HomeMy WebLinkAbout04-0875 PETITION FOR PROBATE and GR~NT OF LETTERS
Estate of Pettevs Elms R No. ~, I-
also known as Elms Ruth Pettevs
To:
, Deceased
Social Security No. 295-03-1080
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/am 18 years of age or older and the execut ors
in the last will of the above decedent, dated March 08, 1991
and codicil(s) dated
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
in the
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Carlisle Borouah. Cumberland County, Pennsylvania, with
h er last family or principal residence at 213 Todd Circle. Carlisle Pennsvlvania
(list street, number and municipality)
Decedent, then 88 years of age, died 9/21/2004
at Sarah A Todd Memorial Home. Carlisle PA
Except as follows, decedent did not marry, was not divorced and did not have a child ~rn or ado~ed
after execution of the will offered for probate; was not the victim of a killing and was never adjudic~d
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of Ietters testamentary
thereon. .'~ / (testamentary; administration c.t.a.; administration d.b.n.c.t,a.)
/// //~z, ,~Z~,..,.~,/~ /, / 9270 Kent Ave NE
~ "J(/f"'(-"~/~-~-/~/~ North Canton OH 4472%1007
~ Lloyd V~ Pettey~, Jr. _ ,)'~' --' 13 Trine Ave
:~ ~s"'~'~uA-r-'C~' f"~'m~c'z4"n~ ~elux-~lt~!~' PA !T'--'i3
~ ~ Marcia R Humer
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CumberlandJ~ ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal repJ~sen-
tative(s) of the above decedent petitioner(s)will well and tru~fl~jlhlini~cor_di~o law.
Sworn to or affirmed and subscribed
before me this 24th day of
Seotember~ 2004 , a,
~& ~.O. Jx~ Register O L
Estate of Pettevs EIma R , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW Seotember~l'~. 2004 , 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 3l~Jl1991
described therein be admitted to probate and filed of record as the last will of Elma R Petters
and Letters Testamqmt~rV
are hereby granted to
Lloyd W Petteys, Jr., and Marcia R Humer
FEES
Probate, Letters, Etc ......... $ I[~ .OO
Short Certificates (--~) ...... $ ~ 5. o o
$10.or>
TOTP~L $ ~
Filed..q .-. ~1..~..-.O .~. ...........
Register of Wills ~ ~
ATTORNEY (Sup. Ct. I.D. No~.
137 Park PI W
Shiooensburo PA 17257
ADDRESS
717.532.9046
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 10503014
No.
Local Registrar
Date
o 1- 0'4
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL,RECORDS
CERTIFICATE OF DEATH
Elma Ruth
Cumberland
213 Todd Circle
Carlisle PA 17013
8.06/26/1916
5/2004 ~.Sprtn~ Hill Cemetery ~l~.Ship~ensbur~, PA 17257
LAST WILL AND TESTAMENT
OF
ELMA R. PETTEYS
I, ELMA R. PETTEYS, of the Borough of Shippensburg Township,
Franklin County, Pennsylvania, revoke my prior wills and declare
this to be my last will:
FIRST: PAYMENT OF EXPENSES - I direct that the expenses of my last
illness and funeral be paid from my estate as soon as may
conveniently be done.
SECOND: BEQUEST - I give, devise and bequeath all my property,
whether real or personal, tangible or intangible, together with all
insurance policies thereon, unto my four children, namely, Lloyd W.
Petteys, Jr., Dennis L. Petteys, Marcia R. Humer and Kathleen M.
Miller, provided they shall survive me by thirty (30) days, in as
nearly equal shares as possible, per stirpes.
THIRD: MINOR'S PROVISION - I direct that any portion of my estate
which passes unto a minor shall be deposited in an interest bearing
account said minor reaches the age of eighteen (18) years.
FOURTH:. PROTECTIVE PROVISION - To the greatest extent permitted by
law, before actual payment to a beneficiary, no interest in income
or principal shall be (i) assignable to a beneficiary or (ii)
available to anyone having a claim against a beneficiary.
FIFTH: DEATH TAXES - Ail federal, estate and other death taxes
payable on the property forming my gross estate, whether or not it
passes under this will, shall be paid out of the principal of my
probate estate just as if they were my debts, and none of those
taxes shall be charged against any beneficiary. This provision
shall not apply to any property over which I have a general power
of appointment for federal estate tax purposes.
SIXTH: MANAGEMENT PROVISIONS I authorize my Executors, as
follows:
A. Retain/Invest: To retain and to invest in:ail f6~ms
of real estate and personal property, including common-.
trust funds, mutual funds and money market deposit ~
accounts and certificates of deposit, regardless of~ny i
limitations imposed by law on investments by executors or
any principle of law concerning investment"
dlversl flcatlon; .~ .
PAGE 1
B. Compromise:
property which,
no value;
To compromise claims and to abandon any
in my Executors opinion, is of little or
C: Borrow: To borrow from and to sell property to my
husband or others, and to pledge property as security for
repayment of any funds borrowed;
D. Sell/Lease: 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;
E. Capital Changes: To join in any merger, reorganiza-
tion, voting-trust plan or other concerted action of
security holders, and to delegate discretionary duties
with respect thereto;
F. Distribute: To distribute in kind and to allocate
specific assets among the beneficiaries (including any
custodian hereunder) in such proportions as my trustee
may think best, so long as the total market value of any
beneficiary's share is not affected by such allocation.
These authorities shall extend to all property at any
time held by my Executors or my trustee and shall
continue in full force until the actual distribution of
all such property. All powers, authorities and
discretion granted by this will shall be in addition to
those granted by law and shall be exercisable without
court authorization.
B~VE~"~H: ~XECUTOR - I appoint my son, Lloyd W. Petteys, Jr. and my
daughter, Marcia R. Humer, or the survivor thereof, Executors of my
Will. Neither my Executors, nor any successor shall be required to
give bond.
IN W!?N~S W~ER~OF, I have hereunto set my hand and seal this ~
day of March, 1991
ELMA R. PETTEYS, Testatrix
PAGE 2
In our presence, the above-named Testatrix signed this and declared
it to be her will, and now, at her request and in her presence and
in the presence of each other, we sign as witnesses:
STATE OF PENNSYLVANIA :
: SS
COUNTY OF FI~NKLIN
I, ELMA R. PETTEYS, 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
therein expressed.
ELMA R. PETTEYS, T~statrix
We, having been duly qualified according to law, depose and
say that we were present and saw ELMA R. PETTEYS, sign the
foregoing instrument 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 at the
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 the
above-named Testatrix and by the
witnesses whose names.appear
oppoSite on this ~¢& day of
March, k991
Notary Public
Notada]
Carol G Rebuck, Notary Pul3ic
Southampton Towl~ship, Frank!in County
My Commissbn Expires May 25, 1993
M~'qber, Pennsylvania Association ol Notaries
PAGE 3
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
EIma R Petteys
Date of Death:
September 21, 2004
Estate No.: 21-04-0875
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
October 01, 2004.
Name Address
Lloyd Petteys
Marcia Humer
Dennis Petteys
Kathleen Miller
9270 Kent Ave NE North Canton OH 44721
13 Trine Ave Mount Holly Springs PA 1 7065
213 Poplar St North Baltimore OH 45872
148 McAllister Church Rd Carlisle PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Forest N Myers, Esquire
Attorney I.D. #18064
137 Park Place West
Shippensburg PA 17257
Phone 717.532.9046
Fax 717.532.8879
e-mail fnmvers@earthlink.net
Capacity:
_X Counsel for Personal Representative
REV-1500 EX + (6-00)
Z
Z
O
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL
Petteys, Elma R a/kJa Petteys, Elma Ruth
DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year)
09/21/2004 I 06/16/1916
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 4 0 0 8 7 5
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
2 9 5- 0 3- 1 0 8 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 1. Odginal Return
El4. Limited Estate
r~-'] 6. Decedent Died Testate (Attach copyofWill)
El9. Litigation Proceeds Received
~---J 2. Supplemental Return
[~4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of Trust)
] 10. Spousal Povert7 Credit (date of death between 12.31.91 and 1_1_95)
] 3. Remainder Return (dateofdeath priorto 12-13-82)
1~15. Federal Estate Tax Return Required
1__ 8, Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TOi
NAME
Forest N Myers, Esquire
FIRM NAME (IfAp¢icable)
Law Office Forest N Myers
TELEPHONE NUMBER
717 532-9046
COMPLETE MAILING ADDRESS
137 Park Place West
Shippensburg PA 17257-9212
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation,. Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11)
9.
10.
11.
12.
13.
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
2~756.84
79,804.71
OFFICIAL USE ONLY
(8)
82,561.55
14,311.51
4~800.00
(11)
19~111.51
63~450.04
(12)
(13)
(14)
63~450.04
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15, Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
0.00 X __ (15)
63,450.04 X .045 (16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
0.00
2,855.25
0.00
0.00
2,855.25
> > BE SURE TO ANSWERALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
Decedent's Complete Address:
STREET ADDRESS
213 Todd Circle
CITY Carlisle ISTATE PA IZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
2,712.49
142.76
Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
(3)
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)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SD)
Make Check Payable to: REGISTER OF WILLS, AGENT
2,855.25
2,855.25
0.00
0.00
0.00
0.00
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; ........................................................................... [] []
b. retain the right 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 payments, benefits or care? ............................................................. [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OFV~F_.,RSON,,RE~P~S~kE FO~FtLING RETURN DATE
ADDRESS 92'70 Kent Aven6e'NE
No~h Canton OH 44721-1002
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS 137 Park Place West
Shippensbur,q PA 17257-9212
13 Trine Avenue
Mt Holly Springs PA 17065
DATE
For dates of death on or after July 1, 1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a)(1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal 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 decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
COPY
LAST WILL AND TESTAMENT
OF
ELMA R. PETTEYS
I, ELMA R. PETTEYS, of the Borough of Shippensburg Township,
Franklin County, Pennsylvania, revoke my prior wills and declare
this to be my last will:
FIRST: PAYMENT OF EXPENSES - I direct that the expenses of my last
illness and funeral be paid from my estate as soon as may
conveniently be done.
SECOND: BEQUEST - I give, devise and bequeath all my property,
whether real or personal, tangible or intangible, together with all
insurance policies thereon, unto my four children, namely, Lloyd W.
Petteys, Jr., Dennis L. Petteys, Marcia R. Humer and Kathleen M.
Miller, provided they shall survive me by thirty (30) days, in as
nearly equal shares as possible, per stirpes.
THIRD: MINOR'S PROVISION - I direct that any portion of my estate
which passes unto a minor shall be deposited in an interest bearing
account said minor reaches the age of eighteen (18) years.
FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by
law, before actual payment to a beneficiary, no interest in income
or principal shall be (i) assignable to a beneficiary or (ii)
available to anyone having a claim against a beneficiary.
FIFTH: DEATH TAXES - Ail federal, estate and other death taxes
payable on the property forming my gross estate, whether or not it
passes under this will, shall be paid out of the principal of my
probate estate just as if they were my debts, and none of those
taxes shall be charged against any beneficiary. This provision
shall not apply to any property over which I have a general power
of appointment for federal estate tax purposes.
~IXTH: MANAGEMENT PROVISIONS
follows:
- I authorize my Executors, as
A. Retain/Invest: To retain and to invest in all forms
of real estate and personal property, including common
trust funds, mutual funds and money market deposit
accounts and certificates of deposit, regardless of any
limitations imposed by law on investments by executors or
any principle of law concerning investment
diversification;
PAGE 1
B. Compromise: To compromise claims and to abandon any
property which, in my Executors opinion, is of little or
no value;
C: Borrow: To borrow from and to sell property to my
husband or others, and to pledge property as security for
repayment of any funds borrowed;
D. Sell/Lease: 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;
E. Capital Changes: To join in any merger, reorganiza-
tion, voting-trust plan or other concerted action of
security holders, and to delegate discretionary duties
with respect thereto;
F. Distribute: To distribute in kind and to allocate
specific assets among the beneficiaries (including any
custodian hereunder) in such proportions as my trustee
may think best, so long as the total market value of any
beneficiary,s share is not affected by such allocation.
These authorities shall extend to all property at any
time held by my Executors or my trustee and shall
continue in full force until the actual distribution of
all such property. All powers, authorities and
discretion granted by this will shall be in addition to
those granted by law and shall be exercisable without
court authorization.
SEVENT~: EXECUTOR - I appoint my son, Lloyd W. Petteys, Jr. and my
daughter, Marcia R. Humer, or the survivor thereof, Executors of my
Will. Neither my Executors, nor any successor shall be required to
give bond.
IN ~I?NESS W~EREOF, I have hereunto set my hand and seal this
day of March, 1991
ELMA R. PETTEYS'~, Testatrix
PAGE 2
In our presence, the above-named Testatrix signed this and declared
it to be her will, and now, at her request and in her presence and
in the presence of each other, we sign as witnesses:
STATE OF PENNSYLVANIA :
: SS
COUNTY OF FRANKLIN :
I, ELMA R. PETTEYS, 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
therein expressed.
ELMA R. TTEYS, T6statrix
We, having been duly qualified according to law, depose and
say that we were present and saw ELMA R. PETTEYS, sign the
foregoing instrument 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 at the
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 the
above-named Testatrix and by the
witnesses whose names ~appear
°ppcsite on this ~¢& day of
March, 1991
Notary Public
No~a~ia! 2, eai
Carol G. Rebuck, No!ary Pu~ic
Sou!harnpton l-c, wnship, Frank!in CoL.,r~ty
My Commission Expires May 25, 1993
Pennsylvania Assocation c,t i%taries
PAGE 3
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Pettevs. Elma R a/k/a Pettevs. Elma Ruth 21 04
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
00875
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Prudential comon stock, 34 shares 1,582.76
United States Treasury, Series E savings bonds
1,174.08
TOTAL (Also enter on line 2, Recapitulation) $ 2~756.84
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Pettevs. Elma R a/k/a Petteys. Elma Ruth 21 04
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
00875
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Cornerstone Federal Credit Union, share account 33,903.78
Cornerstone Federal Credit Union, share draft account
Cornerstone Federal Credit Union, certificate of deposit
Orrstown Bank, savings account #737917
household goods and personal effects
Refund, Todd Home
Nationwide Insurance, refund
Carlisle Sentinel, refund
Prudential Insurance, proceeds of life insurance policy
1,926.28
30,814.90
137.46
2,500.00
1,096.36
129.00
10.50
9,286.43
TOTAL (Also enter on line 5, Recapitulation) $ 79,804.71
(If more space is needed, insert additional sheets of the same size)
12/06/04 MON 14:44 FAX 2495208 Cornerstone FC ~002
CORNERSTONE
F e d e r a I C r e d i I LJ n i o n
COPY
PO. Box 1181.5 East Gate Drive, Carlisle, PA 17013
Telephone (717) 249-1661 FAX (717) 2~19-8208
Member.founded Service based
www. corn erstonefcu.org
Forest N. Myers
1'37 park Place West
Shippensburg, PA 17257
December 6, 2004
RE: Elma R. Petteys
8ir:
The enclosed information is regarding.the account, number 8559, OfElma R. Petteys,
deceaseffas of september 2I, 21X~; Tlie ac, count was opened on, August 30, 2001 in the
names 0f'EtmaRi Petteys aXid'K~ Miller. A checking account and certificate of
deposit, (CD), were opened under this account on July 137 2003 also jointly.
Accmmt Number Type DOD Balance Cerrent Balance
8559-01 Savings $33,903.78 V' $103.89
8559-07 Checking $1,926.28v/ $2,992.00
8559-10 CD $30,814.90x~ $30,999.66
Rft~r her death, an E~tate account was opcnexi by the Executone, Lloyd Petteys Jr. and
Marcia Humer. If you require and' information rcgard/ng this account, please let me
know and' I will get Rio yon as soon as I can. Also, if you need any other information
regarding the above account, please let me how.
Sincerely,
Admin
M~:~n=. ¢~AU~Nir':.C Ar-~nlll~x~ II;;ttttltRAI IY IN~:IIRFI3 To $100.000 J~y THE NATIONAL CREDIT UNION ADI"IINISTRATION
OCT 04 2004 3:24PM CALL CEMTER ?17 S30 2624 p.1
ORRSTO BANK C/corn,
TO:
Law Office
Forest N. Myers
137 Park Place West
Shippensburg, PA 17257
FROM: ORRSTOWN BANK
P.O i BOX 250
SHIPPENSBURG PA 1~257-0250
RE:
ESTATE OF Elma Pelteys DECEASED
DATE OF DEATH: September 21,2004
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
(1]
CHECKING ACCO.U. NTS
ACCOUNT NO. TITLEO~ A~(~0UNT
-DATE OF DEATH
DATE OPENED . PRINCIPLE & ACCRUED INTEREST
ACCOUNT NO.
737917
SAVINGS ACCOUNT
TITLE OFACCOU _NT
Elma R Petteys 11/20/89
DATE OF DEATH
PRINCIPLE & ACCRUED INTEREST
t 37.46 .16
(3) CERTIFICATES OF DEPOSIT
ACCOUNT NO. TITLE. OFACCOUNT
DATE OPENED
DATEOF DEATH
PRINCIPLE & ACCRUED INTEREST
10104104 By Timothea Customer Service Operator
P.O. BOX 250 * SHIPPENSBI~RG, PA 17257 · TEL (717) 53:3-6114
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Pettevs. Elma R a/k/a Pettevs. Elma Ruth
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 04 00875
ITEM
NUMBER DESCRIPTION AMOUNT
1.
2.
3.
4.
5.
8.
9.
10.
11.
12.
13.
14
15
FUNERAL EXPENSES:
Fogelsanger-Bricker Funeral Home
Spring Hill Cemetery
Robert Wyrick, grave opening
Kathies Deli, catering meal after funeral
Ray's Laminating, laminating obituaries
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees Law Office Forest N Myers
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
zip
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills Cumberland County, probate fees and filing fee inheritance
Accountant's Fees
Tax Return Preparer's Fees
Carlisle Regional Medical Center, medicare deductible
Kathy Miller, reimbursement for advances
Lloyd Petteys, reimbursement for advances, organist, pastor & soloist
Todd Home, October billing
Todd Home, final bill
Sprint Telephone
Lloyd Petteys, reimbursement for postage
Cumberland Law Journal, advertisement of estate
Carlisle Sentinel, advertisement of estate
8,595.00
5OO.0O
100.00
297.00
80.00
1,750.00
161.00
876.00
85.00
250.00
1,296.50
64.79
41.44
17.25
75.00
122.53
TOTAL (Also enter on line 9, Recapitulation) $ 14~311.51
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Pettevs. Elma R a/k/a Petteys, Elma Ruth
FILE NUMBER
21 04
00875
Include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Lloyd Petteys, personal loan to Elma Petteys 4,800.00
TOTAL (Also enter on line 10, Recapitulation) $ 4,800.00
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-nm
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Pette_vs. Elma R a/k/a Petteys. Elma Ruth
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
00875
TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers under
Sec. 9116 (a)(1.2)]
Lloyd Petteys
9270 N Kent Avenue
North Canton OH
Kathleen Miller
148 McAIlister Church Road
Carlisle PA 17013
Marcia R Humer
13 Trine Avenue
Mt Holly Springs PA 17065
Dennis Petteys
213 Poplar Street
North Baltimore OH 45782
FILE NUMBER
21 04
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
Lineal
Lineal
Lineal
AMOUNT OR SHARE
OF ESTATE
one fourth estate
one fourth estate
one fourth estate
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)
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
one fourth estate
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 28O601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11 96)
CD 004730
PETTEYS LLOYD W JR
9270 KENT AVE NE
NORTH CANTON, OH 44721-1002
ESTATE INFORMATION: SSN: 295-03-1080
FILE NUMBER: 2104-0875
DECEDENT NAME: PETTEYS ELMA R
DATE OF PAYMENT: 12/1 3/2004
POSTMARK DATE: 1 2/13/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 09/21/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,712.49
TOTAL AMOUNT PAID:
$2,712.49
REMARKS:
SEAL
CHECK# 1008
INITIALS: MW
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INDIVJ;lIOAf,;tAxes
INHERITANCE TAX DIVIStOtfj' .. .- .
PO BOX 280601 .- .-
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REY-1547 EX AFP 02-041
n^
.vL
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-21-2005
PETTEYS
09-21-2004
21 04-0875
CUMBERLAND
101
ElMA
R
rIHD1:~/-
FOREST ~ ':t.tVERS
137 PARlfPL W
SHIPPENSBURG
Allount Rellitted
PA 17257
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Ii:V :r!w.Ex..AF'Fr.r~1.:cJJ'..N5T.icE.oF.iNHErii'flNC'E.TAx.APpIAIsEME'N'~..ALloQ1NCE.("R......_.........-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PETTEYS ElMA R FILE NO. 21 04-0875 ACN 101 DATE 02-21-2005
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)
.00
2.756.84
.00
.00
79.804.71
.00
.00
(8)
NOTE: To insure proper
credit to your account.
submit the upper portion
of this forll with your
tax paYllent.
82.561.55
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/AdII. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts
14. Net Value of Estate Subject to Tax
(9)
(10)
14.311.51
4.800.00
(11)
(12)
(13)
(14)
19.111 51
63.450.04
.00
63.450.04
(Schedule J)
If an assessment was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
NOTE:
.00
63.450.04
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
(19)=
.00
2.855.25
.00
.00
2.855.25
~
TAX CRI!DITS:
~...~. ,........., . t+J AMOUNT PAID
DATE NUI1BER INTEREST/PEN PAID (-)
12-13-2004 CDo0473o 142.76 2.712.49
TOTAL TAX CREDIT 2.855.25
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. 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.)
BUREAU OF INlIIVIDUA"_T~~E,~ "_,
IHHERITAHCE TAX DIVISIDN-,--j ,. - _, ,.-
PO BOX 28Q601
HARRISBURG PA 17128-0601
COMHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
~ _APPRAISEMENT, ALLDllANCE OR DISALLDlIANCE
- OF DEDUCTIONS ANlI ASSESSMENT DF TAX
zaU5frUY 20 PIi/Z: 42
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-16-2005
BUSH
09-15-2004
21 04-0865
CUMBERLAND
101
AlOOunt R..itted
CLERK OF
J DAVID Y~!JRSBSQUFiT
YOUNG & 6.!OItiiG"ATTYSt/',
PO BOX 126
MANHEIM PA 17545
'*
REV-15~7 E~ AFP (03-05)
JAMES
C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
1t!V-"MC,."ft.m.m~m'.'lMn'l!t.!R!'.!WI!It'rflM.Y.m.aWJtaTftJlWf~.'XCr.!l\l'lM.Y.Il?r.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BUSH JAMES C FILE NO. 21 04-0865 ACN 101 DATE 05-16-2005
TAX RETURN liAS: (X I ACCEPTED AS FILED
( I CHANGED
If an asses5Bent was issued previOUSlY, lines 14, 15 and'or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of Line 14 at Spousal rat. (15J
16. ~ount of Line 14 taxable at Lineal/Class A rat. (16)
11. Aorount of Line 1'1 .t S1bUng rat. 1111
18. Amount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax au.
C DI
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Est.t. (Schedule A)
2. Stocks and Bonds (Schedule 8)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule El
6. Jointly Owned Property (Schedule fl
7. Transfers (Schedule Gl
8. Total Assets
(11
(21
(31
('II
(51
(61
(11
125,000.00
109.522.99
.00
.00
127.303.78
.00
105,587.06
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule Hl
10. Debts/Hortgage Liabilities/Liens (Schedule Il
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Gov.r~tal Bequests; Non-elected 9113 Trusts
14. Net Value of Estate Subiect to Tax
25,184.38
(91
1101
46.651.74
(111
(121
1131
11'11
(Schedu1. JI
NOTE:
.00
.00
250,582.39
144,995.32
x 00 =
X 045 =
X 12 =
X 15 =
T
AHDUNT PAID
44,887.50
4,569.19
DATE
11-22-2004
02-22-2005
_BER
CD004661
CD004981
INTEREST/PEN PAID (-I
2,362.50
.00
'{,
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
(191=
NOTE: To insure proper
credit to your account,
suborH the upper portion
of this for. with your
tax pay_nt.
467,413.83
71 .R~1i 11
395,577.71
.00
395,577.71
.00
.00
30,069.89
21,749.30
51,819.19
51,819.19
.00
.00
.00
( IF TOTAL DUE IS LESS THAH $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YDU NAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORM FOR INSTRUCTIONS. I
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
HUMER MARCIA R
13 TRINE AVE
MT HOLLY SPRINGS, PA 17065
RE: Estate of PETTEYS ELMA R
File Number: 2004-00875
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 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 lS due by:
9/21/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
II.. ~p" ~Jkj/J
&~~ vi/NWJ j.~-{fV
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 7/27/2006
PETTEYS LLOYD W JR
9270 KENT AVE NE
NORTH CANTON, OH 44721-1002
RE: Estate of PETTEYS ELMA R
File Number: 2004-00875
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. 1/ for decedents dyin9 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:
9/21/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
.l~' 07'" /L-.1 1I
)02?:rh~ 6'J~/i,'1*ZjAj V:Z?AA'~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
MYERS FOREST N ESQUIRE
137 PARK PLACE WEST
SHIPPENSBURG, PA 17257
RE: Estate of PETTEYS ELMA R
File Number: 2004-00875
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/21/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
J ~":P ~ ~I
t'/;"" ,t ' 1-
Xj~L i...;: " lE;/.J /~ M:4' / '
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
NameOfDecedentj)(j\LYS I ~lMa- (3
Date of Death: ctfi/~ \ /f)..qxp~
Estate No.: 2J - (f>t }. r/8-:t-5 / ~(/;if;'1- (t1fa =r5
I
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 wlifher administration of the estate is complete:
Yes ISl No 0
2. If the answer is No, state when the personal representatIve reasonably be1i~vcs that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal r/presentative file a fmal account with the Court?
Yes 0 No &1 -
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personaljepresentative state an account informally to the parties in
interest? Yes Ell No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: C{f6f cpt I 'J..(:Jj CcJ
~&-
Signature
3-rrPS1-- 1J ;1A1~t51 lsO'
Name . "\
{3 1- fo..r k. f( v-'
(~~'"'Ppel\.) ~IJ ~ {~)5t.
Address
-=tl1-.5-3~.. '1{hlf "
Telephone No.
.
.~ ....'
<:
Capacity:
o Personal Representative
&r Counsel for personal representative
~