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HomeMy WebLinkAbout01-0812 PETITION FOR PROBATE and GRANT OF LETTERS Estate of' Wesk,1I\ No ("vY\o.V\ Be....\l also known as No. To: 21-01-812 Register of Wills for the . Deceased. County of t\J~ Ioe.r\QV\.d. in the Social Security No. 112...- 0\ - 2 <i 2..11 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 executo(' S in the last will of the above decedent, dated and codicil(s) dated May ::z 5"\ \~JDJ". ..... Sa. ro..'^- E\eaVl.~r ~,,\ \ ex(!'c ut r \)(. ( A,,~u~ T 9J ZOO I ) named ,19_ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent, then years of age, died \J u~ I ,~ at - ('~ f"i \ h" 0.: 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: $ r75i 000 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~sfa.V\o\bt\\"Cl.f'~ (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~ '" '<) u c:: '" -o~ .- '" "'~ '" .. a:'" c:: -00 C::";:: cu.;:: ~'" ~c.. "''- ;;0 ~ c:: bl) Vi l16~~.,.{~ Bo:O OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1-- ss COUNTY OF _ CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. affirmed and 30th ~~~ C'.l OQ' ::os Cl - l:: ~ ~ No. 21-01-812 Estate of WESTON NORMAN BElL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW AUGUST 31 ~~2001 ,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 25. 1966 described therein be admitted to probate and filed of record as the last will of WESTON NORMAN BElL and Letters TESTAMENTARY are hereby granted to !ACK NORMAN BEIT. ':n;t"Y(?f:Z,-tL/-jPHMf' /~/ Re ster of Wills FEES Probate, Letters, Etc. ......... Short Certificates( ).......... Renunciation ................ JCP $ 235.00 $ 30.00 $ $ 5.00 TOTAL _ $ 270.00 . . . . . . Al!9Y~.~ )9,. ..4Q9 J. . . . . . . . . . . A TIORNEY (Sup. Ct. 1.D. No.) ADDRESS Filed PHONE tk~~~, ~0--,5/- .3 -</6 c:, COpy A FOR DIVISION OF VITAL RECORDS DECEDENT PLACE OF DEATH USUAL RESIDENCE OF DECEDENT .,; ",m C ~ ~[ 5 .~ ~g. :0 CD ",2 .~ ~ ~ ~ o !! z ~O i E'~ as :J >- ~ ~g ~ ~'U ~ l~ ~ o! ; ili . 10 :I .S-c a Ii .0" @ 8 ~~ .0 ~ ~ a ~ ~ 0- C. Z ~ ~ .~ II: m 01: 0.0- !~ NOTE: if "Pending" must be indicated, so state in part 1 and notify registrar of tinal decision as soon as possible. PERSONAL DATA OF DECEDENT CAUSE OF DEATH TO PHYSICIAN: Complete and sign medical certification (item 28) and return both copies to funeral directOf as soon as possible after determination of cause. FUNERAL DIRECTOR REGISTRAR '" '" '" V> > REGISTRATION AREA NUMBER /dJ 1. FULL NAME OF DECEDENT COMMONWEALTH OF VIRGINIA - CERTIFICATE OF DEATH DEPARTMENT OF HEALTH - DIVISION OF VITAL RECORDS - RICHMOND 21-01-812 STATE FILE NUMBER (last) male female 3. DATE OF (mo.) DEATH Au ust 14 Weston (day) (year) 4. AGE N. Beil lJ o 6. WAS DECEDENT EVER IN U.S. yes ARMED FORCES? 5. DATE OF BIRTH Jan. (mo.) IF UNDER 1 DAY ----r---- hours I minutes IF UNDER 1 YEAR ----T----- months I days I no D~ 15 2001 90 I ears 7. NAME OF HOSPITAL OR INSTITUTION OF DEATH (~none, so stale) 8. COUNTY OF DEATH (if independent city, leave blank) Out Pat. Emer Am DOA o Inpatient Fair Oaks Hospital 9. C;TY OR TOWN OFDEATH o rn Fairfax inside city or town limits? 10. STREET ADDRESS OR RT. NO. OF PLACE OF DEATH yes' no d Dt 3600 Jose h Siewick Drive 12. COUNTY OF DECEDENT"S RESIDENCE (if independent city, leave blank) Fairfax 11. STATE (OR FOREIGN COUNTRY) OF DECEDENT'S RESIDENCE Virginia 13. CITY OR TOWN OF RESIDENCE Fairfax inside city or town limits? 14. STREET ADDRESS OR RT. NO. OF RESIDENCE yes no ZIP CODE Fairfax 15. NAME OF DECEDENT'S FATHER o Dt 22033 4427 Ma'estic Lane 16. MAIDEN NAME OF DECEDENT'S MOTHER Norman W. Beil Bessie Dowhower 19. EDUCATION (Specify only highest grade completed) 17. RACE or DECEDENT 18. OF HISPANIC ORIGIN? Puerto Rican, etc. Dyes If yes, specify Cuban, Mexican, ytno Caucasian 20. CITIZEN OF WHAT COUNTRY Elementary/Secondary (0-12) 1 ? College (1-4 or 5 of) 22. NEVER MARRIED 0 DIVORCED 0 23.:Ft ~~o~~~?e~v~ ~~~tED, NAME OF SPOUSE MARRIEDO WIDOWE~ Eleanor S. Beil 26. KIND OF BUSINESS OR INDUSTRY 27. INFORMANT - OR SOURCE OF INFORMATION 21. BIRTHPLACE (state or country) U.S.A. Pennsylvania 25. USUAL OR LAST OCCUPATION 24. SOCIAL SECURITY NUMBER 172-01-2928 Barbara Kale 28. PART I. Enter the diseases, injuries. or complications that caused the death. List only one cause on each line. Sequentially list conditions, if any. leading to immediate cause. Enter UNDERLYING CAUSE (Disease or injury that initiated events resulting in death) LAST z o ;:: c () ii: ;:: 0: W () .... c () 5 w ~ C PART II. ~ significant ~ contribut:ng to death but not resulting in the underlying cause given in Part I. 26a. AUTOPSY? Dyes '\:.- AUTHORIZED BY; ~ 2Be. IF EXTERNAL CAUSE, IT WAS PRIMARY 0 or CONTRI NG 0 TO CAUSE OF DEATH 26d. DESCRIBE HOW INJURY RELATING TO DEATH OCCURRED YA 28b. IF FEMALE, WAS THERE A PRf3I'IANCY IN PAST 3 MONTHS? ~ yes D no 0 unknown 0 28e. TIME OF INJURY (mo.) 128h. (city or town) I I I (county) (state) (year) 28f. INJURYOCCURRED I:!w A W~~:rk 0 at ~~~~Ie 0 A.M. P.M. 28g. PLACE OF INJURY (home. farm, faclOry, s')';;;te bldg., etc.) (a.m.), (P.~') the date and place and from the cause(s) stated. ~A~~-~--l---------------- : oIV(~1 - - - - - - - - - - - - - - - - - - - - - :ADDRESS OF-ATrEN- -G-PHYsI~IW - - - - {};:i--;Jt"- LI-';;'L&--: (name 01 cemetery or crematory) (city or county) (state) Prospect Hill Cemetery Harrisburg, PA ~~~~~~6UNERAL Everly Funeral Home ADDRESS 10565 Main St Fairfax VA 22030 This is to certify that the original record FAIRFAX VIRGINIA. this is filed with true and correct reproduction of FAIRFAX COUNTY HEALTH DEPARTMENT. a the AUGUST 22Ll.QOl DATE ISSUED ~R~- (SEAL) VOID IF ALTERED OR DOES NOT BEAR IMPRESSED SEAL 21-01-812 THE LAST JOINT WILL AND TESTAMENT OF WESTON NORMAN BElL AND SARAH ELEANOR BElL IF BOTH SHOULD BE KILLED OR DIE AT THE SAME TIME. We WESTON NORMAN BElL AND SARAH ELEANOR BElL of Harrisburg in the County of Dauphin and State of Pennsylvania, being of sound mind memory and understanding, do make and publish this our last joint will and testament, hereby revoking all former joint wills by us at any time heretofore made. All that we possess in the world We hereby bequeath to our two children as follows: (a) To our daughter, Barbara Jean Cale, one-half share. (b) To our son, Jack Norman Beil, one-half share. We name as the Executor of this our last will, our son Jack Norman Beil. IN WITNESS WHEREOF, We have hereunto set our hand and seal ,.-/ this J-S day of May, A. D. 1966. ..Ji"~i70v0L? j,/f:!?t / Jd- / (SEAL) A f1 '. '(7 _~~I.ll e._{t.t h(~( ~_(, .") (SEAL) On this j.(day of May, A.D. 1966, the foregoing instrument, was signed, sealed, published, and declared by the above named WESTON NORMAN BElL and SARAH ELEANOR BElL, as for their last joint will and testament, in the presence of us who have here- unto subscribed our names at their request as witnesses thereto, in the presence of the said Testator and Testatrix and for each other. 'fkc6: j jj~~ (SEAL) /-~' -t1 ~ rJ -r'. --I'- ~ .. ..~ L.-{ij( SEAL) (/ REGISTER OF WILLS OF (;v.tV\.~ ".-J &"",,,1 COUNTY OATH OF SUBSCRIBING WITNESS ~ ~7, fA'. h~ dhh _)b' d' '-Cd d' ' a su scn mg wItness to t e WI presente erewIt, emg u y qua I Ie accor mg to law, de se(s) nd say(s) at present and saw the testat~" , sign the same and that signed as a witness at the request of testa~ in h i./ presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this "3 0 day of d~.~~~O' Ister "/ 4.1?/s'? -- NoIaJ1ea Seal Jo .... CoIemen, NotaIy PubIlc ....Oumber1andBoro. CumberiandCwnly My CommiSSion Expires Sept. 6, 2004 Member. ~l1i1sy:vailla Assoc'a'.ion ct Notaries .-f!!.!!.m.e) (Address) REGISTER OF WILLS OF / COUNTY OATH OF NON-SUBSCRIBIN~ITNESS // ,/ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil will testat_ of (one of the subscribing witnesses to) the presented herewith and codicil believes the signature on the will is in the handwriting of that to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of testat_ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS J~a r ba Vii- \} C q / e (each) a subscriber hereto, (each) being duly qualified according to law, depose(s r q M familiar with the signature of \' codicil testat_ of (one of the subscribing witnesses to) the will presented herewith and ........-- -- ~dicil that 1- believes the signature on th~i}l.--is in the handwriting of -t))~~\t()V; ;\J!(n1(/Y? ,-Pel) to the best of knowledge and belief. Sworn to or affirmed and subscribed before ~O~ /<-e!L ~, ~ me this 30th day of .$:(' Pa r Cl.. ~ rJa11Je) C q Ie . ~AUGUST /l. ~2001 9-9.:} ^I tt)OV'e.s1,'c Ln) rA_ :{'-CO'f t/IJ 22033- ._./~r?_~~~N/)z;"/~~e../~~/ (Address) I / Register t! (Name) (Address) ~ -- , CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Wes..'t-D~ l\L. \)e.-i \ Date of Death: AIJ~ lJS+- I q 200 \ , Will No. PLJD 1 .- 008 12..... Admin. No. ;..J.... 0' - 08 1'- 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 ~\- _ 10) '2.00 l Address LI- 42 -, M<\y~...~\-U:.. 1aV\e. Fa., ~ PCl)C. \ Va. Z "2.0~"3 \9l\ \ "Ql\e.y VI e'N })p ye. 50\ 1, -r'J3 S'rrl~~ f ~ 11- 17DOl Name M(5, Bo.rbO.f"Q. ~e.. .. ~(. :Iac.\( N. ~ei \ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Sf'?*,' 2.0,20 0 \ Signatll" r'" f3.,.;...o.. Name Jo.c.\<.. N. Ee..'.l lo4 \ Vo..\lfit"j ~ lew br;-{.Q.. 80l \ ~ V\5 S'prl'1I\9J) PPt, n 001 Telephone r[11 258- 3q.~Co Address Capacity: V Personal Representative _Counsel for personal representative E- v' IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania, BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Wes~1I'\ N,. Be:~ \ , deceased, Estate No, (Name and Address) TO: I\\r.S, '"Bo.,r\)Oltl ~ \ C6..\e.. 4lfz, Mo.jos\-'\.C" ~~ Fo..\('~y: , vt A~ 2 ~033 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below, M(. ~~~ N.. "Be.,c \ . {o t.U.-Yo \~J"tJ~lA.\ Dr. .ED\ \ ~~ ~('(,^g.~) \>l\ \ 110{)7 The Decedent \Nestotl\ N. Be\ \ day of , '"' , , at FO\ ("' f'o. '/. PeBBsyl....aRia.. VI~ \ v'\. \0.. .~ The Decedent died testate (with a Will); or , died on the A lJ~ ust- ,.., J 2. Of:) I County, The Decedent died intestate (without a Will). The personal representative of the Decedent is (name, address and telephone number). .J llq.. ~. ?>e..~ \ lo4-l Va.\\e'f Vl'eW Dc Bo~ \ 1 V\j Spr\~J ~~. 17007 711- 2.S8 - 3tj,1o~ .,. If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: Signature: ~ '11 ~ ~ Name (print). r::r~\<. ~. 'Bt--i\ Address {Pt..l \ \frL\\e.y V,"ew be. <Bel h nj S~.~S c (.>1\ J t?OOl Telephone (111 '25&- 3~iJ,Co capacity:~sonal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUR~U OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EXI11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 000308 BElL JACK NORMAN 641 VALLEY VIEW DRIVE BOILING SPRINGS, PA 17007 ACN ASSESSMENT CONTROL NUMBER AMOUNT _____u_ fold ---------- -------- 101 I $7,244.75 ESTATE INFORMATION: SSN: 172-01-2928 I FILE NUMBER: 21-2001- 0812 I DECEDENT NAME: BElL WESTON NORMAN I DATE OF PAYMENT: 09/25/2001 I POSTMARK DATE: 00/00/0000 I COUNTY: CUMBERLAND I DATE OF DEATH: 08/14/2001 I I TOTAL AMOUNT PAID: $7,244.75 REMARKS: JACK N BElL CHECK#102 INITIALS: VZ SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS THIS RECEIPT REPLACES RECEIPT CD 000301 . DEPARTMENT OF REVENUE BUREAU OF EXAMINATION POBOX 8327 STRAWBERRY, PA HARRISBURG, PA 17127 September 28, 2001 Dear Jeff; I am writing to inform you about a recent void of a Tax Receipt. On September 25th, 2001, we had a paper jam on the AS400 printer. The Tax Receipt CD 301 did not print so we do not have the actual receipt .I called Infocon and talked to Dawn. We can not reprint tax receipts. If you have any questions about this matter, please give me a call at (717) 240-6246. Sincerely, )LL~~ Sue Koser, Deputy o STATUS REPORT UNDER RULE 6.12 Name of Decedent: -JlVes1-0tIJ N. Be~ I Date of Death: ~h'f J~()OI I I Will No. ~OO 1- 0 0 fl2.... Admin. No. .2.1- 0' - 08 I z.. 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 V 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 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 ~ No d. Copies of receipts, releases, joinders and approval$ of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: ..5e~. 2.0)2.00 , 0__ (J 11. U ~ Signat,urev :Tac.K N. Bei / Name (Please type or print) IoLll ~\~y We.W t),ive. Address BO\ \ ltlS .r-Pf'\ l"Jg S I ?l\. l '700, (717) .:25g -34(oCo Tel. No. Capacity: ~personal Representative (MAH:rmf/AM3) Counsel for personal representative /7-.y'- 7 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-05-2001 BEll 08-14-2001 21 01-0812 CUMBERLAND 101 JACK N BEll 641 VALLEY VIEW DR BOILING SPRINGS PA 17~~7 Allount Rellitted '* REV-1547 EX AFP 112-001 WESTON N MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is'47-EX-AFP-C:i'2-:o0Y-NOYicE--OF-YNHEifiTANCi-TAX-A"PPRA"isEifENT~--ALU)WAifCi-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BEll WESTON N FILE NO. 21 01-0812 ACN 101 DATE 11-05-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re.l 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 .00 .00 .00 178,043.16 .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 NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 .t Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: PAYMENT RECEJ:PT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 05-14-2002*. . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (9) (10) 17,048.78 .00 (1lJ (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 178,043.16 17.048 78 160,994.38 .00 160,994.38 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 7,244.75 .00 .00 7,244.75 .00 7,244.75 .00 7,244.75 ( 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.) .00 X 00 = 160,994.38 X 045 = .00 X 12 = .OOX 15 = (19)= AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE /?- -r'-7 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-I6D7 EX AFP 112-DDl JACK N BEIL 641 VALLEY VIEW DR BOILING SPRINGS C1Wrk111fJ:il7:tn Gourt Cumberland Co., PA "01 NOY 26 All :48 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-19-2001 BEIL 08-14-2001 21 01-0812 CUMBERLAND 101 WESTON N Recoraed 'JffiC,$ of Register of Wtfts Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=i6'irj-ix--AFP-ci1f=ooY------...-fNHERITANCE-YAX--iTAfEMENY-O'F-ACCoui.-f--.-..--------------------- ESTATE OF BEIL WESTON N FILE NO.21 01-0812 ACN 101 DATE 11-19-2001 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: 11-05-2001 P R I NC I PAL TAX DU E : .................................................."""""""""""""""""........".......................................".".""""""".."""""......".".........."............................... 7,244.75 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-25-2001 CDOO0308 362.24 7,244.75 TOTAL TAX CREDIT 7,606.99 BALANCE OF TAX DUE 362.24CR INTEREST AND PEN. .00 !Ii IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 362.24CR 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. , /7- ~- 7 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-UD1 EX iFP 112-DDI Recoroe..... Rer) of DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-31-2001 BEll 08-14-2001 21 01-0812 CUMBERLAND 101 WESTON N JACK N BElL 641 VALLEY VIEW DR BOILING SPRINGS PA l~Rik ClImbend .02 FEB -1 P 1 :44 Allount Rellitted -Ui"t FA. MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your eccount, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6'ifj-E.;f-AFP-fi'2-:ooY------...--iNHERITANCE--YA;f-STAfEMENY-OF'-AccoiJiff--...--------------------- ESTATE OF BEl L WESTON N FILE NO.21 01-0812 ACN 101 DATE 12-31-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 7,244.75 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-25-2001 CDOO0308 362.24 7,244.75 12-12-2001 REFUND .00 362.24- TOTAL TAX CREDIT 7,244.75 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 PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l , REIJ-1500 EX (6-00) . ~ , OFFiC:AL USE ,ONLY C-. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I 7- LJ I W I- li::$l/l ultli: wD-U J:oo ult...J D-ClI D- o:( FILE NUMBER l- ( _ 0 INHERITANCE TAX RETURN RESIDENT DECEDENT YEAR NUMBER 00 S?I L COUNTY CODE DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURIIY NUMBER J- Z W o W o W o 172 01 2928 DATE OF BIRTH (MM-DD-YEAR) 1/15/1911 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURIIY NUMBER DATE OF DEATH (MM-DD-YEAR) 8/14/2001 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Retum o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach capyofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Retum (date of death poor to 12-13-82) o 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attacl1 SchO) I- Z W C Z o D- l/l W It It o U if ~~~~):-,~ ~,,"'~~"f"'l;r"~~'~ ~~~.i:w"U "'-M~~h-j...... ~ ,"!,rM,"'''''l !;"~~~\;. "'. ~ "?:'~Wo:rYfif;t,;":'T~...~j:.l'1l.~"")~ "{a<'7",,".~.o/. ~~ .;""-~~ :a:~~ ~ .1" ;J~~~'1-~~i;J,.l..~~~).1~~-.\;.'f?:,~ ~,..~! ~r~2_,,-~\i~:.~...:,h~.~)=.~17tt ~":;,~:-l'~-;;\ ~-;~ "'~ Xc,.~;.:,~~~>~JJ'~ ~'t' ::~ ;-";.I.!~';!1~~:~~J..~~ Beil COMPLETE MAILING ADDRESS Jack N. Beil 641 Valley View Drive Boiling Springs, PA 17007 FIRM NAME (If Applicable) TELEPHONE NUMBER OFFICIAL USE ONLY 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) . $178,043.16 none none z o ~ ~ !:: D. <( o w a:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral 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 Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (11) 17,048.78 (12) 160,994.38 (13) none (14) 160,994.38 none x.O_ (15) x .04.5.... (16) 7,244.75 x .12 (17) none x .15 (18) t:l.Qt:l.~ (19) 7J211_75 none nonp (6) none (7) none (8) 1 78 , 043 . 16 17,048.78 (9) (10) none 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ .- ~ D. :!E o o g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 160 , q R 9 . 50 none 17. Amount of Line 14 taxable at sibling rate non e 18. Amount of Line 14 taxable at collateral rate none 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURETOAN~;A~C . Decedent's Complete Address: STREET ADDRESS 641 Valley View Dr. STATE PA Z!{'7007 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 7,244.75 none nopp none Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total I nierest/Penalty ( D + E ) 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 non~ none (3) (4) (5) (5A) (5B) 4. 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. 7,214.75 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ~m~l;;,~~[~~~:y.~~;,>n~.~",:-~~;.:'~,.-,...."- 1iIIl"""', ---- '"""""- ~lIa'lll --- -~ PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Gl Q G! IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 GO B [Xl Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, conrect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. n41 v~lley View Drive, Boiling Springs, PA 17007 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE DATE -e\ SIGNATURE 0 ADDRESS ADDRESS ~~~~';\~~.tk~'ot~'S~~~~"*. 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 P.S. {)9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {)9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and liling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {)9116(a)(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. {)9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's Siblings is 12% [72 P.S. {)9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. <!I ,; ~e~t'S;~-<-;.< :~;~~",i ~~.(~;~~: !1~:~'7., 1L~""7~.:~ ?,~;~~.:~,~:;~,,~,z~~;(~f~':",f;r~~~l{t~fts~~~~:o>'~~, ::'~,\ P."'~;F~~~ . Rei. 15GB EX + (1.97) ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Weston N. Beil FILE NUMBER 2001-00812 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ll. 12. 13. 14. DESCRIPTION Waypoint Bank; Acct #3003000301 Waypoint Bank~GD#630104026 Waypoint Bank; CD#~56176995 waypoint Bank; CD#631139771 Waypoint Bank; CD#630148209 Allfirst Bank; CD#87008000386607 (Interest) Allfirst Bank; CD#87008000386607 F{tst Union Bank; CD#247412055715520 First Union Bank; Checking Acct#1000661489988 waypoint Bank~D#630104026 (Interest) Waypoint Bank; CD#630148209 (Interest) waypoint Bank; CD#631139771 (Interest) Waypoint Bank; CD#656176995 (Interest) First Union Bank; CD#24-741-205-5715520 (Interest) VALUE AT DATE OF DEATH $90,508.55 27,019.35 20,007.75 14,006.61 8,003.27 38.81 10,016.28 6,000.00 2,137.46 149.97 25.41 51.24 60.13 18.32 TOTAL (Also enter on line 5, Recapitulation) ~ 1 78 , 043 . 1 6 (If more space is needed, insert additional sheets of the same size) 'lJWaynoint IJ"8 A N K Loo1<for US. 'liVE']] gEt bjOU th:p:. RECEIPT Hcct# Ti r# 3004 SDDA Closeout TRAN# 59 ON 9/04/2001 9/01/2001 11:12:51 AM Ledger Balance .00 3003000301 90,508.55 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code, Certain deposits are subject to delays in availability according to Bank policy. TEL-DOg (10100) THIS IS YOUR RECEIPT Member FDIC V/WayRqipJ Look for us. We'll get you there. RECEIPT Acct# Tlr# 3004 74CD Close Out TRAN# 63 ON 9/04/2001 9/0l/2001 11:16:30 Ledger Balance 630104026 271019.35 AM .00 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-DOg (10/00) THIS IS YOUR RECEIPT Member FDIC V1WayRqinJ Look for us. We'll get you there. RECEIPT Acct# Tl r# 3004 74CD Close Out TRANt 62 ON 9/04/2001 9/01/2001 11:15:29 Ledger Balance 656176995 201007.75 FlM .00 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays In availability according to Bank policy. TEL-DOg (10/00) THIS IS YOUR RECEIPT Member FDIC V1Waynnint 18'A N K Look for us. We'll get you there. RECEIPT Acctl* Tlr# 3004 74CD Close Out TRAN# 61 ON 9/04/2001 9/01/2001 11:14:47 Ledger Balance 631139771 14,006.61 AM .00 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-DOg (10/00) THIS IS YOUR RECEIPT Member FDIC Y1Waynoint I"BANK Look for us. \V=']] gEt bloU thErE. RECEIPT Hcct# T I r# 3004 74CD Close Out TRAN# 60 ON 9/04/2001 9/01/2001 11:14:03 AM Ledger Balance .00 630148209 8,003.27 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-DOg (10/00) THIS IS YOUR RECEIPT Member FDIC V1WayRRt'lJ Look for us. We'll get you there. RECEIPT Acct# T I r# 3002 IDDA Personal TRAN# 11 S 9/08/2001 ledger Baiance 4100039420 10.- 016.28 DePOsi t ON 9,/10/~20i)1 11:26:04 AM 1591584.84 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-DOg (10/00) THIS IS YOUR RECEIPT Member FDIC .-:".'..'4 ;,"I:..~.',~," . -:..,'. ".':. I~"~~~' I'!'""" ',... . . ....""""~:'""..~t. ":'."_"," . .;~...~i.., . ....'~ ,"'. _--:M,.,.':. .-rc-~:. ,'1" .:,,~~.....r:>: ''!'-:''...~....,.__ '" :f!.'':- '_..' '1-.:r""~,,.,'];.,\.,,,~~~,:,-,~,.,,..:._~,;,",,,, '_ "-'. ..~.".';':":"' 11 allfirst Allfirs! Rank ACCOUNT TITLE / OWNER DATE ,c1/-C/i) I ACCOUNT NUMBER .'. .. , '-., ...~ ".-C. ""I'll'") ..)-~ i. &0/ "lt/CG c..-._- ,~ J !. .... i ,\\._ E"..I ,/~;: . . /<1,../J.....--..:.J.,.. .. i ~(AMOy!!T MUST BE ~RITfEN IN WORPS) .\....- .) J " t _t-(..... -,.~\..._ () g '" Q. L " ',-,", -~,~~.....;'1. ' _.....~' ."._ -x" '''....~,.;~..^."._..;.. ,JI ,,' "'~.~~ 22300991~i AMOUNT: $10,016.28 DATE: 7/10/01 PAYEE: R~ESTATE OF : WESTON N. BEIL SOURCE OF FUNDS: CD CLOSING DESCRIPTION: #87008000386607 ACCT. NO.: CK.CHARGE: 0.00 ] ;= '1. ~ S T L ;')::= j'j ,\L~ TIC :'L~ :3 P: ,\):< , f~t'J" Deposit Account Close Confirmation Customer Name(s) and Address WESTON ill BElL ELEMIOR S BElL Taxpayer 10 Number 5172012928 O~e 4427 MAJESTIC LANE 09/08/2001 FAIRFAX VA 22033 ACCOUNT NUMBER: 1000661489988 Available Balance + Accrued .I.nt - Fed W/Hd Due - Admin Fee - Outstanding Db - Closing Fee $2,137.46 $0.00 $0.00 $0.00 $0.00 $0.00 PaId To Customer $2,137.46 Thank you for having chosen First Union for this account. If we can help you with other banking needs, please let us know. 537523 (5OIpj<g) CUSTOMER COPY PRINTED BY STANDARD REGISTER U.S.A. -f~N' TIME DEPOSIT WITHDRAWAL CONFIRMATION Office Name Middletown 1 W Middletown PA Customer Name(s), Address and Taxpayer 10 Number WESTON N BElL ELEANOR S BElL 4427 MAJESTIC LANE c: g iii E !O= c: o () 09 /OcPJ~oo 1 FAIRFAX VA 22033 3172012928 CURRENT BALANCE : + ACCRUED INTEREST: - PENAL TV Af10UNT - FEDERAL W/HD DUE: - WITHDRAWAL FEE : - OUTSTANDING PYMT: $6,000.00 $2.95 $0.00 $0.00 $0.00 $0.00 FULL REDEi'l!PTION CD ACCOUNT NUM3ER: 247412055715520 ... eD E ~ ::s () PP1ID TO CUSTOMER $6,002.95 537568 (5OIPl<g R..O') OFFIC1AL CHECK f~N. ~ -f,-;nQ;?~n;~t 1020 ;- ,",.-"" ...-,,..\d' _.- V v v . Pay To The Order Of : -, ~:: .; $ :~ ~;, 'i" - ;."t~,_:riC,~;::F: ~. L':I,",';L~, ,'"i'~'- Dollars For Issued By integratec Key8ank National Assc VlwagRQint BANK NON. NEGQT1ASLE Look for us. We'll get you therE. ry, 11 06 (1 OO/pkg) RECEIPT Acct# 41~Jv39420 Tlr# 3002 81140.41 lDCA Personal Dppn~it T~A~# 115 ON -'9/10/2001 9/v8/2001 .L'..I.' '?~'14 hM . '-",>, Hfl Ledger Balance 1591584.84 Check and other items received for deposit are sub'ect to the r " . . subject to delays in availability according to Bank P~IiCY. p oVlslons of the Unrform Commercial Code. Certain deposits are TEL-009 (10/00) THIS ISYOUR RECEIPT Member FOIC V1WayRqiraJ Look for us. We'll get you there. RECEIPT Acct# 4100039420 Tlr# 3002 286.75 lDDA Personal Deposit TRAN# 117 ON 9/10/2001 9/08/2001 11:27:35 AM Ledger Balance 159;584..84 PLEASE RETAIN THIS VOUCHER Check Date 08/31/01 247993750 Account No. Int. PInt. Federal W/H Net Int.PInt. 630104026 149.97 .00 149.97 630148209 25.41 .00 25.41 631139771 51.24 .00 51.24 656176995 60.13 .00 60.13 Total: 286.75 .00 286.75 ... w · t PO BOX 1711. HARRISBURG, PENNSYLVANIA 17105-1711 ... . aynoln 235 N. SECOND STREET. HARRISBURG. PENNSYLVANIA 17101 .717/236-4041 'BANK III 2 ~ ? q q :1 ? 50111 .:0 :100000001: ~OO? ~ :1111 ~nk Name FIRST UNION NATIONAL BANK Customer Number Customer Name 200129088 BEll" WESTON N Date Paid 09/05/01 heck Number Principal Amount 54-7183871 Interest Amount Transaction Amount .00 18.32 16.32 Certificate Number Pymt. From Date 24-741-205-5715520 OS/OS/01 Principal Amount .00 Interest Amount 18.32 ----~,- V1Waynoint I8ANK look for U5. We'll 9'et ~ou there. RECEIPT Acct# 4100039420 TJr# 3006 18.32 IDDA Personal Deposit TRAN# 50 ON 9/20/2001 9/20/2001 11:11:49 AM Ledser Balance 162;823.50 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-ODS (10/00) THIS I$VOUR RECEIPT Member FDIC REV-1511 EX+ (12-99) . . ~~ ....~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF WFS'1'ON N. RFIL FILE NUMBER 2001- 00812 Debts of decedent must be reported on Schedule J. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT Neill Funeral Home, Inc. Holiday Inn Harrisburg East (Wake Expenses) Gingrich Memorials (cemetery marker) B. ADMINISTRATIVE COSTS: None 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 None 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) None Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. ProbateFeesRegister of Wills-Cumberland County of PA Accountant's Fees none 5. 6. Tax Return Preparer's Fees none 7. '$13,850.00 1,119.78 1,809.00 270.00 TOTAL (Also enter on line 9, Recapitulation) $ 17 ,048.78 (If more space is needed, insert additional sheets of the same size) PLEASE RETAIN THIS VOUCHER FOR YOUR RECORDS 946804959 9/08/01 000000000400713 $*****13,805.00 CHECK MADE PAYABLE TO: EMERSON D CALE FUNERAL EXPENSES Y'IWayRRi!lJ PO BOX 1711 . HARRISBURG, PENNSYLVANIA 17105-1711 235 N. SECOND STREET. HARRISBURG, PENNSYLVANIA 17101 .717/236-4041 V1WayRRiflJ Look for us. We'l) get you there. RECEIPT Acct# 4100039420 Tlr# 3004 13,805.00 6DDA Withdrawal TRAN# 84 ON 9/10/2001 9/08/2001 11:45:43 AM Ledger Balance 159/584.84 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-009 (10100) THIS IS YOUR RECEIPT Member FDIC '---.~A~ := ;: . .~. - r-' .-'..,. - I' r- c. Pit:. r(::;Ut-4 ) i.!..HL::' ;) /! ern~~ ci). ~ 1 ["j:_" ii"!;,., ~ U'~. ;:~~ ,... ~ ':":-',':"_'! .o~ Name & Address RECEPTION ZZ-BEIL 641 VALLEY VIEW DRIVE BOILING SPRINGS PA ~" \t~ ~N\: HOLIDAY INN HARRISBURG EAST 4751 LINDLE RD HARRISBURG. PA 17111-0000 Phon'" (717) 939-7841 Fax: (717) Q39-9317 17007 Independelltly owned by ROLLINS REALITY TRUST alld op?rated by FINE HOTELS CORPORATION ~ DATE CODE REFERENCE ID DESCRIPTION CHARGE I 08/18 'l~~!18 291 914 0818000 0818001 DMK DMK V1WayRRipJ ~ BANQUET CHARGE rSA/MASTERCARD s $ 1119.78 .00 $ .00 $ -1119.78 Look for us. We'll get you there. RECEIPT Acct# 4100039420 Tir# 3004 1,389.78 6DDA 1,J i t hdr awa I TRAN# 85 ON 9/10/2001 9/08/2001 11:46:44 AM Ledger Balance 159,584.84 . f Room Arrive Date Dept. Date Folio# Room Rate Account MktlSeg Page PAYMENT Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-OOO (10100) THIS IS YOUR RECEIPT Member FDIC I -r-IT 'ACCOUNT NO. XXXXXXXXXXXXXXXX CARD MEMBER NAME xxxxxxxxxxxxxxxx ESTA~L1Si-iMENT NO. & LOCATION "'^BI.lSHMh-';T^"RrHi~ '.. XXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX, XX XXXXX x HGLrnRY lWl~Af,Hl:J!9J1\b 4751 U:~DLE RD HAF~RI.3tJJR8.., PA 1.7111 ,,' _',' '-, ~ I .~3;:;:.?::.;-,'~-'.:l:_ ......~ ~~ r. :~,~ J:'. Tn~[ 4;j~~Ft~'-":.<:~._L~fH[ 0Bi .tri/~~Jl . _. I .; ..~:~.l,',,,/~;,, y t"'oll .'\;;'-:I\:I"\'''\.''l'-i''It.~i!f\.Q TERf1!l1~1L~&S:J -;; dE;\it 'ij',-J'!)r../7'1r..~G'}n 1", T~~AN TYFt::_~-:S'At~E' !:L,'l'-:o-r,;C)'r.: ;-',-;-r;7>l.l!l::,i1P~ ":,il rt"""t~C.~;'......~~,~T:if.:f _ ,"_J .;;,~.:lv~ ,'J ElP DATE 07/94, CAHD T{Ft' VIS~i RCCfi 1 TICKET # i.tkQ7l7 AUTH CODE .?~jJ3~;V .-.r-'-' ',1 ~.4:.i:i if ~)18 TDTA.L ~*~:11 ~t r;;'~~ ::c;::f3 ~. /1 AY.4 .........." I '--1 f ,J :-rJ.h~ ," ' !.oiL- '. .. ' ..', ' .... -. . .. '._-. _", ,f. ,_' _ "',"""c.." 1'/1"','1 '. 0f-:r~Mf-.;; V J...i'!_i... Af~EE TO PAY {~ECl~;E TGTI:t r;j~[{f~T ;~C[-2F~DING TO G~.L ISSUER j';GfEEi~EHT /XX x '. - .-,...,~. 9067 08/18/01 08/19/01 1-1 .00 0-00001 8-BOUS 1 BALANCE $ $ 1119.78 .00 $ .00 J.D. XXX XXXXXXXX.XX XXXXXXXX.XX PLEASE RETAIN THIS VOUCHER FOR YOUR RECORDS 946804960 9/08/01 000000000400713 $******1,389.78 CHECK MADE PAYABLE TO: 'f'. BARBARA J CALE FOR FUNERAL, WAKE, AND REGISTRATION OF WILLS Y',WayRRi,rJ PO BOX 1711 . HARRISBURG, PENNSYLVANIA 17105-1711 235 N. SECOND STREET. HARRISBURG, PENNSYLVANIA 17101 .717/236-4041 RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 170b3 Receipt Date Receipt Time Receipt No. 8/31/2001 10:21:20 1026741 BElL WESTON NORMAN File Number 2001-00812 Remarks BARBARA J CALE AC ------------------------ Distribution Of Receipt ------------------------ Transaction Description PaYment Amount Payee Name PETITION FOR PROBA SHORT CERTIFICATE JCP FEE 235.00 30.00 5.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D Check# 1295 Total Received... ...... $270.00 $270.00 Neill Funeral Home, Inc. 3501 Darry Street Harrisburg, PA 17111 (717) 564~2633 Stephen J. Wilsbach, ED., Supervisor 3401 Marker Street Camp Hill, PA 17011 (717) 737~8726 Federick H. White, ED., Supervisor CONTRACT STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED CASE # Charges are only for those items that you select or that are required. If we are required by law or by a cemetery or crematory to use any Item, we will explain the reason in writing below. Arrangements for: vV/5 Tt> rI 1\/. , I) t~ I t- Date of Arrangement: Date of Death: Y-I; ? e !'..f SERVICES, FACILITIES, AUTOMOBilE, OTHER EQUIPMENT AND OTHER SERVICES: Itemized General Price List: Basic Professional Services of Funeral Director and Staff: Other Care of the Deceased: Embalming $ Sanitary Care of the Unembalmed Remains Dressing, Casketing and Cosmetology Post Autopsy Care/Post Organ Donation Restoration Charge Refrigeration Care and Custody While Sheltering Remains Other Care of the Deceased: Total Care of the Deceased $ Directing of Services and Use of Facilities: Visitation $ Funeral Ceremony Memorial Ceremony Graveside Speciai Hrs. Charge Total Directing of Services and Use of Facilities $ Automotive, Other Equip., Other Services and Other Charges: Transfer of Remains to Funeral Home $ Hearse/Coach and Driver Limousine/Other Passenger Vehicle and Driver Safety/Lead Vehicle and Driver Flower Van and Driver Utility Vehicle and Driver Cemetery tent and grave equipment Additional Transportation Charges: Total Auto, Other Equipment and Services $ And/or Personalized Service Program Package (a complete description of the package that you selected is in the General Price List provided you): $ Other Services: Immediate Burial $ Direct Cremation Without a Service $ Forwarding Remains to Another Funeral Home $ Receiving Remains from Another Funeral Home $ $ Total Service Charges with Personalized Packages $ IN'" 1.- I.e MERCHANDISE: Casket: {;/ f,\ T: \.1'" I:: Outer Burial Containers: ,)1" ;J, ,,,J.;;./"', Cremation Urn: Cremation Container: Clothing as Selected: Grave Marker: Acknowledgment Cards as Selected Memorial Register Memorial Folders/Prayer Cards Combination ~hipping Unit/Air Tray {"A ,",,, , , '... At '(.. . ",1, I' , '. <, ,n., r.' :~ I ['"q ''1 e 'i) ~i , ,. .~; f" .f.' J t...-, I ~) ~~) _'0- )...( "f.'}, Total Merchandise CASH ADVANCES: Sales Tax: Cemetery: i :;:;'>',('{:<., f~ /,' , ,',;. i.. ~- Death Certificates (No, , @$_ -",__J Permit Disposition/Burial Permit Medical Examiner's Charge Honorarium: MusiciansIVocalist: Air or Other Transport: Out of Town Funeral Homes: Newspaper Notices: TelephonelTelegraph/Fax: Motor Escort: {vlFtl/(f, L,lt. (:.,,::' '< It v' (;' :';; i~ (t .,) .,' ( l[ f::,) l S., (:) . -1'/ '');' "'0'''''''- ~...... fI,... \}1:5:.##~ ;jJe I- I Ale 1- If\h' f~ I Ntl- I ,:) l~) , ..,'U $ r~fq?J.-V'.J Total Cash Advances We charge you for our services in obtaining: SUMMARY: Basic Professional Services of Funeral Director and Staff Other Care of the Deceased Directing Services and Use of Facilities Automotive, Other Equip. and Services and/or Personalized Service Program Package Other Services Total Service Charges with Personalized PaCkages Merchandise Cash Advances Total Charges (Credits) to Account: Payments (cash, check, or credit card) Balance due after credits (Genenc - 9/28198 - AL. AK. AA, CO, CT, DC, FL. GA, HI, lA, 10, IL, IN, KS, KY, MA, ME, MO, MI. MN, MO, MS, NO, NE, NH, NJ, NM, NV, OH, OK, PA, PA, AI, SC, SO, TN. VA, WA, WI, WV, WY) 0~1(O ~".~ .... .~< ,:'" ,20 (), ,20 o.f $ 11'l'.r ",) 1 1-5 i'.} '..5 (j, (l(.. $ A ;:t7 ,(, .;...., $ / ,l' "~.;;" ,J.'.:i~ ,J." I () ,;), I. 1..0 i !,I ',,' ,> $ iJ ';'1 r) I 0/) $ $ J ...> 'I. ,.:;.. (NJ ':'1'1 () ,..!j ~,\ ...:l~l r J II ~ ~-,~,,~ ('J, ":~"'.?1 0/) $ ~~,!~~ ~~) '1".(:-r. ",""''''':~ 51)'">,'\...> ( ( ( ( $ Page 1 OF 2 LWN 32A_2724 Neill Funeral Home, Inc. 3401 Marker Street Camp Hill, PA 17011 (717) 737-8726 Federick H. White, ED., Supervisor CONTRACT STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED CASE # Charges are only for those items that you select or that are required. If we are required by law or by a cemetery or crematory to use any Item, we will explain the reason in writing below. 3501 Darry Street Harrisburg, P A 17111 (717) 564-2633 Stephen J. Wilsbach, ED., Supervisor Arrangements for: ; it., \ 'b I,' [:~(Ii ..' ,'1" - il SERVICES, FACILITIES, AUTOMOBilE, OTHER EQUIPMENT AND OTHER SERVICES: Itemized General Price List: Basic Professional Services of Funeral Director and Staff: $ I {.,Ie I. Other Care of the Deceased: Embalming $ Sanitary Care of the Unembalmed Remains Dressing, Casketing and Cosmetology Post Autopsy Care/Post Organ Donation Restoration Charge Refrigeration Care and Custody While Sheltering Remains Other Care of the Deceased: Total Care of the Deceased $ Directing of Services and Use of Facilities: Visitation Funeral Ceremony Memorial Ceremony Graveside Special Hrs, Charge $ "Nt 1:-.5'/.:.": r/{> Total Directing of Services and Use of Facilities $ . :;~)' 1') (lv ~ ~.1 t......., " Automotive, Other Equip., Other Services and Other Charges: Transfer of Remains to Funeral Home $ Hearse/Coach and Driver Limousine/Other Passenger Vehicle and Driver Safety/Lead Vehicle and Driver Flower Van and Driver Utility Vehicle and Driver Cemetery tent and grave equipment Additional Transportation Charges: 1"4 t )~- I. . I tJ (' i- i rl C L l A) "1-. Total Auto, Other Equipment and Services $ And/or PersonafJzed Service Program Package (a complete description of the package that you selected is in the General Price List provided you): $ Other Services: Immediate Burial $ Direct Cremation Without a Service $ Forwarding Remains to Another Funeral Home $ Receiving Remains from Another Funeral Home $ $ J '1(/ :).. t/u Total Service Charges with Personalized Packages ( 'I (f/) (11 $ Date of Arrangement: Date of Death: MERCHANDISE: '\ . Casket: 'f C:lm P () ','f: ,~i' ~ / 1..,/ n ",7 7' r-/ "'! ' , 20 01 .20 01 $ ? ,S5(} 00 Outer Burial Containers: {>f...:" )11 f'\L L. Oil) (: (-?L 1 <- II ti; .) \')1 III II UlJ' C~ tJ1~~S. Cremation Urn: Cremation Container: Clothing as Selected: Grave Marker: Acknowledgment Cards as Selected Memorial Register fl r/~Gt,- 1:5 Memorial Folders/Prayer Cards Combination Shipping Unitlt-ir Tray (fi\ ,~"rOt-,} \{"i',J'<-l . (,~J;~:" "r~.f'"~~J~t~~,) " /.';' 10 i F;'-'~1-' (( .:);.;1. Total Merchandise CASH ADVANCES: Sales Tax:. Cemetery: if 17)/~; . 1 IFu... (\-1"" Death Certificates (No. @ $ Permit Disposition/Burial Permit Medical Examiner's Charge Honorarium: 'PI'!! t:J)t ',';j li\ i~., Z. MusiciansNocalist: Air or Other Transport: Out of Town Funeral Homes: fl. .) ;~. ()I.) f, '...J ~ I..:).:) , rl,.') $ I :" 1r~ (::>{.i ;; " X'I, ""0' .J .. $ //55.{}!) !oo .'" Newspaper Notices: Telephone/Telegraph/Fax: Motor Escort: [ Vt ;:J / } i / j fr) (::: / ,(I Z , _ ", Total Cash Advances $ .:J.. ;,r f(o .(.0 We charge you for our services in obtaining: SUMMARY: Basic Professional Services of Funeral Director and Staff Other Care of the Deceased Directing Services and Use of Facilities Automotive, Other Equip. and Services and/or Personalized Service Program Package Other Services Total Service Charges with Personalized Packages Merchandise Cash Advances T(i)tal Charges (Credits) to Account: Payments (cash, check, or credit card) Balance due after credits $ $ I Phf ,W :'") , I,'? I);" () (" J:J'1?"Y' $ ,., ;:: '.;r. (j) . ,- ~, '.)' ~ " ( ( ( ( , $ ,enenc. 9/28/98 -AL, AK, AR, CO, OT, DC, Fl, GA, HI, lA, ID,ll,IN, KS, KY, idA, ME, MO, MI, MN, MO, MS, NO, NE, NH, NJ, NM, NV, OH, OK, PA, PR, RI, SC, SO, TN,.VA, WA, WI, WV, WYI Page 1 OF 2 LWN 32A_2724 James R. ingr;c/, MEMORIALS "A Tribute to Life" ORDER FORM Order 27847 Supplier Ack.# Date Rec'd Found. ordered Position verified 5243 Simpson Ferry Road, M~chanicsburg, PA 17055 . (717) 766-5622 I --r- ; , . .\ .-" j .~,- j SOLD TO: ---./ ,<, ~.~V J:j Z:. i .'- Complete ..' /-r,l ;'..~ O~?_ t-fJ Date of Order /1 1.. Cemetery I-Po:; PLCt rf J.i.-L. I ~r j Location r, ..... .:~. v+-. Center Over :;2.. Graves Approx. Date of Completion .{~ ~l U ,-} f-;:"::Z (I () I Z:U I ,I,} r :'5 :,j;, ,v .~ , .541..5" 3' rJ 1/ I ,1/ J l~(.~ /J .. .::;0:, Lot # ,:;:'7,-5. f) Phone (H) :2 .~, '17 '.:!' If- I / (W) 2. t"~ Lettering -------....--....-- -------g z: } L - '. --ro {.~Hf2x:. Fi'e2U2e LuZ.$70U >-.JtI~H.AAJ Z/.Zr1JJae ~r1t?M =i tl J.J Ib I I c...7 II -=:7 AAJ d-~ I Iq I~ A tJ(~ I Y. I r;(; PO I "jLJtJer ;1 {)O -- r:: A ..4 < ft" H /"'\ ,'7~-b".- Type of Memorial q '< -.; "!t:;' /'" :z ,~ Material Size .LJ.4:.,~ X~X Finish ---t5'Pou ";1...f Base X X Finish Misc. /' \ Design ( (!,;:(cnVNtJ ~r. 6/" ko s e. ) \ I Location: '/1./..ItcL--' 0.416 ZI;..;-<_ J o Vase -::f?X'OJJt.9 . (t!.I!~I.VN~s:~r-f:-1oSE , , / o Corner Posts $ $ $ $ $ $ /3/!) . IS4./. . ....<'; __ <1..5 I Agree to pay stated balance upon erection regardless of labor troubles or shipments or any other good reasons. This order or contact cannot be cancelled by customer unless agreed by both parties. The article herein mentioned shall remain the property of James R. Gingrich Memorials until paid in full and they reserve thenght to remove the same is not paid as stated. Price Foundation l~riAJ'T'L Agreement: A 50% deposit is required prior to commencement of work. I agree to carefully proofread all names and dates for accuracy and accept full responsibility for any errorsoromissicns. THERE WILL BE AN ADDITIONAL CHARGE FOR ANY LETTERING ADDED TO THIS MEMORIAL AFTER ERECTED ON THE CEMETERY. TOTAL DEPOSIT ) {)/1 . J ..' . ! (/k1 , I' I $ co Dealer Salesman (k;:::)5{r2tU~ '"_..-' Lt:~, /(1' - i WHITE/Otti~ YELLOW/Production . . REV.151'~3 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WESTON N. BElL NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Jack N. Beil 641 Valley View Drive Boiling Spring?, PA 1. 2. Barbara J. Cale 4427 Majestic Lane Fairfax, VA 22033 FILE NUMBER 2001-00812 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE son 1/2 of residue daughter 1/2 of residue 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Deceased Social Security No. 172-01-2928 31st day of August WHEREAS, dated May was admitted on the Register of Wills of CUMBERLAND County, Pennsylvanic Certificate of Grant of Letters No. 2001-00812 PA No. 21-01-0812 ESTATE OF BElL WESTON NORMAN (LA::i'l, r'.1.1<.S'l', J.VIHllJL-C:) Late of MONROE TOWNSHIP CUM.I::l-C:1<.LANlJ CUUN'1' Y. , 2001 an instrument 25th 1966 to probate as the last will of BElL WESTON NORMAN (LA::i'l, .l:<'.1. 1<.::i '1' , J.VUlJlJL-C:) late of MONROE TOWNSHIP CUMBERLAND County, who died on the 14th day of August 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to BElL JACK NORMAN 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 31st day of August 2001. 77,(J1l91<t~/6/~! * *NOTE* * ALL NAMES ABOVE APPEA...~ (LAST I FIRST I MIDDLE) We WESTON NORMAN BEIL AND SARAH ELEANOR BEIL of Harrisburg in the County of Dauphin and State of Pennsylvania, being of sound mind memory and understanding, do make and publish this our last joint will and testament, hereby revoking all former joint wills by us at any time heretofore made. All that we possess in the world We hereby bequeath to our two children as follows: (a) To our daughter, Barbara Jean Cale, one-half share. (h) To our son, Jack Norman Beil, one-half share. We name as the Executor of this our last will, our son Jack Norman Beil. IN WITNESS WHEREOF, We have hereunto set our hand and seal ,/' this J-S day of May, A.D. 1966. ) ,/1....,-- /" ,) .~? l!td;h?4#1t-?-? b*') ~;t d-,?t/ uJ{.;~ t' (SEAL) .,~ LilL I rf~_lld. h 1"( /,d~6.'a (SEAL) On this ~(day of May, A.D. 1966, the foregoing instrument, was signed, sealed, published, and declared by the above named WESTON NORMAN BEIL and SARAH ELEANOR BEIL, as for their last joint will and testament, in the presence of us who have here- unto subscribed our names at their request as witnesses thereto, in the presence of the said Testator and Testatrix and for each other.