Loading...
HomeMy WebLinkAbout95-0165~14h~0ib5 HtDa.tq Rav. 2187 w rEruBAwENr r.wucrrc ©~ 0 i i 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 2001 ? • Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSVLY~~NIA • DEPARTMENT OF HEALTH • VITAL RECORDS y - - CERTIFICATE OFDEATH ~~ 0 0 0 5 4 NAME OF DECEDENT)f-rr, Midde, Ler) p ' w 9ECURffY NUAMBEIi~~ DATE DFDEATNMerri,DM.Nre) +• • -i°~a ~ y FemaCe a. 203 - 10 - 5735 ..Janucvu~ 13 1995 AGE~eFaiday) uNDERTrEAR uNOEnlD,or oATEDFBrrtN e1RnwTACetayrr , PLACE OF DERN)Clrli~ery ar-ae.Mreuciararan. raq Harr Deye Nan AwMA. Ma,a,.Da.wen sre«FaaiglCam» NosPTTU: oTNEn 9 2 rr ~ 3 / 14 / 1 ~0 2 ~olLk C-L. , PA "w"•" ~ EWdipelire ^ oGA ^ I1o1 q RwMnre ~ (~~,~ O couNrvCFDERN crrr,eoRO,TVMPOFOEJaN NAMEpIaaMraneee.piwaeraednaroar) vwsDECEDFJlTOFNI6MINCaRIGwv RACE-AmMbenbarl,errsVMlre,ra "° [~ "" ~ ","` '°""'"°'" ' . Pane M y ountai.n Home Mwvk~e,PMrt•Npn,eee wh~..te Adama kFna.nk,~i.n T 70. ~ DECEDENT'S U81Ml000UPATa7tl KR/D OF BUSwE3alNWS1RY NRa DECEDENT EVERW DECEDENT'S EDUCA710N MARIDLL BLB'Ua•MerAM SUTMVBKi 9PWSE ( N dr ld U ARNED S O n w« . ardaap moal . F RCEa? Mwile, pus maldn narael d ab; 0o nr ue•nGed.) ` ^ ~ ENnrnwµ18e•andry CaYpl D~+•r~ lsu«MI M1• N• ~ la+~ (T~«s.) w Ti C.•!rn.K d~etai,Z bx0/ce daW ,T (. Ta. Ta. 1~. Ta DECEDOMraMAnaioADDRESaRI.r.C~rrr .sb1..mCOal . DECEDENrs pA F nn Pf n C17 "' ~"' 6375 Chambenebung Raad ~ e. w..e.aa~wti.eb RESIDENDE - ' daeedrv ^~ Faye,ttev.eX.ee, PA 17222 ~r~ Adame '°"'"''e4 +~ ,T,x na.0.wn~r s iR/ER'9 NAME (Fial. MidOe. LaeD MOTIER'S NAME,Frr, Mlade, Mrbn Sumams) ,~ Jacob C. Cau,Laon Emma Kau man ,.. INFORMANT'S NAME(TyprPrir Pa-t~l,i.ai,a Waehabau h INFORMANr3 MAa1gADORESa(StrM, DMWbwn, srr.7ePCoda) 440 Kna.iee Ave., Chambenab PA 17201 METNOOOF DIBPDBRM7N DATEDFOrePOSRION .oax Neer) ® CnlralloR^ Rrnwel sew^ • nACE DC DISPOart)aN•N.n.ra«n•wr, G•a•bn ~oc~moN-CwW~wn. s.n. nvcoa «OIMrPbu ~ D«aYi•n.^ on~ „~, 1/11/95 „~pn,i.ng H.c,?,e Cemetery „~Shcppenebung, PA 17257 ACTING ASSUCN LICE118ENUreER NAMEANO ADOT1E990FFASaLRY Ol 1776-L ~n BwirizmlF.H.Inc.,PCI Box 336,Shipperla6ung,PA 17257 Caripw line 29ecad,.aAlwrcrrylp Toarl.aam,Mee.bdBe. eeelA o~a,narm. rlie, deM err Pbe•eWM. LICENSE NUMBEq DATE SIGNED b a~ rlaraarnb e«I rre) ' M«M.OrA ~••r) r ~~ W aF DEIV~ DATE DEAD MaM,Dey~) aMLSDA,sE REFERRED TO MEf LE%ANINERfCORONER7 Q NQ~ a. ~' % 3 . Lc ~. a7. FART F. ~~ dfaeuee1r, ~armmpecellorrrdMarcrrW m. deeN. DO nrlrv armma aei~eswrdiec r•apeebry emr, alrck«Mrerl baur. iApppdm.q /MTM: DUw afpiYkentaorbtlomaMAiEuWpbrleeN,be IYMglOrwwn n•l rereWrpr Brear•AYhO CrM BIMeeb PARTL ometeM dwb BNIEDIATE CAWEIFrrI i A i wre«aaiW m i ~ rdaeer)~ L u-C J OUE TO (OR A S A CONSE W ENCE l r ~ ^errA ~ bburdre DUE TOICR ASACONSEOUENCE OFg l I CAUax IDIa•eaa «injMy i arlMrMleda ~r DUE 70 (OR ASACONSEWENCE OFY- I AN AUIOPBY PERFORMED? WEfE AUIOPBY Ftltl/DppNi$ AW.ABIE PRIDR 70 MANNER Of DEATH DATE OF DUURY TIME DF BLIURY INJURY AT VMOitl(i DE9CPoBE NOW ai.AIRV OCCURRED. MaMh. Da%'kW) COMPLLRgN OFCAUSE OF DEATN7 ry ~~ ^ Nrurr XJ Attidant ^ PurArp Iaa ^ qe ^ No ^ Nr ^ N~ rr'' IM l_.J N~ SuiClde ^ Caednd le dsMmertl ^ a M. 0. PLACE OF INJURY -N IiorM arrn excel 1•aer oab LOCATION Lb. 20. , , Y• (SUaet, CMYrtown, blrel ~W, rc. (Spetily) aD6 70f CEN1N1[II ICMdc aNy one) ' CETRIFYWD FIIYa1faA11 (Phyca;ien arrYMW cair•«dealft..hen arbBier plryrgen lr, Prpburced dgaer~~~yr•d ~,~) . 910NATURE TRLE OF CERTIFIER ~. T .M bewMtlaa, eaep eeeMreeelre b ar eearyq err re•rrree rebel .................... ................................. ~ all. Q 'FRONOIINCNBAND C9ITIFYNG PNYa1C1AN(WlyaiCien boN prawuncnB dark erMtarr,igbtrw «deaal 7blM ber•I•eY ba•rbel/e,elerl oeeurnsrlM are,eleb, err Prae,rr«rbBeeenrele)anel arwwM•IM•el .......................... UCENBE NUMBER /, MAMA Da%lber) /G ale. ~ (-• 70. /~// r `~/S •MEDICJIL F]IAIINIIER/CORRONER AND ADDRESSOF PERSQN VVHO COMPLETED OF OERH (Item 27)Type«PrIM . 1/y _ ~ ~ ~~ ~/ i/ wf u ~ oDu»lw.a.ArrwTwR.rweT ,IRmyepinbn.a.nn«wl..arN»Dm..a.T...~wp.e.,.Rae..b,n.e....(.).Ra ~ nn.nn.ra.rrb .................. ... . - ~v,~- 3w u-r-h ~-/~ O.L ......................................................................... 01' . q , ~ a. ~7Z REOI NATURE R DaE (M«Mh. Day. Near) ~~ 501339~~/ ncv- i ouu cx+ (i-val ~, e'r FOR DATES OF DEATH AFTER 1'2131191 CHECK HERE INHERITANCE- TAX RETURN P ^ RESIDENT DECEDENT OVERTY CREOIT IS CLAIMED -• FILE NUMBER COMMONWEALTH OF PENNSYLVANIA DE (TO BE -FILED IN DUPLICATE PARTMENT OF REVENUE 2195-0165 DEPT.2BObo1 HARRISBURG PA 1 WITH REGISTER OF WILLS) , 7128-obDt COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDD INITIAL) DECEDENT'S COMPLETE ADDRESS Whorley, Martha G.~ 120 S. Queen Street W SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Shippensbtarg PA 17257 W 203-10-5735 1/13/95 3/14/1902 , co°~ C~.mlberland D (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONSI ~ 1. Original Return Y C N oo ^ 4. L'mited Estate = ~ c m b. Decedent Died Testate (Attach copy of Will) ^ 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) of Joel R. Zullin er ~ Su~1'-~~310 Chambersburg Trust Co. Bldg. g TELEPHONE NUMBER Cfiambersburg, PA c7~~ 1 ~ 717 264-6029 ~ C'r,"' ~~.,•, - ^-, ;~, `~-t z 0 a a W z 0 F- o_ 0 x ra- L~:.~~ xU::~.,,~ _~io Under penalties of perjury, I declare that I have it is true, correct and complete. I declare that all based on all information of which preparer has ^ 3. Remainder Return (for dates of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes c_. C= '.J1 -J (B) 23,870.56 R_11d '~R (12) (t3) (t4) 15, 756.18 7,000.00 8, 756.18 x._- x .Ob x ~S~L 1, 313.43 (la) _ 1,313.43 (19) 1, 275.00 (20) (2t) 38.43 (21 A) (21B) 38.43 return, including accompanying schedules and statements, and to the best of my knowledge and been reported at true market value. Declaration of preparer other than the personal represent DATE 115 S. Queen Street, Shippensburg, PA 17257 ADDRESS DATE Suite 310 Chambersburg Trust Co. Bldg. 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2 ) 3. Closely Held Stock/Partnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 ) 5. Cash, Bank Deposits & Miscellaneous Personal Property ( 23, 870 • 56 (Schedule E) 6. Jointly Owned Property (Schedule F) (b ) 7. Transfers (Schedule G) (Schedule L) (7 ) 8. Total Gross Assets (total Lines 1-7) '' 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) 5,9.)' 7, 738.38 Y_ 10. Debts, Mortgage Liabilities, Liens (Schedule I) 376.00 Jr"I 11. Total Deductions (total Lines 9 8~ 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule 1) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Spousal Transfers (for dates of death after b-30-94) See Instructions for Applicable Percentage on Reverse Side. (Include values from Schedule K or Schedule M ) (15) . Ib. Amount of Line 14 taxable at b°h rate (16) (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rate (17) 8, 756.18 (Include values from Schedule K or Schedule M.) 18. Principal tax due (Add tax from Lines 15, 16 and 17.) 19. Credits Spousal Poverty Credit Prior Payments Discount Interest + 1,211.25 + 63.75 _ !0. If Line 19 is greater than Line 18, enter the difference on line 20. This is the OVERPAYMENT. ~^ 1. 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 21A. B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. Make Check Poyoble to: Register of Wills, Agent Chainbersburg, PA 17201 Act 848 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 a: prescribed by the statute will be: • 3°~ (.f3) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 • 2°ib (.04) will be applicable for estates of decedents dying on or after 1/1il6 and before 1/1/97 • 196 (.®1j wiH be applicable for estates of decedents dying on or after 1/1/97 awd before 1/1/98 • Spe+rssrl transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS RY PLACING A CHECK MARK (-~~ IN TW~E APPROPRIATE CLOCKS. YES NO 1. Did decedent make a transfer and: ....................................................... a. retain the use or income of the property transferred, x 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 death transfer property without receiving adequate consideration$ If death occurred after x 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. ~ ~ ~ LAST WILL AND TESTAMENT I, Martha G. Whorley, of 120 South Queen Street, Shippensburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any and all former wills and codicils thereto by me heretofore made. FIRST I direct that all my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease, as a part of the expense of the administration of my estate. SECOND J I give and bequeath the sum of $1,000.00 cash to World Literature Crusade, U.S.A., Box 1313, .Studio City, California. THIRD I give and bequeath the sum of $1,000.00 cash to Piney Mountain Home for the Aged, R. D. 2, Fayetteville, Pennsylvania. FOURTH I g ive and bequeath the sum of $50:0.00 cash to Huntington Page 1 of a .Ten-Page Will College of Huntington, Indiana. FIFTH I give and bequeath the stun of $500.00 cash to the Salvation Army, Inc., Cubmerland County Branch, 20 East Pomfret Street, Carlisle, Pennsylvania. SLXTH I give and bequeath. the. sum of $1,00.:0.00. cash. to Billy Graham Evangelistic Association. SEVENTH I give and bequeath. the sum of $500.00 cash to Irene Hanley for. the. benefit of her radio broadcast of 1073 East St. Louis, Illinois. EIGHTH I give and bequeath the sum of $500.00 cash to Back to the Bible Broadcast, Grand Rapids, Michigan. ~, NINTH I give and bequeath the. sum of $50:0.00 cash to Church of the United Brethern in Christ, Board of Miss ions, Prince Street, Shippensburg, Pennsylvania, to be used for the benefit of Mappru Jong Hospital, S ierra Leone, West Africa. Page:2 of a Ten-Page Will TENTH I give and bequeath the sum of $500.00 cash to Pennsyllania Association for the Blind. ELEVENTH Should any of the aforementioned charities not be in existence at the. time of my decease, then in that event, the share of the charity. that is not in existence at the time of my death shall pass to and become part of the rest, residue and remainder of my estate as hereinafter set forth. TWELFTH i 3 I give and bequeath the sum of $1,000.00 cash to my niece, N~artha Koontz, provided that in the event my said niece should predecease me, I then give and bequeath the sum of $1,000.00 cash ._ .__ r„ ._ _._. ._.. to the Cumberland Valley Humane Society, 2325 Country Road, Chambersburg, Pennsylvania. THIRTEENTH I give and bequeath. the sum c~ $1,000.00 cash to my nephew, Jack Woltz, provided that in the event my said nephew should predecease me, I then give and bequeath the sum of $1,000.00 cash to the child or children of my said nephew, Jack Woltz, in equal shares, share and share alike, or to the .survivor of them then living at .the. time of my .death, equally. Page. 3 of a ..Ten-Page Will FOURTEENTH I give and bequeath the sum of $1,000.00 cash to my nephew, Gordon Woltz, provided that in the event my said nephew should predecease me, I then give and bequeath the sum of $1,000.00 cash to the child or children of my said nephew, Gordon Woltz, in equal shares, share and share alike, or to the survivor of them then living at the time of my death, equally. FIFTEENTH I give and bequeath the sum of $300.00 cash to my nephew, Robert Coulson, provided that in the event my said nephew should predecease me, I then give and. bequeath the sum of $300.00 cash to the child of my said nephew, Robert Coulson, namely, Roy Coulson, absolutely. ~~ '~ SIXTEENTH ;~j I give and bequeath the sum of $300.00 cash to my nephew, 3 Lester Coulson, provided that in the event my said nephew should ,,,, predecease me, I then give and bequeath .the sum of $300.00 cash to .the child of my said nephew, Leste ~ Coulson, namely, Jeff Coulson, absolutely . ~` S.EVENTEENTH I give and bequeath. the sum of $50.0.00 cash to my niece, Patricia Washabaugh, provided that in the event my said niece should predecease me, then in that event, this. bequeat shall pass Page 4 of a Ten-Page Will - ~ ;.?: Cl f to and become part of the rest, residue and remainder of my estate as hereinafter provided. EIGHTEENTH I give and bequeath the sum of $500.00 cash. to my great-niece, Sharon Washabaugh, provided further that in the event my said great-niece should predecease me, then this bequest shall pass to and become part of the rest, residue .and remainder of my estate as hereinafter provided. NINTEENTH I give and bequeath the sum of $500.00 cash to my great-nephew, Richard Washabaugh, provided that in the event my said great-nephew should predecease me, then this bequest shall pass. to and. become part of the rest, residue and- re mainder of my .estate as hereinafter provided. .~ TWENTIETH I give and bequeath the sum of $500.00 cash to my sister-in-law, Lillian Hartzell, provided that in the event my said r sister-in-law. should predecease me, then I give and bequeath the sum of $50:0.00 cash to the child it children of my said sister-in-law, Lillian Hartzell then living at the time of my death, in equal shares, share and share alike. Page 5 of a Ten-Page Will _ ~~~~ ' ~:' s. r .• TWENTY-FIRST I give and bequeath to those persons named thereon certain of my household items as are listed on the attached memorandum, said memorandum being attached hereto and made a part of this my last will and testament. TWENTY-SECOND Should any of my aforementioned legatees predecease me and the share of the deceased legatee has not been disposed of hereinabove, then in that event the share of said deceased legatee s-hall pass to and become part of the rest, residue and remainder of my estate as hereinafter .set forth. TWENTY-THIRD I give, .devise and bequeath the residue of my estate of every nature and wherever situate in equal shares, share .and share alike to the following named legatees: one equal share to my niece, Martha Koontz; one equal share to my nephew, Jack Woltz; one equal share to my nephew, Gordon Woltz; one equal share to my great nephew, Roger Woltz, one equal sh~'e to my great-.nephew, Ronald Woltz; one. equal share to my great-niece, Kathy Swartz; one equal share. to my great-niece, Sharon Hawley; one equal share to my nephew, William Hartzell; one. equal s-hare to my nephew, Paul Hartzell; one equal share. to my niece, Peggy Cosgrove; one equal share to my great-nephew, Patrick Cosgrove; one equal share to my great-nephew, Michael Heishman; one. equal. share to my niece, Page 6 of a Ten-Page Will Eleanor Thrush; one equal share to my great-nephew, Michael Woltz; one equal share to my great-nephew, Gordon Thomas Woltz; one equal share to my great-niece, Joanne Minnich; one equal share to my great niece, Michelle Montaro; one equal share to my niece, Mary Coulson; one equal share to my great-niece, Arlene Oyler; one equal share to my great-niece, Mildred Rhoads; one equal share to my great-nephew, James Woltz; and one equal share to my great-nephew, Josh Randall Woltz. Provided, further, that in the event any of my aforenamed legatees.-should predecease me, then in that event, I give, devise and. bequeath the share of the deceased legatee to the remaining, surviving legatees hereinabove named, in equal shares, share and share alike, to wit: Martha Koontz, Jack Woltz, Gordon Woltz, Roger Woltz, Ronald Woltz, Kathy Swartz, Sharcn Hawley, William Hartzell, Paul Hartzell, Peggy Cosgrove, Patrick Cosgrove, Michael Heishman, Eleanor Thrush, Michael Woltz, Gordon Thomas p~j Woltz, Joanne Minnich, Michelle Montaro, Mary Coulson, Arlene ~" Oyler, Mildred Rhoads, James Woltz, or Josh Randall Woltz. TWENTY-FOURTH An,y fiduciary under this will shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property, whether principal or income, including property held for minors, exercisable without Court approval, and effective until actual. distribution of all property: A. To retain any and all of the assets of my estate, real or personal, without regard to any principle of Page 7 of a.Ten-Page Will diversification of risk. B. To invest in all forms of property , including stock, common trust funds and mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification of risk. C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property, and to give options -for sales, exchanges or leases, for such prices and upon such terms or. conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly each. G. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. TWENTY-FIFTH I direct that all taxes that may be assessed in consequence of my death, of whatever. nature and b'~ whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. TWENTY-SIXTH I appoint. the Commonwealth National Bank with principal Page 8 of a T.en-Page Will offices in Harrisburg, Dauphin County, Pennsylvania, as executor of this my will. TWENTY-SEVENTH No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will and .testament, consisting of ten typewritten pages, the first eight of which bear my signature in the margin for the purpose of identification, this ~Q~' day of CYO ~O~ , 19~. ~i~~~~ ( SEAL). -~C'1°- Signed, sealed, published and declared by the .above-named testatrix, as and f or her last will and testament in our presence, who in her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses. Ad ress ~ `'~- /~~. r ~Q. A re s We, Martha G. Whorley, ~'TI~E'L ~. Z~~~h'/~~.,P. and I'3'1Q -~ ; K ~~, ~'/r~ the testatrix and the witnesses, res.p:ectively, 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 Page 9 of a T.en=Page Will :~;; instrument as her last will and that she had signed willingly (or willingly directed another 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 to the best of their knowledge, the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence . ~. W .Testatrix tnes s Witnes Subscribed, sworn to and .acknowledged before me by the above-named testatrix and subscribed and sworn to before me by the above-named witnesses, this 30't'`' day o f C~ e~o~o~..r 19 8 ti L~ ~~.1..a ~ ~ ~ w~.1c.1....0 l dir. N ry Public TERESA J. t3URKh!`JLDEi;, Notary Public , Shippensburg, Cumberland Co., Pa. My Commission Expires Sept. 9, 199.1 gage 10 of a Ten-Page Will REV-1508 EX+ (2.87) . . ~~ COMMONWEALTH OF PENNSYLVANIA INNERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Martha G. Whorley (All property jointly-owned with the Ripht of ITEM NUMBER 1. Checking Account SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Survivorship musf be diselesed on Schedule F) DESCRIPTION #8-24445, Orrstown Bank Interest accrued to date of death on Item 1 2. Certificate of Deposit #003-050741-C, Orrstown Bank Interest accrued to date of death on Item 2 3. Refund, Blue Cross/Blue Shield 4. Refund, Piney Mountain Horne 5. Refund, Piney Mountain Home Please Print or FILE NUMBER 2195-0165 VALUE AT DATE OF DEATH 16,477.30 49.87 5,000.00 11.99 127.20 72.70 2,131.50 TOTAL (Also enter on line 5, Recapitulation) I $ 2,870 56 )Attach additional 81h" x 11" sheets iF more space is needed.) '~ REV-1511 Ex+ (7.88) SCHEDULE H FUNERAL EXPENSES, COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND IN RESIDENTEDECEDENTRN MISCELLANEOUS EXPENSES Please Print or Type ESTATE OF FILE NUMBER Martha G, 4~orley 2195-0165 ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: I• Fogelsanger/Brisker Funeral Home 5,000:00 B. Administrative Costs: 1. Personal Representative Commissions William 0. Hykes Social Security Number of Personal Representative: 171 28 •-b3?4 1, 194.OOr''~ Year Commissions paid 2. Attorney Fees Joel R. Zullinger 1,194.0% 3. Family Exemption None Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code 4. Probate Fees MAY C. Lewis, Register - JCP fee 5.00;. Letters 50.00; Short certificates 12.00; renunciation 5.00; extra pages 27.00 filing fee 25.00 124 00 C. Miscellaneous Expenses: . ~• CLUnberland Law Journal, advertise letters 40.00 2• News-Chronicle, advertise letters 59.75 3• Charge_ for estate checks 6.63 4• Darlene Kelly „CPA, fee for preparation of tax returns 120.00 5. 6. 7. 8. TOTAL (Also enter on line 9, Recapitulation) $ '7 38.38 (If more space is needed, insert additional sheets of same size.) /~ REV-1512 EX+ (7-88) SCHEDULE I COMMONWEALTH OF PENNSYlVAN1A DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABLITIES AND LIENS RESIDENT DECEDENT Please Print or Martha G. Whorley X2195-0165 REV-1513 EXt (9.81) COMMONWEALTH OF PENNSYLVANIA SCHEDULE "J" INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT tsiAit ~r FILE NUMBER Martha G. Whorley 2195-0165 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT A. Taxable Bequests: Jack Woltz, 6320 Findley Rd., Mercersburg, PA nephew $1,000.0 0 cash; ~ ~ 1/19 of residue 2. James Woltz, 2029 Lake Silver Rd., Crestview, greatnephew $250.00; 1/19 of Florida 32536 residue 3. Michael E. Woltz, Hard Scrabble Road, R.D.#1, greatnephew $250.00; 1/19 of Westfield, N.Y. 14787 residue 4. Joanne Woltz Minnick, 10428 Old Forge Rd., greatniece $250.00; 1/19 of Waynesboro, PA 17268 residue 5. Michelle Woltz Montano, 2021 Rock Fall Rd., greatniece $250.00; 1/19 of Harrisbur, PA 17110 residue 6. Roy E. Coulson, 231 N. Sumner St., York, PA greatnephew $300.00 cash 7. Jeffrey L. Coulson, 64 S. Water St., Spring Grove, greatnephew $300.00 cash PA 17326 ' 8. Patricia Washabaugh, 440 Kraiss Ave., Chambersbur niece d?;~ $500.00 cash PA 17201 `~ --~ 9. Sharon Washabuagh, 440 Kraiss Ave., Chambersburg, greatniece $500.00 cash PA 17201 10. Richard Washabuagh, 1188 Hazlett Rd., Pittsburgh, greatnephew $500.00 cash PA 15237 11. William W. Hartzell, 561 Easy Rd., Carlisle, PA nephew $125.00 cash; 1/19 of residue ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT B. Charitable Bequests: 1. World Literature Crusade, U.S.A., Box 1313, Studio City, CA 91614 1,000.00 cash 2. Piney Mountain Homes/Estates, 6375 Chambersubrg Rd., Fayetteville 1,000.00 caster/, " PA 17222 3. Huntington College, 2303 College Ave., Huntington, Indiana 46750 ,500.00 cash`s 4. Salvation Army, Inc., 20 East Pomfert St., Carlisle, PA 17013 500.00 cashL-'~~ 5. Billy Graham Evangelistic Association, 1300 Harmpn Place, 1 1,00(1.00 cash`" P.O. Box 779, Minneapolis, Minnesota 55440-0779 6. Back to the Bible Broadcast, Box 82808, Lincoln, Nebraska 68501 500.00 cash%"^~ 7. Prince Street United Brethren Church, 20 N. Prince Stree, . 500.00 cash~- Shippensburg, PA 17257 8. Pennsylvania Association for the Blind, 2843 N. Front St., Harrisburg, PA 17110 500.00 cash/~~'r 9. Irene Hanle Radio Broadcast 1073E St. Louis Missouri 500.00 cash / 10. y ~[~a l ttVV ountr~ ~2oaS~ ~haml~elrfsb>~rg P TOTAC CHAR~A B~QU~S Iso enter n ins ecapi u a ion 1 040.00 cash $ ~ nnn nn ~_~_, (If more specs is needed insert additional sheets of same size) SCHEDULE ~~ J.. BENEFICIARIES PAGE II 12. Paul B. Hartzell, 231 F St., Carlisle, PA 13, Eleanor Hartzell Thrush, 972 W. Old York. Rd., Waynesboro, PA 17267 14. Peggy Hartzell Cosgrove, 905 Armstrong Rd, Carlisle, PA 17013 15. Roger Woltz, 33 High Rd., Shippensburg, PA 16. Ronald Woltz, 704 Upham Place NW, Vienna, VA 22180 17. Kathy Swartz, 1274 Fourth Avenue, Chambers- burg, PA 17201 18. Sharon Hawley, 3154 Island Drive, Redding, California 96001 19. Patricik Cosgrove, 905 Armstrong Rd., Carlisle, PA 17013 20. Michael Heishman, 901 Dunbar Rd., Carlisle, PA 17013 21. Mary Coulson, 402 Ricky Road, Mechanicsburg, PA 17110 22. Arlene Oyler, 605 E. Winding Hill Road, Mechanicsburg, PA 17055 23. Mildred Rhoads, 728 W. Siddonsburg Road, Dillsburg, PA 17019 24. Josh Randall Woltz, 6320 Findley Read, Mercersburg, PA 17236 nephew $125.00; 1/19 of residue niece $125.00; 1/19 of residue niece $125.00; 1/19 of residue nephew 1/19 of residue nephew 1/19 of residue greatniece 1/19 of residue greatniece 1/19 of residue greatnephew 1/19 of residue greatnephew 1/19 of residue niece 1/19 of residue greatniece 1/19 of residue greatniece 1/19 of residue greatnephew 1/19 of residue