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No, 21-80 474
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
DORA I. CONNELLY
, deceased.
MARY E. LEWIS
To R.l<<~m:lI1xR."CgL1t\'1E{SIDn< Register of Wills for the County of Cumberland,
in the Commanwealth ot Pennsylvonia.
IS
Petitianer(sQxlllxe the executrix named in the Last Will and
Testament of Dora I. Connelly _" dated 8/4/79
Decedent was a citizen of the United States and a resident of
Township
BG~~, Cumberland County, Commonwealth
Silver Spring
of Pennsylvania.
Decedent died on
8th
day of
July
Tuesday
_the
A. D. 19 80 , in the County of _CumQer1and State of
Pennsy1 vania at the age of 72 years.
:hose ~ her
Decedent has not been married and has not had children born to bim:
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
N/A
as near as can be ascertained; said real
N/A
estate situated as follows
apply
Therefore, your petitioner(s) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
July 11. 1980
Dated
.>\,-~.-s-..'1 j\[, \,Ylt co"",,~
Shirley N. McConnell
Name and address
of Petitioner(s)
1924 Spring Road
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA}
ss
COUNTY OF CUMBERLAND
Shirley N. McConnell
named in above application, being duly
say(s) that the statements set forth in
sworn according to law
this petition are true to the
best of her
knowledge and belief,
and subscribed before ~t_\.!L~_""" r{. 0'L<: C'.0'",.,u.9..\..
~
Sworn to
19 80
me July
I
;//" / ' ,I
'tel,l, _ ' ,(~ /,' ,.- "'-"
~ -
. lIlaxCllxEtximCllmsrort< Register
~IARY E. LEWI S
~
JUly 15, 1980
)-- ~"
Attorney: James R. Humer
Filed:
C:<I-~t!) -~7Y
OEOUCTIONS Al.LOWEO IN
REv-,n' u-n)
OFFICE OF THE
REGISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF
OF Cumberland COUNTY
ANO AGENT OF THE COMMONWEAL TH
EST;l.TE OF DORA I. CONNELLY
()
l.;l.TE OF Silver Spring TOImship
D;l.TE DF FIl.!NG ;l.PP R;l.ISEMENT 'C ') C; -Sf! D;l.TE OF DE;l.TH July 8. 1980
O;l.TE NO. OF NAME OF PA YEE REMARKS AMOUNT
VOUCHER
-
Rel!ister of Wills Letters Test. U sh. ctfs. 23 00
Rel!ister of Wills F i1 in!! RCC & SOD 6 00
The Sentinel Adv. letters 18 00
Cumberland Law Journal Adv. Letters lR . nn
Mvers Funeral Home Services 2252 58
Seidle Memorial Hosnital X-rays 9 00
Howard H. Cohen M.D. Last illness 160 00
Shirlev N. McConnell Reimb. PP&L. Tel. a Trash 109 40
James R. Humer Attorney Fee 640 00
Reserved for closinl! expen es and filing account 100 00
TOTAL 3335 98
,
CDMMDNWE;l.L TH OF PENNSYLVANI;l. }
SS,
COUNTY OF Cumberland
I, Shirley N. McConnell HEREBY CERTIFY, TH;l.T TO THE BEST DF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNER;l.L. EXPENSES ;l.ND
EXPENSES OF ADMINISTR;l.TIDN SUBMITTED TO THE ESTATE OF
DECEASED, AS DEDUCTIONS FOR INHERITANCE T;l.X PURPOSES.
,J'
SWORN ;l.IlD SUBSCRIBED BEFORE ME THIS II Ut
tit' f; AU~USL, ,- 19 8U
4' ), '(.f 1...,:/, (/A f't'A ,j/-
~f^RY PUBUC
My Co. . nion bpil!:' July t.l. \9&1
(utUle. A Cumberland (~
~Q~.L'J"LO \\.\. \'<h
COn1U'O,
(L.S.)
D;l.Y OF
?
'.
.
.
m~.tJ!~JJ!.~~if~~~~~d
I, DORA I. CONNELLY, of Silver Spring TO\a1ship, Cumberland
CounLY, Pennsylvania, declare this to be my last will and revoke all
wills which I have previously made.
I I give and bequeath the sum of Five Hundred ($500.00
Dollars to St. Luke's Episcopal Church, Market and Keller Streets,
Mechanicsburg, Pennsylvania.
II I give and bequeath all the rest, residue and
remainder of my estate, after the payment of all of my just debts,
funeral, administrative expenses and inheritance taxes, and consisting
solely of cash, savings accounts and savings certificates to my four
children equally if living, and if deceased, to his or her surviving
issue per stirpes.
III Any share of my estate which may become distribu-
table to a minor beneficiary may be held in a savings account or
certificate in the name of the beneficiary and not to be withdrawn
until the beneficiary attains the age of 18 years.
IV I appoint my daughter Shirley N. McConnell as
executrix of this will, and if for any reason she shall fail to qualif
or cease to act as such during the administration of my estate, I appo nt
as alternate executor my grandson, Alan R. McConnell.
IN WITNESS \~EREOF, I have hereunto set my hand and seal
7:L
this Lf day of ~~VYf , 1979.
(/
J/J net, l rJ. {IM/,"1/? (lc4,
(j
(SE L)
Signed, sealed, published and declared
by Dora I. Connelly, testatrix above named,
as and for her last will and testament,
written on one sheet of paper, in our
presence, who, in her presence, at her
request, and in the presence of each
other have hereunto subscribed our names
as attesting witnesses:
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OATH OF PERSONAl, REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before m~, th~ Register for the Probate of Wills and granting of Lellers of Administration in and for the County of
Cumberland, pcrsonally came
who, being duly swo rn
Shirley N. McConnell
,do e S depose and say that as
Executrix
of the last Will and Testament of
Dora I. Connelly
deceased
she
will well and truly administer the goods and challels, rights and credits of said deceased according to law. And
also will diligenlly comply with the provisions of the law relating to Transfer Inheritances. Swo rn
July 11. A.D., 19~ ':A{'\..0'-~~< N.
//~" " II,
,/ " (J
l:l.( / L '
j
and subscribed before me.
\'11c. ~~Q
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r Register
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Be it remembered that on the
15th day of
DECREE
July
,A.D.,19~, there was probated and
, ~ I - i I
recorded the last Will and Tesiament of
Dora I. Connelly
Silver Spring Township
late of
,Cumberland County, Pennsylvania,
Deceased. Lellers Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
Shirley N. McConnell
'/1 ) /
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,/c/..(.~
Register
S~6 .
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.'
REV-449 (8.78)
COMMONWEALTH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERAT;ONS
*
1. J- g-O - L;7l.j
COUNTY OF CUMBERLAND
RESIDENT DECEDENT
IMPORTANT:
This return must be cumpleted in d~lail mill filed in duplicate, with nil aWlchcd. with the Itcglstcr of Wills of the
County where decedent resitled; Return is dtlc within nine ntllOlhs "fler d;\le of death. unleNs un extension is grunted
hy the Secretary of Re"cnuc. (Sectiun 70.1 of the Inheritance ami Estate Tux Act of 1961.)
-
-
IN TilE MATTER OF TilE ESTATE OF
} AFFIIJAVIT OF
EXECll1'lllt
AmllNISTItATOR
County
DORA I. CONNELLY
(STATE FULL NAME OF DECEDENTI
Lcto of
Cumberland
Pennsylvania
Cumberland
E'tccutor
Stat. of
}u,
County of
Shirley N. McConnell
~~<< of tho ostata of the aboyo.namod docedont being duly sworn, depose 5
Decedent died
July
8
WA.yl
and soy 5
. 19-B.O...J ~Ollato leaving 0 las, will, copy of which is herolo attached. \
t;EARI ~~~xx I
tMONTHI
Name ond odd,e.. of otlolnoy or }
oth.r outhOfI~.d reprenntoll"e to whom
011 canuflondonce should bo mailed.
James R. H~er, Atty.
1 W. High St.. Carlisle.
PA 17013
That as such Executrix deponenl is familiar with the affairs of said estale and the proflerly constituting
(EXECUTOR.ADMINI5TRA TORI
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH OECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLiJERS TO DECEDENT
None
Thllt the contents of said safe deposit box or boxes are itemized under Schedules
wi th the exception of the following, for the reasons hereinafter set forth:
~ - of this return,
That Schedule A attached hereto aod made part hereor sets rorlh rully and in delail all the re8\ properly
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgagc encumbrances upon each pared of real property at the date of death, giving the amount still due at
death, name of mortgagec, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estintated market value thereor
as of date or death or deeedeot.
ThaI Schedule B attached hereto and made part hereor sels rorth rully 8nd in delail all personal properly
wheresover situated owned by the decedent at the time of death~,all moneys left by the decedent at the time of
death, whether in decedent's immediate possession, standing to de~edent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whclher individually, 'or in trust for any othcr person or persons
giving also separately the accrued interest thereon, if any, down to -the last interest day prior to decedent's
death in the case of savings banks, and to the dale of decedent's death in all other caseSj all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de..
cedent; nil obligations, whether hy statute or agreement they arc designated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of 3rt, household furniture, horses, carriages,
automobiles, boats, and any and all other personal ch:rttels of whatsoever kind or nature, left by decedent,
togelher with lhe fairly eSlimaled markel value thereor; all bonds .nd mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be
less than the face value, it sets forth briefly the reasons for such deprecilltion as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid us of the d.lte of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned hy (he decedent at the time of deat~, with the market value there-
of al such lime.
..
'.
In till" eRSl' ul' securities of' close or "urnll~' corpc.rllLJons, the vtlhll!s r'~lIortcd fire us far as
posslhle s\1bstnnlint(!l1 b)' I'lnnl1clnl SllltclT1t:!nt.s or Ult~ corporntlons, showing t.he IlSS~tH null 118.hl11t.1cs
lhl"reof RS 01' the date 01' (h~nt.h. The sf~hedllle !lIso sets f'ortla till' Interest (\1' dect!dent. nt. t.he time of
death 111 1U1~' cO"'I'"rlnf'fshtp or bllstnC!H., "nd In support. 01' tl1f! value 01' such Inlerest U14~re 1s Ilnncxod to
Sft tit selll'ltlll!!, ftonne tnl s t.n tClTll!llts showing the nssc ts unci I tuh II t t.lcs of sn hi co-Illlr tncrshtp or lnH.lness.
A C(lp~' of llH' co--pltrtncrshlp llgrecmenl, (If ornl, fl slfltem.~nl s~tttn~ fort.h the nlllllre of' t.lm ti~rl~e,,"mt)
t()g.~th"'r wi th R Stfl.tClllf!l1t set.tln~ forth t.he charact.er or the htlslru'ss, 1 ts locat! 1m, 8",1 .mch other f'8ets
11'''rtnlntn~ to till! huslncss itS mIl)' tm IH~rtll1fmt. t.o Il f'"lr nnd Just. Rpprnlsnl 0(' tJIC ctf!cf!dont.'s int.p-rest
thnroln mu....t he sullmltti'ct. It should Illso set f'urth In Itmnl7.~IJ f'orm, tow!ther with the fair market vnlue
lh('r~of, an)' other I'roJlert.~. owned or hoquentlll~cI h)' t.h.' tlecr"fll!nt at the Ume of denth.
The Scftedule C nltached heret.o /lnd mnlte Iltlrl. hprcof' sets forth n true Ilnswcr to ench inquiry
cllntalnetl therein nnllln t.he Cl1se (lJ' tl'ansf'l1rs of property, rent or personal, within t.wo years of' decedent's
death, In contemplation of t1~cedelltl s denth, or Intended to t.'lke effect In possession or enjoyment at or
aft.er deuth, said schedule sets forth the nntuN! ullfl vnluf1 of such propert.y, to whom transferred, the
relationship of t.he transferees to the ,If!ce(hmt, the proportJonnte shnre received hy each trllnsferee and
a] I other facts or n pcrtJnent. nflture rp,l;llrcltn~ snirt t.ransfers. In t.he CIlSP. of' transfers intended to
take effect in possession or enjo)'ll\cnt ul. or nfter dent.h, t.here is also Iltt.llchetl to the schedule 11 cony
of the deed, trust agreement or other Instrument creating the t.rust. Thern Is also set forth in said
schedule 11 list. of all propcrt)', reEll ami personal, with its value, which pa~ses Ilt decedent's death by
vIrtue or the exercise by deceden!., either individually, or .1ointly with /lnother, or any power of appoint-
ment vested in decedent, either individually or Jointly, by the will, deed, or ot.her instrument of another,
with a COllY of the instrument creating such power uttllchetl to the schedule.
Thut Schedule D attnched hereto nnd mu.de part hereof sets forth t.he nnmes /In'l addresses of ft.1l
persons beneficially interested in this estate nl. the time or decedent.' s rlenth, the nature of their res-
pective interests, their relationship, if any, to the decedent, together with the ages at the time of
decedent's death of 1111 minors, annuitants and bencf'lciarIes for life unrler rlecedent's Will. It also
contains {l statement showing which of the benefIcinries nnmed in the decerlent's will, if any, died prior
to decedent, the dates of their rleath, the! r issue, (Uld the relationship of such issue to the beneficiary.
That S.:/iedule E attached hereto Rnd marle a pllrt hereof sets forth all property, real and per-
sand, owned by the decedent jointly wIth another or ot.hers, including intangible, standing in the name
of the decedent nnd others, plus the date nnd plnce of reeord of Instruments effecting the ,"estiture of
real estate and the date of acquisition of personalty, plus the nome, address ,..nrl relationship, if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully llnd in detail all debts
and deductions claimed for and. on behal f of thIs decedent's estate, inclurllng funeral expenses paid;
i'nm1J.~' exemption, where appl icahlc; costs of arlmlnistration of this estatej counse] fees and fudiclary' s
commissions paid or to be Vaid; cost expended for burin! trusts, tombstones or gravemarkcrs, and reli-
gious services, in consequence of t.he denth of the decerlent; debts and claims owing anrl nnpnirl at time of
death; taxes accrued chargeable for period prior t.o dccCllcnt's death (except those allowed under Section
651 of the lnheritonee and Est.ate Tax Act); together with ll. statement of collateral pledged for obliga-
tions, if Rny. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actunlly paid in settlement of any fee, commission or debt is less than the
estimnted nmotlnt claiming and al lowed, that the same will he reported to the Register of Wills, and that
t.he amount of tax assessed can be reassessed in acco rlllUlce therewi tho
ThClt. the totnls of the npproprtatP. columns in Sclleflules "A", "n", "C", "WI, and "Ft! ns directed therein,
have hl?!en carried forwnrd and properly regist.ered in the StUMlRry_
Subscribed and sworn to before me this ......,L.l..f1.........
~\~:\,~,~,!k^......~ (......~~..,..G.:!h:,),~,clG..._-_
(E"'ecutpr:A~;;.inistTlltor )
;!,.~..?4,.,."S.p.r,ing....,Ro.ad"........"......,..,.,..,_.....,....,'-...,--.'
( Street Number)
Garlis.le"....PA..,..1.7,Ol,;)......,............ ........,.....................,..'
(City or Town and State)
,......,.."..,[}':.. J . .~~ day o~ .;:..A!lgtlt~,:~,~~..8.Q,
,-4dL~~~. T,;{tUriU/<-<1v C. '., ."""..,..,
My (0 inion Expires JOlIV It 1981
CodisIV A Cumberland (ounlV
SOTE: Uefore signing nrfIdnvlt mllke ~ure III 1 hlnnk spuces in tile nffldnvit nnrt sched\tle~ annexe(i are
filled in with details or t.he worfl "None", ann 111 CIISC the assets Include rare nnci unlisterl securities,
securities of' close or fnmlly corporltt1ons or an interest In nny co-p"rl.nershiTl or busIness, that the
c1nUl nnd st.at.ements requIrell t1urlcr the pllrll~rn}1h nhove relating to Schedule "n" ure attached. Also mnke
certtdn that column #1 in the "Sunmnry" hilS been rroper1~' complet.erl us nllove-ll1rectert.
RCC-34 14-711
COMMONWEALTH OF PENt;SYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECI!DENT
*'
SCHEDULE "A"
REAL PROPERTY
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death 0/ dece-
dent, Property held by the decedent as tenant in cammon with another or other, should be identified
as to quantum of interest and the estimated value should be that 0/ the decedent's interest only. (Property
held os joint tenonts with right of surviorship or tenoncy by entircties should be reported on Schedule "E,")
The r.al prop.rty located In th. Commonwealth of P.nnsylvanla ,hould bo
d..crlb.d by lot and black numb.r. .tr.ot and .treat numbor, logethor with
a general description of Iho property, with a ,efaren:o to the record of the
conveyance by which the docedenl took Iltle; If 0 farm .Iatfl number of o.
ern; also .Iatomonl of mortgage encumbrance. upon ooch parcel at death
of decodenl. Tax." a.....m.nt., accrued lntere.t on mortgage., ete.,or.
10 bo H.led on Schedule "FII and musl not b. deducted from this schedule.
(1)
(2)
(3l
DEPARTMENT
VALUA TION
CAUTION
(Do not write
In thl. ..pace)
ASSESSED VALUE
FOR YEAR OF
DECEOENT'S
DEATH
ESTIMATEO
MARKET VALUE
None
Insert this totol oppDsite "reol property", Schedule "A" in the X X X X X
"As Reported" column on the last poge 0/ this return.
N~
~
None
REV...." (fI..nl
.~
~
COMMOHWEAL TH OF PEHHSYLVAHIA
TRAt-ISFER IHHERITAHCE TAX
SCHEDULE "B"
PERSONAL PROPERTY
RESIDEHT DECEDEHT
!NSTllUCTIONS: This Schcdulc musl disclose "II laugihle IInd iUlllugihle perslll",1 pmpcrly uwned individually by Ihe
decedenl, IIllhe lime of his delllh. Pmperly owned hI' Ihe decedenl j\linlly wilh anolher or olhcrs musl he listed
under Schedule ..Ii... IUlllngihle pcrsoualplllpcrly, lilled in Ihe nllme \If Ihc deeedenl, bol pllYllble at dentll to another
or nlhers. includiog hnluollimilcd 10 1'.0.11. U.S. SlIvings Blonds lInd Icullltive Ifllsl aeeounls, musl he lisled, despile
thc filc( thnt thcy arc nnt of thc lldminis lcrcu estll tc.
Tangihle persnolll r<operlY should he lisled first (e.g. jewelry, wellring lIl'parel. househuld gouds, lInd
furnishings, buoks, Jlllintings, lIutClmohilcs, tmats. etc.)
Inumgihlc pcrsunul propcrty, such as bonus, trcasury ccrtificatcs, cash un hand and in bank, stocks,
mortgages, uoles, lugether wilh lIeerued inleresl nr dividends, salllries or wllges, iosuranee payahle to the eslate or
fiduciary in said cap liCitI', partnership inlerest>, inlerest in nny undistrihuted eslate of ur income from nny pmperty
held in trust under Ihe will or agreemenl of lInnlher, even Ihough Inellled oolside of the Slale, at the time of denth,
should be Iisteu in this Sdlcdule.
Item
No.
rmM
Lislllnd describe fully
UNIT
VALU(;
ESTIMATED
M....RKET
VALUE
DEPARTMENT
VALUATION
(Do not write in
Ihis space)
1
2
3
4
Cash
Capital Blue Cross, Refund
Washington National Ins. Co., return premi m
Lee N. Foose & Carolyn R. FODse,note dtd
8/11/79. Interest at 7% per year paid
to 12/31/79 and thereafter forgiven
because of illness of debtor.
William L. Beck and Kathy J. Beck, Loan,
no interest charged, balance due
Medicare payment
Pa. Blue Shield payment
25.00
259.87
6.7Z
1000.00
5
300.00
12.00
3.00
6
7
Insert this total oppositc "Personal propcrty", Scheuule "n" in
the "As Rcported" cotumn no the last page of this return.
xx
Ir.-Oc.,,S'1,
~
1606.59
ftEV-452 (8.78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
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SCHEDULE "C"
THAj~S!'EF.S
RESIDENT DECEDENT
4_____.___.__.____4.___. -----...---- --
(1) Did decedont, within t\\'o y~illS of dl~3th, li1uku any trJllSfcr at .iIlY mJt~riOlI P'Ht of hi~ UIJh'. '..,i!llOut rcccivilllJ a valuable and
Hdequa~e considcrE.tion therefor? (,'n~wer y;)~ ul' 1-.0) -~~--
Did decedent, within two yc.lf~ of dr.;,sth, u~lIsft)1' IlrOI)crty from hirmdf to hirm..cll ;;Hld i.tnothr.r cr others (including il spouse)
in joint ownership? (answer yes or nul --1iQ..
If the aon,,'or to (1) cr (2) <Ibovc is in the :Jtfirrll~tilrJO' st..(tl:
(a) Aoo of decedent at time of trarlsfer ~-
(b) Stato of decode nt', h.allh at time of ",ilking the transfor, (Note 11.
(c) Cau,e .f doccdent', death, (Note 1).
(4) Did decedent, in his lifetime, make any trramfer of property without receiving (l vflluablr. or adequate consideration therefor
which was to take effect in possossion or enjoyment at or atter his death? (Ansvrlcr yes or no) No
(0) Was there l.Iny llossiLJility that thl! prop~rty trdf\!.Jcrrcd might return to transferer or his cstato or be sllbject to his
powl1r of disposition? (Answer yes or no) NO
(b) What wos thelran,lereo', ago ultimo at decedent', death? ...JY..A...-
(5) Did decedent in his lifetime make ilny trandcrwithout rt!cciving it valuable ..nd ;Idequdte:: considl~ration therefor under which
transferor expressly or inlpliedly reserves tur his life or ;Jny period which tloC-) not in fact end before his death:
(a) The possession or enjoymunt of or tho right to incomt! troln the property transferred? (AnS\'Vcr yes or no) No
(bJ 1"hc right to designate the persons who shall pm-SC$S or enjoy the property transferred or income therefrom?
(Answor yes or no) No
(6) If the anSwer to (5) (b) above is in the affirmative, ~tate wh~ther the right was n:scrv~d ill decedent alone or others
N 'A
(7) Did decedent in his lifetime make d transfer, the comideration for which was transferec's promise to pay income to or for the
benefit of care of transferor? (AnlONer ye. or no) No
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of 8 roserved
powtlr to alter, amend, or revoke, Dr which could revert to decedent under terms of transfer or by operation of law?
(Answer yos or no) No
(9) If the answer to (8) above is in the affirm.,)tiv~, was the power to ultc:r, umend, or revoke the interest of the beneficiary reserved
In the docedent alono or the decedent alld others? (Answer yes or no) No
NOTE 1: Tho answers to these questions should be supported by affidavit by the attending physician as well as a copy of tho death
certificate.
NOTE 2: If answer to any of the abo~e que~tions is yes, set forth below a description of the property transferred, it's fair market
value at date of death, dates of transfers and to whom ttilnsferred, with relationship of transferees to decedent, if any. Submit
copy of any trust deed or instrument, iT trdnsfers are claim~d to be non.taxable, also subrnit detailed statement of facts on which
said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
MARKET VALUE
( E!ttim&tcd)
(2)
i
(3)
ITEM
DESCRIPTION
DEPT. VALUATION
(Dept. Only)
None
T
Insert this total opposite "Transfers", Schedule "e" in the
"As Reported" column on the last page of this return.
fIIlJ.>1.b
4.9fC
None
I1[.nsllu.H:tratl'~l[i~'~;l(\ 1lt~,ul~
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I, DORA I. CONNELLY, of Silver Spring Township, Cumberland
County, Pennsylvania, declare this to be my last will and revoke all
wills which I have previously made.
I I give and bequeath the sum of Five Hundred ($500.00
Dollars to St. Luke's Episcopal Church, Market and Keller Streets,
Mechanicsburg, Pennsylvania.
II I give and bequeath all the rest, residue and
remainder of my estate, after the payment of all of my just debts,
funeral, administrative expenses and inheritance taxes, and consisting
solely of cash, savings accounts and savings certificates to my four
children equally if living, and if deceased, to his or her surviving
issue per stirpes.
III Any share of my estate which may become distribu-
table to a minor beneficiary may be held in a savings account or
certificate in the name of the beneficiary and not to be withdrawn
until the beneficiary attains the age of 18 years.
IV I appoint my daughter Shirley N. McConnell as
executrix of this will , and if for any reason she shall fail to qua lifT
such during the administration of my
or cease to act as esta te, I appo nt
as al terna te executor my grandson, Alan R. ~IcConnell.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
i'i...
this Lf day of a<<....i,<c,,,:1.. , 1979.
(/
.U)n (.. l ~.
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{~7/11!1 {la.
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(SE L)
Signed, sealed, published and declared
by Dora I. Connelly, testatrix above named,
as and for her last will and testament,
written on one sheet of paper, in our
presence, who, in her presence, at her
request, and in the presence of each
other have hereunto subscribed Dur names
as attesting witnesses:
(~::,'-.. /[.\? <). /11 c: r:'-JL.-?7f,.lf
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REV-04~3 Uaa)
CO~"IONW1,AL 'I'll OF PENNSYLVANI,\
TRANSFER INIIERITANCE TAX
RI:SIDHNT DECEIlENT
- - -
BENEFICIARIES ANIl ,\llllRI'SSI;~ RELATIONSIIII'
(Stale full nurnes and mltJrcsscs of 1\11 who Of step-children nr SlJR\'IVFU HATE INTERF,ST OF
have an interesl. vested, contingcnt or olher" mcgilimat~ chiltJrcn DECEDENT OF IIENEHClAII \'
wise. in estute) urc invuh.cd, set STATE YES IlIKTII IN ESTATE
forth lids (,lct,) 011 NO
Shirley N. McConnell Daughter Yes Legal 1/4
1924 Spring Road
--
Carlisle, PA 17013
Lee N. Foose Son Yes Legal 1/4
R.D.1 Box 246 B
York Snrinas PA 17372
Donnie: p C'onne11v Son Yes Leaa1 1/4
1 ,;n~ Wpe:f' 1 nf'h
Freenort TX 77541
l(~f'hv .Tpan Beck Daul!'hter Yes Le"a1 1/4
D n 1
Livernoo1 PA 17045
- - - - --' - --
--
SCHEDULE "U"
BFNEFI('L\RIES
Deponent further s.ys th.t all the above.named beneliciaries are living at thi s lime except below:
NAME
DATE OF DEA,;;
RESIDENCE
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Transfers
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(Seh. """)
(Seh. UB")
(Seh, "e")
('II'O:iS Taxable Estate
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(I)
(As Reported)
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(2)
(As ()elermined)
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$
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Commonwealth \
National Bank ; . ",-,
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July 21, 1980
James R. Humer
Farmers Trust Building
One \lest High Street
Carlisle, PA 17013
Re: Estate of Dora I. Connelly
Dear Hr. Humer:
In reply to your letter dated July 14, 1980 on the above estate, the
following information listed below is as of D.O.D. July 8, 1980:
Checking Account - #142-107058-0
$996.92 Opened - 11/2/73
Account joint with Shirley N. McConnell
1114-0015689;" 7
Accrued Interest - $1.71
Account joint with Shirely N. ~IcConnell
Savings Account -
$1,488.25
Opened - 10/25/76
Certificate of Deposit -
Princ.
Accrued Interest
Issued
1114-5056
$10,000.00
$23.68
6/27/80
Joint with Shire1y N. HcConnell
If you have any questions, please feel free to contact us.
Very truly yours,
-/~~..eo.~
J. Uichael Troutman
Credit Analyst
JIIT/cg
The Commonwcallh National Bank. 10 South Market Square, Harrisburg. Pa. 17108 (717) 564.9500
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REV.""" ("19.
COMMONWEAL TN OF PENNSYLVANIA
BUREAU OF EKAMINA TION
INHERITANCE TAX SECTION
SCIlEIllILE "E"
JOINTLY OWNEIlI'ROPEln\'
.
INSTRUCTIONS: This schedule must disclose all property, real II lid llersllllill, llWIWd hv the dect:dent inintlv with
another or others, including inlangibles, standing in the name of Ihe decedcnt anJ. olhers. List real estate first, as
entireties, or joint tennnls, giving brief descriptiun, us indical~d under Schedule ""," plus the date und place of
record of instrument effecling veslilure, but dUllut include clltirctics nr lJul of state rCllI estate vullle in eslate
valuotion colulnn. Pcrsonal properly should he listed as in Schedule uB," plus d;!lc of acquisition, and lhe name,
address and relationship (if any) of co-owncrs tn the decedent.
Description of Property, Dutc of Acquisition, Name
A01ress and Relationship of Co-Owners, null Place
of Record of Instrument, where Real Estate.
Unit
Value
Percentage ESlale
Share V;lIuutinn
DEPARTMENT VALUATION
(oFFICIAL USE ONLY)
Vlllue of
Emire
Properly
Vlllue of
Decedent.s
Interest
Dora I. Connell or Shir1e N. McCon ell
l. Com. Natl. Bank, Ck. Acct.
Ul42-107058-0, opened 11/2/73 96.92 50% /' 498.46
2. Com. Nat1. Bank, Say. Acct.
#140015689-7 opened 10/25/76 488.25 50%/ 744.13
3. Interest accrued on No. 2 1.71- 50%""- .85
4. Com. Nat1. Bank, C/D #14-5056 1 000.00 100% 10000.00
issued 6/27/80
5. Interest accrued on No. 4 23.68 100% 23.68
Insert this total opposite "Jointly Owned Property,lt Schedule liEn
in the liAs ReportedU column on the last page of this return.
11267.12
/" ;"6, '1, Iv
~
UV.I" '0+.
Commonw.alth of P,nnlylvonla
D.partm,nt of R,v,nuI
BUReAU OF FIELD OPERt.TIONS
P.O. 100 2970
Hon',burg, P.... 17105
NOTICE OF FILING OF APPRAISEMENT
IN YOUR REPLY
PLE"'SE REFER TO
Investigation Division
Shirley N. McConnell
1924 Spring Road
Carlisle, PA 17013
RE: Estate of
County of
File No.
Dora I. Connelly
Cumberland
21-80-0474
Dear Mrs. McConnell:
You are hereby notified that the n";g;nRl
appraisement in the estate of J)o..a T (!nnn..' '7
has been filed in the office of the Register of Wills of Clnmh..,.lAnn
County on f-p.r , 19.e.o.. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
NnnA
1.606.59
11. 26?12
None
112.873.71
As to such tax that is poid within three months from date of death, a five (5%) percent
discount is allowable. As to any tax that remains unpaid ofter nine (9) months (fifteen months
when death occurred from December 22,1965 to June 16, 1971, inclusive; and twelve months when
death occurred prior ta December 22, 1965) from date of death, interest at the rate of six (6%) percent
per annum is charged.
Any party in interest who is oggrieved by this notice may object thereto within sixty days
after receipt of said notice as provided by Section 1001 af the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Date
'1-.1.,-.10
-4t'.tv. /J / If /flAANJ..)
Signed
Title
Chief 4ppraiser
NOTE: This is not a bill.
REV.457 (1.801
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEDENT
INHERiTANCE TAX
APPRAISEMENT
'*'
Estate of
JA,/?A 'k. (!oIJNeLLy
(JuMJel(lA.JJd
File No. ~ / - 'i 0 - () 1./ 7 'I
County
Date of Death
7- ~- 80
In thl IVlnt that any futur.lnterest In thl. .statel. transferred in paaeulon or onJayment to coll:.tel1ll heirs 01 the dBCedent after thllllxplratlan of any
estate for life ar far years, the Cammanwealth hereby exprealy rO$llrY8I the right to eppralse and auels tr:msfer Inheritance taxes at thelewful collateral ra"
on any such future Interest.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "B"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY -SCHEDULE "E"
TOTAL REPORTED PROPERTY
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS
-0-
7S.7/
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills.
./ftP./JJ),Affn.'/f,'(lJI"Jf{
APPRAISE:R
7- J,.--I'n
DATE
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I llfli;,~li"~I$""';'f""!> ':' '.' 'COMMONWEALTH OF PENNSYLVANIA
.0'11063282,'" ,"", ' DEPARTMENT OF REVENUE
I ,,~. 1'W,\fj"'l,:''.-'''''''' "O~FICI~L RECEIPT" PENNSYLVANIA INHERITANCE AND ESTATE TAX
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I -; RECEIVED _________________rJ.V7
II
= From,
~
ij
m~RID rORrY-THRBI . 6~/100--------------~~s
representing Pennsylvania Inheritance or
Estate Tax due from the following 8slale:
"')
, ~ress
'\
1 W. H~ nn.~
2(k Tox on
$
s
c....1t.,.,
P-,.
1'701:1
6% Tax on
$
s
File No. 21-80-414 Dole of Deo'h'7-A-lCl80
\5';, Tax on S
$
Nome of Decedent
nnga. T _l!n1lnl'RT:LV
$
I
Dole 01 Payment
AuljJU.~ 12. 1980
% Tax on $
Estate To., Act of
May 7, 1927
$
-PAID 011I ACCOUNT-
TOTAL TAX CREDIT
less five percenlum of IOlC if
paid within three months after
d.le 01 death
Plus intorest at the role of
_%from
10
$
572.26
County en...h....., _..vI
Remarks:
s
28.61
s
lfOOO[?OJ@li\lf~ SEAL
TOTAL AMOUNT PAID
s
513.65
NOTE: This Tripltcat8 Receipt to be retained for audrt purpose..
v1
Received by
NOTE: In ace.pUr,g Ih. Iransl.r inh.rltance lax on future 85lotel, prior 10 th. death ollhe Iil.
'.nanl or I.nonl for y'OU, 01 ....id.nc..d by Ihl' rec.ipl, ill, understood Ihal th. Commonweahh ,hall
nol b. pr.c1uded or pr.....nt.d Iram h.r.olter au.uing oddillonol inh.rilanc.e lox 01 the d.alh 01 the
Iif. l.nont or I.nonl lor y.an wh.n.....r II appear' Iho! ,ueh oddil1anol!ox may b. legally due and
coll.diblelor uny ,.olon who!lae....r.
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I, DORA I. CONNELLY, of Silver Spring Township, Cumberland
County, Pennsylvania, declare this to be my last will and revoke all
wills which I have previously made.
I I give and bequeath the sum of Five Hundred ($500.00
Dollars to St. Luke's Episcopal Church, Market and Keller Streets,
~Iechanicsburg, Pennsylvania.
II I give and bequeath all the rest, residue and
remainder of my estate, after the payment of all of my just debts,
funeral, administrative expenses and inheritance taxes, and consisting
solely of cash, savings accounts and savings certificates to my four
children equally if living, and if deceased, to his or her surviving
issue per stirpes.
III Any share of my estate which may become distribu-
table to a minor beneficiary may be held in a savings account or
certificate in the name of the beneficiary and not to be withdrawn
until the beneficiary attains the age of 18 years.
IV I appoint my daughter Shirley N. McConnell as
executrix of this will, and if for any reason she shall
or cease to act as such during the administration of my
fail to qualifr
estate, I appoint
as alternate executor my grandson, Alan R. McConnell.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
t'i.-
this il day of a<-1fA.v)T- , 1979.
(j
Jt1n L l rJ.
{'t';7/7?" fla,
f
(SE L)
Signed, sealed, published and declared
by Dora I. Connelly, testatrix above named,
as and for her last will and testament,
written on one sheet of paper, in our'
presence, who, in her presence, at her
request and in the presence of each
other h~ve hereunto subscribed our names
as attesting witnesses:
t -IL_, It ,? l'. //1 'f~..Jt.'7"" J(i
l'
-"'} J '--"'--'
( . <_..' ),. -1,
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