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Home My WebLink About01-0773CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of HERBERT N. SELL „o ~I-01-773- also known as HERBERT SELL Deceased Social Security No.163208551 VIRGINIA SELL Petitioner(s), who is/are 18 years of age or older, apply)ies) far (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut OR named in the Last Will of the Decedent, dated 1/28/91 and codicil(s) dated n/a Executors named in the Last Wi11 and Testament of Herbert N. Sell renounced their right to administer the estate in favor of their mother and sole residuary legatee under the Will, Virginia Sell. Virginia Sell is exempt from posting a fiduciary bond in accordance with PEF Section 3174(b)(2) State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration c.t.a. (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Residence Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with hislher last family or principal residence at 3009 LINCOLN STREET, CAMP HILL, CAMP HILL BORO, 17011 (list street, number and municipality) Decedent, then 72 years of age, died JANUARY 18 , 2001 , at 3009 LINCOLN STREET, CAMP HILL, PA 17011 (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Relationship Personal property in Pennsylvania ............... (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 130,000.00 Total ..................J................................................................................................. $ 130,000.00 Real Estate situated as follows: ~ ~ I ~ ~/ ~ ~%~~~~~~ ~~~ ~Y ~ v~ ~ ~ ~ ~2~ ~ ~( , /~ ~ ~~ ~ ~ Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I Signature ~,~,~ ~ Typed or printed name and residence VIRGINIA"SELL RW-1 ~ ~ - / .~ ~~ Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and su scribed T~ before me this day of ~lr DECREE OF REGISTER Estate of HERBERT N. SELL Deceased No. ~~f ~~-- / ~d~ also known as HERBERT SELL Social Securitgqy No: 163208551 Date of Death: 1 /18/01 AND NOW, f't ~C~ ~~ 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ^ Testamentary ^ of Administration c.t.a. ((c.t.a., d.b.n.c.t.; pendente liter durante absentia; durante minoriate) ~~~ are h r Vir inia" Sell e eby granted to 9 a p~ in the above estate and that the instrument(s), if any, dated ~ ~~ o'- ~ - described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ Short Certificates(s) ............... $ Renunciation .......................... Extra Pages (~ ) ............... $ !UF J .T.R ....................................... $ JCP Fee ................................. $ • ~~ Inventory ................................ $ Other ...................................... $ TOTAL $ ' ~~ I.D. No: 20944 Address: 2331 Market Street Camp Hill PA 17011 Telephone: 717-763-1383 DATE FILED: Attorney: Linus E. Fenicle lna.pns RFV ~rs~ This is to certify that the information here given is correctly copied from an original certificate of death du~l~' filed with me as Local Registrar. The original certificate will be forwarded. to the State Vital Records Office for permanent tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ,,III'"""~~""""'°'~ ~~~,,,~~p~TH UFPFy-_. 'ys altllo~ i ~~ ~ ~ ~` ~ r~ ~ Local Registrar P 7120881 Uo ate No. MtOS.ISJRw ?1S7 TYPEtPRINT IN PERMANENT BIACKINK i a z 0 W U D O i COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL REGOROS CERTIFICATE OF DEATH NAME Of OE ~ 11T IF ~ . µAdM. La- ~~ ~ I/ ~ ~ (~ SE% I SOCIAL SECINNTY NUMBER ' - ~5~ ( ( ~ DATE AF DEATH rMCM. Oev. '"••tl ~ i -~C C / t. i. ~µ~~ ~,Q j- >,. ~ ~ •• gn, uA~ 1 • ZL~.~ AGE IL Bvthday) UNDERtYEAR LINDER/DAI/ OATEOFBWTH BdTTHPLACfICayarW PIACEOFDERMICh xronyar.'-;w.rWrudaxaanaMr.rsrae- 2 Yrs. -lorene ~ Oeye ~ r -ISUre _ Mirwtw ~ !~~. DaY.'hwI ~ 0 ~ ~ ~ - 2 €) .. Stwd FaegnCarwYfD H I,C~~~ I A 7. C.~.3 ~ • 1 HOSPILLL: r--~ -ER: _ ~~ ^ ERIQApa»rM U OOA ^ - ^ RwMnu L!7 t•°PKNI ^ M. CITY. BORO. T WP OF O EATH FACIL COUNTY OF DERH rrmr~ MMS DE NT OF HISPANIC OR161N? RACE • MIO.n. Stick, yMY.. Nt:. n nst~lulan. give slrea ud RY NAME (II nd K" ` c~,°r' ~ ° rn r t1e. ~ ~•.1: ~ a . , i ~~ . r C \ ,T c~~.i~' C~C~ l.. !J C ~ ~ d ~ . DECEDEM'SUSUALOCCUPQIOa1 KIND OF BUSINESSIINOUSTRY lG~w y+Md vrak dd+e dwnq rnow serWed l a iN d o rot tAMSDECEDENTEVERIN OECEDENT'SEDUCQ-QN YAWTALSWUS-Maawd SURYIVM~gSPOUSE U.S. ARMED f S? h Divorced (SPedY) IM +•M. q» masYn Mrny n ~E EMwa.rMW/Sewrd W CuMg. ` u :[ + ~/^~ '-tJ D (~ p (~ TTaF1l1' ~ GY. (1J~ !- T14. rM-1~ 1 rC.lf v 4 ~R ~ r `e G ` / t' t= hls No ^ tS. ~'~ 1 /` u~a «s~! fe. ~~fl.w I E. a Ts. V I R !/ :1 A ~ \`~I.JC.~ ~r a-f-S SS(SUeeLCityvbasr,SNSa.IgCtxN- OE/~DENT'S-u•~-r CEDENT'S -`~ StaN ~r`~'A Di0 ,h.^ Ne.dKrdNYlNed in Nq. ACTUAL TT. • ~C~ .XS~ '^t ~~' ( ~ . RESIDENCE a.a.d.nt /~ ~j , 1 le.~-di+^-. 3 A41~- `~q I Flt~(1 I ~ '~ TTS. ~l.l~.b ~l ~:%d`•'1, nwr.NpT nd.LY.+rwr~r w a ~d^^^ ~ c•yAOro. FrffHER'S NAME IFirst. Mddle. law) ~ MOTHER'S iFiw. 'O . MMYn P ~ F t AJ p~ ~,. Y+F 'S NAME a I NFORMANT'S MA~r~ ADDRESS 1S1nw. Civ/~ti sI.I.. tP ~ t 1 CZ 1 . V K. 1 ll) l ~~-l ( fy.~ C~~Q L I l9Cf~. n~~.. ~ dr^^-- ME'THOD OF TION GATE OF gSPOSITION Tbrl lion ^ Rerrosr Yam Store D PLACE OF DISPOSITION • Name ac.m.t.rx Cnrrr.tory «Otns(Place L C•yvWrwt, Stan. Lp Coae ~,r~ ~ ~ ` P Q D«wonLeS Ouw fSp•cRV r ~a„ 1 q > 2c~ l 3/e. t/4. Z, ,1~j..L.M+~Y, ~l ~ !o r C-~s ~~. I $'~,~ , (A ~:r ~ ~ . ~~..~ SIGNATURE OFF SERVICE LICE EI] PERSON ACTIIKL A$ SUCH LICENSE NUMBER -~AND ADDRESS OF ~AC~LITY 1J1` / 11 ~~1 1M'~!~ ~~1 r Co1''^:.i ~~~- _ ~ ~ 7D l ~ Q IU / F ~,l - 1-- xx ~ uY C-~-~ . . - 2]ea ady •vtun urtdyinp b Yre new a my anasnedS•, W t at dte t , dae and p4ce aidedff /~ LICENSE~NUMBER ~/'~ ~^ (,. / WQE SKLNEO pMaiai+n. na aveilapM a twine a awm to • and Teel , ~ ~ - ~ ~ ~ ~ unM eaua. a dwn. /, /~-~> - /L. ~ --C/-~J O "~ tx. Lf n' `~"~ hems sa-se rra+w w tornptww W IAIE tK DEATH DATE PR NCED DEAD Mona. O•Y. Year) TARS t SE REFERRED TO MEOICAI E7tAM ^ ~~ parswr.lq prsrwrncpdWh " ~ ' ~ " ~ . >•.. ~ ~~~ ,.. ~lJ M. ~. G n , fT. MILT I: Ereer the d'YeeNa, vyurNa or tomplicwions wtrcn ceuaed d» dawn. Do not Baer the moW a W ,auto as grdiac a apirwory angst, stwca a Mart teilwe. r ApproaimMe PART.: OtMr sipniAew oordsiwo awwidYtp b drtedt, nut List «•Ir one tarwe on eatl. Yre. ~ irMelvel wtween gat rpriYrp it Yts undedylrgewwe gvwr w PAITT 1. WYEDUITE CAUSE (Fwt I anM astd death // L/ t y~ ' ~ ~ ~ ~ ~1 i 1 G:t r~~ " 0. Y i r .. G~ ._L j c~ 'T / Z " /'(J S L. -z. ~ -•E retsirp n Oeasd --+-~s a. ~ DUE TOIDR AS A CQNSEOl1ENCE ... , ~-^ , . 1 r 1I n miu~w n OUE W (OA AS A CONSEQUENCE Of7: 1 crre Enter UMDERLYMID ' CAIKEIDrea+•ar'nrrY e. _ sql s~Yaled ewes Ol1B TOIOR A$ A CONSEQUENCE QF1: I rerrep n detlr) LAST r d . NNS AN AUTOPSY YVETIE AUTOPSY FMIDMiOS MANNER OF DEATH GATE QF BL1l1RY TIME OF 1WURV INJURY Q WORK? DESCRIBE HOW INMIRY OCCURi1ED. PERFORUED7 MWIABIE PRI01170 (Mmf~. D•Y• ~) t ~ EiION OF CAUSE a,IwWw ~ Homrctl. ^ H Y.. ^ F/s ^ AssMea ^ Psndwtp Irrvewgwion ^ M . Mrs ^ W `Ats ^ NO ^ Suinds ^ Could aM W dstemuns0 ^ PLACE OF 1W l1RY - N home. tum, wrea. Iac10ry. oMcs LOCATION ISSeet• CryI W.st SIa41 eu•dirq, ws. ISpec~M 2.e. aea tM. 50.. ]ol. - -?a CE11T1PIER ICnecs arty aryl ER ~.."-' . SKiNATURE AND TITLE OF CERTIFI r 'CEATIF'Y1116-NYBICIAN/PnYSCOncerulyrq cwsed d.ain when anoa,er atWSKan twapmarrred death ana competed awn 231 Ti toe ONI «ery krowledSe, death oceurrsd dw t• tYe eauaa(s) and mennar n stated ............. ..................... ^ r 0 ~. '~ , . ~ A~ .. ....~~r( ' ' - •PROrsOUNGN6 AHD CERTIFYMW PHYSICIAN IPhvscran holh wana,ncug death and cenJyng a cause d aeaa+I R GATE IMOntn. Oey. ENE/p war/l -7 / )? (~ Q f1 // 7 - ~- td, ~/Gi r) ~ 2S C L e tc ie the Yea d my krgvdedSe, wea atx«nd it ttw tb, dole. and place, and dw to dre ewu,a) and manmr as amad ....................... . AND ADDRESS OF rE vvltQ ~ ED OF •71EDICAI E%AMINERICORONER On Ilte Weu of saamin.tlon 1r1d/« Inveetlgation, In mY opinion, deem Declared at the tlme, date, and play, end du1 to in0 GY•e(fl end D mentor ee sieletl ............................................................................................... . Yla. p~ ~ A , Z T[_~.- s J G/ ~ W ~ / ~ ~"~~t ~~- u. ~ . H ' ~ / ~ U REGtST 'S SIGNATURE AND NUMBER ~~~ DATE FILED (Mash. Dav'Irarl u. >.. ~ q ~ • y u - CUMBERLAND COUNTY RENUNCIATION Estate of HERBERT N. SELL also known as HERBERT SELL Deceased The undersigned, DOUGLAS H. SELL, SON (Relationship) (Capacity) of the above Decedent, hereby renounce(s) the right t~C~t r the estate and respectfully request(s) that Letters be issued to V RGINIA SELL T~t~ Witness HIS hand this °,~~_ day of AUGI~T , 2001 (Signature) DOUGLAS H. SELL 115 NORTH CHURCH STREET, MOORESTOWN NJ 08057 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) No d/-D/-77~ NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 CUMBERLAND COUNTY, PENNSYLVANIA RENUNCIATION Estate of HERBERT N. SELL also known as HERBERT SELL Deceased No d/-D/-77~ The undersigned, SON of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters of Administration c. t . a. be issued tc Virginia Sell Witness HIS hand this 16TH day of AUGUST , 2001 . x ~ ~ (Signature) KIRK D. SELL 711 MIDDLE LANE, CAMP HILL PA 17011 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed me this ' - mayday of ~ !Y%~ ~.. Notary P~iblic My Co mission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) No#arlal Seal Monlca q. Zeroher, Notary Public Camp HIII Boro, Cumberland County MY P'nm~lyg910n Exf~l~,s Jan. 14, 2002 Member, Pennsylvania Association of Notaries NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 LAST WILL AND TESTAMENT OF HERBERT N. SELL I, HERBERT N. SELL, now of 3009 Lincoln Street, Camp Hill, Cumberland County, Pennsylvania, 17011, declare this to be my Last Will and revoke any Will or Codicil previously made by me. ITEM I: I direct that all expenses of my last illness and funeral, including my gravemarker and perpetual care, shall be paid from my residuary estate as soon as practicable after my decease as part of the expense of the administration of my estate. ITEM II: I devise and bequeath all of my estate of every nature and wherever situate to my wife, VIRGINIA H. SELL, provided that she shall survive me by thirty (30) days. ITEM III: Should my wife, VIRGINIA H. SELL, predecease me or die on or before the thirtieth (30th) day following my death, I direct that ten (10$) percent of my residuary estate be donated in my memory and in memory of my wife, E~TRGINIA H. SELL, to Trinitx Evangelical Lutheran Church of Camp Hill, or its successors, for the Endowment Fund. ITEM IV: Should my wife, VIRGINIA H. SELL, predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath all of the rest, residue and remainder of my estate, of every nature and wherever situate, to be divided into two equal shares. I direct that the first share of my estate be divided into equal shares for each of my son, KIRK D. SELL, now of Camp Hill, Cumberland County, Pennsylvania ~ t ~ ~ r and for each of his living issue, or the survivors thereof. The second one half of my said estate shall be divided into one equal share each for my son, DOUGLAS H. SELL, now of Moorestown, New Jersey and for each of his living issue, or the survivors thereof . ITEM V: Wherever the word "minor" is used herein, it shall mean any person under the age of twenty-one (21) years. ITEM VI: I appoint the father of the minor, Guardian of any property which passes either under this Will or otherwise to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such Guardian shall have'the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate). In the event that the father of the minor fail to qualify or cease to act as Guardian, I appoint the Trust Department or an employee of HARRISBURG BELCO FEDERAL CREDIT UNION, designated by the Manager of HARRISBURG BELCO FEDERAL CREDIT UNION or its successors to serve in their corporate capacity. ITEM VII: I hereby authorize and empower my Executor/Executrix hereinafter named, to sell any of the real or personal property which I may own at the time of my death, as he/she shall, in his/her sole discretion, deem appropriate for the best interests of my estate and my beneficiaries, upon whatever terms and conditions hejshe deems to be appropriate, and to execute, acknowledge, and deliver all proper writings, deeds of conveyance and transfers thereof. ITEM VIII: I appoint my sons, KIRK D. SELL and DOUGLAS H. SELL, jointly, or the survivor of them, Executors, of this, my Last Will. ITEM IX: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate, without apportionment. IN WITNESS WHEREOF, I have hereunto set my hand this day o f , 19 91. ~~ L HERBERT N. SELL The preceding instrument, consisting of this and three (3) other typewritten pages, identified by the signature of the Testator, HERBERT N. SELL, was on the day and date thereof signed, published and declared by HERBERT N. SELL, the Testator herein named, as and for his Last Will, in the presence of us, who, at ':is request and in his presence and in the presence of each other, have subscribed our names as witnesses hereto. --~~ of r. 1 Cs~:nC~ ~. ~. o f ~ k~ ~~ ~. e ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN I, HERBERT N. SELL, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by HERBERT N. SELL, Testator, this ~ S4 day of ~ L a:.~~...c~,~ , 1991. HER ERT N. SELL o ~ N t ry Public t10TARRAI. SEAL CYNTHIA l0U PJIYERS, hlotery Public Harrisburg. Dauphin County, Pa. My Commission Expires Sept. 7, 1992 COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN WE, the undersigned witnesses, whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator, sign and execute the instrument as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Will as a witness; and that to the best of our knowledge, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed before me by the undersigned witnesses, this Z~~`~t=` day of ,~~~-~t~ , 1991. r~ ,~ witness C~ Witness i _ ;, ~~...--; Not ry Public CY~lTN1A LCU M,YE^S, Not4ry Public Harrisburg, Qauphin County, Pa. My Commission Expires Sept. 7, 1992 v CERTIFICATION OF NOTICE UNDER RULE 5.6 (a~ Name of Decedent: Herbert N. Sell Date of Death: January 18, 2001 Will No. 21-2001-0773 Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 20, 2001 Name Virginia H. Sell Address 3009 Lincoln Street Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except NIA Date: August 20, 2001 David W. Reager, Esquire Reager & Adler, PC 23 31 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative ~/ d~ .+ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH ~ REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Herbert N. Sell a/k/a Herbert Sell Date of Death: Janu 18 2001 Will No.: 21-0 l -0773 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. l is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X B. The separate Orphans' Court No. (if any) for the personal representative's account is: C. Did the personal representative state an account informally to the parties in interest? Yes No X D. Copies of receipts, releases, joinders and approvals of formal or informal _ accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~ r° ~ 3 David W. Reager, Esquire Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone:(717) 240-6345 r~ Date: 12/06/2002 SELL VIRGINIA H 3009 LINCOLN STREET CAMP HILL, PA 17011 RE: Estate of SELL HERBERT N File Number: 2001-00773 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/18/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ,,rr MARY C. LEWIS REGISTER OF WILLS l/~~~ cc : ~ File Counsel Judge REV-1500 EX ~ (6-00! COMMONWEALTH OF REV-150 0 • PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESID ENT DECEDEN DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITI AL) T # 0 DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) W ~~'- ~~'-®t lQ _ d! _~~ 0 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) a y ~1.Original Retum 2. Su lemental R ^ pp etum U a Y woo ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of d th ~ a m ~ 6. Decedent Died Testate (Attacn copy of Will) ea after ~2-~ 2-e2) ^ 7. Decedent Maintained a Living Trust (Attach Q ~ 9. Litigation Proceeds Received copy of trust) 1 O. SpoUSal POVerty Credlt (date of d th ea between 12-31-91 and 1-1-95) z W z 0 a w or 0 U AME V~L~s ~.C S~~L. FIRM NAME (If Applicable) ~} ~ TELEPHO E NU BER 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership orSole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) Q a Q V W ilY 6. Jointly Owned Property (Schedule F) Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) OFFICIAL USE ONLY riot NUMBER ~ ~ coo! - o'_'-= --- ~ ? ~ YEAR _ ~~. SOCIAL SECURITY NUMBER i nip htErURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS w~rH~ ~tL;uKl TY NUMBER ^ 3. RemainderRetum (date of death prior to l2-13-82) 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Ana~n scn o) COMPLETE MAILING ADDRESS l~l oo2-~S7o cd,J~ ~~ ~ ~J57 (1) ,1~J~. Q~21 CO TIFF AL USE ONLY (2) b (3) O ~e-a. . r. ..._ ~ r~~ ; ' , :y '~ : i r t C~ . ~ t :', := f (7) O .. ,- _''~ (8) /~Q~ 4 U C~ (9) ~(~ C~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Q V 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUrrinNC nu o~~~~~~~ .....~ ___ (11) (12) ~'~~ 0c7 (13) ~ (14) ~~ .°~ P)~? - -- -•- •-~-~~•~~ ~~~~ rvRHrrucABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ~Q ~~"r (,~ p ~, X (15) 16. Amount of Line 14 taxable at lineal rate X .__ (16) 17. Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amount of Line 14 taxable at collateral rate X .15 (18) 19. Tax Due 20. ~ (19) Decedent's Com Tax Payments and Credits: ~ ~ Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable Total Credits (A + B + C) (2) D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENTotal Interest/Penalty (D + E) (3) Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE . A. Enter the interest on the tax due. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) ,_, AGENT 5B) Make Check Payable to: REGISTER OF WILLS , . ~ .. z gym, , , ;. ~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY P " " ~__ LACING AN X IN T HE APPROPRIA 1. Did decedent make a transfer and: TE BLOCKS a. retain the use or income of the property transferred; ....................... b retain th i h Yes No a c~ . e r g t to designate who shall use the property transferred or its income; c. retain a reversionary interest; or ~~~~~~~•~~~~""""""""""""•••• '~ d. receive the promise for life of either payments, benefits or care? ................. 2. If death occurred after December 12 1982 did d , , ecedent transfer propert without receivin ade uate consideration Y within one year of death 9 q ? ..................... .......................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 4. Did decedent own an Individual Retirement A a [] ccount, annuity, or other non-probate property which contains a beneficiary designation? ....... ................................................................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND U d n FILE er penalties of'erjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,TorAresct'ARm OF THE RETURN. Declaration of preparer other than the personal representative is based on,~lt information of which preparer has any know e p te. SIGNATURE OF PERS . O SPONSIBLE FOR FI R -~tJR ADDRESS DATE ter. ~_... ~~ ,.,..~~ ~~ /~ ~~~ / v, ~~1J2~~ ~ . //~dQ -..~..... SIG /~ ~ ~~ ~~Q G{ NATURE OF PREPARER OTHER THAN REPRESENTATIVE ~~~~~ DATE ADDRESS _ ,:.< :.. ... For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of tran ~~ ~- ; Mgt [72 P.S. §9116 (a) (1.1) (i)]. sfers to or for the use of the surviving spouse is 3% , For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin s The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fpouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. the surviving spouse is the only beneficiary, ng a tax return are still applicable even if For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the u or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. se of a natural parent, an adoptive parent, The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 7 The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a 1.3 . A sibli ? P S §9116(1.2) [72 P.S. §9116(a)(1)J. individual who has at least one parent in common with the decedent, whether by blood or adoption. )( )] n9 Is defined, under Section 9102, as an REV-1502EX + (t-97) ~ i SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN ESTATE OF ~~t,c_ ~ ~~~ ~.2 ~ y~ J , FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the ce' Gf / ~ ~ ~ 3 between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is 'ointl - survivorshi must be disclosed on Schedule F. p at which property would be exchanged ~ y owned with right of ITEM NUMBER VALUE AT DATE DESCRIPTION 1 • rlC ncnru .341 I' ~-f~4tc1 ~-EtaF~/vf~ ~~, c.~~f~ ~ ~ t I~f` ~ ~~ I~vt( ~~~~ ~~~ TOTAL (Also enter on line 1, Recapitulation) $ ~~ ~ ADO (If more space is needed, insert additional sheets of the same size) Glenda Farner Strasbaugh Register of Wills & Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq. Solicitor OFFICES OF One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Fax: (717)240-7797 Register of Wills and Clerk of the Orphans' Court ~. County of Cumberland Date: May 17, 2010 We are unable to process the enclosed document. It is being returned to you for the following reason: Must be filed in duplicate. Did not include the filing fee of $ ~ , ~ V (Made payable to Register of Wills) ^ Did not include the research fee of $4 per name (see Request for Research form attached). ^ Your Inheritance Tax payment has been processed. You will find your receipt enclosed. Other: . ~ r~Qd ~ ~ ~ ~ , ~ ~fu rn 1 n Gt c~~i ~ Gc' l SGD 1~Ga~ If you have any questions or concerns, please call the office at 717-240-6345 between 8:00 a.m. and 4:30 p.m. Initials ~Ela1e ~~ bu ~-i~inaC, ~ISo, ~~~.~a Addi~i~naf p~o~.le, is due. I ~'~~, and ~-h.e Eck ~11'~..1! ~u . ~..~• ~:~ ~• {:~~ ~; ,, ~ u~ 2010 JUG - , CI~RK Or ~~,~f~ C4Uh_; ~~~,,_,, ~ . '' A~~D CCU.. Pr. . ~ ~ ~ ~ ~ `~' C M CV\ w~ I A ~. ~~,,._ 4 \ ^~ t W °,~ ~ ~~ v~ ~ ~-- O Z =: O ~ O rr ~x ~~ ~~ ~~~ ~~ ~~~ 0 0 f ~S j ~~ ~ Cs ~:~ <. ~~ ~``~ , ,a f~ ~_ . ,.. _.. ., _ _ _.. NOTICE OF INHERITANCE TAX peI1I1Sy~Varl~a ~ BUREAU OF INDIVIDUAL ~ TAXES -- ~-f'.PR~~SEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION `OFD` DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-09) PO BOX 280601 ~ ~ ' - ' ' ' ' HARRISBURG PA 17128-0601 ~„~ L~r~ R1~^ ~L,~ ~i.. '~,, ~ ,;~ ,_ DOUGLAS H~~~L`t' ~ ~~`'~ 115 N CHURCH ST MORRESTOWN NJ 08057 DATE 08-02-2010 ESTATE OF SELL HERBERT DATE OF DEATH 01-18-2001 FILE NUMBER 21 01-0773 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 10-01-2010 (See reverse side under Obj~eetions Amount Remitted MAKE CHECK PAYABLE AND REF4IT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 i~l 1 '' CUT ALONG THIS LINE _ --~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ _ REV-1547 EX AFP-C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: SELL HERBERT FILE N0.:21 01-0773 ACN: 101 ______________ OR- DATE: 08-02-2010 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 105, 000.00 (1) NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) ,0 0 credit to your account, 0 0 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .0 0 6. Jointly Owned Property (Schedule F) (6) .0 0 7. Transfers (Schedule G) (7) .0 0 8. Total Assets c8) _ 105, 000.00 APPROV ED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 5 0 0.0 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .0 0 11. Total Deductions (11) _ 500.00 12. Net Value of Tax Return (12) _ 104,500.00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _ .0 0 14. Net Value of Estate Subject to Tax (14) _ 104 500.00 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 , 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 104,500.00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) _0 0 X 0 4 5 - .0 0 17. Amount of Line 14 at Sibling rate (17) .0 0 X 12 ~ .0 0 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 ~_ .0 0 19. Principal Tax Due (19)- .0 0 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.