HomeMy WebLinkAbout97-00739
PETITION FOI{ PROBATE and GRANT OF LETTERS
No, __~.::L1~7~9
To:
Evllllr of _~a.J<i.&-k,-JI"CJ.ow.
also known (IS _ .'. - -.--
Regisler or Wilh 1'01' the
[h'('I'IIS"II, COUul" or Cumberland in
Social SrwrilY No. [7!l-tJ5-tTm, Comn;onweallh or Pcnnsylvania
The petition or the undersigned respcetrully represcnts Ihat:
Your petitioner(s), who is/K~ 1 R years or age or older an the exeeut ri x
in the last will or the above deel'dent, daled March 27
:lIld emlieil(s) dated ___________ .---------
the
---------~~--.--------_.,_.
named
, 19...91...-.
{..trolt.' rl'lI'Vallll.:irCIlIll\t:lllCl''', t,',g. rellunciation. lkalh of C~CClllor. CIC,)
Deeendent was domiciled at death in Cumberland
h er last family or principal residence at Claremont Nursing
of Cumberland County --frl,iJ)':~iESE'I- Tli,iP
(thl \[fl'rl, IItll11hcr :!1Il11111111cipalilY)
County, Pennsylvania, with
and Rehab Center
I)eeendenl, then 85 years or age. died _~gl!_st 22 ,19 97
at Claremont Nursing and Rehab Center of CumbWllJ1d County
Except as rollows, decedenl did nol marry, was nol divorced and did not have a child born or adopted
arter execution or tw; will orrercd 1'01' probate; was not Ihe victim or a killing and was never adjudicated
incompetent: one
Dcccmlcnl at death o\\'llcd properly with estimated valucs as follows:
(II' domiciled in I'a.) All personal properly
(If not domiciled in I'a.) Personal properly in Pennsylvania
(II' nOI domiciled in Pa,) Personal property in County
Value of real estate in Pennsylvania
situatcd as rollows:
$ 4,250
$
$
$ 65,000
WHEREFORE, petitioner(s) respeelrully request(s) the probale or Ihe last will and codicil(s)
presentcd herewith and the grant or letters Testamentary
(ICS[al'l~'III:UY; auminislr:ltion c.I.a.; :Iuministratioll d.h.n.c.l.a.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF Cumberland f ::;s
The pelitioner(s) above-named .",'"n'(s) or aITirm(s) thai the statemenls in the roregoing pClition arc
true and correct to the best of Ihe kllowledge alld belieI' 01" l1etitioner(s) and that as personal represen-
lativc(s) or the above decedent pelilioner(s) will well and truly administer Ihe eSlate according to law.
S\V~1rI1 to ~r alTinm'd allll sabseribed ~.---1JhAd /} t._, , '"
bel ore 111e I~"S rd-__ day 01 = ~ ~'
~~ _"'<~~ t.tL:MlhcJJ/ : ' ~
. { rJr't CLewis lIeRisler B:
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This i'i (0 (l.'r1if}' lhill tht..' Illfmm.llioll IH:ll' ~i\'el\ l.. l'onl'lllr lIIpi(.d frlllll ,111 IIngin,d U'n if 11..-.11 l' Ilr dl'.lIh dilly tiled Wilh 1I1l' a~
1.0GII It"l~i'ilri1r. Thl' origin.11 Ll'r1ifit..<lll' will hl' I~lrw;mkd III till' SUll' \'iLl! Hl'~ Hid.. ( lHiu' I~lr Pl' 1"111 ,1111..'11 1 tiling.
WARNING: It Is Illegal to duplicate this copy by photostat or photograph,
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4563633
____-"J\UL2_~ 1997
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CO....ONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
HANEOF OEC(DlENTlh....."..l~
,. Maida L. McClow
AOE~~ tJtlOlR1'ftM
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an.19,191 Shamokin,PA _0 _0 "",0 ::::old" _0
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DE DOW QClOlIUSlHE rmw
~~~~~~ New Cumberland
round Hostess Air ort
~'YAlLIGADDAE"CSlI_~.51111.~COdII DECEDENTS
375 Claremont Drive ~~
Carlisle, PA 170 13-8805 ~..:..::'"
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MIlfVl..NAWE(Fnr.......LIIl)
, Charles Diehl
1NFOf'MAHT........(T~
Donna D kema
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II. Bessie Zimmerman
1NF000000rs YAlUNOAOOAESS~ClyIboft. sa..r.,~
347 Po 1ar Road, Dil1sbur , PA 17019
1'LACC000l$PClGITI0tt........atc.n.eery.er..-., LOCRION.~"'.ZIpCooe
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,hamokin Odd Fellows C .. Shamokin, PA 17872
-~=M~~ FH 408 3rd St New cumberd~g;9A
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W'S CASE AUEAAED TO MEDICAl EXAUlNERICOAClH
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LAST WILL AND TESTAMENT OF MAIDA L. McCLOW
I, MAIDA L. McCLOWN, of the Borough of Lemoyne, County
of Cumberland, and state of Pennsylvania, being in good bodily
health and of sound and disposing mind and memory, and not acting
under duress, menace fraud, or undue influence of any person
whomsoever, merely calling to mind the frailty of human life,
and being desirous of disposing of my worldly goods while I
have the strength and capacity so to do, I do make, publish
and declare this my LAST WILL AND TESTAMENT. I hereby revoke,
cancel and annul all my former Wills and Testaments, including
codicils thereto, by me at any time made, and declare this alone
to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME WITH
IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1. I direct that my Executors hereinafter named pay
and discharge all of my just debts, funeral and testamentary
expenses.
ITEM 2. I order and direct that I be buried in a lot which
I own, situate at the Odd Fellows Cemetery, Trevorton,
Pennsylvania.
ITEM 3. All the rest, residue and remainder of my entire
estate, wheresoever situate, and whatsoever it may consist of,
I give, devise, and bequeath, absolutely, and in fee, to my
dearly beloved Daughter, DONNA DYKEMAN. In the event my dearly
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beloved Daughter dies with me in a simultaneous disaster, or
fails to survive my death by sixty days, then I give, devise,
and beq~eath, my entire estate, wheresoever situate, and
whatsoever it may consist of, to my dearly beloved Son-in-Law,
JAMES A. DYKEMAN.
rn ~ Q.. ;f 1n c..d...v-
MAIDA L. McCLOW
1
tI .' J.
. .
.
ITEM 4. I nominate and appoint DONNA DYKEMAN as Executrix
of this my Last Will. Should the Executrix named fail to qualify
or cease to act as Executrix, then I appoint JAMES A. DYKEMAN
as Executor in her stead.
ITEM 5. I direct that my personal representatives, as
well as their successors, shall not be required to give bond
for the faithful performance of their duties in any jurisdiction.
ITEM 6. I direct that all estate, succession, legacy,
inheritance or other transfer taxes, however designated that
shall become payable by reason of my death in respect of all
property comprising my gross estate for tax purposes, whether
or not such property passes under this Last Will, shall be paid
by my Executor out of my residuary estate.
ITEM 7. I grant to my personal representatives herein
named, in addition to, but not in limitation of those powers
vested by law, to be exercised without prior application to
or approval of any court, the power and authority to retain
indefinitely any property, to invest and reinvest any assets
or the proceeds derived from the sale of assets, although said
investments may not be of the character prescribed by law, to
sell, convey, assign, transfer and encumber any property, to
pay, settle or compromise all claims, to make distribution or
divisions in cash or in kind, and in general to exercise all
powers in the management of any property hereunder which any
individual could exercise in the management of similar property
owned in his own right, and to execute and deliver any and all
instruments and to do all acts which may be deemed necessary
and proper.
I--n <<J... ';t /J, < cL.v-
MAIDA L. McCLOW
_______________________________END-------------------------
2
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COMMONWEALTH OF PENNSYLVANIA
SS"..
COUNTY OF CUMBERLAND
I, MAIDA L. McCLOW ,TESTATRIX, whose nome is
signed to the attached or foregoing i.nstrument, having been
duly qualified according to law, do hereby acknowledge th~t
signed and executed the instrument a,: my [,M;T WILL: th.]t I
signed it willinl]ly: and that I signed it as my I.re(, ilnd
vQJ.lIntary act for the purpose thcr0in e:qH,,,;sed.
Sworn or affirmed to and ackn()viJ"d'J"o] hefor,' 10",
by
MAIDA L. McCLOW
I the 'rE~;T^'l'Hr:-:, t:~li!: 27t;J1 ~l.!','
Qf
March
J.992.
~. NOTAnIA'- ~cAL
.ATIORNEY JAMES \'. ,~Cf'. I "ary Pubbc I:
11 CUl'f'.tt!'I~l'lt (":':IJ 1,
. My Commi""n [,p"" May 13. 1995 "
___ .__ ___dfr~
N /lEY PUBI., rc
.1r.chanic~:bllrq, P/\
'I Commission '""p"'" 5/13/95
The preceding instrument consisting of thi" and t\-IO (2)
other typewritten pages, identified by the :>i<]niltlll'''' of 1:1",
'rES'l'lI'rRIX, was on the date thereof signed, [lubl ish,;d ,H,d
declared by MAIDA L. McCLOW ' the 'l'ES'I'/I'rRIX the,." i n nilm'-',;
as and for 6er LAST WILL AND TESTAMENT.
~B~poaj
GLADYS B. S RAMELLI
Res id i ng at 352 S. Spar t i~SLtl_iJ-_L_Y()9ri
Mechanicsbur<], PA 17055
~A/ ~L'
CH . FORT!
Residing at 352 S. sport~~.~::,~0
Me c h ani c s bur _9-,-- P r,___lc2.9.". c,
A F F I D A V I T
COMMONWEALTH OF PENNSYLVANIA
~;s
COUNTY OF CUMBERLAND
We Gl.ADYS B. SPRAMEl.l.1 and ______.CJ:tRLS."FORU . t.i,'
witl10sses whose names are signed to the oU.i1ched 01: [oce<]"; "'J
instrument, being duly qualified according to la~', do c1"iV).;" .-",,1
say that we WC1:e present and snw 'rES'l'ATRIX ~ji9il and (~;.:ccut>-' :\1'"
instrument as her LAS'I' WILL: that she signed "ill; rl'Jly iln<l tic,,': ,';;"
executed it as her free and voluntary act [or the P'I[POS,: t.1:o.:1:';';:"
expressed; that each of us in the hearing and sight of thn
TESTI\'l'RIX signed the HILL as witnesses: and that to l:h(e !",,;I: 01 (,Ut
knowledge the TESTATRIX was at the time 18 01: more 'leafS of ag0, of
sound mind and under no constraint or undue influence.
S'tlorn Olr n.E[irmcd t() ~nd subscJ."i:j;;...;d t() \-J{~ecl;:.; ;j,(-':
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GI.ADYS B. SPRAMEI.I.I
CHR I S FORTI
~ witnesses, tllis
and
27th day of
March
, 1992.,
~,.... NOTARIAL SEAL .
'ATTORNEY JAMES M, BIIClt Notary PiWlio
Cumberland County
" My Ctrnmlssion E.pireo May 13. 1995
~
'N RY PUBLIC
chanicsburg, PA
My Commi',ssion Expires: 5/13/95
3
21-97-739
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COMMONWE:ALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG. PA 17128.0601
RECEIVED FROM:
,-
LINUS E FENICLE ESQUIRE
10 S MARKET SQUARE
SUITE 500 POBOX 1265
HARRISBURG, PA 1710B
FQLDHER[
ESTATE INFORMATION:
FilE NUMBER
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
J~:J~~
~
NO. f\I\ 2 4 2 4 4 5 REV "62 EX 1",'6,
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
l01
'lfO':l I n(H-j no
FOLD HERE
SSN 178-05-2106
(FIRST)
(Mil
21-1997-0739
NAME OF DECEDENT (LAST)
MCCLOW MAIDA L
DATE OF PAYMENT
11 /12/1 997
POSTMARK DATE
0/00/0000
COUNTY
CUMBERLAND
DATE OF DEATH
REMARKS DONNA DYKEMA
C/O LINUS E FENICLE ESO
SEA~HECKIl NO CHECK II
------ - -- ~- -- - - --- ---
TOTAL AMOUNT PAID
$3,000.00
DO
HcC.:,; [r~Fi OF \.....~iL'_S
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DEPARTMENI OF REVENUE
DEPT,21lO601
IlARRISBURG PA 17118 0601
DlCtOlNI'5NMlL lLAST. Il<<SI.ANOMIDOL11N1IWI wil\lldlu.IlkJ(~Iu!>lV."'hIWl..1h
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
21
1997
0739
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IllE NUMBER
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McClow, Maida, L.
SOCIAL SlCURllY NrUM6[1( I IO^lI UllllAll1
178 05 2106 August 22, 1997
IIr APPllCABlrlSURVMNC Sf'QUSl'S NAMlllA'JI,fIRST, ANO MIOOll I SOCIAL SlCUlllIY tlTUMlIl1l
W"~LJ N/ A
I
I "^"::'::arv 19, 1912 I
TIllS RETURN MUSI BE FILED IH DIlPllCAIE WlIH THE
REGISTER OF WILLS
001 Origi"al Relurn 0 1. Seppielnelllalllelurn 0 1 Remailldcr ReIUfIlI"'._P...".""1
o 4.limiled ESlate 0 4a. rulule Inlclcsl ComplOmisc (d.iICl~dcdll'.tII~i 11,llR~1 0 5. Federal Eslale Tax ReUxn R~ired
~ 6. Decedenl Died TeslalelAuJ,htopydW,11 0 7. Decedent Mainl.1inetl a Uving Trust {I\lld~h(opyd 1rU'll1 Q.. 8. Tolal Number of Safe Depos~ Boxes
o 9. Uigalion Proceeds Received 010. Spousal Povclly ClCllit (It.dllo/dcJltlldWI.OCn 12.)191 ;Iod 1,19~1 011. E\cction 10 tax under Sec. 9113(A) (AlLKhSl;hO)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
KAM[ COMl'll'11 MAlllrlGAOUlllSS
Linus E. Fenicle 2331 Market Street
f1RMNMIl 1'"",",",1 Camp Hill, PA 17011-4642
Reager & Adler, P.C.
TH[PtION[ N~B(R
(717 1 763-1383
1. Real Estate (Schedule A) (11
1. Slocks and BOllds (Schedule B) (11
65,000 00
o 00
o 00
o 00
o 00
1,711 45
5,960 57
(8)
15,803 73
o 00
(11)
(11)
(13)
(H)
I (IS)
(IG)
(IJ)
(18)
3 412 09
0100
3,41209
3, Close~ Ileld Corporalioll,Panllership or Sole. Proprietorship (3)
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4, Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Dcpos.s & Mi5Cel~nCO\Js Personal Property
(Schedule E)
G. Jollllly owned Property (Schedule F)
7. Inlee.Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule G or 1I
8. Total Gross Assets (Iotallilles 1, J)
(4)
(5)
(GI
(J)
72,672 02
(9)
(10)
9, Funeral E'pellses & Admillistralive CoslS (Schedule II)
10, Debts of Decedent. Mortgage liabilities, & liens (Schedule I)
11. Tolal Deductions (lolallilles 9 & 10)
15 803 73
56.,868 29
o 00
56,86829
12, Net Value or Estate (line 8 minus lin~ 11)
13. Charitable and Governmenlill BequestsJSec 9113 Trusts ror which an ~lL>(lion 10 tilX has not been
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14, Net Value Subject to Tax (line 11 minus line 13)
15, Amoum of line 14 taxable
at lhe spousal lax rate
See Instructions on reverse side lor 1I) licilhlu nmcenliWC
16. Amount of line 14 taxable
al 6% rale
17, Amount of line 14 taxable
al15%rate
18. Tax Due
19, 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
d 00
x I
o 00
55,868 29
x .OG
x ,15
> > BE SlIRE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Undef pL'Illllics of pcljury. I dl..dilrc \hall have cxarrincd lhis rCIUfll. including accollllilllY~lg ~hcdull.'s ilrlll 5t<IlL'll1t.'11IS, and 10 Ihl.' 1.Jc~ 01 my IUlo'll1l1dge ant.! belie!. il is true. COIICct and cornplell.'. Declaration 01 pl'eparef olher
than !he ~ Il!flIesentalivc i'i basro on aU inlOlmatioooll'dllch IIrl'll<lfl!! hilS ilnv kno'Metklc.
SIGNATURE OF PERSON RESPONSIBLE FOR flUNG RETURN ADORESS DATE
~~J;,,..;t;;.. ilujf'v
SIGNA EPARE Il;:Pll- TAIIVE ADOIlESS D:3/H'ffe
O'ecedent S Com lete Address:
STREET ADDRESS
212 South 7th Street
CITY
STATE.
l'A
ZIP
17043
Lemoyne
Tax Payments and Credits:
1. Tax Due (Page 1 Line 18)
2, CredilsJPaymenls
A. Spousal Poverty Credit
(1)
3,412,09
0.00
3,000.00
150.00
Tolal Credits (A + 6 + C) (2)
3,150.00
6, Prior Payments
C, Discount
3.
InteresVPenalty if applicable
0, Inlerest
E. Penalty
0.00
0.00
0.00
4.
TotallnteresVPenalty ( 0 + E ) (3)
II line 2 is grealer Ihan line 1 + line 3, enter the difference, This is Ihe OVERPAYMENT.
Check box on Page 1 Line 19to request a refund (4) 0.00
If line 1 + line 3 is grealer than line 2, enter Ihe difference, This is Ihe TAX DUE. (5) 262.09
A. Enter the interest on Ihe tax due. (SA) 0 . 00
6. Enler the total of Line 5 + SA, This is Ihe BALANCE DUE. (56) 262 . 09
Make Check Payable to: REGISTER OF WILLS, AGENT
i. . .'- ""_.___ P.:'~_> . ..: ;'__~.~.":,::...:.' '-:. '. . "~','- ~;~~:.~/~:~;t;(:'::i~~rZTf':rf!!:~%~rr~,~ll
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN X tN THE APPROPRIATE BLOCKS
1. Did decedent make a transler and: Yes
a. retain Ihe use or income 01 the property translerred; .............",.......................................... 0
b. retain the right to designate who shall use the property transferred or its income;............... 0
c. retain a reversionary interest; or ................................................ .......................................0
d. receive Ihe promise lor Iile 01 either payments, benefils or care? .......................................0
2. II death occurred on or before December 12, 1982, did decedenl within two years
preceding death transfer properly without receiving adequate consideration? II death occurred
after December 12, 1982, did decedent transler property within one year 01 death without
receiving adequate consideration? ..",."....." ........, ....,..."..",..,.. ,,,...' ...."".." ....."..".."".,..,...,' 0
3. Did decedent own an "in trust 10(' or payable upon death bank account or security
at his or her death? "."..",....""........,....",..",..,.,..,',..,",.,...,,..""""..".....,...""...,...,...."....,.... 0
4. Did decedent own an individual retire men I account, annuity, or olher non-probate property?... 0
5,
K~l~:;.flC::J:~~i:~:~:;;~::::r ~::"
No
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tF THE ANSWER TO ANY OF THE ABOVE QUESTtONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
\[''1i;'jJj):t:'~'''':~'r{/;!:~L5:~~'::~:':.';>''':~'' . .... ..,...,:~...:.'. _ ..:\ .I~.,,,,,~ ..... . ......,:c:.zr:t:!lZi.:~J2t]~J''''l'!i'l1Si''frt1;:,1l
72 P.S. 99116 (a) (1.1) (i) provided for the reduction 01 the lax rate imposed on the net value 01 translers to or lor the use of the
surviving spouse from 6% to 3% for dates 01 death on or after July 1, 1994 and before January I, 1995.
72 P,S, 99116 (a) (1.1) (ii) provided for the reduction of the rate imposed on Ihe net value 01 transfers to or lor the use of the
surviving spouse Irom 3% to 0% lor dales 01 dealh on or after January I, 1995, The statule does not exempt a transler to a surviving
spouse Irom tax, and the stalulory requirements lor disclosure 01 assels and filing a lax relurn are stilt applicable even if the surviving
spouse is Ihe only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY I, 1995 - Please answer the following question by placing an "x" in the
appropriate space.
Old the decedent create a trust or similar arrangement which is solely for the surviving spouse s benefit for his or her entire
lifetime? Yes 0 No lil
If you answered yes to the above question, the lax on the trusl or similar arrangemenl is poslponed untillhe dealh ollhe second
spouse, al which lime it will be fully laxable at the rate(s) applicable to the remainder beneficiary(ies). Enter Ihe value of the trusl on
Schedule J, Part II, in order 10 remove itlrom the calculation ollhe lax due in this eslate, You may wish 10 file Schedule 0 in order to
make the election available under Section 9113, II the election is made, Ihe Irusl or similar arrangement is taxed in the estale 01 the
first decedent spouse, Ihe portion 01 the trust or similar arrangement which benefils the surviving spouse is taxed at the zero lax rate,
and the remainder Is taxed althe rate(s) applicable to Ihe remainder beneliciary(les), II you choose 10 make the election, you must
allach Schedule 0 to a timely. filed tax return, along with Schedule(s) K and/or M in order to show the apportionment ollhe Irust or
similar arrengemenl between Ihe surviving spouse and the remainder beneficiary(les),
Real
""'~~"''''~*
COMMONWEAl. TH OF PENNSYLVANIA
IHHER.TANCE TAX RETURN
RESIOENT DECEOENT
FILE NUMBER
Maida L. McClow 21-1997-0739
AU 'III property owned lolely or.. . t.nlnt In common mUll b. reported II fair market valu.. Fair markol valuo is duFned as tho price at which property would be exchanged
be~""", a wilting buyot and a wiUing seUer, nei~er boing compelled 10 buy Of sen, bo~ having reasonable kncwledge ef ~e relevant tacls. Real preperty which I, !olnlly-owntd with righte'
I I mUI b dl 10lld en Sch dul. F,
ITEM
NUMBER
1.
ESTATE OF
SCHEDULE A
REAL ESTATE
DESCRIPTION
VALUE AT DATE
OF DEATH
See
Property located at
212 South 7th Street
Lemoyne. PA 17043
HUD-l Settlement sheet
$65.000.00
attached hereto
TOTAL (Also enler on line 1, Recapitulation) $
(If more space is needed, inserl additional sheels of the same size)
65.000.00
'~I.iI))~~itJi\i~~~~\~';;j ';'I~"',~""-~',~"~;:;i~'':-, ';..... !",~:.,'.
\
....'....".II.,~~*
COMMONWEAl. TIt Of PfNNSYl VAlM
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
21-1997-0739
Maida L. McClow
IncIud.1he proceed. 0' ~~g.1Ion and Ihe dalellle proceed' werelecei,ed by Illo e,lale. All property Jolnlly.owned with the right 0' 1U~lvoJlhlp mue' b. disclosed on Schedul. F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF OEA TH
1,
America Travelers - premium refund
30.90
2.
Penn Treaty premium refund / LTC Coverage
Policy No.: H99401 & P402678
69.35
3.
Refund from Cumberland County Home
1,111.20
4.
Miscellaneous personal property
500.00
TOTAL (Also enter on line 5, Recapitulation) $ 1.711.45
(If more space is needed, insert addilional sheels of the same size)
"V"~"""'~l~ .
COIolMONWCAI.Ttt OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEOENT
ESTATE OF
Maida L. McClow
.....-...----'...--- '-
SCHEDULE F
JOINTL Y.OWNED PROPERTY
If In ....1 WI' mid. Joint wllhln on. year of the decedent I dale of dealh,1t mUll be reported on Schedule G.
SURVIVING JOINT TENANT(S' NAME
A,
Donna M. Dykema
B.
C.
JOINTLy.oWNED PROPERTY:
ADDRESS
347 Poplar Road
Dillsburg, PA 17019
"
FILE NUMBER
21-1997-0739
RELAnONSHIP TO DECEDENT
Daughter
LETTER DATE DESCRIPTION Of PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT IOOE Indude name of flf\8ncial insMulion and bank accounl number or similar identifying number. DArE OF DEATH DEeDS VALlIE Of
NUMBER TENANT JOINT Attach deed ror)oinU~.held ,eal estale. VALUE Of ASSET INTEREST OECEDENT S INTERf'lT
1. A, 1994 PNC Bank - interest checking account 11,921.14 50% 5,960.57
No. : 51-4009-3184
TOTAL (Also enler on line 6, RecapilulaUon) $ 5,960.57
(If more space IS needed, Insert additional sheets of the same size)
"",mu,",,,,,.
COMMONWEAl TM OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT OECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
21-1997-0739
Maida L. McClow
Oebtl of decedent mUll be reported on Schedule I,
ITEM
NUMBER
A.
DESCRIPTION
,.
FUNERAL EXPENSES:
Stone & Murray Funeral Home
408 3rd Street
New Cumberland, PA 17070
2.
Headstone - purchase and engraving
B,
ADMINISTRATIVE COSTS:
Personal Representative 5 Commissions
Name of Personal Representative (5)
Social Security Numoor(s) I EIN Number 01 Persenal Representati'e(s)
Sireel Address
1.
Cily
Slale
Zip
Yeatts) Commission Paid:
2,
3,
AllorneyFees - Reager & Adler, PC
Family EKemplion: (II decedent 5 address is not the same as claimant s, allach explanation)
Claimant
Street Address
City
Relationship 01 Claimanllo Decedent
State
Zip
4,
Probate Fees
5,
Cumberland County Register of Wills
Accountant 5 Fees
6.
Tax Return Preparer 5 Fees
7,
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Cumberland County Law Journal
The Sentinel
Travel to Courthouse
Copies and Postage
Cumberland County Register of Wills - Inventory
PP&L for decedent's real property - September 1997-March 1998
PA, American Water Co. September 1997 - June 1998
Bell Atlantic - September 1997
Lemoyne Borough Refuse Service
Nationwide Homeowner's Insurance
Tree Removal
AMOUNT
4,498.20
200.00
3,500.00
141. 00
60.00
51.12
9.00
3.34
15.00
221.56
67.96
11. 46
107.00
113.50
175.00
TOTAL (Also enler on line 9, Recapitulation) $ 15,803.73
(If more space is needed, insert additional sheets ollho same size)
"Y'"Il,"'II"~..
COMMONWEAl. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
NUMBER
\.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (includo Dutnghl spousal dislribulions)
FILE NUMBER
21-1997-0739
RELA110NSfllP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
ESTATE OF
Maida L. McClow
1,
Donna Dykema
Daughter
100% of personal
property & residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON.TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheels of the same size)
'nl' loII\IJ<:Jai...n...., hereby ,eMovhOV, ntCllpt. at . COIIIphtc:d cUP7 or ~gc:l 1'" ot tblt ~t.1ot~nt " any "ttll,t~ntl nr.....ed to her.!n.
I KIWI: CARKPUl.t.Y' QIIIPfEl) TIU: JrJtl-l SI"t"nDlRm' ttAT1IKCf":' AJltl TO 'l'H8 !IUT or MY Jl:ltON1.KDaI' AND JaLJIP, 11' n A ftUl Am) ACCUlA'l't
ITATDCEN'1' 0' ALL A~It"TS Nm DlSiUIUItta:lft'5 tWJI' '* IC't ACC'Outn' OR )lY MB Elf 'nI1I ~u.motf~...._ CDTJ". ~'l' I *Y11
UC;.'lUVll) A COPY OF M lI\ID'lg~""""'L:J.. I ~ ~~~.~
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FROM IS '" !I BeTTLI'!I1!NT seRVice
A. SBTTLEMENT nT~rHMENT
717~f)71.6923
1'9'99,03-13
101047
.&67 P.01/0'2
.. TJn 0' Inut
I. I I ... I, tl rtftA I. II Can.. unl"I" 'ILI~n. I" loOM "JuD 1,.h:l1'NoI4I lit' CUI IMCIII
. II VI\ ,. IIIClonY.ln.. P1Il'", lI.ono
c, 1'Un.'ftli. Cllra Lit hunl'Md toll ..,In )"11I . 'tn_nt or "lltud ntt I....nc Cot~". MwnU ,"Id to aNII IIr 'h. ..tl,l."...,t .,.nt
," .1\OVn. It... ..,".d "11<<" _u. paid CNUldCl 1M r.lulnqi tl.Gy ... ahuwn IIu'o tor In'tl.....Uond wnog". .Mlre
ItOt lMIv:t1d III t.lw tuU" I,D lO." ,t/IlIII'I'nlII.IMl/.ln..tl
D, N~ J.HP AllCllI'U Dr IOIlJIOWloX I, 1l.loMlC AJID NlIaIU 0' IllU0811 r.w.Ma:NllDliDC*1lOltD'LDIDIIll
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Q. 1'f'O,ntT'1' a.oe...:IOH ", SIT'TLIJ!.Wtr AllUT ~S.UJ7nJ .. 'lt1'TI.-.mn'DAft "-
2'2 IW11I 7111 C1'kIlrt . . . IlTrJoIPIDtt JlIKV1~', ,II<,
LIMOYICl, .,. nOtl IC.lIrahU,1IU
CI.lMII~ClO\IIIty;'A I'LACI or '1:Tfl.>>UMT
'''5 LfNOLlQT01r.IItOAD
KNUlllnlUM. 'A. n\n
J. IUIIO.A'I or IORStOWIJI'" Tl'!M'AC:'ION It. .Ulft\II.T or 111.UI!." 'I'RI.al'ACI'IOtf
100. c.oSJI L"tOlNl EIUI: noM QQ6la~1Il tOO. at41au AllOIMl' DUa 1'U Ill~
101, CDntrwet ","l., .r1ee .!o,ooo.oo 40t. t'ur.\...vt ..ii. PriM ",000.110
101. "uUllII noptRY 40a. I'cUONll Property
lOJ. IcttlelHllt ClIarg.. to lorrOWtrI" Un.HOO J,loa.'Jo 10).
-
104. tOt.
10!l. tU.
.to4j\llUtlul.a l.u It... pillS ti'/ ScHar In adYllnC'. MjllJtllll'lU tor it.... fill" by I.U., 111 .dVU\CI
10'. City/tOW'T...... t. tile;, Clty/to..n Tax.. to
10?, OIl\ll\t.y'1'l)!.h O1'U-" to 01.01-'9 '''.'5 .07. county nzco 01.12-" to 01-01." :lIU."
101. 'cllOO1'l'Ua1 n).u.,. to 01_01." :lU.411 toO. S1chDg\ 'l'AU' o'.n~u to 01'01 " 28'.48
U9. Tra." u.n." toOt-OI." '.5& .0.. Tn." in.n-" to 06.01.'11 ,'..
no. ne.
lU. tU.
lU. tu.
no. CKOS' AHCOIl'l' DUB nos aouown n,"I." no. ar.OSl N1CUIft' WI 'to ac.z.a ~'i,"o.n
JOO. NlODN'l'Q "AID Br Ok IN aiHALl' 0' eoUOWZl no. IWIlJC'l'IONV nf AHO\:lItt DIll 'l'O ItI.tD
201. oapollt or ..mert IIIOII.Y 1.000.00 501. '11I<<11 DqlOlit {a.. lZl11tlNCltlon'I
2OJ. PrlllClipal M;wi~ 01 n,w 1oClIn/:\1 /In,I'IMl'ln 11)1. Jllt.tlClllllDltlaa"IIIlIlIl~""" 1;...UII "..'.:'"
lO\, f,1f1r1rt11O !(\Inhl 'NIhn V\Lb~oot 1:0 515. ....J..U.... I.....,.. L....... .""j..~t tV
20'. ",, .ayvft ot Utlt 1DO'&'l:gtlgcr. loan
llOS. 505. ,..yott of ICcoad _ngagl INn
206. !lU,
101. 107, 100pol11: 111.D\lI'Ic4 II proc~1
:l00. "I.
lOll. ISOP.
Mjultunh tor It... "'1I.IOI11S by S.U.r MjuatllUl.. tVI' it_ \IIIPIollS tIy tIellu
no. C'ltY/I.~'I'lXIa ,. 110. Clty/towa 'lo'~s ,.
JU. county TUI' ,. !Ill. C'o\mty fUll ~
211. achool Tax.. t. U2. !cbool 'l'aq, ,.
'11. 5\1.
211. su.
11!l. r.n.
21'. ,,,.
111. 517. "91 eounty/T\Ip.'l'uII,r.2,tb A. tfloo111, '1''' 121.4'
211. "..
lU. u,.
220. ~ 'I.1'P .r/roa IlClUOWb 11,000.00 !l20. 'I'O'1'lU. UDUCnOH IM01.Ilfr tQlI ftLLD ..2".4'
)00, euH .&.'1' .rrn.s:t\I:tn' ......Olt/TO oor.AOtn:k 600. CWi ~ t.<l.'n'IoIl'mft' m/FROfC !:1ILLll
101. ~C10D ""'I: ou. reM I'\QUowel' IU_ uol 511."3." 601. nrQ" AnloUnt eu. 1.\1 1~llr l.l.UlCnol ,r.,Il'~~
202. toe.. .\Int P~J.'" by/'or; IQrrowl!' tUn. :nol t U.ooo.oo) 102. :,......c1UCtlONllAlC.tl.U.C' Ulflolno) ( .,211,4.11
Jo:I. CMH tX) "OM 11'tO IIQItROtfIA 1.le1,6'1 UL c:.uN (xl to 11 ...... ....... 511.'".'''
U.I, tlI{pAa"naQrI' or HOUIIIfJ
IJftl trl...... tlrnl.OPl<<lf'I'
CfO NO "01.0'"
l\'Jl
'fO 11m BIS'l' OP
IIWICK MUD RVt1I1
JMl-l JI~' IITI.TIIGlh"l' W111r.'1f 1 MA.... hnMm I' A 'nUB NeD AmIllJoTl J.C'ttlUMT 0.- 1ICI I'\IIID5
011 M1lJo IIi Dlf:IMU:SD 1I't TI/ll tfN[lb.'IGMED ALl PM'l' Q, TflJ 11ll1'Tt.IlliIDl'l' O. ~u TUHu.cT%OW.
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CnrtlU_.t LII DtI II C'tUC c:nry t4/WWJmU.JlUD/PlO"UI
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Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 1997-00739 PA No. 2197-0739
ESTATE OF MCCLOW MAIDA L
ILA~.', rlK~.', MlUUL~}
Late of
MIDDLESEX TOWNSHIP
CUNb~KLAl'lU l;UUl'I'l'l,
,
Deceased
Social Security No. 178-05-2106
day of September
WHEREAS, on the 9th
dated March 27th 1997
was admitted to probate as the last will of MCCLOW MAIDA L
(LA::;'!', rlX::;'!', MlUULt;)
1922 an instrument
late of MIDDLESEX TOWNSHIP
22~ day of AUQust ~ and,
~HEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to DONNA DYKEMA
who ~ duly qualified as Executor(rix)
and ~ agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF,
of my Office the 9th day
-
,
CUMBERLAND County, who died on the
I have hereunto set
of September 1997.
my hand and affixed the seal
~ (I ~ ("veld!';,,,,,,;
, (. xel 'l ~
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
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LAST WILL AND TF.STAMF.NT OF MAIDA L. McCLOW
, .'
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I, MAIDA t.. fotcCt.oWN, or the l\orOlItJh of J,omoyno, County
"
, ,
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oC Cumberland, nnd state o( PClllIsylvc1l\I.." helruJ in IJood hodi1y
"
hoalth and of sound nnd dinpa5ing mind and memory, nnd not ilcting
. ,/..
"1'
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,
under duross, menace fraud, or undue influence of ilny peraon
whomsoever, merely calling to mind the frailty of human liCo,
and being desirous or diopoGing of my worldly qaoun willIe I
h.
have the otrongth and c.1pnclty 50 to do, 1. do m.1kc, puhlioh
I
I
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and declare this my LAST WILT.. ^ND TF.ST^MENT. I hereby revoke,
cancel and annul all my former Willo and Testamenta, including
codicils thereto, by me at ilny time made, and declare this alone
to be my LAST WILL AND TF.ST~~.
AS TO SUCII ESTATE AS IT liAS PLEASED GOD TO ENTRUST ME WITII
:,'
IN TillS LIFETIME, I DISPOSE OF TilE SAME AS FOLLOWS, VIZ:
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ITEM 1. I direct that my Executors hereinafter numed PQY
.':.
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and discharge all of my just debts, funeral and testamentary
.~ .~~,1'
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expenses.
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ITEM 2. larder and direct thnt I be buried in a lot which
.''t
I own, situate at thc Odd Fellows Cemetery, Trcvorton,
,.!
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Pennsylvania.
, ~.:.,.
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ITEM J. All the rest, residuc and remainder of my entire
.,
estate, wheresoever situate, Qnd whiltooever it mny consist of,
I givc, devisc, and bequeath, aboolutely, nnd in fee, to my
, "
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dearly beloved Daughter, DONNA DYKEMAN. In the event my dearly
. '..1
fails to survive my death by sixty claY5, then I give, devise,
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beloved oQughter dies with me in a simultnncous disaster, or
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and bequeath, my entire estate, wheresoever situate, and
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whatsoever it may consist of, to my dearly beloved Son-in-Law,
MAIDA L. McCLOW
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JAMES A. DYKEMAN.
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I'l'BM ". I nomlnntc nnt1 ilppoint OONN^ nYKI~M^N no l':xccutrix
,
,
,
of this my Last will. 5hould the J~xecutrlx namet! Call to qunliCy
or conno to net no t'~xccutrix, then 1 utlPoint J^MI';:; ^. OYKl-:MAN
49 Exocutor in her Btond.
" ,
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ITP.M 5. I direct that my pcroonal rcprcocntiltivcs, as
. "
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well as their GUCCcosors, Ghall not be required to give hond
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for the fnithful pcrforllluncc oC thelr dutic:; .in ilny jur.indlction.
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ITEM G. I uircct that ill1 estate, SUCCc:Hi!on, lcqilcy,
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inheritance or other trnnsfcr taxes, however designated that
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shall become pilyablc by rcnson of my dCill:h in rcnpcct of atl
"
property comprising my gr035 cstlltc for tnx purpone:J, whether
".
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or not SUCll property passes under this Last IHil, shail be paid
by my P.xecutor out of my residuary estatc.
"
.:.
ITEM 7. I grant to my personal rcprc5cntativca herein
"
named, in addition to, but not in limitation of those powers
vested by law, to be cxcrci13cd without prior application to
:!l'.
or approval of any court, the power Clnd authority to retain
indefinitely ilny property, to invest und t'cinve:;t any assets
:1'
or the proceeds derived from tho sale or naaets, although said
investments may not be of the character prescribed by law, to
I','.
,.
so11, convey, assign, transfer and encumber any property, to
','
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pay, settle or compromise all claims, to make distribution or
divisions in cash or in kind, und in general to exercise all
i
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powers in tho manaqcmcnt of any property hereunder which any
\
individual could exercise in the management of similar property
\
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owned in his own right, and to execute and dolivcr any and all
instruments anel to do all acts which lJIilY be deemed llCCCssilry
and proper.
d.,' ,
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MIIIDII L. McCLOW
"
_______________________________r,ND___"________________-----
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COMHONWI':^L1'1J 01,' 1'1':NNGVr,V^N I ^
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COUNTY 01' CUMnlmr.^NO
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I, M^ tD^ L. McCI,OW ,'I'I'::i'I'^'I'n I X, WhOlit! 'WOle in
lilcJIlP.ll to li1ii-.';.I'tt.:i(~1ieTorrtl'I:-;~(J()ln'J innlrumnnt, 1101vinq IIPI!n
duly qU..11lflctl .1ccortlincJ 1;0 1.1w, <10 11I~rr.hy i1cknnw,INItJI' t:hill
nlcJl1ceJ nnd eKN:utl,Hl the lnnlrumC'nl ,'W my I,MiT ""JI,I,: I.h:lI: I
nlqncd it wlllinlJly: nnd tllnt T niqnl~c1 it ;I!j my I"re'! ,Inll
volul1t.:lry DCI:. for thC" IHlI'pnrir l:hC:I',.,in I'K!lI."'!i!i('(I.
"
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5worn or ilCCirlllc:r1 to ....f1d .:Ic:knflw/('r1r(f'r1 h~rl"" IIIr',
by _._..t:t!\'!.Q~_~_'!._.MCHC;:'~.I.Q~__._..___."_ I-he 'l'I':::'I'^'I'Hr:-:, 1,llir; 27th 11:1')
or _.J.\i!L<:h__ I Q,2,2,
"
~"". NOTAOIM. <~,\l . j'
AnOONEY JAMIS \', ,'~Ct', I'....y f'uWi' I:
.. CII:I,hr,ul( ( "'1"1 :
My C'/MIi\u.n l"rplfU Mar 13, 1995 'I
.---------.-.
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N ^UY 1'II1l1,Ie '
\'ch;Jnic!i!Jllr'l. ('^
y {"IHlll1li::~;il'/l l:~:Jl'''1' '. 5/13/95
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'rhe precr.oding imitrumellt con~;jr:lln~1 ol: lid:; i.InJ L\olo .(:n
othr.( typewritten p.:lCjQ:;, identified kl the :;ifJnill,urf! Ill" Un'
'rr-;S'I'^,l'HIX, wan on the d':lte the reo~ r. i (jIH'll, publ i r~l1l.'d .11111
dccl.Hcd by -MAIDA L. HcCLOW , the 'I'E~;'I'^,I'RI>: t.h"'f(!in nilllll~d
DS ilnd for T1C'L: .!;^S'l'-Wn~f;-~~!? '1'1';~'I'^~11'~T.
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COUN1'V 01' CUMIlF.RL^ND
Wo ",.J;llI!.'0.JL.2!'Il^H~h!,J 0'1<.1 __....""CIIIlI,S .LOnT I ' III"
Witllf~:;~r.o5 whose ,Ull1ler. .:Ire siglled to till! id.l.;u:ll/'d Ill' fllll~'1llill,!
inr;trlllnnnt, bcin'J duly qu"li.[.i'H] ,1cc;ordilll.l 1.0 l.'IYl, ,101]1:1"':;" :\111 [
GDY thi1t we WCl:f~ prcnent nnd r.i<lW 'l'I~:;'I'/\'I'Hl): ::il[lI '-Jnd 1.'>:1'1.:111:(' ! II"
instr.ument ,)5 lwr I.A~;'I' Wll~Lj thill: shp !:iqn/!d ''Ii' 1 il1'1ly ;11..1 llldl :;111-
execul:ed it ..1r; IllJr rr.~c LlIIU voluntary '-1/;[: ]01.' till:' [1111 Jl"~;I' l.b".l'ill
cKprl~:;!H~d: thLlt c.Jch or un in thl~ hf~i.lrinq ':HlII !~i'Jld' of l.h'~
'l'IW'J'NI'ltlX :;j9ncd the WII~r, ar. witnC!i!ic!J; and l;Iwl: Lo 1:11(' Iw::t (II "1111"
knowlr.dye the '['gg'l'A'l'IUX wa5 LIt th(~ tinw HI or mOI:\~ year:; of "'Y', (II
soun<l mind nnd under no cnnntraint 01: undue infllJf:lIce.
,
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:;.....orn o.t: .,rfiriiH:d t;d ':;:l"~ :Hlb:H:1 ;:"_'I~ ,...., :.r.f..",: Ii,,' l,t
l'
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and __~_UJU.?.......f.9.[~.T-'.__ wi tnC5:1c:i, tll i_!i
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27t~ <Joy o(
March
19 2.~ ..
".....'- NOTARIAL S[AL ,
"TTOnNEY JAMI,S M, n^CII, 1l.taryl'Wlic
C;UlllbttlslI' Cwulr r.
I, 10\1 C'rIImissi.n ("pires, Mllr 13. 19CJ~
~6bc/__u
N RY I'UIll.IC
,chanicsburq. P^
My Commj;lssion gxpi rns: 5/13/95
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Inventory of the real and personal eslate of
Maida L. McClow
_._-_._--"'~---~_._.._--
deceased
.._.u___...~__.
--.._--...._-.
Real Property located at
212 South 7th Street
Lemoyne. PA 17043
65.000 00
America Travelers - Premium refund
30 90
Penn Treaty premium refund / LTC Coverage
Policy Nos.: H99401 & P402678
69 35
Refund from Cumberland County Home
1 . 111 20
Miscellaneous personal property
500 00
PNC Bank - interest checking account (1/2)
No.: 51-4009-3184
5.960 57
;'
'~1,i,1:)
.-,,",
1"..-
TOTAL
72,672 02
rji" r", 1-'1'-- '''.'1' ''',-
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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Donna M. Dykema
~-~._-- .-.-..--- --'.-. --- ""..._----.-.. _. -.-------- ----,.---- - ..- --..---
being duly according to law, deposes and ..ys that 8 he
Executrix ,_, 0' the Estate 0' Maida L. McClow
late 0' -- _..g,lIloynl!,J!o_r_ollgh .--'-"" -.. ---, '___, Cumberland County, Pa., dec,eased and that the
within is an inventory made by;'>"."" ll_ If> {)",k< ''.''~~,_, ,the said fV({(l{.fL~
of the entire estate of said decedent, consisting of all the personal pr.p..ly and real eslale, except real estate outside
Ihe Commonwealth 0' Pennsylvania, and that the ligures opposite each item 0' the Inventory represent it's 'air value
llS of the date 0' decedent's death,
;;;. (.; ,h..it, f-D
and subscribed be'ore me,
J)~ }r1, {J.~ -Cp.~
en or. Adminidrator
;l-i Ci.--L.dc 2. S-
f
f._])}L
/ NolaJ!elSea1
, MonIce D. ZSn:her, Notary Public
~ HUI BolO, Cumb.llaM Counly
My Commldlol" ( ':~'15 Jan. 14,2002
", 1m r, nns~".no;: "..eel.tllln 01 No~les
/' 7_F[' ' 22
:O&)e"o' Death-
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~_ ;:;~, L '" INSTRUCTIONS
,~,L'", f.~ inventory. must be filed within three months alter appointment 0' personal representative.
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2. ,'{-.uppl~ment inventory must be filed within thirty days of discovery of additional assets.
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3:"':Additiona' sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
191V
Address
Day
August
Month
1997
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT' or REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT.2B0601
HARRISBURG, PA 17128.0601
RECEIVED FROM:
r
LINUS E FENICLE ESQUIRE
2331 MARKET STREET
CAMP HILL. PA 17011
FOLD HERE
ESTATE INFORMATION:
FILE NUMBER
~ -. .' ..
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
~"Jt.lt
~
NO. AA 2 G 9 899 REV"" EX fll,O.,
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
J..Q.L
$?h?fJ9
FOLD HERE -.,
NAME OF DECEDENT
(MI)
DATE OF PAYMENT
::l/:;JfJ/199R
POSTMARK DATE
O/OO/ooon
COUNTY
r.LJMBERI ANI'>
DATE OF DEATH
REMARKS DONNA M DYKENE
CIO LINUS E FENICLE
SEA~HECK# NO CHECK #
----___n_.._~ _____.___.__..._...-.__ ~..._
,
(FIRST)
TOTAL AMOUNT PAID
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.
,
$262.09
nLCiISl'r~:tl OF \,/'-/I!.1-(;
RECEIVED BY
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/!J-dO/ - 7
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
c...
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUIlIlER
COUNTY
ACN
LINUS E FENICLE
2331 MARKET ST
CAMP HILL
PA 17011
06-15-98
MCCLOW
08-22-97
21 97-0739
CUMBERLAND
101
Allount Re..! tted
*
In.II4'UU' u,.,u
MAIDA
L
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEY:is4'n:if-Af'P-fo9'':97riiciT"icEnOF-YNiiERiTANCn:'A'in-pjiRAisEiiEii'r,--ALLOWA"NCrOR'-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MCCLOW MAIDA L FILE NO. 21 97-0739 ACN 101 DATE 06-15-98
TAX RETURN WAS: 1 X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, Real Estate (Schedule Al
2. Stocks llnd Bonds (Schedule BI
3. Closely Held Stock/Partnership Interest (Schedula CI
4. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6, Jointly Dwnad Property (Schedula FI
7. Transfers (Schedule Gl
8. Total Assets
(1)
(2)
(31
141
(5)
(61
(7)
I CHANGED
65.000.00
.00
.00
.00
.00
1. 711. 45
5.960,57
(8)
APPROVED DEDUCTIONS AND EX~MPTIONS:
9. Funeral ExPenses/AdD. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule Xl
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
15,803.73
.00
(11)
(12)
(13)
(14)
NOTE: To insure proper
creeli t to your account I
submit the upper portion
of this fora with your
tax pBYllent.
72,672.02
11;.803 73
56,868.29
.00
56,868.29
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rat. (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 taxable at Collateral/Class B rate (17)
18. Principal Tax Due
NOTE:
TAX CREDITS:
PAYHENT
DATE
11-12-97
03-30-98
RECEIPT
HUHBER
AA242445
AA269899
DISCOUNT 1+1
INTEREST/PEN PAID (-)
157.89
.00
,00 X' 00=
56,868.29 X .06=
,00 X .15=
(181
AHOUNT PAID
3,000,00
262.09
.00
3,412.09
.00
3,412.09
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN. . OO,,~c!"
TOTAL DUE 7.89CR l:SL.,.c,,,
,!i,i"I:
( IF TDTAL DUE IS LESS THAN $1, NO PAYHENT IS REllUIRfJI. I,,{_,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), y(J4IIIAY BE ~",;!! '
A REFUND. SEE REVERSE SIDE DF THIS FORM FOR INSit<<Jc1fDIIS'" ,,''''
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
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RESERYATI~: E.t.t.. 0; ~~~Ing on or before Doc..btu' 12, 1982 h if any future int.r.st In the ..t.t. Is tnn,"rnd
In po.....ion or ..,jo~t to CIa.. B (collateral) benefiel.ri.. of tho decedent after ttMt explreUon of any ..t.t. for
11f. or for years, the C~.lth h8reby".xpr.s.ly rllserVllS ~ right to appralslI and ....s. transfer Inheritance Tax..
.t the lawful Cl... B (coll.t.rell rRt. on any such future Intere.t.
,,'
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PIlRPOSE Of
NOTICE: To fulfill the requlr..-nt. of Section 2140 of the Inheritance end E.tat. Tax Act, Act 21 of 1995. (72 P.S.
Section 9140).
PAYIEHT: Detach the top portion of this Notice and sublllt with your P8Y1NKlt to the Register of WUb printed on the rever.. side.
--Kake check or .oney order payable to: REGISTER OF MILLS.. AGENT
REFLtlD (CR): Ii refund of II tax credit, which WillS not requested on the Tax Return, .ay b. raquestctd by cCMIPlat1ng an "Application
for Refund of PonnsylvenJa Inheritance end Estate Tax- (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District OffIces, or by calling the special 24-hour
an....ring servIce hlMbers for for.s ordering: In PennsylvanIa 1-800-362-2050, outside PennSYlvania and
within local Harrisburg area (717) 787-8094, TOD' (717) 772-2252 (Hoaring I~aired Only).
OBJECTIONS: Any party in interest not satisfied with the epprais~nt, allowance or disallowance of deductions, or a$sos~t
of tax (including discount or interest) as shown on this Hotice .ust object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA DepartHnt of Revlmue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the .atter deter.inad at audit of the account of the personal representative, OR
--llppea1 to the Orphans' Court.
ADI1IN
ISTRATIVE
CORRECTIONS:
Factual errors discovered on this assesSHllt should be addressed in writing to: PA Depart.ent of RevClrlUG,
Bureau of Individual Tay-es, ATTN: Post Asses~ent Review Unit, Dept. 280601, HarriSburg. PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet -Instructions for Inheritance Tax Return for a Resident
Decedent- (REV-lS01) for an explanation of a~inistratively correctable errors.
DISCOltIT:
If any tax due is paid within three (3) calendar .onths after the decedent's death, a five percent (5%) discount of
the tax paid is a11ONCtd.
PENALTY:
Tho 15Z tax ~sty non-participation penalty is c~put.d on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of tho tax ~sty periOd. This non-participation
penalty is DppIIalabh in the SIIIle .anoor and in the the SSllO ti.e period as you would appeal the to and interest
that hes been autlsnd as indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) _onths and one (1) day fros the date of
death, to the date of pay.ent. Taxes which bec~e delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per ~ calculated at a daily rate of .000164. All taxes Which bec~e dolinquent on and after
January 1, 1982 will bear interest at a rate which will vary fro. calendar year to calendar year with that rate
announced by the PA Oepartllent of Revenue. The applicabie interest rates for 1982 through 1998 are:
!!!!: Interest Rate Dally Interest Factor :!!!!' Interest Rate Dally Interest Factor
1982 20i! .000548 1987 9Z .000247
1983 16:< .000438 1988-1991 11% .000301
19114 11% .000301 199' 9Z .000247
1985 13i! .000356 1993-1994 n .000192
19.. 10~ .000274 1995-1998 9;: .000247
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the taK beco.es delinquent will reflect an interest calculation to fifteen (IS) days
beyond the date of the assess.ent. If pay.ent is .ade after the interest co.putation date shown on the
Hotice, additional interest .ust be calculated.
--' -. ~_......".", - .-
STATUS REI'()IrI' UNDER RULE 6.12
Name of Decedent: ~:I:(;~~-' McClnw
Date of Death: AUl!l S 1997
Will No. 1997-007"9 Admin, No,
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules, \ report the following
with respect to completion of the administration of the above-captioned estate:
\, State whether the administration of the estate is complete:
Yes X No
2. If the answer is No. state when the personal representative reasonably
believes that the administration will be complete:
3, If the answer to No, I is Yes, state the following:
a, Did the personal representative file a fmal account with the
Court? Yes No X
b, The separate Orphans' Court No, (if any) for the personal
representative's account is:
c, Did the personal representative state an account informally
to the parties in interest? Yes No X*
*The personal representative was the sole heir.
d,
Copies of the receipts, releases, joinders and approvals of
formal or informal accounts may be filed with the Clerk of
<h, O~h,"" C""~ ?;;cJ""
Signature
Date:
'7/30)c;r
\-/d "',
)11'"
"'~utn~
11;1::)
Linus E, Fenicle
Name (Please type or print)
2331 Market Street. Camp Hill. PA 17011
Address
LV: Zh] \[ n 96.
(717) 763- I 383
Telephone
SU!i\'.,
10 "
\'J8
,',:J38
Capacity: Personal Representative
X Counsel for Estate