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COMMormEALTH Of PWNSYLVANIA I DEPARTMEUT Of HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
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I, IHLLIi\N J. IIELN, of Delaware County, Pennsylvania,
hereby make my will, revoking all prior wills and codicils:
FIRST: I give to my wife, DOLORES C. IIELN, all art-
icles of personal and household use that belong to me (including
without limitation jewelry, wearing apparel, books, pictures, furniture,
furnishings, consumables, silverware, objects of art and decoration,
and all automobiles), together with all insurance policies on such
property: provided, however, that if my wife should not survive me
for thirty (30) days after the date of my death, I direct that those
articles be divided among my children, IHLLIAN A. HELH, DOLORES II.
KIRKPATRICK, and SUZANNE TRUITT, who survive me by thirty (30) days
in such manner as they may agree. Any such property that my children
do not agree upon after a reasonable time shall be sold, and the pro-
ceeds included in my residuary estate.
SECOND: All the rest, residue and remainder of my
estate I give to my wife absolutely and in fee simple: provided, how-
ever, that if my wife should predecease me or die within ninety (90)
days after the date of my death, my entire residuary estate, together
with any life insurance proceeds received directly by my estate shall
be divided into separate and equal shares representing my children
who are living ninety (90) days after the date of my death or who do
not so survive but have a spouse or issue who so survive.
1. A share representing my son, WILLIAM A. HELM,
who has so survived me shall be paid outright to him, provided that if
he has not so survived me, this share shall be divided per capita and
paid among his wife, MARGARET L. HELM, and his children who so survive
me.
2. A share representing my daughter DOLORES H. KIRKPAT-
RICK who has so survived me shall be paid outright to her. Provided,
that if she has not so survived me, this share shall be divided per
capita and paid among her husband, RICHARD A. KIRKPATRICK, and her
children who so survive me.
J. A share representing my daughter SUZANNE TRUITT who
has so survived me shall be paid outright to her. Provided, that if
she has not so survived me, this share shall be divided per capita
among her children sho so survive me; but, if she has no children
(which is the case at this time) sho so survive me, this share shall
be added equally to the shares representing my other two children.
THIRD: For the purposes of this will, any adopted person shall
be treated as though he or she were the natural child of his or her
adopting parents, whether the adoption took place before or takes place
after my death.
-2-
POURTII: 1. If under the provisions of this will any prin-
cipal shall become payable to any grandchild of mine who is under
twenty-five (25) years of age, my Trustees hereinafter named (without
the appointment of any guardian) retain such principal in trust and
expend as much of the income and principal as in my Trustees' absolute
discretion, it may be deemed appropriate to provide amply for the
support, education, medical care, comfort, travel or any other need
of such beneficiary. Any income not so expended in any year may
either be added to principal or be paid to or for the account of the
beneficiary, in the discretion of my Trustees. The remaining principal
shall be paid to the beneficiary upon his or her reaching twenty-five
(25) years of age or to his or her estate if he or she should die
before reaching that age.
2. Notwithstanding the above provisions, if the
principal payable initially or the property held as principal during
the continuance of such a trust shall be or become of such value that,
in the judgment of my Trustees, it shall be uneconomical or otherwise
inappropriate to set up or continue the trust, my Trustees may, in my
Trustees' absolute discretion, distribute the principal, together with
any undistributed income, directly to the beneficiary or to a parent
or guardian of the person or property of the beneficiary, or deposit
such principal and any undistributed income in a savings account for
the beneficiary, with or without withdrawal restrictions as my Trustees
may deem appropriate.
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FIFTH: 1\11 interests hereunder, whether principal or
income, while undistributed and in the possession of any fiduciary
serving hereunder, and even though vested or distributable, shall
not be subject to attachment, execution or sequestration for any
debt, contract, obligation or liability of any beneficiary, and
furthermore, shall not be subject to pledge, assignment, convey-
ance or anticipation.
SIXTH: I direct that all estate, inheritance, succession
and other taxes payable by reason of my death on any property form-
ing part of my estate for the purpose of such taxation, whether or
not such property passes under my will, shall be paid out of the
principal of my residuary estate or out of life insurance proceeds
paid directly to my estate without any resulting adjustment of bene-
ficiaries' interests. I authorize the personal representatives of my
estate and my Trustees to pay all such taxes on remainder or future
interests at such times as may be deemed advisable.
SEVENTH: I give to each personal representative of my estate
and to each of my Trustees the following powers in addition to those
otherwise provided herein or by law:
1. Without being restricted to classes of invest-
ments prescribed or authorized for fiduciaries by statute or cornmon
law of any jurisdiction, to retain any asset of my estate without
liability, and to invest and reinvest in any kind of property (in-
cluding without limitation cornmon and preferred stocks, cornmon trust
-4-
funds, mutual investment funds, and real estate); to hold cash as
part of the principal of my estate or any trust created hereunder in
such amounts and for such periods of time as may be deemed advisable.
I direct the sale of my home, if it be at 1:l Woodbine Road, Manoa,
Pennsylvania, if feasible.
2. To manage, mortgage, pledge and to sell or ex-
change by public or private sale, on any terms, and to lease without
limit as to term, any real or personal property; and to give binding
options, without obligation to repudiate the same in favor of better
offers.
3. To conduct all transactions authorized here-
under without obligation on the part of the purchaser to see to the
application of the purchase moneys.
4. To vote in person or by proxy all stocks or
other securities, and in connection therewith, to delegate discre-
tionary powers; to participate in any reorganization, consolidation,
or merger of any corporation; to deposit securities under protective
agreements or with protective committees; and to receive securities
issued as a result of such proceedings.
5. To hold any property in the name of a nominee
or to hold it unregistered or in such other form as to make title
pass by delivery.
6. To compromise claims, without the necessity
of court approval.
7. To apply directly for the needs of any benefi-
ciary, in case of the disability of such beneficiary through illness
or other cause, any income or principal that is payable to such bene-
ficiary.
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THO~S E. EICHMAN ASSOCIATES. P.C.. 551 wm-\)!NcAS'TEA AVENUE. MAVEA'OAD. PA 18041.121 51 !52~.0300 .
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,THOMAS E. EICHMAN ASSOCIATES. P,C.. 9?OW. 9....0UL ROAD. SPR'NGFIELD. p" 19064, (2151
COMMONWEALTH OF PENNSYLVANIA:
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COUNTY OF " , ( ,I
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We, WILLIAM J. HELM (testator) and //, ,j, ,,' I",.. .'
and" (,,, ." (", , (subscribing witnesses) whose
names are signed tol the attached or foregoing instrument, a First
codicil dated JANUARY 6, 1991 , to will dated FEBRUARY 27,
1966 , being duly sworn, each do hereby declare to the undersigned
authority that the testator signed and executed the instrument as a
First codicil; that he signed willingly; that he executed it as his
free and voluntary act for the purposes therein expressed; that each
of the witnesses, in the presence and hearing of the testator, signed
the will as witnesses; that to the best of my knowledge the testator
was at that time 16 years of age or older, of sound mind and under no
constraint or undue influence,
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Witness's signature
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Testator's s ature
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/~ tness' s s i na ture
Witness's signature
Subscribed, sworn to and acknowledged before me by
WILLIAM J. HELM
J the testator, and subscribed and
,
sworn to before me by / i " "
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witnesses, this j'~ day
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Notary Public's signature
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W-SELF PF'D-ALL.'77
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CERTIFICATION OF NOTICE UNDER RULE 5.6{a)
Name of Decedent:
William J. Helm
June 27, 1996
Date of Death:
Will No. 21-96-569
Admin. No.
To the RegisLer:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Hules was served on or mailed to
the following beneficiaries of the above-captioned estate on
December 12, 1996
Name
Address
Suzanne Tru it t
448 Garland Circle, Lancaster, PA 17602
Dolores H. Kirkpatrick
Will iam A. Helm
523 Coolidqe Street, New Cumberland, PA 17070
1607 Wyndham Road, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except None
Date: December 12, 1996
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Signature
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Name William A. Helm
Address 1607 Wyndham Road
Camp Hill, PA 17011
Telephone ( 717) 975-0426
Capacity:
Personal Representative
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Counsel for personal
representative
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INHERITANCE TAX RETURN mE NUMBER
RESIDENT DECEDENT
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THIS RETURN MUST DE filED IN IJUPlICATE WITH THE
REGISTER OF WILLS
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(Xl 1 Qngln.1IRclum 02 Supplemflnl,1IRclum D J RemalnderRelumliU'olo.""ptUtlUI)~;)
o 4 limited Estale 0 4a Future Inlerest Compro,f<lSe u~r)<!l!~.'7:< 1l-llU) 0 5 Federal Estate Tal Return ReqUired
[Xl 6 Decedent Died Testate 1Au:~ (Cfl of'~'.'{l 0 7 Decedent r.lalnl.1ll'1cd a LIVing TmsIIAe.:.:l\(OO1 01 Tr~\lJ 1. e Total Number of Sale DepoSIt Bo~es
D 9 LIIllJilMn Proceeds Received 010 Spousal Poverty Credll (dl'fol1e~bet..~~ 'n'.91 a'lCIl.'.~~) 011. ElectIOn lota~ under Sec. 9113(AII.&aftxftOI
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
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CCI.lt'ttlEI.lAllI'.G'-DORE&S
851 Wynncwood Rd.
Camp Hill, PA 17011
William A. Helm
FiQ!.lNAt.ll i;'Af~I(.at.~1
1 Real Estate (Schedule A)
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(2)
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9 7 ,9 5 3 .6
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5. Cash, Bank DepoSits & MIscellaneous Pef'Sllnaf Property
(Set,edule E)
6 Jo>nUy Owned Prope~f (Schedule F)
7, Inter,Vlvos Transfers & Miscellaneous Non.Probale Property
(Schedule G or L)
8 Tobl Gross Asset. (IOtallines 1.7)
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1 2 , 0 0 0 0 0
(8) 3 5 o , 7 7 2 .34
9 6 2 0 5 9
1 9 1 1 7 1
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9. Funeral E~penses & AdminlstralJve Costs (Schedule HI
(9)
(10)
10 Deb~ of Dece<lenl. Mong'ge li'bMMls. & Liens (Schedule I)
11. T 01.1 Deduction. (lotallines 9 & 10)
(11) 1 1 5 3 2 3 0
(121 3 3 9 2 4 0 0 4
(13) .0 0
(14) 3 3 9 ,2 4 0.0 4
(IS) .0 0
(16) 2 0 , 3 5 4 .4 0
(17) .0 0
(18) 2 0 t 3 5 4 . 4 0
12 NetV.lueof E.bte(line 8 m>nus line II)
13. Chantablc and Go....ernmental Bequests/Sec 9113 Trusts for which an ele(t()n 10 tal has not been
made (Schedule JI
14. N.t V.lu. Subjecllo Tu(line 12 m>nus Line 13)
15. Amounl 01 tine 14 ta~able .0 0
Z al the spousal tal rate , 0
0 See instructIOns on reverse side lor apphcable percentage
i= 16 Amount of line 14 talable 3 3 9 2 '1 0 0 4
~i!: al6%rate 06
"";) 17. Amount 01 line 14 latable
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U 18 Tax Due
19
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
unaerpenJll.4:!Sol~iJry.tdediYeltlallh.J'o'ee..:mnedltllsretllm lIlctudlllQ;J:C()lTIp.l'1Ylngscht'du'('$W'd~!.t('ff1ft!'1S a'ld1o\ttetlesloflT'y~r'\C'IIl'~ar'ldbeloel II IS lrtlf! corrocland comtlIe18 OedtYall()l'1ol~ep3tl'othel
ltIM l"ieNl~~ 'e('ll'~lallye IS b.Y.OO on a1111'l1orm:t.iOI'I ol....noch ('ll'*,""lfet' h;lS .1", kr'(WolOO-1f.!
SIGNA lURE PERSON RESPOZIBlE FOR FILING RETURN", _ WOR. ESS . t. J / /(
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SIGIIATURE OF PREPARER OTHER THAN REPRESEIHA TI A DRESS
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fll%N.f
Decedent's Complete Address:
SlRHT AD04fSS -
---.-------
CITv
FOI"esl' l'a::JL-ilc.ill..Lh Center
700 Walnut Hottom Road
Carlisle
~TA.H PA
/,P 17013
Tax Payments and Crodlts:
1. TaxDue(PagolUne181
2. Credlls/PolymenlS
A. Spousal Po,eny Credil
8. Poor Paymenls
C. D,sccunl
(11
20,3511.110
21 . 09o~do
1,110.00---
3. Inleres~Penalty If applicable
D.lnleresl
E. Penalty
Tolal Credllsl A - 8, C) 121 22,200.00
.......
TOlallnlereSIPenalty I D. E) (3) 0 00
4. If line 2 is grealer Ihan line 1 -'me 3, enler Ihe difference ThiS IS Ihe OVERPAYMENT.
Check box on Page 1 Line 19 to requesl arelund (4) 1 , 845 . 60
5. If line 1 .I,ne 31s grealer Ihan 'me 2, enler Ihe difference ThiS IS IIle TAX DUE, 15)
A. Enler Ihe Inleresl on Ihe lax due (SA)
8. Enlerthe 101.11 01 Line 5. 5.~. ThiS is llie BALANCE DUE, (58)
Make Check Pay"able 10: REGISTER OF WILLS, AGENT
.....'1iZ\'~~1m..aai:r..!i-I_\i...:.'WF:,,~araft'''~~lliI.iTlT!;~:
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a Iransfer and: Yes No
a. relain the use or income of the property transferred; ............................................................ 0 ~
b. relaln the righl to designate who shall use the property transferred or its income; ................ 0 [)
c. retain a reversionary Interest; or.................... ......................................................................0 []
d. receive the promise for life of either payments, benefils or care? .........................................0 []
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequale consideration? If death occurred
after Dacember 12, 1982, did dacedent transfer property within one yaar of daath without
receiving adequata consldaration? ..............................................................................................lliJ 0
3. Did decedant own an Oin trust for" or payable upon dealh bank account or sacurity
al his or har death? .............. ....................... ................................................................0 IiJ
4. Old dacedenl own an individual retirement account, annuity. or olher non. probate property?.... 0 ~
. , -', '<l. .~;:,. \ ~ ~,.\:.u..'/ , ..: ,l~ ;",:..' ..;
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
'~'/h,-!" .f;Y.fl:t..!j:..J~i~~r.~'~ :'ltill"",..\jt''''-t~;4'\~..'<' .
i!4~:."'lmMR~~
72 P.S. ~9116 (a) (1,1) (i) provided for Ihe reduction ollhe tax rate imposed on the nel value ollransfers to or for the use 01 the
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P.S. ~9116 (a) (1.1) (ii) provided for Ihe reduction ofthe rale imposed on the net value of transfers to or for the use ofthe surviving
spouse from 3% 10 0% for dates 01 dealh on or after January 1, 1995. The stalule does not exempt a transfer to a surviving spouse
from tax, and Ihe stalutory requiremenls for disclosure of assets and filing a laK return are still applicable even if Ihe surviving spouse
Is Ihe only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1. 1995. Please answer IhD following question by placing an Ox" in the
appropriate space.
Did the decedent Greate a trust or similar arrangement which Is sololy for the surviving spouse'a benefit for his or her enllre
lifetime? Yes 0 No ~
If you enswered yes to the above queslion, Ihe lax on the trusl or similar arrangemenl is poslponed until the death of the second
spouse, .11 which time il will be fully taKable at Ihe raters) applicable to the remainder beneficiary(ies). Enter the value 01 Ihe Irust on
Schedule J, Part II, in order to remove it from Ihe calculation 01 the tax due in Ihis estale, You may wish to file Schedule 0 in order to
make the election available under Section 9113. If the election is made, Ihe trust or similar arrangement is taxed in the estale 01 the
first decedent spouse, the portion of the trusl or similar arrangemenl which benefits Ihe surviVing spouse is laKed .lIthe zero tax rate,
and the remainder is taxed .11 Ihe rale(s) applicable to Ihe remainder beneficiary(les). II you choose to make the election, you must
attach Schedule 0 to a timely.fiIed lax relurn, along With Schedule(s) K andlor M in order to show Ihe apportionment 01 Ihe trust or
similar arrangement between the surviving spouse and the remainder benefic/ary(ies).
~,wu.":' ttk
COMMC)flWtAl HI or r[NtjSYlVMjl~
IPmERlTA.NC( TAx. R[lURN
Rf IOftH OfCfortH
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
21 <)(,-OS(,<)
\H II iilm J. Ih)lm
All properly jolnlly-owned with right ollurvlvo..hlp mUlt be dl"lo..d on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
$10,000 U.S. Savin<ls Bond #XI2IS77IJEE (isslwd Feb.191l<)
2.
$10.000 U.S. Savings Bond #X121S777EE (issued Feb. 'B')
3.
$10,000 U.S. Savings 80nd #XI21r,779EE (issued Feb 'B9)
4.
$10,000 U.S. Savings 80nd #X121r,71l0EE (issued Feb. <B9)
5.
$10,000 U.S. Savings Bond #X1215781EE (issued Feb. '89)
6.
$10,000 U.S. Savings Bond #X1215782EE (issued Feb. '89)
7.
$10,000 U.S. Savings Bond #XIH85807EE (issued May 199
8.
$10,000 U.S. Savings Bond #X1885808EE (issued May 199
9.
$10,000 U.S. Savings Bond #X1885809EE (issued May 199
10.
$10,000 U.S. Savings Bond #X2114860EE (issued April'91)
11.
$10,000 U.S. Savings Bond #X2114861EE (issued April'91)
12.
$10,000 U.S. Savings Bond #X2383964EE (issued Nov. '91)
13.
$10,000 U.S. Savings Bond #X2387994EE (issued Jan. '92)
14.
$10,000 U.S. Savings Bond #X2387995EE (issued Jan.'92)
$10,000 U.S. Savings Bond #X2387996EE (issued Jan. '92)
15.
16.
Smith Barney Growth and Income Fund Class B
2601.151 shares G $12.88 each
17.
Smith Darney Money Funds Cash Portfolio Class A
1209.63 shares G $1.00 with $2.23 accrued dividends
(For values of items 16 and 17, see copy of
Snith Barney statement herewith.)
VALUE A T DATE
OF DEATH
$7 , 696
$7 , 696
$7 , 696
$7 , 696
$7 , 696
$7 , 696
$7,132
$7,132
$7,132
$6,720
$6,720
$6,456
$6,212
$6,212
$6,212
$33,502.82
$1,211.86
TOTAL (Also enter on I,ne 2, Recapitulation) S 140, 8 I 8 . 68
(II mOle spa"...e is needed, msen add,tlona' sheets 01 the same size)
........",.'.
~.~
. .
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
CClJIJCtrMAl!Hcr p(Pjljjyt"Ml'A
IM1[RlfAtlCF. 1A( ~lll,;ll~j
UfSIN~jT r1frFrPH
ESTATE Of
fiLE NUMBER
21%-056<)
\Hlll~m J. Helm
Indude the procero3 01 hhgallOn and lhe IMla the proceedS ""Cfe reccl'wcd by the c~t.llc All property jomtly-owned WIth the right of survivorship mUll be diltloled on Schedul. F,
VALUE AT DA TE
OF DEATH
ITEM
NUMBER
1.
DESCRIPTION
Shawmut Bank Connecticut, N.A., $25,000 certificate
of deposit with accrued interest
2.
American National Bank and Tr.ust, II.
$53,000 certificate of deposit with accrued interest
3.
4 .
Checking account #804-055-8170 at Mellon Bank, N.A.
Mellon Bank cheCking with interest account
#3-375-204
5.
Mellon Bank Money-Market extra account
#40-841-0152
6.
Mellon Bank passbook savings account
#19-042-2988
7.
Mellon Bank passbook savings account
#89-042-7210
8.
Mellon Bank certificate of deposit #A24454-C
9. Mellon Bank passbook savings account
#049-043-4693
10. Reimbursement from Blue Cross
11. Reimbursement from Blue Cross
12. Refund from Blue Cross for unearned premium
13. Refund from Forest Park Health Center
14. Refund from Arlington Management
(list continues on next page)
$25,644.38
$55,687.89
$ 4,483.62
$14,474.10
$ 6,199.28
$ 3,125.52
$65,737.85
$ 3,064.72
$ 5,715.07
$ 1,288.00
$ 920.00
$ 302.93
$ 419.00
$ 32.09
SUB TOTAL (Also enter on line 5. Recapitulation) S 187,094.45
III more soace is needed. insen additional sheets of Ihe same sizel
,
.,""'".,.,.*
CC'-lUOfMtAlTH or PEW~SYlVAN1A
IMlEPITAIlCE f,\X RETURN
RF IOfNT eFO PH
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
(contInued)
ESTATE OF
l'Iilliam J. lIelm
FILE NU~~'b6_0569
Includelhe proceeds 01 h1~.lIOn .""lhe dalelhe proceeds.ere receNoo by Ihe e'lale All property jolnlly-own.d with the right 01 Iurvlvo"hlp mUll b. dlstloltd on Sth.dul. F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
16.
Ladies twenty-inch strand of cultured pearls (per
appraisal)
One ladies eternity ring (per appraisal)
$ 700.00
$2,350.00
15.
17.
Secretary style desk and chair
$ 500.00
$ 50.00
18.
Lazy Boy recliner
19.
prepaid funeral plan at The Donohue Funeral Home,
Upper Darby, PA
$7,259.21
.
i
,!
(For values of Items 1 and 2, see copy of
Smith Barney statement, herewith.)
i
!!
(For values of Items 4,5,6,7,8 and 9, see
copy of Mellon Bank statements, herewith.)
Despite the "Investment Certificate Receipt,"
account number A45597-C, for $10,000, the last
item on the safe deposit box inventory --
"Stocks/Bonds Inventory," this certificate actually
was redeemed on Nov. 21, 1994. Please see letter
from Cathy Cole, Mellon Bank, dated Oct. 5, 1999,
copy attached.
TOTAL (Also enteron line 5. Recapitulation) $ 197,953.66
IIf more soace is needed. insert additional sheets 01 the same siIe)
REV.I5tO U+ 12.111
ft~~~~
COMMONwrAltH or PEtH4\nVMllA
INHUIIA,NCI fAX .nUIN
IUIDEN' DEeIDIN'
SCHEDULE G
TRANSFERS
['lfASI I'RINJ OR ryl'[
FILE NUMDER
ESTATE OF
William J. lIelm
21%-0569
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE OUESTlONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES,
ITEM ! DESCRIPTION Of PROPERlY T01Al VALUE DECO DOllAR VAlue
i EXCLUSION % Of DECEDENT'S
NUMBER: Inetude nome 0' 'hit 'IOnI'P'U, 'h." Itllat,onlh'IIIO dI.'tDd..nt, dul.. 01 '/unlI.., OF ASSEt INt. INtERESl
1.
$7,500 given to daughter,
Suzanne Truitt, on Feb. 4, 1996
$3,000. $4,500
100
$4,500
2.
$7,500 given to daughter,
Suzanne Truitt, on Feb. 4, 1996
$7,500
100
$7 , 500
TOTAL (AI,o enter on line 7, Recapitulation)
(II mar.. 'pou' ;5 n~..dt!d, in,~r' uddlt,onol ,hef'" 0' ,ome ,ize'
S 12,000
.....,'"...,.,"'.
COMWIMtALlttOf PUlt/SYLVAtM
INH[R1IANC[ lAX R[lURN
R I P4T NT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
\'Iilliam J. 1It'I.m
FILE NUMBER
21 %-0569
Dtbll 01 decedent mUlt be reported on Sehedule I,
ITEM
NUMBER
A.
1.
2.
3.
4 .
5.
6.
a,
1,
2,
3,
4,
5,
6,
7,
DESCRIPTlOtl
FUNERAL EXPENSES:
The Donohue Funeral Home (prepaid)
The Donohue funeral Home (additional expenses)
Preston Flower Shop - funeral flowers
Kelly Memorials Inc., grave marker
Saints Peter and Paul Cemetery - perpetual care
Lamb Tavern - funeral luncheon
ADMINISTRATIVE COSTS:
Personal Represenlative', Commission,
Neme 01 Pel10nal Representative (s)
SocIal Setur11y Numbe~s)1 EIN Number of Personal Repl1l$llntative{s)
StroelAddress
CI1y
Stale
Zijl
Yee~s) Commission Paid:
AtIOmey Fees
FlmI~ E,emplion: (II decodents address b not Ihe same es claimants, ellach explanallon)
Claimant
Stroet Address
CI1y
RalallOnshlp of Claimant to Decodent
Stale
Z,p
Probate Fees
Accountants Fees
To. Retum Preparef' Fees
Miscellaneous Expenses:
I.. Register of \'Iills - two short certificates
2. Cumberland Law Journal - advertisement of letters
3. Register of \'Iills - short certificate
4. Carlisle Sentinel - advertisement of letters
TOTAL (Also enter on lIne 9, Recapitulation) $
(If more space is needed, insM addllional sheets of the same size)
AMOUNT
$7.259.21
$ 345.24
$ 238.50
$ 350.00
$ 255.00
$ 700.00
none
none
none
$ 321.50
none
none
$
$
$
$
6.00
60.00
3.00
82.14
9,620.59
"''''"'':''''~~~
'F:$Ij)~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMl,lON'h'[AllH Of P(UNSYl VAN!A
ItltiERIUJjC{ TAX R[turttl
R[ It'f NT 0 CHlftH
FILE NUMBER
2196-0569
ESTATE OF
Ni lliam J. Helm
Include un reimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTIOU
Kathryn Fetrow, Treasurer. personal taxes
2. Emerald Drug Store, prescription bill
3.
Carlisle Hospital
medical services
4.
Carlisle Hospital
medical services
5. Presbyterian Homes - nursing home miscellaneous
6. Blue Ridge Haven Nest - balance due
7. Hand R Block - preparation of 1996 state and
federal income tax returns
8. Pa. Dept. of Revenue - 1996 income tax due
9. Holy Spirit Hospital - un reimbursed bill
10. Holy Spirit Hospital - unreimbursed bill
11. Carlisle Hospital - medical services
12. Arlington Management - medical bill
13. Arlington Management - medical bill
14. Dr. Joseph Torcia - medical bill
15. Dr. Creeden - medical bill
TOTAL (Also enter on line 10. Recapitulation) $
Ilf more space IS needed. insen addl\lonal sheets of the same size)
AMOUUT
$ 9.80
$ 60.89
$ 46.00
$ 46.00
$ 10.00
$ 388.92
$ 141.00
$ 227.00
$ 736.00
$ 96.72
$ 78.00
$ 12.37
$ 32.09
$ 9.02
$ 18.00
1,911.71
I, "YISI.II.. 12"1
~:'~'~C\
..~
COMl,lOlt""IAt'" 01 "~N$'l\'Ahl"
lNHUnAHCI ,.... IIIUIN
IlIlDIHIDfCIDIHI
__ ^__... .__H_.
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
William J. Helm
2196-0569
ITEM
NUMBER
-----------_._____ .u__+ _~__. ________._____.__
NAME AND AODRESS OF OENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
----------------_.~ ---. -----~~----"----~-_...
A. TO.lloble 8equol";
.. ".__ -.-0______---
1.
Dolores H. Kirkpatrick
523 Coolidge Street
New Cumberland, PA 17070
daughter
one-third of
residuary estate
2.
William A. Helm
851 Wynnewood Rd.
Camp Hill, PA 17011
son
one-third c;Jf
residuary estate
3.
Suzanne Truitt
448 Garland Circle
Lancaster, PA 17602
daughter
one-third of
residuary estate
ITEM
NUMBER
NAME AND AODRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
8. Charitable and Governmontal Bequ8lh:
1.
-----.----
TOTAL CHARITABLE ANO GOVERNMENTAL BEQUESTS (AIIO ent., on Ii.. 13. R.copitulotion) 5
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October 5, 1999
William A Helm
851 Wynnewood Rd
Camp Hill PA 17011
Dear Kr Helm,
In regards to our conversation about certificate of depoeit
number A445597-C. This certificate of deposit was redeemed November
21, 1994 for the amount of $11,916.58.
.'
P1eaee feel free to contact me with any queetione at the number
listed below.
~
Thank Youl
$E
,.
Personal Banker
Cedar cliff
1510 Cedar Cliff Dr
Camp Hill PA 17011
(717) 731-4858
.
,
.'
fuasl IDill (tlTD [~5tttllu~nt
I, WILLIAM J. HELM, of Delaware County, Pennsylvania,
hereby make my will, revoking all rrior wills and codicils:
FIRST: I give to my wife, DOLORES C. HELM, all art-
icles of personal and household use that belong to me (including
without limitation jewelry, wearing apparel, books, pictures, furniture,
furnishings, consumables, silverware, objects of art and decoration,
and all automobiles), together with all insurance policies on such
property; provided, however, that if my wife should not survive me
for thirty (30) days after the date of my death, I direct that those
articles be divided among my children, IHLLIAM A. HEUI, DOLORES H.
KIP~PATRICK, and SUZANNE TRUITT, who survive me by thirty (30) days
in such manner as they may agree. Any such property that my children
do not agree upon after a reasonable time shall be sold, and the pro-
ceeds included in my residuary estate.
SECOND: All the rest, residue and remainder of my
estate I give to my wife absolutely and in fee simple; provided, how-
ever, that if my wife should predecease me or die within ninety (90)
days after the date of my death, my entire residuary estate, together
with any life insurance proceeds received directly by my estate shall
scrlbed and sworn to before me by
THOl1A5 E. EICHM.r,N
and
be divided into separate and equal shares representing my children
who are living ninetj' (90) days after the date of my death or who do
not so survive but have a spouse or issue who so survive.
1. A share representing my son, WILLIAM A. HELM,
who has so survived me shall be paid outright to him, provided that if
he has not so survived me, this share shall be divided per capita and
paid among his wife, ~~RGARET L. HELM, and his children who so survive
me.
2. A share representing my daughter DOLORES H. KIRKPAT-
RICK who has so survived me shall be paid outright to her. Provided,
that if she has not so survived me, this share shall be divided per
capita and paid among her husband, RICHARD A. KIRKPATRICK, and her
children who so survive me.
3. A share representing my daughter SUZANNE TRUITT who
has so survived me shall be paid outright to her. provided, that if
she has not so survived me, this share shall be divided per capita
among her children sho so survive me; but, if she has no children
(which is the case at this time) sho so survive me, this share shall
be added equally to the shares representing my other two children.
THIRD: For the purposes of this will, any adopted person shall
be treated as though he or she were the natural child of his or her
adopting parents, whether the adoption took place before or takes place
after my death.
-2-
FOURTH: 1. I: uncle~ the p~ovisions 0: this will an:,' prin-
cipal shall become payable to any grandchild 0: mine who is under
twenty-five (25) years of age, m:,' Trustees hereinafter named (without
the appointment of any guardian) retain such principal in trust and
expend as much of the income and principal as in my Trustees' absolute
discretion, it may be deemed appropriate to provide amply for the
support, education, medical care, comfort, travel or any other need
of such beneficiary. Any income not so expended in any year may
either be added to principal or be paid to or for the account of the
beneficiary, in the discretion of my Trustees. The remaining principal
shall be paid to the beneficiary upon his or her reaching twenty-five
(25) years of age or to his or her estate if he or she should die
before reaching that age.
2. Notwithstanding the above provisions, if the
principal payable initially or the property held as principal during
the continuance of such a trust shall be or become of such value that,
in the judgment of my Trustees, it shall be uneconomical or otherwise
inappropriate to set up or continue the trust, my Trustees may, in my
Trustees' absolute discretion, distribute the principal, together with
any undistributed income, directly to the beneficiary or to a parent
or guardian of the person or propert:,' of the beneficiary, or deposit
such principal and any undistributed income in a savings account for
the beneficiary, l>'ith or I.:ithout withdra.....al restrictions as my Trustees
may deem appropriate.
- 3-
FIFTH: hll interests hereunder, whether principal or
income, while undistributed and in the possession of any fiduciary
serving hereunder, and even though vested or distributable, shall
not be subject to attachment, execution or sequestration for any
debt, contract, obligation or liability of any beneficiary, and
furthermore, shall not be subject to pledge, assignment, convey-
ance or anticipation.
SIXTH: I direct that all estate, inheritance, succession
and other taxes payable by reason of my death on any property form-
ing part of my estate for the purpose of such taxation, whether or
not such property passes under my will, shall be paid out of the
principal of my residuary estate or out of life insurance proceeds
paid directly to my estate without any resulting adjustment of bene-
ficiaries' interests. I authorize the personal representatives of my
estate and my Trustees to pay all such taxes on remainder or future
interests at such times as may be deemed advisable.
SEVENTH: I give to each personal representative of my estate
and to each of my Trustees the following powers in addition to those
otherwise provided herein or by law:
1. Without being restricted to classes of invest-
ments prescribed or authorized for fiduciaries by statute or common
law of any jurisdiction, to retain any asset of my estate without
liability, and to invest and reinvest in any kind of property (in-
cluding without limitation common and preferred stocks, common trust
---
funds, mutual investment funds, and real estate); to hold cash as
part of the principal of my estate or any trust created hereunder in
such amounts and for such periods of time as may be deemed advisable.
I direct the sale of my home, if it be at 12 Woodbine Road, Manoa,
Pennsylvania, if feasible.
2. To manage, mortgage, pledge and to sell or ex-
change by public or private sale, on any terms, and to lease without
limit as to term, any real or personal property; and to give binding
options, without obligation to repudiate the same in favor of better
offers.
3. To conduct all transactions authorized here-
under without obligation on the part of the purchaser to see to the
application of the purchase moneys.
4. To vote in person or by proxy all stocks or
other securities, and in connection therewi~~, to delegate discre-
tionary powers; to participate in any reorganization, consolidation,
or merger of any corporation; to deposit securities under protective
agreements or with protective committees: and to receive securities
issued as a result of such proceedings.
5. To hold any property in the name of a nominee
or to hold it unregistered or in such other form as to make title
pass by delivery.
6. To compromise claims, without the necessity
of court approval.
7. To apply directly for the needs of any benefi-
ciary, in case of the disability of such beneficiary through illness
or other cause, any income or principal that is payable to such bene-
ficiary.
-5-
,(, /
0# ..: ~ It .(.'1')'\\. - ,,"'.,). "......
\lILLIAH J. HELM
SIGNED, SEALED, PUBLISHED and DECLARED by the above Testator
as and for his last will. in the presence of us who thereupon at his
request, in his presence and in the presence of each other, have here-
unto subscribed our names as witnesses:
8. To determine whether to amortize premiums or
discounts in whole or in part; to apportion stoel: and e>:traordinary
and liquidating dividends in such manner as may be deemed appropriate;
and generally to determine what constitutes income and principal with
respect to all property.
EIGHTH: 1. I appoint as the personal representative of my
estate my wife, DOLORES C. HELM. If my wife does not survive me, or
if for any reason she shall be or become unable to unwilling to
serve or continue to serve, I appoint in her stead or as her successors
my son, WILLIAM A. HELM, my daughter DOLORES H. KIRKPATRICK. and my
daughter, SUZANNE TRUITT.
2. I appoint as my Trustees my son, WILLIAM A.
HELM, my daughter DOLORES H. KIRKPATRICK, and my daughter SUZANNE
TRUITT, and I authorize each of them to appoint his or her substitute
or successor in the event of disability, death or unwillingness to
serve or continue to serve.
NINTH: No fiduciary acting hereunder shall be required to
give security in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this
day of
-; "...,.t. t."'i
1986.
"
(~~N/I {J\~:pi,~
.
;:'-,,1 -\~"l..l 11' lJ,/I'/' ,I
'. ' 1'/;)' ..-l': j 1
Address
....., ^ ",(. \~ (
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I
(SEAL)
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-6- A daress ./
f!iff!/i;I!l!if /5-1/5 ? COMMONWEALTH OF PENNSYLVANIA
.... DEPARTMENT OF REVENUE
~
L'J
'/-
BUREAU OF INDIVIDUAL TAXES
UOt(RI1AMC[ u.lt DIVISION
D[P.. 280bO 1
HARRlSIURG. PA 171i6.0601
HoTICE or INIIERlT ANtE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWAHCE
or DEDUCTIOHS AHD ASSESSHENT or TAK
J
111_\\.1..&",,,...1
DATE
ESTATE OF
DATE OF DEATM
FILE NUMBER
COUNTY
ACN
08-14-2000
HElM
06-27-1996
21 96-0569
CUMBERLAND
101
WI LUAM
A~ount Renitted
WILLIAM A HELM
851 WYNNEWOOD RD
CAMP HILL
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG TMIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
.":i54,..";,-,';:",.";",."'-,"",.,.;..,.,,,-.,,"",,...;;.,,""'1"...................
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
"nT'" ",eM """. me<...." ".".. "M '" "" ".'H'"
PA 17011
t AX RetURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. (Schedule Al
2. stocks and Bonds (Schedule B)
3. Closely Held stock/pertnershlp Interest ISchedule CI
4. Hortg.ges/Hota. Receivable (Schedule OJ
5. Cesh/Benk Deposlts/HlSc. Personel Property (Schedule EI
6. JointlY owned Property ISchedule f)
7. Transfers (Schedule G)
8. lotal Assets
I CHAHGED
HOTE: To insure proper
credit to your account,
subait the upper portion
of this for_ with your
tax pay".nt.
.00
140.818.68
.00
.00
197,953.66
.00
12.000.00
181
III
121
131
14l
151
1&1
171
350.772.34
9.620.59
1,911.71
1111
1121
1131
1141
APPROVED DEDUCTIONS AND EXEMPTIONS:
Iql
1l0l
q. Funerel Expenses/Ado. Costs/Hlsc. Expenses ISchedule HI
10. Debts/Hortgege LlebIlltles/Llens ISchedule II
11. Total Deductions
12. Het Value of Tax Return
13. Cherltable/GOvernoental Baquasts; Hon-alacted qII3 trusts
14. Hat Value of Estate subject to tax
" . G~? ~o
339.240.04
.00
339.240.04
(schedule J)
19 will
If an assessment was issued previouslY, lines 14. 15 and/or 1&. 17, 18 and
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aoount of LIne 14 at Spousal reta 1151
1&. Aoount of LIne 14 te.able at LIneal/Class A rat. 11&1
17. Aoount of LIne 14 at SIblIng rate 1171
18. Aoount of Llna 14 taxeble at Colleteral/Cless Brat. 1181
l~. Principel tax Due
C IfED
DAtE
09-24-1996
.00
20.354.40
.00
.00
20.354.40
NOTE:
.00 X 00 =
339.240.04 X 06 =
.00 X 00 =
.00 X 15 =
nql=
SfQU '+1
INTEREST/PEN PAID ,-I
1,017.72
AHoUNt PAID
21.090.00
HUHBER
AA146776
i TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
22.107.72
1. 753. 32CR
.00
1.753.32CR
. If PAID AFtER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
, If TOTAL DUE IS LESS THAH $1. HD PA~HEHT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, ~DU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH fOR IHSTRUCTIOHS.I
RESERVATION: E.t.t.. of d.cedent. dYing on or before o.ce~er IZ, 198Z -~ If any future Int.r..t In the ..t.t. I. tran.f.rred
In po.....lon or .nJoy..nt to Cia.. e (collat.r.l) ben.flcl.rl.. of the d.c.d.nt .ft.r the .xplratlon of any ..tat. for
Ilf. or for ya.r., the C~onw.alth h.r.by ..pr...ly r...rv.. the right to .ppral.. and ...... tran.f.r 1~rlt8OC. Ta...
at the 1..ful CI... e (collat.ral) rat. on any 'uch future lnt.r..t.
PURPoSE Of
HOUCEl
To fulfill the r.qulr..ant. of Section ZI40 of the Inheritance and E.tate T.. Act, Act 23 of ZOOO. (72 P.S,
Section 9140),
PAY"EHT I
Detach the top portion of thl. Hotlce end .ub.lt with vour p.y..nt to the R.gl.ter of WIll. printed on the r.v.r.. .Ida.
u"ak. check or .oney ord.r P.Yable tal REGISTER or NILLS, AGENT
REFUND (CR)I
A r.fund of . ta. credit, which .a. not request.d on the ta. Return, .ay be requestad by coaplatlng an -Application
for R.fund of Pennsylvanla Inherltanca and E.tat. Ta.- IREV~1313). ApplIcations .ra av.llabl. .t the Office
of the Reglst.r of Will., any of the Z3 R.vanue DIstrict Offlc.s, or by calling the .paclal 2~~hour
ens..rlng sarvlca nuab.r. for for.. ord.rlngl In Pennsylvania l-aOO-362-2DSO, out.ld. Penn,ylvanl. and within
10c.1 Harrl.burg area (717) 787-8094, S.rvlc.s for ta.pay.r. with .p.clal hearing and .peaking ne.d.:
1-800-447-3010 (TT only).
OBJECTIDHS:
Any partv in Intara.t not .atl.fled .Ith the appr.I'..ont, allo.anc. or dl.allowanc. of d.ductions, or ..s....ant
of tax (Including dl.count or Inter..t) a. shown on thl. Hotlc. .u.t obJ.ct .Ithln .I.tv (60) days of r.colpt of
this Hotlca by:
ADttIH
ISTRATlVE
CORRECTIONS I
uwrltten protast to the PA Dapart..nt of R.venue, Soard of Appeals, D.Pt. 1810ZI, Uarrhburg, PA 1711S-1011. OR
--el.ctlon to have the aatter deter.lned at audit of the account of the per'onal repr...ntatlva, OR
--appaal to tha Orphans' Court.
Factual arrors dl.covared on this a..a....nt should be addre.sad In .rltlng tOl PA Depart.ent of Ravanu.,
Buraau of Individual la.e., ATTN: Post A.se...ent Revle. Unit, Oept. 280601, Harrl.burg, PA 17128-0601
Phone (717l 787-6S0S. See pag. ~ of the booklat -In.truction. for Inherlt.nc. la_ Return for a ke'ldent
Decedent- (REV-IS01) for an ..planatlon of ftdelnl.ttativelY correctable errors.
DISCOlJlT 1
If any ta. due I. p.ld within three (3) cal.ndar .onths after the d.cedent.s death, a flv. p.rc.nt (SXJ dl,count of
the tax paid I. allowad.
PENAL TV:
Tha ISX t.x a~.ty non-participation p.nalty I. co.put.d on the total of the tax and lot.r..t .......d. and not
P.ld b.fore Januarv 18. 1996, the flr.t day .fter the and of the t.. aana.tv period. Ihl. non-participation
penalty I. .ppealabl. In the .... .ann.r and In the the .... ti.. period .. YOU .ould .ppeal the tax and Int.re.t
that has been a..e,Sed as Indlc.ted on thl. notic..
INTEREST:
Int.r..t Is charged baglMlng with Urst day of d.lInquencv, or nine (9) .ooth. and on. tll day froe the d.te of
d.ath, to the date of pay..nt. la.a. Which baca.e dellnquenl before January I, 1981 baar Int.r..t at tho r.t. of
.Ix (6Z) parcent per annua calculat.d .t a dally r.ta of .OOOI~. All t.... .hlch b.c..e delinquent on .nd .ft.r
January 1, 1982 will bear Int.ra.t at . tate which will vary froe c.lendar vear to c.l.ndar ve.r with that r.t.
announced by the PA Depart.ent of Ravenue. Th. appllcabl. Interast rat., for 1982 through lOaD .ra:
!!!r Intoro.t Rate Dally Int.r..t r.ctor !!!! Int.rast Rato Dally tnter..t Factor
1982 2DX .OOOS~8 IlJ88-19lJl 11% .000301
1983 .<X .000~la 1991 9X .000247
1984 11X .000301 199]-19q4 r< .000192
IlJ8S ax .0003S6 IfJ4JS-IIJ98 9X .0002~7
1986 lOX .000274 19qq 7% .0001QZ
1987 9X .000147 20aO AX .OOOZl9
--Int.r..t 1. c.lculatad n. follo.s:
INTEREST = BALANCE or TAX UNPAID X NunBER Dr DAYS DELINQUENT X DAILY INTEREST rACTOR
--Any Notlco I..ued after tha tax hecna.. dellnqu.nt .111 refloct an Int.re.t calculation to flft.an lIS) day,
beyond tha data of the .......ant. If payeent i. .ade after the Int.ro.t co~utatJon dato shown on the
Notice, additional Interest ..st b. calcul.ted.
/5-.//.j- - J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
(\1*
) -
.
BUREAU OF INDIVIDUAL TA~ES
UIlt:AltANC[ lAIC DIVISION
Dl:PI. ir6D6Dl
HARRISBURG, PI. 111:e-O"01
1"-161'''''' III.ftl
WILLIAM A HELM
851 WYNNEWOOD RD
CAMP HIL L
DATE
ESTATE OF
DATE OF DEATM
FILE NUMBER
COUNTY
ACN
09-05-2000
HELM
06-27-1996
21 96-0569
CUMBERLAND
101
WILLIAM
J
Amount R..itt.d
PA 17011
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MAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, sub.it the upper portion of this forn with your tax pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'y:i6iWEX-"FP-nz:m-------iiiiii-iNHE'iiiTANC'E-fiiif-STiiiEiiENf-iiF'-iiccciijiii--iiiii---------------------
ESTATE OF HELM WILLIAM J FILE NO. 21 96-0569 ACN 101 DATE 09-05-2000
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAYHENTS, TNE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 08-07-2000
PRINCIPAL TAX DUE: _______________________________________
20,354.40
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT 01 SCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-24-1996 AA146776 1,017.72 21,090.00
08-14-2000 REFUND .00 1, 753.32-
TOTAL TAX CREDIT
20,354.40
BALANCE OF TAX DUE
.00
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
TOTAL DUE
.00
.00
INTEREST AND PEN.
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MARY C. LEWIS
Register of Wills & Clerk of Orphans' Courl
Cumberlond County Courthouse
Corlisle. Pennsylvdnlo 17013
7000 1670 0010 9163 2049
WILLIAM A.HELM, ESQ.
1607 WY"-'"''
CAMP H
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o INSUFFICIENT ADDRESS IJ OTHER
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~ NO SUCH NUMBERI STREET
~NOT DELIVERABLE AS ADDRESSED
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Estate No.: 21-1996-569
JUL 0 6 20~
ORPIIANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUt\IBERLAND COUNTY
PENNSYLVANIA
In Re: Estate ofWII.I.IAI\I.I. II EU\I
Late ofCAIU.lSI.E BOItOUGII
NO. 21-1996-0569
NOTICE OF FAILUItE TO FILE STATUS ItEI'OItT AND ItEQUEST TO CONDUCT A
IIEAItING I'UItSUANT TO ItULE 6.12, SUI'ItEI\IE COUItT OItI'IIANS' COUItT ItULE
Personal Representative:
Counsel for Personal Representative: WILI.IAI\I A. IIELI\I, ESQ.
Date of Decedent's Death: 06-27-1996
Date of Delinquency Notice: 05-25-2001
The undersigned. Mary C. Lewis. Register of Wills, in accordance with Rule 6.12,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 05-25-, 2001, and that the ten (10)
day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the
Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a
hearing to determine whether sanctions should be imposed upon the delinquent personal
representative or counsel for the delinquent personal representative.
Date: 07-06-2001
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Distribution: Personal Representative
Counsel for Personal Representutive
Estate File
A hearing isseheduled forr.''I111 at c;- Jdn Courtroom No.3.
prior to the hearing date, the heuring will automatically be cun
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: It I Ii II/IIi
Date of Death: (. /:1 ;/ 'If
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Will No. n ' /'itL ( ~ (, ';'
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Admin. No,
pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to complet1on of
the administration of the above-captioneu estate:
1. State whether administration of the estate is complete:
Yes No L.'
2. If the answer is No, state when the personal
representative r~asonably believes that the administration will be
complete: I 'J L I I 'I c,"
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3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The sepal'ate oq,hans' Cuurt No. (if any) for
the personal representative's account is:
c. Did t.he personal representative state an
account informally to the parties in interest? Yes 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.
Date:
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signat.ure
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Name (Please type/or prin~)
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Address ((//ll)' II, II ) "j /'/N!
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,
JRDlJune 30, 1992/17858
nEGl1>"En OF WILLS
Cumberlond County Courthouse
One Courthouse Slluure
Corlisle, PA 17013
NOTICE PURSUANT TO nULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal Representative
Counsel: wrr.r.r:'M :.. HElM. E!'l). ,
RE: &\ate of WIl.LIAM J, HElM
NEW CUMBEHLAND BJoo{x;H
&\ate No.: 21-1996-0569
Dote of Decedent's Death: 6-27.96
, Deccased, Late of
Pursuant to Rule 6.12, lhe above named personal representative or the above named attorney, if
applicable, wilhin two (2) ycars of lhe decedent's death, and annually lhereafter until administration is
completed, is required to file wilh lhe Register of Wills a Status Report as required by Rule 6,12, in
substantially lhe prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed, The purpose of this Notice is to advise
you that unless the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of lhis Notice that the Register of Wills
is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to determine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, if any.
Accordingly, if the requisite Status Report is not filed by 6-3-96 , 19_, you ar~he y
advised that a request will be submitted to the Court in accordan:e with Rule 6.12.
Date: 7-15-96 LJt,a..~6'(~fIJJv f!71IlJU'<-
Deputy egister of Wills
Distribution to Estate File
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MARY C, LEWIS
nlgllter 01 Willi & Clerk 01 O,phln.' Cou,l
CurnhUlllull' Countv CumUlOUSO
Cnrll,lu, POIlI1&ylvlmirl1101:1
UH[)I.UVERAIM
AS AOOR[!>SEO
f{)RWAROING
OIlDER EXPIRED
HeLMb07 ~70~~a003 ~N ~q oS/oe/OO
RETURN TO 5eNDeR
NO FORWARD ORDeR ON FILe
UNABLE TO FORWARD
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STATUS REPORT UNDER RULE 6.12
Name of
Decedent:_14l,' J/i a }1'1
& /.27 /c;!:,
:J. Jltln7
Date of Death:
Will No.
Admin. No. I r9~,- oot;f.:,r;
pursuant to Rule
Court Rules, I report the
the administration of the
6.12 of the Supreme Court Orphans'
following with respect to completion of
above-captioned estate:
Stat~,whether;(dministration of the estate is complete:
Yes No
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2. If the answer is No, state when the personal
representative rea.~qnablY believes that the administration will be
complete: ~_I,j /(}{)
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3. If the answer to No. I is Yes, state the following:
1.
a. Did the personal re~resentative file a final
account with the Court? Yes No
b, The separate Orphans' Cuurt No. (i f 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.
Date:~O
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Signature '
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Name (Please type or print)
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Address (J
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Counsel for personal
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