HomeMy WebLinkAbout97-00432
\
$ ~.
s ; ~ ~
It fat
~ s j I ffi
~ 1 . ~.. 0.
J ~ ~ ~ ~ ~ Ii
t.... ~ ~ ~ o III a:
\:r ~ ~ i d
I .~ e
~
~ L t
~ ~ (( ;: i
I/)
.
"
.
" '.).
PETITION IIOR PRORATE and GRANT (W LETTERS
Estate of ____._.,.!!llI:oI~1 J-:,.III'cLm No, ....... LyJ-cCJ.u1.6.:d...._.,_..___
also known a.f __,.. ,..___..,,_,.._,. To:
___._,,__"" uuu'_' ...,.. Register of Wills for the
__,____.'___ . ,u.n.....'..." Deceased, County of J:'\\!l)bc r I illl"-____ in Ihe
Social Sel'urily No, _uJ1l!!.=-ll~jl}.1:,-.___... Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petltioner(s), who Jar/nre I R yenrs of age or older an Ihe execuU,[S named
in the last will of the nbove decedent, dnted.__Ll!.!,L)J.LL.2.f!L_n,. , 19__
and eodlcll(s) dated Janunry 29,.-1.2.2Q... _._..___._.__u____
=-rr. ~q-
-- 'l.~-=-.._.J--
(!HAI:~ relevRllt clrCUlmlancc.~, C.M. renunciatIon, dclIlh of tXcCUlOf, Clc~)
Deeendellt was domiciled at death In CqmberlnnL-___u County, Pennsylvania, with
h.Js last family or principal residence aL. 25 Furnnce Hollow Ro.a.t4. ~hippenRhur.g....
South Newton Townshill.L.ElL.. u
(list street, numhcr and munclpality)
Decendent, then ._.._ZL years of age, died April 8 , . , 19 97
at~9nd Mount!l!n R.ond. LetterkenDy....'!J2l1!!J!hill.J:rlliliILC.2.\ill.t;'......fA
Except as follows, decedent did (lot marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: _ none
Decendent at death owned property with estimated values liS follows:
(If domiciled in Pa,) All personal property $ 35.000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property In County $
Value of real estate in Pennsvlvanla $ 49 , 000.00
situated as follows: 25 !furnace Hollow Road, Shippensb!!.E.lh
South Newton Towpship, Cumberlnnd County. PA
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and eodlcll(s)
presenled herewith and the grant of lelters__ teBtamentary
(testamentury; administration C,t,R.j administration d.b.n,c,l.a.)
theron,
I~
11
~...
~'Ci
!
Vi
~"'_d~ t<J. ''Jfk
~ wrence . Helm ~-
20 Robin Drive. Box_553 ._
ShiP~enBbllqk PA 17257
-11.17 532-3480.
.?,1,h.Ld:f:. tu.-Lll Jw:'j,'
-,ra"[gef'1:. Wi 11n! d e
_331 East Ornnge Stre!l..t-.
ShippenBburg. PA 17257
(71 7) 532-4068
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH 010' PENNSnVANIA } 88
COUNTY (It' .._J;!ltlBERLAND
The pr.tltioner(s) above.named swear(s) or IIl'f1rm(s) Ihftt the statements in the foregoing petition are
Irlle and eorrect Wthe best of Ihe knowledge amI belief of perltioner(s) and thaI as personal represen-
tative(s) of the above deeed,'nt pelltioner(s) will weiland truly administer the estate according to law,
Sworn tn or affirmed and suo,erlbed ~1:f'-'-'LJL...!:<:~tr;(1f1J~-- ~
before me tlds.... _,._...2..th__. day of j -.._..',7Pl~;7".W.-'-Jl.'.;,7J,I/a;~;,IL,._,_ }"
_._~t>1_~.._.___. ._..,.._.. 19,.9~__ do. LL __
11) 0 j?~~f.&~(;(r~r.i-..-R~RI,~~~ . ~.~~lt.~:uu~:~i~i~!_~i=,-====-= ~
1'(,,') ..:.:<
Th,~ i~ tll cl'rtil')' tb,H tlll' Infolllliltloll IHTI' 1',in'lI i.. \IlIIVclk \.!llllnl (1111ll ,Ill 111Ig(H,d (l'lldk.Hl' If! dt'.-,;'h dill}' 1i[I.d widl IIH
J.fKill Rl'gl.~tr.n, 1'lH' origlllal l'ndlir:atl' will 11,.' Illlw;lIlkd Il" dll''"ILllt' ViLli ItnPld.., l \Hhl' f~l! pnl\h1lh'1l1 lil'llj',
"
ht, lilr lhl~ cl'nitkaH', tt~,{iO
WARNING: It Is Illegal to duplicate this cvpy by photostat OJ photograph,
21-97-432
. 4'f"i.~i"~.ii'\.\.'\.'"."'O.'.f'.'f.'~~.~."'.'~'~
~~.~/ ~.,<:~~,
f3!. . j".
. ". . . II.
~k'" '{~~'
">91~-~ ...\~.."t',~
..EN1 ~ ,,'
" ,J}
;,}J;dt,L/fldL~
1,~Y;11 1~{'gL'itl!ll
4260489
No.
----d,I.a-/-&x-,
Dal'
""IlIJ
OQMMONWSALlHOP rl!N~~VL~~'A. O.PAArM'NTO"~I!At."H. Vi".'. AICOflf08
ceFlTIFIOATE OF DEATH
0141,0[ 11.1 "'._ ~"I _._-,--~ .~.~.-~,_.. _~'_M'~'_~'~"""-+rut-....~.. C~t~~1:~~'l om ""1.~.""I.""" ,,"-Ij'
, m~-mmt~'-T~~ I, J I'. ...' 1~-...A4!L ~L9911
." '~"""':. .kTf~' ,;;~.. r":~J.f;';I";';;4 1:";;h~~~';:;~~TWIJ ,,",:.'i~~!'=;';"""':;';<"""~~~;:"-=';J ~. '1;:'"./ .j
'OVOIT'f' " rll'i\OilO~fwl''iiri\Tii'iT'"~I,~nY!l..IoIt."",,:,~:r.~T.,~,wl'...;","r''''' --..-- ~v.lIIlIIlRDllMlI')F'd!;.iCOiii'iii.rr-:E. '. A';;;'~';-~';U;;;"V<l'..oj,'
~] ""'1]1f,""""';YC'~, ","'" ,
fJl.Q;nkio\ lettriJ./"'lItl('U Twp. Brt\l"d Mlllltl((tl/l Rt/ad 1M._,r.-"..,t/I."O wI\( fl'
~~!!!.!.l!1'l8-oc..syp,qfQ.Ol_~"I'_!IHUi'iJjiI!~I#l(':!).II'ii'iiFfl\ ~]' "'\hfUh'ftWtlii!;E-'~ n u".\I,.''''1 1e.~jilvTi,Ii{Fl"'lT'lI--~-- I'
(}.,.'ffl.....~~""""',j,~'~'m.. ,,-ltll.lli'\r,IMtl"' ..:~.~ __. fft; t"""'AW_I. .... ......-."...."....
",_to.'II-'il<>"",'e,,,j1 ......1>1 /t<!l) ~..;r~..,~".;.,1Y ,1""1 o..O<t.,s"......,,,,, I
t.~ch{J1.(, \.'~C1.qJ~ \ ----'.'VKJ"jd.HU'ltfL '.t _._"_.~.tL_6._ __~..L~~___~ l~1.W.CL___.'L~__.__~.......-.."._.1
~(~~;:t!~w::::~~:';;;:l ~(\,:n(/"~ Ii'" .;l\::~:;~:, .., '"'' r~'!IJ;utl,...qIIJ~ '~ ,,,,x I_~........ S. "'L'tlLJlo't'"~I'W"I. h'.".\___~__ '''~l
Sh b I' 17"7 ,""'" C l C ~-" ']"'_.... I
~J!t~~~~~t~~~~:e~~(\-~-_:.~._-- .. -...- .... '.- ... -..- .I_~.(~""'J c.. (Irh 'Pl Nt u~~.t~.ei:'~,t'~~~~"!::O-oc~,c"o.--'-:.=:;:=-"---"~...o:....,.-,...;.""",.,;:~~,,
,Jr~I'~~\if'-fl""""'''' -------~----~--'-.--."-.".-.....~~.~:__~~- IN ".AN""WItlIlG~t...c.l\fb.oo .......~;)."--._.~--~"_._-".< I
~IUL~,_w_---"'~--'-"ltmrT.Il'o;~""'II,,~------""'-:"""-:M' l ~v-'--~_:....~)
"""""""P-'"J'lI:,~;m c,.....,...li n_,...,~,",~",.I-1 ,..."".'........., 411111q9'1 q,OoI...,P' ti -gu1 rmp ./.lli.lj ,\'uti~mr"~;I' t~!il. I'
""'-'.,..,U ONI''I<....''L-.~______._.. ...,..' .__,.11 r kf c t r
~~m~ptlV.L~f .~ t'\r,'{-lN-ll;lil~l4-:rr&~t'-'" mc.--.--..lI;em0!7k;;Wr'.".~-;. IlL - ~ -~t;.n.i$f.n6J'MCH. -- JIl!'O' ~a!!. -- ~- J:'.~~.IL 'h.: _~n..._~_ -',
!,,-<d~ ,co:', "''''::f..~~-~' ,,,J,,,,,.qIL.7L.l,,. ,.lM,~ef'",~~!I'~k::!.;~~,_I~",,-~).~.', ll6 .'<1<11"'1'2":1 /'^II,:':'[
~=:'::::.':.::::;:::;';~~':,~ ':;::'~:;~::~:~""" .",,, ,..",..""..""","0....., '"""","'" ,~~."~'::':.. I
,,,'''',__ol.lIII~ I
~~~~=~~~__~~~ ~:ru~~\:t~T~!- ~.~~_ I:~~~~I~I ~"~'ri~:-~~~~~=~____ rmr .'~~,: 1.2,t~I_."',.:...:~:~:,r~.,~_ _"'=~~~-I'
1I II, f"'''">4 ....._.. .",....... """""""~"..',~hCO"'..J".. ....,,, I", '~'I. ,,.. 11.0,'"'' "u,',q .."'" .",",.,~, '" "1f'"jl'''II''~'' ,"""_"' ,.."" "lu'. 1,tp,MI....... ,., v' "'. n"~....~_"", ......, -.. '"
,...OMy......,._."..,..,.. l== _'.1I~...,..,""';.-..,."'iI~....._..1'4/l11
"""DlAnC<Wtll'I,'fj I' f I
~-":;~',;:;;:;':".. '.,. "',"v\'.E. .n.Y,'( IInOI.1,{" IHr"/l(1.c( I Pf) ..!I""'t(~._ ~.(}I~"':.!t".';'. m ",I ('.i;IJ(-
l,,,'I(,,,"A~."'U;('~If'rt l (1, r: .
.... p~A~'(. vn.., .. n...IYfM:$,. . <:'P eD.......,,,
f}\I(IOlfllHA<:[fl';rM',u\"1 I
,,--..--+-.-,
I
5~"'__
f"",,"'ItloI9IO_~
,.,_I"'.._'tl,VIHQ
CAllU:rl_"'I'I'"'
",,""_,0-..,
,_.....,o.._IWl
..- "'rn'r- iil;;\ t~.~, (, ;;11'r"1lij'(il~Tf(,---
Wl">jll/1'O!'9~ wt!MAI~~-;i;;;r;;r,~~ lliliVlFn,riiliTTI'. u_.... .t- I-~ "~~~~~1:iifli-';=~= I,,,, t InRi"y M. lkJI)A~ .....}Il~l
M'1II'0I1101lfl' It#.Jl..IlII.fP(lIC'110 .I.I.1",",WI
_ [.J ,^, r~r'I;f"1 ~:""I'I ~~~.~" tN,' I' ','~:.::,:\.'..",::.. rJ,1 ltii.__... ~.~~. .m_~_~T:.__,.[:~I. '.'~~~'. "'. "J...---- ~.. ,"---"
...."" '... "" """ n' ,." m,__' .\,Io(;elll'IN"IjIl'rMI"""'I.<n'I'~I~~ l,-",~~~)IlLM''''i.tril'''''j''''''1
t>;>I<""ll'l'tlCW'"
!!:!-...-_ '.!I'______ 'Q__"__._.____~_-o__"'..~~~ "" . $If,
~rlfl"lIIl'1ICh"'.,.,.,.~'., .... ~~----~~- M{,~I\Tl'~1l ...::;-- f;;;n~"'-'"'
'Cfll',"lfIIIQ"'YalCloUllPP,,,,~,",,,,,.,,t,,,,,,,,,..,,,,,,,'h'~"".ln'''''''''''~'.M;'Urh'''Vf..l;~'.H..".i''"~;'''''l'''''' :'It / ~ ili'
TG..._..""_noI.........,.tlh""'~'_b...IG.....I......lj.""..."'..I.~~"'''~, ~("'_J_f-~ff'(..I_.._...____.~. ". ----~_..-. '~.,"-'.
n~f~~ION[O...,'.."..y' '-'(I,....,
.~"'fllot"'lI'YINQ~IIY1~I~H',..","''''''t'''''.-.-..-..i..'''.'..'~',''''.''..'".f''l~,',-I',:!,,"(">,11" :] i: S'/lrJ 7L
"'f'9_tl~1'''''~' "'01."""'" 'I IN 11m.. ~Ill. ....1 pi.... fNl ~""~ 1"-.'~,~m""l ""~M'~lI ~l.!" ~ Wtfo:oi.Ir'lf ~b4r.~Uiif <iA/.ii..' .......,.--...-
fif~~Il7iiTfi';7i';rLi.-iiTii~-..
'It.OIOlLU"lLltIolIIllCOfIIONftll
0ll1!\4 bIoI;1 ~1.'On\'n'llOn 'nNIIII"...lIaIIlO~, I"mf "pi,,;,,~. rlU'h dt',,"*,lo'Il,. ilm4. ,i.I.. <i',,' r'''". _"II ,i~ll~ lhl .""wfjl.n~
'''''"'~'''''''''':l A' .
.-.--2'~~/.TZ,..""Ri "'~J""'\1f" )/;t. :.'~--"------------" ....;:_1/.'-:;,;<[',-:
/7,.0/ /, ( /,/ , v, "'"
.'1, ,.__ -.-.-lk4y.-1J-1t:.0."...~C-.---.-- _ .
l(ftf A. Tltjt~l't1d
n 100 s, /linn ...-:hi'l't NI\lVilJ'''.
- i\~ir ;~,iO',,' :'J,.' ;'-.;:f;~; -;;_... .....-......
)I E'" i/'." ,/.' /[oJ /;'+;;'''~
. (_.:...-~,,<.("L~ <__.__1>._ '.r'.
PA 177.11
,
:,:1' ,I',
, , I ~' I'
',Ii '
;: ',t.:lii:: ,Ii (':11'
" :>. .:.'11 I.!.'. .1'1'1 I
, 'I , I L 'I' ,',i:
I" 'I' ;'1' 1:::1'11:: il,. : i.:) 'II.
'<>I:I!:111 I:!" li!11
'! ""iil! II ::i If I:: ,
l :':111;',111 :ill AI
',I' ;illl 1 .," :
L I j II . ,\
, 'I") I \V "
:; I I.'. ::'1.'11' I, [
';,:: ii Jill" 1:
, I II' :)11 :1 ~
i 'il ,'.
II !'I"! I 11 {; j f
lili:11 ~ I h
ill!:II,1 ~ r:
;::1 111':111':] ;
1,1 ;i'.:11 ~ )j
::1 I: - ! I
I'i I: I,;' ~
. , ; 1:':1 I':' f Ii
11,:11 I } ~ i
I!::\II !i ~I ::
! II,'. ~ :;il
I pi ,; I ;'1 I,:
::' . 1111:,11' I~I' )';1 i
',i, ,i! III~I ;';11
i ::.,..i;:. 11.111 ~.' :1. !. '11r.: :;,1 ~il
iL" ~: 1'::11 ~~ ~ ~;
1':1 : - i:XJ ~~ v I~I
i I -I 1 LJ ,to. \
.,'1 ;! 1"1 ~ fll ;:1
I,i! ,-.1 _'j i\ II
, ':1 :':1 i'! I \'
1'.1 'ili! I ': i; I)
,:~! ill i::1 '....:,..'..1) ;:1 II~ I
, . 'Iii i, 1'..1
,!"I II Ii) ill ,t,
'I :1:': ';1:: 1111': I
',I' i',I':,I!11 :"1 i III :: I!,!
:" ,II ,'I: ! ",!I. i 'I'
,I - I II ':! ;::11
:il; I! I :1: 1:',1:, ,;1
'I, ,I' !,i " Ii:
'I, I
1::i!',I,
ii I
\ "I
i . ':.1',. ,,'
'I: :'_-: ':1:' 1':1 :1 I:! i '
:'" ",:: I' II '. . I I,' I,: III" II ,I ..' I '
;! ,I: 11 ',(I," ::,,::: Ii"" 1-',' I"'" -, 'i' I'-'j
'i '1'1;::" 'Iii' 111"11;:, i,' 1";1 :1;'1:,11',:,'1:1 !,'I'i,I,I:':,',,'II:' "I:"" 1,','1: ""',, ",
1.,11 111'1 I;; !I I /,; lil.:.:l1Ii.'
'I; III ,'I 11'11 11':1;1. i I' 1I,lfl':II'1 : 1':1: :1\' 'I :il'li i 1'1' Iii I" II':, ,:'
, ,I "I, I"..'. 111,:./ III ' 1',1' I "'I' 'II "'"
I :, II 'I!! :1111':11 'I 1'[1:11111'111111:: !,I, :: ',1,: 'II ::
, I "'I '."1 "I' " I ,., "I'! I 'III 1II1 I '
~",: I : ': I,ll' 1'1 I I .i II!: 1 \ I : i I ; I II! i ; I 'I i: :: :' "
I[ iil:111 J II III )11' ii: I ;:illl,11 i iil i,'iii!I:; i'li: li!1 ;;i'
" II :.:.:.1 I /. i.','.'I' '11 '...~, '1' ,I :' I II; 11'11 :' , Ii I ,i! :' ; : III :' I' 'i j: : " : : ~, :! I: '
" 'I 'I' " I, ::1 :1',:, I .'1 I '; I, 1'1:1 I':!: : I, Ii, '1'1 "
( I " "I" I' " , ,
M I. ;;11 :..:11 I I;. I iil III :, I'; I'! II:! 111';'1 t I;: I'" II;" I':' ,; :::'
" , 'II ':1 :1\1" : I "I ,II ,I', "", ""I ""1
N .1 ,: "..:; i: ,II I,', I' 'I I, 1;11 'd ,:q ':q I, ;1, 'I' . i ,
, ", '" I I' " I'" II , 'I, I, ':
;: ,.i I ~' I ~ I ;; I, 'I ill :',~III :,:1 ill I ~ : I, 'I I!' '111111 i !:, 'I !!!, !, I, ; :,' 'I II I":" :,
." . }"I U I" I "I" I' I' " '" II, ' , '
"I ;;' ;;1' I;: ~"Ii I ;,:111 i.I' I'; '::}I!I'II; 1,:::il!I" ','I'I ,:1
~ 'I' ':1 ; II II:: ;' :: II" ';, i" i '~ ' I i il ii, ;i :; 1111, i: i ' ! I '
x I' ",'.:1.1, ~ I ,:; ; 'I:: ,',' II II 1'111 :' '; i I" I, ::'
II f! l ;; '; I' :.; I 'I' I 11 H ;[!I i: :ill :1 t :;:
: I :.:1.: J ;1' III:!.' I' '.; I I :.' .' !!..i..;.I. i.. i I I: i....... :..' I: ,I I' :,
: I 'I : : : ':,: II : ,II '111/lil'.I.11 ! "
~ 111 ~ z 0 ' I ,\ I ". " 'I '1"1 'I II II
~ ~I.I. III ! .111 i'li' Ii ~I I!I'III jill' 111111j. ii'l!; .
'1""" ':"1' I " ,: II, :'11 .. '.:.'.'..'. 1'1 ...,1 i.. I.,! II 1i1.'.:.'.:.'1 I, I' I '
:: I ':1 II:; ,.", ,I , ,fii" c, I I' 1 ,'I
;Y f:' E i;: I ~'~ ~: I ;:11 I:.:.. -;".' 1..11.'1. 1;1!..~!.II!....P...;ll.li , i! ;!;,
1:1 'I I I" , 'I ,! I" , "'I' "I' I"'"
:':/I'JI. ~IIIII~II 1: I ~ II ~'! Ij !i\lli1fHlil'1ill:'!il !. !II! i'
f, I )~jll 1f,llllii F I ~ :il I~; li:II!11 ,;111 ill::!11 .1 Iii
,
^ I ' " ,\ I I
',' J ,)...1, ~.'.., t! \' ': I ',' I'.: III':...'. .11..1'..:11111'.."....'.'1': Ii... I' I!I
11 Ir! rl r ~ .iI' 1.1 r.i II."..:... I i..i,i~I.'IIIII.'.'.I..1 I': ii:;
I' II tl' I,.i, I, ~ I~I ), I. ;i, w' . iI lilll iEi I I, I .
!i ::II~. I 'i I Ifi! i I:;!III i:I I ( I!i: II Ii 1)1,11 1111:; II 'i I,
:: I I::II!I :;:11 III:;' 1!IIIITi! I :;lli 1,:111 IH II I i:: Ill,:'!I: i;ih:: :,;..1 i i
~' II.. !! : :'.1, I: i.. !,' 1.>1::.1 I!!, 1;:1., i 1111 ill,,!! 11:11 Ii:: I11I :!,H'::: II : Iii:
'_ i ;;11 '..' 1 :Iil.".':" Il'!__"..1 '" ;1::: '-I ill Ii ,I :"1'
II I I: "I' -II!;:!" iJ'i':'1 I' 'il ill!' 1,li I: :'"
I'! 1:1 ",;' !: ,"," - I
,
;11
, ,'I ",
'I, :
i :
,I;
'1,','1' 'I:
,
~ .'
.'.
,
.
~~ :s "CI
,1:3 <l> ~ rJJ
en Z
I1j !@
. <l> t.
~~ J.4 <J ,
<l> ~ ~ ~ ~ ~ (
z~~ el "CI
N ~ Cl.:llii~~~
o H '"
~i><lJ) <t I ~'" ~-....
I 0 . ~ 9 ~~~Er;: ~
U~H .... ~ ~. - ~ - I
~ r:1 '" 0 ..lCJ >II ~ '" t:: J
I ~ "~$;;;ZC
oo~ .... , E
N ~ 0 ill 0 " f
HU J.4 ~~wi,,=..:
~ 0 , lJ) ~~~~~
o;u 0 lJ)
:z; J.4 i:1 . -.. )
~ '~ J.4 ~' ~
H
.4 .. ~
H i:l ~
:z;~~ ~
~ ~ I
....uo
M^RK, WI:lllIJ: ANI! PI:RKINS, ^1T(lMNI;~~ Al I.AW
. 126 KJ;S'f KI~'(j Snu:r. SllII'Pt;NSRlIN(i, Pt:NNA, In57 '1't:U:t'uu"':t (1.,) 532.7388 .'",,,: (117) 5J2~6M12
"
{ ,
.
~~-"oo "',17""1
r.OR OATES OF DEATH AFTER 12/31/91 (I
CHECK HERE IF A SPOUS~AL'/
POVERTY CREDIT IS CLAIMED
-~- ---
FILE NUMBER
21 1997 0432
COUNTY CODE YEAR NUMBER
- -
DECEDENT'S NAME (LAST, FIRST, AND MIUDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
Helm Harold E. 25 F'ulTlc'lCe Hill Road
OECEDENT SOCIAL SECURITY NUMBER lOATE OF BIRTH Shippensburg, PA 17257
184-12-4394 04 08/97 lQ}/23/1924 Coun CUrr1I:X'lrland Count
"APPLlCAB") URVIV 0 SP USE'S NAME ILA"" SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INS fRUCTIONS)
lAST AND MIDDLE INITIA.l.)
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
COMMONWEALiH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
QEPT,2801l01
HAAA'9Du~a, PA 111:11"0601
14, Nel VBlue SubJBct to Te. (Line 12 minus LlnB13)
15. Spouaa' Trlnsler, {1M dalu of dealh a1ler e-3o-941. Su
Ins'ructlonslor Allpllcabl,Perclnllgeon Pl\ge2.(lnelude
\llhJU lrom Schedule K or Schedule M.)
16, Amount of Line 14 t..ablB at 6% rata
(IncludB values from SChBdulB K or SchBdulo M,)
17. Amount 01 Line 14 taxftbla at 15% rata
(Include val~es from Schedulo K or Schedule M,)
18, Principal te. due (Add te. from Lines 15, 16 and 17,)
19. Credits Spousal Poverly Cledlt PrIor Payments Discount
+ 4,000,00+ 210.52-
2E];'~~~I':;i~w~I~~~~~~it~~i~~i;~1~;:;~~~MENT.
21, II Line 18 Is greater lhan Line 19, ontm Ihe dlllerence on Line 21. This Is the TAX DUE.
A. Enter the Interest on the balanco dlJ8 on Uno 21A.
8, Enter Ihe 10lAI 01 L1nA 21 nnd 21A on Line ~18, This is tho BALANCE DUE.
. Make Chock Payablo to: Regl!lor 01 Wills, Agont
~~;'~~f1~I!~ ;1:~~~~;g~;~~:;~~d~~m~:~~~;;~~~~[;~:~~~~~~J~~:~~;~~X;~~,~cm~~~'e1~~to:b~~:;'7~~ ~1:'p~~~'a~~~ ~~~r mX~i~~;~~a~~i~~
representatIve Is based on !'Ulnlormallon 01 which p~opar€lr IHlS any knowlodgo.
.- ~ATUAE OF PE~SON,IlESPONSI~\.E rOR FILING fl,f4{J.. \. ~~'nRESS _ ,
( . .- .\llilU.";'AI.A~'"'''' ,,) ). c,ee Schedule Ettached
51 N TU OF~EPA;;;;;:;JtplHIAN PRESENTATIVE AnORESS
_: _/ \.1 . {/ j....l 126 Fast King Street
SOD 1 NTF'''' Shippensburg, PA 17257
CHECK
APPRO-
PRIATE
BLOCKS
CORRES-
PONDENT
RECAPIT-
ULATION
TAX
COMPUTA-
TION
1, Original Return
2. Supplemontal Return
1] 3, RemBln-dor Return
(fo,datllloltJulllprlorto12-13-82)
D 5, Federal EAtatB Tax Return RBqulIBd
o 4, Limited EAtate
o 48. futuro Intorest CompromIse
(for dates 01 death after 12-12-82)
ire
D 7, Docedenl MalntalnBd a Living TruSI 8. TotA' Number 01 Sale Doposlt Bo.es
(Attoch copy 01 TrUsl) C) ,
no~MI\:Jl:~!!lIIQI!! (lilT .
COMPLETE MAILING ADDRESS
Mark, Weigle and Perkins
126 East King Street
Sm but'C/, PA 17257
58,000.00
100.00
None
None
27 ,551.46
NAME
Je A. Wei le,
TELEPHONE NUMBER
(717) 532-7388
1, RBal Estate (SohBdulB A)
2, Stocks and Bonds (Schedule B)
3, Closely Held Stock/Pa~norshlp Interest (Sch, C)
4, Mo~gagB. and Notes Receivable (Schedule D)
6, Cosh, Bank Deposits & Miscellaneous Personal
PropBrty (Schedule E)
8, Jolnlly Owned Property (SchBdulo F)
7, Transfero (SchBdule G) (Schedule L)
8, Total Grosa Assots (tolal L1nBs 1-7)
0, Funeral E.pensBs, Admlnlstrallve Cost"
Mlacellaneous E'pBnses (Schedule H)
10, Debls, MortgagB UabllllleA, Liens (S~hedulel)
11, TOlal OBducllons (Iotal Lines 9 & 10)
12, Net ValuB of Estate (Line 8 minus L1na 11)
13, Charitable Bnd Govarnmontal Bequests (Schedule J)
(1)
(2 )
(3 )
(4 )
(6 )
IJj
(8 ) 12,056.89
(7 ) None
(8 )
(g) 11,044.32
(10) 4,727.76
(11)
(12)
(13)
97,708.35
15,772.08
81,936.27
None
(14)
81,936,27
(15)
. , .
.
(16)
81,936.27. ,06
4,916.18
.
(17)
o . 00. ,15
0.00
.
(18)
4,916,18
Intere.t
(19)
(20)
4,210.52
(21)
(21A)
(21B)
705.66
0.00
705.66
om q_ ('6-'77
DATE
'1' {'6 ,<:'17
N9<1Pf\l:Hll
, REV-15Oll EX + (12-88) L
COMMONWEALTH OF PENNSYLVANIA SCHEDULE F
IN~~~~~~~E~~~E~~1~RN JOINTLY-OWNED PROPERTY
- -
- -
ESTATE OF
Harold E. Helm
Joint lenlnl(l):
NAME
A patsey L. W ,de
ADDRESS
331 East Orange Street
Shippensburg, PA 17257
20 Robin Drive
Box 553
ShippensOOrg, PA 17257
B Lawrence W, Helm
Jointly-owned property:
FlU! NUMBElR
21-1997-0432
RElLATIONSHIP. TO DECEDENT
Daug ter
son
..
LETTER DATE DOLLAR VALUE OF
ITl!M FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECO'S DECEDENT'S
NO. JOINT OF ASSET "INT.
TENANT JOINT INTEREST
1 A 12/18/89 Dauphin Deposit Checking 1,308.35 50% 654.17
Account #67379877
A 12/18/89 Interest on above item accrued 0.55 50% 0,27
as of decedent's death
2 BA 12/18/89 Dauphin Deposit Savings 12/148,51 33.3333% 4,049.50
Account #4937771507
BA 12/18/89 Interest on above item accrued 74.51 33,3333% 24.83
as of decedent/s death
3 BA 9/6/91 Dauphin Deposit Oertificate of 5/329.70 33.3333% 1,776.56
Deposit #8000436701
BA 9/6/9i Interest on above item accrued 154.68 33.3333% 51. 56
as of decedent's death
4 B 1996 1996 I:bdge Dakota joint with 11/000.00 50% 5,500,00
Lawrence W. Helm
TOTAL (Also on'or on IIno 6, Roc.pltulallon\ $ 12/056.89
PA15091 NTF 12.OA
(If moro spaco Is nooded, Insort addlllonnl sheot. of same slzo,)
Copvrlght FCHml Soflwar. Only, 1994 Neloo, Ifill. N94PAQ91
,\'.-i'
REV.Ul1E1(tI7.UI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMoNweAI.,.H OP "IN~eV~VAN'A
INHIAITA~C8TA' AftTUAN
AEIIOl NT DECEDENT
~
Pl.... Prlnl or Typ.
PILE NUMBBR
21-1997-0432
ESTATE OP
Harold E. Helm
ITEM
NO,
A, Fun.r.II!'p.n...:
DESCRIPTION
1 Fogelsanger-Bricker Funeral J~
S. Admlnl.tr.tlv. Co.lI:
1,
Pellonal Repreeentallv. Commissions
Soolal Security Numbsr 01 Peraonsl Representstlve:
Vear Commissions paid
2. Attorney Fees
Narre: Mark, Weigle and Perkins
3, Family e'emptlon
Claimant Rslallonshlp
Addrea. 01 Clalmonl al deoedenl'a daath
Slreet Addreas
CIIy
Stoia
Zip Code
4, Probate Fees
C. MlsoslIsn.ous Expsns.s:
1 News Chronicle - advertising Letters Testarrent.ary
2 c.\lmberland Law Journal - advertising Letters Testarrentary
3 Register of Wills, CUmberland Cbunty - filing Inventory,
Appraisement, and Staterrent of Debts and Deductions
4 Register of wills, CUmberland County - filing Family Settlement
Agteerrent
5 Mark, Weigle and Perkins - reimbursement for postage, xerox
copies, and long distance telephone calls
6 Linda K. Klein - notary fee
TOTAL (Also enler on line a, Reoa Itulallon
(II mors spsos I. nssdod. Inaortoddlllonol ohooto 01 aomo alzo,)
AMOUNT
5,492.00
0.00
5,OB2.00
0.00
236.50
5B.32
60.00
2B.00
60.00
20.00
7,50
$ 11 044.32
A. Setlle!ncnt Statement
U,S, O.~attrn.nl 01 HOUII'I~
llnd Urban On.lopmlrll ~
,r
nype of Loan
---1lJFII^ 2, 0 FmlV\~b Cony, Unl/lsFlle NUlllber' =r.oa/l Number
970UOHIIOL
__4, [1'y!:' 5,0 Cony, In,. _. _ _ _,_"
C, NOTE: Thl. lorm Is lurnlshoo 10 glvo you a .Ialomonl 01 aOlual 6olllomonl 0061B, AmounlB paid to ano by Iho Balllemonl agonl ara Bhown,
110mB maIKbj "p.o,o," wora palo oUlslda 01 oloBlng: Ihay ara Bhown haro lor Inlormallonal purposes and ar. 1101lnoludad In Ih. 101als,
D. NAME AND ADDRESS OF BORRoweR: TOl'ryL. 1I01tI'y and Tessa L, lIoltry --
1621 L1 n~ay Lot J\o~d. Sh! ppcnlbl/l'9, Penn,yl van!! 17257
Estate of Harold E, lIelm
lormorly 15 Furnace Hoad, Shlppcnsburg, Pcn/lsyl.va/ll,] 17257
Keys tono F I nancl a 1 Mortgage
2270 Erin Court, Lane.lter, P^ 17604.7028
OMlI No. ~&O~'0265
Mortgage Insurance CaSi!iiUillh"r
1;, NAME AND ADDRESS OF SELLER:
F':NAMs AND ADDRESSOF'i::ENDER:
G.PROPERn' 25 Furnace Hollow Roarl
LOCATION: Shlppensl>urg, P^ 172bi
II, SETTtEMENT AGENT: --- --
Mark, I~elgle and Por'klns . Jerry ^, ,Ielyle
PLACE OF SETTLEMENT: l26 East King Stroot, Shlppcnsburg, I'^ ~7251.1391
(TIN . 23.2328815)
I. Sf.TrtEMENT DATE:
.J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANsAC;TION
100, GROSS AMOUNT DUE FROM BORROWER: 1400, GROSS AMOUNT DLlE TO SELLER:
IOl.ConlJa,CI UIUplIO. 58,000,00 <\01. Conl/aCI UI$iI_!!rila 58,000,00 ,
-
~2, Perlonal properly -- 102,Po(fonOllplopllIlY
1----
10:1. SeW'fT)'nl cha'IlU,obOt(OWII: 403,
(ttom 111'\. '1400) l.985,56
_0__-
IO~. 404.
-~
~ <H1/i,
AD,IUSTMENTS FOR ITEMS PAID BY SEttER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELtER IN ADVANCE:
106. Clly/townUllU \0 400, <:Ily/lown \allU . to
107. COlll'lly lolllU 8/ 8/97\0 12/31/97 4il.18 407, COli/II)' lall.o~ H/ 8/91 , \0 12/.)1/97 48.1U '
0/ 8/97" 6/30/98 46107 6/30/98 . _. f------
loa. Auoumanlt 40B. Auoumflnlo 8/ 8/97' " ~._Jl~
- -
109. 4011,
110. 410,
111. "'1.
-
112. .112,
--
120, GROSS AMOUNT DUE FROM 80RROWER: 60,'19<1,81 ~ROSS AMOllNT DUE TO SELLER: SS,S09,?'S
200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT nUE TO SELLER:
~1. D'POIII Of UIr..., monoy 5,800.00 so I, EXCGI ~ doposll (& n e Inslructlon I)
--
.202. r(ln~lpll amount 01 O.W loatl(.) .-- 55,100,00 502~ Sllll18ffiltnl chMgn 10 aollnl (line 1400) 1.336"17
------
~03. ExlQtlng loan(e) laken _~lJbl&CI 10 - J03. Exlsling 10JIl(e) Uk~r'l ~lJblOCI 10 -
20.01. ~Isal Fee Credit 10.00 504. PiYOl! 01 liltl morlgagtloan
-
205, ~5.l'ayoll oi UCOr'll! rnollga~e loan
208. . . . ~OB,
207. [007,
.
208. . 508. --
209. 509,
"-
ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SEltER:
2\0. CllY/lown lUll 10 510. City/lawn IUU 10
211,Oollnly.luu .. .. 10 .. lill. OOllfl1; i;lJl~1 10
- -
212. .........monll 10 5\2, A.....menl; 10
213.', -- -
513, . . .
"--
21., 514.
.,,;, . (......... ........ ...... .. .... . 5\!!, . .
- - -
2\0. 51ll.
- -
. WI.' 511.
-
218, 1-- 510.
2\9, . , 5111. . .
220. TOTAL PAID BY/FOR -
GU,Yl0,00 [;20. TOTAt f1GDIJCTIONS 1.336,77
BOF'lROWER: IN AMOUNT DUE BELtER:
300, CASH AT SETTLEMENT FROMrrO 80RROWER: 600, CASH AT SETTLEMENT TO/FROM SELLER:
301 Gross ilmount due from liorrc)'t/cr (lino 120)"- 60,119<1,Hi 601, Gr'O'~s (lll:()lI~lt due to sellel' (line 1120) 5H.509,25
302, Less olllOllr,t oaiel hv/l'ol' bD~rower (llno 2201 60,9]0 00 601 l,{!sS ['edllct. 'ns 1n alllt (IUD leller(] Ille 520 1,336,77
303, CASH ( DFROM) (@:TO) DORROWER: 4]519 603, CASH ( ~TO) ( o FROM) SELLER: 57,172,46
-----
August 8, 19Y7
HUD-l (3.66) . RESPA, HB 4305.2
PAGE 1
FINAL
._~--~_._~
SETTLEMENT
_._----._-_.__._~--
SELLER NAME .iJ~ & t.:jJ :( ~t /1, C~'-r' _
ADDRESS, lAC; 4,!?fJrv[J.F H/./..,:')(I.," ~ fl'E...._____-:.
S'hrf&/,/,s'l?d4 ~,.
LOCATION OF SALE .;J.5' hIR)t..e,G 1-/.f,JJ.J..t()W f?~A,1)
AUCTIONEER V/J,vH:l2sh fj ~,eT., 91'j~
"7!jj" JoZ'
DATE OF SALE 'F'.2f-L ____
PHONE.
ZIP
C SELLER'SEXPENS~S )
PHONE .~?.:z-" 6~ '/
, .-'..""':c.-,_.';' ',,'.-- .' ,/
( "'RECEIPTS "\ -)
'-j
PROFESSIONAL FEES 95,00
AUCTIONEER $.
CLERK $
CASHIER $
OTHER EXPENSES
~ $ ~/,S"O
$
$
$
$
$
$
$--
$
$
CASH $
CHECKS $
Q!lill. RECEIPTS
:'\
$
$
$
$
, $
$
$
$
$
TOTAL RECEIPTS $-.LO~(.{nO
LESS TOTAL EXPENSES $ I Sl.. . ~O
',I
, ,~
,',
,
1 .,
I ~
CrClTAL;~PEN~ES:"'$ 1S-t...~o. ) ,J
,NET PROCEE.oS PAYABLE TO SELLER
" ,',~
$.905, (0
I for weJ, Ihe .eller, orcept thl, ,elllement and acknowledge receipl of the above 'peclfled nel proceed,
from the auction of my good, and property ,old on the dbove dole, I accepl 011 re'pon,lblllly fur providing
merchantable IIlle 10 all good., and property sold, and for delivery of lille 10 Ihe purchaser,
Lt:Ni5 L ~~" --f!.._ ,~~ ~__ _Dole ?/:{<iJ<lJ
Auchoneer 01 Ca,hier', Slgnaluro ~ ISoller', Signolurel r' /
7-7K-'17 Dale :Lo+nLul J'1..J~a~ Date ?/Qfrf97
015.lIer', Slgnalurel
SELLER'S COPY
,j7;/'C(~ ,..
~ ~ ~;~i7~~': ;J7?()'utl"
~M 7 "
tI( F'iiii---.-------.-... --.
I TAX AND FEES
V[IIK:tf IIII NII/ K;^ll(lN NIJMllIll (VINI II IIIAI;114(1 lHl[JY 1'I'f'( (~;(ltj \K ~~ P\jfi(:I'.i..~E - --------
'/~~~5:/'r?~.(I/l.~~;()f.I~~~~f ~~~I,(H'Y _ _ _ , _ 1I(1(j}~ ___ _ _~~~~~~~C. ~~~:~IO un r~~t'BI
t>INiM,tiiA'ilci-:K-~ "~J^lJiiiO.nili"LJ'iji)1 ;'111' ""'0,:,,,'011 'cE-II1Inio~gi~ECt 10, N MIi(;llANIC L t 'i~l
,<f'5~,~ '),,9 ~:""NA~'~i?"";?L~:::>V-1~*"lr" ..____~, 1 "'LJfIII
leetll'vllllllIMVflVOII!tfl(tIMlft~!\i,hk1 filClNi!l}I~ ~0 . V'''' iMAIILi
1I1c1ng c~1 00 locurnd nlld lhlll UIO ".j,' ..;-lI ..../- . AMUUtH
[J()I[SE!. r.Jf:ll:CTlllC Ihl'lAl/OVeVINII CO(!Ol':! ' .;."'/
B tAm NAME (Oft fULL OlJSlNtS~; NAM!' I INIlLAL
,.", _".-L~:fL?L.-
co.punCIIASf;!1
~ ~ S111",./~L~_-------_._.---_c"~~,""_\Y~.,1V )
~ ~l _".-::.'___lUL!~'!.rs,,---/zSldt.!.c!<.;I,_- :;,.LYf<z/o(t< t5..",
Nolf. If A co.punCIIAstn, OTllfiFl tIlA~' YOun "r\JU~[. 19 lIslI:n(MrLivf.. CIIFGK oNt OF
TITLE WilL Be IS!~Ur:o AS "llNANlR IN COMMON'
JOINT lI:NANIS Willi nIGHT or SLHNlvnWlItlf>
, [';:] (ON IlEAtH Of ON!: ()WNEFl,llltE OO[S TO
.~. SURVIVING OWN!' H I
NOTE IF TIlE VI:HICLc IS Bl:ING U:MiED. CllFCK 1111" uux:K [.I
A
MAI<( 01 VUlICl f
~ 0'"
U.,_ !'.
MiJ=1
9-92
'( /,(1'-:'
:1_ ___
0'''1 l:fl 10 tll!MU~.n
Of APl'lIC,4,(IL[l
l( l\~.(llOI ~;AH'; 11\'1'
x 1'"(0'11'1111 A m:!i
'If,nu Iloll' on r"~""'111
,1/ ?!2'd ,
I" NI
.){
.-!
~
d
-.., 'OJ.:it--ACouiflro/
<.__,.rlllIOjA'lliO
_,' ..t!'/.(~ 1-
_____l..:."...:?._...!.~__....".._.
IHArr; III'
I.I-!;S lAX
cm:oll
/.4 j"'?'- 7
..n.__-L_,yt.....______L.__(:..,..' .----
IllESI' IlLOCK'J If NO mOCK IS CI([CKU'
~;Al f~ lAX
DUE
----- --..-.----
IA. f~l)[llph,,'f1 Ruton
Code IJlIIIS! be '"
numhfit from' to ~:)0I"0l
",)Q. N_
H NAN 1 S IN COMMON
e l.".',1 (ONm:A!I! OT Dtl[ OW!j~R INlrfl[ST (If [)t:nA~;rO
OWNf.Fl (lor: 9 to HIS on Hf:R HElm; on ESIAff I
II' fltOGK III CIIECK[(),CClMPj lOTI' AND AI IACII F(lnM '-lV-II
IEteXijMMiONNq.-'~
, '
C [J ACTUAL MIL EAGE OlfTEflS rnOM OOOMF.THl m-AnING rOf!
" nf.ASONS OTHEn THAN GAUORATKlN HmOA AND ACTUAL
~ ~ . MIl.EAGE IS UNKNOWN
~ 5 WAIINING AN INACIJUFlAlE C[I(IMl'lUl SlA/U.1f.NT MAY MAKE yOU U^f\U~ rOil DAMAGES 10 YOUII
~ TRANSfEm:E. purlfiUANT 10 '409A Of TilE MOTOfl V[llIel[ INFORMATION AND enST
SAwms ACT or 1972
D \91.~~3.~~~~.____~___ .__._m__~ IF NO :':.~.:...{~!:[.CK0 ?~() urN l~'..:~.__ ___._____ __._.._.n.~~~~~~~:..(.;.I,I:.~.~t~..
~ 1ST LltNHOt.DEIl 2ND LIENHot DEFI
:l' ~ .____...., _u.___..__~_.__ ..~_._---- ---~-----.-~--~--..-----_...~--.--.--- .-----~,- ~-----. -_.!..---
~ & STREET SHlH T
~ CITV.-.-.-.-~-----'" .-...-STA~-.----Zlf.---- ClTy----U .....---.-.----STAT-i----.-zip..-..-.---.---- :::J~m~~ ~~n~lrlo~
E~' ~KE O~..~f.'~~~~.!bA~ C -....._. ~fi~l~i... ... _ r 'LL!?.~r..~, MOl~~l.:!.~A..._ _ _ ,,"
'!:e' !lODY TVI'l WDN.BU~:;.lK.[lCl -',K ~lJllKINOF VEHICLE OOGOOO DrAin LJpOOfl
r, rA'SEN(;f.R f"",S"EN(lfA [I IAXI[-] LIMllUSINE[] SCIIOOl [] MASS 0 OTIlERD ["'EAIINOCAPACHY 0 \
TAXI/BUS ~ _..1 _ (JUS . TfTANSIT BUS "
--.--- -'cyuNfjfnC"AI,".[;ffY"(J y[S-r-.Jw-!UHAKE-. ... OI5on-(]\ofo[jOVEfl fi~--- - - - --- ---- H1AW,F(R
~g{gWr;~ii~rN r~~J;fc~r,:j3-_~DYr:s DNO~-- L!Q<~11E~~~)~S!~N-tf~}(j ~?_2--D;[s-i~)N:,) --~- -- ;-!.:~---------
CYCLE _ EQt.l~ _ _ __ ___ ~__~ _ __ _ f~ _ lQ.L\.~_. - - - - --~ - -.- - - - --- IN! JlIY.'iE
~ M~~~~~______.m JJ!~~\1jtf,!9t! [:!:~:s C1NO__ uu ~~~I~g~~~4~1EnEO_______PYE_~_[]~O' ____.u__ ..__~F~_..________....___.~__._.____
~ e MOTOR HOME CflA..'iSrS MfR [ilmy MAKE 8
/. '1 ---t ~ fltI'I.AGl.IJf',lT
8 ~ TRAlLEn. ' IIeo "EQI~T,itEq aROSS Wi: li~\';l'O LDAal':><"'r, (/ "'.1'zQ_
~ I ~itb'iiES __. //7 J& UNLAO'NWT.(EMPlY)':1JC~"",' "h("~ .: '
rn~~ TRACTOR flED m:Gl~T(n[o GnOSS COMBIN~~'.:.!.~'!.'_~_.. ~C~~.. J~~?~~-':~~~~ATION ~~~!~~~~._...,...
~~~,' IiOWAN()WHEIlf;ISVEIHCl[USEO'!
SPfCIAl.MOOllE.
EQlJlrl,-\F.NT'
[1 MILtAClJ:OVl:fI
.._ flY,909
(l[ltJM[TFrT ntAWIO
lllll:
. ..'!:f~
It~H1lg1
.!..CJgj . ~~:{~
.-. /~~!_-
.,- 11!"(l;:;;f1X2~~;'
PFl(JU:SSI~j(;fEf
!, DUfllICflTE flf.O
fEE
NO or CAflOS_._..._....
.
_.___-_0'-0"
___/iL_
.
----~
IOIAL PAlO
lA[lD! IHRUHI
51)1,,1 (RIa C/l(1(;~
hI TillS Amootlr +
G
DAl(llt~AI. f't ATE'; Chock Dna
[-] PlAT (; TO BE ISSU[O flY
- BUIl[AU (T'flOOr Of INSUnANG
MUST BE ATl...CH[Oi
[J lnMlsn:n I mf'lACll.4~Nl Of PLAIr:
[J TnAW'>FEn ~ fl(tIEl\>AL (Jf PLATE
o ~',~:irr~f-l ur Pl,o,/E & Il(PtA(;EMfN! OF
~>LE-~" :', _u.
(;KPII1ES d DlOST C]STOLEN []UEfACr:n rJNE:VE.Rll!!COILOSIINMAIU
~Ih_ :;r;;~! __ _(f~ 't _ NqTE l! '_~EYEH1RECf!Y_~P..-.PIOC~ IS cllock~~t,_m?el!cnn!.!!.I.l~sl compl~~E~!.l2~V.'1.~~
lRANSrEnnEO mOM TIIL~ NO VIN
B ~;.;/:fii,;'i:~1:i~h:~bi(~G~! ).J]7 g-~5.?'15"./ ~. _. _ _u_ J /J 2/IC_A{fic?SJ]/ [J (I~,,~:::_-----
~ ~ i.i:~',::',:,. ;:':' 'i;,:~,~,,;;;,i{.~;ii,~/:'h_~S;A;.? l)lf,NATUFlI. OF Pf:IlGON rnOM WHOM ~I(,N III II[ REU,llONSfIIfl TO APPLICANT
\ ~ _, '~~1f^T~~~~~~%"1:. ~~l~~~~~~~~'~:~~ f~~ ~~IHffl
INSUI1A.tlC( COMPANY Ii"-ME r,fJlICY NO lon--- ----- 6" '[rrnlGY Eff~(TIV~OUCYEXf-1IRATION-
d.~t;:_<;:Zi."JTE_..__ _~ _ 'fIALllfllllll"'!:,? ,[J"t':ik'i"(~2_ _ D'''&.~:d{-i:2=-[''''/ /,:,~r;'~
8 C ISSUI~lG Allf:t~T (PHINT NAMEl" --IA(l[Nr-No--
ICffITlfY TH~Tm-lMONH!.........Q..........(:M....,~-/--__-,_;-Y(AlI~ ./\/"""'/ //c;:- I'-"'r?/J~l 5 .7;...,,,(' ,\1\-";....-:>~~..~ ~
I I lAVE CII[CKI.[) III (If!(IIMINE TllAI llll "tllll..l.1 I~, lt~c,lHTl[l ANI) :._~WL%-_ /; ...~__._....-..n'...._ -.- - :b.<:~_
ISSUED lI:Mf'OflA.AY AfQISHlAl10N 10 1111: AOCNt AI'f'UCArI1_ IN ISS\l\t.lG All1'~1 S)gNAT~ It It f'HOI~E ~jO
COMPLIANCE Willi MI A"f>l.ICAEJL[ f'ltOVI~;IOW. 01' 1111. VI HII;IF CliO!: v.-)_ .:yt' /'. /" /"---.., 7/'" r':1 :) ~L/ /7/'
ANDOf:I'M1IMl:N11l[-GUtATIONfl .,~-<...... "~ri'_' --..-.--' \ I) '\<:< 7 -:f'"
I/WE ACKNOWllDGE n~MMAY lOSE MY/OUfI OI'ElIATlNG rRlVlll:GEIS) UR Vt:tIlClf flEOlSTIlATlON(SHOn'TAIIUI1E 10 MAINTAIN FINANCIAl. I1ESPONSlRlun ON TIlfi
CUflRfNTlY nHilSTIflEO VHIICIF. rOR TH~ POliDO Of REGISTRATION I/WE HIRTlIlfl Al:KNOWUDOE mAT I/WE MAY liE SUn.l[Cl TO A rtNE NOl (XCHDlNO 11;.000 AND
IMPflI:';ON (NT or NOT MORE THAN TWP )2f YEAUS rOR ANY rMS[ STAHMIN1" HIAT l/Wf MAKE ON TIllS fOIlM. AND (/WE CI.I1I11'Y THAT l/Wf HAVE El<AMINfD AND SIGNW
,,' nil'. fORM M1EfllTS COMI'IEll0N ANUl rtlAT If AN [)([MI'lION fflOM PAYMENT or ';AllS TAX IS nAIMlO I AM/WE AlU AlIlllOllIlfll In r:IAIM TIllS EXEMl'llON I/WE
" SUWiCflll; () ND SW(JIlN l I' ., (J TI runTllEnCftlTl'V HIAr fltl STAlfMINTllHEflllN M1E lflUE ANn( Ofl/ltC' AND MAKE A 'PLICATION
o lOfj!lf~E 'J-/~ - - _n _M('_ L/",'/OA..'!'. t'2l- '!'IAll '.!-:' _ _.. '.1 fOflCffHlfl(AlI O~!.!.T!:.t rOf!..TIH ~L~ oEscnmttllNIHOCK A - ----
" _~ I ii' ~ 'J I ',I(lri!\!jll1' OIIIj{iIVIII'll\lllll ^11111\1~~'1ll)'I(,nll}
R _~~__~~~~~J~~l~f (~!:.}.!I' ~:!,.!!;~1'1J!~~____ ,/,/ri"1r(>-(,"! /: ::l(.~I("~,1L
t 1 '. ....... f IJ "'Jrlr\~OI' """111<11111111 \/1'11'(1111"111'111 .11111111
.( S , . ,\..'.';j / I /yt(t'r'1C', eJ:..l:.'<<lV'>. ._u ----~
~ :l ""1 I -: I -'SIGN IN P ESEN<(Ej F NOTARY !\ l I'll HiI III I 7 / ~~~~-
~ ~ Ml55fNGI R NUMBfll
l'U;-ASON ~~(;nRlPi~ACI:M[Nr-'--.-- -~.-
[0-1 E'(Cflr\NGE Pt...Tf; TO liE
- ISSUED [lY IlURE:AU
o lFMPOIlAIlY pt....l[
ISSUED OY FULL AOENI'
IS~;LJING
AGf:tH
INfOlIMAIION
"
Page __~ of ~_,_
SAF~ DEPOSIT BOX INVENTORY
IN~TRU~l'.ldNS ----=:--=-
(1) Ca.h. Reporllolal only,
(2) Sloeks: List in dolail ovory ,omman or proforrod cortiflcolo, warrant or olher righls found In box. Sloeks are
to bo doslgnal.d by name of compo ny, ,0rtHicato numb.r, dolo of certiflcato, no",oln which Hock Is rogiltorod
and number of shares and clan of stock. '
(3) Obligation. ~I U,. S. Governmont: Numb., of itoms, dot. of iuuo, faco valuo, names In which ,oglslored.
(4) Bands: Designate by namo, amount, I.rial number, or oth~r designation,
(5) Bank and Saving. and Loon Panbook.: Stale nom. of depositor, number of book, loll dote appearing In
book, tlam. of bank and bronch, and bolaneo,
(6) Jewelry, Coins, Stomps, Monuscripl,', otc. Llsl and doscrlbo os fully a. poulblo,
(7) Do.d., M"rtgag.., Currlnt Insuronco Pollclos or othor ovldon... alledobtodno". List and do.cribe a.
fully os possible,
(8) All othor contonts.
ITIM-I IrlM OllSCRIPT10N
NO~
1. Ti tle
2. Mi' Helm.
3. Birth certificate for Dessie Louise Keefer.
4. Dauphin Deposit Certificate of Deposit 11103954 in the amount of $4,000.00, titled
I Harold E. Helm or' Lawrence W. Helm or patsey L. Willhide, dated 9/6/91, matures 9/6/94
\3 year term. ,
5. I $100 U. S. Savings Bond is~ued to Sllsan R. vHllhide, dated July 1981.
~ De~d from H. Robert Frehn and Almeda b'rehn to John Helm, dated 6/22/48 for land in
I South Newton 'J.'wp.,' Cumbedand County. Deed No. 19571.
7. Deed_ #19572. from H. Robert Frehn and Almeda Frehn
1
dated 6 22 48 for
land in Soutn Neflton
8. I Deed #5178 from J:hn
I land in South Newton
Twp., Cumberland County.
Helm to Harold E. and Dessie
Twp., Curr~erland County.
L. Helm,
9 , Mort29..~
10. I Mort a e
11.
12.
13.
14.
from Peoples National Bank to Harold and Dessie Helm, dated 3/19/49.
from Peoples National Bank to Harold and Dessie Helm, dated 1/8/54,
from Peopl~s National Bank to Harold and Dessie Helm, dated 11 9 63.
warrant fco~ Peoples National Bank to Harold and Dessie ~lm, dated 11
from Peoples Ni'ltional Bank to Harold and Dessie Helm, ilil,ted 3/19/49. "_
Bond from .Peoples National Bank to Harold and Desm Helm, dated 1/8/54.
~..
--
'Iory that tho obovo record i. corroct ond ,omplotolothe but 01 my knowl.d'Jo
5/19/97
Sl9nalur. Oat"
Assistant vice President and Branch Marketing Manager
Print Num. and Tltl"
NOTEI lis. Mpara1. sn..t:l If n_uuary.
/5 /l/).~
BUREAU OF INDIVIDUAL TAKES
IHHfRITAHCl 'AW DIVISION
DlPT, llll0601
HARMISBURU, PA 111l'k0601
COMMONWEAL TH OF PErmSYL,VANIA
DEPARTMENT OF REVENUE
(,
NOTICE OF INHERITANCE TAK
APPRAISENENT, ALLOHANCE OR OISALLOHANCE
OF DEDUCTIONS AND ASSESSMENT OF TAK
DATE
ESTATl! OF
DA Tl! OF DEATH
FILE NUMBER
COUNTY
ACN
12-22-97
HELM
04-08-97
21 97-0432
CUMBERLAND
1 Dl
JERRV A WEIGLE ~SQ
MARK ETAl
126 EKING ST
SHIPPENSBURG PA 17257
~k
'r;JW/8/
.U'lhlll ," IIt.m
HAROLD
E
t___:.'!.un~ _ Roiilttod
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REG1STER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..
iiif.,;: iS47 "iiC "AF P -f 09-"97"1 "No"fi or -OF"YNH ER"iTAiic'E" 'fAX - A P PR Ai sE',fENr;- A L:i:ciWANCE - iili" - --" - -""" - -" - ,. -"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HELM HAROLD E FILE NO. 21 97-0432 ACN 101 DATE 12-22-97
APPROVED DEDUCTIONS AND EXEMPTIONS:
11,044,32
.. Fun.rel E)(J>>en.../AdM. Co.h/~hc. E><pan... (Schedule H) (,)
10. Dobh/No.!.o.o LhhllltlOl/L1on. (Schodulo I) (l0) 4,727.76
11, TotoI Doductlon. Ill)
12. Het 1J1l1u. of hx R.turn (12)
15. Ch.rlt.bl./Gov~rnn.nt.L SeqU..tIS Hon~.l.cted 911S Tru.t. (Schedule J) 115)
14. Not Vol... of E.toto Subjoct to To. 114)
NOTEI If an asseSSMent we. i.~ued prev10uBly, line. 14, lS andror 16, 17 and 1B will
reflect figures thet include tha total of 6bh returns assa.sad to date.
ASSESSMENT OF TAX:
15. Allount of tine 14 .t 'Spollsal
16. AM<>>\tnt of Line 14 ta)(abh at
17. Allount of tine 14 t.)f.abh .t
18. Principal T.x Due
TAX CREDITS I
PAYNENT
DATE
06-27-97
09-24-97
TAK RETURN WAS, (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF.
, -
APPRAISF.D VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Re.l E.t.te (Schedule AJ
2. Stocke and Bond. ISchedule B)
~. Clo,elv Held stock/Partnership Interest (Schedule C)
4. l1ortgllge./Noh. Receiv.bh {Sch.duh DJ
S. C..h/Blink Deposits/HiIlCl, Perlone1 Proparty (SClhadula E)
6. JolnUy Ownad Praparty (Schedule fJ
7. T....n.f.'.. (Schldule OJ
8. Totlll A...ts
r.ta
Linaal/Cla.. A rat.
Co1lat.ral/Cl... 8 rat.
RECEIPT
NUNBER
AA21147'.
AA242264
DISCOUNT (+)
INTERESTIPEN PAID (.)
210.53
.00
(15)-
(110)
(17)
) CNANGED
III
(2)
(3)
(4)
(S)
(6)
(71
58,000,00
100.00
,00
,00
27,551. 46
12,056,89
......Jl!L
(8)
,00
81,936,27
.00
K ,00.
K ,06.
K ,15.
118)
ANOUNT PAID
4,000,00
705,66
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
~----
TOTAL DUE
NOTE I To lnllure proper
cr.dit to your aooount I
.ub..It tha uppar port Ion
of this for.. with your
t.'.lC PIYllent.
97,708,35
1~.7n 08
81,936,2!,.
,00
81, 936,27
,00
4,916,18
,00
4,916,18
4,916,19
,01CR
,00
--~--
,01CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN 61, NO PAYHENT IS REQUIRED,
IF TOTAL DUE 15 REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS, I
"I'
Ij(~;
RESERYAnOt.. E.t.t.. o' decldenh dying on or he'ore Dea__r 12, 1982 n if any future 1nt.re.t In the ....t. II trlln.filrrtd
In pa.....ton or ."joynnt to Cl... I (croUtt,re!) benefiaA.rl,. a. thl dltOltdent .ft.r the Ql<pJr.Uor\ of Mt" "U.t. for
lifl or for YI.r., thl Co~*lth herlby 'I<pr..ely re..rv.. thl right to epprtl.. Ind ...... tran,'.r InherltlnOl TIMI'
.t the I""ul ClI" . (aoll.tert') r.t. on any .u~h 'utur. Int.r,.t.
PUIIPOSE ~
NOTICE I
PAVttENTI
REFUND (CR) I
OIJECTIONSI
ADttIN
IS1MATIVE
COARf!CTJOHSI
DIItcu.T I
PENAL TV I
INTEREST I
Tu 'ulfl11 the r,qulrlftnh 0' S.atlon 2140 of th. InhtrItInCl' tnd Eltet. TIM Act, Aat Z1 M 1995. 0'2 P.I.
S.aUan '1~0).
OIt.c:h the top ~lCirt1on 0' thlt ~lotic. and .Ub.it with 1I0ur pall..nt tu the R.ght.r of 141111 prlntR on thl r,v.r,. .Ide.
..Htkl cheok or un'lI ord.r peyable tOI REOISTER OF HILLS, AGENT
A r.fund 0' . tlX cr.dIt, which Net not r.ctUut.d on thl Tellc R.turn, .ay b. rlctU..hd by oOllpl.Ung an "ApplIctUon
401' R.4und of Plnnllllvenl. Inherltanc. and E.tat. TaM" (REV'1313). ApplIoatlon. ar. Ivallable .t thIDf,lc.
0' thl R.vl.t.r 0' Will., any 0' the 25 R.venue Oi.trIct Dfflc... or bll calling the .peolel 24~hour
an.werlng IIrvIee nu.b.r. for 40rllll ord.rlng: In P.nn.ylvlnIG IMIOO"362MZOSO, ouhlde P.nn,ylvanll end
within local H.rrl.burg 11'.. (711) 787MI094, TDDW (717) 77Z-?25l (H..rIng J~.Jr.d Only).
Anll p.rty In intere.t not .att.4j.d with thl IPpr.I....nt, .Ilow~. or di.allowancl 0' deduction., or ........nt
04 tll< (Inclucll,1Q discount or lnt.rnt) u .hown on this HoUce IN.t objeot within .bty (611) day. of rH,lpt af
thh Hotic. bill
uwrltt.., prot,.t to th. PA Oepa"tllent of Rll/llnue, Board 04 Appull, D.pt. Z11021, Hlrrhburg, PA
nelilcUon to h.lIl1 thl 'Itt.r dltli"lnld at fludlt 0" tM account of the personal ilpr..entative,
..MIflP..1 to the Orph.".' Court.
17121-1021,
OR
OR
FlOtUIII .rror. dl,covlI'ee1 un thit ........nt .hould b. f1ddrlllu.d In writing tOI PA Depart""t of Rlvenue,
Iur.1U of Individual TI_I., ATTNI po.t A.......nt R.vl.w Unit, Oept. Zan601, Hftrrl.burg, PA 17121-0601
Phona (717) 717-6505. S," plge 5 of tn. booklAt "In.tructlon. for Inheritanc. raM R.turn fo~ II Re.ldlnt
~edent.. (REVM1501) fcr an,MplanaUon of adIllnlttraUYI'lv corrlotabll .rroil.
,
,
.
1
\
,
If MY tlX dull It PIld within t,hr.. (l) caland.r sooth. .ft.r thtl dlcldAnt'. cttath, II flv. p.rcant U;:) dilcount 0'
tM t.M pldd Is .UC>>f.d,
The 15)( tillt lIN'ta..tv non-pl"Uclpltlon p.nalty II cO.PlJted on lh. total of thtl taM end Intlrut ......ee1, and not
paid before ,January 16, 1996, thl f1r~t day aft.r the end cf the tal< a.nllty P.rlod. lhlt non-participation
pen.lty 1. appe.l.bi. In the .a.. sann.r find In the the sa.. tl.. Plrlod a. you Mould appeal thl tal< and lnter..t
thlt hll' bun ......ud u lndlcat.d on thlt notl<:..
Int.rllt Is ch.rg.d blglnning with flr.t day of d.llnquencll, or nine (9) lonth. end OM (1) dwly frol the date 0'
delth, to thl dllt. 04 ply..nt. hM" which bou.. d.llnquent b.for. Januarll I. 1912 bur Interllt at thl rete 0'
.IM ('iO pflrcant p.r InnUIII calculat4lld at II daily rat. of ,OOOlft", All tal<" whiCh blc" d.lInqu.nt on and Ift.r
J...uarv 1, 19l1 w111 baar Int~r..t at a rata whIch wIll vary frOB olll.OOlllr y.a" to callndar Yllr with that rete
lMOOOotd bll thl PA DfIp.rt.."t of R.v.nul. lh. nppllcabh hltlr..t rat.. 'or 1911 through 1998 arll
~ Int.r..t Rate Oal1l1 Intarllt Fa<:tor ~ Interest Ra~.! UallY Interlet Factor
1m 20X ,001l5"1 1911 'X .0OOl"Y
1963 16:< .000431 198AMI991 It:( ,000301
1914 llX .000301 1992 'X ,000Z"1
1915 13:< ,000356 1995.1994 7X .000192
1.16 lOX .00027" 19n-I". 9% .000247
M~lntarl.t I, <:~lculatad a. followll
INTEREST . SALANCE OF TAX UNPAID X NUNSER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
MMAny NotlcI h.ued aft.,. the taM bICQIq. d.lInqu.nt will r.flllet an Int.rut cllcuhtlon to fiftaen (IS) dan
b.lI~ thl d.t. 04 the .......ent. If pay...,t I. R8da Ift.r the Intlr..t co~t.tion dati lhown on thl
Hotlce, additlontl Intarut M.t.t be cllculatMt,
~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUM.ERLAND
III
J./lwronceW._Helm and I'll tso~ L '_,Y~1~~1d..€'
bel"9 duly" "WOn1 . according to law, d.po,., and UY' th.t th.Y__'l.I'e_-..t_h~,_..~_,.. ,
Co..Exec~ltorH 01 tho Eltate 01 .____J!!1IQ].!LE....Uo.lm... ........____ ____~._
late 01. South Newton '1'0I<ll1sh1p, , Cumb.rl.nd County, P'" dacau.d .nd that the
within II .n Inv.ntory mad. by them_, tho uld ..J;Q.;',t;]!,'!..f..!lJO.L!L ---
01 the entire ..hte 01 laid de cad. nt, co",lltl"'l 01 all tho perlonal proporty .nd rul .,ht., eKc.pt real eshta ouhld'a
the Commonwealth 01 P.nnlylvani., ond that the ligur., oppe.ito oach It.m 01 the Inv.ntory repr...nt It', lair valu.
01 01 tho date of d.c.dont', d.ath.
Sworl1 to
,,_ end sub,crib.d b.lora m.,
~yJ-,4f!J,. ....._,..2(' h., I ;;[ ~4J
,/ Co- h"ut.lS.l\WIliItIIllffi'o~ ~1"
Lowrel1ce W. Helm Patney L. W1llhide
20 Ro~1t1.D!i,:,<:.._.__._ 331 E. C,'ang.e St.
P. O. Box 553 Shippen"burg, PA
Shlpponnburg, PA 17257 17257
._- ,.__._..._._-~----~~~-~----
_~~a~.,..., I ~ _ 199..2_
#,..,;(, K LQJ"-;:~
NotirIaI Seal
linda K. Kleil, NolaIy PublIc
~lIbllfg, PA ClIlillnnd CoII1lII
Myoon.liluioo ExpInlI Auguet 15, 2(0)
Dot. of Death ...",
Ad~""
D.y
_"AP.rl_~_______
Month
1997
v..,
INSTRUCTIONS
I. An inv.ntory mult b. filed wlthi" threo montl" alt.r appointm.nt of p8110nal r.~r.,.nhtlv..
2. A suppl.mont Inv.ntory mUlt be 111.d within thirty daYI 01 dllcovery of .ddltional .....h.
3. Additional Ih.... may b. attach.d as to p.llonalty or realty
4. S.. Articl. IV, Flduclarl.s Act 011949,
.
.~
'..CI <II r.Il
~ III i .~ ~,
~
ffi ~ ~
~ . t:7'
N E-l j III
...., ... Iii . ~ ll<
<t ~ W o w ~ U\ ,.
0 a: 0: ~ i~~
I ... -, u.. ~ ... J
r-.. i>
'" u.. ...J jj 0 ~ <II ... .~ ~ ~
I W 0 ~ 0: P:i Z i:
... >
N Z o Q . ..cI ~ ;.:
~ ... ~ H
- m ~ ::l , '"
.J. 'Cl 0 4lt <II ;:0
,.., '"
... 0 ." ~ .
~
k . ~
~ - "C k
0 ~ <II
I .D 1 ~ ...,
-Ii F. 0
I .. d if 0
I ...J ...
. '
..
Inventory
Estate of Harold E. Helm
From 04/08/97 Tb 9/11/97
Description
lIccrued Interest
(fu!cking Accounts
Dauphin Deposit. Checking Account-.TOI"t
, ""'~Ioll""h,..-
savings Accounts
Dauphin Deposit savJros Account
Dauphin Deposit Joint Savings Acct ..:r'''N"r ,
"'1 SOn (.I....~ D~"~hif""
Federal Notes and Bonds
, U. s. savings Bond $100 Series EEl
Certificates of Deposit
Dauphin Deposit C/D .:r...,-t ..\ SO" .~~
t>..\~t'r
Residences
Real Estate residence
Household Goods & Furnishings
Gross Proceeds of Public Sale
Winchester Model 90, .22 Calibre
Marlin M:xiel 336 Rei Rifle
1991 Pontiac SUnbird
1996 D:x:lge Dakota joint w/liawrenCf?
Refuncl!3
Allstate Insurance
Allstate Insurance
SUburban Propane
Sprint - refund dated 9/4/97
Proration of taxes at settl8(jent
Allstate InSUranCe' . hc;xreowner's
.~1
0..
82.51
jU;J
S'I,~'
17:26
Value
Total
'-5 't,'!'f
. .
15,099,22
~
----....-----
.--
J~, /'7 ~..it'
100.00
1,'IP.8,{,-
. L
58,000.00
8,835.10
1.50.00
275.00
2,500.00
s,Soo,oo
. 11
.-----------
. 17"
",2.(,0./ 0
20.60
36.30
28.03
18.96
509.25 ;
79.00 I
!
692.14
97.708.35