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1 A. Five shares to Maurice Elicker, my nephew;
B. Five shares to Rachel Elicker, my niece;
C. Five shares to Bessie Ritter, my sister;
D. Three shares to Vivian Brinton, my niece;
E. Three shares to Janet Keich, my grandniece;
10"'. Three shares to Alverta Efcevitch, my niece;
G. Three shares to Nancy Pires, my grandniece;
H. Three shares to Nancy Wacker, my grandniece;
I. Three shares to Betty Raub, my niece.
VI - Should any of my beneficiaries named in this Will
predecease me, except for my husband Alvin H. Bushey, then I
direct that his or her bequest or share of my estate shall be
delivered and paid over to his or her issue living at the time
of my death per stirpes.
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VII - All taxes that may be assessed in consequence of
my death of whatever nature and by whatever jurisdiction,imposed
shall be considered a part of the expense of the administration
of my estate, and my personal representative or representatives I
shall have the absolute power in his or her discretion to pay the I
!
same at once whether or not the law under which they are imposed
permits the postponement of all or part of them to a later time.
VIII - I appoint my nephew, Maurice Elicker, Executor
of this, my Last Will and Testament. Should he fail to qualify
or cease to act as such, then I appoint my niece, Rachel Elicker,
to act in this capacity. Neither of my personal representatives
shall be required to post bond in this or any jurisdiction.
IN WITNESS WHEREOF, I
';.;J
have hereunto set my hand and seal
Ji
//,~J, < t A. , 1974.
on this, the 1'1,)
day of
AkNOUJ, 1I1J:.1:. IiAnn d
Amb'lnnt.w \l
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SaraH J. Bushey]
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 55:
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
t4aurice Elicker
who, being duly
sworn do
.
depose and say that as
Sarah ,T. Bushey
Exeuctor
_deceased
of the last Will and Testament of
he will well and truly administer the goods and chattels, rights and cr~its of said deceased according to law. And
also will diligently comply with the provisions of the law relating to Transfer Inheritances. Sworn and subscribed before me.
September 17. A.D., 19~1
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Be it remembered that on the~nd day of
DECREE
September
,A.D.,I~2--, there was probated and
recorded the la5t Will and Testament of
Sarah J. Bushey
lateef
~
Hampden Township
. Cumberland County, Pennsylvania,
Maurice r:licker
Deceased. Letters Testamentary were granted to
Witness my hand ~nd ofiicial seal the day and year aforesaid.
563
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:'vREY.1l62U
i ~... I . COMMONWEALTH OF PENNSYLVANIA
, 4 NO. . . DEPARTMENT OF REVENUE
: . '. K 69883 OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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Maurice Elicker ! l}
~~g~vED ""._. K. Arnold,_ Esq,
/TAX AT 6~'"
TAX AT 15%
TAXAT_%
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ADDRESS
2109 Market st,'
ESTATE TAX
TOTAL TAX CREDIT
- - EsT'A TE INFCiRMA riciN ~-- --
DATE OF DEATH_
c
" - ~ -----;.ESS DISCOUNT
FilE NUMBER
DATE OF PAYMENT
~
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~__. PLUS "" INTEREST
NAME OF DECEDENT ~ 1FI1QM TO I
__::..,,________________m___m___________ [;I ~ T~NT PAID
,ff,j~!(61J93
'PAID ON ACCOUNT"
POSTMARK DATE
REMARKS
SEAL
RECEIVED BY
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/ SIGNATURE
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'~. I. COMMONWEALTH OF PENNSYLVANIA
4NO K 69893 DEPARTMENT OF REVENUE
: .' OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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~ RECEIVED Mauro ice Elicker
U FROM
r ADDRESS 2109 l-tarket Street
Camp Hill, Pa. 17011
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lAX AT 6~,,__
TAXAT'50~
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TAXAT_%
ESTATE TA.
TOTAL TAX CREDIl
. - - Es-iA TE iriFC:iRMATioN -:- - - - --------------- ---- ----
DArE OF DEATH September 14,19B1
FILE NUMBER
21-01-579
DATE OF PAYMENT
December 9, 19B1
Sarah J. Bushe
LESS DISCOUNT
PLUS % iNTEREST
(fROM TO___I
NAME OF DECEDENr
m
m
TOTAL AMOUNT PAID
COUNTY
Cumberland
--------------------------------------------
POSTMARK DATE
REMARKS
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PAID ON ACCOUNT
REPLACES tx 69863
SEAL
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RECEIVED BY
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SIGNATURE
24'749.91
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1,237.49 +
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REY"4o\\ EXt 100'80)
COMMON~EAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEDENT
STATEMENT OF
FIDUCIARY
(Instructions on Rey.ne Sid.)
*
Estate of
Last Address
SARAH J. BUSHEY
DDte Df Death
9-14-81
217 St. Johns
Camp Hill,
Church Road
PA 17011
SDciDI Security No. 168-36-3017
StDte File No.
{CITY}
(STATE}
(ZIPI
County File ND. 21-81-579
I. Decedent died:
( ) Intestate (without 0 will)
(X) Testate (leDving 0 IDst will--cDpy attoched)
2. Is the filing of a FederDI EstDte To. Return required fDr this estate? Yes~ No
3. (X ) Executor ) Administrotar
Maurice Elicker Social Security No.
217 St. Johns Church Road
NDme
Address
(CITY)
Camp liill,
(STATE')
PA
17011
(7.IPI
4. All correspDndence should be moiled to (XX) Attorney
Fiduciary.
5. I! an Dttorney is representing the estate, indicDte:
Name James K. Arnold, Esq. Telephone No. (717) 737-3405
Address 2109 Market Street, P. O. Box 737
~amp Hill, PA 17011
(CITY) (STATE) (ZIP)
List DII safe depDsit bDxes registered in the decedent's indiyiduDI nDme, Dr jointly with, or as Dn agent or deputy
of another, or in decedent's individuDI nDme with right Df access by onDlher as Dgent or deputy. Include the name
Dnd address of the bDnk or Dther institutiDn where the safe deposit box is IDcoted, the nome (s) in which the box
is registered and the relDtionship of the joint holders tD the decedent.
NAME ANO AODRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX
NAME OR NAMES IN WHICH
SAFE DEPOSIT BOX IS REGISTEREO
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
NONE
Under penDlties Df perjury, I declDre thot I have eXDmined this return, including accompanying schedules and
statements, and to the best of my knowledge and belief it is true, correct Dnd complete.
h'!.N.. v~ t t~L-
SIGNATURE OF FIDUCIARY
')~/f Z-
I DATE
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rar-{14Ur.
September 25, 1981
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TO: Fi~.!o-Ied_era_l Sayin_g~._a_I1-c1,__LS'll!!____
.1l4 North S_?_COI:19- Street_____________
~~risEurg, Pennsylvania 17101
RE: Estate of Sarah J. Bushey
Social Security Number: 168-36-3017
The following is a complete record of the above decedent's accounts as of
9/14/81
(Date of Death)
If decedent had a safe deposit box, indicate number:
Account No. Type of Balance on Date of Death Names on Account Date
Account Principal Accrued Int. (All OI.'11ers) Opened
23189 C.D. . $24,000.00 $71.42 1ND1 VIDUAL I~arch 20,' 78
26898 C.D. $13,000.00 $39.93 " April 10 '79
12278 C.D. $lD,OOO.OO $53.29 " April
Date:
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September 25, 1981
AUY-A CIlUI', rlf
Harri~~avin'J~_!':S_s_~<:~.1i.t5:ClT1-
_-2-nd_-an<1_.Jli.ne-Str.e€ts-- - -------------.
. Harrisburg, Penns~l':'<l.!1!:<l.____________
RE: Estate of Sarah J. Bushey
Social Security Number: 168-36-3017
The following is a complete record of the above decedent's accounts as of
....9/.li/-B.l
(Date of Death)
If decedent had a safe deposit box, indicate number:
Account No. Type of Balance on-pate of Death Names on Account Date
Account Principal Accrued Int. (All OWners) Opened
4-15-814022 C.D. '$15,508.03 $88.89 Sarah Jane Bushey 12-7-i6
5-16-010557 C.D. $30,025.00 $134.26 Sarah Jane Bushey 9-3-76
5-79485 Opt. $5,898.61 $67.03 Sarah Jane Bushey 9-3-76
Passbook
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'-!}{-y'J-f._JZlll~!..j )_ G<.AL.
/ Signature of Official
.
Date:_9~..1J..!l1
_...s...v1..ngA-.rnttn ..1 ftr
The Ilorrh Sa;~ft8" Auoctation
Haln OfUc:e
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INC.
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737-.8024
737-4719
September 23, 1981
Mr. M. E. Elicker
217 st. Johns Church Road
Camp Hili, pa. 17011
Concerning the jewelry pieces of the Estate of
Sarah Bushey, the rollo~ing Items have been eKamined
and appraised.
Ladies wedding band, 14 kt. yellow gold, there are
seven single cut diamonds approx. 0.02ct. each. $65.00
Ladies diamond ring, 14 kt. yellow gold, the
brilliant cut diamond approX. 0.17 cts. perfection
grade I, color grade 3, there are t~o single diamonds
approx. 0.02 ct. on each side. $120.00
Ladies three diamond ring, 14 kt. yellow gold, two
european cut diamonds approx, 0.20 ct. each very
poor quality, a brilliant cut diamond In center
approx. 0.25 ct. very badly chipped, also cleavage
Inclusions. $50.00
Ladles three brilliant cut diamond ring, 14 kt. white
gold filigree style, the center diamond approK. 0.30 ct.
perfection grade 10, color grade 3, approX. proportions
poor, and t~o large chipps. The two end diamonds
approx. 0.22 ct. each, poor proportions, perfection grade I,
color grade 2, bead set across the finger. $100.00
These plecos have boen examined without the stones
being removed from their settings and are appraised on
that basis. Thl. Is a fair market value at which the property would
change hands between a willing buyer and willing seller If
both had reasonable knowledge of relevant fatts and neither
was under compulsion to buy ar sell.
. r <~7 ;f'~~ t (-:I:: '\!
R. II. Landis, Registered Jeweler
American Gem society
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A. Five shares to Haurice III icker, my nephew;
B. Five shares to Rachel Elicker, my niece;
c. Five shares to Bessie Ritter, my sister;
D. Three shares to Vivian Brinton, my niece;
E. Three shares to Janet Ke ich, my grandniece;
F. Three shares to Alverta Efcevitch, my niece;
G. Three shares to Nancy Pires, my grandniece;
H. Three shares to Nancy Wacker, my grandniece;' .._,
I. Three shares to Betty Raub, my niece.
VI - Should any of my beneficiaries named in this Will
predecease me, except for my husband Alvin H. Bushey, then I
Ii direct that his or her bequest or share of my estate shall be
Ii delivered and paid over to his or her issue living at the time
of my death per stirpes.
,
I'
!' my death of whatever nature and by whatever jurisdiction imposed
I'
I'
I
Ii
I'
, of my estate, and my personal representative or representatives
i
shall have the absolute power in his or her discretion to pay the
VII - All taxes that may be assessed in consequence of
shall be considered a part of the expense of the administration
same at once whether or not the law under which they are imposed
permits the postponement of all or part of them to a later time.
i
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VIII - I appoint my nephew, Maurice Elicker, Executor
of this, my Last will and Testament. Should he fail to qualify
I or ceaSe to act as such, then I appoint my niece, Rachel Elicker,
'I
!' to act in this capacity. Neither of my personal representatives
shall be required to post bond in this or any jurisdiction.
I'
II
,
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IN WITNESS WHEREOF, I
;-;:
on this, the ",-1.~'
day of
have hereunto set my hand and seal
/~
/1) " 1974
. , .{~'~-'\.l ~......./ , .
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Sarah J. Bushey J
(SEAL) ,
Page 2
REV-,.50 l'-:X+ (10-801
COMMONWEAL TH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "Au
REAL PROPERTY
(Instructions 0/1 Rcvcrst.' Side)
ESTATE OF__ SARAH J. BUSHEY
- - -
ITEM DESCRIPTION ESTIMATED DEPARTMENT
NO. MARKET V ALUA T ION
VALUE IOFFICIAL USE ONL YJ
.
NONE
.
TOTAL
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COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHER!TANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
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(Instructions on Reverse Side)
Estate of
SARAH J. BUSHEY
ITEM
NO.
DESCRIPTION
UNIT
VALUE
ESTIMA TED
MARKET
VALUE
DEPARTMENT
VALUATION
[OFFICIAL USE ONL Yl
270 shares common stock in CCNB
Corporation
First Federal Savings
C.D. '23189
accrued interest
C.D. '26898
accrued interest
C.D. tl2278
accrued interest
& Loan Assn.
10.75 2,902.50
15,508.03
BB.B9
30,025.00
134.26
5,898.61
67.03
40,025.01
166.56
10,000.00
153.23
24,000.00
71.42
13,000.00
39.93
10,000.00
53.29
40,000.00
120.72
65.00
120.00
50.00
100.00
3,220.92
Harris savinis Assn.
C.D. '4-15-8 4022
accrued interest
C.D. '5-16-010557
accrued interest
Passbook account '5-79485
accrued interest
State ca~ital Savings
C.D. '00 -15-01815
accrued interest
C. D. '002-20-05756
accrued interest
A8sn.
C.D. '6690150 in Cumberland Valley
Savings & Loan Assn.
accrued interest
14 kt. Yellow gold wedding band
w/d!amonds
14 kt. yellow gold diamond ring
14 kt. yellow gold diamond ring
14 kt. yellow gold diamond ring
Prudential Insurance Company annuity
contract 'A40-4B4
TOTA~ 195,910.40
If oaaitional space is necessory, us~ all" k 11" snee;s.
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two yems ot death, make any transfer of any materiill pmt of his estate without receiving
valuable and adequate consideriltion? (Answer "Yes" or "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 deafh certificate.
c. Affidavit by the attending physician indicating the stilte 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".)
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 ilt time of decedent's deilth? --
5. Did decedent in his/her lifetime milke any transfer without receiving a valuable and ildequate 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".)
6. If the answer to five b. above is "Yes," WilS 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".)
B. Did decedent, at any time, transfer property. the booeficial 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".)
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 decedent and others ( ).
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INFORMATION
ThiS document IS the Notice required to be given under Section 709 of the Inheritance and Estate Tax Act
of 1961 (72 P.S. section 24851.
If the tax is paid within three (3) months atter 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 annum on the amount of unpaid tax. (SEE EXAMPLE BELOW)
EXAMPLE: If a balance of tax due of $2,000.00 is in a delinquent status trom 3-3-80, and payment is mlde
on 5-23-80. the interest is calculated as indicated below:
STEP I
Determine the rate of
interest from the table below.
STEP 2
Multiply the balance of
tax due by the rate of
Interest
STEP 3
Add the interest
to the balance of
tax due,
Interest from 3-03-80 to 5-23-80
Results In: -
2 Months;: ,010
20 O.yS = + .00335
Rate of interest = .0'335
Balance of lax due
Rate of interest
INTEREST
$2.000,00
x .01335
$ 26,70
Balance of tax due
Plus Inlerest to
OJle of Payment (+)
TOTAL t.x and
interest to O,te
of Payment
$2.000,00
$ 26.70
$2,026,70
---------------------------------------------------------------------
1 month .005 4 months ,020 7 months ,035 1 0 months ,050
2 months .010 5 months .025 B months .040 11 months .055
3 months ,015 6 monthS ,030 9 months .045 12 months ,060
1 d.y .00017 II days ,00186 21 days .00352
2 d.ys .00034 12 days .00203 22 d.y, .00369
3 d.ys .00051 13 days ,00220 23 d.ys .00366
4 d.ys .00068 14 days ,00237 24 d.ys ,00403
5 d.y, .00065 15 days .00250 25 dlVs ,00420
6 d.ys .00101 16 days ,00267 26 d.,. ,00437
7 days .00" 8 17 d.ys .00284 27 d.V' 00454
8 d.ys .00135 18 days .00301 28 dlVs ,00471
9 days ,00152 19 d.ys ,00318 29 d.vt ,00486
I 0 d.ys .00169 20 d.ys .00335 30 dlV' 00500
--------------------------------------------------------
Any party In Interest, includIng the Commonwealth and the personal repreSl!nlatl\l(', "0\ ~11Isfl,d Wjl~, lhf
appraisement ,"d anessment may object Within SlX11/ (60l days .fter receipt of thiS Notice IS plow~.d bv
Sect,on 1001 Df the !nhe"lInCe .nd E'lJte TIX Act of 1961 (72 P,S. see 2485 - 10011
MAKE CHECK OR MONEY ORDER PAYABLE TD: "REGISTER OF WILLS. AlItNT"
DETACH THt: TOP PORTION OF THIS FORM AND SU8MIT WITH YOUR PAYMENT TO THE REGISTER O. WillS fOR
THE COUNTY SHOWN ON THE REVERSE, SEE THE INHERITANCE TAX INSTRUCTION BOOt. fOR ADDRESS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
1.
J
55:
.____________~URIC~_ ELICKER
SWOJ::IL_____ according to law. deposes a"d says that he is executor
_ of the Estate of Sarah J. Bushey
lalo of __.I:!1lJJlP_d_E!1l.':r9W!:lsi1.ip ..._.. .... ._,__,_,___, Cumberland County, Pa., deceased and that tho
'th" . t d b him th 'd executor
WI In IS an Inven cry ma e y .__._~___"____ ___ 'I e sal
of tho entire estate of said do cedent. consisting of all the penonal proporty and roal estate, excopt real ostate outside
the Commonwealth of Pennsylvania, and that tho ligures opposite each item of the Inventory represent it's fair value
as of tho date of docedent's death.
being duly
n to
and subscribed bofore mo,
_bM-,-vu~~ ? r-f~~
Executor. Administrator
217 St. Johns Church Road
_ Cal!'.p Hill,..!:~ 17011
Addr...
Data of Doath
14
SEPTEMBER
1981
Day
Month
Vu,
INSTRUCTIONS
I. An inventory mu,t bo filed within Ihree months after appointment of personal representative.
2. A supploment inventory must be filed within thirty daYI of discovery of additional ..sets. ,:,f,;
3. Additional sheets may bo attached as to personalty or realty ".;,;'
,.',l \
4. See Article IV, Fiduciaries Act of 1949. ';'"''
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Inventory of the real and personal estate of
SARAH J. BUSHEY
c
270 shares common stock in CCNB
corporation
Harris Savings Assn.
C.D. 44-15-814022
accrued interest
C.D. 45-16-010557
accrued interest
passbook account 45-79485
accrued interest
State capital Savings Assn.
C.D. 4002-15-01815
accrued interest
C. D. 4002-20-05756
accrued interest
First Federal Savings & Loan Assn.
C.D. 423189
accrued interest
C.D. 426898
accrued interest
C.D. #12278
accrued interest
C.D. 46690150 in cumberland Valley
Savings & Loan Assn.
accrued interest
14 kt. Yellow gold wedding band
w/diamonds
14 kt. yelloW gold diamond ring
14 kt. yelloW gold diamond ring
14 kt. yelloW gold diamond ring
prudential Insurance company annuity
contract 41140-484
10.75
deceased
,'o'rlll.
..._._.~_..._..,_._. "..->" ,..., ..---.,.. --~--
-~-_.._. --.---...---- .--...-....-..
2,902 50
15,508 03
80 89
30,025 00
1.34 26
5,898 61
67 03
40,025 01
166 56
10,000 00
153 23
24,000 00
71 42
13,000 00
39 93
10,000 00
53 29
40,000 00
120 72
65 00
1
\
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\ 3,220.92
I
195,810.40
120.00
50.00
100.00
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ESTATE OF SARAH J. BUSHEY
Late of Hampden Township
Cumberland County, Pennsylvania, Deceased
STATEMENT OF PROPOSED DISTRIBUTION
Balance for distribution ?er First
and Final Account
$156,807.99
The accountant proposes to distribute the
balance for distribution in the fOllowing manner:
TO:
Haurice Elicker ( .151515) $23,758.77
Rachel ElicJ~er ( .151515) $23,758.77
Bessie Ritter ( .151515) $23,758.77
Vivian Brinton (.090909) $14,255.28
Janet Keich (.090909) $14,255.28
Alberta Efcevitch (.090909) $14,255.28
Nancy Pires (.090909) $14,255.28
Nancy Wacker (.090909) $14,255.28
Betty Raub Filson (.O90909) $14,255.28
$156,807.99
Said balance consists of cash.
~U.f.~:~ e ~~h
Haurice Ehcker
t.':..t;
101
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COI1MONNCALTH OF PBNNSYLVANIA)
5S.
COUNTY
OF
CUHI3ETILAND)
!.\AURICE CLICKFR, being duly slvorn according to law, deposes
and says that the facts set forth in the attached Statement of
Proposed Distribution are true and correct, and that distribution
is made in accordance with the Last Nill and Testament of the
decedent dated Harch 25, 1974.
b.. w..e. e. ei.u~,,~.
Maurice Clicker
Sworn to and subsc~ibed before me
...<t,:'~3.iji~ ;"{'~is2.2 ~ day of 1~_d./, 1982
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A. Five shares to Haurice Elicker, my nephew;
.
B. Five shares to Rachel Elicker, my niece;
c. Five shares to Bessie Ritter, my sister;
D. Three shares to Vivian Brinton, my niece;
E. Three shares to Janet Reich, my grandniece;
F. Three shares to Al ve rta Efcevitch, my niece;
G. Three shares to Nancy Pires, my grandniece;
H. Three shares to Nancy Wacker, .. grandnie"Ce-; ,,_.
my
I. Three shares to Betty Raub, my niece.
VI - Should any of my beneficiaries named in this Will
predecease me, except for my husband Alvin H. Bushey, then I
direct that his or her bequest or share of my estate shall be
delivered and paid over to his or her issue living at the time
of my death per stirpes.
VII - All taxes that may be assessed in consequence of
my death of whatever nature and by whatever jurisdiction imposed
shall be considered a part of the expense of the administration
Ii
Ii
of my estate, and my personal representative or representatives
shall have the absolute power in his or her discretion to pay the
srone at once whether or not the law under which they are imposed
,
permits the postponement of all or part of them to a later time.
I
If
II of this, my Last Will and Testament.
I'
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VIII - I appoint my nephew, Maurice Elicker, Executor
Should he fail to qualify
or cease to act as such, then I appoint my niece, Rachel Elicker,
to act in this capacity.
Neither of my personal representatives
shall be required to post bond in this or any jurisdiction.
Ii
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D..... 'Ann li
"
'u,l.e I:
IN WITNESS WHEREOF, I
';'.;)
on this, the
"f ,_'
.", "
day of
have hereunto set my hand and seal
.;;'J..,.~, ,', ./ 1974
' <- , .
.,
_.\/O\'),-:!_ l'\ j~~/I }:11.
Saran J. Bushey J
(SEAL)
Page 2'
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DISTRIBUTION ACCOUNT
Rachel Elicker
Alverta Efcevitch
Nancy Pires
Rings
Ring
Ring
$185.00
100.00
50.00
TOTAL DISTRIBUTION ACCOUNT
$335.00
CmmON\~EALTll OF PENNSYLVANIA)
55.
COUNTY
OF
CU!1BERLAND)
tmURICE ELICKER, being duly sworn according to law, deposes
and says that the Account as stated is true and correct and
that the Grant of Letters and the first complete advertisement
thereof occurred more than four (4) months before the filing of
the Account.
~~~-
l1aurice Elicker
Sworn to and subscribed before me
A."'m,JI, ~II.F Ii n.HI J''r
.,","IoIlH~T tn,
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this .....,........u..~,ay of , 1982
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- 4 -
pennsylvania OepdrtlnOnt of !{evenue
Bureau of Examination
P.O. Box 8327
Harrisburg, PA 17105
,
/
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
TO: Jameo K. Arnold, Esq.
2109 Market Street, P.O. Box 737
Camp Hill, PA 17011
ACN 201
DATE:
ESTATE OF:
FilE NO:
COUNTY OF:
DATE OF DEATH:
10/27/82
Bushey, Sarah J.
21-81-0579
CUmberland
81 09 14
-----------------------------------------------------------------------------------------
f.. DETERMINATION:
1. toxabla eslale based upon:
The Unlled Stal.. Eslote Tax Relurn (Form 706)
The communication from the Federal Government
conflnning the occeptance of or changes to the
Federal Eslate Tox Relorn
2. Amounl of credit lor State doath laxas (0' veri lied)
3. Pennsylvania inheritance tax assessed
(excluding any discaunl and/or inleresl)
4. Nonnallnherllance lox poid 10 ather Stoles or
Terrllorles 01 Ihe United Stote, (excluding
any dlscaunl and/ar inlerest)
5. Total inheritonce tax credits (line item 3 plus line item 4)
6. TOlolllobilily for Pennsylvonia e,Iole lox (line ilem 2
minus line !lem S)
NOTE: Campl'Ie line IIems 7 ond 8 ONLY when delenninallon
Is baud on Federal Closing leller
,
,.
Amount of Pennsylvania estate tax assessed on determination
doled
Addlllan (reducllan) 10 Pennsylvanlo eslot. lax (line IIem 6
minus line IIem 7)
8.
D.I.nnlnation pr.pared by:
Dol.:
$
$ 861.00
$ 25,110.00
.00
$ 25,110.00
$
$ .00
$
$
.-----------------------------------------------------------------------------------------
B. ASSESSMENT:
1. Pennsylvania Estat. Tax r.f1ecled on:
lin. II.m A (6)
line item A (8)
2. less cr.dlts:
D~U-9f.. PAYMENT AMOUNT PAID
INTEREST
IS l_
is I
.IS I
.t Balance of Pennsylvania estate tcJX due
Intere~t is due at the rate of six (6) percent per annum from
Au."n:e"t prepar.d by:
Dot.:
$
CREDJ!.
~
=
~
$
10 Ih. dole al poymenl.
AGENT FOR THE COMMONwt'AL"'-4
SEE REVERSE SIDE FOR INSTRUCTIONS
REV. 483.A EX (9.84)
c.
j,g~
'1;:~t~
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
P. O. BO. B327
HARRISBURG, PA 17105
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
ACN 201
-
. .
,~
DAH02-03-86
ESTATE OF
8 US I'E Y
SARAH
J
r1LENUMBER21 81-0579
DATEOF DEATH09-14-81
COUNTY CUllS ERLAND
ESTATE TAX DETERMINATION AND ASSESSMENT
1. Credit For State Death Taxes as Verified
,. 862.00
2. 25.109.59
3. . 00
4. 25.109.59
5. .00
2. Pennsylvania Inheritance Tax Assessed
{Excluding Discount and/or Interest}
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
4. Total Inheritan~e Tax Assessed
(Linc 2 plus Linc 31
5. Pennsylvania Estate Tax Due
(Linc 1 minus Line 41
TAX CREDITS:
C".:.';
. ~\
,'':.:
Payment
Dale
Receipt
Number
Imelc$l (.1
Amount Paid
_J~_
-
Tollll Til~ Cret.1n _ (;0
Bdl,JncP oi Ta~ Out:' _ CO
Inlele~l _ CO
Tutal Due .00
w alliance Out> Ii lell5 thiln $1 no pl:Iympnt I' rflQulffldl
· IF PAlIl AFTER THI~ DATE SEe "EVERSE SIDE
fOR CALCULATION Of AODITIUNAL INTE"EST
REV.1500 EX ~ (9-011
BUREAU OF EXAMINATION
PENNSYLVANIA DEPARTMENT OF REVENUE
P.O. BOX B327
IiARRISBURG. PA 17106
1/ - 31s -~;;
INHERITANCE TAX RETURN
RESIDENT DECEDENT
0, ..M".......-/.
" . fr
File Number ...t/- PI-,;, ..r?'l
DECEASED
D"adeQI', Neme (Lasl, Firn. end Middle Initiel)
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Soclel Securily umber Dele 01 Deelh
-I- "',;r."{,;/
I. Originel Relurn 1XI
3. Remeinder Return 0
Decedenl" Addres, _~
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>'':-'~.(I- .;,./,;;, /1
/,1 ',,'?/
(~"'!/ /'1'1/, , "
17"11
" ,.-./
CHECK
2. Supplemenlel Return D
APPRD.
PRIA TE
4. Life ESlala D
5. Faderal Eslate Tax 0
Return Reqoired.
6. Decedenl died teslata r\/1 7. Decedent meintained a living 0 B. Number ol..le deposit 0
(Attach copy of Will) lLlJ tru,l (Attach copy 01 tru,t! boxes Invanloried
All corr.spondence and confidantlal tex informelion should be directed to:
BLDCKS
CDRRE.
SPDN DENT N.me
AddreSl
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Telephone No.
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Cily ('4",'(1 //1/
Slele
Recapitul.tien
1. Real Estate (Schedule AI (11
2. Slocks end Bondi (Schedule BI ( 21
3. Closely Held StocklPennmhip Interest (Schedule CI ( 3)
4. Mongages and NOles (Schedule 01 ( 41
5. Cash & Miscell.neous Personal Propeny (Schedule EI ( 51 / / ,:.- /,"-', ,,/j
RECAPIT. 6. Jointly Owned Properly (Schedule FI ( 61 ,( ""'-1';. 'I
.' " J ':~
ULATION 7. Translm (Schedule G) ( 71
8. Totel Grall Allell (Iotal lines 1-71
AND 9. Funeral Expenses Admininrative Costs/Miscell.neou,
Expenses (Schedule HI ( 91 'I .r-: ,,:." / ..~.
.. ~:' , .. '. " ~
TAX 10. Oebll/Mongeges/Liens (Schedule I) (10)
II. Total Deductions hotalllnes 9 & 10)
12. Net Value 01 Estete lline B minus line 111
CALCU. 13. Charilable Bequens (Schedule JI
LATIDN 14. Net Value subject to tax lline 12 minu, line 131
Cemputatleo 01 Tlx
15. Amounl 01 line 14 taxable at 6% rate (151
!include v.luOl from Schedule KI
16. Amount 01 lina 14 taxlbl, 8115% rlta (161
linclude v.lueslrom Schedule KI
17. Principal "' due (Idd tax from line 15 plus tax Irom line 161
lB, Total Prior plymenll:
(II Amount Plid
(bl Plus Dlrtount
(eI Minuslotarest (1BI
19. Balance Due lline 17 miousline 1 BI
Mike Check Plyable to: Registar of Wills. Agent
. .. PLEASE RECHECK MATH" .
( BI
/ I 7 J J(.iJ 7
I
"n 1'<'" 1"~
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/ 7..:' ,~'/7..1 ,.z.
(11)
(121
(131
(14)
I/J, ,~ 17 ..:.'"
x.06'
x.15=
(17)
(191
Under penaltiOl 01 perjury. t declare that I have examined lhil return. including accompanying lthedul.. and stotemenll. and to lhe bOlt 01 my knowledge
and belief, it is true, correct, and complete. Declaration of preparer other thin the personal representative is based on .11 information of which prpPlrer hi'
any knowledge.
SIGNATURE OF PERSONAL REPRESENTATIVEISI
ADDRESS
DATE
SIGNATURE OF PREPARER OTHER TIiAN REPRESENTATIVE
ADDRESS