HomeMy WebLinkAbout02-0803
Register of Wills of Cumberland County, Pennsylvania
Estate of
HELEN M. JONES
PETITION FOR GRANT OF LETTERS
~-O;.. YbJ
No.
Also known as
HELEN F. JONES
. Deceased Social Security No.
MATTHEW J. MANNIX
Petitioner(s), who is/are 18 years of age or older. apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
201-18-5723
A. Probate and Grant of Letters and aver that Petitioners are the executors named in the Last Will of
..I
the Decedent, dated March 10. 1998 and codicil(s) dated
April 23. 2001.
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 to victim of a killing and was never adjudicated incompetent
D
B.
Grant of Letters of Administration
(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:
I Name I
COMPLETE IN ALL CASES:(Altach additional sheets if necessary).
Relationship
Residence
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at
Messiah Village. 100 Mt. Allen Drive. UDDer Allen TownshiD. Mechanicsbura. Cumberland County. Pennsylvania
(List street, number and municipality)
Decedent, then 75 years of age, died August 19, 2002 at Messiah Village. 100 Mt. Allen Drive. UDDer Allen TownshiD. Mechanicsbura.
Pennsylvania
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property.....................................................................$
(If not domiciled in PAl Personal property in Pennsylvania.....................................$
(If not domiciled in PAl Personal property in County....................................................$
Value of real estate in Pennsylvania ......................................................................................................................$
Total......................................................................................................... $
140.000.00
140.000.00
Real Estate situated as follows:
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
I
/~.
11~J>~--~
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioners and that, as personal representative of the
Decedent, Petitione, will well and truly administer the~Lding to law, ,
Sworn to and affirmed and subscribed / vU.J ../ ~
MATTH WJ. MANNIX
Before me this
6th
day of
September , 2002
~)J1.Q/A/~~~
D.:>nna M. otto, 1st Deputy .
;--.
..., ,
I......'
No.
21-2002-803
'-c~
I
-:J
Estate of HELEN M JONES
a/Ida HELEN F. JONES
Social Security No:201-18-5723
Date of Death:
, I?~ceased
August 19. 2002-::.
AND NOW, September 6th , 2002, in consideration of the Petition on the reverse side
hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters./ Testamentary 0 of Administration
d.b.n.c.ta.; pendente I~e; durante absentia; durante minorllate
are hereby granted to MA TTHEW J. MANNIX in the above estate and that the instruments dated March
10. 1998 and April 23, 2001 described in the Petition be admitted to probate and filed of record as the last
Will of the Decedent.
Short Certificate(s) 5 $
Renunciation.............. $
Affidavit ().................. $
Extra Pages (5 )....... $
Codicil............................ $
JCP Fee....................... $
Inventory...................... $
Other.............................. $
TOT AL......... $
15.00
:::72&tD ~~~~
~'/)f
FEES
Letters........................... $ 2311.00
15.00
10_110
5.00
Attorney: EDMUND G. MYERS, ESQUIRE
1.0. No: 20558
Address: Johnson. Duffie. Stewart & Weidner.
301 Market Street. P.O. Box 109. Lemoyne, PA 17043-
Telephone: 717-761-4540
280.50
MAILED LEITERS 'TO ATroRNEY ON 9/6/02
HI05.805 REV 9/86
This is to certify that the information here given is correctly copied fran: an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~ft2~
Local Registrar
Fee for this certificate, $2.00
p
8386623
AUG ~~ L~
Date
.1<3_.21117
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
75
COUNTY OF DEATH
Vrs.
UNllEIIl WIt
-!........
SEX
STATE FlU NUM8EA
SOCIAl SECURITY NUMBER
.. ;).0\ - \~ - 57;)3
\~ ')..U!) l.
NAME OF DECEDENT {Fw... _.lllll)
\-\e\eV"'\ {V'- \
AGE IlaslllW>doy) UNDER 1 YEAR
- ! llayo
!
,.
2. Female
~(C.ly-
SIaIe or F0I'8Igr1 Country)
Harrisbur Pa
:=-""10
!lACE -A_Indian. -. _.. Ole.
I~I
... Cl.1rrt>E>..r lam
DECEDENT'S USUAl. OCC\JlWlOH
(<:-'::::~~~~~:f
.".. Secretary 'II. Resco RefrigE'..rat
DECEDENT'S lUolUNG AllllRESS {SIo.... (;;oy1Town. SIaIe. Z;p Codel DECEDENT'S
ACTUAl.
RESIDENCE
(See_
00 ofhet SIde)
...
,0.
White
SURVIVING SPOUSE
tH WIle. Qlve rnad80 name)
17.. StIle
Q;d
--
......in.
nl!Tlberland 10_7 17d.o :....""='.:::..
MOTHEA'S NAME (fIfSl. MKkIe, Malden Surname)
"_STATUS-_
Never Mar,.., Widowed.
DN<<_I~
Widowed ".
~..r Allen
.....
100 Mt Allen Drive
11. Mechanicsbur Pa 17055
FRHEA'S NAME (Firll. Middle. lase)
1711.
...-.,
1'. Helen Prowell
INFORMANT'S MAII.ING AllllRESS {SIo.... CCyITown. _. Z'" Code)
Removal 'rom SlateD
UCENSE NUMBER
e.
DUE~
231>.
"",,S CASE REFERRED TO "EDICAl El<AMlNERlCORONER? _. CIf
YuO "iA{
28.
I.4pp'oxNnilt. PART U: 0tJw IignifIcanl condiIioN contt'ibutlno\Oduth. buI
; inCeNa& ~ not ~ in the undfHfytng C8YM given in PART l-
10nMt and dNth
I
.
I
I :.
d.
DUE 10 (OR AS A CONSEOUENCE Ofl:
DUE 10 lOR AS A CONSEOUENCE Ofl:
WERE AUTOPSY FINDINGS MANNER OF DEATH
-.....8lE PRIOR 10
COMPLETION OF CAUSE tii:.. 0
OF DEATH' ......... Homa.
-- 0 PendinQ_1on 0
v.a0 No 0 - 0 Could not be drlItlN'fJlined 0
DATE OF INJURY
(~. Day, 'fear)
TIMe OF INJURY
jHJIJRV AT WOAK7 DESCRIBE HOW INJURY OCCURRED.
.... 0 NoD
M. _
o
7 i:J 4" 3
2... 21ll.
CERTIFIER ICMck any one)
-CERTIfYING 9HYSSClAH (Phvsoan certifying cause 01 d8iIttllNt\erl anOlhef pI'IVSlCI8O has pronounced dea&h ana comp\eteo Item 23)
To...beelofmtlutow.....athOCCWf..sduetoUMC8UN(...odm..-ne'......led....................,..... .....................
29.
PlACE Of INJURV - At home, larm, 51'_. factory, ollie.
building, etC. (SpeclfV'
_.
.~~y":~~"::::O:C:~~:~.=~a:.ou~i=~:ld\aC=~:,~)u.S::m':::.'r...tat.d.................. 0
.MEDlCAL EllAloIlHEIlJCORONER
On the~. 0' ..anNNltton and/or my..llgation, in my opmion, d.ath oc.CUU" al thetinl't d.t., Jnd piKe. and due to the cause(.)'nd
manner.aatated............................. .....................................................................
:11..
REGIS
o
-
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004296-00001/3.3.98/EGM/DLM/107365
1!Iast 1Iill aub Wtstamtnt
21-2002-803
OF
HELEN M. JONES
I, HELEN M. JONES, also known as BELEN F. JONES, of the Borough of New Cumberland,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making
void any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debt and the expenses of my last illness and funeral from my
Estate as soon after my death as conveniently may be done.
ARTICLE II
I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines
unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE III
I give, and bequeath the sum of ONE THOUSAND ($1,000.00) Dollars unto CAROLYN
JONES, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE IV
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature
and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J.
MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate
unto his then-living issue, per stirpes.
ARTICLE V
In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years
at the time for distribution of his or her share, distribution of said share may be made in the discretion of my
Personal Representative after considering the age and needs of the beneficiary, either directly to the
beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A 95301
et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of
residence of such beneficiary as the case may be. My Personal Representative may designate as such
Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian
for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any
payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall
not be responsible to see to, or be liable for, the application of such proceeds thereafter.
ARTICLE VI
My Personal Representative shall have the following powers in addition to those vested in them by
law and by other provisions of my Will applicable to all property, whether principal or income, including
property held for minors, exercisable without court approval and effective until actual distribution of all
property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such
manner as they may determine.
B. To retain any or all of the assets of my estate, real or personal, without restriction to
investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to
any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of
diversification or risk.
2
D. To sell at public or private sale, to exchange, 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 or conditions as they deem proper.
E. To allocate receipts and expenses to principal or income or partly to each as they from time
to time think proper.
F. To compromise any claim or controversy.
ARTICLE vn
I name, constitute and appoint my nephew, MATTHEW J. MANNIX, Executor of this my Last
Will and Testament. In the event that my nephew, MATTHEW J. MANNIX, fails to qualify or ceases to
so act, I name, constitute and appoint DAUPIllN DEPOSIT BANK AND TRUST COMPANY,
Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no
fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required
in any jurisdiction.
IN WI~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this I D day of ~ , 1998.
HELEN M. JONES
/;'
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and
Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses.
~t1~
V~n~
3
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
: SS.
COUNTY OF CUMBERLAND
We, HELEN M. JONES, ~~ ~.~~nd .
the Testatrix and the witnesses, respectively, whose names are signed to the attached or egoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed
and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her
free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix
was at that time eighteen years of age or older, of sound mind
BELEN M. JONES II
~L (j1~Jv-
Witness
Subscribed, sworn to and acknow1e
~ ~'~~.J and.
of~~ ,1998.
ed before me by HELEN M. JONES, Testatrix, and
~ , witnesses, this ) ~"""'-'tlay
~.~
Notary Public "
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
4
004296-00001/4.4.01/EGM/KL T/144666.2
21-2002-803
<ltnbitil
to
mast mill an~ m.estam.ent
of
HELEN M. JONES
I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will
and Testament dated March 10, 1998.
Item I. I hereby revoke Article II and Article III of my Will and make no provisions in
lieu thereof.
Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and
Testament dated March 10, 1998.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the :z.yJ
day of ~ ,2001.
(SEAL)
004296-00001l4.4.01/EGM/KL T/144666.2
Signed, sealed, published and declared by the above-named Testatrix, as and for her sole
Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her
presence and in the presence of each other ha~;us as witnesses.
~~4~~
ACKNOWLEDGMENTANDAFnDA~T
COMMONWEALTH OF PENNSYLVANIA
: SS.
COUNTY OF CUMBERLAND
We, HELEN M.
Sh~vr.l(.~ t/l F,st,~'^
JONES,
~ t{,
F:~t1k-
and
, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to
her Last Will and that she had signed willingly and that she executed it as her free and voluntary
act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing
of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of hislher
knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and
under no constraint or undue influence.
~4~~
Witness
004296-00001/4.4.01/EGMIKL T/144666.2
Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and
~lfW Li. M1f;r and ~htir'Q.R If.~~
witnesses, this ~ day of
~
.
,2001.
~
Edmund G. Myers
Pennsylvania Attorney ill No. 20558
ACKNOWLEDGMENT AND AFFIDAVIT
ATTORNEY CERTInCATION
COMMONWEAL TH OF PENNSYL VANIA
ss:
COUNTY OF CUMBERLAND
On this, the e~ ~ ~ day of ~~~ ,2001, before me, the
undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558,
known to me (or satisfactorily proven) to be a member of the bar of the highest court of
Pennsylvania and certified that he was personally present when HELEN M. JONES, whose
name is subscribed to the within instrument executed the same, and that the said person
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
.~~^~~ ~
Notary Public ~...
(SEAL )
NOTARIAL SEAL .
DIANNE LENIG. Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21. 2001
cI
CERTIFICATION OF NOTICE UNDER RULE 5.6{a)
Name of Decedent:
Date of Death:
Will No.:
HELEN M. JONES a1k1a HELEN F. JONES
AUGUST 19, 2002
2002-00803
Admin. No.:
To the Register:
I certify that notice of beneficial interest 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
September 19, 2002.
Name Address
MATTHEW J. MANNIX
215 A Winsor Lane
Haverford, PA 19041
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date: September 19, 2002
4
Signature
Name EDMUND G. MYERS
Johnson, Duffie, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
~ Counsel for personal representative
\- ~
07
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive
any money or property will be determined by the
intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
IN RE: Estate of HELEN M. JONES a/k/a HELEN F. JONES, deceased, No. 2002-00803
TO: MR. MATTHEW J. MANNIX
215 A Winsor Lane
Haverford, PA 19041
Please take notice of the death of decedent and the grant of letters to the personal
representatives named below.
The Decedent HELEN M. JONES a/kla HELEN F. JONES died on the 19th day of August, 2002,
at Messiah Village, Mechanicsburg, Pennsylvania.
The Decedent died testate (with a Will). A copy of the Will is attached.
The personal representative of the Decedent is:
Name
MATTHEW J. MANNIX
Address
215 A Winsor Lane
Haverford, Pa 19041
Telephone
610-645-7700 x. 104
If the Decedent died testate, the Will has been filed with the Office of the Register of Wills of
Cumberland County, Cumberland County Courthouse, Carlisle, PA 17013. Phone No. (717) 240-6345
Signatu~
Name EDMUND G. MYERS
Date: September 19, 2002
Addr~ss
Johnson. Duffie. Stewart & Weidner
301 Market Street
P.O. Box 109
Lemovne. PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
~ Counsel for personal representative
)-,;,:1
e
n
..--._ ----=a
_._--~
Qtuhiril
to
mast mill anh Wtstamtut
of
HELEN M. JONES
I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will
and Testament dated March 10, 1998.
Item I. I hereby revoke Article II and Article III of my Will and make no provisions in
lieu thereof.
Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and
Testament dated March 10, 1998.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the 23v-J
day of ~ ,2001.
(SEAL)
,
.1
"""""\
Signed, sealed, published and declared by the above-named Testatrix, as and for her sole
Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her
presence and in the presence of each other ha~2g as witnesses.
S"'~ AI ~~
ACKNOWLEDGMENT AND AFFIDAVIT
!
;1
i
C0Ml\10NWEALTH OF PENNSYLVANIA
: SSe
COUNTY OF CUMBERLAND
We, HELEN M.
Sh'-t1'-le~ M F,sc"er-
JONES,
Iht~ tt{~
FfitV-r--
and
, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to
her Last Will and that she had signed willingly and that she executed it as her free and voluntary
'"\
act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing
of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of his/her
knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and
under no constraint or undue influence.
Witness
~ 1/ ~h/
Witness
-1.
Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and
ffilrW Ci . .~h;r and ~hvV--fQR fl. ~ wlte.J..
witnesses, this ~. day of
~
.
,2001.
~
Edmund G. Myers
Pennsylvania Attorney ill No. 20558
ACKNOWLEDGMENT AND AFFIDAVIT
ATTORNEY CERTIFICATION
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
"\
On this, the ~:J ~~ dayof~:.......L , 2001, before me, the
undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558,
known to me (or satisfactorily proven) to be a member of the bar of the highest court of
Pennsylvania and certified that he was personally present when HELEN M. JONES, whose
name is subscribed to the within instrument executed the same, and that the said person
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
.~~~ ~~
Notary Public ~
(SEAL)
NOTARIAL SEAL .
DIANNE LENIG, Notary Public
lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21. 2001
-=-==
~. .,-4..~
1Jlnst lIill nub mtstnmtut
OF
HELEN M. JONES
I, HELEN M. JONES, also known as HELEN F. JONES, of the Borough of New Cumberland,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making
void any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debt and the expenses of my last illness and funeral from my
Estate as soon after my death as conveniently may be done.
ARTICLE II
I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines
unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE ill
I give, and bequeath the sum of ONE TIIOUSAND ($1,000.00) Dollars unto CAROLYN
JONES, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE IV
I give, devise and bequeath all the rest, residue, and !emainder of my Estate, of whatsoever nature
and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J.
MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate
unto his then-living issue, per stirpes.
i
~
ARTICLE V
In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years
at the time for distribution of his or her share, distribution of said share may be made in the discretion of my
Personal Representative after considering the age and needs of the beneficiary, either directly to the
beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301
et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of
residence of such beneficiary as the case may be. My Personal Representative may designate as such
Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian
for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any
payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall
not be responsible to see to, or be liable for, the application of such proceeds thereafter.
ARTICLE VI
My Personal Representative shall have the following powers in addition to those vested in them by
law and by other provisions of my Will applicable to all property, whether principal or income, including
property held for minors, exercisable without court approval and effective until actual distribution of all
property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such
manner as they may determine.
B. To retain any or all of the assets of my estate, real or personal, without restriction to
investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to
any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of
diversification or risk.
2
i
~
D. To sell at public or private sale, to exchange, 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 or conditions as they deem proper.
E. To allocate receipts and expenses to' principal or income or partly to each as they from time
to time think proper.
F. To compromise any claim or controversy.
ARTICLE VII
I name, constitute and appoint my nephew, MAITHEW J. MANNIX, Executor of this my Last
Will and Testament. In the event that my nephew, MATIBEW J. MANNIX, fails to qualify or ceases to
so act, I name, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY,
Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no
fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required
in any jurisdiction.
IN WI~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this / D day of;J1~ , 1998.
BELEN M. JONES ,
/;'
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and
Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses.
~tJ>>r-
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d
,~'"
ACKNOWLEDGMENT
cOMMONWEALm OF PENNSYLVANIA
: SSe
COUNTY OF CUMBERLAND
We, HELEN M. JONES, ~ "".~~d ,S::)/v.,-.,-.. ~~ '
the Testatrix and the witnesses, respectively, whose names are signed to the attached or egoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed
and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her
free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix
was at that time eighteen years of age or older, of sound mind
~L fiUvIu-
Witness
Subscribed, sworn to and aCknOWle~ me by HELEN M. JONES, Testatrix, and
~ R). ~ ~ J and. ~ ~ ' witnesses, this 1 ~"""-'ffil.y
of~~ ,1998.
~.~
NOTARIAL SEAL
DIANNE lENIG, Notary Public
lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
4
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT 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
LAWRENCE MEREDITH L
1550A LOVELL CT
PA TUXENT RIVER, MD 20670
__h____ fold
ESTATE INFORMATION: SSN: 201-18-5723
FILE NUMBER: 2102-0803
DECEDENT NAME: JONES HELEN M
DATE OF PAYMENT: 02/14/2003
POSTMARK DATE: 02/12/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 08/19/2002
NO. CD 002169
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02146591 I $751.14
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$751.14
REMARKS: MEREDITH L LAWRENCE
CHECK# 2222
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
?Q'vU
~NWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZlI0601
HARRISBURG. PA 171Z8-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* REVISED NOTICE * * *
FILE NO. 21 02-0803
ACN 02146591
DATE 11-26-2002
*
REV-1545 EX AFP 109-DDl
EST. OF HELEN M JONES
S.S. NO. 201-18-5723
DATE OF DEATH 08-19-2002
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[X] CERTIF .
. ')
MEREDITH MANNIX
22512 IVERSDH-BR D~
~ MILLS MD 211634
\'S'S--O 14 Lv" ELL c.ou(<.\
f>Ar\A~cN\ -g\-.Je~ I MD LDla'')O
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
ALLFIRST FINANCIAL SERVICES has prDvided the Departaent with the inforaatiDn listed belDw which has been used in
calculating the PDtential tax due. Theil" recDrds indicate that at the death Df the abDve decedent. YDU were a jDint Dwner/beneficiary Df
this accDunt. If YOU feel this infDraation is incDrrect. please Dbtain written cDrrectiDn frDa the financial institution, attach e copy
tD this fD'" and return it tD the abDve address. This aCCDunt is taxable in accDrdance with the Inheritance Tax Laws Df the CDaaDnwealth
D~ Pennsylvania. QuestiDns aay be answered by calling (717) 787-83~7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 2183719 Date 06-19-2000
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
10.015.25
50.000
5.007.63
.15
751.14
TAXPAYER RESPONSE
TD insure propel" credit tD YDUr accDunt, tWD
(Z) cDpies Df this nDtice aust accoapany YDur
payaent tD the Register Df Wills. Nake check
payable tD: "Register Df Wills. Agent".
x
NOTE: If tax payaants are aade within three
(3) aDnths Df the decedent's date Df death.
you aay deduct a SiC discDunt Df the tax due.
Any inheritance tax due will becDae delinquent
nine (9) aDnths after the date Df death.
Tax
PART
ill
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
~ The abDve infDraatiDn and tax due is CDrrect.
~ 1. YDU aay chDDse tD reait payaent tD the Register Df Wills with twD copies Df this notice tD Dbtain
a discDunt Dr aVDid interest. Dr YDU .ay check bDX "A" and return this nDtice tD the Register Df
Wills and an Dfficial assessaent will be issued by the PA Departaent Df Revenue.
[] The abDve asset has been Dr will be repDrted and tax paid with the Pennsylvania Inheritance Tax return
tD be filed by the decedent.s reprasentative.
c=J The abDve infDraatiDn is incDrrect and/Dr debts and deductions were paid by YDU.
YDU aust cDaplete PART ~ and/Dr PART ~ belDw.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate. please state your
relationship to decedent:
OF
1
2
3 X
4
5
6
7
8
X
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
Line 5 of Tax Computation)
$
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LAW OFFICES
JERRY R. DUFFIE
RICHARD W. STEWART
C. ROY WEIDNER. JR.
EDMUND G. MYERS
DAVID W. DELUCE
RALPH H. WRIGHT, JR.
DAVID J. LANZA
MARK C. DUFFIE
MELISSA PEEL GREEVY
MICHAEL J. CASSIDY
ROBERT M. WALKER
JOHNSON. DUFFIE, STEWART & WEIDNER
A Professional Corporation
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
WEBSITE: www.jdsw.com
HORACE A. JOHNSON
COUNSEL TO THE FIRM
KEIRSTEN WALSH DAVIDSON
OF COUNSEL
TELEPHONE 717-761-4540
FACSIMILE 717-761-3015
E-MAIL mail@jdsw.com
E-MAIL dlw@jdsw.com
February 19, 2003
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Helen M. Jones
SSN: 201-18-5723
Date of Death: August 19,2002
Your File No. 21-2002-0803
Dear Register:
Enclosed for filing please find the following documents for the above referenced
decedent:
1. 2 Original P A Inheritance Tax Returns. There is tax due in the amount of
$20,250.37. An Estate check is attached to the Inheritance Tax Return
2. Check No. 8609 in the amount of $25.00 representing the filing fees for an
Inheritance Tax Return and Inventory.
3. 1 copy of Pages 1 & 2 of the Pa Inheritance tax return, which we ask that you
time-stamp and return to us in the enclosed envelope.
4. Inventory
5. Inventory (copy), which we ask that you time stamp and return to us in the
enclosed envelopt::;.
Should you have any questions, please do not hesitate to contact our office. Thank you
for you assistance in this matter.
Very truly yours,
.rA ../. f), 1O~~
~eman
Legal Assistant
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
MYERS EDMUND G ESQUIRE
301 MARKET STREET
POBOX 109
LEMOYNE, PA 17043
n______ fold
ESTATE INFORMATION: SSN: 201-18-5723
FILE NUMBER: 2102-0803
DECEDENT NAME: JONES HELEN M
DATE OF PAYMENT: 02/20/2003
POSTMARK DATE: 02/19/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 08/19/2002
NO. CD 002198
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $20,250.37
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$20,250.37
REMARKS: MATTHEW J MANNIX
C/O EDMUND G MYERS ESQUIRE
CHECK#102
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of HELEN M. JONES
No. 2002-00803
also known as Helen F. Jones
Date of Death 08/19/2002
,Deceased Social Security No. 201-18- 5723
MATTHEW J. MANNIX,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I !We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Edmund G. Myers
p""", R'P"~ '
Signature: 6./ ~ L
MATT W J. MANNIX
1.0. No.:
20558
Signature:
Address:
P. O. Box 109
Address:
215 A Winsor Lane
Lemoyne, PA 17043-0109
Haverford, PA 19041
Telephone: 717/761-4540
Telephone: 610/645-7700 x.104
Dated:
Description
Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
,,'
Total:
132,506.73
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
Include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form#RW-7 (1992)
INVENTORY
Estate of:
Date of Death:
County:
HELEN M. JONES
08/19/2002
Cumberland
CASH:
A11first Bank Certificate of
Deposit No.
8-000-000-2184174
118,799.78
Accrued income through date of
death
70.47
A11first Certificate of
Deposit Acocunt No.
87008140259500
5,000.00
Accrued income through date of
death
6.73
A11first Relationship Checking
w/Interest Account No.
0049686100
7,086.57
Accrued income through date of
death
0.34
Reimbursement/Refund received
from AARP Hea1thcare
411.00
131,374.89
STOCKS/LISTED:
32.000 shares Prudential Finacia1,
Inc. Shares valued as per
attached Estate Val
Valuation
1,036.00
1,036.00
-1-
BONDS:
Series EE u.S. Savings Bonds.
Valued as per attached
Savings Bond Calculator
95.84
TOTAL RECEIPTS OF PRINCIPAL...............
-2-
95.84
132,506.73
"
I 7~ SL, - 't
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
REV-1500 EX + (6-00)
CAPB
HpRL
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CRAC
KOTK
ES
C P
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME {LAST, FIRST,AND MIDDLE INITIAL)
G/
OFFICiAL USE ONLY
21-2002-0803
JONES HELEN M.
DATEOF DEATH (MM-OO-YEAA)
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
201-18-5723
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
NUMBER
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
X 1. Original Return
4. LImited Estate
X 6. Decedent Died Testate
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82)
7. Decedent Maintained a Living Trust 1
(Attach copy of Trust)
(Attach copy of WUl)
D 9. Litigation Proceeds Received
3 date of Bath
. Remainder Return prtorto 12-13-S2)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit D 11. Election to tax under Sec. 9113(A}
(date of death between 12-31-91 and 1-1-95) (Attach Sch 0)
';"',]t~J~;~~]t!!!!81M!i!$'ttl!!~;!;l!lMPJ!e!i!iQ\\1~~.ltl!!~~e$~f.j[\ENCE.&:;C;()NFiDeNi\!AL.'jiAX';!~~MA'jiI!!lIl~HOl'1t;f"lBalij".."
NAME COMPLETE MAILING ADDRESS
Edmund G. M era
FIRM NAME (If Appllcable)
Johnson, Duffie, Stewart & Weidner
TELEPHONE NUMBER
P. O. Box 109
301 Market Street
Lemoyne, PA 17043-0109
R
E
C
A
P
I
T
U
L
A
T
I
o
N
6 - 4540
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (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. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(1)
(2)
(3)
Nome
1,131.84
None
(4)
(s)
None
131,396.69
(6)
22,967.65
None
9,420.45
11,073.25
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a}(1.2)
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
20.
OFFICIAL USE ONLY
(8) 155,496.18
(11) 20.493.70
(12) 135,002.48
(13)
(14) 135,002.48
x .0 0 (15) 0.00
X .0 45 (16) 0.00
X .12 (17) 0.00
135,002.48 X .15 (18) 20,250.37
(19) 20,250.37
EFUND OF AN OVERPAYMENT.,.
STIONS ON REVERSE SIDE AND TO REc;HECK MATH
i:'~";"\
Copyright (c) 2000 form software only The Lackner Group, Inc.
"'."""'::>'''::
<,<.,.. .
FOim REV-1S00 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
Mess iah Village
100 Mt. Allen Drive
CITY I STATE I liP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
20,250.37
Total Credits ( A + 8 + C) (Z)
0.00
3. Interest/Penalty if applicable
D.lnterest
E. Penalty
~allntereSI/Penalty ( 0 + E) (3)
4. If Line 2 is greater than Line 1 + line 3, enter the difference Thi~ is the OVERPAYMENT.
Check box on Page 1 Line 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) 20,250.37
A. Enter the interest on the tax due. (SA) 0 . 00
B. Enter the total of Line 5 + SA This is the BALANCE DUE. (58) 20,250.37
Make Check Payable to: REGISTER OF WillS, AGENT . .. .. .
'j;iii>il:iH::i[i::i::;ii::i:::::!i;:nHHj::l:iiH1hi;ji\iiiii:!!:i!!!!i!!i!j:jjiiiji:Hiii::i:iniiiiii::Hi:i:nii::;::nn::ini!!U:nU:HiiHU::::::,::'?:,""i:i:::i:ii:iiHUV/:"U:U:iii:i:ni:n::::::iii:!miiii:
iiii:::i::!ii:::iil!imiliiii::i::iiii:::iiii::i;,i;i;:;;ii!iii!il!iii;iil!!iilIJll\llm;;:ii!:i:m::::
"PL"EASEANSWER'THEFOiIOWiNGQUESTI()NS BY PLACING AN "X,iiN THE APPROPRIATE BLOCKS
1 Did decedent make a transfer and: Ye" No
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property tran"ferred or its income; .
. c. retain a reversionary interest; or . ~DO' ~X'
d. receive the promise for life of either payments. benefits or care? fiJ
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.
0.00
o
o
o
IT]
IT]
IT]
Under penalties of perjury, I declare that r have examined this return, Including accompanyinq schedules and statements, and to the best of my knowledge clnd belief, It is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge
EOFPERSONRESPONSIBLEFORFllINGRETURN MATTHEW J. t'1ANNIX DATE
215 A Winsor Lane
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - . - - - - - - - - -
Haverford, PA 19041
Duffie I Stewart & Weidner DATE
lU9
PA
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 Of for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) 0)].
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) (iO]. The statute does not exempt a transfer to a surviVing spouse from tax, and the statutory requiremerLts 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 fen 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 no~ed in 72 P.S. 9116( 1.2)
[72 P.S. 9116(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. 9116(aXl.3}]. A sibling is defined, under
Section 9102. as an individual who has at least one parent in common witn the decedent whether by blood or adoption.
Copyright(c) 2000 form software only The Lackner Group, Inc. Forni REV-1500 EX (Rev. 6-00)
'REV- 1503 EX + (1 -97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
HELEN M. JONES
SSlf 201-18-5723
08/19/2002
21-2002-0803
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
32 shares Prudential Finacial, Inc. Shares valued as
per attached Estate Val Valuation, CUSJ? #744320102
32.375
VALUE AT DATE
OF DEATH
1,036.00
ITEM
NUMBER
1
DESCRIPTION
UNIT VALUE
2
Series EE U.S. Savings Bonds. Valued 8S per attached
Savings Bond Calculator
95.84
TOTAL (Also enter on line 2, Recapitulation)
(If more space IS needed, Insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems. Inc.
1,131.8/,
Form REV-1503 EX (Rev. 1-97)
'REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN M. JONES
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
5511 201-18 - 5723
08/19/2002
FILE NUMBER
21-2002-0803
Include the proceeds of litigation and 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
NUMBER
1
VALUE AT DATE
OF DEATH
118,799.78
DESCRIPTION
A11first Bank Certificate of Deposit No. 8-000-000-2184174
Accrued income on item 1 through date of death
70./,7
2
A1lfirst Certificate of Deposit ACOCUflt No. 87008140259500
5,000.00
Accrued income on item 2 through date of death
6.73
3
Al1first Relationship Checking w/lntercst Account No. 0049686100
7,086.57
Accrued income on item 3 through date of death
0.34
4
Refund of unearned Premium
21. 80
5
Reimbursement/Refund received from AARP Healthcare
411 . 00
TOTAL (Also enter on line 5, Recapitulation) $ 131,396.69
(If more space IS needed, Insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems Ine
, . Fonn REV-15GB EX (Rev. 1-97)
'REV-1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN M. JONE5
SCHEDULE F
JOINTLY-OWNED PROPERTY
5511 201-18-5723
08/19/2002
FILE NUMBER
21-2002-0803
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
Meredith Mannix
579 Golf Road
South Burlington, VT
Grand Niece
B.
Catharine Mannix
579 Go 1 I Road
South Burlinton, VT
Grand Niece
c.
Jamie Mannix
579 Golf Road
Sou"th Burlington" VT
Grand Nephew
JOINTLY-OWNED PROPERTY,
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bilnk DATE OF DEATH DECO'S VALUE OF
account number or similar identifying nUlT1ber.
NUMBER TENANT JOINT Attach deed for jointly-held real estal,' VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A A11first Bank Certificale 10,000.00 50.00% 5,000.00
of Deposit Account No.
80000002183719
A Accrued income on item 1 15.25 50.00% 7.63
through date of death
2 B A11first Bank Certificate 7,931. 99 50.00% 3,966.00
of Deposit Account No. I
80000002183717
B Accrued income on item 2 13.23 50.00% 6.62
through date of death
3 B Allfirst Bank Certificate 10,000.00 50.00;; 5,000.00
of Deposit Account. No.
80000002183721
B Accrued income on item 3 14.30 50.00% 7.15
through date of death
4 C A1lfirst Bank Certificate 10,000.00 50.00;, 5,000.00
of Deposit Account No.
80000002183715
C Accrued income on item I, 17.16 50.00X, 8.58
through date of death
5 C Allfirst Bank Certificate 7,931. 99 50.00% 3,966.00
of Deposit Account No.
Tot 1 of Contim ation 5chedu1e(s) 5.67
TOTAL (Also enter on line 6, Recapitulation) $ 22,967.65
(If more space IS needed Insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Fo,r~ REV-1509 EX (Rev_ 1-97)
Estate of: HELEN M. JONES
Soc See #: 201-18-5723
Date of Death: 08/19/2002
Item Ltr for
II Jt Ten
Date
Joint
Continuation of Schedule F
(Jointly Owned Propecty)
Description of property
Total Val
of Asset
Decd;j
% Int
Dollar Val of
Deeds Interest
c
80000002183720
Accrued income on item 5
through date of death
11.34
50.00%
5.67
5.67
REV 1511 EX+(l 97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-2002-0803
ESTATE OF
HELEN M. JONES
SSlI 201-18-5723
08/19/2002
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
ADMINISTRATIVE COSTS,
1. Personal Representative's Commissions
Name of Personal Representative(s) _____
Social Security Number(s) / EIN Number of Personal liepresentative(s)
Street Address
City Slale Zip
B.
2.
3.
DESCRIPTION
I
AMOUNT
1
FUNERAL EXPENSES,
Myers-Harner Funeral Home
5,911.00
Year(s) Commission Paid:
Attorney's Fees
Johnson, Duffie, SteWiJrt. 0: Weidner
(If decedent's address is not the same as claimant's attach explanation)
3,000.00
Family Exemption:
Claimant
Street Address
City
Relationship of Claimant to Decedent
Zip
Slate
4.
Probate Fees
Register of Wills
280.50
S. Accountant's Fees
6. Tax Return Pre parer's Fees
7.
1
Other Administrative Costs
Cumberland County Register of
Inheritance Tax Return
Inventory
Additional Short Certificates
Wills 0 L flee
$15.00
$10.00
$ 9.00
Filing Fees:
34.00
2
The Cumberland Law Journal - Estate Advertising
75.00
3
The Patriot News Company - Estate Adver.tisement
119.95
I
I
TOTAL (Also enter on line 9, RecaPitulatioC!~J_~___
(rf more space is needed, insert addltionill sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
_2.,420.45
Fori'll REV-1511 EX (Rev.1~97)
REV-1512 EX + (1-97)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN M. JONES
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SSfl 201-18-5723
08/19/2002
FILE NUMBER
21-2002-0803
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
AARP Debit from Checking Account for Hea1thcare
AMOUNT
1- 205.50
I
I
I
I 0.0/,
906.53
1
560.33
288.05
645.00
8,467.80
2
Allfirst bank fee deducted from AccouTtt.
3
Checks clearing after date of death
4
Final Medical/Pharmacy Invoices
5
Final Medical/Pharmacy Invoices
6
Johnson, Duffie, Stewart & Weidner - Legal Fees for Estate
Planning prior to Death
7
Messiah Village Retirment Home - Final Billing
!
I
I
( . TOTAL (Also enter on fine 10, Recapitulation) $ 11,073.25
. If more space is needed, insert additional sheets of the same size)
COPYright (e) 1996 form software only CPSystems Ine
, . For;)) REV-1512 EX (ReV'. 1-97)
. REV-1513 EX f (9-00)
SCHEDULE J
BENEFICIAR IES
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN M. JONES
SSjl 201-18- 5723
08/19/2002
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116{a)(1.2)]
MATTHEW J. MANN1X
215 A Winsor Lane
Haverford, PA 19041
1
RELATIONSHIP TO DEqqENT
Do Not List Trustee(s)
Nephew
FILE NUMBER
21-2002-0803
AMOUNT OR SHARE
OF ESTATE
Entire Estate
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON RoV 1500 COVER SHEET
II. 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space IS needed, insert additional sheets of the same size)
Copyright (cl :2.000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
LISTING OF EXHIBIT FOR
ESTATE OF HELEN F. JONES
EXHIBIT A
Last Will and Testament dated March 10, 1998
EXHIBIT B
Codicil to the Last Will and Testament dated April 23, 2001
EXHIBIT C
Estate Val Valuation for Prudential Stock listed on
Schedule B
EXHIBIT D
Savings Bonds Calculator valuing Savings Bonds listed on
Schedule B
-==-
-~
roast mUI anll ijlestam.ent
OF
HELEN M. JONES
I, HELEN M. JONES, also known as HELEN F. JONES, of the Borough of New Cumberland,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making
void any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debt and the expenses of my last illness and funeral from my
Estate as soon after my death as conveniently may be done.
ARTICLE II
I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines
unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE ill
I give, and bequeath the sum of ONE THOUSAND ($1,000.00) Dollars unto CAROLYN
JONES, of Camp Hill, Pennsylvania, provided she survives me.
ARTICLE IV
I give, devise and bequeath all the rest, residue, and ;emainder of my Estate, of whatsoever nature
and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J.
MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate
unto his then-living issue, per stirpes.
ARTICLE V
In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years
at the time for distribution of his or her share, distribution of said share may be made in the discretion of my
Personal Representative after considering the age and needs of the beneficiary, either directly to the
beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301
et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of
residence of such beneficiary as the case may be. My Personal Representative may desigoate as such
Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian
for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any
payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall
not be responsible to see to, or be liable for, the application of such proceeds thereafter.
ARTICLE VI
My Personal Representative shall have the following powers in addition to those vested in them by
law and by other provisions of my Will applicable to all property, whether principal or income, including
property held for minors, exercisable without court approval and effective until actual distribution of all
property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such
manner as they may determine.
B. To retain any or all of the assets of my estate, real or personal, without restriction to
investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to
any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of
diversification or risk.
2
D. To sell at public or private sale, to exchange, 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 or conditions as they deem proper.
E. To allocate receipts and expenses to principal or income or partly to each as they from time
to time think proper.
F. To compromise any claim or controversy.
ARTICLE vn
I name, constitute and appoint my nephew, MA'ITHEW J. MANNIX, Executor of this my Last
Will and Testament. In the event that my nephew, MA'ITHEW J. MANNIX, fails to qualify or ceases to
so act, I name, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY,
Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no
fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required
in any jurisdiction.
IN ~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this / D day of ~ , 1998.
HELEN M. JONES .
/;
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and
Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses.
~uIIP>>r-
J)~ ()~k
3
i
~..
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
: SS.
We, HELEN M. JONES, -&~ )-:::l.~~d '
the Testatrix and the wilnesses, respectively, whose names are signed to the attached or egoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed
and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her
free and voluntary act for the purposes therein expressed, and that each of the wilnesses, in the presence and
hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix
was at that time eighteen years of age or older, of sound mind
Subscribed, sworn to and acknowle
"4S;J~ R:l.~~, and.
of~~ ,1998.
!_-----~,-
Witness
fJbJ/J{~. fl(?4jv
Witness
ed before me by HELEN M. JONES, Testatrix, and
~ , witnesses, this I ~ '"'-\lliy
4
~~
Notary Public "
NOTARIAL SEAL
DIANNE LENIG, Notary Public
lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
~
<ltnbitil
to
14a5t Bill null Wt5tamtut
of
HELEN M. JONES
I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will
and Testament dated March 10, 1998.
Item 1. I hereby revoke Article II and Article III of my Will and make no provisions in
lieu thereof.
Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and
Testament dated March 10, 1998.
IN WITNESS WJlEREOF, I have hereunto set my hand and seal on this the 23v-J
day of ~ ,2001.
(SEAL)
--.\,
Signed, sealed, published and declared by the above-named Testatrix, as and for her sole
Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her
....0000"'" in "" _~OO of=h ""'" hav&2U ~ .._"
~~N#~
ACKNOWLEDGMENT AND AFFIDA VlT
COMMONWEALTH OF PENNSYLVANIA
: SS.
COUNTY OF CUMBERLAND
We, HELEN M.
Sh"fCle~ tll FISL?lIl"
JONES,
fr>t~ f{,
rv.~
and
, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to
her Last Will and that she had signed willingly and that she executed it as her free and voluntary
act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing
of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of hislher
knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and
under no constraint or undue influence.
~
Witness
~i/~~
Witness
"""""l
Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and
.ffi.~ lei. .f01't;r and ~hI/0'QR If. ~1/j1te.r
witnesses, this ~ day of
~
.
,2001.
~
Edmund G. Myers
Pennsylvania Attorney ill No. 20558
ACKNOWLEDGMENT AND AFFIDAVIT
ATTORNEY CERTIFICATION
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
,
On this, the .~ ~ ~ day of ~U- , 2001, before me, the
undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558,
known to me (or satisfactorily proven) to be a member of the bar of the highest court of
Pennsylvania and certified that he was personally present when HELEN M. JONES, whose
name is subscribed to the within instrument executed the same, and that the said person
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
'~N..Nvv-L ~~.:...
-<:s,'.~"E;.'
Notary Public
(SEAL)
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumbelland Co.
My Commission Expires Dec. 21. 2001
Estate Valuation
Date of Death:
Valuation Date:
Processing Date:
08/19/2002
08/19/2002
11113/2002
Estate of: Jones, Estate of Helen M.
Account: 4296/1
Report Type: Date of Death
Number of Securities: 1
File ID: JONES
Shares
or Par
Security
Description
High/Ask
Low/Bid
Mean and/or oiv and Int
Adjustments Accruals
Security
Value
1)
32 PRUDENTIAL FINL INC 1744320102)
NYSE
08/19/2002
32.75000
32.00000 HIL
32.375000
1,036.00
Total Value:
Total Accrual:
Total: $1,036.00
$1,036.00
$0.00
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300. (Revision 6.4.0)
. Savings Bond Calculator
Page 1 of I
I;Upillite1
j)Y}e {, ~
1!l1l'if!!l1~;!1l1 t)lyl1 ,
Savinc
Value As or
108/2002
CALCU
U Error - required fields missing.
Bond Info
Series
I EE Bonds
Denomination
Serial Number
Issue Date
~
$150
m
Results
Serial Number Issue Date Series Deuom
Issue
Price Interest
TotlilViiiirn
,~
Interest
Value Rate
YTD Inl
$2.8
# Bonds Total Price
2 $50.00
Total Interest
$45.84
Next Final
Accrual Maturity
L477472034EE 04/1991
L477588011EE 06/1991
EE
EE
$50 $25.00
50 25.00
$22.92 $47.92
22.92 47.92
6.00%
6.00%
10/2002 04/2021
12/2002 06/2021
le end
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
(Please print and/or save this page before submitting your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator
r
r
r
r
httn:/lwwws.oublicdebt.treas.gov/BC/SBCPrice
10/15/2002
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
MANNIX JAMIE
3022 PENN ESTATES
EAST STROUDSBURG, PA 18301
-------- fold
ESTATE INFORMATION: SSN: 201-18-5723
FILE NUMBER: 2102-0803
DECEDENT NAME: JONES HELEN M
DATE OF PAYMENT: 02/21/2003
POSTMARK DATE: 02/19/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 08/19/2002
NO. CD 002201
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02146588 I $595.75
02146592 I $751.29
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JAMIE MANNIX
CHECK# 715
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
$1,347.04
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 1712B-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEKENTL ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV~1548 EX AFP <01.03)
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG PA 18301
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-24-2003
JONES
08-19-2002
21 02-0803
(:UMBERLANI) ..
201-48 - 5723')
02146592
HELEN
M
Amount Remitted
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 ~
RE-Y=is4i5-E3f-AFP--coi-:03l------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-24-2003
ESTATE OF JONES
HELEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
TAX RETURN WAS:
S.S/D.C. NO. 201-18-5723
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
02146592
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES
ACCOUNT NO.
2183715
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE
06-15-2000
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
10,017.16
0.500
5,008.58
.00
5,008.58
.15
751.29
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002201 .00 751. 29
TOTAL TAX CREDIT 751.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEKENTL ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-l.5ti8 EX AFP (01.03)
MEREDITH MANNIX
1550 A LOVELL CT
PATUXENT RIVER MD 20670
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-24-2003
JONES
08-19-2002
21 02-0803
CUMBERlt~ND
20T~' 18::5723
02146591
HELEN
M
~' .l
Amount Remitted
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 ~
RE-Y=is4-i-E3f-AFP--coi-:03l------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-24-2003
ESTATE OF JONES
HELEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
TAX RETURN WAS:
S.S/D.C. NO. 201-18-5723
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
02146591
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES
ACCOUNT NO.
2183719
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE
06-19-2000
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
10,015.25
0.500
5,007.63
.00
5,007.63
.15
751.14
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-12-2003 CD002169 .00 751.14
TOTAL TAX CREDIT 751.14
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
~,..,.. n,..".r-,."...r- ............. ...,.. .......... ___.... ___ ..~.___..____~._ ..
/7-P6-P
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX OIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLOKANCE OR DISALLOKANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV.l54& EX AFP <01-03)
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG PA 18301
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COU""TY
SSN/DC
ACN
03-24-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
201-18-5723
02146588
HELEN
M
Amount Remitted
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 ~
RE-Y=is4-i-EX--AFP--coi-:03J------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-24-2003
ESTATE OF JONES
HELEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
TAX RETURN WAS:
S.S/D.C. NO. 201-18-5723
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
02146588
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES
ACCOUNT NO.
2183720
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE
06-21-2000
X
7,943.33
0.500
3,971.67
.00
3,971.67
.15
595.75
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CDo02201 .00 595.75
TOTAL TAX CREDIT 595.75
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR). YOU MAY BE DUE A REFUND.
~~~ nl""'t.II""'DIt"r'" roT"'" "... ...11'1"'" .............. --- ........--..----..- ..
/?"R6-~
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISIDN
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 EX AFP 111-031
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-07-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
101
HELEN
M
Allount Rellitted
PA 17043
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 ~
REV=isirj-E3Ci;:'p--("OY:03Y-NOTicE--OF-YtiHEifiTAirCE-TAi-jrpPRAisEifENT~--iLl-owAircE-iri-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JONES HELEN M FILE NO. 21 02-0803 ACN 101 DATE 04-07-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
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)
S. Cash/Bank Deposits/Misc. 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
1, 131. 84
.00
.00
131,396.69
22.967.65
.00
(8)
NOTE: To insure proper
credit to your account.
subnit the upper portion
of this forll with your
tax paYllent.
155.496.18
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitab1e/Govern.enta1 Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
9.420.45
11. 073.25
(11)
(12)
(13)
(14)
20.493 70
135.002.48
.00
135.002.48
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
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. A.ount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CR TS:
14, lS and/or 16, 17, 18 and 19 will
returns assessed to date.
.OOX 00 =
.00 X 045 =
.00 X 12 =
135.002.48 X 15 =
(19)=
.00
.00
.00
20.250.37
20.250.37
DATE
02-19-2003
NUMBER
CD002198
+
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
20.250.37
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
20.250.37
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. 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 rNSTRUCTTnN~ 1
1?-J?6W ~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
REV-l60~ EX AFP 101-031
L_
04-02-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
201-18-5723
02146588
Allount Rellitted
HELEN M
PA 18301-0000
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 ~
----------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (01-03)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 04-02-2003
ESTATE OF JONES
HELEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
ADJUSTMENT BASED ON:
S.S/D.C. NO. 201-18-5723
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
02146588
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183720
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 06-21-2000
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002201 .00 595.75
TOTAL TAX CREDIT 595.75
BALANCE OF TAX DUE 595.75CR
INTEREST AND PEN. .00
TOTAL DUE 1i91i.75CR
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $I, 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.)
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSNI'DC
ACN
'*
BUREAU. OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-UD~ EX AFP I Dl-D31
04-02-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
201-18-5723
02146592
Allount Rellitted
HELEN M
PA 18301-0000
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 ~
----------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (01-03)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 04-02-2003
ESTATE OF JONES
HELEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
ADJUSTMENT BASED ON:
S.S/D.C. NO. 201-18-5723
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183715
ACN
02146592
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 06-15-2000
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002201 .00 751.29
TOTAL TAX CREDIT 751. 29
BALANCE OF TAX DUE 751.29CR
INTEREST AND PEN. .00
TOTAL DUE 71i1 ?Qr:R
. IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. 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.)
REV.'470 EX (6-88)
'*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
HELEN M. JONES
FILE NUMBER
REVIEWED BY
Phyllis Hoch
ACN
2102-0803
02146588,02146592
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN.
ROW
Paqe 1
\ 17.. ,j'6. 'J?
~ BUREAU OF INDIVIDUAL TAXES
~~HERITANCE TAX DIVISION
OEPT. z8ii601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
MEREDITH MANNIX
1550 A LOVELL CT
PATUXENT RIVER MD 20670-0000
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
RU-1"~ EX AfP 'D1-D3)
04-02-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
201-18-5723
02146591
Allount Rellitted
HElEN M
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 ~
----------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (01-03)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 04-02-2003
ESTATE OF JONES
HElEN
M DATE OF DEATH 08-19-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0803
ADJUSTMENT BASED ON:
S.S/D.C. NO. 201-18-5723
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
02146591
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183719
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 06-19-2000
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-12-2003 CD002169 .00 751.14
TOTAL TAX CREDIT 751.14
BALANCE OF TAX DUE 751. 14CR
INTEREST AND PEN. .00
TOTAL DUE 71;1 1 ti~R
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX <-J
'* 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
HELEN M. JONES 2102-0803
REVIEWED BY ACN
Phyllis Hoch 02146591
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN.
ROW
Paae 1
/-?-Pt:-R
\.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-IU1 EX AFP (01-051
'03 JUN 20 All :41
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-19-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
02146588
HelEN
M
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG P~~~~l~~
Allount Rellitted
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. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=i&Cf;-EX-AFP--roY=03Y------...-iNHERITANc'E--TAX-SY]rfEHfNT-cfF-ACCoUi,rf--...---------------- -----
ESTATE OF JONES HelEN M FILE NO.21 02-0803 ACN 02146588 DATE 05-19-2003
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: 04-01-2003
PR I NC I PAL TAX DUE: ................................................................................................................................................................................
..........................................
.00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002201 .00 595.75
04-28-2003 REFUND .00 595.75-
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
lli IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
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. )
1?-P6'- P
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-IU1 EX AFP (01-051
Reccl(c:.
of
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-19-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
02146592
HelEN
M
Ref
JAMIE MANNIX
3022 PENN ESTS
E STROUDSBURG
.03
JUN 20 All :41
Allount Rellitted
P A(..:J.8S;,OI
CumbEk
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, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV :i&cf;-E3f-AFP--roY:03'r------...-iNHERITANCE--TAX-SYA-fEHftiT-crF-ACCoui,rf--...---------------- -----
ESTATE OF JONES HelEN M FILE NO. 21 02-0803 ACN 02146592 DATE 05-19-2003
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: 04-01-2003
PR I NCI P AL TAX DUE: ................................................................................................................................................................................
.........................-.....
.00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002201 .00 751.29
04-28-2003 REFUND .00 751. 29-
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
lli
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
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. )
/?-c?6'" 2?
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
J:NHERJ:TANCE TAX
STATEMENT OF ACCOUNT
'*
REV-IU7 EX AFP 101-051
Recore :.
Re~j:~ .',
,..f
L'j
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-19-2003
JONES
08-19-2002
21 02-0803
CUMBERLAND
02146591
AlIOunt R_i tt.d
HELEN
M
MEREDITH MANNIX
1550 A LOVELL CT
PATUXENT RIVER
.03
JUN 20 All :41
MD ~lO
Cumb6ik",
. .... Pi"
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, subllit the upper portion of this forI! with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=i6"ifj-i:x-"Fii-foY:oiY------...-iNirERITANc'f-TAx-sTAyEM'E-tiT-CrF'-ACCOUNy--...------------------ ---
ESTATE OF JONES HELEN M FILE NO. 21 02-0803 ACN 02146591 DATE 05-19-2003
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: 04-01-2003
PR I NC I PAL TAX DUE: ................................................................-....-..........................................................................................................
..............................
.00
PAYMENTS (TAX CREDITS):
PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-12-2003 CD002169 .00 751.14
04-28-2003 REFUND .00 751.14-
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
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. )
STATUS REPORT UNDER RULE 6.12
G;/t/
or......
Name of Decedent:
HELEN M. JONES
Date of Death:
AUGUST 19,2002
Will No.
0803-2002
Admin No.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the Estate is complete:
Yes X
No
2~ If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. If the answer to No.1 is Yes, state 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:
c.
parties of interest?
Did the personal representative state an account informally to the
Yes No X
Executor was Sole Beneficiary
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Date: June 30, 2003
~:~~
......
I
-..l
::::!
J
t..,~~
EDMUND G. MYERS
Name
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, P A 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
N
.......
. .
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~
.......
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w
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'.. >=
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