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HomeMy WebLinkAbout95-0079 This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General. Assembly, approved 29 June 1953, P.L. 304. AuG i 6 20Q1 Date s Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 H,05.1A3 Rev2/87 TYPE?RNlT IN -E1IMANENT BLACK NNC W COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH J02~63 NAME OF DECEDENT (F:rt. M~fMb. Lash SE% SDCUIL SECURT' NUMBER^~ OATE OF DEiON (Hard,. Day. Yser) Harold 0. Sipe ,. Male ,. 192 - 30 - 0565 .. Jan 21 , 1995 , . AOE(Lar BidMay) UNDERIYEAR UNDERIDM DATE OFBRTH sBuS~iT,uNP~LrA~CEr~1Cc~aYaM~_ PLACECF DE.VH[Cawc4 aMy pM-eee.mucfaman door udsl O r O HosP1ULL: MMYAes (M"AR D%', Wr) E .~ onlr r DH'• Ndrrf Meru ' i r . L: I1n s D . t bprfra ^ ERA7uNslbr ^ DDA ^ Nmr C7 RwiCa ~ ^ 1i>Pa~T/1 ^ ; 9/ 22/09 8 5 ~" Pa - r 7 . B couNTV of DEATH cm, BORO, iWP OF OEJBN PACam NAME M m:wAnn Sn'• w•« •^~ rwn~l wAS pECEDENT of HISPANIC ORIOIN7 RACE-Arlydan baarl, sa«~, wNa, rc. 'S°'°"^ esW CrAan s ® va ^ a w N y , p . s ,Ah it e Harrisburg Leader Nursing Home East ; •~~•^•Fw^^"~^•~ ,a Dauphin k sE , M. MARILLLSTJaus-MrrMd suRVrvBgsPDIr DEQEDENraueuALOOawvloN wNDOFeusa+ESSn~rousTRr ,yLgpECEppITEVERIN DECEDENT'sEWCR10N NevrMardW,wbowM, ma+..ar<n~arrrrn.I U.S. ARMED FORCEST (a,. Nod«-Dr*Od» abr n e e o s EMmN„Y~Sam~arY ca1w. . a+rMrow.:donrv., w.^ NeC3 Widow h '°'~' 4 "'a5; h ,,. ,,. urc Clergy ,,,_ C ,,.: ,a. DECEDENT'S WULSq ADDRESS (Sheaf CA'~'•n• $w.7lD Cedal DECEDENT'S ,7e. n., d.a.a.r aYedlrL I"'P~ slr. PeTLT18~[l ya_ni a AQTUAL ,7. ~ . a .n.a.M 446 State Road RESIDENCE ~°'"°"°"" Cumberland b~aYiMilpT ~ I+••^•~•~•~+a+d West Fairview Pa i ew, ~«>~ wNn a«ur erM West Fairv ,>e. ,.. FATHERS NAME 6+sI, MidAe. Lash MQTHER'S NAME (Fer. MitlDls. MaidMl Surrlerris) Oberdorff Mahala E Henry P. Sipe . 70. ,•. avFORMANr'S NAME Oroa~Pr:+) INFOf WANT'S 1AAlLIND ADDRESS R~r•r. CiY/fin.3We. ZOCOtls, 2 Third treet. West Fairview a 1 METHOOOFasPOSIraN DRE OF DISPOSITIDN PLACE OF •NrMa Dr+rnrary LDCAf10N. Gy/b.n.Srb. 2lp Code ~~^ ~~^ (MOMLOSY.'Aterl «~~p Mi~lers~U M. Northumberlan3 Co., Pa DorlalisnQ CY+rISM~ML ^ a„.Jan 25, 1995 ,;Church Cemeter ,,,. ~ NAMEANDADORESBOFRMaIRv ,•. aKS FUNERAL oR ACTINO AS SUCH F.D. 11897-L ,m.Sullivan F. H. ,51 N. Enola Dr.,Enola,Pa Mar 73a<arY arb/bY RIM Drt WrM ba'•'MUDa.tlrNOaunaE attMWM.dW rd Placa.MlW. LICENSE NUMBER (~ ~~ bnr avaLablerwrw «dsrnb and TCe) r arn. ,ap, BsIna 24T8 murMwrrlpred0y TMAEOF OF RH DATE PRDMDUMCED DEAD IM•rMA, DeY•yearl WASCASE REFERREDro MEDICAL E%.V.SNERA7DIWNERT ^ "° w 7' e °'"°"'"°peiwWrawdwln. 1/21/95 as 2: 25P~ ~ , . . . , a7. -ART I: EMwtlrdWnee. nhutl•a"WmplkrbM WdLll arced tlr d.m.DOilsl eraertlv modeol dyar,, Rrcllaaerdlac"respkr•ryamr. afbsk"Mad tailrrs. IAppmx4nre MRT N: Otlw apilSorewldSb+aanerenSrV bdpol. Mt ~Yeervr Mlvnan nr reslhgblM "drryYpdYeSN•rrb PARTI.~ LYIe«T"rearre onaW.Wre. I "rr and Mtlh NNIEDMTE CAUSE IFrW 7 - i ~sC /~ DUE TO (ON ASA CONSEQUENCE DFI: i ~ (('' /eno~.r s>9~s~~ .s ,;~ TJJ s.arrruayMcorlaa"r. , r DUE TO (CR ASACONSEQUENCE OF): I L /-' / L Yarry. Migrrpb YnnNAre ~ /~fGcel" r f /iCG y~/ !Z yr ~ farrw. Erer DNDERLYMO CAYfE(Oroere"'ryry < tlwl ir:tirw sveraa DUE TOICR AS A CONSEQUENCE OF} ; aaAtirpn deeN) LAST tl. WA9 AN AUR7PSV WERE AUTOPSY FSIdNGS MANNER OF DEATH DATE OFINJURV TIME OFINJURV INJURY Ai WORKT DESCRIBE HOYY MUURY OCCURRED. Yeer) P'1of"^ aY • • PERFORMED? A1NS.ABLE PRK1R m ~ ~ ~~ ^ COMPlETK7N OFCAUSE Naval OF DERl17 hs ^ yp^ ACCbrM ^ PerMkq kneWB«bn ^ M . YYa ^ No ~ y1s ^ Ne ^ Suicide ^ Coule M M deterrriinsd ^ PLACE OF INJURY . M Mare, Mm. war.la«erY. eBb LOCATION (Strer. CM/Two. SMb) ErIiIdM0. atc.ISpeGdy) 701. ar. ». aa. CEIITM161(Cneck ardy one) 'CHITIFYWD PNYSKaANIRryscirr carMyirrq cause«tleaVl when andMr MYSic•^has Ornnorarced tlNa~arN wrripleled lldn 23) a.wlo«rnadwbrw r+uMal.nd nrwraba . ......................... ......................... `N 7•M Mrel mFbenlad8• SID of CERTIFlER ~~ / '~•-.~ ~- a,s. G^'+~ . GATE SIGNED .Day,yaMl LICENSE ,,.yip ~~ir'3J.J•~ ~ "i J( •vRDNOUNDINDANDCFJITV1fB10PHrsN7/INIPhYSinCOIf1P~^~nOaesNandurlaf^^9btausade•edt) ....:............... b tlr earrNel errd mwrr r NaMd d d d b . ^ ata. ale. ..... d. err ue P h Sre heel d my braubdD•, daAr eawred a tlr,arre~ WIe, an NAME ANDAODRESSOF PERSON WHO COMPLETED OF DEIDN e"Pr{M TJ 27)T N ndal ~ amen ~. T •~c~Ex eAMBoN~R~~a,M~,~~.~~~~~~~,d~.ar,dP„~,,a„d,,r,,,M~aI,..~,l,,,d ^ ......................................... ... ..... ... ... / IMW r an yp p y 108 Lowther St. , Lemoyne, Pa ........................................... T MMIMt ale. aa. REGISTRAR'SSIQNATVRE ANO NU~ DATE FILED fMOrA~. Day. Year) ~ aa. >•. ~ PE~'I A ION FOR PRORATE and GRANT ®F LETTERS Estate of ~_~~~- 4' . No. ~ ~"~ ~~ ~ -- uLso known as T°' Register of Veils for the ---- Deed. Gounty of Caw- in the Soc{af Security No. !`~~' -~o ' ~'~~~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: D 9"S __ named Your petitioner(s), who is/are 18 years of age or older awn the e~ut _~ 19'~'Z in the last will of the above decedent, dated _ ~~"*~ and codicil(s) dated i (state relevant circumstances, e.g. renunciation, death of executor, etc.) Dexendent was domiciled at deffath in C I'' ~~--County, Pennsylvania, with ..- - ~- ~ ~ 1;9.~t f ntily rstar.~~ep-aid~~ at 4~~ -S''aa ..s_~~ --- (list street, number and muncipality) D cen rtt, the ~~_ Years of age, died "Z'! ' 19 ~~ ; . i a'- - Except as follows, deced t 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: 1?ecendent at death owned property with estimated values as follows: $~~-•OQO O® (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 $ ~ ~ 1100 •,o Value of real estate in Pennsylvania ""T situated cgs- folfow~ ,- -~-- - i' ... a _ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters TESTAMEN I ARY (testamrntary; administration e.t.a.; administration d.b.n.c.:.~ ) theron. V C b .-~ .~ ~ ~ ~5/.S'3 S' ~'w f'e ' c _° ~~ L~~ sttJ •~~~rJie..~, ~A• 17n2S OATI~ OF PERSONAL REPRESENTATIVE C17M1~®N°aVEALTi-~ ®F PE1+~NSYLVANIA t ss ~(3gTN'~'Y ~F, CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will weU and truly administer he estate according to law. . . t Sworn to or affirmed nd subscribed ~'"` ti before me this _~ d f ~„~` ^.~ - - - a i ,~ ( ~ ^~", r . LEIti' Register: ~- h-i~--~~ .;.,.~ ._._~_.,~..._._._.~.~ - ---~,,,~i~..~~ L ~~, 21 - 35 - 79 ~,,,~~~Qy ~~ kEVEREiVG HAROLD Q SIPS ___,____, ~~~ r E~RUAR'f 1, 19 35 , in consideration of tlee pctitian on r`,.,;; Yev~.>;;,, sici~ 1~e:eoi, satisfuctary pzoef tta~ing ;seen presented bei'~re Arse, NOb'EMBER 5 1392 ~~' [S £;E~'~:..~f~ thRe t3-xe iszstruAnentls) dPted ~rs~ri%s<~'. i,v, z=.~ ~ c adArietcu to probatY and 61ezd of .-.ecord as the last iviil of _ _ _ _ REVEREND L~AROL.G 4. SIPE _~:~ ~ ~~~t;~°a~_ TESTA;E(~TA':Y ;R, J. 4dES~EY KUG~ER anJ MRS. ELEAi~OR BRICKER~_______ 1 2tgisttr Of Wi!!s MARY G. LEI,~lIS ~°-~ 4' 1 t~~s .:^~r~a. , Le<cezs, sec....... ... $ ip.GO ;`,- r~adC'S ~;1~, ...... FE6RUA2Y. 1.,~ .1995........ . ~"`- ~`~ O ~ i:l _- IV Q.. .. ~.l - -`~ - O % - ~ .. ,` LR p . ~ v~L r ~~ L' Cll Cf71_i.. ~~ `i: fY: .~ AT1'02NEY (Sup. Ct. LD. No.; ADDRESS PHONE h~it.i i~~J le~;,ters and orr~er to J. Wesley ftugler on 2-1-95. !~ a . 4 ' l E r .. - k x'~. ~y~~~Ay ~ x,G t ' ~ -_ ~s~ :< ~'~ '~ :. i v ~i , ,. . I,ABT fi1ILL i ~, OF ~' RSVERSND }HAROLD O. SIPS '~ I I i! 'I I, REVfiRfiND HAROLD 0. SIPfi, of the Borough of es l rairview, Cumberland County, Pennsylvania, declare this to be ~ ~~, my Leat Will and revoke any Will previously mnde y me. '~ I Ites< 1: I order and direot that all of my estate, real, lil'~ personal and mixed, be liquidated as soon as practioal after i' my deatr. The liquidation may take plane either at public or ~ private sale. !' Item 2: I bequeath the following sums of money to the it I j~ designated benePioiariea: tie a m ~ ~ ,' a ~ _~ a II Ij f' ~ i W oc II C _/ ~' , . ~F (A) Ten Thousand Dollars ($10,000.00) to my daughter, fiSTHER WITMfiR, of Hershey, Dauphin County, Pennsylvania. (B) One Thousand Dollars ($1,000.00) to BILLY GRAHAM EVANGELISTIC ASgOCIATION, Box 779, Minneapolis, Minnesota 55440-0779. (C) One Thousand Dollars ($1,000.00) to DISABLED AMERICAN VE?ERAAiS, Cincinnati, Ohio 45250. (D) One Thousand Dollars ($1,000.00) to FAMILY RADIO, Oakland, California 94660. CE) One Thousand Dollars ($1,000.00) to FREEDOM VILLAGE, U.S.A., ADOPT-A-TEEN PROGRAM, P. 0. Box 24, Lakemont, New York 14857-9990. (F) One Thousand Dollars ($1,000.00) to JEWS FOR JESUS, 60 Raight`Street; San Francisco, California 94102-5895. (G) One Thousand Dollars ($1,000.00) to ST. JUDB BHRIMB, Promotional Center, 309 N. Paoa Street, Baltimore, Meryland 21201-1896. L ;, . \, _~ i <_.: ~C J , ~t~~ • *~ ~~ Y ~ ,~,,. ~z"~%~. ~'~~4'a~~r M~,r ~,. ~~~~~ ~ ,, ~ ,»~,~ .. ~f. ~' {n h~'~)_rt1,~~-' '~, r i1, ~ ~ ~'v r ~~~ r °a±,;, 'fin 1 a x n ~ ~~ \ [h r Z'µ; C w 1 a f` ... / as a H 0 .a 0 (H) One Thousand Dollars ($1,000.00) to TRI-COUNTY ASSOCIATION FOR THB BLIND, INC., 2336 North Third Street, Harrisburg, Pennsylvania 17110. (I) One Thousand Dollars ($1,000.00) to "IN TOUCH MINISTRY" of P. 0. Box ?900, Atlanta, Georgia 30357-9979. (J) Ten Thovaand Dollar ($10,000.00) to the UNITfiD MfiTHODIST CHURCH, West Fairview, Cumberland County, Pennsylvania. i bequeath my tapes, two maohinea,. telephone and Five Hundred Dollars ($500.00) to the United Methodist Churoh of Weat Fairview, Cumberland County, Pennsylvanin, so that the Churoh can carry on a program in which I have a vital interest, namely: "Dial A Prayer Ministry". (R) Five Hundred Dollars ($500.00) to the Goodwill Fire Company No. 1, Weat Fairview, Pennsylvania 17025. (L) All the rest, residue, or remainder of my eatete, I devise and bequeath onto FRBSDOM VILLAGE, U.3.A., Adopt-A-Teen Program, P. 0. Box 24, Lakemont, New York 14857-9990. Itea 3: I direot that all taxes that may be assessed in oonaequenoe of my death, of whatever nature and by whatever juriadiotion imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. Item b: I direot that all my just debts and funeral expenses inoluding all expenses of my last illness, ahail be paid from the neaets of my estate as soon ae praotiaal sifter my decease. ~=t~~.;,~:. I appoint ?tR. J. W88LSY EUGLBR, 483 State Road, West Fairview, Cumberland County, Pennsylvania, and !lRB. fiL&ANOR ARICRfiR, 529 Third Street, West Fairview, Cumberland County, Pennsylvania, Co-fixeautora of thi• my Laet Will. _ __ _ .-,n ., ~_ _ __ , ~i I i '~i i YteB 6: I direot that my Derronal representative, or II their euooesaora, ohall not be reQuired to give bond for the ? ~~ `1 faithful performanoe of their duties in any 3urirdiotion. i _ ` 'i,ti ~' Yteea 7: I dareot that my body, upon death, be delivered ~II to the JOHN C. SULLIVAN FUNHRAL HOMB, North finola Drive, i ~~ Finale, Cumberland County, Pennsylvania; that burial servio,a ~ ~~`~^ i bw held et the United Methodist Churoh, WQrC Fairview, f 9 i Cumberland County, Pennrylvania; and that my body be buried ~I Rex't to my late wife's at Miller's Gross Road United Methodist Churoh Gemetery, Snyder County, Pennsylvania. ~/~ I~ IN WITNfiSS WHBRBOF, I have hereunto •et my hand this _y~~ i ~ i ; /~ ~ day of 1L,~.s1..hyti.~J.~A- , 1992. ~'I f I` ~~ j i I~ ~ ~ hD ~~ I~ R HA OLD O. IPB i \ ~, The preceding instrument oonaieting o! this and two (2) I other typewritten pages, eaoh identified by the signature of it the Testator, RHVHRHND HAROLD 0. SIPH, was on the day and date Il thereof signed, published and declared by RBVHRBIdD HAROLD 0. !i 3IPfi, the Tertntor therein named, as and for hie Last Will, in ~ ~.~' I '~ the presence of eaoh other, have subscribed our Haase as witnesses hereto. ~' 3 9 ~ ~ ~~`~ ~~ ;'. ~ , r residing at '~ Ii ~ .residing at ~ /~? /70f~ ~ , i~ I ~~ ~; , ~ k '~ , " , ~' i ~ =~ ~~" r ,~,y~;~~~y ~ . I I ~ ,'~r~~~ ~ ' Y ~~ ~ :19' ~i;~y N,y 0i.~.; J~ ~..~ .~ ~ tctA ~ F ~ . W 74'' a'-." ~, ~~~ r .,~ ~'~~; e..: •"-- ~tr,:_ ~,, ~ ~ - a5' _ +~^ ,, t~ ~~: ,': ,:I ": ~~ ~ ', { >, 1 ;, t ~ ~~. `~ ~ ..~ ~S ~~ r.x s ~::J ;, ~i a * i. ~~ ~c~ k ~fyY y ..'lY: ~ ~~ !1li II' COTSMONWBALTH OF PBNNSYLVANIA ) COUA~TY OF CUMBERLAND ) se ; i We, REVEREND HAROLD 0. SIPB, ~ N~ ~~ III and ~~<~ /~t'~7%E ~O.;f /~~ _ the Teatator and the witnesses respectively, whose names are signed to the i I I! nttaohsd or forogoing instrument, being first duly sworn, do it i heraby declare to the undersigned authority that the estator signed and exeoutsd the instrument as hie Last Will and thnt j he had signed willingly, and that he exeoutsd it as his free and voluntary sot 'or the purpose therein expressed, and that I j~ eaoh of the witnesses, in the pzaaenoe and hearing of the 'i lid Teatator, signed the Will as witness and that to the beet of ~' his or her knowledge, the Testator was at the time eighteen I i ' C18) years of age or older, of sound mind and under no ~~ oonetraint or undue influenoe. I~ ICI RBVBR HA OLD SIP W i ~G1 r r it i toes/ Subeoribed, sworn and aoknowledged before me ~; .~/~~t.y ~ ~ C--O y~E by RSVBRBND HAROLD 0. !i SIPB, the Teatator, and eubsoribed and sworn ':o before me by i ~~~, C- a~n/ ~ and .~/S .~ ~rs~.e'/E ~-; ~s~it~G= , the witnesses, this S~day of // ~"`^""'-"' ~ ~, ~I:~CXr!'/77 ,i otary Publio t88AL) ~; NOTAPlAL SEAL. EIIEEN B. COYNE, NOTAAY PUBUC HAMPDEPt TWP. CUMBERLMID CO, MY COMMISSION EXPIRES JUNE 28,1998 ~-.._ __ ~.,,, ~•~~~ `1~ '. . ~' ~. ~ _ ;:: `~ ~, ~ ~~w s~ ~ ,~~,. V~ ~K~,~r~ ~ ~: .~r~"Gt " *yvtK ~l,y ~_ ~ J~~~`h Y _ ',' ~ ; ~ ` y~ T ,, ~r~e „ ;•,~ +: 'M„~ ~Bc;Or~1f'C~~-~co of ~'~gi^.t~3r cf ~'~i?Is CE.ti'z I ~ZCr~h IO^t OF 1~OTICE U~iDER RULE 5. 6 (a } ~.Q=~r:<r .~:. urce:ient ~_Fia~~~ ~?. 3t~?e °9S FEE3 'I (3 A9:~d Ut~t:c~ of t7:atla:_e.~.s~~.u~~~trv 293., 149 Cleric- ~ :~:: Court 6r1~31C~,p,~i~ t~.~il1 tic,,,,---~9g5=Ota07~ Admin. No.~_7,~.95-0079 -~ certify that notice of beneficial interest required by f2ia ~-Q 5 • ~ (a; o€ the Orphans' Court °Rules was served on or mailed to '~~~' fvl.~o~:ing beneficiaries of the above-captioned ~2state on ~ie~e Address ?fz~. Egtrex Witmer, 9.655 ltiohard Ayenr.~.Q, OhambArsb,rg, PA 1.7201 tSrsi~:~ac_ ethod~~t Churoh 2nd & North streets, W_s _ rrA;rv;g,~,~ PA 17025 _Ti^t ~S?3rStiL`~~?~,1 £~~~Y_..r_~~ 4. boa 79Q, At 1w~nt.o __ (~A 3057-9979 ~'ri-vnunL-v Asaoo For The Blind rnQ._, 2336 N Third ~atree~ (Continues: c.n 2nd paxge) Harrisburg, PA 17110 23ntic2 has now been given to all persons entitled thereto under Rule 5 . 5 (a } excePt___ pia / / __ <J~~ -----~. S' ure sane r.: ~,. Mme..; m f,~yne )~saui re Address 39Og arket $ts~;:gt "~~Q_~~ i 1 PP i 701 ~ -~i2s';7 Telephone) 71 ~7 737- 4 Capacity: personal Representative X .Counsel for personal rep~esentat.ive -~'} .. - ~~ r ~ irk!. f ?', s' ' ~ P„ta-.~i .,s,,,,~. ),~ 4 4 ~M {,pL ~~ h ~ P ~~ [N~h YFr. WM ~ ~f _ ~ x ~.ec w.w,.a.. r, El~G .,. .. _ _ rtv ,,,k, .' ,1s `,`~~;~,~-A r~~• <3r~r..~y~'iai~A asztere~" area served on or m~il~rd to :~~; . .,~:~<'.~ :.,'°s ~i~c:, ~rosuotxo~acal. Center, ~Ef s H. P~so~. Strut, F~Filtimore, a°SLZ 21201-189~i C~o~canll ~a.re f~o~~~:ay ~~C?. 1, 3rd i~+ Abolition Street®, Weat 1rr~irvieat, PA 1?025 ~~ <<°~,~ar~r~ ~y,;;~.z~.koan. ~.Ieteranc~, P.O. Hox 1&3.01, Cinoinnati, OFi 1~525C-~i301 ~•,ar::r.~~a~ a-'.1.~.~~~, U~r?, Ar3Q,~t-r'1-Tee~a ~ro~ram, F.O. E~oar 2d~, ~.~.k;er~orzt , s'~Y 1455?-9990 ~si:iay !~z~h~~ ~,v~.n~wiietic Assoo., Hose 7?~, Minneeagolis, YatAT 55446-07?~ Jc-~~+~, ~~ra~° .3~~u~, b0 H~i~ht Street, San Francsisoo, CA '94102-5895 .:~a.;.._. a, <,.=~a.~, ~~~kl~z~d, Cab 9GE~~,O ,tT , ~~ ~, i E. ~~ I. f ,b k r ~ •.{ . S • i ' z O d O u t- asooEx. itt.ati Z W 0 W W 0 ~ ~>~ ~~~ ~° i W Y O ~O I ~z 2 O i= W t ~:~, ~ AtTM Of -lNNSYLVANIA MENT Of nEVENUE ~ ' tE-r. ztasot uiG.r~ n~er.,un, Sipe, Harold 0. 192-30-0565;' 4c1. Original Rofurn $ ` ^ 4. limibd Estoto ~~ ~. 6. D.ad.nr Obd T~~ ~Anodt copy of W#li •rl•r 737- 1. Roal EEtoh (Stitedub 2. Stodu and Bonds (Scfi 3. Cbttttly Hold StodJPai 4. Mortgogy and Mohr s. carp, Bank Doporit~ 6 (Sdtedttb E) 6. Joimly Ownod Prop.rt~ 7. Tranrion (Sdtedtrlo G) 8. Toro) Grata Auwt3 (teto 9. Funorol Exp.nroy Alm Exp.twer (sdtedulo H) 10. Dobts, Mottgego liabili 11. Total D.duclions; (total 1 12. N.t Velw of Etuoto (UM 13. Clwrirobk. and Govertw ld. Net Vdw Sub' ro Td 1 S. Ateount of Utt. 11 toxa (Indudo volws from 16. Amount of lire. 14 roxab (lndude volws frwtt S 17. P-indpal Inn dw (Add 18. Credits spouwl Po 19. If lino 18 is 20. If litre 17 is greater tk A. Error the interest B. Emer the total of ftitoke Cbedc 6 /i IN°OAR s~,~tHA1M AP'f[R 13/~1l91 CN[pC N[RE / - J5 =1~4 ~q IE YEAR N 446 State Road A A" A '" We;,t Fairview, PA 17025 1 1!95 9/22/09 Cv~t/3Cd'G,a~vD ^ 2. Suppbm.mol RMUrn ^ 3. Rotnoindor Rotttrn ((or data of dttoth prior ro 12-13.82) ^ 4a. Future Imtrrou ComPromiN ^ s. Ft>d.ral EStt»o Tax (for Bahr of loath ofhr 12-12-82) Rowrn Rtpuind ^ 7• ( Maim r~ua a wit-g Ttva d B. Total Numbs of Safe Deporit Box~3 ) NA .TAX 11N1toRMAT1oN sNOUtDilE DiIECTED•~ , ,~,, ,~ y r ,, E~~auir~ 3901 Market Street Camp Hill, PA 17011-422? /,5 /,nn nn B) (2) Non ip Ittloteq (Scltedub C) (3) None ~ebl. (seitodul• D) (d) None Ilott.otrs P.nonol Propottv~s 5, 6 6 5, 8 2 odttl. F) I I~% 1, 0 0 0. 0 0 tub U 7) _ IVnnA 1-~ (8) 62 , 065 . 8~ live Conn, Mirc~rllarttwtrs (9 9, 6 8 5. 2 4 lips, LIMq (sdtoduks q (lOt , 5 36.14 ~ ~ v a 10) ~ (11) 2 4-.221.3 8 Q minus Un. 1 t) (12) 3 7. 8 ~- h. 4 4 i~tMOl Bogwats (Sdtodul. J) ' ~"~ 16 , S5F ~/ . ~y k M 12 minus (in. 13) at tsw ^~ (ts) 10 , 000.00 duks K or schodub M.) (1 _ 2 / . DDD On 600.00 I at 1 s96 rot. (16) _ 1 '1 . n n n n n tylulo K or sdt.dub M.) x ~3'~ - 1. F~ 5 n n n t from tin. is and from Gn. ib.) • ~ 11 ~ 2 , 2 5 0 . 0 0 m' Credit Prior Poyttt.ms Discount ~ Intorost + + - (18) Ntt. 17, omor t(t. di(f.taton on litre 19 Tbis is tM OVERp None . AVME NT. (19) NQi7O I n• 18, ttmor tM difhrnp on litt. 20. This ii th. TAX DUE. (20) ? , 2 5 0 . 0 0 . ~. bobtta dw on line 20A . r, 20 and 20A on lire. 208. This is the BALANCE DUE (20A) . tbl. ts: Re~hMr of WUb, Aaeet (208) -- r--,^„ • -.•..r,~ ~qv~ ~ ngV..xanMMd Illif fNVIn, indYd ai00111 nr - - ---"'-'_^ •••••~•~T~ ~... _ ,:... hw, terra and otwnpleh. f ds+eion 11to ell not .slab has bairn n ~ Po rk~ xMdt*s and txoNtnenn, and to tIN bat of T ktufwl.d .and b.linF, ed on aU ittfo-molierr of whidt Pr'ePonr „ t any knowkidgn. t~ or trw nto at •olw. DadoroHon of pnponr otbar than tM y g A t~- u~ Wnonol npnwnwtiw i~ DA <, '~ / 7o~i ~, '. t' 1 ~ 1 / a ~/~ ~~~~ INHEkITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ~, ,~ ' :~ {I ~~ ;~ PLEASE ANSWER THE FO(.LOWING QUESTIONS BY PLACING A CHECK MARK (r) IN THE APPROPRIATE BLOCKS. ~ , i, 1. Did decedent make a transfer and: a. retain the use or incot4je of the property transferred, ....................................... ,~ b. retain the right to designate who shall use the property transferred or its income, c. retain a reversionary %nterest or .................................................................... d. receive the promise for life of either payments, benefits or care? ....................... 2. If death occurred on or before December 12, 1982, did. decedent within two years preceding death transfer ~toperty without receiving adequate consideration? If death occurred after December ~ ~, 1982, dial decedent transfer property within one year of death without receiving adequate consideration? ................................................. 3. Did decedent own an 'in f'r:ust for' bank account at his or her death? ...................... '; IF THE ANSWERS ~TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE~~S:CHEDULE G AND FILE IT AS PART Of THE RETURN. ~~.~ -119- .. REV-1502 E% + (12-85) ~ 4~1~&~', a(~ SCHEDULE A COMMONWEAI'H OF PENNSYLVANIA INHERITAtICE TAX RETURN I REAL ESTATE _ RESIDE dT DECEDENT ' ESTATE OF ` ~ FILE NUMBER _:-_ _. Harold 0. SiAe Pro ert ' ( p y ~olntly-owned with Right pi Survivorship must be disclosed on Schedule F) All real estate should be reported at fair morkef value which is defined as the price at which property would be exchanged between a willing buyer and a williny seller, neither being compeller to buy or sell, both having reasoridble knowledge of the relevant facts. ITEM ' NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~' ti~~b Str~tet Street, We3t Fairview, PA (See attached Settlement Sheet) ~t5,~t00.00 1 I ~, ;' '~ TOTAL (Also enter on line 1, Recapitulation) (If morn e.,r•~e ., .,,,,,.1,,.1 ..._..._~ ._-i c. i , S i 5 i~00 00 REV.1309 E%a (2.97) ~ Is r ~ ~ SCHEDULE E CASH, BANK DEPOSITS AND COMMONWEALTH OF PENNSVLV' NIA MISCELLANEOUS INHERITANCE TAX RETURN';, PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF ------ ----- Har_old 0. ~ ~ipe (All properly jointly-owned wish the Rig irF Survivorship muss be disclosed on Schedule fl ITEM ' ' NUMBER ?''A DESCRIPTION fF ~I~ '_ Please Print or Type FILE NUMBER ~/- ~5^ 00 79 1. Mellon Banl~; Checlcin~ Account No. 112-832-0??i~ 2. Meridian B~~nk - Chry~ltin~ Account A1o. 32295568 I' 3. Sale of Pe~~onal Propert~i ii . 1?~~I Federn~. Income Ta:: F.efund ~l 5. Mcdic.~rn R~~und ~, 6. Medicare F.a~'und 7. Oil Refund's i 8. Sewer Refur~ j 9. Sch~nl Tav G~,~f,,,-. .a VALUE AT DATE OF DEATH 2,68?.63 1 , ilb8 . C~9 ?65.86 lia~t,!J4 3!lil . `~3 9 , !I CI 273.81 8.31 8.75 !! :! TOTAL (Also entor on line 5, Recapitulation) $ 5 , 665.82 (At'f~~~h additional 8%" x 11" sheots iF more space is nooded.) 1 ;! ij ' REV-1509 ER+ (lY•88) ~~ i i' ~', } I COMMONWEALTH OF PENNSYLVANIA ~' INHERITANCE TAX RETURN RESIDENT DECEDENT i' I ESTATE OF { Harold n. Sipe ~; ~, Joint tenant(s): , ~ NAME p A• Eleanor M. Bricij r~r i~ ~. '~ I B. ~ ~! i C. II Jointly-owned property: ITEM LFORR DATE UMBER JOINT MADE TENANT JOINT ~ • ~ A ~ 11 /30. SCHEDULE F JOINTLY-OWNED PROPERTY ADDRESS 539 3rd Street West Fairview, PA 17025 FILE NUMBER i~/- 9s-©o7q RELATIONSHIP TO DECEDENT Friend DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF OF ASSET % INT. DECEDENT'S FNTEREST rtificate of Dc~>,oait No. 22,000.00 50% 11,000.00 12474, United Methodi:,t ntral PA Conference i TOTAL (Also enter on line 6, Recapitulation) (If more space is needed insert additional sheets of same size) 1 i, s s ~. oQO . coo REY 1311 E%t (7881 ~r~~±'~ COMMONWEALTH OF PENNSYLVANIAi' INHERITANCE TAX RETURN ' RESIDENT DECEDENT i ESTATE OF ~,_ Harold 0. Sipe , ITEM NUMBER A. 1. B. 2. 3. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. 5CHIEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES DESCRIPTION Funeral Expenses: John Sulliv~r~ Funeral Home ~: Head~ton~ at~ncl en~ravin~ Please P_r_i_n_t_or Type 3ER AMOUNT !~ , 5 5 /I . 0 0 70.00 a j i (' r`. F~ f;, r Administrative Costs` ! ~j Personal Represents 11Ve Commissions ~ Gt~'15i_r y K~^~ I•~-r Social Security Nmber of Personal Representative: ~ F' ~ ~' `~ - 'TG `~ G C/L~~-r~-o-~*i /Z~ ~~.,,~.~ cltrr iG+-~ - 3 v ~ - fI t'1 :: y Year Commissions paid -j~~r ,; Attorney Fees Henn--~ F . Govne , E~ou i r~ w~. Family Exemption ~; ; NSA Claimant Relationship Address of Claimgrnt at decedent's death Street Address City State _ Zip Code Probate Fees Miscellaneous Expen~~s: Patriot News`„"- Advertise Sale of Ho:,pital Bed David Bricko - Hauling Trash Capri Corner"„: 'L-TD - Cement Work at House u , Century 21 a~ the Helm - Commi~5ion r. Realt?, Tran~~;'er Tax (1'/0) 3.00 point Lean Di:;count !' !' J. We~lev K.u~~ler - R.epair~ to house, paintin>; hou:,o for gale, oup'~1ie~, ~nocv removal Sara Kugler sCleanin~ house: hauling trash: lawn care; p~.iititin~ (If more TOTAL (Also enter on line 9, Recapitulation) ~aace is needed, insert additionol sheets of some size.) 3,100.00 3,100.00 138.00 23.80 176.00 920.00 3,0?3.00 ~/I 5-/-I-0 0 _. 1.022.00 789.Or~ ,. .. Es tate of Harold? O. Sipe (Decea:,ed) Continued ~/-qs-o~~~9 SCHEL~L-LE H - Coi~!t inuod : q• Leal Advert~i~ement - Patriot News ~" - Cumberland Law Journal 62.71 10. ' Feeo to Norh~:,t - Settl ~ . 00 ement cost:, 1 ~ 11. !~ Borough Tax ~ 7 l.' l.' 0 1>. ' County. Taro 1.6.38 ~ 13. ~ Filing Fee +-aInhoritance Tax P.eturn . 22.07 1/~. ` Ses~~er and Tr~.~h 15.00 15 . ' PAG1C (Feb - (~ulv ) 69.00 16. f; ~ PP & L (Feb ~-~ July) 53.27 17. F.e~erve:, 101.85 18. Po:,ta~e - Ce ~ti 200.00 .x fied Mail 19. Haar' A 1~ ~ '' . 5 2 ucti n Feo 4 f I~ 238. /a0 ;~ ;~, ii I! ~, 'I i' '~ it ti i~ ' p +. tlt fG "' l ~,:. `: ,! '~i ~. P I 'l ~~, ~; ~' E i 4 TOTAL $19,6 5.2/~ , 1 I ~~~ ~ ~ COMMONWEAIiH Oi PENNSYlVAN1A ~ ~. INMERIIAN<E TAX RETURN ~- ;~ RESIDENT DECEDENT ESTATE OF Harold O. S'~k~e SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABLITIES AND LIENS FILE NUMBER ~r-9~ ITEM ' ' - NUMBER ~ 1~ DESCRIPTION AMOUNT y; - 1' Leader rlurs~i~4~~ Home /t, 536. Iii ~. i V ~~, ~' '' y i ~ r I t k~ ~ ~~ ~' al' 1I ~~ I ~ 4 I: jj,~ ryi I t ': 1. I~: {I "~ I $' S ~I fl' 4% f 1 I. 1 t" iii 4 a _.______.__ ~ ' TOTAL (Also enter on line 10, Recapitulation) $ , 536 . 1 /! ~, (It more space rs needed insert oddifionai sheets o/ same size) !q i . RL-+ 1517 EXa ~7-87) 1 ' r 1' .~:-. . COMMONWEALTH OE PENNSYlVAN1A ~: INHERITANCE TAX RETURN __ RESIDENT DECEDENT ESTATE OF ~; y Harold 0, ~ ~ ITEM j ----- -...- NUMBER NAAAE AND ADDRES A. Tuxoble Bequests 1. ~ y E~thcr Widmer 1655 R.ich~~d Avonue Chamber~b" lrq, PA 1' ~;~ I~~ ~I, ~~,~ ,, j, ,: ;,~ ~i i.. i~ ,' i ~~ SCHEDULE J BENEFICIARIES ITEM ` ' - - NUMBER j ~ NAME AND ADDRESS OF BENEFICIARY AMOUNT OR - _ SHARE OF ESTATE B. Charitable and GQ~yernmental Bequests: ~ --- ~. Bi1117 Grah~m E~7arr;eli~tic A~~oc. 1300 Harmon Place Minneut~ol.~ , M.I~1 55~t03-1988 `~ 1,000.00 ?- L~i~abled :~,'erican Veteran:, P • n . Box ~u~301 Cincinnati! ~ OH ~t5?50-0301 1 , 000 . OQ 3• Family St~~ion:,, Inc. 6?9 Wachint#ton Blvd, Suite B-1° ~; R.aaevi l 1~ ,.. ':CA '?5678 1 , OOC~ . 00 , 3 f i TOTAL CHARITABLE ,AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $ .--------------- ------ _ ~ ROO t ~ftOs _ ____ _ _ __ /9 00 -t-, - ----- - - - _ (If more space Ls needed, insert additional sheets of same size) - ~j. FILE NUMBER ~- l-9s' ao~79 ~ i j I' Estate of Harold! O. Sioe <Decea:,ed) Gontinued i SCHEDULE J_- Coatin ~~. Freedom Vi ~a~e, USA Adopt-A-Te'm Program P . O . Box 2 Lakemont. Y 1!857-9990 5. Jews For J ~~uc 60 Haight reet San Franci,co, CA 9i~102-5895 b. St. Jude SH~ine Promotions ' l'Center ~; ,, 309 N. Pac~j'; Street Baltimore, D 21201-1896 ~! 7. Tri-O'ountzr k }vaociation For the Hlind, Inc. 2336 N. Th~'?~d Street Harricbur~,q~Pa 17110 ~~ 8. In Touch M~rietriec c!o In Tou~h Foundation, Inc. A'TTN: F.obq~t Petmeck~i P.Q. Box 6~g362 Atlanta, G~; 30362 9. United Meth~~dict Church 2nd & Nortl iStreet:, Wept Fairvii~}w, PA 17025 10. Goodwill Fire Company No. 1 Third & Abq~lition Street taut Fairvi,e,~~~, PA 17025 ',' 11. Freedom Vil`~l;a~e U.S.A. P - O . Box 2 /i.' '. Lakemont, ICY 1i~857-9990 f F ~- M !•. /- 9 S -007 ~ 000.00 ,000.00 ,000.00 ,000.00 1,000.00 10,500.00 500.00 F dual Eetc 1. r ~I ~~I 9j ; t .' w a H 0 A .~ O a x [~ Z w W W a ~f LAST WILL 'e O F ~` V REVEREND HAROLD O''~ SIPE iI~I' 'II I, REVEREND HAROLD 0. SIPE, of tie Borough of West Fairview, Cumberland County, Pennsyly nia, declare this to be my Last Will and revoke any Will previously made by me. Item 1: I order and direct tha~;;all of my estate, real, i personal and mixed, be liquidated asi4oon as practical after my death. The liquidation may take pace either at public or private sale. Item 2: I bequeath the following sums of money to the designated beneficiaries: ~ (A) Ten Thousand Dollars ($10,000.00) to my daughter, ESTHER WITMER, of Hershey, Dauphin County, Pennsylvania. (B) One Thousand Dollars ($1,000 ) to BILLY GRAHAM EVANGELISTIC ASSOCIATIO B~x 779, Minneapolis, Minnesota 55440-0779. (C) One Thousand Dollars ($1, ~.00) to DISABLED AMERICAN VETERANS, cinna~i, Ohio 45250. (D) One Thousand Dollars ($1,OO~I 0) to FAMILY RADIO, Oakland, California 60, I'' (E> One Thousand Dollars ($1,OQI` 0) to FREEDOM VILLAGE U.S.A., ADOPT-A-TEEN P GRAIF, P. 0. Box 24, ' Lakemont, New York 14857-9~~0. (F) One Thousand Dollars ($1,OOk 0) to JEWS FOR JESUS, i ~: 60 Haight Street, San rancr~sco, California ~~ 94102-5895. '' (G) One Thousand Dollars ($1,00 ) to ST. DUDE SHRINE, Promotional Center, 309 r acs Street, Baltimore, Maryland 21201-1896. -_ i s !~ X00 00) to TRI-COUNTY (H) One Thousand Dollars ($1, ASSOCIATION FOR THE BLIN INC., 2336 North Third I' Street, Harrisburg, Pennsyly nia 17110. I ' (I> One Thousand Dollars ($1,Q'000) to "IN TOUCH ,, i ~~ MINISTRY" of P. 0. Box 7900,'Atlanta, Georgia i,i r,~ 30357-9979. ~{ (J) Ten Thousand Dollars ($10,OQO;.;~DA> to the UNITED `-,' METHODIST CHURCH, Weat Fairv~ew, Cumberland County, i. Pennsylvania. I bequeath my :`tapes, two ~achinea, ~~ telephone and Five Hundred D liars ($5A0.00) to the v~~' r United Methodist Church of Gl at Fairview, Cumberland County, Pennsylvania, so the the Church can carry 1! ~' on a program in which I havq a vital interest, ~ i ~~ namely: "Dial A Prayer Min; 'try ;; ,~,/ ,I 1 ~,~, (K> Five Hundred Dollars ($50Qr1 ) to the Goodwill Fire 'f ~, ; Company No. 1, West Fairview,., Pennsylvania 17025. , ~~ (L) A11 the rest, residue, or re, ~ n¢~er of my estate, I ,I ~ ; / devise and bequeath onto FRE D~YM VILLAGE, U.S.A., ;, ~; Adopt-A-Teen Program, P. 0~,,ox 24, Lakemont, New ~ ~ ~`~ York 14857-9990. l !~~ ~ d Item 3: I direct that all taxes tlIhat may be assessed in consequence of my death, of whatever rta(ture and by whatever I I jurisdiction imposed, shall be paid fr m my residuary estate as a part of the expense of the admini'„tration of my estate. ~' W ,~-, Item 4: I direct that all my just debts and funeral o expenses including all expenses of my ,last illness, shall be '1~ ~ paid from the assets of my estate as sdon as practical after O I~' ~ my decease. p Item 5: I appoint MR. J. WESLEY UGLER, 453 State Road, West Fairview, Cumberland County, Pennsylvania, and MRS. a ELEANOR BRICKER, 529 Third Street, Weat, Fairview, Cumberland ~~, ' County, Pennsylvania, Co-Executors of a~hia my Last Glill. .y i If, f +' It_ em___6: I direct that m ' Y Aerson~l representative, or l their successors, shall not be requir~d to give bond for .the faithful performance of their duties x'n any jurisdiction. f,! Item 7: I direct that my body, A ~~ upon death, be delivered ~~ to the JOHN C. SULLIVAN FUNERAL HOME ,~ gNorth Enola Drive, Enola, Cumberland County, Penns lvani~ Y that burial services be held at the United Methodist Church, Weat Fairview, Cumberland County, Pennsylvania; and that m Y body be buried next to my late wife's at Miller's Cr;~sa Road United Methodist Church Cemetery, Snyder Count ''~ Y, Penna'yi,lvania. IN WITNESS WHEREOF, I have hereur~';to set m ~ ,•,,~, ^' Y hand this '~_ day of r 1/ ~,~„~~~.t__~ 1992. ' I~ ~ ~ ., a /~ ~ , +REV~ E HAROL O. SIPE he preceding instrument consist g of this and. two (2~ other typewritten pages, each identiff' ~ d by the signature of the Testator, REVEREND HAROLD O. ~ SIPE; was on the da, thereof si ned Y and date g published and declareQi by REVEREND HAROLD O. SIPE, the Testator therein named, as 4 d for his Last Will, in the presence of each other have subsc ibed our names as witnesses hereto. _ ~ ~ 90 residing ate ~ ~ `/ ____residing at ~,+ ,~ y i ~{ i~, -- ~4 II x 1' COMMONWEALTH OF PENNSYLVANIA ) ,i ~' COUNTY OF CUMBERLAND > ss: I We, REVEREND HAROLD 0. SIPS, ~"~~ f' - • ~~Rr~ t ~' and 11S.a rli~~~ Cyo~NG . ~, the Testator and ~~. ~~~ the witnesses respectively, whose nam¢ are signed to the ~E' attached or foregoing instrument, being first duly sworn, do I'. hereby declare to the undersigned autl4~rity that the Testator ~, signed and executed the instrument asii~is Last Will and that he had signed willingly, and that he e~tecuted it as his free i and voluntary act for the purpose ther~in expressed, and that i i each of the witnesses, in the presence1and hearing of the f. Testator, signed the Will as witness acid that to the best of ~'. ~ his or her knowledge, the Testator was`~at the time eighteen lt7 ~'. CA (18) years of age or older, of sound m nd and under no r';f "~ constraint or undue influence. ~ ; r i ~~ :~ ~ ~. CJ'- REVEREND HA SIB Wi s ~~ '1 /~ y+- i ~ C/ tness R ~. ~, ,; .Subscribed, sworn and a nowledged before me ~~e~n/ ~ y,~~ ~ . by REVEREND HAROLD O. 5IPE, the Testator, and subscribed anc~,sworn to be/f~ore me by ~~ /U /1 `/ /~'. [.._. Gyi/C and ~ S ~ . ~1 ~ /L :. o ~ G , the witnesses, this -s`~ day of /C...~ ~L~C_-C~P~ Notary Public EILEEN B. HAMPUEN MY tiAMMISSI ~ Lr.~'v _J~---- (SEAL) A IAL SEAL "f E, NOTARY PUBLIC IP CUMBERLAND CO. i PIKES JUNE 26, 1996 e