HomeMy WebLinkAbout95-0352.~ f
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 1 ~ 20p]`
Date
H105.,r3 Rev. 2/37
TrrEJVRaaT
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06111AIIE1IT
BLACI(
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Fran eropoli, ///' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
a36~~a
~ mw.~~ ~ SOCULL SECURffY NUMBER DATE OF DEATH (M«yh, Dey, Year)
+• Emma M
Baer
.
:.Female a. 211 - 52 - 3294 .April 25, 1995
AGE 3Aaeaald.ri uNDER,vEAR uNOER,DAY avE DF BIRTH ea+nwLACe Kyyyw PLwcEOF DEaN(CLwdtoNy one-,•.iraau~ore o
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Emma Weigle
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Nanc Whisler
30 McAllister Church Rd. Carlisle Pa 17013
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tf A SAPOI<1 ~pEA
INHERITANCE TAX RETURN i~VERnr caEt,tT l
RESIDENT DECEDENT FILE NUMBER
EANIA (TO BE FILED IN DUPLICATE 21
WITH REGISTER OF WILLS) couNrr cope
;ISBURG, PA 17129•uoui
DENT' NAM LA T, FIRST, AI
Baerr Emma M.
211-52-3294
[~ 1. Original Return
^ 4. Limited Estate
^ 6. Decedent Died Testate
(Attach coat of Will)
Michelle R. St.Clair, Esquire
~,
46,866.41
10. Debts, Mortgage liabilities, Liens (Schedule I) ( ) (1 1) 4 , 3 4 0.9 4
11. Total Deductions (total lines 9 & 10)
(12) 4 ? , 5 2 5 4 7
12 Net Value of Estate (line 8 minus line 11)
.
13.
Charitable and Governmental Bequests (Schedule J) (13)
4 2
5 2 5.4 7
13 (14) ,
14. )
Net Value Subject to Tax (line 12 minus line 53
551
2
15
42, 525.47
Amount of line 14 taxable at b% rate (15)
x .ob = r
.
. (Include values from Schedule K or Schedule M.)
x .15 =
AF7<EA 1Z/31f91 CHEtK HERE
95 0352
vFee NUMBE
200 North Hanover Street
Carlisle, PA 17013
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l l) 42 000.00
I. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages and Notes Receivable (Schedule D) (4) 4 866
41
.
Bank Deposits & Miscellaneous Personal Property( 5)
Cash
5
,
.
(Schedule E)
6. Jointly Owned Property (Schedule F) (b)
7. Transfers (Schedule G) (Schedule L) ( ~
8. Total Gross Assets (total lines 1-7) (8)
4 2 9 ~ ~ 3
9. Funeral Expenses, Administrative Costs, Miscellaneous (9)
Expenses (Schedule H) 4 3.91
10
16. Amount of line 14 taxable at 15% rate (16)
(Include values from Schedule K or Schedule M.)
17. Principal tax due (Add tax from line 15 and from line 16.)
18. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ + 1 27 - 58 -
19. If line 16 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT.
(t7) 2, 551 .53
(18) 127.58
(19)
~^ ~ 2 42~ 9S
20. If line 17 is greater than line•18, enter the difference on line 20. This is the TAX DUE. (20)
(2oA)
A. Enter the interest on the balance due on line 20A.
B. Enter the total of line 20 and 20A on line 206. This is the BALANCE DUE. (20B)
Mnka Clseek Payable to: Register of Wills, Agent
Under penalties of penury, ~ aec
it is true, correct and complete. I
based on all information of,~t+hic
ar irue marRe~ .uwo•
the personal representative
DATE
51 ATURE OF PREPARER O ER HAN REPRESENTATIVE ADDRESS I n ~~ ~•„~
200 N. Hanover St.r Carlisle, PA 17013 lX "I
APpR~ RNSWER rHE F
-ATE gLOCKS~LLOWIN-G QVESTIO
NS BY PLACING A CH
' • p-d
decedent make a transf ECKMARK ~`1 IN THE
°• ret er and:
~ re ain the. use or income a f th
re ta-n the right to designate a property transferred ,,,,..
- tam a reversionary intere ~'hO shall use the prOpert • • ' ' • • ..
'eceive the promise for life st or • y transferred or its incoi
rth occ °f either • " '
..
~rn9 death ~ on °r before pe payments, benefits or c • • • ' ' • .
after pew mbe r Property w tho er 12, 1982, di are2 • , , .. • .. .
thaut r r 12. 1982 ut receivin d decedent '
eceiving adeq co d decedent trans~eguote conside din twa •
'ent °Wn an 'in trustuate -deration2 er property withinron2 If cleat)
- 'E AN for bank account at his ... , • ne Year o)
,oM LWER r0 ANY OF or her deaths •• ..
~ ETE SCHEDV~E G rHE gg~VE QllE • • . .
AND F~~E ~r AS p,4 SONS IS YES
~ Rr pF rHE RE
TURN.
~~
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d benef,
,wled98 °n
ncl fep~eSentatrve is
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~~ REY-1502 EX + (12-85) F
~' SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT FILE NUMBER
ESTATE OF
21-95-0352 -
Emma M. Baer
(Property jointly-owned cis cRwh ch property would be exchanged between alwUlingibuyer and a will'ng sells r ne'dfher being cornpellea~
which is defined as the p --
t_o buy or sell, both having reasonable knowledge of the relevant facts. VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
~• Real property known and designated as 313 Zion Road 42,000.00
Mt. Holly Springs, PA 17065
TOTAL (Also enter on line 1, Recapitulation) I $4 2 . 0 0 0 • 0 0
I~
REV- 1508 E%+ i2-87)
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
__
E E OF FILE NUMBER
Emma M. Baer 21-95-0352
A property jointly-owned with the Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION VALUE AT
NUMBER DATE OF DEATH
1. Checking Account #6-74125, Farmers Trust Company $ 975.54
2. Savings Account #6-004518, Farmers Trust Company $1,240.67
(account still titled jointly with decedent's
deceased spouse)
3. Christmas Club account #222-003338, Farmers $1,512.45
Trust Company
4. Personal property and household effects $1,137.75
Please Print or T
TOTAL (Also enter on line 5, Recapitulation) ~ $ 4 , 8 6 6 41
(Attach additional 8'/s" x 11" sheets if more space is needed.)
,REV-1511 EX+ (7-88~
COMMONWEALTH OF PEI
INHERITANCE TAX A
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or T
LE NUMBER
21-95-0352
C.
E
7
8
Emma M. Baer
ITEM
NUMBER DESCRIPTION
A. Funeral. Expenses:
1. Westminster Cemetary
George's Flowers
B• Administrative Costs:
1. Personal Representative Commissions
5' Metropolitan Edison
Social Security Number of Personal Representative: _
Year Commissions paid
2. Attorney Fees
Griffie & ASsociates
3. Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State _
4. Probate Fees
Register of Wills
Miseellaneoua Expenses:
~' Jim Bistline, auctioneer
2' The Sentinel (legal advertising)
3' Cumberland Law Journal_
4' United of PA
Zip Code
93.00
919.70
89.00
40.00
18.86
8.35
TOTAL (Also enter on line 9, Recapitulation) I $4 , 2 9 7. 0 3
AMOUNT
700.00
84.80
2,343.32
(If more space is needed, insert additional sheets of same size.)
REV-1512 EX+ i10-86)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Baer
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABLITIES AND LIENS
21-95-0352
ITEM
NUMBER DESCRIPTION AMOUNT
1. United of PA
22.71
2. Metropolitan Edison
21.20
TOTAL (Also enter on line 10 Recapitulation) ~ $ 4 3 91
(If more space ~s needed insert additional sheets of same size)
REV•1513 EX + ~2-87~
~ -
COMMONWEALTH OF VENNSYLVANIA
INNERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Emma M. Baer 21-95-0352
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP
A T bl
axa a Bequests:
1. Ronald Baer
1817 Willow Road, Carlisle, PA 17013 son
2. Nancy Whisler
30 McAllister Church Rd., Carlisle, PA daughter
3. James Baer
101 Sunset Drve, Carlisle, PA 17013 son
4. Irvin P. Baer, Jr.
1 Larkin Lane, Mt. Holly Springs, PA son
5. Marlin Baer
2536 Ritner Highway, Carlisle, PA son
6. Marjorie Fleisher
18 Creamy Road, Boiling Springs, PA daughter
7. Roxanna Bookas
6039 Edwards Drive, Mechanicsburg, PA daughter
8. Rita Maurice
392 W. Pine St., Mt. Holly Springs, PA daughter
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation)
(If mon space is needed, insert additional sheets of same size)
S
AMOUNT OR
SHARE OF ESTATE
1/8
1/8
1/8
1/8
1/8
1/8
1/8
1 /8
AMOUNT OR
SHARE OF ESTATE
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