HomeMy WebLinkAbout03-0633
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of <JCt.I.HI/~ <;,4R,v€~ No. CJ./---CJ3 - ~33
also known as To:
Register of Wills for the
. Deceased. County of Cumberland in the
Social Security No. A C I /9" I t./ tf" 7- 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 tuhf"/,P :t: a.-I.....~d
in the last will of the above decedent, dated , 19_
and codicil(s) dated I .- R- R'~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was d?miciled. at .death i~ t!UvTl ~ ~.'7 ~ &. /v':/ d CoUI~., Pennsylvania, with
h .~ i' last family or pnnclpal residence at n 5
t-" ~ s or ~Q /y 1./1 P""; P", /70 ~ 5'
(list street, number and muncipality)
Decendent, thej ff'" 0 years of age, died 7 ~ '3 0 ,,~ "::I 00 ~
at SIt{ "'1P t;'.r UJ-<!'s7 Fo-o.vl..e....} /PCi' J7c-'::l.r
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 $ Z CJ 0 ,
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ ~ P, tJ Cl 0
situated as follows: '
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I ss
COUNTY OF Cumberland 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.
Swom to 0< affim",d and ,ub'cdbed ~ tv ~'C7' / (I A_ e gL ~
before me this 4 th day of ~
CY ~ A~st xL2..0..03 _ a
QA- !(J" ~~ ~ ~ IJPr,J ~
Don~. Otto, Is ~Y~iegister. ~
17.../Q ~... 01.
No. 21-2003-633
Estate of Savilla S.Arnett , Deceased
- DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW August 4th P9x 200 m consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated January 8, 1985
described therein be admitted to probate and filed of record as the last will of
Savilla ~ "Arnprr ,
and Letters Testamenrary
are hereby granted to Wayne J. Arnett
j}~,9tJ/Jttid~~/,,#cf~
Rogi,,~ of WHo ~
Donna M. otto, 1st Deputy t
FEES
115.00
Probate, Letters, Etc. ......... $
Short Certificates(8) . . . . . . . . .. $ 221.00 AITORNEY (Sup. Ct. 1.0. No.)
RomlRciatiox x.,. Rage s. . ( 4.) $ 17 00
JCP $ 10.00 ADDRESS
TOTAL _ $161.00
Filed Al,lgl,l:3.t..4 th. . .2 0.0 3. . : . . . . . . . . .
PHONE
Mailed Letters to Executor on 8/4/2003.
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 6/15/2005
ARNETT WAYNE J
225 UMBERTO STREET
NEW CUMBERLAND, PA 17070
RE: Estate of ARNETT SAVILLA S
File Number: 2003-00633
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 7/30/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~1~1AJ~~
I
-.,/
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
JUdge
cP\
JUL 3 1 2003
No. Date
21-2003-633
13 Rey 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STAl'E FilE NUMBER
NAME OF OECEOENT (f lr$l. MI(kSIe. last SEX SOCIAL SECuRITY NUMBER DAlE OF DEATH ,McnIh. Oa). .....
.. Savilla S. Arnett .. Female 3.201 - 18 - 1489 .. July 30, 2003
AGE (La$! Blf1r'1daY) UNDER 1 YEAR UNDER 1 DAY 8IRTHPLACf (Coty itnd PlACE OF DEATH fCt>eck 01>1.,. <lI"8 -- -;ee tllstfUCt.ord on achel sde)
M~ ! 0... Houra ! Minut.. Stale Of fCf&<gn Coonlly) HOSPITAL:
80 v... Hbg, Pa 1_.....0 EAlOutPIIuent 0 OOA.O ="'10
5. 7. ...
. COUNTY Of llERH FACH..lTY N.....E {If nollm.1oJ\J1lO11. give sl:reet and numbeu RACE .1uNncan Indian. Black. WhiI.. etc.
(~I
. ... Cumberland ,J.:. 3rd St. , ... White
DECEDENt.S USUAl OCCU""'ION KIND OF BUSINESS/INDUSTRY 'MS DECEDENT EVER iN MARITAl SWUS.......... SUIMVINCl SPOUSE
(~worIa~~~~=:zi,=r u.s. ARMED FORCES? NeYer Manied. Widowed. III...... QlW mad8n name)
_O~ Iliwln:od lSpecoly)
. lIe. ..Il. ... Widow
DECEDENt'S MAILING ADORESS (Sk.... C"'Ibon. _. Z..CooaI DECEDENT'S "'.SIat. Pennsylvania .7061: .....___.. East Pennsboro
. ACTUAL ""' _.
514 3rd Street RESIDENCE --
lSee IOUJUCIIOna iwlina
West Fairview, Pa 17025 on__l Cumberland -' No. dKedenllived
... '?II. 17d.O ___01 _.
FAJ'HEA'S NAME (Fvst. Middle. Lase) MOTHER'S NAME (Fwst. MtddIe. M8lden Surname)
1.. Bruce Shirley ... Emma Ma Killin er
IHFOAMANT"S NAME (T ypoIPrinl) INFORMANT'S loWllNG ADDRESS (51<.... Colyfbon. _. z.. ~I Pa 17070
-- Wayne J. Arnett _. 225 Umberto st., New Cumberland,
METHOO Of IlISPOSITKlH PLACE OF OISPOSITKlH. N..... of Cemetery. C.1IIQIoIy LOCATION. QIyITown. SIal.. ZIP ~
. _ KI C'.....ion 0 Of 0IMf Plok:.
ou..r ~"" 2003 .Bolling Green Mem Park ..J;:amp Hill, Pa
NAME AND ADDRESSOf FACIlITY
.~ullivan F.H. 51 N. Pa
LICENSE NUMBER
... 6:24 A. M. '5. 30 2003' ...
27. PART I: Ent... the~. ineUltes Of complications which caused the o.ath. 00 not enteru.. mode of dying. such as cardiac 01 respifalory .flest. shock or healt lailure ....,.......... PART U: ou..r~ condIIiona _ing 10 _.llUI
Lilt ontv one cauae on MCh tine. : inleMIt bel\Mren naI resuIing in 1M l.IftdIr1ytng ca.- given in MAT I.
10nMI and dMIh
C()~O I
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DUE 10 lOA AS A CONSEOUENCE Of)o :
!" .
0UE101OA AS A CONSEOUENCE on I
I
c. I
DUE 10 (OR AS A CONSEOuENCE on !
d
WERE Al/lOPSY F.NOINGS MANNER OF DEATH DATE OF INJURY T~E OF INJURY INJURY XI 'NORK1 DESCfUBE HOW INJURY OCCURRED.
_LABLE PRIOR 10 ~ (Uonth. Day. Yearl
COMPLETION OF CAUSE 0
01= OENH? -..... Homicide ....0 NoD
Ac_ Pending kwesligallon 0
....0 NoD 0 o PlACE OF INJURY - AI home. farm~;..'. factofy. office M.
- Coukt not be determ.ned LOCATION (Street. Ciy/Town, SIaIe)
_. ..... buikInQ. etC. t~.v)
n. _.
CSlTlFaER (Check only oneI
-CERTIFYING PHYSICIAN (Ph~ certlfytng cause oJ death when anolhet phy$lC.aJ'l has ptonounced dealh ana compJeied lIem 231
To........ofmWknowMclge..athoccurrwcfduelo....C.u..(.I.ndmatlNr...~...................................... ...... .....
.'AONOUNCING AND CERTlfVINO PHYSICIAN tPhV5'C1iIfl bo&tI ilIooounctflg Oealh and certd'(lf"l9lO cause 01 dealh)
Tau....., 01 my knowledg.. death occurred..t.... lime, date. "nd piKa. and due 10 the cauMis) and manner aa s.aled.. . . .. ......- ......
'IIEDICAL EXAIIINER/CORONER 108 Lowther st
On ,he baaja o. examlne'lon ancllor Investigation. in my opinion, deeth occurred lit the Um.. date, and place, and due 10 the cause(a) and 0 Lemoyne, Pa
:J1.~n.... st.ted.... . . . .. . ... . .. . . . . . .... . . .. . . - .. . .. .. . . .. ... .. .. .... ..... . . . . . . . .. ...... . . . . ...... . .. . .... . . . ... 32.
RE:GI~~'S SIGNATURE ~O N~ ~ OATEFu Da, Yo",
(.. . --:1(.-~e./ ..,~? C!...{.,-Z..:1_ ,.;'..7 .,,~)o?_- /.p(7,/,/ I J I dtftf3
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Ifinst ~ill nub mestnmeut ~/,CJ3-h33
of
SAVILLA S. ARNETT
I , SAVILLA S. ARNETT of West Fairview, Pennsylvania, revoke my
prior wills and declare this to be my will:
GIFTS
I. Real Estate: Upon my death, premises 514 Third Street, West
Fairview, Pennsylvania, shall be sold and the net proceeds of such
sale added to my residuary estate.
II. Residuary Estate: I give the residue of my estate, real and
personal, as follows: In equal shares to my children who shall
survive me, and to the issue, per stirpes, of such child or child-
ren who shall have predeceased me, leaving issue surviving.
ADMINISTRATIVE PROVISIONS
III. Protective Provision: No interest in income or principal
shall be assignable by, or available to anyone having a claim
against, a beneficiary before actual payment to the beneficiary.
IV. Death Taxes: All federal, state and other death taxes--except
generation-skipping transfer taxes--payable because of my death on
the property forming my gross estate for tax purposes, whether or
not it passes under this will, shall be paid out of the principal
of my residuary estate just as if they were my debts, and none of
those taxes shall be charged against any beneficiary. Any death
taxes on future interests may be paid whenever my executors, in
their sole discretion, think best.
V. Management Provisions: I authorize my executor:
A. To retain and to invest in all forms of real and personal
property, regardless of ( i) any limitations imposed by law on
-1-
. . . .
.
investments by executors, (i i) any principle of law concerning
delegation of investment responsibility by executors or (iii) any
principle of law concerning investment diversification;
B. To compromise 1 . and to abandon any property which, in
C_.alms
my executrices' opinions, is of little or no value;
c. To sell at public or private sale, to exchange or to lease
for any period of time, any real or personal property, and to give
options for sales or leases;
D. To join in any merger, reorganization, voting-trust plan
or other concerted action of security holders, and to delegate
discretionary duties with respect thereto;
E. To distribute in cash or in kind.
F. To use administrative or other expenses of my Estate as
income tax or estate tax deductions and to value my Estate for ta.x
purposes by any optional method permitted by the law in force when
I die, without requiring adjustments between income and principal
for any resulting effect on income or estate taxes; and
G. To employ such agents, accountants, attorneys' assistants,
advisors, brokers, banks, investment counsel, tax advisors, and
attorneys, and such other agents or assistants as they shall deem
necessary to the administration of my Estate of any trust created
hereunder without liability for the negligence, mistake, miscon-
duct, or default of such person, provided reasonable care and
prudence was exercised in his selection.
These authorities shall be in addition to those granted by law
and shall be exercisable without court authorization.
-2-
.
. . . .
. .
VI. Beneficiaries under Twenty-One or Disabled: If any benefici-
ary under twenty-one becomes entitled to any income or principal
hereunder, or if any beneficiary who is, in my Executors' opinions,
disabled by advanced age, illness or other cause, become entitled
to any income or principal of my residuary estate:
A. As much of such income and principal as my trustees may
from time to time think desirable for that beneficiary either shall
be paid to him or her or shall be applied for his or her benefit;
and
B. The balance of such income and principal shall be held as
a separate trust for the beneficiary, and subject to my trustees'
power to pay to, or apply for the benefit of, the beneficiary, both
income and principal of such trust shall--together with any net
income therefrom--be kept invested and paid as the case may be, to
the beneficiary when he or she reaches twenty-one years of age or
becomes, in my trustees' opinions, free of disability.
Any funds to be applied under this article shall be applied
directly by my trustees or shall be paid to the parent or guardian
of the beneficiary or any person or organization taking care of the
beneficiary, and my trustees shall have no further responsibility
for any funds so applied or paid.
-'7)-
. ,
.
FIDUCIARIES
VII. Executors and Trustees: I appoint my son, WAYNE J. ARNETT,
-
Executor and Trustee under this will.
Executed f - ~ /'"
, 1 9 ~.s
6aA~Lt/ 5 tZ~~#EAL)
In our presence the above-named testatrix signed this and declared it
to be her will, and now at her request, in her presence, and in the
presence of each other, we sign as witnesses.
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STATE OF PENNSYLVANIA :
: ss.
COUNTY OF ~ :
I, SAVILLA S. ARNETT, having been duly qualified according to law,
acknowledge that I signed the foregoing instrument as my will, and
that I signed it as my free and voluntary act for the purposes there-
in expressed.
1..50~~ S' fl~1L'/
SAVILLA S. ARNETT
We, having been duly qualified according to law, depose and say that
we were present and saw SAVILLA S. ARNETT sign the foregoing instru-
ment as her will; that she signed it as her free and voluntary act
for the purposes therein expressed, that each of us in her sight and
hearing and at her request signed the will as witnesses; and that to
the best of our knowledge she was as that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Subscribed, sworn to or affirmed, .
and acknowledged before me by ~'1A'J~ ~ ~
the above-named testator and by Witness t1
the witnesses whose names appea~ ~
opposite, on r- K- ,1q8~ mtLdr-f/~j I A'J~
Witness
~JK~
Notary Public
./ DOLORES M. OYlER, NOTARY PUBliC
EAST PENNSl;OPC(Wf'" CUMBERLAND COUNTY
MY C()Mf,\;S.~i;j!, cP'I~f:S OCT. 12, 1~S5
Member. r':lm'wl':""a!1:f~ i\'i ,:n{'i;~ti c:r, ~f !\~'::~f.r>!t
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: S'Avlllo <:; . A ~ .u e... -rr--
Date of Death: r='f.L Iy 30 .:too:5
,
Will No. 1. (')0'1 - () 0 lo 3 3 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
Name Address
LJ~~1l-- d ~ ~., ~;l S- ~,." j, ..".:t ,t 1fI..-J ~b..-I_i f"9.
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Infb_7/ UJ.~;ff J ~/~ f/. ,~ ,v.e.7Y ~ C W~tV G clJ.,zlfJ~77'
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all #f ~/t( ~(/J S 7 tout' /YI./rVf~ fk /711:1 J-
,R:A)IVe.-~' ). /.).rzAJe"7"r ,,~(,o lAJ "... 7LtJl /1, {lJ ('~f ,~ pq IU;2.J,-
~ &Uf I~ 4 )./ a"~ '3 q.13 K,- "h'I.c.y '0,.. J.H3y p~ 17t1J()
Notice has now been given to all persons entitled thereto under Rule 5,6(a) except
Date: JI II ~ h3
/ /
Signature
Name Var<# ~~
Address ~ ,a S' 1.bn1.J~7: ,7
AJc..-J tI,~toL,..1 ~ J. p~ J"'lel :t.j
Telephone (,n) 77Y ~/r7
Capacity: -2LPersonal Representative
---
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_Counsel for personal representative
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: /)RIIJP7/ ) ~ (N II-:t q,
Date of Death: /- 30 - 200-3
R\~
Wi1tNo.: ? nO? (lO&,3S Aili.u..:...,. Nu..
,
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rilles, I report the
folloVlring with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes D No~
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: ~ fl) e S c) .J..OOS
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 - NoD
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 0 No D
c. Copies ofreceipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report. .
Date: (r:lo~ (fl)~ </ (T~<#
Signa e u/
Wat//Vz- r ~lUe~
,
...0 Name
("")
..
- ,;l;l51//??6.er~ S;r-
("'i Address /1/... w (!urr1 her I ".. .l f?<? 17cJ?()
c-,,,\
'::-) 7/7 77~ &> Y9'7
,~ ) Telephone No.
Capacity: !Xt Personal Representative
o Counsel for personal representative
V
REV.1500 EX + (S-OOl REV-1500 Of'f'ICIAL USE ONLY
COMMONWEALTH OF
PENNSYL VANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN u__.._....._....
, FILE NUMBER
DEPT. 280601
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT ~L---'22_0 1a..3.-3-
COUNT'\' CODE YEAA NUMl:ltR
- DECEDENT'S NAME (LAST, f'IRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I- SAVILLA 2 0 1 - 1 8 - 1 8 9
z ARNETT S. 4
W DATE OF DEATH (MM.DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W 07/30/2003 04/12/1923 REGISTER OF WILLS
U
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
- -
UJ !Xl 1. Original Return o 2. Supplemental Return o 3. Remainder Return (daleoldealh pnorto 12.'3-82)
I-
< [J 4a, Future Interest Compromise (date 01 death aller 12-12-82' o 5. Federal Estate Tax Return Required
x:-rn o 4. Limited Estate
U ~x:
uJ ~u
:t ~g [R] 6. Decedent Died T estate (Attach copy of Will) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) Q... 8. Total Number of Safe Deposit Boxes
uc..ro
c.. o 11. Eiection to tax under Sec. 9113(A){Attach Soh 01
< o 9 Litigation Proceeds Received o 10, Spousal Poverty Credit (~ate of dealh between 12-31-91 and 1 1-95)
I- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL. TAX INFORMATION SHOULD BE DIRECTED TO:
z NAME COMPLETE MAILING ADDRESS
uJ
c CHARLES E. PETRIE 3528 BRISBAN STREET
z
0 FIRM NAME (If Applicable)
c..
rn
w HARRISBURG, PA 17111
~
~ TELEPHONE NUMBER
0
u 717 561-1939
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--'> .. . ---:r:;
1. Real Estate (Schedule A) (1) 60,950.47. OFFICIAl:'IlISE ONl:Y (11
C,,,,, : '-10
.-, C'. ".,)C-:>
2. Stocks and Bonds (Schedule B) (2) - ;~ .:l ~ ~:fJ
.1'..:" I'-_~' i f.~::J
en In.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ---", j (~-::7
) ,,.--....
4. Mortgages & Notes Receivable (Schedule D) (4) ~~.'-'-') I -,,;,
_0", -- ,.,
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 14,842,57 C',; -~ c)
_ rn
(Schedule E) -, .') c-=:>
en
Z w --1-1
0 6. Jointly Owned Property (Schedule F) (6)
j:: o Separate Billing Requested
~
:::l 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) __d.____..
~ (Schedule G or L)
ii: 75,793.04
<C 8. Total Gross Assets (total Lines 1-7) (8)
0 9,088.29
w 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
~
10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 13,409.43
11. Total Deductions (total Lines 9 & 10) (11) 22,497.72
12, Net Value of Estate (Line 8 minus Line 11) (12) 53,295.32
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus Line 13) (14) 53,295.32
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0
j:: rate, or transfers under Sec. 9116 (a)(1.2) X _(15)
<C 16. Amount of Line 14 taxable at lineal rate 53,295.32 X .045 (16) 2,398.29
I-
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0.. 17. Amount of Line 14 taxable at sibling rate X .12 (17)
:E
0 18. Amount of Line 14 taxable at collateral rate X .15 (18)
U
>< 19. Tax Due (19) 2,398.29
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t- O
20. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
>> BE SURE TO ANSWERALt.. QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
Decedent's Complete Address:
, STREET ADDRESS 514 N. THIRD STREET
CITY I STATE I liP
. WEST FAIRVIEW PA 17025
Tax Payments and Credits: 2,398.29
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D, Interest
E, Penalty
TotallnterestlPenalty ( 0 + E) (3)
4, 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 (4)
5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5) 2,398.29
A. Enter the interest on the tax due. (5A)
S, Enter the total of line 5 + 5A, This is the BALANCE DUE. (58} 2,398,29
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; ............................,..,........................................... 0 00
b. retain the right to designate who shalf use the property transferred or its income; ...........,............. ...,...,...,... 0 !Xl
c, relain a reversionary interest; or ...............,.....,.......................................... ................ ...................,.. 0 00
d, receive the promise for life of either payments, benefits or care? .......................................................,..... 0 IKJ
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?,................."...,............"."..".........,......,.................,...,..,.."... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ...... .........u 0 [X]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .,. ..,.. ... ..... ........ .,.,... ..,. ..... ... ..,., ". ..,...,.... .... ............" ....... .... .... .,. ,.,.. 0 00
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 return, including accompanying schedules and statements, and to t~e best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personallepre~nlative is based on all information of w~ich preparer has any knowledge.
SIGNA.TURE OF PERSON RESPON LE FOR FILING RETUR DATE
7/12/2005
PA 17070
DATE
7/12/2005
ADDRESS
PA 17111
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P,S, 99116 (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 (~t:- ,^ c.G 0 ,') (a) (1,1) (ii)].
The statute does not exempl a transfer to a surviVing spouse from lax, and the statutory requirements for disclosur ~ Ilicable even if
the surviving spouse is the only beneficiary. c\ \ \ ~ . 0.....-'
For dates of death on or after July 1, 2000: . i3' s . CSl~
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at de R P D joptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(a)(1,2)].
The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, e~ ~ . 4-\ (A.S-T 99116(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. ~911E - __, _.._y' ~""V" 8102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
. SCHEDULE A
.
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
. FILE NUMBER
ESTATE OF
ARNETT SAVILLA S.
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real Drollertv which Is jointly-owned with riaht of survivorshic must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1- 514 THIRD STREET 60,950.47
WEST FAIRVIEW, PA
SEE ATTACHED SETTLEMENT SHEET
TOTAL (Also enter on line 1, Recapitulation) $ 60,950.47
(If more space is needed, insert additional sheets of the same size)
A. Settlement Statement u.s. Department of Housing and U,ban Development
R Tvnp nf I n~n OMR Nn 7502- HUD-1 (3186\
I. DFIi^ Z. DfmH^ 3 DConv Ullln' I 6 ':,Ie Numbe, I 7 Loon Numl>e, 8. Mortgnge Insur~U'\ce Ca~e Numher
4. nVA '. Dc,."v 1'1< 05-0180 108:n2.nlL~__. --
Thill form I'll furnl~hed 10 gll...e 'fO'lJ a ,lalemAn' of &CIu.a1 utllsmen1 calli Amoun'. paid 10 and by the H1Himenl agent.Ofe shOVt'rt I TilleExpress Semement System
C. Note: Ilems marked' (P 0 c)" were paid ouislde Ihe clOSing, they are shown hefe for informallOO purposes and are not ,ncluded 10 the lotals
~"::~~~G~~"I~I~oti~~ ~~~ig,y matoie felse statemeot$lo ~.~11:::';'1 Slet~1 on this or "ny othlJr $Imll~r r~r;l1~enilllle$ upon P'in'.... , ., 10." uAC'
D. NAME 01' BORROWER: Adam A. Gauvin and Jenifer Gauvin
. ., "''' .,,~ 380 I Rosemont A venue, Cam-pJiill, P A I]QJJ. _.~_____.__.. ._._______.__
E NAME OF SELLER Estate of Savilla Arnett
^DDUI'SS: 514 North Third Street West Fairview PA 17025
1'. NAME OF LENDfR: America's Wholesale Lender
^')n"E~~ 6430 Southnoint Parkwav. Suite 300 Jachonville FL 32216
G. PROPERTY ADDRESS: 514 North Third Streel, West Fairview, P A 17025
_ _~_ __ _ ___ __ ___________ ____ East Pennsboro Township _________ __ __.__ -
H. SETlUMENT AUl;NT: Supreme Settlement Services, LLC, Telephone: 717-737-83l5 Fax: 7l7-737-9361
PLArF OF SFlTl.FMFNT' 161 South 32nd Street Carnn Hill PA 17011
I STTrI ""',"'T "k'T. 06/3012005 ._--. ---.- .~-_. -, -. --' ~--_.------ "
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GRn!'.!'. AMOUNT DllF FROM RORROWFR 400. ..."""" '''''II'''T DUE TO !':I'I 11'<"
'0' , no,co 75 400,00 401 ,mice 75 400,00
102. P~r""ool Proo~r," 402. Personal Prooe,," I
'M 'rn.'lo ho"""",, lI'n. idOnl 5 720.43 .n,
'0' 'u'
,n, '0'
Adiustm"n" f~, ;,pm' noid nv ~"lIp, in AnVAn.." Adiu~tm/m" fo'll.l!mu~!d bv seller in advance
",. "'1yi.wwu.~_~_ .06
1 n1 {'n"n'" '..0. 06130/05'0 1.2/3D05 112.05 .n7 "^"O'O 'OY'" 06/30/05.~ 12131/05 112.05
H!6LSmogLtll\flL___Q.liflQLQ~l<l()_6nOl05 2_61 408. 06/30/05'00illO/05 2.61
,no 1.05 .no 1.05
>10 410
c-1.1L___ ."
----------
_j.1Z,.___._.,.____.__________._____ ._-_.~-,.~,-,._..,,- '1~
120. GROSS AMOUNT DUE FROM BORROWER 81 236.14 420. GROSS AMOUNT DUE TO .c;l'lI I'R' 75 515.71
~no. AMnl 'NTS PAin RY OR ON RFHAI F OF RORROWER 500. REDUCTION!'. tN AMOIINT mIl' TO SFII FR
2nl nn~.il m 750.00 501 Fx,,,,, n.nn.it ,.... In,"w.llnn"
'00 Prinrj""'1 <unnllnt nJ n.,w I""'''ne 75 400.00 S02 uesJo..seller /line 140m 10 065,24
,n, "vi.linn 503. EXiSlioo
2n. 5n. PO"'" n' "'''1 Mortoaoe Loan
,n5 5n5.
206. .- ~!lL-__._
,n7 507
?08 "0"0. poi" qn'inn. "0'" 4. 500.00 'OR "ollBr..P...a!.~&.J;QSllL_. _._ _n_~~~ 4 500.00
OM 509
An'''SI'''''ots fnr itpm. unno,d ho ""'I" Adjustments for items unoaid bv selle,
om {,i""'~n '0'.' 510,_GI"'"n~n 'oyo'
", 511 "nomlv'ox..
"0 ","nnltoYo. ,,? ","nn"..o.
711. 51'
.., 514
~_n _~__ .,.
?Ie "e ------
...2JL __ _ __ . _ _____ 517
". SIR
,," _.~- "9
'on TnT'" -_._~
BORROWFR 80 650,00 ~'n TOTAL REOJJilJQN AMOUNT DUE SELLER 14 565,24
'00 ~. -. , . ~ ---. EME"'T "",n"" OR TO BORROWER 600. CASt-L....~TTLEMENT TO OR "gnu "'" , "'R
'01 "m.. Ir r r "'00 120\ -- 81 236.14 AnI r.,n.. o~n"ol ""p 'n '.lIe, lItne 4201 75 515.71
302 Leo. iOmuunl!; paid_ bylluL "n,,=o, "ino ?2m 80 650,00 on? ' amoun' due ~elle' "lI!ll:~20\ 14 565.24
~O~. CA"H FROM BORROW1=R - 596.14 603. CASH TO SELLER 60 950. 47
SUBSTITUTE FORM 1099 SELLER STATEMENT: 1ha ioIol'malion contalnRd herof!llrl IS impol1anl t~Jt infol1TlaliQn IOlnd I,S beiog fO.JrnililtJvd Ig. thtllntarnej Re...el'\U8 Sflfvlce_ If you Me r&CIuir&d to me a fill'lurn
a neglIgence peru:1lly or onler sancllon will be Imposed on you If thiS Ilem IS reqUired 10 be f'ElPQr1I1!!d and the-IRS dele;rmlll9S lhal it has- no! been re~ol1ed, The Contract Salfl6 Price described on '
line 401 Above conslitutes fhe GrOS5 Proceeds or thiS transaction
Yoo are I"flQ,.rf!K1 byl-t'W to PfovJde lhe 'Settlement agent (Fed raJll ID No: ) wilh your correC:lla:llpayer iclen1lfic.alion number, Ir ynl.l no f10t prolllOe your CQrrect laxpayef ,denliflC8lion
nl.lmb6f< you may be subtecllo ciVl~ or criminal penalties Imposed by law. Under penalllM- 01 perjury, I certify Iha' the number !lhown on ttlis stalement is my correcllaJllpayar id9nti1'k:ahorl number
TIN -- I -- SELLER/51 SIGNATURE(S), -"----,- I
SHlfR(SJ NEW MAiliNG ADDRESS: ~-,.
SEllER(S) PHON'E ~UMBefl:S. --_.-. (H) IW)
u.s. DEPARTMENT OF HOUSING AND URBAN J)EVELOrMENT File Nu",ber: OS.0180 PAGE 2
~ .SETTLEMENT ST A TEME,NT RI'V III lD.l 1)/%6) Tj"~F, r"~' Selll, , ~. PriR'M 0613Q17nn5 "' lW4? .ur
L SETTLEMENT CHARGES _~ PAID FROM PAlO FROM
700. TOl!\L SALES/BROKER'S COMMISSION based on orice $75 , 4QO ,OO_~9 = 4 ,524.00 BORROWER'S SElLER'S
Oiv,,>on or commiSSion lime lam as follows: .~ FUNDS AT FUNDS AT
'"1. < 2 2117. 00 10, Cent.ury 21 Walak Associat.... SETTLEMENT SETTLEMENT
7no . 2 237.00 In Slor..."b .. A....o"i.at.. R...l E'!tate Grou'P. Inc.. ..
7n' "'~mmi"ion ^',".. ~~"'.m_RI 4 524.00
. 800. !HoMS PAYABLE IN CONNECTION WITH LOAN _..
An, ' OOI1.l'ee 1,000 %Alli.';!d Home Moo::tgaqe 754.00
R02 I n.n OlScoun' -----'lL
Rm An~ra,.al Fe. 10 S,ton..r Appraisals 300.00 ..
~'" f',.... ".~rt 10 Allied Home Mortqaqe _ .,. 60.92
An5 tFee to Lands,afa Flood LR 26.00
"0" T.. Service Fee 10 Countrywide Tax S..rvi.".. . LR 90.00
~_UnderwritinQFp.e to Amll!lrica's Wholesale Lender L~ 195.00 __
AnR Rrn'.r' non F.p .. tn All:i.ed Hom.. Mortgage 754.00
"na "'~'.' P'~.'.ina F.... 10 All:i.ed Ho..... Mort,qaae 295.00
RIO Rmk.r "nyner Fee 10 Alli..d Home Mol"taacr.. 50.00
R11 "(em Paid 10 Rml<", hy Lemier 10 Alli.o&d Home Mortgage $154.00 POC bv Lender
JQQ. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANC"
"^, '_'Mn.' ".~ 06/30/2005 '0 07/01./2005 <ij>S 16.2600 Ida~ 1 navs LR IlL 26
an? "'^"n.~" In~ "Onr~ P,.mi"m In, ... 10
~_.Hazard Insurance Premium for 10
00.
aM
10nn '''''S''!WES DEPOSITED WITH LENDER FOR __
WQQJ Hazard Insurance mo (Ci). $ Imo
, nn, "nrtMa" In."..nr. mo <lIl $ Imn ..
, nn. f';'" Prnn.rtu Tjlx mo @ 5 Imo .
1On4 "D>mtv. Property Ta. mn /Ill S Imo
,nn, ,"0 /Ill 5 Imo
,~. at 0..00 0.00
"00, TITL" r.HARGES
"n, Flectrollic Delive... Fee to Supreme Settlem..nt S..rvic.." 4~L 00
lID? IM.- Fpe.. 10 Supreme Settlement Servic"l!I 20,00
~3 Tale examinallon
11n4 Till_ jn'''ronr.J)inder
Lu.o.5-,___~ent Pren,aralion
11M "'n'.N roe. 10 Nan"" M. Fertenbauqh 20.00 10,00
1107 Allorney'sfees to Chill'le.. E. I?etrie, Attorney-At-Law 35C!~
h........l. ,........." above items No' )
I-UOB Tille+nslJrancp. to Supr$me S.ttl....8nt Ser1J'iC81!J 114.75
IInr',,"_. ."nva jlerns 1'/0' \
11no 'n.n pn"ov __ 75.400.00 -
\-J..wl.-Qwne,'s Poll!;)' 75 . 400 ..00 - 714, 75
.", c"" '00 Cn'''OQ.Eod 900 10 Supreme Settl_nt. ServiceB 150.00
~COunef Fees okO Ia Sur>roome Settlam..nt S",,";.o... 15.50
, 1113 Closi"lli3vcl1r 10 Supreme S..ttlement. Serv:i.ces 35,.00
1200 (';OVERNMENT RECOBDIN('; AND TRANSFER CHAflGES .
12:tH R~~Qrll.ina rll!I!il!S Deed.l._38. 50 MO. -"'" - '1~. 105.00 ,--
On? "'''"1 R stamos Deed1754. 00 'MOrloaa: S ._ 754.00.
on. ~"loT",,'slamp. ----D~4.00 'MortoaoeS 754.00
_1.20.4 ,
1205 .
1,no ADDITIONAL SETTlEME.NT CHARGES
....ll.QL..C<mlraClorAllowanc. ,. to Marl< Kennerly 2 975.00
_1.302 Pest \n'SneC'lion to Biechler , Tillerv ~ rnc. )J5. 00
1303 2005CounlvfTownstJioTaxBs 10 Alici~ D. StinEt, Treasurer 243.20
,,". """A "'.hnn.....'! Taxes '0 C1llllb..r1and County Tax Cla:i.m . 1 184.04
'3....1:. f h~ru SP.-pl to East penn..bo~o Township ~ 115.0'0
~fansaclionFp..e to StJ:'aub , Assooiat.. Real E.utat.e Group, Inc .~95.00
~1. Transadion Fee to Walak/Waltz 125.00
~Ho,""I".oecllOn to B:i.echler , Tillerv. Inc. 275.00
..
.J.41&.1.0TAL SETTLEMENT CH,I\RGES renter on Ii""s 103 Sectinn J and ~02 Section 1$1 5 720.43 10 065.24
HUO CERTifiCATION OF BUYER AND SELLER
I hill.vEI Qilflitlulty f6vle\fr1J'd Ihl!!" HUD.~ S@1I111m8l1l Slalemen1 ami to ttle res' or my knowledge And b@4ief. it is Et 'rue and 8C!':urAte statement of all receipt.!! and diSblJ('S8mElnts made-oOn my BCC~ Of
by me Ifllhis InmSBcbon' I furihl;Jr c~rllfY Ih.;!t I hav$ rece,vAd a COP\' of the HUD-1 Senw,m-ef'I\ S\8\ernem
... ,/-) I
/ //.( :7
. {/ ./- .
(~ ( ((<'>'" >""-?/ ..>J'~ ~ ['1;1 //
A~~~~ (r I~~
,,'
{ ('( '. ,( /"1 ~ vX 'I C..
WARNING. 11 IS It. CRIME TO t<NOWlNGL Y MAKE FALSE STATeMENTS 'IU THf
I'. UN. ITE"O STATES ON THIS OR ANY SIMILAR FORM. PENAL TIES UPON CO~VIGTlaN
. J CAN INCltJOE A FINE AND tMf'RlSONMENt, FOR OETAllS SEE T1TlE 11\
/.f }tJ f,~}.ecno'" 1001 AND ..CTlDN '0'0.
REV.150B EX + (6-98)
*' SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
, RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ARNETT SAVILLA S,
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointfy-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CONSECO ANNUITY 12,684.73
2. CONSECO ANNUITY 1,629.14
3. LIFE INSURANCE PREMIUM REFUND 28.31
4. PNC CHECKING ACCOUNT 500.39
I
TOTAL (Also enter on fine 5, Recapitula1ion) $ 14842,57
(If more space is needed, insert additional sheets of the same size)
REV.151 1 EX + '12.99)
. *' SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
.
ESTATE OF FILE NUMBER
ARNETT SAVILLA S.
Debts of decedent musl be reported on &hedule J.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. SULLIVAN FUNERAL HOME 3,980.50
2. CEMETERY FEES 560.00
B. ADMINISTAATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representative (s) WAYNE ARNETT 3,600.00
Social Security Numbe~s)/EIN Number of Personal Representative(s)
Street Address 225 UMBERTO STREET
City NEW CUMBERLAND State P A Zip 17070
Yea~s) Commission Paid:
2. Attorney Fees CHARLES E. PETRIE 750.00
3, Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Add ress
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 161.00
5. Accountants Fees
6. Tax Return Prepare(s Fees
7. POSTAGE 14.64
8. HOME DEPOT (CHANGE LOCKS) 22.15
TOTAL (Also enter on line 9, Recapitulation) I $ 9,088.29
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX... (6-98)
. . SCHEDULE'
DEBTS OF DECEDENT,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
. RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ARNETT SAVILLA S.
Include un reimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. WEST SHORE EMS 509.85
2. INTERNISTS OF CENTRAL PA 306,39
3, Mel 49.06
4. UGI 157.98
5, HOMEOWNERS INSURANCE 145.50
6. MBNA 6,073.60
7. CHASE MASTERCARD 2,250.00
8. INCOME TAX 1,780.00
9, PNC BANK LOAN 1,285,21
10. 2003 REAL ESTATE TAXES 749.37
11. HARRISBURG PHARMACY 12.00
12. PA POWER & LIGHT 90.47
TOTAL (Also enter on line 10, Recapitulation) $ 13.409.43
(If more space is needed, insert additional sheets of the same size)
. "'v.,"''''''W SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.
ESTATE OF FilE NUMBER
ARNFTT SAV\IIA S.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. WAYNE ARNETT SON 1/6 OF RESIDUE
225 UMBERTO STREET
NEW CUMBERLAND, PA 17070
2. KEN ARNETT SON 1/6 OF RESIDUE
5260 WERTZVILLE ROAD
ENOLA, PA 17025
3. GAYLE HART DAUGHTER 1/6 OF RESIDUE
3913 KINGSLEY DRIVE
HARRISBURG, PA 17110
4. WYATT ARNETT SON 1/6 OF RESIDUE
514 THIRD STREET
WEST FAIRVIEW, PA 17025
5. GWEN ARNETT DAUGHTER 1/6 OF RESIDUE
P.O. BOX 192
SUMMERDALE, PA 17093
6. KEITH ARNETT SON 1/6 OF RESIDUE
6118 GENEVA DRIVE, APT. 26
MECHANICSBURG, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
. o. . ~~
, .-- I
lllnsi ~ill nun tITeshunetti
of
.,
,
SAVILLA s. ARNETT .;:
I, SAVILLA S. ARNETT of West Fairview, Pennsylvania, revoke my
prior wills and declare this to be my will:
GIFTS
I. Real Estate: Upon my death, premises 514 Third Street, West
Fairview, Pennsylvania, shall be sold and the net proceeds of such
sale added to my residuary estate.
II. Residuary Estate: I give the residue of my estate, real and
personal, as follows: In equal shares to my children who shall
survive me, and to the issue, per stirpes, of such child or child-
ren who shall have predeceased me, leaving issue surviving.
i
ADMINISTRATIVE PROVISIONS
III. Protective Provision: No interest in income or principal
shall be assignable by, or available to anyone having a claim
a beneficiary before actual payment to the beneficiary. !
against,
IV. Death Taxes: All federal, state and other death taxes--except
generation-skipping transfer taxes--payable because of my death on
the property forming my gross estate for tax purposes, whether or
not it passes under this will, shall be paid Jut of the principal
of my residuary estate just as if they were my debts, and none of
those taxes shall be charged against any beneficiary. Any death
taxes on future interests may be paid whenever my executors, in
their sole discretion, think best.
V. Management Provisions: I authorize my executor:
A. To retain and to invest in all forms of real and personal
property, regardless of (i) any limitations imposed by law on
-1-
.
. .-
investments by executors, ( i i) any principle of law concerning
delegation of investment responsibility by executors or (iii) any
.~
principle of law concerning investment diver~ification;
B. To compromise claims and to abandon any property which, in
my executrices' opinions, is of little or no value;
c. To sell at public or private sale, to exchange or to lease
for any period of time, any real or personal property, and to give
options for sales or leases;
D. To join in any merger, reorganization, voting-trust plan
or other concerted action of security holders, and to delegate
discretionary duties with respect thereto;
E. To distribute in cash or in kind.
F. To use administrative or other expenses of my Estate as
income tax or estate tax deductions and to value my Estate for tax
purposes by any optional method permitted by the law in force when
I die, without reQuiring adjustments between income and principal
for any resulting effect on income or estate taxes; and
G. To employ such agents, accountants, attorneys' assistants,
advisors, brokers, banks, investment counsel, tax advisors, and
attorneys, and such other agents or assistants as they shall deem
necessary to the administration of my Estate of any trust created
hereunder without liability for the negligence, mistake, miscon-
duct, or default of such person, provided reasonable care and
prudence was exercised in his selection.
These authorities shall be in addition to those granted by law
and shall be exercisable without court authorization.
-2-
.
.
VI. Beneficiaries under Twenty-One or Disabled: If any benefici-
I ary under twenty-one becomes entitled to any' income or principal
hereunder, or if any beneficiary who is, in my Executors' opinions,
disabled by advanced age, illness or other cause, become entitled
to any income or principal of my residuary estate:
A. As much of such income and principal as my trustees may
from time to time think d.esirable for that beneficiary either shall
be paid to him or her or shall be applied for his or her benefit;
and
B. The balance of such income and principal shall be held as
a separate trust for the beneficiary, and subject to my trustees'
power to pay to, or apply for the benefit of, the beneficiary, both
income and principal of such trust shall--together with any net
income therefrom--be kept invested and paid as the case may be, to
the beneficiary when he or she reaches twenty-one years of age or
becomes, in my trustees' opinions, free of disability.
Any funds to be applied under this article shall be appliea
directly by my trustees or shall be paid to the parent or guardian
of the beneficiary or any person or organization taking care of the
beneficiary~ and my trustees shall have no further responsibility
for any funds so applied or paid.
I
.
FIDUCIARIES
VII. and Trustees: I appoint .. WAYNE J. ARNETT,
Executors my son,
-
-c.
Executor and Trustee under this will.
ExecutedJ'" ~ --
, 1 9 ~.s
~A~f't / 5: a4A;(~L)
In our presence the above-named testatrix signed this and declared it
to be her will, and now at her request, in her presence, and in the
presence OI each other, we sign as witnesses.
/}? ~ '1-"'_ w! ..~~~
/
~-- - d' Jkk
-4-
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of ARNETT SAVILLA S. No. 2003 00633
also known as Date of Death 7/30/2003
I Deceased Social Security No, 201181489
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent. that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities,
Name of
Attorney: CHARLES E. PETRIE
1.0. No.: 29029
Address: 3528 BRISBAN STREET
Telephone: (717) 561-1939
Description Value
CONSECO ANNUITY 12,684.73
~:':2 h,,)
C":~
';.Cl c:.;} ~7,J
'-rl
CONSECO ANNUITY =- ,j ] rT'j
--;-:.., Sb.629.14; c)
:-,.o.c_) :.::~ '~; _.:,t ~..~)
._--Cl
1-'.) ., ,j
.--.... Cl~) . i..: ~:lj
LIFE INSURANCE PREMIUM REFUND ., ~--J
28.31 ,.--)
"'.'-, ;-",. . '..~
. . -~-.-.. ' "'r")
.~~ .-- n
CO ~~,,-~ (~~S
_..,n-J
PNC CHECKING ACCOUNT U1 500:~)
W '""j"l
514 THIRD STREET 60,950.47
WEST FAIRVIEW, PA
Total
75,793.04
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11.96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17 1 2B.060 1
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND EST A TE TAX
OFFICIAL RECEIPT
NO. CD 005611
PETRIE CHARLES E
3528 BRISBAN STREET
HARRISBURG, PA 17111
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
_____n_ fold ---------. --------
101 I $2,398.29
ESTATE INFORMATION: SSN: 201.18-1489 I
FILE NUMBER: 2103-0633 I
DECEDENT NAME: ARNETT SA VILLA S I
DATE OF PAYMENT: 07/26/2005 I
POSTMARK DATE: 07/26/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 07/30/2003 I
I
TOTAL AMOUNT PAID: $2,398.29
REMARKS:
CHECK# 832
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
:-"r- '..-..,..:-1 ,....,~~,rr':
BUREAU OF INDIVIDUAt-tAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-18-2005
ARNETT
07-30-2003
21 03-0633
CUMBERLAND
101
APPEAL DATE: 12-17-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9Y!_~~9~9_!~~~_~~~~------~___~~!~!~_~9~~~_~9~!!9~_~9~_Y9Y~_~~99~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SAVILLA S FILE NO. 21 03-0633 ACN 101
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
1) !"" ,-, .~
.4"1 t
CHARLES t PETRIE
3528 BRISBAN ST
HBG
PA 17111
ESTATE OF ARNETT
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(9)
UO)
) CHANGED
U)
(2)
(3)
(4)
(5)
(6)
(7)
60,950.47
.00
.00
.00
14,842.57
.00
.00
(8)
REV-1547 EX AFP (06-05)
SAVILLA
S
9,088.29
13.409.43
Ul)
(2)
(3)
(4)
DATE 10-18-2005
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
75,793.04
22.497 72
53,295.32
.00
53,295.32
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS.
.00 X 00 = .00
53,295.32 X 045 = 2,398.29
.00 X 12 = .00
.00 X 15 = .00
(9)= 2,398.29
.
""''''''.Lr. l+J AHOUNT PAID
DATE - NUHBER INTEREST/PEN PAID (-)
07-26-2005 ~ CD005611 .00 2,398.29
BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-27-2005 TOTAL TAX CREDIT 2,398.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. 132.65
TOTAL DUE 132.65
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. nJl
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE/<.I'
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
BUREAU OF INDIVIDUAL-TAXES.
INHERITANCE TAX DIVISION -
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
r',
U
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-27-2005
ARNETT
07-30-2003
21 03-0633
CUMBERLAND
101
SAVILLA
S
CHARLES EPETRIE
3528 BRISBAN ST
HBG
Allount Rellitted
PA 17111
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF ARNETT SAVILLA S FILE NO.21 03-0633 ACN 101 DATE 12-27-2005
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: 10-18-2005
PRINCIPAL TAX DUE: 2,398.29
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-26-2005 CD005611 .00 2,398.29
11-28-2005 CD006030 132.65- 132.65
TOTAL TAX CREDIT 2,398.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
r<K.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTI~~ OF INHERITANCE TAX
'''~=:rMPRAis~tfENt~. ALLOWANCE OR DISALLOWANCE
/, ':--:bF' D~D("CTrIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP (06-05)
10-18-2005
ARNETT
07-30-2003
21 03-0633
CUMBERLAND
101
APPEAL DATE: 12-17-2005
( See reverse side under Objections)
---
Amount Remitted I /3.1..6 <j I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9~r_~~9~~_r~!~_~!~~______~___~~!~!~_~Q~~~_~Q~!!Q~_EQ~_YQ~~_~~~Q~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SAVILLA S FILE NO. 21 03-0633 ACN 101
r
!
;.~~: \:' ;~:,]
I',. [ I
.,,, II
.I' "t
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
SAVILLA
S
CHARLES E PETRIE
3528 BRISBAN ST
HBG
PA 17111
ESTATE OF
ARNETT
DATE 10-18-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
60,950.47
.00
.00
.00
14.842.57
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
75,793.04
(9)
(10)
9,088.29
13.409.43
(11)
(12)
(13)
(14)
22.497 72
53,295.32
.00
53,295.32
NOTE: I~ an assessment was issued previously, lines 14, 15 8nd/nr 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
53,295.32 X 045 = 2,398.29
.00 X 12 = .00
.00 X 15 = .00
(19)= 2,398.29
. ... ..-. 'U::'-II:.LI" I l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-]
07-26-2005 CD005611 .00 2,398.29
BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-27-2005 TOTAL TAX CREDIT 2,398.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. 132.65
TOTAL DUE 132.65
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
-
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 006030
PETRIE CHARLES E
3528 BRISBAN ST
HARRISBURG, PA 17111
hh____ fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
ESTATE INFORMATION: SSN: 201-18-1489
FILE NUMBER: 2103-0633
DECEDENT NAME: ARNETT SA VILLA S
DATE OF PAYMENT: 11/28/2005
POSTMARK DATE: 11/28/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/30/2003
101 I $132.65
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$132.65
REMARKS:
CHECK# 933
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS