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HomeMy WebLinkAbout95-0258~I -~5~ D~,S~' This is to certify that the certificate hereunto attached is a tine 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 H,05.1~3 Rw. 2IS7 TrnEi.RwT ., p,,R NAME OF DECEDENT(FHI,A ~wK ,. ROXIE At+ES.wle-+w.r) un I 78 Vn. Men cola,rY or: DE,a„ ~~ CumbenXand Fran eropoli, ' ect~ Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT ~ HEALTH • VITAL RECORDS CERTIFICATE OFDEATH /^~~ //~ 'r} }'( ' i'i d•. ue9 SfAERIENUNeER Y,~ L V ti J ~J F• WATSON aocuusE°uRm""MS°! D"'EOSOEaHrow•n.o•r.,e.q wDER,oAV DaEaF SIRTTI ul• 1 MYIW (MaMh, Dq%16eq :Femae.e a. 197.. - 09 - 2233 •• ewTNxACE lcavw R~ACEaR DERHICIw~oNy ono-.onaYUC~anan anrt $IYIl oI Fp•iyi Cgyo}y) „~ oe°) Maaeh 21, 1991 a 9 / 13 / 16 CIT bath V a,E£e y, PA ''O"`" ^ ERa"~""" ^ OTHEp: °°" ^ H" ~ ° ^ Rwe.,r. ® ~» ^ Y.SORO, TMIP OF OERH Sh,ippenebung X NAME PIna irWYm, pi+•anM nM nKnbs) 245 Fact Gan~.iebd Sfinee.t NM8 DECEDENTOF HISPANIC ORKiwi ~,, ~ °'"'~'0~"~0en• RACE•Am•enn aNr,Era~wlw. . "s°'"''' htt or~oENr•susuA~occASw1DN "~^.ac W e Nnaa.awaun.yavr~inpomy KIND OFpU$a,Egya#)UST,{y YMSDECEDENTEYERw DECEDENT'aEDIICRpN ° 'a' al•awgar:aoelus wioaJ U.S. ARMEDFaRCESr coa.y. ~~B~US-Monlo~. mOn,a ~~~) houeQW.(. e „ Ns^ No® Et'm'^MM~tl"Y I1~vs+) l~°°`ry nETmsMAawoADDREes~..i.c~ww•.s~.r.mcaw~ DECEDENrs 'L ' 12 ,., W.idCxV ~ ~a 245 Eae.t Gan6~eed S.tnee-t RESpENCE ,Tasm_ PA ~e na^ w,a.c.anvawl• Shi.ppenebung, PA 17257 an ~ ~•F• Trs NAME1P.,I,Mme,lrq ,n. Cumben.~a.nd !°""I'IPT ,~ tea, eer_ Shcppene bung MoTNERa NAME (P•M. MiaOr, Maian surnrne) ~' tiC Do .fie Many Coone aAANrS NAME(T,gWrinq 'wFDRMANr9 MMMGADDpESS($yeN, caWlo•n. su,., zPCeae) Thomae E. Wateon 612 Wee-coven Road, Shy, enebun , PA 17257 oDOPDUrosrtq„ a.Irfic7 a«eral^ RrwraanSb»^ ovE ~ ~,°F•N•^~•acm««a.c~.•I.Ia, LocATIDN-cMTO••.slw.aPCOe. ~^ 3/24/95 '~'j _ PERSDNACTwGASSUCH ^ 2t0' ,Kxwrs~...e~• p~'n9 fly Ceme-L ~~u.ppenebWCg, PA 17251 776-L ~ Sa `~ I i OF DEATH7 NNUN ~ Iloueti0• ^ AeekINK ^ -Pondgl ^ +>.. ^ No~ rb. ^ No ^ swae. ^ cowarolwae«nu•.a ^ ~ aaw PLACEDFauupv-krom..wm.a.w. aa. ~. ole.ISPadiyl aaTT>FlU, IChecY oNy oro) 'CaATIPYaNa PNYa,CIAN (Phviien earenrre c•uee of a..a when erwew Mvaa.n na b a. h•o, a n,Y bwtiMew. e••UI ocean.eau. ro ar erwp) r.a mx.wr r w,•~0....... aeem ar~aeampiei.e Ilan 23) ^ ..................................... 'PRDNDIa,CN10 ANDCEl,TRyap ~ etravrq ioe•we of a•.mI To tlw w,a•ry K•e,A,ay., a••lnexunaNa•b, grr.•osewbtlr eMp•Iq•nemwMfra •hMa ..................... B. ..... OR IMW~o.InrMlytbn. b mY opiNpy G•,II oeeume ti tl«. UIlu, am, and wlrrlo,r W,W ............... .. pMCO, •IladwbMlacwrp)ana ^ a .........................................................:. REGI ~ ................... ATURE l~ IMawh. D.v. ~ x,e MEDICAL EXAMa,FAACORONERT ~I~I N!s ^ Hot1 j•••ManaeWK 1 ~ /Yb ~Ir c i RY INJURY AT YApFK7 va ^ No ^ IUMBER DATE SIG! ~~ S~~ ale. ADDRESS DF rERSON vmo coMPLETED CAUSE /v or PriRl 3 DUX )3C fL//~'a~+.cnc .t ii ~~ REV•1500 EX+ (11.9I) I ~ , COrd1.1011WEALIH OF PEI IIISIIVAFIIA DEPAR(MEIlT Or REVEtJUE DEPT. 490601 HARRISBURG, PA 17120-0601 t-- z W U W W ti d N W4V vam a Q W z o°GC o O 0 a Z O o. Q u w OC Z O r=- a O v X INHEItITJ~NC[: 1~/\,n RETURN RESIDENT UECI;I)ENT (TO f1E FILED IN UUPLICL\TE WITH REGISiEIt C)F WIIi.LS) iiiinil -__-_ - __--,,- fOR DATES OF DEATH AFTER 12!31191 CHECK HERE IF A SPOUSAL POVERTY CREDIT I5 CLAIMED ^ .-~~c w~rvlntK COUNTY CODE _ I YEAR "' ;"'"1~ L. _ 245 E. Garfield Street SOCIAI SECURITY NUMBER UAfE OF UEAiN UAIE Oi DlRlil Shippensburg, PA 17257 ~ ' _ 197-09-2233 3-21-95 ( 9-13-16 co~nr Cumberland --_ -_-.__.._ .. __-__ Y 1. Original Return ^ 2. Supplemental Rrlurn . . ~ ^ 3. Remainder Return ± ^ 4. Limited Eslale ^ 4a. futuFe hrleresl Compromise (for dates of death prior to 12-13-82) (for dales of death after 12-12-82 ~ 5. Federal Estate Tax G. Decedent Uied Teslale ) Return Required L~ 7. Decedent Mainlainrd o Living Trust _ 8. Total Number of Safe Deposit Boxes _ (Attach copy of Will) (Attach copy of Irual) ALL CORRESPONDENCE,AND,CONFIUENTIAL TAX (NFURNI/1TIUIY SI~OULf? BE DIRECYED T0:_i ry NAME _`_. _~..__., ._ _......_.. .,„. .:...- CC)h1('IEIE~MAIIING ADDRESS - __.H. Anthony_ Adams,_ Esquire _______- 128 E. King Street TElEP110NE t~IUMDER Shippensburg, PA 17257 --- - - ---- -- 1. Real Estate (Schedule A) ~ ~--- ( 11 50, 000.00. __ ._. -- 2. Stocks and fSonds (Schoduln FS) ( ~) 3. Closely Held StocklPartnorship Interest (Schodule C) (3) 4. Mortgages and Notes Receivable (Schodule D) (A) _ __ 5. Cash, Bank Deposits & Miscellaneous Personal Properl (Schedule E) _ __ y( 5) 142, 222.01 _.___- 6. Jointly Owned Properly (Schedule F) (G) _- - 7. Transfers (Schedule G) (Schedule L) (7) - - 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule fl) (9) __ 13_,_459.61 10. Uebls, Mortgage Liabilities, Liens (Schodule I) 10 11 Total D d ' ( B) 192_, 222.01 • e uchons (total fines 9 8 lU) (11) 13,459 61 12. Nel Value of Estate (line 8 minus line 1 1) . 13. Charitable and Governrnentol Bequests (Schedule 1) (t 2) 178, 762.40 . lA, I•let Vuluo Suhjecl to Tax (lino 17. minus lino 1J) -- (13) -- --------------- - __ __ _ 15. Amount of line lA taxable ut G"/o rata (15) 178 [}0 762 I _ _(1,1) _ 1.78.762.40 - , . ( nclude values From Schedule K or Schedule M.) ------ ------x .OG = _ ~~ 725 75 1G. ArnouM of line IA taxable ut 15`% rule (1G) (Include values from Schedule K or Schedul M _---- x .15 e .) 17. Principal lax due (Add tax from line 15 and from line 1G.) 18. Credits Spousal Poverty Credit Prior Payments Uiscuunt Interest 19. Ifhine 18 is greater Ihan line 17, enter the difference on lino 19. This is the OVERP YA M ..TEN i'0. If line 17 is greater Ihan line 18, enter the difference on line ZO• This•is the•TAX DUE. A. Enter Ilse interest on the balance due on lino 20A. B. Enter the total of line 20 and 20A on line 208. This is Ilse [lALANCE DUE. Make Check Payable to: Register of WFlls, Agerrt .__~_____^ ~/- ~/- BE SURI: To ANSWER ALL:gUE tION~ C)N REVERSE SIDE AND Ta RECHECK MATF~ ~i Under penalties of perjury, I declare 1ho1 I have examined Ihis return, uuluding occompanying~schedules and statements, and to the best it is true, correct and complete. I declare that all real estate Iran been reported al True market value. Declaration of preporer other than based on all inform lion o 'clr preporer has any krrowledye. SIGNATURE OF PERS N R PON _ ~-ET ~ - AUURESS _.. t~ GFAT'URE O EPARER ~--' 11AlIVE ---ADDRESS------'-._-_. __ (1 ~) - 10 725.75 (18) (19) (20) 10, 725.75 (20A) (2oB) 10 725.75 ~F my knowledge and belief, le personal representative is r TE' ' DATE COMMONVIEAITH Oi PEIINSYIVANIA INfIERITANCEiAXRETURN SCHEDULE rrArr r RESIDENT UECEDENi _ REAL ESTATE E51A T E O F ---_-___ -------.. --- --- =-- --- -----_ -- _.__ .- Roxie E. Watson Pro ert _ - _ NUMBER ' • .. P y jointly-owned with Right of Survivorship mutt bs disclofed on Schedule "F"--- --- -- - --~-'--~--- -- value which is defined of Ilre price at which property vvovid be exchanged between a willing buyer and a willing seller, neither bean compelled fo buy or fell, both having reasonable knowledge of Iha relevant (acts ~ All roal estate fhovld b'e reported of fair mcike- I -- - a g NUMBER DESCRIPTION ---- YAIUE t4T DATE 1. -----_ OF DEATH Lot of land together with dwelling thereon, in Shippensburg 50.000.00 Borough, Cumberland County, Pennsylvania, as per Deed Book rrW", Volume 21, at Page 509. --- _ - --- -L. -------_-___-___ 10TA1 (Also enter on lino 1, Recopilvlation) $ ._ (H more space is needed insert additional sheets o/some size.)----- ~ rrd.rvwtrt hwry t;oMnr,~NwEn~Tlt ~r- rr:NrosYl_vntaln SC111?I)UI.1_ r'I.,, IttNFtts t nrlc,c_ t nx Its t sJtttt t;/\SI 1 /\NI) IJli~s;1.1-1 /\t 11.VUS fiE51UEN1~ UECEUENT I'L'11SON/\L I'liul'1-11 fY --- STATE OF - __._._.---- _--------. ..------------ _ ---....-- - ~~jl.E NUMUEFI (All property Iolr ITEM NUMBEfi t. 2. 3. 4. 5. 6. 7. 8. 9. _--.13~xia~_... Wax~on . _.. - .. - fitly ownaJ wiUr Ure Illphl nl Survlvvrohlp -__ _ ..._ _ . ___ 1 nrurt hn dl~eluwd on Sehminln ~-j'^- --_ UI_SCI111'1IUN Proceeds of Property sold at public auction Cash (lock box) Certificate of Deposit - Corr>Rtonwealth National Bank Acct #: 4100070492 Certificate of Deposit - Commonealth National Bank Acct#: 4100085657 Certificate of Deposit - Commonwealth National Bank Acct#: 412020 1988 Plymouth K. Car (sold above book) Savings Account - Mellon Bank Checking Account - Mellon Bank Tax Proration to Estate from HUD-1 Sheet VALUE AT UATE OF UEA111 2,402.50 , 3,500.00 10,010.00 50,000.00 30,211.23 3,500.00 31,000.00 11,074.65 523.63 • -----._._..------------------------ . _ _ _ _ _ r --- ------- ----- IU1nL (nlsn enlr.r nn line G, Itecal~ilul~ticm) -- -- -- __..________ ~ 142 222 11( none grncn I~ ns~Jal Irnert ~ddlUrnrnr ~honU of ~nnn ~In) eer•rsn Elr• t7.Er) ~~s COMMOFIWEAETIt OF PEIIrrSY[VANIA INIIERITANCE TAX REIURIJ RESIDENT DECEDENT ESTATC e scN~uu~.~ ~~ FUNERAL EXPENSES, AUMIfJISTRATIVE COSTS AND MISCELLANEOUS EXPENSES 11 E M --! NUMBER UESCRIPTIUN ~-• Funeral Expenses: ~--" )' Fogelsanger-Bricker Funeral Eiome 2. Fees to Open burial lot and expense of funeral meal B• Administratlva Costs: ~• Personal Represenlalivo Commissions Social Security Number of Personul Represenlnlive; _ Year Cornrnissions puid 2. Anorney Fees - H• Anthony Adams, Esquire ~I~ 3. Family Exemption Claimant Relalionslrip • Address of Cl4imanf of decedent's death Street Address City Slate Zip Cod© a. Probate Fees -Register of Wills ' C• Miscellaneous, Expenses: , ~• GASCO -utility at Estate Property 2. Penelec -utility at Estate Property 3. Penelec -Utility at Estate Property 4. PFG Gas Inc., utility at Estate Property 5. PFG Gas Inc., utility at Estate Property 6. Penelec, utility at Estate Property 7. Borough of Shippensburg -Water & Sewer 'e. Penelec ' (If more spots is needed, lrssert aclditionol slseets of same size.) TOTAL (Also enter orr line 9, Recapitulation) $ Please Print or Type 3ER AMOtlNfi .~ 4, 829.20 476.95 5,700.00 277.00 24.47 13.70 15.86 24.74 63.82 15.05 112.32 15.05 CONTINUATION OF SCHEDULE "H" ESTATE OF ROXIE E. WATSON EXPENSE: 9• Borough of Shippensburg (School Tax) 10. Borough of Shippensburg (Utility at Est. Property) il. Recorder of Deeds (Transfer Tax on Est. Prop) 12. Borough of Shippensburg (Utility at Est. Prop) 13. United of Pa. 14. Penelec (Utility at Est. Prop) 15. GASCO 16. Harrisburg Hospital (expense of last illness) 17. United of Pa. 18. Terry L. Shetter (expense of public auction) m AMOUN'~ 462.38 ~ _ 58.54 500.00 113.72 27.11 16.03 38.52 252.60 , 49.27 373.28 ... . ,. , 4`. _:° a ... ,.. • Cprn~uryn•urnr,rn pr rnnr:.rynrun „,,,~,.,,,~,,_-. ,~ n~N~Flcl~tZi~S _ rt5~onn nrr ir+rin -------- ESTATE OF -_-=_ - _ _-------_FItE NUMBER Roxie E. Watson ~ ~ - ITEM - - -_._.._ _ _ ______ ___ - NUMBER NAME ANU ADDRESS OF UEIJEFICIARY _ RELATIONSHIP AA10Ut?li OR -------------- --- SHARE OF ESTATE ` A. Taxable B --------------- _---- 2. 3. 4. equesls: Thomas A. Watson 612 [Jes toyer Road Shippensburg, PA 17257 Larry J. Watson 459 E. King Street Shippensburg, PA 17257 Ronald J. Watson 4355 Knollwood Drive Troutville, VA 24175 Bruce G. Watson 2006 Clifford Drive Martinsburg, WV 25401 ------------------ - ITEM --- --._-_.-- NUMBER IJAME ANU ADDRESS OF BENEFICI ----- - -- B. Choriloble and Governmentol Bequests: --- I. TOTAL CHARITABLE ANU GUVERlJMENlAI B[':QUESIS (Also enter on L (II more spoco is noorled, hrsorl oJdilional shoe a ~,"' ~~ LAST WILL ANI) TL'S'i'AMENT 7 I, ROXIE ELIZABETH WATSON, being of sound mind, memory•anii , ur-derstar-dir-g, do make, publish, anti declare this my Last Will and Testament, hP.r•P.by revoking a]1 prior wills and codicils made at any time before by me. F:[RS'P. T dlrecl that alai. my f'unerril expenses be paid as soon as practical after my death. SLCOPID• ] give, devise Ind berfue;rth rill my property, be it real, mixed or personal, to my husband, Harry B. Watson, a/1:/a Bruce H. Watson. TIiIRll. If my husband should predece;Ise me, or if we should die in a common disaster, then i.n either of those said events, I direct that Shar-e Watson and Sharon Watson, be a]lowed to ase one half of our cemetery lot. FOURTII. II' my husband should predecease me, or if we should die in a common disaster, then .in either of those said events, I give, devise and. bequeath, the rest and .residue of my estate, be it real, mixed or personal,. to Thomas Eugene Watson, Larry J. Watson, Ronald J. Watson, and I3ruce G. Watson, in equa-I share. to share and share alike, per St1I'pP.S. FIFTH. I nominate ar-d appoint my husband, Harry B. Watson, as the Executor of this my Last Will and 'Testament. If he should be unable to serve or rail to serve, then in that event, I nominate and appaint, Thomas Eugene Watson, Larry ,1. Watson, Ronald J. Watson and Bruce G. Watson, as the Executor's of tI-i.s my tirlst: Will and Testament. ' IN WITNESS WIIERGUF, I ROXTE ELI7.ABETH WATSUN, to this my"Last Will and Testament set my hand and sea]. this _J ~`~~~_ day of ~~~~ ~ 1990. ~ ~~~, \~~'~~.~ . ~' l'LG.a~ .~~ ~, fi~ (SEAT;) ~. -~ ,~ Sworn to and subscribed, declared and published by ItUXIE ELI7,ABETH WATSUN, as her Last Will and Testament, and so done in the presence of we the ~ ~~ witnesses. wi-o sign at her request.. ~ ~~~ \. J 1 and in her presence , and i n tttc `~~-''~`~~ ~~-`-t`~•_J.~ ~+~ presence of each other. ~ ~ ,- ~~ ~ , JY"• ',. COMMONWEALTH OF PENNSYLVANIA: :SS COUNTY OF CUMBERLAND I, RUXIE EIIIZABETIi WATSUN, t:he Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby ackt-owledge that I signed and executed the ir2stL•ument as my • Last Will and Testament; ar-d that I signed it willingly; and that I signed it as my i'ree artd voluntary act .for the purposes therein expressed. - ~, r' - ,~={ y~ Sworn to and acknowledged, before -ne by RUXIE ELIZABETII WATSUN, the Testatrix this ~~_il~ day of 1, Notary Public I ~ ~ ,~ i , H AIJTNllA1V Alin f.AC w.~...~....-•. .~„ ~~~~ .~_____,_ _. COMMONWEALTII OF PENNSYLVANIA: COUNTY OF :SS CUMBERLAND . We, If. Anthony Adams attd Sharon Coleman Adams, the witnesses whose names are signed to the foregoing instrument, being duly qualified• according to law, do depose and say that we saw the Testatrix sign and execute 'the instrument as her Last Will and Testament; that she signed willingly and that stle executed it ;is her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses, and that to the best of our knowledge t:hE>, Testatrix was at the time at ]east eighteen (18) or fiOrl? y1?;lr~g oI' i]~P F1rld of SOUtId nlit-ll alld Under t10 constraint or undue lflf lUf'11F:E' . ` ~.. ~'~ 7'. _.. --~ - ~, Sworn to and subscribed before the by H. Anthony Adams and Sharon Coleman Adams, the witnesses, this ~'~h day of ~J Notary Public ~~~ 'r TERRY L. SHE T TE.R ,- " " .r,~ -___ . Auctioneer ~-~~L~ 10390 Rowe Run Road ~ ~;}~~~ ,~~ _ Orrstown, PA 17244 717-532-8082 • ,~ SETTLEMENT 1. Gross income of sale with all total revenues: ~y~~. sa 2. All bills paid by auctioneer that canes off ~~ pa3 . :~ the total: 3. Total of the auctioneer's percentage that ,p~' comes off the gross income: a`j ~ . ~(~ ~- - , Terry Shetter, Auctioneer/Date / 11 ~ ... e ~4~~~-~~ ~CceZ~y~ . ~ '~~`~~ ~~S'f>• oa ~oT~ c / ~` ~~ ~~, ~~ ~~~ ' ~: .~~. '~i~ ~~T- ?`r-~J List of Propert ~Ch'~-ra~~~ / Seller/Date '~J Other Co~nents ~S~ - 00 ~.S <~. d~ S O ~sc~ rry L. Shetter, have agre~7 with ~L~~, ~ _ auctioneer the said pro of perty at the rate of o '~t~-. ~.C"r-~°~'-~. 0 on the ---- tO they ~S.-. a t 5J --~ day is no liens on or against any of the fro' Zhe seller that all of the proper A pert guarantees that bidder without an ~' advertised will be sold at~ The seller also agrees y rejections except on real estate.~e sale to the highest responsible for any-accidents. I will not .. be held • .:. ,.. :, ~' AGREF1vIENT CONTRACT -----_- - l ~~ ~:1 • --_.. S' .~i~m ~ s3a -~3~ z Te ,.l~~ 9,~,~s-- Ter L. Shetter, Auctioneer Da / to ~~ ;,uctio:~zer 10390 Roane Run Road Orrstoi>>n, PA t72~~} ______?17-532-8062 ~~~ ~ .~~ ~«~~ s ~~ /11ud C~ra~uc-.6 p~ ~lceu~c•~Cx~c to r