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HomeMy WebLinkAbout95-0345~- --q~~c~3~5 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. H105.143 R•v. 2/B7 TY-EIMWT IN MAIM MLAgt A z AUG 16.2001 Date ? • Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMINONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS „~ 1 Q ?,}' ~ 1 CERTIFICATE OF DEATH REV,15c0 EX + ~~ ~~~ s~r ,~'COMMONVVEALTH OF PENNSYLVANIA f DL'?ARTMEIJT OF REVENUE DEPT.2e0601 ' HARRI39URG. PA 17128-0601.- REV-1500 INHERITANCE TAX RE RESIDENT DECEDI w....~..... .K:-~:..~.,~. ~ ... _.. ~~,~*~* OFFlCIAL USE ONLY ~"""'~-.« '` 2 1 9 ~ --~ ~ () d ~,:,„.vow T~ ~ ~ ut~.tvtrvrsNAME FRST MIOPLEINmAL useadarMcdocklo erdfeworos _ Z E ll 1 L. aG =E _ ~ R A L =D I IN ;E R~-. ~ .vm'AW~;, t+~n.'hr .+F„a' .~„~,~-~ - W 9~CIPL ~E=UP,ITY'NUAIBE4. 1 6 8 6 ~~ 3 5 2 L~PTE JF DEATH ~, ~ LATE OF BIRTH 9 9 ~ ~ ~ ..,~ . V - - 1 2 ~ ~ 1 9 4 0 9 ~1 ~1 9 3 =1 Q (IF APPLICABLE) SURVIVING SP SE'S NAME (LAST, FIRST, AND MIDDLE INf11AL) SOCIAL SECUR~T; NUTA6ER ~ ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE JOHN E. EUTZY _~ Q ~- ~ Z (o - O'~ - ( REGISTER OF WILLS a rA ®1.OriginalRetum ^ 2. SupplementalRetum ^ 3. RemainderRetum (aaoeofdeaalpriaml2.1~-e2) o ^ 4. Limited Estate ^ 4a. Future InterestCom romise dateoideathafteriz-lz-Ilz P 1 ) ^ 5. Federal Estate Tax Retum Required ~ ®6. Decedent Died Testate (Attacn copy of Will) ^ 7. Decedent Maintained a Living Trust (Attach copy ofTn~st) 8. Total Number of Safe Deposit Boxes a m ®9. Litigation Proceeds Received j' ^ 1 O. SpoUSal POVerty Credft (dace of death behvaerl 12-31.91 and 1-1-y5) _ ^ 11. Electiorrt0 tax under Sec. 9113(A) (Attach Sch o) Z THIS.SECCiONMUST73E"C©11NPEE .fit_L"CORRESPOND NCE:ANd`:GO EH1'd~1i~T CtN:SF[Oillf?$E.DIRECT`EDTO:` w Z NAME COMPLETE MAILINGA®DRESS John R. Zonarich, Es uire 204 State Str~et N ~ FIRM NAME (If Applicable) SKARLATOS & ZONARI ~ v TELEPHONE NUMBER 717 233-1000 Harrisburga PA 17101 Z O H Q J F_ a a V W 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (1) ' } - (2) ' a . (3) _ (4) , ' . (6) ,' ' . (7) - 1 OFFICIAL"USE ONLY (8) ~ _ 3 s.5 0 0 ,0 0 . (9) 6 f 1 ~ 1 .-' ~' 1 ~ (10) ', ~ ~ (11) j -ism 6 .~ 1 7 1 _ 2 1 ~ _ s z 12. Net Value of Estate (Line 8 minus Line 11) (12) - _ 6 7 1 2 1 ~ ~ ~ . 13. Charitable and Governmental BequestslSec 9113 Trusts forwhich an election to tax has not been (13) made (Schedule J) s 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) - 2 ~; 6 7 1 2 1 s ,, 15. Amount of line 14 taxable Z at the spousal tax rate _ ~ ~. ~ X ,0 (15) > ~ O See instructions on reverse side for applicable percentage E' 16. Amount of Ilne 14 taxable X Q ~ .O6 at6°k rate , , (16) : ~ N a 17. Amount of line 14 taxable , g at 15% rate ~ , X .15 (17) , ~, O -.'^~^e s=ice-x~ V 18. Tax Due (18) ~~ _ ..'. ., __ s _. 19. y>'~B>=. ~R~ TO'1~V~~EF~i~11~~5z'>E~t~i _ .. ° ~.T~'3~R ,,~~:c ~, . Under penaR' of ury, I declare at I have zamined this return, including accompanying schedules and statements, and to the hest of my knowledge and belief, it is true, correct and complete. Declaration of prepan;r other than the pars reesent~6ve is ~ed on al nformation of which preparer has arty knowledge. T Auurcts~ John R. Zonarich, Esquire 204 State Street, Harrisburg SIGNATUREI9' I~l 1 E f C~'Q/~ER~TF~N REPRESENTATIVE nl f 1~~~,,.r. ADDRESS Carol M. Salisbury 914 Green Spring Road, Newville PA 17101 PA 17241 DATE ~~ .' vecedent's Complete Address: STREET ADDRESS • Two West Penn Street ciTV Carlisle srATE PA ziP 17013 Tax Payments and Credits: ~• Tax Due (Page 1 Line 18) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Inte~est/Penalty (D + E) (3) 4. If line 2 is greater than line 1 +line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 19 to request a refund (4) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +SA. This is the BALANCE DUE. (5g) Make Check Payab/e to: REGISTER OF WILLS. AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No 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 own an "in trust for" or payable upon death bank account or security at his or her death? ............................................................................... 4. Did decedent own an individual retirement account, annuity, or other non-probate property? ... .. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 72 P.S: §9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995. 72 P.S. §9116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995 -Please answer the following question by placing an "x" in the appropriate space. Did the decedent create a trust or similar arrangement which is soley for the surviving spouse's benefit for his or her entire lifetime? Yes ^ No If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(ies). Enter the value of the trust on Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule O in order to make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must attach Schedule O to atimely-filed tax return, along with Schedule(s) Kand/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(ies). ~ ~tev-~soeex.li~n COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER EtJTZY- CFRAI nlhE R 1 95 OQ~dS InGude the proceeds of litigation and the date the proceeds were recebed by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. Proceeds- survival action OF DEATH TOTAL (Also enter on line 5 Recapitulation) ~ $ 3,5 (If more space Is needed, Insert addlhonal sheets of the same size) .~4 'REV4511IX+11-§71 SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER F_ _tJTZY_ . [FRALDIh R 21 ct5 OO~d Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A• FUNERAL EXPENSES: 1. Hoffrnan-Roth Funeral Home 4,409.00 B. 4. 5. 6. 7 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Fatuity Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State -~_ Zip. Relationship of Claimant to Decedent Probate Fees Register of Wills, Cumberland County Accountant's Fees Tax Return Preparer's Fees Skarlatos & Zonarich -litigation fees and costs prorated to survival action 42.00 1,720.21 TOTAL (Also enter on line 9, Recapitulation) $ 6. 71.21 (If more space is needed, insert additional sheets of the same size) Y~ __ .. ~ REV-1513IX~(tA7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT .ESTATE OF SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. John E. Eutzy 2 West Penn Street, Cazlisle, PA 17013 FILE NUME __ 21 RELATIONSHIP TO DECE[ Do Not List Trustee(s) Husband y R rtn l./ } Entire IUNT OR SH, OF ESTATE ~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1, B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET I $ (If more space Is needed, msert addlUonal sheets of the same size) -, - ~, ~~. t ~xxt~r ~ .~~~~rrt.~~ I, GERALDINE R. EUTZY, of North Newton Township, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executor to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executor to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate as follows: (a) Any inheritance that I receive from my father, Carl C. Rebuck is to be held in Trust by Farmers Trust Company of Carlisle, and the income paid to my husband, John E. Eutzy for life and upon his death, the Trust Fund is to be distributed as follows; (I) $2,500.00 to John W. Eutzy, • (2) $2,500.00 to Theressa Davis, (3) $1,000.00 each to Rebecca Salisbury, Jennifer Salisbury, Jeffrey J. Salisbury, John Earl Eutzy, Carris Freeline, Tiffiny Davis and Tara Davis, and (4) Any balance to Carol M. Salisbury and Carolyn f , M. Eutzy, share and share alike, //t~'"~~' I devise and bequeath all the rest, residue` `and rbmainder of my estate to my husband, John E F Eutzy; providing he ~'~shall survive me by sixty days and if this i g ft does not take effect, then to Carol M, m Salisbury and Carolyn M. Eutzy, share a -s-k~a-rue•.,~-1~~-k a ., ..~ . ~. -.. . 5. I nominate and a ppoint Carol M. Salisbury, Carolyn M, . Eutzy and John W, Eutzy, to be the executors of this my last will and testament• the are to serve as ~....~..,~ _ ~ Y .. ~:..~_ .....~ ._._~. .~~.ch w~itho .r.~..,..~...~.W_-.._.~_,.~.~_ . ul...bond, 6• I hereby suggest that my personal representatives retain the services of Irwin, Irwin & McKnight, as attorneys in the settlement of my estate, IN WITNESS WHEREOF, I have hereunto set my hand and seal this t8. day of May, 1992, ~+° GE € - " ( SEAL) RALDINE R, EUTZY Signed, sealed, published and declared by Geraldine R, Eutzy, 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 subscribed our names as witnesses hereto. d' ~• I= e -- ACKNOWLEDGEMENT AND qFF----I--IT WE, GERALDINE R. EUTZY, BETZI A. MORRISON and SHARON L. SCHWALM, the testatrix and witnesses respectively, whose na are signed to the fore oin mes 9 g instrument, being first dul do hereby declare to the undersigned authority that the to sworn, 9 si ned and executed the instrument as statr~x her Last Wi71 and that she had signed willingly, and that she executed it as her free voluntary act for the ur ose herein ex ressed and P p p the witnesses, in the ~ and that each of presence and hearing of the testatrix, signed the Will as a witness and that to knowledge the testatrix was, at that the best of their time, eighteen years of age or older, of sound mind and under no constraint or and influence. ue COMMONWEALTH OF PENNSYLVANIA -hr~~ GERALDINE R. EUTZY ,~ ICON "SHARD GI ON L. SCHWAL '; ;. - , ~.~ • ~,~+r :~ . ss: ~9 H '~ ~ ~~x ~. S^ r "~~ ~ , sworn to and a'~ nr,~:,tisa ~ ,. COUNTY OF CUMBERLAND Subscribed, GERALDINE R. EUTZY, testatrix, before me by BETZI A. MORRI witnesses, this Lb'~ ~~. day of May;:;:, '; "~ Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of GERALDINE R. EUTZY No 21-95-00345 also known as Date of Death December 28, 1994 Deceased Social Security No. 168-26-4359 CAROL M. SALISBURY Personal Representative(s) 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/VI/e verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: John R. Zonarich, Esquire I.D. No.: 19632 Address: 204 State Street Harrisburg PA 17101 Telephone: 717 233-1000 RW-4 Personal Representative: CAROL M. SALISBURY Dated ' , _~~~ .~~, ~~9y~ • -- • -• ~ ~~~ ,.,G,~~~~a~~~~~~~ u~ ~Cai esia~e outsiae me commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory.