HomeMy WebLinkAbout01-0458
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~T> ,(v\L\~'i ~:~)//, I~'}!) No. 21-01-458
also known as To:
Register of W~~ for the ._ /
. Deceased. County of I 1/11 b,/.'- 1:;.< in the
Social Security No. _ L '7 '';' f-r-" C,' ~~ i' I Commonwealtn of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of , age or older ~n the execut "j:. Ii \( i '
in the last will of the above decedent, dated d;1 G _
and codicil(s) dated
I ;/ .f named
,19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in / \; f /11 r;,' I:.,: / i ;/ . County, Pennsylvania, with
h J last fa~~IY o,r'pri~yi~al res~~n~~,!~t I.,.' '.);' (.. ,:. I, 1,( I)
I ;' ,," I ,~l ' <) ,! i ' '" I I /t/}; C , .,. - / ,. /1>)
. (list street, number and muncipality)
t/\ /' /,--- ~
Defendent, then .(... "~~)'ears ?l age, died _ ' ~ ,;; J ": , ' ti: :, ( '/~' !
at ~,(,{ (" ~(i~: :-',,-_i-'~~_<-Jt" /1,...,1) 1/'/>, ..,;--JI,-l~\1 --:'~,;;J(, '.-<'~ /-;~::.LJ l~'(" :i-'.-- _ .
Except as follows, decedent did not mar;y, was not divorced ancfdid 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:
CD/5, ,.'.~'7~.,~.J ~-r:: J,8d3.8'J-
$ ''E I' .. !!I
$ .
$
$
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 Pennsylvani~ i - ,_,
situated as follows: ~7f<./np . A ,/'(/1, :, ,);/)(1." ':.:/<(' :.,
t ,~/
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Testamentary
(testamentary; administration c. La,; administration d. b.n.c. La.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ 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.
affirmed and
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No. 21-01-458
Estate of
DONALD LEE BOOKS
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MAY 8th ~~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 JANUARY 26. 1995
described therein be admitted to probate and filed of record as the last will of
DONALD LEE BOOKS
and Letters TESTAMENTARY
are hereby granted to BETTY KAREN BOOKS
~//Ir?L.~///~ 10 J,A/('./~J~.c<-l
i _ glster of WI I
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
..2{-pag~s
KeI1Un'Clation ................
JCP
$
$
$
$
TOTAL _ $ 72.00
. . . . . . . . . . .~Y. .2... . f9P.~ . . . . . . . . . . .
25.00
6.00
36.00
ATTORNEY (Sup. Ct. 1.0. No.)
5.00
ADDRESS
Filed
PHONE
H10'UW') REV 9/8()
This is to certify that the infotmation here given is correctly copied fro~ 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.
Li~ ~.~~~~~
Local Registrar
Fee for this certificate, $2.00
p
7248460
APR 2 5 2001
Date
21-01-458
l't105.143Rev.2/87
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
:aRINT
I
,NEN'T
(INK
,.
AGE (Last Birthday)
Vonaf.d Lee
UNDER 1 YEAR
_ Coys
SEX
STATE FILE NUMBER
SOCIAL seCURITY NUMBER
NAME OF OECEOEMT (Fq, Midd\t,. Last)
66 VIS.
COUNTY OF DEATH
Cumbeltland
Book.6
UNDER 1 DAY
Houri ! MinutH
'1.001
BIRTHPLACE (City and
State or Foreign Country)
~JO
...
DECEDENT'S uSUAL OCCUPATION
(':'"..=t.;::':;.,,=~~
".. Sc.hoof. Teac.helt 11. Educ.a.ti.onal
DEceDENT'S ~dl!O ADDRESS (Sl<eol, 9'Y1Town, Stole, Zip Code) DEceDENT'S
601 O~( G~ove Rd. =r~:~
Mec.hanic..6bUltg, PA 17055 ~~~
SURVIVING SPOUSE
(" wfl., give maiden name)
Kozma
,th,
Cumbeltland
Ok\
-..
......
..........' 11..0 :"'''"::''::'.,
MOTHER'S NAME (FWtt. Middle, Maiden Surname)
twp.)
i
I
c+tylborc I
R.~I from Stel'O
5
I:
WERE AUTOPSY FINDINGS
AAILA8LE PRIOR 10
COMPlETION OF CAuSE
OF DEATH?
~~&--I!"- - frJ ~ S-
..... .
'MS CASE REFERRED 10 Me~AL. EXAMINERICORONER?
....~ NoD
...
I Approximate PART II: Other IignifIcant: condItIonI contritM.Iting!o dHth, but
i ==~ not reNl:ing in the undettyfng ell"" glYen in PART I. _
I
I
TIME OF OE.CTH
24. 3105 PM M. .
27. MRT 1: EMItl'UwI tINues, injunM or complteatloM which caUNCI the dnth. 00 not enler the mode of
LiM onty one ell"" on HCI'l RrIe.
DUE 10 (OA AS A CONSEQUENCE OF):
MA~NeR OF DEATH
DATE OF INJURY
(M_, Coy,....~
TIME OF INJURY
INJURY /JJ \YORK?
DESCRIBE HOW INJURY OCCURRED.
NoD
........
.........
SU....
)ll
o
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.--
o
o
o PlACE OF INJURY. At home, ferm,lIreet, 'ectory, offtc:e M.
bulldlng,....(Spoc'Y,
....
_ 0 NoD
_0
Pendtng; tn~.9t1on
Could not be del.rmined
~11a.llol
Oc.
2IlI. 21b.
CERTIFIER (Chtck only one)
-CERTIFYIMO PHYSICIAN (P\'1ys;cian certifying cause of dedl when another physiciIn has pronounced death and completed nem 23)
TothebeetofmyknoWlMgt:.deethoccutredChMtothecauee(.).ndmllnnerHIItated............................o....... to ,..............
n,
.PAOMOUHCIHQ AND CERTlFYINQ PHYSICIAN (Physician boCh pronouncing death and ~ 10 eauae of deelh)
To 1M.... of"" knowtecIgI, dMItI occutrlld at tM tIme,.......nd pIKe, end due to..... C:auM(.) end manner........ . . . . . . . . . .............. .
'MEDlCAL EXAMINPllCOAONER
On \M Melt. at bam\naUonlll'KSlor Invedgatkm,ln my oplnlOf'l, death occurred .t the time, date, and pl.ce. .nd due to the c,uM(.) .nd
manner......ed..................,.................. to...........................................................
31e.
REGISTRAR'S SIGNATURE AND NUM
32.
DATE FILED (Monltl. Day, 'fe8r)
1\ t- \\
34.
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21-01-458
WILL
I, DONALD LEE BOOKS, of Cumberland County, Pennsylvania, being
of sound mind and disposing memory, realizing the uncertainty of
this life, but with confidence in God and trust in His Son, my Lord
and Savior, Jesus Christ, who died for my sins upon the cross, and
rose again to justify me and give me eternal life, do hereby make,
publish and declare this to be my Last will and Testament, revoking
any and all previous Wills and codicils, and hereby will and
dispose of all the property which I own at my death in the
following manner:
ARTICLE ONE
BEQUEST OF TANGIBLE PERSONAL PROPERTY
~1.1 I bequeath to my wife, BETTY KAREN BOOKS, all my tangible
personal property, exclusive of any such property used in a trade
or business.
~1.2 If my said wife does not survive me, I bequeath such
property to my children who survive me, to be divided among them as
they agree.
In the event of disagreement among my children, any
such property that is the subject of such disagreement shall be
sold and the proceeds thereof added to the residue of my estate.
~1. 3 I direct that the expenses of storing, packing, shipping,
insuring and delivering any such property to the beneficiary
entitled thereto shall be paid by the executor as an administrative
expense of my estate.
In addition, to the extent practicable In
the executor's sole discretion, I bequeath any policies of
insurance on such property to the beneficiary entitled to such
property.
ARTICLE TWO
DISPOSITION OF RESIDUE
~2.1 I devise and bequeath all the residue of my estate to my
wife, BETTY KAREN BOOKS, if she survives me.
~2. 2 If my said wife does not survive me, I devise and
bequeath such residue to the following-named or described
beneficiaries in the shares indicated:
(a) Ten percent
(10%)
of such residue shall be
distributed as follows:
(i) Two-thirds (2/3) to my granddaughter, LEIGH
ANNE BOOKS, if she shall survive me; provided, however, if said
granddaughter has issue who survive me, then the share of said
granddaughter shall be distributed to her issue who survive me, per
stirpes.
(ii) One-Third
(1/3)
in equal
shares to my
grandchildren, other than my granddaughter, LEIGH ANNE BOOKS, who
survive me; provided, however, if a grandchild of mine does not
survive me and if such deceased grandchild has issue who survive
me, then the share of such residue to which such deceased
grandchild would otherwise have been entitled shall be distributed
to his or her issue who survive me, per stirpes.
(b) Ninety percent (90%) of such residue shall be
distributed to my issue who survive me, per stirpes.
-2-
~2.3 If my said wife does not survive me and if I have no
issue who survive me, I devise and bequeath all the residue of my
estate to SECOND CHANCE MINISTRIES OF PENNSYLVANIA, P.O. Box 297,
Hummelstown, Pennsylvania 17036, for its general uses and purposes.
ARTICLE THREE
TRUST FOR BENEFICIARY UNDER 21 YEARS OF AGE
~3.1 If any beneficiary (other than an appointee under any
power of appointment granted in this will) entitled to receive a
mandatory distribution of property from my estate is under 21 years
of age, I devise and bequeath such property to the trustees
hereinafter named for the benefit of such beneficiary, in trust for
the following purposes:
~3. 2 While the beneficiary is under 21 years of age, the
trustees shall hold, manage, invest and reinvest the trust
property, shall collect the income thereof and shall apply to or
for the benefit of the beneficiary so much of the net income and,
if the net income is insufficient, so much of the principal of the
trust property as the trustees shall from time to time deem
necessary or proper for the beneficiary's health, maintenance,
support and complete education.
The trustees shall annually
accumulate any net income not so distributed and add the same to
the principal of the trust property.
~3.3 When the beneficiary attains 21 years of age, the
trustees shall distribute to the beneficiary all of the trust
property, including any accumulated income.
-3-
~3.4 If the beneficiary dies before attaining 21 years of age,
the trustees shall distribute to the personal representative of the
beneficiary's estate all of the trust property, including any
accumulated income.
ARTICLE FOUR
APPOINTMENT OF FIDUCIARIES
~4.1 I appoint my wife, BETTY KAREN BOOKS, executor of this
will. If my said wife is unable or unwilling to act or continue as
executor, for any reason whatsoever, I appoint my brother, GLENN
DALE BOOKS, successor executor.
If my said brother is unable or
unwilling to act or continue as executor,
for any reason
whatsoever, I appoint my daughter, LISA M. BOOKS, successor
executor.
~4.2 I appoint my daughter, LISA M. BOOKS and my sister-in-
law, CYNTHIA ROTTY, trustees of any trust created by this will. If
either my said daughter or my said sister-in-law is unable or
unwilling to act or continue as a trustee, for any reason
whatsoever, I appoint my brother, GLENN DALE BOOKS, as a successor
trustee.
~4 .3 I appoint the trustees serving from time to time in
accordance with ~4.2 of this will as guardians of the estates of
any minor beneficiaries under this will, including the proceeds of
any life insurance on my life payable to such minors and any other
property, rights or claims with respect to which I am entitled to
appoint a guardian and have not otherwise specifically done so.
-4-
ARTICLE FIVE
POWERS OF FIDUCIARIES
~5.1 No fiduciary under this will shall be required to give
bond or other security for the faithful performance of the
fiduciary's duties.
~5.2 Any such fiduciary shall have the following powers, in
addition to those given by law:
~5. 3 To invest in, accept and retain any real or personal
property, including stock of a corporate fiduciary or its
holding company, without restriction to legal investments;
~5.4 To invest in, accept and retain stock in an S Corporation
and to take any action that the trustees deem necessary or
proper, including the power to petition a court of competent
jurisdiction to reform any trust created hereunder, in order
to assure that any trust created hereunder be deemed a
Qualified Subchapter S Trust within the meaning of Section
1361(d) (3) of the Internal Revenue Code;
~5.5 To sell, exchange, partition or lease for any period of
time any real or personal property and to give options
therefor for cash or credit, with or without security;
~5.6 To borrow money from any person including any fiduciary
acting hereunder, and to mortgage or pledge any real or
personal property;
~5.7 To hold shares of stock or other securities in nominee
registration form, including that of a clearing corporation or
depository, or in book entry form or unregistered or in such
other form as will pass by delivery;
~5. 8 To engage in litigation and compromise, arbitrate or
abandon claims;
~5 . 9 To make distributions in cash, or in kind at current
values, or partly in each, allocating specific assets to
particular distributees on a non-pro rata basis, and for such
purposes to make reasonable determinations of current values;
~5.10 To make elections, decisions, concessions and
settlements in connection with all income, estate,
inheritance, gift or other tax returns and the paYment of such
-5-
taxes, without obligation to adjust the distributive share of
income or principal of any person affected thereby;
~5.11 To merge any trust created hereunder with any other
trust or trusts created by me or my spouse under will or deed,
if the terms of any such trust are then substantially similar
and held for the primary benefit of the same person or
persons;
~5.12 To allocate, in the executor's sole and absolute
discretion, any portion of my exemption under Section 2631{a}
of the Internal Revenue Code to any property as to which I am
the transferor, including any property transferred by me
during my lifetime as to which I did not make an allocation
prior to my death;
~5.13 To disclaim any interest I may have in any estate if
the executor deems such disclaimer to be in the best interests
of my estate and the beneficiaries thereof; and
~5 .14 To terminate any trust created herein, the principal
of which is or becomes too small in the trustees' discretion
to make the establishment or continuance of the trust
advisable, and to make immediate distribution of the then
remaining trust property to the beneficiary then entitled to
the income of the trust property or, if there is more than one
beneficiary, to the beneficiaries then entitled to the income
of the trust property in proportion to their respective
interests therein or, if such interests are not defined, in
equal shares to such beneficiaries; provided, however, no
trustees shall participate in any decision to terminate such
trust if by reason of such termination such trustees could
receive a distribution of trust property from such trust as
aforesaid. The receipts and releases of the distributee{s}
will terminate absolutely the right of all persons who might
otherwise have a future interest in the trust, whether vested
or contingent, without notice to them and without the
necessity of filing an account in any court.
ARTICLE SIX
PROVISION FOR TAXES
~6.1 All estate taxes, inheritance taxes, transfer taxes and
other taxes of a similar nature payable by reason of my death to
any government or subdivision thereof upon or with respect to any
'-6-
property subject to any such tax, and any penalties thereon, shall
be paid by the executor out of the principal of that portion of my
estate disposed of by ARTICLE TWO of this will, and all interest
with respect to any such taxes shall be paid by the executor out of
the income or principal or partly out of the income and partly out
of the principal of such portion of my estate, in the absolute
discretion of the executor, without reimbursement from or
apportionment among the beneficiaries, recipients or owners of such
property for any such taxes, penal ties or interest; provided,
however, the executor shall not pay any such taxes, penalties or
interest attributable to any property included in my estate solely
because of a power of appointment thereover which I possess but
have not exercised or any qualified terminable interest property;
provided further, however, the executor shall only pay any
supplemental federal estate tax, or any penalties or interest
related thereto, imposed by Section 4980A (d) of the Internal
Revenue Code, if the paYment of such tax by the executor would
cause a net reduction in the amount of all estate taxes,
inheritance taxes, transfer taxes and other taxes of a similar
nature payable by reason of my death to any government or
subdivision thereof. If the paYment by the executor would not
cause such a net reduction, such supplemental federal estate tax,
together with any penalties or interest related thereto, shall be
borne by the recipients of the qualified plan benefit (including my
estate if it is a recipient of any such benefit) giving rise to
-7-
property "to or for the benefit of" any beneficiary who is under
(a) twenty-one years of age, or (b) a legal disability or otherwise
suffers from an illness or mental or physical disability that would
make distribution directly to such beneficiary inappropriate (as
determined in the trustees' sole discretion exercised in good
fai th), the trustees may distribute such property to the person who
has custody of such beneficiary, may apply such property for the
benefit of such beneficiary, may distribute such property to a
custodian for such beneficiary, whether then serving or selected
and appointed by the trustees (including any trustee), under any
applicable Uniform Transfers to Minors Act or Uniform Gifts to
Minors Act, may distribute such property to a guardian of such
beneficiary's estate, or may distribute such property directly to
such beneficiary (except if any of the conditions hereinbefore
described in (b) apply), without liability on the part of the
trustees to see to the application of such property. This
provision shall not in any way operate to suspend such
beneficiary's absolute ownership of such property or to prevent the
absolute vesting thereof in such beneficiary.
~7.5 Except as otherwise may be provided in this will, during
the continuance of any of the trusts created under the provisions
of this will, and thereafter until the property is distributed to
and received by any beneficiary hereunder, the principal sums thus
held in trust for any beneficiary, respectively, and the income
thereof shall not be subject to or liable for any contracts, debts,
-9-
engagements, liabilities or torts of such beneficiary now or
hereafter made, contracted, incurred or committed, but shall be
absolutely free from the same, and such beneficiary shall have no
power to sell, assign or encumber all or any part of the principal
sums or such beneficiary's interest therein, respectively, or the
income thereof, or to anticipate the income.
~7. 6 An individual fiduciary shall be entitled to receive
reasonable compensation for such fiduciary's services hereunder.
~7.7 Every successor or additional fiduciary shall have all
rights, powers, privileges and duties, whether discretionary or
otherwise, herein given to the original fiduciaries and shall be
subject to the same reservations, limitations, terms and
conditions.
~7. 8 If my wife, BETTY KAREN BOOKS, and I die under such
circumstances that it is impossible to determine which of us
survived, it shall be conclusively presumed and this will shall be
construed as if my said wife had survived me.
-10-
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IN WITNESS WHEREOF, I have hereunto set
day of ~/
(l
my hand and seal this
, 1995.
~~L B(J)~
DONALD LEE BOOKS
Signed, sealed, published and declared by the above-named
DONALD LEE BOOKS as and for his last will, in the presence of us
and each of us, who, at his request and in his presence and in the
presence of each other, have hereunto subscribed our names as
witnesses thereto the day and year last above written.
residing at
residing at
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-11-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Ct-rl?1kr/~I?Y
SS:
I, DONALD LEE BOOKS, the testator, whose name is signed
to the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; and that I signed it willingly and
as my free and voluntary act for the purposes therein expressed.
~~G~
DONALD LEE BOOKS
Sworn to or affirmed and acknowledged before me by
,.,/~
DONALD LEE BOOKS, the testator, this ~' day of
Jtf1ltk~ry , 1995.
/'
(SEAL)
~~-~~
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-12-
COMMONWEALTH OF PENNSYLV A
COUNTY OF u~krlr"t
We, Jerrr~y /fEr", le:o
,
SS:
, and 8~ r6~{~ 15, Erl-t }Cc.
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw the testator sign and execute the
instrument as his Last Will; that the testator signed willingly and
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 will as a witness; 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.
~~kA~&~
Witness
Sworn to or affirmed
vklh-e~ // Ernieo
// ~ /+t.~
witnesses, this -,~day of
and subscribed to before me by
and 15 C7r~ltrt:i8 Ernfc..o
...... s.I
Jetn*18~e'Y PItA:
~C::;=~~1997
. f\IolM:l8
, 1995.
( SEAL )
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HBG1i Ernico, JeffreYi 13650
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
/6-c2c:29~/O
REV-1500
OFFICIAL USE ONLY
FILE NUMBER
2.. I - 'L2. I
couNTIooDE YE~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
_ _ .!L 2 g:/
NUMBER
I-
Z
W
C
W
U
w
C
D 1,OriginalReturn
D 4. limited Estate
D 6. Decedent Died Testate {Attach copy 01 Will)
o 9. Litigation Proceeds Received
L
SOCIAL SECURITY NUMBER
- ~& - CJ
0/
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
D 2. Supplemental Return
D 4a. Future Interest Compromise {dale of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A} (Attach Sch 0)
COMPLETE MAILING ADDRESS II
GO I (.l{j) G/ltfUE .Ro
#.ech~n1C5LH1J jJ-;r 176Y)
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
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FIRM NAME (lfAppiicable)
TELEPHONE NUMBER
lf7
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1/ Y563. f? 2-
(6)
(7)
(9)
(10)
I
Q"'3 (8)
.co
J 963 B 2-
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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3 Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(11)
(12)
(13)
1/ '1{;3
'-s:!i
. -
00
/€
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
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
,0_ (15)
x.O_ (16)
, 12 (17)
x .15 (18)
j2J
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS () (
CITY
4-
STATE
o :5-:J-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
sc
Total Credits (A+ B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + 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.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;....... ..................................... ................................... ........ 0 ~
b. retain the right to designate who shall use the property transferred or its income;. .. ............................. D ~
c. retain a reversionary interest; or ................ ..................................................... ........................... D 0---
d. receive the promise for life of either payments, benefits or care? ......... ................................................. D cg:
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................... ........................................................... ........................... D tg::
3. Did decedent own an "in trust for' or payable upon death bank acoount or security at his or her death?............. D ,K!
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................ .... .................................................................... ................. D as:::J
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 penal~es of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct
and complete.
Dec\aralionofpreparerotherthanthepersonalrepresentativeisbased on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
A~RE~~' t31rf $1 ~~
od /L.I;\}-C1 (., fJ
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~
DATE
rn- -0 7~ot
P IJ ~/n:;.s.-
DATE
ADDRESS
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)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The 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,
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)). A sibling is defined, under Section 9102, as an
individual who has at least one parent in common w.h the decedent, whether by blood or adoption.
.,""""".,"".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned wtth the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
~1. /
\T)if
O()
f;; Lj J
~ If)
DESCRIPTION
VALUE AT DATE
OF DEATH
3 C cr-H{llcc;.Tt
/ftaJJ{hou() F~
f! . Box ~6
~1-1! chu/1: c5bu'J
1 D~jJo~/ fs
f3~
oJ--
G c9CJ, () d-
6'1'/.90
f)9/.9o
fl9 17055' - OOL;O
TOTAL(Alsoenteronline5,Recapitulation) $ I 807 O:?-
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) ~.
~!-
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ITEM
NUMBER
A.
Debts of decedent must be reported on Schedule I.
1.
FUNERAL I>XPENSES: .
c/--3 L~ - --;JtrtA~~
6c{ $. A.ft~19
;JIf/. ~ <~11fJ
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
DESCRIPTION
Fi:~
(?~
//t'f-
.~,60~
17C1C, j- J
( (1.f)4~.(/7~
Social Security Number(s}/EIN Number of Personal Representative(s)
Street Address
City
2. Attorney Fees
Year(s) Commission Paid:
_ State __ Zip
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
4.
Claimant
Street Address
City
Relationship of Claimant to Decedent
5. Accountant's Fees
Probate Fees
6. Tax Return Preparer's Fees
7.
State _ Zip
AMOUNT
/1 t?91 (J(J
/2_cO
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
.OD
'''''"".,''''.
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
I.
ESTATE OF
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
&;;0/(5
/UL~ R d
rr1 (70:;5
1.
8tTfy KCfI( zN
{cO ( ~cl.sl:J
/fJ1 ~~ c.~ I C~ b(~'5
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
wzdDw
l w ~ f€-)
AMOUNT OR SHARE
OF ESTATE
1803oCJ2-
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.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ /f'~3 _ r1.?:.-..
(If more space is needed, insert additional sheets of the same size)
~
Date of Death:
Name of Decedent:
Will No.:
Admin No.:
d 00 l- 00 t.{ s-.f>
'-
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on
Name
Address
~~-e+-+y K~v--€-,^ 'ec.oks
(p 0 I
o(~ GirO,:!:: 62'JZ
11l-e c' '^ b~. , Ra..~ l"r D6~
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: ~(o (
73-<'1 If ~ u (~"",A/
Signature
-L~H-y k~..,-ex' ~6C l<s
Name
~'o l
Address
o
[) (~ C;\ro\J e R.&.) tHee l>..b~' , l~ - l1lS"
( '7 l tf) ?ic fO - DRS- I
Telephone
Capacity: [Z] Personal Representative .-"- X< ~ '^ -\ v- ,'>,
D Counsel for personal representative
/"-..;:)0::;. 9'-/0
~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
BETTY K BOOKS
601 OLD GROVE RD
MECHANICSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
.)COUNTY
ACN
06-11-2001
BOOKS
04-24-2001
21 01-0458
CUMBERLAND
101
D.{~
'i~
REV-1547 EX AFP el2-00l
DONALD
L
Allount Rellitted
PA 170~,~.
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=is47-Ex-AFP-n'2=ooY-NoYiCE--oF-YtiHEifiTANCE-YAiC-APPRAisEifENT~--Aii-oWAirCE-iri-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOOKS DONALD L FILE NO. 21 01-0458 ACN 101 DATE 06-11-2001
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. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(S)
(6)
(7)
.00
.00
.00
.00
1,803.82
.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/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
1,963.00
.00
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
1,803.82
1.963.00
159.18-
.00
159.18-
14, IS and/or 16, 17, 18 and 19 will
returns assessed to date.
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
IS. Amount of Line 14 at Spousal rate (IS)
16. Amount 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
TAX CREDITS:
.OOXOO=
.00 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
.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" (CRJ, YOU MAY BE DUE
"D~~II..n c:.~~ D~U~Dc:.~ c:.Tn~ n~ T"'T~ I'"nDM I'"nD TN~TRlIr:TTnN~.l
Date of Death:
STATUS REPORT UNDER RULE 6.12
I)ono..Ld Le~ .~~.s
q I d-lf I d.-co I
,,/
C-
01<
"
Name of Decedent:
Will No.:
Admin. No.: ;). 00 I - 60'15" cf (+'J-edJ.)
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the estate is complete:
Yes eg No 0
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 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: ~'?1 e
c. Did the personal representative state an account informally to the parties
in interest? Yes I81 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: ~/o5 Signat!:;f ~ ~I.v
pe-Hi ((~~"eY\ ~Ks ~'fkJ k,~~
Name
Coo i n Ie( b voDe. a-ltteehD1" g i 'ft
Address
(i / 1 ') {~(o - D8S l
Telephone No.
Capacity: ~ Personal Representative (€..x<'" l^.:tri>Q
o Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/10/2003
BETTY KAREN BOOKS
601 OLD GROVE ROAD
MECHANICSBURG, PA 17055
RE: Estate of BOOKS DONALD LEE
File Number: 2001-00458
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: 4/24/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
/iJn~NU4W~
DONNA M. OTTO ~~
DEPUTY REGISTER OF WILLS
cc: Aile
Counsel
Judge
/
~
o~
INRE:
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
ORPHANS' COURT DNISION
ESTATE OF JULIE MARTIN
NO: 01-00462
STATUS REPORT PURSUANT TO RULE 6.12
Name of Decedent:
Date of Death:
Willi Administration Number:
Julie Martin
April 8, 2001
No. 2001-00462
Pursuant to Rule 6.12 ofthe Supreme Court Orphans Court Rules, I report the following
with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the estate is complete.
Yes No ..[
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete.
Litigation concerning the death of the decedent will most likelv conclude within
the next ninetv to One hundred and twenty (90-120)days.
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:
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 th erk of the Orphans' Court d may be
attached to this report., . . . , , . . . ,,--
Date: March 19,2003
Harry T. Col an, Esquire
Counsel for Personal Representative
148 Adams Avenue
Scranton, P A 18503
Cumberland County - Register Of Wills
Hanover and High Street
Carlislel PA 17013
Phone: (717) 240-6345
Date: 3/10/2003
ANDREW A MARTIN
24 BRENTWOOD ROAD
CAMP HILLI PA 17011
RE: Estate of MARTIN JULIE
File Number: 2001-00462
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. 11 for decedents dying on or after
July 1, 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 4/08/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: J File
Counsel
Judge