The URL can be used to link to this page

Home My WebLink About80-00433 ., .... PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the following persons shall prepare and file a return: a. The personal representative of the estate of the decedent as to properly of the decedent administered by him and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or acquire knowledge; b, The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Statute, including a trustee of property transferred in trust, provided that no separate return need be 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 the county wherein the decedent resided, 3. TIME FOR FILING The return is due nine months after the decedent's death, unless an extension for filing has been applied for and granted 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 tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue as debts of like amount 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, daughter, grandchildren, grandparent, son-in.law and daughter.in.law and at the rate 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 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, 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 transferee liable for the tax. 8. FILlNGOF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both, NOTE: Compensation paid to an estate representative; namely, an executor or administrator, for services performed in administering an estate is reportabie for Pennsylvania Income Tax purposes. This taxable income item should be reported on form PA.40.lndividuallncome Tax Return, , _; :'.-~.(,:;':i;'.::"':~,~_,:,.~t!r:~"':/'",~' ,::,.:':.")r~~,:'~'::~. .:. . :'-' ;: _::.'<<,~. ;'::~.. ,": - \ . ,,:.~,~..?~:.:.~"~'r~ ....:.t:/;;~fit)~~I.'." ~~,~~ ~,;,~{.'I""J':I:'I~'IS.,;.V ; ~ <..':;' :':;;"(;i.~:.:.,: " .. ~::~'j;:;S:~~:fr/';.::\~'- ~ l;,:i'i~t.~~,,,,'l ~:,:';l;'.,!::;;I'A~.I.~ .;."". r.<<.;~~>~....:"':;:::,~' .' ., ";;.:ff,"",~,"':if.';4!i"'-4.i:~~~'~~A" f:' -,iI",. ""I;I;Vf..'.~,t,.R":.' ';,'1.';",' .i','~(" ~,::'~'.~';';.'J '. ~~::~(j~lM~k4~~,,(; 1....~11~'Tloi~;. .\:" '. ....1:.,.~~:'.:..:;.. :~. ....>.\!;\ '.~' '~':::,~"".':' .".:.", 'ii,,,,,~,o(,.~.C"'~'\l"'~'~l,1).l;(':" ; ""'~' '"~''.r':''''' :'. ". .' . ,'... ",'.,, ,. j,~~i:;;;",~~.,,,-]/i!.' ;~. ,:. '~' .... ~;i{:~:2:.~';: .:,::.,:,~ ":;;.::;. :,:,;,,~, <;::V'i';~\~I~~t~',..,.,.:._~! :',_;,:._ .:.._.___;;;. ..:.;,.l:....~~~.--- . ~ \ I ! II I, !I 11 '\ \ Dauphin , memory \ and unders tanding, do hereby mal{e, publish and declare this to \ be my last ~ill and Testament, revoking all former wills. '\ FIRST: I order and direct all my just debts and \ funeral expenses to be paid by my executor, hereinafter named, \ as soon as conveniently may be done after my decease. Ii il '\ estate, real, personal or mixed, of whatsoever kind and whereso- \~ ever situate at the time of my decease, I give, devise and be- \i\ queath unto my sisters and brother, Anne E. J. Creveling, Katharim II D. J. White, Leila J. Ross and Francis E. Jarrett, in equal I; shares, absolutely. \\ \1 Creveling to be the Executrix of this my last Will and Testament. r However, in the event that my sister, Anne E. J. Creveling, may be' Ii unable to perform these duties, I then appoint her son, my nephew, ,I 1'\\ Darryl L. Creveling, to be the Executor of this my last Will and I Testament. II IN WITNESS WHEREOF, I have hereunto set my hand and II seal this..5 day of ~ A. D. 1960. \'("1.1__......:. __..."1_..:1 _........,.I_'--~ __..3 WILL OF flJ)A F. J JlRRETT I, flJ)A F. JARru~TT, of the City of Harrisburg, County, Pennsylvania, being of sound and disposing mind, SECOND: All the rest, residue and remainder of my .' \ I::;V-45' l::X+ (e~801 COMMONWEAL TH OF PENNSVLVANIA OEPARTMENT OF REVENIJE TRANSFER INHERITANCE TAX RESIOENT DECEOENT SCHEDULE "B" PERSONALPROPERTV ~ ~if'(t'~~~~.~' .~,."'~' , :"rpJ,lit., . ~:'I;~~!f~f-I~' . ,....,.(.l~~~..,.r. ~~.,.': '....~V'<~~.#. (lllstructiolls all Reverse Sidol Estate of Ada F. Jarrett I i : ! TEM UNIT ESTIMA TED DEPARTMENT NO. DESCRIPTION VALUE MARKET VALUATION VALUE {OFFICIAL USE ONL Y/ 1 Checking Account /11355-2886, American Bank 1,581.65 2 Cn#9-937-933, Girard Bank 10,280.00 3 261 Sh. American Bank & Trust Co. of PA, common OTC 14.75 3,849.75 4 Refund - Blue Ridge Haven, West 933.70 5 Balance Public School Retirement pay 201. 40 , . TOTAL 16,846.50 1(, j'1(. .r~ 1/' . , lilt " /7010' If odd.t.onal space.s necesSDry, use 8" x 11 sheets, QUESTIONS CONCERNING PROPERTY TRANSFERS I. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No".) Nn 2, Did decedent, within two years of death, transfer property from himself/ herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No",) .J:lll.... 3, If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer, b, Copy of death certificate. c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer, d. All other information supporting nontaxability of transfer, 4. Did decedent, in his/her lifetime, make any transfer of properly without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) No a, Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) Nn b, What was the transferee's age at time of decedent's death? 5. Dill decedent in his/her lifetime make any transfer 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 properly transferred? (Answer "Yes" or "No" ,) No b. The right to designate the persons who shall possess or enjoy the properly transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b. above is "Yes," was the right reserved in decedent alone ( ) or decedent and others ( ), 7, Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) No 8. Did decedent, at any time, transfer property, the bEneficial 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 ei,ght above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone ( ) or decedent and others ( ), '. ". 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 with 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 "B," Include the 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 property, 3, Indicate the percentage of the decedent's interest, 4. Indicate the market value of the decedent's interest, r "" 0 ("l ~ tT1 ~ ,; z ;J> 0 0 U'l - Cl ("l c: 0 ~ z ::: z t"" tT1 t'1 :>:: Z ;>::I 9 ... 9 t"" Z Z tT1 ,.., tT1 Z 9 ,.., -< t'1 ... 9 U'l ~ Z 0 U'l 0 9 't1 't1 ~ C'> -.I ~ :J' ~ ~ -.I ... -- 0 0 ,- .~. " '. "" ..' '..) "" "l Z ~'.' " a ' , t'l p: 0 ~.;"=) ~ ...' '" ,.. ~ ~ c... I IJ.. ~~~~ ~ " ~ c cc ... \ ")I.~ - '" Wl~1 "t-. I "" C'> O~n k;. oc~ > E t-3 o::m cr: o~ t-3 0-- ~t:O ... u"'O ",T- ~ " , ......w I 0::0:: - lW::'l -.I ::r I ~ _,0 0 -< -< I u ~ ?1 tT1 tT1 ~ ;J> ;J> i " , p. ;>::I~ ;>::I~ , , <D <D , 00 00 ! 0 0 I I I I \ I \ \ I , REY-484 EXt ($00801 INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) [i] Original o SupplementDI o Remainder File Number 21_fln_0411 Ada F. Jarrett Estate Name Date 01 Death December 10, lQSO SaciDI Security Number lfll_:>fl_64fl6 REPORT OF INHERITANCE TAX APPRAISER \ I, the undersigned duly appainted Inheritance Tax Appraiser in and far the Caunty af ~p,"l~nr. Pennsyivania, do respectfully report that I bave appraised the real and personal property as reporte in t e aregolng return at tha valu.. set forth opposite each item in the last column to the ri ht In Sch les "A", "B", "C", and "E" Dated: tiAptAmhAr" ?'\, lQfl1 IN" 'ER I ADJUSTMENTS INVENTORY VALUE AS APPRAISED CD DE (HARRISBU RG USE DHLV) REMAINDER APPRAISEMENT CODE Rool Property (Schodulo A) $ None 00+ 92+ Per. anal Property (Scheld",l. B) 16 6 tat Jolnt.Hold Proporty (Schodulo E) 2lH Tran.fers (Schedule C) 30+ TOTAL GROSS ASSETS lh,R Leu D.bts and Deduction. 40- 93- (SCHEDULE F) CLEAR VALUE OF ESTATE o Life Estate ~ FACTOR PRINCIPLE VALUE CODE o Annuity EQ.Il.JlS.E OF REGISTER ONL V ~ COMPUT AnON OF TAX $ $ $ $ $ 6% Tax on $ 15% T ax on $ Tax on $ Tax on $ Tax on $ Exemptions Total Estote TDT A1. TAX INTEREST FROM BALANCE TO $ $ $ Less Credit. DATE OF PAVMENT INTEREST S TAX CREDIT AMOUNT PAID OISCOUNT S + $ = 5 = + BALANCE TO 5 0. .... .<:: Ul ~ 0 E-< ~ ~ ~ +> 0 ;:.. ~ +> r.. Q) 0 Z ~ ~ r.. .0 0 :>- :>- r.. Ill", l1l alil ~ ..., tIl Q)..; ;:l r.. o..r.. ~ Q) +>.0 ~ l1l UlE '" l1l:l U Z ..: [>1U ... 0 ~ ... '" ~ 0 ~ '" 0 It. f-< 0 tIl 0 z d tIl tIl :>- f-< d ... ~ ~ z Z f-< f-< ~ z ::l d ... d ~ ~ z ~ ~ ~ ;:;; c:l ;:l U " Z ~ Z ~ 0 0 -< z ... tIl :l ::: ~ u c:l "" WILL OF fUJA F. JARRETT I, fUJA F. JARRETl', of the City of Harrisburg, Dauphin County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my las t 'Nill and Te stamen t , revoking all former wills. FIRST: I order and direct all my just debts and funeral expenses to be paid by my executor, hereinafter named, as soon as conveniently may be done after my decease. SECOND: All the rest, residue and remainder of my estate, real, personal or mixed, of whatsoever kind and whereso- ever situate at the time of my decease, I give, devise and be- queath lmto my sisters and brother, Anne E. J. Creveling, Kathari D. J. White, Leila J. Ross and Francis E. Jarrett, in equal shares, absolutely. I nominate, constitute and appoint my sister, Anne E.J. Creveling to be the Executrix of this my last Will and Testament. However, in the event that my sister, Anne E. J. Creveling, may be unable to perform these duties, I then appoint her son, my nephew, Darryl L. Creveling, to be the Executor of this my last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this S- day of ~ A. D. 1960. Signed, sealed, published and declared by testatrix as and for her La.st Will and Testament in the presence of us, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as w;in~~s~ _ ... ~-"~ ~ea.-~ J I ,I .' / .,'./ ~. OATH OF SUIISCIUlIING WITNESS .. ALTH OF PENNSYLVANIA I ss: COUNTY OF C IIERLAND This day of before me, Register for the Probate Wills and granting letters of Administration in an the CDmmDnwealth of Pennsylvania, pe onally came .0,,19 , or said CDunty Df Cumberland, in the subscribing witnesses tD the fDregoing instrument 0 II1g to be tht last Will and Testament of , \....-, ';,'.l' . lateDf land County Pa" deceased ,who being duly according to law, depDse and say, th lish, pronounce and declare the said instrument of writing as and fDr '. Testament and Last Will, and at the time Df SD doi was Df sDund and disPDSi mind memDry and understanding, tD the best of and belief, and subscribed befDre Register AFFIDAVIT m DEATH COMMONWEALTH OF PENNSYLVANIA t ss: COUNTY OF CUMBERLAND ~ Darrvl L. Crevelinq being duly S\.,orn says that as nearly as can be ascertainen the said decedent Ad" F ,T"'''''pi-i- died on Wednesday. the at Dr about q: ]t' Sworn If";" day Df , 10th day of December A,D,,19Jl.lL, o'clock, ..!1-M. and subscribed this December /,..>' />' .......-,~ - . / 1,/ ./~/ ,~,..- ~ ..r.;. xJ Register If:9 OATH OF PERSONAL R.;PRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Register for the Probate of Wills and granting Df Lellers Df Administration in and for the County of Cumberland, persDnally came Darryl L. Creveling WhD, being duly Sworn ,do es depose and say that as Executor of the last Will and Testament of Ada F. Jarrett deceased he will well and truly administer the goods and challels, rights and credits Df said deceased according to law, And also will diligently cDmply with the provisions Df the law relating to Transfer Inheritances, swornand subscribed before me, December I 7' A,D., 19 80 /1') ;;J. // /! ' /'. q' /-f)~A7-.f/( 2.... (./f.:.dt:~'/', '7'://.,>c("'.~ ; ~/ - // : ! Register :..; ....: ;~ 00: :", C) :Q) ~r :" :Q) :Q LL. tn: 8; 00: 0 8; :11:; :':l ..,; gj; ..!ol '" -I 1>:; g ..,: .0:: , 'l'J'I ~: -I ""i ~ <l'i I - 0; - .. ,<::~ - .: ,~ U; CD; E: I ~ r...: 8: U: .-< ..:i = rzli 14: N ~l ,~ Ill: '"d <l': :&1 Q) Q; 0 ~ 10; 00 : Z ....: . : " :11:: -: B ~ ~ 'i III: '"d - 0 = ~ ,~ l/) ~ Z [il as DECREE Be it remembered that on the 4th day of March ,A,D.,19~, there was probated and recDrded the last Will and Testament of East Pennsboro Township Ada F. Jarrett late of . '.. Deceased, Letters Test.amentarv were granled tD Witness my hand and Dfficial seal the day and year aforesaid, , Cumberland County, Pennsylvania, Darryl L. Creveling ~ . .... 1'10 i I <,t.""'.,,,.,",,:,;,,:, CODICil 11.80 433 DAUPHIN ~ COUNTY, 88) This .................0..7.::............... day of .....:::..]uLw.,.<}-.~,. ...,..........,..,...... A, P., 197:.12..(1 befDre me ~,..~.l~~.n9.~..~......1-!!'J~.~.""O..., Register for the Probate of Wills and granting letters Df AdministratiDn in and for said County of ~, in the CDmmon- wealth of Pennsylvania, personally came .. ,.......,..~.~:r,r.().P...~.,.,l'ur.~.Y...,.........,.................. .......' .......,.................the subscribing witness~ tD the fOregDing instrument Df writing purpDrting to be a ....................codici! to the last Will and Testament of .......~~.a...r..~. ..>!.~.~:r~.~~...... ......................, Dated .?/J~!7.l...... late Df...Ellst...pennaboro..,Township,........ Cumberland County, Penna., deceased who being duly ..~,WQ.rl')..--.. according to law, depose and say, that ....P'~...~~!!.. present, saw and heard the testa....~.#;l!;.., ..____"..~",~..J1:.,.__.;r.~rl:',e,tt............s:gn. seal, publish, pronounce and declare the said instrument of writing as and fDr a ......,..... codicil to h..~~,....,Testament and Last Will, and at the time of so doing"..!!:h~.....was of sDund and dispDsing mind, memory and un- derstanding, to the best of ......Q,i,!ll,.. knDwledge, observatiDn and belief, ?l~/J.:.jl';t,:f," ~_IIIl& It,UPlJMlIlt Register~'lIs (1 I1f\r7~ f1 ........"....,.~,.~.:.....,.,............J:............. Carroll F. purdy .................................................................................. ................................................................................. j ,'I,Cl ,," (-c; " ~ gJ ~ c c c ~ c Z I- " W Q) Ul W 0 " ~- ::E C) t- r-. o Zen. III J: - 0( lIJ t- 0 !::. D- u ..J.... - a: - z . ~ IIJ :J .J C) o I&. lD 0( a: ~~w~i .( ~ z 0 lI) ..Ji.3i\ia: w. I 0: "- Q)" ~ OJ: N t:.. ~ I~ ~ '" " N I- '" ~ .. Ii<": OH ~~ .!< 0 +' ,.-I ~>1 t5 a I; (Xl OJ :::1 o Ul 1ll<Jl H +' 0 ~ Z .-l+' Z <Jl OJ t!> 0:<: "OJ ZZ H ~ O~E-<:d! '" .-l+' ~\ll ::> 0 o H <Jl H (Xl - 0 l") 00 OJ+' 0 '" E-< 0 ~~~~~ o OJ""": . 0 - .-l E-< a III OJ ""Ill 0 U>< E; ~ H .-ll;.-l E-< 0~E-<8E-< .-l+'.-l -+' Ii<Z 0 .. 'Cl ~ E-< Z <Jl 1ll<Jl 011; 00 0 [:; OJ ..:~..:~ :;0: ~ I; OJ O. U tll Zl")E-< p:: OJ 0:::1.0 E;u OJ o rilE-< -al1l.o~ ~ . .-l --.,~ H .~Z ~ Ul,.-I Ul 00 <Jl Ii< .-l E-<f>< H;I: OJp., ...-1 ~~ ~ ..: H 00 OJ 01; . E-< ..: E-<":UIllP:: zo I; .. ;I: 0 <Jl ~ ~ .:~.~ ~~Zp.,o 00 . 1ll:>1 Ii! Z ~ III HO<:r.. :E:r-I P.d~ j:Q ;I:~ .~ E-<~ 0 , .1' Z::> HU .' " " ESTATE OF: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 4.1?' {)llJ~.,...,; 1980 , ADA F. JARRETT, An Alleged Incompetent PRELIMINARY DECREE AND NOW, this)jt/J day of ~IU-' , 1980, upon consider- ation of the within petition a~otion of Robert D. Stets, attorney for the Petitioner, it is ordered and decreed that a citation be awarded and directed to be served on Ada F. Jarrett, the alleged incompetent, to show cause why she should not be adjudged an incompetent and a guardian of her estate be appo inted. RETURNABLE, the 1;tL. day of (lu_Jt'--oJ-t- , 1980 at /o:~ o'clock!.LM., Room No.;t in Orphans' Court Division, Cumber- land County Courthouse, , Carl isle, Pennsyl- vania, at which time a hearing will be held. BY TH COURT: E. , . r ~ti 0 .~ .. \ \\\~~ ~l ~~ bG~^ 101 fl_;: ~'~ .) social Security Benefits Teacher's Pension $146 per month $604 per month $750 per month 7. The alleged incompetent was never been a member of the Armed Services nor is she receiving any benefits from the United States Veterans Administration. The alleged incompetent is unable to manage her property due to the fact that she is suffering from advanced stages of senility, is unaware of her external environment, cannot recognize close family members, and must receive 24-hour care to meet her basic needs. She is presently under the care of Nathan Sussman, M.D., the family physician, whose office is at 609 N. Second Street, Harrisburg, Pennsylvania 17102. 8. The name and address of the proposed guardian is Darryl L. creveling (nephew-petitioner) 1427 Dublin Road, Maple Glen, Pennsylvania 19002. 9. The alleged incompetent executed on May 5, 1960 a will which Petitioners believe is the last will executed by the alleged incompetent. That will at Paragraph 2 appoints as Executor the incompetent's sister Ann E. J. Creveling, or her son, Darryl L. Creveling, in the event she would be unable to perform her duties. Ann E. J. Creveling is now deceased and Darryl L. Creveling will act as executor should the May 5, 1960 - 3 - ';1)'" ; ',' (9 tl~'U~ J.., , I.",;.. "', \) will be admitted to probate. A copy of that will is attached hereto and made a part hereof as Exhibit "A". 10. On February 9, 1966, Ada F. Jarrett executed a power of attorney in favor of Alfred Creveling, husband of Ann E. J. Creveling and father of Darryl L. Creveling, the proposed guardian. Said Alfred Creveling died on April 18, 1980 and his son Darryl L. Creveling is the executor of his estate. 11. The expenses of Ada F. Jarrett are currently running at the rate of approximately $1,500 per month. The greatest part of this expense, $1,225 per month, is the cost of her care and maintenance at Blue Ridge Haven West. It is the belief of Petitioners that said Ada F. Jarrett's yearly income from all sources including social security and pension payments will not be sufficient to meet the annual expenses being incurred for her support. Petitioners expect that the proposed guardian will have to invade principal for the support of Ada F. Jarrett and therefore request this Court to authorize invasion of principal on her behalf. 12. The proposed guardian has no interest adverse to the alleged incompetent other than his right to share in the residue of the alleged incompetent's estate pursuant to the will executed on May 5, 1960 in which the proposed guardian's mother, now deceased, was bequeathed a one-fourth share of the residue of the alleged incompetent's estate. - 4 - . ,y" u. .....0 :'~'II", lul i..,;:. . \ \ f)[. nD'!) I - , '\ ,-- ESTATE OF: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ADA F. JARRETT, An Alleged Incompetent NO. .-3-33 1980 AFFIDAVIT OF SERVICE ~h~l1ftiNE Y. ~'Nt+Rft , being duly sworn according to law, deposes and says thatShe is an adult individual and a resident of Dauphin County, q-l-\V day Of*1980, at Pennsylvania, and that on the 3: 00 o'clock, did serve upon Ada F. Jarrett, an alleged incompetent, Blue Ridge Haven West, 770 Poplar Church Road, Camp hill, Pennsylvania, a Citation notifying Ada F. Jarrett that a Petition has been filed requesting that she be adjudicated an incompetent and that a guardian be appointed for her estate and notifying her of her right to file objections to said Petition with the Orphans' Court. The Citation and attached Petition were served by personally handing to Ada F. Jarrett a copy of same at the above-mentioned address. ~~~, ~'~~a.... Sworn to and subscribed before me this 9th day of July, 1980. yueti~ ",,.: OH ~~ rilo-:IZ riI 0-:1:><00 U P<OOHCO H ZOO'" ~ ZZH.-l ~riI:> riI ilP<t( +' 00 l:: o . (j) '" u:><ii;: +' 0 . Eo< (j) "'i~F) p, riI o 0'" " ~ ou '" . 0 ii;: U_ .,. Eo< () U E, l:: H ::>000 [;l H '" 8~~ . H .. p:; 'll ii;: :<:0 '" ..: (j) riI ~ Z 0 t") 0\ riI :t::riI (j) U Eo<~O riI M Eo< '" M z::> gS ,.: ,.: HU 00 0 ~ riI ,.: . . , ' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT .~.""~ ~ APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made far consent to the transfer of the fallowing securities Df a Pennsylvania Corporation or D National Banking Association located in Pennsylvania: DATEJulv 14. 1981 (D) 288 Rh (b) American Ri'lnk (c) Common (NOTE: In describing securities enter in (a), ab Ole, either the number of shares of stack or the face amount of registered bonds, in (b), the nDme of the issuing company and in (c) the class of stDck or the stated interest rat. and maturity dDte of registered bonds.) (261 issued prior to death-27 sh Stock Dividend Rec'd after death) ISSUED ON Various ,andh~vingaTOTALMARKETVA'lUEOF$11q1 nn(V"l"" rd' nl sh) (Oa.e) as of the date Df death Df the decedent, Ada F. Jarrett , on Dec. 10. 1980 , (Name ~f Decedent) (Dote of death) whD was IDte of 770 Poplar Church Road. Camp Hill. Cumberland . (County) PA (Stat.) (Street and Number) (Post Office) I The securities are registered as follows: nt'l" F .T"r,."tt (Nome or names In which certificates ore registered) 1427 Dublin Road Maple Glen. PA 19022 (Add....) NAME OF APPLICANT r.l"yrnn L Rlnnm McNees, Wallace & Nurick COUNTY FILE NUMBER q/-i1/-f/J 3 ADDRESS OF APPLICANT ' ADMINISTRATOR) EXECUTOR ) Darrvl.L. Crevelinq (Name) 8 BUREAU FILE NUMBER SIGNA TURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS PLICA ION, IT WILL NOT BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES (1 ;7.''1 DA TE ~ /~ I ~. I hereby consent to the transfer of the above securities now registered in the name Df t~far Did Decedent~nd waive the filing of a certificate certifying tD the payment of the transfer inheritance tax to which the property of said Decedent is made subject pursuant to the provisions 01 the Act 01 June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, as amended. This is also in Dccordance with the provisions of the Act of April 9, 1929, P .L. 343. This Consent tD Tronsler the herein described property operates only in reference to the estate DI the abDve.named Decedent. Signed for the Secretory of Revenue By COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } IS: Darryl T. rrpuplillr being duly s"orn "~...J.o. 'llccorl:lingto law, deposes and says that he __~c Executor .' .," . of the Estete of Ado F, JnrretC_,_,__. late of Jl.a.atJ'Jmns.!lQr.o-IQ\,nshlp , Cumberland Coonty, Pe,. deceased and that the . h'" d b Darryl L. Creveling h 'd Executor Wit In IS an Invontory ma 0 y _ ----.1 t e S81 of the entire estate of said decedent, consisting of all the persona' property and real estate, except real estet. outside the Commonwealth of Pennsylvania, and that the figures .opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, /1/ ,', " ,(/ 1:.' x.. A)a~Yz-,,,'1b,",,, 7 Darryl L. Creveling August /3 ~ ~9-.~ NOTARY UOVc'OF NEW JERSEY Ml, .Commission Expires Ju~ 19, 19a,l 1981 Executor. Administrator 1427 Dublin Road I Maple Glen, PA 19002 Add"u Date of Death 10th Day Vur December Month 1980 INSTRUCTIONS I. An inventory must b. filed within three months after appointment of person or representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. 0- ,',f\. ~ I... cr: I,';;' 1.1," :~~~; 1.1: 0; cc 6.. - .~::~: l1..IL ~ C;:2 0-- ~10 0:;") cc OG ~:z "'OJ -::> '... ~(1: - ~'" ..c 1'0 Ul u 5 >- 0 "" l;2 w ... " ... ~ ". ~ '" w ~ 0 " <J a.. ... u .... 0 0 II> 0 " " ,..... '" w W .0 C '" '" :r c.: Ul " ,,=, ... I- a.. LL " a.. "z I Z ... ... '" ~ ... <( 0 ... " c.. 0.., 0 W LL W ... QJ :I: co > 0 <( c.: ~ a.. ,;:. Ul <(QJ I Z - ... <J .-< Z 0 0 ... " QJ " N <<: Ul ~ ... .-< II> Z 0 0 c.: .-, " u Ul .-< Z w <( '" ... ~ a.. "" . ~ " <=l ... '" . ~ 0 0: ... Ul " ... QJ .D "" ", QJ QJ " E 0 .0 ... Z - ..! " ~ 0 0 0 <J ... U u: co 0:; ~ Inyentory 01 the real and personal ..tat. ~I ADA F. JARRETT " '.1 Checking Account #1355-2886, American Bank Cn#9-937-933, Girard Bank 261 Sh. American Bank & Trust Co. of PA, common OTC at 14.75 Refund - Blue Ridge Haven, West Balance Public School Retirement pay \ ; i I \ , I , deceand, 1,581 65 10,280 00 3,849 75 933 70 201 40 II II II I I i I I I \ TOTAL 16,8'4 50 r.l!~j~il~~~- -- ~oM~~;i;i~~o~~NIA- ----=-~ ~"'" ,. OFFICIAL RECEIP1'. PENNSYLVANIA INHERITANCE AND ESTATE TAX I I" ' j = I III I It a ~. RECEIVE ,j FROM ,t'~\AODRESS 100 pine street, P.O BOX 116 ESTATE TAX TAX AT 6% TAX AT 15% Robect D state McNeee. Wlllace & Nurtck. At YlfIlXAT_% Harrisburg, PA 17108 '--ESTATEj"NFOFiMATj(iN-;-;':'-C-;~b~~--io---i980----- OATE OF OEATH.... ' $561.60 TOTAL TAX CREOIT FILE NUMBER 21-80-433 lESS DISCOUNT PLUS % INTEREST (FROM TO_I OATEOFPAVMENT July 15, 1981 m m TOTAL AMOUNT PAID $561.60 NAME OF DECEDENT Ada E. Jarrett C umber land COUNTY ~------------------------------------------- POSTMARK OA TE ) REMARKS: ) ~' "PAID ON ACCOUNT" SEAL RECEIVED BV _/ / ( /. ! ,) /l I, / . ;',.//, - j '-_ . / I t'..A.,f.,.....(.~ SIGNATUFE I REGISTER OF WILLS -,---.----.-.-.-- August 7, 1980 Carlisle, Pennsylvania THE COURT: We are ready to proceed. MR. STETS: If it please the Court, I would like to begin with an opening statement. THE COURT: I think the only issue preliminarily would be some testimony concerning where this lady resided prior to her going over to Blue Ridge. MR. STETS: Would you like the certificate of service and the citation service at this time? THE COURT: We will admit them at this time. We will mark them Petitioner's Exhibits 1 and 2. MR. STETS: In addition to the parties mentioned in the petition as next of kin, we have learned there are two surviving children of the deceased brother who should have been notified. We did send them a copy of the petition informing them of the time and place of this hearing. And that was made by certified mail. THE COURT: They were sent when? MR. STETS: On July 7th by certified mail, return receipt requested. THE COURT: MR. STETS: in West Virginia. THE COURT: Have you got your cards back? Where do they live? One lives in Florida. And the other party lives -3- MR. STETS: \~e have received the cards back and we have also received an unrequested notarized statement by one of the children indicating consent to this proceeding which is also attached to the service. THE COURT: MR. STETS: The return receipt cards, are they attached? Yes, they are. NATHAN SUSSMAN, M.D., called as a witness, being first duly sworn according to law, testified as follows: BY ~IR. STETS: Q Would you please state your name? A Dr. Nathan sussman. Q Your residence is? A My office is at 805 North Second street, Harrisburg, pennsyl- vania. Q Where do you reside? A At 2880 sunset Drive, Camp Hill. Q How long have you resided there? A Pardon? Q How long have you resided at that address? A Since about twelve years, ten or twelve years. Q Have you practiced medicine for that same length of time in Harrisburg, pennsylvania? -4- A In Harrisburg I have been practicing since 1945. Q Could you describe the nature of your practice? A My practice is primarily Rheumatology with a secondary practice of geriatric medicine. Q Do you know Ada F. Jarrett? A I do. Q Is she one of your patients? A She is. Q For how ~~ has she been your patientS? A She he been a patient of mine since she moved into the Harrisburg area in the latter part of 196B or '69. Q Is she still your patient today? A She is still my patient. Q At this point, Dr. Sussman, we are primarily concerned with the events surrounding the change of Mrs. Jarrett's residence from the home of her brother-in-law to Blue Ridge Haven West in Cumberland County. Could you explain to us what the circumstances were that surrounded that change from her brother-in-law's home to the Blue Ridge Haven West facility? A Well, the scenario at that time as far as I can recall was precipitated by several events. Number one, the death of Miss Jarrett's sister, the late Mrs. Creveling, and also Mr. Creveling's desire to remarry. This she objected to considerably. Q Did Mrs. Jarrett live with her brother-in-law and sister at the time she was your patient? -5- . . 11 Oh, yes. Shc did live with her sister and brother-in-law. Q Could you continue? A Miss Jarrett developed an acute emergency situation neces- si tating surgery for an inguinal hernia. And thi.s was operated upon by Dr. Clarence Moore. She made an uneventful recovery and returned to the apartment where Mr. Jarrett and his late wife had lived with Miss Jarrett, and with the assistance of a visiti.ng nurse. Q At this time then Hiss Jarrett's sister was deceased and Miss Jarrett was living with her brother-in-law at the apartment with the assistance of a visiting nurse? A That is true. Q Was it necessary that she have some health care during the day? A Yes. She needed a certain amount of supervision because of her relatively recent post-operative status and a concomitant weakness that existed then. ~\r. Creveling had to be at work during the day so she would be alone and unassisted. Q Is it your understanding from your conversations with Miss Jarrett that she could have remained in that home if she had desired to do so? A If she were able to pursue all of the activities of daily living without difficulty, and did not resent the fact that Mr. was contemplating marriage. Q Could you explain her attitude to the impending marriage of her brother-in-law to the prospective spouse? -6- '~l .. A She resented the prospect considerably. Although her sister, Mr. Creveling and Miss Jarrett lived very compatibly in the apartment for a number of years. And when Mrs. Creveling had her demise, Mr. Creveling was extremely supportive and exercised more than the usual attention. So that her home life there left nothing in want. However, when Mr. Creveling was contemplating remarrying, she became a little bit disturbed and depressed by the prospect. And this antedated her hospital admission. Q Was her resentment based upon the fact that someone other than her sister would now be residing with her brother-in-law? A This is the impression that I got. She resented the idea that someone would come in physically and assert the area that her sister occupied over the years. Q Your impressions about this were obtained how? A Well, Miss Jarrett would relate these things during our visitations. And of course, this had some impact on her well-being. Her appetite diminished. Insomnia became a chief complaint. But she had no particular complaint about Mr. Creveling at any time. Q Do you believe at that time Miss Jarrett had the mental capacity to decide to change her living circumstances and move to a different residence? A She had the mental ability to be judgmental as to where she wanted to be physically. Now, we are pinpointing an area of time prior to her hospitalization. And her post-hospital mentation and behavior. -7- BY THE COURT: Q One of the things we have to ask you is whether or not in your opinion her physical or mental condition would be proIToted by her being here today? A No. I think her physical and mental condition is the summation of the deteriorating changes secondary to chronologic age. Q Has she been bedridden now for you say a period of time? Can she get out, walk, or is it in a chair? A She sits in a chair daily. This is one of the regulations we adhere to. That the patient shouldn't be bedbound day after day. And the patient should be lifted and assisted into a chair. And if possible the patient should ambulate with assistance. I saw her as recently as this past Sunday. And the nursing personnel did assist her in ambulating from her bed to a geriatric chair. Once there she completely immobile. THE COURT: I have no further questions. You may be excused if you wish to excuse him now. DARRYL L. CREVELING, called as a witness, being first duly sworn according to law, testified as follows: BY MR. STETS: Q Could you state your name and address, please? A Darryl L. Creveling, 1427 Dublin Road, Maple Glen, pennsyl- vania, 19002. -13- \ . ' together with your father and your aunt? A Well, we would just sit around and talk for awhile and go out to dinner, and come back to their apartment and visit for another short period of time, an hour or so. Q You would converse at that time with your aunt? A Yes. She would join in the conversation. I don't recall ever having any conversations with her that my wife or my father weren't present, private conversations. Q I would like to direct your attention to that period, the few months preceding her move to the Blue Ridge Haven West? A It was shortly after she came home from the hospital that we were up in Harrisburg. And she just told me that she didn't feel like going out to dinner that day. She just didn't feel up to it. And we went out to dinner and came back. And she sat around and talked for a little while with us before we left. Q At this point, which was after the operation but before she moved into the Blue Ridge West facility, was it your impression that she was lucid and able to carryon a conversation? A Yes. Q Do you feel she was able to make decisions or at least express opinions concerning her condition and welfare? A I think so, yes. Q Did your aunt ever speak to you about her desire to leave the apartment? A No. She never did. But my -- I guess, and as I said, it -16- .'~ was always in the presence of my father, and she didn't want to antagoni him. It was never mentioned. She never mentioned it. ~1y father told me that she had talked to him about it after he told her that he was going to get remarried. Q What did your father tell you she had said to him? A She said that she just didn't feel that she could live there with my father and his wife, that she would prefer to leave when he did get remarried or if he did get married. Q Based on whatever knowledge you do have, do you feel that there was ever any intent on your aunt's part to return to your home after he remarried? A No. I don't think she ever felt that way. Q If you were appointed guardian of Ada Jarrett's estate, do you believe that you are competent to handle her financial affairs? A I feel that I am. Her financial affairs are relatively simple. Q Do you also believe you could adequately handle these matters from your home in Maple Glen while she is residing at Blue Ridge Haven West? A Yes. I see no problem with that. Q Are you aware of the conflict of interests you may have with Ada Jarrett as a residuary beneficiary under her will or next of kin? A Yeah, I understand that. I don't really consider it a conflict though. -17- Q Do you know approximately when he might have died, what year, roughly? A I would guess probably about 1975. Q To the best of your knowledge he only had two children which would be Miss Kimberling and Mr. Jarrett, a daughter and a son? A Right. Q The petition lists approximate assets of your aunt now as being around $21,000.00 or they were about that at the time that the petition was filed, would that be correct? A In that area, yes. Q Did you have an occasion when you signed this to look at those assets and see what they are comprised of? A Yes, I did. Q Who has been paying her bills at the Blue Ridge? Has she been able in past time to sign checks herself or how were they done? A No. My father had her power of attorney. And he was paying her bills and taking care of other financial matters. Q He would turn these things then over to you if you were appointed the guardian, at least what records there were? A Yes. Q You have lived at your present address approximately how long? A Sixteen years. I presume you will be staying there probably until you retire? Q -19- A I intend to. I I , i I i i Q In addition to the assets listed, there is a statement that your aunt is receiving social security and a teacher's pension of approximately $750.00 per month. To your knowledge is that the only additional income that she would have? A She has a few shares of a bank stock that pays a small dividend. Q Have you seen your aunt recently? A I saw her about three months ago, yes. Q Did she know who you were? A She was asleep. Prior to that, which was about four or five years ago, she had no recognition of me at all. Q \'1hen did your father die? A In April of this year. Q April of 1980? A Right. Q Have any of her bills been paid since April of '80? A I have paid out of my own funds her insurance premiums and some of her doctor bills. But I haven't been able to pay the nursing home bills. Q So the nursing home bills, I am sure they are pressing some- body to get them paid? A I have heard several times from them. Q Assuming that this last will and testament dated May 5th is in fact her last will and testament, as I read it you would now -20- \ , i ! I I i I \ I I i \ .,j I i i ! \ I \ i - -, ESTATE OF: IN THE COURT OF CO~ION PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ADA F. JARRETT, ORPHANS' COURT DIVISON 433 ORPHANS' 1980 AN ALLEGED INCOMPETENT ORDER OF COURT AND NOW, August 7, 1980, the court having heard the testimony of Nathan Sussman, M.D., and Darryl L. Creveling, and from this testi- mony the court finds that Ada F. Jarrett is an incompetent within the meaning of Section 5501 of the pennsylvania Decedents, Estates and Fiduciaries Code, 20 PA C.S.A. 5501, and Darryl L. Creveling, the nephew of Ada F. Jarrett, is appointed the guardian of her estate. The presence of Ada F. Jarrett at the hearing is excused because the court is satisfied that because of her physical and mental condition her welfare would not be promoted by attending the hear:ng. pursuant to Section 5536 of the above act, the guardian is authorized to expend principal as well as income from the estate of Ada F. Jarrett for the following purposes: 1. To pay for the past, present and future care and main- tenance of Ada F. Jarrett at the Blue Ridge Haven West Nursing Home in Camp Hill, Cumberland County, Pennsylvania, or other similar tution. 2. To make reimbursements to any person who has paid for her past care at the Blue Ridge Haven West Nursing Home and other h~.~:\ jJJ) " . '''&H~ ., ,-,iU ,.._..... __ __ -=-- ~~ ~ __ ~ ___ ~ ~~ --r....~ dREV.118UX ", ' liI,1g;li?:'.-,,;:::., ,;,;, '". ' COMMONWEALTH OF PENNSYLVANIA 4 'NO'iK'ii29'l91f. .... DEPARTMENT OF REVENUE :'(:':.":,,' ,',", OFFICI~L RECE'IPT . PENNSYLVANIA INHERITANCE AND ESTATE TAX IlY . ~ ~ II = I "M' Il FROM AOORESS 100 Pin. st.. P. O. Box ,-\ I \ - TAX AT 6% Duryl L. Cr.v.ling TAX AT 15% Mc..... Wlllece . Nurick. A tv. ~Al~AT_% 116 ESTATE TAX Barri.burg. PA 17108 TOTAL TAX CREDIT $1.178.67 '--~f~Tg[~i:'~~ATI(iN7--~-c~";-10~ -1980---- FILE NUMBER 433 orphenl S.ptelllber 22, 1981 A6e r. Jarrett m m TOTAL AMOUNT PAID DATE OF PAYMENT LESS DISCOUNT % INTEREST To_I PLUS (FROM NAME OF DECEDENT C ulllber 1en6 $1.178.67 I COUNTY I ------------- -- _______n_ _n_______n 1 POSTMARK DATE_ . I .) REMARKS: 1\ ~~ . I I j I I 11 11---.--.-.---------------.---- ---~-.-- I I I 1 I I 1 i I I j I i "PAID OR ACCOUNT" / ~' . f t-'-; , ~ '. I:v-,~ SEAL RECEIVED BY REGISTER OF WILLS REV.455 E)(+ l3.aOI , COMMONWEALTH OF P~NNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS ~, t'H'~~" i.~ . 1'.-:" " , ' . ~ ,-.:;. I"'~ It3'j.1$~ File No, ,.;; /- If{,) -1.33 - Estate of Ada F. Jarrett Date of Death 12-10-80 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Relationship to Decedent Claimant's Address at time of Decedent's Death ITEM NO. REMARKS AMOUNT Funeral Bill 2,042.00 Grave Marker 435.00 Le al Service 1,100.00 52.10 uar ans p ees 756.50 Executor's Commission 850.00 Filing fees ,.00 DATE NAME OF PAVEE Neill Funeral Home North Wales Grant Co. McNees Wallace & Nurick McNees, Wallace & Nurick Darr 1 L. Crevelin Darryl L. Creveling Register of Wills I I I 1 I I I I TOTAL 5, 24tf. 60 I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the e~~ate as dedu~t~s for IlJheritance Tax purposes; I f... ;{Jf1A;{;.~/??A'-c'{c-to; rj;1j,f/ n,ury L eve] ing ;/ SIGNATURE OF FIDUCl'ARV DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ h-:-14 ~ &, () AT / /~ % TAX RATE ~1..~~"rl:jd /d -2 -rf/ OA1E 'S133HS "L! x ,,~g 3Sn A~VSS3J3N SI 3JVdS lVNOlilOOV :il 'slqap a~l 6u!~od JoI ~I!l!q!suodsaJ a~1 pawnsso SO~ o~M uosJad a~1 ~q pau6!s aq Isnw WJoI au 'L 'paW!Dp 6u!aq Iqap ~~Da 10 lunowo a~l Jalu3 '9 'paw!op Iqap ~~Da JoI uwnlD~ S~lDWaJ a~1 U! UO!lDuDldxa jO!Jq D ap!ADJd 'S 'oa~Dd ~~Da ID sawou a~l J:Jlu3 '~ 'P!Dd JO/puo p')JJn~u! SoM lqap ~~oa ~~!~M un alop a~1 HllU3 'E 'paIS!1 wall ~~oa 01 sJaqwnu aA!ln~asUo~ u6!ssV 'Z 'uwnlo~ lunowo a~l U! paw~op lunowo a~l puo uwnlo~ S~JowaJ a~l U! "Uo!ldwaxa ~l!woI" Jalu3 'luapa~ap a~1 01 d!~suo!lolaJ Ja~/s!~ puo ssaJppo 'awou S,IUDW!DP a~l alo~!pU! 'paw!op 6u!oq S! uO!ldwaxa ~l!woI a~lll '[ ":i,, 3ln03HJS !)NI13ldWOJ ~O:l SNOIDn~lSNI 0 0 co co a- a- M M "" ~ ~ I1l n c:P .! < ~ M ~~ - '" l<l l<l M ~r;1) '" ;.. ;.. .<: 0 _...~ !-] tJ .... CJ, ",. U) ... M r...C) ;:; ., a ~J'-l 1111 '"' r- ~~'J - " '"' ..: ;"'-,' ~ p., ~s~: -;>:0 ... ! " I1l . ~; ~..~ E M M .., ::l M .:-"1 ~ P- .... , 0 ~ r>:l Z ~ p., ~ \C P- o ~ 0 ~ - .... '-' ~ .... '-' =: ~ ~ 0 !-< 0 CIl 0 Z c:i CIl l<l CIl ;.. !-< c:i - z Z !-< l<l !-< l<l Z ::l c:i - c:i ~ =: 5 ~ l<l l<l Z ~ Z 0 U ~ Z ~ S! CIl ~ 8 0 - ~ 0 ....l 'UJnla~ xOi aWO~UIIDnp!A!pUI.O~.Vd WJoI uo papodaJ aq Plno~s wall owo~u! alqoxol S!U 'sasodJnd xOi awo~ul o!UDAI~suuad JoI alqopodaJ S! alDlsa uo 6u!JaIS!U!WPo U! pawJojJad Sa~!AJaS JoI 'JoloJIS!U!WPo Jo Joln~aXa uo '~Iawou ~DA!loIUaSaJdaJ alolsa uo 01 Plod UO!IOSuadwo:> :3i0N _ 'sMol alolsalul o!UoAI~suuad a~1 ~q Jo II!M 0 ~q ssod ~~!~M SlaSSD ISU!060 ~Iuo a)qoMollo S! uO!ldwaxa ~I!WDI au 'luapa~ap a~l so Plo~asno~ awos a~llo sJaqwaw aJO o~M sluaJod Jo IUaJod 0 ~q paw!op aq uo~ uO!ldwaxa a~1 'Pl!~~ Jo as nods ~~ns ou S! aJa~IIUaAa a~l ul 'uo!ldwaxa a'll W!oP uo~ Plo~asno~ awos a~llo Jaqwaw 0 S! o~M luapa~ap a~llo PI!~~ ~uo ua~l 'SI~6!J Ja~/s!~ pal!ajJoI SO~ asnods a~ll! Jo 'asnods ou S! aJa~lll 'o!UoAI~suuad U! pal!~!wop pa!p o~M luapa~ap DID as nods 0 ~q paw!ol~ aq ~ow uO!ldwaxa ~1!WoI V 'alnpa~~s S!~l 01 pa~~ollo aq Plno~s paw!ol~ 6u!aq slqap a~l JoI ~l!l!qo!l s,alolsa a~1 Jo s,luapa~ap a~l poddns oj' a~uap!A3 'pal!l S! UJnla~ xOi a~uol!Ja~ul a~1 Wo~M ~I!M SIl!M 10 JaIS!6a~ a~llo 10AOJddo a~1 01 pa!qns alD alolsa uo ISU!D60 paw!op 6u!aq slqap IIV 'sasuadxa 10!Jnq palolaJ Ja~lo puo Ja~Jow aAoJ6 Jo auolsqwol 'lollo!Jnq 0 10 ISo~ a~l 6u!pnl~u! sasuadxa 10!Jnq puo 10JDUnl 'saal ~Jo!~np!j 'saal ~aUJOllo 'uo!lDJIS!U!WPo 10 ISO~ a~l 6u!pnl~u! alqow!ol~ aJO SWal! Ja~lo 'alolsa Jo luapa~ap a~l ~q paJJn~u! slqap 01 uO!l!PPo ul 'alolsa a\qoxol Ja~/s!~ ISU!060 alq!l~npap aJO ~Ioap Ja~/s!~ 01 JO!Jd luapa~ap a~1 ~q paJJn~u! Sa!I!I!qo!l pa!jS!loSUn NOliVW~O:iNI XVi 3:>NVil~3HNllV~3N3!) ~ INFORMATION To insure proper credit to your account. tho narne of tho estate and file number should bo clearly print. ed on the check or money order. This assessment is made In accordance with Soction 708 of the Inhcrit3nce and Esttlte Tax Act of t96' (72 P,S. ~ 2465-708), To the extent thot inheritance tax is paid within three (3) months after the death of tho decedent, a discount of five (5) percent is allowed (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 the expiretion of nine (9) months after the decedent's de.th (72 P,S, ~ 2485.711 I, Inherit. nee Tax on a future Interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P,S, S 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: ------------ --- ------ --------- - -- - ---------- -- - - - --- - --- -------- -- -- -- - -- -- t month ,005 4 months ,020 7 months ,035 10 months .050 2 months ,010 5 months ,025 8 months ,040 11 months ,055 3 months ,015 6 months .030 9 months ,045 12 months ,060 1 deys ,00017 11 days .00186 21 days ,00352 2 days .00034 t2 days ,00203 22 days .00369 3 days ,00051 13 days .00220 23 days ,00386 4 days ,00068 14 d.ys .00237 24 days .00403 5 days ,00085 15 days ,00250 25 days ,00420 6 deys ,00101 16 days ,00267 26 days ,00437 7 days ,oolt8 17 days .00284 27 days ,00454 8 days ,oot35 t8 days ,00301 28 days .00471 9 days ,00152 19 days .00318 29 days ,00488 10 days .00169 20 deys ,00335 30 days ,oosoo -- ------------------- ------------ --- ----- ------.---- - - ----------.. ------ Any party in interest, including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (60) days after receipt of this Notice as provided by Section tOOl of the Inheritance and Estate T', Act of 1961 (72 P,S, ~ 2485.1ootl. Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: 2'.80 433. JERRY R. DUFFIE, ESQ, Solicitor MARY C. LEWIS Register of Wills & Clerk of the Orphens' Court OFFICES OF Itgisttr of lUlls sub OUtrlt of 1:l1t Ql)rpl1sus' Qrnurt Cllounty of Cllumbtrlanll COURTHOUSE, CARLISLE, PA 17013 February 25, 1981 TO THE REGISTER OF WILLS IN AND FOR DAUPHIN COUNTY IN THE MATTER OF THE PROBATE OF THE LAST WILL AND TESTAMENT OF: ADA F. JARRETT In pursuance of the Probate, Estates and Fiduciaries Code of 1972, Section 3154, you are hereby Commissioned and Deputized by me, to take and receive the affidavits of Carroll F. purdy. C1J1/1A' J {], P ~wiS Register of wills Cumberland county, Pennsylvania COMMONWEAL TH OF PENNSYL Y ANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FDR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT +~ ~ DATE :rn" 2'l. 1~8? APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made lor Coosent to the transler 01 the lallowing securities 01 a Pennsylvania Corporation or a National Banking Associalion located in Pennsylvania: (fQrmcrlv. J\Jn(.)J:i'1an '\anl: (a) l? ~'1. (b) ~m~"'; <'~n r"",r'j,,..,, T'",' r, <;'rnd- (',... ~r. ..,~ (c) ('g 1\IIlCl 11 (NOTE: In describing securities enter in (~): ab Ofe, either the number 01 shares 01 stock or the lace amount 01 registered boods, in (b), the name 01 the issuing company and in (c) the class 01 stock or the stated interest rate and maturity date 01 registered bonds.) ISSUED ON Unknotm , and having a TOTAL MARKET V A-LUE OF S '77 nn (D.'.) asolthedatealdeathalthedecedent,1\"~ 1". .1",..,..,,1-1- ,anno(' 1,'.1QP'l (Home of Decedent) (Dale of death) who was late of 778 Pn~lar C:'lllr,.."11 ntP1f1. ('~m"l ~;;" (Street and Humber) (Post Office) (111Mht:\,...l ::p''H1 (County) P;:t (5'.'.) The securities are registered as lollaws: n<'!" 1;' .;~,..t:"++ (Name or namCl In which certificates orc registered) ADMINISTRATOR) EXECUTOR ) Darrvl L. Crovelincr \ (Nome) i M 0"") P (Address) NAME OF APPLICANT ,..1 ",:i-n" ., 'l' nnm 0- '/:1'.1 ',6:"'0'1, \'lallace F, Huric1: COUNTY FILE NUMBERo?/-~t:J-?..;,....:;J ADDRESS OF APPLICANT" "", riQ',ur'j. j?~,- 171Q 0 // ,.. BUREAU FILE NUMBER SIGNATURE OF APPLICANT . NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS ~ PLICA TI N, IT WILL NOT BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATE I hereby consent to the transler 01 the above securities now registered in the name 01 t Decedent and waive the Iiling 01 a certificate certifying to the payment 01 the transler inheritance tax to which the property ul said Decedent is made subject pursuant to the provisions 01 the Act 01 June 20, 1919, P.L. 521, as amended and the Act 01 June 15, 1961, P.L. 373, as amended. This is also in accordance with the provisions 01 the Act 01 April 9, 1929, P.L. 343. This Consent to Tronsler the herein described property operates only in relerence to the estate 01 the above.named Decedent. By