HomeMy WebLinkAbout04-0894PETITION FOR PROBATE and GRANT OF LETTERS
Estateof BEULAH Mm MIXELL
also known as
, Deceased
$ocialSecurityNo. 179103963
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut RIX
in the last will of the above decedent, dated JUNE 12. 1991
and codicil(s) dated
To:
Register of Wills for the
County of ~ in the
Commonwealth of Pennsylvania
named
(state relevant circumstances, c.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with
h ER last family or principal residence at 12 NAUGLE ROAD. SOUTH NEWTON TOwNsHIP,
SHIPPENSBURG, PA 172~7
(list street, number and municipality)
Decedent, then 91 years of age, died 9/6/04
at SHIPPENSBURG HEALTH CARE CENTER
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 ajudicated
tncompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal propen'y
(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 letters TESTAMENTARY
thereon.
(testamentary; administration c.t.a.; administxation d.b.n.c.t.a.)
/~ SHIPPENSBURG ~ .~PA
~ KATHRYIq' E. LINDSAY /
~t257
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~
COUNTY OF CUMBERLAND~ SS
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and con'ect to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affm~l~_~::~d subscribed ~.../~ /C/~ C. ~
before me this ~" "~ day of
OCTOBER. 2004
.t
~~~~ RegisterO
Estate of BEULAH M. MIXELL , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW (~0.~-0 ~'? ~.. ~', c,~ ~) C.~ ~ , in consideration of the petition on
the revere side hereof, satisfacto~ proof having been presented before me,
IT IS DEC~ED ~at ~e ~s~ent(s) dated
described ~erein be ~i~ed to probate ~d filed ofrecord3slhe last will of
~d LeRers
~e hereby ~ted to
FEES
Probate, Letters, Etc .........
Short Certificates ( ) ......
TOTAL
Filed .
Register o£Wil~ ~--~0 ~,0,~'~' 'O
ATI'0RNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the infom~ation here given is correctly copied from an original certificate of death duly filed with me as
l_ocal 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 0502974
No.
,
I
CERTIFICATE OF DEATH
s. 91 yr~ 3/27/1913 ~*~ r-I ~,~ F1 m~F1 ~x1 ~,~ r~ ~'
~C~berland ~. Shippensburg ~ealt~ Care Center ~n.~..~ ~)
t&Harry Clever Naugle
E. Lindsay
Mary Etta Helm
18 Road, PA 17257
011776-L ~DBox336
LAST WILL AND TESTAMENT
I, Beulah M. Mixell, of South Newton Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any
will or codicil previously made by me.
ITEM I: I direct that all my just debts and funeral expenses, including
my gravemarker and all expenses of my last illness, shall be paid from my
residuary estate as soon as practicable after my decease as a part of the
administration of my estate.
ITEM II: I give, devise and bequeath to my grands~i Kirk~Lindsa~ the
occasional round table, one Ray-O-lamp with shade, the maple ~tch Cmp~oard,
all guns and accessories, bayonettes, fishing equipment, Cleverer Naugl~
pocket watch, the cedar chest, and the card table with f. Our chazrs.
ITEM III: I give, devise and bequeath to my granddaughter, Monica
Lindsay, a black onyx necklace and earrings with diamonds, the gold rind from
Kuwait, the end table with drop wings, the three-corner cupboard with the
dishes which are in that cupboard, the Mixell Hamilton pocket watch, the
wooden corral with cactus glasses and pitcher, one Ray-O-lamp with shade, the
sewing machine, and my automobile.
ITEM IV: I give, devise and bequeath the rest, residue and remainder of
my estate except for the items specifically set forth above to my daughter,
Kathryn Lindsay, who is to receive a one-half share, and to my grandchildren,
Monica Lindsay and Kirk Lindsay, each of whom is to receive a one-quarter
share of the rest, residue and remainder.
ITEM V: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid
from my residuary estate as part of the expenses of the administration of my
estate.
ITEM VI: I appoint Kathryn Lindsay executrix of this my Last Will and
Testament.
ITEM VII: I direct that my executrix or her successors shall not be
required to give bond for the faithful performance of her duties in any
jurisdiction.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will
on ~ sheets of paper, dated this /~ day of
and
Testament,
June, 1991.
Beulah M. Mixell
The preceding instrument, consisting of this and one other typewritten
page, each identified by the signature of the testatrix, Beulah M. Mixell,
was on the day and date thereof signed, published and declared by Beulah M.
Mixell, the testatrix herein named, as and for her Last Will, in the presence
of us, who, at her request, in her presence, and in the presence of each
other, have subscribed our names as witnesses hereto.
COMMONWEALTH OF PENNSYLVANIA:
: SS
COUNTY OF CUMBERLAND :
We, Beulah M. Mixell, ~]~1 ~*~fC~L ~
and
the testatrix and the witnesses, respectively, whose names are~signed to the
attached or foregoing instrument, being first duly sworn, do hereby declare to
the undersigned authority that the testatrix signed and executed the
instrument as her Last Will and Testament and that she signed willingly (or
willingly directed another person to sign for her), and that she executed it
as her free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the testatrix, signed
the will as witnesses and that to the best of our knowledge, the testatrix was
at that time eighteen years or older, of sound mind and under no constraint or
undue influence.
Beulah M. Mixell
Subscribed, sworn to and acknowledged,
by BeUlah M. Mixell, the testatrix
and sworn to before me by ~tm ~e~f~
and ~ll~-~,~df~ , witnesses, this
/~daf of June, 1991.
Notary Public
PAULA M. REED, Notary Public
Shlppensburg Twp., Cumberlend
My C~nmissio~ Expires Dec. 13, 199
IN RE: ESTATE OF
1RENE MARY
MENDOCK
A/K/A IRENE MARY
BR1NKERHOFF MENDOCK
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
No. 21-04- 0895
CgRTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Irene Mary Mendoek a/k/a Irene Mary BfinkerhoffMendoek
Date of Death: August 7, 2004
To the Register:
I cevti~ that notice of e~tate administration required by Rule 5.6 (a) of the
~..~.?,,,,.~' Cm~r* P.~:1~ was stn-ced on or mailed to the beneficiary of the above-
captioned estate on October 25, 2004:
Name
Martin A. Mendock, son
Martin F. Meradock, husband
Barbara A. Kennedy, daughter
and parent of
Kyt¢ Keiiaedy, i~ul~o~
April Kennedy, granddaugh~
Address
19 Shadowbrook Drive
Flatrock, N.C. 28731
908 Sheffield Ave.
Mechauicsburg, PA. 17055
284 Dogwood Drive
Hummelstown, PA. 17036
given to all pe~ons known
Rul~ $%74L~:3 to ~e ~d~i~ed to ~ entitled
284 ~o~ ~ve
:~ H~elsto~ PA 17036
~-, Exe~ for E~te
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 01/10/2005
WINDER SALLY J
9974 MOLLY PITCHER HIGHWAY
SHIPPENSBURG, PA 17257
RE:
Estate of MIXELL BEULAH M
File Number: 2004-00894
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 01/14/2005
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Personal Representative(s)
Judge
Sincerely,
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 01/10/2005
LINDSAY KATHRYN E
18 NAUGLE RD
SHIPPENSBURG, PA 17257
RE: Estate of MIXELL BEULAH M
File Number: 2004-00894
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 01/14/2005
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
t3Ett'~~H /11.
/'1 J >{ ~ i-/....-....
Date of Death:
5 E"?TEM Bt::: I<...
'fl. 200Lf
,
Admin. No. ;{M4 - {)O~4
Will No.
To the Register:
I certify that notice of (beneficial interest) estate .dministration required by Rule 5.6(a) of the O~h~' Court Rules was
served on or mailed to the following beneficiaries df the above-captioned estate on l.J'lD_O~. :
I .
~
Address
f1l~'Yll C'A
((<Irk ~.
13;k/
tlrJS(j
h31:) !;Jy~?vtJ. ()~~f/JI 7d4<f
27-1 0 )V Third. S J- 2J ,::-1.
~shV70 fA j 1110
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
ilJ;il DC;
~/4Jij JwJ-.-
Signature U
Name Sit III J W,:Jy /
Address !fi71{ ;1td~. ~JdLV Idwo
S' ~ IqF5 t1-VY~ fA
Telephone ill) 7 S3J- q 17 C:,
Capacity: _ Personal Representative
'It]:2 lid ?,-
~COUl1sel for personal representative
,
REV-l$OO EX + (6.00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
I-
Z
W
C
W
(.)
W
C
MIXELL BEULAH M.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
09/08/2004 03/27/1913
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
W
I-
",:$.,
,,"''''
w""
,,00
0"'-'
"10
..
..
00 1. Original Return
D 4. limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dateofdealh after 12.12-82)
D 7. Decedent Maintained a living Trust (Attach copy ofTrusl}
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1.1.95)
I-
Z
W
o
Z
o
..
.,
w
'"
'"
o
"
E;el~L .. .'. ,~u..~~"'!tlMl!JIi.. iilE.;~Ml!J;IQ!lMj!jDENffALff~;ll'leRMii\mI!lM;; .. """;1
COMPLETE MAILING ADORESS
9974 MOLLY PITCHER HIGHWAY
TELEPHONE NUMBER
717 532-9476
OFFICIAL USE ONLY
FILE NUMBER
21-040894
"""C'5UNTYCCiO'E -----vEA~ - - ND'imR- -
SOCIAL SECURITY NUMBER
178-10-3963
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of dealh prior 10 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
SHIPPENSBURG PA 17257
OFFICIAl'USE ONLY
(1)
(2)
(3)
(4)
(5)
z
o
5
:J
l-
ii:
0(
(.)
w
0:::
1. Real Estate (Schedule A)
2. Stoct<s and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly OWned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-
:J
0.
::iii
o
(.)
~
I-
15. Amount of line 14 taxable at the spousal tax
rale. or transfers under Sec. 9116 (a)(1.2)
x _(IS)
15,303.23 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amoont of line 14 taxable at collateral rate
19, Ta Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
2,555.25
21 ,944.64
(8)
24,499.89
8,319.81
876.85
(11)
(12)
(13)
9,196.66
15,303.23
(14)
15,303.23
688.65
68865
Decedent's Complete Address'
STREET ADDRESS 0
NAUGLE R AD
CITY I STATE I ZIP
SHIPPENSBURG PA 17257
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
688.65
Total Credits (A + B +C) (2)
3. InteresUPenalty it 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. It 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. (5A)
B. Enter the total at Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
688.65
688.65
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 IKJ
b. retain the right to designate who shaii use the property transferred or its income; ... ..................... 0 IKJ
c. retain 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 IKJ
3. Did decedent own an 'in trust fo~ or payabie upon death bank account or security at his or her death?.. ........... . 0 IKJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....... . ........................... .................................. ... ........... ...... 0 IKJ
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 pe~ury, I declare that I have examined this return, including accompanying schedules and statemenls, and to the best 01 my knowledge and belief, if is true, correct
and complete
Declaration of preparer other Ihan the personal represel)lative IS based on all informatiorl of which pre parer has any knowledge
SIGNATURE OF PERSON R.SPONS/BLE FOR FILING RETURN
ADD;{(i~;~~~
SHIPPENSBURG
SIGNATURED P ROTHERT AN Rf~
ADDRESS 9974 LLY PITCHER HIGHWAY
:s~
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){l.l) (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. !i9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of ascot" 'Oll'\.-l fili...... "I...." ~.......~... -.- _':ll u'-"--'-'e
even jf
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 a stepparent of the child is 0% [72 P.S. !i9116(a)(I.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's iineal beneficiaries is 4.5%, except'
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. 99116(a)(1.
individual who has at least one parent in common with the decedent, whether by blood or adoption.
NAp!;.
'e parent,
16(a)(1)].
,as an
7~ Au.sl
'S",--"",,"?,.'r'..''1'1I!'>~
.....,-,~..o--"",.,.~y_"""
~=-
"f';'",-'CF.".j..':"'''''
LAST WILL AND TESTAMENT
---
I, Beulah M. Mixell, of South Newton Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any
will or codicil previously made by me.
ITEM I: I direct that all my just debts and funeral expenses, including
my gravemarker and all expenses of my last illness, shall be paid from my
residuary estate as soon as practicable after my decease as a part of the
administration of my estate.
ITEM II: I give, devise and bequeath to my grandson, Kirk Lindsay, the
occasional round table, one Ray-O-lamp with shade, the maple hutch cupboard,
all guns and accessories, bayonettes, fishing equipment, Clever Naugle's
pocket watch, the cedar chest, and the card table with four chairs.
ITEM III: I give, devise and bequeath to my granddaughter, Monica
Lindsay, a black onyx necklace and earrings with diamonds, the gold rind from
Kuwait, the end table with drop wings, the three-corner cupboard with the
dishes which are in that cupboard, the Mixell Hamilton pocket watch, the
wooden corral with cactus glasses and pitcher, one Ray-O-lamp with shade, the
sewing machine, and my automobile.
I~EM IV: I give, devise and bequeath the rest, residue and remainder of
my estate except for the items specifically set forth above to my daughter,
Kathryn Lindsay, who is to receive a one-half share, and to my grandchildren,
Monica Lindsay and Kirk Lindsay, each of whom is to receive a one-quarter
share of the rest, residue and remainder.
ITEM V: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid
from my residuary estate as part of the expenses of the administration of my
estate.
ITEM VI: I appoint Kathryn Lindsay executrix of this my Last Will and
Testament.
ITEM VII: I direct that my executrix or her successors shall not be
required to give bond for the faithful performance of her duties in any
jurisdiction.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will
and Testament, written on ~ sheets of paper, dated this ~ day of
June, 1991.
~
~ J?(~-€ (SEAL)
Beulah M. Mixell
The preceding instrument, consisting of this and one other typewritten
page, each identified by the signature of the testatrix, Beulah M. Mixell,
was on the day and date thereof signed, published and declared by Beulah M.
Mixell, the testatrix herein named, as and for her Last Will, in the presence
of us, who, at her request, in her presence. and in the presence of each
other, have subscribed our names as witnesses hereto.
d~Mt~~
Sit'tr. }JJJ~
residing at
~~
AJtWlJ7l6 fA
residing at
COMMONWEALTH OF PENNSYLVANIA:
SS
COUNTY OF CUMBERLAND
We, Beulah M. MiKell, '<,_ /OlLvl lVl Q~(("Q .IlI: and Sd{~ -J {jjinder ,
the testatrix and the witnesses, respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn, do hereby declare to
the undersigned authority that the testatrix signed and executed the
instrument as her Last Will and Testament and that she signed willingly (or
willingly directed another person to sign for her), and that she executed it
as her free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the testatrix, signed
the will as witnesses and that to the best of our knowledge, the testatrix was
at that time eighteen years or older, of sound mind and under no constraint or
undue influence.
~ tfl'. 7/?~/t2~
Beulah M. Mixell
\ ,
d!J'VI-o JVt~ ~~
lW-v JI))(~~
.
Subscribed, sworn to and acknowledged,
by Beulah M. Mixell, the testatrix
and sworn to before me by )./ch. M'~rec( TIT
and ~S.:dl "';.' ,nder , witnesses, this
l:Jtftda of June, 1991.
-IblQ --{I{. .l1uct
Notary Public
NOTARIAL SEAL
PAULA M. REED, Notary Public
Shlppensburg Twp., Cumberland Co" Po,
My Commission Expires Dec. 13, 1993
,e;"~",.",,, .
COMMONWEALTH OF PENNSYLVANIA
lNHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
MIXELL BEULAH M.
FILE NUMBER
21 04
0894
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
NET PROCEEDS OF PUBLIC SALE OF PERSONAL PROPERTY 4/12/05
VALUE AT DATE
OF DEATH
1,355.25
2
1988 CHEVROLET PICK-UP TRUCK, TITLE 40279984201, IN FAIR CONDITION
TITLE TO DECEDENT
1,100.00
3.
1985 CHEVROLET SEDAN CAR, TITLE 37156236101
100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space IS needed, insert additional sheets 01 the same size)
2 555.25
'''':509''.''"'',.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
MIXELL BEULAH M,
FILE NUMBER
21
04
0894
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. KATHRYN E. LINDSAY
18 NAUGLE ROAD
SHIPPENSBURG, PA 17257
DAUGHTER
B
c
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DEWS VALUE OF
NUMBER TENANT JOINT deedforjointly-heldrealeslate, VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1- A. 1998 M&T BANK CHECKING ACCT 97406155 25,049.61 50. 12,524.81
2 A 1998 M&T BANK SAVINGS ACCT 21000001029611 18,839.66 50. 9,419.83
TOTAL (Also enter on line 6, Recapitulation) $ 21 944.64
(If more space is needed, insert additional sheets of Ihe same size)
co
____ STFD 1 THF TRANSACTION STMT FORMAT 04/09/28
96 OP EBRN MS 50852 ACTION COMPLETE
COlD
ACCT
14.26.58
STMT
ACTI ON
PROD CODE DDA
CURR CODE
ACTN POST EFFECTIVE
TRACE I D
.. 09/01
.,( 97406155 SHORT NAME MIXELL BEUF
PAGE 4 SEARCH FROM 104/07/20 THRU 104/09/22
CHECK NUMBER TRAN AMOUNT DIC BALANCE
DESCRIPTION
US TREASURY
483.05
312 CIVIL SERV
20,000.00
4,849.61
C
020042391668253
.. 09/03
=~
.. 09/08
.. 09/09
.. 09/10
.. 09/10
.. 09/13
PF: 1-HELP 3-PLVL
24,849.61
~,049.60
24,951.61
23,601.61
C
6003006652 DEPOSIT
200.00
C
6007049039 DEPOSIT
4324
5426287046 CHECK NUMBER
4327
5513784563 CHECK NUMBER
4326
5239812828 CHECK NUMBER
4325
5427326714 CHECK NUMBER 4325
4330 9,432.00
5132076240 CHECK NUMBER 4330
6-INQ 7-SB 8-SF. 9-ASUM 11-CUTO -STSM
98.00
D
4324
1,350.00
4327
4,851.00
4326
D
o
18,750.61
36.00
D
18,714.61
9,282.61
D
M{;'~UI'i\C flJRERS ilND TP.Al)ti{S mUST CQMp'^,jV
IJ'''' ~r'" ~(lTIi"" ' N, I
"'MI."Ii I l_ '.A"
.,,, >.",.,._.,,- ..,~..-:~ ~;::.~'."::: -; ':--:-'..... --_.......-...~.,......
/'
I N ~~~~. 6 ~ v-.\ 0-..."'- yY\. Y'Y\ \ y. E'.- \ I
~ DATE I AMOUNT/CODE I B::~~ r::E~::~:~LII
VOHUUVl ~w~~~~UV.VV U **~b Uw 0 ! u ~~
NO.
2
3
27AUGOl ****$200.00 D **$61950.36 177 024302
01DECOl ****$410.46
5 - .t 6FEB02 ****$160.. 00
I **$62360.82 000 000000
D **$62520~82 177 014207
.
6
l-~ 1 ,T.iN02 *-~~~1;~.*t2~-r~, 55 ,. -, ,'*$62754., 3'7 ~-EY;- 0(":''<1(11)
7
.:.) 1 DCC02 1-'-***$224-" 27 I ~*$!:,2978" 7.t,~ 00<: (ltY:(l(:(j
8
j 8j~1ARO':: *~'~~$iO-;')<(!O ~\; ~*$b2878. ""l':l C~n(' (H)CnOO
(;',!F,;':'C"-\J- .,)1' -~..~-~'q;r'Je" oe 1.' **$1,2078 ~ 74 ,: / j-~_l_l.,c;-'n'7
9
10 I.JU Z 2 '03 .....;5..{)5 ISlq:':r Ct~(jg. "6'1
11 pww '- L uJ voLa,05 ..20 ,~f L i.il,J;;L9..;n
12 IWU L. i.. UJ uoi.:Hl5 /(>00-,0 W (.;;/ a.J..'.,).7
CJ..f7da:t:LC/ PLEASE INFORM US 4JI!8'5?t,1",
APR 0 2 '04 682s..oBHA~~"~SS 59 ,353.(0(,.
13.- ,
1.HAY 07 '04 6825-05 10,000 #.uD I-j q . 353. (JJ(;
1sHAY 07 '04 6825<05 ry;- w J.t1 3.3 q. &1.0
16.100 16 '1}4 ~ .5DC LV i-{ ~ S'.3? {U(P
8'0 QOO,oow 683 .IoCo
1.SEP 03'04 682841 IS; f?.n, ~6
2O~t 6825-05 9,'1,,/.<< w 9LfJ.f>. (glp
~3,;ti")
.H'J-'i':i
~3~t9
21
22
23
2.
Dauphin Deposit Bank and Trust Company
SAVINGS DEPARTMENT
NOnCE-This book shoukl be presented at this bank at I98s1 once in each year so that It may be posted,
the .lnterest entered and the balance shown. In making wRhdrawals, always present your pass-book--we
decllfle to pay unless you do.
CODES: 0 - Deposit W - Wflhdrawal I-Interest
/
IWlUFACTURtR!: AND TRADERS TRUST em?'
28 WALNUT BOnOM ROAD
5HlPPENSBURG, PA 17257
"'v.""".,,.,"*
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
MIXELL BEULAH M.
FILE NUMBER
21
04
0894
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
ALLSTATE, OUTSTANDING ACCOUNT
82.56
2.
SHIPPENSBURG HEALTH CARE CENTER, BALANCE OF CARE ACCOUNT
766.50
3.
SPRINT, OUTSTANDING ACCOUNT
27.79
TOTAL (Also enteron line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
876.85
''''.,'''".,''''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
MIXELL BEULAH M.
FILE NUMBER
21
04
0894
Debls of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. FOGELSANGER- BRICKER FUNERAL HOME 6,882.00
2 TRINITY UNITED METHODIST CHURCH, FELLOWSHIP FOLLOWING FUNERAL 50.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AttomeyFees SALLY J. WINDER 1,264.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. ProbaleFees REGISTER OF WILLS 89.00
5. Accountanfs Fees
6. Tax Return Prepare~s Fees
7. KATHRYN LINDSAY, REIMBURSE FELLOWSHIP EXPENSES 34.81
TOTAL (Also enter on line 9, Recapitulation) $ 8319.81
(if more space is needed, insert additional sheets of the same size)
REV~1513EX"*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
MIlIElI BI=IILAH M. 21 04 OR94
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 dlsmbutlons, and transfers under
Sec. 9t 16 (a) (1.2)]
1. KATHRYN LINDSAY DAUGHTER ONE-HALF NET
18 NAUGLE ROAD
SHIPPENSBURG, PA 17257
2. MONICA LINDSAY BITNER GRAND DAUGHTER ONE-FOURTH NET
6393 EBENEZER ROAD
ORRSTOWN, PA 17244
3. KIRK LINDSAY GRAND SON ONE-FOURTH NET
2210 N. THIRD ST. 2ND FLOOR
HARRISBURG, PA 17110
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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert addilional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
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
WINDER SALLY J
9974 MOLLY PITCHER HIGHWAY
SHIPPENSBURG, PA 17257
uuu__ fold
ESTATE INFORMATION: SSN: 178-10-3963
FILE NUMBER: 2104-0894
DECEDENT NAME: MIXELL BEULAH M
DATE OF PAYMENT: 06/08/2005
POSTMARK DATE: 06/08/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/08/2004
NO. CD 005405
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $688.65
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 4342
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$688.65
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
08-22-2005
MIXELL
09-08-2004
21 04-0894
CUMBERLAND
101
APPEAL DATE: 10-21-2005
( 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
CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS -
REy:is47-EX-AFP-coi:osi-NOTicE-OF-iNHERiTANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
BEULAH M FILE NO. 21 04-0894 ACN 101
BUREAU OF INDIVtiU{)~~~ rfpr'F il=
INHERITANCE TAX DIvlSldl(.' ....... Iv._<<.
. /"'.,,-.,.T,-.... '-'.
PD8DX28060l '~,"__-'i""f"'- .
HARRISBURG PA 17128-06Gl ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSMENT OF TAX
ZDD5 llG 30 f,i, II: 24
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CLEP'\ (T
ORF:- :.~,:'~.:: C,'-'
SALL VOW WINDER - ',,\
9974 MOLLY PITCHER HWV
SHIPPENSBURG PA 17257
ESTATE OF MIXELL
'*
REV-IS'? EX AFP (06-05)
BEULAH
M
TAX RETURN WAS: (X) ACCEPTED AS FILED
( ) CHANGED
DATE 08-22-2005
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~ abb returns assessed to date.
ASSESSMENT OF TAX:
15. A~unt of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. AJlount of Line 14 .t SibUng rat. (171
18. ADount of Line 14 taxable .t Collater.l/Class Brat. (18)
19. Principal Tax Due
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. ISchedul. A)
2. Stocks and Bonds (Schedule BJ
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank DeposltsIMisc. Personal Property (Schedule E)
6. Jointly Pwnad Prop.rty (Soh.dul. F)
7. Transfers (Schedule 8)
8. Totel Assets
(ll
(2)
(3)
(4)
(5)
(6)
(71
.00
.00
.00
.00
2.555.25
21. 944.64
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Ad.. CostslHisc. Expenses (Schedule H)
10. Debts/HortgeQ8 Liabilities/Liens (Schedule I)
11. Total Deductions
12. N.t Value of Tax Return
13. Charitable/Governnantal BequestSj Non-elected '113 Trusts
14. Net Velue of Estate Subject to Tax
8,319.81
(9)
(10)
876.1l5
(11)
(12)
(13)
(14)
(Schedule .J)
NOTE:
.00 X
15,303.23 X
.00 X
.00 X
00 =
045 =
12 =
15 =
(19)=
NOTE: To insure proper
credit to your account I
sub.it the upper portion
of this for. with your
t"" p."....t.
24,499.89
Q.1Q6 li6
15,303.23
.00
15,303.23
.00
688.65
.00
.00
688.65
TAX DITS.
'.J AMOUNT PAID
DATE MHlER INTEREST/PEN PAID (-)
06-08-2005 CD005405 .00 688.65
TOTAL TAX CREDIT 688.65
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 HAY BE DUE
A REFUND. SEE REVERSE ~Tni:' (tIC' TUTC! e........ ..-- _u________
Cumberland County - Register UI W~~~b
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
LINDSAY KATHRYN E
18 NAUGLE RD
SHIPPENSBURG, PA 17257
RE: Estate of MIXELL BEULAH M
File Number: 2004-00894
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 lS due by:
9/08/2006
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.
Si?5erely C . '
A5%4J~__ l7tF:m:-0i)~
U
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
r~
j
Cumberland County - Register ur Wl~~S
One Courthouse Square
Carlisle, PA 17013
Phone: (71 7) 240 - 6345
Date: 7/27/2006
WINDER SALLY J
9974 MOLLY PITCHER HWY
SHIPPENSBURG, PA 17257
RE: Estate of MIXELL BEULAH M
File Number: 2004-00894
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 lS due by:
9/08/2006
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,
.tJ c/ , Lt. /J
;:J~ lZ~d/JJ1~~.(~~,~
Glenda Farner Strasbaughl
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
I
.1..,,)
.)
Register of Wills of Curnberland County
STATUS REPORT UNDER RULE 6.12
".., , ,1
b{1-l G\.j, /'1\' /h; 'i({l_
e'" J ()'
. _-::u~ '!~ ;fn I -f\... \ I
), " , I \ " " c:;r C (' I
~ ,D c' 1 .-- C' (j 0 \ '1
Name of Decedent:
Date of Death:
Estate No.:
) r ,/' cf
/_L/;~_j .
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 ~ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a fmal account with the Court?
Yes 0 No)&
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 JX1 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:
B "/ -' (:{
.
In. i
I v "~!l
<.; ..' 'j ~> J.I
f11!cf-J({ J2L-
S/~ ILL __oj.
Name I~,(, 'jl I )) ,. / /l
/ '7./ ~.' v ( I :J
SIL I JJ)L I V;:,):; II r (\
Address ' . )
(7 I :ld 'S '5 J--
Telephone .
> C""
. (/
l v\~, ,. I
I<J<i:f " If \..~ i j
-(),\ \).f-~f
/) Yo' 7 ,:-
Capacity: 0 Personal Representative
~ounsel for personal representative
- ~
~. ..
~