HomeMy WebLinkAbout96-00164
Oath of Personal Representative
commonwllllh 01 Plnnlylvlnll
COunly o. CUMBERLAND
The Pelllloner(~ above-named swear(s) or arnrm(s) thai the slatements In the loregolng Pellllon are true
and correct 10 the best 01 the knowledge and beRel 01 Pelllloner(R! and thaI, as personal representotlve(s) 01
the Decedent. Pelllloner(s) wtll well and truly admnlster the estate according to law.
Swom to or arnrlned and subscribed ~ '-IJ. u.J.~
.1ELISSA II. ,IELKER
~erole me this ~.!...-day 01
FEBRUARY t9 96
-~-
"...OlCV'vL/ C~'-{,) __/4j~f\') l~UUL/
MARY 'c. LEWIS or the Replster &lL-U/-
No. ClI-19C1l.J> -I uY-
Eslate 01 CLARENCE W. CARR Deceased
Soclal Security No: 196-14-4871 Dale 01 Death: , I'?h 191'.
96
AND NOW, FEBRUARY 22 ' 19 . In conslderallon
01 the Pet1\l0n on Ihe reverse side hereon, aallslaclory prool having been presented belore me,
IT IS DECREED that LellellllEl Testamentary 0 Of Admlnlstrallon
lIIJu.c.L&: pIft6em. tI.;....... ...,.iII; N.... m1,....
are hereby granted to
MELISSA H. WELKER
In the above estale and Ihatthe Instrument(s) daled 15 June 1991
described In the Pellllon be admllled to probate and Rled 01 record as Iho lasl Will 01 Decedsnt.
FEES
Lellers ....~................ $
Short Certrncale(s) .... $
Renunclatlon ............ $
Affidavits ( )............. $
Extra PlIl;Ies ( )......... S
Cod1cll ...................... S
JCP Fee ................... S
Inventory .................. S
OIher ....................... S
TOTAL ............. $
18.00
l'fLJ...,..
3.00
3.00 Addr..!: View Dr.
Enoln, PA 17025
5.00 Telephone: ("117)732-3552
29.00
room .nw.I rlQt 2 .12
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"'" -JI&,. I SE, frEE>> t" eLa- Vi(' ~, JlN;3 r'f
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RegIster or Wills or CU~l!lERLAUD
County, PennsylvanIa
OATH OF SUBSCRIBING WITNESS
EIIII.ol
CLARENCE W. CARR
-1lJ,Lf
No.
1'10 known II
.1l.ClIuod
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KAREU L. ENSlo\IUGER,
(d~ lublcllblng whnl" to the 0 rodlclltl,Uwlll(I' p....nl.d h...whh, (iidhl b.lng duly qUlllflld Iccordlng to
law d,poII(I'lnd IIvll'lh.t Ihlfffii'lff"v WII/CW~~ p....nl .nd IIW Ih. lbov. T.llllol(ml/<.lgn the ..m. Ind
thl' Ihillilllliiv Ilgn.d II II whn... .llh. r.qullt of Tlllftlor(iflllln hl!ll~.11 p..e.ne. and 0 In the p....nc.
olllch olh.. U In th. p..SlnCll Dr the olhnr eubscrlblng wllnu.(n.' .
<<~,/. r~.. l~..--
(Slgnelur I
KAREN L. ErISMINGER
106 Mountain Lane
lO'nnT^ P^ 17~
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Sworn 10 alelllrmld Ind .uh!Crlbtd
b.rar. m. Ihll 21 B t ._ day
01 FEBRUARY. 19-9.6-
'JY~ (~ i .~/'- (\'";~~ lL~.f p'*.~n) ]:?p..tll~
I .. - 'MARY C. LEWIS REGISTER ~'It.).2Lt.l.tf'
I. .. ~ , . :-
1510...... MoI....., Nq~.!'l. ..... ofIId.. NOTE: To b. lak.n by offiCII lutharlud 10 IIdmlnlttlt olthl.
........od III 1donWt1.. ..;'," ShM d.1t 01 ' PIIUI hlVI prll.nllh. origInal or copy oIlnllrum'nl(11
..",,,,lion 0/ No"""1 Clllm1"~"'" III tlm. 01 nalarlzlllan.
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CERtlF1Chflull ')L~otlct UIIUER RULE ~.61~1
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114l1ut ut V4celhlltl: 1_ P.ARR I ",..a"IICE W.
oall dt Vdltlltl_ :>6 .Too".....,. 'pp~
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, ""', . . I t!nt:!! i lhat It''Ul!I'tlt IHIM Held lttl:.tlll: Uqtl lrl!'l by
.,'. "Ill. ~.6IAl of I:.h. U~~,ltell"lU6Utl: Ituhll wat Utv.d on or "'lIll~d 1:0
'. . U. toUo,", IItJ bllltd 1,1: LAf,~',.~,~ 1:.". Abd"e.cAI'l:1dluttl e"Utoe 011
.. ..,17..April 1996 ,I'~,.
Ham. .1 . . .11:', ; MdulIlI
.
,~ELISSA II. WELKER . ,73~, Belle Vista Dr.. Enola. PA 11J2~_
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MlCl !.6IA' 1tItt:."h,.."................k" '
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t.heret:o uII.let
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11/17/96
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lIam. DONALD B. OWEN. ESQ.
Addtftlll 195 Mt. Viev Dr.
Enola. PA 17025
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1I0'rICE OF BENEFICIAL IN'rERES1' IN ESTATE
BEFORB TilE REGISTER OF WILI.S, COUHTY OF CUMBERLAllD , I'ENHSYLV^,lI TI
In re Estate of CLARENCE W. CARR , doceased,
(henof lc \"rYI
(addrenn)
please taka notIce of the death of decedent and the grant ur
letters to the personal representatlve(s) named below. You may h/lV"
a benefIcIal" interest in the estate as follows I
100% heir
(if additional space is needed, use back of page)
Name of decedent Clarence W. Carr
-.---
Last known addresS 736 Belle Vista' Dr. Enola, PA
of decedent Clarence W. Carr
-..- -_....--
Date of death 1 26/96
place of death PolyClinic MfH~ i ,..,,1 f'lot::lt9P
County of grant of original letters Cumberland
.
Decedent died X test.ate intestate.
A copy of the will X ie _Ie not attached.
-
_._-
Hame(s), addrese(es) and telephone number(s) of all personal
repreeentativee appointed
Harne
Melissa H. Welker
Address
736 Belle Vista Dr., Enola, PA
Telol'hono
732-0585
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7, 5..... o.d Bo.d, ISch.dul. RI
3, dOI.I, ...Id SlorUPor'n."hlp '"I'fI'" {StJuuful. ()
A. Mortgag., and Nol.' R.celvable ISch"dul" OJ
5. Cash, Ion. O.pol1" & Mhcellnn.au. rllnnnnl r,operly.
15ch.dul. fl
6. Joln"y Owned P,or"'r (Sch.dul. '1
7. Tran,',n ISrl,.dul. ot 15cl",,-Iul. It
8. Tolol 0'011 Au,," (Iolollln., 1.71
9. Funllnl bp.".... Admlnhlrnliv. Cn.", Mlu.llonflouI
bp..... ISch.dul. III
10. O.bll. Mor'gng" lIabilitl... U.n. ISchedul. I)
". To.ol D.ductlo., ('0..111.01 9 & 10)
12. N.I Value of Ellal. (lln. 8 m'nuI Un. II)
13. Chartlabl. nnd Qov,,"mfl"lnl &ellul.1I (Stfutdutlt J)
U. N.t Valu. 5ubl'" 10 To_Ill.. 17 ml.u' II.. 131 I IlISOLVElIT ESTATE
"_____"._H._'_.__._' _,. - \----.--- ' .
15. Spousal t,an,',,, (fof dol" a. d.alh nf,., 6.30.f~") ",
5.. 'n,lfudlonl fOf ^f,pllcobl. '",IInlog. on RflYflfI" lIS} __ _ _ d
Sid.. (Includ. .,olu.. ,om Sch.dul. K 0' Schedul. M.' -
16. Amounl of Un. U Inllabl. 01 6% '01. 1161
('ndude valu.. f,om Schfldul. K 0' Schtldute M.I
17. Amount of Un. U Inllobl. 01 15% 'ntlt
Ilnclud. .,olu.. f,om Sch.duh, K or Schfldulft M I
18. VII.clpoll., du.l^dd 'n_ I,.m II... 15. 16 ..d In
19. C"dill Spou.ol Po."uly Credll P,Io, Pnym.nll Ohcounl Inlf'I""
..... ---.-.---- - + .-----.-- +._----- '.
20, 1111..1911 UfOO'" Ihon 1I.. lB. 1.11' .hl dill.fO." a. lIn. 20. Thllli the OVfRPAYMUlT.
an
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B, f.'.. .h. 10'01 olll.. 71 ..d 71^.. l~71B'. ihi' II ,h. BAlANC! bUr.
Malo Cho<. 'ayabl. I.. Re,,,,OI .1 Win., II,..,
..:- ~-.._, JI- ~ 8i SU.Rl TO ANSW!~~lL QUUTIONS oN UV!~S_~~~~_ABf!.~'~Ec~r~~~A'~_~_~:. . '. .. ~
Unrlfl' r..nohj" 01 r..'lu'y I d.clare that 1 hove 'Ilomln.d ,hit "Iu,n. Indudlng accompanying nhfldul.. ond .,olflmftnlt, "nd to Ih.. hltl 01 my lnowl"',lg.. and \'flli"f,
II It hllf'. rorrfltl and comp'"I.. I dttlore lhnt atl real."nll hot hflfln fflro.tAd all'u' mn,hl vallll O.,ln,n,IM n' r'flrn,..' nlh.., thon Ih. rlf.nn"1 '''r,..,..",,,t1,,f1 h
hrnt'd on ol1lnlo,mallon 01 whlc'!.P"po,II hat any lnowtldgt::t., I)..' v:: ..JJ l I J ' ~ . ')
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l.lEI,HlSA II. WELKER. 736 lIelle Viota !Jr., .noln, PA - Executrlx/ II' ,.;z,o!. Fiy
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INHERITANCE TAX RETURN ~o'y:~~~'mDIT IS ClAIMID I
RESIDENT DECEDENT iiii iiUMiiiii
rn"':,w::I~\W.'H,r:i~mlr"lA (TO BE FILED IN DUPLICATE 21-96-0161,
"''''lfJ:~ l~t'lI..06G' WITH REGISTER OF WILLS) (QUIII1 tour
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CARR, CLARENCE W.
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NAME
I~ELISSA II. WELKER
ADDRESS
736 Delle Viota Dr.
Enoln, PA 17025
RElAlIOllSllIr 10 DECEDENI
grand niece
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J,..'nl'y 'Iwnlll,f rllop.,ryt
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fOR lOlAL VMUE DECO'S DOLLAR VMUE Of
"11M'" JOltn MADE DESCRlrllON Of rROrERIV
UNANI JOINf OF ASSn ~~ INI, DECEDENf'S INURESI
I. A --r--- NCAcc6tint N 5l~~011-0~7-4 - 595.73 50% 297.61 --
Checking Account
2. A ? PA. National Dank-Savingo ,412.70 50% 706.35
Acct N 32005 l2~55
""^l (^hn flnl,., "" Ii"" It. P"'fI,'itulr,ri"'l1l
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Pennsylvania NaUor'] Bank ~
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LAST STArEK~~r UAT!;: 01-31-96
TIllS STATEKENr DA T1:1 04-30-96
UIRECT STATEKENT INQUIRIES TO: l11-Z33-6434
~
~
l"ELl SSA II W~LK.ER
CLARI;HCE .. CARR
WI1UFREU K CARR - r{' ., . /
136 DELLE VISTA OR
ENJLA.~A 110Z5-1302
(,/, '1/ r, '.>
**0*00*0...".0000000000*0 DEPOSIT TRANSACTIONS 0...00.00000.00000000.....
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02/09 0.46 CLOSING INTEREST
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lllTEREST PAID 'tEAR TO UA TE 1.55
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ANNUAL' PE t YI~lb EA NED Z.02t
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PNClBANIK
Snlllh("tlllfat. IIA
Statement
C W CARR
WINIFRED CARR
HELlSSA WElKER
736 BELLE VISTA DR
ENDLA PA l7025-l302
111,1111,,1111"1,1,1,11111,111,,11111,"1,1,11,1,11
mlllNT, NUttIER 11-4111-'-74
NTEREST CHECKING
UR
NIHlrnD CARR
IlILUIA NILMlR
STHT EHD DATE
AC:OUHI HIIIIHR
TAN 10 H11118ER
LAIT ITHT IND DATI
ACCOUNT SUMMARY
'-lI1W
51-4111-0~71t
1"-14-4871
11-16-"
PREVIOUS IALANCE
1.147,18
DEPOSITS/CREDITS
...
UUUIlB ~ NITHDRANALS/DE~
10 501,85 545.85
DAILY ACTIVITY
12-15-"
CHECKS AND
OTHER DUITS
10,00
15,"
174,58
57,00
15,"
51. 26
50,00
72,94
U.SI
51.11
4.11
ENPLAHATIDN Dr TRAHSACTION
YOUR PREVIOUS STATEHEHT BALANCE
CHECK 1857 REr. 24905455
CHECK 18S5 RErR 24002618
CHECK 1859 REr. 24882456
CHECK 1841 RErR 275175.2
CHICK 1852 REF' 28087748
CHECK 1841 REr. 28878754
CHECK 1845 REF' 2174269.
CHICK 1844 REF' 22562511
'HICK 1842 _UEl-2Z0IlU.
CHECK 1845 RErl 2514'751
ACH DEIIT 119072110010
PRIORITY II PLUS rE8 OUES
IHTEREST PAYHEHT .
CLDSIHD TRAHSACTION
ACCOUNTINFORMA~ON
~IHIIMl IALANCE
'"RAGE IALAIItE
'VG COLLECTED IAL
cHARGEs/rEES lHOUHT
cHICKS PAID
fELEPNOHE TRANSFERS
.11
475,27
475.27
,18
10
I
5U,85
THE ANNUAL PERCEHfAGE YIELD EARHED IAPYE' IS,
THE HUNBER OF DAYS IN THIS INTEREST PERIOD IS,
TNE AVERAGE DAILY IALANCE USED fOR THE APYE IS.
THE INTEREST EARHED DURIHO THIS PERIOD IS,
SUMMARY OF CHECKS
""'
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-
LAST PAGE
ENCLOSURES
PADE
FOR tUsl0ttER SERVICE CALL
1-810-557-2262
DEPOSITS AIID
OTHER CREDITS
...
INIEREST PAID THIS PERIOD
INTEREST PAID THIS YEAR
1... 1-
21
U5.69
...
CHECK OAT! CHECK DATE CIIECK OAT!
IMIW Mll!IlIlI WI! IIIII1W 6IlllllIlI WI! 1I!IIlll! ~ WI!
1852 15." 11-19 1841 57.11 11-11 184~ 72.94 11-24
1855 15.97 11-17 1141 51.26 11-19 1145 51,11 O1-SD
1857. 11.18 01-17 1142 26,51 01-26
1859. 174.51 01-17 1145 II." 01-25
. OAP IN YOUR-CHECK-SEqUENCE
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744,67
694,'7
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5U,25
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NUMBER
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rrulMOUWlAnH or "UNS'IVAU'A
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1 SCH:lDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
..-- .-.-
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Ploa.o p.ln' D' Typ.
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2l-96-0l6/j
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,-.,
CARR, CLARENCE W.
DES':RIPTlON
AMOUNT
I,
Fun..al Eop.n.."
Sullivan Funeral HOme
$ 3,279.00
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Voa. Commlnlonl paid _ _ __ .. __. .. . _ __ ___
-0-
2,
Allo.ney f..,
300.00
3, family E Klmpllon
Claimant _ ___ .. _ __ .. __ Rolallan,hlp
AcId.." a' Claimant at docodonl" doalh
s,...t Add,.,,______...___
Clly ..____ _____
.__... ... _5101. ... __ __ _ Zip Cod.
P,obal. f..,
Filing Fee
MI...llan.ou. Exp.n...,
DPW-Certified Mailing/Estates Recovery Act N ~9
29.00
15.00
2.52
6.50
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.,,:::='~,~:r.'" MORTGAG_E L1ABLITIES AND L1E~~__ __. rr'D'. P,lnl D' !vP.! __..
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IlEM
!lUMBER
DESCRlr!lON
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$ 769.35
hll.60
55.1'0
2.22
31. 53
16.00
31. 35
15.00
.-----.- ._--- .,-_._~
Ford Citibank/Visa ~126-0023-l26l-h7l1
2. Triotan Aosoco Bill N-acct 5275761,
3. TlIIDdot lIome Car~ - 1961l,I,671A
" " . "I . " bill 3/27 dated
,I,. Capital Credit Corp.
.
5. ClIIDp lIill Animal lIoopit~Toke care of Mr: Carr'o dog
6. Dell of PA - Final Bill
7. Golden Loke
.____._______,._0._ .__ -.-.....
$ i,025.~5
TOTAL (^ho ,n,,.r on IinA 10, R"tnrllu'"'tnn)
,.--..-.----. .._- ----.
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800-95D-511~
1"'1' .11" '"''
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Ford '-;;tIbanl< Visa Willi NO ANNUAL rEE
M:coun' NlI"'bp,
41~8 0023 1261 4717
1'~'1I!!llT ~IlE DME 01/29/96
S'.'....nIlCIn.lnQ D.I. To'.' Cudll L1no Co," M,"n,oU..II tI.", nolonc'
01/09/96 .4800 $1900 .769.35
BOX 6500
SIOUX rALLS. SO
57117
^'i'AUlIhll CI f,tIt , 111'"
.4030
----'..-.
^'i'All1h1r (':",,"'111111
U90D
...~_.
66.75
79 ,~o
100.60
35.97
97.3~
262.11
127.18
, ntl r...~ .t.~ r ,- ,'.
121H 12113 6VOJQFDO TAIL1UIID/Fl T CoHrUttllO
12/18 12/18 976V9110l'\ J C IIEIITlEL & soliS
12/18 12/18 DY.!iV9110H J C HEIITlEL & 50115
12125 12/23&QflDYS87 BOSCOV DEPARTHE11T STORE
12/23 12/23 L1I2KZliQS KllART 00009123
12/30 12/30 tyYOTHLQ GIMIT FOOD 159
12130 12/30 HIIKB99H2 OUIIIIAHS 1056
415-11113-7300 CA
CARLISLE rA
CARLISLE rA
eMir lULL rA
EIIOLA rA
I1ECIIMucsnUR rA
MECHAIIlCSBUR9rA
.,
TOT AL
116
311
o
154
1I FORO REBATES SUMMARY ·
".last Month' s nalance
Rebates Earned this Honth
Rebates Redeemod/Expired
current Balance
0.00,
Your total 1995 finance charges were ·
EXTRA CASH FOR THE HEW YEAR. post-holiday sole",
bills, or doctor deductibles-you'ro covered, Got
CAsH with your Citibank card at over 2~O,OOO All'S.
If YOU don't knoW your Ptll (per!lonal Identification
lIumber). cllll 1_1100-950-5114 to ra"uest a pill form,
~l. .~ 19CO,(P 7 .
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769.35
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111.15:1
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1. 51250:(
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SCHEDULE J
BENEFICIARIES
Flii "ilMftlR~---
2]_96-0161&
.---' -...-... .'.
~,~
[()W&ONW1'U"'" "..",nY"IlIA
......MI~' tAllt'U.N
.IItOIN1IKtOINt
__ ..~ ....... .11
Em" O.
CARR, CLARENCE W.
----.--.--.-.-----------. --------- .-----.
AMOUNI OR
SHARI O. IIIAlI
RlLAT10NSHlP
---.-...-.-
.----.-.----------------- -'-.. --.----- -------.-
nlM
NUMlllR
NAMI AND ADDRISS O. lllNEFlCIARV
..----- .----.-----
~rnndnlecc
100%
A, laoable 8equII'"
I.
MelisDn 11, Welker
736 Belle Viotn Dr.
Enola, PA 17025
SSM: 205-56-61'02
.
.
......--
~ ..--.----"'- --*
-~...-_.-
------
AMOUNT OR
SHARI OF UTAlI
neM
NUMllEll
NAME AND ADbllESS OF llENEFlCIARY
---
---.--... ---..------
I. Charllable and G.,ernmental lequII'"
I.
-.-.------
- .... ..- .-. .. .- - -" .----.---..
TOTAL ClIAR"AltE AND GOVERNMENTAl IEQUESIS IAlta entor an IIno 13, Ro<ar"ulaU.nl S
___ .._ __._'_'__ ___d__'_'_-" ..-
. ._- .---.--
.._.___0. .--.--.....
__ __ ----------.---~i;;;;;;-,P.<~ i,-;:;~~i.d,l"..rt addiiio~;.1,j,O.I~~'~ame Ilnl
./ cj'
STATUS REPORT UNDER RULE 6.12
Name of Decedent: CARR, CLARElICE W.
Date of Death: January 26, 1996
Will No.
21-96-0164
Admin. No.
pursuan~ to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably b~lieves that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following I
a. Did the personal representative file a final
account with the Court? Yes No X .
b. The separate Orphans' Court No. (If any) for
the personal representative's account is:
c. Did t.he personal representative state an
account informally to the parties in interest? Yes X* No
d. Copies of receipts, releases, joinders and
a~provals of formal or informal accounts may be filed with the
crrk of the Orphans' Court and may be attached to this report.
* Note: Perso~al Repreoentative io the only heir
Datel~ '--rY1,,(}; f'1f'or~ '-fJ. LJ...a.dJ:1J/lJ'L
s.i~nature MELISSA 'II. WELKER,
and lIeir
Executrix
. ':,
"
..
Name (Please type or print)
736 Belle Vista Dr., Enola, PA 17025
Address
N
'-
N
(71'( 732-0565
Tel, No.
,-
~. ~
l,.,."
c.: -,
. 1
~:h
.) j
Gu
Capacity: XX
Personal Representative
and only heir
Counsel for personal
representative
(KAH:rmf/AH3)
_' -~ _ _ r' ...... _ .
IS-Y6 -/'/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIOUAL TAXES
INH[RITAHCE TAX DIVISION
PEP,. lID601
HARRISauAG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS ANO ASSESSHENT OF TAX
DONALD BOWEN ESQ
105 MT VIEW DR
ENOLA PA 17025
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-20-97
CARR
01-26-96
21 96-0164
CUMBERLAND
101
Anount Ralli Uad
(I
~
*'
tn.I'" II '" III.'"
CLARENCE
W
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ....
iiE'Y:is4"'i"Ex-"iip-nZ:96rNci'ficE""eiF--iNHEiiifAiicE-YAx-jiPPRjiiSEHENT-;-"LrciiiAiicE-iiliumm_um__-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CARR CLARENCE W FILE NO. 21 96-0164 ACN 101 DATE 01-20-97
If an assessment was issued previoUSly, lines 14, 15 and/or 16. 17 and 18
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAXI
15. A.aunt of Lina 14 at Spousal rat. (15)
16. A.aunt of line 14 t..ab1e at Line.l/C1.s. A rate (16)
17. Aaount of Line 14 t..abl. at Collataral/Class B rata 117)
18. Principal Tax Due
TAX CREDITS I
PAYHENT
OATE
TAX RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, R.al Estata (Schedula Al III
2, Stocks and Bonda ISchedule 01 (21
S. Clo..1y Held stock/Partnarship Intara.t (Schedule C) (5)
4. Hartgage./Nota. Raceivable (Sch.dule DI (41
5. Cash/Bank Deposit./Hisc. Per.onal Property (Schadule E) 15)
6, Jointly Ownad Proparty (Schedula FI 161
7. Transfar. ISchedule G) (7)
8. Total A..at.
APPROVED DEDUCTIONS AND EXEMPTIDNSI
9. fun.ra1 Expen.a./A~. Co.tl/Hi.c. Expan... ISchedule HI . 19)
10. Dabts/Hortuaua Llabllltla./Llan, ISchadula II 1101
11, Total Daductlon.
12. Net Value of Tax Return
IS. Charitable/Gavarnaent.1 Bequasts ISchadule J)
14. Nat Valua of Estata Subjact to Ta.
NOTE:
RECEIPT
NIIIlOER
DISCOUNT It I
INTEREST (-I
CHANGED
,00
,00
,00
.00
102,00
1,044,22
.00
IDI
3,632.02
1,025,45
1111
1121
IlSI
1141
,00
,00
.00
X .00.
X ,06.
X .15.
llDI
AItOUHT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
sublllt the upper portion
of this far. with your
tax pa)'ltant.
1.146,22
4.6~7 47
3,511.25-
.00
3.511 . 25-
will
.00
,00
.00
,00
,00
,00
,00
,DO
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY DE OUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
Roeo:, I'
Reri."_.
".<1 of
VIIilis
'97 JAN 17 All :46
CIOf"
Cumb.,I;_ ~
...,lull
Co" PA
RlSERVATIDNI E,..t.. 0' decedent, dwlng on or be for. Oec.~r 12, 1'.2 .. l' eny future 1"'.r..t In the ....t. I, tr~.f.rred
In po.....lon or enJoy-.nt to el... . (colll'.r,l) beneflcl.r.,. 0' thl decedent .ft.r the I.plrs.lon of eny ..t.t. for
11'. or 'or y..r., the Co..onwe,lth hereby ..pr...ly rll.tv.. the rlaht to appr.... ~ ...... tren.f.r tnherlt~. T....
at the l,,'ul el... . (colllt,r.l) r.t. on any luch lutur. 1"I.r..t.
PIJIPOS[ 1*
HDflCE:, To fulfill the requlrHMh of Section ZlU of the Jnhe,.!tMCI Met Est,t, rl. Act. Act 2Z of 1991. 72 P.S.
Section 21'1.
PAYMENT, o.tKh the top portion of thl, Notice IInd 1ut.1t with your PlY"'" to the Algllte.. 0' "lIh p,.lnllld on the rIYlr.. ,Ide,
...".... cMdt or MMY order plyMib tOI REGISTER OF HILLS, AGENT
All p.,..",. rectlved &N11 fint be ~1Jed to any Int.,...t which ..y be M ..lth eny r...lndtlr .,.11M1 to" the t.x.
REfUCD CCRh A r.fwMI of a t.. crNIt, ....Ich .... not nqueltMl on tM Tax R.turn, NY be r8qU8.t8d by cDllpI.tlna ., '"Appl1utlon
'ar R.fund af Penn.ylv.,la Inherlt8nCa end E.tata Tax'" CREV-ll1S). Appllc.tlon. .r. .v.ll8ble at the Office
0' the Aegl.ter of Will', .,y of the 23 R.vlnUl DI.trlct Offlc.., or by c.lllno the specl.1 2~-hour
.,~rlno ..rvlce nu8ber. for fora. arderlngr In Penn.ylvenl. 1-aOO-S6Z-Z0S0, out. Ide Pennsylvlnla ~
within 10C81 Harrllburg ar.a (717) 717-1094, TOOl (717) 772-2Z52 CHe.rlng I.,.lrld Only).
OI,JEClJOHSI Any party In Int.r..t not ..thf18d ..Ith the 8PPr'ls-.nt, .Uowanc. or dlsallow8nC' of dMuctlon., or ........"t
of t.. Clncludlna dl.count or Int.r..t) a. .hown on thl. Hotlc. .u.t object within .Ixty (60) dly. a' rec.lpt of
thl. NoUu byr
.-..rlttan prat..t to the PI Dep.rtaent of R.VInUl, Bo.rd of Appeal., Dlpt. Zal0Z1, H.rrlsburg, PA 171ZI-IOZ1, OR
--al8CUan to havII thI uU.r dlt.ralnad .t audit of tM 8CCDU'tt of thl p.r'OI\IIl npra."'t.Uva, OR
--appaal to t~ Orphan.' Court.
lIlHlN
UflATlVE
COARECTJOHSI
Factual .rrar. dl.cov.red on thl. ......sent .hould be Iddr...MI In writing tor PI OIp.rt-.nt of R.VInUl,
lur.... of Inct1vldu.1 Tax.., ATTNa Po.t A.......,t R.vl... Unit, O.,t. 210601, Harrisburg, PA l7UI-UU
Phone (717) 717-6S0S, Sea p... S of thl bookl.t '"In.tructlon. for tnherltanc. T.x R.turn 'or a R..ldent
Decadent'" CAtV-ISOI' for en ,xplanatlon of adalnl.tratlv.1Y correctabl. .rror..
OtSCOUfT r
If MY tlX due Is paid ..lthln thraa CS) c.lend.r Itonth. aft.r thl dacedent'. daath, a flv. perul'lt UX) dlscDU'tt 0'
the tax p.ld Is .Uowed,
PEHAL TVr
ThI ISX tlX eane.ty non-partlclp.tlon penalty I. c~ted on thl total of thl tlx ~ Int.r..t ......ad, and not
paid before January II, 1996, thl flr.t d.y a,t.r tM and 0' thl t.x eane.ty period. Thl. non-Plrtlclp.tlon
penalty II appe.labl. In thl .... unntIr and In thl thl .... tI.. par lod II you would appe.l tha t.x Met Int.r..t
thllt he. bean ......Id .. Indlc.tMl on this notlc..
INTEREST I
Int.r..t I, chargld b..lnnlno ..Ith 'Ir.t d.y of delinquency, or nlns C,) ~th. Met on. CI) d.y 'r~ the d.t. of
death, to the d.t. of p.y.."t. T.x.. which bee... delinquent ba'ora Janu.ry 1, I'IZ be.r Int.r..t at thl r.t. 0'
.Ix I'X) percent par ~ c.lcul.ted .t . d.lly r.t. 0' .000164. All t.x.. which bee... delinquent on and .,tlr
Janu.ry I, 1'12 ..III b..r Int.r..t .t . r.t. which will v.ry 'ro. c'lend.r y..r to calendlr y..r ..Ith thet r.ta
ennouncld by thl PA Dap.rtaant 0' Rlvenue, The appllCabl. Int.r..t r.t.. 'or 1"Z through 1"7 .r'l
'!!!! Inter..t R.tl Dally tnt.rl.t ractor !!!! Inta,...t Rat. O.lly Int.,...t Factor
1912 zn .0005411 1917 9X .00OZ47
1915 I'X ,OOOUI ""-1991 lliC .00nGl
1964 IIX ,OOUOl I99Z 9X .DOazO
1915 I5X .OOOSS' 1995'1_ 7X .00019Z
1916 In . OQQZ1~ .995-1997 9X .ooazu
-"Int.rllt I, c.lcul.ted .. 'ollow"
INTEREST . BALANCE OF TAX UNPAID X HUNBER OF DAYB DELINqUENT X DAILY INTEREST FACTOR
--Any Nollc. I..uad .ft... the till beelMS' dellnquant will r,UKt an Int.,.ut c.lcul.tlon to flft.", US) dlYs
baronet the d.tl of the ..........t. If p.y...,t I. .eeN .ft.,. thl Intlrllt COllPUt.tlon det. ahowi on the
Notlc., additional Int.r..t au.t be calcul.t.d.
--,,,,,,!,,,-,,,,..