HomeMy WebLinkAbout02-0281PETITION
Exmm o/ Nevin E. Carpenter
also known a~
Soctal Security No. 195-07-3870 '
The petition of the undersigned respectfully represents ~
Your Petitioner(s), who is/~e 18 y~s of age or older ~ the ~r
in ~he last will of the above d~t, ~ted ~'~ 4
and codicil(s) dined July 9~ ~997
named
.19 87
(state relearn circtmuta~ccs, c.{. ~~ ~ of ~. ~.)
Deccndent w~ domiciled at d~th in ~rl~d _ C~TY, ~enn~y~a, wkh
~ l~t family qr pH~p~ r~iden~e ai ~ 20 ~ol S~t, ~ew ~~ ~rougn,
C~rland Co~uy, ~yx~a
Deccndent, then 93 y~s of age, ~ ~a~ 26, 2002 , ~
at ~d~ ~ty~ Pe~yl~a '
Except ~ follows, d<edent ~d not m~, ~ not ~vo~ ~d ~d not ~ve a child bom or
after execution of the a ill offer~ for probate; w~ not the ~ of a ~g ~d w~ never adjudicated
incompetent: _
Decendent at death owned property w~th est/mated values as follows:
(if domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(if not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
~300~000,00
$
WHEREFORE. petitioner(s) r~pecffully
presented herewith and the grant of letters
theron. ,
Jon F. LaFaver
request(s) the probate of thc last will and codicil(s)
testament~-~
(tcstam~tagy; ac~nmisu'adon c.t.a.; administration d.b.n.c.l.a.)
New Cumberland, PA ] 7070
OATH OF PERSONAL I~FPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CU~ERLA~
The petitioner(s) above-named swear(s) or affirm{s) that the staterooms in the foregoing petition are
true a~nd correct to the best of the knowledge and belief of petitiOner(s) and that as nersonal re-resen-
tanveu) of the above decedent petitioner(s)will ~~.~ ~ate~mcording t; law.
,~w.o.,-n to or affirm~'d,~,_and subscribed c. (~-"'/'~ '~-;~ \~"~"~ c~
uczore me this -.~cn .,.. _,- f -.
Mar~h _
No. 21-2002-2~1
Estate ofNevin E. Carpenter
,Decer, sed ·
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW March 19th ~2002_. ~ comideta,ion of ~e petition on
the reverse side hereof, satisfactory proof having been pre, eared before m~
IT IS DEC~ED tha~ the insolent(s) ~t~ Aunt 4, 1987 ~d July 9, 1997
described ther:in be admitted to probate ~d filed ofr~rd ~ ~e l~t ~ of Nevin E. ~nt~
and Letters .Testamentary
are hereby granted to Jon F. LaFaver
FEES
Probate, Lett?s, Etc .......... S, 200.00
SCheft. C¢13'[ficates(1.O) $, 30. O0
lCli ..........
x-Pages ( 3 ) $ 9.00
JCP TOTAL S 254~- $~0
F~ted . March~ 19.th, ~QQ2. ................
~d~. Stone #39785
ATIORN?.~' (Su~. Q. I.D. No.)
414 Bridge ~t., New Cumberland, .~A 17070
ADDRESS
(717) 774-7435
PHONE
MAILED LETTERS TO DAVID H. STONE. ON 3-19-2002
21-2002-281
REGISTER OF WILLS OF ¢o~~ COUNTY
OATH OF SUBSCRIBING WITNESS
(eae~) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that 8e,>wa$ present and saw
Nevin E. Carpenter
the testat or , sign the same and that He
request of testator in h is presence and (in the~pres~ce 9~ each other)~
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this ' 13th
'March ,,~
MA~Y//C. LEWIS
day of
Register
(Name)
(Address)
(Name)
(Address)
signed as a witness at the
the presence of the
REGISTER OF WILLS OF ¢on~e.x~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of ,
codicil
testat~ of (one of the subscribing witnesses to) the will presented herewith and
codicil
that believes the signature on the will is in the handwriting of
to the best of
knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19.__
Register
(Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF ~ COUNTY
OATH OF SUBSCRIBING WITNESS
Constance L. Karli
21-2002-281
~dicil
(eaob~ a subscribing witness to the ~ presented herewith, (~ being duly qualified according to
law, depose(s) and say(s) that she was
Nevin E. Carpenter present and saw
Sworn to or affirmed and subscribed before
me this /~
-- day of
the testato~ _, sign the same and that she signed as a witness at the
request of testat or in h ±s presence and ~ (in the presence of the
other subscribing witness(es)).
(Name) Constance L. Karl±
1034 Swar~a~ore Rd., New Cumberland, PA
(Address)
(Name)
(Address/
NOTARIAL SEAL
I KAYE R- LIJCKL=Y, Nolaty Pul311c
I Ne'v Cumtermd Bom. ~ Co.
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
testat_
that
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of
codicil '
_ of (one of the subscribing witnesses to) the will presented herewith and
believes the signature on the will is in the handwriting of
to the best of knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19.~
Register
(NemO
(,4ddre~r)
(Name/
(Address/
21-2002-281
REGISTER OF WILLS OF CL~berland COUNTY
OATH OF SUBSCRIBING WITNESS
Jon F. LaFaver
codicil
(each) a subscribing witness to the w~presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that He was present and saw
the testat or , sign the same and that He signed as a witness at the
request of testator in ~ presence and (in the presence of eacJ~ other) (~he presence of the
other subscribing witness(es)). ~~
Sworn to or affirmed and subscribed before
me this 18th day of (Name)
--March ( /7 ~ .lX3X 200~
MARY ~. LEWIS Register ~
(Name)
(Address)
21-2002-281
REGISTER OF WILLS OF Cumberland COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
We are familiar with the signature of Suzann~. M'; Leave'tie .,
cod
testate_ of~.~.~ ,,f the subscribing witnesses~[~,jJ the presented herewith
and
codicil
that
believes~he signature on the ~is in the handwriting of
Suzanne ~. Leav~lle
to the best of their knowledge and belief.
Sworn to or affirmed and subscribed before
me this 18th day of
March ~/~ - ~2002 /~
(Name)
(Name)
(Address)
RENUNCIATION
21-2002-281
In Re Estate of Nevin E. Carpenter
deceased.
To the Register of Wills of
Cumberland
County, Pennsylvania.
The undersigned Wilbur Klinee one of the Co-Executor of
the above decedent, hereby renounce(s) the .right to administer the estate and respectfully ask(s) that Letters
Testamentary
be issued to Jon F. LaFaver
WITNESS hand this day of ?q9 .
(Signature)
(Address)
(Signature)
(Address)
(Signature)
(Address)
Codicil to the Last Will and Testament
of
NEVIN E. CARPENTER
21-2002-281
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County, Pennsylvania, being of sound
mind, memory and understanding do hereby make, publish and declare this as and for a
Codicil to my Last Will and Testament dated August 4, 1987.
I.
I hereby revoke paragraph II E. on page two of my Last Will and Testament aforesaid
(wherein I bequeathed 10% of my residuary estate unto the Senior Citizens Center of
New Cumberland Pennsylvania).
II.
I hereby amend item II F on page two of my Last Will and Testament to read as follows:
"Twenty (20%) per cent unto MRS. ADA BOSTOCK of 5121 Circle Drive, Harrisburg,
Pennsylvania, if she survives me."
III.
All other parts of my Last Will and Testament shall remain in full force and effect, and
unchanged, except as herein provided.
Page one of two pages
IN WITNESS WHEREOF, I,
hand and seal this
NEVIN E. CARPENTER have unto this Codicil set my
day of July, 1997.
Nevin E. Carpenter
SIGNED, SEALED, PUBLISHED AND DECLARED as a Codicil to his Last Will and
Testament by NEVIN E. CARPENTER, the Testator, in the presence of us, who have
hereunto subscribed our names as witnesses at his request, in the presence of said Testator
and in the presence of each other.
Page two of two pages
LAW OFFICES
317 THIRD STREET
NEW CUMBERED, PENNSYLVANIA 17070
LAST WILL AND TESTAMENT
OF
NEVIN E. CARPENTER
21-2002-281
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County,
Pennsylvania, being of sound mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and
Testament hereby revoking and making void any and all other wills
~ ~be done after my decease.
· ~ II.
-~ ~ ~ All'the rest, residue and remainder of my
'.
:~ ~real, personal or m±xed, and wheresoever situate,
~'~ ~dev±se and bequeath as follows:
~by me at any time heretofore made.
I
I direct that my Executors hereinafter named shall pay all
~my just debts and funeral expenses as soon as conveniently may
estate, whether
I hereby give,
o~ A. Thirty (30%) per cent unto my late wife's cousin, MARY
KLINE, or if she is not living, then unto her husband, WILBUR KLINE,
now of Mont Alto, Pennsylvania.
B. Twenty-Five (25%) per cent unto ST. MATTHEWS LUTHERAN
CHURCH, Green and Seneca Streets, Harrisburg, Pennsylvania, in
memory of my late wife, Thelma E. Zimmerman Carpenter.
C. Fifteen (15%) per cent unto the AMERICAN RED CROSS,
HARRISBURG AREA CHAPTER, Harrisburg, Pennsylvania.
D. Ten (10%) per cent unto the BETHESDA MISSION of
}iHarrisburg, Pennsylvania.
Page one of three Pages
E. Ten (10%) per cent unto the SENIOR CITIZENS CENTER of
New Cumberland, Pennsylvania.
F. Ten (10%) per cent unto MRS. ADA BOSTOCK, if she survives
me, of 5121 Circle Drive, Harrisburg, Pennsylvania.
III.
I hereby nominate, constitute and appoint my attorney, JON F.
i~LaFAVER, ESQUIRE, and WILBUR KLINE as Co-Executors of this, my
Last Will and Testament. If either the said Jon F. LaFaver or
~Wilbur Kline should predecease me, fail to qualify or cease to act
~as such, then the other shall serve alone
IV.
No fiduciary acting under this Will shall be required to
gpost bond in this jurisdiction or in any jurisdiction in which he
~may act.
I'N WITNESS WHEREOF, I, NEVIN E. CARPENTER, the Testator,
~have unto this, my Last Will and Testament, set my hand and seal
~this day of August, A. D., 1987.
SEAL)
Page two of three Pages
~i SIGNED, SEALED, PUBLISHED and DECLARED by NEVIN E.
I/the Testator, as and for his Last Will and Testament, in
!iof us who have hereunto subscribed our names as '
~i witnesses
!!request, in the presence of the said Testator and in the presence
:!of each other.
CARPENTER
the presen~
at his
Page three of three Pages
STONE, LAFAVER ~ SHEKLETSKI
A PROFE~RPORATION
ATTORNEYS AT LAW
414 BRIDGE STREET
NEW CUMBERLAND, PA 17070
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)_
Name of Decedent: Nevin E. Carpenter
Date of Death'
February 26, 2002
Will No.
2002-00281
To the Register:
I certify that notice cf beneficial interest required by
Rule 5 6'-') ef the Orphans' Court _u~es was served on or ma~d
to the feliewing beneficiaries of the above captioned estate on
April 8, 2002'
Wilbur R!ine
Pest Office Box 132
Houn% Al~o, PA 17231
Bethesda Rission
6!! Rei!y Street
Harrisburg, PA 17102
Lower Susquehanna Synod ELCA Pks. Ada Bos2ock
successor Eo St. Hatthews Lutheran Church 5121 Circle Drive
900 South Arlington Avenue Harrisburg, PA 11112
Harrisburg, PA 17109
American Red Cross
harrisburg Chapter
1804 North Sixth Street
Harrisburg, PA 17102
Commonwealth of Pennsylvania
Office of Attorney General
Charitable Trusts & Organizations
Section
14~ Floor, Strawberry Square
Harrisburg, PA 17120
Notice has now been given tie all persons entiE!ed t}er~te under
Rule 5.6(a).
Date:
Capacity:
DAVID N ~TONE, Esquire
414 Bridge Street
New Cumberland, PA 11010
717-774-7435
Personal Represenzativ6
X
Counsel for Personal
Representative
CORPORATE CLAIM FORM
CUMBERLAND COUNTY, PENNSYLVANIA
FILE #21-02-281
ESTATE OF NEVIN CARPENTER
The undersigned hereby presents for filing against the above estate this statement of claim and
alleges:
BEVERLY ENTERPRISES/dba BEVERLY HEALTHCARE OF
GETTYSBURG.
PO Box 180970 Fort Smith, AR. 72918-0970
The basis of claim is: SEE ATTACHED
The amoum of the claim is $1230.84 whLch is now due and owing.
Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true
to the best of my knowledge and belief.
Signed on_APRIL 25, 2002
I SWEAR THIS STATEMENT IS CORRECT
Subscribed. and sworn to before me
Notary Public
My commission expires
BzWERLY
~ll~ E N T E R p R i S Es
/'/~' 2_o
April 26, 2002
Cumberland County
Register of Wills
City Court
1 Courthouse Square Room 102
Carlisle, PA. 17013
Dear Mr.or Madam:
Enclosed please find itemized statement, a claim form and a check in the amount of
$5.00 to be used to file a claim against the estate of Nevin Carpenter, case #21-02-281.
Mr. Carpenter incurred this debt while a resident in our facility, Beverly Healthcare, of
Gettysburg..
If you should need additional information or have questions regarding this please feel
free to contact me at 501-201-2322 Monday thru Friday from 7:30 to 4:30 CT.
Sincerely,
Corporate Collections
encl:
CC:
Jon S. Lafauer
David Haean Stone Esquire
Client's File
P.O. Box 180970
Fort Smith, AR 72918-0970
(479) 201-2000 · 1-877-8BEVERLY
BEVERLY ENTERPRISES/dba BEVERLY HEALTHCARE OF GETTYSBURG
P. O. BOX 180970
FORT SMITH, AR. 72918-0970
ITEMIZED RESIDENT STATEMENT
RESIDENT NAME RESIDENT NUMBER
NEVIN CARPENTER 03926-91127-43290
DATE PREPARED
STATEMENT TYPE: ~ INTERIM DISCHARGE ~ ITEMIZED 4126102
DATE/PERIOD COVERED DESCRIPTION UNITS CHARGES PAYMENTS
711-7131101 PRIVATE PORTION RM. CHARGE 31 $4,714.58
7/14/01 INCONTINENT FEE $150.00
PAYMENT $3,731.85
8/1-8/31/01 PRIVATE PORTION RM. CHARGE 31 $4,714.58
8/1/01 BARBER AND BEAUTICIAN I $8.50
8/14/01 INCONTINENT FEE $150.00
. PAYMENT $4,873.08
9/1-9/30/01 PRIVATE PORTION RM. CHARGE 30 $4,648.68
9/1/01 PERSONAL NEEDS $45.00
9/6/01 DERMAGRAN OINTMENT I $13.20
9/14/01 INCONTINENT FEE $150.00
PAYMENT $4,856.88
10/1-10/31/01 PRIVATE PORTION RM. CHARGE 31 $4,562.50
10/1/01 PERSONAL NEEDS $45.00
10/15/01 INCONTINENT FEE $150.00
10/22-10/26/01 GAUZE SPONGE 2 $2.00
PAYMENT $4,699.50
11/1-11/30/01 PRIVATE PORTION RM. CHARGE 30 $4,562.50
1111101 WANDER GUARD I $45.00
11/7/01 BARBER AND BEAUTICIAN $8.50
11/14/01 INCONTINENT FEE $150.00
PAYMENT $4,562.50
12/1-12/31/01 PRIVATE PORTION RM. CHARGE 31 $4,562.50
12/5/01 BARBER AND BEAUTICIAN I $8.50
12/15/01 INCONTINENT FEE $150.00
!PAYMENT $4,571.00
1/1-1/31/01 PRIVATE PORTION RM. CHARGE 31 $4,562.50
1/5-1/14/01 GAUZE SPONGE 4 $4.00
1/5-1/13/01 PO LYS KIN 9 $6.96
1/14/01 INCONTINENT FEE $150.00
t/24/01 UR CATH TRAY I $3.00
PAYMENT $4,562.50
2/1-2/25/01 PRIVATE PORTION RM. CHARGE 25 $4,073.66
DATE/PERIOD COVERED DESCRIPTION UNITS CHARGES PAYMENTS
2/6101 BARBER AND BEAUTICIAN $8.$0
2/20/01 SUCTIOM CATJ KIT t $¶.00
PAYMENT $4,562.50
~ {'~_1 ~'" ~ '
,?
BAlaNCE FORWARD CHARGES CREDITS AMOUNT DUE
$0.00 $37,650.65 $36,419.81 $1,230.84
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001216
STONE DAVID HEAN
414 BRIDGE STREET
NEW CUMBERLAND, PA
17070
........ fold
ESTATE INFORMATION: SSN: 195-07-3870
FILE NUMBER: 2102-0281
DECEDENT NAME: CARPENTER NEVIN E
DATE OF PAYMENT: 05/24/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/26/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $6,500.00
REMARKS:
TOTAL AMOUNT PAID'
DAVID H STONE ESQUIRE
$6,500.00
SEAL
CHECK#5
INITIALS: VZ
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500 / 7 ~ OFFICIAL USEONLY
INHERITANCE TAX RETURN F, LENUMeER
RESIDENT DECEDENT 21 2002
COUNTY CODE YEAR
0281
NUMBER
DECE-
DENT
CHECK
APPRO-
PRIATE
BLOCKS
COR-
RE-
SPON
DENT
RECA-
PITULA-
TION
TAX
COMPU-
TATION
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Carpenter, Nevin E
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
02/26/2002 12/07/1908
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
195-07-3870
THIS RETURN MUST BE FILED IN DUPLICATE
WITH THE REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. Original Return
4. Limited Estate
6. Decedent Died Testate
(Attach copy of Will)
9. Litigation Proceeds Received
2. Supplemental Return
4& Future Interest Compromise
(date of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach a copy of Trust)
10. Spousat Poverty Credit(date of death between
12-31-91 and 1-1-95)
3. Remainder Return
J~ (date of death prior to 12-13-82)
,,~ 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
-] 11. Election to tax under Sec, 9113(A)
(Attach Sch O)
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE & CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
David H. Stone
FIRM NAME (If Applicable)
Stone LaFaver & Shekletski
TELEPHONE NUMBER
717-774-7435
COMPLETEMAILINGADDRESS
414 Bridge Street
New C,~mherland, PA 17070
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F)
~-] Separate Billing Requested (6)
o.0o
127,138.76
0.00
0.00
33~723.63
0.00
0.00
7. Inter-Vivos Transfers & Miscellaneous
Non-Probate Property (Schedule G or L)
(7)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H)(9) 25,812. 77
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,078.4 6
11. Total Deductions (total Lines 9 & 10) (11)
12. Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13)
has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
O'~-;FICIAL USE ONLY
160,862.39
27,891.23
132,971.16
66,485.58
66,485.58
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers un der Sec. 9118 (a)(1.2) 0. 0 0 x .00 (15)
16. Amount of Line 14 taxable at lineal rate 0. 0 0 X .045 (16)
17. Amount of Line 14 taxable at sibling rate 0. 0 0 X .12 (17)
18. Amount of Line 14 taxable at collateral rate 6 6, 4 8 5 · 5 8 X .15 (18)
19. Tax Due (19)
20. ~ I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I
0.00
0.00
0.00
9,972.84
9,972.84
>> BE SURE TO ANSWER ALL QUESTIONS ON PAGE2 AND RECHECK MATH<<
0 PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP- Forms Software Only
PA REV-1500 EX (6-00)
Decedent's Complete Address:
Page 2
STREET ADDRESS
120 Carol Street
C,TY I STATE I Zip
New C~herland PA 17070
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
6f500.00
342.10
(1)
Total Credits (A + B + C) (2)
0.00
0.00
Total Interest/Penalty (D + E) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4)
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 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
9,972.84
6,842.10
0.00
3,130.74
0.00
3,130.74
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; ....................................... I ~
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 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 which
contains a beneficiary designation? ........................................................ ~-~ ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
kUnnde.r p,enalties of.pe, rjury, I declare that I have ex, amined this return, including accompanying schedules and statements, and to the best of my
ow~eage ~nd belier it is true c(Wtect a~d complete. Declaration of preparer other than the personal representative is based on information of
which preparbr has a~ly kn~wle~[e, j /'/
SIGNAT~ PEI~.C~I ER.~,~E FOR FILING RETURN DATE
~/ ? t? VC--~..'~-~------ /~ .. / ~- ._~ .-~.
ADI~R'E~SS ,~ 2 0U'' caro"~ -S'~,
New C~m~erlanc~, PA 17070
~~ OT~R THAN REPRESENTATIVE DATE
d, PA 17070
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. I 9118 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S. § 9116 (a) (1.1) (ii)].
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 July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased ch lid twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 29116(aX1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. § 9116(1,2) [72 P.S. § 9116(aX1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [7'2 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual
who has at least one parent in common with the decedent, whether by blood or adoption.
0 PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP ~ Forms Software Only
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Carpenter, Nevin E 21-2002-0281
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NO. DESCRIPTION OF DEATH
1. 5,039.63
Prudential Sec.-5000 FHLMC
MCB Bond SERIES 1507 UU
POOL dated 5-1-93 due
5-15-2023
Putnam Inv.-Diversified Inc.
Putnam Inv.-PA Tax Exempt
Inc. C1 B
Putnam Inv.-US Gov't Inc. Tr
C1 B
Scudder High Yield
Opportunity B-1,770.758 shs.
Scudder Strategic Income B
6,008.087 shs.
Scudder US Gov't Sec.
4,223.476 shs.
C1 B
18,678.68
17,609.59
8,104.61
15,476.42
25,654.53
36,575.30
TOTAL (Also enter on line 2, Recapitulation) $ 127,138.76
(If more space is needed, insert additional sheets of the same size)
0 PA15031 NTF 33300 Copyright 2000 Greatland/Nelco LP- Forms Software Only
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Carl3enter~ Nevin E 21-2002-0281
Include proceeds of litigation & date proceeds were received by the estate. All prop. jointly-owned with right of survivorship must be disclosed on Sch. F.
ITEM
NO.
DESCRIPTION
Harsco, Inc. pension checks for March and
April
PNC Bank-Checking Acct. #5140009624
Prudential MoneyMart Acct. #AAA-310311-17
Prudential Sec.-cash account
Waypoint Bank-Cert. of Deposit #566233771
Blue Cross/Blue Shield-refund
Income Tax refund
VALUE AT
DATE OF DEATH
883.84
12,533.54
6,727.00
0.83
13,186.37
167.05
225.00
TOTAL (Also enter on line 5, Recapitulation) $ 33,723.63
(If more space is needed, insert additional sheets of the same size)
0 PA15081 NTF 33305 Copyright 2000 Greatland/Nelco LP- Forms Software Only
EV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Carpenter, Nevin ~.. 21-2002-0281
Debts of decedent must be reported on Schedule I.
ITEM
NO. DESCRIPTION AMOUNT
9
10
11
12
13
14
15
FUNERAL EXPENSES:
Musselman Funeral
Home-funeral expenses
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Jon F T,aFaver
Social Security Number(s)/EIN No. of Personal Representative(s)2 0 8- 2 4- 0 2 32
Street Address 120 Carol Street
City New C,~mherland State PA Zip 17070
Year(s) Commission Paid: 2002/2003
AE0rney Fees Name: David H. Stone, Esquire
Family Exemption: (If decedent's address is not the same as cl~mant's, aEach explanati0n)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Check paid by decedent but not cleared by bank until
after death
C,~mherland Law Journal-advertising grant of letters
The Patriot News Co.-advertising grant of letters
Prudential Financial-securities account fee
PNC Bank-service charge
Harsco Trust-Reimb. on pension checks for March
and April
Register of Wills-2 short cert.
Reserve for closing expenses
7,454.00
8,043.00
8,043.00
0.00
254.50
0.00
0.00
350.00
75.00
108.43
75.00
20.00
883.84
6.00
500.00
TOTAL (Also enter on line 9, Recapitulation) $ 25,812.77
(If more space is needed, insert additional sheets of the same size)
0 PA15111 NTF 33308 Copyright 2000 Greatland/Nelco LP- Forms Software Only
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Carpenter, Nevin E 21-2002-0281
Include unreimbursed medical expenses.
ITEM
NO. DESCRIPTION AMOUNT
3
4
5
H. Frederick Martin MD-debt of last
illness
Kelly Financial Serv.-prep. of 2001 income
tax returns
Pharmerica-debt of last illness
Beverly Enterprises-expenses incurred
at home
Gettysburg Hospital-services rendered
50.00
224.50
491.87
1,230.84
81.25
TOTAL (Also enter on line 10, Recapitulation) $ 2,078.46
(If more space is needed, insert additional sheets of the same size)
0 PA15121 NTF 33309 Copyright 2000 Greatland/Nelco LP- Forms Software Only
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Carpenter, Nevin E 21-2002-0281
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I
1.
II
1.
TAXABLEDISTRIBUTIONS[includeoutrightspousaldi~dbutions, and
tran~emunderSec. 9116(a)(1.2)]
Kline, Wilbur
Rm. 314 Providence Place
2085 Wayne Rd.
Cb~mhersburg, PA 17201
Bostock, Ada
5121 Circle Drive
Harrisburg, PA 17112
late wife's relative
friend
39,891.35
26,594.23
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATEI ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLEANDGOVERNMENTALDISTRIBUTIONS
Lower Susquehanna Synod ELCA, successor to
St. Matthews Lutheran Church
900 S. Arlington Ave.
Harrisburg, PA 17109
American Red Cross, Harrisburg Chapter
1804 N. Sixth St.
Harrisburg, PA 17102
BethesdaMission
611 Reily St.
33,242.79
19,945.67
13,297.12
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 66 , 485 . 58
(If more space is needed, insert additional sheets of the same size)
0 PA15131 NTF 33293 Copyright 2000 Greatland/Nelco LP- Forms Software Only
'Estate of: Carpenter, Nevin E
Schedule J Part 2 -- Charitable and Governmental Distributions
Page 2
21-2002-0281
Item
No.
3 Harrisburg, PA 171002
Description
Amount or
Share of Estate
TOTAL. (Carry forward to main schedule) ...... 0.00
Codicil to the Last Will and Testament
of
NEVIN E. CARPENTER
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County, Pennsylvania, being of sound
mind, memory and understanding do hereby make, publish and declare this as and for a
Codicil to my Last Will and Testament dated August 4, 1987.
I.
I hereby revoke paragraph II E. on page two of my Last Will and Testament aforesaid
(wherein I bequeathed 10% of my residuary estate unto the Senior Citizens Center of
New Cumberland Pennsylvania).
II.
I hereby amend item II F on page two of my Last Will and Testament to read as follows:
"Twenty (20%) per cent unto MRS. ADA BOSTOCK of 5121 Circle Drive, Harrisburg,
Pennsylvania, if she survives me."
III.
All other parts of my Last Will and Testament shall remain in full force and effect, and
unchanged, except as herein provided.
Page one of two pages
317 THIRD ST2-~EET
NEW CUMBERL.A3WD, PENNSYLV,~.NLq 17070
LAST WILL AND TESTAMENT
OF
NEVIN E. CARPENTER
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County,
Pennsylvania, being of sound mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and
'Testament hereby revoking and making void any and all other wills
~by me at any time heretofore made.
I
Z
I direct that my Executors hereinafter named shall pay all
~my just debts and funeral expenses as soon as conveniently may
:be done after my decease.
II.
All the rest, residue and remainder of my estate whether
~ '
~real, personal or mixed, and wheresoever situate, I hereby give,
~devise~ and bequeath as follows:
A. Thirty (30%) per cent unto my late wife's cousin, ~RY
~KLINE, or if she is not living, then unto her husband, WILBUR KLINE,
now of Mont Alto, Pennsylvania.
B. Twenty-Five (25%) per cent unto ST. MATTHEWS LUTHERAN
CHURCH, Green and Seneca Streets, Harrisburg, Pennsylvania, in
imemory of my late wife, Thelma E. Zimmerman Carpenter.
C. Fifteen (15%) per cent unto the AMERICAN RED CROSS,
F~RRISBURG AREA CHAPTER, Harrisburg, Pennsylvania.
D. Ten (10%) per cent unto the BETHESDA MISSION of
Harrisburg, Pennsylvania.
Page one of three Pages
SIGNED, SEALED, PUBLISHED and DECLARED by NEVIN E. CARPENTER,
the Testator, as and for his Last Will and Testament, in the presence
~of us who have hereunto subscribed our names as witnesses at his
request, in the presence of the said Testator and in the presence
iiof each other.
Page three of three Pages
Prudential
Prudential Securities Incorporated
16430 North Scottsdale Rd., 4th Floor
Scottsdaie, AZ 85254
June 5, 2002
Jon F. Lafaver
414 bridge Street
New Cumberland, PA 17070
RE:
Estate ofNevin E. Carpenter
Account No. AAA-310311
Per your request, please accept this letter as written statement indicating the
date of death balance of for the above referenced account.
On the date of death, February 26, 2002, the balance of the account was
$11,767.46
If you need further assistance, please feel free to contact us at 1-800-603-
1584. We are available Monday thru Friday between the hours of 9am and
6pm EDT.
Regards,
Nicholas Miller
Client Account Representative
The information contained
herein is based on sources we
believe to be reliable but its
accu~ac',,, is not guaranteed
PUT NAM INVESTMENTS
Putnam Investor Services
Post Office Bo.r 41203
Providence. Rhode ~s[and 02940-120.'~
1-800-225-158 l
April 17, 2002
DAVID H STONE
STONE LAFAVER & SHEKLETSKI
414 BRIDGE STREET
PO BOX E
NEW CUMBERLAND PA 17070
Account No.: A991195073870BBBV
Account No.: A561 195073870BBBK
Account No.: A751195073870BBBK
Registration: Nevin E Carpenter
Reference No.: 0362328220
Dear Mr. Stone:
ac. counts
'[hank you for your correspondence regarding the above-.referenced accounts. The , '
values as of February 26, 2002 are as follows:
Account Number Share Balane~:!;5~&~'
A991195073870BBBV 1,967.552 $8.95 $17,609.59
A561195073870BBBK 626.322 $12.94 $8,104.01
A751195073870BBBK 2,032.501 $9.19 $18,678.68
To sell or transfer the shares, we require the following additional documentation:
A letter of instructions beating the guaranteed signature of the Legal
Representative. A signature guarantee is required to p~'ov¢ fi:et the sig ~ature !~
genuine. This guarantee may be obtained from an investment dealer or a bank.
(If the account will be transferred) The enclosed Form W-9, completed and
signed, which certifies the taxpayer identification number for the new account.
This certification, which is mandated by the Internal Revenue Service, ensures the
number is correct and.the person to whom the number is assigned has not been
informed by the IRS that they are subject to backup withholding.
Mr. Stone
Page Two
April 17, 2002
We cannot accept notarization in place of a signature guarantee or certification because it does
not provide the complete legal protection necessary to process this transaction.
The present accounts have the Telephone Redemption Privilege and Dividend Distribution Plan
service options. To retain these options on new accounts, the new owner(s) must complete and
return the enclosed forms.
To expedite the processing, please include our reference number shown above or a copy of this
letter. We will transfer or sell the shares at the net asset value price, in effect at the close of
business, on the day we receive the required documents.
Should you have additional questions, please call us toll free at 1-800-225-1581. One of our
representatives will be pleased to assist you.
Sincerely,
Raymond Gautreau
Putnam Investor Services
enc.
Dividend Disbursement Form
Telephone Redemption Privilege
W-9
Scudder Investments Service Company
P.O. Box 219151 Kansas City MO 64121
April 5, 2002
Stone LaFaver & Shekletski
Attn David H Stone
414 Bridge St
New Cumberland PA 17070
Inquiry #:
Fund:
Account #:
20287784
Scudder US Govemment Securities Fnd-A
05555696643
Dear David H. Stone:
We are writing in response to your request for information regarding the value ofNevin E.
Carpenter's account(s). Please accept our condolences for your loss.
The information below is only for the date you requested, February 26, 2002:
FUND NAME(S)
Scudder U.S. Government
Securities
NUMBER OF SHARE ACCOUNT
SHARES PRICE BALANCE
4223.4760 $8.6600 $36575.30
Scudder Strategic Income
B shares
6008.0870 $4.2700 $25654.53
High-Yield Opportunity
13 shares
1770.7580 $8.7400 $15476.42
Please contact the Shareholder Services Department at (800) 621-1048 if we may be of further
assistance. Our service representatives will be happy to help you Monday through Friday, 7:00
a.m. to 6:00 p.m., and Saturday, 8:00 a.m. to 3:00 p.m. (Central Time).
Sincerely,
Maria Alvarado
Service Specialist
~PR-~8-2~ !1:54
PNCBANK CIF DEPARTMENT
412 785 8857
~.81×81
Ap~l 8, 2002
/SCP
Stone, LaFaver & Shekletski
Attorneys at Law
414 BHdge Street
PO BOX E
New Cumberland PA 17070
RE: Estate ofNevin E Carpenter, Deceased
SSN: 195-07-3870
DOD: 02/26/2002
Dear Mr. Stone:
Lu response to your request for Date of Death balances for the customer noted above, our
records show the following.
ACCOUNT
'~5.'/.0009624
DOD Balance:
NEVIN E CARPENTER
12,530.54 + $3.00 accrued interest
Established 01/01/1978
Please note that this office only provides date of death balances for deposit accounts
(IRa, s, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC branch
office.
Sincerely,
.Mefian Don_nelly
· -800~762-1775
?7-PYSC-04-F
370 First Avenue
":~"=':':':~h, PA 15219
:, -~ember of The PNC Finanelal Services Group
On~ PNC Plaza 249 Fifth Avenue Pittsburgh Pennsylvania 15222 2707
TOTAL P.81
LCC;< ,--OR US. WE'LL GET YOU THERE.
04/04/2002
STONE LAFAVER & SHEKLETSKI
414 BRIDGE ST
NEW CUMBERLAND PA 17070
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
The information which you requested on the account(s) of NEVIN CARPENTER DECEASED
(Social Security Number 195-07-3870) is/are as follows:
566233771
CERTIFICATE
12/04/92
13067.88
118.49
13186.37
Account Ownership SOLE
Name of Joint
Owner. if any
Date Ownership
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner. if any
Date Ownership
Was Established
Additional
Information
Requested
PLEASE COMPLETE W-9
rely, , t
SENIOR SERVICES REP.
P.O. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711
Toll F~'EE 1-866-WAYPOINT (I-866-9;=9-7646) · IN YORK AREA 717/815-4500 · www. wa~lpointbank.com
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Jon F. LaFaver
being duly sworn according to law, deposes and says fhaf 'he is the Executor
o.f the Estate of Nevin E. Carpenter
late of ----Ne--w---C--u-~m~_e_r_l_a_nd__S°r°ugh .... , Cumberland County, Pa., deceased and that the
wlfhln is an inventory made by Jon F. LaFaver , the said Executor
of the entire estate of said decedent, cons;sting of all the personal property and reaJ estate, except rea~ estate outs|de
fha CommonweaJth of PennsyJvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
and subscribed before me,
19 Jon F. LaFav(~cutor -
120 Carol St.
New Cumberland, PA 17070
Address
Date of Death 26 02 2002
2.
3.
4.
Day Month Year
INSTRUCTIONS
An inventory must be filed wlfhin three months after appolnfment of personal represenfaflve.
A supplement inventory must be filed within thirty days of discovery of additional as_s~ets.
Additional sheets may be attached as fo personalty or realty '
See Arflcle IV, Fiduciaries Act of 1949.
O
O
]hventory of the real and personal
Nevin E. Carpenter
deceased
Inventory
Estate of Nevin E Carpenter
From 02/26/2002 To 10/03/2002
Description
Accrued Income
Form 706 Schedule B
Common Stocks
Scudder US Gov't Sec.
Scudder Strategic Income B
Scudder High Yield Opportunity B
Putnam Inv.-US Gov't Inc. Tr C1 B
Putnam Inv.-Diversified Inc. C1 B
Putnam Inv.-PA Tax Exempt Inc. C1 B
Federal Notes and Bonds
Prudential Sec.-5000 FHLMC MCB Bond
Form 706 Schedule C
Cash on Hand
Harsco, Inc. pension checks
Checking Accounts
PNC Bank-Checking Acct.
Money Market Accounts
Prudential MoneyMart Acct.
Prudential Sec.-cash account
3.00
Certificates of Deposit
Waypoint Bank-Cert. of Deposit
118.49
Form 706 Schedule F
Refunds
Income Tax refund
Blue Cross/Blue Shield-refund
Value
36,575.30
25,654.53
15,476.42
8,104.61
18,678.68
17,609.59
6,727.00
0.83
225.00
167.05
Total
122,099 13
5,039 63
127,138 76
883 84
12,533 54
6,727 83
13,18( 37
33,33] 58
39~ . 05
160,861 .39
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001 762
DAVID HEAN STONE ESQUIRE
414 BRIDGE STREET
NEW CUMBERLAND, PA 17070
........ fold
ESTATE INFORMATION: SSN: 195-07-3870
FILE NUMBER: 2102-0281
DECEDENT NAME: CARPENTER NEVIN E
DATE OF PAYMENT: 10/22/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/26/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,130.74
TOTAL AMOUNT PAID:
$3,130.74
REMARKS- JOHN LLAFAVER
C/O DAVID H STONE ESQUIRE
SEAL
CHECK# 12
INITIALS: CW
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF ZNDZVZDUAL TAXES
ZNHERZTANCE TAX DTVTSZON
DEPT. 280601
HARR/SBURg, PA 17128-0601
DAVID N STONE
STONE ETAL
qlq BRTDGE ST
NEW CUHBERLAND PA 17070
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
BATE
ESTATE OF
BATE OF DEATH
FZLE NUHBER
COUNTY
ACN
12-10-2002
CARPENTER
02-26-Z002
21 02-0281
CUHBERLAND
101
Amount Rae'i 'l:'l:ed
NEVIN E
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-02) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
BZSALLO#ANCE OF BEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF CARPENTER NEVIN E FZLE NO. 21 02-0281 ACN 101 DATE 12-10-2002
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ]:NTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks end Bonds [Schedule B) (2}
$. Closely Held Stock/Partnership Znterest (Schedule C} (3)
q. Mor~gages/No~as Receivable (Schedule D) (q)
E. Cash/Bank Deposits/N/sc. Personal Property (Schedule E) (5)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule ;) (7)
8. Total Assets
APPROVED BEBUCTZONS AND EXEHPTZONS:
9. Funeral Expenses/Ada. Costs/Hisc. Expanses (Schedule H) (9)
10. Debts/Mortgage L/ebilit/es/L/ens (Schedule Z) (10)
11. To~el Daduct/ons
12. Net Value of Tax Return
127~158.76
.00
33~723.63
.00
.00 NOTE: To /nsura proper
credi~ to your account,
subait the upper portion
.00 of th/s fora w/th your
tax payment.
.00
(8)
25,812.77
15.
lq.
NOTE:
2,078.q6
(11)
(12)
Cher/~eble/Govarnaental Bequests; Non-elected 9115 Trusts (Schedule J)
Na~ Value of Este~:a Sub~ec~ to Tax
:Zf an assessment ~as lssued previously, lines la, 15 and/or
reflect flgures that include the total of ALL returns assessed to date.
160,862.:59
27.891.2~
132,971.16
6,500.00
3,150.7q
TOTAL TAX CREDZT
BALANCE OF TAX BUE
ZNTEREST AND PEN.
TOTAL DUE
9,972.85
.01CR
.00
.01CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THIS FORH FOR ZNSTRUCTIONS.)
ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
AMOUNT PAZD
ASSESSMENT OF TAX:
1.;. Aaoun~ of L/ne lq et Spouse1 ra*e
16. Amount of L/ne lq ~;axebla et Lineal~Class A ra~a
17. Amount of L/ne lq et S/bl/ng re'ce
18. Amount of L/ne lq taxable e~ Collateral/Class B ra~e
19. Pr/nc/pal Tax Due
TAX CREDZTS:
PAYMENT RECEZPT OTSCOUNT (+)
DATE NUMBER ZNTEREST/PEN PAZD (-)
05-2q-2002 CD001216 $q2.11
10-22-2002 CD001762 . O0
(15) .00 X O0 = .00
(16) .00 X Oq5 = .00
(17) .00 x 12 = .00
(18) 66,q85.58 x 15 = 9,972.8q
(19)= 9,972.8q
(13) 66,q85.58
(lq) 66,q85.58
16, 17, 18 and 19 will
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-02-0281
FIRST AND FINAL ACCOUNT
AND PROPOSED DISTRIBUTION OF
NEVIN E. CARPENTER, DECEASED
JON F. LAFAVER, EXECUTOR
LATE OF THE BOROUGH OF NEW CUMBERLAND
Social Security No.: 195-07-3870
Date of Death: February 26, 2002
Date of Executor's Appointment: March 19, 2002
Date of Advertising Letters Testamentary:
Cumberland Law Journal - April 12, 19, & 26, 2002
The Patriot News Co. - April 2, 9, & 16, 2002
Accounting for the Period: February 26, 2002 to January 31, 2003
Purpose of Account: Jon F. LaFaver, Executor, offers this account to
acquaint interested parties with the transactions which have occurred
during his administration.
The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for
additional information or questions or objections can be discussed
with:
Jon F. LaFaver
120 Carol Street
New Cumberland, PA 17070
David H. Stone, Esquire
Stone LaFaver Shekletski
414 Bridge Street
New Cumberland, PA 17070
SUMMARY OF ACCOUNT
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Proposed Distribution to Beneficiaries
Page
11
Fiduciary
Acquisition
Value
$110,084.77
Principal
Receipts
Net Gain (or Loss) on Sales or
Other Dispositions
Other Receipts
Less Disbursements:
Administration Expenses (Prin)
Fees and Commissions (Prin)
Funeral Expenses (Prin)
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
Income
Receipts
Less Disbursements
Balance before Distributions
Distributions to Beneficiaries
Income Balance on Hand
Combined Balance on Hand
1
2-3
4-5
5
5
8-10
$14,541.97
16,086.00
7,454.00
$160,862.39
-784.18
0.00
$160,078.21
38,081.97
$121,996.24
15,000.00
$106,996.24
$ 3,088.53
0.00
$ 3,088.53
0.00
$ 3,088.53
$110,084.77
RECEIPTS OF PRINCIPAL
Estate of Nevin E Carpenter
As of 01/31/2003
Page 1
Assets Listed in Inventory
(Valued as of date of death)
Fiduciary
Acquisition
Value
Cash on Hand
Harsco, Inc. pension checks
Checking Accounts
PNC Bank-Checking Acct.
$3.00 Accrued Interest
Money Market Accounts
Prudential MoneyMart Acct.
Prudential Sec.-cash account
Common Stocks
Putnam Inv.-Diversified Inc. C1 B
2,032.501 Units
Putnam Inv.-PA Tax Exempt Inc. C1 B
1,967.552 Units
Putnam Inv.-US Gov't Inc. Tr C1 B
626.322 Units
Scudder High Yield Opportunity B
1,770.758 Units
Scudder Strategic Income B
6,008.087 Units
Scudder US Gov't Sec.
4,223.476 Units
Federal Notes and Bonds
Prudential Sec.-5000 FHLMC MCB Bond
5,039.63 Units
Certificates of Deposit
Waypoint Bank-Cert. of Deposit
$118.49 Accrued Interest
Refunds
Blue Cross/Blue Shield-refund
Income Tax refund
$ 6,727.00
0.83
$ 18,678.68
17,609.59
8,104.61
15,476.42
25,654.53
36,575.30
$ 167.05
225.00
$ 883.84
12,533.54
6,727.83
122,099.13
5,039.63
13,186.37
392.05
TOTAL INVENTORY $160,862.39
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
06/17/2002 Prudenital Sec.-5000 FHLMC MCB Bond-final
call
1,039.63 Units
Net Proceeds
Fiduciary Acquisition Value
Net Loss
07/02/2002 Putnam Inv.-Diversified Inc. C1 B
2,032.501 Units
Net Proceeds
Fiduciary Acquisition Value
Net Loss
07/10/2002 Putnam Inv.-US Gov't Inc. Tr C1 B
626.322 Units
Net Proceeds
Fiduciary Acquisition Value
Net Gain
07/24/2002 Scudder US Gov't Sec.
4,223.476 Units
Net Proceeds
Fiduciary Acquisition Value
Net Gain
07/24/2002 Scudder Strategic Income B
6,159.387 Units
Net Proceeds
Fiduciary Acquisition Value
Net Loss
07/24/2002 Scuder HighYield Opportunity B
1,770.758 Units
$ 1,000.00
1,039.63
$ 18,516.08
18,678.68
$ 8,129.66
8,104.61
$ 36,997.65
36,575.30
$ 26,054.21
26,308.88
Gain
25.05
422.35
Page 2
Loss
39.63
162.60
254.67
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Net Proceeds
Fiduciary Acquisition Value
$ 14,626.46
15,476.42
Net Loss
08/07/2002 Putnam Inv.-PA Tax Exempt Inc. C1 B
1,967.552 Units
Net Proceeds
Fiduciary Acquisition Value
$ 17,684.87
17,609.59
Net Gain
Total Gains and Losses
Less Gain
Net Loss
Gain
$ 75.28
$522.68
Page 3
Loss
$1,306.86
522.68
$ 784.18
$ 849.96
DISBURSEMENTS OF PRINCIPAL
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Page 4
Administration Expenses Prin)
02/27/2002 Check paid by decedent but not cleared by
bank until after death
03/04/2002 Prudential Financial-securities account fee
03/07/2002 PNC Bank-service charge
04/17/2002 H. Frederick Martin, MD-debt of last illness
Check number 1
04/17/2002 Kelly Financial Serv.-prep. of 2001 income
tax returns
Check number 2
04/17/2002 Pharmerica-debt of last illness
Check number 4
05/02/2002 Beverly Enterprises-expenses incurred at home
Check number 6
05/17
2002 Register of Wills, Agent-payment on account
of inheritance tax w/5% discount
Check number 5
05/23/2002 Harsco Trust-Reimb. on pension checks for
March and April
Check number 7
06/11/2002 Gettysburg Hospital-services rendered
Check number 8
07/02/2002 Register of Wills-2 short cert.
Check number 9
10/16/2002 Register of Wills-filing Inheritance Tax and
Inventory
Check number 11
10/16/2002 Register of Wills, Agent-payment of
Inheritance tax
Check number 12
10/31/2002 Register of Wills-add'l probate costs
Check number 13
10/31/2002 Stone LaFaver & Shekletski-Reimb. on
advertising in two newspapers ($183.43) and
probate ($254.50)
Check number 14
350.00
75.00
20.00
50.00
224.50
491.87
1,230.84
6,500.00
883.84
81.25
6.00
25.00
3,130.74
35.00
437.93
DISBURSEMENTS OF PRINCIPAL
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Page 5
01/24/2003 Reserve for filing First and Final Acct. and
closing expenses
Fees and Commissions (Prin)
10/31/2002 Stone LaFaver & Shekletski-Attorney's fee
Check number 14
11/01/2002 Jon F. LaFaver-Executor's commission
Check number 15
Funeral Expenses (Prin)
04/17/2002 Musselman Funeral Home-funeral expenses
Check number 3
TOTAL DISBURSEMENTS OF PRINCIPAL
1,000.00
8,043.00
8,043.00
$ 14,541.97
16,086.00
7,454.00
$ 38,081.97
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Page 6
To: Wilbur Kline
Partial distribution
07/24/2002 PNC Bank-Estate Checking Acct.
Check number 10
$ 15,000.00
TOTAL DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES $ 15,000.00
PRINCIPAL BALANCE ON HAND
Estate of Nevin E Carpenter
As of 01/31/2003
Page 7
Checking Accounts
PNC Bank-Estate Checking Acct.
Less: Income balance on hand
PRINCIPAL BALANCE ON HAND
Current
Value
$110,084.77
$110,084.77
3,088.53
$106,996.24
Carrying
Value
$110,084.77
$110,084.77
3,088.53
$106,996.24
RECEIPTS OF INCOME
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Dividends
Prudential MoneyMart Acct.
03/25/2002 Prudential MoneyMart-dividend
04/24/2002 Prudential MoneyMart-dividend
05/24/2002 Prudential MoneyMart-dividend
06/24/2002 Prudential MoneyMart-dividend
07/09/2002 Prudential MoneyMart-dividend
Putnam Inv.-Diversified Inc. C1 B
03/20/2002 Putnam Inv.-dividend on Diversified Inc. C1 B
05/08/2002 Putnam Inv.-dividend on Diversified Inc. Cl B
06/19/2002 Putnam Inv.-dividend on Diversified Inc. C1 B
07/24/2002 Putnam Inv.-dividend on Diversified Inc. C1 B
Putnam Inv.-US Gov't Inc. Tr C1 B
03/20/2002 Putnam Inv.-dividend on US Gov't Inc. Tr Cl B
06/19/2002 Putnam Inv.-dividend on US Gov't Inc. Tr C1 B
07/24/2002 Putnam Inv.-dividend on US Gov't Inc. Tr C1 B
Scudder High Yield Opportunity B
03/25/2002 Scudder-dividend on High Yield Opp. B
05/20/2002 Scudder-dividend on High Yield Opp. B
06/12/2002 Scudder-dividend on High Yield Opp. B
07/24/2002 Scudder-dividend on High Yield Opp. B
8.00
10.00
12.00
13.00
5.06
48.06
123.98
154.52
121.95
121.95
522.40
33.20
28.81
28.81
90.82
112.80
113.15
113.15
114.04
453.14
Page 8
RECEIPTS OF INCOME
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Page 9
Scudder Strategic Income B
03/21/2002 Receipt of 38.984 shs. Scudder Strategic
Income B pursuant to reinv, dividend
04/23/2002 Receipt of 38.658 shs. Scudder Strategic
Income B pursuant to reinv, of dividend
05/23/2002 Receipt of 36.151 shs. Scudder Strategic
Income B pursuant to reinv, dividend
06/21/2002 Receipt of 37.507 shs. Scudder Strategic
Income B pursuant to reinv, dividend
Scudder US Gov't Sec.
03/25/2002 Scudder-dividend on US Gov't Sec.
05/20/2002 Scudder-dividend on US Gov't Sec.
06/12/2002 Scudder-dividend on US Gov't Sec.
07/24/2002 Scudder-dividend on US Gov't Sec.
Total Dividends
Interest
PNC Bank-Checking Acct.
03/07/2002 PNC Bank-Interest on Checking Acct.
04/04/2002 PNC Bank-Interest on Checking Acct.
PNC Bank-Estate Checking Acct.
04/29/2002 PNC Bank-Interest on Estate Checking Acct.
05/30/2002 PNC Bank-Interest on Estate Checking Acct.
06/27/2002 ?NC Bank-Interest on Estate Checking Acct.
07/30/2002 PNC Bank-Interest on Estate Checking Acct.
$ 167.63
169.32
157.62
159.78
654.35
$ 177.39
177.39
177.39
177.39
709.56
$ 1.29
3.81
5.10
$ 2.01
1.93
2.15
11.43
2,478.33
RECEIPTS OF INCOME
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
08/29/2002 PNC Bank-Interest on Estate Checking Acct.
09/27/2002 PNC Bank-Interest on Estate Checking Acct.
10/30/2002 PNC Bank-Interest on Estate Checking Acct.
11/27/2002 PNC Bank-Interest on Estate Checking Acct.
12/30/2002 PNC Bank-Interest on Estate Checking Acct.
Prudential Sec.-5000 FHLMC MCB Bond
03/15/2002 Prudential Sec.-interest on 5000 FHLMC Bond
04/15/2002 Prudential Sec.-interest on 5000 FHLMC MCB
Bond
05/15/2002 Prudential Sec.-interest on 5000 FHLMC MCB
Bond
06/17/2002 Prudential Sec.-interest on 5000 FHLMC MCB
Bond
Waypoint Bank-Cert. of Deposit
05/20/2002 Waypoint Bank-Cert. of Deposit
Total Interest
Tax Exempt Interest
Putnam Inv.-PA Tax Exempt Inc. C1 B
03/01/2002 Putnam Inv.-PA Tax Exempt C1 B-dividend
03/29/2002 Putnam Inv.-tax exempt dividend on PA Tax
Exempt Inc. C1 B
05/20/2002 Putnam Inv.-tax exempt interest on PA Tax
Exempt Inc. C1 B
06/12/2002 Putnam Inv.-tax exempt interest on PA Tax
Exempt Inc. C1 B
Total Tax Exempt Interest
TOTAL RECEIPTS OF INCOME
20.51
20.67
23.40
17.04
19.99
119.13
29. 17
17.50
11. 67
5.83
64.17
171.39
62.53
58.59
69.17
60.12
250.41
Page 10
$ 359.79
250.41
$ 3,088.53
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Estate of Nevin E Carpenter
For Period 02/26/2002 Through 01/31/2003
Page 11
To: Wilbur Kline
Residue of estate
Cash
$ 16,749.86
Total
To: Lower Susquehanna Synod ELCA
Residue of estate
Cash
$ 16,749.86
33,678.88
Total
To: American Red Cross, Harrisburg Chap
Residue of estate
Cash
$ 33,678.88
20,207.33
Total
To: Bethesda Mission
Residue of estate
Cash
$ 20,207.33
13,471.55
Total
To: Ada Bostock
Residue of estate
Cash
$ 13,471.55
25,977.15
Total
TOTAL PROPOSED DISTRIBUTIONS TO BENEFICIARIES
$ 25,977.15
$110,084.77
COMMONWEALTH OF PENNSYLVANIA :
COUNTY OF CUMBERLAND :
SS:
Jon F. LaFaver, Executor under the Last Will and Testament of
Nevin E. Carpenter, deceased, hereby declares under oath (penalties
of perjury) that he has fully and faithfully discharged the duties of
his office; that the foregoing First and Final Account is true and
correct and fully discloses all significant transactions occurring
during the accounting period; that all known claims against the
estate have been paid in full; that, to his knowledge, there are no
claims now outstanding against the estate; and that all taxes pres-
ently due from the estate have been paid.
~-~on F. LaFaver
Sworn to and subscribed
before me this /~Aday
of ~~ , 2003.
Notary Public J
NOTARIAL SEAL
TINA M. BURKE'Y, Nola~j Public
New Cumberland aa'o, Cumberland Co.
My com~!gn _Expires April 15, 2005
Codicil to the Last Will and Testament
of
NEVIN E. CARPENTER
21-2002-281
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County, Pennsylvania, being of sound
mind, memory and understanding do hereby make, publish and declare this as and for a
Codicil to my Last Will and Testament dated August 4, 1987.
I.
I hereby revoke paragraph II E. on page two of my Last Will and Testament aforesaid
(wherein I bequeathed 10% of my residuary estate unto the Senior Citizens Center of
New Cumberland Pennsylvania).
II.
I hereby amend item II F on page two of my Last Will and Testament to read as follows:
"Twenty (20%) per cent unto MRS. ADA BOSTOCK of 5121 Circle Drive, Harrisburg,
Pennsylvania, if she survives me."
III.
All other parts of my Last Will and Testament shall remain in full force and effect, and
unchanged, except as herein provided.
Page one of two pages
IN WITNESS WHEREOF, I, NEVIN E. CARPENTER have unto this Codicil set my
hand and seal this
day of July, 1997.
Nevin E. Carpenter
SIGNED, SEALED, PUBLISHED AND DECLARED as a Codicil to his Last Will and
Testament by NEVIN E. CARPENTER, the Testator, in the presence of us, who have
hereunto subscribed our names as witnesses at his request, in the presence of said Testator
and in the presence of each other.
Page two of two pages
LAST WILL AND TESTAMENT
OF
2~-2002-~81
NEVIN E. CARPENTER
I, NEVIN E. CARPENTER, of Lemoyne, Cumberland County,
iPennsylvania, being of sound mind, memory and understanding, do
"hereby make, publish and declare this as and for my Last Will and
Testament hereby revoking and making void any and all other wills
~by me at any time heretofore made.
I.
I direct that my Executors hereinafter named shall pay all
~~my just debts and funeral expenses as soon as conveniently may
[be done after my decease.
II.
Ail the rest, residue and remainder of my estate, whether
personal or mixed, and wheresoever situate, I hereby give,
~devise and bequeath as follows:
A. Thirty (30%) per cent unto my late wife's cousin, ~tRY
~ ~KLINE, or if she is not living, then unto her husband, WILBUR KLINE,
now of Mont Alto, Pennsylvania.
B. Twenty-Five (25%) per cent unto ST. MATTHEWS LUTHERAN
CHURCH, Green and Seneca Streets, Harrisburg, Pennsylvania, in
memory of my late wife, Thelma E. Zimmerman Carpenter.
C. Fifteen (15%) per cent unto the AMERICAN RED CROSS,
HARRISBURG AREA CHAPTER, Harrisburg, Pennsylvania.
D. Ten (10%) per cent unto the BETHESDA MISSION of
Harrisburg, Pennsylvania.
Page one of three Pages
E. Ten (10%) per cent unto the SENIOR CITIZENS CENTER of
New Cumberland, Pennsylvania.
F. Ten (10%) per cent unto MRS. ADA BOSTOCK, if she survives
me, of 5121 Circle Drive, Harrisburg, Pennsylvania.
III.
I hereby nominate, constitute and appoint my attorney, JON F.
LaFAVER, ESQUIRE, and WILBUR KLINE as Co-Executors of this, my
Last Will and Testament. If either the said Jon F. LaFaver or
~Wilbur Kline should predecease me, fail to qualify or cease to act
~as such, then the other shall serve alone.
IV.
No fiduciary acting under this Will shall be required to
gpost bond in this jurisdiction or in any jurisdiction in which he
~may act.
IN WITNESS WHEREOF, I, NEVIN E. CARPENTER, the Testator,
~have unto this, my Last Will and Testament, set my hand and seal
~this ~ day of August, A. D., 1987.
Page two of three Pages
SIGNED, SEALED, PUBLISHED and DECLARED by NEVIN E. CARPEN'33~P.,
i'the Testator, as and for his Last Will and Testament in the pre.~cnce
I! '
of us who have hereunto subscribed our names as witnesses at his
request, in the presence of the sa'id Testator and in the presence
~of each other.
Page three of t.hree Pages
inventory of the real and personal estate of: "-
Nevin E. Carpenter
deceased
Inventory
Estate of Nevin E Carpenter
From 02/26/2002 To 10/03/2002
Descrip~icn
Accrued Income
Form 706 Schedule B
Ccm,mon Stocks
Scudder US Gov't Sec.
Scudder Strategic Income B
Scudder High Yield Opportunity B
Puunam inv.-US Gov't Inc. Tr C1 B
Pusnam Inv.-Diversified Inc. C1 B
Fu:nam Inv.-PA Tax Exemp~ Inc. C1 B
Fecerai Nones and Bonds
?rucensial Sec.-5000 FHLMC MCB Bond
Form -06 Schedule C
Sash tn Hand
Harsco, inc. pension checks
2kecking Acccunus
Bank--Checking Acc5.
>!cnev MarkeE Accoun5s
Prudennial MoneyMaru Accu.
?ruuen5ia! Sec.-cash account
3.00
'ier-_ificase= of ~e~o=i~
Wa':'~cin~ Bank-Cern_. of Deposit
118.49
Firm -06 Schedule F
Refunds
-nscme Tax refund
Blue Cross/Blue Shield-refund
Value
36,575.30
25,654.53
15,476.42
8,104.61
18,678.68
17,609.59
6,727.00
0.83
225.00
167.05
Total
122,099
5,039
127,138
883
12,533
6,727
!3,1
33,33
39
160,86
13
.05
'39
COMMONWEALTFi OF PJ:NNSYLVANIA
COUNTY OF CUMBERLAND
Jon F. LaFaver
and subscribed before me,
19
being,'duly sworn according to law, deposes and says fhaf:"Ee . is the Executor
of the Estate of Nevin E. Carpenter
late of N-e--w---C---u- -m]~-e_r_l_a_n_d__B°r°ugh , Cun~berland C0unfY~ Pa., deceased and that the
within is an inventory made by Jon F. LaFaver , the said Executor
of the entire estate of said decedent, consist;ng of all the personal property and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
~1 St.
New Cumberland, PA 17 0 7 0
Address
Date of Death
26 02 2002
Day Month Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirfy days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
THE PATRIOT NEWS
THESUNDAY PATRIOT NEWS
Proof of Publication
UnderAct No. 587, Approved May 16, 1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Michael Morrow being duly sworn according to law, deposes and says:
That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws
of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in
the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-New~ and The
Sunday P~,triQt-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the
City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th,
1854, and September 18th, 1949, respectively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published in
their regular daily and/or Sunday/ Metro editions which appeared on the 2nd, 9th and 16th day(s) of April 2002.
That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that
all of the allegations of this statement as to the time, place and character of publication are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this
statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and
adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in
the office for the Recording of Deeds in and for said County pf/Dauphin in Miscellaneous Book "M",
Volume 14, Page 317. ~~ ! !~~i's
PUBLICATION ...........................................................
COPY ;~i~ i~ ~r~...' . !r'P..~' 18th da~y/O~ April/~2 A.D.
Terry L Russ@Il, Notary Public~-,~
Harrisburg, Dauphin County "~J'/~/-'~'~/ /-/~'~ -- (-- ~
My Commission Expires June 6, 2002 I NOTARY PUBLIC
Estate Notices (West)
EXECUTOR'S NOTICE
Letters Testamentary on the Estafe of
evln E. Cerpenter, lore of the Borough of
ew Cumberlgnd, County of Cumb~'land,
~,.nd CommonWealth of Pennlylvanla,
rs~d, have been granted 'to the under-
~r~AIl'Person$ Its hldebl~ ted te the Sah:l E$tcde ars
~. having claims wlll present them without
Jon F. I..FeVer
NeW CuO~blrlOlld, PA 17070
[~Dgvld H, Stone, E~lulrl
~ *STONE LeFAVEE & SHEKLETSKI
;~P.(X ~m - .
NeW Cllmberlmld, PA
Member, Pennsylvania Association ot Notaries My commission expires June 6, 2002
~/.~/./, L STONE, LAFAVER & SHEKLETSKI
ATTN: DAVID H. STONE
-~l~'j~//' 414 BRIDGE STREET
NEW CUMBERLAND, PA. 17070
Statement of Advertising Costs
To THE PATRIOT-NEWS CO., Dr.
For publishing the notice or publication attached
hereto on the above stated dates
Probating same Notary Fee(s)
Total
$ 106.68
$ 1.75
$ 108.43
Publisher's Receipt for Advertising Cost
The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
been duly paid.
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
STATE OF PENNSYLVANIA :
:
COUNTY OF CUMBERLAND :
SS.
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
APRIL 12, 19, 26, 2002
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
C~xpenter, Nevin E., dec'd.
Late of the Borough of New Cum-
berland.
Executor: Jon F. LaFaver, 120
Carol Street. New Cumberland,
PA 17070.
Attorneys: David H. Stone, Es-
quire, Stone LaFaver & Sheklet-
ski, P.O. Box E, New Cumber-
land, PA 17070.
Roge~ Iv~ Morgenthal, Editor
SWORN TO AND SUBSCRIBED before me this
26 day of APRIL, 2002_
NOTARIN.¥~i,LTM
LOtS E. SNYDER, Notaly Public
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Nevin E. Carpenter
Date of Death: February 26, 2002
Will No. 21-02-0281
To the Register:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court
Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is
complete: Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration
will be complete:
3. If the answer to No. 1 is Yes, state the following:
(a) Did the personal representative file a final
account with the Court? Yes X No
(b) The separate Orphans' Court No. (if any) for
the personal representative's account is: N/A
(c) Did the personal representative state an account
informally to the parties in interest? Yes No
Date:
(d) Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed
with the Clerk of the Orphans' Court and may b~ attached
to this report.
414 Bridge Street
r~- q ~u-'~G~l~%:%New Cumberland, PA 17070
~?-:",.~- ~: - '_->U~i,~717-774-7435
X
Personal Representative
Counsel for Personal
Representative