HomeMy WebLinkAbout01-0989
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of flllre 4/ F, 'E4€tC.. No. dlJ -0 j... q fq
(
also known as To:
Register of Wills for the
. Deceased. County of Cumberland in the
Social Security No. ;2 0:3 -/0 - 3 elo Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(8t, who ishre 18 years of age or older an the executR "-lC ,
in the last will of the above decedent, dated .2 t:> 7)~L.
and codicil(s) dated
named
,19 %'7
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in rv c.<AoH k I A-N)f) County, Pennsylvania, with
h /5 last family or principal residence at ra,€'t?sr pA-;2/d .AI(L,z.5~ f-kr,.&.
'7,:JO {"t/4/,N~,.-~r~Rd (?.4-?2/i~s/~ fJ,4 /7t:l/3 U
I '
(list street, number and muncipality)
Decendent, then '? 3 years of
at ,tfl r P41l!K IV "'-125 . . 6T
Except as follows, decedent did n t marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
,;2. t) c.7;
,19/)1
$ .l.
$
$
$
~.cV
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters t: -;. r-: ~ cAr r:
(testamentary; administ ation c.I.a.; administration d.b.n.c.l.a.)
theron.
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OATH OFPERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 'I ss
COUNTY OF Cumberland J .
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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/7-17-1/
No. 21-2001-989
Estate of
HARRY E. BAER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW October 30tQ___._ ~_ tc%_200,lin consideration (,'
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated December 26th, 1987
described therein be admitted to probate and filed of record as the last will of
HARRY E. BAER
TESTAMENTARY
SUELLYN J. GRAHAM
"-,:e t:e:,it~CH'. 'JD
and Letters
are hereby granted to
. MAJ/J ~J-I:-
RY C. LEWIS'~7
FEES
Probate, Letters, Etc. .........
Short Certificates( ~ . . . . . . . . . .
Renunciation ................
X_Pages (0)
JCP
525.00
515.00
$
-0-
5 J. 00
TOTAL _ $ 4, _ n n
. Oct-oher. .:W.th'r 2.00.1. . . . . . . . .
ATTORNEY (Sup. C:. 1.D. No.)
ADDRESS
Filed
PHONE
MAIL LETTERS '1'0--. ,. ''''~I~r
,'. .- . ..
"-;:4..\....
, ..
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat , sign the same and that signed as a witness at the
request of testat_ in h presence and (in the' presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19---,--
(Name)
(Address)
Register
(Name)
(Address)
21-2001-989
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
i~ ,-,'
=-' Ct ~ II r /t( J C R 41-1--Fhn
~~~~xiJMf~~i~~ being duly qualified according to law, depose(s) and say(s) that
I am familiar with the signature of Harry E. Baer
codicil
testat-O-r-- of llonExadX:thexxobcoribincx>>'itReSSC$C~) the g> presented herewith and
codicil
that I believes%tte signature on th~s in the handwriting of
Harry E. Baer
to the best of my knowledge and belief.
Sworn to or affirmed and subscribed before ~ d /L.k.z-........._
/'~ c) /
me this 26th day of ./! (Name) ~
October }(l~~1 L// '/v";1Ute v;( ~~
:;a d7- j) (Addre}S)
Register 7"l' ~ ;(Y'~)' ~a /7&:'/7
U (Name)
(Address)
H105.905 REV.(09/00)
This is to certify that this is a true copy of the tecord which is on file in the Pennsylvania Division of Vital Records ill accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
G\~5.~/~.
Robert S. <ZinJnerman, Jr., MPH
Secretary of Health
Charles Hardester
State Registrar
No.
~!/~
2340921
OCT 2 2 2001
Date
21-2001-0989
H105.143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
TYPE/PRINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT(Flrst MiOltIe, Last)
SEX
SOCIAL SECURITY NUMBER
DATE OF DEATH(Moolh.-o.y, Year)
,. Harr
Baer
UNDER 1 YEAR
Months Days
UNDER 1 DAY
Hours Minullls
, Male .. 203 _ 10 _ 3810
PlAce OF OEATI-(CMdl only one. see instructions on other side)
HOSPITAl:
InPlllenl.D
...
FACILITY NAME (If not instltlllion, gille stlllet and number)
~October 2 2001
83
Other
(Specify) 0
. I.
COUNTY Of DEATH
RACE-Americ8n Indian. B18clli, White, ate
(Specify)
lb. Cumberland
DECEDENT'S USUAl OCCUP"TION
(Give kind of woR. done during most
of wortdng I"'; do nGluse retncl.)
11..S stem Analist ...Railroad
DECEDENrs MAILING ADDRESS (Street, CityfTown. Stlte, Zip Code) DECEDENTS
ACTUAl
RESIDENCE
(SHinstJuctIons
onotl'1erSicle)
Ie. CarliBle
KIND OF BUSlNESSIlNOUSTRV
WAS DECEDENT EveR IN
U.S. ARMED FORCES?
v.. 1ZI N. 0
1L
10. Whi te
SURVIVING SPOUSE
(Ifwife,givemlldennlmei
171. StMe
PA
DOl
decedent
liveinl
township?
two
Forest Park Nursing Center
Carlisle, PA 17013
17b.County
Cumberland
17d.1KJ '::h:='U':ri::of Carlisle
eitylboro.
...
FA THER'S NAME (First, Middle, Ust)
... Harr Baer
INFORMANT'S NAME (TypeJPrinl)
~Mrs. Suell n Graham
METHOD OF OI~~..lOiXI Cremation D Removal from Stale D
Donation D other (Specify)
211.
SIGNA
o
PlACE OF DISPOSITION. Name of Cemetery, Cremltory
Of Olher Place
o
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<J)
::>
<J)
$
;;!
.7, 2001
LICENSE NUMBER
nb. FD-012975-L
~LProspect Hill Cemetery
no. P.O. Box 424,
17103
Inc.
To lhe tIesI. of my knowledge, death occ:ufTed at the time, dale iIIld place stilled.
(SignalureanclTiUe)
,...
TIME OF DEATH DATE PRONOUNCED DEAD (MOnth, Day. YelK')
LICENSE NUMBER
24. 5:15 AM M. 21. October 2, 2001
27. PART I. EnterUle diseases. injuries or comptical.ions which caused lhe death. Do not entet"1he mode of dying, such as calOlK Of respiratory arrest. shock or heart failure
list only one cause on each line.
DATE SIGNED
(Month, oa" Year)
23b. 231;.
WAS CASE REFERRED TO My~~~ EXAMlNERlCORONER?
".
Approximate
I inte....,al between
onsel: and death
NoIXI
PART II: OlhersignificanlCOndilionsconl.ribulingtode8lh.bul:
not resull:ing inlhe undertying causeglven in PART I
',-
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{ :
d.
WERE AUTOPSY FINDINGS
AVAILABLE PRIOR TO
COMPLETION Of CAUSE
OF DEATH?
DUE TO (OR AS A CONSEQUENCE OF):
MANNER OF DEATH
v.. 0 No 1ZI
v.. 0 N. 1ZI
Natural IXJ
Accident D
Suicide D
DATE OF INJURY
(Month,Ca" Year)
TIME OF INJURY
INJURY AT WORK?
DESCRIBE HOW INJURY OCCURRED.
Homicide
o
o
o ....
v..D N.D
Pending Investigation
Could not be determlnect
....
2... ZIb. 21,
CERTIFIER(Check only one)
*CERTIFV1NG PHYSICIAN (Physician certifying cause of death when another physician has pronounced death and completed 1l9fTI 23)
To the best of my knowledge, death occulTltd due to the cause(s) and manner as stated_
.PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To the best of my knowledge, death occurred at the time, date, and place, and due to the causees) and manner as. stated
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*MEDfCAL EXAMINERlCORONER
On the basi. of examination and/or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and
manner a. stfied. _ _
o
PA 17241
1(,1.71 t, 10 /\'I
DATE FILED (Monlh, Da" Year)
...
be: tc'Q.u d. 200 I
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) bein
law, depose(s) and say(s) that
uly qualified according to
present and saw
//
--
the testat , sign the same and that " // signed as a witness at the
request of testat_ in h presence and(in"the presence of each other) (in the presence of the
other subscribing witness(es)). ,.r
_,;'C
Sworn to or affirmed and subscribed'b~fore
/
me this day of
19_
(Name)
(Address)
Register
(Name)
(Address)
21-2001-989
REGISTER OF WILLS OF e~Ja~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
/nll-.f//; cu/ J t~ 14 h 19 /),1
(each) a subscriper hereto. (each) being duly qualified according to law, depose(s) and say(s) that
70"/1/1 familiar with the signature of J.I /4 /21Z1/ E. /3.Ll1=i?
cod~
testat 0/2.. of (one of the subscribing witnesses to) the ~ presented herewith and
codicil
believoe-the signature on the @is in the handwriting of
.1
that
#4f1/ ,F. dft'~
to the best of /Jfv knowledge and belief.
/
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Register~
(Name)
$.fr-77 /-fElt / I. G/4r1/H?t
(Address)
/// ,o?)~~~c~/ C:A--~
o
(Name)
J::?'//5~/Of~:/'1 /7/)/<7
(Address)
LAST WILL AND TESTAMENT
of
HARRY E. BAER
21-2001-989
KNOW ALL MEN BY THESE PRESENTS, That I, Harry E. Baer, residing
at 4097-Apt.D, Cypress Road in Harrisburg, Dauphin County, Pennsylvania,
being of sound mind and memory, and desiring to dispose of all my
earthly possessions, do hereby make, publish and declare the following
instrument in writing to be my last will and testament, hereby revoking
and void all other wills or instruments in writing by me heretofore made.
ITEM 1. I give, devise and bequeath all of my estate, real,
personal and mixed, and wheresoever situate, in equal shares, unto my
children, namely: Charles E. Baer, son; Harry R. Baer, son; Sue11yn
J. Graham, daughter; and Janis C. Hamm, daughter.
ITEM 2. If any of my children is not living at the time of my
death, then in that event, I give, devise and bequeath all of my estate,
real, personal and mixed, and wheresoever situate, in equal shares, unto
those children still living.
ITEM 3. I nominate, constitute and appoint as Executrix of this,
my last will and testament, my said daughter, Suellyn J. Graham.
ITEM 4. In the event my said daughter, Suellyn J. Graham, pre-deceases
me or her or my death occurs simultaneously, I nominate, constitute and
appoint as Executor of this, my last will and testament, my said son Harry R.
Baer.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
:L e:, t/. day of December, A.D. 1987.
,r
~ ~~SEAL)
-c1
named testator as
Signed, sealed, published and declared
and for his last will and testament in our presence, who, in his presence, at
his request, and in the presence of each other, have hereunto set our hands
as attesting witnesses.
~~.~
:..';?~, ~2
residing at~96J1 b~~~Dt://t;. ;2/)//2..
res iding at 4D '1" IJ ~-e-r-A of: , -I.J.Iu ' ,Jl/J. /7/1 A.
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
//~t2Cj E, '6lfE12
(J
c
/tJ / ,;7'/01
. ,
Date of Death:
Will No.
Admin. No.
~(}c)/- t1tJ 7'?9
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 I ~/.3 / t' 1
Name
Address
[1A4;e/to-S ? &/2-
J/; IV /S {~ ;/ /1m ff7
b 7 :i j r: /1 b;beK /),f,. <:);,/1/ k E 6 9 S-I 3(;,
, ,
71 l/N~;'v llut3. Jk/lI~'U4?j. A /7//1
/ (J ,
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: c:7~;0;L
,
Signature
f',,\
1,1;1
('J
0:
Name Ln./~ _ ~ L t'
./ ~U /~
Address ~f /'~ y~
/,f/:/~, 4"1/70/7
Telephone (1/1) ~ 3;2 - V /3;
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LI..J
Li...
Capacity: / Personal Representative
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JJ=
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_Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I
J
ss:
being duly according to law, deposes and says that he
of the Estate of II~~ E, 13;<h::"e
late of ~~rP~1( _~d... (}N~I(!,___(}t-;e/;s Ie , Cumberland County, Pa., deceased and that the
within is an inventory made by cSae--//o/H c.f, GA!.4-HJt1rn "' the said jJ~"'/ ~..e'"5t9f'?79n~
:)f the entire estate of said decedent, consisting of all the personal propdrty and real estate, except real estate outside
~he Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
n of the date of decedent's death.
and subscribed before me,
/4..~A~~.
Su~/I'YN J G',e~~
l/-I "2J7t<,'''t:tL 1/l7Vt::; 7h1Isju;!!I/I~ /7d,Kj
Address C/
d 'l S((P'(~P..PtL ~ 'k.u 1
~\~
NOTARIAL SEAL
CHARLES A HARBOLD, Notary Public
Camp Hili Boro, Cumberland County J
My Comml88lon 'Expires Dec. 30, 2006
Date of Death
;l~<
tfJ(!-77J j €/2.-
dl (JO I
Day
Month
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
~E.~
deceased
/. F':-/!S477.4/ {lkJ"".I~
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..../..'
----
STATUS REPORT UNDER RULE 6.12
Name of Decedent: 73.41:/2-/ 1I/1~,I!t 6.
Date of Death: //J-tP;l.. -.;J..C;o /
Will No.:
~/- ~o/-CJ9'i1'7
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No ~
2. Ifthe 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 Qg
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 t&1 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.
~ ~~L,#. ~
g(gnature (/
$<<-fF/I~A/ J: G"M~
Name
Date: 9-,;17- ,;Mo3
~
IO~
'1/ d'1lPddeL {AN6/ A'/15J~/ f?4/7d~
Address
7/7 - t/3~ -tf/3 'J
Telephone No.
Capacity: I2?l Personal Representative
o Counsel for personal representative
/')-/-?- .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
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-03-2003
BAER
10-02-2001
21 01-0989
CUMBERLAND
101
.J, 12
r"
SUELLYN J GRAHAM
41 DOGWOOD LN
DILLSBURG
PA" 17019
Allount Rellitted
'*
REY-1547 EX AFP lDl-D5l
HARRY
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 ~
REY=is4j-EX-iFP-("OY:03Y-NOYicE--OF-YtiHEififANCi-7fA'x-A"PPRA-isEifENT-,--iL'rOWANci-cfi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAER HARRY E FILE NO. 21 01-0989 ACN 101 DATE 11-03-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
( ) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
9,395.07
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
. ". ,,~...
DATE
KI:l,;I:.Lr'1
NUMBER
l+J
INTEREST/PEN PAID (-)
(9)
(10)
9.266.88
NOTE: To insure proper
credit to your account.
subllit the upper portion
of this forll with your
tax paYllent.
9.395.07
9.395 07
.00
.00
.00
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
.00
.00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
128.19
(11)
(12)
(13)
(14)
. DO X DO =
. DO X 045 =
. DO X 12 =
. DO X 15 =
(19)=
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: 'tJAe/C.. 4~~cL- 6.
, (J
Date of Death: /IiI-eJ;( -~o /
Will No.:
c52/- ~O/ -?J 92'7
Admin. No.:
Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No ~
b. The separate Orphans' Court No. (if any) for the persqnal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes 181 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: 9-,;1./- ,;M03 ~ ~~/,~ ~
s(gnature (/
~~/I~A/ v: GM~
Name
Iff ;JJ~(PddL LANt:.; AII.5j~/ -!?417d4
Address
7/7 - '/3;2 -'1/3 'j
Telephone No.
Capacity: ~ Personal Representative
o Counsel for personal representative
~EV-1500 EX (6-001
\'1- \"1- 4
REV-1500
-
\:
-
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
FILE NUMBER
~L-Ql
COUNTY COOE YEAR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~~q<t~
NUMBER
I-
Z
W
C
W
()
W
C
DECEDENT'S NAME (LAS~, ~RST, AND MIDDLE INITIAL)
73AEI!. HM- e.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
/ /) - () ;l - :ZOO / II - 3 t'J - I 9/7
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
~t)3 - 10 - .39/tCJ
W
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o 1. Original Return
o 4, Limited Estate
~ 6, Decedent Died Testate (Attach copy of Will)
o 9, Litigation Proceeds Received
o 3. Remainder Return (date of 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)
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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NAME f7 ...,.. /'1
0/t.-c If,. W V I ~!2A H--A7n
COMPLETE MAILING ADDRESS / _
t.f( Z; t)~UJPt/P L/f1I/c
7)/(15 bU-~ / fJA- /r~/~
FIRM NAME (If ApplICable)
TELEPHONE NUMBER
717- 1/3..7 - </-13
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
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9; 3 9s'o7
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(11)
(12)
(13)
1. :3 9S,()7
~
~
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(6)
(7)
(8)
1~ 375-'07
(9)
(10)
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/ ,;l P. /9
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)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O _ (15)
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16. Amount of Line 14 taxable at lineal rate
x.O _ (16)
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
(19)
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
. - REV-1508 Ex'. (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF 73 // -
,4E~~H~~7 ~.
Include the proceeds of litigabon 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.
FILE NUMBER
ITEM
NUMBER
1.
DESCRIPTION
F"-Inrn t5,if-Nf<.. /lee r;~ /71'?- ~ 366.5
( of;t:e~AA~ )
VALUE AT DATE
OF DEATH
#,z 379,,t) 'j
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d,
j / /"'.a _ ,L? Y#s t-l~r:rA/(!e
rtfte € -;---u tJ'L.L:} t-I-r <.::r/C-U~-r )
{jJ~e-p;:nZ> p~e72-FrI e~t/~
#S,;L~~7~7
#.
~ 7'~9F
3
Pt=-7l s en? 4--/ (! /0 y I'f ~?
, ..9, ~
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ ~39S-:()7
/
M."'.'~11 E~ "IVI1l
. "-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
R~.SIOEItT DECEDENT
ESTATE Of "L2 / / A
/J ~~ j-frf";ft/2 C-jr
,
Include unreimburlled medical expenses.
ITEM
NUMBER
1
SCHEDULE I L
DEBTS OF DECEDENT.
MORTGAGE LIABILITIES & LIENS
E: FilE NUMBER
DESCRIPTION
~tfJ.ec5r ?;:r~K ~/r'~ ~#~,.e . C~//.:s/e-,-f?r-
/
TOTAL (A/so enter on line 1 D. Recaplu alion)
(I' more space 1$ needed, insert additional sheets of the same, size)
AMOUNT
-#" /.;z~/7
$ I~?,I?
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF"lJA6e/ H~A!l E:
FILE NUMBER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
.::3uEIIC/~v J: ~-4-~
Iff 7JatJ tU(/dtf' {A?t/f:7
7JI lis b lJ/!j I fJ;1/'ltJ/9
,,(, (! h-47ele-s E 13~,e ~
h 1 S'-e/lbA7C~ JJ/2tv~
$,f/v .Jdse/ 01 9S-13b
JIr # i.s {', ;//11?1 /??
9'/ II#e////V flt/etlqe
4;2~~ &(.(, I P/I /7///
OA-uj' ~/L
3313
(I)
1.
:5oN
3~
.3
(~f)
3,
7J~(j' Te/L
33Y3
(!tf)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ I
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
of
HARRY E. BAER
KNOW ALL MEN BY THESE PRESENTS, That I, Harry E. Baer, residing
at 4097-Apt.D, Cypress Road in Harrisburg, Dauphin County, Pennsylvania,
being of sound mind and memory, andodesiring to dispose of all my
earthly possessions, do hereby make, publish and declare the following
instrument in writing to be my last will and testament, hereby revoking
and void all other wills or instruments in writing by me heretofore made.
ITEM 1. I give, devise and bequeath all of my estate, real,
personal and mixed, and wheresoever situate, in equal shares, unto my
children, namely: Charles E. Baer, son; Harry R. Baer, son; Suellyn
J. Graham, daughter; and Janis C. Hamrn, daughter.
ITEM 2. If any of my children is not living at the time of my
death, then in tpat event, I give, devise and bequeath all of my estate,
real, personal and mixed, and wheresoever situate, in equal shares, unto
those children still living.
ITEM 3. I nominate, constitute and appoint as Executrix of this,
my last will and testament, my said daughter, Suellyn J. Graham.
ITEM 4. In the event my said daughter, Suellyn J. Graham, pre-deceases
me or her or my death occurs simultaneously, I nominate, constitute and
appoint as Executor of this, my last will and testament, my said son Harry R.
Baer.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
:2 ~t/. day of December, A. D. 1987.
/'l
~ ~e~SEAL)
-c?
named testator as
Signed, sealed, published and declared
and for his last will and testament in our presence, who, in his presence, at
his request, and in the presence of each other, have hereunto set our hands
as attesting witnesses.
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residing at7!9611 ~-A,~ rf: /J4,. ;2////1....
res id ing at 4 () 1 to I) Beec/u.€, -e-rA.t: ..:! JI-:." 1J1/.J. 1711)..
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REV-1511EX + (1-9?)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF -;)
IJ,4-c"e I'
FILE NUMBER
~/t7 ~
Debts of decedent must be reported on Schedule I
ITEM
NUMBER
A.
DESCRIPTION
1.
FUNERAL EXPENSES:
(!"c#lrk ;CC#(e7U4-/ /I~e; 2J/11s6v(J/ 1!4
R..J.. Ro-n 64!~ ~ ~ k &HtO~~/s 1Je-N bj'2d(7K " fj,
~D 6n??E) /
CoI071/A-/ C/~6 / ff,q7ZJ2./',S f;u1J I --fJa
{ F'- t;7l--""; (UA;tc-A €.Q-n. )
1< Et/. J1 UA!!/'e-/ 'E ~4-/cCt:ls/<\ / {/A?e~5it?f ...,:?,.
{S~{//~e} /
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
ct.
3.
tf,
8.
1.
Name of Personal Representative (s) ..5U-F//~/V J- G'.RA-~
Social Security Number(s) I EIN Number of Personal Representative(s) ~t;; - 3,,:z. - Sl9d-3
Street Address ~/~ UJet"If'L 4hvr
City ,Z),/;fl'u~7 State ?# Zip /7tO/?
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
2.
3.
State
Zip
4.
City
Relationship of Claimant to Decedent
ProbateFees C~ ,6-e&IA-ND [7t1fH.-<---nry/ .s#d~r C!67e-~~C~
5.
Accountant's Fees
6.
Tax Return Preparer's Fees .5f"?J rr- ~ syc:rrrl (7.,A7t!-lr5 Ie I f?:1
( re-De?f!---1'T I -:1',., ~ ~~)
7.
AMOUNT
.JI ~ ~I J>. .3 F
.# I o9.s. vo
,/
.# 'I "1 ;).. !SO
,.If" SO. 4"tJ
$' I ~G" tJ-CJ
..// <Is, dZ)
~ ,;2 to , erz.
TOTAL (Also enter on line 9, Recapitulation) $ ~ 2 ~ t, r Y
If more space is needed, Insert additional sheets of the same size)