HomeMy WebLinkAbout97-00078
Xl
~
ti
~
...
'13
i:l
4>
.c
...
.....
o~
,:,cn
4>'""
~~'
4> 4>
~~
E 4>
" (J
~~
4>'0
t::~
....Ill
0'0
*
E"IUI" (~I AHa Vf.lrnu Tibbetts
al.m know" liS .
PETITION FOI~ ItRoIlA'n: Ilnd (;RANT OF LETTERS
al-/qq']- 0'1 ~
No.
10:
_ ,/)('('I'a.H'r1,
Social Seelll'IIY No, , 165-10-9224
lI.e~i'lel or Wi I" 1'01 Ihe
('011 lilY of Clllllh(wlUlld ill Ihe
('oll\llIll11wl'allll of P('nll~ylvllnlu
The Pl'titiol1 olthl' t1nder~i~IH'd rl'l"lwctlully 1('prL"'Il'llll" thai:
YOIII pel il iOlll'r(\), who islt.llll I H years 01 "1(1' 01 oldel llKXKl<lIl1X'lIK a credllor IIxllIlIlI
XIlXKO{kaIKx1dkllktlKxllxwnlxOlXlic:NKxkmx\( , of t.he decedent.. ,,__. dllxxxxxx
lCK\lllxmmkxllllOO ,'I'll", c:Iecedent, by Inst Will d~tcd November 3,1987, U!lf!1e,c;l\y'ilmQr
I{otzm"oye,r, ,lIS, "_E,,XC, cuto.r~ W,nn,l, e"r, K9l, Z, mo,ycr,p,re, dcccuse,dAltll,Vcm, II ,Tib, b,(\,ttsJSee..estate
flied to No. 21.-93~lQ32}. Ttv? (jQcoden\ nUlnedArthur C{(mpp.elll\s.all\lrMl\l.E~QYl!1I',
howeversee"RenunciatlonofArthur Cumpbelldatod N ovembor.1, .199.6.. ,Seo,1llso_Renunciatlon ·
(~tnll' rdl'\il1l1 (IJ\'lll1l,'OlIIl'l''', {',j:. (.'lllllldJllll\ll, dt'dlh lit (,H'n!!'lI, ell'.)
De~en(klll was dOlllidlrd III dealhlllC\IInb!lI'lll.nd " ". ,. .... ('oUIlIY, PennsylvlInia, wilh
ILcr., last family or prindpalll',idl'n~l'.1I, lQOQWestSo\ltltfltj'eet.Q!lJll~leLPeD.n.~m!!nia
-11.0.13"....._..._ ".. .._...____''.~.
(I1~1 ~lll'~'l, Illlllllit'l lUll! 11l1llhllMIllVl
lkl'endetll, Ihen _,,~jL,__. year" of age, died .,..,.J'!prU ,7, m_".,_._' IsO~_."__,,,
aim.. ,Carlislallospltal,Carlislc, Pennsylvania. .._ ,__ ._"._,,___, ,.__""..'
F'~el'l a' follows, dc('edent didnol nli"T~', 11'11' not divoreed alld did 1101 have a child born 01' adopted
after e,,'\'ulion of the will offered for probate; lI'as nOllhe 1'\('lim or a ,hlillg Hnd was never adjudicated
i IIl'O n II,el en I :.__lio..exception,..to, the,hesLat Petiti onel"s. knowledge. ''',,'..__h.,,_.,_.....
De~el\(lcnl al dealh oll'ned properly lI'ilh l,stilllaled values as folloll's:
(II' domiciled in Pa,) All personal properlY $_gQ,OOO.QQ..___
(If nOI domiciled in I'a,) Personal properry in Pennsyll'ania $"
(1lnol domklletl inPa,) P('!Sonal properlY in ('ounl~' $..________
Vahll' or leal \"\SIIlIC ill Pennsvlvnnia $__..,
siluall'd It, follows: ..____"_J'fon~_!__.._.__.__., ."_,_.__<.h_+__...wo. ~___~_._._________
WHI:REFORE, pelilioner(s) respeetfully request(s) the prOball' of Ihe lasl will and codldl(s)
presenled herewith and the granl of lellrrs"...9L1\.dmln.ls.tratiQll.C..Wl"_,,,n._~,,~__,_._
(ll'~lUl11l'l1lilt~.; adrnilli'\OiltiOI1l',I,U.; udm,lll<,tratlOn d.h.I1.l',l.u.)
Iheron,
,
'-
~
:97
(.t:
~ ;t
'".!~
~'r.
-"-
i 0:
;j,
7:
~ 7
,., ,... ., ~'.n.J;..~:2.,~-
.epb, _ . 1'lley. attorney for...~_._
.SarahA.'fodd Memorial Hom.e..lru:.,
.8.creditor.. .. ._,m, .",_",.,__".,_,,_
, 5 South Hanwer..Str.oll.t__,.____
,Carlisle, PA 17QLL.___.__
. .'''___~_,,_,._~__.oo_____
.' ---... ~.~_._------+~
OATH OF PERSONAL REPRESENTATIVE
COMMO"iWI':AI,T11 OF l'ENNSnVANIA
COl'~n' (H' ,ClJMBERLANll
I
, o...!..'
r .",
Till' l'l'lilllllll'H\1 al1(l\l'-1\i111H'd \\\l'i\l(\) ur illlirl1l(\J lhal Illl' \(,HI'ml'lll.. in the foregoing petition ar~
1 rUl' illld ..'{ II: l'l'l (\1 I hl' hl"" 011 Ill' ~ 110\\ It'd!!l' and Ill'lil'l oll'L'1 iIIOlll.'r(lo) and I hill a~ personal rcprcscn-
lilli\'l'(~) (Jf I Ill' ill)l1\T dl'l'cdl'lH jli'lilinlll'I(\1 will well and lIuly i1dlllini\tc']" tile c."ilalt.' according to law,
Swmn Il\ III :1l'f\111\rd and "'Ul'~l.til)l'd I ~1 ~ ,-- >:~l In
hL'lol'l' tll< I ill', 24 th d:l~ tll )9'
I S
'i,J\~UAR'( \./', r-., \ t'/'J)'YI 97 , "
t It.~lJ( (/'<WUoi'Fi'L / I/)L. UILl} I . ~
M.^ Y e.. LEWIS iI""""',f,'VJ/'1' :::c
lb. I f.Xt .. ( ~
I'
1'111" I'> 1llll'lldv tll,11 dlll!d'>IIIUII"11
Illl.1i Hq~I'>llill Till 11I11',IILlI'!'!II!1 dtl
I" " ('1\, " ,. "II', 'I'll ! " " 'd ij' III,! Ildl, III "I .1e,1111 ,Iul\ lill'd \~ I tll 11ll' .1'>
\', dl II' 11<1"\ .1, ,.. I: 'i,,1. \ " I 1:, , i.. , HII' 1,,1 t" 11(1,I11t111 li1ln!'
WARNING: It II 1II0llAI to dupllcnlo Ihls copy by photostAt or photogrAph,
I;n' In1 (lib {{'I lillt illf', }- I (HI
'~! .~" """ \\, \'~..u..l.'.~~; (~
.~,,"- C~...I
-. ,- '.\'
[(Iul HC,1~1';(I;1l
3426605
No,
^I'I\. c, IQq"
I);ll(!
'HO~ lUll" 11"
COMMONW!ALTH OF PENNSYLVANIA. DEPAFl.TMENT OF HEALTH' VITAl., RECORDS
CERTIFICATE OF DEATH
'1IIN1
RO
'.
VlfQelllVU,A
-'r-~'"
UN III 1<<
-- ~.
A e O~ ," II
,~'''' '" 01, ..."
'Imll'l..ACljI;.,.II{\
$lI1t"""'"'1'C(loJhl"/1
llOlI'tll'<lr","i11
8f~ K>CIAI,$lCUM'~~{JfoIU"
.,F,m.lo ,..165 10 9224
"'.ACI Ol!.qHIC!'>tIt.~.....!I.!!!: """""'I<<1I",,"""'~j
"" "'
1~liOIl/k* ff\t<'lvlpo11f11l0
l;I~rfO'tJU'H,"'_ Uo.~....,
4,April 7, lC)96
IlINT
l!~l(
'I~"'e 01 Ol!((D('lT, '. "'<lOe '""I
Alto Tibbotts
AQ[',U.!k'NJOtl
r-Ol,o'l""
O<R'
AtlB,),1915
""",
Carlislo l Cnrlisle !lospital
~IN Cl'~~,S8lINClvitllY_.._ "tatlf.f~~6~~t~f OfctDfNf'UOUC.ar1
.,.ur] ~1;1 II4~'1
Carlisle
=~lU
"
Ctlmher Iflnd
_n.' ~(i.Qt.H.Lllt.~t,;\tf~.
-iGNO....,rJ_.~~"'~n;j"..,.
o-lopl'''r;IIIlI,''''....'M'tf<ortdl
II Latwrer
o(C({)l:~l{.iIojQAOOAUlifSb"',C"""'- Swt tfJCO<ltI
Toclci Home
1:000 W South St
II ,arli.''l101 I'A 17011
~7THm~~...--~-
Pet.or Kot?:moyor
Todd Home
I,lN~5:r~{J~'tIl
~I~"'rl
.vfM\l~'U'OVSI!
I""~"'__I
~,
l".D_.CIICtdM~'"
----I
___IWI> ,
ITll.~
"1''1'-';
!
PA 17013
A.....,...I''''''ll<III(]
[1
O~f Of~ I'OY'TIO~
,1,1"',"01'_1
~rr, 1 (l I
19%
~,;T "",booft.R'"lt.~~
Nt. !loll y Springs ,
~c\ Co. PA I
~',l-eml~~R;r~A \'mrll
O,(f.s;o;mr-----.---'
~N ~\ ~~I.jl... '-A"",;,!' I \q'\i(;> .
::licA~fAniiiiii1ilCiM(~~ JAIlIIi. ~..
.....~ "",[)
!~0~=M<\ ~l'''Ml ~~.:=::=..o-==~~~
tOflMlW"".1tI I
......LW.I.1l1. r:. ...t..J,;;flr:..A.!L'?_:i.~;)!.~{..~_~_tl-r:{t)J~'N"'C----1Jl~ P,,>::;,tlt..C AtvlC TU(l<"~~~~____11
DVfIDI[~0I"mOU('I(.l(>rl i
b ---out'li)i(iIlii",icfliffiM";Kt1it--J---'--~-'---~'- .."'-_ ______~.__.__.__~__:___--_ ;tI C:C-II.'E~!L--A.1:lIf'E, I ~ ~ l....lll......
:
--_.__, .,-_.___..___.___. -4'_'''''-
,
,
..,
III,lE INJUAY
lll'T'r
anover
(t{;fIiSENUI,lBEIl
, _...--_..-._.._-_._---_._.._--------~-,--_.
DUE IC> 1I!Il 018 ~ CQ/'-l~( OIJE ~,C( (1(1
wtllt:.AUm:5;~~;~1mr;IM ~="~,"=,,....
......,lJ,..~E PlloOfl TO
COI.ll'lETlQfl()fCAUSI
01t>EA11'l1
"'4,,,,.1
flI
o
u
OAI(O;-;;;JUIlV-~'.-.---
jt,l"""'t'iI,""1
'NNnVlifwOAA.1
llUCnlliEtlONlNJUllVOCCUIlIltD
II,,,,,,,,.,.
[]
(]
U ~f.0fTfW.Jil;7j,r;;;;;;t,iil~Hi.I;;..;.;:..o'1&.l,I.
110I4*10.." I""""'!
,..
1'n 0 '4o[J
"WM'"
PI""""'li"'~lloQ"~'"
..,,1Xi
.... U
~OJ
""'~
C_,""l'I""'''~",1<J
,..
e'/'Il"'"j,j"ii'i,~,-;::;,.",.--'
'cunlFYINQ ~1IY1ltllN ,P'"\-:,,, ''"''l''Il'.~~.. cf "'.'f, "t,,,. ."'><1'", ~'...,.."hlll.u"''''M'I..''' ~"'I(""('I"'" ~"'h lJI
f".,.....Il.r"','''''''I9<l'''.d..'h...~..''"'O...,.ItII....llI'Itll''''''''M.'n.l.ltd '
..
...
ANDII IO'CEA'IF~A/
II 71..; 4!:
. J~E SlllUIolllf ~--,- .... lni.iOia07~;-00'-';;;--'-~-. "j
k() llctH/JO.J't-S~) -6: f.1I.. 7.....!!t4r.
~Al,lfA}jDAOOf\t!.H.,PEIl90NI'o'HOCO.../'(tTIOClU Cl' "If!
'foI(OfC.I,lUUmJ("'COAO~1'1I ill"t.llllfIl'lI;NP'I~I/JIl;f--off)U J. WOOI'/ ,......f> I
Qn Ihl bull 011'1"'lnI1l0n .ndljl.lnVI.lIUIIIOn.ln "'v .~11lIIln.1I4.lh ne~ultld 'Ilhl IIml, lIllt, 'nd ~I'ct, .n" dut IIf In4 clUlI(lllnll f] I.~ 'j if ,~ v r l ~..; ,t,,'J I
"::;~::':~~""'''~w.,,'" ------.---. ,-..::..::,-,,---~:-._',,:~~~--:_:,-,-,--' ::, (#,~'t~'f![i-..~ I ","~S~.! >1__iJ~ ~ ,_____ __
'u-,~\"""",--~_.,\~\~~~,\<:,'s::. u,__. ,_, ,.?k\ ,a.uQI ",_, -Jl~s~':'i,_\"C\L,,,__~_ '
. '''ONOUHCli'IG ANn nATI',INQ rH'I'IfCI AN ,rl.,,,,,,". ,""" I' .-.-".t~"'<I".'~' ""I \ ""f'I'<! _1 ,; "ul' '" "''''1
1.lh. t>nt.'''''.'''''''Uflt. ~"'h"'l""""'t~.tl/rl', ~II', Inclp'O<;t, "ol4.., 10 '104 14UIlII)..... ""nn" " """
11/2/871 D40
THIRD.l I hereby order g,nd.f direot my ElteO\ltor,
hereinafter named, to pay all my just debts I ;funeral expenses,
testamentary expenoes and all Inheritance, Estate, Transfer and
Suooession Taxes, ae soon as may be oonveniently done after my
death, out of my residuary estate.
FOURTH: All the rest, residue and remainder of my
estate, be it real, personal or mixed, of whatsoever kind and
wheresoever situate, I hereby order and direot my Exeoutor to
sell at public or private sale or sales, as he, in his sole
discretion, shall deem to be in the be$t interests of my estate.
The net proceeds thereof shall be added to and beoome a part of
my residuary estate,
FIFTH: I hereby give and bequeath the ffum of One
Thousand ($1,000.00) Dollars to Arthur Campbell, because he has
been a good friend to me.
SIXTH: All the rest, residue and remainde~ of my
estate, be it real, personal or mixed, of whatsoever kind and
wheresoever eltuats. I hereby give, deVise and bequeath to the
Humahe Sooiety of the United States, Washington, D.C., to be u$ed
at its sole discretion, for projects to benefit animals. I make
this devise beoause of the affeotion for animals I have had all
,/) 'i .J,', -1' ~
-.L~I!A4 (/:.ea /;IU '::4'-,K.k~
- 2 -
Rocar'liI I of
RaIl I! ',VIl!1!
'97 JAN 24 P 2 :34
810T',. (>ul
urribi;!1 ,.1 ,(j (,0.. PA
s ~ til . i ~
f::
~ ttl I ~ ! '
I!l r~ij
~ I!l
H
1 [;-<
14
~ 1:\ <ll . < ~
tl ~ ~;~j~
~ g:
~ ~ ~ ~
~. ~
~
. .
. .
.
.
JJ I (iCr I 1- () 'I ~
RENUNCIA TION
In Rc BAtate of
111..711 1/ TIBBETTS
deceased,
The undenlgned
LU n't /3 f::R.,LnN?
f.\ R1HU ~ C /1/1'1 P /3t;./...L
'-. ~r
County, Pennsylvania,
To the Register of WUlA of
of
the above decedent. hereby renounce(s) the righl to administer the estate and respectfully ask(s) that Letters
-rf:-Sr A1'l\r::N TA R. Y
t-J fA
I
be Issued (0
WITNESS
my
hand this 2-q dayof,J:11 N
,19 qrf.
. d~ f/ /~ ~~"
('.(/ l' L/PVV '4'"
/
(Slan~lur.)
(Addr...)
(Slanelur')
CIO t:~ (Mdr.S!)
't5 IJl N :J a;;
Ol$. - (~
1~':~ ;-.:" 0- d
r,}
, . g) c;i
n 0, ~ [' (Slanatura)
r;! .lj "-j
~) i;~
li? ,I
Pi i;~
a: d
(Addra..)
CERTIFICATION OF NOTICE UNDER RULE 5.6L!l
,
Name of Decedent I
Alta Vera Tibbetts
Date of Dsathl
April 7 , 1997
Admin. No.
21-97-078
Will No.
To the Regislerl
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of the above-captioned estate on
~rch 4, 1997 I
~ame
A.ddress
Arthur Campbell, 48 West High Street, CarliSle, PA 17013
The Humane Society of the Unlt(,d States, 2100 L Street N.W., Washington, DC 20037
Notice has now been given to all persons entitled thereto under
Rule 5.6 (a) except no exceptions
pa te : March 4, 1997
, "f
~)/!;~ ~ - )' ~
s~;~fure
0 17<(
,~ t'I
a~ ~L)';
N
'l'~~: Cl.. ,-)
..'
1
~ ;),
:?'
,~) ,:.i' J":'l
u ~) P\ .,~
Q)OC iii "
0: C3
Name_:' Stephen D. Tiley
Address 5 South Hanover Street
Carlisle, PA 17013
Telepholle ( 717) 243-5838
GapacitYI
x
Personal Representative
x
Counsel for personal
representative
Illvl!;"Xlf"(IIi'] I~~;
COMMON;~!'YiVl'NII'
(I~ IWHMINl Of fiLVI NUl
...t01"(I"::;'~~;lijOOOi _~~~=,_ __~E~~D~!'!LQ,~fEPE~.I,,_,__ ,,,"''''''
{lICfUfNT'!i NN~r (11.';1, fIfiST_ N-1[1 Millin f 1f/11IAI) II~e ~ N,\!I._l>'''~1 ~I kI'N,lIF ~",d',
T' / f) B ET /..S fl L T II 1/ (" I,' Iv' It
-'f;'(il:iAI'g(liiiiiyN\iirfirR--,"-~-'--,----~",-u{'iMf'Oi(lnTf;.-".., .. ^ --'---oATfT>>wmTr"""".-
REV-1500
INHERITANCE TAX RETURN
(/;
/5- 15t.,.,- 13
fiLE HUWBER
'J /
.",
1 7
I'VII
{) (J () "I /1-
Htll.!/Ifll.
-~-- ~-~t"c=_=
/ {~ ..5-- / (). 9.:<.1 'I c'l ,/1 {i Z I / '/ {/~, (I F I (J 7 II i / .r
niN';;LICABI'::'::"NG ~~I::~I I\AS! f~:~ '''::~~:,^I ~:i' "'":TL"-~~~_~~~-] __THIS RETUR~~U~;;;~I~E~~~~~~~iE:iHI Till .
~ \, Original Rollllfl [J 2. Supplemonlill ROlllnl ['J 3. Romnlndor ROluml~~I~O'(jIj,ntl'\f")'I,) I} 11~JI
t' J 4. l irnllod ESlale [] 4a, FUlllre !rI\aresl COmpfOfTli3tl (~dtt\ ()ld~,'Itn nf\llf \l.12S?1 [J ~) FOdoral Estale TiI~ RUlurn Req\Jlred
~ 6. OocodlJI11 (}lnd TH~talo (MN;htoI'Vo! W'II\ [] 7. OfJCl.1dont Mailllillnod flUving TnllOl (Ailochwpylil ft~'11 ,r;? B ToMI Number 01 Snfe Doposit B[,)xo~
[J g, l iligation Procoods Reccivml 010. Spousal Poverty Cradit (dollllCJ{dI)JilhbclfIYMn Inl.91 Md I.l'~~l [] 11. Election to lax undor Sec. 9113(A) (AII/lO;l1 ~:'::I'('I
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIOE'lTIAI. TAX INFORMA T!ON-SHOL,mE DIRECTEDTO,---
N;Mf--. COI,jplEIf:i.tAllINC,AClC1Rf:SS ,--_.~_..__..
__,_,;jTf (II i.~}, 77 L ( y, (.54' (I, Ii! ( _ ,) Sew TN 1)1'9(0'(1 (/u!. .5T,
"""""'& 11I'J;JlIf;t' 'I A " -J I. i;}I')
r-'Ki' NV-L1Ll,!- cJ.19/!./../Sd, rr no I:')
lilf;I'H/~.f NlJl,mHI ~I tf :1 >- .5' $ 3~ - ---~---
I RC'i1 E~",lo (Schedu~ A) 111
2 Slocks and Bonds (Sc/1odule BI 12)
3 Closely Held Corperalion.Pa~ne"'hlp or Sole.Prop~elo"'hli' 131
4. Mo~gagos & NolOS Re"'ivablo (Schodule D) (4)
5. Cash. B'nk Depo'l~ & MlsoolI,neou' Pe",on,1 ProP<'rty 15)
::z (Sch.du~ 'I
0 6 Joinlly Ownod Proporty (Schedule FI (6)
5 1. Inler.Vivos Transl.", & Misoollanaou, Non,Prob"e Property 171
~ (Schadul' G 01 LI
0: 6. Total Gross A"et'IIolal Lines 1,1)
0:( 9. funeral E'pen,os & Admln~lraUve CoslSlSchedu~ H) Ig)
0
~ 10. Deb~ 01 D,ceo,nl, Mongage Li,bllitles. & L~n' ISchedulel1 110)
11. Total Doductlo", IIotai Line, 9 & 10)
I 'l1s
~OL}
;.:: {~
g.~
I ~; , (J I 'f, ,c.' ,I
'T\
):c: 4
(6)
1/,L'Jtlt! '/'i
(II)
z
o
F:;
~g
...~
~
o
12 Net Vilue olE'tJ'elLine 8 minus Lina 1 I)
13. Ch'~tJlble ,nd Govemmenlal Bequests/See 9113 TJUslSlol which an election 10 IS, has nol beeo
m,de (Schedule J)
14. Net Velue Subject to Tax (Line 12 mlnu, Lina 13)
15. Amounl of 110' 14 \a,able
at the spousal tax rate I ,
See Instruc1lor1, on rove"'e "dA lor applicable peroon\ago
16. Amount of line 14laxable
'16% lalo
tI. Amounl of line 14 \axablA
'I 15% "'e / , {) (J 0
.15
112)
113)
1141
, ,0
115)
,
.06
(161
Ill)
(181
(J 0 X
16. Tax Duo
19.
~
~
'"<
~
'u
t-.,l
..
~~
0'1
/ ~
$'~
(t') 0
~ ,', ~"I
(~),. r~
" w
c! ()
" l'
';""'1
,:;0
:m','!
&ra
'J2f9.0/
II,OtfO.y%
.5, <g 1 '8". ~ .'3
1,9 17> Zi?3
-
I,OOu O()
-'
1:f'O.()()
-
1.)'0 .00
> >BE SlIRE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
l.Iod<<poolltiM ofparjll1Y, I d8cllll'8 thet t I\Ive examln&:llhls reMn, including 8CCOnlpa1ylng ~hedulos WId ataloll'llmls. Md 10 ltlCl best ClI my krlowIedgtJ llOd belief. II is true, coffecllrld oompI&ta. DecllVetioo of prepNOI olMl
blntheDOOiOOllreorosent&tivels~oIwt1lcf1[lfeDhfhaslW1vktlOWledotJ,
SIGNATURE Of PER ON RESPONSIBLE FOR FiliNG RETURN ADDRESS
. 1~' ~2~? . 'i~__ 5. S. llanoy'~I' Sl., CUI"lisleL PAl 7013
PREPAREHOTHEI\THAN REPRE TATIVE ADDRESS
..----~----..-~--.-__..__..__..._.~___.__._.__.___...e.. ..,._.~~,...~_~_________._
DATF.
Mav 26. 199~
DATE
Decedent's Completo Address:
l~:~~==~ I:i,.~:::'!~"h~::=-
- J-,"i1i---PAh -li,;;,,;_1
-'-'. ----,---- ------,j
Tax Payments and Credits:
1. Tax Duo (l'age ILl,,,, 18)
2. CredilslP,'ymonls
A. Spousal Povo~y Crtldll
8 Prior Paymonl' ::~:~:=:::::I6 8 -tli-=:
C. Discount
(I) ___ 150.00
ToIal Crodlls ( A , 8 . C I (21
168.26
3,
InleresVPenally If applicablo
D. Inlorest
E.Penally
_________...J.!l..J1.!L
4.
T otallntorosllPanally ( D . E I (31
II line 21s greater Ihan lino 1 . 1I1l0 3, elltor lhe dllleronca. This is tlra OVERPA YMENT,
Check bOK on P.ge 1 Line 19 to requelt. refund (4)
If line 1 + lino 315 graaler Ihan IIno 2, enler IlIe dlfferenoe. Tills is tho TAX DUE, (5)
A. Enter Ihe iMeresl on tho la' dllo (5A)
8. Enter the \Olal of L1no 5. bA This is !l10 BALANCE DUE, (58)
T Make .fheck ~bJe 10: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfor and:
a, relaln the use or Income of the property transferred; ,..
O. retain the right to designate who shall use the property transferred jlr Its income; ,..
c, retain a reversionary Interesl; or...
d, receive the promise for life of ellher payments, benefits or care? ........,......
2. If death occurred on or bafore December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1982, did decedent transfer prooerty within one year of death without
receiving adequate consideration? ,.. ......,.. .............,.. .0
3. Did decedent own an "In trust for" or payable upon death bank account or security
at his or her death? ,.. ............................... ... .......... ......".....0
4. Old decedent own an Individual retiroment account, annuily, or other non-probate rroperty? ...0
18.26
5.
~.l!J!
0.00
Yes
.....0
,0
,,0
...,0
No
liJ
liJ
liJ
liJ
8'J
~J
liJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS tS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE tT AS PART OF THE RETURN
72 P,S, ~9116 (a) (1,1) (I) provided for the reduction of Ihe tax rate Imposed on Ihe net value of transfers to or for Ihe use of Ihe
surviving spouse from 6% to 3% for daten of death on or after Juiy 1, 1994 and before January 1, 1995.
n P,S. ~9116 (a) (1,1) (II) provided for the reduction of the rate Imposed on the net value 0f transfero to or for the use of the surviving
spouee from 3% to 0% for dates of death on or afler ,January 1, 1995, Tha stetute does not exempt a transfer to a surviving spouse
from tax, and Ihe statutory requirements lor dleclcsure of assats and filing a tax return ere sllll applicable even if the survlvln9 spouse
is Ihe only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Pi ease answer the following question by placing an "x" In the
appropriale space.
Old the decedent create a trust or .Imllar arrangement which Is solely for the sUr\llvlng spouse'. benefit for hi. or her entire
lifetime? Yes 0 No [~
If you answered yes to the above question, the lax on the trusl or similar arrangemenl is poslponed untIl the death of the second
spouse, at which time It will be fully taxable atlhe rale(s) applicable 10 Ihe remainder beneficlary(les), Enler the value of the trusl on
Schedule ,I, Part II, in order to remove it from Ihe calculallon of the lax due In Ihls eslale, You may wish to file Schedule 0 In order to
make the election available under Section 9113. If the alection Is made, the trusl or similar arrangement Is taxed In the ealete of Ihe
firsl decedent spouse, Ihe portion of Ihe tru&t or similar errangemenl which benefits Ihe surviving spouse Is laxed allhe zero lax rate,
and the remainder Is taxed at Ihe raters) applicable 10 the remeinder beneficlary(les). If you choose 10 make Ihe election, you muat
attach Schedule 0 to a timely-filed fax relurn, along wilh Schedule(s) K andlor M in order to show the apportion men I of the trusl or
similar arrangement between the surviving spouse and the remainder beneflclary(les).
Decedent Confirmation
1,-.'
"'.
Rc:
Exlalc of
SSN
DOD
-
D~scrlJ>t1on
AccolIlIl No,
Accollnl Type
Dale Opened or bSllcd
Date Closed or Matured
Date of Death Balance
PLUS
Date of Death Accrued Int,
Joint Owners (If any)
Date of Joint Ownership
Alia Vema Tibbetts
165-10-9224
04/07/96
Accollnt Account
8fi-0067J-R 5.311 S-03G9.6
Cheekillg Snving~
01/24/77 11/01/89
02/13/97 (Closed) 10/31/96 (Closed)
$ 9,'192,07 $115.40
PLlIS PLUS
$3.39 $.40
None None
Account
PLUS
Special Comments: N/A
(Il" I/R/9R)
D.teP,'cparcd: Mny 19'" )')lJ8 Prcllarcd by: nenita D, Wriglll
Page: 2
STATUS REPORT UNDER RULE 6.12
Date of Death:
Alta Tibbetts
April 7, 1996
Name of Decedent:
Will No.
Admin. No.
21-97-078
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estatel
1. State whether administration of the estate is complete:
Yes No X
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I DurinR: 1998
3. If the answer to No. 1 is Yes, state the following I
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court 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. CopieG 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.
S'&~'~~ .1
Date:
May 12, 1998
,
~.4;
./ -
- 0
0 -'!.I \I) t=g:
0 :;lQ;
u2== a: ,0 -
~.~ ,'j1:'; ,
d
\'.. rt) )
'- I
.- .
"
", U) ~ .'<j
u (;;
~. .",., ',.
8&1 '0
rJ!.rt; ~ d~
Stephen D. Tiley
Name (Please type or print)
5 S. Hanover St., Cat'lIsle, PA 17013
Address
( n T 243-5838
Tel. No,
Capacity:
X Personal Representative
Counsel for personal
representative
(MAH I rmfl AM3)
/'J'- --I()~I3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
ItttERIUNCI: UK IHVJSION
DfPl. l80601
H.ARRISBUNO, PA 1712ft~ObOl
NOTICE OF INHERITAHCE TAX
APPRAISENENT. ALLOWAHCE OR IlISALLOlIANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
08-31-1998
T 1B8ETTS
04-07-1996
21 97-0078
CUMBERLAND
101
I,-~,=o~~~:==~'~~~----J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiE'v: i54-j'"ii[OAFP Of o'9:97rNoi'-icE --oF" 'fNHEii if ANcE" TAx" A"PPRXisEHENT';'" Ai. "roNANce .oR--."- - -.-"" - - - -"-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ALTA V FILE NO. 21 97-0078 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
If an DSBB.s~ent was issued preViously, lines 14, 15 and/or 16, 17 and 18
reflact figures that include the totsl of ~" returns assessed to date.
ASSESSMENT OF TAX:
IS. A.ount of line 14 at Spous.l
lh. A.ount of Lin. 14 taxable at
17. AltOUnt of Li,.. 14 t.)(UJle at
18. PrlnoIpal Tax Due
TAX CREDITS:
PAYHENT
DATE
05-13"1998
STEPHEN D TILEV ESQ
5 S HANOVER ST
CARLISLE
PA 17013
ESTATE OF TIBBETTS
TAX 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 E.t.t. (Schadule Al
2, Stocks and Bonds CSOh5dulfl B)
3. Clo..ly Held stock/Partnership Int.relt (Schedule C)
~, Mortgages/Note. R.c.iv~l. (Schedule DJ
6. C.sh/Bank Oaposlts/Hlsc. Personal Property (Sch.dula E)
6. Jointly Owned Property (Sohadule f)
7. Tranufars (Schadula G)
8. Total Acsats
APPROVED DEDUCTIONS AND EXEMPTIONS:
lJ. Fumwal Expen..s/^cHl. Costc/Hisc. Expenses (Schedule H)
10. Oabta/Hortgage Liabilltte5/Ltans (Son-dule I)
11. Total Deduotions
J.2. N..t Vah.. of r.x R.turn
13. Cherit.bl./G~varnM.nt~l Bequa.tsJ Non-.lacted 9113 Trust$
14. Net Value of E~tat. Subject ~o Tax
NOTE:
rat.
Lineal/Claus A rata
Coll,taral/Class brat.
RECEIPT
_BER
AA270072
DISCOUNT 1+)
INTEREST/PEN PAID C-I
18.19-
1 CHANGED
Ul
C21
UI
(4)
CSI_
(6)_
I'll
,00
875.QO
,00
16,014.01
--..ll.
,00
,00
(8)
l
.
C91
C101
11,040,98
,00
1111
U21
(15)
U4)
UY-IHll1.', fit")
AI.TA
V
(Sohedule J)
US)
U6)
1171
,00
,00
1.000.00
X .00.
X .06.
X ,15.
U8.)
DATE 08-31-1998
NOTE I To in.ur_ propat'
cr,.di t to your acco.....t 1
subalt the uppar portion
of thh forM with your
tax pay..nt.
16.889..:~_
11.040 98
5,848.03
4,848,03
I.OOO~
will
,00
,00
150,00
150,00
T~TAL_!AX -~~EDI!~__-=1~~07~
B;N:~;C~~~:~:~EXp:~~E~_~-- ==-_~.~~ :~::
IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS r.F.FLECTED AS A "CREDIT" CCRI. YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FOkH FOR INSTRUCTIONS.}
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
AHOUNT PAID
--168 :26-
He:( ,
1-11
'98 l\lIG 2B 1'2 :00
Clt'lt
CUli1l;
,J!
I'A
RESERYAUOth l!:.t.t.. of dtHdenh dyihQI em Dr ~f(Jr. DtoNtKlr ll!, 1'82 ~~ if ,"w future Jnhrut In the ..tate h trlln.fa,'r4KI
In po..e..lon or enjoy.-nt to Cia.. B (coll.tarall blOIflalarlla of tht dec.dtnt Mft.r thf .~pJr.tlon of In~ ..tat. for
11f. or for ~..r8, the CCHllll~lIlth harltby O)(Pffillnb 1""1'11" tho risht to apprah. and au... trllmlfar l~rltRnO' 1.)(la
at tt,8 lawful Clan: B (ooll.tllrel) fnh on any luch future lnterollt.
PIJllPOU Of
NOTICE I
T~ fulfill thM r.qulr~~nt. of Soot Ion 21QO of the Inherltmnc9 and t.tat. TII~ Aot, Act II of 1995. (F2 P.S.
SIOtion 1}140).
PAYHEHT I
Detach tho top portlun of this Hotl08 and sub_it with your pey..nt to tho RI21Rter uf Willi prlntftd on t~ rlvar.. aide.
~~Kak. chock or 1IO,~y ordllr ppvabh to: REGIStER OF' MILLS, AGENT
REFUND (en) I
A refund of a tex credit, whIch was not rllquntad on the Tel( Retuf'n. may be r8qu8Itttd by cCllpl.Unu an "Applic.tlon
f(.ll' R.fund of Pennsylvania Irtherltanc')1I and Eltah Tax" (REV-1313l. AppllGstlons al'G flvaUabl. at the Offie;8
of the Re"hhl' of WIlh. any of tho Z!t RevomMl lUs1.rlt:t GHlcMI. or by (laHlng the speoiel 2it-hoUl'
annWJrlng s.rvice nu.bers for forM' ordering I In Pennsylvania 1-800-36l~20S0, outside Pennsylvania ond
",!thin ll)Qal Harrisburg Itrea (717) 787-809(1, TOOl (717) 7n-2?,52 (H"orlng I~81r'lld OnlY).
OBJECTIONSl Any party In Int..r..t not utisfltlt with thfl hpprahell8nt. allowance nr dlsal10wMlce of deduotlon.. or ...........t
of tal< (lnoludlng discount or Interut) fI$ shown on thh Notice R\.ISt object .Jlthln shcty (60) allY, of reoelPt of
this Nottoe bYI
--written protut tn the PA Dopllttllitnt of Rovenue. Board of Appuls, Dept. 281021, Harrisburg, PA l712;ARI0Zl, OR
-~lIl.ctlc.on to hlliVII the IS8tter- dllterlllned at audit of thfi 8r.collnt of the per.onlll repru8fltetlv.. OR
uappeal to thll Orphans' Court.
ADMIN
IS1AATIVE
CORREClIONS:
faotuttl IIrror& dhcovur~ on this aueulltlnt fihoulc1 be adc1rllu.d 111 wrHlng tOI 11" Dapart...nt of R.Vfl~,
BurelKJ of IndivIdual Taxes, ATTNl Post h.uuent R....lew Unit, n.pt. ~80601, Henltburu, PA 17\28-0601
PtlUM (711) 181"6505. Se. pDge 5 of thg bookht "Instructions for Inherlt8neal h~ RGturn for a R8Illdent
nec.dent" (REV-IS01) for an explenotlon of a(..lnI.trDtI....l~ ccrr~tt.bltl errors.
DISCDtRfT I
If 110)' tax dU4 It pold within thrlHl {3l oalendar Ilonths "fter th. decedllnt's d..th, a HvCl peroent (5;0 dhoOd'lt of
the tax paid 1. a~low.d.
PENAl. TV I
The 15~ tal( .-oe.ty non-PGrtlctpfitton p~lalty i~ to~uted on the totft! of t~. t~l( and lnter.,t ....~..d, Hnd not
petd afore JlInuery 18, 1996, the flrlt dey after the and of thA tax 8llfjft9ty perIod, Thls non-partiolpation
PQna!ty Is IPpealftb18 In the ...e ..nner wnd In tho the 111116 tillfl period as YOU would "Ppeal the tax end IntQr..t
that hilS be.n ....a.ed as indicated on thi6 notloe.
INTEREST I
Intarut Is charged t..glnntng with first da~ of doUnqUftno~. or nine (9) IIOnth1li end one (1) d.y frOll the dete of
d...th. to the date of pe~lIfilt. JeHU MhlCh bocallM dellnquent Daforll January 1, 198Z bear Intlllit'.st at the rete of
six (6-in percant per IlMUlII caloulated .t a dell~ rllt" oi- .000164, All taxu which beCN" delinquent On IIfld aft.r
JtN"IUarv 1. 1982 will b..r intor..t fit .. rat. whIch Mill vaty fro. oalendar Yto'ltlr to oehndar Yflar with that rat.
annPUnCod by the PA Depart..nt of RevenlKt. TM applloeble Interut rates for 196Z tht'ough 1998 flUIl
'!!!.r tnter.st Rote Il.Ih Interut Faotor ~. Interut Rut. OaBy Interest FllIotor
I981 20X .000548 1987 9% ,OOOl47
19&3 16% .000438 198fH991 11% .000301
1l)84 11~ .000301 1992 9' ,DOOZ4"
1985 13:':: .000356 I993~1994 7'1. .000192
19&6 10% .OO()214 1995ri998 9% .OOOZ47
....Int.r..t II oflioulahd .. folloWlIl1
INT~REST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--An!f' MoUf'.e inued .fter the tali b.00ll85 delinquent wlAI refleot an Intlljlrest clIllculaUon to Hft.., US) dfly.
beyond tht_ date of th. 8.......nt. If poy..nt I. ..do aft.r the lnte,...t cOIpUtatlon date lho~ on the
Notto., additIonal Int.r..t .ust b. calCulat.d,
\
",
~
" 'co , , \ " . >! . , Ii . ~'
"
1,1'1 '
,1'1'"
,I; I'
hi
rlii II <;;) I
~li[cU! .,:J
I ,jl. 'y," "'/ "
" "-:.... "', ' ~-"\
i.", i'-', ""-j II
I/,;)(;f:' '{I{;
!I~\i ~, ,~
~lJ)'<.kJ.l/
S 'I ,V:',R,! !: ~ Ii'
lIL'J\).I~lljd
~,~
L' L", (.1"
t;..J :~.i:
",
.
I.'i
.,
!>.~,
, -"'"
,i:l
'rl'
Ll..l
(.'(;
~"'I
~ ~~~
q
.':1
"'~~
:j~,
(,\"
, ,
I';':
S,~~
Cll
'f"i m ~
! gl$ ~
Iii' Q'.... ~
13~~ar.:
lil~"l\O~
p.... , ....1 ~")
......~r.o
~.; 0 '>'iN-<
O.iJ'T.J ~
~ ~ ,
,Q QJ t"I.J ,.
iJ t::\.C4
'"",' 13 ~j-l (iJ l-l
<<hI.< Or.:. I'
(l) ro ..n
) ~ rJ Ul
l3~'lli 'r:
Ei! >. ~,
a ;:; 01
(.) ~ ::c:l
u
.
., "'"' ....... ',_ "'>4'" -, ,',h-'
"'
-
-
-
"'
::
.
-S
'":l
-
"'
-
-
j
;s
:
-
i -
"'
~ :J
I ==
.
"'
-
-
=
:
8"" ::!
-=
~d~~ == .,.,
~ti .. -=
8 -=
u~~~ ~
~ ~ ~ ~'
,....~ j I)
~
~~ ~ f1
...
0
r-
...
ill !'"
l~)
")
,
'-'i-ILl
,
'~;
oj'
"~~,
I
, t,'
t-. .. ,'f
4
, ,
r t \
"II _ii;, t
',,' '1~I',.,
~ 'I'
,.."
1/
\~ ',1-1
IA ~. i ~
',"', V :
.
)
, .
. ~ f'
,..-/'
i~,
,
-r.
I
!
{"
l;
..-.. ---..,.,...,-
........ .,....-.,--,._--,-..,......~.JJ, ~ ......'..r ...,. .
r~" ,