HomeMy WebLinkAbout01-0283
Estate of '_ fan e
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
,1. Hu.b Lr
No.
To:
Register of ~lls for the
Deceased. County of GufYIh ~-;d anri in the
Social Security No. ,.1(1 ,Q - , (tJ - L.( ( ~O 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 executl'l/
in the last will of the above decedent, dated 62..b Jw) ~ '
and codicil(s) dated
named
, 19--1LZ-
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
hCI
County, Pennsylvania, with
"
-fI..1 rr7IJrl Lc1c'Yl
(list street, number and muncipality)
Decendent, then 7 c., years of age, died ) J } 0 rLh /.J. .
at .~ toe 1m Chllrch of GoO ~Tllrsing Home North Middleton
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:
Decendent 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:
, '}9. cJ.LO I ,
(\~
3('(1 oct'..
)
$
$
$
$
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
inistration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1. ss
COUNTY OF Cumberland J
The petitioner(s) 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 petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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Mary
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N 21-2001-283
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Estate of
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"JiiYI e
J
Hulo '2/'
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW March 14th ~ 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 February 16th. .1 gR7
described therein be admitted to probate and filed of record as the last will of
Jane J. Huber
and Letters Testamentary
are hereby granted to Susan Huber Jensen, N/K/A Susan Huber
FEES
P b 270.00
ro ate, Letters, Etc. ......... $
S 30.00
hort Certificates( lID . . . . . . . . .. $
Renunciation ................ $
x-Pages (3) $ 9.00
JCP TOTAL _ $ 5.00
Filed . ~A~9tl. .1.4 (200), . . . . . . . $. .:U4. 00. .
AITORNEY (Sup. Ct. 1.D. No.)
ADDRESS
PHONE
.-
CALL EXECUTRIX WHEN LE'ITERS ARE lX)NE
H 1 ()<;.:~()':; '~'~y
Th lS is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Local Registrar
Fee for this certificate, $2.00
p
7178514
"'AK 1 2. 'LBO'
Date
21-2001-283
05. 143 Rev _ 2187
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT If 1'31. MtddIe, lasll
SEX
STATE FilE NUM8E.R
SOCIAL seCURITY NUMBER
)
Cumbvr.tand
2f e.mate.
'.202 - 16 -4180
DAlE OF DEATH IMcni'l. 0..,. ....,
.. O~- I 2.. - 2..00,
.. Jane. J. Hubvr.
AGE (l'" 8w1I><loYl UNDER . YEAR
_ Doyo
UNDER . OM
....... -
!
DATE OF BlATH BlRTHPlACE (C"V and PLACE (y DEATH (Ct<<k only 1)1'\8 -- iee ,nsuudoOn9 on 0Ihel SlOe)
',Month. Cay, '..1 SlaM Of fcrelC)ll CounlfYI HOSP1lAl:
/:IMque.hon.i.ng,PA :",_0
FACLfTY NAME (It noIlf'1l.1'lUbon. gl.... wee\' ana oumbefl
=..vI 0
76 y,.
COUNTY OF DERH
CRY.
RACE. AmerIcan IndiIn. Black. While. etc.
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WhLte.
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DECEDEHT'S USUAl OCCUPlQ'1ON
~...=:~~::~:':'
ll..Ctvr.k T .wt ll.commonwe.atth 06 PA '2.
DECEDENT'S IoW\.ING ADOAESS (So.... CoIy/1i>wn. SIaM. Z.. CoXl DECEDENT'S
801 No~th Hanovvr. ~~~
CMl.wle., PA 17013 ~..::':"'"
.1.
FRHER'S NAME IFnI., Middle. LUI)
II. Ge.M e. E. Je.nk.i.M
INFORMANT'S _ (TypoIP<inI)
. Mit.6. SMan Je.Me.n
METHOO OF DISPOSITION
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SUIMV1NG SPOUSE
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Cumbvr.land
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DATE PRONOUNCED DEAD (Month. Day. _I
2..
17. MRT I: Enter the diHuP. infuOn Of compliCatioN which caused the death Do noI enler,he mode 01 dying, such as cardiac or ,espiratory ~".sl. Shock or hean failur.
U. Oftkt/ one C8UM on each hN
IS. 0"3 - n. - "2-00 I
PART I: OIhar~_""""""""_.bul
not NIUIing in _ undIrtying eauM Qiwn in A\RT I.
c.
\ltJ1:v..MON. f\
DUE 10 lOR AS A CONSEOUENCE OF):
rut\\'J
(tltE 6Ml.. VAI<..l4~1'l1l- b IStA't:,
~."S frlAl.olA
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d.
DUE 10 lOR ASA CONSEOUENCE Of):
DUE 10 COR AS A CONSEQUENCE Of):
WERE AUTOPSY FINDINGS MANNER OF DEATH
A\lULAaE PRIOR 10
COMPlETlOH OF CAUSE a-- 0
OF DERH1 ......... Homiddl
-- 0 Pending InvesUgaUon 0
_0 No 1M" - 0 Coukt not be determtned 0
DATE OF INJURY
tMonth. Day. -'81'1
TIME OF INJURY
INJURY J(f WORK? DESCRIBE HC70Y INJURY OCCURRED.
Yea 0 NoD
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28b.
ClllTIFIER ICheck only oneI
-ceRTIFYING PHYSICIANif'h't$lClilO cerlltylng cause d death when anoU'1er phVSlCoan has plonounced dealh ana completed Itern 231
TolttelMeto....yknowledee...thoctUfNd..tolhec.uae(.).ndm.nne'................................,.. ,..........."..
a.
PLAce OF INJURY. At home. ta.m. street. fac:tort. off\ce
blMkIng, etC.ISpecllv)
....
-PAOMOUNaHG AND CE..TIFYING PHYSICIAN (Phy5lClafl bOth O)'onouoclfl9 OEtalh and c~ to cause of dealh)
To..... beetot....,knowledQft. duthoccurrecl ............ da", and plac.. ancf due to the caUH(a) and manne, ..a.atH.............
.MEDICAL EllAMINERlCORONER
On the ba... of .xamlnatlon .neIIOf' l"v.sUialion.ln my opinion, d.ath occu"ed a. the lima, d.t., and place, and due to Ihe c.us.(s).nd
manner.1 ...ted., ... ... . . . . . . . . . , . . .. ... . ... . , , . . .. . .... . .... ........ , , , . . . ... .. . . .. . .. . , .. . , , ., .. .. . . .. . . .......
31a.
LAST WILL AND TESTAMENT
0):0'
JANE J. HUBER
I, Jane J. Huber ot 202 Ridgeview Drive, Marysville, Perry
County, Pennsylvania 17053, being of sound and disposing mind,
memory and understanding, do make, publish and declare this to
be my Last Will and Testament, hereby revoking all Wills and
codicils heretofore made by me.
ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of
my last illness, shall be paid from my residuary estate as soon
as practicable after my death as part of the expense ot the
administration of my estate.
ITEM II. I devise and bequeath all of my estate of every
nature and wherever situate to my husband, Richard Huber, it he
survives me by thirty (30) days.
ITEM III. If my husband, Richard Huber, predeceases me or
dies on or before the thirtieth day following my death, I
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devise and bequeath all of my estate of every nature and
wherever situate to my children and their issue per stirpes.
ITEM IV. I direct that any and all Inheritance, Estate
and Transfer taxes imposed upon my estate passing under my Will
or otherwise, shall be paid out of the principal ot my residual
estate.
ITEM V. I appoint my husband, Richard Huber, Executor of
this my Last Will and Testament.
In the event ot his
renunciation, death, resignation or inability to act tor any
reason whatsoever, I appoint Susan Huber Jensen of Newport,
Pennsylvania, Executrix of this my Last Will and Testament. In
the event of her renunciation, death, resignation or inability
to act for any reason whatsoever, I appoint Gwen Ann Zeird of
Litiz, Pennsylvania, Executrix of this my Last Will and
Testament.
I relieve my Executor or Executrix from the
necessi ty of posting securi ty in connection wi th his or her
duties as such in any jurisdiction in which he or she may be
called upon to act.
ITEM VI. This Will is not the product of any contract or
agreement between me and my husband, Richard Huber, and my
husband shall be free to dispose of any property (whether
2
II
I
, .' .
acquired under this Will or otherwise), either during his
lifetime or by Will, as he deems proper in his sole discretion.
ITEM VI I. In the event my husband, Richard Huber, dies
under such circumstances that there is not sufficient evidence
to determine absolutely whether he survived me, I direct tor
purposes of this will that he shall be conclusively presumed to
have survived me.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last Wi 11 and Testament, which consists ot __L pages, to each
of which I have affixed my signature this _~~day of
February, one thousand nine hundred and eighty-seven (1987).
~~ ~-- 'Y/~
Jane J. Huber
3
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF -~-f!~--------
ss
~w._e,}AN I HUBER and t2-~ /~
_-LL. ______, the testatrix and the wi tnesses
r spec~ive~y names are signed to the attached or
toregolng ln trument, being first duly sworn, do hereby declare
to the undersigned authority that the testatrix signed and
executed the instrument as her last will and that she had
signed willingly, and that she executed it as her free and
voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the testatrix,
signed the wi 11 as wi tness and that to the best of thei r
knowledge the testatrix was at that time eighteen years of age
or older, of sound mind and under no constraint or undue
influence.
and
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Testatrlx
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Subscribed and sworn to and
before me by JANE J. HUBER,
a s scribe nd sworn to
I '
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acknowledged
Testatrix
and aC~ged
, and ' 14
-_.~.
before me by
r'
_ l , 1987.
day of
/~~ g.LA jJ
~6tary pu6ric ru'
/,l:[;f/f,Y G. SUPKO, Notary Public
ii'::, Perry County, Pa.
~':.:n:;:::Oi1 Expires June 29, 1987
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
-:r ~ t-l ~ :r 'r\ V-- tf E. re..
Date of Death:
0'3 - l 7-- 7":)0 \
Will No.
2~o 1- 'Q\1 ~ t'3
oL 1- 1J \ --;:) ~ r'3
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 (Y\ f:to..i ;L I -;L ~ ~ l :
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Address
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Q:.......,'
Date:
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Signature >< At<J)(j/] I #, r~
Name ~u...sP,,~ ~. TCCN~f~
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Telephone (J 11) 7 31 - '$ / 5 -;L-
Capacity: ~ Personal R~presentative
Cettft8el {Qr p~m~aal rapfa&aRtlWve -.
.
MEMBER
VERNON M. MARTIN, Jr.
Certified Public Accountant
12 SUMMIT DR.
DlllSBURG, PA 17019
717-766-8156
MEMBER
AMERICAN INSTITUTE OF
CERTIFIED PUBLIC ACCOUNTANTS
PENNSYLVANIA INSTITUTE OF
CERTIFIED PUBLIC ACCOUNTANTS
December 10, 2001
Pennsylvania Department of Revenue
Bureau of Individual Taxes
Inheritance Tax Division-EXT
Department 280601
Harrisburg, PA 17128-0601
Regarding the Estate of Jane J. Huber
Estate Number 21-01-0283
c/o Susan H. Jensen, Executrix
625 Good Hope Road
Mechanicsburg, PA 17055
Dear Sir/Madam:
We are writing to request a six month extension for the above referenced inheritance tax
return. Since the decedent died March 12,2001 and withdrew money from her IRA
before her death, a federal tax return will need to be filed after January 1,2002. We also
need her final interest statements to file the federal and state returns. Therefore, at this
point we can only estimate what her federal and state personal income taxes will be.
Please grant us an extension for these reasons.
Enclosed please find a check for $2,500 to cover the estimated balance of inheritance
taxes due.
Please let us know if there are any questions.
Very sincerely,
(J..
h\,iJ
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~AuoCVTJ IJt:J~1 B~
Vernon M. Martin, Jr., Tax Return Preparer
Susan H. Jense~ecutri~
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
VERNON M MARTIN JR
12 SUMMIT DR
DlllSBRURG, PA 17019
-------. fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 202-16-4180
FILE NUMBER: 21 - 2001 - 0283
DECEDENT NAME: HUBER JANE J
DA TE OF PAYMENT: 12/18/2001
POSTMARK DATE: 12/11/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 03/12/2001
REMARKS: SUSAN JENSEN
CHECK#1014
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: PB
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 000656
MARY C. lEWIS
REGISTER OF WillS
AMOUNT
$2,500.00
$2,500.00
/6-02/'./-6
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
'02 JUL 23
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-15-2002
HUBER
03-12-2001
21 01-0283
CUMBERLAND
101
.'5
SUSAN H JENSEN
625 GOOD HOPE RD
MECHANICSBURG
'*
REY-1547 EX AFP <01-021
JANE
J
Allount Rellitted
PAI..17050-1129
C~t
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-roY:02Y-NOTici--OF-YNHiiiiTANCE-TAX-APPRAisiMENi'-,--AL:rOWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HUBER JANE J FILE NO. 21 01-0283 ACN 101 DATE 07-15-2002
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. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Hisc. 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
328,392.00
.00
42.000.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO)
14,276.00
.00
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
370,392.00
(11)
(12)
(3)
(4) _
14.276 00
356,116.00
.00
356,116.00
NOTE: 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. 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
.00 X 00 = .00
356,116.00 X 045 = 16,025.22
.00 X 12 = .00
.00 X 15 = .00
(19)= 16,025.22
TAX CREDITS:
~ R"'''''',U I l+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
05-22-2001 AA496633 684.21 13,000.00
12-11-2001 CDOO0656 .00 2,500.00
TOTAL TAX CREDIT 16,184.21
BALANCE OF TAX DUE 158.99CR
INTEREST AND PEN. .00
TOTAL DUE 158.99CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
(/
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
:r F11-1 f :r t\ '" d't. .e...
Date of Death:
0-:3- 1-:2. - ;z..~o I
Wi 11 No. ;t ~ ~ \ - () \) ;2.- ~ '3
Admin. No. ~1_O{_o~t3
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 -.,t... No
2. If the answer is No, state when the personal
representative reaJonablY believes that the administration will be
complete: N _~
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;(.
b. The separate Orphans' Court No. (if any) for
the personal representative's account is: fJ~A
c. Did the personal representative state an
account informally to the parties in interest? Yes)( 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.
Da te: 'f /}1J(j Ol- ftJ, ol.OOa
~i9:;;L~4? <j.J ~-tJ/MV , .efL~
Sv...SA~ H. 3"~\,i.r€,,~
Name (Please type or print)
b ')... <; C-O~,~ H- ~ l' ~ e"\)
Address 'ME:.C~f",1-1-\,S i'C:~(;- fA
J
- I/O~O,
(7 If ) 7~1- 8 fS"l-
Te 1. No. '
~ Personal Representative
, Ii',
"
()
-l()t.
I' f
ZD.
Capacity:
Cgun3el for personal
r~pr~.e~t:i-ve-
(MAH:rmf/AM3)
\, /6-';;;/-'7-6'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REY-ln7 EX AFP 101-021
SUSAN H JENSEN
625 GOOD HOPE RD
MECHANICSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-12-2002
HUBER
03-12-2001
21 01-0283
CUMBERLAND
101
JANE
J
PA 17050
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=i6Cfj-EX-AFP-rOY:OzY------...-iNHiRiTA'NCE-TAX-STAfEMENT-OF-ACCouiif--.i.---------------------
ESTATE OF HUBER JANE J FILE NO.21 01-0283 ACN 101 DATE 08-12-2002
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-15-2002
16.025.22
PR I NC I PAL TAX DUE: ....................................................................................................................................................................................-.....................................
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-22-2001 AA496633 684.21 13.000.00
12-11-2001 CDOO0656 .00 2.500.00
07-23-2002 REFUND .00 158.99-
TOTAL TAX CREDIT 16.025.22
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO 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. >
REV.1500EX (o-OOj
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
I-
Z
W
Q
W
(J
W
Q
w
...
:ll::~tI)
00:"
w"o
,,00
00:-'
....
..
"
I-
Z
W
C
Z
o
..
"'
w
0:
0:
o
o
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
H", ~eR.. :J{>q<( :r.
DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
03- J)..- Jo'O' 04-_0fo- ~<-{
(If APPLlCABLEfJ7AG SPOUSE'S NAME (LAST, fiRST, AND MIDDLE INITIAL)
g 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (Ahach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trusl)
o 10. Spousal Poverty Credit (date afdeath betwee[\ 1"l-31-S1 aml1.1-95\
OFFICIAllJSE ONLY
..Ie:. - C) / 7.:~._
FILE NUMBER
2...1 vf 00;:1..73
CQUNTYCODE
-----
NUM8ER
YEAR
SOCIAL SECURITY NUMBER
;2'O;I..-lio
t-flf:v
THIS RETURN MUST BE FILEIl:1f[DUPLlCATEWITH THE
REGISTER OF WILLS $/ ~ - rct
SOCIAL SECURITY NUMBER
f./ /'/1 -
o 3. Remainder Return (date ofdealh prior 10 12.13.82l
o 5. Federal Estate Tax Return Required
!!..- 8. Total Number of Safe Deposit Boxes
o 11, Election \o\ax under Sec. 9113(A) (Al1acllSch0)
t'::'
NAMES,,^ S' 1'- , I U 'J€
r'''' 1', <.:; 1.1 S'<=. H
FIRM NAME (If Applfcable) r< ) "
TELEPHONE NUMBER 7 /7 _ 7:31 - 7 I ";;:t-
COMPLETE MAILING ADDRESS
" ;2. ~ G<>., ~ t-I",.ce:
~ E:.(.~fll,,(<:.rf.l'v-.a.~
)
f-,;, .
ff1 170~O
oF'Fici.t..LUSE ONLY
. .
"-.,-
o
f'
I
\.:;)
(B)
370391--
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
3;1- '?:' 3 ~ ;L
(11)
(12)
(13)
1'1 I--'<C
3~' (I ~
z
o
5
:J
l-
ii:
<(
(J
w
It::
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & No\es Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule 1-1)
(9)
(10)
N ;L7y,
(14)
55~ If!".
(6)
(7)
4;)... -000
,
/I"D";I5.).")....-
I
(k, 0 ~5. ~'J...
,
z
o
!;(
I-'
:J
Il-
:E
o
(J
g
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTiON!! 0 EVl:RSE SIDE AND RECHECK MAtH < <
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I)
11. Total Deduclions (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 (Sct\edule J)
14. Net Value Subject to Tax (Une 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, Of transfers under Sec. 9116 (a)(1.2)
x.o_ (15)
x .0 'ii (16)
x .12 (17)
x .15 (1B)
(19)
16. Amount of line 14 taxable at lineal rate
"3S!"
II ro
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20J8J
Decedent's Complete Address:
STREET ADDRESS ~ l' \..., _ f/..
CITY
C~r<L.I)L-e
Tax Payments and Credits:
t Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
( 3 ""~::l.O<:l
, G, '7 'f, 1'1
+ l.<()"'.o~ '-<.l '''' '?
&4."10\';;'" \l
Total Credits (A+ B + C)
(2)
/ ~ / '/4. 1'1
3. InleresUPenatty if applicable
D. Interest
E. Penally
TotallnleresUPanal1y ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Pagel Line 20 to request a refund (4)
ZIP
17~
I~, 0 ;;:J, "J,...?-
I ::'1, (")-1
S. If Line 1 + Line 3 is greater than Line 2, enter the difference. This Is the TAX DUE.
(5)
(5A)
(5B)
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
..,,...,, __ ".. ........... ~......, .,. '" ,,_ _. . ..=,...~.... ..IJ ,.. .,.",.=-.~,.
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
... 0
................ 0
... 0
................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
.. 1Zl
o
....0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
1. Did decedent make a transfer and:
a. retain the use Of income of the property transferred;.........."..................................
b. retain the right 10 designate who shall use the property transferred or its income;.
6. retain a reversionary interest; or.....................................................,
d. receive the promise for life of either payments, benefits or care? ...................
without receiving adequate consideration? ............................... .............................................
3. Did decedent own an nin trust for" or payable upon death bank account or security at his or her death? ........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............. .............. ..... ......... .... ....... ................... ..... ......... ......,........ ..............
i
{i
o
r1
l3
Under penalt\es of perjury, I declare lhall have examined this return. including accompanying schedules and statements, and 10 the best of my knowledge and belief, it is true, correct
and complele.
Declaralion of pre parer other than the personal representative is based on aU information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
~ /1 Jl tUn #. J- /lIr7.11YI1.-
ADDRESS \
0/}-':; C-~"r)) H "f", (2,,;:>, fii
SIGNATURE OF PREPUt< ROTHER THJ.N REPRESENTATIVE
. 'Y^' .~Z,
l' ~.,
t<DDRESS
DATE
$- .;>,-y.- O~
110S'C)
E;,c.. \-\i?\ ~\ I c..S; aV. (<. ~
VEf;NON M. MARTIN, JR., CPA
1 Z SUMMiT DRIVE
DlllSBURG, PA 17019
.717.766.8156 _ 717.766.2511
... .. ____.....-'m.............. ...._........ ..._.. .._. ............ ......_."... .~~............... .._,......... ....." ....
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 P.S. ~9116 (a) (1.1) (i)].
-+
fA
/
DATE
:;--}.../-o,1..
". '"
For dates of death on or after January 1, 1995, the lax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (aj (1.1) (iill.
The sta.tute does not exemDt a transfer to a surviving spouse 1rom 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.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty.one years of age or younger at death to or for the use of a natural parent, all adoptive parent,
Of a stepparent of the ch"d is 0% [72 P.S. ~9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries Is 4.5%, except as naled in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)J.
The tax rate Imposed on the net value of transfers to or for the use of the decedent's sibiings 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.
REV.1508 EX. (1.g1j
'*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
,-r- ~T
J p.. ~\ (-
FILE NUMBER
;;11' '1 \... 00 ')... 'i ?
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hv..r.u/?..
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
~.
4, J
s. l-
t,.. j
'3.
7, ).
'to j
q,
t7
l)"'II'~",r '..;f:\\'~
:2-'3-:; i-l, S'E:<-" t";> s/.
f.1cu- p~ 1'1/01
,
DESCRIPTION
/Ii<- "3 '"'~'" '" I ~(7"':)
VALUE AT DATE
OF DEATH
'77-'i!.1l,
C'J)
I....,
,
Cy
1-:3 ~ '-1-'3,07
,
1'1\ 1";;>'1> P ~ ,I j..1 rs (>, ,I 1<:. ~ "3 '"l '1- " , I .L". 'i
5<f~ \.A f.J..,,,-, S'r
f'I\' ,-'-r::...e.s Gv. It (:.., P(), /7 or." \
/ ~ H ",~,<>...I ~~ (] PI ~Ifc... (VI P,""\;;'V' "I.-~
101 LI .Ie. ,,_,I ~~, (1,,-1, (.J. ~
f'1\r>-lli';V""'-~, Pi\ /10$'3
A,u...\,(>.r-- I1f>,HI<. J.', ~1\l'OI9<"(
~.:J"'~ ('I\p..\'t<:.f-.... S--,.... P--;l-I'lO I "ll..
c. Ii'< oM pH. '-'-, p f>, 1'1 I) II
~. :JOb 0<-1;1." c-;;'
q/ O){'19 C~'C:.'ICf.'~
'-/7-, 'n7. 3'7
~.'J..7~. ~5
C'''Y
c'')
'31 G. I{ . <7
,
'7\< I <11 , ~ <)
.. ,
~ -;:1.0'3 <(0 OOQ 0 if 4.,. C".)
.,.<> 010::5,00
D'I,
27 ~-:s:).-z..1
r-"'",,",,"'H (1(>, \.11<'
1(, (.. u-. 5 M /., 1-\,
'\),,-....s,g"'Il..C- p~ nol9
<$'3/.., Do?'" ("",r
\P """ -- -;) _~ ~- .)
C. 11 h./'" " cr
f(l. "J' ~,";> 1=,~ rd (1. ,"'-
[.., 1" E"'!' €.s (C::f'C""~~"~
5'10.0:>
TOTAL (Also enter on line 5, Recapitulation) $ '3:L ? ,:3 q I. "19
(If more space IS needed, Insert additional sheets of the same size)
''''.,,'''''.,,'''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
ESTATE OF
T"'\-\t:
FILE NUMBER <:7
"?--I_ 01- 007. 6'5
1-\ '~~S({.
I
T,
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM THE i'JAMEOF THE TRANSFEREE,THEIRRELATIONSHIPTODECEDENTANOTHE OAT EofTRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
II'? c>.'" f',") ATT,o\,CH ACOPYOFTHE DEED FOR REAL ESTATE. 11FAPf1.ICAB:E)
NUMBER VALUE OF ASSET INTEREST
1- Rx f\, ~ -(?. '" ':T. H'v- e",-~ SaN l!t</al 10, 000 / 00 '7~ 3:'J<lo -7.000
I ,
~, PGt-Pf".p, y, j..!,,,,a(f\. j)/,<,.c.,'...,Ic<l-I}.1- /::)v'1, ~Jo.......~ 7<:>"''''
L- f'..J.) l/i,/.,,\ 10,0':>'::> ,
3. G-wG\-' A, -Z t \r2..~ 0Av-Cr Po <r.../i... II,!/o /--,! -:")-0:) I 00 f), 3~<",:.') 7,"';:''''
I
/1 , (.),I..\- I ~"" (;:. L.E:;\t<:. .) ~o j-{- I+'- /Do'l, '3ov-.'" 7, o.~...?
I 11,</ 10, 00<> !
f.,(>...,.J '"
~, :s v-- ~ ~ ~., f-\. ~~~'<-'E\\/\')~'J-.c..\' -(~ (::), "';J ,;J (--,~ -'. ~oca 7 ",,,,,,
,
/hl., \
0. {.\ L ~ (d; ':> L. ~~~'\SE\' 5:,1':)\-\..1..1_ ll"w /::::J "''' C /.;:) q, 3"J~ (I .,,00
, .
I( "I j",
TOTAL (Also enter on line 7, Recapitulation) $ '(-;J.,:)OC)
(If more space is needed, insert additional sheets of the same size)
REV.1511 EX+ (12-99)
.9J",.,.:'!tC:~..
~J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
!~""rf'E(I...
J
q-"" ~( <c 'X
FilE NUMBER
~ 1_ 01- 00 ;L'l'3
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: f>€~'~\':""L-V~"'\ ,~ c:: fZ-.EM (>.;.--- \] K ~ ~<..\ E:'.~"'" S"IQ
1. I' " 7,7
"
01<."1>-" 1,..,.- p.,,,,-''") I" s.~ ,,"'- ?--~o
~L3> <:: ..:J lJ.. ,-' --::- .,e.......~ rSv-r=? Ie?"" '!>o'O
j)Ht'I -I: ~..'>~I +' ~ ?-'?-s 1.3 :l-;z..
------..-
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative{s) 5v.5i\11 H, '3e~'.>E\(
Social Security Number(s)IEIN Number of Personal Representalive(s)
Street Address Co ?-~ cJ. "''''' \-I"pf (2:"
City '(VI\S(;J.t.\"\crf.!v..rl.... .. State p~, Zip (71!:0
Year(s) Commission Paid; :;L~v ( "';',000
2. Attorney Fees r,\ ) ""
3. Family Exemption: (If decedent's afdress is not the same as claimant's, attach explanation)
Claimant t\ ~
Street Address
City State _Zip
Relal10nship of Claimant 10 Decedent
4. Probate Fees '349
5. Accountant's Fees
6. Tax Return Preparer's Fees ~oa()
7. fA <;~- .....,...... E -::r: I" c. oW' ( ,-'<cp.. 7 ccS -'3. \'"I., IV "'0'-" AI,.. - Pf\ LI.;) 1-1'3
7;. FE":"> 'C/t.I"<.- f S IG-r.' '" 1-' 1'><.- -:S::"" '- '''''' € '\,,-' ,.r _ ~"I>.. "'" I"" (j 0 ~'O11 I
q (.I.")0E;1l:.."T,IIiJC-: -t P l S'E; 1'\""""- 11-\ f I". J ~ p'rtL. <$<.. t f'f\ 17<:'l11 7/
,
/"', I' e:: '^"'^ at"-'- 1\";>1 LP\w :J'lv."" A'- 7S
c: f'Y'-'-<SL' 00, (/'"1\'3 I <{ ~7
/I. IJ,/?""e. (""-10 F r\ f\(L'''' f\" tq., '/1tc. \~. P0 \74 '0 'Z
) ;2..Q/?
I=". MIS ~E-""\" f'l1\ EO"",! '"0 O"-""'1~.$ fA ... \ .~..) "J;. ~,-,t- r, S
TOTAL (Also enter on line 9, Recapitulation) $ ! L.( ;L -, ("
(If more space is needed, insert additional sheets of the same size)
REV.1513 eX+ (1.97)
ESTATE OF
NUMBER
I.
'S.
II.
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
/-+ '" .g '" r'l...
J
, I "
-'rt~E
r
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1.
!2IC'Aj),,.."3:> (T. ~\,,~~~
'-"L '$" Y "^ a \-\ ~ ~,g ~ 1.-..... C t=""~ Il- "" (2.'-".
'Dv-\-\C.f\~q4"H fA (7'Q;"'o
I
;;to
6w hI Ii\-. -Z eo ua,'S)
Z I( N c'->i ~ h~,,~' re")
I.- ('"' rr'2- P A 17 -';;l(-:!
,
r
.> u.. S f\ "
\-\ . :Jf, \ s; C ,I
G-","'Y h~(,E
<:0 :z.S
(2."
f(l. o~5o
M E;c..\-' /";-' 'c..,. (J",.e.r;;..
/
FILE NUMBER
~1-ol- oo;2.~3
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
00 Not List Truslee(s) OF ESTATE
S' <l \-\
/ /'( 70c.,
<Dt-'., c;.. r''-'' E fl.
/(Z,7<::>';
']) t\ ",G- ""<'\~.e..
/ fir;, 70{
~'$'(.,. II (.,
c-r "'" P, t-
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
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 $
(If more space is needed, insert additional sheets of the same sile)
.':,;
,'(ii"
I
.
ESTATE OF JANE J HUBER
~
1:0 2 20008 b81: b811" 1.00 ? ~:I b8:1:1:18 2 I. 5
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PLEASE RETAIN THIS VOUCHER FOR YOUR RECORDS
683338245
3/15/01
000000000400713
$.....10.728.96
CHECK MADE PAYABLE TO:
THE ESTATE OF JANE J HUBER
~IWayRqi!lJ
PO BOX 1711 . HARRISBURG, PENNSYLVANIA 17105-1711
235 N. SECOND STREET' HARRISBURG. PENNSYLVANIA 17101 . 717/236-4041
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CERTIFICATE OF DEPOSIT
NON TRANSFERABLE
55'
?()? 16-4180
FIRST NATIONAL BANK OF MARYSVILLE
101 LINCOLN ST.. BOX B. MARYSVILLE, PA 17053
no -pe-ncU+'-'\ D\)e +0 l)ect +1rI
INTEREST PAYMEM"f OPTION
o MONTHLY
xfXJ QUARTERLY
o SEMl,ANNUAll Y
o AT MATURITY
xliO CAPITALIZE
o DEPOSIT TO
o MAil CHECK
3060420
PAYEE(S):
,l;:\onA Hll~r
3025 Chestnut
'Under penallies of pe~ury. I certify (l)lhat the number shown on
this torm is my correct talq:layer Identificabon number, and (2)lh8t I
am not subject to badlup withholding. elttler because I hlI,.. not
been notified that I am .ubject to bac;l(up withholding as a resuh ole
lailure 10 report all inIeresl or dMdends, or the Internal ReY'Il1'1Ue
Servleehas noIIfied me that I arnoolongersubjecl:lObedo:up
wllhholding.lelsocerttfylhalins~regar11ingrespon..tolhis
certification have been provided and lIl~plained to me"
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ORIGINAL (i~"'}i"t"'~'~f fO OOO~",l\ .0 (''; C"\3.. ;--- REDEEMED VAlUE
ISSUE AMOUNT ....~.:,,~,,~.~..... ,+, ..;.~:. .".. .~. . ,<, DOUARS$ -40 000 nn
PAYABLE TO THE NAMED PAYEE(S) UPON PRESENTATION OF" THIS CERTIFICATE, PROPERLY ENDORSED, ON THE MATURITY DATE. INTEREST WIU BE PAID AS AGREED
SUBSTAHnAl PENALTY FOR EARLY WTTHDRAWAl
CUSTOMER MUST SELECT EITHER OPTION BElOW:
DAUTOMATlCAllY RENEWABLE 1'HIS CERTlFlC.t.TE WIll. BE RENEWED AVTOMATlCAU.Y FOR
AN ADDITIONAl PERIOD OR PERlOOS EQUAL TO TliE ORIGiNAl TERM Of TliE CERTlflCATE
AND AT THE INTEREST RATE IN EFFECT ON THE RENEWAl OA TE UNLESS PRESENTED FOR
PAVMENTWTTHINTEN (10) DAYS OF THE MATURITY DATE.
miNGLE MATUAITY. THIS CERTIFICATE MATURES ON THE MATURITY DATE
BELOW AND WILL NOT BE AVTOMATlCAU.Y RENEWED, (NO EST wsu.
BE PAID FOR P AMATU flY.)
1-5-2000
ISSUE DATE
5.64
ANNUAL RATE
"
MATURITY DATE
1-5-2002
24 months
TERM
4-C\
UR~;'I,&Jl~~~~lN~:iU{[~jLE\ l
. ~ ". '.~ -- , -
.dM'''''''''.PA1705:HlO17
MAIN. OFFICE
95168 t
(/
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60-12391313
DATEMARCH 16, 2001
PAYTOTIiE
ORDER OF
ESTATE OF JANE HUBER
********.**'If*****************.***************'$r"---.-. - ~- ,-'1
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.... allll,rst ISSV'i~ BY; TRAVELERS EXPRESS COMPANY, INC,
W' DRAWEE: FIRST INtERSTATE BA~K
HELENA, MT
Allfirst Bank
!
DATE
PAY
TO THE
Drawer: Alll1rst Bank ORDER OF
A/. ES r AlE OF JANE J. HUBER
.~~ Thirty Eight Thousand Six
AUTHORIZED SIGNATURE dnd 57/100 Dollars
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03/16/01
$38611.57
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ISSU!':D BY: TRAVELERS EXPRESS COMPANY,INC.
DAAWEE~ l=IAST INfERStATE BANK
HElENA,MT
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DATE
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ESfAfE OF JANE J. HUBER
03/\6/01
$J81I,I.00
Drawer: Alllirst Bank
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TO THE
ORDER OF
fhirty Eight Thousand One
One and xx/IOO Dollars
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202-16-4180
Tnxpayerl.U. No.
DILLS BURG
$
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L^NC^STFIC I'^. 17fJIl>!
wlmsc 1."hlrl's~ is
80,000.00
JANE J HUBER
12 SUMMIT DR
DILLSBURG, PA
~ UL i ClI'l
B~'N}<
17019-0000 'bq. D103. 0D
[} 8 ~,m IH~dols ~ ~Ct3
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This. ccitilic!'.. ~hut
have
hilS deposiled in the b:H1k Dollars
pay:tble to Ihe Registered I [older lis~cd above ill t.:llnCll~ fUIHI~ upon lhe lllllturily 30 l1JOlllh(s)/~~ ancr Jale herein specified only upml Jlrcscl\tati~11\ .\Ill!
~urrCl1dcr of his (.:crtilk'a\c, prnpnly ellllorSl'{}. A111111;l) Illlcresl Rille fllr Origil1al 'Icrlll: 4 RHO W'. lllJeJ1!.~duJiw:..mJilffiC!~UJ!!LJ.!L.$}mlUl~.1II.Jl.u:
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is suhje'ct tll the ~cnns
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NOT TRANSFERABLE EXCEPT ON THE BOOKS OF THE FULTON BANK.
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203400000467
I: 51, 25"'00001:
PROOF OF PUBLICATION
State of Pennsylvania,
County of Cumberland.
Sherry Clifford, Classified Ad Manager of THE SENTINEL,
of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th,
1881, since which date THE SENTINEL has been regularly issued In said County, and that the printed notice
or publication attached hereto Is exactly the same as was printed and published in the regular editions and
issues of THE SENTINEL on the following dates, viz
Copy of Notice of Publication
-..xecuTAIXIlOTI'6E'.\
lettert Testamentary dn
th'. Eslal. ot JANE J.
HUB!A, ral. of 1M.. '
Township of North
Middleton, Cumberland
County, Pennsylvania,
deceased. hails been
granted to the
undersigned.
All persona knowIng them.
selves to be Indebted to
saId Estate will make
payment Immediately,
and those havl,ng claims
will present them for
settlement!.
Susan H. Ja""". f::xeciJtrbt
625 Gbod Hope Ad.
Mechahlcsburg, PA17055
May 19, 26 & June 2, 2001
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of publication are true.
~ V~<1~'/
June 6, 2001
Sworn to and subscribed before me this
day of June , 2001.
O. ~{/Pl
6th
c5t1.-tJul
Notary Public
My commission expires:
NOTARIAL SEAL ~
SHIRLEY O. DURNIN. Notary Pub:;c:
Carlisle Bora.. Cumbeilanc1 County
My Commission Expires Aug. D, 20')3
Thi.s is to certify that the information here given is correctly copied from an original ccrtific~te of death dul}~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office tor permanent filmg.
WARNING: It Is illegal to duplicate this copy by photostat or photograph.
No.
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Fee for this ccnificate, $2.00
Local Registnu
P 7178524
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IOS.143A8\I.2181
COMMONWEALTH Of PENNSVLVANIA . DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAAlEOFDfCEOENTIF".. Midde.l....'
'"
SYAJE ~'lE ....lnd.EIl
SOCIAL SECURITY NUMBER
.. Jane J 0
Il<GEtl..e_yl
HubVl
UNDEA I YUA
~ D.,..
'Fefll<l.te
,. 202
- 16
-4180
OATE OF DEATH ,I.lc.roh. Oa)'-"'j
..O~- 1Z--"2.DO(
So. 76 y,.
COUNTY OF DEAlH
mv.eo
4-6-24
PlACE OFoe""'H(CI'>ec~ only"". ,_ -.ee '~..''''''"","on_'_,
HOSPITAl
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Chfiltch 06 God NfiIt~.lng Home
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US.AflI.lEDFQACES1 _
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MARITAL $T.QUS. M..-rikI
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,.. Widowed
$UP.\lWlNG Sf'QUSE.
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DEC OENT'SlJ$UAl(lCCUMION
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DECEDENT'S MAllJNIJ AOORESS (Sl'M. Cory".",.". SIM.. Zrp Code! DECEDENT'S
801 NOJrth f-IanoveJt ~~NCE
CaJtltile, PA 17013 ~':..~'i""
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". lona Watt
INfORMANT'S MAILING AOORESS (SlreM. CilyfTo.on, Saar., lip Codel
625 Good Ho e Road, Mechan.lc~bfi!t ,PA 17050
plACE Of I)ISPQSlt\0t4 . w.._ Ql C._,.,.,. C,.rna!ory lOCRION . City{Town. Sial.. lil' Code
~Q~~K.C~emation Soe-iety 06
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NAUE.o.NOAOON;SSOFFACflITY C-1:.e.mlt
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LICENSEtillMeEI\
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COMPlETION OF CAUSE
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REGIST 'SSIGNATUA~NlJ~
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Register of Wills of CUMBERLAND County, Pennsyl.....
Certificate of Grant of Letters
No. 2001-00283 PA No. 21-01-0283
ESTATE OF HUBER JANE J
\ LA::;'l', r 1 K;:''1', M1 JJJJLt. )
Late of
NORTH MIDDLETON TOWNSHIP
CUM~~MLANU CUUN~I,
,
Deceased
Social Security No. 202-16-4180
day of March
2001 an instrument
WHEREAS, on
dated February
was admitted to
the 14th
16th 1987
probate as the last will of HUBER JANE J
(LA::;'l', r 1K::;'l', M11.JI.JLr.)
late of NORTH MIDDLETON TOWNSHIP
12th day of March 2001 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to SUSAN HUBER JENSEN and NKA SUSAN JENSEN
who have duly qualified as Executor(rix)
and have agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF,
of my Office the 14th day
,
CUMBERLAND County, who died on the
I have hereunto set my hand and affixed the seal
of March
2001.
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
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21-2001-283
LAST WILL AND TESTAMENT
010'
JANE J. HUBER
I, Jane J. Huber at 202 Ridgeview Drive, Marysville, Perry
County, Pennsylvania 17053, being of sound and disposing mind,
memory and understanding, do make, publish and declare this to
be my Last Will and Testament, hereby revoking all Wills and
?odicils heretofore made by me.
ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of
my last illness, shall be paid from my residuary estate as soon
as practicable after my death as part of the expense at the
administration of my estate.
ITEM II. I devise and bequeath all of my estate of every
nature and wherever situate to my husband, Richard Huber, it he
survives me by thirty (30) days.
ITEM III. If my husband, RiChard Huber, predeceases me or
dies on or before the thirtieth day tollowing my death, I
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devise and bequeath all of my estate of every nature and
wherever situate to my children and their issue per stirpes~
ITEM IV. I direct that any and all Inheritance, Estate
and Transfer taxes imposed upon my estate passing under my Will
or otherwise, shall be paid out of the principal ot my residual
estate.
ITEM V. I appoint my husband, Richard Huber, Executor of
this my Last Will and Testament.
In the event ot his
renunciation, death, resignation or inability to act tor any
reason whatsoever, I appoint Susan Huber Jensen of Newport,
pennsylvania, Executrix of this my Last Will and Testament. In
the event ot her renunciation, death, resignation or inability
to act for any reason whatsoever, I appoint Gwen Ann Zeird of
Litiz, pennsylvania, Executrix of this my Last will and
Testament.
I relieve my Executor or Executrix from the
necessity of posting security in connection with his or her
duties as such in any jurisdiction in which he or she may be
called upon to act.
ITEM VI. This Will is not the product of any contract or
ayreement between me and my husband, Richard Huber, and my
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husband shall be free to dispose of any property (whether
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acquired under this Will or otherwise), either during his
litetime or by Will, as he deems proper in his sole discretion.
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ITEM VII. In the event my husband, Richard Huber, dies
under such circumstances that there is not sutficient evidence
to determine absolutely whether he survlved me, I direct tor
purposes of this will that he shall be conclusively presumed to
have survived me.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last Will and Testament, which consists ot' _.L pages, to each
ot which I have affixed my signature this
/ /, t:J.. day of
February, one thousand nine hundred and eighty-seven (1987).
~~.~-- 'Y/~
Jane J. Huber
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF _-I,2.dX~f- __________
~' w_,_eX,A N] J. HUBER and _Jl"~h~ I~
-LL ,the testatrix and the witnesses
r s~ec~ively whose names--are signed to the attached or
toregoIng In trument, being first duly sworn, do hereby declare
to the undersignea authority that the testatrix signed and
executed the instrument as her last will and that she had
signed willingly, and that she executed it as her free and
voluntary act tor the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the testatrix,
signed the will as witness and that to the best of their
knowledge the testatrix was at that time eighteen years of age
or older, of sound mind and under no constraint or undue
inf luence .
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and
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TestatrIx
q-r~Ad ~MW
w~ ~d: A. ~R-~
WI ess
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Subscribed and sworn to and
before me by JANE J. HUBER,
?t:1~i brt&~ sworn to
wItnesses t~is ~ day of
acknowledged
Testatrix
and ackn wledged
, and
, 1987.
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.'. !f?~V G. SUPKO, Notary Public
'-': [\:i'ry County, Pa.
'", '",...,;.::;Qj') Ex)lres June 29, 1987
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