HomeMy WebLinkAbout01-0971
Estate of . \-\Gt"{(\ e+ C -:b(@.pe.r
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
~;){ -01 -97/
No.
To:
Register of Wills for the
Deceased. County of ~fYl~' ~ti in the
Social Security No. ~~ I ' ~ - ~ 1 <34 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age~\ ?~ef an the execut.( IX
in the last will of the above decedent, dated ~
and codicil(s) dated
named
,19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~mb-u \OI\d CountYh Pennsy~a~~1 with
h t (' last amily or prin_cipal residence at ~ 5 e. L'6 b Uf'f\ a.d) ocr~m~~le.
u ~ \\ T~j
(list street, number and muncipality)
Decendent, thell lP 5 years of jl,ge, die~:-=J q~\ . l'J:OlOCI ,
at ;;J.S E. Li ~ buq"\. It(j) ljQvJm~Q._
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 Fa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ iO) ~O()
$
$
$
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
of the last will and codicil(s)
tion c.La.; administration d.b.n.c.La.)
theron.
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OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF ~m~ \~ot'~ .
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 welA and truly administer the estate ac<:ording to law.
Sworn to or affirmed and subscribed ~~ '(It. 'ra.~~ f!l
. ~Qefore me thIS ?7nd day of ~
- . ~-- - -r.uas 0... tJ\. "^ ~ l..0 \ , . a
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No. ?1-01-Q71
Estate of
HARRIET E DRAPER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
crrmRRR ::n+-20.0L_.___: 9__. in con~ideration c:' "I~!~ petitior~. Dn
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated Q-1 11-1 qqc;
described therein be admitted to probate and filed of record as the last will of
HARRIET E DRAPER
and Letters testamentary
are hereby granted to 'T'prp~~ M Mt""'T r.nl)11.1 ; tl
77/() ~<,u~-?",,<)40
. R~r of Wills /~
/
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
1f~<e~~ion ................
JCP
SO.OO
n.OO
27.00
5.00
88.00
$
$
$
$
TOTAL _ $
AITORNEY (Sup. C:. LD. No.)
ADDRESS
Filed
PHONE
1105.805 REV 9/86 h
This is to certify that the information here given is correctly copied fro~ an original certificate of death duly filed wit me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
?;~L> ;(~ ~
Local Registrar
Fee for this certificate, $2.00
p
7691056
~~~J I ~ oloCJ I
~ Date
Item #- 3
~,^/-J.d- -
sho:.J I' b-L
~ 101
21-01-971
f./(
HI05 ;4JR.. 2187
COMMONWEALTH Of PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
,YPflPAINT
IN
PERMAIoEN r
BLACK INK
~
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~
a
~
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4. Se tember 17 2001
NAME Of DeCEDENT If.~;'~.(;dj;~--- _u__.___._
OAIE Of OEArH.McnoIt. Ua,. ~,
BIRTHPlACE (Co"_
3ta.. Of fCftlql COUflh'VI
5.
COUNTY OF OERH
65 Y..
::;1Iy,D
III.
CUmber land
RACE . Amencan Indian, 8lack, Wh.a. oIC
tSpeao,I
white
DECEDENT'S USUAL OCCUMJION
\~=: ::io"::'::::'.:2.:i'
. .... Office Administrat Accoun i
DECEDENT'S MAILING ADORESS (SI,.... Cllylbon. SIaIe.l"op COdeI
25 East Lisburn Road
Bowmansdale PA 17008
SUflVIVING SPOUSE
tY _. ill"" m-. '*""1
Pennsylvania
14.
17.n....__in Ttpp::>r Allpn 'T'wp
-
1711.
Did
--
We in.
Cwnberland --.,1 1711.0 :"'-':-.'::::01
MOTHER'S NAME ,F... ModdIe. _ Surname)
Evel Hall
a1y-
II.
lHFORMANT'S MAIlING AOllAESS (SIr.... CIlyITown. SIaM. Zop Code)
2011.25 East Lisburn Rd. Bowmansdale PA 17008
P1.ACE OF DISPOSITION, _ 01 ~..." C,.malOly lOCATION. CilyI1Owll. SI.... Zip CoclIl
Of 01.... PIK.
NoD
l I
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co:( _
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HJ
H.
, Apprcunmate
. WervW betwMn
:----
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PART II:
OllIe, "'IIi"llcanl c:andiIjona conlIobuling lO daalh. llUl
noI ..lUllIng in IIle UIldefttlnQ __ given .. P>\RT I
C,.
[ :
DUE 10(00 AS A CONSEOUENCE Of):
OUEIOCOO"5ACoNstOUENCE~----'-- -
.k-
<}
(J
~
,J
WERE AUTOPSY FINDINGS MANNER OF DEATH
~E PRIOR 10
COIoIPlETION OF CAUSE )(f 0
OF DEATH? ........el HomIClda
Acelden( 0 Pending mvesuoauon 0
YaD No 0 Sutc:lde 0 COuld not: be determined 0
OATE OF INJURY
(Moo'" Day. .......,
TIME OF INJURY
INJURY AI 'NORK?
DESCRIBE HOW INJURY OCCURRED
o NoD
3010 M.
PlACE OF INJURY. AI home, 'arm, .,ee., ractory, office
building, .tc ISpec.r....)
~ _ a ~
CERTIFIER IC._ oniy onel
.CERTIFYING PIotYSICIAN (Ph.,.SIC..,.. cefldytng cause ~ de..... wnBn .:ulOlher pfl'Y~'0II1 t1dS prOOOtJOceo dedlh ana compleled tlem 231
To" beet of m,; knowledge, de.... occ~ du4 Ie the c.aUM'{a) and rn."".r .. ._atN.
O-C0.~J!l~___
IJd IJ1/0 I
...AONOUNClNG AND CERTtFYlNG PHYStClAH (PhV5'Caan both j.)fOllOuflCIll9 OCdltl dud ~eflllYlfl9 10 Cduse of dedth)
To 1M tM.. o. 1ftV' knowlH9A, deathoccuned.at at...llne. date,.and place, and due to thecaUH(a) and manne,.. st.ted..
'MEDICAL EXAMINER/CORONER
On the baaj. 01 ...minatlon andlot lnvestigAtion. in my opinion. death occulted a' the lime. dale, .nd place, and due to the c:ause(a) 1100
manne,.. stated.. " . . . . . . .. _ _ . _ _ . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
J'.
REGIS T
J4 .s:~fb It) b (lie I 9/ ~ (}o
2L-61~l
LAST WILL AND TESTAMENT
Of
HARRIET E DRAPER
It HARRIET E. DRAPER, now ofBowmansdale, Cumberland County, Pennsylvania, being
of sound and disposing mind, do hereby make, publish, and declare this to be my Last Will and
Testament, hereby revoking and making null and void all prior Wills and Codicils made by me at any
time heretofore.
ITEM 1- I direct that all my legally valid debts, funeral and administrative
expenses) and debts incurred or payable because of my death, shall be paid by my Executor,
hereinafter named, from my residuary estate as soon after my death as practicable. All death taxes)
including federal, state, and other death taxes~ with respect to the property fonning my gross estate
for tax purposes. whether or not passing under this Will~ including any interest or penalty imposed
thereoot shall be considered an expense of administration of my estate, without apportionment or
right of reimbursement. Taxes on future interests may be prepaid.
ITEM II. I bequeath my household and personal effects, jewelry, automobiles,
and other tanaible personalty oflike nature" in equal shares to the following persons who survive me
by thirty (30) days:
A. My daughter, TERESA M. McLOUGHI.JN; butt if she should not so
survive me, then this bequest and its share sha111apse, and such property shall be distributed
to the other beneficiaries designated under this Item of my Will.
B, My daughter, ELIZABE1H A JACKSON; but, if she should not 80
survive me~ but leaves descendants who so survive me, such descendants shall receive, ~
sti(l)e.\ the share that she would have received bad she so survived me~ subject, however, to
the trust provisions contained hereinafter if applicable to such descendants. Presently;, the
descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson.
C. My son, JOSEPH P. DRAPER; but, if he should not so survive me,
but leaves descendants who 80 survive me. such descendants shall receive, ner stit:pes~ the
share that he would have received bad SO survived me. subject. however, to the trust
provisions contained hereinafter if applicable to such desamdants. Presently ~ the descendants
of my said son include Kimberly Ann Draper:l Samantha Mary Draper) Christine Patricia
Draper" and Kasey Lee Draper.
Such property shall be divided by said beneficiaries as they shall agree. As to those items upon which
they shall not agree, distribution shall be determined by my Executor.
ITEM nT. J eive, devise and bequeath all of the residue ofmy estate, whether real)
personal, or ~ and wherever situate, including any property subject to any power of appointment
which I may now have or hereafter acquire, in equal shares to the following persons who survive me
by thirty (30) days:
A_ Mydaughter;o TERESAM. MclOUGHLIN; but, if she should not so
survive me, then this bequest and its share sballlapse, and such property shall be distributed
to the other beneficiaries designated under this Item ofmy Will.
B. My daughter, ELIZABETIi A, IACKSON~ but, if she should not so
survive me, but leaves descendants who so survive me, such descendants shall receive, ~
~ the share that she would have received had she 80 survived me, subject, however, to
the trust provisions contained hereinafter if applicable to such descendants. Presently, the
descendants afmy said daughter include Christina Michelle Jackson and Jessica Ann Jackson.
C. My son, JOSEPHP, DRAPER; but, ifhe should not 80 survive me7
but leaves descendants who so suryive me, such descendants shall receive, per stiq>e~, the
share that he would have received had so survived me, subject, however, to the trust
3
provisions contained hereinafter if applicable to such descendants. Presently, the descendants
of my said son include Kimberly Ann Draper, Samantha Mary Draper ~ Christine Patricia
Draper;w and Kasey Lee Draper.
ITEM IV. Any property }>Using hereunder to a beneficiary who, at the time of
my death, is under the age of twenty-five (25) (the nBeneficiary")~ shall be held IN TRUST)
NEVER TIiELESS, by my Trustee" hereinafter named1 for the benefit of such Beneficiary, upon the
terms and for the purposes and uses, as follows:
A. My Trustee shall hold and invest the principal of the Trost corpuS!I
collect the income therefrom, and expend and apply 80 much of the net income (any income
not so expended or applied to be accumulated and added to principalt and 80 much of the
principal and accumulated income, as my Trustee shall deem necessary or advisable, in the
sole and absolut.e discretion of my Trustee> for the support, maintenance, and education
(inCluding college education, both graduate and undergraduate) of the Beneficiary~ after
taking into consideration other r~y available assets and sources ofinOODle. Duling illne~~
or emergency. my Trustee may either pay a distribution to the Beneficiary!, or may make a
distribution for the benefit of the Beneficiary.
4
B. At the time the Beneficiary attains the age of twenty-five (25), the
Trust pertaining to the Beneficiary shall terminate, and my Trustee shall distribute the then.
remaining principal and aooumulated or undistributed income to the Beneficiary.
C. IftheBeneflciary should die during the existence of this Trust, it shall
be divided and then continued for the benefit of any then-living issue of the Beneficiary, p.a:
stU:pes. with such beneficiaries being substituted for the Beneficiary for all purposes including
distribution at certain aae& as set forth above.
D. If the Beneficiary should die before attaining the age of twenty-five
(25) without leaving issue surviving as aforesaid, then that Trust shall terminate, and its assets
shall be divided into as many equal shares as are created under Item ill hereof for the benefit
of those children of mine~ or their issue, per stirpes, living at the time of the death of said
Beneficiary, and then distributed to such beneficiaries; Provided, however~ that jf a Tnlst
established hereunder for any such beneficiaries exists at the time of such distribution, then
such distribution shall be made to that Trust for Bucb beneficiary.
ITEM V. The interest of beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation.
5
\.
ITEM VI. I hereby appoint my daughter, TERESA M. McLOUOlll.JN, to serve
as the executrix (the "Executor..), ofthi&. my Last Will and Testament. In the event of her refusal or
inability to so sene, I then nominate and appoint my daughter, ELIZABETH A JACKSON, and my
80~ JOSEPH P. DRAPER. or the survivor of them, to serve together in sucb capacity as Executor.
ITEM 'VII. I hereby appoint TERESA M. McLOUGHLIN, to serve as the trustee
(the 'trustee") ofany Trust created hereunder with regard to any Beneficiary. as defined herein. In
the event of her refusal or inability to so serve, I then nominate and appoint my daughter,
ELlZABETII A. JACKSON, and my son, JOSEPH P. DRAPER, or the survivor of them, to serve
together in such capacity as Trustee.
ITEM vm. I direct that my Executor and Trustee shaI1 not be required to give
bond or post any other security for the faithful performance of duties in any jurisdiction.
ITEM IX. My Executor and Ttustee shall have the following powers in addition
to those invested in them by law and by other provisions of my Will applicable to all property,
whether principal ofi11come. exercisable without Court approval, and effective until distribution of
all property:
A. To retain any investments I may have at my death so long as my
Executor or Trustee may deem it advisable to my Estate or Trost so to do-
6
B. To vary investmentst when deemed desirable by my Executor or
Trustee, and to invest in such bonds, cornmon trust funds controlled by my Executor or
Trustee, stocks!' notes, real estate mortgages, or other securities or in such other property,
real or personal, as my Executor or Tmstee deem wise, Vlithout being restricted to so-called
legal investments.
C. In order to etTecf"a division of the principal of my Estate or Trust or
.- for any other purpoIIe, including any final distribution, my Executor or Trustee is authorized
to make said divisions or distributioos of the personalty and realty partly or wholly in kind.
If such division or distribution is made in kind, said assets are required to be divided or
distributed at their respective values on the date or dates of their division or distribution.
D. To sell either at public or private sale and upon such terms and
c.onditiOI18 88 my Executor or Tmstee may deem advantageous to my Estate or Trust, any or
aU real or personal estate or interests therein owned by my Estate or Trust severally or in
conjunction with other persons or acquired after my death by my Executor or Trnstee, and
to consummate said sale or sales by sufficient deeds or other inltrumentg to the purchaser or
pW'Chasers, conveying a fee simple title, ftee and clear of all trust and without obligation or
liability of the purchaser or purchasers to see to the application of the purcha..ae money or to
make inquiry into the validity of said sale or sales; al80t to make, execute, aclmowledge, and
deliver any and aD deeds, assignments, optiollB) or other writings which may be necessary or
7
desirable~ in carrying out any of the powers conferred upon my Executor or Trustee in this
paragraph or elsewhere in my Will.
E. To mortgage real estate, and to make leases of real estate for any
period of time as is deemed reuonable by them.
F. To borrow money from any party to pay indebtedness of mine, or of
my Estate or Trust, expenses of administration, or inheritance:- legacy, estate or other taxes.
G. To pay all costs, taxes, expensest and charges in connection with the
administration of my Estate or Trust.. My Executor shall pay expenses of my last illness and
funeral ~.
H. To vote any shares of stock which form a part of my Estate or Trust,
and to otherwise exercise all the powers incident to the o'Mlersmp of such stock.
I. In the discretion ofmy Executor or Trustee, 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 ormy Estate or Trost.
8
ITEM X.
Any person who shall have died at the mme time as me, or in a
conunon disaster with me" or under such circumstances that it is difficult or irnpo8sible to determine
who died first, shall be deemed to have predeceased me.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament, consisting of nine (9) typeWritten pages) this.6.. day of September, 1995.
~.ct!, ~
HARRlET E. DRAPE
We, the undersigned, henby certifY that the foregoing Will was signtXL sealed, published and
declared by the above-named Testatrix, HARRIET E. DRAPER, 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 above written, and we certify that at
the time of the execution thereof: the said Testa.trix was of sound and disposing mind and memory.
J cmcl -Z i (/)~tU1 residing at )) ) eCyy;uU:c s k@ ( -P/J.
~ Ie-Sa.. r (VIe [Y) ( .11{-r i {' residing at
w ~ II~ I e I :jJ 11 ~_________~_____..~
.......-
9
----------------------------------------------------------------------------------------------------
.
COMMONWEALTH OF PENNSYLVANIA
COUN1Y OF BAlFnun Cv..mberwd
SS.:
. We, the Testatrix, and ~e+ 2: h'"'me~ . and
~_f\"\G 0\l.t..r~ r; e 5 the witnesses, respectively, whose names arc signed to the
foregoing instrument, being first duly sworn~ do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will, that she had signed willingly, and that
she executed it as her froo and voluntary act for the purposes therein expre8sed~ and that each of the
witnesses, in the presence and heMing of the Testatrix, signed the Will as witness and that to the best
ofherlher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and
under no oonstraint or undue influenQe,
. ~
~cr~
HARRIET E. DRAP
~*- ~1l.A1JM?uAU
1JWitn~s .
F~J1 0 50 C'>.- In C iYl.l k 11=1l. L!L
Witness
Subscribed~ sworn to and acknowledged before me by the Testatrix, HARRIET E, DRAPER, and
subscribed and sworn to before me by ~~-12+ '~~W"'\ecmG!O- a...id
'-::rRf~ (Y)c.- IY\~~ e !) witnesses, this _ J'J day of September, 1995.
Notarial Seat .
Judith A. Walter, Notary PubHc '
I Upper Allen Twp., Cumberland County
I My Commission Expires May12, 1998
Member, Pennsylvania Association of Notaries
(SEAL)
{NIUI:'WlU019:"'19\chpr-br.w~1
10
-
-,~.
11,/5- ;f
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8060l
HARRISBURG, PA l71Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 01-0971
ACN 01153789
DATE 11-16-2001
C;
qV/
REV-lS4S EX AFP <89-08)
Reco:-ocd Office of
Re[H~tA" \I"'" EST OF HARRIET E DRAPER
~!..1t__1 "vilIS .
5.5. NO. 221-22-8104
DATE OF DEATH 09-17-2001
.01 ole 12 P 2 :f9lUNTY CUMBERLAND
TYPE OF ACCOUNT
(i] SAVINGS
o CHECKING
D TRUST
D CERTIF .
TERESA L MCLOUGHLIN Cte-r'-- ,'-
25 E LISBURG RD 1 K. ,~.. ,- 'IT
BOWMANSDALE PA 1700lC,urnberl.~,,_,'t-_-___j_- .'. i".")iJ I
..... .. Co., PA
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Depart.ent with the information listed below which has been used in
calCUlating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions .ay be answered by calling (717) 181-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 139721-00 Date 04-26-1994
Established
PART
[!]
Account Balance
Percent Taxable
A.ount Subiect to
Tax Rate
Potential Tax Due
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
x
NOTE: If tax pay.ents are .ade within three
(3) months of the decedent's date of death,
you may deduct a 57. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
The above infor.ation and tax due is correct.
I. You .ay choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "An and return this notice to the Register of
Wills and an official assessment will be issued by the PA Depart.ent of Revenue.
B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. c=J The above information is incorrect and/or debts and deductions were paid by you.
You must co.plete PART ~ and/or PART ~ below.
PART
[!]
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subiect to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
OF
1
2
3
4
S
6
7
8
x
x
PART
[!]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line S of Tax COMputation)
I
$
Under penalties
COMPlete to the best
j. fit. me~
AXPAYER SIGNA
of perjury, I declare that the facts I
of my knowledge and belief.
~
have reported above are tru., correct
HOME (-) 11 ) fJi(1. ft(s-(P
WORK (1/7 ) fo17-t1J(jg
TELEPHONE NUMBE
and
1~~110 I
D~ E
)'.'~" ' '. ," > ..,:"'. ..1.;,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG I PA l11Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 01-0971
ACN 01153790
DATE 11-16-2001
u
j,K.
REV-15~3 EX AFP (09- DO)
Recora€c]
Register
of
'NiBs
EST. OF HARRIET E DRAPER
S.S. NO. 221-22-8104
DATE OF DEATH 09-17-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[Xl CHECKING
o TRUST
o CERTIF .
.01 01 C 12 P 2 :30
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TERESA L MCLOUGHLIN
~~W~A~~g:~~G RD PA 1 CJlArj\b--{e~-\~'--. '_"_~.' C:ourt
aifffl fJdrl\.i Co., PA
MEMBERS 1ST FCU has provided the Department with the info....ation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedentl yoU were a joint owner/beneficiary of
this account. If you feel this information is incorrectl please obtain written correction from the financial institutionl attach a cOpy
to this farm and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co.monwealth
of Pennsylvania. Questions may be answered by :a11ing (111) 181-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 139721-11 Date 04-26-1994
Established
Account Balance
Percent Taxable
A.ount Subiect to
Tax Rate
Potential Tax Due
x
1,630.27
50.000
815.14
.045
.68
ESPONSE
To insure proper credit to your account I two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Willsl Agent".
PART
[!]
x
NOTE: If tax payments are .ade within three
(3) .onths of the decedent's date of deathl
you ~y deduct a 57. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
The above information and tax due is correct.
. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest I or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. E:J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. c=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
[!J
TAX RETURN - COMPUTATION OF
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. A.ount Subject to Tax 4
S. Debts and Deductions S
6. A.ount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT'TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
x
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line S of Tax Co.putationl
that the facts I
and belief.
have reported above ~re ~ue,
HOME ( 1 t1 ) (,11 / "I'r~5 ip
WORK (1 f7 ) (Jq"7 - {J, () rz
TELEPHON NUMB
correct and
/8/7/1)/
DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG1 PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILE NO. 21 01-0971 ~~
ACN 01153791
DATE 11-16-2001
REY-1545 EX AFP <89-00>
Recoraed
Register
of
~Vifls
EST. OF HARRIET E DRAPER
S.S. NO. 221-22-8104
DATE OF DEATH 09-17-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[Xl SAVINGS
o CHECKING
D TRUST
o CERTIF .
"OlDIe 12
P 2 :31
** TERESA L MCLOUGHLINClerk-(i
~~W~A~~g:~~G RD PA 17Qtilbenand co,:uPA
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE~ PA 17013
"EHBERS 1ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedentl you were a joint owner/beneficiary of
this account. If you feel this infor~tion is incorrectl please obtain written correction from the financial institutionl attach a COpy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answared by ceIling (7171 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 139721-05 Date 05-04-2001
Established
PART
[!]
x
2~003.16
100.00
2~003.16
.045
14
ESPONSE
To insure proper credit to your accountl two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wil1s1 Agent".
Account Balance
Percent Taxable
AMount Subject to
Tax Rate
Potential Tax Due
x
NOTE: If tax payments are made within three
(3) months of the decedent.s date of deathl
you may deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interestl or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent"s representative.
C. ~ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
lINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
S
6
7 X
8
If you indicate a different tax rate~ please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on line S of Tax COMputation)
Under penalties of perjury~ I declare that the facts I
complete to the best of .y knowledge and belief.
,J. (li. ()'lC~ ~l ~Lll,;U
TAXPAY R SIGNATUR
I
$
and
iei~dJ
DA E
. ....~M.~'.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
"'",,,,," '., "'~,.' ''',
REV-1162 EX( 11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MCLOUGHLIN TERESA M
25 E L1SBURN ROAD
BOWMANSDALE, PA 17008
-------- fold
ESTATE INFORMATION: SSN: 221-22-8104
FILE NUMBER: 21-2001- 0971
DECEDENT NAME: DRAPER HARRIET E
DA TE OF PAYMENT: 12/12/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/17/2001
NO. CD 000637
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $129.63
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$129.63
REMARKS: TERESA M MCLOUGHLIN
CHECK#102
SEAL
INITIALS: DO
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
C
w
(.)
w
c
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Draper, Harriet E.
REV-1500
~
_,_~! 7=LS..___L(l,___,__,___..~
FILE NUMBER
~L-di __~2i
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
221 - 22 - 8104
DATE OF DEATH (MM-DD-YEAR)
9/17/2001
DATE OF BIRTH (MM-DD-YEAR)
2/19/1936
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
fX] 1. Original Return
o 4. Limited Estate
o 6, Decedent Died Testate (Attach ccpy of Will)
o 9, Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-l2-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date ot death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
I-
Z
W
C
Z
o
D-
Ul
W
II:
II:
o
U
NAME
Teresa M.
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
25 E. Lisburn Road
Bowmansdale, PA 17008
......... ....
-'
(1) ;-
: ',-
(2)
"
(3)
(4)
(5) 4320.36
2030.68
(6)
(7)
(8) 6351.04
(9) 5422.63
(10)
(11)
(12)
(13)
5422.63
928.41
TELEPHONE NUMBER
717-697-1956
(14)
q?8 41
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
z
o
~
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:;)
I::
Q"
<C
(.)
w
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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
928.41
x .0_ (15)
x .0 45 (16)
41.78
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)
z
o
~
~
:;)
Q"
:E
o
(.)
><
~
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
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
x .12 (17)
x .15 (18)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19)
41.78
20.0
REV-1508 EX + (1-97)
,
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
"
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Harriet E. Draper
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.
1996 Dooge Neon
(Kelly Blue Book)
VALUE AT DATE
OF DEATH
$ 508.62
3800.00
ITEM
NUMBER
1.
DESCRIPTION
Members 1st FCU Christmas Club (139721-02
Interest Income reported on 1099-INT 11.74
TOTAL (Also enter on line 5, Recapitulation) $ 4320 . 36
(If more space is needed, insert additional sheets of the same size)
-
REY.1:OOE,~+(1.97) ~. . .
..~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
Harriet E. Draper
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
Teresa M. McLoughlin
25 E. Lisburn Road
Bowmansdale, PA 17008
Daughter
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY 'Io0F DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for joinUy.held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1991 Members 1st FCU
500 Louise Drive
Mechanicsburg, PA 17055
Savings 139721-00 $ 427.92 50% $ 213.96
Investment Savings 139721-05 2003.16 50% 1001.58
Checking 139721-11 1630.27 50% 815.14
TOTAL (Also enter on line 6, Recapitulation) $ 2030.68
(If more space is needed, insert additional sheets of the same size)
...
..I
REV-1511 EX+ (12-99) .
., ~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Harriet E. Draper
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER
A
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Malpezzi Funeral Home, Mechanicsburg, PA
Grace Lawn Memorial Park, New Castle, DE
Isaac's Restaurant - Mechanicsburg, PA
Rothermel's Florist - Mechanicsburg, PA
$4392.41
420.00
433.20
177.02
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Represenlative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City_
State __ Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City_
State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 5422. 63
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
NUMBER
I
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1
Teresa M. McLoughlin
25 E. Lisburn Road
Bowmansdale, PA 17008
Elizabeth A. Jackson
137 Parma Court
Newport News, VA 23608
Joseph P. Draper
202 Wordsworth Drive
Wilmington, DE 19808
Daughter
Daughter
Son
AMOUNT OR SHARE
OF ESTATE
1/3
1/3
1/3
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
.~ 'l\1ell1bers 15T
Hl)ERAL CREl)(T UNION
Instructions for Recipient
Box 1. Shows interest paid to you during the calendar year
by the payer. This does not include interest shown in box 3.
If you receive a Form 1 099-INT for interest paid on a tax-
exempt obligation, see the instructions for your income tax
return.
Box 2. Shows Interest or principal forfeited because of early
withdrawal of time savings. You may deduct this on the
"Penalty on early withdrawal of savings" line of Form 1040.
Box 3. Shows interest on U.S. Savings Bonds, Treasury bills,
Treasury bonds, and Treasury notes. This mayor may not be
all taxable. See Pub. 550, Investment Income and Expenses.
This interest is exempt from state and local income taxes.
This interest is not included in box 1.
Box 4. Shows backup withholding. For example, persons not
furnishing their taxpayer identification number to the payer
become subject to backup withholding at a 31 % rate. See
Form W-9, Request for Taxpayer Identification Number and
Certification, for information on backup withholding. Include
this amount on your income tax return as tax withheld.
.......-
Box 5. Any amount shown is your share of investment
expenses of a single-class REMIC. If you file Form 1040, you
may deduct these expenses on the "Other expenses" line of
Schedule A (Form 1040) subject to the 2% limit. This
amount is included in box 1.
Box 6. Shows foreign tax paid. You may be able to claim this
tax as a deduction or a credit on your Form 1040. See your
Form 1040 instructions.
Nominees. If this form includes amounts belonging to
another person, you are considered a nominee recipient. You
must file Form 1 099-INT for each of the other owners
showing the income allocable to each. You must also furnish
a Form 1 099-INT to each of the other owners. File Form(s)
1099-INT with Form 1096, Annual Summary and Transmittal
of U.S. Information Returns, with the Internal Revenue
Service Center for your area. On each Form 1099-INT, list
yourself as the "payer" and the other owner as the
"recipient." On Form 1096, list yourself as the "filer." A
husband or wife is not required to file a nominee return to
show amounts owned by the other.
IMPORTANT - TAX DOCUMENT ENCLOSED
~s.). k
A-f'tOV nf
n
I , CORl=IECTED (if checked)
PAYER'S name, street address, city, state, ZIP code, and telephone no. Paye(s RTN (optional) OMB No. 1545-0112
MEMBERS 1ST FEDERAL CREDIT UNION
5000 LOUISE DRIVE ~@O1 Interest Income
MECHANICSBURG PA 17055
Form 1099-INT
PAYER'S Federal identification number I RECIPIENTS identification number 1 Interest Income not Included in box 3 Copy B
23-1360906 22-1228104 $ 11.74 For Recipient
RECIPIENT'S name.S1reel oddre.. (Including apt. nc).City. slate, and ZIP code 2 Early withdrawal penalty 3 Interest on U.S. Savings This is important tax
Bonds end Trees. obligations information and is
ESTATE OF HARRIET E DRAPER $ .00 $ .00 being furnished to the
Internal Revenue
C/O TERESA M MCLOUGHLIN 4 Federal Income tax withheld 5 Investment expenses Service. If you are
25 E LISBURN ROAD $ .00 $ required to file II return,
a negligence penalty or
BOWMANSDALE PA 17008 6 Foreign tax paid 7 Foreign country or U.S. other slInctlon may be
possession imposed on you If this
income is taxable and
Account number- (optional) the IRS determines that
210567 $ It has not been
reported.
Form 1099-INT
(Keep for your records.)
Department of the Treasury - Internal Revenue Service
34174
Send Inquires to'
5000 Louise Drive
, .. '.., , . PO Box 40
"l\If/e""'tnberslST Mechanicsburg, PA 17055
.1 ~ ... www,members1sl.org
FEDERAL CREDIT UNION
Main Switchboard: (717) 697.1161 or (800) 283.2328
Call-24: (717) 697 -4372 or (800) 283-4372
TOO: (717) 697-5312 or (800) 283-2328 ex!. 5312
TeleBranch: (717) 795.6049 or (800) 237-7288
Member's
Statement
of Account
Account Number From TO Page
139721 10-01-01 10-31-01 1 of 2
SIMPLIFY YOUR BILL PAYING
ROUTINE WITH BILL PAYER. SEE THE
ENCLOSED INSERT FOR MORE
INFORMATION.
1703
I\\l "LItu..OV
{J)\
HARRIET E DRAPER
Cia TERESA M MCLOUGHLIN
25 E LISBURN RD
BOWMANSDALE PA 17008-0000
SUFFIX:OO SAVINGS
100101 141700008
100101 141700008
100101 HOLIDAY CLUB TRANS
102401 TFR TO SHARES 210567-00
103101 DIVIDEND
JOINT OWNERS: TERESA M MCLOUGHLIN
Y-T-D DIVIDENDS:
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD I 2.25%
ANNUAL PERCENTAGE YIELD EARNED I 2.26%
437.00
-437.00
508.62
-936.95
1. 32
20.33
SUFFIX:02 HOLIDAY CLUB
100101 HOLIDAY CLUB TRANS
-508.62
Y-T-D DIVIDENDS: 8.62
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD
I 2.30%
SUFFIX:05 INVESTMENT SAVINGS
101601 SHARE WITHDRAWAL
102401 SHARE DIVIDEND
'10240 I SHARE wi THuRAWAL
-4392.41
5.80
-622.42
JOINT OWNERS: TERESA MCLOUGHLIN
Y-T-D DIVIDENDS:
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD I. 0%
ANNUAL PERCENTAGE YIELD EARNED I 2.68%
64.66
SUFFIX:ll CHECKING
BEGINNING BALANCE
DEPOSITS
DRAFTS
DEB I TS/F EES
MAINT/SERVICE CHGS
ENDING BALANCE
694.99
437.00
177 .02
954.97
.00
.00
TOTAL NUMBER DRAF S CLEARED
YOUR AVG DAILY BA ANCE WAS
YOUR LOW MONTH BA ANCE WAS
1100101 PAYROLL ALLOCATION FROM
I
13972 1-00
437.00
NOTICE; SEE REVERSE SIDE FOR IMPORTANT INFORMATION.
508.62
.00
481 .38
.00
1131.99
SEND ALL INQUIRES TO THE CREDIT UNION AT THE ADDRESS SHOWN ON PAGE # 1
1704
""
mberslST
d, CREOlT UNION
1 3972 1 1 0 - 0 1 - 0 1 1 0 - 3 1 - 0 1 2 of 2
<AN$l/E:Ff,
OA rEOATE/
100101
1019 101801
102401
........fAANSACTIONOESCRIPTION
DIRECT DEPOSIT REG-E TRANSACTION
141700008
SHARE DRAFT # 681
TFR TO SHARES 210567-11
1018015703
...AMOUNT...........
-437.00
-177.02
-517.97
13At...J,\.t4CE
694.99
~_.---
\ 517.21.D
.uu
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ~ * * * *
NO.
681
AMOUNT
177 .02
JOINT OWNERS: TERESA M MCLOUGHLIN
Y-T-D DIVIDENDS: .00
NO.
AMOUNT
NO.
AMOUNT
NO.
TOTAL:
AMOUNT
177 .02
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD
I 1.50%
--- ------------------------------------------------------------- ------------ ---
FOR 2001
* IRA YTD * OTHER YTD * TOTAL YTD * TOT~L YTD * TOT~L YTD *
DIVIDENDS DIVIDENDS DIVIDENDS WITH~OLDING FOR EITURES
.00 93.61 93.61 .00 .00
...
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENI OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 0 1 - 0971
01153791
11-16-2001
REV-1545 EX AFP (09-00)
EST. OF HARRIET E DRAPER
S.S. NO. 221-22-8104
DATE OF DEATH 09-17-2001
COUNTY CUMBERLAND
TVPE OF ACCOUNT
[iI SAVINGS
D CHECKING
D TRUST
D CERTIF .
** TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE PA 17008
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If yoU feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PennS'Ilvdnid. Questions md'l be answered b'l calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 139721-05 Date 05-04-2001
Established
t\>
I 'f'l-\'4.fcount Balance
\' \S:'!" P~rcent Taxable
~ Amount Subject to
\
'(\lJ Tax Rate
~' Potential Tax Due
x
2,003.16
100.00
2,003.16
.045
~,:: "/ 90.,14
.~~ \>I.) .
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany 'lour
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
yoU may deduct a 51. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
[!J
above information and tax due is correct.
You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
x
PAVEE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knOWledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
';1+' I.' J
TAXPAVER SIGNATURE
,j
~nMMONWE4LTH OF PENNSYLVANIA
DEPARTMENT 'OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 0 1 - 0971
01153790
11-16-2001
REV-154l EX AFP (09-00>
EST. OF HARRIET E DRAPER
S.S. NO. 221-22-8104
DATE OF'DEATH 09-17-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[i] CHECKING
D TRUST
D CERTIF.
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE PA 17008
(,
JA
Iv"
\u\~\~l
~ l c:f
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in
calCUlating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answer'ed by calling (717) 787-11327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accouni No. 139721-11 Daie 04-26-1994
Esiablished
" S";l Accouni Balance
~...~, "\) Perceni Taxable
~;~~~ Amouni Subjeci io
l(~ Tax Raie
Poieniial Tax Due
x
1,630.27
50.000
815.14
.045
36.68
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
PART
[!]
x
NOTE: If tax payments are made within three
(3) months of the decedent.s date of death,
you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
The above information and tax due is correct.
~. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or yoU may check box nA" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent.s representative.
C. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
If you indicaie a differeni iax raie, please siaie your
relaiionship io decedeni:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Daie Esiablished
2. Accouni Balance
3. Perceni Taxable
Q. Amouni Subjeci io Tax
5. Debis and Deduciions
6. Amouni Tax~ble
7. Tax Raie
8. Tax Due
PART
@J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF
1
2
3
Q
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL IEnier on Line 5 of Tax Compuiaiionl
$
Under penaliies of perjury, I declare ihai ihe facis I
compleie io ihe besi of my knowledge and belief.
\ -0. r'll rfl c ':fi (~-(/t{~J\ Q 'l/l~.J
TAXPAYER SIGNATURE
have reporied
HOME (111
WORK c7H
TELEPHONE
correci and
I(){~/ ~ t. j
DAT
"
'CoMMQNWE~lTH OF PENNSYLVANIA
oEPARTMENT'oF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 0 1 - 0971
01153789
11-16-2001
REV-1545 EX IFP 'D9-DDl
EST. OF HARRIET E DRAPER
S.S. NO. 221-22-8104
DATE OF DEATH 09-17-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
!il SAVINGS
o CHECKING
o TRUST
o CERTIF .
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE PA 17008
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth
of Pennsylvania. Quastiorts may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 139721-00 Date 04-26-1994
Established
. J\
,,'~ '\
't'
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
427.92
50.000
213.96
.045
.tl,IS ~63
,
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
IT]
A. "[/{'The above information and tax due is correct.
M, 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box uAu and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. [J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. [J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
TAXPAYER SIGNATURE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMI'NT OF REVENUE
BUHEA:U OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
/) ^ t.,')(,::)
/,) l11;' (;...:J
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MCLOUGHLIN TERESA M
25 E L1SBURN ROAD
BOWMANSDALE, PA 17008
----~--- lold
ESTATE INFORMATION: SSN: 221-22-8104
FILE NUMBER: 21-2001- 0971
DECEDENT NAME: DRAPER HARRIET E
DATE OF PAYMENT: 12/12/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/17/2001
NO. CD 000637
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $129.63
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: TERESA M MCLOUGHLIN
CHECK#102
SEAL
INITIALS: DO
RECEIVED BY:
TAXPAYER
$129.63
MARY C. LEWIS
REGISTER OF WILLS
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I
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WHEREAS, on the 23rd
dated September 15th 1995
was admitted to probate as
Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 2001-00971
PA No. 21-01-0971
I
ESTATE OF DRAPER HARRIET E
(LAo'l' , Fl~o'l', jVlllJlJLt;)
Late of UPPER ALLEN TOWNSHIP
CUIVjJ:)t;~LA1\1lJ CUUNT'f.,
Deceased
Social Security No. 221-22-8104
day of October
2001 an instrument
the last will of DRAPER HARRIET E
(LAo'l' , Fl~oT, jVlluULt;)
late of UPPER ALLEN TOWNSHIP
CUMBERLAND County, who died on the
17th day of September 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 MCLOUGHLIN TERESA M
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 23rd day of October 2001.
7'N/~'suf~yJ ~~{~"'l
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
"
LAST WILL AND TESTAMENT
Of
HARRIET E. DRAPER
I, HARRIET E. DRAP~ now of Bowmansdale, Cumberland County, Pennsylvania, being
of sound and disposing mind, do hereby make, publish, and declare this to be my Last Will and
Testament. hereby revoking and making null and void all prior Wills and Codicils made by me at any
time heretofore.
ITEM I I direct that all my legally valid debts, funeral and administrative
exp~n8es) and debts incurred or payable because of my death, shall be paid by my Executor,
hereinafter named, from my residuary estate as soon after my death as practicable. All death taxes,
including federal, state, and other death taxes, with respect to the property forming my gross estate
for tax purposes. whether or not passing under this Will, including any interest or penalty imposed
thereon, shall be considered an expense of administration of my estate, without apportionment or
right of reimbursement. Taxes on future interests may be prepaid
... i. ,... ....".,;;..,'1;':"...., .a "<'V.:jt,: .,..:,,*.~. ',"..~. ';,;1, .,~ '.. ....".
_....."..~~~-,...._,--.,...---,......~._""'......._<..."""'-"""'<._-,._.~..~,....,
ITEM II. I bequeath my household and personal effects, jewelry, automobiles,
and other tangible personalty of like nature. in equal shares to the following persons who liUrvivc me
by thirty (30) days:
A. My daughter, TERESA M, McLOUGHLIN~ but, if she should not so
survive me, then this bequest and its share shall lapse, and such property shall be distributed
to the other beneficiaries designated under this Item of my Will.
B. My daughter. ELIZABETH A JACKSON; but, if she should not so
survive me, but leaves descendants who so survive me, such descendants shall receive, ~
sticw, the share that she would have received had she so survived me, subject, however, to
the trust provisions contained hereinafter if applicable to such descendants. Presently. the
descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson.
C. My son, JOSEPH P. DRAPER; but, if he should not so survive me,
but leaves descendants who so survive me) such descendants shall receive, per stit:pes, the
share that he would have received had SO survived me. subject. however. to the trust
provisions contained hereinafter if applicable to such descendants. Presently, the descendants
of my said son include Kimberly Ann Draper, Samantha Mary Draper, Christine Patricia
Draper) and Kasey Lee Draper.
~
... .
....,.,-' ""''''''~'''.~''';,"''''' ""'.~,' ...."'-..:...""'~~~._.,."'.",',~.\fl3"'.<).............'~<,'.._...........
,.
",,,. ""~ ~'."-'~ - '''''-'''''.'''''''''- "."",_,i_""_..,....,.......,,,.,~,,..'" ,.~,~ ~".'..,.' "~".," """"','_,,, ~_ '.,
Such property shall be divided by said beneficiaries as they shall agree. As to those items upon which
they shall not agree, distribution shall be determined by my Executor.
ITEM nT
I ewe, devise and bequeath all of the residue of my estate, whether real,
personal, or mixed, and wherever situate, including any property subject to any power of appointment
which I may now have or hereafter acquire, in equal shares to the following persons who survive me
by thirty (30) days:
A My daughter, TERESA M. McLOUGHLIN; but, if she should not so
sw-vive me, then this bequest and its share shall lapse, and such property shall be distributed
to the other beneficiaries designated under this Item of my Will.
B. My daughter, ELIZABETIi A. JACKSON~ but, if she should not so
survive me, but }e,aves descendants who so survive me, such descendants shall receive, ~
~, the share that she would have received had she so survived me, subject, however, to
the trust provisions contained hereinafter if applicable to such descendants. Presently, the
descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson.
C. My son, JOSEPH P. DRAPER; but, if he should not RO survive me,
but leaves descendants who so survive me, such descendants shall receive, (let sticpes, the
share that he would have received had so survived me, subject, however, to the trust
3
""
<\;.)t;-' ,'(:I'",~,;,~.M"l<t>l~
w
provisions contained hereinafter if applicable to such descendants. Presently, the descendants
of my said son include Kimberly Ann Draper, Samantha Mary Draper, Christine Patricia
Draper, and Kasey Lee Draper.
ITEM IV. Any property passing hereunder to a beneficiary who, at the time of
my death, is under the age of twenty-five (25) (the "Beneficiary"), shall be held IN TRUST,
NEVERTHELESS, by my Trustee, hereinafter named, for the benefit of such Beneficiary, upon the
terms and fOf the purposes and uses, as follows:
A. My Trustee shall hold and invest the principal of the Trost COrpUB~
collect the income therefrom, and expend and apply so much of the net income (any income
not so expended or applied to be accumulated and added to principal), and so much of the
principal and accumulated income, as my Trustee shall deem necessary or advisable, in the
sole and absolute discretion of my Trustee, for the support, maintenance, and education
(inCluding college education, both graduate and undergraduate) of the Beneficiary, after
taking into consideration other readily available assets and sources of income. Duling illness
or emergency, my Trustee may either pay a distribution to the Beneficiary, or may make a
distribution for the benefit of the Beneficiary.
4
..
I
,~""~,""N,.....~,;,_,..____."..~...,, .j\(!, .. I
__~~r""""""""~.~~""""''''''''';'''~
B. At the time the Beneficiary attains the age of twenty-five (25), the
Trust pertaining to the Beneficiary shall terminate, and my Trustee shall distribute the then-
remaining principal and accumulated or undistIiibuted income to the Beneficiary.
C. If the Beneficiary should die during the existence of this Trust, it shall
be divided and then continued for the benefit of any then-living issue of the Beneficiary~ nm:
~ with such beneficiaries being substituted for the Beneficiary for all purposes including
distribution at certain ages as set forth above.
D. If the Beneficiary should die before attaini.ng the age of twenty-five
(25) wtthout leaving issue surviving as aforesaid~ then that Trust shaH temrinate, and its assets
shall be divided into as many equal shares as are created under Item ill hereof for the benefit
of those children of mine, or their issue, per stirpes, living at the time of the death of said
Beneficiary, and then distributed to such beneficiaries; Provided, however, that jf a Tmst
established hereunder for any such beneficiaries exists at the time of such distribution., then
such distribution shall be made to that Trust for such beneficiary.
ITEM V.
The interest of beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation.
5
.
.. ....'
.'
ITEM VI.
I hereby appoint my daughter, TERESA M. McLOUGHLIN, to serve
as the executrix (the "Executor"), of this, my Last Will and Testament. In the event of her refusal or
inability to so serve, I then nominate and appoint my daughter, ELIZABETH A JACKSON, and my
BOn, JOSEPH P. DRAPER, or the survivor of them, to serve together in such capacity as Executor.
ITEM VII.
I hereby appoint TERESA M. McLOUGHLIN, to serve as the trustee
(the "Trustee") of any Trust created hereunder with regard to any Beneficiary, as defintld herein. In
the event of her refusal or inability to so serve, I then nominate and appoint my daugbter,
ELIZABETII A. JACKSON, and my son, JOSEPH P. DRAPER, or the survivor of them, to serve
together in such capacity as Trustee.
ITEM Vlll.
I direct that my Executor and Trustee shall not be required to give
bond or post any other security for the faithful performance of duties in any jurisdiction.
ITEM IX.
My Executor and Trustee shall have the followin8 powers in addition
to those invested in them by law and by other provisions of my Will applicable to all property,
whether principal of income, exercisable without Court approval. and effective until distribution of
all property:
A To retain any investments I may have at my death so long as my
Executor or Trustee may deem it advisable to my Estate or Trust so to do.
6
.
B.
To vary investments, when deemed desirable by my Executor or
Trustee, and to invest in such bonds, common trust funds controlled by my Executor or
Trustee, stocks. notes, real estate mortgages, or other securities or in such other property,
real or personal, as my Executor or Trustee deem wise, without being restricted to so-called
legal investments.
C. In order to effect-a division of the principal of my Estate or Trust or
for any other purpose, including any final distribution, my Executor or Trustee is authorized
to make said divisions or distributions of the personalty and realty partly or whoUy in kind.
If such division or distribution is made in kind, said assets are required to be divided or
distributed at their respective values on the date or dates of their division or clistribution.
D. To sell either at public or private sale and upon such terms and
conditions as my Executor or Trustee may deem advantageous to my Estate or Trust, any or
all real or personal estate or interests therein owned by my Estate or Trust severally or in
conjunction with other persons or acquired after my death by my Executor or Trustee, 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 trust and without obligation or
liability of the purchaser or purchasers to see to the application ofllie purcha..~ money Of to
make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and
deliver any and an deeds, assignments, options, or other writings which may be necessary or
7
. .
~
~
desirable, in carrying out any of the powers conferred upon my Executor or Trustee in this
paragraph or elsewhere in my Will.
E. To mortgage real estate, and to make leases of real e~1ate for any
period of time as is deemed rcaaonable by them.
F. To borrow moncy from any party to pay indebtedness of mine) or of
my Estate or Trust, f..'Xpenses of administration. or inheritance, legacy, estate or other taxes.
G. To pay all costs, taxes, expenses, and charges in connection with the
administration of my Estate or Trust. My Executor shall pay expenses of my last illness and
funeral expenses.
H. To vote any shares of stock which fOITIl a pfU1 of my Estate or Trust,
and to otherwise exercise all the powers incident to the ownership of such stock.
1. In the discretion ofmy Exerotor or Tru&tee, to unite with other owner&
of similar property in carrying out any plans for the reorganization of any corporation or
company whose securities form a part ofmy Estate or Trust.
8
.
. .
..
ITEM X.
Any person who shall have died a.t the <mme time as me, or in a
conunon disaster with me, or under such circumstances that it is difficult or impossible to determine
who died first, shall be deemed to have predeceased me.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Telrtament, oonsistin.g of nine (9) typewritten pages, this J6.- day of September, 1995.
~o:I, W~
HARRIET E. DRAPE
We, the undersigned, ~ e<<tifY that the foregoing Will was signed, sealed, published and
declared by the above-named Testatrix, HARRIET E. DRAPER. 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 above written, and we certify that at
the time of the ex~tion thereof, the said Testatrix was of sound and disposing mind and memory.
:](tnct-Z i (n~maf1 residing at
&echculA'c .s: ~@ ( fJA-
~~le.SQ r (VlCmurtrie.residing at
LJ ej/ ~/I e I ;P/1_~_~__
4~""""
9
--------------------------------------- -----------------------------------------
--
COMMONWEALTH OF PENNSYLVANIA
COUNTY OFDA1J1?nli'~ Clkffiber!ord
'\
..
88.:
- We, the Testatrix, and ~P+:2 tY\i"e~ , and
-r-e&~Li!\c 0\L-Lr'\- r; e > the v.,i.tncssca, respectively, whose names arc sig...'1.cd to t.1C
foregoing instrument, being first duly sworn" do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will, that she had signed willingly, and that
she executed it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesse:s, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best
ofherlher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and
under no constraint or undue influence,
-~c.~~
HARRIET E. DRAPE
Caw ct ~n..rnlli~
~tnes .
rl0J1Qj)t\'-- /Y)c m 1 k J. tfl ~
Witness
Subscribed, sworn to and acknowledged before me by the Testa.trix, HARRIET R DRAPER. and
subscribed and sworn to before me by ~t.l-p pi- ~. rt'\1In~r I'T'\~ and
'-=r~re~ Me fY\...v1-r~ e . witnesses, this _ 1'7 day of September, 1995.
< vtJk
(SEAL)
Notarial Seal
Judith A. Walter, Notary Public
Upper Allen ~wp., Cl!mberland County
My COlnmisslon Expires May 12. 1998
Member, Pennsylvania Association of Notaries
[NIiH:Wll.#() 19 .'Rill~pr-br.w~l
10
~.
, ~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
\-\ Q((;~+ ~, 'J)("QPR-r
q\ \~\QI
Date of Death:
Will No.
dl-Ol-C!t-"
Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on q \. 0 ~
Name
Address
Q34.08
Pol PQfrno..Q.-t, Ne~f'o(t- rJews, VA
JaGer\--. p, 'D(~p-tL aO:l WOrdSWort-l-) Dr, \N:\/Yl:~tO('.1)E 1'1~o~
-,- eus a.. N\ - t\I\ e.l 00~ ~ \ I'''' g.s E' - L; 5 bV( ,.., Rcl, BQVo/I'N.).,sd o"lt \ {'A Il 0 0 ~
C\ ,'-za.be,+V\ (\,
nc."kRc-n
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
t \ d 9 \ O~
LJ.rfl - I Yl eot ~-.!
Signature
0'1 .....
-:q Q:
,~ /'1
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8:
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c:::x::
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CD a:: $ :;;
CC ,., U
....,
~
Name leCeso... M._ Me;. Lou t h \ .{}.'
Address ~ 5 E, L \'sh0rt"\ rz d
BOWMQjlsdaLt PA l,CO%
Telephone 111,) liS 1 - 'C\6 G,
Capacity: X Personal Representative
_Counsel for personal representative
\. /:/-/t..S-=- /~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 11128-0601
'*
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-l!i41 EX iFP U2-00)
Recore<:.':
Ref)st;,
L; ot
TERESA L MCLoUGHLI~2
25 E LISBURG RD
BoWMANSDALE
FEB -1
P 1 :42
PA~8
Curnberk.:,
PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153789
Allount Rellitted
HARRIET
E
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-V:is~i-EX--AFP--(i]f:oO)------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
HARRIET
COUNTY
CUMBERLAND
E DATE OF DEATH 09-17-2001
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACN
01153789
ACCOUNT NO.
139721-00
TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
427.92
0.500
213.96
.00
213.96
.45
9.63
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 06-18-2002~. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 9.63
INTEREST AND PEN. .00
TOTAL DUE 9.63
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENTL ALLOWANCE OR DISALLOWANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1541 EX AFP (12-80)
113
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153791
AIIaunt Rellitted
HARRIET
E
Recorn2t
ReQi::;t
,'. of DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
P 1 :42 SSN/DC
ACN
TERESA L MCLOUGHLIN .02 FES-1
25 E LISBURG RD
BOWMANSDALE PA 17~k(.
CurnbBi
1 FA
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 ~
iifv=is4-i-E)f-AFP--fi1f:ooi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
HARRIET
E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01153791
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
139721-05
TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-04-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
2,003.16
1.000
2,003.16
.00
2,003.16
.45
90.14
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY o6-18-2oo2~. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 90.14
INTEREST AND PEN. .00
TOTAL DUE 90.14
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
Recore;,,' of
Recbtf':
REV-1548 EX AFP (12-001
-02
FEB -1
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P 1 :42cOUNTY
SSNI'DC
ACN
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153790
HARRIET E
TERESA L MCLOUGHLIN
25 E LISBURG RD ",CLerk,"
BOWMANSDALE PA 17uefUYlbenc:", .
! I r!
'L; ~ ..
Allount Rellitted
PJ\
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-V=is4-i-ix--AFP--ri2-:ooi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01153790
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
139721-11
TYPE OF ACCOUNT: () SAVINGS (>0 CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
1,630.27
0.500
815.14
.00
815.14
.45
36.68
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 36.68
INTEREST AND PEN. .00
TOTAL DUE 36.68
· IF PAID AFTER THIS DATE, 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. )
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(l/{S/1'1
*C/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
IEY-1541 EX AFP 112-00>
PA 17008
DATE
ESTATILJloF
. itA TI'. 0 [OF DEATH
FILE NUMBER
COUNTY
-02 FEB -~:~~C:S6
~~~~b0'JS;. HA~l JAtK PA::: :::t::MIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153790
HARRIET
E
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
Cd-. ,~.}I \ ().Lvfl \
0V ~ lfi;:).
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iifi=is4-i-E)f-AFit-rilf=oQi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01153790
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
139721-11
TYPE OF ACCOUNT: () SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
1,630.27
0.500
815.14
.00
815.14
.45
36.68
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WIllS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 36.68
INTEREST AND PEN. .00
TOTAL DUE 36.68
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCU~ TION OF ADDI IONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQ~IRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT.. ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
COMMONWEALTH OF PENNSYLVANIA {11_,. /J t.J
DEPARTMENT OF REVENUE I J-'
*,c/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
NOTICE OF INHERITANCE TAX
APPRAISEKENTL ALLOWANCE OR DISALLOWANCE
OF DEDUCTION~, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REY-1541 EX AFP 02-001
nf DATE
" ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
FEB -8 P 1 :5lJiSN.lDC
ACN
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153791
Allaunt Rellitted
HARRIET
E
ReCCIIC:,::
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
.02
PA 170bBE.'rk
Curnbe; i 'J,
I~ ~\~~I
G&- cp"'la~
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 ~
iifi=i54-i-i)f-AFit-fiz-:oQi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01153791
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
139721-05
TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-04-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
2,003.16
1.000
2,003.16
.00
2,003.16
.45
90.14
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER ?ORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 06-18-2002~. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 90.14
INTEREST AND PEN. .00
TOTAL DUE 90.14
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDI IONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT" ( CRl, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTI~S. l
COMMONWEALTH OF PENNSYLVANIA 17...-./5... I '-I
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 171Z8-0601
*'
v
NOTICE OF INHERITANCE TAX
APPRAISE"ENT~ ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONtj~_AND ASSESS"ENT OF TAX ON
JOINTLY KELD OR TRUST ASSETS
REY-1548 EX iFP C12-DD)
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
.02 FE8-8
PA 17008 C:S'fh.
CUITlbend(I~::,
J~ '11~l~~
U0~ IDd-
DATE
~ATE OF
;:IJATE OF DEATH
FILE NUMBER
COUNTY
P f~DC
AclC
02-04-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153789
Allount Rellitted
HARRIET
E
F:i\
MAKE CHECK PAYABLE AND~EMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-V=is4-i-i)f-AFFr-rilr=ooi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-04-2002
ESTATE OF DRAPER
COUNTY
CUMBERLAND
HARRIET E DATE OF DEATH 09-17-2001
ACN
01153789
FILE NO. 21 01-0971
TAX RETURN WAS:
S.S/D.C. NO. 221-22-8104
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
139721-00
TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
427.92
0.500
213.96
.00
213.96
.45
9.63
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT1 SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS1 AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 9.63
INTEREST AND PEN. .00
TOTAL DUE 9.63
. IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADD I IONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REqUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl1 YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
~
If
ti'
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
MCLOUGHLIN TERESA M
25 E L1SBURN ROAD
BOWMANSDALE, PA 17008
-------- fold
ESTATE INFORMATION: SSN: 221-22-8104
FILE NUMBER: 2101-0971
DECEDENT NAME: DRAPER HARRIET E
DATE OF PAYMENT: 06/06/2002
POSTMARK DATE: 06/05/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 09/17/2001
NO. CD 001260
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $41 .78
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$41.78
REMARKS: TERESA M MCLAUGHLIN
CHECK#104
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
~-., /'7- /~ /~
\:. I
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
l2
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
REV-UOIi EX AFP Cl2-00)
~:3
'-.
07-12-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153789
Allount Rellitted
HARRIET E
PA 17008-0000
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-1604 EX AFP (12-00)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 07-12-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
ADJUSTMENT BASED ON:
S.S/D.C. NO. 221-22-8104
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
01153789
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO. 139721-00
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 00
· IF PAID AFTER THIS DATE, 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 17128-0601
REV-1604 EX AFP U2-00)
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
PA 17008-0000
07-12-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153790
AlIOunt Rellitted
HARRIET E
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (12-00)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 07-12-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
ADJUSTMENT BASED ON:
S.S/D.C. NO. 221-22-8104
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
01153790
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO. 139721-11
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 04-26-1994
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE nn
· IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
{ IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ1
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
TERESA L MCLOUGHLIN
25 E LISBURG RD
BOWMANSDALE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 17128-0601
REV-l'04 EX AFP Cl2-00>
PA 17008-0000
07-12-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
221-22-8104
01153791
Allount Rellitted
HARRIET E
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-1604 EX AFP (12-00)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 07-12-2002
ESTATE OF DRAPER
HARRIET E DATE OF DEATH 09-17-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0971
ADJUSTMENT BASED ON:
S.S/D.C. NO. 221-22-8104
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
01153791
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO. 139721-05
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 05-04-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
1.000
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT. SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 00
· IF PAID AFTER THIS DATE, 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
REV-1470 ~X (~)
'* INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
DECEDENrs NAME FILE NUMBER
HARRIET E. DRAPER 2101-0971
REVIEWED BY ACN
Phyllis Hoch 01153789,01153790,011
53791
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN.
ROW
Paae 1
! /?-/s:/y
~BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'(J2 JUL 26
TERESA M MCLOUGLIN
25 E LISBURN RD
BOWMANSDALE t....PA 17008
/-',
\ .! ~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-22-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
101
.;; >; :19
*'
REY-1541 EX AFP 101-02)
HARRIET
E
Allount Rellitted
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 ~
iffi=is4j-iif-AFP--coi-:oz'r-NoTIci--oF-i-NHiifiTANci-TAX-APPRAIsiifENT-,--Ar:rowANci-ifli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DRAPER HARRIET E FILE NO. 21 01-0971 ACN 101 DATE 07-22-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
} CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
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 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
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
n}
(2)
(3)
(4)
(5)
(6)
(n
.00
.00
.00
.00
4.320.36
2.030.68
.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/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO}
5,422.63
.00
(ll)
n2}
U3}
U4}
NOTE:
.00 X 00 =
928.41 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.
6,351.04
'i.422 63
928.41
.00
928.41
U9}=
.00
41.78
.00
.00
41.78
TAX CREDITS:
. ". ....... "..'W..... . I T+l AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-12-2001 CDOO0637 2.09 129.63
06-05-2002 CDOO1260 .00 41.78
TOTAL TAX CREDIT 173.50
BALANCE OF TAX DUE 131.72CR
INTEREST AND PEN. .00
TOTAL DUE 131.72CR
. 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.)
/?-/~-/~
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-in7 EX AFP CUi-a2)
j(
. .....
:! 7
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-19-2002
DRAPER
09-17-2001
21 01-0971
CUMBERLAND
101
HARRIET
E
TERESA M MCLOUGLIN
25 E LISBURN RD
BOWMANSDA~~. PA 17008
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 ~
RE-Y=i6"ifj-E3f-AFP-co1-:o2j-------...--iNHERITANCE--TA3f-SY'1rfEME-NT-ifF-Aifcouiff--...---------------- -----
ESTATE OF DRAPER HARRIET E FILE NO. 21 01-0971 ACN 101 DATE 08-19-2002
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-15-2002
P R I NC I PAL TAX DU E : ...........................................................................................................................................................................................................................
41.78
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-12-2001 CDOO0637 2.09 129.63
06-05-2002 CDOO1260 .00 41.78
07-30-2002 REFUND .00 131.72-
TOTAL TAX CREDIT 41.78
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
~\.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: \-\ Q('r \ eA- G. 1:)C'a..p..e..r
Date of Death: q \ \.., \ () t
CJ~K
Will No.:
geo\ - ooq,\
Admin. No.: ..J.l-. () \ _. oq'l
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes~ No 0
2. lfthe 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 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date:~ICB !J,rn.r(Je-;t~
Signature ~
r:::er.eeo.. M.. tv\Q..L<:HJ6" \ .,-)
Name
r--
c9 5 E. L('sbocr') R:..cl
I
Address
G()~'sd~lsL ~A
/
II ()o~
(Y"'\
~.::::i
'I f'-:'"
..-" ~........
., t,,-lJ91 - \ c;SLD
Telephone No.
Capacity~ersonal Representative
o Counsel for personal representative
-.::::t