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This is to certify that the certificate hereunto attached is a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is
subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital
Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed
and commissioned as directed by Act 66 of the General. Assembly, approved 29 June 1953, P.L.
304.
Auc i ~_200~
Date
? •
Fran eropoli, ct
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL I~CORDS _
CERTIFICATE OF DEATH D ~ ~~
REV-1500 EX+ (7.9~ ~, J O
J -~ ~ ~~
COMMONWEALTH OF PENNSYLVANIA ~
DEPARTMENT OF REVENUE
DEPT. 260601
HARRISBURG, PA 1 71 2 8-0601
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INHERIT CE TAX RETURN
RE ENT DECEDENT
~(TO PILED IN DUPLICATE
WITH REGISTER OP WILLS)
FOR DATES OF DEATH R 12131191 CHECK HERE
IF A slaousaL
POVERTY CREDIT IS CLAIMED ^
FILE NUMBER
2( -
COUNTY CODE
Q5 - ~ 3Z(
YEAR NUMBER
APPLICABLEI SUING SPOUSE'S NAME (LAST, FI0.5T AND MIDDLE INITIAL)
J~ 1. Original Return
^ 4. Limited Estate
Decedent Died Testate
(Attoch copy of Will)
uc(.eutnl•5 C~OM~'P~L]E..T~E ADDRESS
~j~1.(~ G~M~~ --t~t1.1.~ P~OpO(,tCr~t , P/} ISO I i
/~ l CouMv I .1 ~1~/1 ~J ~I l~
_ I 1(J~ ~ Q"~ ~-I~~i I
^ 2. Supplemental Return
^ 4a. Future Interest Compromise
(for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
_(Attoch copy of Trust)
^ 3. Remainder Return
(for dates of death prior to 12-13-82)
^ 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
Zoe wiu.e v~.
CPou1p PR 70~ I
1. Real Estate (Schedule A) / (1) ~
2. Stocks and Bonds (Schedule B) (2 )
'
3. Closely Held Stock/Partnership Interest (Schedule C) .-
(3 )
4. Mortgages and Notes Receivable (Schedule D) (4 )
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5) . Q
•-
b. Jointly Owned Property (Schedule F) (b )
7. Transfers (Schedule G) (Schedule L)
8. Total Gross Assets (total Lines 1-7) (7) ~7 8 s~Z18 /~L~3-I
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) ~~ ZL (
Expenses (Schedule H)
10. Debts, Mortgage Liabilities Liens (Schad I I)
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 Lins 21B. This is the BALANCE DUE.
Make C6eak Payable to: Register of Wills, A~eet
u e (10)
11. Total Deductions (total Lines 9 8~ 10) (11) _-
12. Net Value of Estate (Line 8 minus Line 11) (12) __
13. Charitable and Governmental Bequests (Schedule J) (13 __
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
15. Spousal TransFers (for dates of death after b-30-94) ~ D.
See Instructions for Applicable Percentage on Reverse (15) x ~_
Side. (Include values from Schedule K or Schedule M.) -
16. Amount of line 14 taxable at b% rate- (16) .Ob -
(Include values from Schedule K or Schedule M.) --
17. Amount of Line 14 taxable at 15% rate (17) 15 . •---
(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 Pa ment~ Discount Interest
20. If Line 19 i;,pFeater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) --J
~~ _
(21)
(21 A)
(21 B)
it is true, correct and complete~l ~declarerthat all ~eal esta a has base replorted at true ma rke9value~ Declarat ontof preparerdothehethan
based on all information of which preparer has any knowledge.
SIGNATURE [)F PERS[)N ooson/.lem~e ms's ~.. ~..........._.. _
"' /'1 -
>t my knowledge and belief,
~e personal representative is
DATE
DATE
(18) ~ f~
Act 348 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°r6 (.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 estatss 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 (/~ IN THE APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred, .......................................................
b. retain the right to designate who shall use the property transferred or its income, ...............
c. retain a reversionary interest; or ...................................................................................
d. receive the promise for life of either payments, benefits or care$ .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration$ If death occurred after
December 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideration$ ...................................................................................................
3. Did decedent awn an,__~in~trust for'. bank account at his or her death$ ......................................
r. -~
-1F TI~ ANSWER TO ANY OF
YOU MUST ~l°OMPL-ETE SCHEDULE G
,~, -
THE ABOVE QUESTIONS IS YES,
AND FILE IT AS PART OF THE RETURN.
TO WHOM IT MAY CONCERN:
THOMAS J. PROSSER DIED ON MARCH 6, 1995, LEAVING HIS WIFE,
SHIRLEY A. PROSSER, AS THE SOLE BENEFICIARY OF HIS ESTATE UNDER
HIS WILL. AT THE TIlVIE OF HIS DEATH, THE INHERITANCE TAX ON SPOUSAL
TRANSFERS WAS 3%. IN ORDER TO OBTAIN THE 5% DISCOUNT, THE
INHERTI'ANCE TAX WAS PREPAID ON 6/5/95 IN CUMBERLAND COUNTY,
RECEIPT # AA047837.
SHORTLY AFTER THE INHERITANCE TAX WAS PREPAID, THE
PENNSYLVANIA LEGISLATURE PASSED A LAW WHICH REPEALED THE TAX
ON SPOUSAL TRANSFERS, RETROACTIVE TO 1/1/95. THEREFORE, MRS.
PROSSER IS ENTITLED TO A FULL REFUND OF THE INHERITANCE TAX
THAT WAS PREPAID ON 6/5/95. THIS TAX RETURN IS BEING FILED TO CLOSE
OUT THE ADMIl~TISTRATION OF THIS ESTATE AND TO OBTAIN A REFUND OF
THE PREPAID TAX.
THANK YOU FOR YOUR ATTENTION IN THIS MATTER.
RE'V-1503 EX~ 14-86)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS AND BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
(All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.)
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
,. ~ 5. emu( 5 ~mds ~~ ~
Z~ I ~lccou fi~ i ~ ~~ ~ x.08
fzA ~
~ .fi ~`' Gh .. ,~.1 i2,iZ
~ , 2 ~ @ 5i.12~ I,q
.i~fi~~, ~ ~ ~ 51.5x0 -- Z2,~1.0~
~~~ ~ ~l ~ ~ ~-150 -- 5,5011:15
'~,~ , io0 ~ ~ ~.~15 --- ~,~'1.~0
~; fi (G05~ ~ x.125 -- x,512,50
~~~ ~ ~ @ ~2 .~75 ---- 13i I~0.00
~~~ ~ ~ a~ ~Z. 7~ - i 5.8Z.o0
~C~na~l ~ , i~ @ 32 8~5 3,2~`1.5D
M -n ~nl ~ @ 2Z.5oo ~-- i i,Z~j.o~
~ ~ ~ 25.1~Z5 .-- 5 I ~5. o0
~P~eir~cc~ IC~~ ~ ~ .2~ -- 3~ S.DD
~mi~ , M~ne~ fci~cls , Z, laZq . 3 ~ ~ I -Z~j.
~- f~lr~ucfn ~~nm ~ 2~2 ~Pn ~ 21/~ ~ "T~.50
5 - ~~~:i N~r5, 1 ~s~ ~ 3~Y~ ' 5~-~, ~~
7- ~ L~ ~ s~ ~ IQS~~ I~~i-G~3
~. ..~~~ ~~ 518 ~,~1a.75
l~o. ~eli~ic~~~, Z~Zs~ ~ ~Ilz i~,~~.oo
I ~ . `~ - G fi I~iS C rC~t ~ 2J Z ~ ~ ~il'8 Co,11~, 5a
TOTAL (Also enter on line 2 Recapitulation) I $
. - ---;
REV-1508 EX+ (2-87)
COMMONWEALTH OF PENNSYLVANIA
INHERRANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
-O F ~~j
L-
Please Print or
l~+n prop~rry ~otntly-owned with the Riah1 of Survivor:6~e ~..~~.e 1.~ .1z..t..._~ __ e_~_~..~_ ~.
(Attach additional 8yz" x 11" sheets if more space is needed.)
REG-1511 EX+ (~BB)
SCHEDULE H
FUNERAL EXPENSES,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES
RESIDENT DECEDENT
Please Print or Type
MBER
ZI -~-_32~
AMOUNT
!~-~IUMf~ J ~ 1~~
ITEM
NUMBER DESCRIPTION
A• Funeral Expenses:
,.
B.
2
3
4.
C.
l .
2.
3.
4.
5.
6.
7.
8.
Z,1~:ZZ
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney Fees
Family Exemption ~~yy ~~
Claimant ~ Relationship SL~LJI,I~
Address of Claimant at decedent's death
Street ~~Ad~~dppress r~ S• ~~~ ST•
City ~14~~ ~{~~ State r' Zip Code 1 1U_
~0
Probate Fees D ~ .
~~ /
Miscellaneous Expenses:
~J
'~
TOTAL (Also enter on line 9, Recapit
(If more space is needed, insert additional sheets of same Sze.)
__ ~ .....
" 'T ~ I ~J'~ ; L~
._
R E Y-1513 EX + ~-87)
1` ~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
,~i~ S- T~'L~~.. Zi-g5-3~f
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequests:
,. ~~r ° A. R~r~~
2~0 .~~~
~~~ ~- I I , ~ I~01 ~ j~
S~k~
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) $
(If more space is needed, insert additional sheets of same size)
~~,~~ tl~ ~i.YL~ (~E~k~.1~tPltk
OF
THOMAS J. PROSSER
I, THOMAS J. PROSSER, of Cumberland County, Pennsylvania,
declare this to be my Last Will and
being of sound mind and body
Testament and revoke any and all Wills and Codicils previously
made by me.
ITEM I: I direct that all of my just debts, funeral
expenses, attorney fees, and all administration expenses
shall be paid from the assets of my estate as soon as practicable
after my decease.
ITEM II: I hereby give, devise and bequeath all of my
estate of every name and nature and wheresoever situate to my
wife, SHIRLEY A. PROSSER, provided she shall survive me by thirty
(30) days.
ITEM III: If my wife, SHIRLEY A. PROSSER, :Fails to survive
me by thirty (30) days or we die in a common disaster, I hereby
residue and remainder
give, devise and bequeath all of the rest,
of my estate to my son, BRIAN T. PROSSER, his heirs and assigns.
ITEM IV: All transfer inheritance taxes shall be paid out
of the proceeds of my estate.
oint my wife,
ITEM V: I hereby nominate, constitute and app
SHIRLEY A. PROSSER a Executrix of my estate. If she is unable or
unwilling to serve in this capacity, I then nominate, constitute
and appoint BRIAN T. PROSSER as Executor of my Estate.
ITEM VI: I direct that my Executor or Executrix as the case
may be shall not be required to give bond for the faithful
~ ~~
performance of his/her duties in any jurisdiction.
IN WITNESS
WHEREOF, I have hereunto set my hand and
--~~ of Sept
~er,l9gg• seal this
/, .7
1~ ~ j
1 ~~ ~y_--
Thomas J. Prosser --~_
Signed, sealed,
J• PROSSER, published and declared b
in the the Testator, as and for, y the above
presence of us his Last Will named THOMAS
his request as witness who have hereunto and Testament,
Testator, thereto, subscribed our names,
and of each other, in the presence of the at
said
Name .o /~~. ~.~ .%3 i '7~ . a g x ~' .l~
~~ /Jc,u >
~,_ _ . , ` 1. Address ~ ~!oi,
Vame '' ' ~
Address ~ --__,
~- ~ ~ _
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUry3cRcnN) SS:
We,
/•lpH..vs"
/. j~ivasss'~7
and -lu ~, e- ~-vrs._ .r T
/~~ the T --~
witnesses estator and the
t respectively, whose
or foregoing instr
names are signed to the attached
ument, being first dul
declare to the }' sworn, do hereby
undersigned authorit
and executed Y that the Testator signed
the instrument
that as his Last Will and Testament
he had signed willin and
glY (or willingly directed another to
si9^ for him) and
that he executed
act it as his free and vo
for the purposes therein luntary
witnesses, expressed, and that each of t
in the presence and he
the Will hearing of the Testator signed
as a witness and that
knowledge, the tO the best of his or her
Testator was at
that time eighteen (lg~
age or older, of sound mind and
years of
influence, under no constraint
and I, the or undue
said Testator do hereby acknowled
signed and executed the
instr 9e that j
that ument as mY Last Will and Test
I signed it willingl ament,
Y, and that 2 signed it
voluntary act for the purposes
as mY free and
therein expressed.
~ /
~~.., r/=
Testator
~.4ac4
Witness
Subscribed, Witness
acknowled s~"'orn to and
ged before me by
the Testator ~ ~"SSA,
and sworn and subscribed
to before me by
'~~> f''c v C ~ _
,-- c.. t,.,> ~.,~, s j /z -"'- and
witnesses, ~'~'°t ~ ~_
-~_l-`his _~ day of
A.D,, 1988.
wvrAitl~l St,4~ ^ .__
Marg3rat T. Fc ter. hioi~r, nUbEr,
Qump fji~j, ~n (;Ilmhn 1• ~ ,
REV-1547 EX AFP (12-94)
COMNGNiIEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAxES NOTICE OF INHERITANCE TAX ACN 101
DEPT. 280601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DATE 10-30-95
DATE OF DEATH 03-06-95 OM
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS N0.
PAYMENT TO THE REGISTER OF WILLS, •• COUNTY CUMBERLAND
MAKE CHECK PAYABLE TO REGISTER OF WILLS~RAGENTH YOUR TAX
KATHLEEN BUCKLEY MURREN REMIT PAYMENT TO:
206 WILLOW AVE REGISTER OF WILLS
CAMP HILL PA 17011 CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Amount Rs d
CUT ALONG THIS LINE RETAIN LOWER PO_RTION_ FO_R YOUR RECO
REV-1547 EX AFP (12-9
- - ---------- ---
4) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ~----""-------
ESTATE OF PROSSER
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENTROF TA
THOMAS J FILE N0. 21 95-0321
TAX RETURN WAS: (X) ACCEPTED AS FILED ACN 101 DATE 10-30-95
RESERVATION CONCERNING FUTURE INTEREST _ ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: SEE REVERSE
1. Real Estate (Schedule A) ORIGINAL RETURN
2. Stooks and Bonds (Schedule 8) f1)
3• Closely Held Stock/Partnership Interest (Schedule C) •00
(2) 200 224.39
4• Mortgages/Notes Receivable (Schedule p) (3)
5. Cash/Bank Deposits/Misc. Personal pro ert •00
(4) .00
6. Jointly Owned Property (Schedule F) p y (Schedule E) (5)
7• Transfers (Schedule G) 18 000.00
(6) .00
8• Total Assets (7)
APPROVED DEDUCTIONS AND •00
9. Funeral Expenses/Adm. EXEMPTIONS: (8) 218, 224.39
10. Debts/Mortgage Liabilities/Lisns•(S hedula I)chedule H) (g)
4,734.22
11. Total Deductions (10)
12. Net Value of Tax Return 0
13. Charitable/Governmental Be (11) 4 74G ~~
14. Net Value of Estate SubjsctutotTaxSchedule ~) (12) 21 3,490.1 7
NOTE: (13) .00
reflectsfigurestthat inciudeptheitotal' (14) 213,490,17
ASSESSMENT OF TAX: lines 14, 15 andior 16, 17 and 18
Of ALL returns assessed to date. Will
15. Amount of Line 14 at Spousal rate
16. Amount of Lins 14 taxable at Lineal/Class A rate (15) 213,490.
(16) • 00
17. Amount of Line 14 taxable at Collateral/Class B rate (l~) 1 7 X .00_
18. Principal Tax Due ' 00 X • 06. . 00
TAX CREDITS: • 00 x • 15. . 00
PAYMENT (18) • 00
DATE RECEIPT
NUMBER DISCOUNT (+)
06-05-95 AA047837 INTEREST (-) AMOUNT PAID
.00 6,000.00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE 6,000.00
INTEREST 6,000.OOCR
TOTAL DUE •00
( IF TOTAL DUE IS LESS THAN gl 6,000.OOCR
IF TOTAL DUE IS REFLECTED AS/A~ PAYMENT IS REQUIRED.
CREDIT' (CR), y0U MAY BE DUE