HomeMy WebLinkAbout01-0079
REV_1500 EX + (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
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ANDERSON HARRIET L
DATE OF DEATH (MM-DD-Yea<1
DATE OF BIRTH (MM-DD-Year)
00 1. Original Return
o 4. Limited Estate
[XJ 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
D 2. Supplemental Return
o 4a. Future Interest Compromise Idale ot dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Allach copy 01 Trust)
o 10. Spousal Poverty Credit (daleofdealhbelween 12-31.91 and 1-1-95;
OFFICIAL USE ONLY
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03/23/2000 01/04/1929
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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TELEPHONE NUMBER
717/697-4650
MECHANICSBURG
FILE NUMBER
21-010079
""'COONTYCCii5E -YE.o\R- - -iiiiiiER--
SOCIAL SECURITY NUMBER
195":22-4556
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
03. Remainder Retum (daleord&alhpliol"Io12-1J..82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Box.es
o 11. Election to tax under Sec. 9113(A) (AIIach Sdl 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MURREL R. WALTERS III ESQ 54 EAST MAIN STREET
FIRM NAME (If Applicable)
X .0-(15)
X .0_(16}
X .12 (17)
X .15 (18)
(19)
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
PA 17055
OFFICIAL USE ONLY
4,301.21 ,
(6)
4,301.21
ANDERSON JOHN A.
1. Real Estate (Schedule A)
2. Slocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
4,926.00
(11)
(12)
(13)
4,926.00
-624.79
3. Closely Held Corporation, P or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule 0)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Join!y Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (Iolal lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines. 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has nol been
made (Schedule J)
(14)
-624.79
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13}
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal lax
rate, or transfers under Sec. 9116 (a}(1.2)
16. Amount of Line 14 taxable allineal rate
17. Amount of Line 141axable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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Add
ece ents omplete ress:
STREET ADDRESS
. 22 PATTON ROAD
CITY I STATE I ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
L Tax Due (Page 1 Line 19) (1)
2. Credits/Paymenls
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
Total Credits (A t 8 t C ) (2)
3. InleresVPenally if applicable
D. Interest
E. Penally
T olallnleresVPenal1y ( 0 t E ) (3)
4. If Line 2 is greater than Line 1 t Line 3, enter the difference. This is Ihe OVERPAYMENT.
Check box on Page 1 Line 20 10 requesl a refund (4)
5. if Line 1 t Line 31s 9realer than Line 2, enter the difference. This is the TAX DUE. (5)
A Enter the Interest on the tax due. (M)
8. Enler Ihe lolat ot Line 5 t M. This Is the 8ALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or Income of the property transferred; ........................................................................... 0 00
b. retain the right to designate who shall use Ihe property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ........................................................................,............................. 0 00
d. receive the promise for life of either payments, benefils or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedenllransler property within one year of dealh
without receiving adequate consideralion?............................................................................. ................. 0 00
3. Did decedenl own an "in Irust for" or payabie upon dealh bank account or security at his or her death? ................. 0 00
4. Did decedenl own an Individual Retirement Account, annuily, or other non-probate property which
contains a beneficiary designation? ....................... ......................... ....................................................... 0 00
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 penal6es ot peljury, 1 declare '!nail 'nave examined this relum, including accom~anying schedules and statements, and to the besl of my knowledge and belief. it is true, correct
and complete.
Declaration of pteparer other than the personal represenla~ve is based on all InformatiOn of which preparer has any knowledge.
SIGNATURE OF PERSO E P N lE FOR F, LING RETURN
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ADDRESS
MU R . WALTERS III ESQ
54 EAST MAIN STREET, MECHANICSBURG
PA 17055
For dates of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (al (1.1) (in.
For dales of death on or after January 1, 1995, the tax rate imposed on the net value of Iransfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (lill.
The statute does not exemol a transfer 10 a surviving spouse from tax, and Ihe stalulory requirements for disclosure 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 Juiy 1, 2000:
The tax rate imposed on the nel value of transfers from a deceased child twenty-one years ot age or younger al 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)1.
The tax rate imposed on the net value oflranslers to ortor the use oflhe decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(ln.
The lax rate imposed on the net value of Iransfers 10 or for the use of Ihe decedent's siblings is 12% [72 P.S. ~9116(a)(1.3n. A sibling is defined, under Section 9102, as an
individuai who has al ieast one parent in common with Ihe decedent, whether by biood or adoption.
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COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
ANDERSON HARRIET L
FILE NUMBER
21
01
0079
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. CREMATION SOCIETY OF PENNSYLVANIA 1,000.00
B. ADMINISTRATIVE COSTS:
1 Personal Representative's Commissioos
Name of Personal Representative (5)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
GiJy Stale Zip
Year{s) Commission Paid:
2. Attorney Fees MURREL R. WALTERS III ESQ 360.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Clalmant JOHN A . ANDERSON
Street Address 71 WINTER LANE (MOVED AFTER DEATH OF WIFE)
GiJy ENOLA Slale PA Zip 17025
Relationship of Claimant to Decedent HUSBAND
4. ProbaleFees REGISTER OF WILLS 60.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. VITAL RECORDS DEATH CERTIFICATES 6.00
TOTAL (Also enler on line 9, Recapilulation) $ 4 926.00
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(If mo'e space IS needed, Insert additIOnal sheets of the same size)
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, COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
I
SCHEDULE B
STOCKS & BONDS
ESTATE OF
ANDERSON. HARRIET L
All property jointly-owned wltil right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21 01
0079
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
4,301.21
CAMPBELL SOUP COMPANY
144 SHARES COMMON STOCK
NET SALE PRICE
TOTAL (Also enter on line 2, Recapitulation) $
(II more space Is needed, insert addillonal sheets of the same size)
4301.21
JAN-17-2001 13:14
MURREL WRLTERS, ESQ
P.01/07
PETITION FOR GRANT OF LETTERS
Estate of HARRIET L. ANDERSON
No.
21-01-79
sdso known as N/A
j Deceased
Sodat Security No,195~22-4556
;)etltloner(s), who is/srB 18 years of age or older, dpply)i~:;) for:
[COMPLETE "A" OR ns" BELOW:)
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A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut OR
Decedent. dated 2/24/00 and codicil(s) dated nona
named in the Last Will of the
Continued on a Separate P~ge
Stt){(2) relevant clrCU;'1sfancp,!>, e.g., renunciation, death of executor. ele
E~capt as follows, Decedent did not marry. was not divorced and did not have a chifd born or adopted ~fter execution of the documents offered
:or probate: was not the viCtim of a killing and was never adjudicated incapacilated:
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B. Grant of letters of Administration
(C_l.OI.. d,bn,C.t.a.: pendente lite, dU(i~nle absentia; durante minoritat~)
Petltioner(s) after a proper search has/have ascertained ti,e Decedent left no Will and was survived by the following spouse
(if any) and heirs:
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Name Relationship Residence
--
......--~....-- -..
-
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County. Pennsylvi;:!n;;:l, with his/her last family Of principal
residence at 22 t'ATTON DRIVE, MECHANICSBURG BOROUGH
(list otreet. numb~1' ()r\d municlpality)
Decedent. then 71 years of age, died MARCH 23 I 2000 , at HOLY SPIRIT HOSPITAL
(loc~tion)
Dec€'cIent at oeath ownad property with estimated valu~s as fot/ows;
(ifdomJciled In PA All personal prop~rty .............-.. .......,,,.......... $
{if not domiciled in PA Personal property in Pennsylvania "................ $
(i' nor domiciled in PA Persorlal property i" County..... . ................... $
Value of real estate i~ Pennsylvania ..,".........."....,......--........ ..d................ ............. $
T ota 1 ................ - . .. . . ... ... . . . .. ... ... '. . .. .. .. . , . .. . .. , , . -,. ... . . . . . , . .. , . , , . , . . . , $
4100Q~O~
4tOOO.O~
Reaf Estate situatad as follows: NONE
Wherefore. Petitioner(s) respectfully reqUElSl(S) the probate of the Last Will and Codlcil(s) presented with this Petition and ths grant of letters in
the appropriate form to the undersigned;
Signature
/
Typad or printed name a:d residence
.JOHN A. ANDERSON
71 WINGER LANE
ENOLA PA 17025
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JAN-17-2001 13:15
MURREL WALTERS, ESQ
P.02/07
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLANb
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
Jnd correct to the best of the knowledge and belief of Petitioner(s) arId that, as personal representative(s) of the
Jecedent, Petitioner(s) wi\l 'l/~ell and truly adrninister the estate according to taw.
3worn to and affirmed and subscribed
I(IP~J
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)efore me this 17 th "_ d8Y of
JANUARY 2001
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:state of J:lAR8!ET l-. ANDERSDN
DECREE OF REGISTER
No.
Ilso known as HlA
Social Security No:.1~22-4~~
I in consideration of the Petition on the
AND NOW, JANUARY 18, 2001
~verse side hereon, satisfactory proof havrng been presented before me,
r fS DECREED that Letters ~ Testamentary CJ of Admjnistration
Deceased
21-01-79
Date of Death:
March 23, 2000
re hereby granted toJOHN A. ANDERSON ~
((c.I.a.. d.b.n.r..t.; pen(lcq'~ lite; durante sbsen\i3: dttrante minoriate)
I the above estate and that the instrument(s), if any, datedfebruary 24, 2000
ascribed in the Petition be admitted to probate and filed of record as the Last Will of Decedent.
FEES
etters .......,.. _........................ 0
hort Certfficates( s) ...............
enunciation ..........................
xtra Pages (
) ...............
r.R.......... ......0< 0 00' 'h... ....... ....
~ P Fee ..... 0 0 . . . . . . . . " . " . . . ... .. .....
ventory ................................
lher ...................................:..
TOTAL .......... ,..................$
$
25.00
~;Y (7 /~LU~j ,12/.{-( / m...tC.
R0Gi~~r of Wills /f
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6.00
Sig re
9.00
5.00
Attorney: MURREL R. WALTERS, III
\.0. No: 24849
Address: 54 EAST MAIN STREET
MECHANICSBURG
PA 17055
45.00
Telephone: 711.697~4650
DATE F'LED:~?//~ /? ,~/
~t.4h tv azuX:7~
HIOS.90S REV. (09/00)
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
(;t,L JI~
~~s,~/'6r'
Robert S.~erman, Jr., MPH
Secretary of Health
Charles Hardester
State Registrar
1325827
JAN 0 3 2001
Date
21-01-79
Hl05.143 A..... 2187
COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECOROS
CERTIFICATE OF DEATH
027329
TYPElPRINT
IN
PERMANENT
BLACK INK
~I
t.Hcvor..<..e.t L. AndVt..6on
AGE (lastBit1hday) UNDER 1 YEAR
Woncha 0.
SEX
2. F e.ma.ie.
STATE ~llE NUMBER
SOCIAL SECURITY NU'-48ER
J. 195 - 22
NAME OF DECEDENT (Forst. MIMe. last,
UNDER 1 DAY
DATE OF 8lRTH
,.Mon.h. Day. .....,
81RTH~ ;C"Var.d
StaI4 01 Fcreogn Counl'vl
5-
COUNTY OF l)E)PJH
71 Y....
........ ! MinuI..
lit.
CumbVtia.nd
DECeDENT'S USUAL OCCUPIO'ION
(Give lund al work done dur.-.g mosI
01 working !iN: do not use 'ebred.l
tlL Home.ma.k.Vt 111t.
OEa:OENT'S MAILING AOOAESS (Street Cityno-. SIaM. Zrp Codel
22 pa.tton VJr.-i..ve.
t~e.eha.n-i..e..6buJr.g, PA 17055
FArnER'S NAME (First, MJddIe. last)
t.. HMJr. A. Sfugle.
1NF000000S NAME (T ypelPTinl'j
20L MJr.. John AndVt..6on
METHOD OF OISPOS1TIOH
8urilII 0 Cr--.n ~ ~~Sl...O
oo..r (SpecilyI
SURVIVING SPOUSE
I"......!JII"' m-. namel
John Ande.Jr...6on
NIp.
Me.c.ha.n-i..e..6buJr.q
ciIyl'bon>.
17109
171 09
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not fMUIIin9 in.". ~ _ g;... in PNn' I.
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WERE AUlOPSY FINDINGS
~PAIORlO
COMP\.ET1ON OF CAUSE
OF 0ERH7
Homicide
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DATE OF INJURY
IManth. Day. -l
TIWf: OF INJURY
INJURY AT WOAK7
DESCAI8E HOW INJURY OCCIJfWlEO.
PwncIing~
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o ~OF INJURY. A! home. tum~_, faclory,oIfic<I ...
buiIdIrlg. *. cSpeolvl
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Could not be de1emuned
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-MEDICAL EXAMINER/CORONER
On the n.i. ot ellamil\lltlon anelleM' investigation. in my opinion. death occurred at lhe lime. date, and pIKe, and due to ltle cause(.) and
mattner" statecl.....................................,...............,.... -....... -...............................
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REGISTRAR'S SIGNATURE ~R
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: I~ ~~ { r::r
1/.1- ~ (., J
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Date of Death:
Will No.
Admin. No.""2- (- CJ I . -( cr
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal rep;~sentative file a final
account with the Court? Yes No ^.
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative st~e an
account informally to the parties in interest? Yes I No
d. Copies of receipts, releases, joind rs and
approvals of formal or informal accoun~ay be fil with the
:::::Of~~)~:ans' Court and may be r~ 0 s report.
Si<j9ature
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Name (Please type or print)
~I f~ /UL~ tUEc.tI ~ 1i'<7~~ ~~
Address
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(-t{7 ';C17 -'f4,r\)
Tel. No.
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Capacity:
Personal Representative
x
Counsel for personal
representative
(MAH:rmf/AM3)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE .NUMBER
COUNTY
ACN
05-21-2001
ANDERSON
03-23-2000
21 01-0079
CUMBERLAND
101
MURREL R WALTERS III ESQ
54 E MAIN ST
MECHANICSBURG PA 17055
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0~
v' REY-lS'i7 EX AFP (12-00)
HARRIET
L
Amount Remitted
CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
4,301.21
.00
.00
.00
.00
.00
(8)
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=iS4j-iX--AFP-fi2':ool--NOy-iCi--oF-YNHERiTANCi-YAjrAPPRA-isiirENT-,--AiLOWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ANDERSON HARRIET L FILE NO. 21 01-0079 ACN 101 DATE 05-21-2001
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. 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
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
NOTE:
(9)
(10)
4,926.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
4,301.21
4.926 00
624.79-
.00
624.79-
(19)=
.00
.00
.00
.00
.00
.00
(11)
(12)
(13)
(14)
.00 X 00 =
.00 X 06 =
.00 X 00 =
.00 X 15 =
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
JRD/June 30, 1992/17858
~
Estate No.: 21-01-79
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
In Re: Estate of Harriet L Anderson
Late of Mechanicsburg Borough
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: John A Anderson
Counsel for Personal Representative: Murrel R Walters III
Date of Grant of Original Letters: January 18, 2001
Date of Delinquency Notice: April 28, 2001
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5 .6( e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on April 9 ,2001, and that the ten (10)
day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the
Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a
hearing to determine whether sanctions should be imposed upon the delinquent personal
representative or counsel for the delinquent personal representative.
Date: May 25, 2001
.i..>
. Lewis, Register of Wills
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for ~4~: f;34 in Courtroom No.3. If the Certification of Notice is
filed prior to the hearing date, the hearing will automatically be c~?elled.
OK ~ (,p... ~-O\
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,.
CERTIFICATION OF NOTICE UNDER RULE S.6(a)
Name of Decedent: Harriet L. Anderson
Date of Death: March 23, 2000
Will No. Admin. No. 2001-00079
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on January 18, 2001.
Name
Address
John A. Anderson
71 Winter Lane
Enola, P A 17025
I
/
~I
i
I
Notice has now been given to all persons entitled there
Date: 6/4/01
Signature
Name: Murrel R. Walters, III, Esq.
Address: 54 East Main Street
Mechanicsburg, P A 17055
Telephone: (717) 697-4650
Capacity: _ Personal Representative
~ Counsel for personal representative
21-01-79
LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, HARRIET L. ANDERSON, a resident of Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this to be my LAST
WILL and TESTAMENT, hereby revoking any and all wills and
Codicils previously made by me.
I
I declare that I am married to JOHN A. ANDERSON, and that I
have three (3) children, JOHN JEFFREY ANDERSON, LARRY LEE
ANDERSON, and GREGORY GENE ANDERSON.
II
I direct that all my just debts and funeral expenses shall be
paid from my residuary estate as soon as practicable after my
decease.
III
I direct that all taxes that may be assessed in consequence
of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid from my residuary estate as a part of the
expense of the administration of my estate.
IV
I give, devise and bequeath all my property, whether real or
personal, wherever situate, including any property over which I
may have a power of appointment to my husband, JOHN, provided that
he survives me by thirty (30) days.
V
If my husband should predecease or fail to survive me by
thirty (30) days, I give and bequeath my jewelry to my nephew's
wife, ANNE HOUCK, per capita.
VI
If my husband should predecease or fail to survive me by
thirty (3D) days, I give and bequeath my cookbooks to my son,
JOHN JEFFREY, per capita.
VII
If my husband should predecease or fail to survive me by
thirty (30) days, I give and bequeath a set of dishes known as
the Friendly Village stoneware to KATHLEEN SMALL, per capita.
VIII
If my husband should predecease or fail to survive me by
thirty (30) days, I give and bequeath the sum of TWENTY-FIVE
THOUSAND DOLLARS ($25,000.00) for the education of MATTHEW SMALL
to his parents to be utilized as they deem appropriate for his
education.
IX
If my husband should predecease or fail to survive me by
thirty (30) days, I give, devise and bequeath all the rest,
residue and remainder of my property, whether real or personal,
wherever situate, including any property over which I may have a
power of appointment, to my sons, JOHN JEFFREY, LARRY and GREGORY,
in equal shares, per stirpes.
"
^
I nominate, constitute and appoint my husband, JOHN A.
ANDERSON, as Executor of this LAST WILL, to serve without bond.
If my husband is unable or unwilling to act in that capacity, then
I nominate, constitute and appoint my son, JOHN JEFFREY ANDERSON,
as Executor of this LAST WILL, to serve without bond. If JOHN
JEFFREY is unable or unwilling to act in that capacity, then I
nominate, constitute and appoint my son, GREGORY GENE ANDERSON, as
Executor of this LAST WILL, to serve without bond.
IN WITNESS WHEREOF, I, HARRIET L. ANDERSON, have set my hand
to this LAST WILL this v1~
day of ;;{ ~~..4-~~
, 2000.
1~ 6/ U~~~~~,
HARRIET L. ANDERSON
2
Signed, sealed, published and declared by the above-nam~
HARRIET L. ANDERSON, as and for her Last will and Testamen~ln
the presence of us, who, at her request and in her presenc , and
in the presence of each other,
as witnesses.
h~/~~~~~~~;~~to~:;:~r~bed 0 names
Ii k L,,"
~-;) </J ,fjCLUkC3-
3
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, HARRIET L. ANDERSON, 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 WILLi that I signed it as my free and
voluntary act for the purposes therein expressed.
1/~if'~
HARRIET L. ANDERSON
Sworn or affirmed to and acknowledged before me by HARRIET L.
ANDERSON, Testatrix, this ~ I/W- day of ~-:-t'/'L.dC eLy , 2000.
[Ut I~ )VI. 4/~:-ll-
Notary Public
Notarial Seal
Diane M. Smith, Notary Public
Mechanicsbur~ Bore, Cumberland County
My CommissIon Expires June 22, 2000
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
._"
We, I ) )lA. rr ~ I K. h./.~,~.. If A (5 f (.J..f and /.....Ct r- /,.... t.).. (; I '0. l-. ( S ,
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 sign and execute the
instrument as her LAST WILLi that HARRIET L. ANDERSON signed
willingly and that she executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the hearing
and sight of the Testatrix signed the Will as witnesses; d that
to the best of our knowledge, the Testatrix was at th time 18
~~~~: ~:fl~~~C~~ more, of sound mini"/j,;~Pi' ? ;~ traint or
flIt I IlL
'//~ [J ~~1
KaJti1L J <.. . Y<-J1tU /Lt~
Sworn or affirmed to and acknowledged before
me this.;?I/)U.-'day of .;J( 0' Ii..... tJ '~J ' 2000.
(\, . '. ~---. ;
t U.a # \..-L ) } I , ,<;IiYk-.l.I"-.:
Notary Public
4
Notarial Seal
Diane M. Smith, Notary Public I
Mechanicsburg Borc, Cumberland County I
My Cem~ssien Expires June 22.:....2.~_O:.?.J