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Home My WebLink About03-0976PETITION FOR PROBATE and GRANT OF LETTERS Estate of /Jf/It,~J; ~. ,t~aJ"~7~ No. also known as To: Deceased. Social Security No. o~[~l-/f - ~[ Register of Wills for the County of Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r/x in the last will of the above decedent, dated and codicil(s) dated in the named 19~7 (state relevant circumstanees, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ('?o~'~/a. qff/ County, Pennsylvania. with htr last family or principal residence at ~t#~/' ~n~ f//g ~.] /7~ /~,~'~'~,~ ,~ (list street, number and muncipality) Decendent, then ?~. years of age, died ~ /7/',~'. l/ ,~--~'t~03., Excep{ as ~ollows, decedent ~tid not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully req,uest(s)~ the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 COUNTY OF ~J~ml~eP.l~Nl~ f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well an~ truly administer the ~e~tate accc~rding to law. Sworn to or affimed and subscribed ~ ~ ~~~ befor9 me this fi~' day of [ ~r~ ~. ~/~.~r. ~ / ?- ./ ' ) :? -. - ~ Estate of , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having b.een_presented before me, IT IS DECREED that the instrument(s) dated ~C~//~/~-~,:.~/4~.~.~/ ~/ /9~?.~ described therein be admittqt to probate and filed (o~f,r~ecord as the last win of ~d Letters ~~t cF/) ~&' ' ~e hereby ~ted to ~~ ~ .~..~'T)~, in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... Renunciation ................ ~'~) TOTAL Filed .. ~.-. :~7.C~ Register of Wills ~_~/Q ATTORNEY (Sup. Ct. I.D. No.) 3~13 ADD.SS 7/7- ~ -~2~ PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9650397 No. Local Registrar ~ oo3 Date Rev. 2t87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER I NAME OF DECEDENT (First' Middle' Last) ...... ISEX-- o ISOCIAL SECURITY NUMBER ] DATE OF DEATH (Month, Day, Year) U.E.,"' R V Months Days ! Hours [ Minutes I {Month, Day, Year} I SmteorFo~eignCountry) HOSP~I~: IOTHER ,. 96 Yrs. I I ], &-Z7-1907 I. Ling.e.e. stown,Pal'"""[~ ~o.,,.,I-I ~o~l--I ,~ n ,..,.~r-1 o~ n CITY, BORO, TVVP OF DEATH [ FACILITY NAME (Il ~t insUtulion, give street and number) [WAS DECEDENT OF HISPANIC ORIGIN? [ RACE - .~ican indian, Black, White, et !~1 COUNTY OF DEATH m ~ ~tr Cumberland ~ .... I ...... / · / INo[5~ Y,I--],yos. s~C~be,. I{SPe~) DECEDENT'S USUAl. OCCUPATION KIND OF BUSINESS / INDUSTRY }NAS DECEDENT ~VER IN ' S[SECEDENT~S EDUCATION I MARITAL STATUS - Ma~ ed, I SURVIVING SPOUSE / Yes [] No ~ Elem~r~¥Seconda~/ C~ D!vo~,ced (SPerry) ,,.. Ho~e~:fe I,,,. I,'. DECEDENT'S MAILING ADDRESS (Street, City/Town. State, Zip Code) [ DECEDENT'S ACTUAL 17c. 1700 ~ke~: S~reet IRESlDENCE 17a. State POlq~q~'rl~lI/3tq'[l~ decedentDid [] Yes. decedentlivedin [wp. Caren Hi~-~ PA I ?/111 I (See instructions live in a 15. P' ...... I on other side} 17b. Cou~t~ Cu. mberlan~ tew. mp? lid. 1~ NO, decedent lived wimin actual limits ~f C~[m.D H~ city/b(xo. FATHER'S NAME {First, Middle. Last) MOTHER'S NAME (Fkst, Middle, Maiden Surname) ~.. Wellington Zimm~man ~. ~ff L. Bola:on INFORMAN'I~S NAME (Type/Print) INFORMAN'FS MAILING ADDRESS (Streel City/Town Stele. Zip Code) 2o,. Jerrq A. Walme~, Sr. 2o~. 27 Nottin,~htun Drive, Mechcmiesbttr.q~ PA 17050 METHOD OF DISPOSITION I DATE OF DISPOS~TION ~ PLACE OF DiSPOSITiON- Name o! Corrmtery. Crsmatov/ [LOCATION- City'own, Stee. Zip Code o~,Is,~ []I~. 11-17-2003 I o'S Cemetery l~d' Ha~risbt6r.q~ PA NAME~OADDRESSOFFACILm~ Zimmerman-Auer ~uneral Home, Int 2~a;~ 2~c. Shoo! s~q~ OF FUNERAL SER~t~E Llff~NSEE DR PERSON ACTING AS SUCH UCENS£ NUMBER ......... '~. ! y g , occurred al the.~llw~, da~ a~l p~ac~ slal~:~[ LICENSE NUMBER ' DATE ~IGNED pe~.;:,L...c~.:~~y Ir,ME O~T.. - I DATEI~ONOUNCEI~EAD (Mouth, Day, Year) '~- I WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONER? E ' /~'. ,.5:A-/J i't(Y~M-I~,."l~_~,.~--_-~-,..l[~.,__. /I ,,P-~a~ I~" Y.B[] .o [~.--------' IMMEDIATE CAUSE (Final ~ any, ~ to ~ale {: ~ TO (O~S A CO~SE~EN~ ~): ~use. Ent~ UNDERLYING : CAUSE (~ase Ct ~u~ resul~g ~ ~ath ) ~ST [ onset and PERFORMED?WAS AN AUTOPSY AvAWERELABLEAUTOPSYpR oRFINDINGSTO I MANNER OF DEATH | (Mo~e,DATE OFDay.INJURYyear) I TME OFN JURY INJURY AT WORK? I DESCR BE HOW INJURY OCCURRED. I COMPLETION OF CAUSE I Natural[] Homicide I--11 I I I°FDEAT"?I .... [] .....,,.-. 51 I ,..[] NoD I Ye, B Nol~I Ye, D .o~Z Isu.id.[] couid.o,,.dete~ined n'°"'l~----- ~ I ~ I ~ I F~CE_~I~R~' At h~e, farm. air.t, fa~, ~ I LOCATI~ (SVeeL ~o~, Slate) CERTIFIER (C~ ~ me) SIG~TURE ~D TITL~ C '~RO~OUNCmG AND CER~FYmG PHY~N (~y~ ~m ~n~ ~am an~ ~m~mg to cause o~ death~ I LICENS~UMBER- ~.. - ' -~TE SIGNED (~m, Day Year) *MEDm~ ~MINE~CORONER I (t~m 27) Ty~ ~ ~l bllll of examlnitl~ a~l~ nvest gatl~ n my Dp n on dea~ occurred at t~ time da~ and place and due to the cauiee(s) and I /~_ DATE FILE'~ (l~on-th D~y, Year) RENUNCIATION In Re Estate of //~/~,]/ ~' ~0~/~/~ deceased. To the Register of Wills of ~/~ ~"~Zff~) County, Pennsylvania. The ~dersigned ~ILZI~ F~~/ ~: ~ n~ ~e~r ~ ~,71 of the above d~edent, hereby renounce(s) the dght to ad~ffister the estate ~d resp~tfully ~k(s) that Letters be issued to ,f-~'/dA~y /4:. /4/,4zL///~-/~/ ~5'~. WITNESS hand this / q 7-~ day of, ,?~~. , ~3~ ~tg, (Address) (Signature) (Address) (Signature) (Address) LAST WILL AND TESTAMENT OF MARY G. BOYER I, MARY G. BOYER, of 3621Centerfield Road, Harrisburg, Dauphin County, Pennsylvania, 17109, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. ITF2~ I - I direct my personal representative to pay my just debts, funeral expenses, estate and inheritance taxes as soon after my death as may be found convenient. ITEM II - I give my household furnishings, clothing and other personal effects to JERRY A. WALMER, SR. ITEM III - All the rest, residue and remainder of my estate shall be converted into cash and divided as follows: A. Forty-three and one-half percent (43-1/2%) thereof to JERRY A. WALMER, SR., 5725 Kendall Court, Cornwells Heights, Pennsylvania, 19020, and if he has predeceased me said share shall be divided equally among such of his children as survive me, and if no such children survive me, his share shall be added ratably to the shares of the other residuary legatees. B. Thirty and one-quarter percent (30-1/4%) thereof equally to the children of John W. Crum, being LESLIE CRUM CLECKNER & FEAR£N ATTORNEYS AT LAW HARRISBURG, PENNSYLVANIA YEAGER, LINDA L. CRUM and TINA CRUM NORBY, or the survivors of them, and if no such children survive me, this share shall be added ratably to the shares of other residuary legatees. C. Eight and three-quarters percent (8-3/4%) thereof to JAMES E. GILBERT, now residing in Honolulu, Hawaii, if he survives me, and if he fails to survive me, this gift shall fail and shall be added ratably to the shares of the other residuary legatees. D. Eight and three-quarters percent (8-3/4%) thereof to CRAIG J. GILBERT, now residing in Honolulu, Hawaii, if he survives me, and if he fails to survive me, this gift shall fail and shall be added ratably to the shares of the other residuary legatees. E. Eight and three-quarters percent (8-3/4%) thereof to ROY G. SCHMIDT, 17 Rillo Drive, Wayne, New Jersey, 07470, if he survives me, and if he fails to survive me this bequest shall go in equal shares to his children, and if he has no children who survive me, said bequest shall fail and shall be added to the shares of the other residuary legatees. ITE~ IV - I hereby appoint JERRY A. WALMER, SR., and WILLIAM FEAREN as Executors of my estate. Jerry A. Walmer, Sr., shall not be required to post any bond if he is a nonresident of Pennsylvania. IN WITNESS ~EREOF, I have hereunto set my hand and seal to CLECKNER & FEAREN ATTORNEYS AT LAIE HARRISBURG, PENNSYLVANIA this my Last Will and Testament, this . /~' 1987. day of MART G. (SEAL) Signed, sealed, published and declared by the above Testatrix, MARY G. BOYER, as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each, we believing her to be of sound mind and memory, have hereunto subscribed our names as witnesses. '1 of CLECKNER & FEAREN ATTORNEYS AT LAW HARRISBURG, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: We, MARY G. BOYER, /Z~'W /~ rra~ ¢~ , and ~£~ £. ~c~~ , the Testatrix and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. BOYER~?Testatrix Subscribed, sworn to and acknowle ged~before me by MARY G BOYER, the Testatrix, and subscribed and sworn to before me by and day of witnesses, this CLECKNER & FEAREH ATTORNEYS AT LAW HARRISBURG, PENNSYLVANIA ICHERY[ l. WELSH, NOTARY PUBLIC ~ ~::~mrnission Expires March 26, 1990 R'arfisburg, PA Dauphin County MARY G. BOYER William Fearen, Esquire CLECKNER AND FEAREN ATTORNEYS AT LAW 31 NORTH SECOND STREET HARRISBURG, PENNSYLVANIA I?lOI CERTIFICATION OF NOTICE UNDER RUI ~E 5.6(a) Name of Decedent: Date of Death: Will No. Mary G. Boyer November 11, 2003 Admin. No. 21-03-0976 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 December 15, 2003: Name Address Jerry A. Walmer, Sr. 27 Nottingham Drive, Mechanicsburg, PA 17050 Leslie Cram Yeager 2202 Forest Lane, Harrisburg, PA 17112 Linda L. Crum 4922 Janelle Drive, Harrisburg, PA 17112 Tina Crum Norby 6933 Catamaran Drive, Carlsbad, CA 92009 James E. Gilbert P.O. Box 1063, Kilauea, Hawaii 96754 Craig J. Gilbert P.O. Box 590/4225 Kanikele Street, Kilauea, Hawaii 96754 Roy G. Schmidt 17 Rillo Drive, Wayne, N. J. 07470-3418 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: December 15, 2003 CHARLES E. SHIELDS, III 6 Clouser Road Mechanicsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3524 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17O55 fold ESTATE INFORMATION: SSN: 201-18-5341 FILE NUMBER: 2103-0976 DECEDENT NAME: BOYER MARY G DATE OF PAYMENT: 02/03/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $12,825.00 REMARKS: - SEAL CHECK#104 TOTAL AMOUNT PAID: 2,825.00 INITIALS: JA RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OFINDIVlDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003965 WALMER JERRY ASR 27 NOTTINGHAM DRIVE MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SSN: 201-18-5341 FILE NUMBER: 2103-0976 DECEDENT NAME: BOYER MARY G DATE OF PAYMENT: 05/21/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,151.23 REMARKS: JWALMER TOTAL AMOUNT PAID: $2,151.23 SEAL CHECK# 116 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~EV-1500 EX COMMONWF~LTH 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) B o Y E R , 1/14 ,~ ~ y G . DATE OF BIRTH (MM-DD-YEAR) m&-,~7- /'=/o7 DATE OF DEATH (MM-DD-YEAR) /1 -- II -- (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) r--] 2. supplemental Retum '--] 4a. Future Interest Compromise (date of death after 12-12~2) [---~ 7. Decedent Maintained a Living Trust (Atac~ copy of Trust) -"--]10. Spousal Poverty Credit (date of death between 12-31-9f and I-1-95) OFFICtAL USE ONLY FILE NUMBER COUNTY CODE YEAR [~1. Original Return J--~ 4. Limited Estate [~6. Decedent Died Testate (Attach copy of Will} [~9. Litigation Proceeds Received NUMBER 9 7 SOCIAL SECURITY NUMBER o/- /3 - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURtTY NUMBER E~] 3~ R~mainder Retum (date of death prior to 12-13-82) F'--] 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes --"]11. Election to tax under Sec. 9113(A) (Attach Sch O) FIRM NAME (IfApplicable) TELEPHONE NUMBER '7/7- 7&b -o2oq 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Rece[yable (Schedul~ D) (4) 5. Cash, Bank Deposits & Miscellaneous 'Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) --']Separate Billing R~uested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. COMPLETE MAILING ADDRESS G, C L oc~&TP ~. I'~ ECH,RAJ lC$ ~ bt ~, P~ 0 o (8) / 7 o_P.E' USE ONLY (11) (12) (13) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1/7, ..<'4, SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate t7. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate o 'I/o¢, $'/I. s-4, x .0 o (15) x .0 q~ (16) x .12 07) x .15 (18) I.~". 6~I, 23 19. Tax Due (19) > > RE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS CITY ISTATE ~ IZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + 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 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. (3) (4) (5A) O (SB) 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: Yes No a. retain the use or income of the property transferred; ................................. i ........................................................ [] [] b. retain the dght to designate who shall use the property.transferred or its income; ............................................ [] [] c. retain a reversionary interest; or ....................................................................................................... .'...:. ........... i. [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December, 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pequry.~ declare that I have examined this return, inclu0ing accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer.a~er than the personal representative is based on all infotTnation of which preparer has any knowledge, SIGNAT.?RE O~,~RSON RESPOJ~SIBLE)'OR F-~-IN~ I URN ,~ A" DATE SIGNATI.,.~.F__.~F PR~PAREE~THER..T,t~iN REPRESENTATIVE ADDRESS DATE For dates of death on or after July 1, 1994 and before January 1,199§, the tax rate imposed on the net value of transfers to c;r for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (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) (ii)]. 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 dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. 'i he tax rate imposed on the net value of ~ransfers to or for the use of the decedem% iinual beneficiaries is 4.5%, except as no[ed in 72 P.S. §9116(1.2) [72 P.S. §9~16(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. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003524 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 201~18-5341 FILE NUMBER: 21 03-0976 DECEDENT NAME: BOYER MARY G DATE OF PAYMENT: 02/03/2004 POSTMARK DATE: ' 00/0~/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $12,825.00 iREMARKS: TOTAL AMOUNT PAID' $1 2,825.00 CHECK//104 sE~,L ............ INITIALS' JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ,~ O y~"/~/ /~l~y' ~. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER $~ y/,'vo$ ,,Cdc 77. DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH I, fOO.eO (If more space is needed, insert additional sheets of the same size) POSTMARK CREDIT UNION for first class financial services December 30, 2003 Charles E. Shields, IH Attorneys At Law 6 Clouser Road Mechanicsburg, PA 17055 Re: Estate of Mary G. Boyer S.S. # 201-18-5341 Account # 1257 Dear Charles E. Shields, IH: The account of Mary G. Boyer with Postmark Credit Union was owned since December 11, 1958 and she was sole owner. Interest (dividends) is paid on the last day of the month for accounts. The following is an account status on November 11, 2003. Type Opened Savings 12/11/1958 Checking 12/11 / 1958 Balance 11/11/2003 Interest Rate $114,417.76 0.80% 1,779.25 0.00% There are no beneficiaries and no safety deposit boxes on the account at Postmark Credit Union. This should provide the information for you to handle the estate. If you have any questions please call. Very truly yours, Member Services 2630 Linglestown Road - Harrisburg, PA · 17110-3666 717.671.5119 REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 8 0 Y~',,¢, //'/,4,,~y G'. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ,2,/-~- ¢76 ITEM NUMBEF 5. 6. 7. ?. It}. II. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address ,~d'7 ~,¢/~7"?-//jf'~'~/~' City ~ ~/~ ~ Year(s) Commission Paid: Attorney Fees ~ ~ ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State ~,~1¢ Zip City Relationship of Claimant to Decedent State Zip Probate Fees ~.~) ~/~/~,,~. l..5~4¢~.~ O~" ~R~' C~'7-l~,~l¢.~¢t. ?'~,.~ Accountant's Fees TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT ~/15. oo immerman u r FUNERAL HOME, INC. 4100 JONESTOWN ROAD, HARRISBURG, PA 17109 · 717 545-4001 · DALEA. AUER, PRESIDENT - MARIANNE E. CORL,~I~V~SOR Mr. Jerry A. Walmer, Sr. 27 Nottingham Drive Mechanicsburg, PA 17050 11-12-2003 Mary G. Boyer-- Deceased X Professional Services X Trust Loss Out-Of-Town Transportation $3,520.00 -$912.00 SUB TOTAL $2,608.00 X Casket-Stauffe~ Miller X Outer Container-Wilbert Monticello Suit/Dress Underclothing Slippers Register Book-Pink Rose Memorial Folders-Pink Rose Thank You Cards-Pink Rose Crucifix 20g Jupiter G$1,295.00 $950.00 $30.00 S40.00 510.00 SUB TOTAL $2,325.00 Grave Opening Charge-Shoop's Cemetery Equipment Obituary Notice-Patriot Classified Notice Long Dlstanc~ Teiephone Calls Honorarium 3 Certified ,Copies Hairdresser-Heather Callas Casket Spray Flowers Stone Cutting Cumberland Co. Va Benefit 5690.00 5181.30~'- $100.00 S6.00 $40.00 '/~'~ .... $159.00 2105.00 -$100.00SUB TOTAL 2-17-2004 TOTAL PAID BALANCE DUE S1,181.30 S6,1!4.30 S5,993.00 $121.30 GEORGE M. HOUCK (1912-1991) CHARLES E. SHIELDS, HI ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and C louser Roads MECHANICSBURG, PA 17055 TELEPHONE (717) 766-0209 FAX (717) 795-7473 Janet Brackbill H & R Block 70 W. Main Street Mechanicsburg, PA 17055 April 13, 2004 Dear Janet: Please find enclosed Check No. #115 in the amount of $435.00 for preparation of taxes for the estate of Mary G. Boyer. Thank you. CES case Enclosure Very truly yours, Charles E. Skields, III COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT OECEDENT SCHEDULE ! DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF /~'O,V~'-/~'~, ~,~jl'~.J,,,' ~o FILE NUMBER ,A/-z).~- 77~ Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) PATIENT' NAME: BOYER, MARY PATIENT NUMBER: 'I ~gg4 DETACH ALONG PERFORMATION AND RETURN STUB WITH PAYMENT AMOUNT DUE CALL NUMBER 111501W AMOUNT $ BILLING DATE: J 1t03/2Q03 ENCLOSED THIS SERVICE IS NOT COVERED BY MEDICARE OR MEDICAL ASSISTANCE. VISA AND MASTER CARD ACCEPTED WIEST SHORE EMS - BLS 205 GRANDVIEWAVE CAMP HILL, PA t7011 PATIENT NAME: BOYER, MARY PATIENT NUMBER: DETACH ALONG PERFORMATION AND RETURN STUB WITH PAYMENT AMOUNT DUE CALL NUMBER 110524W AMOUNT $ BILLING DATE: '~ lfQ3J2QQ3 ENCLOSED THIS ACCOUNT IS PAST .DUE! -Send your payment now or contact our office to make pa~-rnent arrangements. VISA AND MASTER CARD ACCEPTED WEST SHORE EMS - BLS 205 GRANDVIEW'AVE CAMP HILL, PA 17011 ESTATE OF MARY G BOYER JERRY WALMER.CO EXECUTOR 2, NO 'NGHAM DR MECHANICSBURG PA 17050 DATE 60-810112313 102 METZGER, WICKERSHAM, KNAUSS & ERB, P.C. P.O. BOX 5300 HARRISBURG, PA 17110-0300 (717) 238-8187 TAX I.D. 23-2871395 SINCE 1888 Jerry A. Walmer 27 Nottingham Drive Mechanicsburg, PA 17050 December 16, 2003 Billed through 11/30/2003 Invoice# 46786 JLH Our file# 000060 01512 WALMER, JERRY A. Mary G. Boyer Balance forward as of invoice dated November 20, 2003 Payments received since last invoice Accounts receivable balance carried forward DISBURSEMENTS 11/30/2003 Fax. Billing Summar~ Total expenses incurred Total of new charges for this invoice $176.00 176.00 $0.00 $3.00 $3.00 3.00 $3.00 Total balance now due ** Trust account remaining balance is $3.00 PLEASE MAKE CHECKS PAYABLE TO METZGER WICKERSHAM CD '"t-~ ~0 ¢, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outdght spousal distributions) SCHEDULE J BENEFICIARIES II. / 7o.~ 7'-- ~vl~ c~' ENTER DOL~R AMOUNTS FOE DISTRIBUTIONS SHOWN ABOVE ON LINE NON-TA~BLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOE WHICH AN ELECTION TO TAX ~S NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART H - 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) 7s- 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET LAST WILL AND TESTAMENT OF MARY G. BOYER I, ~L~R¥ G. BOYER, of 3621Centerfield Road, Harrisburg, Dauphin County, Pennsylvania, 17109, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. ITEM I - I direct my personal representative to pay my Just debts, funeral expenses, estate and inheritance taxes as soon after my death as may be found convenient. ITEM II - I give my household furnishings, clothing and other personal effects to JERRY A. WALMER, SR. ITEM III - All the rest, residue and remainder of my estate shall be converted into cash and divided as follows: A. Forty-three and one-half percent (43-1/2%) thereof to JERRY A. WALMER, SR., ~5725 Kendall Court, Cornwells Heights, Pennsylvania, 19020, and if he has predeceased me said share shall be divided equally among such of his children as survive me, and if no such children survive me, his share shall be added ratably to the shares of the other residuary legatees. B. Thirty and one-quarter percent (30-1/4%) thereof equally to the children of John W. Crum, being LESLIE CRUM ECKNER & FEAREN ATTORNEYS AT LAW ISBURGo PENNSYLYANIA YEAGER, LINDA L. CRUM and TINA CRUM NORBY, or the survivors of them, and if no such children survive me, this share shall be added ratably to the shares of other residuary legatees. C. Eight and three-quarters percent (8-3/4%) thereof to JAMES E. GILBERT, now residing in Honolulu, Hawaii, if he survives me, and if he fails to survive me, this gift shall fail and shall be added ratably to the shares of the other residuary legatees. D. Eight and three-quarters percent (8-3/4%) thereof to CRAIG J. GILBERT, now residing in Honolulu, Hawaii, if he' survives me, and if he fails to survive me, this gift shall fail and shall be added ratably to the shares of the other residuary legatees. E. Eight and three-quarters percent (8-3/4%) thereof to ; ROY G. SCHMIDT, 17 Rillo Drive, Wayne, New Jersey, 07470, if he ~ survives me, and if he fails to survive me this bequest shall .... go in equal shares to his children and if he has no children who survive me, said bequest shall fail and shall be added to the shares of the other residuary legatees. ITE~ IV - I hereby appoint JERRY A. WALMER, SR., and WILLIAM ?EAREN as Executors of my estate. Jerry A. Walmer, Sr., shall not be required to post any bond if he is a nonresident of Pennsylvania. IN ~ITNE~ ~{EREoI~, I have hereunto set my hand and seal to ,I£R & FE:ARE:N INEy$ AT LAW this my Last Will and Testament, this 1987. day of BOYER/ (SEAL) Signed, sealed, published and declared by the above Testatrix, MARY G. BOYER, as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each, we believing her to be of sound mind and memory, have hereunto subscribed our names as witnesses. of ECXNER & F£AREN ATTORNEYS AT LA~ PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: We, MARY G. BOYER, /~U~ D '/~rg~ ~,~- , and ~(J L. ~~ , the Testatrix and witnesses· respectively, whose names are signed to the attached or foregoing instrument· being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly· and that she executed it as her free and voluntary act for the purposes therein expressed· and that each of the witnesses· in the presence and hearing of the Testatrix· signed the Will as witnesses and that to the best of their knowledge· the Testatrix was at that time eighteen (18) years of age or older· of sound mind and under no constraint or undue influence. witnesses, this ~CKNER & FEAREN SBURG, PENNSYLVANIA Subscribed, sworn to and acknowledged before me by MARY G. BOYER, th~:Testatrix, and subscribed and sworn to before me by L'CI,..' Fi ~ /--.._¢__.~ ~-' and " C" / - · /--'~J--~ day of ~ ¢ ,, ~ / ~.,~ ...... ¢*¢~ , 1987. _- /'/ /,.,: CtlF. RYI- L WELSH, NOTARY PUBLIC ~ ,Cammission Expires March £~, i990 Fmrfisburi[, PA Dauphin County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: 11-- Will No. Pursuant to Rule 6.12 of the Supreme Court Orphans' court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ No__ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal r~resentative 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: CD (MAH:rmf/AM3) Signature Name (Please type or print) Address Tel. No. Capacity: Personal Representative Counsel for personal representative BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX OIVISION DEPT. 180601 HARRISBURG, PA 17118-D601 CHARLES E SHIELDS III 6 CLOUSER RD NECHANICSBURG PA 17055 CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERZTANCE TAX APPRAZSENENT, ALLOHANCE OR DISALLOHANCE OF DEDUCTZONS AND ASSESSHENT OF TAX REV-1;d? EX &FP DATE 07-19-2004 ESTATE OF BOYER NARY G DATE OF DEATH 11-11-2005 FZLE NUNBER 21 05-0976 COUNTY CUNBERLAND ACN 101 Amoun~ Reei~ed HAKE CHECK PAYABLE AND RENZT PAYNENT TO.' REGISTER OF NILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS -~ REV-1547 EX AFP (01-03) NOTZCE OF /NHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF BOYER NARY GFZLE NO. 21 0:5-0976 ACN 101 DATE 07-19-2004 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNTNG FUTURE ZNTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~a*e (Schedule A) 2. S~ocks and Bonds (Schedule B) $ Closely Held S~ock/Par~nership Zn*eres~ (Schedule C) Hot,gages/No,es Receivable (Schedule D) $ Cash/Bank Deposi~s/Hisc. Personal Proper~y (Schedule E) 6 Jointly Owned Proper~y (Schedule F) 7 Transfers (Schedule G) 8 To,al Asse~s APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos~s/Nisc. Expenses (Schedule H) 10. Debts/Hot,gage Liabilities/Liens (Schedule ~) 11. To,al Deductions 12, Ne~ Value of Tax Re~urn (1) .00 (2) .00 ($) .00 (4) .00 (S) 117/297.01 (6) .00 (7) .00 (8) NOTE: To insure proper credi~ *o your account, submi~ ~he upper pot*ion of ~his form wi~h your ~ax payment. 117,297.01 12,651 (9) (10) :504.03 (11) 12.955.45 (12) 104,341.56 15. 14. NOTE: Cher/~eble/Governmen~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0 Ne~: Value of Es~ca~e Sub,~ec~ ~o Tax (14) 104, :541 . 56 T~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w111 re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amoun~ of Line 14 a~ Spousal ra~e 16. Aeoun~ of L/ne 14 ~axable 17. Amoun~ of Line 14 a* Sibling ra~e 18. Amoun~ of Line lfi ~axeble a~ Collateral~Class B ra~e 19. Principal Tax Due TAX CREDZTS: PAYMENT RECEZP1 DZ$COUNT DATE NUHBER INTEREST/PEN PAZD (-) 02-0:5-2004 CD00:5524 675.00 05-21-2004 CD00:5965 (15) (16) (17) (18) IF PA[D AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDZTZONAL ZNTEREST. TOTAL TAX CREDZT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE ( TF TOTAL DUE 1S LESS THAN $1, NO PAYNENT TS REQUZRED. ZF TOTAL DUE TS REFLECTED AS A 'CREDZT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THZS FORN FOR ZNSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Comaon#aalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfut Class B (collateral) rata on any such future interest. PURPOSE OF NOTZCE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of the Register of gills, any of the Z3 Revenue District Offices, ar by calling the special Iq-hour answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers aith special hearing and / or speaking needs: 1-BOO-qq7-5020 (TT onIy). Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice oust object eithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of AppeaIs, Dept. 281021, Harrisburg, PA lTlgS-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. IS0601, Harrisburg, PA 171ZS-0601 Phone (717) 787-6SOS. See page S of the book[et "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-la01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacadent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the rolm1 of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BZ through gOOq ara: Interest Daily Interest Daily Interest Oaily Year Rate Factor Year Rate Factor Year Rate Factor 198Z gO[ .OOOSqB ~'~'~-1991 Ill .000301 ~ 9Z .OOOZq7 1983 16Z .000458 199Z 9Z .000247 2002 6g .000164 1984 llZ .000301 1993-1994 7Z .000192 ZOOS SZ .O00X~7 1985 13X .000~56 1995-1998 9Z .O00Z~7 200q 4Z .000110 1986 lOX .000274 1999 7Z .OO019Z 1967 IOZ .000274 ZOOO 7Z .OO019Z --Interest is calculated as follows: ZNTEREST = BALANCE OF TAX UNPAZD X NUI{BER OF DAYS DEL/NQUENT X DAZLY ZNTEREST FACTOR --Any Notice issued after tho tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.