HomeMy WebLinkAbout01-0779
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
~
Estate of
CHARLOTTE S. CROW
No. ;<1 -OJ -? 7Y
also known as
Late of the BorouQh of Carlisle, Cumberland County, PA
, Deceased
Social Security No. 202-14-5794
Petitioner(s}, who islare 18 years of age or older. apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
..
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut~ named in the Last Will of the
Decedent, dated AUQust 9,1993 and codicil(s) dated N/A
State rekJvant circumstances. e.g., renunciation. death of executor, 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:
c;I B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
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:
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 231 N. Hanover Street. BorouQh of Carlisle. Cumberland County. Pennsvlvania 17013
(list street, number and municipality)
Decedent, thenj!L years of age. died AUQust 13. 2001, at Thornwald NursinQ Home. BorouQh of Carlisle. Cumberland County, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property ...... 0 0 0 0 0 . . . 0 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1-0t) I 000
(If not domiciled in PAl Personal property in Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 o. $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ..................... 0 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $
Total....................................................................... .... $ oz.-CO, ,I W
Real Estate situated as follows: N \) N\t"
Wherefore, Petitioner(s) respectfully request(s) 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
James W. Evans
3401 N. Front Street, P.O. Box 5950, Harrisburg, PA 17110-0950
Form RW-1 Page 1 of 2 (Dauphin County - Rev. 9192)
) t - d--'--\
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
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 and that, as pers al representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate accor i g to law. 7
Sworn to and affirmed and subscribed
before me this
20th
August 2001.
'm{C ~
Estate of Charlotte S. Crow
also known as
d9Y of
DECREE OF REGISTER
Deceased
No. 21-01-779
Social Security No: 202-14-5974
Date of Death: August 13 . 2001
AND NOW, AUGUST 21 ,2001, in consideration of the Petition on the reverse side
hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary 0 of Administration
are hereby granted to James W. Evans
(c.t.a.; d.b.n.c.t.; pendente lite; durante absentia; durante minoritate)
in the above estate and that the instrument(s), if any, dated Auaust 9.1993
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters............ ...............
Short Certificate( s).... ~...
Renunciation. .............. ...
Affidavit ( )..... ..... .......
Extra Pages ( )............
Codicil...... ............ ..... ...
JCP Fee........................
Inventory & Tax Forms...
Other......... .mPIES.......
TOTAL................
Form RW-1 Page 2 of 2 (Dauphin County - Rev. 9192)
$ 235.00
$ 24.00
$
$
$ 21.00
$
$ 5.00
$
$ 3.50
Attorney:
I.D. No:
Address:
Vicky Ann Trimmer. Esauire
49679
3401 North Front Street. P.O. Box 5950
Harrisbura. PA 17110-0950
717-232-5000
AUGUST. 20,2001
$ 288.50
Telephone:
DATE FILED:
269644
H 105.805 REV 9/86
This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg.
me as
WARNING: It is illegal to duplicate this copy by photostat or photograph.
21-01-779
p
7578355
~~.~~~
Local Registrar
Fec for this certificate, $2.00
No.
AUG 1 4 2001
Date
H1OS.iQAew.2fl7
COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
<T
.T
~
NAME OF DECEDENT IF"" MICkIe. l..,
.. Charlotte S. Crow
dl .
Currberland
Carlisle
SEX
..Female
STAll ~f M1MIlIEA
SOCIAL SECURIT'r NUMBER
.. 202 14 - 5794
DATE Of' DEATH ,MeIWl. 0..,. .....}
.. August 13, 2001
AGE(l..~
UHllER . YtAR
....... Daya
UNDER 1 DAY
Hour. ! 1Mftut.
81RTHPl.ACE (Cry Ilftd P\.AQ: OF DER'H fCtoecJ. Q'lfy Of'ft _ ioM .,.ruetoOOt on om.. __I
St... 01 Fcrll9' eour.." HOSPITAL
. '_....0
.. Carllsle PA ...
FACn.rrv NAME (If notlnll'UJOn. 01'4.'"' ana number.
=.,,0
96 v...
COUNTY OF llERH
.... DECEDENT EIlER IN
U.S. ARMED FORCES?
....0 ...tifJ
RACE. AIMftCan Inchn. --. WhiI., .ee.
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,.. White
SURVMNO SI'OuSE
I' .... gIW' INlCIIn nM'IlM
DECEDEHT'S USUAl UMlON KlNO OF OU....SS/lNDuSTRY
(~~';:''=':::l:r
".. Homemaker " Own Home
CECEDENT.S.......OIO ADDRESS 180.... c_ _ Z"~I DECEDENT'S
231 N. Hanover Street ~~
Carlisle PA 17013 ~~
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17.. ....
PA Old
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Cn!Tlh.>rl and -' ....~ ::...":"..':::'..
MOTHEA'S NAME iFillI. Micde. MMten SurNmeJ
It. Mary Haverstock
INFORMANTS ....'UHG ADORESS _ c.,1bon....... Zip~1
~ 127 W. High St., Carllsle, PA 17013
PI.ACE Of DISPOSITION -1Qme of c.m.t.ry. CrllfftalOty lOCRIOfII. CityITown. St.... ~ CodIt
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F,Q'HER'S NAME IF.... M~. 1.....
'". John T. Sheafer
INFOFlMAHT's_Cl,........., Katherine S. Strohm
'111.
Carlisle
METHOD OF OOSPOSlT1OH
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DUE 10 lOR AS' CONSEQUENCE Of),
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WERE AUTOPSY FfHOtNGS MANNER 0# DEATH
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COMI'I.ETIOH Of' CAuSE 0
OF llERH? - -
- 0 Pending arw...1val1On 0
....0 ... ....0 ...0 ........ 0 Could noli bII determined 0
DATE OF lNJURV
I-"'ar,. _,
TIME OF INJURV
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fHJURV III VW>AK1 DESCRIBE HOlN INJURV OCCURRED.
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To........of"'Y~.....oce.........due.._C..,-.(.J.ndrn.IWWt'...tIltH.................................................... .
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PlACE OF INJURy. AI home. farm. .....Iac:Iory. offtce
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-MEDIC..l. EXAMIHERlCORONER
~~ ~~::=~':'.'~~'~.'.~~~~'::~~t~~~: ~ ':'.~ ~.~~~: ~~~ ~~~~~~ ~~ ~~~ "~'..~'~: ~.~~~: ~~.~~~ ~~ ~~ ~~~~~).~~ 0
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REGISTRA.R'S SIGNATURE AND NU
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oPftONOUNcJMQ AND CEM'I'YINQ PHYSM:IAN f~ bOlh ;)f0l'l0UllC"'O 0Nlt'I Mld cen"'f'nlileocauM tA dQttIl
· h ..... of "'" knowtltdgw. de.1ft OCCurrM at... 1tIne. date. and pt<<e. end due to lhe ceuM(.J end menne, e. .leIH.
lag! Jiill an~ me~tamettt
.o.r
CHARLOTTE s. CROW
I, CHARLOTTE S. CROW, of the Borough of Carlisle,
Cumberland County, Pennsylvania, do make, publish and declare
this to be my Last Will and Testament, hereby revoking all
Wills and Codicils by me at any time made.
ITEM I: I direct that all inheritance and
estate taxes becoming due by reason of my death, whether such
taxes may be payable by my estate or by any recipient of any
property, shall be paid by the Executor out of the property
passing under ITEM IV of this Will, as an expense and cost of
administration of my estate. The Executor shall have no duty
or obligation to obtain reimbursement for any such tax so paid,
even though on proceeds of insurance or other property not
passing under this Will.
ITEM II:
expenses of my last illness
property passing under this
administration of my estate.
I direct the Executor to pay the
and funeral expenses from the
Will as an expense and cost of
ITEM III: I may leave a written statement or
list in my safe deposit box disposing of certain items of my
tangible personal property not otherwise disposed of herein.
Any such statement or list in existence at the time of my death
shall be determinative with respect to all items devised
therein. If no written statement or list is found in my safe
deposit box or elsewhere and properly identified by the
Executor within thirty (30) days after the probate of my Will,
it shall be presumed that there is no other statement or list.
Page 1
c;jC:
.
(b) To vary investments, when deemed desirable
by the Executor, and to invest in such bonds, stocks,
notes, real estate mortgages or other securities or in
such other property, real or personal, as the Executor
shall deem wise, without being restricted to so-called
"legal investments", and without being limited by any
statute or rule of law regarding investments by
fiduciaries.
(c) In order to effect a division of the
principal of my estate or for any other purpose,
including any final distribution, the Executor is
authorized to make said divisions or distributions of
the personalty and realty partly or wholly in kind.
In the event a division or distribution is made in
kind, such division or distribution shall be made at
the fair market value of the property at the date of
division or distribution. Should it appear desirable
to partition any real estate, the Executor is
authorized to make, join in and consummate partitions
of lands, voluntarily or involuntarily, including
giving of mutual deeds, recognizances or other
obligations, with as wide powers as an individual
owner in fee simple.
(d) To sell either at public or private sale and
upon such terms and conditions as the Executor may
deem advantageous to the estate, any or all real or
personal estate or interest therein owned by the
estate severally or in conjunction with other persons
or acquired after my death by the Executor, and to
consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all
Page 3
CSe
trust and without obligation or liability of the
purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the
validity of said sale or sales; also, to make,
execute, acknowledge and deliver any and all deeds,
assignments, options or other writings which may be
necessary or desirable in carrying out any of the
powers conferred upon the Executor in this paragraph
or elsewhere in my Will.
(e) To mortgage real estate, and to make leases
of real estate.
(f) To borrow money from any party, including
the Executor, to pay indebtedness of mine or of my
estate, expenses of administration or inheritance,
legacy, estate and other taxes, and to assign and
pledge assets of my estate therefor.
(g) To pay all costs, taxes, expenses and
charges in connection with the administration of my
estate.
(h) To vote any shares of stock which form a
part of the estate, and to otherwise exercise all the
powers incident to the ownership of such stock.
(i) In the discretion of the Executor, to unite
with other owners of similar property in carrying out
any plans for the reorganization of any corporation or
company whose securities form a part of the estate.
(j) To disclaim any interest in property which
would devolve to me or my estate by whatever means,
Page 4
c~~
including but not limited to the following means: as
beneficiary under a will, as an appointee under the
exercise of a power of appointment, as a person
entitled to take by intestacy, as a donee of an inter
vivos transfer, and as a donee under a third-party
beneficiary contract.
(k) To do all other acts in the Executor's
judgment deemed necessary or desirable for the proper
and advantageous management, investment and
distribution of the estate.
ITEM VI: Any person who shall have died at
the same time as I shall have, or in a common disaster with me,
or under such circumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my
death, shall be deemed to have predeceased me.
ITEM VII: If at any time any minor child
shall be entitled to receive any assets hereunder, my Executor
shall act as Guardian of the assets payable to such child.
Such Guardian may receive and administer all assets authorized
by law, and shall have full authority to use such funds in any
manner it shall deem advisable for the best interests of such
child. Said Guardian shall have all the rights and privileges
as to the Guardianship(s) and its assets as are herein granted
to the Executor as to my estate and the assets therein.
ITEM VIII: I hereby nominate, constitute and
appoint JAMES W. EVANS to be the Executor. The Executor and
Guardian are specifically relieved from the duty or obligation
of filing any bond or other security.
Page 5
ed~
ITEM IX: I direct my Executor to retain the
law firm of METTE, EVANS & WOODSIDE to serve as legal counsel
in the administration of my estate.
IN WITNESS WHEREOF, I have set my hand and seal to
this, my Last Will and Testament, consisting of this and the
preceding five (5) pages, at the end of each page of which I
have also set my initials for greater security and better
identification this day of , 19
&) (fAAl~ _AI P(Y~,,'-(SEAL)
CHARLOTTE S. CR6w
We, the undersigned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament, in the
presence of us, who, at her request and in her presence and in
the presence of each other, have hereunto set our hands and
seals the day and year first above written, and we certify that
at the time of the execution thereof, the said Testatrix was of
sound and disposing mind and memory.
(SEAL)
Residing at 17~~,
~~ ~ 17007
Residi' g at \~LW'neJL\\.o \Lei
c..n.-.1 \\~::,\..1 . ~ ~ \1 a \ 3
Residing at .~..< I TUIA.N/!;E~f1I.y /)(J."
C JI/h41IJE.~(!;u J4.. Cr, PC(. 17~O I
I
(SEAL)
(SEAL)
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CU~D/ttC(
)
)
)
SS:
I, CHARLOTTE S. CROW, Testatrix, whose name is signed
to the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will and Testament; that
I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
G '6'Ji4.#~ .4., ~ff- (SEAL)
HARLOTTE S. CROW
Sworn to and subs~ribed
befo~e.me this ~ day
of {/(..-UjU'aT- ,19 .
//n_~~ ~ ~-0
'--=-1 Notary ~
My Commission Expires:
(SEAL)
NOTARIAL SEAL
~ Cyn~hja l. Darr, Notary Public ..
:'outh M'd(le,tco Twp..Cumherland Count
My CommIssion Expires May 18. 1991
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
We . (1){j~.) 13 5 e n . f e mcL . ~e e elV {!'(}A.R.,,/t:,
and b:l0l0A v. Mde/}I.J ()/? ,the Witnesses whose names are
sign~ to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testatrix, CHARLOTTE S. CROW, sign and execute
the instrument as her Last Will and Testament; that Testatrix
signed willingly and that she executed said Will as her free
and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testatrix signed the Will
as Witnesses; and that to the best of our knowledge the
Testatrix was at that time eighteen (18) or more years of age,
of sound mind r no constraint or undue influence.
a'MV Yd 4~,~~
rwi tness
Sworn to and subs~ibed
befo~ me this ~9:day
of [,ULn- ' 19 ~
My Commission Expires:
(SEAL)
<\I '.:p.\IIc.
N01ARIAL SEAL
Cynthia L. Darr. Notary Public
S.uth Middleton 1wp..Cumber!and County
M ~~ml1\issicn Ej;pim Ma.y",.W,.19
Any subsequent discovered statement or list shall be ignored.
Any such property not listed in such a written statement I give
and bequeath to I give and bequeath to RICHARD S. CROW, JR.,
STEPHANIE A. CROW, MICHAEL C. CROW, DAVID W. CROW, and
ROBERT J. CROW, or the survivors of them, absolutely and in fee
simple, all of my household furniture and furnishings, books,
pictures, jewelry, silverware, automobiles, wearing apparel and
all other articles of household or personal use or adornment
and all pOlicies of insurance thereon, to be divided among them
as they shall agree. Should there be no agreement, such
property shall be divided among them by the Executor in as
nearly equal portions as is deemed practical in the sole
discretion of the Executor, having due regard to the personal
preferences of such individuals.
ITEM IV: I give, devise and bequeath all
the rest, residue and remainder of my estate, not disposed of
in the preceding portions of this Will, to RICHARD S. CROW,
JR., STEPHANIE A. CROW, MICHAEL C. CROW, DAVID W. CROW,
ROBERT J. CROW, and KATHERINE S. STROHM, in equal shares. If
any of said individuals are not living at my death, the share
of said deceased individual shall be divided equally among
those individuals named herein who are living at the time of my
death.
ITEM V: In the settlement of my estate,
the Executor shall possess, among others, the following powers:
(a) To retain any investments I may have at my
death, including specifically those consisting of
stock of any bank even if I have named such bank as
the Executor herein, as long as the Executor may deem
it advisable to my estate so to do.
Page 2
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/""
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Charlotte S. Crow
Date of Death: August 13. 2001
Will No. Admin. No. 21-01-0779
To the Register:
I certify that notice of 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 September 10. 2001 :
Name: Address:
Adrienne C. Crow 2160 Greentree Road. Unit 210W. Pittsburgh. PA 15220
Richard S. Crow 3714 Grandview Drive. 196L. Simpsonville. SC 29680
Stephanie A. Crow 1711 Timberidge Drive, Bethel Park. PA 15102
Michael C. Crow 18301 Carriage Drive. Morgan Hill. CA 95037
David W. Crow 2112 Kenzie Drive. Pittsburgh. PA 15205
Robert J. Crow 365 2nd Street. Jersey City. NJ 07302
Katherine S. Strohm 127 West High Street. Carlisle. PA 17013
M. Jacqueline Baker 1052 Telegraoh Road. Rising Sun. MD 21911
Jean B. Baker 3234 Peavine Road LST. #122. Fairfield Glade. TN 38558
Cambri Crow
c/o Michael C. Crow. 18301 Carriage Drive. Morgan Hill. CA 95037
Malorie Crow
c/o Michael C. Crow. 18301 Carriage Drive. Morgan Hill. CA 95037
.
E.
",,/
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
None
Date: September 10. 2001
;/4 ~~ ~-
Signature
Vickv Ann Trimmer. Esquire
Name
3401 North Front St., P.O. Box 5950
Harrisburg. PA 17110-0950
Address
(717) 232-5000
Telephone
Capacity: _ Personal Representative
---X- Counsel for Personal
Representative
:271500 _1
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METTE. EVANS & WOODSIDE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
HOWELL C. METTE
ROBERT MOORE
CHARLES B. Zw ALL Y
PETER J. RESSLER
LLOYD R. PERSUN
CRAIG A. STONE
JAMES A. ULSH
DANIEL L. SULLIVAN
STEVEN D. SNYDER
CHRISTOPHER C. CONNER
JEFFREY A. ERNICO
KATHRYN L. SIMPSON
P. DANIEL ALTLAND
ANDREW H. DOWLING
MICHAEL D. REED
PAULA J. LEICHT
GARY J. HElM
DAVID A. FITZSIMONS
GUY P. BENEVENTANO
THOMAS F. SMIDA
3401 NORTH FRONT STREET
P.O. BOX 5950
HARRISBURG. PA 17110-0950
TELEPHONE
(7171 232-5000
FAX
(7171 236-1816
JOHN F. Y ANINEK*
VICKY ANN TRIMMER
TIMOTHY A. HOY
KATHLEEN DOYLE Y ANINEK
JAMES M. STRONG
JENNIFER A. Y ANKANICH
RANDALL G. HURST*
SUSAN D. ANDERSON
OF COUNSEL
JAMESW. EVANS
mSNO.
23-1985005
*MARYLAND BAR
http://www.mette.com
November 8,2001
Mary C. Lewis
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
\':\
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RE: Estate of Charlotte S. Crow
File No. 21-01-0779
11139.1
Dear Ms. Lewis:
Enclosed please find a check payable to "Register of Wills, Agent" in the
amount of $20,000.00, representing a prepayment of inheritance tax in the above-
referenced estate. Please send a receipt for this payment to my attention in the
enclosed envelope.
Thank you for your assistance.
Very truly yours,
~oJ~' \(rv\O~
Lisa J. Kno~
Paralegal to Vicky Ann Trimmer
LJK!
Enclosures
cc: James W. Evans, Executor
:277551 _1
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
METTE EVANS & WOODSIDE
3401 NORTH FRONT STREET
POBOX 5950
HARRISBURG, PA 17110-0950
hhh__ fold
ESTATE INFORMATION: SSN: 202-14-5794
FILE NUMBER: 21-2001- 0779
DECEDENT NAME: CROW CHARLOTTE S
DATE OF PAYMENT: 11/09/2001
POSTMARK DATE: 11/08/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 08/13/2001
NO. CD 000509
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $20,000.00
I
I
I
I
I
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I
TOTAL AMOUNT PAID:
REMARKS: JAMES W EVANS
C/O METTE EVANS & WOODSIDE
CHECK# 111
SEAL
INITIALS: SK
RECEIVED BY:
$20,000.00
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
,
.' REV-l5IIOiJ_J
REV-1500
~* COMMONWEALTH OF
PENNSYlVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
. HARRISBURG, PA 17128-0601
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INHERITANCE TAX RETURN FILE NUMBER
2..-1--0 I
RESIDENT DECEDENT COUHTYCOOE YEAA-
~ 1. Original Return 0 2. Supplemental Relum 0 3. Remainder Return (dale d dealh prior 10 12-13-82)
o 4. Limiled Estate 0 4a. Future Interest Compromise (dale d dealh after 12.12-82) 0 5. Federal Estate Tax Return Required
~ 6. Decedent Died Testate (AIIad1lXlp)'d\'\1lij 0 7. Decedent Maintained a Living Trust (AIlachcopydTrusI) D. 8. ToIal Number of Safe Deposit Boxes
o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (doteol_~ 12-31-91 and 1-1-85) 0 11. Election to tax under Sec. 9113(A) (A1Iach Sch 0)
THIS SEcnON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME "2 COMPLETE MAILING ADDRESS J..
loLl 5. Hanover 31
Cor-lisJe, VA /70/3
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DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL)
'0:
DATE OF DEATH (M .YEAR)
D, - 12. - ZOO I I , - 0 1 - k:. I q '9
(IF APPlICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
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FIRM NAME (.~.)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Pallnership or SoIe-Proprielorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Join~ Owned Property (Schedule F)
o Separate BiDing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. FUIleral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Une 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an eleclion to tax has not been
made (ScI1eduIe J)
D
(1)
(2)
(3)
(4)
(5)
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(6)
D
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(9)
(8)
5,O<S3.ao
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(10)
14. Net Value Subject to Tu (Une 12 minus Line 13)
SEE INSlRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 9116 (a){1.2)
2\/L4'80.3'4
x ,0_ (15)
16. Amount of Line 14 taxable at finesl rate
x .0 _ (16)
17. Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
OO-=:J3~
NUMBER
SOCIAL SECURITY NUMBER
5 ~ - 42.. - Co 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
121 - 01 - 32~7
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(13)
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(14)
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(17)
(18)
(19)
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> > BE SURE TO ANSWER ALL auESOONS ON REVERSE SIDE AND RECHECK MATH < <
.
DeCedent's Complete Address:
STREET ADDRESS 300 W '1 \
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Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. CreditsJPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Z1~ ),0 I .
o
Total Credits ( A + B + C ) (2)
a
3. InterestlPenalty 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 Une 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
o
A. Enter the interest on the tax due.
o
(5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) 0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN AX" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use 01' income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred 01' its income; ............................................ 0
c. retain a reversionary interest; 01'.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits 01' care? ...................................................................... 0
2. If death 0CCUIT8d 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 seaJrity at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity, 01' other I'lOIl-probate property which
contains a beneficiary designation? ........................................................................................................................ 0
AD
Lovllsle.
PA
11013
ATE
1120 01
11013
For dates of death on 01' aller July 1, 1994 and before January 1, 1995. the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)).
The statute does no! exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a lax return are stiff appUcable even if
the survivilg spouse is the only beneficiary.
FOI' dates of death on or aller 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 paren~ an adoptive parent,
or a stepparent oflhe 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 decedenfs lineal beneficiaries Is 4.5%, except as noted in 72 P.S. S9116(1.2) (72 P.S. ~9116(a)(1)).
The tax rate imposed on the net value of transfers to 01' fOl' the use of the decedenfs siblings is 12% (72 P.S. 19116(a)(1.3)). A sibling is defined, under Section 9102, as an
Individual who has at Ie88t one parent In common with the deceden~ whether by blood or adopllon.
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COMlotONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
Fl.E NUMBER
2 J - OJ. ()07QQ
DESCRIPTION
VAlUE AT DATE
OF DEATH
Yo. L..\ "1 \ C\ S Y1C),y- e. ~ W G:t L Q) ~2..<..o . 8 3
GLee.. Y"ue.d d I vi de..nd ~ 12-./ S
IO~'8'.11
I
2
-
12.1(0. d::)\9 Sru.Y'e.s So.\oYY\on &o+hex-.s
F="UY\d cD $ I~. <6YZS
'~.Oo2. .q<.:,
TOTAL (Also enter on line 2, Recapitulation) $ lo. '5 \ . 1...0 -;
(If more space is needed, insert additional sheets of the same size)
_.-....,,, *'
COMMONWEAlTH OF PENNSYlVANIA
~H:~~~~ PERSONAL PROPERTY
ESTATE OF. FLE NUMBER
May\! Ellen Kc~ 2/-DI-007QQ
Include the proceeds of IligItion and the dale the pIOCeeds were . y the eslale. AR property jointIy~ with the rlght of .lI'VIvOllhIp m..t be dlleloaed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
m~fO\nt Ban~ Accwnt .l:t= Q0<85LJ512
Y/2Q.45
2.
ScDomon S YY'\ \ t-'n "fu-y n ~~ 'B~", L De.f:>os I t
"?rc3rQVY) A.LLcu.~t ~ "12'-f - 032-~ l
3Z.~2 .22.
TOTAL (Also enter on line 5. Recapitulation) S l L\ \ \ . lo "I
(If mote space is needed. insert addtional 8heeIs of the same size)
-....,.." .-
COAI.tONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF L
f'!iJ.ry E} /en J(e.a7 j()3
DeblI of decedlInt IJIUIt be IIpOI1Id on Schedule..
FI.E NIMJER
2/ -0/ ~ Do7Qq
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAl EXPENSES:
1. t-\of-r~ l<ofu
5. coo
B. ADMINISTRATIVE COSTS:
1. Personal Represenllltive s Comnissions
Name of Personal Representative (5)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Addntss
City Stale Zip
Yea/(s) Commission Paid:
2. AIIomey Fees 0
3. FlIIl1ly Exemption: (If decedent s address is not the same es claimant s, attach explanation)
Clainant
Street Address
City Stata ~
Relationship of Claimant to Decedent
4. Probate Fees ~O.OO
5. Accountant s Fees
6. Tax Return f'nlparers Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 6083.00
(If more spece is needed. insert additional sheels d!he same size)
LAST WILL AND lESTAMENT OF MARY ELLEN KEATING
I, MARYELLEN KEATING, of Carlisle, Cumberland County, Pennsylvania, do make, publish and
declare this as and for my last will and testament, hereby expressly revoking all wills and codicils made by
me heretofore, and dispose of my estate as follows:
ITEM I I direct the payment of my just debts and funeral expenses, including a suitable grave marker, as
soon as conveniently can be done following my decease.
I1EM II I direct that all state and federal transfer inheritance tax, estate tax, succession tax or any other
tax, including any interest, assessments or penalties thereon, that may become due and payable by virtue
of my death, or by virtue of the passing of any property either under my last will and testament, or in any
other manner, shall be paid by my estate, just as if such taxes were my debts, and no beneficiazy shall be
required to payor refund any part thereof.
I1EM III The articles of household use in the home of my husband, WILLIAM J. KEATING, and myself
are owned by the two ofus as tenants by the entirety, and I therefore make no disposition of the same
because upon my death, he will be the sole owner thereof by operation oflaw, ifhe survives me.
ITEM IV My tangible personal property (excluding money, securities and the like) and my motor
vehicles, together with all insurance relating thereto, I give and bequeath unto my husband, if he survives
me.
ITEM V All of the rest, residue and remainder of my estate of whatsoever nature and wheresoever
situate, I give, devise and bequeath unto my husband, WILLIAM J. KEATING, ifhe survives me.
ITEM VI If my husband does not survive me or if we die in such a manner that the sequence of our
deaths cannot be determined, I bequeath my estate to our six children, share and share alike. In the event
that one or more of our children pre-decease me and are survived by children of their own, then the
parent's share shall be distributed among their own surviving children, per stirpes. If one or more of our
children predecease me and leave no children of their own, their bequest shall lapse and be distributed to
our children that survive me.
ITEM VII I nominate, constitute and appoint my husband, WILLIAM J. KEATING, as executor of this
my last will and testament If my husband is unable or unwilling to serve as executor, I appoint John C.
Oszustowicz, Esq. as executor. No executor shall be required to give bond.
-tfi...
In WITNESS WHEREOF, I have hereunto set my hand and seal this I () - day of September,
1997. Y7( ,tlb<tA 1(j41zr. .
MARY:::t KEATING '"f:
Signed, sealed, published and declared by the above-named testatrix, MARY ELLEN KEATING, as and
for her last will and testament, in the presence of us, who at her request, in her presence and in the
presence of each other, have hereWlto subscribed our names as witnesses thereto.
~'~~~~!f:L,
of (I<g Il1 J1 S:t I MI-. ~, (JA /701, S'
ofl03 ~.~a,
Jelckl~-- -. i<14. I ?~()?
We, MARYELLENKEATING, iv 1J..../-t.l/tMp and at,,;J L. Ht4h4...I_. .thetestatrixand
the witnesses, being duly qualified, acknowledge that Y ELLEN KEATING signed the foregoing
instrument as her last will and testament, and that the witnesses obselVed the signing. All of us
acknowledge that we signed freely and for the purposes expressed therein.
'1Jf 1i1 f}h4< ~4~:J
~lId, 17J1U4fJAo
AJ~ )f>>rtkuu~./~.t
Sworn or affirmed to before me by MARY ELLEN KEATING,
. and this /~. day
of September, 1997.
J2/~~
Notal)' Public
, CARlDflrAWUI..
I MYCOMMI~~;M
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REV-1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 17- ~ Y
DEPARTMENT OF REVENUE -
DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0779
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Crow' , Charlotte S. 202-14-5794
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
08/13/01 03/20/1905 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
3. Remainder Return
CHECK r Original Return W Supplemental Return 8 (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach a copy of Trust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
j'ijJ~$g9TJQNiMlJ$.'tiieQMe~p;AijWeQijijg$.P9ijQgijQgiPQNfi'~ftljtAttA*JijfQijMAiiQij$ftQQ~ijijpiij!mprQi
NAME COMPLETE MAILING ADDRESS
COR- Vicky Arm Trirrmer, Esquire 3401 North Front Street
RE- FIRM NAME (If Applicable) P.O. Box 5950
SPON
DENT lVIette, Evans & Woodside Harrisburg , PA 17110-0950
TELEPHONE NUMBER
(717) 232-5000 ..........
-:- "'
f;,.' ~FFICIA1C~E ONLY
1. Real Estate (Schedule A) (1 ) Nane
2. Stocks and Bonds (Schedule B) (2) 96, 873'.58 =
None -r-
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) -r-.
~
4. Mortgages & Notes Receivable (Schedule D) (4) None J
Cash, Bank Deposits & Miscellaneous Personal Lv
5.
Property (Schedule E) (5) 289,538.09
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested (6) None ..c:..~
'1..D
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7) None
8. Total Gross Assets (total Lines 1-7) (8) 386,411. 67
9. Funeral Expenses & Administrative Costs (Schedule H)(9) 16,643.54
10. Debts of Decedent, Mortgage Liabilities, & Liens(Schedule I) (10) 4, 593 .43
11. Total Deductions (total Lines 9 & 10) (11) 21,236.97
12. Net Value of Estate (Line 8 minus Line 11) (12) 365,174.70
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None
has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 365,174.70
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (aX1.2) X .0 (15)
TAX 16. Amount of Line 14 taxable at lineal rate 302,961.41 X .0 45 (16) 13,633.26
-
COMPU- 17. Amount of Line 14 taxable at sibling rate 62,213.29 X .12 (17) 7,465.59
TATION 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00
19. Tax Due (19) 21,098.85
20. D Ipl'f~OKij~Rl$lfYQOAflI:(J:jI:(QijlE$.jji\fGAij/EfQNP9fAijO\tjSReAt~l\f'tl
..
"?':;;:eeStlfll;:TQANS.WI;BALt;QQE:iSTIQN$QNFAQE:i:i!ANQRE:iGHI;CKMAJ:H~;<<
o PA15001
NTF 29755
Copyright 2000 Greatland/Nelco LP - Forms Software Only
..
Estate of: Charlotte S. Crow'
21-2001-0779
S1:MVJARY OF .ALI.D::ATICNS 'IO BENEFICIARIES
Taxable at lineal rate
Richard S. Crow'
Stephanie A. Crow'
Michael C. Crow'
David W. Crow'
Rotert J. Crow'
60,592.28
60,592.28
60,592.28
60,592.28
60,592.29
302,961.41
Taxable at sibling rate
Katherine S. Strohm
62,213.29
PA REV-1500 EX (6-00)
D d C I
Add
Page 2
ece ents omp.ete ress:
STREET ADDRESS
231 NOrth Hanover Street
CITY I STATE , ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
21,098.85
20,000.00
1,052.63
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
21,052.63
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER O~ ~I~LS'HAGI:NT
(3) 0.00
(4)
(5) 46.22
(SA) 0.00
(5B) 46.22
........................................................-...~~,...............,........................,..................-.....
............................................................., .,..................................................................
.. .........pLEASE.ANSWER.THE..FOLLOWING..QUESTIONS.Sy.P'LAciNG' AN ''''X;;'IN'THE'APPROPRiATE'SLOcks''
Yes No
~ I
B ~
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred; .......................................
b. retain the right to designate who shall use the property transferred or its income; .................
c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
2.
~
Under p . Ities of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowle ge and belief, it is true, correct and.. mplete. Declaration of preparer other than the personal representative is based on information of
which re arer has an knowled ~ .
DAT
r z/u L
ADDRESS
3401 NOrth Front Street, P.O. Box 5950, Harrisburg, PA 17110-0950
DAT
y- ?~L
[72 P.S.!i 9116 (a) (1.1)(i)].
For dates of death on orafter January 1,1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. !i 9116 (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 fillOg 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. !i9116(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.!i 9116(1.2) [72 P.S.!i 9116(a)(1)].
The tax rate imposed on the net value of transfers to or forthe use of the decedent's siblin9s is 12% [72 P.S.!i 9116(a)(1.3)]. Asibling is defined. under Section 9102, as an individual
who has at least one parent in common with the decedent, whether by blood or adoption.
o PA15002
NTF 29756
CoPyri9ht 2000 Greatland/Nelco LP- Forms Software Only
Estate of: Charlotte S. Crow
21-2001-0779
The following person(s) are signing the retunl as representative (s) of the estate:
Janes W. Evans
3401 NOrth Front Street
P.O. Box 5950
Harri~, PA 17110-0950
REV-1503 EX'+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charlotte S. Crow
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
21-2001-0779
ITEM
NO. DESCRIPTION
VALUE AT DATE
OF DEATH
1 DPL, Inc. - 675 shares of CCUlllJLl stock at $25.655 per share
17,317.13
2 ElF 1st Exchange Series AT&T - 510 shares of camon stock at
$127.905 per share
65, 231. 55
Dividend on abJve stock declared prior to decedent's death
103.02
3 Ente:rgy Corp. - 375 shares of camon stock at $37.61 per share
14,103.75
Dividend on abJve stock declared prior to decedent's death
118.13
7 CPA31 NTF 10905
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 2. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
96,873.58
-
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charlotte S. Crow
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with right of survivorship must be disclosed on Sch. F.
ITEM
NO. DESCRIPTION
21-2001-0779
Interest on al:xJve item accrued as of decedent's death
VALUE AT
DATE OF DEATH
200.00
see 13.00
46,459.21
6.37
3,165.27
3,201. 75
5.25
5,843.80
189.61
22, 694 .48
68.96
103,155.86
478.90
14,208.68
217.00
6,863.19
404.64
19,438.30
1 Cash found in hare
2 Fractional $ .10 currency and miscellaneous foreign currency;
attached appraisal of D & S Coins dated 10/23/01.
3 M&T Bank Checking Account #509477
4 M&T Bank Savings Account #1500-42-00943915
5 Me:rrill Lynch Ready Assets Trust Account
#663-18892
Interest on al:xJve item accrued as of decedent's death
6 M&T Bank Certificate of Deposit
#3100-39-10078194
Interest on al:xJve item accrued as of decedent's death
7 M&T Bank Certificate of Deposit
#3100-39-11159745
Interest on al:xJve item accrued as of decedent's death
8 M&T Bank Certificate of Deposit
#3100-39-11159703
Interest on al:xJve item accrued as of decedent's death
9 M&T Bank Certificate of Deposit
#3100-39-11167714
Interest on al:xJve item accrued as of decedent's death
10 M&T Bank Certificate of Deposit
#3100-39-11173365
Interest on above item accrued as of decedent's death
11 M&T Bank Certificate of Deposit
#3100-39-11176012
Total fran continuation paqe (s)
62,923.82
7 CPA81 NTF 10908
Copyright Farms Software Only, 1997 Nelca, Inc.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
289,538.09
Page 2
Estate of: Charlotte S. Crow'
21-2001-0779
SGIEITJLE E -- Cash, Bank De:posits and Miscellaneous Personal Property
Item
No. Description
Value at Da.te
of Death
11 Interest on ab:Jve item aCCnled as of decedent's death
30.48
12 M&T Bank Certificate of Deposit
#3100-39-11176187
7,824.91
Interest on ab:Jve item aCCnled as of decedent's death
5.65
13 M&T Bank Certificate of Deposit
#3100-39-11177763
26,145.97
Interest on ab:Jve item aCCnled as of decedent's death
96.55
14 M&T Bank Certificate of Deposit
#3100-39-11178563
7,786.71
Interest on ab:Jve item aCCnled as of decedent's death
18.79
15 M&T Bank Certificate of Deposit
#3100-39-11179751
12,746.21
Interest on ab:Jve item aCCnled as of decedent's death
13 .45
16 Household goods and funrishings and miscellaneous items of
personal property; see attached appraisal of William G. Rowe,
Appraiser, dated 09/25/01.
4,915.00
17 Net proceeds fran sale of refrigerator and dishwasher by Rowe's
Auction Se:rvice. See attached staterrent dated 12/17/01.
75.00
18 Eleven (11) Japanese Woodblock Prints; see attached appraisal of
James L. Price dated 12/29/01.
1,800.00
19 M=rrill Lynch dividend check #51555750, dated 07/27/01, uncashed
at decedent's death
104.55
20 M=rrill Lynch - EIF 1st Exch stock dividend paid 08/01/01 but
not received until after death.
104.55
21 Internal Revenue Se:rvice - refund on final personal federal
incare tax return
956.00
22 u. S. Treasw:y - Taxpayer Relief Refund
300.00
TOTAL. (Carry forwaDj to main schedule) . . . . . .
62,923.82
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charlotte S. Crow
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2001-0779
Debts of decedent must be reported on Schedule I.
ITEM
NO. DESCRIPTION
A. FUNERAL EXPENSES:
AMOUNT
1 Hoffman-Roth Funeral Hare, Inc. - funeral
expenses
115.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) JanES W. Evans
Social Security Number(s)/EIN No. of Personal Representative(s)
Street Address 3401 NJrth Front Street, P.O.
City Harrisburg State
3,500.00
146-20-2078
Box 5950
PA Zip 17110-0950
Year(s) Commission Paid: 2002
2.
3.
Attorney Fees Narre: Mette, Evans & Woodside
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
10,000.00
0.00
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
383.50
5.
Accountant's Fees
0.00
6.
Tax Return Preparer's Fees
0.00
See Schedule attached
Total fran continuation page (s)
2,645.04
7 CPA11 NTF 10911
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16,643.54
Estate of: Charlotte S. Crow
SOiEDJLE H, PART B -- Administrative Costs
Item
No. Description
7 Cumberland Law JOUJ:nal - advertisement of legal notice
8 The Sentinel - advertisement of legal notice
9 Linden Hall Antiques - appraisal of personal
property
10 Jazres L. Price - appraisal of Japanese prints
11 Merrill Lynch - annual account fee
12 M&T Bank - check printing and service fees
13 William E. Hoffm3n - October and November apartrrent :rent
14 Bonnie L. Kepner - cleaning apartrrent and
sorting and packing personal property
15 Carl Stine - renoval of trash at decedent's
apartrrent
16 Sprint - telephone utilities
17 Can::2st - cable
18 PP&L - electric utilities
19 031 - gas utilities
IDrAL. (Carry forward to main schedule) . . . . . .
Page 2
21-2001-0779
Anount
75.00
101.31
125.00
75.00
39.12
12.16
600.00
985.00
95.00
225.16
76.13
140.53
95.63
2,645.04
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charlotte S. Crow
Include unreimbursed medical expenses.
ITEM
NO.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
DESCRIPTION
1 Pennsylvania ~ment of Revenue - balance owed on 2001
personal state i.n.cc:m: tax retUDl
2 American Red Cross - Lifeline seIVices for August 2001
3 Carlisle Apothecary - pharmacy bill
4 Carlisle Regional Medical Genter - hospital bill for 03/17/01
hospitalization
5 Carlisle Regional Medical Genter - hospital bill for 07/24/01
hospitalization
6 Gentral Perm rvJed.ical Group - rca:lical seIVices
7 Carcast Cable - cable bill
8 CUmberland-Gcxx:iwi11 Fire Rescue EMS - ambulance se:rvices
9 PP&L - electric bill
10 PharMerica - pharmacy bill
11 PharMerica - pharmacy bill
12 Sprint - telephone bill
13 Thomwald Hare - nursing hare charges
14 UGI - gas utility bill
15 Yellow Breeches Elrergency Medical SeIVices, Inc. - ambulance
seIVice
16 William E. Hoffman - rent for decedent's residence, August and
September 2001
21-2001-0779
AMOUNT
8.00
17.00
269.31
594.00
594.00
30.30
34.69
48.34
62.93
558.70
8.51
35.77
1,656.64
45.24
30.00
600.00
7 CPA12 NTF 10912
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
4 , 593 .43
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Charlotte S. Crow
21-2001-0779
RELATIONSHIP TO DECEDENT AMOUNT OR
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SHARE OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
See Schedule attached
ENTER DOLLAR AMTS. FOR DISTRIBS. 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
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
7 CPA13 NTF 10913
(If more space is needed, insert additional sheets of the same size)
CoPyri9ht Forms Software Only, 1997 Neice. Inc.
Estate of: Charlotte S. Crow'
SGIEDULE J, Part 1 - - Taxable Distributions
Item
No.
Narre and Address of Beneficicu:y
1 Richard s. Crow'
3714 Grandview Drive
196L
Sirnpsonville, SC 29680
2 Stephanie A. Crow'
1711 Timberidge Drive
Bethel Park, PA 15102
3 Michael C. Crow'
18301 Carriage Drive
fvb:t:gaI1 Hill, CA 95037
4 David W. Crow'
2112 Kenzie Drive
Pittsbuxgh, PA 15205
5 Robert J. Crow'
365 2nd Street
Jersey City, ID 07302
6 Katherine S. Strohm
127 W. High Street
Carlisle, PA 17013
Relationship
Grandson
Granddaughter
Grandson
Grandson
Grandson
Sister
Page 2
21-2001-0779
Arrount
60,592.28
60,592.28
60,592.28
60,592.28
60,592.29
62,213.29
,.
,/
fuast 1fi11 ana Q[e$tctltt~nt
OF
CHARLOTTE S. CROW
I, CHARLOTTE S. CROW, of the Borough of Carlisle,
Cumberland County, Pennsylvania, do make, publish and declare
this to be my Last Will and Testament, hereby revoking all
Wills and Codicils by me at any time made.
ITEM I: I direct that all inheritance and
estate taxes becoming due by reason of my death, whether such
taxes may be payable by my estate or by any recipient of any
property, shall be paid by the Executor out of the property
passing under ITEM IV of this Will, as an expense and cost of
administration of my estate. The Executor shall have no duty
or obligation to obtain reimbursement for any such tax so paid,
even though on proceeds of insurance or other property not
passing under this Will.
ITEM II:
expenses of my last illness
property passing under this
administration of my estate.
I direct the Executor to pay the
and funeral expenses from the
Will as an expense and cost of
ITEM III: I may leave a written statement or
list in my safe deposit box disposing of certain items of my
tangible personal property not otherwise disposed of herein.
Any such statement or list in existence at the time of my death
shall be determinative with respect to all items devised
therein. If no written statement or list is found in my safe
deposit box or elsewhere and properly identified by the
Executor within thirty (30) days after the probate of my Will,
it shall be presumed that there is no other statement or list.
Page 1
e;J<::.
Any subsequent discovered statement or list shall be ignored.
Any such property not listed in such a written statement I give
and bequeath to I give and bequeath to RICHARD S. CROW, JR.,
STEPHANIE A. CROW, MICHAEL C. CROW, DAVID W. CROW, and
ROBERT J. CROW, or the survivors of them, absolutely and In fee
simple, all of my household furniture and furnishings, books,
pictures, jewelry, silverware, automobiles, wearing apparel and
all other articles of household or personal use or adornment
and all policies of insuranc~ thereon, to be divided among them
as they shall agree. Should there be no agreement, such
property shall be divided among them by the Executor in as
nearly equal portions as is deemed practical in the sole
discretion of the Executor, having due regard to the personal
preferences of such individuals.
ITEM IV: I give, devise and bequeath all
the rest, residue and remainder of my estate, not disposed of
in the preceding portions of this Will, to RICHARD S. CROW,
JR., STEPHANIE A. CROW, MICHAEL C. CROW, DAVID W. CROW,
ROBERT J. CROW, and KATHERINE S. STROHM, in equal shares. If
any of said individuals are not living at my death, the share
of said deceased individual shall be divided equally among
those individuals named herein who are living at the time of my
death.
ITEM V: In the settlement of my estate,
the Executor shall possess, among others, the following powers:
(a) To retain any investments I may have at my
death, including specifically those consisting of
stock of any bank even if I have named such bank as
the Executor herein, as long as the Executor may deem
it advisable to my estate so to do.
Page 2
C ~-c/
(b) To vary investments, when deemed desirable
by the Executor, and to invest in such bonds, stocks,
notes, real estate mortgages or other securities or in
such other property, real or personal, as the Executor
shall deem wise, without being restricted to so-called
"legal investments", and without being limited by any
statute or rule of law regarding investments by
fiduciaries.
(c) In order to effect a division of the
principal of my estate or for any other purpose,
including any final distribution, the Executor is
authorized to make said divisions or distributions of
the personalty and realty partly or wholly in kind.
In the event a division or distribution is made in
kind, such division or distribution shall be made at
the fair market value of the property at the date of
division or distribution. Should it appear desirable
to partition any real estate, the Executor is
authorized to make, join in and consummate partitions
of lands, voluntarily or involuntarily, including
giving of mutual deeds, recognizances or other
obligations, with as wide powers as an individual
owner in fee simple.
(d) To sell either at public or private sale and
upon such terms and conditions as the Executor may
deem advantageous to the estate, any or all real or
personal estate or interest therein owned by the
estate severally or in conjunction with other persons
or acquired after my death by the Executor, and to
consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all
Page 3
CSe
l
trust and without obligation or liability of the
purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the
validity of said sale or sales; also, to make,
execute, acknowledge and deliver any and all deeds,
assignments, options or other writings which may be
necessary or desirable in carrying out any of the
powers conferred upon the Executor in this paragraph
or elsewhere in my Will.
(e) To mortgage real estate, and to make leases
of real estate.
(f) To borrow money from any party, including
the Executor, to pay indebtedness of mine or of my
estate, expenses of administration or inheritance,
legacy, estate and other taxes, and to assign and
pledge assets of my estate therefor.
(g) To pay all costs, taxes, expenses and
charges in connection with the administration of my
estate.
(h) To vote any shares of stock which form a
part of the estate, and to otherwise exercise all the
powers incident to the ownership of such stock.
(i) In the discretion of the Executor, to unite
with other owners-of similar property in carrying out
any plans for the reorganization of any corporation or
company whose securities form a part of the estate.
(j) To disclaim any interest in property which
would devolve to me or my estate by whatever means,
Page 4
c~~~
I
.\'
including but not limited to the following means: as
beneficiary under a will, as an appointee under the
exerCIse of a power of appointment, as a person
entitled to take by intestacy, as a donee of an inter
vivos transfer, and as a donee under a third-party
beneficiary contract.
(k) To do all other acts in the Executor's
judgment deemed necessary or desirable for the proper
and advantageous management, investment and
distribution of the estate.
ITEM VI: Any person who shall have died at
the same time as I shall have, or in a common disaster with me,
or under such circumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my
death, shall be deemed to have predeceased me.
ITEM VII: If at any time any minor child
shall be entitled to receive any assets hereunder, my Executor
shall act as Guardian of the assets payable to such child.
Such Guardian may receive and administer all assets authorized
by law, and shall have full authority to use such funds in any
manner it shall deem advisable for the best interests of such
child. Said Guardian shall have all the rights and privileges
as to the Guardianship(s) and its assets as are herein granted
to the Executor as to my estate and the assets therein.
ITEM VIII: I hereby nominate, constitute and
appoint JAMES W. EVANS to be the Executor. The Executor and
Guardian are specifically relieved from the duty or obligation
of filing any bond or other security.
Page 5
(!1 c
ITEM IX: I direct my Executor to retain the
law firm of METTE, EVANS & WOODSIDE to serve as legal counsel
in the administration of my estate.
IN WITNESS WHEREOF, I have set my hand and seal to
this, my Last Will and Testament, consisting of this and the
preceding five (5) pages, at the end of each page of which I
have also set my initials for greater security and better
identification this day of , 19
/ "\ #/ ' y:;'
C5) l' '1 A? /r; &.-J?::-, AI. p' (? /,l-;tfl""'" ( SEAL)
CHARLOTTE S. CROW
We, the undersigned, hereby certify that the foregoing
will was signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament, in the
presence of us, who, at her request and in her presence and in
the presence of each other, have hereunto set our hands and
seals the day and year first above written, and we certify that
at the time of the execution thereof, the said Testatrix was of
sound and disposing mind and memory.
(SEAL)
Re.s i ding ~ / 7 h+-:)J.!1LH~ 1
i~'<-i~/X1 ~ "-)P't-.'K~~ -t c. /'100 7
Res idihg at V"L LW'f\t?...\L\ \.0 \Ld
C.-D..'>! \,'.,,'u ~ p,. \~ LH 3
Residing at 'i5..< I TUIA.Nf3E1'<"'Y Dt2"
C)/~ tJE.~6 u K Cr, PC{. /7':201
I
(SEAL)
. (SEAL)
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C CI I1'--Lce/d C(/}1.J:(
)
)
)
SS:
I, CHARLOTTE S. CROW, Testatrix, whose name 1S signed
to the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will and Testament; that
I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
!J ~
~~~iE*'f1;o~4. cr,?/' j'~7/- (SEAL)
Sworn to and subs&ribed
befo.l;e me ~his .7 day
of {.Zt/j~.O;LT-- , 19 .
/J
My Commission Expires:
(SEAL)
NOT f',RiAl SEAL'
_ ~ynlhl; ,L Om, Notary Public ..
::,outf, tl.iC~ittcn Two r h~ I
'{1 C .' r.. JumuJ:and Countv
. y omflllrSlon ExPII ES May 18. 1996
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
and
Cl'lC)!-J 13 :)e r7 . 'i e /7 IC'-- , -:i)oe e r2 ^/ (!~!r'(L.l' }-/<
, I / r , the Witnesses whose names are
sign to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testatrix, CHARLOTTE S. CROW, sign and execute
the instrument as her Last Will and Testament; that Testatrix
signed willingly and that she executed said Will as her free
and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testatrix signed the Will
as Witnesses; and that to the best of our knowledge the
Testatrix was at that time eighteen (18) or more years of age,
constraint or undue influence.
Witness ~
Q~~2{~~~l-~
Wl tne ~s
(Z~?V y;~ ~JtJU,j{_~~,;(1
/ .
Wltness
,,/ ',Ll?.-J-
My Commission Expires:
(SEAL)
NO'T tRIAL :;~AL
Cynthia L. Dorr, ~:rt1ry Public
SGulh !Jiiddift~n 1';:p,r.ci';berie.nd County
MY.S)mmj2,i (P l.tA'!' (~ :,~ay_),e, 19~
REV.JB5 EX + (l.nl
,'.
Si ,~~
~~J~;{t
SAFE DEPOSIT BOX
INVENTORY
COMMONWEALTH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT 280601
HARRISBURG. PA 17128.0601 Please Print or Type
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETU~NED TO ABOVE ADDRESS
COUNTY CODE FILE NUMBER SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER
21 2001-00779
DECEDENT'S NAME ILAST, FIRST, MIDDLE)
Crow, Charlotte S.
ADDRESS OF DECEDENT (STREET) (CITY)
231 N. Hanover Street Carlisle
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
(NAME)
Vicky Ann Trimmer, Esquire
DATE OF DEATH
2001
(STATE) (ZIP CODE)
PA 17013
(STREET ADDRESS)
(CITY)
1ST ATE)
(ZIP CODE)
3401 N. Front Street P.O. Box 5950 Harrisbur
NAME, ADDRESS AND RelATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. (NAME) (RELATIONSHIP)
PA
17110
Vicky Ann Trimmer, Esquire
(STREET ADDRESSI
3401 N. Front Street, P.O. Box 5950
b. (NAME)
Attorney for Est3te
(CITY) (ST A TEl
Harrisburg PA
(RELATIONSHIP)
(ZIP CODE)
17110
(STREET ADDRESS)
(CITY)
(STATE)
(ZIP CODE)
c. (NAME)
(RELATIONSHIP)
(STREET ADDRESS)
(CITY)
(STATE)
(ZIP CODE)
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAME)
M&T Bank
(STREET ADDRESS)
(CITY) (STATE) (ZIP CODE)
Carlisle PA 17013
DATE AND TIME OF LAST ENTRY
One West Hi h Street
. NAME OF PERSON MAKING LAST ENTRY
James W. Evans
DA TE OF CONTRACT TO RENT BOX
J-2J-1'3
NUMBER OF BOX
3537
NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. (NAME)
b. (NAME)
(ST ATE)
James W. Evans, POA
(STREET ADDRESS)
3401 N. Front Street, P.O. Box 5950
(STATE) (ZIP CODE)
Charlotte S. Crow
(STREET ADDRESS)
231 N. Hanover Street
(CITY)
(ZIP CODE) (CITY)
Carlisle PA 17103 Harrisbur PA 17110
NAME AND TITLE OF EMPLOYE TAKING THE INVENTORY
Vicky Ann Trimmer, Esquire, per authorization of PA Department of Revenue
WAS A WILL IN THE BOX? DYES ~NO If yes, a, Date of will:
removed from box on 8/20/01 by Executor
b. Name and address of personal representutive, if named in the will
(NAME)
James W. Evans
3401 N. Front Street. P.O. Box 5950
(STREET ADDRESS)
Ha.rrisburg
(CITY)
PA
(ST A TEl
17110
(ZIP CODE)
c. Name and address 01 attorney, if any
(NAME)
Vicky Ann Trimmer, Esquire
(STREET ADDRESS)
3401 N. Front Street. P.O. Box 5950
(CITY)
Hilrrisnllrp-
1ST ATE)
"PA
(ZIP CODE)
1711 n
Page __ of
INSTRUCTIONS
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are
to be designated by name of company, certificate number, date of certificate, name in which stock is registered,
and number of shares and class of stock.
(3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered
and type of ownership, i.e., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in
book, name of bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe os
fully as possible.
(8) All other contents.
ITEM ITEM DESCRIPTION I ( ~-1r
NO.
/ r /l / /1.1 c''r ;. o ~./-f co ~ )--0, (\ 1-, U [. h -tv/. J~ s. (q .....J /I In. /9 f;J I Ii, If
Z ;: A"'I"'-1~.J 'T,,<./) r c. 0 Js /1 . \ ..... - C ~/fy/..~ I ( r~ -.1 / J /a, 6/ o/(g If! l...,!f)
, '-' '-"
.
J F"t,"',.., Or/' ,- j- j; (jJcJ. rp: C 1,. -1v I. /~ .J Cnu ,} /7..)- /7" J~ .r!/7JA.,
/'.1" ,.- CiJ
V PAr/"7if" (;1// I c.? - IV, If\J?. {;'o (I, tv I~ if,; .J: D"l.~ 't' /y 17/- 'II] 1J~7
,~ r--;::-. '" .J.'; 1\ J .- 9' C J,--1Y L /./.: f. Uz.'-'<.J l/ I) /7(, y/i IU/
.} _ A .. / .ivJ r c IJ / r:- l,:";ll. G.
I?:., ., "J y J-I L'I
f"J'11 tw "7 ..-., '~r ctJ 0, ()-...'U c.l"t.'tv Lf{1:!" J (n,-, 51J--(9io ~-
(., ,
7 rr,..i It C~~\k I f/v/ T ej;' to , JUJ C ~A-< I eft.", s: (' rL,v--- /~IL.lfh'J.. I',} .z.;)!.)
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I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COpy OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
S'GZEd / \ r/II II SIG~~~
/0h ..,/~-
P7_~E /~~~; ""THC.-'- PRI7:AND CHECKAP~E BOX BELOW,
. ;' '-/'-5 i I c/'-? /~",,-:.Jrl ,4- ,.., c- ,
PRINT TITLE-' CHECK APPR'OPRIATE BOX,
~4/"..'-1 ~ C'l~ 1: o Executor(trix) o Administrator(trix)
o Estate Representative D Joint owner of safe deposit box
SAFE DEPOSiT BOX INVENTORY
)'
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NOTE: Attach additional 8'12" x 11" sheet (s) if necessary or use duplicates of this page of form.
Private Client Group
~~
j( , ....IIi.......".. ", .'.. .... ",
~ ~fle!rrbn bynch
Milwaukee Center
III E. Kilbourn Ave.
Ste.2100
Milwaukee, Wisconsin 53202-6646
4142249800
8009370744
FAX 414291 4172
September 17, 2001
Lisa J. Knode, Paralegal
Mette, Evans & Woodside
3401 NOlih Front Street
P. O. Box 5950
Harrisburg, P A 17110-0950
Dear Ms. Knode:
Re: Account Number 663-18892
N/O Mrs. Charlotte S. Crow
Pursuant your correspondence of September 4, 2001, please find enclosed
a schedule of assets held in the above referenced account, and their value
as of the date of death, August 13,2001.
Money market (Merrill Lynch Ready Assets Trust), interest from July 28
through August 13t\ 2001 is $5.25. The Entergy Corp (New) dividend of
$118.13 was ex-date of 8/1 % 1 and the ElF 1 st Exchange Series dividend
of$103.02 was ex-date 8/13/01.
T have enclosed a copy of both the July and August 2001 monthly statements;
and per your request, subsequent monthly statement copies will also be sent
to you.
If you should need any additional information or have any questions, please
do not hesitate to contact me at (800) 937-0744. Thank you.
Sincerely,
G. Joan Brehm
Senior Associate
Enclosures: July and August monthly statements - 663-18892
/gjb
fI!E IN"!)I<!.~ArlON SET FORTH HERriN WAS OBTAINED FROM
SO\..H~'._~'C:S WHiCH WE BfUEVE R:LI~.B~~. ,....BU:_ WE. DO NOT I
~ ~ I"'~ ~~;~'~p~~:? ~.~~; ,u ;';'I~:' :~I ~i..H,": ~ ;'!!~ld;~'''~~f~~I\~~: ~ ~~'~:T~~Y
~'Ul'\CH'r\SE CR SJ\!-E OF A,NY SEClJr'<lTIES OR COMI.,rlOCHT1ES.
MERRILL LYNCH HISTORICAL PRICING INFORMA TlON
Multiple Security Listing Table
Ticker
Description
Date
High
Low
Close
Volume
Cusip
DPL
ATF
ETR
DPL INC
EQUITY INV FD UT 1 EXC A T& T
ENTERGY CORP NEW
8/13/01
8/13/01
8/13/01
25.790001 25.520000 25.719999 299,300
128.800003127.010002128.600006 6,900
37.980000 37.240002 37.410000 277,900
23329310
29470070
29364G10
The information set forth was obtained from so~rces which we believe reliable, but we do not guarantee its
accuracy. Neither the information nor any opinion expressed constitutes a solicitation by us of the purchase
or sale of any securities or commodities. 15 : 48 : 40, 09/12/2001
, ACCOUNT # F/C # PAGE # TELEPHONE #
663 18892 0010 1 414-224-9800
MRS CHARLOTTE S CROW
231 N HANOVER ST
CARLISLE PA 17013-2420
STATEMENT PERIOD
07/28/01 TO 08/31/01
FINANCIAL CONSULTANT
EISENDRATH/WIELGOSH
SS OR ID
202-14-5794
INVESTOR
CREDIT LINE
OFFICE SERVING YOUR ACCOUNT TYPE
III E KILBOURN AVE
MILWAUKEE WI 53202 CASH
*****
ACCOUNT SUMMARY
*****
OPENING BALANCE CLOSING BALANCE
$.88CR $.88CR
INVESTMENTS
$93696
MONEY ACCOUNTS PRICED PORTFOLIO
$3,212.55 $96,909.43
*****
TAX INFORMATION SUMMARY
*****
DESCRIPTION
THIS STATEMENT
YEAR TO DATE
*****
$104.55CR
MONEY ACCOUNTS SUMMARY
$l,404.20CR
REPORTABLE DIVIDENDS
*****
MONEY ACCOUNT
OPENING
BALANCE
CLOSING
BALANCE
DIVIDEND/INTEREST
THIS STMT. YEAR TO DATE
MERRILL LYNCH READY ASSETS
$3,201.75
$3,212.55
$10.80
$61.55
*****
DAILY ACCOUNT ACTIVITY
*****
DATE TRANSACTION
07 28 OPENING BALANCE
08 01 *Dividend
08 31 Check
08 31 Dividend
08 31 Journal Entry
DESCRIPTION
PRICE
AMOUNT
ElF 1ST EXCH SR AT&T SHS
HOLDING 510.0000
MONTHLY AMT ISSUED
10 ML READY ASSETS TRUST
0.80000 DIV/INT REINVEST
FROM 07-27 THRU 08-30
1 ML READY ASSETS TRUST
FULL SHARE ACCUMULATION
$.88CR
$104.55CR
$104.55
***** CURRENT PORTFOLIO
$.88CR
*****
CURRENT MARKET CURRo EST.
PRICE VALUE YIELD INCOME
25.950 $17516 "3.62 $634
121.050 $61735 2.30 $1420
38.520 $14445 3.27 $472
$93696 $2526
08 31
CLOSING BALANCE
QUANTITY INVESTMENT DESCRIPTION
675 **DPL INC
510 ElF 1ST EXCH SR AT&T SHS
375 **ENTERGY CORP NEW
TOTALS FOR PRICED INVESTMENTS
CHECK YOUR ACCOUNT INFORMATION ANYTIME 1 ENROLL IN MERRILL LYNCH ONLINE\SMj
AT WWW.MLOL.ML.COM.
Delaware
END OF STATEMENT
AUGUST
2001
.
D & S COINS
224 FOURTH STREET
NEW CUMBERLAND, PA. 17070
(717) 774-4182
Customer's
Order No.
DATE
/O)i3
I
d(
1%_
SOLD TO
ADDRESS
SALESMAN
TERMS
CASH CHARGE C.O.D. PAID OUT RETD. MDSE. RECD. ON ACCT.
QUAN.
DESCRIPTION
PRICE
AMOUNT
&VJ~
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........
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ALL Claims and Return
SIGNATURE
.rgM&rBank
September 14,2001
RE:
Estate Search
The Estate of:
Date of Death (D.O.D.)
CHARLOTTE S CROW
8/13/2001
To Whom It May Concern:
Identified below is the account information requested.
J. M&T Bank accounts in which the decedent's name appears:
Account Account Number Account Title Opening Branch
Type
CHK 509477 CHARLOTTE S CROW 4319
JAMES EVANS POA
SAV 15004200943915 CHARLOTTE S CROW 4319
CD 31003910078194 CHARLOTTE S CROW 4319
CD 31003911159703 CHARLOTTE S CROW 4319
CD 31003911167714 CHARLOTTE S CROW 4319
CD 31003911173365 CHARLOTE S CROW 4319
CD 31003911176012 CHARLOTE S CROW 4319
CD 31003911176187 CHARLOTTE S CROW 4319
CD 31003911177763 CHARLOTTE S CROW 4319
CD 31003911178563 CHARLOTTE S CROW 4319
CD 31003911179751 CHARLOTTE S CROW 4319
CD 31003911159745 CHARLOTTE S CROW 4319
2. Loans, Mortgages, or other obligations titled in the decedent's name
Account Number
Amount Owed
D.O.D.
Balances
(Includes Accr.
Int. )
$46,465.58
$3165.27
$6033.41
$103,634.76
$14,425.68
$7267.83
$19,468.78
$7830.56
$26,242.52
$7805.50
$12,759.66
$22,763.44
Account Description
SEP 2 i 2001
Accrued Interest
$6.37
$.00
$189.61
$478.90
$217.00
$404.64
$30.48
$5.65
$96.55
$18.79
$13.45
$68.96
NO Safe Deposit Box titled in the Decedent's name existed at our office.
If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724-
2440 outside of the Buffalo, NY calling area. Thank you.
Sincerely,
M&T BANK CORPORATION
BY: Y3 a./ur~.A-~ ~~L/{'~~#-
Authorized Signature
DATE: Ci-j Y .-0)
Manufacturers and Traders Trust Company · 1100 Wehrle Drive, Po. Box 767, Buffalo, NY 14240-0767
.
LINDEN HALL ANTIQUES
211 OLD STONE HOUSE ROAD
CARLISLE, PA 17013
717-249-1978
To: Jim Evans, Attorney
Mette, Evans & Woodside
3401 North Front street, P.O. Box 5950
Harrisburg, PA 17110-0950
From: William G. Rowe, Appraiser
211 Old stone House Rd.
Carlisle, PA 17013
Re: Personal Property Appraisal
Estate of Chariotte S. Crow
231 North Hanover street
Carlisle, PA 17013
LIVING ROOM
Mahogany break front
Television
Cherry tea table
Walnut sideboard
Electric clock
Brass floor lamp
Lamp stand
Banquet lamp
Sofa. no value
Upholstered chair, no value
Oriental lacquer trays (2)
Oriental lacquer box
4 Sets books @ $20.00 each
Books - 2 volume, Penna.
Floor lamp
Linens
Oriental rugs, 2 @ $110.00 each
Hooked rug
Appraisal
, '\ .
\l/iLJ(1~
~ D1\\ T~
""""J -
'.\
\j
$350.00
$35.00
$120.00
$350.00 .
$20.00
$15.00
$30.00
$250.00
$0.00
$0.00
$30.00
$25.00
$80.00
$15.00
$5.00
$50.00
$220.00
$20.00
9/25/2001
Luggage
Bird bath
Waste paper basket
BEDROOM
Cherry bedroom set with box/mattress
Set 6 ladder back chairs, needle point seats
Chinese vase lamp
Amethyst lamp
2 Lamps @ $5.00 each
Eastlake Victorian arm chair (velvet)
Eastlake Victorian arm chair (floral)
Maple table
Card table
Waste paper basket
2 Shawls
Twin bedspreads, pair (stencilled)
Quilt, dark blue (frayed edge)
Quilt, light blue
Early blown bottle (stopper broken)
Ironstone pitcher (Hawthorne)
Dresser jar
White pitcher (lion handle)
Vases, small, pair
Knick knacks
5 Brass candlesticks @ $5.00 each
Silver candlesticks, pair
Brass collectibles
Compote with lid
Trumpet vases, pair
Appraisal
$5.00
$20.00
$5.00
$300.00 .
$600.00 '
$35.00
$15.00 '
$10.00
$110.00
$70.00
$20.00
$5.00'
$5.00
$25.00
$30.00
$85.00
$150.00
$25.00
$150.00
$10.00
$25.00
$15.00
$10.00
$25.00
$40.00
$30.00
$45.00
$30.00
2
9/25/2001
"
Print "Seller of Old Books" $25.00
Misc. soft goods $10.00
Oriental bowls, 2 @ $15.00 each $30.00
Crock, new, Geneva $100.00
Plate, Sterling $40.00
Plate, pierced rim, Sheffield $15.00
Casserole, covered - Reed & Barton $30.00
Tray with candle stuffer $10.00
WWll shell bowl $10 00
Ash tray, silver rim $5.00
BEDROOM
Twin beds, no value $0.00
Christmas items, lot $5.00
Vacuum cleaner, no value $0.00
Set of Revere Ware $30.00
Misc. kitchen items $20.00
Sad iron $5.00
KITCHEN
Castor set. metal frame $10.00
Luncheon plates (8), Heisey $40.00
Luncheon plates (5) $5.00
Butter plates (5) $5.00
Stemware, gold rim (11 ) $55.00
Goblets, honey comb (6) $15.00
Set China - Austria, Carlsbad $325.00
Salt & pepper shakers (4) $15.00
Cup/saucer, Wedgewood $20.00
Compote, small $20.00
Appraisal
3
9/2512001
.
"
..
Finger bowls (2)
Plates. small (6) - different patterns @ $5.00 each
Shell mold, copper
Bowl. pressed glass
Bowl, large, footed - Fostoria
Bowl, small, footed - Fostoria
Tea pot, Korea
Faberware compote, amethyst liner
Set dishes, modern Ironstone
Cups/saucers (4) - Bavaria
Cups/saucers (4) - Royal Copenhagen
Cup/saucer - Blue China
Cup/saucer - Bone China
Vase, Heisey
Butter dish with lid - damaged
3 Salt dips
4 Salt dips
6 Small Sterling salt spoons
Bowl (Hall's)
Chairs, pair - fan back, maple
Rug, oriental - damaged
Step ladder
BASEMENT
Cedar-lined chest
Shipping trunks - WWII. wood (2)
Foot locker
File cabinet, metal
Appraisal
TOTAL
$10.00
$30.00
$10.00
$25.00
$45.00
$20.00
$10.00
$25.00
$10.00
$25.00
$35.00
$5.00
$10.00
$25.00
$10.00
$15.00
$20.00
$45.00
$15.00
$25.00
$10.00
$5.00
$100.00
$20.00
$5.00
$5.00
$4,915.00
'.' .' . -,...-"'"'--- ')
..~ <~-"" - ~-~-.-':,.
William G. Rowe
4
9/25/2001
. , .
. .
'. \ ROWE'S AUCTION SERVICE (RR 79L)
Bill Rowe (AU 1538L)
Ben Rowe (AU l092L)
2505 Ritner Highway · Carlisle, PA
249-2677 697-4794 249-1978
Bob Rowe (AU 2276L)
Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For Satisfaction
SELLERS NAME
ADDRESS
OTHER
AUCTION DATE/LOCATION
DATE
PHONE
AUCTIONEER %
CLERK %
DESCRIPTION OF MERCHANDISE
,"
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise. goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in
this agreement.
AUCTION SIGNATURE
SELLERS SIGNATURE
Total Sales (Clerking -Tickets Attached) $
Less Sale Expense:
% Commission Auctioneer $
% Commission Clerks $
OTHER:
TOTAL SALE EXPENSE DEDUCTED $
SELLERS NET $
AUCTION SIGNATURE
SELLERS SIGNATURE
-
~ " .
, .
..
JAMES L. PRICE ANTIQUES
831 Alexander Spring Road
Carlisle, Pennsylvania
Estate of Charlotte S. Crow
Appraisal
1. Collection of eleven Japanese Woodblock Prints.
Mid- to- late nineteenth and early twentieth century
figural and landscape.
Value as a collection: $1,800.00
I have appraised the aforementioned items to the best of my ability
as to their fair market value.
/J
c/~~ ../ ~~
James L. Price
December 29, 2001
J4N
o 9 2002
01 .. .
I . I
cW~~~
FUNERAL HOME, Inc.
219 North Hanover Street
Carlisle, Pennsylvania 17013
(717) 243-4511
WILLIAM E. HOFFMAN
Supervisor
WILLIAM L. CHRISTOPHER
Director of Funeral Services
August 31
2001
20.
To Mette Evans & Woodside
PO Box 5950, 3401 N. Front St., harrisburg, PA 17110-0950
REFERENCES: Charlotte S. Crow
Itmes not included on the prepaid funeral expense contract:
Ten certified copies death
Hairdresser
Monument Letterine
Total
To be credited when receive from Cumbo Co. VA
Total Due
$ 75.00
30.00
90.00
$ 215.00
-100.00
$ 115.00
rfu.&J1 \'1 \ 0 I
cQ , (\\). 0 ~ :&
" .. I ·
t I
Hoffman-Roth Funeral Home, Inc.
219 North Hanover Street
Carlisle, P A 17013
(717)243-4511
September 10, 2001
Mette, Evans & Woodside
PO Box 5950
3401 North Front St.
Harrisburg, P A 17110-0950
The Funeral Service for Charlotte S. Crow
13572-175
SEP
1 2001
.-
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
(A) OUR SERVICE:
BASIC SERVICES OF FUNERAL DIRECTOR&STAFF.
USE OF STAFF AND EQUIPMENT:
( Miles Transported). . . . . . . . . .
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Carver Casket. . . . . . . . . . . . . . . . . . . . . . .
Monticello Interment Receptacle. . . . . . . . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . .
CASH ADVANCES
Opening Grave. . . . . . . .
Clergy Offering . . . . . . .
Certified Copies of Death Certificates.
Hairdresser. . . .
Monument Lettering. . . . . .
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
CONTRACT PRICE
. . . . . . . . . . . .
HISTORY
09/05/2001 Memorial Guardian Plans.
09/10/2001 Cumberland County VA
09/1 0/200 1 Estate. .
09/1012001 Discount. . . . .
TOTAL AMOUNT DUE
This statement is net and payable in full within 30 days of receipt.
$3490.00
$150.00
$3640.00
$1567.00
$1010.00
$6217.00
$400.00
$75.00
$20.00
$30.00
$90.00
$615.00
$6832.00
$-6567.05
$-100.00
$-115.00
$-49.95
$0.00
Please return this portion with your Remittance
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - -
$
Amount Enclosed
Service 10 # 13572-175
Charlotte S. Crow
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 001028
RECEIVED FROM:
TRIMMER VICKY ANN
3401 NORTH FRONT STREET
HARRISBURG, PA 17110-0950
ASSESSMENT AMOUNT
CONTROL
NUMBER
____un fold ---------- --------
101 I $46.22
ESTATE INFORMATION: SSN: 202-14-5794 I
FILE NUMBER: 2101-0779 I
DECEDENT NAME: CROW CHARLOTTE S I
DATE OF PAYMENT: 04/03/2002 I
POSTMARK DATE: 0010010000 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 08/13/2001 I
I
TOTAL AMOUNT PAID: $46.22
REMARKS: VICKY ANN TRIMMER ESQUIRE
CHECK#138
INITIALS: AC
SEAL RECEIVED BY: MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
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Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Charlotte S. Crow
No. 21-01-0779
also known as
Date of Death
August 13,2001
late of the Borough of Carlisle, Cumberland
County, Pennsylvania,
Deceased Social Security No. 202-14-5794
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
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 of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made
subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Vicky Ann Trimmer
I.D. No.:
49679
Address
3401 N. Front Street, P.O. Box 5950
Harrisburg, PA 17110-0950
Telephone:
(717) 232-5000
DESCRIPTION
....-.-'-
... ,j .... ;
,- .
0" fO
CU\LUE
N
Real Property:
....-.'
:I~
,L
NONE
1
W
Personal Property:
j:";'
1.,,0
675 shares of common stock in DPL, Inc. @ $25.655 per share
510 shares of common stock in ElF 1st Exchange Series AT&T
@ $127.905 per share, including accrued dividend
375 shares of common stock in Entergy Corp. @ 37.61 per share,
including accrued dividend
17,317.13
65,334.57
14,221.88
Cash found in home
Fractional $.10 currency and miscellaneous foreign currency
200.00
13.00
Personal Property (cont.):
~
M&T Bank Checking Account #509477, including accrued interest 46,465.58
M& T Bank Savings Account #1500-42-00943915 3,165.27
Merrill Lynch Ready Assets Trust Account #663-18892, including 3,207.00
accrued interest
M&T Bank Certificate of Deposit #3100-39-10078194, including 6,033.41
accrued interest
M&T Bank Certificate of Deposit #3100-39-11159745, including 22,763.44
accrued interest
M&T Bank Certificate of Deposit #3100-39-11159703, including 103,634.76
accrued interest
M&T Bank Certificate of Deposit #3100-39-11167714, including 14,425.68
accrued interest
M&T Bank Certificate of Deposit #3100-39-11173365, including 7,267.83
accrued interest
M&T Bank Certificate of Deposit #3100-39-11176012, including 19,468.78
accrued interest
M&T Bank Certificate of Deposit #3100-39-11176187, including 7,830.56
accrued interest
M&T Bank Certificate of Deposit #3100-39-11177763, including 26,242.52
accrued interest
M& T Bank Certificate of Deposit #3100-39-11178563, including 7,805.50
accrued interest
M&T Bank Certificate of Deposit #3100-39-11179751, including 12,759.66
accrued interest
Household goods and furnishings and miscellaneous items of personal 4,915.00
property
Refrigerator and dishwasher 75.00
Eleven (11) Japanese woodblock prints 1,800.00
Merrill Lynch dividend check #51555750, uncashed at death 104.55
ElF 1st Exchange stock dividend paid 08/01/01 but not received until 104.55
after death
Internal Revenue Service - refund on final personal federal income tax 956.00
return
U.S. Treasury - Taxpayer Relief Refund 300.00
TOTAL 386,411.67
(Attach Additional Sheets If Necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value
of each item, but such figures should not be extended into the total of the Inventory.
Form RW-7 (Dauphin County). Rev. 9/92
288574
I
\.. /"}-c:J - y
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-13-2002
CROW
08-13-2001
21 01-0779
CUMBERLAND
101
VICKY ANN TRIMMER
METTE ET AL
PO BOX 5950
HBG
ESQ
'02
j'111Y 17
~):2 .
L,:
P A 17 OlD' ('
Allount Rellitted
*'
REV-1547 EX AFP <Ol-D2)
CHARLOTTE S
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=is4-j-i3CAFP-foY=02Y-NOTici--OF-YtiHiiiiTANCE-TAX-APPRAisiMENT~--AL1-oWAi'-cE-oR-------------- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CROW CHARLOTTE S FILE NO. 21 01-0779 ACN 101 DATE 05-13-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
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)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
( ) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
96.873.58
.00
.00
289.538.09
.00
.00
(8)
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
I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AIIount 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
TAX CREDITS:
NOTE:
DATE
11-08-2001
04-03-2002
~~-~~. .
NUMBER
CD000509
CDOOI028
l+'
INTEREST/PEN PAID (-)
1.052.63
.00
16,643.54
4.593.43
(11)
(12)
(13)
(14)
(9)
(10)
.00 X
302,961. 41 X
62,213.29 X
.00 X
00 =
045 =
12 =
15 =
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
386,411.67
21.236 97
365,174.70
.00
365,174.70
(19)=
.00
13,633.26
7,465.59
.00
21,098.85
AMOUNT PAID
20,000.00
46.22
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
21,098.85
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
PLEASE FILE THIS REPORT WITHIN 'lWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF
THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION.
0v'
oK.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Charlotte S. Crow
Date of Death:
AultUst 13. 2001
Will No.
Admin. No. 21-2001-0779
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 ---K- No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No--X-
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account informally to the
parties in interest? Yes --X- No_
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: December 3. 2002
~. /L4L-
Signa1ure
Vickv Ann Trimmer. ESQuire
Name (Please type or print)
3401 North Front Street. P.O. Box 5950
Address
Harrisburg. PA 17110-0950
(717) 232-5000
Telephone
Capacity:
_ Personal Representative
312181
---K- Counsel for Personal
Representative