HomeMy WebLinkAbout01-0758
PETITION FOR PROBATE and GRANT OF 'LETTERS
Estate of 't.m~L tV. \<~LL\J
a/so known as ...
No.
To:
Register of Wills for the
1 Deceased. County of CUf..\.~En.L~ in the
Social Security No. \~~- 32- ?q4~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executJ!!lt"
in the last will of the above decedent, dated . ""~ "t 2.2.
and codicil(s) dated
21-01-758
named
,19~
(state relevant circumstances, e.g. renunciation. death of executor, etc.)
Decendent was domiciled at death in ~<2- County, Pennsylvania, with
her last family or principal residence at \'2..\'t. ~ \"O:i:)L€ 'bQ., vE QARL\SLE \ pA l'lD \ 3
~\i20 C~ C.~~Ll9lf
(list street, number and muncipality)
~cendent, then q C year.!..~~ _di~d "'1 - \ <6 ,19 Z-C'lO \,
at~C\;~t..\~ ~t-\e3 EL\~U { ~t\ .
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ \"5 Qt::2:). l.,TC)
$ J
$
$
WHEREFORE, petitioner(s) respectfully r~uest(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters ~f\~tVl:t\.(l "t!
(t~~~entary; administration c.La.; administration d.b.n.c.t.a.)
theron.
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-g .g ,2. \'2. 'B \~L~ 'I::)t2\ V E.
QS'p C'.~L\'3LE\ PA. \-rO \....~
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OATH OF" PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF Cv~e2..ll\MD
The petitioner(s) above-named swear(s) or affrrm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of 'tioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will w II an iuly administer the estate according to law.
Sworn to or affirmed and
before me this 9th
AU US
t";'}
OQ'
S
~
I::
~
~
~o. 21-01-758
Estate of
ETHEL W KELLY
, Deceased
DECREE OF PROBATE A~D GRANT OF LETTERS
AND NOW AUGUST 15 ~, 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 MAY 22, 1997
described therein be admitted to probate and filed of record as the last will of
ETHEL W KELLY
TESTAMENTARY
THOMAS H KELLY III
and Letters
are hereby granted to
>7/~V~'-N~Li) AI; / 4~'-Y
eglster of Ills
FEES
Probate, Letters, Etc. ...... ... .
Short Certificates( )..........
x-pages
Renunciation ................
JCP
$
$
$
$ 5.00
TOTAL _ $ 258.00
. . AUGUST. . . 9.,. .200.1 . . . . . . . . . . . . .
235.00
9.00
~.uu
AITORNEY (Sup. Ct. I.D. No.)
ADDRESS
Filed
PHONE
21-01-758
R OF WILLS OF
ATH OF SUBSCRIBING WI
codi .
(each) a subscribing witness to the will p
law, depose(s) and say(s) that
herewith, (each) being duly qualified according to
present and saw
the testat , sign the same an<ythat signed as a witness at the
/
request of testat_ in h .//presence and (in the pr ence of each other) (in the presence of the
/
other subscribing witness(e~
Sworn to or affirme and subscribed before
me this day of
19_
Register
(Name)
(Address)
REGISTER OF WILLS OF CO)J\~~Q..~~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
--;;f'4\S.\\.Il€.LL~ and.. !OLr\{),oe k he.\\y
(each) a subscriie~ hereto, (each) being duly qualified according to law, depose(s) and say(s) that
.sr:: A\-'\ Wf> o..~ 0 ~ familiar with the signature of ~~L W~ KELLLr' ,
~
testat_ of (one of the subscribing witnesses to) the will presented herewith and
-;t \t: codicil
that Iv) €...- r PELl evE. believes the signature on the will is in the handwriting of
~ U-J- KELLt2
1 1..>d"'~ LV ("-
to the best of ~, knowledge and belief.
Sworn to or affirmed and subscribed before
me this 9 th day of
~ AUGUST lY2001
~~~~:/"lIJb /4;:"1
Register
-t~ t4.A.~ \\ ~ LL "l ~
(Name)
~~ \.2 ~,~LE ~\VC
( ~ress)
G_~L\.$.LE ~ \..10\3
.
t J \ (1J1!!,e~ I. ~
/~CM.A./Jll.AQ !1: 'f{ L ( il{
(Address)
f~l9- S;cldls Dri~ Cctfl/S~, PA 170/3
{ ~
WARNING: IT IS IllEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. T 4 8 6 6 3 8 8
/iffl'";;';;:'/"'
,'\i;'E~\.\ t\ OF ;;1;~,::;;-
;(.II\...\.~/ ------<(4'.' n~~\
/,,\ ~~/ '. Y.): \\
I~"~/ 9.~'~~\
i$~! ~lio. \~1\
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'"i <?;\ " /A.:~\lJ
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'7(~"", 'l/Y{Ni \\\ ~ ;",1"
~~!!-!!.!!1!!Jji!~~ /
7-18-01
Date of Issue 01 This Certification
21-01-758
Name of Decedent
ETHEL
First
W
r~1IcJdr:::
KRT-,T.Y
:,ast
Sex
FRM~T .E
Social Security No.
194-32-2946
Date of Death
7-18-01
Date of Birth
7-0c}-11
Birthplace
PENNSYLVANIA
Place of Death
MASONIC HOMES
F';:}c\\ity Name
LANCASTER.
COUll tv
W. DONEGAL 'IWP.
Pennsylvania
City Borough or Town;h'll
Race__ WHITE Occupation SCHOOL TEACHER , Armed Forces? (Yes or No)
Decedent's
Marital Status WTOOWED Mailing Address MASONIC HOMES ELIZABETHTOWN
r'Jurnhor ;treet ell,; or TOV\"l
NO
PA
State
Informant __ MASONIC HOMES Funeral Director _____' DAVID T. SEKELY
Name and Address of
Funeral Establishment 110 N. MARKET STREET ELIZABETHTOWN, PA
Part I:
Immediate Cause
Interval Between
Onset and Death
(a) ESOPHAGEAL CARCINOMA
(b)
(c)
Part II:
( d)
Other Significant Conditions
Manner of Death
Natural ~
Accident
Describe how injury occurred:
Suicide
Homicide
Pending Investigation
Could not be Determined
o
o
o
Name and Title of Certfier
J. KENNETH BRUBAKER 1M. D .
(MD., 0,0., Coroner, M.E.)
Address
MASONIC HOMES
ELIZABETHTOWN
This is to certify that the information here given is correctly copied from an original certificate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Records Office for permanent fitin:~o/i(",,,~ 36:,~,,:,~
7-18-01
25 IRIS CIRCLE
ELIZABETHTOWN
. , ~";ecp:\e,-j Ill,' \_t);:a'i Rt'gl~"tr21
StrEet ArjrJres';;
City, Borough, Township
It
21-01-758
lLa!)t Will anb UCe!)tament
ETHEL w. KELLY
I, ETHEL W. KELLY, of Bloomfield Borough, Perry County, Pennsylvania,
declare this to be my Last Will and revoke any will previously made by me.
ITEM I: I direct that my funeral expenses, grave marker and the costs of
the administration of my estate be paid out of the residue of my estate as soon as
may be convenient after my death.
ITEM II: I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed, shall be paid
from the residue of my estate as a part of the administration thereof, to the end
that no beneficiary hereunder, or any other person, shall be charged with or
required to pay any part of such taxes.
ITEM III: I devise and bequeath my entire estate of every nature and
wherever situate, whether real, personal or mixed, to my son, Thomas H. Kelly,
III, provided he survives me by thirty (30) days.
~ ITEM IV: Should my son, Thomas H. Kelly, III, predecease me or die on
~ or before the thirtieth (30th) day following my death, then and in that event, I
devise and bequeath my entire estate of every nature and wherever situate,
whether real, personal or mixed, as follows:
A. I bequeath all my furniture and furnishings and the contents of
my home to my daughter-in-law, Lorriene K. Kelly, and request that she make
distribution of the Boone family heirlooms to my grandchildren in her discretion.
further request that she distribute any other items of furniture, furnishings and
household contents as she may deem fit.
i
.
B. I devise and bequeath the rest, residue and remainder thereof
to FINANCIAL TRUST SERVICES CORPORATION, IN TRUST,
NEVERTHELESS, to be held, administered and finally distributed according to
the following terms:
1. A separate trust shall be created for each of my
grandchildren in equal shares and shall be used for the support, maintenance and
education of them. It is my desire to preserve the principal of the trusts for later
distribution to my grandchildren as provided below, but the Trustee may make
use of the principal, if necessary, for the support, maintenance and education of
them. After each grandchild reaches the age of twenty-two (22) years, each shall
! have the right to withdraw portions of his trust corpus according to the following
VI schedule:
a. Upon or after reaching the age of twenty-two (22) years,
one-third (1/3) of the corpus.
b. Upon or after reaching the age of twenty-six (26) years,
one-half (1/2) of the remaining corpus.
c. Upon or after reaching the age of thirty (30) years, the
entire balance of the corpus.
3. When each grandchild reaches the age of thirty (30) years,
his trust shall terminate.
4. Should any of my grandchildren die before receiving the
entire corpus of his trust, his issue shall succeed to his rights under his trust, per
stirpes. If he shall die without issue, the remaining corpus of his trust shall be
distributed pursuant to the above schedule to his brother, per stirpes.
J_ . oJ
"
--
5. No interest of any beneficiary of the trust created under this
will or any codicil hereto shall be subject to anticipation or voluntary or involuntary
alienation.
ITEM V: I authorize and empower my hereinafter named executor or
alternate executrix to convert any property that I may own at my death, whether
real, personal or mixed, at either private or public sale, whichever in their opinion
is deemed best, other than the furniture and furnishings and contents of my home
previously bequeathed, hereby vesting in said executor or alternate executrix full
power and authority to make, execute, acknowledge and deliver good and
sufficient deeds or assurances of title therefor, taking into consideration what
would be best for any of my children who may then be minors.
ITEM VI: I appoint my son, Thomas H. Kelly, III, executor of this my Last
Will. Should my son, Thomas H. Kelly, III, fail to qualify or cease to act as
executor, I appoint my daughter-in-law, Lorriene K. Kelly, alternate executrix of
this my Last Will.
ITEM VII: I direct that my executor or alternate executrix shall not be
required to give bond for the faithful performance of their duties in this or in any
other jurisdiction.
d
IN WITNESS WHEREOF, I have hereunto set my hand this d. ~ day of
May, 1997.
e.tRJ- U5' t< ~
~.
3
i
The preceding instrument, consisting of this and three other typewritten
pages, each identified by the signature of the testatrix, was on the day and date
thereof signed, published and declared by ETHEL W. KELLY, the testatrix therein
named, as and for her Last Will, in the presence of us, who, at her request, in her
presence and in the presence of each other, have subscribed our names as
witnesses hereto.
il~~~~6C
~i~
,
JRD/June 30, 1992/17858
DEe 0 4 2001
In Re: Estate of Ethel W. Kelly
Late of Carlisle Borough
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-01-758
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Thomas H. Kelly III
Counsel for Personal Representative:
Date of Grant of Original Letters: August 15, 2001
Date of Delinquency Notice: November 25,2001
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5 .6( e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on November 15" 2001, and that the
ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule
5. 6( e) the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: December 4, 2001
~.
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for ~ ~ fJ; / ~ "tM :3- at 7>:~ In Courtroom No.3. If the
Certification of Notice is fil a prior the hearing date, the hearing will automatically be
cancelled.
,
'-.
G:
-----
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
~'\'dtL W - \<E.LL'{
Date of Death: :J u t....l{
\ ~ '?_C>O \
)
Will No.
2- t " 0 l - -15 %
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 onA iJG- \ 5 ) 2. 00 \
Name
Address
~oJ.t\k'5 \J. . ~ELLl{ $
\2 \2.~\~VLc- 'U\<\V\:..
r! Ae.L\SL t? PA. \ lo l3
.
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
SigJ!!?/.J~~
Date: ~!\lJ'J~~~ l'L\ lad 2-
,
Name ~~ \.\_ _\(tLL-\'( -m-
~o
l""l
N
CO
c::::::t:
:::(
('I
_.,-
Address l2 \2- ~\-PDLE 1)~\0E.
C~~'2.L\SL~, ~ \. l 0 \ 3
.
<Il:::t
-
Telephone (ll1) 24.5 - Q08 g-
t~:~ ,.t::~;
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00:>
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50
Capacity: / Personal Representative
_Counsel for personal representative
, -. ".-.
January 11 , 2002
Thomas H. Kelly III
1212 Biddle Drive
Carlisle, PA 17013
IN RE: ESTATE OF ETHEL W. KELLY
Failure to File Certification
Dear Mr. Kelly:
A hearing was set for January 11, 2002, at 9:30 a.m., in the Courthouse in Carlisle,
at which you failed to appear.
The certification must be filed in the office of Register of Wills.
We must hear from you within twenty-four hours; please phone Donna in the
Register of Wills office at 240-6409, if you have any questions.
Sincerely,
Sandra S. Gobrecht, Secretary
Judge Hoffer's Chambers
E.
---
CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: ETHEL W KELLY
Date of Death: "1 / \ % /D l
Will No.: 21-01-758
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
Name
Address
A.~-vtR. 5uR\J\\I\~ ~\.{ ~O~ER D~ '30 'U.\\\'(S} I 'B~Q.A\}A.E-
aOLE. 'BEl.JEF\C-i\\2-~ O~ r\~Q. ~\E.. ALL ~\LL~ ~~UE '8)::E0
PPr\\:) (VS wELl AS ALL \\\XES 'DU~,
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: \ z/n/o \
Si~~~+
~Of-A.P8 ~ - ~E-LL\( .TI:C-
Name
\2-\'2- \3\'\)1)L~ :DR\vE eA-QUSL~\?A c106
Address
0\
":"7
N
0:
0\
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w
"':.J 0
6
, .. -
CD P
a:
<t
0...
24 5 -qD~8
Telephone
", Capacity: M Personal Representative
~~.;t D Counsel for personal representative
;':6
,'...0
't: s::
..1) =
50
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
KELLY THOMAS H III
1212 BIDDLE DRIVE
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 194-32-2946
FILE NUMBER: 21-2001- 0758
DECEDENT NAME: KELL Y ETHEL W
DA TE OF PAYMENT: 10/23/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/18/2001
NO. CD 000424
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,622.31
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$3,622.31
REMARKS: THOMAS H KELLY III
CHECK# 0098
SEAL
INITIALS: SK
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
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
KELLY THOMAS H III
1212 BIDDLE DRIVE
CARLISLE, PA 17013
n______ fold
EST A TE INFORMATION: SSN: 194-32-2946
FILE NUMBER: 21-2001- 0758
DECEDENT NAME: KELL Y ETHEL W
DA TE OF PAYMENT: 12/12/2001
POSTMARK DATE: 12/11/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 07/18/2001
NO. CD 000630
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $192.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$192.00
REMARKS: THOMAS H KELLY III
CHECK# 1171
SEAL
INITIALS: DO
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
'v /6-0260-/)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANC~TAX DIVISION
DEPT. 280601
HARt~3BURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
Recor(l"~n
Reoi'J'3:
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-10-2001
KELLV
07-18-2001
21 01-0758
CUMBERLAND
101
.01
THOMAS H KELlV III
1212 BIDDLE DR
CARLISLE
Ole 17 P12:02
eteri~ (U3
CumberIan(i
_/__:-~i. '':'
PA
*'
REY-1547 EX AFP (12-88)
ETHEL
W
Anount Renitted
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
69~261.21
23~490.41
.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 ~
RE-,,=is4j-ix--AFP--fi'2:0(ir-Ncli"-ici--oF-iNHERiTANci-;-'A;C-l-PPRAisEMENi'-,--iLt-OWANCE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KEllV ETHEL W FILE NO. 21 01-0758 ACN 101 DATE 12-10-2001
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/Adn. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate SUbject to Tax
(9)
(10)
5,,126.00
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax paynent.
(8)
92,,751.62
2.863.18
(11)
(12)
(13)
(14)
7.989 18
84,762.45
.00
84,,762.45
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 at Spousal rate
16. Anount of Line 14 taxable at Lineal/Class A rate
17. Anount of Line 14 at Sibling rate
18. Anount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
(15) .00 X 00 = .00
(16) 84,,762.45 X 045 = 3,814.31
(17) .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 3,814.31
TAX CREDITS:
PAYHENT RECt:IPT I DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
10-23-2001 CDOO0424 .00 3,,622.31
PAVMENT MUST BE MADE BV 04-18-2002*. TOTAL TAX CREDIT 3,,622.31
BALANCE OF TAX DUE 192.00
INTEREST AND PEN. .00
TOTAL DUE 192.00
. 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-1470 EX (6-88)
*' INHERITANCE TAX
/ EXPLANA liON
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
DECEDENTS NAME FILE NUMBER
Ethel W. Kelly 2101-0758
REVIEWED BY ACN
John Kuchinski 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
E Total on Schedule E was not correctly carried forward to recapitulation page.
ROW
Page 1
/tr~so~//
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*
C/'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
REY-1U7 EX AFP H2-00l
Recorck'
Re}jist::.'f
of DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P 2 :O~UNTY
ACN
01-22-2002
KELLY
07-18-2001
21 01-0758
CUMBERLAND
101
ETHEL
w
THOMAS H KELLY III
1212 BIDDLE DR
CARLISLE
'02
JAN 25
AIIount Realitted
PA 1701~ierk.<
Curnberidil.)
i-d t
PA
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, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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ESTATE OF KELLY ETHEL W FILE NO.21 01-0758 ACN 101 DATE 01-22-2002
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: 12-10-2001
PR I NCI PAL TAX DU E : ..m........................................................................................................-.........................................................................................................
3,814.31
PAYMENTS (TAX CREDITS):
PAYMENT I RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-23-2001 CDOO0424 .00 3,622.31
12-11-2001 CDOO0630 .00 192.00
TOTAL TAX CREDIT 3,814.31
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" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: 't:-n-\~L u). ,Z~LL'-(
Date of Death: \ <6 ~u L ~ 6 \
Will No.:
2\-0\ ..c15~
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 ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: ~II~
c. Did the personal representative state an account informally to the parties
in interest? Yes g No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this r~
Date: \306 03 ~~
Si . e
~kN3. ~, K~LL~~
Name
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CJ\n:L'<;LE~ ~A \ -'0 \3
Address
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Telephone No.
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Capacity: ~ Personal Representative
o Counsel for personal representative
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Kelly, Ethel W
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
07/28/01 07/09/11
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
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IX] 1. Original Return
o 4. limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 43. Future Interest Compromise (date 01 death after 12.12-ll2l
o 7. Decedent Maintained a Living Trust (Attach oopyolTIIl5I)
o 10. Spousal Poverty Credit (date oIdeafl between 12-31-91 and 1-'-95)
FILE NUMBER
2 1 - 0 1
o 0 7 5 8
~- -- ------
COIJNTY CODE YEAR NUMBER
SOCIAl SECURITY NUMBER
194
32
2946
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAl SECURITY NUMBER
o 3. Remainder Return (dale of death prior 10 12.13-821
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11. Election 10 tax under Sec. 9113(A) (AIlach Soh 0)
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NAME
COMPLETE MAILING ADDRESS
Thomas H. Kell , III
ARM NAME (II Applicate)
1212 Biddle Drive
Carlisle, PA 17013-4289
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
OFFIClt~L USE ONLY
(8)
92,721. 62
TELEPHONE NUMBER
717-245-9088
(11)
(12)
(13)
7,989.18
84,732.45
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held CoIporation, Partnership or SoIe-ProprieIorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. .JQir1tIy Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (Iotal Unes 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (tolal Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1)
(2)
(3)
(4)
(5)
69,231. 21
(14)
84,712.4')
(6)
23,490.41
:1,R12.90
(19)
3.812.96
(7)
(9)
(10)
5,126.00
2.863.18
13. Charitab/e and Governmental BequestslSec 9113 Trusts for which an election 10 tax has not been
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus Une 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES
15. Amount of Line 14 taxable at the spousa/ tax
rate, Of transfers under Sec. 9116 (a)(1.2)
x .0 _ (15)
x .0 jU (16)
16. Amount of Une 14 taxable at lineal rate
84,732.45
17. Amount of Une 14 taxable at sibling rate
x .12 (17)
x .15 (18)
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
.. .
Deceaent's Complete Address:
STREET ADDRESS
1212 Biddle Drive
CIT(;arlisle I STATE PA I ZIP
17013-4289
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
190.65
Total Credits ( A + B + C ) (2)
190.65
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 line 20 to request a refund (4)
3,812.96
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
3,622.31
(5)
(5A)
(5B)
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
3,622.31
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
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0
No
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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 retum. including accompanying schedules and statements. and to the best of my knowledge and belief, rt is true. correct
and complete,
Declaration of preparer other th.aD-lb personal representative is based on all information of which preparer has any knowledge.
ADDRESS
Biddle Carlisle, PA 17013-4289
SIG~~ OF P~EPARER OTHER T~AN REP~ESENTATIVE
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ADDRESS
246 Oak Grove Court Mechanicsburg, PA 17055-9702
DATE
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DATE
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For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS. ~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. 99116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still 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 from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent.
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. S9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)). A sibling is defined. under Section 9102, as an
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SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Ethel W. Kelly
FILE NUMBER
21 01 00758
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUlVivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
DESCRIPTION
Certificate of Deposit, Acct 31003910978592 @ M&T Bank
Certificate of Deposit, Acct 31003910978609 @ M&T Bank
Certificate of Deposit, Acct 31003910978617 @ M&T Bank
Certificate of Deposit, Acct 31003910978625 @ M&T Bank
M&T First Interest, Acct 1006169 @ M&T Bank
Personal Statement Savings, Acct 15004200896792 @ M&T Bank
Pension - Public School Semployees' Retirement System
VALUE AT DATE
OF DEATH
10,553.96
10,517.23
10,479.65
5,239.82
1,298.32
31,015.31
156.92
TOTAL (Also enter on line 5, Recapitulation) $ 69,261.21
(If more space is needed, insert additional sheets of the same size)
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SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNS' l VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Ethel W. Kelly
FILE NUMBER
21 01 00758
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
ADDRESS
RELA TrONSHIP TO DECEDENT
A.
Thomas H. KElly, III
1212 Biddle Drive
Carlisle, PA 17013-4289
Son
B.
c.
JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. AUach DATE OF DEATH DECO'S VALUE OF
UMBER TENANT JOINT deed for joinUy.fleld real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 2/98 Quick & Reilly Investment 46,980.82 50 23,490.41
Acct 219-220219 PB168
TOTAL (Also enter on line 6, Recapitulation) $ 23,490.41
(If more space is needed, insert additional sheets of the same size)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21 01 00758
Ethel W. Kelly
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Frank S Miller Funeral Home
Elizabethtown, PA
1,168.00
1.
B ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State _ Zip
Year(s) Commission Paid:
2. Attorney Fees
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Thomas H. Kelly, III
3,500.00
Claimant
Street Address 1212 Biddle Drive
City
Carlisle
17013
State -EL Zip
Relationship of Claimant to Decedent Son
4.
Probate Fees
258.00
5. Accountant's Fees
6.
Tax Return Preparer's Fees
200.00
7.
TOTAL (Also enter on line 9, Recapitulation) $ 5 , 126.00
(If more space is needed, insert additional sheets 01 the same size)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FilE NUMBER
Ethel W. Kelly
21 01 00758
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
94.50
2,768.68
1.
2.
First Aid & Safety Patrol of Lebanon, Lebanon, PA
Masonic Homes, Elizabethtown, PA
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,863.18
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
21 01 00758
NUMBER
I
FILE NUMBER
Ethel W. Kelly
1.
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS [include ou1right spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Thomas H. Kelly, III Son
1212 Biddle Drive
Carlisle, PA 17013-4289
AMOUNT OR SHARE
OF ESTATE
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 11- 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)
WHEREAS, on the 15th
dated May 27th 1997
was admitted to probate as the last will of KELLY ETHEL W
(LAb'l' , to' 1 l<.b 1', JYl1lJlJL.t;)
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Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 2001-00758
PA No. 21-01-0758
ESTATE OF KELLY ETHEL W
(LAb1', t"ll<.b'l', LVlllJlJL.t;)
Late of
CARLISLE BOROUGH
CUIVIH.t;l<.LANlJ CUUN 1''{ ,
Deceased
Social Security No. 194-32-2946
day of August
2001 an instrument
late of CARLISLE BOROUGH CUMBERLAND County, who died on the
18th day of July 2001 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills :Ln and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to KELLY THOMAS HIlI
who has duly qualified as Executor (rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
! of my Office the 15th day of August 2001.
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**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
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JLagt Will alIi) 'aI:egtament
ETHEL w. KELLY
I, ETHEL W. KELLY, of Bloomfield Borough, Perry County, Pennsylvania,
declare thi~ to be my Last Will and revoke any will previously made by me.
ITEM I: I direct that my funeral expenses, grave marker and the costs of
the administration of my estate be paid out of the residue of my estate as soon as
may be convenient after my death.
ITEM II: I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed, shall be paid
from the residue of my estate as a part of the administration thereof, to the end
that no beneficiary hereunder, or any other person, shall be charged with or
required to pay any part of such taxes.
ITEM III: I devise and bequeath my entire estate of every nature and
wherever situate, whether real, personal or mixed, to my son, Thomas H. Kelly,
III, provided he survives me by thirty (30) days.
ITEM IV: Should my son, Thomas H. Kelly, III, predecease me or die on
or before the thirtieth (30th) day following my death, then and in that event, I
devise and bequeath my entire estate of every nature and wherever situate,
whether real, personal or mixed, as follows:
A. I bequeath all my furniture and furnishings and the contents of
my home to my daughter-in-law, Lorriene K. Kelly, and request that she make
distribution of the Boone family heirlooms to my grandchildren in her discretion.
further request that she distribute any other items of furniture, furnishings and
household contents as she may deem fit.
B. I devise and bequeath the rest, residue and remainder thereof
to FINANCIAL TRUST SERVICES CORPORATION, IN TRUST,
NEVERTHELESS, to be held, administered and finally distributed according to
the followinglterms:
1. A separate trust shall be created for each of my
grandchildren in equal shares and shall be used for the support, maintenance and
education of them. It is my desire to preserve the principal of the trusts for later
distribution to my grandchildren as provided below, but the Trustee may make
use of the principal, if necessary, for the support, maintenance and education of
them. After each grandchild reaches the age of twenty-two (22) years, each shall
f I' have the right to withdraw portions of his trust corpus according to the following
V schedule:
a. Upon or after reaching the age of twenty-two (22) years,
I 3 one-third (1/3) of the corpus,
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~ b. Upon or after reaching the age of twenty-six (26) years,
one-half (1/2) of the remaining corpus.
tV c. Upon or after reaching the age of thirty (30) years, the
entire balance of the corpus.
3. When each grandchild reaches the age of thirty (30) years,
his trust shall terminate.
4. Should any of my grandchildren die before receiving the
entire corpus of his trust, his issue shall succeed to his rights under his trust, per
stirpes. If he shall die without issue, the remaining corpus of his trust shall be
distributed pursuant to the above schedule to his brother, per stirpes.
.. ',' ..
5. No interest of any beneficiary of the trust created under this
will or any codicil hereto shall be subject to anticipation or voluntary or involuntary
alienation. .
ITEM V: I authorize and empower my hereinafter named executor or
,
alternate executrix to convert any property that I may own at my death, whether
real, personal or mixed, at either private or public sale, whichever in their opinion
is deemed best, other than the furniture and furnishings and contents of my home
previously bequeathed, hereby vesting in said executor or alternate executrix full
power and authority to make, execute, acknowledge and deliver good and
sufficient deeds or assurances of title therefor, taking into consideration what
would be best fOf any of my children who may then be minors.
ITEM VI: I appoint my son, Thomas H. Kelly, III, executor of this my Last
Will. Should my son, Thomas H. Kelly, III, fail to qualify or cease to act as
executof, I appoint my daughter-in-law, Lorriene K. Kelly, alternate executrix of
this my Last Will.
ITEM VII: I direct that my executor or alternate executrix shall not be
required to give bond for the faithful performance of their, duties in this or in any
other Jurisdiction.
. d
IN WITNESS WHEREOF, I have hereunto set my hand this d- ~ day of
May, 1997.
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