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HomeMy WebLinkAbout04-1121PETITION FOR PROBATE and GRANT OF LETTERS Estate of RAYMOND D. HECKMON No. also known as To: Deceased. Social Security No. 181 - 12-1801 Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executrix named in the last will of the above decedent, dated January 30, 2002, and codicil(s) dated [none]. (State relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 6 Mooreland Avenue, Mt. Holly Springs Borough. (List street, number and municipality) Decedent, then 88 years of age, died November 14, 2004, at 6 Mooreland Avenue, Mt. Holly Springs, PA. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated 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 mai estate in Pennsylvania situated as follows: None $ unestimated $ WHEREFORE, petitioner respectfully requests the probate of the last wj[1 a~nd codicil(s) presented herewith and the grant of letters testamentary thereon. ~' - (Testamentary, administration c.t.a.; administration d.b.n.c.t.a.) ~; ' ~ Maxine R. Heckmon 6 Mooreland Avenue Mt. Holly Springs, pA 17065 (717) 486-8543 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are tree and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed be~re~?ethis ~5~-~''~ dayof ~ ~_ C~ ~egister MaxineR. Heckmon tqo. d1-04- Estate of Raymond D. Heckmon, Deceased DECREE OF PROBATE AND GRANT OF LETTERS ANDNOW,~t~m~_- ~: o3,C~ , in consideration ofthe petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated January 30, 2002, described therein be admitted to probate and filed of record as the last will of Raymond D. Heckmon and Letters Testamentary are hereby granted to Maxine R. Heckmon. Will Book Page FEES Probate, Letters, Etc. Short Certificates(g) TOTAL Edward L. Schorpp, Esquire (17495) ATTORNEY (Sup, Ct. I.D. No.) MARTSON DEARDORFF WILLIAMS & OTTO 10 East High Street Carlisle, PA 17013 (717) 243-3341 Filed ,fs is to certify {hat the information here given is correctly copied frmn an original certificate of death duly filed with me as I,,~cal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy blt photostat or photograph. Fcc for this certificate. $2.00 ? }0783773 No. Local Registrar NOV 1 5 2004 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS ~ CERTIFICATE OF DEATH ~'~ ~6 Moorelana Ave I--~,,~ l~, -- ' ' ~o~"'~?'~.~- I~ ....... ~,., ~ .......... m% [,~ ~9~ ,~Mt. Holly Springs,PA17065 ~ . HollySpings, pA17065 LAST WILL AND TESTAMENT I, RAYMOND D. HECKMON, of the Borough of Mount Holly Springs, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible fi.om the assets held or passing under ITEM FIVE hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO In the event my spouse shall predecease or fail to survive me by thirty (30) days, then I give such items of personalty as are itemized in a certain list attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof.: tn such. event, I also bequeath the sum of Three Thousand Dollars ($3,000.00) to my son, Ja~es W. ~eckmon. ITEM THREE '~:~ If my spouse, MAXINE R. HECKMON, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, .~to my said spouse, absolutely. If my said spouse doe. s not so survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FIVE hereof. ITEM FOUR In the event my said spouse shall disclaim all or any portion of any devise or bequest made to my spouse under the foregoing ITEM THREE, then the amount otherwise payable shall be held by my Trustee under ITEM FIVE hereof. For purposes of the Trust established under Page 1 of 7 Pages [initials] ITEM FIVE hereof, my said spouse shall not be deemed to have predeceased me by virtue of my said spouse's exercise of the right to disclaim set forth herein. ITEM FIVE RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS THREE and FOUR hereof, if any, for the following purposes: A. My Trustee shall pay the net income, at least quarter-annually, to my spouse, MAXINE R. HECKMON, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse. B. My Trustee shall further pay to my said spouse, annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the Trust hereunder. C. Upon the death of my said spouse my Trustee shall distribute the principal of the Trust to my children in equal shares, absolutely. D. In the event that any of my said children shall fail to survive my spouse and me, but shall leave issue surviving, then such deceased child's share shall be held by my Trustee and the net income therefrom shall be used for the support, maintenance and education of the issue of such deceased child. My Trustee shall use as much of the principal as it shall deem desirable for said purposes. My Trustee shall distribute absolutely the principal of such share of such deceased child to the issue of such deceased child per stirpes as each shall attain the age of twenty-five (25) years. In the event that any of try children shall fail to survive my spouse and me and not leave issue surviving, then such deceased child's share shall be added to the shares of my other children as if originally a part thereof. ITEM SIX POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions Page 2 of 7 Pages D [initials] hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution. A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of the Trustee) or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; F. To assume continuance of the status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the share distributed Page 3 of 7 Pages [initials] to any distributee to be composed of property similar to or different from that distributed to any other distributee; I. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of the fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; Page 4 of 7 Pages [i~tials] beneficiary; 3. beneficiary; 4. To a legally appointed guardian of such beneficiary for the benefit of such To a person having custody of such beneficiary for the benefit of such By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a full and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SEVEN PROTECTIVE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder shall not be in any way or man~. er sub!ect to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. ITEM EIGHT APPOINTMENT OF EXECUTRIX AND TRUSTEE I nominate, constitute and appoint my spouse, MAXINE R. HECKMON, as Executrix of my estate. In the event that my said spouse shall predecease me or fail to act as Executrix, [initials] Page 5 of 7 Pages then I appoint JAMES W. HECKMON as Executor of my estate. I nominate, constitute and appoint my spouse, MAXINE R. HECKMON, as Trustee of any trust created hereunder. In the event that my said spouse shall fail or be unwilling to continue to act as Trustee, then I appoint JAMES W. HECKMON as Trustee of any trust created hereunder. ITEM NINE WAIVER OF BOND I direct that neither my Executrix(or) nor my Trustee shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this ,.~O~'~ day of (SEAL) Ra~ond D. Heckmon SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as wimesses thereto, in the presence of the said Testator and of each other. Page 6 of 7 Pages COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS. ) We, Raymond D. Heckmon, Edward L. Schorpp, and ~ ,4~f~(,~ .X/(ff'~rt/~,~) the Testator and the wimesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that the Testator has signed willingly, and that the Testator executed it as his flee and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a wimess and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Raymond D. Heckmon, Testator Wimess wi ss the witnesses, this ~q~day of Subscribed, sworn to and acknowledged before me by Raymond D. Heckmon, the Testator, and subscribed and sworn to before me by Edward L. Schorpp and /Y] ar ~ ~ g4~,~,~4v~u/ , '2002. Not~"y Publl'i~ ' ~.~/ CORRINE L. MYERS, Notary ~ ~ ~m,m~s~ Ei~res May ~, 2~ Page 7 of 7 Pages Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: Edward L. SchoIpp, Esq. Ten East Hight St InvoiceNo: Invoice Date: Estate of: Estate No: 186 1/31/2005 RAYOND D HECKMON 21-2004-01121 " Carlisle, PA 17013 35,00 Total $35.00 Qty 1 Fee Description Additional Probate Fee Total: $35,00 Olecks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment, Thank you, .)- / ,,(' I;' { :,..: F:\FILES\DA TAFJLEIESTA TES\10437 .2.notice.cer CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Raymond D. Heckmon Date of Death: November 14, 2004 File No. 21-04-1121 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on or about January 4,2005. Mrs. Maxine R. Heckmon 6 Mooreland Avenue Mt. Holly Springs, P A 17065 Mr. Gary D. Heckmon 48412 S.E. Squaw Mountain Road Estacada, OR 97023-7534 Mr. James W. Heckmon 134 Pine Grove Road Gardners, P A 17324 Mr. C. Mark Heckmon 12311 Baker Terrace Woodstock, 1L 60098 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: January 10, 2005 -~xP~ Edward L. Schorpp, Esquire MARTS ON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, P A 17013 (717) 243-3341 Attorneys for Personal Representative Signature Name lo-'.:..~ L)c.. d~ 11.. " (", " Cl Ln (." CL o '" '--:"' :::L-:-~ C.L--: r~-, c: LU C~ o W'''' -.") r.;"":) =~, c;:"J <'-J () , , *1 COMMONWEALTH OF PENNSYLVANIA I DEPARTMENT OF REVENUE ~ DEPT,280601 HARRISBURG, PA 1712B-0601 I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) HECKMaN, RAYMOND D. P::iATE OF DEATH (MM-DO-YEAR) iOATE OF BIRTH (MM~DD-YEAR) \ 1\/14/2004 I 08/08/1916 I (IF APPLICABLE) SURVIVING. SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) HECKMON, Maxine R. ~1I81 1. Original Return 0 2 Supplemental Retum :.::: ~ I 0 4. Limited Estate 0 4a. ~ i 1l8J 6, Decedent Died Testate (At1ach copy 0 7. of Will) ~ 0 9. litigation Proceeds Received 0 R~V. UlIO EX. 16-00) r -~-- -~---- ----- ~ - ~-------~----~ ---- --I I ! I~FllE NUMBER--------=-=============-=' 21 2004 01]2] -----L COUNTYCO~~_~F3____ l SOCIAL SECURITY NUMBER --- , 181-12-180] ~. THIS RETURN MUST. BE FILED IN DUPLICATE WITH THE _L _ REGISTER OF WILLS I SOCIAL SECURITY NUMBER - 520-20~9255 o 3. Remainder Relum (date 01 death prior to 12-13-02) o 5. Federal Estate Tax Return Required o 8 Total Numberof Safe Deposit Boxes REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ z w c w " w c Future Intere~t Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-.951 o 11.ElectIon to lax under Sec. 9113(A) (Attach Sch 0) ~ w ~ ~ c " THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ~AME ICOMPLETE MAILING ADDRESS Edward L Schorpp, Esquire IRM NAME (If applicable) Martson Deardorff Williams & Otto Ten East High Street Carlisle, PA 17013 ELEPHONE NUMBER 7] 7/243~3341 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) I I I L_ --___J None c.",f->:'~< '_",:)1:::;- ~ (1) (2) (3) (4) (5) (6) (7) 248,613.21 3. Crosely Held Corporation, Partnership or Sole-Proprietorship None z c ;0 ~ ~ ~ ~ 0: ~ " w ~ 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6, Jointly Owned Property (Schedule F) o Separate Billing Requested 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) 3,787.00 None None None None (8) 248,613.21 (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 3,787.00 12. Net Value of Estate (Line a minus Line 11) (12) 244,826.21 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 13) (13) (14) 244,826.21 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) (15) 244,826.21 x ,00 0.00 z c ;0 ~ ~ ~ ~ c " ~ ~ x .045 (16) 16. Amount of Line 14 taxable at lineal rate 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 120. 0 I ;>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< --~- Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 6 Moore\and Avenue CITY I STATE- PA .fp-;;~-- Mt. Holly Springs Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresVPenalty (0 + E) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 0.00 -._- (5A) (58) 0.00 Make Check Payable 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 a. retain the use or income of the property transferred;. .....................................,..... ~ :: ~:~::~ ~;e~~~~l~on:~:~~ar:s~:~. .~~~~~, ~~~ .~~~.:~.~.~.~.~~..t.~~~~.~~.~~~~.~~.i.t.~ inco~~::::....... ..... ....,....... d. receive the promise for life of either paYnlents, benefits or care?................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........ . .................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .... . 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?...... ...................................... ............................ 0 No C8] C8] C8] C8] C8] C8] C8] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. preparer other than the personal representative is based on all information of which preparer has any knowl'-ldge ADDRESS SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Maxine R. Heckmon '1 .~" _l-'~''L.e.__/ .Ii.. /:~~:t~:c.'--;!:YYt-~,;7/'r-/ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 6 Mooreland Avenue Mt Holly Springs, P A 17065 .' --oATE--~ SlGNA1URE OF PREPARER OTHER THAN REPRESENTATIVE EdwardL. chorpp sg.u~)/1 .~j~~," ~-= ,/ ..,',/' '" =;~..//; ~-' ~t '" d~~ A""~' 7,..-",. ,.", --t~-'\..----., ..-~, '" .,... :,;-'~i./;:LJ' )t},,)-:-".:j:L,.: ...... ~j;!,:';; ? ..'K..... r/:,< ADDRESS DATE Ten East High Street Carlisle, PA \7013 ,:r; 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. !J9116 (a) (1.1 l {ill. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse (s 0% [72 P.S. 1$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 (rom a deceased child 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. S9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 45%, except as noted in 72 P ,So S9116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. S9116 (a) (1.3)J. 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. '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT .\ FILE NUMBER 21-2004-01121 ESTATE OF HECKMON, RAYMOND D. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ---r- , ITEM lVALUEATDATEO NUMBER DESCRIPTION ~ UNIT VALUE DEATH 1 400 shares common Bristol Myers Squibb (CUSIP 110122108) 9,683.00 24.2075 2 493.959 shares Dodge & Cox Balanced Fund (CUS1P 256201104) 78.86 38,953.61 3 528.797 shares Meridian Growth Fund (CUSIP 589619105) 36.88 19,50203 4 457.596 shares Meridian Value Fund (CUSIP 589619204) 41.50 18,990.23 5 11575.938 shares Van Kampen US Govt Fund-A (CUSIP 921129102) 13.95 161,484.34 ___---.--J_ _ TOTAL (Also enter on line 2, Recapitulation) 248,613.21 . ; .,; , , SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETUF<N RESIDENT DECEDENT ESTATE OF I FILE NUMBER ~---2l- 2004 - 01121 HECKMON, RAYMOND D. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I ErN Number of Personal Representative(s): Street Address City Year(s) Commission paid State _ Zip 2. Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Maxine R. Heckman Street Address 6 Mooreland AVenue City Mt. Holly Springs 3,500.00 Relationship of Claimant to Decedent State PA Spouse Zip 17065 4. Probate Fees Register afWills of Cumberland County 272.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Register of Wills, filing fee, inheritance tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) \ , I --r-- , I 3,787.00 REV.1S13 EX. {9.00~ ~ ~ SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT i I I L I FILE NUMBER I 21-2004-01121 ~~----= ESTATE OF HECK1vlON, RAYMOND D. I RELATIONSHIP TO I DECEDENT ~.r.u.sfPP("::1 Ispouse I I I I I NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) . Maxine R. Heckman 6 Mooreland A venue Mt. Holly Springs, P A 17065 Entire Residue Enter dollar amounts for distributions shown above on lines 15 through 1 B, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ------"--- -- --'-,--- --,,-'- -- ---' -'-----' ,,--- REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) Name of Decedent: RAYMOND D. HECKMON Date of Death: November 14,2004 File No. : 21-04-1121 Social Security No.: 181-12-1801 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 thefollowing: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No x [No accounting was necessary because spouse is sole beneficiary and Executrix of estate.] d. Copies of receipts, releases, joinders and approvals offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signature} hilfl10'i;. a . ~ Name:. Hillary A. ean, EsqUIre Address: MARTS ON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, PAl 70 13 (717) 243-3341 Counsel for personal representative c::) Co. Date:_ May 17,2005 FIFILESIDA T AFILEIEST A TESI I 0437.2.srep rJR