HomeMy WebLinkAbout06-06-13 (2) � 150561014Q
REV-1500 EX �°,-,°,
PA DepaRment Of RBVOnUe OFFICIAL USE ONLV
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 2 1 � 4 7
ENTER DECEDENT INFORMATION BELOW
SoCial SeCUfity Numbef Daie of Death MMDDVYYV DatB of Blrth MMDDVVYV
0 9 1 8 2 � 1 2 � 2 � 2 1 9 1 9
DecedenPs Last�Name Suffix DecedenPS First Name MI
H 0 Y M I L D R E D L
(It Applicable�Enter Surviving Spouse's Information Below
Spouse's Last Name SuKix Spouse's First Namr� MI
Spouse's Social;iecurity Number
THiS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� l. Original Return � 2 Supplemental Return � 3-Remainder Retum(data of death
prior to 12-13-82)
� 4. l,imited Estate � ba.Future Interest Compromise(tlate of � 5_ Federal Estate Tax Retum Required
death after 12-12-82)
Q 6. Oecedent Died Testate � 7. Decedent Maintained a Livinq Trust 1 EI. Total N�mber oi SaPe Deposi[Boxes
(Attach Copy o(Wllq (Attach Copy of Trusq
� 9_Lltigation Proceeds Received � 10. Spousal PoveRy Credlf(daCe of death � 1"-Election to tax under Sec.9913(A)
between 1231-91 and 1-1-95) (Attach Sch.-Q1
CORRESPONDENT-THIS SECTION MUST HE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL T,�INQFORMATION_SjI0UlR8 RECTED T0;
Name Day�me-.yelephone�.�lumb� <>
C'J _V, C r..
D A V I D H S T 0 N E , E S Q U I R E 7^� _7�� 7 `�= 4 =?7;:4 3 5
a n r
r-.�.�71 . �j-3 . !_...
',RBGI�PER OF WILL9 tYSE ONLY ��.
:=C r� -
f _ C".. --r _ � ��.
First line of address �� � � �
4 1 4 B R I D G E S T R E E T -r, `' � �' '
� N in <7
Second line of address � �
City Dr PoSt OffiCe StatB ZIP COde . _. DATE FlLED ..
N E W C: U M B E R L A N D P A 1 7 0 7 �
Correspondent'se-mai�address: DSTONEaSTONELAW • NET
Under penalties oi per��ry,I tleclare that I have examined this reWm,inclutling accompanying schetlules and slatements,antl to the best of my knowletlge and belief,
d�s ime,correct and complete Deciaration of preparer other than the personal representative is based on all information of which preparer has any knowletlge.
SIGNATURE OF PERSONg�S�PONS�IB�LE FOR FlUNG RETUg�N� � DATE
�,�'ld'l�rf/i.. K--�U 1 �l[ CC.(.�lfl1L �_.S . �.3
ORESS
744 CARO STR ET NEW CUMBERLAND PA 17�70
SIG R PAR R THERTHAN REPRESENTATNE / OATyE
t �c' -.J /..j
AD
414 BRIDGE� STREET NEW CUMBERLAND PA 17�70
PIEASE USE ORIGINAL FORM ONLY
Side 1
� 150561�14� 1505610140 � � t �
��
� 1505610240
REV-1500 EX
Decedenfs Social Security Number
oeceaenrs Name: M I L D R E D L . H 0 Y
RECAPITULATION
� Reai estace�scneawe n> . _ _ . . . _ _ . . . . _ _ . . . _ _ . . . . i. 1 0 0 0 0 0 , 0 0
z stocks and Bonds(scneduie B> . . . . z. 8 8 5 . 5 �
3. Closely Held Corporation, Partnership or Sole-Proprietorship(SChedule C) . . . . . 3. •
4. Morigages and Notes Receivable(SChedole D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. .
5. Cash. Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . 5. 8 3 4 9 , 3 9
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. •
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested . . . _ . __ 7. ,
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . B. 1 0 9 2 3 4 , 8 9
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 3 1 3 5 2 . 8 3
10. Debts of Decedent, Mortgage Liabilities, and Liens(SChedule I) . . . . . . . . . . . . . 10. � 9 4 3 . � �
�L 7ota� Deductions(tota� �ines 9 and �0) . . . . ��. 3 9 2 9 5 . 8 3
�2 Net Value of Estate(Line e minus Line 11) �2. 6 9 9 3 9 . 0 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been matle(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. ,
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . 14. 6 9 9 3 9 . � 6
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
atthe spousaltax rate, or
transfers under Sec. 9116
(a)(12)X • � � . � 0 15. � . 0 0
16. Amount of I_ine 14 taxable
at�inea�rate x • �45 6 9 9 3 9 . 0 6 �6 3 1 4 7 . 2 6
17. Amount of Line 14 taxable
at sibling rate X .12 � . � � 17. � . 0 Q
18. Amount of L.ine 14 taxable
at collateral rate X .15 � . 0 � �g, � . � 0
is. rnxoue _ _ . . _ . _ . . _ _ . _ . . _ . _ _ _ . _ . �s. 3 1 4 7 . 2 6
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610240 1505610240 J
REV-1500 EX Page 3 File Number
DecedenYs Complete Address: 21 12 1�47
DECEDENT'SNAME
MILDRED L • HOY
___ __ _--
STRFETADDRESS -�-� -� --�---
730 ELKW00D DRIVE
_ _ _.__
_ _ _ __ _ —_ ___ _ ___ _—
CITY STATE Z�p
NEW CUMBERLAND PA 17070-
Tax Payments and Credits:
�- TaxDue(Page2, �'me�9� (t) 3 ,147 • 26
2 Credlts/Payments
F PriorPaymenrs 3,500 • 00
B, Discount 157 • 36
TotalCredits(A�B) (2) 3,657 . 36
3. Interest
�3� a . o 0
4. If Line 2 is greater than L.ine 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 51� • 10
5. If Line 1 +Line 3 is greater�han Line 2,enter the difference,This is the TAX DUE. (5) � • 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 iransfer and�. Yes No
a. reta�n the use or income of�he proper(y trans(erred: ............................................................._....... ❑ Q
b. retain ihe right to designate who shall use the property transferred or i�s income: ............................... ❑ X❑
c. retainareversionaryinterestlor ..........................................._._................_............................_ ❑ �
d, receive the promise for life of either payments, benefits or care? ...................................._................. ❑ ❑X
2. If dealh occurred after December 12, 19&2,did decedent transfer property w�thin one year of death
withoutreceivingadequateconsideration? .......................................................__................._......._ � �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ._...... ❑ QX
4. Did decedent own an individual retirement account,annuity or other non-proba�e property,which
contains a beneficiary designation?....................................__.......................................................... ❑ ❑X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of tcansfers to or for the use of the surviving spouse is
3 percent[72 P.S. §9116(a)(1.1) (i)j.
For dates of death on or after Jan 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[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
fling a tax retum are still ap�licable even if the surviving spouse is the only benefciary.
For dates of death on or after Juty 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of aye or younger at dealh to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P S. §9116(a)(t2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal benefciaries is 4 5 percent,except as noted in
�2 P.s §siis�i2� ��2 P s. §s��s(a)(�)1.
• The lax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent[72 P.S. §9116(a)(1 3)].A sibling is defned, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EXt(12-12)
pennsylvania SCHEDULE A
�JEPARTMENTOFREVENUE
NHERirnNCETa;iREr�RN
REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MILDRED L - HOY 21 12 1047
All real property owned solety or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real propertythat is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if ihe property has been sold,
ITEM Include a copy of the deed showing decedenPs interest if ovmed as tenant in common. VAWE AT DATE
NUMBER OFDEATH
DESCRIPTION
1 • Property located at 730 Elkwood Dr New Cumberland , 100 , 0�0 . 00
Cumberland County , PA sold to Miro Gojmerac and
Rachel M . Eaton, jtwrs on September 28, 2012
_ TO7AL(Also enter on Line 1, RecapiWlation.) $ 100 ,0 0 0 • �0
If more space is needed,use additional sheets of paper of the same size.
Rev-i soa ex.�e-i z>
pennsylvania SCHEDULE B
DEPARTMENTOFREVENUE
�NHER�TAN�ET�xRET�RN STOCKS & BONDS
RESioENT�ECEOENT
ESTATE OF FILF NUMBER
MILDRED L • HOY 21 12 1047
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 • 28 shares MetLife Inc stock a �31 . 625 each 885 • 50
( Friday 11-16-12 average 531 . 31 , Monday 11-19-�2
average 531 • 94 )
TOTAL(Also enter on Line 2, Recapitulation) E 8 8 5 • 5 0
If more space is needed, insert additional sheets ot the same size
. _
REV�1508 E%�(OB-12)
pennsylvania SCHEDULE E
oePnRTMeNTOr-aeveNUe CASH, BANK DEPOSITS & MISC.
INHERITANCE TA;(RETURN
ResioENr�ECEnENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
MILDRED L - HOY 21 12 1047
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
!TEM VALUE AT DATE
NUMBER OESCRIPTION OF DEATH
1 • Cash on hand 280 • 00
2 Cumberland County-county reimbursement 100 • 00
3 Dunns-personal property sold 150 • 00
4 Homeowners Insurance refund 56 • 00
5 Life Insurance-premium refund 20 • 72
6 Medical insurance refund 489 . 07
7 PA American-refund on water service 34 • OS
8 PNC Bank-Checking Acct �514�030722 6 ,324 . 19
Princ • 56, 324 • 19, Int • S01
10 PNC Bank-Checking Acct �5140�30722 - Accrued Int 0 . 01
12 The Bridges-Reimb on living expenses 895 • 35
TOTAL(Also enter on Llne 5, Recapitulatlon) $ 8 ,3 4 9 • 3 9
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX*(10-09�
pennsylvania SCHEDULE H
oEPnarnnFNror aEVeNUe FUNERAL EXPENSES AND
wHERirnNCernxRETURN ADMINISTRATIVE COSTS
RESIDENT�ECEDENT
ESTATE OF FII.E NUMBER
MILDRED L • HOY 21 12 1047
Decedent's debts must 6e reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
Parthemore Funeral Home-funeral expenses 40 • �0
Fred Oppel-Reimb for Parthemore Funeral Home exp 10 ,846 • 52
Gingerich Memorials-stone 165 . 00
B. ADMINISTRATIVE COSTS�.
1. Perso�al Representative Commissions�,
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year�s)Commission Paitl:
2 . nnor�E:yFeeS David H Stone, Esquire 7,500 • 00
3. Pamily Exemption:Qf tlecedenTs address is not Ihe same as claimanfs,attach explanation.)
Claimant
Street Address
City State ZIP
Rela�ionship of ClaimaN to Decetlent
4 • Proba�e Fees S e e #3 b e l o w
5 . AccounlantFees:
6 • Tax ReWm Preparer Fees:
7 • PNC Bank-safety Deposit Box fee 20 • 0�
2 PNC Bank-withholding tax paid 0 . 07
3 Jennifer Raves-Reimb for probate costs 319 • 50
4 Stone LaFaver 8 Shekletski-Reimb for 2 adv 264 . 54
5 Stone LaFaver & Shekletski-Reimb for bank fee 20 - 00
6 William Raves III-Reimb on expenses 800 - 00
7 Settlement costs ($12508 • 39 less reimb $1304 . 41) 11 ,203 • 98
8 UGI-gas service at property 15 . 92
9 PPL-electric service at property 27 • 30
10 Register of Wills-filing Inh tax return 8 Inv 30 • 00
11 Reserve for closing expenses 100 . 00
TOTAL(Also enter on Line 9,RecapiWla�ion) $ 31 ,3 52 • 8 3
I(more space is neetled,use additional sheets of papei of Ihe same size.
NEV-1513 FX�(OL10;
pennsylvania SCHEDULE J
❑FPARTMENiOFREVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDEM DECEDEINT
ESTATE OF: FILE NUMBER:
MILDRED L • HOY' 21 12 1047
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME.4ND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee�s) OF ESTATE
� TAXABLE DISTRIBUTIONS pndude outrightspousal disiributions and hansters under
Sec.9116(a)(t2),]
1 • DENISE I_ OPPEL Lineal 34 ,969 . 53
441 N ENOLA DRIVE
ENOLA , PA 17025
2 . JENNIFER ANN RAVES Lineal 34 ,969 . 53
744 CAROL STREET
NEW CUMBERLAND , PA 17070
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
ll. NON-TFXABLE DISTRIBUTIONS,
A SPOUSAL DSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1 •
B.CHARITABLE=AND GOVERNMENTAL DISTRIBUTIONS:
1 •
TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use addltional sheets of paper of the same size.
�I ' +`-I15V!IOYmiltlxedA2-[]2
I!
i LAST WILL AND TESTAMENT
OF
MILDRED L. HOY
I, MILDRED L. HOY, of the Borough of New Cumberland, Cumberland
County, Pennsylvania, declare this to be my las1= wi11 and revoke any
wiL� previously made by me.
ITEM I : I direct that my Executrix hereinafter named shall pay
all my just debts and funeral expenses as soon as conveniently may be
done after my decease from the residue of my est;ate .
I'PEM II : I devise and bequeath all the re:;t, residue and
remainder of my estate of every nature and wherever situate, in equal
shares to my daughter, DENISE L. OPPEL, and my qranddaughter, JENNIFER
ANN RAVES .
ITEM III : I appoint my Executrix and her successors guardian of
any property which passes, either under this wi11 or otherwise, to a
minor xnd with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so, provided that this ap-
pointment of a guardian shall not supersede the right of any fiduciary
' in its discretion to distribute a share where possible to the minor or
� to anot.her for the minor ' s benefit . Such guardian sha11 have the
power to use principal as well as income from time to time for the
Page 1 of 2
_
II
minor ' s support and education (including college educaticn, both
graduate and undergraduate) without regard to his or her parent ' s
ability to provide for such support and education, or to make payment
for_ these purposes, without further responsibility, to the minor or to
the minor ' s parent or to any person taking care of the minor .
; ITEM IV: I appoint my granddaughter, JENN:CFER ANN RAVES,
Executrix of this my last will .
ITEM V: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of her duties in
' any jurisdiction .
IN WITNESS WHEREOF, I, MILDRED L. HOY, have hereunto set my hand
and seal this 13 day of � �-e�. „ 2009 .
— � �� ` ��,
' � ( G'� � r' c�_ "r� � ,
MILDRED L. HOY � '
SIGNED, SEALED, PUBLISHED and DECLARED by P�ILDRED L . HOY, the
Testatrix above named, as and for her Last Will and Testament, and in
the presence of us, who at her request, in her presence and in the
�
� presence of each other, have subscribed our names as witnesses .
��
�
� � (
� ! _ � C/L� i LLt/��e�.��s4„ ��o
es�.__ Address
� `}
k')P ��, �Uu,, U�A��'�_��
Wi.tnes:s Address �
Page 2 of 2
'I I
I
ZULF.�DHDU-IOV Mild�ed-730 ElkwmA Drivawpd
Tnx Parcel#: 26-24-0809-036.
Address: 730 Elkwood Drive
New Cumberland,PA 17070
DEED
�
TAIS INDENTURE made the Ls�'" day of ,)E��.f�CE� , in the year 2012,
between JENNIFER ANN RAVES, Executrix of the Last Will and Testament of MILDRED L.
HOY, late of the Borough oF New Cumberland, County of Cumberland, and Commonwealth of
Pennsylvania, of the first part, hereinafter called the Grantor,
- AND -
MIRO GOJMERAC and RACHEL M. EATON,joint tenants with right of survivorship,
of the second part, hereinafter called the Grantees;
WHEREAS, the said MILDRED L. HOY became in her lifetime seised, as of fee, of and
in a certain tract of land, together with the improvements thereon erected, situate in the Borough
of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, and more
particularly described hereinafter;and being so thereof seised,died on September 18,2012,having
first made her Last Will and Testament in writing dated September 13, 2004, duly probated and
registered in the Office of the Register of Wills of Cumberland County on September 25, 2012,
wherein and whereby she appointed as Executrix, the said JENNIFER ANN RAVES, to whom
]�etters Testamentary were duly issued by said Register of Wills on September 25, 2012, wherein
and whereby said premises hereinafter described were not specifically devised,all as in and by said
Will and the records of said Register of Wills, recourse thereunto being had, appears:
NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in
consideration ofthe sum of ONE HUNDRED THOUSAND and NO/100------($100,000.00)--------
Dollars, which has been paid to her by the said Grantees at or before the sealing and delivery
hereof,receipt whereof is hereby acknowledged,has granted,bargained,sold,aliened,released and
confirmed, and by these presents does grant,bargain, sell, alien, release and confirm unto the said
(Jrantees,
ALL THAT CERTAIN piece or parcel of land situate in the Borough of New
Cumberland, Cumberland County, Pennsylvania, bounded and described as follows, to wit:
BEGINNING at a point on the southern side of Fifteen and One-half Street, which point
is one hundred ten(110)feet East of the southeast corner of Locust Street and Fifreen and One-half
Street and at the dividing line between Lots Nos. 9 and 10, Block "B° on the Plan of Lots
hereinafter referred to;thence eastwardly along the southern line of Pifreen and One-half SYreet one
hundred one and seventy-two hundredths(101.72) feet to a point at the westem line of Lot No. 12,
I3lock "B' , on the Plan of Lots hereinafter referred to; thence southwardly along the western line
of Lot No. 12, Block "B" aforesaid, one hundred twenty (120) feeC to a point at the northem line
of Lot No. 45,Block"B", one the Plan of Lots hereinafrer referred to; thence westwardly along the
northern lines of Lots Nos. 45 and 46, Block "B" on the Plan of Lots hereinafter referred to one
hundred two and ninety-five hundredths (102.95) feet to a point at the western line of Lot No. 7,
-1-
Block"B",one the Flan of Lots hereinafter referred to; thence northwardly along the westem lines
of Lots Nos. 7, 8 and 9, Block"B" on the Plan of I..ots hereinafrer referred to one hundred tweoty
(120) feet to a point, being the place of BEGINNING.
BEING Lots Nos. 10 and 11,Block"B",on the revised Plan of Part oY Zimmerman Acres,
which Plan is recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Plan Book 4, Page 85.
HAVING THEREON ERECTED a dwelling known and numbered as 730 Elkwood
I)rive,New Cumberland, Pennsylvania.
BEING the same premises which Elmer E. Zimmerman and Elizabeth R. Zimmerman,his
wife, by Deed dated November 16, 1950, and recorded November 16, 1950, in the Office of the
Recorder of Deeds of Cumberland County in Deed Book 14,Volume"M", Page 460, granted and
conveyed unto Charles F.Hoy and Mildred L.Hoy,his wife. Chazles F. Hoy died on December 25,
1990, thus by operation of law vesting title in A4ildred L. Hoy, deceased.
TOGETHER with all and singular the buildings, improvements, ways, streets, alleys,
passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances
whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders,
rents,issues and profits thereof,and all the estate,right,title, interest,property,claim and demand
whatsoever of her,the said MILDRED L.HOY,at and immediately before the time of her decease,
in law, equity, or otherwise howsoever, of, in, to or out of the same.
TO HAVE AND TO HOLD the said lot or piece of ground above described, with the
buildings and improvements thereon erected, hereditaments and premises hereby granted or
mentioned, and intended so to be, with the appurtenances unto the said Grantees, to and for the
only proper use and behoof of the said Grantees, forever.
AND the said Grantor, for herself and her respective heirs, executors and administrators,
does covenant, promise and agree to and with the said Grantees,their heirs and assigns, that she,
the said Grantor,has not heretofore done or committed any act,matter or thing whatsoever whereby
the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or
encumbered in title, charge, estate or otherwise howsoever.
IN WITNESS WHEREOF, the said Grantor has l�ereunto set her hand and seal the day
��nd yeaz first above written.
Signed, Sealed, and Delivered
in the Presence of .
_7�+,�-�1" 1 _WI N f � (SEAL)
Witness . , _NN[--1��TdN RAVES, Executrix ofthe
Last Will and "Cestament of MILDRED L. HOY
-2-
COMMONWEALTH OF PENNSYLVANIA .
: SS:
COUNTY OF :
On this, the day of , 2012,before me a Notary Public, the undersigned
officer,personally appeared JENNIFER ANN RAVES,Executrix ofthe Last Will and Testament
of MILD2ZED L. HOY, known to me or satisfactorily proven to be the person whose naine is
subscribed to the within instrument,and acknowledged that she executed the same for the purposes
therein contained.
IN WIT'NESS WHEREOF, I have hereto set my hand and notarial seal.
Notary Public
I hereby certify that the precise address of the Grantees is � � 7 S • 5� �T' .
_�Q._l�w. r Pr� �1 l�3
Q �,I /
DATE: � 2 S � 2. ,i.,�(.+�. �
At orn for C„���f
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uec. G. [UiL L : 47r!w riu� nank � - � � iuo. LD� I r. I
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October I1, 2012
David H Stone Esq. _
Stone Lafaver & Shekletski
414 Bridge St
POBoxE
New Cumberland,PA 17070
TtE: Mildred L Hoy
SSN:
b011: 09-18-2012
Deax Ivlr. Stone:
Tn response to your request for Date of beath(DOT)) balances for the customer noted above, our
records show the following:
Checking Account
Accouut# 5140030722 Established: 10-01-1963
MII.DR�D L HOY
DOD balance: $ 6,324.19 +p.01 accrued inurest
Inurest paid 01-01-2012 thru 09-18-2012 $ 1.06 YTb
Safe Deposit Box
The decedent maintained safe deposit box#463
MTLDILED L HOY
Located at:
Cedar Cliff Mall
1104 Cazlisle
Camp Hill, PA 17011
(717) 76l-3180
Please note that this office provides date of death balences for deposit accounts (IRAs, CDs,Chccking and
Savings). We do not process any financial transactions or provide statements. Tf you need essistance wirh
any ofthese itcros,please call 1-888-PNGBANK(1-888-762-2265)or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Ban1S N.A.
Member FDTC
Page 1 of 2
Jec. 6. Z011 1 :43NM YNt; 6a�k No, Lbll r• [
This message is intended for the use of the individual or enrity ro which it is oddressed and may
contain information thar is privileged, confidenrial and exempt from disclosure under applicable law.
If the reader of this message is nor the intended recipient or the employee or agent responsibde for
delivering this message to the intended recipient,you cxre hereby notified that arry disseminarion,
distribution or copying of this communications is sYrictly prohibrted. If you have received rhis
communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this fared document
Page 2 of 2
� r 485�0041046
REV-485 EX(OS-04)
SAFE DEPOSIT
BOXINVENTORY
PADepartmenlolRevenue PLEASE USE ORIGINAL FORM ONLY
Social
09/18/2012 21 12 1047
Decetlenfs Last Name SuRix First Name MI
Hoy Mildred L
�ADDRESS OF DECEDENT STREET� GTV�. STATE�. ZIP CODE.
730 Elkwood Drive New Cumberland PA 17070
NAME ANO ADDRE55 OF PERSON RE�UESTING iNE OPENING OF TME SAFE DEPOSIT BOX
NAME David H Stone, Esquire _
_ __— -- — _ _ _ __ —_ _ -- -- ---
STREETAGDRESS� CITY STFTE ZIPCODE:
414 Brid e Street New Cumberland PA 17070
NAME,ADORE55 AND RELATIONSNIP�IF ANY)TO DECEDENT,OF PERSON�S)PRESENT AT THE BOX OPENING
a. NAME RELATIONSHIP�.
Jennifer Ann Raves �randdaughter_ _
_ ___ _ _ _ - -
sraeernooaess cirv ��- srAre ziacooe.
744 Carol Street New Cumberland PA 17070
_ __ _
b. vAME ____._ .._. __..._.._._
RELATIONSMIP�
._ .. --. ___ __. ...___.
STREET AODRE55� �� CITV � STATE ZIV CODE�
. .. ... . . ____. _ .
c NAME . . ___._ . _ . _. _._ . _ . .____ .___ ..
RELATIONSHIP�.
_ .._.. .__ .. _.. .__. .. . .._.____ . _____._. . _ .__ -_
iIREETA�DRE55 CITV $TATE � ZIPCO�E
NAME ANO ADORESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BO%IS LOCATED
NAME
PNC Bank
- _ - - _ - - -- _
STREET ADDRESS. �� CITY STATE ZIP CODE.
1104 Carlisle Road Cam Hill PA 17011
. NAME OF iERSON MAKING LAST ENTRV DATE ANO TIME OF LAST ENTRY
Jennifer Ann Raves 9/25/12 0:00 am
DATE OF CONTRACT TO RENT BOX NUMBEA OF 80% 1 TITLE UNDER WHICH BOX IS REQUESTED
02/16/1987 i 463 Mildred L. Hoy
�NAME ANO ADDRE55 OF PERSON�S)HAVING ACCESS TO BOX
a. NAME b. NAME.
Mildred L Hoy _ I Jennifer_Ann Raves
- - - _ _ __
STREET4DDRESS I� STREETADDRESS.
730 Elkwood Drive 744 Carol Street
_ - - - _ _ _ _ _ — - __ .__
C11V STATE ZIPCODE CITV � STATE� ZIPCODE
New Cumberland PA 17070 New Cumberland PA 17070
NAME ANO TITLE OF EMPLOVEE TAKING THE INVENTORV
Schuyler Helm, fnancial sales consultant
WAS A WLLL IN THE BO%7 G �ES Q NO ❑yes, a. Date o/will:
. _. .._. .- ..- ___ - ___ ._ _. . .-_ ._-___
b. Name and addresa o/per�onal rapresentative,It named in iha will
NAME
-.___ _ .._. __-___. ..... . . .-___... _.___ _-_.__
STREET ADDRE55 GTV � �� STATE� � ZIP CO�E
._ . . _ -__ _.. _. _.. _...
. .. ._ . _. .__ ... .._. _. _.. _._._- -..
c. Nama an�atltlreas of attorney,i�any '
NAME
. .. . . ._-___.'_. _____-_-__ _ _.. . ___ _...__ . .__... - _ - _ .._.. ._"'_ .. - _.
S1REE1/ADDNE55 CIiV�. STATE ZIPCODE.
L 4850�041046 48500041046 J
�ME AND ADDRESS OF PERSON S HAVING ACCESS TO BOX...cont...
' c. NAME:
� Denise L. Oppel ,
I STREET ADDRESS:
I 441 N. Enola Drive
I�CITY: STATE: 21P CODE: I
Enola PA 17025 �
� �I _ �
� REV-485 EX
SAFE DEPOSIT BOX INVENTORY Pa9e _-____ of . ___
INSTRUCTIONS
I (1) Cash: Report�otal only.
(2) Stocks: List in detail every common or preferred certifcate,warrant or ofher rights found in box.S�ocks are to be designated by
'� name of company,certifcale number,date o/cerlilwte,name in which slock is registered,and number of shares and class o(stock.
I, (3) 061igations of U.S.GovernmenL Number o(items,date of issue,face value, names in which registered and type of ownership,
i.e.,jointly held, Oayable on tleath,etc.
I (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) i
i� (5) Bank and Savings and Loan Passbooks: State name of deposibr, num6er of book, last tla�e appearing in book,name ot bank
'�� antl branch.antl balance.
II (6) Jewelry, Coins,Stamps, Manuscripts,elc: List and describe as(ully as possible.
�� (7) Deeds,Mortgages,Current Insurance Policies or olher evidances of indebtedness: List and describe as fully as Oossible.
�I (8) A�I other contents.
�' (9) Return Comple�Ed fO�m l0: �EPARTMENT OF REVENUE
', INMERITANCE TA7(UIVISION
'� DEPT.280601
HARRISBURG,PA 17128-0601
r INO I ITEM�ESCRIPTION i
. . ._ .. . . _ _.. _—_ ..._ . .. .__ - _ . _ __. _ __.___ __._ _ -____ _ __..._. . .___. . i
1 � personal papenvork �
__. . _ . ..__ . . ______ . . . -- -___- _--.__- ___. .. .. . . . . .._ _ __ ._- ...
I . . '�. . . __.. . . . . __. . . __ __ ._. ._ ._... .. . . . . ... . _ _. . . .. . .. . _. .___ ....
II .. . . ___---- . ._. ..�. ..-._ .___ __. ___. .. ---_ __ _ . .. . _ _.
�. .__... ._. _--.___. ._ __ _ .. _ _ .. . _ . .. .. .___. _. _ . . ._- ---- ��
.. _. . ._. . .. . . . ...___.
I .. .- .. --. _.-.- ----- --- -- -- .- _ .._ ...._-�
�
-� - - �- -. _ _. __ j
. .I . . . . ._ ____..___ _ _ . . . ... _._ _. __.. .____.._ _-_____ __._- __ .-_-_-__--� �
. . i . . _.. ._. _ .. . _. -- -_..__ _ __.._.__ _..___. .. ____ . ..___ .__._ .. __. ___..
. ,� .. . . _ . - �- - -----_ . .. ... .. . .. _ . . . .._. . .
... � ._ .__ _ ..... _.. .
�i I CERTIF>I UNDER PENAC OF EXJUR 7HAT THE ABOVE RECORD IS PERSON RECEIVING COPV OF
� CORR AR6 L'QRIP TE 1'O 11ME B�5 OF MV KNOWLEDGE AND BELIEF. SAiE DEPOSIT BOX INVENTORV:
F9GNM RE , '� \ SIGNATURE I
_ _ . °_-� -_. _ _ ----- -- -- -- �
I PRwTNnME PRiNTNnMEANOCHECKAPPROPRiATE80%BELOW. �� ,
David H. Stone, Esqwre _ __ _ �'
___ - - -- --- --- ---_ _ __ __--- -- -
� PRINiTIT�E DAiE CHECKAPPROPRIATE90x. .
I
Attorney for Estate of Mildred L. Hoy i -� ❑^E"eLU`��°�"� ❑�1em����1B1O,�""�
�, . u Eslate RepresentaLVe �Joinl owne!ol sale tleposi�em
'� NOTE: Attach additional 8'h" x 11" sheet(s) if necessary or use duplicates of this page of form.
�The DeDatlment is aul�orized hy law,42 U.SL.§405(c)(2)(C)�i),to require disclosure ol Social Secunty numbers in wnnection with administenng slate tax laws.the OeDarlment uses Ihe
Soc�al Seariry number to identrty Ne tlecedent antl personal representatives of Ne estate.The Commonwealth may also use ihe information in exchange o�Wx informalion agreemenls i
with Federal and local laxing authonties.The stale law pmhibits ihe Commonwealt�'s personnel hom disdosing confdenlial lax information except Por oRicial Duryoses.
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STONE LnFAVEA & SHEKLETSKI
ATTORNEVS AT LAW
414 BRIDGE STREET
DAVID H. STONE POST OFFICE BOX E OF COUNSEL
GERALD J.SHEKLETSKI NEW CuMHERi.wxb. PA 17070 CHARLES H.STONE
www.stonelawnet .10N F. LwFAVER
TELEPHONE pl])774-']435
JUne 'S � 2�13 FACSIMILE 017)774-3868
RegistEr of WilZs Office
Cumberl.and County Courthouse
1 Courthouse Square
Carlisl.e, PA 17013-3887
RE: Estate of Mildred L. Hoy
No. 21-12-1047
Greetings :
Enclosed please find an original and one copy of the Inheritance
Tax Return and Inventory for the above mentioned estate . Please
clock :in the copy of the Inventory and send it back to my office
along with any receipts in the enclosed stamp addressed envelope .
A:Lso, enclosed is check #3267 in the amount of $30 . 00 for filing
the rerurn and inventory.
Should you have any questions, please do not hesitate to contact
my office.
Very truly yours,
STONE LaFA�F!ER & SHEKLETSKI
, ' '�'`.,� I
1: '
� �,. �
Da�zd �H.'�St ne`
DHS/tmb
Enclosures
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