HomeMy WebLinkAbout95-0113I ~~ ~ v ~ ~~
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.
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AUG 16 20aT
Date
H105.,~3Rw. 2/87
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Fran eropoli, ' act
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH ~ ooa ~~ /n
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, ,r.a, noise, us) SE% SOCML SE{TIRTTV NIMS7ER _ __ DATE OF DEATH (Mren, Dey, lYer)
,. HsncMl V. Frost :Male s. 199 ..._ 07 _4862 ~ January 17, 1995
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NAME AND ADDRESS OF W/q COMPLETED CAUSE OF DEATN
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
7ECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Frost Hershell V
iOC1AL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH
199-07-4862 01/17/1995 09/02/1918
APPLICABLE) SURVIVING SPOUSE'S NAME (LAST,FIRST AND MIDDLE INITIAL)
1. Original Return
4. Limited Estate
^X 6. Decedent Died Testate
(Attach copy of wll)
ALL CORRESPONDENCE AND
NAME
Roger B. Irwin
'ELEPHONE NUMBER
717-249-2353
3.
~5.
0 8.
CHECK HERE
AMOUNT RECEIVED (SEE INSTRUCTIONS)
0.00
Remainder Return
(for dates of death prior to 12-13-82)
Federal Estate Tax Retum Required
Total Number of Safe Deposit Boxes
LETE MAILING ADDRESS ('~ ('~
IRWIN, McKNIGHT~_ r_~'HUGHEB
60 West Pomfret-'Street f
Carlisle PA 17b1~ --
1. Reat Estate (Schedule A) 1 5 ,
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Hekf Stock/Partnership Interest (Schedule C) (3) Noi3e
4. Mortgages and Notes Receivable (Schedule D) (4) Node
5. Cash, Bank Deposits 8, Miscellaneous Personal Property (Sch. E) (5) 275 , 933 . $
~ -'_
6. Jointly Owned Property (Schedule F) (8) _
5 , 006.09 `
7. Transfers (Schedule G) (Schedule L) __
(7) None
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) 49
181.71
Expenses (Schedule H) _ ,
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 969.87
11. Total Deductions (total Lines 9 r£ 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
15. Spousal Transfers (for dates of death after 6-30-94)
S I
~,
(8) 355, 939.89
(11)__ 50 ,151.58
(12) 305 , 788.31
(13) 300 , 782.22
(14) 5 , 006.09
ee nstructions for Applicable Percentage on page 2. (15) 0.00 X = 0.00
(Include values from Schedule K or Schedule M.)
16. Amount of Line 14 taxable at 6% rate (16) 0.00 X .06 =
(Include values from Schedule K or Schedule M.) 0.00
17. Amount of Line 14 taxable at 15% rate (17) 5 , 006.09 X .15 =
(Include values from Schedule K or Schedule M.) 750.91
18. Principal tax due (Add tax from Line 15, 16 and 17.) (18)
19. Credits/Sp Poverty Prior Payments Discount 750.91
Interest
0.00 + 0.00 + 0.00 0.00 (19) 0.00
20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20)
Q ^ ~lo;ck:heie it ; ~iar±s:r :; uwistii7 arofunes(vt ai+r ov:: mint: 0.00
21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21)
A. Enter the interest on the balance due on Line 21A. 750.91
B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. (21A) 0.00
Make Check Pa able to: R aster of Wills, A snt (21B) 750.91
- - BE SURE TO ANSWER ALL tiUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~
correct and eomplet~e,riudryecjere that all areal estate h s txen reported at true m~ark~etovmal~ue Declaration of ~ta~~' t° t e o
preparer other than the ~ now e a e , t s true,
which preparer has any knowledge. personal representative Is based on all information of
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Roger B . Irwin
60 West Pomf_r_ et Street DATE
' Carlise, PA 17013 -----"----"-----"--"--'---'-'-
RE PRE OTHERT AN REP ESENTATIVE IRWIN, McKNIGHT & HUGHES
~ 60 West Pomfret Street GATE
----------------------------------------------------- ~i~t'%1'ar
Carlisle PA 17013
Copyright (e 199 form soft y Systems, inc.
Form (Rey; 7_gq)
FOR DATES OF DEATH AFTER 12/31/91
IF A SPOUSAL
POVERTY CREDIT IS ~M D
FILE NUMBER
21-95-113
DENT'S COMPLETE ADDRESS
1020 Goodyear Road
Gardners, PA 17324
ty Cumberland
SOCIAL SECURITY NUMBER
2. Supplemental Retum
4a. Future Interest Compromise
(for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(Attach a copy of Trust)
~ENTIAL TAX INFORMATION SHOULD BE [
TO:
r ,
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net vaiu~ ~4 transfers to or for
the use of the spouse. The rates as prescribed by the statute will be:
•3°~6 (.03) will be applicable for estates of decedents dying on or after 711194 and before 1/1196
•2% (.02) will be applicable for estates of decedents dying on or after 111196 and before 1/1197
•1°~ (.01) will be applicable for estates of decedents dying on or after 111/97 and before 111198
.Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
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, .
c. retain a reversionary interest; or . .
d. receive the promise for I'rfe of efther payments, benefits or care?. .. .. .
2. If death occurred on or before December 12, 1982, did decedent within two years preceding 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 adequate
consideration?
3. Did decedent own an 'intrust for' bank account at his or her death? .. .
YES NO
X
X
X
X
X
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.
Copyright (c)1994 form software only CPSystems, Inc.
Form 1500 (Rev.7-941
REV - 1502 EX + (12-85)
~M~N~~~q~$~~/ANIA I SCHEDULE A
~~ff''^" REAL ESTATE
ESTATE OF _ FILE NUMBER
Hershell V. Frost SS~~ 199-07-4862 01/17/1995 21 95 113
(Property jointy owned with Right of Survivorship must bs dlselosed on Schedule F) All real estate should bs roported at fair market value
which is defined as the price at which property would bs exchanged between a willing buyer and a willing seller, neither being compelled to
bu or sell, both havin reasonable knowled • of the rokvant facts.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
OF DEATH
1 1020 Goodyear Road, -
Gardners, Dickinson
Township, Cumberland County,
more particularly described
in Deed Book"M", Vol. 12,
Page 347. Property sold
06/23/95 to Rodney L. and
Delores J. Shields
(settlement sheet attached).
TOTAL (Also enter on line 1, Reca itulation)
(If more space is needed, insert additional sheets of same size.)
Gopyrlght (e)1994 form software only CPSystems, Inc.
75,000.0
s 7 000.00
Form 1500 Schedule A (Rev. i2-es)
REV - 1508 EX + (2-87)
COM ~~~A~T}{~~gy~yANIA
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
Hershell V. Frost SS~~ 199-07-4862 01/17/1995
II roe 'oi owned with Ri ht of Survivorshi must be diselos~d'on Sdr
ITEM
NUMBER DESCRIPTION
1 Adams County National Bank, ;.-
checking account ~~141-806-8
(confirmation attached)
2 Adams County National Bank,
Certificate of Deposit
~~44-0000049 (confirmation
attached)
3 Adams County National Bank,
Certificate of Deposit
~p44-0004643 (confirmation
attached)
4 Aetna car insurance
cancellation refund
5 Costume Jewelry sold
6 Donegal Companies, refund
homeowners policy
cancellation
7 1990 Lincoln Continental
sedan, VIN42502524801FR sold
05/13/95 to Charles O. and
Phyllis L. Marks
8 Meridian Bank, Certificate
of Deposit ~~3034010060
(confirmation attached)
9 PNC Bank, N.A., Certificate
of Deposit ~p1713160114271
(confirmation attached)
10 PNC Bank, N.A., refund of;
credit balance on credii»~'~
card
11 Proceeds of public sale held
05/13/95 by Charles Spahr
(see continuation schedule attached)
Total of Continuation Schedule(s)
TOTAL (Also enter on line 5 Reca itulat' )
21-95-113
VALUE AT DATE
OF DEATH
27,104.15
15,036.68
wn s
(Attach additional 8 1/2" x 11" sheets if more space is needed.)
Copyright (e) 1994 form software ony CPSystems, Inc.
Form 1500
10,024.45
53.00
603.00
22.00
14,500.00
15,010.59
50,141.03
18.00
12,933.00
130 ,,4$7 , 90
2 933.80
edule E (Rev. 2-87)
Estate of: Hershell V. Frost SS~~ 199-07-4862 01/17/1995
CONTINUATION SCHEDULE
Continuation of Schedule E
ITEM DESCRIPTION VALUE AT DATE
~~ OF DEATH
12 TV Cable of Carlisle, 10.34
cancellation refund
13 Waddell & Reed Financial 6.71 130
477.56
Services, United ,
Accumulative Fund
(confirmation attached)
130,487.90
f ,:^
REV - 1509IX + (t2-gg)
coM~~gH41'fb1~r>Y "' ANIa SCHEDULE F
___ _ __ ~~b""~~ r~Y'" JOINTLY-OWNED PRI
Hershell V. Frost SS~p 199-07-4862 Ol 17 1995 r~~t nuttAeER
21-95-113
Joint tenant(s):
NAME
A. Arietta Orris
B.
C.
Jointly-owned property:
ITEM L FOR R DATE
NUMBER JOINT MADE
TENANT JOINT
1 A 02/198
ADDRESS
57 Ladnor Lane
Carlisle, PA 17013
RELATIONSHIP TO DECEI
iend
DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF
OF ASSET °~, INT. ECEDENT INTEREST
Farmers Trust Company, 10,012.18 50.00% 5,006.09
Certificate of Deposit
~~32164 (confirmation
attached)
TOTAL (Also enter on line 6, Reca Rulation) 5 , 006.09
(If more space is needed, insert additional sheets of same size.)
Copyright (c) 1994 form software only CPSystems, Inc.
Form 1500 s~nedule F (Rev, ti-se)
REV - 1511 EX r (7-88)
COM ~I~~gl,jj{,a~,gy~vANIA
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
C, SATE OF
Hershell V. Frost SS~p 199-07-4862 O1 17 1995
ITEM
NUMBER DESCRIPTION
A• FuneralExpsnses:
1 Gibson-Hollinger Funeral
Home
B• Administrative Costs:
1. Personal Representative Commissions Roger B. Irwin
Social Security Number of Personal Representative: 193 - 24 -1402
Year Commissions paid 1995
2. Attorney Fees Irwin , McKnight & Hughe s
3. ~ Family Exemption
Claimant none
Address of Claimant at decedent's death
Street Address
Cky
4. ~ Probate Fees
C• Miscellaneous Expenses:
1 Advertising costs for sale
of costume jewelry
2 Cumberland Law Journal -
estate notice publication
3 Charles Spahr, lr commission
on sale of real estate at
public sale
4 Charles Spahr, l0y
commission on sale of car
and household items at
public sale
State Zip Code
(see continuation schedule attached)
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9. Recaeitularlnnl
~n moro space ~s neeaea, insert additional sheets of same size.) i
Copyright (e)1994 form software only CPSystems, inc.
Form
Relationship
oror Ty~~
ILE NUMBER
21-95-113
AMOUNT
7,311.20
~ ,..
17,300.00,
17,300.00
0:00
302.00
26.40
40.00
750.00
2,743.30
3 , 40$ :'$1
s'
-'181.71
u1e H (Rev. 7-88)
Estate of: Hershell V. Frost SS~~ 199-07-4862 01/17/1995
CONTINUATION SCHEDULE
Continuation of Schedule H-C
ITEM DESCRIPTION
~~ AMOUNT
5 Settlement charges on real
estate at 1020 Goodyear
Road, Gardners, PA
6 Patricia A. Rosendale, CPA,
preparation of 1994 personal
income tax returns
7 Patricia A. Rosendale, CPA,
fiduciary income tax return
preparation
8 Register of Wills, filing
fees
9 Advertising, tent and toilet
rental fees at public sale
10 Public Sale preparation help
- 375 hours
11 The Sentinel - estate notice
publication
785.00
80.00
75.00
25.00
870.97
1,504.00
68.84
3,408.81
°'
REV - 1512 EX + (1-93)
SCHEDULEI
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCETAX RETURN
_-_ - RESIDENT DECEDENT MORTGAGE LIABILITIES MID
Hershell V. Frost SS~~ 199-07-4862 01/17/1995 21-95-113
ITEM
NUMBER DESCRIPTION AMOUNT
1 Aetna Casualt
I
y
ns.,
automobile policy ~p233 SY 94.00
2936245
2 Adams County National Bank,
check wrote 01/14/95 cleared 76.13
bank 01/20/95
3 Adams County National Bank,
check wrote 01/13/95 cleared 90.52
bank on 01/18/95
4 Irwin, McKnight & Hughes,
01/13/95 Power of Attorney 36.00
preparation
5 Met-Ed, acct. ~~6643 17
452517 154.47
6 R & A Bender, Inc., acct.
~~BC2350 260.00
7 RWC Emergency Physicians,
acct. ~~8531717 62.36
8 Carolyn R. McQuillen, county
real estate taxes for acct. 142.85
~~08423279014
9 United Telephone, account ~~
717-486-3938 (258) 53.54
TOTAL (Also enter on line 10, Reca itulation) S
{If more space is needed, insert additional sheets of same size.)
Copyright (e) 1994 form software only CPSystems, Inc.
Form 1500
a6~9.87
I (Rev. 1-93)
REV - 1513 EX + (2-87)
CDMIMN~NT~NT ANIA
SCHEDULE J
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequests:
1 Uriah United Methodist
Church
925 Goodyear Road
Gardners, PA 17324
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitula
(If more space is needed, insert additional sheets of same size.)
Copyright (c) 1994 form software only CPSystems, Inc.
AMOUNT OR
SHARE OF ESTATE
300,782.22
300,782.22
Form 1~ Schedule .I (Rev. 2-B7)
~, .. -- - ~, _ o~ , ,
~~x~~ i11 ~n~ ~~~t
~~en~
I, HERSCHELL V. FROST, o f Dickinson Township, Cumberland
County, Pennsylvania, declare this instrument to b~e my last will
and testament, hereby expressly revoking all wills and codicils
heretofore made by me.
1. I direct my executors to pay all of my debts, funeral
and administrative expenses as soon as may be done conveniently
after my decease.
2• I authorize and empower my executors to sell any realty
owned by me at my death and not specifically devised or bequeathed
herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do if living.
3. I give, devise and bequeath .all-of my estate, of every
nature and-wherever situate to Uriah United Methodist Church.
4. I nominate and a ....`
ppoint Roger B. Irwin and. Harold S. Irwin,
_..... a.,.~:..
Jr., to be the executors of this my last will and testament; they
are to serve as such without bond.
5. I hereby suggest that my personal representative retain
_. , _ .
the services of Irwin, Irwin & Irwin, as attorneys in the settlement
of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
~,_. da .~ .....~ ___..._ .. .
y of February, 1980.
. ~~ ~~
~`~~~ ~ "-Iz~~'~ ( SEAL )
HERSCHELL V. FROST
Signed, sealed, published and declared by Herschell V. Frost,
the testator above named, as and for his last will and testament,
in the presence of us, who at his request, in his presence and in
the presence of each other have subscribed our names as witnesses
zereto.
'\ "" ~ Ili c~ a ~l1
ACKNOWLEDGEMENT AND AFFIDAVIT
We, HERSCHELL V. FROST ~ BETZI A. MORRISON ,
and J. MARIE JONES , the testator and the witnesses,
respectively, whose names are signed to the foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the instrument
as his Last Will and that he had signed willingly, and that he
executed it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and
hearing of the testator , signed the Will as a witness and that
to the best of their knowledge the testat or was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
~~~~ ~L~~ J~~
HERSCHELL V. FROST
BETZI A. MORRISON
J. MARIE JO S
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by
HERSCHELL V. FROST , the testator , and subscribed
and sworn to before me by BETZI A. MORRISON
and
J. MARIE JONES , witnesses, this Sr day of
February 19 80
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