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HomeMy WebLinkAbout95-0125This 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. /~'~. ~,~.,uA...z„ nv~wnrrr x~ vemuw x~acr W AuG ~ s 20oT Date ? ~ Fran eropoli, ' ect Division of Vital Records P.O. Box 152$ New Castle, PA 16103 COYYONWEALTH OF PENNSYLSMNIA • DEPARTMENT OF HEALTH • VITAL RECOpDS CERTIFICATE OF DEATH `~ Q ~ ~ ~ 6 REV-1500E:1~(7-94) INHERITANCE TAX RETURN FOR DATES OF DEATH AFTER 12/31/91 RESIDENT DECEDENT POVERTY CREDIT S CLAIMED FILE NUMBER CO gDEPARTMENTOFPRE ESN~EA" (TO BE FILED IN DUPLICATE DEPT. 280601 WITH REGISTER OF WILLS ¢}~ HARRISBURG, PA 17128-0601 21 ~95 COUNTY CODE YEAR DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS He ner, Otto F 325 Wesley Drive DECEDENT SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Mechanicsburg Pa 17055 195-07-2709 Ol 23 95 05 28 1914 County Ctunberland (F RSTAND M ODLERNITIAL) SPOUSE'S NAME (LAST, SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) CHECK APPRO- PR IATE BLOCKS CORRES- PONDENT RECAPIT- ULATION TAX COMPUTA- TION 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of WiII) 2. Supplemental Return 4a. Future Interest Compromise (for dates of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) U 3. Remainder Return (for dates of death priorta 12-13-82) ~5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes NAM E Mellon Bank N.A., ~cecutor TELEPHONE NUMBER 717 780-3112 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely. Held Stock/Partnership Interest (Sch. C) 4. Mortgages and Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (Schedule L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) COMPLETE MAILING ADDRESS P.O. Box 1010 RM 181-0336 Harrisburg Pa 17108 (1) (2) (3) (4) (5) 17,740.60 (6) (7) (9)_ 10,190.92 (10) 1, 261.31 (8) 17,740.60 (11) 11, 452.23 (t2) 6, 288.37 (13) 3 , 590.98 14. Net Value Subject to Tax (Line 12 minus Lin 13 15, e ) Spousal Transfers (for d t f d (14 a es o eath after 6-30-94). See (15) Instructions for Applicable Percenta e on Pa 2 I ~ ~ DO x .00 _ - g ge . ( nclude values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at 6% rate (16) 0 00 (Include values from Schedule K or Schedule M.) . x .06 17. Amount of Line 14 taxable at 15% rate (17) 2 697 39 x 15 (Include values from Schedule K or Schedule M.) , . . 18. Principal tax due (Add tax from Lines 15 is d f9. , an 17.) Credits Spousal Poverty Credit Prior Payments Discount (18) Interest 0.00+ ?0. - (1s) If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT " :i '::::::::;;: _" ----._._._...v...._............ ..............._..................._...... ....... ....... .._... .. ii ::~tirF+Mil; . 2p ... .. _ If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. A. Enter the interest on the balance due on Line 21 A. B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. Make Check Payable to: Register of Wills. Aaent ft is true; correct and ative is based on all in SIGNATURE OF PE SIGNATURE OF PR at true market value 2,697.39 0.00 0.00 404.61 404.61 0.00 (21) 404.61 (21 A) ~ ~ 00 (21 B) 404.61 aiiu w me nest or my knowledge - n of preparer other than the personal - ~••~~~.,~~, vrscrntatnlHIIVE vgDDRESS PA15001 NTF 6679 Copyright Forms Software Only, 1994 Nelco, Inc. N94PA001 ave te. I declare that all real esta n of which preparer' has any "FI hEEJURN ADDRESS 0125 NUMBER DATE DATE Estate of: Otto F Hepner SiJrMg1RY OF ALiACl~TIONS TO BETJEF'ICIARIES Class B Lynn L Mash Caroline M Packer M Gladys Updegrove 314.42 314.42 2,068.55 2,697.39 21-1995-0125 PA REV.-1500 EX (7-94) 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 rates as prescribed by the statute will be: • 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1196 • 2% (.01) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1% (.01) 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. 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 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 property without receiving adequate consideration? If death occurred after December 12, 7982, did decedent transfer property within one year of death without receiving adequate consideration? ..................... . . . . . . . . . ................... 3. Did decedent own an 'in trust for' bank account at his or her death? ...... . . . . ... . . . . . ... . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. PA15002 NTF 6880 Copyright Forms Software Only, 1994 Nelco, Inc. N94PA002 FEbi7508 EX+(2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Ot (All p ITEM N0. to F He ner FILE NUMBER roperty Jointly-owned with the Right of Survivorship must be disclosed on Schedule F) 21-1995-0125 DESCRIPTION VALUE AT 1 DATE OF DEATH Checking Account No. 5080032338 with PNC Bank 1,654.70 2 Interest accrued to date of death on item no. 1 0.37 3 Certificate of Deposit No. 02-54-241195 with Harris Savings Bank 1 035.48 ' 4 Interest accrued to date of death on item no. 3 2.45 5 Certificate of Deposit No. 02-54-241218 with Harris Savings Bank 2 070.95 ' 6 Interest accrued to date of death on item no. 5 4.04 7 1994 Buick; sold at auction 11,985.00 8 Currency; appraisal attached 499.00 9 Annuity payment dated 1-15-95 from The Prudential Contract No , . DOS431950 85.68 10 Subscription refund from the Patriot News Company 41.10 11 Cash on Hand 14.00 12 Claim payment from Medicare - Pa Blue Shield 76.53 13 Premium refund from Merchant's and Businessmen's Mutual Insurance Co. 27.00 14 Premium refund from Allstate Insurance Co. 130.20 15 Premium refund from Capital Blue Cross 114.10 TOTAL (Also entar nn lino S (Attach additional 8 1/2" x 17" sheets if more space is needed.) PA1508t NTF 1215 Copyright Farms Software Only, 7994 Nelc o, In c. N94PNU87 17,740.60 REV-1511 EX+(7-gg) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or Type w~Ni~vr Otto F He ner ITEM NO. DESCRIPTION A. Funeral Expenses: 1 Myers-Harnex Funeral Home Inc. -statement 2 George H Geise -Reimbursement for funeral meal B. Administrative Costs: 7. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees 3. Family Exemption Claimant Address of Claimant at decedent's death Street Address City 4. ~ Probate Fees FILE NUMBER 21-1995-0125 AMOUNT 6,079.00 100.00 3,000.00 0.00 0.00 232.00 C. Miscellaneous Expenses: 1 Cumberland Law Journal -estate notice 40.00 2 Patiot News Co. -estate notice 149.92 3 Harry M Wiener -appraisal fee 100.00 4 Conmtonwealth of Pennsylvania -death certificates 15.00 5 Medi-Claim -claim sevice 75.00 6 Register of Wills, Cumberland County -short certificates 15.00 7 Harrisburg Auto -auctioneer's fees and expenses ,~ 285.00 8 Closing Costs 100.00 TOTAL (Also enter on line 9, F (If more space is needed, insert additional sheets of same size.) PA15111 NTF7278 Copyright Forms Software Only, 7994 Nelcn, Inc. N94PA1 t t Relationship State Zip Code 10,190.92 REV-1512 EX+(t/93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, M[~RTf~Ar:~ 1 IAQ11 ITiG'L+ wu~ ..~.... tsTATE OF Otto F Hepner ITEM Please Prlnt or FILE NUMBER 21-199-ni~~ NO. DESCRIPTION 1 Kenneth H Heisey, DDS -professional service 2 Bethany Village -statement 3 Harrisburg Urological Assoc. -professional service 4 Bell Atlantic -statement 5 EKG Assoc. -professional service AMOUNT 51.00 1,082.65 54.81 61.60 11.25 TOTAL (Also enter on line 70, Recapitula (If more space is needed, insert additional sheets of same size.) PA15121 NTF 2eao Copyright Forms Software Only, 7994 Nelcc, Inc. N94PA727 1,261.31 REV-1513 EX+(2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Otto F He ner ITEM NO. NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: 1 Lynn L Mash 4571 Sequoia Drive Harrisburg, Pa 17110 2 Caroline M Packer 325 Wesley Drive Mechanicsburg, Pa 17055 3 M Gladys Updegrove 1301 Grampian Blvd, Apt 3A Williamsport, Pa 17701 ITEM NO. NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: See Schedule attached None None FILE NUMBER RELATIONSHIP Sister-in-Law TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space Is needed, Insert additional sheets of same size) PA15131 NTF 1220A Copyright Forms Software Only, 1994 Nelco, Inc. N94PA73t 21-1995-0125 AMOUNT OR SHARE OF ESTATE 314.42 314.42 2,068.55 AMOUNT OR SHARE OF ESTATE 3,590.98 RE1[-1513 EX+(p-g7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ~....+. ~ yr Otto F ner ITEM NO. NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: 1 Lynn L Mash 4571 Sequoia Drive Harrisburg, Pa 17110 2 Caroline M Packer 325 Wesley Drive Mechanicsburg, Pa 17055 3 M Gladys Updegrove 1301 Gran>pian Blvd, Apt 3A Williamsport, Pa 17701 FILE NUMBER RELATIONSHIP None None Sister-in-Law ITEM NO. NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: See Schedule attached TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space Is needed, Insert addltlonal sheets of same size) PA15131 NTF 1220A Copyright Forms Software Only, 1994 Nelco, Inc. N94PA131 21-1995-0125 AMOUNT OR SHARE OF ESTATE 314.42 314.42 2,068.55 AMOUNT OR SHARE OF ESTATE 3,590.98 Page 2 Estate of: Otto F Hepner 21-1995-0125 SCHFfxrrF ,T, Part B -- Charitable and Governmental.Bequests Item No. Name and Address of Beneficiary Amount 1 Zion Lutheran Church, Stone Valley HRC 68, Box 61 314.42 Da7mltia, Pa 17017 2 Zion Lutheran Church 265 North Enola Drive 2,200.92 F~ola, Pa 17025 3 Zion United Church of Christ P.O. Box 384 827.42 Herndon, Pa 17830 4 The Phoebe-Devitt Home 1925 Turner Street 124.11 Allentown, Pa 18104 5 The Bethany Children's Home ~ #2, Box 96B 124.11 Wcmelsdorf, Pa 19567 ~'~. (~'ry forward to main schedule) . 3,590.98 C~Oo p}~ ~tiust ill ttrca ?~IEStttm:nt of OZTO F. HEplTEIt KNOW ALL MEN BY TAESB PRESENTS, that I, OTTO P. HEFliBR, of 2250 Apartment D, Williamsburg Drive, Harrisburg, Dauphin County, Pennsylvania, being of lawful age, sound mind, memory and understanding, do make, publish and declere this instrument to be my Last will and Testament, hereby revoking any and all Wills heretofore made by me. FIB? I direct my hereinafter-named Executor to pay out of my estate all my just debts, including the expenses of my last illness, funeral expanses and the expenses for the dating of my monument on my grave. S~ ° My said Executor is also authorized and directed to pay out of my estate all inheritance, legacy, or estate taxes on my estate oz on the devolution of any portion thereof or levied by rcason of my death, including those levied on proceeds of policies of insurance on my life, whether or not the property, transfer, or proceeds with respect to which said taxes are levied is a part of my estate at my death. Yom= (A) In the event that my wife survives me, I ive g devise and bequeath unto my wifo, BVSLYN L. SSPNBR, all my Preoprty, real, personal and mixed, wherever situate and whether acquired.before or after the execution of this Will or to which i am entitled at the time of my death. (B) However, in the event that my wife should predecease me, or my wife and I should die in a common disaster or Page 1 of 6 Pages '~~ ~- '~ .~ •. j / ~.~. L (SEAL) OTTO F. SSPNSB under such circumstances that it cannot readily be determined which of us died first, or i.f my wife, regardless of the cause of her death, shall survive me for less than ninety days, then I provide that subsection (a) of paragraph THIRD shall be null and void, and I will and direct that during the said period of ninety days or leas during which time my wife shall survive me, she shall have a life estate in my estate, and the remainderman interest therein shall be divided as follows: One-half (1/2) of the residue tbereof shall be divided as follows: 1. I give and bequeath the sum of ONE T800S11ND DO~LIaRS (S1,000.00) unto the Trustees of the STONE VALLBY LOT$ERAN C$ORCB of R.D., Dalmatia, Pennsylvania to be used for general churoh expenses. 2. I give and bequeath the sum of SBVEN T800S11ND DQ'LLARS (57,000.00) to ZION LOTHL'RAN C80RC8 of Enola, Pennsylvania, to be held in trust and to be known as the "Otto and Evelyn Hepner Trust Fund", and the income therefrom is to be used !or general church expenses, After ten (10) years from the date of my decease, any part of the principal may be used for general church expenses. 3. I give and bequeath the sum of ONB 7'HOOSJ-ND DOLLARS (51,000.00) to each of my friends, LYNN MASH and C7IROLINB Pl1ClC8R of Harrisburg, Pennsylvania. 4. All of the rest and remaining portion of the said one-half (1/2) interest thereof I will and bequeath as follows: a. Oae-third (1/3) thereof I will and bequeath unto my sister, ALENB GEISE, b. One-third (1/3) thereof I will and bequeath unto my sister, IV11 M. RADEL, /~ Page 2 of 6 Pages l _9!~ r ~~~ ~~ ~~in ~ ~ (SEAL) OTTO F. BEPNER' J c. One-nineth (1/9) thereof I will and bequeath unto my nephew, S8RBN8 HBPNSR, d• One-nineth (1/9) thereof i will and bequeath unto my nephew. THC~J71S SEPITER, and e. One-niaeth (1/9) thereof i will and bequeath unto my niece, 8LIZ1~8L-Ta hI.87l11aTDER. However, i! any of the above-named sisters, nephews, or niece shall fail to survive me and shall leave a spouse living at the time of my depth, such spouse shall take their deceased spouse's share. However, if the said named pezson shall fail to survive me and shall not leave a spouse but shall leave a descendant or descendants living at the time of my death, such descendant or descendants shall represent their ancestor tnd take said ancestor's share per stirpesf however, if any of the above-named persons shall fail to leave a spouse or a descendant, such person's share shall lapse and be distributed to the survivors of the above-named persons in tt~e same portions as above stipulated. The other One-half (1/2) of the rasidne thereof shall be divided as follows: 1. I give and bequeath the sum of T1Qp TAOUSAND PIQB BUNDRBD DOLIJ-RS ($2,500.00) unto my sister-in-law, GL~IDYS I7NDBGROVB. However, if she predeceases me, then this provision shall be null and void. 2. I give and bequeath the sum of ON8 THOUSAND DOr,~RS ($1,000.00) unto the Trustees of ZION UNZTED CHQRCS OF CHRIST of Serndon, Northumberland County, Pennsylvania, ro be used for general church expenaes_ / ~l ~, / Page 3 of 6 Pages ~_ ;~~j ~ ~ ~~ ,! G ~i ~i___(SEAr.) OTTO F _ HEYNF- .R ~- J 3. I give and bequeath the sum of ON8 HU1~iDR8D FI1rTY DOR.L11Rg 0150.00) unto the PSOSBS-DEVITT HOME of Allentown, Pennsylvania. 4. i give and bequeath the sum of ONS HIINDRBD PIB?7C DOLT.ARS (S1S0.00) unto the BETS]-NY CBILDREN's ROME of Wpmelsdorf, Pennsylvania. 5. All of the rest and remaining portion of tha residue of the said one-half (1/2) interest thereof, I give and bequeath as follows: a. One-fourth (1/4) thereof unto my sister-in-law, GLADYS IIPDEGROVE, b. One-fourth (1/~) thereof unto my brother-in-law, J08N DPDEGROVE, C. One-fourth (1/4) thereof unto my brother-in-law, ROBERT UPDEGROVE, AND d. One-fourth {1/4) thereof unto my sister-in-law, ~11BBLI.E PROt+7ELL. However, if any of the above-named brothers-in-law and sisters- in-law shall fail to survive me and shall leave a spouse living at the ' time of my death, said spouse shall take said deceased boother-in- law's or sister-in-law's share; however, if t:he above-named brothers- in-law or sisters-in-law shall fail to survive me and shall not leave a spouse but shall leave a descendant or descendants living at the time of my death, such descendant or descendants shall represent their ancestor and take said ancestor's share per stirpesf however, if any of the above-named brothers-in-law and sisters-in-law shall fail to survive me and shall fail to leave a spouse or descendant living at the time of my death, such person's share shall lapse and be Page 4 of 6 Pages ~ ~/in •~ ayr~jl,v~,r,>~ ~ (SEAL) O?i'O P. BEFNEIt . ... J. distributed to the survivors or the above-named brothers-in-law and sisters-in-law. FOORTH: 2 name, constitute and appoint COlQlONWEU?H 1111TIp~y BAli1C, 10 South Market Square, Flarrisburg, Pennsylvania, as Executor of this my Last will and Testament, and I authorize and empower CWOlOI~WBALTH ~UITIODUIL BA'IIC, pending settlement of my estate, to sell, convey, mortgage, lense, exchange, encumber or otherwise dispose of any and all of the property, real, persona]. or mixed, at any time belonging to my estate, either at public or private sale, without prior approval of Court, and at such times and for such prioe or prices and in any suoh case upon such terms as it may think best in its discretion, and I authorize and empower A+y said Executor to execute, acknowledge and deliver to the purchasers, grantees, mortgagees, vendees, assignees, or other persons, such contracts, deeds, mortgages, bonds, bills of sale, and all other instruments of writing necessary or proper. My Executor shall also have the power to compromise or otherwise settle or adjust any and al] claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could do if living. My Executor shall further be empowered to carry on and conduct any business enterprise in which I may be engaged at my death, to retain any assets including stocks or securities which I may own at the time of my death pending settlement of my estate without regard to whether or not such assets or securities are legal investments for fiduciaries and may make distribution in kind to my Trustees. Pending settlement of my estate, my Executor shall also have tha authority in its discretion to convert, sell, exohange, or dispose of such assets and securities either for cash or for terms satisfactory to it and to acquire other assets inoluding securities as it may deem desirable. My Executor shall futher be empowered to I Page 5 of 6 Pages ~~~ ,~ ~ / j,~~L L O?TO F. BEPNSR (SEAL! ,~, borrow money, and to pledge assets of my estate as security therefore, for the purpose of paying taxes which may be levied upon or payable by my estate, in accordance with this Will in the event that funds in the hands of my Executor -shall be insufficient to pay such taxes and if, in the opinion of my Executor, it appears that convarsian of securities and other assets, real and personal, would be made at a sacrifice. ZN WITNESS WHEREOF, I, OTTO F. 88PNER, have hereunto set my hand andn~seal too this, my Last Will and Testament, this ~~}day of -1~1/..~.,.,/.~ A.D., 1991. SIGNED, SEAL, PUBLISHED, and DECLARED by the above- namad Testator, OT'=O P. HEPNER, as and for his Last will and. Testament, in the presence of us, who at his request and in the presence of each other, have hereunto set ur names as witnesses: ~, at: / Reu..~.~,~.,.:.r..,.., r/ ~~i . ~`~ ~ C 7 fees ding at:. _ `' - ~' ~ " ~ ( SEAL = O - HEPDiSR ! ' Tf1Td D qp