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HomeMy WebLinkAbout95-0245PETITION FOR PROBATE and G~.NT OF LETTERS Fstate of t~TA~iII.rF M. GIBBON also known as Deceased. Social Secrlrity No. 207-07-4193 No. ~ ~ - 4~-" ~, yS To: Register of Wills for the County of CiIIvIBII2LAL~ID - in the Commonwealth of Pennsylvania 'The petition of the undersigned respectfully represents that: Your petitioner(s), who is/sae 18 years of age or older an the execut rix , 1990 ed in the last will of the above decedent, dated April 6, and codicil(s) dated (state televant arnimstanea, e.e. ratunciation. death of uecutor. etc.) Decedent w•as domiciled at death in Ctntlberland County, Pennsylvania, with h er last family or principal residence at 139 W. Vine Street Borough of Shir~nan~town ,A14~ 1701 / {list street. number, 'Twp. or Boro.l Deceden~thcn,~-82 ycars~of age, died 1"~~ 6• - 19 9- 5 -~ Fxcept as follows, decedent did not marry, was not divorced and dtd not have a child born or adopted after execution of the will o_ ffered for probate; was. not the victim of a killing and was never adjudicated incompetent: Dtcedent at death owned property with estimstcd values as follows: (If domiciled in Pa.) All personal property S 10.000.00 (If sot domiciled in Pa.) Personal property in Pennsylvania S (If not domiciled in Pa.) Personal property in County S 0,0 Value of real state in Pennsylvania situated as follows: 139 W. Vine St_. Rnrrovth of Shir~nStawri. WHEREFORE. petitioner(s) .respectfully request(s) the probate of: the last will and codicil(s) presented herewith and the grant of letters ~estament~T'y (trscamcntary; administration e.t.a.; admiaisuuion d.b.n.at.a.) theron. Y V 7 ~ Y Y d ~ c~ .- wL Y v. 7 ~ C N ~~/Vw~+~ ~ ~~~ T//V v/ P1ne Ridote Drive Lewis Center. Ohio 43035-9360 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 ss COUNTY OF ~ J The petitioner(s) above-named swear(s) or affirm(s) that the statements is the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal repruen- tative(s) of the above detedent petitioner(s) will well and truly adminpister the estate according to law. Sworn to or affirmed and subscribed ~'~-d-~~~ ~74-~~ r., Judith Inn before me this 20TH day of c MARCH M V (' I FIJTC ~ Rooicrer /3- a~ - ~ NO. ?_1 - 95 - 245 Estate of Rr~r-y~?r:rr.: M. czsso~l -Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~ APRIL 10, 19 95 „ in consideration of the petition on the reverse side hereof. satisfactory proof having been pruented before me. IT IS DECREED that the instrume:~t(s) date~April 6, 1990 - described therein be admitted to probate and filed of record as the last will of Rhuabelle M. Gibson and Letters ~ta~rwn+-a ; are hereby granted to Judith r.i nn _ _ _ _ FEES Probate, Letters. Etc.......... S 200.00 Short Certificates( 1) .......... S_ 12 ; n~ Renunciation S X-Pages ............... 9.n0 JC P 5----~ TOTAL S_ ~~_~~ Fd~ ,,,,,,,.APR IL. 10;.1995......_.... ~~ C._ ~ :_ - o N --- - ; ~_ - -s _ ~; !y: fLi~ I.i , V V ._ Re~sta of ~tIs MARY C. LEWIS - Horace A. Jan (06340) Johnson, Duffie, Stewart & .Weidner 301 Market St ~p ~pp~'~x 109 e, PA 17043-0109 ADDRESS (717) 761-4540. PHONE Mailed letters and order to attorney on 4-10-95.- ., ~_~ DO NOT WRITE IN MARGIN RESERVED FOR ODH DATA CODING b. d. e. IF DEATH OCCURREOIN INSTITUTION, GIVE RESIGENCE BEFORI AGMISSION L_- 1~ I(. I. m. n. o. P• Q~ r. s. L u. SEE INSTRUCTIONS ON OTHER SIDE i r n n Q N w 2 ~n __ ~/ Ohio Department ar Health Reg. Dist. No. ./ VITAL STATISTICS Primary Reg. Dist. No. a~~4 CERTIFICATE OF DEATH State File No. /~~~~`/ TYPE OR PRINT IN PERMANENT BLACK INK Registrar's No. 1. DECEDENT'S NAME /First, Middy, LASTI 2. SEX 3. DATE OF DEATH RHUABELLE M. GIBBON FEMALE N(a~cN ~;' 5 4. SOCIAL SECURITY NUMBER 6a. AGE -Last Birthda Sb. UNDER 1 YEAR Sc. UNDER 1 DAY 8. DATE OF BIRTH (Month, 7. BIRTHPLACE (City and State o Months Days Hours Minutes 207-07-4193 (Years) 81 I I ay'cFiar~7,1913 C~~l;`~~'IIVSYLVANI~ I 1 8. WAS DECEDENT EVER IN U.S. 9a. PLACE OF DEATH (Check only one) 26a. NATURE OF P ON ISSUI PERMIT 26b. DIST. No. 27. DATE PERMIT ISSUED ~5 .~ ~ ~ one ion p 20d. DATE OF DISPOSITION 21 a. NAME OF EMBALMER 21 b. LICENSE NUMBER March 7, 1995 Jeffrey A. Craig 7854A 22a. IGN R FUN AL RECTOR OR 22b. UCENSE NUMBER 23. NAME AND ADDRESS OF FACILITY OT P N ~ (o! Licensee) 30~ 2 SCHOEDINGER NORTH CHAPEL ~~~ 5554 KARL ROAD 24. REGI SIG ATURE 26. DATE FILED (Month, Day, Year) ~ /~-9.S COLUMBUS, OHIO 43229-3608 ~~ ~~~ ~~ ^ Yes g(NO HOSPITAL C3Clnpatient ^ ER/Outpatient ^ DOA OTHER: ^ Nursing Home ^ Residence ^ Other (Specify) ib. FACILITY NAME (I( not institution, give street end number) 9c. CITY, V ILLAG E, TWP., OR LOCATION OF DEATH 9d. COUNTY OF DEATH ST. ANN'S HOSPITAL WESTERVILLE FRANKLIN 10. MARITAL STATUS -Married, Never Married, Widowed, Divorce 11. SURVIVING SPOUSE (If wife, give maiden name) 12a. DECEDENT'S USUAL OCCUPATION (Give kind of work done during most of working life. Do not use retired.) 12b. KIND OF BUSINESS/INDUSTRY 'Spa°'"'WIDOWED ~ =- NONE HOMEMAKER OWN HOME 13a. RESIDENCE -STATE 13b. COUNTY 13c. CITY, TOWN, TWP., OR LOCATION 13d. STREET AND NUMBER 139 WEST VIDE STREET PENNSYLVANIA CUMBERLAND SHIREMANSTO~M 13e. INSIDE CITY LIMITS. 13f. ZIP CODE 14. WAS DECEDENT OF HISPANIC ORIGIN? if C b 15. RACE -American Indian, Blac ecif ) Whit t (S 16. DECEDENTS EDUCATION (Yes or No) an, y u (Specify No or Yes - It yes, spec C Y N y e, e c. p 'clemen Secondary (0-12) College ` YES 17011 es o Mexican, Puerto Rican, etc.) 3 i WHITE ~ I(1-.or~I y: pel: 17. FATHER'S NAME (First, Middle, Lasf) ERVIN LAUVER 18. MOTHER'S NAME (first, Middle, Maiden Surname) ETHEL M. FRIESE 1JUDITHNLINNE (Type/Print) 'gb~3687G PINES~SIDGEd DRIBVE,RurLEWISuCEIVT~R,TDOIiIaO~ ZI-+30'35 20a. METHOD OF DISPOSITION 20b. PLACE OF DISPOSITION (Name of cemetery, crematory, or 20c. LOCATION -City or Town, State (~ Burial ^ Cremation Removal from State ^D t ^Other(S e~i, ) other place) ROLLING GREEN CEMETERY CAMP HILL, PENNSYLVANIA y 28a. CERTIFIER (Check only CERTIFYING PHYSICIAN one) o the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner as stated. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ^ CORONER On the basis of examination and/or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated 28b. TIME OF DEATH 28c. DATE PRONOUNCED DEAD (Month, Day, Year) 28d. WAS CASE REFERRED TO CORONER?. 5 :30PM MARCH 6, 1995 ^ Yes CjCND 28e. SIGNATURE AND T coi. ua.,o.oc ,.~,.,ocr, n~ ~-•••- •--- 29. NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH (Type/Print) (AA DR. KURT RINGLE M.D., 5797 BEECHCROFT ROAD, COLUMBUS, OHIO 43229 30. PART I. Enter the diseases, injuries, or complications that caused the death. Do not enter the mode of dying, such as cardiac or respiratory arrest, ~ Approximate Interval shnrlr nr haan failure. List only one cause on each line. TYPE OR PRINT IN PERMANENT BLACK INK ,Between Onset 32. MANNER OF DEATH 33a. DATE OF INJURY 33b. (~latural ^ Pending (Month, Day, Year) Investigation ^ Accident 33e. PLACE OF INJURY - At ^ Suicide ^ Could not be building, etc. (Specify) Determined ^ Homicide 33c. INJURY AT WI M ^ Yes ^ No .street, factory, office ^ Yes [% No 33d. DESCRIBE HOW INJURY OCCI IPLETION OF .. OF DEATH? ^ Yes ^ No ~N (Street and Number or Ciry or Town, State) 21 - 95 - 245 ~ ~ Q ~~ Cr) _ ,. ~~ ~ - -'"t F Ck: Y- (r. ~ ~ pry` i_f W I~i~ v v THIS IS A CERTf~I~ f;~F~r ~?F 7HE ORIGsNAI CERTa€~rAiE F!~,E:~11'~~"'ej~: f:D~1+~`':'iE~ DEPART NIEFv`~lit'ti,~i~ r~',. °t C~.[ ~s",`;~ ask ~:is`~:;~YRICT#25 P~ ~ ~ ~~ V' yr... ~~ ~ slc~w]_~02 59C/Gibson.W ~tt~t mill ~zrc~ (7~ PsY~unrttt ,. RHtABECd,E M. GIB,9G~) I, RHUABELI,~ M. GIB9ON, of the Borough of Shiremanstown, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for msT Z:ast Will and Testament, hereby revoking all other Wills heretofore made by me. ARTICLE I I direct the payment of my legal debts and the expenses of my last illness and the disposition of my ,~,~air,~ from my estate as soon after my death as conveniently may be done. All of the foregoing shall be considered expenses of the administration of my estate. ARTICLE II I bequeath my tangible personal property (excluding cash or securities), together with any existing insurance thereon, to my daughter, JUDPIH LII~i of 3687 Pine Ridge Drive, Galena, Ohio, provided she survives me , by thirty (30) days. If she does not so survive me, I bequeath my tangible personal property, together with any existing insurance thereon to my niece, I~ 'Y N176S, of 11 Amity Drive, Mechanicsburg, Pennsylvania. ARTICLE III I devise and bequeath all of the residue of my estate to my daughter, J[AIZH LIt1d, provided she survives me by thirty (30) days. If she does not so survive me, I devise and bequeath all of the residue of my estate to my niece, I~Il~Y N06S . ARTICLE IV Should neither my daughter, JiDIZH LII1d, nor arty niece, AIl~'Y N06S, survive me by thirty (30) days, I devise and bequeath all of the residue of my estate to CAI~lP HIIL CH[R~I 0~' CAD, 123 N. 21st Street, Camp Hill, Pennsylvania. ARTICLE v I appoint my daughter, JUDIZH LIIaI, Executrix of this my last Will. In the event of her inability or uaiwillinr3ness to act or continue to act as Executrix, I appoint my niece, PY~i~.'Y N06S, Executrix. In the event of the inability or unwillingness of Nancy Noss to act or continue to act as Executrix, I appoint DIAUPFIIN DEP06IT BAN[C AID Zlab`P oC1~~ANY, Executor . IN FTI'II~'S.S tid~70~', I hereunto set arry hand and seal this 6 ~- day of ~~J~ , 1990. Rhuabelle M. Gibson Signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament in the presence of us, who, at her request, in her presence and in the presence of each other have hereunto subscribed our manes as witnesses . CON~VEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss: I, Rhuabelle M. Gibson, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acl~xywledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my fret and wluntary act for the purposes therein expressed. 1'I'I . M. Staorn or affirmed to aril acl~Iawledged before me, by Rhuabelle M. Gibson, the Testatrix, this low day of o~-•~v~..~-- 1990. Notary 'c NOTARIAL SEAL DIANNE LENIG, NOTARY PE181IC LEMDYIiE BORO. CtNIBERLAND CO. MY CDNMiSSIflN ERPIRES DEC. 21. 1993 AFFIOAVI'P CONID9~Nh1EALTH OF PEDIlV.SYLVANIA ss: COUNrY OF CUMBERLAND . We, ~._. ~,,~ ,~"~ . ~,,~ _~, ~ and `(~ ~ 1 tJ . W . ~ .the witnesses ~~ .-~ whose names are signs to the foregoing instr~unent, ing duly qualified accordingly to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sign of the Testatrix signed the Will as witnesses; and that to the best of our }~x7wledge, the Testatrix was that time at least 18 years of age, of sound mind and under no constraint or undue inf'------- Sworn to or affintted to and subscribed to before me by ,~ ~a, . ~~,-~n-r-~ ~r ~~• ~ ~r 1 ~:,.,,J,,.~. ~,C-. ,witnesses, this (o`}.k~ day of or.,,`v,.,~, 1990. ati No y ' ' c~~-~C_~ [IOTARIAi.SEAI OI#IDIE tEN1C. trOTARI~ PUBLIC tt:porNE eoRO, cut6EatANp co. M1' tO~MtSStOdF EXPIRES OEt. 21, 1993 ~~ J 7 21 - 9 5- 2 4 5 Non-Resident Executors' Bond with Corporate $uretq That we.... Know all Men by These Presents: -JiIDITH.-LII~iN ..... ...................................................•---------•--•--•------•-----........---••---------..........----------. as principal, and the ------ AETNA.. CASUALTY-.-&-.SURETY-..COMP,~~I~ ..........................:...................................as surety are held and ermly bound unto the Commonwealth of Pennsylvania for the use of the Commonwealth and such person or persona as may be interested therein, in the sum oY ($...... 20 = 000 _ ~ TWENTS;-_,THOUSAND.• &-_NO-_ CENTS---.-----.------,---__---.dollars, to be pzid to said Commonwealth, to which payment well :tnd truly to be made, we bind ourselves jointly and severally, our heirs, executo-•s and administrators, successors and personal representatives and assigns, firmly by these presents. Sealed with our seals, dated the.....31.st __ ... -.__ day of.....M?,RCH____________________________ _________ __ _ .,-.in the year of our Lord one thousand nine hundred and.......NINETY--FIVE----------------------~ lg--...95•, The Condition of this obligation is such, That ii the above bounden ............................................................................................ ------JUDITH--LINN------------------ eC~el[OdI~D~...EXEC~1Tl~I-X----.---_.----of the last will and testament of........~~u.~~ELL~...~.....G.~BQN..-..--------...------------- ...................... .....................................................................deceased, do make or rauae to be made, a true and perfect inventory of all and singular the goods, chattels and credits of the said deceased, which have come or shall come to the hands, possession or knowledge of ....................JUDITH..-LINN,.--,---.........--------- .........................................................................•-----•-------...- ..-...........-----........the said ~c~t~ic ----- EXECUTRIX- ------- ----------------- --- ---- --- ---- -------- or into the hands and possession of any other person or persons for..-..__..HER .............._-...-.........----...-....and the same so made, do exhibit or cause to Ue exhibited into the Register's Office, in the Q-zulty ~ CUMBERLAND ,at ~ be,Et:Ere the ...3.Oth.---.day of........IIINF~------------------------------------------------- next ensuing; and the same goods, chattels and credits, and all other the .goods, chattels and credits of the deceased at the time of ---------------- H$R--.----------.---_.---._.-----..---.---------------death, which at any time after shall come to the hands or possession of the said ------------------ - ---- --- ------ -- ----- ------ - ------------ JUDITH...I,.INN............_.......---------.......--------------------------------------........-- ----------- ...----------------------------.......... or into the hands and possession of any other person or persons for..........~R ...................................................do well and truly administer according to law. And further, do make or cause to be made, a just and true account of............HEE .......................... said administration at or before the....B)"~t-........day ot.......IlEC.EMBED ...................Anno Domini 19.......9.., or when thereunto required by the Orphans' Court, and shall faithfully account far the proceeds of any sales of real estate made under said ~viil, and all the rest and residue of said goods, chattels and credits, which shall be found remaining upon the said executor's account, (the same being first examined and allowed by i.he Orphans' Court of theQp,C~lII11~C'13rid ~,St~ll t~'1].VE'r' i~ pay unto such person or persons respectively, as the aforf~said Orphans' Court by their decree or sentence, pursuant to law, shall limit and appoint, and shall well and truly comply with the laws of the Commonwealth, relating to inheritance taxes. And if it shall hereafter appear, that any later last will and testament was made by the said deceased, and tl-e same shall be proved according to law, if the said .......................... JUDITH LINN elil#..F~CUtX~s aforesaid being thereunto required do surrender the said letters testamentary into the Register's Office aforesaid, then this obligation to be void otherwise to remain in full force. in Witness Whereof, ~Ne have hereunto set our hands and seals the day and year first above written. Signed, sealed and delivered in the presence of JUD LINN, EXDQJTRIX ~~ •------------------------------------------------------------------------------------------------------- s>msi. ,. ~-~ --- smm~s>L -- E. WC~FE, ~;I'IDRNE,'Y ~' FACT :~ fa c^ ~ ~ c£' *~Y _ ~ r._.. ..t.'S _ LL - rS ~'; ~ ~ U U ~ THE /ETNA CASUALTY AND SURETY COMPANY +, , ~ I'~' ~ I"! ~. Hartford, Connecticut 06156 LIFE & CASUALTY POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S1-IN-FACT KNOW ALL MEN 8Y THESE PRESENTS. THAT THE ETNA CASUALTY AND SURETY COMPANY, a corporation duly organized under the laws of the Scats of Connecticut, and having its principal office in the City of Hartford, County of Hartford. State of Connecticut, hath made. constituted and appointed, and does by these presents make, constitute and appoint Kenneth E. NOlfe, John R. Gephart, III, Robert N. Looker or Marlin J. LDOker - - of HarriSbUrg, Pennsylvania ,its trueandlawfulAttomeylsi-in-Fact.wiMtullpowerandauthoriryherebyconferred to sign, execute and acknowledge. at any place within the United Slates, or, if the following line be filled in, within the area there desig- natetl ,the following instrument(s): by his/her sole signature and att, any and all bonds. reeognizanees. contracts of indemnity, and other writngs obligatory in the nature of a conc. recognizance, or conditional undertaking, and any and all consents incidents thereto not eXCeeding the SlAll of ONE HUNDRED THDUSAND (5100,D00.00) DDLLARS - and to bind THE (ETNA CASUALTY ANO SURETY COMPANY, thereby as fully and to the same extent as if the same were signed by the duly auNOrized officers of THE eETNA CASUALTY ANDSURETY COMPANY, and act the acts afsaid Attomeylsl-in-Faa, pursuantto the authority herein given, an hereby ratified and confirmed. This appointment is made under and by audtoriry of the following Standing Resoludona of said Company which Resolutions are now in full force and ether: VOTED: That each of the following officers: Chairman. Vice Chsinnan, President, Arty Exeartive Via President. Arty Senior Vica President, Any V ice President, Arry Assistant Via President, Arty Secretary, Arty Assistant5ecreeary, may from time to time appointResident Via Presidents. Resident Assistan[ Secretaries. AROmeys-in-FSa, and Agereb to act for and on behalf of the Conepany and may give arty weh appointee weh authority as his eertifitaa of authority may Prestxilte to sign with tM Comparry's name and seal will the Company's seat bonds, reeognizsrues, eontntts of indemnity, and other writings obligatory in the naan of s bond. rsexgnizartee, or conditional untertaking, and arty of said officers or the Board of Directors may at arty time remove arty weh appointee and rwoke the power and auMOriry given him. VOTED: That any bond, retxtgnizana, txrttract of indemnity, orwriting obligatory in the Man of a bond, rseognizana. or eonditionat undertaking sh~l be valid and finding upon the Comparry when la- aigned by the Chairman, the Vies Chaimtsrt, the President, an Executive vice President, a Senior Vla President. a Vies President, an Asttitttsnt Yip Presidattt or by a Resident Via President, pursuant to the power Prescribed in the artificate of wthoriry of such Resident Via President, and duly attested and seated with tMComparry's aeM by a Secretary or Asaistsnt Secretary or by a ResitlentAsaistant Set:rmry, purwart tothe power prteatxitoed in the artifieKeotauthortry of wt9t Resident Assistant Setxeary; or Ibl duly exeeuNd lunder seal, if natriredt by one a mon Attomeya-in•Faa pursuant to Me power Dresaibed in his or their esrtifiate or certificates of wthocity. This Power of Attorney and Certificaa of Authority is signed and sealed by facsiritih under artd by authority of the following Standing Resolution voted by the Board of Ltiret:tors bt THE ETNA CASUALTY AND SURETY COMPANY which Resolution is now in full forte and effect: VOTED: That the signaan of each of the following offiara: Chaimtsn, Via Chainnsn, President, Any Exewtiw V'ta President. Any Senior Vice Prtesidertt, Any Via President. Arty Assiwent Via Prtuiderrc, Any Secretary, Any AateistantSecretary, and the seal of the Comparry may be affixed by fscaimih to arty power of attorney or to any prtifiate relating thereto appointing Resident Vta Presiderm, Reaidartt Assistant Secretaries or AROmeyrin-Fact for purposes only of paurtirg and aResdnq bonds and undertakings and oUtervtrritlttps obligmrry in the nstwe therwf, and any such power of attorney or eertifieate bearing weh fatsirttiie atgnattun err fsoimite seal shah be valid and binding upon the Company and arty such power se atoseuted and taniftad by weh taoimile signaan and facsimile sal shall be valid and binding upon the Company in the future with t'eapect LO NY baW W YndeRlldng t0 whidt it h attadted. tN WITNESS WHEREOF, THE .ETNA CASUALTY AND SURETY COMPANY has caused this instrument to be signed by its Senior Vice President and its co-porace sesl to tae hereto sMxed this 14th dory of Ma 19 gD _ y '-'r ~~ THE CASUALTY SURETY COMPANY ea.. ,: ~? .,~,•• star of Conneetieut J P. KiesTtan ss. Hartfow Senior Vitx Prasidertt County of Hartford On this 14th day of May , t9 90 , bNon me penonauy nme J0.SEPH P. IQEANAN to me known. who. being by rrte duty sworn, did depose and esy: that M/sM is $9!!].OT V].Ce President of TMF,ETNA CASUALTYAND SURETY CDh~ANY, tIN COrpOraOOn described in and whidt etcewted the above insbumertt: that he/she knows the seal of viii w: r,oration: thatthe seN aRitted to tM said insnurMnt is such eotporaa aeN: and that he/she axeatad the said inmument on geftalf of the eorpontion,by \ of hiafier ofRa under tM Starl6ng Resoludone thereof. •, +e*Ya ~~ 1/~ I ;.~ .'re~~o -~ eonrniasien.seires M 3t, t9 g$ Notary Public ~`"~ D@Othy L. CERTIFIC/': rE I, the undersigned. $eCr6tary of THE ETNA CASUALTY AND SURETY COMPANY, a stock corporation of the Staaof Connecticut, 00 HEREBY CERTIFY thattM foregoing and atnehed Power of Attorney and Certifieateof Authority remains in full force and hssrtot bNn rwoked; and furMermore, that the Standing Aesdudons of the Board of Oiratxors, as set forth in the Certificate Of Authority, are now in force. Signed and Sealed at tree Home Office of Me Company, in the Ciry of Hartford, Stall of Con t o~tw Mis 31St day of March 19 95 ~••. J , ,....~`'' sy w ~a.,, c e ~', (5-1921)IM12-90 W-•• PRINTED 1N U. S.A, _ Re 4 _, a.~ CERTIFICATION OF NOTICE UNDER RULE 5.6 (a ) ~~ ~'' ~ ~°',~iu Name of Decedent: RHUABELLE M. GIBBON •G~ ~~N~Y _~~ ~~ ~ .1~~~$ Date of Death: March 6, 1995 Will No. 0245 Admin. No. To the Register: I certify chat notice of beneficial interest required by Rule 5.6(a) of the OrE~hans' court Rules was served on or mailed to tl~e following beneficiaries of the above-captioned estate on ABril 10. 1995 Name Address Judith Linn (Daughter, Sole 3687 Pine Ridge Drive Beneficiary and Executrix) Lewis Center,. Ohio 43035-9360 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: sig~~ ' Name H ace A. Johnson, Esquire J on, Duffie, Stewart & Wei ne Address 301 Market St.. P. o_ Rnx 1 ~9 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative ~-35 AA a4T828 CC?MME3NWEALTH ©F PENNSYLVANIA NO. ~PARtMENT Of REVENUE ~' REV-,}6~ EX i<-9<i OFFICIAL RECEIPT • PENNSYLVANIA INHERITANCE AND ESTATE TAX , "~ , - FOLD HERI RECEIVED FROM: JOHNSON HORACE A 3RD 8 MARIfET STREETS . P. O. EIOX 109 LEMOYNE PA 1?043 ESTATE INFORMATION: © FILE NUMBER 21-- 1993-0243 SSN 2 ?-O?-4193 © NAME OF DECEDENT (LAST) (FIRST) (MI) DATE OF P © POSTMAR COUNTY DATEOFD AH REMARKS ACN ASSESSMENT AMOUNT CONTROL NUMBER i01 +63,?00.00 FOLD HERE a. TOTAL AMOUNT PAID +>r~ _ 7AA _ t'~n JUDITH LIMN gG C /O HORACE A JQHNSC?N ESQ SEAL CHECKi1 °.505 RECEIVED BY ``~ ~r '~ ~ ~ . '~'`~ f;~.a.c.,~l_. 51 NAT R ,,.,~ ~~:~1~ REGISTER OF WILLS MARY C , I.EW I S ' REl3I5TER OF WIl.L.S ~__._:_~, __Reast~ ~f__~dill~_. 4ffiCe _ ___ ____ _ ._. __________ _____ TO Cumberland County Courthouse .l__~our~hoias~ _~quar~ . ___ _~ _ __ _ __ __ _ _.._ _ ___~__ _ _ _ ___ --~.i,~J.~_~ _~Z413_-3_~$Z____.____.________.____-_----.___ FROM JOHNSON, DUFFIE, STEWART & WEIDNE: Attorneys at Law P.O. Box 109 LEMOYNE, PA 17043 SUBJECT: _ F'GtatP _of Rh__,._~hPl l P__~.___ri h,~c~n ___________'___~_______________ DATE: __ __~.~31~9.5_ _ _ _._. FOLD ~ NO. 21-95-0245 TX~1~ ~ Ma rr~h Fi _ 19 9 5 _._ _ ...___. _ __.__E~cInGE'd _is..a.Check_ i11_the_ a_ ~u_nt__of..._S3_,_.7.Q.O.._O.Q_._as_a...~~n_t__on._a~ _n,~nt________ __ . ___ .. _ _.__ _..___Of_. ZI1~lerlt.3T1C.~_T3X__.f.O~, the_.dbQVE-~ant_~._? c_??le_c3 F.G..__tatPT.. h!?i ncr marlP_y~~_,,,tj7,e,___.__. _ ____ _.______.~Q_rlays_to_allChet f!'~r__the_,5$_diGC-~i~nt_ ___.__~._____.__.._______ .___.___. __._____.____ ___.__________ 1 ~L ~ J ~'~' Zt.. -"i.= It!}~I~tlt1l11l}!!!I~!!~!!l1113t1141!~!}!l~l~llt!!lltl~~i4!!~ ir_ _~u-l tEK,1500 EX+ (7-94) ~, INHERITANCE TAX RETURN FOR DATES vF DEAiM AFIeK 1 s-s E rY E c.ne~.n Wont ^ (P OVERTY CREDIT IS CLAIMED _, RESIDENT DECEDENT FILE NUMBER COM MONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE 21 95 0245 DEPARTDEPT.28060jVENUE WITH REGISTER OF WILLS ~ COUNTY CODE YEAR NUMBER HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS Gam, ~m~wr.T F M_ 139 West Vine St . 2 SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Shiremanstvwll, PA 17011 W W ° V 207-07-4193 3/6/95 3/17/13 c°,~, ~ p ( IF APPLICABIEI SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL( SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) ~ ~] 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (for dates of death prior to 12-13-82) Y a y =oo ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required -~ w (for dates of death after 12-12-82) a m ~] 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust - 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach copy of Trust) fliA1. Tom:' y= ~o Nnn1E Horace A. JohnSOn, ~• COMPLETE M ILI AD Johnson, Duffie, Stelllrart & Weidner v~ TELEPHONE NUMBER 301 Mar~Cet St. / P. O. BUX lO9 1717 1 761-4540 PA 17043-0109 z 0 a. a W z 0 a d 0 x a 1. Real Estate (Schedule A) (1) 75,000.00 2. Stocks and Bonds (Schedule B) (2) 48.50 3. Closely Held Stock/Partnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 ) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 12 r 202 - 52 (Schedule E) 6. Jointly Owned Property (Schedule F) (6 ) 7. Transfers (Schedule G) (Schedule L) (7 ) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) ~-2.626.97 Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 1 1. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Spousal Transfers (for dates of death after 6-30-94) See Instructions for Applicable Percentage on Reverse Side. (Include values from Schedule K or Schedule M.) (15) 16. Amount of Line 14 taxable at 6% rate (16) 74,624.05 (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rate (17) (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 + 3,700.00 + 194.74 _ 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. 21. 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. Maks Check Payable to: Register of Wills, Agent (8) • t°' 87,251.02 (tl) _12,626.97 (12) _74624.05 (t3) _ -0- (14) _74,624.05 -0- x . -_ x .06 = - 4, 477.44 x.15= -~- (18) - 4,477.44 _ (t9) - 3,894.74 1201 - (2 t) _ 582.70 (21 A) - -0- (21 B) - 582.70 Under penalties of perjury, I declare that I hove examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. 516NATURE OF PERSpN R6GPOD7518LE FOR FILING RETURN ADDRESS 3687 Pine Ridge Dr. DATE LewiG Center, OH 43035-9360 _ ~~ ~ 9~ f-Et~R~SENTATIVE ADDRESS 301 Market St. P. O. BOX 109 DATE ~y.._1 Lemoyner PA 17643-0109 / sq . 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 1/1/96 • 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1 % (.O1) 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 (r) IN THE APPROPRIATE 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$ ................................................................................................... X 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. ~, V _ C~ .~ (°J "'S ~~ ~.., - (J U r- REV-1502 EX+ (12-85) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENiDECEDENT ESTATE OF FILE NUMBER GIBBON, RHUABELLE M. 21-95-0245 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule Fj All real estate should be reported at fair market value which is defined as the price at which property would be exehanaed 6.*...........,:u:.... r....,__ __~ _ ._.:ue__ __rr__ _ _,.~ .. s ~~--•- -~--- •~ ..~a,.~,,, u~aerr vaarnonar sneers of same size.) { ~ ' , • 1 L) )FHA 2 1 J FMHA ~. I ) CONV. UNINS. Lemoyne, Pennsylvania 17043-0109 +.(jvn s.I )coNV.ws. 6. FILE NUMBER: 7. LOAN NUMBER: (717) 761-4720 15sao2 s. MORT. INS. CASE NO.: 9917-1 C. NOTE: Tllis lorm is furnished to give you a statement 01 actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.o c.j' were paid outside the cbsing: Ihey are shown here for inlormalional purposes end are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F NAME AND ADDRESS OF LENDER: John F. Voystock, III Judith Linn, MELLON BANK, N.A. Beth B. Voystock of Rhuabelle M. Gibson 10 S. MARKET SQ. HARRISBURG PA 17101 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: " t. SETTLEMENT DATE: 139 West Vine Street Assured Land Transfers Inc. 05/15/95 Shiremanstown Borough PLACE OF ' A • U.S. DEPARTMENT OF HOUSING and URBAN DEVELOPMENT ' SETTLEMENT STATEMENT ,,.,..,~ OMB No. 2502-0265 y ,o ASSURED LAND ~~ ~' ' TRANSFERS, INC. Third & Market Streets 8. TYPE OF LOAN P O Box 109 .0 75391.13 1203.33 aoa CASH (~ FROM) ([ ) TO) BORROWER 25588.34 so:1.CASH (pp TO) ((]FROM) SELLER "v+ • „ 74187.80 Buyor of Dorlovwr's Signaturo $ellar's Siynaluw HUD t Rov. 51a6 CUMBERLAND County SETTLEMENT: 301 Market Street Lemoyne PA 1704 3 J SUMMARY OF BORROW ' . ER S TRANSACTION: K. 9UMMARY OF SELLER'S TRANS ACTIO! loo GROSS AMOUNT DUE FROM BORROWER +oo.GROSS AMOUNT DUE TO SELLER tot. Contract sales price +In.CoMracl sales price tot. Personal properly +o2.Personat property Loa. Settlement charges to borrower (line 1400) 1 la. +oa. Los +a. +os. Al Ijuslmonts for items paid b sell i d y er n a vance Adjuslmenls for iloms paid by seller i n advan 105 1:11yfIOWn Las 10 tor t C 0 +rIG.CiIyROM11aM 10 . oun y tat l0 1 1 2 3 +OLCounlytat o 1 1 105 Assessments to +05.Assessmrnls 1O 109 School 1O 1 +Iro. School 0 Ito wrl q en 1 0 uo. wr: q en In m 1 +11. m 117 +IZ. Ilrl GROSS AMOUNT DUE FROM BORROWER 79588.34 uo.GROS3 AMOUNT DUE TO SELLER ?on AMOUNTS PAID BY OR IN BEHALF OF BORROWER 5oo,gEDUCTION9IN AMOUNT DUE TO SELLER Iol. Deposit or earnest money 1 0 sot.Excess deposit (seo instructions} 7oz Principal amount of new ban(s) 5o2.Selllemenl charges to seller (line 1400) 7oa Existing ban(s) taken subject to soa.Exisling loan(s) taken subject to to so+ Payoll of First Mortgage Loan 2os sos.Payoll of Second Mortgage Loan 205. soy. zo7. 507. 7011 505. 209. 509. Adjuslmenls for items unpaid b sel ler y i/n Ci R Adjuslmenls for items unpaid by s eller . ly own tat l0 510. City/Town tat 10 211. Calory lax to 51 t. CWnly tat le 117 Assessments l0 512.Assestmenls l0 21J 10 21+ Sla. to 715 51+, 716 S I5. 717 515. . 71a 517. 719 515. 519. 77o TOTAL PAID BV/FOR BORROWER 54 0O0. 00 s7o TOTAL REDUCTION AMOUNT DUE SELLER :If10 CASH AT SETTLEMENT FROM OR TO BORROWE R ao1 Gross amount due Iron borrower (line 120) 4 500.CASH AT SETTLEMENT TO OR FROM SEILER J07 Loss amoum paid bypor borrower (line 220) 501 Gross amount due to seller (line 420) sn7.Less reduction amount due seller (line 520) ' ~s ••^•^'.,.. •qru w wlrofa arty amounlf ceeatlfd Iw tliflwrfamsnl N an NIwaN Mann _ __ _, _...e.... . ........ .... .... nvu- r SanMmanl Slalemanl. $elllanranl Apsnt Alrnby erPrc Nly cempenfallon Iw Mf Mrvlcef in Ihh Iranfaclien. 0 acceunl Mr • Fadaraey Inwrstl inNNUlipn antl le Gadil any inlaroN w aarnaA IO rtf nwn account as arkliwrnat HUD CERTIFICATION OF BUYERS AND SELLERS I have carefully rovi~e/Yw/e~/d+JIh~o~HUD- t So111emenl 5lalemonl and to the bell of my knowlodpe and belief, it is a Iruo end accurate statement of ell receipla end disbwsemenls made on my acc nl bL/ s Ilansacllon. I further certfly Ihal I have recoivod a copy of the HUD- t Se111emenl Statement. ~~~ ~~ b~, Bvlw w S Dwarf Sgnalws Sager: Sianalww Bvyw'f AdA.aaf i Irhona: SaMr's New 11tlrMSff 6 ITprre: IM 1I11D-1 Se111fmaM SlNemenl which 1 have oreParsds a Irw antl aeeenN aeeouM of Ihill Iranfaelion. 1 hero caused or wiN eauaa Ihn lands In M drshwfatl w aecwdanco with Ihn Ntlemenl SNIMrrsnl A nl ` ~' - ~/. S /~3'-' WARNIN(: 11 K • crYne In ~newMply maFn Iflfe dalemnnlf M the Uneed Stoles en Ihh w a Drrlc I rlb Ie 11 S. Cade Snclam 1001 and :ecl.rn IOIO. M f.niMr Iwm Panaaiaf rgnrrr cnwicllon can be-nte • IYra and Yrrgifonmcnl. Fw dnlaNf ana __ - - - __ _ _ _. _ _. _ Inn1.1 qrv 1./aR REV-1503 EX+ (4.86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS GIBBON, RHUABELLE M. 21-95-0245 (All property jointly-owned with Right of Survivorsl~io mu:t 6e a:.~i.,.ea __ t~L_J•.1_ e • - -~--- •- ••--~~~...~~a~~ vuu„wna~ sneers or same srze.J REV-1508 EX+ (2-87i COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY OF GIBBON, RHUABELLE M. Please Print or T 21-95-0245 (All properly jointly-owned with the Right of SurvivorsYAie mu:t 6. dl:ele..d .... e.,t.~a..~_ c~ (Attach additional 8'/i" x 11" sheets if more space is needed.) .-~'~ REV-1511 EX+,~-881 SCHEDULE H • FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND COMMONWEALTH OF 7ENNSYLVANIA Please Print or INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES RESIDENT DECEDENT FILE NUMBER ESTATE OF 21-95-0245 GIBBON, RHUABELLE M. ITEM DESCRIPTION NUMBER A, Funeral Expenses: 1. Myers-Harner Funeral Home, Inc. -funeral expenses 2. Camp Hill Church of God -food/serving -funeral brunch B. C. 1. 2. 3. 4. 1. 2. 3. 4. 5. 6. 7. 8. City State Zip Code - Administrative Costs: Personal Representative Commissions - Social Security Number of Personal Representative: Year Commissions paid Attorney Fees - Johnson , Duf f ie , Stewart & Weidner Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address 4,000.00 226.00 Probate Fees -Register of Wills - Cumberland County Miscellaneous Expenses: 110.00 Looker, Wolfe & Gephart - Executrix's Bond 40.00 Cumberland Law Journal - advertise Letters 51.82 The Patriot-Evening News - advertise Letters 25.00 Register of Wills -file Inventory & Inheritance Tax Return 36.76 Bell Atlantic - PA final telephone charges 29.74 PA American Water Co. -final water service charges 43.61 Pennsylvania Power & Light -final electric service charges 22.80 Lower Allen Township - sewer charges 2,182.85 Sub~ibtal from additional Sheet TOTAL (Also enter on line 9, Recapitulation) $ 12,626.97 AMOUNT $ 5,756.88 101.51 (If more space is needed, insert additional sheets of same size.) + r SCH®ULE H ESTATE OF: GIB9ON, RTifu-RF'fTF M, 21-95-0245 C. Miscellaneous ~penses - Continued: 9. Recorder of Deeds - Transfer Tax 750.00 10. Notary Fees 6.00 11. HOA Dues - Shiremans Garden - adjusted at settlement 16.94 12. Judy C. Prowell, Tax Collector - County real estate taxes adjusted at settlement 139.56 13. Assured Land Transfers - disbursing fee 35.00 14. UGI -final gas service charges 66.53 15. Marlene Deimler - cleaning Condo (139 W. Vine St.) prior to sale. 43.50 16. Judith Linn - Lewis Center, Ohio to Shiremanstown, PA and return - (780 miles round trip) Trips on 3/7 to 3/11; 3/20 - 3/25; 4/22 - 4/23; 5/13 - 5/15 Total - 3,120 miles @ .29 per mile 904.80 PA Turnpike Tolls -total for 4 trips @ 12.20 per trip 48.80 Judith Linn - reimbursement for charges for overnight stay at Hampton Inn on May 13th and May 14th due to settlement on decedent's Condo at 139 W. Vine St. 171.72 S~b~ibtal $ 2,182.85 REV-1519 EX+ (2-87) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INNERITANCE TAX RETURN RESIDENT DECEDENT C!'T~Tr w GIBBON, RHUABELLE M. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: ~- Judith Linn 3687 Pine Ridge Drive Lewis Center, Ohio 43035-9360 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: 1. FILE NUMBER 21-95-0245 RELATIONSHIP AMOUNT OR SHARE OF ESTATE Daughter Personal Property & Residue AMOUNT OR SHARE OF ESTATE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) S (If more space is needed, insert additional sheets of same size) Inventory cf the ; eai cnd ,,^vE!sOf12~ est2te of RA[JABII,LE M. GTBSON deceased 1. Real Estate - No. 139 West Vine Street, Borough of Shiremanstown, Cumberland County, Pennsylvania. (Deed Book "E", Volume 26, Page 203) Sale Price 2. $50.00 - Series EE Bond - dated November 1, 1985 Date of death value, plus accrued interest 3. Household Goods - sold - net proceeds 4. Nationwide Federal Credit Union Account No. NFCU #21608017 Share .1 balance CUchex .9 balance 5. Nationwide Insurance Co. - homeowner's policy premium refund ". ,, `r -, _. N -_~ _.~ rt ~= U U 75,000 ~ 00 48 50 2,350 00 5,435 175 4,378 177 38 ~ 00 87,251 ~ 02 r STATE OF OHIO ~ ~: e COUNTY OF ~ Judith Linn de oses and says that she 'c ~''r°^"}rix being duly ~''r"'T' according to law, p of the Estate of Rhuabelle M. Gibson BoY'ou~h of Sh?~~t~l _ Cumberland Coun+y, Pa., deceased and that the late of --------- - ~jg Judith jinn _ ,the sa-d within is an inventory made by of the entire estate of said decedent, consisting of all the personal proparty and real estate, except real estate outside the Commonwealth or Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. ,. '.it~rn to and subscribed before me, - 19 95 ~ ,~"."Pain"SF ` ~` ~ ` 2 ` 1 ~ LAMES Y. HAU w # ~ QQ~ NOTAIIY MIBUC '~.11!!1 pAi E . I LAY COMMISSI~1 ~.'sTH O~•~Oa~ ' "~.,lF,oF `°~ a~ `. of Dea~~ t D 6th a e Day EzacufiorAdmt~iftrafor Judith Linn. ix 3687 Pine Ridge Dr. Lewis Center, Ohio 43035-9360 Lddns: Mo~n+hC~ Tear 1995 INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. t u, d' N O ~, o, r~ N 0 z fem.. W ~ a- N O Z > Z = ~ ~ ~ d. ~ ~ Z O W W ~ a ~ ~ M c~, ~I W z a i ~I~ i I N ~ ~ 0 ~ ~ -~ o~ O ~ a o a ~ ; ~"~ - .O o b ~ + .dj Q W . l~ N r-I r h ~ ~ ~ W `; i ~ + U "' ~ 1 ~ ~ ~ ~ ~ q ~ N ~ o ~ ~ ~ O 'T. h rOri ~ ~ o c I ~ U ii ao ' QA ~~~~~ 3 CC+MMC-NWEAITH C+F PENNSYtVAN1A NO. pEPARTMENT OF REVENUE "' ~" ` ~, REV-1162 EX le-Gel OFFICIAL ItECE1PT • PENNSYLVANIA INHERITANCE AND ESTATE TAX ,_ - FOLD HERL RECEIVED FROM: JC1HN£ON HORACE A 301 MARKET STREET P O BOX 109 LEMOYNE IAA 17043 . ESTATE INFORMATION: FILE NUMBER © 21-1995--024s 38N 20?-07-4193 © NAME OF DECEDENT (LAST) (FIRST) (MI) GIE1'SON RHUAHELLE M DATE OF PAYMENT © POSTMARK D E COUNTY CUMBERLAND DATE OF DEATH ACN ASSESSMENT AMOUNT CONTROL NUMBER REMARKS .TUD I TH L I NN 1 FOLD HERE- TOTAL AMOUNT PAID ~~®~-?0 CW ~~°1 _~ SEAL CHECKi~ "511 ~ ~' ' ~ '~, .r ,:.% ~ .. RECEIVED BY REGISTER OF WILLS MARY C . LEW I S r .r ; REGISTER DF' WILLS om , N O i.~y i d ~~ ~O ~g Nx N A A a [~ N ° a C/~ z r~ C7 I m O ~ ' ~ D m o -7 ~ -, , r. -~ N ~ _ j ~~ i ~ ~ t~, i ~ ~ ~ o z Q m >- 0 O f a ~ 0 N Z z o 7d rn ~ m ,•~ D N m m p ~ . 0 i • ~ S f'f m IH z ~~ ' d ~ o -~, '~ -_ U!u W m O h~ lJ1 ', ' N i i fi ~~ i I i ~~ Ai n i ~ o ~ ~ o ~ ~ ~ ~n ~, W N I-~ ~ ~ ~, I~ tiD ~~ ~+ w ~ ~ i I,.1. ~ ~ i ~ F~ H O I-j ~ ~ (t Ir ~C '~ I ~ a ~ ~ ~ ~ I ~ I • ~ ~' '~ N ~ rt ~ ~ ~ ~ ~ M N H ~ ! N ( D CT ~ E • E Q (t 0 N ~ ~ ','U t ~ H ~ ~ ~ ~ n rt F N ~ ri' ~ I ~ i' r ~i ' ~ • ~ ~t rt t i N I ~ O _ ~ Z ~ O Z ~ v ~ ~~ ~ ~ Q 111 ~ m g~ v~~.m v~~ ~ ~ m v rn ~o ~ _ ~ ~ i~"-ay_ ~ REV-1547 EX AFP (12-94) CONMOINiEALTH OF PENNSYLVANIA DEPARTMENT ~ REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPT. 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG, PA 17128-0601 ACN 101 DATE 09-25-95 I~nVMDGLLG ~~ FILE N0. 21 95-0245 DATE OF DEATH 03-06-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO ^REGISTER OF NILLS, AGENT^ REMIT PAYMENT TO: HORACE A JOHNSON ESp REGISTER OF WILLS 301 MARKET ST CUMBERLAND CO COURT HOUSE PO BOX 109 CARLISLE, PA 17013 LEMOYNE PA 17043 Amount Rewitted CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (12-94) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOMANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GIBBON RHUABELLE M FILE N0. 21 95-0245 ACN 101 DATE 09-25-95 TAX RETURN WAS: (X) ACCEPTED AS FILED ( l CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortya9es/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Porsonal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adw. Costs/Misc. Expenses (Schedule H) 10. Debts/MortgaGe Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governwental Begwsts (Schedule J) 14. Nat Valw of Estate Subject to Tax (i) _ 75 ~ 000.00 (2) 48.50 (3) .00 (4) . 00 (5) 12.202.52 (6) .00 v) .00 (8) 87,251.02 (9) 12, 626.97 clo) .00 (12) 74,624.05 ti3) .00 (14) 74,624.05 NOTE: if an assess~aent was issued previously, lines 14, 15 andior 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) . 0 0 X . 0 0_ . 0 0 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 74,624.05 X .06= 4,477.44 17. Amount of Line 14 taxable at Collateral/Class B rate (17) .00 X•15= .00 18. Principal Tax Due (lg) 4,477.44 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) AMOUNT PAID 05-31-95 AA047828 194.74 3 700 00 06-21-95 AA047913 .00 , . 582.70 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 4,477.44 BALANCE OF TAX DUE .00 INTEREST .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) C1 cs ,. Lu RESERVATION: Estates of decedents dying on or boforo Daooabor 12, 1982 -- if any future interest in the estate is~~t#ansforred in possession or enjoyaant to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Cosiaonwaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Texas at the lawful Class B (collateral) rata on any such future intarast. PURPOSE OF NOTICE: To fulfill the requirewnts of Section 2140 of the Intwritanee and Estate Tax Act, Act 22 of 1991. 72 Section 2140. PAYMENT: Detach the top portion of this Notice and subeit with your payeont to the Register of wills printed on the reverse side. --Melee chock or aonay order payable to: REGISTER OF MILLS, AGENT All payaents received shall first bs applied to anY intarast which aay bo due with any resiaindor applied to the tax. REFUND CCR): A refund of a tax credit, which was not requested on the Tax Return, aaY bo requested by eoapleting an ^Application for Refund of pemrilvania Inheritance and Estate Tax^ CREV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the spacial 24-hour answering service rxnbars for foss ordering: In Pamsylvania 1-800-362-2050, outside Pemsylvania and within local Harrisburg eras (717) 787-8094, TDDB (717) 772-2252 (Roaring Is~aired Only). OBJECTIONS: ~ytaxr(includingrdiscount oriinte~r st~as shown onsth~istNotica wst objactriwithin~sixtydCo60ltdays~ofrrocsiptpoft this Notice by: OR --olectionpt thavetthe aatteradetewinedfateaudSt~ofothe aceountaof~tho PorsonallroprasontetivaPA 170188-1021, --appeal to the Orphans' Court. ADMIN ISTRATIVE CORRECTIONS: Factual errors discovered on this assessaont should ba addressed in writing to: PA Departeant of evenuo, Bureau of Individual Taxes, ATTN: Post Assossaant Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Soo Page 3 of the booklet ^Instruetions for Inlwritanco Tax Return for a Resident Docedont^ (REV-1501) for an explanation of adainistratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar eonths after the decedent's death, a five percent (5%) discount of tFw tax paid is allowed. INTEREST: Interest 1s charged bogiming with first day of delinquency, or nirw (9) aonths and one (1) day frog the data of ~xtC6~)oPa ~~ tpo~faprxw^onalculatad atia daibolyrotalonf~.~On00164forAll~as which82bocaao dalinquantton arwlaaft r Jamoun od~by9thewPAlDapart1iontroftRevenueateThoi PPlicablarintarastaraa asrfora1982 throughr1995rarath that rata Year Interest Rata Daily Interest Factor Year Interest Rata Daily Interest Factor .000548 1987 9% .000247 1982 20% .000301 1983 16% .000438 1988-1991 11% ,000247 1984 11% .000301 1992 9% .000356 1993-1994 7% .000192 1985 13% 9% .000247 1986 10% .000274 1995 --Interest is calculated as follows: INTEREST = BALANCE OF TAX {JNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --bayondtithe data ofathorassasswant~~Ifspdol~in'quontsadolaftor~tM~intarostsconputatianodato fishown on(1~ days Notice, additional interest gust be calculated. ~ v STATUS REPORT UNDER RULE 6.12 ~-~~:; r_ ~, Name of Decedent: RHUABELLE M. GIBSON -, Date of Death: March 6, 1995 Will No.~/- 9~- 245 , y Admin. No. - Pursuant to Rule 6.12 of the Supreme Court Or , Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b• The separate Orphans' Court No. (if any} for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes The Executrix was also the sole beneficia NO X d. Copies of receipts ~freleases e. approvals of formal or informal accounts may be~fileddwithathe Cerk of the Orphans' Court and may be aL-tached to this report. Date: 0 2 9,S S riorac Johnson Name lease type or print) Johns Duffie, Stewart & Weidner 301 Market St. P. O. Box 109 Address Lemoyne, PA 17043-0109 1717) 761-4540 Tel. No. Capacity: Personal Representative X Counsel for personal (MAH:rmf/AM3) representative J