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HomeMy WebLinkAbout94-00792 "-,,- --->~ i';' ';.' .\'J :::: ['< ..;:,( "' i,- ''-''~}'-\'" >. -, ", . '1'"' !J. .:.- -,': ., ". .,q': c-, '-<, Eslule of DLI'it:. ~. BtJ/?TNc~ ulso klWII'1I us DCIVEI3URTNER-- I)ETITION )<'OI{ I)ROnA TE and GI{ANT OF LETTERS ':<1- 9'1- 11';:z.. No. To: Register of Wills for Ihe lJ"Ct'USL'tI. Coullly of (I .uf>1J1e.I'ltirJd. in the S"t'iuISecllrilyN". -SI$'- .3<1- ?;q;).q Conllllonweallh of Pennsylvania The pelltion of the nlldersigned respectfully represellls Ilull: Your pelltloner(,). who Is/tOfe IN l'ears of uge o~ \lider nn Ihe executi'< In Ihe laS! will of Ihe ubove decedeut, dilled _J':/1:l..'J.ldnb~,.. I and codlcll(s) duted . '}:med , 19~ hi ale u:lc\'ulIl dU:lIImIUII(c\. e.lI. lI:lIIl11dlllloll, dClllh uf c\cClllor. ell',) Decendenl was domiciled UI demh In (!...;m II U lasl fumll~oJ princlpnl residence al .oA liD S; (11\1 Mrccl, lIulllh1.'r "lid lTIulldpulilY) County, Pennsylvania, wllh r. L. ...;>e..-A yeurs of uge, died ll.u''O ~ ~J 6)lR , 19 q.f. ". . Except as follow ,deeedelll . nol marry, wns nOI divorced und did nol have a child born or adopted aner execullon of Ihe will offered for probale; wus nOllhe victim of a killing and was never adjudicated Ineompelelll: Deeendelll al dealh owned properlY with eSlhnated val lies us follows: (If domiciled In I'a,) All personal properlY (If not domlcilcd in Pa.) Personal properlY III I'ellnsylvunlll (If 1I0t domiciled in Pa.) I'ersollal properly III COllnly Value of real eslale in Pennsylvania sllualed as follows: 11- fz ,uo lin ....0,000 s s s s WHEREFORE, pelllloller(s) respeelfully requesl(s) Ihe probale of lhe lasl will and codiell(s) presented herewith and the gralll of lellers -rel;~a m'.{"\+a.~ (leslalUcnlar)', ndm 15lratlon c.l,a.: udmlnlslrullon d.b.n.c,I.D.) lheron. 'g .!i _ LoUISE" _ eu..,,,, '6~ "'0 -g,g c'. ~~ ll'. ~o ! Vi ~ . / 3D' (.. " '. I O!> I t. ~. '7 ~.!jj D- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH 01<' I>ENNSYI,VANIA } 1:18 COUNTY OF CUMBERLAND Thc petltloner(s) llbove.nllmed s\Yellr(s) or llffirm(s) Ihallhe slulemenls In lhe foregoing pellllon arc Irue llnd correel 10 the besl of Ihe knowledge and belief of pctilloner(s) and Ihat as personal reprcsen- tallve(s) of the lIbove deecdenl pelllloner(s) will wellllnd Iruly administer Ihe eslale according 10 law. Sworn 10 or llffirmed12lfW SlIbscrlbed41~,1, Pk~, d~~. ~h.~?7' , ~ bel' rs W~ IS dll of ~~ E ,'~,~L... ~ tP It. 1\1 I. Q\(..c..I-u..D.l . A no~'S' ~ '.i .//;. ~#. ~ MA C. LEWIS ReRisler. {/- ~ ;)6$- 3 , N 21 - 94 - 792 O. Estate of OLIVE S. BURTNER a/k/a OLIVE BURTNER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW SEPTEMBER 16. 19....2L, In considerallon of the pelltlon on Ihe reverse side hereof, sallsfactory proof having been presenled before me, IT IS DECREED that the lnstrument(s) dated NOVEMBER 14. 1963 described Iherein be admilled to probate and filed of record as the last will of OLIVE S. BURTNER a/k/a OLIVE BURTNER and Lellers TESTAMENTARY are hereby granted 10 LOUISE BROWN FEES P b L E S 235.00 . ro ale, ellers, Ie... .. .. .. . Shorl Certlncales( 4) ... .. . .... S 1? . 00 Renunclallon ,.........,..... S . .-~ages S o.uu JCP 5.00 . TOTAL _ S ?5R.OO Flied .,., .~!'.~H!'I,B.~~, .1,q,. JP,~4:,...,.. '--J7!}~">f a ,f(!. ~ ,(lU. D. 7n.r::r-n ~J' 'f U Real"" 01 Will, I;r p MARY C. LEWIS " ~.h4'.IE~~J4 AlTORNEY (Sup. CI. 1.0. No.) 3/lSIQ J4.J'~~~U~/~/7~ ADDRESS / 717-7'''-O2.~ PHONE nn c' 'J , , f'-.j Vi ", Mailed letters and order to attorney on 9-16-94. . . <, "- .. .-:' \'1. <~! -' , '.'! ,:' '.-' (J 0' Cr: . -' Eb ;-, ,\ Z6l - 176 - ~Z " i ! i I I I 'j ! . , . , LAST WILL AND TESTAMENT KNOW ALL MEN BY THESE PRESENTS, thllt I, OLIVE BURTNER, a legal resIdent of New Cumberland, PennsylvanIa, being of sound and disposing mind and memory, do hereby mal,e, publish and declare this Instrument as my LAST WILL AND TESTAMENT, In manner and form following, that Is to say: 1. I hereby caneel, annul and revoke all wills and codicils by me at any time heretofore made; 2. I hereby appoInt my husband, CALVIN R. BURTNER of New Cumberland, Pennsylvania, as executar of this my LAST WILL AND TESTAMENT, and I request that he be permitted to serve without bond and without sorety thereon and without the Intervention of any court or courts, probate or otherwise, except as required ~ law; I hereby authorize and empower my said executor, in hIs absolute discretion, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate (any purchaser thereof not to be required to see to the application of the purchase price), to invest, reinvest, or retain Investments of, my said estate In other than legal invest- ments; to settle, compromise, adjust or submit to arbitrstion, In such manner and upon such terms and conditions as he shall deem meet and proper, any and all claims by or against my estate; and to perform all acts and to execute all documents my said executor may deem necessary, convenient or proper in the premises; In the event that he shall predecease me or shsll for any reason refuse or be unable to Sl!rvc or to continue serving as executor hereof, (Page 1 of 3 pages) ('J/J..~ ~ ~~At;;;';~ OLIVE B N R ~ ~ II/tJ '. " then I hereby appoint my daughter, LOUISE BROWN of 302 East Narbll.! Street, MechanlcBburg, PennBylvanla, aB executrix in hlB Btead, to Berve without hond or Burety and without Inter- vl.!ntlon and with like powerB and authority In the premlBeB; 3. I direct that my JUBt debtB and funeral expenBes be paid aB soon after my deceaBe aB mIIY be practicable; 4. I hereby give, devl Be and bequeath all my estate and .1 i I ~ , '! i i I , ; property; Including all property of which I Bhall die seized and possessed and all property to which I sholl be otherwise entitled at the time of my decease, of whatever kind or nature and wherever sItuated, be It real, personal or mixed, together with any lapsed legacy or devise and 011 property over whIch I shall have power of dlBposltlon or appointment, to my belovcd husband, CALVIN R. ( BURTNER, now rcsldlng in New Cumberland, PennBylvania, as his sole and abBolute property, If he shall survive me, being fully confident that he wIll suitably provide for any children of ours I, that shall survive mc, but not ImposIng nor Intending to Impose I ( any legal or equitable obligation on him so to do; 5. In the event my sold hUBband ohall not survive me, I give, devise and bequeath 011 my lIald elltate and property, absolutely and forever, share and ohare aUke, to our children, NRS. LOUISE BROWN, MRS. DORIS WOJCIK, ~IRS. GENEVIEVE HELD, CALVIN R. BURTNER, JR., and ROBERT E. BURTNER, or to such of them as sholl survive me; If (Page 2 of 3 pages) ~ 8 ~""~.A; OLIVE BURTNER . . ~ J!'fk8 1#/.1 . . , I1I\Y oC our children shall not Rurvlve me, then to the descendants oC such child or ehlldren per stl rpes and not per capita; 6. Wheresoever In thIs my WIll It is provided that any person shall henef It hereunder I C such person sha Il survive me, for the purprnes of this Will such person shall he deemed not to have survived me If we sholl die at the some time or he or she shall survive me but die wIthin thirty (30) dllYs ltm1edllltely follow- I"g my decease. IN WITNESS WlmREOF, I have ot CarlIsle Barrocks, Pennsylvania, this l'f-;t/..day of November, 1963, set my hond nnd seol to this my LAST WILL AND TESTAMENT consisting oC three (3) typewritten pages, this Inclllded, the preceding pagcs hereoC bearing my signature. (i.!l~:"". ,!'J .......J"" ,~ OLIVE BURTNER ( SEAL) Signed, sealed, pobllshed and declared by the obove-named Tcstatrlx, OLIVE I'URTNER, as her LAST WlLL AND TESTAl-mNT, In the presence of all of us ot one time, and at the same time we, at her request and In her presence ond In the presence of each other hove hereunto subscribed our names as witnesses, and we do hereby attest to the sound and disposing mind and memory of said I Testlltrlx at the date hereof, and to the performance of the ofore- sold acts of exeeullon ot CarlIsle Borrocks, Pcnnsylvonlo, thIs /t/;tI. day of November, 1963. WlTNESSES: 1f!1()'~ ~~~,~~~.... 4~ #. /1~ 1/ (poee 3 of 3 pOlles) ADDRESSES: 6.30 ')tJ~J,t-~(j,,(~;6.,IJ. ~D.~/I ~k;'e. G~. , .J,:l~,;J.J- ~~-<' #-"< " /..uu~.;.. . ... .~."t:'c~-. 'f...,.. - . e. CERTIFICATION OF NOTICE UNDER RULE 5,6(0) Name of Decedent: Olive S. Bunner Date of Death: August 26, 1994 Will No. Jiit ,91..1'1 - 1?~ Admin. No, TO:rHE REGISTER: I cernfy that notice of beneficial interest required by Rule 5,6(0) of the Orphans' Coun Rules was served on or mailed to the following beneficiuries of the above-caplloned estate on September 26. 1994: ~ Address Louise B, Brown Genevieve Held Roben E, Bunner Stephen F. Wojcik Randolph F. Wojcik Linda Ann Bilhelmer Sandra L. Ellis Dennis J. Bunner Raymond C, Bunner Roben C. Bunner 302 E, Marble St.. Mechanicsburg. PA 17044 13303 Marceline Drive, San Antonio, TX 78232 36 Sapling Drive, Kennell Square, PA 19348 1576 Virginia, Melbourne, FL 32935 317 Blacksmith Arch, Yorktown, VA 23693 2131 Masters. Missouri Cily, TX 77459 4411 Downes Drive. Indianapolis, IN 46236 P,O, Bo" 18657, Indianapolis, IN 46218 1999 Arrow Smith, Manteca, CA 95336 53 Wallace Street, Steilacoom, W A 98388 Notice has now been given to all persons entitled thereto under Rule 5.6(0) e"cepl N () N E. Date: September 26, 1994 auAv c: ~Odd/II CHARLES E. SHIELDS, III Mellon Bank Bldg., 2 W. Main St. Mechanicsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Represenlotive I.. ou 4 --. .._ -"'. -.._. ., - __ __ _.. - - - - - __ 0-___ SHIELDS CHARLES E III 2 W MAIN STREET IVl '-11,V'/U.UO I I I I I I I I , I lOtOHllf 1 I I RECEIVED FROM: & ACN ASSESSMENT r;t CONTROL I;,I NUMBER AMOUNT MECHANICSBURG PA 17055 lOlOHur ESTATE INFORMATION, 1':'1 IE MBER 5:1 21-1994-0792 I!l'I NAM LA ,.. BURTNER OL I VE S II A m saN 315-34-9929 I T M M R A NlY CUMBERLAND A A REMARKS m TOTAL AMOUNT PAID CHARLES E. SHIELDS III, ESQ. SEAL REGISTER OF WILLS --------------------------------- ,~ ,..." I .. .. .---- . \ , ---.-----.~...__._.A.~... ...--'l"t.- . ~.'~ I . . . I L/ - J, .3 b' - 3 INHEHIlANCE TAX HElIJllN HESIDENT DECEDENT <OI.\I.\OIlWI^,1I1 o. rIlIlISlIVAIII^ (TO BE FILi:D IN DUPLICATE "J Ufr"RIM[t1l Of A(V(HUl i: . "^."\l~~,U~JrJl,,o'" Willi REGISTER OF WILLS) CUU1I1VCO\){ ~-==rfifftUiirnf~i1r~ln~ri;u:;;riiYiiiiit,in;j,ll~ii' ,_...." - ~ - --.-'-:~...:..;;.:-::_~-- __",Co: 't,jHiirilfttlii~fijif'~fir;~ii~-'::=O;-..h IJUln'Nlm, OI,lVE B, ]'j \'IImh,y IJd vc E ~liiiAi "iciiill,jiui.iHi ,__u. Jl'^'i II' "'''111 11'''"1)' .111'" "~~dln"lcHbl1rf), P^ 17044 !:l ]J 'j-J'HI'J/.'J 11-;'(,-'101 i1J-I"II'1 '''''''', L'lIud.'1 1.'11<1 (I/.MCL' ^Uell 'lM.'.) _~ ,,,.,,,,,,,,,..,..,...., "....,; '''''''''.~' ...=~:~~:..'~.. ':"~~ _ I'~~~::~,,~~:'~......__C:':~~~~~""'" ",11;11';"'''',' . p.' . ,,('-'.!SUO fi."IT 'UI ~ )(:$'" hlg:~ 0;09 "'It'" .. .0- tlili "0 ..z 6~ ~- 51{)- dol '~ ,~':\\l'l~\ 'I.4.HGJ>> rOR U/llF.5 or UI/l1II /llnR I2f3119t CIIICK IIIR 11/1 SrOU5/IL .. rOYIRlY Cn!DIIIS CL/lIMIU 0 mi lIuMuiR .. m . ----......------ 9,1 Vr^R 792 IIUMor rn 1. O'lglnol R,lu,n I] 2. Surphllnenlal Rt'IUln IJ 3. [] A, lImit..d hlol, r loin. rulur,. InhHIl' CnlTlp,otnhn [.1 5. (lnr dtlh" 01 dfOUlh n'hH 17.11.01) I~ 6. U"Cfldl!lIl OlluJ Tnllnlo I I , lJ"Utllrtll' Mullllllinnd II lh.illll TruI' .L O. 10101 Number 01 Sule Dopa III OO.~I (AtltUh .'OflY nl Willi, . "I^llnlh~~I~Y of. I,.u-"I.. . _ . .,.... _._., . ._. _ ._.._________ iiLicORRESPONDENCEANDCOflFIIJEtHlAL TM INFORMATIOfl SIlOULD DE DIRECTED TO. iiAMf--. .------. .-. - --.-~.---~ - i:;ji,\riiin.i;.iiiiiii'i.ilil~i\\'-------_.- CII^ltlliS B. SIIlEW:;, 111 iiiiriiUiifTiui.\ar. . t 717 ) 7GG-0209 '" o r.: 5 E ~ hl .. I. Rcul Ellole (Sch.dul. Al 2, S'OC~I and Oomh (Schedvl. Al 3. (lalely tfclt! Slot~/rnrlll~fll,ifl Inh'r"" ISlheclvl" q 01. Mor'g"gol and Nolel Retciwllhlo ISdu~tlule 0) 5. emh, BUllk O""ollll & MhcflUOll"OUI Itrflollul rlfl(lf"ly ISthedul," E) II, Jol1111y OWIIOt! P,opn,'y (Sd'rclul,. r) 1. hundo" (Sthodule 0) (5thrlllule q O. Tolal Oroll Au ell (10101 line I 1.7) 9. funerol hpenlel, Admlnlllrollve COlli, MI"eUonoouI hpenlel (5thedul. HI 10. aebll, Mo'lgoge L1abllllles, lIenl (Schedule I) '1. Tolol O.duc,lons (Iolallln" '1 & 101 12. Nel Value 0' Ellale (line 8 mlnuI line 11) 13. Charlloble and Governmenlol Oe'1u.III (Sdledule J) 14, Nel Value 5ubJ.ct 10 To,," (line 12 mlnuI line 13) 15. SpouloITranl'e" Vor dol.I 01 denlh oller 6.30.901) See Inll,uellom for Ar,pllcable Percenlage on Rftwe"n Side. (Indude values ,om Sthedule K or 5thedvle M,I 16. Amounl 01 line 14 la.lloble 01 6% ruin (Indude volut" horn Sthetlulr, K Of Sthodul" M) 17. Amounl olUne 14 lallahle 01 15% 'ul" llndude value I from 5thedule K at Sthedule M.1 10, rrlndpol h.. due (Add 10.11 ftOl1lllllft\ IS, '6 fl11I117,) 19. C"HIIII 51)OUlol rovnrly Cro,lil rllnr rUYI1l""h o .$11,910,00 z o r.: .. 0- '" ~ :I! o '" S 2 11. ~""ln Stl:eet Nedmnlcnburg, - u N(j'II~ (I)_~n____._..___'_ 121 ..,209, (j74 .34 (J 1 IXX'II';. (4) . I:JDI'II'; . (Sl!~ f"),2211.44 I'^ ( 61 (7) . l'Il)III'; nUNI': (91 $ 29,732.95 (101 .$_7.05..A2 I B I o (15) (16) ug1.3.,}0'!... H _ K._IS _K .06 = Remainder Relurn (for dolll 01 deolh prior 10 12.13.8; redo,nl Ellalt Tall Relur" Required 17055 $273,902.70 (II) (121 113) (141 $ 30,510.37 $243,384.41 o $243,384.41 o $ 14,603.06 o 1171 .___..Jl___x .15 a (101 ..~_JA.J!.Q.;3.0G OhcolJlll . :;GJO, 00 llller"ll () 20. If Une 19 Is oreole, Ihon line 10, enh., Ihe dllfer"nut all L1l1e 20, Thh II Ihe OVERPAYMENT. Ii! 0 21. IIl1l1e 10 II oreale, Ihan line 19, enl.r Ihe dllflJrence on line 21. Thh II 11.0 TAX DUE. A, Enler Ih. Inlerlll on ,he balance dun 011 line 21 A. O. Enl.r 111.10101 0' line 21 and 21A online 210. Thh h II.. BALANCE DUE. Make Check Payable 101 Reghler of Will., Auent _._________~_~_. DE SURE TO A!'I.~'!V~.~.~~L 9iJ!S.Tl~!l!2E...R.~Y.!'R5E.~!>~ ANl!.:r_C?...RECItEC~.~ATtt <II( <II( p.thtr penolll"I of Id"'lvry, I dodnrn Ihall hovt' unll1h'f'd Ihl, rt'IVln, 11Idudilln Otcrunl1U1Iy'IIlU ulu!dult'll om' Ilnlt'lIl1p.I1I1, and 10 1110 bell of my .1I0wledge and belie ~ I 'drue, (01/1',.',1 an comp,lelA, I declare Ihol all renl "tlaln 1101 bUll repolled allrue mar~el value. Olldaro!lon 01 pr.parer olhor Ihan the penonol rep,.lenlatlve t _ 01. o~~~mal~o w!.1th.P.fI .,are, hal any .nowlollge, iiUiiXiiii o,..'ruoiTin iiiirroll ,muo II~~ AouiBi AlI<;'-- ~ ~ 302 E. ~bl:blc Stl:eet, ~b:hnl1lcsburg, P^ 17055 tlA UII 0' ,ilrAIIUOiiiiiliiAU'.irliiiim.lIV( Al'ii~TB ~ 2 N. ~bin Stxcct, ~lechnnicsburg, l'^ 17055 Chotk hare If you tUO lot1uo.llnd d tofu"d 0' yoUt avottJdylttO"t. ..- (211 (2IA) (2IB) (19) (20) $ 12,GOO.00 o $ 2,003.0G o 2,003.0G $ .. , AclI/48 of 1994 provldo. for tho roductloll of tho lox ra'o, ''''I'olod on tho 1101 voluo of tran.fon to or for Iho u.o of the .pou.e. The raIn. a. pro,c/lbod by tho .talulo will bOI · 3% (,031 will be appllcablo for 01'010. of docodollll dying on or allor 7/1194 and bofore 111196 · 2% (.021 will be applicable for o,'ato. of docodont. dying on or of tor 1/1196 and before 111/97 · 1% (,011 will bo appllcablo for 0"010. of docodonl. dying on or aflor 111/97 and before 111/98 · Spou.al transfors occurrIng on or allor 1/1/98 will bo oxo"'pl from Inhorltanco tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (v) IN THE APPROPRIATE BLOCKS. J, Old docedont make a transfer and: o. rota In tho use or Income of the property transferred, ....,.......,.......................................... b. retain the right 10 designate who Ihal/ use the properly transferred or Its Income, .............., C, retain a reversIonary Interest; or ...........................,....................................,.................. d. receive .he proml.e for life of either payment., benefits or co rei .........................,..,.......... 2, If deolh occurred on or before December 12, 1982, did do cedent within two years preceding deolh Iransfer properly wllhout receiving adequate conslderalloni If dealh oecurred afler December 12, 1902, did decedenl Ironsfer properly within one year of deolh without receiving adequate consideration' .,..... to. ...... ,....., t........ ,.,.oo,...... ....., t.." to ..... ,.. ,..."..,...".., H. ,....... t.... 3. Old decedenl own an 'In trust for' bonk account at hi. or her dealh'..,................................... .ill. ..llit x x x X X X X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES I YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. * COMMONWEAltH D. .ltUU't'lYAHIA IHHUIIAHCf lAX .(tURN IttSlDtHt DlctDIHt ESTATE OF Uy.1I0J (J,. 14.1&1 SCHEDULE B STOCKS AND BONDS FIlTH MBER 21-94-792 ' OLIVE S. DUHN'rER IAlI pr.porlY ,.tntly..wnod with Right of Sur.I....hlp mull bo dl"t...d .n Schodulo F,l ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. DESCRIPTION SEIUFS E $25.00 oenanination U.S. Savings Donds (see sheets attached for this and each fo11CMing entry) SEIUES E $50.00 SEIUES E $100.00 SERIES E $200.00 SERIES E $500.00 sERIES E $1/000.00 SERIES BE $1/000.00 VALUE AT DATE OF DEATH $ 111. 76 $ 150.54 $15,348.16 $32,303.68 $81/693.00 $75,326.00 $ 4/741.20 tOTAL Aho enter on IIn. 2, Reco ltulol1on (" more spoce I. "..d.d, insert oddilionol .heols of sam. size.' s i ii ,\ q 11 ES'l'/I'l'E 01' OLIVE S. I3UIUNEH FIill NUMIlEH 21-94-792 Schedule B. continued ~F.nT"'-C; R SlOO.OO Uf.)(lpm)t-. V111. C 476 079 172E l-Ur. 67 $ 447.04 C 476 600 614E /lpr. 67 $ 447.04 C 477 793 352E l-Uy 67 $ 451. 32 C 477 793 373E JWle 67 $ 456.20 C 477 793 372E JWle 67 $ 456.20 C 480 234 920E July 67 $ 456.24 C 481 771 106E /lug. 67 $ 456.24 C 481 771 107E /lug. 67 $ 456.24 C 482 539 210E Sept. 67 $ 439.76 C 482 539 21lE Sept. 67 $ 439.76 C 482 539 238E O::t. 67 $ 439.76 C 482 539 239E O::t. 67 $ 439.76 C 483 796 736E Nov. 67 $ 444.04 C 483 796 737E Nov. 67 $ 444.04 C 483 796 738E Nov. 67 $ 444.04 C 483 796 837E Dec. 67 $ 449.44 C 483 796 838E Dec. 67 $ 449.44 C 485 839 506E Jan. 68 $ 449.40 C 485 839 505E Jan. 68 $ 449.40 C 490 902 39lE June 68 $ 442.68 C 490 902 390E June 68 $ 442.68 C 494 262 455E l-Ur. 69 $ 420.80 C 494 262 456E Mar. 69 $ 420.80 C 495 286 344E May 69 $ 424.88 C 495 286 346E May 69 $ 424.88 C 495 286 345E May 69 $ 424.88 C 492 579 787E Sept. 69 $ 425.40 C 492 579 788E Sept. 69 $ 425.40 C 506 996 188E Jan. 70 $ 416.04 C 506 996 189E Jan. 70 $ 416.04 C 506 996 190E Jan. 70 $ 416.04 C 522 936 355E July 71 $ 354.36 C 525 674 762E Oct, 71 $ 355.20 C 529 372 910E Nov. 71 $ 342.92 C 531 954 633E Jan. 72 $ 347.12 C 1 021 766 152E Sept. 73 $ 332.52 . \ \ 'l'OrllL $15,348.16 ESTA'l'E OF OLIVE S. nUImlER Schedule n. Continued SEIUES E S200.00, Mar. 67 Feb. 68 Mar. 68 Feb. 69 lIpr. 69 June 69 Aug. 69 O::t:. 69 Nov. 69 Jan. 71 Jan. 71 Feb. 71 Feb. 71 Mar. 71 June 71 June 71 July 71 Oct:. 71 Nov. 71 Dee. 71 Jan. 72 Feb. 72 Feb. 72 Mar. 72 Mar. 72 lIpr. 72 lIpr. 73 May 73 Aug. 73 Oct. 73 Oct. 73 Nov. 73 Nov. 73 Dee. 73 Dee. 73 Mar. 74 Aug. 74 Sepl:. 74 Dec. 74 Dec. 74 July 75. Sept. 75 Oct. 76 Nov. 76 Jan. 77 Mar. 77 'lUl'1\L '_T' "..'.~7'n ~_""'--'-"_"_."_'~'""_~~""__'~"_"'U_.'-<-,_~_"""'-~...,..._~.'___.~"_.. "" .', R 39 602 766E R 39 809 295E R 40 602 90lE R 40 602 910E R 41 506 842E R 41 506 843E R 41 506 844E R 41 506 902E R 41 980 604E R 41 980 78GE R 41 980 785E R 41 980 789E R 41 980 790E R 43 540 682E R 43 540 69lE R 43 540 688E R 43 910 673E R 44 566 546E R 44 566 55lE R 44 566 693E R 44 566 699E R 44 566 70lE R 44 566 702E R 44 566 78lE R 44 566 782E R 44 566 785E R 100 949 038E R 100 949 156E R 100 949 090E R 100 949 095E R 100 949 096E R 100 949 127E R 100 949 128E R 100 949 130E R 100 949 129E R 100 949 144E R 103 266 574E R 103 266 652E R 103 836 858E R 103 836 859E R 104 312 183E R 104 960 328E R 202 139 525E R 200 140 082E R 200 140 088E R 200 140 119E FILE NUMBER 21-94-792 lle<lerrDJI:. Va 1. $ 894.08 $ 898.80 $ 866.32 $ 873.12 $ 841. 60 $ 840.72 $ 850.80 $ 850.80 $ 820.08 $ 728.16 $ 728.16 $ 729.84 $ 729.84 $ 729.84 $ 705.44 $ 705.44 $ 708.72 $ 710.40 $ 685.84 $ 687.60 $ 694.24 $ 695.92 $ 695.92 $ 695.92 $ 695.92 $ 695.92 $ 675.28 $ 655.60 $ 664.96 $ 665.04 $ 665.04 $ 645.68 $ .645.68 $ 646.24 $ 646.24 $ 627.44 $ 634.88 $ 616.40 $ 623.84 $ 623.84 $ 612.88 $ 595.04 $ 574.24 $ 579.84 $ 581.52 $ 564.56 $32,303.68 ES'I'A'l'E Ol' OLIVE: S. UUJrlllEIl l'Iill NUMBlm 21-94-792 Schedule D. Continued SEIUP.s g S500.00 lle<let11)t. Val. D 88 348 976E o 90 371 219E o 90 732 950E o 90 732 956E o 90 732 960E o 90 732 972E o 91 237 502E o 95 033 03lE o 101 221 985E o 101 396 805E o 101 898 875E o 101 898 888E o 101 898 890E o 102 592 762E o 102 592 756E o 103 017 610E o 103 017 643E o 103 137 2<12E o 104 046 98lE o 104 046 985E o 104 053 657E o 104 057 850E o 104 510 02lE o 104 510 028E o 104 510 027E o 104 510 18lE o 104 510 182E o 104 776 54lE o 104 510 190E o 104 776 549E o 104 776 548E o 105 327 44lE o 105 327 442E o 105 327 443E o 200 280 878E 0,200 280 /887E 0.200 280 95lE o 200 280 956E o 201 838 022E o 201 838 027E o 201 838 037E o 201 838 039E o 201 838 065E o 205 123 93lE o 205 123 933E o 205 658 933E o 206 179 817E Mar. 67 I'eb. 68 Mar. 68 1Ipr. 68 May 68 lIug. 68 July 69 Mar. 72 I'eb. 73 IIpr. 73 May 73 lIug. 73 Sept. 73 Jan. 74 Feb. 74 Mar. 74 IIpr. 74 June 74 July 74 lIug. 74 Sept. 74 Nov. 74 Jan. 75 Feb. 75 Feb. 75 Mar. 75 Mar. 75 IIpr. 75 IIpr. 75 May 75 ~lay 75 June 75 June 75 June 75 July 75 lIug. 75 Sept. 75 Oct. 75 Sept. 76 Oct. 76 Dec. 76 Jan. 77 IIpr. 77 July 77 lIug . 77 Sept. 77 Oct. 77 $ 2,235.20 $ 2,247.00 $ 2/165.80 $ 2,165.80 $ 2/187.40 $ 2/213.20 $ 2,122.20 $ 1,739.80 $ 1/688.20 $ 1/688.20 $ 1,639.00 $ 1,662.40 $ 1/662.60 $ 1/615.60 $ 1,615.60 $ 1/568.60 $ 1,568.60 $ 1/58<1.40 $ 1,587.20 $ 1,587.20 $ 1/541.00 $ 1/555.80 $ 1,559.40 $ 1/559.40 $ 1,559.40 $ 1,514.00 $ 1,514.00 $ 1,514.00 $ 1,514.00 $ 1,528.60 $ 1/528.60 $ 1,532.20 $ 1,532.20 $ 1,532.20 $ 1/532.20 $ 1/532.20 $ 1,487.60 $ 1,487.60 $ 1,435.60 $ 1,435.60 $ 1,453.80 $ 1,453.80 $ 1,411. 40 $ 1,428.00 $ 1,428.00 $ 1,386.40 $ 1,386.40 cont'd. ESTA'l'E OF OLIVE S. DUln'NER FILE: NUMDER 21-94-792 Schedule D. Continued SF:RTR<; F. SJ.ooo.oo lledenlJt:. Val. M 101 857 044E July 1973 $ 3/317.60 ~I 102 974 254E May 1974 $ 3/167.20 M 200 280 762E Nov. 75 $ 3/004.40 M 200 280 765E Dec. 75 $ 3,010.80 M 200 280,767E Jan. 76 $ 3/011.20 M 200 280 693E Feb. 76 $ 3,011.20 M 200 280 711E Mo,r. 76 $ 2,923.60 M 201 882 013E /\pr. 76 $ 2,923.60 M 201 882 016E May 76 $ 2,951.20 M 201 882 046E Nov. 76 $ 2/899.20 M 201 882 085E Feb. 77 $ 2/907.60 M 201 882 089E Mar. 77 $ 2,822.80 M 201 882 092E May 77 $ 2/850.80 M 206 384 147E Nov. 77 $ 2,542.80 M 206 723 583E Jan. 78 $ 2,550.00 M 206 519 915E June 78 $ 2/457.20 M 206 519 922E July 78 $ 2/457.60 M 206 519 9.46E Aug. 78 $ 2,457.60 M 206 519 952E Sept:. 78 $ 2,409.20 M 206 519 980E Dec. 78 $ 2,438.80 M 206 519 984E Jan. 79 $ 2,439.20 M 206 519 989E Feb. 79 $ 2,439.20 M 206 519 990E Mar. 79 $ 2,391.20 M 208 081 566E May 79 $ 2/414.40 M 208 081 573E June 79 $ 2/420.00 M 208 081 589E Aug. 79 $ 2,420.00 M 208 081 591E Sept:. 79 $ 2,332.80 M 208 081 593E Dec. 79 $ 2,354.80 'lUl'J\L $75/326.00 " \ \ , ESTATE OF OLIVE S. DtJR'lNER FILE NO. 21-94-792 Schedule B. Continued f;F.IlTRC: ~ $lrnnn.nn ".>rlt>"V". V.,l. M 434 428 EE M 434 427 EE M 434 426 EE Feb. 80 Feb. 80 Feb. 80 $1,580.40 $1)580.40 $1/580.40 'lUI'1\L $4 I 741. 20 UVU(I,Utl2111 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY <;I"J~'~. ~ COMMONWEAlTH 0' PENNSYtvANIA INHUIJANel lAX IIWIN InlDINI DICIDINI ESTATE OF Ploa.o Prlnl ar l 0 FILE NUMBER OLIVE S. DUR'll'lEIl (All p,ap..'Y lalnlly-awned wllh th. Righi af Su,vlvanhlp mu.1 b. dl.cla..d an Schedule FI ITEM NUMBER DESCRIPTION 1. Reimburserrent - I'lT lIartford, Supp1em. Medical Insurance 2. Checking l\ccount No. 5140008664 pNC Dank 3. l\ccr. Int. to d.o.d. on #2 4. Savings l\ccount No. 5130174538 PNC Dank 5. l\ccr. Int. to d.o.d. on #4 6. C. D. No. 0413160177753 PNC Dank 7. l\ccr. Int. to d.o.d. on #6 8. C. D. No. 0413200177754 PNC Bank 9. l\ccr. Int. to d.o.d. on #8 10. united Methodist Hares for Aging 11. Refund re: Medical Insurance TROA Medi-p1us 12. Refund re: Medical Insurance TROA Medi-p1us 13. Refund: Medical Insurance TROA Medi-p1us 14. Old chair of no tangible value which was given to the united Methodist lIares for the Aging* *Decedent died in nursing hotre without any other tangible personal property. 15. Refund from IRS on personal incorre tax (estim.) 21-94-792 VALUE AT DATE OF DEATH $ 7.94 $ 2,836.19 $ 5.21 $15/522.29 $ 29.34 $20/000.00 $ 30.82 $25,000.00 $ 44.18 $ 657.10 $ 14.67 $ 55.33 $ 25.37 $ -0- $ 124.00 (Allach additional aYJH )( l1H ,h..III' mOrl .pace II needed.) TOTAL AI.a onlor an IIno 5. Roea Itulatlan 564 228.44 ~~' y~ ,~ h;,\ l J ~i ~ ~,~ ~.~ ) ~ ~~" ~~~1..,'~ , ~ F' "j \l ~ '1 ~ '1 if~ d~,.:J ~ ~ ~ t rr~1~ i ~-i . ~ cr~a i ~ .. I I I 11'1 IS II lit 1'111 ESTATE OF ITEM NUMBER A, 1. 2. . L SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMOuwrAttll or rrNN$YlVAUIA ItUlrllllAUCr fA. '(lU'U RUIUfNI u((rouu Ploa.o P/lnt 0' TVPo 'RUMliER OLIVER S. BUR'lNER DESCRIPTION Funo/al Exponll" Myers Funeral lIare, Inc., of Mechanicsburg Rolling Green Celmtery - work on scroll on I1\1rker B, Admlnl.t,atlvo Ca.'" 2. 3. 4. C, 1. 2. 3. 4. 5, 6. 7. 8. 1. 5% Personal Rep,..entallve Com million. U:luise Brown 069 5aclal Seeu,lly Number of Personal Rop,olenlallvo: Yea, Cammllllan. paid 20 _ 1251 Alla'ney fee. d1ar1es E. Shields, III 5%, 4%, 3% family Exompllan Clalmanl None Relallan.hlp Add,e.. 01 Claimant al doeodont'. doath 5t,ee' Addre.. Clly 51ale Zip Code Probate feo. and short certificates MI.cellanoau. Expen.e" lIdditional Death Certificates lIdvertising in ClDlIoorlancl Law Journal lIdvertising in Patriot Metro-West lIdditional Probate Fee Filing account (est:lm.) Photocopies and certified l1\1iling of accountings (estim.) II & R Block - for preparation of close-out 1040 and fiduc. return (est:lm.) ($95.00 + $130.00) Filing Irlhetitahce Tax 'Il6!tlirn' . TOTAL (Alia onlor on lino 9, Reeapllulatlon) (II mo,o >paee I. needed, In.." additional .heel. 01 .ame 01.0.) 21-94-792 AMOUNT $ 4/271.00 $ 195.00 $13,500.00 $11,000.00 None $ 258.00 $ 15.00 $ 40.00 $ 48.95 $ 35.00 $ 105.00 $ 25.00 $ 225.00 $ 15.00 $29,732.95 lIV.lSIUhl"ll . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS PI. D" Print or Typ. FILE NUMBER .' COMMOUWIAIlH 01 PlN"'Yl'~ANIA IHHUI'AUU'AlltlUIH IUIOUH OICHHfH ESTATE OF OLIVE S. BURWER 21-94-792 ITEM NUMBER DESCRIPTION AMOUNT $ 674.00 $ 48.97 $ 7.62 $ 32.00 $ 7.62 $ 3.46 $ 11. 75 t. Return of Social Security Jldministratlon overpayrrent 2. l\1ert Pharmacy at Bethany Village 3. 0lW1ey l-Edica1 1\Ssociates 4. Sue Carr's Beauty Shop 5. 0lW1ey l1:ldica1 1\ssociates 6. l\1ert Pharmacy at Bethany Village 7. Brennen-Weaver D.P.M. TOTAL (Aho enlor on line lOt Rocapllulallon) 'If more 'poco i, nftffdod, Inser' ocldilianol slleels 01 some size.) $ 785.42 n~ 111111. 1I'1J ~"~.~ ....~ CO....MOUWI'I1H Of ,IHNUl...'"" INHUIlANCI IA. ..IUIN IIIIOINI PIClOINI SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER OLIVE S. BUInNER 21-94-792 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxabl. Hoqu..'" 1. See Schedule and Diagram Attached ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charllabl. ond Governmental Bequelhl 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.. onlor an lino 13, Rocapltulatlan) 5 (If more .pan I. n..dld, In.." addlllonal .h.... of 10m. IIz.) , .-.-. . ~. . ,., . ~llJ '" .... " ~ 6i ~~ ~~ ~~ ~:t- 'i;1I) - l::) ... I' .' ~ ~ I~ " , t' >'t~~ .. ~'j ~ '. s'li ., S h at. "!n~ .. '(!~ rl . ~ " ~ ~~ ij Ii I. ~ ~ ~ Io\!! :>"~ S: '" ~ ... J ~'" l:I ~ ) 3 o }l ;;R b .'1 ~ ~ ~ ~ 'i -5 .~ ~ c! .i! .Jl. \, \ 4 { cd cd \J \.i -.. . ." i .. .., -" ~ ~ II> ... >::: 1- >::: :t:! ~ .'" .E :v. .'1 ~ :;1., ~~ ::t '<: . \i ~ .{ j ~ ~ It . ." VI ~ .;J .' lIame Louise B. Brown Genevieve Held Robert E. Burtnar Doris Wojcik (Decelled April 17, 1993) Children (3) Stephen F. Wojoik Randolph F. Wojcik .: ~. .'. ClIlLDREII OF f!:.!.Y!i I1JRIIIEn tddress 3U2 East Marble Street Mechanicsburg, PA l7U~5 13303 Marceline Drive San Antonio, IX 78232 36 Sapling Drive Kennett Squire, PA 19348 1576 Virginia Melbournl, FL 32935 317 Bllcksmith Arah Yorktown, VA 23693 Linde Ann Bilhe1mer 2131 Masters Missouri City, TX 77459 Calvin R. Burtner, Jr. (Dlcelled Augult 12, 1992) Children (4) Sandra L. Ellil Dennia J. ~rtner Raymond C. ~rtner Robert C. Burtner . <<11 Downes Drive Indianapolis, 111 ~6236 P.O. Box 18657 lndianapolil, 111 46218 1999 Arrow limi th Manteaa, CA 95336 53 Will ace 5treet 5tei11coom, WA 98388 I a'f 0~~.. tl!~~ .!Z..I ~. ~ 069-20-1251 ~~ 211-22-7168 Ys: 309-36-2435 y!: 263-84-U047 y,~ 263-84-0048 y,~ 263-84-0049 ~I~ 309-70-6786 1/'UJ 3U9-70-73-49 Yw 3U4-56-2325 '/ze 3u8-52-47U4 Y-:l-D I h1'II I 111'1 rl,y "1'1'"t III II')' I"llll'.ht "'. IJIllI ~m Illul\Ill III 101 l:nlll 1I"lhl,' IHlr..l, 'tt'chn"ll...hutn, ""llIu'ylvnllln, nn Nlt'cultlx In hili "Irn,l, lfl flt!tvr \JllIUlIII hnllll fll r.lIU'l y nlll) vllhulIl Illlpr- "f'IlI'ml nnd wllh lilt" 1'11\0"'1" 1111I1 nlllll'HII)' III thr. ,lll'mln""1 1, I dlll'cl thllt "'y )1I"t .It'ht... 1IIlfllulIPIIII rXIIPllnpn 1m Ilnl.t 1111 ,Hlnll nrtf''' lilY .h'l...nRf' nil ,ully I..:, 'I.nl'l Il'nhll', 'I. I I1l'lrh)' "lvI', .1t,...I"" nlld b"'lurnlh nil m)' r"lnlO nllll Il,O,lrllYl I Ill' I UlII 111\ nil 1""I'f'lI)' nr whlr'h , flllnll lilt:' nr.lrl'd nlltl II o"nt:.'IUU'lt nud nil plul'rll)' III '"!llch I (lhnll hI! nlllt:.'IWlftc "lIlllll'd ftt Ihe 1I111" (II "'y ,1t'f"'lIn". fir ",IIlIt..v". ~llId fll nnlulr nllll "1I1'1""v,,r _l1ullled, Ita It If.nl, ,w.ftllllnl flt ITIlx(',I. l'lnfl'''"r wllh nil)' IAllllrd 11'8"1')' fir drvl"" nlld nil Illflllrll)' uvrt IoIlllch I nhnll hnve I'nl.t(lr vI dl"llIIntlloll nr "!'I'ltlnhurlll., In ITI)' ,,"IIIYI'" h"Ahnml, (:AI.YltI n. nURUII!R, 111)\1 r",.'d'll" In 1lf'1.t CllIuhr.rltUul, 1'(>lllln)'lvnnln, nn hi" anl~ nl,,1 nhnnllllr 1111I11I'11y, I' I". nhllll 11llJvlvr. tnf!, hrlnn ftllly con(It!l'ul Ihnt hr will Rullnhly "Juvlde rnr nllY chllduHllI[ mlrn thnt ehnll flurvlvl! lilt', hut lIul ""I'onlltfl linT Inlendln" In InlllOBO fill)' (('nnl IIr l"lultnlJle uhllnntlulI un him 1m In dUI S. In the l'vl'nl my ""Ill Imallnnd nhnll lluL fllJrvlvl! me, 1 give, dcvl"1! nntl hrfluf!nlh nil nl)' IInld enlntr. nnd rruI1t'Tl)', nlJBulutely And [orevrr, IIlhnre find Ahnrl! nllltr., to nur chlldff:'n, tins. LoIJHiE nnOWlI, IIns. lJURlS WUJCIK, IIRS. (iEIIEVIF.VE IIIU.IJ, cALVIU n. lIunUIEn, JR., and nanERT E. nUnUll:It, ur In nllcll or thrill ntl IIhnl1 Aurvlvc nll!1 If (hgc 2 uf J 1'"Rrs) /bJl.~ R ~ ijL1ViiiUR~~ ~- "file. l1!1UJ /11/) :' " ~ ~, -.-----......- ~ . .... ..~, -".- --.- -- -... . .--- - - -..-___.__ . ..'.. .. ______u.,._ ..~_ ___ ;'i.h nil)' ur nut e"IIII'I'1I fill,. I I Hltt nUlvlvl'I"I', tlll'l\ In ,lip dl'Acrn.ll1l1t" 111 filii'll dll III h. ,'hi III, I'll pl.t fit Ill"'" "1111 11111 I"'t ,'nllll"1 f,. Whr'I'''.lrVI'1 III thin 11I1 \.1111 II III 1",lvlllr.1 Ihnl nil)' 11I'tf"'" IIh"'1 hrlll'III hrll'1I11.II'1 Ir flllell I"','mlt IIhnll nlltvlvn mu, rnl" thl! 1"111""1'" III Ihl1l1l111 nlll'll 1'1"""11 11111111 III' d,.,.fU"" lIut In hnYl' 'ltltYly".lll1l' I( \Il" nl11lllllltJ nl tllfl nflllll! llhll.' lIr 1111 UI' IIlll' flhnll IIu,vlvl' h'I' hut ,II" within thllly (111) Ilny" In..wlllnl,'ly rnllll"''' I un my dccrn,,,,. W WIIIIES!l IWlmF.Ur, I hnyl' nt tn,ll"h' I1'Htl1clol. rrllnllylvnnln, 1I1"'.L~rJny ur II'Jven,hrt, PHI], nrt '"y hnwl nntl flcnl In lhlll my l.Asr WlI.L Nit) 1t~SINmtlr cnllnllllllllt or Ihtrp. (1) l)'Jlcwtlltrll Ilnn"". lhln I lie I Utll"tl , tltr 11trerlllnr. fln,:rn hrll'llr 11I'nr11lr. hI)' nlnunlurc. ~ A.. ,"1-:-:- --' :mJv~~ (SF.AI.) SII~Il...I, nrn I "II, "111011 nIli'd 111111 IT"I.'I n r ".1 1.'1 I Itr. nl,nvr.-Ilmurd 1""lnlrIK, 0I.1Vr. IlIlRII1F.R, nn h!:'t I.ASI" \.111.1. Aim 'IF.S1NUmr, In tho Iltrflrllen ur nil IIr "'. nl 'll1e llllll', nllll nt Ihl! Rllmc lime W", nt . her rC"lul'nt ntlll III hrr I'rrnrnce nml III tile I1tl'nencu uC cnch ulllCr hny" hrtrtllltu nuhRcrl!ortl IIl1t IIftlllCft nn 'I111ll'nnl.'n, nnd WQ du hetehy nttenl to tho ..nulul nllll dlflJIII"IIlr, nlllllJ "llil n't'mutYllr "nld TClltntrlK III tltt' dnll! h,'tt'u(, nlld In lhl! JlrlCnthlnllce or thro 1l(lltC.. Bnld net.. or (!xC'cutlnn III Cnrllnll! IInnncllli. 1'(,llllnylynnln, thin /t/~ dny IIr lIuYt'01hrr, l'Jr,) , IIl11lnSSF.S. ~L..dAJ.Cl,,,tJtuL .v (l hl. ' <:;b..t...: r:. ~.. ,.. (/"..W n'.I'/Ntfpv I' (lInn" ) u( J 11~I\('n) ^lJllllltSmm I tdrJ }VA..?"".. Jltn-l;(j .1,"4.4. ,;':D.tfi.I, ~~. (;...~ ,l.J.J"JJ- tv.~~v.....(! .?H " /.<A"44: ~ , ~ . i' \ -... - -..~ "".- . . l_.____ _ M______ __.__._._ , , -..- - - - .---:..- "'--'''-.' - -.0----,-.....- _.. __ ___ _ _ _ _ ___ ___ __.__ "W~.AA ~047743 COMMONWEALTH OF PENNSYLVANIA . UNO.. DEPARTMENT OF REVENUE OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX '1~Il'Jfll""41 .~.H~~ ~~ RECEIVED fROM: fJ ACN ASSESSMENT P:'I CONTROL ~ NUMBER AMOUNT SHIELDS CHARLES E III e W MAIN GTREET lul .c:,VU.:I.Ub MECHANICSBURI3 PA 17055 ESTATE INFORMATION, fJ FILE NUMBER el-1994-0792 E'I NAME OF DECEOENT (LASTI ~ BURTNER OLIVE S II DATE OF PAYMENT m POSTMARK DATE COUNTY SSN 315-34-8ge9 (FIRST' (MI) CUMBERLAND OATE OF DEATH S/iiU.J REMARKS LOUISE llROWN m TOTAL AMOUNT PAID SEAL CHECK" 13 RECEIVED BY 9Jii<: i .. " -" $e,003.0/' PB M 047743 is replecing M 047741 REGISTER OF WIllS /. ." v,::....\ SION4JUR'i. '.' ;/d'~.j ~':/ " -'." / ;.. J ,r;_,.. /.:>'J~'I.i I ., / : ~---------_._-~----------------------------------~- , I MARY C. LEWIS REGISTER OF WILLS .---- . -...._-.----:.-...--...._.~ 41- .', , -,....... \ , 4 -. ,,- ........ .~. ._ . .. --- -...- - .----.---- ..~~-. ._._-_._~----_._- --_.~- - -,...- --- -- --.------ - ----_._~ .I -F~.AA 0477 41 COMMOND~:~~~T ~~ R~~~~:YLVANIA OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX lfY-lI61fllU'1 ~.. i ,.,.' RECEIVED FROM, i ACN ASSESSMENT I!'I CONTROL ~ NUMBER AMOUNT I I 1- 'O'O.II! SHIELDS CHARLES E III P. W MAIN STREET 101 .i:' ,ov.~ .Vb MECHANICSBURG PA I70:'i:5 OATE OF OEATH \. \^t= B9E!9 , (Mil ,)..1 U . ',!\ \ Ji ,\\ , '\ ~/ . ) \ ) ESTATE INFORMATION, ~ FilE NUMBER g 21-1994-0792 ~ NAME OF OECEOENT Ij;,I RT II OATE OF PAYMENT EI POSTMARK E COUNTY 31:'i-3 ~) REMARKS LOUISE BROWN m TOTAL AMOUNT PAID 52.003.06 PB SEAL CHECK.. 13 RECEIVED BY 510NA1URE REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS 'V~-----------_._-~.~~~-:--'----------________T_~_~_______ I .. I . " .-'t,' " .~ I : \ , ',' .... _._".~ -.....- :-. .---- -:.'~""""""'_"'~_ M-'-T.,r-......-.~ . .. TOTAL DISBURSEMENT OF PRINCIPAL RECEIPTSOFINCOME (esllm,) DISBURSEMENTS OF INCOME INCOME BAlANCE ON HAND RECAPITULATION: TOTAL PRINCIPAL RECEIPTS TOTAL PRINCIPAL DISBURSEMENTS TOTAL PRINCIPAL BAlANCE ON HAND TOTAL INCOME RECEIPTS TOTAL INCOME DISBURSEMENTS BAlANCE ON HAND FOR DISTRIBUTION ADVANCED DISTRIBUTION: Louise B, Brown Genevieve Held Robert E. Burtner Stephen F, Wojcik Randolph F, Wojcik Linda Ann BI/helmer Sandra L. Ellis Dennis J, Burtner Raymond C. Burtner Robert C. Burtner ' PROPOSED DISTRIBUTION OF PRINCIPAL: As per paragraph 5 of Last Will and Testament LouIse B. Brown 1/5 Genevieve Held 1/5 Robert E. Burtner 1/5 3 $274,026.78 $ 44,491,43 $229,535.35 $ 8,965,68 S 0 $238,501,03 $28,000,00 $28,000,00 $28,000.00 $10,000,00 $10,000,00 $10,000.00 $ 8,000,00 $ 8,000,00 $ 8,000.00 $ 8,000.00 $19,700,20 $19,700,20 $19,700,20 , . $ 44,491,43 $ 8,965,68 $ NONE $ 8,965,68 r:, ~ I . ii . . - .. " As per paragraph 6 of Lasl Will and Teslamenr Slephen F. Wojcik Randolph F. Wojcik Linda Ann BI/he/mer Sandra L, Ems Dennis J, Burrner Raymond C. Burrner Roben C. Burrner 1/15 1/15 1/15 1/20 1/20 1/20 1/20 $ 5,900,06 $ 5,900,06 $ 5,900.07 $ 3,925,06 $ 3,925.06 $ 3,925,06 $ 3,925,06 \ I I i i I r r 4 t .' , ...-- " .' Interest Entries: 9-26-94 Estsle account $ 6.09 10-12-94 C.O, $ 61.64 10-12-94 C.O. $ 88,36 10-25,94 Estste sccounl $ 22.83 11-14-94 C.O. $ 63.70 11.14.94 C.O, $ 91,30 11-23-94 Estste account $ 21.09 12-12-94 C.O, $ 77.26 12-12-94 C,O. $ 88.95 12-23-94 Ests(e accounl $ 5,52 1-12-95 C,O, $ 79.84 1-12-95 C.O, $ 91.31 1-25-95 Eslate account $ 6.42 2-13-95 C.O, $ 79,83 2-13-95 C,O. $ 91,30 2-22-95 Estsle account $ 5,72 3-13-95 C.O. $ 72,11 3-13-95 C,O. $ 82,46 3-24-95 Ests(e account $ 8.43 $1,042,16 Esllm, addlt, Interest on U. S. Bonds since d,o,d, a $7,923,52 ($217,597.86 . $209,674,34 a $7,923,52) TOTAL ESTIMATED INCOME RECEIPTS $8,965,68 5 /' .. .. ,~il;:::.' ~i. '.! " '1:-1' 'Ii !;': . \.\, ,Ii: '~'.'!'... ., u.: LOUISE B, BROWN, Execulrlx of the Estate or Olive S, Burtner, deceased, hereby declares under oath that she has fully and faithfully discharged lhe dulles of her olllce, that foregoing First and Final Account Is true and correcl and fully discloses all the significant transactions occurring during the accounllng period: that all claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid, ~~~~--- LOUISE B, BROWN Sworn and subscribed to before me this 1.!d:L day of ~ A,O, 1995, --~-g~ /J Notary Public Nolmiill SoaI ChaJ10s E. ShookJs III. NoIaIy NJIIo MllCharOcsburn Boro. CurriloMnd County My Commisslon EJqJres Juno 20, 19!11l I erY'lS)fYBIlIa" tIono 5 l' "..'. '-^!ll UII.t. ^1I1J II;SINII;1I1 ~IIUlf ^I,l. 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'i'-';';:" '~', ' ~ , '-',".J i c_'_': o<'.l;",~; ,::":',' -,:, "-{'.;'\.'", '-", " ",,:.y\-, '",- "'.,; ,'. ~, '; . .! ,';;',. .i~i'" ~ '.~~.~,~/>,': ~ ,,' ':.~ ',:' ~ i',' (// REV-1547 EX AFP (12-94* COHHOHWEAlTH OF PENNSYLVANIA DEPAR1HENT or REy(NU( BUREAU OF INDIVIDUAL TAXES DEPr. 280601 IIARRISlURO, Pi l1ua'0601 /1/ .J 3~-.:S e" ACN 101 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF OEOUCTIONS AND ASSESSHENT OF TAX DATE 08-21-95 STATE OF FILE NO. DATE OF DEATH 08-26-94 COUNTY CUM8ERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAVMENT TO: CHARLES E SHIELDS III 2 W MAIN ST MECHANICS8URG PA 17055 REGISTER OF WILLS CUM8ERLAND CD COURT HOUSE CARLISLE, PA 17013 Anount R..Hted CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiE'v:isW-Ex-Aj:p'-(i'2'=94i-Noi"IcE--oi1-YNHEiili'ANcE-;:AX-iipiiiiiiISEH€N'T-,--Ai.'LoiiANcE-ijli----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF 8URTNER OLIVE S FILE NO. 21 94-0792 ACN 101 DATE 08-21-95 TAX RETURN WAS. (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I E.t.t. (Schedule AJ (1) 2. stock. and Bond. (Schedule OJ (2) 5. Clo..ly Hald Stock/P.~tn.r.hlp Int.r..t (Schedule C) (3) 4. Hortg.gal/Not.. Receivable (Sch.dule OJ (4) 5. C..h/Bank Deposlta/Hi,c. Parson. I Property (Schedule E) IS) 6. Jointly Owned Property (Schedule F) (6) 7. Tran,fara (Schedule GJ (7) 8. Tot.l A...t. I CHANGED .00 209,674.34 .00 ,00 64,228.44 .00 .00 Ie) 273,902.78 APPROVED DEDUCTIONS AND EXEMPTIONS: 29,732.95 9. Funaral Expan.../Ade. Cost./Hisc. Exp.n... ISch.dul. H) (9) 10. D.bt./Hartg.g. Li.blliti.s/Li.n. (Sch.dul. I) (10) 785.42 11. Tot.l D.duction. 111) 12. H.t V.lu. of T.M R.turn 112) 13. Ch.rU.bl./Gov.rn".nt.1 a.qu..t. ISch.dul. J) 113) 14. H.t V.lue of Estat. Subjact to Tax (14) NOTE: If an assessment wes issued previOUSlY, lines 14, 15 end/or 16, 17 and 18 will reflect figures that include the total of 8hh returns essessed tD date. ASSESSMENT OF TAX: IS, AMount of Lin. 14 at Spou.al 16. Amount of Lin. 14 taxabl. at 17. AMount of Lin. 14 tax.bl. .t 18. Princip.l T.x Due 3n.~IR 37 243,384.41 .00 243.384.41 r.t. Line.I/CI... A r.t. Coll.t.r.I/CI... a r.t. (15) (16) 111l .00 243.384.41 .00 X .03. X .06. K .15= ,00 14.603.06 .00 14,603.06 1181 TAX CREDITS: PAYHENT DATE 11-18-94 05-10-95 DISCDUNT 1+1 INTEREST (-J 630,00 .00 RECEIPT NUHBER MM913204 AA047743 AHDUNT PAID 11,970.00 2,003.06 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 14,603.06 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TDTAL DUE IS LESS THAN .1, ND PAYHENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YDU HAY BE DUE A REFUNO. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I nn 5 ;:' td _., :0 .' t" .., ,;/ ro,J l.J .' .:>. RtUMV'UOHI [UI'" of dle.den" drlnll on or b.fo,.e D.c....,. 12, l'IZ .- If any lutur. Int.r..t In the ..tat. h transferred In po.....lon or anJov..nt to el... a (coUat.r.n batMlf!cl.,.I.. 0' tha dUldant afta,. thl IxplntJon 0' any ..tat. for II'. or for V.."" thl CD..~..lth herlbv ..pra..lv ,....rv.. thl right to .pp,..I.. and ...... trenl'." Inheritance ,.... at thl l~'ul etl.1 a (coll.t.,..l' t.t. on any such future Int.r..t. PURPOsr Of' NOJlCE, To fulfill thl nqulr...".. of bcUon Zl4iD 0' the Inh.,.1tencI and Eat_t. lex Act, Act 22 of 1991. 72 P.S. "ctlon U4D. PAYHENf, Detach ,t. top portion 0' thh Hotlc. and lub.it with your pIV.."t to thl RIghter of WUla prJnbd on tM revers. lid.. ~.".h cMok or lonlV' ord.,. pavabla tal REGISTER OF HILLS, AGENT All pay..,." r.calved shall 'Ir.t ba applied to any lnt.n.t which Bay IMi due with ....y r..alnder applled to the hlC. A(fUND CCA)I A refund 0' . t.1C credit, which w.. not reque.ted on tha hlC R.turn, ..y b. r.qu..t.d by co~l.tlng .... "Appllc.tlon far Aafund 0' P.nn.ylvanla Inharltanc. and E.tate TalC" (REVaI31!). Application. ar. av.llabl. at tha Offlca 0' tM A.aht.r 0' WUh, any of the Z3 R.venue Dhtrlct Offlc.., or by call1na the .p.ctal Z4-hour ."....rlna ..rvlce nuaber. 'or 'or.. ord.rlnDI In Penn.ylvanl. 1-800-36Z-2050, out.lde P.nn.ylvanla and within locel H."hburg .n. (717) 787-8094, TOO' (717] n2-2252 (II....lng IIIp.lred Only). O'ACTlONS, Any p.rty In Int.r..t not ..thfled with the app..al..nnt, aUowDnce or dlsaUowllnC. of deduction., or .......ent 0' ta. (Including discount or Int.r..t) a. .hown on thl. Hotlc. au.t obj.ct within .l~ty (60) d.y. of r.calpt of this Hotlc. bYI ADttIN ISlAATtY[ CORRECTIONS a .-wrlttan prot..t to the PA aap.rta.nt af R.v.nue, Board of Appaals, D.pt. 281021, Har..hburg, PA 17128-1021, OR --.lactlon to ha.... the ..tt.r datar.lnad .t audit of tha .ccount of the p.rson.l repr..antatlv., DR --appeal to tha Orph..,." Court. INTEREST I factual ...ror. dl.covar.d on thl. ........nt .hould be addr...ed In ....Itlng tOI PA Dapa..t..nt of Aavanu., lur..u 0' Indlvldull Tan., ATTH. Po.t A..........t R.vl... Unit, O.pt. 280601, Ullrrhburg, PA 17128-0601 Phon. (717) 787-6505. S.. pag. 5 of tha bookl.t "In.tructlon. for Inharltanc. TalC Raturn 'or a R..ld.nt O.c.dant" (REV-IS01) for an ..planatlon of adalnl.tratlvely corr.ctabl. .r..or.. ., any tn due II paid within thr.. C!) calenda.. IIOnth. a'hr the d.cad.nt'. d..th, . flv. p.rc.nt (5:0 discount 0' the h. paid h allow.d. Int.....t I. charg.d bealnnlng with 'Ir.t day of dall~lCY, or nln. (,) .onth. and ana (I) day 'roe the d.t. ~f d..th, to the data of paya.nt. 'alC.. whIch bee... delinquent b.'or. January 1, l,a2 b..r Int.r..t at tha rat. of .Ile (6):) p.rcent p.r annuli calculat.d at . dally rah of .000164. All talC.' Which baea.. d.llnquant on and .ft.r January I, 1'82 will baar Int.r..t at a rata Which will vary fro. cal.ndar y.ar to cal_nda.. y..r with that ..at. announc.d by tha PA Dapart.ant of A.venue. Th_ appllcabl. Int.r..t ..at.. for 1'82 through 1995 ar.. OISCOUN'1 ~ Int.ra.t Rate Dally Int.r..t Factor !!!r Int.r..t Rata Dally Int.....t Factor naz 'O~ .000548 1987 .~ .000247 198] 16~ .ooooa 19n-I991 1I~ .000501 1'84 11:<: .000301 ..., .. .000247 1'85 15:( .000556 1995-1994 7~ .000192 1986 10:<: .000274 1995 .~ .000247 --Inhra.t h calculat.d a. '0110".1 INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Not Ie. I..u.d aft.r the talC baco... d.llnquent ~lll r.flact an Int.r..t c.lculatlon to flftaen (IS) day. bayond the data of the 1II......nt. If p.y.ant Is Nd. aft.r the Int.r..t co.putatlon data shown on tho Not Ie., additional Int.r..t au.t b. calculat.d. \>'-"',,-'''1.'':''.'+', c ESTATE OF OLIVE S. BURTNER I I I I I I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-94-792 ORDER OF COURT AND NOW, October. 12/1995, the withJ.n account J.s confir.med and dJ.str.J.but1on dJr.ected l.n accor.dance with the schedule.. 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