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HomeMy WebLinkAbout01-0904 PETITION FOR PROBATE and GRANT OF LETTERS Estate of 't-IJ"'k I A '" fV1, t3 A R LC;- No. c;;l / - 0 I - q 0 c.{ also known as To: Register of Wills for the . Deceased. County of ~uMgmLANn in the Social Security No. (~ 0 - 0 q - g ''1 'i- 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 execut fJR in the last will of the above decedent, dated and codicil(s) dated 7~tC'tt ,r;~~~C'E A <;~) (lA-O\WO l-til...L pA- I,{)I' , (state relevant circumstances, e.g. renunciation, death of executor, etc.) named , 19~ /.l PI? , L II I I q q 3 Decendent was domiciled at death in (!Um SE'flLANJ) County, Pennsylvania, with h .E12 last family or principal residence at 74 F="J:)iEWAi 1)1?'v~) Q~m to f...I ILl.- , (,0' , (list street, number and muncipality) ,~~oo I , 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: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -rE:S-rR mENrA (2'( (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. - '" '-' <IJ U ~';i;' \), A rJ~ ~. m,q/2 '(.$ U Q~~Il\~'f~: fQ"l~ I 3~ <IJc.... 50 ~ s::: bO l:i3 r1J {Jl~ 0___ (! .0IL ~ OATH OF'PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF (' VMBFPLANt) 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 adminis~e estate according to law. swo.rn to or affirme~d SUbscribed. { ~ e.YH1~ ~ 4b f~oree t~hiS ~. , d~~~,r( ~. _ ~ _ ~ ~v DIArJi-= C fYJAavS ~ . ~~n~.L' .f!..~' ~ R~~~ ~ /7 - /,... '-I No. 21-01-0904 Estate of LILLIAN M. GABLE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTOBER 2nd ____. .0_. ______ ~~l, in consideration C "-J-'e twtlticw. 'om the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated FEBRUARY 4, 1975 described therein be admitted to probate and filed of record as the last will of LILLIAN M. GABLE and Letters TESTAMENTARY are hereby granted to DIANE C. MARKS ~a Jt.u.c:oI?.IN t!.4..K~ fJNWiy-, I ' Register of Wills FEES P b L E il' 18.00 ro ate, etters, tc...........;> Short Certificates( 2) . . . . . . . . .. $ 6 . 00 ~.EX'l'U.r.G.l... $ 3.00- JCP $ 5.00 TOTAL _ $ 32.00 Filed . 9~.rr:Q~P:R .2,. 2.QQ~. . . . . . . . . . . . . . . . ATTORNEY (Sup. Ct. LD. No.) ADDRESS PHONE MAILED LETTERS AND ORDERS TO EXEC. OCTORBER 2, 2001 21-01-904 \REGISTER OF WILLS OF COUNTY "'" OATH OF SUBSCRIBING WITNESS '. '\'" '-" codicil (each) a subscribing witnes 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\~t signed as a witness at the request of testat_ in h prese~'c6.,_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 REGISTER OF WILLS OF CumLJE~.(,O COUNTY OATH OF NON-SUBSCRIBING WITNESS ~UJMO.)~ . 9it~ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that I AM familiar with the signature of ,Z/J..J.. IAN In. (l,AI?JL~ codicil testatfi'f of (one of the subscribing witnesses to) the ~ presented herewith and codicil that . .I believithe signature on th~iS in the handwriting of oClLLIArI 117. a1l8L~ to the best of -Pi Y knowledge and belief. Sworn to or afflrmed and subscribed before ~i'14(O (!"" ~~tJA../J~ m, th~ t3 ~ .::;; (Name) I / (] ~_ 1'1 F.4/f)WIIV UR.. (kmPHILl/rA ~f. ~U.)(J,'P" .(I.G, .,v:;..iIAJ)J~41"' ~ fAddreSS)' Register U l,cftV€ Q. /Y) AR /( S ~ (Na'!J!l. OV';":' 71.( F ~ I ~ /,f;A Y lJ,Q., (! "7 m F' !il L ~ fJ. (Address) 21-01-904 REGISTER OF WILLS OF (2 i.l lu h/~Rb9/t1i~ COUNTY OATH OF SUBSCRIBING WITNESS ;S; h 11 ,S' I / . i~ ~ codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that h~ llJ/L's present and saw L III ,(1 () IrJ (~f1,h Ie the testa~ y , sign the same and that he signed as a witness at the request of testat-u-- in hl"- presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). i:: P.JA .... (Name) [Of M~ V. ,t~bJlJj) (4, , , . I (Address) Sworn to or affirmed and subscribed before me this I .<Jf day of (Q~Ln!JlU . '/ ~ -...ml]', -; ~ . /J ./1 /l/l ni2 (')" 1). it " )(..(/Uj t . I ..10 ~. e, (l .:.fi.L 11..) uJ'Li~ - ,I' I , Register (Name) (Address) REGISTER OF WILLS OF (! (llU hcPMI'//.J COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil testat_ of (one of the subscribing witnesses to) the will presented herewith and codicil that believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) O'.?~" ':;'~;'~~:G is to certify that the information here given is correctly copied fron: an original certificate of death durir filed with me as Loed Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent 1 mg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. t2~ //( q;;;A-~ Local Registrar Fee for this certificate, $2.00 p 7621506 AUG 3 1 ZOO1 Date 143,..". Vl7 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (f".. MidlM. L., 1. Lillian Good Gable AGE (laIIlIorlNIayl UNDEA 1 YEAR UNDEA 1 M Iolonh 0.,. HaIn!,....... SEX female SWIFU~ SOCIAL SECURITY NUMBER 3. 180 - 09 -3174 DAlE OF DEATH oMonIh, OII~. ._, Aug.29,2001 ~en Twp. OECEDENf'S USUAL 0CCUPlIlJI0N KINO OF 8USlHESSIINOUSTAY (~.g.a:::.:::2."" 11~t:ary dealership OECEDENT'S UAIUNO ADDAESS (SIr...~. s... Zip COlNl OECEDENrS 74 Fairway Dr. ~ --- 1a. Camp Hill, PA 17011 onOlNlr'" MIHER'S NAME IFnI. ~.lMIl 18. Frank Good WOIlMANTSIWIE (T~iane C. Marks 8IRTHI'LACE (C.ty alICI ~OI fa-.gnClulrn PUCll OF DEAfH lCNdI only """ - .... .,.,ucLo<>s on _ _I HOSPITAL; OlHER: I",**" 0 ERIOuIpMiM 0 ~ 0 :::=- 0 L lMI\S DECEDENT EIlER IN u.s. AJUotEDFOACU? 11. -.0,.9' 1~ 2 11L SUIe Pennsylvania DlcI ....... ... in a t7lt.~ClmIberland ......., 11..0 =--:-':::01 MOTHER'S NAME iF... ModdIe. ..... Sur~ 1 Lillian S rout ....fl1Tc:r:=~c:...~ittl'~A 17011 if~er.===- 1;;:::== ,~A~7011- ~fu~~lb1e &.nan Stv.-324 ~~ ~~c-_ --~r~5diqIS-L J~;:~~roL_ r::eAEFEMEDTO:OUAaMNE~ . ...,tf --- - j ~ PAln'I: DIler....... ClIlIIdIiaM CIlIlWibulInQ ....... buI :...,.,.__ lIIIl.....,in..~_gl.-ilI """ I. I OIIMI aIld dealIl , I , DECEDENrS EDUCATION MARITAl.. SWUS....... ~ MIniM. WlcIDlIoM. eoa.oe 1lIoGtcMC5PKM (l'~Of$+1 lyidowed 1'c)Cl........... ...... ::.v, 0 SUAVlY1NG SPOUSE I..... gooe_"""'" CilpW. E DUE 10 lOR AS A CONSEQUENCE OF): WERE AlJTOf'SY FIiIOINGS ~ PAIOI'IlO c:owoumoN "CAUSE OF DERH? liIAHNER OF DEATH DATE OF INJURY 1-. Oey, ....) TIME OF INJURY INJURY Af WORK? DESCAI8E HOW INJURY OCCl.IMED. HaIr" ~ o ~ ~~ ... 0 NoD No~ ... 0 No ~ AI:cidM Suicide CouId_be~ :IlL 2Ib. a. C81r.... ~ 0flIy one\ oCEllTlPY1NG PHYSICIAN ~cerWwong.,... d _ _ __ p/1yIC_ '* pronounc:ecl ClNII atlO cOlnllllllld ft.... 231 To........oI.'~.duIIt............._.._cauM(.I.....___.......,......................,....,.....,.............., . OMEDeCAL EXAMlNERICOROHER On .... bHIa of ..emIna1lon and/or 1nVe......ion.1n my opinton. d.ath occuned .t .... 'Ime. d.... ~ p1ac.. end due to .... c:euM(s) and )1.~ .. at.1... . .. . . . .. . . . . . . . . . . . . . .. . .. . . . . . . . . . . .. . . . . . .. . . . . . .. .. .. . . . . . . . . . . . . . . . . .. . . . .. . .. . . .. .. . . . . . . .. _. REGIST~:~~MU~ .. (,bA-'V'" "C o/~ j.l(~/~ I .. jSlGHArUAE AHo TITlE OF CERTIFIER )(! 31... IlJ~..h?I ()~ .lll-~ IUCENsEmR . u .. ToRE~~.~.'llIat) ./ o 31.. . . 1J~{'L~131!1. ~lfWdlrr ~(), _ZlPL =2~~~OFPERSON~CAUS€e~(U:. o U. -V ~.~A-_L"1D~_ C!::;~"'d 0 0 ;- ...,--,---~--- _ (/.. r- OPR0MQ41NC1NQ AM)CEJlTU'YINQ~1PhY-=- bcllh "",nou,,,,"'Il_ _cetlllylnglO~ d_' To'" ..... 01 "" _-.. _...._.... _. ...... _ pIec.. and.... to tile cUMI.. 1nII_ as -'atM.. . . . . . . . . . . . . . . . . . . . . . . . . llNOLD, SUKE & BAYLEY ATIORNEYS AT LAW 2 J O!/ KUKET STl.EET All, HILL, PENNSYLVANIA 17011 21-01-904 LAST WILL AND TESTAMENT OF LILLIAN M. GABLE I, LILLIAN M. GABLE, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testa- ment, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and fu- neral expenses out of my estate as soon as may be practicable af- ter my death. II - I devise and bequeath all of my estate of every nature and wherever situate unto my husband, Henry J. Gable, Jr., providing he survives me by sixty (60) days. III - Should my said husband fail to be living on the sixty-first (6Ist) day following my death, then I devise and bequeath all of my estate of every nature and wherever situate unto my daughter, Diane C. Marks. IV - All taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be considered a part of the expense of the administration of my estate, and my personal representative or representatives shall have the absolute power in his or her discretion to pay the same at once whether or not the law under which they are im- posed permits the postponement of all or part of them to a later time. v - I appoint my husband, Henry J. Gable, Jr., Executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as such, then I appoint my daughter, Diane C. Marks of Leola, Pennsylvania, as Executrix of this, my Last Will and Testament. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. ~ !.~~&-rrAA f ~d.J'c Page 1 this, the IN WITNESS WHEREOF, I have hereunto set my hand and seal on d day of ~~ i/~ V1{h~ (SEAL> -Lillian M. Gable -f"t-It , 1976- Signed, sealed, published and declared by LILLIAN M. GABLE, Tes- tatrix therein named, on this and one (l) other sheet of paper as and for her Last Will and Testament in our p~esence, who in her presence, at her request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~p~ / J.. Name lJ ~.1;--edIA. Ad ress / ~dJh~ (Name ~Ad6,4 . NOLO, SUKE & BAYLEY A1TORNEYS AT LAW 2109 MAAII.ET STIlEET Page 2 MP Hn.I.. PIlNNSYLVANIA 17011 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Lillian M. Gable Date of Death: August 29, 2001 Administration No.: 21-01-0904 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was given to the following beneficiary on October 19,2001. Diane C. Marks 74 Fairway Drive Camp Hill, P A 17011 .,.- ...- . ,if'or"V' { C Notice has now been given to all persons entitled thereto Date: October 19, 2001 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RICHARD L PLACEY 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 -------- fold EST A TE INFORMATION: SSN: 1 80-09-31 74 FILE NUMBER: 21-2001- 0904 DECEDENT NAME: GABLE LILLIAN M DA TE OF PAYMENT: 11/28/2001 POSTMARK DATE: 0010010000 COUNTY: CUMBERLAND DATE OF DEATH: 08/29/2001 NO. CD 000565 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,636.96 I I I I I I I I TOTAL AMOUNT PAID: $2,636.96 REMARKS: DIANE C MARKS C/O RICHARD L PLACEY ESQUIRE CHECK# 3532 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS /1-//-1 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 RICHARD L PLACEV ESQ PLACEV & WRIGHT 3631 N FRONT ST HBG PA 17110 Recoru", DATE. RelJj~J;. ~EsfATt OF DATE OF DEATH .02 JAN 2i~~~~~~ER ACN 01-21-2002 GABLE 08-29-2001 21 01-0904 CUMBERLAND 101 ~S~ 'W'J' C/ REV-1547 EX AFP (12-00l LILLIAN M (I" p~ Allount Rellitted C,erK' Glllnb8nd!:' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=is47-ix--AFP-fi'2-:ooi--NO;:YCE--OF-iNHERiTANCi-YAX-A-PPRA-isEifENT~--ALLOWANCi-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GABLE LILLIAN M FILE NO. 21 01-0904 ACN 101 DATE 01-21-2002 CHANGED I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will r~lect ~igures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. A.ount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 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) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets 1I) (2) (3) (4) (5) (6) (7) .00 3.00 .00 .00 .00 75,214.25 .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 (9) UO) 13,533.92 .00 1I1) (2) (13) 1I4) NOTE: .00 X 00 = 61,683.33 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 75,217.25 13.533 92 61,683.33 .00 61,683.33 1I9)= .00 2,775.75 .00 .00 2,775.75 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-28-2001 CDOO0565 138.79 2,636.96 TOTAL TAX CREDIT 2,775.75 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .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 "CREDIr' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) C/ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF.DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lillian M. Gable Date of Death: Auqust 29, 2001 Estate No.: 21-01~0904 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 x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: (date) 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? y~ ~ X B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) C. Did the personal representative state an account informally to the parties in interest? Yes 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. CJ a: p ..L:l ,;: s= 9:~ S !'JO Date: March 7, 2002 WI 9 2. f"'") ,-- 0::: -::::r::: :c (717) 236-9577 (MAH:nntlAM3) Telephone No. Capacity: Personal Representative x Counsel for Personal Representative R.W. - 58 RE]' isoo EX !6-llW COMMONWEAlTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 C- REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFicIAL USE ONLY o 9 0 4. ----- NUMBER COUNTY CODE I- Z W o w o w o DECEDENrS NAME (lAST, FIRST. AND MIDDlE INfTlAl) GABLE, Lillian M. DATE OF DEATH (MM-OO-YEAR) DATE OF BIRTH (MM-OD-YEAR) August 29, 2001 August 18, 1910 (IF APPlICABlE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAl.) n/a w .., :ll:~1I) oll:::ll: w~o :1:00 011::....1 ~ID ~ 4( IX] 1. Original Return o 4. Limited Estate IX] 6. Decedent Died Testate (AIIach c;opy of WI) o 9. litigation Proceeds Received SOCIAl SECURITY NUMBER 180 09 - 3174 THIS RETURN MUST BE FILED IN DUPlICATE WITH THE REGISTER OF WILLS SOCIAl SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (dale of dea1Il after 12.12-82) D 7. Decedent Maintained a living Trust (AIIach c;opy of Trust) D 10. Spousal Poverty Creal! (dale of dea1Il_ 12-31-91 and 1-1-95) D 3. Remainder Refurn (dale of _ prior 10 12-13-82) o 5. Federal Estate Tax Return Required 8_ Total Number of Safe Deposit BOxes o ". Election to tax under See. 9113(A) (AIIach SchO) ~ z w o z o ~ II) w II:: II:: o o NAME Richard L. Placey, Esquire F1~J~") Wright TELEPHONE NUMBER (717) 236-9577 3631 North Front street Harrisburg, PA 17110-1533 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation. Partnership or SoIe-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & MisceRaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Bil6ng Requested 1. Inter-VIV~ Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Totaf Gross Assets (total lines 1-1) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Oecedenl, 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 GovemmeniafBequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) z o ~ ::) !:: D. ~ o w 0:: 14. Net Value Subject to Tax (Line 12 minus line 13) COMPLETE MAILING ADDRESS (11) 13,533.92 (12) 61,683.33 (13) .00 (14) 61,683.33 SEE INSmUCTlONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) z o ~ ~ ::) D. :i!: o o g 16. Amount of Line 14laxable at lineal rate 11. Amount of line 14 taxable al sibling rate 18. Amount of line 14laxable at collateral rate 19. Tax Due 20.0 ~ -- - ~ ,- - - -- ~ - -- - - -- - . - - - - - - -- ~- - ~ ..... ~ _; ~- ~ _ ~- , . ~, : _ n _ T_ _ _ - - - - - - . - - ~ - - - - - - - - - - - -- 61,683.33 x.O_ (15) x .045 (16) x .12 (11) x .15 (18) (19) '2:;775.75 2, 77'5. 7 5 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT RfV.1503Ex+(l-97) '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT LILLIAN M. GABLE FILE NUMBER 21-01-904 ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Applied Medical Devices, Inc., 200 shares common stock (Valued at $.01S/share) $ 3.00 (See stock valuation attached) TOTAL (Also enteron line 2, Recapitulation) $ 3.00 III; ___ ___ ~_ ___..1......1 :__........ .....4...:..:............. ....&................ J .......... ........-- ....:-_\ ~istorical Quotes Page 1 of1 ~!FINANCE~ Finance Home - Yahoo! - Help ~orelnfo:~IChartINewsIPTofileISEC Historical Quotes AMDI.OB Month Day Year Start Date: I~~~. ~~, LO!.! End Date: IA~~. L2~: l~1. @;' Daily C Weekly C Monthly C Dividends Ticker Symbol: 1C3'!1~i:()~ Date Open High Low Close Volume Adj. Close* 29-Aug-01 0.015 0.015 0.015 0.015 52,000 0.015 Download Spreadsheet Format * adjusted for dividends and splits, please see F AQ. Questions or Comments? Copyright @ 2001 Yahoollnc. All rights reserved. Privacy Policv - Terms of Service Historical chart data and daily updates provided by Commodity Svstems. Inc. (CS/). Data and information is provided for informational purposes only, and is not intended for trading purposes. Neither Yahoo nor any of its data or content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. http://chart.yahoo.com/t?a=08&b=29&c=01&d=08&e=29&f=0 1 &g=d&s=amdi.ob&y=O&z=... 10/24/01 REI/.1Sl9 EX + \1.&1) . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT LILLIAN M. GABLE FILE NUMBER 21-01-904 ESTATEOF If an asset was made joint within one year of the ~I date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Diane C. Marks 74 Fairway Drive Camp Hill, PA 17011 Daughter B. c. JOINTL Y-OWNED PROPERTY: lETTER DATE DESCRJPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE lncIlde name ct finMcialinstilulion and bri a:coont number or simiIlr iden1ifying number. A1Ia:h DATE OF DEATH DECO'S VAlUE OF 'IlMIlER TENANT JOINT deed for joinlIy-beId real eslalB. VAlUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 9/99 Fulton Bank C.D. 022-0114156 Principal - $40,000.00 Interest - $ 46.51 40,046.51 50% 20,023.26 2. A 10/92 Waypoint Bank C.D. 466238875 Principal - $25,002.66 Interest - $ 116.04 25,118.70 50% 12,559.35 3. A 11/97 Waypoint Bank C.D. 466316856 Principal - $10,000.00 Interest - $ 46.41 10,046.41 50% 5,023.21 4. A 2/84 Allfirst Bank Checking 0038303124 6,320.70 50% 3,160.35 5. A 3/98 Allfirst Bank C.D. 87008141076450 - Principal - $40,003.69 Interest - $ 72.47 40,076.16 50% 20,038.08 6. A 4/93 UGI Corporation 1,000 shares commo Hi-$28.99; Lo-$28.52; Valued $28.8 28,820.00 50% 14,410.00 (See bank letters and stock valuat on attached. ) TOTALJAlso enter on line 6, Recapitulation) $ 75,214.25 (If more space is needed. insert additional sheets of the same size) FUlton Bank CAPITAL DIVISION · LANCASTER/CHESTER DIVISION DROVERS BANK DIVISION · GREAT VALLEY DIVISION (717)291-2437 October 30,2001 Placey & Wright 3631 North Front Street Harrisburg, Pennsylvania 17110 Dear Mr. Placey: RE: Lillian M. Gable, deceased August 29, 2001 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Mastercard # 5401132009003141, open 2/1990, limit $8,200.00, balance $-0-, last paid 8/15/01, in her name only. CD # 022-0114156, open 9/22/1999, matures 9/22/2004, balance $40,000.00 and accrued interest $46.51; paying 6.06%, joint with Diane C. Marks. The decedent also has a safe deposit box, # 212 at our West Shore Branch, in her name only. If you should have any further questions, please do not hesitate to contact me. Very truly yours, " ~~.~ Karen D. Hillegas Credit Inquiry Processor - "ONFIDENTI 0,,<< lJ tl ~gH*- f t. ".. 'urr,;gho"! '.l~ ~ 'tis In orma {On b I , " ..v1J ,. : answer to your inquiry, :. lO responsibility is assumed .by t, . '~~,--"n ;t.~ opinion herein exPfessed IS subiBCtto chaH~,'c; POBox 4887 " Lancaster, PA 17604 www.fultonbank.com 1-800-FULTON-4 ~IWay~i!'J LOOK FOR us. WE'LL GET YOU THERE. 10/26/2001 PLACY & WRIGHT 3631 NORTH FRONT ST HARRISBURG PA 17110 The information which you requested on the account(s) of LILLIAN GABLE DECEASED (Social Security Number 180-09-3174) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership ITO ITO Name of Joint DIANE MARKS DIANE MARKS Owner, if any Date Ownership Was Established 466238875 CERTIFICATE 10/13/92 25002.66 116.04 2~1l8.70 466316856 CERTIFICATE 11/06/97 10000.00 46.41 10046.41 10/13/92 11/06/97 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Infonnation Requested ~~r SENIOR SERVICES REP. P.O. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-B66-929-7646) . www.waypointbank.com Nov 05 01 05:39p ALLFIRST CIS 3029342955 p.2 !l allflrst MUir,! Fin;;ncial C;:nLcr N..'\. 1'0 Oox 900 Millbonl. DE 19966 November 5,2001 Pll1cey & Wright Attorneys At Law 3631 North Front Street Harri!lburg, PA 17110~1533 Re: E\'lllle olLiilian A-l GaMe Social SecurilV: 180-09-3 J 74 Dale ot'Dearh: Auf{1.JS/ 29. 200} DcaI' Sir or Madam: PCI' yo,Jr inquiry dated October 19.2001 please be ::dviscd that at the time of death. lite above-nilmed decedem held on deposit with this bank the tollow;ng' I. Type ojAt'counr Golden A<~e Checking ACL'ounr Number 0038303/24 O'tlnership (:Vunu:s .;f) Lillian M Cable, Owner Diane C. ,Harks, Owne" HenFJ:J. Gable, DEeD Openi/1R Dule fJ2/28/84 Balallcr? un Date o.fDealh S6,320.70 .-lc.:crlled IJ1!ere.w s ()(XJ Jf )fa! $6,320. 70 ') 1;1W '~f4ccu!/nl Cerlijica[r! ojDeposil tlcCt,unt Numher 87008 f.I I 076450 O'i xrship (Nam<-'S (!I) Lillian M. Gable, O>mer Dhme C. Mark\'. Owner Op":/ling Date 03//8/98 Bd(mct;;' Ol? Date of Demh f40,003.6Y 4 cV/'1i(.:d Imere.I'! :; 72.47 Tow': UO.076./6 Nov 05 01 05:39p ALLFIRST CIS 3029342955 p.3 7i'::s fl:"\'l.!.i' (ft-.:..... n.....,r hrc/ude (HI,,\' t/cmflnt.'i in )I'hid111~c Jl'c(.'(J,,'(~d may have (JeeJ1 "'~tcd as PU1ft:r OlrJlff}f't1i..')'. C'fstodi'::OlI)! CJ/ijnl'HI Trlln.~ii!fs; PM!p"',Jll'C11(OI(W:! Paye'c, 0," ",,.((sfcr.: lmdcr a ff'ri/tc::n ..fgn:ement. ForJi:rlher ()(X{)~cJl i~.fol'ma/i()lI. .::ios,u"e,S (lild/or reimbw.'i!:IlIt.'It/ ~I.jimd,\' re.ter fa helr)}:- hranr.l1: wrST SnORE I'LA"_'\ OJ'FICI: 1200 M\RKET STREET Lt:::\10YN[, "\ 171143 711-25:'-2271 $lOcerely, ./ lv' / \ , 1/ ,- 11 ~V11. J~(/v~.;Lt.( StI<! i, inlbJe Assislant I Cis Services, (302; 934-2909 Jiistorical Quotes Page 1 of 1 ~IFlNANCEim1 Finance Home - Yahoo! - Help More Info: ~ I Chart I News I ProfIle I Research I SEe I Msgs I Insider Historical Quotes NYSE:UGI Month Day Year Start Date: L~~JL. ~~-.J 101 j End Date: 1~u.~.1?9 J lq~.:. @ Daily C Weekly C Monthly C Dividends Ticker Symbol: I~~i Date Open High Low Close Volume Adj. Close* 29-Aug-01 28.62 28.99 28.52 28.98 2,068,900 28.98 Download Spreadsheet Format * adjusted for dividends and splits, please see FAQ. Questions or Comments? Copyright @ 2001 Yahoollnc. All rights reserved. Privacv Policy - Terms of Service Historical chart data and daily updates provided by Commodity Svstems. Inc. (CS/). Data and information is provided for informational purposes only, and is not intended for trading purposes. Neither Yahoo nor any of its data or content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. http://chart.yahoo.com/t?a=08&b=29&c=0 1 &d=08&e=29&f=0 1 &g=d&s=ugi&y=O&z=ugi 10/19/01 ~~~.,.." . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS LILLIAN M. GABLE FILE NUMBER 21-01-904 ESTATE OF Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. 2. Musselman Funeral Home, Inc. Rolling Green Cemetery $ 8,774.50 760.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative s Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address n/a City State Zip Year(s) Commission Paid: 2. 3. Attomey Fees Placey & Wright 2,500.00 Family Exemption: Of decedent s address is not the same as claimant s. attach explanation) Claimant Diane C. Marks Street Address 74 Fairway Drive Camp Hill City Slate P A Zip 17011 Relationship of Claimant to Decedent Daughter 4. Probate Fees Cumberland County Register of Wills 32.00 5. Accountant s Fees 6. Tax Retum Preparers Fees 7. 8. 9. 10. 11. 12. 13. Johns Hopkins - debt of decedent Lower Allen EMS - debt of decedent Hampden Township EMS - debt of decedent wes2 Shore EMS - debt of decedent CPO - debt of decedent Special Care - debts of decedent Reserve for future costs, taxes and expenses 40.99 100.00 75.00 40.80 16.56 194.07 1,000.00 TOTAL (Also enter on line 9, Recapitulation) $ 1 3 , 533 . 92 (If more space IS needed, insert additional sheets of the same size) REV-1513 EX + (1-97) '* SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT LILLIAN M. GABLE FILE NUMBER 21-01-904 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not listTrustee(s) OF ESTATE ESTATE OF NUMBER I. NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Diane C. Marks 74 Fairway Drive Camp Hill, FA 17011 Daughter Entire Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) .00 .0, SUKE '" BAYLEY ToRNI:YS AT LAW 09 WAl.KI!T SR..aT ILL. PBNNSYLVAN'A 17011 21-01-904 LAST WILL AND TESTAMENT OF LILLIAN M. GABLE I, LILLIAN M. GABLE, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testa- ment, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and fu- neral expenses out of my estate as soon as may be practicable af- ter my death. II - I devise and bequeath all of my estate of every nature and wherever situate unto my husband, Henry J. Gable, Jr., providing he survives me by sixty (60) days. III - Should my said husband fail to be living on the sixty-first (6lst) day following my death, then I devise and bequeath all of my estate of every nature and wherever situate unto my daughter, Diane C. Marks. IV - All taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be considered a part of the expense of the administration of my estate, and my personal representative or representatives shall have the absolute power in his or her discretion to pay the same at once whether or not the law under which they are im- posed permits the postponement of all or part of them to a later time. V - I appoint my husband, Henry J. Gable, Jr., Executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as such, then I appoint my daughter, Diane C. Marks of Leola, Pennsylvania, as Executrix of this, my Last Will and Testament. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. /<) ~/~~t~ vr ./7dJc Page I .. . ' '-;:, 1lNOlO. SLlKE .,. BAYLEY ArrORNI'VS AT LAW 2109 MAIK-IT snlET UlI. HILL. PIIIN"NSV\.YANIA 170t I IN WITNESS WHEREOF, I have hereunto set my hand and seal on ,.- day of -77~ ~~ '1h~ (SEAL) Lillian M. Gable this, the ~rlt , 1976,- Signed, sealed, published and declared by LILLIAN M. GABLE, Tes- tatrix therein named, on this and one (1) other sheet of paper as and for her Last Will and Testament in our presence, who in her presence, at her request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. \kf~ 11- Name / ' eJ ~/,4~ Ad ress . ~dJ0~~ (Name 4~ /1 ..' ..~ , Ad ress )- Page 2