HomeMy WebLinkAbout02-0421
PET)TION FOR j'ROBATE and GRANT OF LETTERS
Estate of' I/.;CA/(Sf; /J/;9j'f5f<:M/y} No. 21-02-421
also know;;K;; To:
Register of WjJls fovt~y A /}
.,.., ~ . D..eceased. County of Ct$b;cr.uJ;1.1/ in the
Social Security No. / f, ",Y' 0<; ~ - )/ .s9t Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that: , P
Your petitioner(s), who is/are 18 years of age or older an the execut Olt
in the last will of the above de den, dated
and codicil(s) dated
named
,19_
h
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
J
/'?/u
Decendent, then _ ~
at
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will ffered f~r probate; was not the victim of a killing a as neve djud' tel
incompetent: C, v '0. /
/ , ~ ~N
Decendent at death owned property with estimate values as follows:C~ ~ ~ ft ty"
(If domiciled in Pa.) All personal property $ '_--' / J ~;'J
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
1st street, number and muncipality) . . ~'
years of age, died 55//:;;' ~~v:2, 194-,
last will and codicil(s)
--,-.
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
~
<I>
1)'
U
'"
'"
~3
'" ..
~'"
'"
-00
co::
~ '.0
3&:
'" '-
50
'"
'"
OIl
Ui
/1ft:t;-TI11~vt~~ ?f~vi$if;;'"Y
/ II t7Cc .14,
tJt?*fild<;&-'fJ n /7r;S~
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALT~OF ~NNSYLDNIA I S8
COUNTY O.~ 0$ (jL('~U IJl J
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 p itioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and y minister It71 tat accordi g to law.
Sworn to or affirmed and.subscribed~ III ~
before me this 25th day of ~.
~ xi: 2002 ~
/?~ (~~//-'h-pn/ifJZ'~L ~
! Register B2
//-60 - J
No. 21-02-421
Estate of
RICHARD J MAYBERRY
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIL 26 ~ 200~ 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 APRIL 10, 2002
described therein be admitted to probate and filed of record as the last will of
VANCE MAYBERRY
TESTAMENTARY
RICHARD J MAYBERRY
and Letters
are hereby granted to
i... a~" -
'7-?//I.{t~ "~AJ~~~hj) /r1/j~/~'
/eglster 0 Wills I
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
lteHfi1kEiition ................
JCP
$
$
$
$ 5.00
TOTAL _ $ 93.00
. ,i\PLi), .??". .~Q9?........ .. .. ....
70.00
17.00
6.00
AITORNEY (Sup. Ct. 1.D. No.)
ADDRESS
Filed
PHONE
~_L/ ~ ~c~, ~
...---...,.,.-
';:-~ ':.. ."
d
1'0
1'-)
,-n
0'"
.
THE LAW OFFICE
'of:
JAMES M. BACH
Attorney-At-Law
352 S. Sporting Hill Road
Mechanicsburg, PA 17050
737 -2033
LAST WILL AND TESTAMENT
FOR
VANCE MAYBERRY
Last Will And Testament Of
VANCE MAYBERRY
I, VANCE MAYBERRY, of the BOROUGH OF MECHANICSURG,
COUNTY OF CUMBERLAND, COMMONWEALTH of PENNSYLVANIA, being in
good bodily health and of sound and disposing mind and memory, and not acting under
duress, menace, fraud, or undne influence of any person whomsoever, merely calling to
mind the frailty of human life, and being desirous of disposing my worldly goods while I
have the strength and capacity so to do, I do make, publish and declare this my LAST
WILL AND TEST AMENT. I hereby revoke, cancel and annul all my former Wills
and Testaments, including codicils thereto, by me at any time made, and declare this
alone to be my LAST WILL AND TEST AMENT.
AS TO SUCH ESTATE IT HAS PLEASED GOD TO ENTRUST ME WITH IN
THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1.
ITEM 2.
ITEM 3.
ITEM 4.
ITEM 5.
I direct that my Executor hereinafter named, pay and discharge all of my
just debts, funeral and testamentary expenses.
All the rest, residue and remainul::t of my entire estate, w11eresoever
situate, and whatsoever it may consist of, I give, devise and bequeath,
absolutely, and in fee, to my dearly beloved nephew Richard J.
Mayberry, per stirpes.1
I nominate and appoint, RichardJ. Mayberry, as Executor of this my
Last Will. Should the Executor named herein fail to qualify or cease to
act as Executor, then I appoint Richard C. Mayberry as Executrix in her
stead.
I direct that my personal representatives, 'as wen as their successors
shall not be required to give bond for the faithful performance of
their duties in any jurisdiction.
I direct that all estate, succession, legacy, inheritance or other transfer.
taxes, however designated that shall become payable by reason of my
ITEM 6.
I grant to my personal representatives herein named, in addition to,
but not in limitation of those powers vested by law, to be exercised
without prior application to or approval of any court, the power and
authority to retain indeftnitely any property, to invest and reinvest
any assets or the proceeds derived from the sale of assets, although
said investments may not be of the character prescribed by law, to
sell, convey, assign, transfer and encumber any property, to pay,
settle or compromise all claims, to make distribution or divisions in
cash or in kind, and in general to exercise all powers in the
management of any property hereunder which any individual could
exercise in the management of similar property owned in his own
right, and to execute and deliver any and all instruments and to do all
acts, which may be deemed necessary and proper.
~l~
VANCE MAYBERRY
--------------------------------------------------~~~-------------------------------
ACKNOWL~DGM~~T
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND
)
)
ss
I, VANCE MAYBERRY. the TESTATOR, 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 purpose therein expressed.
Sworn to or afftrmed and acknowledged before me, by: the TESTATOR this 10TH day of April,
2002.
V~C9 ;J;,\~~
VANCE MAYBERRY
.~ .
...-..,..-..----....
,
Notarial Seal .
Cynthia J. McElwee, Not~ry Public
Londonderry 1\tlp., Dauphin County
My Coml1'1lssI0" Expires June 5, 2003
M b ." -. . -"'--";,,,,"llon of Notaries
em or .,' .". '. >.
lLL'--"':--..
The preceding instrument consisting of this and two (2) other typewritten pages,
identified by the signature of the TESTATOR, was on the date thereof signed, published and
declared by V AN CE MAYBERRY, the TESTATOR therein named as and for his LAST
WILL AND TESTAMENT.
f3~ ~~~L-
WITNgSS
Residing a(;%7$ /1 r"?1f'iK~'
f
~~~17Pt~C5~~~6~~ ~
Residing at III j 5o.A-<1/bma.Jt..M S .(
III!R.rpt,,-hJ, /7a7.
I24iMlJ ~~ OJ .
WITNES ~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND
)
)
ss
weE. 4tH ,Y fJ nd..ersov and ~ /CA-/I7~ DC-- M lJ-IhUlA.)f'ne witnesses whose
names are signed to the attached or foregoing instrument, being du(y quaIAied according to law,
do depose and say that we were present and saw the TESTATOR sign and execute the
instrument as his LAST WILL; that the TESTATOR signed it willingly and that he executed it
as his free and vo1untary act for the purpose therein expressed; that each wirness in the hearing
1f1d sight of the TEST A TOR signed the WILL as witnesses; and that, to the best of our
knowledge, the TESTATOR was, at the time, 18 or more years of age, of sound mind and under
no constraint or undue influence.
Sworn to or affirmed and acknowledged' before me, by: TI",-~V\v\ c r~() ,,-,
~~~~;:t:2,:m"''', ~ 10'fJ7:J~~~+1"
WITN S WITNESS
~t\"~,,. '" 0'i' ;t14^--'-->-
>ARY PUBLIC
,,_...,....-~./"
and
Cynth' J Notarial Seal
l la. McElwee N
M ondonderry TWD d ot~ry Public
y CommissIon EX~i aUphm County
Memb .' -.-. '. res June 5, 2003
CI, j"'ll:tl1, , " ":"'""',.'
, ~ "., riS",;)cialion of Notaries
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MAYBERRY RICHARD J
181 RIDGE HILL ROAD
MECHANICSBURG, PA 17050
-------- fold
ESTATE INFORMATION: SSN: 168-26-7396
FILE NUMBER: 2102-0421
DECEDENT NAME: MA YBERRY VANCE
DATE OF PAYMENT: 07/17/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 04/18/2002
NO. CD 001417
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $7,209.20
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: RICHARD J MAYBERRY
CHECK#102
SEAL
INITIALS: DO
RECEIVED BY:
REGISTER OF WILLS
$7,209.20
MARY C. LEWIS
REGISTER OF WILLS
~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: V(\- ~C€ ~ f,;r:{tltL1
Date of Death: 't - \ s:- - () ''2..-
Will No.
Pt+ Nu.
2 (-02-- D'{2- \
Admin. No.
P.-1 tJO.
G 1- () Z- a l{ ~ I
To the Register:
I certify that notice of (beneficial interest) 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 -, - I 7 _ <::> '1.--'
Name
Address
Rl C-~ T.
~P)~
IX'/ f tObu lite- teA.
Iv\.~ 0-\ 170S"
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
~/~
.
Date:
~~O~
, \
~'flYf/+1
SIgnature
N,m, f,C.If/JltO.cr, ~d~
Address / J7/ 13 06& /I~ C( Pol
J1 Ci"?fI/f-tJt ~t3 ~ p+-
, ,
170sD
Telephone V t') )7<1" - 6 CO;7
Capacity: V Personal Representative
~:::J
...." '-...-
_Counsel for personal representative
~/--?-6CJ-/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
RICHARD J MAYBERRY
181 RIDGE HILL RD
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
colM-Y
ACN
09-16-2002
MAYBERRY
04-18-2002
21 02-0421
CUMBERLAND
101
'*
REY-1547 EX AFP C D1-D2)
VANCE
J
Allount Rellitted
" ",
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is'4i-EX--AFP--foY:02Y-NOTicE--OF-YtiHER-ifANCE-TAX-APPRjrisEifENT:--AL1-owAifcE-oR"-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MAYBERRY VANCE J FILE NO. 21 02-0421 ACN 101 DATE 09-16-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
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. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
38,269.86
.00
28.915.68
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
10,811.52
.00
(11)
(12)
(13)
(14)
NOTE:
.00 X
.00 X
28,915.68 X
27,458.34 X
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
67,185.54
10.811 52
56,374.02
.00
56,374.02
00 =
045 =
12 =
15 =
.00
.00
3,469.88
4,118.75
7,588.63
(19)=
TAX CREDITS:
,..."..... .-. (+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
07-17-2002 CDOO1417 379.43 7,209.20
TOTAL TAX CREDIT 7,588.63
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
.
REV.1500 EX (6-00) REV -1500 OFFICIAL USE ONLY ~
COMMONWEALTH OF I 7- tt1~/
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FI LE NUMBER
DEPT. 280601 RESIDENT DECEDENT 2.L _ oz _~~"21.-
HARRISBURG, PA 17128-0601 --
COlMY CODE YEAR .....BER
DECEDENTS NAME (lAST, FIRST, AND MIDDLE INIT~) SOC~ SECURITY NUMBER
I-
Z MAYBERRY, VANCE J 168-26-7396
W DATE OF DEATH (J.IM.()D-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
C
W 04-18-2002 10-26-27 REGISTER OF WILLS
0
W (IF APPLICABLE) SURVMNG SFOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
N/A
LU [XJ 1. Origira Retum 0 2. SupplerrentaI Retum 0 3. Remainder Return (date ofdealh prb-Io 12-13-82)
'"'
:::.:::~(I) 0 4. Limited Estate 0 4a. Future lmerest Compromise (dale of d.liler 12-12-82) 0 5. Federal Estate Tax Retum Req~red
u """
LU"-U [XJ 0
"DO 6. Decedent Died Testate (Atlachcopy ofWilj 7. Decedent Maintained a Living Trust (Attach ropy ofTnm) _ 6. TaIaI Number of Safe Deposit Boxes
uO:-'
,,-",
~ 0 9. Utigation Proceeds Rere\'ed D 10. Spousal Poverty Credit (dala of dealh between 12-31.91 W'd 1-1-95) 011. Becliontotaxur<lerSec.gl13(A)I""""smo)
I- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
z NAME COIIPLETE MALlNG ADDRESS
w
0 RICHARD J MAYBERRY
z 181 RIDGE HILL ROAD
0
"- FIRM NAME (If AWicab") MECHhNICSBURG, PA 17055
'"
LU
0:
0: TELEPHONE NUMBER
0
u 717-796-0507
-
1. Real E_(Sched~eA) (1) - ~FICIAL USE ONLY
2. Slacks ar<l Bor<Is (Schedule B) (2) '-
c
3. Closey Held CorporaIion, Partnership or Sole-Proprietorship (3) "
-'
4. Mortgages & Noles Rerevable (Sched~e D) (4) -,'
5. Cash, Balk Depos~ & MiSCEllaneous Personal Property (5) 38,269.86 -
(Sched~e E) -~..
Z
Q 6. J~ntIy Owrod Property (SchedlJe F) .,
(6) w
!;;: o Separate EMling Requested
...J 7. Inter-Vivos Transfers & MiSCEllaneous Non-Probate Properly (7) 28,915.68
::::l
!:: (Schedule G or L)
D.. 6. Total Gross Assets (talal Ures 1 - 7) (6) 67,185.54
<(
0 9. Funeral Expenses & Admi~straive Costs (Schedule H) (9) 10,811.52
W
II:: 10. Debts 01 Decoder!, Mortgage Uabilffies, & Uens (Sched~e I) (10)
11. Total Deductions (toIaI Ures 9 & 10) (11) 10,811.52
12. Net value of Estate (line 8 mtlllS line 11) (12) 56,374.02
13. Charita~ell1d Govemnental BequestslSec9113 Trusts furwh~hanelecliontotax has rolbeen (13)
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus Une 13) (14) 56,374.02
SEE INSTRUCTIONS FOR APPLICABLE RATES
Z
0 15. Am:lur!ofUno14taxableatlhespousaltax
!;( rate, or transfers ur<ler Sec. 9116 (a)(1.2) X .0_ (15)
I- 16. Am:lunt of Uno 14 taxable at lineal rate X .0_ (16)
::::l
D.. 17. Am:lunt DlUno 14 taxabfe at sibling rate 28,915.68 X .12 (17) 3,469.88
:::E
0 16. Am:lunt of Uno 14 taxable atc<Jfal"", rate 27,458.34 X .15 (18) 4,118.75
0
~ 19. Tax Due (19) 7,588.63
20. 0 I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
STFPA42021F.1
,
Decedent's Complete Address:
STREET ADDRESS 6 WEST GREEN STREET
CITY MECHANICSBURG
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Peyments
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount
STATE P A
ZIP 17055
(1)
7,588.63
379.43
Total Credits (A + B + C) (2)
379.43
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnleresUPenalty (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 Une 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
7,209.20
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
7,209.20
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................ D [1g
b. retain the nght to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . .. D [1g
c. retain a reversionary interest; or ....................................................... D [1g
d. rec~ve the promise for life of either payments, benefits or care? ....................... .. D [1g
2. If death occurred aJIler December 12, 1 982, did decedent transfer property within one ye<r of death
without rec~ving adecuate consideration? . . . . . . . . . . . . . . . . . .. .. .. .. .. .. . . . . . . . . . . . . .... D [1g
3. Did decedent own an "in trust for" or payable upon death bank accounl or security at his or her death? . . . .. D [Xl
4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which
contains a beneticiarydesignation? ....................................................... IX] D
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 doda,e that I have examinerlthis return. irduding accompan~ng scredules and sI3erronls. and to the best of "'I knowledge and bd~, n is true. correct and
oomplele.
Ooda' prep r o1herthan the persooaI ,epresentative i on all i_on ofwNch preparer has '"'YknowIedge.
PE N RES NSI E TURN
DATE
/7-1)2--
ST MAIN ST, MECHANICSBURG, PA 17055
For dates of death on or aJIler July 1, 1994 and before January 1, 1995, Ihe tax rate imposed on the net value of transfers to or for the use olthe surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)).
For dates of dealh on or aJIler January 1,1995, the tax rate imposed on the net value of lransfers 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 Iransfer to a surviving spouse from tax, and the statutory recuirements for disclosure of assets and filing a tax retum are still applicable even
if the surviving spouse is Ihe only beneficiary.
For dates of death on or aJIler 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. 99116(a)(1.2)].
The tax rale imposed on the net value of Iransfers to ortor 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 orfor the use of the decedent's siblings is 12% [72 P.S. 99116(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.
STFPA42021F.2
REV-150B EX + (1-97) (I)
COMMON'NEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
VANCE J MAYBERRY
FILE NUMBER
21-02-0421
Include the proceeds of litigation aM the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
ALLFIRST BANK CASH IN BANK
A)MONEY MARKET CHECKING #9905-8606-8
B) PASSBOOK SAVINGS #87004916706536
C) CHECKING ACCT #9505-8607-6
1968 PONTIAC AUTO POOR CONDITION
33,397.64
2,659.17
1,213.05
1,000.00
2
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
38,269.86
STFPA42021F.9
REV-1510 EX'" (1.97)(1)
COMMONWEAlTH OF PENNsnVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
VANCE J MAYBERRY
FILE NUMBER
21-02-0421
Ttis sci'edule 1llJ~ be oom~eled.m filed rr ire answer to any of quesioos l11Yough4 on ire reverse s~eofire REV-l5IJQ COVER SHEET is yes.
DESCRIPTION Of PROPERTY %OF
ITEM IN;lLOE TIE I'WJE OF TIE TRANSFEREE. TIEIR RELATlONSHP TO DECEDENT AN) M DATE DATE Of DEATH DECO'S EXCLUSION TAXABLE VALUE
NUMBER OF TRANSFER ATTAOiA COPY OF TIE DEED FOR REAL ESTATE VALUE Of ASSET INTEREST (IF APPliCABLE)
1. METLIFE ANNUITY #935 301 209 M 28,915.68 100 28,915.68
TOTAl. (Also enter on line 7, Recapitulation) $ 28 915.68
(If more space is neeced, insert additional sheets of the same size)
STF PA42021 F.11
REV-1511 EX + (1--97) {Il
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VANCE J MAYBERRY
Debts of decedent must be reported on Schedule I.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-02-0421
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MALPEZZI FUNERAL HOME 8,567.00
2 GINGRICH MEMORIALS 1,680.32
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Persona Representalivo(s)
Social Security Number(s) I EIN Number of Personal Represerlaive(s)
StreetAd<lress
City st;;e Zip
Year(s) Commission Paid:
2. ~Fees
3. Family Exemption: (~decedenfs address is not Ire same as d~manfs, attach explanation)
Claimant
Street Address
City Stale Zip
R~atiOl1Ship of Ciainmt to Decedent
4, Probate Fees 93.00
5, Acro.Jntarl'sFees 425.00
6. Tax Return Preparer's Fees
7. FINAL DOCTOR BILL 1.12
8 VERIZON FINAL PHONE BILL 30.08
9 FILING FEES 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 10.811. 52
STF PA42021 F_12
(If more space is needed, insert additional sheets of the same size)
REV.1513 EX'" (9-00)
COMMONVv'EALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
VANCE J MAYBERRY
FILE NUMBER
21-02-0421
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List TlIlstee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include oulright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
1. RICHARD J MAYBERRY
181 RIDGE HILL ROAD
MECHANICSBURG, PA 17055 NEPHEW 100
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 1\ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, inseri additional sheets of the same size)
STFPA42021F.14
Last Will And Testament Of
VANCE MAYBERRY
I, V ANCE MAYBERRY, of the BOROUGH OF MECHANICSURG,
COUNTY OF CUMBERLAND, COMMONWEALTH of PENNSYLVANIA, being in
good bodily health and of sound and disposing mind and memory, and not acting under
duress, menace, fraud, or undue influence of any person whomsoever, merely calling ro
mind the frailty of human life, and being desirous of disposing my worldly goods while I
have the strength and capacity so to do, I do make, publish and declare this my LAST
WILL AND TESTAMENT. I hereby revoke, cancel and annul all my former Wills
and Testaments, including codicils thereto, by me at any time made, and declare this
alone to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE IT HAS PLEASED GOD TO ENTRUST ME WITH IN
THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1.
I direct that my Executor hereinafter named, pay and discharge all of my
just debts, funeral and testamentary expenses.
lTEM2.
All the rest, residue and remainder of my entire estate, wl:1eresoever
situate, and whatsoever it may consist of, 1 give, devise and bequeath,
absolutely, and in fee, to my dearly beloved nephew Richard J.
Mayberry, per stirpes.l
".1'
ITEM 6.
I grant to my personal representatives herein named, in addition to,
but not in limitation of those powers vested by law, to be exercised
without prior application to or approval of any court. the power and
authority to retain indefmitely any property, to invest and reinvest
any assets or the proceeds derived from the sale of assets, although
said investments may nut be of the character prescribed by Jaw, to
sell, convey. assign. transfer and encumber any property. to pay,
settle or compromise all claims, to make distribution or divisions in
cash or in kind, and in general to exercise all powers in the
management of any property hereunder which any individual could
exercise in the management of similar property owned in his own
right, and to execute and deliver any and all instruments and to do all
acts, which may be deemed necessary and proper.
~~
VANCE MAYBERRY
--------------------------------------------------~1'r~-------------------------------
, ,
,
Notarial Seal .
Cynthia J. McElwee, Notary Public
Londonderry 1wp., Dauphin Countjl
My Commhis1011 Expires June 5, 2003
Membor. p ,1' _.~ .. Y'J:~nltjOn of Notaries
~'-l<~~ t~l ~) ,lL,-~~
Y PUBLIC
The preceding instrument consisting of this and two (2) other typewritten pages,
identified by the signature of the TESTATOR, was on the date thereof signed, published and
declared by VANCE MAYBERRY, the TESTATOR therein named as and for his LAST
WILL AND TESTAMENT.
t3..eZt? f2 ~~~~
\VITNESS
kz"
Residing at lCJ8 'Jl.~
{
'--7?[-'....'1'P1J ('7tJ~'W, ,'3.:'\.t,t.z _
Residing at 1/1 i 5<0,41 li:ml14. ~t 'is. ./
/!J(rlliJ ,;?/J i /705:5
f~~i "All CJlVIrlA h J~
WITNES
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND
)
)
ss
weE. 4tH Y A ndersatl and () f;',.H/7~JJr, 1>1 f)Yh21A.)fne witnesses whose
names are signed to the attached or foregoing i~strument, being du(y quaI1fied according to law,
do depose and say that we were present and saw the TESTATOR sign and execute the
instrument as his LAST WILL; that the TESTATOR signed it willingly and that he executed it
as his free nnd vo;untary act for the purpose therdn expressed; that each wimess in the henrinz
."d sight of the TESTATOR signed the WILL as witnesses; and that, to the best of our
knowledge, the TESTATOR was, at the time, 18 or more years of age, of sound mind and under
no constraint or undue influence,
Sworn to or affirmed and acknowledged. before me, by: n"~h"\ l ,-"'''', '" and
I.!:',~w-..\ ( r''\~Jh,,,-) ,witnesses, this ~day.o~)20 2.
~i.&~&l~~~_, _ ii~7J{(Utttt~'