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HomeMy WebLinkAbout95-0204a~-q~-oa~u 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. auc i s ~o~ p Date Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 N708. i~S Rav. ?/B7 nrERaNT w nEnetu/Enr NANEGRDEDEDOrr~e BuacwK ,, Joseph AOEBaet BHiaerl 84 vIa NOiDEgN Cumberland ~ ~ ° r e COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH STN[RIE NUMER W. Gossett Jr. ~" L Yale SDDIAI SECURrtr NUMBER a. 172 .Ol _5914 uNDEe+oir DREGFBBRII awrNPUCtapv.w H•Iaa I aalraaa IIAwrI, oM. ~l i«•qn Cauryl ~ PucEOSDEaNIa a«+v,,,.-,...,~,,,,d,.,,,a~.,,w, . ~on A e an 17,1911 ~ hwtw^ EPopry,apNa^ DaA^ , CRY. BOIq.TNTOF IN:.t711 FACl7fYlMMEla rotirflaan. pla nealarrl nurnE«) Yiddle T 11Rf OFIMBPANID ORgw N ^ ~ seX >tvp. ~ umberlaad County Nursiag Home a w 8,..,~anl,Da,.A. .rta• n.taRteal t IoaoPeuswES&wWSrnv LW DECEDEMEVEAw GECEDENi'BEDUGPION ~ . A. a u.a~gyEDralcESr Nww~ Iw,~,"""*.e „wuPP1Y COmpaIIy .• n. N.^ _ ~,~ 1+I . Yarrp~aa~~'~ ~2575Q fE OF DERH gtorin, pry,',y„ larch 7, 1995 Reeiarp ^ rsoec~M ^ ~M•NYyI Ye1rt. Btaek 1MaN White 111 mnoaeilrliy ucinda Fager 5138 E. Trindle Rd. ACTUK RESIDENCE t7a. Stra ____•~°~••• ••~° en ~ +h. 1...e,aa~+n~.eti +~Yeohanicsburg, PA 17055 ~, ~'°"` '"~'"` t`"' Cumberland ~•" Jo'seP~~sett Sr r `M'°° N°T s ~ . ~o . ' uL A~•rlesg~, D,s.,,,,,,,s i wFO~uoi~n~aRett `"~ ' ~ NEtI1oo oP~~+ ~. lr~n d fe"~°ui~e'o~j`an°~caburg, PA 17055 a.rLJ DgRlallea^ RanarYtmnBlre^ D«.aa^ oar,ts~AA ^ DRE o f DrewetTloN ~ ~!(I 10, 1995 RAC[OfDgPO511t0N-N•awatCerneter,l~ BYRPtgg Green M i l ~OCatDN•CEWb•nBtw,n-C•a emor a Park Cam Hill, Pa 17011 wBltlBllMIE Oi NIIIfRAL ~+\ OR PEIIBDN ACRNO A89lICN l-L tta. ~n ~~ ,,,~, PavatJan keel aearetarulraaem tMlaraf aw Ptac•rera. a . , Yechaniosburg, PA 17055 LICENSE NUNBEIt aauaeafaaaN~ 3618 aar 0a ••n~plNp M ~ Da ORESq/Ep ~~ QS_ d~~-~ ~.~~3/-z ~- whola•naewwaaw. 1 ~ p x b PItDNDUNCED OFAD BApIh. March 7 1995 lp.n wts GABS REFERREDW ME01CAL 17(ANIMERICOgONEp, , w• ^ ~^ at ~ . „, r.MRrt: Ear.Bt. alewaa, +ijurM.«mrrgraan~ tMatn. Do not enlerBnne,aaaYalB.walYnlWt« ~•NY •na cair an•wlWn. IwpiNrry aneel.eMCa«Mert taaua. iApgor.~r ~pTCEarW~o~~~ \ - 1 ~OMYI MILT M: Otlyryp~~ ,• ~~••1~IBMtln 1111MyYgBp AEI[ aYMate 7MLYw0 «ej«y L/18T OF7 OF CAUSE ]~, Iteonn. Dry. 16at) - _ Iralrr LJ N°miae• ^ A1~ Attlara ^ PwlayyNeWga,Ia,i ^ +-. ^ N•C'] 11a ^ No ^ Sukiae ^ G•uNnatratermnW ^ aaa PLACE oP w,luuRr -a roer, n.,,. w..I 1SP•r+M tYR71f1El, ICnad ola, olW ~- m•• ~. •cotrtPrlNtsPLnBLeuNIPnr.K..e=•roN+g~aw.aa.nwlw.aeear.mwc~anna cm,PNleairnz3l 7e er tNet a ary M^•M•a8•. awn eee•r,ea a•e r tti eaeeM•1 ena mem« •• •twu~~ aeon ano ^ •-noND~ Ba ~eERrLPrwoPNrsNawNlPn,~,~4„eat,•,maasan,..o1•~„raaeml et.,ye, aan eecur,ea atYn trr,ate, nm gece, enaawbUU ee•••1.1altl mann«ee wt.a .................. ~, w ..... O 'tMEp1CAL E%AMINER/CORONER OR +~• traN el •+alnanalbn+Awa rvytlipirn, in my •pnlon, oath xeurrW N LM tNm, dar, antl aca, and aue to tha eauaa a) atq ~ ]ta.««1Me as •t•t•d ............ . .. ^ ...................................................... w........ ~ REGISTRAR'S SpNaURE AND NUMBER b. OAI t[>e tn.. *'. n. ^ rr ^ NBER DRE SNiNEDItAmal. Dry. 1 _.pOS-P S S- L 7+4 3 7 ! s ODRE~OF PERSON WMO CDNPLEfED CAUSE DERN cctbvrt fz-. GAS -Da 17p~~ ~1_I'~LL[M~'Ni ~(1.11~1C ~}(Z Ll~.i l.LT ~/a NoMn UaY. 1avI < / 5~~~~~~ REV-1500 EX+ (7.94) S' ~ INHERITANCE TQ:X s4ETURN /~ RESIDENT DECEDENT \__~ COhN10NWEALTH OF PENNSYLVANIA ~'r0 BE FILED IN DUPLICATE DEPARTMENT OF REVENUE ^__ DEPT. zaobol WITH REGISTER OF WILLS) HARRISBURG, PA 17128-0601 ~- z W D W W O W eY6y Y V ~ J m c t%! ~ W W d: ~ oz ~~ z 0 d W s ° z 0 f= f 0 w a 1'`-"1-~yi4 3 7 95 Ir APiLICA6LEl SURVIVING SVOUSE'S NA/.1E (UST, FIRST AND MIDDLE INITIALI SOCIAL SECURITY NUMBER Counr GOSSETT LUCINDA C. ®1. Original Return ^ 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future Interest Compromise (for dates of death after 12-12-82) ® b. Decedent Died Testate ^ 7. Decedent Maintained a Livin Trust Y ~~ (Attach copy of Will~@ (Attach copy of Trust) g FOR DATES OF DEATH AFTER 14/31191 CHECK HERE IF A SPOUSAL POVERTY CREDIT IS CLAIMED ^ FILE NUMBER CODE 21 EAR ~ 20NUM 5138 E. TRINDLE ROAD MECHANICSBURG, PA 17055 ^ 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 TELEPHONE NUMBER MARKET SQUARE BUILDING 717 766-3172 MECHANICSBURG~~•t~, 17055 ~7 1. Real Estate (Schedule A) (1) 432.2 - 2. Stocks and Bonds (Schedule B) (2 ) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages and Notes Receivable (Schedule D) (4) - f 5. Cash, Bank Deliosits & Miscellaneous Personal Property (5) 3, 500.00 '~'1 (Schedule E) b. Jointly Owned Property (Schedule F (6) - ~ : ~~' r_~; 7. Transfers (Schedule G) (Schedule L) (7) ~ ~.. ~ ~=" .~:: ~ " 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) (9) _ 16.163 00 (8) 435. 755 65 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 863.51 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (11) 17,026.51 13. Charitable and Governmental Bequests (Schedule 1) (12) 418, 729.14 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) ' 15. Spousal Transfers (for dates of death after b-30-94) (la) 418,729.14 See Instructions for Applicable Percentage on Reverse Side. (Include values from Sched l K (15) 408. 729.14 x ~~ _ 12 R7 261 u e or Schedule M.) - • - _ . 16. Amount of Line 14 taxable at b% rate (Include values from Schedule K or Schedule M.) (16) x .06 = 17. Amount of Line 14 taxable at 15% rate (Include values from Schedule K or Schedule M.) (17) 10, 000, ~~ x .15 = 1 ~ 500.00 18. Principal tax due (Add tax from Lines 15, 16 and 17.) 19. Credits Spousal Poverty Credit Prior Payments Discount Interest (18) _1_3, 761 _ R7 + + 688' 09- _ !0. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT (19) (20) 688.09 '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 21B. This is the BALANCE DUE. Make Check Payable to: Register of Wills, Agent > ,~ under penalties of perju it is true, correct and car based on all information (21) 13,073.78 (21 A) (21 B) 13.073 78 re that all eeal estate has been~repourted at true maarke9va ue~Declarationtof preparerdother carer has any knowledge. NG RE URN ADDRESS or my Knowledge and belief, the personal representative is DATE 2 3 DATE J'1 z ~ Act #4ii< of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the uss 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 1/1/96 • Zq6 (.14) 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 • Spoassrl tr®a:fers occurring on or after 1/1/98 will bs exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS aY 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, 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$ ...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. I ~ t ~ REV-1503EX+ ~4-66) ~ a COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS JOSEPH W. GOSSETT, JR. 1995-00204 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) IT EM NUMBER DESCRIPTION ~~ $10,000.00 - SCHOOL DISTRICT OF ALLENTOWN GO BOND, SERIES OF 1987, ISSUED JULY 14, 1987 MATURED AUGUST 1, 1991, INTEREST 6.47 PR 10,000.00 INT 77.15 2• $25,000.00 - PHILADELPHIA MUNICIPAL AUTHORITY - BUILDING LEASE RENTAL, SERIES 1990, ISSUED MARCH 15, 1990, MATURITY MARCH 15, 199.6, INTEREST 6.77 PR 25,000.00 INT 830.62 3. $20,000.00 - COUNTY OF LEHIGH - G 0 BOND, SERIES OF 1991, ISSUED FEBRUARY 12, 1991, MATURITY AUGUST 1, 1997, INTEREST 6.17, PR 20,000.00 INT 110.30 4. $25,000.00 - PHILADELPHIA MUNICIPAL AUTHORITY - JUSTICE LEASE BONDS, SERIES 1991-A, ISSUED AUGUST 19, 1991, MATURITY NOVEMBER 15, 1997, INTEREST 6.257 PR 25,000.00 INT 479.45 5~ $25,000.00 - SWARTHMORE BORO AUTHORITY, SWARTHMORE COLLEGE REVENUE BOND, SERIES 1990, ISSUED OCTOBER 4, 1990, MATURITY SEPTEMER 15, 1996, INTEREST 6.357 PR 25,000.00 INT 621.95 6• $15,000.00 - COUNTY OF BUCKS - G 0 BOND, SERIES 1989, ISSUED APRIL 20, 1989, MATURED MARCH 1, 1995, INTEREST 6.87 PR 15,000.00 INT 19.56 7• $25,000.00 - HEALTH CARE FACILITIES OF SAYRE - GGUTHRIE HEALTH CARE SERIES 1991-A, ISSUED APRIL 15, 1991, MATURITY MARCH 1, 1998, INTEREST 6.37 PR 25,000.00 INT 25.89 8• $25,000.00 - HEALTH CARE FACILITIES AUTHORITY OF SAYRE - HEALTH CARE REVENUE BOND, 1989 SERIES A, ISSUED NOVEMBER 7, 1989, MATURITY NOVEMBER 1, 1999, INTEREST 7.07 PR 25,000.00 INT 608.90 TOTAL (Also enter on line 2, Recapitulation) /IF mnro cnn~n ie nce.Je.J .Henri .,.J.J;I;......1 rl.ee~...l ........ ..~.. 1 VALUE AT DATE OF DEATH 10,077.15 25,830.62 20,110.30 25,479.45 25,621.95 15,019.56 25,025.89 2 ,608.90 S REV•15~3EX+ fd-86) '~' . SCHEDULE B fOMMONWEALTH OF PENNSYLVANIA STOCKS AND BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JOSEPH W. GOSSETT, JR. 1995-00204 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) IT EM NUMIER DESCRIPTION $20,000.00 - RHILADELPHIA REGIONAL PORT AUTHORITY, COMMONWEALT LEASE REVENUE BOND, ISSUED AUGUST 29, 1990, MATURITY AUGUST 1, 1997, INTEREST 6.45' PR 20,000.00 INT 116.63 10 $10,000.00 - SAINT THOMAS TOWNSHIP MUNICIPAL AUTHORITY, SEWER REVENUE BOND, SERIES 1985, ISSUED JANUARY 28, 1986, MATURITY DECEMBER 1, 1995, INTEREST 9.07 PR 10,000.00 INT 239.18 11 $30,000.00 - CARBONDALE AREA SCHOOL DISTRICT, G 0 BONDS, SERIES 1991, ISSUED MATURITY APRIL 15, 1996, INTEREST 5.9' PR 30,000.00 INT 615.86 12 $10,000.00 - BOROUGH OF MEDIA WATER REVENUE BOND, SERIES 1987, ISSUED OCTOBER 15, 1987, MATURED JANUARY 1, 1993, INTEREST 67 PR 10,000.00 INT 108.49 T3 $10,000.00 - BOROUGH OF LANSDALE GUARANTEED ELECTRIC REVENUE BOND, SERIES 1989, ISSUED MARCH 6, 1989, MATURED JUNE 1, 1992, INTERES 6.3 PR 10,000.00 INT 1.72 14 $10,000.00 - PROVINCE OF ONTARIO, 30 YEAR 15 1/87 DEBENTURE, ISSUED JULY 20, 1981, MATURITY MAY 1, 20L1, INTEREST 15 1/87 PR 10,000.00 INT. 522.79 15 $25,000.00 - DAUPHIN COUNTY HOSPITAL AUTHORITY, HOSPITAL REVENUE BOND, SERIES 1991 (POLY CLINIC), ISSUED SEPTEMBER 11, 1991, MATURITY AUGUST 15, 1995, INTEREST 5.4~ PR 25,000.00 INT 73.97 16 $25,000.00 - PUERTO RICO HOUSING FINANCE CORP, MULTI-FAMILY MT REVENUE BOND, PORTFOLIO A, SERIES 1, ISSUED MAY 31, 1990, MATURITY JANUARY 10, 1996, INTEREST 6.6' PR 25,000.00 INT 253.15 TOTAL (Also enter on line 2, Recapitulation) ___ _.__ 1 VALUE AT DATE OF DEATH 20,116.63 10,239.18 30,615.86 10,108.49 10,001.72 10,522.79 25,073.97 25, 25/3,!15 ~/ S REV•1503 EX+ (d-861 ~~ - COMMONWEALTH Of PENNSYLVANIA INHERITANCE 7AX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS AND BONDS JOSEPH W. GOSSETT, JR. 1995-00204 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.j ' ITEM NUMBER DESCRIPTION ~~ $30,000.00 - RED LION SCHOOL DISTRICT, G 0 BOND, SERIES 1990, ISSUED NOVEMBER 2, 1990, MATURITY APRIL 1, 1997, INTEREST 6.47 PR 30,000.00 INT 668.05 I8 $25,000.00 - BERKS COUNTY MUNICIPAL AUTHORITY REVENUE BOND, SERIES A OF 1989, ISSUED OCTOBER 12, 1989, MATURITY OCTOBER 1, 1997, INTEREST 6.85 PR 25,000.00 INT 741.30 19 $25,000.00 - SCRANTON-LACKAWANNA HEALTH & WELFARE AUTHORITY, HOSPITAL FACILITIES REVENUE BOND, SERIES 1989B, ISSUED JANUARY 4, 1990, MATURITY JANUARY 1, 1996, INTEREST 6.457 PR 25,000.00 INT 291.57 20 $10,000.00 - HOSPITALS & HIGHER EDUCATION FACILITES AUTHORITY OF PHILADELPHIA, ISSUED JUNE 22, 1987, MATURED JULY 1, 1992, INTEREST 6.07 PR 10,000.00 INT 108.49 21 MERRILL LYNCH READY ASSETS TRUST, ACCOUNT 063-872-39554-6 PR 25,690.53 INT 50.10 TOTAL (Also enter on line 2, Recapitulation) ru .~.,.e ..,....e ,~ ..ee.~e,~ ~,,.~.~ „a,r;+:.,.,,,i .tive+...~ .,,me .,tee I VALUE AT DATE OF DEATH 30,668.05 25,741.30 25,291.57 10,108.49 25,740.63 g43z,Z55.65 • REV-IISOC EX+ (2-871 SCHEDULE E CASH, BANK DEPOSITS AND COMMONWEALTH OF PENNSYLVANIA MISCELLANEOUS 'N RESiIDENTEDKEDENTRN PERSONAL PROPERTY ESTATE OF JOSEPH W. GOSSETT, JR. (Aii Property jointly-owned with fhe R1ght of Survivorship must be disclosed on Schedule FI ITEM NUMBER DESCRIPTION 1. 2. 1977 CHEVROLET PICK-UP TRUCK -INOPERATIVE 1982 LINCOLN SEDAN -FAIR CONDITION Please Print or 2195-204 VALUE AT DATE OF QEATH 300.00 3200.00" ~. TOTAL (Also enter on line 5, Recapitulation) $3500.00 (Attach additional 8'/:" x 11" sheets if more space is needed.) • REV-1511 EX+ ~8-86) SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or NUMBER 2195-204 JOSEPH W. GOSSETT, JR. ITEM NUMBER DESCRIPTION ~-• Funeral Expenses: • 1• MYERS FUNERAL HOME - 1`ZECHANICSBURG B. ,. ~; COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 1 2. 3. Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid Attorney Fees Family Exemption Claimant LUCINDA C. GOSSETT Relationship WIFE Address of ('laimant at decedent's death ss 5138 E. TRINDLE ROAD ECHANICSBURG State PA Zip Code 17055 2,847•t~ta + 1 1 , f~ 0 0 • it ~:) + ~ ~ 5 0t) • U !J + xpenses: 225•oa + ~ - 15.00 9 ~~ • ~ (a + 'OR ACCOUNT - 75.00 l 7, 663 • UI;~ ~ u •. c~ AMOUNT 2,847.00 11,000.00 ~ ~~ ~. c., 226.00 90.00 TOTAL (Also enter on line 9, Recapitulation) $16,163 0 (If more space is needed, insert additional sheets of same size) - ,- _ _-: 'j> REV.1512 EX + (10.86) COMMON WEAITH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOSEPH W. GOSETT, JR. -" L17J- LV4 ITEM NUMBER DESCRIPTION AMOUNT 1. PA WATER COMPANY 22.29 2. BELL ATLANTIC 31.05 3. JOHN RUSSELL, BILL OWED FOR PLOWING SNOW 15.00 4• U.G.I. - GAS BILL 189.63 5. PP&L 51.02 6. HAMPDEN TOWNSHIP, TRASH REMOVAL 33.00 7. HAMPDEN TOWNSHIP - 1995 REAL ESTATE TAX 521.52 ~/ i SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABLITIES -AND LIENS TOTAL (Also enter on line 10 Recopitarlotion) $ 863 51 (If more spoce is needed insert additional sheets of same size) • REV-1513 EX+ (2-87) COMMONWEALTH OF PENNSYLVANIA INNERITANCE TAX RETURN RESIDENT DKEDENi cJ~NIC VF - JOSEPH W. GOSSETT, JR. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: ~• LUCINDA C. GOSSETT 5138 TRINDLE ROAD MECHANICSBURG, PA 17055 2• CLEO G. GOSSETT DAUPHIN COUNTY NURSING HOME HARRISBURG, PA ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: 1 SCHEDULE J BENEFICIARIES FILE NUMBER 2195-204 RELAT OI N HIPS AMOUN R SHARE OF ESTATE WIFE I RESIDUE OF ESTATE SISTER I $10,000. BEQUEST AMOUNT OR SHARE OF ESTATE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) $ (If more space is needed, insert additional sheots of same size) LAST WILL AND TESTAMENT OF JOSEPH W. G03SETT, JR. I, Joseph W. Gossett, Jr., of th® Township of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this rqy ' Last Will and Testament, hereby revoking and making void any `and all Willa `` by me heretofore made. 1. T direct the payment of all nKY dust debts and funeral expenses ae soon after my decease as the same can conveniently be done. 2, v ,, I give, devise and bequeath the sum of 'Ten Thousand 010,000.00) Dollars to my sister, Elsie J. Care, but in the event she should predecease me, the gift shall lapse and fall into the residue of my estate. 3. I give, devise and bequeath the sum of Ten Thousand 010,000.00) Dollars to my sister, Clementine Parvus, but in the event she should pre- decease me, the gift shall lapse and fall into the residue of my estate.. ;~, lt. ' t'' r .' 4 I give, devise and bequeath the sum of :Ten Thousand (~10~000.00)~'. Dollars to my sister, Cleo G. Gossett, but in the event she should pre- decease me, the gift shall lapse and fall into the residue of my estate. 5. ~ ~, °. , r :~ ? All the rest, residue and remainder of nay`estate, real, personal and ~,, ~: - - mixed, I give, devise and bequeath to ~ wife, Lucinda C and in fee simple. Gossett, absolutely 6. In the event, however, that my wife should predecease~me or should die within thirty.~30) days of the'date oY' a0-~ death, ,,Z:; 6ive,.~. de vise :; and~:'begaeath '~ the residue of my estate as follows: (~a) One-half to Elsie J. Care," ~ Clementin® Parvas< and Cleo G. Gossett, in equal shares, pro~~ng h~evgr~ that should any of said legatees predecease men the share bequeathed to h©r shall lapse and be distributed in equal abates to the named legatees who survive me. fib) One-half in equal shares to the following relatives of my wife, Lucinda C. Gossett: Caroline E. Fager, Thomas Chorpenning, Jr,, Robert Chorpenning and Thomas Chorpennin j g~ II ~ provided however, that should at~y of said legatees predecease me, the share bequeathed to him or her shall lapse and be distributed in equal shares to the named legates who survive me, 7. I nominate, constitute and appoint the Harrisburg~National Bank, Mechanicsburg Offices to be the guardian of the estate of atop legatee who i not of age on the .date of s my death, and direct that said guardian in .its sole discretion shall a 1 `~ . PP y principal as well ae interest for~the maintenanae~ education and support of such legatee when the same is in his best in without the necesait of terest Y petitioning the Orphans Court for permission to make such expenditures; I direct that said guardian shall take of all insurance or annuity contracts on Possession ~Y life and any and all pensions .,r., . ._.. ... .- r.R': or death benefits from any society or organization of which I am a member said proceeds to be added to the share of each legatee under this Will. 8. Z nominate, constitute and appoint ~ wife, Lucinda C. Gos$ett~. to be ° the Executix of .this my Last Will and Teetament,~and in the .event she should pz~edecease me or for any reason be unwilling or unable to act as such, then I nominate, constitute and appoint, John M. Eakin, to be the Executor of this may last Will and Testament in her place and stead. IN''WyI,,T~NESS WHEI~CIF, I have hereunto set my hand and seal this o~tp"~ day °f - - t , 1961. Signed, sealed, published and declared by the above named Joseph W. Gossett, Jr., as and for his Last Will and-Testament, in the presence of us who have hereunto subscribed our names as witnesses, at his request in his. presence and in the ~ Prosence of each, other. ~. REV-1547 EX AFP (12-94) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT ~. ~= REVENUE BUREAU OF I N D I VIDUAL TAXES DEPT . 2806 O 1 HARRISBURG ~ PA 17128-0601 NOTICE OF INHERITANCE TAX ACN 101 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 09-18-95 CSIAIC urr ~~ ~ ~~-+~~ ~~ w DATE OF D E~1TH 03-07-95 FILE N0. 21 95-0204 COUNTY CUMBERLAND NOTE: TO = N SURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAVM E NT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT T0: JOHN M EAKIN MARKET SQUARE BLDG MECHANICSBURG PA 17055 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Amount Remitted CUT A;..RNG THIS LINE ------- ---RETAIN-LOWER- PORTION- FOR- YOUR RECORDS - REV-147 E X AFP (12-94) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWA' OR ---' DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTAT E O F GOSSETT JOSEPH W FILE N0. 21 95-0204 ACN 101 DATE 09-18-95 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 432,255 65 2. StoaKs and Bonds (Schedule B) (2) .00 3. C1 o sa lY Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) •.00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 3,500 00 6. Jointly Owned Property (Schedule Fl (6) .00 7. Transfers (Schedule G) Total Assets (7) .00 S. (a) 435, 755.65 APPROVED D EDUCTIONS AND EXEMPTIONS: 9. Fun®ral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 17,663.00 10. Deb t s~Mortgage Liabilities/Liens (Schedule I) (10) 86 3 5~ 11. Total Deductions (11) 18 576 1 12. Nst Value of Tax Return (l2) 417,229.14 13. Charitable/Governmental Bequests (Schedule J) (lg) .00 14. Net Value of Estate Subject to Tax (14) 417 229 14 NOTE: I'P an assessment was issued previously, lines reflect figures that include the total f 14, 15 andior 16, 17 and 18 will o ALL ASSESSMENT OF TAX: returns assessed to date. 15. Amount of Line 14 at Spousal rat' (15) 407, 229.14 X . 00 16. Amount of Line 14 taxable at Lineal/Class A rat' (16) 0 0 = . 00 17. Amount of Line 14 taxable at Collateral/Class B rata (17) . 10, 000.00 X .06= 15 .00 18. Prin~iPal Tax Dua X . _ 1, 500.00 TAX CREDITS: (18) 1,500.00 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) AMOUNT PAID 06-05-95 AA047836 75.00 ,: „" ,_ * IF PAID AFTER DATE INDICATED, SEE REVERSE FnR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 13,148.78 BALANCE OF TAX DUE 11,648.78CR INTEREST .00 TOTAL DUE 11,648.78CR ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLFCTFn ec w ••rornrT.. ,,..,, „_„ .. _._ REV-14 ~0 EX (6-881 COMMONWEALTH OF PENNSYLVANIA DEPARTMEN' OF REVENUE BUREAU OF INI')IVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME ~ Josezzh W. ~ SCHEDULE STEM NO. $ _._Amo>3nt__of__Sche.duie _B_._i~.._~'elryorted.__on_the__first__line_of,_the__reea it_ula page incorrectly. Inserted on Line 2 of the recapitulation p ~~,-~ g _._ --_ E3 _.._ _ _ _.._ _... er ect on 3121 of 1994 Act, effective January 30, 1995, the Family Exemption was._amended,_.. increasinsf__the.__amou.nt.__of, the claim _from__~2,©00 $3,504.0(}. INHERITANCE .TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES 215 101 TAX E);AMINER: Daniell PAGE .-=— pennsyLvania 1V DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14) INHERITANCE,j WIS-:ION OF STATEMENT OF ACCOUNT PO BOX 28 �OT U HARRISBURVVAe?,�2'�-b&Df� frr �';JLLS DATE 02-09-2015 FEB Fm ESTATE OF GOSSETT JOSEPH W DATE OF DEATH 03-07-1995 FILE NUMBER 21 95-0204 COUNTY CUMBERLAND EAKW""""' Jl,!'O��H' N, M ACN 101 MQJKI�VES�QbAU'E' BLDG Amount Remitted I MECHANICSBURG PA 17055 1 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE --► RETAIN LOWER PORTION FOR YOUR RECORDS --- - - ---- ------- - ' I - - 7EAilif O� iCC70bif i ii--1 i i f -E-k-AFP (12-14}-----*;; -flt�HiiffAE TAX STATEMENT ESTATE OF:GOSSETT JOSEPH W FILE NO. : 21 95-0204 ACN: 101 DATE: 02-09-2015 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-11-1995 PRINCIPAL TAX DUE: 1,500.00 PAYMENTS (TAX CREDITS) : PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER INTEREST/PEN PAID 06-05-1995 AA047836 75.00 13,073.78 10-13-1995 REFUND .00 11,648.78- TOTAL TAX PAYMENT 1,500.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.