HomeMy WebLinkAbout02-1109PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~Fs-r~c ~ ~ ~ ~ ,
Also known as
No.: ~~`-Ua~- ~ ~ 4 l
To:
Register of Wills for the
_ Deceased.
Social Security No. li l8 ' / ~ 3~
County of in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older and the exect_Q~ named in the last Will of the
above decedent, dated ~^ and codicil(s) dated ~~O ~(/ ~ ~,, ~-/ ~
(state relevant cryryircumst nces e.g. unciation, death of executor, etc.) /~ _ ~~ ' p
1..~ ~~
Decedent was domiciled at death in Coun Pennsylvania; wit h last family or pr' cipa„~,
residence at ~g D ~ 14 '~ ~ ~ /w~~~ J~'O~^ // V
T (list street, number and nicipality) ~ ~
.iv
Decedent, then g ~ years of age, died /~' / at ~ ~ l ,
Exce t as follows decedent did trot man ,was not divorcedid not haveG~ orn or
p Y
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 $ ~~ 3 •~ ~ ~~
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
~d o~~
Value of real estate in Penns lva is n ~ ~ ~j/ O~ $ ~
Situated as follows: ~~~ ~y+- ~ (a.,~,(qJ oK~-l
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last Will and codicil(s) presented
herewith and the grant of letters Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
thereon. ~~~
s' ~ n do,/'e ~ CoH ,r t
.~ _
~~ ~.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }
} ss
COUNTY OF Cumberland ~
The petitioner(s) above-natr~ed 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(s) of
the above decedent petitioner(s) will well and truly administer the estate according to law.
fore ""~ /~
Sworn to or affirmed and subscrtbed be {
6th Decemher
me this day of {
~: ~ ~~ ~
Register ~~~~'~~- ~~
Donna M. Otto, lst Deputy %~~„//yj
/7 J/~~7__ ~F
No. 21-2.002-1109
WILLIAM S. HARPER, JR.
Estate of ,Deceased
DECREEE OF PROBATE AND GRANT OF LETTERS
AND NOW, December 6th 20Q2n consideration of the petition on the reverse
side hereof, satisfactory proof having been presented before me, ~ ~ ®~
IT IS DECREED that the instrument(s) dated ~ D. ~..e.~i ~gBG G~_ ~ ®. S .
Described therein be ad tt ~~~o probate an sled of record as the last Will of ~__;~and Letters
are hereby granted to ~~~~~~~`/+r' 07 ~~ v ~"~
FEES
Probate, Letters, Etc...........$
Short Certificates (~ ..........$
~~x..x-.Pages ...$
J~P (2) $
TOTAL $
270.00
18.00
6.00
10.00
304.00
gister of w iris uonn~ M v Otto, tst ueputy
Filed . l~ecemb~~.. ~Z~k~. 2Q0.2.......
Ja s M. Bach 18727
ATTORNEY (Sup. Ct. I.D. No.)
52 S. Sporting Hill Road, Mechanicsburg, PA 17050
ADDRESS
717-737-2033
PHONE
EXECU'T'OR PICKED UP LETI'L12S GN THE SAM DAY (out of state )
12-6-2002
f pis .,
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'I '" I°' ~ I .7,° +2T7 7~ tir7tt'CC:I~V CO~L(~ ~S"ti;i'i :zl O:~ i -_.dl ~_
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s .. t _ f:t~r':aa ~~) C~La,O~if:~$~ I~I"Gl:i +`.;,C~~:ay" ~ ~:a1~~:a~Ca,`"iie'~~ ~ ~3~~ts:..
Hey ve7
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DEC 0 3 2002
__ __ _ __
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CEfiTIFICATE OF DEATH
5 LATE FILE NUMBER
NAME OF DECEDENT (F~rv. Middle. Lass SE% SOCIAL SECURITY NUMBER GATE OF UEATH,MCnm. Uay. rears
p
,. W~..C..C~am S. Ha
n~~, Jn. :. Ma Le 7. 161 - 18 - 9330 eT>Kf(~~~~' ~ 2t.Y~~
_
AGE (Lass Brnndayl UNDER t YEAR UNDER t DAY DATE OF BIRTH BIRTHPLACE IC•ly end PLACE OF DEA7H ~Ch~c. a-ly one ~ ~rsuuceurw nn aloe, noel
Months Days Hours , Minutes ~MUnth. Uay reen Slalea FCreyn Counuyl HOSPITAL. OTHEP:
2 Yrs.
CLyme~c
PA
7-3-1920 InpalWn~ EFVOulpauenl Li OOA ^ Homa g ^ Reswsnu 01Mr
~ 'Spa""'^
,
,
0
a O e. ,a.
COUN7V OF DEATH CITY, BORO. TWP OF DEATH FACILITY NAME III not msl~NUOn. give street and numbed WAS DECEDENT Of HISPANIC ORIGIN? RACE ~ Amsrlcan Indian, 818Ck, Whtte. etc.
ISDeuM
No ® Yae ^ II yM
apaGly Cubsn
Cumben2and Fa~~ Penn bona ~-~ 7 {r
• ,
,
~"~Oc' r~<c. ~ Mearart.P°a"dR1ca","` Wh~.te
111
i 9
M. k. b.
DECEDEM'S USUAL OCCUPATION KIND OF BUSINESS/INOUSTRV WAS DE DENT VER1N .
.
DEC ENT'S EDUCATION MARITAL STATUS~Marnad SURVIVING SPOUSE
(G18 krt,d d vaxk done dururg ng51 U.S. ARMED FORCES?
of wwbrq bls; do rw, use relueal Ele
Yea® "°^ S , on1 n. ,est. rade can veled Never Marred, Witlowsd. Ill wde. give maalen nalnel
memary/Secondary Cortege Divorced ISpec,Ml
Txa~nman Ra~P~coad `°.'_' 12 jaor5" U1-i
dawen
• ,,,. 116. ,2. u, .
u. ,s.
DECEDENT'S MAIUNG ADDRESS (S1reeI. GryR°wn. Stale. l,p Coeel DECEDENT'S
Penne
~v L/,~
17o
^YM
aeceaen lived in T11Lm
dPh rw
a
an~
48 Oah Avenue ~
ACTUAL. 17s. Stale
RESIDENCE .
,
p.
D1d
~
.
decrWem
PA 17011
L~
Cam
H~ (See 1nSIrU<IWn6
onaharsldel
b hP live m a
l
^ w°~~
'a'"
"
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'°"'"a""'
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p a
t>b.D°en 1m ,Td.
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1m
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<ttylbpro.
n
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FATHER'S NAME (First. M,ddle. Last) MOTHER'S NAME IFasl. MidUle. Maiden Surnames
n en
Sn
L~
S
H
tU~~ Je~e~
e S
t
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,9.
INFORMANT'S NAME (TypelPrinq I NFORMANT'S MAILING ADDRESS ISbeet. Cay/TOwn, Stale. Zip Ca]el
211. Gl~..~.~~.am L. Hcve en 2~. 5 Andover Cocue~t, La arts N.~ ue.L, CA 92677
METHOD OF DISPOSITION DATE OF DISPOSITION
(Monet
Year)
Day PLACE OF DISPOSITION - Noma W Comet ryG r`rs~aelo~l` ~
or Olner Place Cn emax c
an S
a LOCATION ~ City?own, Slala, Zp Coss
^
Banal ^ Cremation ® Removal Irom Slate .
. .
7
Dpne,ipn^ anerlspecM ~ Deeemben 3 2002 Penny ~van~a Cnema~on Hcvch~
~bu~c PA 17109
21a
. 2,s, - 2,b. ~ 21n, .
. 7
' SIG URE FUNERAL SE IC LICENS E RPERSONACTING SS LICENSE NUMBER NAMEANOADORESSOFFACILITV /(QI17a ,(.an (JC,(.Q. y a ennhc~ van.ca
~ 4100 Janea~town Road Hcvcn.c~sbun A 171D9
,
. 22.. :2b. 22<.
plate i ma 23aC only w n wet 1ng To the at of my al occurrod a1 the 11ma. dale arM place slated.
w LICENSE NUMBER GATE SIGNED
p sician nd available at a of death (Sgna a and 7. ) (MOnm. Day. Year)
' < ily d death.
27a
23b.
2k.
Item <-28 muss W comps TIME OF OEATM GATE PRONOUNCED DEA01MOnm, Day, v art WAS CASE REFERRED TOMEDICAL E%AMINER/CORONER7
~
^
~ J L
. perapn woo prdrtouncec death. Ya.
No
27. PART I: Enter the diseases, injuries or compkcatlons which caused Ire death. Do rot enter Ire mode of tlymg, such as cardiac or respuatory arrest slwck or heart IaJure. i Approvmab PART II: Omar signi(caM wrMiliorte cdMripldky td death. bus
L1s, pMy OM <aUSe OIt BsU lino. ~ interval Datwean na nsutting in the urldsrgnng cause given m PMT 1.
onset and deaN
IMMEDIATE CAUSE IF,nal [L~ /. ~ / l
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/
- disease a conanron ~ v/ `,'4•'IA•!` '
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7 t
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I
t
7
G
es dug m deems-- a.
DUE TO IOR AS A CONSEQUENCE OF): --l
"~ Segwntialry kal conrktions b. r
a:7 it any, Nadinpwunmediale DUE TO (OR ASA CONSEQUENCE OF): I
I
~3 caus.. Enter UNDERLYIH1i '
CAUSE(Disease or ~nNry c-
~~ ma1 mnia,ed evens DUE TO (OR AS A CONSEQUENCE OF): I
resWmg n deems LAST
d
-
WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
PERFORMED? AVAIUBLE PRK]q TO IMa,m. Day. Years
ON OF CAUSE
D da ^
l ® H
EA M
O om¢i
Nawre 1
Ya9 ^ No ^
^
Accident ^ Pending Inve911galiOn
]ds
M.
J00.
70c.
- Yes ^ No ®
Yea ^ No ®
Suicide ^ Could not De determined ^ _ _
. __ _r
pUCE OF INJURY - At home, tar , sveel. la gory, omcs _
LOCATION (Sneer C,tylTUwn. S1ale1
building, alG. ISP«x;av1
^.2Y. 29b. 29. 30s. 70f.
CERTIFIER (Check oniy ones
NATUR DTI
G
T E CE 7FIER
1
'CERTIFYING PHYSICIAN IPnysicran certayu,q cause a dean weer another pnvvcan has prUnoura'.ed deem and canulelyd Mein 231 rJ /
To the bast of my knowledge, deem occurred due to Iha cause(s) arW manner as slatod ................................. ................... . L ~ '
b
7
~, ~ GATE SIGNEDIMa ,Uay. Years
LICENSE NUM Efl
" 'PRONOUNCING AND CERTIFYING PHYSILIANIPhysK'~an ash Pronoul~c~nq deem and cenAy,nq to cause of deaehl i-
~ 71t
MD I)/ l„+'~1yL~ 71d. Z
Z- L! 7
1
V SL
1
l
:
To Iha best of my krwwledgn, death occurred at Ina Ume, dale, and place, and due to IM cause(s) arM manner as stated ...... .................... ._ -
_
_.__-___
._
- __
_.
. _
"_
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OFO ATH
(Item 2 71 T ypa a PHn,
~, 'MEDICAL EXAMINER/CORONER J b '~' l • ~ ' L t (/)
~` V 1 / 1 V ~ N ~
On the Gaeta of eaaminatlon andlor inveatigauon, in my oplNOn, death occurred at the time, date, and place, and d
......................
t
,
d
ue to the cause(s) and ~
.... ... ........... L,
.
~
C,
•
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~~
..........................................................
a
e
mannerass
71a. ~
•
to~l
72. ~, (
f
''y~ `- ct
REGI$7'SiAR'S SIGNATl.W~ AND y)1fdBE DATE FILEDIMOnm U y, resit
H105.RU5 RED' 9B6
This 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, $2.00
4612639
No.
Local Registrar
ate
;a~Rev. 2/B7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
NAME OF DECEDENT (Fast. Middx. Leal SEX SOCIAL SECURITY NUMBER DATE F D TH, cnm. Oay.'roaU
,. Donathy M. HanpeJt :.Female ,. 200 - 07 - 5440 ..
AGE(Lasl Buttulay) UNDER,YEM UNDER,0/0' DATE OF BWTN BBTTHPUCE (City and PLACEtK OEQHICheca ody one-sea v,xructuxn on alum aael
ModM , Dap Hwn , MMwlaa lMonm, DaY.'r.ml SMtaa FaagnCwnuy) HOSPIUL OTHER:
^ „
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~
i DoA
3 -17 -19 Dean y , PA Irlpatwnl ^ ERIOutpatlam ~
~ ^ Rmriartu ^
~yl ^
7 8
Y,,
COUNTY OF DERH CRY, BORO. TWP OF DEATH FACILRY NAME pl rol mffiMlon. 91w sne61 and ruwnoerl ViA$T qDECEDENT OF HISPANIC ORIGIN? RACE - Altuncan Indian, Bladt. Wluta. mc.
h~
`sD°`N1
^"
O
O
~e
Ul
pa•°p'a'"
i
in•
Cumbenkand East Penwsbona 1 <' ~ NalpL Y..
Mu~cm1! PuMO Rfcan, mc.
I
,. ,o.
• N k. .d. , rr
DECEDENT'S USUAL OCCUPRION KING OF BUSINESSIINOUSTRY WAS DE EDENTE ERIN DECED NT'S EDUCATK)N MARITAL STQUS-Martial SURVIVING SPOUSE
U.S.MMED fORCES9 n cam Navm Mmrro, Widow W, ltl wA•. qne rnaiaan namel
(Give wlwdworkdorw dwug moat
,ab:mrtdea.r ed,
t
o{
ce~~) w~-~~~am S. Hcvcpen, Jn.
d2a" (,`~«'I Ma~n
Y°^ "°~ E°;x
~
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,~
~
~
,
Gavennment
,a. ,a. ,a.
,x
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.
,,.. „D.
DECEDENT'S MAIIINO ADDRESS (SUM.Cayliown,swa. ZpCowl DECEDENT'S PA Did ,TC.~wa, a.cdmtllMOM Hampton Twp. twP.
St
b
7
a
a
48 Uah Avenue RES DENCE 1
~
Cam H~2~ PA 17011 ISeenwuctlona
p , an amm sld•1 Cumber-hand '°"r"""PT ,Td.^ w~Daitm.dt,ue~id aAYAOro
,.. 1T0. cou
S
'
urname)
S NAME ?Fast. MiOOIe. MaIWn
FATHER'S NAME(Fvq, Matdle. lavl MOTHER
Kath~eyn Sm~.#h
(U~2~~am F. Skean ,,,
,,
,
INFORMANT'S NAME (iypmPruul INFORMANT'S MAILING ADDRESS (Sued. CiN/TOwn. SWS, Ip Code)
48 Uah Avenue Cam H~.x~, PA 11011
xae
J
.
n.
Mn. GI~k~2am S. Han en
Lp Cow
State
xa
LOCATON - CiyRown
d C
C
,
.
.
r
• • .
METHOD OF DISPOSITION DATE Of DISPOSITION PLACE OF DIS SITION - tttw
wQMrPMCa~'nema~-tan 3"a~~ce"~°"y o~
~
Y
y'
wr)
13~urial^ Cramalw,:~RMloval lrom SlMa^ (MOM'
Hcvcn~..~bl,Utg, PA 17109
^ Ue-tobe~t 16, 1997 PA Cnematony
x,d-
Da,utla,^ Dmm(speda^
x,e.
x,n
.
x,a.
' SK3N/IT~IRE OF FUNE SERVICE UCE E PERSON.AC SSUCH LICENSE NUMBER NAME ANO ADDRESS OF FAGLITY JCem(( an. aC~CQ y a enniSy Van~t.a
4100 Jone~~town Road Hann.v~bun PA 177 09
1
1 , , x,,, uc.
x1a. ~ LICENSE NUMBER DRE SIGNED
darns only n uruNir,, b tM Dam d my knowNdpa. earn occwrad at IM time. dale and PI•a• Stated. (MOM. DaY• Y9ar1
l
t
C
omp
e
e
pnyatcun n no(v aela 1 • d Galn to (Sigrutwe and TaWI
candy cause of dNm. xa0. 2k.
xN' WAS CASE REFERRED TOMEDICAL EXAMINER/CORONER9
Ilnms x.-xb nutty W compNtad tuy TIME OF DEATH GATE PR CED DEAD IMOnm, Day. Yeml ~~
wa ~
'-D
`
Moron wlto prenouncaa deem. ~ - v I (~
~~ U ~^ ~ 2n.
1 J M
x0
.
.
xa,
xT. PART I: Enter IM OiaaaNa, injwisa m camplicatana wDicn uusw Itw eamD Oo rot adar IM mode al dyMp, sucn u cardiac or r• n ?cry areal, Sftock a Man lanura i ~Im~~ PART I1: Omar tiGrulk•nt txlrtdXiOM coMriDuWtq to Maln. Dul
ltot raadlutq m tDa trrtdartyap utrw 9ivmt n PMT 1.
LIat ody one calua txt aacn Mrw.
lour and If..tn
IYYEDIATE CAUSE (F~ny ~
asaase orcw,dsion r~t '~~~
-- a
.
raa,alap m deem)
DUE TO IOR AS A C EOUE E OFI:
Sagrntusy Ra, I;ondAiona D. DU (OR AS A CON OUENCE ~ I
d any, I••dur9 b irnmadiaU 1
cauaa. Enlm UNDERLYING I
CAUSE (Disease or inNry c' DUE lOR AS A ONSEOUENCE C]FI:
1
• ?tut,nAialM evaras ,p
n deem) LAST C t
s
uq
rtsstr
d
DATE Of INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
•
WAS AN AUIOPSV WERE AUTOPSY FINDINGS MA ER OF DEATH
IMOnm. Oay. Year)
PERFORMEDT AWILABLE PRKKIiO I\'~~
COMPLETION OF CAUSE
^
Natural tf-~ NomKtda
GF OEATHT Y.. ^ No ^
Acceded ^ Pendrn, Inrasegatbn ^ M
.
`I~,T ~ 3N
SuKId• ^ Could nd W detarmmed ^ PLACE OF INJURY - Al home. tmm, slrem. Iadory. oMCa LOCATION ISlrem. C~ty/fown. Sala)
^
^
No
No all Yp
Vaa
' \ Wilding, etc. ISpecdyl ~-
~
xN. 260. xa. 7M.
IGNATU NO TITLE OF CERT
CERTIFIER ICneU only oral
'CERTIFYING PHYSICIAN IPnyvewn cmWyur9 cause d dean when angnm pnrscun nas ppwunced deem aiw comdele0 Dam 231
..................................
t
d
l 7
a/o
...................
a
e
To the WN of my krow4d,a, deem occwrad dw b m• cauu(SI and manner as e .
mm. .Year
DATE SIGN
ED
LICENS UMBER
• /
O
II^^
/ "LG77// "f7
~~
~
'PRONOUNCING ANO CERTIFYING PNYSICIAN IPDyscwn oar yar~a„rcvuJ Uealh ervl .:wLlyurq to cau5aduealnl ^
... ^
s Nat„d
d ,
W
- 71d.
.............
manner a
To m• Daat o, my krowbd,a, dean accurrad alma Uma, date, and DMCa, and dw 10tH cauaa(a) an NAME AND ADDRESS QF PERSON WHO COMPLETED CAUSE DEATH
- (Item 1 T~ a~Prin1 ~ ~
0/ , 1 ///~~y
~j(`y V
~
'MEDN:AL EILAYINER/CORONER ^
f uaminatlon and/or ineestlga,ion, in my opinion, daallt occurred al the llma, dab, and place. and due to Ina uuae(a) end
b
O ~
V
l~
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On lha
r
.............................. ...........
manner as elated ............................................. ~~
~
ax.
a,a. DATE FILED (MOnm. oay. Yearl
~ ~ J ~_ ~
E AND NUMBER
R
REGISTRAR'S SIGNATU ~j {,
/
~
/ ~~ ~.
LAST WILL OF WILLIAM S. HARPER, JR.
JAMES M. BACFI
ATTORNEY AND
COUNSELOR AT LAW
352 5. SPORTING HILL R
M ECHANICSBURG,
I
PENNA. 17055
TE L_(7t7) 737-2039 ~
I, WILLIAM S. HARPER, JR., of the Township of Hampden,
County of Cumberland, State of Pennsylvania, be.in in
~~ g good bodily
health and of sound and disposing mind and memory, and not acting
~~
~I under duress, menace, fraud, or undue influence of any person
I
whomsoever, merely calling to mind the frailty of human life, ~
;,~ and being desirous of disposing of my worldly goods while I have
'' f
~ ~
! the strength and capacity so to do, I do make, publish and de-
~f clare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel
i
and annul all my former Wills and Testaments, inr_luding Codicils `
i
ij
thereto, by me at any time made, and declare this alone to be my
LAST WILL AND TESTAMENT.
,`
' AS TO SUCH ESTATE AS IT HAS. PLEASED GOD TO ENTRUST ME
i
'~ WITH IN THIS LIFE, I DISPOSE OF THE SAME AS FOLLOWS, VIZ• i
•
,;
ITEM l: I direct that my executors herei_nafter_ named
pay and discharge al.l of my just debts, funeral and testamentary
expenses. !
ITEM 2: I order and direct that my bodily remains be j
buried in a lot which I own, situate at Rolling Green Cemetery, j
' `; !
Camp Hill, Pennsylvania. ~
~~
,' ITEM 3: All the rest, residue and remainder of my j
'~
entire estate, wheresoever situate, and whatsoever it may consist
I
i
j~ of, I give, devise and bequeath, absolutely, and in fee, to my °
II~ (~
dearly beloved wife, DOROTHY M. HARPER. In the event that my
I
dearly beloved wife dies with me in a simultaneous disaster, or i
f
fails to survive my death by thirty (30) clays, then I give,
!
devise and bequeath my entire estate, wheresoever situate and
~ f
whatsoever it may consist of, absolutely and in fee, to my dearly
! j
beloved son, WILLIAM L. HARPER, per st.irpes. I
ITEM 4: I nominate and appoint DOROTHY M. HARPER as
Executrix of this my Last Will. Should the Executrix fai_] to
[ /t
~ c.~!}t": ~ rye
WILLIAM S . HARPER, JR~t
COMMONWEALTH OF PENNSYLVANIA
. ss
COUNTY OF CUMBERLAND
I ~ Wi 11 iam S . Harper , Jr . Testator, whose name is signed
to the attar_hed or f.oregoi_ng instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will.; that I signed i_t willingly; and
that I signed it as my free and voluntary act f.or the purpose there
in expressed.
Sworn or affirmed to and ar.know]~ged before me, by William
S. Harper, Jr., Testator, t_hi_s ~ day of February 1986
lK--_-_
~' 0 PUBL~C
My Comm.i si_on Expires: ~/j~/~~
The preceding instrument r_onsi_sti_ng of this and one (1) other
typewritten page, identified by the signature of the Testator, was
on the date thereof signed, pub]i_shed and der..lared by William
S. Harper, Jr. the Testator therein named as and for hi_s Last
Will and Testament, i_n our presence of each other, have hereunto
subscribed our names as witness.
~ ~. ~~
Resi_d.i_ng at 352 So. Sporting Hill Rd.
,,~y ~~;
Resi_di_ng
Mechanicsburg, PA 17055
at 352 So. Sporting Hill Rd.
Mechanicsburg, PA 17055
A F F I D A V I T
JAMES M. BACS
ATTORNEY AND
COUNSELOR AT LAW ~'~
352 5. SPORTING HILL Rq'
MECHANICSBURG,
PENNA. 17055
TEL (717)737-2099
COMMONWEALTH OF PENNSYVLANIA
ss
COUNTY OF CUMBERLAND
WE, James M. Bach and R. Edward Kitchen _, the
witnesses whose names are signed to +.~he attar_hed or foregoing in-
strument, being duly quali_fi_ed accord.i_ng to law, do depose and say
that we were present and saw Testator sign and execute the instru-
ment as h.i_s Last Wi_] l; that= he signed wi_] 1 _ngly and that he execute
it as h_s free and vo7untar_y act= for_ the purpose therein expressed;
that each of us i_n the hearing and sight of the Testator signed the
will as witnesses; and that to the best of our knowledge the Testat r
was at that time ].8 o.r_ more years of age, of sound mind and under n~
constraint or undue influence.
Sworn or aff..i_rmed to and subscribed to before me by James
M each and R. Edward Kitchen witnesses, this
-~U~-day of February 1986.
_ ~L~
NOTARY UBLIC
My Commission Expires : ~,j/ `V~
fi i
;~
Ii ~
iI '
if, I
j{ to qualify or cease to act as Executrix, then I appoint WILLIAM
li ~
`~ L. HARPER, as Executor in her stead. j
i~ ~ '
' ITEM 5• I direct that my personal representatives, as
,;,
~~~~I, well as their successors, shall not be required to give bond for `!
';I, urisdiction.
'~; the faithful performance of their duties in any j
~~'~ ITEM 6: I grant to my personal representatives herein ',
~, ;
`~' named, in addition to, but not in limitation of those powers
~,'
`! ;
~I vested by law, to be exercised without prior application to or
i '
approval of any court, the power and authority to retain indef- I
~~'~ initel.y any property, to invest and reinvest any assets or the
i
'~ proceeds derived from the sale of assets, although said invest-
i
l
'' ments may not be of the character prescribed by _law, to sell, i
,,'
'~,
,; convey, assign, transfer and encumber any property, to pay,
settle or compromise all claims, to make distribution or divisions!
,,~i
'~ in cash or in kind, and in general to exercise all powers in the '
'4
Iii management of any property hereunder which any individual could
'! exercise in the management of similar property owned in his own '
'I right, and to execute and deliver any and all instruments and to
'~ do all acts which may be deemed necessary and proper`.
~W
~, ~ ~~ ~ ~ ~' ~-s ~l ,
WILLIAM S. HARP R, .
END
JAMES M. BACH
ATTORNEY AND
COUNSELOR AT LAW
852 S. SPORTING HILL RC
MECHANICSBURG.
PENNA. 17055
TEL. (7!7)797-2033
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Wi 11 i am S . Harper , Jr .
Date of Death: December 1 , 2002
Will No. 2002-01109 Admin. No.
To the Register:
I certify that notice of (benef"icial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on March 12, 2003
Name
Address
William L. Harper 5 Andover Court, Laguna Niguel, CA 92677
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: March 12, 2003 YYIQ,d .
Sig ature
Name James M. Bach
Attorney At Last
Address 352 S. Sporting Hill Road
Mechanicsburg, PA 17050
Telephone 717 737-2033
Capacity: % Personal Representative
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
BACH JAMES M
352 S SPORTING HILL ROAD
MECHANICSBURG, PA 17055
fold
ESTATE INFORMATION: ssN: 161-~s-9330
FILE NUMBER: 2102-1 109
DECEDENT NAME: HARPER WILLIAM S JR
DATE OF PAYMENT: 12/15/2003
POSTMARK DATE: 1 2/12/2003
couNTY: CUMBERLAND
DATE OF DEATH: 1 2/01 /2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 ~ S 16, 623.26
TOTAL AMOUNT PAID:
REMARKS: WILLIAM L HARPER
C/O JAMES M BACH ESQUIRE
CHECK#1040
SEAL
INITIALS:
RECEIVED BY:
DONNA M. OTTO
S 16,623.26
DEPUTY REGISTER OF WILLS
REV-1162 EX111-96)
N0. CD 003337
REGISTER OF WILLS
/ ~-/o7- y
REV-I!lll)EX~
REV-1500
OH"tClflJ, USE ONLY
. COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128.0601,
INHERITANCE TAX RETURN RLENUMBER
i2/ -0.2-
RESIDENT DECEDENT COUNlYCOO' '..R
-~~Q..Cf-
MJMBER
...
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Attorney James M.. Bach
FIRM NAME 1'....._1
COMPLETE MAILING ADORESS
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DECEDENTS NAME (lAST. FIRST, AND MIDDLE INITIAL)
D7~6~;-~~;6'~~Rrilli~m_S~I'-DA~;;~i~~~;~Y~---'- .
2/.1._______ _____~______
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURJTY NUMBER
161-18-9330
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (dated dealh prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Tolal Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AllachSdlO)
352 S. Sporting Hill Road
Mechanicsburg, PA 17050
(1) $109,000.00
(2) 0.00
(3) 0.00
(4) 0.00
(5) $314,716.00
(6) 0.00
(7) 0.00
(8) $423,716.00
(9) $ 40,124.42
(10) 0.00
w
...
"~l:!
fda..o
:J:~9
0..11I
..
<
[R] 1. Original Return
D 4. Umited Estate
o 6. Decedent Oied Testate {A\Iac:flCOjlyofWiIl}
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale ofdeelh alter 12-12-82)
o 7. Decedent Maintained a LMng Trust (AUachcqJyofTrustl
o 10. Spousal Poverty Credit (dale of dBalh between 12-31.91111d 1-1-95)
(11)
(12)
(13)
$ 40,124.42
$383,591. 58
0.00
TELEPHONE NUMBER - -~---
(717) 737-2033
(14)
$383,591.58
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a:
1. Real Estate (Schedule A)
2. Slocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or SoIe-ProprietOl'Shlp
4. Mortgages & Notes Receivable (Schedule 0)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Join!y Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Une 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 Une 13)
(17)
0.00
$ 17, 261. 62
0.00
0.00
$ 17,261.62
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
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II.
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
'.0____ (15)
_, .04.5~16)
(19)
16. Amount of Line 14 taxable at lineal rate
___1383,591.58
17. Amount of Line 14 taxable at sibling rate
_ _________~_ x .12
18. Amount of Line 14 taxable at collateral rate
, .15 (18)
19. Tax Due
20.0
CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
48 Oak. Avenue
CITY
STATE
Camp Hi 11
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 1 g)
2. CredttslPayments
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount
ZIP. 17011
(1)
$17,261. 62
-0-
-=-o=- ..
~.~-~~------------_._-
-0-
3.
TotaICredits(A+B+C)
(2)
0.00
InterestlPenalty if applicable
D. Interest
E. Penalty
-0-
_..,._---~~_._._--
-0-
________u_____
4.
TotallnteresUPenalty ( 0 + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. Th~ is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(3)
(4)
(5)
(SA)
0.00
0.00
$17,261. 62
0.00
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $17, 261 0 62
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X.IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the nght to designate who shall use the property transferred or its income;............................................ D
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for i1fe of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property wnhin one year of death
without receiving adequate consideration? ...........,.....................................................................".""...................... 0
3. Did decedent own an Oin trust fo~ or payable upon death bank aocount or secunty at his or her death? .............. D
4. Did decedent own an Individual Retirement Aocount, annuity, or other non-probate property which
contains a beneficiary designation? .............................................................................................."....."................. 0
No
IX]
IX]
IX]
IX]
IX]
IX]
IX]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjLry, I declare thai I have examined this return, including accompanying schedI.des and statements, and 10 the best of my knowledge and belief, ills true, correct
and complete.
OecIar8tIonofpreparerothetthanthepersonalreprese Uveis based on aU inbmallonofwhichpreparerhasany 1u1ov.1edge.
:~~7~E1-':: ~ETURN ... l'iilltarU.. Haxpgr
5 Andov",r CCo.urt '..I,,!~ana.l-J!mIel.,...Q~_.2.~()77_.._.__
:D7~;EOF.PRE~: OTH~R;:R~PR~ameS...Mo.!3aCh,_Atj;QJ:ne-Y-At.._Ii<lR_.
352 s. fuxlrt-i-.r1rr..tIi 11 ROAQLMechanicsburq, PA 17050
DJTE h
11-1_9 t:'3
DATE
For dales of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survMng spouse ~ 3%
[72 P.S. ~9116 (al (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (im.
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dales of death on or after Juiy 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren~
ora slepparentofthe chiid is 0% [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficianes is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-'502 EX. (6-9*
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDUU A
REAL ESTATE
ESTATE OF
FILE NUMBER
William S. Harper, Jr. 21-02-01109
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 jolntly-owned with right of survivorship must be dlsc:IOIed on Schedule F.
ITEM
NUMBER
,.
DESCRIPTION
48 Oak Avenue, Camp Hill, Pennsylvania 17011
(See Settlement Sheet Attached)
VALUE AT DATE
OF DEATH
$109,000.00
TOTAL (Also enter on line 1, Recapitulation) $1 09 , 000 . 00
(If more space is needed, msert additional sheets of the same size)
A'o.
OMS NO, 2502-0265 ,,".-
A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.oFHA 2.QFmHA 3.0CONV. UNINS. 4.oVA 5.00CONV.INS.
6. FILE NUMBER: I 7. LOAN NUMBER:
SETTLEMENT STATEMENT HOCKLEY.R 024202880
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you B statement of Bctual 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 ~re not inCluded in the t~~~/S.
1.0 3/98 HOCKLEY.R.PFOJHOCKLEV.R115
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
ROBERT W. HOCKLEY AMERICA'S WHOLESALE LENDER
SANDRA K. HOCKLEY WILLIAM L. HARPER. Executor
of the Estate of William S. Harper, Jr.
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23.2402316 I. SETTLEMENT DATE:
48 OAK AVENUE PURITY ABSTRACT COMPANY
CAMP HILL, PA 17011 February 25, 2003
CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT
3329 Market Street
Camp Hill, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSAC110N
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 109000.00 401. Contract Sales Price 109000.00
102. Personal Prooertv 402. Personal Prooertv
103. Settiement Charoes to Borrower lLine 1400\ 8683.97 403.
104. 404.
105. 405.
Adjustments For Items Paid By Seller in advance Adiustments For Items Paid Bv Seller in advance
106. CountvlTwp Taxes to I 406. CountvlTwn Taxes to
107. City Tax to : 407. City Tax to
108. School Tax 02/25103 to 07/01103 ! 303.52 408. School Tax 02/25/03 to 07/01/03 303.52
109. 1ST aTR SEWER/REFUSE $9902/25/03 to 04/01103 , 38.50 409. 1 ST aTR SEWER/REFUSE $99 02/25/03 to 04/01103 38.50
110. I 410.
111. 41,.
112. 412. i
120. GROSS AMOUNT DUE FROM BORROWER 116,025.99 420. GROSS AMOUNT DUE TO SELLER i 109,342.02
I i
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or earnest money I 6000.00 501. Excess Deoosit ISee Instructions' ;
202. Principal Amount of New Loan!s) I 98,100.00 502. Settlement Charnes to Seller lLine 14001 ! 7.828.00
203. Existina loan(s) taken subiect to I 503. Existinn loanls' taken sublact to
204. 504. Payoff of first Mortaaae
205. 505. Pavoff of second Mort a e
206. 506.
207. 507. IDenosit disb. as nroceedsl
208. 508.
209. 509.
Adiustmants For IIams Unpaid Bv Seller Ad'ustments For lIems Unna/d Bv Seller
210. CountvlTwa Taxes 01/01103 to 02/25/03 I 35.01 510. CountvlTwo Taxes 01101/03 to 02125/03 35.01
". f"'lh.T.... 'n I ~11 r.itv T;:!.y to I
, L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ 109000.00 -;a) 6.0000 % 6 540.00 PAID FROM PAID FROM
Division of Commission (fine 7001 as Follows: BORROWER'S SELLER'S
701. $ 3,295.00 to REIMAX REALTY ASSOCIATES FUNDS AT FUNDS AT
702. $ 3,245.00 to CENTURY 21 PISCIONERI REALTY, INC. SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 6,540.00
704. TRANSACTION FEE to RElMAX REALTY ASSOCIATES 195.00::l
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination Fee 1.0000 % to ALLIED MORTGAGE CAPITAL CORP. 981.00
802. Loan Discount 0.5000 % to AMERICA'S WHOLESALE LENDER 490.50
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Flood Cert Fee to LANDSAFE FLOOD 25.00
807. Tax Service Fee to COUNTRYWIDE TAX SERVICE 90.00
806. Document Prep Fee
B09. UNDERWRITING FEE to AMERICA'S WHOLESALE LENDER 500.00
810. BROKER PROCESSING FEE to ALLIED MORTGAGE CAPITAL CORP. 295.00
811. BROKER FEE to ALLIED MORTGAGE CAPITAL CORP. 874.00
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 02n5/03 to 03/01/03 @ $ 18.140000/day ( 4 days %) 72.56
902. Mortasae Insurance Premium for months 10
903. Hazard Insurance Premium for 1.0 vears to POC
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 months $ 23.12 ner month 69.36
1002. Mortaaae Insurance 0.000 months $ 74.39 ner month
1003. CountYlTwo Taxes 13.000 months $ 19.36 ner month 251.68
1004. CilVTax months $ ner month
1005. School Tax 9.000 months @ $ 73.27 per month 659.43
1006. months tal $ Sf month
1007. months tal . nor month
1008. AGGREGATE ESCROW ADJ. months Ifil $ Der month -141.81
1100. TITLE CHARGES
1101. Settlement or Closina Fee to
1102. Abslract or Title Search to
1103. Title Examination to
1104. Insured Closina Letter to First American Title Insurance Co. 35.00
1105. Document Prenaration to ATTORNEY JAMES BACH DEED/POC
1106. Notary Fees to CASH 12.00
1107. Attorney's Fees to
(includes above item numbers: )
1108. Title Insurance to PURITY ABSTRACT COMPANY P.03-056 903.75
fincludes above item numbers: I
1109. Lender's Coverage $ 98,100.00
1110. OWner's Coverage $ 109,000.00
1111. PA ENDORSEMENTS:l00,300,900 to PURITY ABSTRACT COMPANY 150.00
1112. OVemioht Fee/package to PURITY ABSTRACT COMPANY 15.50
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordin9 Fees: Deed $ 38.50; Mortgage $ 72.50; Releases $ I 111.001
1202. City/County Tax/Stam s: Deed 1 090.00' Mortnane I 1 090.001
.. 4 nnn nn
Page 2
REV-1503 EX- (6-<18*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDUU B
STOCKS & BONDS
ESTATE OF
William S. Harper, Jr.
All property JolnUy......ed with rlght of sUNlvonhlp mull be disclosed on Schedule F.
FILE NUMBER
21-02-01109
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
NONE
TOTAL (Also enter on line 2. Recapllulation) $ 0.00
(II more space Is needed. Insert additional shaets of !he sama size)
REV-l504 EX- (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDE~T DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
William S. Harper, Jr. 21-02-01109
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-propcletorships.
ITEM NUMBER
NUMBER
,.
DESCRIPTION
VALUE AT DATE
OF DEATH
NONE
TOTAL (Also enter on line 3, Recapitulation) $ 0.00
(If more space is needed, ilsert additional sheets of the same size)
REV-1507 EX+ (6-96) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
William S. Harper, Jr.
FILE NUMBER
21-02-01109
All property Jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
NONE
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
0.00
REV-lS06 EX_ (6-96) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
.RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
William S. Harper, Jr.
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owntd with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-02-01109
ITEM
NUMBER DESCRIPTION
1. 1998 Buick Regal
VALUE AT DATE
OF DEATH
$ 7,500.00
$ 750.00
$ 1. 734.00
$ 2,692.00
$ 14,359.00
$ 77,062.00
$107,751.00
$ 34,668.00
$ 68,200.00
2. Household Contents
3. Checking Account at waypoint Bank
Account No. 0400010621
Account No. 0430001430
4. Money Market Account at waypoint Bank (Acct. No. 3106104025)
5. Kemper Advantage III
Savings Account No. K00548931
Savings Account No. FK4014132
6. Invest Financial
Savings Account No. E66-001791
7. United States Series E Bonds
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
314,716.00
REV.'509 EX' 16-98.
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOiNTlY-OWNED PROPERTY
ESTATE OF
William S. Harper, Jr.
FILE NUMBER
21-02-01109
If an asset was made joint within one year of the decedenfs date of death,lt must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
NONE
B.
C.
JOINTLY.OWNED PROPERTY:
lETTER DAlE DESCRIPTION OF PROPERTY .OF DATE OF DEATH
ITEM FOR JOINT MACE INClUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIt.lILAR DATE OF DEATH OECO'S VAllE OF
MJM8ER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HElD REAL ESTATE. VALlIE OF ASSET INTEREST DECEDENTS INTEREST
,. A. NONE
TOTAL (Also enWon line 6, Recapitulation) $ 0.00
(If more space is needed, Insert additional sheets of the same size)
REV-1Bl. EX' (6-1l6*
COMMONWEALTH OF PENNSYLVANIA
INHERITANce TAX RETURN
RESIDENT DECEDENT J
SCHEDULE G
INTER.VlVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
William S. Harper, Jr.
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET Is yes.
FILE NUMBER
21-02-01109
ITEM DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE THEIR RELATlONSlfP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXClUSION TAXABLE
NUMBER THE DATE OF TRAHSFER. ATTACH A cr:Pf OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE
1.
NONE
TOTAL (Also enter on line 7 Recapitulation) $ 0.00
(If..... space Is needed, Insert addltlonalsf1eels of llle same siZe)
REV-'511 EX. (12.99.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
William S. Harper, Jr.
FILE NUMBER
21-02-01109
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
NONE
B. ADMINISTRATIVE COSTS:
,. Personal Representative's Commissions $21,185.80
Name of Personal Representative(s) William L. Harper
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 5 Andover Court
City Laguana Niguel State~Z1p 92677
Year(s) Commission Paid: 2003
2. Attorney Fees (James M. Bach, Attorney at Law) $10,000.00
3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation)
Claimant
Street Address
City State _ZIp
Relationship of Claimant to Decedent
4. Probate Fees $ 304.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Register of Wills (PrObate) $ 15.00
8. See Sheet Attached $ 8,619.62
TOTAL (Also enter on line 9, Recapnulatlon) $ 40, 124.42
Debts of decedent mUlt be reported on Schedule L
(If more space Is needed, Insert additional sheets of the same size)
SCHEDULE H
FUNERAL EXPENSES & ADMINISTRATIVE COSTS
Estate 0 f
William S. Harper, JI.
File Number
21-02-01109
PP & L Electric Utilities
Cumberland Co. Law Journal Legal Ad
Patriot News Legal Ad
Pennsylvania American Water Company
AT&T
Repairs to 48 Oak Avenue, Camp Hill, P A
Andrews & Patel (medical bill)
Jackson Gastroenterology (medical bill)
Hampden Township Real Estate Taxes
$110.00
$75.00
$117.61
$17.00
$41.00
$45.00
$49.00
$78.00
$99.00
Settlement Charges for Sale of 48 Oak Avenue, Camp Hill, Pennsylvania:
Commission Paid at Settlement to Re/Max Realty Assoc.
Commission Paid at Settlement to Century 21 Piscioneri Realty, Inc.
Transaction Fee
Recorder of Deeds
Tax Certification Fee
Repairs to Property
Taxes (To Date of Sale)
$3,295.00
$3,245.00
$195.00
$1,090.00
$3.00
$125.00
$35.01
Total
$8,619.62
REV-1512 EX+ (6-96)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABILmES, & UENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDEt'IT DECEDENT
ESTATE OF
William S. Harper, Jr.
ALE NUMBER
21-02-01109
Include unreimbursed medtcal.xpen....
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
NONE
TOTAL (Also enter on line 10, Recapitulation) $ 0.00
(If more space Is needed,lnsert additional sheets of the same size)
Rev.1513EX'(!J.OO1 ..
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
William S. Harper, Jr.
FILE NUMBER
21-02-01109
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 00 Not Ust TRlsllo(s) OF ESTATE
I TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under
Sec. 9116 (01 (1.2)]
William L. Harper Son 100%
5 Andover Court
Laguna Niguel, CA 92677
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE
NONE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NONE
TOTAL OF PART 11- ENTER TOTAL NON-TAXASLE DISTRiBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, Insert additional sheets of the same size)
BUREAU OF INDIVIDUAL TAXES
INHERTTANCE TAX DZVTSION
DEPT. 180601
HARRISBURG, PA 17128-0601
WILLIAM L HARPER
5 ANDOVER CT
LAGUNA NIGUEL
CA 92607
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOTICE OF /NHERZTANCE TAX
APPRAISEHENT. ALLOHANCE OR DISALLO#ANCE
OF DEDUCTIONS,, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 12-29-2005
ESTATE OF HARPER JR
DATE OF DEATH 11-01-2002
FILE NUMBER 11 01-1109
COUNTY CUMBER LAND
· SSN/DC 161-18-9550
ACN 05101q8~
Amoun'l:
REV-I~8 EX AFP
WILLIAM
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP [01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 12-29-2005
ESTATE OF HARPER JR
WILLIAM S DATE OF DEATH 12-01-2002 COUNTY CUMBERLAND
FILE NO. 21 02-1109 S.S/D.C. NO. 161-18-9550 ACN
TAX RETURN WAS: CX) ACCEPTED AS FILED [ ) CHANGED
05101~8~
dOZNT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. q00010621
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING C ) TRUST ¢ ) TIME CERTIFICATE
DATE ESTABLISHED 07-06-1995
Account Balance 2,118.22
Percent Taxable X 0.166
Amount Subject to Tax $55.0~
Debts and Deductions - .00
Taxable Amount
Tax Rate X .15
Tax Due 52.96
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT [+)
INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 01-06-ZOOq
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
AMOUNT PAZD
.00
52.96
.91
55.87
TOTAL TAX CREDIT I
I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. ~
TF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" ~ CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
BUREAU OF INDIVIDUAL TAXES
TNHERZTANCE TAX DIVTSTOH
DEPT. Z8060!
HARRISBURG, PA 171Z8-0601
DOROTHY
~8 OAK AVE
CAHP HILL
HARPER
PA 17011
COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE
NOT/CE OF /NflER/TANCE TAX
APPRAISEMENT) ALLONANCE OR DISALLONANCE
OF DEDUCTIONS) AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 12-29-2005
ESTATE OF HARPER JR
DATE OF DEATH 1Z-OI-ZOOZ
FILE NUMBER Z1 02-1109
COUNTY CUHBERLAND
-. SSN/DC 161-18-9330
ACN 05101R87
Amoun~ Rem/'l:'~ed
REV-15~8 EX AFP (01-03)
WILLIAM S
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ""~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 12-29-2005
ESTATE OF HARPER JR
WILLIAM S DATE OF DEATH 1Z-O1-Z00Z COUNTY CUMBERLAND
FILE NO. 21 02-1109 S.S/D.C. NO. 161-18-9350 ACN
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
05101~87
dOZNT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTIOH: WAYPOINT BANK ACCOUNT NO. 310610~025
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 09-03-1983
Account Balance
Percent Taxable X 0.166
Amount Subject to Tax 2,~01.76
Debts and DeductAons - .00
Taxable Amount 2,q01.76
Tax Rate X .00
Tax Due .00
TAX CREDITS:
1~,~10.Z8 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
WITH VOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE) SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
TF TOTAL DUE IS LESS THAN $1, NO PAYMENT TS REQUIRED.
IF TOTAL DUE TS REFLECTED AS A "CREDIT" { CR), YOU HAY BE DUE A REFUND.
SEE REVERSE STDE OF THIS FORH FOR INSTRUCTIONS. }
.00
.00
.00
.00
BUREAU OF ZNDTVZDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
WILLIAH L HARPER
5 ANDOVER CT
LAGUNA NIGUEL
CA 92607
CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE
NOT/CE OF /NHERTTANCE TAX
APPRATSEHENT, ALLO#ANCE OR DTSALLONANCE
OF DEDUCTTONS, AND ASSESSHENT OF' TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 12-29-2005
ESTATE OF HARPER JR
DATE OF DEATH 12-01-2002
FILE NUHBER 21 02-1109
COUNTY CUMBER LAND
*. SSN/DC 161-18-9350
ACN 03101q86
Amoun~ Remi~e,d
REV-I;48 EX &FP (OI-OS)
WILLIAM S
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA I7013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLONANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-29-2003
ESTATE OF HARPER JR NILLIAM S DATE OF DEATH 12-01-2002 COUNTY CUMBERLAND
FILE NO. 21 OZ-1109 S.S/D.C. NO. 161-18-9330 ACN 05101q86
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORNATION
FINANCIAL INSTITUTION: NAYPOINT BANK ACCOUNT NO.
$10610~025
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 09-03-1983
Accoun~ Balance 1~,~10.28
Percen~ Taxable ~ 0.166
Amoun~ Sub~ec~ ~o Tax Z,~01.76
Debts and Deductions - .00
Taxable Amoun~ 2,q01.76
Tax Ra~e X .15
Tax Due 360.Z6
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
NITH YOUR TAX PAYMENT TO THE
REGISTER OF NILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
ffREGISTER OF WILLS, AGENT.ff
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 01-06-ZOOq
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ZF pAID AFTER THIS DATE, SEE REVERSE FOR CALCULAT/ON OF ADD/TZONAL INTEREST.
( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT 'rs RE{IUZRED.
'rF TOTAL DUE TS REFLECTED AS A "CRED.rT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF TH.rS FORM FOR 'rNSTRUCT'rONS.
.00
360.26
6.21
366.q7
BUREAU OF INDIVIDUAL TAXES
XNHERXTANCE TAX DXVTSTON
DEPT. 280601
HARRXSBURG, PA 1712&-0601
DOROTHY
q8 OAK AVE
CAMP HILL
HARPER
PA 17011
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLONAHCE OR DISALLOHANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP
DATE 12-29-2005
ESTATE OF HARPER JR WILLIAM
DATE OF DEATH 12-01-2002
FILE NUMBER Z1 02-1109
COUNTY CUMBERLAND
:SSN/DC 161-18-9550
ACN 03101q85
Amoun~ Remi~ed
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-29-2003
ESTATE OF HARPER JR WILLIAM S DATE OF DEATH 12-01-2002 COUNTY CUMBERLAND
FILE NO. 21 02-1109 S.S/D.C. NO. 161-18-9330 ACM 03101~85
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO.
~00010621
TYPE OF ACCOUNT: C ) SAVINGS (~ CHECKING ¢ ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 07-06-1993
Accoun~ BaZance 2,118.22
Percen~ Taxable X 0.166
Amoun~ Sub~ec~ ~o Tax 353.0R
Debts and Deductions - .00
Taxable Amoun~ 353.0~
Tax Ra~e X .00
Tax Due .00
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REI~UTRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE STDE OF THIS FORM FOR INSTRUCTIONS. )
.00
.00
.00
.00
BUREAU OF TNDZVZDUAL TAXES
TNHERZTANCE TAX DTVTSTON
DEPT. 28060!
HARRTSBURE, PA 17128-0601
C014140NWEALTH OF PENNSYLVANIA
DEPART14ENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
RE¥-16~7 EX AFP
'04 FEB 13 73:29
JAMES 14 BACH ATTY
$52 S SPORTING HILL RD
14ECHANICSBURG PA 17~Q~. ; _ :,~.~- ~O,J(-t
DATE 02-16-200~
ESTATE OF HARPER JR
DATE OF DEATH 12-01-2002
FILE NU14BER 21 02-1109
COUNTY CUMBERLAND
ACN 101
WILLIAM S
CUT ALONG THIS LINE ~
Amoun~ RaeLti:ed I
14AKE C14ECK PAYABLE AND RE14ZT PAY14ENT TO:
REGISTER OF WILLS
CU14BERLAND CO COURT HOUSE
CARLISLE, PA 17015
RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOT/CE OF ZNHERZTANCE TAX APPRAZSE14ENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESS14ENT OF TAX
ESTATE OF HARPER JR WILLTA14 S FZLE NO. 21 02-1109 ACN 101 DATE 02-16-200~
TAX RETURN NAS: { X) ACCEPTED AS FILED { } CHANGED
RESERVATION CONCERNZNG FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks end Bonds (Schedule B) (2)
3. Closely Held Stock/PartnershAp Interest (Schedule C)
4. Mortgages/Notes ReceAvabla (Schedule D)
S. Cash/Bank DaposAts/MAsc. Personal Property (Schedule E)
6. JoAntly Owned Property (Schedule F) (6).
7. Transfers (Schedule G) (7).
8. Total Assets
APPROVED DEDUCTIONS AND EXE14PTZONS:
9. Funeral Expenses/Adm. Costs/MAsc. Expenses (Schedule H) (9)
10. Dabts/Hortgaga Liabilities/Liens (Schedule 1) (10)
11. Total Deductions
12. Net Value of Tax Return
109~000.00
.00
.00
.00
$1~/716.00
.00
.00
(8)
qO,12~.~Z
.00
NOTE: To Ansura proper
cradAt to your account,
submAt the upper port/on
of thAs form with your
tax payment.
~25,716.00
(11) 40.124.42
(12) 383,591.58
13.
14.
NOTE:
ASSESS14ENT OF TAX: 15. Amoun~ of LAne 14 et Spousal rate
16. Amount of LAne 14 taxable et Lineal/Class A rate
17. Amount of LAne 14 at SAbling rate
18. Amount of LAne 14 *axebla et Collateral/Class B rate
19. Principal Tax Due
TAX CREDTTS:
PAYHENT
DATE
12-12-Z005
12-22-2005
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Net Value of Estate Subject to Tax
.00
383,591.58
Zf an assessment was issued previously, 11nas 14, 15 and/er 16, 17, 18 and 19 Nill
re~lect ~igures that include the total of ALL returns assessed to date.
(2~) .00 x O0 = .00
(26) 585,591.58 x 0~5= 17,261.62
(17) .00 x 12 = .00
(re) .00 x 15 = .00
(1;)= 17,261.62
RECEIPT
NUMBER
CD003357
CD003366
DISCOUNT (+)
INTEREST/PEN PAID (-)
.00
.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-25-2005
ZF PA/D AFTER DATE INDICATED, SEE REVERSE
FOR CALCULAT/ON OF ADDITIONAL /NTEREST.
AMOUNT PAID
16,625.26
638.36
TOTAL TAX CREDTT I 17,261.62
BALANCE OF TAX DUEl .00
TNTEREST AND PEN. 2~2.08
TOTAL DUE 2~2.08
TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REQUTRED.
TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR), YOU MAY BE DUE~
REFUND. SEE REVERSE STDE OF TH/S FORM FOR TNSTRUCTIONS.) ~ ~ ~
BUREAU OF INDIVIDUAL TAXES COHHONNEALTH OF PENNSYLVANIA
INHERITANCE TAX DZVTSZON DEPARTHENT OF REVENUE
DEPT.
HARRISBURG, PA 171Z8-0601 INHERITANCE TAX
RECORD ADdUSTNENT
JOINTLY HELD OR TRUST ASSETS
:~'~ '~ ~g~J O~ DATE 02-11-200~
2~ ~:/~J~S ESTATE OF HARPER JR
DATE OF DEATH 12-01-2002
FILE NUHBER 21 0Z-1~09
'~ F~ 20 [[~1:21 COUNTY CUHBERLAND
N[LL[AH L HARPER ~N/DC 161-18-9550
5 ANDOVER ~.T ACH 0~101~8~
LAGUNA NZ~ '." CA 9~07~d~ Amoun* Remi**,d
....... .... PA
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF ~ZLLS
CUH~ERLAND CO COURT HOUSE
CARLISLE, PA 170~
REV-i&D4 EX AFP COl-aS)
CUT ALONG THIS LINE ~,~
REV-1604 EX AFP (01-03)
RETAIN LO#ER PORTION FOR YOUR RECORDS
~ INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS ~
DATE 02-11-2004
ESTATE OF HARPER JR WILLIAM
S DATE OF DEATH 12-01-2002
COUNTY CUMBERLAND
FTLE NO. 21 02-1109
ADJUSTHENT BASED ON:
S.S/D.C. NO. 161-18-9350
ADMINISTRATIVE CORRECTION
ACN 03101484
dOZNT OR TRUST ASSET ZNFORNATION
FINANCIAL INSTITUTION: NAYPOINT BANK ACCOUNT NO.
400010621
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TINE CERTIFICATE
DATE ESTABLISHED 07-06-1993
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions -
Taxable Amount
Tax Rate X.
Tax Due
TAX CREDITS:
.00
0.166
.00
.00
.00
.15
.00
NOTE:
TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBHZT THE UPPER PORTION
OF THIS NOTICE NZTH YOUR TAX
PAYHENT TO THE REGZSTER OF #ILLS
AT THE ADDRESS SHOgN ABOVE.
HAKE CHECK OR HONEY ORDER PAYABLE
TO: "REGISTER OF #ILLS, AGENT."
PAYHENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AHOUNT PAID
TOTAL TAX CREDIT-F--
BALANCE OF TAX DUEI
INTEREST AND PEN. J
TOTAL DUE /
ZF PAZD AFTER THZS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL ZNTEREST.
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORH FOR INSTRUCTIONS.)
.00
.00
.00
.00
BUREAU OF INDIVIDUAL TAXES
*rHHERTTANCE TAX DI*VISION
DEPT.
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
'04 FEB 20 .11] :2I
WILLIAM L HARPER
5 ANDOVER CT
LAGUNA NI~:~L CA 9,2~6~
,~:mL;';~ ;$~:: Co., PA
DATE 02-11-200q
ESTATE OF HARPER JR
DATE OF DEATH 12-01-2002
FILE NUMBER 21 02-1109
COUNTY CUMBERLAND
SSN/DC 161-18-9550
ACN 05101q8~
I Amoun~ Rem/~ed
REV-I$Oq EX AFP (01-0S)
WILLIAM S
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~
REV-1604 EX AFP (01-03)
#~ 'rNHERZTANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE 02-11-200~
ESTATE OF HARPER JR WILLIAM S DATE OF DEATH 12-01-2002 COUNTY CUMBERLAND
FILE NO. 21 02-1109 S.S/D.C. NO. 161-18-9330 ACN 03101q8q
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO.
q00010621
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 07-06-1993
Account Balance
Percent Taxable X
Amount Subject ~o Tax
Debts and Deductions -
Taxable Aeouni
Tax Rate X.
Tax Due
TAX CREDITS:
.00
0.166
.00
.00
.00
.15
.00
NOTE:
TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
HAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REgUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH~S FORM FOR INSTRUCTIONS.)
.00
.00
.00
,00
BUREAU OF ZNDZVZDUAL TAXES
/NHERZTANCE TAX DTVZSTON
DEPT. 280601
HARRTSBURG, PA 1712&-0601
COMMONWEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
ZNkERZTANCE TAX
RECORD ADdUSTMENT
RE¥-1;95 EX AFP
WILLIAM HARPER
5 ANDOVER COURT
LAGUNA NIGUEL
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
:~ ~OUNTY
ACN
CA ~z6~T ~f
O$-Z6-ZOOq
HARPER JR
1Z-01-ZOOZ
21 02-1109
CUMBERLAND
101
Aaoun'l: Rem J.*l:'l:ed
WILLIAM
HAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To Lnsure proper cred/~ ~o your accoun~ subei~ ~he upper por~:lon of ~hLs form w/th your ~ex paymen~c.
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1593 EX AFP (01-03) ## ZNHERZTANCE TAX RECORD ADdUSTMENT ~
ESTATE OF HARPER dR
WILLIAM S FZLE NO. 21 02-1109 ACN 101 DATE O$-Z6-Z00q
ADJUSTMENT BASED ON:
ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Es~a~e (Schedule A)
2. S~ocks and Bonds (Schedule B)
$. Closely Held S~cock/Par:knershLp Tn~eres~ (Schedule C)
q. Hor~cgages/No~es Receivable {Schedule D)
6. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E)
6. Jointly Owned Proper~y (Schedule F}
7. Transfers (Schedule G)
8. To~el Asse~s
DEDUCTZONS AND EXEMPT:IONS:
9. Funeral Expenses/Adalnls~ra~:ive Costs/
10.
11.
1~.
1-~.
lq.
TAX:
15.
Miscellaneous Expenses (Schedule H)
Debts/Hot,gage LLabilt~ies/Liens (Schedule 1)
To,al Deductions
Ne~ Value of Tax Re~urn
(1) 109/000.00
(2) .00
($) .00
(~) .00
($) 76zq50.00
(6) 119~155.00
(7) .00
(9) qO,12q.qZ
(10) .00
Char/~eble/governeen~al Beques*s; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Subjec~ *o Tax
Amoun~ of L/ne lq a~ Spousal ra~e
(15)
(8) $0~,585.00
(11) qO;12q.q2
(la) Z6~q58.58
(15) . O0
(1~) 26qzq58.58
.OOx O0 = .00
16. Amount of Line lq taxable et Lineal~Class A rate (16)
17. Amoun~ of Line lq e~ Sibllng ra~a (17)
18. Amoun~ of Line lq ~axable a~ Collateral/Class B re~e (18)
19. Principal Tax Due
TAX CREDZTS:
~AY~bNI
DATE
12-12-2005
12-22-2005
NUMBER
CD005557
CD005566
ZF PA~D AFTER DATE 1NDZCATED~ SEE REVERSE
FOR CALCULATION OF ADDZTIONAL ZNTEREST.
UI~GUUNI (*J
INTEREST/PEN PAID (-)
166.$0-
.00
26q~q58.58 x Oq5= 11~900.6q
.OOx 12 = .00
.OOX 15 = .00
(19) 11~900.~6
AMOUNT PAZD
16,625.26
638.36
TOTAL TAX CREDZT I 17,095.32
BALANCE OF TAX DUEl 5,19q.96CR
ZNTEREST AND PEN. .00
TOTAL DUE 5,19q. 96CR
( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR)~ YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)
STATUS REPORT UNDER RULE 6.12.
Name of Decedent: William S. Harper, Jr..
Date of Death: December 1, 2002
Will No.: 2002-01109 Admin. No.: 21-02-1109
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
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
~--]Yes [] No
bo
The separate Orphans' Court No. (if any) for the personal
representative's account is: N/A
Did the personal representative state an account informally to the parties
in interest? [] Yes [] No
a)
Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
Date: November 19, 2004
Capacity:
nature
James M. Bach, Attorney-at-Law
Name (Please type or print)
352 S. Sporting Hill Road, Mechanicsburg, PA 17050
Address
717-737-2033
Phone No.
Personal Representative
X Counsel for Personal Representative
STATUS REPORT UNDER RULE 6.12
Date of Death: 1'2-/i /OZ.
Will No.: ~-- 0 0 2 - ~ / / O? Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
i. State w__~er administration of the estate is complete:
Yes
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 f011ow/ng:
a. Did the personal ~j,~entative file a final account with the Court?
Yes _ 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 ~'] No ~
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Cleric of the Orphans' Court
and may be attached to '
this report.
Address
Telephone No
Capacity: ~Personal Re2resentative
~] Counsel for~personal representatR, e
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DTVZSZON
DEPT. Z80601
HARRTSBURG, PA 171Z8-0601
COMHONWEALTH OF PENNSYLVAN:[A
DEPARTMENT OF REVENUE
'rNHERZTANCE TAX
STATEMENT OF ACCOUNT
REV-160? EX AFP (01-03)
WILLIAM HARPER
5 ANDOVER COURT
LAGUNA NIGUEL
'04 ?iffy Z4
CA 92677
DATE 05-05-200q
ESTATE OF HARPER JR
DATE OF DEATH 1Z-OI-ZOOZ
FILE NUMBER 21 02-1109
/!~ONTY CUMBERLAND
ACN 101
I Amoun~ Remi~ed
WILLIAM S
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~C ~co your account, subei~ ~he upper por~[on of ~his form wi~h your ~ex payment.
CUT ALONG TH'rS L'rNE ~ RETA'rN LOWER PORT'rON FOR YOUR RECORDS *~
REV-1607 EX AFP (01-03) x## INHER'rTANCE TAX STATEMENT OF ACCOUNT x~
ESTATE OF HARPER JR WILLIAM S F'rLE NO. Z1 02-1109 ACN 101 DATE 05-05-200q
TH'rs STATEMENT 'rs PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHO#N DELO#
ZSA SUMMARY OF THE PR'rNCZPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, 'rF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-25-200~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
11,900.56
PAYMENTS
PAYMENT
DATE
12-12-2005
12-22-2005
0fi-15-200~
(TAX CREDITS):
RECEIPT
NUMBER
CD005557
CD005566
REFUND
DISCOUNT (+)
INTEREST/PEN PAID (-)
166.50-
.00
.00
AMOUNT PAID
16,625.26
658.56
5,19~.96-
TOTAL TAX CREDIT 11,900.56
BALANCE OF TAX DUE .00
INTEREST AND PEN. .BO
TOTAL DUE .00
'rF PA'rD AFTER TH'rS DATE, SEE REVERSE
S'rDE FOR CALCULAT'rON OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1~
NO PAYMENT IS REQUIRED.
'rF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~
YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF THIS FORM FOR INSTRUCTIONS. )
~/-~470 EX (6-88)
I~IHEI~ITANCE TAX
EXPLANATION
: COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
~)ECEDENT'S NAME FILE NUMBER
WILLIAM S HARPER 2102-1109
REVIEWED BY ACN
SCOTT ELLISON 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
THE JOINTLY OWN ITEMS HAVE BEEN REMOVED FROM SCHEDULE E AND ENTERED ON
SCHEDULE F.
ROW Pane 1
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/10/2004
BACH JAMES M
352 S SPORTING HILL ROAD
MECHA_NICSBURG, PA 17055
RE: Estate of HARPER WILLIAM S JR
File Number: 2002-01109
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6 12) in the above captioned
estate. '
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET 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 will become delinquent on: 12/01/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
CC:
File
Personal Representative(s)
Judge