HomeMy WebLinkAbout04-0131PETITION FOR PROBATE and GRANT OF LETTERS
also known as To:
Register of Wills for the
County of
in the
~ Deceased.
Social Security No. _ /?c~" /'~ -- ~e'~ 7 y
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/~a,r~, 18 years of age 9.r older an the execut.& Ir'
in the last wilt of the above decedent, dated
and_p,.odicil(s) dated _ ,
Commonwealth of Pennsylv'ania
named
,19~-' ~,/
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cu. ~ ~ ~v, ~i ~,t~... County, Pennsvlvania, with
h~~st family or principal residence at
(list street, number and muncipality)
De.c0ndent~ then __~__~ _~ years of age, died
Except as follows, decedent did not marry, was ~ot divot -- '
ced 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:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania ,.____
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3
COUNTY OF f 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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administerAlte estate according to law.
.... 77:
bS~f~rr~ mtO .,o.r aff..ir~,m~r~, and subscribed ~:::~:~~:-~~~
~ e tins !(: day o~ ...... ~ ~.
No.._~I-~/-/-/~ /
Estate Of ~~s V: ~'~\o~ ~3~- , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
and Letters ~
are hereby granted to
,)1~'~, in consideration of the petitionon
FEES
Probate, Letters, Etc .......... '~
Sl~Ort Certificates(~) ..........
Renunciation ................ $
TOTAL ~
Filed ...F..~..~¥...U.~. :~ ~ ......
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9 9 6 1 4 2 4 JAN .P, 2 2004
Local Registrar ...r//'
No. Date
H105.143 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
I NAME OF DECEDENT ,Firs'. Mi~Jdle. LaI', ' [SEX [ SOCIAL SECURIT;T~EM~NUMBER I [:~ATE.OF DF-ATH (Morllfa. Day. Year)
1 James M Blood Jr I Male I 178 16 4274 I
i~AGE(LastBkthday) UNDERIYEAR I UNDERI[;)~y I DATE OF BIRTH BRTHPLACE Ci~---'L:. .......... Jr'.__ . . I .
~.b. Cumberland I.. ast Pennsboro I.. ' ' 1,0
ofe~i.'~{ ~I~.. O..--k~--l----J I U.S.~MEDFORCES?I ~°~N~estFa~l~d I Nev~Mam~,~, I
~1,. ~upe~v[so~ I"~ ~m7 Depot hz ~ "-~ 113 9 (~2) o-,~,) I ~[do~ed I
' I"- I · I~4' I
DECEitS MAI~I~ A~RESS (S~, Citron. Slate. Zip ~e} I DECE~N~S
]0l Plain St . [ACTUAL t7a. Smte PA md 17c. ~ Yes,~nigv~in East Pennsboro
RESI~NCE ~nl
Su~erdale, PA 17093 I(~,~,~ Cumberland
lS. [ ~ m~r ~) 1lb. ~y l~ns~p? 17~. ~ No. ~nt ~
~. James M. Blood Sr. ~,. Paulzne Jones
INFOR~NUS NAME {Ty~l} ] INFORmerS ~Lt~ ~$S (St~. Cily~ St{~. ~}
~,. Richard J. Blood [,~. ~uu riaxn St. Sum•errata ~a 17095
~,,. ~(s~) ~,~. I/24/2004 [z,~.Woodlawn Memorial Garden{~ Lower Paxton ~p. 17109
2~-~~~ .~~ 12~. DOI2774-L 22c. Richardson F.H. 29S.Enola D~.EnolaPAI7025
Ill 24-~ mull ~ ~( ' · ' '
.... ~ I TIME~F D~T~ I DATE PR~OUNCED D~D (Mo~ Day Year) I WAS CASE REFERRED TO A MEDICAL E~MINER ~ORONER?
IMMEDIATE CAUSE (Final
~luv/ / c.
) LAST d.
* interval be4w~ rmt resulting in the underF/ing cause given in PART I
:
:
DATE OF INJURY TIME OF INJURY
m,0,. ,ob.__ NoD
PLACEOF N~URY-A home fa~
~30e. .
LICENSE NUMBER DATE SIGNED (M~th Day, Year)
3~c. O
~ME A,D A~ESS OF PERSON ~O CO~ETED CA~E OF DEATH
{ll~ 27) Ty~ ~ Print
3z ~'~/
DATE F~D (M~. D~. Year)
WAS AN AUTOPSY I W~RE AUTOPSY FINDINGS I MANNER OF DEATH
PERFORMED? AVAILABLE PRIOR TO
I COMPLETION OF CAUSE I NaturalL~ Homicide
__]OF DEATH? IAccident[] Pa•ling Invesligatio~
2da. ! 2.,.
CERTIFIER (Clmck only o~e)
'~o°~"9 ~uEc. t_"~ ^"2_c~"?~."o P.YS,Cl^,
u,. u~t e! my ire•cage, leith occurred at the time, date, and place, and riue to the caule~(i) and manner al stated ...................... []
*MEDICAL EXAMINER/CORONER
On the balls of examination end/or Inveitigatlo.'l, In my opinion death occurlld at the time, date, arid place, and due to the caulel(I) and
manner al stated ........................................................................................ ~ ................................................................... []
of
JAMES M. BLOOD, JR.
I, JAMES M. BLOOD, JR., of East Pennsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as and for my last Will and Testament, hereby revoking
and making void any and all wills or codicils at any time heretofore made by me.
ARTICLE L
I direct payment of all my just debts and the expenses of my last illness and
funeral from my estate as soon after my death as conveniently may be done. I
authorize my Executrix to expend funds from my estate for the purchase, erection and
inscription of a suitable grave marker. Ail the foregoing shall be considered expenses
of the administration of my estate.
ARTICLE H.
I devise and bequeath all the rest, residue and remainder of my estate, of
whatever nature and wherever situate, unto my wife, SYLVIA A. BLOOD, provided
that she survives me by a period of thirty (30) days.
ARTICLE HI.
Should my wife, SYLVIA A. BLOOD, predecease me or die on or before the
thirtieth (30th) day following my death, I direct the following:
A. I give and bequeath the sum of Five Hundred ($500) Dollars unto the
Summerdale United Methodist Church.
B. Ail the rest, residue and remainder of my Estate of whatever nature
and wherever situate, I give, devise and bequeath unto my son, RICHARD J. BLOOD,
Carlisle, Pennsylvania.
ARTICLE 1~.
I nominate and appoint my wife, SYLVIA A. BLOOD, Executrix of this my Last
Will. Should my wife, SYLVIA A. BLOOD, fail to qualify or cease to act as Executrix,
I nominate and appoint my son, RICHARD J. BLOOD, Executor of this my Last Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the
day of /~_,~ , 1984.
(SEAL)
Signed, sealed, published and declared by 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 hereunto subscribed our names as witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
; SS;
COUNTY OF CUMBERLAND :
I, JAMES M. BLOOD, JR., whose name is signed to the foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes therein expressed.
.... James M. Bloodt Jr.
Sworn or affirmed to and acknowledged before me, by JAMES M. BLOOD, JR.,
this //~ day of ~/~ , 1984.
~ Notary P~blic
OTARY PUBLIC
MY COMMISSION EXPIR[S ll]~l: 16, 198~
LEMOY~[, PA Ctli~B'~Rt~!l~ C9~J~TY
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
the witnesses whose names are signed to the foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw the Testator sign
and execute the foregoing instrument as his Last Will and Testament; that he signed
willingly and that he executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testator signed the Will
as witnesses; 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 or affirmed to and subscribed to before me by
and /:Z~, ~./)/.?~,-~c , witnesses, this /~"~/day of
OF
JAMES M. BLOOD, JR.
MYERS, MYERS, FLOWER & JOHNSON
ATTORNEYS AT LAW
LEMOYN E, PENNSYLVANIA
CARLISLE:, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Admin. No.:
To the Register:
James M. Blood, Jr., deceased
January 20, 2004
2004-00131 and 21-04-0131
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
the following beneficiaries of the above-captioned estate:
Name
Richard J. Blood
Summerdale United
Methodist Church
Address Date
100 Plain Street
P.O. Box 191
Summerdale, PA 17093
2/17/04
101 Plain Street
203 Second Street
Summerdale, PA 17093
2/17/04
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) .
Date: o~2y/~l/~ fi'~
Name
Gregory R. Reed
Vd "oD PUelmqumo
Address 3120 Parkview Lane
Harrisburq, PA 17112
gZ:Zla Bt B3J ~.
Telephone (717) 238-0434
X
Counsel for personal
representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003833
BLOOD RICHARD J
100 PLAIN STREET
SUMMERDALE, PA
17093
........ fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
ESTATE INFORMATION: SSN.. 178-16-4274
FILE NUMBER: 2104-0131
DECEDENT NAME: BLOOD JAMES M JR
DATE OF PAYMENT: 04/16/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/20/2004
101 I $9,400.00
'
REMARKS:
SEAL
CHECK#340
TOTAL AMOUNT PAID:
$9,400.00
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
-DEPT. 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003987
BLOOD RICHARD J
100 PLAIN STREET
SUMMERDALE, PA
17093
........ fold
ESTATE INFORMATION: SSN: 178-16-4274
FILE NUMBER: 2104-01 31
DECEDENT NAME: BLOOD JAMES M JR
DATE OF PAYMENT: 05/28/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/20/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $262.26
TOTAL AMOUNT PAID:
9262.26
REMARKS: J M BLOOD JR
SEAL
CHECK#344
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
'~.~.,~~ HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 _ 04 0131
COUNTY CODE YEAR NUMBER
I--
Z
UJ
UJ
UJ
~..
Z
Q
Z
O
{3.
(/3
UJ
n,
O
Z
UJ
n~
Z
0
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Blood James M. Jr.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
01/20/04
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
r~l. odginal Return
r-j4. Limited Estate
~']6. Decedent Died Testate (A,ach co~ o~Wa)
r'--~ 9. Litigation Proceeds Received
[~2. Supplemental Return
E~4a. Future Interest Compromise (date el'death alte," 12-12,82)
---I. Decedent Maintained a Living Trusl (^~tach cow
[]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
SOCIAL SECURITY NUMBER
178-16-4274
THIS RETURN MUST BE FILED IN DUPLICATE WITH
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
'--]3. Remainder Return (date of death prier to 12-13-82)
r-15. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
r-"~ 11. Election to tax under Sec. 9113(A) (~ch S(
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED '
NAME
Gregory R. Reed, Esquire
FIRM NAME
TELEPHONE NUMBER
(717) 238-0434
COMPLETE MAILING ADDRESS
3120 Parkview Lane
Harrisburg, PA 171 11
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
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 1) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
85,000.00
137,373.98
27,282.23
(8)
23,994.71
(11)
(12)
(13)
(14)
249,656.1q
23,994.W
225,661.4{
500.O0
225,161.4~
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount oi' Line 14 taxable at the spousal rix
rate, or frans[ers under Sec. 9t16 (a)(1.2) x .0 ___ (15)
16. Amount of Line 14 taxable at lineal rate .......................... _2-_25, ~1.6_1...._48._ x .0 4__5__ (16)
10,132.2f,'
17. Amount of Line 14 taxable at sibling rate ................................... x .12 (17)
18. Amount of Line 14 taxabte atcollatera~ rate ............................ x .15 (18)
19. Tax Due (19)
10,132.2~.
-,, '-., ~; ~:~l~,~: Tn AlU~Wi::I~ Al I (311F.~TIONS ON REVERSE SIDE AND RECHECK MATH < <
101 Plain Street
I
l c;~Ysummerdale
i zi~
17093
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
STATE
PA
(~)
Interesf~Penally if applicable
D. Interest
E. Penalty
9,400,00
470.00
Total Credits (A + 8 + C ) (2)
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
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. (5)
~ A. Enter the internal on the tax due. (SA}
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
9,87¢~
26~[~,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the properly transferred; ......................................................................................... [] []
b. retain the right to designate who shall use the propeily transferred or its income; ............................................ [] []
c. retain a reversionary interest; or ........................................................................................................................ [] []
d. receive the promise for life o[ either payments, benefits or care? ...................................................................... [] []
2. If death occurred al~er December 12. 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust for' o¢ payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Relirement Account, 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 FILE IT AS PART OF THE RETUI:
Under l~-~a/§es o/pezju~, I ~ thai I have e,~.[~.ed Ibis relurn, indu(~ng -,.,~,¢anying sC, edules and statements, and to Ihe best of my knowledge and belief, it is true, correc/and complete.
Oedaratioe o¢ prepare' o~ tba~ ~e ~rso,.'bfl represe~at~ is based on ~1 Jdo~atim of which p~eparer has any km~,.,4edge.
SIGNATURE OF P~ER4cSC>N4:~E~ONSIBLE FOR FJ[4NG RETURN
DATE
ADDRESS
SIGNATURE OF PREPARER-~THER ~HAN'REC~RES~NTATiVE ----
ADDRESS
DATE
For dates o[ death on or after July 1, 1994 and be[ore January t, T995, the tax rate imposed on the Pet vaiue of transfers to or [or the use of the surviving spouse is 3%
[72 F.S. §9116 (a) (1.1) (i)]..
For dates of death on or a/let January 1, 3995, the tax rate imposed on the net value of transfers to or .~or [,he use o[ the surviving spouse is 0% [72 P.S. §9116 (a) (1.t
The statute does not exempt a transfer Io a surviving .spouse from lax, and the sta~,utor:/ requiremems for disclosure of assets and fling a tax return are still applicab;e e'
the surviving spouse is the only beneiiciary.
For dates of death on or after .July 1, 2000:
The lax rate imposed on the net value of transfers from a d~eesed child r, venty-one years of a§e or younger at death to or ,~or the use of a natural Detent an adoptive p;
or a s!epparent of the chile is 0% ~2 P.S. §9116(a)(1.2)]. , ·
The tax rate imposed on the net value of transfers lo c,,' for ¢',e use of the decedent's lineal beneficiaries s 4.5%, except as noted in 72 P.S. §9 ~ i 6(1.2) [72 P.S. §9116(a)(1)}.
The ~:ax rate imposed on the net value of I:ransfers to or for ~,e u~ DJ [he decede~t's siblings is 12% [72 P.S. §9116(a)(1.3}]. A sJb!in9 is defined, under Sec!ion 9~02, ~
n,di~..irh I21 whn h2~; 2,t I~.a.ql r,.np, n;~ranl in common ~,eth the decedent., whether by b!ood or ados~ion.
SCHEDULE "A"
REAL ESTATE
ESTATE OF:
James M. Blood, Jr.
FILE NO. 21-04-0131
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
ALL THAT CERTAIN tract or parcel of land with
the buildings and improvements thereon erected situate
in East Pennsboro Township, Cumberland County,
Pennsylvania, more particularly bounded and described
as follows, to wit:
BEGINNING at a point at the northwesterly comer of Park
Avenue and Plain Street; thence along the northerly line of
Park Avenue, south 72 degrees 05 minutes west, 84.30 feet
to a point on the easterly line of a 12 feet wide ordained
alley; thence along same north 19 degrees 50 minutes west,
44.55 feet to a point at dividing line between Lots Nos. 3
and 4 on the hereinafter mentioned Plan of Lots; thence
along said dividing line north 70 degrees 10 minute east,
84.25 feet to a point on the westerly line of Plain Street;
thence along same south 19 degrees 50 minutes east, 47.36
feet to a point, the place of beginning.
BEING Lot No. 3 in Plan of Lots laid out by Maurice W.
Lightner, and being formerly known as No. 1 Plain Street
but now known as 101 Plain Street
(See copy of Tax Assessment Database attached hereto,
marked Exhibit "1 .")
Assessed value 61,590 x 1.05 (common level radio = $64,669.50
However, a more accurate fair market value is $85,000.00.
TOTAL SCHEDULE "A" $ 85,000.00
SCHEDULE "H"
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
ESTATE OF:
JAMES M. B.LOOD, JR.
FILE NO. 21-04-0131
ITEM
NUMBER
DESCRIPTION
Funeral Expenses:
1. Richardson Funeral Home, Enola, PA
VALUE AT DATE
OF DEATH
$ 2,960.00
Bo
Administrative Costs:
Personal Representative's Commissions
o
o
o
Attorney Fees
Filing fees - Register of Wills
The Valley Times
and Cumberland County Law Journal (Advertise Letters)
Commonwealth of Pennsylvania
(Honda Title Transfer; Honda plate and Title; Saturn
Title Transfer)
Boreman & Babb, CPA
(Income Tax Preparation 2003)
Internal Revenue Service
(2003 income taxes)
6,500.00
272.00
85.00
107.00
140.00
462.00
10.
11.
12.
13.
SCHEDULE "H"
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Page 2
PA Federal Credit Union
Final payment for VISA
Credit Card #4109-7300-0006-0818
Nationalwide Insurance
Final payment for Car Insurance
Pennsylvania Power & Light
(Final Electric Bill)
Comcast
(Final TV Cable Bill)
Verizon
(Final Bill)
AT&T (Final Bill)
$ 3,296.98
213.76
123.73
121.51
116.02
21.96
14.
15.
16.
17.
18.
19.
20..
Shipley Oil
(Final Bill)
Verizon Wireless
(Final Bill)
Pennsylvania/American Water
(Final Bill)
Enola Borough - Garbage/Sewer (Final Bill)
Alicia Stine Tax Collector
(2004 Bough/County Taxes)
Nationwide Mutual Fire Insurance
(HomeOwners Insurance)
Payoff of 2001 Honda Civic
258.00
60.21
36.63
201.60
199.55
309.00
8,509.76
TOTAL SCHDULE "H" $ 23,994.71
SCHEDULE "E"
CASH, BANK DEPOSITS AND
ISCELLANEOUS
PERSONAL PROPERTY
ESTATE OF:
FILE NO. 21-04-0131
James M. Blood, Jr.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
New Cumberland Federal Credit Union
Account # 1085
Savings
Checking
Xmas
Vacation
24,800.27
2,877.08
482.40
1,633.87
(See copy of letter dated February 19, 2004
from NCFCU attached hereto, marked
Exhibit "2" and incorporated herein by reference)
American Express
Account # 01051762504 1 002
Account # 01151762504 9 002
Account # 01231762504 9 002
(See copy of letter dated February 25, 2004
From American Express attached hereto, marked
Exhibit "3" and incorporated herein by reference)
PNC Bank
Account #5130110024
(See copy of letter dated April 12, 2004 from
PNC Bank attached hereto, marked Exhibit "4"
and incorporated herein by reference).
33,822.64
24,267.58
19,013.54
307.00
SCHEDULE "E"
CASH, BANK DEPOSITS AND
ISCELLANEOUS
PERSONAL PROPERTY
ESTATE OF:
James M. Blood, Jr.
ITEM
NUMBER DESCRIPTION
FILE NO. 21-04-0131
VALUE AT DATE
OF DEATH
o
o
71 U.S. Savings Bonds
Series E and EE
(See copy of Savings Bonds listed by
serial number and issue date from the
U.S. treasury web cite, marked Exhibit "5"
and incorporated herein by reference)
1995 Saturn SL2 - mileage 42,600
Traded In
2001 Honda Civic - mileage 25,700
$ 19,669.58
1,500.00
9,000.00
TOTAL SCHEDULE "E" $137,373.96
SCHEDULE "F"
JOINTLY-OWNED PROPERTY
ESTATE OF:
James M. Blood, Jr.
FILE NO. 21-04-131
A. Richard J. Blood
100 Plain Street
Summerdale PA
son
JOINTLY-OWNED PROPERTY:
Item Date made Description
Number Joint
1. A. 09/08/1968
Pennsylvania Central
Federal Credit Union
Acct #14698-010
Shares:
Checking:
Christmas Club
Vacation Club
(See a copy of Pennsylvania Central Credit
Union letter dated Feb. 18, 2004 attached
hereto marked, Exhibit "6" and incorporated
herein by reference.)
Date of Death % of Date of Death
Value Asset Decd's Value of
Interest Interest
$ 30,588.39 50o/0
21,027.99 50%
178.67 50%
2,769.38 50%
$15,294.20
10,514.00
89.34
1,384.69
TOTAL SCHEDULE "F" $ 27,282.23
SCHEDULE "J"
BENEFICIARIES
ESTATE OF:
James M. Blood, Jr.
ITEM
NUMBER
NAME AND ADDRESS
OF BENEFICIARY
A. Taxable Bequests:
Richard J. Blood
100 Plain Street
Summerdale, PA
FILE NO.
RELATIONSHIP
Son
21-04-0131
AMOUNT OR
SHARE OF
ESTATE
100% residue
B. Charitable and Governmental Bequests:
Summerdale United Methodist Church
203 Second Street
Summerdale, PA 17093
$500.00
Page 1 of 1
Detailed Results for Parcel 09-12-2995-086. in the 2000 Tax Assessment Database
DistrictNo 9
Parcel II) 09-12-2995-086.
MapSuffix
HouseNo 101
Direction
Street PLAIN STREET
Ownerl BLOOD, JAMES M & SYLVIA
Owner2
PropType R
PropDesc & PARK AVE
LivArea 780
CurLandVal 14000
CurlmpVal 47590
CurTotVal ! 61590
CurPrefVal
Acreage 0.09
CIGrnStat
TaxEx 1
SaleAmt
SaleMo
: SaleDa
SaleCe
SaleYr
DeedBkPage
YearBIt 1920
HF File Date
HF_Approval_Status
EXHIBIT "1"
· New Cumberland Federal Credit Union
P.O. Box 658 New· Cumberland, PA 17070,0658
Phone: (717) 774-7706 · 1-800-716-2328 · Fax: (717) 774-7996 · Web: www. ncfcuonlin~.org
February 19, 2004
Gregory R. Reed
3120 Parkview Lane
Harrisburg, Pa 17111
Dear Gregory,
NAME
James M. Blood, Jr. Deceased
ACCOUNT NUMBER
1085
BALANCE AT TIME OF DEATH $24,800.27
(INCLUDING ACCRUED INTEREST)
TYPE OF ACCOUNT savings
ACCRUED INTEREST
JOINT OWNER
$2,877.08 $482.40 $1,633.87
checking Xmas vacation
included in above figures
Sylvia A. Blood
DATE JOINT OWNERSHIP ESTABLISHED March 5, 1963. Also t~e date
that the account was opened.
P.S.
Please send a death certificate so that the insurance claim
can be processed.
Sincerely
/
Crai~ $oulliard
Exhibit "2"
®1
February 25, 2004
Joseph L Baird, CPA
Financial Advisor
Attorney Gregory R. Reed
3120 Parkview Lane
Harrisburg, PA 17111
Re:
James M. Blood, Jr., Deceased
SSN # 178-16-.4274
Mr. James Blood, Jr. held three accounts with American Express.
accounts.
American Express
Financial Advisors Inc.
IDS Life Insurance Company
Suite 100
116 Cocoa Avenue
Hershey, PA 17033
Bus: 717.534.9980
Fax: 717.520.9780
Bus: 888.995.4223
jbaird@epix.net
All three were non-qualified
The values indicated are as of his date of death, January 20, 2004.
Mutual Funds
Account Number
01051762504 1 002
01151762504 9 002
01231762504 9 002
Total Value # ofshares Asset Value/Share
$33822.64 3861.168 8.740
$24267.58 5352.158 4.520
$19013.54 2889.595 6.580
All three accounts had a beneficiary assigned to them, Mr. Richard Blood, son 100%.
The accounts are in process of being transferred to Mr. Richard Blood.
Advise if there are further questions.
Sincerely,
~x.~cial Advisor
Cc: file/cpm
Exhibit "3"
American Express Financial
Advisors Inc. Member NASD.
An AEFA associated financial
advisor franchise. Insurance and
annuities are issued by IDS
Life Insurance Company, an
American Express company.
American Express Company is
separate from American Express
Financial Advisors Inc and
is not a broker-dealer.
~PR-12-2004 22:17
412 968 3458
P.01/01
PNCBAN<
April 12, 2004
Gregory R. Reed
3120 Parkview Lane
Harrisburg, PA 17111
Estate of lames M. Blood, deceased
SSN: 178-164274
DOD: 1/20/2004
Dear Mr. Reed:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Savings Account
Account #5130110024
JAMES M BLOOD, JR.
SYLVIA A BLOOD
DOD balance: $306.96 + $.04 accrued interest
Established 05/01/1978
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts), We do not process any fl-.nchd
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1488-762-2265) or stop by your local PHC Bank branch
office. ·
S~lcerely~
Rachelle Wells
1-800-762-1775
PT-PF$C-04-F
500 first Aw.
Pittsburgh PA 15219
Member FDIC
Exhibit "4"
TOTAL P.01
Savings Bond Calculator Page I of 2
~ Savinc
01/2004 Up date Help
Series Denomination
EE Bonds $1,000
Serial Number Issue Date
# Bonds Total Price Total Interest Total Value YTD lw
71 $7,106.25 $12,593.33 $19,699.58 $291.
Issue Issue Interest Next Final
Serial Number Date Series Dehorn Price Interest Value Rate Accrual Maturit;.
M28905096EE 01/1989 EE $1,000 $500.00 $644.80 $1,144.80 4.00% 07/2004 01/201!
M28905095EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905094EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905099EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905098EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905097EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/200401/201!
M28905102EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905100EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/200401/201!
M28905101EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/200401/201!
M28905105EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905104EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
M28905103EE 01/1989 EE 1,000 500.00 644.80 1,144.80 4.00% 07/2004 01/201!
Q6169911043E 04/1977 E 25 18.75 101.42 120.17 4.00% 04/2004 04/200'
Q6155575839E 04/1977 E 25 18.75 101.42 120.17 4.00% 04/2004 04/200'
Q6155574619E 04/1977 E 25 18.75 101.42 120.17 4.00% 04/2004 04/200'
Q6169914692E 06/1977 E 25 18.75 102.86 121.61 4.00% 06/2004 06/200'
Q6169913441E 05/1977 E 25 18.75 102.61 121.36 4.00% 05/2004 05/200'
Q6169912246E 05/1977 E 25 18.75 102.61 121.36 4.00% 05/2004 05/200'
Q6182941395E 07/1977 E 25 18.75 102.84 121.59 4.00% 07/2004 07/200'
Q6182940179E 07/1977 E 25 18.75 102.84 121.59 4.00% 07/2004 07/200'
Q6182940179E 07/1977 E 25 18.75 102.84 121.59 4.00% 07/2004 07/200'
Q6182938910E 06/1977 E 25 18.75 102.86 121.61 4.00% 06/2004 06/200'
Q6191487158E 01/1977 E 25 18.75 103.82 122.57 4.00% 07/2004 01/200'
Q6191485898E 08/1977 E 25 18.75 100.46 119.21 4.00% 02/2004 08/200'
Q6182942655E 08/1977 E 25 18.75 100.46 119.21 4.00% 02/2004 08/200'
Q6204166759E 10/1977 E 25 18.75 100.46 119.21 4.00% 04/2004 10/200'
Q6191489557E 10/1977 E 25 18.75 100.46 119.21 4.00% 04/2004 10/200'
Q6191488357E 09/1977 E 25 18.75 100.46 119.21 4.00% 03/2004 09/200'
Q6204170446E 11/1977 E 25 18.75 90.58 109.33 4.00% 05/2004 11/200'
Q06204169211E 11/1977 E 25 18.75 90.58 109.33 4.00% 05/2004 ll/20ff
Q6204168016E 10/1977 E 25 18.75 100.46 119.21 4.00% 04/2004 10/200'
Q6223564259E 01/1978 E 25 18.75 90.88 109.63 4.00% 07/2004 01/200~
Q6223561813E 12/1977 E 25 18.75 90.88 109.63 4.00% 06/2004 12/200'
Q6223560616E 12/1977 E 25 18.75 90.88 109.63 4.00% 06/2004 12/200'
Q6232506268E 02/1978 E 25 18.75 88.73 107.48 4.00% 02/2004 02/2001
Q6232506268E 02/1978 E 25 18.75 88.73 107.48 4.00% 02/2004 02/2001
Q6232507452E 02/1978 E 25 18.75 88.73 107.48 4.00% 02/2004 02/200~
Q6223563044E 01/1978 E 25 18.75 90.88 109.63 4.00% 07/2004 01/2001
Q6245592470E 04/1978 E 25 18.75 75.01 93.76 2.51% 04/2004 04/2001
Q6232508623E 03/1978 E 25 18.75 75.01 93.76 2.51% 03/2004 03/2001
http://wwws.publicdebt.treas.gov/BC/SBCPrice
Exhibit "5"
4/13/2004
Savings Bond Calculator Page 2 of 2
Q6232509841E 03/1978 E
Q6245594870E 06/1978 E
Q6245590172E 04/1978 E
Q6245591350E 04/1978 E
Q6270801063£ 06/1978 E
Q6270802254E 06/1978 E
Q6245593660E 05/1978 E
Q6286431076E 08/1978 E
Q6270803421E 07/1978 E
Q6270804584E 07/1978 E
Q6286433487E 09/1978 E
Q6286434715E 09/1978 E
Q6279345858E 08/1978 E
Q6201485010E 10/1978 E
Q6291477138E 10/1978 E
Q6291805059E 01/1979 E
Q6291478334E 11/1978 E
Q6291479505E 12/1978 E
Q6291806220E 01/1979 E
Q6291807434E 01/1979 E
Q6291803820E 12/1978 E
Q6312149031E 03/t979 E
Q6312146662E 02/1979 E
Q6312145511E 02/1979 E
Q6326666281E 04/1979 E
Q6312147864E 03/1979 E
Q6326665122E 04/1979 E
Q6390363552E 02/1980 E
Q6326667409E 04/1979 E
Q6326667409E 05/1979 E
Q6390364824E 03/1980 E
iView 10 I Viewing Bonds 1-71
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
18.75 75.01 93.76 2.51%
18.75 70.73 89.48 4.00%
18.75 75.01 93.76 2.51%
18.75 75.01 93.76 2.51%
18.75 70.73 89.48 4.00%
18.75 70.73 89.48 4.00%
18.75 70.51 89.26 4.00%
18.75 69.00 87.75 4.00%
18.75 70.76 89.51 4.00%
18.75 70.76 89.51 4.00%
18.75 69.00 87.75 4.00%
18.75 69.00 87.75 4.00%
18.75 69.00 87.75 4.00%
18.75 69.00 87.75 4.00%
18.75 69.00 87.75 4.00%
18.75 70.08 88.83 4.00%
18.75 69.83 88.58 4.00%
18.75 70.07 88.82 4.00%
18.75 70.08 88.83 4.00%
18.75 70.08 88.83 4.00%
18.75 70.07 88.82 4.00%
18.75 68.34 87.09 4.00%
18.75 68.34 87.09 4.00%
18.75 68.34 87.09 4.00%
18.75 68.34 87.09 4.00%
18.75 68.34 87.09 4.00%
18.75 68.34 87.09 4.00%
18.75 66.76 85.51 4.00%
18.75 68.34 87.09 4.00%
18.75 69.18 87.93 4.00%
18.75 66.76 85.51 4.00%
Please rate this service.
(Please print and/or save this page before submitting your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator i
Submit Survey , I Reset I
03/2004 03/2001
06/2004 06/200~
04/2004 04/200~
04/2004 04/2001
06/2004 06/2001
06/2004 06/2001
05/2004 05/2001
02/2004 08/2001
07/2004 07/200~
07/2004 07/2001
03/2004 09/2001
03/2004 09/200~
02/2004 08/200~
04/2004 10/200~
04/2004 10/2001
07/2004 01/200!
05/2004 11/2001
06/2004 12/200~
07/2004 01/200!
07/2004 01/200!
06/2004 12/2001
03/2004 03/200!
02/2004 02/200!
02/2004 02/200!
04/2004 04/200!
03/2004 03/200!
04/2004 04/200!
02/2004 02/2011
04/2004 04/200!
05/2004 05/200!
03/2004 03/201{
http://wwws.publicdebt.treas.gov/BC/SBCPrice 4/13/2004
I
FEDERAL CREDIT UNION
Serving Members since 1938
www. pacentralfcu.com
email Pacenfcu@aol.com
Main - 959 East Park Drive
Harrisburg, PA 17111
Branch - 25 West Main St.
Shiremanstown, PA 17011
717-564-4661 or 800-356-3875
fax 71%564-1503
February 18, 2004
Gregory R. Reed
Attorney at Law
3120 Parkview Lane
Harrisburg, Pa. 17111
Re: James M. Blood, Jr., Deceased
Accoun~ 14698-010
Dear Mr. Reed:
In reply to your request on the above referenced member, the information is as follows:
1. Account opened 09/08/1968
2. Names on the account: James M. Blood, Jr.&/or Richard J. Blood
3. Balances as of date of death:
Shares: $30588.39
Checking: $21027.99
Christmas Club: $178.67
Vacation Club: $ 2769.38
We will need a death certificate for Mr. Blood. If you have any further questions, you
may contact our office at (717) 564-4661 or toll free (800) 356-3875 Ext. 205.
Sincerely,
Sharon M. Lehman
Member Services
Exhibit "6"
.{
of
JAMES M. BLOOD, JR.
I, JAMES M. BLOOD, JR., of East Pennsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as and for my last Will and Testament, hereby revoking
and making void any and all wills or codicils at any time heretofore made by me.
ARTICLE I.
I direct payment of all my just debts and the expenses of my last illness and
funeral from my estate as soon after my death as conveniently may be done. I
authorize my Executrix to expend funds from my estate for the purchase, erection and
inscription of a suitable grave marker. All the foregoing shall be considered expenses
of the administration of my estate.
ARTICLE II.
I devise and bequeath all the rest, residue and remainder of my estate, of
whatever nature and wherever situate, unto my wife, SYLVIA A. BLOOD, provided
that she survives me by a period of thirty (30) days.
ARTICLE III.
Should my wife, SYLVIA A. BLOOD, predecease me or die on or before the
thirtieth (30th) day following my death, I direct the following:
A. I give and bequeath the sum of Five Hundred ($500) Dollars unto the
Summerdale United Methodist Church.
B. All the rest, residue and remainder of my Estate of whatever nature
and wherever situate, I give, devise and bequeath unto my son, RICHARD J. BLOOD,
Carlisle, Pennsylvania.
ARTICLE IV.
I nominate and appoint my wife, SYLVIA A. BLOOD, Executrix of this my Last
Will. Should my wife, SYLVIA A. BLOOD, fail to qualify or cease to act as Executrix,
I nominate and appoint my son, RICHARD J. BLOOD, Executor of this my Last Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the
day of ~ , 1984.
(SEAL)
'James' M. Blood, Jr.
Signed, sealed, published and declared by 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 hereunto subscribed our names as witnesses.
ACKNOWLKDGMENT
COMMONWEALTH OF PENNSYLVANIA :
:
COUNTY OF CUMBERLAND :
I, JAMES M. BLOOD, JR., whose name is signed to the foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes therein expressed.
/ / Jame~ M. Blood~.~r.
Sworn or affirmed to and acknowledged before me, by JAMES M. BLOOD, JR.,
this J/~J~ day of ~ , 1984.
0Notary P~blie
TARY PUBLIC
MY COMMISSION EXPIRES JUNE 16,
LEMOYHE, PA CUk'B£RI~{~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
the witnesses whose names are signed to the foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw the Testator sign
and execute the foregoing instrument as his Last Will and Testament; that he signed
willingly and that he executed it as his free '~nd voluntary act for the purposes therein
expressed; that each of us in the hearing "and Sight of the Testator signed the Will
as witnesses; and that to the best of our .~,~oWled..ge, the Testato~ was at that ,time 18
or more years of age, of sound mind and under no'constraint or undue influence.
and ~,~.,~J ~.///~y~,-~ , witnesses, this /~ day of ~~. ~',.'.
· 1984.
~' Notary,, ~Pu. bUe
'~- ;. , ' '~'~' ? :", ? ~.! L'~ .:
NOTARY PUBLIC
IN THE OFFICE OF THE REGISTER OF WILLS
OF CUMBERLAND COUNTY, PENNSYLVANIA
IN THE MATTER OF TIlE ESTATE OF :
JAMES M. BLOOD, JR., LATE OF TIlE :
TOWNSHIP OF EAST PENNSBORO, :
CUMBERLAND COUNTY, deceased :
NO. 2004-00131
RECEIPT
FINAL AND COMPLETE RELEASE
AND INDEMNIFICATION AGREEMENT ~co .
KNOW ALL MEN BY THESE PRESENTS, that I, Claud HerSh
Chairman of the
Board of Trust~o_~ , of the SUMMERDALE UNITED METHODIST CHURCH, a non-
profit corporation, hereby declare that I am authorized to sign this Receipt on behalf of said
Church, I do hereby acknowledge receipt from RICHARD J. BLOOD (hereinafter referred to as
"Fiduciary"), Executor of the Estate of JAMES M. BLOOD, JR., deceased, the sum of Five
Hundred and 00/100 ($500.00) Dollars in satisfaction of all claims, distribution, shares and
property, (real and/or personal, tangible and/or intangible) due the undersigned from the estate.
The undersigned acknowledges receipt of Notice of Beneficial Interest in Estate from the
FIDUCIARY and timely information from FIDUCIARY when requested by the undersigned.
1N CONSIDERATION WHEREOF, the undersigned does hereby remise, release,
quitclaim and forever discharge the FIDUCIARY and the respective heirs, personal
representatives, successors and/or assigns thereof as well as said decedent's estate, of and from
all manner of actions, cause or causes of action, debts, dues, claims and demands whatsoever,
both in law and in equity, against the FIDUCIARY, individually, corporately and/or in a
fiduciary capacity, and against said decedent's'estate, whether as legatee under the Last Will and
Testament and/or as heir-at-law of said decedent and/or as claimant/creditor and/or in any other
capacity which the undersigned has had or now has or ought to have had for or by reason of any
act, matter, cause or thing from the beginning of the world to the day of the date of these
presents.
AND IN FURTHER CONSIDERATION WHEREOF, the undersigned does hereby
expressly stipulate, covenant and agree, in consideration of the aforesaid distribution and
payment, to indemnify and hold harmless said FIDUCIARY and the respective heirs, personal
representatives, successors and assigns thereof against loss from any and all further claims,
demands and actions, in law or in equity or otherwise, that may hereafter at any time be made or
brought by the Commonwealth of Pennsylvania, or anyone in its behalf, for any unpaid
Pennsylvania Death Transfer Inheritance Taxes or by the Internal Revenue Service, or anyone in
its behalf, for any unpaid Federal Gift or Estate Taxes on the gross taxable estate of said
decedent and the undersigned hereby waives any and all rights of exemption, both as to real and
personal property, to which the undersigned may be entitled under the laws of this or any other
state as against such claim for reimbursement or indemnity.
The undersigned does hereby consent to the discharge of the FIDUCIARY without notice
to, or necessity ofjoinder of, the undersigned.
IN WITNESS WHEREOF, the undersigned has duly executed this Receipt, Final and
Complete Release and Indemnification Agreement the day, month and year set opposite the
signature of the undersigned.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
:SS
On this, the ~+t. day of ~ ~ ,2004, before me, the undersigned,
personally appeared ~ic~od~ ]4~-~ ,whoacknowledgedhimselforherselftobe
Cha±rmanw Brd of Trustees, of the SUMMERDALE UNITED METHODIST CHURCH, a non-
profit corporation, and that he/she as such cha±rman , being authorized to
do so, executed the foregoing release for the purposes herein contained by signing the name of
the Corporation by himself/herself as
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Betty J. Erdman, Notary public
E? ~ Twp., Cumberland County
MY ~ommission Ex~r6~ Jan. 13, 2008
PROOF OF PUBLICATION
State of Pennsylvania,
County of Cumberland.
Rich Canazaro, Internet Director of THE SENTINEL,
of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th,
1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice
or publication attached hereto is exactly the same as was printed and published in the regular editions and
issues of THE SENTINEL on the following dates, viz
Copy of Notice of Publication
The Sentinel
March 01,08,15, 2004
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of publication a~ ~
March 18, 2004
before me this
Sworn to and~ubscribed 18th
dayo, .)'~?~ , 21~.
: r*:' / Nc~t~l"~) Public
My commission expires:
NOTARIAL SEAL
DAWN M. SHUGHART, Notaw Public
Cartisle, Cumberland County
My Commission Expires Nov. 28, 2006
Proof of Publication of Notice in
THE VALLEY TIMES-STAR
COUNTY OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
Gregory R. Reed, Esquire
Andrew J. McMullin, being duly sworn according to law, deposes and says that he is the Editor
of "The Valley Times-Star" which is a weekly newspaper of general circulation published in
Shippensburg Township, Cumberland County, Pennsylvania, by Latrobe Printing and Publishing
Company, a corporation duly organized and existing under the laws of the Commonwealth of
Pennsylvania having its principal place of business at 1011 Ritner Highway (P.O. Box 100),
Shippensburg, Pennsylvania; that he is authorized to and does make this affidavit on its behalf;
that the printed notice, advertisement of publication attached hereto is the same as was printed
in the regular editions and issues of "The Valley Times-Star" on the following date(s):
February 25 and March 3 and 10, 2004
Affiant further deposes that neither he nor "The
Valley Times-Star" and The Latrobe Printing and
Publishing Company have any interest in the subject
matters of the aforesaid notice or advertisement, and
that the facts set forth in the foregoing affidavit is
tree and correct.
Swo~ and subscril0ed before me this
t~>'4d- Dayof ~ ,2004
Nota~ia{ Seal
Kristen L. Slatler, Notary Public
B~lfo~d Bom, Bedford Ooun~
My Comrniss~on Ex,res Feb 13, 2006
Member, Pennsy¢vania Associa~on Of Notades
Notary Public
To: "The Valley Times-Star"
Shippensburg, PA 17257
For publishing the notice attached hereto:
On the stated date(s) .............. $ 47.25
Affidavit .......................... $. 2.00
Total .............................. $ 49.25
Copy of Notice of Publication
BUREAU OF INDIVIDUAL TAXES
/NHER/TANCE TAX DZVTS/ON
DEPT. Z80601
HARRTSBURG, PA 171Z8-0601
GREGORY R REED ESQ
5120 PARKVIEW LN
HBG PA 17111
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHER/TANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE 07-19-2004
ESTATE OF BLOOD JR
DATE OF DEATH 01-Z0-2004
FILE NUMBER 21 04-0151
COUNTY CUMBERLAND
ACN 101
Amount Rem'i t'l:ed
REV-1547 EX AFP (D1-03)
JAMES M
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BLOOD JR JAMES MFZLE NO. 21 04-0131 ACN 101 DATE 07-19-2004
TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Estate (Schedule A) (1)
2. Stocks and Bonds {Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
4. Nortgagas/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Risc. Personal Property (Schedule E) (5)
6. JointZy Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. Dabts/Hortgage Liabilities/Liens (Schedule
1:1. Total Deductions
12. Net Value of Tax Return
15.
14.
Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Nat Value of Estate Sub~act to Tax
85~000.00
.00
.00
.00
157z$75.96
Z7,282.25
.00
(8)
25,994.7!
.O0
NOTE: To /nsure proper
cred/t to your account,
subm/t the upper port/on
of th/s form w/th your
tax payment.
NOTE:
ASSESSMENT OF TAX:
1.;. Amount of L/ne 14 at Spousal rate (:1.~)
16. Amount of L/ne 14 taxabZe at Lineal/Class A rate (:16)
17. Amount of L/ne 14 mt S/bl/ng rate (17)
18. Amount of L/ne 14 taxable mt Collateral/Class B rate (18)
19. Princ/pal Tax Due
TAX CREDITS:
PAYHENT RECEI~I
DATE NUMBER
04-16-2004 CD003853
05-28-2004 CD003987
DISCOUNT (+)
INTEREST/PEN PAID (-)
494.74
.00
Xf an assessment was issued previously, lines 14, 15 and/or 16, 17,
reflect figures that lnclude the total of ALL returns assessed to date.
· O0 x O0 = . O0
ZZ5,161~;*x 045, 10,1:52.26
.00
o e,x is = .oo
TOTAL TAX CREDIT
I
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
10,157.00
Z4.74CR
.00
24.74CR /~t~
IF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR}, YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF TH'rS FORN FOR INSTRUCTIONS. )
( IF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS RE~UTRED.
(:11) 23.99~,71
(:12) 225,661.48
(13) 500.00
(14) 225,161.48
18 and 19 wi11
249,656.19
RESERVATZON:
Estates of decadents dying on or before December IZ, 1981 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Caaeongealth hereby expressly reserves the right to appraise and assess transfer inheritance Taxes
at tho laafu! Class S (collateral) rate on any such futura interest.
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADHZN-
ZSTRATZVE
CORRECTZONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 15 of ZOO0. (71 P.S.
Section 91qO).
Detach the top portion of this Not[ca and submit mith your payment to the Regis[ar of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, ah[ch Has not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office
of the Register of Hills, any of the 23 Revenue District Off[cas, or by calling the special Iq-hour
answering service for forms ordering: 1-800-361-1050; services for taxpayers ~[th special hearing and / or
speaking needs: 1-800-4q7-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this No[ica must object within sixty (60) days of receipt of
this Nat/ca by:
--~rittan protest to the PA Department of Ravsnuo~ Board of Appeals, Dap[. 2810Z1, Harrisburg, PA 1711D-1011, OR
--election to have the matter da[ermined at audit of tho account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Dmparf~ent of Revenue,
Bureau of Zndtvidual Taxes, ATTN: Post Assessment Rev[aw Unit, Dept. Z80601, Harrisburg, PA 17118-060!
Phone (7173 787-6505. See page 5 of the booklet "instructions for Znheritance Tax Return for a Resident
Decedent" (REV-150I) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (5Z) discount of
the tax paid is allowed.
Tho 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 tho same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning ~ith first day of delinquency, ar nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (DX) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after
January 1, 1981 ~ill bear interest at a rate which w[11 vary from calendar year to calendar year with that rate
announced by the PA Daparbaent of Revenue. The applicable interest rates for 1981 through Z004 ars:
Interest Daily Interest Daily Intarest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20X .O005qB ~'~-1991 11Z .000501 ~ 9X .000247
1963 162 .000438 1992 92 .000247 Z002 62 .000164
198~ 112 .000301 1993-199q 7Z .000192 Z003 52 .000137
1985 132 .000356 1995-1998 92 .000247 ZOOq 42 .000110
1986 102 .00027q 1999 7Z .000192
1987 lOX .000174 ZOO0 71 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUNBER 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 on the
Notice, additional interest must ba calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURr., PA 17128-0601
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
'04 SEP ~5 A8:24
GREGORY R REED ESQ
3120 PARKVIEN LN
HBG C'. !~:~,. 17111 .
DATE 08-16-2004
ESTATE OF BLOOD JR
DATE OF DEATH 01-Z0-2004
FILE NUMBER 21 04-0151
COUNTY CUMBERLAND
ACN 101
Amoun~ Remi~ed
RE¥-I&G7 EX AFP
JAMES M
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credi~ ~:o your account, submit: ~:he upper por~:ion of ~his for. wi~h your ~ex payment.
CUT ALONG TH'rS LINE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS ~
REV-1607 EX AFP (01-03) ~# TNHER'rTANCE TAX STATEMENT OF ACCOUNT ~
ESTATE OF BLOOD JR JAMES M FILE N0.21 04-0151 ACH 101 DATE 08-16-2004
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH IN THE NAHED ESTATE. SHONN BELON
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-12-2004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
10,132.26
PAYMENT RECEIPT DISCOUNT
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
494.74
04-16-2004
05-28-2004
08-OZ-ZO04
CD005835
CD003987
REFUND
.00
.00
9,400.00
262.26
24.74-
ZF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
TOTAL TAX CREDIT 10,132.26
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR /NSTRUCTIONS. )
cumberland County - Register Of Wills
One Courth9use Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 12/16/2005
REED GREGORY R
3120 PARKVIEW LANE
HARRISBURG, PA 17111
RE: Estate of BLOOD JAMES M JR
File Number: 2004-00131
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.l2) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES. NO.
103 SUPREME COURT RULES DOCKET NO.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 is due by:
1/20/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
Mf (( .' .' '
" , I" I.
~A-'~.{J.ut-~
GLE~IDA FARNER STRASBAUbH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
\11
. ~
~~
~~~
f.~ la5" "\,.\
~ ~J
~
Re;:SR5t,er o:fVI\'''1n~ <iJJf CiUi.iih.Jtbei~land C\QfUllt"j
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
:r ~e<;
fV1-
Blood
::r v".
Date of Death:
::J c:;lm 10\ Gt V' I
~() J '2-00 V
,
Estate No.: 21
Ol{- 13/
.
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 ~ No 0
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 [mal account with the Court?
Yes 0 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? Yes 0 No}4
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be flied with the Clerk of the Orp hans' co~and ma be
attached to this report " V
1</20/05 __~ LC-.A
SIgnature
Date:
~n
Gr~d~7 ). ~~/
Name
3/.)..0 4:fv/~ ~ €-
A~':;:~.,?_ 0 >! !:f r? III -
Telephone No.
r- ~
(0_, :
Capacity:
O D------_l D Q--Oso-+-+~"e
~ Cl'::'V.Lla.J.. J..'...........t-'J......... vJ..H..a.l.l v
~ \:. 1 ~--.- -- --1 -.--- -t-+-: 0
~o~rnse_ .!..t.J1. }ie!~o..!..ia._ lCplese.!..!. a,\"!'V",-,
(,
V~