HomeMy WebLinkAbout01-0733
PETITION FOR PROBATE and GRANT OF LETTEI\S
ESta~ of Emma M. Farence
also known as
No.
To:
Register of Wills for the
Deceased. County of Cumberland in the
Social Security No. 174-46-6410 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who ktare 18 years of age or older an the executor~
in the last will of the above decedent, dated Tllnp?R, ?OOO
and codicil(s) dated n/a
21-01-733
named
~~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
her last family or principal residence at Messiah Village. 100 Mt. Allen Drive r
Mechanicsburg. PA. 1701)1), TTpppr Allpn 'T'olo7T1~h;p
(list street, number and muncipality)
Decendent, then 83 years of age, died Au~ust 2. 2001 ~xxxxxx ,
at Messiah Vil1aget'-100 Mt Allpn nrim::', MpC'h:::miC'Q}'I11rg, PA, 17055
Except as follows> dec~enf:did not marry, was not divorced and did not have a child born or adopted
after execution of th~ will otfer~ for probate; was not the victim of a killing and was never adjudicated
incompetent: nj a
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: None
$ 250,000.00
$
$
$
WHEREFORE, petitioner(s) respectfully r~uest(~ the probate of the last will and codicil(s}
presented herewith and the grant of letters tes ame tary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
-
~
u
c::
o
"0_
._ en
rn::;'
Qq;l
"O.~
;'P
'Vi'~
41....
~o
Gj
c::
1lO
i:i5
John A. Farence
9463 East Menlo Circle
Me~.q, A7. R';?07
a~ ~~4/<~
/
Charles L. Farence
PO 262
Dauphin. PA 17018-0262
~ 1- ~p'l~\:.(..-
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF ~F1lT Aim
No.
21-01-733
.
.
Estate of Emma M. Farence
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW Augus t 8 ~-ZOO-l-, 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 June 28, 2000
described therein be admitted to probate and filed of record as the last will of Emma M. Farence
and Letters Testamentary
are hereby granted to r.h;:J r 1 p ~ T.
F;:Jrence ;:Jnd John A. Farence
Will Book #
Page
~IY ryf:mliu~AU ,a,,"r
ster of W
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
x-pag~s.
RenunCiatIOn ................
JCP
$
$
$
$
TOTAL _ $ 305.00
. . . . .4V~P.~~. ~'" . ?9P.~ . . . . . . . . . . . . .
270.00
18'88
12.
5.00
ATIORNEY (SilO. Ct. I.D. No.)
Jered L. Hock, Esq., I.D. #19211
3211 North Front Street
ADDRESS
PO Box 5300
Harrisbur~. PA 17110-0300
PHONE
(717) 238-8187
Filed
~-Iv d/~~<;;,cJ
WARNING: IT IS IllEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMOI'JWEAL TH OF PENNSYL VANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. T 4 9 6 0 211
,j'" "i -;/i -,/-;;;;-;, ;;;;;;;.:,
/.llil(. ,,\.\H Of PL:A>~,
/(.\,\~~ \.- r"_/'~~~f /f --:.~\
Il ~~... .~-:::\
"~~/ ~~'\~\\
~g~, :.:\~~
il:;;i~:: .. ;Lf!)
\\ a.'.j/~-' .. . ~/J
'~~~~""'" .. . /~p
'~~~-!jMEN11J\/~~~~"Y'
':.'~-::'~~.!/.!.!.!;!!J!!J.;!J, "
August 3, 2001
Date of Issue of This Certification
21-01-733
Name of Decedent
EIIIIIa
M.
~Ald(j i
Farence
r~1 r<t
Last
Sex __!_~I!l~~~________ Social Security No_
174 - 46 - 6410
Date of Death
August 2, 2001
Date of Birth May 1, 1918
Birthplace Warrington Township, York County, Pennsylvania
F (]c.:!li~y f\Jarl~
f)
Cumberland County
Place of Death
Messi.ah Village
( :nli'l!
City, Boroug;, n~ Township
Upper Allen Twp. Pennsylvania
Race______~_l:1_~!:~~___ Occupation Housewife
Decedent's
Mantal Status _~ido~~~___ Mailing Address
- Armed Forces? (Yes or No)
No
~JV'l~Wt
Messiah ~illage, P.O. Box 2015
Mechanicsburg
PA
Stief'
City or To\"1'f
State
Informant Mr. Charles L. Farence Funeral Director ~~f~t t D. Brenneman, FD
Name and Address of
Funeral Establishment _ Cocklin Funeral Home. In~_lQ~~. Chestnut Street. Dillsburg. PA 17019
I
Interval Between
Part I: Immediate Cause Onset and Death
(a) __ C~_~anc..!"ea~___________________
(b )_________________
(c )_________
----.l
I
I
I
Part II:
(d) _______
Other Significant Conditions
Manner of Death
Describe how injury occurred:
Natural ~XX Homicide 0
Accident Pending Investigation 0
Suicide
Could not be Determined
o
Name and Title of Certfier
Michael L. Gluck, MD
(M.D., D.O., Coroner, M.E.)
Address
108 Lowther Street, Dillsburg, PA 17019
This is to certify that the information here given is correctly copied from an original certificate
of cleath duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Records Office for permanent filing.
t/-~OiVII~~--~-.~ 6760~,strlcINo
- Al.~~.11,,~r: '~~.I i~.C..>.'.' - __~53 Logan &QML- Dillsburg. PA 17019
- . -. :3:n.,"et flcidru:~s City. Borcugh. Township
21-01-733
LAST WILL AND TEST AMENT
OF
EMMA M. FARENCE
I, EMMA M. FARENCE, of Outlook Pointe at Creekview, 1100 Grandon Way,
Mechanicsburg Post Office, Cumberland County, Pennsylvania, revoke any prior Wills and
Codicils and declare this to be my Will.
ITEM 1. I give my household and personal effects and other tangible personalty of
like nature in as nearly equal shares as practical to my sons, CHARLES L. F ARENCE and
JOHN A. F ARENCE. If either son is not living on the thirty-first day after my death, I give his
share to his issue per stirpes who survive me by thirty days.
ITEM 2. I give all the rest, residue, and remainder of my estate in three equal shares
as follows, subject to the survival provisions of this Will: one-third (1/3) to my son,
CHARLES L. F ARENCE; one-third (1/3) to my son, JOHN A. F ARENCE; one-third (1/3) to be
divided equally among my grandchildren. For purposes of this Will, the phrase "my
grandchildren" shall mean all of the natural children of my son, CHARLES L. F ARENCE, from
both of his marriages and also his step-daughter, SHIRLEY SENTEI, and also the adopted son of
my son, JOHN A. F ARENCE, WILLIAM C. F ARENCE, and the two step-children of my son,
JOHN A. F ARENCE, JENNIFER NORSTROM and BRIAN NORSTROM.
Document #: 178630.1
ITEM 3. (a) I direct that if either of my sons does not survive me by thirty days,
his share shall be given instead to his spouse if she survives me by thirty days. If neither one of
my sons of his spouse is living on the thirty-first day after my death, I give that son's share to his
issue per stirpes who survive me by thirty days. For purposes of this Will, I include within the
phrase "issue per stirpes" the natural children of my son, CHARLES L. F ARENCE, from both of
his marriages and also his step-daughter, SHIRLEY SENTEI, and also the adopted son of my
son, JOHN A. F ARENCE, WILLIAM C. F ARENCE, and the two step-children of my son,
JOHN A. F ARENCE, JENNIFER NORSTROM and BRIAN NORSTROM.
(b) If any of my grandchildren, as defined in this Will, do not survive
me by thirty days, their share shall lapse and be given instead to my other grandchildren, as
defined in this Will, in proportion as they would otherwise take shares of my estate.
ITEM 4. I direct that all my just debts and the expenses of my illness and burial,
including my grave marker, shall be paid from my residuary estate as soon as practicable after
my death as part of the expense of the administration of my estate.
ITEM 5. In addition to the powers granted by law or by other parts of this Will, my
Executors shall have the following powers:
(a) To retain any and all assets of my estate, real, personal, or mixed,
without regard to any principle of diversification, risk, or productivity, except as may be
otherwise expressly provided herein;
(b) To sell at public or private sale, to exchange, to lease, to pledge, to
mortgage, to transfer, to convert, or otherwise dispose of, and to grant options with
respect to, any and all property, real, personal, or mixed, at any time forming part of my
Document #: 178630.1
estate or trust estate in such manner, at such time or times, for such purposes, for such
price or prices and upon such terms, credits, and conditions as may be deemed advisable;
( c ) To invest and reinvest the trust property in stocks, bonds,
mortgages, notes, insurance policies, annuities, common trust fund participation, or other
property of any kind, real, personal, or mixed, irrespective of any statute, case, rule, or
custom limiting the investment of trust funds, except as expressly provided otherwise
herein;
(d) To settle, compromise, contest, prosecute, or abandon claims in
favor of or against my estate or any trust as may be deemed advisable;
(e) To allocate receipts and disbursements to principal or income or
partly to both and to ascertain principal or income in accordance with the laws of the
Commonwealth of Pennsylvania;
(f) To make distribution or division of the trust or estate in cash, in
kind, or partly in both, to postpone distribution by agreement with a beneficiary and to
distribute articles of tangible property to a minor or to any person to hold for a minor
within the limits authorized by statute or rule of law; and
(g) To exercise any law-given option to treat administration expenses
either as income tax or estate tax deductions, without regard to whether the expenses
were paid from principal or income, and without requiring reimbursement.
ITEM 6. No bond shall be required by my Executors, but if bond is nevertheless
required, it shall be without surety.
Document #: J 78630. J
ITEM 7.
I appoint my sons, CHARLES L. F ARENCE and JOHN A F ARENCE,
Executors. If either fails to qualify or ceases to act, I appoint my other son as sole Executor.
Executed this ~ day of
]Ur>t:-
, 2000.
11~/;; 1~~
Emma M. Farence
Signed, sealed, and published and declared by the above-named Testatrix, EMMA M.
FARENCE, as and for her Last Will and Testament, in the presence of us, who, at her request, in
her sight and presence, and in the sight and presence of each other, have hereunto subscribed our
names as witnesses.
~/~ ~d~ess /,t~o;~7/ //7-
~ ~. 771~H/A
Address
'IYlJ~~AA1 . PA
/
Document #: 178630.1
Commonwealth of Pennsylvania
ss
County of UrhJ PHi ~
We,EMMAM.FARENCE,and Rv~.J // #~";;/1r!"~vC.. . and
~ ~t 111. #1/I,e.r , the Testatrix and the witnesses, respectively, whose
name e sIgned to the attached or foregoIng Instrument, bemg first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrwnent as her last Will
and that she had signed willingly (or willingly directed another to sign for her), 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 Will as witness and that to the
best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
~~~ I~
Testatrix
I2/ff~~~
Witness
~g~ -In. --fJtj&
W ness
SWOR.1~ to or affirmed and acknowledged before me by the above named Testatrix and
witnesses this 2P'~ay of ::Tv r--<--- , 2000.
IL-t (2 4b
Notary Public '
My Commission Expires:
(SEAL)
NOTARiAl SEAL
CAROL A. LYTER, NOTARY PUBUC
Harrisbu.... Dauphin County
My ~mmission Expires Dee. 28, 2000
Document #: 178630.1
INRE:
ESTATE OF EMMA M. FARENCE,
Deceased
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
NO. 2001-00733
CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Emma M. Farence
Date of Death:
August 2,2001
Estate No.:
No. 2001-00733
I hereby certify that notice of beneficial interest 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 August 13, 2001.
Name
Address
Mrs. Brenda Beyer
3210 Conowago Road, Dover, P A 17315-2912
Mrs. Karin Baker
PO Box 208, Dauphin, P A 17018-0208
Mr. Charles Farence, Jr.
3936 Elmerton Avenue, Harrisburg, P A 17019-1248
Mr. Ricky Farence
25 Beers Avenue, Duncannon, PA 17027
Mr. David Farence
318 Sheetz Road, Halifax, P A 17032
Mrs. Shirley Senteio
550 Deville Dam Road, Shermansdale, P A 17090
Mr. Randy Farence
440 Windy Hill Road, Shermansdale, P A 17090
Mrs. Linda Smith
269 Linway Road, Lock Haven, P A 17745
Barry Farence
PO Box 262, Dauphin, P A 17018-0262
Carolyn Silcox
96 Beard Road, Enola, P A 17025
William C. Farence
101 Elderberry Drive, Levittown, P A 19054
Document #: 2/3448./
Brian R. Norstrom
9463 E. Menlo Circle, Mesa, AZ 85207
Jennifer Ann Norstrom
9463 E. Menlo Circle, Mesa, AZ 85207
Charles L. Farence
PO Box 262, Dauphin, P A 17018-0262
John A. Farence
9463 E. Menlo Circle, Mesa, AZ 85207
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
Jered L. Hoc, squire
AttomeyI.D. No. 19211
3211 North Front Street
P.O. Box 5300
Harrisburg, P A 17110-0300
(717) 238-8187
Attorneys for Personal Representative
Date: August 13, 2001
Document #: 213448.1
BUREAU OF INQIVIDUAL TAXES
INHERI'JANCE TA>ro DIVISION
DEPT. Z80601
HARRISBURG I PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
JERED L HOCK ESQ
METZGER WICKERSHAM
PO BOX 5300
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
*.'
REV-1547 EX UP (01-02)
06-10-2002
FARENCE
08-02-2001
21 01-0733
CUMBERLAND
101
EMMA
M
Allount Rellitted
PA 17110
Jh~'l. 47
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 ~
~-: -:- ~ =- ::'~_':_:'~;-':.__~____~____"":::-...______ _______.::_'!!_____ ________,________ _lIII__..__~---_5.--.::a-....2.:..!Jl--.- - ----- -----~--....., - - ~ - -
/,h -;2f/fl- Xg
'\ BUREAU OF INDIVIDUAL TAXES
'\, INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG1 PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
IlEV-1607 EX AFP Ul-D2)
JERED L HOCK ESQ
METZGER WICKERSHAM
PO BOX 5300 l..
HBG ~'A 17110
TC: ,JUL 2 (;
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-22-2002
FARENCE
08-02-2001
21 01-0733
CUMBERLAND
101
EMMA
M
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 ~
R'E-y-=i6of-E3f-AFP--fol-:02i-------ii..--iNifERI,.-ANc'E-;:AX--STA-fEME-ri;:-ifF'-AC-couiif--..ii---------------------
ESTATE OF FARENCE EMMA M FILE NO.21 01-0733 ACN 101 DATE 07-22-2002
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: 06-10-2002
PR I NC I PAL TAX DUE: ...........................................................................................................................................................................................................................
14,606.42
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-31-2001 CDOO0464 684.21 13,000.00
04-30-2002 CDOO1128 .00 893.00
06-17-2002 CDOO1304 .22- 29.47
TOTAL TAX CREDIT 14,606.46
BALANCE OF TAX DUE .04CR
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .04CR
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. )
- -
/b'-;Yf-- ~~'
~ BUREAU OF INDIVIDUAL TAXES
INH~ITAN'~AX 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
DATE
ESTATE OF
DATE OF DEATH
fjLE NUMBER
:1 CbUNTY
ACN
06-10-2002
FARENCE
08-02-2001
21 01-0733
CUMBERLAND
101
'02
dUl_ -1
JERED L HOCK ESQ
METZGER WICKERSHAM
PO BOX 5300
HBG
Ie"
PA 1711d~v
*
REV-1547 EX AFP UI-02)
EMMA
M
Allount Rellitted
(1)
(2)
(3)
(4)
(S)
(6)
(7)
.00
133.983.00
.00
.00
144.499.00
41.541.00
52.151.00
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 ~
R"E-y=is"4-j-EX-AFP-fcff:oz'r-NCi;--icE--OF-'rtiHEiiiTAirci-~fAX-A-PPR7risEirENT~--Ai:i-oWAiici-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FARENCE EMMA M FILE NO. 21 01-0733 ACN 101 DATE 06-10-2002
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
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
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
32,509.00
15.078.00
(11)
(12)
(13)
(14)
(9)
(10)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
(8)
372,174.00
47.587 00
324,587.00
.00
324,587.00
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:
lS. Allount of Line 14 at Spousal rate (lS)
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
324,587.00 X 045 = 14,606.42
.00 X 12 = .00
.00 X 15 = .00
(19)= 14,606.42
TAX CREDITS:
r"."cnl Kc",c.&.rl I+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
10 31-2001 CDOO0464 684.21 13,000.00
04-30-2002 CDOO1128 .00 893.00
INTEREST IS CHARGED THROUGH 06-25-2002 TOTAL TAX CREDIT 14,577.21
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 29.21
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .26
TOTAL DUE 29.47
. 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.)
REV-1410 EX (~88),
-.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
REVIEWED BY
ITEM
SCHEDULE NO.
H
INHERITANCE TAX
EXPLANATION
OF CHANGES
Emma M. Farence
FILE NUMBER
CHARLES WRIGHT
ACN
2101-0733
101
EXPLANATION OF CHANGES
The deduction for travel expenses has been disallowed. The executor or administrator of
the estate is the only person entitled to claim these expenses in conjunction with the
administration of the estate.
ROW
Page 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
/0-"d-t.J&?-/3
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
si-
c:....-
FILE NO. 21 01-0733
ACN 01145230
DATE 09-28-2001
REY-154S EX AFP U9-00)
; l
EST. OF EMMA M FARENCE
S.S. NO. 174-46-6410
DATE OF DEATH 08-02-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[X] CHECKING
D TRUST
D CERTIF.
** CHARLES L FARENCE SR
PO BOX 26'2
DAUPHIN i PA 17018
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
VARTAN NATIONAL BANK has provided the Depart.ent with the infor.ation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~.onwealth
of Pennsylvania. QUAstions..y be answered bY ~alling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 153- 015-3 Date 01-23-2001
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
41,541.11
50.000
20,770.56
.045
934.68
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice .ust acco~any your
pay.ent to the Register of Wills. Hake check
payable to: "Register of Wills, Agent".
x
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent.s date of death,
you .ay deduct a 5~ discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
Tax
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. D The above infor.ation and tax due is correct.
1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you .ay check box "Aft and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
~o be filed by the decedent's representative.
C. D The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
OF
1
2
3
4
S
6
7
8
x
x
PART
@]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line S of Tax Computation)
perjury, I declare that the facts I
my knOWledge~a~ belief.
/0-JcrL~
have re~rted abOV1~. yueri07!{ tf
HOME ( 7(7 ) ;- r
WORK ( )
TELEPHONE NUMBER DATE
., ,.","'t,~It, ""'.,....')! ',-.' >'t.t',,(.i._' >>J.:..'''~'' " .'.:...
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
METZGER & WICKERSHAM
3211 N FRONT STREET
POBOX 5300
HARRISBURG, PA 17110-0300
-------- fold
ESTATE INFORMATION: SSN: 1 74-46-641 0
FILE NUMBER: 21-2001- 0733
DECEDENT NAME: FARENCE EMMA M
DA TE OF PAYMENT: 11/01/2001
POSTMARK DATE: 10/31/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 08/02/2001
NO. CD 000464
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $13,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$13,000.00
REMARKS: CHARLES L FARENCE
C/O METZGER & WICKERSHAM
CHECK# 1001
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 001128
DUPLICATE
HOCK JERED L ESQ
POBOX 5300
3211 NORTH FRONT STREET
HARRISBURG, PA 17110
-------- fold
ESTATE INFORMATION: SSN: 1 74-46-641 0
FILE NUMBER: 2101-0733
DECEDENT NAME: FARENCE EMMA M
DA TE OF PAYMENT: 04/30/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/02/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $893.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$893.00
REMARKS: CHARLES L FARENCE
C/O JERED L HOCK ESQUIRE
CHECK#1007
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOCK JERED L ESQ
POBOX 5300
3211 NORTH FRONT STREET
HARRISBURG, PA 17110
__n_n_ fold
ESTATE INFORMATION: SSN: 1 74-46-6410
FILE NUMBER: 2101-0733
DECEDENT NAME: FARENCE EMMA M
DA TE OF PAYMENT: 06/18/2002
POSTMARK DATE: 06/17/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 08/02/2001
NO. CD 001304
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $29.47
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$29.47
REMARKS: C/O JARED L HOCK ESQ
CHARLES L FARENCE
CHECK# 1011
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
-
~
STATUS REPORT UNDER RULE 6.12
Name of Decedent
Date of Death
Will No. 2001-00733
Emma M. Farence
August 2. 2001
Admin No.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No.
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report.
Date:
Proofs of Publication are ~
July q , 2003 _
Signature
Name J ered L. Hock. Esquire
(Y1
~.;: -r
o
Address 3211 North Front Street
P.O. Box 5300
Harrisburg. PA 17110-0300
~~~=:
..-l
=:J
..
Telephone
(717) 238-8187
r
t)
2
\"'\
P
Capacity:
Personal Representative
X Counsel for Personal
Representati ve
284196-1
,
.. .. .......
, -
..
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16,1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Michael Morrow being duly sworn according to law, deposes and says:
That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws
of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in
the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The
Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the
City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th,
1854, and September 18th, 1949, respectively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published in
their regular daily and/or Sunday/ Metro editions which appeared on the 21 st and 28th day(s) of August and the 4th
day(s) of September 2001. That neither he nor said Company is interested in the subject matter of said printed
notice or advertising, and that all of the allegations of this statement as to the time, place and character of
publication are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this
statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and
adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in
the office for the Recording of Deeds in and for said County 0 auphin in Miscellaneous Book "M",
V;I~:L11~:::~~' ........................ .. ..)~..................................
COpy
, NOTICE. .,,"
Letters Testamentary In the E,.1 ~
EmrnaM. Fartnc:e, late of Upper AI_ ~.'
ship, Cumberland County, PennsYfvan~~
ceosed (died Aueust 2, 2001), hqyjng t>
eranted to the undersigned, 011 PerSOns .
dlb1ed to said esiate are recwes1ed to mate.. "-
Immediate qoyment and tho$e. having claims '
to Pf'8Mftt ttiefn without detay to:
==&6~,eo.Executor .
Daulthtn, PA 1711"-2
or
Jolin A. FGrerIce~ Co-IEMCUtor
M63 East Menlo CIrcle
~ AZIS2I7'
or
.IencI L Hoell, E..re
METZGER, WleKERSHAM, KNAUSS &
ERa, P.C.
P.o. Box 5300
3211 Nortb Front Street
Harrtsburg, PA 11"....
Notarial Seal
Terry L. Russell. Notary Public
Harrisburg, Dauphin County NO ARY PUBLIC
My ComMission EMpires June 6,2002
My commission expires June 6, 2002
Member, Pennsytvania Associatien 01 NQtaries
METZGER WICKERSHAM
ATTN: JERED L. HOCK
P.O. BOX 5300
HARRISBURG, PAt 17110
Statement of Advertising Costs
To THE PATRIOT-NEWS CO., Dr.
For publishing the notice or publication attached
hereto on the above stated dates $
Probating same Notary Fee(s) $
Total $
127.89
1.50
129.39
Publisher's Receipt for Advertising Cost
The Patriot News Co., publisher of The Patriot-News and The Sundav Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
been duly paid.
By................................................................... .
"" .
#
...
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
STATEOFPENNSYLVANIA :
SSe
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
VIZ:
AUGUST 24,31, SEPTEMBER 7,2001
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
Farence. Emma M.. dec'd.
Late of the Township of Upper
Allen.
Executors: Charles L. Farence.
P.O. Box 262. Dauphin. PA 17018-
0262 and John A Farence. 9463
East Menlo Circle. Mesa. AZ
85207.
Attomeys: Jered L. Hock. Esquire.
Metzger. Wickersham. Knauss &
Erb. P.C.. P.O. Box 5300. 3211
North Front Street. Harrisburg.
PA 17110-0300.
~~
Roger M. Morgenthal, Editor
SWORN TO AND SUBSCRIBED before me this
7 day of SEPTEMBER. 2001
NOTARfAL'SEAl.
LOIS E. SNYDER, Notary Publfc
CIrfisIe Boro, Cun'Iber.and County
My ConInIuion Expires March 5. 2005 .
\
REV -1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 /" ;}.<jg'- /~~
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT ;J./ 0; 1l1~
COUNTYCDDE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Farence Emma M 174-46-6410
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
08/02/2001 05/01/1918 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
- -
3. Remainder Return
CHECK ~ 1. Original Return ~ 2. Supplemental Return B (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
~ate of death after 12-12-82)
PRIATE 6. Decedent Died Testate 7. ecedenl Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach copy 01 Will) i:ttach a copy of Trust)
BLOCKS 9. Litigation Proceeds Received 10. pausal Poverty Credit (dale of death between 0 11. Election to lax under Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
tHi$$!i$tipNMi.l$tIlI!CQM!!!;;l!tIWAijWC~~_l!~CQN~jQ.i,Mit~]N!'QRMAtIQN$fflQj.jiiPjjjjpii'liWtijpi'Qi
NAME COMPLETE MAILING ADDRESS
COR- Jered L. Hock, Esquire 3211 N. Front St. ; PO BOx 5300
RE- FIRM NAME (If Applicable) Harrisburg, PA 17110-0300
SPON
DENT Metzger Wickersham
TELEPHONE NUMBER
717-238-8187
OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1) 0
2 Stocks and Bonds (Schedule B) (2) 133,~. d
3. Closely Held Corporation, Partnership or Sole~Proprielorship (3) ;0 i"-.;
4. Mortgages & Notes Receivable (Schedule D) (4) . 0
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 144,499 L<J
6. Jointly Owned Property (Schedule F) .:::J
0 Separate Billing Requested (6) 41,541
RECA- '.,'
PITULA- 7. Inter-Vivos Transfers & Miscellaneous _1'::0"
TION Non - Probate Property (Schedule G or L) (7) 52,151 UJ
8. Total Gross Assets (total Lines 1-7) (8) 372,174
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 33,165
10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) (10) 15,078
11. Total Deductions (total Lines 9 & 10) (11) 48,243
12. Net Value of Estate (Line 8 minus Line 11) (12) 323,931
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0
has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 323,931
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (aX1.2) 0 X .0 00 (15) 0
TAX 16. Amount of Une 14 taxable at lineal rate 323,931 X .0 0.045 (16) 14,577
-
COMPU- 17. Amount 01 Une 14 taxable at sibling rate 0 X .12 (17) 0
TATION 18. Amount of Line 14 taxable at collateral rate 0 X .15 (18) 0
19. Tax Due (19) 14,577
20. 0 lPl1i'lbk!j~i'!~!f~_~i$tlfj!jAR~NPOfN<lOV!;RPlljM~1
(/
;/
. .. .................................;.,o\.lilE;$Ul'lEIOAN$WE.RAUlO!l"'$'!JON$.Ol'l~~~ANP..RECHECKMlitB;;+.............
o PA 15001
NTF 29755
Copyright 2000 Greatland/Nelco LP . Forms Software Only
Estate of
Name
Address
Tax ID
Name
Address
Tax ID
174-46-6410
Executors (Page 1)
Charles L. Farence Sr.
P.O. Box 262
Dauphin, PA 17018-0262
209-28-9982
John A. Farence
9463 East Menlo Circle
Mesa, AZ 85207-
196-38-4817
PA flEV-1500 EX (6-00)
D d 'C I
Page 2
ece ent s omplete ress:
STREET ADDRESS
Messiah Village, P.D. Box 2015
cumberland County
CITY I STATE I ZIP
Mechanicsburg PA 17055
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
14, 577
o
13,000
684
Total Credits (A + B + C)
(2)
13,684
3. Interest/Penalty jf applicable
D. Interest
E. Penalty
o
o
TotallnteresVPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
..}~~~~S~~ck Payable to: REGISTER OF WILLS, AGENT............
':-:::::::':,{::::;:;,;:::):,t::::}/}\;:::)}\??::t::::::)::: ...._...,_..'......_ .....'..,..;...,.,.., .;.....-.........-.;......,'.,...'.._,...'_...,.........,.... ...., ,.:...,.:':.:.:.:-:...::.:.
:::.:::~::::.:::...:.:.:.:., :.:. '..,..,....,.......:,:...'...:::~: :::::::':::::;:::;::,y:::::::. :.:_:.:.:.:.:.:.:.:.:<
:':';':-:':"::":':':':':::::':::::':':',::':::::':',::':'::""":":":"::':::"'::::':::::':":< ':.:-:.:.;.:.:,:.,.",.;":'" ;::::~';::::::::'::::':':':::;::::::::::::::::::;:::::::t::r:';::::::;:::::::':
:::::::::':::::;:::::::::':::::'::::~:':';::'~: "::,::":,:,,,:,::::,,,:;:::,:,,::.:.,. :.:,;.:.:.:,;.:.;.,.',:,:,:,:,,':':" . . ... :::-:':::':';':':':"-':::"':':"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
(3)
o
o
893
o
893
.:;:,..,........
...'..,........'.-....'.........'..
-"""-""-'-"',"-'-'
.,..........'....,.
.......'..............,..............
.................
.._'_....._...,w.:..,..._......
,
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred; ........ . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income;
c. retain a reversionary interest; or. . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? ...........
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . .
3. Did decedent own an "in 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? . . . . . . . . . . . . . . . .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my
knowledge and belief, it IS true, correct and complete. Declaration of preparer other than the personal representative is based on information of
which preparer has any knowledqe.
T E OF P R SPONSIBLE FOR LING ETU (l ,.., DATE /
J ./.Yt- ({{ 0 2.--
Yes No
~I
B ~
o
~
Dauphin, PA 17018-0262
DATE
LO/O 2-
ADD
3211 N. Front St.; PO Box 5300
Harrisburg, PA 17110-0300
on spouse
[72P.S. I 9116(a)(1.1)(i)).
For dates of death on or after January 1, 1995, the lax rate is imposed on the net value of transfers to or for the use of the surviving spouse Is 0% [72 P.S. li 91 16 (a)(1.1)(ii)j.
The statute dl"lAo:. nnl pl/pmnl a transfer to a survIVing spouse from talC, and the statutory requirements for disclosure of assets and filing a talC return are slll! applicable even
jf
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 froma deceased child twenty.one years of age or younger at death to or for the use ofa natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S.1l9116(a)(1.2)].
The talC rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiariesls 4.5%, eICcept as noted in 72.P.S. I 9116(1.2) [72 P.S.IS1 16(aX1)].
The tax rate imposed on the net vatue of transfers to or for the use of the decedent's siblings Is 12% [72 P.S. 19116(aX1.3)]. 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.
o PA15002
NTF 29756
Copyright 2000 Greatland/Nelco LP - Forms Software Only
REV-1502EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the
price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
FILE NUMBER
ITEM
NO.
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
9 PA15021 NTF 10871
Copyright 1999 GreatlandlNelco LP - Forms Software Only
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
SCHEDULE B
STOCKS & BONDS
FI LE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NO.
11.
VALUE AT DATE
OF DEATH
DESCRIPTION
12 Series E u.s. Savings Bonds
in names of John Z. Farence or
Mrs. Emma M. Farence (John Z.
Farence was the husband of
decedent and pre-deceased her
by several years), all issued
at various dates in 1974, 10
with $500 denominations and
$375 issue price, 1 with $200
denomination and $150 issue
price, and 1 with $25
denomination and $18.75 issue
price. The 12 are given a
total value of $24,109.98.
See printout from
publicdebt.treas.gov website
attached hereto and
incorporated herein by
reference. Total value
$24,109.98.
24, no
2
18 Series H U.s. Savings
Bonds, all in the name of Emma
M. Farence, all $1000
denominations, each valued at
$1000. Total value $18,000.
See printout from
publicdebt.treas.gov attached
hereto and incorporated herein
by reference. Total value
$18,000.
18,000
Total from continuation pages
91,873
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
133,983
9 PA15031 NTF 10872
Copyright 1999 Greatland/Nelco LP - Forms Software Only
Schedule B (Page 2)
Estate of: Emma M. Farence
Item
No.
Description
Value at Date
of Death
3
23 Series E U.S. Savings
Bonds, all in names of John Z.
Farence or Emma M. Farence
(John Z. Farence was the
husband of decedent and
pre-deceased her by several
years) f all issued in February
to April 1975, all $500
denominations with $375 issue
price. Total value
$52,533.40. See printout from
publicdebt.treas.gov website
attached hereto and
incorporated herein by
reference. Total value
$52,533.40.
52,533
4 5 Series E U.S. Savings Bonds,
all in names of John Z.
Farence or Emma M. Farence
(John Z. Farence was the
husband of decedent and
pre-deceased her by serveral
years), all issued in February
or April 1976, 2 with $500
denominations and $375 issue
price, and 3 with $200
denominations and $150 issue
price. Total value $7172.44.
See printout from
publicdebt.treas.gov website
attached hereto and
incorporated herein by
reference. Total value
$7172.44.
7,172
Total (Carry forward to main schedule)
59,706
Schedule B (Page 3)
Estate of: Emma M. Farence
Item
No.
Description
Value at Date
of Death
5 6 Series E U.S. Savings Bonds,
all in the names of John Z.
Farence or Emma M. Farence
(John Z. Farence was the
husband of decedent and
pre-deceased her by several
years), all issued April to
June 1975, all $1000
denominations with issue price
of $750. Total value
$27,057.60. See printout from
publicdebt.treas.gov website
attached hereto and
incorporated herein by
reference. Total value
$27,057.60.
27,058
6 6 Series EE U.S. Savings Bonds
all in the name of decedent,
all issued 08/92, all $1000
denominations, with issue
price of $500, each valued at
$851.60. See printout from
publicdebt.treas.gov website
attached hereto and
incorporated herein by
reference. Total Value
$5109.60.
5,110
Total (Carry forward to main schedule)
32,167
Savings Bond Calculator
Villue As Of
Page I of I
Savin
108/2001
Help
CALCU
Update
Bond Info
Series
Denomination
Serial Number
$11,000 II
I EE Bonds
.
Results
# Bonds
6
Total Price
$3,000.00
Total Interest
$2,109.60
Total Value
$5,109.60
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
08/1992 EE $1,000 $500.00 $351.60 $851.60 6.00%
08/1992 EE 1,000 500.00 351.60 851.60 6.00%
08/1992 EE 1,000 500.00 351.60 851.60 6.00%
08/1992 EE 1,000 500.00 351.60 851.60 6.00%
08/1992 EE 1,000 500.00 351.60 851.60 6.00%
08/1992 EE 1,000 500.00 351.60 851.60 6.00%
Le(end
Note Description
Nl Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
http://www . publicdebt. treas.gov / serv let/SB CPrice
Issue Date
YTD
$2
Next Final
Accrual Maturi
02/2002 08/20
02/2002 08/20
02/2002 08/20
02/2002 08/20
02/2002 08/20
02/2002 08/20
8/7/01
Savings Bond Calculator
Value As Of
Page I of I
Savin
108/2001
Help
CALCU
Update
BOlld Illfo
Series
Denomination
Serial Number
$125
JI
I E Bonds
JI
R esu Its
# Bonds
12
Total Price
$3,918.75
Total Interest
$20,191.23
Total Value
$24,109.98
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
05/1974 E $25 $18.75 $96.43 $115.18 4.00%
07/1974 E 200 150.00 773.60 923.60 4.00%
07/1974 E 500 375.00 1,934.00 2,309.00 4.00%
05/1974 E 500 375.00 1,928.60 2,303.60 4.00%
05/1974 E 500 375.00 1,928.60 2,303.60 4.00%
04/1974 E 500 375.00 1,906.80 2,281.80 4.00%
04/1974 E 500 375.00 1,906.80 2,281.80 4.00%
03/1974 E 500 375.00 1,906.80 2,281.80 4.00%
02/1974 E 500 375.00 1,952.40 2,327.40 4.00%
02/1974 E 500 375.00 1,952.40 2,327.40 4.00%
01/1974 E 500 375.00 1,952.40 2,327.40 4.00%
01/1974 E 500 375.00 1,952.40 2,327.40 4.00%
View 10 I Viewing Bonds 1-12
Le(lend
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
http://www . pub1icdebt. treas.gov / servlet/SBCPrice
Issue Date
YTD
$7
Next Final
Accrual Maturi
11/2001 OS/20
01/2002 07/20
01/2002 07/20
11/2001 OS/20
11/2001 OS/20
10/2001 04/20
10/2001 04/20
09/2001 03/20
02/2002 02/20
02/2002 02/20
01/2002 01/20
01/2002 01/20
8/7/01
Savings Bond Calculator
Vallie As Of
108/2001
Page I of I
Savin
Help
CALCU
Update
Bond Info
Series
Denomination
Serial Number
$1500 .
I E Bonds
.
Reslllts
# Bonds
5
Total Price
$1,200.00
Total Interest
$5,972.44
Total Value
$7,172.44
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
04/1976 E $500 $375.00 $1,836.00 $2,211.00 4.00%
02/1976 E 200 150.00 752.08 902.08 4.00%
02/1976 E 200 150.00 752.08 902.08 4.00%
02/1976 E 200 150.00 752.08 902.08 4.00%
0211976 E 500 375.00 1,880.20 2,255.20 4.00%
le,elld
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
http://www.publicdebt.treas.gov/servlet/SBCPrice
Issue Date
YTD
$3
Next Fina
Aecrual Matur
10/200 I 04/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
8/7/01
Savings Bond Calculator
V,llue As Of
108/2001
Page 1 of2
Savin
Help
CALCU
Up date
Bond Info
Series
1 E Bonds
Denomination
Serial Number
$1500 .
.
Results
# Bonds
23
Total Price
$8,625.00
Total Interest
$43,928.40
Total Value
$52,553.40
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
03/1 975 E $500 $375.00 $1,870.80 $2,245.80 4.00%
04/1975 E 500 375.00 1,870.80 2,245.80 4.00%
03/1975 E 500 375.00 1,870.80 2,245.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
02/1 975 E 500 375.00 1,915.80 2,290.80 4.00%
View 10 I Viewing Bonds 1-23
Le!end
http://www.publicdebt.treas.gov/servlet/SBCPrice
Issue Date
YTD
$1,9
Next Fina
Accrual Matur
09/2001 03/20
10/2001 04/20
09/2001 03/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
02/2002 02/20
8/8/01
Savings Bond Calculator
Value As Ot
Page 1 of 1
Savin
108/2001
Help
CALCU
Update
BOlld IlIto
Series
Denomination
Serial Number
$11,000 ..
I E Bonds
.
Results
# Bonds
6
Total Price
$4,500.00
Total Interest
$22,557.60
Total Value
$27,057.60
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
06/1975 E $1,000 $750.00 $3,795.60 $4,545.60 4.00%
06/1975 E 1,000 750.00 3,795.60 4,545.60 4.00%
04/1975 E 1,000 750.00 3,741.60 4,491.60 4.00%
04/1975 E 1,000 750.00 3,741.60 4,491.60 4.00%
04/1975 E 1,000 750.00 3,741.60 4,491.60 4.00%
04/1975 E 1,000 750.00 3,741.60 4,491.60 4.00%
Lp.,elld
Note Description
Nl Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
http://www. publicdebt. treas. gov / servlet/SBCPrice
Issue Date
YTD
$5
Next Fina
Accrual Matur
12/2001 06/20
12/2001 06/20
10/2001 04/20
10/2001 04/20
10/2001 04/20
10/2001 04/20
8/7/01
REV-1504 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
. INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent,
other than a sole-propiertorship. See instructions for the supporting information to be submitted for sole-proprietorships.
SCHEDULE C
CLOSELY-HELD CORPORATION
PARTNERSHIP or SOLE-PROPRIETORSHIP
FILE NUMBER
ITEM
NO.
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
9 PAl5041 NTF 10873
Copyrighl1999 Greatland/Nelco LP - Forms Software Only
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o
REV-1507 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FI LE NUMBER
Emma M. Farence
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NO.
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
9 PA 15071 NTF 10874
Copyright 1999 Greatland/Nelco LP - Forms Software Only
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o
REV-1508 EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH. BANK DEPOSITS. & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Emma M. Farence
Include proceeds of litigation & dale proceeds were received by the estate All prop. jointly-owned with right of survivorship must be disclosed on 5ch. F.
ITEM
NO.
11.
DESCRIPTION
Clothing and personal effects
of decedent, all old and used,
carried at no value. Please
note that decedent was
resident of nursing home and
did not retain household
furnishings and other such
items from her own home.
VALUE AT
DATE OF DEATH
o
2
Mellon Bank
Account #222-342-6368
29,566
3
Mellon Bank
Account #885-000-1358
43,320
Interest accrued to 08/02/2001
19
4
PNC Bank
CD #31200183615
17,000
Interest accrued to 08/02/2001
41
5
PNC Bank
CD #31900177355
48,186
Interest accrued to 08/02/2001
121
6
PNC Bank
Checking Account #5080183902
6,246
Interest accrued to 08/02/2001
1
9 PA15081 NTF 10875
Copyrighl1999 Grealland/Nelco LP - Forms Software Only
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
144,499
REV -1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Charles L. Farence Sr.
ADDRESS
P.O. Box 262, Dauphin, PA
170180262
RELATIONSHIP TO DECEDENT
Son
B. John A. Farence
9463 East Menlo Circle, Mesa,
AZ 85207
Son
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
Include name of financial institution and bank
ITEM FOR MADE account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF
JOINT
NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
11. AA 01/23/2001 One-half of Vartan National
Bank Account, with DOD balan e
of $47,541.11, reduced by
$6000 for two $3000 exemptio s
. for transfer within one year
of death. The DOD value of
this half is $20,770.56. 20,771 100.000 20,771
2 B 01/23/2001 One-half of Vartan National
Bank Account, with DOD balan e
of $47,541.11, reduced by
$6000 for two $3000 exemptio s
for transfer within one year
of death. DOD value of this
half is $20,770.56. 20,771 100.000 20,771
TOTAL (Also enter on line 6, Recapitulation) $ 41,541
9 PA 15091
NTF 10876
(If more space is needed, insert additional sheets of the same size)
Copyrighl1999 Greatland/Nelco LP - Forms Software Only
REV-1510EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
This schedule must be completed and filed jf 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 INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RELATIONSHIP TO DECD & DATE OF TRANSFER.
NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
11. Annuity, G1enbrook Life &
Annuity Company
Contract #GA0591100,
Beneficiaries Charles L.
Farence Sr. and John A.
Farence. DOD value
$52,151. 04 . 52,151 100.000 0 52,151
.
. - a,
TOTAL (Also enter on line 7, Recapitulation) $ 52,151
9 PA 15101
NTF 10877
(If more space is needed, insen additional sheets of the same size)
Copyrlghl1999 Greatland/Nelco LP - Forms Software Only
REV-1511EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I
ITEM
NO. DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
1 John A. Farence, son of
decedent and Co-Executor -
necessary air fare for travel
from Arizona to attend
funeral, probate Will, take
oath as Co-Executor 656
Total from continuation pages 2,318
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 14,300
Name of Personal Representative(s) Charles L. Farence Sr.
Social Security Number(s)/EIN No. of Personal Representative(s)
Street Address P.O. Box 262
CityDauphin State PA Zip 17018
Year(s) Commission Paid: 2002
2. AttorneyFees Metzger, Wickersham, Knauss & Erb, P.C. (estimated) 14,300
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 305
5. Accountant's Fees
6. Tax Return Preparer's Fees 810
7.
1 Cumberland Law Journal -
estate notice 75
2 Reserve for closing 50
3 Reserve to file Account 131
4 Reserve to file Releases 91
Total from continuation Dages 129
TOTAL (Also enter on line 9, Recapitulation) $ 33,165
9 PA15111 NTF 10878
Copyrighl1999 Grealland/Nelco LP - Forms Software Only
(If more space is needed, insert additional sheets of the same size)
Item
No.
2
3
4
5
6
7
Schedule H part 1 (Page 2)
Estate of: Emma M. Farence
Description
Amount
John A. Farence, son of
decedent and co-Executor -
reimbursement for purchase of
necessary airline ticket for
his wife for travel from
Arizona for funeral
John A. Farence, son of
decedent and Co-Executor -
necessary car rental and
gasoline from Baltimore to
Harrisburg and use during
bereavement/funeral period and
probate
John A. Farence -
reimbursement for flowers for
decedent's funeral
John A. Farence, son of
decedent and Co-Executor -
reimbursement for food during
time of funeral/bereavement
John A. Farence, son of
decedent and co-Executor -
necessary hotel in Harrisburg
and Baltimore for trip for
funeral and probate
Pastor David Smith -
honorarium
Total (Carry forward to main schedule)
656
328
450
219
515
150
2,318
Item
No.
5
Estate of: Emma M. Farence
Description
The Patriot News - estate
notice
Schedule H part 2 (Page 2)
Amount
Total (Carry forward to main schedule)
129
129
REV-1512EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma M. Farence
Include unreimbursed medical expenses.
ITEM
NO.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FI LE NUMBER
DESCRIPTION
AMOU NT
1.
1 Commonwealth of Pennsylvania -
personal income tax liability
of decedent
58
2
IRS-personal income tax
liability of decedent; 19 amnt
of fed tax was due to cashing
of US Savings Bonds prior to
DOD during 2001 in order to
pay nursing home bills & other
bills)
11,133
3
Messiah Village - debt of
decedent
77
4
Pinnacle/Hospice - debt of
decedent
3,810
9 PA15121
NTF 10874
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
15,078
Copyright 1999 Greatland/Nelco LP - Forms Software Only
REV'1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Emma M. Farence
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outri9ht spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
1
1. arin Baker
.0. Box 208
auphin, PA 170180208
1/39 of Probate
or $5,903.54
Granddaughter
2
renda Beyer
210 Conowago Road
over, PA 173152912
1/39 of Probate
or $5,903.54
Granddaughter
3
harles Farence Jr.
936 Elmerton Avenue
arrisburg, PA 171091248
1/39 of Probate
or $5,903.54
Grandson
otal from continuation pages
$306,220.40
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET
II NON- TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
I
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
o PA 15131
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
o
NTF 33293
Copyright 2000 Greattand/Nelco LP - Forms Software Only
Estate of: Emma M. Farence
Item
No.
4
5
6
7
8
9
~o
~~
~2
Description
Charles L. Farence Sr.
P.O. Box 262
Dauphin, PA ~70~80262
Barry Farence
P.O. Box 262
Dauphin, PA ~70~80262
David Farence
3~8 Sheetz Road
Halifax, PA ~7032
John A. Farence
9463 East Menlo Circle
Mesa, AZ 85207
Randy Farence
440 Windy Hill Road
Shermansdale, PA ~7090
Ricky Farence
25 Beers Avenue
Duncannon, PA 17027
William C. Farence
~O~ Elderberry Drive
Levittown, PA ~9054
Brian R. Norstrom
9463 East Menlo Circle
Mesa, AZ 85207
Jennifer Ann Norstrom
9463 East Menlo Circle
Mesa, AZ 85207
Schedule J part ~ (Page 2)
Relation
Son
Grandson
Grandson
Son
Grandson
Grandson
Grandson
Grandson
Granddaughter
Total (Carry forward to main schedule)
Amount
1/1 Vartan Account,
or $20,771; 1/2
annuity, or
$26,075.50; and
1/3 Probate, or
$76,7461 totalling
$123,59L.50
1/39 Probate, or
$5,903.54
1/39 Probate, or
$5,903.54
1/2 Vartan Account,
or $20,771; 1/2
annuity, or-
$26,075.50; and
1/3 Probate, or
$76,7461 totalling
$123,59L.50
1/39 Probate, or
$5,903.54
1/39 Probate, or
$5,903.54
1/39 Probate, or
$5,903.54
1/39 Probate, or
$5,903.54
1/39 Probate, or
$5,903.54
Schedule J part 1 (Page 3)
Estate of, Emma M. Farence
Item
No. Description Relation Amount
13 Shirley Senteio 1/39 Probate, or
550 Deville Dam Road $5,903.54
Shermansdale, PA 17090 Granddaughter
14 Carolyn Silcox 1/39 Probate, or
96 Beard Road $5,903.53
Eoola, PA 17025 Granddaughter
15 Linda Smith 1/39 Probate, or
269 Linway Road $5,903.53
Lock Haven, PA 17745 Granddaughter
Total (Carry forward to main schedule)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
REV-1514 EX + (1-97)
(Check Box 4 on Rev-15OQ Cover Sheet)
FI LE NUMBER
Emma M. Farence
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5~ 1 ~89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found
in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
D Will D Intervivos Deed of Trust D Other
. .......................L1FS...eSTATE...INTEFlESrCALCUllAtlON.................
NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS
LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE
n Ufe or D Term of Years
n Life or D Term of Years
n Ufe or n Term of Years
n Ufe or D Term of Years
1. Value of fund from which life estate is payable $ 0
2. Actuarial factor per approriate table 0
Interest table rate - - 3 1/2% 06% 010% o Variable Rate %
3. Value of life estate (Line 1 multiplied by Line 2) $ 0
TERM OF YEARS
ANNUITY IS PAYABLE
NAME(S) OF
ANNUITANT(S)
DATE OF BIRTH
NEAREST AGE AT
DATE OF DEATH
o Life or 0 Term of Years
o Life or 0 Term of Years
o life or 0 Term of Years
o life or 0 Term of Years
1. Value of fund from which annuity is payable $
2. Check appropriate block below and enter corresponding (nUmbeB
Frequency of payout - - 0 Weekly (52) 0 Bi-weekly (26) Monthly (12)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) Other ( )
3. Amount of payout per period
o
o
$
o
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate 0 3 1/2% 0 6% 0 10%
o
o Variable Rate
%
o
6. Adjustment Factor (see instructions)
7. Value of annuity -- If using 3 1/2%,6%, 10%, or if variable rate and period payout is at end of period,
calculation is: Line 4 x Line 5 x Line 6
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3
o
$
o
$
o
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G
of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17.
(If more space is needed, insert additional sheets of the same size)
9 PA15141 NTF 10881
Copyright 1999 Greatland/Nelco LP - Form!; Software Only
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE M
FUTURE INTEREST
COMPROMISE
REV -1647 EX + (1-97) (I)
ESTATE OF
(Check Box 4a on Rev-1500 Cover Sheet)
FILE NUMBER
Emma M. Farence
This schedule is appropriate only for estates of decedents dying after December 12. 1982.
This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in
possession and enjoyment cannot be established with certainty.
Indicate below the type of instrument which created the future interest and attach a copy to the tax return.
nWiII n Trust n Other
I. Beneficiaries
NAME OF AGE TO
BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY
1.
2.
3.
4.
5.
II. For decedents dying on or after July 1,1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9
months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse
exercises such withdrawal right.
n Unlimited right of withdrawal n Limited right of withdrawal
III. Explanation of Compromise Offer:
IV. Summary of Compromise Offer:
1. Amount of Future Interest $ 0
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet) $ 0
3. Value of Line 1 passing to spouse at appropriate tax rate
Check One 06% 03% 00%
(also include as part of total shown on Line 15 of Cover Sheet) $ 0
4. Value of Line 1 Taxable at 6% Rate
(also include as part of total shown on Line 16 of Cover Sheet) $ 0
5. Value of Line 1 Taxable at 15% Rate
(also include as part of total shown on Line 17 of Cover Sheet) $ 0
6. Total value of Future Interest (sum of Lines 2 thru 5 must equal Line 1) $ 0
(If more space is needed, insert additional sheets of the same size)
9 PA 16471
NTF 26890
Copyrighl1999 Greatland/Nelco LP - Forms Software Only
REV-1649 EX + (1-97)
COMMONWEALTH OF
PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE 0
ELECTION UNDER SEC. 9113(A)
(SPOUSAL DISTRIBUTIONS)
FILE NUMBER
Emma M. Farence
Do not complete this schedule unless estate is making election to tax assets under Section 9113(A) of Inheritance & Estate Tax Act.
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust.
This election applies to the Tru5t(marital, residual A, B, By-pass, Unified Credit, etc.).
If a trust or similar arrangement meets the requirements of Section 9113(A), and:
a. The trust or similar arrangement is listed on Schedule 0, and
b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0,
then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the
election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property
is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of
the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable
asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement.
PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's
surviving spouse under a Section 9113 (A) trust or similar arrangement.
DESCRIPTION VALUE
Part A Total S
PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made.
DESCRIPTION VALUE
9 PA 16491
NTF 10882
Part B Total S
(If more space is needed, insert additional sheets of the same size)
o
Copyright 1999 GreatlandlNelco LP - Forms Software Only
Estate of Emma M. Farence
174-46-6410
SUMMARY COMPUTATION OF RESIDUARY ESTATE
r.
LAST WILL AND TESTAMENT
OF
EMMA M. FARENCE
I, EMMA M. FARENCE, ofOutIook Pointe at Creekview, 1100 Grandon Way,
Mechanicsburg Post Office, Cumberland County, Pennsylvania, revoke any prior Wills and
Codicils and declare this to be my Will.
ITEM I. I give my household and personal effects and other tangible personalty of
like nature in as nearly equal shares as practical to my sons, CHARLES 1. F ARENCE and
JOHN A. F ARENCE. If either son is not living on the thirty-fust day after my death, I give his
share to his issue per stirpes who survive me by thirty days.
ITEM 2. I give all the rest, residue, and remainder of my estate in Wee equal shares
as follows, subject to the survival provisions of this Will: one-third (113) to my son,
CHARLES 1. FARENCE; one-third (113) to my son, JOHN A. FARENCE; one-third (113) to be
divided equally among my grandchildren. For purposes of this Will, the phrase "my
grandchildren" shall mean all of the natural children of my son, CHARLES 1. FARENCE, from
both of his marriages and also his step-daughter, SHIRLEY SENTEI, and also the adopted son of
my son, JOHN A. FARENCE, WILLIAM C. FARENCE, and the two step-children of my son,
JOHN A. F ARENCE, JENNIFER NORSTROM and BRIAN NORSTROM.
Document II: /78630. I
..
ITEM 3. (a) I direct that if either of my sons does not survive me by thirty days,
his share shall be given instead to his spouse if she survives me by thirty days. If neither one of
my sons of his spouse is living on the thirty-first day after my death, I give that son's share to his
issue per stirpes who survive me by thirty days. For purposes of this Will, I include within the
phrase "issue per stirpes" the natural children of my son, CHARLES L. F ARENCE, from both of
his marriages and also his step-daughter, SHIRLEY SENTEI, and also the adopted son of my
son, JOHN A. F ARENCE, WILLIAM C. F ARENCE, and the two step-children of my son,
JOHN A. F ARENCE, JENNIFER NORSTROM and BRIAN NORSTROM.
(b) If any of my grandchildren, as defined in this Will, do not survive
me by thirty days, their share shall lapse and be given instead to my other grandchildren, as
defined in this Will, in proportion as they would otherwise take shares of my estate.
ITEM 4. I direct that all my just debts and the expenses of my illness and burial,
including my grave marker, shall be paid from my residuary estate as soon as practicable after
my death as part of the expense of the administration of my estate.
ITEM 5.
In addition to the powers granted by law or by other parts of this Will, my
Executors shall have the following powers:
(a) To retain any and all assets of my estate, real, personal, or mixed,
without regard to any principle of diversification, risk, or productivity, except as may be
otherwise expressly provided herein;
(b) To sell at public or private sale, to exchange, to lease, to pledge, to
mortgage, to transfer, to convert, or otherwise dispose of, and to grant options with
respect to, any and all property, real, personal, or mixed, at any time forming part of my
Document #: /78630. J
..
estate or trust estate in such manner, at such time or times, for such purposes, for such
price or prices and upon such terms, credits, and conditions as may be deemed advisable;
(c) To invest and reinvest the trust property in stocks, bonds,
mortgages, notes, insurance policies, annuities, common trust fund participation, or other
property of any kind, real, personal, or mixed, irrespective of any statute, case, rule, or
custom limiting the investment of trust funds, except as expressly provided otherwise
herein;
(d) To settle, compromise, contest, prosecute, or abandon claims in
favor of or against my estate or any trust as may be deemed advisable;
(e) To allocate receipts and disbursements to principal or income or
partly to both and to ascertain principal or income in accordance with the laws of the
Commonwealth of Pennsylvania;
(f) To make distribution or division of the trust or estate in cash, in
kind, or partly in both, to postpone distribution by agreement with a beneficiary and to
distribute articles of tangible property to a minor or to any person to hold for a minor
within the limits authorized by statute or rule of law; and
(g) To exercise any law-given option to treat administration expenses
either as income tax or estate tax deductions, without regard to whether the expenses
were paid from principal or income, and without requiring reimbursement.
ITEM 6. No bond shall be required by my Executors, but if bond is nevertheless
required, it shall be without surety.
Document #: 178630.1
11111
ITEM 7.
I appoint my sons, CHARLES 1. F ARENCE and JOHN A F ARENCE,
Executors. If either fails to qualify or ceases to act, I appoint my other son as sole Executor.
Executed this ~ day of
JlUl e_
,2000.
G~'J; 1~~
Emma M. Farence
Signed, sealed, and published and declared by the above-named Testatrix, EMMA M.
F ARENCE, as and for her Last Will and Testament, in the presence of us, who, at her request, in
her sight and presence, and in the sight and presence of each other, have hereunto subscribed our
names as witnesses.
~/ ~ #f:=L Ldfuess /~N'5.L7/ /fl
~pA_ '-i!? 7l1jf/A Address ftC'/d.fdiiJ'idYJ PA
Document ff: 178630. I
iI1!I
Commonwealth of Pennsylvania
: ss
Countyof VA,JPH,.-)
We,EMMAM.FARENCE,and Uv,J #. ,;1/..,..l/1"'~,^- . and
~ ~i. 111. d1. -; j...,.. . the Testatrix and the witnesses, respectively, whose
name e signed to the attached or foregomg mstrument, bemg 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 (or willingly directed another to sign for her), 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 Will as witness and that to the
best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
;;<#f~4 f~
Testatrix
~--Y' /P" #!::L:~
Witness
~pjJL...;n. -/'ft.l&..
W ness
SWORt'\[ to or affirmed and acknowledged before me by the above named Testatrix and
witnesses this #clay of Jv;....<.-- , 2000.
d~' (2 <4-l-
Notary Public
My Commission Expires:
(SEAL)
NOTARiAl SEAl
CAROl A. LYTER, NOTARY PUBUC
Harrisbull. Dauphin County
My Commission Expires Oec. 28, 2000
DocumenJ #: ) 78630.1