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Home My WebLink About95-0108~I -q5 ~dlag 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. Date AUG 16 200 f Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 N,os.uaR... zATT TY-E?"'"T M COMMONWEALTH OF PENNSYLWIlpA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH aWERLE NU11aB1 v V L _ _ _. REAYAlIBIT BuacBa NAME OF DEGEOEN,IFnl MW7a, EaEO ,. e.~ie~7TH 6~eHKO SE% a. FMAte~ aOCIAI SECURRY NUMBER ,.~sq -ay -84-78 ORE OF DEIPN JMrdI. OaA ~aerl •. i~aCA ADEtLareilald.rl uN0611 YEAw OIbFJ1, Dlr oaeassB„N eBrtl.,ACEIay.aa p,ACEOSOERNIaN Ei antym.-r.:.ECw.marr ad.l 5 MEnika = Dare 8 Haub t MYNIr IMarWI. Dr{, War) 9~boFuuDlCamN N, O SR, ~.L,~(~ ^ ^ //A1 N~ Yle COUN,YOF DERV CJMt'it'LLnNU ~ _ 9~~a `~9 SIA~NLQEf,CISj /~J~• ^•^'^'C' ENOUpIrM 7. CITY, BORO OERN !NAME pI nElarYwan. gira,arlan0runbw) --//'' ~ • P~/l/A!S$Ea£U ~~Y .SP~r7 ~ ~,SpiTU~ DOA Iblb ^ WAB OEC®FM ORNISMNIC OIIIBBI7 ~.~I:~.~'~''D'°"` Rri4s^ (SpiEYI^ RACE-AEaNlrn rdirl BNaLW {/~/d 7rE DECEDBIT' uBUJIL OOQIMIDN KBDOF BUSpESBRNWSfRY wAe EVERW OECEDEITSEOI1GfgN MARI9K SLQUB•Mrrrd SIIRYMBIB BROE/9E IDw a.~wumlre.~m41 wMw u.a:ARMEDRORCES'r ° C Nr.Mrdaawlse..a olr"c.'IOwaN a.+..v»mronlal.w rn ly $LY 1Ce~-fAKY i G. EVA G• w^ Ro~ wn'a~eO "wq ~.I ~1ab D ' ~ 's 'i } '~ /voec.E o ' oECEnENrBNMUIDADD11Ef6(ArL ~,E~ .91Y•.zocaad ` ~'" DECEDENTS ~ ~ HAS /',~t~ e ~ fC Ll 9 oS ra./Jo CC ACR/AL ,7a 9Y. ~R..O~wbaN.A Y. DM ,7a MaG P~- »°ss RESIDENCE n.ueaan. a.o.e.a Mra u l mans •de1 ,TC JAa bc2UnJD ~~ ,Ta^,.EBiIE~Bb~ra RKfIIER'B NAMEIFrq Middle. LeEB ,,. 6co~r {tGr2rS M07NE11'B NAME MeieenSunamsl ,.. TIiA Sid/Pc,e NfORW,MT4 NAME Ri'a~rV SMABIIq ADpEDB ae.EL CaE~EbNR.srr.zncada rC.nN/+~.D owe= 317 ENO 5'j: NC-'+A~ 0~+-+15~<tM+o PA• /7070 MEnaboRDIBRDBIrIDN GFDIBPDerrlD,l wECew D~ROarrloN•Nra.acNaNErr<b•aNbn LOCRION-DW/B+eeESIr.,A,e•d. BIeIb ^ CrerneElEa ^ RemEEb Aaal9le,e^ ® ^ . DM. WbI ~ c• vOtlw 7r)b ++ //~~ /~ D•rWR Dlart h4naEilyL j-9.S rs ~-~ ~ e. r-N ~~ nAN, rY ~iEY'7~j /~EGISTi~;~ y /~'/~rL/} /q BgNRURE OF FlBIERAL UCENBEE AB BUCM LICFNBE Nl1MBER NAYS ANDADDIEBBOF RECBRY ' q~{Q ,,.,0/~7S5-L ~, NEILL ~'jj. 3 yo/ HAfXfT ST ~r~,l HJU ~'y. i7o~ ErAb aaa2 ony ebwyay tl. rwa rbWedpe,a.EEa oavndrdrmlw a.b alld pros Ne,Ed. UCEESE DRE S1011E0 BM•~raaaAaBEBIe ba.aeE.nb .rarrl •rd4'erbeddaeM. D.y.u.n 77e asaanEwWaallplbEaq op DERV oREPRONOIN,CEDOEADIMOrin.Oeµnvl . WABCABEREfERREDlOMEDICALE7fAMYERICOR0NER7 .w•wllwle..a..n. /~+-- ! , ~ U 7 -~ yr ^ N• Y-~ / J M. 'µ aI7. RMRk EnrrMd4eree, MyurWaraorap4rarwNr abM Yle dawn. D•na enrrBlemoe.aala4 eudEr or rnM. rxaa Mr,rMn. ~ACMO.wrr MR7R OIMrdP~+e rrlSlblamla4WnBbdrtl4W W OnlyarbfJlMemaaalar. IiiblwlMrwl nEInwYNyilb Ewdrµgrw yrRb RYRI. BBIIY~TE IF~ral C N S Nwflip in aEEl11-_ larrandbrl i ~ . C ~1 DIE IOfOR ASACONSEWENCE OFy AIbRY/Yadglrl~ ,~ ~ ! v __ BanEErNapbYrallaAab Enb EBOMLYBIB OUE W(OR ASACwsEDUENCE OFI: I r CM/BllOlEeen or+lleY i Mdleledewr DUE IO,DR ASACpJ'.ifOUENCE OFk rrIAINBn aEn4 WT I WAB AM AUIOpBY WERE AUfO1BY f11dNG9 HANKER OF OERH DRE OFINNIRY TIME OFIN.AWY BUURYR WORK? DESCRRIE 11014 INJURY OCCURRED. pERFOR6IED? P,MOR lD PEann. pay, 1141 °F~ NrrY Eb kid ^ OFOF DGVN9 m e We ^ Ne ^ A~tiaEa ^ Perdlq rl'•NIDYIOn ^ M yYe ^ N• ~ 1'ee ^ Na ^ 9uldae ^ Car rlal0eaebrrllYled ^ . PLACE Of INJURY • p amM. Ierm, MINI. rEaarK aBr LOCRION (SaeeL CeyRwa, Smrl ~K •r~ ISPEeN1 aM. z,. aN. aar. ODafMBR iCAeeA mr, mN TITLE OF FIER •O6,TMYBKi PNYBICJAN (Pl.ya~w.carElyinq ollNa awn wns. ananer anr•eyn Iw Pmwcatl W W anoewrOM401mn Yal Ts M Ma a •M IulwrdBa, deMAaaeurlad dEw b M eaEN•fel•N eNnnr N WEN ............................................. ........ ' 'PROIIOEBICJNB AND C6ITIFYWO PNYBICIA11 Pa a a W l1CE //N~UMBER DRESKi11ED IMOrN. Dpc`Mrl ~ COn be y lpmwncnp ae leMl Glalpngrocauaed aeon/ I T•IM Gw,awlTkMwrdB•.aaBEe•eINMrUle,rr,aw,raq.N.eN dwbaM earel•IeN mannxN Wra .................. ........ ^ ,J ~~ a,s. at -MEDIC EI M NAME AND ADDRESS OF WNO COMPLETED CAUSE OP DERV Dram 271 Typearprix ~R~ PeTF°~ gn.,E~e M.a. AL G NIER/CORONER Ow tlb kaW o1gaRMRrIOn andla Mlnraatgellon, in my apfnidn, deatll •CCUrrW at,M tNne, dra, and pres. and due to,IEe eauae(a) alEd rKanmrrrard ~ ^ ~ ~ ' OTC /6 7 LOB a e... y7J kX ST ................ a,.. .................................................................. ......... ....... am GrnoyJ~Ea7Pn• /~• 43 REGI 'S SIGNRURE AND NUMBER DRE FlLEOMmn. OaY.'barl /99s ~3 ~BA/urv+2 ~. n . , aa.. ~ a 1 REV-15oD Ex+ (7.9a1 ~ ~" FOR DATES OF DEATH AFTER 12!31191 CHECK HERE INHERITANCE TAX RETURN IF A SPOUSAL ^ POVERTY CREDIT IS CLAIMED RESIDENT DECEDENT FILE NUMBER COMMONWEALTH OF PENNSYLVANIA DEPART ENT F VE (TOB E FI L ED IN DUPLICATE 21 95 U108 M O RE NUE DEPT. 280601 .s / ~ WITH REVISTER OF WILLS HARRISBURG, PA 17128A601 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS BUGHKO, ALEl2EITA Gauntry Meadows W SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH 4905 E. TrlTldle Rd. W 159-24-8278 1/22/95 9/18/09 Mechanicsburg, PA 17055 c°~ p IIF APVUCABLEI SURVIVING SPOUSE'S NAMF (LAST, FIRS1 AND MID°lE ~NITIALI SOCIAL SECURITY NUMBER AM I INSTRUCTIONS) ~++ ~] 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return Y a ti (for dates of death prior to 12-13-82) ,".,dcY.s ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Re ulred q =OZ° ~ (for dates of death after 12-12-82) c m ~] b. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach copy of Trust) AlL,CORRESPONDENCE AND CONFIDENTIAL TAX_INFORMATION SHOULD BE,DIRECTED TO::- Ly W NAME Richard W. Stewart, ESSC;. COMPLETE MAILING ADDRESS Johnson, Duffle, Stevlrart & Weidner ~ o TELEPHONE NUMBER 301 Market St. , P. ~. BOx 109 7 7 7 -4 1. Real Estate (Schedule A) (1) ~ ~ ~ ~7 t 2. Stocks and Bonds (Schedule B) (2) ~ - `..~ 3. Closely Held StocklPartnership Interest (Schedule C) (3) u ~, - -, ~ - 4. Mortgages and Notes Receivable (Schedule D) (4) _.., - 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (5 ) 26,525.94 ~ `-' Z (Schedule E) t- - _ Fp- b. Jointly Owned Property (Schedule F) (b) - ~~` ' CVa-= "' ~ T,1 ~~ u~ ~ 7. Transfers (Schedule G) (Schedule L) (7) r :- Q "'~. a 8. Total Gross Assets (total Lines 1-7) (8) 6,525.94 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) 1.861.88 Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 8 10) (11) 1,861.88 12. Net Value of Estate (Line 8 minus line 11) (12) 24,664.06 13. Charitable and Governmental Bequests (Schedule J) (13) -0- 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 24.664.06 15. Spousal Transfers (for dates of death after b-30-94) See Instructions For Applicable Percentage on Reverse (15) x, = -0- Side. (Include values from Schedule K or Schedule M.) ' _ 16. Amount of line 14 taxable of b% rate (16) 24.664.06 x .ob = 1, 479.84 (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable of 15°k rots (17) x .15 p -~- c (Include values from Schedule K or Schedule M.) a 18. Principal tax due (Add tax from Lines 15, 16 and 17.) (18) 1,479.84 d 19. Credits Spousal Poverty Credit Prior Payments Discount Interest + + 73.99 _ (19) 73.99 a 20. If Line 19 is greater than line 18, enter the difference on Line 20 . This is the OVERPAYMENT. (20) ~ ~ ^ .. 21. If line 18 is greater than line 19, enter the difference on line 21 . This is the TAX DUE. (21) 1, 405.85 A. Enter the interest on the balance due on Line 21A. (21A) -0- B. Enter the total of Line 21 and 21 A on Lins 21 B. This is the BALANCE DUE. (21 B) 1, 405 _ S5 Make Cheek Payable to: Register of Wills, Agent ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE 31DE AND TO RECHECK MATH Under penalties of perjury, I declare that I have examined this return, including accompanxing schedules and statements, and to the best it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of prepare, other than I based on all information of which areoarer has env knowledge. ~w i~RC ur r[rtaurv rVrvJ~tll[ hV ILING R ADDRESS 317 Reno St . C _ ~~n "Z~~` New Cumberland, PA 17070 ~wnvlTi7 RrA-o'rT1e~~Cn DER 7MAtd'RF'-Rf JEhT^'A~iVE ADDRESS 301 Market St., P. O. Box 109 - ~'~~~-(~ y"~ ___ Lemovne, PA 17043-0109 Richard W. Stewart, Esq. a If my knowledge and belief, le personal representative is DATE ~ ~ ,~ ys DATE ~ / ~ y~ Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rotas as prescribed by the statute will be: • 3% (.03) will be opplicabls for estates of decedents dying on or after 7/1/94 and before 1/1/96 • 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1 % (.O1) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance-tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (-~) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: 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, ............... X c. retain a reversionary interest; or X ................................................................................... d. receive the promise for life of either payments, benefits or care$ ....................................... X 2. If death occurred on or before December 12, 1982, did decedent within two years preceding X death transfer property without receiving adequate consideration$ If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving X adequate consideration? ................................................................................................... 3. Did decedent own an 'in trust for'. bank account at his or her death$ ...................................... X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. • is'~ - ~ - .~ ~~tt~t mill ~zn~ (7~ PsYttmPnt OF Alfretta Buchko I, Alfretta Buchko, of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my last V4~ill and revoke any Will previously made by me. ITE`:I I. I devise and bequeat~i all of my estate of every nature and wherever situate in equal shares to such of my children, Joyce M. Otten, Gwenda L. Zakis, Beverly G. Sheaffer, and Ronald C. Howe, as survive me by thirty (30) days. Should any of my above named children predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath the share of such child to his or her issue, per stirpes, living on the thirty-first (31st) day following my death; and should any such child of mine leave no such issue living on the thirty-first (31st) day following my death, I devise and bequeath the share of such child to my issue, per stirpes, living nn the thirty-first (31st) day following my death. ITEM II. I direct that all taxes that may he assessed as a consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEI`i III. I appoint my son, Ronald C. Howe, Executor of this, my last Will. Should my son, Ronald C. Howe, fail to qualify or cease to act as Executor, I appoint my daughter, Beverly G. Sheaffer, Executrix of this, my last Will. ITEI~i IV. I direct that my Executor or his successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITE1I V. I direct that my Executor or his successor shall servz without cumpensation. IN WITNESS WHEREOF, I, Alfretta Buchko, have hzreunto set my hand and seal this %c/% ` day of • ~ ~ . ~ ~. , 1993. - ~ ; f (SEAL) Alfretta Buchko SIGNED, SEALED, PUBLISHED AND DECLARED, by Alfretta Buchko, the Testatrix above named, as and for her Last Will and Testament and 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. Witness Address Witness Addre~`' ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND . I, Alfretta Buchko, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I sinned it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Alfretta Buchko Sworn to or affirmed and acknowledged before me, by of'~~-- ~-- , 1993. ~, the Testatrix, this ~~i ~'' day l~ -~ ~- Notary Public ~ .~ 1~4y commission expires: (SEAL) ~_~___._. __._._..... _. ._-..____.._._. _._._.., _J ~ -_ I ` AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA , COUNTY OF CU1~IBERLAND :SS: ~..- We, _~`,::_.:,,. k. ~~~~"- ~' and /J~,:., ~..:. ,;~ti.f~ ,the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were resen and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and ~~0.'untary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed tha Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. i~J~+l L~ Sworn to or affirmed and subscribed to before me by ~2 .~.~, y~ ,~: - witnesses, thisiy`''day of~~.. , 1993. ''"ate ~~'~''=~~~=. ~-;~.,;Y- ._ Notary Puy}. ' My commission expires: (SEAL) IE:~Cr!iE 3J~J. ,;;„tdERLAt~D Co. y'~ CC`>r••I55IQV Ez?IR=_c pEC. 2r, 1953 REV.ISOB EXr (7871 CaMMONWEAITM Of PENNSYLVANIA INNERRANCE TAX RETURN RESIDENT DECEDENT BUCHKO, ALFRETTA SCHEDULE E CASH, BANK DEPOSITS AND M{SCELLANEOUS PERSONAL PROPERTY Please Print or NUMBER 21-95-0108 (All proposrry jointly-owned with the Ripht of Svrvivership must bo disdosod on Sehedub F) ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH 1. Dauphin Deposit Bank & Trust Company Checking Account No. 0018490417 Date of death balance 5,031.85 2. Harris Savings Bank Money Market Account No. 05-05-002125 Date of death balance, plus accrued interest. 19,132.16 3. Country Meadows - refund - month of death 2,361.93 TOTAL (Also enter on line 5, (Attoch odditional 8K" x 11" shNts ii more spoco is n~ed~d.) S 26,525.94 REV.1517 EX+ (788) " ~.. ~, ~ SCHEDULE H ~.~: ~ `~ FUNERAL EXPENSES, COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES RESIDENT DECEDENT ESTATE OF BUCHKO, ALFRETTA Please Print or JMBER 21-95-0108 ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: 1. Neil Funeral-Home - funeral expenses 690.00 B. 1 2 3. 4. C. 1. 2. 3. 4. 5. 6. 7. S. Administrative Costs: Personal Representative Commissions _ Social Security Number of Personal Representative: Year Commissions paid Attorney Fees _ Johnson, Duffie, Stewart & Weidner Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code Probate Fees - Register of Wills - Cumberland County Miscellaneous Expenses: Cumberland Law Journal - advertise letters The Patriot-News Co. - advertise letters Register of Wills - file Inventory & Inheritance Tax Return Harris Savings - Estate account checks Reserve for close-out costs 900.00 80.00 40.00 62.71 25.00 14.17 50.00 TOTAL (Also enter on line 9, Recapitulation) I$ 1, 861.88 (If more space is needed, insert additional sheets of same size.) REY~15U C%r P•67) Q. 1' COMMONWEAETN OF PENNSYLVANIA INNERITAHCE TAX RETURN RESIDENT DFCWfNT ESTATE Of BUCHRO, ALFRETTA SCHEDULE J BENEFICIARIES FILE NUMBER 21-95-0108 ITEM NUMB ER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequests: t. Joyce M. Otten - 426 N. Pitt Street Daughter One-fourth Carlisle, PA 17013 Residue 2. Gwenda L. Zakis -Box 301, R. D. #1 Daughter One-fourth Landisburg, PA 17040 Residue 3. Beverly G. Sheaffer - 539 65th St. Daughter One-fourth Rutherford Heights Residue Harrisburg, PA 17111 4. Ronald C. Howe - 317 Reno Street Son One-fourth New Cumberland, PA 17070 Residue ITEM NAME AND ADDRESS OF BENEFICIARY AMOUNT OR NUMBER SHARE OF ESTATE B. Charitable and Governmental Bequests: 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) I$ (If more space is needed, insert additional sheets of same size) cry c~ 0 ~_ cha ~~: ~._ L"7 Cfl