Loading...
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. I~ ~~ -~ o=~ ~ -g .g ,2. \'2. 'B \~L~ 'I::)t2\ V E. QS'p C'.~L\'3LE\ PA. \-rO \....~ -;;-et '1:).... :;0 ai c co Vi 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\ \~ Q, -.;-:::1 \~ t-:t'1 .,tJ j-' , ,h~1 ~ \, ' '... . ' ,I \'*~", c*t '"i <?;\ " /A.:~\lJ '.- )C , '~" ,''/ \~- ~,f' ..'._" ' . ..~t-v,\~1 '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::~; :z .::c: -, ~.) t",..",.; 00:> &0: ~ ~~ \1)= 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\ .-- 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 ~ REY=i6ifj-EX--AFP--ri'2:of.-r------...--iNirER'iTANCE-fAX--STA-fEMENf-OF-A'ifcouiff--.-..------------------ --- 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. ) . C// o~ .r " <# . 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 \2..,'2 o\~L.E \)R, CJ\n:L'<;LE~ ~A \ -'0 \3 Address (\t) 2.'-\5-'to~ Telephone No. (uJ) "05-\~3D 4 A ,r \0 0 v- Capacity: ~ Personal Representative o Counsel for personal representative ... . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 KI: V-' :>UU INHERITANCE TAX RETURN RESIDENT DECEDENT W I-: ll::!1I) ua:ll: wll.U :J:oo ua:..l 1l.1lI ll. <( I- Z W Q W o W Q 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) / (, ~~ ). 5 6 .. II SJ- c.-.. 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) z o ~ ~ ~ a. :e o o ~ I- Z W o z o ll. II) W a: a: o u 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 z o 5 ~ l- ii: <( o w 0:: 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 EO E] E] E] KJ [] ~ 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 ~-t>lldv"C.lG ~ ?J#..4.h- ADDRESS 246 Oak Grove Court Mechanicsburg, PA 17055-9702 DATE &!.1 (}(1..T C) I DATE /0 111/ (.) I , \~, ,,~ _,.,111 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 . .. .. .' '...f I I.J ..L_.II__._L. LI__J __ _...l__.I.=__ .. 'W 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) '- - 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) .. ~h 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 ~m\.~ '~. 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;) '. '.,.......~I K .,,' \ ,- , ", .) +JI:;" "f- .' \, "f . ......~ ...... v ~ iI;-. ' "'\I,.... .~ ',-,,,,, )11...... ..... \ ;).' -.." :':."~~ ., '::;. \\.' : /,. ,,, \.., "" in) ... . 'Of . ~, Ii . ' .' '~ t2~ :::' : ' ',. ''''''; .....' ::" '\. _I: .:' ~("~~ " . "\.~\., 'iN ....(~~ ,~' ' ". ..k _" ". \ " . .---- f~ i'I-'l,<- , '-. .. "n Q ~ i \~':. '. ..\ \~. "., '~""~~/IfIIliI.\.I. 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. ~/' (.? ~r~!,i(f' ~"7' **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) ~ -i =.t',__ ... ~ 3 ~ o 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, '"" ~ 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. ~.1~cl uS- \/\ ~~tLl\ //~ (