HomeMy WebLinkAbout96-00177
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NO: 043276
NET AMOUNT
.REGI
GOLDBERG, KAllMAN & SHIPMAN, P,C,
DISCOUNT TAKEN
AMOUNT PAID
Bernice Daley
33.50
VENDOR:
OUR REF. NO, YOUR IN\!, NO,
45 49 18821-
INVOICE AMOUNT
Estate ot
33.50
INVOICE DATE
02
11/25/9
.00
33.50
Che k total
33.50
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Register of Wills of Cumberland County, Pennsylvania
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PETITION FOR GRANT OF LETTERS
Estate of
Bernice H. Delev
No. O)/-Cf{o- 1'77
also known as
Social Security No, 202-20-6118 3
, Deceased
Carolyn L, PollY
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(COMPLETE 'A" OR 'B' BELOW:)
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A, Pro bale end Grant of Lellers and aver Ihal Pelitioner(sl islare Ihe execut~named in Ihe Lasl Will 01 Ihe
o.ectpi~~'udfJ~ds A~~~~Rln w~J..1. nave rg~ifi~~~itlS)t~rJldr ~~~UL LO uerve 1.0 lUVor 01 l..arO.1.yn L.
o y per enunCln 10n 1 c a .c "lme 0 e 1 10n
IteN ......... dl......._... ,'___...... .--....
Except al follow'. Decedent did not marry, was not divorced. and did not have II child born or adopted after eXllcutlon of the document. offered
for probata; WII' nol the victim of II killing find WIIS naver adjudicated Incompetent: NO EXCEPTIONS
l{a
B, Grenl 01 Lellers of Administration C . T ,A.
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Pelilioner(s) aller a proper search has/have ascertained Ihal Decedenllell no Will end was survlvad by the lollowing spouse
(il en I and heirs:
Namo
Relatlonlhl
Residence
(COMPLETE IN ALL CASES:) Attoeh oddlt!onal Ih..tllf n.e....ry,
Decedenl was domiciled al dealh in ClImhejrland County, Pennsylvania, wilh his/her laslfamily or principal resldance
at 30::\ N 23rd SUAAl Cnmn Hill. Cn!!m: ~LI Bornuoh Cumhp.rlAnd COllntv PennsvlvnniA
...................................,
20 Il<lrrlsburg. Hospitnl, Harrisburg, PA
Decedenl, Ihen -6.3- years of age, died Fnbnl8rv . 19J1lL, al
.--
Decedent at death owned property with estimated values al follows:
l1f demlellod In PAl All p.rlen.1 preporty .".."".",..""."..".," $
(If not domiciled In PAl Perlonal property In Pennlylvanla ..................... e
l1f not demlcllod In PAl P.llen.1 proporty in Ceunty ,...,.,.."""..".,',., $
Value of real eltate In Pennlylvanla ............................................... e
Total., ,.. . . ,. , , . , , , , , . . . , , , , . , , . , . . , , , , . , , , , , . , , . , , . , . . , , , , , , . . , . . $
Real eltata Iltuated .1 followl: 303 N 23rd Strflflt C8mn Hill. Penmlvlv8ni"
5,00000
60.000 00
66.00000
Wherefore, Petitlonertll relpeotfully requelt(l) the probate of tho lalt Will and Codiciltl) presented with this Petition and the grant of letter. In the
appropriate form to the undersigned:
SI na ure
T ed or rioted name and relldence
-'f.' -/.'/..-1:/ I /
CAHOLYN L, POI,LY
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2311 New York Avenue
Cump Hill, I'A 1'(011
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21 - 96 - 177
Oath of Personal Representative
.
"monwealth of Pennsylvania
lunty of Cumberland
j' The Petltloner!sl above-named swear!sl and afflrm(slthatthe statements In the 'oregolng Petition are true and
l correct to the best 0' the knowledge and belief of Petltloner(s) and that, as personal representatlve!sl of the Decedent.
Petltloner(s) will well and truly administer the estate according to law.
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CAHOl,Yl\ 1.. POI,LY (
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Sworn to and affirmed and subscribed
before me this
26TH
day 0'
FEBRUARY 19
71f"'dif f/L" I.... L9m (ffi fh .
MARY C. LEWI1
No.
21 - 96 - 177
Estate of BERNICE H DALEY
Deceased
Social Security No: ?O"_?O_6!'81
Date of Death: Februllrv 20. 1096
AND NOW, FEBRUARY 26. .19 96 . in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters IJ Testamentary 10: of Administration C. T .A.
........t.~ ............;...........; u_..........
are hereby granted to ('^PnT Vtl I PnT LV
in the above estate and that the instrument(s) dated 7/10/81
described In the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters,..,.. .....,.."..,....,.,' $ 115.00
Short Certificatels),)...... $ 9.00
R " 1 $ 5.00
enunciation.......,..... .....
Affidavit ( )................. $
Extra Pages ( 2)..........., $ 6.00
Codicil......,..,..,..,..".,.... $
JCP Fee......................., $ 5.00
Inventory,.,.,....",.,..,..,., , $
Other, ....,."..,..,.........,.,' $
TOT AL................ $ 140.00
1lfn '(f@ i{, ,;' ^ f" . j)'mlltJl ro"
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MARY C. LEWIS
Attorney: Ronald M, Katzman. Eso.
1.0, No: 07198
Address: Goldbem. Katzman & Shioman. P.C,
P.O. Box 1268. Harrisbllm. PA 17108-1268
Telephone: (7171 234-4161
Mailed letters and order to attorney on 2-27-96.
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1.><:.1 Rell;,tr." The o,illill"lfellilk;Ilt' will he [",\\",,,,,"" '0 till' SI.,I<' Vil"II(",o"l, Olli,,' tor I'CIlIl,Il1<'IIII,lm~,
WARNING: Ill. lIIeg81to dupllcato this copy by photostat or photograph,
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Fl'l' (or Ihi'i (l'rlillC,IIC, $2.00
3399915
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D.I,e
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COMIIONWEAlTH 0' PENNSYLVANIA' OEPARTIIENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
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2604-1 Paces Place Atlanta. Ga. 30339
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LAST WILL AND TESTAt-IENT
OF
BERNICE Il. DALEY
I, BERNICE H. DALEY of the Borough of Camp Hill, Cumber-
land 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 estate of what-
ever nature and wherever situate unto my children, Phyllis A.
Swartzlander, Carolyn L. Polly and Dennis M. Daley, in equal
shares per stirpes.
III - I appoint my son, Dennis M. Daley, Executor
of this, my Last Will and ~estament. Should my said son fail to
qualify or cease to act as such, then I appoint my daughter,
Phyllis A. Swartzlander, to act in this capacity. Neither 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
10
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, 19B1.
day of
^."OLD,SLl.. lira OAYUY
AnnlNtTt...,UW
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Bernice H. tpaley
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(SEAL)
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Signed, sealed, published and declared by BERNICE H. DALEY,
Testatrix therein named, on this and one (1) other sheet of
paper as and for 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.
~f t~I' ~t:-
Address
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A dress
A.IfOLb,SLIIlIl. n4YL."
.It.TmlNIYI At 1..10.
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Page 2
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COMMONWEALTH OF PENNSYLVANIA)
55.
COUNTY
OF
CUMBERLAND)
,~, the undersigned, the testatrix and the witnesses.
respectively, whose names are signed to the foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument
as her Last Will and that she had signed willingly (or willingly
directed another to sign for her), and that she executed it as
her free will and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and
hearing of the testatrix signed the will as witness and that to
the best of their knowledge the testatrix was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
?
Subscribed, sworn to and acknowledged before me by the
testatrix , and subs~ibed and sworn to before me by both
witnesses. this /0'r.P day of July . 19 81 .
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Notary Publ1c
A_MOLD, Su.. & n.VL.V
,,1'TOIHI"I'I AT uw
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Thelma S, McCausr.., Notary Public
Mr Comminion bpittl My 1. 1984
(Imp HiD. PA Cumbttilnd County
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INRE: ESTATEOF
BERNICE II. DALEY
: IN TilE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPIIANS' COURT DIVISION
: No. 1996-00177
f-ERTIFIC-ATlON OF NOTIC-E UNDER RIII.E S,61Bl
Name of Decedent:
Date of Death:
Will No.
BERNICE H. DAI.EY
Febmary 20. 1996
Admin No,
1996-00 177
To the Register:
1 certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
March 28 1996:
l:kJmt.
Address
Dennis M. Daley
2604-1 Paces Place
Atlanta. GA 30339
Phyllis A. Swartzlander
7521 WertzViIle Road
Carlisle, PA 17013
Carolyn L, Polly
2311 New York Avenue
Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5,6(a) except..NLA.
Date 311.J?~qc. SignatureAM~,/'At ~
Name Ronald M. Katzman Esq.
Address CJoldherl' Kalzman & Shipman P.C.
320 Markel St. P.O. Box 1268
Harrisbllrl' P A 17108-1268
,J Telephone (717 ) 234-4161
Capacity:
_ Personal Representative
, ( ~.
X Counsel for personal
representative
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RECEIVED FROM.
&
ACN
ASSESSMENT '='
CONTROL ~
NUMBER
AMOUNT
. CAROL VN L POLL V
2311 NEW YORK AVE
101 13,800.00
,:J
CAMP HILL, PA 17011
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ESTATE INFORMATION.
FJ IE UMIR
21-1996-0177
!I NAME Of DECEDENT (lAST)
1;1 DALEV BERNICE H
II DATE f PA'fMfNT
B roSTMARX DATE
COUNTY
1010 ""' +
,
.,
SSN 202-20-6483
(fIRST) (Mil
CUMBERLAND
DATE Of DEATH
o 6 m TOTAL AMOUNT PAID .3,800.00
CAROL VN POLL V CW ,
, SEAL CHECK' 10:5 RECEIVED BY 'liMA::/. ,,{;;.'U ~~ I'~'
MAR V C. LE~S ";;/Jr:1/.4U I}/Jitj..
~ REGISTER OF WILLS REGISTER OF WILLS /~.'
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REMARKS
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LAW OPPlellfl
GOLDBERO, KATZMAN & SUlFMAN, P,C.
RONALD M, KAUMAN
HARRY., GOLDBlRO
,. LtC SHIPMAN
PAUL J. EPOIlTO
NEIL HENDtASHOT
J. JAY COOPeR
THOMAI c, BACNNeR
Ja.l A. ITATLtA
APRIL L, STRANO.KUTAY
auy H BROOKS
JEF'eRSON J. SHIPMAN
KAROl a. 'tUCHTtNBtROCR
JERRY J. RUllO
ARNOLD', KOOAN
MICHAEL J. tROCCHZI
EVAN J. KLINE, III
DRCW p, GANNON
STtVtN E. GRUBB
oua NAAKRT STAftKT
8TRAWnSRHY 8QUAHft
P.O. nox luon
IIARRlsnURO. PBNNIIYLVANIA 1710n.lunn
TBLBPIIONK (717) 110...101
PAX (7171 un..onon
",RTHUR L. GOLDBtAG
0' COUHKL
HtRIHU orrlCt
ei] WUT CHOCOLAT[ AVtN~
P. 0, BOX eee
H[ASHeY. PA. 170]]
11171 &3].404D
June 20, 1996
CARLlILE: O,'ICC
e3 WUT POlllrRtT sTRCtT
CARLlSL[, PA. 1701]
17171 24e.oeD7
YOAK or'IC[:
2 weaT IllARJ(tT STRUT
YORK. PA. 17401
17171 84].7DI2
ICORAUPOND TO
HARRISBURG orrlC[1
Mary C, Lewis, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Bernice H. Daley. deceased
No. 1996-00177
Dear Ms, Lewis:
Enclosed please find our check in the amount of three dollars ($3,00) to cover the cost
of one (1) fresh short certificate for the referenced estate, Please fOlward it to me in the
envelope which I have provided, Should you have any questions. or need any additional
infonnation, please do not hesitate to contact me,
,- N
C:!!1 :-: ~ct
~ (.\ Very truly yours,
:'~~ ~~ G: ('
'r)
t- ',' ~ .' . 'J t(/c
.' "
N ({ (j \"v.<.:d I J.
" ,.
", ,', ~
d ~;
~,
0.;, '.l
<.> q) .n l.
<DO: ~ "~ E Elizabeth S, Eck
a: ~8
Paralegal
lese
Enclosures
/ c;- - ,,'/- I-L
OAtES OF DEATH AfTEA lUlU" CHECK HERE
POUSlL 0
IERfY CREDIT IS CLAIMED
PILE NUMBER
--
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
HUtrAOER
RIV" UOOEX .('1.141
21-96.0171
YEAR
COIolMFm~WWll'lMb~ANIA
HAARI~i8~t.~'ZI'060'
COUNTY CODE
DECEDENT'S COIolPLETE ADDRESS
303 N. 23rd Street
Camp Hill. PA 17011
D
E
C
B
ij
DECIDENT'S NAIoIEILAST, FIRST. AND loll DOLE INITIAL)
Dale Bernice H,
SOClAl. SECURITY NUIoIBER
202.20.6483
AIoIOUNT RECEIVED(SEE INSTRUCTIONS)
DATE OF BIRTH
07/29/1912
C<Nn Cumberland
~F APPLICABLEjSURVMNO SPDUSE'S NAIoIE(LAST,FlRST AND IolIDDLE INITIAL) SOCIAL SECURITY NUIolBER
DATE OF DEATH
02/20/1996
R.lT\Ilnd.r R.turn
(lor dillS ot dlllh prior 10 12-13-B2)
Fldlrll E.IIII Tu RIMn Rlqulrld
To'" Numb" 01 Slfo Dopo'~ BoxlS
2. Supplomonlll R.lurn
4.. Futur. Inl.r.st Compromis.
(lor dallS 01 dOllh 0"" 12-12-B2)
og 5. Oocodonl Diad T..,.lo 0 7, Oocodonl Mlln,.lnad o living Tru.1
(Alllch co ot Win) (Anlch 0 co ot Tru.l)
C P All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
o 0 NAIolE COIolPLETE IolAlLINO ADDRESS
n g Ronald M, Katzman Goldberg, Katzman'" Shipman, P,G.
~ Ii TELEPHDNENUIolBER 320 Markot Street. P,O, Box 1268
T 717 234-4161 Harrlsbur PAr" 1108-1 68
1, ROIl EstllO Schedulo A 1 5 ,
2. Slocks Ind Bond. (Schedula B) (Z)
3. Closoiy Hold SlockIPlrtnonhip Inl"..1 (Schedulo C) (3)
4. Mortgagos and Nol.. Rocolvabla (Schedula D) (4)
5, Clsh. Bank Doposits & Mlsconlnaous Pononal Proporty (Sch, E) (S)
5, Jo1nt1y Ownad Proporty (Schedula F) (I)
7, Tronsto" (Schedula G) (Schodula l) (7)
I, To,.1 Gross Assols (lo,.llInas 1-7)
I. Funeral EJ(pens.s. Administrative Costs. Miscellaneous
Exponsos(SchoduIaH}
10. Dobis, Mortgogo llabil~ios, lions (Schodulol)
11. To'" Doducllons (lo,.llIn.. 9 & 10)
12. Nil Valuo of Es,.lo (lIna 8 mnus llna 11)
13. Choritabla and Gov"nmon,.1 Boqu..1s (Schodulo J)
14. Nol Valuo Sub' 110 Tu (lIna 12 mnus llno 13)
11. Spousal Transl"s (lor dal.. ot doalh a"" 6-30-94)
SI. Instructions for ApplM:8b1e Percentage on pag_ 2.
(lncludo vllu.. trom Schedula K or Schedula M,)
11. Amount ot lIna 14 ,.""bla a16'1o ralO
(lncludo valulS from Schedulo K or Schodulo M,)
17. Amounl olllna 14 ,.""bla al 15'10 ralo
(lncludo valulS trom Schedula K or Schodulo M.)
11, Prlnclpal"x duo (Add,.x from llna 15. 16 ond 17,)
11.Crod~slSp Povorty Prior Paymonls D1.counl
. 3,800,00 . 200,00
ZO, 1I1Ina 191s groalor than llna le, onlor tho dlfforonco on llna 20, This Is lhe OVERPAYMENT,
~ 0 Chock ho,o II ou aro,o uo,lIn a ,olund of ou, OVO I monl.
Z1, 1I1Ina 18 Is groalor lhon llno 19, onlor lhe dlfforonco on lIna 21. This Islho TAX DUE.
A. Enlor lhe Inllrosl on lhe balanco duo on lIna 21 A,
B, Enlo, Iho to'" olllno 21 and 21A on llna 21B, This Is tho BALANCE DUE,
Make Chock Pa ablolo: R 1,10' of Willi, A onl
~ ~ BE SURE TO ANSWER All QUESTIONS ON PAGE Z AND TO RECHECK MATH .. ..
poNI . pol"'}'. ...... II...n,nc "IIlCCompo"l'''II1C . .......,.,.. ... my now go. .,.. r...,
....oc. ond compIoI.. docllr.'hI,.1I rOIl nlll. hll _n r.por'od.. U... ""ko' v.I..., DlCllllllon.' pr.por.. .,h...hln 'ho po......l'.pr_nllllvo I. bI'" on .llln'o<",lIon.f
which prtparer hlS'rrJ know*lgt.
C A f
V~O
CRC
KOK
P S
X 1, Original Rolurn
4, lIrritod Es,.lo
01.
ll.
R
E
C
A
P
,
T
U
l
T
o
N
59.30
Nono
None
12 ,411. 78
50.00
None
87 ,521.08
(8)
(I)
8,517.60
12 ,001. 34
(10)
20,518.94
67,002.14
(11)
(1Z)
(n)
(14)
67,002.14
(11)
0.00 X
0.00
=
(lS)
67 .002, 14 X ,06 =
4,020.13
~
(17)
0.00 X .15 =
0.00
(11)
4,020,13
C
o
M
&
I
T
I
o
N
Int.rest
4,000,00
0,00
(11)
(ZO)
(21)
(ZlA)
(ZlB)
20,13
0,00
20,13
SIGNATURE OF PERSOH RESPONSI8t.E FOR FILING RETURN
1 ' . I .
(.(!,\.. t . ~tt
SIONATURE 0 PREPARE~N REPR,
~:~::",:.~"."",'nc.
Carolyn L, Polly
2311 New York Avenue
eam - - iim- - -Pi." -"i 70ii - -" - -" - - - - - -"""" - - -" -""" - - --
Goldberg. Katzman'" Shipman, P.C,
320 Market Street, P,O, Box 1268
H-';';r ii,burii;" PA - - i Yi6il:i26ii - - - - - - - - - -" - - - - - -" -"
DATE
11-'3-9ID
DATE
C;'
II' 7 "-?
Form tHO (Rev.1.14)
Act '48 of IBM provld.. for the~uctlon of the tax ralll Imposed on ut":'" value of tran.,.... 10 or 'or
\he u.e 01 \he 'POUIt. The ralll .. prllcrlbed by the .tatul. will be:
.3"10 (.03) will be applicable for ..tatll of decedenl. dying on or after 7/1/94 and belore 1/1/86
.2% (.02) win be applicable lor ..tatll of decedenll dying on or after 1/1/98 and belore 1/1/87
.1% (.01) will be applicable lor ..11111 01 decedenll dying on or after 1/1/87 and belore 1/1/88
.SpouIII tran.I.... occurring on or aller 1/1/88 will be .x.mpt lrom Inherlllnce tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (Xl IN THE APPROPRIATE BLOCKS.
YES NO
I. Old dlcedlnt mlkl a trlnsler and:
L rolalntheuSlorlncomoofthopropertytransflrrld",. ". "",.".",.""," ..""",. X
b, rolaln the r1ghllo designata who shan USI tho proplrty tronsflrrld or Its Incoml, ' , , , , , . , , , , . . , , , , , , , , X
c. rolalna..vorslonaryInll"st:or , , , , . , , , , , , , , , , , , , , , , . , , , , , . , , . , , , , , , , , . , , , , , , X
d, rocllvo the pro..... lor lifl olllthor peymonts, bonlrols or CI..?, , , . , . , . , , , . . , , . . . , . , . . , , , , . , , X
z. "doom occurred on or bolo.. DlClmber 12, 1982, did dlcldlnt within two y"rs prlCldlng dllth
trlnsfer property without rlCllvIng adlqultl conslderallon? II dllth occurrld aher Dlclmber 12,
1982. did dlCldlnt trlnsfer property within Onl yoer 01 dllth w~hout IICllvlng IdlqUltl
conslderlllon? ' . . , . . , , , , , . , , , , . . , , , , . , , , . , , , , , . , . , , . , , , . , , , , . , , , , , , , , , X
3. Old docedlntown an 'In INst lor' bonk account It hls or hor dlath? ""..,..",.""".,.,...,., X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES.
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
CopyrIght(.)!1U Iaml.._ only CPSyst...,'nc.
F""" 1500 (Rrt,7,14)
~lV - IIOZ IDC + (11,11)
~
co......MbYAH1A
UTATI OP FILl NUMIER
Bernice H. Dale 55 202-20-6483 02 20 1996 21-96-0171
property JoIntly-owntd willi Righi 01 sumvorahl, muatlll dlacloleel on Scheelute FI All r..,..tatl lhould III ra,orteel at lalr """'at value
whicllla dalIneel .. the ,riel at which 'lOJIorty would IIIlxchanleelllllwHn I willing buyor and I willing lollor, nollhor IIIlnl com,lIlee1 to
or alii bolh havln ,..aonabll knowleel 0 oIlhl ralnan! lactl,
ITEM
NUMBER
DESCRIPTION
-
VALUE AT DATE
OF DElI TH
1
Real Estate located at 303 North 23rd Street.
Camp Hill. PA, valued per HUD-l settlement sheot
(copy attached)
75.000.00
. 75 000.00
TOTAL (Also ontll on 6ne I, RIca ltulallon)
(II more spacI Is nelded, Inslrt addhlonal Sholts 01 same Slzl,)
Col>1rlghl(c) 11M form oof\wlll rrit cpSytt...,Inc.
'orm 1110O Sc_ II (Ilov, It,ll)
illY. 1101 IX + (4.11)
..
o
CO"~imMg~NlIA
ISTATI 0'
SCHEDULE B
STOCKS AND BONOS
FILE NUMBER
21-96-0177
Bernice H. Daley SSO 202-20.6483 02/20/1996
owned wHh RI hl 01 SUlYlvorahl mUlt be dllclot'" on Sch"'ul. F,)
DESCRIPTION
VALUE AT DATE
OF DEATH
1
59.30
One (1) $50.00 U.S. Savings Bond, Series EE.
titled solely in decedent's name. issued June 1983
TOTAL (Also .nI., on One 2. R.cI ltulallon)
(II moll SpIClis neod...,Ins.rt Idditlonal sho.ts of SI",. slz.,)
COpyItfhl(c) 1114..... "'twill oNt Cl'Syo.....,Inc.
.
59.30
Form 1500 Schodulo B (Rov,4'1I)
ftlV.IIOIIX' \I,ll)
~
r-.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Pi.... PrInI 0' T .
FILE NUMBER
21-96-0177
COIol.~WI'~AHIA
IITATI 01'
Bernice H. Daley SSO 202-20-6483 02/20/1996
(All
ITEM
NUMBER
1
owned with RI hI ollurvlvorohl mUlt be dll.IOIod on S.hodul. Fl
DESCRIPTION
VALUE AT DATE
OF DEATH
727.40
Personal Property located at decedent'a
reeidence. valued per listing (copy attached)
2
1994 Subsru Impreza. 4-door ~edan, 5-speod
manual transmission. valuod per listing
(copy attached)
8.675.00
3
Dauphin Deposit Bank Checking Account No.
0027126099. principal balanco. valued per
Bank's letter (copy attachod)
2,539,80
Accrued Interest
1.16
99.00
104.26
4
Internal Revenue Service .. 1995 Tax Refund
5
commonwealth of Ponneylvania. property tax
rebate (1995)
82,35
156.27
6
Homeowner'e insurance premium refund
7
Refund of county real estate taxos (see HUD-1)
22.89
8
Refund of school real estate taxes (aee HUD-l)
9
Refund of eewer charges (soe HUD-1)
. 12 411. 78
TOTAL (A1.0 .nt.. on line 5. R..I ~ulollon)
(AlIoch .dd~lonaI8 1/2' . 11' .ho.ts K more .pIC.1t nt.dod,)
CopyIIghl (el 1114'.... 10''''''0 only Cl'srs-,In<.
'....1100 s<hod... E (....., Z.Il)
3.65
~
r-..
ftlV. 1101 IX . 111.11)
COMll.mm4\a~AHI.
SCHEDULE P
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-96-0177
IITATI OF
Bernice H. Dale
Jolnllonant(ol,
02 20 1996
ADDRESS
1300 Motter Avenue
Frederick, MD 21701
RELATIONSHIP TO DECEDENT
granddaughter
A,
NAME
Lee Neff
B.
C,
ITEM LETTER DATE TOTAL VALUE DECD'S DOLLAR VALUE OF
FOR MADE DESCRIPTION OF PROPERTY
NUMBER JOINT OF ASSET 'JoINT, oECEDENTINTEREST
TENANT JOINT
1 A 10/ /86 One (1) $50,00 U.S, 50.00 50,00'; 25,00
Savings Bond, Series EE
2 A 10/ /B6 One (1) $50,00 U,S, 50,00 50,00'; 25,00
Savings Bond, Series EE
TOTAL (Also onl" on IIno 6, Roeooit\llalionl Is 50.00
Jolnlly-ownod proporty.
(If moro spoeo is n..dod, Insort .dd~ional shoots 01 sarno sizo,)
Cop)'rl9h1lcl'~''''' ..""'"....., CPSpl.....,'nc.
F.... 1500 Sc_ F (II.., 11,11)
,
ftlV .lIlIlX . (1.11)
~
f",
COIol~.MbYANIA
I5TATI OP
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Plea" Prlnl or ·
FILE NUMBER
21-96-0171
02 20 1996
DESCRIPTION
AMOUNT
Bernice H. Dale
ITEM
NUMBER
A. punenl b,.na..'
2.378.00
1
Myers-Harner Funeral Home
..
Admln\llrellV' CoelI:
p.rsonal R.P....ntativ. Convrisslons
Social S.eurlty Nuni>l' 01 p.rsonal R.pre..ntative:
VII' Cornn1sSlons plld
1,
z.
AlIOrllIY FHs
Goldberg. Katzman & Shipman. P.C.
3.
Flr,.ily Ex.~tion
Claimant
Add.... 01 Claimant II doced.nt's d.lth
SIIIII Add....
CIly
-
Zip Cod.
R.lationshlp
Slal'
4,
probate FilS
Register of Wills
C, Mllcellan...... Ex,.nl'"
1
2
3
4
The Patriot-News ., advertising expense
Cumberland Law Journal,' advertising expense
Regiater of Wills ., short certificates
Goldberg. Katzman & Shipman. P.C. ., reserve
for closing costs
Register of Wills ., filing fees for inheritance
tax return and inventory
Real estate closing costs ., title charges and
1/2 transfer taxes. per HUD-l (copy attached)
5
6
5.000.00
140.00
75.10
40.00
9.00
50.00
25.00
800.50
. 8 517.60
TOTAL (Also .ntor on tine 9. Rocl ~ulationl
(II more ',Ie. I. noeded, Inll" Idd~lonal .hMll 01 11m' Ill',)
Copyrlght(c) 1194 tormlOt\ware frit CPSyat_.Inc.
Form 1500SchodIM H(RrI, 7-11)
,
~IV' ,11I IX + Iz.l1)
~
f"'.
COM~~AHIA
mA11I 0"
SCHEDULE J
BENEFICIARIES
"ILII NUMBIR
21-96-0177
Bernice H. Dale
ITEM
NUMBER
SS 202-20-6483 02 20 1996
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
1
A. T..able Baqull1S:
Dennis H. Daley
431 Delancey Court
Hechanicsburg. PA 17055
Son
1/3 share
2
Phyllis A. Swartzlander
7521 Wertzvi11e Road
Carlisle, PA 17013
Daughter
1/3 share
3
Carolyn L. Polly
2311 New York Avenue
Camp Hill. PA 17011
Daughter
1/3 share
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charltoble and Governmental Blqull1S:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also Inlor on Ilno 13, RocI itulallon)
(II morl .pacI Is nolded, In.ln Idditlonal.holts of .amo .IzI.)
CoIJ1IlIhl (e) 1114 '.n".'twon rrif CI'SyoI...,'nc.
.
Fonn 11500 Schod'" J (.....z.17)
0.00
TABLE OF
......:.... .'
exhibit A
~
()
..t.c..o (1)
~
r",
LAST WILL AND TESTANENT
OF
BERNICE H. DALEY
I, BERNICE H. DALEY of the Borough of Camp Hill, Cumber-
land 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 estate of what-
ever nature and wherever situate unto my children, Phyllis A.
Swartzlander, Carolyn L. Polly and Dennis M. Daley, in equal
shares per stirpes.
III - I appoint my son, Dennis M. Daley, Executor
of this, my Last Will and Testament. Should my said son fail to
qualify or cease to act as such, then I appoint my daughter,
Phyllis A. Swartzlander, to act in this capacity. Neither 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
10
w~
, 1981.
day of
LD.luu II 114ru:".
.."..,......T"'.
__ft_n
c......."-"- _
J
, ,
..:kr ',l.l.t.~
(SEAL)
4,~~
Bernice H.~ley
"- ---.
."_. ._-
~
r-,
COMMONWEALTH OF PENNSYLVANIA)
COUNTy
OF
CUMBERLAND)
55.
WE, the undersigned, the testatrix and the Witnesses,
r'.p.r"'.ly, who.. n.... .r. "go.d .0 .h. for.golng 1n..rum.n.,
b'lng f1... dUly 'wo", do h.r.by d'rl.r. '0 .h. und.r"go.d
,u'ho.l.y .b.. .h. ""..r1. 'lgo.d .nd ".ru..d .h. 1n..rum.n.
.. h.r Lo" Will .nd .h.. .h. h.d "gn.d Willingly (or Willingly
d1r.r..d .no.h.r '0 .lgn for h.r) , 'nd .ba. .b. "'ru..d 1. ..
her free will and voluntary act for the purposes therein
expressed, and that each of the Witnesses, in the presence and
h..r1ng .f .h. """r1. .lgn.d .h. w111 .. Wi..... 'nd .h.. ..
the best of their knowledge the testatrix Was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
..-'7
Witnes .
N/(?~ ~
Witness
SUbscribed, SWorn to and acknowledged before me by the
testattix , and sUb~ibed and sworn to before me by both
Witnesses, this /0 day of JUly , 1981 .
. - -
~-<,./ l :fu- ./'
, otary Pu c
.
.
.............. a......
'..'''~If'I'''.
'.---......
..~"'- -...
;;{.;~:'
~:~\..
TheIn" s. "''''Oslin. NOb,., /It,fI6c
AI, c_.... Ex.... u., I, "'4
C4m, Hili. '4 c.."itrla.ct C...."
'"
^
Register of Wills of Cumberland County, Pennsylvania
RENUNCIA TION
Estate of BERNICE H OAt EY
also known as
No,
, Deceased
The undersigned, TIp""" ~ M. DR.1 P-V nnn Phvl1 i ~ A. Swn.rt7.1 n.nrlpl"'. son of
(Relallonshlpl (Capacily) and da.ugh ter
Ihe above Decedenl, hereby renouncelsllhe right 10 admlnlsler the eSlale and respectfully requestlsllhal
Lellers TA<lnmAnlnlV be issued 10 Ca.rolyn L, Polly
Wilness
23rd- day of
i
Dennis M.
(Signature)
(Address)
Sworn III or affirmed and subscribed
belo~ me Ihis ~ .51:17 day of
,.~)J"Jfo'~" r 19 7t: .
- .
1...-...........................
...... .. ............ ........
..._.........._J
NOTARIAL SEAl
MARY L MYS. NOTARY PlJ8UC
HARRISBURG. DAUPHIN co. PA.
MY COMMISSION EXPIRES APRIL 14, t997
enunciation, executed outside the Office of Regtlter of
Will, are required In loma countl.. to ba nolarized.
F.-1lW-4~c...,.""",Mn
~
-.:#
.(I'UID <D
J;llhlblt C
o
'"
~
IIW"'''''. ~'I ......
(OMMOHWUltM 01 'IHH'T\Y"HlA
01""'''"' 01 .n'Hul
,.unAfiKl'U INtltOM
JO" OffICI toI nll
""..,tltulO.'A lPIOMU7 PI.a.. Print or T p'
MUIT II COM'IITID IY U'.UINT...T1VI 0' "N...NCI...IINITlTUTION WHERI SAIl DI'OSIT lOX 15 lOCATED "'ND UTU.NID TO ...IOVI ...00.155
COUNTY COD' "II NUMB'I SOCI...L SlCUIITY 01 DIATH CllmlCAn NUMB.I
33 c '3 I 2 -"' -t.. !J"'J
N A I",";./"ST, "'IDDlIl I I ...T 0' ....TH
pA G:--Y (.)~I~ rr. '7...-2.0-q~
...DDIISS 0' DIC.DINT Isml11 I /'1_ 1-'- I L1ClTYl rJ l"AlIl II" CODII
? D 'J (\, 2. J ""\ S;- Vn 71 (''4- / ? 0/ )
NAM' "'ND "'DDRlSS O. 'IISON ..QUISTING THI OfENING O. THI s...n D.,OSIT BOX
IN...II I
fi>~ 1/,,(
IsmlT ADDlIlS1
r"J5"-L. \
SAFE DEPOSIT BOX
INVENTORY
N"'M', ...DDRlSS "'ND RlLATlONSHIf IIf ...NYI TO DECEDENT, o' ,IRSON!SI 'IESINT...T THE BOX OflNING
.. (HAMil IULAflONSH1'l
_fll~lIl~ 7:;>m...,Iv-/Io-.
I"RIIT ADDRml IClTYl
S'uf\.(L.1 '"2.. L./..J {I..
tJ~I'-...J"V,ILr. fl.J...
Cft-.<- L.t.r I.t.
IClTYl
(J...~
ISTAlIl II" COOl)
/701 r
ISun) (lIP CODE)
~, CAMEl L. p", LL'j t1u..lnONSHI'1
~,'I.YN 1> ,.,.".../ iv'"XJ'-
ISTIUT ADOlnS) IClTYl (SU.rE) II"CODII
;):]1 \ (lJ e-,..., YO..:.I<" r~.~ IJ-:(.. fI'", /-, .;
,. IN....II (IELATlONSHI'1
(STIlEl ADOllSSI IClTYl ISTAlIl Ill'CODII
NAMI ...ND "'DDRESS O' flN...NCIAL INSTITUTION WHERE THE SAn D.,OSIT BOX IS LOCATED
IN....II
~o('J..,fV
IsrlllT ADOlUS1
/1.tJ() tr-.T-<A~ fr-
o NAM, 0' fEISON MAKING LAST ENTIY
~'1111.!
DATI O' CONT....CT TO RENT BOX NUMBER O' BOX
~I,y (,'!- /30 i
NAME AND ADDRESS o' 'IISONISI HAVING ACCESS TO BOX
., iN....II
ph I( III ( )t.<' ol'-'J C......t.l/'-
(STUll ADOIUS)
/)""'-fC" /;- ({ 1I"v-....
{ IClTYl
l"'r)-.'1tN'
AlATEI fIlP COD!1
V"'''''' /7o'f3
DATI AND TIME OF LAST ENTRY
2,-1.7...-4(,.
TlTU UN...I'ER WHICH BOX IS REGISTERED
(,!,J."rUv, c(.. H /)" L:. .
II. IN AM!!)
{SUUT ADDIUS)
(CITYl
I>TAlI1
II"CODIIIClTYl
I>TAlIl
(ZIPCODl)
NAMI AND TlTLI O. IMfLOYl TAKING THE INVENTORY
C'AA 1'10... C; (~t..-;"i'"'''' ~ (Y'o..".Io(....'71 ,...."i~
WAS'" WILL IN TIll BOX? aYES 'i'{N0 H YO" ., D.,..f willi
II. Nam. and addt... .f ,enonal ,.)...."'.11.... 11 namod I" the will
iN....ll
ISTaUT ADOlnS)
(CITYI
I$TAU)
111"ODI1
c. N......ncI .dcl,... ., _Homey. tf on.,
IN....I)
ISTltn ADOIlSSI
(CITYI
ISTAnl
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,-...
Page
SAFE DEPOSIT BOX INVENTORY
INSTRUCTIONS
(1) Calh. R.port tolal only.
(2) Stockll lIat In d.,olI .v.ry common or prel.rr.d c.rtl!ical., warrant or alh.. rlghll lound in bo., Slacka are
10 b. dllignal.d by nom. of company, c.rtllicol' numb.., dol. of c.rtillcal', nom. In which alack la reglsl...d,
and numb.. 01 ahorea and don 01 alack,
(3) Obllgallonl of U, S. Gov..nm.nll Numb.. 01 it.ma, dol. of inu., lac. valu., namll In which reglst...d
and typo 01 own.rship, i.." lolntly h.ld, payabl. on d.ath, .Ic,
(4) Bond.. DIIlgnal' by nom., amount, a..lal numb.., or alh.. dllignalian. (B.or.. Banda)
(5) Bank and Savlngl and Loan POllbook.. 5101. namo 01 dopoaitor, numb.. 01 book, loa' doll app.arlng in
book, namo 01 bank and branch, and balanco.
(6) J.w.lry, Coin I, Stampa, Manulcrlpll, .tc, llsl and doacribo aa fully aa ponlblo,
(7) Dlldl, Mortgagll, Curr.nllnluranu Pollcl," or oth.. .vld.nclI of Ind.btodn,", lIat and doacrlb. aa
fully aa poniblo.
(81 An other cont.nll,
't- r.,...:n., o::...llftc~...
~-- -
ofJ
i>'jt. \~'1 1,....-
PI:'rc. ,'tttL.l, "":f.,~EM DESCRIPTION
".l.1< \.<..........,..r '.It,.f f-t.......-- _ ~ ITA ,,~-r.
p",.,. I J- rr-J-s-
:)Cn fl. ';)?AJ Jl\J:;..f fI,<.{.
J:FtLt. -Dro 7(/o/!t
2> V r!> ' 1../91'1'
q,-.i... " ^' Do:.. Z)rt> 7":> Vi J
(,).!'"ll"..,,, l..lrftrr--- ~ro ~/I 37
'2,..."'.1. '-r _ sr. ;::-ro/yo..... LuiNtvv cJ""""'-L
A'Z-,/o7_ r;....._l.~
-vo- ~ (H.,I.-b<r./ ("1"1'rlA ~A..C'...-.n..i_
"."</M ?>.a..t ~~~1 ,..1 to 21m 1-/ " _ 7/l..t+cr
'-l( ct- 4.,a....A (, L{,
~/~-lf J _ , /oJ ;t.~ I
.II- bl't U
tf ';2.b I J '.>
_"';:Jib ~ I - 'I] '7-c"-
t.(,ll:.....~ Ci.-
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(I Tc. /.. r
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Fc,,~
tm '.-11,."....,
t.ln
2.-~8..,
IN ,,~Ct-
I-W', d,
_ ))11) 3-:;,,-/)--
."'l.f,'" _ ~(~,p 7:>~' tjl.',v.A~
~.....-t:' 11,;"'....' _ rz.... ~vl.(,..... 411..
c;" as- Jr I N'f'~ 0- II rt) 'J -{. -51-- 7-..'-
A fl'lI"rot'- C t", .J !fy- fY { r 10 It
l. "i'.'l. /jOf\-.f>$- l.h'7J)-t...8:l- 7.'\ so' /7>/'b "-
5"4 .'J- r.~""'" /~Al ~tL- ~ to-~F~.. /1.>i'l> lo-fb - P,1. ~<' G:. - t!,t.__c."~ l!"-
I urllfy under p.nalty of perlury Ihol tho above record II corr.d and compl.t. to tho bllt of my knowl.dg.
and b.lI.f.
Gfr
'ri"' N:~:: n~ ;'''y
CI.fII- 'n c:- (-TI' 11"(" .-:z",..-..J.., r......~"f"T"_, "..~/L,
NOH: jlttoth ad~ltlonal pv," " 11. sheetlflll np.p~!ary or ule dupllcalp! D/ !hl! C"~~ of fDr""
__.__.._ -_T" . - --
-
( ^1';
Dol.
(),J-0'7-1 t
o
<_".._;,,,,,,..~o..;.;.""~__""'-~:"~"_'.'T"-'-"--"
..~,.@
exhibit 0
,,_.~.,.,. ._'~""'. "4._,
o
--.-.------------- -----.--- .-------..--- ----~_.. -'----
. III UtrAllI.....HI tlf ItfltJf\~t1I}l"'...HIIf'VnOl..A'1lI ,.... OUfl'1ft 1M10J'"
5[1 II IMU AII.MUII IIIII"M)
I....,....
ASSURED LAND
TRANSFERS. INC. II IYP[ or to^,'
Third"" Mnrkol Slrools
r.o, Box 109 1_11"1" Illru'lA J Ilea'''' IJI'WS
Lornoyno, Ponnsylvonio 17043-0109 ~ 'lleflf,., If"
II ritE ,"JUIIU' , ' lO"'U'IIIf,1RU'
(717)7Gl.4720 1000(,1
II UUIlI IU, CASE 00
t"llo /IOJ60-1
CflOl[ Ih.. In,m i,luIIU'''II" In UIV. VOlI II .IAl..n..,1 nt Af.lulIl ,.111"",..,1 rn.l, "-"IOl",I. plIitlln ."" hy Ih. '1I11ltlllllfll 'U"" A'. .ho""," U."" ,n",..1I
'hi 0 ~ )' "'11'. rAi., nul'MIII lIul r.1o""Q.lh.y AliI "WHlrn IUIIIIIIM .,lfflml'.lnAlllIIIlIlIUI AmIA,.,wlllldlHI.111n '''II kll"I.
I) HAUr "'Un "'IJI)".:!'.! OJ' ItlltVIOWr 11 F "AUE ""II,"llIWW!'IlIUr ".111111 r PlAJ,lF "un A1)()flf;5SOF' 1('II)(n
Woodrow J. Colbort Cnrolyn L, Polly
IJindn I" Colbort Adm 1111 ntr"trl x of tho CMHI
Eotnto of
nernlco II. Ilnloy
o. rnort:ntY lOCAIIOtf II :\F111 UAFrH Anon I S{ HUt,I(fH OA1{
JOJ N, 2Jrd street A9Durod L.1nd Trnns(orG, Inc. 06(19/96
Camp 11111 DOROUGII M.Af:1: Or'iFtlIIMFflI
Cumbgr1and County J01 Hnrkgt street Lomoyno PA 1704l
J. IUU'UftY 0' laRROWF.n" '""H....C"OH~ II:. IUM'U"' 0' IILlln', ,nAN,ACtlON:
tDO anon A"OUHt QUI ,nou IOAnoWI!l 'OIl anon "MOUNt DUI 10 nUln
101 CnnlIA(1 ul.. Jtuc, I:ruOO~Olr tnl Conll~cl ulll' JtlICII 150lJO,OO
II., rll"nr'.II"tIl",.'I,;, tftJJ1I1I1MIIIJ"npA,lr
1111 Sfllllnln,,", eIlA'OUln 0011"*11' {IIn. I~OOI 1);'.:1.:> ..,
... ...
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Adlll.lmnn'llo, "Am' (laid IIV ,"IlA' .... AdvAltr,1I ^"""lmlllllllof IllImt rlllld by ",11M In AIt'llIl\(lI
IfIllC1tylh,..,II. '" .""CII,Il""",I,," '"
III Cnl...tyl.. 06/19/96<, 'I' 156.n t\HCOI""ytu 06/19/9""'12fJ 1196 I'. ,l1
IIlIA"."-'1 .. 4nAAnlluINlfllt '"
.. ~ch"1 06D9/9","06TJO/9' U,II9 ..,. School 06/19/96<, ,.. 22,89
II. :,ewer: ~l)OI 6 mo. end 6/l J.b' 41ft Sewor: ~601 6 mo. end 6fJ " J.65
'" ...
'"~ ..,
'" 011011 AUOUHt DUI '"0'" lonAQwlR 76508. )1 "0 anon ......OUNT DUI 10 IILUA 75182.81
lOll AMOUN1I PA'D" OR IN IEIlALF 0' 10RnOWIR !oI!II nlOUClIOHS III ."OUH1 OUll0 UUEA
"' 0'00'11 01 .,m.sl money 10JO,OO SOl E_cnn dllDOSlI I..' 1f1ll,ucllOn'l ,UU
"" flfinClp.IAmOllnl at n.w lnllnt" ~, 511\11.,.,.,,1 (hllotl 10 tln., (Ilnl 14001 "u
PO' Ed.lluQ 1Oan(.) ,""'" sub,tl:l'O 'IU E1ltUl'O to""l') liken ,ubjtcllO
... 104 Pllyoll 01 Fif'l "'OflgIlO' loan
lIards Savlngs Bank J882,24
... Sot rayol! 01 Stcond "'ollo.gltoan
'" ...
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"" ...
... ...
^dl'''lm,"l'' 10f tltln. unpaid by ..nil' ^dru.lmflfll.IOl' Ilem. unPlid by tllhll
""Cltyn~l.. '" IlllCllyna_IU ..
'11 Ctlunl.,lu .. "I County I.. ..
,,,A,,"n_" .. '''A....'"''"U '"
'" School .. '" Schoo' '"
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'PO 'au\. PAID 1'I'I,on lannoweR 1000.00 "" 'aT At RIDUClION AM aU"' DUI In\.lR 5682, H
30lI CAlli AT IUTUMINT ,nOM on '0 10nnOWlR lllllI CUlt AT ,,"\.III'N' ,oon 'ROM lULU
"'I O'OU ",nnunI dlHlllOn1 bOfIOWl1 (IIn. 120) 76500,JI 101 Olon amounl du. 10 unll (IInl "201 7518L81
"', ta.. amounl pIlkl brllOf hOlIOWI' (IInl 220. 100U. UU Mltl" IldOCllon amounl OOt "nil (lint 5(0) 5682.74
..., CAS II 100 FnOIl) III TO) oon~OWEn 75508,)1 ..., CASIlIOQ TOI II I FnOIl) SELLEn 69500.07
...}'~ 0 .(J Q(...J /I'h.' JI.... ;f, ,0. II ,: U... ',i(iA../.~~JJ;{
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'UNUI Af 'UNO''''
n""'.lIlofl;or'wnt"w"'tMn. 'lllll..'"...,....' 'l'oE.lI $.00 =~ tI"l,M'NI
I.. I .n ' ~:
ID, 1 On
,., ConllnlUton PI"' ,. S.III,,",," I
I.. 'I
lIOO ""'1 ,AUIU IN COIINICTlO" ""II LOAN
101 lCtJlnO'IQ",lIonr.. "
1101 to."OltcolIlIl "
11)) App,el'" r.,10
." C'ldll ",pori 10
... lend.,. "",..ICllOOr..
... MOfIU.gll In,Of_lCe Appllclllnfl,..ln
OJ' Auurnrllmf..
OM
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'"
mill'" "IOUUIlD" LINOln 10 II 'AlPIN AOYAlle'
101 Inl",,,,,,,," 0;/19/96 1006/ ]0/9, 01 Id..,
tol MOItOIOllnlllfltFtCf P,.."1Om 10' mn '0
to) Ihn.rd InlUlaN:f f',.",1Um '01 ,.. '0
"'. y"lfJ
"'.
tI)O "nlny., 01'011110 WIlI'UNDEA ron
001 'IAUld "'tOlfnCl mn 01 '''0 ~~t..~'K"~
001 Mmlglo.I"llllIOC' mo 01 "00 }'fjlj' .
001 Cltyllnwn I'. mn 01 ~M !'l,-:'
004 Counly I.. mo 01 24.44 'M , ~
005 ^U..lfflen'l mn 01 ~,oo i+A'
. ,
00ll mo os 6],41 "00 I..
.., mo 01 ..oo fl:-n
';!;\
00ll mo 01 'M )~1; . . iIi ~
100 1I111 CHAROU
10 I SaUIMnenl or ck)lln", I.. In
101 ^h"UI(lorllll....,ch '0
10' rlU. ...mln.hon '0
,.. lill.ln,urlne. blnd.r '0
10' Oocumenl p,.p.r.llOn '0
,.. NoI,'yl... '0
'" ^"orn.y'.,.., '0 II.O.C.
1_Ir.k",.. allOY' tten., No I Doell prellaration ~l'"~'}~t.~-~t>rn.;~1~tltlc:_~i-m~i;~ .
,.. IIlt.llI,mAlle. 10 ^GourOll Lnnd 'l'rnnolero -
lindud., ,bov. i1M1' No I 1102 110] 1104 1100
lot l.nd,,., coy'"",' ,
110 OW".". COY"'",' S 75,000
III.D1Bb fee Assured Land Transters ] .00
III tOea t;X t"ee J\SDuroCJ Lanu Trans[ers 1 15.50
'" 1
100 aavlAH...", AlCORDINO AND 'RAHUU CHARon
0'01 R.cordinO I...: Cud S lJ,OO Morlglg. I Mile S lJ,OO
2'01 Cily/counly 1.!l./tlampl. a..dS 750. OQMnllg.o. S 50,00
20' SIII'lu/,lemp, D..d S 750. OOMOf.gao. S 750,00
...
...
lOO ADDitiONAL nnL""I'" CItA"OU
lOI SUI"'" '0
lO, r..llnlp.etlOn '0
lOJ
lO'
lO.
... 10'AlIl1TlI"lN' CIlAnOl' lllNOf onllnel IOJ .nd 501, 5ec1lon1J~dJtI lJ25,50 000,50
,....... .0'......,,........,.. ..--.."r..--"IMI..._ue....'.._._...._... .._... ..-.-.......,1110-1 ..........11"'--... ____ II..... ......,...,........
,._.......................,._..~...I..__~...........H.........-...ltlt.'_..,.fIo_........""............._.....W.................___.....-..
...,......._..................._HI...
HUO CInTlPICATlON 0' IUnnl AND IILLlRI
Ih...clI.luIy".....d hllUO.1 s..~ 51"""" and II) lheh..tof""~IlV-1M b...,," II .If\HI .nd .cCUlIII. '11'_' olllllCelolllltd dltburllfNfll.
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1...11I.).I.~-yf'IIl~...."........_........,I'_...H.........IIloIiI"_KIIiM 1"-....- ....._............H...........t1t...___.....
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..............~-.......4.~~;J...~-"',..,_. ~_ltel.,...~
ExhIbIt E
t""'\
f"",
Bernice H. Daley
303 North 23rd SlTeet
Camp Hill PA 17011
Page 10(3
AIITOMOBIT.E
1994 Subanl ImpreZ3, 4 door sedan. 5 speed manual w/19,500 miles
VIN JFlGC2243RB535249
HOl'i1E
Small wood/aluminum ranch, 3 bedrooms, I bath, kitchen, dining
rootIl, living room, 1/2 basement, semi-attached 2 C3l' garage
S 8.675,00
575.000,00
" MAIN BEDROOM 5 70,75
1 full size bed S 15,00
1 dresser S 25.00
2 night stand S 16.00
1 small chair S 3.00
2 small table lamps S 2.00
1 large table lamp S 2.50
I clock radio S 1.50
I telephone S ,75
mise, cologne and cosmetics S 0
misc, cosrume jewelry S 5,00
misc, clothing in drawers (see note I) S 0
misc, clothing in closet (see note 1) S 0
misc, shoes (see note I)
SMALL BEDROOM 1 5 32.00
I twin bed S 10.00
I dresser S 15,00
1 night stand S 5,00
2 small table lamps S 2,00
mise. clothing in drawers (see note I) S 0
misc clothing in closet (see note I) S 0
SMALL BEDROOM #2 5 32.00
1 twin bed S 10.00
I dresser S 15,00
I night stand S 5,00
2 small table lamps S '!,OO
11
r-.,
Bernice H. Dnley
303 North 23rd Street
Camp Hili PA 17011
Page 2 of3
BATHROOM
I scale
misc. towels and wash cloths
mise, medicnl supplies
mise, bathroom supplies
mise, personnl cnre items
mise, cosmetics
s 32,511
S 2,50
S 10,00
S 12,50
S 7.50
S 0
S 0
S 73,50
S 25.00
S 4,50
S 4.50
S 1.00
S 2,00
S 8.50
S 7.00
S 4.00
S 4.50
S 2,50
S 10.00
S 0
S 101.00
S 30,00
S 32,00
S 25.00
S 10,00
S 4,00
S 192.25
S 15,00
S 7.00
S 5,00
S 15.00
S 10,00
S 35,00
S 9.00
S 15,00
S 20,00
S 4,00
S 3,00
KITCHEN
I refrigerator
I coffee maker
1 full size mixer
1 hand mixer
I pressure cooker
I table
2 chairs
1 portable radio
I telephone
I lonster
misc. small hand tools
mise, food items (see note 2)
DINING ROOM
I table
4 chairs
I buffet
2 decorative ceramic bowls
mise, table cloths
LMNG ROOM
I couch
I chair. cloth rocker
I chair
3 end tables
I smnll coffee table
I 19" color television
I small television stand
3 table lamps
I wall clock
1 plastic wall plaque set
I foot stool
.,.-.,.,
t".
D
Dauphin Deposit Bank
and Trust Company
MAIN OFFICE: 213 MARKET STREET. HARRISBURG, PENNSYLVANIA 17101
"7 2~S.2'21
Decedent Confirmation
Name:
Bernice H, Daley
Social Security No.: 202-20-6483
Date of Death (000): 02/20/96
Account No. 4301720750047244
Type Charge Card
Date Opened
or Issued 07/31/85
Date Closed
or Matured 02/29/96 (Closed)
Date of Death
Sa 1 ance -0-
PLUS
Date of Death
Accrued Int. -0-
Joi nt OIiners
(;f !I/lY) None
Date of Joint
OIinership
0027126099
01301301
Checkin9
Safe Ceposi t Box
06/01/78
09/13/68
$2,539.80
Not Aoplicable
Location:
$1,16
West Shore Plaza Office
None
None
Special Comments: N/A
Additional infannation availabl. at $20,00 per hour. One hour .1ni.U8.
Date Prepared: March 15. 1996 Prepared by: Carolyn A. 8erkebile
QJstaner M!I/lagement Infonnat ion Cept. (CMI)
Telephone No. (717) 255-2054
Page 1 of 1
fora 00-020-218 (REV 7/93)
ExhIbIt H
o
a
....'-:....
Ii J:..\Y."!.~"'~'m,....""",,---,
.,;..' ,.
t'"'\ (",
10 HARRIS!"
Dl SAVINGS BANK
235 :-lorth Second Street
P,O, Box 17\1
Harrisburg, Pennsylvania 17105-1 ill
717/236-1041
July 15, 1996
Elizabeth S. Eck
Paralegal
P.O. Box 1268
Harrisburg PA 17108-1268
RE:
Estate of Bernice H.
SSN 202-20-6483
Loan Account Number
property Location
Daley
1051001055
303 N 23rd St
Camp Hill PA 17011
Dear Ms. Eck:
Please find enclosed the information you requested on the estate of
Bernice H. Daley. Ms. Daley currently holds a mortgage loan on the
above referenced property. The account was established January 31,
1995. The principal at the time of death, February 20, 1996, was
$4,167.93. The account shows no change in ownership or
registration since that date.
If you should have any questions, please feel free to contact me at
1_800-554-4572, ext 259.
Sincerely,
!.l',u/J (U,-- &etu1V
Michelle Crouse
Loan customer Service Specialist
Enclosure
J/ II 1" 1oq6
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
E8t81e of
Bernice H, Dolev
No.
1996.0177
0180 known e8 Dale of Deolh Fobruorv 20. 1996
,Deceased Soclel Security No, 202-20.6483
I, Corolvn L. Pollv.
Personal Represent.llvell) of the above Estat., deceased, verify that the Itema .ppeDrlng In the following Inventory Include .11
of the perlonal I.S.t. wherever .Ituate and all a. the tealeatlt8 In tho Commonwealth of Pennsylvania of ,aid Decedent. that
the valuation placed oPpollte each Item of aald Inventory rllpresents Itl fair value .a of the data of the Decedent', death, and
that Decedent owned no real altete outaJda of the Commonwealth 0' Pennsylvania except that which appea,sln . memorandum
It the end of this Inventory. Irw. verify that the statements made In this Inventory ar. true and correct. IMe undl"tand that
f 11.e .memenll herein ere m.de .ubj.ctto the pen.ltI.. 01 18 P., C.S, S.ctlon 4904 r.l.tlng 10 un.worn lel,llIcetlon 10
euthorltle.,
Pellonal Representative:
Name of
Attorney:
Rontlld M. Klltzmnn ESQuire
Name:
C.!uolvn L. Polly Administratrix
I,D. No.:
07198
Slgnetu,e:1 (. )~_..~:~ _~ iJtA.Lr-
O.ted: ..11--1/ y y
Add"..:
320 Market Stnter. Post DUlce Box 1268
HarrisburD. fA 17108.1268
Telephone: 17171234-4181
Description
Veluo
75,000.00
727.40
8,875,00
2,539,80
1,16
pc: 99,00
1:04,26 - . :;1
,59.30
7jO.OO
265.16
"
1, Reel eslele loceled el 303 North 23rd Streel, Cemp Hili, PA
2, Per.onel property loceled el decedenl'. residence
3, 1994 Suberu Impreze, 4.door seden
4. Deuphln Deposit Benk checking eccounl #0027126099
Accrued Inlerest
5, Inlernel Revenue Service.. 1995 lex refund
6, Commonweellh of Pennsylvonle .. 1995 property lex rebele
7. One (1) U,S, Seving. Bond, Series EE, solely owned
6, Two (21 U.S, Sevlng. Bond., Serle. EE, jointly owned
9, Refunds for homeowner's Insurence, rest eslala Ie xes & sawer ch.rges
IAuech Additional Sheel. If necessary)
Tolel: . 87,521.08
NOTE: The Mlmot.ndum of ".1 IIt.I. out,lde thl Commonwealth of PIMlytV.nll m.y, It thl el.ctlon of thl plrsonal "",..,ntlllve, Include
the ".Iue of Itch Itlm, but luch flgut.. should not b, 'lltendld Into thl 10t,1 01 the Invlntory.
.
~J "
LAW O"IC..
GOLDDERO, KATZMAN & SlUI'MAN. P,C,
ROHAU) M. KATJIoIA.N
HAM' a. OOLDIlAU
r, LIE IHII'MAH
,AlL J. EIPO~TO
felL ICMXAIHOT
J. JAY COOPaI
THOMA' C. IROKR
DAVID C. MILLtR
~ A. ITATLDI
APRIL L. t"IANO.KU'AY
OUT H. IROOKI
.D"ERION J. SHIPMAN
ARNOLD e. KOGAN
JERRY J. RUlao
KA~ S. rt'UCHTtfetRQ[R
MCHAa. J. CItOCEHZI
EVAN J. KLIC. ..
DREW P. CIAht<<)N
DUO MARKaT PlTHBaT
ft'TRAWhIlRHY AQUAB.
P.O, bOX UUIR
IIARB.AnURO. raNNIIYLVAHIA nlOO'luon
Tlu.IIPJlONII(717) UD4'4UU
PAX (711) U04'0000
"RT""" L. GOLDI(AQ
or C~HL
TOAK Of"ICE:
110 t MAAKU STRttT
YORK. PI.. 1740.
17171 84,J'7811
November 7, J996
CARLISLE OfrlC[:
53 WElT POMrRtT ITRUT
CAAlIlI.[. PA. 17013
17171245.0507
t€R~[Y orrlCt:
825 FISHBURN ROAD
P. O. BOX DD!!
!CAtHeY, Po\.17033
17171 a:13.4040
Mary C, Lewis, Register of Wills
Cumberland County Courthouse
I Courthouse Square
Carlisle, PA 17013
ICORREIPOf<<) TO
HARItIS8UAQ OfFICE'
Re: Estate of Bernice H. Daley, deceased
No. 1996-00J77
Dear Ms, Lewis:
Enclosed please fmd an original and one copy ofa Pennsylvania Inheritance Tax Return for
the referenced decedent. An estate check in the amount of$20.13 is also enclosed to cover additional
tax due the Commonwealth,
Also enclosed for filing is an original and one copy of an Inventory.
To indicate your receipt of these documents, kindly fOlWard a time-stamped copy of this letter
along wilh a receipt for the tax payment to me in the envelope which I have provided.
Should you have any questions, or need any additional infonnation, "lease do not hesitale to
contact me, or Ronald M, Katzman, Esquire. counsel to the estate. p ('l cC> :~ iR
,,,
Very truly yours,
(~l
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6.
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Elizabeth S, Eck
Paralegal
lese
Enclosures
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LAW OPPless
GOLDBBRG. KATZMAN & SHIPMAN. P,C,
ARTHUR L. Q()U)8tRQ
or cw.1tL
RONALD M. KAllMAN
...... I. QOO.OIKIOO
" Lm SHlPM.....
p"I.A. ,J. [.,oIlTO
NtIL ICI<IlVlIHOT
J. JAY cooPtR
.-.tc. -"
DAVID C. MILLtA
.JCItfrI A.STATLER
APRIL L "RANO.KUlA"
GUT H. 1A00K1
.JU'tAION J.IHIPMA"
.......... I, KOOAN
JtRRY J. RUllO
K..... t. 'WCHT......otA
J4QtAD. ,J. CROCDi%1
tvAH J. KLt't. II
DRew P. QANrfON
DUO MAR.aT RTRaBT
8TRAwnaRRT SQUARS
P.O. BOX tgco
IIARRI8DUBO. PBNN8TLVANIA ITIOO.IUno
TBLBPJlotnC (7l1) U04.4ItU
PAX (717) U04,000D
CARLlILI: orret
83 WUT po",rAtT .tRtET
CARI.ISLt. PA. 17Ot3
17171 24&.0507
YORK Of'rlCt,
110 t. MARKET ITRUT
yORK. PA. 1740.
17111114'.1011
November 13,1996
HtRIHt't err,,!::
BID 'I~URN ROAD
P.O BOlt: aeD
HERSHeY. PI.. 11033
17171833.4040
ICORReSPOND TO
HARRISBURG o"ICCI
Office of the Register ofWil1s
Attn: Cheryl
Cumberland County Courthouse
I Courthouse Square
Carlisle, PA 17013
Re: Estate of Bemlce H. Daley, deceased
No. 1996-00177
Dear Cheryl:
Pursuant to your telephone conversation wilh Attorney Katzman's secretary on November
12,1996, enclosed please find our check in the amounl of$25,OO to cover filing and invenlory fees.
I apologize for the inconvenience this may have caused your office,
Should you have any questions, or need any additional information, please do not hesitate to
contact me.
Very lruly yours,
i
tlL
!
/1, . '
I. CU) I...i;.ttJ 1
Elizabeth S, Eck
Paralegal
J.
lese
Enclosure
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RECEIVED FROM.
D
ACN
ASSESSMENT P:I
CONTROL ~
NUMBER
AMOUNT
RONALD M KATZMAN ESQUIRE
Ivl
.e:::u. 1;.:1
POBOX le6B
HARRISBURG, PA
1710B-U!69
ESTATE INFORMATION,
EJ I N MIER
el-1996-0177
!I NAME Of DECEDENT (lAST)
1;1 DALEY BERNICE H
I DATE Of PAY NT
B fOSTMARK DATE
CO NTY
SSN 202-20-6493
(FIRST) IMI)
CUMBERLAND
DATE 0 DEATH
:
,
REGISTER OF WilLS
m TOTAL AMOUNT PAID .eo. 13
", cw
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I. (I I .' " . '
RECEIVED BY, /11;, II. / ( f.:./ JU.~/) tJ.~..'.4
" .. //SlGNATU.J,. . :.'
MARY C. LEW:rS '//iU'A) j)/. ,y...;
REGISTER OF WILLS U>
REMARKS
CAROLYN L POLLY
C/O RONALD M KATZMAN ESQUIRE
CHECK" 122
SEAL
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BUREAU Of INDIVIDUAL TAXES
INHlI.TAHC( 'AX DIVISION
DlPT.I'I""
HAARlllURG, PA 1'.'..0'01
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
*'
NOTICE Of INHERITANCE TAX ~
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
In.la4r II U'll..."
RONALD H KATZHAN
320 MARKET ST
PO BOX 126B
HBG
DAT!
!STAT! OF
DAT! OF DEATH
FILE NUHB!R
COUNTY
ACN
02-25-97
DALEY
02-20-96
21 96-0177
CUHBERLAND
101
AIoount R..1t t.d
BERNICE
H
PA 17108
HAKE CHECK PAYABLE AND REHIT PAYHENT,TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'v:is4j-Eic-Aj:p"(i'F96T"iioi"icEuOF-YNHERiiiiN'CE-i"AX-A-PPR'AisEifiiij-'--ALLoiiAiicE-iili---_u---um_--
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF DALEY BERNICE H FILE NO. 21 96-0177 ACN 101 DATE 02-25-97
TAX RETURN WAS I I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, Rul Eat.t. CSchaduI. Al
2. stock. _ _. ISchoduI. BI
5, Clo..ly Kald Stock/P.rtnerahlp Int.r..t ISchodul. CI
..., Korlg_.lNot.. Rae.habl. ISchadul. 01
5, CaohlBank Dopa.lt.lNl.o, P.r.anaI Property ISchoduI. EI
6, Jointly _ Property ISchaduI. FI
7, Tran.f.r. ISchaduI. 01
I, Tot.l A...t.
I I CHANOED
75.000,00
59.30
,DO
,00
12.411.78
50,00
,DO
III
HOTEl To lnaur. proper
creel! t to your eccount,
.ubIolt tho uppar portion
of thl. for. with your
tax paYl*'tt.
III
121
151
141
151
C61
171
87 . 521. 08
APPROVED DEDUCTIONS AND EXEHPTIONS:
8,517,60
9, F..,.r.I E_.../A... Co.hllllac. Expan... ISchodul. HI 191
10. IlebhlHortg_ LlabUltI../LI.n. CSchaduI. II 1101 12.001,34
11, Totol Deduction. 1111 ;In. ~I R Q4
12, Kat V.l... of Tax R.tum 1121 67,002.14
15, CI\IIrltlObl./Oov.r...antol B.qu..h ISchodul. JI IISI' DO
14, N.t V.I... of Eatot. SUbjaet to T.. 1141 67.002,14
NOTE: If an ass.ss.ent was issued previously, lines 14, IS and lor 16, 17 and 18 will
rwflsct figures that includa ths total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15, A>>ount of Line 14 .t Spou..I r.t. 1151
16. A>>ount of Line 14 t..abI. .t Llne.I/CI... A r.t. CI61
17. A>>ount of Line 14 taxabl. .t Coll.t.r.l/CI... a r.t. 1171
11. Principal Tax Ilua
,00 X ,00.
67.002,14 x,06.
.00 X ,15.
1111
,00
4.020,13
,00
4,020.13
TAX CREDITS:
PAYHENT
DATE
05-17-96
11-08-96
DISCOUNT Ctl
INTEREST I-I
200,00
,00
RECEIPT
NUllBER
AA1l2859
AA146934
AI10UNT PAID
3,800,00
20.13
TOTAL TAX CREDIT
BALANCE OF TAX DUt
INTEREST AND PEN.
TOTAL DUE
4.020,13
.00
,00
,00
. IF PAlO AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS THAN .1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRI. YDU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS.I
RESERVATION I
PIJRPClU 01'
teTlCEI
PAYHEN'TI
REf\III (CA) I
OUCTlONSI
alliUM
ISTllATlVE
CORRECTIONSI
DISCDtIfTI
POIAlTY.
INTERUTI
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In pa.....lon or enJoVNftt to Cle.. I (ooU.t.r.U benlflcl.rI.. of the _edent .fter tM .xp!rIUun-:f IrtY .it~ for
11'. or far VI.n, the C~.lth hereby .xpr...lv re.erve. the right to .",,11. Wtd ...... tr,,".r Inhlrltenc. T....
.t the lewful CI... I (coll.t.r.l) r.t. on MY IUCh future Int.r..t.
To 'ulfll1 the r~lreeent. of Section 1140 of the Inhlrltenc. end E.t.t. TIX Act, Act 21 of 1"1. 7Z P.S.
SecUon 2140.
OItKh the top porUon 0' thl' MoUc. Wtd .ubl1t ..Ith your P'YMnt to the Reght" of WUlI printed on the revar.. llde.
....... check or -v order payable tal REGISTER OF MILLS, AGEHT
All p.~t. rKIII"... shill flr.t be .,,111C1 to IIftV Int.r..t tlhlch ..v be ..... with MV r_Indlr 1IPP11ed to the tax.
A r.h.nI of . tax credit, Nhlch .... not reque.ted on the TIX Altum, ..v be reque,tld bv CQIlPI.UntI ., '"Appl1c.Uon
for Rlh.nI of Plnnnlv."l. Inhlrlt.-.cl IInd E.t.t. TIX'" (REV-1S1S). Appl1c.Uon, .r. InUIbI. .t the Office
of the .....t.r of WUh, ."v 0' the n R""",,, O..trlct Offlc.., or bv cellini the epeel.1 24-hour
.""",rl"l ..rvlce ~r' for fo~' orderlngl In penn.vlvanll 1-100":561-2050, out. Ide P,"",vlvenl. end
Idthln lace1 Harrhbur. .r.. nl7J 717-1094, fDO' (717) nz..un (....rlf'lll I..-Ired Only).
IIr1 party In Intlr..t not nthfled ..Ith the ."r.h..."t, .Uonnc:. or dl..Uonnc. of dldUCUon., or ...........t
of tIX (Including discount or Inter..U .. IhoNn on thl. NoUce ...t obJKt ..Ithln ,betv (60) IhlV' of rK.lpt of
thl. NoUce bVI
.....rlUen prot..t to the PA Dlpsrblnt of A."...,., aolrd of AppI''', Dept. ZlI021, Harrlsbur., PA 17111-1021, OR
....IKt1on to hIv. the ..Uer dIIt.ralned .t audit of the KCQU'lt of the perlOMl r.r..ent.U"., OR
...."..1 to the Orphan.' Court.
Feetua1 .rron dltcOYlred on thl, ........"t shoUld be addnuld In ..rlUnt tal PA Depert..,t of Aev"""
lur.-u of Individual T...., ATTNI Po.t A......-nt A."I... unit, Dept. 210601, Harrisburg, PA 17121"0601
Phone (717) 717"6505. III Pili 5 of the bookl.t '"In.tructlon, for Inhlrltenc. Tax A.turn for. A.,ldlnt
~t'" (REV"IS01) for en .xpl.netlon of ~lnl.tr'tl".lv correct.bl. error..
If env tax due II p.ld ..Ithln thr.. (S) C111enct.r aonth. after the decedent" cII.th, . five percent (5%) dllCDU1t of
the t.. peld II .1l(Mfld.
The tsX tax __.tv non-perUclpatlon perwltv I. cDIIPUted on the totll of thII tu end Inter..t ......ed, end not
peld before JInUIrv II, 1996, the first dav .fter the and of the tu .-M.tv period. Thl. non-partlclp.tlon
pene1tv I, .....llbl. In thII .... IIMIr end In the the .... tI.. period II you 1IIOUld .....1 thl tax end Intlr..t
that has been ......ed .. Indlc.ted on thl. notlc..
Intlr..t I, chIIrgld bltlmll'll with first dav of dIIll~v, or nil'll (t) aonth. and ani (1) day frDl the dati of
..th, to the At. of PQIInt. Texll Nhlch bIaII dIIllnquent before Januarv 1, nlZ bI,r Inter..t .t the r.tI of
,be (6Xl parc.,t per '""'" c.lcul,ted .t . Ihllh nt. of .000164. All tex.. which bIaII delinquent on end .ftlr
Januarv 1, 1911 ..Ill belr Int.r..t .t . r.t. which ..Ill ".rv froe c.lendar v..r to c.l~r v..r ..Ith that r.t.
lnnQUftCed by the PA o.p.rt-.nt of A."enue. The ~llclbl. Int.r..t r.t.. 'or I'IZ through 1"7 .r'l
'!!!t Int.r..t A.t. a.lly Int.r..t Fector !!!!' Inter..t A,t. O.lly lnt.r..t Fector
I'll 21Z .000$041 19.7 91 .OOOZ47
1913 16% .000431 1'''-1''1 IIX .000SOI
1'" IIX . UOSDl 1"2 91 .0DOZ47
ItlS I~ .DOOSS6 I "s-I994 7X .000192
1916 lOX .UU74 1"5-1"7 91 .0UZ47
".Int.r..t I. calcul.tld .. followlI
IKTEREBT . BALAKCE OF TAX UNPAID X KUKBER OF DAYS DELI"qUEHT X DAILY IKTEREBT FACTOR
....My MoUce blUlCl .fter the t.. bee... dellncp.Mnt ..UI r.flect ., Inter..t calculation to flft.... US) dlv'
beyond the date of thII .........,t. If plYM"t II AdI after thl Inter..t cu.putatlon dlt. IhoWI on thII
MoUe., IddltlDMI Inter..t ...t be calcullt".
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STATUS REPORT UNDER RUI.E 6.12
Name of Decedent:
BERNICE H. DALEY
Date of Death:
February 20. 1996
Will No.
Admin,
1996-00177
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules. I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2, If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes. state the following:
a,
Did the personal representative file a fmal account with the Court?
Yes No X
b.
The separate Orphans' Court No. (if any) for the personal
representative I s account is:
c,
Did the personal representative state an account informally to the parties
in interest?
Yes X No
d,
Copies of receipts, releases, joinders and approvals of formal or
infonnation accounts may be filed with the Clerk of the Orphans I Court
and may be attached to this report,
Date: J.,JJf,cn
t2_~+1
Sign3'ture
CXl 't:<(
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Ronald M, Katzman. E.~Q.
Goldber~, Katzman & Shipman. P.C.
320 Market Street. P.O. Box 1268
Harrisbur~. PA 17108-1268
(717) 234-4161
Personal Representative
X Counsel for personal representative
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