HomeMy WebLinkAbout01-0210
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
/t,-02IL - q
REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
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"1......
7"",
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
February 17, 2001 January 6, 1944
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Day, Arthur R. III
~ 1. Original Return
o 4. Limited Estate
Q 6. Decedent Died Testate (Attach copy afWill)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date ofdealh between 12.31.91 and 1-1-95)
FILE NUMBER
2 1 0 1
o 2 1 0
COUNTY CODE
YEAR
NUMBER
SOCIAL SECURITY NUMBER
186
- 34
0091
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME
COMPLETE MAILING ADDRESS
FIRM NAME {If Applicable)
Market Square Building
Mechanicsburg, PA 17055
OFFICIAL USE ONLY
(8)
$18,974.92
TELEPHONE NUMBER
(11)
(12)
(13)
I. Q~,) ()()
.
$14,112.92
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5) $1R,Q74 Q?
(14)
$11.,112 92
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Reques
er Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(I)
o
o
(6)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9) 4.862.00
(10)
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 not been
made (Schedule J)
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 tax
rate, or transfers under Sec. 9116 (a)(1.2)
$14.11? 92
x.O_ (15)
x.O_ (16)
x .12 (11)
x .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUNO OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
200 Greenwich Drive
CITY Me~honi~sh"ra I STATE I ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
o
Total Credits (A + B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
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PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves No
a. retain the use or income of the property transferred;..... ....................................... .................. ......................... D w
b. retain the right to designate who shall use the property transferred Dr its income; ........ ...................... D w
c. retain a reversionary interest; or............. ......w....... uun"'>m",. ................. ................ ...................................... 0 IXJ
d. receive the promise for life of either payments, benefits Dr care?.... ................. ................ ................ ............. D w
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ..... .................................. ................... ................. .................. ............ D IX]
3. Did decedent own an "in trust for' Dr payable upon death bank account Dr security at his Dr her dealh? .............. D IKJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .............. ............................ ....................................... ..................... [ig 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 peTjury, I declare that J have examined this return, inc1udil1g accompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct
and complete.
Oedaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
RSON RESPONSIBLE FOR DATE
4
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DATE
fA.
For dates of death on Dr aner July 1, 1994 and before January 1, 1995, the tax rate imposed on the net vaiue of Iransters to or tor the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or aner January 1, 1995, the tax rate imposed on the net value ot transfers to Dr for Ihe use of the surviving spouse is 0% [72 P.S. ~9118 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if
the surviving spouse is the only beneficiary,
Far dales of death on or aner 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,
Dr a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The tax rale imposed on the net vaiue 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. ~9118(a)(I)].
The lax rale imposed on the net value of transfers to Dr lor the use of the decedent's siblings is 12% [72 P.S. ~9118(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with Ihe decedent, whether by blood Dr adoption.
fWV-l508 EX + (1.971
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEOENr
ESTATE OF
FilE NUMBER
Virginia B. Day
21-01-0210
Include the proceeds of I!tigatkm 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
VALUE AT DATE
OF DEATH
PNC Bank, Account 51-4016-4016-4368, see attached
$ 1,244.36
2.
Surgical Physicians, Refund
10.00
3,1
1996 Mitsubishi 3000 GT SL Coupe 2D, see attached
14,850.00
4.
Pinnacle Health Hospitals, unpaid compensation
2,870.56
TOTAL (Also enter on line 5. Recapitulation) $18,974.92
(If more space IS needed, Insert additIonal sheets of the same slze)
Express Checking Account. St.at.ement.
PNC Ballk
o PNCBAN<
Primary accollnt number: 51-4016-4368
Page 1 of 1
For the period 02107/2001 to. 03/0812001
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Number of enclosures: 0
Q
VIRGINIA B DAY
200 GREENWICff DR
MECffANIC5BURG PA 17055-6858
'U' For 24-hour customer service or
clIrrent rates: Call 1-888-PNC.BANK
~ Write 10: Customer Service
PO BQX 609
Pill' burgh PA 15230-9738
!it Visit us at www.pncbank.com
iii TOD terminal: 1-800-531-1648
For hearing itnp:lired dknts on'~'
0111' <1IlIltlal Priraf:Y Policy 51"1(':111('111 is (,lIdosed. Pl(':aSt~ IT,'jew it to lhul out how we use your Cinandal
alff.! pC'l"sol1al iufol'lIl<lliotl to hdp you reach YOUf goals.
Express Checking Accollnt SlImmary
Account number: 51-4016-4368 Account link ~ mnnber: 0186340091
Virginia 8 Day
Please see the Activity Detail section for
additional information.
Bala..ce Summary
Beginning
balance
~l-19..17
Deposlls and
other additions
29.Um
Checks and other
deductions
6.00
EndIng
balance
1.238.36
Average: monthly
balance
J,155.G9
Charges
and feu
(i.OO
Activity Detail
Depo..it.. a..d Otlaer Additio....
Dale Amounl Descrlplfon
02/ lG 29.t8~l DinT' l)qJOsil . Dil" ~t'P Pilln;lt'le B(,OlJlh 0000:17
There was 1 Deposit or Other Addition
totaling $294.89_
Ottoer Deduction..
Dale
03/08
03/03
Amount
5.00
1.00
Description
Service Ch:llJ!c
COllln'lled Check Rr!lllll Fee
There were 2 Other Oeductions totaling
$8.00.
Daily Bala..ce Detail
Dale
02.-'07
B"fan(,E!
9.H)..t7
Dale
O~,/IG
Balance
1.2.H.3G
Dale
03j08
Balance
1.238_36
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,",.triahle or llxed anlluity, and (01111'01 wh(,1I yot! pay taxes 011 YOllr earnings, Learn 1II0re abutH irn'eslillg ill allllUities by
nmLwling a l'NC lhok(,l~tge COI p hIH'~lllletl1 C(lm.ttllalll 10 s('1 lip a fn'<, no-uhligalion ("'ollsuhatioll. PNC BrokentJ{<' h"'<'51111('ot
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,my PNC aallk hriH1ch ollir(".
Kelley Blue Book Used Car Values
.. aten... BI... Book
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'<;ft~, Family Fo,....d-Mercu,...y\""''.\','~''
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CtItli91e, I'd ~ .,., ,~
Click 011 the image above 10 visillhis Rdverliser
Ulll'! U\",I( 1",llln.11l l~f~I''',1
Pennsylvania' March 15, 2001
1996 Mitsubishi 3000GT SL Coupe 20
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Engine: V6 3.0 Liter
Trans: Automatic
Drive: Front Wheel Drive
Mileage: 42,000
Equipment
Air Conditioning
Power Steering
Power Windows
Power Door Locks
Tilt Wheel
Cruise Control
AM/FM Stereo
Cassette
Premium Sound
Dual Air Bags
ABS (4-Wheel)
Leather
Consumer Rated Condition:
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Financing QuotE!
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Power Seat
Sliding Sun Roof
Rear Spoiler
Alloy Wheels
Excellent
"Excellent" condition means that the vehicle looks great, Is in excellent
mechanical condition and needs no reconditioning. It should pass a smog
inspection. The engine compartment should be clean, with no fluid leaks. The
paint is glossy and the body and interior are free of any wear or visible defects.
There is no rust, The tires are the proper size and match and are new or nearly
new. A clean title history is assumed. This is an exceptional vehicle.
Trade-In Value
$14,850
Trade-in value represents what you might expect to receive from a dealer for
this consumer owned vehicle. Keep in mind that the dealer must then absorb
the cost of making the vehicle ready for sale, advertising, sales commissions,
arranging financing and insurance and standing behind the vehicle for any
mechanical or safety problems.
Now get a new car price report of the car
you are thinking about purchasing next.
CopyrIght @ 2001 by Kelley Blue Book Co., All Rights Reserved. Mar-Apr 2001 Edition, fhe Information
in this report was printed from the Kelley Blue Book Web site (www.kbb.com) and Is Intended for the
htlp ://www.kbb.com/kb/k i .dll/kw .kc.ur?kbb;OJ I 747 &;l&39&6;M!;G2&
03/IS/200!
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER. VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
Virginia B. Dav
71-01-0710
This schedule must be completed and filed if the answelto any of Questions 1lhrough 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1.
DESCRIPTION OF PROPERTY
jM(.uJ[)fni~NI\ME0I1KF lRJ\N$FERFE, THEIRRELAlic1N?,II'f'lOOECEUENT AND THE D~Tr 'JF TRANSFER
AlIACHACOPYorIHFDrWH1RRfA( {S\~1F
DATE OF DEATH
VALUE OF ASSET
%OF
DECO'S
INTEREST
EXCLUSION
IFi\PPlICABLEi
TAXABLE VALUE
Vanguard Growth Index Fund Inv.
No. 09916996225 - beneficiary named on
account is Arthur R. Day, III, husband
$5,570.46
100
100
None
TOTAL (Also enteron line 7, Recapitulation) $
(If more space is needed, Insert additional sheets of the same sIze)
: /i:1 ~) ~- /
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THE.Vanguacd:iROUr.
ARTHUR R DA Y /I[
200 GREENWICH DR
MECHANICSBURG, PA 17055-6858
March 20, 2001
Growth Index Fund Inv
09916996225
Dear Mr. Day:
Please accept our sincere condolences on your loss. We are responding to your letter
requesting the account value for the above referenced account registered to Virginia B. Day.
As ofFebrumy 16,2001, the Illllnber of shares, the price per share, the value oflhe account,
and the accrued dividends (if applicable) were as follows:
Fuud
Sh3l'es
Price
Value
Accrued
Divideuds
N/A
Growlh Index Fund Inv
188.829
$29.50
$5,570.46
For more infOlmation please visil our website at www.Vanguard.com. You can also call
our Client Services Department al 1-800-662-2739. An Associate will assist you.
Sincerely,
Client Services Deparlment
ksr
00569942
Pn~l OnitT Bo'{ 2()OO, \'alle.\' Forge. PCl1lls.\-kania 19.,R2-26oo
('10 ('(H)-IOOO' \\'\\"W.\':111J..!;\l:Inl.nllll
REV-1511 EX+ (12-99) _
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Virginia B. Day
21-01-0210
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Cremation Society of Pennsylvania $1,145.00
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Aepresentalive(s)
Social Security Number(s)/EIN Number of Personal Represenlative(s)
Street Address
City ___._____._____._____...__'______ _ State ____ Zip
Year(s} Commission Paid:
2. Attorney Fees 125.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation} 3,500.00
Claimant Ar,..hl1T R n.:::ty TTT
Street Address 700 ~r~p.nfJirh nritTP
City Meehan!Ga~, State -FA- Zip 170~~
Relationship of Claimant to Decedent hl1!'::hAnn
4. Probate Fees 77.00
5. Accountant's Fees
6. Tax Re1urn Preparer's Fees
7. Filing Fees 15.00
TOTAL (Also enter on line 9, Recapitulation) $4,862.00
Debts of decedent must be reported on ~hedu'e 1.
(II more space is needed, insert additional sheets of the same size)
R€II-\SlJE:<.p-97)
'*
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEOENT
ESTATE OF
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Us! Trustee(s) OF ESTATE
l. TAXABLE DISTRIBUTIONS (include outrighl spousal dislributions)
1. Arthur R. Day III Husband Entire Estate
200 Greenwich Drive
Mechanicshurg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
- ~ ._~
Virginia B. Day
21-01-0210
(If more space is needed, insert additional sheets 01 lhe same sIze)
I)ETITION FOn l)nOnATE and GRANT OF I ~TTERS
~I"'O I-J-LO
E<;tate of Virginia B. Day
also known as
No.
To:
Register of Wills for the
, Deceased. County of Cumberland in the
Social Security No. 186-34-0091 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or
in the last will of the above decedent, dated Ol'tnhpr 10
and codicil(s) dated
named
, 19 fiQ
(state relevant circumstances, e.g. renunciation, death or executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
ILer last family or principal residence at 200 Greenwich Drive. Mechanicsburg.
(H~m~rlpn TownRhip)
(list street. num"er and muncipality)
Deceildent, then --3L_ yeats of age, died February 17 2001
at Harrisburg HOSp-ttfll, H<1rrisbllrg, PA - .
Except as follows, decedent did not marry, was not divo, ced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property wi !J 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 estale in Pennsylvania
situaled as follows:
$25,000.00
$
$
S
None
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
preo;ented herewith and the grant of letters testamentary
(testamentary; administration c.I.a.; administration d.b.n.c.l.a.)
theron.
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III
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Mechanicsburg. PA 17050
OATH OIl I)EltSONAL ltEl)ltESENTATIVE
COMMONWEAI.JTH O"~ IlENNSYL VANIA } ss
COUNTY OF cumberland
The petitioner(s) above-named sweaH~) or affirm(s) that the statements In the foregoing petition are
true and correctlo the !'~st or the khowledge and belief of petilioner(s) and tlHlt as personal represen-
tative(s) of the above decedent petitioner(s) will well and trul/administer t tale according to law.
~~ /
Sworn to or affirmed and subscribed C ,/ ~
before \lie lhis 21st daY-Ooll
February l~ "L 0
~
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No.
21-2001-210
Estate of
Virginia B. Day
, Deceased
DECUEE O}-' I'RODATE AND GItANT OF LETTERS
AND NOW February 22, ~ 2001 in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated O~t:nh~r 10, 1 qfiq
described therein be admitted to probate and filed of record as the last will of
Virgini;:! R n.qy
and Letters 1'p~t:.qmpnt:.qry
are hereby granted to Arthur R. Day III
~!~
~
Lewis ~
FEES
X-Pages (0)
~
$ 60 .00
$ 9 .00
$
$
TOTAL _ $
febr:tJi;lry. .22oo.,.200l . . . . . . . . . . . . .
Probate, Letters, Etc. .........
Short Certificates(3) . . . . . . . . . .
Renunciation ......... .?:t;:-R . .
S.t;)l\
-0-
74.00
ATTORNEY (SuI?' CL t.b. No.)
John M. Eakin ff6351
Market Square Building, Mechancisburg, PA 17
ADDRESS
Filed
717-7fi6-1172
PHONE
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MAIL LETTERS 'IO ATI'ORNEY
This is to certifY that the information here given is. correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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(l"';t!2v .-".,. 0 ~ ~
~.~..V?(/ ~ ~I "~~?-";;''':t~d'''~;/:?~'' tP___*'
,/
Local Registrar 0'
Fee for this certificate, $2.00
p
7176988
FES 1 q 200f
Date .
21-2001-210
IS.;43 Rev. 2187
COMMONWEALTH Of PENNSVLVANIA . OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAME Of DfCEDENllhsr. MiQdIa!, last
I.
SEX
STAlE FILE NUMBER
SOCIAL SECURity NUMBeR
3. 186 -
8lRTHPlACE 1C.ty ar4
Stal60l'rCfeq'lCQOt\Uy) PA
MARtTAI. STATUS._
Never Manied. W'tdowed.
~lSl>oc"'tl
". MaJl.Jl.-ied AJr.thWl. R. Va.
11e.o .....--.._.. Hampden TwP.
III
.711.
Cumbvr.,ea.nd
l);d
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Mina
-..nip?
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""Y-
2:1c.
LICENSE NUMBER
Ill-Oc. \
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I inlerv.I~
: 0ftMt and duIh
I
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NeD
PART n: OIIlorsigni/lconl_ ccnI1iIIul;ngro...... but
not ~ in the undeftying caw. given in PART I.
Se#r/5
DuE '<<l\OR AS A CONSEOUENCE Of):
lb.
e.
d.
WERE AUlOPSY FINDINGS
~E PRlOA 10
COMP\.ETlOH OfF CAUSE
OF DEAl'H?
DuE 10 \OR ASA CONSEOUENCE Of):
DuE 10 \OR AS ACONSEOUENCE Of):
....0
MANNER OF DUrH
Nol",oI 8"" Homicidll 0
Accidenl 0 Pending 1nwaI~ 0
-... 0 Could noli be determined 0
!lATE OF INJURY
(Monlf'I. Day. Yeat)
TIliE OF INJURY
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I~I/~II( I
WILL OF VIRGINIA B. DAY
I, VIRGINIA B. DAY, of 7 Richland Lane, Camp Hill, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
Item 1. I direct that my just debts and funeral expenses be paid by
my hereinafter named executor as soon after my death as may be found convenient.
Item 2. I direct that all taxes that may be assessed in consequence of
my death, by whatever nature and by whatever jurisdiction imposed, shall be paid
as a part of the expenses of the administration of my estate.
Item 3. I devise and bequeath the residue of my estate of every
nature and wherever situate to my husband, Arthur R. Day, III, providing he shall
survive me by sixty days.
Item 4. Should my husband, Arthur R. Day, III, predecease me, or die
on or before the sixtieth day following my death, I devise and bequeath fifty per
cent of my residue to be divided equally among my brothers Stanley F. Bender and
Marvin L. Bender and my sisters, Elaine A. Bahn and Winnie J. Bender. The remain-
ing fifty per cent is to be divided equally among my husband's brothers, Donald A.
Day and Douglas R. Day and my husband's sister Marjorie A. Day.
Item 5. I appoint my husband, Arthur R. Day, III, as executor of this
my last will. Should my husband, Arthur R. Day, III, fail to qualify or cease
to act as executor, I appoint Douglas R. Day, as executor of this my last will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of
()c/c-I~ 30
, 1969.
-z. /, . . . B. Oa.;;--
'/.-7/~ ..11
(SEAL)
The preceding instrument, consisting of one typewritten page, was on
the day and date thereof signed, published, and declared by Virginia B. Day, the
testatrix therein named as and for her last will, in the presence of us, who at
her request, in her presence, and in the presence of each other have subscribed our
names as witnesses hereto.
aI-}, ~4
~
ItEGISTEU 01;' WILLS OF CUMBERLA COUNTY
OATH Of' SUDSCRIIJI WITNESS
codicil
(each) a subscribing witness to the will pr ented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat , sign the same an hat signed as a witness at the
reqUest of testat in I resence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and s
scribed before
day of
19
(Name)
me this
/
/
/
/
/
./
(Address)
Register
(Name)
I'
/'
(Address)
/
21-2001-210
REGISTER 01..' WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Elaine A. Bahn and Winifred J. Bender
~KJC~i\aX~ (each) being duly qualified according to law, depose(s) and say(s) that
they :::ire familiar with the signature of Virginia B. Day
~
testat rix of :(onc<:~ooot:kJt:xmIN:nm~~lll!~otl!l~ the will
that
p.<!ch
presented herewith and
~
believes the signature on the will is in the handwriting of
Virginia B. Day
to the best of t'hpi r knowledge and belief.
Sworn to or affirmed and subscribed before (J,) (~~-{ ..AL'-J ~ ~/\.
me this 21st day of (Name) /IOg)
Februa n-2}llLl .. /d.-YO )//Yl/$~ Vlt;:z-JJ::>I(' m5{H"7-.1}t(~lVe6 A
~~~p~ d'(7t~~
(Name)
r,) G (-f/ -h9-k -Lf$ ~ dV;
(Address)
~-~./ /~
~~-.~ /)> \).) f
f
------
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Names of Decedent: Virginia B. Day
Date of Death: February 17,2001
Will No. 2100f2001
To the Register:
I certify that notice of beneficial interest required by Rille 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
October 11, 2000.
Name
Address
Marvin L. Bender
Winifred J. Bender
Elaine A. Bahn
Audrey Lyter
Carol E. Kabakjian
Donald A. Day
Marjorie A. Hamlett
401 Emerald Lane, Carbondale, IL 62901
1240 Timberview Drive, Mechanicsburg, P A 17050
936 Woodbridge Drive, Enola, P A 17025
RR #1, Box 54, Chicken Hollow Road, Newport, PA 17074
17 Lewis Avenue, East Lansdowne, P A 19050
10612 Sourwood Court, Laurel, MD 20723
914 Cabriole Court, Eugene, OR 97401
Date: February 23, 2001
Notice has now been given to all persons entitled thereto un
Name: John M. Eakin
Address: Market Square Building
Mechanicsburg, P A 17055
Telephone: (717) 766-3172
Capacity:
Personal Representative
_x_ Counsel for Personal
Representative
\, /b-~/~- 9
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~~.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESS"ENT OF TAX
JOHN MEAKIN
MARKET SQUARE BLDG
MECHANICSBURG PA 1705.5
\...'c._'
--I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
"I ,C?OUNTY
'. -ACN
05-29-2001
DAY
02-17-2001
21 01-0210
CUMBERLAND
101
*'
REV-1547 EX Afp (12-111
VIRGINIA
B
AmO\B'lt Remi Hed
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 ~
REY=is4j-EX-AFP-n'2-:0()r-NC)YiCE--OF-YtiHEififANCE-YAx-A"PPRA"isEi"ENT~--AL1-oiAi"-cE-oR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DAY VIRGINIA B FILE NO. 21 01-0210 ACN 101 DATE 05-29-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. "ortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/"isc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
18,974.92
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad.. Costs/"isc. Expenses (Schedule H)
10. Debts/"ortgage 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
(9)
(10)
4,862.00
.00
(11)
(12)
(13)
(14)
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. AmO\B'lt 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: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
18,974.92
4.86? 00
14,112.92
.00
14,112.92
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
14,112.92 X 00 =
.00 X 045 =
.00 x 12 =
.00 x 15 =
(19)=
.00
.00
.00
.00
.00
PAY"ENT RECEIPT DISCOUNT (+) A"OUNT PAID
DATE N~BER 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 PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR), YOU "AY BE DUE
.l RFFlINn. !':.FF RFUFR!':.F !':.TnF nF THT!':. FnRM FnR TN!':.TRlIr-TTnN<:: 1
\ /6 -02/0-~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c,i
(,
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
JAN
JAN
845
HBG
L BROWN ESQ
L BROWN & ASSOCIATE
SIR THOMAS CT 9
PA f]cl09
04-23-2001
HOOVER
01-19-2001
21 01-0175
CUMBERLAND
101
*/
REY-1547 EX AFP 1l2-00l
HILDA
s
Amount Remitted
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
CHANGED
.00
2,167.08
.00
.00
.00
.00
.00
(8)
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
(15)
(16)
(17)
(18)
1,518.00
17.229.66
(1lJ
(12)
(13)
(14)
.00 X 00 =
.00 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
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-Ex-AFP-ri'2-:00Y-NoTlcE--oF-YNHERITANCE-TAx-jrPPRAISEi"-ENT~--A[i-oWAifcE-oR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOOVER HILDA S FILE NO. 21 01-0175 ACN 101 DATE 04-23-2001
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
IT an assessment was issued previously, lines
reTlect Tigures that include the total OT ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
NOTE:
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
2,167.08
18.747 66
16,580.58-
.00
16,580.58-
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
.00
.00
.00
.00
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 DI:IC'I,..n ~cc DI:"CD~C eTnc nil: TLlTe II:ftDW CORD T...~TDII.......Tn...~ ,.
I' /
L,/or\
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Virginia B. Day
Date of Death: February 17. 2001
Will No.
2001-00210
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 ttached to this report.
Date: January 16. 2003
John M. Eakin
Name (Please type or print)
Market Square Building, Mechanicsburg, PA 170~
Address
( 717) 766-3172
Tel. No.
Capacity:
Personal Representative
X
Counsel for personal
representative
(MAH:rmf/AM3)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/06/2003
ARTHUR R DAY III
200 GREENWICH DRIVE
MECHANICSBURG, PA 17050
RE: Estate of DAY VIRGINIA B
File Number: 2001-00210
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 2/17/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: J File
Counsel
Judge