HomeMy WebLinkAbout02-1118PETITION FOR PROBATE & GRANT OF LETTERS
Estate of JACK BRITTON COOPER SR. No. 21-02- /~~8
also known as To: Register of Wills for the
deceased. County of Cumberland
Social Security No. 247-56-2091 Commonwealth of Pennsylvania
The Petition of the undersigned respectfully represents that:
Your Petitioners, who is 18 years of age or older and the Executor named in the Last Will of the above
. The Executor
decedent dated August 27 2002 ,and codicils dated none
named none died .Renunciations for none attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal
residence at 55 White House Road Southampton Township Shippensburg
Decedent, then 71 years of age, died November 15 ~ 2002, at Winchester Medical
Center Winchester Virginia
Except as foil Will offered?or probat mesas not the v ctimrof a kil ngi and was never iadb dicateddopted
after execution of the
incompetent:
Decedent at death owned property with estimated values as follows: $25.000.00_
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in PA
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania, situated as follows:
WHE FORE, etitioners respectfully requests the probate of the Last Will and Codicil(s) presented
herewith a the gran f letters testamentary thereon.
Signature( a iden I ~) of~titioner s
Marcu A.
60 We omfret Street
Carlisle 13
717-249-2353
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss
COUNTY OF CUMBERLAND
The Petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct tv the best of the knowledge and belief of Petitioner(s) and that s personal representative of
the abovs ds~cadent, petit'soner(s) will well and truly administer the est Ie accordi to~a~_
Sworn to or affirme~nd subscribed
before me this ~_day of
Dnecember , 2002.
~ J ~ n t ` ;~~~ eg~ster
i~ ~~, ~ i ~
No. 21-02- i ~ ~ 8
Estate of _jACK BRITTON CnnPER SR
,deceased.
DECREE OF PROBATE & GRANT OF LETTERS
AND NOW, December to 2002, in consideration of the Petition on the reverse
side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated
August 27 2002 described therein be admitted to probate and filed of record as
the Last Will of Jack Britton Coooer Sr • and Letters Testamenta
Marcus A. McKni ht III are hereby granted to
7
Register of Wilis~~4J
FEES IRWIN McKNiGHT & HUGHES
Probate, Letters, Etc........ $ 60.00
Short Certificates(-3- ) . , , . $ 9.00 Marcus A. McKnight {I!. Esquire (25476)
Renunciation(s) ........... $ ATTORNEY (Sup. Ct. I.D. No.)
JCP .. ..... $ 10.00
Other Will Pages (-3-) 60 West Pomfret St. Carlisle PA 17013
$ 900 - ADDRESS
TOTAL: .. $ 88.00
Filed .~c~-nnbe,z...~q,. ~~aZ.. .
717-249-2353
PHONE
C~~ '~
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.. v DEPARTMENT OF HEALTH~a
Bureau of Vital Records and Health Statistics
CERTIFIED .COPY OF DEATH RECORD
COMMONWEALTH OF VIRGINIA -CERTIFICATE OF DEATH
DEPARTMENT OF HEALTH -DIVISION OF VITAL RECORDS -RICHMOND
COPY A
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FOR DIVISION OF REGISTRATION
AREA NUMBER .++~ CERTIFICATE
NUMBER
~ STATE FILE
NUMBER
VITAL RECORDS ~\
-C_/] ~
DECEDENT 1. FULL NAME (first) (middle) (last) 2. SEX male female
OF DECEDENT
JACK BRITTON COOPER SR. ~ ^
3. DATE OF (mo.) (day) (year) 4. AGE IF UNDER 1 YEAR IF UNDER 1 DAY 5. DATE OF (mo.) (day) (year) 6. WAS DECEDENT yes no
DEATH - - - T - - - - - - - r - - - -
months days ~ hours minutes
I I I I BIRTH EVER IN U.S.
ARMED FORCES? ^ Y-I
11 15 2 0 0 2 71 years 1J
PLACE OF 7. NAME OF HOSPITAL OR INSTITUTION OF DEATH (il none, so state) I Out Pat. 8. COUNTY OF DEATH (if independent city, leave blank)
DEATH I DOA Emer Rm Inpatient
WINCHESTER MEDICAL CENTER ~ ^ ^ ~j
9. CITY OR TOWN OF DEATH inside city or town limits? 10. STREET ADDRESS OR RT. NO. OF PLACE OF DEATH
WINCHESTER ~] ^ 1840 AMHERST STREET
USUAL t 1. STATE (OR FOREIGN COUNTRY) OF DECEDENT'S RESIDENCE t2. COUNTY OF DECEDENT'S RESIDENCE frt independent city, leave blank)
RESIDENCE
OF DECEDENT PENNSYLVANIA CUMBERLAND COUNTY
73. CITY OR TOWN OF RESIDENCE inside tiry or town limits? 14. STREET ADDRESS OR RT. NO. OF RESIDENCE I ZIP CODE
yes no I
SHIPPENSBURG ^ (JX 55 WHITE HOUSE ROAD '17257
PERSONAL 15. NAME OF DECEDENT'S FATHER - 16. MAIDEN NAME OF DECEDENT'S MOTHER
DECE ENT NOAH COOPER MARY RILEY
17. RACE OF DECEDENT 18. OF HISPANIC ORIGIN? If yes, specity Cuban. Mexican, 19. EDUCATION (Specify only highest grade completed)
WHITE Puerto Rican, e[c.
® no ^ yes
1 ~
Elementary/Secondary (0-72)
College (14 or 5 +)
20. CITIZEN OF WHAT COUNTRY 21. BIRTHPLACE (state or country) 22. NEVER MARRIED ^ DIVORCED ^ 23. IF MARRIED OR WIDOWED, NAME OF SPOUSE
if
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k
USA SOUTH CAROLINA
1.t11~
®
^ vorced
eave b
an
)
(
d
FAYE HARRISON
MARRIED
WIDOWED
24. SOCIAL SECURITY NUMBER 25. USUAL OR LAST OCCUPATION 26. KIND OF BUSINESS OR INDUSTRY 27. INFORMANT - OR SOURCE OF INFORMATION
247-56-2091 PAVING CONTRACTOR ASPHALT/PAVING TERRY RANDOLPH/DAUGHTER
28. PART I. Enter the diseases, injuries, or complicatons that caused the death. Do not enter the mode of dying, such as cartliac or respiratory arrest, shock, or heart failure. INTERVAL BETWEEN
CAUSE OF DEATH list only one cause on each line. ONSET AND DEATH
,gyp ' y,~, ~,'
(A ~-' Ca ~ ~o .Y~ W t IN t.A.+L @ m ~-lV~-r W I
IMMEDIATE CAUSE (Final disease or
) ~Q
TO _-
condition resulting in death)
DUE TO (OR AS A CONSEQUENCE Off:
PHYSICIAN:
if any
leading (B)
Sequentially list conditions
Complete and
sign medical ,
,
to immediate cause. Enter UNDERLYING DUE TO (OR AS A CONSEQUENCE OF):
certification
(item 28) and CAUSE (Disease or injury that initiated n.' ' 4.
events resulting in death) LAST U
(1 na ~
`h F~G~G
~A~S
return both ,
. a.~c~,
C
copies to funeal Z PART II. Other si ng ificant conditions contributing to tleath but not resulting in th denying cause given in Part 1. 2ga. AUTOPSY? yes no
director as soon O y AUTHORIZED BV: ~I]/
^ L7
as possible after
determination of f
t, ~-~"~ fJ ~ L Q bs~~-'I f~~'~ ~~ V ~ sin k
cause. ti 28b. IF FEMALE, WAS THERE A PREGNANCY 28c. IF EXTERNAL CAUSE, IT AS 28d. DESCRIBE HOW INJURY RELATING TO DEATH OCCURRED
G IN PAST 3 MONTHS? pRIMAriV ^ or CANTRIBUTING ^
NOTE: if W
U ~}~
es ^ no lJ unknown ^ TO CAUSE OF DEATH
"Pending" must Q 28e. TIME OF INJURY (mo.) (day) (year) 28f. INJURY OCCURRED 28g. PLACE OF INJURY (home, farm, 128h. (city or town) (county) (state)
be indicated, so O factory, Street, office bldg., etc.) I
state in part 1 p A M while ~ not while ^ I
•-and notity ~ p,M. at work at work I
registrar of final 28i
decision as soon - , -
~ ~
as possible. ~ ra-m?~p.m.) on the date and place antl from the cause(sj stated.
To the best of my knowledge, death occurred at W
_____
________ ___________________________________________TDATE SIGNED:___________________
ACTUAL ~ I
SIGNATURE ~ R~ ~. 3 ~-.a-" y~-yJ I N(f~(yy~,~/,~ ~-~ ~QO~,
V
~
_
1
~
"
_______________________________i______________;__________
______r
_
_
______________
F
_
NAME OF ATTENDING PHYSICIAN (Type or Print) I ADDRESS OF ATTENDING PHYSICIAN
Cal (~ ~c~FBt 12 • Z ~'~c m O ' I m ~ S+ . W ~ ~ V .~- G~
FUNERAL 29. BURIAL REMOVAL CREMATION 30. PLACE (name of cemetery or crematory) (city or county) (state)
DIRECTOR OF BURIAL,
REMOVAL
ETC.
~ ^ ^ ,
WICOMICO CEMETERY SALISBURG MD
31. (Signature of funeral director or person legally filing this certificate) HOME ANDUNERAL BROWN FUNERAL HOME
P.O. BOX 821
,
,
~~ ~~~ ADDRESS: 327 W. KING ST. MARTINSBURG WV 25402
REGISTRAR 32. 'nature of registrar) •~ „ DATE RECORD \~\
!/Y_- FILED: \\olC Oa
II RESERVED FOR -
REGISTRAR'S USE
N
_ _ _ _
This is to certify that this is a true and correct reFroduction of the original record filed with the FREDERICK/`VINCHESTER
DEPARTMENT OF HEALTH, `VINCHESTER, VIRGINIA, 22601.
Date Issued '~;a ' ~ ~ `'~~ ~~ ~~ ~ ~~ ~~~~
(SEAL) Registrar
ANY REPRODUCTION OF THIS DOCUMENT IS PROHIBITED BY STATUTE. DO NOT ACCEPT UNLESS IT BEARS THE
IMPRESSED SEAL OF THE FREDERICK/WINCHESTER DEPARTMENT OF HEALTH CLEARLY AFFIXED.
SECTION 32.1-272, CODE OF VIItGINIA, AS AMENDED
LAST WILL AND TESTAMENT
I, JACK BRITTON COOPER, SR., of Adams County, Pennsylvania, being of sound
mind, disposing memory and full legal age, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me.
ONE. I direct my Executor, as the case may be, to pay all of my debts, funeral
and administrative expenses as soon as convenient after my decease. Furthermore, I direct that
all state, inheritance, succession and other death taxes imposed or payable by reason of my death
and interest and penalties thereon with respect to all property composing of my gross estate for
death tax purposes, whether or not such property passes under this will, shall be paid by the
Executor or Executrix of my estate.
TWO. My Executor may, at his discretion, compromise claims, borrow money,
retain property for such length of time as he may deem proper; lease and sell property for such
prices, on such terms, at public or private sales, as he may deem proper; and invest estate
property and income without restriction to legal investments unless otherwise provided
hereunder. I authorize and empower my Executor to sell any realty and/or personalty owned by
me at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could
do if living. My Executor is authorized and empowered to engage in any business in which I may
be engaged at my death, for such period of time after my death as seems expedient to said
Executor.
THREE. I give, devise and bequeath my estate of every nature and wherever situate
to my children, VIVIAN LORRAINE RANDOLPH, CECILIA REBECCA HEINBAUGH,
TERRY LEE RANDOLF, JACK BRITTON COOPER, JR., in equal shares, per stirpes. If
any of my aforementioned children predecease me, their share shall be divided equally by the
issue of said predeceased child If said child predeceased me without leaving issue, then said
child's share shall be divided equally to my children or the issue of a predeceased child (to the
extent said predeceased child would have taken).
FOUR. I nominate and appoint MARCUS A. McKNIGHT, III, to be the
Executor of this my Last Will and Testament.
FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive
me by thirty (30) days.
SIX. No Executor acting hereunder shall be required to post bond or enter
security in this or any other jurisdiction.
SEVEN. No beneficiary may assign or anticipate his or her interest in any income or
principal held or distributable hereunder; and no beneficiary's creditors may attach or otherwise
reach any such interest.
EIGHT: I want my children and grandchildren to know that I love them very, very,
very much.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day of
August, 2002.
SEAL)
,TACK BRIT N OOP , SR.
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
ACKNOWLEDGEMENT AND AFFIDAVIT
WE, JACK BRITTON COOPER, SR., SHARON L. SCHWALM and
JACQUELINE L. DRAWBAUGH, the testator and witnesses respectively, whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the instrument as his Last Will and that he had
signed willingly, and that he executed it as his free and voluntary act for the purpose herein
expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the
Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen
years of age or older, of sound mind and under no constraint or undue influence.
JACK BRITTON C OPE , SR.
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by JACK BRITTON COOPER, SR.,
the testator, and subscribed and sworn to before me by SHARON L. SCHWALM and
JACQUELINE L. DRAWBAUGH, witnesses, this 27th day of Au st, 2002.
r ~ ,~}~ ~~
-...~~ ~ Not ry Publ
Notarial Seai
Martha L. Nail, Notary Public
Carlisle i3oro, Crsmberland County
My Cammission Expires Sept. 18, 203
Member, i'e~~i~swivaii~a Asscciat~osi ai fv~;~r;Ws
J
Name of Decedent:
Date of Death:
Estate No.:
To the Register:
JACK BRITTON COOPER SR.
November 15, 2002
21-02-1118
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on December 18, 2002 .
Name Address
Faye B Cooper 6280 Carlisle Pike Lot #529, Mechanicsburg, PA 17050
Terr~L Randolph 158 Richard Lee Drive, Greenville, NC 27858
Vivian L Randolph 1560-101 Wimbeldon Drive, Greenville, NC 27858
Jack B Cooper Jr 2215 Bi>;lerville Road #46 Gettysbur~, PA 17325
Cecelia R HeinbauCh 2127 Newville Road Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none .
. / l~
Date: 12/ 18/02
Signature
IRWIN, McKNIGHT & HUGHES
Name Marcus A. McKnight III, Esquire
Address 60 West Pomfret Street
Carlisle, PA 17013
Telephone (717) 249-2353
Capacity: Personal Representative
X Counsel for Personal Representative
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: John J. Thrush
Date of Death: November 23, 2002
Will No.: 21-02-1118
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 February 13, 2003
Name Address
Irvin S. Thrush Sr. P.O. Box 61 Amberson PA 17210
Mahlon W. Thrush 432 Pine Grove Road Gardners PA 17324
Rozanna E. M ers 5345 Orrstown Road Orrstown PA 17244
Marv Lou Hershey 3 Oakville Road Shippensbur~, PA 17257
Mt Rock Church 22 Mt Rock Road Shippensbur~, PA 17257
Gospel Tide 550 Cleveland Avenue Chambersbur~ PA 17201
Lelonnie Thrush EXer 8043 Roxbury Road Roxbury, PA 17232
Brethren in Christ Board for World Missions P.O. Box 390 Grantham PA 17027
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: 02/13/03
Signature
Name: Hamilton C. Davis, Esa.
Address: P.O. Box 40
Shippensbur~ PA 17257
Telephone: 717-532-5713
Capacity: personal representative
X counsel for personal
representative
\\' \~
{\' \\) REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
REV~ 1500 EX + (6-00)
CAPB
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COMMONWEALTH OF PENNSYL.VANIA,
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
COO er Jack Britton
DATE OF DEATH (MM-DD-YEAR)
FILE NUMBER
OFFICIAL USE ONLY
21-02-1118
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
247-56-2091
THIS REfURM MUST BE FILED IN DUPLlCATEWlTH THE
NUMBER
REGISTER OF WILLS
so IAl S CURl Y NUMBER
o
o
3 date of death
. Remainder Return rior to 12-13-82)
S. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch 0)
DATE OF BIRTH (MM-DD-YEARl
Coo er, Fa e B.
X 1. Original Return
4. limited Estate
X 6. Decedent Died Testate
(Attach copy of WiJf)
o 9. litigation Proceeds Received
2.
4a.
7.
Supplemental Return
Future Interest Compromise {date of death after 12-12-82)
Decedent Maintained a Living Trust
(Attach copy of 1 rust)
Spousal Poverty Credit
(date of death between 12-31-91 and 1-1-95)
010.
P NAME
C
0 0 Marcus A. McKni ht
R N FI RM NAM E (If Applicable)
R 0
E E IRWIN & McKNIGHT
S N
T TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
C
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P
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A T
X A
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5
Real Estate (Schedule A)
Stocks and Bonds (Schedule B)
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 01 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)
91,000.00
739.20
None
None
16,810.97
None
7,750.00
18,402.62
1,520.62
x
X
X
X
.0 0
045
.12
.15
OFFICIAL USE ONLY
-'"
t::.-.
(8) 116,300.17
(11) 19.923.24
(12) 96,376.93
(13)
(14) 96,376.93
(15)
(16)
(17)
(18)
(19)
0.00
4,336.96
0.00
0.00
4,336.96
R
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C
A
P
I
T
U
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A
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(4)
(5)
(6)
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.
0.00
96,376.93
0.00
0.00
Copyright (e) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
55 White House Road
CITY I STATE I ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
4,336.96
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
54.06
Total Interest/Penalty ( 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 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
54.06
0.00
4,391.02
0.00
4,391.02
,,/j;,:m:mmwmwwmW:Wiwm'W.':iWWi'ij'w,mw:::'i!'WJIWJiW.;Ji!i..,:W:,:,i,:iwmw,:wWW;:"Wi"m;,'::W::,iwmWmWJW)))jijlWmm])jl:W!i@mW!'!iji')!ji.l.1::-1.:)::]
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN
1.
i}:;l'l
."X;;
IN'iA~:~~:~bP~IAT~.~LO~KS
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest: or .
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12. 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes No
~~
[]]
o
[]]
[]]
o
o
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, It is true,
correct and campi . Declaration preparer other than the persona) representative is based on all Information of which preparer has any knOWledge.
SIGNATURED ~S ESP OR FILING RETURN Marcus A. McKnight Esq.
60 West Pomfret Street
---Carr{sle,-'P"---l'i613- - -- -- -- - .-- - -.- --- --- --- --
IRWIN & McKNIGHT
60 West Pomfret Street
--carE'sle:-P"- - 1 '.7613-- ---- --- --- -- - - --- -- - --- --
OA E
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (lOJ. 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 natura!
parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2}J.
The tax rate imposed on the net value of transfers to or for rhe use of the decedent's linea! beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(11].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings ;5 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX \~ev. 6-00)
, REV~1502EXt(1-97)
COMMONWEAL.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack Britton Cooper SS# 247-56-2091 11/15/2002 21-02-1118
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledge of the relevant facts, Real property which is jOintlY-OWned with riaht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
1 2127 Newville Road, Carlisle, West Pennsboro Twp. - Cumberland 91,000.00
County (appraisal attached)
SCHEDULE A
REAL ESTATE
TOTAL (Also enter on line 1, Recapitulation) $ 91,000.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1S02 EX (Rev. 1-97)
, REV~1503EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Jack Britton Cooper
88ft 247-56-2091
11/15/2002
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-02-1118
ITEM DESCRIPTION VALUE AT DATE
NUMBER UNIT VALUE
OF DEATH
1 105 shares Nextel Partners Inc. 7.04 739.20
TOTAL (Also enter on line 2\ Recapitulation) 739.20
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc:.
Form REV... 1503 EX {Rev. 1-97)
, REV~1508EX+(1-97)
COMMONWE.6ILTH OF PENNSYLV.6INIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack Britton Cooper SS# 247-56-2091 11/15/2002 21-02-1118
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.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ITEM
NUMBER
1
DESCRIPTION
Orrstown Bank, checking account
VALUE AT DATE
OF DEATH
8,810.97
2
2001 Dodge 1500 Pickup, short bed, 53400 miles, 2WD - sold to
Brenneman's Auto Sales & Service
8,000.00
TOTAL (Also enter on line 5, Recapitulation) $ 16,810.97
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
, REV-1510EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jack Britton Cooper
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
SStl 247-56-2091
11/15/2002
FILE NUMBER
21-02-1118
This schedule must be completed and filed it the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY %OF
ITEM RELAW8~Mfil~ t~b~~~5~~TT~~J~~~~lT~E6F t~~~~FER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH ACOPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 Cece1ia Heinbaugh, daughter 2,750.00 100.00% 2,750.00
- cash 11/2002
2 Heaven Cooper-Zweemer, 8,000.00 100.00% 3,000.00 5,000.00
granddaughter, cash 09/2002
3 Vivian Randolph, daughter - 2,750.00 100.00% 2,750.00 0.00
cash 11/2002
TOTAL (Also enter on line 7, Recapitulation) $ 7,750.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1510 EX (Rev. 1-97)
. REV-151l EX t (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Jack Britton Cooper
SSIJ 247-56-2091
11/15/2002
FILE NUMBER
21-02-1118
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES,
1 Brown Funeral Home 7,544.35
B. ADMINISTRATIVE COSTS,
1. Personal Representative's Commissions 4,900.00
Name of Personal Representative(s) Marcus A. McKnight Esq.
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 60 West Pomfret Street
City Carlisle State PA Zip 17013
-
Year{s) Commission Paid: ().,c02)().Ob~
2. Attorney's Fees IRWIN & McKNIGHT 5,400.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
-
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 88.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Cumberland Law Journal - estate notice publication 75.00
2 Register of Wills - filing fee 25.00
3 Steven W. Barrett Real Estate - appraisal 275.00
4 The Sentinel - Legal - estate notice publication 95.27
TOTAL (Also enter on line 9, Recapitulation) $ 18,402.62
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1511 EX (Rev. 1-97)
, REV~151'2 EX + (1-97)
COMMONWEALTH OF PEWNSYL VANIA
tNHERITANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jack Britton Cooper
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SSfJ 247-56-2091
11/15/2002
FILE NUMBER
21-02-1118
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
Cumberland County Tax Claim Bureau, taxes due
AMOUNT
1,258.12
2
Irwin McKnight & Hughes, attorney fees due (divorce)
262.50
TOTAL (Also enter on line 10, Recapitulation) S 1,520.62
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form softwareonty CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
, REV~ 1513 EX + (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
Jack Britton Cooper
SSII 247-56-2091
11/15/2002
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Includeoutrfghtspousal distributions, and
transfers\1nder Sec. 9116(a)(1.2.}]
1 Jack B. Cooper, Jr.
2215 Biglerville Road #46
Gettysburg, PA 17325
2
Cecelia R. Heinbaugh
135 Media Drive
Carlisle, PA 17013
3
Terry L. Randolph
158 Richard Lee Drive
Greenville, NC 27858
4
Vivian L. Randolph
2735 Ritner Highway
Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
Daughter
Daughter
FILE NUMBER
21-02.1118
AMOUNT OR 5FlARE
OF ESTATE
1/4 remainder
1/4 remainder
1/4 remainder
1/4 remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 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
0.00
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 (c) 2000 form software only The Lackner Group, Inc,
Form REV-1513 EX (Rev, 9-00)
LAST WILL AND TESTAMENT
I, JACK BRITTON COOPER, SR., of Adams County, Pennsylvania, being of sound
mind, disposing memory and full legal age, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me.
ONE. I direct my Executor, as the case may be, to pay all of my debts, funeral
and administrative expenses as soon as convenient after my decease. Furthermore, I direct that
all state, inheritance, succession and other death taxes imposed or payable by reason of my death
and interest and penalties thereon with respect to all property composing of my gross estate for
death tax purposes, whether or not such property passes under this will, shall be paid by the
Executor or Executrix of my estate.
TWO. My Executor may, at his discretion, compromise claims, borrow money, .
retain property for such length of time as he may deem proper; lease and sell property for such
prices, on such terms, at public or private sales, as he may deem proper; and invest estate
property and income without restriction to legal investments unless otherwise provided
hereunder. I authorize and empower my Executor to sell any realty and/or personalty owned by
me at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could
do if living. My Executor is authorized and empowered to engage in any business in which I may
be engaged at my death, for such period of time after my death as seems expedient to said
Executor.
.
THREE. I give, devise and bequeath my estate of every nature and wherever situate
to my children, VIVIAN LORRAINE RANDOLPH, CECILIA REBECCA HEINBAUGH,
TERRY LEE RANDOLF, JACK BRITTON COOPER, JR., in equal shares, per stirpes. If
any of my aforementioned children predecease me, their share shall be divided equally by the
issue of said predeceased child If said child predeceased me without leaving issue, then said
child's share shall be divided equally to my children or the issue of a predeceased child (to the
extent said predeceased child would have taken).
FOUR. I nominate and appoint MARCUS A. McKNIGHT, III, to be the
Executor of this my Last Will and Testament.
FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive
me by thirty (30) days.
SIX. No Executor acting hereunder shall be required to post bond or enter
security in this or any other jurisdiction.
SEVEN. No beneficiary may assign or anticipate his or her interest in any income or
principal held or distributable hereunder; and no beneficiary's creditors may attach or otherwise
reach any such interest.
EIGHT:
I want my children and grandchildren to know that I love them very, very,
very much.
k
IN WITNESS WHEREOF, I have hereunto set my hand and seal this d! day of
August, 2002.
^~~AL;
QJACK BRIT N OOP , SR.
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
ACKNOWLEDGEMENT AND AFFIDA VIT
WE, JACK BRITTON COOPER, SR., SHARON L. SCHWALM and
JACQUELINE L. DRAWBAUGH, the testator and witnesses respectively, whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the instrument as his Last Will and that he had
signed willingly, and that he executed it as his free and voluntary act for the purpose herein
expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the
Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen
years of age or older, of sound mind and under no constraint or undue influence.
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by JACK BRITTON COOPER, SR.,
the testator, and subscribed and sworn to before me by SHARON L. SCHWALM and
JACQUELINE L. DRAWBAUGH, witnesses, this 27th day of Au ust, 2002.
~
-~_.'-
Notarial Sea! I
Martha l. Noel, Notary PUbliC~
Carlisle 80ro, Cumberland County
My Commission Expires Sept. 18, 2:)03
Member, Penilsylvania As::.;ociatioi'j Oi N:),)~;Q':;
1-
S. W. BARRETT REAL ESTATE & APPRAISAL SERVICES
APPRAISAL OF
..~
LOCATED AT:
2127 Newville Road
Carlisle, PA 17013
FOR:
Jim Hughes, Esquire
60 West Pomfret Street
Carlisle, PA 17013
BORROWER:
COOPER, Jack B.
ASOF:
November 15, 2002
BY:
Stan A. Skowronek
Certified Residential Appraiser
124-126 NORTH HANOVER STREET, CARLISLE, PA 17013 717-243-<;646 AND FAX 717-243-8627
F~e No. 03-0013
S. W. BARRETT REAL ESTATE & APPRAISAL SERVICES
FIIQNo. Q'3~Q0'13
,I
'I
Jim Hughes. Esquire
60 West Pomfret Street
Carlisle, PA 17013
File Number: 03-0013
In accordance with your request, r have personally inspected and appraised the real property at
2121 Newville Road
Carlisle, PA 11013
The purpose of this appraisal is to estimate the market value of tile subject property, as improved.
The property rights appraised are the fee simple interest in the site and improvements.
In my opinion, the estimated market value of the property as of November 15, 2002 is:
$91,000
Ninety-One Thousand Dollars
The attached report contains the description, analysis and supportive data for the conclusions,
final estimate of value, descriptive photographs, limiting conditions and appropriate certifications.
Respectfully submitted,
q.[{'~O')Jr),'t\_
Stan A. Skowronek
Certified Residential Appraiser
I
I
I
124-126 NORTH HANOVER STREET. CARLISLE. PA 17013 717-243-6646 AND FAX 717-243-8621
PrODertv Oeser/otlon File No. 03-0013
ProllertvAdd~ss 2127 Newville Road Ch Carlisle State PA ZipCode 17013
lenal Descrjntion Deed Book L-35. naQe 949 County Cumberland
Assessor's Parcel No. 46-07-0477-035 Tax Year 02/03 R.E. Taxes $ 1 130.00 50ecial Assessments $ N/A
Borrower COOPER Jack B. Current Owner Same Gocunan\: I Owner I Tenant I Vacant
.. ProoertvrirlhtsaDlltaised Xl FeeSirmle I I leasehold I Pto'eclTvne I I PUD I I CondomniumlHUONAonlv\ HOA$ _ N/A fMo.
Neinhborhood or Proiect Name West Pennsboro Townshin Man R!!ference 07-0477 Census Tract 0128.00
SalePrk:e$ N/A Date of Sale N/A Description and $ amount of loan char"es/concessionsto be aidb seller N/A
Lender/Client Jim Huahes ESQuire Address 60 West Pomfret Street. Carlisle, PA 17013
Annraiser Stan A. Skowronek Address 126 North Hanover Street Carlisle PA 17013
Location W Urban ~ Suburban i=! Rural Predominant Single family housing Presentlanduse%
Built up OOver75'l6 00 25-75% 8 Under25% occupancy r(~E ~:.f One family ~
Growth rate 0 Rapid c&J Stable Slow 00 Owner 95 ~ Low N~~ 2-4family ~
Property values [K] Increasing 0 Stable 8 Dedining 0 Tenant I 120 Hinh 50 MuKi-famly ~
Demandlsupply ~ Shortage ~ Inbalance ?=( Oversupp'y ~ Vacail:(O-5%) I>?,{}, Predominant':>>::: Commercial 0%
Marketin"lIme I I Under3mos. tXI3-6mos, I IOver6mos I I V"".n!'ove<5%' 100 I 25 Vacant) 60%
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: Subject Is bounded on the north by Creek Rd, on the east by route 34, on the south bv
: Newville Rd and on the west bv Old Mill Rd.
. Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc)
~~~ ~re no adverse factors to affect marketabilitv of subiect. Diverse stable emrllovment and all sUDoortina amenities are
" within easy drivinn distance. SMSA 3240. NOTE. Occunant is the dauClhter of Jilck B. CooDer.
SUMMARY APPRAISAL REPORT
UNIFORM RESIDENTIAL APPRAISAL REPORT
Land use change
o Not likely o Likely
(X) In process
To: Residential
-.-
Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time
.-such as data on competitive properties for sale in the neighborh ood,descriptionofthe prevalence of sales and financing conce ssions,etc,):
ProDertv sales records and MLS statistics show a stead" moderate increase In orooertv values over the past vear. Averane
marketina time af 80-100 davs shows a aood balance of supplv and demand. Few sales and financinQ concessions are
needed in the neiahborhood.
. Project Information for PUDs (If applicable).. is the developer/builder in control of the Home Owners' Association (HOA)? U YES U NO
Approximate lotal number of units in the subject project N/A Approximate total number of units for sale in the subject project N/A
De~cribe common elements and recreational facilities' N/A
Dimensions See leQal description Topography Basically Level
Snearea .80 Acre mIl Corner Lot DYes.-OO-No Size Tvoical for area
Specific loning classification and description Residential Shape IrreQuJar
Zoning compliance [Xl Legal r---'>O Legalnonco~g(Grandfalhereduse) Ulllegal U Nozoning Drainage A,QEears adequate
Hi"hest & best use as Im"roved: I XI Present use I I Other use lex"lainl View Residential
Utilities Public Other Off.site Improvements Type Public Private landscaping l\veraQe
Electric~y 00 200 amo Street Macadam Ii] 0 Driveway Surface Macadam
Gas 0 Curb/gutter None 0 0 Apparent easements None Indicated
Water 0 Well Sklewalk None 0 0 FEMA Special Flood Hazard Area U_ Ye~ [X] No
Sanitary sewer P Sentic Street lights None b) b) FEMA Zone X Map Date 03/04/88
StormseWef I i Allev None I I I I FEMAMaflNo, 4215900005 A
Comments (apparent adverse easements, encroachments. special assessments, slide areas, illegai or legal nonconforming zoning, use, etc.)' On site water
and sanltar svstem are common for area and have no adverse affect on marketabilitv. There are no adverse easements
encroachments or other adverse conditions.
GENERAL DESCRIPTION EXTERIOR DESCRIPTION
No. of Units 1 Foundation Cone. Block
No. of Stories 1 Exterior Walls Vinvl
Type (Del/Att) Detached Roof Surface ASDhatt
Design (Style) Ranch Gutters & Dwnspts. Aluminum
Existing/Proposed Existina Window Type Double hunn
Age (Yrs.) 7 StomvScreens Thermal
Effectrve A e Yts.l 2-3 Manufactured House Modular
. ROOMS Fover Livina Dinino Kitchen Den
Baserrent
Levell
. Level2
FOUNDATION
Slab. None
Cra.\lSpace Full
Basement None
SUflllPUflllN/A
Dampness None Obs.
Settlement None Obs.
I Infestation None Obs.
Fam-;-Rrn Rec, Rrn
BASEMENT
lveaSq.Ft
% Finished
Celing
Walls
Floor
Outside Entry
None
N/A
N/A
N/A
N/A
N/A
INSULATiON
Roof 0
Ceiling * [XJ
Walls * 00
Floor ~OO
None ==0
o
c__
Bedrooms
# Baths
Laundrv
*R Factor Unk
Oth_er Area S~,Ft.
area
3
2
1118
0
Finished area above radecontains 5 Rooms' 3 Bedroom'sl' 2 BathI5': 1118 S uare Feet of Gross LivinnArea
INTERIOR Mater~ls'Cond~ion HEATING KITCHEN EQUIP. ATTIC AMENITIES CAR STORAGE
Floors CaroetNinvl Type FHA Refrigeralor 0 None 0 Fireplace(s)#",---------- [Xl None [Xl
Walls Drvwall Fuel Oil Range/Oven [Xl Stairs 0 Patio Concrete fRJ Garage # of cars
Trim'Finish Wood CondilionAv Disposal 0 Drop Sta~ 0 Deck 0 Attached
Bath Floor Vinvl COOLING Dishwasher 0 Scuttle 00 Porch Covered 00 Detached
Bath Wainscot Dr\1\A1all Cenlral Yes Fan/Hood fRJ Floor 0 Fence 0 Built.ln
Doors Hollow Core otheF None Microwave R Heated R Pool R Carport .--
Averane Condition CondilionAv WasherlD"'er Finished Drlvewa 3/Mac
Addilionalfeatures(special energy efficient items, etc,): Front cDvered porch. Rear concrete patio. SkyliQht.
Condition of the improvements, depreciation (ph~sical, functional, and external), repairs needed, quality of construction remodeling/additions. etc
ments are in averaae condition with no ohvsical or functional inadenuacies a;'narent.
Improve
--
--
Adverse environmental conditions (such as, but not limited to, ha~ardous wasles, toxic ~ubslances. etc.) prese~1 in the improvements, on the site, or in lhe
immediate Vicinity of the subject property: No adverse environmental conditIons are aDDarent/dlsclosed.
r'""O,.MacFormIO ~Sl
PAGE 1 OF2
""od'",'ld ",i"'l p,~,o~ Dlo"'" "","""", ""","....I~Ul< B721 ""'" ,'~m~"'"" 00",
F,MOI,<,O,,,,,,1004 ~.9:l
ion Section
SUMMARY APPRAISAL REPORT
UNIFORM RESIDENTIAL APPRAISAL REPORT
_STfMATED SITE VALUE.
ESTIMATED REPRODUCTION COST-NEW OF IMPROVEMENTS:
Dwelling 1,118 Sq. FI. @$. 55.00
Crawl 1118 Sq. F\. @$; 3.00
. Well sentic norch natio -
Garage/Carport _S(\-Ft@$._
To!al EslimatedCosl Ne'l: 'I,
Less Physical Functional External
. Depreciation $5 000 $0 $0
Depreciated Value of Improvements . .
.~'i.. Val\1e of Sile \mpiovelMnls
INDICATED VALUE BY COST APPROACH.
ITEM I SUBJECT
2127 Newville Road
Address Carlisle
ProximitvloSubiecl
Sales Price
PricelGrossLiv.fvea
Dataandlor
Verification Sources
VAlUEPDJUSlMENTS
Sales or Financing
CoflCellosion'i.
DateofSalefTime
Location
LeaseOOQf"eeSmw.
S~e
ViElw
Desion and Anneal
au<>'ivofConslnJdiJn
Ao,
CondHion
Above Grade
RoomCount
GloosLNiMk'ea
. Basement & Finished
Rooms Below Grade
FunctionalUUH~
Heatin ICoolinn
. En"""~1:l!icienlllel'1l$
GaranelCa-rnort
Porch,Patio,Deck,
Fireolacefs\,ele
Fence,Pool,ele
Averaae
Fee Simole
.80 Ac/Ava
Res'rdential
Ranch/Ava
AvnNinvl
7 Yrs.
Averane
ToIa' I B~r"'. I
2
3: 2.00
1118S";Fi.
Crawl Space
.$ 61,490
. 3,354
. 14,000
.
DESCRIPTION
None, Conv
DOM 85
01/02/2002
S~erio~5%1
Fee Si~le
,8! AcJAV;;
Residential
Ranch/AV;;-
Avn/Brick
31 Yrs
Averane
BalM
Tol.: : B~'m. '
.=$
B.ths
File No 03.0013
Comments. on Cost Apllroac!>. <,,\le!>. '10'<), %l\JICI! <01 e<o'3\ e"l\male,
si!evalue, square fool calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the pro~.erty)
Cost new from Marshall Swift Valuation Service
Handbook and local cost anal sis. Land value from
Market Data Comparison, Depreciation based on af:le life
observed condition and Market Data Anal sis.
Estimated RemaininCl Economic Life is 50~55 vears
25 000
.2
73 844
3,000
101800
COMPARAB\..E NO. '3
50 Creek Road
Carlisle
-!12i-MI E 4.38"-WiC
92000J8lliillill; $ 95 000 ~~$
$ 85,43 m $ 9_~,50 ~
MLS/Courthouse Records MLS/Courthouse Records
COMPARABLE NO.2
221 Longs Gap Road
99 900
'{-I$MillllrM'Il
DESCRiPTION
None, FHA
DOM14
03128'2002
Suoerior{~5%,
Fee Slmole
,32 Ac/Ave
Residential
Ranch/Ave
A\lr1IBrldAlum
18 Yrs
Averane
I >"tM-ustmool DESCRIPTION >(_.'Must",ont
None, VA
OOM 119
: 03/19/2002 :
-4150 S~ior/ ~5~J;\ -4995
Fee Sim::le
1500 1.25 Ac/AW; -1000
Residential
Ranch/Ava -
AvnJAlum
21 Yrs
Averane
-4 BOO
Tal.I'ed,,,,s'
~~'eotl>o
6: 3: 1.00;
10BOS::-Ft.
Full Bsmtl
Unfinished
Averane
EBB/None
TVEical
1 Car Garage
Porch
2,000
o
-3,000
3000
-2000
2,000
i.905
NelAdillolal t Ix]. '$ 2600~t X. $ 4750 t Xl. '$
AdjumedSalesf'Tice ijl'1jl!:r 18,0% '
ofComnarable $ 89400 $ 90,250 N~' ;tOW. $ 95,905
Comments on Sales Comparison (including the subj@ct ?f<l?@ft~'s cOl'l'lPalib\Ii\~ 10 Ihe 1\&19l1bolhood, etc) Indicated range of ....alue IS $89,000 to
$96000, Location adiustment reflects the sub'ects orooertv abutthid the pennsvlvania TurnDike. Excess acrea"'e
adiustments are made at $3 OOO/acre, These are the best sales comnarables known to be available.
= $ 18,844
Est. Remaining Econ. Life
= $ 5,000
'$
.$
'$
COMPARABLE NO. j
10 Burgners Mill Road
alainfield
MI
$ N/A $
$ 0,00 $. $ 84.25 ~
Inspection AppOata/Courthse
Courthse Rec
DESCRIPTION
5:
Averaae
FHAlCA
Tvnjcal
None
Porch/Patio!
1 Fireclace
None
6: 3: 1.00;
1092S.R
Full Bsmtl
Familv Room
Averaae
EBBINone
Tvnical
None
Porch
None
B.'1lS
2,000
o
-5,000
B: 3: 1,00 '
1112 So.Ft.
Full Bsnitl
Unfinished
Averane
HP/CA
T..Y.eical
None
Porch
2,000
ITEM SUBJECT COMPARABLE NO_ 1 COMPARABLE NO.2 COMPARABLE NO.3
D~I@, Price and Oala 01/03/92
Source for prior ~es $31,500 None None None
m:hinvearolaooralsal Courthouse Courthouse Courthouse Courthouse
Analysis 01 any rurrent agreement of sale, option, or listing of tile subject property and analysis of any priorsafes of subjed and coMllarables w~hin one year of the dale of appralsal:
No Drior sales within the nut twelve months,
2,000
o
-3,000
3000
2,000
Works hOD
-2 500 None
91000
NIA
INDICATeD VALUE BY SALES COMPARISON APPROACH $
. INOICATEmVALUE BY INCOME APPROACH IIfll.nnlicablel Esti~;ed~arkeiR~~t.$ .. N/A" tMo~Gro~Ren~~~"i~~" N/A:$
This appraisal is made 00 "as is' 0 subject 10 the repai'5, aKemtions, inspections or conditions listed below 0 subjecl10 co~tion per plans and specifications.
COndilionsofAppraisal: The property has been appraised in current condition, This appraisal;s for client only, nontransferable, See
attached addendum.
Final Recondiation: Cost and Market Analysis consistently supports the estimated market valUe, GRM analysis was found
rnannronriate for this analvsis. Greatest weiQht is applied to the Market Data Analvsls. SupportinQ file Information
. substantiates these estimates.
Th@ purpose of !h~ appraisal is to estimate 1he market value of the real property that Is the subject olthis report, based on the above cond~ions and the e&rtil'lca!ion, contingent
andlill'iiting cond~i{lns, and market value deflnilion !hat are stated in the alladled Freddie Mac Form.\391Fa nnie Mae Form 10048 (Revised ~__)
. I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OFTHIS REPORf,ASOF 11/15/2002
(WHICHISTHEDATEOFINS.PECTlONANOTHEEFFECTIVEOMEOF1'HISREPORT)T~ 91 000. ... . .
APPRAISE~ (l c-\ / \( SUPE SOR~PRAl:'_::~ 1JNLflF RH~UIREeri.
Signature ~\.J.'~!!:.)""lrl~A\.- Signalu", ---- t. J.____
Name Stan A. Skowronek Name Steven W. Barrett. SRPA, SRA
Da11;l Report Signed 01/10/2003 Date R@portSiqned 01/10/2003
S~a\eCeM\Caliol\-# RL-001512-L StatePA Stat@Cerlificationll GA-000298~L State PA
QrStaleLicensell State OrStateLicensell RB-026921~A State PA
Ff..~;.M.cF"'mro 5-93 c;ertlfleCl KeslClentiil PAGE20F2 CertlTled uenerarAPpralser f"'~Motf"""'100<\ e-g1
Appraiser
Pr"",,,"j",inrll'o~'oiI O~""I So~,""",.ch-"., IOO.1JUm .......1"'1or'_""'0"'
Steven W. Barrett R.E, Appr. Svc.
ODid OOmd Not
lospec!Property
SKETCH/AREA TABLE ADDENDUM
Case No
I Pr?perty Address 213.7 NeWville Road
City Carlisle - -- C~~tY Cumberland-
Borrower COOPER~ Jack B.
::. ~e.!:lderfCllen~ Jim-Hughes, ~squ~e -___
ApP~ls~r ~me St~E A. Sko~ronek
File No 03-0013
State PA
Zfp--1i6-1~-
lie Address 60 Wes-t"Pomfret Street, Cadisls, PA 17013---
_ _EppiAd~ress-126N_~~_ ~~ove~~~~I9~~~~~,_PA"17013
1-
Concr~ie Patio
: I
, I
"-;.c
Bedroom ~/ ~ I Kitchen
I Bath'
m )"U',_L
/
",'&
<
.,,'f
<J'
II
I
I
E
o
2
.",
Q)
tll
- 1.'- .J
,J
,
Bedroom I
Living
Comments:
Scale: 1 = 10
---AREA CALCULATIONS sUMMARY'-C---l 1....L1VTNG-I\RrABREAKDOWNu 1
i:~~r-!~~~p~~6i-~-~~~: ~~I:~--T"lJ~~~I~. I ~h~st2:i~r:~~o,,:;.oo --~~i l~l::~::t::Sl..1
Coners.. Psdo 441.0000 1517.0000 I I ! \
I
I
I
I _ TOTAL LIVABLE (rounded)
I___~~._._,,"._--~-,...~._._-~-
1118 1 Area Total (rounded)
1118
_._-~.-....-"--~- .~..._.-~---~.
APEX SOFTWARE BOO.8SB-99S8
A~.Bl00"wA~~)(11
e'~-
~-r~
ORRSTOWN BANK
~~(S~UW~~
DEe 27 2002
TO: Law Offices
Irwin McKnight & Hughes
60 West Pomfret Street
Carlisle, PA 17013
IRWIN, McKNIGH1 & H~GHE5
FROM: ORRSTOWN BANK
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Jack B Cooper Sr
DATE OF DEATH: November 15, 2002
DECEASED
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
(1) CHECKING ACCOUNTS
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
108006228 Jack B Cooper Sr 4/12/02 8,810.97 .14
(2) SAVINGS ACCOUNT
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
(3) CERTIFICATES OF DEPOSIT
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
Date: 12/26/02 By: Timothea Customer Service Operator
P.O. BOX 250
SHIPPENSBURG, PA 17257
TEL. (717) 532-6114
jAN 16 2003 3:07PM
CALL CENTER
717 530 2624
p.2
Following is a list of account held by Jack B Cooper, Sr. SS# 247-56-2091
CHECKING ACCOUNTS:
Jack B Cooper, Sr 108-006228
Principle $ 8,810.97
Jack B Cooper, Sr. 108-006102
Faye B Cooper
Principle $ 100,396.55
Opened 4-12-02 Closed 12-20-02
Totallnterest 2002 $ 38.70
Opened 2-11-02
Closed 4-03-02
Total Interest 2002 $ 396.55
Jack B Cooper, Sr 108-002429 Opened 2-11-02 Closed 5-20-02
Faye 8 Cooper
Principle $ 199.09 Total Interest 2002 $ 43.85
Jack B Cooper, Sr 106-001626 Opened 9-8-00 Closed 3-20-02
Faye B Cooper
Principle $00 Total Interest 2002 $ 62.99
CERTIFICATES OF DEPOSIT:
NO 506-0059682
Vivian Cooper or 24 month
Jack B Cooper, Sr
Cashed by Jack Cooper on 9-20-02
NO 506-0059681
JackB Cooper, Sr
Vivian Cooper
Opened 9-8-00 Face value $ 79, SOO.OO
Total Interest 2002 $ 4,398.63
24 month Opened 9-8-00 Face Value $79,500.00
Partial distribution 8-28-02 $ 9,000.00
Partial distribution 9-11-02 20,000.00
Final distribution 9-20-02 50,551.69
Totallnterest 2002 $ 4,360.57
Cashed by Jack Cooper on 9-20-02
NO 506-0059695
Vivian Cooper 24 month
Jack B Cooper, Sr.
Opened9-12-00 FaceValue $19,500.00
Redeemed 7-9-02 Total Interest 2002 $ 805.64
BUREAU OF XNDIVIDUA~ TAXES
INHERITANCE TAX DIVISION
DEPT. 240601
HARRIS8URG1 PA 111Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AHD ASSESSMENT OF TAX
,','~'iGe of
"i o'/i.lillS
i:iC"'"
, ~o." '.
DATE
ESTATE OF
DATE OF DEATH
11.8 '3rfILE NUMBER
, . 'COUNTY
ACN
01-12-2004
COOPER SR
11-15-2002
21 02-1118
CUMBERLAND
101
,--Iv
'04
HII25
MARCUS A MCKNIGHT
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE
ESQ
*
v
Allount R..itted
IEV-15"U AFP (II-OJ!
JACK B
CGurt
CO., PA
MAKE CHECK PAYABLE AND REHIT PAYMENT TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
REY=is"4i-EiCAFip--("oFo:3riioi'"icE--o"f"'rtiiiEififANclri'"Ax-jiPPRAiiiEifEiiT~--AL.i.oIiAifcinjR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COOPER SR JACK B FILE NO. 21 02-1118 ACN 101 DATE 01-12-2004
TAX RETURN WAS: [X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON. ORIGINAL RETURN
1. R..I Estate (Schedule A)
2. Stocks .nd Bonds (S~hedul. B)
3. CloselY Held Stock/Partnership Interest (Schedule C)
4. Mortgaloles/Notes RIIe.l",abl. [Schedule 1))
5. C.sh/Bank Deposits/Misc. Personal Property (Schedul. E)
6. JointlY Ownad Property (Schedul. f)
7. Transfers (Schedule G)
8. Tot.l Assets
III
[21
131
{41
{51
{61
(71
91.000.00
739.20
.00
.00
16.810.97
.00
7.750.00
(81
G:'::i";;"
PA 17 oi3\ .,...;~.
APPROVED DEDUCTIONS AND EXEMPTIONS.
9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule Il
11. Tot.l Deductions
12. Net Value of Tax Return
13. Ch.ritabl./Go"'er~ent.l Bequests; Non-.lected 9113 Trusts (Schedule J)
14. H.t Valu. of Estet. Subj~t to T.x
I~ an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will
reflect ~igures that include the total o~ abh returns assessed to date.
ASSESSMENT OF TAX.
1S. Araount of Line 14 .t Spousal rate US)
16. Aaount of Line 14 t.xable .t Lineal/CI.ss A rate (16)
17. Anount of Line 14 .t Sibling r.t. (17)
18. Anount of Line 14 taxable at Collateral/Class 8 rat. (18)
19. PrincIpal Tax Due
NOTE.
(91
1101
18,402.62
1.520.62
nIl
1121
1131
1141
.00 X
96,376.93 X
.00 X
.00 X
NOTE: To insure proper
credit to your account,
subJlit the upper portion
of this fo~ with your
tax pay..ent.
116,300.17
19.9:1'3 :1'4
96,376.93
.00
96,376.93
00 =
045 =
12 =
15 =
.00
4,336.96
.00
.00
4,336.96
1191=
TAX C~
r.' ('J ANDUNT PAID
DATE NU"8ER INTEREST/PEN PAID (-)
11-14-2003 CD003229 54.06- 4,391. 02
TOTAL TAX CREDIT 4,336.96
BALANCE OF TAX DUE .00
INTEREST AND PEN. .01
TOTAL DUE .01
. 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 HAY SE DUh-\L
A REFUND. SEE REVERSE SIDE Of THIS FORM FOR INSTRUCTIONS.) ~ I,
~ \\ ~\)
'\;\<.\1" \' l~\~ ''l\ I ~3.
RE't'~ fsoo EX + (6-00)
CAPB
HpRL
EplO
CRAC
KOTK
ES
C P
o 0
R N
R D
E E
S N
T
C
o
M
T P
A U
X I
T
I
o
N
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
D
E
C
E
D
E
N
T
COMMONWEALTH OF PENNSYLVANlA
DEPARTMENTQF REVENUE
OEPT,2B0601
HARRISBURG. PA 17128-0601
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
COO er Jack Britton
DATEOF DEATH (MM.DD-YEAA)
COUNTY CODE
SOCIAL SECURITYNUMBEA
OFFICIAL USE ONL '(
21-02-1118
YEAR
NUMBER
247-56-2091
THIS RETURN UUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
11 15/2002 09 10 1931
(IF .A.PPLlCABLE}SURV\VING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
X 1. Original Return
4. Limited Estate
X 6. Decedent Qied Testate
X 2. Supplernental Return
4a. Future Interest Compromise (dale of death after 12 -12 -82)
7. Decedent Maintained a living Tfusl 1
(Attach copy of Trust)
(Attach copy of WHO
o 9. litigation Proceeds ReceIved
3. (dale of death
. Remamder Return prior to 12- 13-82)
5. Federal Estate Tax Retl.l1l'l ReqUired
8. Total Number of Safe Deposit Boxes
D 10, Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A)
(date: of death betwee.1'I12~31-91 and 1-1~95) (AttaCh Sch 0)
TillS SaCTION MI.ISTBE COMPLEl'ED.AtLCORRESPOtlDENCE "CONFIDENTIAL TAX INFORMATION SHOULD BaOIRECTaDTO:.
NAME COMPL.ETE MAIl-ING ADDRESS
Marcus A. McKni ht Es .
FIRM NAME(JfApplicatl:lel
IRWIN & McKNIGHT
TELEPHONE NUMBER
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
R
E
C
A
P
I
T
U
L
A
T
I
o
N
9-2353
Real Estate (Schedule A)
Stocks and Bonds: (Schedule B)
Closely Held Corporation. Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
S. Cash, Sank DepOSits & Miscellaneous Personal Property
(Schedule E)
6. Joinlly 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 Sub'eet to Tax (Line 12 minus Line 13)
(1)
(2)
(3)
None
None
None
(4)
(5)
None
303.00
(6)
None
None
370.00
None
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
':.0("".:)
-'n
ill
(8) 303.00
(11) 370.00
(12) (67.00)
(13)
(14) (67.00)
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Une 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. . CHECK HERE IF YOU ARE REQUESTiNG A REFUND OF AN OVERPAYMENT .
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AtlD TO RECHECK MATH < <
x .0 0 (15)
(67.00) X .045 (16)
X .12 (11)
X .15 (18)
(19)
Copyright (c) 1;:000 form software only The Lackner Group, Inc.
0.00
0.00
0.00
0.00
0.00
Form REV-1500 EX (Rev_ 6-00)
Decedent's Complete Address:
STREET ADDRESS
55 White House Road
CITY
Shi
STATE
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
~
ZIP
17257
0.00
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty it applicable
D. Interest
E. Penalty
0.00
Total Interest/Penalty ( D + E) (3)
4. If line 2 is greater than Une 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 Une 2. enter the difference. This is the TAX DUE. (5}
A. Enter the interest on the tax due. (SA)
8. Enter the total of Line S + SA. This is the BALANCE DUE. (58)
Make Check Pay."le 10: REGISTER OF WillS, AGENT
'. ""''''''::'';i:n:n::iH::iii?in:;'''''' ;""1;',-- -, - . -. ,. '-"""-""""""'l1;ij:'::it:ijUH':l";"";"" ""';";;:;i:i:nn;j:;U:::i:::!;g:'!;;i>'"''
0.00
0.00
0.00
0.00
pLEASE.ANSWER..THE..FoLLOWING QUESTiONS13YPI..ACiNGAN..'~X"iN.THEAPPROPRIATE. BLocks..
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . ~ ~~x
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or .
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "jn 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.
o
o
o
rn
rn
rn
Under penalties of perjwy, I declare t at I have examined this return, including accompanying schedules and statements, and to the best of my k.nowledgeand belief, it is true,
preparer other than the personal representative is based on alllnformatlcn of which preparer has any knowledge.
NSl8LE FOR FILING RETURN
Marcus A. McKnight Esq.
60 West Pomfret Street
- -Car fisie-,- - foX - - i i6i3 - - - -- -- - - - - - - - - - - - - - - - - - - --
IRWIN & McKNIGHT
60 West Pomfret Street
- - -car"flsie- - - foX - - i i6i3- - - - - - - - - - - - - - - - - - - - - - - - - --
DATE
~
DATE
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 la) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value ot transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and firing a tax return are still applicable even it the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)).
The tax tate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at ~ast one parent in common with the decedent, whether by blood or adoption.
......... .4.....^....... ._
REV-150s EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jack Britton Cooper
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
881ft 247 - 56 - 2091
11/15/2002
FILE NUMBER
21-02-1118
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 $100.00 Bill 150.00
2 $2.00 Bill 3.00
3 2 1/2 Dollar Gold - American Indian 150.00
TOTAL (Also enter on line 5, Recapitulation) $ 303.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-15GB EX (Rev. 1-97)
REV-1Stl E~ + (1-97)
.COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Jack Britton Cooper
SS11 247-56-2091
11/15/2002
FILE NUMBER
21- 02 -1118
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES,
B. ADMINISTRATIVE COSTS,
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representatlve(s)
Street Address
City State Zip
-
Year(s) Commission Paid:
Z. Attorney's Fees IRWIN & McKNIGHT 200.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State ZIp
-
Relationship of Claimant to Decedent
4. Probate Fees
S. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Harry Dodson - Appraisal Fee 50.00
2 Orrstown Bank - Fee to Drill Safe Deposit Box 105.00
3 Register of Wills 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 370.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc,
Form REV-1511 EX (Rev. 1-97)
,(9-00)
;OMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
lATE OF
jack Britton Coooer
NUMBER
I.
SSI! 247-56-2091
11/15/2002
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
1ransfersunder Sec. 9116(aX1.zl]
Jack B. Cooper, Jr.
2215 Big1ervi11e Road #46
Gettysburg, PA 17325
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
Daughter
Daughter
FILE NUMBER
21-02-1118
AMOUNT OR SHARE
OF ESTATE
1/4 remainder
1/4 remainder
1/4 remainder
1/4 remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE. ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
2
Cecelia R. Heinbaugh
135 Media Drive
Carlisle, PA 17013
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 (c) ZOOO form software only The Lackner Group. Inc.
3
Terry L. Randolph
158 Richard Lee Drive
Greenville, NC 27858
4
Vivian L. Randolph
2735 Ritner Highway
Carlisle, PA 17013
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
0.00
Form REV-1513 EX (Rev, 9-00)
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PLEASE REMIT TO:
P.O. BOX 643543
PITTSBURGH, PA 15264-3543
PHONE : 330/490-3667
REFERENCE-IN?~;-;~~g:TiC-"'D~~~~;~O
'-S-ERVI"CEL DC' A T ION
ORRSTOWN BANK
DOWNTOWN CARLISLE OFFICE
22 S HANOVER ST'
CARLISLE
SITE NO: 002784730
,-~EBOLD
. ~ CUSTO~
DIEBOLD FEDERAL~D #
. CUSTOMER NO CALL NO
001466465 4670550
S ORR5TOWN BANK
o ATTN: STEVE OLDT
L MAIN OFFICE
D 77 E lUNG 5T
PO BOX 250
SHIPPENSBURG PA 17257
SERVICE GROUP
34-0183970
P.O. OR
PA 170130000
T
o
REGUESTED BY: CINDY HOCKLEY
DESCRIPTION
SAFE DEPOSIT BOXES
SAFE DEPOSIT BOX DRILLING
DIEBOLD REP: C MILLER
COMP DATE:
12/28/04
1 ~
$80.00
SO BOX ACCESSORY LOCK, RS DOOR
1 ~
$25.00
AS REGUESTED, TECHNICIAN DRILLED OPEN SAFE DEPOSIT
BOX 19, REPLACED AND REKEYED THE LOCK. TESTED FOR
PROPER OPERATION. BILLING PER QUOTE OF $105.00.
? ", S'~ 1 \\1
SERVICE TOTAL
PARTS TOTAL
80. 00
25. 00
STATE AND LOCAL TAX
10 .
.00
TERMS: DVE UPON RECEIPT AMOUNT DUE
'FORM NO 2297., REV 11/98 IMPORTANT INFORMATION ON REVERSE SIDE
105.00
"_ ____ ___ __ - .__, __ _._ .__ - _._. ___..__ ___ .'__ _'n __ _.__
--' ---.- ---,- ,--- ---- --- -- -. ---- ._-- .-.- -- --- --- -.- .- -- -- - - - -
COpy
\~
August 27, 2003
Law Offices of
Irwin, McKnight & Hughes
60 West Pomfret St.
Carlisle, Pa.17013-3222
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
(717) 787-3930
FAX (717) 772-0412
Re: Estate of Jack B.Cooper Sr.
File Number 2102-1118
Dear Mr McKnight:
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before February 15,2004. Because
Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional
extension(s) will be granted that would exceed the maximum time permitted.
Sincerely,
y ~•
r' „_
!~'~,~ _ ~fsi-a-M,~ffer, ~u~e~vi~sor
Document Prods' ~n Unit
Inheritance Tax Division
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
MCKNIGHT MARCUS A III
60 W POMFRET STREET
CARLISLE, PA 17013
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssrv: 247-56-2osi
FILE NUMBER: 2102-1 1 18
DECEDENT NAME: COOPER JACK BRITTON SR
DATE OF PAYMENT: 1 1 / 14/ 2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 5/2002
REV-1162 EX111-96)
N0. CD 003229
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 54,391.02
TOTAL AMOUNT PAID:
REMARKS: MARCUS A MCKNIGHT III ESQUIRE
CHECK# 020513
SEAL
INITIALS: JA
RECEIVED BY: DONNA M. OTTO
54,391.02
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Register of Wills of CUMBERLAND County, Pennsylvania
INVENTORY
Estate of Jack Britton Cooper No. 21- 02 -1118
also known as Date of Death 11/15/2002
Deceased Social Security No. 247 - 56 - 2091
Marcus A. McKnight Esq.,
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. I/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: Marcus A. McKnight Esq.
I.D. No.: 25476
Address: 60 West Pomfret Street
Carlisle, PA 17013
Telephone: 717/249- 2353
Personal Representative
Signature:
Marc s A. McK t Esq.
Signature:
Address: 60 West Pomfret Street
Carlisle, PA 17013
Telephone: 717/24 - 3x53
Dated: '~ ~~ U
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: Jack Britton Cooper
Date of Death: 11/15/2002
County: Cumberland
CASH:
Orrstown Bank, checking 8,810.97
account
8,810.97
PERSONAL PROPERTY:
2001 Dodge 1500 Pickup, short 8,000.00
bed, 53400 miles, 2WD - sold
to Brenneman's Auto Sales &
Service
8,000.00
STOCKS/LISTED:
--------------
105.00 shares Nextel Partners Inc. 739.20
739.20
REAL ESTATE/PA:
2127 Newville Road, Carlisle, 91,000.00
West Pennsboro Twp. -
Cumberland County (appraisal
attached)
91,000.00
-1-
COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0501 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 ER RFP (O1-OS)
is
" `~ ~~~ DATE 01-12-2004
"?., ESTATE OF COOPER SR JACK B
DATE OF DEATH 11-15-2002
ILE NUMBER 21 02-1118
•~ ~~-~ ~~ }'~ ~~ OUNTY CUMBERLAND
MARCUS A MCKNIGHT ESQ ACN 101
IRWIN & MCKNIGHT !I Amount Remitted
60 W POMFRET ST = _ 1 ~~
CARLISLE PA 17013~~ -
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COOPER SR JACK B FILE N0. 21 02-1118 ACN 101 DATE 01-12-2004
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 ) (1) 91 , 0 0 0 . 0 0 NOTE : To insure proper
2. Stocks and Bonds (Schedule B) (2) 739.20 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule Dl (4) .00 of this torn with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)_ 16,810.97 tax payment.
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 7,750.00
8. Total Assets (g) 116,300.17
APPROVED DEDUCTIONS AND EXEMPTIONS:
9.
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
(9) 18,402.62
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10). 1,520.62
11. Total Deductions (11) 79.9 4
12. Net Value of Tax Return (12) 96,376.93
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 96,376.93
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 96,376.93 X 045 . 4,336.96
17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due (19)= 4,336.96
TAY CRFIITTC•
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
11-14-2003 CD003229 54.06- 4,391.02
J
TOTAL TAX CREDIT 4,336.96
BALANCE OF TAX DUE .00
INTEREST AND PEN. .O1
TOTAL DUE .O1
* TF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~<
A REFUND- SFF RFUFRSF STnF nc ruTC cnoM rno TucronrrTn.~c-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PD BOX 280601
HARRISBURG PA 17128-0601 REV-1547 EX AFP (03-BS)
DATE 03-28-2005
ESTATE OF COOPER SR JACK B
DATE OF DEATH 11-15-2002
FILE NUMBER 21 02-1118
COUNTY CUMBERLAND
MARCUS A MCKNIGHT ESQ pCN 101
IRWIN & MCKNIGHT Amount Remitted
60 W POMFRET ST
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~r~- RETAIN LOWER PORTION FOR YOUR RECORDS ~
~~a~rs~r~t•x~•tv~~ro~s-xat~z~-t~•i~~rr~atx•t~x•~~a~~~~rr;•~r~~rda~-at~-••••••••••••• •••
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COOPER SR JACK B FILE N0. 21 02-1118 ACN 101 DATE 03-28-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. O1
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule Bl (2) .00 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 of this fore with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 303.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (g) 303.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
370 .00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 37 0 . 0 0
12. Net Value of Tax Return (12) 67.00-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) •~ U
14. Net Value of Estate Subject to Tax (14) 96,309.93
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX: "
15. Amount of Line 14 at Spousal rate (15) • 00 X 00 _ . 00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 96,309.93 X 045_ 4,333.94-,
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .OD
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 - .00
19. Principal Tax Due (19)= 4, 333.94
TOX CREIfiTS-
DATE
NUMBER +
INTEREST/PEN PAID (-) AMOUNT PAID
11-14-2003 CD003229 54.03- 4,391.02
TOTAL TAX CREDIT 4,336.99
BALANCE OF TAX DUE 3.05CR
INTEREST AND PEN. .00
TOTAL DUE 3.05CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .~c_~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/11/2005
MCKNIGHT MARCUS A III
60 W POMFRET STREET
CARLISLE, PA 17013
RE: Estate of COOPER JACK BRITTON SR
File Number: 2002-01118
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 11/15/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
G:!:::~::::::=:r
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
h~
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
JACK BRITTON COOPER. SR.
Date of Death:
NOVEMBER 15. 2002
No. 21-02-01118
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: ~ Yes _ No
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 X No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? X Yes No
Date:
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the lerk of 0 an's Court and may be
attached to this report. (
10/21/2005 L
N e (please type or print)
60 e
Address
Carlisle. PA 17013
City, State, Zip
(717) 249-2353
Telephone Number
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Personal Representative
Counsel for Personal Representative
Capacity:
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