HomeMy WebLinkAbout01-0320
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of l/eyilyl T Wtt.tJe. bvu~ J:.. No. ..2./- a /- 3 z.a
also known as To:
Register of Wj.J.ls fOl the
, Deceased. County of (!-~"" hPv /a '" d in the
Social Security No. ~OO - :J..^ - 6 Lj)'7 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age 21 older an the executf' I 'i
in the last will of the above decedent, dated l..I.-.f2'- I I .3 0 )
and codicil(s) dated
IV I /}
named
,19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in (!,(/111 by1~ cf _ County, Pennsylvania, with
h ,J last family o}i Ilrincipal residence at .I VT n ;'V'I J1€- /" a J? ~
f.!C.( lr //J Ie m /7e;/3
/ (list street, number and muncipality)
Decendent, then /? ~ _ years of age, ~ed ~J.u. v f;. 7 , >> ;1..t>o 0 ,
at 2 b /V,;, 6_,J7~ L-pPLL ~Y/I_. F';f .
Except as follows, decedent did not marry, was not div~rced 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:
()
$
$
$
$
o
WHEREFORE, petitioner(s) respectfully request(s) the ,probate of the last will and codicil(s)
presented herewith and the grant of letters H J -h )J, <"VI ~ v .:::;
(testamentary; adminIstratIOn c.t.a.; admmlstratlOn d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEAIJTH OF PENNSYLVANIA 1.- ss
COUNTY OF _ t!.Lfj)) ACf-/a /?cf 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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No.
21-01-320
Estate of HERBERT T. WASHABAUGH SR.
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH 23 ~ 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 APRIL 30, 1997
described therein be admitted to probate and filed of record as the last will of
HERBERT T. WASHABAUGH SR.
and Letters TESTAMENTARY
are hereby granted to
CARITA C. WASHABAUGH
Y7JJ.lf't' ~hK;' pP<. (J a~d7~
Register of WilIs
FEES
Probate, Letters, Etc. ......... $
Short Certificates( 3) . . . . . . . . .. $
~ EXTRA.PG.S.3... $
JCP $
TOTAL _ $
Filed .~~~~. ~.3.~. ?~.~~.................
18.00
9.00
9.00
5.00
41.00
JOHN C. OSZUSTOWICZ, ESQUIRE
ATTORNEY (Sup. Ct. l.D. No.)
104 SOUTH HANOVER STREET
ADDRESS
CARLISLE, PA 17013
717- 249-5326
PHONE
CALLED ATTORNEY MARCH 26, 2001
H105.905 REV.(09/00)
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~II~
G\~s,~/<cr.
Robert S. <ZimInerman, Jr., MPH
Secretary of Health
Charles Hardester
State Registrar
1243906
HOV 0 92000
Date
Hl05.143 Rev. 2187
COMMONWEALTH OF PENNSYLYANIA . DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
TYPElPAINT
..
_ENT
IIL.ACK INK
01
NAME OF DECEDENT (Ant. MIdcIe,l.MQ
1. Herbert T. Washabaugh
AGe(lllll~ UNDER 1 YEAR
MontM : Deys
o:'l;tlrt;GI~~7::
Sr.
sex
..male
SWE AlE NUMBER
SOCIAL SECURITY NUMBER
.. 200 22 - 6427
ORe Of llERHl_. Coy._
.. October 27. 2000
.. 70 v...
COUNtY OF OERH
UNDER 1 DAY
..~l""""
...'(.. :
~O
1;'".lm:-ti~;l.;:;!;.;!.
Cumberland
white
SURVMNG SPOUSE
(II wile, giwtnlliden 1WM)
1S. Carita Curti s
S. Middleton
..
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en
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en
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DUE 10 (OR /IS A CONSEQUENCE OF):
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~t-:::J} J;6 ,,"dlti-~ .
t b
DUE 10 (OR AS A CONSEQUENCE OF):
DUE 10 (OR AS A CONSEOUENCE OF):
No a(
_0
NoD
Coutdnotbe~
DATE OF INJURY
(Moolh.Oov._
o
o
o
TIME OF INJURV
INJURY KI WORK?
DESCRIBE HOW tNJURV OCCURRED.
WERE AUTOPSY FtNDtNGS
-....aLE PRIOR 10
COMPlEllON OF CAUSE
OF oe.crH?
MANNEROFDERH
.......
3
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o
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.... 0 NoD
~
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~
.......
-
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PlACE OF INJURY . AI. homei, Iarm...... taclory. offICII
-....-
_.
._~
On the __ of .....lnlltlon.-:llar I~. In my opinion. dHth DCCUrNd lit thetlme. elite. Md pI8CI,.... due to the C8U8e(.) IlI'MI
............................... ....... ........................ ........ ..... ......... .......... ..... .......... ....
....
REGISTAAR'S SIGNATURE AND NUMBER
lAir I ~ M1
IrMr
--
CEII1'INR (a.:tc ClliyCJ'\e1
-CIRIFfINCI PHYSICIAN (PhyIiciIn certifying cauIe at dMI1 when ancIher physiciM has pronounced deeIh Md cunpIeIed IWn 23)
lO"'beelof",,~. dIllIIh__clUlltothe~.)"'" ....................................................................
...
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-PROIIQUNCNI AND C8R11FYING PHYSICWI (Physician both pronouncing deIf1 and CMtIyingtocauee of dMlhl
lO.......oIlIIY~.dMlhoccurnd...........date. ....,.... ....clUllto...caa..c:.)...........................................'.
...
Jadf ~ilr ana
ol
(rJfnmenf
HERBERT T. WASHABAUGH, SR.
I, Herbert T. Washabaugh, Sr. of Carlisle, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and
Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me.
FIRST
I order and direct my personal representative hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the administration of my estate as soon after
my death as is reasonably possible. However, my personal representative need not accelerate and pay
those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous
to retain or renew and pay as they become due and payable. If I do not own a burial plot or a grave
marker at the time of my death, I authorize my personal representative, in his, her, or its sole discretion,
to purchase a burial plot and to erect a suitable marker at my grave, and to expend sums from my estate
for this purpose.
SECOND
I give, devise, and bequeath my entire estate together with all insurance proceeds thereon of
whatever nature and wheresoever situate to my beloved spouse, Carita C. Washabaugh, providing that
she survives me by sixty (60) days.
~&~~~~
THIRD
Should my spouse, Carita C. Washabaugh, predecease me or die on or before the sixtieth (60th)
day following my death, then I give, devise, and bequeath my entire estate together with all insurance
proceeds thereon of whatever nature and wheresoever situate in equal shares to my children, Herbert
Thomas Washabaugh, Jr., of Montgomery County, Maryland, Timothy Curtis Washabaugh, of
Frederick County, Maryland, and Cynthia Ann Washabaugh Fenton, ofCarIisle, Cumberland County,
Pennsylvania, who survive me by sixty (60) days, per stirpes.
FOURTH
My executor and trustee are authorized and empowered to exercise from time to time in his, her
or its sole discretion and without prior authority from any Court, in respect of any property forming part
of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon
trustees or executors and the testator intends that such powers be construed in the broadest possible
manner.
FIFTH
I nominate, constitute and appoint my spouse, Carita C. Washabaugh, Executrix of this my Last
Will and Testament. In the event Carita C. Washabaugh is deceased, unable or unwilling to serve or
shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint Herbert Thomas
Washabaugh, Jr., to serve instead. I direct that my personal representative shall not be required to give
or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction.
SIXTH
I hereby declare it to be my expressed desire that my personal representative employ the Law
Offices Of Ron Turo of Cumberland County, Pennsylvania, for legal advice and assistance regarding this
my Last Will and Testament, they having considerable knowledge of my affairs, views and wishes
respecting any matters that may arise at the probate of this instrument, the administration of my estate,
and the execution of the powers herein mentioned.
J~-aJ~
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this
30th day of April, 1997.
4~1/~'
Witness i/ ___'5
t~7WAftt~
Witness
~J../;f.t:J.JJ~ .
Herbert T. Washabaugh, Sr.
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I, Herbert T. Washabaugh, Sr., the Testator whose name is signed to the attached or foregoing
instrument, having been duly qualified according to the law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as
my free and voluntary act for the purposes therein expressed.
~tt]J(I...I/~Pr.:. tfr..h .
Herbert T. Washabaugh, Sr.
Sworn or afTlrIIled and acknowledged before me by Herbert T. Washabaugh, Sr., the Testator, this
30th day of April, 1997.
JmMULIML
NWIe. NIl a..Il J 18t, .....,NIIc
~ ..... an .111I11 CIunIr. PA
~c-..... I . . -. *".13."
VJ~ tlw; fl;~v
I~ Public
,
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, Lisa M. Whistler and Robert J. Mulderig, the witnesses whose names are attached to the
foregoing document, being duly qualified according to the law, do depose and say that we were present and
saw testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and
that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing
witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that
to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
AJnu~
~~~
\
Sworn or afftrDled and subscribed before me by Lisa M. Whistler and Robert J. Mulderig this 30th
day of April, 1997.
a......
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CIrIIIlt ..... ~.Al",,"" CIunlJ. PA
QI ~ 11m NIr. '1.-
~b (bM1 r2ipt/P
tary Public
E:
~
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
/;1.y4~ T r 0CiJ-/!a--fau ~ J;r.
V
Date of Death:
Ie) I). 7/00
/
Will No.
j2.oo J - (')0 ."5;)- 0
Admin. No.
,J. /-0 I - CJ J ~ 0
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 C, - (() - 0 I
Name
Address
t!tJ-y ,I-~ e. 0d~ )au-ci
C/
1~ %y-h. bVI ~L k,~ &11' I,~- ~/7013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
6' ~;;..(P -0 I
9tx)
S. U/V
19nat
Name J;;h A.I (/ tJr2c.t.J-IoCvlCL-
Address / () c; -G", Id 4 hcJ vev Jl-
&v /;~ I3r /7tJ/3
Telephone (
) 7/7 ;;..q.3 7VJ7
Capacity: _ Personal Representative
ACounsel for personal representative
(!....
~*"',;""'''- COMMONWEAlTH OF
. PENNSYlVANIA
. DEPARTMENT OF REVENUE
DEPT 2110601
HARRISBURG. PA 17128-0601
REV-1500
j(P-,J}q ~ I~
INHERITANCE TAX RETURN FILE NUMBER
RESIDENT DECEDENT c~ckE-12,J- Q !u2.ER~ k Q
I-
Z
W
Q
W
(.)
W
Q
DECEDENrs NAME (LAST, ARST. AND MIDDLE INITIAL)
ms '
DATE OF DEATH (MM-DD.
THIS RETURN IlUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
51 - 4<-1 - ~40
SOCIAL $fCURITY NUMBER
t T Sr
DATE OF BIRTH (MM-DD-YEAR)
/0- .00 ~'Y-2-q
(IF APPLICABLE) SUR'IIVING SPOUSES NAME (LAST, FIRST, AND MIDDLE INITIAL)
V\Usha n+a
200
22-
0J427
..
..,
":S12
:.l18
J: ...
" III
..
~ tOrigilalRetum D2.SuPPlementalRetum D3.Rema\nderRetufn(wlealdealllPfior\o12-13-a21
o 4.limiled Estate 0 4a. Future Interest Compromise (date of delllll allor 12-12-62) 0 5. FederaJ Estate Tax Return Required
o 6. Decedent Died Testate {Altat:h alPY ol'WNQ 0 7. Decedent Maintained a Living Trust (Altach alIlY ctTnw) 8. Total Number of Safe Deposit Boxes
o 9. liligatiorlProceeds Rec:eived 010.SpousalPoveltyCredit_tldea1tJbetween12-31-9'lIIIdl-HI5j D'1.EleCtlontotaxunderSec.9113(A){AltacIlSdlO}
THIS SECTION MUST BE COMPlETEO. AlL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME \,-,1.. COMPLETE MAIUNG ADDRESS
I In 05 51DWIC lOLl S Hilr)OVer 6t
FIRM~lll~e)
fur-lISle.. PA 110/3
lfi
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i
"
31
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a:
(1) 0
(2) 53q2 CXJ
13) 0
(4) 0
(5) 0
(6) 0
(7) Jt..jq 221.15
n " :0
- fu d ::0
3 m
OJ' ~ (1l ()
0- l(;} ()
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1. Real E_ (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Crosely Held Col]>oraIioo. Partnership" SoIe-Propri....rnp
4. Mortgages & NoleS Receivable (Schedule D)
5. Cash. Bank !leposifs & MisceIleneous Personal Property
(Schedule E)
6. ~Owned PlOperty(ScheduIe F)
o Separate BiRing Requesled
7. Inter-Vivos Transfers & Miscellaneous Non-Proba\e Property
(Schedule G" L)
6. Total Gross Assets (tolal Lines 1.7)
9. Funeral Expenses & Administrative Costs (_Ie H)
10. Debts of 0_1. Mortgage L~bil.... & L~ns (Schedule I)
11. Tolel Deductions (total Unes 9 & 10)
12. Net Value of Eltate lUna 8 millUS Una 11)
13. Charitable and Governmental BequestslSec 9113 T!USts fa! which an electioo tetax has not been
made (Schedule J)
(6) ;55,21375
(lD)
~ EDo
o
00
(9)
(11) <6.500.00
(12) l'-i~ '713 75
(13)_ 0
14. NetVelueSulljectlo Tax ILine 12 milus Una 13)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABlE RATES
(H) /'-I(P,713 75
z
o
~
I-"
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Q.
:E
o
(.)
g
15. Amount of Line 14 taxable at the spousal tax
rale. or _ under Sec. 9116 (eX1.2)
16. Amount of Line 14 _~e at lneal rate .
\ y L., , II 2> '7 5
o
x.o_ (15)
x,o_ (16)
l( .12 (17)
x.15 (lB)
(19)
o
17. Amoont of Line 14 taxable at sibling rate
18. Amount of Une 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
,
Decedent's Complete Address:
I ~"'..... 21 Ii h d
" U~:II 91'"
CITY c.o..y- \ I S e..
Tax Payments and Credits:
1. Tax Duo> (Page 1 line 19)
2. Creditsi1'aymonls
A. Spousal Poverty CnldiI
B. Prior Payments
C.DiscotJnt
Ll\
I STATE pp..
I ZIP 1/0'3
(1)
o
Total Cnldils (A + B + C)
(2)
o
3. II1tBRlslIPenaIty Wawlicable
D. Interest
E.Penalty
TotsIlnterustlPenalty ( D + E )
4. ~line 2 is greater than line 1 + line 3, enter the dlflerence. This is the OVERPAYMENT.
Check box 011 Page 1 line 20 to "'1- I refund
5. Kline' + Une 3 is greater thIn Une 2, enter the dlllerence. This is the TAX DUE.
A. Enter the intenlsI 00 the lax due.
(3)
(4)
(5)
(SA)
(58)
o
B. Enter the tolal of line 5 + SA. This Is the BAI.AIICl! DUE.
o
Make Check Payable to: REGISTER OF wrU.S, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did _ maI<e a \lllNlIer and: Yes No
I. relain the usa or income of the property IrSIl.ftmd;......................................................................................... 0 ~
b. retain the righ!1o designate who shall use the property transferred or its Income; ........................,................... 0 QS]
c. retain al8Velllionary interest; 0'.......................................................................................................................... 0 181
d. receive the promise for life of either paymonlB. benefils or care? ...................................................................... 0 g]
2. If _ occulllld after DllI:IInIler 12, 1982, did -.1 transfer properly within one yea, of_
without receiving adeq1Jate considelalion? .................................................................................................. 0 ~
3. Did decedent _ an 'In IrusI for" or payable upon doallt _ aalOtllIl Of seGIIIIty lI. his Of he! de8lI\? .............. 0 (2g
4. Did -.; _ In Individual ~Account, annuity, or other 00Ilil- property wIlid1
conIalns a beneIciary desiQna'Jon? ........................................................................................................................ g'J 0
IF THE ANSWER TO AllY OF THE ABOVE QUESTIONS IS YES. YOU lUST COMPI.ETE SCHaIUI.E G AND RLf IT AS PART OF THE RElURN.
lhIer penIIieI of peljuIy, I dec:bn Ih8t I have.....1IiI nun. irK*dng accomplIn)'ing ~ _ sIIlIlItnflnt$, and ktlle best d my ~ and belief. i .M, mm!d Irld ~
DecinIIon Dfpreparerolherllan tleper1Oll8l ~ ilbHed on 8IIinform8l1andwl1lch prepererl'lllSsrryknQwledge.
SIGNATURE Of P RE FOR
.
ADDRESS
10<.-\
\-\ o.Y\O \Ie-I" st.
C.O:(\ Isle. , "PP\
\101.3
For dales of _ on or aller July 1. 1994 and before January 1. 1995, the lax rate imposed on the net value oftran8fers 10 or for the use of the surviving spouse is 3%
[72 PS. ~9116 (a) (1.1) (l)J.
For dltes of doallt on or afte, January 1, 1995. the lax rale imposed on the net value of transfers fD or for the use of the SlMling spouse is 0% [72 P.S. ~9116 (I) (1.1) (n)l.
The s1alu1e does not _ a IransIer to a surviving spouse ltom lax, end the staIl*"Y ~ for dIodosure of .- and IiIIng I lax _ Ilffl s1I1 apjlIicabIe ...... .
the SUMWlg spouse Is the only baneficIaIy.
For dates of dea\h on Of llIef July 1. 2000:
The lax rate imposed on the I1Ilt value of transfers froIn . <leotl-' "'Id twenty.ooe years of age or younger 81 death 10 or for the use of I natural paren~ an adopUve paront,
or a stepparent of the child Is 0% [72 P.S. ~116(.)(1211.
The lax ,ate Imposed on the net value of_IS 10 or for the use of the decedan1's HneaI beneficiartas Is 4.5%, except as noted In 72 P.S. ~116(1.2) [72 P.S. ~9116(a)(1)J.
The Ia> rate imposed on the net value of tran8fers 10 or for the use of the decedent's siblings is 12% [72 P.S. ~116(1)(1.311. A sibling Is dafined. under Section 9102. IS an
indMdUll1M1o has at ieast one parenlln common with \he deceden~ whether by blood or adoption.
,
'''''''''''''''"''*
COMMONWEALm OF PENNSYLVANIA
INHERITNlCE TAX RETURN
RfSlDENT DeCEDENT
ESTAlE OF
H
Wa.sho.baujh
InClude... procoeds of IltigatiClfl andlho dIIIlll1e procoeds wenll8coivOd by Ihe e_. AII_rty ~Iy_.....the rtght01 eurvlYorshlp m..tbe dilc_ 00 Sc;hodule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 33. Shcu--<::-s 0+ I'-\a.nor Cere. :J:nc.
Common stvc..t.
CDSp ->> olo4D55 \0 I
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Sr
FIE NUlIBER
21-01 - 0032.0
531:\ 2.00
OJ i>11.o
TOTAL (Also enter on lirle5, Recapitulation) $ ~ 3q2 .00
(W more space is needed, insert additional shooIs of the same size)
RiV.,,,,,,.,,..,,.
eot.NONWEAlTli Of PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VlVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF \ \.
H WO-ShO-ba~h Sf
This scIIeduIelllUll bec:ompleled and ftIod Ktho answer to lII1y ofqueslfons1lhrough 4 01\ the....... ,ide of the REV.1500 COVER SHEET Is yes.
FILE NUMBER
21 -01 -0032-0
DESCRIPTION OF PROPERTY %OFDECDS
"' ~';.~D NaJIlEnEPNEOFnElMH8FBlEE. natFlS.A'JIJIrIlHPTODBBlENTHIlM ~TE(f"1RNlllFER. DATE OF OEA TH INTEREST EXCLUSION TAXABLE VALUE
ArrAOlAOOPY(fTHEl&iDfORREALESTATE. v.",. ....1
1. The.. Ame.."i CGV' F"'uY\ds 6voop l'-iq 82\.1.: I DO?'.. 0 1'-1'1 gZI. I
,
INIV I due..l 12e..-h Y'G.rne.nt
po, c.c.OLJrot f+ 51.:.51.0 % 11.0'-1
TOTAL (Also enter on line 7, Recapitulation) $ H'1 821.'"15
(W more space IS needed,lnsert additional sheets 01 tho same size)
s
"".""EX"""".
COMMONWEALTH Of PENNSYlVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATEOF 1\. \.1,.., Q
r vILlsho..bClU3h 0r
Dobls of doc:edonl mull be ~ on ScIIeduIe L
FILE NUMBER
71-01-00320
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t runerol Home- 73600.00
TnOmJ3 6e.1 <.:el
Ui)XY\WS bU1' 'VA
B. ADMINISTRATIVE COSTS:
1. P......a1~_.COrM1i8sions
Name of Personal Rept9S8lltallve(s)
Social Security NumbeI(.) I EIN N\lll'llef of Per>ona\ R_enlBllve(s)
SlreetAddre..
Cily Stale Zip
y..~.) Convnissloo Paid:
2. Attorney Fees
3. Faml)' Exemption: (If deCedents adctess is not the same as claimants. attach explanatkm)
Ciainanl
Slreet Addnl..
City SIBle Zip
R_h~ 01 Clalmsnl 10 Decedent
4. Probate Fees
5, Accountant s Fees
.
6. fax RelUm Pr8parer s Fees
7.
TOTAL (Also en"" 01\ line 9, Rllcapltuiation) $ 2S~OO
..
(W more opece IS needed,lnsert additionel__ of the some IlZe)
\ / b -c;) /9 - /c::v
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, AllOWANCE OR DISAllOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
Record:
Reri(,)j~
of DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P 1 :@UNTY
ACN
01-29-2002
WASHABAUGH
10-27-2000
21 01-0320
CUMBERLAND
101
JOHN OSZUSTOWICZ
104 S HANOVER ST
CARLISLE
'02 FEB-1
'*
REV-1547 EX AFP 1I2-DD)
HERBERT
T
Allount Rellitted
PA 1701t:;i.::rk
CUmbef;b..
FJ;,\
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=is4-,-e3f-AFP--n2-:0oY-NoYice-oF-iNHeifiTAifcE-TAx-7fpPRA-iseiiENT~--ALiowAifCE-('-ri-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WASHABAUGH HERBERT T FILE NO. 21 01-0320 ACN 101 DATE 01-29-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
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~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of line 14 at Spousal rate (15)
16. A.ount 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
X R ITS:
AY T R CEIPT
DATE NUttBER (_)
146,713.75 X 00 = .00
.00 X 045 = .00
.00 X 12 = .00
.00 X 15 = .00
(19)= .00
AMOUNT PAID
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
5.392.00
.00
.00
.00
.00
149.821. 75
(8)
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
(9)
(10)
8,500.00
.00
(11)
(12)
(13)
(14)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
155,213.75
A.linn nn
146,713.75
.00
146,713.75
.00
.00
.00
.00
( 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.)
-
-
L
STATUS REPORT UNDER RULE 6.12
Name of Decedent:~ lr.
Date of Death:M 21 2.(y)(')
Will No. Lon / - 00 ~2..0
V\JQ~")hahJ{5h 8r
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:
Admin. No. 21 - 01- 0320
1. State whether administration of the estate is complete:
Yes y... No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. I f 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:
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 af formal or informal accounts may be filed with the
Cerk of th~,Orphans' Court and may be ttached to this report.
I,' ,j
,
Date:~
IL
type or print)
~Qnover sf. Carlisle
Address
L11l) lY3- 7'-137
Tel. No.
(MAH:rmtIAM3)
Capacity: Personal Representative
)( Counsel for personal
repreSentative
~
AGREEMENT TO INDEMNIFY, RECEIPT, AND RELEASE
THIS AGREEMENT, by and among Carita C. Washabaugh Executrix of the Estate of
Herbert T. Washabaugh Sr. Deceased, and Carita C. Washabaugh.
WHEREAS, Herbert T. Washabaugh Sr. died October 27,2000, testate, a resident of
Cumberland County, Pennsylvania; and
WHEREAS, the Last Will and Testament of Herbert T. Washabaugh Sr. dated Apri130,
1997, was duly probated in the Office of the . ills of Cumberland County,
Pennsylvania as appears of record at Num r 21-01-0320 copy of the Will is attached hereto
and marked Exhibit A); and
WHEREAS, Letters Testamentary were issued to Carita C. Washabaugh on March 23,
2001; and
WHEREAS, said Executrix has duly administered the estate according to the laws of the
Commonwealth of Pennsylvania; and
WHEREAS, in Paragraph Second of his Will, decedent gives, devises, and bequeaths his
entire estate together with all insurance proceeds thereon of whatever nature and wheresoever
situate to his beloved spouse, Carita C. Washabaugh; and
WHEREAS, Carita C. Washabaugh has been furnished with a complete listing of the
estate assets, receipts and disbursements; and
WHEREAS, it is the desire of the parties to this Agreement that final distribution of this
estate be accomplished without a formal accounting to the Orphans' Court Division of the Court
of Common Pleas of Cumberland County, it being the desire of the parties to avoid the expense,
delay and publicity of a formal accounting.
NOW, THEREFORE, in consideration of the mutual promises, covenants and agreements
recited herein, the parties do agree as follows:
1. Beneficiary does hereby release and forever discharge Executrix, from any and all liability
which she had or may have or which may from time to time arise in connection with her
service as Executrix of the Estate of Herbert T . Washabaugh Sr., Deceased, and hereby
authorize and request the Orphans' Court Division to charge the same against her share of
said estate, and in consideration for said distribution, hereby agree to refund any amounts so
.
distributed which may be required to fully discharge any tax liability of the estate, debts of the
decedent, or administration expenses.
2. The party to this Agreement acknowledges that this Agreement shall be indexed and recorded
in the estate proceedings and that the terms hereof shall be binding upon her respective heirs,
successors, executrixs, administrators and assigns.
This Agreement shall be governed by the laws of the Commonwealth of Pennsylvania.
March
,2002.
a 11 ~"'--<O. LJ~~L
Carita C. Washabaugh, Executrix J
~..;. ~C.. [iLL Q~l.
Carita C. Washabaugh, Beneficiary J
~" 11~
SS1
.
Jftdf~nr ana (~81RPtlf
01
HERBERT T. WASHABAUGH, SR.
I, Herbert T. Washabaugh, Sr. of Carlisle, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and
Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me.
FIRST
I order and direct my personal representative hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the administration of my estate as soon after
my death as is reasonably possible. However, my personal representative need not accelerate and pay
those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous
to retain or renew and pay as they become due and payable. If I do not own a burial plot or a grave
marker at the time of my death, I authorize my personal representative, in his, her, or its sole discretion,
to purchase a burial plot and to erect a suitable marker at my grave, and to expend sums from my estate
for this purpose.
SECOND
I give, devise, ~d bequeath my entire estate together with all insurance proceeds thereon of
whatever nature and wheresoever situate to my beloved spouse, Carita C. Washabaugh, providing that
she survives me by sixty (60) days.
>>:i-aJ~~'.
-
THIRD
Should my spouse, Carita C. Washabaugh, predecease me or die on or before the sixtieth (60th)
day following my death, then I give, devise, and bequeath my entire estate together with all insurance .
o P rfllJ I1)UrIA, ~
proceeds thereon ofwbatever nature and wheresoever situate in equal shares to my chi1dren,'fierbert /rr'u/
Thomas Washabaugh, Jr., of Montgomery County, Maryland, TImothy Curtis Washabaugh, of -f. Jo ." J
Pennsylvania, who survive me by sixty (60) days, per stirpes.
Frederick County, Maryland, and Cynthia Ann Washabaugh Fenton, of Carlisle, Cumberland County,
FOURTH
My executor and trustee are authorized and empowered to exercise from time to time in his, her
or its sole discretion and without prior authority from any Court, in respect of any property forming part
of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon
trustees or executors and the testator intends that such powers be construed in the broadest possible
manner.
FIFTH
Will and Testament. In the event Carita C. Washabaugh is deceased, unable or unwilling to serve or
I nominate, constitute and appoint my spouse, Carita C. Washabaugh, Executrix of this my Last
shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint Herbert Thomas
Washabaugh, Jr., to serve instead. I direct that my personal representative shall not be required to give
or. post bond for the faithful performance of his, her or its duties in this or any other jurisdiction.
SIXTH
I hereby declare it to be my expressed desire that my personal representative employ the Law
Offices Of Ron Turo of. Cumberland County, Pennsylvania, for legal advice and assistance regarding this
my Last Will and Testament, they having considerable knowledge of my affairs, views and wishes
and the execution of the powers herein mentioned.
respecting any matters that may arise at the probate of this instrument, the administration of my estate,
)~-aJ~
IN WITNEss WHEREOF, I have hereunto set my hand to this my Last Will and Testament this
30th day of April, 1997.
4{/h~~
Witness (/
AMAfl1~
Witness
jjJ~kLJJ.,t..~~ .
Herbert T. Washabaugh, Sr.
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, Herbert T. Washabaugh, Sr., the Testator whose name is signed to the attached or foregoing
instrument, having been duly qualified according to the law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as
my free and voluntary act for the purposes therein expressed.
/k, 1~:/;-7'41.~ f) ~ a.. ~ ..h .
Herbert T. Washabaugh, Sr.
Sworn or affirmed and acknowledged before me by Herbert T. Washabaugh, Sr., the Testator, this
30th day of April, 1997.
,
Vdwk I2tw al;dt#~~~
I~ Public
/
I
ImNULI8L
""I:IIMIt c:a.n _I ~ .....,......
CIrIIM .... ^~...d c:..nr. PA
c.~_' I~. Nw. ~..
-
--
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
foregoing document, being duly qualified according to the law, do depose and say that we were present and
We, Lisa M. Whistler and Robert J. Mulderig, the witnesses whose names are attached to the
saw testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and
that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing
witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that
under no constraint or undue influence.
to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and
A1nu~A
~r~
day of April, 1997.
Sworn or affirmed and subscribed before me by Lisa M. Whistler and Robert J. Mulderig this 30th
-AlULIBL
"~-_ClfiLlII!t.. ""'PubIc
CIrIIII.., ~"'~4 c.une,.PA
... ~ . r J. ....13._
~(
ACCOUNTING FOR HERBERT T. WASHABAUGH ESTATE
ASSETS OF ESTATE
1. 337 shares Manor Care, Inc. common
stock Cusip # 564055101 @ $16.00
2. The American Funds Group Individual
Retirement Account #56568164
TOTAL ASSETS
$ 5,392.00
149.821.75
$155,213.75
EXPENSES & LIABILITIES OF ESTATE
Thomas Geisel Funeral Home
Filing and Probate Fees
Advertisement of Grant of Letters
Attorney's Fees
TOTAL EXPENSES & LIABILITIES
$ 8,500.00
51. 00
149.39
350.00
9.050.39
TOTAL A V AILABLE FOR DISTRIBUTION TO BENEFICIARIES
$146,163.36