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Home My WebLink About02-0965PETITION FOR PROBATE and GRANT OF LETTERS Estate of also known as ~caa ecurc; Frieda B. Weller No. 21-02- A 105 rie a e er '1'0: Register of Wills for the _ County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are l 8 years of age or older and the executors named in the last will of the above decedent, dated May 18, 1998 and codicil(s) dated N/A (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with the Decede;nt's last family or principal residence at 442 Walnut Bottom Road (Borough of Carlisle) Carlisle, PA 17013 (list street, number and municipality) Decedent, then 96 years of age, died at Carlisle Regional Medical Center, Carli October 22, 2002 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: No Exceptions Decedent .at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not dorniciled in Pa.) Personal property in Pennsylvania (If not dorniciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 150,000.00 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.; admimstration d.b.n.c.t.a.) thereon. ~~ J et Weller Cherr 5228 Cobblestone Drive Mechanicsburg, PA 17055 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tatives} of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or atiirn~ed and surs~ribed before me ~riir '?~~~~y of ~r~' 0~~:'~0~3c,R. 2001 ~--- R gister Lam/ ~~-~~'~ No. ai-oa-9c~s Estate of Frieda B. Weller Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~c'~~R°~R 2 ~ , , 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 May 18, 1998 described therein be admitted to probate and filed of record as the last will o Frieda B. Weller and Letters Testamentary are hereby granted to Janet We er herry Register o Ji FEES Probate., Letters, Etc. $ 235.00 Robert G. Frrg', 46397 Short C•°rtificates(2) $ ATTORNEY ~Scip. Ct. LD. No.) ~,~ x -t,~,~~~ _ ., $ ~y .~ 5 South Hanover Stl'eet ~~ ~ p $ L70 Carlisle, Pennsylv~inia 17013 "~'~ta1~,~ ~2 ~~ . ACS ADDRES-S Filed..a1.1'ec1"'arty " 10 - 2 a - (717) 243-5838 PHONE l I$ G iU ;'1-* ..~~IC 1. ~:-au _ ~IFSi71 {tl:I"C cfil't'11 lS COI'Cl'.CC~C li)~!.,.t ,l'+:!II. <;_l; L3C1~°,?1ii~ ~~:CC'fI:.:IC~ +'';~+.... i .,. .,., "1 _. Y;d~ ~!~ - -1~:1.' .C a _.. .r14.-..li qt~l ;?t'; ~t117i'v TC~ti'_tii ~U 'L~l'~ `°'. tz_ ,~.. ~l.Cl( i•~'> ~~~f It ,_ ~;~ ~::,, ,_, ;r~~~€~~i~a+~:: ; ss ill~gai #c dlapii~~te this ~.~~; ~/ ~iaritos#a# sJr ~a~~lt~~s~~ '.,~. ~~'___~703_4.8..8 N,os. ;.3 Ray. veT tNT °NT NK ,~. ~ ~ ~~ ;, d~~~Zd z ~L y, ~~: Z1 y ~ . '~ III :I .~ ~, a `* `~ ~ ,~ ~~ . ~,9T~EN~ I~ _ ~ N~ acT 2 ~ 2ooz ,~, , ,, COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT Of HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT tFyv. Mieeb. Laal SE% SCCIAL SECURITY NUMBER M DATE OF DEATH ,MCrM. Day, Karl ,. Fril~da B. Weller x. F ]. 065 - 38 - 7776 .. 10/22/2002 AGE Qas Byewayl UNDERIYEAR UNDER,DAY DATE OF BIRTH BWTHPUCE ;CAyaM PLACE Of DEIBHIChck oMy nne ruCl~Orq marnN SOai Monlna DaYS Hours • Mklutp 'Mmin. Day ~A'.«I $191ed FpegnCwnttyl HOSPITAL: OTHER 96 Yp. 1/30/1906 Philadelphia,PA „pa,am ® ERIOtApst,p a DDA C „~ ^ „~,,,,,,~ ~ s~til ^ COUNTY OF CIERN CrtY, BORO.iWPOF OEATN FACILITY NAME IIInp In9~Nlgn, give sheet one rv%nnerl WAS DECEDEM OF HISPANIC ORIGIN? RACE.Amenunlr10ian, BOCk, wnee src . . • Clmiberland Carlisle Boro. Carlisle Regional Medical Center ~:® w««~R~'~'«'~""yCi°'"' `~") ,a , +. ,, White . DECEDEM'S USUAL OCCUPA710N KIND OF BUSINESS/INDVSTRY YMS DECEDENT EVEP IN DECEDENT'S EDUCATION MARITAL STMUS. Mertae SDRVfVING SPOUSE (Grv•Iwopygrk epb QUruuqp moo U. S.ARMEDFORCES? I n aee can ao Nev«Martae Wk,o•.eo . , (e Me 9i••msnen namel d.wrkkq M•; eo no, use ref ee 1 H• ^ No ® EbrNnurylSecmeary Coeegs ~~ 15PecM ,,. Hom~naker ,,,.Her awn Home ,: 12'D„' o a p s.l - ,] JAidowed . , . ,,. DECECK:NT'S MMLING ADDRESS (Stre«.ChlTOy",. S,ase. Zo COO« DECEDENT'S ^ "` S'" PA yY• aaceMnl~" 442 Walnut Bottom Road RESIDENCE ~ee.,~ "`' ree - ` Carlisle, PA 17013 ~$eBM11""""" "~°~ ,rv pt'"~' ,,,, Clnnberland te.m«kp? ,,,,® WI~I,Neco"`o`"ImWRm~aaol Carlisle ;I A FMHER'S NMAE (Fky. Mbola. Ust) e•e e r MOTHER'S NAME jFya,. M~ook. Marten $yrnamel ,.. Charles - Yackle ,,. Katherine - Ebert MIFORMANT'!i NAME (TylnPrintl ,,,- Janet W. Cherry INFOIIMANT'S MM IMO A ESS Sheol, CAy $MN, Zip 1 z~ 5228 Cobb~es~.one give, `~'echanicsburg, PA 1?055 METHOD OF [%SPOSITION • fY r•rll•liplr l~3 RM1eyy Ilgn Stab ^ DME tY DISPOSITION (Mp"^. aY.'"°r) PUCE OF DISPOSRpN- Nama «Cametery, Crematory or Olfl« %K• LOCATION . Cily/TOwn, S,at•. Zp Cee• ~A~ ^ Oor,.ten ^ « • x,.. ' ,,,• 10/24/2002 x,~ast Harrisburg C~n/Cretn t,a Harrisburg, PA 17109 SIGNRURE OFF L SERVICE LICEy$EEQR PER$p~AC11NG AS SUCH LICENSE NUMBER NAME ANO ADOgESS OF FACILITY ~ ~ xx, FD 012633 L m F~ving Brothers Funeral Herne, Carlisle, PA 17013 C 'F/~~Lp C/~^ CmW«• Aems 23•<oMy when c•rtAyirg ' ~ e «a«A'M`«nm•ol aam to b M• W« « Mwbegs, Matn oUUrree al tM nrM, ar,e dace Relso. LICENSE NUMBER (Signanwe TAe) ~.. f-~ . ~~~n.- t/ Rita ~'~ x]e. ~ ESIGHED _ ~i o ~=aa -o .z- R•ms 2A-xB rm•1MC«np«s0W pram M,e paqurlp. W.M. TIME OF DEMM GATE PRONOUNCED DEAD(Mmm, Day.v ) WAS CASE REFERRED TO MECNCALE INERICORONER? io -a a - o ~-- ,~ p ~ . N~ ^ / :a. 7 M. xe. r. xT. 1ART L• E:nt•r tM orseas•s, inryrae w comDlicanoru.NCn auaee tM Death. Oo not ent« 1M moos o1 eymq, such as cartkac or respbalory anent. sfbck or Mart ladur•. i Approxlm«• PAR71 dn•r spn;,ICani cg WXiorr• opry,iprgFy,e a•M, e« Cal only oM uw• m sap, Ikle. ~ im•nM o•nra•n np r•su%R,q n BI• urtMrk ir Do i R PARE I / q ls. g yn w . , ore•t arq 0uM IYYEpATE CAUSE (Final t e a ss.seor carx on _)~AS I S ~ rsuarq a+e•nnl-- ` _ D11E TpIOR ASACQ~+S~WENCE OF): ( \ STC~Y+ ~ )~ 1L l ' 4 v l,• m , '/l Z1~(LY1 ^ swa.rttwyR•tmnelllm. e. K•rry, k,sokgwknrMe;•,• OVE 10 (ORA CONSEQUENCE OF): I cauN. Enbr UNDERLYMVO ' ; DAl1EE(Oq•w ar eMAy <. • mr kr;aNO ewmts Dl1E TOIOR ASACONSECIUENCE OF} _. resuae,, n ee«nl LAST 1 e . YLL4 AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH GATE OF INJURY TIME OF INJURY INJURY M WORKT DESCRIBE HOW INJURY OCCURRED. PERFORMED? MMIIABLE PRgR TO (Mmm. Day. Ysarl COMPLETION OF CAUSE of OERNT N«w•1 ~ I, ^ k; orrl e• ybs ^ ~ ^ ^ AeegeM Pentlinq InyHll9etkm ^ 70•. ]On. M. 70c. ]00 YN ^ IVO Yw ^ No ^ Sorties ^ Court M a e«•mnmeo ^ PUCE OF INJURY -AI home Mtm Brest lapo o,fic• LOCMION Sk /T C , , . ry, ( e". Ay ows,, Stahl nuAek,q, «c. ISpecAN xr xae. r. ]a. ]a. CE1RIFiERICI•rA mryarvl CERTIFYING PHYSICIAN IPhysc•an c"uy~ng cart d oeam .Men anpn" pnysican Ms pmwnceo seam arq canpHee Item 2]I SIGNATURE AN TITL OF CERTIFIER Te tlr• a•et «my Rrrowteoge, oe•M xcume Mw b IM ewee(al one manner as statW ..................................................... • ]tn, r ~ . • ~ •-ROIgVSICING AND CERTIFYING -MYSICIAM Pn I rs¢~en twm ponwrceg seam one cenAyyq b a. a seam, LICENSE NUMBER // DATE SKiNEDI~«,m. DSy,Nxl „ ; ^ Te 1M neat «my knewteegw, eeaM oeeurreG at IM Bme, date, arM pbce, art sue Ie 1M cause(. ono manner es s,•1•a .......................... ~$ l0 a 9 L z.3 1 ]/e. ]td I G NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEdH • •YEDICAL.EXAMINER/CORONER (item 271 Typs m Prin, s ) ~rl s~••/ S'7 2Z1 Oe tM M•is of a%aminaflon anE/m investigation, in my oDlnian, ds•,h oc<umee H,ne llma, sale, and plate, arM due to Me Cause(s) MM ^ T•flnN at sfal•A........... ............................................... .... ..... ... .. ............ ],.. . ~'D ~ J ]x C ., J; ~ ~ ~ 3 REGISTRAR'S SIGNATURE AN R . pATE FILED (Mpen. Oay. ,larl ~ >.. LAST WILL AND TESTAMENT OF FRIEDA B. WELLER, also known as FRIEDA Y. WELLER 21-02-965 I, FRIEDA B. WELLER, a/k/a FRIEDA Y. WELLER, of Cumberland County, Pennsylvania 17013, declare this instrument to be my Last Will and Testament, in manner and form following: FIRST: I hereby expressly revoke all Wills and Codicils heretofore made by me. SECOND: I hereby direct my Executrix to pay all my just debts, funeral and administrative expenses out of my estate, as soon as practicable after my death. THIRD: I direct that all taxes which may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be paid out of my estate as a pant of the administration of my estate. FOURTH: I give, devise and bequeath the remainder of my estate, real, personal and mi~:ed, whatsoever and wheresoever situate, to my daughter, JANET WELLER CHERRY. FIFTH: Should my daughter, JANET WELLER CHERRY, predecease me, I them give, devise and bequeath the said remainder of my estate in equal shares to my granddaughters, DEBORAH GAYLE CHERRY and LAURA ELIZABETH CHERRY. Should either of my said granddaughters predecease me, her share shall be distributed to the surviving granddaughter. SIXTH: I hereby nominate, constitute and appoint my daughter, JANET WELLER CHERRY, to be the Executrix of this my Last Will and Testament. In the event JANET WELLER CHERRY shall be unable to serve as Executrix for any reason, I then nominate, constitute and appoint my granddaughters, DEBORAH GAYLE CHERRY and LAURA ELIZABETH CHERRY, and my attorney, ROGER M. MORGENTHAL, ESQUIRE, as Substitute Co- Executors. No personal representative or trustee shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal this ~~ day of , 1998. tom-. .L~ ~'~~.~ ~-~rz~= FRIEDA B. WELLER, a/k/a FRIEDA Y. LLER SIG]vED, SEALED, PUBLISHED and DECLARED in the presence of: ~~~----- 2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . ss. I, FRIEDA Y. WELLER, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by FRIEDA B. WELLER, a/k/a FR][EDA Y. WELLER, Testatrix, this ,/ ~~ day of ~ , 1998. ~~~-~ ~ ~ L~.~ ~~ ~,i FRIEDA B. WELLER, Testatrix, a/k/a n~ ~. FRIEDA Y. LLER, Testatrix Notary NOTAFMAL $EA4 TEflESA J. BUPMWOL-REF', Notary Public CeAie4e, Cumberia~d ~,ounty, PA ~ My Cornm~elon Ex- ,.f-nb. 21, 2000 COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND We, ROGER M. MORGENTHAL and PATTY D. OLYARNIK ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix, FRIEDA B. WELLER, alsc- known as FRIEDA Y. WELLER, sign and execute the instrument as her Last Will; that he signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the sight of the Testatrix signed the Will as witnesses; and that: to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ROGER M. MORGENTHAL PATTY D. OLYARNIK ,witnesses, th1S OS'`~ day of `,~~~ , 1998. ~~ L~ -~. fitness ___~ ~~ Notary ublic NOTARIAL SEAL TERESA J. BURKFIOLDER, Notary Public Cartisl®, C~xriberlerid County, PA i~1y Commisaio~ Expires Feb. 2 ~ , 2000 and 4 CERTIFICATION OF NOTICE UNDER RULE 5.6 (al Name of Decedent: Date of Death: Will No. To the Register: Frieda B. Weller October 22, 2002 21-02-965 Admin. No. I Certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 15, 2002 Name Address Janet Cherry 5228 Cobblestone Drive Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except No Exceptions. Date: January 29, 2003 _~ Name Robert G. Frey Address 5 outh Hanover Street Carlisle, Pennsylvania 17013 elep one 7 7- -5 Capacity: _ Personal Representative X_ Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: FREY REBERT G ESQUIRE 5 S H,4NOVER STREET CARLISLE, PA 17013 REV-1162 EX111-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: ssN: os5-3a-~~~s FILE NUMBER: 2102-0965 DECEDENT NAME: WELLER FRIEDA B DATE OF PAYMENT: 01 / 1 6/2003 POSTMAI3K DATE: 00/00/0000 CouNTY: CUMBERLAND DATE OF DEATH: 10/22/2002 AMOUNT 101 ~ $ 2, 900.00 TOTAL AMOUNT PAID: REMARKS: ROBERT G FREY ESQUIRE SEAL CHECK#1000 INITIALS: JA RECEIVED BY: DONNA M. OTTO S 2, 900.00 DEPUTY REGISTER OF WILLS NO. CD 002053 REGISTER OF WILLS 217 OFFICIAL USE ONLY REV-1500 EX (6-00) COMMONWEALTH OF REV-1 500 ,- PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN DEPT_ 280601 FilE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2 1 - 0 2 9 6 5 COUNTY CODE YEAR NUM6ER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- Frieda B_ Weller 065-38-7776 ro DATE OF DEATH (MM-DD-YEAR) IDATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUSTSE FILED IN DUPLICATE WITH THE 0 W 10/22/2002 1/30/1906 REGISTER OF WILLS &l (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 0 w 0 ,_ Original Relurn 02 Supplemental Return 03 RemalnderRetum(dateofde<rthplior!ll12-13-82l ~ '" ~ ~ 04 D4a- 05 ~ '" Limited Estate Future Interest Compromise (dale of death after 12-12-82) Federal Estate Tax Return Required 0 ~ 0 w 0 0 06 0 ~ ~ ~ ..Q..8 0 & m Decedent Died Testate (Attach copy of Will) 7_ Decedent Maintained a Living Trust (Attach copy of Trust) Total Number of Safe Deposit Boxes < 09 0,0_ 0" UtigaUon. Proceeds Rece\lJed Spo\l$S\ ?0'I&rt)' Cllll1i1 (da\8 01 d8a\h 'oa\wtl8n "l2-31-91 and 1-'-95) Election 10 lax under Sec. 9113(A) (Allach Sch 0) ....~!!;~~l'ipf,j.'M~!!'lilli!~iijll'PM!!!!!!Ul;li:~i!;iQm$~p~ii~l~rrl!iIl~!i!~j!!~1I1 i'iim~~!iI~~~~mlif,jI~~ilil;li~iilp!ml!!lOO\lii!l;I!!Il;F am I- z NAME COMPLETE MAILING ADDRESS w 0 Frev 5 South Hanover Street z Robert G_ ~ FIRM NAME (If Applicable) Carlisle, PA 17013 '" w F rev & Tilev '" '" TELEPHONE NUMBER 0 U 717-243-5838 OFFICIAL USE ONLY ,_ Real Estate (Schedule A) (1) NONE 2_ Stocks and Bonds (Schedule B) (2) 4,678 3_ Closely Held Corporation, Partnership or Sole.proprietorship (3) NONE 4_ Mortgages & Notes Receivable (Schedule D) (4) NONE 5_ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 1,485 6. Joinlly Owned Property (Schedule F) (6) 68,560 Z o Separate Billing Requested 0 >= 7_ <( InterNivos Transfer & Miscellaneous Non-Probate Property -' (Schedule G or L) (7) NONE :::> l- ii: TOTAL GROSS ASSETS (total Lines 1-7) 74,723 <( 8_ (8) frl 5,494 '" 9_ Funeral Expenses & Administrative Costs (Schedule H) (9) 10_ Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10) 47 11_ TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 5,541 12- NET VALUE OF ESTATE (Line 8 minus Line 11) (12) 69,182 "- Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0 14_ Net Value Subject to Tax (Line 12 minus Line 13) (14) 69,182 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15_ Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec.9116 (aX1.2) x _0 - (15) 0 Z 0 >= 16_ Amount of Line 14 taxable at lineal rate 69,182 x _0 ~ (16) 3,113 ~ :::> Q. Amount of Une 14 taxable at sibling rate _12 0 :IE 17- x (17) 0 U X 18_ Amount of Line 14 taxable at collateral rate x _15 (18) 0 <( I- 19_ Tax Due (19) 3,113 200 ~1'~,,:~~'fI.il!llllf[_il~i.ll:ii1r.~~~ '.'>:.,.'BEi$Q\'l.E'ttaAN&WERilt:lJ'QQE'st!:)l\i.'ii'Ol\ite'\1l!F.' .Ei1lll......il:llJ\j .i'E...1.......... ~.M~it!,j.i~ii~m ""', .. .............. .. ....... ...... ..T$. ....B....RS.....!!!Ei.....!1'iRI.!:l1il :!!iiitii?iJ>'<'iiio'i'i':>i'" i}Ji7 -~ L- ece en s omole e ress: STREET ADDRESS CITY I~TATE I~IP Carlisle PA 17013 21~ Frieda B. Weller o d t' C I t Add Tax Payments and Credits: ,. 2. Tax Due (Page 1 Line 19) Credits/payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,113 2,900 145 Total Credits (A + B + C ) (2) 065-38-7776 3,045 3. Interest/Penalty if applicable D. Interest E.. Penalty 4. TotallnterestlPenalty ( 0 + E ) 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 (3) o 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (4) (5) (5A) (58) AGENT o 68 Make Check REGISTER OF 68 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. 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? If death occurred after December 12,19S2,did decedent transfer property within one year of death without receiving adequate consideration? Did decedenl own an "in trust for" or payable upon death bank account or security at his or her death? Yes o o o o o o 2. 3. 4. Did decedent own an Individual Retirement Account, annuity or other non.probate property which contains a beneficiary designation? No [8] [8] [8] [8] [8] [8] o [8] IF THE ANSWER TO ANY OF THE ABOVE QUESTiONS is YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. DATE Fd,~~... 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, and comolete. Deciaration of prellarer othef ttlan the P&SQnal fe!3fesentati'49 is based on all information of which preparer has any knowledae SIGNATURE OF PERS040 18 FOR FILING RETU~ e 7, 2. 00.3 DATE (('",IV 7 71 Z. C<!3 ,IIALlI, ~~ ADDRESS 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% F2P,S. Section 9116 (a)(1.1)(i)J. For dales of death on or after January 1, 1995, the tax rate impoSed on the net vallle of \ransfers\o Of for Ine use of Ihe surviving spouse IS 0% {72 P.S. Section 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 8ssets and filing a tax retum are still applicable even if the surviving spouse (s the only benef\ctary, For dates of death on or after July 1, 2000: The lax rale imposed on the net value of transfers from a deceased child twenty-one years of age Of younger at death to or for the use of a natLJral parent, an adoptive parent, or a stepparent of the child is 0%[72 P.S, Section 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or fer the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. Section 9116(1.2) (72 P.S. Section 9116(a}(1)]. The lax rate imposed on the net value of Iransfers 10 or for the use of the decedent's siblin9S is 12% [72 P.S. Section 9116(a)(1.3)] .A sibling is defined, under Section 9102, as an individual who has atleasl one parent in common with the decedent, whether by blood or adoption AT REV-1S03 EX + (1-97) {Il COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frieda B. Weiler All property jointly-owned with right of survivorship must be disclosed on Schedule F. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-02-965 ITEM NUMBER 1. DESCRIPTION 189 Shares 01 Metlile @ 24.75 per share VALUE AT DATE OF DEATH 4,678 TOTAL (Also enter on line 2 Recaoitulation\ $ (II more space is needed, insert additional sheets ofthe same size) 4678 AT . REV-15GB EX + (1.97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frieda B. Weller SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-965 Include the proceeds of I~igotjon and the date the proceeds were received by the 88181&. ALL PROPERTY JOINTLY-OWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F ITEM NUMBER 1. 2. DESCRIPTION M&T checking account no. 1145592 (see statement attached) Blue Cross Refund VALUE AT DATE OF DEATH 1,440 45 . TOTAL (Also enter on line 5, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 1,485 AT . REV-15m! EX+ (1-97) (ll COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAA RETURN RESIDENT DECEDENT SCHEDULE F JOINTL V-OWNED PROPERTY ESTATE OF Frieda B. Weller FILE NUMBER 21-02-965 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Janet W. Cherry 5228 Cobblestone Drive Mechanicsburg, PA 17055 Daughter B. C. JOINTLY-OWNED PROPERTY: -~ETTER ! DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM ,FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. DATE OF DEATH DECD S VALUE OF NUMBER TENANT JOINT Altach deed for 'oinllv-held realestale, VALUE OF ASSET INTEREST DECEDENT SINTEREST 1. A. 1992 M&T savings account no. 15004200061121 50,049 50.00% 25,025 2. A 1992 Accrued interest on above account 8 50.00% 4 (See statement attached) 0 3. I A 1992 Discover Bank note due 7/18/06 10,450 50.00% 5,225 4. A Ford Motor Note due 3/15/05 9,600 50.00% 4,800 5. A Ford Motor Credit due 6/15/07 9,200 50.00% 4,600 6. A GMAC note due 2/15/07 9,450 50.00% 4,725 7. A Greenwood note due 6/16/03 10,200 50.00% 5,100 8. A Sears note due 1f15/04 12,360 50.00% 6,180 9. A Nuveen Qualified Preferred Income Fund 2 12,000 50.00% 6,000 10. A Evergreen US Government MMA 13,802 50.00% 6,901 (See statement attached for Items 3 through 10 above) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL {Also enter on line 6, Recaoitulation $ 68,560 (If more space is needed, insert additional sheets of the same size) AT REV-1511~EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Frieda B. Weller 21-02-965 Debts of decedent must be reoorted on Schedule ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home 1,315 2. Internment 1,000 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 1,500 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 255 5. Accountant's Fees Included wi atty. fee 6. Tax Return Preparer's Fees Included wi atty. fee 7. Inheritance tax filing fee 15 8. Final Medical Bill to Omega Medical Labs 37 9. Final Medical Bill to Pharmerica 98 10. Final Medical Bill to United Church of Christ Homes 1,274 TOTAL (Also enter on line 9 Recaoitulation) $ 5,494 (If more space is needed, insert additional sheets of the same size) AT . . REV-1512 EX.. (1-97) {Il COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frieda B. Weller SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-02-965 Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. DESCRIPTION Visa Account no. 4313 0270 7301 3382 Final Telephone Bill to Sprint Final Credit Card account bill AMOUNT 13 15 19 TOTAL {Also enter on line 10 Recaoitulationll$ (II more space IS needed, Insert additional sheets 01 the same size) 47 ~- / ~-~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION WEPT. 2sa6ol. NOTICE OF INHERITANCE TAX HARRISBURG, PA 1712s-obol pppRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 ER RFP (O1-OS) DATE 05-05-2003 ESTATE OF WELLER FRIEDA B DATE OF DEATH 10-22-2002 FILE NUMBER 21 02-0965 COUNTY CUMBERLAND ROBERT G FREY ACN 101 F'REY & TILEY Amount Remitted ~i S HANOVER ST CARLISLE PA 17013 MAKE CHECK PAYA8LE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 _____________________ -------------------------- ---------------------------------------------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WELLER FRIEDA B FILE N0. 21 02-0965 ACN 101 DATE 05-05-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (i) .00 (2) 4,678.00 (3) .00 (4) .00 (5) 1,485.00 (6) 68,560.00 (7) .00 (a) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 74,723.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 5,494.00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 0 0 47 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) . 00 541 5 (11) . . 11. Total Deductions 69, 182.00 12. Net Value of Tax Return (12) .00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedu le J) (13) 69,182.00 14., Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously, lines 14, 15 s t andior 16, 17, 18 assessed to date. and 19 will urn reflect figures that include the total of ALL re ASSESSMENT OF TAX: .00 X 00 = .00 15. (15) Amount of Line 14 at Spousal rate 00 X 182 69 045= 3,113.00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) . , 00 1 2 - .00 17. Amount of Line 14 at Sibling rate (17) X . 00 _ 15 . 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) X . 113.00 3 (19)= , 19. Principal Tax Due R ~ INTEREST 01-16-2003 cuuuzu5a 03-27-2003 CD002347 ~+~ AMOUNT PAID PAID (-) 152.63 2,900.00 .00 68.00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 3,120.63 BALANCE OF TAX DUE 7.63CR INTEREST AND PEN. .00 TOTAL DUE 7.63CR ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A •'CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~T~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Freida B. Weller, aka Freida Y Weller Date of Death: October 22, 2002 Will No. 21-02-0965 Admin. No. 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 (X) No ( ) 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes ( ) No (X ). (b) The separate Orphans' Court no. (if any) for the personal representative's account is: (c) Did the personal representative state an account informally to the parties in interest? Yes (X) No ( ) (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: October 2.2003 ~- Signature Name (Please type or print) 5 South Hanover Street Carlisle. Pa 17013 Address (717) 243-5838 Telephone No. Capacity: ( )Personal Representative (X) Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT FREY & TILEY 5 SOUTH HANOVER STREET CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 065-38-7776 FILE NUMBER: 2102-0965 DECEDENT NAME: WELLER FRIEDA B DATE OF PAYMENT: 03/27/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/22/2002 NO. CD 002347 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $68.00 I I I I I I I I TOTAL AMOUNT PAID: $ 68.00 REMARKS: JANET W CHERRY C/O FREY & TILEY CHECK#1005 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS