HomeMy WebLinkAbout02-0542PETITION FOR PROBATE and GRANT OJF~ LETTERS
Esrare of ~ ~,1~ i Th ~IIPn Hn un rV1~L1~_ No. _ a ~ - V ~ " S~
also known as To:
Register of Wills for the
Deceased. County of (~,. vkl~l zn~ in the
Socia! Security No. 17(0 - 31~ - S N B ~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that: ~{2c~i(n2t Zink Kell
Your petitioner(s), who Is are 18 years of age or older an the executriX named
in the last will of the above ecedent, dated .}+ riL I D ~ In1
and codicil(s) dated _NIFF
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~uvftbtn~pinrJ, County, Pennsylvania, with
hvxt last family or principal residence at 4d'~ P,,rkK' rAp fir{ (y1,aT ,l ~ t pq 161 f
(list street, number and muncipali[y)
Decendent, then ~_ years of age, died ~]Ga~ 7j 2-06,~ ,~
at Lctaotcxr Cr~xh, ~l Fi~a~(c- f~'r ~ .1 F v1r +- st- tin '
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 i
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ U24 ~ L`00
(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: NOn
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and [he gran[ of letters~e 4}nrrwr3cs-~
' (testamemary; administration c[.a.; administration d.b.n.c.t.aJ
[heron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF ~ ~ l {
The petitioner(s) above-named swear(s) or affirm(s) [hat [he statements in [he foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as persona] represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirm Tl+and subscribed ~eiltic~ ~,i-6eJ ~~~(,/~,,/ ~
efor.~mc this _ d - of ~f- ~•
A
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No..~ i - ~~ -5 ~E
Estate of .~ U. D'1 T (~ E~-1-C'N ~'ff1 YV1 M G Nr j) ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
t ~~G~
AND NOW ~~V ~ ~~ .t9~ , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~ ~~ l ~ - t `~
described therein be admitted to probate and filed of record as the last will of
and Letters __L
are hereby granted to
ZI
~~/
Register of
FEES
Probate, Letters, Etc.......... $~
Short Certificates( ) .......... $ ~ ~ ( (~'
RL[In11CIttt'10r1 ~~~5 .... $~
s~C. $ J ~ ~
TOTAL _ $ C~C~
Filed ...................................
-----
ATTORNEY (Sup. CL LD. No.)
ADDRESS
PHONE
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'his is to certify that the informalion here given is correcrhr copied from an original certificate of death duly tiled with me as
Local Registrar. The origi~a! certiheaee will he forwarded ro the Stare Viral Records Office for pemlunent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Pcc for [his certificate, $L00
' Lo~ registrar
f
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Nr NAME OF OECECEHi lfrv Maa•rul
I. Judith Ellen Hammond
.Of pay e+mmrl uNCEP nw
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423 Parkside Road
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COMMONW EALTN OF PENCERTIFICATE OF DEAT H EALTM • VITAL RECORDS
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~PED15TRAR'S3KNYVRE AHONVMBEP ' I/j7~J 7/9~ , ~'~
LAST WILL AND TESTAMENT
OF
.IUDITH ELLEN HAMMOND
I, Judith Ellen Hammond, of Camp Hill, Cumberland County, Pennsylvania, social
security number 176-36-5482, being of sound mind, memory and understanding, do hereby make,
publish and declaze this to be my Last Will and Testament, hereby revoking and making void any
and all former Wills and Codicils made by me at any time heretofore.
FIRST I direct that all my just debts and funeral expenses be paid by my
Executor hereinafter named as soon after my death as is
conveniently possible.
SECOND I hereby give, devise and bequeath unto my children, Michael H.
Zink and Heather Zink Kelly my entire estate, real, personal or
mixed, wheresoever situate, of whatsoever kind and description, to
be divided equally between them.
TH1RD All estate, inheritance and other death taxes, together with interest
and penalties, payable with respect to property or interests passing
under my Will shall be paid out of the principal of my residuary
estate without apportionment. Any estate, inheritance or death
taxes due as a result of property or interest not passing under my
Will shall be paid on a pro-rata basis by the transferee(s) of said
property or interests.
FOURTH I hereby nominate and appoint my daughter, Heather Zink Kelly to
be Executor of this, my Last Will and Testament, and hereby direct
that she shall serve in that capacity without the requirement of
giving bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last
Will and Testament dated tlus 10th day cf April, 2002, and written on two (2) sheets of paper.
ITH ELLEN HAIVIMOND
Signed, sealed, published and declared by the aforementioned Testatrix, Judith
Ellen Hammond, as and for her Last Will and Testament, in our presence, who in her presence, at
her request and in the presence of each other haee hereunto subscribed our names as witnesses.
2
~~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We, Judith Ellen Hammond, the Testatrix in, and _ m r,~~ ~ e- ~1, Fn1~,cjs}w n
qtr ~ . Ic, ~ ~ or and ~~ fyr~ S (Y) , l.vm ~ ,the
Witnesses to the Last ill, the attached or foregoing instrument, who have signed the instrument,
having been duly qualified according to law do depose and say:
(a) that I, the Testatrix,. do hereby acknowledge that I signed and executed the
instrument as my Last Will, that I signed it willingly and as my free and voluntary
act for the purposes therein expressed; and
(b) that we, the witnesses, were present and saw the Testatrix sign and execute the
instrument as her Last Will, that she signed it willingly and executed it as her free
and voluntary act for the purpose therein expressed; that each of us in the hearing
and sight of the Testatrix signed the Will as a witness and that to the best of our
knowledge the Testatrix was at that time eighteen or more years of age, of sound
min~d±~a,,nd~under no constraint or undue influence.
mil, ~ °-" 7Y~ay9t.C-Zfif. ~L~,
Tes atrix rt~~
~~-~ ~~
Witness
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
On this, the ~.S day of April, 2002, before me 1'l~ ~~(ltr~~ ~ ~ (°~ ~,/~ ~,~((
the undersigned officer, personally appeared _~ i _ ~~ N ,known to me
or satisfactorily proven to be a member of the bar of he highest court of Pennsylvania and
certified that he was personally present when the foregoing acknowledgment and affidavit were
signed by the Testatrix and witness.
In witness whereof, I hereunto set my hand and official seal.
GU!G
Honorable William W. Cal well
United States Distr_ct Court
Middle District of Pennsylvania
`~
CERTIFICATION OF NOTICE UNDER RULE 5 6(al
Name of Decedent: Tudj11~ ~,`~efl I~~YYIVYIn~Ir~
Date of Death:
. ~~~_ 5y~
Will No. Admin. No.
To the Register:
I certify that notice of 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
~,Q~~ IS ~ba
_ ~
Name Address
L~'1i(11ne~ ~.7_~nk ~~al til IlnuuxV S-i~reA~-
Q( i~,~ ~~BI 8'
~r~.wu? N~tl , P-R 17 a 1 I
Notice has now been given to all persons entitled thereto
Rule 5.6(a) e~GFR
Signature'~B`17~on ~{~nL Y~(~QV,U DatesU U ~ oZ~~~
Name ~Q~-{~i1N~' 2j,/lk ~P~~U
Address ~drkS~dr? Q[,.
~_}~i1TPA nc~~ I
Telephone(~l~ )_q~~_~ ~~
Capacity: Personal Representative
„_ r
Counsel for Personal Representative ~~'
~:
Inventory of the real and personal estate of
V ~.~ ~ ~ ~ t ~~ ~ e i~ ~1 ~iLY~/~ 1'~~I~ deceased
~ax~k Acc ou t~+ - S~;~s ~ C~1eC(;i ~
I~eV~ ~~Sy I va ni a St ale ~vv~P I cyee 's Cred.~ f (,~~~ ~
Acc.ou~t I~l~w~~-2 gyo3~ X15 ~ 3~( as4a~ o~
auou~.t a~+u ~~ ;nc~ de,~~ts~
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COMMONWEALTN OF PENNSYLVANIA l ~.
COUNTY OF CUMBERLAND ~
being duly according to law, deposes and says that he
of the Estate of
late of ---- Cumberland County, Pa., deceased and Chet the
within is an inventory made by - the said
of the entire estate of said decedent, consisting of all the personal pro par+y and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
and subscribed before me,
19
Eseeu}or - Adminisirefor
Address
Dafe of DeatF
Day
Month
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. $ee Arficle IV, Fiduciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17126-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 001419
KELLY HEATHER ZINK
423 PARKSIDE ROAD
CAMP HILL, PA 17011
-------- role
ESTATE INFORMATION: ssrv: 1~s-3s-5aa2
FILE NUMBER: 2102-0542
DECEDENT NAME: HAMMOND JUDITH ELLEN
DATE OF PAYMENT: 07/17/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/07/2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 51,032.22
REV-1162 EX~11-96)
TOTAL AMOUNT PAID:
REMARKS: HEATHER ZINK KELLY
CHECK#119
SEAL
INITIALS: JA
RECEIVED BY
REGISTER OF WILLS
51,032.22
MARY C. LEWIS
REGISTER OF WILLS
~- /S
~ ~~
BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX BxvlslBN DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-6601 NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-15O EM LFV In-p2l
DATE 08-26-2D02
ESTATE OF HAMMOND JUDITH E
DATE OF DEATH OS-07-2002
FILE NUMBER 21 02-0542
COUNTY CUMBERLAND
HEATHER ZINK KELLY ACN 101
423 PARKSIDE RD
CAMP HILL PA 17011 Anount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONO THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS t __________
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HAMMDND JUDITH E FILE NO. 21 02-0542 ACN 101 DATE 08-26-2002
TAX RETURN WAS: f X) ACCEPTED AS FILED ( )CHANGED
Ni5ED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate [Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Neld Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. transfers (Schedule G]
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (q) 11,400 .47
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 9,513 .60
11. Total Deductions
(11) 70.914-07
12. Net Value of Tax Return f12) 24,145.31
13. Charitable/Governmental Bequests) Non-elected 9113 Trusts (Schedule J] (13) .00
14. Net Value of Estate Subject to Tax Ily) 24,145.31
NOTE: Ifi an assessment was issued previously, lines 14, 15 and/or 16, 17
18 and 19 will
refilect fiigures that include the total of ALL returns assess ,
ed to date.
ASSESS MENT OF TAX:
15. Anount of Lina 14 at Spousal rate I15) .00 X 00 _ .00
16. Anount of Line 14 taxable at Lineal/Class A rate (16] 24,145.31 X 045 - 1,086.54
17. Anount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Anount of Line 14 4axable at Collateral/Class B rate (18] .00 X 15 - .00
19. Principal tax Due (19)= 1,086.54
TAX CREDITS'
---
DATE
NUMBER ~
INTEREST/PEN PAID [-)
AMDUNi PAID
PAVMFNT MIICT Rr Mnnr nv no_n~_ ~nn>..
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 1,086.54
INTEREST AND PEN. .00
TOTAL DUE 1,086.54
(1) .00 NOTE: To insure proper
f2) .00 credit to your account,
(3) .00 submit the upper portion
(4) .DO of this fora with your
(5) 45.059.38 tax payment.
[6) .00
I7) .00
I8) 45, 059.38
• IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
BuREau of INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TA% o1v1s1oN DEPARTMENT OF REVENUE
DEPT. 288681 INHERITANCE TAX
NARRI8811RG, PA 17128-8fi 01
STATEMENT OF ACCOUNT
REY-16A] FN RF/ (Y1-w)
DATE OB-26-2002
ESTATE OF HAMMOND JUDITH E
DATE OF DEATH OS-07-2002
FILE NUMBER 21 02-0542
COUNTY CUMBERLAND
HEATHER ZINK KELLY -'" ACN 101
423 PARKSIDE RD
CAMP HILL PA 17011 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: io insure proper credit to your account, submit the upper portion of this fora with your tax payment.
CUT ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS 1
--°-----------------x. --.
REV-1607 ~° '-- '--------------------------------------------------
~**
ifiElE
ESTATE OF HAMMOND JUDITH E FILE N0. 21 02-0542 ACN 101 DATE 08-26-2002
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY 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: 08-26-2002
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
1,086.54
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-l AMOUNT PAID
07-17-2002 CD001419 54.33 1,032.22
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
^ IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ''CREDIT" fCR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
1,086.55
.O1CR
.00
.O1CR
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
\ Lv,! --3-_
FILE NUMBER
Z.--L-~ 2- fL':L/b__
COUNTY CODE YEAR NUMBER
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SOCIAL SECURITY NUMBER
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'5'-j'6'd-
II (p
DATE OF BIRTH (MM-DD-YEAR)
~ Ow-~D- q~~
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
NIl\.
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[0< Original Return
o 4. Limited Estate
~ Decedent Died Testate (Attach COj)y of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
D 4a. Future Interest Compromise (date aldeath alter 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copyofTrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior to 12-1HI2)
o 5. Federal Estate Tax Return Required
Jfl. 8. Total Number of Safe Deposit Boxes
o it Election to tax under Sec. 9113(A) (Attach SchO)
...,
Z
W
C
Z
o
"-
II)
W
0:
0:
o
o
COMPLETE MAILING ADDRESS
Lf;;l. 3, '".PM(<.Slde Rd. .
C6.vY\f [-\lll) P A \701/
TELEPHONE NUMBER
W'_ .....-
>.,'.
.:- d
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1) ---A11:JfI q,.
(2) ,; ~t..
(3) N~J'(:,
(4) ~ J~y-
(5) 4585'1. 38'
--~.'
OFFICIAL USE ONLY
r.
cO'
r-
4. Mortgages & Notes Receivable (Schedule D)
z
o
~
~
l-
ii:
<(
(.)
W
It:
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(9~ II 4ro'tY
1
(10) ..,g 6 I,~. (00
(8) 4 '5.D54\ .31>
(8) 1-.\01\\[
(7) NfZ,fV G-
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)
(11) ;J()QI4. 01
.
(12) &4. 1'-I5..~1
(13) rJ (aN c;
(14) .J.4, 11./5,31
13. Charitable and Governmental 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
z
o
!;(
I-'
~
0.
~
o
(.)
~
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
'.0_ (15)
,012 (16) \D~ i.o. 5~
16. Amount of Line 14 taxable at lineal rate
~l.\ \L/S;.6\
17. Amount of Line 14 taxable at sibling rate
, .12 (17)
, .15 (18)
(19) 10 S(o. 5 'i
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
> > BE SUR6\
Decedent's Complete Address:
STREET ADDRESS Lj d,
CITY
Tax Payments and Credits:
1. Tax Due (Page lUne 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount .riLl. ?, d-
3. InteresUPenalty if applicable
D. Interest
E. Penalty
(1) \ 0 )Sto. 5 Lj
Total Credits (A+ B + C) (2) 5<1. 3 d-
TotallnteresUPenalty ( D + E ) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
B. Enter the total of Une 5 + 5A. This is the BALANCE DUE.
(5) f 0 3 a. d-. d-
(5A)
(5B) I n,,,a. .;l::l
5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax dUe.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;............................"............................................................ ( .
b. retain the nght to designate who shall use the property transferred or its income; ............................................ D
c, retain a reversionary interest; or............................................................,.................................................,,,......... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .......................................................................,.........,............................ 0
3. Did decedent own an "in trust fo~ or payable upon death bank account or secunty at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ D
No
iH
[;igJ
I)i,i]
[jjI
Under penalties of perjury, I declare that I have examined this ret1.lm, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Dedaralion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG ATURE OF PERSON RESPONSIBLE FOR FILING RETURN
ADDRESS
Jfd,,~ fh.I1J~ Prl_ ('B~ t,{ , ~
SIGNATURE OF PREPARER OTHER THAN REPRE NTATIVE
DATE
ADDRESS
For dates of death on or after Juiy 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)l.
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 survivin9 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 retum 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)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficianes is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net vaiue of transfers to or for the use of the decedenfs 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.
""'WlS,"'''''".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
:r u.fu TY\ (. l-kMMMd
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
1.
DESCRIPTION
1?xu1k. {\C.C-DUfY\ $ '3'-1031 I{S<O 3LJ
t:e.nn\',j \vOfIi2- state. T-W\,?I~ ee CPeclit
P.O. C!>OI' i.oIO\~
\\1JJV\.i~\;JW'~lPh \'1 \o\J> -10' ~
~;1f" C\tleC'N'j .ALLOJ)..n\s
VALUE AT DATE
OF DEATH
t,fSQsq ,3'6"
u. (\ i 6Y\.
TOTAL (Also enler on line 5. Recapitulation) $ <1505'1, 3g
Ilf more space is needed, insert additional sheefs of the same size)
REV-1511 EX+ (12.99) .
~j-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
:J lA.!.lilVt t.. ttCLm WI(\.1J.
FilE NUMBER
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. ~ t\ome. lC05W>Ftuilj~ U'Se.,e.n) 1<e-pV'd fu.1'\e(a.( Ht>me. (PLjDl.3S"
2. W'vle~li":l ) WV qOO.oO
\'i\eill.lrY1U\T - G~,>w tJlefflo(1J~ wVee\."i,IN\I
3. Gw,r'l'\ He. ... MMs.ua.'l Vt.e. - 9r. wte.'s l).ruteo.l'imocii!>l ~ J,lS !0.2.
t~..a':), 10 Ii
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) \-\pcJV\eI lil\.~ I(e L L\3
Social Security Number{s)/EIN Number of Personal Representative(sl f25
Street Address ~ a 2, 'Pi".,\:-Sidp RrI
City ~ H-ilA~ stateaziP)lOII
Year(s} Commission Paid: 101 A-
I
2. Attorney Fees t-J/A
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant \.\Po...1V\Pf Ziol\L ~p f I <a- 80'500 Q5L
StreetAddress-.!:l.1::, (Ja.(\::-<;0e eJ )
City Co....~J-h \,l Stale -1?tt.- Zip 11011
Relationship of Claimant to Decedent Dr) 11 j lI\.Te J:..
~
4. Probate Fees 1=;lirj ~es.) SnoR:! (e,...,tlB~ + L2g,c.J. No \ i c.e,.S tf.3/'g
5. Accountant's Fees R::5
/6
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 11'-100 ~
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
REV''':''''''''.
COMMONWEALTH OF PENNSYLVANIA
tNHE.R1T M-lCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
EST ATE OF
Include unreimbursed medical expenses.
ITEM
NUMBER
1
2..
"
4.
5-
(".
,.
'iI.
q.
10.
II.
12.
I:'.
1'-1.
IS.
110.
\1.
@
DESCRIPTION
\!.fIi CJMR /1YLc, ~W;t'h S~(S.
Si\ufA Sfn':j ArvU>;JaN,Q
NoAA'Ie.o.DT' ro.J\Aol~'i\
CoYY\{l\l<1e ~
M5 l\IVI.C P~'L1.J,.\'\ 6ro"'f
\-\Dlj S~1I1it ttosp,tc.\
(hA.-\\'I'\ouJh rlitrhWcJL. 'P<z>f. Ass()
?UAd~ V\i\W..ical Cnt2...
It.
\'\.
0.0
Pu.Io\it. ~V1'U! _ New ~S""ilU
ASSoC.i3\eS",,,, lJ\eJAidAe.
\10..-1.\(,\ ~'.t ',\oc,\)i-\-&\
M, lton \-kAs~ Piled. CvJe..
\l;\t~ R fsT ClW/. LlV\IlJY' (V; sa.)
M~Ve*.b\~'t,
A"f.>Oc.,~ R.~,o\O)iS1S
t. f'1IlIC., ~ NI-\
\0""...... "1 Oen:} -EMS
S .....s'b!At hD.nna e: (VIS
T"""'~T
,?(lj\\:.\~ Mlj (vI~.
.
{)le(.lM.. v'\.oTe- dece..Oel'lt 0. ic.l nol Vl(l...l}( meclica\ ~d..J/\-CR
C4wl ea6h of' -t(,\kO{. \::>1 \AS . (;) \Qe.i ::)'pc<-J oV-f- <9J 1t....e.
eSTWQ.....
AMOUNT
J,SO'-l gg..
OS'!51
l;;}lo.9,
700 g:;
Co7lJi/
lq'1!!
(#)\<8
110'33-
;).1 ca-
(o'-{'!S?
35(.lJi/
C(Sc;l ~
9- '-\ \~ ii3-
10":9.
lD'2
\~3 !5-
\31~
4;1.3.,g
~1e2.
l.\lPS U
TOTAL (Also enteron line 10, Recapitulation) $ QlSl3 ~
(If more space is needed. insert additional sheets of the same Size)
'~"'~".""".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1. MicV\ueJ 111\1\V--
fOal \N,llowwcat <;twJ-
Orldo, rl- 3d-~l<i;
1. I-\ecA.The.r 2\1\~ \:e.\l~
4a3 ?OJ\'KS\c.\e. Rtl. .
(1\VI{! l-\\ \\ , \> f\ n D \ \
SON
50'1'0
\)OVJ..cy.-k<<-
50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 additionai sheets of the same size)
LAST WILL AND TESTAMENT
OF
JUDITH ELLEN HAMMOND
I, Judith Ellen Hammond, of Camp Hill, Cumberland County, Pennsylvania, social
security number 176-36-5482, being of sound 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 former Wills and Codicils made by me at any time heretofore.
FIRST
SECOND
THIRD
FOURTH
I direct that all my just debts and funeral expenses be paid by my
Executor hereinafter named as soon after my death as is
conveniently possible.
I hereby give, devise and bequeath unto my children, Michael H.
Zink and Heather Zink Kelly my entire estate, real, personal or
mixed, wheresoever situate, of whatsoever kind and description, to
be divided equally between them.
All estate, inheritance and other death taxes, together with interest
and penalties, payable with respect to property or interests passing
under my Will shall be paid out of the principal of my residuary
estate without apportionment. Any estate, inheritance or death
taxes due as a result of property or interest not passing under my
Will shall be paid on a pro-rata basis by the transferee( s) of said
property or interests.
I hereby nominate and appoint my daughter, Heather Zink Kelly to
be Executor of this, my Last Will and Testament, and hereby direct
that she shall serve in that capacity without the requirement of
giving bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last
1
Will and Testament dated this 10th day of April, 2002, and written on two (2) sheets of paper.
:ffi5'~ ~~
ITH ELLEN HAMMOND
Signed, sealed, published and declared by the aforementioned Testatrix, Judith
Ellen Hammond, as and for her Last Will and Testament, in our presence, who in her presence, at
her request and in the presence of each other have hereunto subscribed our names as witnesses.
(
~/vtL[ -r; Ire
2
COMMONWEALTH OF PENNSYLVANIA)
)
COUNTY OF CUMBERLAND )
We, Judith Ellen Hammond, the Testatrix in, and rnCl'i~ ie.. JY'\. (:;n~~'^ ,
Sr,\'(< E. TeuJ()/' and -.JGffi<' ~ tv}, lY,M:\ , the
Witnesses to the LastWill, the attached or foregoing instrument, who have signed the instrument,
having been duly qualified according to law do depose and say:
( a) that I, the Testatrix, do hereby acknowledge that I signed and executed the
instrument as my Last Will, that I signed it willingly and as my free and voluntary
act for the purposes therein expressed; and
that we, the witnesses, were present and saw the Testatrix sign and execute the
instrument as her Last Will, that she signed it willingly and executed it as her free
and voluntary act for the purpose therein expressed; that each of us in the hearing
and sight of the Testatrix signed the Will as a witness and that to the best of our
knowledge the Testatrix was at that time eighteen or more years of age, of sound
mind and under no constraint or undue influence.
~~
it )A
T es atrix
(b)
.
~ -ttj. t!'~
It'r
S~Z- -r; I b,--
Witness
COMMONWEALTH OF PENNSYLVANIA )
)
COUNTY OF CUMBERLAND )
On this, the jScJ.day of April, 2002, before me W, 'II/aM /AI f I.IIc/u1.tl (
the undersigned officer, personally appeared 1Y1fl.4Q., L M. r=:., 1'" i 5 -Ie j VJ . known to me
or satisfactorily proven to be a member of the bar ot'the highest court ofpennsylvama and
certified that he was personally present when the foregoing acknowledgment and affidavit were
signed by the Testatrix and witness.
In witness whereof, I hereunto set my hand and official seal.
_~~'1'
United States District Court
Middle District of Pennsylvania
4
& S INON LLP
Heather Z. Kelly
ph (717) 237-6732
fx (717) 231-6637
hkelly~rhoads-sinon.com
FILE NO 99000/99950
Re.-
July 2, 2004
Judith Hammond
Glenda F. Strausbaugh
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Dear Ms. Strausbaugh:
Enclosed please find a Status Report Under Rule 6.12 with regards to the above.
If you have any questions, please do not hesitate to contact me.
Very truly yours,
RHOADS ~; S1NON LLP
By:
Heather Z. Kelly
HZK/tlp
Enclosure
Rhoads & Sinon LLP · Attorneys at Law ° Twelfth Floor · One South Market Square · P.O. Box 1146
Harrisburg, PA 17108-1146 · ph (717) 233-5731 ° fx (717) 232-1459 ° www. rhoads-sinon.com
STATUS REPORT UNDER RULE 6.12
Name ofDecedent:~'cL~-~ ~-~e~r'~O('~c~
Date of Death: 5] 3] 0 ~
Will
A~. 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 t//' No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
Yes
If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
parties in interest? Yes
Did the personal represent/ative state an account informally to the
No ~/'
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this
report.
Signature
Name (Plebe type or print).
Ad,ess
Tel. No.
Capacity: ~ersonal R~resentative
~Co~sel for personal
representative
255154.1