HomeMy WebLinkAbout95-0237~I qs-0237
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.
AUG 16 2001
Date
H105.,a3 Rw. 2/87
TYPERRMT
W
PERAIAl1ENT
a,LAac rate
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Fran eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLIMINIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
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NAME OF DEf:EDENT(FraL Midre, SEX SDCULL 9ECURIT'NUMBER DATE OF OERH(MOnlh. Dey. Yev)
+• r' z. Male ~- 166 - 58 - 3993 •• 1/26/95
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~~ ong , Timothy L • - ----- PA 17025
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1995-00237
REV•1502 EX+ (12.85) ~
,~ SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INFIERITANCE TAX RETURN _____
RESIDENT DECEDENT _ -"--"-"- - ----
_ ___ .. ----_ _ __ . _ _ __.. - -- __--_ FILE NUMBER
ESTATE OF
_ Timoth L. Lon -
(Property jointly-owned with Right of Survivorship muss be disclosed on Schedule F) All real estate should be reported ai fair market value
which is defined as the price at wl~ic{i property would be exchanged between u willing buyer and a willing seller, neither being compelled
- - ~ --• t--•'
---- _ .
1995-00237
r-- ~
+tV-ISO~IY•~~IS~ SCH~nULE ~~ „
4.~'t,a cnst{, nar~ic ~E~'osrrs nr~r
rnlscr:F.~nr~EOUs
~p,,t,.IUfIWfAllll Of PEI IIISYlV At11A i'ERSOMAI. f 120 F'EF2TY
IllllIWIT AIILF IA.( Nf IIIN IJ ,. ... _. ..
Nf SI0fI11 UE~EU l11T "- """'- ""-~----------
_~._ ._....__.. ___... ..__.-___cc.__r. ._... ___
esr.~r~^
Timothy L. Long _ _.______
Plonso Prinl or Ty
- FILf_ rllPubnr:k -"--_---
VALUE AT
DATE OF DEATH
$ 421.08
6,000.00
2,000.00
2,500.00
S 10,9 1.08
i
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i.
;,
1
TOYAL 1Al~o ontor on lino_5,'Rac~~itulnlion~T~
(Atluch addili~nal 015" x 11" dl..l~ i( mor• Ipac• IJ n..d.d (
~;
REV•1509 EX+ (386(
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Timothy L. Long
FILE NUMBER
Joint tenant(s):
NAME
A.
Jean L. Long
B.
C.
'ointly-owned property:
ITEM
NUMBE LETTER
FOR
JOINT
TENANT DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
_ TOTAL VALUE
OF ASSET DECD'S
% INT. DOLLAR VALUE OF
DECEDENT'S INTEREST
~• A 4/19/8 auphin Deposit 25, 133.69 ,, •~50% $12,566.84
Statement savings
~ ~
~~
Account #5332627785
~~I~~~
y~
TOTAL Also enter on line 6, Recapitulation) I $ 12 , 5~6 . 8 4
1995-00237
SCHEDULE F
JOINTLY-OWNED PROPERTY
ADDRESS RELATIONSHIP TO DECEDENT
Route #209, Box 99 Mother
Tower City, PA 17980
(li more space is needed insert additional sheets of same size)
__
1995-00237
REV IS11 Ext tB a6, SCHEDULE H
St.•~ 4t `~ FUNERAL EXPENSES,
.r~.1~;;~;A
ADMINISi RATIVE COSTS AND
f.OMMOr1WEAlT1! OF I'ENNSYIVAr11A
nutrelrnncE tax urnn<rr MISCEL.I.ANEC-US EXPENSES Please P
- _--._
- -- rint or Type _-___
_ _.
ulsnt(rrr uecrrxrn
_-_ _.____.. FILE NUM(3ER
ESTAT O
Timothy L. Long _
ITEM -- DESCRIPTION AMOUNT
NUMBER -- - -
A,.--_---- -~- -Funeral Expenses:
1. Carl Funeral Home, Tower City, PA $5,196.00
2. Greenwood Cemetery, Tower City, PA
775.00
3. Family and Friends Diner - funeral dinner .
392.82
4. Methodist Church Auxiliary
50.00
125.00
5. Dr. Rev. Gunter
100.00
6. Rev. Sonenberg
7. Mr. Miller - maintenance to clean church ,
25.00
2,000.00
8. Stone
g, Administrative Costs:
f , Personal Representative Commissions --
Social Searrity tJumlter of Personal Representative:.
Year Commissions paid ______.___-----___---
2. Attorney Fees Jacqueline L. Russell 6, 540.00
3. Family Exemption
Claimant _ Relationship ..---_------_------------------
Address of Claimant at decedent's death
Street Address -------------------_-------------- ------ _ _-- ------------- -------
City ________ _ _-_-.Slate _- _-_ Zip Code _ __
4. Probate Fees Cumberland County 258.00
C. Miscellaneous Expenses: '
I• Appraisal of real estate 80.00 ~
2. Miscellaneous, travel, long distance phone 125.00
calls, notary, etc.
3. Transfer cost for'deed 13.50
TOTAL (Also enter on line 9, Recapitulation) S • 15 , 80.3 2
(if more space is needed, insert additional sheets of saute size)
_ -
1995-00237
REV-131Y EJf+ (I•S9) +~ SCHEDULE 1
.. .
EDEfJT
r
DEBTS OF DEC
COMMONWEALTH Of PENNSVlVAN1A MORTGAGE LIABLITIES AND LIENS pM.ecse
NCE TAX RETURN print or Type
IN t IERITA
RE SIDENT DECEDENT
FILE NUMBER
ESTATE OF
Timoth L. Long
ITEM DESCRIPTION AMOUNT
NUMBER
Marine Midland Mortgage Corporation, 95 Washington
$64,720.54
Street, Buffalo, New York - mortgage on
real estate
~~~.) General Motors Acceptance Corporation, P.O. Box
1078, Baltimore, Maryland - car loan
6,832.06 ~'
~ #034-0263-78669
32
2
~,
~~ Oakwood .Center Radiation Oncology, .
4 , 23
Mechanicsburg, PA
• 800.13
4; Tax -.federal income for 1994
251.16
5, Tax - state income for 1994
TOTAL (Also enter on line 10, Recapitulations I $ 7 6 , 8 3 6.21
(tf more space is needed, insert additional sheen of same size.)
1995-00237
Evasl~ Ex. tae~l
,~~~ SCHEDULE J
COMMONwEAlill of VENNSYIVANIA BENEFICIARIES
WNERITANCE TAX RETURN
ESTATE OF
Timothy L. Long
ITEM NAME AND ADDRESS OF BENEFICIARY
NUMBER
A. Taxable Bequests:
t. Gary Kauffman
840 Belle Vista Drive
Enola, PA 17025
2. Elmer L. Long and Jean Long
Route #209, Box 99
Tower City, PA 17980
FILE NUMBER
AMOUNT OR
RELATIONSHIP SHARE OF ESTATE
Friend Life interest
in 840 Belle
Vista Drive,
Enola, PA
Parents residuary
(If more space is neudud, insert additional shouts of same size)
T.... r, r _,.._. _ _
`~~"r
LAST WILL
I, TIMOTHY L. LONG, of East Pennsboro Township,
Cumberland County, Pennsylvania, declare this to be my Last
Will, hereby revoking all prior Wills and Codicils.
FIRST: I direct that the expenses of my last illness and
funeral be paid out of my estate as soon after my death as is
convenient and expeditious in the judgment of my Executrix,
hereinafter named.
SECOND: I give and devise my homestead real estate
situate at 840 Belle Vista Drive, Enola, East Pennsboro
Township, Cumberland County, Pennsylvania, together with all
household goods and furnishings therein, to my friend, Gary
Kauffman, without lilability for waste, for his life so long
as he desires to use such premises as a home and pays all
costs of maintenance thereof, including taxes, assessments,
insurance and ordinary repairs, said property to be insured in
~~., a reasonable amount insuring the interest of the remaindermen
~ as well as himself.
Upon the death of my friend, Gary Kauffman, or
~ at such prior time as he no longer uses said premises as a
home for himself, then I devise said premises to my father and
mother, Elmer L. Long and Jean Long.
~r-~ THIRD: I give, devise and bequeath all the rest, residue
~~~ and remainder of my estate to my father and mother, Elmer L.
~.~~ Long and Jean Long. It is my desire that my parents
distribute all cash assets of said residue to my then-living
brother and sisters.
i~ FOURTH: All estate, inheritance and other death ta~ees,
together with any interest and penalties payable with respect
to property or interests therein subject to taxation by reason
1~ of my death and whether passing under my will or any codicil
thereto, or otherwise, including jointly held and other non-
testamentary property shall be paid out of the principal of my
residuary estate without apportionment.
FIFTH: I hereby nominate, constitute and appoint my
mother, Jean Long, Executrix of this my Last Will. Should my
mother, Jean Long, be unable to so serve for any reason
whatsoever, then and in that event, I nominate, constitute and
appoint my friend, Gary Kauffman, Executor of this my Last
Will. I further direct that they shall not be required to
:OTT CRAMER post any bond to secure the faithful performance of their
orneyatLaw duties in the Commonwealth of Pennsylvania or in any other
~. Drawer 159 jurisdiction.
nnon, PA 17020
~ ~
"~' ~#A1
IN WITNESS WHEREOF, I have hereunto set my hand and seal '`~
to this my. Last Will, which consists of one (2) sheets of
paper, dated this ~ 7 f-!~ day of January, 1995.
1 / ~ (SEAL)
Timoth Lon
The writing contained on this and the one preceding page
was signed and sealed by Timothy L. Long and by him published
and declared as his Last Will, in the presence of us, who have
hereunto subscribed our names as witnesses at his request, in
his presence, and in the presence of each other.
SCOTT CRAMER
iorney at Law
O. Drawer 159
annon, PA 17020
)i;i~i~t~f,
't~
<<~.i~.. ~~, 1
COMMONWEALTH OF PENNSYLVANIA )SS
COUNTY OF PERRY ~
I, Timothy L. Long, testator, whose name is signualifiede
attached or foregoing instrument, having been duly q
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act
or the purposes therein expressed.
~rwZ~~.cn ~t~cL~7na ~~l ~" ~'~
SWORN or affirmed to and acknoteStator,
before me by Timothy L. Long,
this 17t`~day of January, 1995. ~
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'tot. SCOTT CRAMER
O ~ Attorney at Law
annP•O. Drawer 159
incannon, PA 17020
w
_ . _,.~.
COMMONWEALTH OF PENNSYLVANIA )
)SS
COUNTY OF PERRY )
We, ~Ju.~cav~r~ Cn~o~e 4ln~ro~o,r~ and ~. ~CUE_~ ~('(~yh~~ ,
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw testator sign
and execute the instrument as his Last Will; that Timothy L.
Long signed willingly and that he executed it as his free and
voluntary act for the purposes therein expressed; that each of
us in the hearing and sight of the testator signed the will as
witnesses; and that to the best of our knowledge the testator
was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
~~~ ~
SCOTT CRAMER
ttorney of Law
O. Drawer 159
:annon, PA 17020
SWORN or affirmed to and subscr~be~
to bed re me b ~~,~ SClv~r~ ~~rnlP ~f~Uu- rY~('11'~
and 1~, SC(~~~~'lO~y~~e( , witnesses,
th~i~~s t 7 t4 day of January, 1995.
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