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Home My WebLink About01-0124 PETITION FOR PROBATE and GRANT OF LETTERS c:L1- 01- I~Y Eva M. williams No. To: Estate of also known as Register of Wills for the , Deceased. County of Cumber land in the Social Security No. 201-16-493R Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(J:), who is/aa 18 years of age or older an the execut or in the last will of the above decedent, dated ()('otnh..-r?l:), MCkXJulDk>i:~ Ada S. Perry, one of the subscribing witnesses died Sp~tprn~r ~. 1qqq named , 19---16.- (state relevant circumstances, e.g. renunciation, death of executor, etc.) DecelKlent was domiciled at death in Cumber land her last family or principal residence at Messiah village, nri ve , Upper All pn Town~h:i p, n 1ITI~r 1 rind ~ollnry, PA (list street, number and muncipality) County, Pennsylvania, with Apt. 705, 100 Mt. Allen DeceRdent, then 75 years of age, died January 8, , }Qc 2001 , at Mp~~i rlh vi 11 rlgP, MpC"'hrlni C"'~hllrg, PA 17()l:)l:) 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: DeceIltient at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: Nnne $ Undetermined $ N./A $ N/.l\ $ None WHEREFORE, petitioner(~ respectfully request(s) the probate of the last will ~~~ presented herewith and the grant of letters Tcst.:HRCnt.:lry (testamentary; administration c. La.; administration d. b.n.c. La.) theron. ,-.. ~ 0) u .:: 0) :9-v;- "'~ 0) ... cq~ -00 ~'':: c;I;j"';::::: 3~ 0) '- ~o ... .:: bO CIi ~,8;J~/R Frank R. Wi11irlrn~, Jr. Messiah "illao:e, Apt 705 100 Mt. Allen nri ve MpC"'hrln~C"'~rnJrg, PA 170l:)S-'OlS OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF <nmmLAND J Sworn to or affirmed qt..and subscribed { ~hiS _ d/9 ~ ~i ~~ (!{j'~~~1- . .' eglster ,';). [) f..' - ; C The petitioner(x) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitionerUt) and that as personal represen- tative(i) of the above decedent petitioner(~ will well and truly administer the estate according to law. ;LJ:~ J' I ~ / ;:;~k~~ifi~ / ' ~ s::. - l:: ~ ~ j' / " t...::) No. 21-01-0124 Estate of EVA M. WILLIAMS , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 30, it 2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(x) dated ()c-orohPr ?'i, 1 'nn described therein be admitted to probate and filed of record as the last will of Elva M. Williams and Letters 'T'P1'lr.:::lTTlPnr r1ry are hereby granted to Frank B. Williams, Jr. 'mu~r!, ,Von~<L)~ ~d, ~~~ Re~ster of Wills Probate, Letters, Etc. ......... $ Short Certificates( 2) . . . . . . . . .. $ Renunciation ................ $ JCP $ 5.00 TOTAL _ $ 61.00 Filed . ..J~1!~:Y. )9... .~99.1.............. 50.00 6.00 ~~~ William L. Sunda 06354 FEES ATTORNEY (Sup. Ct. I.D. No.) 39 West Main Street Mechanicsburq, FA 17055-6230 ADDRESS (717) 7nn-9n?? PHONE MAILED LETTERS TO ATTORNEY JANUARY 30, 2001 (I Hl05.112 REV '3'8B (FEE FOR THIS CERTIFIC;\TE $:'OIJ! WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYL/J. Nl.i. DEPARTMENT OF HEALTH vir A.L H: I:Or:D~, LOCAL REGISTRAR'S CERTIFICAlIOI\Ji OF [lEA1- CERT. NO. T 4 7 912 3 0 /";I;;"i7i1;/7;;;-.~ {iii{'~\~\UlF pr.'~;;~~ "11':";.\ 1"/ ~,C:I(1'-' 1" ~../ "\J:J:.\.\ if~i -~\~;.\ Ii ~ '!!' \:P ~ I~Q! . '~: !~%' '~<-)I' ,~~; Ih~1 I~ ~~.,;/~// %!~" . ../~~/I ,,",,,,~-!r~iENt~' ~'i\I!~ ~~!!.!!!!f.!!.!!J!.!.!/ January 10, 2001 Date of Issue of This Certi1ication Name of Decedent Eva M. Wi lliams F'lst Middle ~ a 5 t Sex ' Female Social Security No. 201 - 16 - 4938 Date of Death January 8, 2001 Date of Birth June 26, 1925 Birthplace Mechanicsburg, Cumberland County. Pennsylvania F'i'.ciI!1v NarDP Cumberland County Upper Allen Township Countv City, Borough or Tov,mship Pennsylvania Place of Death Messiah Village Race . White ____Occupation English Decedent's Marital Status ~___~arrieL__ Mailing Address Teacher Armed Forces? (Yes or No) No P.O. Box 2015 Messiah Village Mechanicsburg PA Number Street Citv 0: T OWl Slate Informant Mr. Frank B. Williams Name and Address of Funeral Establishment Funeral Director Scott D. Brenneman. FD Coek.lill 'Puneral lIome, Ine. ,30 R. Chestnut Str.eet. O1.11sburg, PA 17019 (c) I I I I I I -----L. I I I I I I -----1 I Part I: Immediate Cause Interval Between Onset and Death (a) _____~_o!~ Cancer (b) _________ Part II: (d) __ Other Siqniflcant Conditions I .--,---- I I I Manner of Death Natural ~ Accident 0 Suicide Describe how injury occurred: Homicide Pending Investigation Could not be Determined o o o Name and Title of Certfier Michael A. DeMichele, MD Address 108 Lowther Street, Lemoyne, PA 17043 (M.D.., D.O., Coroner, ME) This is to certify that the information here given is correctly copied from an original certificate of death duly filecl with me as Local Registrar. The original certificate will be forwarcled to the State Vital Records Office for permanent filing. ~~ r' ~..~ 67608 LOCdl Registrar of Vital Records 153 Logan Road. Dillsburg, PA 17019 District No January 10, 2001 ~~'ff0~I:;;\'e'~~~)':'ll ;:::ec;i:'_.trill Street Address City. BOIOU<;:lh. r'Jwnstl,ip 21-01-0124 REGISTER OF WILLS OF ~nMRRRr.ANn COUNTY OATH OF SUBSCRIBING WITNESS william L. Sunday ~ (..) a subscribing witness to the will presented herewith, (OOlCk) being duly qualified according to law, depose(s) and say(s) that I was present and saw Eva M. williams Sworn to or affirme1J'nd subscribed before me this ~9. day of ~ .f 2001 fl)a)-tf: - e.Cl, ~/~4 Register the testat rix , sign the same and that I signed as a witness at the request of testat rix in h er presence and (i1I1JdUJJPrtlSlellareclltc~ (in the presence of the other subscribing witness(.)), ~ t,/~ 'II' 0( ~ W1 1am L. S ay 39 West Main (Name) Street Mechanicsburg'. PA 17055-6230 (Address) (Name) (Address) \ RISTER OF WILLS OF cnmEm.AND COUNTY OATH OF NON-SUBSCRIBING WITNESS , Jr. and Luc L. Ca (each) a subscriber hereto, (each) 'ng duly qualified according to I ,depose(s) and say(s) that t.7~ ~'Ce fami' with the signature of Eva M. williams ~tWc will that we, and each of us, presented herewith and ~Rii signature on the will is in the handwriting of testat-Xix- of to the best of our Eva M. knowledge a ) V 0AJl{fiJss)) ~~Lo.p,()_ Lucy L.(J (Name) ~app 113 East Marble Street Mechanicsburg (Address) PA 17055 "" "~ ~ 21-01-0124 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS /' /,/ / // / /' codicil (each) a subscribing witness to the will presented herewith, (each) bei law, depose(s) and say(s) that Sworn to or affirmed and subscribed me this day of 19_ duly qualified according to present and saw the testat , sign the same and that request of testat_ in h presence and (in other subscribing witness(es)). signed as a witness at the e presence of each other) (in the presence of the (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS FRANK B. WILLIAMS, JR. (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that he is familiar with the signature of EVA M. WILLIAMS ~ testat~ of (one of the subscribing witnesses to) the will that HE presented herewith and codicil believes the signature on the will is in the handwriting of EVA M. WILLIAMS to the best of his knowledge and belief. Sworn to or affirmed and subscribed before ~ me this 29 th day of J~UMY ~ 2001 ~fuyJ?,~hMI(J#IJ'fl./1. ~~~ Register 13 hW~~ ;i1~ (Name) (Address) (Name) (Address) LAST WILL AND TESTAMENT 21-01-0124 I, EVA M. WILLIAMS, of the Township of Monroe, County of Cumber- .. land and State of Pennsylvania, being of sound mind, memory and under- standing, do make, publish and declare this to be my last Will and Testament, hereby revoking and making void all former wills, codicils and other testamentary dispositions by me at any time heretofore made. 1. I direct my Executor, hereinafter named, to pay as soon as prac- ticable after my decease all my just debts and the expenses of my last illness and burial. 2. I give, devise and bequeath all of my estate - real, personal and mixed - unto my husband, Frank B. Williams, Jr., absolutely. 3. Should my said husband predecease me, then and in that event I give, devise and bequeath all of my said estate unto my children, Gordon L. Williams, Lucy L. Capp and Alan E. Williams, equally, share and share alike. 4. I nominate, constitute and appoint my husband, Frank B. Williams, Jr., executor of this my last Will and Testament. Should my said hus- band fail to qualify or cease to act as executor, I appoint my said daughter, Lucy L. Capp, executrix of this my last Will. IN WITNESS WHEREOF, I, EVA M. WILLIAMS, the testatrix, have here- unto set my hand and seal to this my last Will and Testament this ~,jtlt day of O~~ 1976. Z/I--d. 111 ... W dt~ (SEAL) Signed, sealed, published and declared by the above named Eva M. Williams as and for her last Will and Testament in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. aLv A/~ ~~<~7 , CERTIFICATION OF NOTICE UNDER RULE 5.6(a) 5- Name of Decedent: Eva M. Williams Date of Death: January 8, 2001 Will No. 21-01-124 Admin. No. 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 Name Frank B. Williams, Jr. Address Messiah Village, Apt. 705 100 Mt. Allen Drive, Mechanicsburg, PA 17055 Gordon L. Williams 109 Sanford st., Oak Hill, West Virginia 25901 Lucy L. Capp 113 East Marble St., MeChanicsburg, PA 17055 Alan E. Williams 3396 Santa Cruz Dr., Riverside, California 92507 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: April 30, 2001 SignatureJ7~ / ~4 Name William L. Sunday 7 Address 39 West Main Street Mechanicsburg, PA 17055-6230 Telephone ( 711 766-9622 Capacity: _ 8ccXX1d:Rxpax~~ ;=i ~Counsel for personal representative -... . . IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. ~ Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. ~:-~,.f. '~;~rl~')--"'\v I, . \ I ;:::.::..; " \. -./7 '~iJ BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Eva M. Williams Estate No. 21-01-124 (Name and Address) , deceased, TO: Frank B. Williams, Jr. Messiah Village, Apt. 705 100 Mt. Allen Drive Mechanicsburg, PA 17055-2015 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Eva M. Williams day of January , 2001 , at Pennsylvania. . died on the 8th Cumber land County, The Decedent died testate (with a Will); IN, a copy of the Will is attached hereto. ~~~ldC~~~:iJWHPJ. The personal representative of the Decedent is (name, address and telephone number). Frank B. Williams Jr. (717) 766-5389 Messiah Village, Apt. 705 100 Mt. Allen Drive Mechanicsburq, PA 17055-2015 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 170l3. Phone No. 717-240-6345 > - 1Vlt1l1J~~~U~~lt~JtlJKlOO!lSJmllCHrcl.1fcrea:XltxKkllilliGb:atOOXJOOrDmdcMrllXk<<:f)ffiDIIXHticthe ~}(KumxJClt~XAtlcfOlact1lJ,XkbCClXblx<<K:iJfccar~IIK,xImcX)OOljxRbooeJlloc~i~1i)J6&fi A copy of the Will or Petition may be obtained by contacting the Register of :illS and paying the chan for duplication. D.t" April 26, 2001 Sign'lu<<: ~~ ~ ..-L~/ Name (print) W11harn L. Sunday Address 39 West Main Street Mechanicsburg, PA 17055-6230 Telephone (71'1 766-9622 Capacity: Jt<<UJA1cRlf~ktJe Counsel for personal representative ... . IMPORTANT NonCE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. :r .. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. In re Estate of Eva M. Williams , deceased, .~---- -----.. II;, ",J/ /-'." r-:-..,.-,\ /7 ~ ' i ; ) J ',/ . ~..~~/' ~.:".::~-:~~. ~ J \ j , Estate No. 21-01-124 (Name and Address) TO: Gordon L. Williams 109 Sanford Street Oak Hill, West Virginia 25901 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Eva M. Williams day of January , 2001 ,at Pennsylvania. Cumberland , died on the Ath County, The Decedent died testate (with a Will); w, a copy of the Will is attached hereto. 'JMIC~~rdClf~~~\\l~~JWHIJ. The personal representative of the Decedent is (name, address and telephone number). Frank B. Williams Jr. ( 717 ) 766-5389 Messiah Village, Apt. 705 100 Mt. Allen Drive Mechanicsburq, PA 17055-2015 . IT the Decedent died testate, the will has been filed with the Offic'e of the Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If)lU(IJOtlIf~.1IUudxb:IK!lC~JQXJIU(kllOKJOJtc!tItJ<lSKl1IIlClIrct.xcmrxXltX'trJnmJk1IJIDi:aaxJWXJOtodcMJJJJ(k<<:f}UiCllXR<<tht ~JUf.&t1lfJCltOoobeJdXAtJcbllCMJ,X~lOtmxblxll(Il:SlfCC:lfIQClafJfIlK~XtOOl~xRbune"*xJUXi~~J6aJfj cr .. A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges. or duplication. Date: April 26, 2001 Signature: ~., r:: u,~v Name (print) William L. Sunday./ Address 39 West Main Street Mechanicsburg, PA 17055-6230 Telephone ( 71 '1 766-9622 Capaci t y: I"dtlltllJA2cR.1f~JCtX<<al)w Counsel for personal representative '" . .... ... IMPORTANT NO'TICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. ..... BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. (t-' :~: ;';=~':;5) \\(/7 ,',)..\",,)/U \' "-,,,.~ ----....... L In re Estate of Eva M. Williams , deceased, Estate No. 21-01-124 (Name and Address) TO: Lucy L. Capp 113 East Marble Street Mechanicsburg, PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Eva M. Williams day of January , 2001 ,at Pennsylvania. Cumberland , died on the Ath County, The Decedent died testate (with a Will); W, a copy of the Will is attached hereto. ~~~~IfKMK~~~~'WHPJ. The personal representative of the Decedent is (name, address and telephone number). Frank B. Williams Jr. (717) 766-5389 Messiah Village, Apt. 705 100 Mt. Allen Drive Mechanicsburq, PA 17055-2015 . . If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 . .. ~K~~~U~~kiloJfJOlKlht.xCSKl>>XJlfc:t.KcmIxXl1:lAdmiJJiGbei:QQXDXXJbxkxidtXkOCf)fHllIXRtictbe ~J(K.bJClt~h~khllClXblxlx<<:Slfcmr~IIK;xIllacX)OOljxiUxxJeJlicc~jl~:jKXbfj A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the char Date: April 26, 2001 Signature: ~-~ ~ Name (print) William L. Sunday Address 39 West Main Street MechanicSburg, PA 17055-6230 Telephone ( 71'1 766-9622 Capacity: P<<>>XM1cR.1f~M Counsel for personal representative '" ""- IMPORTANT N8T1CE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. ~. - BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. (.. '~~'j /-::.~. r--~\~\\..l : .. r \. i t J , l ',,). ::-~~~_./ \' . "<-../ \j LI In re Estate of Eva M. Williams , deceased, Estate No. 21-01-124 (Name and Address) TO: Alan E. Williams 3396 Santa Cruz Drive Riverside, California 92507 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent day of January Pennsylvania. Eva M. Williams , 2001 ,at Cumberland , died on the 8th County, >>'cIC1\I~~~lf~i("'~~JWHJJ. The Decedent died testate (with a Will); w, a copy of the Will is attached hereto. The personal representative of the Decedent is (name, address and telephone number). Frank B. Williams Jr. (717) 766-5389 Messiah Village, Apt. 705 100 Mt. Allen Drive Mechanicsburq, PA 17055-2015 - .. if the Decedent died testate, the will has been filed witl; the Office of the Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 17013. Phone No.7 J 7-240-6345 1VIl1I1~~~ft!.IC~~J.t~JOJKlfJt.Xl8KQQlCllfcb:tml1'XltJ/KJmilakllXDi:OlIXJD\Xtbl:Olk~Xkacf}fklllXR6c)he ~JUf~mxJCltnmIbmXUfC8~)CfC8amcbooxKS:ttcmrIl)(XarJfm)dtKX)OOljxRbooe"*xmli~j3KXlJfi A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges fo duplication. Date: April 26, 2001 Signature: Name (print) William L. Sunday Address 39 West Main Street Mechanicsburg, PA 17055-6230 Telephone (71'1 766-9622 Capacity: JtMJ0fIQJc:R.K~)w Counsel for personal representative , "'. ".l"~ '1,', "~.~~':"."";"'I~"',,,_~.1~."~rtl'~~~ " ~ ! . ~. .' I - ..... " ,: .~'. .:.. i ~,- '( ~: . LAST WILL AND TESTAMENT land and State of Pennsylvania, being of sound mind, memory and under- I, EVA M. WILLIAMS, of the Township of Monroe, County of Cumber- standing, do make, publish and declare this to be my last Will and and other testamentary dispositions by me at any time heretofore made. Testament, hereby revoking and making void all former wills, codicils 1. I direct my Executor, hereinafter named, to pay as soon as prac- ticable after my decease all my just debts and the expenses of my last illness and burial. -~ 2. I give, devise and bequeath all of my estate - real, personal and mixed - unto my husband, Frank B. Williams, Jr., absolutely. ~, '.:l~ J 1,'J 3. Should my said husband predecease me, then and in that event I give, devise and bequeath all of my said estate unto my children, ,*~; 'tt."1 ," Gordon L. Williams, Lucy L. Capp and Alan E. Williams, equally, share and share alike. j , , .~: 4. ~: r, ,\ ,Ii I nominate, constitute and appoint my husband, Frank B. Williams, COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND L J 55: according to law, deposes and says that he ; ~ rhE' RXeC1ltor of the Estate of Eva M. wi 11 iam~ late of ____ _y~t:'- AJ..lerL'l:'9\<IDebip--------- , Cumberland County, Pa., deceased and that the within is an inventory made by him -, the said RYE'l"l1rOr of the entire estate of said decedent, consisting of all the personal propl!rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Frank B. williams, Jr. being duly !=\Worn 2.? ;9C2001 !J~~( williams, Jr. Sworn ro and subscribed before me, Messiah Villaqe - Apt. 705 100 Mount Allen Drive Mechanicsburg, PA 17055-2015 Address ~ber, PennsylvanIa AsSOciation of NWlfI,,!j Date of Death 8 January Month 2001 Year Day INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. 0.. ..... >- .c -0 Ul CD I- W ~ '" ~ 0:: I- ~ III W -< CD Q. l- E-! u 0 Vl CD 0 W W ..... 0 :I: 0:: r-f c: I- Q. r-f Q) I- ....I LL Z <( 0 ..... r-f III LL ....I 3 r-f Q. UJ 0 <( w oel; >- > Z 0:: . +- Z 0 ~ '"' c 0 ~ :JI 0 Vl Z ~ 0 0:: 0 Z w <( ::> 4jIto Q. "'0 c III - -;: 0 CD ..Q "'0 QI E +- ..! III :JI ....I 0 u: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 000339 SUNDAY WILLIAM L 39 W MAIN STREET MECHANICSBURG, PA 17055 ACN ASSESSMENT CONTROL NUMBER AMOUNT ___u___ fold 101 $231.39 ESTATE INFORMATION: SSN: 201-16-4938 FILE NUMBER: 21-2001- 0124 DECEDENT NAME: WILLIAMS EVA M DATE OF PAYMENT: 10/02/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/08/2001 TOTAL AMOUNT PAID: $231.39 REMARKS: FRANK B WILLIAMS JR. C/O WM L SUNDAY ESQUIRE CHECK# 7080 SEAL INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS /6-c2LJ6-/0 '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP <12-001 of DATE V\;;!IS ESTATE OF DATE OF DEATH FILE NUMBER All :51cOUNTY ACN RecorLlc ( Reg:::::t- '01 NOV 16 WILLIAM L SUNDAY 39 W MAIN ST MECHANICSBURG PA 170!iaerk"" Cumberianc 11-12-2001 WILLIAMS 01-08-2001 21 01-0124 CUMBERLAND 101 EVA M Allount Rellitted 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--fiZ'=oOY-NO'fici--OF-YNHEriifANCE-i'-AX-;'-PPR;'-isiifiNT~--AiXoWAtiCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILLIAMS EVA M FILE NO. 21 01-0124 ACN 101 DATE 11-12-2001 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage 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 I~ an assessment was issued previously, lines 14, IS 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. 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 TA C ITS: PA MENT DATE 10-02-2001 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) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets NOTE: R CE PT NUMBER CD000339 D SCO T (+) INTEREST/PEN PAID (-) .00 ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 140,000.00 13.987.70 .00 5.142.00 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 159.129.70 (9) (10) 14,027.59 189.94 (11) (12) (13) (14) 14.217 53 144,912.17 .00 144,912.17 139,770.17 X 5,142.00 X .00 X .00 X 00 = 045 = 12 = 15 = .00 231.39 .00 .00 231. 39 (19)= AMOUNT PAID 231.39 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 231. 39 .00 .00 .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.) I CJvI STATUS REPORT UNDER RULE 6.12 Name of Decedent: Eva M. williams Date of Death: January 8, 2001 Will No. 21-01-124 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 Cerk of the Orphans' Court and may be attached to this report. Copy of Family Settlement Agreement dated 11/21/02 is attached hereto Dat.e= I~-z..... -Oc- ~ or4 . ~.::: Signature William L. Sunday Name (Please type or print) 39 West Main Street - Ste. #1 Mechamicsburg, PA 17055-6230 Address ( 717 ) 766-9622 Tel. No. ~apacity: Personal Representative X Counsel for personal representative (MAH:..rmf/AM3) WILLIAM L. SUNDAY DAWN S. SUNDAY Attorneys - at - Law 39 West Main Street, Ste. 1 Mechanicsburg, PA 17055-6230 Phone (717) 766-9622 Phone (71 7) 766-9698 Fax (717) 795-7280 November 27,2002 Cumberland County Court House Register of Wills Carlisle, P A 17013 Dear Acting Register: Enclosed herein, in duplicate, is Family Settlement Agreement in the Estate of Eva M. Williams, No. 21-01-124 together with check #7186 issued by Frank B. Williams, Jr. to your order in the amount of $17.00. Please file the original Family Settlement Agreement and time-stamp the copy and return to me in the enclosed self-addressed, stamped envelope. I am also enclosing herewith, in duplicate, Status Report Under Rule 6.12 in the Estate of Eva M. Williams. Please insert the date you file the aforesaid Family Settlement Agreement on the original and duplicate Status Report, file the original and return the time-stamped copy thereof to me in the enclosed envelope. Thank you for your cooperation. Yours very ~l>j / /~;(~ William L. Sunday WLS/cg Enclosures 21-01-124 FAMILY SETTLEMENT AGREEMENT THE FIRST AND FINAL ACCOUNT OF FRANK B. WILLIAMS, JR., EXECUTOR UNDER THE LAST WILL AND TESTAMENT OF EVA M. WILLIAMS, LATE OF THE TOWNSHIP OF UPPER ALLEN, COUNTY OF CUMBERLAND, AND STATE OF PENNSYLVANIA, DECEASED, AND RELEASE OF THE DISTRIBUTEE UNDER THE WILL OF SAID DECEDENT HERETO ATTACHED. Date of Death: January 8, 2001 Dates Letters Advertised: Cumberland Law Journal- February 16,23 and March 2,2001 The Sentinel- February 7, 14 and 21, 2001 PERSONALTY PRINCIPAL ACCOUNT DEBITS Accountant charges himself with the Personal Property set forth in the Inventory filed in the Office of Register of Wills in and for Cumberland County in the amount of: $153987.70 Accountant also charges himself with the following: Advancements by Frank B. Williams, Jr., surviving spouse, Executor and sole legatee, devisee and distributee under the Will of said decedent, to pay debts, funeral expenses, administration expenses and taxes of said decedent. 2001 Jan 15 Paid To transfer auto title 6.00 18 Paid AT&T Universal card 89.94 26 Paid Funeral Expense 8454.88 26 Paid Medical Expense 89.61 Mar 2 Paid Medical Expense 10.39 Oct 1 Paid Additional Probate Fee and Filing Fee 210.00 Oct 1 Paid P A Inheritance Tax 231.39 Oct 1 Paid Y2 Attorney's Fee and Costs Advanced 2727.71 CARRIED FORWARD $11819.92 $153987.70 2002 Nov Paid One-halfY2 Attorney's Fee and Filing Family Settlement Agreement Total Advancements by Fr~~11iams, Jr. to pay Debts, Expenses and Taxes 2002 Oct 2 PERSONALTY PRINCIPAL ACCOUNT DEBITS (Continued) BROUGHT FORWARD $11819.92 $153987.70 2517.00 $14336.92 $ 14336.92 Register of Wills - Refund of Excess filing fee 5.00 TOTAL PERSONALTY PRINCIPAL ACCOUNT DEBITS $168329.62 2001 Jan 15 18 26 26 Mar 2 Oct 1 1 PERSONALTY PRINCIPAL ACCOUNT CREDITS Accountant asks credit for the following: $ 6.00 89.94 8454.88 89.61 10.39 1 Commonwealth of P A - Transfer auto Title AT &T Universal Card - Account Payable Cocklin Funeral Home, Inc. - Funeral Expense Internists of Central P A - Account Payable Internists of Central P A - Account Payable Register of Wills - Additional Probate fees $185.00 Filing Fee 25.00 Register of Wills, Agent - P A Inheritance Tax William L. Sunday - 12 Attorney's Fee Reimbursed costs advanced as Follows: Probate Fees $ 55.00 (2) Short Cert. 6.00 CLJ - Notice 75.00 Sentine1- Notice 87.35 Postmaster-Notice 4.36 Frank B. Williams, Jr. - Refund of Excess Filing Fee CARRIED FORWARD 2727.71 210.00 231.39 1 $2500.00 227.71 5.00 $ 11824.92 PERSONALTY PRINCIPAL ACCOUNT CREDITS (Continued) BROUGHT FORWARD $ 11824.92 2002 Feb 12 Frank B. Williams, Jr. - Reimbursement of partial Funeral expenses advanced 1935.07 Nov Nov William L. Sunday - Balance of Attorney's Fee Register of Wills - Filing Family Settlement Agreement 2500.00 17.00 Total Expenditures $ 16276.99 Accountant also asks credit for the following: Wedding ring - Interred with decedent Bracelet - Interred with decedent Clothing $ 100.00 50.00 50.00 TOTAL PERSONALTY PRINCIPAL ACCOUNT CREDITS $ 16476.99 ADV ANCEMENTS 2001 AT&T Universal Card Refund - Deposited to Joint Account 1997 Pontiac Grandam CP, 4 cyl (30) Prints of paintings painted by decedent @ $15.00 . Mac Computer $ 659.00 9375.00 450.00 $ 1368.63 TOT AL ADVANCEMENTS TO FRANK B. WILLIAMS, JR. SOLE LEGATEE, DEVISEE AND DISTRIBUTEE UNDER WILL OF SAID DECEDENT $11852.63 RECAPITUALTION PERSONALTY: Principal Account Debits $168329.62 Credits 16476.99 Total Distributable Estate $151852.63 Less: Advancements 11852.63 Balance in hands of Accountants for Distribution $140000.00 THE AFORESAID BALANCE CONSISTS OF THE FOLLOWING: First Mortgage evidenced by Deed of Trust and Promissory Note dated April 18, 1996 from Gordon L. Williams and Jill A. Williams, husband and wife, Trustors, to Eva May Williams, Beneficiary, in the amount of $140,000.00 with interest at ten (10%) percent per annum on real estate situate in the County of Washoe, State of Nevada, described as follows: Assessor's Parcel Number 077-240-18 described: Parcel 3 of division of Land Map No. 115 filed in the office of the County Recorder of Washoe County, State of Nevada, on July 19, 1989 under File No. 1337817, official records. Recorded in Book 4550 Page 0164 Balance on Date of Death $140000.00 DISTRIBUTION AND AWARD TO: Frank. B. Williams, Jr., sole legatee, devisee and distributee under Will of Eva M. Williams First Mortgage evidenced by Deed of Trust and Promissory Note dated April 18, 1996 from Gordon L. Williams and Jill A. Williams, husband and wife, Trustors, to Eva May Williams, Beneficiary, in the amount of $140,000.00 with interest at ten (10%) percent per annum on real estate situate in the County of Washoe, State of Nevada, described as follows: Assessor's Parcel Number 077-240-18 described: Parcel 3 of division of Land Map No. 115 filed in the office of the County Recorder of Washoe County, State of Nevada, on July 19, 1989 under File No. 1337817, official records. Recorded in Book 4550 Page 0164 Balance on Date of Death $140,000.00 RELEASE WHEREAS, Eva M. Williams, late of the Township of Upper Allen, Cumberland County, Pennsylvania, died on the 8th day of January, 2001, having first made her Last Will and Testament in writing on October 25, 1976, which, since her decease, was duly probated on January 30, 2001 before the Register of Wills of Cumberland County and Letters Testamentary were issued to Frank. B. Williams, Jr. the Executor named in the Will of said decedent; and WHEREAS, the said Eva M. Williams by her said Last Will and Testament gave, devised and bequeathed all her Estate to her husband, Frank. B. Williams, Jr., absolutely; and WHEREAS, Frank. B. Williams, Jr. survived the decedent; and WHEREAS, the Estate of Eva M. Williams is distributable solely to Frank. B. Williams, Jr., and the said Frank. B. Williams, Jr., has elected and does hereby elect to take the assets of said Eva M. Williams, the decedent, in kind. NOW KNOW ALL PERSONS BY THESE PRESENTS, that I, Frank. B. Williams, Jr., the sole legatee, devisee and distributee entitled to share in the distribution in the Estate of said decedent, and the only person entitled to share in . the distribution of said Estate, do hereby declare and say that I have examined the foregoing Account and Schedule of Distribution and find the same to be true and correct and in strict accordance with the terms and provisions of said Will, and do hereby acknowledge that I this day have had and received an assignment of and from Frank B. Williams, Jr., Executor of the Estate of said decedent, the First Mortgage evidenced by Deed of Trust and Promissory Note dated April 18, 1996 from Gordon L. Williams and Jill A. Williams, husband and wife, Trustors, to Eva May Williams, Beneficiary, in the amount of $140,000.00 with interest at ten (10%) percent per annum on real estate situate in the County of Washoe, State of Nevada, recorded in the official records in Washoe County, Nevada in Book 4550, Page 0164 and Book 4550, Page 0171 respectively, as set opposite my name in the above stated Schedule of Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purparts and dividends which were due, owing, payable and belonging to me and by any means whatsoever, for or on account of my full share, part or dividend of the Estate of the said decedent and all interest accrued thereon. NOW THEREFORE, I, Frank B. Williams, Jr. do by these presents remise, release, quit-claim and forever discharge the said Frank B. Williams, Jr., his heirs, executors and administrators, of and from my said share of said Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any other act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these said presents. AND, desiring to avoid the delaying and expense of the settlement of the said Estate by filing the foregoing account of said administration in the Office of the Clerk of the Orphans' Court of the Court of Common Pleas of Cumberland County, Pennsylvania, and by having the balance in the hands of the Executor, as shown by said Account, distributed by the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, do hereby agree that the foregoing statement concerning the manner of settlement may be recorded with the same effect upon me as if the same had been reported by the said Orphans' Court Division of the said Court of Common Pleas. AND, in consideration of the aforesaid settlement being made without the aid of said Orphans' Court Division of said Court that I do hereby agree that if any debts or demands other than those included within The First and Final Account of the said Frank B. Williams, Jr., Executor of the Estate of Eva M. Williams, deceased, as hereinbefore set forth, shall be hereafter recovered against the Estate of said Eva M. Williams and be legally payable out of the same, that I, . . . . . Frank B. Williams, Jr. shall return to said Executor such amounts thereof as may be necessary to pay such legally enforceable debts or demands. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .:JJ gy:. day of AIov'r:w8~ ,2002. ~ 'll UJ ~ ;tr(SEAL) rank B. Williams, Jr. ' STATE OFPENNSYLVANIA ss. COUNTY OF CUMBERLAND Before me, the subscriber, a Notary Public in and for said State and County, personally appeared, Frank B. Williams, Jr., and in due form of law acknowledged the foregoing Release to be his act and deed and desired that the same might be recorded as such. _~:;;:;~;y hand and not~~~o;eal this oO.f/ day of .... y~ (SEAL) r':',..,, .- '-,)~,' ',j v ", m'V-I,.rIOH{6-~0I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPl 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY ~ 1(:; - 2I)G Ie w t-, :w::~(I) 0."" w"O ,,00 0"'--' ..", .. " FILE NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT ~~-lLL ~~-2-A_ COUNTY CODE YEAR NUMBER I- Z W C W U W C DECEOENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) williams, Eva M. DATE OF DEATH (MM-DD-YEAR) January 8, 2001 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER 201 - 16 4938 DATE OF BIRTH (MM-DD-YEAR) June 26, 1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) '-- williams Frank B. Jr. [X] 1, Original Return D4,LimitedEstate [X} 6, Decedent Died Testate (Mach copy 01 Will) o 9. Lillgation Proceeds Received o 2. Supplemental Return D 4a. Future Interest Compromise (dale of death aftef 12.12.82) D 7, Decedent Maintained a Living Trust (Attach copy of Trust) D 10, Spousal Poverty Credit (date of death between 12.31-91 and 1.1-95) D 3. Remainder Return (date 01 death prior 10 12-13.82) D 5. Federal Estate Tax Return Required ...Q. 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AnachSch o) t-, z w o z o .. U) w '" '" o o NAME COMPLETE MAILING ADDRESS 39 West Main Street Mechanicsburg, PA 17055-6230 william L. Sunda FIRM NAME (II Applicable) TELEPHONE NUMBER (717) 766-9622 1, Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) OFFICIAL USE ONLY 3. Closely Held Corporation, Partnership or Sole-Proprietorship (1) (2) (3) (4) (5) 140000.00 13987.70 z o ~ ::J l- ii: c( u W D:: 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested (6) (7) 5142.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Total Gross Assets (lotallines 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/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (8) 159129.70 (9) (10) 14027.59 189.94 (11) (12) (13) 14217.53 144912.17 o . 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 144912.17 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o < I-' ::J Q. ::!! o U g 15. Amount of Line 14 taxable at the spousal tax 139770.17 rate, or transfers under Sec. 9116 (a)(1 ,2) x "000- (15) n 16, Amount of Line 14 taxable at lineal rate 5142.00 x"o~ (16) 231.39 17. Amount of line 14 taxable at sibling rate n x ,12 (17) n 18. Amount of Line 14 taxable at collateral rate 0 x .15 (18) 0 19. Tax Due (19) 231.39 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~.~:';~'~~.;I[}!)ITliK~,~ilJ'!'hl R1!f]~:rall ~~J!~kt..{tl,~~l ,):J..~);,'".;1!{::,'s~;~:i;~i~. jt, 1~~(\ ': .' . ~.., :~ Decedent's Complete Address: STREET ADDRESS ______.._..102J1.essiah Villaae P. O. Box 2015 ~1echanicsbura I STATE PA I ZIP 17055-2015 -CITY -- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 231. 39 o o o Total Credits (A + B + C) (2) () 3. InteresUPenalty if applicable D. Interest E. Penalty o o (3) (4) (5) (5A) (5B) 4. TotallnteresUPenal1y ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT, Check box on Page lUne 20 to request a refund o 5. If line 1 + line 3 is greater than Line 2, enter the difference. This is the TAX DUE. ::>,1 ,'l A. Enter the interest on the tax due. () B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. ::><1 ,'l Make Check Payable to: REGISTER OF WILLS, AGENT r":~7:"'~1w:'~~f~'~^~~~~:~~~V;~"~~'i",:..',"'!"''''\!it'mJr''",,'''''f'l/~\'f~,~~:I,..,!,\,.i""i"~' ".,,,......,,',...l.,.,_~__m__",T' ,.. PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS * Except as an 1ncident of J01nt 1 Did decedent make a Iransfer and OWnership Ves No a retain the use or income of the property transferred, . ... . .... D [Xl * b. retain the right to designate who shall use the property transferred or its income; ................ ................... D [XJ * c. retain a reversionary interest; or.. ......... .............. .............. .................. ..... . 0 [XJ * d. receive the promise for life of either payments, benefits or care? ...... ........... .................................... .. 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..... ... ........................................... ............................ [Xl 0 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. D [X] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ................ ........... ........ .............. IX] D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaralion of preparer olher than the personal represenlalive is based on all information of which preparer has any knowledge ADDRESS DATE Se t "hr 2001 Box 2015, Mechanicsburg, PA 17055-2015 DATE .:?? ADDRESS 39 W~Rt Main Street. Mechanicsburq. PA 17055-6230 '~";:-.'n,'" ....,-. ',,!.,-~ '~~:;"'01:~3-t~r\VF"'!.';r.K"j~/:~;:;r1"73r;$l'fJ,1~~~'.lv_":'l"<r~~I~.~,. ~~._., ~__~~~"_..._u _.~ _ ~...... For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS ~9116Ia) (1.1) (i)]. For dales of dealh 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 PS. 99116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The lax 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. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(I)]. The tax rale imposed on the nel value of transfers 10 or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ""~""""'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE D MORTGAGES & NOTES RECEIVABLE Eva M. williams FILE NUMBER 21-01-0124 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 VALUE AT DATE OF DEATH DESCRIPTION First Mortgage evidenced by Deed of Trust and Promissory Note dated April 18, 1996 from Gordon L. Williams and Jill A. Williams, husband and wife, Trustors, to Eva May Williams, Beneficiary, in the amount of $140,000.00 with interest at ten (10%) percent per annum on real estate situate in the County of Washoe, State of Nevada, described as follows: Assessor's Parcel Number 077-240-18 described: Parcel 3 of division of Land Map No. 115 filed in the office of the County Recorder of Washoe County, State of Nevada, on July 19, 1989 under file No. 1337817, official records. Recorded in Book 4550 Page 0164 Balance on Date of Death $140,000.00 TOTAL (Also enter on line 4, Recapitulation) $ 140,000.00 (If more space is needed, insert additional sheets of the same size) <J.., REVI50BEX,!1911 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva M. williams FilE NUMBER 21-01-0124 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 DESCRIPTION VALUE AT DATE OF DEATH 1. Checking Account #5000001719 in PNC Bank N.A. in individual name of Eva M. Williams Balance on Date of Death Accrued Interest $ 1935.07 0 9375.00 659.00 100.00 50.00 450.00 50.00 1368.63 2. 1997 Pontiac Grandam CP, 4cyl 3. AT&T Universal Master Card - Credit Balance 4. Wedding Band (buried with decedent) 5. Bracelet - (Buried with decedent) 6. (30) Prints of paintings painted by decedent @ $15.00 7. Clothing 8. Mac Computer purchsed May 8, 2000 - Valued @ purchase price Paid from joint bank account . TOTAL (Also enler on line 5, Recapitulation) $ 13987.70 (If more space is needed, insert additional sheels ot the same size) REV-1510 EX.j- (2.871 <,>,:!.~ #>....,:.,-~4,'-t\ ''''',e~.'h COMMONWEAllH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G TRANSFERS Jo~o!'o""o'''o"''''3''~ FILE NUMBER ESTATE OF Eva M. williams __________ ___2l--Ql~l.2~L.__________..___ THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OFTHE COVER SHEET IS YES. ""~:'" I "",h_ .." ,:::;;:::::.:~:'%,.,,~::::::::: ';;''''0"' . '';jt~iff~;- 81,\'t\i\I!~\ 1. Lump sum death payment from Social Security Administration paid to Frank Williams, husband of decedent. $ 255.00 . Exempt from tax 2. Prorated payment from Commonwealth of Pennsylvania Public School Employees' Retirement System paid to Frank Williams, husband of decedent, beneficiary. 273.57 Exempt from tax 3. ash gifts from separate account of decedent to Paul Williams, grandson f decedent, wi thin one (1) year of ate of death and in calendar year as follows: DEC'd % $ VALUE OF DEC'd INT. INTEREST 2/02/00 100 % 500.00 3/14/00 100 % 2000.00 4/26/00 100 % 2000.00 6/26/00 100 % 1000.00 8/01/00 100 % 1000.00 9/ /00 100 % 1500.00 TOTAL $8000.00 $3000.00 8000.00 100% $5000.00 CARRIED FORWARD S 5000.00 (If more space ;s needed, insert additional sheefs of same size.) q. REV-1510 EX+ {2-87) ,,~)9;9l\ .', ~\~f:;,.,.. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~~~~=~~~"'" "''' O. "" _~~ ~. -- ------------------FILE-NUMBER----- --~-- ESTATE OF Eva M. williams 21-01-0124 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPTION OF PROPERTY - - - EXCLUSION TOTAL VALUE ._-__DE~~~~lE~~6t~if,~--- NUMBER Include name of the transferee, their reJation~~~_~~e of transfer. u .____ __ OF AS~_~_!.-__. __.JNL_J~ INTERESI____ $ 5000.00 Cash gifts from separate account of decedent and from joint account of decedent and her husband to Gordon Williams, son of decedent, within one (1) year of date of death and in calendar year 2000. DATE DOC'd % INT. 4. $ VALUE OF DED'd INTEREST 4/24/00 100 % $1000.00 6/09/00 100 % 300.00 9/16/00 100% 546.00 12/1/00 100 % 546.00 Sub-total $2392.00 9/01/00 50 % 250.00 12/11/00 50 % 500.00 As TOTAL $3142.00 $3000.00 3142.00 Shown 142.00 5. Cash gifts from separate account of decedent to Eric williams, grandson of decedent, within one (1) year of date of death and in calendar year 2000. DATE DOC'd % $ VALUE OF DOC'd INT. INTEREST 1/02/00 100 % $1000.00 5/13/00 100 % 250.00 TOTAL $1250.00 $1250.00 1250.00 100 % 0 6. Cash gift from separate account to Gretchen Williams, wife of grandson, within one (1) year of date of death and in calendar year 2000. DATE OOC'd % $ VALUE OF DOC'd INT. INTEREST 5/13/00 100 % $ 250.00 $ 250.00 250.00 100% o _ c:l\IffiIE;IJ...fQRWARD ____ lIDlIIUl'lr""''''''''',",_''''''''~ S (If more space is needed, inserf additional sheets of some size.) 5142.00 REV-ISlO EX+ (2.87\ ".'h~~ ''''....'~J/j_::-- COMMOr"WEAW-t OF PENNSYlVANIA INHERIfANCE lAX RETURN RE~ID~~! I?~~~~~~!__ ___ EST ATE OF 1 SCHEDULE G TRANSFERS ...=_.~.~c~=.,d~ThlI1FJl) L_ Nm, '''"' o. ~" FILE NUMBER Eva M. williams21-DI-D124 --,---_.. -- - ---,------.,.----~ ----.,---------,-----.. THIS .SCIlEf:)U.LE.".IUSI.BE COM!LETED.~ND .filED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM OESCR\PTlON Of PROPERTY NUMBER Include /~a~_~_~'Yl~ ~r~~s.!.~~~__~~~~!.~a.'~n$hip /0 dece.~en'J ~~_'~~.f 'ransfer, _ EXCLUSIO BROOGIIT FORWARD .7. Cash gift from separate account to Jennifer Foreman, granddaughter, within one (1) year of death and in calendar year 2000. DATE DOC'd % $ VALUE OF DOC'd INf. 1NTERFSf 2/12/00 100 % $ 50.00 5 O. 8. Cash gift from separate account to Steve Foreman, husband of granddaughter, wi thin roe (I) year of death and in calendar year 2000. DATE DOC'd % $ VALUE OF DOC'd INf. IN'l'EREST 2/12/00 $ 50.00 100 % 9. Cash gift from separate account to Kimberly Lee, son's step-daughter, within one (1) year of death and in calendar year 2000. DATE DOC'd % $ VALUE OF DOC'd . INf. INTEREST 4/10/00 $200.00 200. 100 % 10. Cash gift from separate account to Tyler Capp, grandson, within roe (l) year of death and in calendar year 2000. DATE DOC'd % $ VALUEi.OF DEC'd INf. IN'l'EREST 4/20/00 100 % $500.00 500. 50. TOTAL VALUE DECO. DOLLAR VALUE N % OF DECEDENT'S OF ASSET .l!iL..... INTEREST $ 5142.00 00 50.00 100% 0 00 50.00 100% 0 00 200.00 100% 0 . . 00 500.00 100% 0 s 5142.00 CARRIED~~ (If mote space is needed, inser' addilional sheals 01 same size.) REV.1510 EX+ 12.871 ~'E:;~;~ COMMONWEALTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G TRANSFERS cJ~~} J -----",,," "'!'IQ'c~~coccc~~ FILE NUMBER ESTATE OF Eva Williams 21-01-0124 - ._------_.._._~------ -----~_._--~-~_._- ---~--------_....._---_._.,."--- THIS SCHEDULE MUST BE COMPLETED AND FILED IFTHE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OFTHE COVER SHEET IS YES. -- _._._----_._------_._._------~--.,_.._--- - -_.--- ~-"'_._-------_._~--- ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECO. DOLLAR VALUE EXCLUSION % Of DECEDENT'S NUMBER Include nome of the transferee, th~i~_,:_I~_t~o~~~ip to dec~~~~~~ ~~!:~I transfer. ___ ___~_~S~~!______ ____!NT,__ I,,:!!EREST__ BRaJGRT FCHWID $ 5142.00 11. Cash gifts from separate account of decedent and from joint account of decedent and her husband to Lucy Capp daughter, within one (1) year of death and in calendar year 2000 as follows: DATE OOC'd % $ VALUE OF DOC'd INT. INTEREST 6/00 100 % $ 250.00 6/28/00 100 % 500.00 Sub-Total $ 750.00 6/10/00 50 % 250.00 12/23/00 50 % 800.00 As TOrAL $1800.00 $1800.00 $1800.00 Shown 0 12. Cash gifts from joint account of decedent and her husband to Kevin Capp, son-in-law, within roe (1) year and in calendar year 2000. DATE OOC'd % $ VALUE OF OOC'd !NT. INTEREST 8/05/00 12/23/00 50 % 50 % TOrAL $ 250.00 800.00 $1050.00 $1050.00 $1050.00 50% o 13. Cash gift from separate account of decedent to Savannah Lee, daughter of son's step-daughter within one (1) year of death and in calendar year 2000. . DATE DOC'd % INT.. $ VALUE OF OOC'd INTEREST 12/01/00 100 % $ 100.00 $ 100.00 $ 100.00 100% o CARRIED FORWARD s 5142.00 (If more space is needed, insert additional sheets of same S;20.) REV 1510 EX+ (2-871 't.,t" h.1.,,\;jn\')\. .,. '''~~!:;'''' COMMONWEAlTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G j TRANSFERS .. (q:mlNUJIDL___ PLEASE PR!f'i.~_~YPE_~~ . .... -.------.FiLE'NUMBER.--- ESTATE OF Eva M. Williams 21-01-0124 THIS SCHEDULE MUST BE COMPLETED AND FilED IF THE ANSWER TO ANY OF THE QUESTiONS ON THE REVERSE SIDE OF THE COVER SHEET is YES. --------_._-------~._.~~.- --... ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DEo~D. g~~V~~ci:~V,~ NUMBER 'nclude name of the tronsferee, their relatianship'o decedent, date _~~.~~~~~~~:.. _________ _---.?!. ASSE~_ __ ~_JNT..__._ _.__ INTEREST $ '5142.00 14. BRaJGIIT FCRWARD Cash gift from separate account of decedent to Asia Lee, daughter of son I s step-(laughter, wi thin one ( 1) year of death and in calendar year 2000. DATE DElC'd % INT. $ VALUE OF DOC'd INTEREST $ 100.00 $ 100.00 $ 100.00 100% o 12/01/00 100 % 15. Cash gifts from separate account of decedent and fom joint account of decedent and her husband to Alan Williams, son, within one (1) year of death and in calendar year 2000 as follows: DATE, DOC'd % $ VALUE OF DOC'd INT. INTEREST 8/01/00 10/01/00 12/01/00 100 % 50 % 50 % TCIl'AL $1000.00 250.00 750.00 $2000.00 $2000.00 $2000.00 As Shown o 16. Cash gifts from joint account of decedent and her husband to Nancy Williams, daughter-in-law, within one ( 1) year of death and in calendar year 2000. DATE DOC'd % $ VALUE OF DOC'd INT. INTEREST 8/23/00 50 % $ 250.00 12/01/00 50 % 750.00 TCIl'AL $1000.00 . . $1000.00 $1000.00 50% o ________ TOTAL (Also e_n..!.~.r":,~ line 7, Recapitulation) $ 5142.00 (If more space ;s needed, insert additional sheets o{ some size.} REV-1511EX'11-97) '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva M. Williams FILE NUMBER 21-01-0124 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Cocklin Funeral Home, Inc. - Funeral Expense $ 8454.88 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 Ci~ Slate Zip Year(s) Commission Paid: 2. Attorney Fees 5000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ci~ Slale Zip Relationship of Claimant to Decedent 4. Probate Fees 55.00 Register of wills - Additional Probate Fee 185.00 5. Accountant's Fees . 6. Tax Return Preparer's Fees 7. Register of wills - (2) Short Certificates 6.00 8. Cumberland Law Journal - Executor's Notice 75.00 9. The Sentinel - Executor's Notice 87.35 10. Postmaster - Mailing Notices to heirs 4.36 II. Charlyn Y. Guerriero - Notary Fees 10.00 12. Register of wills - Filing PA Inh. Tax Return and Inventory 25.00 13. Reserved for Filing Account 125.00 TOTAL (Also enter on line 9. Recapitulation) $ 14027.59 (If more space is needed. insert additional sheets of the same size) Il:EV.1S~931 . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Please Print or Type FILE NUMBER 21-01-0124 COMMONWEALTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva M. wiliams ITEM NUMBER DESCRIPTION AMOUNT 1. AT&T Universal VISA Card - Account Payable $ 89.94 2. Internists of Central PA Ltd Account Payable 89.61 3. Internists of Central PA Ltd Account Payable (1/8/01) 10.39 . TOTAL IAlso enter on line 10, Recapitulation) $ 189.94 (If more space is needed, insert additional sheets of same size.) nrvl~l)n '(1 ~') ~J' COMMONWEAlTH OF PEUNSYlVAlllA II~IIERITANCE lAX RETUI1tI RESIDENT OECEOEIH ESTATE OF Eva M.Williams SCHEDULE J BENr:FICIARIES FILE NUMBER 21-01-0124 -- -- RELATIONSHIP TO DECEDENT AMOUIH OR SHARE NUMRER NAME ANU ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Truslee(s) OF ESTATE --- I-T AXABLE DISTRIBUTIONS (include oulrlgl1l spousal dlslrlbullons) '- 1. Frank B. Williams, Jr. Spouse (Husband) Entire probate 100 Mt. Allen Drive Estate Messiah village - Apt 705 All Joint Property P. O. Box 2015 Transfers (Sch G Mechanicsburg, PA 17055-2015 Item 1 and 2) 2. Paul williams Grandson Transfer (Sch G 4440 Washington Street Item 3) $5000.00 Apt 1 L Boston, Mass 02131 3. Gordon Williams Son Transfer (Sch G 3355 wilcox Ranch Drive Item 4) $142.00 Reno, Nevada 89510 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 1'- NON-TAXABLE DISTRIBUTIONS A SPOUSAL DISTRIBUTIONS UNUER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. . . B. CHARIT ABLE AND GOVERNMENT AL DISTRIBUTIONS 1. . TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space Is heeded, Insert addillonal sheets of the same size)