HomeMy WebLinkAbout95-0366~.I` _~j~~D'>~p(~
This is to certify that the certificate hereunto attached is a true and accurate copy of thl~ 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, L>ivision 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 200T
Date
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Fran eropoli, ' ect
.Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
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REGISTRAR'S SIGNATURE UMBER ORE FILEOIMOnIn. Day. Nwl
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* FOR DATES Of DEATH AFTER 14/31/91 CHECK HERI
INHERITANCE TAX RETURN p
U
-~ OVERTY
CR[DIT IS CLAIMED ^
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPART
PTO BE FILED IN DUPLICATE RILE NUMBlR
~ MENT OF REVENUE
DEPT. 280601
HARRISBURG
PA 17128A601 WITH REGISTER OF WILLS) °~~ ~qS 4366
,
' COUNTY CODE YEAR NUMBER
DECEDENT
S NAME (LAST, FIRST, AND MIDDLE tN1T1Al) DECEDENT'S 5OMPLET DD ESS
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SOCIAL SECURI NUMBER rur
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DATE OF DEATH DATE OF BIRTH gam/ /~' ~~VBIr Sty
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(IP A-PIICAaIEJ SVRVIVING SPOUSE'S NAME (LAST, FIRST AND MID E INITIAL) SOCIAL SECURITY N MBER AMOUNT RECEIVED (SEE INSTRUCTIONS)
~ ~ 1. Original Return ^ 2. Supplemental Return ^ 3
Remainder Return
Y `~ .
fL... J~~~ .L J__.L
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oa U a. umlted tstate LJ 4a. Future Interest Compromise
(for dates of death after 12-12-82) ^ 5. Federal Estate Tax Return Re~utred~f
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a 6. Decedent Died Tsatate g
^ 7. Decedent Maintained a Livin Trust
(Attach copy of Will) (Attach copy of Trvat) 8. Total Number of Safe Ds oait Boxes
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COMPLETE i A
e aL aX os ~Io 90 ~ ~v. /Ua~tG, S'~
v ~ TELEPHON UMBER
~ zyq- `t30 Cat-r'~is ~~
~~, ~
~70:~..
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) s~~ _
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) •Z 3~ /6 g. g .~. .
z (Schedule E) F
6. Jointly Owned Property (Schedule F) (6) - -~'
S 7. Transfers (Schedule G) (Schedule L) (7 ) _
~ 8. Total Gross Assets (total Lines 1-7) (8) _ _ ~ 3, ~66• qZ
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) - ~/.~~ .S'-~
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10) (11) ~/J~l „S'-t~L
12. Nat Value of Estate (Line 8 minus Line 11) (12) ~ 9, rfl~ 7.3~
13. Charitable and Governmental Bequests (Schedule J) (13)
14. Net Value Subject to Tax (line 12 minus Lins 13) (14) ~7~ Q / 7 3S"
15. Spousal Transfers (for dates of death after 6-30-94)
Sss Instructions for Applicable Percentage on Reverse (15)
Side. (Include values from Schedule K or Schedule M
) x,_=
.
16. Amount of Lins 14 taxable at 696 rate (16) ~ ~ Q / 7. 3
(Include values from Schedule K or Schedule M.) ~ x 06 = ~ / [ f~t~
z 17. Amount of Line 14 taxable at 1596 rate (17)
(Include values from Schedule K or Schedule M
) x .15 =
o .
18. Principal tax due (Add tax from Lines 15, 16 and 17.) (1B) ~~~~ ~! f
~ 19. Credits Spousal Poverty Credit Prior Payments Discount Interest
~ 20. If line 19 is greater than Line 18, enter the difhnna on Line 20. Thls is the OVERPAYMENT. (20)
~^
21. If Lins 18 is greater than Lins 19, enter the difference on Line 21. This is the TAX DUE. (21) ~ ~~3. X14
A. Enter the interest on the balance due on Line 21A. (21,4)
B. Enter the total of Line 21 and 21 A on line 21 B. This is the BALANCE DUE. (21 B) _
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Make Cheek Payable to: RetOlster of Wills, A>-ent _
itJistruiecorrect an~comp~lets~I declarotthat all real ~stats has bees rsplordtisd a t
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S TU OF P RE SIB R flll URN ADDRESS DATE
SI E E E M REPRESENTATIVE ADD ESS `
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Act X48 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°i6 (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
• 290 (.OZ) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
• 19~s (.O1) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98
• Spousal transfers occurring on or after 111/98 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 own an 'in trust for'. bank account at his or her death$ ......................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE. IT AS PART OF THE RETURN.
~ SCHEDULE E
~
CASH, BANK DEPOSITS AND
COMMONWEALTH OF PENNSYLVANIA MISCELLANEOUS
'" R~~~~ oe~ceoeR ~R" PERSONAL PROPERTY
Please Print or T
ESTATE OF FILE NUMBER
~~~e l /1~I Gl~
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(All property letntiy-owned with fhe Right of Surviwnbip must be diubsed on Sehedul F) yS
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ITEM DESCRIPTION
NUMBER ~ VALUE AT
DATE OF DEATH
1. /°NG ~ar,K, N. ~,
'~ la's le P~IGe
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2
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/¢cccrrr~ t No. .~i boa ~1/y82-. Chi e~,('ia~ ,gcrov.~ ~"
/~a/ante at c~iE.tB o~~tatli ~ 6, 3//, ~7
~ccYvec~ ~vi~evts~ ~~"da~ o~al~tG, ~, 90
~tl~/ ,cLCOVat dc./ahce ~ 6,3/3, v7 'ts=-
6, 3~3,a7
C`S'C e ~9,py 0>~ ~e~ r~ ~ ~s~.c~ e cX
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2 . PI(/G ,~lQn~, /~/, ~,
y2 y2 ~/~s/~e /°,,~Ce
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~ccovnt~0. ~3036.f/~'~i -~tvings~t~avh~
/
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3. ~~tvrc~ p,C'~o~ ~ne - re~v.~al o~C~ictr es ~
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TOTAL (Also enter on line 5
(Attach additional Sys' x 11° shssb ii moro space is needed.)
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PNC Bank, N.A.
4Y41 Carlisle Pike
Camp hill, PA 1701 l
June 9, 1995
Ledgard L. Goshorn
907 West North Street
Carlisle, PA 17013-1747
RE: Ethel M. Walk
Date of Death: May 12, 1995
Social Security No.: 203-10-4018
Dear Mr. Goshorn:
PNC I~A~N~ lE~
As per your request for information on .accounts the above
referenced decedent held with us, the information is as follows:
-Checking Account No. 5140241482 opened 10/03/84 in the name of
Ethel M. Walk. Balance at date of death: $6,311.17. Accrued
interest: $1.90. Interest paid year-to-date:. $18.70.
-Savings Account No. 5130365182 opened 12/30/85 in the name of
Ethel M. Walk. Balance at date of death: $.16,318.52. Accrued
interest: $15.70. Interest paid year-to-date: $37.94.
If I can be of any further assistance, please feel free to contact
me at (717) 730-2321.
Sincerely,
~~~, ~
Edith Tancil
Miscellaneous Services Supervisor.
Bank Operations
ET/mky
REV-ISII EX~ (7-88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ca~~~c yr
~~~
ITEM
NUMBER
A.
~.
~,
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pleass Print or
~- 9.s =
DESCRIPTION
Fcuneral Expenses: ~'
Glf/inp ~~d~1Qys ~vher~~ - ~r1e`q.l ..~P-f/'vi'C.c°s
Everett/Y~~r6~e d f~rra~) to ~/~S /~,c~ _~n ra/e
1'! 8c~-q~Stpn 2 ~ ovl
B• Administrative Costa: ,, /
1. Personal Representative Commissions NOr! ~
Social Security Number of Personal Representative:
Year Commissions paid
2.
3
4.
C.
t.
2.
3.
4.
s.
6.
7.
8.
Attorney Fees
/Uo~re
Family Exemption ~ohE
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State
Zip Code
Probate Fees
Red.; ~s`~e{,~ off' GUi/ls - Cv~ ,b er~an ~ Cdurt z`~/
Miscellaneous E/x~pe/'nses: / ,
~~is~er CIT u/i~~-s - S'ya~ Ceti ~' c~,~s
~P~~~~ o~~//s- ,JGP des
Tl1e Ser~jn e / - le ~-wl ho~'ce a.~l/er~i'sc~y ~--
(~
TOTAL (Also enter on line 9, Recapitulation) ~ $
(If more space is needed, insert additional sheets of same size.)
AMOUNT
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REV-IS1] E%~ ~2-Bl)
RATE OF
~~~ef
ITEM
~~
AITM Of PENNSYWANIA
'ANC[ TAX RRTURN
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
~ . L eo?~. ~~.~-nesZx.~C
Po fox F
Faye t~"evi//2, /~~ /7222 - oG/ 3
.2• /~ar~~ia. ~v~Z~oH
/3386 rcOYlhiG~a~l
S"a.r~.~o~'a., ~ 9s'o ~o
yob` .G~J. /Va~tG, ~'~,
Carlisle, ~a. /7D/3
~. ,~se~,~y,9 yoF~~a~
-S ~l~.rri e~ -~ yUr! Uzi vl
Car~i~s~2, ~~-• /70/ 3
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
6. Charitable and Governmental Bequests:
FILE NUMBER
RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $
(If more space is needed, insert additional sheet: of same size)
s~e~ _ ~~eci ~o b~~st
q~augy,'rev /OD
gi~Ze~'' ~`/DO• o0
Je
D~~s tie
,~~z~~i ~e r ~3 07`" i' ~S i ~ e
D~ os ~u-fe
l~avg ~ ~~ ~ o,~ //
p~ /^Bs idve
Des Z`~~'e
AMOUNT OR
SHARE OF ESTATE
LAST WILL AND TESTAMENT OF ETHEL M. WALK
I, ETHEL M. WALK, of the Borough of Carlisle, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will
and Testament in manner and form following:
1. I hereby expressly revoke all Wills and Codicils
heretofore made by me.
2. I hereby direct my Executor~to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. I direct that all taxes that may be assessed in
consequence of my death of.whatever nature and by whatever
jurisdiction imposed shall be paid out of my estate as a part of
the administration of my estate.
4. I direct that my Executor shall return any gifts from
'either my children or the children of my late husband, Glenn
Walk, in kind, to the donor, if the donor so wishes.
5. I give and .bequeath the sum of One Hundred Dollars
($100.00-each to my stepdaughters, Martha W'. .Sutton and Leota
M. Fahnestock, provided they survive my death.
6. I give, devise and bequeath the remainder of my estate,
of every nature and wherever situate, in equal shares, to my son,
Ledgard L. Goshorn; my daughter, Rosemary A. Hoffman; and my
daughter, Harriet A. Huntzinger; should any or all of my said
children not be then living, his or her share shall pass to his
or her issue, per stirpes.
7. I nominate and appoint my son, Ledgard L. Goshorn, as
Executor of this my Last Will and Testament;.and as substitute
Executrices, I nominate and appoint in order of preference, first
my daughter, Rosemary A. Hoffman; and second, my daughter, Harrie
A. Huntzinger.
8. I direct that my Executor, as well as-his successors,
shall not be required.to file bond or security in any jurisdictiol
IN WITNESS WHEREOF, I.have~hereunto set my hand and seal
this ~6`f't day of May, 1985.
.;~
(SEAL)
Et el M. Wal
WITNESS:
COMMONWEALTH OF PENNSYLVANIA
. SS.
COUNTY OF CUMBERLAND ,
I, Ethel M. Walk, Testatrix, whose name is. signed to the
attached or foregoing instrument, having. been .duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it
willingly; .and that I signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Ethel
M. Walk, Testatrix, this ~~ ~ day of May, 1985.
Testatrix
Grl i e.~~ ~~Z.''~
]ANICB S. FiEit'['ZLEit, NOTARY PCJl~9C
Cumlxslaad Couaty Carlisle, PA
Iviy Commiation i~irea Jamury 27,141
COMMONWEALTH OF PENNSYLVANIA
. SS.
COUNTY OF CUMBERLAND .
We, ~Roger.P4..Morgenthal and Laura A. Bistline, the
witnesses, whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testatrix, Ethel M. Walk, sign
and execute the instrument as her Last Will; .that she signed
willingly and that she executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the hear-
ing 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 or more years of age, of sound mind and under no constraint or
', undue influence.
Sworn or.affirmed to and subscribed to before me by James
D. Flower, Jr., and Laura A. Bist.line, witnesses, this ~~~ day
of May, 1985.
Wit e s
m
fitness
JANICB B. HBRTZLBR, NOTARY PUBLIC
Cumberland County Csrli~e, PA
MY Commbaion FaPdca January 27.1987