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HomeMy WebLinkAbout96-00761 ;.' , . ~ CI) ... c d 1;; -z ~.. i'_" ., PETITION n>H PlwnATE IInd (;HANT OF LETTEI{S 62 \ - q to - '}i4>(_ Lilli'" III _ QORI~WOOOlll!'.:f 11111/ A ",;"," "' OORl S M^,ll [ 1:I\OMI\S. Nu. 10: Il~~i'l~r of, \\'111\ flu Ih~ COUllty (lit '1,'n\t.J.~td(l_L~_d_ in lhe C(HIH1I1HI\H'allh (11' )Jcnllsyl\'allia [,.'t't'f1\1.tl. Sorilll S,'I'''''I.'' ;\'o,.~.'U ' . ~,:~ '. DbJ:.! rile.' IlL'IiliOlll1f llll' lImll'l"'I~IH.'d Il"Pl'l.:lttllly Il'll1l'\Cllh Ih:\!: Ymll pl'liliOlH.'It\), \\ho j.../all.,' IS Yl'al' \,1' "pl' Of ollie! iltllhl' \.'\l'1.:t11 ~h,t\lc,.~L" tJi.\._'.J_"_.J___ named inlh~ la'l \\ill of III<' a\1o,,' ,Ie"',lenl, <Ial~<I. _ 1 , "....." _I. ...,._........ ,_. II)_';!.~L alllt ((Hlil,:il(...) dilll'd - ~-----'._- ...----.---- - -- _.._~.~ ---."-'- --------- tqah.' Id~'\.1II1 ~1I(.IIII'I;lIl~.l.'. I'.)!. Il:lHlIK101lillll. dl'0I1h Illl"CI,;ultll, 1,'1.:.) J}C(1'11lh:nl \\01\ dumidll'd at death ill_~Q__~~J!.~J)s~ICu_\d._---.- ___~. COlIIU)'. Pcnn~yl\'aniat with hu........ la,1 family'" prindp,,' ,~,id~n~~ at ,,).')..:/.._<;,1.,..:.J",....L.. u::J,--1=\., d ~I \ j ._ " .. I _.~ t:u.Nl _J 1.,.l.l..y...0/nt",,"'p,.j-LJ.._U,"-,G.o:,,-_._-- 111,1 'll~'~'l. llUlllhl'l .lI1'.Il11l1lhlp..hl~1 \)~~~nd~nl. Ih~n __4~n~_ y~a" of ag~. <lied. __,"')"'0.'/ '1. .11)<1 I.. . .1lQ.~~L\..l./I\J.)-,~\.,--1:\~t~\.L--LQ..(;Y:b_Lk..L'~fJ,d~(~..J.",~TLl..e, bl....:.I_'~_,...,....'_ (.. ,'i --,,~ .~:( . (:'.......1'1 <1' follo\\\, dCl.:edenl did nul marry. "ill" nut {.Ii\'nn..:ed \lml did nut ha\'c a child born or adopted aflt:r .."t:cutiun uf th... will uffereu rur prohate: W<.l!'\ nul the \klim ur it killing. and Wt.1\ never adjudicated in~omp~l~nl: ~'I-'l/L\__--._-_.._-'---~' -,~.. Decl.'mkllt al dea1h owned property \\ilh c'1imalcd \'aluc' a' follnw..: (If d",,,idled in I'a.) Allp~N",,,lprop~r1Y (If not domidkd in Pa.) Pep,unal pruperty in Penn,yl\'aniu (II nl11 ,Iomi~iled ill 1'",) I'~"''''al prop~r1Y in COIlIllY \'ahll' ~lr I'l'al ,-,'Ial\.' in Pcnll\\'I\'ania ,ilual..:d a... 1'0110\\"': _NC.~~-~._--__-__~-_~._-__~ sA-:2rr, s s s .~---_.__._-_.-----_..- - _... .,.___~__..__._u.._'+'__ _______._ ---" -+----.~....--._--------,.- \\ III:KEHIKE. p~lilion~r(\) '~'I,"~lflllly '~qn~.,t(" lh~ prnh(l\~ 01 Ih~ liI'l will and codicil(s) pr~,~nl~d h~,~\\ilh and lh~ granlof 1c1f~"...:1~.-:';'U\ ""..<:.N~,L(...,,,-,/ , 11\."I,lIIH"I1,.lI~; a.tnlllll'II,.'tt1l1 ~,l.a.; .hhnini\lraliun d.h,11.I.:.1.a.) th"'1l11l. ,. i: " - :t ~ ~:~ 7:" 0hL.'LLL'7.r ;(c(_~l.-i..,~b<.. u:w... -- --- - .,-_.---_.. - --.,-----------.---..-.- ..._-_.~--_._--_. - ...--.-.--------------.- - ---_._-,-- ---~.. ---..--------- ._~-, ?C'.'h::....ils.t u ,\..\C,CC.IO:'.i~.I."LD_N.u(, . d-If.5.;L...~ W""."" ,.1" (,9 ,CI).'J;;:)'~J..~'IG;).3..._, :.... 7 .----_.._.-.- .. ~----. .-- --_..-- -- -------- .. . ---_....------- -------------.------- -_....._._--'^- .-.----.....-..--- _..-.,-~--.-,- ----------.-...-. . -----..-- OATH OF PEnSONAL REPRESENTATIVE CO:\IMO:'l!WEAl.TII 0... l'Ei'i:'l!S\'l.\' ANIA !. s:-; cOt\T\' o.....uG..U]1BERLANO J 11u: pctilinlU.'I('1 ahl1H'-llallll'U \\\l'jut...) ur arnl'nu"'} Ihal thc ..lat....l1\cl\" in lhc forcgoing petition arc Irw,,' .1I1d ~lllH..~t IUlhe hl"1 01' Ih.... J..lHmkdgc ami hdief of pt:litiul\I.:r(\} and that 01\ pcr\ollal rcprc~cn. tatiH'blllf till,' ah~"l.' dl,.'Cl'(k'nt pctithmcl(") "ill \\l'1I allll truly .Illmini\t....r tll... C,WIC according. lola\\'. ...:J ,y~j.'-'-d>J(,"~ 1_....t,_.L-~-\I.J '''' €" ~ ~ ;;;- - S\\llTI1 It' 01' an.'ifIlH,,'d. ami "".I."I..'rihC\1 \ " hel,"',' III" Ihi, 20TH "'1\ of 71JJ~~zr1~~t~,p !.fJ'O;'L'it~ fJfiL, " M.(l.RV C LEWIS Ik~i,~,F X1 ld~-~ . - .---------_.__.--~._---------_.-----~.__..." --.--.-----.--.----- N ;> 1 - 96 - 761 o. Estate 01' DORIS WOODRUFF afk/a DORIS MAInE THOMAS . Dcccascd DECIU:E 01' l)nOnATE AND GnANT 01' LETTERS AND NOW OCTOBER 2. 19~, in consideration of the pelillon on the reverse side hercof, satisfactory proof hll\'ing been prc,entcd beforc me, IT IS DECREED thallhe inMrnmenl(s) dlllcd MAY 1, 19B7 dcscribed Ihereln bc admilted 10 prob:llc and tiled of record liS Ihe la'l will of DORIS WOODRUFF a/kfa DORIS MARIE THOMAS TESTAN'ENTARY SHIRLEY ROBBINS BASS IInd lCllers are hcreby granted to fJt~. MARY C. LEWIS FEES Probllle, Lellcrs, Etc. ......... Short Certificates! 3) . . . . . . . ., . Renunciatioll ................ X-Page JCP $ ;>5.00 $---9....oD- S s 3,00 TOTAL _ s-J.:28- . . . . .OCTOBER. 2., .1996 . ... . . ... . . . ATTOKNEl' (Sur. Cr. I.D. No.1 ,\IlDRESS Fllcd I'HONE nn .-: ::- , , ~J -l,C l-i -J ~ , '-, ,.;.. C.'('". Mailed letters and order to Executrix on 10-2-96. PAIlENTS DEHNR 1112 (Rlvt..dS1t4 Rlvlew2lt7) VITAL RECORDS SEAlJ UOfIIlI r:^"0l1t1~ ou'^nIM[tn or [UIJIROUMftll,llr.Allll. AIm ,lAftJ"^lllr.r.ollHC[S fUM[ cnlltl1 ron IILAl1I1Afln WVII10tlMrt"^l ~'AIl511C!O - VlT"ll4[CQllDS !.[CIIOfI CERTIFICATE OF DEATIl ncgl,I,nlloll 0 33 - 7 0 Dlstrlcl No. toe.lllo. " . F 1:0 '1'11 .Itllh, "f.l'" September ~, 1996 J l; ;11M VI llll"lI. M,'., ." Doriu Mario 'l'homau I y, I. I C (ltl/ll, ..."~.. ;''''6/20/31 trurTDTiTj'i:i"c NC t. -r,ouArtrwmm;m;mr L: '/(,;Wfltyl otr""''lI"Crnmlry) '.WiJ.son Co. .. J.nr::ti"tfli:iitJ'iY _ mt:nI t~...t1J 65 MUIlU" & !b. 00' I Hou', 50. ()I~' ,241-52-2027 WAS utCr.ll[lU H'l.I1Ul AI1MCUN6CCS1 ft.. ct No)} .. 1.1 [RlCMllllllnt U 00" OIum 1I Uunlnollome (] nnldlllK' 'A<.;llll....UA {/ t.:ll'1',IO'M',Olll . :ill-CI I lb. Columbia lIeritage 1I0spit \,1. 'l'arboro ~~~"'M>'Yes I .till', .", OJ I ..-j .',g"""" I"n'''.'(; a C I (IY' WOf M,lIIt.d, WdOMd, Ouotud fS,..c~, don. dunnQ nil" oIll1i","llI '01, {lo "'l' III' ,.fr,.d) to. Divorced \I. '" assemb worKer 1::;1 ., ._ l,;UU LI Y, .0 10 .. I.' , UU .. L1 Oth., (Spwf.", ~ ... Edgecombe Il.I . '51\ > ".J rui t dealer n,. PA ...Cumberlanc n, Ht. 11011 s.I .(; I c,; It .tI .,,1 IIP.me 'lI'" f"" ""'" (YuOINo) No-I!.t". ~{i~cub.1I, Irl'IIc'1\ ",,-,foR/nil, Yes 17065 .kIUV" N""S"'''~} n.. IS!, '4. tiE rs ~ fl'.st .. odd~. hI!) If. William Howell Thomas IW-UfIIMW'S rIA E "yr' 'rnt1J Shirley Bass tI.. n~ 324 Chesnut st., Apt. ""'lIun n I,n, urClUlUI S lOUCAlI0U,Sp.ctlyOfllyhlghfl.,,,,.d. DI.ck, 'MIll., tic (~l'rc""J cotrflMltd) rwrren'.ry&cond.tyjt).';J con.".",.".} White Otn 15. n. U II. 151<<A Ell Nst Iddl., ,Id'rt Sum.me] Ruby Elizabeth Ellis " lLlIlO AWH 55, n.I.na NvtttM' Of Run' UOU/fI Numb,r, (;/1')' Of rMII, .sr"., I' COO, P. O. Box 204 Macclesfield, NC 2705 lib. .. u "c. plOlm, n.rra o.~..nOn..I.nd 0..11I .,t n., . ,unn.J1u"n,OICDlI1p . ". IUU" . II In Il.n . llflll.'lIt lI.pproprlal., tnw,klCIltco..kotlot, or drugu'l Lblonlt onlUUUon Ilth~. fl'RJNror rYF'Q PIlMEDIATE CAUSE ---+ /J Q ~~~:~:~::::1I ~~~~~~~f~~:~~~,11.W utS,- IndlllhJ ';J 5.qu.nbfthlcontUIonI b 6~'1 'C..,...J:t. Ji,uu<, l.ny,lt.dlnllkJ'm,.dIl1lt llUE10(OAA , ,IUI. Enle' UtlOERL VIHO CAUSE (Olsu" 01 'iury ltlalk\1II1,dlY,nl. IfllI....I~duIhILAST. IIUIIJCllIlnp" ",'I""ot Qt...I' rl. , A'1t'~r" -'uUrlown .., rJ'oJ d ....:r7.~ , I Q 20a. d i1.. ''''~ I. U\hef Ilgndlunl COnd,tlOtll conlll ling to dealh no',eaullmg n II undll 1 nil calla. glnn In 'art, auch ..lobacco, a CO, 01 NO ua.; la Iln, Itc. 2Db. Oi:J<ib1fYUOINo 11e',Wl!1I tndlOg.tonaidfled nd,lelfl'lnWlgcauII U I ..caal"'''' 10 ,dltal larno" CruOl 0 21a. 21b. 21e. 22. M NO ICE: 5 AI WIlEQUlUl;5 IlAl^llUtA USOUl: 0 HAU ,tCIUE.N ,tto IClUE,5UIClUE,on UNUt;" SUSPlClOUS, NUSUA ,onUNt4^lUI CI CU tiC DE REPonTED 10, 1.110 CERTIFIED OY A MEDICAL EXAMltlER ON A MEDICAL EXAMINER'S CERTIFlCA TEOF OEA TH Am DEAtH rAlUNQ ItlTOtUESE CATEGORIES ISWTlI tUE MEDICAL EXAMI Efrs CTlON REe1^nDlESS OF ntE lEUatu OF SURVIVAL FOllO'MtlO lUE UUOERlYINO INJURY. SlUt UU: NO II .OfC UIHI t PA, Tarboro, NC 27006 ". Ii uoo OF UtS SIIIUIf CIi Of $POSI lot (Nan'l' of un.',ry, t:1I1!'lll1oty. 01 olhfl loeA lut CIty Qt own, Sial.. lp ~od. D~I,' 01>,...1100 On."",.., p'''') stantonsburg Cemetery Stantonsburg (wilsonl, 25a. fJ [)on'linn 0 Oth.., 2!lb. 2!le. 278 3 IlAM~~h~r:;~'ss~Y~l~~~'t~n, POBx3932, Wilson 1:!Ut'f))i'~o'L~"'~\r.l't'RTeford 2&.1. 2Sb. I ;G15 ..,) Of U George W. Rouse 2Cd. NC 2Gc. LICENsE tlUMUI;;.H 2081 2S.. '---"..-;. -..-.----.--.-----..--. . --. ...-- .--...-.--.-" .~. -.-.- --...-.... to certify that the same as recorded in foregoing DEATII CERTIFICATE is a true and correct the office of the Register of Deeds of Edgecombe S..;;/, i.~ , I - This is copy of County. Witness my hand and official seal, this the 19...:&. /'-f dsy of Gladys c.~elt7n, Register o~;~eds of Edgecombe County. By: I J .~JVf-'IL - tt It-t,,.,,, ,"'/''''''/---- J Deputy/^~tant nn c: -- -, '0 G' :rJ -r: f;-' ,.-., C'. er. "'tl N Cl (,. ..~ .... :-., 'D ,.n c:, V' . > - ~~ :(q . , co Ifi 0\ ~ \,;:< In. o N Eb v, \..J ...,:, () ,-';' <liLt: a: 'D P' ~: ..J::; UU t; ~ .. ~ )( ~ >0 g:; IlC W i ~l . -t " u .. IE . -: .- I '" :z: = :I 0 u , . - .( ~ t; 9 ii ~ p.; ~ 2 ~ uj :l R ~ ::J ~ e~ ~ ~ l'l ~-~ ~ ~ o Q ...t; ~ ,c . t =: t:I ~ ~ 10> n ~~l fft '" '" ~ l'l E ~, ... ~ ' . ll:l ~ .. 8 .. .. ~ ~ ~ )( .. ~ o . .. l'l :z: ... <.l ~t S ::! u . :z: IE :: 101 0 :z: t, ~ .- ., t; 0 lil 2 ~ -" . - .. .. -.. . .... .. '. last ]mill nub QJt$taUt~tt! NORTH CAROLINA WILSON COUNTY I, DORIS WOODRUFF, of the County of Wilson and State of North Carolina, do hereby revoke all former Wills and Codicils heretofore made by me and do hereby make, publish and declare this my Last Will and Testament in manner and form as follows: Item One I direct my Executrix hereinafter named to pay all of my just debts and funeral expensea and to erect at my grave such monument as she may deem proper. Item Two I will, devise and bequeath unto my grandchildren the sum of Two Thouaand .' j Dollara ($2,000.00) each upon the fOllowing conditions: I direct my Executrix to pay said sum to each of my grandchildren at the time of my death unless said grand- child has not graduated from high school. In the event the grandchild has not graduated from high school, I direct my Executrix to set up and pay the $2,000.00 bequest into an intereat bearing insured savings account for their benefit to be delivered to said grandchild at the time of graduation from high school. Item Three I bequeath unto my son, William Glenn Robbins, my diamond solitaire ring. Item Four I bequeath unto my daughters, Patricia Dianne Woodruff and Shirley Robbins Bass, all of my personal clothing, jewelry, and other personal items, share and share alike. Item Five All the rest and residue of my property of every Sort, kind and description, both real and personal, I will, devise and bequeath unto my children, absolutely and in fee simple, share and share alike. Item Six I hereby nominate, constitute and appoint Shirley Robbins Bass, my daughter, the Executrix of this my Last Will and Testament, and direct that she should be allowed to serve without bond. IN TESTIMONY WHEREOF, I the said .J'r to this instrument this I; day of DORIS WOODRUFF, the Testatrix, () ')~'L v sign my name , 1987, and being first dUly sworn, '.. or .. ., do hereby declare to the undersigned authority that I sign it willingly, that I execute it as my free and voluntary act for the purposes therein expressed, and that I am eighteen years of nge or older, of sound mind, and under no constraint or undue influence. m~/A_~RIS ~:;:;fW (SEAL) . /1 -/-,z:;- ~C.; o4/~~ (1.. 01--u.<... ,/"': {( -fa-vt~:"'" Q'L' ,and ~A:.. e:. J:-:;t~c.,..v'- , the witnesses, sign our name to .tn1s instrument being first duly sworn, and do hereby declare to the undersigned authority that the Texta- trix signs and executes this instrument as her last Will and that she signs it Willingly and that each of us, in the presence and hearing of the Testatrix, hereby signs this Will as witness to the Testatrix's signing, and that to the best of our knowledge the Testatrix is eighteen years of age or older, of sound mind, and under no constraint or undue influence. ;~,? '--f .....1~/::::::, of Wilson, NC of Wilson, NC --&Ltc E. , .I of Wilson, NC NORTH CAROLINA WILSON COUNTY Subscribed, sworn to and acknowledged before me by DORIS WOODRUFF, the Testatrix, and subscribed and sworn to before me by 4/.:';/";-<- C. -a-1-U;. ,-fd. and /'!.t.T/ r. 4un<- ,witnesses, this /~' day of ~M~~ C:. '/ ?71A'J , 1987. cS~~~. ~J/ A1~ Notary Public My Commission Expires: I~bf/;>O .f- CERTIFICATION OF NOTICE UNDER HIJJ,~; 5.6 ( ill. Name of Decedent: Doris \~oodruff MK/A Doris No.1rie Thomas Date of Death: Sentember 9. 1996 Will No, 1996-00761 Admin. No. PA No. 2196-0761 To the Registerl 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 October 30. 1996 ~ Dianne Robbins \~oodruff Address 4237 Yeaton Glen Circle, Win~ton-S~lpmJ N C. 27107-370 C/O Dianne Robbins Woodruff Address same as above) 104 \~att St., Nt. Holly Springs. Pa. 27065 P. o. Box 284, ~~cclesfield, N. C. 27852 William Glenn Robbins Joseph Glenn Robbins Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: October 30, 1996 J6A ~ 10. "" 1L~Q:)n.n.l)) Signature U' Name Shirley Robbins Bass, Executrix Address P. O. Box 284 N f Nacclesfield, N. C. 27852 Telephone ( 91fl 827-4530 0' I X Personal Representative Capacity: (J() Counsel for personal representative REV. UOO (lit l' Q.al c- I ':J I J- S' - r INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ~. Il~:. :~C\ -. """ fOR OATl5 Of OIAIH AnlR 12/31191 CHICK HIRI If A SPOUSAL . POVERty CRlOnlS CLAIMIO I I fill NUMB<~ / COUN'Y CODE f) (" YEAR 7t;,j NUMBER ... % w '" w u w '" COMMOUW(AllH 0' PrNN5VlVAUIA DEPARTMENT Of REVUWE DEPT '80bOl tlAARI51URG. PA 11U80bO~ OIClOlNT!! UAMlI1A!!1. fll!!l. At~O Ml00lllrflllMl I \r. \ ,~; >.J. jf I'}~' J- oT IIQfrL~~1r:D9_~'\'.s--~ :'r:1V~-'-'''I!J'-\L SOCIAl SlCUliiy-tWMltl-' -- DAn 0.' 01A1'1. OAIIO..' B\~lIl. ..' \) c3., 1-5a- 0."&3.. q. q.q(" fa.aD '~f " ..."""" "",,,GO "0"" 'N'.' ,"" '''' ..,,~;""~.;~"-]'O('" 'I~:~Y ,,~".~. - -. w ... :lIII::5:cn U.... w"'u ::c",co U"~ 1:'" .. .... "'% Ww ..", ..% 8~ IJIUOfUl!! COMrllTl AOOlt!!!! .3~'f Che.::n f)u.:f- ~I-. Qpt.; M-f.. Ho~ .spR.\'-J:;rsI,-fA li(JIoS CO""'f c.....mbe.Jl../o.I\d... --.--.--- AMouuT Ill(IIVlO I~(f 1t.~T~uC110tlSl ~ -- ~-~------------ r -1 3 Remainder Return - (lor dale' of death prior to 12-13.821 [] 5. Federal E\late To. Relurn Required II 2 Supple menial Relurn fB'1. Original Relurn o 4. limited E,'ote [J 40. future Intere,t Compromi,e (far dote, of death aher 12.12.82) ~. Decedent Died Te,lole [J 7. Decedent Mainlained a living Trust (Allach copy of Willi (AlIach copy of Trusl) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. --------_.~~_._- . _ 8. Total Number of Safe Depo,it Bo-.8' NAM( .5h', il.le. :cn.::..s nU'HON( NUMI(fI At" )~~".<f5&.>CH)lqlq) &A"'~1:I<:l2>(W (OMPL(t( MAILltlQ AOOfllSS '7.0 .'Daf- a&<f MQ.cde..:s 1='1 c..L'"D ,N 1:... ';"'8s;.1...~ ( "-. .,' . If line 19 i, greater lhan line 18. enter the difference on line 20. Thi, i, the OVERPAYMENT. a D.III:?:r:1~iI'H,.I"TI'I'.'I(-.'.I.I",ltllll~...(.Irrr.r:~"TI.III..'\'''>IJ~.~..T.I'1 II line 18 is greater than line 19, enter the difference an line 21. Thi' i, lhe TAX DUE. A. Enter the intere,t on the balance due an line 21A. B. Enter Ihe tatol of line 21 and 21A on line 21B. Thi, i, Ihe BALANCE DUE. Make Check Payable to: R.glst.r of Will,. ~!J.!nl % co S ::> ... e:: .. U w .. 1. Real Eslale (Schedule A) 2. Slacks and Bond. (Schedule BI 3. Clo"ly Held Stock/Partnership Inlere" (Schedule q 4. Morlgage' and Nale' Receivable (Schedule 01 S. Cash, Bank Depo,it' & Mi"eUoneou' Personal Property (Schedule EI 6. Jointly Owned Property (Schedule f) 7. Tran.fe" (Schedule G) (Schedule l) B. Talol Gran Aueh (totallin" 1.7) 9. Funeral EJltpen,e,_ Adminidrotive Co"'. Mi"eUaneou, E.pen,e, (Schedule H) 10. Debt,_ Morlgoge liabililie,. liens (Schedule I) 11. Tolol Deduction, (total line, 9 & 10) Net Value of Estate lline 8 minu, line 11) Charitable and Governmental Beque'h (Schedule JI Net Value Subjeclta To. (line 12 minu' line '3) Spou,al Tran,fen (for date, 01 death aher 6.30.941 See Instruction, lor Applicable Percentage on Revene Side. (Include yalues ham Schedule K ar Schedule M.) Amount 01 line 14 taxable 01 6% rote (Include values from Schedule K or Schedule M.l Amount of line 14 taxable at 15% role (Include yalues from Schedule K or Schedule M,) Principal tax due IAdd to. horn line, '5. 16 and 17.) Credit' Spou,al Poyerty Credil Prior Payment' 12. 13. 14. 15. 16. 17. % co ;: lB. e ... 19. ::> ... :E co U >< 20. .. ... 21. + .-;; I') __~30..ne._..~_____.___. 12) --~C\Q!]."'~----- " , (31 ~_~_ODGe ' (4) _ ,~ hOf\~~~__ (5)_.,_.'-l<?i.q~__ " (6) _._~r\c,)l\... " (7) __~nUl\f!. 'I (B) ~ ~o-r.u4 j--- (9)_:l.::1ua,SS___ (101 ~__igQ~Uu-~- (II) "1,8.3ad~ (12) _U,~~8p-,-51 ) (13) ______ (141 0_ (151 -----)(. -----= ---_..-----------,.~-- (16) ._x .06 = (171 .x .15 = --------.. ------ ---_._--- (lBI Oi"ount + ------------. Intcresl (19) (201 (21) 121A) (21B) ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO REC:HEC:K~MATHd -;.c, .(. ...----- Under penalties of perjury, I declare that I have uomined Ihi, relurn, including accompanying schedule, and slatemenh, and 10 the best of my ~nowledge and beliel. it i, true. correct and complele. I declare that all real e,lalo ha, been rcported 01 true market value Declaration 01 preporer 01 her than ttle personal representative is ba,ed on all information 01 which preparor tla' any ~nowledge SIGUA!UI( O' JI(ISOU I[!!PON!)llll fOi 'lur.G-Q(IU1f4-- u -A'OPg'l !l.~-- .--. _on.._' - ...._______w.. ..,,--- .- OAT( -..---'- ----~----.- ,,~~.i~p~,~i.6-j,1..~f;';'~.?,.,B_. (),~; cJ.8'-t l "'n'\Q..c.c..l V D' i..lJ:J- J lLc. D-1OS"- o']/~llq7~-- IIV-UOI U. (2-11) .f~ COMMONWfAlTH Of PENNSYLVANIA INKllnANC. ,.AX IltUIN lISlOINt DICIDINt SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or l' e FilE NUMBER ESTATE OF IhunlCL.S Do"":,S f'vt. (All prop.rty 10In'lv-own.d with I . Rlahl o. Survlvoflhlp mutl b. dlulo..d on Sch.dul. F) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ..t. f..,s.,.oL.j 15<.>.= I) C h"c:.K\ ".5 f\cc.t>u..n+. ~,n"-"c..\ a..L "'il..~ u:>A.,p' ~+. H... \..- ;J. Co..~+ 'D', a..mond ,",-', '''9 I qt.-r f"r\........,. "-'-I C uu.,5"'''' .3 ,= .0"" :0) b) TOTAL (Also enter an line 5, Reea itulatian) S A-f '-/ c.f1 . (.,) (Attach addilional BVJ" )( "" ,h.." if more 'poc. h n..d.d.) " ,,~i~:~l\ .. ~l:l/.,.. COMMONWEAltH Of PfNNSVWAN1A INHERI,ANCE lAX .(lURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please P,lnt or Type L _._...n ...... ....---...-.. FilE 'lUMBER '(yUlll_.\'''l ESTATE OF I ITEM DESCRIPTION AMOUNT '1 NUMBER I A. Funeral Expenaeal ! -'-}-.,l.J"..,a...~ 'l,~lvltA+U" r u. ,,0<0.. I .::5e,.p...V'IC.e.-~ (C_ump/e..+e..) 1. i' . 0 . '2::01< q~.:l..J G,(.,..,.,.c.o LLl~ N.C. . 3-~ ~q.5 , MOI\u.mt-n'l- ~.....,.',c..~ "'<..5 .co ~ IOUJIo.l ~. Q 0u..J)'/-fl..,-/ .f:""lo~ ':::'1-101' d..So,OO B, Administrative Caatll 1. I Personal Representatiye Commissions - 'Boll - 8~4 'In .;1.0.<.>,,-, Social Security Number 01 Personal Representatiye: c)'4/u } I '/<I.., <oj.,. "'1 Year Commissions paid _I qq '1 I 2. I Allorney Fees "NO~""" I 3. Family Exemption Claimant Relationship Address 01 Claimant at decedent's death 5t,eet Add,e.. City Stale Zip Code 4. Probate Fees C. Mlacellan.oua Expensea: 1. ?E -+',-1 ~ 0" fop... ? 1>..., b ",--I-co- GlS .CJu 2. :5hulL.;- Q.-'l.:t., ~', c.o.......... g,O<.:> 3. E.'I.-+A.a. '7~~ 0,&>0 4. JC'...-p F'........ 5.0:..> 5. 6. 7. B. TOTAL (Also ente, an line 9, Recapitulation) (II more apace la needed, In..rt additional she.1a 01 same size.) S '1,lua..65 \ .~ ~~.<, IIVUlJUtl'''' -!~ COt,lMONWIAHt4 or ,hm\n\lANIA INtlIIlIANC11AlI InUIN lIilDltI,OlelDINI J SCHEDULE J BENEFICIARIES .. FILE NUMBER ESTATE OF -r ho mo..6 'J)oP...'O "-'\ I ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequesh: 1. S-~ o..n I~"J \ \ .)( ,~d.....u.. ~f' "Ii 3-"1 VI:A-+Of\ Cr..." CJ ALlo:... \..I..)', n~ <.)" . .0",-10. m l-J. r . '-- . bPa.J\d.et:>f"'\ 4> 3, Ut...O , .::Jc.&<.p.... G. ?-o b b', n,:, Af*.CJG ;UllIlOl\..9ct.i-l:. ~ pi . r-oc..lc. '1 Mou.., ,;.-, I\.J.(. al'llCJ~ C,flo.r\d=" a.,UOu u,S, I L',Q.I''' G. 't\obb',ns Ie,,\: \..l..)Q.-H- .5l . 1-\+. HuLL'j ~pfJ..:n9s/1'A ',u65 .::un 1" 'Y', a..n nL WoodR..u..fl=" "i i':>-i '1e.o,:;I-on Gle" C', o..c./.. t.,,)",,~-ton. ~"-"', Nt... '])a.U.3k~e.~ Yo ~ -::Sh'o ...Ie'! :OA..:!>S r,?Q.:2l...... ~'f M.O,cdc.SP."C/) N ,c. . .).,8S"-' , -!?Jh-l-l:.A. ~ ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also .nl.r on Iln. 13, R.copilulollon) S (If more spac. Is needed, Insert addll1onallhee.. of lame Iln) -roo '~"".~., '''C'' . A""'h~"r<-.' , HERITAGE HOSPITAL. 111 HOSPITAL DRIVE TARBORO He 27886 . TJoMl~'DORIS 00001000888300614000000190002 .~ . . fl l PAGE 1 OF J l . f Iii :"A'tE~' i.r.eil!!'\...J;P...~c.. FORWARDINO & ADDRESS CORRECT/Oil REQUESTED' ~1!~~(A.tiW[~M~ . . MAIL PAYMEIIT TO 00' ',' d THOHAS DORIS PO BOX 284 HACCLESF/CRISP NC 27852 HERITAGE HOSPITAL. 111 HOSPITAL DRIVE TARBORO IIC 27886 pLEASE PRlIIT CHAIIGE OF ADDRESS OR PHOIIE IIUMBER ABOVE TO RECEIVE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH YOUR PAVMENT. TO PAY BV CREDIT CARD. SEE AUTHORIZATION NOTICE ON THE BACK. _...._-.....-...--~.-.=......,"=...=~~".=...~~~~=~~.~~===..~.,~".===~~~=.==~~..-.=......=..-.-..---.=..,=.... 0~ :s~~ I c{) d~cQ ~ ~.. d~ ~ . flQj -~ pc~ . --/."1 \? (/' /....') - "'" /1 .... tJ COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU Of INDIVIDUAL TAXES INllfRl IANC[ fAx DIVISION D[Pf. :aOtlOI HARRJSBURC, PA 111~8.D601 NOTICE Of INIIERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AND ASSESSNENT Of TAX SHIRLEV BASS PO BOX 284 HACCLESFIELD DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 09-09-97 TlIOHAS 09-09'96 21 96-0761 CUM8ERLAND 101 NC 27852 Amount R.",itt.d (!- ~~~\ lI;.fii..., . 11,-1\.' U I" 111.'11 DORIS H HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... iiEW iS4"7" EX-AFP--fiii-:97rNOYicE--OF-XNHEifiTAiiciryA'x-'A -ppR'A-isEifiNT-,--,UXciwAiicE-ijii----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF THOMAS DORIS M FILE NO. 21 96-0761 ACN 101 DATE 09-09-97 TAX RETURN WAS: t X I ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Est.t. (Schedule AI 2. Stocks and Bondi (Schedule 81 3. Closely Held stock/Partnership Int.r..t ISchedule C) 4. Hartg.ges/Notes Receivable (Schedule DJ S. Cash/Bank Deposits/HIsc. Personal Property ISchedule EJ 6. Jointly Owned Property (Schedule FJ 7. Transf.r. ISchedule G) 8. Tot.l Asset. CIIANGED III (21 (31 141 (5) (61 (71 .00 .00 .00 .00 4,407.04 .00 .00 (81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.ral Expenses/Adn. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax R.turn 13. Charitable/Governnent.l Bequ.sts (Sch.dul. J) 14. Net V.lu. of Estat. Subject to Tax (9) IlDI 7,702.55 190.00 (111 1121 1131 1141 NOTE: If an assessment was reflect figures that ASSESSMENT OF TAX: 15. Anount of Line 14 16. Anount of Lin. 14 17. Anount of Lin. 14 18. Princip.l Tax Du. TAX CREDITS: PAYMENT DATE NOTE: To in sur. proper cr.dit to your account, sub.it the upper portion of this forn with your tax payn.nt. 4,407.04 7.897 ~~ 3,485.51- .00 3,485.51- issued previously, lines 14, 15 and/or 16, 17 and 18 will include the total of ~ returns assessed to date. at Spousal r.te taxable at Lineal/Class A rat. tax.bl. .t Collateral/Class B rate 1151 1161 1171 .00 X .00. .00 X .06. .00 X .15. I1BI RECEIPT NUMBER DISCOUNT 1+1 INTEREST/PEN PAID (.) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE · If PAID AfTER DATE INDICATED, SEE REVERSE FOR CALCULATION Of ADDITIONAL INTEREST. .00 .00 .00 .00 .00 .00 .00 .00 If TOTAL DUE IS LESS TNAN $1, ND PAYNENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" (CRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE Of TillS FORM fOR IN.;'UCTIDNS.I r. RESERVATIONr .) (j E...t., 0' dleld.nt. d1Jna on or bator. Dlc..ba,. 12. 1911 -- If en~ lutur. Int.r... In thl I.t.t. 1_ transllrred In .......Ion o. .nJo...nl 10 CI... a (.011.1...1' ban,'I.I..I.. ., Ih. d...d.nl "1.. Ih. .,pl..II.n 0' an. ..1.1. '0. II'. .. '0. ""', Ih. C...on."llh h...b. "P....I. ........ Ih. 'Iahl I. opp..I.. and ...... I'.n.,.. /nha.II.... T.,.. at t~. lawful CII'I I (co11at.ra.) t.t. on ."~ luch tutur. Jnt.r..t. PllIlPOSE Of' NOTICE, To fultlll thl requir...nt. of Slctlon ll~O of the Inherltancl and [,t.t. Tax Act, Act 21 0' 1995. (72 P.S. Section 91ttD J. PAYHEHT I D.lach lhe lop P..II.n 0' Ihl. H.II.. ond .ub.11 .llh ..u. P....nl I. Ih. R'al.I.. 0' NI/I. p.lnl.d on Ih. ....... .Id.. .'Mall ChIck or 'on.~ ord.r payabl, tOI REGISTER OF HILLS, AGENT REFtRrtD (CR), A r.fund 0' . tax crldlt, which wa. not r.qul.tad on the Tax Rlturn, .ay ba raqua.tad by coapla'tng an "ApplicatIon for R.fund 0' PennsYlvania Inheritance and E,t,t. Tax" (R[V-131J). Application, ar. Ivellable at the O"lcI of thl Rlgl,t.r of Willi, any 01 thl 23 Revenue Dlltrlct Olflc.., or by call1ng tha ,plcl.1 Zit-hour enlwarlng '.r~lc. nu.b.r. for far.. ord.rlngl In P.nn'YI~anle l~aOO-]6Z~Z050, out. Ida Plnn'YI~anla and wIthin local Harrl'burg araa (717) 787-1094, TOO' (717) 77Z-ZZSZ (Haarlng lapalred Only). OBJECTIONS I Any p.rty In Intara.t not .atl.flad with the ftPpr.lla.ant, allowanca or dllallowanc. of d.ductlon., or a"'I..ant of t.x (Including dl.count or Int.r..t) a. .hown on thl. Notlc. lU.t obJact wIthin sixty (60) day. of rac.lpt of thls Notice by: ADHIH ISTRATlIJE CORRECTIONS I --..IUan P..I..I 10 Ih. PA D.p..I..nl 0' R...nue, I...d ., APP"II, D.pl. ZalOZl, H...llbu.., PA I7IZI-/OZI, OR .-.llctlon to ha~1 the .attlr dlt.raln'd at audIt of thl account of tha par.onal r.pr"lntatlvl, OR ~'apPl.1 to the Orphan.' Court. OISCOUNTr r.ctual .rrors dl.covlr.d on thIs al""'lnt .hould be addr....d In writing to: PI. O.part..nt of Rlvlnue, '~rllU of Indlvldull Tax.., ATTN: Po.t A.....a.nt R'Ylaw unit, O.pt. Z80601, Harrl'burg, PI. 171Za-0601 Phon. (717) 787-6505. S.. P'g. 5 of the bookl.t ~In.tructlon. far Inh.rltanc. Tax R.turn for. R..ld.nt O.c.dlftt~ (REV-1501) for an ,xPlanatlon of adalnlstratlvlly corr.ctable .rrors. PEHALTYr /' an. I., due I. p.ld .llhln Ih... III ..I.nd.. '.nlh. .,t.. Ih. doc.d.nl'. d..lh, . '1.. P"'.nl ISX, dl'..unl 0' the tax paid Js allowed. INTEREST: ThI lS~ tax lanesty non-p.rtlclpatlon p.n.lty Is coaput.d on the total of the tax and Int.r..t a......d, and not p.ld bafor. January la, 1996, the flr.t d.y aftlr thl .nd of the tax '~esty period. Thl. non-participation pan.lty Is appe.labl. In the .... aanner and In the the .... tl.. p'rlod a. YOU would app.al the tax and Int.r..t thlt has b..n .......d a. IndIca tad on this notlc.. Int.r.st I. chargld baglnnlng with flr.t day of d.llnqu.ncy, or nlnl (9) aonths and ani (1) d.y fro. thl dltl of de.th, to the d.t. of P'Y'lnt. 'axI. whIch blca.. dallnquent bafore January 1, 1"2 b.ar Int.r..t et the rata of six (6~) p.rcent p.r annu. calculat.d .t a dally rata of .000164. All ta.I' which b.ca.. d.llnqulnt on and eft.r January 1, 1'82 will b.ar Int.r..t at a rat. which will Vary fro. calendar y..r to cal'ndar Ylar with that rat. announc.d by the PI. OIPart.lnt of R.vlnu.. Th. appllcabl. lntare.t rata. for 1'82 through 1'" ara: !!!! Inter..t Rata Dalty Intarl.t Factor :!!.!r Int.r..t Retl Dally Intar..t Factol" I'll ZO~ .000548 1987 .~ .0002"7 1'13 16~ .ODDU' 1981-1991 IU .DDOlln 1914 lU .000101 1992 .~ .000247 I.as 15~ .000556 1995-1994 7~ .000192 1986 10;( .OOOU... 199!i.-l997 .~ .000247 --Interest 11 calculat'd .. fol1owlI INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotlca lS.Uld .ftlr the ta. blcoa.s dallnquent will rlfl.ct an Int.r..t calculation to flftlan (IS) day. blYond the date of the ........nt. If paY"nt I. aad. aft.r the Inter..t co~tatlon data .hown on the Hatlce, additional Intlr.st au.t be c.lculated. '.. " .,', , w' . ," ',t' '. .; .~L> . ctJ. " . .,<~. \ . .:. rf.\:/~~.i;~~ \ ., ,I _ ~"'~/; "'r 'f"~ . ';, : ':'oj:' ::;/,;;~~.,:,.; ,~ l' ~. ~...' \" t. , ,. ii!"" .,' ,~,'~' :~'- rti. '", t-', ~h"'.t:' ..~.;:, ",.; ;1:1"''''1~:''~' . :,,: ',~:..,.;..:.i(.'i\h') ,,~ 1,,0 \;.; 'j' ;, :..,:.':.~ ;:7. .>;'{~'j ~ ., '." l::<'! \, -~ ',' ,., , . ~ ':' ,~: ,.,' ,--' -, ~.:t~..,<~'", ~'. , .o"r " 0" ",' " ','"~'; . ?:),'>:. F~'~. -,< .. .~ .' .,' )/,: . ~-. .. ~".' f,- ,.,:.' ,:.i''::~ -. ~ ~':.~~ :. " ,,,~,"'H .' .. ,-' .,.>.'-".-. .:~::,:~:~> ',:,;.::~:.:{;'.' 1 . , . ':. .- :~'.';:.:,. -, -.' ,'-' , .- ' ~ ~ _r . ,". '; . " ,,-, ,>"-<,,,,"';-> . ,. ~ :..; ":~~:":<.'~'~\~ p' > iJ . l . , , "-y' " , (.> r.~,~IL', :~'i:.'; ."" ".,j,!' ..;..! '<'.~ 'w '; ~ .1 : , r ,.:... ,',- ,': J*-v -1~.~ JRD/June 30, 1992117858 Estate No.: 21.1996.0761 ORPHANS' COURT DIVISION, COURT OF COMMON PLEAS OF CUM8ERLAND COUNTY PENNSYLVANIA 1996.0761 No In Re: Estate of WIUS I'oQODHUFF Late of MT HOLLY SPIUNGS OOHOOGH NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDucr A HEARING PURSUANT TO RULE 6,12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: SHIRLEY HOBBINS BASS Counsel for Personal Representative: Date of Decedent's Death: 9.9.96 Dale of Delinquency Notice: 10.22.96 The undersigned, Mary C. Lewis. Rcgister of Wills. in accllrdan,c with Rulc 6.12, Suprcme Court Orphans' Court Rules. hercby notifies the Orphans' Court Divi5ion. Court of Common Pleas of Cumberland County, that neither the abovc named personal represenlative nor the abovc 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 Rcgister of Wills on 11.9.96 ,19_, 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 whethcr sanctions should be imposed upon the delinquent personal representative or counsel for the dclinquent personal representative. "-1)Ultl {7'~L" u~Lj- Mary . Lcwis, Rcgistcr Date: 11.16.96 Distribution: Personal Rcpresentative Counsel for Personal Represcntative Estatc File .11). ... I. II A HFAHING IS SF.f FOH ~tU/IJ JI couj{rHCXl'l NO.3. IF THF. STATUS HEroHT IS WTI.L MJTCMATICALLY BE CAN(.'F,\,!,ED. I tJ ~ eJ AT FILED PHlOH TO THF. HFAHI ~ 30 IN DATF., WE HF1,iUNG GFO' . " ..... JRDIJune 30, 1992(\1858 In Re: Estate of JX)iUS \'UJDHUFF Late of MT HOLLY SPHINGS OOHOUGll ORI'lIANS' COURT DIVISION, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLV ANIA Estate No.: 21_1996-0761 1996-0761 No. NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING pURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: SHIHLEY HOBBINS BA55 Counsel for Personal Representative: Date of Decedent's Death: 9_9_96 Date of Delinquency Notice: 10-22-98 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 CierI< 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 11_9-98 ,19_, 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. DK" 11-16-96_ '-/htHI {I.;I,;." '.... u~'I- Mary . Lewis, Register f Wills Distribution: Personal Representative counsel for Personal Representative Estate File .ill . . . I. . (/ . A HF.AHI~ IS SlIT FOH ~/;{Jj-f/V it / q If 8 AT (X)tli<l'HCX:t-I NO.3. IF THF, STATUS HEroi<l' IS FILED PHIOH TO THE HF.AHI WILL hUlU'lATICALLY BF. c,;N(..'1'.T.LF.D. ) ~ 30 IN Dhm, THE HF.AHING "