HomeMy WebLinkAbout01-0038
REV-1500 EX + (6,00)
/t" ~;2(YlJ- /3
OFFICIAL USE ONLY
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
J../ 0 I
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
31
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
St dahar Mildred L.
NUMBER
DATE OF DEATH (MM.DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
235-36-3424
TIllS RETURN MUST BE FLED IN DUPUCA
11~li'~()00 11/22/1925
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
X 1. OtiginalRelurn 2. Supplemental Return 3. Remainder Retum (d~
P"
CAPB 4. LimiledEstate 4.. ~jJp~r~~N~re~' Compromise (dale 01 death after 12-12- 2) 5. Federal Estate Tax Return
HpRL X 6. Decedenl Died Teslale 7. Beqeitedt Maintained a Living Trust 1 8. Tolal Number of Safe Depo
EplO
CRAC (At1ach copy of Will) tAtBobmJpyolTrusl)
KOTK 09. Litigalion Proceeds ReceivedD 10. 0
ES Spousal PovertyCredi! 11. Election 10 tax under Sec. 9
C P
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R N
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E E
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NAME
COMPLETE MAIUNG ADDRESS
1)J:8~1 dealh between 12-31-91 and 1-1-95) (Altach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Terrence J. Kerwin, Es uire
FIRM NAME (If Applicable)
27 North Front Street
Harrisburg, FA 17101
KERWIN & KERWIN
TELEPHONE NUMBER
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71 362-3215
1 Real Estate (Schedule A)
2Stocks and Bonds (Schedule B)
3Closely Held Corporation, Partnership or
Sole-Proprietorship
4Mortgages & Notes Receivable (Schedule D)
5Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6Jointly Owned Property (Schedule F)
Deparate Billing Requested
7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
a10tal Gross Assets (total Lines 1-7)
9Funeral Expenses & Administrative Costs (Schedule H)
1([)ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
1fTotal Deductions (total Lines 9 & 10)
1.wet Value of Estate (line 8 minus Line 11)
13:::haritable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
1..fJet Value Subject to Tax (line 12 minus Line 13)
(1)
(2)
(3)
None
None
None
(4)
(5)
None
25,328.59
(6)
235,383.88
(7)
None
(9)
(10)
11,,297.28
None
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
150..mount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16C\mount of Line 14 taxable at lineal rate
17Amount of Line 14 taxable at sibling rate
180.mount of Line 14 taxable at collateral rate
19Tax Due
20.
0.00 X .0 0 (15)
0.00 X o 45 (16)
160,214.05 X .12 (17)
0.00 X .15 (18)
(19)
OFFIC!AL USE ONLY
(8) 260,712.47
(11) 14,297.28
(12) 246,415.19
(13) 86.201.14
(14) 160,214.05
0.00
0.00
19,225.69
0.00
19,225.69
o OF ANOVeMAYMENT'.
ON REVERSE SIDE AND TO RECHECK MATH < <
Copyright (c) 2000 form software only The Lackner Group. Inc.
FormREV-1500 EX \
Decedent's Complete Address:
STREET ADDRESS
54 Devonshire Snuare
CITY STATE I ZIP I
Mechanicsburg PA 17055
Tax Payments and Credits:
nax Due (Page 1 Line 19)
2Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
19,225.69
0.00
Total Credits ( A + B + C) (2)
0.00
3lnteresVPenalty jf applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E) (3)
4Jf 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)
Slf 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 the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
"""""'~E:~~~:~j~~~~:~~jjij~j~::~6tt6~1~~j~G~~i"16~j~j::~~:'~t~~:;~~"'~~"
0.00
0.00
19,225.69
80.73
19,306.42
"X"
i~""i~:~m~~~:~"6~:~:i~i:~'''~t6~:~:~:mmm:''
Yes No
~~
1Did 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?
21f death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?
3Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? [K]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, -
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
D
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Under penalties 01 pe~ury, I declare lhat 1 have examined lhis relum, including accompanying schedules and statements, and to the best 01 my knowledge and beliel, it is true,
correct and complete. Declaration of preparer other Ihan the personal representative is based on all information 01 which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
Helen M. Stydahar
_ _ _~~ _ P_~~~!l_s)~~!_~ _ ?~l~~~~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ ___
Mechanicsburg, PA 17055
KERWIN & KERWIN
27 North Front Street
----------------------------------------------------
Harrisbur PA 17101
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SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE
For dates of d h 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) (ii)J. 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;s 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)J.
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(a)(1)).
The tax rate imposed on the net value of transfers to orfor 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.
Copyright (e) 2000 form software only The Lackner Group. Inc
Form REV-1500 EX (Rev. 6-00)
RElI-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mildred L. Stydahar
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
SSII 235 - 36 - 3424
11/24/2000
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
American Express - single premium non-qualifying
annuity
VALUE AT DATE
OF DEATH
15,195.50
2
MFS Government Mortgage Fund B (IRA)
Account No. 0031/00060113112
MFS Service Center, Inc.
P.O. Box 2281
Boston, MA 02107-9906
10,133.09
0.00
TOTAL (Also enter on fine 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Copyright (el 1996 form soHwara only CPSystams, Inc
$ 25,328.59
Form REV-1508 EX (Rev. 1-97)
RE)J.1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mildred L. Stydahar
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
SSfl 235-36-3424
11/24/2000
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
A.
SURVIVING JOINT TENANT(S) NAME
Helen M. Stydahar
ADDRESS
RELATIONSHIP TO DECEDENT
54 Devonshire Square
Mechanicsburg, PA 17055
Sister
B.
c.
JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF OATE OF DEATH
ITEM FOR JOIN MADE Inelude name offinaneial instilulion and ban DATE OF DEATH OECO.S VALUE OF
aecounlnumberorsimilaridenfi!yingnumbe.
NUMBER TENANT JOINT AlIaeh deed !orjoinfly-held real eslate VALUE OF ASSET INTEREST DECEDENT'S INTERES
1 A 07/08/91 Residential 241,800.00 50.00% 120,900.00
Property at
54 Devonshire Sq.
Hampden Township
Mechanicsburg, PA
2 A 07/25/91 Checking Account 4,937.08 50.00% 2,468.54
No. 33396795
Allfirst Financial
Services
3 A 07/25/91 Checking Account 13 ,050.73 50.00% 6,525.37
No. 33316787 ~ -
Allfirst Financial
Services
4 A 05/03/95 Certificate of 6,618.37 50.00% 3,309.19
Deposit
Allfirst Financial
Services
5 A 05/03/95 Account 19,063.18 50.00% 9,531.59
No. 391- 2600019772
Evergreen Funds
P.O. Box 2121
Boston, MA 02106-2121
0.00
Tot 1 of Contim ation Schedule(s) 92,649.19
TOTAL (Also enter on line 6, Recanitulation) $ 235,383.88
T
(If more space is needed insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems, Inc
Form REV-1509 EX (Rev. 1-97)
Estate of: Mildred L. Stydahar
Sac Sec II: 235-36-3424
Date of Death: 11/24/2000
Continuation of Schedule F
(Jointly Owned Property)
Item Ltr for Date Description of property Total Val Decds Dollar Val of
II Jt Ten Joint of Asset % Int Deeds Interest
6 A 2/95 Account No. 67141686217 43,389.42 50.00% 21,694.71
Van Kampen - Fund A
Tax Free High Income
7 A 2/85 213 shares stock 15,336.00 50.00% 7,668.00
Monongahela Power Company
valued at $72.00 per share
8 A 11/95 556 shares stock 22,551. 36 50.00% 11,275.68
Bell South
valued at $40.56 per share
9 A 5/85 346 shares stock 19,397.80 50.00% 9,698.90
Bell Atlantic (now Verizon)
valued at $56.063 per share
10 A 2/84 144 shares stock 3,276.00 50.00% 1,638.00
Southwestern Bell
valued at $22.75 per share
11 ^ 1/97 16 shares stock - NCR 768.00 50.00% 384.00
valued at $48.00 per share
12 A 3/98 144 shares stock - SBC 7,515.07 50.00% 3,757.54
valued at $52.188 per share
13 A 9/96 340 shares stock Lucent 5,333.92 50.00% 2,666.96
valued at $15.688 per share
14 A 12/83 397 shares stock A.T.& T. 7,766.51 50.00% 3,883.26
valued at $19.563 per share
15 A 11/93 500 shares stock 20,405.00 50.00% 10,202.50
Allegheny Energy
(f/k/a Allegheny Power
System, Inc. )
16 A 8/93 800 shares stock 7,600.00 50.00% 3,800.00
Allmerica Securities
(f/k/a State Mutual
Securities Trust)
valued at $9.50 per share
Estate of: Mildred L. Stydahar
Soc See #: 235-36-3424
Date of Death: 11/24/2000
Continuation of Schedule F
(Jointly Owned Property)
Item Ltr for
II Jt Ten
Date Description of property
Joint
Total Val
of Asset
Deeds
% Int
Dollar Val of
Deeds Interest
17 A 1/97 New Castle Sanitation 10,000.00 50.00% 5,000.00
Certificate #0275
Authority Bond
18 A 5/99 Mars Area School 10,000.00 50.00% 5,QOO.00
District Bond
19 A 12/92 Indiana Company Hospital 5,000.00 50.00% 2,500.00
Authority - IIR - 0258
20 A Ii 1;- Commerce Bank 6,959.27 50.00% 3,479.64
Checking Account
--------------
92,649.19
REV-1511 EX + (1-9?)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mildred L. Stydahar
FILE NUMBER
SSfl 235-36-3424
11/24/2000
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. UNERAL EXPENSES:
Funeral Home 7,939.93
.
B. DMINISTRA TIVE 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's Fees KERWIN & KERWIN 6,000.00
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 100.00
- -
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
8 Cumberland Law Journal - Estate Notice 75.00
9 The Sentinel - Estate Notice 87.35
10 Register of Wills - Additional Short Certificates 20.00
11 Closing Costs 75.00
TOTAL (Also enter on line 9, Recapitulation) $ 14,297.28
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 folTl"l software only CPSyslems, tne
Form REV-1511 EX (Rev.1-9?)
RE!V-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mildred L. Stvdahar
NUMBER
I.
1
SSlf 235 - 36 - 3424
11/24/2000
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
~XABLE DISTRIBUTIONS (include outright spousal distributions):
Helen M. Stydahar
54 Devonshire Square
Mechanicsburg, PA 17050
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Sister
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
J oint Holder
Beneficiary
on all Accounts
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
~. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
See Disclaimer Attached
1
Diocese of Wheeling - Charleston
1300 Bryon Street, Wheeling, WV 26003
2
Diocese of Harrisburg
4800 Union Deposit Road
Harrisburg, PA 17105
43,100.57
43,100.57
86,201.14
Form REV-1513 EX (Rev_ 1-97)
"
IN RE: ESTATE OF
IN THE COURT OF COMMON PLEAS
MILDRED L. STYDAHAR
CUMBERLAND COUNTY, PENNSYLVANIA
NO, 2001 - 00038
ORPHANS' COURT DIVISION
FILE NO,: 2001 - 00038
RELEASE AND DISCLAIMER
.
.
I, HELEN M. STYDAHAR, do hereby disclaim and renounce and release any and all
interest I may have in various joint assets that were established by my late sister, MILDRED L.
STYDAHAR I am disclaiming these assets so that they pass in accordance with Paragraph
FOURTH of my sister's Last Will and Testament duly probated in the Register of Wills Office of
Cumberland County and docketed to No. 2001-00038, The following is a list of assets for which
I have formally disclaimed my interest:
1. Van Kampen Tax Free High Income Fund - A, Account No~9-67r416862/7, with
a date of death value of $43,389.42,
2, Evergreen Tax Free High lncome Fund - B, Account No, 391-2600019772 with a
date of death value 0[$19,063.18.
3, Various shares of stock with the company name and value as follows:
a, 213 shares of stock Monongahela Power Company valued at $15,336.00.
b. 556 shares of stock Bell South valued at $22,551.36.
I
346 shares of stock Bell Atlantic (now Verizon) valued at $19,397.80.
144 shares of stock Southwestern Bell valued at $3,276.00.
16 shares of stock NCR valued at $768.00.
144 shares of stock SBC valued at $7,515.07.
340 shares of stock Lucent valued at $5,333.92.
397 shares of stock A T & T valued at $7,766.51.
500 shares of stock Allegheny Energy (f/k/a Allegheny Power System, Inc.)
valued at $20,405.00.
j. 800 shares of stock Allmerica Securities (f/k/a State Mutual Securities Trust)
c.
d.
e.
f.
g.
h.
.
.
i.
valued at $7,600.00.
By this Disclaimer fifty percent (50%) of the value of the aforesaid accounts will be
transferred to the Diocese of Harrisburg, which in turn will distribute the appropriate portion to the
parish known as Saint Katherine Drexel Parish (formerly Blessed ~atheri!,le Drexel) in
Cumberland County, Pennsylvania. Fifty percent (50%) of the value ofthe aforesaid accounts will
be transferred to the Diocese of Wheeling-Charleston, which in turn, will distribute the appropriate
portion of their share of these accounts to Saint Ann's Catholic Church in Shinnston, West
Virginia.
2
."
IN WITNESS WHEREOF, I have set my hand and seal this 16th day of
August
,2001.
~E~E;';/~~AHlR
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF DAUPHIN
On this, the 16th day of August , 2001, before me a Notary Public, the
undersigned officer, personally appeared HELEN M. STYDAHAR, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~'i/~
Notary Public
My Commission Expires:
D:flak/docfdlsclalm.mls
Notarlal Seal -
Nancy J. Ugon, NolaJy PublIc
Washlnllton 1Wp., Dauptlln County
My Comni1sslon Expires May 21, 2005
_. PennsytvanlBAssocfatton
3
FacetW1n Scre.n Print for publio, from "eANA_Loginl! 03/23/20018:48,2) A)f
CUMBERLAND COUNTY ASSESSMENT OFFICE
I Short Nam.
. WISor HAMil
. 1IRST NAME
'C/O NAl'lZ
'ADDRESS1
'ADDUSS2 .
'POST OUICE.
'STATB & ZIP,
STYDAHlIR.
S'IYDAIlAR
HELEN M &
HBLBN II &
CONTROL # 10005316
SO, 4 PARCEL, 10-lS-1604.347.-U54---3
, SPEC IO. 3000 LOT, 0~3A.U07..054.
~. TbBCK. 10.19-1604.347.
IIILDRBD L ll.OJJJ.. O~.
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, DEED BK/PG.... .00351-01114 .
, DATE or BALB.. .07/08/1991
. SELLING PRICS, 165'00
DISTRICT, l~ - KAKPDIlN T~S~I,~
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MILDRED L
54 DEVONSHIRE SQUARE
MECK1.NICSBlJRG
PA ,17055
Situ.. 54 DBVONSHIRB SQOARE
Prop O.Bcrip., VILLAGE OF WBSTOVBR
LAND USE UP!. 107
NEIGHBORHOOD, 270
DEEDID ACRBS. .00
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MAR-21-01 01:49 PM ADVANTAGE CAPITAL
131346224201
p.02
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INVESTMENT MAHACIlM.lNT
W, invent,d the mutuel fund"
Investment Summary
MF5 HERITAGE TRUST CO TRUSTEE
IRA RIO MILDRED L STYDAHAR
54 DEVONSHIRE SO
MECHANICSBURG PA 17050-6873
Year-lo-Oale Stal,menl
January 1, 2000 to December 29, 2000
Page 1 of 3
Dealer
ADVANTAGE CAPITAL CORPORATION
16420 PARK TEN PL STE 210
HOUSTON T)( n084.5052
Rap Name RUSS 8ONASSO
Rap Number RB1
08aler 8ranch 00052111163
1,"11I",11I,",1,1,11""1/,,',,1,1,,.1,,11,,/,1,,1,,1,1,,11
Your Account at a Glance
Beginning Value 01101/2000
Additions
Wiehdrawals
Change in Value
$10.308.19
$0.00
$1.215.00
$1,039.90
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MFS Government Mortpge Fund-A
0031/00080114495
MFS HERITAGE TRUST CO TRUSTEE
IRA RIO MILDRED L STYDAHAR
Prlmary Beneficiary HELEN M STYDAHAR
1.542.327
$6.57
$10,133.09
$846.09
$0.00
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IRA Contributions
InVHting t~ retirement 'eem WIth an IR~ Rememb<< jllU haye uAUI April
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08ller Servlc.a Web alte
1-800-343-21129 www.mla.com
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MAR-21-01 01:51 PM ADVANTAGE CAPITAL
13846224201
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VAN KAMPEN
INVESTMENTS
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COpy OF YOUR CLIENT'S CONFIRMATION
DECEMBER 31, 2000
TAX FIlEE HIGH INCONE FUND - A
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ADVANTAGE CAPITAL CORP
RUSSELL BONASSO DIV 163
216 VIRGINIA AVE
CLARKS8URG WV 26301-3048
MILDRED L STYDAHAR &
HELEN M STYDAHAR JT TEN
54 DEVONSHIRE SQUARE
MECHANICSBURG PA 17050-6673
I
.
Your Name:
Your Number:
Your Dealer-8ranch:
BONASSO RUSSELL
RBI
9991~RBl
fund No. 39 I
Account No. 671U6862 7
A I ph. Code STYDAHARKl
SSN/TIN ON FtLE
ollr client's tranlncl/O!'S
Transaction
Sh.",.
'1111. r""'lkIlon
TUIlll
Sb.....Own<<l
3.215,141
3,211.1.1
3.215.1.8
3.ue,,,,
3,215.5.1
3,US,541
3.3ts.14'
2,21&,541
3,215.14'
3,315.541
3,215.1.'
2.281..4'
3.215.5.1
,
E
1131
2/2.
3/31
.128
S/31
8/50
7/31
8/31
1128
10/31
11/20
12/'8
IEGINNING IA~ANCE
1/31 INCOME 01\1 CASH
2/21 . INCOME 01\1 CASH
2/21 INCOME DIY CASH
./2a INCOME DIY CASH
5/21 INCOME DIV CASH
1/20 INCOME DIV CASH
7/21 INCOME 01\1 CASH
8/21 INCOME OIV CASH
1/28 INCOME OIY CASH
10/31 INCOME DIY CASH
'1/30 INCOME DIY CASH
\2/2' INCOME DIV CASH
21S, 8 1
21S.80
2'I.ao
215.9.
alS.S0
"J;~8
204.29
204.21
20. . 30
204,29
204.30
204.28
3,285.549 at $13.1800'
$.3,389.42"
"Your ClIent. Account Vllul la of \2/28/2000:
SIlII//Ila'J' qfyollr client's nccollnt J'eal.-to-dtlte
Genera'lIlfOr",alion 800-411-5666
TC*! DI-r..... &/Id. iLOti..tweOl.Jrlt.tl ..~. .0.... Yll\Ir tll<nl ""'0'
QtJleto.u-!buUn1t. GNal' DUllI'ftMnlllll. Dkld~utp; U\ ca;.lf\r.:1\t(. 1:\)t1\_ + Nun Cutiln.c.te Fonu . TUUlI $hatet ~
2,520.81 2,520.87 3,295.5490 3.295.549
'YIIW dkIIl'. ~don up," III Letter of bUm. Summuy
IIInlInC ~"'1fIII\I; PpII.r ~.I LO.I.No. llpe:r.tkm n.~ . _f1\Q1tDt'1.-Q.I.. ~I JW4 tft IW~
CASH I CASH
1
I
.
un
l_,I'~\l'~~t '"
MAR-21-01 01:51 PM ADVANTAGE CAPITA~
'J:. Evergreen Funds'"
~IN(:E 19:\1
131346:224201
P.05
P.O.. B.. 2/2/, Bon.., AlA 02/06 -2/11
1-800-:m-2618
YEAR-tO-DATE STATEMENT
January I, 2000 to December 29, 2000
,"p/.//
A~couJ1J JIIum.ber
391-260001977:1
ADVANTAGE CAPITAL CORP
216 VIRGIN!A AVENUE
CLARKSBURG, WV 26301
'Dr thr <<ceDUIIl ,g
MILDRED l STYDAHAR
HELEN M.STVDAHAR JT TEN
54 DEVONSHIRE SQUARE
MECHANICS6URG, PA 17055-6873
Dcal... 11': 0398
Branch II: 0404 Clatk.bUl& -163RBl
ll.opreIOIIlollve ID: RBI BONASSO
Shareholder', Tax IP: 235-J6-H24
financlal Advlm AtcOWl! H: 5U93J50751
Quolr,,. Symbo~ VMPIX
MARKET V ALtJE Hr" " 1M curltnl ,./u, 0/ yt)/I.r .llInr, ......1:
Beginning Value
on 1/1/00
Shares on Price on
12/29/00 12/29100
2.2\M74 S8.61
Market Value
on 12/29/00
$19,063.18
Pund - Accounl Number
IIJgh Illcom. Munlo/pal Btmd - B
391-2600019772
$18,64150
SUMMARY OF TRANSACfIONS Hilt It . )001'-1..."".. """"1 o/.ddklofU 10 or dedltclll1lU from Ihls .<<01101:
Pund - Account Number Investment. Redemptions Dividend. Capital Oain.
Hit Income MlIlllclpll Bond - B $ 1,028.22
3 1-2600019772
TRANSACfION ACfIVITY H." ale rho thl.1iJ o/..ch /ra....,/.. jar ytJUf cllalll'. "COVIII/^" yclJt:
Date Description Rate Amount PI ice Shares Share Balanc.
1/1/00 llegIMlnl Ballnce 2.214,Q74
114100 Cub Dlvldel\d $76.39
1.Itl00 C..h Dlvldend 7MI
3/1/00 Ca.rh DivIdend 76.61
Jl3lloo Ca.rh Dividend $m8 84.1>
4128/00 Ca.rh DlvldClld .038 84.\3
5131100 C..h Dlvldend .036 79.71
6130/00 Cuh Dividend .037 8l.92
7/31/00 Ca.rh Dlvtdend .OJ7 81.92
8131100 Cub Dlvldend . .0369 81.70
9f29loo Cash Dlvldl>Dd .036 79.71
1013lfOO Carh Dlvldead .0356 78.82
!l/JO/OO Carh DlvldeDd .0329 72.84
12.29-00 Ca.h Dlvltlclld .OJ'J 7.1.73
CheoJc I'aymenl 73.73
Chco. No. 001054017
12/29/00 I!tIdl.og Ballnce $8.61 2,214.074
Upon Jedemplioo of Fund .bares, your clicnl may pay a sales charge 00 some or all or their accounl
.ale.. Por an explanation of rales charges please call Bvorgreen or review tbe fund's prospectus.
ACCOUNT FEATURES lie.. IUS rho .''',l/III .ptl... yoru .U.., Iur, ..",..d:
SYltemaUc
Capit.l Investment
Guius Plan
Syslematic
Withdrawal
Plall
Electronic
Pundt
Tral1&rer
Pund - Account Number
Divldcnds
HlJh Income MUlllclpal BOlld - B
391-1600019772
Ca.h
Ca.rh Ne..
None
NOll.
Represenlative COpy
ImP
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If
!!111
.
II
II
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American Express Financial Advisors
Requested by: THOMAS R WILLIAMS
Summary of Accounts
fJ~ 1; fJ.u:;/.L tJ ~
Group Number:
01837 125 2 001
Account Values:
Account:
Valuation Date:
Sub-Account Value:
Value:
SING PAY N QUAL ANN
MILDRED L STYDAHAR
0000 0930 0139 3628 9 004
FIXED ACCOUNT
11/24/2000
$15.195.50
$15.195.50
TOTAL
$15,195.50
w
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ew
o
Commerce
~Bank
. 4aeQ CAHUSi.E PIKe
L1ECHANICSBURG, PP. 1 '1O&"J
03. (] 124 t1
..i"'~"
fl/'}1J1.Y)11
03
JANUAJlY 22.200 I
PAY U8E1EN M. STYDAIWl
TO THE ORDER OF
.........................................
$6.959.27**
::~::};:;::::~;::;:::::::':;;:;'::.. .',',
........ ....., .. ::;~:~::;.._.? ..:.:......;.
DOLLARS
RE:
/'
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" /,
j,;>"'~..i,' .' -'/;:~'".(. , ,,- -<-
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'-. "::.RoN:l'fESOl"IABLE
11"0:;0 ~ c " ,-..- ': SO c ~..O loB I.,: 5 ~ elUDUD -j BIl'
, ,
LAST WILL AND TESTAMENT
OF
MILDRED L. STYDAHAR
I, MILDRED L. STYDAHAR, currently of the County of Cumberland and
Commonwealth of Pennsylvania. being of sound mind, memory and understanding, do make
and publish this, my Last Will and Testament, hereby revoking and making void all former
Wills by me at any time heretofore made.
FIRST:
I direct my hereinafter named Executrix to pay all my legally
enforceable debts, funeral expenses, administration expenses, and inheritance, estate,
succession or excise taxes. which I owe or may become due on account of my death, as soon
as may be convenient after my decease.
SECOND: By way of explanation, at the time this Last Will and Testament is
being drafted and signed, all of my assets are held in joint names with my sister, HELEN
M. STYDAHAR. It is my desire, request and direction that all of my assets shall pass on
my death to my sister, HELEN M. STYDAHAR. However, in Paragraph Third of this,
my Last Will and Testament, 1 provide for a number of specific bequests of certain amounts
of money. On my death, while my assets will pass to my sister, HELEN M. STYDAHAR,
if she survives me, 1 have had discussions with my sister in which we have agreed that on
my death, HELEN M. STYDAHAR, will pay the specific bequests set forth in Paragraph
Third, providing she, in her sole discretion, determines that she does not need the monies
that would be needed to fund the specific bequests for her own health and well-being.
.1I':OOIlY M. KERWIN
f"""ENCIt J K""WlN
'>O"EF.. D. KLIlWIN Page 1 of 4 Pages
LLY MCCLURE K"RWIN
ATTORNEYS AT LAw
~.::(.~~
MILDRED L. STY AHAR
(SEAL)
THIRD:
In the event my sister, HELEN M. STYDAHAR, predeceases me or
fails to survive me, I give and bequeath the following:
A. I give and bequeath Five Thousand Dollars ($5,000.00) to my nephew,
DAVID F. STYDAHAR, if he survives me.
B. I give and bequeath Five Thousand Dollars ($5,000.00) to my nephew,
JOSEPH P. STYDAHAR, if he survives me.
C. I give and bequeath Five Thousand Dollars ($5,000.00) to my niece,
STEPHANIE STYDAHAR, if she survives me.
D. I give and bequeath Five Thousand Dollars ($5,000.00) to my nephew,
GEORGE M. STYDAHAR, if he survives me.
E. I give and bequeath Two Thousand Dollars ($2,000.00) to my niece.
BARBARA COOPER, if she survives me.
F. I give and bequeath Ten Thousand Dollars ($10,000.00) to the SAINT
ANN'S CATHOLIC CHURCH. located in Shinnston, West Virginia.
G. I give and bequeath Ten Thousand Dollars ($10,000.00) to the DIOCESE
OF WHEELING-CHARLESTON, for general purposes.
H. I give and bequeath Ten Thousand Dollars ($10,000.00) to BLESSED
KATHERINE DREXEL PARISH; located in Cumberland County,
Pennsylvania, for debt reduction.
I. 1 give and bequeath Ten Thousand Dollars ($10,000.00) to the DIOCESE
OF HARRISBURG, for general purposes.
1. I give and bequeath One Thousand Dollars ($1,000.00) to the HUMANE
SOCIETY OF HARRISBURG, PENNSYLVANIA.
K. 1 give and bequeath One Thousand Dollars ($1,000.00) to the HUMANE
SOCIETY OF CLARKSBURG, WEST VIRGINIA.
Ci~E"O"Y M. KERWIN
Tt;RRENCE J KERWIN
JOSEPH p, K~RWIN Page 2 of 4 Pages
'LL-Y McCI,.URE KU'W'N
",TTORNEY!; "'T......W
~X~
MILDRED L. STYDA AR
(SEAL)
GREGORY M. KEIIWIN
TERnEN(:E J. KERWIN
JOt;~PH O. KERWIN
IO~~Y McCLURE K~"W'N
.nOIlNEYS AT LAW
L. I give and bequeath Three Thousand Dollars ($3,000.00) to ALICE HOOD,
currently of Georgia, if she survives me,
M. I give and bequeath Three Thousand Dollars ($3,000.00) to ROBERT
HOOD, currently of Georgia, if he survives me.
N. I give and bequeath Two Thousand Dollars ($2,000.00) to the AMERICAN
CANCER SOCIETY.
FOURTH: In the event my siSler. HELEN M. STYDAHAR, predeceases me and
the foregoing specific bequesls have been made, I give, devise and bequeath all the rest,
residue and remainder of the property, be it real. personal and mixed, whatsoever and
wheresoever the same may be situate at the time of my death as follows:
A. Thirty-Five Percent (35%) of the residue of my estate shall pass to the
DIOCESE OF HARRISBURG, for general purposes.
B. Thirty-Five Percent (35%) of the residue of my eslate shall pass to the
DIOCESE OF WHEELING-CHARLESTON, for general purposes.
C. Fifteen Percent (15%) of lhe residue of my eslale shall pass 10
BLESSED KATHERINE DREXEL PARISH, located in Cumberland
County, Pennsylvania.
D. Fifteen Percent (15%) of the residue of my estate shall pass to ST. ANN'S
CATHOLIC CHURCH, localed in Shinnston, West Virginia.
FIFTH:
I nominate, constitute and appoinl my sister, HELEN M.
STYDAHAR, as Executrix of this, my Last Will and Testament, authorizing and
empowering her to sell and convey any and all real estate of which I may die seized and
possessed. In the event my sister, HELEN M. STYDAHAR, fails to survive me, or is
Page 3 of 4 Pages
MIL~~~'t-S~D~i L ''V
(SEAL)
;~EGORY M. KE"WIN
cEIlIlO:NCE J KEIlWIN
JOS/:PI; D. KERWIN
C~ y McC<-......t KERWlN
AnOIlN.,......TI-AW
, .
unable or unwi11ing to serve as Executrix of this, my Last Will and Testament, I nominate,
constitute and appoint TERRENCE J. KERWIN, as Executor of this, my Last Will and
Testament.
I funher direct that my Executrix or personal representative shall not be required to
post bond to act in said capacity.
IN WITNESS WHEREOF, I, MILDRED L. STYDAHAR, have hereunto set my
hand and seal, to this my Last Will and Testament, this ~ day of April, 1998.
SIGNED, SEALED, PUBLISHED
and DECLARED by the ahove-
named Testatrix, MILDRED L.
STYDAHAR, as and for her
Last Will and Testament, in
the presence of us, who at
her request and in the
presence of each other. have
hereunto set our names as
witnesses:
1.1 ""-"''''-'/29 ~&,'M~' ~h0'8 : ~;( ~. .t.. ,
Residing at:. :MILDRED L. STYDA: AR
"J?7d,if"1J I fl)). :
(tif.:!l~/nK~ 'I/~~fl8:
Residin at:
/YI~,1'1t
Page 4 of 4 Pages
(SEAL)
c;ljrlwilllll)'dahat_1fl11
UJ.'/U"-i~UU
J.U.J.J.
I.,LL.J. -> 11..-1, WI VJJ.LI..-->
I.L I _'W_ ..;"_'-_
PETITION FOR PRO.BATE and GRANT OF LETTERS
Register of Wills fOf the
. Dc!ctQsed. County of Cumberland in the
Social Security No. 235-36-3424 Commonwealth of Pennsylvania
The pelition of the undersigned respectfully .represeOlS that:
Your petilioner(s), who is/are 18 years of age Or older an the execut rix
in the J8,~~ will of the above decedent. dated April 24
and codicil.(s) dmed
No.
To:
21-01-38
Estate of Mildred L. Stydahar
also known as
named
, 19~
(51:lIe relevlInt cirC'lmSlanl:C~, ql. rM\lncialh>n, dCllth or ClIccutO', etc.)
Decendent was domiciled at death in Cumberland County. Pennsylvania, with
her last family or principal res.idence at 54 Devonshire Square,
Mechanicsburg, Pennsvlvania, 17050 C..I-1ArrqrlQ n '-n." p )
(1151 strCC1, number ond muncipalhy)
Decendent. then 7'i years of a~, died Nove~ber 24 ,-1-9:: 7000 ,
at Hospice House, Susquehanna Township, Daup in County. 1-Il'IfYlrldrv iiA/P'
E!xcept as follows, decedent did not marry, was not divorced and did nOI have a child born or adopted
after execution of the will offered for probate; was not the victim of a kllling and was I\~ver adjudicated
incompetent:
Oecendem at death owned properly with estimated values as follows:
(If domiciled in Pa.) All personal properly
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) rers-onal properly in County
Value of real estate in Pennsylvania
situated as follows:
$ 100,000.00
S
S
$
~
..
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U
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.. ~
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'lI,-
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c:
OIl
VI
reqll~st(s) the probate of Ihe last will and codicil(s)
testamentary
(le~lOmel1lary; actminimution !:.l.a.: ad;n'luimaIIQIl lI.b.n.c.l.a,)
\..\ ~ ... ,\.)..:.' '" .
"" ~:~. " ~. . It,"" \,
, '.' l .
~ ..,...., ~\".."
"
.~~,~;b.~
Helen M. StydaSar
54 Devonshire Square
Mechanicsburg. PA 17050
WHEREFORE, petitioncr(s) respect full,
prcs~nted herewith and the gram of letters
therol1.
OATH OF PERSONAL REI.RESENTATIVE
COMMONWEALTH OF PENNSVL VANIA
COUNTY Of CUMBERLAND
} ss
I b -~CYO - /3
Sworn to or affi~mcd and subscribed
before me this th day of
(JANUARY . ~ 2u01
7?J;/~I/()~//U'" --:P.I,u//l.C./~/
Re Ister
The pctitioner(s) at,ove-named swear(s) or arfirm(s) that the statements in the foregoing petition are
true and cotreet to the best of the knowledge and belief of petitioller(s) and that as personal represen.
tative(s) of the above decedent peLitioner(s) wjll well and truly adJl1inister the estate according to law.
~~,~~~~ ~
, 09'
::!
I:l
2'
~
:s:
No. 21-01-38
Estate of
MILDRED L STYDAHAR
t Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JANUARY 9 U:..2.Q.QL, in consideralion of the petition on
the reverse side hereof, satisfactory proof havins been prellented before me,
IT IS DECREED that the instrurnenl(s) dated APRIL 24, 1998
descdbed therein be admitted to probate and filed of record all the last will of
MILDRED L STYDAHAR
TESTAMENTARY
HELEN M STYDAHAR
and letten
are hereby granted to
)z .-"
;: / / /
,/l?LLY(/ /'t:~:.~~t<H//AL) h..U/L-L'.Lz'-t
/ / tSISter of ails ~
fE.ES
5.00
Tj::;!?f? t: /1/0.,/3 .J '"' k 6Ntv) 11/
A nORNEY (~p..Ct. I. D. No.) ;} 99 /J :L
~ 7 11/. t::~"./f ../,
I-IAIfIYIS/!;v/?'.(J (jJfJ )7/0 I
ADDRESS
Probate, leners. Etc. .... . . . . .
Shon Cerlificates( )..........
~-pages
Kenurrclation ................
JCP
S
$
$
S
TOTAL ~ ~ 229.00
.. ..JNJPA.~Y. .&... ~O.Q~. .. . . . . . . . . . . .
200.00
15.00
9.00
filed
'7/7-' 3'd-.-3d.-/S
N-lONE
~~
Register of Wills of Cumberland County, Pennsylvania
OATH OF SUBSCRIBING WITNESS
Estate of
Mildred L. Stydahar
No.
21-01-38
also known as
, Deceased
Holly M. Kerwiri
(each) a subscribing witness to the 0 codicil(s) Dwill(s) presented herewith, (each) being duly qualified according
to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and
that she/he/they signed as a witness at the request of Testator(rix) in his/her/their presence and 0 in the presence
of each other 0 in the presence of the other subscribing witness(es).
t~/Yl, ({~
ignature)
Millersburg,.PA
(Address)
~~n'?1w~
,2, 7 &: f'Jrbn.zt U; fldM~//J /7/0J
(Address) .J
Sworn to or affirmed and subscribed
before me this
5th
day of
January ,~~ 200~
C~/~
?;.a-, ~d
.' otary Public
, My Commission Expires:
Notarial Seal
Tina L. Lloyd, Notary Public
Washington Twp., Dauphlrl County
My CommTsslon Expires Sept. 13, 2001
(S1gnalUl. and seal 01 NOIlIfY 01 other olllclal
NOTE: To be taken by officer authorized to administer oaths.
Please have present the original or copy of Instrument(s)
at time of notarization.
quail lied to administer oaths. Show date ot
exphadon o' Nota,y'. convnlsalon.}
rorm RW-2 IUauphln County - Rev. 0/02)
This is to certify that the information here given is correctly copied from an original cerrificate of death duly filed with me as
l,ocal Registrar. The original certificate will be forwarded to the State Vital Records OHlce for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~i~'7;,~,
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~- 114""----... /'U..\.~...-
-""--_ I MEN! ~'i:" ",.,
"""""""O/HIUIJIJIJII'
~~~df
.-
Fee for this o:rtificate, $2.00
P 7023740
#,- all -~e?
~
Date
21-01-38
H105 :o&Jf\ev 2la7
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
,---,
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HAW( Of DECEDENT Ih'. M~. .._
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AOE(l_~ UHOEAtYEAR
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STRE ,rilE *"'MA
SEX SOCI..... SECURITY NUMBER
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000
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-..au! PAIOR 10
COMl'1.ETION 01 CAUSE
CWDEArH7
DUE OOICA AS _CONSEQUENCE Of),
OlE lOtoA AS A CONSEQUENCE ClF):
UANNEA OF DEATH
ORE 0# IKJURY
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TIME Of lHJUfty
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T............, knDwlMQ., .....OCCwrM at........ ..... and pIIIe_, aM dUll 10 "'CauM(s) aM menne... ".IMI
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: MILDRED L. STYDAHAR
Date of Death: November 24, 2000
No. 2001- 00038
To the Register:
I certify that notice of 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
January 9, 2001.
Name:
Address:
HELEN M. STYDAHAR
.
54 Devonshire Square
Meehaniesburg, P A 17050
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE
Date: January 26,2001 Signature: ~ -;:: ~
Name: Te enee J. :erwin, Esquire
Address: 4245 Route 209
Elizabethville, P A 17023
Telephone: (717) 362-3215
Capacity:
Personal Representative
Counsel for Personal Representative
_x_
D:/Iak\eSlale\Slydahar .5-6
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: MILDRED L. STYDAHAR
Date of Death: November 24, 2000
Estate No.: 2001-00038
Pursuant to Rule 6.12 of the Supreme Court Orphans I 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?
No X
Yes
b. The separate Orphans' Court No. ( if any) for the personal representatives'
account is :
c. Did the personal representative state an account informally to the parties in
interest? Y es ~ 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.
/k {)~,{ ~
Signature ~
Date: April 1, 2002
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TERRENCEJ. KERWIN, ESQUIRE
4245 ROUTE 209
ELIZABETHVILLE, P A 17023
(717) 362-3215
~I
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-,' .............
Capacity:
_ Personal Representative
~ Counsel for personal
representative
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of
Mildred L Stydahar
No.
. 2001-0038
also known as
Date of Death
November 24, 2000
, Deceased Social Security No.
235-36-3424
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.
Personal Representative:
Name of
Attorney:
Terrenc.e J Kerwin Esquire
j ~~.~e.. ~~~....J
1.0. No.:
2.llil22
Helen M Stydahar Executrix
Address:
27 North Front Street
Dated
Q-l1!-ol
Harrisburg PA 17101
Telephone:
(717) 238-4765
Description
Value
1.
American Express - single premium non-qualifying annuity
$ 15,195.50
2.
MFS Government Mortgage Fund B (IRA)
Account No. 0031/00060113112
MFS Service Center, Inc.
P.O. Box 2281
Boston, MA 02107-9906
$ 10,133.09
(Attach Additional Sheets if necessary)
Total: $ 25,328.59
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.
D:INLIEST A TEIINVENTORCMB
KERWIN & KERWIN
ATTORNEYS AT LAW
4245 ROUTE 209
ELIZABETIlVILLE, PENNSYLVANIA 17023
GOVERNORS' ROW
27 NORTII FRONT STREET
HARRISBURG, PENNSYLVANIA 17101
237 UNION STREET
MILLERSBURG, PA 17061
(717) 362-3215
(717) 362-3215
(717) 896-9089
FAX (717) 362-4459
E-mail kkl@epix.net
(717) 238-4765
FAX (717) 238-8455
549 MAIN STREET
LYKENS, PA 17048
(717) 453-7422
Please Reply To:
o ELIZABETHVILLE OFFICE
o HARRISBURG OFFICE
September 6, 2001
PATRICK E. KERWIN (1913-1987)
GREGORY M. KERWIN
TERRENCE J. KERWIN
JOSEPH D. KERWIN
HOLLY McCLURE KERWIN
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013-3387
RE: Estate of Mildred L. Stydahar
Estate No.: 2001 - 00038
EXPRESS MAIL
Dear Register of Wills:
Please find enclosed herewith an original and two copies of an Inventory, an original and two
copies of an inheritance tax return, and an original and one copy of a Release for filing in the above
Estate.
I would also like to obtain five Short Certificates in this Estate.
I have enclosed a check payable to the Register of Wills, Agent in the amount of$19,306.42
for payment of the inheritance tax. I have also enclosed a check payable to the Register of Wills in
the amount of $50.00 for the five Short Certificates and the filing fees for the Return, Inventory, and
Release.
Enclosed is a self-addressed, stamped envelope for return of the receipt and clocked-in copies
tome.
Thank you for your kind assistance.
Very truly yours,
/~~ ~/L
TERREN~KERWIN
TJK:lak
Enclosures
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KERWIN TERRENCE J ESQ
E. MAIN STREET RR01
BOX 566
ELlZABETHVILLE, PA 17023-9765
___uu_ fold
ESTATE INFORMATION: SSN: 235-36-3424
FILE NUMBER: 21-2001- 0038
DECEDENT NAME: STYDAHAR MILDRED L
DATE OF PAYMENT: 09/10/2001
POSTMARK DATE: 09/07/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 11/24/2000
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
REMARKS: HELEN M STYDAHAR
CHECK# 1016
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 000245
AMOUNT
--------
I $19,306.42
I
I
I
I
I
I
I
I
$19,306.42
MARY C. LEWIS
REGISTER OF WILLS
)~ - ,,1LOV- i3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*7'~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRIS8URG, PA 17128-0601
REV-16D7 EX AFP ll2-DDI
ReCOf>
Re~;is,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-10-2001
STYDAHAR
11-24-2000
21 01-0038
CUMBERLAND
101
MILDRED
L
TERRENCE J KERWIN
KERWIN & KERWIN
27 N FRONT ST
HBG
ESQ '02 JAN -4 P12 :32
Allount Rellitted
ClerK.'
PAl tl6i\1be :Hr . PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV =i(;ifj-EX--AFP--fi'2-=Otjr------...--iNHEiiYANc'E-TAX-STAfEME-N'T-cfF'-Ac-couiff--.-..---------------- -- ---
ESTATE OF STYDAHAR
MILDRED
L FILE NO.21 01-0038
ACN 101
DATE 12-10-2001
THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW
IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-15-2001
P R I NC I PAL TAX DUE: .......................................................__.........._...._._......_..____._._._.__..._____.........................................._...._._....._._._.......__._._...._._..
19,225.69
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-07-2001 CDOO0245 66.48- 19,306.42
11-26-2001 REFUND .00 14.25-
TOTAL TAX CREDIT 19,225.69
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR),
YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. )
/0.';/CXJ-/3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
TERRENCE J KERWIN ESQ
KERWIN & KERWIN
27 N FRONT ST
HBG PA 17101
10-22-2001
STYDAHAR
11-24-2000
21 01-0038
CUMBERLAND
101
Allount Rellitted
'*
REY-1547 EX AFP <12-001
MILDRED
L
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV =iS4-j-EY-AFP-fi'2-:ooY-NoYicE--oF-YtiHEifiTAifcE-TAx-jrPPRAisEirENT-:--ALrOWAifcE-'(fi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STVDAHAR MILDRED L FILE NO. 21 01-0038 ACN 101 DATE 10-22-2001
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts [Schedule J)
14. Net Value of Estate Subject to Tax
TAX RETURN WAS: [X) ACCEPTED AS FILED
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. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
09-07-2001
NOTE:
RECEIPT
NUHBER
CD000245
DISCOUNT (+)
INTEREST/PEN PAID (-)
66.48-
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( ) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
25.328.59
235.383.88
.00
(8)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
260,712.47
14.~97 28
246,415.19
86.201.14
160,214.05
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
.00
19,225.69
.00
19,225.69
19,239.94
14.25CR
.00
14.25CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
(9)
(10)
14,297.28
.00
(11)
(12)
(13)
(14)
.00 X 00 =
.00 X 045=
160,214.05 X 12 =
.00 X 15 =
(19)=
AHOUNT PAID
19,306.42
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
~ EXPRESS
MIJIL
UNITED STIJTES POSTIJL SERVICE@
POST OFFICE
TO ADDRESSEE
. . .
Day of Delivery
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D. Yltar o 12 Noon 3PM
Military
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Int'l Alpha Country Code
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Postage
$
Return Receipt Fee
COD Fee
Insurance Fee
Total Postage & Fees
6i1
U.S. POSTAGE
PAlO
ELIZABETHVILLE,PA
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SEPOI,'Ol
AMOUNT
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DELIVERY (POSTAL USE ONLY)
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Mo. Day U AM [JPM
Delivery Attempt Time Employee Signature
Mo. Da 'I AM UPM
Delivery Date Time Employee Signature
Mo. Day AM U PM
DWAIVER OF SIGNATURE (Domestic Only): AddItional merchendlee insurance is void If waiver
of signature ls requested. I wish delivery to be made without obtaining .signature of addressee or
addressee's agent ~f delivery employee judges that article can be left in secure location) and I authorize
that delivery employee's signature constitutes valid proof of delivery.
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: MILDRED L. STYDAHAR
Date of Death: November 24, 2000
Estate No.: 2001-00038
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. Ifthe answer to No.1 is Yes, state the following:
a.
Did the personal representative file a final account with the Court?
No X
Yes
b. The separate Orphans' Court No. ( if any) for the personal representatives'
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: April 1, 2002
j'J"~
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-
TERRENCE J. KERWIN, ESQUIRE
4245 ROUTE 209
ELIZABETHVILLE, P A 17023
(717) 362-3215
1'''\
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, -
-'
Capacity :
_ Personal Representative
---X- Counsel for personal
representative
IN RE: ESTATE OF
MILDRED L. STYDAHAR
NO. 2001 - 00038
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FILE NO.: 2001 - 00038
RELEASE AND DISCLAIMER
I, HELEN M. STYDAHAR, do hereby disclaim and renounce and release any and all
interest I may have in various joint assets that were established by my late sister, MILDRED L.
STYDAHAR. I am disclaiming these assets so that they pass in accordance with Paragraph
FOURTH of my sister's Last Will and Testament duly probated in the Register of Wills Office of
Cumberland County and docketed to No. 2001-00038. The following is a list of assets for which
I have formally disclaimed my interest:
1. Van Kampen Tax Free High Income Fund - A, Account No. 39-671416862/7, with
a date of death value of $43,389.42.
2. Evergreen Tax Free High Income Fund - B, Account No. 391-2600019772 with a
date of death value of$19,063.18.
3. Various shares of stock with the company name and value as follows:
a. 213 shares of stock Monongahela Power Company valued at $15,336.00.
b. 556 shares of stock Bell South valued at $22,551.36.
1
c. 346 shares of stock Bell Atlantic (now Verizon) valued at $19,397.80.
d. 144 shares of stock Southwestern Bell valued at $3,276.00.
e. 16 shares of stock NCR valued at $768.00.
f. 144 shares of stock SBC valued at $7,515.07.
g. 340 shares of stock Lucent valued at $5,333.92.
h. 397 shares of stock A T & T valued at $7,766.51.
1. 500 shares of stock Allegheny Energy (f/k/a Allegheny Power System, Inc.)
valued at $20,405.00.
J. 800 shares of stock Allmerica Securities (f/k/a State Mutual Securities Trust)
valued at $7,600.00.
By this Disclaimer fifty percent (50%) of the value of the aforesaid accounts will be
transferred to the Diocese of Harrisburg, which in turn will distribute the appropriate portion to the
parish known as Saint Katherine Drexel Parish (formerly Blessed Katherine Drexel) in
Cumberland County, Pennsylvania. Fifty percent (50%) of the value of the aforesaid accounts will
be transferred to the Diocese of Wheeling-Charleston, which in turn, will distribute the appropriate
portion of their share of these accounts to Saint Ann's Catholic Church in Shinnston, West
Virginia.
2
IN WITNESS WHEREOF, I have set my hand and seal this 16th day of
August
,2001.
;E~-E;~.~~~~R
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF DAUPHIN
On this, the 16th day of August , 2001, before me a Notary Public, the
undersigned officer, personally appeared HELEN M. STYDAHAR, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~'<y<7/~
Notary Public
My Commission Expires:
D: /lak/doc/disclaim.mls
Notarial Seal
Nancy J. Ligon, Notary PublIc
W~on Twp., Dauphin County
My CommIssion Expires May 21, 2005
Member, PennsytvaniaAssociatiOnotNotartes
3