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OATH Qt' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of
Cumberland, personally came
John smith
who, being duly sworn
, does
depose and say that as
Executor
of the last Will and Testament of
Lucy Ellen Walters
deceased
he 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 Tranrl:.(. In~eritanees. ~wor ~ j"d sl~bScLi.b(e Jd befo~e2e.
January 14 A.D., 19~' I C-tCv., Ld )./._k<<t-.",Y -..ry7f/U>i..~-
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DECREE
Be it ,~emembered that on the
16th
day of
January
31
,A.D.,19_, there was probated and
recorded the last Will and Testament of
Lucy Ellen Walters
late of
East Pennsboro To',mship.
, Cumberland County, Pennsylvania,
Deceased. Letters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
J01111 Smith
0;~.ry ('/
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IN RE: ESTATE OF
LUCY ELLEN WALTERS, DECEASED,
LATE OF EAST PENNSBORO TOWNSHIP
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ,,:J/ - ,r; 0, 3'1
RE: CONFIRMATION OF ACCOUNT SET ASIDE; EXCEPTANT GIVEN FIVE DAYS
TO FILE FORMAL EXCEPTIONS
ORDER OF COURT
AND NOW, May 4, 1982, at 10:09 A.M., it appearing that Mabel
Bolden was in court this morning with the intention of filing
exceptions to the First and Final Account and Statement of Proposed
Distribution in the Estate of Lucy Ellen Walters, and having failed
to make her presence known until after an order was entered confirming
the accounting and directing distribution,
That order is vacated and the confirmation set aside, and the
said Mabel Bolden to be given a period of five (5) days within which
to file formal exceptions.
By the Court,
,J.
William C. Dissinger, Esquire
Samuel L, Andes, Esquire
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t'Sr-!!, .;.v,;._:~ ,I,I,~ J.<J
COMMONWEALTH OF PENNSYLVANIA
, COUNTY OF ~MIf
ss
Before me a Notary Public in and for said County and state, personally
appeared JOHN WILLARD SMI~R who being duly sworn according to law, deposes and
:;says that the facts set forth herein are true and correct to the best of his
,. knowledge, information and belief.
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Sworn to andsubscribed
,." : I<efor9 me this J2ii.day
,_(',\~t S'M':/b~LttUf ' 1982.
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i I Member, Pcnnsi'!v:miil ,6.~S:J(::i:4~lIj of i~"!.~li~~
Smith
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DISSINGER & DISSINGER
"TTORNEVS AT LAW
400 SOUTH STATE ROAD i'
MA,nYSV1LLE, PA 17053:!
TEL. 717 957.3474
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i\ ColOtp HU1, cu;!\b~rlll.nd County, pon:'\Gyl'J:\ll1,,., ,,,bIG or: nOllnd r.nd d1ol'on1nB ll1r.d,
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ii C01lory e.nd ut\t\orot.,:U:l<l1l1i.l, do t::lko IJ'-1blloh ll:-.d dcnl!\::o 1.:11(\ to bo Il'J Lnllt \ln1 \
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I' and TOl;U1:l0nt, hOJ."Oby rovd(loe; !loll \11113 ad. cod1cllo horetofore JP,ll.(\0 by 110,
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LUCY ELWI \11.1,'4;';'.:1
ITi>:)! I, I d1reot thll.t Illl tlY dobtn P,l;o' !:Imom exponaoD, 1n~lud-
1ng JJY cOlilOtory lot IIond gra.ycr.lt\1'kor IIond all olql,mCOQ of lAY lnat UlnoD', shall
bo pa1d frOG IlY rea1dcnry "!ltate 0.6 floon ll.8 practlcll.ble ll.ftor ay dea.Ul e.u part.
of tho oxpenso of tho w1n1otl:6t1on of IlY O!ltnte,
ITEM U, I dovis" llond boqUIla.th 'i!lY watch and e.ll 81 jOllolry to
Leady Wentz (Krs, wUl1atl WlllltZ) of l:llola, PGII/l/Jylvan1e.,
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lTEl4 III, All thll ro8't, roll1duo ILlld rorr.o.1ndor of Jr! eD~to.3hall
.:: be oold MIl tho procoodo dividod cqu;~lly jx,tllll0n John Sn1th of R, D, 1,
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i: Box 1911., 1".a.ryl3v111o, PGnnsylVllon1e.l Donn1B Doldon of 16 Mc.r~l !load, Brookside
, llallll.rlt, Delavnrol Il.lld Pogr;)' SJdth.of !l, D. 1, Box 191A, }1R.ryGvillll, Ponnsy1-
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ITEM IV, For ronnonl3 I anro not to di!lclooo, I ohoosO to 10ave .
noth1ng to 8:J d&uj7,htor tlable Dolden of Martal Road, Brooluddo, Nawarlt;
DOlallAX'<l,
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I'tr:lI V, I d1roc t tho. <~ o.ny nnd ,,11 I nherl V.nco, E& ta to and
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, T~nsfcr 1:.I1.'JC00 1npo2od upo, 'A:./ ootato pa.lslns un::lor 'IlY W1.11 or othor>l1se,
be pl.l.1li out or tho prlnc1po.l or flY I'\'Jl.IldUl\l""1 oatl\to,
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DlSI-;I:-':U I<':I~ .\: DISSI ;\;(lJ<':I~
~'TlOf~NEYS AT LAW
400 SOU Ol 51 ATE ROAD
MAflYSVILLf:. r'f:NN5YLVANIA 170~3
MARY A. E'ITER DISSINGER
WILLIAM CHESTER Dl.ssrr~GER
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February 1&, 1982
:)H,C~ 717D57.3474
717 9~7.2nS
RESIOtl'lCr; 71', D!57.2C7t';
IN REPLY REFER TO
FIL.E NO.
79-258
f.lr. John Hillard Smith
R.D. 1, Pox 191~
1'~rysvi11e. Pennsy1vonia 17053
Dear Mr. Smith:
'I'his is to advise YO" that ,Tohn l'iil1ard Smith, "Y.ecutor under
the will of V.Jcy Ellon ;-.1alters, rler:0i\Se..l, (later1 f)cto'b(~r 1, 1979, has
filed the first an'.l final account of his administration of the saB
decedent's estate in the Office of the Register of Hills of Cumberland
County, Per.nsy1vania. The account will be cal1.0(1 for auo1it before the
Honorable ,Ju,lge S!lUgart, on :':ay 4, 1982, at 9:3IJ ~.r,:. in Courtroom
110. 1, CUmher1anu County Courthouse, Carlisle, Dennsy1v,lnia. 1\ copy
of the account will be furnisher' on request.
This notice if; G!mt to you uS i'.n intf'!rester:-: party I in accordance
with the Rules ()f Court.
The Fxecutor .:t.ckno"'le\~ges your interestr; in the estate,
compri~;ing (}~ one tbir~1 of the residuary bcqlle~!tlle,..l to you in Clause
II of the Jocedent' s will. ,~t the a.tldi t the Court will 00 adv incu
that said interests are recoginized l:'j' the F'::~~Cl..ltor ann thrlt awards
Ghould be entered acc:"l:"din'Jly.
You are not required to uppcJ.r at the audit. !~O\olcvcr, if you
do not appear in person or by cOllnsel, the r.onrt ,,'ill assume that you
agree with the accounting an<1 the distribution prol'osed by the a.ccount-
ants.
f.;incerG,ly YOllrE:,
William C. Dissinger
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I)IHHI:-';UI":I~;" I)IH...q:-';UI'~I~
ATTOHNF-Y5 AT l.AW
400 SOUIII ~T^lE flOAO
MAHYSVILLI:. PtNr~SYLVAt~I^ 17053
February lG, l'i32
'j" I'.:~ 71'! P!l7.3474
MARY A. ETTER DISSINGER
WILLIAM CHESTER OISSINGr,R
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IN RfPLY REFER TO
79-2'jR
FILE NO._______
Hr. Denis Bolden
110 patter horn Drive
Fox Chase
llewark, Delaware 19713
Dear 11r. Bolden:
~'his is to advise you that John Hillard Smith, 8xecutor under
the will of Lucy Ellen ~';iJltarfi, cJeceaFied, <Jated. OctobE:r 1, 197'), has
filec1 the first ani! fini\l ilccount of i1is aclministration of the uair]
decedent's estate in the Office of the rO'Jister of ':'ills of Cumberland
County, Pennsylvaniil. The account .....ill be calle., for iludit before the
Honorable Judge Shugart, on Hay 4, 1'382, at 9::10 ;'..r-~. in Courtr.oom
No.1, Cumber1anrl County Co',rthouse. r.arlis1e. Pennsylvania. i\ copy
of the account will 1:0 furnished on '''''1'lest.
This notice is sent to you tHi an intc'!::'csted party, in accorrlanc::c
with tho Rules of r.ourt.
'l'he l?xccutor acknowlenqes your interests in the cstat~,
comprising of one thirrl of tho residuary bequP.:ilthe.~1 to you .in Clt\use
II of the decedent 1 s \'rill. At the au(lit t.he Court \01111 be ofI.,lvise(l
that said interests are recoginizec by the P.xccutor. ~nd that awards
should be entered accordingly.
You are not required to a!!pear at the .."\u~it. HO\\TeVer, if you
do not appear in person or by counnal, the Court will aSS\1m~ that you
agree with the accountir,g ann the distrihlltion propose<1 hy the account-
ants...
Sincerely yonrs,
~,-alliarn C'. Di.ssinger
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ATTORNEYS AT LAW
400 SQLJrtt ~rA1E ROAD
t.,lMO'.,VI1.Lf r'FttN~~YLVANIA 17053
MARY A t: 1 rr.R OI!:"!:iINul:;;R
WILLt.\M (;HE5TfR Dr5~U~GER
7abrtlary l~, lJ;~:
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'H<;ltJE:~;Ct 717 9~7.2C7G
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IN REPLY REFER TO
FILE NO --l=-n~'-
iX:J. '.'Ubll ~-Qlrfc-n
19 N.:'\rtall ~'.O.\':
T!roo;;:rdr:,c, r,'c.wi,rk.
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l~ear ~r~. ~ol~~~:
';'r.lz iu b"l :l';vi~:f. 1",1'.: tlu.... ~'):-1i1 "1.1 l..:;r I ;~:~"~t.i!, :':::C:;"~~C'1.4 ludur
tr.a ','ill o~ !' '.!t:y ':] l::-n . ',11 t:t~,~:!J, ,1',,!(:I)!!:'>t~ 'f ~ 'i;":t.~;~')Ct,")"<'l" )., 1~7q, La.b'
file.] the firDt t~n.: (inn1 Jaccnnt or :,1:3 ;,\:';;:d.nir..ltl':.~.i\..'m of ~;J,(1 awill
(locC:'.ir...nt't. estlJ.tc i:-: thl.i: ':'fficu ',Jt tho.:! \t.'<:;,iutcr 0:..,:111:.' o:Z Cur.l~'f!rlcll\"!
'~ol;nt:y, P+:'-H!ltiylv;'l.!li:... .~ :','~''';:sCJ~:..t 'Id 11 ~.~Q ~'.:tllt':':l~ :~r):- .?\u'lit bofore thl!
rQncrnt,l~) ":u'I~(: ;::},'l:./:;,rt., 0::;;:: ~~.:'lJ. J., 1~+3'::, ,~~. '; 3(: "'" i.'.. irl ~~f.)t1rtroO:!1
"10. 1, Sl.t~b~,l.anl', :(';'-.In-':'~' r:'Jl'!.rt.LOt.~t~, ::.:.rl1~1t!', PrH1n$yl\'lUli~. .\ copy
of the ;Jccount .l!ll :.:n :"urolnJlc: on rt"1.p.II.\8t.
:!,d.~~ notiL'':': .i.~, ~;U~.~. tc y~~' ;:";;', ,",I. lU'J.ai, Ct',; .i;LLor \oIho hag;
oC.'iV1h..,l ...lith t::.Q r:~OL1tc:;S, t"'~:,ti\tc~ ,T~r.J rL~'.,;.cinric~ -:ch.~ (:'I; 11)72,
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Proof of Publication of Notite in The Patriot and The Evening News
and The Sunday Patriot-News
Under Act No. 381, 1\[lJlfO"OO Mn,' 16. 1029.
Commonwea, Uk of PennsJllvania, }
COllntll of Dauphin ,,":
James A, Shoon b' d I I' t I d d'
...................................,....[;...........................,....,................. ClOg u y sworn aeeor, 109 0 aw, eposes sn says.
That he is theHe.t.,lIQ.Y,.Mr.,l:,~f THE PATRIOT - NEWS CO., a corporation organized and existing
under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at
812 to 818 Market Street, in the City of Harri,burg, County of Dauphin, State of Pennsylvania, owner
and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT.NEWS
newspapers of general circulation, printed and pnblished at 812 to 818 Market Street, in the City,
County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY
PATRIOT. NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th,
1D49, respeetively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and
bl' h d' th' I }letro \\Ie;lt h' h d th 1rd 10th and 17th dny
pu IS e 10 elr regu ar ridltlOns and Issues W Ie appeare on e ....rl'......................f.....,......................
,o.f...F..ehr.ull.r.y...,1.Sl$l.....................................,.....................................................................,......,...............,.........,
That neither he nor said Company is interested in the subject matter of said printed notice or adver.
tising, and that all of the allegations of this statement as to the time, place and eharaeter of publieation
are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to
verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolu-
tion unanimously passed and adopted severally by the stoekholders and board of directors of the said
Company and subsequently duly recorded in the offiee for the Recording of Deeds in and for said Count)'
of Dauphin in Miscellaneous Book "M". Volume I-I. Page 317, ' .
Copy of Notice or Publication .................,........,.. .. 'I..'<tI~.../j.J:.~.. ,i..........;"Co:: ...........,
Sworn to sUbs~n d fore me IS ..., . e ..day of
" EST~TE,~OTICE' , F.!':,~!.:~~.r..{' . . 1981 a2~' / ~', 'th .
Letters .,Test.mentary, In the
Estate'.ofLUCV,lmen-WaUer$. ................. '# ",.. ':.S" ''>1'!,' ,,; ,.' 'er;1 ....~
late:'of,IEast.pennsboro,Town' HAR S8U~l;, Dt.UJ ."R~ , ;"ublUt
shlp,'CumberlandCounty, pcnn. I
,iVlvanla,;havlng been granled to M'" MY COMMISSION E,XPiHfS 'G, 5. 1984
the~"'rJdel1:lg'ned.a,Uperson' In. y CommISSiOn expIres ....'t....H...........I..~...... ......{..
lIibrecpto'sald :e,tateare reo Menloer, rl::nnsylvaQIJ fI'i;;Jl allOll 0 r~O!tHleJ
I'qlintt!:ttom.kelmmedr.lepay. S f Ad . · 'e..... (
l~il~WM)m';~;~~u~I~:'ri: fatement 0 vertlslng osls
! "JohnWlIIllrd_Smllh',,'. .
Box."IA :..~-,r~,,;.
Marys.vllle, Pennsylvenle 11053
'ortolleretlor.l'leYl ,
WlIIlamC. Dissinger, Esquire
201 Maple AvelJue,' Suite I.B
Marysvllle,Pennsvlvanla 17054
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To THE PATRIOT.NEWS CO., Dr.
For publishing the notice or publication attached hereto on the
20,01
above stated dates. $........"".............,..
Probating same $...............7.5........
Total $........?Q,,1!?..,....
Publisher's Receipt ,for Advertising Costs
THE PATRIOT-NEWS CO., publisher of THE PATRIOT and THE EVENING NEWS and the
SUNDA Y PATRIOT.NEWS, newspapers of general cireulation, hereby aeknowledge rceeipt of the
aforesaid notiee and publieation costs and certifies that the same have been duly paid.
THE PATRIOT.NEWS CO.
By ",,,,..,,,,,..,..,,,,,,,..,,..,...,,,,,,,,.......,,,,..,......,,..,,..,.........,,,,
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DISSINGER & DISSINGER
ATTORN(':VS AT LAW
400 SOUTH STAn: AO,lD
MAnYSVILLE. PA 170~3
Ttl-. 717957.3474 i
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
Estate of LUCY ELLEN WALTERS, Deceased
Late of East pennsboro Township
FIRST AND FINAL ACCOUNT
OF JOHN WILLARD SMITH,
EXECUTOR
i: Date of Death: December 10, 1980
':Letters Granted: January 16, 1981
First Complete Advertisement of Grant of Letters: February 3, 1981
,Account stated to February 10, 1982
SUMMARY AND INDEX
PRINCIPAL
i;
Pages
1 $40,238.95
1 -0-
1 $40,238.95
1 7.844.39
$32,394.56
2 -0-
2
2 -0-
32,394.56
Receipts
Net Gain or Loss on Conversion
,Adjusted Balance
Less Disbursements
,Balance before Distributions
Distribution to Beneficiaries
Investments
Capital Changes
,principal Balance Remainin'J/'
l-
INCOME
, Receipts
Less Disbursements
'Balance before Distributions
Distribution to Beneficiaries
Income Balance Remaining
2
2
$ 2,329.95
-0- _
2,329.95
-0-
COMBINED BALANCE REMAINING
$ 2,329.95
34,724.51 34,724.51
J''-'" 1";1
bGC!:,J::; pm 0 t.:i:J
"
,i
.
",
fRINCIPAL RECEIPTS
': Inventory Filed
:' 10/14/81 Per Copy of Inventory Attached (Exhibit n An)
$40,238.95
Adjustments to Account Values
NONE
i: Subsequent Receipts
Ii NONE
I!
,
!!
,
"
2/25/81
2/25/81
2/25/81
2/25/81
2/25/81
DISSINGER & DISSINGER i
ATTORNEVS AT LAW
.400 SOUTll STAn: ROAn;
MAI\YSVILLE. PA 170!S3
2/25/81
6/ ,2/81
6/ 2/81
TEL. 717 9!57.3474
6/ 2/81
6/ 2/81
6/ 2/81
10/30/81
2/ /82
2/ /82
TOTAL PRINCIPAL RECEIPTS $40,238.95
PRINCIPAL CONVERSIONS INTO CASH
NONE
i
,
I
,
I
!
,
,
,
I
$ 20.76 i
I
18.00
I
1,947.85 I,
I'
,
35.00 I
J
,
!
537.95 ,
I
6.33 ,
,
30.00 i
I
I
25.00 I
2,011.95 I
I
3,167.06 I
,
I
5.00 I
20.00
I
88.00 I
,
19.49 I
,
,
7,844.39 I
PRINCIPAL DISBURSEMENTS
Patriot News, Ad. of Grant of letters
Cumberland County Law Journal, Ad. of Grant
of Letters
Ronald C. L. Smith Funeral Home, Burial
& Funeral
John W. Smith, Reimbursement for Costs of
Probate and Letters
Blue Ridge Haven West, Nursing home care for
decedent
Professional Pharmacy, Medication for decedent
Anthony Yannone, Appraisal of Jewelry
Dissinger & Dissinger, Reimbursement for
costs advanced
Dissinger & Dissinger, Attorney Fee
Register of Wills, Inheritance Tax
Register of Wills, Cost of Filing Inheritance
Tax return
Rice Memorial Works, Headstone ingraving
Register of Wills, Cost of filing First and
Final Account & Distribution
Register of Wills, Inheritance Tax
TOTAL PRINCIPAL DISBURSEMENTS
f Or" l' f'!) P " j "0
,'U;\ .,:";v .\(,[ ,<)
-2-
.
COMMONWEALTH OF PENNSYLVANIA I,
COUNTY OF CUMBERLAND J
IS:
W g~-::tL
_19 g/
../
Exocu'or . Administrator
/7 i{"-:11
'(
Date 01 Death
10
Day
1?-
Month
lQBO
Vur
INSTRUCTIONS
I, An inventory must be filed within three months after appointment of personal representative,
2, A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be altached as to personalty or realty
4, See Article IV, Fiduciaries Act of 1949.
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QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of dealh, make any transfer of any material part of his estate without receivinp,
valuable and adequate consideration? (Answer "Yes" or "No".) NO
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".) ~
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 heallh 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".) 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 bElleficial 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, 11 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 decedimt and others ( ).
nEV-453 EX-t (10-801
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
~,
~'
" . '
;~,.~.il~~~~P.!':'.t.
"J,~l~:_..,
(Instructions on Reverse Side)
Estate of
Lucy Ellen walters
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
ell Leadv Wentz , Eno1a. PA Step dauahter x Jewe1rv-$1,OOO.OO
(21 John Willard Smith Grandson x one-third
R.D. 1, Box 191-A
Marysville, FA
(3\ Pennv Smith Granddaughter- x one-third
R.D. 1 Box 191-A in-law of residuary
Marvsville PA
(41 n"'nn' ~ Bolden Grandson x one-third
11 n Pa ttorhorn Orive . of residuary
",'" ('''.~e Newark, Delaware
1 "71'
----_.--_.._---~-
-
The above beneficiaries were living at the time of the decedent's death except for the following:
NAME
DATE OF DEATH
If additional space is necessary I use 8%-" x 11" sheets.
REV.454 (1-80)
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
R ESIOENT OECEDENT
SCHEDULE "E"
JOINTI, V OWNED PROPERTY
(lm;tructiol1S on Rl.'ver.m Sic/e)
Estate of
Lucy Ellen Walters
P
TOT AL E VALUE OF DEPARTMENT
ITEM R
DESCRIPTION MARKET C DECEDENT'S VALUATION
NO. VALUE E INTEREST IOfficial Use Only}
N
T
NONE
TOTAL THIS PAGE /I~~ ~ /fl
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 all personal propertY
as indicated in the instructions for Schedule "S", Include the name, address and relationship to the
decedent of the co'owner (si and the date the joint ownership was established,
2. Indicate the total markel 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-SI8 FO (7.80)
.~
~~~
COMMONWEALTH OF PENNSYLVANIA
CEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Dear Mr. Smith:
Mr. John Smith
R.D. 1, Box 191-A
Marysvi11e, PA 17053
RE: Estate of
County of
File No.
LlI("Y Rll p.n W;:!1 tpl",q
Cumberland
21-81-0034
You ore hereby notified that the Or; g; nol
appraisement in the estate of Lucv Ellen Walters
has been filed in the office of the Register of Wills of Cumberland
County an January 27 , 19..,g. Said appraisement reflects the following valuotions:
Real Estate
Personol Property
Jo in tl y Owned
Transfers
Total
NONE
$40,21R,q~
NONE
NONE
$40,238.95
As to such tax that is paid within three months from date of death, a 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 thereto within sixty days
after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Date
tJ/lz7/i'~
I I
Sign~ ..--i;L)d~
Title
NOTE: This is not a bill.
Chief Appraiser
REV.4U EX+ (MO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
o Original
o Supplemental
o Remainder
File Number
21-81-0034
Estate Name
Lucv Ellen Walters
Date of Death December 10, 1980
Social Security Number -ill-16-8645
REPORT OF INHERITANCE TAX APPRAISER
I, tho undo..ignod duly appalntod Inhoritanco Tax Appraiser In and far the County of
Pennsylvania, do respectfully report that I have app,'aised the real and personal property os reported in the foregoing
retum at the values set forth opposite each item In the last column to the right in 5che les "A", liB", "C", and "E"
Dated: r)f'.z.?/% 2. . ~ ' .'~
INHE TANCE TAX APP. ISER
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY VA~UE AS APPRAISED CODE (HARRISBURG USE aN~Y)
Rool Proporty (Schodulo A) $ NONE Da+ 92+
Personal Property (Schedule B) 40 238. 95 10+
Jolnt.Hold Proporty (Schedulo E) 0 2ll+
Transfer. (Schedule C) NONE 30+
TOTA~ GROSS ASSETS 40 238. 95
Leu D.bts and Deductions 40. 93.
(SCHEDU~E F)
CLEAR VA~UE OF ESTATE
o Life Estale !!!ll FACTOR PRINCIPLE VA~UE CODE
o Annuity
Ell1l USE OF REGISTER ON~ Y
!;Qll
COMPUTATION OF TAX
$
$
$
$
Tax on $
6%
Tax on $
15%
Tax on $
Tax on $
Tax on $
$
Exemptions
Total Estate
TOTAl. TAX
INTEREST FROM
BA~ANCE
$
$
$
TO
Less Credits
DATE OF PAYMENT
INTEREST
DISCOUNT
+ $
AMOUNT PAID
TAX CREDIT
$
=
$
$
+
=
INTEREST FROM
BA~ANCE DUE
BA~ANCE
TO
$
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REV.455 (1.80)
, COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
Estate of Lucy Ellen walters Date of Death December 10, 1980 ___ Fil" No, ~.{J ''li'J',:;''!
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Relationship to Decedent
Claimant's Address
ITEM DATE
NO,
1. 2/25/81
2. 2/25/81
3 . 2/25/81
NAME OF PAVEE
REMARKS
OLLo<~
n-F T.e..t.t~rg
I
AMOUNT
Patriot
Cumberland Co. Law Journal
Ronald C. L. Smith
Advertisement of Grant
'0 "7(:.
Advert'
Bur ia1 and
;lnt'
q47 Rt;
4.
5.
Funeral Home
2/25/81 Blue Ridge Haven West
2/25/81 John W. Smith
6.
7.
8.
2/25/81 Professional pharmac
6/ 2/81 Anthon Yannone
Cost of Grave
Reimbursement for Costs
of probate and Grant of Letters
Medication
9.
10.
William C. Dissin er
A raisa1
Reimb r ement fo CQat
advanced
Attorne 's fee
2<;.nn
William C. Dissin er
Estimated Additional Adm. Cost
I
.l=
TOTAL THIS PAGE I 1,.!,..!J2_J:4-
I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debt/funeral
expenses and expenses of administration submitted to the es~at~, as de~uctiOIl\fOr 11l1~erita,ncc Tax purp~,s~s~ ,~
.;' \,0___'-_ ,.)".L a I I, /
SlaNATur~E OF A"TonNr:Y/r:IDUc'IAi~Y _h. nr,Tr:
OFFICIAL USE ONLY
DE8TS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S .1/ t, 11. tl
/
AT
---
(P !!tIt; PERCENT,
q7)()-'tf.,l~~. qI?~
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 including 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 there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1, If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column,
2. Assign consecutive numbers to each item listed.
3. Enter the date on 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,
COMMONWEALTH 01' PENNSYLVANIA
COUNTY 01' CUMBERLAND
l
J
ss:
--.--..---..-------.-. .- ..
John Willard smith
.,--,-.-- .-..,--. ------..-...----
____ ..._... __.___,._._ ____.._ .__d" .
.------.-..
being duly sworn--. .__ according to law, deposes a"d says that he .,__,is_the....executor--,---
_______,-,-----,.--,..-.....-------_..-' of the Estate of Lucy E. Walters
late of ___. E,as.t, pennsborough __._,____, Cumberland County, Pa., deceased and that the
within is an inventory made by ...J:ohn_.Willar.d-5mLth..- ,-- -, ------, the said_e~Ut.OX-.-
of the entire estate of said decedent, consisting of all the personal prop.,ty and real estate, except real estate 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.
'1'/ I ;'
~.: 1'//"(<:",1/1/'/
, ,I
~I
'I' '
19 / /
1-StrQ,^~lJ .~~
, 0- Ex",lo." Adminillrotor
/
,<'>>,(/-) ,-( J
and subscribed before me,
,
\'--~'r-c/ Ii I < " . ", f.-I
-----:' .' f</ /
B TTY J6 JONESJIllII,RlI'URlfC
MAnYSVlllE OOliOUGlI, f'ERR\ Cilll;ITY
MY COMMISSION [XPIHES JiW 16, 1984
Ml'lllber. P{'nnsVlv~nlil ,4r,~(1(':'!tlr,l~ fJI ~H~"h
-----.
Addreu
Date of Death
10
Day
12
1980
Month
Vear
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal 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.
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
*'
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
COUNTY FILE NO:
. / .'
,
'I
DATE
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.'
DATE OF DEATH
....> /".{- if' < ),,;-j' /;151)
I
COUNTY
, '
~'
Appraised Value 01 Estate:
Real Estate
$
..--.---
Personal Property
+ ,/
) ,,:':t ,/"}
.'
Jointly Held Property/Transfers
+ _._--_.-~_.-
Total Gross Estate
$ /...// ....,. ...,,/ ,./,)
,
/
~-
Total Approved Deductions
^ .//-, I.
/i. ~/, t:
Clear Value of Estate
$ ".~j ,,'://, / /
Less: Approved Charitable Exemptions
--~-_.~ --.-
Clear Value of Estate Subject to Tax
S //; I~,://, //
Amount Taxable @ 6% Rate $ -1..'/ , J ./~) tax due
Amount Taxable @ 15% Rate I I ~ J/ tax due
.'
$ ///j / (;>1
I
;' 7/ /
I' 0"
S _, //I!,
,,~II,
/
//:. Cj
******
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
/.
,
$ -:",
will be granted if the
/~.-.!.1.(.1 "t'~> \ :t.C_./C4.L. ,'" . ('in
A" five pare'e'nt discount totaling
Inheritance Tax is paid by
/
.. // . "i LL"
, : . .//__~~_ 7 V
;,,/,7/ j/'-
".' I (( , , :J
Less Credits:
DATE OF PAYMENT
"/
AMOUNT PAID
INTEREST
TAX CREDIT
DISCOUNT
jd-/~'-)'I
,
$ :::i'li ,) /i("
i
$ ;;"/1" ? t'~/
/
+ S
$
=
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
$
/"/ .. 'I'
I -~ ,I _
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
- I ' , ,~
.':'::./JA" './....,_l(-....i,:.~!...,:.- ..,' "/"); /'(,'--/ ~I
'AsseSS~d~; '," / /'1. " I I;~' ,'\,'"
See Informetion on Rever58 Side Agentfortl'l..CommO~'l8l1h' I
/,/
v
...'X/I
", '-f'_)./'"
REV. 1583EX (3-B2) 101
~ BUREAU OF EXAMINATION ASSESSMENT
PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX CON1Iildl9",~
P,O, 80X 8327
H~lfi1U wIl1\!lft:. RECORD ADJUSTMENT oAJl-81-00U
ESTATE OF FILE NO,
DATE OF DEATH COUNTY
NOTE: TO INSURE PROPER CREOIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF
WILLS, AGENT,"
lIllliua C. Di..inger, ..q,
201 Map1. Ann_
SlIit:e 1-8
Kazyevi11., PA 17053
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
CUT ALONG THIS LINE
-----------------------------------------------------------------------
Luay Bl1en lI&l~~INHERITANCE TAX RECORD ~~-:.uil~~W 101 4-29-82
ESTATE OF FILE NO. ACN OATE
eoU.CtiClll of _11en. All.... lilt
ADJUSTMENT BASED ON:
VALUE OF ESTATE:
" Real Estate (Schedule Al ( II
2, Stocks and Bonds (Schedule BI ( 21
3, Closely Held Stock/Partnership Interest (Schedule Cl ( 31
4, Mortgages and Notes (Schedule DI ( 41 40,238,95
5, Cash & Miscellaneous Personal Property (Schedule E) ( 5)
6. Jointly Owned Property (Schedule F) ( 6)
7, Transfers (Schedule Gl ( 71 40,238.95
8, Total Gross Assets ( 8)
OEOUCTIONS ANO EXEMPTIONS:
9, Funeral Expensesl Administrative Costs/Miscellaneous 4,697,84
Expenses (Schedule H) ( 9)
10, Debts/Mortgages/Liens (Schedule I) (101 4,697,84
I" Total Deductions (Ill 35,541.11
12, Net Value of Estate (121
13, Charitable Bcquc!>ts (Schedule Jl (131 35,541.11
14, Net Value Subject to Tax (141
TAX: 24,027,40 1,441,64
15, Amount of line 14 taxable at 6% rate (151 11,513,71 X,06= 1,727.06
16, Amount of line 14 taxable at 15% rate (161 X,15= 3,168,70
17, Principal T.ax Due 117)
TAX CREDITS:
PAYMENT
DATE
RECEIPT
#
DISCOUNT (+1
INTEREST H
AMOUNT PAID
10-14-81
2-26-82
It 69753
L 010839
18,00 -
,43 -
3,167,06
19.49
NO INTEREST IS OUE IF PAlO BY
IF PAID AFTER DA TE INDICATED SEE REVERSE FOR INSTRUCTIDNS,
TOTAL TAX CREDIT
BALANCE OF TAX OUE
(If Balance Due IS less than $1.00 no payment is required)
-0-
RETAIN THIS PORTION FOR YOUR RECORDS
\
,I
INFORMATION
If the tax is paid within three (3) months after the decedent's death. a discount of 5% of the tax paid
is allowed.
Inheritance Tax becomes delinquent nine (9) months after the decedent's death. Interest is charged at the
rate of six (6) percent per annuf"!l on the amount at unpaid tax. (SEE EXAMPLE BELOW)
EXAMPLE: If a balance of tax due of $2.000.00 ;s in a delinquent status from 3-3-80. and payment is made
on 5-23-80. the interest is calculated as indicated below: -
STEP 1
Determine the rate of
interest from the table below.
STEP 2
MultIply the balance of
tax due by the rale of
interest.
STEP 3
Add the interest
to the balance of
tax due.
Rate of
2 Months =
20 Oays =
interest =
,010
+ .00335
,01335
Balance of tax due
RaM of interest
INTEREST
S2,OOO.00
x ,01335
S 26,70
Balance of tax due
'PlUS Interest to
Date of Payment (+)
TOTAL tax and
interest to Date
of Payment
$2,000,00
$ 26,70
Inlerest from 3-03-80 to 5-23-80
Results in:
$2.026.70
----------------------------------------------------------------------
1 month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,OlD 5 months ,025 8 months ,040 1 1 months ,055
3 months ,015 6 months ,030 9 months ,045 1 2 months ,060
1 day ,00017 " deys ,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 days ,00085 15 days ,00250 25 days ,00420
6 days ,00101 16 days ,00267 26 days ,00437
7 days ,00118 17 days ,00284 27 days ,00454
8 days ,00135 18 days ,00301 28 days ,00471
9 days ,00152 19 days ,00318 29 days ,00488
10 days ,00169 20 days ,00335 30 days ,00500
-------.--------------------------------------------------------------
MAKE CHECK OR MONEY ORDER PAYAB~E TO: "REGISTER OF WI~~S. AGENT"
OETACH THE TOP PORTION OF THIS FORM ANO SUBMIT WITH YOUR PAYMENT TO THE REGISTER OF WIL~S FOR
THE COUNTY SHOWN ON THE REVERSE. SEE THE INHERITANCE TAX INSTRUCTION 800K FOR AOORESS,