HomeMy WebLinkAbout96-00190
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I)ETITION .'OR PROBATE and GRANT OF LETTERS
E~/Ull' uf L-.......CD...LW, 0~r No. 21-/QQll-/QO
aim kllulI'lI as;;l To:
._--- Regi'ler of Will, for Ih~
. J)l'<,ca,<c'd. County of C,,_r.>LI11"".l in the
Sudal Srl'llri(v Nu, _\~U -l (!, 7J '/ Commollweallh of I'enll,ylvania
The pelilion of Ihe under,iglled re'peetfully repre,elll' that:
Your pelitionert'), \lho i,/are IN year> of age or older all the execuL,-; .
in Ihe la'l will of the above decl'delll. daled _ or v "" \ t,
and codicil(,) daled -
named
, 19~
Nillt' rde\anl drClllml,,"!:C", e.i%. wllll1dalion, lI~'.lIh of C\C(lIlor. CIe.)
DecendcllI wa' dlllniciled al death in C. .........'y.;,.,..,\ ~_ Counly, Pennsylvania, wilh
h i ~ la,t family or principal rrlenee at 3 ~ A 1/,
~.:.4~_..sat"'-""l4J~~' $" Iifi-Llld,./'/.-
,- U - (11\1 ,net,'!, number ;md mundpalil)1
,19 q fr.
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Deccndent. Ih141 ' years of age. died
I' ' " - ) I'
al___,,<"-<).f' ..e _' 'I.'
Except as follow', decedcnt di nolmnrry, wa' not l)ivo ced and did not have a child born or adopted
after e\ccution of the will offered for probale; wa' 1I01lhe viclim of a killing and was never adjudicated
in~ol11p~tcnt: fVCl'^.~
Deeendent at death owned property wilh e'limated value, as follow':
(If domiciled ill I'a.) All persollal property
(If 1101 domiciled in I'a.) Personal property inl'enn,ylvallia
(II' 1101 domiciled in I'u.l Personal property in Coullty
Vnlue of real ~\HlIC in Pcnns)'I\'ania
silllalcd as follows:
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$
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reque'tt'l the probate of the last will and eodieil(s)
1<.;I~' '.M <>..-1- ^ /'~
t1l:'lilI11Clll;U~'; ill.hllini\ItJlion.;~ .il.; 1Il1minimation d.b,n.c.l.a.}
WHEREHIRE, pelilioner(,) re,pectfully
pre,emed herewith alld the gram of ICllers
Iheron.
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OATH 01<' PERSONAL REPRESENTATIVE
COMMONWEAI.TH OF ~rSYI.V ANIA
COlJl'lT\' OF C _, " l.....a
} 88
The pctiliuner(sl abovc-named ,weart') or affirm(') Ih"llhe 'talemelll' in Ihe foregoing petition are
truc "nd cunecllolhc hcst uf thc hr,uwlcdge and hclief of petitioner(s) lllld thai a' personal represen.
Iativc(q of Ihe .Ihmc dccedllll peliliuner(,) "ill \lc~lnd truly adminisler the e,late according to law.
S\\llIn hI UI "I firmed ami Sl,I',crihed 1'~~~~
hefore mc Ihis _ _2.9,t.!L.____ da) of I ~'
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No. 2./- 19q~ - /qO
Estate of I.EROY W. BEAll
. Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH 1, 1996 19_, in consideration of the petition on
the reverse side hereof, satlsfaclory proof having bcen prescnted before me,
IT IS DECREED thai the Instrumenl(s) dated JUNE 13. 1983
described therein be admilled 10 probate and filcd of record as the last will of
LEROY W. BEAR
TESTAMENTARY
ELIZABETH ANNE BEAR
and lellers
are hereby granted 10
MARY
FEES
Probate, lellers, Etc. ..,.,..., S 40.00
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Rmunclallon ,.....,.......'. S .
JCP S 5.00
TOTAl_ S 84.00
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ATTORNEY (Sup. CI. 1.0. No.)
'"2.. 1- :s;. JlI. R-~-Y- SI":-
I-h..or(\., ~~~ESK"
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PHONE
LETTERS AND ORDER WERE MAILED TO THE ATTORNEY
MARCH 4. 1996.
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WARNING: Ills 1lI0go1 10 dupllcato this copy b)' photoslal or photograph.
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JAtl. t 8 1996
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3341624
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COMMONWEALTH 0' P(HHSYLVANIA. DEPARTMENT 0' HEALTH. vITAL RECORDS
CERTIFICATE OF DEATH
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I, LEROY W, BEAR, of South Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my last will and
testament, hereby expressly revoking all wills and codicils heretofore
made by me.
1. I authorize and empower my executrix to sell any realty
owned by me at my death, at either public or private sale, and to
give good and sufficient deeds therefor, in fee simple, as I could do
if living, My executrix is authorized and empowered to continue to
engage in any business in which I may be engaged at my death for such
period as seems expedient to said executrix,
2. I devise and bequeath all of my estate of every nature and
wherever situate to my wife, Elizabeth Anne Bear, providing she shall
survive me by sixty days.
3. Should the gift in Paragraph No. 2 not take effect, I devise
and bequeath all of my estate of every nature and wherever situate to
my children, share and share alike, the child or children of any
deceased child taking the share their parent would have taken if
living.
4, Should any child be under the age of twenty-one years at my
death, then all of my property given in Paragraph No. 3 shall be held
in trust by CCNB Bank, N.A., of the Borough of New Cumberland,
Pennsylvania. The trustee, as well as my executrix, is hereby
authorized to retain unconverted, any property, real or personal, that
I may own at my death and shall be under no duty to convert the same
into legal investments. The trustee shall have the power and authority
to hold, manage, invest and reinvest and to pay over the net income of
the trust property to or for the use and benefit of such of my children
.
,
as may bc under the age of twenty-one years, or to accumulate the same
in the sole discretion of the trustee. The trustee shall be under no
duty to distribute or use the income equally for each of my children
under twenty-one years, but may distribute or use it unequally in its
discretion, The trustee is also authorized and empowered to pay over
to or for the use and benefit of, any of my children whether under or
over twenty-one years, such portion of or all of the principal of the
trust estate as in its sole discretion seems proper, for the maintenanc~
education or setting up of a child in business or in a profession or
for similar purposes. The trustee shall be under no duty to distribute
or use the principal equally for each of my children, but may distribut
or use principal unequally in its discretion. My primary object is
the support, maintenance and education of such children as may be
under twenty-one years, When the youngest of my children reaches the
age of twenty-one years, then whatever remains of income or principal
of the trust estate shall be distributed equally to my children, share
and share alike, the child or children of any deceased child taking
the share their parent would have taken if living and subject to the
same trust provisions if he, she or they are under twenty-one years
of age.
5. I nominate and appoint Elizabeth Anne Bear to be the executri
of this my last will and testament; she is to serve as such without
bond. Should she die before my death, renounce or refuse to serve for
any reason or die leaving any of my estate unadministered, my eldest
child being under the age of eighteen years, I nominate and appoint
Harry W. Bear and Geraldine K, Bear, as substitute executors with the
same powers as are given herein to my executrix and also without the
-2-
filing of any bond. If, however, at my death, any child of mine is
eighteen years or older, such child or children shall be the substitute
executor or executors of this my last will and testament, also to serve
as such without bond, with the same powers as are given herein to my
executrix.
6. Should the gift in Paragraph No. 3 take effect, I hereby
direct that Harry W, Bear and Geraldine K, Bear, shall be the guardians
of the person of any of my children who shall be under the age of
eighteen years at my death,
7. I hereby suggest that my personal representative retain the
services of Irwin, Irwin & Irwin as attorneys in the settlement of my
estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
r3 r: day of June, 1983.
I~ltt U 8.;.(V'j/
LE Y W. BEAR
(SEAL)
Signed, sealed, published and declared by Leroy W. Bear, the
testator above named, as and for his last will and testament, in the
presence of us, who at his request, in his presence and in the presence
of each other have subscribed our names as witnesses hereto.
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ACKNOWLEDGEMENT AND AFFIDAVIT
We,
LEROY W, BEAR
, BETZI At MORRISON
,
and
SHARON L. SCHWALM
, the testator 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 testator signed and executed the instrument
as his Last Will and that he had signed willingly. and that he
executed it ashis free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and
hearing of the testator ,signed the Will as a witness and that
to the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence,
~'l?4-(~( 1-5.~/L/
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, SHARON L. SCHWALM'
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
Subscribed, sworn to and acknowledged before me by
LEROY W. BEAR , the testator ,and subscribed
and sworn to before me by BETZI A. MORRISON . and
SHARON L. SCHWALM
June . 19 83.
, witnesses, this 13 ~ day 0 f
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CERTIFICATION OF NOTICE UNDER RULE 5.6 fa},
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Name of Decedent: Leroy W. Bear
Date of Death: 01/15/96
Will No. 190 of 1996
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Admin. No.
To the Register:
I 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
06/07/96
Name Address
Elizabeth Anne Bear 302 RAyman Ave., Boiling Springs, PA 17007
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: 06/07/96
.~~
Signat e
Name John B. Mancke, Esq.
Address
2233 N. Front St.
Harrisburg, PA 17110
Telephone(71~ 234-7051
Capacity:
Personal Representative
x
Counsel for personal
representative
/5-'b<{-/I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
.OR OATIS O' DIATlt Ama 12/31/91 CHICK HIU
If A SPOUSAL
POVlRTV CRIDIT IS CLAIMID 0
fILl HUM"R
21 96 190
COUNTY CODE YEAR NUMBER
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l!Y.!500 fX. 111.911
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COMMONWlAlTH OF PlHNSYLYAHIA
DfPAITMlNT 0' I'YINUI
DIrT. 210601
HA..ISlu.a,'A 1712..0601
M N Iol.I
Bear, Leroy W.
A
302 Rayman Avenue
A '" Boil ing Springs, PA 17007
02/21/40 Cumberland
o 2. Suppl.m.nlal R.lurn
c...
IX] 1. Original R.lurn
o 4. Umitod Eslat.
o 3. Remainder Return
(la, dOl.. of doath prior 10 12,13-821
o S. F.d.ral E.lal. Tax
R.turn Required
Q.. 8. Total Numb.r af Saf. O.pa.il Ba...
o Aa. future Int.r..t Compromit.
(Iar do'.. af d.alh ah., 12,12,B21
~ 6. olc.d.nt Died T.slall 0 7. Olcedent Maintained a Uving Trult
(AHach copy af WilO I"'Hach cap af Trull)
ALk~1I1CE AND CONflDEN1\AL.TAlCINFORMAt\ON'SHOULDIIE DIRECTIDTO.... ,',!' ;-.Jii':'-(Jt'< J,;(.,:,~~':,,,:;:.';,;;'
AN. ML MAliN A
1. R.al Estal. (Sch.dul. AI ( 1)
2. Stcd<. and Band. (Schodul. B) ( 21
3. Cla..ly H.ld StadclPartnonhlp Inl.,..1 ISchodul. q (3)
4. Martgag.. and Nat.. RKolvabl. (Schodul. 0) ( 4)
5, Ca.h. Bank D.po.ill & Mllctllantou. Ponanal Prap.ny( 5)
(Schodul. E)
6. Jalnlly Ownod P,apony (Sch.dul. F}
7. Trans/on (Schodul. G) (Sch.dulo LI
8. Talal G,all A...II (Iatallln.. 1-7}
9. Fun.ral bpens.., Administratlvl COlts, Miscellaneous ( 9)
Expon... (Sch.dul. HI
10. Dobl.. Mangago Uabllilift, Uon. (Schodul. I)
11. T 0101 O.dudian. (Ialallin.. 9 & 10)
12, N.t Valu. af E.lal. (Iin. B minu.lln. 11)
13. Charitabl. and Gav.rnmental Boqu.." (Sch.dul. JI
14. Not Valuo Sub oct 10 Tax (lin. 12 minu.lin. 13)
IS, Amaunt of Iin. 14 laxabl. at 6% '010
(Indud. valu.. fram Schodul. K a' Schodul. M.)
16. Amount af lin. 14 laxablo at 15% ralo
(Indud. valu.. fram Schodul. K ar Sch.dul. M.)
17. Principal lax duo (Add lax "am IIn. IS and from IIn. 16.1
1 B. Cr.dits Spousal Pov.rty Cr.dit Prior Poym.nh
+ +
19. If Iin. 18 is g..all, Ihan Iin. 17, ont..lh. din...nct an Iin. 19. This i.lh. OVERPAYMENT.
aD..:nr:I.ifUl_I"'~.I'.'""''''I'I~'II.I,....'''IIraI'1~.TJ:'I'1.....L'Ulltl.....I..,I.
John B. Mancke, Esq.
N NUM
234-7051
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A I N M
199-34-9189
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01/15/96
2233 North Front Street
Harrisburg, PA 17110
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500.00
( 6)
(7J
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6,526.94 :i:- ~
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( B)
13,801.25
0
(11)
(12)
(13)
(141
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" .15"
(17J
Discount Inler.lt
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7,026.94
13,801.25
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20. If Iin. 17 I. grtoll, than lin. 18, .nllr Ih. dln...nct an lin. 20. Thl. i. Ih. TAX DUE. (20)
A. Enl.. Ih. in'....t an Ih. balanct duo an Iin. 20A, (20A)
B, En'.. Ih. lalal af lin. 20 and 20A an lin. 20B. Thl. I. Iho BALANCE DUE. (20B)
Mak. Chock Payabl. ,., R.gl.,...f Will., Ag.nl
,'" . ' "'.' ", ..n:suU,to,ANSWKAU:QUISTIONS'ON:UVOSE SlDI'AND toR1CH1C\C MAnt"'-':' .",,: .' i~~ .'.;
Und.. p.nalll.. of porjul)', I doda.. Ihall hav. uamin.d Ihl. r"urn, inciuding accampanying .chodul.. and "allmon", ond 10 Iho b." 01 my knowlodgo and boliof,
II is lru.. corred and comple1e. I dldor. thai all real "tate hal been reponed at true market value. D.daralion of preparer ather than the p'rlanol representativ. is
bosed on al11nformatlan of which preparer has ony kno.ledg..
,I NA NIL I N U AD /' <'" OAT!
.t, ,J;d'/t/!f" ( i!J.....~ I / "~;l. , I 1/1'(',,)... ?J-. C; /97
I ~. . "AN N IV A 2 33 North Front S re o/t(T , '7
~~ Harrisbur , PA 17110 4/29/97
o n B. Manc Esq.
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SCHEDULE F
JOINTLY.OWNED PROPERTY
COMMOHWIAIJH O. PlHHSY\.YANIA
INHlIlTAHClfAl IrTUIN
_UIDIHT DeC1D1NT
I5T ATI 0'
Leroy W. Bear
'Ill NUMBER
21 96 190
Jolnllonanlllll
r4AMI
A. Elizabeth Anne Bear
ADDRESS
302 Raymon Avenue
Boiling Springs, PA 17007
RlLAnONSHIP TO DECEDENT
Wife
B.
C.
Jolntly-awnod p",potty.
LITTER DATE
ITEM FOR TOTAL VALUE DECO'S DOLLAR VALUE OF
NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. A 3/18/69l~~mberS Federal CEedl~6M~i88 4,350.48 50% 2,175.24
I are aVlngs cc. -
2. A 12/30/94 Members Federal Credit Union 419.53 50% 209.76
I Share Savings Acct. 1148432-0
3. A 12/31/7~ Members Federal Credit union 1,479.30 50% 739.65
I Checking Acct. 19683-11 I
4. A 1/6/95 I Members Federal Credit Union 690.28 150% 345.14
Checking Acct. 1148432-11
12/30/9~ Alliance Capital Reserves I
5. I
A 6,114.31 50% 3,057.15
Acct. 13500247042
6. A Property located at 1375 pine 35,000.00 Held with right of
Road, Dickinson Township, PA survivorship
7. A Property located at 302 20,000.00 Held with right of
Rayman Ave., Boiling Springs, PA survivorship
TOTAL (AI.o onlor on IIno 6. RlCOpilularion)
(If more 'pace is needed in,.rt additionol .h..1s of .ame ';18'
S6,526.94
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SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
AMOUNT
COMMOHW!.A.lrH O' 'EHHSYlYANIA
tNHflUfANCe TAl UTUIN
USIDENf DECEDENr
PI.al. Print a, Typ.
1.
2.
3.
8.
I.
Leroy W. Bear
DESCRIPTION
ITEM
NUM8ER
A. Fun.ral Exp.n....
Gibson-Hollinger Funeral Home, Inc.
Cumberland Crossing Retirement community
Shull-Koontz (headstone)
7,283.00
869.40
3,434.00
Admlnlltratlve Calli:
Plnonal Representalive Commissions
Sadal S.cu,ity Numb.. .f po".nal Roprolonlatiyo:
Vlar Commissions paid
2, A"amoy Fe..
3,
4.
C.
1.
2.
3.
4.
S.
6.
7.
8.
2,000.00
Family Exomplian
Claimant Elizabeth Anne Bear Rolation.hip
Address of Claimant at decodont's doath
Wife
Street Address ::\07 R~~n AUI~nl1~
City Boiling Springs Stalo PA
Zip Code
84.00
probate Feo.
Mllc.llaneous Exp.n....
Yellow Breeches Ambulance
130.85
TOTAL (AI.o onlo' on line 9. Rocapitulalian)
(II more .pac. Is ne.d.d, In..rt additional sh..tl al same .1...)
S 13,801.25
...,.lSn u. (1-111
SCHEDULE J
BENEFICIARIES
\
*
(C)MIIIIO"wtAl.tM Of ,....."".......
.......ANCI 'AX..,...
......, --'
FILl NUMB.R
21 96 190
mATI OP
Leroy W. Bear
AMOUNT OR
SHARI OP 1ST loTi
ITIM
NUMB..
NAM. AND ADDRI5S OP BENEFICIARY
RELAnONSHIP
1.
A. To..ble loqvollll
Elizabeth Anne Bear
302 Rayman Avenue., Boiling Springs, PA
Wife
100\
ITIM
NUMBE.
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARI OP ESTATI
I. Ch.ri,.ble .nd o.._m....1 BequollS:
1.
TOTAL CHARITABlE AND GOVERNMENTAL BEQUESTS (Alao onto, .n IIno 13. R_pitul.rion) S
III ..... """CO I. nooclod, In"" .ddltl.nal ,hoots .f samo silO)
i
I
I
f
la$t 1mlill attb: Q} ~ $!anttnt
I, LEROY W. BEAR, of South Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my last will and
testament, hereby expressly revoking all wills and codicils heretofore
made by me.
1. I authorize and empower my executrix to sell any realty
owned by me at my death, at either public or private sale, and to
give good and sufficient deeds therefor, in fee simple, as I could do
if living. ~y executrix is authorized and empowered to continue to
engage in any business in which I may be engaged at my death for such
period as seems expedient to said executrix,
2. I devise and bequeath all of my estate of every nature and
wherever situate to my wife, Elizabeth Anne Bear, providing she shall
survive me by sixty days.
3. Should the gift 1n Paragraph No. 2 not take effect, I devise
and bequeath all of my estate of every nature and wherever situate to
my children, share and share alike, the child or children of any
deceased child taking the share their parent would have taken if
11 ving .
4. Should any child be under the age of twenty-one years at my
death, then all of my property given in Paragraph No.3 shall be held
in trust by CCNB Bank, N,A., of the Borough of New Cumberland,
Pennsylvania. The trustee, as well as my executrix, is hereby
authorized to retain unconverted, any property, real or personal, that
I may own at my death and shall be under no duty to convert the same
into legal investments. The trustee shall have the power and authority
to hold, manage, invest and reinvest and to pay over the net income of
the trust property to or for the use and benefit of such of my children
as may be under the age of twenty-one years, or to accumulate the same
in the sole discretion of the trustee. The trustee shall be under no
duty to distribute or use the income equally for each of my children
under twenty-one years, but ~ay distribute or use it unequally in its
discretion. The trustee is also authorized and empowered to pay over
to or for the use and benefit of, any of my children whether under or
over twenty-one years, such portion of or all of the principal of the
trust estate as in its sole discretion seems proper, for the maintenanc~
education or setting up of a child in business or in a profession or
for similar purposes. The trustee shall be under no duty to distribute
or use the principal equally for each of my children, but may distribut
or use principal unequally in its discretion. My primary object is
the support, maintenance and education of such children as may be
under twenty-one years. When the youngest of my children reaches the
age o~ twenty-one years, then whatever remains of income or prin~ipal
of the trust estate shall be distributed equally to my children, share
and share alike, the child or children of any deceased child taking
the s'hare their parent would have taken if living and subject to the
same trust provisions if he, she or they are under twenty-one years
of age.
5, I nominate and appoint Elizabeth Anne Bear to be the executri
of this my last will and testament; she is to serve as such without
.
bond, Should she die before my death, renounce or refuse to serve for
any reason or die leaving any of my estate unadministered, my eldest
child being under the age of eighteen years, I nominate and appoint
Harry W. Bear and Geraldine K. Bear, as substitute executors with the
same powers as are given herein to my executrix and also without the
-2-
riling or any bond, Ir, however, at ~y death, any child or mine is
eighteen years or older, such child or children shall be the substitute
executor or executors or this my last ~i11 and testament, also to serve
as such without bond. with the same powers as are given herein to my
executrix.
6. Should the girt in Paragraph No. 3 take errect, I hereby
direct that Harry W. Bear and Geraldine K. Bear, shall be the guardians
or the person or any or my children who shall be under the age or
eighteen years at my death.
7. I hereby suggest that my personal representative retain the
services of Irwin, Irwin & Irwin as attorneys in the settlement or my
estate.
3r'
I '
IN WI~ESS Wr~REOF, I have hereunto set my hand and seal this
day or June, 1983.
,
...:
. -.....;./1 ;,,;..
LEOOY
/.,. 8.J-~.-/
'Ii. BEAR
(SEAL)
Signed, sealed, published and declared by Leroy W. Bear, the
testator above named, as and ror his last will and testament, in the
presence or us, who at his request, in his presence and in the presence
or each other have subscribed our names as witnesses hereto.
&%tA.~
>6IA/.J A_~
t'
t./ vJ"ln}A ~
,
-3-
ACKNOWLEDGEMENT AND AFFIDAVIT
We,
LEROY W. BEAR
BETZI A, MORRISON
,
,
and
SHARON L, SCHWALM
, the testator and the witnesses,
respectively, whose names are signed to the foregoing instrument,
being first duly sworn, do hereby deelare to the undersigned
authority that the testator signed and executed the instrument
as his Last Will and that he had signed willingly, and that he
executed it ashis tree and voluntary act for the purposes therein
expressed. and that each of the witnesses. in the presence and
hearing of the testator . signed the Will as a witness and that
to the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
~'~k(BJltv1,/
1.".1:. AR
~~~ '
ell:. . 'l'lOKRD1Qj~
~~~ ~ 0...t~/A/_)
, SHARON L. SCHWALM'
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
.
.
.
.
5S:
:
Subscribed. sworn to and acknowledged before me by
LEROY W. BEAR
. the testator ,and subscribed
and sworn to before me by BETZI A. MORRISON
, and
SHARON L. SCHWALM
. witnesses. this /3 ~ day ot
June
. 19 83.
. (!L?;/S ~
,
.
.
Membersl.
FEDERAL CREDIT UNION
SHARE SAVINGS ACCOUNT:
Account Number/Suffix
Date Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Name of Joint Owner, if any
Date Joint Ownership Created
1
9683 -00
8-18-67
$4.344.61
$5,87
Elizabeth Anne Bear
3-18-69
2
148432 -00
12-30-94
$419.06
$.47
Elizabeth Anne Bear
12-30-94
CHECKING ACCOUNT:
Account Number/Suffix
Date Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Name of Joint Owner, if any
Date Joint Ownership Created
9683 -11
12-31-79
$1.478.09
$1. 21
Elizabeth Anne Bear
12-31-79
148432 -11
1-6-95
$690.28
S.OO
Elizabeth Anne Bear
1-6-9~
I~ESTMENT SAVINGS ACCOUNT:
Account Number/Suffix
Date Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Name of Joint Owner, if any
Date Joint Ownership Created
N/A
N/A
INDIVIDUAL RETIREMENT ACCOUNT:
Account Number/Suffix
Date Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Name of Beneficiary
N/A
N/A
Estate of LEROY W. BEAR
Date of Death 1-15-96
Social Security No. 199-34-9189
2-14-96
Date
Insurance Claims Supervisor
Title
5275 East Trindlc Road . P.O. Box .10 . Mcchanicsburg, Pennsylvania 17055 · a 17) 697-1161
[D: APR 17'96 7:52 No.002 P.02
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SHULL - KOONTZ ~ ~0
130 Ealt Queen 5t, '~~ \) Y I
Chamberlburg, PA 17201 \) \)
phone: 717.26-4.6916 0 /
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,WaRP. 7/1/. ~aJ./ sEJ?P lOP
Monumenl~~,.t,.-1<. J1 . 9 Jt d ~ d fJ IJ 1... 9 ',conlracl Work Per. hr.
:::,~-C;( /-d K IJ-~ fd::: ::=~::::,~$Ji~;:~;
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.ccur.cy 01 the .bov. sp.lllngs .nd d~i;; "lOV.etll L fJ OJ III tJ ,J ~ 0
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o Check How 10 leller Leller Ihls way opposite C,Q Y.. J--
. ~1tl.IJ,lld ('I,f""'l.oa - NO eIlA~~G) 1J.4,/./.J/L III
Unll Price $. To '7 <r.: Flower Vase $ ;::'~ Lf}; Cornef Post $ . :~Ial $ "3 'I ~J v,
alt..:.. s · &' ...'flr: tJ ~ I!I.J..(..'$ #.g I 9 'I. II I A.I)" s $/ too. "0 ~/H.., s /....?<J 9. " 0
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l.grll'lh.I..ld m.morl.I, wllh 1I11.lh.r.'o .nd rlghlo' po.....lon Ih."O',lh.1I r.m.ln vour p.rson.1 prop.rly unllll h.v. p.ld lor II
In lull. In d,'.ull of .ny p.vm.nl h."undtr. IlItlnll you 'A rtpoIII...nd "mov.lh. ..Id m.morl.l. wllhoul gulllor Ir..p... or olhtr
wrong,.nd .ulhorl:. .nd .mpow.r vou,ln my n.m. .nd on my bth.II,lo .pplV lolh. m.nlg.m.nl 01 ..Id c.m.ltrV or olhtr p"mlsn'or
. plrmlllor III "mov.1 .nd 10 I.k. .ny olhtr II. pi VOU m.v d..m n.c....rv or ..p.dl.nl .nd lurlh.r .gr.. '0 ..v. VOU harml... Irom
'ny enlrv, "po..elllon .nd "mov.1I you mlV Ih.n r.I.ln ..Id m.morlllor dlspos. 0111.1 vour own dllc"lIon wllhoul b.lng .nsw.rabl.
, me lor II or lor Inv protl.dS Ihe"Irom,
Ordlrs no' lubllcl to cantllllllon. All con.racll conllng.nl upon slrlk... Iceld.nll. .nd olh.r CIUIII b.vond our conlrol.
I und.rst.nd fhl' 60 dIVu".r pllClmlnlo' Ihe m.morl.'. FINANCE CHARGE will bttnltr.d on Ihl billing dll.. IIlscompulld bV I
periodic ralt at IIf.,. plr monlh which II .n .nnuII plrtln,.gl nt. a' 15,. Ippll.d 10 th. prevloul bll.ne. b.,o" d.ducllng credlll.
plym.nls Of' Iddlng purchUluppeerlng on Ihlnl.l.m.nl. To Ivold FINANCE CHARGE p,V Ih. "N.'" B.llncl" be'orelhl billing dill
n..1 monlh.
, AGAEE THAT ALL LETTERING AND DATBS GIVEN ON AIOVE ORDER AAE COARECT.
'ALIa HAVEIUN INFORMID AND UNDERSTANDTHATTHBRE WILL II A CHAROE FOR ANV LETTERING DONE AFTEA
THB MEMOAIAL HAS IIIN ERECTID IN THE CEMETERV.
I ALIa ACKNOWLEDGE THAT I HAVEIEEN GIVEN MV FOUNDATION OUAAANTE.~' IF .AP~~I~AILE' ~
~ 6~ /) V E J 0 ;-: C stamer s SIgnature
eEdlE~ OAf 1.01:
JOC/l;CO
R(.,w- cRto
Per
V.. No
Grave Marked
Call Evening Before
.,
BlueCross.
BlueShield.
Explanation of Benefits
TIIIS IS NOT A BILL
Fedeml Employee l'rllgmm
PEHNSYLVAHIA ILUE SHIELD
PO lOX 1'00S7 CAKP HILL PA 1701'-0057
LEROY BEAR
302 RAVMON AVENUE
BOILING SPRINGS PA 17007-9778
KEDICAL QUESTIONS CALL 1-aOO-779-69Qa,
DENTAL QUESTIONS CALL 1-BOO-7Q6-a6B7
CLAIM HUKlER' '70_S0l0071
OAT! RECEIVED. 0211_"7
DATE PROCESSED. 02121"7
DATE PAID. 02121"7
PATIENT NAME. LEROY IEAR
ID HUKlER. 1150511113
CHECK HUKlER. 50'5'2'1
SUIVWIY OF STAHDARD omOll IEKEFITS ON THIS CL.UII
IEKEFrr CHECK EllCl.OSED
PROVIDER NAME. YELLOW IREECHES AKSU DATES OF SERVICE. alia"" - alia""
TYPE OF ISUBllITTED INEGOTIATED I/llllICIIVERED I ellP I
.
55.aal'211
l'1.aal'211
10.101'211
WHAT YOU
",aa
U.Z5
15.61
'15.001
5.zsl
'1.111
1z,.001
15.751
1'1,'101
a15'.15
al50.15
172.001
21.001
u.zol
21Z.Z0
A/1IULAIlCE I
AJlluLAIlCEI
A/1IULAIlCE I
zzs.ool
35.001
so.aal
53.a5
TOTALS
.z".oo
77.11
. ellPLAIlATIOll OF CODESIRE/IARKS
'Zl--ALLOWAlLE CHARGlS FOR COVERED SERVICES IY NON-PARTICIPATING PROFESSIONAL
PROVIIIERS ARE PAID lASED UPON THE NON-PARTICIPATINCl PROVIDER ALLOWAHCE. SEE
COVERED CHARGES IN THE DEFINITION SECTION OF YOUR ILUE CROSS AHIl ILUE SNIELD
SERVICE .EKEFrr FUH IROCINRE. YOU ARE RESI'OIlSIILE FOR THESE CHARGES.
YOUR RESI'OIlSIBIUTY TO THE PROVIIIERISI IS ~~;Oi~ lIE FAID al5,.15.
THE FROVIIIER CAK COLLECT az". 00 FIlOIt YOU E SERVICES.
"
..................................................................................
WHAT YOU OWE
SllI1IIARY OF OI/T-OF-!'OCKET ellPEHSES FOR U"
I CALENDAR YEAR CATASTROPHIC PROTECTION
CALElGIAlI YR DEDUCTIBLE a I DEDUCTIlLE PPO NOH-PPO
PER AD/lISSION DEDUCTIBLE a I
coIIISIIUI4CI a 53.aJ I
COPAYIlEHT a IWHAT YOU HAVE PAID
NON-COVERED CHARGES a 77.11 I INDIVIDUAL 'azoo.ao a= a'61
PRECERTIFICATION PENALTY a 1 FAJlILY
I AHHIIAL IIAXD\UII
TOTAL. a lS0.15 I INDIVIDUAL azaa.oo az,aao as,750
I FAJlILY
Any rnubmlulon of 1IIglble IIPln... on thl. clllm mull b. recolvld no IIlIr thin OocImber 31 of 1111 Cllllndar Yllr following thl
dall of ..rvice or go da'/1llrom thl pnlCIII dall on Ihll fonn. whlclll.lr I. \allr.' "",17012, F _,....5
,
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
"
L--
'*
/s.sJ'- II
IUREAU OF INDIVIDUAL TAXES
INHlAlfAHC[ talC DIVISION
Q(pf. In,a 1
HAAAlSIURG, PA 1111..06Dl
NOTICE OF INNERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
tH.II.'1I "' III.'"
JOHN B MANCKE ESQ
2233 N FRONT ST
HBG PA 17110
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
07-21-97
BEAR
01-15-96
21 96-0190
CUHBERLAND
101
LEROY
W
Altount RI.tltad
MAKE CHECK PAYABLE AND REHIT PAYHENT TOI
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .....
ifili:iSCjj"EX-Aj:ji"i03:9'rniiiiicE--oF-YHliEliifiitiCE-YAiriippiiiiisEHiiii'-,--m.-OwANcE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF BEAR LEROY W FILE NO. 21 96-0190 ACN 101 DATE 07-21-97
TAX RETURN WAS, I I ACCEPTED AS FILED I XI CHANGED SEE ATTACHED NonCE
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Eat.t. ISch.dul. AI
2. Stocka IIIld Bonda CSc:h.dul. II
s. Cloa.ly H.ld Stock/P.rtn.rahlp Jntar..t CSch.dul. CI
4. "orielga./Hot.. Receivable (Schldule DJ
S. Ca.h/Bank DIPolita/Hile. Parlonll Property .Schedule E)
6. Jointly Dwn.d Prop.rty ISch8dUl. FI
7. Trenlfarl (Schedule OJ
I. Tot.l A...t.
111
C21
151
141
151
161
171
,DO
.00
,DO
,DO
500,00
6.526.94
,00
cel
NOTE~ To insure proper
credit to your account,
.ub81 t th8 upp.r portion
of thl. for. with your
tax pIYlllnt.
7,026.94
APPROVED DEDUCTIONS AND EXEMPTIONS I
t 15,301.25
9, Funeral Expan.../Ad.. COI a'Hllc. Expan... (Schedule H) (9)
10. o.bt.lHortg8g. LI.bllltl.a/LI.na ISchadul. JI 1101 ,DO
11. Tot.l D8ductlona 1111
12. H8t V.l... of T.x R.turn CUI
15. Ch.rltabl./Oov.rna.nt.l I.qu..t. ISch.dul. JI 1151
14. H8t V.l... of E.t.t. Subj.ct to T.x 1141
NOTEI If en ellell.ent wel issusd previouslY, lines 14, 15 end/or 16, 17 end 18 will
reflect figures thet include the totel of ALL returns essessed to date.
ASSESSMENT OF TAXI
15. AllOUI\t of Lln. 14 .t Spou..l r.h IlSI
16. ~t of Lln. 1~ t..8bl. .t LIn8.1/Cl... A r.t. 1161
17. ~t of LIn8 14 t.x8bl. .t Col1.t.r.l/Cl... I r.t. 1171
le. Prlnolp.l T.x ou.
TAX CREDITS I
PAYHENT
DATE
11i .~nl 'Ii
8,274.31-
.00
8,274.31-
.00 X,OO.
.00 x' 06.
.00 X .15.
1181
.00
.00
.00
.00
RECEJPT
HUHBER
DISCOUNT It I
INTEREST/PEN PAID C-I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. JF PAJD AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL JNTEREST.
I IF TOTAL DUE IS LESS THAN tl, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDn" ICRI, YDU HAY IE DUE
A REFUND. SEE REVERSE SJDE OF THIS FORH FOR INSTRUCTIONS. I
.
RESERVATIONI Elt,t.. of decedent. dVlng on or before Dlc..a.r 12, 1'12 -- l' InY future Intar..t In the .,lat. I, trenlf.rred
In po.....lon or enJoy.ent to el... . Ceolt,t,r,l) beneflclarl., of the decadent a,t.r the I.plratlon 0' 1n1 ,,'at. 'or
11" or for v..r., the C~..lth herebY I.pr..,ly r...rv.. the right to ~r.l.. ~ ...... trlnl'.r Inherlt.ncl '1.1'
It the l~ful el... . (coll,'.ral) rat. on eny luch future Int.r..t.
PIlRPClU <IF
NOTICEI To fulfill the requlr..-nt. of SectIon Zl~D of the Inheritance end E,tat, TI. Act, Act 21 of 1995. e7l P,S.
SecUon ,.40).
PAYltDfTI DetKh the top portion of thl, NoUee and ,ubII!t with your PIPIn' to the RI.ht.r of WUII printed on the rlvlrs. tide.
...... check or IIONI, order p,y.tlll tOI REGISTER OF MILLS, AGENT
REF1.ICD (CRh a r.'uncI of . ... crfMIlt, Nhlch .... not raque...d on the ,.. Rlturn, ..y b, raqueltMt by c"pIIUne In "AppUcatlDn
for R,fund of penn.vlvenla Inherltanca end E.t.t. T.." (AEV.1Sl)). Appllc.tlon. .r. .v.lllbl. .t thl Dfflc.
of the A..I.t.r of Will., anw of the ZS A.venue DI.trlct O"lc.., or by calling thl .pacl.1 Z4-hour
anfWIrln, ..rvlc. ~r. 'or 'or.. crdlrlng: In Penn.wlvanl. 1.IOO.S6Z-2050, out.lda Penn.ylvanla ~
within lacal ~rrl.burl ar.. (717) 717.1094, TOOt (717) 772.2252 (H..rlnl lap.lr.d Onlw).
OIJECTIOHSI Any party In Int.r..t not ..tl.fled with thl appr.I..aent, .llow.nc. or dl..llowanc. of deduction., or .......ent
0' t.. (Including dl.count or Int.r..t) .. shown on thll Hatlc. au.t ObJ.ct within II.ty (60) d.w. of rec.lpt of
thl. Hotlc. bYI
.-wrlttan prot..t to the PA Dapart..nt of A'v~, ao.rd 0' Appa.I., Dept. 211021, Harrl.bura, PA 171ZI.I021, DR
....lactlon to haY. thl ..ttar det.r.lned .t audit of the account of thl personal rapra.ant.tlv., DR
".appa.l to thl Orphan.- Court.
"'1"
IITllATlYE
ctltRECTJOHS I
factu.1 .rror. dl,cov.rad on thl. ......aant ~Id be addr...ad In writing tal PA Dap.rtaent of R.vanua,
aur.au of Indlvl~1 T...., ATTNl Po.t A......ant R.vl.. unit, Dapt. 210601, H.rrl~r., PI 17121-0601
Phone (717) 717-6505. St. pag. 5 of thl bookl.t "In.tructlon. 'or Inherltanc. T.. R.turn 'or. R,.ldant
Decadent" (REV.ISOI) for an ..planatlon of ~Inl.tr.tlv.ly corractlbl' .rrora.
If any ta. due I. p.ld within thr.. (S) c.lendar aonth. .ft.r the decedent-. death, . flv. percent (5X) dllCount of
the t.. p.ld I' .llowed.
DISCOUNT:
PENALTYI
The ISX t.. aant.ty non.p.rtlclpatlon penalty II coaputed on thl total of thl t.. and Intar..t .....IId, and not
p.ld bafor. January II, I"', thl flr.t day .ft.r the and of the t.. .-natty period. Thl. non-p.rtlclpatlon
penalty II appeal_I' In thl t.. anner and In the the ... tI.. parlod II you would appaal the t.. and Intar..t
that hat bien .....nct .. Indlc.tM on thll notlc..
INTEREST I
Intar..t II chargltd blglMlng with first NY of dallnquency, or nlM (9) IlOntht and ana (1) dey frOll thl deta of
death, to thl data of ptIYMnt. Talllt which bac.. dal1nquant before January I, nil ba.r Interllt .t the rata of
.1. (6X) parcent par ..-.. c'lculated .t . dellY rat. of ,000164. All t'1lI1 which b1c.. delinquent on and after
Jenuary I, 1.12 viii be.r Int.r..t .t . r.ta which viii vary frol c.landar y.ar to calandar wear with that r.ta
announced by thl PA Departa..,t of RavWlUl, The appllcabl. Int.rut rat.. for I'az through 1997 ar'l
l!!! Inter..t A.t. D.lly Int.r..t Factor !!!! Inter..t Alt. D.lh Int.,..t Factor
un lOX .000541 1917 9X .000247
I'as laX .OOUSI I.U-I"I llX .000SOl
I." IlX .000Stl I"Z 9X .000247
1"5 In .00055A 1"5-1'" 7X .000192
I'" lOX .000Z7~ 1"5-1'" 9X .OOOZ47
ulnter..t II ulcul.ted .. follow'l
INTEREST . BALANCE OF TAX UNPAID X HU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Notlca I..ued .ft.r thl t.x beCDII. d.llnquent will r.'lact an Int.r..t c.lcul.tlon to 'I't.an (IS) dlY'
beyond thl dlta of thl ......eant. If Ply.-nt I. aada ,'t.r thl Int.r.tt cOlPUtatlon data ahown on the
Notlc., IId.l!tlonal Int.r..t ...t ba ulcultted.
,
',",
~'-',~
""-j
"";;j
- :)::j~t
.~. ii=-;;/'Plljf/uV /(1t.'fI~'~~-: (, .. /1
~,:-<j 5__~ _;;/'~-,~""7.,,~--~.~.:!9_t< -// ~ -:. -.~
~._.,~~-.. ~._r:/~___~~:'1
r" ._____-d- ._'<J7i'-~-~.-~ --3,. ScJP.~--- ..' ----........-- _____.__~f
~ ::
r~ (,
=~=-~=~~=='_~__~~~~._:"..-'~..~~-.......- ... ..... ~.~~:=-_:~~_-.._~=~~~=::~-., '-'-:-:f~
.. .,~
._..__'_____"""''''' .....___""-' ___. . w'" _. ..." UU'''__ .-.......-- -- ..----.--.:....---,-::.,';~
'j).
"
.
INHIRITANCE TAX
IXPLANATION
OF CHANGES
filE NUMBER / c:1-l
9'" -at tv
A N /d/
;1TIM't""
'~f;.NO'.; (
IXPLANATlON OF CHANG IS
7.1....
,... !.:3
--
---.-.. ---------.--'-------
....-.- ---..........------------.-:----:-;,:!
~ - ......--_._--~_.-_.-.._-'---_. .'- -~-----~._._-- .--- "'':;
-----.....----.. .-..----..--..--.....--- --..-,-
.__ no ,,' _' _.___. ____,._._.__ ~ i~
--~~_._-_..--...~._-_._._--- ....". ----..--.---
ii.'
~j-
.__..__.........---~._--_._.._._,...- --_.:_-----_._~-:~~
"')1
..._,__.__m~___.___..___...___._.,...____._~, '. -~"i.'~'~
---.-_..__._..^.._-_..._.._._----,----~_._~,~+~~
';'.'1.<0
;,':2~~
,.~
..-.~::~
:~'~-~:1~~
-"';'.~~
. <<
_._.__.".~+_..~.~~-_.._...,- .. .'.
':1n;~
.... - ~.-_..- -.- .-- ._-_.._--_.~----_.~-,_...--~,;. . ,,:'\.'::~~
-;:it
:~ --~_~=-~-,i
!~'f~
",
;-"
.._~__ _. .~._ _. .~.__._~___._._..._.__._..._:_-:.{e~
:-'-<f!~
----,..""'*
~~'.~
ld"'-:
!,.-..-I
_*_____._.~______.m__ ._.....___._.. ...-" ..'- -...'-
..._..,,_.--.--~ .-.--
----_.~-----"-_.---,,._-"-- ._. ,.
"d...._m~'_____' +- .".-.. -......
-----.-----.
.--. --.~..- ~.."----- ....
.____n__.._..____.' ....-~.
..- --_.~._.."--,,~----- .----..----
.__."._---~._-...-...--- -..
--..-..".. ..--~_.-..-
--_.~"'---~..-........,,-_..._.+._.._--- .
-~..--_._-~_._.-
-_.._-~_."'_....._---... ...---- .
.-..___M"_'_' '
~ ___~_ ._....... .~_ _. _n
._____.__H_...._..U_..-m____
.--.---------- -. ._.-~,."
~-_.~ ........- -.... ..-- .+- ........-..-
._~_~,_.4".___
._...~,~,_._--_._.- ...-.--. -....
..n .., ___.~.'m.' '-." ----..+
#
/p'/
"'l-;~/,
/'
PAGE
TAX EXAMINER:
JRD/JUDO 30, 1992/17858
REGISTER OF WILLS
Cumberland County Courthouse
Ono Courthouso Square
Carlisle, PA 17013
NonCE pURSUANf TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal Representative
Coumd: JOHN B. MAN~K~, ~~u
RE: &tate or t.EHOY W. BEAH , Decensed, L:lte or
SOUTH MIDDLETON TWP
&tate No.: 21-1996-0190
Date or Decedent's Death: 1-15-96
Pursuant to Rule 6.12, the above named personal representative or the above named anorney, if
applicable, within two (2) years of the decedent's death, and annually thereafter until administration is
completed, Is required to file with the Register of Wills a Status Report as required by Rule 6,12, in
substantially the prescribed form, showing the date by which the personal representative, or anorney, as
applicable, reasonably bdieves administration will be completed. The purpose of this Notice is to advisc
you that unless thc requisitc Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, 15 appropriatc, within ten (10) ca1endu days after the datc of this Notice that thc Register of Wllls
Is required to DOtify thc Orpbans' Court Division, Court of Common Pleas of such ddinquency and to
request that said Court conduct a hearing to determlnc whether sanctiom sbould be imposed upon thc
ddlDqueut personal representative and the ddinquent personal representatlvc's coumd, If any.
Accordingly. If thc requisite Status Report Is not filed by ,_ 1 ,; , 19c1il. you uc hereby
Idvlsed that a request will be submined to thc Court In accordance with Rule 6,12.
Date: 2-26-98
Distribution to Estate File
STATUS REPORT UNDER RULE 6.12
Name of Decedent I JJ~~~:~ /JJ, 0-e,tV{
Date of Deathl
I I Admin. No. ~ I r(P /90
Will 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 estatel
1. State whether administration of the estate is completel
Yes 'f No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
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 If
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes ~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
cerk of the Orphans' Court and may be attached to this report,
Datel ?)'>1)9r Si~~
..- \",1 V VlIA/ f3 AI ItIJ C;':' E-
o :'
Name (Please type or print)
M /1,13G N FI<DUT 1-f!J&
I GT /7I1D
-.'
.... Address
,-
(:~ , .) ( 7/"/) /1 ;3L/- 17{61
01." .1' .1 :
c: _. ,_ .J
uc. Tel, No,
Capacity:
Personal Representative
~Counsel for personal
--r-representative
(HAH trmfl AM3)
..y.Il""". 1"."1 Ira. R DAT.tS Of. ot^..TIt MUR 111J..'I? 1 CIlECK IlERE
c.;,!,~ INHERITANCE TAX RETURN ~,;,,~~~,u~:~Dlr IHI^'MtD C1
": ,>~ (TORBEESIFD.,ElNEDT IDNECoEuDpWEl'NICTATE \"'ILili2',i.'l^i1iR"" ----....-- -- -----..--
~C"'MOHWf...ITIl QF Jtomsyw...",A (\',' 1"0
OlPMUMUH (~, H,/[~lJ( I 'J' 'J
,..",,~f:~ ,,'~~:\"""" . . . WITH REGISTER OF IllS).. (OUIllY (OOf. ..' vFAR NUMftf.R
"i"~'.:';;;:";:;;;;'~;""'"""'''''~~~'....'_=I''''';;','';;:;::;~:"~;;,,::-'.~ ." .. . ..-
\I;'if~f:[3U:;I~~'1"J:;_.-n-'----\O~~/i\f/~~--\OA~[D ~'l'/ '10 1. B~'~l~'~)~~'l~~~ LIl<J:l1 PA 1. 7007
,I..",~l,
- ------~~- -~._--_.._-~-_._---~-----_._.._---_.- ----.-..---------.------
~ I. O,;g"oo' Ro,",n=l 1. ;ul'l'l,,,no,,'''' ~.,",n 0 3. Romoi"do, RMo'n
llot dat." ,}f dlHllh prior ta ''2., ).82)
C} 5. F'Hinrol E1l0lQ T,U,
RolUfn Rnquircd
.2_ J. r'Hol Numb"r of Suf" DlIpOlil BO,"1I1
---.10
~
-
~
a
..
u
..
a
"
~:!'"
",""'"
~3.U
-00
-",...
U",ll1
'"
,{
I
'^ ~
.. Z
x"
"" a
o Z
uO
...
.
o Ja. rvlurlt lnt"roll C","prf)fnil"
(Iar .hwlS nf dlitllh oiler 12.12.;)21
;~l b. Ollcud"nl Oind Tlllll.11l iJ 7. Ol!C;tldl'lnl Moil1toineJ !J Li\lintJ TrlUl
(,\lInch copy of willl (,"I,lIoeR <:.upy of fru\I'
- . -----.---.----
'ALl;CORRESPONDENCE AND CONFIOENTlALflllC INFORMATION, SUOULD De DIRECtED TO, -'
~'''''''t .. iZM...Htf MAllItii';A.OO'~n~---
Johll B. Manckc, E9Q. 2233 North Front Street
\;mi""'" NOMo"---------...------.------' lid r r i:Jb U L'Y, ~l\'. 1'/110
. ~ .. J
('/17 I 234-7051 '. . '"
--~;::.--=~...=::.~=-:=--=:...~-="=:-:-~~---~--=-_._-.:.=..:=-:;-=:==~---:.~::.-.......,=;..-:' -----=!'---==-_.
o J. limihui ESlnlu
", .'
'.'
:"
~
Q
-
<{
..
::>
~
;:
<{
u
'"
"
1. Rool E"ol. (S,h.dol. Al ( 'I
1, S'o,k. and aond. ISd,.dol. 0) ( 2)
3. CI..oly H.ld Slod<JP,,,ne,,hil' 1"'0'0" (S,h.dolo q (31
J. .'.\ort90go\ and Nehls ~ccci...cbll) ~5c.'cduIQ 01 l'l
I 5. Cosh. Bank Deposits &. MhceilllMOIJI ?/trsannl ?ropony( 5)
tS,hodul. EI
6. Jointly Owned ProperlY {Schfldule n
7, Tronsfon ISc.nedule Gj (SchudullJ II
a. Total Gron ,\uolS lIolQllines 1.TI
q. FUMrcl hoenses, AdminhlrotiVll Costs, Miscllilaneous ( ?)
EJ.po"sOS {Scr,,,dulo HI
lQ-:-Or:abu, Mortgoglt liaDilitlus, li,,"s (Sdu'Idulo I)
11. Total Oeductions {tolollinlls q !. 101
12. Net Vclue of Euate (Iina 8 minus tinIJ 111
'3. Charitable end Govurnmonlol Bnqutun (Sc.hodul" J)
lA. Ne. Velun 5ubjoct 10 Tax (lino 12 minus linu 13)
o
.-!L.
o
il.,-
50l).O2-
'.':'
. .
\"
,':..J
~ :)
6, 52~-,-~
t)
I 6)
( iJ,
7,026.94
( 81
13,801.25
o
13,80\.25
(10)
III)
(121
(13)
IUl
___x .C6 =
0_
0_
o
:z:
o
~
...
::>
...
::E
o
u
)(
<{
...
15, Amoonl of line \J 'axoblo 01 6% ro'o (151
(Includo values from Sd\edulq K or Scllodule M.l
16. Amount of liM 14 tnJ.able at 15% rote (16)
(Includo volullls from 5chedull) K or Sd10dulfl M.)
17, Principal lox do. (Add lox Itom Ii.. 15 and f,om linn 16.1
18. Crodits Spousal Povltny Cturiit Prior Paymants Discounl
(18)
(lql
o
x .15 =
o
(171
Inlerosl
o
o
+
+
19. If Une 10 is greater Ihan nnu 17, "nlar the difforonce on line 19. This i, Ihe OVERPAYMENT.
aD I....:r.n~ iloll ..I,,".ll..!J - .11'1.111 ,I tllll: m. _ i .1 tf'r.'r. r:1 :lrF}11..i'J.'1.l ~'llllllll ~
(201
(20A)
12081
o
o
o
20. If linG 17 is grlloler than Bnel lB, enter Iho difforenca on lina 20. This is tho TAX DUE.
A. Enler lhllt interesl on tho balance dUG on lind 20A.
B, En'.r ,h. .0101 of Ii no 10 and 20A 00 lin. 20B. Thi. i. ,h. BALANCE DUE.
Make Check Pavablo tot Regiat., of Will., Agent
" ...... BESURETO'ANSWER.A~QUEST10N~ON:REVERSIrSIDE'AND TO' RECHEClCMATH:""""'" -::;';;:":: '/'"
Und.r p.noltl.. 01 p.'jo'Y. I d.do'. .ho' I ho.. uumined ,hi. '....n. ,n,:oding o"...p"ny,ng "no dot.. and "Olo...nlt, ond ,. .h. bUI of..y knowl.dg. ond b.li.f.
.1 i. "0., '0"." ond ,o..plo... I d.do,. ,ho' oil ,.01 ."",. ho. b..n "po",d 01 "00 ...,\., .0100. O.do,olion 01 p'.p.r.r .,h.r ,hon.he p...onol r.p,...n,o'i.. i.
~a,.d on all Information of "",hith p"partlr has any ~nowl.dglt.
'1.<i~;IURf Of ;U~O.U U,'ON$lllf fOlllllJ-r;O RETURU I ~O~.;;$:J /J i{/. (' ~ ";~/.IE ~
"it, .<-V/t//('l-"t.'~ 1::.tL '~Jc.;;L 'YLJ.2L!L.!:z'1.'Z e_u~/V'Zi")O:;.5 tAl- '//- 9 t..27
" ~, ,." R "'N Of N '"" '00 $ 2133 North E'ront st/C'ec~ oA' I
lS"V~ lIarrisbur , PA 17110 4/29/97
Bsq.