HomeMy WebLinkAbout95-0191This is to certify that the certificate hereunto attached i ~, ~~ ~ ~~
s a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Fr
subscribed thereto, was at the time of subscribing the same and now i
ank Yeropoli, whose name is
Records of the Department of Health,~for the Co s Director, Division of Vital
and commissioned as directed by Act 66 of the Ge era AssemblPennsylvania, dul a
304. Y ppointed
Y, approved 29 June 1953, p,L,
AUG 16.200
Date ~ •
Fran eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
H1t4t11a R,v, yB~
+-~r COMMONW~TH OF PENHSYLN1~HIA ~ ~ OF HEALTH .VITAL RECORDS
"' CERTIFICATE OF DEATH
Grace V. rticke
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REGISTggR'S SgNATUREAND NUMBER •.•••.••.••..•••••••.. •..•..•
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INHERITANCE TAX RETURN F£1R 4MN>•4 ~ IEMATM AFTER 1 ~4~V 1 I71E M~M. ~1iRi
~~`A'ap~,11#~L
i RESIDENT DECEDENT pO~ c wt es culME~a ^
COMMONWEALTH OF PENNSYLVANIA
(TO BE FILED IN DUPLICATE FILE NUMBlR
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG
PA 17128
0601
WITH REGISTER OF WILLS) 21 - 9 5 - 0191
,
. COUNTY CODE YEAR NUMBER
H DECEDEN ' NA ,FIR ,AND MI L INI IAL
W MICKEY, Grace i.. 81 9 Bridge Street
V SOCIAL SECURITY NUMBER f DATE OF DEATH
DATE OF BIRTH N2 W Cumber 1 and , PA 17 070
0 195-16-3797 ./ /
02/25/95 08/29/22
~,~MY Cumberland
W
~-
ay
®1. Original Return
^ 2. Su lemental Return
PP
^ 3. Remainder Return
W du
=00
^ 4. Limited Estate
^ 4a. Future Interest Compromise (for dates of death prior to 12-13-82)
^ 5. Federal Estate Tax
Vdm
® (for dates of death after 12-12-82
)
Return Required
~
Q 6. Decedent Died Testate
(Attach copy of Will) ^ 7. Decedent Maintained a Living Trust
(Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes
y F NAME L E M 1 1
WZ
~ c
R. David Cowen, Esquire
P.O. Box
208.
~ ZO TELEPHONE NUMBER ~ Upper Da rby, PA 1.9:082 ,-~
d 610 734-0655
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1. Real Estate (Schedule A) (1) $ 70 , 000 . 00
2. Srocks and Bonds (Schedule B) (2) None
3. Closely Held Stock/Partnership Interest (Schedule C) (3) None
4. Mortgages and Notes Receivable (Schedule D) (4) None
.
S. Cash, Bank Deposits & Miscellaneous Personal Property( 5) $_ 1~69U : 92
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) None
7. Transfers (Schedule G) (Schedule L) (7) None
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) $ 11 , 247.59 ,
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, liens (Schedule I) (10) $ 4 , 3 9 3.54
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 1 1)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (line 12 minus line 13)
~.
( 8) $ 71 , 696.92
(11) $ 15 , 641.13
(12) 5 055_79
(13)
15. Amount of line 14 taxable at 6% rate (15) $ 5 6 , 0 5 5 . 7 9 x 06 '
(Include values from Schedule K or Schedule M.)
16. Amount of line 14 taxable at 15% rate (16) x .15 =
(Include values from Schedule K or Schedule M.)
17. Principal tax due (Add tax from line 15 and from line 16.)
18. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ + _
19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT.
~^
i'.0. If line 17 is greater than line 18, enter the difference on line 20• This is the TAX DUE.
A. Enter the interest on The balance due on line 20A.
B. Enter the total of line 20 and 20A on line 20B. This is the BALANCE DUE.
Make Check Payable to: Register of Wills, Agent
Under penalties of perjury, 1 declare that I have
it is true, correct and complete. I declare that all
based on all information of which preparer has
lr~~l PE ' N gE~SP0111, BLE FOR FILING REl
5h'^e"'rr D HL~a`[X~
5 PA~ HE HAN REPRESENTAT
Da (fO en, Esqui
$ 3,363.35
(1~ $ 3, 363.35
(18) .None
(lq) /'~ None
(20) ~ 3, 3 6 3. 3 5
(20A)
(206) $ 3, 3 6 3. 3 5
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,~) IN THE
APPRaPRIATE BLOCKS.
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 December 12, 1982, 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? ...................... 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.
REV-1502 EX+ (12.85) ~ ~
COMMONWEALTH OF PENNSYLVANIA
SCHEDULE A
REAL ESTATE
FILE
Grace V. Mickey, Deceased 21-95-0191
(Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value
fir more space is needed, mserf additional sheep of same size.)
'
a
REV-1508eX+i2-87) SCHEDULE E
CASH, BANK DEPOSITS AND
COMMONWEALTH OF PENNSYLVANIA MISCELLANEOUS
INMERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF
Grace V. Mickey, Deceased
Please Print or Typ
ER
21-95-0191
(All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION VALUE AT
NUMBER DATE OF DEATH
1. Closing Balance from checking account $ 96.82
PNC Bank
2. Old Guard Mutal Insurance Company Policy H-0060585
Refund excess homeowner's insurance premium 100.00
3. Tangible personal property located at 819 Bridge
Street, New Cumberland, PA, including personal
clothing 1,500.00
TOTAL (Also enter on line 5, Recapitulations I $ ,~ 696 q ~
(Attach additional 8Y:" x 11" sheets if more space is needed.)
REV•1511 E7C+ (7.881 SCHEDULE H
!! FUNERAL EXPENSES,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
IN RESIDENTEDECEDENTRN MISCELLANEOUS EXPENSES please print or Type
ESTATE OF FILE NUMBER
Grace V. Mickey, Deceased 21-95-0191
ITEM
NUMBER DESCRIPTION .MOUNT
A. Funeral. Expenses:
~• Parthemore Funeral Home
$ 6,872.00
2. Mt Olivet Cemetary - Grave Opening expenses 500.00
3. Gingrich Memorials - monument & engraving 426.00
4. Expenses of Funeral luncheon/Dinner - Casa Rillo 325.54
5. Miscellaneous Funeral expenses 50.00
B. Administrative. Costs:
1. Personal Representative Commissions _
_
Social Security Number of Personal Representative:
Year Commissions paid
2. Attorney Fees Darrell C. Dethlefs, Esquire 142.50
R. David Cowen, Esquire 1,200.00
3. Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees 156.00
C. Miscellaneous Expenses:
~• Register of Wills - filing fee inventory 10.00
2_ William J. Mansfield, Inc. - Legal Advertisement 155.5.0
g• Harrisburg First Service Corp - Expenses Sale of Rea
Estate 79.00
4. Terminix - Termite Treatment and Repairs 779.10
5. U. S. Postal Service - Express Mail Charge Real Estat 10.75
Settlement
6. Trash Removal 130.00
7. Gingrich Plumbing - Repair water leak - Settlement 111.20
8. Miscellaneous Administration Expenses - affidavits,
9 filing fees, etc. 250.00
• Travel Ex enses from Media to New Cumberland 50.00
TOTAL (Also enter on line 9, Recapitulation) $ 247.59
~'
(If more space is needed, insert additional sheets of same size.)
REV-1512 EX+ (7-88( R~,
t s~~
' COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABLITIES AND LIENS
ITEM
NUMBER
t.
2.
3.
4.
5.
6.
7.
P{ease Print or Type
FILE NUMBER
21-95-0191
DESCRIPTION AMOUNT
PNC Bank - Loan payment account no. 40018001087549 $ 119.57
PNC Bank - Balance due personal loan account
no. 40018001087549 3,335.90
Metmor Financial - Mortgage loan payment 313851-8 127.77
Metmor Financial, Inc: - Payoff balance mortgage loan
no. 313851-8 594.21
Mechanicsburg Rehab Center - Balance due TV charges 110.22
Boscov's Department Store - Balance due charge accoun 97.47
Pa. American Water Co. -.Balance due 8.40
TOTAL (Also enter on line 10, Recapitulation) I $ /4', 393.54
(If more space is needed, insert additional sheets of same size.)
REV-1513 EX+ (2-87) ~
LY
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA B E N E F I C IAIt 1 ES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
P
ESTATE OF FILE NUMBER
Grace V. Mickey, Deceased 21-95-0191
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequests:
~ Sherry D. Hall Daughter /3 Residue
100 Cove Lane, Media, PA 19063
2. Sandra C. Weigel Daughter /3 Residue
415 Big Spring Rd, New Cumberland, PA
3. Donald L. Soloninka Son /3 Residue
819 Bridge Street, New Cumberland, PA
4. Susan Elizabeth Weigel Granddaughte $1,000.00
415 Big Spring Rd, New Cumberland, PA
5. Gregory Scott Weigel Grandson $1,000.00
415 Big Spring Rd, New Cumberland, PA
6. Kimberly D. Laporta Granddaughte $1,000.00
341 Maple Lane, Carlisle, PA 17013
7. Jessica Rebecca Hall Granddaughte $1,000.00
100 Cove Lane, Media, PA 19063
8. Rachel Ann Hall Granddaughte $1,000.00
100 Cove LAne, Media, PA 19063
9. Angela Elais Spelas Granddaughte $1,000.00
309 11th Street, New Cumberland, PA
10. Samuel R. Soloninka Grandson $1,000.00
137 D, 1425 Apple Dr, Mechanicsburg, P
11. Anthony L. Cole Grandson $1,000.00
4341 Carlisle Pike, Camp Hill, PA
12. David L. Soloninka Grandson $1,000.00
405 Shady Drive, Endwell, NY
ITEM NAME AND ADDRESS OF BENEFICIARY
NUMBER
B. Charitable and Governmental Bequests:
AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $
(If more space is needed, insert additional sheets of same size)
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Re ister Of Wills Receipt Date 7/20/1995
Hanov ei and High Stree~ Receipt Time 11:06:59
Carli sle, PA j7013 Receipt No. 1005437
MICKEY GRACE V
File Number 1995-00191
Remarks R DAVID COWEN ESQ
Distribution Of Receipt
Transaction Description Payment Amount Payee Name
INVENTORY 10.00 CUMBERLAND COUNTY GENERAL FUN
Check# 160310.00
Total Received......... 10.00
~~.
21-95-191
LAST WILL OF
GRACE V. MICKEY
I, GRACE V. MICKEY, of New Cumberland, Pennsylvania
declare this to be my last Will, hereby revoking all prior vJills
and Codicils.
FIKST: PAYMENT OF EXPENSES - I direct that the expenses of my
last illness and funeral be paid from my estate as soon as
practicable after my death.
SECOND: SPECIFIC BEQUESTS AND DEVISES -
A. I give all of my tangible personal property,
including any automobiles ,. together with all insurance on such
property, in equal shares to such of my children as survive my-
self to be divided among them as they shall agree. Shou~~1 there
be no agreement, such property shall be equally divided ar:~ong
them as my Executor, in its sole discretion, shall determine.
B. I give to each of my grandchildren as survive mc.
an amount up to the sum of ONE THOUSAND DOLLARS ($1,000.00). I
further direct that said sum shall be placed in a certificate of
deposit or other interest bearing instrument until such grand-
child shall reach the age of eighteen (18) years; and that said
instrument may be delivered to the person taking care of such
child at such time as my Executor, in its sole discretion, shall
determine, and the reoeipt of such person shall be a complete
release of my Executor.
THIRD: SALE OF REAL ESTATE - I direct that any real estate
owned by me at the time of my death shall be -sold and the
proceeds thereof added to the residuary of my estate.
;,:
FOURTH: DISPOSITIVE PROVISIONS - I give, devise and bequeath the
entire residue of my estate to my children, SHERRY D. HALL, SANDRA
~C. WEIGEL and DONALD L. SOLONINKA, or their issue, per stirpes,
absolutely.
FIFTH: PROTECTIVE PROVISION - All principal and income shall,
until distribution to the beneficiary, be free of debts, contracts,
alienations and anticipations of any beneficiary, and the same
shall not be liable to any levy, attachment, execution or seques-
tration while in the possession of my Executor.
SIXTH: TAX CLAUSE - All estate, inheritance, succession and
other death taxes imposed or payable by reason of my death, and
interest and penalties thereon, if any, with respect to all
property comprising my gross estate for death tax purposes, whether
~~or not such property passes under this Will, shall be paid .out of
!the principal of my general estate as if such taxes were adminis-
~tration expenses, without apportionment or right of reimbursement.
I~Such taxes shall be paid at such time or times as may be deemed
ladvisable. No property received by my Executor from a benefit play
(qualified under the Internal Revenue Code and exempt from estate
(tax shall be available for the payment of the debts, death taxes
or administration expenses of my estate.
(SEVENTH: AFTER-ADOPTED CHILDREN - All references herein to a chil
jor children of mine, or to the children or issue of my children,
shall include any persons lawfully adopted while a minor either
;prior hereto or after the date of my death, and their issue.
EIGHTH: APPOINTMENT OF EXECUTOR - I appoint my daughter, SHERRY
D. HALL, Executrix of this Will and she shall not be required to
give bond or furnish sureties in any jurisdiction. If my said
daughter fails to qualify or predeceases me, I appoint my son,
DONALD L. SOLONINKA, instead and give to said Executor- all rights
powers and immunities set forth in this Will, including the
-2-
h
requirement that said Executor serve without bond. In the event
that my said daughter and my said son fail to qualify or pre-
decease me, I appoint my daughter SANDRA C. WEIGEL, instead and
give to said Executrix all rights, powers and immunities set
forth in this Will, including the requirement that said Executrix
serve without bond.
NINTH: POWERS OF FIDUCIARY - In addition to the powers above
provided for, and those given by law, my Executor, without any
order of court and in its sole discretion, may:
i A. Sell,pursuant to option or otherwise, at public or
private sale and upon such terms as the Executor shall deem best,
i
I any real or personal property belonging to my estate, without
regard to the necessity of such sale for the purpose of paying
(debts, taxes or legacies.
B. Retain any or all of such property not so required
wii:hout liability for any depr.eci.at.ion thereof .
C. Assign or transfer certificates of stock, bonds or
other securities.
D. Adjust, compromise and settle any and all claims in
favor of or against~my estate.
E. Conduct .and carry on all business now conducted by
me and. to do all things necessary or proper in the usual course
of business until such time as the business can be sold or
distributed as a going concern or otherwise, and the Executor
shall be exonerated from any loss which may result thereby.
F. Do any and all things necessary or proper to
- 3 -
CO SS.
~/
`' COUNTY OF~~. '.: i' '
'!`~ I, GRACE V. MICKEY, Testatrix, whose name is signed to
instrument having been duly qualified according to
'~`, the foregoing
Flaw, do hereby acknowledge that I signed and executed the in~nrdu-
~Iment as my Will and Tesfreenandtvoluntarynactlforlthenpurposes
that I signed it as my
~~therein expressed. ~ ~j
GRACE V. MICKEY ~~
,t ~pNW1;AL'1'H YJ'+NLVSYLVHLVIH:
Notary
'i ~I.
j ~~
I'
I
acknowledged before me, da of
the Testatrix, this Y
~> .- /.
No a y Publ''
i
., t,..
;i `~-~ GEGRGE N. A~YERS, NnfAP,1 t L..u~.
^~0 COI1teTY
CU~-°=h'
RO
I
j COMMONWEA ~ OF PENNSYLVANIA:
I --~
.
NEw CUYfiERlA1+D EO
-dY CG6tµ1SS;Q~ EtPtF[5 tiav 7r, !yR:
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ss
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`i COUNTY OF Ll ~~~ ~ t.d~/Gi1~ 3(~•Y
Member. VtnaSylven+a Assor.+~t,o+~ 0! Su
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and ~~~~^ ~ ['_,~~..~.,• •-- ,
We , ?~ "
are s
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ng
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we
that
~ thtr witnesses whose names
ay
d
a
depose
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law
to
ualified according
l
d
I~
ment
t
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y q
u
being
it
signed
'~ were present and saw t
1GRACEdVeXMICKEY
tr
that
estament
~,as her last Will and T
cuted it a
s her free and voluntary aci.
~~willingly and that she exe
in expressed; that each of us in the hear~nc
h
t
,for the purposes there
tatrix signed th
T a
e Will as witnesses; and t
es
;;and sight of the
the best of our knowledge, the Te statrix was at thzt time
d and under no
i
I; to
" eighteen (18) or more years of aae, n
of sound m
';~; constraint or undue influence.
,
;
1
/
' ` / ' + x'-11._. ; - , ~ i , _.
'1 G~-c.~ ~ :J ~
~~ ~ Witness
(~ Wi'tness
~~ .
~,' Sworn or affirmed to and subscribed -to b~efofe me, a~in..
ii Notary Public, by 1N Ewitnesses, this ~-day of
1984.
uf4RGE t;, y~VE!2S. ti~ni,pY Plid!_tC
ht9LRtA!~ ; SpRG CUMI'! „L}.M1~UCUiJi~[1'
ktw cat
- 5 - MY COMIMiSCa;r~ i.XV1~C5 '~t?V. 28. 14£+
Mtmbu, Pt~nsYl'ran+i gytiorrur,~n of ~;ol:nts
Sworn or affirmed to and
Public, by GRACE V. MICKEY,
1984.
r
`(complete the administration of my estate, all as fully as I
I
Ilcould do if living.
I,'~ IN WITNESS WHEREOF, I have hereunto set my hand and
,,~ da o f ~~.....~.- A. D. 19 8 4.
~I seal this Y
M .~~ ,.~ ~ ._.~~.. ( SEAL )
GRACE V . MICKEY ~~~
SIGNED, SEALED, PUBLISHED and DECLARED by the above-
Ilnamed GRACE V. MICKEY as and for her Will and Testament in the
resent at the same time, who at her
presence of us, both being p
(,Ire uest, in her presence and in the presence of each other have
I q
!hereunto subscribed our names as witnesses thereto.
'i , a
I~ Wi'_ness
Address
,..
o,-c.`-~-a r ~
Address
Witness
- 4 -
i
IN THE COURT OF COMMON PLEAS
Register of Wills of Cumberland County, Pennsylvania _
IlVVENTORY
Estate of Grace V. Mickey, Deceased No. 1995 - 00]91
Date of Death: 02/25/5
Social Security No.: 195-16-3797
Sherry D. Hall, Personal Representative(s) of the above Estate, deceased, verifies that the items
appearing in the following Inventory include all of the personal assets wherever situate and all
of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair market value as of the date of the
Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of
Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We
verify that the statements made in this Inventory are true and correct. I/We understand that false
statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to
unsworn falsification to authorities. .
Attorney: R. David Cowen, Esquire
I.D. No.: 26680
Sherry D. Hal Executrix
Address: P.O. Box 208
Upper Darby, PA 19082
Telephone: (610) 734-0655
Tangible Personal Property:
Date: ~ ~ ~~~ ,
Tangible personal property and household furnishings,
including personal clothing located at 819 Bridge Street,
New Cumberland, PA
Real Estate:
House and lot, located at 819 Bridge Street,
New Cumberland, Cumberland County, Pennsylvania
Sale Value
Total
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$ 1,500.00
70.000.00
$ 71.500.00