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'" ,I' ,', PETITION FOR PROBATE ead GRANT OF LETTERS Estate of .10^N fl. SItfflNS No. dPl- ri/-- ()~ also known as. To: .1011N BOYD SIWiONS _ ReIPster of ffil.lMffi.A9fu Deceased. County of In the Social Security No. 207-07-40!17 Commonwealth of PellnsylvanJa The petition of the undcrslsned respectfully represents that: Your petltloner(s), who Islltt 18 years of age or older an the execut or In the last will of the above decedent, dated October 29 , and codlcil(s) dated ~-; oamed , 19-L (1I11e relcvanl d'Cl'l1UlanCCl, c... "nundltion, death or executor, ClC.) Decedenl was domiciled nt death In Clul1berland County, )?ennsy)vanla, n er last family or principal residence at 208 Senate r\Venue ^ t. .101 (. w ) East Ppnnsboro TownshIn (U.t 8trHt, number, Twp. or Boro.1 Decedenl.lhcn 75 l'earsofage, died Decembi..)r 16, ,19 93 at lInrriRhllrg f1m~pi t'ill . Except as follows, decedent did not marry, was not divorr.ed and did not have a child born or adopted after execution of the will offered for probate: was not the victim of a kllllns and was never adjudIcated Incompetent: . Decedent at death owned propeny whh estimated values as follows: (If domiciled In Pa.) All personal propeny S 8,500.00 (If not domiciled In Pa.) Personal propeny In Pennsylvania S (If not domiciled In Pa.) Personal propmy ill COUnlY S Value of real estate in Pennsylvania S None situated as follows: WHEREFORE, petitloner(s) respectfully request(s) the probate of the last wlU and codlcll(s) presented herewith and the granl of letters Tes tamen tllrv (te"amcnlary; admlnlllradon c.l.a,; admlnllllation d.b,n.c.t.I.) theron. J~ 111 !~ t'o J <i . ~~. ,1'7'-" L ~;" L~ .f!R.1.~:..r Ste en ll. . Hel r 601 Manor Rd. Cllmp HU 1. P^ l70n OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CLMBEHLlINO The petltloner(s) abol'e.named swear(s) or afOrm(s) that the statements In the fore80lns petltlon ara lrue and correct to the best of the knowledge and belief of petltloner(s) and that as personal represen- latlve(s) of the above decedent petltloner(s) will welllll}fl, truly administer the estate accordins to law. Sworn to or amrmed and subscribed J .~~, I {~ JktJ;;( ~ before e this 3 d of _ Sh'phfm B. II...lI"..rt ~. . y 19 a J{, t . !lij 1 Register \ J- ~ No. ?1 - \)4 - Oli Estate of JOlIN B. SDKHi a/k/a JOAN OOYD SDKHi I Deceased DECREE OF PROBATE AND GRANT OF LETrERS AND NOW _ . JANUAR Y 4 19~ In consideration of the peddon on the reverse side hereof, satlsfactory proof havlna been presented before me, IT IS DECREED that the lnslnlment(s) dated October 29, 1986 described therein be admltted to probate lDd filed of record as the Jast wlIl or Joan B Simmons a/k/a Joan Boyd Simmons lDd Lellers TE;'st8lOOntarv are hereby sranted to St8phen B. Helbert 'I1fA~1- (iJ,XL~" IJ.~ &, Rqbter 01 Tl MARY C, LEWI S ' FEES Probate, Lellers, Etc. ,...,.... S Shon Certlflcates( 5) .. .. .. .... S Renunciation ..",. t . . . . . . It. S X-Pages S JCP TOTAL _ S 40.00 15.00 9.00 6~:8R , Horace ^. Johnson (06340) A TfORNEY (Sup. Ct. J.D. No.) Johnson, Duffie, Stewart & Weidner 301 Market st., P. O. Box 109 ADDRESS Lemoyne, P^ 17043-0109 ( 717) 761-4540 PHONB Filed ... I ,',. ,~~~y~~X. q I. .1.~~~... ',' I' t. I r- t:~ ':) r;') :10.; ;"1 r., . C,". , : l'\ I -~ .~ '" i':'!j .' ", "I () lU .~ " "" ~ , ,un: P" a: , Mailed.letters and order to attorney on '-4-94. WAIlNIN\;: II I~, 11.1.I:1i^1. It> ^I.IIY ""~; \.1'1'1 011 TO IHII'II\;(,II IIY 1'110rU!d^1 011 1'1I0[()(i1li11'll. COMMONWEAL TI1 Of PWNS\l.VANIA DePARTMENT OF IlEALTII VITAL R~CORDB LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. 2034004 ~--''11ir.i)il;iim'omi;c"iimitiiiro;;-- II-- -,t.. () -1--3 t:!:Jlfl~nla (b) .-.--------------...-----..--.----r------.--t I 1 (0)_________._______...._.._.._______..___.__._:_ , , I , (d) Part II: Other Significant Conditions ----------~------_._~--_.._._._-_.._.-._.~ Manner of Death: Natural 0 Accident 0 Suicide [J Describe how Injury ocourrod: o o Could not be Determined 0 11 /"':) . Name and TI,'" " C,.'''m __$-.t;;;L.. ....Tr--....0-..... ........... "_n.._n._. ,/, Lf( .lMJl., D.O., Coroner, M,e,) Address-_~M.':<A:s=:...........U~'_'_=__-_..--m.!:..!l:t..- :&.~:.e... ._:_....._.. ..___ This is to certify that the Information horo given Is c.orrectly copied from on original certificate of death duly filed with me as Local Roglstrar, The orlolnal certificate will be forwarded to the State Vital Records Ollice for pormanent filing, Homloide Pending Investigation ,. 1.;- - j... - y~ I -- -.l'~;:~.;~IItI:'~Jr"~~ifl~.::;ftl~.--- -. ~~).!----iilW,;:tTi;-;---....- ----li;!ri'I;;.i;;;Ji~lr;i:';1ilT.;QI,iJ~; -.-- ,i~ . _. .. -.. - -..- 'f,-,i~'-jh\;,j~~-:- ,~--- ._-~~- om_.__. - -~I;~.( Ij(-;;~l~:r;T;,v.o;.!~p- ~ .--.. 21 - 94 - 06 ., ,. "1 "., .. , O'l) :tll~~ r: ~'" " .~ I ~ ',J " , .. 1.1 II) ~! ,if; 8 ~;'I Ola: a:, .' " ,,' ,,' " " .1' " II" ," , ,\" d' " i, ,I ,. ,I ,', " " . " " " ,'. " .'.1 .! ,1,1 " ,. " , " , . ',' ,\ \ \ I ~ ; I: " (. 1-,",' " ,. ,., I. ,I' " , , , ,\ ,,\' ,'. \. , 10" " 'I ,"" " " ". " 01, ',' I. I" '" ... 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'\ 1'" "'i. , "~I .11'1 'i,",1 " ,'I I,"" '", , I'. t. ',c l\ !1 i'l. " . ,I, ., ., ,II"~, " ,f',' " d, "'I " .,. ',I;' ,. I,' l'.l' <,I: .'11 , " I'," " " ,I" p , , " ,. . 'i" 'I.' ,. , .,1, I' ,if,",l: ". " t. '~, I,. ,,' '" .\. " " " , , ,,' .' " " /. I"~ t'/(I' I: " ,. " " ", Ilil I . ~ I , , . ," ,,/ ,. , " " ,10. " " '." , I'" " I'" . ,. ., I,': ." ':" " " IH i',.- ;,1,1 ";',:",!" '.' .,1,' j .,, . , " " I. ,I " ,.' ". '(, ..' ," no " " 'I " " I' .. " ., ,"/ ,\ ;,'(0 i I' ,. , /, L " , ): I", :1" " " oi: " , , ',,/,r ,. ,. "..' ;' I' "I, I', ,. " 11- ' I' . . ',', , .II'" '\1 ,. , ,I' 'I .I' " ,i,'" ;. "II' " ,: , ,. '1\ 'I' "," ,-" '.' "~I "', ~'9. ~~: /') I' "I '. I"~ I, I'! .i.,I,' , ". \.' L 'j" ""1 , ~. , .. , ,j' ',' " " "Ii; " ., f l, ..) \ " "\1 i:~ ,:t. ,_~ 'I', " ,/ " " " ,', ) t .J p " , " '1 " iI I ~ ~ ',.' .' . . " '" ", ~ ,I; '. ;,' ,', '" '.. ,. " ", " ,I' " I,'", ," " \, " ." " ., ,", " " " " I' ~ !, I I, , ,. '. I", ,I' Hi ,,'" 1'(,1 ,. ;, j.' \' , , , '\, ','. .' .. , " !II " 1 -",./' Ii. II " " [, '1", " " l' ,'11 '-ii-". 'j' - Ii ,,' ,',1.\ ", ,. " " ,. "'-', '" " ,. i,'," I. ,. ,; ,j. .. " '. " ,', --" \; ,'\ , Ii " '1. "', .. /, " " " " \' .' ,,' , :1' ,,, ;\, " " , ' , H 1"'. " ',,, ; i. Ii" w. ::oil ':~ n R~9.. (j.\,:~ .1 tJt 0(; .''':0 ffi~(J' ~'l'iJ(~ VlO .... ~ ~ 1Il ~ ttn ;) ~ ~ qq ~ ~ W ~q , i [;~ .1: I \/J 'v ".J '. I.' , ~\'l 'J'. " J!' , ,. !, I, \: '( ~ ,-! :, ' I' ,Ii , , .,. , :,! " r I' , , ,. I" ", ,', ;,1' " " .,'1 '.t. 'I' ,1:",I\'f' , " " :' .1' I.', .' .' ,. ',. ,. \. , " \,'1, , !rast Jlill nub ffiestnuteut of JOAN BOYD SIMMONS I, JOAN BOYD SIMMONS, of Hampden Township, Cumberland County, Pennsylvania, do make, publish and deolare this to be my Last wm and Testament, hereby revoking and making void any and all former \\'l11s made by me. I. I dlreot that all my legal debts and funeral expenses be paid and satisfied by my Exeoutor hereinafter named, as soon after my death as may be found convenient. II. I bequeath my sterling sliver service, my wedgewood china and my Alpha Chi Rho ring, whloh formerly belonged to my deceased husband, A. Harvey Slnunons, to hio daughters, REBECCA SIMMONS DAVIES, GER'rRUDE SIMMONS NEFF, and CATHERINE SIMMONS, or the survivor of theml to be divided among them In suoh manner as they ohoose. III. I bequeath my automobiles, household and personal effeots and other tangible property of ilke nature, (not inoludlng cash and seourlties), together with any existing Insurance thereon, to my son, STEPHEN B. HELBERT. IV. I give, devise and bequeath all my son, STEPHllN B. HELBERT. the rest, residue and remainder of my estate\ ~ . ~, V. Should my son, STEPHEN B. HIlI,BERT, not survive me, then I give, devise and bequeath all the rest, residue and remainder ot my estate to the daughters of my deceased husband aforementioned. VI. I appoint my son, STEPHI;N B. HEl.BERT, Executor ot this my Last Will. Should my son, STEPHEN B. HELBERT, tall to qualify or cease to aot as Executor, I appoint CCNIl BANl(, N.A. ot New Cumberland, Pennsylvania, Executor ot this my Last Wlll. IN WITNESS WHEREOF, hereunto set my hand and seal this.:? '1 ~ ,1986. day ot ~ ~~~t1IVJ; (SEAL) Joan Boyd Simmons Signed, sealed, pUblished and declared by the above..named Testatrix, as Rnd for her Last Will and Testament, In the presenoe of us, who, at her request, In her presenoe and In the presenoe of each other have hereunto subsorlbed our names as . witnesses. . . . ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA 1 SSI COUNTY OF CUMBERLAND I, JOAN BOYD SIMMONS, 'restatrlx, whosll name Is signed to the foregoing Instrument, having been duly qualified according to law, do hereby aoknowledge that I signed and executed the Instrument as my Last Will and Testamentl that I signed It willlnglYI and that I signed It as my free and voluntary act for the purposes therein expressed. ~ ~~~~ C/ JOAN BOYD SIMMONS Sworn or affirmed to, and acknowledged before me, by JOAN BOYD SIMMONS, the 'restatrlx, this J 9 t.\) day of ~"\"l. , 1986. -~~",. ~ ~.,~, Notary Public OIMllll I.C:i~. NOTARY' My Commllllon ['pit.. Ol<,,,b" /1. 1989 umoyne, I'J Cumberland Coun" " I, . AFl1lDAVl'1' . OMMONWIlAL1'1I 011 PENNSYLVANIA 1 1 SSI OUNT\' 01<' CUMBEIU,AND I We, ~.. . .. {.\. .it""........" and C, ({ ~w.:.J:l,-l,.'" l\~)' t the witnesses whose ames are signed to the Coregoing Instrument. being duly qualified according to law, o depose and say that we were present and saw the Testatrix sign and execute the oregolng Instrument as her Last Will and Testamentl that she signed willingly and hat she executed It as her Cree and voluntary act for the purposes therein xpressed, that each of us In the hearing and sight of the Testatrix signed the Will s wltnessesl and that to the best oC our knowledge, the 'I'estatrlx was at that time 8 or more years oC age, of sound mind and under no c nstralnt or undue Influence. Sworn or affirmed to and subscribed to beCore me by ~ "'I. (f""'~ . nd .k:~Wl.lJ.),,,, LJ I~' . , witnesses, this,}') %ay ofQ~-^- , 1986. . ~, .... 1 1 lJ.-.",,-,- ~~v........ Notary PubllcC ~. DIANrlE Ir'''~, NOTARY', . My CummlSllon I'pllll Dmmbo,21. 1089 14moyne. PA Cumbo,lend Counl, ,\ ~. g~ \0 :-J J',. ,. :0 ;T:1m (II " " '-'1 [l, I hJ CERTIFICATION OF NOTICE UNDER RULE 5.6{a) , . ; I 1.1 -n,. " Name of Decedent I Joan B.. Sirnnons a/k/a Joan Boyd liiiironsl: f.r>' (l - h Date of Deathl Will No. 0000& DeCf:!lnoor 1&, 1993 Admin. No. cx.'!- qlf~ O~ To the Registerl I ce.rtlfy that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court :Rules was served on ~lMt the !Olliwing beneficiaries of the above-captioned' estate on "J/I/f _ 1 , , - Name stephen B. He100rt Address &01 Manor Rd., Camp Hill, PA 17011 Notice has now been given to all persons entitled ther.eto under Rule 5.6(a) except None Name ohnson, Esq. . Du e, Stewart & Weidner Address2~ Market st., P. O. Box 109 Lemoyne, PA 17043-0109 Date,l ~/!~t/ Signa.:ur Telephone (717) 7&1-4540 'capacityl_____ Personal Representative X Counsel for personal representative '. ,. 1 . ' I','.', "r ,,:1:'/' '.''',: " . 'II!"." 'I, : I.' <.'.1 ' :1: : j .,. ! ',' I \". I.," I !! ,-,' . " ill I"~,: '.'.1 " '.,"\'" .., . /' N' ,. , ,"',' , I ,\, ,I. /..'J j' ~ \ \ "'. . ~ '",!, ~ " . J' l' " . I,' \ .',; ','I ' ", '.1' .' ~. ' ,"., " (.' :'. ! \ . 1'." 'I, ,. ' li-:' . . " ffi ~ "1,,, U] 'I'. ~,: ~ ~ ~ ~ 8 $ ~ ~ 1"~ ~ ln~~g~ 1II ~ ~ d ffi. Ii: 0 :E n: Il. Ii: ~ 0 ~ :l ~ l'1 >- o Cl J z o Ul z :c o .., "".." ..I ~ tn 5 0 ~ a: - LL. 1 . , \j , w, c" r" " ;,' , I " . .I.' ':.1 i~ 8 p\ G ~. 8 ~~ r- I&:lil ~ otJaa 3i~~ :II ~ III t&< UlIlC O~8P< ~~i~ ~~~a " ' " , " , ,. t' ',I . I' I ',', I '. \ ' ," I,,' I . ~, " 1 .\ . ' I: \ 1" , ,. , , "t, .' " . I.' ,II " " ' , (',' \ ( : I',. .. ., . ~ ~ Q o '\ jI/ .,. J 'il.. (j Ifn~WltIlIAIHAmR12/31/91CHICKHI_1 "YI:;i;,v. INHERITANcE TAX RetURN 'OVIUY mlllTlI CLAIMIII 0 ,~\iil'~' RESIDENT DECEDENT ;llfiiuM".-iii....--- COMMONWEAlIH 01 P!NNSY\VAN" (TO BE FILED IN DUPLICATE I "1, 94 DEPARTMeNT 0' REvENue ~ H.RRI!fJ:~,~~on:2BOOOI WITH REGISTER OF WILL~l... ~OlJ~r~i?eJc..-...- YEAR N . M LA , I IT, .NO MIDOI! 'NIII'lI ---.... ...... nlotllYm1 ~tlJm Ulr SJHoK:N;, JOAN B. a/k/a SnM:tlS, ,JCW~ Il>V1> mil lkuNI'O ^Vll., IIpt. 301 OClAllECillI1Y NUM!!. '-rOAflOflif.mr--rDAWOfllllil 1'~IIIt. I\UllUlhon> 'I'ownllhip 207-07-4097 112/16/93 lJ/22/1l1 em" 11111, I'^ 1'/011 ......... . " . C?~~I, ('UW1::liLl\N1L_. o 2, Suppl.m.nlal R.lurn [] 3, R.malnder R.lurn (/0' dalll a' d.alh prior 10 12.13,82 1.1 5, F.deral Ellal. To. R.lurn R.qulred __ 8, Tolal Number of Safe D.po.1t 8a.e "v.IIIO EI' 111,011 1. Real E"ole ISchedule AI I 11.. 2. Slack, and Bond. ISchedule 8) I 21 ..._, . <I. 110,QO.__......... 3. Clo.ely Held Slock/Partne"hlp Inle,e" ISchedule q I 31 . 4, Mart8ages and Nate. Recelvabl. ISchedule 01 ( 4) . 5, Ca.h, Bonk Depo.ilt & MI"ellaneaut P."anal Properly( 51 . ISch.dule EI 6. Jolnlly Owned Property ISchedul. FI 7, Trantfer'lSchedule GllSchedule LI B, TOlal Groll Auelt Ilolalllnll 1.71 9. Funoral E>pen.e.. Admlni,I,allv. Ca,It, Mllcelllln.ou, I 91 ' e.penlO' (Schedul. H) 10. Debit, Mortgage Liabilities. lI.n, (Sch.dul. II 11. 10101 Deducllon. (10101 line, 9 & 10) 12. Nel Value a' Ellote IlIne 8 mlnv. IIn. 111 13. Charitoble and Governm.nlal 8.queslt (Sch.dul. II 14, Nel Value Subject 10 To, (line 12.."'ln.v,Hn. IJI 15. Amounl 01 line 14 laxobl. at 6% ral. (Inelude ,alue. 'rom Sch.dul. K or Sch.dul. M.I 16, Amounl a' IIn. 14 ta,obl. 01 I.~% '0" Ilnclude ,alulI from Scheuul. K or Sch.dul. M.I 17. Prine/polio, duelAdd ladrom Iln. 1 ~ and Irum Ii". 161 18, Credilt Spaural Poverly C"dll "rio, raym.nl' Ol"ounl Inl."" --- t t 1!J.4!1, u_._.____ 19. If line 18 IIs"alll ,han Iin. 17. .nllllh. dilf"."tI on Ii". 19. Thil II Ih. OIlIAPAYMINT, 110 20. If IIn. 171. s"alll Ihon line 1A. ..1"lh. ,lill..."ce on line 20. Thll II ,h. T"'X DUE. A. Enlll tho Inlll'" on Ih. balance due on line 20A. 8, Enler Ihe 10'01 of line 20 and 20A on 11,," 20ft. lhll II Ihe IAL...NCI DUE. Mak. ChlC_~...P~V~bl. tOI R..I,I" 0' WUIo, .....nt .. .. . .. II SURi'YO'ANSW.liALLQUlltlONI ON uvitiii"liDI"'ND TO MlCHICK MATH.. -----.. -~.._...._. ,... ... -.-,.----..--.- _..,~.__.__._~ Under penchlll of perjury, I d.do,. Inot I hall' ..omlned Ihll ,,'urn, InclucJlnu u(cumpanylng l(h.dul.. and Ilot.menlll and to Ih, bet I of my knowl.dg. and b.lh II h Irue, correct and camplflle, I ded.H' Inn' nil rltol ",Inl. nfl, hllln '''1'011"11 nllrll' mark,' yolu. D.claraHon of prepar., olher than th, perlonal "prellnlollvl!l baled on olllnformallon 01 which prepa,,, nOI ClOy knowlldlJlI SION 1 E 0/ '5 N R ;0 i," 0'R "!'N~ A!/'II" "'OWl (,0 I MlIIlClr HCl/l(I ......------ - DATE ~ " ~ CJret'J/Te'r\!.. .' CIIIIII1 III 11, I'^ 17C!,ll...._.___._._____ ~'I- tit/ __ "' IfHn~,vf '1II1iB! :101 Milrkut: SI., P. O. Box 109 A ~ .~)-"jL'llX)yrl<I,..I'I\n043-0109 _ .J-N~''i . Johnson, EHq. ~ ~~~ 52-, ..Ill ~ ~ ~ =Q 0% VO .. 0006 NUMB!' Gll. O,iglnal R.turn o 4, Llmilld Ellale o 40. Futura Inl.flll Compromit. Ifo, dalll of d.alh aft.. 12.12,821 XX 6. DIC.denl Died Te,IOI' 0 7. D.ced.nt Malnlain.d a Living lrull IAllach copy a' Will) (Allach c~er31 T r~!!L "'U COARlSPONDENCE "'ND CONPlDENTIAL TAX IN'ORMATlON IHOULD II DIIl.CnD TOI "AM . h r~'mn.UllltlO AD~ml Horace A. Jo nson, Esq. ,101 r~lIrk\Jt fit.,!'. n. l10x 109 ~o~~~O~u~IDuffie, Stewart & Weidner .. I.tllKlynu, l'^rll.QO..()I09 ." 717 J..... 761-4540 I, ' 'I I ",': - l__;..-;:c_~:=. ". ,_. ,..4:__"':___~.:...._H:~..l."J..:.~:':_~_::::..:_ 'I % o 3 E ~ III . ?-...!.i4.1..?J.n.. u. ._~'" :, , <\ , q I 61. I 71 9,684.27 (101, 1 .H2!l!,<J!!.________ 1,:1(.4,01 I 81 1131 . (II) ~189.09 (12) 6,495.18 113) _ -0- ... .n......__ (14) 6,495.18 (f,4?:i,JJL..____M .06. 389.71 % o ~ S ~ o v S (161. -0- ...._.____M ,\5. (171 389.71 (18) (19) 19.49 Chc(k hou.! " VOU 1111' "'IIIII""l1l1 II 11,1111111111 Y"II' ltlll'IJIUVlIlI'lll 370.22 -0- 370.22 1201 120AI 1208) R/V. UO) U + (','61 ~,.l.~ '1.},!f... COMMONW'AlT~ 0' PfNNmVANIA '~1\W~1~,!o~~WmRN .__....n..' IST"TlOP 'n' . ...........nn. n , SCHEDULE B STOCKS AND BONDS " . .n,.... T"""'~'jIit~'ijoMIiJ'~=~: = SIt+1ONS, JOAN Il. a/k/fJ SIM'-lOOH, .IO^N IKWIl 21.94.0006 --_._-.-~-_...- .. ." '. .. _ _._._~...__u ._ ..._...,__.-... I"" p,op.rly jolnlly-own.d with RI,hlol lurvl.'llhlp m.;! It. dl"I...d on Ich.dul. Po) -----.-.--. -,--'.. "" "-'.. . '. ," ..,,- .-.-.....~..........._.....~_._._~- ..--:---~--.......;...-. N~T~rER IlESCRIPTlml VAmED~~f~TE --~~- --.---- '_'m.. ,______0_'..____. .....~..__ , ,-- " 1. 7 - $1,000.00 WhHtl III.1Vun MunJrdpl11 ^"thorit:.y J,uZtlrnu Countv, l'ulUlHylv(lIdn Stl\\\Jr Ri:lvtlnull BondA - Bur.iurl of 196] InttlrtJstl 4% - MIlt:lInJAI .Illflllllry.1., 2003 Datu of dllllth VlI.1.UlI ^ccnloo Jnttll:ullt ,7,000.00 140.00 "i , 1\' Ii " , ;! , , . .. " , . ., . , " , I, ,. ',', . I , , .' _......-----....--.~- __~-.__j.-..-.;--..----~T"L ~~.!!!..~I~. 2, RICapllulation) , (II mOil .poc. II n..d.d, I..." addillonallhH" 0' lum. IIII.) $ 7,140.00. uv.;jot'utr2.l7I I SCHF.DULE E lCASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY *' COMMONWeAlTH 0' "NN!Y(VANIA INHI.IlAHCl'AX .nU.H '''IIOIN'DIClOINT ESTATE OF PI.ol. Print Dr T . FilE NUMB R 21-94-0006 SIMMONS, JOAN B. a/KIa SIMMONS, JOAN BOYD IAII p,oporty lolnlly_nod with ,ho Rl,hl of SUNI.ouhlp m..1 b. dl"lo..d on S,hodulo PI ITEM NUMBER DESCRIPTION 1. 1964 Ford Escort - date of death value 2. Household Goods - decedent's apartment - date of death value 3. Airerican Sentinel Insurance Canpany - premium refund 4. Susquehanna View Apartments - security deposit refund 5. PNC Bank, N.A. - Checking Account No. 5140056493 Date of death balance 6. AutUJTU1 Haze Mink Jacket - sale price 7. Sterling Silver Service WedgelroOd China Alpha Chi Rho Ring - per Paragraph II of decedent's Will - not in decedent's possession at the time of death. TOTAL Allo .nt.r on line 5, Reea IAllac~ additional eVl" )( 11" ,h....1l mort 'pac. I, "..d.d.1 VALUE AT DATE OF DEATH 500.00 500.00 2.11 68.00 1,274.16 , 200.00 Meemed $ 2,544.27 'uvau.., I'.UI "TATI 0' ITIM NUMBER A. B. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. ,&J;q9j\ _.:ijll.1'fo COMMONWIAlTH 0' PfNN'Y1VANIA INHI!I1ANCI T.. WURN RIIIOINT OICIOINT SCHEDULE H ~ FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pleal. P,ln' or Tvp. NUMBIR 21-94-0006 SIMMONS, JOAN B. a/k/a SIMMONS, JOAN BOYD DESCRIPTION AMOUNT 1. Funo,ol bp.nl..1 W. Orville Kimnel Fun\;!ral HOl1P., Inc. The Columbarium for Mount Calvary Episcopal Church Interment in Kirk's Garden 500.00 350.00 2. 1. Adlnlnll',atlv. COIIII Penonol Reprelentative Commillions Social Security Number of Personal Reprelentative, Year Cammilllons paid 2. Attorney Fees .. Johnson, Duffie, Stewart & Weidner 750.00 3, Family Exempllan Claimant Addre.. of Claimant at decedent's dealh Street Addrell City Zip Code Relationship State Probate Fees - Register of Wills - Cumberland County ,69,00 Mllc.llon,oul Exp.nl'I' Cumberland Law Journal - advertising letters 40.00 66..08 25.00 25.00. The patriot-Nl:lW8 Co. - advertising letters Register of Wills - file Inventory & InherHance Tax Return Reserve for close-out costs TO~AL (Also .nler on line 9, Recapitulation) (If more IPUC' II n..d.d, Inlll' additional Ih..1I of lam. cln.) $ 1,825.08 .1~,U12~IJ,+ 11.1_1 ,@'. ~', .~ " - COMMONWIAIlH 0' "NN$Y\V4NIA INHlllTANCf fA.x Ululi04 IfIIOINT OfCIDf"lT ESTATE OP ITEM NUMBER 3. 4. 5. 6. 7. 6. L SCHEDULE I DEBTS OF DECEDENT, _ MOR~GAGE L1ABLI~!E.S AND LIENS L Plea.. Print or Tvpe PILE NUMBER 21-94-0006 SIMMONS, JOAN B. a/k/a SIMMONS, JOAN BOYD DESCRIPTION AMOUNT 1. Connor-Rich-Kearney-Torchia Associates - decedent's account balance not cowred by Med:l.care 70,42 2. Harrisburg Hospital - outstanding balance on Account Number 432568829 for services IBndered 0/20/93 not covered by Medicare. 333.70 Holy Spirit Hospital - outstanding balance on Account Number 4070330 for services rendered 5/20/93 not covered by Medicare. 46.62 Women's Medical Assoc. - decedent's account balance not covered by Medicare 2.71 The A. Z. Ritzman Associates, Inc. - decedent's account balance not covered by Medicare 50.56 Grady & Ferry, P.C. - outstanding balance on Account Number 00950 for dental services rendered 10/4 & 11/30/93 92.00 Harrisburg Hospital - balance dL'e dect.'Clent I S account IllUllber 942676714 for servict8 rLJIlJered 12/11/93 to 12/16/93 - Inpatient deductible not satisfied. 676.00 Charles Furriers - charge for storage of Mink Jacket, plus repairs, Cleaning & glazing & insurance 90.00 . TOTAL IAllo Inlor on IIn.l0, Recopltulatlon) III mort rpore I. n..dld, /nllrl oddlllono/ .h..k 0/ 'am. ./...) $ 1,364 .01 " Inventory of the real and personal estate of JOlIN B. SIMOlS a/k/a' J<Wl OOYD SIIMm deceased 1. 7 - $1,000.00 White Haven Municipal Authority Luztlrne County, ~nnsylvania - Sewer Revtlnue Bonds - Series of 1963 Inter.est: 4 % - Matures: January 1, 2003 Date of death value, plus accrued interest 7,140 00 ~OO 00 500 00 2 11 68 00 11',274 16 2lJO 00 2. 1984 Ford Eacort - date of death value 3. Household Goods - d~edent' s apartn~nt - date of dl:lath valutl 4. American Sentinel Insurance Company - premium refund 5. Susquehanna Vitlw Apart1\1ents - security deposit refund i 6. PNC Bank, N,A. - Checking Account No. 5140058493 ~ date of death halance 7. Autumn Haze Mink JClcket - sale price 8. Paragraph II of decedent's WHl: Sttlrline Silver Service Wedgel'XX'il China Alpha Chi Rho Ring - not in decedent's possesAion at the time of death. M 'IUrA!. 9,684 27 ., " , 0("') ~ Ii, \13 :0 -, .I.>, :1:1<0 r ,I, n , () it:,; ,.(J --, \1/ ;.: 5\! ;, iJi to 0 (.0 , , COMMONWEALTH OF PENNSYLVANIA 'l COUN1Y OF CUMBERLAND J (!" u: Stl:!phen B. Hl:!lbert being duly sworn according to law, depolu and says that he :Is Executor _ 01 the Estate 01 Joan B. Sinmons a/k/a Joan Boyd Sirnrons late 01 2~!_ Penns,boro _'I.:,?~~_s~lp ___ , Cumberland County, Pa.. deceased and that the wllhin Is an Inve.,ory made by _ Stephen B. Ht:!lbert , the sald_ EXt:!cutor 01 the elllire ..hte or said decedent, consisting 01 all the personal prop.rty and real estate, ucept r..1 eslat. ouhld. th. Comnlonwe~lth 01 Pennsylvania, and that the ligures opposite each Ihm 01 the Inventory repruent II's fair valve ~s o( the dah of decedont's death. S~rn to ""('\\'.1;"\,,,-- \'( \.'.... 19~_ ~f 1$ i;ik{ .6u'Jm~ Eucutor. a'mlnhlr..tot stephen B. Helbert, Executor 601 Manor Road and subscribed before me, " < NOTAIUAL S l DIANNE lENIG, Nolary 'Pii lie lemoyne Borough Cumberland Co, My Commission Explros Dee. 21, 1997 , C<Ul1p Hill, PA 17011 Add".. Oat. 01 O..th 16th DIY Decarber Month 1993 Yilt INSTRUCTIONS I. An Inventory mUlt be flied within three months arhr appointment 01 persona' representetlv., 2. A supplement Inventory must b. flied within thirty daYI of discovery 01 addlllonalllleh. 3. Additlonalsheeh may ba attached 01 to personalty or really 4. S.. Artlcla IV, Fiduciarlal Act 011949. ~ iB ~ ~ ~ ~ ~ ~ ." '" ~ w . ~ .1 j ~ to- ~ E'< . ~ ~ u 0.. ~ ~ u . 0 u III ~ W IX ~ Q . i!: 0.. 0.. ElIl ~ -' L~ II ~ . 8 0 U. ..J ~ 0 0.. == . 0 < .,;. ,~ <Ill ~ Z c: ~ ~ '1' .. 0 c 4-< '" Q .j.J ~ 8 ::l VI 0 0 IX Z ~ U .. " I < I Z w t:C ." . . ~ 0.. /I 0<( ~: - ~ l ~ d 1 0 . u ..Q ." .... I u e . 0 - . if 0 o I Ii . u CD " ~ -' ....;., - -_.- --. -.. -.- - ---- --...- -- ..- ..--- --.- .-- --.~ ..-- ....-.. ._-- ..-- -- ~- -- -.. --- --.... -.-. - --. -- -- ---- RECEIVED FROM, I m AMOUNT JOHNf.10N IiOnACF. A SRD & MARKET aTREET8 fO"l "370.E!f' LEMDVNE PA 17043 fOlO I/ut '010 HilI ~u.J9~ REMARKS STEPHEN fl. IiELBEfH m TOTAL AMOUNT PAID "S7<l.ee sa. REGISTER OF WillS RECEIVED B~/~~;?<~NA:~(("" ;J.j ./ jJ (' . . I 7';: MARV c. LEWI~l.:'';'' 'LJ.(C';:'.'(' REGWTErl Of" wII.L6 . ;! (r . SEAL CHECK" 11 e , -, -~..- -.- -_. ..- -~T'" _4_ '-~... - - ...- -.. -- .-.- - --., -.-- ....- --_._ _._ --- .__ _.._ __-_ _ _ ,__ , I , . 3 (;. I ~ r J RIV-1547 IX AFP (10-931* CIlIIlOHlIULTlt Of Pl!IlNSVLYAIIU lIE1'AATII!HT Of At:\'I:1IJf, IlUAfAU Of INDIYIIIIlAL TAlIEl DEPT, 110601 HARRIIIURQ. PA 1717a-OAOl 1'( ... 16'1 - 'I ACN 101 NOTICE OF INHE_ITAHCE TAM AFF_AISENEHT, ALLOWANCE 0_ DISALLOWANCE OF DEDUCTIONS. AND ASSESSNEHT OF TAM DATI 07-25-94 . FILE NO. DATI OF DIATH 12-16-93 COUNTY CUMBERLAND NOTE. TO INSU_E F_OFE_ C_EDIT TO YOU_ ACCOUNT. SUINIT THE UFFE_ FO_TION OF THIS FO~ WITH YOU_ TAM PAYNENT TO THE _EGISTER OF WILLS. NAKE CH3CK FAYAILE TO "_EGISTER OF WILLS. AGENT" REMIT PAYMf.NT TOI HORACE A JOHNSON ESQ JOHNSON ETAL PO BOX 109 LEMOYNE PA 17043 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 L A-..t _..Utod CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .. i(E"Y= isiij"iX"AFin 1'0-:93"1" .Nci'r"ici" OF .INHiRiT Ailei" YAX.'A"PPRi i iiifiiir;" ,\L.rciiiA.ilei.iili...... ......___ow DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SIMMONS JOAN B PUE NO. 21 94"0006 ACN 101 DATI 07"25-94 TAM _ETUIIH WAS I (X I ACCEPTED AS FILED I ) CHANGED RESERVATION CONCERNING FUTURE INTEREST . SEf. REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..l Elt.t. ISuhodul. Al (11 2. Stock. end Bonda (Schedu1o II 121 3. Clcl.ly Hold Stock/P.rtn.rlhlp Int.r.ot lSohedul. CI (31 4. Nort_./Hot.. _oed.eb1o (Schedul. 01 141 I. Colh/lonk Dopo.lt./NI.o. F.rlen.l Property IS~l. EI III &. JointlY o...od Prcporty (Schodul. F) (61 7. Tronlf.r. C Sohedul. G I (7l a. Tot.l Au.to .00 7,140.00 ,DO .00 2,544.27 ,00 ,00 ta) 9.684.27 APPROVED DIDUCTIONS AND EXEMPTIONS I 9. Funor.l Expon..I/AOolnl.tr.tl.. COlt II Nho.llon...... Exponl.. (Soh.dul. HI (91 1.825.00 10. OIlbto/NortG_ Llebl1lUu/Llon. ISchodul. I) 1101 1 ,364.01 11. Totd _Uen. Ill) 12. Not V.lu. of T.x _.turn 1121 13. Ch.rltllbl./Ilo..rnooont.l I__"to (Schedul. JI IUI 14. Not v.l... of Eot-t. Subj.ct 10 T.x (4) NOTEI If In ........nt WI' i..uc~ pr.viou.ly, lin.. 14, 15 Ind/or 16 Ind 17 will r.fl.ct figur.. thlt includ. the tot.l of ~ r.turn. .......d to dlt.. 3.189.09 6.495.18' ,00 6,495.18 ASSESSMENT OF TAXI 11. Aoount cf Llns 14 t.xebl. .t 6X r.t. 16. Aoount 01 Llns 14 t.xebl. .t llX r.t. 17. Frlnclp.l T.x Duo TAX CREDITS I FAYNE NT UCEIFT DXSCOUNT (+ I DATE NUNIE_ INTE_EST 1-) USI U61 6 .495,18 M,D6 . .00 M.lI . (7) 389.71 .00 389,71 ANOUHT FAID 03-14"94 856040 19.49 370,22 TOTAL TAX CREDIT BALANCE OP TAX DUE I NTER EST TOTAL nUE 389.71 ,00 , DO .00 . IF FAID AFTE_ DATE INDICATED. SEE _EvE_SE FO_ CALCULATION OF ADDITIONAL INTE_EST. IF TOTAL OUE IS LESS THAN 61. NO PAYNE NT IS _EQUI_ED. IF TOTAL DUE XS _EFLECTED AS A "C_EDIT" IC_), VOU NAV HE OUE A _EFUHD. SEE _EVERSE SIDE OF THIS FOIIH FO_ IHtTRUCTIOHS.I ,I" \ I ,LJ ,;( I' , f;O\ ',', ~t: :'.-. ,. '("j ", ~" " I.i 'I. Iii ,'H ::.1 n: yO , , ,i " , , , i 'I . ,. !, " ". ,. ,,' AEIIRYATIONI E.t,t., of ~t. dyIng on or, blfor. Deceeblr 12, 1912 ~~ If env futuro Jnter..t In thl..tat. 1. tfln.farr" . In PO'Hlllon or .njo~t' to Cl... . (00111tlraU benefJollrl.. of thl cMoedlnt Iltlr thl expiration of MY ..tat. far llf. or fnr y..r., the C~.lth hereby Ixpr...lv r...rv.. the rllht to appr.I.1 end ...... tran.f.r Inherlteno. TaM" at thl 1.ful Cl.n I (coll.tarIU nt. ~ InV IUd't future Intar..t. PIJRlIOSE 01' MOntE I To fulfill thl rlqUlr..."h of SectJon 2140 of the InhtritlnCl' n E.tlt. TIIM Aat, Aot 22 of 1991. 72 P'.', SooUon 2IU, PAYtEHTI Detach thl top portion of thll NoUCI end '1bI1t Nlth your PIYllnt to the RltSllht.r of Willi prJntld on the rtvlrN IJ.. ..!tok. ._ or oonoy ordor p.....I. to, REaISTER OF NILLI, AIlEHT AU P.vwentl reoalveet shall fJr.t blapplJad to InV Int.r..t NhJch ..v bI drJt Nlth InV r...lndlr epplJed to the tlX. REI'UtO (CR)I A rthnd of . tllC credit, Nhlah WI' not r.....tld on thI T.lC A.turn, ..v bI taqut,tld tty COtIpllUntI an "AppUeaUon far Aefund of Pennlvlvanla InherltlnC' and Elt.ta Tax" (REV-l!I!). Applta.1Ion. .r. IVllllbl' .t thl Offlal of thl AltSllhtlr of WIUI, MY of thl 25 AlvlOUe Dbtrlot Offia.., or by cIUI,. the 'f*llll 24-hour InlNlrlna ..rvlol nuablr. for for.. orderJngl In penn,vlvant. 1-'00-562-2050, out.lda Penn.vlvanl. end within 1...1 Horrlollurl".. (717) 717'1094, TOO' (7171 n2-2252 (Ho.rl"" 1"".lrod Ilnly), OIJECTlOHII MV party In Inter..t not ..thUed NJth the eppr.h...,t, l11oN.-w:1 or dlt.UowtnClI of dIduotlon., or ...........t of tllM (JnolucUng dltt'otI'lt or Int.r..t) I' .hown on thlt Hotiel ",.t objeot wlthJn .hctv (60) din of rlGllpt of thl. MoUct bv. .-Ilrltttn prot"t to the PA Depart..", of AIVIOUe, Board of APPtlh, DEPT. 211021, Hlrrllbura, PA 17121-1021, OR ..~.leatlon to MY, the ..Ulr detlralned lit audit of the ItOcount of the par.anal rlpr",...t.Uvl, Oft ........1 to thl Orpfw1.' Court. AOIUN IITllATlI/l! CORRECTIONS I FIOn.l .rrOrt dhoovlrld on thlt ........,t should be IIddr.ued In wrltlnt tOI PA o.p.rt....t of AevltJUl, IUrllU of Indivlduel TIXI., ATTNI POlt A......-nt RIVII.. unit, DEPT. 2'0601, ~rrJtbur., PA 111"-0601 Phone (111) 7'7-6501. SN P... S of thl bootel,t "In.trUCItlon. for Inheritance TlI( Alturn far. RuldOnt Dta~tH (REV-1S01) for an Ixplanatlon of IdIlnl.tr.tlvllv correctabl. .rrorl, If any tllC due 1. plld within thrH (5) alllndtr lIORth. Iftlf thl dtotdt::1t'. IJNth, . flva percIOt UX) dllClOUnt of thl tIX paid 11 Illow.d. OllCllUIlT' INTEIIl(IT. Int.r..t It nrted bltlnnlne with first dav of dellnquencv, or nlna (9) IlOnth. Ind on. (1) de, frOll ,thl dlt. of dNth, to thl cA.tl of PIVMnt. TIM" Nhlch btc.. delinquent tMfor. Jenuarv 1, 1912 bltr Inter..t at thl ,..ta of .ht (6~) "ralnt per ..,.,. c.lculltld .t . chillY rlt. of .0001"'. All hlC.. Mhlch blO... dtlinqvent on Mld .ft.r JlnUlry 1, 19'2 will bI.r Intar..t .t . r.t. which Nll1 varv froe calendar VI.r to aalendar y..r with thlt r,to ennounotd bv thl PA o.,.rtaent of RlvlnUI. Th' eppllalbl, l"tlrlQt r.t.. for 1912 through 1994 .rll ~ tnterllt Alt. DllhI Int.r..t Factor ~ Inter..t A.t. DillY Int.r..t FHtor 1912 20X .00054. 1916 lOX .000274 1915 16X .000451 1917 9l .000247 \114 IU .000501 1911'1991 m .000101 1915 I!X .000556 1992 9l .000247 1995-1994 7l ,000192 --Intlre_t II allaul.tld .. fol!ow'l IHTEllElT . IALANCE aF TAX UlIPAIO II HVIlIIEIl OF DAYS DELINQUENT II DAILY IHTEllEllT FACTOR ~-Anv Notlcl 1..UId Iftlr thl tlM becott. delinquent will r,flHt '" Int.r..t aelauletlon tQ flft"" (15) d.v. bivOf'd thl atl of thl ......-nt. If Plvwant 1. ... Ift,r thl Intlre.t O~tlt1on dlte lhottn on thl Notto., Iddltlonel Inter..t lU.t be a.loulatld.