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Home My WebLink About02-0577PETITION FOR PROBATE and GRANT OF LETTERS Estate of S . RUTH FLEGAL also known as 21-02-577 No. To: Register of ~ltlls fort e Deceased. County of 5~!'n~--~~ in the Social Security No. 19 8- 3 2- 7 3 6 3 Commonwealth o1' Pennsylvania The petition of the undersigned respectfully represents that: Co- Your petitioner(s), who is/are 18 years of age or older an the execut ors named in the last will of the above decedent, dated November 5 , , 19_22 and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberlan h e r last family or principal residence at (list street, number and muncipality) Decendent, then ~ ~ years of age, died Apr i 1 17 , , Dgx 2 0 0 2 at . Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will 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 $ .~bt Q'bD . 00 (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: 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.t.a.; administration d.b.n.c.t.a.) theron. f ~ ~~ ^ °' //// Laura can Barnett ert D, Fle ~0 435 S. Centre Street 705 Robinson Avenue ~~;, Phili~sbura, PA 16866 Roaring Siring, PA 1667_ Na - 4. ~o c on OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CENTRE 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,~nd truly administer the estate according to law. Sworn to or affirmed and subscribed ~ before me this 13TH day of ~~ JUNE i9z 2 fl fl 2 '~ : ' o ~ o / CE RE COUNTY RE ST)sKgister / J- ~it~ -~~~" OF WILLS County, Pennsylvania, with No. 21-02-577 Estate of S . RUTH FLEGAL ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JUNE 20 ~g~ 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 November 5 , 19 9 3 described therein be admitted to probate and filed of record as the last will of S . Ruth Flegal and Letters Testamentary are hereby granted to Laura Jean Barnett & Robert D . Flegal FEES Probate, Letters, Etc.......... ~ 80.00 Short Certificates( ) .......... ~ 9.00 x-pages -~Q Renunciation ................ $ JCP ~ 5.00 TOTAL $ 103.00 Filed .. JI~t>a . 2Q,..20Q2 ................. . R ster of Wi David C. Mason, Esquire #39180 ATTORNEY (Sup. Ct. I.D. No.) P.O. Box 28, Philipsburg, PA 16866 ADDRESS (814) 342-2240 PHONE J,.- G __ ~..`_ ~_ ~_ t`,.' t~,,y This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. L Fee for this certificate, $2.00 ~~~~ Local Registrar P 8223245 No. 21-02-577 H,DS.,uR.. 4167 7Y-E/-RINT IN PERMANENT BLwac uat ~~ 1 `1 STATE FII NAME OF OECEDEN71FrN. M.ptlu. LaRI SE% SOCIAL SECURITY NUMBER DATE OF DEATH;MOrM.O•v. earl S. Ruth Fle al ~• female ~• 198 - 32 - 7363 ~ ri1 17 2002 AGE ILa! B.n.oryl UNDER , YEM UNDER , Oro' DATE OF MRTH llRf WIACE (Ch arw PUCE OE DERN /CnrL n'N en• - see n'yn,n'ra^a w' goer w•1 MeM• I Days F1pu• t MYaA•• IMtYXn. O•y.'hrl 9r or FOr•gn Couwyl NOSP,TN- OTHER: 04-04-1906 Denver, CO 96 vn InprNra ^ ERIOuronwn ^ DDA ^"„'"'"'0a ~ RbWrw• ^ rs~w~nT ^ . 6. 6. T. ECEDENT OF HISPANIC ORIGIN? RACE ~ Am•rlran IM•n. BMCi. WnX•. Mc D COUNTY Of OE1QN CTTV BOIro. iWP OF DEATH MCIIITY NAME P nq nP•AOn. qM fRw ana ryrmp•r~ YM9 ~ y ~ Np E.i 1M ^ X yb, e0•c+T,' Cue•n. (SPa 1y) (/ ~ /~ ~ PwnoRw• .,•. h l/ r M.Mnn white All T shi U d C l /~ ~ . . ,o. en own p w. pper - ~ CLmber an c_Ss rp. o. w DECEDENT'S USUAL OCI;uFaaN %XXOOF BUSN+ESSANDU3Tnv wA3 DECEDENT EYERw DECEDENT'S EOIICATION MARfTAL S7iATUS-M•m•e SURVIVING SPOUSE (GM Nna N rorY aorN waIArn•qo nasal U. S. ARMED F011CE37 N•vr Mani W. N/fppwW. Ip.Ma. grv• npM Nm•1 ENm•rrr'B•LaIMry Crl•W DHrue lSp•chl f a r a E a r• npn ,E •; • nr w• n o .l w^ N•® pIT °'°s" I ,a. W1dCAJed „ T10n2 12 - ,,,. school teacher ,,,, elementary education ,:. ,a. oECEDENrSMAn.wccADdresSlsr...cAdw.n.SMl.roGoo.l oEC~NT's Pennsylvania a.o.aNw.ek UPPer Allen ,7• ~w. 100 Mt. Allen Drive - ,T..~ da . . RESIDENCE a.c.a.r• ~° Mechanicsburg, PA 17055 «~~~ ~ Cumberland '°"ntl1ep7 na l ~N ^ , 6. ~~ . .X en n b o aryr0oro FQHER'$ NAME IFrR. MqU•. LM MOTHER'S NAME fF'rf. Mgal•. M•b•n $,Anam•1 16_ James H. Black ,.• Leona Dale INFORMANTS NAME (TYprPr•'R INFORMANT'S MAllWO ADd1ES815•w. GMTp•m, SIr. Lp CaMI 3a. Laura Barnett 435 S. Centre Street, Phili burg, PA 16866 METHOD OF DISPOFTION DATE Of dSPO&TM]11 PUCE OF p ~ N•m• of C•m•I•ry, Cr•mamry LOCATION ~ CXy/Wan. SbN. Zo ~~• ron^ RMIOV•Indn Sltl•^ B W® C OW. Twl rwn• w o•nron^ oXR.ISp.arL ^ April 22, 2002 Philipsburg Cemetery Philipsburg, PA 16866 T,a s, ,e. ,a. SERVICE IND AS SUCH LICENSE NUMBER NAME AND ADDRESS OF FAC,LTTV ~,. FD-012277-L ~.Beezer-Heath F.H., 719 E. Spruce St., Philipsbur PA 16866 CempMl• X•ms lb my XrpWap•, W W ocewr•a r rM nI,H, iM ane plat. N•Ir,a LICENSE NUMBER DATE SIGNED pM1yMtiM ~ rq Ilrrq a 0•rn b TiX•) PAanN. D•Y'r••rl oanaY raub a earn. 3!•, 370. 3x. X•ma 3.-46 mralGOOmpNrW OY TIME OF DEATH OATS PRONOVNCEOOEADIMOr%n.Dry. Ybr) YMS CASE REFERREDro MEDICAL E%AMINERICORONER? - pr••rl •1W prpnow,c••a••N. N•^ No I~ ' / ~ - O Z ~ ~ / ~ ~ / r. :. `~' M. 30. 37. PART 1: EnIM M Owws, InsXi•• a corripAFanor+wniNl oua•a m• Deco Dp nr wM,M mpN o, %aq, ellM b Grai•C ar napw•Idy artw. Ngee w Grl lbw.. I ApproAenr• PART n: dn« aiylilku%corlaleorr mrmaAlrq N awn, eul Cal oNy one Farr on .etas Nr. ~'un•rYr Oww•M rol r•araq w tln wlarryMq orr R^•n n PARE l I arl•r •rla awn 11MIEdATE uuSE (FvW ~ I Cct 4Y\ P~CI CL. _ °°r°gna`~'lnl~ . , . o,lE ro laa As A wNSEQITENDE SC° V P (' L p' (~~n ~ g n ~ , j s.w•nna6y Xw wllaXirN e DUE ro,OR AS A CONSEQUENCE OF} t I X cry, I••a0q n nrrrr• urr. EnNr 1111OFlILY11O ~ C111 S[ I 0 ~ e. ••••• or+yury R 1 •Ml niM•a •-•rwa Ol1E ro l A'S NCE OFT: r•RAXrp n a•••0 LAS7 0. • VMS AN AUIOP$Y MERE AUTOPSY FMidN('S MANNER OF DEATH DATE OF IWURY TIME DF IWURY IWURY AT NORM? DESCRIBE HOW IWURY OCCVRRED vERFDRArtm AM%/.BLE PRIOR ro IMOnm. Dw, wrr COMPLETION OF CAUSE N I ~ H i r ^ OF DEATH? ,MM• pm F MR ^ Np ^ Att1aFX ^ P•r,airy Irl.•rgNM ^ M. ~ Y•• ^ No ~ IY• ^ N• ^ Suicia• ^ CauM mlGwwmal•a ^ • PLACE OF IW URY . M bm•. hrrr,, NrNI. I. 1pry, OMIq LOCATION ISner. Ch,<. Sml•I WIA6q, Nt. I- •cMl 360. 3!. ]6•. ]01. CEIR,FIE111CnzX ONy pnr $XiNA7URE AND TtTIE OF CERT,FI R r 'CEMIFYMri PNYSIdAN IPnyac.an crlrMV'r5 caub b awn ..nr AndnM pnyLCUn nas pMdmt•o aesln ant compaaa Xem 2JI ` Te B,• OM r my Xn•wNay, bras eeeanae au Y Xy e•u•.,fl •na m•nn•r b •I•t•a ..................................................... 310. LICENSE MDER D E STONE IMOrie.. O•r 1 '-ROMOUMGMD ANO CERTIFYING -NYSICIAN IFTyycyn ppm yarro,rrcrcg p•aln arq cM~Mrg to cwsa d aea%~1 Tp,M Gal el my erorNiaO•. MaM Opewr•a N,G Ilrn•, b,•, ana elec., an! au• le IG c•uaN•1 ease manner •• a,•I•a .......................... ^ G )te. ~ l a. NAME D SS OF PERSON WMOCOMPLETEO CAUS Of ' (Item Z71 Typ• or Print ~ OO ~ JOE p S..r O 14 MEDICAL EXAMINER/Cg10NER • On,M DaN• o, •:•min•tlon arlo/or InY•aliq•tbn, in my opinion, a••tn «CUn•o al,he Ilm•, a•b, ease plea.. Ana aw to Ine ueblq and L,EI'+"tovNE ~ PA 1 X043 Sla. l3. REGIST R' NATURE ANO NUMBER DATE FIL ( . m O y. TSan an ]]. /~ ~~ / / ].. iLLJ' ~ ~ ~ O. C~ Q Date COMMONWEALTH OF PENNSYLVANIA • DEPARTINENT Of HEALTH • VITAL RECORDS CERTIFICATE OF DEATH 21-02-577 LAST WILL AND TESTAMENT OF S. RUTH FLEGAL KNOW ALL MEN BY THESE PRESENTS, that I, 8. RQTH FLEGAL, currently of Philipsburg, Centre County, Pennsylvania, being of sound and disposing mind and memory do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all former Wills and/or Codicils heretofore by me made. FIRST: I direct my personal representatives hereinafter named to pay all the expenses of my last illness and burial as soon as practicable after my decease. SECOND: I hereby give, devise and bequeath the sum of Two Thousand ($2,000.00) Dollars to the Presbyterian Church of Philipsburg, Centre County, Pennsylvania. THIRD: All the rest, residue and remainder of my estate, whether it be real or personal and wheresoever the same may be situate, I do give, devise and bequeath equally unto my children, namely, CHARLENE RUTH BAOGSMAN, ROBERT D. FLEGAL, LAIIRA JEAN BARNETT and LEONA JANE RAPSEY, share and share alike. If and in the event any of my children should predecease me, I give and bequeath his or her share of my estate unto his or her children per stirpes and not per capita. FOURTH: I do direct each of my children above named to distribute to each of their children the sum of Two Thousand Dollars ($2,000.00), and to each of their grandchildren the sum of Five Hundred ($500.00), to be paid from each child's share of my estate. FIFTH: I direct that all inheritance, estate or other taxes in the nature thereof together a?th any interest and pznalties thereon, becoming payable because of my death, with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from my residuary estate, and no person receiving any beneficial interest shall be required to contribute or refund any portion thereof. LASTLY: I hereby nominate, constitute and appoint my daughter, LAIIRA JEAN BARNETT and my son, ROBERT D. FLEGAL, as Co- Executors of this my Last Will and Testament. My Co-Executors hereunder shall have the following powers, in addition to those powers conferred by law: To dispose of any asset of my estate, includi.~g real estate ac private ar public sale at such price or prices as they shall see fit; to lease, encumber or option any portion of my estate; and to make distribution of my estate in kind, in cash, or partly in kind and in cash. No bond or other security shall be required of my Co-Executors in any jurisdiction. My Co-Executors shall not be compensated for acting in said capacity as Co-Executors. IN WITNESS WHEREOF, I ha/ve hereunto set my hand and seal this ~_~ day of ,~~~..s~~.,~,~?~1 , 1993, to this my Last Will and Testament consisting of three (3) pages. Signed, sealed, published and declared by the Testatrix as and for her Last Will and Testament, in the presence of us, who in her presence and at her request and in the presence of each other, have hereunto subscribed our named as witnesses thereto. ( ~ ~ -,,?' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CENT;R~E : s I, ~ - ~~"U"rU ~"^h/~'2__.-- , the Testator/Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the said instrument as my Will, that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed.~i'~~ R ~~~`~~°~'" '` .CIS"" Sworn to and subscribed before me, the undersigned Notary Public, the said Testator/Testatrix, this 5~`'' day +~...., II COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CENTRE :s: //~~ ~ i /! ~ We, ~ and ~f s'~1~I ~ , ~ ,~*i / i r( i7Z,F"'`? the witnesses whose name are signed to the foregoing instrument, being qualified according to law, do depose and say that we were present and saw the Testator/Testatrix therein named sign and execute the said instrument as his/her Will, that he/she signed willingly and that he/she executed it as his/her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the said Testator/Testatrix signed the Will as witnesses; and that to the best of our knowledge the said Testator/Testatrix was at that time 18 or more a rs of age, of sound mind and under no constraint o undue infl~e ce. Sworn to and subscribed before me, the under}gned Notary Public, by the said ~.~itnesses; this ~;''~ day of ~CV rv16~r , 1993. N.P. M-~ E5 1~7 h~ CENTRE COUNTY OFFICE OF REGISTER OF WILLS AND CLERK OF ORPHANS' COURT Roger A. Bierly, Register Kimberly Barton, Dep. Christine Soster, Deputy COC Willowbank Office Building 414 Holmes Ave., Suite 2 Bellefonte, Pennsylvania 16823 Telephone (814) 355-6724 Fax (814) 355-8685 June 13, 2002 Mary C. Lewis Register of Wills & COC 1 Courthouse Square Carlisle, PA 17013 Dear Mary: Alice A. Saylor, Clerk John R. Miller, III Solicitor I am enclosing a Petition for Probate and Grant of Letters, the original Will, the Death Certificate and an Estate Information Sheet and a check in the amount of $138.00 in regards to S. Ruth Flegal, late of Cumberland County, deceased. I have taken the oath of the executrix and the executor in the above captioned matter, therefore, I am forwarding all papers to you for probate in your county. If you have any further questions, please feel free to contact me at the number listed above. Thank you for your anticipated cooperation. Sincerely yours, Roger .Bierly Register of Wills & COC Enc:kb CERTIFICATION OF NOTICE UNDER RULE 5 6(al Name of Decedent: S. Ruth Flegal Date of Death: 04/17/2002 Will No. 2002-00577 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 06/25/2002 : Name Address Laura Jean Barnett 435 S. Centre Street Philipsburg, PA 16866 Robert D. Flegal 705 Robinson Ave. Roaring Spring PA 16673 Leona Rapsey 40 Essex Road Cam Hill PA 17011 Charlene Ruth Baughman Circ e Drive Harrisburg, PA 17112 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: ~.~~ ~S "~v2 Signature Name: David C. Mason, Esquire Address: 409 N. Front Street, P.O. Box 28 Philipsburg PA 16866 Telephone(814) 3422240 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: MASON DAVID C ESQUIRE 409 N FRONT STREET PO BOX 28 PHILIPSBURG, PA 16866 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: ssN: ass-32-7363 FILE NUMBER: 2102-0577 DECEDENT NAME: FLEGAL S RUTH DATE OF PAYMENT: 1 1 / 1 2/ 2002 POSTMARK DATE: 1 1 /06/2002 couNTY: CUMBERLAND DATE OF DEATH: 04/17/2002 AMOUNT 101 ~ 52,398.77 TOTAL AMOUNT PAID: REMARKS: LAURA JEAN BARNETT C/O DAVID C MASON ESQUIRE SEAL CHECK# 13 INITIALS: CW RECEIVED BY: MARY C. LEWIS 52,398.77 REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 001830 REGISTER OF WILLS First Ciass Mail MASON LAW OFFICE 409 N. FRONT STREET P.O. BOX 28 PHILIPSBURG, PA 16866 osa$1 ~- REGIS'PER OF WILLS ~ CUMBERLAND COUNTY COURTHOUSE ~ HANOVER & HIGH STREET .-,,, , ~ n i 'i Ji.tto4ney of Lain 409 NORTH FRONT STREET P.O. Box 28 PHILIPSBURG, PENNSYLVANIA IG866 (814)342-2240 FAX (814) 342-5318 November 6, 2002 Register of Wills Cumberland County Courthouse Hanover & High Street Carlisle, PA 17013 In RE: Estate of S. Ruth Flegal Dear Sir or Madam: Enclosed in duplicate please find Inheritance Tax Return relative to the above for filing, together with my check in the amount of $15.00 for filing costs. Also enclosed please find a check payable to "Register of Wills, Agent" in the amount of $2,398.77 representing the balance of inheritance tax due. Thanks very much. DCM:bIb Enclosures cc Laura Barnett Robert D. Flegal Very truly yours, MASON LAW OFFICE David C. Mason f~ ~~ ~ - ~~ ' ~ ~7' COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1557 ER ~FP (01-02) DATE 12-23-2002 ESTATE OF FLEGAL RUTH S DATE OF DEATH 04-17-2002 FILE NUMBER 21 02-0577 COUNTY CUMBERLAND DAVID C MASON ~Si~ - l ACN 101 MASON LAW OFFICE Amount Remitted PO BOX 28 PHILIPSBURG `„ PA 16866 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT H OUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ --------------------------------------- ____________________ -------------------------- ------------------------- REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FLEGAL RUTH S FILE N0. 21 02-0577 ACN 101 DATE 12-23-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN Real Estate (Schedule A) (1) .00 1 NOTE: To insure proper . (2) 16,846.24 credit to your account, 2. Stocks and Bonds (Schedule B) 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 59,904.6 2 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 750.86 76 8. Total Assets (81 , APPROVED DEDUCTIONS AND EXEMPTIONS: 11,820.93 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 9.623.96 11. Total Deductions (11) 21.444.89 55,305.97 12. Net Value of Tax Return (121 2,000.00 13 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . (141 53,305.97 14. Net Value of Estate Subject to Tax 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: 00 00 .00 15. Amount of Line 14 at Spousal rate (151 . = X 045. 97 305 53 2,398.77 16 Amount of Line 14 taxable at Lineal/Class A rate (16) . , X . 17 Amount of Line 14 at Sibling rata (17) • 00 X 12 . 00 . 18 Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 .00 . (191= 2,398.77 19. Principal Tax Due I Ax - GA71 1 .7 - DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 11-06-2002 CD001830 .00 2,398.77 TOTAL TAX CREDIT 2,398.77 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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.) .~2V~1500<::X. (6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT .' . < :,:': '., ',::~: ,: " , ,~. " ' '~:~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEn 280601 HARRISBURG, PA 17128,Q601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U W C FLEGAL, S. RUTH DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 04/17/2002 04/04/1906 (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W 0- ::.:::~(I) 0"'''' w~O J:a::9 0.... .. <( [KJ 1. Original Retum o 4, Limited Estate (R] 6. DecedentOiedTestate (AltacllcopyofWan) o 9. litigation Proceeds Reeeived o 2. Supplemental Return o 4a. Future Interest Compromise (date of deatll atter 12-12.82) o 7. Decedent Maintained a living Trust (AIlach copv ofTrusQ o 10. Spousal Poverty Credit (date of deatll between 12-31.91 and 1-1.95) 0- Z W C Z C .. <J) w '" '" C o IlmilieilceiAN iGO"''''IlENitlAtT AX INF:ORMA nON SHOULDBEiIlIBECmeDiiToJiii::,jij COMPLETE MAILING ADDRESS 409 N. Front Street, P. O. Box 28 NAME David C. Mason, Esquire FIRM NAME (If Applkable) MASON LAW OFFICE TELEPHONE NUMBER 814-342-2240 Phili sbur z o j:: <( ....I ::> !:: a.. <( o w a::: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 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 1) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus Line 11) 13. Charitable and,Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedlde J) 14. Net Value Subject to Tax (line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o j:: ~ ::> a.. :!E o u S 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X (15) 53,305.97 X .045 (16) X .12 (17) X ,15 (18) (19) 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 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT OfFICIAL USE ONLY ~ 17- 7()- I FILE rMBER. -' ~ -.. '1 __22'L COUNTYCOOE ~JL1- NUt.lllER SOCIAL SECURITY NUMBER 198-32-7363 THIS RETURN MUST BE FilED IN DUPLICATE WrrH THE REGISmER OF WILLS SOCIAL SECURITY NUMBER o 3.RemainderRetum (daEoIdealhpriorto12,13.82) o 5. Federal Estate Tax Return Required _ 8. T ota] Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (~IISchO) PA 16866 OFFICIAL USE ONLY I I 16,846.241 , I "~ 59,904.62 (8) 76,750.86 11,820.93 9,623.96 (11) (12) (13) 21,444.89 55,305.97 2,000.00 (14) 53,305.97 2,398.77 2,398.77 ',R~HaC:Ki'M D d , C Add ece ent s omplete ress: STREET ADDRESS . 824 Lisburn Road, Apt. 229 CITY I STATE I ZIP 17011-7102 Camp Hill 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) 2,398.77 Total Credits (A + B + C) (2) 3. InteresUPenally if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Pagel Line 20 to reque.t a refund (4) 5. If Line 1 + Line 3 is greater than Line 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 + SA. This is Ihe BALANCE DUE. (5B) Make Check to: REGISTER OF AGENT 2,398.77 2,398.77 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transter and: Ves No a. retain the use or income of the property transferred: ........................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income: ............:........................... 0 ~ c. retain a reversionary interest; or ...............",...............................""."'..........,.,................................ 0 ~ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 ~ 2. If dealh occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?......". ................,.................".... ......................."", 0 [Z] 3. Did decedent own an 'in trustfor" or payable upon death bank account or security at his or her death? ................. 0 ~ 4. Did decedent own an Individual Retiremenl Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of pre parer other than the personal represel'\lative is based 01'\ all ir'lformatiorl of which prepar a wledge. SIGNATURE F P RSON RESPONSIBLE F FILING RETURN IE OATE AOORESS - ();JJ 1-.3-~;J.. OATE II-~-Qz..-..- AOORESS 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. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disciosure of assets and filing a tax return are slill applicabie 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" 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 chiid is 0% [72 PS. ~9116(a)(1.211. 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. 99116(a)(1)]. The tax rale imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. .. LAST WILL AND TESTAMENT OF S. RUTH FLEGAL KNOW ALL MEN BY THESE PRESENTS, that I, s. RUTH FLEGAL, currently of Philipsburg, Centre County, Pennsylvania, being of sound and disposing mind and memory do hereby make, publish and declare this as and for my Last will and Testament, hereby revoking and making null and void any and all former wills and/or Codicils heretofore by me made. FIRST: I direct my personal representatives hereinafter named to pay all the expenses of my last illness and burial as soon as practicable after my decease. SECOND: I hereby give, devise and bequeath the sum of Two Thousand ($2,000.00) Dollars to the Presbyterian Church of Philipsburg, Centre County, Pennsylvania. THIRD: All the rest, residue and remainder of my estate, whether it be real or personal and wheresoever the same may be situate, I do give, devise and bequeath equally unto my children, namely, CHARLENE RUTH BAUGHMAN, ROBERT D. FLEGAL, LAURA JEAN BARNETT and LEONA JANE RAPSEY, share and share alike. If and in the event any of my children should predecease me, I give and bequeath his or her share of my estate unto his or her children per stirpes and not per capita. FOURTH: I do direct each of my children above named to distribute to each of their children the sum of Two Thousand Dollars ($2,000.00), and to each of their grandchildren the sum of Five Hundred ($500.00), to be paid from each child's share of my esta te . FIF'l'H: I direct that all inheritance, estate or other taxes in the natu.re th f t t . h . t t d 1<- ereo age her .at any 1.n eres an pena ~ies thereon, becoming payable because of my death, with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from my residuary estate, and no person receiving any beneficial inte.test shall be required to contribute or refund any portion thereof. LASTLY: I hereby nominate, constitute and appoint my ~ daughte~, LAURA JEAN BARNETT and my son, ROBERT D. FLEGAL, as Co- Executo~s of this my Last Will and Testament. My Co-Executors hereunder shall have the following powers, in add't. 1. 1.or-t to those powers conferred by law: To dispose of any asset of my estate, including real estate at private or public sale at such pr~ce or prices as they shall see fit; to lease, encumber or option <any portion of my estate; and to make distribution of my estate .:in kind, in cash, or partly in kind and in cash. . . No bond or other security shall be required of my Co-Executors in any jurisdiction. My Co-Executors shall not be compensated for acting in said capacity as Co-Executors. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,1' day of ~114~V'~~~ , 1993, to this my Last Will and Testament consisting of three (3) pages. .( J.1.?~L".6~fab(SEAL) signed, sealed, published and declared by the Testatrix as and for her Last will and Testament, in the presence of us, who in her presence and at her request and in the presence of each other, have hereunto subscribed our named as witnesses thereto. ~;~I,i~: , t~---,'l-IL' I ,,_ ("Z::C?t//t:..&-c/t..--, COMMONWEALTH OF PENNSYLVANIA COUNTY OF CENTRE :s: ~hk1 name is signed to the foregoing instrument, having been duly qualified according to law, do'hereby acknowledge that I signed and executed the said instrument as my Will, that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. I, s. VLlTU , the Testator/Testatrix whose Sworn to and subscribed before me, the undersigned Public, bl the said Testator/Testatrix, this 5~ of fJ(}l/PUW r , 1993. ~ i()JV1 fl, ~j lfJr9-cL l.~__] COMMONWEALTH OF PENNSYLVANIA COUNTY OF CENTRE :s: /} ,,/('/1 We, and H/J/l L, if/I // I t! /7f.5f;'''1 the witnesses are signed to the foregoing instrument, being qualified according to law, do depose and say that we were present and saw the Testator/Testatrix therein named sign and execute the said instrument as his/her Will, that he/She signed willingly and that he/she executed it as his/her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the said Testator/Testatrix signed the will as witnesses; and that to the best of our knowledge the said Testator/Testatrix was at that time 18 or more e rs of age, of sound mind and under no constraint 0 undue infl e ceo u., M- / J j'j)/;' , (~,:,_'~1:;.(ct;.-:P;7Z ':/2 c.1-?'~. ' ;/ :..-~..t:_"J7"L.. ./i I Sworn to and subscribed before me, Public, by the said witnesses, this ~+h 1993. the under~t,gned Notary day of fJ.OVPn"IJ{' r , 41 ,- " . '(.I { N.P. I~~~,I lI'IaJIlMlSSlON ~~ 'I'" () ;1, , L i,l' f 'cA-A ""'--' _.L-(.-li ~ """'''''''''''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FLEGAL S RUTH AU property jointly.owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER ITEM NUMBER 1. DESCRIPTION 2,916.454 shares Liberty Strtge Ineme B(CLSBX) @ $5.63 per share VALUE AT DATE OF DEATH 16,419.64 2. 15 shares of Prudential Financial 426.60 TDTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 16,846.24 'REV'~"'.":"_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FLEGAL S. RUTH FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION PNC Bank, Certificate of Deposit, Certificate No. 31300188192, VALUE AT DATE OF DEATH 5,000.00 2. PNC Bank Checking Account #51-4023-6165 33,519.73 3. PNC Certificate of Deposit, Certificate No. 31300188193 5,000.00 4. PNC Certificate of Deposit, Certificate No. 21001027961 6,000.00 5. Commonwealth of Pa. Re: PSER's check 654.89 6. MetLife Investors USA (Annuity) Policy # C3002016 9,730.00 TOTAL (Also enter on line 5, Recapitulation) $ (if more space is needed, insert additional sheets of the same size) 59,904.62 ""~''''''''''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FLEGAL S. RUTH FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Beezer-Heath Funeral Home 6,447.40 2. Century Florist 200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Laura J. Barnett & Robert D. Flegal 3,837.54 Social Security Number(s) I EIN Number of Person at Representative(s) 160-30-7606 200-26-4387 Street Address City State Zip Yea~s) Commission Paid: 2002 2. Attorney Fees David C~ Mason, Esquire 1,000.00 3. Family Exemption: (If decedenfs address is not the same as clairnanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County Re: Letters Testamentary 103~00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. The Sentinel Re: advertisement 122.99 8. Register of Wills, Centre County Re: qualifying Executors to Will 20.00 9. Cumberland County Law Journal 75.00 10. Register of Wills, Cumberland County, to file Inheritance Tax Return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 11,820.93 (If more space is needed, insert additional sheets of the same size) ;:'''''',.:':''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FLEGAL. S. RUTH FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 7,644.25 1. Messiah Village 2. The Woods 369.54 3. PharAmerica Re: invoice for medication 665.27 4. Internists of Central Pa. 42.31 5. Center of Neurobehavorial Health 22.52 6. Quantum Imaging 57.69 7. Reimbursement to PSERS for overpayment 163.98 8. Harold H & G Tax Service 85.00 9. Met Life Insurance Co. 67.73 10. U. S. Treasury RE: taxes 505.67 TOTAL (Also enteron line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,623.96 'R~V_1513EX"(. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER FL"''''i\1 S RIITH RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include oumght spousal distributions, and transfers under Sec. 9116 (al (1.2)] 1- Laura Barnett daughter 1/4 residue 435 S_ Centre Street Philipsburg, PA 16866 2_ Robert D. Flegal son 1/4 residue 705 Robinson Ave. Roaring Spring, PA 16673 3_ Charlene Baughman daughter 1/4 residue 112 Circle Drive Harrisburg, PA 17112 4_ Leona Rapsey daughter 1/4 residue 40 Essex Road Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1_ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Presbyterian Church of Philipsburg 2,000.00 TOTAL OF PART Il- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 2,000_00 (If more space is needed, insert additional sheets of the same sizej STATUS REPORT UNDER RULE 6.12 G~VJ Name of Decedent: S. RUTH FLEGAL Date of Death: April 17, 2002 Will No.: 2002-00577 Admin. No.: 21-02-0577 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 fKI 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.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No r::g 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]]l No 0 c. Copies of receipts, releases, joinders and approval of formal r informal accounts may be filed with the Clerk of the. Qrph ' Court and may be attached to this rep t.-.... Date: J-f"-{p -Of 0, R ~'oJ 0.. David C. Mason, Esquire Name ~;, -' ci:':L1... p ~,.~ .:1 ~ :.;(3 409 N. Front St., P.O. Box 28 Address Phi1ipsburg, PA 16866 814-342-2240 Telephone No. c:c I ,~ a:: = Capacity: 0 Personal Representative o Counsel for personal representative