HomeMy WebLinkAbout04-0454Register of Wills of~ Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Marcella A. Headdings No. ~-~- ~q-
also known as Marcella A. Headings
, Deceased Social Security No. 207-28-8125
Petitioner(s), who is/are 18 yea~s of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix
L~ Decedent, dated 10/16/03 and codicil(s) dated
NONE
named in the Last Will of the
State relevant circumstances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minodtate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary, c~
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 275 High Road, Shippensburg, PA 17257
(list street, number and municipality)
Decedent, then .89 years of age, died April 13 ,2004 , at Chambersburg, Pennsylvania
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ......................................... $
(if not domiciled in PA) Personal property in Pennsylvania .................... $
(If not domiciled in PA) Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total ..................................................................................................................... $
30,000.00
30,000.00
Real Estate situated as follows:
275 High Road, Southampton Township, Cumberland County, Pennsylvania
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
I ~[2~.,~.~.~-_....._ "/ ~/.~?-Signature ~:~.~ Typed or printed name and residence
Patricia M. Ott
275 High Road
Shippensburg, Pa. 17257
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
before me this ~'ff'-"~- day of
DECREE OF REGISTER
Estate of Marcella A. Headdinqs
Deceased No. ~:~,~ - O~- ~5 ~
also known as Marcella A. Headings
IT IS DECREED that Letters [~ Testamentary [] of Administration
are hereby granted to Patricia M.Ott
Social Security No: 207-28-8125 Date of Death: 4/13/04
AND NOW, May \ [ , 2004 in consideration of t~Petition
on the reverse side hereon, satisfactory proof having been presented before me, ,
(c.t.a.. d,b.n.c.t.; pendente lite; durante absen,~tia; durante minoritate)
in the above estate and that the instrument(s), if any, dated October 16, 2003
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .................................... $-'"~ , ~
Short Certificate(s) ............... $ I_t _ b0
Renunciation .......................... $
Affidavit ( ) ....................... $
Extra Pages( ) .............. $ ~. ~)0
Codicil ................................. $
bb
JCP Fee ................................. $ IO,
Inventory & Tax Forms ............. $
Other ...................................... $
Attorney
Attorney:
I.D. No:
Address:
RW-7A
TOTAL ............................. $ qc~-00
Telephone:
DATE FILED:
LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS, that I, MARCELLA A. HEADDINGS
to Pennsylvania being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament hereby revoking
all prior wills and codicils by me at any time heretofore made.
FIRST: I direct the payment of all my legal debts, funeral
expenses including my grave marker and all expenses of my last illness, state,
federal estate and inheritance taxes and administration costs shall be paid as
soon as may be conveniently done following my decease leaving all specific
bequests free of tax to the legatee.
SECOND: I give, devise and bequeath all my property be it real, mixed
or personal to my daughter, Patricia M. Ott. I make no provi~l~ns in Bis will~f~t
my son, Larry Stine since he has a home and it is my intent that bot ~ll:~n_~ y
children be secure.
THIRD: I nominate and appoint my daughter, Patricia M. Ott~i~s .r..
Executrix of this my Last Will and Testament. The said Executrix shall serve
without bond of any nature or kind.
IN WITNESS WHEREOF, I, MARCELLA A. HEADDINGS this my Last Will
and Testament set my hand and official seal, this 16th day of October, 2003.
Marcella A. Headdi~gs - - - C]
Sworn to and subscribed, declared and
Published by Marcella A. Headdings, as
Her Last Will and Testament, and so
Done in the presence of we the
Witnesses, who sign at her request,
And in her presence, and in the presence
Of each other.
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND ·
I, Marcella A. Headdings, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge
that I signed it willingly and that I signed it as my free and voluntary act for the
purpose therein expressed.
Marcella A. Headdings -~'
Sworn to and acknowledged, before me,
By Marcella A. Headdings, Testatrix
This 16th day of October,2003.
Notary Public
I Notarial Seal I
H, Anthony Adams, Notary Public
~hippensburg Boro, Cumberland County
My Commission Expires May 15, 2006
M~1111~, PermayNania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND ·
WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whose
names are signed to the foregoing instrument, being duly qualified according to
law, do depose and say that we saw the Testatrix sign and execute the
instrument as her Last Will and Testament; that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatrix signed the Will as
witnesses, and that to the best of our knowledge and belief the Testatrix was at
the time at least eighteen (18) or more years of age and of sound mind and
under no constraint or undue influence.
Sworn to and subscribed before me by,
Darlene M. Bigler and Sharon Coleman Adams,
The witnesses, this 16th day of October, 2003.
Notary Public
~ Notarial Seal
I _. H. Anthony Adams Not p ,
Shi ri , ary ublic
~ , umt~rland County
/ *~Y Commission Expires May 15. 2006
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 08/02/2004
ADAMS H ANTHONY
49 W ORANGE ST SUITE 3
SHIPPENSBURG, PA 17257
RE: Estate of HEADDINGS MARCELLA A
File Number: 2004-00454
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 08/21/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Personal Representative(s)
Judge
Sincerely,
Clerk of the Orphans' Court
Cumberland County - Register Of wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 08/02/2004
OTT PATRICIA M
275 HIGH ROAD
SHIPPENSBURG, PA 17257
RE: Estate of HEADDINGS MARCELLA A
File Number: 2004-00454
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHAi~S' 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 08/21/2004
Your prompt attention to this matter will be appreciated.
Thank You.
CC:
File
Counsel
Judge
Sincerely,
Clerk of the Orphans' Court
CERTIFICATION OF NOTICE UNDER RULE 5.6(a1
Will No. Admin. No. ~[ t - (i) ~'/- O ~{ -~ %/
To the Register:
I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on {~,oq~ o%4, } [ i ~O/hV :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except.
Capacity: __
Personal Representative
~Counsel for personal representative
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died
without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, Cumberland
In re Estate of Marcella A. Headd ngs aka Marcella A. Headings
File No,
TO: Patricia M. Ott
, PENNSYLVANIA
, deceased,
(beneficiary)
275 High Road
Shippensburg, PA 17257
Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below.
The Decedent, Marcella A. Headdings aka Marcella A. Headings , died on 4/13/04
in Cumberland County
X The Decedent died testate (with a Will)
__ The Decedent died intestate (without a Will)
Name(s), address(es) and telephone number(s) of all personal representatives appointed:
Name Address
Patricia M. Ott 275 High Road, Shippensburg, PA 17257
Telephone
717-532-2860
If the Decedent died testate, the Will has been filed with the Office of the Register of Wills of:
If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of:
A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication.
X A copy of the Will or Petition is attached.
Date
I I
Capacity:
X
Personal Representative
Counsel for Personal
Representative
Signature
Name
Address
Telephone
H. Anthony Adams
49 W. Orange Street, Suite 3
Shippensburg PA 17257
717-532-3270
LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS, that I, MARCELLA A. HEADDINGS
to Pennsylvania being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament hereby revoking
all prior wills and codicils by me at any time heretofore made.
FIRST: I direct the payment of all my legal debts, funeral
expenses including my grave marker and all expenses of my last illness, state,
federal estate and inheritance taxes and administration costs shall be paid as
soon as may be conveniently done following my decease leaving all specific
bequests free of tax to the legatee.
SECOND: I give, devise and bequeath all my property be it real, mixed
or personal to my daughter, Patricia M. Ott. I make no provisions in this will for
my son, Larry Stine since he has a home and it is my intent that both my
children be secure.
THIRD: I nominate and appoint my daughter, Patricia M. Ott, as
Executrix of this my Last Will and Testament. The said Executrix shall serve
without bond of any nature or kind.
IN WITNESS WHEREOF, I, MARCELLA A. HEADDINGS this my Last Will
and Testament set my hand and official seal, this 16th day of October, 2003.
Marcella A] Headdings
Sworn to and subscribed, declared and
Published by Marcella A. Headdings, as
Her Last Will and Testament, and so
Done in the presence of we the
Witnesses, who sign at her request,
And in her presence, and in the presence
Of each other.
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND :
I, Marcella A. Headdings, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge
that I signed it willingly and that I signed it as my free and voluntary act for the
purpose therein expressed.
Marcella A. Headdings
Sworn to and acknowledged, before me,
By Marcella A. Headdings, Testatrix
This 16th day of October,2003.
Notary Public
Notarial Seal
H. Anthony Adams. Notary Public
Shippensburg Born, Cumberland County
My Corem ss on Exp res May 5, 2006
Mel~bet, P~nWtv~nie AssoOation of Notaries
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND :
WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whose
names are signed to the foregoing instrument, being duly qualified according to
law, do depose and say that we saw the Testatrix sign and execute the
instrument as her Last Will and Testament; that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed;
that each Of us in the hearing and sight of the Testatrix signed the Will as
witnesses, and that to the best of our knowledge and belief the Testatrix was at
the time at least eighteen (18) or more years of age and of sound mind and
under no constraint or undue influence.
Sworn to and subscribed before me by,
Darlene M. Bigler and Sharon Coleman Adams,
The witnesses, this 16th day of October, 2003.
Notary Public
Notarial Sea~ ]
REV-1500 EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Headdin 5
DATE OF DEATH (MM-DD-Year)
Marcella A
DAfE OF BIRTH (MM-DD-Year)
11
OFFICIAL USE ONLY
FILE NUMBER
a L-il~_()'-Ls=.~
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
2 0 7 - 2 8 - 8 1 2 5
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
Q... 8. Total Number of Safe Qleposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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04/13/2004 09/24/1914
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[RJ 1. Original Return
D 4. Limited Estate
[RJ 6. Decedent Died Testate (AttachcopyofWiH)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
D 10. Spousal Poverty Credit (date 0' death between 12-31-91 and 1-1-95)
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NAME
H. Anthon Adams
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
49 W. Orange Street
Suite 3
TELEPHONE NUMBER
717-532-3270
Shi
(1)
(2)
(3)
(4)
(5)
(6)
(7)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D 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)
(9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
X _(15)
37,696.36 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. 0
CHECK HERE IF YOU ARE REQUESTiNG A REFUND OF AN OVERPAYMENT
(8)
(11)
(12)
(13)
(14)
r
43,890_00
()
PA 17257
OFFI~1 USE ONLY
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4,879.93.j. :
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48,769.93
11,073.56
11 ,073.56
37,696.37
37,696.37
1 ,696.34
1,696.34
Decedent's'Complete Address:
STREET ADDRESS
275 HiQh Road
CITY I STATE T ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) _I 6 q b. 3 <j
,
Total Credits (A + B + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
Total Interest/Penalty ( 0 + E)
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
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
(4)
(5)
(5A)
(5B)
to: REGISTER OF WILLS, AGENT
\ 6 9 {" ~l(
5.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check
16q~. 3Y
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 property transferred; ........................................................................... D IXl
b. retain the right to designate who shall use the property transferred or its income; ........................................ D I&l
c. retain a reversionary interest; or ...................................................................................................... 0 I&l
d. receive the promise for life of either payments, benefits or care? ............................................................. D I&l
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................... D I&l!
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D I&l
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... D I&l
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 pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN URE OF PERSON ~ESPONSIBLE FOR FIL'.W ~N DA E
02 ~ &-.. . ()
ADDRESS Patricia att
275 High Road, Shippensburg
SIGNATURE PREPARER OTHER THAN RE~~IVE __
ADDRESS H. Anthony Adams
For dates 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 surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)). 'D. ;', p C:;;I-'
'-' '- C-A-J C.) 0
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 th .
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of PC\. 'l 0 (3.:)
the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000: f.\ P'i::::>
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death
or a stepparent of the child 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 beneficiaries is 4.5%, eXCE
The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1'''JJ. p. SlDmTg '''=nn-.., w._ --.__. . 102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
(1.1) (ii)).
Ible even if
to
. (,) ('.:)
)tive parent,
J L\ (ASt
9116(a)(1 )].
REV-1502 EX + 1.6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Headdings Marcella A
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with ri!lht of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
43,890.00
275-277 High Road
Shippensburg, PA 17257
as per deed of January 19, 1972 in Deed Book "R" volume 24 page 1021
map # 39-13-0104-018A Land Value (less than 1 acre) $39,000.00. Improvement
1968 Mobile Home 4890. Total 43890 X Common Level ration Factor of 1.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
43 890.00
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REV-1509 EX + (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Headdings
FILE NUMBER
Marcella
A
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIOtilSHIP TO DECEDENT
A. Cindy Barklow
275 High Road
Shippensburg, PA 17257
grand-daughter
B
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JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1/28/80 M& T Bank -Checking Account #97282278 9,759.86 50. 4,879.93
TOTAL (Also enter on line 6, Recapitulation) $ 4 879.93
(If more space is needed, insert additional sheets of the same size)
REV-!'" EX.".
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Headdin9s
FILE NUMBER
Marcella
A
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Fogelsanger-Bricker Funeral Home
6,138.40
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attorney Fees H. Anthony Adams
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant Patricia Ott
Street Address 275 High Road
City Shippensburg State PA
Relationship of Claimant to Decedent daughter
1,250.00
3,500.00
Zip 17257
4.
Probate Fees
142.00
5.
Accountanfs Fees
6.
Tax Return Preparer's Fees
7.
Chambersburg Hospital (Expense of Last Illness)
43.16
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11 073.56
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
H dd'
M
SCHEDULE J
BENEFICIARIES
II
A
! I
FILE NUMBER
ea me 5 arce a
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (al (1.2)]
1. Patricia M. Ott daughter 100%
275 High Road
Shippensburg, PA 17257
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS: ,
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
REL426D
CUMBERLAND COUNTY
Public Inquiry
Cntl Number 39 734
Map Number 39-13-0104-018A
Old Ref
Grantor
Grantee(l)
(2 )
Address
HEADINGS, PAUL C & MARCELLA A
275 HIGH ROAD
SHIPPENSBURG PA 17257
SITUS: Desc. (1) 277 HIGH ROAD
(2 )
Property Desc. (1)
(2) LAND LESS THAN 1 ACRE
(3) Mobile Home - With Land
Preferred Land Val
Land Val 39000 Total Value
Improvement Val 4890 43890
Mineral Val
F12=Cancel F10=Sales F5=Taxes
Acreage
SOUTHAMPTON TOWNSHIP
SHIPPENSBURG AREA S.D.
Land Use Code
Consideration
Sale Date
Deed Bk/Pg
Taxable/Exmpt
Clean&Green?
Sqft
Bldg Area
Gross Area
Dimensions
Year Built
Initial Struct
Mobile Home Code
Mobile Home Park
Mobile Home Mfg.
Mobile Home Year
Mobile Home Unit
II
.800
RT
TAXABLE
690
100 350
1968
BURLINGTON
II
rlM&I'Bank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
August 3, 2005
Law Office
H Anthony Adams
49 West Orange Street, Suite 3
Shippensburg, Pennsylvania 17257
Re: Estate of Marcella A Headdings
Social Security: 207-28-8125
Date of Death: April 1], 2004
Dear Sir or Madam:
Per your inquiry dated July 27, 2005, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1.
Type of Account
Checking Account
Account Number
97282278
Ownership (Names oj)
Cindy A Bark/ow *
Marcella A Headdings *
Patricia M Ott, POA
Opening Date
01/28/80
Balance on Date of Death
$9,759.86
Accrued Interest
$ 0.00
Total
_...._.....__..... .."'_0_..
$9,759.86
Please be advised, there was no safe deposit box found for the above decedent.
* For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call
the Walnut Bottom Office # 717-532-2414.
Sincerely,
~~/t?~
Nancy Clagett
Records Management
I'
LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS, that I, MARCELLA A. HEADDINGS
to Pennsylvania being of sound and disposing mind, memory and understanding~
I
do make, publish and declare this my Last Will and Testament hereby revoking
all prior wills and codicils by me at any time heretofore made.
FIRST: I direct the payment of all my legal debts, funeral
expenses including my grave marker and all expenses of my last illness, state,
federal estate and inheritance taxes and administration costs shall be paid as
soon as may be conveniently done following my decease leaving all specific
bequests free of tax to the legatee.
SECOND: I give, devise and bequeath all my property be it real, mixed
or personal to my daughter, Patricia M. Otto I make no provisions in this will for
my son, Larry Stine since he has a home and it is my intent that both my
children be secure.
THIRD: I nominate and appoint my daughter, Patricia M. Ott, as
Executrix of this my Last Will and Testament. The said Executrix shall serve
without bond of any nature or kind.
IN WITNESS WHEREOF, I, MARCELLA A. HEADDINGS this my Last Will
and Testament set my hand and official seal, this 16th day of October, 2003.
'-~l 0- k(""%~ 4. 4~X--;~~~ fFAL)
Marcella A. Headdings .
I'
Sworn to and subscribedr declared and
Published by Marcella A. Headdingsr as
Her Last Will and Testamentr and so
Done in the presence of we the
Witnessesr who sign at her requestr
And in her presencer and in the presence
Of each other.
//fi
(/ .' I{ Ai/~1
'--./
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
Ir Marcella A. Headdingsr whose name is signed to the foregoing
instrumentr having been duly qualified according to lawr do hereby acknowledge
that I signed it willingly and that I signed it as my free and voluntary act for the
purpose therein expressed.
I'. " .
)1.Jc'i...\.-"'-' ,:"",,- c~._.,
Marcella A. Headdings
J.D
Sworn to and acknowledgedr before mer
By Marcella A. Headdingsr Testatrix
This 16th day of Octoberr2003.
~-9
Notary Public
~
Notarial Seal
H. Anthony Adams, Notary Public
Shippensburg Boro, Cumberland County
My Commission ElIpires May 15, 2006
Member, PoonS'y'lvania AsSOCiation 01 Notaries
II
, .
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whosel
names are signed to the foregoing instrument, being duly qualified according to!
law, do depose and say that we saw the Testatrix sign and execute the i
I
instrument as her Last Will and Testament; that she signed willingly and that sh~
executed it as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatrix signed the Will as
witnesses, and that to the best of our knowledge and belief the Testatrix was at
the time at least eighteen (18) or more years of age and of sound mind and '
under no constraint or undue influence.
iJf1A ~-/Lk- -17J.(3[:viA)
J
/,
.\C:jjuuoc
C'i' - (i-'
_-;~~IC4tC/ -l~tt<~
/-
Sworn to and subscribed before me by,
Darlene M. Bigler and Sharon Coleman Adams,
The witnesses, this 16th day of October, 2003.
~~
Notary Public
~
H Notarial Seal
ShjpPe~~~~nYB Adams, Notary Public
My Comm.g. oroE, Cumberl:1nd County
ISSlOn Xp1res May 15. 20()6
Member, PennsY'val1ip AOs~(, ,\,,~;;;-I
-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT_ 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ADAMS H ANTHONY
49 WEST ORANGE STREET
SUITE 3
SHIPPENSBURG, PA 17257
_~__nn fold
ESTATE INFORMATION: SSN: 207-28-8125
FilE NUMBER: 2104-0454
DECEDENT NAME: HEADDINGS MARCELLA A
DATE OF PAYMENT: 09/06/2005
POSTMARK DATE: 09/06/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 04/13/2004
NO. CD 005765
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,696.34
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 2407
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$1,696.34
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
11-14-2005
HEADDINGS
04-13-2004
21 04-0454
CUMBERLAND
101
APPEAL DATE: 01-13-2006
( See reverse side under Objections)
Amount Remitted I I
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:is47-Ex-AFp-coj:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEHENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARCELLA A FILE NO. 21 04-0454 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
H ANTHONY ADAMS
STE 3
49 W ORANGE ST
SHIPPENSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17257
ESTATE OF
HEADDINGS
REV-1547 EX AFP (06-05)
MARCELLA
A
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 11-14-2005
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
ll)
(2)
(3)
(4)
(5)
(6)
(7)
43,890.00
.00
.00
.00
.00
4,879.93
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
llO)
ll, 073.56
.00
(11)
ll2)
ll3)
ll4)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
48,769.93
11 .073 56
37,696.37
.00
37,696.37
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 =
37,696.36 X 045 =
.00 X 12 =
.00 X 15 =
ll9)=
.00
1,696.34
.00
.00
1,696.34
Kt.\;U.'" (+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
09-06-2005 CD005765 .00 1,696.34
BALANCE OF UNPAID INTEREST/PENALTY AS OF 09-07-2005 TOTAL TAX CREDIT 1,696.34
BALANCE OF TAX DUE .00
INTEREST AND PEN. 54.85
TOTAL DUE 54.85
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. (](
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ADAMS H ANTHONY
49 WEST ORANGE STREET
SUITE 3
SHIPPENSBURG, PA 17257
__nhn fold
ESTATE INFORMATION: SSN: 207-28-8125
FILE NUMBER: 2104-0454
DECEDENT NAME: HEADDINGS MARCELLA A
DATE OF PAYMENT: 11/23/2005
POSTMARK DATE: 11/22/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 04/13/2004
NO. CD 006029
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $54.85
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
H ANTHONY ADAMS, ESQ
CHECK# RSK
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
$54.85
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
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BUREAU OF INDIVIDUAL-,TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
:".~- -,
i_. j t I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
c:q
"-JU
(\
H ANTHONY"iADAMS
STE 3
49 W ORANGE ST
SHIPPENSBURG
*'
REV-1607 EX AFP (03-05)
12-12-2005
HEADDINGS
04-13-2004
21 04-0454
CUMBERLAND
101
AIIount R_1 tted
MARCELLA
A
PA 17257
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
--+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF HEADDINGS MARCELLA A FILE NO.21 04-0454 ACN 101 DATE 12-12-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED SSTATE. SHOWN BELOW
IS A SUHKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-14-2005
PRINCIPAL TAX DUE: 1,696.34
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-06-2005 CD005765 .00 1,696.34
11-22-2005 CD006029 54.85- 54.85
.
TOTAL TAX CREDIT 1,696.34
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
c
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
ADAMS H ANTHONY
49 WEST ORANGE STREET
SUITE 3
SHIPPENSBURG, PA 17257
RE: Estate of HEADDINGS MARCELLA A
File Number: 2004-00454
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
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:
4/13/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
'Co
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
OTT PATRICIA M
275 HIGH ROAD
SHIPPENSBURG, PA 17257
RE: Estate of HEADDINGS MARCELLA A
File Number: 2004-00454
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
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:
4/13/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
{i
Re2:ister of Wills ofCllrnhprbnil Coun~T
STATUS REPORT UNDER RULE 6.12
Name of Decedent: \"Y'\ll f Oe \ \~ ~,
C>..- \'" c.. \Y\~ C...Q \ \6-
Date of Death: <...{ I i ~ I d-.c:J:) Y
Estate No.: dDC> \.{ - D (J ~r 5 y
\~:',()~~lb,~"{ <;
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. Statwther administration of the estate is complete:
YesR NoD
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. I is Yes, state the following:
Did the person~presentative file a final account with the Court?
Yes D No Y\.
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
a.
c.
Did the person;\!(epresentative state an account informally to the parties in
interest? Yes A No D
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
, \ ~CCos,"~ ~
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Name
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Add,ess 9 \ ~O<;> N .~ lN~ I~'
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Telephone No.
Signature
Dat"~
Capacity:
~ersonal Representative
~ounsel for personal representative
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