HomeMy WebLinkAbout04-0068PETITION FOR PROBATE & GRANT OF LETTERS
Estate of
also known as
JOSEPH T. CLIPPINGER
, deceased.
Social Security No. _ 171-05-1020
No. 21-04- ~'o~::;~
To: Register of Wills for the
County of Cumber/and
Commonwealth of Pennsylvania
The Petition of the undersigned respectfully represents that:
Your Petitioners, who are 18 years of age or older and the Co-Executors named in the Last Will of the
above decedent dated October 10, 2003 , and codicils dated none The
Executor named none died Renunciations for none attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal
residence at 147 West South Street, Carlisle Borou.qh
Decedent, then 93 years of age, died January 3 ,2004, at Carlisle Reqional
Medical Center, Carlisle, Pennsylvania '
Except as follows, decedeo, t did not marry, was not divorced and did not have a child born or adopted
after execution of the Will offered for prObate; was not the victim of a killing and was never adjudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in PA
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania, situated as follows:
147 West South Street, Carlisle Borouqh, Cumberland County
$1000.00
$
$.
$~5,000.00
here,~ith and the grant of letters testamentary thereon.
i.. S~_ re(s) ~?.~R~s) °f Petiti°ner(s):
L,nwood T. Clippinq~e~r r Ronald B. Clipl~i~q;r
2563 Walnut Bottom Road 351 West North Street
Carlisle, PA 17013 Carlisle, PA 17013
717-776-7353 717-243-4885
WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented
-G-~a r y L/Clippinc~e~/
916 Petersburq Road
Carlisle, PA 17013
717-258-6922
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF CUMBERLAND ·
SS
The Petitioner(s) above named swear(s) or 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 of
the above decedent, petitioner(s)will well and truly administ~.7~e~7~~.~
Sworn to or affirmed and subscribed
~ore me this ~ day of i rd~z~''';× Garv/L. Clipl3in-qer / ~/I
a~.~/.,~,.....~ ,2004. ~ d& ~
~~~.~.~,/~, ~;r~.~~ R~lald B. Clippin~elL/,-~
· Linwood T. Clippinger
No. 21-04-
Estate of JOSEPH T. CLIPPINGER
, deceased.
DECREE OF PROBATE & GRANT OF LETTERS
AND NOW, January ~.~- ,2004, in consideration of the Petition on the reverse
side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated
October 101 2003 described therein be admitted to probate and filed of record as
the Last Will of Joseph T. CliDoincler ..; and Letters Testamentary are hereby
granted to Gary L. CI opincler, Ronald B. Clippinqer and Linwood T. Clippinqer
FEES
Probate, Letters, Etc ........ $115.00
Short Certificates(-2- ) .... $ 6.00
Renunciation(s) ........... $
JCP .................... $10.00
Other Will PaRes (-2-) .... $ 6.00
TOTAL: .... $137.00
Filed ............................
IRWIN & McKNIGHT
Roger B. I~il~, Esquire ( )
ATTORNI~(~up. Ct. ,.D. No.)
60 West Pomfret St., Carlisle, PA 17013
ADDRESS
717-249-2353
PHONE
LAST WILL AND TESTAMENT
I, JOSEPH T. CLIPPINGER of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my Executors to sell any realty owned by me at my death,
and not specifically devised herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do if living.
3. I devise and bequeath all of my estate of every nature and wherever situate to my sons,
RONALD B. CLIPPINGER, GARY L. CLIPPINGER and LINWOOD T. CLIPPINGER, share
and share alike.
4. I nominate and appoint RONALD B. CLIPPINGER, GARY L. CLIPPINGER and
LINWOOD T. CLIPPINGER to be the Executors of this my Last Will and Testament; they are
to serve as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys for the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
October, 2003.
day of
Signed, sealed, published and declared by JOSEPIt T. CLIPPINGER, the above-named
Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his
presence and in the presence of each other have subscribed our names as wimesses hereto.
.4 CKNO WLEDGEMENT AND AFFIDAVIT
WE, JOSEPH T. CLIPPINGER, SHARON L. SCHWALM and MARTHA L.
NOEL, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed thc instrument as his Last Will and that he had signed willingly, and
that he executed it as his frec and voluntary act for the purpose herein expressed, and that each of
the witnesses, in thc presence and hearing of thc testator, signed the Will as a witness and that to
thc best of their knowledge thc testator was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
'~~~-~ ~-'~J~O'SC~PH T~__~LI~NO
SHARON L. SCHWALM
~- 'MAR~
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
Subscribed, sworn to and acknowledged before me by JOSEPH T. CLIPPINGER, the
testator, and subscribed and sworn to before me by SHARON L. SCHWALM and MARTHA
L. NOEL, wimesses, this t o" day of October, 2003.
ry Public
Notarial Se. al
Roger B. Irwin, Nolary Public
Carlisle Bom, Cumberland County
My Commission Expires Oct. 3, 2004
Member, Penn,wtvan~a Association of Notales
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Estate No.:
JOSEPH T. CLIPPINGER
JANUARY 3, 2004
21-04-0068
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on February 11,2004 .
Name Address
Gary L. Clippinger
Ronald B. Clippinger
Linwood T. Clippinger
916 Petersburg Road, Carlisle, PA 17013
351 West North Street, Carlisle, PA 17013
2563 Walnut Bottom Road, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none .
Date: 02/11/04
Signatur~
IR~/~j~cKNIGHT
Name Roger B. Irwin, Esquire
Address 60 West Pomfret Street
Capacity:
Carlisle, PA 17013
Telephone (717) 249-2353
X
__ Personal Representative
Counsel for Personal Representative
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. ;)80601
HARRISBURG, PA 171Z8-0601
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-04-0068
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
171-05-1020
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
DECEDENT'S NAME (LAST, FIRST,ANi MIDDLE INITIAL)
Clippinger Joseph T.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
01/03/2004 10/30/1910
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. OriginaIReturn :). SupplementaIReturn
4. Limited Estate 4a. Future Interest Compromise (date of death after 1;'- 12-82)
6. Decedent DiedTestate 7. Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[----~ 9. Litigation Proceeds Received r--110. Spousal Poverty Credit
(date of death between 12-31-91 and 1 - 1-95)
NAME
Roger B. Irwin Esq.
FIRM NAM E (If Applicable)
IRWIN & McKNICHT
TELEPHONE NUMBER
7i7./249-2353
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole -Proprietorship
4. Mortgages & Notes Receivable (Schedule D) , (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) '(6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
SOCIAL SECURITY NUMBER
(date of death
3. Remainder Return prior to 12-13-87)
5; Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
Election to tax under Sec. 9113(A)
(Attach Sch O)
COMPLETE MAILING ADDRESS
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
.~ C
77,8o0 .~0~
783.~7'
NOne
None
908.00
556 ;36
None
(8)
16,367.64
5,378.48
(11)
(12)
80,048.03
21,746.12
58,301.91
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 58,301.91
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2) X .0 0 (15) 0.00
16. Amountof Line 14 taxable at lineal rate 58,301.91 x .0 45 (16) 2,623.59
17. Amount of Line 14 taxable at sibling rate X .12 (17) 0_:00
18. Amount of Line 14 taxable at collateral rate X .15 (18) 0.00
19. Tax Due (19) 2,62~.~
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
ADDITIONAL Personal Representatives
Estate of Joseph T. Clippinger SS# 171-05-1020 01/03/2004
*********************************************************
Under penalties of perjury, the undersigned declare that they
have examined this return, including accompanying schedules and
statements, and to the best of their knowledge and belief, it is
true, correct and complete.
Signature
Name
Address Line 1
Address Line 2
City, State, Zip
Date
Signature
N~e
Address Line 1
Address Line 2
City, State, Zip
Date
Ronald B. Clippinger
351 West North St.
Carlisle, PA 17013
Linwood T. Clippinger
2563 Walnut Bottom Road
Carlisle, PA 17013
REV-150Z EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger SS~
SCHEDULE A
REAL ESTATE
171-05-1020 01/03/2004
FILENUMBER
21-04-0068
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 price
at which property would be exchanged 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 jointly-owned with ri~lht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
147 West South Street, Carlisle Borough - sold 03/31/2004;
settlement sheet attached
TOTAL (Also enter on line 1, Recapitulation) $
OF DEATH
77,800.00
77,800.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc, Form REV-1502 EX (Rev. 1-97)
REV-1503 EX + (1-97)
COMMONWEALTH OFPENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Joseph T. Clippinser SS~/ 171-05-1020 01/03/2004 21-04-0068
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE
OF DEATH
1 10.2041 shares Hershey Foods Corp - traded on the NYSE, 76.80 783.67
C OQ~Q1 on
TOTAL (Also enter on line 2, Recapitulation) 783.67
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97)
REV- 1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
S$# 171-05-1020 01/03/2004 21-04-0068
Include the proceeds of litigation and the date the proceeds were received by the estate, All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Miscellaneous household goods 908.00
TOTAL (Also enter on line 5, Recapitulation)
908,00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
REV- 1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger SS#
SCHEDULE F
JOINTLY-OWNED PROPERTY
171-05-1020 01/03/2004
FILENUMBER
21-04-0068
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Gary L. Clippinger son
B. Ronald B. Clippinger
C. Linwood T. Clippinger
916 Petersburg Rd.
Carlisle, PA 17013
351 West North St.
Carlisle, PA 17013
2563 Walnut Bottom
Carlisle, PA 17013
S on
son
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank
account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attachdeed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1 ABC 01/17/02 Waypoint Bank - checking 2,225.43 25.00%' 556.36
TOTAL (Also enter on line 6, Recapitulation) $ 556.36
(If more space is needed insert additional sheets of the same size)
Copyright (c) '1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97)
REV- 1511 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger SSi/
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
i7i-05-i020 01/03/2004
FILE NUMBER
21-04-0068
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
2
3
4
5
6
FUNERAL EXPENSES:
Ewing Brothers Funeral ~tome
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees IRWIN & McKNIGHT
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal -
Lindsey' s Hauling, trash
Mellon Bank Investor Relations
Register of Wills filing fee
Roy D. Gottshall Auctioneer -
Settlement charges on sale of
State Zip
estate notice publication
removal
certificate replacement
appraisal fee
real estate
4,409.00
3,970.00
137.00
75 00
695 00
30 00
25 00
50 00
6,847 17
Total. of Continuation Schedule(s) 129.47
TOTAL (Also enter on line 9, Recapitulation) $ 16,367.64
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev, 1-97)
Estate of: Joseph T. Clippinger
$oc Sec #: 171-05-1020
Date of Death: 01/03/2004
Continuation of Schedule H-B7
(Other Administrative Costs)
Item Description
Amount
The Sentinel - Legal - estate notice publication
129.47
129.47
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS# 171-05-1020 01/03/2004
FILENUMBER
21-04-0068
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1
2
3
4
5
6
7
8
9
10
Agway Energy Products
Belvedere Medical Corp.
Borough of Carlisle ~ water/sewer
Carlisle Regional Medical Center
Central Penn Medical Group
Cumberland County Nursing Home
Cumberland Goodwill Fire & Rescue
Peerless Insurance
Penn Power & Light Co.
Waste Management
AMOUNT
294.58
34.71
30.16
313.28
221.96
4,057.68
44.25
101.00
264.00
16.86
TOTAL (Also enter on line 10, Recapitulation) $ 5,378.48
(If more space ~s needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev, 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph T. Clippinger SS#
NUMBER
SCHEDULE J
BENEFICIARIES
II.
171-05-1020 01/03/2004
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.Z)]
Gary L. Clippinger
916 Petersburg Road
Carlisle, PA 17013
Linwood T. Clippinger
2563 Walnut Bottom Road
Carlisle, PA 17013
Ronald B. Clippinger
351 West North Street
Carlisle, PA 17013
FILENUMBER
21-04-0068
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
S on
Son
Son
1/3 remainder
1/3 remainder
1/3 remainder
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
LAST I, VILL AND TESTAMENT
I, JOSEPH T. CLIPPINGER of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my Executors to sell'any realty owned by me at my death,
and not specifically devised herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do if living.
3. I devise and bequeath all of my estate of every nature and wherever situate to my sons,
RONALD B. CLIPPINGER, GARY L. CLIPPINGER and LINWOOD T. CLIPPINGER, share
and share alike.
4. I nominate and appoint RONALD B. CLIPPINGER, GARY L. CLIPPINGER and
LINWOOD T. CLIPPINGER to be the Executors of this my Last Will and Testament; they are
to serv'e as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys for the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
October, 2003.
day of
Signed, sealed, published and declared by JOSEPH T. CLIPPINGER, the above-named
Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his
presence and in the presence of each other have subscribed our names as witnesses hereto.
A CKNO WLEDGE3IENT AND A FFIDA VIT
WE, JOSEPH T. CLIPPINGER, SHARON L. SCHWALM and MARTHA L.
NOEL, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed the instrument as his Last Will and that he had signed willingly, and
that he executed it as his free and voluntary act for the purpose herein expressed, and that each of
the witnesses, in the presence and hearing of the testator, signed the Will as a witness ~,d that to
the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
.... "---/ i' //.'5:"-~--'7
30S~pH T~CL I~IN GER/'"
SHARON L. SCHW~M
MARIA ~EL
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
Subscribed, sworn to and acknowledged before me by JOSEPH T. CLIPPINGER, the
testator, --- ~ *~ '- -~--
aCn,, ~,LM and ~'Li, RTHA
aha subscribed and sworn to vctote me by SHARON L.
L. NOEL, witnesses, this ~ o" day of October, 2003.
3. tv&-___
i.,'"Not~ry Public
Notarial S~l
Roger B. Irwin, Ncaary Public
Carlisle Boro, Cuml~rland County
My Commission Expires Oct. 3, 201;4
Memt~er, Pennsylvania A,*,scciatlcn of Notaries
OMB NO. 250_~-0265 ~
-ir
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT
SETTLEMENT STATEMENT
B. TYPE OF LOAN:
1.E~FHA 2 E]FmHA 3 [~]CONV. UNINS. 4, I-'IVA
6, FILE NUMBER: 7 LOAN NUMBER:
ZELLC03-04 0134018514
8. MORTGAGE INS CASE NUMBER:
5. E~CONV. INS.
C NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown
Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
10 3/98 (ZELLC03-04 PFDFZELLC03-04114)
E. NAME AND ADDRESS OF SELLER:
D NAME AND ADDRESS OF BORROWER:
CARQN A ZELL
262 GIBSON STREET
CARLISLE, PA 17013
G. PROPERTY LOCATION
147 WEST SOUTH STREET
CARLISLE, PA 17013
CIJMBERLAND County, Pennsylvania
THE EST OF JOS, T. CLIPPINGER
147 WEST SOUTH STREET
CARLISLE, PA 17013
H SETTLEMENT AGENT 25-1894310
Salzmann, Hughes & Fishman, P.C
PLACE OF SETTLEMENT
95 Alexander Spring Road, Ste. 3
Carlisle, PA 17013
F NAME AND ADDRESS OF LENDER:
MEMBERS 1ST FEDERAL CREDIT UNI
PO. BOX 40
MECHANtCSBURG, PA 17055
I. SETTLEMENT DATE:
March 31,2004
J. SUMMARY OF BORROWER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER:
101. Contract Sales Price I 77,800.00
102. Personal Property I
103 Settlement Charges to Borrower (Line 1400) ~ 3,651.12
104.
105.
Adjustments For Items Paid By Seller in advance
106. County/Twp Taxes 03/31/04 to 12/31/04 I 521,83
107. School Taxes 03/31/04 to 07/01/04 i 381.6(
108. Assessments to
109. ~
110.
111
112.
120. GROSS AMOUNT DUP FROM BORROWER i 82,354.55
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER:
1,000.00
201 Deposit or earnest mone~/
202. Principal Amount of New Loan(s)
203 Existin~ Ioanis) taken subject to
204
75~ 175.00
205.
206.
20'7. ,
208.
209
Adjustments For Items Unpaid By Seller
210 CountylTwp. Taxes to
211. School Taxes to ~
212. Assessments to
213 i
214
215
216
217
218
219
220. TOTAL PAID BY/FOR BORROWER
76,175.00
300. CASH AT SETTLEMENT FROM/TO BORROWER:
301 Gross Amount Due From Borrower (Line 120) 82,354.55
302. Less Amount Paid By;For Borrower (Line 220) i( 76,175.0(:
303 CASH( X FROM)( TO)BORROWER
6,179.55
The undersigned hereby acknowledge receipt of a completed copy of pages 1&2
K SUMMARY OF SELLER'S TRANSACTION
400. GROSS AMOUNT DUE TO SI:I ! I:R:
401, Contract Sales Price 77,800,00
402. Personal Property
403.
404.
405
Adjustments For Items Paid By Seller in advance
406 County/Twp, Taxes 03131104 to 12/31t04 521.83
407. School Taxes 03/31/04 to 07/01/04
408. Assessments to
409
410.
411.
412,
420. GROSS AMOUNT DUE TO SELLER
381.60
502
503
504.
505
506
78,703.43
500. REDUCTIONS IN AMOUNT DUE TO SELLER:
501. Excess D,eposit (See Instructions)
Settlement Char~les to Seller (Line 1400)
Existing Joan(s) taken subject to
Payoff of first Mortgage
Payoff of second Mortgage
507 (Deposit disb. as proceeds)
508.
509
Adjustments For Items Unpaid By Seller
510. County/Twp Taxes to
511 School Taxes to
512 Assessments to
513
514
515
516.
517.
518.
519
520. TOTAL REDUCTION AMOUNT DUE SELLER
6,847.17
6,847.17
600. CASH AT SETTLEMENT TO/FROM SELLER:
601 Gross Amount Due To Seller (Line 420) 78,703 43
602. Less Reductions Due Seller (Line 520)
603. CASH ( X TO)( FROM)SELLER
6,847.1 tl
71,85626
Mellon Investor Services
A Mellon Financial Compan>~'''
P.O. Box 3338
South Hackensack, NJ 07606-1938
0003341 01 AT 0.292 **AUTO T6 0 1218 17013-343447 C01 BTHA! -1
I,,,111,,,111,,,,,,11,,11,,,11,,I,,I,,11,,I,,I,1,,11,,,I,,11,1
JOSEPH T CLIPPINGER &
EDNA M CLIPPINGER TEN ENT
147 W SOUTH ST
CARLISLE PA 17013-3434
Shareholder Of:
1218 01 0003341 0012900
Page 1 of 3
HERSHEY FOODS CORPORATION
INVESTOR SERVICES PROGRAM
STATEMENT PRINT DATE: 1 2/17/2003
cusiP: 001-750-42786610
SYMBOL: HSY
ACCOUNT KEY: CLIPPINGEJOSET0300
INVESTOR ID: 125304678542
CHECK THE INVESTOR RELATIONS PAGES OF OUR WEBSITE
(VVVVW.HERSHEYS.COM), FOR ANALYSTS' PRESENTATIONS,
CONFERENCE CALLS WITH THE INVESTMENT COIVIMUNITY, ETC.
ACCOUNT QUESTIONS?? CALL 1-800-851-4216.
Year-To-Date Account Summary
AS OF: 12/16/2003 CASH I
INVESTMENTS I
, TOTAL MARKET V,*~LUE [$) CLOSING PRICE ($} ] ($)
787.76 77.2000
TRADING FEES PAID BY ($} / SERVICE FEES PAID BY ($) SALE OF PLAN SHARES ($}
Current Activity Information
Save this Statement for Tax Purposes
DIVIDENDS
TOTAL ($} I tAX WITHHELD ($) I AMOUNT TO INVEST ($)
14.57 I I 14.57 14.57
NET AMOUNT
iNVESTED ($)
CERTIFICATED SHARES HELD SHARES HELD BY
SHARES HELD10 BY YOUBY 0.2041 PLAN OTHER PLAN(S}
TOTAL
SHARES
10.2041
RECORD
DATE
TRANSACTION DIVIDEND I SHARES ACQUIRED . I CASH TOTAL
INVESTMENT ($) GROSS ($}
PAYABLE DATE DESCRIPTION RATE I OR WITHDRAWN
11/25/2003 COMMON DIV DEND . 0.39500001 0.0517 4.01
12/15/2003
I
TAX TRADING FEES PAID BY ($) SERVICE FEES PAID BY ($) '
WITHHELD ($)I COMPANY SHAREHOLDER CO~IY I ~HOLDER
I
I
Year-To. Date Transaction Detail
i PARTICIPATING RECORD DATE DISTRIBUTION
TOTAL CERTIFICATED SHARES I SHARES HELD I SHARES HELD BY TOTAL
NET ($) HELD BY YOU I BY PLAN I OTHER PLAN(S) SHARES
4,01 , 10 0.1524~ 10.1524
I
DATE TRANSACTION CASH NET TRADING SERVICE AMOUNT PRICE PER SHARES ACQUIRED SHARES HELD
DESCRIPTION INVESTMENT ($) DISTRIBUTION ($) FEES ($) FEES ($) INVESTED ($) SHARE ($) OR WITHDRAWN BY PLAN
BALANCE FORWARD 0,0000
03/14/03 COMMON DIVIDEND 3.28 3,28 63.2540000 0.0519 0.0519
06/13/03 COMMON DIVIDEND 3.29 3.29 72.1000000 0,0456 0.0975
I09/15/03 COMMON DIVIDEND 3.99 3.99 72.6651901 0.0549 0,1524
12/15103 COMMON DIVIDEND 4.01 4.01 77r5800000 0,0517 0.2041
HERSHEY FOODS CORPORATION
CusIP: 001--750--42786610
ACCOUNT KEY: CLIPPINGEJOSET0300
JOSEPH T CLIPPINGER &
EDNA M CLIPPINGER TEN ENT
147 W SOUTH ST
CARLISLE PA 17013--3434
Al or.er(s) must sign and date above
( )
Partial Withdrawal (Continue Plan Participation)
Issue a certificate for this r
number of shares:
Sell this number of shares: [
Full Withdrawal (Terminate Plan Participation)
I--I Issue a certificate for all full shares
' Il and a check for fractional shares.
Sell all plan shares.
Additional Cash Investments
Write the amount enclosed:
Make check payable to:
HERSHEY FOODS/MELLON BANK
YOU MAY INCREASE YOUR SHARES WITH
OPTIONAL CASH INVESTMENTS OF $25
UP TO $250,000 PER YEAR,
Deposit of Certificates
Deposit the enclosed number
of shares:
7575 125304678542 00175042786610CLIPPINGE JOSET0300IR00104
LOOK FOR US. WI~'LL 12il~T YOU THI~R6.
1/23/2004
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE PA 17013-3222
The information which you requested on the account(s) of JOSEPH T CLIPPINGER
(Social Security Number 174-05-1020) is/are as follows:
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
100367432
CHECKING
011702
2225.43
0.00
2225.43
JTO
GARY L
CLIPPINGER
071702
tR g,,'.iN & McKN!GH F
Additional
Information
Requested
ROANLD B CLIPPINGER & LINWOOD CLIPINGER ALSO JOINT
~S in~er~e.!,y,,, _
SENIOR SERVICES REP.
P.O. Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711
Toll Free 1-866-WAYPOINT (I-866-9E~9-7646) · IN YORK AREA 717/815-4500 · www.wa~dpointbank.com
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
~)EPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD 003757
IRWIN ROGER B ESQ
60 W POMFRET ST
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 171-05-1020
FILE NUMBER: 2104-0068
DECEDENT NAME: CLIPPINGER JOSEPH T
'DATE OF PAYMENT: 04/02/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/03/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,492.41
RiEMARKS:
CHECK# 021055
SEAL
TOTAL AMOUNT PAID:
$2,492.41
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Gar L. Cli in er Ronald B. Clippi_ng~_r and Linwood T. Clippin_~er
be;ng duly_ sworn
according to law, deposes and says that they. are the E___~xecutors
late of the Borough of Carlisle of the Estate of Joseph~r
-, Cumberland County, Pa., deceased and that fha
within is an inventory made by the above-named e_p~ppns
----- , the sa~d Executors
of the enHre estate of sa~d decedent, consisting of al~ ~he personal property and real estate, except rea~ estate oufside
the Commonwealth of Pennsylvania, and that the f~gures
as of the date of decedenf's death, opposite each ~fem of the Inventory represent if s fair value
Sworn
this
and subscribed before me,
daY_of April, 2004
Dale of Death
i /~ Roger B. Irwin, Nolm-~ Public
~ C Carli[~ Boro, Cumberland Count~--~
' -, ..... ~aon of No~des
03 0l
Day ~o,~h
"'=-,~"~ · lppinger, Executor--
35/yest North Street~arlisle, Pa 17013
~om Road, Carlisle, PA 17013
2004
INSTRUCTIONS ~.~ ':
I. An inventory must be filed w~fh~n three months after appointment of personal
represenfaHve.=t~·
;' I
2. A supplement ~nvenfory must be filed wifhln fhlrfy days of d~scovery of addlflonal assets. NJ
3. Addiflonal sheets may be attached as fo personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
> Oz<
Z o,-,
~ Z
Inventory of the real and personal estate of
JOSEPH T. CLIPPINGER
deceased
1. 147 West South Street, Carlisle Borough - Sold ...............
2. 10.2041 shares Hershey Foods Corp. - traded on NYSE - Common .......
3. Miscellaneous household goods .......................
77,800
783
908
79,491
00
67
00
67
BUREAU OF ZNDZVZDUAL TAXES
'rNHE:RZTANCE TAX DTv'rSTON
DEPT. 280601
HARRXSBURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOT'rCE OF /NHER'rTANCE TAX
APPRA/SENENT, ALLOWANCE OR D'rSALLONANCE
OF DEDUCT'rONS AND ASSESSNENT OF TAX
REV-1647 EX AFP
ROGER B IRWIN ESQ
IRWIN B HCKNIGHT
60 W POHFRET ST
CARLISLE
DATE 05-Z4-ZO04
ESTATE OF CLZPPINGER JOSEPH T
DATE OF DEATH 01-05-Z004
FILE NUHBER Z1 04-0068
COUNTY CUHBERLAND
ACN 101
PA
Amoun'l: Remi'l:'ted
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~
REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF CLIPPINGER JOSEPH T FILE NO. 21 04-0068 ACN 101 DATE 05-24-2004
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~narship /n~eres~ (Schedule C) ($)
~. Not,gages/No,as Receivable (Schedule D) (~)
5. Cash/Bank Daposi~s/Hisc. Personal Propar~y (Schedule E) (5)
6. Jointly Ovnad Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Assa~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9).
10. Debts/Hot,gage Liabilities/Liens (Schedule 'r) (10)
11. To~al Deductions
12. Ne~ Value of Tax Re~urn
77z800.00
785 67
O0
O0
908 O0
556 56
O0
(8)
16,567.64
NOTE: To insure proper
credi~ ~o your account,
submi~ ~he upper portion
of ~his fora ,i~h your
~ax payment.
15.
1~.
NOTE:
80,048.05
ANOUNT PA'rD
2,492.41
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
reflect flgures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Aaoun~ of Line 1~ a~ Spousal ra~a (15) . O0 X O0 =
16. Amount of Line lI taxable at Lineal/Class A rala (16) 58,501.91 X 045 =
17. Amoun~ of Line lq a~ Sibling ra~a (17) . O0 X 1Z =
18. Aaount of Line 1~ taxable et Collateral/Class B rata (18) . O0 X 15 =
19. Principal Tax Due (19)=
TAX CREDZTS:
PAYHENT RECETpT DT$COUNT
DATE NUHBER TNTEREST/PEN pA'rD (-)
04-02-2004 CD005757 151.18
.00
.00
2,625.59
.00
.00
2,625.59
IF PAID AFTER DATE 'rND'rCATED, SEE REVERSE
FOR CALCULAT'rON OF ADD'rT'rONAL /NTEREST.
2,62:5.59
.00
.00
.00
TOTAL DUE 'rS LESS THAN $1, NO PAYNENT TS REI)U'rRED.
TOTAL DUE 'rS REFLECTED AS A "CRED'rT" (CR), YOU HAY BE DUE
REFUND. SEE REVERSE S'rDE OF TH'rS FORN FOR 'rNSTRUCT'rONS. )
Cheri*able/Governaen~al Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Ne~ VaXue of Es~B~B Sub~mc~ ~o Tax (1~) 58, $01.91
[f an assessment #as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill
5~578.48
(11} 21.746.12
(12) 58,501.91
RESERVATION:
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 19BI -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (cotlataraZ) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Not[ce and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF #ILLS, AGENT
A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax'* (REV-1315). Applications ara available at the Office
of the Register of Mills, any of the ES Revenue District Offices, or by calling the special Z4-hour
ansaering service for forms ordering: 1-800-36Z-ZOSO~ services for taxpayers with special hearing and / or
speaking needs: 1-BOO-447-30ZO (TT only).
Any party in interest not satisfied aith the appraisement, alloaanca, or disallowance of deductions, or assessment
of tax (including discount ar interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZI, Harrisburg, PA 171Z8-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. ZB0601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lEO1) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15X tax amnesty non-participation penaltY is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the data of payment. Taxes ahich became delinquent before January l, 198Z bear interest at the rate of
six (6g) percent per annum calculated at a daily rate of .009164. All taxes which became delinquent on and after
January l, 19BI will bear interest at a rate which mill vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 ~8-1991 llZ .OOOSOl ~ 9X .000247
1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6Z .ooo164
1984 llg .000301 1993-1994 7Z .O0019Z ZOO3 5X .000137
1985 13X .000556 1995-1998 9Z .000Z47 2004 4Z .OOOllO
1986 IOZ .000Z74 1999 7X .O0019Z
1987 XOZ .000Z74 ZOO0 7Z .00019Z
--Interest is calculated es follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown an the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
JOSEPH T. CLIPPINGER
Date of Death:
cA.
No. 21-~0068
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:
JANUARY 3. 2003
1. State whether administration of the estate is complete: ~ Yes _ 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.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X No
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? X Yes No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of Orphan's Court and may be
attached to this report.
Date:
12/0712005
/V4J~ '5. &t-
Signature
IRWIN & Mc IGHT
Roger B. Irwin. Esquire
Name (please type or print)
60 West Pomfret Street
Address
Carlisle. P A 17013
City, State, Zip
(717) 249-2353
Telephone Number
! ,
(
X
Personal Representative
Counsel for Personal Representative
Capacity:
~t'
Cumberland County - Register Of Wills
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 12/06/2005
IRWIN ROGER B ESQ
60 W POMFRET ST
CARLISLEI PA 17013
RE: Estate of CLIPPINGER JOSEPH T
File Number: 2004-00068
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 I NO.
103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
1/03/2006
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYI
~JI, ,Sz::;'IU1 ~~kJ
~a<A:._ t'~.r{.-Vt>';'''''''''_ ....,.....,..-............0-
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
'~t