HomeMy WebLinkAbout80-00443
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
This...........".......~!..~.~.~............. ........ .."...... ........... day of ........."", ....~:!\\:'....."...... .."...."",.., "".. ". A.D., 19..~~!...
Mary C. Lewis
before me R;~l."l a E. :\}uloru^-, Register for the Probate of Wills and granting letters of Administration
in and for said County of Cumberland. in the Commonwealth of Pennsylvania. personally came ..............
Richard C. Snelbaker and Janet M. Forry
................................................................................................................................................................................
the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and
Testament of .... ~ !:.~.~~ ~~..~.:...~ ~1!!I!:~.I!.~............".,........""...... "......."............. Da ted ~?:: ?l!,~.:.y'..?. .1. J.~.~. ~.........
late of .......,,~.?~~!:..f...~.~.~.~..r.~~??.~.'.~~p... .............. ,.....,....",.......... "...."...... .., Cumberland County Pa., deceased
who being duly .....~.~~::?................."......... according to law, depose and say. that ......~.I:.~.y.,,~~.~.~................
present. and saw and heard the testa..t;R.!;'.......................... .............C;,1;Hn:J,!l.~..!.\r...;U!1!m9.n\3...........................
sign, seal, publish. pronounce and declare the said instrument of writing as and for h.1~........... Testament
and Last Will, and at the time of so doing .............\;\~.................................was of sound and disposing mind
memory and understanding. to the best of ..........:I;MJ.r..........................knowledge. observation and belief.
........S"'................................oo ._lb., bofu~ ..~~~d",l.......................
...y..~.i:-:Y.I<:-i.-::.....?2J.,..S;::?:(q.~~...................
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Rltkm:a . A ilL, Regl~
..................................................................................
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
...............................................................~.~!~.':\~.~..~.~~.?~~...................................................................being duly
..........~~.?:.~........................... says that as nearly as can be ascertained the ~aid decedent ..........................
....................S!~~.~.~.~.~...~:....~.~~?~~..................,..............................................:. ........ ...............................died on
.............W!!.~.I;:<;.~~~y................. the .............??;t;!!...........day of ............~.l!.I;:~.................................. A.D., 19.?R...
at or about ...............2.:::.L............... o'clock, P.:.M.
....~.~~~:!l.....................................,and subscribed this
.................:!-.~.;t;......................... day of ....).p.~y..............
19. ..?Q.., before
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RltLJ.ull . An' E1", Regl;i1;"'-.;
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF CUMBERLAND SS:
Before me, the Register fill' the Probate of Wills and gl'llnting of' Letters of Administration in and for
the County of Cumberland, personally came ......P.!!!I.I.~I.CC.+...~.i;l.l.~~~.I:.l?...~!:~..P.':.y.~?...!}.:...~.'?~Y.!:.r:.......................
who. being duly ...~\'mn:l..............., do .......... depose llnd say that as ....~!)~...<;.J;<..'f.~~!;!?".'?..................................
of the last Will and Testament of ........q~~p.~!'!.'?...~,...p.~!1!!\'.'?.I:1:~............................................................deceased
.......~.1~7.~.......... 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. ....~.~.'?r.!!.............. and subscribed
before me.
........~.';l.~.~.x'................................... A. D., 19 ...~.~.....
iii~~::q~~~d.................
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DECREE
Be it remembered that on the .........?~....... day of ..............~~~?:'.......................... A. D.. 19 ~.~..... there
was probated and recorded the last Will and Testament of .....9.JA~~~..~.,...~~~!!1.9.~.~..................................
lateof.....~.9.~~..~~~!:.~...~~!~~n~.~............................. Cumberland County, Pennsylvania, Deceased. Letters
TESTAMENTARY SAMUEL SUl~lONS AND DAVID IJ. COOVER
....... ................................................ were granted to .................................................................................. ..........
Witness my hand and official seal the day and year aforesaid.
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LAW O,.,I,CE8
SNELBAKER.
, McCALEB a: ELICK.ER
r^s'r WHL l\ND 'rESTANENT
I, CllARI,ES A. SIMNONS, of the TownshIp of Lower Allen, County of
Clm1ber land and Conunonwea lth of pennsyl.vania, being of sound and d is-
posIng mind, memory and understanding, do make, publish and declare
this as and for my Last Will and Testament, hereby revoking and making
void all former wills and codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral
expenses be paid by my Executors, hereinafter named, as soon as conven-
Iently may be done after my decease.
SECOND. It is my will and desire that my remains shall be interre
in my burIa 1 plot In the cemetery at the TrInd Ie Spring Lutheran Church
located In Silver Spring Township, Cumberland County, PennsylvanIa. If
I have not already provIded for a grave marker for said plot during my
lifetime, I order, direct and authorize my said Executors to procure an
appropriate marker and have the same erected on said plot.
THIRD. I authorize and empower my Executors, hereinafter named,
to sell and convey any real estate I may own, either by publiC or
private sale or sales, for such pl'i.ce or prIces and upon such terms and
conditions as they shall deem best, and to deliver to the purchaser or
purchasers thereof such deed or deeds as may be proper to vest good and
marketable title in the purchaser or plll'chasers thereof.
FOURTH. I give and bequeath unto THE fIRST BANK AND TRUST CONPAN
OF MECllANICSBIJRG, PENNSYTNANIA, as my Trustee, the swn of Three Thousa d
($3,000.00) Dollars, in trust, nevertheless, to ho Id, manage, invest
and reinvest the same, and to use the net income therefrom (1) to
provide and purchase flowers fot' placement at my grave and the graves
of my parents, namely, John Simmons and Elizabeth Simmons, at the same
time and at appropriate seasons,. said graves being located in the
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u.w OFFICI:.
SNELBAKER.
McCALEB 8; ELICKER
cemetery at the 'J'r:imlle Spring Lutheran Chur'"h mentioned hereinbelow;
and (2) to pl'ov:ide and pm'chase a basket of fl'esh flOl~ers for placement
:in the said Trindle Spring Luthel'an Church on ~10ther's Day and Father's
Day of each year, said flow"1's to be ded:icated to the memory of my
pal'ents above named and to be placed at their graves following the
worship services of such days; and (3) to use any net income which
remains after performing the first two purposes above for the maintenan e
and upkeep of the monuments and grave markers on the bud.al plots i.n
which my parents and I are interred.
FIFTH. I give and bequeath W1tO THE FIRST BANK AND TRUST COMPANY
OF MECHANICS BURG , PENNSYLVANIA, as my Trustee. the Slml of Five Thousand
($5,000.00) Dollars, in trust, nevertheless, to ho Id, manage, invest
and reinvest the same, and to pay the net income therefrom annually to
TRINDLE SPRING LUTHERAN CHURCH, located in Silver Spring Township,
Cumberland County, Pennsylvania, to be applied by said beneficiary on
account of the salary of the pastor of said Church. If the foregoing
trust should fail or terminate because of any reason whatsoever, I orde
and direct that the fWlds attributable to or then held in such trust
shall be distributed Wlto said TRINDLE SPRING LUTHEHAN CHURCH to be hel
and used by said Church in accordance with the terms and provisions of
said trust.
SIXTH. I give and bequeath unto TilE FIHST BANK AND TRUST Cm1PANY
OF MECHANICSBURG, PENNSYLVANIA, as my Trustee, the sum of Fifteen
Thousand ($15,000. DO) Do llars, in trust, neveJ'the less, to hold, manage
and invest the same, and to pay ove!' annually (or on more frequent
periodic intervals at the discretion of the Trustee) the net income
thel'efrom lmto THINDLE SI'HING C!:~lE'l'ERY ASSOCIATION OJ' its successor) 1'0
the geneJ'a 1 upkeep and l11a intenance of the cemetery at Tr ind Ie Spl'ing
Lutheran Church located .in SHver Spring Township, Cumberland County,
Pennsylvania. Should said cemetery cease to exist, I order and direct
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LAW O"ICEII
, SNELBAKER.
McCALEB a ELICKER
fUI'ni:tul'e, tools and pel'sonal (,ffects unto illY nephew, SA~IUE[, SINMONS,
and his wife, CELESTA Snl~10NS, as tenants by the entil'eties, absolutely.
FIF1'EENTlI. I give and beqUl~ath the Slun of Fifteen Thousand
($15,000.00) Dollaps unto THE FIRST BANK ANO TRUST CmlPANY OF MECHANICS-
BURG, PENNSYLVANIA, as my Tl'ustee, in trust, nevertheless, to hold,
manage, invest and reinvest the same for and duping the natural lifetime
of CET,ESTA Sn1NONS (wife of my nephew, Samuel Simmons) and to pay over
in semi-annual installments the net income thepefl'om Wlto the said
CELESTA SINMONS during her natural lifetime; and upon the death of said
life benefieiary, I order and direct that said trust be terminated and
the then remaining net balance of both prineipal and income shall be
distributed in equal shares unto each of the following persons that may
be surviving, namely, CATHY LYNN rASH, BARBARA ANN t-lUMMERT and SHERRY
LYNN N\JMt'1ERT, share and share alil<e, absolutely.
SIXTEENTH. I order and direct that all taxes that may be assessed
in consequence of my death, of whatever nature and by whatever juris-
diction imposed, shall be paid from my residuary estate as part of the
expense of the administration of my estate.
SEVENTEENTH. I give, devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situated, unto THE FIRST BANK AND TRUST COMPANY OF
MECHANICSBURG, PENNSYLVANIA, as my'l'rustee, in trust, nevertheless,
to hold, manage and invest the same 1'01' and during the natural lifetime
of my nephew, SAMUEL Sn1~lONS, and to pay ovel' in semi-annual install-
ments the net income therefrom unto my said nephew, SAMUEL SIMMONS,
during his natural lifetime; and upon the death of my said nephew,
I order and direct that said trust be tel'minated and the then remaining
net balance of both pl'ineipal and income shall be distributed unto
TRINDT..E SPRING LUTHERAN CHURCH located in Silver Spring Township,
Cumberland County, pennsylvania, to be used for Church building purpose',
LAW OFfICES
,,',. SNELBAKER,
'MCCALEB a ELICKER
.
absolute ly.
EIGHTEENTH. larder, direct and authorize the aforesaid THE FIRST
BANK AND TRUST COMPANY OF ~IECHANICSJlURG, PENNSYLVANIA, to be paid its
usual and customary fees ancl conunissions as may be established from tim
to time after my death by said Bank for its services as Trustee of the
several trusts hereLmder. Should the said THE FIRST BANK AND TRUST
COMPANY OF MECHANICSBURG, PENNSYLVANIA, cease to exist by reason of any
merger Ot' consolidation, I order and direct that the successor thereof
shall be substituted as the trustee of the several trusts hereinabove
created.
NINETEENTH. I nominate, constitute and appoint my nephew, SAMUEL
SIMMONS, and my friend, DAVID B. COOVER, to be the Executors of this,
my Last Will and Testament, bothto serve without bond.
IASTLY. I order and direct my Executors named hereinabove to
engage the services of RICfffiRD C. SNELBAlillR, Esquire, as attorney for
said Estate and my Executors, said attorney having an intimate knowledg
of my business affairs and of my intentions and desires expressed in
this, my Last Will and Testament.
IN WITNESS WHEREOF, I, CHARLES A. SI~lt'IONS, have herelU1to set my
hand and seal to this, my Last \Vi.ll and Testament \~hich consists of fiv
(5) typewritten pages to each of which I have affixed my signature this
7th day of January, A.D., One Thousand Nine HlU1dred Eighty (1980).
/t~,.tI-'>Cr ( ;{ II V .. ~_ (SEAL)
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The preceding instrument, consisting of this and four (~) other
typewritten pages, each identified by the signature of the Testator was
on the date thereof signed, sealed, published and declared by CHARLES A
SIM~10NS, the Testator therein named, as and for his Last Will and Testa
ment, in the presence of us, who, at hi1';. quest, in hi s presence, and
in the presence of each other, have subscri names as witnesses
hereto. /~d~<.,~. J.2~'
(J-..r'"1^.f" )1). \ =I <'>-'I.^-, A
{/ (/
No. 2\.8:0 4J3
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
CHARLES A. SIMMONS
, deceased.
Mary C. Lewis
To Ri:~baOOcJlZx:A~:demIlm, Register of Wills for the County of Cumberland,
in the Commonwealth ot Pennsylvania.
IS<.
Petitioner(s) are the execut ors named in the Last Will and
Testament of Charles A. Simmons dated January 7. lqRQ
Decedent was a citizen of the United States and a resident of
Township
Lower Allen Township ~, Cumberland County, Commonwealth
af Pennsylvania.
Decedent died on wednesday
A. D. 19~, in the County of
the 25th
day of June
cwnberland
State of
pennsylvania at the age af 92 years.
Joost bas<. Jb.El.l<.
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 personal property to the value of
Unestimated and of real estate to the value of
None
as near as can be ascertained; said real
N/A
estate situated as follows
apply
Therefore, your petitioner(s) respectfully C1jll~ far the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated July 1, 1980
Name and address
of Petitioner(s)
~L'Ht< i '/,Z Ad-r",',.. N-Z-CJ)~
Samuel Simmons
501
PA 17055
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
Samuel Simmons and David B. Coover
named in above application, being duly sworn according to law
saY(li) that the statements set forth in this petition are true to the
best af their knowledge and belief. .
s~'" ond ,ub"db,d b,fo" "'if""! .</'-" fa"''''
me July 1, 19 80 /1 /(i{'iP'~f(tU'L
~-I~ (!. IXL:~"'~.J
j;l19l::la~ Iii. P.Rg~ ,Register
-,-_.._------
~
McCaleb & Elicker I
~f}/o
July 2,
1980
Attorney: Snelbaker,
RCC-J (4-73)
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28,1956, P,L, 1757, and Act of June 15, 1961,
P,L, 373, os amended)
;+
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COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax an the transfer af the property
described below:
1. Bureau File II 21-BO-IJLJ.3
2. Date of Death ~.1l_Tl~---.?~.,-J9~~...._..__.__.__
3. Date of Approval .-1JtJ.:!!9~~&;,...mJ
4. Name of Decedent Charles A. Sinunons
5. The Commonwealth's apprai sed value of the property for whi ch an exemption is claimed is S 5,000.00
(Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the varue of
the property has been establi.hed by apprai.al by the Commonwealth, except in those case. where the amount of the gift
or bequest represents 0 stated fractional or percentage portian of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit 0 copy af the document authorizing the transfer, unless
such material has been previously filed.
WILL "ill
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Nome and Address of Charitable Organization receiving property:
NAME Saint Paul's Lutheran Church
ADDRESS Wertzville Road, Enola, Pennsylvania 17025
o See listing on reverse side for additional charitable organizations covered.
B. I certify that the information contained herei.n is, to the be:t of my knowledge and be7!~rue.a~d correct.
Signature of Applicant~ l.~/rr,' :r'(~t";'/~'7;';?"-:J / 4ilL I <(;g~<-,"L-<~'
R. D. 1
Address of Applicant Mechanicsburg, PA 17055
501 James Street
Mechanicsburg, PA 17055
Official Title
Co-Executors
.Date tft'1 ). '; /f'tC)
I
This form must be completed In triplicate and 011 three caples delivered to the Register of Wills for the County In which the decedont
resided, or In which letters were luued for 0 non_resIdent decedent's estate. If the decedent was 0 non-resident of Pennsylvania and
letters were not Issued by 0 Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Ol/lpartment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write below this line. For Official U.e Onl
APPRDVED: For the Secretary of Revenue REFERRED to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
~ (SI ature of R gi.ter of Will.)
'.( /j'J! k./ ~/Y?A-
~ (County)
i0 ~~nJ-<!J.;2 0 / f,fIJ
(Date of Appro:'I)'
(Initial. of Regi.ter of Will.)
(Authorized Signature)
i
,
I
(County)
(Title)
(Date of Referral)
(Date of Action)
* Soe reverse sido for rensons
MUST BE FILED IN TRIPl..I(,HF
RCC-3 (4.73}
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Ac' 01 Moy 28, 1956, P,L. 1757, ond Ael 01 June 15, 1961,
P,l, 373, as amended)
.'-
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COMMONWEALTH OF PENNSYLVAHIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed fer the approval
of an oxemption from Pennsylvania Transft'r
Inheritance Tax on the transfer of the proporty
described below:
1. Bureou File II. 21-80_-lili:'l.------ --
2. Date of Death il':111en25 ,19~.O_ .- . .
3. Date of Approval _*V:C22l..~~ /.:liP
4. Name of Decedent Charles A. Simmons
5. The Commonwealth's appraised value of the property far which an exemption is claimed is $ 15 ,000 .00
(Note: Where the property is other than a specified amount of cosh, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously Hied.
WILL 1fj;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If ather, explain)
7. Correct Business Name and Address of Charitable Organi'tation receiving property:
NAME Trindle Spring Cemetery Association (Trindle Spring Lutheran Church)
ADDRESS 15 State Road, Nechanicsburg, pennsylvania 17055
o See listing on reverse side for odditionol choritoble organizations covered.
8. I certify that the information contained herein is, to the best of my knowledge and belief,
~,!;;;~'/> '/c /<J-:.rJ
Signature of Applicant.;'
/
R. D. 1
Address of Applicant Mechanicsburg, PA 17055
501 James Street
Mechanicsburg, PA 17055
Officiol Title
Co_Executors
Dote (Jet ). I 19f{o
This form must be completed In triplicate ond 011 three copies delivered to the Register af Wills for the County In which the decedent
resided, or In which letters were Issued for a non..resident decedent's estate. If the decedent was a non.resldent of Pennsylvania and
letters were not Issued by 0 Pennsylvania Register of Wills, deliver 011 three copies to the Director, Bureau af County Collectlonl,
Penna. Department of Revenllo, 26 S. 4th Street, Harrisburg, Pa.
00 not write below this line. For Official Use Onl
APPROVED: For the Secretary of Revenue REFERRED to Bureau Headquarters
Approved 0
For Secretary of Revenue
;d
Denied' 0
"d (Si ature of Register of Wills)
/ , te4t~~
I~-.--.-
~ (County)
t/j Wt:-rJ<J.;H /1 jIJ
(Date of Appra:al)
(Initials of Register of Vlills)
(Authorized Signature)
(County)
(Title)
(Date of Referral)
(Date of Action)
* See reverse side for reasons
MUST BE FILED IN TRIPLICA Te
RCC..314.1Jl
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, \956, P,L, 1757, and Act of June 15,1961,
P,l., 373, os amended)
..
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'-~', ~,()
COMMONWEAL TI1 OF PENNSYLVAtIlA
DEPARTMENT DF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application i. horaby filad for tho approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on tho transfer of the property
da.cribad balow:
1. Buraau Fila 11__2l.:!l.0-L~IL3_._
2. Data of Oaath .._ Jun",25..19BD_
3. Data of Approval _:l!tkkuUt:-:C2j~?:;~i;-----
4. Nama of Oacadant Charles A. S1JIlIl1ons ft
1 (7?11i('I.,rlj) .:1,:3 I, ~
5. Th. Commonwealth'. opprai.ad value of the property for which an exemption is c10imad is S Entire Residue .
(Hate: Where the property is athor than a specified amount of cosh, the exemption cannot be approved until the value of
the property has been e.tobli.hed by opproisol by the Cammonwaalth, axe apt in those casas where the amount of the gift
or bequest represents 0 sta1ed fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such moteriol has been previously liled,
WILL If;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, explain)
7. Correct Business Nome and Address of Charitable Organization receiving property:
NAME Trindle Spring Lutheran Church
ADDRESS 15 State Road, Mechanicsburg, Pennsylvania 17055
o See listing on reverse side for additional charitoble orgonizotions covered.
B. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
Signature of Applicant "~?JI'" ~ I //;'/'" ./:0""/ 1~lll(&t::;LtLU.--/
R.D. 1
Address of Applicant Mechanicsburg, PA 17055
501 James Street
Mechanicsburg, PA 17055
Official Title Co-Executors
Dote February 20, 19B1
This form must be completed In triplicate and all three caples delivered to the Register of Wills for the County in which the decedent
resided, or In which letters were Issued for o'non.rosident decedent's estato. If the decedent was 0 non.resident of Pennsylvania and
letters were not Issued by a Pennsylvaniu Register of Wills, deliver 011 three copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg. Po.
00 not write below this line. For Official Use Onl
APPROVED: For the Secretory of Revenua REFERRED to Bureau Haodquorters
Approved 0
For Secretary of Revenue
Denied* 0
vz-V
(Initial. of Regi.ter of Will.)
(Authorized Signoture)
(County)
(Titl.)
(Dote of Referral)
(Dote of Action)
. See reverse side for reasons
MUST BE FILED IN TRIPI.tC~T~
. .
'"7.JQ~. - ~}~~ ~ '"', I OJ S'-?
AFFIDAVIT OF
FIDUCIARY
(Instructions on Reve..e Side)
cr I-..rt D- t(-r.......:s~-~t.-iI
,
REV.449 EX+ (3.801
COMMOHWEAL TII OF PEHHSYLvAIlIA
DEPARTMEHT OF REvEHUE
TRAHSFER IHHERITAHCE TAX
RESIDEHT DECEDENT
'*
Estate of
Charles A.. Simmons
Dote 01 Death
.June 25, 1980
Lost Address Wesle.y' Drj.ve (Bethany Village)
Social Security No.
182-36-8512
Mechanicsburg, PA 17055
Bureau File No.
21-80-'1LI3
tCITY)
(Hi\. TF.I
('lIP)
Cuunty File No.
21-80-'1LI3
1. Decedent died:
( ) Intestate (without 0 will)
(X ) Testate (leaving a last will--copy attached)
2. Is the liling of a Federal Estate Tax Return required lor this estate? Yes~ No
Address R. D. 1
Mechanicsburg, PA 17055 Mechanicsburg, PA 17055
[CITY) (STATE) (ZIP)
Administrator! Administratrix
David B. Coover
501 James Street
3. ( X) Executor/Executrix
Name Samue 1 Simmons
4. All correspondence should be moiled to ( X) Attorney
) Fiduciary.
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5. If on attorney is representing the estate, indicate:
Nome Snelbaker, McCaleb & Elicker
Address 44 West Ma in Street
Mechanicsburg, PA
(C1TYI (STATEI
17055
('Z.lP)
List 011 sole deposit boxes registered in the decedent's individual nomehor jointly with, or os an agent or deputy
of another, or in decedent's individual nome with right 01 access by onot er os agent or deputy. Include the nome
and address 01 the bonk or other institution where the safe deposit box is located, the nome (s) in which the box
is registered and the relationship of the joint holders to the decedent.
HAME AHa AOORESS OF BAHK OR OTHER IHSTlTUTlOH
IN WHICH aECEaEHT MAINTAINEO A SAFE aEPOSIT BOX
HAME OR HAMES IN WHICH
SAFE DEPOSIT BOX IS REGISTERED
RELATIOHSHIP OF JOINT
HDLaERS TO aEcEDENT
The First Bank and Trust Com an
Decedent
ain,and Market Streets
Mechanicsburg, PA 17055
David B. Coover, Deputy
Under penalties 01 perjury, I declare that I have examined this return, including accompanying schedules and
statements, Md to the best of my knowledg/nd",,:?ie.f:,~ ~:, ~:~e~ c,~~t.~ndc.~:.~~~t~. ,,//2 f,)/
I / H,/"'5'/l{u< ',)/) /7'))
SIGHATURE OF FIDUCIARY DATE
,
PENNSYLVANIA INHERITANCE TAX GENE~~~XQ~MATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Acl of 1961 plllvlde~.III"lllie lollowlllJ~ persons shall plep;ue "nd file
a return:
a. The personal representative of the estate of the decedent as 10 propr:lly olllie decedent adlninislered by him
and such adrfitional property which is or lIIay be subJecllo Inlielit;lIlce Tax III whicli he/she sliallliave or
acqui te knowl edge;
b. The transferee ofTHoperly upon the transfer of wl1iclllnheritance Tax is ollllay be illlposed by the 1961 Slalute,
including a trustee of property transferred in [llIsl, provided Ilia 1 no separ,lle rell/1nlleed 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 duplicale with the Regisler of Wills of lhe counly wherein the decedent resided.
3. TIME FOR FILING
The return is due nine montlls aller 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 thai" . . .any person who wi.ll.fully fails to file a return or other report
required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately fouild 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 line.al descendants, s,!Jch as father, 1II0ther, 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 016% 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 properly, which lien remains in effect until
the taxes and interest have been paid in full. The taxes may be sued for against any leal property in the decedenf's
estate or against any property belonging to a transferee liable for the tax.
8. FILING OF FALSE RETURN
Any person who willfully makes a false return or reportleQuired of him shall, ili accordance with Section 793 of the
1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced 10 pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year 01 both.
REV.451 EX+ (3.Sol
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*'
(Instructions on Roverse Side)
Estate of
Charles A. Simmons
i ITEM ESTIMATED DEPARTMENT
I D ESCR I PTI ON UNIT MARKET VALUATION
I NO. VALUE VALUE (OFFICIAL USE ONL Y/
I
i
, 1. United States Treasury Notes and Bonds:
i
I Accrued Va lue on
Amount Due Rate Interest D.O.D.
$10,000 8/15/80 --g- $325.00 $10,012.50 $ 10,337.50
10,000 10/31/80 an 135.59 10,025.00 10,160.59
I 10,000 11/15/80 7JAl 158.33 9,965.62 10,123.95
5,000 1/31/81 93'tf 196.35 5,0511. 69 5,251.04-
10,000 1/31/81 9::v4- 392.70 10,109.37 10,502.07
I 10,000 5/15/81 7!;;- 83.33 9,94-6.87 10,030.20
I 5,000 8/15/81 7 126.39 4-,921.88 5,04-8.27
i
i 5,000 8/15/81 7 126.39 4-,921.88 5,04-8.27
10,000 8/31/81 9~ 307.4-7 10,134-.37 10,114-1.8li
5,000 8/31/81 95"s 153.73 5,067.19 5,220.921
5,000 2/15/82 6~ 115.10 li,817.19 4,932.29
I 5,000 2/15/82 6 3!l3 115.10 4-,817.19 11,932.29
10,000 8/15/82 9 325.00 10,050.00 10,375.00
10,000 8/15/82 9 325.00 10,050.00 10,375.00
5,000 3/31/83 9t 115.10 5,031.25 5,14-6.35
, 10,000 8/15/85 8% 297.92 9,606.25 9,904-.17
10,000 8/15/85 8% 297 .92 9,606.25 9,904-.17
10,000 2/15/87 9 325.00 9,821.87 10,1116.87
10,000 2/15/87 9 325.00 9,821.87 10,1116.87
5,000 11/15/88 8 3,/li li8.61 4-,760.9li 11,809.55
. 5,000 11/15/88 83/4- 48.61 4-,760.94- 4-,809.55
5,000 11/15/88 83;1+ 4-8.61 4-,760.94- 1~,809 .55
5,000 11/15/88 8 ~- 4-8.61 4,760.911 4,809.55
2. $10,000 Federal Home Loan Bank Bond, dated
2/27/78, due 5/28/85, 8~/o coupon, in book
entry form, value on date of death 9,512.50
accrued interest 60.94
3. Checking Account No. 150-465-3, First Bank
and Trust Company, balance on date of death 1,0311.19
4-. Savings Account No. 506-972-9, First Bank and
Trust Company, balance on date of death 7,590.83
accrued interes 63.26
5. $10,000 Time Certificate No. 3273, First Bank
and Trust Company, balance on date of death 10,000.00
accrued interc t 83.33
TOTAL THIS PAGE CONTINUED
-'
CONTINUED ON PAGE 2
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Old 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".) No
2. Old decedent, within two yearsof death, transfer property from himself/ herself to himself/herself and another party
or parties (Including a spouse) In joint ownership? (Answer "Yes" or "No".) ..NLl.-
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 property 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".)
b. What was the transferee's age at time of decedent's death?
5. Did 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 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".) l(Jn
6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or 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, tile 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".) No
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".)
. . ,"'.
R'EV.454 EX+13.801
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
(Instructions on Reverse Side)
*
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
Estate of Charles ^. Simmons
TOTAL Pe VALUE OF DEPARTMENT
ITEM DESCRIPTION MARKET , DECEDENT'S VALUATION
NO.
VALUE ~ INTEREST (Officiel Use Onlv)
NONE NONE NONE
TOTAL THIS PAGE NONE
- '.
,
,?':".~'; ',:"~1"'" ..,'. .' f. il
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. Soth 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 aii personal property
. as indicated in the instructions for Schedule "S". 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.
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REV.SIB 'FO (7-80)
~~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELO OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Samuel Simmons
R. D. iFl
Mechanicsburg, Pa. 17055
David B. Coover
SOl James Street
Mechanicsburg, Pa. 17055
RE:
Estate of Charles A. Simmons
County of Cumberland
File No. 21-80-0443
Dear Sir:
You ore hereby notified that the original
appraisement in the estate of Charles A. Simmons
has been filed in the office of the Register of Wills of Cumberland
County on March 19 , 19!U:... Said appraisement ref/ects the following voluations:
Real Estote
Personal Property
Jointly Owned
Transfers
Total
-0-
$218,754.46
-0-
-0-
$218,754.46
As to such tax that is paid within three months from dote of death, 0 five (5%) percent
discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months
when death occurred from December 22, 1965 to June 16,1971, inclusive; and twelve months when
death occurred prior to December 22, 1965) from date of death, interest at the rote of six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may object thereta within sixty doys
after receipt of said notice os provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Dote ~larch 19. 1981
j21'~~;':(J ) '/i'f~ /ltJ}(J )
Signed
Title Chief Appraiser
NOTE: This is not 0 bill.
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REV.455 (1.eo)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEDENT
,,'J)!":- I ~ ll(
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
Estate of Charles A. Sil1ll1lons Dateo! Death .June 25, 1980
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
File No, 2.l.-80-IJIJ3
Claimant
Relationship to Decedent
Claimant's Address
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
1 Register of Wills Probate costs 65.00
2 Cumberland Law Journal Advertising executors' not ice 18.00
3 West Shore 1.1:i.mes AdvertIs InIT executo~,,' nnH"e 1 Q ~Q
4- Register of WHls Short certificates 2.00
5 Myers Funeral Home, Inc. Fun era 1 expenses 5,90lf.6l1
6 First Bank and Trust Company Safe depos it box inventory 5.00
-
7 Dixon's Pharmacy Account 22.23
8 Cowlev Associates Profess i ona 1 services 186.00
9 First Bank and Trust Company, Bur] a 1 trust per Item Fourth of
Tl'ustee said Will 3,000.00
10 Register of Wills Filing fees 9.00
11 Samuel Simmons Co-Exccutor's commission 5,4-67.50
12 David B. Coover Co-Executor's commission 5,lf67.50
13 Snelbaker, McCaleb & Elicker Attorneys fee -. 10,935.00
.
1lf Reserve for filing account, r .leases, notary fees and m iscell-
aneous costs 100.00
TOTAL THIS PAGEl $31 201. 2 6
J 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 spbmitted to the estate as deducti;:""".or Inherjta ce Tax purposes.
. xi".,n ;,d;// I f"/ /;11<. e, ,j0) 'I'",,~ ,) /J \ );;)
SIGNATURE OF Al'TSflI r:/FIOUCIARV DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S 3i. J /) /. ,}ll, AT
J '
h--
PERCENT.
:3 - ;Jc-;:.t/
L1!-I.TE
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 the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses inciuding the cost of a burial lot, 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 liability for the debts being claimed
should be attached 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 tllere 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.
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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 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.
INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
RCC-3 \4_731
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28/ 1956. P,L, 1757, and Act of June 15,1961/
P.L. 373, as amended)
.'
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'{t.:. '..
COMMOllWEAL TH OF PENHSYLVMIIA
OEPARTMENT OF REVENUE
BUREAU OF COUHTY COLLECTIONS
Application is hereby filed for the approval
of an exemption from Pennsylvania Transfer
Inhoritance Tax on tho transfer of tho property
described balow:
1. Bureau File I' ~:80-~~3_
2. Date of Death ___Ju,II~_~~,L~9t!0
3. Date of Approval
4. Nome of Decedent Charles A. S1l\II1onll
5. The Commonwealth's appraised value of the property for which an exemption is claimed is S !:>>.OOO.OO
(Hate: Where the property is other than 0 specified amount of cash, the exemption cannot be approved until tho value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount 01 the gift
or bequest represents a stated fractional or percentage portion of the entire e,tate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was elfected and submit a copy of the document authorizing the transfer, unlo..
such material has been previously filed.
WILL ~;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0:
OTHER 0:
(If other, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
HAME Trindle Spring Lutheran Church (See Item Fifth of said Will)
ADDRESS 1!:>> State Road. Mechanicsburg. Pennsylvania 1?0!:>>!:>>
o See listing on reverse side for odditional charitoble organizations covered.
8. I certify that the information contained herein is, to the best of my knowledge and beliel. truo and correct.
. ;J ,'. 1/ . < ~i
Signature of Applicant /, .,<,-"",' ./.. /1/ (~'" J / (/(t <( ~ I~'U
Addre.. of Appl icant
R.D. 1
Mechanicsburg. ~ 1?0!:>>!:>>
501 James Street
Mechanic.burg, ~ 170SS
This form mu.t be completed In tdpllcote and all three copl.. delivered to the Regl.ter of Will. fa. the County In which tho deced.nt
".Ided, or In which iette.. were Istued for 0 non_re.ldont decedent'. e.tote. If the dec.dent wa. 0 nan.retldent of Pennsyivanla and
lotte" we.e not Issued by a Penn.ylvanlo Regl"e. 01 Will., deliver all th..e caple. to the Olrecto.. Bureau of County Collection.,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Pa,
Olliclal Title
Co-Executors
Date February 20. 1981
Do nol write below this line. For Olliciol Use Onl
APPROVED: For the Secretary of Revenue
REFERRED to Bureau Headquarters
Approv.d
(Signature of Regist.r of Wills)
(Initials of Reglst.r of Wills)
(County)
(County)
g'4~
Jf/~;;7/
(Date of Action)
.. See rever.e .Ide for realonl
(Date of Approval)
(Date 01 R.ferral)
MUST BE FILED IN TRIPlIC.T~
INSTRUCTIONS
To insure proper credit to your occount, the nome of the estate and file number should be
clearly printed on the check or money order.
This determination and assessment is mode in accordance with Section 421 and Section 732
of the Inheritance and Estate Tax Act of 1961, 72 P.S. 2485-421,732.
The estate tax. imposed by Section 421 is due at the dote of the decedent's death but sholl
not become delinquent until the expiration of eighteen (18) months after decedent's death provided
that any estate tax occasioned by a final change in the Federal return or of the tax due thereon
sholl not become delinquent until the expiration of one (1) month alter the person Iioble to pay
the tax receives final notice of the increase. Calculate interest from the delinquent dote shown
on the foce of this form to the dote of payment using the fo!lowing interest tab'e:
---------------------------------------------------------------------------------
1 month .005 4 month s .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 day .00017 11 days .00186 21 days .U0352
2 days .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 day s .00386
4 days .00068 ]4 days .00237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .001]8 ]7 doy s .00284 27 days .00454
8 days .00]35 ]8 days .0030] 28 days .0047]
9 days .00]52 19 days .00318 'lI days .00488
]0 days .00]69 20 days .00335 30 days .00500
.--- -------------------------- --- -- ----------- ----~-- ---- ---------------- ---- ------
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 ]001 of the Inheritonce and Estate Tax Act of ]96] (72 P.S.
~ 2485-100])
Make check or money order payable to:
"Register of Wills, Agent"
Moil to the address listed below:
....
,..
.
INFORMATION
To insure proper credit to your account, the name of tho estate and file number should be clearly print-
ed on the check or money order,
This assessment is made in accordance wilh Section 708 of the Inheritance and Estate Tax Act of
1961 (72 P,S, ~ 2485.708),
To the extent thot 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, S 2495.716),
Inheritance Tax, other than tax on a fUlure interest. is due at the date of the decedent's death and becomes
delinquent at the expiration of nine (9) months aftcr the decedent's death (72 P,S, 9 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 thereafter (72 P,S, 9 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:
------------ --------- ---------- -- - ---- - -------- - - - -- - --- --- ----- -- -- - - - -- --
, month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,010 5 months ,025 9 months .040 11 months ,055
3 months ,015 6 months ,030 9 manths ,045 '2 months ,060
1 days ,00017 " 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 ,00403
5 deys ,00085 15 days ,00250 25 days ,00420
6 days ,00101 16 days ,00267 26 days ,00437
7 days ,00118 '7 days ,00284 27 days ,00454
8 deys , ,00135 1 8 days ,00301 28 days ,00471
9 days ,00152 19 deys ,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 thereto wilhin sixty (60) days after receipt of this Notice as provided by Section
1001 of the Inherita"ce and Estate Tax Act of 1961 (72 P,S, 9 2485.1001),
Make check or money order payable to:
"Register of Wilis, Agent"
Maii to the address listed below:
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.... . ..
Inventory of the real and personal estate of
Charles A. Simmons
deceased
REAL ESTATE
NONE
TOTAL REAL ESTATE
EERSONALTY
1. United States Treasury Notes and Bonds:
Accrued Value on
Amount Due Rate interest D.O.D.
$10,000 8/15/80 9 $325.00 $10,012.50 $10,337 50
10,000 10/31/80 8 7/8 135.59 10,025.00 10,160 59
10,000 11/15/80 7 1/8 158.33 9,965.62 10,123 95
5,000 1/31/81 9 3/4 196.35 5,054.69 5,251 04
10,000 1/31/81 9 3/4 392.70 10,109.37 10,502 07
10,000 5/15/81 7 1/2 83.33 9,946.87 10,030 20
5,000 8/15/81 7 126.39 4,921.88 5,048 27
5,000 8/15/81 7 126.39 4,921.88 5,048 27
10,000 8/31/81 9 5/8 307.47 10,134.37 10,441 84
5,000 8/31/81 9 5/8 153.73 5,067.19 5,220 92
5,000 2/15/82 6 3/8 115.10 4,817.19 4,932 29
5,000 2/15/82 6 3/8 115.10 4,817.19 4,932 29
10,000 8/15/82 9 325.00 10,050.00 10,375 00
10,000 8/15/82 9 325.00 10,050.00 10,375 00
5,000 3/31/83 9 1/4 115.10 5,031.25 5,146 35
10,000 8/15/85 8 1/4 297.92 9,606.25 9,904 17
10,000 8/15/85 8 1/4 297.92 9,606.25 9,904 17
10,000 2/15/87 9 325.00 9,821.87 10,146 87
10,000 2/15/87 9 325.00 9,821.87 10,146 87
5,000 11/15/88 8 3/4 48.61 4,760.94 4,809.55
5,000 11/15/88 8 3/4 48.61 4,760.94 4,809 55
5,000 11/15/88 8 3/4 48.61 4,760.94 4,809 55
5,000 11/15/88 8 3/4 48.61 4,760.94 4,809.55
2. $10,000 Federal Home Loan Bank Bond, dated 2/27/78, due 5/28/85, 8 1/2%
coupon, in book entry form, value on date of death 9,512.50
Accrued Interest 60.94
3. Checking Account No. 150-465-3, First Bank and Trust Company, balance on
date of death 1,034.19
4. Savings Account No. 506-972-9, First Bank and Trust Company, balance on
date of death 7,590.83
Accrued Interest 63.26
5. $10,000 Time Certificate No. 3273, First Bank and Trust Company, balance 0
date of death
Accrued Interest
10,00 .00
8 .33
6. $10,000 Time Certificate No. 3370, First Bank and Trust Company, balance 0
date of death
Accrued Interest
10,00 .00
12 .08
Continued
..
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COMMONWEALTH Of PENNSYLVANIA \.
COUNTY Of CUMBERLAND J
ss:
----'-.-
being duly _ according to law, doposes o"d says that he --'"
__-- of tho Estate of
lote of _..--...----. ....._........ ._.._-'" ...._.__._.---' Cumberlond County, Po., deceased ond thot the
within is on inyentory mode by ___ ., the soid
of the entire estate of said decedent, consisting of all the personal prep.rty ond real ostate, except reol estate outside
:the Commonwealth of Pennsylyania, and Ihallhe figures opposite each item of the Inyentory represent it's foir yolue
.as of tho dato of decedont's death.
.._-,---_.---~--- ------
and subscribed before me,
Ellocutor . Administrator
19
Addr."
Dote of Death
Day
Month
Vel,
\ INSTRUCTiONS
. \ I. An inyentory must be filed within three months after appointment of personol repre5entative.
2. A supplement inyentory must be filed within thirty days of discoyery of additionol ossets.
3. Additional sheets may be attached a5 to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND J
55:
SMlUEL SUlMONS and DAVtlLB-'-__COOVJlIL------
--.------.------- ,--,-----,--, --,......,.-..--'...'.-.-'-
--_._-'-----
bcing duly sworl)..__.- according 10 law, dcposcJ a"d sayt Ihal t hCY-1lw--t:he-
~e.C.\l.t9J:IL----------.-.------. of Ihc Estale 01 Ch.rlPR ^- Simmons
lele of ____..Lower.-Al1en T.ownship.--- _ ..'_ _" ____---, Cumberland Counly, Po., deceased and Ihat the
wilhin is an invenlory made by ___Ssl'lueLSJ.l11l1lonaJlruLnavJLlL ._CQjLVeL-., Ihe said Executors
of Ihe cnlire eslalc of said deccdcnl, consisling of all the personal prop.rly and rcal cslatc, exccpt rcal estate outside
Ihe Commonwcallh of Pennsylvania, and Ihal Ihe figurcs opposite cach item of Ihe Inventory reprcsent iI's fair value
as of Ihe date of decedenl's death. . (7' - .
_ and subscribed bcfore me, \ :
() j.:r-U-'-'''-- 1(" , 19 B 1 \
__R~-1L,~~ani~Hburg, PA, 170"
-------..--
1
Sworn
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E'IlOcutor s A.cLn1ois.tulcl
/;t,:~{ II '1' (WIc_
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GAIL A.LAUER, NOTARY PUBLIC
MECHAN1CSOURG BORa, CUMBERLAND COUNTY
MY COMMISSIOI~ EXPIRES APR, 14, 198,'
Mp.mbm. Prnnsvlvani;j A'i~nciallon 01 Notaries
501 James Street, Mechanicsburg, PA. 17055
Addre"
Dale of Dealh _-12tlL-
Day
Jllnp
Month
lQRO
Year
n
I. An inventory must be filed wilhin Ihree months after appoinlment of personal representotiv~r;;
;::..<1
2. A supplement inventory must be filed within Ihirly days of discovery of oddilionalassets. ;'i,;~
fTl.
3. Additional sheets may bc attached as 10 personalty or really :.2~'~
'"',.,.
4. See Arlicle IV, Fiduciaries Act of 1949. ,.::,'
INSTRUCTIONS
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FiL'st and Final Account and Statement
~-----------_.---~--------------------_.-------
In the Court of Common Pleas of
Cumberland County, Pennsylvania
Orphans' Court Division
No. ~!.:-_ll.g::~l!2-___----------- ~ ~-----
of_]~~9P_~~~_~_Qj_~t!~J2U!jlQO-_QE-;L1m~-L-----
Simmons and Ilavi.d n. Coover, Executors
XI.
under the Last Will and Testament of
C h~.!:.! ~!'__~;__~!!J1!1lgU~-~-ll!.l;.e-.Q,U~'IleJ~.Al.J..en
Township, Cumberland COllnty,
Pe n n s y 1 van! '!.~.P..~S2_'!.i::~!!.____________________
---------... -
----------------------.-----------------------
..-----....--. -.....--.,. - ..--.- .....-----..-..---..---..---..
---....---------------,....----.....--------..---..-..--....-.....------..-------.------..--------------..----..
Madam: ________________ ---....-----------------------.
---..------------------..------------..-------..--..-'.
We hereby withdraw the First and Final Account and Statement
.......-...----------..--..---..---..--------..-----..-----.....------..-..--..----..-..------------....---...---......
of Proposed Distribution in the above captioned csta te.
.------------------..----..--.--------------------------------..----------..----------..--------------
-------------------..-------..-..------------------..-..----------------....----------------..-----------
-------------------------- --... -..- ,.-------------..-- ....- ------. ..---- -..-.. .-.:- --...... -.. --- ----- -- ---..-....-
._--_.._---_.._..-----------_...--------_..-~---------~.._---~..-....._--~.......-_.....---_..__._-----_.._-~.._---
To .!'!~:L~;__T;:~..i:.~.l__~':~}_~~~L9I_\YH_l~_
JOO(~
"
____~~~~~~2:___l_2"7------------------------ 19~~___
Snelb.a'ke
-~.._-
leb & ElickeJ;'
t~
--------------------------------~----_.._---
Attorney for ~t t'
.'Estate
'.t' 08P'CE '781
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,
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LAW OFFICES
SNELBAKER.
McCALEB &: ELICKER
I'J:HSON^I.'J'Y - I'RI NC II'^I, M:COIJN'j'
CIU:Jl!.TS
The ^eeountonts cLaim c.'cdit I'D" tltc puymcnt of tlte
following items from pe!'sonillty pdneipal:
Dixon f s Pl1il1"llliICY, lne.: Oll tH tanding check
7/30/80 Dixon's 1'IIil"tliley, Ille.: accoullt
7/30/80 First Bonk Hnd Trust Compilny: sill'e deposit
box rent
7/30/S0 cowley ^ssociotes: p!'ofessional services
7/30/80 ~lyers Funeral 1I0me, Inc.: fune.'al expenses
2/25/81 Register of Wills: HUng fees
31 6/81 1I01y Spirit 1I0spital: account
3/23/81 Register of \vil Is: puyment on aecount of
I'ennsylvaniil T!'[lJ1sfel.' InheJ.'itance Tax
lJl 3/81 John Simmons: cash bequest
'II :V81 Samuel Simmons, HI: caslt bequest
'II 3/81. John Br'undt and Evelyn Ilrandt: cash bequest
III 3/81 St. Paul's Lutheran Church: cash bequest
lJl 3/81 Cathy Lynn Lash: cash bequest
lJl 3/81 Barbar'a ^nn ~lummert: cash beques t
'II 3/81 Sherry Lynn Mummert: cash bequest
II/U/81 pennsylvania Department 01' Revenue: 1')80
Individual Ineome Tax
11/27/81 Snelbaker, McCaleb & Elicker: puyment On
account 01' attorneys fee
11/27/81 Samuel Simmons: payment on account of
co-executors 1 commission
71 8/81 Fit'st Bank and Trust Company: safe deposit
box t'ent
9/10/81 David B. Coover: payment on account of
co-executors 1 commission
101 1/81 Snelbaker, MeCaleb & Elicker: Reimbut'sement
for pt'obate costs. ^dvet'tising Executors'
Notice, certified eopy of \vHl ilnd Short
Cet'tificates
10/ 1/81 The First Bank und Trust Company of Mecltanics-
burg, pennsylvania, Tt'ustee: Bequest in
Trust pet' Item Fout'th of suid Will
101 1/81 The First Bilnk und Trust Company of Mechanics-
burg, penllsylvaniu, Trllstee: Ilequest
in Trust per Item Fifth of suid Will
101 l./81 The First Bunk and Tt'ust Company of Meehanics-
but'g, pennsylvania, Tt'ustee: Bequest in
Trust per Item Sixth of saie! \\liU
- 2-
"., 100 . " t'-()7
L,~..n t~~~ /
75.G5
22.23
5.00
186.00
5, 901l . 611
6.00
12.75
J.l1,1I98.32
3,000.00
lU,OOO.OO
12,00U.00
5,000.00
5,000.00
5,000.00
5,000.00
13 .90
5,000.00
2,700.00
5.00
2,700.00
109.89
3,000.00
5,000.00
15,000.00
I
I
I
I
LAW OFFICES
SNELBAKER,
McCALEB a ELICKER
RECAP I TU lJ\TH1N
1.. PI,RSONM,'IY
A. PRINCIPAIJ ACCOllNT
DebIts $<!20,<!57.011
Net Gain III 11.62
Sub-Total 220,IIU1.66
Credit!,; 135,QII8.<!0
Balan"e 811.,1153.116
n. INCOME ACCOUNT
Debits <!O, 1011. ')0
Credits 8,563.<!1I
Balanee Il,S1I1.66
C. NET IlALANC E OF PERSONALTY $95,Q95.12
II. JU:AL ESTATE
A. PRINCIPAL ACCOUNT
Debits
CredUs
Balanee
NONE
NONE
HmlE
B. INCOME ACCOUNT
DebUs
CredHs
Balanee
NONE
NONE
NONE
C. NET BALANCE OF REAl, ESTATE
NONE
Ill. NET BALANCE OF ESTATE FOR DISTRIBUTION:
$95,995.12
..G-
100 I"..'.' "'"'J.'1
l:::~? n