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IN RE: ESTATE
IN THE COURT OF COMMON PLEAS
MARGARETTA S. WHITE
OF CUMBERLAND COUNTY, PENNA.
ORPHANS' COURT DIVISION
DECEASED
NO. ~/-9(.. -3tjO
ORDER OF COURT
AND NOW, ~h.~ -\ 1'/ , 1996, upon consideration
of the within petition of Trinity Evangelical Lutheran Church of
Camp Hill, and pursuant to 20 Pa. consolidated Statute S3102, it
is hereby ordered and decreed that John E. Slike, attorney for
the petitioner I is hereby authorized to receive and collect all
accounts and assets of Margaretta S. white to pay the costs of
administration as set forth herein, the claims against the
decedent, and to distribute the balance remaining to Trinity
Evangelical Lutheran Church of Camp Hill.
BY THE COURT,
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SAIDIS, GUIDO, .,
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SnUFF & 1'-
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MAS LAND 0:: ;
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2109 Markel SUCCI () .~ ""
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IN RE: ESTATE
IN THE COURT OF COMMON PLEAS
MARGARETTA S. WHITE
OF CUMBERLAND COUNTY, PENNA.
ORPHANS' COURT DIVISION
DECEASED
NO,
PETITION FOR SETTLEMENT OF SMALL ESTATE
,
:1 TO
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THE HONORABLE, THE JUDGES OF THE SAID COURT:
The petition of John E. Slike respectfully states that:
1. Margaretta S. White died on the February 251 1995,
::
[ a resident of Frey Village Retirement Center, North Union Street,
,I
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:1 Middletown, Pennsylvania, a domiciliary of Upper Allen Township,
Ii Cumberland County, Pennsylvania. A copy of her death certificate
II is attached hereto as Exhibit "A."
II
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i 2001 Chestnut Street, Camp Hill, Pennsylvania, the residuary
2.
Petitioner is Trinity Evangelical Lutheran Church,
SAIDIS, GUIDO,
SHUFF &
MAS LAND
2109 Mark" 5'=.
Camp Ifill. PA
I beneficiary of the Last Will and Testament of Margaretta S.
! White.
i
II
II 3. Margaretta S. White died testate, leaving a will
i dated February 14, 1987, which will has not been probated. The
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[ original of the will is attached hereto as Exhibit "B."
I
Respectfully submitted,
SAlOIS, GUIDO, SHUFF & MASLAND
.....,
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(
Joh I " Slike
Cou ~el'for Trinity Evangelical
utheran Church of Camp Hill
JOINDER AND CONSENT
J. STEWART HARDY, states that he is Pastor of Trinity Evan-
gelical Lutheran Church of Camp Hill and does hereby consent to
the attached Petition and joins in the prayer thereof.
...~~~
/"71. StewartHar y
SAlOIS, GUIDO,
SHUFF &
MAS LAND
2109 Market SIn:c1
Camp Ilill. PA
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WARNING: Ills IlIegnllo duplicate this COllY by photostat (.r photograllh.
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COMMONWEALTH Of PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECOROS
CERTIFICATE OF DEATH
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LAST IVlLL AND TESTANENT OF r.lAHGAltETTA S. HIIITE
I, ~lARGARETTA S. I~IIITE. of the Village of Grantham,
TOI...nship of Upper Allen, County of Cumberland and State of
Pennsylvania, being of Hound and disposing mind, memory and
undcrotanding, do make, publish and declare this my Last Hill
and Tes tament, hereby revoking and making void all former IVills
by me at any time heretofore made,
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can conveniently
be done.
2.
I give, devise and bequeath all the rest. residue and
remainder of my estate, real, personal and mixed, whatsoever
and wheresoever the same may be situate, to my husband, A. J.
IIDITE, absolutely and unconditionally.
3.
In the event that my husband, A, J. ImITE, should
predecease me, or should he die at about the same time os I do,
such as in on accident common to both of us, or should he die
within thirty (30) days of the date of my dcath, then in any of
such events, I give and bequeath all the rest, residue and
-1-
remainder of my estate, of \~hatsuever nature and wheresoever
the same may be situate, to TRINITY EVANGELICAL LUTIIERAN
CHURCII, of 2000 Chestnut Street, Camp IIi 11 , Pennsylvania,
17011, absolutely and unconditionally.
l. .
For the purpose of facilitating the settlement and
distribution of my estate, I authorize and empower my Executor,
hereinafter named, to sell any and all real estate which I may
own at the time of my decease, as well as my personal property,
at either public or private sale or sales.
LASTLY, I nominate, constitute and appoint my hus-
band, A. J. IVHITE, Executor of this, my Last IVill and Testa-
ment, and in the event that my said husband should predecease
me, or should he be unable or unwilling to serve in such capa-
city for any reason, then in such event, I nominate, constitute
and appoint THE CONNONIoJEALTH NATIONAL BANK to be the Executor
of this, mY Las t IHll and Testanent, in his place and stead.
IN IoJITNESS IoJHEREOF, I have hereunto set my hand and
seal this /L/rh
day of February, A. D. 1987.
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, /ilargaretta S. I~hite
(SEAL)
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Signed, senled, published nnd declared by the
above-named l-IARGARETTA S. HlilTE, as and (or her Last \Hll
and Testament, in the presence of us, who, at her request
and in her presence, and in the presence of each other,
have hereunto subscribed our names as witnesses.
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WHJN\<lEAL'11l OF PENNSYLVANIA)
)SS:
OOUNIY UF Cll~I1IEI\LAIW )
I, NARGARETTA S. WIIITE , the testatrix . whose MII1C is signed
to the attached or foreljoil1l'. in.'ltrunent, having been duly qualified according to law.'
do h~reby acknowledge that 1 signed and executed the instrUnent as my Last Will and
Testament; trot I signed it willingly; ilI1d that 1 signed it as my free and voltmtary
act and deed [or the purposes therein expressed,
Sworn and affinned to ilI1d acknowledged before me, the //1".0{ day of
Fehruary . A. D,. 19..liL'
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My Ccmnission Expires: 5,<'/,;;'--; d/'''/
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(SEAL)
WNJN\oID\L1li OF PENNSYLVANIA)
)SS:
OOtJNl"{ OF CUNIII':RLANIl )
We. the lU1dersigned. J. Robert Stauffer and
/#"" ,{,; /r> cf./;;, ,the witnesses whose names are signed to the attached or
foregot'ng instIUllent, being duly qualified according to law. do depose and say that
we were present and saw the testat.I~' NAI1.GARETTA S. \.nUTE
sign and execute the instrUJlent as :hi.K/her Last \~ill and Testament; that the said
testatrix NAnGAIU~TTi\ S. HIIITE , signed the same willingly and
that the said !.!AIWARETTA S. WIIITE. ' executed it as~/her free and
voltmtary act for the purposes therein expressed; that each of us, in the hearing and
sight of the test.ltrix ,signed the Will as witnesses; and that to the best of our
knDwledge the testatrix ,was. at the time, 18 or I1lJre years of age; of sound mind;
and under no constraint, duress or tmdj influence,
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9;.rorn and subscribed to before me this f ./
/~'4f day of Fehruarv ' 19 87,
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My ~sion E.'tpires: ..J:.-~' ,:;'/; .,'7','/
/
Register of Wills of Dauphin County, Pennsylvania
RENUNCIA liON
Estate of -.f)~~RillH S. IVI ~Je.________.__
No.
also known as
, Deceased
The undmslgncd.
"IeI/o", (3o",t.) IV. A. I (\tt.I\t~ El;eM.:r:___
tRdatltlllstllpl (C;lpat:llyl
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Hw abuve Decedent. hurt!hV ftlllOUllr.t!lsl Iht: fl(ltU hi illllllllllsler till! l:!'olilll~ illlil ft~"'IWCII\llly '1'l!IW...ljl->J Ihal
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Witness
hand this day ul , l~)_
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Sworn In Of illllrnwtJ ;IIHI suhscf.lwll
bel ore me ttus day 01
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Notarv Puhllr.
My Comnusslun EXIUrl!s'
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.. Dec. 22, 1989
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COMMONWEALTH OF PEIINSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
TPL SECTION . CASUALTY UNIT
POBOX 8'86
HARRISBURG PA 17105
Horrell 23, 1995
JOlIN SLIKE ESQUIRE
SAlOIS GUIDO SI lUFF' & MASIlIND
2109 ~1I\RKE'l' STREET
P 0 IlOX 737
CAMP HILL P1\ 17011
RE: Estate of Margaretta IVHITE
Dear 1\ttorney Slike:
Pursuant to your letter dated March 21, 1995 regarding the
estate of Margaretta IVHITE.
Due to the limited annunt of assets availabie and the outstanding
claims (Frey Village & Rhoades Phar.) the Department will not seek any
recovery pertaining to this estate.
If you have any additional questions. please feel free to
contact 00.
Sincerely.
"~'~' ~~
'H-, ~ .
Ronald O. Hill. Mmager
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
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FILE NUMBER
"'I..It,ll""\~.i "llllll"'I"" ,A'I'A
!j(' All ~~" '11'1 \ II'"
'I ',' -~ ,'I
"A'lll', d I'i 1'1 \ ('. ~ ,'I" I
cnu~11 Y COD[
l[,llt
~.UlJn[R
lJI.Cr.Ol PI' ~I COlJl'll' [ AOOlllS~
Gnmlhmn Road
Grlllll ham. I'A 1707.7
'1 1:'I'I'-.tl"I)IIA',I 'II',' Atlll.II'!) I "j"''',
~
~
I
I,JlI1I I', M.II' C'II I" 1.1 ~;.
\IIA!1 .11 iii A'1l 11"11 01 1l'111..
i1,' ;' " ll') !:I '1 'Iltl'\
I -~-,-- C..':'~"'l;
1 I "..,.j Allll . '.11'.,\"1,., ',11,,",1 '.I,A..II : "',!llll',! "'ll' ,),::011 j'~lll,ll ',OCI,ll ',lCUllIT, PjUMBEH
AIJOupH n[CEIV[D.~;U IIISTRUCTtONS'
'" ,A, ',11 pW',I,l.'l.l11l 'I
)' II) .'.' !II
Cumlwr I fino
D'2.---;;-l;I;II;"llI"~I.11 RclUln
o 4a. fllllj'" I!llme<,l COfllprOml~c
1101 d,lloc, 01 deillh altor 12. 12-S2)
[X] 6 (JIll mlllnl Ol4lfj 111'~1,t11.l [J 7. Oecedllnt M,llnlmned a liVing Tru!Ot
._. ____ !~~.!!5~Et 01 W~_~ ; Altitch d copy 01 Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
------*--
Remainder Rolurn
(lor dales of death prIor to 12.13-82)
Fedoral Estale Ta. Roturn Required
TOI.11 Number 01 Safe DepOSIt Bo.os
A 11101,
CPt 1";;11.
It po'
~ R C
K 0 K
P 5
C P
o 0
R N
R 0
E E
S N
T
1)'''l"11.11 HI'lulI'
I ,In,h'lt 1..1,111'
05.
8.
tlAIAI
,I ,,11Il I,:. Sllko, !~.
It. LI"1l01,L 'lul.tUlH
COMPLETE MAILING ADDRESS
Saldls, Guido. Shuff
2109 Market Street
Carn HIll PA 17011
& Masland
R
E
C
A
P
I
T
U
L
A
T
I
o
N
717 717.11.05
1. Un,I' E ',lillC! (Schedule A! 1
2. 'jIOt:I<-. ;tnd Bond.. 1 ~Ictllldljl(. B (2)
J Clo'illl)' Hold Sloclo./P,HlnfH',hlp Int(>re...t SChl!dulf' C (3)
4, MOllfJilC)Il'. and NOlfl'> R(>(elvilblo SChl'dulf' 0' (4)
S. C.I'.ll 0.11,10. Oopo!t'h & MI"CHlt,tnl10U'.. Pfll..OIMI Propt"ty (Sch El (5)
6. JOlnlly Ownod Ploperty (Schudule F\ (6)
7. Tr"fl~tOI"i (Schedule G I (Schedule l \ (7)
8 iotal GrO'i"i AV:iol!o "olal Lines 1.7'
9 rum!!,,' F'rwn'io!. At1m,nl\U.lllve CO',ls Ml';ceU,uH'!OU'i
(Ipon'.".. '.5chodult' H'
10. Oohl'i MOIIC},lgO ll.lblllliC!", Llon'i $ch(>dulo I
11. Tolal O~duC110n'.ll{)t.I' line'> 9 & 101
12. 1lt'1 y"lue 01 E~l,lt(.' 1Llne 8 m1nu,;; line 11
13. Ch.l'ltilble .md Governmenlal Beque~l'i Sch('dule J'
14. t~e1 Y.llue Sublectlo Ta. illnc 12 mlnu... Line 131
15. Spou...,,1 Tran'i!er...llor dales of d(',lth .1tt(>l 6-30-94)
S('O In'illucl1ons fOI Apphc,lble Perccntilgc on page 2
(Include v.1lues from Schedule K Of Schedule M 1
16. Amount olUne 14 la.able at 601. rate
Ilnclude values hom Schedule K Of Schedul(' M )
17. Amount olUne 14 ta.able at1S'/. rato
(Include values from Schedule K Of Schedule M 1
18. Prlnclp,ll lax due (Add ta.trom Line 1S t6 and 17 )
19. C,edl'''.ISp Poverty P'IOr P,lyn)(>nt'. OI~,COllt11
(19)
(20)
(9)
1.81.5.01
(8)
11.3.00
573.17
(II)
(12)
(13)
(14)
0.00 X ,
0.00 X 06 '
0.00 X 15 '
0.00
1,81.5.01
(10)
916.17
928.81,
928.81.
(15)
0.00
(16)
0,00
T
A
X
C
o
M
P
U
T
A
T
I
o
N
(17)
(IB)
0,00
Inlerest
0.00
(J.OO
20. tlll"lJ 19 I", 9'Cillcr than line 18 enle! the dlllelellCl' on lme 20 ThiS IS lhe OVERPAYMENT.
[IJ 0 Check here if you are requestins a refund of your oyer aymenl.
21. II line 1SI!> 9roalor thiln lIne 19 cnlN tho dlllerence on Line 21 ThiS IS lho TAX DUE.
A. Entor Ihe Inle'o'.1 on the l.lal,lIlce du(> 011 Lln~ 21A
-- ---.-,*--
(21)
( 21A)
(21B)
0,00
0.00
0.00
B. Enlellhe lotal at llm- 21 ,Ind 21A on lme 218 Tl1I'. I'.> the BALANCE DUE.
Make Check Pa able 10: Re Isler 01 Wills. A cnl
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~
UM'" r.... .it,., 01 p'llufy I <,,,(I.U! Ih .11 t,.."to ...am'",,(j U""i,..hull ir><:lu(lll1q ,te(o",p.I1,lnq ~(h~dule",tnd sl.lements Al'l(llo th~ best 01 my kno-...1edge and bfol",t, II (s llue
conllel,fHI (o"'r~..I" I d",(I.", th.t..1l '....I....I.le h,n b"..n If'pOIIf'\1 at lll-'" mar~,,1 vollue D~cldl.\lOllol prep4rel ottllH Ih..n Ihe ~1~on.1 rep'..s"ntAlt~"... bA~ed on all mlolm.llon 01
<Iot',ehf""f,.II'''I1",..n-tlno...IPdq''
~;t(.liAl Ull[ Of P[rt.;O'. rl[SPON';lI]l[ J:QH flll',G I'll lunN
.J oh" E. S 11 ko, I::sq,
P. O. Box 737
Camp H 11], PA 17001
Saldl". Guido, Shuff &
21 09 Market Street
Camp' HI i i : . pi' . i Jili i . . . .
DAlE
':itGI.At Lnr (H I'r1[I'AIIER OTH[R THAlli R[PRf'i[NT AliVE:
Masland
CATE
.-..--.....-.--..-..-.*.
rOil., 1500 n...... 1.9~;
c.l'll'."I'" " "N4 '('l""..oll...,,,..onl,.rp',,"i,..n,.. \'>';
Act #48 01 1994 provides lor the reduclion 01 the tax rates Imposed on the net value ot translers to or lor
the use 01 the spouse. The rates as prescribed by the statute will be:
03010 (.03) will be applicable lor estates 01 decedents dying on or after 7/1/94 and before 1/1/96
02% (,02) will be applicable lor estates 01 decedents dying on or after 1/1/96 and belore 1/1/97
01% (.01) will be applicable lor estates 01 decedents dying on or after 1/1/97 and belore 1/1/98
o Spousal translers occurring on or after 1/1/98 will be exemptlrom Inheritance tax.
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
x
a. rotaln the use or income of the property transferred.
x
b. retain the right to designate who shall use the property transferred or its income.
......,. .
x
...... .
c. retain a reversionary interest; or .
.............,.,. .
x
d. roceive the promise lor lile of either payments. benefits or care? .
....... .
...... .
2. It death occurred on or belore December 12. 1982. did decedent within two years preceding death
transfer property without receIving adequate consideration? It death occurred atter December 12,
1982. did decedent transfer property within one year of death without receiving adequate
consideration? . . . . . . . . . . . . . . .
x
........ .
x
3, Did decedent own an 'in trust for' bank account at his or h,r death?
............ .
............... .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Form 1500 (Re... 7.941
CopvrltJ~II(, ,qq, In"" 'nll......,.. nn'''' CP~V'\I","' 'nr
REV. 1!lotl rl . 171ft,
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
Pl.... Print or T .
FILE NUMBER
co"rN~.lt~~~{~m~~ihr'NI'
ESTATE OF
Mar'lIrotta S. IIhlto
ITEM
NUMBER
A. Fun.rll Expen...:
SS!I 203.JO.2270
02 25 95
DESCRIPTION
AMOUNT
B. AdminIstrative Costs:
1, Personal Representative COmmissions
Social Security Number of Personal Representativo:
Year Commissions paid
2. Attorney Fees Saldls, Guido, Shuff & Masland 300.00
3. Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees
C. Miscellaneous Expenses:
1 Register of IIllls - filing fees for petition 18.00
2 Landis Jewelers - appraisal 25.00
TOTAL (Also enter on hne 9. Recaprtulation)
(II more spece Is needed, Insert additional .heel. o' .ame size.)
Copyl1atll 'cl 1994 tOlm !loth....'1t only CPSY'lIl!m!l Ire
s
343.00
Fo'm 1500Sctlf!dulf' HIR"v 7.8e\
REV. 1St] EX'. {Z-871 .
SCHEDULE J
BENEFICIARIES
cO"~N\l\1rtitl4'bo:~~jht"lA
ESTATE OF
FILE NUMBER
SS/! 203-10.2270
02 25 95
AMOUNT OR
SHARE OF ESTATE
Mar oretto S, Whlto
ITEM
NUMBER
.
,
"
I
I
, i
i
,
I
,I
'I
i
,I
I
I
I
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
A. Taxable Bequests:
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Chantable and Governmental Bequests:
1
Trinity Evangelical Lutheran Church
2000 Chestnut Street
Camp Hill. PA 17011
1007.
s
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enlel on line 13. Reca Kulalionl
(If more space is needed, insert additional sheets 01 same size.)
Copyrlqht Icl1994 form solh"'''. only CPS,;,stems.lne
Form 1500 Schedule J IP@'i Z.871
,.-'"
.,"",~_._....----..----..----~
--
0.00
"
737-8024
2129 Market Street
Box 481
Camp Hill, PA 17011
Volumetric calculations are approximate, based on estimated
measurements. The actual weight of any stone(s) can be
considerably different than the estimate by formula.
When items are marked with the fineness of the metal, the
appraised value is based on that marking unless otherwise stated.
When there is no marking on the item, the method used to estimate
the metal content is the nature and appearance of the material
as well as any testing as noted.
These pieces have been examined without the stone(s) being
removed from their settings and are appraised on that basis.
This is a fair market value at which the property would change
hands between a willing buyer and willing seller if both had
reasonable knowledge of relevant facts and neither was under
compulsion to buy or sell.
Barry R. Landis
Page 2 of 3
INC.
,;
c---
D
E
C
E
D
E
N
T
I ' J ( ) \ . ) ron O"T[!J m OtAHi Af nit \lI.l11ljl Cll[ClC.ll[n[
INHER1TANCE ~Ax RETURN ~tv1\;~~~~'tD" IOCLA''''W 0
RESIDENT DECEDENT FIl:E NUM~R ,/
(TO BE FilED IN DUPLICATE ILc J)e..~ -f~
WITH REGISTER OF WillS eaUNlfeaDE 0/1 ,[AA b NU"'OEA .0 Y.b
DECEDENT'S NA~EtLAST ,FIRst. AND MIDDLE INITIAL) OECEOEHtSCOMPlEtE: AQOfl[SS
Whl to. Mar 'orotto S. Grnnthum Road
SOCIAL SECURITY NUMBER DATE OF OEATH DATE OF BIRTH Grantham, PA 17027
203-10.2270 02/25/95 12/15/03
REV - I!lOO EX . (7-941
cAB
H P t
E PO
C R C
K 0 K
P 5
C P
o 0
R N
R D
E E
5 N
- T
ea"'~FPltMh! Wl,'l.fM:'ilMANIA
HAARISB5~t.~\Z8'()('OI
Cumburlllnd
Counly
f1emaindor Return
liar date. 01 dealh prIOr 1012-13.82)
Fedoral Estale Tax Return Required
T atal Number of Sate Deposit Boxes
,IF APPllCABlEISURVIVING SPOUSE'S NAME 'LAST ,FIRST AND MIDDLE INITIALI
SOCIAL SECURITY NUMBER
AMOUNT REC[IY[OlSEE INStRUCtlONSI
2. Supplemental Return
4a. Fulum Inlorest CompromIse
liar datos 01 death aher 12.12-821
[]] 6. Decedent Died Testate D 7. Decedent MaintaIned a living Trust
IAnach cop 01 W,II) (Mach a cop 01 Tru.t)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
X 1. Original Return
X 4, limited E.tate
o 5.
8.
COMPLETE MAILING AQDRESS
Saidis, Guido, Sht'fh&
2109 Markot Stree~ ,7
Cam Hill PA 170fl
R
E
C
A
P
I
T
U
L
A
T
I
o
N
NAME
John E. Sliko, Es .
TELEPHONE NUMBER
717 737-3405
1. Real E.tatelSchedule AI 1
2. Stock. and Bond.ISchedule BI (2)
3. Clo.ely Held StocklPaMe..hip Interest (Schedule CI (3)
4. Mongage. and Note. ReceivablelSchedule 01 (4)
S. Cash. Bank Deposits & Miscellaneous Personal Propeny (5ch_ El (5)
6. Jointly Owned Property (Schedule F) (6)
7. Tran.le.. (Schedule G) (Schedule L) (7)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses. Administrative Costs. Miscellaneous
E'pen.e.ISchedule HI
10. Debts. Mortgage liabihties. li~ns (Schedule I)
11. Total Deduction. (total Line. 9 & 10)
12. Net Value of Estate (line 8 minus Line 11)
13. Charitable and Governmental Bequests (Schedule Jl
14. Net Value Subject to Tax (Line 12 minus Une 13)
15, Spou.al Tran.fe.. (for date. 01 death aher 6-30-941
See Instructions for Applicable Percentage on page 2
(Include values from Schedule K or Schedule M.)
16. Amount of Line 14 taxable at 61/1 rate
IInclude value. from Schedule K or Schedule M )
17. Amount 01 Line 14 taxable aI1S'/, rate
(Include values from Schedule K or Schedule M.)
18, Principalta, due (Add ta, from line 15, 16 and 17,)
19. Credits/Sp Poverty Prior Payments Discounl
(19)
(20)
0,00
0.00
Masland
:0
~~
.n
,'"
,"
(9)
- .
~
~
C'I
1,845.01
~r, \ "- r-::
,.
0
(8)
343.00
573.17
(11)
(12)
(13)
(14)
0.00 X ,
0.00 X ,06 =
0.00 X ,15 '
(18)
Interest
0.00
"
1,845.01
(10)
916.17
928.8/,
978.84
~l.OO
(15)
0,00
(16)
0.00
T
A
X
(17)
0.00
C
o
M
p
U
T
A
T
I
o
N
+
.
20. If Line 19 is greater than LIne 18. enter the dlllerence on Lino 20 This is Ihe OVERPAYMENT.
[I] 0 Check he,e If au are reque.tln a refund of your over aymenl,
21. If Line 18 is greater than Line 19. enter Ihe difference on Line 21. This is the TAX DUE.
A. Enter the interest on the balance due on Line 21A
B. Enter the lotal of Line 21 and 21A on lino 21B Thl5 15 the BALANCE DUE.
Make Check Po oblelo: Re 1s'e, of Wills, A ent
.. .. BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH · ·
Und~t pl!nJiIlI~sol perJury, I declJifl' that I have eumlned thiS return. Il"Ctuctmg accompanying schPdutes and slat~meots. and to th~ best 01 my ~no....tPdge and belief. Ills true.
cOII~c1 and compt~le I dKlare thlt aUrt'al estat~ hn be~n r~poftPd at true mar~el value O~claraljonol pr~parer othl!" than the pefsonalr~pr~senlalive Is based onatl tnlor~ttonot
which prepare' hn aITj ~now'Pdge.
(21)
(21A)
(21B)
0.00
0.00
0.00
E OF PERSON RESPONSIBI.E FOR FlUNG RETURN
,John E. Slike, Esq.
P. 0, 1I0x 737
C;.n;' iiii i:PA.i'liirii......
Soldls, Guido, Shuff & Masland
2109 Market Street
C;.n; - 'iiiii': 'PA" .i'liiii..................
DATE
.5 Jj!If.,
5'()
L\..
CATE
N REPRESENTAl1VE
.
(I ,
.j;,'
1994 formsoltwa," only CPSystoms, Inc
't"'"
REV - ISOB EX. (2.87)
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCEllANEOUS
PERSONAL PROPERTY
Ploase Pllnt or T 0
FILE NUMBER
cO"~N\\1~~{\'W~~'NIA
ESTATE OF
Margaretta 5. White
5511 203.10-2270
02/25/95
musl be disclosed on Schedule F)
DESCRIPTION
VALUE AT DATE
OF DEATH
1
2
3
4
Mellon Bank checking account
Blue Cross/Blue 5hield refund
Tangible personal property
Two diamond rings - per attached appraisal
1,196.81
93.20
75.00
480,00
TOTAL (Also enler on line 5, Reca ~ulalion)
(Anach add~ional8 112' x 1 r sheels W more space is needed,)
Copyrl;hl (Cl1994 form sollwlI. ant)' CPSystems, Inc:,
$ 1 845.01
Form 1500 Schedule E {Rev. 2-871
REV. 1&11 EX. (7.88)
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Plo"o P,lnl 0' T 0
FILE NUMBER
CO"~N\l\1~c\\,~~r'Nl'
ESTATE OF
Mar uretta S. White
ITEM
NUMBER
A. Funer.1 EJlpln...:
SSII 203.10.2270
02 25 95
DESCRIPTION
AMOUNT
B. Admlnlsl,"tlv" Cosls:
t. Personal Representative Commissions
Social Security Number of Personal Representatiye:
Year Convnissions paid
2, Attorney Fees Saidis, Guido, Shuff 6. Masland 300.00
3. Family Exemption
Claimant Relationship
Address of Claimant at deceden!"s death
Streel Address
City State Zip Code
4, Probate Fees
C, Mls.elllneous Expenses:
1 Register of Wills - filing fees for petition 18.00
2 Landis Jewelers - appraisal 25.00
TOTAL (Also enter on hne 9, Re.aprtulahonl
(If mo.e IPI.ell noeded,lnserllddillonll Iheels 01 lime Ilze.)
Copyright Ie) '994 lorm SOltwlf' only CPSyst.ms,lnc.
s
3/.3.00
Form 1500Sehedul. HIRe~. 7.88)
RE\' ~ 1&12 EX. 0.1))
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Pl.... P,lnl of T ·
FILE NUMBER
cOMrH~l~\~~Oftl~~~r'tYAHIA
ESTATE OF
02/25/95
Mnrgaretta 5. Whito
551! 203,10,2270
AMOUNT
ITEM
NUMBER
DESCRIPTION
1
2
3
Froy IIlllago
Rhoads Pharmacy
Joan Thomas _ reimbursement for U.Haul charges
375.72
117.55
79.90
TOTAL (Also enter on line 10, Recap~u\alion)
(II more space is needed, insen add~ional sheets 01 same size,)
Copyf19h1 (c) '994 form sol1w.r. only cPSy,t,ms,lne.
S 573.17
Form 1500 Schodule I(R.... '.11)
737-8024
2129 Market Street
Box 481
Camp Hill, PA 17011
February 1, 1996
John E. Slil,e
2109 Market street
Camp Hill, PA 17011
concerning the jewelry estate pieces of the Estate of
Margaretta S. White, the following items have been examined
and appraised.
The enclosed report, in duplicate, has been undertaken to
determine an approximate estate value for the items as described.
Each item has been examined to the best of my ability to
determine fair market value only. The procedures, wording and
values would all be different if this report was undertaken
for other purposes.
This report or any copy does not carry with it the right of
publication without prior written consent nor may it be used
for any purpose by anyone other than the above named, and as
such, may only be used in its entirety and with this cover
letter.
The specific description of the gems or jewelry is for the sole
purpose of identification in order to determine the parameters
for valuation. The description is based upon grading and other
techniques and equipment availalJle to, and used oy Landis
Jewelers, Inc., at the time of examination. The description
may reasonably vary from other descriptions of the items listed,
and may vary in the future as a result of changes and
improvements in grading techniques and equipment.
Unless otherwise stated, the weights of all mounted stones are
estimated by formula. Many mountings restrict examination of
details of the gemstone; unless specifically stated that stones
were removed and graded, statements referring to color and/or
internal pureness are provisional; approximate weights are
determined by volumetric calculation; estimate replacement cost
is based on assumed species, size and quality.
Page 1 of 3
INC.
737-8024
INC.
2129 Market Street
Box 481
Camp Hill, PA 17011
Volumetric calculations are approximate, based on estimated
measurements. The actual weight of any stone(s) can be
considerably different than the estimate by formula.
When items are marked with the fineness of the metal, the
appraised value is based on that marking unless otherwise stated.
When there is no marking on the item, the method used to estimate
the metal content is the nature and appearance of the material
as well as any testing as noted.
These pieces have been examined without the stone(s) being
removed from their settings and are appraised on that basis.
This is a fair market value at which the property would change
hands between a willing buyer and willing seller if both had
reasonable knowledge of relevant facts and neither was under
compulsion to buy or sell.
Barry R. Landis
Page 2 of 3
REV-ls47 EX AFP 11Z09S*L :1
COMHOHWfAllll or PIHHSYlVAHIA ACN 101
DIP"I""IN' Of U(VIHUl NOTICE OF INHERITANCE TAX
BUR[AU or INDIVIDUAl furs APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
~~:~is~~:~~. p, 1"'....01 _,OF DEDUCTIONS AND ASS~SSHENT_ DF UX.. _~ATE ~O,9_~~Oc~:~'
ESTATCOF-j;jHITE .~ -5 FILE NO. -21 9'F03iiOc
DATE OF DEATH 02-25-95 COUNTY CUMBERLAND
NDTF.: TD INSURE PRDPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PDRTIDN OF THIS FORH WITH YOUR TAX
PAYHENT TO THE REGISTER DF WILLS, HAKE Ct(ECK PAYABLE T'O "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
JOHN E SLIKE ESQ
SAlOIS ETAL
2109 MARKET ST
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND.CO COURT HOUSE
CARLISLE. PA 17013
AJlount R."Ut.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ii"iv:i5'4i-Eif"AFP--nF9ST"NOi"icE--O,:uiNHEififiiiicn'-AiDippiiiiisE'if€N,..;-.H.l"OWAiicE-iiri-mm----mm
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WHITE M S FILE NO. 21 96-0340 ACN 101 DATE 09-10-96
TAX RETURN WAS: (X I ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. C Schedule A) (1)
2. stocks and Bonds (Schedule 8) (2)
3. Closely Hald stock/P.,-tn.,-shi.p Interast (Schedule CJ. (3)
4. Hartg.g../Hot.. Receivable (Schedule DJ (4)
5. Cash/Sank Caposits/Hise. P.rsonal Property (Schedule EJ IS)
6. Jointly Owned Property (Schedule f) (6)
7. Transfers (Schedule G) (7)
8. Total Assat.
.00
.00
.00
.00
1.845.01
.00
.00
(BJ
1.845.01
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expensas/Adn. Costs/Hisc. Expense. ISchedule H) 19)
10, Debts/Ho,tgege Llebllltle./Llen. (Schedule II (101
11. Total Deductions
12. Net Value of Tax Raturn ,
13. Charit.b1a/Govarnnent.1 aeque.ts ISchedule J)
14. Net Value of Estata Subjact to Tax
343.00
573.17
lIlJ
1I21
1I31
1I41
q16 17
928.84
928:84
.00
If an assessment was issued previOUSly, lines 14. 15 and/or 16. 17 and 18 will
reflect figures that include the total of ALL re~urns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14
16. Aabunt of Lin. 14
17. Anount of Lin. 14
18. Principal Tax Due
NOTE:
at Spousal
taxable at
taxable at
.00
.00
.00
.00
.00
,00
.00
X .00=
X .06=
X .15=
lIBJ
rat.
Lineal/Class A rate
Collateral/Class a rate
1I51
1I61
1I71
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHBER
DISCDUNT ('1
INTEREST ('I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEl
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.0,0
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATIDN OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN SI. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YDU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FDR INSTRUCTIONS..
()l
RESERVATION I E,lat.. of decedent. dying on or before Dec..b.r 12. 198Z -. If any future lnter..t In the ..tate I. transf.rred
In pa.....lon or enJoy..nt to tla,' e (collaterall beneflclar..' of the decedent aft.r the I.plratlon of any .,tat. for
Ilf. or for y..r., the Co..onwealth her.by ..pr.s.lv re..rv., the right to apprals. and all." tran,f.r Inheritance ,....
at the lawful Cia.' a (collateral1 rat. on any such future Inter..t.
..
PAYHENTl Detach the top portion of this Notice and subelt with your pay..nt to the Reghter of wills printed on the re".ru sid..
..Hake check or .oney order payable tal REGISTER OF MILLS. AGENT
All pay..ntl received shall first be applied to any lntor..t which ..y bl due with any r...lnder applied to the tax.
To fulfill the requlre..nt. of Soctlon Z140 of tho Inheritance and E.tate Tall Act, Act ZZ of 1991. 7Z P.S.
s.ction Z140.
PURPOSE OF
NOTICE:
REfUND (CA): I rofund of a tall crodlt, which was not requ..ted on the Te. A.turn, .ay ba roqu.ltod by coapl.tlng an RAppllcatlon
for Aofund of ponnlylvanla Inh.rltance and Eltat. TallR (AEV-1313). Applications aro avallablo at tho Offlc.
of the Aoglster of will., any of ~h. Z] Aovonu. DI.trlct Offlc.i, or by calling tho sp.clal 24"hour
answ.rlng s.rvico nu-bor. for for.' orderlngl In Ponnsylvanla 1-800-36Z-Z050, outside Ponnsylvania ,nd
within local HarrisbUrg area (111) 181-8094, 100' (111) 11Z-ZZSZ (Hoarlng I.palred Only).
OBJECTIONS: Any party In Int.r..t not .aUsflad with the apprah...nt, allowanc. or disallowance of d.ductlonl, or an.....nt
01 ta. (Including discount or Int.r.st) a. shown an thl. Notlc. .u.t object within .Ixty (60) day' of r.calpt of
thlt Hotlc~ byt
--written prota.t to the PA nepart.ant of Ravenu., Board of App.al., napt. Z81021, HarrisbUrg, PI 111Z8-1021, DR
--alectlon to have the .attu detar.lnod at audit of tha accQW1t of tha pusonal npresontatlve, DR
--appaal to tha Orphan.' Court.
ADHIH
ISTAATlVE
CORRECTIONS I
Factual error. dlscov.rad on thl. ass..s.ant should ba addressed in writing tal PA Depa-t..nt of Revanue.
Bur.au of Individual Ta..', AnHI Po.t An.....nt Ravl.w Unit, n.pt. 280601, Harrisburg. PA 11128-0601
Phon. (111) 181-6505. S.e pago 3 of tho booklet "InstructI6n. for Inheritanc. Ta. Roturn for a Ae.ld.nt
n.c.dent" (REY-ISOI) for an e.planatlon of adalnl.tratlv.lY correctable .rror..
If any tax due I. paid within thr.. (3) calendar .onth. after tha d.c.dent'. daath, a flvo parcent (5~) discount of
the ta. paid I. allow.d.
The 15~ tax aanesty non-participation penalty la co.put.d on tho total of the ta. and Intor.st a.ses.ed. and not
paid bofor. January 18, 1996, tho first day .ftor tho ond of tho t.x aanosty porlad. Thi. non-participation
ponalty It appo.labl. in the .a.. .annar and in tha the saaa tI.. parlod a. you would app.al the tax and Intarut
that ha. ba.n ..s....d a. lndlcatod on thl. notlca.
Intora.i I. charged bag inning with flr.t day of delinquency, or nina (9) eonth' and one (I) day fro. the date of
death, to the date of pay..nt. T.... which baca.. dallnqu.nt bafore J.nuary 1. 1982 bear Int.r.it .t tha rate of
.Ix (6~) percant par annu. calculatad at a d.lly rata of .000164. All ta... which bec... dalinqu.nt on .nd .ftor
January 1, 1982 will b..r int.r..t at . r.ta which will vary fro. c.land.r yaar to calDndar ya.r with th.t rata
announc.d by the PA Oepart..nt of Ravenuo. The appllc.ble Int.rost rate. far 198Z through 1996 .re:
~ Inter.st Rat. Dally Interest rltctar !!!r Intere.t Rllta DIllly Int.ratlt rllctar
198Z 20X .000548 1987 .X .000241
1985 16:C .000438 1988-1991 1I~ .000301
1911" IU .000301 1992 'X .000241
1985 13:C .00n56 1995-1994 1% .000192
1986 "lOX ,00021" 1995-1996 .X .000241
~-Inter..t Is calculated os followlI
DISCOUNT:
PEHALTYl
INTEREST:
INTEREST = BALANCE D~ TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~-AnY Hotlce i.tlued after tha tax beco.etl delln~u.nt will refl.ct an Int.ra.t c.lculatlon to fift.en IIS1 day.
bayond the date of tha a.s.....nt. If p.yftant I. ..de .fter the lnt.ra.t co.put.tlon data shown on tha
Hotlca, .ddltlonal Inter..t .Ult b. c.lculated.
n(,
e:,
STATUS HJ:POln:..11W)FJ1..HlLLEJ!.12
'''-,
Date o[
Decedenl: Cf%:u.(j~tTa-
(J./-I--
Deillh:__ '.LI-~f~
,;21- '1(, - .3ID
,.), t-12t:-~
Name o[
Will No.
Admin. No.
'-'"1
hl
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court
Rules, I report the (011 ow i nC] w iLh respect to completion o[ the
administration o( the above-caplioned estate:
1. state whether administration o( the estate is complete:
Yes v 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 [ollowinC]:
A. Did the personal representative file a final
account wi th the Court? Yes No../
B, The separate Orphans' Court No. (i[ any) [or the
personal representative's Account is:
C. Did the personal representative state an account
informally to the parties in interest? Yes~ No_
D. Copies o[ receipts, releases, joinders and approvals
of formal or informal accounts may be filed with the
Clerk o[ the Orphans' Court and may be attached to
this report.
1/~/ft
1\ 1L",t... ,C')
SiC]?l1ture
..!.h,1I ^' E.
Name (Please
ot3,)<. 7a7
Address .
.
,
Date:
i.tL
.s/../~ E.
type or print)
{!~hljJ JI~t. .;!;
.
17~/,o7.37
( 7171 73 7 - .3 t/o~--
'l'elephone Number
Capacity:
Personal Representative
............. Counsel for personal
representative
RW-23