HomeMy WebLinkAbout03-0762 PETITION FOR PROBAT~nd GRANT OF LETTERS
Es,a,e o/' a'. No.
also known as ~l,O,q~q ~ 0". ~ To:
, Deceased.
Social Security No. /~0- t~ 7 ' ,~ ./ '7
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or .older an the
in the last will of the above de, c~dent, dated '
and codicil(s) dated dj/
Register of V~ills for the
County of F--J/Jt#~&''7~Z-~tAj/j in the
Commonwealth of Pennsylvania
,19 n~n~ed
Decendent, then
at
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in (~,O~~-~]~J 0 County, Penbsylvania, with
last f.amily or vrincipal residence~t~
~1~/I-~/~$/,3 ~q~ ,~/~ /'7o ~o ' '
(~st street, number and muncipality)
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: . ..
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 requ__est(s) the prob.ate of_the, last will and codicil(s)
presented herewith and the grant of letters 'T~ ~' 7-~ql ~'] ~-,,~'' 7'-,~-Zi' ¥
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF k~,~r~k,-,,o_~k,~c~ J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed c~ ~~~- ~ ~
befor~e this ~ ~ay of [ ~
R~ster ~ ~
Estate Of
DECREE OF PROBATE AND GRANT OF LETTERS
, Deceased
AND NOW
consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ...~Tct [ ~ ~.c_~.. [ ~ ~.~..~
described therein be admitted toprobate and filed of record as the last will of
and Letters \ & ~3c:o~ ~ a c,,-'~¢ ~_~
are hereby granted to ~--1.~ [~ v-x k'¥~, ~ ~,~O.¥a_ ~
FEES
Probate, Letters, Etc .......... $ ~--~ '~
Short Certificates(~N-) .......... $ ~ ~. ~
Renunciation ................ $
TOTAL ~ $ ~5~ t. ----'
Filed .. ~ {?o:L.~...tO. ~ ~ ~...
Register of Wills
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
OF
EDWARD J. WEISS
I, EDWARD J. WEISS, of 76 Pine Hill Road, Enola, Cumberland
County, Pennsylvania, being of sound mind, memory and understanding,
do make and publish this my Last Will and Testament, hereby revoking
and making void all former wills by me at any time heretofore made.
ITEM ONE: I direct that my funeral be conducted in a manner
corresponding with my estate and situation in life, and that all of my
just debts and funeral expenses be fully paid and satisfied as soon as
may be convenient after my decease.
ITEM TWO: All the rest, residue and remainder of my estate, real
and personal, of whatsoever nature, and wheresoever situate, I give,
devise and bequeath unto my loving wife, Margaret C. Weiss; in the
event my loving wife, Margaret C. Weiss, shall predecease me, then I
give, devise and bequeath all the rest, residue and remainder of my
said estate unto my four children: Helen M. Slaven, Edward J. Weiss,
Jr., Margaret C. Crouch and John E. Weiss, in equal shares, share and
share alike.
ITEM THREE: I nominate, constitute and appoint my loving wife,
Margaret C. Weiss, to be and act as Executrix of this my Last Will and
Testament. In the event my said wife, Margaret C. Weiss, predeceases
me, or is unable to serve as Executrix of my estate, I nominate,
constitute and appoint my daughter, Helen M. Slaven, as Executrix of
my estate and she shall serve without posting bond or security. Said
Executrix shall have the authori'[y to sell any real estate of which I
died seized and possessed. It is my desire that no appraisement be
made on my estate, and I hereby dispense with such appraisement.
IN WITNESS WHEREOF, I have heretofore set my hand and seal this
, 1992.
EDKARD ~. KEIS~J
(SEAL)
Address
Witness
COMMONWEALTH OF PENNSYLVANIA,
COUNTY OF CUMBERLAND, to-wit:
I, EDWARD J. WEISS, the Testator whose name is signed to the
foregoing instrument consisting of this and two other typewritten
pages, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will;
and that I si~ned it willingly and as my free and voluntary act for
the purposes therein expressed.
Sworn to and subscribed before me by EDWARD J. WEISS, the
Testator, this ~day of. d~/~,' , 1992.
VWstF~Boro,~~ EDWARD J. , Testator
My O0r0~s~ ~es No~. 14, 1~
NotariZe ~~
CO~ONWEALTH OF. PENNSYLVANIA,
COUNTY OF ~B~LAND, to-wit:
Wo,~~~~ ~'- and~/~~)~~ ,
whose names %re signed to the attached o~foregoing instrument, being
duly qualified according to law, do depose and say that we were
present and saw EDWARD J. WEISS, the Testator hereof, sign and execute
this instrument as his Last Will; that the Testator signed willingly
and executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the Testator signed the Will as a witness; and that to the best of our
knowledge the Testator was at that time e~ghteen (18) or more years of
age, of sound mind and under no constraint or undue influence.
Address
Sworn to and subscribed before me by
,iA , ~2.~
! WestFairviewBoro, ~.um[~enan~-.~_!~.~ I
l My CommLssion Ex~re~ Nov. 14,1~ 11
Member, Pennsylvania Assoc~n ot Nolaries
witnesses, this
day
of
SP 0
Ndtar~,~l Ic
o ~
Name of Decedent:
Date of Death:
CERTIFICATION OFNOTICEUNDER RULE5.6(a)
Edward .1. Weigh; gr
September 4: 2003
Will No. 2003-00762 Admin. No.
To the Register:
I certify that notice of (beneficial 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 0o_ t ohor 6~ 200't :
Name Address
Edward J. Weiss, Jr., 3713 Janney Lane, SW, Roanoke, VA 24018
Mnrgnr~t g_ Crouch. !0 Lake Shore L~ne, L~nde~berg.
John E. Weiss, 9 Cardinal Drive, Stevens, PA 17578
p_a 193~n
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: Ortnhor 6_ 200'1
Signature
Name Helen
Slaven
Address
P. O. Box 94
Hnn~; VA 2272'1
%lephone 540-948-6552
Capacity: X 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
NO.
REV-1162 EX(11-96)
CD OO3317
SLAVEN HELEN M
P O BOX 94
HOOD, VA 22723
........ fold
ESTATE INFORMATION: SSN: 160-07-2017
FILE NUMBER: 2103-0762
DECEDENT NAME: WEISS EDWARD J
DATE OF PAYMENT: 12/08/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/04/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $724.91
TOTAL AMOUNT PAID:
t~724.91
REMARKS:
SEAL
CHECK# 106
INITIALS' JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Inventory of the Real an~ Personal Estate of
E~war~ J. Weiss, ~ecease~
Helen M. Slaven, Executor
Wachovia Account %2000020559513:
9/29/03 ROBC Limited Partnership (refund)
10/10/03 PNC Account %50-8039-5323 (partial transfer)
10/15/03 Bethlehem Steel Corporation (August pension)
PBGC (Bethlehem Steel, September pension)
10/28/03 Blue Cross/Blue Shield refund
Summerdale Federal Credit Union-Account %1/80.0
12/2/03 Sale of WalMart and UniMart stock
Balance, PNC Account %50-8039-5323
Total
1,530 90
12,730 42
686 54
686 54
364 46
5,783 04
1,906 45
1,424.21
$ 25,112 56
DISBURSEMENTS
Estate of Edward j. Weiss, deceased
Helen M. Slaven, Executor
Check #
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
Date
10/6/03
10/6/03
10/6/03
10/6/03
10/15/03
11/10/03
11/10/03
11/20/03
11/20/03
11/26/03
12/5/03
12/5/03
12/5/03
12/5/03
12/5/03
Payee
West Shore EMS
Alert Pharmacy
Carlisle Regional Medical Center
Register of Wills (3 short letters)
Helen M. Slaven (reimbursement)
Sullivan Funeral Home .... $6,045.00
Pastor George Jensen .... 100.00
Enola Church of God
(donation for luncheon). 500.00
Register of Wills (probate) 81.00
Postage 8.09
$6,734.09
Central Penn Medical Group Emergency
Central Penn Medical Group Emergency
Lehigh Valley Physical Therapy
Diane M. Dils, Esquire (reimbursement
for Cumberland Law Journal ad)
Diane M. Dils, Esquire (reimbursement
for The Sentinel ad)
Holy Spirit Hospital
James R. Gingrich Memorials
Carlisle Regional Medical Center
Mobile X-Ray Imaging, Inc.
Diane M. Dils (legal fee)
Total
Amount
$ 52.54
222.28
76.21
9.00
6,734.09
248.00
28.40
151.19
75.00
81.59
88.63
80.00
840.00
66.50
250.00
$9,003.43
Recapitulation - 12/8/03
Total Inventory and Income to date .............. $25,112.56
Total Disbursements to date .................. 9,003.43
Net estate to date ................... $16,109.13
x .045%
Inheritance tax due to date ............... $ 724.91
COMMONWEALTH OF
PENNSYLVANIA
DEPT, 280601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
,,~ i - 03 00762
P-gUNTY CODE YEAR NUMBER
DECEDENFS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECI. JRII¥ NUMBER
I-'- WEISS, EDWARD J 167-07-2017
Z
I,J.I DATE OF DEATH (MM-DD-YEAR~ DATE OF BIRTH {MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
¢3 '
U.I 09/04/2003 08/04/1912 REGISTER OF WILLS
U,J ~' F APPLICABLE) SURVIVING SPOUSE'S NAME {LAS'Ii FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
LU
Z
LU
Z
O
UJ
n,
o
(.,1
U.I
~ 1. Original Return [] 2. Supplemental Return ~ 3. Remainder Return (date ofde~thpnor to 12 13-~2)
~ 4. Limited Estate [] 4a. F,,ture Interest Compromise (~te oral.th afl~ !2-12~2) ~ 5. Fedora, Estate 'Tax Return Requ,red
~6. Decedent Died Testate (Atu[~ ~¢ of~ii) ~ 7. Decedent Maimaine~ a Living Trust (A~ch co~ of T~st) ......8. Total Number o[ Safe Deposit Box~
~ 9. Litigation Proceeds Rece~ed ~ 10. Spou~i Pove~F Credit (date :,rd~ be~,~ ~.3~-9~ a~ ~4..95) ~ 11. Bection to tax under Sec. 91'13(A),At~a~ s~ c~
NAME
HELEN M, SLAVEN
FIRM NAME (ffApplicable)
TELEPHONE NUMBER
540) 948-4800
1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Propfietorsi
4, Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property'
(Scheduie E}
COMPLETE MAILING ADDRESS
P 0 BOX 45,
HOOD, VA. 22723
6. Jointly Owned Property (Schedule F)
F--~ Separate B ing Recuested
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 (Line 8 minus Line 11)
13.
14.
(7)
(9)
(~)
7,641.00
(10) ............................................................ ..9.Z.2_:_0..o.. ..........
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line ! 3)
21,978.00
('..~) 8,613.00
{12) 13,365.00
(t 3)
(14) 13,365.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tex
rate, or transfers un,er Sec. 9!16 {a)(1.2)
16. Amount of Line 14 ta~(able at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 ~axable at co!lateral ,,ate
19. Tax Due
13,365.00 x .0
45
x .12
x .15
20. ~[~
(15)
('16)
601.43
Decedent's Complete Address:
STREET ADDRESS
2100 BENT CREEK BLVD
C~TY M ECHANICSBU RG STATE PA ZiP 17050
Tax Payments and Credits:
1. Tax Due {Page 1 Line 19) (1)
2, Credits/Payments
A, Spousal Poverty Credit
B. Pdor Payments 724.91
C. Discount 30.07
601.43
754.98
153.55
3. Interest.f Penalty if applicable
D. Interest
E. Penalty
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page t 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 tota! of Line 5 + 5A, This is the BALANCE BUE,
Total Credits ( A + B + C ) (2)
Total Interest/Pena!ty ( D + E ) (3)
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent ma,~e a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the ,fight to designate who shall use the property transferred or its income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise 'for life of either paymenB, benefits or (:are? ...................................................................... [] []
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 ;in "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 perjury, I declare that I have examined this retom, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tree, correct and complete.
Declaration of preparer other than the personal representative is based on all infon~ation of which preparer has any know~edge.
ADDRESS
P 0 BOX 94, HOOD, VA. 22723
SIGNAT~.~E OF PREPAAER OTU~r.,~ .THAhR?RESENTATIVE
128 BE'LLEVlEW AVE ORANGE VA 22960
..iDATE
For dates of death on or after July 1, 1994 and be~re January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[7.2 P.S. §9','16 (a) (1.1) (i)].
For dates of death on or alter January 1, 1995, the tax rate imposed oil the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (!.1) (ii)],
The statute does not exem~oJ 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 natursl parent, an adoptive parent,
cra stepparent of the child is 0% [72 P.S. §9116(a)(! .2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's linea! beneficiaries 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 decadent's siblings is 12% [72 RS. §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.
RB¢-1503 .FJ(+ ~6 9
COMMONWEALTH OF PENNSYLVANIA
iNHERITAN(';E TAX RETURN
REStDENT DECEDENT
ESTATE OF
EDWARD J. WEISS
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
00762
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT BATE
NUMBER DESCRIPTION OF DEATH
14 SHARES OF WAL-MART @60.08 PER SHARE
800 SHARES OF UNI-MART @1.50 PER SHARE
841 00
1 200.00
TOTAL (Also enter on line 2, Recapitulation) $ 2,041.00
(if more space is needed, insert additional sheets of the same size)
R~¢-1508 EX+ (6-98) ~_~
-~-
COMMONW~EALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EDWARD J. WEISS
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
00762
Include the proceeds of litigation and the date the proceeds were received by the estate.
All proper'o/jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1
SUMMERDALE FEDERAL CREDIT UNION - ACCOUNT #1/80.0
PNC BANK ACCOUNT ~0-8039-5323
5, 783.00
14,154.00
TOTAL (Also enter on line 5, Recapitulation) $ 19,937,00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)~;~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EDWARD J. WEISS
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
00762
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
2
3
4
5.
6.
7.
FUNERAL EXPENSES:
SULLIVAN FUNERAL HOME
PASTOR GEORGE JENSEN
ENOLA CHURCH OF GOD
JAMES R. GINGRICH MEMORIALS
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal ReDresentative(s)
Social Security Number(s)/EIN Number of Personal Representative(s) _
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State . Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
HELEN M SLAVEN, REIMBURSEMENT FOR TRAVEL FROM VA. TO PA - 680 MILES @.36
TOTAL (Also enter on line 9, Recapitulation) $
6,045.00
100.00
500.00
80.00
250.00
271.00
100.00
50.00
245.00
7 641.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX.- (12-03) ~
-,~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EDWARD J. WEISS
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
00762
Re 3ort debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
5
6
7
8
9
WEST SHORE EMS, BILL
ALE RT PHARMACY, BILL
CARLISLE REGIONAL MEDICAL CENTER, BILL
CENTRAL PENN MEDICAL GROUP EMERGENCY, BILL
CENTRAL PENN MEDICAL GROUP EMERGENCY, BILL
LEHIGH VALLEY PHYSICAL THERAPY, BILL
HOLY SPIRIT HOSPITAL, BILL
MOBILE X-RAY IMAGING, INC., BILL
PA DEPARTMENT OF REVENUE, 2003 INCOME TAX
53.00
222.00
7600
248 O0
28.00
151.00
89.00
67.00
38.00
TOTAL (Also enter on line 10. Recapitulation) $ 972.00
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+
COMMONWEALTH OF' PENNSYLVANIA
iNHERI?ANCE ]AX RETURN
RESIDENT DECEDENT
ESTATE OF
EDWARD J. WEISS
NUMBER
2
3
4
[!
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a)
EDWARD J. WEISS, JR, 3713 JANNEY LANE SW, ROANOKE, VA., 2401_
JOHN E. WEISS, 9 CARDINAL DRIVE, STEVENS, PA, 17575
MARGARET W CROUCH, 10 LAKE SHORE LANE, LANDENBERG, PA 1_
HELEN M. SLAVE, P O BOX 45, HOOD, VA. 22723
SON
SON
DAUGHTER
DAUGHTER
FILE NUMBER
)0762
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.25
0~25
0.25
0.25
$ 0.00:
(If more space is needed, insert additional sheets of the same size)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DTVZSTnN
DEPT. 280601
HARRISBURG,, PA 171Z8-0601
HELEN M SLAVEN
PO BOX 45
HOOD
VA 22725
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
RE¥-1607 EX &FP (01-05)
DATE 09-07-2004
ESTATE OF WEISS SR
DATE OF DEATH 09-04-2005
FZLE NUHBER 2! 05-0762
COUNTY CUMBERLAND
ACN 101
I Amoun~ Remi~ed
EDWARD J
HAKE CHECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credi~ ~o your eccoun~c, subei~ ~:he upper portion of ~:his form wi~h your ~cax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS '~
REV-1607 EX AFP (01-03) #xx INHERITANCE TAX STATEMENT OF ACCOUNT x~
ESTATE OF WEISS SR EDWARD J FILE NO. 21 03-0762 ACN 101 DATE 09-07-2004
TH'rS STATEHENT IS PROV'rDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM 'rN THE NAMED ESTATE. SHO#N BELO#
'rs A SUMMARY OF THE PRINCIPAL TAX DUE, APPLXCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 07-19-2004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
601.43
PAYHENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
12-08-2005
08-16-2004
CD003317
REFUND
.00
.00
IF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULATION OF ADDITIONAL /NTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT' (CR),
TOTAL TAX CREDIT
601.43
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
Glenda Farner Strasbaugh
Register of Wiils
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(71 7) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
E state of:
Estate No:
302
4/8/2005
EDWARD T WEISS
21-03-0762
HELENMSLAVEN
138 WOLFTOWN HOOD ROAD
P.o. BOX 94
HOOD, VA 22723
JA
Qty
1
Fee Description
Short Certificates
Fee Total
2.00 $2.00
Total:
$2.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please rerum one copy of this invoice with your payment. Thank you.
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
HELENMSLAVEN
138 WOLFTOWN HOOD ROAD
P.o. BOX 94
HOOD, VA 22723
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
302
4/8/2005
EDWARD T WEISS
21-03-0762
JA
Qty
1
Fee Description
Short Certificates
Fee Total
2.00 $2.00
Total: (l
Iv (I( JI- /;;; 3'/5'
$2.00
afL~
. ,
~r:-47tL
~~~~
~/
/~~
Otecks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
v
-"'
D i:" C i:" I \{ i:" n ('I'''' 1 f\ "'M~, ~ i/
J\L- '-I t '-'-" ',' ( lj
Estate of WEISS EDWARD J
La te of MECHANICSBURG BOROUGH
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-03-00762
Date:
10/17/2005
NO.: 21-03-00762
SLAVEN HELEN M
POBOX 94
HOOD VA 22723
.,...
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6. 12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: SLAVEN HELEN M
Personal Representative Counsel: ** NO INFORMATION FOUND **
Date of Decedent's Death: 9/04/2003
Date of Delinquency Notice: 9/04/2005
The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans'
Court, in accordance with rule 6.12, Supreme Court Orphans' Court
Rules, hereby notifies the Orphans' Court Division, Court of Common
Pleas of Cumberland County, that neither the above named personal
representative nor their counsel, have filed with the Register of
Wills or Clerk of Orphans' Court, his/her Status Report required by
Rule 6.12, Supreme Court Orphans' Court Rule, and that the
requisite notice, pursuant to Rule 6.12, Supreme Court Orhans'
Court Rules, was given by the Clerk of Orphans' Court on 8/09/2005
and that the ten (10) day notice to file the status report has
expired. Accordingly, in accordance with Rule 6.12 the Court is
hereby notified of such delinquency and the undersigned requests
that a Court conduct a hearing to determine whether sanctions
should be imposed upon the delinquent personal representative or
their counsel.
cc: File
Personal Representative
Counsel
G6~~
Clerk of Orhans' Court
A hearing is scheduled for November 21, 2005 at 10:00 AM in
Courtroom No.2. If the Status Report is filed ~to the
hearing date, the hearing will automatically jP~cancellled.
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Helen M. Slaven
Post Office Box 94
Hood, Virginia 22723
(540)948-6552
email -theslavens@earthlink.net
November 16, 2005
Glenda Farner Strasbaugh
Register of Wills and
Clerk of the Orphans' Court
1 Courthouse Square
Carlisle, PA 17013-3387
In Re: Edward J. Weiss -- File #21-03-00762
Dear Ms. Strasbaugh:
I am in receipt of "Notice of Failure to File Status Report "
on the above styled estate. This "Notice" refers to a notice in
reference to a "Status Report" being given on 8/09/2005. I received
no such request for a "Status Report".
On June 1, 2004, I sent, via UPS, two copies of "Rev-1500
Inheritance Tax Return" to your office. I assumed this was all that
was needed to close the estate. I am enclosing another copy of this
return (without supplements).
I am also enclosing the completed "Status Report" which was
attached to the "Notice" mailed to me on October 25, 2005.
I am assuming this report will end the matter and that the
estate of Edward J. Weiss is approved and closed. Please let me know
if this is not the case.
Thank you so much.
Sincerely yours,
/'J/uJ71l ~
Helen M. Slaven
Enclosures
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Ff)ttJ/J~ /J T /A/FIS.s
Date of Death: &9 /(1 tf / ;).. tJ 0 ~
I I
Estate No.: 4/-03- tJtJ 7~~
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:
Y es ~ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes ~ No 0
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]gl No 0
c. Copies of receipts, releases, joinders and approval of fonnal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
L;jL~
/./duu /l1 ~
Date:
Signature
/1e-aJ /1J. 5uvetJ
Name
~cJ. Edt q~ f1at1/J, tI/l ~~7:;{ ~
Address
911)- 9~g.~ss-~
Telephone No.
Capacity: M Personal Representative
o Counsel for personal representative
vI:
Rt.'J-'Slv.'tEJC (fiJ1J)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
@@fP>\y
FILE NUMBER
03
00762
-IlUI.lBER--
'* COMMONWEALTH OF
PENNSYlVAN~
." ~ .. OEPARTMENT OF REVENUE
, DEPT. 280601
.. . . ~ HARRISBURG, PA 17128-0601
OOUNTY COIlE
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OECEDENrs NAME (LAST, FIRST. AND MIDDLE INITIAL)
WEISS, EDWARD J
';;~:2:;~ (W~D.VEAR) "--"~~~:~;~~\4MnD~EARI
iiF APPLICABLE) SURVIVING SPOUSE'S NAi.i:(lASI; FIRSfANO M1DOlEii~rrlAi..)-
SOCIAL SECURITY NUMBER
167-07-2017
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~ 1. Original Retum
o 4. Limited Estate
IX] 6. Decedent Died Testate (AUlxhCOll'f oIMI)
o 9. Litiglltion Procllllds Received.
o 2. Supplemental Retum
o 4a. Futurelntllresl Compromise (:mtIl alrleeth_ !2.12-8?1
D 7. Decedent Mainmined a Living Trust (AtIBclt (OIlY of T....)
D 10. Spousal Puverty Credit (OOto or deeIh betWlllll112.3~ .91 iIIII 1-!-95)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
_._.,_._~_._.. .-_ - .~__._. ,,_.. ______ . _..___n ._..__._ ______.___. .~__~__.__
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dale ordoo'hlll1or '0 '2..1~.82!
o 5. Federal Estate lax Relum ReqlJ!red
8. Tolal Number of Safe Depostl Boxes
o 1'1. Eleetion to tax under Sec. 9113(AIIAl"'''' Sel: 01
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....t~l$..~~rl.....M~t..II..Q..utt~Q;.At'.~q~AI.~.,~~._..IOH'..mI#Tt,~(:.lNfo.mMt""..~U'~.....m'lm-~DT~t...
NAME COMPLETE MAlUNG ADDRESS
'::I~L~~_~=--~!-~YEN POBOX <t5:' 'I'"
FIRMNAME(.~l HOOD, VA. 22723
TELEPHONE NUMBER
(540) 948-4800
(1)
(2)
(3)
(4)
(5) ............................___.._........_~~~~9.Q...._._..
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a:
1 Real E.tale (Schedule A)
2. Slocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes RllCllivable (Schedule D)
5. Cash. Benk Deposits & Miscellaneous Personal Properly
(SchedUle E)
6. Joinny Owned Properly (Schedule F)
D Separate Billing Requested
1. Inter-Vivos Translers & Miscellaneous NOlI-Probate Property
(Sdledul9 G or L)
8. Total GrolS A!lHIs (total Lines 1.7)
9. Funeral Expenses & Admlnlstrative Costs (Schedule H)
10. Debts of Decedent. Mortgage Liabllnias. & Liens (Schedule I)
11. Totll Deductions (lolall.ines9 & 10)
12. Net Value of Estlte (line 8 mill us Une 11)
13. Charitable and Governmental BequestS/See 9113 Trusts for whiclllln eleclion to tax hes not been
made (Schedula J)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable all!1e spousal tax
rate, or transfers under Sec. 9116 (aX1.2)
x .0 _ (15)
13,365.00 x.O ~ (16)
2,041.00
(6) .._._..._.._m___.__..._...__....__._..____....._._.
(7)
21,978.00
(9)
(10)
14. Nllt Value Subject 10 Tax (line 12 mmus Line 13)
(8)
7,641.00
972.00
(11)
(12)
(13)
8,613.00
13,365.00
(14)
13,365.00
.'.."...,...,........,'.
........ .,. -.....,...
. .........-...,............_...,-.
16. Amount of Une 14 taxable at lineal rate
601.43
x .15 (fill
l( .12 (17) --.-.......----.-..-....-.......-..........._.........m.......
17. Amount of Linll 14 IlIxllbla at mUng rete
18. AI1l'Junl of Line 14 taxable al collalelsl rate
19. Tax Due
20.~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVl::RPAYMENT
..:......,....'i.:.;....::..:.'.:.iii.jji.B~..~.:rO'.A~!lvw~.Ali#dtir$ti~.;('JW.~~.t;:.:~ANO~~fl.~MA1:H..K#:;::::;:
::.::::~::::}{;/:\::;::::::{:~::~::::: ... ::::;:<;:::;:::::'::::;
........'.'............, .....'....;.;.;.;.:.:-:.: ::;:::::::;:::::;-::;:;:;:::::;:::;
(19) .......-..................h............m....h.....h. _..J~()1A.3..... ...
-Decedent's Complete Address:
STREET AOORESS
_ 2100 BENTCREEK6LYP
ci'iYMECHANicSBURG-------------------
I STATEpA-----~~-TlIP1;~~~--.--.---m--
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
601 43
724.91
30.07
Total Credits ( A t B tel (2)
754.98
3. InleresllPenaity it applicable
D. Interest
E. Penalty
153.55
TotallrlleresVPan.1lty ( D + E ) (3)
4. II Line 2 is greater lhan Line 1 + Line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE.
(5)
(SA)
(58)
A. Enter the interest on lhe lax due.
B. Enter the tolal of line 5 + 5^-. This is the BALANCE DUE.
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
a. retain the use or income of lhe property Iransferred;.......................................................................................... 0
b. retain !he right 10 designate who shall use the property Iransferred or its income; ..................._........................ 0
c. relain a reversionary inlerest: or.......................................................................................................................... 0
d. rer.eive lhe promise for life of either payments. bef1efits or (:are? ...................................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequale consideration? .............................................................................................................. 0
3. Did decedent own an "in Irllsl for. or payable upon death bank acoount or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Accounl, annuity, or other non-probale property which
oonlains a beneficiary designation? ........................................................................................................................ 0
No
~
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00
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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 p8l181lies of PIllPY. I dllcllII8lhall hlIv8 emrined iii r8ltm, indudng 8~ng Id18WIts and IIlat&rnenll. am 10 III best 01 my knowIIdgI and blllief. it II We. COIllId and cmnpIele.
Dedaraton 01 pI1IplIIllt' oll..ttan I1e perIOIlIII ~Ils b888d on all fnformalon of which prepaI1II" hllll any knowIedga.
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ADDRESS r7'
POBOX 94, HOOD, VA. 22723
..SIGN~JU .E ~REP~~ om TH~RESENT^-TIVE
ADORES
128 B LLEVIEW AVE ORANGE VA 2296
ATE
oj "J D 'f
For dales of death on or after July 1, 1994 and bebre January 1, 1995, \he lax rate imposed on the net value of lransfers Co or for the use of the surviving spouse is 3%
(72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or aileI' January 1, 1995, the lax raJe imposed on Ihe nel value of lransfers to or for Ihe use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)).
The slalule does nol exempt a lransfer to a sUIVivlng spouse from lax. and the slalutory requirements for disclosure of assets and flUng a tax relum are still applicable even if
the survMng spouse is !he only beneficiary.
FIJI dates Ilr dlllllh 01\ or aRIlI .'uly 1, 2000:
The lax rate imposed on !he net value of lral'lsfers from a deceased child twenty-one years of age or younger al death 10 or for the use of a natural parenl. an adoptive paren~
or a steplJsrenl of the child Is 0% I72 P.S. ~9116(a)(1.211.
The lax rale imposed on the net value of transfers to or for the use of \he decedenfs linea! beneficiaries Is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. g9116(a)(1)).
The tax rate imposed on lhe nel value of transfers to or for \he use of Itte decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)1. A sibling is defined, under Section 9102 as an
individual who has at least one parent in common with the decedent, vmether by blood or adoption. .
REV-1503 EX. (6-98)~.
~
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
EDWARD J. WEISS
FilE NUMBER
00762
All property folntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
14 SHARES OF WAL-MART @60.08 PER SHARE
800 SHARES OF UN I-MART @1.50 PER SHARE
VAlUE AT DATE
OF DEATH
84100
2
1,200,00
TOTAL (Also enter on line 2, Recapitulation) $
(f more space is nlltlded, insert additional sheets of the semB size)
2,041.00
RF.V.1508 E'X+ (6-98)
_,<~O_
~
COMMONW'EAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDE'.NT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
EDWARD J. WEISS
FILE NUMBER
00762
Include the proceeds of litigation and the date the proceeds were received by the estate.
An property jointly-owned with right of survivorship must be dlsolosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 SUMMERDALE FEDERAL CREDIT UNION - ACCOUNT #1180.0
2 PNC BANK ACCOUNT #150-8039-5323
5,783.00
14,154.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, inselt additional sheel$ of the same size)
19,937.00
REV.1S11 EX+ (12099).
COMMONWEAtTH OF PENNSYLVANIA
IN~ERlTANCE TAX RETURfII
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
EDWARD J. WEISS
FILE NUMBER
00762
Debts of decedent must be reported on Schedule L
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
2
FUNERAL EXPENSES:
SULLIVAN FUNERAL HOME
PASTOR GEORGE JENSEN
ENOLA CHURCH OF GOD
JAMES R. GINGRICH MEMORIALS
6,045.00
100.00
500.00
80.00
1.
3
4
B. ADMINISTRATIVE COSTS:
1. Personal Represen18liYe's Commissions
Name of P8ISOnel Represen18lMt(s)
Socls1 Security Number(s)/EtN Number or Personal Representative(s)
Street Address
City
Slate
Zip
Year{s) Commission Paid:
2.
Attorney Fees
250.00
3. Family Exemption: (tr decedent's address is nollhe seme as claimant's, attach explanation)
Claimant
Street Address
City
Slate .
,Zip .
Relattonship of Claimant to Decedent
4. Probete Fill
5. Accounlant's Fees
6. Tax Return Preparer's Fees
7. HELEN M. SLAVEN, REIMBURSEMENT FOR TRAVEL FROM VA. TO PA. 680 MILES @.36
TOTAL (Also enter on line 9, Recapitulation) $
(II more space is needed, insert additional sheets oIlhe same size)
7,641.00
REV.1512 EX-112.03) ..
COMKlNWEAl TH OF PENNSYLVANIA
INHeRITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LlABIUTIES, & LIENS
ESTATE OF
EDWARD J. WEISS
Report deblllncurred by the decedent prior to deltth which I'8m.lned unpaid a. of the dltte of deltth, Including unl'8lmbul'll8d medical expense..
ITEM VAlUE AT DATE
NUMBER DESCRIPTION OF DEATH
t
FilE NUMBER
00762
2
WEST SHORE EMS, BILL 5300
ALERT PHARMACY, BILL 222.00
CARLISLE REGIONAL MEDICAL CENTER, BILL 76.00
CENTRAL PENN MEDICAL GROUP EMERGENCY, BILL 248 00
CENTRAL PENN MEDICAl GROUP EMERGENCY, BILL 28.00
LEHIGH VAlLEY PHYSICAL THERAPY, BILL 151.00
HOLY SPIRIT HOSPITAl, BILL 89.00
MOBilE X-RAY IMAGING, INC., BILL 67.00
PA DEPARTMENT OF REVENUE, 2003 INCOME TAX 38.00
3
4
5
6
7
8
9
TOTAL (Also enter on line 10, Recapitulation) $
(If more space Is needed, Insert additional sheets of the same size)
972.00
RFV-t513F.X+(9.(lO) t,.JnO
-
f.oMPMJNWEAl TH Of PENNSYLVANIA
INff[RHANCE TAX RHlIRN
RESIDENT OECF.DE'NT
SCHEDULE J
BENEFICIARIES
ESTATE OF
EDWARD J. WEISS
RElATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS Of PERSON(S) RECEIVING PROPERTY Do Not LIlt Trultee(s)
I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions. and lIansfers under
Sec. 9116 (a) (1.2)1
EDWARD J. WEISS, JR, 3713 JANNEY LANE SW, ROANOKE, VA., 2401 SON
.
FILE NUMBER
00762
AMOUNT OR SHARE
OF ESTAT~
0.25
2 JOHN E. WEISS, 9 CARDINAL DRIVE, STEVENS, PA, 17575 SON
025
3
MARGARET W CROUCH, 10 LAKE SHORE LANE, LANDENBERG, PA 1 DAUGHTER
a
0.25
4
HELEN M. SLAVE, POBOX 45, HOOD, VA. 22723
DAUGHTER
0.25
ENTER DOlLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-I500 COVER SHEET
" NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAl DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space Is needed. insert additional sheell of the same size)
0.00