HomeMy WebLinkAbout02-0117
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Pr.tr')I S I1!n'-l-r.,HS
also known as
No.
To:
21-02-117
Register of Wills for the
Deceased. County of C C/ - ,6 lr /. "',; in the
Social Security No. 175-10-9232 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut '" Q
in the last will of the above decedent, dated r,,""y~. '7
and codicil(s) dated
""'-v
named
, 19..2L-
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in t...J >>-.b<...- /0 '? cI County, Pennsylvania, with
h I < last family or principal residence at
/ I 171d,';l" ~ 10 -1 C4/ll-fSL-i;: ~ No,./nG.l;: I viP)
(list street, number and ffiuncipality)
Decendent, then '12 years of age, died December 5 ,x\!2001
at 1~.vM p-
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: _
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
uJ?L.,>'.......+r,/
$
$
$
$
5" ~ OCJI.!J &? ...?
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
(testamentary; administration c.La.; administration d,b.n.c.La.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1.. ss
COUNTY OF ___~pMBERLAND 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 petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed 7h<.,L (f:"":- J A ,Let- '"
before me this 28th day of ~.
JANUARY ~ 2 "
E'
/ ~
R~~rer ~
/7/'_ 212 . ""
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No. 21-02-117
Estate of
PERCY S WILLIAMS
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW FEBRUARY 1 ~. _ ~--1QQ2 in comideration ( ,., ,.<':iti,"', on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated February 22. 1999
described therein be admitted to probate and filed of record as the last will of
PERCY S WILLIAMS
and Letters TESTAMENTARY
are hereby granted to ROBERT J TRACE
FEES
Probate, Letters, Etc. ......... 5 115.00
Short Certificates( ).......... 5 6.00
ReRt}fia~tion ............... 5 6.00
JCP S 5.00
TOTAL _ S 132.00
Filed ..... :FEBRUARY .1.. .2002. . . . . . . . . . .
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ADDRESS
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~HONE
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69-CS-ll-Will ond Testament
Henry Hall, Inc., Indiano, PA
21-02-117
31, PERCY S WILLIAMS
of
l1Q, Tnni~n P~g Rn~n Monrnp ~nwn~hip
County of
Cumberland
and State of
PennsYlvania
being of sound mind, memory and understanding, do make and publish this my last Will and
Testament, hereby revoking and making void aU forme,' Wills by me at any time he!'etofore made.
ITEM 1.
I direct that my hereinafter named Executor or Executrix
shall pay all my just debts, funeral expenses and the expenses
of the administration of my estate.
ITEM 2.
I direct that I be buried from the Cocklin Funeral home
in Dillsburg, Pennsylvania using the same services etc. in which
my wife Sarah Ruth Williams was buried and further that I be placed
between my wife Sarah Ruth Williams and my son Richard S. Williams.
ITEM 3.
I further direct that my house, furniture, tools and
equipment etc. be sold and the monies realized shall be distributed
as follows;
(a). I give and bequeath the sum of One Thousand
($1,000.00) Dollars each to Jay Zeigler, Jim
Fry, Elmer Zeigler and Charlie Wagner and
Lynwood Hoover.
(b). The balance remaining shall be divided among
Betty Zeigler, Robert Williams and Pauline
Thrush, share and share alike, their heirs
and assigns.
All inheritance or transfer taxes shall be paid by my
ITEM 4.
estate as if they were expenses of administration.
(Over)
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COMMONWEAL 1'1-1 OF PENNSYLVANIA
COUNTY OF CUMBEKLAND
WE, Percy S .._Wi!lia~s_~,
Susan T. Newton . and
~~r~~rpt. R. Trace
The Testat or
and the witnesses.
respectively, whose names arc signed to the anached or toregolllg IIlstnunent, being duly
sworn. do herebv declare to the undersigned authority that the Testat~~,,_ signed
and execurcd the instrument as ~his _._Last Will and Testament and that he
e"ccuted It as .~_ hee and voluntary act tor the purposes therelll ""pressed, and that
each of the witnesses. III the presence ~nd heanng of the Testat .9.~ sIgned the \Vill as a
witness and that to the bcst of his or her kllO\\lcdgc. the Tcstat91;____ was at that clghteen
(18) veal'S of age or oldeL of sound nund and under no constrault or undue Illfluence, and
L the said Testa! ~_~ do hereby acknmvledgc that I signed and '.:\.ccuted th~ instruml.::nt
as my Lust \Vill and Testament that I signed it wlllingly'. and that I signed It as my frl:C
and voluntary act for the purposes therein nprcssed
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Subscribed. sworn to and
acknowledged before me b~
Percy S. Williams _
lhl:: T i.:stat ~~___ J.nd subscribed
and s\\'orn to before me b~
susan T. Newton and Margaret B. Trace
witnesses. this 22nddavof
Ee_bruat::L--- .~D 1999
- ~'> ~-r46i.,L.,~
Notar.' blLC
NOTARIAL SEAL
MARC^91-: .. FGSTEH, Notary Public
Calllp Hili, PA ~umOerland County
My CommiSSion ExpIres Aug. 7, 2000
L~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
P.:R<:Y .5, 'NII-L.IAMS
Date of Death:
])€r/tHMI< 5~ J..() 0 I
Will No.
'41. 02.- 0 III
Admin. No.
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 / V' /~ ILl 5'. :2 0 0 :1
.
~ame
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Address
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
NON"
Date:
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Signature ~ J~./ "......<--
Name
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Telephone (7/7)1 J '1-9,{ ff I
Capacity: v/ Personal Representative
_Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRI~;BURG, PA 17128-0601
AEV-1162 EX{11-96}
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ROBERT J TRACE ESQUIRE
331 N 28TH STREET
CAMP Hill, PA 17011
nn_n_ fold
ESTATE INFORMATION: SSN: 175-10-9232
FILE NUMBER: 2102-0117
DECEDENT NAME: WilLIAMS PERCY S
DATE OF PAYMENT: 07/08/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/05/2001
NO. CD 001385
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,368.17
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TOTAL AMOUNT PAID:
REMARKS: ROBERT J TRACE ESQUIRE
CHECK# 1041
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
$3,368.17
MARY C. lEWIS
REGISTER OF WillS
REV-1500fX{E-OO)
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OFFICIAL USE ONLY V V
_jl~~9_ - ,,;L_________
FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
-21_ - --" 2.... ..Q..L L -:J- _
COUNTY CODE YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
WILLIAMS, PERCY S.
DATE OF DEATH (MM-DD-YEARj
12-05-2001
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
175 - 10 - 9232
DATE OF BIRTH (MM-DD.YEAR)
3-21-1908
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
!KJ 1, Original Return
o 4. Limited Estate
i!J 6. Decedent Died Testate (Attach oopy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12-82)
o 7. Decedent Maintained a Living Trust {Attach oopy of Tn.lst)
o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME
COMPLETE MAILING ADDRESS
331 N. 28th Street
Camp Hill, PA. 17011
Robert J. Trace
FIRM NAME (If Applicable)
TELEPHONE NUMBER
(717) 737-9581
1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1) $ 70,000.00 #'''~.. ..- OFFICIAL USE ONLY
-
(2) None
(3) None
(4) None
(5) 11 ,403.96
(6) None
(7) None
(8) $ 81,403.96
(9) 18,222.45
(10) None
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & AdmlnistraUve Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1)
11. Total Deductions (total Lines 9 & 10)
(11) 18,222.45
(12) 63.181.51
(13) )J.....":l......
(14) 63,181.51
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election 10 tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
,.0_(15)
'O~-(16)
2618.17
58,181.51
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
, .12 (17)
18. Amount of Line 14 taxable at collateral rate
$ 5,000.00
'.15 (18)
750.00
3,368.17
19. Tax Due
(19)
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
...
Decedent's Complete Address:
STREET ADDRESS 1191 Indian Peg Road
CITY Mechanicsburq, I STATE PA I ZIP 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)
3,368.17
Total Credits (A + 8 + C ) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
3,368.17
8. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE.
(5)
(5A)
(58)
A. Enter the interest on the tax due.
1.1fiR.'7
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......... ........................ ................... 0 1&1
b. retain the right to designate who shall use the property transferred or its income;.. ............. 0 1&1
c. retain a reversionary interest; Of....... ....................... .............'" . . ................... ........ 0 ~
d. receive the promise for life of either payments, benefits or care? .................. . .................... D lKl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ...... ..................... . ............... .... D ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...... .................... 0 IXI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Ul1der pel1alties of perjury, I declare that I have examil1ed this return, including accompanying schedules and statements, and to the best 01 my kl10wledge and belief, it is true, correct
and complete.
Declaration of pre parer other thal1 the personal representative is based on all il1formation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
lllJl! ~I! .~ I __..~__~ll!f.r 1. -
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries Is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. S9116(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.
REV.l502E~ + (1-97)
.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PERCY S. WILLIAMS
FILE NUMBER
@1-02-0117
AU real property owned solely or as a tenant in common must be- reported at fair market value. Fair marke1 value is deiined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled 10 buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with
right of
survivors hiD must be disclosed on Schedule F.
ITEM
NUMBER
1,
DESCRIPTION
VALUE AT DATE
OF DEATH
ALL that certain tract of land situate in Monroe
Township, county of Cumberland and State of'Pennsyl-
vania, bounded and described as follows:
$ 70,000.00 *
BEGINNING at stones; thence North 4-3/4 degrees West,
'2689.30 feet along land now or formerly of Jacob M.
Hertzler to a stone; thence by land now or formerly of
Michael Brandt, mow or formerlt of Graybill.
North 84-1/2 degrees East, 53.00 feet to a point;
thence along lands now or formerly of George E.
Westhafter, being the remaining portion of the tract
of which the parcel herein conveyed was a portion,in
a Southerly direction to stones, the point and place
of BEGINNING.
HAVING thereon erected the premises known and numbered
1191 Indian Peg Road, Mechanicsburg, PA. 17055
BEING the same premises(Sans a one story cabin
erected by the deceased) which Brian G. WolY,
Single Man, by his deed dated May 12th, 1997 granted
and conveyed to Percy S. Wi11ims, Single Man, which
deed is recorded in the Office of the Recorder of
Deeds in and for Cumberland County in Book 157,
PEjge 589.
* This property sold for pO, 000.00 on 4 /17/02 and
settled 6/03/02. There' was no proration of taxes
no utliities and transfer stamps were affixed to
the Deed.
TOTAL (Also enter on line 1, Recapitulation) $ 70, 000 . 00
(If more space is needed, insert additional sheets of the same size)
Rt:.V.1508 EX + (1-97)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PERCY S. WILLIAMS
FILE NUMBER
21-02-0117
Inclucte the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned 'Nith the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBE"
1.
DESCRIPTION
Commerce Bank- Checking Acct. #0032084741
VALUE AT DATE
OF DEATH
2,603.09
$
2.
Sale of Personal Property (Auction)
8,356.15
3.
Refund from Sprint
9.27
4.
Refund from Holy Spirit Hospital
335.45
5.
Cad. Sedan 1970
(Junk)
100.00
TOTAL (Also enteron line 5, Recapitulation) $ 11,403.96
(If more space is needed, insert additional sheets of the same size)
'REV-1511 EX+ (12-99) ^
. . ~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
PERCY S. WILLIAMS
FILE NUMBER
21-02~0117
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Cocklin Funeral Horne $ 6,400.68
30 N. Chestnut St.
Dillsburg, PA. 17019
B ADMINISTRATIVE COSTS:
1. Personal Representative's Comm'lsslons
Name 01 Personal Representative(s) Robert J. Trace 5,670.00
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 331 N. 28th St.
City Camp Hill State .E.A---- Zip ] 70] 1
Year(s) Commission Paid: 2002
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) NONE
Claimant
Street Address
City State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees 132.00
5. Accountant's Fees None
6. Tax Return Preparer's Fees None
7. Cumberland Law Journal -- Advertising Estate 75.00
8 The Sentinel -- Advertising Estate 84.11
9. Holy Spirit Hospital -- Hospital Services 1,~88.36
10. Register of Wills ( 6 ) -- Short certificates 18.00
11. West Shore EMS -- Ambulance 81.85
12. OSL-DBA Ortho-Institute-- Repair of Broken leg 11 7.56
13. L. G. Connor -- Appraisal of Real Est. 375.00
14. Weir G. Ryder, SR. -- Auctioneer-Per. Prop. 1,230.83
SUB TOTAL (Also enter on line 9. Recapitulation) $ H773.49
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
15.
16.
17.
18.
19.
20.
21.
22.
23.
24
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
SCHEDULE H (Continued)
Estate of PERCY S. WILLIAMS
Recorder of Deeds
Register of wills
Harrisburg Waste Facility
Walmart
Auto Zone
Fisher Auto Parts
Home Depot
Giant Stores
84 Lumber
, Orf 0 s Carpet
Pat Roads
Radzievich Markets
MCI
GPU
Sprint
Discover Card
Hunger-Truffel Orthopedics
Susquehanna Surgeons
OSL-DBA Orthopedics
Quantum Imaging/therapy
Robert Williams
Or tho-Dr Litton
Margaret T. Foster
Register of Wills
File No. 21-02-0117
1% transfer Tax $
Short Certificates(9)
Waste disposal
No parking signs
Car inspection
Battery and parts
Paint -toilet seat
Gloves, Pan, brush
Lumber-attic struts
Carpet remnant
Hauling Punch Press
Glade Plug-ins
Telephone Bill
Light Bills
Telephone Bill
Balance due
Boot for Broken Leg
Medical treatment
Medical treatment
Medical treatment
New locks and keys
Medical treatment
Notary Public
Filing Estate papers etc.
Grand Total
700.00
27.00
123.20
4.72
25.11
48.80
4.95
5.83
39.77
26.50
20.00
5.08
44.91
146.32
106.98
677.05
46.55
19.89
53.04
3.33
33.35
11.58
25.00
250.00
$ 18, 222.45
REV.1513 EX + (1-9?)
.
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
J.
2.
3.
4.
5.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
PERCY S. WILLIAMS
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Elmer Zeigler
1667 Trindle Rd.
Carlisle, PA 17013
Jay Zeigler
6 East Wood Dr.
Carlisle, PA. 17013
Jim Fry
495 Silver Spring Rd.
Mechanicsburg, PA. 17055
Charlie Wagner
159 Simmons Rd.
Mechanicsburg, PA. 17055
Lynwood Hoover
566 Miller Rd.
Mechanicsburg, PA 17055
FILE NUMBER
21-02-0117
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Friend
Friend
Friend
Friend
Friend
AMOUNT OR SHARE
OF ESTATE
$1,000.00
$1,000.00
$1,000.00
$1,000.00
$1,000.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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.
NONE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
NONE
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ NONE
(If more space is needed, Insert additional sheets of the same size)
- .
;,v '''''X-''.n '*
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
(Continued)
ESTATE OF
PERCY S. WILLIAMS
FILE NUMBER 21-02-0117
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
1. TAXABLE DISTRIBUTIONS (Include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not Lilt Trulte.(I)
6.
Betty Zeigler
1400 W. Trindle
Carlisle, PA
Daughter
AMOUNT OR SHARE
OF ESTATE
1/3 Remainder
1/3 Remainder
1/3 Remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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
Rd.
17013
7. Robert E. Williams
900 Eppley Rd.
Mechanicsburg, PA 17055
Son
8. pauline~Th~ush
40 Old Orchard Circle
Camp Hill, PA 17011
Daughter
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
~
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE D~STRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
NowE
1
"_.q;.l1-w111 ond T...~
Hwwy ....,11, 1I'lC., Indiana, PA
21-02-117.
,
i
J, PI::RCY S
WIl.l.IAMS
of
l1Ql Tn~i~n P~g ~n~~ Monrnp~nwnQhir
County of
Cumberland
and State of
PennsYlvania
being of sound mind, memory and understanding, do make and publish this my last Will and
Testament, hereby revoking and making void all former Wills by me at any time he,'etofore made.
I1'EM 1.
I direct that my hereinafter named Executor or Executrix
shall pay all my just debts, funeral expenses and the expe9ses
of the administration of my estate;"
ITEM 2.
I direct that I be buried from the Cocklin Funeral home
in Dillsburg, Pennsylvania using the same services etc. in which_
my wife Sarah Ruth Williamswa's buried and further that I be placed
between my wife Sarah Ruth Williams and my son Richard S. Williams.
ITEM 3.
I further direct that my 'house, furniture, tools and
equipment etc. be sold and the monies realized shall be distributed
/
as follows;
'(a). I give and bequeath the sum of One Thousand ,.
.',"
'($1,000.00) Dollars each to Jay Zeigler~'Jim
Fry,Elmer Zeigler and Charlie Wagner.and
Lynwood ..' Hoover.
(b). The balance remaining shall be divided amon~
Betty Zeigler, Robert Williams and Pauline
Thrush, share and share alike, their heirs
and assigns.
ITEM 4.
All inheritance or transfer taxes shall be paid by my
~
estate as if they were expenses of administration.
IOvF'r)
~
~-.
- .....: ..'
~-
-:!_;.J~"",,".,
.
1 do hereby make, cO'll8titute and appoint
Robert J. TrA~Q
to be Execut ..I:U:-of this my last Will and Testament..,-.. ;;Inn; fhf' pr"d"""a"e~
me, I then appoint Pauline Thrush to be the Executrix of this,
my Last Will and Testament.
:1. \0.._
IN WITN}!:SS WHEREOF, /, p", r<"y '" W; 1 1 i ams .
the. Testat or
nnd
.,
above named, have hereunto subscribed. .my name and affixed my seal, the
day of
Fwbr'lary
in the year of our Lord one thousand
nine hundred N;n..tcy_N; n.. (1999).
'-;1
(hj",]S')jj~ "e'
! J_,
Signed,s~q.~d,P1fblishe<!- and declared liY tke. q.bOJje named,. p", r"y.<: wi 1 1 i am'"
as and for hi" last Will and Testament, in the presence of us, who have here
unto subscribed our names at 1:}; " request as witnesses thereto in the presence of
said testat~and of each other.
".
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COMMONWEALTH Of PENNSYLVANIA
COUNTY' Of CUMBERLAND
I
I
55:
Robest J, Trace
being duly
~lJnrn _ according to law, deposes and says that he i s thp-
Executor __________ of the Estate of PERCY S. WILLIAMS
late of ___ ._.
- MQnroeTOwnsbip un ---___~_, Cumberland County, Pa., deceased and that the
within is an inventory made by ---- him- _ _ ___ __ _ , the said 'J:i'Vl=H"'l1r.nr
of the en'tire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
9UTnrn
f-n
and subscribed before me,
.-J/
~ .=,-- ;;1,pp;J.
(
.~"-k 1~ \, ~~ r
\~ NOTARiAl SEAL I
MARGARET T cnSTER. Notary Public J
Camp Hil,. Cumberland County
Commission Expires Dec. 27. 2004
5th canber
;;;?~j#/~,~
En t t . ~cmrin+duior
331 North 28th Street
Camp Hill, PA
17011
Address
Date of Death _
2001
Doy
Month
Year
INSTRUCTIONS
J. An ir,ventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Addil'ional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of r 949.
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Inventory of the real and personal estate of
PERCY S. WILLIAMS
deceased
0.
/
1. All that certain tract of land situate in Monroe Township,
Cumberland County, pennsylvania 2689.30 X 53 of mostly
mountain area.
Having thereon erected a one story cabin known as and
numbered 1191 Indian Peg Road, Mechanicsburg, PA. 17055
2. Checking Account # 0032084741===Commerce Bank
3. Sale of all personal property (Auction)
4. Refund from Sprint
5. Refund from Holy Spirit Hospi
6. Cad. Sedan (1970) Junk
Total
* This property sold for $70,000.00 on April 17, 2002 and was
settled on June 03,2002. There was no proration of taxes nor
utilities. Transfer stamps in the amount of $700.00 were
affixed to the deed at the time of recording.
8
L_
C
r-
L
$ 70,000 00*
2,603 )9
8,356 5
9 ,7
339 q5
100.)0
81 ,403 ~6
:J
/) .-; - l;-.)' '/ ,. -:;
"'v
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREA~I OF INDIVIDUAL TAXES
INHERITANCE T~X DIVISION
DEPT. 2,B0601
HARRISBIlJRG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ROBERT J TRACE
331 N 28TH ST
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
. .FILE NUMBER
iCOUNTY
ACN
09-02-2002
WILLIAMS
12-05-2001
21 02-0117
CUMBERLAND
101
*'
RfV-1547 EX AFP [81-an
PERCY
S
PA 17~1,1
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 ---
REV=isW-EX-AFP--filFiizY-NOT"icE-OF-YNHEifiTAN-CE-YAX-APPRAisEii€NT-;-AL.'rOwAN-CE-ifri-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WILLIAMS PERCY S FILE NO. 21 02-0117 ACN 101 DATE 09-02-2002
TAX RETURN WAS, I X I ACCEPTED AS FILED
I CMANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
].. Real Estate (Schedule A)
2',. stocks and Bonds (Schedule 8)
3,. Closely Held stock/Partnership Interest (Schedule C)
~. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Parsonal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
III
121
131
141
151
161
171
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. Charitable/Governaental Bequests; Non-elected 9113 Trusts
14. Net Value of Estate Subject to Tax
191
1101
70,000.00
.00
.00
.00
11,403.96
.00
.00
181
18,222.45
.00
(Ill
1121
1131
1141
(Schedule J)
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ abh returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (IS)
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
.00 X 00 = .00
58,181.51 X 045 = 2,618.17
.00 X 12 = .00
5,000.00 X 15 = 750.00
1191= 3,368.17
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
81, 403.96
18.'?? 45
63,181. 51
.00
63,181.51
Tay CRl1nITS:
,.. AI10UNT PAID
DATE NUMBER INTEREST/PEN PAID (-I
07-08-2002 CDOO1385 .00 3,368.17
TOTAL TAX CREDIT 3,368.17
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 PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
RESERVATION: Estates of decedents dying on or before Dece.ber 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Co..onwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
To fulfill the require.ents of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAYMENT:
Detach the top portion of this Notice and sub.it with your payment to the Register of Wills printed on the reverse side.
--Make check or 1I0ney order payable to: REGISTER OF KILLS" AGENT
REFUND (CR):
A refund of a tax credit, which was not requested on the Tax Return, may be requested by co~leting an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050} services for taxpayers with special hearing and I or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraise.ent, allowance, or disallowance of deductions, or assess.ent
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Depart.ent of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the .atter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS:
Factual errors discovered on this assessment should be addressed in writing to: PA Depart.ent of Revenue,
Bureau of Individual Taxes, AllN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedentn (REV-ISOl) for an explanation of administratively correctable errors.
DISCOUNT:
If any tax due is paid within three (3) calendar .onths after the decedent's death, a five percent (5Z) discount of
the tax paid is allowed.
PENALTY:
The 15% tax aMnesty non-participation penalty is co.puted on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty periOd. This non-participation
penalty is appealable in the same manner and in the the same time periOd as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of paYMent. Taxes which becalle delinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary fro. calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 20;:: .000548 1992 .. .000247
1983 16% .000438 1993-1994 n .000192
1984 11% .000301 1995-1998 9;:: .000247
1985 13Z .000356 1999 n .000192
1986 10Z .000274 2000 8;:: .000219
1987 'X .000247 2001 9Z .000247
1988-1991 11;:: .000301 2002 .X .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax beco.es delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assesSllent. If payment is .ade after the interest COMputation date shown on the
Notice, additional interest Must be calculated.
tt.. c>f
4. .
'y
Name of Decedent:
'F) 5 IA I
:c;?cy '. , VV/.LL!,AH'5
C/I
or\
STATUS REPORT UNDER RULE 6.12
Date of Death: yi3CEM1'3cK
s-; ;2.00'
Admin. No.:
-
Will No.:
'21 -Ol..-b\ '1
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
I, State whether administration of the estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. I is Yes, state the following:
a Did the personal representative file a final account with the Court?
Yes No jgl
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes lZl No 0
Date: ~O'"
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
and may be attached to this report.
4kLrf'~{
Signiture
RoI3E~ T J. 7714o?
Name
J J/ IV..:2.t;3 J",
Address f)
CA /'11' IIIL L / A
/
/701/
Telephone No. (71"7) 7 3} - q; 8 {
Capacity: IXl Personal Representative
o Counsel for personal representative