HomeMy WebLinkAbout97-00723
H105112 I'UN t1B!I
WE[ F(1t! 'THIS
CERTIFICATE $~OU)
WARNING: iT IS ILLEGAL TO ALTER THIS COPY on
TO DUPLiCATE BY PHOTOSTAT on PHOTOGRAPH.
COMMONWEAL Tli or- f'ENNf,YL,Vf,Nl^
UEPAATMH4l OF tlrMnt VITAL rn(:{Jlm~,
21-97-723
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT,NO.3560437
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Name of Decedent...~LAWr.€!n~g .S.We.ig~nl
ft'.!
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Sec~_.M~J.~._..,___Social SeclIlity No ._,Jll:2fi.:.6713.
Date of Birlh~~lY9!u1930_u 13irthplace ___._Dillsburg,. PA
Date of Death __..__~1L.__.19.9L...
Place of Death.. _.}jLl,l:.~,,~P i ri L HO$!lLtalCulI\berl~np-C(}. . East PennSb(H;q,;I,\'!t7;;,;;c,;-._-_~....f'.ll.nrl~YJ~<!nl.<!
Race~..MIti.te...__.....OGClIpatiofl :r1'.uck.-.lJl'.iv.er.-...~.------ ^"Tlod Forcos? (Yos 01 No) __~~.._.....___.
Ducodent"s
Marital Statos .....N~.v<lr.MaIT jildMailing Address "-;~;,9"1n..fil vd, ".f1flchan lcsburg..;fJtdlO&!;.......-..--;,"'....-........
Informant___.Har.old_F.
Name and Addross of
Funeral Establishment
.He igard
.... _ FUn(Hal Director
Scott D. Brenneman,..h-l}...-.~-.---_....-._-
Patt I:
Immediate Cause
,
I Interval Belween
: Onset and Death
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Other Significant Conditions . I
_.......l\..tri a 1 FJb.cUJ aUon_..____.__..__..._________-._____.__l.._~___.
.... GOCKUN.flJNERAlo-HOM~lHlls_burg; PA
17019
(a) ------\Jflper&a-s troin t-est+na4- .JHee1:li-ng"-'" -_.
(b) ..----.....SqlHllllOU-S-.. Gel-l.Cill'€4tlfHIla...of-.t'-lle-.e-wpnagu s
(c)
Part II:
(d)
Manner of Death
Natural P1XX Homicido
Accident tJ Pendin(l InveslIg,ltlon
Suicide [I Could not be Dotermined
Describe how injury occurred:
[I
[]
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Name and Title of Certfier _. n. Junn.Lf.er:.L__Cadiz....M..D._....._...m__
Address _.lQ..f-rJDuJ ..Rel ,. ~f)IIIQY.ll()LPA__jJJJljnL____..
---'---"- (MD,,-l5o., Coroner~"M:Ec).
This is 10 certify that tl10 information hore givon is correctly copied from an original certificate
cf death duly filed wlthm8 as Local Registrar. The original cOltlllcate will be torwarded 10 tho
State Vital Records Dllieo lor [wrrnanollt fili)1:/ '.... . _ .:""'..,, c... ..
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fOA OArEl Oft (lEA'" ArTER \21 '''' CHECIJ( 'U!J~E t
If A SPOUSAl, ..
1Jl'll .
FILE NUMBER
,
I j ,,)/)0 .< 'u')
INHERITANCE TAX RETURN
RESIDENT DECEDENT
eOlA~~mH.hl~Wl"WWWNI' (TO BE FILED IN DUPLICATE
HAAAIIR8~!j,~\I'.06OI WITH REGISTER OF WILLS eOUNlYeODE
OlelDINT'1 HAlAl (lAST, "RU. 'ND lAlDOlI IHm'L) OEeEOINn eO...Plln.OORESS
\lei ard Lawrenuo S. 9 H111 Boulovard
SOCIAllECUAITVHUlAUR O.TIO'OE.Tfi O.,IDFOIATIl Moeh.nlesburg, PA
177-26.6713 08/17/1997 07/09/1930
fiJ-Ir.:,JcI
ASV.llOOllC .(1.14)
A:I tv
r\~\ vll
Cumborland
21.97.0723
VF..R
17055
NU....ER
.0040UNT RECEIVEO (SIIINSlnUeTlONS)
0,00
Q' APPlIC.OlEISURVIVIHO SPOUSE'S N....E (l'S1,"RSI'ND ""DOLE INITI'l)
O,lglnol R.,urn
L1m1t.d Eltll'
--'---03. ~,;d.;'R;lu'n
(10' d.t.. 01 d..,h p,lo, 10 \2.13-82)
F.d...1 Eslal. Tn R.lu,n Requlr.d
Tolal Numb.. 01 Sol. Olpo,ll Do..s
2. Suppllmenlol Rei"'"
4.. FutulI Intertst Compromls.
(10' dallS 01 dellh efte, 12- 12.82)
Oecld.nt Died TlSlel. 0 7. Oec.d.nl Mllnlalned a Living T.u,1
(Ah.ch copv 01 Will) (Mach. copv of T,u,l)
C P ALL CORRESPONDENCE "'ND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
2 HA.Ir.4E COJ.4PLETE MAJlINO ADDRESS
~ D \1m. D. Schrack III Esq. Wm. D. Schrack, III Esqulro
I fi TElEPHONEHU...SER 12/1 II. Harrisburg Street
. T 717 4~2.9733 Dlllsbur PA 1'7019-0310
1. ROIl ElIot. (Sohldull A) 88 ,
2. Stockl Ind Bondi (Sch.dule B)
3. CIoIII)' H.1d Slock/P.~n."hlp Int....t (Schedul. C)
~, Mo~gog.. .nd Nol.. R.celvlble (Sch.dule D) (4)
5. C..h, Blnk O.po.lls & MI.cellaneous P...onll P,op.rty (Sch. E) (5)
.. Jolntl)' Own.d P'Op"rty (Schedul. F) (6)
7. Tran.I". (Sehedllll 0) (Sch.d"le L) (7)
.. Tot.1 G,o.. A...I. (total Lines 1.7)
9. Funeral EllpenslS, Admlnistrallve Costs, Miscellaneous
E'p.nl" (Schedul. H)
10. D.bl., Mo~g.ge LI.bllltl.., LI.n' (Sch.d"l. il
11. TolIl Deductions (toll I L1n.. 9 & 10)
12. Net Valu. 01 Eslal. (L1n. 8 mlnu. L1n. 11)
13. ChI,lIlble Ind Gov"nmenlll Bequeets (Schedul. J)
1~. NIt Vllu. Sub ect 10 Ta. (Line 12 mlnu. Line 13)
15. Spou.al Tran.f". (for dall. 01 death .fte, 6-30-94)
S.. Insltuctlon.lor Applicable P"c.ntage on pIg. 2.
(lnclud. values from Sch.dule K 0' Schedule M.)
15. "'mount 01 Lint 1~ taxabl. aI6~. ral.
(Include v.lu..lrom Schedule K 01 Schedule M.)
17. Amount 01 L1nl 14 ,..abl..' 15'10 I.t.
(lncl"d. valu..lrom Sch.dule K 0' Sched"la M.)
1.. P,lnclpel tax due (Add ta, from Lln. 15. \6 Ind 17.)
19. Credlt./Sp pov.rty P,Io, Plvments Ol.count
.20,000.00. 1,013.05
20. If Line 191. g,..I" Ihln Line 18, Int" the diff.r.nc. on line 20, Thiel. the OVERPAYMENT.
[fJ ~ IChICk h.r.11 you "" ..qu.stlng a refund 01 yollr OVllpayment.1
21. If Lint 181. g,,"t.r th.n Lint 19, ent., the dllf...nc. on L1n. 21. This I,'he TAX DUE.
.... Enl.. th.lnt"..t on tho b.l.nc. clue on Lln. 21A.
B. Enle' tho tolll 01 L1n. 21 .nd 21A on Lln. 21B. Thl.I' the BALANCE DUE.
Mak. Ch.ck Pa .blelo, R. 111" 01 Willi,... enl
~ .. BE SURE TO "'NSWER ALL QUESTIONS ON P"'GE UND TO RECHECK MATH ~ ~
Und., plNIU" ot p'fJUf)',1 dec .111 It IY.ln ntd th . IIluln, nc:. U(4 l"I9.cc:omPfrTf l'I9lChedu.I. Il'llmenll, I 10 1h, c.sl 0 rrr( now edge. I. t I · true,
contet and compl"I. I dICla,' th.I llll ,..I..,.tl hll betn '.porttd .llr\.MI milk., ",.Iut. O.cllraUon of pI.~r.r olh.r lhln lh. p'r.onal fllp""nl.lI"tl. bawd on Il1lnfolmltlon or
which pt'.pa'" hili'" knowledge.
S10N.TURE Of f~RSON RISPONSIBLE FOR FILING RETURN Harold F. \Ie 19ord --
?.5_~. Y!l.~g~F. .~~!'_~ - -........ - -.. -..... -' -..........-
lIe11svl11e, PA 17365
11m. D. Schrack, III Esquire
~~.It _ '!I:. .~!lF.J;:!~!>_,-!"g. .~~!:"~.~1;......... - - -..... -.....
-- Dl11sburg, PA 17019.0310
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None
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81,628.26
None
None
(9)
33,/158.44
(10)_
1,096.85
(15)
(16)
(8)
(11)
(12)
(13)
(14)
x
=
X .06 =
~
(17)
135,072,97 X .15 =
(18)
C
o
M
!
N
Interest
(19)
(20)
(21)
(21^)
(21B)
169,628.26
34 ,555.29
135 ,072.97
135 ,072.97
0.00
0.00
20,260.95
20.26Q.,2.?_
21 ,013.05
752.10
0.00
0.00
0.00
DATE
Er(5. ~--
O'TE
f.r~~. ;"4)
Act '41 ot 1"4 piovld.. 'tor the reduction 01 the tax rites Imposed on Ihe nel vllue ot trlnlters 10 or tor
the UN ot the lpoule. The rll.. II pr..crlbed by the stltule will be:
.s" (.03) will be Ippllclble lor ..tit.. 01 decedents dying on or alter 7/1/94 Ind belore 1/1/98
.2% (.02) will be Ippllcable lor esllles ot decedents dying on or alter 1/1/98 Ind betore l/l1if7
.1" (.01) will be Ippllclble tor ..tiles ot decedenl. dying on or alter 1/1/97 Ind belore 1/1198
.Spou..1 trlnsters occurring on or aller 1/1/98 will be exempt trom Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did d.c.d.nl mok. a "an.t.r and:
.. fllIln th. use or Income of the property translerred" .
x
..,.",....;.,..".."".,.... ,
b. rtlaln th. rlghllo d"'gnll. wh? .hall"..lh. prop..1y Iransf.rred or II. Inco""" . , . . . . , , , . . . . . . , . .
x
c. "Illn. ,.".rslonlf)' Int.rest: or . , . , . , . , , , , . . . . . . . . . , . . . . , , . , . . , , , , . , '," , , "
x
X
d. reo.lv. th. proml.. tor 111. of .lIher paymenl.. b.n.lII. or ca,,? . . . . . , . . . , . , . . . . . ,. . . , , . .
2. It d..lh occurred on or b.'ore D.c.mber 12, 1982, did d.c.d.nl wllhln two yea" prec.dlng d..lh
lren.ta, prllparty wllhoul rec.lvlng ad.qu'I' con.ld..ellon? It dtllh occurr.d after D.c.mber 12.
1182, did d.c.d.nt ,ran.for prop.rty within on. year 01 d.alh wllhout recllvlng ad. qual.
conslder.tlon? . . . . , , , . . . . , . . . . . . . . . , . , . . . . , . . , . . . . , , . . . , , . . . , . . , . .
.., "
3. Did d.c.d.nl own an 'In Irust for' bank acco"n'a' hi. or her d.alh? . . . . . . . . . . , . . , . . . . . . . . . . .
X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
CCl'V'lthl (0) I~ form ooflwlI'''~ CPSyoloms, I...
Form 1100 (Aw. ?-tl)
., ,-"
r-- _.. ..
.. u.n, IlEPAnTMI'1N' OF IIOU!I't1C1 _n.t lJno^HOCV[lOfllllr:Nf OMD ,,~. 1~'.OIl'
SI:TT~.tp.I^rr,M"Nr -- llhrruo
CORNERSTONE L ..,It'"~.
LAND TRANSFER, INC. --- --
0, 1Y~" OHO^N
5 West Moln Slrool -- :I.X I C(.lNV, lJNtN!l.
I.llfHA 1.IIFMtlA
Shlromonslown, PA 17011 '.IIVA I.' leom."".
, I 7,LoANNLIMnIiR:
D. fiLii NUMOOI1:
Phono: (717) 730.9004 Fox: (717) 730.9005 970503 5214016
t, Mom, INn, CACll tm.!
--------
C, NOlEllhl,'olm II luml.hacllo 01'10 YOII l\ .IllloUlOHlllf nclunl .olllomonl co.I,. NnOtmh pnld 10 lInd by Iha .olllemlfll.gonl II. .hown, Itlm. mllk.d
'(p,Q,Q,)' WI/a pnld ouhlclo thl ciolino; thay nro ,hown hOlo lor ~IOlIll.lloonl Plllpou,l\fld.,. nallnch./dad In 111.101.1..
0, HAMS ""to AODnll89 OF POnnowf:.n. E. N^Mf: ANn ^Dum:!l! o~ SELLon: F, ~lAM(! "'NO /IC>OIU!SB ClP LENDIIIl:
WII,LIIIM C. 'I'ROUTM^N R!l'l'h'rR Of' LIIWRRNCR 9. IIMIiRICII' 9 WIIOl.R9ALIi
WIRGIIRD, p.!D ' III1ROLD 1'. LENDRR
WRIGIIRD, ^DMINIS1'RJ\TOn 155 North /,nke Avonue
Pnnndena CII 91109
Q. rnOPEAlV LOCAlION: II. !If.TlUiMHNr ^O(!W: I. Sl!llLEMENT 0"1[:
9 IlILL I\OUI,EVIIRD SQ!\tlP.ltSTONP. LI\ND 'I'RJ\HSI'P.R 11/25/97
MONROE TOWNSIII P I'LACE or sum.IiMENT:
CUMDRRLI\ND COUNTY f> WEST MAIN S'rRR~'l' I S III REttjIlNS1'OWN PA
J. IUMMARY or nannoWER', TRANSAOTIO"I - K. SUMMARY or IlILlln', TRAtl,^ClloUl
loa. anon AMOUllT PUll FnOM DURnOW!1I 4nu,onoss "MOUtn DUIi TO SBLllln
10t,Conllnctl/tlolprloll ,UU (O-I.C:nlll/llcllnhnrlllclI- ---riuuuu,OU
IOl.lll1lSlInnl/lIl1ll1uIV .1I1.1'i1l1onnIIIlOpOI!y - ""'-
10l. UullloC!lonl chl'lr{lllslo lJOIIUWOI ltillu "IOU) 2669.15 40l.
104. (IH.
lot. 401.
^ltlullmanll lilt lluml rnld by lul101 in nclvllnoo ^dlutlrnol1l= 1001Iolr\s flnlcJ by SOUOI ~\ advQnco
lOO.Clly/lown l'~ ,. 4G4.Cllyllowll~~ "
!OP. COlN"Y I:.. H/.'/~?,.12nl/97 21.10 40P.Coynlylll. 11/25/97,. _12/31/97 21 . ~n-
-- -
lUll ^U"Uj'lIllltl ,,, (HlI.AUtlllllllH'" "
,0>. "('ltJ'll. IT71lfJ1l"I;:;1ffi7J117~1l --m;7;-;T7- 411U.1I('111.101, 11/25/9710 OG7'Jl17m! 'bb.4',
110. ,. 410. " --
III. 411,
Ill. 411, ,-
lto. ORon ""IOU'1T DUll FnoM DonnOWfin 91256.00 un,onOSS AMOUt/lDUI TO SEllIn 80507.65
M. AMOUNTS PAID DY on IU DEIIALP OF oonnoW4n 1000. RIDUCTION, IN AMOUNT UUB TO SELLin
fOl.Olflo'llorallfrlO61l1lonllY U8UO.OU UI.r;~OU' (lopo.1I (100 ~lIlfUCtlOIlI)
Ill', Pllncll111llllllUlIlll 01 HOW IoUII(S) 50!iOO.OO 'M.Sutllomolll chllt{ln, [0 laUu' (Iillo 11,001 U ;l\7r-
IfI"J. tlJllllil'lfJlo:l!l(s)lnkllllsuhltll:lln -- U~ Iixl'IlllU 1011l\('1Iilkllll.uhluCI10
~-- ~ut.l'IlYlllI 01 n'.GI MOII{lfl(JQ lWUl
....
... 14!t.PClyoll 01 !locolltl MIlIIgnu'looll
'"'' '"
lill. "',.
'IIR. '1111.
"~. r.ll'I.
^'I~lIhHO'II' IUf !IuII1:> ,",plll,1 by Ilullur ^ujulllllonl'lof IInlll'''lI1pnll.l uYlolloI
Ito.CllrlloWlIIU ,. ~IOCltylrowlllnll "
".. CO\II\I)' Ill. I. il I.Couut)' Lu ,.
"',Auou'nGnll ,. ~1.._AItOI""Qnll ,.
"3. IClIOOL " '13.1I1.'IOOl. 10
".. 514.
- -
fIl. ,,~.
'" !.1I1.
",. ",. q
'" 1,111
",. U'J --
- .. _..
IJli, TOTAL rAID BY/I'on DonnOWlin 59300.00 UO.10TAl nEDUCTiOIl AMOUtll DUE SELLIn 1318.00
~. CAlli AT nnLIMErll FnOM on TO DonnOWln Clon.CASII Al SIlnUMENT TO on 'nOM taLLER
MI, OIOllllCllOOll1 duo IflHlI UOIfoWltI (hllO I~O) 91256.00 liQl.Ufou GlllOlIlll duo II) .alhu (IIno ~:lO1 88587.r.5
~I Lan 1I1'IOI1I'l1 pllld tJyllar hOllowo, lilli' :!W) ~i~:rOQ."'OO Clol,lau ,nducllon flmOllnl duo ullo, (111'10 5~U) 1318.00
"..OASI~CO '~OMY(1)~P.~V. ~195G, 00 . ,.,C^"~IIXI TO) Jll fnOMI OCLLr.n 87269.65
., ,f /- I C;/'7"X!': . , ',. /U' /,'.1 r? ,I.
1-..-__
V '- V I ::b. U c::;) Ui) v '2:~
. c-O
PII'fOl ac Bouawo,', Sl\)IIalUIO
tolo,'.Glonnlulo
~
llUO, I nlW. tJDQ
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
SlV. 1I0U)(' (l.'7)
COM.~W",^,.worANIA
.ITATIO
Lawrence S. Weigard SSO 177-26-6713
08/17/1997
-own.d with RI hI of Su,vlvollhlp mu.l b. dl.clo..d on Sch.dul. F)
OESCRIPTlO'~
Automobile insuranco rofund
2
Harris Savings Bank - Certificate of Deposit 005-55-289191
3
Health insursnce refund
4
Magaz ine refund
Mellon Bank, N.A. checking account 1!140-070 - 5289
Mellon Bank, N.A. checking account 1!222 - 942 -7378
Mellon Bank, N.A. Growth Certificate UO-A05622-C
Mellon Bank, N.A. Growth Certificate 1!14-A61665-C
5
6
7
8
9
National Geographic - magazine refund
10
Reimbursement of real estate taxes - sale of 9 Hill Blvd..
Mechanicsburg, fA
11
12
West American - homeowner's insurance premium refund
.Public sale receipts
TOTAL (Also .ntor on IIn. 5, R.e. hulltlon)
(Anlch Iddhlonal8 112- . II' sh..ts N mort 'P"C' L, ",.d.d.)
Copy.ltlht (e)'''' 'lIfm IOflw'" only CPSy"...., Inc.
Pl.... Print or T .
FILE NUMBER
21-97-0723
VALUE "T DATE
OF DE" TH
55.62
3,665.41
92.75
5.50
41,989.75
366.13
6,556.34
5,552.27
31.17
587.65
132.67
22,593.00
. 81 620.26
'./m 1100 Schodulo E (R.d.'?)
.
'0 ~ :q '"
~I~h~ ij \0
0 CO ,..:
\0 ~
,...; N
~ W~~~ (~
..::..>
'" .... '<t ~ .... _ ..~ ~ 0
~!:l8 " ,...; '1 ~~o ~
0- :8 \0 ~~:;;~:%
00 It, '"
~~~Q "'" '0 ''1. ''1. ~' r;; 1;:: we t ~
- \0 '"
~ 0"- ... ' 888,1,<'1
~ U ....""
... Ill... 0 ~~!!!!!
li;~ j8aaaii
, 00000
'1'\ 0 .... III t''l3UUUUU
~&l;~~~ ~ 0 00
d d .,; 8 ::: , I I I I
.... e~
00 N ~\.:l~p
'0
~~~~~~ o .~
;:;~-:ll'ti' ';il
~ I ~ ~ .S
" ~~~!t
0 '0 '0 co ~ 15 .~ 11 ~
.... .... "1 '1 ~~~C~~~
~tJ "- 00 .,; '" '"
0 \0 R ~ i=l:ltl><l:l
0-" '"
~~~~E .... \0 '"
...
Po. ill -C l::H:l
~
,S
~!h i:;u~
~~ r; i '~ t i ~
u u u ~ .;.c ... '
() Q., C) C) VlVl ~
""I ~~ U u
I '~i j t
~~ ;:l; '0 ~ '" Vl~~ 0
cI. . 'I , ~ I I t I , I
.... '"
0 ~ 'i' ~ .
r!. ."
QO 0 0 0 lC~<h~!:!15
'tl 'tl 1. 'tl ..
~. .E' ,~. ~
'u ~ ~
~ ~ Cl
vi vi vi vi tJ
.. .. .. " ~
u I u I
~~ " ! ol:l
.. E..~..~
! ~
...l ~. .!l~6~.s1l
oS.'" oS 1Il
'ii .. .. Cl 1
'" 'i
0 Ji] 5 m
0
u
u \JBI'~l4J
0- co U -C
00 .... l.:i , 1
'" ~ '1'\ Cl..Olll Vl
81 'Q ~ '"
I \0 III , , , , , ,
0 N
~ ... .... U
:g ~ 0
"I 0 ~u~u~l!l
'" ~ , '"
... ~ ... u
-c:z. .... .... :<: Uo..OlXlo.Vl
.
AL
SETTLEMENT
.
SELLER NAME ~ 'J-:.-! cwJ~
1 IJiII ~,
/;;~-t.&<.(j-
LOCATION OF SALE 6)1 M '
~ .-.M~a-V
S. tU,V..,fj- a../.A'/,
DATE OF SALE
PHONE
/0/1 fr'/?
ADDRESS
(l/7-
ZIP
11v I 7"
AUCTIONEER
PHONE
0/) 1. ~ '3 8"/ S'-
:..;.....,
";
F, (. . .
,""
( SELLER'S EXPENSES")
(
. .RECEIPTS~ ...
'13PJ.t S// 'C ' ,,1b, ()(, ~ (:
PROFESS ONAI FEE .",~ (UJ/l41( :>.s-;-'
6;oc.,r: ,:AUCTIONEE (S~$ e:2S:/, 2.. ,
o<~, oelC> ''1.> <::"~v,,...... ,;t ~?o ..S-bO I "-i) : ',i
CLERK"" <J c.l>. $ 0(1) .:<. 00, I',.
,':: SD6 ~): (S-. . \C r ,"iJ ~- -"
.,'f ;2(1,,0 O,lTV CAS~R I PO $~" CJ ~ rrD ::~}
:1 (?;f,,,"u, IV tea.l~ 'f/'8'o, crv!..
:i, ()' OTHER EXPENSES I,
CASH
$. I '1'1~.t,(
$ ,< :3 , I ~. ,J~:<;
,"
CHECKS
"-I
.
.",'
a.'de/'.
$
!'(i
1",'1
~3(;. 7{) f:::;\
OTHER RECEIPTS .
$
$
$
$
$
$..
$
4'__ $
,../
.J',
".:~
,
,t.:
.,
0t ~.Ih'~f/& $
~;, f
$
$
$
$
$
$
$
- $
, '
TOTAL RECEIPTS
$
$ ..<"J~6~ -171 J--:'
.
$ :<.ti72.. (S-,
:"~2Z;S93(ClO i..
$ .. ..,.. ,
, , :' "'J"'_' I
,
,I
. ., ..,'. " ',~
',~J
"H'
i','
:,'!;
lESS TOT Al EXPENSES
'.,
..
~l EXPENs~:st:$ o?lf 7i)1 !JJ';; . NETPROCE~bs PAY~B';~',~6;'~K~~':
.:.. " !
'.
,,,:~ 'I; ''\,' I.' ' ..",. '.
1 lor we), Ihe seller, occepl Ihls selllemenl and acknowledge receipt of the obove specified net proceeds
from the oucHon of my goods and proporly sold on the above dole. I occepl oil responsibility for providing
merchanloble Iitle 10 all goods, and properly sold, ond for dollvery of IlIle to Ihe purchaser.
Auctioneer or Co,hl.r's
11/ 5-!~ 7 Dolo
~~4 ~ lLJ~ Oalo.a2if;.LE? /
(Seller', Slg~~
Dole
(Soller's Signa lure)
~FII.~'~ rnny
SCHEDULE H
FUNERAL. EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
RIV .11111~ . fI.U)
COMIllll\1r,m~g,WbYAN'A
ESTATE OF
Lawrenoo
ITEM
NUMBER
A.
..
C.
1.
2,
3.
4.
Pl.... Print or T .
PILE NUMBER
21- 97 - 0123
5. lIeigard
5511 177-26-6713
08/17/1997
DESCRIPTION
1
pun,,"1 Esp.nl'"
CockUn Funeral Home - funoral and intermont
Admlnllt..llv. COlli'
PI..onal Rlprl..nlltlvl Commissions
Soclll Slcurlty Numb.. 01 Porsonll Alpre,snletl.", 166 -12.5195
VI" Convnlsslons plld
Anornty F...
Wm. D. Schrack, III Esquire
Flmlly E..mplio"
Clllmanl
Addrlss of Clalmanl II d.c.d.nt'. d.ath
Stre.1 Address
City
Allatlon'hip
Stal.
Zip Codl
Probll. F...
Register of Wills
1
Mllclnlnlnu. Esp.n...'
Arlene Baker - care to docedent prior to death
2 Associated Products Services. rental of Port-A-Potty for public
sale
3 Cumberland Law Journal . estate advertisement
4 Daisy S. Ohrum Appraisal 5ervices - appraisal of 9 Hill Blvd. ,
Mechanlcsburg, PA
5 Expense of sale of real estato - 9 Hill Blvd., Mechanlcsburg, PA
17055
6 Expense of public sale
7 George Haar . auctioneer ser.vices
Total of Continuation Schedu1e(s)
TOTAL (Also .nl.. on line 9, AIel lIulllion)
(If more "p".. I. n..d.d, In..rt .ddlUonll .hOl'" 01 I.m. 1111,)
copy,,,.,t (c) 1M4 form IOflw." on~ CPSYIlemt, l~,
AMOUNT
3,420.98
8,481.41
6 , 500 . 00
263.00
250.00
88.00
60.00
275.00
1,318.00
2.472.15
2,070.15
8,259.75
. 33 458.44
Form 1SOOSch~u'. H(R.", 7.")
eEV. '~IZ IX. (I.'l)
~_~'..... _.~ _~;,;-O',,_, _
cO~lWmrtm4\<YA~~r'lYANIA
IITA Ta OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Lawrence S. Weigard SS# 177-26-6713 08/17/1997
--wEM
NUMBER
1
--
DESCRIPTION
Bell Atlantic - debt of decedent
PI.1t
AMOUN1'
9.13
2
Central PA Medical One Associates - last illness expense
6.45
3
Comfort Care - home visits
4
5
CPU Energy - debt of decedent
50.00
17 .57
50.88
962.82
. 1 096.85
TOTAL (Aleo enler on line 10, Reca Ilulallon)
(If more space Is n..ded, Ineart additIonal sheels 01 same sl.a.)
COfI'I'lth' (c) '"4 tormlattw.,. only cpsv,tt"", Inc.
Holy Spirit Hospital - last illness.expense
6
Mary Murray, Tax Collector - school taxes due
form 1500 s.hoelule I (eOY, '-'l)
.~..-...:, 'FLr~.~~P\\-';'+~i';,';;:'~'"" ",~~,
IN RE: ESTATE OF
LAWRENCES. WEIGARD
DECEASED
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-97-0723
RECEIPT, RELEASE, REI<'UNDlNG AND INDEMNITY AGREEMENT
CONCERNING INITIAL DISTRIBUTION FROM ESTATE
THIS AGREEMENT, made this ~ay of A1A-R. ClI, 1998, based upon the
following circumstances:
1. LAWRENCE S. WEIGARD died Intestate on August 17, 1997. and Harold
F. Weigard, qualified as Administrator of his Estate.
2. Each of the general Beneficiaries has received an acce.ptable accounting of
the disposition of the assets of the Estate, and desires that the distribution
of the assets of the Estate be made without the formality of an accounting
in the Orphans' Comt Division of the Cumberland County Court of Common
Pleas, and the Administrator is willing to make this distribution upon the
execution of this Agreement.
3. The Beneficiaries desire to forever settle and comprornise any and all claims
and rights which they may possess. now 01' hereafter, in the Estate and to
confirm their acceptance of the Informal Account (the "AccOUht"),
r
CONSENT TO REcmn, RELEASE
REFUNDING AND INDEMNITY AGREEMENT
s;..ONCERNING DI~Rnn)TION FR9M ESTATE
THE UNDERSIGNED, JANET M, IIOFFMAN, II Beneficlllry of the Estllte, of
LAWRENCE S, WEIGARD, decellsed, hereby c,onsents to the Receipt, Relellse, Refunding
IIlld Indemnity Ag.cement Concerning Distribution From Estate, II copy of which hilS been
provided to her. The undersigned also IIcknowledgcs receipt of her share of the Estllte, liS
more pllrtlculllrly dese,ribed In the IIforcsaid Agreement, including the Schedule of
Distribution, subject to 1111 the terms IInd conditions specified therein., '
) / " - ;,/ //;'
/(.7 ~t (', ) l;' }1"" Y7'vr d'''--
, JANET M, 1I000'F,Mj\'N
rt. ,c,-d' ,lis; '" 4 ~, ..1 a " 3
STATE OF
Plor,d",-,
SS,
COUNTY OF L~.(..
_, 1998, before me, a Notllry
On this, the I '1 ~ ~ny of
MavJ.,
,
Public, the undersigned officer, persol1lllly IIppellred JANET M. 1I0I"FMAN, known to me
to be the person whose nllme is subscribed to the within Instmment, IInd IIcknowledged thllt
she executed the Slime for the purpose therein contained,
IN WITNESS WIIEREOI''' I I\lIve hereunto set my hllnd and Notllrilll Sell\.
N6T~~P~B~I~,,"Q,~,-~
----. \
""';:;::'\:':"" ",,' MICiElA BOWLING
~i,'~",'I,"""')'ii MY{l!lj.W:,\",.~IO,tl ~(,;r. 403B84
~. :""1,' !. , I '( ,It: I '>;;11, 'l\t:"! f, I !)I)ll
I ..".' -',
.,.' ,,;\ ';"li\I';.\, 1),111,>1'-'11\[1,1'>
~...,~.,_.,""',." - -- ._,-~.."......-..._...'.........---
COMMONWIALTH OF PENNSYLVANIA
DIPARTMINT OF REVINUE
/6--- :;tYJ ......'S..
IUREAU OF INOIVIOUAL TAXES
UK.HANCE 'AN OIVIIUON
Dt:Pt. 2.0601
HAARISIUAO/ PA 111lS'0601
~
NOTICE Of INIlERITANCE TAX
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF OEOUCTIONS AND ASSESSHENT OF TAM
DATI
UTATE OF
DATI OF DEATH
FILE NUMIER
COUNTY
ACN
05-18-98
WEIGARD
08-11-97
21 91-0123
CUMBERLAND
101
WM D SCHRACK III ESQ
124 W HARRISBURG ST
DILLSBURG PA 11019
*
UHu,t.."U,.'"
LAWRENCE
S
t- - AMount RoMlthd j
-- --
----------..---.-
( I CHANOED
111_
(21
(51
(4)
(&1
(6)
(71_
88.000,00
.00
.00
,00
81.628..li.
,00
.00
(II
MAKE CHICK PAVABLI AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINI ~. RITA IN LOWER PORTION FOR YOUR RECORDS ~
iiiv:i54-j-ix-Aj:ji-nIF9'ri-iioi'-icr-oF-YNiiiiiifANCi-YAn-PPRAiiiHEiir;-ALIoWANCnili---------------n
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WEIGARO LAWRENCE S FILl NO. 21 91-0123 ACN 101 DATE 05-18-98
APPROVID DEDUCTIONS AND EXEMPTIONS I
t 33,458.44
9. funeral E)(pan.../Ad... COI ,/Mhe. Expan... (Schedule H) (9)
10. Oebh/Hortgaga LlabUltlu/Llenl (Sohadul.. II (10) 1.096.85
n. Total De_Uonl nil
12. Nat Valua of Te. Raturn (121
1S. Charitable/Goyern..ntal ..qu..ta; Non~.l.ct.d 9113 Tru.t. (Schedule J) CIS)
14. Net Valua of !It-ta Subjeot to To. n41
NOTII If an .....I..nt wa. i..u.d pr.viou.lY, I1n.. 14, 15 and/or 16, 17 .nd II
rafl.ct figural that inalud. th. total of ~ r.turn. a......d to dat..
ASSISSMINT OF TAXI
1&. .Mountof line 14 .t Spou'.l rat.
16. AMount of Line 14 taxable at Lin..l/CI... A rat.
17. AMount of Line l~ taxable at Collateral/CI... 8 rat.
11. Principal Ta. OUO
TAX CRIDITSI
PAYHENT
DATE
11-03-91
TAX RETURN WAS I (X) ACCEPTEO AS FILED
RISERVATION CONCERNING FUTURI lNiiiiST - SII RIVERSE
APPRAISID VALUI OF RETURN BASED ONI ORIGINAL RETURN
I. Raal Eobte (Schedule Al
2. stock I and Bondi (Schedula .)
S, ClolO)y Nald Stook/Partnerlhlp Interut (Schedule CI
4. Hartl..../Not.. Rloeivable (Sch.dull ~)
I. C..h/8Ink D'POlltl/"llo. Parlonal Property eSchedull E)
o. Jointly Owned Proporty (Schadula FI
1. Tranaflrt (Sc~.dul. G)
I, Tobl A..ah
RECEIPT
NUHIER
AA242429
OISCOUNT (+ I
INTEREST/PEN PAlO (-I
1,013,05
CISI
1101_
1171
,00 X .00.
~. X ,06.
135,012.91 X .15.
I1IJ
NOTE I To lnlur. proper
crldit to your Icoount,
Dub.it the upper portion
of thll fora with your
tax ply..ent.
169.628.26
lta.lilili 'II
135,012 .91
,00
13,5,012.91
will
,00
.00
20,260,95
20.260,95
21,013.05
152.10CR
,00
752.10CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL OUE IS LESS THAN .1. NO PAYHENT IS REQUIREO.
IF TOTAL OUE IS REFLECTEO AS A "CREOIT" (UI, YOU HAY IE OUE
A REFUNO. SEE REVERSE SIDE Of THIS FORH FOR INSTRUCTIONS.'
AHOUNT PAlO
20,000.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
rw ~ ~f
g"
") , ~
<<, ~~t (;I
f\! OJ l1,'
b .~ n.
N
-
C" -~I'
c.," ?ill ;;'~
J ~ =;;t J
~_f~ - Iii
~ Q.
~ ICl
RESERVATION. E,.,t.. of dittdlnt. aVln. on or be'or. DIC.-b.r 11, 1911 .~ 1f InY future Int.rl.t In in. I...t. II 'rlnlf.rr"
In ,......ton or 'nJoy..", to Cl... I (coUe',rll) bentHoS.rilla, tn, _Ment .ft.r tha IMP1"Uon of My ..te.e for
11f. or for Vllr., \h'COMonw..1th~rHY IMpr...h r...r..... t~ rllht to .",.11. Md ...... t,.".,., InhlrltlnCll TIM"
It the '.wful Cl... I {coll,t,rel)r,', on .ny .ueh future In..r..t.
PIJRPO$E Of
NOTlCEI To 'uHUI tn, r.qulrlHntl of Slctlon 21\0 of the Inherltenu Itnd E.t,t, "1( Act, Act 21 of 199i. <72 P.I.
Slotion .litO),
PAVttEN11 D,tlch thl top portion of 'hll NoUcl and ,ubllllt wUh your Plv..nt to thl ..,liter of NUh Ftrlntltd on thl rl....r.. .IH.
--HIlk. ClMck or eonlY order payabll tal REalSTER OF MILL., AGEMT
REFUND (C'U I A rlfund of . hM crldlt, Nhlch ...1 not r.quelted on the T'M R.turn. ..y b. r.que.tld bv ClOllpI.tlne en "&,.,lIc.t1on
for Rlfund of P.nnlvl"ltnl, InhflrltlM' end Elt.t. TIM" (RfV~UIU. .",pllc.tlon. Ir. .".Ulbl1 It the DffiCl
of thl RII1thr of WHI., IInY of thl n R.venul 01ltrlct Office., or bV c.lllng the IPlol.1 Z4-hO\lr
1n.....r1nil ..rvlcl nutlblrI for forlll or.rlngl In P-"'v!vllnle 1.'00-S6Z~2050, out.lde "IMIVhlrll, IN1d
..lthln 10011 Hlrrhbur, .r., (717) 717-1094, TOOt (111) l1l~ZZSiZ (....rinjJ 1..,llr.d Only).
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OIJECTlDNlI Anv P.,.tv In Inter'lt not .,thU.d ..Ith the apprl.....nt, ,UOWIn<lI or dhlUOWIWWII of NducUon.. or ......lIInt
oftlM (Including dlloount or Int.r..t) I' .hown an thle Notlcl llU.t objlct within .lMtv (60) diU of recll,t of
thl. NotlcI bVI
--..tlttln protl.t to t". PA Dlplrt.."t of ~I"'nue. Ia.rd of AppI'lI, Dept. lllOZ1, H.rrhburl, PA 17lZ'~lOZI, 011I
ul'lcUon to hllVI the ..tter dltlrelnld .t wldlt of the MCOunt of thl Plrlonl' rtPrltlnt.UII., OR
~~IIPP,'l to the Orph.",' l:ourt.
AIIIIIM
IITRAlIY!
CORRECTlONSI FlOtull .rror. dllco"lrld on thl. ........"t .hould b. .ddr....d In writing tal PA o.p.rt-.ntof AI"lnue.
lurelU of Individual '"'0(1.. ATTNI Po.t h......nt Revll" Unit, D.pt. Zl06QI. Hlrrllbur,. PA 1712'~0601
Phone (117) 787-6S0S. SI' p,,, S of the bookl.t "In.tructlon. for Inh.rltanol '1M Rlturn for. R..ldlnt
hold.nt" (AE\I~l!iiOl) for In IMPlllnlUOn of IIdltlnhtretl"ll't oorrlot.bll .rrorl.
DISCOUNT I
If InV tlM due It Plld within thr.. U) otlendlr Mnth. Ift.r the d'Clldlnt'. de.th. . fl"l p.ro,"t (SX, di.oount of
thtl t.M PIld Is .Uowld,
PfNAlTYI
TM lliX hM ..,..tv non~pertlclp.tlon pen.1tv is ONpUt.d on the tot.l of n,. t.1l Md InUr..t ......ed. 1M not
Plld blforl Januery 18, 199', thl' fI"t d.y .fter thtl .nd of thl h. .Mllt)' p.rtod. Thill non-plirUelpltlon
Plnll tv h 'PPIII.bl. In thtl .... lIlanMr II'ld In tt,e the .... till' p.r lad I' ~ou ..ould IPP'" thl tiN end tnter..t
th.t hi' bl.n .......d .. IndICl.t.d on tht. notlcl.
.IMTEREIl.
Interllt It chlrlltld b.,lnnlng with flr.t d.~ of dellnqulncy, or nln. (9) IIOnthl and one (l' dill' fro. ttMI date of
.Ith, to thtl dlt. of pI'lI..nt. TIM" NhlClh b.e... dtllnqu.nt b.fore Jenu.rv I. I9IZ be., Int.rut It thl rltl of
.1M ('X) ptrolnt per IMUII o.lcul.tld It a d.llv rllt. of .00016~. All t'lClt Which blc", delinquent on end .U.r
Jlnu.rv I, 1912 NIII bllr Inter..t .t . r.tl Which ..Ill "Iry frol e.l.ndlr v..r to e.l.ndlr 'lI..r with thlt r.tl
lMOUf1cld bV thl PA Dlp",'..nt of R.v.l\UI. Th. appllc_lI Int.,..t ret.. for 1'12 thtOtJIh 199' eral
US!: Int.r..t R.t, Dltlv (ntlre.t f.r-tor !!!r Int"..t A,t. Ollllv Inter..t factor
191Z ZOX .00051\' 19.7 91- .000llt7
1911 \6X .000'" 1911.1991 11% ,000101
19M 11% ,0nnOI ..., .~ ,0002-'1
19t~ lSX .000U6 1991-199~ 7~ .00019Z
1916 lOX ,00021tt 1995-199' .~ ,000Z..7
--Intlt..t il oalcul.t.d .. fol1owlI
INTEREST. BALANCE OF TAX UNPAID X NUNIU OF DAYI DELINQUENT X OAILY INTEREIT FACTOR
.~Any Notlc. Is.uld .ft.r the tlM blcau. d.lInquent ..UI reU.ct an Intlrllt Cl.IClUlltlon to flft..n <1S) dev.
blyond the date of the ........nt. If pl)'..nt i, udI .ft.r the tntlrllt oo.,utltlon dlte .hown on thl
NoUOI, udltlon.1 Int",.t w.t be o'ltulat.d.
PA_,
DttlMlh the top portion of thit NoUoI ... .w.H _Ith your P.~t ... PIIw.tlll to the'MM! I!id.edd,....
,rlnted an ttM rever.. I''''.
If REIIDI!NT i1ECEDI!NT ..... ...... 0' _. o,do, .....,.. to, REOISTU OF WILLa. AOENr.
If ......-RESIIlENT D1!CEIlENT .....ohock 0' _. o,do, ......1. to, COlttONNEALTH Of PEIIlSVLVANIA.
IRl'FlMD (ctth A refUnd of . tll( oredit, which w.,. not r.que.ted on the 'II( R.,turn, ..y be ".qullted by CCMIp.taUna ~
"Applloatlon for ".~ of Pennl:rlvenl, I~rltenc. ~ E,t't, TIM" (REV-ISIS). Application. ara avalllbl. .t
the 0"10. of the keeleta,. 0' Willi, eny of t~ 25 RlvlnUe Dlltrlot O'flo.. ur fro. the o.partlent'l Z4ahour
~swer'", ""vIOl ~r. for for.. or~rlngl In PennIYlvenla l-laOaS614Z0S0, out.l~ Penn.:tlvInJ,
end within loca. Herrllburl Ir.1 (7.?) 7"-'09~, TOO' (117) 712-2252 (He.rl"l lipelred only).
REPlV TOl eu..tlon. ,...-"dlng ."ror. contained on thl, notlee thould be ~r"'ed tOI PA o.plrt-.nt of Aavenue, lur.~
of IndiVidual TIM", AITHI Po.t ,....-..nt Review unit, Dept. Za0601, Hlrri.burl, PA 1712'-0601, ~
(711) 7'7-6505,
DISCOUNT r
If tny tlK ~ 1. paid within thr.. (5) oal~.r ~th. aft.r thl deo~t.. de.th, . flv* percent (5XI dl.count
of the tlKplld 1. .11~.
'PENALTY,
The IS~ tlK -.n..ty non-Plrtloipatlon peRllty I. co.put.d on thl totll of the t'K and Int.r..t all"'ed, ~ not
paid before January la, 1996, thl flr.t day .ft.r the end of thl t.K aane.ty parlod,
INTEREST I
lnt.r..t II cNIriH bellnnlne with Urat day of delinquency, or nine (9) IIOIlth. and one (1) dIIy frOll tht d.t. of
"th, to tht date of PIYNnt, TIIC" which bee... deUnquent before ~rY 1, 1912 bHr Int.r..t .t the r.t. 0'
.i~ (6XJ p.rcent PIt ~ cllculated It . dilly rat. of .OOOI6~, All tllC', whloh bee... delinquent on Ind a~t'r
Jenyary 1, 1912 will bear 1nt.r..t at a rat. Which will v,,,y frOll c.l~,. year to oalena.r y..r with that rata
*AnoUnoad by the PA o.plrt-.nt of .avenu.. The IPPllcabla Intar..t rlt.. for 1"2 through 1991 .rl,
V.., lnt.rl" Itat. Dilly lnt.ra.t factar ..., Inta,...t R.t. Dally Intara.t '~tor
'NZ !Ole ,OOO54e 1987 9~ ,OOG2~7
'N. 16~ .00001 1'''-1991 11:< .000501
..... .U .OIISOI '99' 9~ ,0102'47
1915 U~ .'10556 1995-1994 ,~ .0!J0192
1916 1O~ ,01'27. 1995-1991 9~ .0002'47
-.Int'rllt h aalcul.ted .. fall..,
IN'tlllBlT . IALAllCE OF TAX UNPAIO ~ NUlllER OF OAYS OELINIlUENT X DULY INTEREST FACTOR
-~,"y Notloa I.sued .ftlr the talC bec~. dlll~MM1t ~III rlflact en Intlr..t cIlcUI.tlon to flft-.n (11) dI~.
lNIyond the dlta of thl ...........t. If p.y...,t It ... aft'r thtl intar..t c~t.Uon dIIt. eno..n on the
Notio., ~Itlonal 1nt.r..t au.t be aalaul.tad.
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