HomeMy WebLinkAbout04-0883PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Mussette P. Leahy
also known as
Deceased.
Social Security No. 427-~16-2602 '
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executor
in the last will of the above decedent, dated July 27, 1.9.59
and codicil(s) dated
To:
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
in the
named
,19___
Decendent was domiciled at death in Cumberland . County, Pennsylvania, with
h er last family or principal residence at 10 E. Windinm Hill Road. Mechanicsburg
(list street, number and muncipality)
Decendcnt, then 76 years of age, died August 16~ 2004 , 19. _,
at Claremont Nur~tn~ & gph~bilttation -
Except as follows, deced-ent 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 ora killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(lf domiciled in Pa.) All personal property $ 95,000.00
(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 the grant of letters te~l;amentary
th~pn. .cD.
(testamentary; administration c.t.a.; administration d.b.n.¢.t.a.)
10 E. WJnd~ng H~ll Rand
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ~
COUNTY OF
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 anti'truly admij~.ister/the ~estate ag~orlling to law.
REGISTER OF WILLS OF cm~sm,.~'~ COUNTY
OATH OF SU SCRIBING WITNESS
J, Robert Stag~fer and John M. Eakin ,
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that they were present and saw
M~$~ette P. Leahy ,
the testat rix , sign the same and that they signed as a witness at the
request of testatrix in h er presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)). .,,"7 .,.4
No.
Estate of
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~~ ~e~ .~x ~.~[ ,~0Oq ~ , 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 ~-~ - [q~q
described therein be admitted to probate and filed of record as the last will of
~d Letters ~~,_O~'~ ~
~e hereby granted to~Vl~ ~', C ~ [ ~
Probate, Letters,"Ete .......... ~/3~, · O~
Short Certificates( ) .......... $~
Renunciation ................ $ ~. ~
TOTAL ~ ~. ~
Filed . ~. ?.~Z .~.~. ...................
ATTORNEY (Sup. C~. I.D. No.)
ADDRESS
PHONE
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Mussette P. Leahy
a]so kJqow;~ as
Deceased.
Social Security No. 427-34-2402 '
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executor
in the last will of the above decedent, dated July 27, 1959
and codicil(s) dated
To:
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
in the
named
,19__
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 10 E. Winding Hill Road. Mechanicsburg
(list street, number and muncipality)
Decendent, then 76 years of age, died August 16, 2004 , 19.
at Claramant Nursing & Rehabilitation .
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 $ 95,000.00
(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 the grant of letters testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
~vid Michael Leahv (/
10 E. Windqng Hqll Rand
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF
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 anc~truly admit.aster/the .estate a9~or~ing to law.
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SU SCRIBING WITNESS
J. Robert Stauffer and John M. Eaktn ,
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that they were present and saw
Mussette P. Leahy
the testat rix , sign the same and that they signed as a witness at the
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~-o9."1 ~ [<:[,~cI
described therein be admitted to probate and filed of record as the last will of
and Letters ~t~c~x .,~',~"~_A~t'"~_t'a-,."~ --}~"~j~
are hereby granted to"~ {~'x/'lr~ V"~', c' ~L~_ [
~q ,,~OOq. j~ , in consideration of the petition on
,.~F..A~ ~ FEES
Probate, Letters, Etc ..........
Short Certificates( ) ..........
Renunciation ................
TOTAL
Filed . ~. ~.~.~.9. ...................
A'ITFORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SU SCRIBING
~ WITNESS
J. Robert Stauffer and John M. Eakin
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that they were present and saw
Musaette p. Leahy
the testat rix , sign the same and that they signed as a witness at the
request of testatrix in h er presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this c~L) P~ day of
Register
f. Robert STauf~
Market Square Building, MechanicsburF,, PA 17055
.
John~ Eakin (NamO
MarkeC Square Building, MechanicsburE, PA 17055
{Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
testat__
that ..
to the best o ~l'C~-~ .
sw, .:to or . rme'ti subscribed before
me this. DC-~ day of
19
familiar with the signature of
codicil
.~. (one; i~ the subscribing witnesses to) the will presented herewith and
,- believes the signature on the will is in the handwritin~ of
knowledge and belief.
Register
(Name)
(Address)
(Name)
(,4 ddress)
· RENUNCIATION
In Re Estate of Mussette P. Leahy
To the Register of Wills of Cumberland
County, Pennsylvania.
The undersigned Richard D. Leahy Jr. of
the above decedent, hereby renounce(s) the fight to administer the estate and respectfully, ask(s) that Letters
Testamentary
be issued to David Michael Leahy
WITNESS
hand this "~/~ day of Ang,,,~t , 19
463 Brook Circle, Mechanic~burg
(Address)
(Signature)
(Address)
(Sisnature)
(Address)
JUq-26-2B~2 0~:45A FROM: T0:843~72 F:SxS
RENUNCIATION
In Re Estate of
Musse~e Y. LeaEy
deceased.
TO the Register of Wills of
Cumberland
County, Pennsylvanie.
authorized signatory for Mellon Bank NA, successor to Harrisburgof
The undersigned
National Bank
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
t est ame~a~y
be issued to D~vid Micha.e~ Leah¥
WITHE, SS my
handthis ]~/~ day of September .19 2004.
Mellon Bank, Successor to Harrisburg
Natio~al~ank
(Signature)
Ymr]~. PA
(Address)
(5~tur~)
(Addr~.~}
(Si~c)
(Address)
SEP 1~ 20~4 12:~2 PAGE.Z5
his is to certify that the information here given is correctly copied ['rom 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 10545672
NO.
Local Registrar
Date
CERTIFICATE OF DEATH
Cumberland Middlesex Twp.
U.S. Government
10 East Winding Hill Road
Mechank:sburg, Pennsylvania 17055 :s*,m~m~
William R. Pope
Dav~l
Claremont Nursing & Rehabilitation
19, 2004
FDq)14318-L
2402
Jordan
LAST WILL AND TESTA/4ENT OF MUSSETTE P. nRa~v
I, ~ussette P. Leahy, of the Township of Upper Allon, County of
Cumberland and State of Pennsylvania, being of sound and disposing mina,
~emory and understanding, do make, publish and declare this mY Last
Will and Testament.
I direct mY personal representative hereinafter named, to pay all
m~ Just debts and funeral expenses as soon after my as t~e sa~
can be conveniently done.
X
2.
All the rest, residue and remainder of my estate, of whetso~r
nature and wheresoever situate, I give, devise and bequeath unto my dear
husband, Richard D. Leah~, absolutely and unconditionally.
In the event that my said husband should predecease me, or should
he die within thirty (30) days of the date of my death, then in such
event, I give, devise and bequeath my entire estate, real personal and
mixed, to The Harrisburg National Bank, in trust, nevertheless, for the
following purposes:
To hold, invest and reinvest the same, and to apply the net income
derived therefrom to the support, maintenance and education of my sons,
~Ichard D. Leah~, Jr. and David MichaelLeah~. I hereby authorize and
e~power my said T~.lstee to expend principal as well as income of said
trust fund to Xnsure the comfortable support and care of my said sons
and particularly for the purpose of furthering their education in college
or some technical or trade school after thei.r graduation from High School.
When the youngest of my two aforementioned sons attain the age of
twenty-one (21) years, then upon such event, I direct that said trust
cease and determine, and that the principal of said trust fund, together
with any income that may be accumulated thereon at that time, be paid
over to m~ sons, Richard D. Leahy, Jr. and David MicheelLeah~, share
and share alike.
In the event that either of m~ said sons should predecease me, or
should die before having received his share in my estate, then in such
event, I direct that his share be paid over to his surviving brother
when he becomes twenty-one (21) years of age.
For the purpose of facilitating the management of my trust estate,
I hereby authorize and empower my said trustee to sell any and all real
estate which I may own at the time of my decease, at either public or
private sale or sales and to convey the s~ ~me_' to the purchaser or purchasers
thereof by good and sufficient deed or deeds in fee stwple.
I nominate, constitute and appoint my brother-in.lew, Kenneth M.
Leaby, to be the guardian of the persons of my said sons during their
minority, and in the event that he is unable to act in this capacity,
then I nominate, constitute and appoint my brother, Benjamin Owens, of
Mobile, Alabama, to be the guardian of the persona of my said sons during
their minority.
LASTLY, I nominate, constitute and appoint my husband, Richard D.
Leaby to be the Executor of this my Last Will and Testament, and in the
event +.hat my said husband should predecease me, then I nce-inate, con-
stitute and appoint The ~arrisburg National Bank to be the Executor of
this my Last Will and Testament in his place and stead.
IN WITNESS W~E~OF, I have hereunto set my hand and seal this
day of July, A. D. 1959.
Mussette P¥~Leaby
-2-
Si~ned~ sealed~ published and declared by the above named
Mussette p. Leahy, as and for her Last ~11 and Testa~ant in
presence of us~ who have subscribed our names hereto as w~tnesses~
at the request of said testatr~x~ in her presence and in the presence
of each other.
-3-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Mussette Leahy
DateofDeath: August 16, 2004
Will No. 21-04-OR.R3 Admin. No.
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 Ropr,~,~har 99. ?nc5 :
Name Address
Richard D. Leahy, Jr. 463 Brook Circle, Mechan~csburg. PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date:
Signature ~ ! ~ ~
Eakfn
Name ~
Address Market Square Building
Mechanicsburg, PA 17055
Telephone (713 766-3172
Capacityl __ Personal Representative
X Counsel for personal representative
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF [ND~VIDUAL TAXES
DEPT. 280601
HARRISBURG, F~A 17128-0601
RECEIVED FROM:
EAKIN JOHN M
MARKET SQUARE BUILDING
MECHANICSBURG, PA 17055
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 004579
........ fold
ESTATE INFORMATION:
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY;
DATE OF DEATH:
REMARKS:
SSN: 427-34-2402
2104-0883
LEAHY MUSSETTE p
11/03/2004
11/03/2004
CUMBERLAND
08/16/2004
TOTAL AMOUNT PAID:
ACN
ASSESSMENT
CONTROL
NUMBER
101
AMOUNT
$2,606.28
¢2,606.28
SEAL
CHECK# 2
INITIALS; JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEP~ 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONEY
FILE NUMBER
2 i -~_A_
COURTYCODE YEAR
RUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE iNITIAL) SOCIAL SECURITY NUMBER
~' Leahy Mussette ? 427 34 2402
U,I OATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
U.I 16 August 04 4 September 27 REGISTER OF WILLS
[U (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
m [] 1, Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdo, to 12-13-82)
[] 4. Limited Estate [] 4a. Future Interest Compromise Idate of death gLer 12-12-82) [] 5. Federal Estate Tax Return Required
[~6. Decedent Died Testate (A~ch copy el WillJ [] 7. Decedent Maintained a Living Trust (A~ach copy of Trust) __ 8 Total Number of Safe Deposit Boxes
~j 9~ Litigation Proceeds Received [] 10, Spousal Poverb/Credit (date of death between 12-31-91 and 1-1 95) [] 11. Election to tax under Sec. 9113(A) (A~ch Sch OF
NAME
John M. Eakin
FIRM NAME (if AppliCable)
TELEPHONE NUMBER
{717) 766-3172
n~
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Padnership or Sole-Proprietorship
4, Mortgages & Notes Receivable (Schedule D)
5, Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Properly (Schedule F)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8, Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10, Debts of Decedent, Mortgage Liabildies, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
COMPLETE MAILING ADDRESS
Market Square Building
Mechanicsburg, PA 17055
(2)
(3)
(4)
(5)
(6)
(7)
101.054.36
(9) 997.00
(10) 39.092.29
13. Chantable and Governmental Bequests/Sec 9113 Trusts for which an erection to tax has not been
made (Schedule J)
14~ Net Value Subject to Tax (Line 12 minus Line 13)
~"~ C IA L~t~ S E ONLY
(6) t01.054.86
(11) 40,089.29
(12) 60,965.57
(13)
(14) 60,965.57
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)(12) x .0 (15)
16. Amount of Line 14 taxable at lineal rate 60,965.57 x ,0 45 (16)
17. Amount of Line 14 taxable at sibling rate x .12 07)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due 09)
2,743.57
Decedent's Complete Address:
S1REETADDRESS Claremon~: Nursing & Rehabilitation I STATE ZIP
CITY Carlisle, PA I 1~0~3
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 2,743.45
1'~7.17 Total Credits (A + B + C) (2) 137.17
3. InterestJPenafty if applicable
D. Interest
E. Penalty Total Interest/Penalty ( D + 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 OUE. (5) 2,606.28
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
2,606.28
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 premise 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-prebate 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 pedury, 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 I ~e p
based on all information of knowledge,
SIGNATU
REPRESENTATIVE
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)l.
The sta ute dges not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still app~iceble 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 vatue 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 stepparant of the child is 0% [72 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneflciades is 4.5%, excep! as noted in 72 P.S. §9116(1.2) [72 RS. §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 blcod or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mussette P. Leahy
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONALPROPERTY
FILE NUMBER
21-04-0883
thclude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivomhip must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Mortgage dated January 17, 2003, in favor of decedent on premise~
at 10 East Winding Hill Road owed by David M. Leahy and Vicki D.
Leahy, husband and wife, see attached.
Principal $97,t82.11
Interest 404.93 7/17 to 8/16
Claremont Nursing Home - Patient's in house account
PNC Bank, Checking Account 4003-7158
97,587.04
1,685.70
1,782.12
TOTA~ (Also enter on line 5, Recapitulation) $101,054.86
(If more space is needed, insert additional sheets of the same size)
TIIAT We, David M. Leahy and Vicki D. Leahy, husband and wife
heldaadfi~dyboundu~to Mussette P. Leahy, single person
t~0~.,umolNinty-Nine Thousand Four Hundred Ten ($99,410.00)
lawful money o~ ~e U~ 5~t~ ~ ~ to be
~d~ .... C~oL.--L~Two Thousand and Three (2003)
Ninty-Nine Thousand Four Hundred Ten ($99,410.00) DoH~.
in five (5) years from the date hereof together with interest
at the rate of five (5%) percent per annum, the Obligors are
required to pay the sum of Five Hundred ~irty-~ree and 65/100
($533.65) Dollars on the day of February 2003 and on the
like day of each succeeding month during the te~ of the obli-
gation, interest shall be paid first and the balance applied
to principal. Nothing herein contained shall be construed to
alter the maturity date above written.
wit~ottt nny fraud or futth~ d~lay, trod ~o ~ Ume ~ ~ ~d ~t ~ ~ ~ ~t ~ ~e
d~ ~ ~e M~tgage a~n~g ~ b~d ~ f~ ~e ~t of ~e M~g~ , ~
g~ ~d ~ble St~ ~m~ ~m~y or ~p~, to ~e ~t ~ at l~t Nintv-Nine
Tho~9n~ou~ Hundred Ten ~o~ars ~d t~s ~t no ~ ~ ~d ~g n~
s~ma~epay~tof pr~ncipa~ or
~t ~ ~ ~&s~ 30
~doby ~o ~d Obll~s, ~heir heirs . or ~ &~ ~ ~ s~ ~
0~ ~d pd~ ~ ~al~ st t~ ~on of ~o ~ld Oblig~ . her ~ n~, ~.
due &~n. ~ ~maid. to~h~ ~th an a~ey s m~lon ~ ~ve ( ~ ~L ~ &e s~d ~-
n~ , ~ ~ n Jud~mt or Judgm~ ~ fa~r~ ffm n~ 0~ , her
~u~~n~ngn~t ~8 for the unpaid balance.
Al.I,
IIll;I,~~ ~1; %tll,dj,,~ II1.11, l~n tho To~nmblp of Oppor Allen~ ~ounf. y of
{70) l'~.l; Io ~,, 1,'.,~ pin t,, t1~ llno of oU~or lan~ of ~o ~ran~ora
Havin~ thereon erected a
Winding Hill Drive.
auti~orize a writ of execution to be issued upon Ihe judgement obtah~ed upon this obligation, or by v~me
t~ ~mHny~g ~d~mre of ~g*~ ~d tl~ s~:id Obli~ do h~eby waive ~d ~ m
........................... F'~' "~'~ ......................................... / ........... ~'~ ........... ~ ................. ~ .................... 't'"'" (~)
................................................................................................. ] .......... ~:f~:,.~.~ ..........
V~ck~ D.~eahy f
Fortheporlod 0~05/2004to 0~07/2004
HUSSETTE P LEAHY
10 E WINDINg HILL RD
MECHANICSBURO PA 17055-5624
[;ular Cheoking Aooount Summary
trot number: 51-4003-7158
afloe Summery
455.12 2,654.00 .O0
1,983.18
3,109.12
.00
PHmary account number: 51-4003 7158
Page 1 of 1
Ntlmber o[ enclosures: 0
For 24-hour banking, customer service and
transact on or nteres rate nformatlon,
sign on to Account Link ® by Web on
pncbank.com ol call 1-888-PNC-BANK
Para smvicio en espanol, 1-866-HOLA-PNC
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Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
~ Visit ,s at pncbank.com
Mussette P Leahy
Please see the Activity Detail section for
additional itfformation.
tivity Detail
recite end Other Additiona
Amount Description
~3 1,327.00 Col'p{n'ale ACI l Mist Pay
DolTreas 303 X0591655161500
'3 1,327.00 Corporate ACH Misc Pay
Do|'rreas 393 X0591655161590 '
There were 2 Deposits and Other Additions
totaling $2,g54.00.
Balanoe Detail
Balance Bate Balance
,782.12 09/03 3,11)9.12
REV-1511 EX+ (12-99)~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mussette P. Leahy
FILE NUMBER
21-04-0883
Debts of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1.
5.
6.
7.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Pemonal Representative(s)
Street Address
City State __ Zip
Year(s) Commission Paid:
AEorney Fees
Family Exemption: (If decedent's address is notthe same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Filing Fee
State Zip
AMOUNT
750.00
$ 232.00
$ 15.00
TOTAL (Also enter on fine 9, Recapitulation) $ 997. O0
(If more space is needed, insert additional sheets of the same size)
· L~':~,~'~f'g/, f~#' I . _ : _ .
c.~,~.,~.,,,,rk~ nmi. h.~. w.~ / DEB I S 01- DEC EDEN T
.,.S,U~.,UL~UL.i / <IUAGE LIAUILIIIE~ & LIENS J
ESIAIE OF FILE NUMBER
~usseCCe ~. ~eah~
21-04-0883
IIFM
NUM[IER ( I:~I;P, II' II )Il
I. Pa Department of Welfare, See attached
101AL (Aho eider oil line 10, Recapllulallon)
AMOUIIT
39,092.29
$ 39,092.29
space Is needed, I.sed additloual sheels of lite same size)
JOHN M EAKIN ESQUIRE
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
I:O BOX 8486
HARRISEURG, PA 17105-8486
october 8, 2004
Re: MUSSETTE LEAHY
CIS #: 980161615
SSN: 427-34-2402
Date of Death: 08/16/2004
Dear Mr. Eakin:
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $39,092.29 against the above-mentioned estate. This
claim is for restitution of medical assistance granted on behalf of the
decedent for which the Probate Estate is now responsible to reimburse the
Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as
amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's
itemized statement of claim.
A portion of this medical expense, namely $12,780.33, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $26,331.96, is
to be entered as a priority Class 6 claim against the estate.
Please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected. If the
estate accounting is complete, please provide a copy. If the estate contains
real estate, please provide copies of the deed, the latest tax assessment,
and a current appraisal, if &reliable.
Sincerely,
Susan E. Naylor
TPL Program Investigator
717-772-6265
717-772-6553 FAX
REV-1~i13 EX+ (9-00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
2
Mussette P. Leahy
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
FILE NUMBER
21-04-0883
TAXABLE DISTRIBUTIONS [include outright spousal di~ributions, and transfers under
Sec. 9116(a)(1.2)]
David Michael Leahy
10 E. Winding Hill Road, Mechanicsbur
Richard D. Leahy, Jr.
463 Brook Circle, Mechanicsburg
RELATIONSHIP TO DECEDENT
Do Not List l~uetee($)
son
Son
AMOUNT OR SHARE
OF ESTATE
1/2 residue
1/2 residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE D~STRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
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)
LAST WIL5 AND TESTAMENT OF MUSSSTTE P. IF~AHY
Ir Mussette P. Leaky, of the Township of Upper Allen, County of
Cumberland and State o1' Pennsylvania, being of sound and disposing mind,
memory and understanding, do make, publish and declare this my Last
Will and Testament.
I direct my personal representative hereinafter named, %o pay all
my Just debts and funeral expenses as soon after my decease as %he sa~e
can be conveniently done.
Ail the rest, residue and remainder of my estate, of whatsoever
nature and ~herasoever situate, I give, devise and bequeath unto my dear
husband, Richard D. Leahy, absolute]~v and unconditionally.
In the event that my said husband should predecease me, or should
he die within thirty (30) days of the date of my death~ then in such
event, I give, devise and bequeath my entire estate, real personal and
mixed, to The Harrisburg National Bank, in trust, nevertheless, for the
following purposes~
To hold, invest and reinvest the same, and to apply the net income
derived therefrom to the support, maintenance and education of my sons,
~ichardD. Leaky, Jr. and David Michae~Leah~. I hereby authorize and
empower my said Trustee to expend principal as well as income of said
trust fund %o insure the comfortable support and care of my said sons
and particularly for the purpose of furthering their education in college
or some technical or trade school after thei~ graduation frem High School.
When the youngest of my two aforementioned sons attain the age of
twenty-one (21) years, then upon such event, I direct that said trust
cease and determine, and that the principal of said trust fund, together
· with any income that may be accumulated thereon at that time, be paid
over to my sons, Richard D. Leahy, Jr. and David MichaelLeahy, share
and share alike.
In the event that either cf my said sons should predecease me, or
should die before having received his share in my estate, then in such
event, I direct that his share be paid over to his surviving bx~t, her
when he becomes twenty-one (21) years of age.
Fei' the purpose of facilitating the management of my trust estate,
I hereby authorize and empower my said trustee to sell any and all real
estate which I may own at the time of my decease, at either public or
private sale or sales and to convey the same to the purchaser or purchasers
thereof by good and sufficient deed or deeds in fee simple.
T nominate, constitute and appoint my brother-in-la~, Kenneth M,
Leahy, to be the guardian of the persons of my said sons during their
minority, and in the event that he is unable to act in this capacity,
then I nominate, constitute and appoint my brother, Benjamin Owens, of
Mobile, Alabama, to be the guardian of the persons of my said sons during
their minority.
LASTLY, I nominate, constitute and appoint m~ husband, Richard D,
Leah~ to be the E~cutor of this m~ Last Will and Testament, and in the
event that my said husband should predecease me, then I n~tn, a~e, con-
stitute and appoint The Harrisburg National Bank to be the Executor of
this m~ Last Will and Testament in his place and stead.
IN WITNESS h~E~OF~ I have hereunto set my hand and seal this
day of July, A. D. 195~.
Signed, sealed, published and declared by the above named
Museette P. Leahy, as and for her Last Will and Testament in ~he
presence of us, who have subscribed our names hereto as witnesses,
at the request of said testatrix, in her presence and in the presence
of each other.
BUREAU OF ZNDZ~/IDJJAL~T~
PO BOX 280601 --
HARRISBURG, PA ~i¢ ....
200 DEC 29 AH 9:09
CLERK OF
' '~ ~URT
HECHANZCSBU~G PA ~70~
COMHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-27-2004
LEAHY
08-16-2004
21 04-0885
CUMBERLAND
MUSSETTE
Aaount Reai~'l:ed
HAKE CHECK PAYABLE AND REMIT PAYMENT TO.'
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LEAHY MUSSETTE FILE NO. 21 04-0885 ACN 101 DATE 12-27-2004
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVAT]:ON CONCERN]:NG FUTURE ]:NTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate [Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
~. Mortgages/No,es Receivable (Schedule D) (q)
E. Cash/Bank Deposits/Hisc. Personal Propar~y (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/Hisc. Expenses (Schedule H) (9)
10. Dabts/Nortgaga Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Nat Value of Tax Return
101~054.$6
.00
.00 NOTE: To insure proper
.00 credit to your account,
.00 subait the upper portion
.00 of this fora with your
tax payment.
.00
(8) 101,054.86
997.00
39~092.29
(11)
(12)
~o.089.29
60,965.57
13.
NOTE
Charitabla/Govarnaantal Bequests; Non-elected 9113 Trusts (Schadula J) (13)
Nat Value of Estate Sub,act to Tax (1~)
zf an assessment ~as issued previously, 11nas 1~, 15 and/or 16, 17,
reflect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Ammount of Line 1~ at Spousal rata
16. Aaount of Line 1~ taxable a~ Lineal/Class A rats
17. Aaount of Line 1~ at Sibling rata
18. Aaount of Line lq taxable at CoZlatara1/Class B ra*a
19. Princi)al Tax Duo
TAX CREDITS:
PAYMENT RFCETPT DISCOUNT (+)
DATE NUNBER INTEREST/PEN PAID (-)
11-0:5-2004 CD004579 1:57.17
.00
60,965.57
18 and 19 w111
(15), .00 x O0 = .00
(~6) 60,965.57 x 045= 2,74:5.57
(:].7), .00 x 12 = .00
(18) .00 X 15 = .00
(19)= 2,74:5.45
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
AMOUNT PAID
2,606.28
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
2,74:5.45
.00
.00
.00
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT TS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE STDE OF THIS FORH FOR /NSTRUCTIONS.)
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Mussette P. Leahv
Date of Death: 8/16/2004
Will No. 21-04-0883
Admin. 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 X No
2 . If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete :
3 . If the answer to No. 1 is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No X
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 X 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.
Date: 4/11/2005
~
(:")
~m
Signat e.
John M. Eakin
Name (Please type or print)
Market Square Building
Mechanicsburl;l PA 17055
Address
<.:)
(....!
(717) 766-3172
Tel. No .
Capacity :
Personal Representative
I '
x
Counsel for personal
representative
~