HomeMy WebLinkAbout02-0365Register of Wills of Cuaberland
PETITION FOR GRANT
Estate of John C. Smith
also known as
Betty C. Smith
County, Pennsylvania
OF LETTERS
No.
, Deceased Social Security No. 189-16 - 6527
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix
the Decedent, dated 08/31/2000 and codicil(s) dated None
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 3605 Kohler Place, Apt. 14, Hampden Township, Camp Hill, PA 17011
(list street, number, and municipality)
Decedent, then 76 years of age, died 06/04/2001 at Holy Spirit Hospital, Camp Hill, PA
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 real estate in Pennsylvania
(Location)
8,000.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the appropriate form to the undersi~lned:
Signature
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
IBetty C.
Apt. 14,
Typedorprintednameandresidence
Smith, 3605 Kohler Place
Camp Hill, PA 17011
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~'~3.~ C-. ~/'~k~
Betty C.~Smith
before me this 9th day of
APRIL , 2002
/ ~/' For the~egiste~
No.
Estate of John C. Smith
Social Security No: 189-16-6527 Date of Death:
AND NOW, APRIL 10
21-02-365
Deceased
06/04/2001
2002 , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary [~ Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Betty C. Smith
in the above estate and that the instrument(s) dated 08/31/2000
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $ 40.00
Short Certificate(s) ..... $ 3.00
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... $ 9.00
Codicil ........... $
JCP Fee .......... $ 5. O0
Inventory .......... $
Other ........... $
TOTAL ......... $
Prepared by the Pennsylvania Bar Association
~: ~ I~egiste~ of Wills
Attorney: James D. Bo~ar, Esquire
I.D. No: PA 19475
Address: One West Main Street
Shiremanstown, PA 17011
Telephone: 717/737-8761
57.00
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
21-02-365
REGISTER OF WILLS OF Cumberland COUNTY
OATH OF SUBSCRIBING WITNESS
James D. Bogar, Esquire and Joan E. Brothers
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that they were present and saw
John C. Smith
the testat Or , sign the same and that they signed as a witness at the
request of testat or in h is presence and (in the presence of each other) (in the presence of the
other subscribing wimess(es)).
Sworn to or aff'n'med and subscribed before
me this /-~4-/X. day of
apr, I 20oz
! BONNI~ L ~m¥% NOTARY PUBU~_ I
ISHIREMANS"TOWN BORO., CUMBERLAND COl
I MY COMMISSION I~PIRI~S APRIL 18. 2005J
(Address)
Oc~n E. Brothers (Name)
One West Main Street, Shiremanstown, PA
(Address)
PA 17011
17011
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
testat__
that
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signatnre of
codicil
of (one of the subscribing witnesses to) the will presented herewith and
codicil
believes the signature on the will is in the handwriting of
to the best of knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
20
Register
(Name)
(Address)
(Name)
(Address)
21-02-365
LAST WILL AND TESTAMENT
OF
~OHN C. SHZTH
I, JOHN C. SMITH, of Hampden Township, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, unto my wife,
BETTY C. SMITH, provided she survives me by sixty (60) days.
SECOND: Should my wife, BETTY C. SMITH, predecease me
or die on or before the sixty-first (61st) day following my
death, I devise and bequeath all the rest, residue and remainder
of my estate of whatever nature and wherever situate, including
any property over which I hold power of appointment and together
with any insurance policies thereon, as follows:
(A) Fifty-five (55%) percent thereof to my daughter,
SHARON S. HILLEGAS, provided that should she predecease me, then
to her son, MICHAEL S. HILLEGAS, JR.
(B) Forty-five (45%) percent thereof to my grandson,
MICHAEL S. HILLEGAS, JR., provided that should he predecease me,
then to my daughter, SHARON S. HILLEGAS.
THIRD: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
FOURTH: I direct that all inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
2
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
FIFTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SIXTH: I nominate and appoint my wife, BETTY C. SMITH,
Executrix of this, my Last Will and Testament. In the event of
the death, resignation or inability to serve for any reason
whatsoever of the said BETTY C. SMITH, I nominate and appoint
SHARON S. HILLEGAS, Executrix of this, my Last Will and Testa-
ment. In the further event of the death, resignation or inabil-
ity to serve for any reason whatsoever of the said BETTY C. SMITH
and SHARON S. HILLEGAS, I nominate and appoint MICHAEL S.
HILLEGAS, JR., Executor of this, my Last Will and Testament. I
direct that my Executrix or Executor, as the case may be, and
their successors, shall not be required to post security or a
bond for the performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this ~31~% day of
l~.z.,~-~ , 2000.
N C. SMITH
(SEAL)
Signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his request, in his presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address /-- ~~-/-~-'~~
Address
4
EV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
REV-1500
CAPB
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME{LAST, FIRST, AND MIDDLE iNiTIAL)
Smith John C,
DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-DO-YEAR)
06/04/2001 I 01/22/1925
{IF APPLICABLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL)
Smith, Betty C,
1. Original Return 2. SupplementaIReturn
4. Limited Estate 48. Future lnterest Compromise (date of death after 12-1Z-87)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust
(Attach copy of Will) {Attach copy of Trust)
I I 9. Litigation Proceeds Received I 110. spousal Poverty Credit
(date of death between 1Z-31-g 1 and 1 - 1 - 95)
OFFICIAL USE ONLY
FILE NUMBER
21-02-0365
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
189-16-6527
THIS RETURN MUST BE FILED IN DUPUCATEWITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
{date of death
3. Remainder Return priorto 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
r----] 11. Election to tax under Sec. 9113(A)
{Attach Sch O)
NAME
James D. Bo~ar Esquire
FI RM N AM E (I f Applicable)
TELEPHONE NUMBER
717/737-8761
COMPLETEMAILINGADDRESS
One West Main Street
Shiremanstown, PA 17011
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13.
14.
None
12,368~
None
None
None
None
None
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14)
OFFICIAL USE ONLY
12,368.21
0.00
12,368.21
12,368.21
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
12,368.21
X .0 0
X .0 45
X .12
X .15
(15)
(16)
(17)
(18)
(19)
0.00
0.00
0.00
0.00
0.00
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
3605 Kohler Place
Apt. 14
CITY
Camp Hill
ISTATE
PA
ZIP
17011
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
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Lin~ 20 to request a refund {4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 * SA. This is the BALANCE DUE. (SB) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Total Credits ( A + B + C ) (2)
1. Did decedent make a transfer and: Yes No
a. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. ['~ ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [-'"] ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on ail information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR F[LING RETURN Betty C Smith DATE
~. 3605 Kohler Place
C_, ......................... 5/15/02
SIGNAT~.URE OF PI~PARER OTHER THAN REPRESENTATIVE James D. Bogar Esquire DATE
Shiremanstown, PA 17011
~ ..................... 5/15/02
Fo; daie; 0f de'at~ ;3r; 'kaffe~j~iy 'ii i'~94' arid' befo'r',' ~Jar~ary i, i9951 the iax r~t;' imposed. 0~ the net ,~aiue Of tran;fers iD or io; t~e use Of ihe '
surviving spouse is 3°/° ['~2"P~. 9116 (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. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased 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. 9116 (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 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software onh/The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV- 1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
John C. Smith SSf/ 189-16-6527 06/04/2001 21-02-0365
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 1,994.872 shares Prudential Financial Mutual Fund 6.20 12,368.21
TOTAL (Also enter on line 2, Recapitulation) 12,3 68.21
(If more space is needed, insert additional sheets of the same size)
Copyright {c) 1996 form software only CPSysterrts, inc. Form REV-1503 EX (Rev. 1-97)
Prudential Financial
William H. Stotler, LUTCF
Representative
The Prudential Insurance Company of America
Greater Harrisburg Agency W SH & HARX
150 Corporate Center Drive, Suite 105
Camp Hill, PA 17011-1759
Tel 717 975-8150 ext.7142 Fax 717 763-8974
April 9, 2002
Mr. James D. Bogar, Esq.
One West Main Street
Shiremanstown, Pennsylvania 17011
Dear Mr. Bogar:
You requested values for Mr. John C. Smith's Annuity and Mutual Fund Accounts on the
date of his death, June 4, 2002. Enclosed you will find a statement from the Annuity
Center.
The Mutual Fund in John's name had 1,994.872 Shares and it closed on the date of his
death at $6.20 for an account balance of $12,368.21.
If you require any other numbers or facts, please do not hesitate to call me.
Best,: wishes and kind regards!
Sincerely yours,
William H. Stotler, LUTCF
Agent
Registered Representative,
Pruco Securities Corporation
A Prudential company
751 Broad Street, Newark NJ 07102-3777
REV- 1513 EX * (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT OECEDENT
ESTATE OF
John C. Smith SS~/ 189-16-6527
SCHEDULE J
BENEFICIARIES
06/04./200Z
RELATIONSHIP TO DECEDENT
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(aX1.Z)]
Betty C. Smith
3605 Kohler Place
Apt. 14
Camp Hill, PA 17011
De Not List Trustee(s)
Spouse
FILE NUMBER
21-02-0365
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c~ ;~000 form software only The Lackner Group Inc. Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
JOHN C. SMITH
I, JOHN C. SMITH, of Hampden Township, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, unto my wife,
BETTY C. SMITH, provided she survives me by sixty (60) days.
SECOND: Should my wife, BETTY C. SMITH, predecease me
or die on or before the sixty-first (61st) day following my
death, I devise and bequeath all the rest, residue and remainder
of my estate of whatever nature and wherever situate, including
any property over which I hold power of appointment and together
with any insurance policies thereon, as follows:
(A) Fifty-five (55%) percent thereof to my daughter,
SHARON S. HILLEGAS, provided that should she predecease me, then
to her son, MICHAEL S. HILLEGAS, JR.
(B) Forty-five (45%) percent thereof to my grandson,
MICHAEL S. HILLEGAS, JR., provided that should he predecease me,
then to my daughter, SHARON S. HILLEGAS.
THIRD: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
FOURTH: I direct that all inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
2
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
FIFTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SIXTH: I nominate and appoint my wife, BETTY C. SMITH,
Executrix of this, my Last Will and Testament. In the event of
the death, resignation or inability to serve for any reason
whatsoever of the said BETTY C. SMITH, I nominate and appoint
SHARON S. HILLEGAS, Executrix of this, my Last Will and Testa-
ment. In the further event of the death, resignation or inabil-
ity to serve for any reason whatsoever of the said BETTY C. SMITH
and SHARON S. HILLEGAS, I nominate and appoint MICHAEL S.
HILLEGAS, JR., Executor of this, my Last Will and Testament. I
direct that my Executrix or Executor, as the case may be, and
their successors, shall not be required to post security or a
bond for the performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this 3~$'~ day of
, oo o.
,.'JO~N~ C. SMITH
,J
(SEAL)
Signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his request, in his presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
/' I ~
Address ~c
Address
4
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: John C. Smith
Date of Death: June 4, 2001
Will No. 21-02-0365
Admin. No.
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
April 23, 2002:
Name Address
Betty C. Smith
Sharon S. Hillegas
3605 Kohler Place
Apt. 14
Camp Hill, PA 17011
724 Carol Street
New Cumberland, PA 17070
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except:
None
Date: 5/15/02
Capacity:
Esquire
One West Ma~.JStreet
Shiremanstown, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent: John C. Smith
Date of Death:
June 4, 2001
Will No.
21-02-0365
Admin. No.
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:
State whether admin-istration of the estate is complete:
Yes x No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is: N/A
c. Did the personal representative state an
account informally to the parties in interest? Yes x No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: 5/15/02
Signature
'-.Q James D. Blear, Esquire
.... Name (Please type or print)
One West Main St.
~ Shiremanstown, PA 17011
.~_. Address
,~ (717 I 737-8761
~.L~ ~ ..... _2 Te 1 No
Capacity:
__Personal Representative
(MAH:rmf/AM3)
X
Counsel for personal
representative
~ BUREAU OF TNDTVTDUAL TAXES
/NHERITANCE TAX DTVTSTON
DEPT. 1806nl
HARRTSBURG, PA 17118-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHERZTANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-i~? EX AFP C01-02)
JAHES D BOGAR ESQ '02 JL~:,i
I W HAIN ST
SHZREMANSTOWN PA 17.011
DATE 06-17-2002
ESTATE OF SMITH
DATE OF DEATH 06-0q-2001
FILE NUMBER 21 02-0565
COUNTY CUMBERLAND
ACN 101
Amount
JOHN C
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTTON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-01) NOT/CE OF ZNHER/TANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF SMITH JOHN CFZLE NO. 21 02-0365 ACN 101 DATE 06-17-2002
TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks end Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
4. Mortgages/Notes RocoAvablo (Schedule D)
5. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly O~nad Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/MAsc. Expenses (Schedule H) (9)
10. Debts/Mortgage LAabAIAtles/LAens (Schedule 1) (10)
11. Total Deductions
12. Net Value of Tax Return
.0O
12~$68.21
.00
.00
.00
.00
.00
(8)
.00
.00
NOTE: To insure proper
credit to your account,
submAt the upper port/on
of this form ~Ath your
tax payment.
12,$68.21
(11) . O0
(12) 12,568.21
13.
14.
NOTE:
ASSESSMENT OF TAX:
15. Amount of Line lq at Spousal rate
16. Amount of LAne 14 taxable et LAneal/Class A rate
17. Amount of LAne 14 at SAblAng rate
18. Amount of LAne 14 taxable at Collateral/Class B rate
19. PrAncA~al Tax Due
TAX CREDITS:
PAYHENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-)
Char/table/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (15) . O0
Net Value of Estate Subject to Tax (14) 12,:568.21
zf an assessment was /ssued prev/ously, lines 1~, 15 and/or 16, 17, 18 and 19 ~/ill
reflect figures that include the total of ALL returns assessed to date.
(15). 12,$68.21 X O0 = .00
(16). .00 X 0~5 = .00
(17), . O0 X 12 = . O0
(lB), .00 x 15 = .00
(19)= . O0
AHOUNT PAZD
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADD/TZONAL INTEREST.
.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)