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1)1.:TITION I'OR I)ROnATE IInd (il{ANT ()II U:Tn~RS
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I(I'f~"I'" 01 Wilh 10' 1111'
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8oc;,,1 S,'cllri/y No, .1(j7:-!~:-@96 ('OIllIl\OHWl'ullll oll'cnnsylvllllin
The pelillon olllle undersigned respeellullY replescnls IlInl:
VOlll" ptlilionel'(s), who is/lllllC IK ycnrs Olllge or older nn Ihe exel'!1I or
In the Insl will of the IIhove decedent, dilled -- __July 20.,.." ...
~ ..M,;u;tin-P.u ,CarbauQh -Lenounced ".his
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'''WIt' Il'll-Villll rir..;\ll1l'1W\K'\'<;, t',y, rClIlllldulll1t1, death ill nCl'lItol, cl..:.)
Decendl'nl WII' dOllllciled nl delll II in.. Currbet:l/llYJ . .-" -"""--'" counly', I'ennsylvllnia. with
h."j"lL":. 111>1 IlImily 01' prindp"1 residcnce III ..~~Q...!lQQ~. ~c1LNffl!R.\\F.9_.J!i~ell ,-,--
~iJ;>L. _Q.1lI'I:.>erland..Co~PA..-..-_.-_.._.-._-_.-~-_..._"
(list street, nUllilll.'r and ulllll':lpality)
I)ecendelll, Ihcn .... 89_ years of age, died _",)'ooe "{&t.__" ._______, 19_ 97
:;1 j5Q_BooZ~.~...lllopeilelL TrwnshipL_.Q.unbcrJ ,mcl ('l1l1nty, PI\ -'
Exer'f,t ii' roliow", dccedenl did nol many. WIIS nOI divoo"ced IInd did nol hllve a child bol'll or adopted
after txeclllilll\ of ,hc will nffered 1'01' probale; was nOllhe victim of II killing and was never adjudicated
IlIcom:letclll: . .I1?1'~---~-----_.--'--"--'
Decendenl :" dC2.lh owned property with eSlimmed vallles liS follows:
IIf domiciled ,n I'll.) All personal propcl'IY $_f"Q.JlJ1Q..Q.Q.--.
(If nel domidled in Pa,) PerSllnal propcrty ill pcnnsylvania $-.-------
(If 1101 dllll\idlcd ill f'a,) Personal property in COllnty $....,
Value of renl estale in Pcnnsvlvnnia $ ,0,000.00
sil\lalCd as follows: .450 Bbo~U~d, NewbU!'g_lli~':3.n~.hjp.L C\mbedand
County J "1'~_...----"-._"-"---'-'--'--"--""'-'--'"-"-------
----_._---_.~---~._...~---~--~-----------~-_._.,.~-----._~-
WHEREFORE, pelitioner(s) respectfully requcsl(S) Ihe probllle of Ihe lasl will and codiei\(s)
presentcd hercwith and Ihe granl of leI\CrL_testarren~L--..
(lcslamcntary; i1dr\lilli~tration c,t.a,; udmlnistration d,b,n,c,l.a,)
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'l'tlIRD
I give, devise and bequeath the residue of my estate of every
nature and wherever situate to my children, namely Leroy S.
Carbaugh, Martin E. Carbaugh, David E. Carbaugh, Jr., william D.
Carbaugh, and Betty J. Carbaugh Eyer, in equal shares, provided
that the share of any child who predeceases me or dies on or before
the thirtieth day following my death, shall be distributed to his
or her issue, per stirpes, liv ing on the thirly-f ir st day following
my death, and in default of any such then-living issue, such share
shall be added to the share or shares of my other children.
FOURTH
In the event that anyone entitled to a share of my estate
should be under the age of eighteen years at the time for
distribution to him or her, I constitute and appoint commonwealth
National Bank guardian of any property which passes either under
this will or otherwise to said minor. Said guardian shall, in the
guardian I s sole discretion and without Order of Court, use
principal as well as income from time to time as may appear to be
necessary for the minor's welfare, comfort, medical
care,
recreation, support and education, without responsibility to the
minor or to any person taking care of the minor 1 and the remaining
balance in the hands of said guardian shall be distributed to said
minor when he or she attains the age of eighteen years. If such
minor dies prior to attaining the age of eighteen years, said
guardian is authorized in the guardian's discretion to pay part or
Page 2 of a Six-Page Will
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all of his or her funeI'al expenses and the remaining balance j,n the
hands of said guardian shall be distributed to his or her personal
repl'esentative. In the event the funds held by the guardian for
any minor become, in the opinion of the guardian, too small for
proper and eff iaient administration, the guardian, in the
guardian's sole discretion, may deposit such funds in a savings
account in the name of the minor.
l!'IFTH
It is my desire that my executor liquidate all of my personal
property and turn the same into cash at public sale.
SIXTH
Any fiduciary under this will shall have the following powers
in addition to those vested in them by law and by other provision~
of my will app1i()able to all property, whether principal or income,
including property held for minors, exercisable without Court
approval, and effective until actual distribution of all property:
A. To retain any and all of the assets of my estate,
real
personal, without regard
any principle
of
or
to
diversification of risk.
B. To invest in all forms of property, including stook,
oommon trust funds and mortgage investment funds without
restriction to investments author i zed for Penn sy lvania fiduciaries,
as they deem pl'oper, without regard to any principle of
diversification of risk.
page 3 of a Six-Page Will
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C. To sell at publ ic or pr iVllte sale, to exchange or to
lease, for any period of time, any real. or personal property, and
.to giv(;I options for sales, exohanges or l.eases, for such prioes and
upon such terms or oonditions as they deem proper.
D. '1'0 allooate reoeipts and expenses to prinoipal or
inoome or partly to each as they from time to time think proper.
E. To oompromise any olaim or controversy.
F. To distribute in oash.
G. To hold property in their names without designation
of any fiduciary oapaoity or in the name of a nominee or
unreg is tered.
SEVENTH
I direot that all taxes that may be assessed in oonsequenoe of
my death, of whatever nature and by whatever jurisdiotion imposed,
shall be paid from my residuary estate as a part of the expense of
the administration of my estate.
EIGHTH
I appoint Martin P. Carbaugh and William D. Carbaugh as
oo.,.executors of this my will. Should both the said Martin P.
Carbaugh and William D. Carbaugh predeoease me, fail to qualify or
cease to aot, I appoint Betty J. Carbaugh Eyer as exeoutrix of this
my will.
Page 4 of a Six-Page Will
"
NIN'l't1
No bond shall be required of any fiduciary hereunder in any
. jurisdiotion.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my laat will and testament, consisting of six typewritten
pages, the first four of whioh bear my signature in the margin for
the purpose
9"7
of
identification,
this
2-D JI..- day
of
, 19_11.
/ j,,_~ '/ rA (;~~ (5FAL)
Signed, sealed, publ ished and dec lared by the above-named
testat"or, as and for his last will and testament in our presence,
who in his presence, at his request and in the presence of each
other have hereunto set our hands as attesting witnesses.
,~~ j'~ /.ic,-:~~hR1~ cK .,.:~~
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, t,he testator and the witnesses, respectively,
we,
Dav id
E.
Carbaugh,
~/dA PI. "<'AA""
whose names are signed to the attached or foregoing instrument,
being f irst dul~i sworn, do hereby declare to the undersigned
authority, that the testator signed and executed the instrument as
his last will and that he had signed willingly (or directed another
to sign for him), and that he executed it as his free and voluntary
act for the purposes therein expressed, and that each of the
Page 5 of a Six-Page will
wi tnellse s, in the presenoe and hear in9 of the testator B ignBd the
will as witnesses and to the best of their knowledge, the testator
waS at that time eighteen years of age or older, of sound mind and
under no oonstraint or undue influence.
-4~ :ji
es~ator
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w tness
Subscribed, sworn to and acknowledged
before me by the above-named testator
ahd subscribed and sworn to before me
by the ab2te-named witnesses this C:;O-tL.
day of_ ~ ' 19,jL.
\.. .lj.~e-d ;-:-A'~lf!~
. Notary C
NOl ARIAl SEAL
1ERESA J. BURKHOI.DER, Notary Publlo
S\;lppon,burg Boro. Cumberland Co" Po.
My Commission Expire, Sept. 9, 1991
page 6 of a six-page Will
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~J 1. Original R"urn I I 1
[] . lImlled E.loI. [
~] 6, Decedent Died Teltole II 7. Decadenl Maintained Cl LIving Truit
" (.o.!loch copy 01 Will) IAttach copy 01 Trulll
.~ eQ....~ND.NC. AND CONPID.NTIA'L TAXlNPORMA"QN 'HQ"LD .. DIIICT'II T()I
~ . COMPlfTf M^tll~IO AOORESf,
Joel R. Zullinqer 200 Chambers burg Trust
TElEPHONTN"UMDfR-.--------" ___n___~_'" -< Chambersburg, PA 17201
I",
~.,?'l:r.'r.!\"
.......9a
COMMONWEAlTtl Of f'f.NNSYlVANIA
DEPAIHMfNT Of REVf.NUE
OfPT 280601
.___......n~;.,R~!SIUROL~.~.~~.l.~~:~.~ ,_ _.
OEC!DHH'S NAME (lAST, '11I~iT, Awi MlllOlE I~ml^l) .-----
Carbaugh, David E.
'o~~~I~~U;~6N~i~': " IDA~/~~/~;
II' "P'lIC"'~lf) \lJ~~IVltlO HOlJ1n ~j"Mf [1~',1, fl~~l Mil> ~'I(J(Jlf INoIl,l1
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lil
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1" Real EllO" ISch.dul. AI
2" SIock. ond 80nd. ISchedulo 81
3. Clately Held 510<:k/Parlnflnhip Interest (Schedule Cl
.4. Morlgage' und Nole" Receivable 15ch"dulo 01
5. Cash, Bank Depollll & Mhcelloneous Personal Property
ISch.dul. EI
6. Jointly Owned Property ISchedule FJ
7, Tronlle" (Sth.dule 01 (Schedulo q
8. Tolal Gron Anets (10101 Lines 1.7)
9. Funeral EKpensel, Adminlstrallv& Costs, Mis(ollaneous
EKpen", ISchedule H)
10. Debll, Murtgage liabilities, Uen, ISchfldule II
11, Tolol Deductions (tolalllnfl" 9 & 10)
12, Net Value of Eltot'lllne 8 minullIne 11)
13. Charitable and GO....flrnm.nlal Bequesll (Schedule JI
1.4. Net Value Subject to TaK ~l!~.!~_~ minu, lint! 131
15. Spousal Trantlers (for dales of death after 6.30.9.41
S.. lnltrudlonl for Applicable Percentage on Re....erse
Side. (Include valuel from Schedule K or Schedulf1 M.I
16, Amount of Une 14 tall;oble at 6% role
Ilndude ....alues from SChedule K or Schedule M.)
17, Amount of line 14 taKable at 15% rale
Ilndude values from SChedule K or Schedule M.l
18. PrinclpallaK due (Add tOK from lines 15, 16 ClOd 17.1
19. Credih Spaulol Poverty Credit Prior Panmen'"
,.....,_____ + 2, ~8__. O<L
I
Ii:
~
.
B
S
'OR OATIS O. DIATH Anll '213 "" CHICK Hili
I' A SPOUSAL ."
povon CUDIl IS CLAIMID U
..iL.-N-UMii.... . ___________H_______... -------.--~-----.,,-
21-97-0559
COUNTY CODE..
YEAR
NUM~!,~
\~/~/;~~'7
I'OC'AI 5f(U"" "iJM'"
Supplftmenlcll Return
Df(EOEN"~ WMPlfIE ^NlIHSS
450 Booz Hoad
Newburg, P^ 17240
C'"''''[ AM,,~i~~;~'~~'l'UCllON~
II 3. Remaindor Return
(lor do'.. 01 d.olh prior to 12.13.82)
II 5, Foderal ElIot, TaK Return Requlr.d
..Q_ 8. Tolal Number of Safe Deposit Bo",.s
."..:---'-~~--:---~;
Co.
Bldg.
._----------~-_......- ._.~_._-~-_.._.__._.....__.'----~.__..
______~._"_.._._'".._._~.__...,__.,..____~._'_....__...no
i I). 33,.000.0.0__
121 - .------P
13) ---_._,- .._~-~_.-
('1 ..--~-_........--~.---
151_ 20_!2~O"~_!2__..__
(61 _._..h034. ~l,_,__
171..---.---------.
10,489.3~__
( 8 I _"""~~! 784.63
Iq I..
1101
2 ..58.6....3.3'---~
13,075.66
41,708.97
11'1
1121
1131
11'1
-4"1,'708. 97 ~-.....~-
1151 --,",....-" ---..--"".,--"
116) ~i.IQ_8. 9L.~____". "06 .
__..J.,~Q? 54 _______
1171 m.______.._.__~.._. .15.
Dj.~ount Inlerell
liO.OO
+ _______________ - '_'0__"-"---
(18) .".} !_?O~ . 54._.__.._
.__2",4~,g":.CJ0_.__...__~_
1191
(20)
20, II lln. 19 II 9,eoler Ihan line 18. enler Ih. dill".nce on lint 20, Thl.I.lh. OVUPAYMINT.
lIeJ
CI1t'lk In II II you (If!' ll:qUI.\llnB (I ,..fund 01 your OV('qHlynH'nt
102. 54
- ------- . .--.--------.---.-.-.
121)
121.0.1
12181
102-:-54
21. If line 18 h greater than line 19, enler the difference on line 21. ThIs Is the TAX DUE.
A. Enter the lnt.rest on the bolance due or. lIl1e 21 A
8, Enl" Ih. 10lal of lint 21 and 21 A on lIn. 21 B" This I. Ihe BALANCE DUE.
Mak. Ch.ck Payabl. '0' !l!.!I.,,, of Will.. A,.nl ..,
II '''1. TO AN.W.I ALL QU..TION' ON IIV.I.!. .ID. AND TO .sell.CK MATH <( ~
, dol" I I have t1)\omlned Ihi" return, including accompanyIng schedules and statemen", ond 10 Ihe bell of my knowledge and beU,f,
It I, . c mplete are I loll real estate has been reported uttrue market ....olue, Oedorallon of preparer other than ,he personal representntlve Is
b.af mall n of pre rhos any knowledge.
/' I P NR - j E ~ETURN --~-'-AD'DRf$$-'------' ..---.-...----------,-.-"~-.--...,.-,..-.~---. DA1E---~.-----
. ~. "'!t':'':fr'ij:ilt'. 29.1l::i~ _L_-",R"-.l72'Q... .1?-Zoo2J1"-
'-Iii J.L~-A/" . __,~~~=~~~~~~A~l:i~~o~~.~-~ld~:H...,--~--.n-.m /d-~2=:~~
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I give, ,1evise llnd bequeath the residue of my estate of every
nature and wherever sHuate to my children, namely Leroy S.
carbaugh, Martin E. Carbaugh, David E. carbaugh, Jr., William D.
Carbaugh, and Be tty J. carbaugh l>yer, in equal shares, prov ided
that the share of any child who predeceases me or dies on or before
the thirtieth day follOWing my death, shall be distributed to his
or her issue, per stirpes, living on the thirty-first day following
my death, and in default of any such then-living issue, such share
shall be added to the share or shares of my other children.
FOURTH
In the event that anyone entitled to a share of my estate
should be W'lder the age of eighteen years at the time for
distribution to him or her, I constitute and appoint commonwealth
National Bank guardian of any proper.ty which passes either w1der
this will or otherwise to s aid minor. said guardian shall, in the
guardian I s sole discretion and without order of Court., use
principal as well as income from time to time as may appear to be
necessary for the minor · s wel fare,
comfort, medical care,
recreation, support and education, without responsibility to the
minor or to any person taking care of the minor I and the remaining
balance in the hands of said guardian shall be distributed to said
minor when he or she attains the age of eighteen years. If such
minor dies prior to attaining the age of eighteen y"ears, Baid
guardian is authorized in the guardian's discretion to pay part or
Page 2 of a six-page Will
,~
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,".....
all of his or her funeral expenses and the remaining balance in the
hands of said guardian llhall be d is tributed to h is or her personal
representative. In the event the funds held by the guardian for
any minor become, in the opinion of the guardian, too small for
proper and efficient admini.stration, the guardian, in the
guardian I s sole discretion, may deposit such funds in a savings
account in the name of the minor.
FIFTH
It is my desire that my executor liquidate all of my personal
property and turn the same into cash at public sale.
SIXTH
Any fiduciary under this will shall have the fpllowing powers
in addition to those vested in them by laW and by other provisions
of my will applicable to all pr()perty, whether pri.ncipal or income,
including property held for minors, exercisable without court
approval, and effective until actual distribution of all property.
A. TO retain any and all of the assets of illY estate,
real or personal, without regard to any prinoiple of
diversification of risk.
B. TO invest in all forms of property, including stock,
common trust funds and mortgage investment funds without
restriction to investments authorized for pennsylvania fiduciaries,
as they deem proper, without regard to any principle of
diversification of risk.
Page 3 of a Six-page Will
~, ..ttle.41\\t 'tatellent
U,S, Department ot Houling
and urban Oev.lopm.nt
OMB No, 2S02-0H5
S, Typ. of 1Qa"
1. PHA 3 _,1lHA ). ConY, Unine,
4, VA I, ConY. In..
6, pi le number
" ~an nuMb.r.
I, Mortgage in.urano. 0... nuab.r
"1-201
C, HOTII Thie fo~ i. furni.h.d to give you. .t.t...nt of aatual ..ttl.~ent ooeta, AMounta paid to and by the
utUa.ent agant ara ah(lwn, Ite". .a"ked a. (Pocl'wll1'a paid outaida th. 010.1n91 they ara ehown hare for
intonational purpo". and an not inoluded in the tot..h.
-----
P. Nam. and addr... of lander I
parm.r. and M.rchat\t. Tt'\l.t c.
r. o. Box -T"
Chal'l\banburg, PA 11201
._-,-----
D, N".. and addu.. ot borrower I
J..... it "by
Naney K Aby
Alie. A AbV
8, Ha.. .nd .ddr..' of ..llerl
Ratate D.vid U. carbaugh
Q, Property locatlonl
no Bool Road
Newburg, PA 11240
It, aetthm.nt ag.nt!
Arhn. p, Maht.
'hoe ot ..ttle..nt I
211 Ch.Mb.r.burA Tru.t Buildin9
Ch.aber.burg, PA 11201
I, S.tt lell.nt. date 1
s.pteab.r 2], 1'"
-,
J" SUMMARY 0' BORROWIR'S TRAN/JACTtONS K, SUMMARY OP SBLLBR'S 'l"RANSACTIONS
--
100, aROSS MOUNT DUB PROM BORROWBR I 400. aROSS AMOUNT OUR TO SBLLBRI
--- --
101, Contr.ct eala. price n,OOO,OO 401. Contraot ulan price )),000. 00
-
102. per.on.l property 4D:!:. ParGonal property
101. Sattla..nt chrg, to borrow.r I lille l.f100 1.106.&1 403,
-" - ..
lO.fl. principal raduot ion 62.81 404. --
10S. 405.
-- -
ADJU!TMIIHTS POR ITI"S PAID BY SBLLBR IN ADV,WCH AOJUSTMBNTS POR ITSM! PAID BY SIILLRR IN ADVAHCB
10f, City/town tax.. 09/2'1-/'7 to 12/31/9" 16,11 40f. City/town t.x.e 09/23/t? to 12/]1/" 16.11
;~_~~y t.x.. o'/U/t? to 06/]0/91 215.59 401. county talC.. .'/"/" to o,/]o/u 2U.59
101. ,........nt. to 40', A.......nt. to
109. 409.
110, 410.
111. 411,
112. 412.
120. GROSS AMOUNT DUB PROM BORf{OWKR )5,001.09 420. GROSS AMOUNT DUB TO SBLLBR 33,231.7'1
200. ,,"OUNTS PAID flY OR IN BBHALF 0' BORROWRRl SDO. RHDUCTIOHS IN AMOUNT DUB S8LLBRl
201. napoeit or a.m..t money SOL Bxc." dapo.it taa. in.truction.l
202, principal amount of new loan(.) J5,OOO.OO S02. Satt1.mant ch.rgee to ..11.1'/ Una 1400 ]65 .00
'-- takan .uhj.ot to
20]. Ixieting loan(e) 503. lxi.ting 10.fl (.) t.k.n .U~;.C1t to
204. Cloaing co.te paid by ..Uar 604. Payoft at tir.t MOrtg.g. loan
205. 505. Payotf of ..cond .ortgag. loan
20'. SO,. D.pon.it on contract
20'1. Aggregat. a.orow Ad;. 1.0t 501. Cloainq co.u paid by ..11ar
201. SOl.
20t. 509.
ADJUSTftBNTS POR ITS"S UNPAID DY SBLLBR ADJUSTMBNTS POP ITIMS UNPAID BY 91LLIR
City/to"," tax.. -
210. to 510, city/town tau. to
211, county taxa. to 511 . county taKas to
212. A.....m.nt. to 512, A.....m.nta to
-
Hl, 51),
--
H4. SH.
215, S15 .
2\1. 5U.
211. 511.
211, sa.
:lU. SUo
220. TOTAL PMD BY /POR BORROWIR ]5,001.0' 520. TOTAL RIIUUCTION #.MOum DUB SBLLIIR 31&.00
-
JOO, CASH AT SB'M'I.BHlm PROM/TO BORROWBR 'DO. CASH AT SBTTLHMBNT TO/PROM BBLLBR
- I
)01, Gro.. _mount due from borrow.r j lin. 1>. JS,OOl,09 601. OroBo amount chle to .aller I Line 420 lJ, 2)1. 77
"-
302. L.a. amt, paid by/tor bon'o'<lel' ; Line 2" ]!i,OOl,O' 602, Lello reduct. .m\:. due ..llerl l.in. !i:lO ~6:~
- ~-_.-
J01. CAS" t - P"'OM) t .J\ TO) BORROWBR 0.00 60l. CM" I .J\ TO) I - PROMl SBLLBR \ J2,U'.n
Sftttl...nt .acr.tary S.ri.., PO R....rch COIIput.r S.rvic..
HtJD-1 (10/") RISPA, HI 4301.2
III:!I 11'I 0
.. 0
. .
... 0
...
"" i
~m
11'I "... ,!II
.... 0
. .
... ...
.. ..
N 0
. .
0 N
N
gal ~i~f
111I; i Iii
.. 0 ~ \D~
... 0 iSS
. .
.. 0
N I I I t
~ I~~~
ii:il
004 ...
11'I 0
. .
.... ...
~ .. ....
0 41 41 III
. . .... fB 41
0 N III ..
N .~. '01:1
I~ ~ ~R
g 'e -'I' ~
~ 41 ti 41 )
U U I
~ I ~ '; .f
11'I 0 ~t;.!lc\::~
II 'f '"
I I I I II
0 ...
"" N IHI~~CIl
.A I
....
Cl 0
.
nl
f&tf ....
t III ~ .. III
~ alii ~u I 41
..
Ql
,A:l u, ti E HIll [
. ~ . Q toot. 0 t:J1.
I It1 U 1t1. fJ~~'~~
~ GI '" t'" I
-ri4 U 'r4..... ... a'oI ill a
!~ i~ 3: III III
~i 8.~ III
... .. . 0 & ~ !
"" 00 I ':llll Ql .
... .. .. 6t:!!
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SCHEDULE H
FUNERAL EXPENSES,
CQMMONWIAIIH Of "NN$VIVAN" ADMINISTRATIVE COSTS AND
IN~:::~~~~'o~~',~l:J\'N MISCELLANEOUS EXPE~SES _", no PI.m. Pr!,!" 0' Typ.
~=; E._ ~~~~~9~._.._,_____,_u.._,_,"._.._.. _u. "__ . u _ _,. u ~JU:l~~~~~~59
ITEM
NUMBER
-_.~--- -~~---~-~~~------_._----.~-------_._-_._---- ------.--~--.----,+~._._.__.._--,-- -_...._.~~.~.-..........~-----
A. Fun.ral Exp.n....
1. Fogelsanger-Bricker f'uneral Hane
IIt..."tlll..II.II,
.
DESCRIPTION
1.
B. Admlnl.',allv. Co.,"
2.
3,
4,
C.
1,
2,
3.
4,
5,
6,
7,
8.
Pe"onol Rep,e.enlotlve Commlllionl William D.
Social Security Number of Pe"onol Repre.enlotlve,
Year Comml..ion. paid 1997
Carbaugh
175 - 30
1275
Alto,ney reel
Joel R. Zullinger
Family exemption
Clolmonl
Add,e.. of Clolmonl 01 decedenl'. deolh
none
Relotlon.hip
SI,eet Add,e.. _________.____.,,___u_____
Clly _____"'___...__________Slole ___ Zip Code
P,obote Fee. Mary C. Lewis, Register - probate fees 117.00; addi-
tional short certificate 3.00; filing retl~n 15.00
MI...llan.ou. Exp.nll"
Cumberlaro Law Journal, advertise letters
!\dams Electric, utilities
NewS-Chronicle, advertise letters
Coovers, cleaning decedent's residence
Tinothy S. Sponseller, settlemant fee on sale of decedent I s
real estate
Transfer tax on sale of decedent I s real estate
TOTAL IAllo enler on line 9, Recapitulation)
" (If more .po.. I. n..d.d, In..,, additional .h..'. 01 .am. .11..)
AMOUNT
4,550.00
2,500,00
2,500.00
135.00
60.00
110.00
57.72
211. 61
35.00
330.00
S 10,489.33
REV. 1500E)( . (1.94)
.~
~~ OATEH Of' DEATH Af'Tr!H 12/31/91 CHECK HERE
,\ SflOU!lAl ri
.p.~~~EnT,( CHEOt T !1!J{.I.MdJLQ._J..---L.....-._~._~
FILE NUMBER
C P
o 0 NA>.4E
R N
R D Neil Hendershot., Esq.
~ ~ TELEPHONE NU>.4BER
- T 717 234 -4161
1. Real Estate (Schedule A) 1
2, Stocks and Bonds (Schedule BI (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4, Mortgages and Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (Sch" E) (5)
6. Jolnlly Owned Property (Schedule F) (6)
7. Transle" (Schedule G) (Schedule L) (7)
8, Total Gross Assets (total Lines 1,7)
9. Funeral Ellpenses, Administrative Costs, Mi!icellaneous
E'penses (Scheoule HI
10. Debts, Mortgage L1abilllles, Liens (Schedule Il
11. Total Deductions (total Lines 9 & 101
12. Net Value 01 Este" (Line 8 minus Line 11)
13. Charltabl. and Governmental Bequests (SChedule J)
14. Net Value Sub ect to Ta' (Line 12 mlnu. Line 13)
15. Spousal Transfe" (for dates of death aher 6-30-94)
See Instructions for Applicable Percentage on page 2,
(Include value. from Schedule K or Schedule M")
16. Amount 01 Line 14 taxable at 6% rate
(Include values from Sch.dule K or Schedule M")
17. Amount 01 Line 14 taxable at 15% tate
(Include values from SchedulB K or Schedule M.)
18. Principal lex due (Add ta' from L1n. 15, 16 and 17)
19. Credits/Sp Poverty Prior Payments DIscount
. 9,000.00 . _.~73.68
20, If Line 19 is gr.at.r than Line 18, .nte, th. dlff.r.nce on L1n. 20" This Is the OVERPAYMENT.
~ 0 ICheck here"" you l,e reque.lIng . "fund of your OVllp.ymenl.!
21. If Line 18 i. gr.ater than Un. 19, ente' the diff.rence on Lln. 21. This Is the TAX DUE.
A. Enter the Interest on the balance due on Line 21A.
B. Enter the total 01 L1n. 21 and 21A on Line 21B This is the BALANCE DUE.
M.ke Chock P. .ble 10: Re 1,111 of Wille A enl
~ ~ DE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~
Under penalties 01 perlury, I declare thlll hl\le o:Clmlnod thIs return, IllCludlng Iccompanylng scheduleslnd statr,"\8nls, Ind to the 1':ieSI af my knowledge Ind belief, Ills true,
corr~ct Ind complete. I dlJtl"e thlt IU rlJal89tate has been reported It Iroo market \llluo. DOtld,.llon 01 pr.parer other than tho penonal replesentatl\le Is based on IlIlnformaUan 01
which preparer hll'ny knowledge.
COB
H Ii L
ERg
Co K
K P S
C0>.4~Fr..l'II~~~1 \~1~;fl\.NJj!,I.\\~ ANrA
HARHI9Rm:t.~~ 19\cli-oool
INHERITANCE TAX RETURN
RESIDENl DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COUNIYCOUli
D
~
E
~
T
OE(:r:OENT'!l NAMt: (lA~i', FlRflT, AND MlDl'IL.r.INHIAll rW(;nH~NT'!i COMf'l.fTF. AODRr:~I~1
Ua~K1.ull\(J I.ou' HO l/,~) BO!-i I or Avolluo
r.~~~~l, ~.F~~~~1'8N~>.4n:' "l~~/~~~;~~~~"t;~~;;~~,~;:'~ "E"'I:.om()~::::)(J ::: otll:()/, :\
(IF APPUCABLE)SUAVIVINCl :IP()U5E'S NAME (L.AftT ,FIRST AND MIDDLE: INITIAL) SOCIAL ~,f:CUfllTY NUMBER
"---oa.
o 5,
o 8.
X 1. Original Return -.----------QT SupplemenUlI Roturn .-_.
4. Limited Estate D 4.. Futuro Intorost Compromiso
(for dat." ot death .fte, 12' t 2 - 82)
[K) 6. Decedenl Died Testate 07. Decedont Mainlained il Living Trust
(Attach copy 01 Will) (Attach a copy 01 Trustl ..
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
7.l-97'()%O
'(EAn
NUMOEA
AMOUNT AECEIVEO(Sn INSTfWCTlON9)
0,00
Remainder Aelurn
(for dales 01 death prior to 12..13"82)
Federal Estate Ta)( Retum Rtlqulted
Tolal Numl'er of Safe Deposit BOl(es
COMPLErE MAILING ADDRESS
Goldberg, Katzman & Shipman, P.C,
320 Market. St., P.O. BOK 1268
Hard "bur PA 17108 -1268
, .0
1.9,1,16.6/,
None
None"
10,129.01:
4,087.35
None
R
E
C
A
P
I
T
U
L
A
T
o
N
(9)
1/. ,880.2/,
(10)
30,1,68,78
(15)
0.00 X
(1&)
0.00 X "06'
~
g
~
I
T
o
N
(17)
67,664.31 XIS'
Interes!
(8) __..--1]0,633.00
(11)
(12)
d~l
(14)
45,349.02
85,283.98
17,619,67
67,6611.31
0.00
0.00
10,149.65
(18)
10,1/,9,65
(19)
(20)
9,473.68
0.00
(21)
( 211.)
(2IB)
675.97
0.00
675.97
DATE
~/JtJ/1B
Mary Kay Torretti
295 Smoketmm Road
Lewisi:;~I:g',P^ "ilo)j..., 'n. n'" n ..n...'..
Goldberg, Kat.zman & Shipman, P.C.
320 Market. St" P.O. BOK 1268
H~-':rl,:b~;:': - pi\"" iii6il-:ii6Sn" - ""... H" -",
DATE
FO~~~:':'.\I
!,,~' \~.,'~. (.,..,
1*'\
SC\,\!O\.l\.e. 8
S'I'OCll.S ..NO BONOS
f\~" 8'"
?\..91.0~00
COM~~q\,~~~'H\'
06tIO/\. 991
--
~_.
Of D~'~~
~n,60
D \ SSil \11, . loll ,0181
\'.\.,,\1\0 \.,o,,\ao BV a .
~.~~
\,,,.,. I o\nl\ .o..nl =----- -=-
~EIA OESCIIIP~ION
....... ~~" "."" "",'0, .n"
\. 'ten (\.0) \lnlleod S " \1 \.996 lehro,'!'," l\pr, \.991,
\ doleUS from oc,' ~\. \.0 ch
.",'~' ..,. . ' ",oo 00, ..,,,od ,," ". ..
.n .n" ,... .."" - " . ,od"" ..."" .."" -'
per \nformale\on oblea\ne rom
Ne'" 'ior\<.'
. \Ces.' \In\ted Gro"P of
.....n , ...' "...,,., '~~~""-, ,....",,, .",...
~utua\. funds, l\ccount No. f' f E\.a\ne L. Dav\S, va\.ued
. aunt for the bene ,t 0
ment ...cc d \ \.etter (I\ttached)'
per ba\.ance reporte I'
\11'\ ted Graul' of
.....n ' ..., "....,., ,,,.,.~. S- .."., p" ",,,,.
~ut"a\. funds, l\ccount No. \.936138- ,
reported In \.etter (atteched),
11I~'~' of
'36,9\.9.'1.&
11, 98~. 78
'1.
3
----
~O~.~ \,100 In'eI on II"" 2,I\IC' 110\OI\On)
~~Id, In..lI.dd\I\OI\IlIO\lOI'O o\..fIII olll,)
, 49 4\.6.&4
'DIm ~\tO acnedul.8 ,n", ....)
R~V ' 160H}(t I' ,'11
. ...__ ..-, ... -0 ~ ._~."
...-...,
--
~ '\
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
.
OOMmm~.~<<~N\'
.STA 10'
Pi.... Print 0 T
PILE UMB.R
21-97-0560
Elaine Louise Davis 5S/! 17/,_1,0-0387
06/30/19'J'/
2
3
4
olnlly-own.iWilh RighI oi Survlvorohlp mUlt b!.dl.clol.d on Schedul. F)
DESCRIPTION
Miscellaneous personsl property in Decedent's rosidiiOc.;-:V".;:r;:;;d--
per actual s810s.
Members First Federal Crodit Union -- Share Savings Account No.
18388,00, principal balance, valuod per Crodit Union's lottor
(attached) ,
Accrued interost on above Account
Dauphin Deposit Bank & Trust Co. -' Checking Account No, 3101744.
principal balance, valued per Bank's letter (attached).
5
Accrued interest on above Account
6
Diamond Ring, valued pet actual sale to Harris Jewelers
7
Chern Lawn' - Refund for lawncare servicE'S
8
J. Jill Company - - Mail order ca"talog refund
9
1983 Buick sedan ._ Valued pOl' actual sales price to used car
dealer.
10
Refunds at settlement on sale of house re real estate taxes I
County/Towpship real estate tax
School District real estate tax
11
Intarna1 Revenue Service ,- 1997 Income Tax Refund claimed
12
Erie Insurance Co. .- Refund on automobile insurance premium
13
U.G,I. Utilities, Inc. -- Refund on gas service
TOTAL (Also .ntlr on IInl S, Alclpnulotlon)
(Mlch Iddnlonel8 1/2" , 1 r ,heets If moll specI Is needld")
Copyright (e) 1t9~ 101m IOftWll1l only CPSVSllt'l'I, Inc:.
..------"'--
VALUE AT DATE
OF DEATH
3,41.3,72
125.40
0.24
2,734,66
1.20
800.00
101.92
210.00
55,00
7.95
301.85
1,902.00
262 , 00
213.07
. 10129.01
form 1100 Schedule E (R.v. Z.a1)
Anv" IIOHX . 111"")
SCHl!pULE P
~o NEP PROP I! TY
cm'.~d~~I<<'N"
STATIOP
_~na LOlllao DII.~.!.~_ SS/i 1711.I\Q.:Q.387
JoIAlllnlnt(I):
__ NAME
~ lrane Z, Davis
8, Mary Kay Torre.ttl
C. Carol /Inn Falling
Jointly-own'" p,oPlrty:
ITEM
NUMBER
1
LETTER
POR
JOINT
TENANT
ABC
DATE
MADE
JOINT
12/01/89
"-
,
----.---
ADDRESS RILATIONSHIP TO DICIDINT
606 III rrr,;-iiWSL.-: Apt.. III MothaT'
CloarflaJd, I'A 16830
295 Smokotown Rond Slstor
Lowlsburg, PA 17837
101 lIaverly Avenue Sister
lIilmlngton, DE 19803
DESCRIPTION OF ?ROPERTV
Clearfleld Bank & Trust .-
Certificate of Deposit No.
16734, Principnl Balance
valued per Bank's letter
(attached) .
"
,
ABC 12/01/89 Accrued interest on above
Certificate of Deposit.
--
TOT AL VALUE
OF ASSET
16,285.89
DECD'S
'41NT,
25,00);
DOLLAR VALUE OF
ECEDENTINTIREST
4,071. .47
63,53 25,00);
15,88
11087,35
TOTAL (Also Inl.' on line 6, R.oa Ilulallon)
(II mor. spac. Is need.d, Ins.rt add"lonal she.IS 01 same sIZ'")
CopyrlQh' (e) '"-4 '0'", loftw.re only CPSvatems, Inc:.
FOfm flOO Schedule F (R,y, 12-88)
RF.V. l61Zf.)(. (l-IJI
~
,...."
COMrN\l\1!!,\1l~~'V~~f;Y.NI.
IITATIOP
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Pi.... Print 01 T .
PILI NUMBER
21.97-0560
Elaine Loulee Ilavls
5511 17/,./,0-()387
06/30/1997
ITEM
NUMBIR
I
10
DESCRIPTION
Members Firat Fedoral Credit Union.. Loan baiance on Account
No. 18388,09, principal due on date of death vslued per leUer
(att>.lChed)
2
Membors First Fadoral Credit Union.. Loan balance on Account No.
18388.11, principal due on dato of death valued per letter
(attached) .
3
Members First Federal Credit Union -" Visa charges under Account
No, /1287590000183885, billed by creditor & paid by Estate
4 First Union Bank ,. Balances due on Mastercard credit card:
Principal balance on Account No. 5410541320012723
Subsequent final billing on Mastercard account
5 P P & L ." Electric bill
6 Bell Atlantlc-PA ". Telephone bill
7 Pinnacle Health Hospitals .- Medical bill unrelmbursed or covere
8 Harris Savings Bank -- Home Equity Loan No. 01.52-200565
principal balance valued per Bank's letter (attached).
9 Accrued Interest due on above obligation
P P & L
Final electric bill
11 Borough of Lemoyne -- Sewer & trash bill
12 Penna. Water Company .- Water bill,
13 Quantum Imaging & Therapoutic Assocs., Inc. .. Medioal bill
oosts unrelmbursed & not covered (5 bills)
14
15 Suburban Cable -- Cable television bill
U,G,I. Utilles, Inc.
Gas bill
16 Pinnacle Health Hospitals -. Medical bills unrelmbursed and not
covered by insurance
17 Erie Insurance Co, .- Homeowners premium, less later refund
18 U,G.I. Utilities, Inc. .. Final gas bili.
Total of Continuation Schedule(s)
TOTAL (AI,o .nl., on line 10, R.ca Ilulallon)
(If more spac. i, na.d.d, Insert addilional shill' of ,ame slza,)
Copyrlghl (c) 1994 form aoftwlfe only CPSYltem!l, Inc.
AMOUNT
6,329,88
6,948,03
15./18
5,540,87
112,69
44.89
46.79
43.30
8,536.10
6,49
45.00
53.00
10.00
314.85
78.00
4/1,64
75,00
113.00
78,00
2 032,77
. 30468,78
Form 1100 Schedule I (Rev, 1.tl)
....
Ii
f""",
'<'--'--oJ..'-'-__~_.l"
14lo..;'_______.......".,..................._..,;T,~_,... _-, ~ __
. . ..,., ._~,-.~""
"".-"h'_<;._~_.__",~,_.
-~"-"""";';"~'~""''''''''''''''''~'''''''''4'''''''~'"",~"
LAST WILL AND TESTA~IEl{!
OF
ELAINE LOUISE DAVIS
. '..'
I, ELAINE LOUISE DAVIS, a resid~nt of 145 Bosler Avonue,
Lemoyne, Cumberland County, Pennsylvania, being of sound mind and memory,
do make, pUb}ish and declare this to be my Last Will and Testament, hereby
revoking all Wills and Codicils heretofore made by me.
ITEM I. I direct that all of my, just
debts, funeral expenses, and the cost of administration of my estate be
paid as soon as practicable after my death. I direct that my Executrix
payout of my estate, asa general charge thereon, all inheritances,
estate, succession, and other taxes, together with any interest or penalty
thereon assessed by reason of my death, with regard to all properties and
assets subject to such taxes, whether or not such property and aSSets pass
under this Will.
ITEH II. I give, devise and bequeath all
the rest, residue and remainder of my property, real, personal or mixed,
tangible or intangible, of whatsoever nature and wheresoever located and
all property to which I may be entitled or over which I may have any power
of disposition or appointment and whether acquired during or after my
lifetime to my relatives in the following manner; per capita distributionl
...'
(A) 20% to St. Timothy Luthern Church
4200 Market Street
Camp Hill, PA.
(B) 8% to Rlchel E. DaVis, (neice)
(C) 811 to Benjamin Z. Davis, (ne.~ht"lJ.l) ,cD
I, C/O 8 St. Austin's Place
Staten Island, New York
(D) 8% to Joel A. Torretti I (nephew)
(E) 8% to Andrew D. Torretti, (nephew)
(F) 8% to LUke C. Torretti, (nephew)
(G) 8% to Mary Kay Torretti, (sister)
C/O 29S Smoketown Road
Lewisburg, PA 17837
(M) 8% to Ian N. Failinc;" (nephew)
-(I) 8% to CllrQ-1: Ann Failing, (sister)
C/O S2 Chemen de la Foret
78860 St. Nom La. Breteche
Yvelines, France
/) (1' , " J
'/-''LU''<--
,f t .'Lc,~~"' ,Q." :L,". ~
, .
.~
f""!
,....,
, .,,_'c-'--<....~_"_", ~."'_-.._.....--..
rr',
----
, r .......,__.....E,~"'_,,...._"""l'-"'!-"...~"'___
~ ~"'_.t'f",'.'. -
(01) 8' to John Il. Davis, (father)
(K)" 8' to Irene Z. Davis, (mother)
C/O 727 Weaver Street
Clearfield, PA 16830
. "..'
ITEM III. I hereby nominate, constitute and
appoint my sister, Mary Kay Torretti as sole Executrix of this, my last
Will and Testament. I direct that no bond b~ required of my Executrix in
connection with her duties as such in any jurisdiction in which she may be
called upon to act insofar as I am able by law so to do. In the event my
sister, Mary :ay Torretti, is unable to act for any reason, I then 1
nominate my ~ther sister, Carol Ann Failing, as my Alternate Co-Executrix.
ITEM IV. My Executrix shall serve without
bond and is hereby authorized and empowered to sell at public or private
sale or sales all of the personal property of which I may die seised and
to likewise sell all real estate of which I may die seised, and to convey
the same by fee simple deed or deeds to the same effect that I could
personally do, if living. The powers herein conferred shall be to my
named Executrix and all successors thereto and shall be in addition to and
not in limit3tion of other powers conferred on said fiduciaries. .
ITEM V. In addition to the above powers, I
authorize and empose by Executrix as follows:
(A) to compromise, adjust, release and discharge in such
manner as my Executrix and Trustee deem proper, all debts and claims owed
by me or my estate;
(B) to sell, lease or exchange at public or private sale,
or in such manner, at such prices and upon such terms of credit or
otherwise as my Executrix may deem proper, all or any part of my property,
real or personal or mixed;
(C) to execute, acknowledge and de'liver instruments of
conveyance, including deeds in f~~ Simple;
(D) to borrow money for the purpose of paying estate,
inheritance, or other taxes which are required to be paid and to secure
any such loan by pledge or mortgage of all or any part of my property, and
to execute the necessary inst~uments to carry out such powers;
(E) to distribute my estate in kind, or partly in money and
partly in kind, and to determ~ne the fair value at which any property so
distributed in kind shall be received by the distributees;
....
, . -/' //! '
it?tw-"-<-'~7 " .O;,"C4>-~
...
, "
,-\
t""'I
...--".,
"""'C"_",-""",";_"'_U_.",...I_"""'_4"",_",,,,-,,,..t_!ti~'''''''''1 lJ
"'_"""'" ,,; "_";_~'" h'Mjh.~,.."~;...i~_t";AlJ,t. .!'W;! "l"-'.'-'.'
;,,~,_~:":"""" ..<....;....;.;,. _.JU...!, -iF. ,., ,,_.~'~~;'H,F~~ "_1
(F) to conduct any business in which I have an interest at
the time of my demise for such period as my ExecutriX may deem properl to
borrow money and pledge the assests of the business: to do all other acts
that I, in my lifetime could have done; to delegate such power to any
partner, manager or employee without liability for any loss .osutring
therein; to organize a corporation to carryon said business by itself or
jointly with othersl to contribute all or part of the said business as
capital to such corporation and accept stock in said corporation in
consideration thereforl to hold such stock for the uses of this, my Will,
and to vote said stock or to sell the same as to my Executrix may seem
best I
(G) to retain all stocks, assets, bonds and investments
owned by me without being confirmed to what is known as legal investments I
"'
(H) to execute any options to purchase:
(I) to apply for stocks, bonds or other investments I
(J) to pu~chase or otherwise acquire real estate.
(K) to retain indefinitely any part of my assets, real or
personal, which is or may become unproductive or to make sale thereof: to
9ay carrying charges and expenses of the pronerty out of other principal
or income of my estate.
ITEM VI. It is my desire and intention to
be cremated and my ashes disbursed at sea instead of the standard funeral
burial with casket and cemetary plot. My Executrix shall have full
discretion as to all arrangements concerning the above.
IN. WITNESS WHEREOF, I have hereunto set my hand and seal to"
this my Last Will a~d Testament, c;:onsisting of t.h'ree" (3) typewritten
pages, each bearing 'my "ignature,' this f .day OL,~LiJ.-C,,--t~t'L. ,A.D.,
1987. '
/' ..,'
"I! "-' /!
\\~ Lll,t-I~L./-_...,fC~U.I.-<i'!.- ,'l':':<~"'.(..-J~r
ELAINE LOUlSE DAVIS
(SEAL)
Witness;
, ~IUU/Jo J. L-J.1tllw
I'
I
.,.-
. lJaDflI'A",ME~" ()f1l('......1\.IlI1IJf1~;.~f()liVEl.OPIM!-;;~._---_M. r", OM8N<J,2502.0H&
SETTLL~ :J1^'LMLNr -~ lUlU'II"
SECURED LAND In,,,'1II1
TRANSFERS, INC. -
8 TYPE OF lOAN
3800 Merk.1 Slre.1 !.IIfHA 1,1 I "-'HI. .),IICOtN.Uiim-
Cemp HIli, PA 17011 .; 'VA . j XOONV. JNS, "-
1\ FILl! Nt/Mnen I ',~OANNUM96R
Phon.: 781.7744 1-:-:; 107962 690170
., MOAT, It18. GASE NO
- ..
u NOYE~ Thlt IOlrt'llt lumlth.d In gIVa '(01/ of .lIll.mllll' ol.r.lu.llI.tII.-rIl\n' co~l, A"lOIlIlI' "lid In and by tht ,.lUlItnllfll1'J'1ll1I" thown. IItml ml.hd
'Ip 0,0,)' Wlfl plid otlllldtlh. r.101if1V: IhllV I" .hown h.,. lor ~In/lnllllonll pU'JlOUlI Ir.d If' nnllnolud.d In Ih.totlll
o NAME ANOAOOnIlSS 011 AOMOWf:R Il NAMIl AND MlOOE99 OF ~uiiLe" - F. NAMl! ANO AOOO(S8 OF Ull<<>en'
Stefanie K, Krout Mary Kay Torretti I M~llon Mortgage Company
Bxecutrix of the Rotate
of Blain. Louise Davis 501 Holiday Dr,
a/k/. Blaine L, Davis Pitt.burgh PA 15230
a, PROPl!"'VlOCAflON II. BETflEtMNT AlIENT: I.M!TflEMEmOATIi:
145 Bosler. Avenue Secured Land Transfers Inc, 12/15/97
Lemoyne BOROUGH PlAoe OF SF:fllliMtNl:
CUMBBRLAND County 3000 Mark8t St I Camp Hill , PA 1'1011
J, .UMM.....V Of' laR"OW."" T""HuClTtaH: k, 'UMMAIlV 0' .IlL'JIl'! "'AHueTlaNI
100. OllO" "MOUNT aUI ""OM IO'U'OWI" 400 OflOIl ...MOUNT QUI TO IILLlIIl
lOl.Oool'ICIIlI..p,!". +tlICOnl'lolllluPflcl b7llll1f;1Il
'Q~IlJn'lp~"IY .."PII,on.lpfOPIIIY
un 91111tmtn1 chi' .. 10 bouow.r INn. UOO) .5] ...
". ... ,
'"~ ...
AdjtJ.lmen!. fo,lltml 1).ld by ..11., In ,dvlncl /ldjullmenll 101 i1tml J!.,d by 11I1., In .dv.nc.
IIM:Cllyllown.1aJI " ~06,Clty"~;; 1I~ "
lOr Cloun,,,II~ [:r f1579'1i01T/ ---or. 401,OOUfllVlI~ T27l1rlJl'T" T:rTIT
101......."'*'1. " 401 Au...menl' "
lot 'chorJl " JU1.85 0101. 'ghool ~ .85
'I' e ,533.00/a e1ld1na L2/: 5.19 m Ref: e n 5.79
Ill. ."
-
",. '"
110.0"0" AMOUNT OUI '''OM lOR ROW'" 70325.12 UOO"OIl AMOUNT DUI TO lULU 67315.59
*. "MOUN"; ''''10 n 0" IN IIH,UI' o"la'UIOWIf!; 601). ftlDUOTlOHI IN .....OUNT aUI TO IILLU
.., lpo,lt Of '"""' mon'Y 2000. lO"e..c... dlpo.11 (... in.lnlcllon,)
101. Prlnclpll IIfIOUnI of n.w Io.Oj.) 6365 W.S.UItmIlf'lI ohllglllO till" (lln. 14tOO) 13353,00
lOS. E.dlllnQ !o1n(1) IMen lubl.OIIO lIO.,e.'IUng 101l'l(1) I,""" ,ubjeclto
... to4P.yoft 01 FifltMOrlg.gel,oln
NONE
... iOIPlyofl 01 Second MOftg.g. Loll'!
--
.!!!.- ~ ...
~r.I8al , Cr Retort '"
11>>, OS- ~081na Cost re ... oB Closln Cost Cred: -1909;,0
... ...
Adju,lm."l. lor iteml unplld by ..11., AdjUllm.nl.lol lIem. unplJd by .tII.,
'!OClttllownlll " ilo.ClI'I'llownllll "
'lI,Oountflll " '''.COtlnly''l .
'U,A'..,,,,,,,", " '".AIMltrMllll "
Ill.......' " II~, 'chool .
to. ."
... III.
-
,It. ".,
m ."
I!I, "'
... "'
,". TOTAL 'AID IV/I'O" la""OWIJI: 67849.50 no. TOTAL "'OUOTION AMOUNT OUt IILL'" 15262.50
100. OAIH AT ..nU"'NT I'"OM 0" TO 'O""Ow." IOO,OAIH AT..nt....NT TO 0" ""A.. IILL'" ~
..," fOIl MlClOnl dut 110m bellOWtf (lIn. 1201 70325.12 1II1,0ro.. anlOUf\l 00.10 ,.1", (lint "20)
301. L"I~' plld bvllof bollOWtf (lln. 220) 67849.50 _.l"1 ,.ductlon emaunl 00. ,.lltt jllnl 520)
sa. CAlM IDa ""OM) II I TO) .O....OWIR 2475.62 I ",a.IHIIlIITOI II ,'"OMlle'.Le" 52053.09
",~.""'''.''';-'-'
~,.
.".,.IO,,-.'.lNgnelW"
1MlItf',81QJl1I\N.
HlO-IAw.""
'fIII(,.. .
~
~
Waddell' Reed, Inc.
AcqTl 16636?95
0?-lB-199? .
GROUP/SOl INFORMATION FOR: DAVIS
ELAINE L
WM'l'-AIct
PAGE 1
.......___....................__..n....wu__....._____.......................
*_____________________________501 Information------------------------------'
*________________Group 6315717 Values (NAV Date 07 17 1997)-------:--------+
Total Value Full Load Funds:
Total Value Reducad Load Funds:
Total Value Defarred Funds:
50,269.43
.00
.00
Account Prod Share Balance Cur rent Value SaSOI Account Total
16636?95 623 0.000 0.00
18636?95 625 1,514.966 16,997.92
t6636?95 630 1,317.565 21,911.11
IB636?95 634 0.000 0.00 38.909.03
19361365 201 0.000 0.00
19361365 621 188.410 7,879.31
19361385 625 310.258 3,481. 09
19361365 750 1,274.350 1,274. 35' 12,'634,,75
* THIS VALUE EXCLUDED FROM GROUP VALUES
"'"
;;
...:. ..".
""""
,-..,
Waddell << Reed, Inc.
ACCOUNT SUMMARY FOR 18636795 ON 07-18-1997
WMT-AI11
FIDUCIAAY TRUST CO NH CUST
II1A OF ELAINE L DAVIS
FBO ELAINE L DAVIS
145 BOSLER AVENUE
LEMOYNE PA 17043
Surname :
Acct CIs:
Group No:
Client
DAVIS ELAINEL Sve Rep: 33014
21 INDIVIDUAL RETIREMENT PLAN
6315717 SOl ('f/N): N AIS: Y
00021 Home Ph : 717-763-7250
----SSN---- ---OOB---- --Work Ph--:'
174-40-0387 03-12-1949 717-790-1928
ACCT lIAS NO LP PRODS
Slain..
SPOUSE
Tax ID Nbr
174-40-0387
MUTUAL FUNDS
'NAV Date- 07-17-1997 Product $IShr Date Amoun t .. Facel Serie~1
Prd Fund Share~ Value LAD Opened Inve~ted DC Cert CvtCon EC
623 UAF .000 .00 040395 OllBBB .00 RR 000000
625 ura 1514.966 16997.92 070197 040395 10733.04 RR 000000
630 UNC 1317.565 21911.11 070197 040395 15696.96 RR 000000
634 UH2 .000 .00 040395 0219BB .00 RR 000000
"THIS AMOUNT MAY BE INCORRECT-TO INSURE ACCURACY REVIEW ACCOUNT HISTORIES
'"
r""'"'I
(""\
. M~nlR~'0~
"" " InllUl'lll1ce Cla!.IlllI Department
5275 East Trindle ROl!d
P,O, Box 40
MechanicsburS. PA 17055
(717)697-1\6\
aJ-lARE SAVINGS ACCOUNt
Aecount NumberlSuffix
Date Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Name of Joint Owner, if any
I
18388-00
6/28/7 6
$125.40
$,24
None
2
l,.OAN ACCOUNI:
Account NurnberlLoan Nurnber
Original Date of Loan
Principal Balance at Date of Death
Name of Comaker/Cosigner
Collateral Held
18388-09
11/4/86
$6329.88
None
Property . 145 Bosler Ave
Lemoyne, P A 17043
$1.71716
Daily Interest
I"OAN ACCoUNi:
Account NumberlLoan Number
Original Date of Loan
Principal Balance at Date of Death
Name of Comaker/Cosigner
Collateral Held
Daily Interest
\8388.1\
6/20/91
$6948.03
None
Signature
$2.23320
yYSA AccmlliI:
Account NumberlLoan Number
Original Date of Loan
Principal Balance at Date of Death
Name of Cornaker/Cosigner
Collateral Held
4287590000183885
7/24/96
$1718,\1
None
N/A
"l""""'" IST.l""ff"" CREDIT ,tJNI<m
)v~c;bf-a;-
Denise A. Anders
Insurance Department Supervisor
...
Estate of Elaine L. Davis
Date of Death: 6/30/97
Social Security No: 174-40-0387
July 28, 1997
JU\" ".~ a ,<j~1.
,
Account No.
Type
Date Opened
or Issued
Date Closed
or Matured
.~
1'""'1
D
Dauphin Deposit Bank
and Trust Company
MAIN OFFICE: a'3 MA~~ET STREET, HA~RIS8URQ, PENNSVLVANIA 1710'
711 2!!,a.a.
Decedent Confirmation
Name:
Elaine L. Davis
Social Security No.: 174-40-0387
Date of Death (000): 06/30/97
31017444
__~~_______________.__.... ___ ..__......,_.... ____....__________....__ _________ ______ ___f.____4~
Checking
--- --------... -~.- -.---........ --- ---- --- ---...------------- --------.....----------------
01/25/97
....---.------ ---.----------- ----....--------...---------- ----------------.--------
08/06/97 (Closed)
--..----... ----......---------- ----...-----------------"" ---_......_-~_......------------
Date of Death
Balance $2,734.66
------------------------ ---------------~-------- ------------------------
Date of Death
Accrued Int. $1.20
------------------------ ------------------------
-----~-~----------------
Joi nt OM'lers
(if any). None
---------------------- ------------------------ -...-.......------...---------
------------------------ --------------..---------
. ...
------...-----------------
PLUS
Date of Joint
OHnership
------------
------------- ------------------------ ------------------------ ------------------------
Special Comments: N/A
Additional inforaation availabl. at ,ao.oo per ~,r. One hour .iniaua.
Date Prepared: August 20, 1997 Prepared by: Cheryl A. Bowers
Telephone No. (717) 255-2054
Customer Management Infornlation Dept. (CMI)
Page 1 of 1
'AUG221997
Po.. 00-020-218 (AZV 7/")
/5'-ltff-,/djI
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
*
.lv.IUlumu",,,
DAVID
J
HOTEl To in.ure proper
creel1 t to your HClaunt,
.ubwlt tho upp.r portion
of thl. for. .Ith your
t.. P._t,
54,784,63
"APPROVED DEDUCTIONS AND EXEMPTIONS I
t 10,489.33
9. Fun....al !>epen..a/AdII. COI I'"JIO. Exp.n,.. (Schedul. H) (9J
10. lI<lbh/Nort.... LiobUltI../Li.n. lSoh.duh II nOI 2.586.33
11. Tot.l Doduotlon. 111) _
12. N.t V.l... of T.. Return n2)
11. Ch.rU...h/lo..,......,t.l I.q....hl Non-.l.ot.d 9111 Tru.h ISch.dul. J) nS)
l~. Not V.l... of Eotot. Subj.ct to T.. n~1
NOTEI If.n ......M.nt w.. i..u.d pr.vioU'ly. lin.. 14. 15 .nd/or 16. 17 .nd II will
r.fl.at figur.. th.t includ. th. tat.l of ~ r.turn. .......d to d.t..
AIIEIIMENT OF TAXI
U. Aoount of Lln. l~ .t Spou..l r.t. CUI
16. Aoount of Line l~ t.....l. .t Lln..l/Cl... A r.t. (161
11, Aoount of Line l~ t.....l. .t Coll.t.r.l/Cl... I r~t. (1~1
II. Princlp.l T.. Du.
TAX CREDITS I
PAYNENT
DATE
o '20-97
10'27-97
IUNEAU OF INDIVIDUAL TAXES
INHERITANCE 'AX DIYISION
DEPT. 210601
HARJU.IURa, PA 11121-0601
NOTICE Of INHENITANCE TAX
APPNAISENENT, ALLOHANCE ON DISALLOHANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
JOEL R ZULLlNGER
200 CHAMBERSBRG"TR CO
CHAMBERSBURG PA 17201
DATI!
ISTATI OF
DATI OF DIATH
FILl NUMIIR
COUNTY
ACN
01-27-98
CARBAUGH
06-26-97
21 97-0559
CUMBERLAND
101
Aoount-N.oltt.d
r
MAKI CHECK PAYAILI AND REMIT PAVMINT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINI ... RITAIN LOWIR PORTION FOR YOUR RICORDS ...
itiV: ii'4'j'ix""APP""iiif:97Y"iiiit"ici"OF' i"NHiiiiTANC'i" ''fA'X" "A.p 'RA"iiiifiii'f...Ai.i"OWAijC'i.'liliuu..............
DISALLOWANCI OF DEDUCTIONS AND ASSESSMINT OF TAX
IITATI OF CARBAUGH DAVID E FILE NO. 21 97-0559 ACN 101 DATI 01-27-9~
TAX NETUNN HAS. (X) ACCEPTED AS FILED
RISEr.VATION CONCIRNING FUTURI INTERIIT . SEI REVERSI
APPRAIIID VALUE OF RITURN IASID ONI ORIGINAL RETURN
1. N..l E.t.t. ISoh.dul. A)
2. StookE end lond. ISohodUl. II
S. tlo..ly Hold Stook/P.rtner.hip Int.r..t ISoh.dul. C)
~. Nort...../Not.. N.o.lv...l. (Soh.dul. D)
J. Cooh/l"'" o.po.U./NIoO. P.r.on.l Prop.rty ISoh.dul. E I
6. Jointly O.ned Prop.rty ISohedul. f)
1. ~ron.f.r. ISohedul. I)
I. Tot.l A...t.
I ) CHANOEO
(1) 33JDOO.OO.
(2) .00
IS) ,00
I~) .00
l&I 20.750.12
(6)_~O34, 51
(7) .00
(Il
,00 X .00.
41,708,97 X .06.
.00 X .15.
nil
NECElPT
NUNIU
AA242259
AA242400
DISCOUNT It I
INTENF.ST/PEN PAID 1-)
120.00
,00
ANOUNT PAID
2,280.00
102.54
TOTAL TAX CREDIT
IALANCI OF TAX DUI
INTERIST AND PIN.
TOTAL DUI
w IF ~AID AfTEN DATE INDICATED, SEE NEVENSE
FON CALCULATION OF ADDITIONAL INTENEST.
I ~. 07~ ,&
41,708,97
.00
41, 708,97
.00
2,502.54
,00
2,502.54
2,502.54
,00
,00
.00
I If TOTAL DUE IS LESS THAN '1, NO PAYNENT IS REquINED.
If TOTAL DUE IS NEfLECTED AS A "CAEDn" ICU, YDU NAY BE DUE
A NEFUND. SEE NEVENSE SIDE OF THIS FDNN FON INSTNUCTIDNS.I
E
~ !
RI'ER~ATloHl E.t.t.. of deoedtnt. dVlng ~n or blfarl Dlc.-blr 12, 1"2 ~~ If '"v futurl 'nt.rl.t In thl ..t.tl II tr~.f'ffl4
In po.....lon or anjoy"'" to el... 1 (CoUltlrlU "'MHol,"'.. of thl .Clldent ,ftlr the IMPh'.Uon of MV ..tlte for
lIfe or for VI.r., thl C~I,lth herlby .Mpre..ly rl.lrv" thl right to .,pr.I., end ,..,.. tren.f.f' l~r'tlnO' TIMI'
.t thl lawful C1I" . (col1,t.r.l) rltl on env 'UGh futurl 'nt.r..t.
PIIIlPOK Of
MOlICtl Tu fulfill thl rtqulrltHnh of s.otlon ZlIlO of thl I""'rlt.nc, and Eltltl TaM Act, Act 21 of 1991. (12 P.I.
I"Hon 91ltO),
PAVPI!NTl Dlt"h thl top p~rUon of thh NoUCI Md .ubtllt wAth your ply..nt 'to thl R.,hter of Nll11 prlntld on the "\rlfll .1de.
--M'h ohlck or IIOO'~ order p.vabll to' REDI.TEI OF MILLS, AaENT
.FUND (CR)1 " refund of I hM Clredit, which w.. not r.que.ttel on thl TIM R.turn, "V b. rtqlHllttd by COIlPI,tlnt In "."lIcaUon
for Rlfund of Plnn.ylv,"la Inhlrltencl end E.tlta '1M" (RE~-IS1S). Appllcltlon. Irl ,vllltbla at thl Off'O'
of thll Ra.llt.r of Will., ..,y of thl n Rlv,nut Dlltrlot OffiCI', or by olUln. thl.pecl.l 2ft-hour
en....rl". s.rvlc. ~r' for for.' ordlrln" In P.nn,Ylvlnl' 1-.00~J62-2050, out.ld. penn.ylvanlt and
..Ithln 10ClII Herd.bur. It'll (717) 111-10.lt, TOOt (111) 772-2252 (....rln. I....lrtd OnlY).
DlJECTl0f4S1 "n'l Plrty In Inttrl.t not ..thflld with thl ."r.ItPlnt, 11l0"IIMI or dl..Uowlncl of deduction., or ........"t
of t'M (Including dl.count or Int.r..t) .. .hown on thl. Kotlcl .u.t obj.ct ..Ithln .IMty ('0) dI>>' of rlcllpt of
thlt NotlCI bYi
--written prot..t to the .." Dlplrt..nt Df ".v."...., 10lrd of ,pplll., O.pt, 21102:1, H.rrltbUr., PA 11121-1021, Ollt
-~lllctAon to h.vo the ..Uer d.tlr"ln.d It .udlt of thl "count of thl per.on.1 r.prt.entIUv., OR
--."..1 to tho Drph.".' Court.
ADMIN
IITRATIYE
CORRECTIONS I
PENAL!V.
FaotuII .rror. dl.coVlrld an thl. ......lent .hould bl addr....d In wrltlnt tal PI D.p.rt",nt of R'v,nue,
Iur'lU of Indlvldu.l "M", "'NI po.t .......ent R."I... Unit, b.pt. 280601, Hlrrl.bur" PA 1712.-0601
PhaM (111) 71"-650i, S.. p,,, 5 of thl bookl.t "In.truotlon. f",r tntMlrlttnCI hM Rlturn for I A..ldlnt
Decedent" (REY-liOl) for In uplllf\flt1on of _llllttrIUv.1Y correcUbl1 error..
tf ,"'I tlM due It p.ld within thr" (J) celender IIOnthM Ifter thl dlc.dlnt'. dt.th, . flvl perClant (IX) dhoount of
thl t.M ".Id It .11owed.
ThI llX t'M -.nt.tv nan-portlolp.tlan pon.ltv I. co.,uttd on the tot'l of thl t&M and 'nt.r..t .....i.d, end not
paid before Jenu.ry II, 1"', thl flr.t dlY .fter thl end of thl tlM .-ne.tv plrlod. 'hi. ~-p.rtlclp.tlon
plnllty It ."..ltbl1 In thl .... .lMIr Ind In the thl .... U.. "rlod II VOU IIHtUld ftPfHIIl thl t.lC end 'nter...
thlt h.. bean ........ a. Indlcat.d an thl. notlc..
Int.r..t I. Clhlrttd betlnnl", with flr.t dlV of dalln~Y, or nlnt (,) IIOnth. end one (1) dly fr.. thl dltl of
dlath, to thl d.t. of PIV.."t. 'llC" ..nlch blc... dllIn....-nt blfore Jlnu.rv I, I'JZ be.r Inter..t .t thl rltl of
.IM (6XJ p.rcent par ~ c.lcul.t.d .t . dillY r.t. of .0001", All talC" which bee... dlll~t an end Iftlr
JInU.rv 1, 1"2 ..Ill b..r Int.rl.t It . r.t. which ..Ill Vlry fro. c.llnd.r y..r to c.lend.r v.,r ..Ith th.t rlta
announc.d !:Iy thl P' O'Plrtont of R.".nue. ThI ."lIcllbl. Inter..t rete' for 1..2 through 199' ""
~ Inter..t Rltl DIllv Int.r..t F.ctor !!!! lnt.rllt Rltl Olllv Int.r..t FMtor
1.1l 20X .OOU.. 1917 .~ .000241
I'U l'~ .nOOltSl UI'-1991 11;( .00OSOl
...~ \IX .000101 ...' .~ .ooot~'
1"1 UX .000516 l"I-I~ 1~ .0001.2
1'16 m .00ot7~ 1"'-1'" .~ ,OO02lt7
--Int.r..t I. c.lculetld .. follaw'l
DISCQUrl'1
INlllll!l!.
I"TEIElT . BALANCE OF TAX UNPAID X NUNIEI OF DAVI DELINQUENT X DAILV INTElraT FACTDI
_4"''1 Hotlo. II'UICI att.r thl t'M blCHII d.U~t ..111 reU.ct an Int.r..t c..cul_Uon ~o fUtlen (IS) d.U
beVond thl dlt. of thl ........nt. If p.v-.nt I. aide Ift.r thl Inter..t caaputltlon d.te .hown on thl
Motl~l, tddltlanal Inter..t ...t be c,lcul.ttd.
~tt~ohmlnttolnven~
No, 1997,0066
Date of Death: June 30, 1997
Dept, of Revenue # 21.97-0660
E.tate of Elaine Loul.e Cavl.. Ceoll.ed
--
---
1.
Oecedent'l residence and lot, looated at 146 Boaler Avenue, Borough
of Lemoyn., Cumberland County, Pennavlvanla, valued per
ectuell8l. clOled on 12.16.97, per HUD.1 Settlement Sheet, being
groa8 prooaeds of I8la, before feel and cOltl
Ten 110) U. S. Serlel EE Sevlngs Bonds, with various Issua dates from
Decamber 1996 through April 1997, all with fece value ot .'00.00, valued
at .61,16 eaoh, per Intormetlon obtained online through the Federal
Reserve Barlk of New York
Waddell & Reed Flnanolal Servloes . United Group of Mutusl Funds,
eccount #1863679-6, IRA for the benefit of Elaine L. Davis, date of
death balance valued per Investor's letter
Weddell & Reed Flnenolal Servloes ' United Group of Mutual Funds.
eccount #1936138.6, date of death balanoe valued per Investor's
letter
2.
3,
4,
6.
Miscellaneous personal property in deoedent's residenoe, valued per
aotual sale
Members 1 st Federal Credit Union, share savings account #16388-00,
date of death principal balance, valued per credit union letter
Accrued Interest - Account #18388.00
Dauphin Deposit Bank and Trust Company, checking aocount .'3101744,
dete of death prlnolpal balanoa, valued per bank letter
Acorued Intereat - Acoount #3101744
Diamond rlng, valued par epprallal
Chem Law. Refund for lawn oare services
J. Jill Company. mall order oatalog refund
1983 Buick - valuad per ectual seles price to used car deeler
Refunds at settlement on sala of houae regarding real estate taKes:
a, CountylTownshlp real estate taK "
b, Sohool Dlstrlot real estata taK
Internal Revenue Service - 1997 Income tax return claimed
Erie Insuranoe Compeny . Refund on automobile Insuranoe premium
U,Q.I, Utilities, Ino. ' Refund on ges service
6.
7.
8.
9.
10.
11.
12.
13.
14,
16.
.67/000,00
611,60
36,919,26
11 ,985,78
3,413,72
125.40
.24
2,734.86
1.20
800,00
101.92
210.00
66,00
7,96
301,86
1,902.00
262,00
213,07
Total: """"",."",.,;' t , , , .' $ 126,646.66
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fiRST CLASS MAIL
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1.AW O'1,IIUUS
OOl..DBa.I{G. KATZMAN &. SHIPMAN. p,C,
]:10 MAMKl'.1' 8TReHT
8'rRAWIUUlRV 8QIJARH
I",U.POX 11ft"
IIAIUURDllRO, PltNNSV1.VANIA 1710..U68
TO:
Mary C. Lewis, Register of Wills
Cumberland County Courthouse
I Courthou.~e Square
Carlisle, PA 17013-3387
1,"11I".11I...."11,.1111.11,1111,111\.1...11."11
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