HomeMy WebLinkAbout95-0275ai -q~ oz~s
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 16 200
Date
H,OS.Iq Rev. 4/B'7
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PERMANENT
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Fran eropoli, ct
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFlCATE OF DEATH
336816
NAME OPD~NT(FRat MNOe, leq SDI SOCIAL SECURITY NUMBER DRE OF DERNtM"ML Deµ'!er)
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~.;.~ INHERITANCE TAX RETURN
'~~w=~ RESIDENT DECEDENT
'~~MMONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE
DEPARTMENT OF REVENUE
DEPT. 280601 WITH REGISTER OF WILLS)
HARRISBURG, PA 17128.0601
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Eppley, Edna S.
199-36-0871
® 1. Original Return
^ 4, limited Estate
® ecedent Died Testate
Attach copy of Will)
17 1 944-1333
FOR DATES OF DEATH AFTER 14131191. CH ERE
IF A SPOUSAL
POVERTY.CREDIT IS `CLAIMED ^
FILE NUMBER ^ _. _
LINTY COD
NUMBER
422 Walnut Bottom Road
ATE OF DEATH DATE OF BIRTH Thornwald Home
Csrli~le, PA 17013
4/3/95 7/13/1395 co~~y Culrberland
^ 2. Supplemental Return
^ 4a. Future Interest Compromise
(for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living.Trust
(Attach copy of Trust)
^ 3. Remainder Return
(for dates of death prior to 12-13-82)
^ 5. federal Estate Tax
Return Required
.Q 8. Total Number of Safe Deposit Boxes
Pannebaker and Jones, P.C.
4000 Vine Street
Middletown, PA 17057
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1. Real Estate (Schedule A) (1) 111nne
2. Stocks and Bonds (Schedule B) f (2) None
3. Closely Held StocklPartnership Interest (Schedule C) (3) None
4. Mortgages and Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property( 5) Ala
(17 ~ _ 'iR
(Schedule E) ~
b. Jointly Owned Property (Schedule F) (b) NOne
7. Transfers (Schedule G) (Schedule L) (7) None
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) _13.604.72
Expenses (Schedule H)
i 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 1 , 384.69
1 1. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests (Schedule 1)
14. Net Value Subject to Tax (line 12 minus line 13)
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( e) .94.072.38
(1 t) 14, 989.41
(12) 79,082.97
(13) 16 , 500.00 /t
(14) 62,582.97
15. Amount of line 14 taxable at b% rate (15)
(Include values from Schedule K or Schedule M.) x .Ob =
16. Amount of line 14 taxable at 15°/a rate (lb) ~j9 ~ 5$7 _ 97 ~~~~!~
(Include values from Schedule K or Schedule M.) x .15 = 9 , 387.45
17. Principal tax due (Add tax from line 15 and from line 1 b.) (17) _ 9 , 387.45
18. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ + 469.37 _ (1 s) _ l.Fi9 _ ~7
19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT. (19)
~^
20. If line 17 is greater than line 18, enter the difference on line 20. This is the TAX DUE. (20) 8, 91$.08
A. Enter the interest on the balance due on line 20A
. (20A)
B. Enter the total of line 20 and 20A on line 20B. This is the BALANCE DUE. (20B)
Make Check Payable to: Register of Wills, Agent
under penalties of perjury, I declare that I have examined th
it is true, correct and complete. I declare that all real estate I
based on all information of which preparer has any knowlec
SIGNATUR OF PERSON RESPONSIBLE FO,R FILING RETURN
'- W
return, including accompanying schedules and statements, and to the best of my knowled a and belief,
s been reported at true market value. Declaration of preparer other than the personaJ,eg~se~gtgtive is
e.
)DRESS 960 Valley Road DATE J
Marysville PA 17053
~oRESSPannebaker and Jones, P.C. DATE
4000 Vine Street G /
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (~j 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.
' REV-1508 EX+ (2-871
SCHEDULE E
_ ` CASH, BANK. DEPOSITS AND
:ACTH OF PENNSYLVANIA MISCELLANEOUS
DANCE TAX RETURN PERSONAL PROPERTY
DENT DECEDENT
Edna S. Eppley
(All property jointly-owned with the Righf of Survivorship musf ba ditelosed on Schedule fJ
ITEM DESCRIPTION
NUMBER
Please Print or
LE NUMBER
00275-1995
VALUE AT
DATE OF DEATH
1. Refund of Funds held by Thornwald Home
2. First National bank of Marysville CD ~~3056208
(See Attached)
3. PNC Bank CD ~~i083270126190 and checking account ~1~5140303882
(See Attached)
4. First National Bank of Marysville Interest on CD 43052955
5. First National Bank of Marysville CD4~3052955
6. First National Bank of Marysville Account 430-571-5
7. Lady's Yellow Gold Filled Hunting Case Design Watch
8. White Metal Pocket Watch
9. Lady's 14kt White Gold Filigree Di amond Ring
10. Lady's White Gold Filled Wrist Wat ch
11. U.S. Series H Bonds (See Attatched Exhibit)
12. Refund Capital Blue Cross
$ 51.46
13,041.28
23,721..57
178.84
40,802.99
13,727.14
35.00
No Value
400.00
No Value
2,000.00
114.10
,,.
/.,;,'
TOTAL (Also enter on line 5, Recapitulation) $ 94, 072-. 38
(Attach additional 8'h° x 11" sheets if more space is needed.)
gevisn E,c+~•eep SCHEDULE H
. FUNERAL EXPENSES,
.
COMMONWEALTH OF PENNSYLVANIA
ADMINISTRATIVE COSTS AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISCELLANEOUS EXPENSES
Please Print or Type
ESTATE OF FILE NUMBER
Edna S. Eppley 00275-1995
ITEM
NUMBER DESCRIPTION AMOUNT
A. FuneraLExpenses:
1. Michael J. Shalonis Funeral Home $3,792.00
James R. Gingrich Inc., Memorials 60.00
B. Administrative Costa:.
1. Personal Representative Commissions Frederick W. Adams
_ _
Social Security Number of Personal Representative: 181 10 0361
4, 700.00
Year Commissions paid 1995
2. Attorney Fees Pannebaker & Jones, P.C. 4,700.00
3. Family Exemption
Claimant N/A Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees Reimbursement of Pannebaker and Jones, P.C. for 162.00
Register of Wills, Cumberland County
C. Miscellaneous Expenses:
1. Appraisal Fee Personal Jewelry Henry J. Ruhl Jewelers 75.00
2. Carlisle Sentinel For Estate Ad 75.72
3. Cumberland County Law Journal 40.00
4.
5.
6.
7.
8. ~,~'~'
TOTAL (Also enter on line 9, Recapitulation) $
4.79
~~r more space 1s needed, insert additional sheets of same size.j
~~ REV-1512'EX+ )7.88) }
' COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABLITIES AND LIENS
Please Print or
c~ur~c yr FILE NUMBER
Edna S. Eppley 00275-1995
(If more space is needed, insert additional sheep of same size.)
P
REV-15.13 'EX + (2-87~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
rsrAria OF FILE NUMBER
Edna S. Eppley 00275-1995
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequests:
`~ 1• Mary Eater Myers Friend ite Gold Watch
777 Oakville Road iamonds around
Shippensburg, pA 17257 ig white gold d
ing, and mother
~' 2.
Bernice and Andy Schmauch atch.
3403 Chestnut Street Friends $500.00
-Camp Hill, PA 17011
X13. Eleanor Steele Friend ig Gold Necklac
303 Church Street
Marysville, PA 17053
4. Ruth Baker Friend lass chicken an.
213 S. Main Street quare Vase with
Marysville, PA 17053 lue Flowers.
~~5. Frederick W. Adams Friend 25,000 and balm
960 Valley Road
Marysville, PA 17053 state
6. Walter Roberts Friend 25,000.00
305 Valley Street
Marysville, PA 17053
CONTINUED ON ATTACHED
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequests:
'~.yi Chestnut Grove Cemetery Association of Marysville
40b Maple Avenue
Marysville, PA 17053
,~f 2. Marysville Civic Club
326 Cameron Street
Marysville, PA 17053
v 3. Perry County Heart Fund
C/0 AnLerican Heart Association
610 Community Way
I;ancaster, PA 17063 , - _; ?E~_; .~- ,7
1-~ .+1
~, 4. Perry County Cancer Fund
33 C. South Second Street
P.0. Box 64
Newport, PA 17074
CONTINUED ON ATTACHED.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation)
AMOUNT OR
SHARE OF ESTATE
wi
it,
iaml
's
ice
$2,000.00 ,./~
$1,000.00
/,--,
$1,000.00 r~
$l, 000.00 ~~/
S
(If more space is needed, insert additional sheets of same size)
EDNA S. EPPLEY
FILE NO. 00275-1995
CONTINUED
A. TAXABLE BEQUESTS:
ITEM NAME AND ADRESS OF BENEFICIARY RELATIONSHIP
NO.
~ 7 Mary Vandenburg
C/O Masonic Homes
Benjiman Franklin
1 West, Building Room 1125
Elizabethtown, PA 17022
8. Mae Roberts
305 Valley Road
Marysville, PA 17053
ITEM NAME AND ADDRESS OF BENEFICIARY
NO.
B. CHARITABLE AND GOVERNMENTAL BEQUESTS:
~;5. Marysville Masonic Home Lodge 458
11 Morningdove Way
Duncannon, PA 17020
6. Marysville Fire Company
326 Cameron Street
Marysville, PA 17053
~ 7. Marysville Ambulance Club
326 Cameron Street
Marysville, PA 17053
8. Holy Spirit Hospital
503 N. 21st Street
Camp Hill, PA 17011
J 9. Salvation Army
1122 Green Street
Harrisburg, PA 17102
~~ 10. Kinkora Pythian Home
25 Cove Road
Duncannon, PA 17020
11. United Church of Christ
117 Verbeke Street
Marysville, PA 17053
Friend
Friend
AMOUNT OR
SHARE OF ESTATE
$1,000.00
Dish with the
Indian on top.
AMOUNT OR
SHARE OF ESTATE
$1,000.00
$2, 000. 00 ~~,/
$2,000.00
~~/
$5,000.00
$500.00 `/
$500.00
$500.00 ~,,
TOTAL. $16..500
Register of Wills of Dauphin County, Pennsylvania
INVENTORY
Estate of __ Edna S. Epple No. 00275-1995
also known as
Date of Death 4/3/95
Deceased Social Security No. 199-36-0871
Personal Representativels) of the above Estate, deceased, verify that the items appearing in the following inventory include all
of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that
the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and
that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum
at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that
false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to
authorities.
Personal Representative:
Name of
Attorney: James Pannebaker Frederick W.~r~ms ~
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m t~r;
LD. No.: ~9F,h7 - -
L_ _
Address: 4000 Vine Street Dated
Middletown, PA 17057 - )
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Telephone: (717) 944-1333- -
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Description
Refund of Funds held by Thornwald Home Value
$ 51.46
First National Bank of Marysville CD i<~3056208 13,041._28
PNC Bank CD ~~1083270126190
_,_ 23,721.57
First National. Bank of Marysville Interest on CD X63052955 178.84
First National Bank of Marysville CD 463052955 40,802.99
First .National Bank of Marysville Account 4630-571-5 13,727.14
Lady's Yellow Gold Filled Hunting Case Design Watch 35.00
White Metal Pocket Watch No Value
Lady's 14kt White Gold Filigree Di amond Ring 400.00
Lady's White Gold Filled Wrist Wat ch No Value
U. S. Series.H Bonds (See Attatched Exhibit) 2 000.00
Refund Capital Blue Cross 114.10
Total: y4,U72.38
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include
the value of each item, but such tipures should not be extended into the total of the Inventory.
RW-8
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LA~'.C wt r.r, nrvn •i'h:ti~i'AMF.NT
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RC~NA S . EPFLEY
_. Edna S. Eppley, having my lega,i, residence at 442 Walnut
Aottom Road, Thprnwaod Hoorn, C'arlirl,e, Cumberland County, Common-
wealth of Pennsylvania, cia hereby declare this to he my Last Mill
and Testament, revoking all ether wills and Codicils heretofore
made by me.
ITBM ONE: I rliKce~t that the expenses of my last
illn®ss and funeral he paid from my estate as soon as practiCzrble
after my death.
iTEN[ TWp; t C1eva s~: ranri hQqueath all of my properky
of whatsoever nature and wheresoeverr situate, a~s follaws_
(1) z give and hegueath m,y white gold watch with the
diamonds around it, my bic~ whine; r~nlci ttia~mand ring with one
(1) and eight (8) small dirmcnets, and area my M hers, Emma Jane
Milligan's, watch to Waxy F:cit:er. Myr.r.!;.
(2) I give and Metlue~~th to thr. Marysville a Company
of Marysville, Pennsylvania, Ch~> sum of 52,A0 0.
(~) I give anc) hc~riuc;rarh r.r> r;hr± Chestnut .ave Cemetery
Association of Marysville, thr. sum c~C 82,OgA 0.
(4) I gi~anc~ bequet~r.h to t.hc Marysville Civic Club the
sum of 51,004.00.
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AIJG-2!F-9'.S F12I Y.3 : 49 Pa~nn~ba.k er and. Jon~~. p _ G1~
• rau~-tom-ya r 1~ 1 1 3:49 P'ann.eba~c er ana .T+anes p _ ~,q, - -
7
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{$) i dive bec~ue:,r.h tc~ r_hE~ Marysville Ambulance Club
the sum of s2,pOp-pp
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{6) i give a equeath to the Perry County Heart k'und
the "sum of $1, 400.00. /..--~'`-
{7f x give an/d ~~ueath to tkae Perry County Cancer Fund
the sum of 51,00 .00' p
~,.
{$) I glue and bequeath the Marysville Masonic Rome
Lodge 458 the sum of S1..OUA.00.
.~°".
{9) I give and bequeath to the Ftaly S it Hospital of
Camp Hill, Pennsylvania, the sum at 55,000.00
t10) I give and bequeath to Frederick w. Adams of Marysville,
Pennsylvania, the sum of 525,000.00.
{11) i gave and bequeath ko Walter Roberts of Marysville,
Pennsylvania, the aunt of $25,000.00.
(12) I give and bequeath to Mrs, ,T. T. Mulheron the sum of
S1,OOO.OQ.
(13) I give and bequeath to Bernice and Andy Schmauch the
sum of 5500.00.
{1~) I dive and bequeath my big gold necklace that had been
my Mothers, which she reeeivErl from hcr. Aunt Maggie Jahns when
she waa married fn .Tu1y la, 1Ri3$, r.~ Eleanor Steele.
{15~ I give anti bequeath my bi,y aicl cluck, that was my
grandfathers long beEare my fak:her was married in 1888, to
Walter Roberts.
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qUG-2~i-9~ FRI 1.TS ~'S0 F~OLYIYSL~~i~ICE-1^ QI'~Cr ~7OYt~~s - P. 0~i
,
(16) I give and bequeath the glass chicken, on the livxrtg
rporq stand, and the squa~rc~ va~,ir, an t;ht: television with blue
flowers, to Ruth Baker. ~~
(17~x give and bequeath to the Salvation AXmX the sum
o£ ssoa.o~.
(1$) I give and bequeath to Mary vancienburg the sum of
$1,000.00,
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(19) I give and bequeath to the [cinkora Pythian Home fn the
,.--~"
Cove the cum o£ 55.00 an memory of my husband, ~togex L. EQQley,
/~....-
who died March $, ].980.
(20) I give and bequeath tq the UnitF2d Church a£ Christ,
Marysvf lle, Pennsylvania, the sum of $5-A~8';~AO.
(21) i give and bequeath the dish, on top of the air condi-
tiotleX with the Indian on top, to Mae Roberts.
(22) I give, devise and bequeath all the rest and residue
of my Estate to Fradexxck W. Adams, and if he should £ail to sur-
vive my death, then I give, devise and hQqueath all the zest and
residue o£ my Estate to the Clnited Church of Christ of Marysville,
Pennsylvania.
XTEM xHREE: All estate, inhexxtance, succession anc)
other death taxes, imposed or. payahl.c try reason of my death,
and interest and pena7.tieS thereon, wzth ra:~pect to all ptcope~srty
~l~
~~r~~
M UL+~La~7.7 r ee 1 1.~ ~ ~{~ r'ann~naK tsr ana J On ~?S _.- - - __ -. - -
P 0 6
comprising mY grass estara fnr dcatt~ tax purposes, whether or not`..`...
such property passes ,.~ncinr this wi,l..i., shai.l he paid out of the
principal of My gEneral estate, as zf such taxes were administration
expenses, without apportionment ax right of reimbursement. z
authorize my Legal representatives to pay alZ such taxes at such
time or times as may be deemed advisable.
iTEM FOCTR: I appoint James 8. Pannebaker, Esquire,
of the law firm of Pannebaker anci Assvcxates. P.C., as attorney
for my Estate since he is familiar with my interest, intent,
and wishes.
YTEM FIVE: ~ appaint Frederick W. Adams aS Executor
of this Will and direct that. he he permitted to serve without bond
and without any intervention of any court except as required by
law. I authorise my Executor to sell, encumber, mortgage, invest,
c9fatribute in kind, or retain any items of property of my estate
in such manner as he shall deem prapex, limited only bX his own
discretion. If for any reason my ~'xecutar appointed under this
Will should fail, to serve stn that capacity, I Appoint the CCNB
Eank, N.A., of New Cumberland, PennsY'ivani.a, or its corpprate
successor, as the l:xecutor~of my t,ast Will and Testament, with
the same powers and privileges set forth above.
~- tit-rs.
/~~/~'~
MSJ <a~ L ~~77 r IC 1 1 .ti ~ ~ 1 1""Q f"1 Y'I@C~C7.K E~ r R rI IC1 J O,YI@ S
~-'- b r
Ytd WITNRSS idHt;RF'4F, ,[ f+~avct sip Middz~:i:~wn, Pennsylvania.
this ~ ~ day of
.~ , 1984, set my
hand ~tnd seal to thisr My Last Wx],1 and Testament consisting
of five (5) pages
~ ~ mod,'/ ~
EdniE (SEALy
PD
SIGNED, sealed, published and declared by Edna S. Eppley,
the above named Testatrix, as anc~ for her Lest Will and Testament,
in the p~'esenee of us, who, at her request, in her presence and
in the presence o! each other, have hereunto subscribed our name$
as witnesses.
Residence
~~_
~esidenCe~~~/pp~~~ ~~11~
-~i-
r~uaa-c.~- y„a r rc 1 1 a a~ ran r-~e o+otK er ano ..~ ones
r . ~a Ls
ACKnl~wta~rxaFME'NT
COMMONWEAL7`H OF PENNSYLVANIA ,
COUNTY pE~ DAUPHIt+T HS'
On this. the "~~day of
~~'~' , 1984, before
nte, a Notary Public, the undersigned officer, persona~.ly appeared
Edna S. Eppley, known to me (or satisfactori].
y proven ) to tie the
person whose naate is subscribed to the attached ar Foaregoing instra-
ment. acknOw,iedged that she signed and executed the instrument as
her Last Will.: that she sic~ttec~ it willingly: and that she signed
it as her free and voluntary act for the purppses therein expressed.
IN WITNESS WHBRBOF, T hereunto set my hand end official
seal.
(SBAL) 1~.~.K.I 7i. ~.9C.L.Q~k
Notary u ~
EILEEN (L CDSfE~ IIOJ~- PD~IC
MW~S1' ICWi~t~SION E~lER~l,WNE
. ~ro0er, Wnn~ylp~~ A~wclttb~ of Nalewp
r+a.au-cam,.- ~~ r ~c 1 1 a a~ ra~nneoar. Nt er +a.na .a c.n~+s _
' r_ ~y
r
Ct)UNTY ~OF dALiPC~Z~I $S'
~Pe ,
v' and~/t~m J .~ n~C~ ~o
the witnesses whose names are signed to the attached or
foregoing instrument, being duly 9ualifi.ed according to law,
do depose'and sax that we were pre$ent and. saw the testatrix
Sign anti execute the instrument as her Last Will; that she
signed willingly and that she executed it as hex free and
voluntary act £or the purposes 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 the
testatrix was at that time 18 nr more years of age. of sound
mind and under no constaraznt -
SWORN and eubscrib~ to
befoz'e me, this _~ day
..of. , 1984.
f7 w
h• .//JI-iI(
of ary, ~ u 1 C ^'r4il
.. ~~~
1~1 ~~
~~t, P~~~~WNF i,1~i7 '
~wocloaon of Kebrfir