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(FEEfOfl TtllS
CERTlfICA.TE 12001
WAHNIN(i: IT I~i 11I.EUA ,'III.ILlI 1111:; I ill'\' Oil
TO I.1IJPl.Il:AII IIV fl'I(Jllll;'fAI OR PllmOCdlili'll.
oE~f~~~~~bA(nJA~~I:'VtrN~~~rg~os
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT, NO, 2040902
_JIHIl1tt1W.. ? ~.._JO.9.J__
......l'IlTI01.ii\u(t..."ttn.tcllt~',c"lIml
Name of Decedent
rift!
CARRIL_.._.
_ . . B~i',;--. -.-.-..--.----- COULSO~;;r..--~.----
Sex .Eema..e~..._~_Soclal Security No,_._._... 205~.J6"6.069.. _ .__.____ ...Date of D!lalh__.__.a.1J12./j_2.9L~
Date of Birth ._-D.!JJALJ.8.9L__..____. Blrttlplace__ .V,Ltt'..6bUllg. Yoltk_ COUJl.tl/..-P.eiU!4l/luan~a ....._.____.__.
Place of Death _ChwJ.c.ILa.{J1ad..Home..--Cll!J.tu. te. ._.CumbC?1l.laM_Couui.L/._..______.._.______ _'_h' ___Yen.rl~1Y.l!11Ia
ra:,ILII' N,mH f.,jnnl/ e", tllPlJ,JLjI,... ["",nU,I"
Race _~a.J.J.C.a.6i.OJL_. Occupation .-..-HoLUll!U1i.neJHamen MakC?1l.__ .__.. Armocl Forces? (Yes or NO)__..No______
Decedent's
Marital Status _./JJ.irlOIll ___.n____ Mailing Address.. 9,!;g;".Hi11c4ut~.~l)~,--/l~.f.t4bU4!hi;.r~,:~,,-J-7C.I.9----.,"'"
Funeral Diroctor ....J .-LiWU/Cackl~Il--F-D .C.I C33I-,L-----.--__
Informant ...RoliaJuiL_COlLt'..6oIL._._ ___
Name and Address of
Funeral Establlshment-COCKLlILEUNERAL
(d) ..
Part II: Other Significant Conditions
HOME.__3a.N. -Cltutllut .st.--VUl4bWl.9..P-A--J7CI-9."~424____
: I nterval Between
: Onset and Death
,
,
------....------.--..--..------..---.. .... --....-..--..... ---.. . ________m ---.-._-....;-..---J--Week--_
,
,
(b)~J- TlIne t 7 'lnee t j 0'1__________.._...____________.______.________:_____1---W~~___
,
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.._-_._-----~-,-_._---. -., '--_._---~----'._----------- -_.---....._- -,j----..---------.---
,
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--,----.--- --'-.-.--...,-..---.-.-..--_._...._~_.___._.._L
(c)
Part I: Immediate Cause
(a) ~Pp6<6
---------_._~.._--_....,--_.-._--.~,_.__.._._----~-_..__....-.---.----
Manner ()f Death:
Natural !Xl Homicide 0
Accident 0 Pending Investigation 0
Suicide 0 Could not be Determined 0
Doscrlbe how Injury occurred:
._~_._--_._.._---_.._---_.._. _._.._-----~--
..".---..-.-----......-.--------....-----------
Name and Title of Certifier ------GeOltge-p......Bltal!4cum._ .l4....-Al.12._.__ ..._ on ______. ...... _ .._. ___u._____.__
. - . . (M:6.. 15.0.. Coroner, M.E,)
Address .-----------nn--SSC.-WalllutBottomRoad, -CMU4l~, I'A.. 17 Q.13- ... ..... n_...____.________
This Is to cerllfy thot tho Inlormatlon horo givon Is corroclly copied from nn orlglnol
death duly flied with mo as Local Rogl8lrnr. Thu orlqlnal cortllicolo will bo forwnrdod
Vital Records Office lor perrnanentllllng.
cortlflcato of
to the State
_JIIIIIJnJ/U_ _2 J._ _'_9.94_._
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IDaslllill ann ID:esbtmtttt
of
CARRIE R. COULSON
I, Carrie R. Coulson, of the Township of Warrington, County
of York and COlmnonwea1th of Pennsylvania, her.ewith publish and declare
this my Last Will and Testament.
ITEM 1. I direct that all my just debts and funeral
expenses be paid as soon after my decease as may be convenient to the
proper administration of my estate.
ITEM 2. I direct my hereinafter named Executors to convert
my entire estate into cash at either public or private sale and under
such terms and conditions as shall be advisable for the proper
administration of my estate. I then direct my said Executors to
distribute the proceeds thereof in equal shares among my children
providing, however, that should my son Merle Coulson predecease me,
his share should go to my grandson, Dale Coulson. The shares of my
other children shall be distributed per stirpes and not per capita.
Credit, however, shall be taken for such allowances or advancements
made by myself during my life to any of the children.
ITEM 3. I nOloinate, constitute and appoint Merle Coulson,
Charles C. Coulson, Stanley M. Coulson, and Roland E. Coulson, or the
survivors of them as Executors of this my Last Will and Testament,
vesting in them all the powers necessary for the proper administration
of my estate. I further stipulate that my Executors shall serve with-
out the necessity of posting Bond for the proper performance of their
duties.
-1-
f , "
IN WITNESS WHEREOF, I, Carrie R. Coulson, have hereunto set
my hand to this, my.Last Will and Testament this tenth day o~,
August, 1966.
(\ A"'~ /I R. co.V. L.....~
SIGNED, PUBLIS~D and DECLARED by the above named Carrie R. Coulson
as and for her Last Will and Testamont in the presence of us, who at
her request and in her presence and in the presence of each other,
have signed our names as witnesses hereto.
~~~ ~'I""ding at~1' t:J
a"ding at ~~ .0\,
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21 . 94 - 99
REGISTER 01<' WILLS OF _ CUMl3lmr,AND COUNTY
OATH OF SUBSCRIBING WITNESS
Ma r i etta..E'.......l.e.hme..r._---'UlcL.J.an.e....lI. A1eKander
ClIcIJ~k
(cue h) u subscribing whness 10 the will presented herewith, (euch) being duly quullfied uccording 10
luw, depose(s) and suy(s) thlll they 1'/.eLfL- presenl and suw
Carrie R. Coulson
the testat or _, sign Ihe sllmc and thill_they _.._ slgncd IlS a wllness at the
reqllest of leslnt.2~ in IL~ presence and (In Ihe presencc of ellch olher) (In lhc presence of lhe
other subscribing wltness(es)), ,
Sworn 10 or ufflrmed ult(~ubscrlbed before ~~t,;(..l.r.l....'I(,;::14~et. /'
me IhIS~' , :Jx~___ d(U~ 9f Ma rl e ttil F. (MlInl1)o r
ot1_rl)l(I~~JJ,'t4-~-~ 19LL _..4. mnr.lLSl:-....._f1ill"bllrg, PA 17019
" ~ '"(J . (I\d..d.,r,essl /..' ""~"'.... t1, ,)
.,' 'I r '.- r ," "_"_' r )i ;-:/' /Y/-/' "
..""",< c.-e. : ?tfe? (,,/1!"~ ;?t-~/.'('{'
I ' , " ,xlfvame) .
I I" ',j . ,110" I ;fl'
I" "I ( n"lrimnri> !':I' . nil1"burg, PA 17019
I M)'\ I' Id, ,I, lnYl (A Id ~
~,\I{',h~ Pj'( 11 \ '''(lli i1\'. {\'II','\Ili'c~ f.\7\ ;L~ I (. rfSS
REGISTER OF WILLS OF COUNTY
OA TH OF NON-SUBSCRIBING WITNESS
(cuch) u subscrlber..J1ereto, (each) being duly qUllllfled uccordlng to luw, dep\)Se(sf~~d suy(s) thllt
. fumlllnr with the slgnuture of _---:../
codIcil
.lestal_ of (one of Ihe subscribing wltnesscs 10) Ilw' will presenled herewhh and
, .. .. codicil
that . bclleve~.thc' slgnulure on the will is In the handwrhlng of
',-,",,-
teslnt,_ believes the signature of the wll!.-flresenled herewith and thut
codicil /" .
/
believes lhe slgnulure on Ihe will I~.lr(lhe hundwrltlng of
to the best of kllllwledge IInd belief.
/
Sworn 10 or afflrmed.atfd subscribed before
,/
me this .. . __ day of
/
19__.
.'.....
(Name)
,
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--.<-
(Address)
"
Register
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.. . 'IlENUNciAnON
In Re BSlale or
CARRIE R. COULSON
deceased,
Cumberland
. To Ihe Re.lller of Wills of CdunlY, Pennsylvania,
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The undersigned ICw'"" 11 ~ n r ~ or
Ihe above decedent, hereby renounce(s) the right 10 admlnlsler the eslale and resllectrullyask(s) Ihal
Letlen 'PF.STAMF.NTARV
be Issued 10 Rnll Ann IC rnl11 Clnn
WITNESS nil r
hanwthls ?R~l1day of
'J~r\11V~r
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Subscribed and Iworn 10 beforo me
Ihll 28ttdayof January
1994
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tJOO K ''''''fq 11.~ni)' flt4b
DiL"'huIUI1('fl,l, "['I},I_i"!ll!Y
My (Xlfl,mb<1h , !. ':111', ,. \ !l'()~
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M;~le C. couisg'~" 'I
611 Hillcrest DrivA. ni 11 RhllT'Q. PA
Stanley M. cout~l
262 Carlisle Road, Dillsburq, PA
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Charles C. Co~r~~n
1571 Baltimore Road, Dillsburg, PA
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
cc""O',...."",(I/ "l""""',"'" (TO BE FILED IN DUPLICATE
t)fflMll~tI.l ell ~h(llU{ 21
"'" ,r.::,', :~'~\:'"~'c, WITH REGISTER OF WILLS) (OU>I'Y CODE
. -"'.'.i D-itrtjr:if\'1i^-j;\lli~:sr~.~sr~-;;r)-'~~i:i\';'i~^:.'.. ,_~~':''':;:;;;;;~~'-;;'~::;':'':':;-''m!-t5i~'jf~ ;'~~~'~fl! Aoo'~'i'ss-
ffi COULSON, CARHIE [l, I ROI N, Hanover Street
J__ \OCI:~~;;~~~:M~~i~:;_~'.~.:'_:r'f~~';~;~~'4.ID'f~~~i~~~'~~-~~~~:~~j~~'b:: ] ~ ~~] 3
~ Kl I. Origin,,' R,'urn 2 5upplnmenlal R,'urn 0 3. Romainder ROiurn
~::lUl Ifar dalll 01 d.alh prlarlo 1201 3,821
@g:~ L:.14 linlllOd EllalO ,10. Fuluro Inlo,,,, Compromho OS. Fodoral E"o', Tux
o ~O 110' dolll 01 doalh ailor 12. \ 2.821 ROIvrn R.qvlrod
g;iil Ki 6. D.codnnl OlOd T.llalO 7. Oocodonl Ma;n'a".d a living Troll .l. 8. TOlal Number 01 Sol. 0'1'0'" Box..
<l p IAlIach copy 01 W,I'I IAlIoch copy 01 T,ulll
-'-1--'-- ,~n~.Co.RRi.spo~~~~ci ~.~~ ~.()NFIDeNTIA~~:B.'I~~Q.'!.~A.~'TI.P6t[jIH,rO:Qtii' B'I- P'~~mECJ~:O_.TO',____
PLUM (/,In MA,IWh', .\OvR $
~ ~ Jane M. Alexander, EsqUire 148 South llalt1more Street
~ ~ rm/H6'Nt"NUwi-' .--.---...... --.---- p, O. !lox 42 J
v ~ Dillsburg, PA 17019
l.Z,~.? J_'u,~~2=.i.?}L .--'""~'""'==-=-~c",,==cO' _uu
Rf v', SOQ f ~. (II ,<.J I)
1. Roo' Ella" ISch.d,lo AI I 11 _______.Q_..O.0. ______
2. S'ockl and Bond, 15ch.d,lo BI I 21 ..._______..JL...Q.Q......__...__
3. C1olOly H.ld 510ckIPorln."hip InI'"'' , (Sch.d,lo CJ (31 ._.u...._..Jl':"'O_~.._._._
4. Mor'gagOl ond No'OI Receivobl. 15('"dul, DI 141. ..... .. Q_I 00.... .....__
5. Calh, Bank D.po'i" & Mllcullonoo", P'",Q""I Properlyl 5) ......6 ~...'..~.~~.~..1.9. .___
IS,hod,l. EI 0 . 00
6. JOlnlly Ow"d P,oporly (5ch.d,l. FI I 61 ...u......
7. T,anllo" (Sch.d,lo GI (5ch.dul. II ( 7) ___._n....o.o.___
8, Tolol Grall Allo" Ilolallin" 1.71
Q, Futloral E..;pen~os, Admilllslrolivo COlli, Miscellanoous I 91 _p .
E,ponlO' /5,h.d,l. ~II
10. D.bl., MOrlgago LiobilltiOl. lio" 15ch.d,l, II
11. T 0'01 D.d"lion, 110101 Ii no I 9 & 101
12, NO! Valv. 01 Ella" Iii,,, 8 minuo Ii"e 111
13. Cho,ilabl. and Govornmenlol B.q'"'' 15ch.dul. J)
'_0.-,_.__.__ .!..~~._~.~I~y_~~,~~.,~~.~iO~! .'~!~,XJ!I!U.!,~. I~!fllll 111'11 1~.L
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fOR OAT'" Of DIATH AnlR 12/31/91 CHICK HUI
If A SPOUSAL .
POVERTY CRI~J! .IJC~A!M!.~Jl_..._.. _.....
filE NUMBER
94
YCAR
0099
NUMBER
on
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.7..,304...7.2..u...._..
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(12) 61 37.hOO--
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(l51___6.l.,.3J3. !l0......____" .Oh 3l..21l2....D__
0.00 0.00
(l61._...u.._....__... .._......_x .15 a
15, AflIiJunl of linu 14 !ull,oble ul 6',(, ("Ill
jlndvde valvo, from SchecflJll' K or S(h~'dlJIO IAI
16, Amovnl of line 14 loxoblo 01 15% ral('
, llnrlvdo valve, from Scheuvlo K or ScI'llclJlo M,J
117 PrlllclpallCl" dve (Add 10.-; from Iino 15 clIld Irom Ilno 161
18. Credjh Spovsal Poverly (rodil Prlllf PClyrm'1l11 DhcQ~nl
, 3,i120 !~O
. . . ._.. L..........
(171
3,682.43
Inloro,'
3,600.00
..__.___._._Q.,..9.Q.__
82 .43
11BI
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11Q 111I'Ill 18 II 'J'l',lltor I"on 11",,17 l',II," Ill' l,h'HtHHl' elf' lino IQ Thil i, Iho OVERPAYMENf,
tl' ri~;f,-rlr.'I'JI~,rf.'I'l'I IlJI,:!...Jd,,.:r.t:'I~.ltl'l.'l'llj:.I.:J"'II.ltl~
10 III"" 11,. U""'" 'hon I"" IU, ,,,,,,, H,,, .1,lIu'"'''" un;,no 20 Th,."'),u TAX DUE,
A Entor lhll inhHQlI on Ille bolufI(u dvu 01\ II/ll1 20A.
1201 ____
120AI --__'O"..M..__
120BI . \i2.......4,J.
B EnI" Ih. 10101 01,,,. 20 ond )OA ,,,. """ 20B Th" II Iho BALANCe DUE.
. . .. Ma~o Ch.,.k. Pa~abl.. 10: R.g;.'" 01 Will" AU'.".I.
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PLEASE ANSWER THE FOL~OWING QUESTIONS BY PLACING A CHECKMARK (,..) IN THE
APPROPRIATE BLOCKS.
. ...!.J~?
1, Old decedent make a transfer and:
a, retain the use or income "f the property transferred, ""'"''''''''''''''''''''''''''''''''
b, retain the right to designate who shall use the property Iransferred or Its Income,
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c, retain a reversionary interest or ,.........."....",..,......""1"".111..'..,...'11."'11"'1..1.
d, . receive the promise for life of either payments, benefits or care~ "'"''''''''''''''''''
2, If .death occurred on or before December 12/ 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration~ If death
occurred after December 12/ 1982, did decfldent transfer property within one year of .
death without receiving adequate conslderatlon~ '''""""""""""",,,,,,,,,,,,,,,,,,,,,,,,
3, Old decedent own an 'in trust for' bank account at his or her deathL"""",,,,,,,,,,,,
'! X
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, .
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OFTHE RETURN.
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l SCHEDULE E 1
CASH, BANK DEPOSITS AND
MISCEllANEOUS
. PERSONAL PROPERTY ._ ,,,,=,,=~l~~~ Print or Type
FILE NUMBER
COMMONWillH O' PlNNI'''AN''
INHI HellAX mUlN
miD HI DICIDINl
hTATE OF . -
CARRIE R. COULSON
(All p..,.rty lol.tiy.owntd with tho RI,hl 0' Su",I,o"hlp mUll bo dllClo..d on !ch.dul. F)
2194-0099
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE Of DEATH
1.
Mellon Bank Money Market Checking Account
#220-070250
34,627.06
2.
Mellon Bank Premium Checking Account w/Interest
Account *222-108770
6,728.70
4,008.70
6,012.75
5,007.11
5,008.80
4,008.98
3. Mellon Bank Income Certificate *22-A53770C
4. Mellon Bank Income Certificate #22-A53769C
5. Me llpn Bank Income Certificate #22-1\53767C
6. Mellon Bank Income CertJ.ficate #22-A53765C
7. Mellon Bank Income Certificate #220-085658C
8. Church of God Home, Inc. - refund of fee
3,554.00
S 68,956.10
IA"och oddltlonol ,1\" H II" Ih.OI' II mo.. IpOCO It n"d.d I
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Mellon Bank
..
February 18, 1994
~h,lIon think, N,i\,
~h'II(111 Ilunk Coni.,'
1',0, Ilox 'j8flIJ
I'hllndolphln, f',\ IlJlOl.78IJU
Jane M Alexander
Attorney At Law
148 S Baltimore St
Dillsburg,Pa 17019
RE: Estate of Carrie R Coulson
Dear Ms Alexander:
In accordance wIth your request, the followIng InformatIon Is provIded as
of Januarv 22. 1994
Interest Total
PrIncIpal Earned Interest
Account Ba lance From Last Total Earned
Number As of PostIng to Balance Th Is Year
and Date Type of Da te of Da te of To Date of To Da tit of..
II tie Opened Al:-'2lIllt -DutL Death Death On th -
220-070250 1/5/83 Money Mkt $34,579,37 $47.69 $34,627.06 $47,69
Canie R Coulson Checking
222-108770 1/5/83 Premium $6,720,15 $8.55 $6,728.70 $8,55
Carrie R Coulson W/ Interest
22-A53770C 4/8/87 Income $4,000.00 $8.70 $4,008.70 $8.70
Carrie R Coulson Certificate
22-A53769C 10/4/88 Income $6,000.00 $12.75 $6,012,75 $65.47
Carrie R Coulson CertifJ.r.ate
22-A53767C 11/ 4/90 Income $5,000,00 $7.11 $5,007,11 $7.11
Carrie R Coulson Certificate
22-A53765C 1/7/91 Income $5,000.00 $8.80 $5,008.80 $8.80
Carrie R Coulson Certificate
220-085658C 10/5/89 Income $4,000,00 $8.98 $4,008.98 $8.98 "
Carrie R Coulson Certificate
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Number
, and Dlt,
TI t Ie Opened
422-242 4/28/89
Carrie R CQulson
Safe Deposi t
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Please contact this department If ,you have any questIons.
Sincerely,
d~
Hellon Bank, M.A.
Hrltten CommunIcatIons (199-5380)
P.O. Box 7899
PhIladelphIa, PA 19106-7899
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To Oat, of
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COMMONW'Allrt 0' 'INN$'(lVANIA
INHUWANCllAK .I'U""~
~f110IN' OterOINl
iSTAT! 0'-.
CARRIE R. COULSON
ITEM
NUMBER
DESCRIPTION
A. funeral bp.n""
1,
Cocklin Funeral Hqne M funeral expenses
125.00
8. Admlnlltratlv. Caltll
1.
P.rlanal R.pr...ntallv. Camml..lonl Ro 11 a nd
Social S.curlty Numb.r af P.'lonal R.pr...nlatlv"
Y.ar Commllllonl paid 1 q q 4
E. Coulson
201 uf 3471-
3,447.80
2,
Allorney F".
Jane M. Alexander, Esquire
3,447.80
3, Family EK.mptlon None Cl aimed
Claimant R.latlon.hlp
Add'.ll of Claimant at d.c.d,nl'. d.alh
St,,,1 Add,...
Clly _
5101.
Zip Cod,.
4,
Probal. F".
Wills M Petition for
$115 Renunciation $ 5
$ 9 JCP Fe~ $ 5
Extra P~ges $ 3
Inventory and Inheritance
13 7.00
25.00
40.00
1,
Register of
Probate
Mllcellaneoul bp.n"" Short Certs
Register of Wills - Fi~ing
Tax Return
Cumberland Law Journal M advertising Executor's
Notice
The Sentinel M advertising Executor's Notice
Leslie K. Neidig - notary fees on Inventory and
Re 1 ease
62.12
c,
2,
3,
4,
5,
Register of Wills M Filing Estate Release
10.00
10.00
6,
7,
8,
TOTAL (Allo '"'I' on IIn. 9, R~caplllllnllQnl
(If mort .pac. It n"d.d, In"'l addlllonallh.... of lam. .In,)
S 7,304.72
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REV.IIU -IlX' 110131
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARRIE R. COULSON
SCHEDULE "I"
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
FILE NUMBER
ITEM
NUMBER DESCRIPTION
1. Carlisle Hospital - expense of last illness, debt of decedent
/. Belvedere Medical COrp. - expenso of last illness, debt of deced nt
3. Pease Pharmacy - debt of decedent
4. AWe Emergency Physicians - debt of decedent
5. Carlisle Imaging Associates - expense of last illness
6. ~~rk E. Pinker, D.P.M.F.A.C.F.S, - debt of decedent
7. PA Department of Revenue - 1993 individual PA income tax due
8. Brockie Medical Supply - expense of last illness
" ,
TOTAL (Allo enter on line 10, Recapitulation)
(11 mort 'PIC' I' ntldld In"'1 additional thtlll of urn. 11111
";,1.
2194-0099
AMOUNT
80,99
4.82
87.79
14.78
3.71
7.09
. 75.24
3.16
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. 277.58
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IHHIIIU...(I'.... UlUIH
"1101N10telo1NT
ISTATI OP
CARRIE R. COULSON
SCHEDULE J
BENEFICIARIU
PILE NUMBER
2194-0099
N~TJ~IR NAME AND ADDRISS OP BENEPICIARY
ITlM
NUMm
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3.
4.
A, TaKable Beq'"ll1
Merle C. Coulson
611 Hillcrest Drive
~Dillsburg, PA 17019
Charles C. Coulson
1571 Baltimore Road
Di11sburg, PA 17019
Stanley M. Coulson
262 Carlisle Road
Dillsburg, PA 17019
Rolland E. Coulson
610 Hillcrest Drive
Dillsburg, PA 17019
RELATIONSHIP
Son
So.n
Son
Son
B, C~a,llable and Governmenlal hqUllIll
NAMI AND ADDRESS OP BENIPICIARY
None
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aho enll' on line 13, Recapll,IOIlon)
III molt tplce It nu~ed, In..,f addltlonol .hUlt 0' '" me ,III)
I~;ijJJIIH""'{th'\"-).,j"1/ ":"" " ,-
AMOUNT O~
SHARI 0' ISTATI
1/4 Residue
1/4 Res idue
1/4 Residue
1/4 Residue
AMOUNT OR
SHARI 0' ESTATI
0.00
s
0.00
'..
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IN WITNESS WHEllEOF, I, Carrie R, Coulson, haVe hel'Oun,to lit
my hand to this, my Last Will.nd Testament t.his tenth day of
August, 1966.
01'.1 "A~" ((. ~_. 1 A....-uJ
.,
SlONED,'l'UBLISl\ED and DECLARED by the above named Carrie R, Coulso~
as and for her Lalt Will and Testament in the presence of us, who at
her request and in her presence and in the presencs of each cthsr,
heve signed our names as witnesses hereto,
~..~n.:, 1~.?"~"di"."J7~7' t:J
edding at ~~1.-a {J? <!.
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COMMONWIALTH Oil .INNSYLYANIA l
COUNTY O""MU~ yaHK J
UI
H()IIl\n~II,;..__COllI.fJOI1
being duly. .__JJ.\'IUrll _ _ .._. IQcordln9 to IIW, depoltl Ind IIY' thlt h.
.. _ J.il--J:.:X.OCUt.:.'':i1:, --..,..._ of the Ett.t. of _ C'iq:rJQ R ~nI11af'\n
Iltl 0/ .. _ ell r 1111.1 0 Borough ___ ____ ....__, Cumbllllnd County, PI" d.c....d end that the
within Is an Inv.ntory mada by _ ..((()Ul\1l~LIL.__C.9\lLfJg_n_.___, the ..Id-hecutor
0/ the .nllro IIt.t. 0/ ..Id d.c.d.nt, conllstln9 0/ all the ptrlontl prop.rty and r..1 ..tat., 'MC.pt r..1 ..tat. outald.
the Commonw..lth 0/ Pennlylvanla, nnd that the /Iguru Oppollt. uch It.m 01 the Invantory r.pr'l.nt It', /alr v.lu.
al 01 tha date 01 d.cadent'l duth,
Sworn
...&1. d~~wjJ ~) G:.t.b'--
h...t., . MOlI.ht,oto,
,..
and lublcrlbed b.lore m.,
r: __19_~
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610 III11crest Drive
DIllsburg, PA 17019
j, "II'llljlJ I
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UI:j;~'~:;.i"'I_I'i:"~IJ'I/: '/~ t,\:W" (I t~~.'~
AddrOll
Oat. 0/ O..th _._._..~_.---------------_..---_._--..-J.
DIY Mo.th
94
VII'
INSTRUCTIONS
I. An Inv.ntory mull b. /1I.d withIn thr.. monthl allll appolntm.nt 0/ p"'lon.1 ,.pr...nt.llv..
2, A luppl.m.nt Inventory mUlt b. lII.d within thirty daYI 01 dllCOVIIY 0/ addltlon.lalltlt.
3. Additional ,hult may b. attach.d .. to perlonalty or rulty
. 4, S.. Article IV, Flducllll'l Aot 0/ 1949.
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Inventory of the real and per~onal estate of
CARRIE R. COULSON
deceased
1. Mellon Bank Money Market Checking Account #220-070250 34,627 06
2. Mellon Bank Premium Checking Account w/Interest Account
#222-108770 6,728 70
3. Mellon Bank Income Certificate #22-A53770C 4,008 70
4. Mellon Bank Income Certificate #22-A53769C 6,012 75
5. Mellon Bank Income Certificate *22-A53767C 5,007 11
6. Mellon Bank Income Certificat'e *22-A53765C 5,008 80
7. Mellon Bank Income Certificate #220-085658C 4,008 98
. 8. Church of God Home, Inc. - refund of fee 3,554 00
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TOTAL
68,956 10
..,
,
, lO'OH'"
r ESTATE INFORMATION:
EJl
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..,..... -...... -- _.- -... ..~- -- .~.... '-- ,,- .--- -- __.. ___~ ..,_ - _0.- _'_.~
,--.~. .,.. .~.._.. -- --- -- f'-~~ ..._ "_'_ __.. _ _ _ __.-<..-
RECEIVED FROM,
&
ACN
ASSESSMENT III
CONTROL 1:.1
NUMBER
AMOUNT
. ALEXANDEr{ JANI; M
149 S aALTIMORE 6T
,1.71
_..1, 'fC-:V, Ou
D I I.L Bal"~13
PII 1701 'I
fOIPHlI1
F.!1-1994-(l(J99
E DENT IlASTI
COULSON CARHIE R .
M
flflN e05-' 1 1.',,6069
{FIRSTI IMI
'.
-
TV
ClIMBt:RLANll
rnH
r
m TOTAL AMOUNT PAID
,
REMARKS
94
ROLLAND E. COUl.SON
.:3. 4eO. ()(l
CW
SEAL
CHECK" Wlb
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RECEIVED BY":'.:... :, " 1"GNAidR! . L.~ "'"
MARY C. LEWJ!li ,I~:.'
HEGI8TI!I~ OF' W LLtl
REGISTER OF WILLS
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RECEIVED FROMI
I
ACN
ASSESsMENT P!I
CONTROL I:iI
NUMBER
AMOUNT
ALEXANDER JANE M
148 S BAL T1 MORE ST
101
.ee.4;;l
DILLSBUR8 PA 17019
1010 Hut
ESTATE INfORMATlOtf::::]
B M E!1-1994-0099
!II EN LA
~ COULSON CARRIE R
II liAfE Of PAYMENT
OJ:, LEP 1Q4
EI OSTMARKDATE .
NY
CUMBERLAND
SSN e05':'16-6069
m TOTAL AMOUNT PAID
.ae.4S
PEl
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REMARKS
HOLLARD E COULSON
SEAL
CHECK" loel
REGISTER OF WILLS
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REV'1!l47 EX AFP I08094*l
CO""ONW~Al HI or P[NNSYLYANIA
OEP'ATHEHT OF AI 'EHUE NOTICE OF INHERITANCE TAK
aUAt'u OF THomou.. '''E5 APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
UEPT. 1&0601 '
"ARAIUUAO,", 11110 '0"1 OF OEDUCTIONS AND ASSESSHENT OF TAK DATE 11 - 07 - 94
E'mfEOF coli"rflfff'= CARRIE'" -r' .- =FILENO. ~qr=~
DATE OF DEATH 01-22-94 COUNTY CUMBERI.AND
NOTEI TO INSURE PROPER CREDIT TO YUUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAK
PAYHENT TO THE REOISTER OF WILLS, HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT Tal
1~'7
~
51
ACN
101
JANE M ALEXANDER ESQ
148 S BALTIMORE ST
PO BOX 421
OILLSBURG PA 17019
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
EA.O~ Ro.iUod
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOA YOUR RECORDS ..
R iV: i!i4i' EX" "A j: p'" i 0'8-:94"1" -floYi c r"o F - "iNil HilI f Aiic i" Yf. x' AP pilA i ii EH'EflT"; -A L i owiiN"C i" b-Ii - - - - - - -. -"" -" 0'_
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COULSON CARRIE R FILE NO. 21 94-0099 ACN 101 DATE 11-07-94
TAK RETURN WAS I I X I ACCEPTED AS FILED
I CHANOED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Rool E.toto I Sohodub A I 11 I
2, Stock. ond Bond. ISohodulo BI 12)
3, Clo.ol~ Hold Stock/Plrtnor.hip Intlro.t ISchodulo CI 13)
4, Hortgogo./Noto. Rooolvoblo ISchodul. 01 14)
5, Co.h/S.nk Dopo.lt./HI.o, Por.onol Proporty ISchodull EI 151
6, Joln1ly Ownod Proporty ISohodulo FI 161
7, Tron.hr. I Sohodub 0 I 171
8, Totll A...t.
,00
..!!1.
,00
,00
61), 956 , 10
,00
,00
181
68,956,10
APPROVED DEDUCTIONS AND EXEMPTIONS I
9, FUnorll E,pon.o./Ad., Co.t./Hi.o, E,pln.o. ISohodulo HI (9)
10, Dlbtl/Hortglgo LhblllU../Lhn. ISoh.dull II 110)
11, Totol Dlduotlon.
12, Nit Volu. of TI' Rlturn
13, Chlrltobl./Oovlrn.lnt.l Boquo.tl ISchldull JI
14, Not Voluo of E.tlto Subjlct to TM'
7,304,72
277,58
1111
1121
1131
1141
7.582.30
61,373,80
,00
61,373,80
If an a..e..ment wa. i..ued previou.ly. line. 14. 15 and/or 16. 17 and 18 will
reflect figure. that ino1udB the total of ab1 return. a.....eu to dat..
ASSESSMENT OF TAXI
16, A.ount of L1n. 14 It Spou..l r.t. 1151
16, A.ount of Lin. 14 tlHlbl. ot Lin..l/Cl... A rotl 1161
17, A.cunt of L1n. 14 toHobh It Coll.t.r.l/Chn Brito 1171
18, PrincipII TI' DUI
NOTEI
,00 K'OO,
61,373,80 K ,06,
,00 K ,15.
1181
,00
3,682,43
,00
3,682,43
TAX CREDITS I
PAYHENT
DATE
04-18-94
06"22-94
RECEIPT
NUHBER
XA885974
MM886204
DISCOUNT I + I
INTEREST 1'1
180,00
,00
AHOUNT PAID
3,420,00
82,43
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
3,682,43
,00
,00
.00
. IF PAID AFTER DATE INOICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REfUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,I
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RUERYATJOHI E,t.t.. of dle.d.nts d'ilnll on or b,'or. D.c..b., 12, 1982 ... if anv future Int.rut In thl ..t.h II tr'n'flrred
In POI....lon or enJov..nt to el... I (coll.t.r.l' bln'flel.rl.. of thl dlced.nt .ft,r thl explr.tlon of ,ny I.t.t. 'or
11ft or for Vllr., thl Couonwulth h,r.by .lCpru.1v ,...rvII thl right to IIpprah. llnd '''UI tran,'.r Inh.rlhnll' T.k..
at thl !'w'ul Cia.. B (collat,raU rat. on anv .uch lutu,. lnt.rllt.
PURPOSE OF
NOTICE I To fulfill thl r.qul,...."h of Slctlon 21400' thl Inheritlnc. and E,tat. fix Act, Act ZZ of 1991. 72 ?S.
5.otlon 2140,
PAV"ENTI D.tach thl top portion of thll Hotlu and .ub.lt with your pIYI.nt tn thl R.gltt.r of Willi printed on thl rly,r.. lid..
.'Hlk. chick or lon.v ordtr Plyablt tOI REGISTER OF HILLS, AGENT
All PIY'.nte r,cIllltd .hall first bl IPPUld to Iny Intlrut which uy bl dUI with Iny r..ainder appllld to thl tax.
REFUND (CAll A refund of a hlC artdlt, which WII not raquuted on thl TIIC Rlturn, .ay bl raqullt.d bv eUlpllt1ng In "Applleltlon
far A.fund of Plnn'Vlvanla Inhlrltancl and [.tatl TalCu IAEY'll13L Apllllcltlon. are ao/Illablt at 'hi Dffio.
af the Algl.tlr of Will., Inv of 'hi 23 RllltnUI Dlttriot OffiCI', or bv cllllno the 'Plclal 24-hour
In.wlrlng ,.rvlol nutblr. for fori' ord.rlngl In Plnn'vlvanla 1-800-562-Z050, out'ldl Plnnlvlvanla and
within 10011 Hlrrl.burg Ir~a (111) 181-8094, TOOl (111) 112'2252 (Hllring Ilpalrld Onlyl,
OBJECTIONSI Anv partv In Int.rl.t not Iltl,flld with tht .Ppr.I....nt, .Ilow.nc. or dll,llowanc. of d.duotlon., or ........nt
of tllC (Including dl.ccunt or Int.r..') al Ihown on thl. Hotlc. IU.t objlo' within .IMty (GO) d.v. of reelipt of
thll Hotlel byI '
"written prot..t to the PA Depert..nt of AtVlrMJ" IOlrd of ApPIIII, DEPT. 281021, Harrhburg, PA 11121-1021, OR
'.II.ctlon to havt thl utter detlrelnld ., .udit of thl .Cleount of the perlonal rtpr...ntltlv., OR
'..ppul to thl Orphan.' Court.
AOltIN
ISTRATlYE
COAAECTIONSI Flotu.l error. dllaov.,.d on thl, as......nt .hould bl addr....d In writing tOI PA DIPart..nt of A.v.nue,
aur..u of Indlvldull TaM", ATTHI Po.t A"I"I.nt Alvllw Unit, DEPT. 280601, Hlrrllburg, PA 11125'0601
Phone (1171 787-6505. Su p.ge 3 of thl boaklet "Inltructlon. for Inherltancl TIIC Rlturn for I Auldent
Olcldent" (AEY-ISOII for an IlCphnatlon of .dllnhtratlvllY correctable errorl.
DISCOUNT I If Inv tlX due I. paid within three (3) caltndar lonth. aft.r thl dlcldlnt'l dtlth, a flv. Plrc.nt (5~) dl.oount of
thl talC paid h allowld.
IHTERESTI Intlr..t I. oh.rg.d blolnnlng with Ilr.t dav of dlllnqulncv, or nlnl (~) Month. .nd on. (1) day fro. the dlt. of
d..th, to the dati of oaV.lnt. Taul which blell. dlllnquent b.fore Janulrv 1, 1952 b.ar Inter..t at the retl of
lhe 1.610 perc.nt par .nnu_ calaulatld at . dallv rat. of .000164. All tOICII which blenl dlllnqutnt on and .fter
Jlnuary I, 1952 will bur Intlr..t at a rat. which will vary fro. callndar yur to callndar yur with that rate
,nnouno.d by thl PA U.partMlnt of A.vlnu.. Th. applleabll Intlr'lt ratl' for 1952 through 1994 .rll
'!!!!; Inttrllt RltI Dallv Inter..t Faotor Y.!!! Intarut Aatl DallV Int"..t Factar
lYI2 20% ,000541 1916 lOX ,000214
1911 16X .000411 1911 9~ ,000241
1914 IlX ,000501 1911'1991 IIX .OOOMI
1915 llX .000156 1992 9X ,000241
1995'1994 IX ,000192
--Int.r..t II cllaul.t.d II follow"
INTEREST . 8ALANCE OF TAX UNPAID X NUN8ER OF DAYS DELINQUENT X DAILY INTERE8T FACTOR
.-Anv Hotlcl ISlUld Ifter thl 'IIC bloo." dlllnqu.nt will "Ulot an Interut a.loulltlon to flft"n CIS) daVI
beyond thl dltl of thl ...u...nt. If pIY.lnt It lade Iftar thl Intlr..t co.putatlon data Ihown on the
Hotlca, addltlonll Int"rut IU.t b. o.laulatld.
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DlIIsburg, PA 17019
(717) 432-4514
FAX (717) 432-2812
April 18, 1994
./
Register of Wills
Cumberland County Courthouse
Hanover & High Streets
Carlisle, PA 17013
RE: Estate of Carrie R, Coulson
File No, 2194-0099
Dear Ms, lewls:
Enclosed herewith Is estate check number 1016 In the amount of $3,420.00
which represents a payment on account of Inheritance tax In the above-captioned
estate,
We are basing this payment on $60,000 times the 6% and then taking
advantage of the 5% discount leaving a payment due of $3,420,
Also enclosed is it stamped addressed envelope for return of the receipt for
payment,
Thank you for your cooperation in this matter,
..
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CERTIFICATION OF NOTICE UNDER RULE 5. 6la l,
Name'of Decedent I
CARRIE R. COULSON
Date of Death, Januarv 22, 1994
Will No. Eotate No, 1994-00099 Admin. No.
,.
To the Registerl
I certify that notic. of benefici~l interes~ 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
.1AnuAry 2<;, 1 CJ94 I
~
Address
MAr 1 A (". Cnlll Ron
611 Hillcrest Drive, Dillsburq, PA
262 Carlisle Road, Dillsburg, PA
Stanley M. Coulson
Charles C. Coulson
Rolland E. Coulson
1571 Baltimore Road, Dillsburg, PA
610 Hillcrest Drive, Dillsburg, PA
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Datel~f/9;::j/
- .,/ ~~0''?~-:?k'.4;'/'
i nature ~
(N e Jane M. Alex~~der, Esquire
Address 148 South Baltimore Street
Dillsburg, PA 17019
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432-4514
CapacitYI
Personal Representative
X Counsel for personal
representative
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REGISTER OF WILLS OF YOnK COUNTY
STATUS REPORT BY PERSONAL REPRESENTATIVE
,. No. 21-194-4-0099
rqq.t,
SOC. Sec. No.
N.me 0' Deo,dent: CARRIE R. COULSON
D,'e of Dealh: JANUARY 22, 1994
Name of Pereon.' Repr8senlatlve(s):
205-16-6069
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Exeoulor
Administrator
Administrator c,t,8.
Admln/strator d,b,n,
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Is the administration of the estate complete? Ves x No
II "yes," how was the administration ended? (check one)
Tolal amount paid to date to creditors and for funeral admlnlstrallve
expenses.
Total value of distributions to date to benellciorles
" adminlslratlon Is not complete, esllmated value of assets sllll In
administration
$ 14,187.40
$ 56,003.67
$
I certify under penalty of perjury that the f regoing In'ormatlon Is oorreolto the beet of my
knowledge, Informallon and belief,
Date: APRIL 18. ___ 1995
'"' .....~
. 0 )/% /41 ,Lie/'
rlnl'or type na e below signature Ind Indlul'.
whelh~r per onal representative or counoel
Jane M. A exander, Esquire
Attorney for the Estate
This report must be signed by the per al representative, or one of them when more than.
one, or by counsel lor the eslate,
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04/ 18,<9421 ~..
JANE M. ALEXANDER
ATTORNey AT LAW
,.. 10UTH HAL TIMORS STRnT
P.O. lOX 481
. DILLI.URCI, PINNIVLVANIA 17010.048 1
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q~,l berland County, Courthouoe
H~ over & High Streets
'C r1is1e, PA 17013 .
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