HomeMy WebLinkAbout01-0734
Estate of
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
.~tJ~~~. LAWVER, .~~ No. fAl-OI- D'7~1
also known as
, Deceased
187"':'30-2915
Social Security No.
"e:tlfiuuu.C.'. whlJ la/... tU yea,. o' au- II' oIde.. ap,"vUu.. 1m:
(COMPLETE" A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix named in the Last Will of the
Decedent, dated JUNE 25, 1 991 and codicil(s) dated
~
"
l-id.e." E. I c> .,J .j .(.C d ( e. <!. 0 n ra!J UQU'J L, , 9'/ l2,
S'ale reSow,," circun\a'ft"c". ..g., renunciation, death n' eXKuto.. etc.
Except as follows. Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incompetent:
Q
B. Grant of Letters of Administration
Ce.'.a.. d.b....c.'...: pvt"fenta ..,,,; tlu....... "hM.ttU"'; .....,."tu ......"..,...t:.
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I Name Relationship Residence I
(COMPLETE IN ALL CASES:) Attach addl',!onaf sheots if necessary.
Decedent was domiciled at death in, 'CUMBERLAND
residence at 3614 KENT DRI~ MECHANICSBURG,
County, Pennsylvania, with his/her last family (){ pri
PA 17050-2226.g (l.f\ -;OW'n~t"
IIt~ .!.vul. nUlUhf~1 nUtI ".m.f~.t"tli'y)
Decedent, then
91
years of age, died
JULY
2
2 0 0 1 at HERSHEY MEDICAL CENTER
, -'
fI.IN;IIUIHI'
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personAl property .............................. $
(If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ............................................... $
Total .. . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Real Estate situated as follows:
120,000.00
-8-
- -
-0
17.0.000 00
Wherefore, Petitioner(sl respectfully request(sl the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Typed or printed name and residence
~
, MECH1ffi:c:B.R:;
RW-7
1 (y~ 2 4- ~ - J Lf
II
Oath of Personal. Representative
Commonwealth of Pennsylvania
County of Cum1;:>~r land
The Petitioner(s) above-named swear(s) and 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 representative(s) of the Decedent,.
Petitioner(s) will well and truly administer the estate according to law.
I!L~ a./1~
Sworn to and affirmed and subscribed
11 ~ ,ft-
before me this I, U day of
~y - ~~..
~ ..G .~i/JpMlCm~~
.oE~~~ER
.Ar'~..LKl:4K W. LAWVER, JR.
E~!~te.. ot
'- -'
Deceased
~/-DJ- 731
No.
also known as
Social Security No:. 187-30-2915 Date of Death: JULY 2," 2001
AND. NOW, /t:tJ.I::1J I!), 20~, in consideration of the petjtjo~
'on- the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters /Xl Testamentary 0 of Administration
are here.by g'ranted 'to ELISABETH A. ROBERTS
't:.I.".~ 11'1.11.1; I . Itltucll:III'~ hlU, IIIII,MIII: n"Mw,lu,; ,hlln..ll: 1I..llIlIIl;llu,
in the above estate and that the instrument(s) I jf any I dated JUNE 25. 1 991
described in the Petition be admitted to probate and filed of record as the l(=1st Will of Decedent.
'. FEES
Letters.......................... .
Short Certificate(s). .{:}}..
Renunciation............. ~....
Affidavit ( ).................
Extra Pages (I )............
Codicil......................... .
JCP Fee........................
Inventory & Tax Forms...
Other...... .'......"...............
TOTAL............... .
RW-7 a,
$ ~35.o0
q.O-O
$
$
$
$ 0.00
$
$
$
$
6.00
$ ~bi~'OO
ANTHONY T. MCBETH, ESQUIRE
Attorney:
1.0. No: 53729
Address: '407 NORTH FRONT STREET
HARRISBURG. PA 17101
Telephone: 717-238-3686
DATE FILED: ~l'-l fu J 21JOl
, -
n/7L
~I-ol- "..? I
REGISTER OF WILLS OF LUM~ArUL COUNTY
OATH OF SUBSCRIBING WITNESS
Kt> b<:,~ t D, ~a. n ~f1
~l
(each) a subscribing witness to the~q~esented herewith, (each) being duly qualified according to
law, depose(s) and sat! that (.-r n-e. I&2Q.$.. present and saw
the testat y- , sign the sa!De a~d that Q 9~'t D.. ~ at) ~ nsigned as a witness at th~
request of testat~ in h ,'~ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)). -:;/ 0 ~ A
)( Sworn to or affif!Ded ~ subscribed before 0 ~ ~ ,--
me this..30 day of (Name)
\..~~ _~-~ 2..51>" JJ. 2..1\l,() ~-r:.. HAU./'.r But6;PA-l111P
~ ~ (Address)
gister
(Name)
Notarial Seal
MelIssa S. Snyder. Notary Public
Harrisburg. Dauphin County
My Commission Expires Feb. 24, 2003
Member, P&nhSylvania ASSOCiation of Notaries
'-,
(Address)
'"
'\
REGISTER OF WILLS OF COU
",-OATH OF NON-SUBSCRIBING WITN
"
:~'~.,.
".."
(each) a subscriber hereto, (each) ing duly qualified cording to law, depose(s) and say(s) that
fam . ar with the gnature of
codicil
testat_ of (one of the will presented herewith and
codicil
that belie es the signature on the will is in the handwriting of
,//'
to the best of
kIJ.0"ledge and belief.
.,,/~
Sworn to or affirmed an~/,8llbscribed before
me this / day of
,,/
19_
'"
"-,
""
'.'"
(Name)
(Address)
.//
Register
(Name)
(Address)
G~l-Ol- 03Lj
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness ( the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
signed as a witness at the
the presence of each other) (in the presence of the
the testat , sign the same and that
request of testat_ in h
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19_
(Name)
Register
(Name)
(Address)
. .. !
REGISTER OF WILLS OF U.4II41.R~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
atJ~ 1. ~
(each a sub~criber hereto, (each) being duly qualified according to
familiar with the signature of ,
co~
subscribing witnesses to) the ~ presented herewith and
codicil
that believes the signature on the will is in the handwriting of
knowledge and belie~ /'
Sworn to or affirmed an~ ~ubscribed before ./~4-
'TH
me this ~. day of
~L~ I
'/1 I7d~ ()
(Name)
(Address)
H10'i.90'i REV.(09100)
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~!I~
G\~s.~/~.
Robert S. ~erman, Jr., MPH
Secretary of Health
Charles Hardester
State Registrar
1831425
JUL 18 2001
Date
Hl05.14J R.... 2187
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
TYPElPRlNT
IN
PERMANENT
Bl.ACK INK
.:;(
NAME OF DECEDENT (f,rs.. Mid<lIe. Las,
t.
AGE (Las_VI
SEX
STATE FilE NUMBER
SOCiAl SECURITY NUMBER
a. Male
3. 187 - 30 -
UNDER . YEAR
-- Days
BIRTHPLACE (Ctfy iiIIld PlACE OF' OERH (C~k Of"otV t)('O -. -;ee 'r\3lfUChons on 0Ihet 'SIde)
Stale '" fCteogn CounuYI HOSPITAl;
Philadelphia, PA I__~ ERIOu<patien' G
7. ...
FACILITY NAME (II not ",Sloful1on. QlVt! SlJeeland number,
White
MAR1TAL STRUS . M_
_-.....w_.
~1Si*'lly)
Widowed
SURVIVING SPOUSE
1"_. ;JMO_name,
N/A
-.
METHOD OF DlSPOSl~
O llurioI ~ c_.... 0 __Stal.o
~ 0Ihar (SpaclIy'
2'L
SlGNAJURE OF
7, 2001
RSON ACTING AS SUCH LICENSE NUMBER
Stephen R. Hall Ub. FD 012068L
b the bell of my knowtectge, oealn occurred. the time, date and place .led.
(SignaIUle ana nle'
::- n""n-y
Mini
-...;p? .7...0 :n..~=oI
MOTHER'S NAME If.5I. _. M_Sul"""",)
It. Anna Shields
INFORMANT'S MAIUNG ADDRESS (SIt.... ClyITown. _, Zip Codel
~ 3614 Kent Drive, Mechanicsbur 17055
PLACE OF DlSPOSlTlON. Nama 01 ~ary, Crematory LOCRlON. CilylTown. Slat., Lop Coda
",OU-PIKe
.....
3614 Kent Drive
t~Mechanicsburg, PA 17055
FRHER'S NAME (F.... Middle. LasI)
... Arthur William Lawver
N'ORMAHT'SNAME(TypaIPrinI) Elisabeth A. Roberts
dly/lIOr1I.
....
z
@ ..
~
o
u..
o
w
~
<
z
ate.
Pine Grove Cemete
NAME AND ADDRESS OF FACILITY
_.114 West M .
LICENSE NUMBER
23a.
IME OF DEATH
24. 5"":. - M. as.
27. MRT I; Enlerthe diaMMs. tniuriesorcomplicatiofwwhit;h causedlhe death. 00 not ani... the rnoc:Ie of dying, S
lial: onty one ca.UN on MCb line.
'Z-C:> D I
2311. _.
Wl\S CASE REFERRED 10 MEDICAL EXAMINERlCORONER?
...0 No~
a.
I Approximate PART II: Other signiftcanl conditions conInbuling 10 death. but
In...... _n 11OI.....aing in _.-tty;ng _ given in IWIT I.
I onMt and death
I
:
\...
'V
~
~
--.)
\::::S
-.}
L 7^-o.u. ~^ ~~
DUE 10 (OR AS A CONSEOUENCE Of):
~
I:
DUE 10 (OR AS A CONSEOUENCE 0Fl:
DUE 10 (OR AS A CONSEOUENCE 0Fl:
WERE AUlOPSY FINDINGS
-.LAkE PRIOR 10
COM~OFCAUSE
OF DEATH?
MANNER OF DEATH
ORE OF INJURY
(Menlll. Day. _)
TIME OF INJURY
INJURY ,q \NORK?
DESCRl8E HOW INJURY OCCURRED.
Suicide
00
o
o
HomOda
Pending ~tion
o
o
o ~E OF INJURY. AI home, ",",,~Hl. Iaclorv, olftca
IluillIInQ. ere. ISpeoIv\
:JOe.
.... 0 No 0
_Ulal
~
.:S
...c:::
"t
-1:::
-
Na~
...0
NoD
M. __
'MEDlCAL EXAMINER/CORONER
On _ ...... of examination and/or investigation, in my opinion, death oceurred at the lime, dale, and placa, and due 10 Ihe cause(a) and
manner a. stated.. .. . . .. .. . .. . .. . . . . .. . .. .. .. . . . . .. . . .. .. .. .. .. .... .. . . . . .. . . . . . . . . . .. .. .. . .. .. ; . .. . . . . . .. ... .... .
31..
REGISTRAR'S SIGNATURE AND NUMBER
"
Q 1..2 1..:2.1...2 I ~
PA 17033
Could I10l De dallnnonecl
2Ib.
CERTIFlEIlICheck only"""
-CERTIFYING PHYSICIAN (Physcan cerIlfytng cause cJ death wh8f'\ another ptW$IC.an has Pfonounced death ana compeeted "em 23)
To...bMtof""knowIecIge.de....~duelOthec:.use(s..ndm.nne'...tated........................................ ......... ....
a.
-PIIONOUNCING AND CERTIFYING PHYSICIAN (f'hv!;IclaO both OlrnnounclNJ death and certd'(lllg 10 cause 01 deartll
To the beet ot my knowtedge. death occurred al!he lime. dale, and piKe. and due ta lM cauM(.) and manner a. stated
34.
7- ~-ol
11Ia~t 1AAiU an~ 'Q}~~tam~nt
OF
ARTHUR W. LAWVER
I, ARTHUR W. LAWVER, of Mechanicsburg, Cumberland County, and
Commonwealth of Pennsylvania, do hereby declare this to be my Last
will and Testament, revoking all other wills and Codicils
heretofore made by me.
ITEM 1: I direct ,:-that all my just debts, funeral expenses,
administration costs and inheritance taxes on my estate be paid as
soon after my decease as may be found convenient.
ITEM 2: I give, devise and bequeath all of my estate, real,
personal and mixed, of whatsoever nature and wheresoever situate,
to my beloved wife, HELEN E. LAWVER, absolutely.
ITEM 3: If my wife, HELEN E. LAWVER, should predecease me, I
give, devise and bequeath all my estate, real, personal and mixed,
of whatsoever nature and wheresoever situate, to my daughter,
ELISABETH A. ROBERTS, or to her issue per stirpes.
ITEM 4: Should my daughter, ELISABETH A. ROBERTS, predecease
me without issue surviving, then I give, devise and bequeath my
entire estate as follows:
A. 40% to my son-in-law, ALLAN F. ROBERTS, and
B. 60% to the EVANGELICAL LUTHERAN CHURCH IN AMERICA, or its
successor, to be divided equally among the World Hunger Appeal, the
Division for Global Mission and the Division for Outreach.
If my son-in-law, ALLAN F. ROBERTS, should predecease me, then
his 40% share shall go to the EVANGELICAL LUTHERAN CHURCH IN
AMERICA to be divided as set forth in this ITEM 4:, B.
ITEM 5: In the event that any beneficiary under this will and
I shall die under such circumstances that there is no sufficient
evidence that we died otherwise than simultaneously, such
beneficiary shall be deemed to have predeceased me.
ITEM 6: I appoint my beloved wife, HELEN E. LAWVER, the
Executrix of this will and direct that she be permitted to serve
without bond and without any intervention of any court except as
required by law.
I authorize my Executrix to sell, encumber,
mortgage, invest, distribute in kind, or retain any item of
property of my estate in such manner as she shall deem proper,
limited only by her own discretion. If for any reason my Executrix
appointed under this will should fail to serve in that capacity, I
appoint my daughter, ELISABETH A. ROBERTS, my Executrix with the
same powers and privileges set forth above. If for any reason my
Executrix, ELISABETH A. ROBERTS, appointed under this will should
fail to serve in that capacity, I appoint ROBERT D. HANSON,
ESQUIRE, my Executor with the same powers and privileges set forth
above.
IN WITNESS WHEREOF, I have at Harrisburg, Pennsylvania, this
d- r day of June, 1991, set my hand and seal to this my Last will
and Testament.
. ~~ L:/
az.~ -n. ~~,-e.-7-/
ARTHUR W. LAWVER
Signed, sealed, published and declared by the above named
Testator, ARTHUR W. LAWVER, as and for his Last will and Testament,
in the presence of us, who, at his request, in his presence and in
the presence of each other, have hereunto subscribed our names as
s e
rzJ1; y ~~~ .
c: ~I
2 Residence '>13
~{? ~...../A J /J! /73 6~
I
.
\.,
---
t.-
Name of Decedent:
CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
ARTHUR W. LAWVER
Date of Death:
JULY 2. 2001
Will No.:
2001-00734
Admin No.:
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on NOVEMBER 20, 2001
Name
Address
ELISABETH A. ROBERTS, 3614 KENT DRIVE, MECHANICSBURG, PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE
Date: 1( -)) ~O ,
ANTHONY
Name
, ESQUIRE
15
-:-:
ct
407 NORTH FRONT STREET
HARRISBURG, FA 17101
Address
r"\
N
0-
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N
:>-
~
(717) 238-3686
Telephone
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0..5:
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(J)CC
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(13 .
:.: CapacIty:
, (1)
,(: ..0
'1;... ~
~:s
Uu
D Personal Representative
~ Counsel for personal representative
p
;. . ...., .
1 .
L~;
~._-....-
E
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA
In re Estate of
ARTHUR W. LAWVER
, deceased,
No.
00734
of 2001
TO: ELISABETH A. ROBERTS
3614 KENT DRIVE
(beneficiary)
(address)
MECHANICSBURG. PA 17055
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below. You may have
a beneficial interest in the estate as follows:
ALL OF THE ESTATE
(if additional space is needed, use back of page)
Name of decedent ARTHUR W. LAWVER
Last known address 3614 KENT DRIVE
of decedent MECHANICSBURG, PA 170~~
Date of death JULY 2, 2001 .
Place of death DAUPHIN COUNTY, PENNSYLVANIA
County of grant of original letters
CUMBERLAND
Decedent died
x
testate
intestate.
A copy of the will X
is
is not attached.
Name(s), address(es) and telephone number(s) of all personal
representatives appointed
N~me Address Telephone
(717)
ELISABETH A. ROBERTS, 3614 KENT DRIVE, MECHANICSBURG, PA 17055 732-4128
...
.. ~ . .. . ~ . . - . . , - .
~~::::;.:;:;~:::;.:~:::;~;,;
.-
'!/last ~iH aub 'Q}estament
OF
ARTHUR w. LAWVER
I, ARTHUR W. LAWVER, of Mechanicsburg, Cumberland County, and
Commonwealth of Pennsylvania, do hereby declare this to be my Last
will and Testament, revoking all other wills and Codicils
heretofore made by me.
ITEM 1: I direct -:.that all my just debts, funeral expenses,
administration costs and inheritance taxes on my estate be paid as
soon after my decease as may be found convenient.
ITEM 2: I give, devise and bequeath all of my estate, real,
personal and mixed, of whatsoever nature and wheresoever situate,
to my beloved wife, HELEN E. LAWVER, absolutely.
ITEM 3: If my wife, HELEN E. LAWVER, should predecease me, I
give, devise and bequeath all my estate, real, personal and mixed,
of whatsoever nature and. wheresoever situate, to my daughter,
ELISABETH A. ROBERTS, or to her issue per stirpes.
ITEM 4: Should my daughter, ELISABETH A. ROBERTS, predecease
me without issue surviving, then I give, devise and bequeath my
entire estate as follows:
A. 40% to my son-in-law, ALLAN F. ROBERTS, and
B. 60% to the EVANGELICAL LUTHERAN CHURCH IN AMERICA, or its
successor, to be divided equally among the World Hunger Appeal, the
Division for Global Mission and the Division for Outreach.
If my son-in-law, ALLAN F. ROBERTS, should predecease me, then
his 40% share shall go to the EVANGELICAL LUTHERAN CHURCH IN
AMERICA to be divided as set forth in this ITEM 4:, B.
ITEM 5: In the event that any beneficiary under this Will and
I shall die under such circumstances that there is no sufficient
evidence that we died otherwise than siruultaneously, such
beneficiary shall be deemed to have predeceased me.
ITEM 6:
I appoint my beloved wife, HELEN E. LAWVER,
the
Executrix of this Will and direct that she be permitted to serve
-:' ~:; -:.:.~:;:;:~:.:;::~::.:~~:.:~:~::.:
without bond and without any intervention of any court except as
required by law.
I authorize my Executrix to sell, encumber,
mortgage, invest, distr'ibute in kind, or retain any item of
property of my estate in such manner as she shall deem proper,
limited only by her own discretion. If for any reason my Executrix
appointed under this will should fail to serve in that capacity, I
appoint my daughter,' ELISABETH A. ROBERTS, my Executrix with the
same powers and privileges set forth above. If for any reason my
Executrix, ELISABETH A. ROBERTS, appointed under this Will should
fail to serve in that capacity, I appoint ROBERT D. HANSON,
ESQUIRE, my Executor with the same powers and privileges set forth
above.
IN WITNESS WHEREOF, I have at Harrisburg, Pennsylvania, this
,~~ day of June, 1991, set my hand and seal to this my Last will
and Testament.
U-1 L,-)1 ~'.,- --"--<:-.'2-/
ARTHUR W. LAWVER
Signed, sealed, published and declared by the above named
Testator, ARTHOR W. LAWVER, as and for his Last will and Testament,
in the presence of us, who, at hj.s request, in his presence and in
the presence of each other, have hereunto subscribed our names as
es e
~----
Residence ;1 s-t'ZJ IV ,.k_bf-
~~
c - . --t.....\..-.... i
Residence m~ ~
~Y'~_/A.) //1 /7.36s--
I
(zjtzg}j ~p;_ ~)
;.;". ~..~<;~:..:;:.:~:.;::;>::;:::::.:;:;
CUMBERLAND
Register of Wills of ~~mm1 County, .Pennsylvania
INVENTORY
ARTHUR w. LAWVER
2001-00734
Estate of
No.
Date of Death
7/2/2001
also known as
, Deceased
Social Security No.
187-30-2915
a~
atJ~
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the folio wing inventory include all
of tho personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent. that
the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and
that Decedent owned no real estate outside ot the Commonwealth oi Pennsyivania except that which appears in a memorandum
at the end of this inventory. IlWe verify that the statements made in this Inventory arc true and correct. It We understand that
false statements herein a,o made subject to the penalties of 1 B Po. C.S. Soction 4904 relating to unsworn falsification to
au thorities.
Personal RepresentCltive:
Name of
Attorney:
ANTHONY T. MCBETH
53729
ELISABETH A. ROBERTS
1.0. No.:
Address: 407 NORTH FRONT STREET, FIRST FLOORd
APRIL 22, 2002
HARRTSRURG, PA 17101
Telephone: (71 7) 238 - 3 686
Description
Value
AMERICAN EXPRESS AXP SELECT FUND
AMERICAN EXPRESS AXP MUTUAL FUND
AMERICAN EXPRESS AXP GROWTH FUND
AARP INVESTMENT FUND NO. 0209099 366-2
CASH - FIRST UNION BANK ACCOUNT NO. 1000 65525406
EVANGELICAL BOARD OF PENSIONS ACCOUNT
*AMERICAN EXPRESS ANNUITY 0930 0266 7615 3 004
*AMERICAN EXPRESS ANNUITY 0930 0266 7624 5 004
*AMERICAN EXPRESS ANNUITY 0930 0295 1218 1 004
$6,361.00
$25,880.00
$12,111.00
$24,810.00
$4,526.00
$1,127.00
$3,640.00
$5,937~00
$22,357.00
* EACH OF THESE ACCOUNTS WAS OWNED JOINTLY WITH
THE EXECUTRIX, PASTOR LAWVER'S DAUGHTER. THE
DECEDENT'S SHARE OF DATE-OF-DEATH VALUE IS
REFLECTED HERE.
Total:$1 06,749.00
(Attach Additional Sheets if necessaryl
NOTE: The Memorandum of real estate outside the CommollweJltlJ of PCIlIISylvilI1iJ Illay. ,1t the electiol1 01111(: pelsolla/ rcprt:sellt;IIIVt:. IlIclude:
the value of each item. but such figures should not bc cxlellllt:d into the total of the Inven(ory. .
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~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG I PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*
REV-1U7 EX iFP n1-02)
ANTHONY T ~8'ET~UL 26 '\: 1 :2U
1ST FLR
407 N FRO"J ST
HBG ~:'>.. ' PA 17101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-22-2002
LAWVER
07-02-2001
21 01-0734
CUMBERLAND
101
Allount Rellitted
ARTHUR
W
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 ~
RE-v=i6oj-iif-iFP--flfi.:o2i-------...-iNifEiI'fANc'E-YAX--SyjffEMENY-OF'-Aifcouiif--.-..---------------------
ESTATE OF LAWVER ARTHUR W FILE NO. 21 01-0734 ACN 101 DATE 07-22-2002
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, 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: ........n...............................................................................................................n................................................................................................
4,022.00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-19-2002 CDOOI094 .00 4,022.00
06-19-2002 CDOO1310 11.21- 11.21
TOTAL TAX CREDIT 4,022.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
\,
I b -~J?w 14"
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG I PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'02
JUN 1 7
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
f\ 3 ~O 4
ANTHONY T MCBETH
1ST FLR
407 N FRONT ST
HBG
06-10-2002
LAWVER
07-02-2001
21 01-0734
CUMBERLAND
101
*
REV-1547 EX AFP UI-D21
ARTHUR
W
\.,>
PA 1 ~10:t
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is'4-i-Ex--AFP--(lff=o21--NcfficE--oF-YtiHEifiTANci-i"AX-APPRjrisEi'-ENT~--ALi-owANcE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LAWVER ARTHUR W FILE NO. 21 01-0734 ACN 101 DATE 06-10-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. 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
(l)
(2)
(3)
(4)
(5)
(6)
(7)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(l0)
.00
69.162.00
.00
.00
5.653.00
31.934.00
.00
(8)
16,321.00
1.040.00
(ll)
(l2)
(l3)
(l4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
106,749.00
17.361 00
89,388.00
.00
89,388.00
14, 15 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:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
T
+
INTEREST/PEN PAID (-)
.00
DATE
04-19-2002
NUMBER
CDOOI094
.00 X 00 =
89,388.00 X 045=
.00 X 12 =
.00 X 15 =
(l9)=
AMOUNT PAID
4,022.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-20-2002 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
4,022.00
.00
.00
4,022.00
4,022.00
.00
11.21
11.21
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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
MCBETH ANTHONY T ESQ
407 NORTH FRONT STREET
HARRISBURG, PA 17101
-------- fold
ESTATE INFORMATION: SSN: 1 87 -30-2915
FILE NUMBER: 2101-0734
DECEDENT NAME: LAWVER ARTHUR W
DA TE OF PAYMENT: 04/22/2002
POSTMARK DATE: 04/19/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 07/02/2001
NO. CD 001094
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,022.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: ANTHONY T MCBETH ESQUIRE
CHECK# 251
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$4,022.00
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
MCBETH ANTHONY T ESQ
407 NORTH FRONT STREET
HARRISBURG, PA 17101
-------- fold
ESTATE INFORMATION: SSN: 187-30-2915
FILE NUMBER: 2101-0734
DECEDENT NAME: LAWVER ARTHUR W
DA TE OF PAYMENT: 06/20/2002
POSTMARK DATE: 06/19/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 07/02/2001
NO. CD001310
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $11.21
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$11 .21
REMARKS: ANTHONY T MCBETH
CHECK# 5361
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
~v
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Estate No.:
ARTHUR W. LAWVER
7/2/2001
2001-00734
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 No X
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: upon clearance from Pa. Dept of Revenue,
approximatel~areP-1-02
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: (Not Applicable in Dauphin County)
C. Did the personal representative state an account informally to the parties in
interest? Yes No
D. Copies of receipts, releases. joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
CJ.:::
=-
ANTHONY T.
Date: 4/22/02
('"'11
r"-J
N
P
>-
. -
...." f"'"
--"~
407 NORTH FRONT STREET, FIRST FLOOR
Address HARRISBURG, PA 17101
(MAH:rmtl AM3)
(717) 238-3686
Telephone No.
Capacity:
Personal Representative
X
Counsel for Personal Representative
R.W. - 58
4'
C'Ii!.,;
o
.....
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
ARTHUR W. LAWVER
Date of Death:
JULY 2, 2001
Will No.:
2001-00734
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 ~ 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 !:!l
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 jg No 0
EXECUTRIX WAS ONLY HEIR
c. Copies of receipts, releases, JOInders and approval of formal or
informal accounts may be filed wi the Clerk of th . Orphans' Court
and may be attached to this reR
~ Date: 6/J 7 103
. - ---;:::r-
_r-
--;.~
ex:)
ANTHONY
Name
~
'"
,:,.::.:
.......
'""
p
407 NORTH FRONT STREET
HARRISBURG, FA 17101
Address
(717) 238-3686
Telephone No.
':.5C5
Capacity: 0 Personal Representative
fX1 Counsel for personal representative
4
.
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 6/10/2003
ROBERTS ELISABETH A
3614 KENT DRIVE
MECHANICSBURG, PA 17055
RE: Estate of LAWVER ARTHUR W
File Number: 2001-00734
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: 7/02/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: /File
Counsel
Judge
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REV-15DOEXI~~)
,,-,
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV -1 500 O:FICI~USE ONLY
~llL~J.jj_=--t 1/ __
INHERITANCE TAX RETURN FILE NUMBER r----------
RESIDENT DECEDENT CiN"TYboE- ~EA-,1- ...Q ~ER-7....3_4
w
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SDCIAL SECURITY NUMBER
LAWVER ARTHUR
DATE OF DEATH (MM-DD-YEAR)
07-02-2001
187 - 30
2-915
W.
DATE OF BIRTH (MM-DD-YEAR)
10-06-1909
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
o 4. Limited Estate
[X] 6, Decedent Died Testate (Attach copy of Will)
D 9. litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date o/death after 12-12.82)
o 7. Decedent Maintained a Living Trust (Attach copyofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
NAME
COMPLETE MAILING ADDRESS
407 NORTH FRONT STREET
FIRST FLOOR
HARRISBURG, PA 17101
ANTHONY T. MCBETH
FIRM NAME (If Applicable)
TELEPHONE NUMBER
(717)
238-3686
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
~
>-" ~<
d OFFIC~L;l SE ONLY
N
69,162
'"',
;~
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)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
1'-)
"J
5,653
(6)
11, 'l,4
~.,,)
'",)'i
(7)
(B)
106,749
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 1 0)
(9)
(10)
1 h, 171
1,040
(11)
(12)
(13)
17 ,361
R'l.,RR
12. Net Value of Estate (Line 8 minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
89,388
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
,.0_(15)
, .0 A.5. (16)
4,022
16. Amount of Line 14 taxable at lineal rate
RCJ,1RR
17. Amount of Line 14 taxable at sibling rate
, .12 (17)
18. Amount of Line 14 taxable at collateral rate
, .15 (18)
19. Tax Due
(19)
4,022
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS 3614 KENT DRIVE F'
CITY I STATE I ZIP 17050
MECHANICSBURG PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
".O?? 00
Total Credits (A + 8 + C) (2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
8. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE.
(5)
(5A)
(58)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
4.022.00
A. Enter the interest on the tax due.
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 IKJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 IXJ
c. retain a reversionary interest; or.............".............................m.... ............................ ..................................... 0 IX]
d. receive the promise for life of either payments, benefits or care? .............................. ................................ 0 IXJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................ ................................. ................................ .......................... D IX]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 IX]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............... .......................... .............................. ............................. ............... 0 IXJ
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 thai I have examined this return, including accompanying schedules and stalemel'lts, and to the besl of my knowledge and belief, it is true, correct
and complete.
Declaration 01 preparer other Ihanlhe personal representative is based on all information of which preparer has any knowledge.
(hfl t7lcsbJ~
DATE
'f.{?/cJ:J...>
~7,,1,Z-
DATE
-o'Zr
For dates of death on or after July 1, 1994 and before January 1. 1995, the tax rate impo d 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)(I.2)J.
The tax rate imposed on the net value of transfers to or for the use ofthe 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)J. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
'REV"~""I""".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
LAWVER
ARTHUR W.
FILE NUMBER
21-01-00734
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. AMERICAN EXPRESS AXP SELECT FUND
2. AMERICAN EXPRESS AXP MUTUAL FUND
3. AMERICAN EXPRESS AXP GROWTH FUND
4. AARP INVESTMENT FUND NO. 0209 099 366-2
VALUE AT DATE
OF DEATH
6,361.00
25,880.00
U,111.00
24,810.00
COPY OF ALL STATEMENTS, INCLUDING VALUES FOR ACCOUNTS
SHOWN ON SCEDULE F, ARE ATTACHED.
TOTAL (Also enter on line 2, Recapitulation) $ 69, 1 62. 00
(If more space IS needed, insert additional sheets of the same size)
REV-1511BE~+(1.97)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LAWVER ARTHUR W.
FILE NUMBER 21-01-00734
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly"owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
DESCRIPTION
FIRST UNION BANK - ACCOUNT 100065525406
EVANGELICAL BOARD OF PENSIONS ACCOUNT
VALUE AT DATE
OF DEATH
$4,526.00
$1,127.00
TOTAL (Also enter on line 5, Recapilulation) $ 5 653. 00
(if more space is needed, insert additional sheets of the same size)
REV.l509 EX + 11.&7)
'*
SCHEDULE F
JOINTL Y.OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF LAWVER ARTHUR
W.
FILE NUMBER
21-01-00734
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
ELISABETH A. ROBERTS
3614 KENT DRIVE
MECHANICSBURG, PA 17050
DAUGHTER
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MAOE Include name of financial institutioo and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate, VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1985 ~MERICAN EXPRESS ANNUITY $7,280.00 50 $3,640.00
0930 0266 7615 3 004
B. 1985 AMERICAN EXPRESS ANNUITY $11,874.00 50 $5,937.00
0930 0266 7624 5 004
C. 1985 AMERICAN EXPRESS ANNUITY $44,713.00 50 $22,357.00
0930 0295 1218 1 004
TOTAL (Also enter on line 6, Recapitulation) $ 31,934.00
(If more space is needed, insert additional sheets of the same size)
REV.1511E~.(:.971
'*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
LAWVER ARTHUR W.
21-01-00734
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. TREFZ & BOWSER FUNERAL HOME, INC. 8,066.00
(a copy of statement attached)
2. FUNERAL LUNCEON 226.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Persona! Representative (s)
Social Security Number{s) f EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2 Attorney Fees 4,000.00
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant ELISABETH A. ROBERTS 3,500.00
Street Address <1';14 KP.N'I' nRTUR
City MECHANICSBURG State PII Zip 17n~o
Relationship of Claimant to Decedent nn nr:l.PPF.'D
4. Probate Fees 252.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees 145.00
7. ADVERTISING 132.00
TOTAL (Also enter on line 9, Recapitulation) $16,321.00
(If more space is needed, insert additional sheets of the same size)
""."",~..".,,).
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
21-01-00734
FILE NUMBER
LAWVER ARTHUR W.
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1. 2001 FEDERAL INCOME TAX
2. 2001 STATE INCOME TAX
3. 2001 LOCAL INCOME TAX
4. MILTON S. HERSHEY MEDICAL CENTER - INTERNAL MED
5. HEALTH;S~;cc
6. ROBERT W. HAMILTON, MD
7. MILTON S. HERSHEY MEDICAL CENTER - CHAIR RENTAL
8. MILTON S. HERSHEY MEDICAL CENTER - PHYSICIANS GROUP
285.00
8.00
12.00
396.00
13.00
209.00
7.00
110.00
TOTAL (Also enter on line 10, Recapitulation) $ 1 , 040. 00
(If more space is needed, insert additional sheets of the same size)
,,,,.,,,,,:.,,,",,.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
LAWVER ARTHUR W.
21-01-00734
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I . TAXABLE DISTRIBUTIONS (include outnght spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1, ELISABETH A. ROBERTS
DAUGHTER
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
ANTHONYT. McBETH
ATTORNEY AT LAW
407 NORTH FRONT STREET
CAMERON MANSION
HARRISBURG,PA 17101
E-mail: atmlawl@aol.com
PHONE (71 7) 238-3686
1-8OQ.227-6916
(for 717 area)
FAX 017) 238-3575
April 19, 2002
Commonwealth of Pennsylvania
Department of Revenue
Department 280601
Harrisburg, PA 17128-0601
Re: The Estate of Arthur W. Lawver, Deceased; File No. 21-01-00734
Ladies and Gentlemen:
Attached is the Inheritance Tax Return and payment for the Estate of Arthur W. Lawver. We
were waiting and have been waiting for a long time, for the late Pastor Lawver's fina1 hospital bill.
We expect the uninsured portion of that bill to be substantial. It is for the reason that we are filing
the Inheritance Tax Return at this point, so that the time does not run any longer. We anticipate
having to file a supplemental return deducting that fina1 hospital bill, but felt it inappropriate to wait
any longer to file the original.
Under these circumstances, we respectfully request that the Department waive any interest
or penalty that may otherwise be due. We thank you for your consideration,
ATM:rnss
\
. Stephm R. Hall, Supervisor
Uretz & IJoWjer 9uneral Jlome,
Jnc.
II4 West Main Street. Hummelstown, PA 17036
Phone: 717'566'0451
Statement of Services and Merchandise
July 23, 2001
Mrs. Elisabeth A. Roberts
3614 Kent Drive
Mechanicsburg, PA 17050- ?,ZGo
Services for: The Rev. Arthur W. Lawver" Jr.
Date of Death:
Pr()fessional Services
Services of Funeral Director and Staff
for a Standard Service.............................................
for a Graveside Service ............................................
Embalming.... . . . . .. .. .. . . . . . . . . . . . . .. . . . . . . . . .. .. . .. . .. .. .. .. . . . ...
Other care of Deceased ............................................
Facilities
Use of Facilities for Visitation ...................................
Use of Facilities for and Services for a Service ..............
Use of Facilities for a Memorial Service .......................
Saturday Fee. ........ ................... ...........................
Transportation
Transfer of Deceased to Funcral Home........................
Hearsc .............................................................
Family Car (l) ......................... ...........................
Flower Car.........................................................
Out of Town Transportation... ..................................
$1350.00
$ 330.00
$ 800.00
$ 250.00
$ 300.00
$ 650.00
$ 650.00
$ 200.00
$ 275.00
$ 220.00
No Charge
$ 100.00
No Charge
TREFZ & BOWSER FUNERAL I-lOME, INC.
Page 2.
Merchandise
Casket (I8 Ga. Steel Ext. Moselle Crepe Int.) ...............
Outer Burial Container (Wilbert Asphalt Scaled Concrete) .
Acknowledgement Cards .............................. .........
Register Book...... ............ .............................. .....
Memorial Folders ............ ................................... .c.
Cash Advances
Certified Copies (2 @FederaIExpressRate) .................
Clergy Honorarium .................. ..................... .........
Obituary Notices (Harrisburg) ...................................
Ccmetery Charges ..................................................
Cemetery Equipment ..............................................
Flowers............................................................ ..
Organist............................................................ .
Total Due
Less Professional Discount
Please remit by August 23,2001
$1490.00
$ 650.00
No Charge
$ 30.00
$ 45.00
$ 20.50
$ 315.00
$ 133.00
$ 475.00
$ 150.00
$ 216.77
$ 150.00
$8800.27
$ 734.00
Balance Due $8066.27
:~i&t~ii~
.-
]la$t ~ill anb 'Q}~$tam~nt
OF
ARTHUR W. LAWVER
I, ARTHUR W. LAWVER, of Mechanicsburg, Cumberland County, and
commonwealth of Pennsylvania, do hereby declare this to be my Last
Will and Testament, revoking all other Wills and Codicils
heretofore made by me.
ITEM 1: I direct,:.that all my just debts, funeral expenses,
administration costs and inheritance taxes on my estate be paid as
soon after my decease as may be found convenient.
ITEM 2: I give, devise and bequeath all of my estate, real,
personal and mixed, of whatsoever nature and wheresoever situate,
to my beloved wife, HELEN E. LAWVER, absolutely.
ITEM 3: If my wife, HELEN E. LAWVER, should predecease me, I
give, devise and bequeath all my estate, real, personal and mixed,
of whatsoever nature and wheresoever situate, to my daughter,
ELISABETH A. ROBERTS, or to her issue per stirpes.
ITEM 4: Should my daughter, ELISABETH A. ROBERTS, predecease
me without issue surviving, then I give, devise and bequeath my
entire estate as follows:
A. 40% to my son-in-law, ALLAN F. ROBERTS, and
B. 60% to the EVANGELICAL LUTHERAN CHURCH IN AMERICA, or its
successor, to be divided equa,lly among the World Hunger Appeal, the
Division for Global Mission and the Division for Outreach.
If my son-in-~aw, ALLAN F. ROBERTS, should predecease me, then
his 40% share shall go to the EVANGELICAL LUTHERAN CHURCH IN
AMERICA to be divided as set forth in this ITEM 4:, B.
ITEM 5: In the event that any beneficiary under this Will and
I shall die under such circumstances that there is no sufficient
evidence that we died otherwise than siIllUltaneously, such
beneficiary shall be deemed to have predeceased me.
ITEM 6: I appoint my beloved wife, HELEN E. LAWVER, the
Executrix of this Will and direct that she be permitted to serve
,<:,:,:,,~;::.'=:~:;~;::,~~.:i
~~%.i~~lli:~lili
without bond and without any intervention of any court except as
required by law.
I authorize my Executrix to sell, encumber,
mortgage, invest, distribute in kind, or retain any item of
property of my estate in such manner as she shall deem proper,
limited only by her own discretion. If for any reason my Executrix
appointed under this Will should fail to serve in that capacity, I
appoint my daughter, ELISABETH A. ROBERTS, my Executrix with the
same powers and privileges set forth above. If for any reason my
Executrix, ELISABETH A. ROBERTS, appointed under this Will should
fail to serve in that capacity, I appoint ROBERT D. HANSON,
ESQUIRE, my Executor with the same powers and privileges set forth
above.
IN WITNESS WHEREOF, I have' at Harrisburg, Pennsylvania, this
,~~ day of June, 1991, set my hand and seal to this my Last Will
and Testament.
a:1L_)i k',,--c-oz-'/
ARTHUR W. LAWVER
signed, sealed, published and declared by the above named
Testator, ARTHUR W. LAWVER, as and for his Last will and Testament,
in the pref.ienCe of us, who, at h~.s request, in his presence and in
the presence of eac~ other, have hereunto subscribed our names as
~s e
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Turner and Associates
A financial advisory branch
October 3,2001
Law Offices of Anthony T. McBeth
407 North Front Street, 1st Floor
Harrisburg, PA 17101
Re: Estate of Arthur' Lawver
Date of Death: 07/02/2001
Dear Mr. McBeth,
Enclosed please find the infonnation you requested regarding Mr. Lawver's
accounts. I apologize for the delay in getting this infonnation to you. See
below for all date of death values:
Principal Valne Accrued Dividends Gross V.lue
AXP Select Fund $6,355.51 $5.70 $6,361.21
00 I 0 5455 9709 7 002
AXP Mutual Fund $25,879.69 $0.00 $25,879.69
0010745597095002
AXP Growth Fund $12,111.22 $0.00 $12,111.22
00 II 9787 3960 2 002
Annuity $7,280.85 N/A N/A
0930026676153004
Annuity $11,873.57 N/A N/A
0930026676245 004
Annuity $44,712.98 N/A N/A
093002951218 I 004
i\dv;lnr;cd Allvi:mr Group
Charles A. Turner, CFp1lI!
Senior Financial Advisor
CmnFIEO FiNANCIAL PlANNER™
practitioner
George l. Storey
Financial Advisor
Joseph l. Baird, CPA
Financial Advisor
Thomas H. Garlic
Senior Paraplanner
Heidi M. Duckworth
Paraplanner
American Express
FinanciaJ Advisors Inc.
IOS life Insurance Company
Suite 200
405 East Chocolate Avenue
Hershey. PA 17033
Bus: 717.533.4070
fax 717.520.9200
Bus 88B.739.8B34
amexcat@epix,net
American Express Financial
Advisors Inc. Member NASa.
An AEFA associated fmancial
advisor franchise. Insurance
and annuities are issued by IDS
life Insurance Company, an
American Express company.
American Express Company is
separate from American Express
Fjnancial Advjsors Inc. and
is not a broker-dealer.
If you have any questions or require any further information, please do not
hesitate to contact me. Thank you for your attention to this matter.
)2i e1' ~~
J seph L. Baird, CPA
Personal Financial Advisor
JB/dp
Ene. (I) estate settlement form
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