HomeMy WebLinkAbout02-1112PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~ ~~ ~ ~~,~ ~ ct No. ~~ U oZ - /~ / ~
also known as
~ ~~ To:
---' Register of Wills for the
Social Security No. ~ Deceased. County of C;(,~ ~.L.~+~,~~
" in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut Q~X
in the last will of the above decedent, dated X4-,0 ^ ,1 ,~f ~~ q~ named
and codicil(s) dated 1s'1f' ~} , 19.E
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~ JA.eJ~'s~'1{.~v~
last family or principal residence at County, Pennsylvania with
(list street, number and muncipality)
1ecendent, then __~' ~ ~
at ~„ t vz ;~ Years of age, died ~v' D ~w1 I?zk~- ~~ , 19 ~ ~ ~
~, ~ 1~-~"f~ ~- c-~~ >
Except as follows, decedPn~ 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:
Decendent 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 real estate in P nnsylvania
situated as follows: "~ -} J -
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '-
theron. (testamentary; ad nistration c.t.a.; administration d.b.n.c.t.a.)
~~~~
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF ~ y ~t,~~2y~,.~,)
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the hest of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above deredert petitioner(s) will well and truly administer the esthte according to law.
Sworn to or of 'rm~d and subscribed ~_ G',l/j~,,.Q~'~~C~ ~ ~~ ~,~,~ ~~,~i
be a me this ~-~ day of
~~
-- A
~.
~J~e~ e aster ~
/~ /O~- 7
No. ~o~ - l~i~/
Estate of ,Deceased
DECK E OF PROBATE AND GRANT OF LETTERS
ATTORNEY (Sup. Cr. LD. No.)
AND NOW Q~~~2:P~rrz~.~~ ~ ~~~J in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
and Letters
are hereby a to
FEES od
Probate, Letters, Etc.......... ~o~~`
Shin,~ertificates( ) .......... ~~,0°
G~G@~ ~ LO• o ~
TOTAL ~,~~
Filed ~~ -g -cJ,~J .................... .
,~aegister o
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N OV 1 5 2002
+3 Hev ve? COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
~'
,,Ruth Irene Baney SE% SOCIAL SECURITY NUMBER DATE OF DEATH ,MCnm, Day. 'read
Female
186
05
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ast Bktno.,yl UNDER ~ YEAR UNDER 1 DAY DATE OF BIRTH BIRTHPLACE (CAN arA .
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PLACE OF DEATH rCnec„ om
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Months Days Hours MkIpIM v'rearl Swta«FCre~yn Counoylr~
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HOSPrtAL:
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81 "_ ~'eb12, 1921 uniata Count
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COUNTY OF DEAfH CITY, BORO, TWP OF DEATH FACILfTY NAME III nor ,nv~Ntan, gwe seeet and umUer, WA$ DECEDENT OF HISPANIC ORIGIN?
RACE - Ame
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Cumberland East Pennsboro T ~ /
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DECEDENT'S USUAL OCCUPRION
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KIND OF BUSINESS/INDUSTRY WAS DE EDENT EVER IN
(Give bnd of work done «uag rtgsl U.S. ARMED FORCES? t0•
DECEDENT'S EDUCATION MARITAL STATUS-Named SURVIVING SPOUSE
5
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o/workug life; do n«use rekredl Alsedek I S Elem
Waitress Y•=^ ^b~ i on
,
all tads ctxn red Never Marr,W, Widowed. III wAe. ~,ve ma,den namel
enurylSecondary CoWge Dworc•d (SpeaNl
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t~•- „h.Restaurant „- „ roil ,ta«s.l idowed
IECEDENT'$ MAILING ADDRESS (Buser. CsyROwn. Slate, Zip Coder DECEDENT'S s.
316 Third Street ACTUAL 17s. Stab Did ,Ta^ w.
deceMn IivW in
RESIDENCE
New Cumberland, PA 17070 0~0'^="~'~ ,
deceeam twD
live at.
rnervde, Cumberlan
t=- 17h. Coon d townanip? No,axewnlGwd New Cumberland
tTd
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FATHER'S NAME irirsl. Midas Last) .
wenm atlualNmna of
c„ypoyp
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Harry E i c hma n MOTHER
S NAME tFrst. M,tldle. Madan Surname)
,s Rebecca Elscesser
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INFOR NT'$NAME (ty Prinq
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INF T'$ AILINGA DRESS
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N .519Ie Zip Code)
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METHOD OF DISPOSITION DATE
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z
,
~ewisberry, PA 17339
O
DISPOSITION
^ (MOnlh. Day
Year)
Burial ^ Cremation ® R
l I PLACE OF DISPOSITION • Nart,e of Cemetery, Crematory LOCATION -Ciryrtown, SIaN. Lp Code
O
h
P
.
emova
rom Slate
Ooneliort^ aner(SOecMt ^ ovember 19,2002
xle. 21h or
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on-o-Cite Crematory Schaefferstown
PA 17088
,
SIGN OF FUNERAL R ICE LICENSEE R PE ACTING AS H LICENSE N M
O ~ f~3
C ,
x,e. 210.
NAME ANO ADDRESS OF FACILITY
42-L
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ori~-: ~_ Stone&MurrayFH408 3rd St New Cumberlan A
Co items 23a<only wMn rsrtiying Tot y krowledge, death occurred at the ume, data and ace stated.
pn a nor avasahle al Ume of dean to ~
1 atur Tnlel xxe.
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LICENSE NUMBER
DATE SIGNED
e Iry cause of death.
-
2 (MOnm, Day, Year)
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hams 20-28 moat M completed by TIME OF DEATH DATE PRONOUNCED DEAD IMOnm. Day.
zl pnraon woo proraunces deem.
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es or complicalans which Gused the death. rqI sorer the mode of dying, such as caraac «respuatory arrest, sMCk or risen tadure. i A
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i
IMMEDIATE CAUSE (Final n r,~ n~y~, /
n.sease«conaeon a C. VL/v l--y ~ jY- I II C 1~ f (~
esuumg n deaml ---
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nlenal hNWMn n« resuXGtg in tM urtderlytrtg cause given n PART I.
t onset arM deem
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t any, kuding b ,mmediale OUE TO (OR A$ A CONSEQUENCE OF):
cause. Enter UNDERLYING
CAUSE(D,sease rx ,nWry c.
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trat maiale0 evems DUE TO (OR AS A CONSEQUENCE OF)~
~•,esuN,r,g n oeaml UST
0
WAS AN AUIOPSV WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
i~~lH PERFORME07 AVAILABLE PRIOR TO
(MOnm. Day,
COMPLETION OF CAUSE .
vearl
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OF DEATH? Natural ® Hom,ciW
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'~ AccWenl ^ Pend,ng lnvesrigatian ^
Yea ^ No^
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a«ory, otlice LOCATION (Street. GN?own. State)
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CERTIFIER ICnai-k unN oral 3a.
'CERTIFYING PHYSICIAN (Ph s,c,an cen,l m
y y g cause of deans when anomer phys,C,an has prpnpur`.Cetl deem ano c«np,eled !tam 231
~~ To me Wet of my knowktdge
denh xcurrad d
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l SIGNATIf~E///,,,ND TITLEF. 9F CERTIFIER
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'PRONOUNCING AND CERTIFYING PHYSICIAN IPhys,can bom pronouncing deem antl cenAy,nq to cause of tlealnl
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my knowledge, death occurred at me Ilme, date, and place, and due to the cause(s) and manner aastated .......... ~ ~
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'MEDICAL EXAMINER/CORONER _
NAME AND ADDRESS OF pjERSgN WHO COMPLETED CAU OFD TH ^
(Item 2/) Type or Print (-
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On the heaia of eaaminatlon and/or investigation, in my opinion, death occurred at the lime, date, and lace, and due to the cause(s) and A -J7 nl p
J 1 ~^ Y1 /+ L~ p
~
31amenner as slated ............. .P......................
............................ ........... ........... ......
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XS~ RAR 5 SI` ~ MBER DATE FILED (MOnm. Day. year)
3e.
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~z~t ~iI1 ~zn~ (7~ P~Y~zmPnt
~ IT 74~T
I, R[JTH IRENE BANEY, of the (:ounty of (:umberland and
commonwealth of Pennsylvania, being of sound mind, memory and
understanding, do make, publish and declare this to be my
LAST WILL and TESTAPiENT, hereby revoking and making null and
void any and all Wills and (;odicils, or writings in the
nature thereof, at arty time heretofore made by me.
1. As my personal representative, I appoint my daughter,
(:C)NNIE PiAE WILLIAPSS()N, to be the Executrix of my Last Will.
2. I d~.rect that my funeral anc~ burial expenses, and my just
debts, be paid from my estate as part of the administration
of my e~:tate.
3. I direct that all taxes assessed and payable because of
mlr death, be paid from my r~asiduary estate as part of the
administration of m;f estate.
4. For all purposes of this Last ~9i11, ::ny Estate shall mean
and include all real and personal property of any kind and
every nature whatsoever, wherever siwuate, in which I may
have ~;ny interest at the time Jf my death, including <3ny
property over wh~.ch I may have power of ap~•ointment.
~~
~`
5. I give, devise and bequeath all of my Estate, in equal
shares to my son, HARVEY E. BANEY, and my daughter, (:ONNIE
PSAE tidILLIAPiSON, if they survive me, but if either one fails
to survive me, then all to the survivor.
6. If any legatee, beneficiary or devisee, shall fail to
survive me by thirty (30) days, I direct that I shall be
deemed to have survived such legatee, beneficiary or devisee
and that this Last Will and all its provisions, except where
specifically stated otherwise, shall be construed on this
assumption notwithstanding the provisions of any law
establishing a contrary presumption.
7. I direct that no Executor or Guardian appointed by this
Last Will shall be required to give any bond, notwithstanding
any provision of law to the contrary; but if any bond shall
be necessary no sureties shall be required.
8. ti~dhenever any Personal Representative or fiduciary
nominated and appointed by the provisions of this Last Will
need legal counsel or advice concerning the administration of
my estate or the provisions of this Last Will, it is my
preference that Albert Z. Bogert, Esquire, be consulted, if
he survives me, he having intimate knowledge of my affairs,
views and wishes in matters concerning my estate.
IN WITNESS WHEREOF, I have subscribed my name and
affixed my seal this ~ day of ~~ ~ ,1998.
~,/
Ruth Irene Baney
A(;KNUWLEDGPiENT
(; OritsUNWEALTH OF PENNSYLVANIA
SS:
(;OIJNTY OF (;Ur2BERLAND
I, RUTH IRENE BANEY, Testatrix, whose name is signed
to the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my LAST WILL, that I
signed it willingly and that I signed it as my free and
voluntary act for the purposes therein expressed.
Ruth Irene-Baney
Sworn or affirmed to and acknowledged before me by Ruth Irene
Baney, Testatrix, this ~x ~'~ day of a. 1998.
/ /~/{ , 4~j /~/~
`sr/I}`Jl,~.. 'r.., l ~/ / ~.. NYC. CtiC ~~~ ~~~%[.-f,
Notar Public
Notarial Seal
Lisa M. Ledebohm, Notary Publ+c
New Cumberland Boro, Cumberland County
A F F I D A V I T My Commission Expires July 20, 1998
Member, Pennsylvania AseodAtion of Notaries
(; Ops>!4ONWEALTH OF PENNSYLVANIA
SS:
(;O[lNTY OF (;(Jr'lBERLAND
We , Albert Z . Bogert , Esq . and ~~Ft~~ ~~' I2la~ ~ ` < <' Qrvl.~L'll ~ the
witnesses whose names are signed to the attached or foregoing
instrument being duly qualified according to law, do depose
and say that we were present and saw the Testatrix sign and
execute the instrument as her LAST WILL, that Ruth Irene
Baney signed willingly and that she executed it as her free
and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testatrix signed
the Will as witnesses and that to the best of our knowledge,
the Testatrix was at the time eighteen (18 ). years or more of
age, of sound mind and under no constraint or undue
influence.
~'~ c
~,
ST
Sworn or affirmed to and acknowledged before me thisx~l day
of ~ ^ ~~ 1998 .
~ ~ ~~~ ~2~ ~ ~ ~~ ~l~~~
Notar Public
Notarial Seal
Lisa M. Ledebohm, Notary Public
New Cumberland eoro, Cumberland County
My Commission Expires July 20, 1998
AAernber, perr~sytvartiaiLssoaerbon of t~lotati6es
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(al
1 ~~~ ~~~ ~~, ~~
Date of Death: N ~ JC~~ ~J~`- ~~~ ~ C~ ~!
Will No. ~'Zy y~ ~~ ~ ~ ~ ~ 1 ~ Admin. No. ~~ ~ 7 ~ ~L . ~~ ~ ~ ,~,' ~ ~ ~ rJ~
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a of the Orp eans~Cou~rt R~ul~was
served on or mailed to the following beneficiaries of the above-captioned estate on _ ~ .,
Name Address
., ~~
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N~~'
Date: r ~J~-~ \~C ~ ~ ~ {~ Q'~
Signature '~.,~ i`~ r ~, ,
Name ~~~ ~ 1 '~~ V t-1''~' ~~ ~~~
L_
n
Address ~ ~ -~ ~ ~S ~~T'~ ~ '~ ? L ~' ~. ~- ?`~'/'_'~/
~!
~ s
Telephone (117) ~~-~c~_ ~~~-j,
Capacity: Personal Representative
.Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
HAVAS JOHN ESQ
101 PINE ST
P O BOX 932
HARRISBURG, PA 17101
fold
ESTATE INFORMATION:
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SSN: 186-05-4990
2102-1112
BANEY RUTH IRENE
06/27/2003
00/00/0000
CUMBERLAND
11/15/2002
ACN
ASSESSMENT
CONTROL
NUMBER
N0. CD 002748
AMOUNT
TOTAL AMOUNT PAID:
REMARKS: JOHN HAVAS ESQUIRE
SEAL
CHECK#108
INITIALS: JA
RECEIVED BY:
58,979.93
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REV-1162 EX(11-961
TAXPAYER
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
N0. CD 002748
HAVAS JOHN ESQ
101 PINE ST
P O BOX 932
HARRISBURG, PA 17101
fold
ESTATE INFORMATION: ssN: ~ as-o5-nsso
FILE NUMBER: 2102-1 1 12
DECEDENT NAME: BANEY RUTH IRENE
DATE OF PAYMENT: 06/27/2003
POSTMARK DATE: OO/00/OOOO
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 5/2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 58,979.93
TOTAL AMOUNT PAID:
REMARKS: JOHN HAVAS ESQUIRE
CHECK#108
SEAL
INITIALS: JA
RECEIVED BY: DONNA M. OTTO
REV-1162 EX111-96)
58,979.93
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 002952
HAVAS JOHN ESQUIRE
6121 STEPHENS CROSSING
MECHANICSBURG, PA 17050
told
ESTATE INFORMATION: SsN: ass-o5-4990
FILE NUMBER: 2102-1 1 12
DECEDENT NAME: BANEY RUTH IRENE
DATE OF PAYMENT: 08/28/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 5/2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 5416.00
TOTAL AMOUNT PAID:
REMARKS: JOHN HAVAS ESQUIRE
CHECK#115
INITIALS: JA
5416.00
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV-ia'~ ~X f6-88)
PUREAiJ OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIDN
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 E% AFP (O1-OS)
DATE 08-11-2003
ESTATE OF BANEY RUTH I
DATE OF DEATH 11-15-2002
FILE NUMBER 21 02-1112
~!.".r .~ {~' ~~ COUNTY CUMBERLAND
JOHN HAVAS ESQ - ACN 101
6121 STEPHENS CROSSING
MECHANICSBURG PA 17050 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER POR_TION_ FOR YOUR RECORDS ~ _
--------------------------------------------------------
-----------------
REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BANEY RUTH I FILE N0. 21 02-1112 ACN 101 DATE 08-11-2003
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Totai Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 22,996.96
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions
(11) .996 96
12. Net Value of Tax Return (12) 208, 779.28
13. Charitable/Governmental Bequests; Nonelected 9113 Trus ts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 208, 779.28
NOTE: if an assessment was issued previously, lines
reflect figures that includ
th
t 14, 15 andior 16, 17, 18 and 19 will
e
e
otal of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 208,779.28 X 045. 9,395.07
17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due (iq)= 9
395
07
TAX CRE1fiTC• ,
.
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
06-27-2003 CD002748 .00 8,979.93
TAITFDCCT Tc f`uAOrr}~ runnur~n
- - -- ---•----~~ ....~vv.• vv ~V LVVJ
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 8,979.93
BALANCE OF TAX DUE 415.14
INTEREST AND PEN. .63
TOTAL DUE 415.77
(1) 75 ,000.00 NOTE: To insure proper
(2) 102 .122.72 credit to your account,
(3) .00 submit the upper portion
(4) .00 of this form with your
(5) 29. 802.49 tax payment.
(6) 16. 268.51
(7) 8. 582.49
(8) 231,776.21
Bl"nEAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
~rl~ C ~~
~ C ~: ~~
~~ X07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
6121 STEPHENS CROSSING
MECHANICSBURG PA 17050
V
REV-1547 EX AFP c01-OS1
DATE 08-11-2003
ESTATE OF BANEY RUTH I
DATE OF DEATH 11-15-2002
FILE NUMBER 21 02-1112
,:-i COUNTY CUMBERLAND
ACN 101
Anount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _
REV-1547 EX AFP (Ol-03j NOTICE OF INHERITANCE T~iX AFPitAISEMENT, ALLOMiANCE OR ------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BANEY RUTH I FILE N0. 21 02-1112 ACN 101 narE 08-11-~nn~
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 7 5 000.00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2)_ 102,122.72 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fore with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)_ 29,802.49 tax payment.
6. Jointly Owned Property (Schedule F) (6) 16268.51
7. Transfers (Schedule G) (7) 8 , 582.49
8. Total Assets (g) 231,776.21
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 22,996.96
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) - ?_7.996.96
12. Net Value of Tax Return (12) 208, 779.28
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 208,779.28
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 _ .00
16. Anount of Line 14 taxable at Lineal/Class A rate (16) 208, 779 • 28 X 045 . 9, 395.07
17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due (lq)= 9,395.07
TAX CREDITS•
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
06-27-2003
T\IT L'nrl•T Tn CD002748 .00 8,979.93
-•.~.•~... ~v v..r,.~v jai ,III~VVVII VV-LV-LUUJ
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 8,979.93
BALANCE OF TAX DUE 415.14
INTEREST AND PEN. .63
TOTAL DUE 415.77
^ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE STnF nF rurc rnom rno T\IC T O11nTTnun ,
RF~~ .' 'J cX (6-88)
Y~ ~ INHERITANCE TAX
~,
~~ ~{~"' EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
RUTH I BANEY 2102-1112
REVIEWED BY ACN
John Kealy 101
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
F 2 Changed percent taxable to 100%. The account was not jointly owned but was held by the
decedent "In Trust For" her children.
G 1 "In Trust For" accounts are fully taxable with no $3,000 exclusion allowed, see Section
2107(c) (7) of the Inheritance Tax Act of 1991.
ORIGINAL Page 1
1 ~~la?- ~ COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601 INHERITANCE TAX
HARRISBURG, PA 17128-0601
STATEMENT OF ACCOUNT
REY-1607 EX ~FP (O1-Y3)
JOHN HAVAS ESQ "" ~' '
6121 STEPHENS CROSSING
MECHANICSBURG PA 17050
DATE 09-08-2003
ESTATE OF BANEY RUTH I
DATE OF DEATH 11-15-2002
FILE NUMBER 21 02-1112
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1607 EX AFP (01-03) ~** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF BANEY RUTH I FILE N0. 21 02-1112 ACN 101 DATE 09-08-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-11-2003
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
9,395.07
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
06-27-2003 CD002748 .00 8,979.93
08-28-2003 CD002952 .74- 416.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST. l
( IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YoU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
9,395.19
.12CR
.00
.12CR
'EV-1500EX(li.'lO)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPl 280601
HARRISBURG, PA 17128.0001
~
REV-1500 :r
11- \0."'-,
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFHClAL use ~JNLY
FILE NUMBER
c?u;TYck, - 4EAf- () Jsi- L:b
SOCIAL SECURITY NUMBER
//{b - oS - 4-910
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dateD/death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11, Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME
vAS
FIRM NAME \11 App\icable)
COMPLETE MAILING ADDRESS .
Jorit'V \-\.4-vVl-5 r=- S Q\J'~
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(; 1J..-~ Sie./tlvV'5 C.<t.D SS/Mj
Me.. C)-t*MC.sI?Jt2-6; f'rf, I 7 D.!,~
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(14 7 Gj DOO ,00
(2) ItQ:J..j J .J-".J., 7J-
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(B) ( )..;)..)-( 00'/,
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~1,OriginaIReturn
o 4. Limited Estate
o 6. Decedent Died Testate (i\.\tacl\CIJ~~o!Wi!!)
D g, Litigation Proceeds Received
o 2. Supplemental Return
o 4a, Future Interest Compromise (date of death alter 12-12-82)
o 7, Decedent Maintained a Living Trust l.!1tlach copy 01 Trusl)
o 10, Spousal Poverty Credit (date of death between 12-31.91 and 1-1-95)
(11) .}-;).../fl 6. 1'6
(12) /'11"f:.1}'f. Of
(13) - f)-
.rf /01) SS'f. () c.;.
(15)
(14f &;tt7q. <(3
(17)
(18)
(19)
I
11. ill'l, f3
,
q 7 - J.J-1 if
1. Real Estate (Schedule A)
2 Stocks and Bonds (Schedule B)
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3. Closely Held Corporation, Partnership or Sole-Propr'lelorship
4, Mortgages & Notes Receivable (Schedule OJ
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)
(7)
10 () 1f"3
I
S, ,5 f- J-
,
,
(6)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9) ;+')7 Q96 J{6
- O~
(10)
1Q Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has nol been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15, Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_
11 /99, S-S"'f, 0 f
, .0 't4-
16, Amount of line 14 taxable allineal rate
17. Amount of Line 14 taxable at sibling rate
, 12
18. Amount of Line 14 taxable at collateral rale
x .15
19 Tax Due
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS _3/ b T I-\- \ ia- \ !2l2J:2.. T
CITY /..Ie-A/ c J,'\Al7e1t 44N \)
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)1
Total Credits (A + B 1- C ) (2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This IS the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
ZIP /7070
~q7({.q3
(
5. 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
II?,q 7q. 9'3
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
~
~
~.
~e. Sc.ke.du/e
~. &.
.................0 ~.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;....
b. retain the right to designate who shall use the property transferred or its income;..
c. retain a reversionary interest; or... .
d. receive the promise for life of either payments, benefits or care?....
2. If death occurred 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? . .
Yes
........0
.........0
....0
......0
.............~
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and slatemel1ts, arid to the best of my kl10wledge and belief, i! is true, correct
and complete
Declaration of preparer other th lhepersonal representa ve is based on all information of which preparerhas any knowledge
SIGNATURE OF PERS
ADDRESS
").}...I _
SIGNATURE OF PREPARER OT
ADDRESS
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. 99116 (a) (1.1) (i)].
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 is 0% [72 P.S. 99116 (a) (1.1) (Ii)
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for dlsclosure of assets and filing a tax return are still applicable even
the surviving spouse is the only beneficiary.
For dates of death on or after Juiy 1, 2000:
The tax rate imposed On the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
The lax rale 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. 99116(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. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as a'
individual who has at least one parent in common with the decedent, whether by blood or adoption.
,REV.''''''I':9''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF ()
" VT 1-\
. FILE NUMBER
:c R.e../V Q.. PJA NQ.. j J. ro d- - 0 /II d-..
All real property owned solely 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 self, both having reasonable knowledge of the relevant facts. Real property which is jointJy-owned with
right of
survivorshi" must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
] I b T~'vJ.::y
C I+OMQ-)
Sl.
/ /JeW CvM0E.RLvElN'D/ (J,4-, ~7,~~
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
'''''''''''''''''''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF /)
V,,01H-
:r::.~eNQ..
1.3 .4N'<-j
FILE NUMBER
ff...Do~- Ot' (~
All property jointly.owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
A Ll- Si7R e.
(\-cc:T #-
G--l eN./? Il~",-
LI ;::e
AvN v' rl
IIO)/I,)..J.. '7)...
G-A- J-o G~ -, d-
TOTAL (Also enter 01\ line 2, Recapitulation) $
(If more space IS needed, Insert additional sheets of the same size)
RPJ.'ro<EX:r,,,,.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP or SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
f(.irnf ~N~ l?4rvf<-i d--t;O)...- 0 (10-.
Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship.
See instructions for the supporting information to be submitted for soJe-proprietorships.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
/Vel
A~f ICe? b /~
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, Insert additional sheets of the same size)
REV_1505EX + (1-97)
'*'
SCHEDULE C.1
CLOSEL Y.HELD CORPORATE
STOCK INFORMATION REPORT
fb4rve'1
FILE NUMBER
d-OOJ-- {)(llJ-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE 1M RETURN
RESIOENT DECEDENT
ESTATE OF II
r-<- Vi'\..\- .:J:.A..Q.N Q..
Zip Code
State of Inoorporation
Date of Inoorporation
Total Number of Shareholders
Business Reporting Year
1. Name of Corporation
Address
City
2. Federat Employer 1.0. Number
3. Type of Business
ProductiService
4.
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE
STOCK Voting I Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK
Common $
Preferred $
Provide all rights and restrictions pertaining to each ciass of stock.
5. Was the decedent employed by the Corporation? 0 Yes o No
If yes, Position Annual Salary $ Time Devoted to Business
6. Was the Corporation indebted to the decedent? 0 Yes o No
If yes, provide amount of indebtedness $
7. Was there life insurance payable to the oorporation upon the death of the decedent? 0 Yes 0 No
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years ffthe date of death was prior to 12-31-<12?
DYes 0 No If yes, 0 Transfer 0 Sale Number of Shares
Transferee or Purchaser
Attach a separate sheet for additional transfers and/or sales,
Consideration $
Date
g. Was there a written shareholders agreement in effect at the time of the decedent's death?
if yes, provide a copy of the agreement.
DYes
o No
10. Was the decedent's stock sold?
DYes
o No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? 0 Yes 0 No
if yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interestin other corporations or partnerships? 0 Yes 0 No
If yes, report the necessary information on a separate sheet, including a Scheduie C-l or C-2 for each interest.
A. Detailed calculations used in the valuation of the decedent's stock.
S. Complete oopies of financial statements or Federat Corporate lnoorne Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach oopies.
D. List of principal stockhoiders at the date of death, number of shares held and their reiationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
REV.~507 EX+ (1-97)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF /J
/CU-r}-J
ileNe.
FILE NUMBER
o
() I / I J.-
An property jointly-owned with right f survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
-No;v~
TOTAL (Also enter on line 4, Recapitulation) $
(1f more space is needed, Insert additional sheets of the same size)
'EV.'~m"I'..n.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DEe DENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Include the proceeds of litigation and the date the proceeds were recei ed by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
l/:l.
a.e if./ €..
ITEM
NUMBER
1.
;J,
VALUE AT DATE
DESCRIPTION OF DEATH
fJlf/C ClkoL//U6- f}cc:r: #- S-j-Lf-007-Lf5'..L6 I-H"
~13; 9f<1. 17
1M 10 (J-eItJ,v r?t1NI<(I.vve~ Fr/vrtn.l(rtJ-l- (o",,<-yO)
)4-c.CT- ()J-i).....3/J.oooo!03<fOI)... /~/j}13~3J-
TOTAl (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ )...'9;~O.l~ tf-'1
REV_1S09EX+(1-97)
'*'
SCHEDULE F
JOINTL Y.OWNED PROPERTY
COMMONWEALTH OF PENNS' LVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
y( V 1"' ..\t::~.,-, e t?J 4 N e.. ~
If an asset was made joint within one year of the decedent's date 0 death, it must be reported on Schedule G.
FILE NUMBER
..J.. OOJ.-- () \ ( D_
-
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RElA TIQNSHIP TO DECEDENT
B. 1+.41< V€...1 E. {';)ItAj~1
serB' !<o>STO\A/IJ Rc,f" LelP;S hf>A'L' 4t.
n'3 '39
/,+f}~ LercHwo.trf-} vOJ"Co4V"fl14tll r-?.4.
I
1 70 l \
'l),4uG-H-n,Q
A. (0 f./ iJ,"- M, WILL[(.l-USol
SQ,J
c,
JOINTLY-OWNED %OF DATE OF DEATH
LETTER DATE DESCRIPTION OF PROPERTY DATE OF DEATH DECO'S VALUE OF
ITEM FOR JOINT MADE Include name of financial institution and bank a::count number or similar identifying number. AlIa::h VAlUE OF ASSET INTEREST DECEDENT'S INTEREST
NUMBER TENANT JOINT deed for jointly-held real estate.
1. A. 01/11~ ,oNe (bN'~ c .0, ftc#3/J-OOJ.I'f731 J .1V?1J..I0 ,k f(;130,70
St
Ib, ~...r<>-b\:sW Ol/I? /.)-00 ( ~
~. A I Dp;'f4 (>IJL 6kv/L.. c'V. (J.-(!.t:J.ff3f5ool.m,Q7 9; 337, Fit i-
s. 3ftd.-. {o
to ~~\old"..,.( tOfo)..! J..,llol 3
j% ~ ( ~-e"",- (J,A.JL \
L-e.. T-rea. ~k~
I
TOTAL (Also enter on line 6, RecapltulatiDn) $/O,DIf'3. 30
e ize
PROPERTY
(If more space IS needed, Insert addltlDnal sheets of the sam s )
","'''O~''\'-'''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
ESTATE OiJ
f5, Vn+ .r~N<2- 1?1hV'<-;
This schedule must be completed and filet! if the answer to any of questiOns 1 through 4 on the reverse side of the REV.150Q COVER SHEET is yes.
FILE NUMBER
d-o oJ.- - 0/11 J...
ITEM
NUMBER
1.
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, TKEIRRELATlONSHIPTODECEDENTANDTflE DATE OF TRANSFER
ATTACH A COPV OF THE DEED FOR REAL ESTATE.
(J N (. (j IJ'N 1< C ,P . l'k<:,-; :#=-
j I 300.}..~ 900
.e-stcb \ IS ~ ec1 [) I/O~ J-ooJ-
c v'i. ~,o;-y o-t \\/i)/ oJ-)
~+ . -re J),V~! v:'c~ .
C"" p/.Jd!. M, itV IL LI\'Ut)'CAJAbV)k-h
8. I+M,:Jfl..1 E., ~.-t-NI ts"".v)
( ~ ee P /tiC L eA-~ lfJH-~h )
0/0 OF
DATE OF DEATH DECD'S
VALUE OF ASSET INTEREST
EXCLUSION
TAXABLE VALUE
IFAP~ICABLE
~5~ J-.'f1 f
-
3
()€>O
J: SJ'J., '/'/
TOTAL (Also enter on line 7, Recapitulation) $ 0. s 8'J... If-c1
(If more space is needed, insert additional sheets of the same size)
REV.1511El+(1-97)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF /J
N.V,f!
X/2.e ,{/Q
Mtv'<-'f'
/
FILE NUMBER
,)-€>OJ-- OIIIJ-
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
B
1.
2.
3.
4.
5.
6.
7.
<6'.
q.
10 .
l t .
jJ...
13,
I If'
DESCRIPTION
FUNERAL EXPENSES:
S+<-.....<L .& ~U~r FVN~( )j'OuU'
c: (-\<J~ S- ~c..~ (5J S-T-> .
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
(.-0 fl/tJle f(.
.
WILLI4/f1.SD,v
/h/- ~\t- d-..67,}...
.
Social Security Number(s) I EIN Number of Personal Representative(s}
Street Address ~~k~O S :i7""tJLVio./ ~oI.
City L~L~ ko.A.j State /14.
Yea<<s) Commission Paid: 1)-0 0,1
Zip
/ 7 .".5 39
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
S1reet Address
City
Relationship of Claimant to Decedent
State
Zip
Probate Fees
Accoun1ant's Fees .....
-'ltA-""t
Tax Return Preparer's Fees /
-(J~.
,
C...t.:p .......(!.LL ,1.&-.,v.eM.. (.(.. a<.e J'ZJzc"',.........
hklL I';;,LU eiV l.}oN..1L 0 (;:: DCLee f><2.v,
{Leu.-' <9$,bh. '\~ 0"" Mol;.." o:flr.veu~.Aa.4-
~~. :J:'..v $',
lJ+<1 ; h.y, 1- cI ~.v - VI/' c.", s },
.h3J-u,'l.Q. v-I-. I, '\-<<4- P. \~....e r1e-f~ (" si-s
001'11";!J( Ie. 1- g ~A-t t"'~ve.l c.~b
ve.",Lri 1M' c r" ~
AMOUNT
;)....~6'f.
00
?oo.
1:"Cf"
7/000. O'O~
7 .)0 o.~
.
-()-
,;2-66. b'U
..r7. cn:J
/tJo.&-c'
4'l:. f><.J
tr67.J-t
Y'3.1nr"
16G<? 7tJ
JO/<txr
lOt!', (7r::r
o
TOTAL (Also enteron line9, Recapitulation) $ J.-J.- 9'rr;. <J:6
(If more space is needed, insert additional sheets of the same size)
REV-1512EX.(1-91)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
c;i-vOJ- - 0 II f J...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
!4.. 11tH- ::t=k.ve
/&-1NQ.r
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
A/~ .ve..
TOTAL (Also enter on line 10, Recapitulation) $
(If mare space is needed, insert additional sheets of the same size)
REV..1513 EX+ (9-00)
*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
134N~""1
/<.. vI""' H'
:t~N Q..
NUMBER
I
NAME AND ADDRESS OF PERSON(SI RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (01 (1.2)]
CONM:.e. M. wIO-rMSol\J
sq~ A-OjS,j-o<.v,v ~ c=(
Lev/if ;"0'-'<'// (J;1-' n 33q
Htlj1-v'"-t E. 13 /JfIv~,/
i 4:0 ,;- /.-eM i.vo..a-~ ~0C<.P1'
Gz"""'V' \-\-i l\ I f?iA, i 70 \ \
1.
J.
FilE NUMBER
~(;;)d-- V /II J.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
1do.ukkA..
S"o /U
00~
,j()%'
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(Ii more space is needed, insert additional sheets 01 the same size)
0PNCBAN<
June 5, 2003
Connie M Williamson
598 Rosstown Rd
Lewisberry, Pa 17339
Scp
RE: Estate of Irene R Baney (Deceased)
SSN: 210-26-9567
DOD: 11/15/2002
Dear Ms Williamson:
In response to your request for Date of Death balances for the customer noted
above, our records show the following:
Certificate of Deposit
Account#3120021473 I Established 07117/2001
IRENE R BANEY
CONNIE M WILLIAMSON
HARVEY BANEY
DOD balance: $20,792.10 + $301.29 accrued interest
Account#31500219897 Established 10/02/2001
IRENE R BANEY DECD ITF
CONNIE M WILIAMSON
HARVEY E BANEY
DOD balance: $ 9,337.81 + $5.29 accrued interest
Account#31300222900 Established 01/02/2002
IRENE R BANEY DECD ITF
CONNIE M WILIAMSON
HARVEY E BANEY
DOD balance: $8,582.49 + $7.87 accrued interest
Page I of2
Checking Account
Account#5140074426 Established 07/01/1978
IRENE R BANEY
DOD balance: $13,989.18 + $1.56 accrued interest
Please note that this office only provides date of death balances for deposit
accounts (IRAs, 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 call1-888-PNC-BANK (1-888-762-2265) or stop by your local
PNC Bank branch office.
Sincerely,
i4c~~z- {L . 'IlAA/rYlfJ
Louise A Rump
PNC Decedent Reporting
Firstside Center
500 First Ave, 4th Fl CIF
PittsburghPA 15219-3128
1-800- 762-1775
Member FDIC
Page 2 of2
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
HAVAS JOHN ESQ
101 PINE ST
P 0 BOX 932
HARRISBURG, PA 17101
RE: Estate of BANEY RUTH IRENE
File Number: 2002-01112
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 11/15/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
Cumberland County - lZeglster-'Ur: WlJ..J..o
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/11/2005
WILLIAMSON CONNIE MAE
598 ROSSTOWN RD
LEWISBERRY, PA 17339
RE: Estate of BANEY RUTH IRENE
File Number: 2002-01112
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 11/15/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~~
GLENDA FARNER STRASBAUbl
REGISTER OF WILLS
cc: File
Counsel
Judge
(f
v-
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/11/2005
HAVAS JOHN ESQ
101 PINE ST
POBOX 932
HARRISBURG, PA 17101
RE: Estate of BANEY RUTH IRENE
File Number: 2002-01112
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1/ for decedents dying on or after
July 1/ 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 11/15/2005
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYI
kw,-~~
GLE~mA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
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en
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
NameofDecedent:J'\)T~ r(.lQ~e /J~f
Date of Death: t l / llj / 0 2-
I '
Estate No.: ;L \ 0 :J.... 0 \ \ \ (].
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 ~ No 0
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 0 No ~
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)'f No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: \ \- 0," -OS
{Jt/)L/\I~<A,--, fJ/ ttP (;/:(~~
- Signature
, .
<:-0 IV U WL --M ~ w,LL, ff^1 YQ tV
Names:t~ (J..cf)S<b~jJ ~a.o{
LlLwc.{; b.e.d.. 'lL 1 J f7 rA-.. / 7 '3 ~
Address
(")
....,..-.,
i
717- q 3g- -b~
Telephone No.
Capacity: ~Personal Representative
o Counsel for personal representative
Vb
June 3, 2006
Cumberland County Register of Wills
1 Courthouse Square
Carlisle, PA 17013
RE: File No. 2002-01012
PA File No. 21-02-1012
Date of Death 08/10/2002
Social Security 234-01-7282
At this time I am requesting 4 short certificates of probate to be dated within 2006 and have
enclosed a check for the $16.00 along with a postage paid envelope per the instructions provided.
I have also enclosed a copy of the obsolete probate for reference.
Should you have any questions or concerns I can be reached at 760.963.7725, thank you in
advance for your attention to this matter.
Kind Regards,
,---_,
David A. Boward
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SHORT CERTIFICATE
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I~ MARY C. LEWIS
Register for the Probate of Wills and Granting
Letters of Administration &c. in and for said
County of CUMBERLAND do hereby certify that on
the 13th day of November A.D.,
Two Thousand and Two,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of BOWARD EMORY A late of SOUTH MIDDLETON TOWNSHIP
in said county, deceased, to BOWARD DAVID A
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand ofdNovembea the seal
of said office at CARLISLE, PENNSYLVANIA, this 13th day
A.D., Two Thousand and Two.
File No. 2002-01012
PA File No. 21-02-1012
Date of Death 8/10/2002
S.S. # 234-01-7282
!~"' Register
~~~~
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL