HomeMy WebLinkAbout01-1058
Estate of' Le.n4 L. tv,l;,f~rJ
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
No. ;l{- Ol- I DSe
To:
Register of Wills for the
Deceased. County of C umber/OAtd in the
Social Security No. /':1. -It! - 71/5"Z Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut r-; 't
in the last will of the above decedent, dated
and codicil(s) dated
fIIote: lIn.r()/d J;;: JiJin ft!rr d/u:l /ha r,J, ~ $~ /9",3
rn~ I
named
, 19~
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cum bt.rla."eI County, Pennsylvania, with
last family or principal residence at ~2Z G-effvsbuII't; Re/., mee,han/csb"".tt
11 7j;. IVa.n/4 /7csS- a C1
(list street, number and muncipality)
OM-#hu-
~ 7W.. /~ 5.
Except as follows, cedent did not marry, was not lvorced 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 $ /ottJ","o .0'0
(If not domiciled in Fa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ t)
situated as follows:
WHEREFORE, petitioner(s) respectfully re~est(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters -I-~ 'AI~l-tV'(
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF-PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1 ,.s
COUNTY OF ClthlBe7L.L'htIL> jS
\
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 aJ9l tr~ly.adfl~Jster thjst.ate according to law.
Sworn to or affirmed and subscribed )( I{ ~ 'i!!j!'l../~. J L '"
before me this 16TH day of ~.
()II) ? c:a
"L.iL:Ftn.. ~' I
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No. 21 - 01 -1058
Estate of
LENA L WINTERS
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW NOVEMBER 19, ~ 2001 in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated MAY 1 ~ 1975
described therein be admitted to probate and filed of record as the last will of
LENA L WINTERS
TESTAMENTARY
and Letters
are hereby granted to
PATRH~TA WTNr,FRT
FEES
Probate, Letters, Etc. .........
Short Certificates( 7) . . . . . . . . . .
Renunciation ................
X-Pages
JCP
$ 200.00
$
$
$ 6.00
5.00
TOTAL _ $ ?~? on
Filed ...... ~.q~~~~.E.~ .19.,. .~99.1. . . . . . . . .
/1 on
r!kkl: ~dv7lL
AITORNEY (Sup. Ct. 1.0. No.) atfS/3
&, C1c~ser Rd. AtedtlZh,'csb"'{j"Pif /7oS!,
ADDRESS
7/7-7~~-azo?
PHONE
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Mailed letters to attorney on 11-16-01.
21 - 01 - 1058
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)
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CO
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Register
(Name)
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(Address)
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REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
p
~Tf!./'-/A L. J;1,;/,'N'GEIL T
~~QtH a subscriber hereto, (~~ being duly qualified according to law, depose(s) and say(s) that
SHE IS familiar with the signature of LENA L WINTERS
xQU(lt~t<
testatJUL of (Xl~lf X l{)l X ltit-X ~Xt>>~Qtmtt(<< X ~XtX1~$$~;: XC<>) the will presented herewith and
X~(4J(
that S H F believes the signature on the will is in the handwriting of
h__ LENA K WUBTERS
to the best of HER knowledge and belief. /J
Sworn to or affirmed and subscribed before h.. ~
me this day of
a>fJ ~~
(Name)
(Address)
(Name)
(Address)
21 - 01 - 1058
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)
REGISTER OF WILLS OF Cum 131=7l LA-ND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
CIt{Jr/~s E: .51/1 'elc/s tff a?ttl A, fr/c'R L. W/J'J1e..rt
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
lu:. tutg{ site are. familiar with the signature of LentZ L. w;,nh.r
~
testat~ of (ORe ef tA@ 31:l6serieiRg ur'tlle~~~E to) the will presented herewith and
~8aieil
that ht. 4: /'lei she believes the signature on the will is in the handwriting of
~n A L. h//.1'1 rerS
to the best of h/JMtK her knowledge and belief.
~~r:~
Chllr/~ S E: (N~e) Sit /elcl.s :or
6 C/oust!r ~~ lJIechanic5"hto. /1/1 /7oS.r
(Address)
fJt:lfr,'C./~ t... (Name) 11/,'rJ/~rt-
~2Z C~tfYSb~~9 f7,~... l11ecJu:tnl'cs6L{~, flll/7fJS'r
(Address)
Hl05.~ 12 f'lEV 8/88
IFEE FOR THIS
CERTIFiC.A TE $2.00)
-,
WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. T 4 9 7 6 6 7 3
C:tm~f.,",!b.~1
Name of Decedent
Lena
L.
Winters
First
Middle
Last
Sex
Female
Social Security No.
December 27, 1921
192 - 14 - 7452
Date of Death
October 13~ 2001
Date of Birth
Birthplace
Needmore, PA
Place of Death
422 Gettysburg Pike
Cumberland
Mecbanicsburg
Pennsylvania
Facility N8me
County
City. Borough or Township
Race
White
Occupation
Widowed Decedent's
Mailing Address
Homemaker
Armed Forces? (Yes or No)
422 Gettysburg Pike, Mecbanicsburg, P A 17055
No
Marital Status
Number
Street
City or Town
State
Informant Patricia L. Wingert
Name and Address of
Funeral Establishment
Funeral Director
Richard J. Grove
Grove Funeral Home, P.A. 141 W. Main St.~ Bancock, MD 2J7So..0368
Part I:
Immediate Cause
Metastatic Renal Cancer
Interval Between
Onset and Death
(a)
(b)
(c)
Part II:
(d)
Other Significant Conditions
MFlnner of Death
Natural XX Homicide 0
Accident 0 Pending Investigation 0
Suicide 0 Could not be Determined 0
Describe how injury occurred:
Name and Title of Certfier
Robert J. Musser, MD
Adrlress
204 l\1ummer Lane, DiIIsburg, P A
(M.D., D.O., Coroner, M.E.)
This is to certify that the information here given is correctly copied from an original certificate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Records Office for permanent filin .
October 16~ 2001
29-275
Dlstnct No.
Date Rpcflved by Local Registrar
310 E. North St., McCODneUsburg, PA 17233
Street Address
City, Borough, Township
-
21 - 01 - 1058
D-CT-Willand Testament
Henry Hall, Ine., Indiana, Pa.
:J.
LENA L. 1~INTERS
, of
Thompson Township
County of Fulton and State of Pennsylvania,
being of sound mind, memory and understanding, do make and publish this my last Will and Testa-
ment, hereby revoking and making void all former Wills by me at any time heretofore made.
I
I direct the payment of my debts and the expenses of my
last illness and funeral from my estate as soon after my death as
is practicable. If there is no cemetery lot available for my inter-
ment owned by me at the time of my death, I hereby authorize my
personal representative to purchase such a lot together with a
suitable marker to be inscribed and erected on the said lot using
therefor funds from my estate in such amount as my personal
representative shall deem necessary and appropriate.
II
I direct that all taxes payable as a result of my death
shall be paid out of my estate to the end that all dispositions made
hereunder shall be tax free.
III
All of my estate, whether real, personal or mixed and
wherever situate, I give, devise and bequeath to my beloved husband,
Harold E. Winters.
IV
In the event, however, that my husband should fail to survive
me, should die within thirty (30) days after my death, or should die
in a common disaster with me, then I give, devise and bequeath my
entire estate as follows:
(1) I give, devise and bequeath my entire estate,
whether real, personal or mixed, to my children,
Patricia and Karen, in equal shares.
(2) If either of the above named children should
predecease me, then I direct that their share
shall pass to their issue, if any, per stirpes.
V
No interest passing under this Will shall be subject to
anticipation, pledge, assignment or voluntary or involuntary
alienation until such time as it is actually received.
VI
In addition to powers vested in him by law, my Executor
shall have the following powers applicable to all property held by
him including all property held for the benefit of minors, effective
without the order of any court and until distribution of all such
property is actually made:
(1) To retain any property received by him including the
stock of any corporate fiduciary acting thereunder;
(2) To sell real estate for any purpose publicly or
privately for such price and on such terms as shall
be deemed proper without liability on the purchasers
to see to the application of the purchase money;
(3) To compromise controversy between beneficiaries;
(4) To distribute in cash or kind any or all of my
property at valuations fixed by him and in this
regard, to convey my real estate to either of the
above named beneficiaries in their name alone
provided that they shall pay one-half (1/2) the
value thereof to the other beneficiary named
herein.
VII
It is my express wish that the real estate shall not be
exposed to public sale and the hereinafter named Executor may hold
the estate open as long as is necessary to secure a reasonable price
for the said real estate at a private sale.
VIII
The Executor of this Will is hereby excused from the
necessity of posting security in connection with his duties as such
in any jurisdiction in which he may be called upon to act insofar
as I am able to do so by law.
I do hereby make, cO'n8titute and appoint
my husband, Harold E. Winters,
to be Execut or of this my last Will and Testament, provided, however, that if he
should fail to qualify for any reason, then I appoint my daughter,
Patricia Wingert., to be Executrix of this my last Will and Testament.
In ~itnt~~ _btrtof~ l~ LENA L" WINTERS ,
the Testatr~x above rwmed, have hereunto subscribed my name and affixed my seal,
the Is t day of May in the year of our Lord
one tMusand nine hundred seventy five.
~ )(?7 .
..-. ~::?~sU."''':'_''':-'_~'~''_d___'_ e
Signed, sealed, published and declared by the above flamed LENAL . WINTERS
as and for her last Will and Testament
in the presence of us, who have hereunto subscribed OU1" names at her request ~
witnesses thereto in the presence of the said Testat rix and of each other.
~~:;~.l/l~"'d""'_"_"__'__'_'
-----~-:!_~--f...~~../.~z::~:.:~ '1-e~::::~~::::::.'~________ _ __ _.
E
---
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: LENA L. WINTERS
Date of Death: October 13,2001
Will No. Admin. No. 21-01-01058
TO THE REGISTER:
I certify that notice of beneficial interest 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
December 12,2001:
Name
Address
Karen J. Andrews
420 Gettysburg Pike, Mechanicsburg, Pennsylvania 17055
422 Gettysburg Pike, Mechanicsburg, Pennsylvania 17055
Patricia L. Wingert
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: December 12, 2001
Ol:::t
;~
W,""
~t'~&
CHARLES E. SHIELDS, III
6 Clouser Road
Mechanicsburg, P A 17055
Telephone: (717) 766-0209
Counsel for Personal Representative
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~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-06Ql
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT# ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG PA 1~055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-14-2002
WINTERS
10-13-2001
21 01-1058
CUMBERLAND
101
*
REV-l547 EX AFP CUl-02)
LENA
L
AIIount 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 ~
REY= i54-j-ix-AFP--coi-:o 21--NoTici--oF-iNHEifiTiirci-'f Ai-APPRjrisEi'-ENT~--AL1-owANcE-ifi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WINTERS LENA L FILE NO. 21 01-1058 ACN 101 DATE 10-14-2002
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
NOTE:
.00
18,908.67
.00
.00
218,123.64
5,043.34
67.676.68
(8)
30#967.46
275.20
(11)
(12)
(13)
(14)
.00 X 00 =
278.. 509.67 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.
309#752.33
31.24:;>> /t/t
278#509.67
.00
278..509.67
(19)=
.00
12..532.93
.00
.00
12..532.93
TAX CREDITS:
r"I"l:nl 1'{1:~I:J.rl II (+, AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-06-2002 CD001384 .00 12..539.43
10-07-2002 REFUND .00 6.50-
TOTAL TAX CREDIT 12..532.93
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
· IF PAID AFTER DATE INDICATED.. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).. YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
\.. /?-- r::2 e:2 - I
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-IU7 EX AFP 101-02>
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG PA, J7055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-21-2002
WINTERS
10-13-2001
21 01-1058
CUMBERLAND
101
LENA
L
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, submit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R'Ey=i60j-ix-AFP-(Cir:02i-------...--iNHERi'fANCi-Tix-STjrfEM'E-tiT-OF-AC-COUiiy--...---------------------
ESTATE OF WINTERS LENA L FILE NO.21 01-1058 ACN 101 DATE 10-21-2002
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: 10-07-2002
P R I NC I PAL TAX DUE: ...........................................................................................................................................................................................................................
12,532.93
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-06-2002 CDOO1384 .00 12,539.43
10-07-2002 REFUND ..............- .00 6.50-
TOTAL TAX CREDIT 12,532.93
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" (eR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
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
CHARLES E SHIELDS III ESQUIRE
6 CLOUSER ROAD
MECHANICSBURG, PA 17055
-------- fold
ESTATE INFORMATION: SSN: 192-14-7452
FILE NUMBER: 2101-1058
DECEDENT NAME: WINTERS LENA L
DA TE OF PAYMENT: 07/08/2002
POSTMARK DATE: 07/06/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 10/13/2001
NO. CD 001384
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $12,539.43
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: CHARLES E SHIELDS III ESQUIRE
CHECK#104
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$12,539.43
MARY C. LEWIS
REGISTER OF WILLS
/ 7--;).~ --j
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
o
July 10, 2002
Telephone
(717) 787-3930
FAX (717) 772-0412
Charles E.Shields III, Esq.
6 Clouser Road
Corner of Trindle & Clouser Rd
Mechanicsburg, Pa.17055
Re: Estate of Lena L. Winters
File Number 2101-1058
Dear Mr Shields:
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before January 13,2003. Because
Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional
extension(s) will be granted that would exceed the maximum time permitted.
r-
Sincerely-r-
j ;.'..'1 /;,/ /! /./1. ;1 d
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~ ! ij~'):ln 'v:J(ifl!t;!U~I/: '\../
~rey D. Hollenbush, Supervisor
. ..' ...,.Document Processing Unit
Inheritance Tax Division
(}/
STATUS REPORT UNDER RULE 6.12
<-/- ~. / I __.~A )
Name of Decedent: ~ ~. ~~
Date of Death: ~ /3,;l(x;1
,
Will No.
;2/-o/-/os-Y
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 Lhether administration of the estate is complete:
Yes y" No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
~ 2:~~-p
S~gnature
Date:
fD ., 'f ~ oz..r-
':'J
'"
Charles E. Shields, III
Name (Please type or print)
6 Clouser Road, Mechanicsburg, PA 17055
Address
s; ~::
L l ~.lrtr' ZOo
(717 ) 766-0209
Tel. No.
Capacity: Personal Representative
~counsel for personal
representative
( MAH : rm f I AM 3 )
CJ
,:'l
v'"
STATUS REPORT ~NDER RULE 6.12
Name of Decedent:
L eA1t;. L.
IN,~ fU'~
Date of Death:
I IJ.... I 3 - (/ I
Admin. No. 2/-0) - }OS'O
Will 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 administ=ation of t~e estate is complete:
Yes X No
/ "
2. If the answer is No, s~ate when the personal
representative reasonably believes t~at the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal repFesentative 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 =epresentative state an
account informally to the parties in i:1terest? Yes X No
d. Copies of receipts, r21eases, joinders and
approvals of formal or informal acccunts may be filed with,the
Cerk of the Orphans' Court and may be attached to this report.
~f:~P
Signature '
1-10-0,3 ,
, Date:
_~ E. SHIELDS III
Name (Please type or print)
6 Clouser Road, Mechanicsburq, FA 17055
Address
( 717) 766-0209
Tel. No.
(MAR: rmf/AM3)
Capacity: Per~onal.Representative
~Counsel for personal
representative
REV- 1500 EX 16-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY ~
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FILE NUMBER
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COUNTY CODE YEAR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
J2-L~~~
NUMBER
I-
Z
W
Q
W
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W
Q
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
WIN/€I?SJ LENIT L.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
//) -/3 - ~ol /:l.-~7-19ZI
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
,vIA
SOCIAL SECURITY NUMBER
1'1.7.. - III
- 7LfS Z
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (dale of death between 12.31-91 and 1-1-95)
o 3. Remainder Return (dale of death prior 1012-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME CH Itt<.LE 5 E.
5HIEZD57lL
COMPLETE MAILING ADDRESS
" C LOU Ser<. /loA-I::>
rvlcCHRN/CS13 UR~ PA /7oSS"
FIRM NAME (If Applicable)
TELEPHONE NUMBER
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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)
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)
(1)
(2)
(3)
(4)
(5)
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OFFICIAL USE ONLY
(6)
(7)
(9)
(10)
(8)
"130 I 9~ 7. 4fo
:t ~ :J 7 5. Ol 0
~ 3oQ, 7S:2. 33
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(11) ~I, ;{ '1'2. .,'
(12) ~~7e. .::rl:>9.f47
(13) -0-
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(14) ::J. 7 3',
x .0 f?- (15) 0
x .0 .L/S %
(16) 1:J....5.3~. '13
(/
x .12 (17)
t'J
x .15 (18)
(19) / :/, 63,;;z.73
14. Net Value Subject to Tax (Line 12 minus Line 13)
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)
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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
tJ
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
~'_.',"'" *'
COMr~ONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FilE NUMBER
WIN TG"/(S J LE'N/1 L
;2,1-01- 01 0s-8
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
E",.7hV /lRNC€" p~//J1/: R.4rE;" RESEFJf2l1E FuND
~
:Z, 1953. t:>57 c5ju~r~s at '7. 2/ //.er share -
(Gee le-/kr frOM /l-AlCHP,( F/If//M/t!/Hl 6~Pt/P /l'IfAC),~d)
~
/8'" 9'oe'. ~7
TOTAL (Also enter on line 2, Recapitulation) $ IS? / <1 P 8: (,7
(If more space is needed, insert additional sheets of the same size)
! h (Ar d;l:?
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" ~LJ!J.4t i:::j
ANCHOR FINANCIAL GROUP
"...Solid Advice from Trusted Advisors..."
January 30,2001
Charles E. Shields, III Esq.
6 Clouser Rd.
Mechanicsburg, PA 17055
Re: Values of investment for Lena L Winters, deceased, as of October 13, 2001
Dear Charles,
The investment account we held for Mrs. Winters as of her date of death was as follows;
Eaton Vance Prime Rate Reserve Fund, 2,053.059 shares @ $9.21 per share =
$18,908.67.
Please call if you have any additional questions. We are happy to be able to assist you.
Sinc~rely,.
., ;'
.'
,'"
.c,
/ /~-
~ c.'(". . ",.,,~
/''1. Nelson Wingert, CLU
415 Fallowfield Road, Suite 300, Camp Hill, PA 17011
2173 Embassy Drive, Lancaster, PA 17603-2387
(717) 975-0509. (800) 377-3097. Fax: (717) 975-0587
email: anchor@anchorfinancialgroup.com · www.anchorfinancialgroup.com
Securities offered through Multi-Financial Securities Corp. Member: NASD/SIPC
~'~":"~ '*
CO/4';tONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
~/-ol -lOSS
W/N7G7?S
,
FILE NUMBER
LG7V/1
L.
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
VALUE AT DATE
OF DEATH
DESCRIPTION
Attrlle.sT F/A//IA' t!1/l-L Ce:N-r~1 AI./!.
/1-.) (!.,q~I<IA/G /P~Cr: #: Poz03:J..7~/)l:>
13.) CEF7l.TIP:: ~F l>E7Ias IT .;Ijt g (JOt!)o 00 IS" 17/9 'j
C,J IN7: /'!C!CJt. 7D 7), D. b. ~AI 8.)
]).) CEK..rlF. of 1/EPo!;/T :& 8000000 <: 0713 9l:>
E,) INr: Aeclt. 70 :P. p. b. /IN 2>.)
rI I} i32..3S
fl'
//:)} OoO.eJO
'~3". 67
~7" '"r,.'17
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.:?be-.91
F.) CENT/I=: 61F 7)Ei)OosrT # ?/)OOOt>o2379SJ.8
,-
//:)) t:)oo,a>
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G.) /NT: A (!(!'Il. To 'D. o. II PI>! 1='.)
(see /effer frOIl! /fLL.F/~ST dl/-&u;hu/ J;eretoJ
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A . ) ..5IW/AlGS Ac.e 7:
g.) IN/: A-CC~. TD 1>. D. D. PH A.)
c,) eE72rlF. 0/= ])EPOS If
:0.) / N7. /I CCIf. to 1:>. D . D. oN C.J
F.) een-,.e:: 01= l:>EPoS IT
F)
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H.) /!V7: .4CCR. TIJ 2>. t>.D. oH G.)
{see. /e.#-r IrIJII1 /fIllQ/(JHP/cG a If~c"e'/ h~relv/
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IN'?: A(!C~ 70
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/ 1"I!)()0. eJO
? 57.07
3.
FIftJ.m~s ~ rni:IU!..HANTS 8 A-Nk A-#.JD Tteus-r (F ~ M "8I1-NI<)
Cheek,'o II-(!~t :If /*IO:l.tft:JO/
(see /etft!r frt?Af ;: flJ! ~/f4cJ,~q" herdP)
/
/, :l:l~ 'IS
&l1h~u.d
TOTAL(Alsoenteronline5,Recapitulation) $ ;:;"/~ /;(3.fptf
(If more space is needed, insert additional sheets of the same size)
:,,'~\_a. .' :/-:),",(.:7//1 l,f- ~:;./t cut&,
. . D allfJrst
C".~
Allfirst Financial Center N.A.
EO. Box 900
Millsboro, DE 19966
January 31, 2002
Charles E. Shields, III
Attorney At Law
6 Clouser Road
Corner of Toodle and Clouser Roads
Mechanicsburg, PA 17055
RE: Estate of Lena L. Winters
Date of Death: October 13, 2001
Social Security Number: 192-14-7452
Dear My. Shields:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
L Account Type..... .. .. . .. .. . . .. . .. . .. ... Checking Account
Account Number. ............... ....... 0020327406
Ownership (Names ofJ.............. Lena L. Winters
Opening Date.......................... .03/03/86
Balance on Date ofDeath.........$1,832.35
Accrued Interest
$
0.00
Total.... .... ........................ ... ....$1,832.35
2. Account Type..... '" '" .., . .. .... .. .... Certificate of Deposit
Account Number. . .. . . .. . .. .. . .. . .. . ... 8000000 1517199
Ownership (Names ofJ.............. Lena L. Winters
Opening Date................ .... ...... .12/29/94
Balance on Date of Death....... ..$10,000.00
Accrued Interest
$
28.67
Total........... ....................... .....$10,028.67
110
. Page 2
January 31, 2002
3. Account Type. . .. . ... . . . . .. . . . . . . . .. . ... Certificate of Deposit
Account Number.. ..................... 80000002379396
Ownership (Names of}.............. Lena L. Winters
Opening Date................,......... .02/24/00
Balance on Date of Death....... ...$27,666.4 7
Accrued Interest
$ 268.81
Total............................,........ ..$27,935.28
4. Account Type.... . . .. . .. . .. . . . . .. . .. . ... Certificate of Deposit
Account Number....................... 80000002379568
Ownership (Names of}.............. Lena L. Winters
Opening Date.................... ,..... .07/28/00
Balance on Date of Death....... ...$10,000.00
Accrued Interest
$
31.76
TotaL............... ...... ....... ... .......$10,031.76
The decedent did not have a safe deposit box with Allfirst.
TIlls letter does not include any accounts in which the deceased may have been listed as power of attorney,
custodian of uniform transfers, representative payee, or trustee under a written trust agreement.
For any additional information on these accounts, please contact our branch at:
279 N. Pennsylvania Ave.
Hancock, MD 21750
Phone: (301) 678-5528
Sincerely,
Llta;)t1lV z.J0V~
Charlene Warrington, Associate I
(302) 934-2722
RsJ: OF: wl/VT~5) LElJI/J L..
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~ AmeriChoice
--- ~FEDERAL CREDIT UNION
Cumberland County's Community Credit Union
March 20, 2002
Charles E. Sheilds, III
6 Clouser Road
Mechancisburg, PA 17055
RE: Estate of Lena L. Winters
Social Security # 192-14-7452
Date of Death: 10/13/2001
Dear Mr. Shields:
As per your request the following are the accounts that Lena Winters had with
AmeriChoice FCU.
Principal Ace. Int. Balance Date Open/Issued
,4) Savings 9674.91 6.83 9681.74 4/27/01
c.) CD 15100.00 30.03 15130.03 4/27/01
(this CD has joint owners: Patricia Wingert and Karen Andrews)
E.) CD 57000.00 107.90 57107.90 5/22/01
C;J CD 11000.00 57.07 11057.07 7/6/01
The first CD listed is the only account Lena had joint owners listed with her.
Lena Winters did not have a safe deposit box.
Please let me know, if there is any thing else you need.
Sincerely,
~cL ;;( /,.~
Cindi Wolf
Office Supervisor
~ r~,~-I
lENDER: ."-'-
Main Office: 20 Sporting Green Drive, Mechanicsburg, PAl 7050 . Phone: (717) 697-3474 . Fax: (717) h97-3713
Pennsboro Commons Office: 326 East Penn Drive, Enola, PA 17025 . Phone: (717) 909-0460 . Fax: (717) 909-0465
Mechanicsburg Office: 5267 East Simpson Ferry Road, Mechanicsburg, PA 17055 . Phone: (717) 795-4800 . Fax: (717) 697-7852
Website: www.americhoice.org . [-mad l);, Through Our Website
I Equal I
epportunlly
'LENDER
o
CREDIT UNIUN:i
~BANK
t~~vJi/vJ ~.f
FARMERS & MERCHANTS BANK AND TRUST
A SUSQUEHANN.4 BANe
February 15,2002
Charles E. Shields, III
6 Clouser Road
Mechanicsburg, P A 17055
RE: Lena L. Winters Estate
SS# 192-14-7452
DOD: October 13, 2001
To Whom It May Concem:
In response to your letter received January 30, 2002, here is the above customer account
information as of October 13, 2001.
. Account Title:
Account #1
Lena L. Winters
. Account #/Certificate #:
Checking 1401024001
. Date Opened/Maturity Date:
3/18/83
. Interest Rate:
.00%
. Account Balance:
$1,224.95
. Accrued Interest:
$.00
. YTD Interest:
$.00
If! can be of further assistance, please feel free to call.
Sincerely,
~~.~
jl Janet M. Peters
Support Services Supervisor
1- 717 -625-6295
JMP/cr
24 North Cedar Street, P.O. Box 1000, Lititz, PA 17543-7000/800-311-3182/626-8043
FAX 625-4478
f\VST NATION4L lJ
~~ IJ(o~ ~~
1'- I
j~"f. "
).kll.h..rF.D.I.C
101 Lincoln Way West, McConnellsburg, PA 17233 . (717) 485-3123
Loan Department: (717) 485-5909 · FAX: (717) 485-3570
Needmore: (717) 573-2227 · Fort Loudon: (717) 369-3312
February 7, 2002
Charles E. Shields, III
Attorney At Law
6 Clouser Road
Mechanicsburg, Pa. 17055
RE: Estate of Lena L. Winters
Attorney Shields:
With regard to your letter dated January 30th the date of death information on
accounts held here by Lena L. Winters are as follows.
Safe Deposit Box - There was no Safe Deposit Box
Checking 5272021 $ 1,578.19
CD #116045 $ 6,300.00
CD #118105 $11,000.00
CD #118106 $11,000.00
CD #118107 $17,450.00
CD #SV605599 $ 2,500.00
CD #SV607467 $10,600.00
DaD Int.
DaD Int.
DaD Int.
DaD Int.
DaD Int.
DaD Int.
-0-
$55.27
$55.27
$87.67
$ 9.41
$24.17
If you have any further questions, please feel free to give me a call.
Sincerely,
,
.-.~" \\. \"
\""',-'--',L.--
Sheila Fraker
Customer Service Representative
. .........,
r:;"~1 t(; -?Ji,(JA4 ;;..,r-
.
c;..ol:-
--r......
The
FULTON COUNTY
NATIONAL BANK
- AND -
TRUST COMPANY
100 L.W:E. P.O. Box 38, McConnellsburg, PA 17233
(717) 485-3144
February 7, 2002
Charles E. Shields, III
Attorney At Law
6 Clouser Road
Comer of Trndle and Clouser Roads
Mechanicsburg, P A 17055
RE: Estate of Lena L. Winters
DOD: October 13, 2001
SSN: 192-14-7454
Dear Attorney Shields:
As per your request here is the information requested for the Estate of Lena L. Winters.
Sterling checking account #12-00995
Date of death balance $2,023.89 plus $27.19 interest
Individual account
Certificate of deposit #11-35158
Date of death balance $7,500.00 plus $25.52 interest
Individual account
Certificate of deposit #11-31393
Date of death balance $5,400.00 plus $1.49 interest
Individual account
Certificate of deposit #11-31123
Date of death balance $6,000.00 plus $28.08 interest
Individual account
,
Certificate of deposit #11-31230
Date of death balance $6,500.00 plus $1.04 interest
Individual account
If you have any questions or need any additional information please contact me.
Sincerely,
~2f4
Tricia L. Long
Data Deposit Clerk
REV-l509 EX + (1-97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
cmAMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
W IN,€t<S,
LENA-
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
2{ - 0/- /tJsi
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Pltit2.ICIA- 1. W11f/6~ T
Lfzz GIFrryS,sute6- PII<€
M~CHI'fJ\lI~S S c.lI~.G-,,;71'f ftOS;-S-
B. KA-J!.GN J: /!/l/Dt<.t:WS
'fz.o G/FT7y.5B UIe6- fJlK.E
IJ1~CHHN/CSGl(lic;.. "F1/1 /7os;-S"
c.
D A- tl G.H 7G7C
PAUGH TG7e
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. ~8 'f/Z1/ol /fAfE/l/CHtJlcG F/IDseAt. (!.l!EDIT l{N/ON ~
(J.D. iF 33/Cf'-WJ = ,r;~ /OO.bD1 1/5"" /30.03 3"3'/-31, f.
5; 0'13. 3L{
:!n+. Jf. e.er. ~'" Th ol.o.d.= 7S 30.0.3
1- X" fefenYll.G .{." sd1ed €. ikm :l . c.) to.)
D-Ylc.l fv SdJed. G-. I . J.) ~ .:? II.) (r,." %fJ'~)
($t'e. a...l~o letter- t,.om A hlEP-lC-H 0 let:
a tt-Cl d'V J fr, sched. E" ).
TOTAL (Also enter on line 6, Recapitulation) $ S; o'l3.3c.{
(If more space is needed, insert additional sheets of the same size)
,,---,-, *
COMMONWEALTH OF PENNSYLVANIA
, INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
WIN TEl<. 5, Lt:NI!
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes.
.;l/-OI-/05K
TAXABLE VALUE
." ~
- 31 tJCO.tJO -= 3~ otJF,3lf
EXCLUSION
IF APPLICABLE)
,.
~,oco.(){)
~
- 3,aoo.tX>
II
3 PIX). oj)
"
11
33, (. ,tf. .3'1
- 0-
- 0-
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
,~ '76. 'f?
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
ATTACH A COPY OF THE DEED FOR REAL ESTATE.
/I)
Plfrl!./CIA L. WIN GtFN. T I LM.t!6J./TG7(
'1/21/tJl - 33 '13 70 inferest /,.., /l-men'cho,'a
Fedel"tl/ Creel/I Un/on C.D. #' 33/'1,,-{go
x- l"eference fz, Gcl1~ d ki. t.t.Md F. I" If.
G-,'{f,5 of hrso/1tl 4 /'YIab WI'fIJ,n / year
pf C/. t? &I. (see. scJ,alu/~ a ffa.~ht!(1 J.
OJ! of fen f:hpJ15Dncl /Jailors (fo,800.00)
y,"p check daliri fJ1flj' 30, 2001
6iff pi TwerJ7 ThPr.t~'U1d /Jt:Jl/ll.l'f (fo,a>o.tJo)
v/a check datirl I1k:f; 10" 2.001
ITEM
NUMBER
1.
A.
B.)
t-}
JJ)
,4..)
K;fICFN J: ,4/yj)~EWS -D/fUG/iTEJ"<
if/2.7/t?/ - 33)3 % /nfere5f ;r/ Ah1er/~ho"a
~derq/ Creel,ll//I,'pn C..J>. -# 331tU. -'-6
)(- referenu -Iz:, ScMed t::. C!Al.d 1=. I, 8.
(;,'F!s of fJ~r.sonalfy I'J1Cll/~ wI/n/n /y~(J.1"
ef cI.c.tI. (Sa scitec/u/e Cllhuhecl)
G,-/i cf k 711tJIIsuul /Jt?/Iars (~/o/POO,~)
j//q elteck tla!h/ /JJa.y31, 2<</1
(;,rf #f /iVUl'r 71zb1l54~'" blp/lor.r ~,Pa>.~
y/Q cl,eck eluled CJ&. 10 2po/
,
8.)
c.)
j))
3,
A.
/J/-'lRK /l-Nj)~FI1/S - 6~/lNLJSt)/t/
G,'/ts Df ~rso/1altr /Hack /VIM,''? I Yt!!~
<9/' R.t:J.&I'. (5~~ .schedule a/fCtckd).
4.
A.
A?.l/-7IHE/4I ~LJREIt.IS- G~/1-~.DSo/ll
(;,'fls bf h;s""olty mlRd~ U//~/'n I year
()f c/.o. qI. (Se~ sdtulule arhclud).
G~l: (jMfthtlP/'o;, RLUIe :z)
~
DATE OF DEATH
VALUE OF ASSET
~
S; {)I./ 3. 3'1
-;t I 9' 5. DO
I
%:
10, 000. DO
0?0 oa:?oo
~ 37;~. 34
1>S; Pf./ 3.3'1
~
I, ~ 2S:PO
'I.
1/:1,. O(}O,iI!'O
~
20, 000. co
~ :3 6J, , ''I. 3'1
~
;Z :i S. "D
,
;;Z 80. ~D
%OF
DECD'S
INTEREST
/00/0
/t>o/.,
11J07c
/ {)O j'"
loo/".
IPO ,t.
/ PO /...
/ {)o %
IDol&>
loo?&>
REV-1SI0 EX + (1-97)
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
W / N rE7<.~ La./ A
FILE NUMBER
;21-a/- lOSe
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INClUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
NUMBER
Y fa? ;? - C!R/l1h'nutLh'on pate
5: {!,If ,f!Pt Y /tI /f/yj)~S - 6-t2A-Nl>.l>A-IAGHTCJe .T ~
hr.s0//4/1j /J14 dt' 11///111 J" / year Isv.lJo /tJ01D 3, ooO.ITo -0-
A-. G,'fls of
tJf tf.o.d ($~I! sckdu/e rnfqckal).
b. /'t () eN eFtt€' .8 t{ eN wA-".J> - 6.1Uld /).1> AU 6-# T c---r(
A. G~'{f5 01 ~rS0I74/ty lJ1ti.d~ w;IfJ,J, / year
,31 d,t:'.Q. &e PIfACI"cI ~dule}.
~ ::< SlJ. IN>
r
/,()o ~ - 3: 000. 00
-If) -
7, k/IJ1~E,et.Y /I/€ TZN//(' - 6A'/lAl1Jl>AU6I{T~
A. G,.ffs of ~/Jal'f made UI/'liJiJ? / Yf.!(lr
~f c/.t:I.t:/. &e 5d~qlule g~cheal).
~
~ 030.tJO
"
(poll' - 3,l>CO.(JC)
-0-
8. cd IK W/NG~~ r -- &/2;f/-HDS()N
,A-: (g,-f!s of f/er.roha/1 mtule tv,~~'n / yt!A.r
t)f c/.o.tt. (See sc.4e1u./e cr/l2:lck~)
l'
525: ()O
,
/ tJ{) to - 3, DCJ:).co
-C>-
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
it ~; J- ~ tud Lv : {YU c'r:i
FfL ~ (Le h 2j ,LNLT~
LENA L. WINTERS
ROUTE NO.3, BOX 97
MERCERSBURG, PENNSYLVANI~ 8~066234
2053
FOR rK~
':05 2 .0 8':
~~~~,-~
2053 ~OOO~OOOooO~
20 :l
2 ?~o bill
LENA L. WINTERS
ROUTE NO.3. BOX 97
MERCERSBURG, PENNSYLVANIA 17236
2054
65-40/521
DATEfYJ~ .3 t I d-l> 6/ BRANCH 79
PAY. ~011B270 320 '18 1679 1578
b~~~;t:~~", (~~~.. 'Z' in . r...J .@.~jo 000.. dO
~ ....- .c:9/ " )...- J ~ s::... ..s::.. ~ ~." .~-' J
. J do
~ SecUllIyloOltllll'1i
fj~/AL7-"",.J 'f)~~ .J /d~-DOlLARs!!.l:=~~nb'"
_Fm.~=
SA1.ISIUIIf, IWlYU1lO ACCOUNl1NG CENTEJI
0311
FOR 01*
':05 2.ufo 08':
~~ ~ 'fJJ~~ __!!
2oS~ ~OOO.OoOOOO~
20:l 2? ~o
b,,1
~6-v
s~ Go- I.. C. v
J. /.
5J~G. ,'-'
'"
_.~."<>c__-...&~......"",,,:.:A.O'~""" ~,.~.t~. ""'-='---Jrr""--'l"I~
~~
,
~~ft.J (f :z.' #'
..- 366
.~~~-~~~~
~ ~~~~tl~ - ~
· ~~ ~ /l.. l....
_ ~~~ ~~~/.~1fl~
a:tH 13 105071: l.l-ooqqS" OUr. ofODOiDDDIJDD.o'
10/11101 Check #0365 l\:OO1.l:n- S2070OO.OO-_.
. ._~-~' 'M"',", "., ..~ . .--~. ...", .......')'.....''if=''-"' .-....."'..ijii'".=.,..~'~...,.,...<.,;'"
Account 1200995
Statement Date 1 0/15/2001
Page I of 1
~~J...tJ &-. I-P. v'
IIN&L 1RNJBI5 ,,:=- 387
._6A.;t,...4~~-~ _ dk~J...:wI
~iL~;._.~~7.:;~>i~ I'$'~~o~ ~
r -I. r.L .L l. - ~
~. - ~ ... "'t.& Z .........1 -:.- ~ ~ ~ bnllUS.;::
...,... 01~ 300 It. .279 S28Z
~-;:n:~ J'?:/i:!:db.
__ 3,11- . I. __' _ ,
CD31.31DSD?C l~qq5lfl 0:1&1 /DDDlOOODDD/ i
I ,
- -lO!12101--€h^..ck-#0367 Amount $10,000.00
CllmRU~!S JY.lzpoqlny
~~J~~
ClmlRU~!S lClUM.O
'SW,ICll ::lures ::lql tIltM. lunourn ~U!U!lml::ll ::lq) 101 p::lnss! ClUO M:;lU pug
p;}l~pU:UlnS pug P~U~!S ~q osp! lsnm CllRJ!.HUClJ S!ql 'UOpdUlClP:;ll p!p.rnd Aug uodO 'p:;ll~pUClllns pug p;m~!s ~q lsnUl ~lRJ!.HUClJ S!ql 'UOpdUl~p:;ll AIlR:;l lOtI
'uoPUUl.IOJU! Al~uCld JO} CllnSOp~!p S~U!^RS U! qlnll. lnoA ~~S . Alp!U:;ld ql!M AlPUlUUl OllOpd p~UlCl~p:U ~q AUUl :;llUJy!U:;lJ S!ql JO suo!uod IP! 10 AUV
':;lll.lSOPS!P S~U!^RS U! qlnll. lnOA ClClS 'UOPRun01U! p!M.:;lUCll JotI . AlpmRUl III JY.lMClUCll Clq 10U ARUllO AllUl CllRJy!llClJ S!ql.
'd!qSJO^!AmS JO Slq~!l HtlJ ql!M d!qS1CluMO lu!of
S:;llEJ!PU! SJ~UMO :;lJOUllO OMl JO :;lllrnU :;lql U! :;lJIlRnssI 'UO!Un l!PCll:) Clql JO S){ooq :;lql UO ld~JX~ PClU~!SSl? 10 ~llClJSugll 'P:;l~P~Id ~q lOU Alml :;llRJ!.Hll:;lJ S!qJ,
lSCll:;llU! SAUP 08 I 01 ~nl>3
^IqluoW
p!Mlllpql!M. :l{J;)q:)
% 06'~
% OLL' ~
SHl.NOW 09 'Ultl:)
900'll LZ/vO
lOOZ/LUvO
OO'OOl'~I
.,
:Al1~U~d l~M~JpqltM A[J1l3
: . b;;lJd lU;;lWAlld PU;;lP!^!Q
:potH;;lW 1U;;lWAlld PU;;lP!A!Q
:PI;;l!A ;;lSlllU;;l:)l;;ld llmuuy
:;;llll~ PU;;lP!A!Q
:uOndp:)S;;lQ
:~llla AlPOlllW
:p;;lnssI ;;llllO
:lunowy ;;l111:)!}!1l;;l:)
Z~vL-vl-Z61 :l~qwnN AHln::l;;lS IllpOS
~~OLI Vd D~naS:)INVH:)tlW
tl)lId D~naSAl.l.tlD zzv
SM.tl~aNY 'f Ntl~Y)I
l.~3.DNIM. ''1 YI:)l~l.Vd
S'M:3.l.NIA\ '1 V N3.'l
:(S)l;;lUMQ luno:):)y
OZO-96 lEE
:J;;lqwnN luno:):)v
31 V::>I:lll~3::> 3~VHS ~V3A 5
~~OLl Yd DMoaS:)INYH:)tlW
tlAIMG N3.3.~D DNUMOdS or
NOINfl l'Q'.~ lYll.a..~
a:>fOlf:>IJaWV ~
Personal Property of Lena L. Winters
(Dispersed within one year prior to death)
R P "LW' rt
eCIPlent: atncla mge
ITEM ESTIMATED VALUE COMMENTS
Bed, trundle $100 needs some repair
Book shelves $20 varnished finish; originally unfinished
Books $50
Chairs (6), dining, rush-bottom $120
Crib $125
Cupboard, comer $500
Cupboard, jelly $300
Dinette set (table, 4 chairs) $100
Jewelry: gold wedding band, $250 plain gold wedding band;
diamond engagement ring, watch, very small diamond in engagement ring;
miscellaneousco&umejewelry Lorus brand watch;
co&Uffie jewelry is 5 & 10-cent "variety"
Lamp, hanging (ceiling) $75 now electrified, originally kerosene
Rocking chair, child's, bentwood $25 insect damage
Table, game $50 damaged
TV, color $25 15 years old
VCR $25 13 years old
*Miscellaneous household goods $200
TOTAL $1965
* Miscellaneous household goods - includes dishes & glassware, pots & pans, linens, lamps, throw rugs, etc,
Page I of 5
Personal Property of Lena L. Winters
(Dispersed within one year prior to death)
R t Kar J Andr
eClplen : en . ews
ITEM ESTIMATED VALUE COMMENTS
Bedroom suite, oak $500 double bed, washstand, dresser w/mirror
Books $50
Chest of drawers, oak $150
Clothes tree $25
Desk, oak $250 some damage
Low boy, oak $50 legs cut off
Table, dining, oak, w/6 chairs $200
Table, secretary, oak $50
Vanity w/mirror, Waterfall $150
*Miscellaneous household goods $200
TOTAL $1625
* Miscellaneous household goods - includes dishes & glassware, pots & pans, linens, lamps, throw rugs, etc.
Page 2 of 5
Personal Property of Lena L. Winters
(Dispersed within one year prior to death)
R .. t M kAndr
eClplen : ar ews
ITEM ESTIMATED VALUE COMMENTS
Credenza, snruall, VVaterfall $75
Fishing rods (3) $50
Mower, riding $50 15 years old
*Miscellaneous household goods $50
TOTAL $225
R" tMth And
eClplen : at ew rews
ITEM ESTIMATED VALUE COMMENTS
Living room suite $100 sofa, 2 overstuffed chairs - worn, faded
Microwave oven $25 5 years old
Stand, magazine $30 needs repair
Table, coffee $25
*Miscellaneous household goods $100
TOTAL $280
* Miscellaneous household goods - includes dishes & glassware, pots & pans, linens, lamps, throw rugs, etc.
Page 3 of 5
Personal Property of Lena L. Winters
(Dispersed within one year prior to death)
ReCIpIent: arolyn . ews
ITEM ESTIMATED VALUE COMMENTS
Rug, 5'x8' area $35 from Home Depot, 5 years old
Sewing machine w/stand & stool $50
Stand, plant $15
*Misce11aneous household goods $50
TOTAL $150
C I Andr
R ..
R h 11 B h aid
eCIPIent: oc e e uc w
ITEM ESTIMATED VALUE COMMENTS
Books $25
Chair, rocking $30 20 years old
Desk, small $50 10 years old
Table, sofa $20
Vanity table w/stool $75
*Misce11aneous household goods $50
TOTAL $250
* Miscellaneous household goods - includes dishes & glassware, pots & pans, linens, lamps, throw rugs, etc.
Page 4 of 5
Personal Property of Lena L. Winters
(Dispersed within one year prior to death)
R t Kimbe I N tznik
eClplen : flY e
ITEM ESTIMATED VALUE COMMENTS
Bedroom suite $600 double bed, night stand, dresser w/mirror,
chest of drawers
Books $25
Cabinet, kitchen $50 damaged/repaired
Recliner $75 5 years old
Rug, 4'x6' area $30 from Home Depot, 5 years old
Sofa $200 5 years old
*Miscellaneous household goods $50
TOTAL $1030
R .. t Erik W. rt
eClplen : mge
ITEM ESTIMATED VALUE COMMENTS
Dresser, cottage $300 refinished
Wardrobe, oak $200
*Miscellaneous household goods $25
TOTAL $525
* Miscellaneous household goods - includes dishes & glassware, pots & pans, linens, lamps, throw rugs, etc.
Page 5 of 5
REV-1511 EX+ (12-99)
_9",Itr~
, ~.m:-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
.;1..1-01- 0/058
W/N7Ei(S
I
FILE NUMBER
ITEM
NUMBER
A.
L E/V /I
L
Debts of decedent must be reported on Schedule I.
DESCRIPTION
1.
FUNERAL EXPENSES:
G-r-ove Fut1e.1"I1./ HOWIe, P. A-. DF I-lUVl cock, /VIurylcurd
:James Hec.: J'l S I GrlLVe -ol;~3 i Y1:J
DCUYlQ,SC1J.S C.h....'.s.f-;611 Chlo\..d, - for 4...nc..yn.l ll1e.../ h.llo.....;~ se.rv,'ce
Re~. JlIU'')' J:i'. S;""/k. - rfph~rtz,./um /r.r o/fic;ah7 a.f Serf/,'e<<
S/;ne tJr/"r ChI/rei, pi ~ 8nd~rrM -fi>r ft.oe/ 7i>r bJl?a1 ~3.
J;::=/OWlj' ~ra)' ;;.,. .cu.l1eral
.1.
3.
4,
5..
h,
B. ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
Name of Personal Representative(s) P I/..,-;e lei A '-. fN I N GE="R.r
Social Security Number(s)/EIN Number of Personal Representative(s) ;
Street Address if 22 Gl: T7Y S B u Ie (j.. PI KG
City /}1EeH,tJ/V/C$ BUJeG.-
State~Zip /70SS
Year(s) Commission Paid:
2.
Attorney Fees CH I1-IC L ES iF. Sill e:-~D.s ..oz:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant P~7JeIC./H L. W/No€I2T
Street Address '1zz GEtTYS 8u~G- PIKE
City IJ/ ~ ~f./ /I- AI / c s all Ie G State .J2L Zip
Relationship of Claimant to Decedent j) /I tt 6H T E7f
/70S!>
Probate Fees 1Ut'/ ""j,'llal
5. Accountant's Fees
5.
It>.
/ I,
4.
6.
7.
f
.
I S:5 ue
tS>f short cerf,'/;'ca.fes
Tax Return Preparer's Fees
FIDyet kA/I~.shcK/ "#-et!bttn/'h; A-ssoc~a~s (reser~)
Cum fur/lutel fliw J{;/.trna./
ifdve,fi.Ji"d
/It/verI-Is,'''!
/lA'e/,'f'dH4:/
fl.pe//h 'tJna. I
II')
In JlkrriSbll(j fl.1r;l)f
Sho,-t c:erft"hca.fes
/J1elro-he"t
,on 64 ~ -ke
FI'/;,,] fee !Dr hlt'd J;J~t!r;-faMct! ~~ Kefurn
AMOUNT
If ft., 33 If. $7:)
~ 306.DO
~ /00'00
$lIDO.DD
? S'b. DO
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TOTAL (Also enter on line 9, Recapitulation) S 30, 9 (.7. L./{,
(If more space IS needed, Insert additional sheets of the same size)
. <5CHE]). fl. ~nt C/.
f2ST 01= WIN-rER~, LEA//! L.
I ~ . &:> M lYI i 5 S ion -h> f' oJ1)11 V tLna fJrcc:t. 0 ~ /,'B CA; cl a.. +-" 0 Vl
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(s~e. shed tl~)
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a111I relate! ~/JMses
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REV-1512 EX' (1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
CO'MMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
W/NTIEJeS~ LE/J/A
L.
FILE NUMBER
::2/-0/- O/DSf'
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
IT'I: 00
;r ;;; 's7J, 20
~ Zl,~o
1.
.:<.
3.
r;-m6er 1//7 d&tr/a/ /l5SoC/n.h'o~ - e1'5-$essnre4t
&p.:f4/ 6'1l(e {""OSs
;:J~J1nt1, ~t: of' ,.f'et/e/lue - iJuSoJ7al ~c)n%' ~)C.
TOTAL (Also enter on line 10, Recapitulation) $ (). 75.20
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX. (1-97)
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
CO~MONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
WI /frees; LEYJ//J.
FILE NUMBER
;2/-0/- i!JIO.s-P
L
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
(Sf'oIJSF5 HI1-J> PlllFDFC!E/fSlE1> j)€CEtJEJl./T)
f/A T/C/C/H L W/N6/F/2T
~ZZ Gt:rrysBuJe6 PIKE;
mGCH~/I//cS13UIf?0 ,0/1 17oS-S-
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
D/I- U {,..H T c-'"'7f?
y~
~.
K/l-REN X/I/JIJ)/.!EU/S"
'fZeJ 6c=-rrys B &{.!f!.(;. PIKG"
111&?t!///f/J//cSBttJe.0~.-? 1705S-
Yz..
f).lttlGHrc'"'"7f;?
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
U-CT-Will end Testament
Henry Hall. Ine., Indiana, Pa.
. ].
LENA L. t.JINTERS
, of
Thompson TmVTlship
County of Fulton and State of Pennsylvania,
being of sound mind, memory and understanding, do make and publish this my last Will and Testa-
ment, hereby revoking and making void all former Wills by me at any time heretofore made.
I
I direct the payment of my debts and the expenses of my
last illness and funeral from my estate as soon after my death as
is practicable. If there is no cemetery lot available for my inter-
ment owned by me at the time of my death, I hereby authorize my
personal representative to purchase such a lot together with a
suitable marker to be inscribed and erected on the said lot using
therefor funds from my estate in such amount as my personal
representative shall deem necessary and appropriate.
II
I direct that all taxes payable as a result of m~ death
shall be paid out of my estate to the end that all dispositions made
hereunder shall be tax free.
III
All of my estate, whether real, personal or mixed and
wherever situate, I give, devise and bequeath to my beloved husband,
Harold E. Winters.
IV
In the event, however, that my husband should fail to survive
me, should die within thirty (30) days after my death, or should die
in a common disaster with me, then I give, devise and bequeath my
entire estate as follows:
(1) I give, devise and bequeath my entire estate,
whether real, personal or mixed, to mv children,
Patricia and Karen, in equal shares.
(2) If either of the above named children should
predecease me, then I direct that their share
shall pass to their issue, if any, per stirpes.
, .
,
I .
V
No interest passing under this "'Till shall be subject to
anticipation, pledge, assignment or voluntary or involuntary
alienation until such time as it is actually received.
VI
In addition to powers vested in him by law, my Executor
shall have the following powers applicable to all property held by
him including all property held for the benefit of minors, effective
without the order of any court and until distribution of all such
property is actually made:
(1) To retain any property received by him including the
stock of any corporate fiduciary acting thereunder;
(2) To sell real estate for any purpose publicly or
privately for such price and on such terms as shall
be deemed proper without liability on the purchasers
to see to the application of the purchase money;
(3) To compromise controversy between beneficiaries;
(4) To distribute in cash or kind any or all of my
property at valuations fixed by him and in this
regard, to convey my real estate to either of the
above named beneficiaries in their name alone
provided that they shall pay one-half (1/2) the
value thereof to the other beneficiary named
herein.
VII
It is my express wish that the real estate shall not be
exposed to public sale and the hereinafter named Executor may hold
the estate open as long as is necessary to secure a reasonable price
for the said real estate at a private sale.
VIII
The Executor of this Will is hereby excused from the
necessity of posting security in connection with his duties as such
in any jurisdiction in which he may be called upon to act insofar
as I am able to do so by law.
'" ~
I do hereby make, constitute and appoint
my husband, Harold E. Winters,
to be Execut or of this my last Will and Testament, provided, however, that if he
should fail to qualify for any reason, then I appoint my daughter,
Patricia Wingert., to be Executrix of this my last Will and Testament.
3Jn Mitne~s ~bertof, I, LENA L. WINTERS
the Testatr~x above na,med, have hereunto subscribed my name and affixed my seal,
the Is t day of May in the year of our Lord
one thousand nine hundred seventy five.
'-.p/ , .....7.-, .
6~ //;;./}. ~
_.:.. ~~:L.?..c.!.__n_~..__/~~.0-:~d..kL_______...___ ~
Signed, sealed, published and declared by the above ttamed LENA L. WINTERS
as and for her last Will and Testament
in the presence of us, who have hereunto subscribed ou'/" names at her request a;
witnesses thereto in the presence of the said Testat rix and of each other.
~ / ;1/
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