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HomeMy WebLinkAbout80-00374 .' ;,' '. :-:1 -',~ ' ": . ",~' .': l':', ,;.., ..: H ~ !;1 CI) ~ fe . .. >< II< ~ . H gj i3 ~ .. .~ ~ Eo! . ~ ..: CI) . ~ ~ ~ ~ CI) .~ ~ I-:> '.f'. ",i.:,. ','J' .:' i-,(~i .\ :i' ,:.'i. i,:. 'I, 1.,' , .I ",,:,-,"'j ",,-, > ow. 0 . JJ ~ 0 ca \0 - z &:I NO. 21.80 3711 PETITION FOR LETTERS OF ADMINISTRATION IN '1'1,11+: EHTA'1'1t: OF ...."""",J.~.~~.~...A,~"J:1~,y.,....~!...""......,,. 1)(~CEASED. , MARY C. LEWIS ro .,....,..,.....",.,.,...,......,..,.,...,"".",...,......,..................."..."...."....".........-.-......".-....- HeKI..tm' or \\'111.. 1'01' till! ('ounl,\' of CUl11lwt'iand, in the Commonwealth of Penn,ylvani". The l"e! (tlou of .... ...,. """ ... ,.... ... ....,....... ... ... ...D.9I.<?~1:\y'.,l:1.,...~.<?n~ng~I_._..._....."_..._..,,... ."....."...-....-... ,..........., "......"........,...,'''' ..., '" "'" """ n'..peel fully ,howel h I hllt .,,, ....".....J.~,\l_~.~..l\-. ,. ...l:1.~y'.,_.._~I.,.."... "........ . II' t I' Middlesex Towushlp C I '1' I C t, St. t of Pel nsyl Willi n reM (en 0 .."'''......".......'''''''''..........................'idKooxxbc. . -,tun Jet ,Ull oun j ,de 1.- vnnln, nnd IL Citizen of United Stllte", and depnl'ted this life inte"tllte in the County of .?~~,~.7.~.~~~ .....,..,..".".....,........ .......... ILlld StILle of ,...... ...... ._..... ........ ." ."....~.e.~~_~Y..~:II1!.?.~1!.._.. ......-....-....-..-....-.....".........'-... on ............l:!9.n4~y..."....... the ""..........~.?~?_......""... dll)' of _........_....!!I.~y..............._............. A. D.. 19~.Q...... ILt the ilK" of ....R.9."..... )'elll'''. 'fhnt the "nld ....._......".."J.~J!.i?~.._A.,...Mi1-y..,.."s.);,..,,_....._....... deceased, left ,ul'viving the following mimed widow or husbnnd, heirs and next to kin, to wit: Nnme Rellltiollship Residence "J ~ ~,~ ~., ,(\,:.J:!~Y.. I... .~.~.:... ", "." ".-... Son .J\~r.t.l~:t;;_..M.._.,.._.R,.P.......~............ ._.I:'!~~~.~h.!.._~~:1....'!.'?~.~......~_~~.~.S 1112 Oak Street ................................................................ ............................................ ,...,....",.",................................................ ............................................ "P..Qh,Q.t.\).Y."J1.,....!l.l?;!.JjThg.~);"".....- .....!?~~Jilh~~E._.."........... ................................................................ ............................................ ".G!i\r,U~Jli!_....J;'.~):.\n-.ih."..11.9.1J- ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ That those above named include all of the next of kin, so far as known. The said decedent was possessed of personal propert)' to the estimated value of $"S.,OO.O".O.O""""... and of Real Estnte. less incumbrance, to the estimated value of $"""_._N.l?Th~"""_,,..,,._ as near as can be ascertained. That the said Real Estate in so far as is known is located in _"".NlA.:_.._._..."...""""-...-""""-"..."",,.,, ........................................................................................................................................................................................ Therefore, your petitioner(s) respectfully appl)'(ies) for Letters of Administration in the above nnmed estnte. Dllted ...""..."""~.~Y."}Q.I""",,,,,,""" A_ U., l!)~.o.,,_ SIgnature and Address of Peti t ioner (s) ....'J.N~1'&:.~i"...""._..".." ........................................................................................ ........................................................................................ 1112 Oak Street ........................................................................................ Carlisle, Penna. 17013 COUNTY OF CUMBERLAND .......................""... ,....._"_.,,_........,,.....Oo.'!:'.o.t.hy... H._.J~o.llinge.h......"....-......_....._.."..._.......""......""-'" 1 t ss: COMMONWF:ALTH OF PENKSYLVANIA named in the nbove applieation being dul)' ..._""...i?W.Q);,P'-.""""".""""_._,, accordinll to Ill\\', sa)' that the facts set forth in the above npplication are true to the best of .he'!:'"_",, knowledge and belief. ~~~~_~~,,~.~~.:~:9J:"""_"""""'''''' and SUbs:~bed 1 ::~b~~~~~":~g~~-':::":::::::::::: .._........._._"."_.......,,............""".""....". A_ D_. 19_".._.." .".-....-.-.........".".."..--.........--...-...-....-.."...."...-"..-",,"-..-. ""~, c!. ..-? .) -,,-....lJl41f"''''''':'''1~-~~~-i'~~~;--'' ............."......"...........-..,,-.-.-.,,-..-.".-...."....".""".".......,,- Ii;; 0 Filed: ."...~.~~~...~.,......J.?~.9.............."...."........... Attorney: (ovel') .."........__...._...".........._".....""._....._._.~.""." John M. Eakin I"a . '5.'U' OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } HS: Dorothy M. Bollinger ...... ............. ...."...... ....... ................. ........._...... "....... ".... ............ "... _.............. _....""... "... _.. "".... ".._..",.., petitioner (s) being duly ......._..........~:w.<?);n._..............."...._... according to law do ~_~"_,,.._. depose and say that as the administra j;.ri~..... of the estate of ..""........"J.~:>.s.e."A.".May..,...S_r.,._..._....""".."......,,_....,,......-............... ........................................................................................................................................................................................ deceased _...."h~;-...,,_._. 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. ..............._......~~~.!?._.............._..._.. and subscribed before me. .................J19,y_...~_O.........".........- A. D., 19.ai:L.. R~~~-..e.....4~"......._..._............. _._..~-J-'~~~-er....".............. ............................................................................................ DECREE Be it remembered that on the ......._....1~h.."....,,-. day of .......".....i!.H.~~._,,"_................. A. D., 19..~!L Letters of Administration in the estate of ._..._.._....... .._.........."'..........~.~~.!!.~_..~.!...!1!.ii':y.,._..I?.;.._..................... Middlesex Township .... ......._......_...... ............, ...._................. ........ '''''' ........ late of .. _........ -... -..... .......-..... -. ""..... .............., "..... ............."'... _ Dorothy M. Bollinger Cumberland County, Pennsylvama, deceased, were granted 1:0 .......-.........-..."".........."..-......................-....... ........................................................................................................................................................................................ Witness my hand and official seal the day and year aforesaid. _.._...........921tUf._-~.'..~~i.~t~~........ ( . HARTFORD ACCIDENH!lo~~~ct,~~DEMNITV COMPANY 000033 POWER OF ATTORNEY Know all men by these Presents, That the HARTFORD ACCIDENT AND INDEMNITY COM- PANY, a corporatiDn duly Drganized undor tho laws ollhe State 01 Connocticut, and having its principal Dlfico in tho City Df HartlDrd, CDunty of HartfDrd, State 01 Connecticut, does hereby make, constitute and appDint ROBERT L. BRACKBILL and/or GENEVIEVE P. LUCAS of I~ECHANIC3BURG, PENNSYLVANIA, its true and lawful AtlDrney(s)-in-Fact, with full power and authority to each of said Attorney(s)-in-Fact, in their separate capacity if more than one is named above, to sign, execute and acknowledge any and all honds and undertakings and Dther writings DbligatDry in the nature the reo I Dn behall Df the cDmpany in its business of guaranteeing the fidelity of persons hDlding places of public or private trust; guaranteeing the perfDrmance Df cDntracts other than insurance poli- cies; guaranteeing the performance Df insurance cDntracts where surety bDnds are accepted by states and municipal- ities, and executing Dr guaranteeing bonds and undertakings required or permitted in all actions Dr prDceedings Dr by law allowed, in penalties not exceeding the sum of ONE HUNDRED THOUSAND DOLLARS ($100,000.00) each, and to bind the HARTFORD ACCIDENT AND INDEMNITY COMPANY thereby as fully and to the same extent as if such bDnds and undertakings and other writings obligatory in the nature thereDf were signed by an Executive Officer Df the HARTFORD ACCIDENT AND INDEMNITY COMPANY and sealed and attested by Dne Dther Df such Officers, and hereby ratifies and cDnfirms all that its said Attorney(s)-in-Fact may do in pursuance hereDf. This pDwer Df attorney Is granted by and under authDrity of the following prDvisions: (1) By-Laws adDpted by the StockhDlders of the HARTFORD ACCIDENT AND INDEMNITY COMPANY at a meet- ing duly called and held on the 10th day of February, 1943. ARTICLE IV SECTION 8. The President or any Vice-President, acting with any Secretary or Assistant Secretary, shall have power and authority to appoint, for purposes only 01 executing and attesting bonds and undertakings and other writings obligatory in the nature thereof. one or more Resident Vice-Presidents, Resident Assistant Secretaries and Attorneys-in-Fact and at any time to remove any such Resident Vice.President, Resident Assis- tant Secretary, or At1orney.in-Fact, and revoke the power and authority given to him, SECTION 11. At1orneys-in-Fact shall have power and authority. subject to the terms and limitations of the power of attorney issued to them, to execute and deliver on behalf of the Company and to attach the seal of the Company thereto any and all bonds and undertakings, and other writings obligatory in the nature thereof. and any such instrument executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed by an Executive Officer and sealed and attested by one other 01 such Officers. (2) Excerpt frDm the Minutes of a meeting of the BDard of DirectDrs of the HARTFORD ACCIDENT AND INDEM- NITY COMPANY duly called and held on the 11th day of June, 1976: RESOLVED: Robert N, H, Sener, Assistant Vice-President and Thomas F. Delaney, Assistant Vice-President, shall each have as long as he holds such office the same power as any Vice-President under Sections 6. 7 and 8 of Article IV of the By-Laws of the Company. This pDwer Df attorney is signed and sealed by facsimile under and by the authDrity of the foilDwing Resolution adDpted by the DirectDrs of the HARTFORD ACCIDENT AND INDEMNITY COMPANY at a meeting duly called and held on the 6th day Df August, 1976_ RESOLVED. That. whereas Robert N. H, Sener, Assistant Vice. President and Thomas F, Delaney, Assistant Vice-President. acting with any Secretary or Assistant Secretary. each have the power and authority, as long as he holds such office, to appoint by a power of attorney, for purposes only of executing and at1esting bonds and undertakings and other writings obligatory in the nature thereof, one or more Resident Vice-Presi- dents, Assistant Secretaries and Attorneys-in-Fact; Now. therefore, the signatures of such Officers and the seal of the Company may be affixed to any such power of attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. In Witness Whereof, the HARTFORD ACCIDENT AND INDEMNITY COMPANY has caused these presents tD be signed by its Assistant Vice-President, and its corpDrate seal tD be hereto affixed, duly attested by its Secretary, this 9th day of August, 1976. Attest: ,#'~.,~:::::: ' HARTFORD ACCIDENT AND INDEMNITY COMPANY O:':'f" ..._~ - - ~:;:: J)~ Thomas F, Delaney Assistant Vice-President STATE OF CONNECTICUT, / COUNTY OF HARTFORD, \ ss. On this 9th day Df August, A.O_ 1976, before me personaily came Thomas F. Delaney, to me known, who being by me duly SWDrn, did depDse and say: that he resides in the County of Hartford, State of CDnnecticut; that he is the Assistant Vice-President Df the HARTFORD ACCIDENT AND INDEMNITY COMPANY, the corporation described in and which executed the above instrument; that he knows the seal Df the said corporation; that the seal affixed to the said instrument is such cDrpDrate seal; that it was SD affixed by order Df the Board Df Directors Df said corporatiDn and that he signed his name thereto by like order_ ~~ STATE OF CONNECTICUT, / Gloria Mazo!as. Notary Public COUNTY OF HARTFORD, \ 55. CERTIFICATE My Commission Expires March 31,1978 . I, the undersigned, Assistant Secretary of the HARTFORD ACCIDENT AND INDEMNITY COMPANY, a CDnnecti- cut CDrpDration, DO HEREBY CERTIFY that the foregoing and attached POWER OF ATTORNEY remains In full fDrce and has nDt been revoked; and furthermDre, that Article tV, Sections 8 and 11, Df the By-Laws Df the CDmpany, and the ResolutiDns Df the Board Df DirectDrs, set forth in the Power of AttDrney, are now In fDrce_"), <? Signed and sealed at the City of Hartford. Dated the ~tJdG day of 1 ~ 19170 ~ " Form S.3507.8 Pnnted In U.S.A INFORMATION To insure proper credit to your account. tho name of the estate and file number should be clearly print. ed on the check or money order. This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of 1961172 P_S.! 2485-7081. To the extent that inheritance tax is paid within three (3) months after the death of the decedent, a discount of five (5) percent is ellowed (72 P.S. ! 2485.716). Inheritance Tax, other than tax on a future interest, is due at the date of the decedent's death and becomes delinquent at tho expiration of nine (91 months after the decedent's death (72 P.S. ~ 2485.711). Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereaher (72 P.S, Ij 2485.712). Calculate interest from the delinquent date shown on the face of this form to the date of actual payment using the following interest table: --------------------- ---------- --- ---- - -------- - - --- - -- - -------- -- -- - - - -- -- 1 month .005 4 months .D2D 7 months .035 10 months .05D 2 months .Dl0 5 months .D25 8 months .040 11 months .055 3 months .D1S 6 months .D3D 9 months .045 12 months .06D - 1 days .00017 11 days .00186 21 days .00352 2 days .00034 12 days .00203 22 days .00369 3 days .00051 13 days .00220 23 days .00386 4 days .00068 14 days .00237 24 days .DD4D3 5 days .00085 15 days .D0250 25 days .0042D 6 days .001Dl 16 days .00267 26 da'ls .00437 7 days .00118 17 days .D0284 27 days .D0454 8 days .00135 18 days .00301 28 days .00471 9 days .00152 19 days .00318 29 days .00488 10 days .00169 20 days .00335 30 days .00500 -- ------------------- --------- --- -- -- ------- ---.----- - - - --------- --- --" Any party in interest. including the Commonwealth and th~ personal representative. not satisfied with the assessment may object thereto within sixty (60) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S.! 2485-10011. Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: //-t;7~ '-f RE.....'19 EK+ (7-801 COMMONWEAL TH OF PEHNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT INHERITANCE TAX RETURN FOR INSOL VENT EST A TES (Instructions on Reverse Side) CDUN TY ND. 'J / (/. .? //1 " / .,fl'-,) STATE ND. ( ) Exec. (xl Adm. Other Nome Dorothy M. Bollinger , II / "0 -.(Jl) Social Security Ho. ". ~. ,)" ~ III ,. K Estote 01 .T",~~i", A MI\}' Lost oddress (STREET) ... z Middlesex Twp. Cunberland Co. , Pa. w Cl w (ctTv, {STATE) (liP) U W Cl Date of Death M"y lq, lQ80 Address 1112 Oak Street (STREI::T1 Carlisle, Penna. ICITY) (STATE) (ZIPI Undor penalties 01 periury, I declare that I have examined this return and to the best 01 my knowledge and belief it is true, correct and complete. X /)t1'(iil/1 'I ';it) ;611///.'1' c'lul) Slgna'ture of Fiduciary / Oi'lte ,. " ~ U ::> Cl ii: Sociol Security No. 172-01-5702 TYPE OF ASSE'! DESCRIPTION Personal Checking Account 120-136-089-2 Fulton Bank Personal Checking ACCOlIDt 61-381724, Hani1ton Bank Personal Savings Account 1-280845, Fanners Trust Co. ~ Cash ... w ~ ~ Miscellaneous Personal Items TOTAL ESTIMATED MARKET VALUE DEPARTMENT VALUA TION (OFFICIAL USE ONLY) $ 16.64 275.38 766.48 97.11 45.00 were appraised in accordance with Pennsylvania low; $1,200.61 OFFICIAL USE ONLY I do hereby certify thot the ebove osse I ~.<-1l- f AP RAISE DATE NAME OF PAYEE Oct. 21, '80 Brackbill Insurance Register of Wills Myers Funeral Heme Administratrix' Bond J-JJ.-,r? / DATE NATURE OF CLAIM AMDUNT CLAIMED $ 54.00 21.00 2,232.00 Letters of Administration '" z o ;:: u ::> Cl w o Cl z ~ ~ ... "' w o Funeral Expenses ," ,,;r;'il(j]iJl,O:J ;, \' ~,:;i,: ~IO - \~.~:: '13 ;;1): I: d HZ IiiI' lB. ..L;;mH ,-'" " OFFICIAL USE ONLY s d _g 0 1- ti-fJ DEau c. lIONS ALLOWED TOTAL $2,307.00 PATE '" INSTRUCTIONS ASSETS: TYPE OF ASSET -Indicate whether the asset is real estate, personal property, transfer or jointly..owned. DESCRIPTION _ List all assets owned solely by the decedent or owned jointly with another party or parties 05 tenants in common or as joint tenants with right of survivorship at the time of death. Include the dccedcnt's p~rcentage of ownership, the name (5) and relationship to the decedent of the surviving ioint ownNS and the estimated market value of the dcccdcntls interest as of the date of death. Include intangible personal property titled in the name of the decedent but payable at death to another party or parties including but not limited to P.O.D. U.S. Savings Bonds and tentative trust accounts. List any property transferred by the! decedent within two years of death for which he/she did not receive valuable and adequate consideration. Describe all real estate located in Pennsylvania by lot and block number, street address, number of acres and include a general description of the land and buildings" Also, include the book and page number in which the deed is recorded and the exact title as indicated an the deed. DEBTS & DEDUCTIONS - Unsotisfied Iiobilities incurred by the decedent prior to his/her deoth are deductible ogoinst his/her ta.1Coble estate. In additic..n to debts incurred by the decedent, other items ore claimable including the cost of admini stration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tomhstone or grave marker. List the date on which each debt was incurred and/or paid and the names of each payee. Provide 0 bri ef explanation of the nature of each debt claimed and the amount being claimed, Evidence to support the decedent's or the estate's liauility for the debts being claimed should be attached to this return A family e.1(cmption 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 e1(C'i1lption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who ore members of the same household as the decedent. " .. > .. ~ > Z 0 > :;; 0 ~ 0 '" m , m 0 II> ~ II> ~ 0 ~ , ~ '< " ., ~ ." ~ " ~ ;; ;, .. . , m '" m ~ :j ,.. ~ ~ " D .'it , e, n c ~ r- " 0 n > m > ! z > 0 0 0 II> 0 m C'l n c: 0 -l ~ r- m '" Z '" > Z z r- z m -l m -l !=l z !=l !=l z -l -< II> m II> !=l II> -l Z 0 0 '" !=l " '11 > ::! 0 z -l m r- m ." :J: o Z m Z !=l ~ .. < -< m > '" -< m > '" ~ ~ INFORMATION PLACE FOR FILING - The retum is to be filed in duplicote with the Regi'terof Wills of the county wherein the decedent resided. TIME FOR FILING - The return is due nine months after the decedent's death, unless an extension for filing has been applie"d for and granted by the Secretary of Revenue within the nine-month period. FAILURE TO FILE RETURN _ Section 791 of the 1961 Statute provides thot",. .ony person who willfully foils to file 0 return or other report required of him sholl be personally lioble. . .to a pcnalty of 25% of the tal( ultimately found to be due or $1,000 whichever is the less to be recovered by the Deportment of Rcvenue os debts of like amount ore recoverable by law." NOTE: Fees paid to an estate representa~ive; namely, an executor or administrator, for services performed in ad- ministering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income item shoud be reported on . form PA-40-lndividuollncome Tax Return.