIo. A ont
. . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TD RECHECK MATH .. ..
Under peNIU.s 01 petllM'Y.1 d.cIl'.lhatl h........m1ntd this "h.l'n.lrcludlng aCCOmpol"yinq schedul.s'nd statemenl.. .nd 10 Ih. bn1 01 """ tnowledg. .nd bellet, IllS I''''',
c:on.cl.nd com"lete. I d.c~telh.t.1l 'e.1 nl.t. hll bHn ,epa'lld .111\" mI,tet ....,..... D.c:I.,.Uon ot prepat.' olher Ih.n the pe'SONI ,eptnent.U...els baSed on.n Inlorm.lUon 01
whkh ,,'.pI,e, hll Iny tnowled9.
FILE NUMBER
CO"MFmH.M:\'If".MIWiI~ANIA
HARRISa5~t,'tI.m\z;'0601
D
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C
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DECEDENT' NAME (LAST, FIRST .AND UIDDlE INITIAL)
PETERSON HELEN W.
DECEDENT'S COUPLETE ADDRESS
3453 Greon Stroot
Camp Hill, PA 17011
SOCIAL SECURITY HUUBER
179-36-1672
DATE OF OEATH
02/01/96
OATE OF BIRTH
02/13/13
County Cumborland
(IF APPLICABLE) SURVlVlNQ SPOUSE'S NAUE ILAST .FIRST AND Ul00LE INITIAL) SOCIAL SECURITy NUUBER
2. Supplemontll Roturn
4.. Future Inl.r.st Compromise
lIor dol.. 01 dOlth Ihor 12-12-82)
[]] 5. O.cedent Died T.st.t. D 7. O.c.d.nt Maintain.d I living Trust
(Attach co 01 Will) (Attach 0 co 01 Tru.t)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED TO:
Xl. Original Rolurn
4. Llrnilod E.lall
05.
1 B.
COUPLETE UAlLlNQ AODRESS
Saidis, Guido, Shuff
2109 Markot Stroot
Cam Hill PA 17011
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12 ,110.63
Nono
Nono
22,250.23
8,110.12
Nono
(9)
18,179.80
(10)
4,171.33
(15)
0.00 X
(16)
2196-0161
YUR
HUMBER
AMOUNT RECEIVED (SEE IHSTRUCrlONSI
0.00
R.maind.r Return
(tor dot.. 01 doalh prior to 12-13-82)
F.dlr.1 Estat. TII R.turn R.quir.d
Tolal Number 01 Solo Dopo.~ Bo...
Ex Masland
(8)
146,864.98
(11)
(12)
(13)
(14)
22 , 351.13
124,513.85
124 513.85
:
0.00
7,470.83
12/,,513.85 X .06 :
0.00
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A
T
I
o
N
(17)
0.00 X .15:
Lovo11 L. Poterson/John E. Stiko
2109 Markot Stroot
tam.' iiiii': .PA. - "i7Ciii........"".. -. - -. -..........
Saldls, Guido, Shuff Ex Mas1and
2109 Market Streot
tamp' iiiii': 'PA.. -i 7ciii - -....... -" - -..... -..... -...
Inllr.st
SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE
""f'....I.,..' '.., ,Qq. In'... '''11....'.. ""tv C:PSy.'emt Inc
(1B)
7,470.83
(19)
(20)
6,81,2.11
0.00
(21)
(21A)
( 21B)
628.72
0.00
628.72
otJ"/;.r. /'1 V
F..
IR.....7.'.)
CODICIL TO
THE LAST WILL AND TESTAMENT
OF
HELEN W: PETERSON
I, HELEN W. PETERSON of the Borough of Camp Hill, Cumberland
County, Pennsylvania, declare this to be the sole codicil to my Last
Will dated January 7, 1981.
I - I hereby revoke the appointment of James K. Arnold. Esq.
as one of the Coexecutors of my Last Will and Testament in Paragraph
VIII thereof, and appoint John E. Slike, Esquire, to act in this capa-
city, along with my son, Lovell L. Peterson. Should either of my said
coexecutors fail to qualify or cease to act as such, then I appoint
Dauphin Deposit Bank and Trust Company to act in this capacity. None
of my personal representatives shall be required to post bond in this
or any jurisdiction.
II - In all other respects I hereby ratify, confirm and
republish my Last Will dated January 7, 1981, together with this sole
codicil as and for my Last Will.
the
IN W~ESS WHEREOF~have hereunto set my hand and seal on this,
7 day of ~ ' 1985.
4tk/~'f1~
elen W. Peterson
(SEAL)
Page 1
ARNOLD &.: SLIKE. ATTOkNln."T.LAW, Ilot MAun STUlT. CAJoCr HilL p" HOIl
Signed, published and declared on the date thereof by the above-named
HELEN W. PETERSON, as and for the sole codicil to her Last will dated
January 7, 1981, in the presence of us, who, at her request, in her
presence, and in the presence of each other, have hereunto subscribed
our names as witnesses hereto.
Camp Hill, PA
Address
i
('.
Name
jLJ~. .I
Landisburg, PA
Address
ARNOLD k SLIKE, AnoaNlYS.AT.LAW.lIDt MAUlT STun, CAMP HILL. '" nOli
Page 2
....._...._.".- _ ._-_.-t-~-''''~-'''''''' I -
LAS't WILL' AND 'tESTAMENT
OF
HELEN W. PETERSON
I, HELEN W. PETERS Oil of the Borough of Camp Hill.
Cumberland County, Pennsylvania. declare this to be my Last
Will and Testament, hereby revoking any will previously made by
me.
I _ I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II _ 1 devise and bequeath all of my automobiles and
all other articles of personal or household use. including but
not limited to household goods, furniture, personal effects,
and other tangible personal property, to my son, Lovell L.
Peterson.
III _ 1 devise and bequeath all the rest, residue and
remainder of my estate of every nature and wheresoever situate
unto my trustee hereinafter named, III TRUST, nevertheless for
the following uses and purposes and under the following terms
and conditions. The trust shall be held for the benefit of my
said son, Lovell L. Peterson. for life. Out of the income
derived by the trustee, it shall pay all th~ necessary costs
,POLIt. SL'.. &- On"."
Anat.Nn" At u..
-......".."
c....l"".h..."~.....-
J/1J4jb i- ~ I ~.nJ
Page 1
,., .~.... ~._,-.._--.--... ., ;
and expenses of the trust including reasonable compensation of
the trustee. l~y son shall have the right to withdraw the
income from the trust estate at 'least quarterly, and any income
not withdrawn by him within sixty (60) days of the end of any
calendar year shall be added to the principal and no longer be
subject to withdrawal. The trustee. at its sole and absolute
discretion, may expend from time to time sums of principal which
may be necessary for his support, health and maintenance, includ-
ing but not limited to hospitalization and medical expenses.
Upon the death of my said son, the remaining trust estate shall
be distributed to his then living issue per stirpes, and if he
has no such issue surviving him, including afterborn issue,
then it shall be distributed as follows:
A. 50% to the daughter of my deceased husband
by a former marriage. Christine Shepherd. if living. and if
not to her then living issue.
B. 50% to the Shriners Hospital for Crippled
Children, a corporation.
\."OLD. Sua. a D...TUT
.noaHI'Yt,,'UW
_..M"''''''
(....."'.,......,.........
IV _ I appoint Dauphin Deposit Bank and Trust Company,
Harrisburg. Pennsylvania guardian of any property which passes
either under this will or otherwise to a minor or incompetent
and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so. Such guardian
shall have the power to use principal as well as income from
e minor's support and education (including
Page 2
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AlutOLD, !ILl.... II D.t.YLa.
4TTO&N1\'I4TU,W
--..........
C....."'-.......-....-
I'
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,.-......_-............_-.._~.,..~,'". ,".'
...., .
college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
support and education, or to make payments for these purposes
without further responsibility to the minor or to the minor's
parent or to any person taking care of the minor.
v - The principal and income of the trust hereinabove
created shall be free from anticipation, assignment, pledge or
obligation of any beneficiary and shall not be subject to any
execution or attachment or to voluntary or involuntary aliena-
tion.
VI - The trustee hereinafter named shall have the
following powers and duties in addition to those already vested
in it by law and other provisions of this will:
A. To retain any or all of the assets of this trust,
real or personal, including its own stock, without regard to
any principle of diversification or risk.
B. To invest in all forms of property, including
stock, cornmon trust funds and mortgage investment funds whether
operated by it or others, without restricton to investments
authorized for Pennsylvania fiduciaries, as it deems proper,
without regard to any principle of diversification or risk.
C. To sell at public or private sale, to exchange,
or to lease for any period of time, any real or personal property
and to give options for sales, exchanges or leases, for such
prices and upon such terms or conditions as it deems proper.
D. To allocate receipts and expenses to principal or
or partly to each as it from time to time thinks proper
sole discretion.
income
in its
ff~IIx1/~
Page 3
Page -1_ of _Z-
SAFE DEPOSIT BOX INVENTORY
INSTRUCTIONS
(1) Caah: Reparllalal only.
(2) Slack.: Li.1 in delail every cammon or preferred cerlilicale, warranl or alher righ" found in ba.. Slach are
to be designated by nome of company, certificate number, dale of certificate, name in which Slock is regislered,
and number of shares and clan of slack.
(3) ObI/got/an. of U. S. Governmant: Number of ilems, dale of inue, face value. names in which regislered
and Iype of ownership. i.e., joinlly held, payable an dealh. elc.
(4) Bond.. Oesignale by name. amaunl. serial number, or alher de.ignalion. (Bearer Bands)
(5) Bank and Savlnga and Loan Pa..book.. Slale name ~f deposilor. number of book. lasl dale appearing in
book. name of bank and branch, and balance.
(6) Jlwalry. Colna, Stampa, Manu.crlpta, ItC: Lisl and demibe as fully as ponible.
(7) Dead., Mortgaga.. Currant InaurancI PoI/cia. or other avldlnc.. of Indabtadna..: Lisl and describe as
fully as panible.
(8) All athar cantanta.
ITEM DESCRIPTION
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NOTE:
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Attach additional 8'h" x II" ahaat (.)If naca..ary or usa dupllcata. of thl. palla of farm.
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cO"'~HqlO:tM.lJ,t\!l,.e'il\.ll~:Q,yAHIA SCHEDULE A
''Rl'ilb1llt"b~.l'f" REAL ESTATE
ESTATE OF FILE NUMBER
HELEN Y. PETERSON SSj 179.36-1672 02 01 96 2196.0161
(Proporty Jointly-OWned with RighI of Survivorship musl be dllclolod on Schodulo FI All r..IOIlllo Ihould be roporlod IIIllr markol vlluo
whIch II dollnod litho prlca II which proporty would be o.chlngod betwHn I willing buyor Ind I willing lollor, nollher baing compollod 10
or ..11, both hlvln r...onablo knowlod a 01 tho roloVlnl IleII,
ITEM
NUMBER
VALUE AT DATE
OF DEATH
DESCRIPTION
1 Residential property located at
3453 Green Street. Csmp Hill Borough
assessed at 7,620 per attached copy of tax bill
104,394.00
7.620 x common level ratio of 13.70
S 104 394.00
TOTAL (AI.o onlar on lin. \, R.c. ~ulalion)
(II moll'P.C. i> na.dld. in..n .dd~ioftll sha." ol..ma .iz..l
CODY'\Qtllltl \". 'DI'm soltwlrt only cpsystems.1nc.
F_l!lOO Schod'" A \,..... IZ.85)
.
RIV. 1103 EX + (4.16)
cO"'lI.m~g~"'A
ESTATE OF
SCHEDULE B
STOCKS AND BONDS
FILE NUMBER
2196-0161
HELEN Y. PETERSON ssg 179-36-1672 02/01/96
(All
ITEM
NUMBER
ownacl with R ht 01 Survlvorshl mUll be dllcloled on Schedule F.I
DESCRIPTION
VALUE AT DATE
OF DEATH
1
329 sha of PP&L common
25.625
8,430.63
2
115 sha of Orrstown Financial Services common
32
3.680.00
TOTAL (Also enlar on line 2. Raca ~ulatlonl
(II mora spica i> needed. Insen Idd~ftllshae" of sama size.)
Cooy,lqht'cl 1994 fOtffllCftw.re orly CPSyttems.lnc.
S 12 110.63
Fonn 1500 Schld'" B IA.., 4-1,)
RIV. 1109 EX + 11Z.1I)
SCHEDULE F
JOINTLY-OWNED PROPERTY
CO"'~Hm~~~~"'A
ESTATE OF
HELEN Y. PETERSON SS 179-36-1672
FILE NUMBER
2196-0161
02 01 96
JolnllOftlntlll.
RELATIONSHIP TO DECEDENT
Son
A.
NAME
Lovell L. Peterson
ADDRESS
3453 Green Street
Camp Hill, PA 17011
B.
C.
LETTER DATE TOTAL VALUE DECO'S DOLLAR VALUE OF
ITEM FOR MADE DESCRIPTION OF PROPERTY
NUMBER JOINT OF ASSET % INT. pECEDENTINTEREST
TENANT JOINT
1 A 06/01/70 PNC Bank Acct. 2.571.53 50.00'; 1,285.77
5140049503
2 A 09/01/79 PNC Bank Acct. 1,178.39 50.00'; 589.20
5140162071
3 A 09/30/92 Prudential Municipal 12,470.30 50.00'; 6,235.15
Fund, Acct. No.
3900185549
The fo1 lLowing ccount el ists; however, the tax will
be paid by the beneficil ry. It is not to be cons id red
a part f the state:
4 A Prudential Insurance Co.
annuity with date of death
balance of $86,542.53
TOTAL (Also enler on lint 6. Reclo~ulationl 8,110.12
Jolnlly-owned prop arty.
{II mort SpIC' ts Mlded, InSlrt additlonll sheets of Slme siz..}
r."~,h1hlll" '~4 tn'," "nflwI,1t ontyCPSy.lefM.lnc
Form 1500 Schedule F (R.... '2-88l
RIV.lI1UlC. (1.11)
..._;"'....~""".i;',.. ,',
~;,. ~U.;:::..~.......~.,.t:,...l .,-'---",
. _..... .............b....':.. ,...";;,"^,_._.___.
. ,.,.",J.. .
4__~__'''';'''-..
CO"'II._4\~~~1hY"'A
UTATlOF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Piau. Print of T a
FILE HUMBER
2196.0161
HELEN W. PETERSON ssg 179-36-1672 02/01/96
ITEM
HUMBER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
DESCRIPTION
Bell At1antic-PA
PP&L
PAWC
The Bon-Ton - debt of decedent
Susquehanna Surgeons
Conner-Rich, Kearney & Torchia
Ann Markley, Tax Collector - county and borough taxes
Apria Hea1thcare - balance due
Innera-Davis Associates
PA Dept. of Revenue. 1995 individual tax due
Hartman & Scheuchenzuber, CPA's - tax preparation
EKe Asaoc iates
Security and Life Syatems - balance due on monitoring contract
A. Z. Ritzman Asaocietes
Waste Management of Central PA
Ann Markley, Tax Collector - school taxes
Borough of Camp Hill - aewer rental
USAA - insurence
AMOUNT
151.41
439.24
101. 87
64.32
35.98
100.00
444.32
2.14
48.15
130.00
245.00
6.65
1,012.00
55.53
71.76
1,168.68
60.00
34.28
TOTAL (Also ani.. on Una 10. R,c. .ulotlon) S
(It moll IplCO i> naedod, Insln Idd~ioftllshae" of sima lizl.)
Copyrtgh1 fe) '"4 form MI'tw.,. 0f'It CPSyItllfM,lnc.
"
.--'--"'-'-'-
"-
r
,
, .
. ~''''::':'''::'''''-~-- --- - - - _.:- ~ - _:.- ~-'- - - - ---'- -'- =,
I
RECEIVED FROM:
1\'-";"\(.lI'.:~'l!1.~!"'1ll'~'I...>}~~~'fr;:"~':;:iJ"~r;"'\~-~' '';'\''~1:\i:~ ' =
fO.;!I"NSYLYANtA'l\~Wil.~~~~f~' ' G. !i'l\"I~ '''If!' .
^.. !+,..~~...!" (i!-,t ,~,,~,.f ~':: e,c..]1':'f..1.'i~~l'k...~..
811.1 .;Joii3:il fi/1; ":J~~f .:-~~~.t'~~~-:l::'iif>,:.i-./;:""
.~,. ~;!t'""..,." ,1,),'lt!l"",,'l,\ '4~'f;"'l;;il~tj,;j'~;:;i'1:.
IN CI D-&ftITAX'J~"',1Iii~1'1 .,,:~
,,'.. _. _....'-"^ _.. " ___. ..... . .~~,~l._ . _~~ .~..tf 'f!, jl'!'(4!"Ji
ACN
~ ASSESSMENT P:' AMOUNT
II CONTROL 1;1
NUMBER
.
SLIKE JOHN E
2109 MARKET STREET
101
t61:9.72
CAMP HILL, PA 17011
SSN 179-36-1672
(FIRST) (MI)
W
CUMBERLAND
E Of DEATH
REGISTER OF WILLS
fa TOTAL AMOUNT PAID .62e. 72
SK
RECEIVED BY 9/k.J ~oHC . .;I4w-< ""1 ~.PV
MARY C. LE~{S N~ I'AhJ,,()r.1'c.L
REGISTER OF WILLS ~
REMARKS
JOHN E SLIKE ESQUIRE
SEAL
CHECK" 1024
,
~----; _ _ _.-...: -'-- .-'-- _ ~ ~~{-- _.- .-~.- _ - -- -- - - -.- -,- -:------,-_.
.
\. -, "':
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11-
- ,--
r'T.-
_21
~~ .-.~
~ - .
.- -- ,.--"
20. If L1n. 19 i. ,,"aI" than lIn. 18. tnl., the diRt,.nc. on L1n. 20. Thl,1I the OVIRPAYMENT.
riD
21. If lIn, 18 It ""01., Ihon Lln. 19, ,nl" th, diH.,,"c. on Lin. 21. Thll i"h. TAX DUE.
A. Enl" Ih.lnt"'1I on the balonc. due on Lint 21A.
B. Enl., Ih. 10101 0' L1n. 21 ond 21 A on line 218. Thl. it Ih. BALANCE DUE.
Moke ChICk Poyable 10' Regl.t.. el Will., Agenl
IA'NSWII1~U;QUESTIONs;oN'RMRS.,S1DI:AND,TO_RICHICKiMAUlli(O f$';f"ji. \
Und.r Plnalll.. of perjury. I d.clar.thot I have uomln.d Ihl, ,.'urn. Including accompanying tch.dul.. and "at.mlnU, and fa the blat of my ~nowl.d9' and b,li.f,
1111 truI. corrld and compl'll. I dldor. that 011 r.ol "tal. hal bit" ,.port.a ollru. marlt' yolu.. D,c1aration of pr.po,,, olh., thon IhI plrsonal r.p,,,.nlativl i.
balld on 01 Infor 'on of which r. or., hat any knowl.dge.
SIGN 1 01 'lUNG .nUIN ADDUU OAf( A
2109 Market St., Camp Hill, PA /1~'/7'
ADDlln DAIl '
2109 Market St., Cam Hill, PA /I/~r;-/tj'r;.
~.
IlV.UOO IX. tl,("l
~
..:5:::
IIlfu
"'i9
u:r"'
~8
...,
":0:
B~
I 5 - 51& -II
*,.9
'(\
.....
'OR DATIS 0' DIATHAnlR 12/31191 CHICK HIRE
If A SPOUSAL
POYIRTY CREDIT IS CLAIMED 0
'Ill NUMIIR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
COMMONW!ALTH 0' 'INNsnVANIA
DI,,,,UM(NI Of IlVINUI
Df,T 210601
HAUISlU_O.'A 1112..0601
CIO N' NAM IlA . flU. AND MIDOlllNI tA\1
PETERSON, HELEN W.
COUNIY CODE
2196 - 0161
YEAR NUMIER
DlCEDENT', COM'UU ...DOIIU
3453 Green Street
Camp Hill, PA 17011
c.." - Cumberland
AMOUNt '(CIIVID 1$(( IN$u.uCY.ON$1
8
a
III
.,
$O(IAl SleUltllY HUMIU
179-36-1672
DATI Of 0lA1H
DAn 0' IIIIH
02/13/13
I" ,,'''1(....111 lu''I'vlHO lfOUU" "'AIIIIIl"". 'IU' "NO ""'ODlllHlIIA'1
01.
04.
~ 2. Supplemental Rtlur"
o 3. R.maind., Relur"
(10' dol.. 01 d.o,h prlo, 00 12.13,821
o 5. F,d,ral ellolt Tall Rtlur" Requir,d
Original Rt''''"
o 40. Futur. Inl.,tst Compromit.
('0' dolO I 01 d.olh oft.. 12.12.821
06. D.ced.nt Di.d Te"ott 0 7. Olc,d,nl Maintained a living TruI'
(Alloch copy 0' Willi (Alloch copy of T,ull)
ALL'CORRISPONDINCI;AND'CONflDINTIAL'TAXINFORMATlON SHOULD BE DIRECTED TO. .
HAM 'OM,un "'AJ,llHO ADDlUS .
John E. Slike, Esq. ~a~a~s, uu~do, Shuff
2109 Market Street
Camp Hill, PA 17011
limit.d ellal.
_ B. TOlol Numb.r of Sol. O,polil BO.llII
& Mas1and
737-3405
:0:
.,
3
!
co
111
( 21 8,430.63
(3)
(41
(51 3,227.62
( 61 9,766.19
(7)
( 91 685.00
(101
685.00
1. R.ol 101010 (Sch.dul. AI
2. S'ocll ond Bondi (Sch.dul. BI
3. ClolOly H.ld Soocl/Palln."hlp Inl...II (Sch.dul. C)
.. Mortgogll and Naill R.c.ivobl. (Sch.dul. 01
5. COlh, Bonlc O,polill & Mil"Uon,oul P.nonol Prop.rty
(Sch.dul. E)
6. Jointly Own.d Property (Sch.dul. f)
7, fron.I." (Schedul. GI (Sch.dul. L)
8. Tolol Grall Au." (totallinll 1.7)
9. Fun.rol E.IIp.n"l, Adminiltrativ. COlli, MilC.llan,oul
Exp..... (Schedul. H)
10. O.bll, Mortgog. liobiliti.., li.nl (Sch.dul. I)
11. T 0101 D.duct;on. (10101 Un.. 9 & 101
12. N., Valu. of Eliot. (lin. B minuI lin. 11)
13. Charitabl. and Gov.rnm.ntal S.quIIII (Sch.dul. J)
U. N.t Yolu. Sub .<110 To. (line 12 mlnul L;nl 13)
15. Spoulal Trand,,. (for dot.. of d.ath ah.r 6.30.9.)
5.. Inltrudlonl for Applicabl. P.rcenlag. on R.v.,.. (151
Sid.. (Includ. volu.. from Sch.dul. K or Sch.dul. M.l
16. Amounl 01 lIn. U lo.obl. DO 6% '0" (161
(Includ. ...olu.. from Sch,dul. K or Sch.dul. M.)
17, Amount 01 Un. U la.abll ot 15% '01. (171
Ilnclud. ...olu.. from Sch.dul. K or Sch.dul. M.)
18. P,inclpoloo. du'IAdd 10. ',om lIn.. 15. 16 and 17,1
19. Cr.dill Spoulol Po....rty C,.dit Prior Paym.nll
+
(81
21,424.44
(111
(121
(13)
(141
20,739.44
20,739.44
)(._-
20,739.44
)( .06 -
1,244.37
x ,15 .
:0:
2
S
iC
.
B
~
..
(IB)
1,244.37
DilCount
In'''''1
(191
(20)
+
C'lI'(k IH'IU ., you OIf' ft'(tul'\ling n r('fund of your oVl'fpoynwnt
1,244.37
(211
(2IA)
12181
1,244.37
_9.~~~j{'i""\~ {;"~"':';''':''''''
RE'I.lI01EX + IJ.l7)
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Pial.. Prlnl or T .
FILE NUMBER
2196-0161
CO"'II.~_,WbY"'A
UTATEOF
HELEN Y. PETERSON ssg 179-36.1672 02/01/96
-owned with AI ht 01 Survlvorahl must be dllclOled on Schedulo Fl
DESCRIPTION
VALUE AT DATE
OF DEATH
1
2
USAA savings account No. 00006 98 72
827.62
Household goods and personal effects
2,400.00
....
...L_
--
. .-.
I. 3,227.62
~
I.
0,1,'
I:
..
f,
:
\
f
I
~
USAA f.
USAA
9BOO Fredericksburg ROld
Sin Anlonlo. r.... 7B2BB
FEBRUARY 01, 1996
USAA NUMBER : 00006 98 72
I
/
FOR AUTOMATED VOICE RESPONSE
INFORMATION ABOUT YOUR SSA. CALL
I-BOO-531-6095 AND PRESS I ON
YOUR TOUCH-TONE PHONE
MRS HELEN W PETERSON
3453 GREEN STREET
CAMP HILL PA 17011-4420
**THIS IS NOT A BILL OR A CHECK. THIS IS A STATEMENT OF YOUR ACCOUNT eALANCE.**
SUBSCRIBER'S SAVINGS ACCOUNT ACTIVITY
1.
2.
PREVIOUS BALANCE IN YOUR ACCOUNT
L~SS CASH DISTRIBUTION (12/26/95)
NEW SSA BALANCE
PLUS NEW ALLOCATION AS OF 12/31/95
CURRENT BALANCE
$
768.50
61. 48
3.
4.
$
+
707.02
120.60
5.
$
827.62
As you know, the net worth of the Association constitutes those funds that are
held in reserve as invested assets, to assure that we can meet regulatory
requirements, sustain a sound financial position in the eyes of the industry's
rating agencies (Best's, Standard & Poor's and Moody's) and survive the
consequences of catastrophic contingencies. These funds are the principal
measure of our financial strength and appear in the consolidated balance sheet
of our Annual Report. Part of this net worth resides in the individual
Subscriber's Savings Account of each USAA member: collectively, the allocated
funds held in these accounts constitute 58% of our aggregate net worth,
Each year the Board of Directors may authorize a new allocation of the
Association's income from the current year to these accounts in order to
sustain an adequate capital position for the purposes stated above and to
minimize our tax liability. Cash distributions to members may also be made
periodically from these accounts when the net worth held by the Association
exceeds the amounts needed for these purposes. (For example, in December
1995, USAA members with a minimum of $350 in their accounts received 8% of
their SSA balances, for a total distribution of $178 Million.)
As long as you are a member, funds in your SSA remain with the Association,
unless the Board of Directors specifically authorizes cash distributions. SSA
allocations and distributions are not considered taxable by the Internal
Revenue Service. (However, if your insurance premium is a business expense
deduction, then the allocation added to your SSA reduces your deduction.)
.
b . RIV. 11011;; + I'Z.1I1
SCHEDULE F
JOINTLY-OWNED PROPERTY
co"'r"m~_,WbY"'A
.ITATI OF
~EN W. PETERSON SSn 179-36-1672
Joint 101llll1(1).
A.
HAMI
Lovell L. Petsrson
B.
C.
Jolnlly-ownod proporly.
02/01/96
ADDRESS
3453 Groen Stroet
Camp Hill, PA 17011
FILE NUMBER
2196.0161
RELATIONSHIP TO DECEDENT
Son
LETTER DATE DECO'S
ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DOLLAR VALUE OF
HUMBER JOINT OF ASSET % INT. ECEDENTINTEREST
TENANT JOINT
1 A 07/28/94 PNC Brokerage acct 19,532.38 50.00~ 9,766.19
No. 22055358
TOTAL (Also entl! on Tina 6. RlClo~ulatlon) 9 766.19
(II moll spica Is naeded. Insen Idd~ioftll shoo" olsama size.)
CGpyrlQhl (e) '994 form toltw.'. rrit CPSy.ternt, Inc.
Form 1500 Sch~ua. F CRtv. 12.84)
..."- .--"..~
.
PNC lBIRUOKlERA(G lE
THROUGH THE COURTESY OF
PNC SECURITIES CORP
Inveslmcnts olhcr than
Certificates of Dcposlt:
rmu . ~Ia\' I.me \'"hll'
I!MM .:'\Il'(llllk (;\I,Ir.lIIll'e
PERIOD
06/28/96-07/31/96
sue SEC/TAX 10
179-36-1672
PAGE
ONE PNC PLAZA
Twelfth Floor
249 Fifth Ayenue
Pittsburgh. PA 15222-2707
liE LEN W PETERSON AN[)
LOVElL L PETERSON .ITWROS
3453 GREEN STREEl
CAMP IIILL PA 17011
ACCT NG
22055358
OFFICE
3311
A/E
3259
YOUR REPRESENTATIVE: TIlOMAS DILELLO
717-881-4003
----_..~ .>-,~~.
A C C 0 U N T V A L U E
DESCRIPTION MARXET VALUE l(, PORTFOLIO
MONEY MAPKET rUNDS 5.86CR
MUTUAL EUNDS 19.556.9DCR 100.0
VALU. 13.5C:Z.":'Ccr:
NET VALUE LAST PERIGO 18.532 .3SCR
PERCENT CHANGE 0.2 INCREASE
EAR N I N G S
SUM MAR Y
DESCRIPTION
TIllS PERIOD YEAR-TO-DATE
TAXABLE INClJoIE
DIVIDENDS
TOTAL TAXA8LE I~COMF
TOTAL
100.45 746.33
100.45 748,33
100.45 74B.33
COM BIN E 0
CAS H
SUM MAR Y
DESCRIPTION
AMOUNTS PAID AMOUNTS RECEIVED
BALANCE
BALANCE FRlJoI PREV STATEMENT
5 , BBCR
AMOUNTS CREDITEO DUE TO:
EARNINGS
AMOUNTS PAID DUE TO:
REINVESTED EARNINGS
100.45
100.45
ENDING BALANCE
100.45
100.45
5,8BCR
YOU R
P 0 RTF 0 L I 0
SUM MAR Y
ACCOUNT
TYPE
SYMBOL
QUANTITY
DESCRIPTION
CURRENT
PRICE
MARXET
VALUE
EST ANNUAL
INClJoIE
E!iT
YLO
MUTUAL FUNDS
CASIt
GNUSX
2347.768 INVESTORS TRUST GOVERNMENT
rUND CLASS B
8.330
19.556.90
o AIL Y
Ace 0 U N T
ACT I V I T Y
DATE
ACTIVITY
QUANTITY
DESCRIPTION
AMOUNT
BALANCE
7/23/96 RECEIVED
OPENING ACCOUNT BALANCE
ACTIONS AFFECTING YOUR PORTFOLIO
12.059 INVESTORS TRUST GOVERNMENT
rUND CLASS B
OIl' REINVST @ B.330 07/24/96
0.00
7/23196 DIVIOEND
DIVIDENDS AND INTEREST
INVESTORS TRUST GOVERNMENT
rUNO CLASS B
INCOME OIl'
100.45CR
CONTINUED ON PAGE 2
---,...-.--..-
2~
3:;
0'-
m
\.
r..
...- "
NOTICE.
c
o'
. .-
. ,
('
-0':
)>~
To fulfill the ,..,1......,.t. of Section 1140 of the I....rlblnc. ... [Itot. Tax Aot, Aat IZ .f 1"1.
lleUon Z141l.
lS! ::0::0
~8
c -'~
If) 0
n '-~ ("
~' ;~,
~ ~~ '1'
...."
is ~h)
- iiiO
(..j -
\0
(71 P.I.
D1tad1 the top portlon .. tt1h Matl_ ... __It with your ~t to the bllstor ., Mllll printed on the
rwer_ .1d1.
n _. c:Mdc or ~ order PQIIblo tol REIIllTEJI (II' WUll, ACIOfT.
All ~tI rttOIlved ..11 flrot M ...,U" to ~ lnt.r..t ...,lc:I1 .., M .., .SUl ~ ....lndllr ."Ued to the tal
NYIlDIT.
m1.IID (eI). . rerv.d of 0 tax credit, Mhld1 .... not r....tld on the tax return, .., be ,....t.. bJ ..IoU". In --..ll_tlan
for ..fund of Pent.,1wnl. I""rl~ end E.t.te Tu" (REV-IllS). AppU.tlonl.,.. .willll,lo at tN D.ft.. of
the _lltor of IUlh, InJ' ., the z:s ~ Dbtr!ot Offlcel or by aUl". U. .......1 Z4.hDUr "'....r1"11 MrVl..
.....,. for 10,.., .nSerll'11l In Pemnlwnlo l-IDD"S6Z-ZD50, autll. PwWInlnnl. end vlthln I_I
Harrhbul"'lorM (717) 7.7-10114, ml (717) nl-ItsZ (....,.1"' 1~lr" Onlv).
OIJECTllllla lIr'I.-b In 1ntor..t not ..tllft.. ...v. the ..,.ral..."t, all-. or dl..U__ o' ~t1on. or .........t
.f taac UnoludS.... cu-...t Dr lnt.,...l] .. ......, on tit" Not1~ -v obJeat .Ithln .lxt>>' (61) _. of r_l,t of
thl. MoU. t.v.
..-....ltt.. ,rob.t to the PA Deperu..t of Rev....., IMrd of .,...11, Datlt. 1110U, .....rhbul"ll, P' 17UI-lOU, OR
--.Ieatl,.. to ....,. the ..tt.r ...,..Ined .t the MIdSt of the ~t of the ...r..... .....reMnbUve, OR
.......... to the 0"""" Court
AIIlIIM-
lllUTZVE
CCIIIECTIONII ,.tuel .rrore dlacovered on ttlh ......wIt thould 1M; Bdd....Md In .rIU", tal P. Depert.Mt of RweruI,
Iur-.. gf IncUvlo..l Tue., .fTto': P lit ...........t Rwl... .....St, DEPT. 210601, H1rrhburl, P' 17UI"0601
Phone (717) 717-'505. s.. pega ~ of the booklet -In.tructlon. for Inherlt.noe T.. R.turn for. R..ldent
DMedent" (REV..nOI) for ., IJqIl_tlon of ...lnhtraUyeb correat..e error..
DIICCUCT.
If ." ta due 11 peld ..Itt'll" tt'lr.. (S) ~."r eonth. .ft.r the cIecIdwIt's _th, . flve percMt (U)
dl8OClU"lt of U. tax peld II .11owd.
The lU ta __.tv ...,..pertlclP11Uon pw'IOl ty II COIIIPUtN on thI totsl of the to tnd Int.r..t .....Md, tnd not
,.Id balan ......ry II, I"" the Unt dQ' .ft.r the .-.d of the talc __.t>>' ...rlod. Thl. non-participation
,...ltv Ie ....1.1. In the .... ....r ... In the the __ U_ period .. 10U MOUld .....1 the tUl ... Inter..t
thet he. been ........ .. IncuC8ted on this noUOI.
POIAl. n.
Int.rllt II cherged beglml", with first dQ' of d1111~, Dr "1M (t) eonttl. ... OM (I) _
f,. the .t. of ..th, to the .t. of PII,..-at. Tu.. IMfdoh __ dell.,.,.,t before ......ry ., lHI
beer Int.r..t .t the rat. of .1. (U) pe,,*,t per .... ~lt:ul.ted .t . .11, Mlt. of .001114.
.n taxe. MhIClh __ .1I,....,t on or .fter "...,.ry 1, IHI ..Ill beer Int.".t .t . nt. ....Joh ..Ill V'l1'Y f...
_landt, reer to _landtr reer with thet nt. ~ by the PA DIpIIr'-'t of R..,..... The ...11_1.
Int....1t r.t.. for lHI through 1"7 ''''1
11llI1lUT.
Yoo. Int.relt Rlt. Otll, Int.r..t feator ~ Inter..t bt. Otll' Int.r..t Feator
1HZ ZlI .000141 lH7 n .00OZ47
INS 11% .00001 1911-1"1 111 .00OS01
lH4 111 .00nOl l"Z n .00IZ47
lNS 151 .00OS56 1""1994 n .IU1U
1911 lOl .000174 1"5-1"7 n .100147
""Intt,..et It _loul.tld .. faU...
IIlTDEIIT . IALAllCIl OF TAX UICP&ID X NUIIIER OF DAYI DELIIlQUEIlT X DilLY IIlTEIIElIT FACTOR
--Any Motl.. It....... .ft.r the tu ..... .1I,...-,t ..Ill r.fleat In Interllt ~lcul.Uon to flft.... US) _.
bQond the dlt. of U. IIMI..,t. If ~t I, .. .ft.r the Int.....t ...-ubtlon dIIt. ~ .. the
Mati.., tddltl_l Int.,...t w.t be _loul.ted.
I:;:" 16 - 1/
COHHDNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'i~
l___~
BUREAU OF INDIVIDUAL TA~ES
INHERITANCE TAX DIVISION
D(PT. Zl06Dl
HARRJIIURG, PA 171Z.'0601
NOTICE OF INHERITANCE TA~
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TA~
1...It.,,, tI' 111.'..
JOHN E SLIKE ESQ
SAlOIS ETAL
2109 MARKET ST
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
W
12-02-96
PETERSDN
02-01-96
21 96-0161
CUMBERLAND
101
HELEN
AMount R..Ut.d
PA 17011
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER DF WILLS
CUMBERLAND CO CDURT HDUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ii'iV': i54-j-Ex-"Fji-io''-:9lii-iiij'''-icEnciTYNHEiiifAiicE-YAx-jipjiiijiisEifEiii'-,--,U,i-ciwANCE-iili-n--------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATI! OF PETERSON HELEN W FILE ND.21 96-0161 ACN 101 DATE 12-02-96
TA~ RETURN WAS, I XI ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. RooI Eet.to (Schodul. AI III
2. Stock. _ Bondi IScheduI. BI 121
5. Cla..ly Held Stack/Partner.hip Int.r..t (Schedule C) 131
4. Hortg.gel/Not.. Receivabl. (Schedule OJ (4)
5. Caah/lank D.pollta'Hilo. Parlonal Property (Schedul. EJ (5)
6. Jolntl~ Owned Propart~ ISchadulo FI 161
7. Tranlforl ISchadulo 01 171
I. Total A...t.
I CHANGED
104.394.00
12.110.63
.00
.00
22.250.23
8.110,12
.00
IBI
NOTE~ To Inlur. proper
cradit to your account,
lubeit the upper portion
of thl1 for. with your
talC pay..nt.
146.864.98
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral El(pen.../A~. Co.t.'Hlle. Expen... (Schedul. HI I')
10. Dobtl/Hortgogo LleblIltlol/Llanl ISchadulo II 1101
11. Tot.I Daduotlonl
12. Not Volu. of To. Roturn
15. Chorltablo/GoyorneentoI SOquOltl (Schodulo JI
14. Not Value of Elt.to Subjoot to To.
18,179.80
4.171.33
1111
1121
1151
1141
".~lil 1~
124.513.85
.00
124.513.85
If an a.sessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figure. that include the total of ~ returns assessed to date.
ASSESSMENT OF TAXI
IS. A.aunt of Llno 14 at Spoulol rata 1151
16. Aoount of Llno 14 to.ob10 at Llno.I/Cloll A rata 1161
17. A.aunt of Line 14 t..ablo at Collotorol/Clol1 8 rata 1171
IS. Prlnolp.1 To. Duo
NOTE:
.00
124.513.85
.00
~ .00_
~ .06_
~ .15.
IIBI
.00
7.470.83
.00
7.470.83
TAX CREDITS:
PAYHENT
DATE
04-29-96
08-29-96
RECEIPT
NUHBER
AA112791
AA146672
DISCOUNT (+ I
INTEREST (-I
342.11
.00
AIKlUNT PAID
6.500.00
628.72
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
7.470.83
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN 61. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
\
c)
r';
i
:.-....:J
1
,::-~ .~.
/j(;
RESEAvaTIONa E.tat.. af d.cedent. dvlng on a~ ~far. Dec.~r Il, 191' -- If any future Int.r..t In t~ ..t.t. I. tran.f'rr~
In po.....lon a~ ~Jav..nt ta CI... . Ccall.t.~..) ~flcl'rla' af the d.cadant .ft.~ the .xplr.tlon of any ..t.t. fo~
llf. or for y..r., the Ca-.onwe.lth hereby axpra..ly r...rv.. the right to appr.l.a and ...... tran.f.r Inherltanc. Tax..
.t the lawful CI... . (coll.t.r.l) r.t. on any .uch future Int.r..t.
PIJRPOSt llf
NOTICE: fo fulfill the ~aqulr'unts of Section llU of the Inherltanc. end E.t.t. Tax Act, Act II of 1991. 7Z P.S.
Section lUlO.
paYMENfa Detach the top portIon 0' thl. Notlc. and .ubalt wIth your pay.ant to the R.gl.t.~ 0' Will. prlnt.d on the r.v.r.. .Id..
-""ek. ch.ck or .on.y ord.~ payabl. to: REGISTER OF HILLS, AGENT
all p.,..nt. r.c.lved shall '.r.t ~ appll.d to any Int.r..t whIch ..y b. duo wIth any ~.a.lnder appllad to the tax.
REF\InJ (CRh . nf..nl of . tax cr.cHt, whIch .,u not raqu4l.ted on the Tax R.turn, .av b. r'qI.M.t.d by co.I.Ung an "Appllc.tlon
'Or R.fund 0' Penn'Ylvanla Inherltanca and E.tat. fax" (REV-1313). 'ppllc.tlon. .r. .v.llabl. .t the O'flc.
of the Ragl.t.r 0' Will., any 0' the l3 R.v.nu. OI.t~lct Offlc.., or by c.lllng the .pacl.1 ".hou~
an.warlng ..~vlc. nuabar. fo~ fo~" ord.rlng: In Pann.vlvanl. 1"100"]6l.l050, out.ld. Penn.ylvanla and
.,Ithln loc.l H.rrlsburg .r.. (717) 717"1094, TOOl (7171 77l"l25% (Ha.~lng lap.lr.d Only).
DIJECflDNSa Anv p.rty In Int.r..t not ..tl.fled with the appral..eant, .llowanca or dl..llowanc. of deduction., o~ ......-.nt
of tax (Including dl.count a~ Int.r..tl .. shown on thl. Notlca au.t ObJ.ct within .Ixtv (60) d.y. 0' r.c.lpt of
thlt Notlc. bva
...,~Ittan prot..t to the pa Departaent of R.venu., loard of App.al., D.pt. lllOll, Hlrrl.burg, Pi
.....lectlon to haY' th. ..tt.~ d.t.ralned at audit of the account of the par.onal ~,pr..antatlva,
.-appea. to the Orph...." Cou~t.
171za....Z1,
OR
OR
aDMIN
ISTRAlIVE
CORRfCTlDNS:
Factual arrar. dl.cov.rad on this ........nt .hould ~ addr....d In wrIting to: PA Oap.rtaant of A.venue,
Bur.au of Indlvldu.1 T.x.., ATTN: Po.t A......-nt R.vlew unit, Dept. 210601, Har~l.burg, Pi 17121-0601
Phone (717) 7.7"6505. Sa. pag. S of the bookl.t "In.tructlon. for Inharltenc. fax R.turn fo~ . R..ldant
Dac~t~ (REV-ISOI) for an .xplanatlan of adalnl.tr.tlvalv correctable .rror..
DISctIt*T:
If any tax due I. paid within thr.. (3) c.lendar aonth. .ft.r tha decadent"s d..th, . flv. parcent C5%1 dl.count of
tM tax p.ld It .Uowed.
PENALTY a
The 15% tax -.na.ty non"p.~tlclp.tlon pen.lty I. co.put.d on the total of the t.x and Int.r..t ......ed, and not
p.id before Janu.ry II, 1996, the 'Ir.t d.v .fta~ the 8nd of the t.x .~.ty p.~lod. Thl. non.p.rtlclp.tlon
penalty I. appealabla In the .... .annar Met In the tha .... tI.. p.rlod u you would .....1 the tax and Inh~ut
that h.. bean ......ed a. Indlc.t.d on thl. notlc..
INTER[ST~
Int.r..t I. charged beginning with flr.t d.y of dellnquencv, or nlna (91 aonth. and ona CII d.v fro. the d.t. of
d.ath, to thl data of payaant. Tax.. which bac... d.llnquent b.for. Januarv 1, 19.2 b..~ Int.ra.t at the r.t. 0'
.Ix C6XI p.rcent par ~ c.lculatad at . dally rat. of .00016'. All t.... which b.ca.. d.llnquent on and .ft.r
January I, 1911 will b.ar Intara.t .t a rata which .,111 v.ry fro. calandar y.ar to cal.ndar y.ar .,Ith th.t r.ta
announcad by the p, Depart..nt of Rav.nua. Th. appllCabla Int.ra.t ret.. for .,.Z through .996 ara:
'!!!r Int.rut R.t. Oalh lnt.rut Factor :!!!r Intara.t Aat. Dally Inlar..t Facto,.
1911 lOX .0005"1 1917 'X .0002'7
I9IJ 16X .000'11 1961"1991 llX .000501
191' llX .000501 1991 'X .000"7
1915 ISX .000356 1995.1994 7X .0001"
1916 lOX .00D%7" ."5"1996 'X .000l,,7
--Int.rut II calculat.d .. foU"".:
INTEREST a BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. Inuad afta~ the tax b.coae. daUnquent will raflact an lntarut calculation to flftaen (151 dlY'
bevond the data of the .......ant. If plVlant I. .ad. aftar the Intar..t coaput.tlon d.ta .hown an the
Hotlc., addition.. Intar..t .u.t b. c.lculatad.
.",...- --.....~..._... '-
,
.
~--------------------------------~
I
I
I
I
m"~~ ,~,~",..", P' '" '''',' ", ' ~, , , '"" "' - ">^ .,"-- '~-"~!M~~
( ...r,;.yf..,..;~~ ,.,-~....,..J i>.. 4~';' ' J... ',' " . c . ~ \ " '~..l" '"., .-.p. '!loT
.~ .;11,:.0: !'no' \., " .~l", ~ ". -< ,'. ~ ( " ~ j. ... J. t'~'\'~ .,~....,..-.'i~";< ~~~J1' S \;!!
'I~CO~U\IIIALTHOr PENNSYLVANIA' ~! ;~:,' ;' :':iif,~}:';;;~~'"" '\:
(' ,.\,~ I 'h'l',l~'}!,..".~ .." ,,- , '\ ~ " t '"" <....~,~!~..,'" '~'"f''' ,.
" 1""'~OJIUYINU.' .d_ ..'..',., l'/""'-
#0 ,""'. ,,-~;;-..,~: -. ,,' .r} .,. _" ,~, -ot . ~'1"'"t'.~.
~.'.."c' '. -:.~ . ". '" .. ... , . , ~.,
}(~"M"',,,'I\""~".\,,),,,,,,,,--, ''''''''''.'_ ','., ".','e, -"-'k'" ""~"';~!I;
~:~:O~"SYLYANIA!N,"~NCI~ND~.~~~ll~M;:t.
RECEIVED FROM.
&
ACN
ASSESSMENT P:'
CONTROL ...
NUMBER
AMOUNT
JOHN E SLIKE
2109 MARKET ST
lv1
.1.C:::'t't.t:;IIl
CAMP HILL, PA
17011
ESTATE INFORMATION:
!II ILE N MIER
Ii 21-1996-0161
!II NAME Of DECEDENT (lAST)
~ PET RSON HELEN W
II DATE 0 PAYMENT
B POSTMARK E
COUNTY
SSN 179-36-1672
(fiRST) (MI)
CUMBERLAND
DATE Of DEATH
REGISTER OF WillS
m TOTAL AMOUNT PAID .1 .244.37. '.
VZ ~
RECEIVED BY 9lJ1J.7 Il'~-.J~ ~kV " J
MARY C. LEWIS .. 7;1;'..~,
REGISTER OF WILLS .-, /'"
REMARKS
JOHN E SLIKE ESQUIRE
SEAL
CHECK" 104e
:;
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NOTICE. To fulfill U. ,..,lr-.b of Section Zl4D of thI ZnrltMCtl .. [It,t. Tax Act, Aot II of 1"1. (12 P.I.
IeCltlon 1140),
PlYMDfT. Debclh tM tap portion of thl, NoU_ ... .-.It "Jth rour ~t to U. ....,t.r of NIlIl print... an the
reverl. ,...
..- ....., CIhMk or -V order ....1. to. I1E11II1DI at WILLI, MlDfT.
All ~t. .....lved "11 flrd _ ....11.. to .,y Intlr..t tthlClh ->> bII .., "UIt ." r_I"" ....U'" t. tN 0..
RE11III (till A nf\nl of . tax credlt, ....Ich .... not r..-sted on U. tax r.tum, .., be r.qullted br c-..laU". ~ -Appllatlon
for ....... of Penn.,........ tmerlt..... WId E,bt. Tax. (REV-nu), application. ar. "",U_1. at the OffiCII of
U. helda,. of NUh, MY of U. Z3 ...... DI.trlot a,llcel Dr br Qll1"11 the ......1 Z4"hour ."...rl... Hrvlce
,...ra for for.. order...... In ......QIYMI. l-laa-36Z-ZGSD, out". ""Qlv.dl Ind ..Ith!" loal
...",.1..,,...... (717) 717....94, TUD' (717) nz-uS! (....'1,.. t..,.lred Onh).
OI.J(CTIDNSI ...,. ~rty In Int.r..t nat ..th'.ad .,Ith the 1lPP...I~t, .U0WW'tC8 Dr d!..U0wnc8 of decklctlonl Dr .....~t
of tax Clnoludl,.. dJlCOWtt or Interest) I' ....., on this Notice ~ abject ..lthln .beb (60) _. af r.-Ipt af
this Matlos hi
-......Itten problt to tM Pi a.,.r'-'t af A...., brei af ......h, _to 21UI1, ",rrisbul"I, Pi 17121.1121, DR
.....Iectl,... ta IwVII the .ttlr dlhrlllned It the _It af the ICCCUtt af the "rlGnll npr....,tlith,., DR
........1 ta the 0".,...,.' Court
AIIIIN-
IITlIATM
COARECTICIII. F.Ml .rrors dlSCOYllrld an thll .........t lhauld bIi Ilddr...1ld In ..rIU,... tal Pi __rbent af ...,...,
IurMU af Indlvl~1 TUII, Arnel Past ........t Aevl... LMIt, DEPT. ZlO'Dl, "rrllburt, Pi 17UI-u01
Phone (717) 7.7-6505. See PIOI 5 af the booklet -In.tructlon. far Inhlrltenc. 'ax Altum far I A..ldent
DIoIden~ (A[V.1501J for en axpl~tlDn af edllnl.tr.tlvllw correct...l. .rror..
DISCClUfTI
If In>>' tu ~ is ,.ld ..Ithln thr.. UJ CIII"r -.nth. .ft.r the decedent'. dMth, . flw perCltlt (UJ
dllCDW\t af the tile plld is IUawed.
PO'll TVt
Th: 15% ~ ..,...t:o Mn-,.r~hlp.t1on pwl:lI! ty h c~.:t= :n th: tote! ~f tho t::t and Intc;"lU~ Dlsc:Kd. :t'Il! net
plld before Jenulry .1, ."', U. flnt _ "t.r the end af U. tax .....b perlad. Thh nan-partlc1P1tlan
,..Ib I. .....1...1. In the ... .......r end In the the ... tI.. plrlad .. !tOY .....ld .....1 U. tu end Inter..t
thet ... been ......... .. Indlcetld an thll natlce.
11fTtIlUT.
Inter..t II cNrllld ~IMI"I ..IUI flnt dQ af dallnquwcw, Dr nl,. C9J IGnth. end aM (1) dQ
fr. the dlt. af dMUt, to the dlt. af p..,..,t. ,.... Wllch bee-. .ll~t blfor. JInuIry I, 1.12
_r Inter..t .t u. nt. af .1. (U) PlrCltlt plr ... celeulltld .t . dIIlb nt. af .000164.
'U tanl ....lc:fI __ .ll~t an Dr .fter ,J.....,.~ I, 1..2 ..UI belr Inhr..t et . nt. ...,Ich ..IU VI~ frOll
esl....r yur ta e111"r weIIr ..Ith that rate ..-.ouncld bv the Pi Deperbent af AIIftRM. The ."UCllble
Interllt nt.. far 1,1l through ."7 erel
Yoo. Inh,..1t Rltl o.lly Int.r..t FlOtar Yoo. Int.r..t Rite o.llv Int.r..t r.tar
INZ ZlI .110541 IN7 tI .000247
1M3 161 .0004" 1911-1"1 111 .OOOSGI
19M 111 .110501 I"Z tI .011247
111I5 ISI . oalS56 1"5-1994 71 .Olll'!
1916 101 .DOOl?4 1"5-1"7 tI .011247
--Int.,...t 11 .Icullted .. fall_I'
IIlTEIlElIT . UUIlCll DF TAX UItl'AID X NVIIBER OF DAYS DELIHQUEIlT X DAILY IIlTEIlElIT F&croR
..AIty MaUes l..uM .fhr the tax becoeI. .1I~t ..Ill r.fl_t en Int.r..t C8lcul.Uan to flftMn US) _.
beyond the dIIt. af 1M .........t. If ~t II .. .fter the Int'r11lt ~t.tlan dilt. .,..., an the
Mati., IddIU_I Int.,...t ...t .. aleul.tld.
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COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
IHHEAlfAHCE TAil DIVISION
MPT. :80601
HARAlSIURC, PA 17111-0601
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
c...
JOHN E SLIKE ESQ
SAlOIS ETAL
2109 MARKET ST
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-20-97
PETERSON
02-01-96
21 96-0161
CUMBERLAND
101
Allount H..Hted
PA 17011
-
1I1-I"''''''III.t..
HELEN
W
MAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER DF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'y:isW-EX"AFii-n'2:ijiij-iicificE--cin-tiHEiiiTANCE"Ylix-iipjiRiiisEiiEiir;-ALi.-ciwAiicE-ifli-uumu----m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 101 DATE 01-20-97
TAX RETURN WAS, I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. R..I Eltoto (Schodulo AI III
2. Stockl end Bondi ISchodulo BJ 121
3. Clo..ly Held stock/Partnership Int.r.lt (Schedul. C) (3)
4. Hortgegel/Not.. Receivabla (Sch.dula DJ (4)
5. CalhJ8ank o.pollta'Hllc. Parlonal Property (Schedule E) (5)
6. Jointly Owned Prop.rty (ScheduI. FI 161
7. f,.anl#.,.. (Schedule OJ (7)
a. Total A...t.
I CHANGED
NO. 01
.00
8.430.63
,00
.00
3.227,62
9.766.19
.00
IS)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral bpan.../AdII. Cost./Hhc. bpln... (Schedule HJ (9)
10. Dabtl/Hortgoge LlablIltlol/Llonl ISchodul. II lID)
11. Tot.I Oaductlonl
12. Net Value of Ta. Ratur-n
13. Ch.rlt.bl./Gov.r~.nt.l Baqua.t. (Schedule J)
I~. Not Vlluo of Elt.t. Subjoct to Tax
685.00
.00
1111
U21
USI
U~I
HOTEl To in.ur. proper
cr.dit to your account,
.ub.it the upper portion
of thi. for_ with your
tax pa~t.
21. 424.44
6A~ no
20,739.44
.00
145.253.29
NOTE:
14. 15 and/or 16. 17 and 18 will
returns assessed to date.
If an assess.ent was issusd previously. lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spou..l rat. (15)
16. Aaount of Line 14 taxabl. .t Lin..I/CI... A rat. (16)
17. Aaount of line 14 taxabl. .t Coll.t.raI/Cl... Brat. 1171
18. Principal Tax Dua
TAX CREDITS:
PAYHENT
DATE
04-29-96
08-29-96
12- 04-96
.00 X .00.
145.253.29 X .06.
.00 X .15.
ue)
RECEIPT
NUHBER
AA1l2791
AA146672
AAIB4916
DISCOUNT (+1
INTEREST (-I
342.11
.00
10.14-
AHOUNT PAID
6.500.00
628.72
1,244.37
INTEREST IS CHARGED FROM 12-05-96 TD 01-2B-97
AT THE RATES APPLICABLE AS DUTLINED DN THE
REVERSE SIDE DF THIS FDRM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
8,715.20
.00
8,715.20
8.705.06
10.14
.14
10.28
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN '1, NO PAYHENT ZS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. VDU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Reco",
R"f!
, or
"'1 III!>
'97 JAN 17 AII:4 6
Chi!:
Comu.
JLltl
(;(,., PA
RESERVATION. E.tat.. of dec~t. dying on or before Dec~r 12. 1'.' -. l' ~v future Int.r..t In thl I...t. I. 'ran,f.tt.d
In po.....lon or enJoyunt to tl... . (coUlt.r.U b~flcl.rl'l of the dle"nt after the ..plratlon 0' any ..t.t. for
II" or for y..t., the C~.lth her-oy ..pt..tlv rll.ry.. the right to eppr.I.. and ...... tran".r InherltlnCl ,....
It the l.wful Cia.. I (col1.t.ral) r.t. on any ,uch lutur. Int.r..t.
PIJlPOS[ 01
NanCE I
To 'ulflll the r~lr..-nt. 01 Section 2141 0' the Inherlt~. ~ E,t,t, ,.. Act. Act It of .991. 72 P.S.
Section 21U.
PAM"T.
Detech the top portIon 0' thl. Hatlel and .~It wIth your p.~t to the Rlal.t.r of Will. printed on the r.v.r.. side.
u"', check or lIOMy ordtlr pIyeb1, tal REOISTER OF MILLS, AGENT
All p.,...,t. rec.h,~ shlill flr.t be eppllMl to ."y lnt.rut which ..y b. dI.Mi with any r...lnd.r .ppllM to thl t...
mum ICAlI " r.f1.ftI of . t.x credit, .....Ich .... not r....ltad on tM Tax R.turn, ..y b. r.qu..tlld by coapl.tlnt ." "Appllcltlon
for R.fund of Penn,ylvanl. lnh.rltanc. end E,tat. Tax" CREY.I]I]). Appllc.tlon. .r. avall~l. .t the Offlc.
of the R.ght.r of Willi, any of the Z] A.vlftUl Dlltrlct Office., or by ceiling tM ,peclal 2".hour
.",..rlng ,.rvlc. nueber. for for.. ordering, In Penn,ylv."l, 1.100.]',.:050, out, Ida Penn,ylv."l. end
within loul HIIrrhburg .r.. (111) 711.10"', lDD' 1117. 772.ZZ5Z IH..rlng 1..lr.d Onlyl.
OBJECTIONS I Any p.rty In Int.r.,t not ,.tl.flld with the appr.l,eeent, .llowene. or dl,.llowenc. of deduction" or a".,.-.nt
of tax lInclucUng dbcOl6\t or Int.rut) ., .hown on thl. Matlce MI.t obJ.ct within .bty (6at day, of recalpt of
thh Hotlc. byl
..wrlttan prot..t to the PA Pep.rtBlnt of R.vanua, laird of App.al., Dept. 211021, Hlrrl.burg, PA
...Iectlon to have the ..tt.r d.t.ralned at BUdlt of the .ccount of the Plr.on.1 rapr.,."t.tlv.,
..lIpSMal to the Drphan,' Court.
11121.1021,
OR
OR
AI>>UN
ISTRATtVE
CORRfCTIDHSI
Factual .rror. dl,cov.rad on thl. ....,.-.nt .hould be addr...ed In ..rltlng tOl Pi Gaplrt.ant of R.VInUl,
Bur.au of Individual TaM", ATlHr Po.t A.....eant R.vl... Unit, D.pt. :10601, H.rrl.burg, PA 1712..0601
~ 11171 711.6505. See Pili 5 of thl bookl.t "In.tructlon. for Inherltanc. "M R.turn for a R..ldent
Decadent" CREY.IS01) for an 'Mplan.tlon of ~lnl.tratlv.ly corr.ct~l. .rror..
DIKUll
If any t.. dI.Mi I. paid within thr.. I]) clland.r .onth. .ft.r the d.c.dant'. de.th, . flv. parc."t 15%' dl.count af
the tlX p.ld II .lIowad.
PDlAL TVI
The 15X t.x a.na.ty non.p.rtlclp.tlon panalty I. CQlPUtad on thl tot.l of thl t.. end Int.r..t ......ad, end not
Plld bafor. January I', 1996, thl flr.t d.y .ft.r thl and of thl t.. .-na.ty p.rlod. 'hi. non.p.rtlclp.tlon
PlNlty 11 1IPPI.1MiI. In the .... .annar and In the thl .... till p.rlod II you would IIPPI.I the tlM end Intlrut
that ha. bien ......ad .. Indlc.ted on thh notice.
INTEREST 1
lnt.r..t II charged M8lmlng with flr.t d.y of d.lInquency, or nlntl f9. .onth. end one ell day fro. the d.t. of
death, to the d.t. 01 p.y.ant. r.... which bee... delinquent blfor. Janulry I, 19.2 bI.t Int.r..t .t ~ rlt. of
.1. 16XI parcent par ~ c.lcul.tad .t . d.lly r.t. 0' .0001"'. All t.... which bee... delinquent on end .ft.r
January I, nil will bI.r Int.r..t .t a rat. which ..III v.ry froe caland.r y..r to calend.r y..r ..lth that r.t.
announced by the Pi Dep.rt,,"t of R.venue. lhl appllcabl. Int.r..t r.t.. for 19., through 1"7 .r.1
!!!! lnt.r..t Rat. D.lly lnt.rut factor ~ lnt.r..t R.t. O.lIv Int.n.t factor
1911 lOX .0005"1 1917 .. .OD02~7
19as I.~ .0000' 1911.1991 11:< .ODUOI
I'" II~ .0QnOI I"" ,~ .0D02oU
1915 U~ .00nS6 199].1"4 1> .00019:
191. I.~ .00027" 1995.1997 .. .0002'"
"Int.rut iI c.leul.tM .. follo..lI
INTEREST . SALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY ZNTEREST rACTOR
uAny Notice Is.ued aft.r ttM tax bacHl. cMllnquant wll1 nfl.ct an Intlrut calcul.tlon to flft.an liS. d.n
beYond the d.t. of the ......eent. If p.y.ant 1_ .Ida aft.r th. Int.r..t coeput.tlan dlt. shown an ttM
Notlca, additional lnt.r.,t au.t be calcullt.d.
CDHHDNWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
JMtERUAHCE U. DIV!SJOO
DlPT. ZlUOl
HARRISBURG. PI 11111-0'01
NOTICE OF INNERITANCE TAX
APPRAISENENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
JOHN E SLIKE ESQ
SAlOIS ETAL
2109 MARKET ST
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-20-97
PETERSON
02-01-96
21 96-0161
CUMBERLAND
101
Anount R..ltt.d
PA 17011
*
'.1011.'" '" III.t..
HELEN
W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER DF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:is4TEx-iii:'ji-nF9&rHi.oYicnWYHHEiiifANcE-YAx-A'PPRA'isEiiiHT";"iii.i"ciwAiicE-Ori-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 101 DATE 01-20-97
APPROVED DEDUCTIONS AND EXEHPTIDNS:
9. Funeral Expen.../A~. Co.t.'Hllc. Expln... (Schedul. HI (,)
10. Dobtl/NortOIOo Llabllltlol/Llonl ISchodul. II 1101 .00
11. Total Daductlonl 1111
12. Not Value of To. Rotum n21
13. CherHable/Go...er,,""t.1 Illqulst. (Scheduh J) (13)
14. Net Value of Eatat. Subjoct to To. n4 I
NOTE: If an aSSBs.mBnt was i'SUBd prBviously, linB' 14, 15 and/or 16, 17 and 18 will
rBfIBct figurBs that includB thB tDtal of ~ rBturns assesssd to datB.
ASSESSHENT OF TAX:
15. AMOUnt of Llno 14 at SpouI.l rata 1151
16. A.aunt of Llno 14 to.ablo .t Llne.l/CloI1 A rata 1161
17. Aeount of Line 14 to.ablo at Collotorol/Cloll B rata 1171
18. PrinciPII Tlx DUI
TAX RETURN WAS. I X I ACCEPTED AS FILED
I I CHAN;ED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEHENTAL
1. Rool Elt.to ISchodul. Al
2. Stockl and Bondi ISchedule BI
S. Cloa.ly Held stock/Partnership Int.r..t (Schedule C)
4. Hertgag../Not.. Receivable (Schedule D)
5. C.ah/lank Plpa,ita'Hila. Perlon.l Property ISchedule E)
6. Jointly Owned Property ISchedul. FI
7. Tr~.f.r. (Schedule OJ
I. Tot.l A.let.
RETURN
III
121
l31
I~I
151
161
171
ND. 01
.00
8.430.63
.00
.00
3.227.62
9.766.19
.00
ISI
685.00
.00
145.253.29
.00
X .00.
X .06.
X .15.
nBI
TAX CREDITS:
PAYNE NT
DATE
04-29-96
08-29-96
12-04-96
DISCOUNT l+ I
INTEREST (- I
342.11
.00
10.14-
RECEIPT
NUNBER
AA112791
AA146672
AA184916
AI10UIIT PAID
6,500.00
628.72
1,244.37
INTEREST IS CHARGED FROM 12-05-96 TD 01-28-97
AT THE RATES APPLICABLE AS DUTLINED DN THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTEt'To in lure proper
credit to your eccount,
lubtolt the uppor portion
of thll for. with your
tex PI_t.
21,424.44
~AIi nn
20.739.44
.00
145.253.29
.00
8.715.20
.00
8.715.20
8,705.06
10.14
.14
10.28
. If PAID AFTER DATE INDICATED. SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1. NO PAYNENT IS P.EQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. VOU NAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
N ~8:
0<1) 1/1
N 3
",= ., ~
a.. .~ 0
()~ 'u
.-""
.~ : .... co
Uo N d
"r:
1j '- ~ .!~
m tV '.
073 '(11
.. ... '..0
0'-
...' -=e
uco p;
cua: ~8
a:
. ,-" '.~--~,-
,,- f~-I/
CDHHDNWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INliERITANCE TAX
STATEMENT OF ACCOUNT
'-
*'
BUREAU OF INDIVIDUAL TAXES
INHrRI'AHC[ ,ax DIYISION
OfP'. l10601
HARAlsIURa, pa 171ll'0601
1I',ItU,.aUIU""
JOHN E SLIKE ESQ
SAIDIS ETAL
2109 HARKET ST
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
02-18-97
PETERSDN
02-01-96
21 96-0161
CUHBERLAND
101
HELEN
W
A.ount R..lttod
PA 17011
HAKE CHECK PAYABLE AND REHIT PAYHENT TOI
REGISTER OF WILLS
CUHBERLANO CO COURT HOUSE
CARLISLE. PA 17013
NOTEI To inlur. prop.r cr.dit to your account, lub.it th. upp.r portion of thil for. with your tax pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
ifiV':iiiiij-E'ic-AFjo--n Z-:96y----n.iii-iNHERii'Aiic'Eni'AX-STA-iitiE-tii'-ilTAC-CoiJiiiuiili.-----n---u---------
ESTATE OF PETERSDN HELEN W FILE ND.21 96-0161 ACN 101 DATE 02-18-97
TNIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURREHT STATUS OF THE STATED ACN IH THE HAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT, 01-13-97
PRINCIPAL TAX DUE, 8,715.20
PAYMENTS (TAX CREDITS),
PAYMENT RECEIPT DISCDUNT C+) AHDUNT PAID
DATE NUHBER INTEREST C-)
04-29-96 AA1l2791 342.11 6,500.00
08-29-96 AA146672 .00 62B.72
12-04-96 AA184916 10.14- 1,244.37
01-28-97 AA185119 .14- 10.28
-
o
(Y)
-
~
..:~ q.;
-
5:
.:?
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
8,715.20
.
It'\
N
1'. CD
l.J~, ~
U """l
IF PA-iti tMTER TIltS DATE. ~E REVERSE
SIDE fGR CALCULATION ~~ITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN II,
NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
.00
.00
.00
.
.....
._- --- -....--~--.._-- ~~-
PAMHTa
Detach the top portion of thl. Notlcl and lubalt with your ply.,nt Ilda Plyable to thl n,.. end addr...
printed on the ranr.. .Ide.
If RUIMHT DEC[O[", _eke check or MMY order paYable tal REGISTER OF WILLS, ACENT.
If NOtHftS1DtHT DECEDENT .... check or 1tOI11ll' order plyable tOI CO""OHWEALTH OF PENNSYLVANIA.
All p.,..nt. '.c.ly~ ~11 bl .,pllld flr.t to any 1",.,..t which "Y b. due with eny r...I~r .,,111d to the t...
REF1ICD (ath A refund 0' . till cnel11, which .... not requ..tad on thl 'Ill Rlturn, ..y ba r...,..ted by co...l,"", an
"application 'or R.fund of Penn'Ylvanl, Inheritance end [,tata Ta." (REV-ISIS). ',pllcatlont .t. IVlllabl. .t
the O"lcI 0' the AI.ll',r 0' Willi, ,"y 0' the 2S A.v~ District O"lc.. or fro. the O'P.,t-.nt', "-hOur
..,....rlng ,.rvlcl nu.ber. for for.. ordering, In P~'Ylv..,l. 1-100-362-2050, out.lde Penn.ylvenll
~ within 10cII Hlrrl.burg .r.. 1717) 717~109', TOO. (717) 772.2252 CH..rln, 1.,.lr.d only).
REPLY TOr Due.tlon. r',lrdlng Irror. cont.lntd on thl. notlc. lhould b. .ddr....d tOI PA D.p.rtlent of A.VInUl, Bur.1V
of IndlvldUll TtxII, AfTN, Po.t A......ent Alvlew Unit, nlpt. 210601, Hlrrllbur" PA 17121.0601, phone
C7171 717-6505.
DISCOlJlTI
If IftY tax due I. paid within thr.. CJ) c'ltnd.r .onth. aftlr the d.cadent', dl.th, I five p.rc.nt C5~1 dllcount
of thl t.. p.ld II .Ilowtd.
PfNj" TYI
The 15~ t.. eenelty non-plrtlelpltlon p.nllty I. c~t.d on thl tot.1 of the tlx ~ Int.ra.t .......d, ~ not
plld befora J~.ry II, 1996, thl flr.t d.~ Ift.r thl end of tha tax tana.ty parlod.
INTEREST I
Int.r.,t I. charted beginning with flr.t dlY of dall~ey, or nlna C.) .onth. ~ one III d.y fro. thl dlt. of
dlath, to thl dlt. of PIV-tnt. TIXI' which bICI" d.llnquent bafor. Jenu.ry I, 1..2 be.r Int.r..t .t thl r.ta 0'
.1. 16XI p.rcant Plr annul e.lcullt.d at a dall~ rat. of .000164. All t.x., which blc", d'llnqu.nt on ~ .ft.r
Jenu.ry 1, 1..2 will b.lr Int.r..t .t . rlt. which will vary frOI e.lend.r y..r to clllnd.r y.lr with th.t rlt.
announced by thl PA D.p.rtltnt 0' A.v.nu.. Thl ."llc.bla Int.ra.t rlt., for 1911 through 1991 Iral
Yilt Int.rllt Aatl Dilly Int.ra.t Fector Yllr Inter..t A.ta DIII~ Int.r..t Factor
1.1l zn .oon.. .91' 'X .00GlU
191' .6X .000411 ltal-I991 IIX .000301
1914 .U .001301 ."z 'X .0oolU
1915 ISX .000556 1995-.'" IX .000192
1"6 .'X .000214 1995-1991 'X .Oool.,
."Int.rllt I. cllcul.ted .. follow'l
INTEREST . BALANCE DF TAX UNPAID X NUHBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
....Any Notice luued .ft.r thl t.x b.COM. dellnqu.nt will raflact 11\ Intlrt" calculltlon to flft"" In) dly.
beyond thl dltl of thl ......-.nt. If plyaent I. ltd. Ift.r thl Int.r..t coeput.tlon d.tl .hown on thl
Notlcl, addltlon.1 Int.r..t ~.t b. c'lcul.t.d.
,.----,,--.,
/5,r~ - II
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
c:
..
Ilfo1..,.."'IU.NI
HELEN
)
LOVELL L PETERSON
3453 GREEN ST
CAMP HILL PA l70l1
t
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
W
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA l7013
HOTE. To lnlur. proper crodlt to your ..count, IUD. It tho uppor portion of thl. fore with your to. poyoent.
DATE OF LAST ASSESSMENT OR RECDRD ADJUSTMENT. 12-16-96
PRINCIPAL TAX DUE,
PAYMENTS (TAX CREDITS).
DISCOUNT (+) AMOUNT PAID
INTEREST (-)
89.78- 5,282.33
BUREAU OF IIIDIVIOUAL TAXES
INHERITANCE TAX DIVISIoN
D€PT. ZI"Dl
HARRlllURQ, PA 17121."01
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-10-97
PETERSON
02-01-96
21 96-0l61
CUMBERLAND
96003380
AllOUI\t RHI Hod
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -4
ii'i'j:i6cij.iX.AFp.liZ:96Y-....-.iii.iiiiiERiTAHC'!.i'AinTATEilEHi'-OF-Acciiiliiy-.iiJi..._...._........_....
ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 96003380 DATE 02-l0-97
THIS STATE"ENT IS pROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH IH THE NAKED ESTATE. sHOWN BELOW
IS A SUttlARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAYIIENTS, THE CURRENT BALANCE, AIID, IF APPLICABLE,
pROJECTED INTEREST FlGllRE.
,I
II
'I
i\
, '
: \'
!
"
, ,
,:
"1 !
\
I
I
,
I
PAYMENT
DATE
01-10-97
RECEIPT
NUMBER
AA185062
O.:fl
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L1-
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~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER THIS DATE, SEE REUERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL OUE IS LESS THAN .1,
HO PAYIIENT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" ICRI,
YOU !lAY BE OUE A REFUllD. SEE REVERSE SIDE OF THIS FORtI FOR IHSTRlJCTIONS. I
5,192.55
5,192.55
.00
.00
.00
PAYIDT,
Detech the t. portion of thb Notle. Met ___It "lth your Plyaent aede p.pbl. to the nMe Ind ldett...
prlntlld on the r.ver.. I1c1t.
If IInlllOlT Il(CEIlOIT -. ....... or ___. ordor P..obl. to, REGISTER OF WILLS, AGENT.
If HOIH'.SIIlOIT Il(CEIlOIT _. _k or ___. ordor p..obl. to' CIlIlItONIIEALTH OF PENNSYLVANIA.
AU PQMints ,...Ived ....11 1M ..UecI first to eny lnt.r..t which ..y be due .,lth My ''''.ncM,. 1PP1I1Id to the tax.
REFUND (CAlI' r.f\n:t of . tax crldlt, lilhlch .... not r..,..ted on the Tax Rlturn, ..y be r.qullted by eMIIl,tlnt IIr'I
"'AppllClltlon for Refund of PennlYlnnl. ZriMrltwcl Ind Eat,t, To" (REV-UlS). Appllcltlon. .r. awUlbll It
the Office 0' the R..llt,r of Willa, My of the tJ Revenue DI.trlct Offlc.. or fr~ the o.p.rt-.nt". Z'-hour
Wl~rlng Hrvlcl nu.blr. for for.. orderlngl In Penn'Y1Y".' 1-'DO-S6Z-Z0S0, out,lde Pennlvl.,.,.,
Ind within lOCI! HarriSburg .r.. (717) 7'7-'094, TOO. (717) 77Z-ZZSZ CHeering 1.,.lrlld only).
REPLY Ta, b,Uon. r....rdlng .rrar. contained on thh notte. thould be edd,...ed tal P' Oeptirbwlt of AIV.,.., au,.....
of Indlvldull T...., ATTNa Po,t ......-ent Rlvl.. unit, Dept. Z10601, HarrJabur., PA 171".0601, phone
17171 117-15'5.
DISCO''''''
If My tax ~ h 'lid .,Ithln thrH CS) cII"'ar Nnth. aft.r the dac:edent'. death, I fJVII ,.rc....t (5%) dl.count
of the tax ,aid I. Illowed,
PENAL TV!
n. 15% tax ~,ty nan.,.rtlcl,IUan ..-nIl ty h caput. an ttMI tot.l of ttMI tu end Jnt.r..t ......., WId not
'lid bafara J.nuary 18, 1996, the fJr.t day aft.r the and a' ttMI tu .-na.ty ,.rlod,
INTEREST I
Intera" h charged ballmlnt vlth fJrlt day a' dellnqtMnCy, or nine (9) Mnth. and OM (1) day 'r. the dIIta a'
death, to the data a' 'IYNnt. Talll' which bee_ delinquent be'ar. J....ry 1, 1912 bear Intar..t at the rat. of
... (0) ,.rCMt ,.r ...... calculltMl It I daUy rata of .000164. All tax.. Wllch bee.. delinquent an end aft.r
Jlnuary 1, 1'82 viiI bear Int.r..t .t I r.t. Wllch NIll v.ry 'ro. cll~r y..r to cal~r ya.r with that r.t.
announced by the 'A o.,.rtaent 0' R.venue. The appllcabl. Int.r..t rat.. for 1"2 through 1997 Ir'l
V..r Int.r..t Rat. Dally Intar..t Factor
Vaar
Intaraat R.t.
DailY Int.r..t Factor
I9IZ ZIX .00054' 1"7 OX .00n47
I9IS 10 .00"31 1911-1991 11% .00OS01
1914 IIX . "OSIl I99Z OX .000147
1"5 IU .00OS56 1995'1994 n ....In
I'll IIX .000114 1995.1991 OX .00n47
."Int.r..t I. calculated .. fol1o..11
IHTERElT . BALANCE OF TAX UNPAID X NUKsER OF DAYS DELINQUENT X DAILY IHTERElT FACTOR
".Any Notlca luuad .ftar the tu beeGle, dellnquent Nlll r,UKt ., Int.r..t c.lculatlon to 'lit.., US) dQ,
beYOnd the data of the ...........t. If ,IYNnt I. .... aft.r the Inter..t CMpUt.UCIrI data IhoMn CIrI ttMI
Notlca, additional Inter..t au,t be c.lculated.
~d
Recore ;'0:: ,..ic;' of
R('~.;,:..~r (,;; \,\,:Hs
'97 nPR 28 P2 :I)~
'eOpOU lII/lllJlM pepnPu,II'" IUBWlIllllS PllIllO Ado~ 'tCler". ','
'UI~ 10 IXI'1 j/'CufTlb,. " .I
JIBI/'AJetouIuIq '.1011 1M." III BllIlIB BI/I UIISBJBIUI UlI WIl!IO OIl
8^1I1/ 011U1lU1lOOCIt 8\11 01 UMOUll U08Jed J8410 .\1_ 01 ~IJ":
IUSWllll' PlIIdun A.IIM 01 UlMllI ualq 11II/'UOjlnCllJIIIO PBSO<lO'J
10 IUlIWBllIlS PIli 01 IUOp:l8/qo UBIlIJM Bill 01 Aep 18111 941 10
pUll UOllllWJUlIlI3 lOJ unO:) 8\11 01 pBIU98SJd Iq III'" 8WIl1l oql
UBI/'" &:IlIld PUlIBWII'8111P Bill 10 pUll 'uollnq,Jl810 p1I8odOJd 10
IUeWlIllllS 814110 IIuUY 81ll jO &:IIIOU U9U1J'" \lI4IAJIUlI:J Aq9J94/
:'" PA
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SAlDIS, GUIDO,
SHUFF '"
MASLAND
2109 Mubl SIRcl
Camp HIll PA
DISBURSEMENTS
Debts of Decedent:
Bell Atlantic
PAWC
PP&L
Bon-Ton
Susquehanna Surgeons
Conner-Rich-Kearney & Torchia
Bell Atlantic
PAWC
Ann Markley, Tax Collector - county & boro taxes
Apria Healthcare
Inners-Davis Associates
Hartman & Scheu chen zuber - tax preparation
PP&L
EKG Associates
Conner-Rich-Kearney & Torchia
Bell Atlantic
A. Z. Ritzman & Associates
Borough of Camp Hill - sewer
PP&L
PAWC
Waste Management
A. Z. Ritzman & Associates
USAA - car insurance
Westinghouse Security Systems
Bell Atlantic
PAWC
Westinghouse Security Systems
Bell Atlantic
A. Z. Ritzman & Associdtes
Westinghouse Security SYBtems
PP&L
Ann Markley, Tax Collector - school taxes
PAWC
PAWC
Bell Atlantic
Westinghouse Security SYBtems
PP&L
Waste Management
PAWC
Westinghouse Security Systems
PP&L
Bell Atlantic
PAWC
4
$ 26,94
12.46
108.22
64.32
35.98
32.27
33.31
17.59
444.32
2.14
48.15
245.00
97.10
6.65
67.73
18.30
39.77
60.00
74.27
18.58
35.88
53.75
34.28
98.00
23.55
17.02
22.00
34.58
1. 78
22.00
70.34
1,168.68
21. 25
14.97
19.98
22.00
89.31
35.88
16.71
22.00
78.25
26.96
18.98
Westinghouse Security Systems
PP&L
Bell Atlantic
Westinghouse Security Systems
PP&L
PAWC
USAA - home owners insurance premium
Bell Atlantic
Waste Management
PAWC
Borough of Camp Hill - sewer
Westinghouss Security Systems
PP&L
PAWC
Bell Atlantic
Westinghouse Security Systems
PP&L
Bell Atlantic
Bell Atlantic
Westinghouse Security Systems
PP&L
PAWC
Westinghouse Security Systems
Waste Management
Bell Atlantic
PAWC
Westinghouse Security SYBtems
PP&L
22.00
86.56
25.50
22.00
56.16
20.16
206.07
27.05
35.88
17.02
60.00
22.00
60.31
20,55
33,30
22.00
99.07
33.30
35.93
22.00
132.23
20.20
22.00
35.70
43.53
17.06
22.00
98.12
Total Debts of Decedent
$ 4,663.65
Funeral EXDen.e.1
SAlOIS, GUIDO,
SHtlFF &:
MASLAND
2109 MarbI_
Camp HIII.PA
Musselman Funeral Home
Reimbursement to L. L. Peterson for:
Grave opening
Marker down payment
Rolling Green Cemetery - balance due
Total Funeral ExpenBes
$ 5,641.00
605.00
326,00 931.00
on marker 326,00
$ 6,898.00
5
SAlOIS, GUIDO,
SHUFF '"
MASLAND
2109 M..uc St...c
CIlop HIl~ PA
INCOMB ACCOUICT
RECEIPTS
Prudential Securities - February annuity $ 450.00
Prudential Securities - March annuity 450.00
Pru-Mutual Fund - dividend 46.42
PP&L - dividend 274.72
Prudential Securities - April annuity 450.00
Orrstown Financial Services - dividend 19.55
PP&L - dividend 274.72
Pru-Mutual Fund - dividend 46.56
Orrstown Financial Services - dividend 19.55
Pru-Mutual Fund - dividend 44.57
Pru-Mutual Fund - dividend 49.49
PP&L - dividend 274.72
Orrstown Financial Services - dividend 274.72
PNC Bank - interest on estate checking
account from 2/22/96 to 1/29/97 173.75
TOTAL INCOMB RECEIPTS $ 2,BU.34
7
SAlOIS, GUIDO,
SHUFF "
MASLAND
2109 Market sum
Camp Hili. PA
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY
OF
CUMBERLAND)
JOHN E. SLIKE and LOVELL L. PE~ERSOH, Executors under the
LaBt Will and Testament of Helen W. Peterson, deceased, hereby
declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing First and Final
Account is true and correct and fully discloBeB all significant
transactionB occurring during the accounting period; that all
known claimB againBt the estate have been paid in full; that, to
their knowledge, there are no claims now outstanding againBt the
estate; and that all taxes preBently due from the estate have
been paid.
Sworn to ~d sUbscribed. before me
thiB t7f.5 day of ~ ~ , 1997
~J.0n~
/Notary public
NOTARIAL SEAL .
THELMA S. McCAUSUN. Nolary Public I
Camp Hili. Cumberland COUnty
My Commlsslon Expires July 3, 2000
---- -....- .
..t!u;:....i,.;:..h.:.:t->=>"-;.::~ ~--
,..--',.-.-"
INVEN'rORY OF 'rHE REAL AND PERSONAL ES'rA'lE OF
HELEN W. PE'rERSON, DECEASED
Real Estate:
ReBidential dwelling located at 3453 Green Street,
Camp Hill, PA
$l04,394.00
Personal ProDertv:
8,430.63
3,680.00
20,540.23
1,600.00
110.00
329 BhareB of PP&L common @ 25.625
l19 BhareB of OrrBtown Financial Services common @ 32
PNC Bank account No. 5140049482
1986 Dodge Aries Bedan - actual sale price
$2.50 gold piece
$l38,754.86
TOTAL
.
. .
~..-~..~--_... .....-
Signed, published and declared on the date thereof by the above-named
HELEN W. PETERSON, as and for the sole codicil to her Last Will dated
January 7, 19B1, in the presence of us, who, at her request, in her
presence, and in the presence of each other, have hereunto subscribed
our names as witnesses hereto.
Camp Hi 11 , PA
Address
, ('. ~. F Landisburq, PA
Name Address
Page 2
ARNOLD Ie SLIKE. AnOlN1VS."T.U,W, 1109 "'Aun STUlT. CAM'IIIL1.,'A nOli
... ""~""~,_~,,,,,'Jll' ~...
.:1 ....,.,WI.~W-
"" ". - . ..
. .
.. .
LAST WILL AND TESTAMENT
OF
HELEN W. PETERSON
I, HELEN W. PETERSON of the Borough of Camp Hill,
Cumberland County, Pennsylvania, declare this to be my Last
Will and Testament, hereby revoking any will previously made by
me.
I _ I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II _ I devise, and bequeath all of my automobiles and
all other articles of personal or household use, including but
not limited to household goods, furniture, personal effects,
and other tangible personal property, to my son, Lovell L.
Peterson.
III _ I devise and bequeath all the rest, residue and
remainder of my estate of every nature and wheresoever situate
unto my trustee hereinafter named, IN TRUST, nevertheless for
the following uses and purposes and under the following terms
and conditions. The trust shall be held for the benefit of my
said son, Lovell L. Peterson, for life. Out of the income
derived by the trustee, it shall pay all the necessary costs
,.-OLD, !IURa 1tI DIoTUT
Ano&NIT1 AT ""w
_............,
c:..........................-
JJk ?J.lJl~
Page 1
'.
.........--..-.. <00
'. - '.....'.-.-........-..-.------.:..O""'-';'.i.oI.-._....,
.
'.....'....._..'.: 0,-
and expenses of the trust including reaBonable compensation of
the trustee. 11y son shall have the right to withdraw the
income from the trust estate at least quarterly, and any income
not withdrawn by him within sixty (60) day~ f the 0nd of any
calendar year shall be added to the principal and no longer be
subj ect to withdr8\~al. The trus tee, at its sole and ab:,ol lite
discretion, may expend from time to time sums of principal which
may be necessary for his support, health and maintenance, includ-
ing but not limited to hospitalization and medical expenses.
Upon the death of my said son, the remaining trust estate shall
be distributed to his then living issue per stirpes, and if he
has no such issue surviving him, including afterborn issue,
then it shall be distributed as follows:
A. 50% to the daughter of my deceased imsband
by a former marriage, Christine Shepherd, if ljving, and if
not to her then living issue.
B. 50% to the Shriners Hospital for Crippled
Children, a corporation.
\II1fOLD,SU....O.t.l'La"
ATft&HIYI " LA.
__n......
c.....Il,...r-,,~..""-
IV - I appoint Dauphin Deposit Bank and Trust Company,
Harrisburg, Pennsylvania guardian of any property which passes
either under this will or otherwise to a minor or incompetent
and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so. Such guardian
shall have the power to use principal as well as income from
e minor's support and education (including
Page 2
:;
I'.
!
.
VI _ The trustee hereinafter named shall have the
following powers and duties in addition to those already vested
in it by law and other provisions of this will:
A. To retain any or all of the assets of this trust,
real or personal, including its own stock, without regard to
any principle of diversification or risk.
B. To invest in all forms of property, including
stock, common trust funds and mortgage investment funds whether
operated by it or others, without restricton to investments
authorized for Pennsylvania fiduciaries, as it deems proper,
without regard to any principle of diversification or risk.
c. To sell at public or private sale, to exchange,
or to lease for any period of time, any real or personal property
and to give options for sales, exchanges or leases, for such
prices and upon such termS or conditions as it deems proper.
D. To allocate receipts and expenses to principal or
income or partly to each as it from time to time thinks proper
in its sole discretion.
.-----.,..
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college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
support and education, or to make payments for these purposeB
without further responsibility to the minor or to the minor'S
parent or to any person taking care of the minor.
V _ The principal and income of the trust hereinabove
created shall be free from anticipation, assignment, pledge or
obligation of any beneficiary and shall not be subject to any
execution or attachment or to voluntary or involuntary aliena-
tion.
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~UL 1 0 1997
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SAlDIS, GUIDO,
SHUFF '"
MASLAND
2109 Mutd SIRet
Camp Hill. PA
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IN RE: ESTATE OF
IN THE COURT OF COMMON PLEAS
HELEN W. PETERSON,
OF CUMBERLAND COUNTY, PENNA.
ORPHANS' COURT DIVISION
NO. 1996 - 161
DECEASED
DECREE
r-f{
ARD NOW, this / b - day of
at <<' ? J o'clock, ~.m., upon motion
~Jl-j/, 1997,
/'
of John E. Slike,
Esquire, it is hereby decreed that in accordance with the First
and Final Account confirmed by this court on June 17, 1997, the
following described real estate be awarded to Dauphin Deposit
Bank and Trust Company, IN TRUST, nevertheless under the
provisions of the LaBt Will and Testament of Helen W. Peterson
dated May 7, 1985:
ALL that certain unit in the property known, named and
identified in the Declaration referred to below as
Green Oaks Condominium, located in the Borough of Camp
Hill, Cumberland County, Pennsylvania, which has
heretofore been subjected to the proviBions of the
Pennsylvania Uniform Condominium Act, 68 Pa.C.S.A.
53101 et Beq., by the recording in the Office of the
Recorder of Deeds in and for Cumberland County, a
Declaration dated April II, 1989 and recorded May 19,
1989, in Misc. Book 364, Page 405, and Plan Book 58,
Page 27, being and designated in such Declaration as
Unit 18, also known as 3453 Green Street; as more fully
described in such Declaration, together with a
proportionate undivided intereBt in the Common Elements
(as defined in such Declaration) of 12.58.
BEING the same premises which Blue Star Properties, a
PennBylvania General PartnerBhip, by its deed dated
June 7, 1989, and recorded in Deed Book~, Vol "2;",
Page ~1? ,Cumberland County recordB, granted and
conveyed unto Helen W. Peterson, the within-named
decedent.
-
I
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Helen W. Peterson
Date of Death: February 1, 1996
Will No. 00161 of 1996
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 i No
2.
representative
complete:
If the answer is No, state when the personal
reasonably believes that the administration will be
3 .
If the answer to No. 1 is Yes, state the following:
a. Did the pe~onal representative file a final
account with the Court? Yes)<i No
b. The separate Orphans' Court No. (if any) for the
personal representative's account is: /1/~
c. Did the personal representative state an account
informally to the parties in interest? Yes Xi 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: I )../?--7.. / f"
I I +
John E. Slike, Esquire
.D. No. 06262
SAIDIS, GUIDO, SHUFF & MASLAND
2109 Market Street
Camp Hill, PA 17011
(7171 737-3405
" .
~"
Capacity:
Personal Representative
X counsel for personal
Representative
. .,
T<;;'~,~'f:~I~.' "-~,',:'''-r.t:~
;gf'~~k:,'::::.;,;".:"-~;r~ :, ;;.,:;:<~I;:~'!~~~~%e~f;;;~:1:~;J~!f~
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.
.
RECEIPTS OF PRINCIPAL k
"
I'
Fiduciary I"
Acquisition I'
Value t.
----------- ,
I
CASH:
I
08/20/97 Estate of Helen W. Peterson 1,784.19
04/08/98 Estate of llelen W. Peterson - 255.00
Proceeds on sale of 5 shares
of Orrstown Financial Services
Conunon Stock
07/08/99 Lovell Peterson Trust 7.49
07/26/99 Lovell Peterson Trust 2,750.00
07/27/99 Lovell Peterson Trust 335.00
01/05/00 Transfer From Income 9.06
02/08/00 Transfer From Income 78.12
03/07/00 Transfer From Income 78.11
04/05/0D Transfer From Income 78.12
07/18/00 Transfer From Income 678.Dl
08/11/00 Transfer From Income 275.00
--------------
6,328.10
STOCKS/LISTED:
-------------
06/30/97 115.000 shares Orrstown Financial 3,68D.00
Services Conunon -
Received from the Estate of
Helen W. Peterson
06/30/97 658.000 shares PPL Resources Inc Hldg 16,861.26
Co -
Received from the Estate of
Helen W. Peterson
--------------
20,541.26
3
.
.
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL
Gain Loss
08/11/97 658.000 shares PPL Resources Inc Hldg Co.
Net Proceeds 12,976.26
Fid. Acq. Value 16,861.26 3,885.DO
09/03/97 115.000 shares Orrstown Financial
Services Common
Net Proceeds 3,759.52
Fid. Acq. Value 3,68D.DO 89.52
09/11/97 1. 000 share Marketvest Funds Inc
Intermediate US Govt Bond Fund .593
Net Proceeds 9.74
Fid. Acq. Value 9.76 0.02
09/18/97 351. 453 shares Marketvest Funds Inc.
Equity Fund .590
Net Proceeds 4,92D.34
Fid. Acq. Value 4,830.00 90.34
02/20/98 1. 039 shares Marketvest Funds Inc
Intermediate US Govt Bond Fund .593
Net Proceeds 10.29
Fid. Acq. Value 10.16 0.13
02/25/98 50.865 shares Marketvest Funds Inc
Intermediate US Govt Bond Fund .593
Net Proceeds 500.00
rid. Acq. Value 497. 51 2.49
05/06/99 25.562 units ARK Funds US Government
Bond Portfolio
Net Proceeds 250.DO
Fid. Acq. Value 250.D2 0.02
08/06/99 8.412 units ARK Funds US Government
Bond Portfolio
Net Proceeds 80.00
rid. Acq. Value 82.28 2.28
09/08/99 8.430 units ARK Funds US Government
Bond Portfolio
Net Proceeds 80.0D
Fid. Acq. Value 82.45 2.45
5
10/06/99
04/06/0D
07/17/0D
07131/00
08/16/DO
12/01/0D
31. 64 6 units ARK Funds US Government
Bond Port folio
Net Proceeds 300.00
Fid. Acq. Value 309.53
105.708 units ARK Funds US Government
Bond Port! olio
Net Proceeds 1,000.00
Fid. Acq. Value 1,033.93
75.269 units ARK Funds US Government
Bond Portfolio
Net Proceeds 7CO.OD
Fid. Acq. Value 736.21
32.154 units ARK Funds US Government
Bond Portfolio
Net Proceeds 3DO.00
rid. Acq. Value 314.5D
42 . 644 units ARK Funds US Government
Bond Portfolio
Net Proceeds 40D.OD
Fid. Acq. Value 417.10
9.53
33.93
36.21
14.50
17.1D
1,520.994 units ARK Funds US Government
Bond Portfolio
Net Proceeds
Fid. Acq. Value
14,525.49
14,876.89
351. 4 D
----------------------------
TOTAL GAINS AND LOSSES/PRINCIPAL...........
182.48
4,352.44
4,352.44
LESS LOSS.............................
NET GAIN OR LOSS...........................
(4,169.96)
-.------------
6
08/10/00 Mark E. Hilbert Associates - 275.DO
Appraisal Expense
08/16/00 Transfer to Income 241. 8D
09/05/DO A11first Trust Company of PA, NA - 8D.OD
Trustee Fee
10/D5/DD A11first Trust Company of PA, NA - 79.97
Trustee Fee
11/06/00 A11first Trust Company of PA, NA - 80.DO
Trustee Fee
12/05/00 A11first Trust Company of PA, NA - 85.51
Trustee Fee
DI/05/01 A11first Trust Company of PA, NA - 85.48
Trustee Fee
02/02/01 A11first Trust Company of PA, NA - 85.45
Trustee Fee
03/05/01 A11first Trust Company of PA, NA - 85.41
Trustee Fee
04/05/01 A11first Trust Company of PA, NA - 85.37
Trustee Fee
04/17/01 Transfer to Income 394.90
D5/07/01 Allfirst Trust Company of PA, NA - 85.12
Trustee Fee
06/05/01 Allfirst Trust Company of PA, NA - 85.03
Trustee Fee
D7/05/01 A11first Trust Company of PA, NA - 84.98
Trustee Fee
--------------
TOTAL GENERAL DISBURSEMENTS......................... 9,172.15
RESERVES
--------
Cumberland County Register of Wills - 17 4.00
Account Filing Fee
Saidis, Shuff, Flower & Lindsay PC - 65D.OD
Attorney's Fee
--------------
TOTAL RESERVES...................................... 824.00
--------------
TOTAL DISBURSEMENTS OF PRINCIPAL.................... 9,996.15
..-----------.
9
INVESTMENTS MADE - PRINCIPAL
1 Units Cost
-------
08/25/97 342.D67 shares Marketvest Funds Inc. 4,700.00
Equity Fund 1590
08/25/97 1,024.590 shares Marketvest Funds Ine 10,00D.DO
Intermediate US Govt Bond
Fund 1593
09/D5/97 9.386 shares Marketvest Funds Inc. l3D.00
Equity Fund 1590
09/05/97 379.098 shares Marketvest Funds Ine 3,700.0D
Intermediate US Govt Bond
Fund 1593
09/22/97 500.035 shares Marketvest Funds Ine 4,920.34
Intermediate US Govt Bond
Fund 1593
11
RECEIPTS OF INCOME
DIVIDENDS
Marketvest Funds Inc. Equity Fund *590
--------------------------------------
09/02/97 .
5.06
Orrstown Financial Services Common
----------------------------------
08/20/97
01/07/98
02/06/98
22.80
D.50
1.05
24.35
TOTAL DIVIDEND INCOME.... ... ...... .... ....
29.41
....-.--------
INTEREST
ARK Funds US Government Bond Portfolio
--------------------------------------
D4/06/98
05/04/98
06/01/98
07/01/98
08/D3/98
09/01/98
10/01/98
11/02/98
12/Dl/98
01/D4/99
02/Dl/99
03/01/99
04/01/99
05/03/99
06/01/99
07/01/99
08/02/99
09/01/99
lD/Ol/99
11/01/99
12/01/99
01/D3/00
D2/Dl/00
03/01/DD
04/D3/00
05/01/00
06/01/00
07/03/DD
08/01/00
09/01/0D
26.90
89.76
92.21
89.44
91.72
82.28
79.24
81. 61
80.24
82.94
81.41
74.63
83.37
79.26
75.60
74.66
78.86
77 .58
74.56
76.66
75.36
75.79
76.72
74.48
78.83
75.4D
75.75
71. 79
73.48
69.66
14
.
10/02/00 67.83
11/01/00 68.54
12/01/DO 67.08
--------------
2,523.64
ARK Money Market Portfolio
--------------------------
07/D1/98 0.16
08/03/98 2.27
09/01/98 2.18
10/01/98 2.16
11/D2/98 2.04
12/D1/98 1.52
01/04/99 1. 49
02/01/99 1.25
03/01/99 1.15
04/01/99 D.99
05/03/99 D.16
06/01/99 0.53
07/01199 D.4l
08/02/99 0.09
09/01/99 0.D3
10/01/99 D.05
11/01/99 1.07
12/01/99 1.11
Dl/03/00 1.02
02/01/00 D.68
03/01/00 D.70
04/03/00 0.42
05/01/00 4.32
06/01/0D 5.D5
07/03/00 3.60
08/01/0D 2.80
09/01/00 1.54
10/02/00 1.28
11/01/00 1.42
12/01/00 1.34
01/02/01 79.73
02/01/01 75.70
03/01/01 62.06
04/02/01 64.96
05/01/01 57.35
06/01/01 52.26
07/02/01 45.86
--------------
48D.75
Capital Reserve Account
-----------------------
09/03/97 26.32
10/02/97 4.89
11/03/97 0.04
12/02/97 0.05
12/31/97 0.64
D2/02/98 0.21
03/02198 0.22
IS
.
.
09/21/98
D9/23/98
10/05/98
10/22/98
1D/23/98
11105198
12/07/98
12/17/98
12/21/98
01/05/99
01/D6/99
01/13/99
01/22/99
01/26/99
02/05199
D2/17/99
03/02/99
D3/05/99
03/29/99
.
.
.
.
Pennsylvania American Water Company -
Utility Expense
31. 74
Pennsylvania Power & Light Co -
Utility Expense
90.08
Allfirst Trust Company of PA, NA -
Trustee Fee
99.40
Pennsylvania American Water Company -
Utility Expense
31. 91
Pennsylvania Power & Light Co -
Utility Expense
68.89
Allfirst Trust Company of PA, NA -
Trustee Fee
99.20
Al1first Trust Company of PA, NA -
Trustee Fee
99.23
Pennsylvania American Water Company -
Utility Expense
21.31
York Waste Disposal Inc. -
Utili ty Expense
25.92
Allfirst Trust Company of PA, NA -
Trustee Fee
99.17
Pennsylvania Power & Li9ht Co -
Utility Expense
60.49
Ann M. Markley -
Real Estate Tax -
1998 School Taxes Camp Hill District
1,349.50
Pennsylvania American Water Company -
Utility Expense
25.34
Pennsylvania Power & Light Co -
Utility Expense
104.65
A11first Trust Company of PA, NA -
Trustee Fee
99.15
Pennsylvania American Water Company -
Utility Expense
43.47
Pennsylvania Power & Light Co -
Utility Expense
14 .49
Allfirst Trust Company of PA, NA -
Trustee Fee
99.00
Pennsylvania Power & Light Co -
Utility Expense
83.92
20
~
.
.
.
.
.
.
08/11/00 Transfer To Principal 275.00
09/05/0D A11first Trust Company of PA, NA - 43.D8
Trustee Fee
10/05/00 Allfirst Trust Company of PA, NA - 43.06
Trustee Fee
11/06/00 Allfirst Trust Company of PA, NA - 43.08
Trustee Fee
12/05/00 Allfirst Trust Company of PA, NA - 46.04
Trustee Fee
01/05/01 A11first Trust Company of PA, NA - 46.D2
Trustee Fee
02/02/01 Allfirst Trust Company of PA, NA - 46.01
Trustee Fee
D3/05/01 Allfirst Trust Company of PA, NA - 45.99
Trustee Fee
04/05/01 Allfirst Trust Company of PA, NA - 45.97
Trustee Fee
04/18/01 Ann M. Ramsey - 394.9D
Real Estate Tax - 2000 School R/P Tax
for 3454 Green St.
05/07/01 A11first Trust Company of PA, NA - 45.83
Trustee Fee
OS/23/01 Seabury & Smith, Inc. - 88.89
Insurance Premium
06/05/01 A11first Trust Company of PA, NA - 45.78
Trustee Fee
D7/D5/01 A11first Trust Company of PA, NA - 45.76
Trustee Fee
--------------
TOTAL DISBURSEMENTS OF INCOME................. . 9,628.31
----------.-.-
23
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..published and declared on the date thereof by the above-named
A. PETERSON, as and for the sole codicil to her Last Will dated
if 7, 1981, in the presence of us, who, at her request, in her
~nce, and in the presence of each other, have hereunto subscribed
names as witnesses hereto.
Camp Hill, PA
Address
, t. jJ~. jl Landisburq, PA
Name Address
Page 2
ARNOLD" SLlKE, ATTOINUS.AT.I,AW. 110. ~Aun STlln. CANP HILl. PA nOli
---..~"
.
'."OLD. Sua. . IIATL8T
ATnlUIITt AT "'..
--.."'"""
c.... .I.....h_"_~_
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..__._lUO...:... ...~.:~~~.: -.-.';:- ..-:;.:....:.;;~. - ..:.... ..._~.._.'"':':.~. ......-:-.-.':'f'~-=.,.
LAST WILL AND TESTAMENT
OF
HELEN W. PETERSON
I, HELEN W. PETERSOll of the Borough of Camp Hill,
Cumberland County, Pennsylvania, declare this to be my Last
Will and Testament, hereby revoking any will previously made by
me.
I - I direct the pa~ent of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II - I devise and bequeath all of my automobiles and
all other articles of personal or household use, including but
not limited to household goods, furniture, personal effects,
and other tangible personal property, to my son, Lovell L.
Peterson.
III - I devise and bequeath all the rest, residue and
remainder of my estate of every nature and wheresoever situate
unto my trustee hereinafter named, III TRUST, nevertheless for
the following uses and purposes and under the following terms
and conditions. The trust shall be held for the benefit of my
said son, Lovell L. Peterson, for life. Out of the income
derived by the trustee, it shall pay all the necessary costs
JU~ 1- tall.l-nJ
Page 1
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........~~....."
and expenses of the trust including reasonable cocp~nsation of
,'.' ".'';':::'.~ ." . ')o..n :'.,~ -' '.'
the trustee. My son ~hal~"hav~ the right to withdraw t~~
I ". ..... ~ .
income from the trust estate at least quarterly, and any income
. " . . . . ~ Ii . '. '~ '.' :'. .
not withdrawn by him within sixty (60) days of the end of any
:. ,./ . .
calendar year shall ?~ a~?~~ to the principal and no longer be
subject to withdrawal. The trustee, at its sole and absolute
discretion, may expend from time to time sums of principal which
may be necessary for his support, health and maintenance, includ-
ing but not limited to hospitalization and medical expenses.
Upon the death of my said son, the remaining trust estate shall
be distributed to his then living issue per stir?es, and if he
has no such issue surviving him, including afterborn issue,
then it shall be distributed as follows:
A. .50'7. to the daughter of my deceased husband
by a former marriage; Christine Shepherd, if living, and if
not to her then living issue.
B. 50'7. to the Shriners Hospital for Crippled
Children, a corporation.
\.IifOLD, Sua. 6 II."L."
A~'ATU."
--..........
c..,......'...n.........-
IV _ I appoint Dauphin Deposit Bank and Trust Company,
Harrisburg, Pennsylvania guardian of any property which passes
either under this will or otherwise to a minor or incompetent
and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so. Such guardian
shall have the power to use principal as well as income from
e minor's support and education (including
Page 2
,
.. .
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.
college educa~ion, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
Bupport and education, or to make payments for these purposes
without further responsibility to the minor or to the minor's
parent or to any person taking care of the minor.
v _ The principal and income of the trust hereinabove
created shall be free from anticipation, assignment, pledge or
obligation of any beneficiary and shall not be subject to any
execution or attachment or to voluntary or involuntary aliena-
tion.
VI _ The trustee hereinafter named shall have the
following powers and duties in addition to those already vested
in it by law and other provisions of this will:
A. To retain any or all of the assets of this trust,
real or personal, including its own stock, without regard to
any principle of diversification or risk.
B. To invest in all forms of property, including
stock, common trust funds and mortgage investment funds whether
operated by it or others, without restricton to investments
authorized for Pennsylvania fiduciaries, as it deems proper,
without regard to any principle of diversification or risk.
C. To sell at public or private sale, to exchange,
or to lease for any period of time, any real or personal property
and to give options for sales, exchanges or leases, for such
prices and upon such terms or conditions as it deems proper.
D. To allocate receipts and expenses to principal or
or partly to each as it from time to time thinks proper
sole discretion.
AIUIOLD. Sua. . II.YUT
AT1'ClIHI11"'''''''.
--.........,
c.....u..h-.......-.-
income
in its
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:
S~gned, sealed, pubf~B~~~ and declared by HELEN W. PETERSON,
Testatrix therein named, on this and four (4) other sheets
of paper as and fot:,her Last Will and Testament in our presence,
who, in her presence,' at her request and in the presence of
each other, have hereunto subscribed our names as attesting
witnesses. '
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Page 5
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I
IN RE: ESTATE OF
HELEN W. PETERSON,
DECEASED
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 0161 OF 1996
PETITION FOR APPROVAL OF
THE RESIGNATION OF ALLFIRST TRUST COMPANY AS TRUSTEE AND
THE APPOINTMENT OF COMMUNITY TRUST COMPANY AS SUCCESSOR
TRUSTEE OF THE TESTAMENTARY TRUST OF HELEN W. PETERSON
AND NOW COMES Allfirst Trust Company of Pennsylvania, N.A., successor by
merger to Dauphin Deposit Bank and Trust Company, by and through its allomeys,
Saidis, Shuff, Flower & Lindsay, and states the following in support of this Petition:
I. The Decedent, Helen W. Peterson, died February I, 1996, having made a
Will and one Codicil, duly probated on February 20, 1996, on which lellers Testamentary
were granted on February 22, 1996, to Lovell L. Peterson and John E. Slike, Esquire, as
Co-Executors.
2. In her Will, the Decedent devised and bequeathed the residue of her estate
in trust, for the lifetime benefit of her son, Lovell L. Peterson, appointing Dauphin
Deposit Bank and Trust Company as Trustee, without naming a successor Trustee.
3. Decedent's Will gave her son, Lovell, the right to withdraw income from
the Trust at least quarterly, and authorized the Trustee, in its discretion, to expend
principal for Lovell's support, health and maintenance.
4. Decedent's Will instructs the Trustee, upon her son's death, to distribute
the remainder of the Trust to Lovell's issue; or, should there be none, to Christine
Shepard and to the Shriners' Hospital for Crippled Children, in equal one-half shares.
5. Petitioner Allfirst Trust Company of Pennsylvania, N.A., successor by
merger to Dauphin Deposit Bank and Trust Company, desires to resign as Trustee of the
Trust; and Community Trust Company has agreed to act as Successor Trustee of the
Trust. (Community Trust Company's consent to this Petition is allaehed hereto.)
6. The sole lifetime beneficiary and both named contingent remaindermen of
the Trust have given their consents (which arc allached hereto) to the resignation of
Petitioner as Trustee and to the appointment of Community Trust Company as Successor
Trustee of the Trust.
7. Afier notice duly given to all parties with an interest in the Trust,
Petitioner has filed with the Clerk of the Orphans' Court a First and Final Account,
including a proposed schedule of distribution in conformity with the relief requested by
this Petition, and scheduled to come up for confirmation on August 28, 200 I.
~ ____.....~i~~.-_d.l~~. ,_.'" ..'
JUL. 25. 2001 8:56A1.t73734SHC LEGAL DEPARTMENTLAN!)
vm f~~ 2 O~~tL ~:. J~1 16116
CONSENT OF BENEIIICIARY
The Shriners' Hospital for Crippled Children C"Shimers' HospllB~') hereby consents to
the resignation of Allfim Trust Company as Trostee of the Trost created under the Lasl Will and
Testament of Helen W. Peterson (the "Trost") and the appointment ofConununily Trost
Company aa Suc:celSorTlU!tee oflhe Trust. I,JlIY Fleisher ;, hereby certilY that I am
employed In the Legal Dcpanmenl of the Shrincrs' Hospital and am authori7.od to execute Ihls
Consent on behalf or Shrincrs' Hospital.t-
WItnesS:
J~~
1r.,6e Cattl!U
(SEAl.)
leinher, Managing AttOrney
Shriners' Hospital-\-
*n/k/a Shrinnrs lIosp1tllls for Children
. , . .
IN RE: ESTATE OF
HELEN W. PETERSON,
DECEASED
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY PENNSYL VANIA
: ORPHANS' COURT DIVISION
: NO. 0161 OF 1996
CERTIFICATE OF SERVICE
AND NOW, this 251h day of July, 2001, I, Thomas E. Flower, Esquire, of the firm of
Saidis, ShutT, Flower and Lindsay, hereby certify that I this day served n true and eorrect copy of
the foregoing Petition upon the parties listed below via United States Mail, postage prepaid,
addressed as follows:
Office of the Attorney General
Of the Commonwealth of Pennsylvania
16th Floor, Executive Office
Strawberry Square
Harrisburg, PA 17120
Mr. Thomas Vrecenak
Legal Department
Shriners Hospitals for Children
P.O. Box 31356
Tampa, FL 33631.3356
Mr. Lovell L. Peterson
3543 Green Street
Camp Hili, PA 17011
Ms Christine Shepard
368 Blueberry Pond Drive
Brewster, MA 02631
Respectfully submilled,
SAlOIS, SHUFF, FLOWER & LINDSAY
By:
Thomas E. Flower, Esquire
Supreme Court ID 1183993
2109 Market Street
CampHiII,PA 17011
(717) 737-3405