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No. 21.80
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PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
RTCHAHD H. NICKUM
, deceased.
Harold B. McLane, Deputy
To niel.are C. ,.,ne8men, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
. . IS IHelen H. Nj.ck\m1 died rlay 5, 1976
Petltloner(S) t.tra>the execut or named in the Last Will and
Testament of RICHARD II. NICKUM dated
Decedent was a citizen of the United States and a resident of
.:J:GwR&R ip
Borough, Cumberland County, Commonwealth
Carlisle
of Pennsylvania.
Decedent died on
Mondav
the 2] st
day of Apl"i 1
A. D. 1980 , in the County of
Cumberland
State of
Pennsy 1 vania at the oge of years.
-has- -Res her
Decedent has not been married and has not had children born to him
since the execution of the above described Will.
Decedent was possessed of persanal property to the value af
'./AJES7. and of real estate to the value of
none
as near as can be ascertained; said real
estate situated as follows
.apply
Therefore, yaur petitioner(s) respectfully applies 02 the probate
of the said Last Will and Testament and for tt!,!rs Testament thereon.
Dated
April 25, 1980
Name and address
of Petitioner(s)
One West
~rlisle
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
Farmers Trust Co, Dennis C. Caverly, 'I'rust Officer
named in above application, being duly
say(s) that the statements set forth
sworn according to law
,titian~ are true to the
best of
hi,.
-~
knowledge and belief.
and subscribed befare
Sworn
~'il 25 1980
,
~l'!_ \.0 I
. ~.). " Deputy
IS'lt Rj~~ ~:E.:2;:.., "Register
1980
Attorney:
Wm. A. Kramer,
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..y/
2nd/ .
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F. One (1) "hare LiI.,reol' leo Joannie Eadill "nd
Deni::.;c Hurlock, tho children of' my h;Jll'-:;);itur,
Elizabeth h. Hadin, il' living tIt the time or
my dc~,.th, in (:(1U!l.1 i:;h:lrC~j, t.i!wre nud nlt:u'O ~Ilike.
G. One (1) "IUll'e thereof to be divided in equal
shares, share and LilH...re ,i.l.ike, among and be-
twcon the followinB named individualG: Betty
EttinGer and n(!r cld1rl!'(:n, TI;:1.})h Et:t:inc;er,
Hac G. Ettin::;cr and Helen Ettin:'cI' :.nu r'I,ll'tha
Ettingor ::md. her ui..l1lC;htcr GhirJ.C'y ~'~t.;t:LnG'crt if
living at the tDnc of my death.
Should any of the "bove named individualfJ die "Ii.thout leavinG
children him or her surv~,ving at the time of my death, or predecease
me as provided in Par"graph SECOj.;jJ herein. I order and direct that
said share or shares be udded to ~nd form n part of my residuary estate
and be divided equally among the remo.ininc: uhar"s.
Should any individual entitled to sh"re in my estate not
have attained the a[';e of tl'lenty-one (21) years at such time, I hereby
nominate, constitute 3.nd appoint the Farmers rJ:rust Company, of Carlisle,
Pennsylvania, to be his or her ~rustee until ouch time. The net income
from said trust fund is to be used for the miJintenancc, support,
education, he",lth, benefit ",nd General Heli'"re of said individu"ls,
at the discretJ.on of the Trustee.
LASTLY: I hereby nominate, constitute and appoint the Farmers
Ii'rust Company, of Carlisle, Pennsylvania, to be the 'Executor hereof, it
to serve without bond in the Commol1\"ealth of Penns;{lvania or else..,here.
I request my Executor to employ Kr:llner & Kr"mer Attorneys-at-
La 1'1 , Carlisle, Pennsylvania, to serve :J.S the attorneys in the settle-
ment of my Est:J.te.
IN ';IITNESS HEEREOF, I have hereunto Get my hand und seal this
,;)e> I\ct d:J.Y 0 f July. 1976.
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WI'fNESS:
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I 5S:
COUNTY OF CUMBERLAND \
This. ........................ .?7:~ ..::!~............ ...... ............... day of........... ...... ....~p.!;.:~~......... ...... ........ ......... A.D., 19..6.Q..,
Harold B. McLane, Deputy
before me Riel.II!!1 R. '.llIlurn'IA, Register for the Probate of Wills and granting letters of Administration
in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally eame ..............
Wm. A. Kramer 2nd and Merlene J. Marhevl<a
...................................)............................................................................................................................................
the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and
Testament of ........ .....!U.QJ!!).!\P....t\ ......N);!!.K!!~... ......................... .... ....... ......... Dated .. ............. ........ ..................
lat.eof.......~~.~...~.<?r.~.l;l.I,'/):1...?t..9.~x.H?}.~................................................ Cumberland County Pa., deceased
who being duly ................~Y!.'?r.!!................ according to law, depose and say, that .........~.l:.~X......................
present, and saw and heard the testa..1t.9.r........................., ......RlQkl.!lRJ:I...IJ.....N.1Q)).1J.M...............................
sign, seal, publish, pronounce and declare the said instrument of writing as and for h;\..~............ Testament
and Last Will, and at the time of so doing ...........................h.e..................was of sound and disposing mind
memory and understanding, to the best of ......................l<b.a:i.r.............knowledge, observation and belief.
...SllT.or.n................................ and subscribed before
....w~:!.A~.1;:t!i::y::u.,..M.l~................
\..t\1 r n~--1s\ ;A
......1~~~.....~?:..f\f....:.?~'!.....~.~~.~~~
>>:..1..__..1 ~ ^ _..1--1J- Register --,,- .
..................................................................................
lzJ.;1 c..l1~tu..D.'YJi}.wJ1..tf)lt&.........
M~rlene J.~arhevka
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
...................................................... ~.I:1:... .~:.:. .~~.~.I:1~.\\)... .? ~!?.................................................... ......... .being duly
.................il.~Q^'XI................... says that as nearly as can be ascertained the said decedent ..........................
..... .................................................R l.C.llIlRD.. ~1 ,... J:l J: s::.K!Jf1..................................................................... .died on
.........I:1~X!~~.:t.......................... the ..........?~~.~..............day of ..........~J?~~~.~................................ A.D., 19.~.~..,
at or about ............~.~.:.?~................... o'clock, ~.:.M.
...............~Y!.<?~:p...........................and subscribed this
......................?~:~~................. day of ....~.p.r..+).........
19, ~.R...., before
. ./1 /
c.-c)ljj /) -;;7'Vj /} n<L _/
...............:..........:.:.;:"\'.':;:"......;{r.AM~"r..................
Wm. A. Kramer, 2nd
'-~\LlI)~('r~:~~..I~~.~i.?~+\::.....?~.~~~.~.!:.
lUa1.!lli E. ._I.lh._!.\;~klSteI ----.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH 01" PENN8YLV ANIA }
COUNTY OF CUM~ERLAND 88:
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for
the County of Cumberland, personally came .....................................................................................................
who, being duly ......il.W,Q);'.(1.........., do .......... depose and suy that us...."J);lIf7.9.\.l.I;.Q.r.........................................
of the last Will and Testament of ...............................lU.C.lIIl.I:\D....1:l......uJ:.G.nl1'~...................................deceased
....,;1..1<................ will well and truly administer the goods and chattels, rights and credits of said deceased
according to law. And also will diligently comply with the provisions of the law relating to Transfer
Inheritances. ....Sl'l.o.r.n............ and subscribed
before me.
~r..."'"ll.:..,.,....................... A. D., 19.an......
'Yf.~~(.jJ~I.................~.~?~~~
:a:.. . _UI, Registe.r-------
.................................................................................
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DECREE
Be it remembered that on the .....J~.~!~........ day of ..................~k:~~.~..................., A. D., 19 ~~...., there
wa p ob ted d 0 d d th I t W'II d T t t I' l1.ich<J.rd H. Nickum
s r a an rec r e e as 1 an es amen 0 .............................................................................
f Carlisle .
lateo ............................................................................, Cumberland County, Pennsylvama, Deceased. Letters
Farn1ers Trus t company
'festamentary
....................................................... were granted to
............................................................................................
Witness my hand and official seal the day and year aforesa~.
..._(\ 't. ". i
. (.~~(..i.1J~.".........~.:.~~~..~
~~"\';--lWglster.
.
COMMONWf:ALnl Gi "ltl"!'"
,
~crld\T~.':;~n ': I
BUf~EAU elF (,Cdjf~ r', .'d.;..
I;'
,:1'1'11(" llOr! n!E WI) CONSENT
-II) lilt-Wi' I.R ',ECURITIES
1<l:Glj il:I~[[) IN IHE I'IAME I
OF A RESIDENT DECEDENTl
'*
ll,',:.) ,I,'
DATE__H~y 28, 1980
APPLICATI~" ,,,'UT ,,- "" ,'" IlJ TRIPLICATE'
___::!'~ \1l',V';1 u":':. ...c....... ... ,., -' -.1
TO THE PENI,~YLVAt,IA DEPI,RT/.IEtH OF REVENUE:
App:";Ulicn I,. :,cIChy modc for emsent to thc transfer of the following securities of a Pennsylvania
Corporation 01 (J Ho;iolllll Bnnkinq Association locCllcd ill Pennsylvania:
(oL___~~__P _Jb) C.H. Mas land & Sons ___m'___'___ __(cL-~n
(NOTE: III describina so,:",iti"' en'cr in {"l. c.hOle, either the l1umher of shares of stock or the face amount of
registewd b",,,h, in (b~, tl"'1(lI;," "I ,he ".;"ing compallY and in (c) the class of stock or the stated interest rate
'and Illuturity date of rcgis:::rcd honos.)
ISSUED ON __~~\'~ 1. 1965 .
_ _, ell': hO'/ing (j TOTAL MARKET VA<LUE OF $
245.00
as of the dole of donlh or tht. decedenl, --.-
(Nume or Dl'c!:Jcnl)
, on April 21. 1980
(Dato of death)
(1il!!.j
Richard H. Nickum
.-.-.--'---"" .-----
who wos late r,f____~Ol_.liarriS\)Urg-p:llte.-~aJ:l:lsl-e-LCl!IIIl'erbn..<!.LPAJ.701L_
~.S!lf.lc! ann NllrnliN) (Pt'o;t OHicc\ (County)
(Stote)
The securities (lie regis!l'red 0'. hllo'"'' Richa.l:~_]~~__N_i~1:wn_lI.nd- Helen H. Nickum, Jt. Tan.
(Homc or ncmf!S In which certificates arc rogistered)
ADMINISTRA ~ OP)
EXECUTOR
(Addross)
HAME OF APPLlCAllT Farmers Trust Co.
P.O. Box 220
COUNTY FILE NU!\L'I'='R __21:-8_0::~~Q---_ ADDRESS OF APPLICANT (;a'd:!.sle. PA 11013
(' ..^\ If), I
BUREAU FILE rIUMBER.. ._.. _____SIGNATURE OF APPLICANT ~bi.,:-j ..::1.Lw'c
NOTICE: IF YOU FAIL TO PROPERLY m.L IN ANY PORTION OF THIS APPL!EATION, IT WILL NOT BE
CONSIDERED COMPLETE /,I.m WILL BE RETURNED TO YOU FOR COMPLETION.
Farmers Trust Co.. P.O. Box 220. Carl~slc, PA 17013
~Nal1w)
________..___~____.".+___ .__ . ____.... 0"___'. .____.__.__.___,__._._n~._..._..._
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
t:;.QNSENJ_ TO_]~~ANSFER SECURITIES DA TE ~;,. ,go. /9,f'd
I hereby cOllsent to the t;-ooster of the "Gave securities now registered in the name of the ofO~id
.'".-... ...-----..------- -----
Decedent and \Voive the filing of a certilicote certifying to the payment of the transfer inheritance tax to which
the properly of soid Decodent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L 521,
os amended and the Act of .lUll<:' is, 1961, P,L. 373, os amended. This is also in accordance with the provisions
of the Act of April 9, 192", P.L. 3\3.
This C"n5""t io Tlorde, I;", 11I',,,in described properly operotes only in reference to the estate of the
nbove~namcd Dccl"!den1.
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Signed for the Secretory of Revenue
By..2;-I-:t~c-e . ,;Yw~J
./) (5i9 ",e)!)
lr~-:_~------Q//J'?J~Mui..-
I-~ I1le) (County)
! .
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate.
In addition to debts incurred by the decedent or estate, other items are claimable including tl1e cost of administration,
attorney fees, fiduciary fees, funeral and burial e~,penses including the cost of a buriallnt, tomhstone or grave marker.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed
should be attached to this scl1edule.
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spouse, or if tile spouse has forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent. The family exemption is
allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column.
2. Assign consecutive numbers to each item listed.
3. Enter the date on wl1ich each debt was incurred and/or paid.
4. Enter the names of each payee.
5. Provide a brief explanation in the remarks column for each debt claimed.
6. Enter the amount of each debt being claimed.
7. The form must be signed by the person who has assumed the responsibility for paying the debts.
.'
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inherilance anti Est"te T"x Act of 1961 provides lIwt the followinR persons shall prepare and file
a return:
a. The personal representative of the estate of the decedent as to property of the decedent adl1linisteretl by him
and such additional property which is or l1Iay be subject to Inheritance Tax of which he/,he ~holl have or
acquire knowledge;
b. The transferee of property upon the tmnsfer or which Inheritance Tax is or may be imposed by the 1961 Statute,
including a trustee of property transferred in tfllst. provided that no separate return need be made by the transferee
of property included in the return of a pC! sonal reprcsoutiltive.
2. PLACE FOR FILING
The return is to be filetl in duplicate w:th the Register 01 Wills of the county wherein the decedent resided.
3. TIME FOR FILING
The return is due nine months Mter the tlecedent's tleath, unless an extension for filing has been applied for and
gmnted by the Secretary of Revenue within the nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report
required of him. . .shall be personally liable. . .to a penalty of 25% of the lax ultimately found to be due or $1,000
wbicbever is the lesser to be recovered by the Department 01 Revenue as debts of like omount are recoverable by
law."
5. TAX RATES
Inheritance Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife,
son, daugbter, grandchildren, grandparent, son-in-law and daughter-in-law and at tbe mte of 15% as to all others.
6. PAYMENT OF TAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rate of 6% per annum accrues thereafter until payment is made. All poylllents received are first applied to any
interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED.
All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7. FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest have been paid in full. The taxes may ,be sued for against any real property in the decedent's
estate or against any property belonging to a transfelee liable for the tax.
8. FILING OF FALSE RETURN
Any person who willfully makes a fatse return or report required of him sh;lll, in accordance with Section 793 of tbe
1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay il fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or botl1.
REV.451 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEDENT
Estate of
ITEM
NO.
SCHEDULE "8"
PERSONAl. PROPEi1TY
(llIStrw;liom- fill th'v/.'rs/.' Sld/!)
RICHARD H. NICKUH
..".,."...,~-........"~",c-,,......"',=="=""-".L.-""
DESCRIPTION
1
2
3
4
5
6
7
8
Proceeds sale P~rsonal Property
Certificate of Deposit 20055, Farmers Trust Co.
Interest to date of death Item #2
Certificate of Deposit 20723, Farmers Trust Co.
Interest to date of death Item #4
Certificate of Deposit 20746, Farmers Trust Co.
Interest to date of death Item #6
Certificate of Deposit 1929, Dauphin Deposit Bank
& Trust Co.
Interest to date of death Item #8
Certificate of Deposit 1926, Dauphin Deposit Bank
& Trust Co.
Interest to date of death Item #10
640 shs. Delaware Fund, Inc.
95 shs. Knouse Food Co-Operative, Inc.
40 shs. C.H. Masland & Sons
Proceeds Policy 749891, Massachusetts Mutual Life
Insurance Company
Proceeds Policy 809890, Massachusetts Mutual Life
Insurance Company
Proceeds Policy 722935, The Travelers Insurance Co
Proceeds Policy 583542, Provident Mutual Life
Insurance Company
Proceeds Policy 556688, Provident Mutual Life
Insurance Company
Proceeds Supplementary Contract 313 858 RBB,
Metropolitan Life Insurance Co.
Proceeds Policy 2567345A, Metropolitan Life Ins. C
Proceeds Policy 2124829A, Metropolitan Life Ins. C
Proceeds Policy 34087, Prudential Insurance Co.
Proceeds Policy 711054, Metropolitan Life Ins. Co.
Interest Metropolitan Life Insurance Co.
Massachusetts Mutual Life Insurance Co. annuity
check dated 4/13/80
Checking Acct. 5-37004, Farmers Trust Co.
Refund Church of God Home, Inc.
Refund Medicare
Refund Pa. Blue Shield
Refund Capital Blue Cross
Refund C.H. Masland Co. Health Insurance claim
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
UNIT
VALUE
11.36
100.00
6.125
ESTIMATED
MARKET
VALUE
3,594.07
20,708.53
551.11
34,526.04
209.88
15,000.00
85.10
1,000.00
7.70
1,000.00
2.67
7,270.40
9,500.00
245.00
2,161. 23
11,086.40
1,500.00
4,053.90
1,013.48
1,500.00
1,051.89
1,699.45
2,750.00
305.45
49.09
16.59
3,699.92
1,109.00
640.20
153.30
34.60
40.96
TOTAL THIS PAGE 16.26,565.96}
*
DEPARTMENT
VALUATION
(OFFICIAL USE ONL YJ
I:n n I'. 'rL.
47j1(-
1. Did decedent, within two years of de~th, m~ke ~ny trnnsfer of ~ny m~teri~1 p~rl of his esl~le without receiving
valuable and adequate considernlion? (Answer "Yns" or "No".). no
2. Did dncedent, withinlwo ynars of death, tmnsfer property from himselfl herself to himself/herself and aoother party
or parties (including n spouse) in joint owoership? (Answer "Yes" or "No".) ~
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontnxable, provide the following
information:
a. Age of decedent at time of transfer.
b. Copy of death certificate.
c. Affidnvit by the attending physician indicnting the stnte of decedent's henllh at time of transfer.
d. All other information supporting non taxabi I ity of transfer.
4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valunble or adequate consideration
therefor which wns to take effect in possession or enjoyment at or after his/her denth? (Answer "Yes" or "No".) no
a. Wns there any possibility that the property transferred might return to trnnsferor or his/her estate or be subject
to his/her power of disposition? (Answer "Yes" or "No".)
b. What was the trnnsferee's age nt time of decedent's denth?
5. Did decedent in his/her lifetime make any tmnsfer without receiving a valuable and adequate consideration therefor
under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her
death:
a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) -~
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Yes" or "No".) _ no
6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others.
OUESTIDrlS CONCERNING PROPERTY TRANSFERS
7. Did decedent in his/her lifetime make a transfer, the consideration lor which was transferee's promise to pay income
to or for the benefit or care of transferor? (Answer "Yes" or "No".) M
8. Did decedent, at any time, transfer property, the bmeficial enjoyment of which was subject to change, because of
a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of
law? (Answer "Yes" or "No".) nn
9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Yes" or "No".)
REV.453 (l.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of
RICHARD H. NICKUM
SCHEDULE "D"
BENEFICIARIES
.
(lnstmctinns on R(!'mrst! ShltJ)
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
..
L10v~ H Ni~kum brother ves ~ v,,~.-7..L.Yrs . 1 share of Residue
Ryda1 Park on the Fairway, Apt. 2 8
Rvda1 PA 19046
Lauretta V. Lvnn sister ves ( er 21 yrs. 1 share of Residue
4020 Castor Avenue
Phila. . PA 19124
..
Edith A. Lort sister yes ( ver 21 yrs. 1 share of Residue
R.n. ~ Box 10<; A
Se1bvvil1e DE 19975
-.." -------- --~----- ----
Robert Perinchief nephew yes C "er 21 yrs. 1/3 share of Residue
--
1148 W. Highland St.
Whitewater, WI53190
Graham K. Perinchief neph,,~_..__....___ ..L':.s________~ "-eL~J..Ys_~_ 1/3 share of Residue
----.-.--
1846 Camino Drive ----------------- ----------
----.~-_.-~_.... -..- - --------.-----..---
Forest Grove, OR 97116
Burt Perinchief nephew yes ( ver 21 yrs. 1/3 share of Residue
P O. Rnx 166 - ------ --- ---- -----
Lake Mary, FL 32746
..
Delores N. Moore step-niece yes ( Iver 21 yrs. 1/2 share of Residue
5233 Brendonridge Road -- --
Indianapolis, IN 46226 ..----
- ---
-- _."--- ._~_~_..n --- -.
; The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
".
REV.453 (l.801
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
SCHEDULE "D"
BENEFICIARIES
*,
(Instruction., on !rn'/lJrSCf Sid/f)
Estate of
RICHARD H. NICKUM
=- -
BENEFICIARI ES AND ADDRESSES RELATIONSHIP SURVIVED DA TE OF INTEREST OF BENEFICIARY
DECEDENT 81RTH
- - - -
Vernon R. Nickum steP:-neghaW-_____ _Y~!L___J vaLllJL~ _liZ-share of Reaidlle.
Bridgeboro Road
-------- --
Moorestown NJ 08057
-- .
Jean Madill Kracher s teo-niece vas ( ver 21 yrs. 1/2 share of Residue
205 Cherrv Street
M> IIn"" lJT nRnt;n
Denise Hurlock o>an_n{ ano -y.as ,..o~ 0] yrs. 1/2 sharp. of Resinue
6433 Lenox Court -- --
Bensa1em PA 19020
--~-~_..~._- ----..-..... -_..._-,-'._--- --.---------------"" - .--' --------
Bettv Ettin2er Class B ~_s_, ( !ver 21 vrs. 1/6 share of Residue
Moreland Towers, Aot. 315 beneficiary
-----.- -
Hatboro, PA 19040
-
Martha Ettinger Class B -y~~------( "_er_2J_Yl'-",_ _1.!~_sh;!.,-,,-_,!_f Residue
--'--'-- ----- ...----.-
6519 North Fifth St. Beneficiary
._---~-_.- ...----_.--- ..-----_.__..0- ...~_._--_. .--- --.'-. --- __..___n .._-_._-_..._-_.,--_._._"-~-
P 'nh{o 1>A 101% ___u
-----.-.. -
-- -
Ra10h G. Ettinger. Jr. Class 11 -- \-y.!'~er 2.LYIfu__ 1/6 share of Residue
n07 GTPpn Rn::lr1 beneficiary _._---~-- -------- u.._~___.__..
.----.
Ros1yn, PA 19001
Helen L. Bevan Class B yes ___ C er 21 yrs. 1/6 share of Residue
101 Williams Lane --- benefic!-'lEY.. ____ __
.__..----_.._---~..~- --
Hatboro. PA 19040 ---____._0- -
--~._--,.__._- -..--...-------- ---
- ..-- --- - - ___'0" n'".''' --- --.- . ...._-~- --- --- --...- ---.-'- --
The above beneficiaries are living at this time except for the following:
NAME DATE OF DEATH
--------- .----------
------- -------
--'.--- ---~----_._.
,.,'
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INSTRUCTIONS FOR SHCEOULE "0"
1. List full names and addresses of all who have an interest in the estate
either vested, contingent or other interest.
2. Indicate the beneficiary's relationship to the decedent. Specify if
stepchildren or illegitimate children are involved.
3. Indicate "Yes" or "No" if the beneficiary survived the decedent.
4. Indicate the date of birth of the beneficiary if the interest is a life
interest, term certain interest or a future interest.
5. Indicate the interest of the beneficiary in the decedent's estate.
For example: Specific bequests of a diamond ring. savings bonds
or cash of $5,OPO; bequest of 25% of residue; remainder interest; etc.
6. At the bottom of Schedule "0" state those beneficiaries who are not
living at the time the return is being filed and include date of death.
REV-453 (1-BO)
COMMONWEALTH OF PENNSYLVANIA
. OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEDENT
SCHEDULE "D"
BENEFICIARIES
~~
. 'r_- r(~\
. ~l
.
(fnstfllctions 011 R(!'mr,m Sid(})
Estate of RICHARD H. NICKUH
. - -.
BENEFIr:IARIES AND ADDRESSES RELATIONSHII' SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
-
Hae E. Jackson Class B -- lJes 0 er 21 yrs. JL6 share of Residue
2209 Lawnmont Aot. 104 beneficiary
Austin TX 78756 -
Shirley Ettinger Eyre Class B ves C er 21 'iEs. 1/6 share of Residue
328 Unoer Valley Road beneficiarv
" .. u_,__ ". ,aM;/'
NOTE: Paral!raph Second of Will divides Resi ue into sev n (7) equal shares
.. ----...- ------------ -,~-----
.--
.
_ --------,---------- ----------_.~-- --- -.---.--------- --------
-
_ ------------ 1------------- -..-------------.. _..____m ______n. _ ._-~_...._----~--
-
-
--- ----------+ ---- ---------- ------- ---
-----
-- .--- -.---..-..---
-- -- -- - -.-... -- .-...~...._----- ---_..,- -~ --- -- - - - -- -
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
Mabel H. Perinchief
unknown
Elmer R. Nickum
unknown
--------
REV.4!54 EX+ (3.80)
COMMONWEALTH OF PENNSVLVANIA
. DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RE610ENT DECEDENT
SCHEDULE "E"
JOINTL V OWNED PROPERTY
*
(Instructions on Roverso Sldo)
Estate of
RICHARD H. NICKUf!
-
P
ITEM TOTAL \ VALUE OF DEPARTMENT
DESCRI PTlON MARKET DECEDENT'S VALUATION
NO. VALUE INTEREST (Olflela' Use Only)
- ~
NONE
,
,
"
..J
I
"
TOTAL THIS PAGE N~LU
~- "PI''''
, ~
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
Schedule "E" must include all property, real and personal, owned by the decedent jointly with another
party or parties as joint tenants wilh right of survivorship. Both tangible and intangible property are to be
included. List real estate first.
1. Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property
as indicated in the instructions for Schedule "6". I nclude tile name, address and relationship to the
decedent of the co.owner (s) and the date the joint ownership was established.
2. Indicate the total market value of the jointly owned properly.
3. Indicate the percentage of the decedent's interest.
4. Indicate the market value of lhe decedent's interest.
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INFORMATION
To insure proper credil 10 your account. tho name 01 'I'" uSlOte and lilo numbor should be cl"",ly print-
ed on the check or money order.
This assessment is made in accordance wilh Soction 708 of the Inheritance and Estate Tax Act of
1961 (72 P.S, ! 2485.7081.
To the extenl .hat inheritance tax is paid within three (3) months alter the dealh of Ihe decedent. a
discount of fiva 15) percent is allowed 172 P,S, S 2485.716).
':,heritance Tax. other than tax on a future interast. is due at the dale of the decedent's death and becomes
daiinquent at the expiration of nine 191 months alter the decedent's death 172 P,S, 1 2485.711). Inherilance
Tax on a future interest is peyabie within three (3) months after tho transfer takes effect in possession and
enjoyment and is delinquent thereafter 172 P.S. 9 2485.712), Calculate interest from the delinquent dale shown
on the face of this form to the date of actual payment using the following interest table:
---------------------------------- ------------- - - _.- - --,- --.-------- -- -- - ----
, month .005 4 months .020 7 months .035 10 months .050
2 months ,010 5 months .025 B months ,040 11 months .055
3 months .015 6 months ,030 9 months ,045 12 months .060
1 days .00017 11 days ,00186 21 days .00352
2 days .00034 12 days .00203 22 days ,00369
3 days .00051 '3 days .00220 23 days .00386
4 days .00068 14 ctays ,00237 24 days ,00403
5 days .00085 15 days .00250 25 days .00420
6 days ,00101 1/; days ,00267 26 days .00437
7 days .00118 17 days ,00264 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00'52 19 days ,00318 29 days .00488
10 days .00169 20 days ,00335 30 days .00500
-- ------------ ------- --- --- - - - --- --- - - .-- -- - --- .--- - - - - --------- ------
Any party in interest. including the Commonwealth and the personal representative. not satisfied with
the assessment may object Ihereto within sixty 160) days alter receipt of this Notice as provided by Section
1001 of the InheritanCe and Estate Tax Act of 1961172 P.S, S 2485.1001),
Make check or money order payable to:
"Register of Wills. Agent"
Mail to the address listed below:
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities Incurred by the decedant prior to his/her death are deductible against his/her taxable estata.
In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses Including the cost of a burial 101, tombstone or grave marker.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liablliw for the debts being claimed
should be attachad to this schedule.
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent. The family exemption is
allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column.
2. Assign consecutive numbers to each item listed.
3. Enter lhe date on which each debt was incurred and/or paid.
4. Enter the names of each payee.
5. Provide a brief explanation in the remarks column for each debt claimed.
6. Enter the amount of each debt being claimed.
7. The form must be signed by the person who has assumed the responsibility for paying the debts.
/"
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
----..--
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of ]961 pruvide~; lhatthe (01101'11111; persons Shill I prepare and file
a return:
a. The personal representative of the estate of the decedent as to property of 1110 decedent adlllillisteled hy him
and such additional property which is or may he suhjectlo IlIheritance Tax of which he/she sh~111 have or
acqui re knowl edge;
b. The transferee of property upon the transfer of which Inheritance Tax is or may he imposed by the 1961 Statute,
including a trustee of property transferred in trust, provided that 110 separate return need he made by the transferee
of property included in the return of a personal representative.
2. PLACE FOR FILING
The return is to be filed in duplicate with the Register of Wills of IIle cOllnly wherein the decedent resided.
3, TIME FOR FILING
The return is due nine montlls after the decedent's death, unless an extension for tiling has been applied for and
granted by the Secretilry of Revenue within the nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Stalute provides that" . . .any person who willfully lails to file a retum or other report
required of him.. .shall be personally liable. . .to a penalty of 25% of the lax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as d(~bts of like amount are recoverable by
law."
5. TAX RATES
Inheritance Tax is payable at the rate of 6% on transfers to lineal descendanls, such as father, mother, husband, wife,
son, daughter, grandchildren, grandparent, son-in-law and daui,lJ1ter-in-law and at the rate of 15% as to all olhers.
6. PAYMENT OF TAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any
interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED.
All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7. FAILURE TO PAY
The taxes imposed, togelher with any interest thereon, are a liell upon real properly, which lien remains in effect until
the taxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's
estate or against any property belonging to a transferee liable for the t;rx.
8. FILING OF FALSE RETURN
Any person who willfully makes a false return or report lequired of liirll sli;rll. in accordance with Section 793 of the
1961 Statute, be guilty of a misdernemlor ;rnd, on convictioll thereof, shall be sentenced to pay a fino not exceeding
$1,000 or undergo imprisonment not exceeding one yem or both.
" "l.
,
, .
REV.451 EX+ (3.80)
COMMONWEALTH OF PENNSVL VANIA SCHEDULE "B" *'
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX PERSONALPROPERTV
RESI DENT DECEDENT
(Instructions on Reverse Side)
, Estate of RICHARD H. NICKUM .
ESTIMATED DEPARTMENT
ITEM DESCRIPTION UNIT MARKET VALUATION
NO. VALUE VALUE (OFFICIAL USE ONL Y)
1 Refund, C.H. Masland & Sons, hospital and
medical insurance 1,593.52
.
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I TOTAL THIS PAGE ~ .n .J, .s- ~rvfi'
1,593.52
II~
'"
J.l M
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.'
.'
IN TilE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYINANIA
ORPHANS' COURT DIVISION
IN THE ESTATE OF RICHARD 11. NICKUM, LATE OF THE BOROUGH OF CARLISLE
SCHEDULE OF PROPOSED DISTRIBUTION
Balance for distribution as per First and Final Account filed
December 12, 1980
g=!~~",~n~~~
DISTRIBUTION:
Lloyd H. Nickum
principal Cash
Income Cash
13,988.73
878.56
14,867.29
Lauretta V. Lynn
principal Cash
Income Cash
13,988.73
878.56
14,867.29
Edith A. Lort
principal Cash
Income Cash
13,988.73
878.56
14,867.29
Robert Perinchief
principal Cash
Income Cash
4,662.91
292.85
4,955.76
Graham K. Perinchief
principal Cash
Income Cash
4,662.91
292.85
4,955.76
Burt Perinchief
Principal Cash
Income Cash
4,662.91
292.86
4,955.77
Delores N. Moore
Principal Cash
Income Cash
6,994.36
439.28
7,433.64
UBE?, 9"1 ,..',[ 68'/
.'
Vernon R. Nickum
Principal Cash 6,994.36
Income Cash 439.28
7,433.64
Jean Madill Kracher
Principal Cash 6,994.36
Income Cash 439 .28
7,433.64
Denise Hurlock
principal Cash 6,994.36
Income Cash 439.28
7,433.64
Betty Ettinger
Principal Cash 2,331.46
Income Cash 146.42
2,477.88
Martha Ettinger
Principal Cash 2,331. 46
Income Cash 146.42
2,477.88
Ralph G. Ettinger, Jr.
principal Cash 2,331.46
Income Cash 146 . 42
2,477.88
Helen L. Bevan
principal Cash 2,331.46
Income Cash 146.42
2,477 .88
Mae E. Jackson
Principal Cash 2,331.45
Income Cash 146.43
2,477 .88
Shirley Ettinger Eyre
Principal Cash 2,331.45
Income Cash 146.43
2,477.88
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4/28/80
4/29/80
5/5/80
5/8/80
5/12/80
5/14/80
5/16/80
5/29/80
6/2/80
6/3/80
6/6/80
6/10/80
6/13/80
6/30/80
7/22/80
9/22/80
12/11/80
PRINCIPAL DISBURSEMENTS
Westminster Cemetery, Inc., dute on memorial
Kenneth R. Guistwite, M.D.
Register of Wills, Letters Testamentary
Kenneth R. Guistwite, M.D.
Carlisle Hospital, claim
Notary fees
Registered mail expense
Cumberland Law Journal, advertising Letters 'restamentary
Elizabeth Schiffman, jewelry appraisal
Hoffman-Roth Funeral Home
Carlisle Radiology Associates, P.C., claim
Hoffman-Roth Funeral Home, Death Certificates
Register of Wills, Short Certificates
Orthopedics, Ltd., claim
Notary fees
The Evening Sentinel, advertising Letters Testamentary
Register of Wills, Short Certificates
Zeigler's Storage & Transfer, Inc., moving and storage
postage and insurance
Belvedere Medical Corp., claim
Register of Wills, partial Penna. Inheritance Tax due
Register of Wills, filing Inventory and Debts & Deductions
Register of Wills, balance Penna. Inheritance Tax due
Reserved:
Wm. A. Kramer, 2nd, Esquire, attorney fee
Farmers Trust Compsny, commission
Closing and Filing Costs
Total Principal Disbursements
4/28/80
5/6/80
5/8/80
6/9/80
\
I
I
\
,
1
!
.
,
1
6/17/80
6/19/80
6/30/80
INCOME RECEIPTS
Interest, Certificate of Deposit 20055, Farmers Trust Co.
Interest, Certificate of Deposit 20723, Farmers Trust Co.
Interest, Certificate of Deposit 20746, Farmers Trust Co.
Interest, Certificate of Deposit 1926, Dauphin Deposit Trust
Interest, Certificate of Deposit 1929, Dauphin Deposit Trust
Interest, Policy 722935, The Travelers Insurance Co.
Interest, policies 749892 and 809890, Massachusetts Mutual
Life Insurance Co.
Interest, Policy 313 858 RB, Metropolitan Life Insurance Co.
Interest, policies 556688 and 583542 Provident Mutual Life
Insurance Co.
Interest, policies 2l24829A and 2567345A, Metropolitan
Life Insurance Co.
Interest, Policy 34087, Prudential Life Insurance Co.
Interest, Certificates of Deposit Farmers Trust Co.
Total Income Receipts
3
lIm ~ '1 1",[ to",\)
10.00
381.00
44.00
627.00
2.20
3.00
3.41
18.00
60.00
2,352.00
35.00
18.00
4.00
30.00
3.00
21. 50
3.00
263.28
3.33
10.00
11,500.00
6.00
4,055.92
5,642.42
5,642.42
250.00
~==~~,!,~~~~~~
Co.
Co.
20.17
209.88
97.27
2.43
2.43
10.85
95.36
22.00
46.62
30.02
32.56
5,910~
~===g'!'~b~~g~
,
\ ..____~__~~ ~ ____ -.::a.: __~---=- ,. --.
d.AIV.'l1e2EX, .' "
~tlN~" ,",: " " ,';. COMlI!'\qNWEALTH OF PENNSYLVANIA
: 4 NO!K000351.. ' ' DEPARTMENT OF REVENUE
, "r"~,"'" 'OFFICIAL RECEIPT" PENNSYLVANIA INHERITANCE AND ESTATE TAX
',",.,' ,
e
I j,
I ~ ,RECEIVEO ranllll'. Tru.t Company
i JjFROM
1 w. High Str..t
ADORESS
-
TAX AT 6%
TAX AT 15%
TAXAT_%
ESTATE TAX
4,055.92
cadi.le, Pa.
17013
TOTAL TAX CREOIT
'--E"sTATEINFciRMiii'10"N"':':-rl1ii -1980----------
OATE OF DEATH'" ,
21-80-290
FILE NUM8ER
LESS DISCOUNT
PLUS % INTEREST
IFROM TO_I
OATE OF PAYMENT
Dea.aber 12, 1980
NAME OF OECEDENT
m
---- ---. m
TOTAL AMOUNT PAID
RICHARD H. SICKtIM
cwabedand
4,055.92
COUNTY
------ ---------------
POSTMARK Dill'.-
I'AI>> Olll ACCOUNj.'
REMARKS:
SEAL
RECEIVED BY
,: /,,"" vi
//=:I~~~~:,d
REGISTER OF WILLS
------.-------.----..--.--.------ ------
II
; RECEIVED
II
ill From,
= Irass
U
-.dollors
::"ll- ---
11@~1~1',~!~;~;~;i,:; ,',.,:.':, COMMONWEALTH OF PENNSYLVANIA .
"l.'t;4\\u",~~i:~,J"J~'1,"", ,I .:' I '
6f.1lj"\!1""~ ",',,;o"'-:' ". DEPARTMENT OF REVENUE
:'(~"~,~(t,~:?~,~19IAL.RECEIPT' ~~~~~~LV~~~A I~_~~.~I~~~~E AND ESTATE TAX
II
~
____-'______--.J.&V&1lI THOUI~UD
representing Pennsylvania Inheritance or
E!llole Tal( due from the following estate:
......."'. ",,,,,,.t!. l!~.n.y
C."li-l.,
..,.
non
6% Tax on
s
s
s
s
s I
$
S ] ~, J 05 2~
$ 605.26
1 W. Hi;h s~ral!l1:.
2'7, Tax on
$
{ File No.
Dole of Payment
21.80_200 Dole of Deoth4-21-19aO
15'7" Tax on $
t Name of Decedent
ueillt& H. NlelWM
7" To)( on S
Estate Tax. Act of
May 7. 1927
July 21. ]980
.. PAID ON ACCOUNT-
lOT AL TAX CREOn
Less fi" e percenlum of lax if
paid within three months after
date 01 deoth
Plus interest at the role 01
_'{"from
10
$
County Q,IIIl'......lan4
Remarks:
11.500.00
'iYOO~[P[L~@&'iY~ SEA L
TOTAL AMOUNT PAID
s
NOTE: This Triplicllte Receipt to be retllined tor lIudj{ purposes.
Received by
NOTE: In accepting the IraMler inheritance tall on luture eltotel. prior 10 the death 01 the lile
lenonl or tenant lor yeorl. 0' evidenced by Ii'll, receipt. il il undeutoad Ihat the Commonwealth ,hall
nol be precluded or prevented from hereafler oueuing additional Inheritance 10. at Iho deolh of the
Ille lenonl or tenant for yeorl whenever II appearl lhal luch additional 10. ITVJY be legally due and
collecliblelor any realon what,aev.r.
.-.----.------.-- .---- ----- ------.--.---------- -.--.--.-