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Home My WebLink About95-00458 .~',.;..'..~~J.~i,~,~",<';':~"';'_"....~~;'L~L",:~:;;..:-~;<.;,........,............i~N....~~""",~=,,;...........,.,....~~~~.:..;""..:;~~.w.-. 21 - 95 - 458 ~, .- ;,. ... ~ ~ '. , 1'.; / .~, ,. ~, - ':': - tn. ~r) ~;; - o (..) _~.l . '0? .-;; .,.'-' "6 ~8 ~,. 0 .eo. N !B c;: . ,. ~ ! l,.' ,;. 1.:) i_-'~ <<5 'I.;;~ ('l ,I' (uo.: a: ~ ., Oath of Personal Representative Commonweallh 01 Pennsylvania Counly 01 CUMBERLAND The Petltloner(s) above.named twear(s) or affirm(s) thallhe slalemenls In Ihe foregoing PettUon are lrue and correct 10 the best oltt.e knowledge end be~el 01 PeUlioner(s) and thaI. as personal representallve(s) of the Decedent, Petitioner(s) WIll ,",ell and I~:er Ihe eslale according 10 law, Swom 10 or affirmed and subscrit>cd b "711 t!c;i!Md before me this 28TH day 01 SEPTEMBER 1;_ 95 No, 21 - 95 - 458 Es1ale 01 RA Y S. BERRY Deceased Sodal Security No: 1 74-05-004 B Cele 01 Dealh: June 13. 199, AND NOW. SEPTEMBER 8, , 19 95 . In consideration 01 the Petition on the reverse side hereon. satislactory prool havlnQ been presented before me, lT IS DECREED that Leners (8) Testamentery 0 Of Admlnlslration ~;~ IIoI.CWlI.,tM ~d.."""""" are hereby granted 10 Ga i 1 McCord In the above estale and Ihalthe Inslrumenl(s) dale-d February 22. 1974 described In the Petillon be admlt1ed 10 probate end filed of record as the lasI Will 01 Decedent. FEES Leners ..................... S 60.00 Short Certlficale(s) .... S 12.00 Renunciation ............ S Allidavits ( ) ......--... S Extra Pages ( )......... S Codicll ...................... s JCP Fee ................... s 5.00 Inventory .................. S Other ....................... S TOTAL ._.......... S 77.00 7l1a?t(! ~l~pA-fJm(~ ~ . 1.tDfotW.u. MARY C. LEWIS Anernoy: Linda A. Clotfelter 72963 3464 Trindle R~ lD.Nc: Add....: ";J Camp Hill. PA 17011 (17,17:) 7;6,8.7613.:. Tolophcno: , , .:"U Fom lAW., Pooo 2 .. 2 Pftpl/edbJhPeftUytv...... e.. AJ,aao_ZD\ ISllO' Mailed letters and order to attorney on 9-11-95. ~ ". LAST WILL AND TESTAMENT I, RAY S. BERRY, of the Borough of Carlisle, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my Last Will and Testament. 1. I give, devise and bequeath all of my estate, both real and personal property, unto my wife, GAIL E. BERRY, absolutely, and I hereby appoint my said wife as Executrix of my estate. 2. In the event my said wife shall predecease or fail to survive me, then I give, devise and bequeath all of my estate, in the following manner: A. I give the sum of One Thousand ($1,000.00) Dollars unto each of my wife's children, GAIL McCORD, ALPHRETTA HIGHLANDS and JOHN STEEL, absolutely. B. All the rest, residue and remainder of my estate, after the payment of my debts, funeral and testamentary expenses and the above legacies, I give to GAIL McCORD, absolutely. 3. I hereby appoint the said GAIL McCORD as Executrix of my estate under the Second Paragraph of my Last Will and Testament. IN WITNESS WHEREOF I have hereunto set: my hand and seal this .t{,::JA,(day of February, 1974. fen" ""E:J . .- - c;/R'ri:(~-: fie~ (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testator, RAY S. BERRY, as and for his Last: Will and Testament. in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of said Testator and of each ot er. , LAW OP'P1CU MAAUON AIID 8NtLDAICtn ;,---..~ -... B8TATB OF RAY 8. BBRRY 88 #174-05-0048 Subscribing Witnesses: 1. John McMillen, Jr. 24 Liberty Court Carlisle, PA 17013 (717) 240-0127 Please contact Mr. McMillen. He will sign the oath of subscribing witness at the courthouse. 2. Mary Lea Shenk 172 Richland Road Carlisle, PA 17013 (717) 258-6575 Please see signed oath of sUbscribing witness attached. ~" 21 - 95 - 458 REGISTER OF WILLS OF Cumberland COUNTY OATH OF SUBSCRIBING WITNESS JOliN W. McMHI,AN, JIl. xodlcll (each) a subscribing wllncss 10 Ihe will presenled herewith, (<IMlI) being duly qualified according 10 law, depose(s) and say(s) Ihal he was presenl and saw nny q, RpT""ry Ihe leslal or ,sign Ihe same and Ihal he signed os 0 wllness allhe requcsl or leslal or In 11 is presence and (In ~he 11 encc or each olher) (In Ihe presence or Ihe Olher subscribing wllness(cs)). '. ) );)/1) AII-' - Y7} 0 Sworn 10 or arnrmed nd subscribed berore . I , tJ. Iff ( II Y I~- me Ihls day or ,j (Name) lu"~ 19 c _:; 24/'Liberty Ct., Carlisle. PA 17013 A(}~ (Addrcss) Register (J . (Name) (Address}." (") c:- -' V"i '.31 -.,?' :. ~~ ,-" REGISTER OF WILLS OF COUNTY -,J OATH OF NON-SUBSCRIBING WITNESS ~t '. I~..J (each) a subscriber hereto, (each) being duly qualified according 10 low, depose(s) and say(s) Ihal ramlliar wllh Ihe signature or codicil leslal or (one or Ihe subscribing witnesses 10) Ihe will PJcsenlctf'herewlth and //-codlell Ihal believes the signature on the will is in the handwriting or ,"" ..-' " 10 Ihe besl or knowledge anabelier. //" Sworn 10 or arrlrmed and sJlbscrlbed before ,/ me Ihls/ day or ... ./ 19_ ...... (Name) , (Address) Register (Name) (Address) REOISTER OF WILLS OATH OF WITNESS TO WILL EXECUTED BY MARK , (each) a subs<:rlblng witness to the e~~il presented herewhh, (each) being duly qualified according to law, deposc(s) and say(s) that: testat was unable to sign h name thereto; testat 's name was subs<:rlbed thereto In testat 's preseace; testat made h mark thereon; testa' and dependenl5(s) was (werc) prcsent whea testa' 's name was subs<:rlbed and when testat made h codicil signed the wlll wlll as wltness(es). Sworn to or arrlrmed and subscribcd mark; and testal was prcsent when the undersigned tH_'1 before me this day of I~NI 19 "-I -... For the Register , r < , h.j'l- /0 .I , REV-1547 EX AFP 112-95)* COHHONVEAlTH OF PENNSYLVANIA DEPaATHtNf OF REVENUE BUREAU OF INDIVIDUAL IAlC[S PEPT. 210601 HARRISBURG, PA 1111a-0601 NOTICE Of INIIERITANCE TAM APPRAISEHENT. ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AND ASSESSHENT Of TAM DATE 06-05-96 ACN lOl S ATE OF FILE NO. DATE OF DEATH 06-l3-95 CDUNTV CUMBERLAND NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT TilE UPPER PORTION Of TillS fORH WITII YOUR TAM PAYHENT TO TilE REGISTER Of WILLS. HAME CIIECM PAYABLE TO "REGISTER Of WILLS. AGENT" REMIT PAYMENT TO: CUT ALDNG THIS LINE ~ RETAIN LDWER PORTION FOR YOUR RECORDS ~ iiE'v:is4i-Ex-iiFjniZ:9ifj-iiiificniF-YriHEiiii'AiicE-TAX-iippRiiisEHE'ii:r;-iii.i:oiiANCE-ijli---m-.--------- DISALLOWANCE DF DEDUCTIONS AND ASSESSMENT OF TAX RAY S FILE NO. 2l 95-0458 ACN 101 LINDA A CLDTFELTER ESQ CRAIG A DIEHL LAW OFFIC 3464 TRINDLE RD CAMP HILL PA 170ll ESTATE OF BERRY TAM RETURN WAS, I X I ACCEPTEa AS fILEa RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE DF RETURN BASED DNI ORIGINAL RETURN 1. R..I eat.t. (Schadul. AJ (1) 2. stocks and Bonda (Schedul. OJ (2) 3. Clo..ly Hald stock/Partnership Inter.at (Schedul. C) (3) 4. Hortg.g../Hot.. Raceivabl. (Schedul. DJ (4) 5. Cash/Bank Deposita/Hisc. Parlonal Property (Schedul. E) 15) 6. JointlY Owned Property (Schedul. F) (6) 7. Tranlf.,.. (Sch.dul. OJ (7) 8. Tot.1 A...t. APPROVED DEDUCTIONS AND EXEMPTIDNS: 9. Fun.,..l Expan.../Adn. COlts/HiIC. e~pense. ISchedule H) (9) 10. Debts/Hortgage Liabilitie./Lien. (Schedule I) (10) 11. Total Deduction. 12. Net Velue of Tax Return IS. Charitable/Governnantal aaqua.t. ISchedu1e J) 14. Net Value of e.tat. Subjact to Ta~ NOTE: If on assassment was issued previouslY, lines reflect figures that includa the total of ALL ASSESSMENT OF TAX: 15. Anount of Line 14 .t Spou..l r.te (15) 16. Anount of Lin. 14 taxable .t Linaal/Cla.. A rat. (16) 17. Anount of Lin. 14 taxabla .t Coll.taral/Cl... a rata (17) 18. Principal Tax Du. TAX CREDITS: PAYHENT aATE 03-08-96 DISCOUNT l+ I INTEREST 1-) RECEIPT NUHBER AA1l2593 .00 REGISTER DF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA l70l3 Anount Ra.ittad . DATE 06-05-96 ) CHANGED ,00 ,00 .00 ,00 l.871.91 l3.234,48 ,00 IBI l5.l06.39 6.931,72 .00 1111 1121 C131 1141 6.Q31 7? 8.l74.67 ,00 8.l74.67 14, 15 and/or 16, 17 and 18 will returns assessed to data. .00 H'OO. 8.l74.67 H .06. .00 H ,l5. I1BI ,00 490.48 ,00 490.48 AHOUNT PAlO 490,48 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 490.48 ,00 .00 .00 c' , . If PAlO AfTER DATE INDICATEa. SEE REVERSE fOR CALCULATION Of AOOITIONAL INTEREST. If TOTAL DUE IS LESS THAN fl. NO PAYHENT IS REQUIRED. If TOTAL OUE IS REfLECTEa AS A "CREOIT" ICRI. YOU HAY BE DUE A REf UNO. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS,) r- 't~ 0<(. i5 'rl lIl; .~~ 0\ '. ( " l~~ ...: ., l{' " ~ ~.l ': . , (l ;.J '-) ...',' '0 .' 8 Ola: P- Oi - a: u RESERVATIONI E,..t.. of d.c.d~t. d~lng an or belar. p'c.~.r 12, 19.2 .~ .. ~~ lutur. lnt.r..t In thl ,,'at. I, 'tln.f.trad In po.....lon or .nJav'ant to Cia,. . leoll_t,r.l) b.n,flclarl.. of thl dlcld.nt .,t.t thl Ixplt.llon of InV ,,'at. 'or 11'. or 'or v..r., thl Co..anw..lth hat.by IMPr..,.v r...tv.. thl right to appral.. and ...... ttln,'.r Inherltancl Tlw.. at thl lawful CII" . Ceal1a'.r.1' t.t. on any such future Int.r..t. PURPOSE OF HOTtCEI To fulfill the requlta..nt. of SlctJon Zl~a 0' t~ loh.rltanc. 'nd E,t.t, Tlx Act. Act 22 of 1991. 12 P.S. Sactlon rUD. PAYHEHTI D,tlch thl top portion of thl. Hotlel Ind .ub.lt wllh your ply..nt to thl RIDII'ar of willi printed on the taver.. ,Idl. ""aka chick or IIOnlY ardu p.yebl. tal REGISTER OF' MILLS, AGENT All p.y.ente r.c.lv.d sh.ll 'Irst b. .pplled to eny Inter.st which .ey b. du. with any r..elnd.r eppll.d to the te.. REfUND ICR)I A r.'und a' . t.x cr.dlt. which w.. not r.que.t.d on Ihe T.w Return, .ay ba raqu..t.d by caapletlng en "Appllc.tlon far R.fund of Pennnlvenle Inh.rltanc. and Estet. Tell" IREV~I51;S). Application. .re avellebl. at Ihe Office of the Real.t.r of Will.. eny of the 21 R.venu. DI.trlct of,lca.. or bV C.lllng tha .p.clal Z4.haur enswerlng ..rvlc. nuBb.rs far far.. ard.rlngl In Pennsylvanl. l~aOO.3'2~2050, aut.lde PennsYlvanl. and withIn lac.l H.rrhburg area (717) 787.'094. TOOl 1717>> 772.2252 Olurlng bp.lr.d Dnly). OBJECTIONS I Any p.rty In Int.r..t not I.tlsflad with the .Ppr.I....nt, al)awanca or dl.allowanc. a' deduction.. or .......ant of t.x tlncludlng dl.count or Int.r..t) .e shawn an thl. Notlc. BU.t obJ.ct within .Ixty .'0) d.y. of rlc.lpt 0' thl. Hotlc. byl ~.wrltt.n prot..t to the PA D.p.rt..nt of R'v.nu., lo.rd of App..I., D.pt. 211021. Harrl.burg, PA 17128.1021, OR ~~alactlon to h.v. the ..tter d.t.ralned .t .udlt of the .ccount of the par.on.l r.pr..entatlv.. OR wwapp.al to the Orphan.' Court. ADHIH ISTRATlVE CORRECTIONSI Factu.1 .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tal PA Dep.rt..nt of R.venu.. lur..u of Indlvldull Tell.', ATTNI po.t A.......nt R.vl.w Unit, D.pt. 210601. t1.rrhburg, PA 171211.0601 Phon. (717) 717.6505. S.. p.ga 3 of the bookl.t "In.tructlon. for Inharltanc. T.x R.turn for a R..ld.nt Olcedlnt" tREY-ISOI) for .n ..pl.n.tlon of a~lnl.tratlv.ly corr.etebl. .rror.. If any t.x du. I. p.ld within thr.e 13>> c.l.nd.r .anlh. .ft.r the d.c.d.nt'. d..th, . flvl p.re.nt (S~) dl.count of thl tax Plld I. allow.d. DISCOUNT I PEN,UTVI Thl 15~ tax .an..ty non.p.rtlclpatlon pen.lty I. eOllput.d on the tat.1 of thll t.x and Int.r..t .......d, and not paid b.fbr. J.nuary 11. 1996, the flr.t d.y .ft.r Ih. .nd of the tax aana.ty period. Thl. non.p.rtlclp.tlan p.nalty I. app.al.bla In the .... ..nnlr .nd In tha Ih. .... tl.. plrlad a. you would .PPI.I tha t.. and Intarast th.t h.. b..n .......d .. Indlcat.d an thl. not Ie.. IHTERfSTI Int.r..t I. ch.rged b.glnnlng with flret dey 0' d.llnqu.ncy. or nln. C9J lIonth. and onll (I) day frail the d.t. of da.th, to the d.t. of p.y..nt. Tax.. whIch b.c... d.llnqu.nt b.fore January 1, 1912 b.ar Int.r..t .t the r.t. of .Ix (6~) pare.nt per annua c.lcul.t.d .t . d.lly rat. of .000164. All t.x.. which b.ca.. delinquent an and .ftar January I, 1982 will b.ar Intar..t at . r.t. which will v.ry froll cal.ndar y.ar to c.lend.r y..r with that r.ta announced by the PA D.partllant of R.venu.. Th. appllcabl. Int.r..t rat.. far 198Z through 199' .r'l '!!!!: Int.re" Ret. Dally Int.r..t Factor !!!r Int.r..t Rat. Dally Int.r.at Factor 1912 20X .000548 1917 .. .000247 1911S 16~ ,000418 1911.1991 nil .000101 1914 lU .001'lS01 1992 .. .000Z47 1915 UiI .00OSS6 1993.1994 1X ,000192 1916 10~ .000274 1995.1996 .. .00Q2U ulnt.rut I. calcul.tad .. fallow.. INTEREST a 8^L^NCE OF T^X UNP^Ia X NUHBER OF D^YS DELINQUENT X D^ILY INTEREST F^CTDR ~~Any Notle. Inu.d aU.r tha t.x b.co... d.lInqulnt will rafl.ct an Intar..t c.lculatlon to flft.en CIS>> d.y. b.yond the det. of tha .......ant. I' p.re.nt I. .ad. .ft.r the lnter..t co.put.tlon de'l .hown an the Hollc.. addltlon.l Interut lIlI.t b. ulcul.tad. IN THE MATTER OF RAY S. BERRY, An Alleged Incapacitated Person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. '1 S -oYSl . . ORDER OF COURT AND NOW, this -rt. r3 day of June, annexed petition, 1994, upon consideration of the . it is Ordered and Decreed that a citation be awarded, directed to Ray S. Berry, to show cause why he should not be adjudged an incapacitated person and a guardian appointed; hearing to be held in Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvania, on the 3rd day of August, 1995, at 3:00 p.m. At least 20 days notice of the hearing, including a copy of the Petition and contents of the Notice attached hereto, shall be given to Ray S. Berry, the allegedly incapacitated person, by personal service of a copy of said petition and citation, and by service of notice upon the next of kin who are sui juris, , personally or by certified mail, and upon any person or institution providing residential services to Mr. Bsrry. BY THE COURT, ~!o~~.ot' !.J. Linda A. Clotfelter, Esq. 3464 Trindle Road Camp Hill, PA 17011 Attor.ney for Petitioner :rc IN THE MATTER OF RAY S. BERRY, An Alleged Incapacitated Person I I I I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. NOTICE A petition to have you adjudged an incapacitated person has been filed with this Court by Gail R. McCord. A hearing is scheduled in this matter for Thursday, August 3, 1995, at 3100 p.m., in Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvania. You are strongly encouraged to be present at the hearing, and you are warned that important rights may be loet as a result of the proceeding. You have the right to be repreeented by counsel and the right to request the appointment of counsel and to have counsel so appointed paid by the Court where you are unable to afford to pay an attorney. YOU SHOULD TAKE THIS NOTICE TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Court Administrator Fourth Floor Cumberland County Courthouse Carlisle, Pa 17013 (717) 240-6200 ,-F""; . ~ , " '.11 J"fl.1- " .'~ , . , ..' .J" .,;",..,.... .~., . .' ., ,." '."~K">:f1~,iiMi(?~~"W~~.d ~:::",; ;'. ,:"",,it~!.:';:i\.i:0:'1;S;,;'~~:i'f,\\:;~~~ft! '<,' ,",,' ;} t,41. ~';-~"!~~iiiJ',ri(hf" '", 1,- ,,}:~F!'f?(,1l~W,l<;:;:r;;;:;: : ~.~!:i~~I.-~ -_)~-I-:'_;~;-; .. _.",,:,.'*1 -~ XN THB HATTBR OFI I I I I I I I IN THB COURT OF COKMON PLBAB OF CllHBBRLAHD COUNTY, PBHNBYLVANIA ORPHAN'B COURT DIVXBXON RAY B. BBRRY, An Alleqed Xnaapaaitated Person NO. 115- ORPHAN' B COURT PBTXTXON FOR DBTBRMINATION OF XNCAPACXTY AND APPOINTMBNT OF GUARDIAN To the Judges of Your Honorable Court: This petition respectfully represents: 1. petitioner is Gail R. McCord, of 159 Oak Flat Road, Newville, Pennsylvania, 17241. Petitioner is the step-daughter of Ray S. Berry, who is the alleged incapacitated person in this proceeding. 2. The alleged incapacitated person is domiciled at Leader's Nursing and Rehabilitation Center located at 940 Walnut Bottom Road, Carlisle, pennsylvania, 17103. 3. The alleged incapacitated person is eighty-five (85) years of age, having been born on August 9, 1909. 4. The alleged incapacitated person is not a member of the Armed Forces of the united states. 5. The alleged incapacitated person's marital status is widower. 1 6. Those persons, if any, who are alleged incapacitated person's next of kin and their relationship to same, of whom your petitioner has knowledge are as follows: a. Gail R. Mccord, Step-daughter; b. Alphretta Highlands, step-daughter 2520 spring Road Carlisle, PA 17013; and c. John Steele, step-son B07 Petersburg Road Carlisle, PA 17013 7. Petitioner seeks to have herself appointed both guardian of the person and estate of the alleged incapacitated person at the request of the Prudential Insurance Company of America who requires a competency determination in order to process a cash surrender claim on the alleged incapacitated person's insurance policy number OMS 422971 and because the alleged incapacitated person is susceptible to undue influence and disposition of his estate. B. The alleged incapacitated person is incapable of handling his financial affairs for the reasons set forth in the attached Affidavit and competency Report, prepared by Michael O. Daniels, M.D., marked as Exhibit "A" and made a part hereof. 9. To the best of Petitioner's knowledge and belief, no other Court within this Commonwealth has appointed a guardian for the alleged incapacitated person. 10. To the best of Petitioner's knowledge and belief, no other petition has been filed for the appointment of a guardian for said incapacitated person. 2 . ' .' 11. The Petitioner, having no interest adverse to the alleged incapacitated person, agrees to act as Guardian if this Honorable Court shall so appoint. 12. The Petitioner seeks plenary guardianship of the alleged incapacitated person's estate and limited power over the person, to wit: Powers of general care, maintenance and custody, power to designate the place for the incapacitated person to reside, power to provide required consents or approvals on behalf of the incapacitated person, and the power to assure proper medical and psychological services. 13. Petitioner, as proposed Guardian, states as her qualifications: She has acted in a fiduciary capacity for the alleged incapacitated person for approximately three (3) years, acting as his Power of Attorney. 14. The alleged incapacitated person has income consisting of: a. Money due from the Social Security Administration in the amount of $789.00 per month; and b. A monthly pension in the amount of $88.33 per month. 15. The alleged incapacitated person has assets, real and personal property, of which Petitioner is aware, in the amount of approximately $500.00 consisting of clothing and personal effects. 3 NO. 95- ORPHAN'S COURT ,. IN THE HATTER orl RAY S. BERRY, An Alleged Incapacitated perscn I I I I I I I IN THE COURT or COHMON PLEAS or CUKBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION VBRlrICATION I, GAIL R. MCCORD, verify that the statements made in the fcregoing PETITION FOR DETERMINATION OF INCAPACITY AND APPOINTMENT OF GUARDIAN are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 4904, relating to unsworn falsification to authorities. Date: o 9//..4& ~ff" t/ 4th'R'/:1/(!:&vL GAIL R. McCORD . '. ;.. .~.~.;., "'h' "- -." " 'f.' *.,........fff,-!jo..~~""_......l-,..!:'>ic"i1'.....; ,~\!~~,' ~-"~,.~: RAY S. BBRRY, AD AUeqacS IncapacitatacS Person I I I I I I I IN THB COURT 011' COHMON PLUS 011' CUMBBRLAND COUNTY, PBNNSYLVANIA ORPHAN'S COURT DIVISION IN THB HATTBR 011'1 NO. 95- ORPHAN'S COURT CONSBNT 011' PROPOSBD GUARDIAN I, Gail R. McCord, step-daughter of Ray S. Berry, do hereby certify that I am willing to act as Guardian for the Estate of Ray S. Berry, an alleged incapacitated person, if the Court shall so appoint. Further, I do hereby certify that I am not a fiduciary of any estate in which the alleged incapacitated person has an interest, nor have I any interest adverse to the alleged incapacitated person. The facts and opinions contained herein are true and correct to the best of my knowledge, information, and belief. Dated: /. r1 /? /(...- ft? '+//4t/ Z-2. ?/ 41;/ k! "1#~dpd Gail R. McCord Sworn to and subscr~bed Before mp this i/,-Hi day of ~\"'G,> , 1995. Jon~i; NOTARlAL SEAL DONAlD SEMIC. Nay PubI1c Can;! Hili Bolo. Cll!terland County My Commission Ellplrcs May 6. 1996 ,_:tp.;::'t;!.;\~~~~ji.. f~;~*.:~~':\"J;.'I~m~ .. . ...I.lIl1llllAl......"tW. 'Mtff... 'f''' ...,-.,,,,. (t) . ~ ., 'j , , i I. I ; I I .' ., COMPETENCY REPORT AFFXDAVXT COKMONWBALTB OF PEHN8YLVANXA COUNTY OF CUMBBRLAND I I 88 I, MichaelO. Daniels, M.D., 303 North Baltimore Avenue, Mount Holly springs, Pennsylvania, being duly sworn according to law, depose and say that I am a medical doctor in the Commonwealth of Pennsylvania, and I have examined the patient, Ray S. Berry, an alleged incapacitated person, with care and diligence and based upon said examination and observations am of the opinion that said patient is incapacitated so as to be unable to manage his own affairs for the reasons set forth in the attached report, and that the facts and opinions contained therein are true and correct to the best of my knowledge. information and belief. ~~ Michael O. Daniels, M.D. Sworn to and ~bs~ibed Before me this 0 D. day of ~'-?d"L- , 1995. 4'd:;- /12~?,-~.-e:. Notary PUblic Nol.1rloISoaI Wllams.~NlIo ~~E>pIrosOl1 ~ IN THE MATTER OF RAY S. BERRY, An Alleged Incapacltated Person , IN THE COURT OF COMMON PLEAS OF , CUMBERLAND COUNTY, PENNSYLVANIA , ORPHANS" COURT DIVISION , NO. 21-95-458 , , , CITATION WE COMMAND, YOU that laylng aslde all business and excuses whatsoever, you be and appear In your proper person before the Honorable Judges of the Common Pleas Court, orphans' Court Dlvision at a session of the sald Court there to be held, for the County of Cumberland to show cause why he should not be adjudged an lncapacitated person and a guardlan appointed, hearlng to be held in Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvani.a, on the 3rd day of August, 1995,at 3:00 p.m. At'least 20 days notice of the heari.ng, i.ncludlng a copy of the petltlon and contents of the Notice attached hereto, shall be given to RaY S.Berry, the allegedly lncapacltated person, by personal service of a copy of said petltlon and cltation, and by service of notlce upon the next of kin who are sur juris, personally or by certified mail, andupon any person or institution provldlng residentlal servlces to Mr. Berry. wi,tness my hand and officJal seal of ofHce at CarUsle, pennsylvanla, thls 14th day of June, 1995. ~ (',. ~IH" n.. PR :J.nJ.-t.6 MaryS. Lew.s I , Clerk of Orphans' court Cumberland County Carllsle,Pa. " . .. ' ,\ . <,: IN THB MATTER oPa RAY S. BBRRY, An Alleged Inoapaoitated Person a a a a a a a IN THB COURT OP COMMON PLBAS OP CUMBERLAND COUNTY, PBNNSYLVANIA ORPHAN'S COURT DIVISION NO. 21-95-458 ORPHAN'S COURT DISCONTINUANCE To Mary C. Lewis, Clerk of orphans' Court: Please mark this action discontinued due to the recent death of the alleged incapacitated person, Ray S. Berry. LAW OFFICES OF CRAIG A. DIEHL Dated: J Lll\t. M" , q '15 Clotfelte Esquire torney ID No. 72963 3464 Trindle Road Camp Hill, PA 17011 (717) 763-7613 .f;-- CERTIFICATION OF NOTICE UNDER RULE 5.6{a) Name of Decedent: RAY S. BERRY Date of Death: June 13 , 1995 Admin. No. Nill No. 1995-00458 To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court ~Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Ortolw 5,/jQ1 : , ~ Address Gail R. McCord Alphretta Hiqhlands John Steel ,~q ORk F'R~ HnR~ Npwuil'p PA 1724~ 2520 Sprinq Road, Carlisle. PA 17013 807 Petersburg Road. Carlisle. PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: 10- r;. ~5 (ft~>;j,~u:.D- r:L~ Name Linda A. Clotfelter, Esquire I1l Address 3464 Trindle Road Camp Hill, PA 17011 (-'1 f'.." o ,- . . i..'_l Telephonep'17) 763-7613 Capacity: Personal Representative . Counsel for personal representative a:U4 i5i x '~-') 5 uu ... "(V.I~OO Ill'. 17ft., ~... ~ ..S" trllE~ ,",09 '-''''.. ~ z " ;:: c ~ ~ ,. " '-' g '~ 9.'-~ IJ ,,' ~..., . (\ _i.'01..:.,... COMMONW(Allt. ,:.., "rtm!l"l\~'. A Otf'",UMIN' or io(....(NU( DI" :'1(,1,.01 tiARAlSIURO, FA 171'8.0001 _. Dtcl IN .~ "'AMI !lA' ,'11. ,"he ""bOIII'~II'AIj IS. !:>~l - 10 /: I'OR OATIS 0' DIATH AnlR 12/31/91 CHICK HIRI INHERITANCE TAX RETURN 'l~ot::~yU~:~DIT IS CLAIMID 0 RESIDENT DECEDENT fiLl NUMBIR (TO BE FILED IN DUPLICATE 21 95 WITH REGISTER OF WILLS) ICOUNTY CODE YEAR OIClDINt'. COM'I! IADDIIU []: 1. Original Retur" o A, limited EUal. 0 40, Future Inl'"'' Compromi.. (for dOl.' of death oft., 12.12.82) [)C6, eeudent Died T'lIal. 0 7, D,ced.nt Molnloln.d a living T,uI' (Alloch copy of Willi IAlloch copy of Trull) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. NA'elNDA A. CLCYrF'ELmR, ESQUIRE c'thW'~i'i,'M~I~F CRJl1G A. DlI'JIL 3464 TR1NDLE ROAD CAMP lilLI., PA 17011 o ... ili Ii! :d o ERRY RJlY S. toOCIAl ucu..n NUMIUI CAli 0' 0("'" 00458 NUMBER IDA" 0' IllIH 8 9 09 10CIA\ UCUIITl t4u"'IU I LEADEfl NURSJI\I:; [, RElINHI,1TATIVE CENTER 940 WALNlJJ' 1300"J'Q-1 flD.. CARLISLE'17813 Co." CUolI3ERLAND AMOUNl 'l(IIVID I~U INn.veltCN') 174-05-0048 6/13/95 I"l ""11(...,11 l~h'.'~C.I'Ol.llll "''''II''''' "." ...'c ...~t.1 ..' "'II o 2, Sl:pplemental Return :il15 "'0 "'z 8~ HU'MONl NUMIU 717 763-7613 03. 05. ..Q e. Remolnd., R,'urn (for dol.. of death prior to 12.13.82) F.d,ral Ellol. To); Relur" Required Tolal Numb., of Safe D.posit Bo.... z " 5 ~ :d '" 1, Rlol Eliott (Sch.dul. AJ 2. Sloch and Bond. ISch.dule B) 3, CloSlly Held Slock/Porln,rahlp Inl.,.., (Sch.dul. C) A. Mottges.. and NOI'. R.cei~obl. (Sch.dul. 0) 5. COlh, Bonk D'POlltl & MIsullaneous P".onol Prop.rly (S,h.dulo E) 6, Jointly Owned Prop.rl)' (5ch.dul. FI 7. Tron,f", (S,h.dulo 0) (S,h.dul. L) 8. Total Gran An... (Iota I L1n.. 1.7) 9. Funeral bp'n'... Administrati.... COlh, Mile.lIon,oul bpln... (Schedule H) 10. D.bh. Morlgcg. liabilities. Uen. 15ch.dul. I) 11. Total D.ductionl (Iotollln.. 9 & 10) 12. N., Valu. 0' Estol.llIn. 8 mlnu. lint 111 13, Charltabl. and Gov.rnmental B'quel" ISchedul. JI lA. Nel Volu. Sub eet 10 Tall (lIn. 12 mlnu. lIn. 13) 15, 5poulal Tranl'.rl I'ar dole I of d.alh a't.r 6.30.94) 5.. In"rucllonl 'or Appllcabl. P.runlag. on R.v.rs. Sid., I'nclud. volulI hom Schedul. K or Sch.dule M,) 16. Amounl of lIn. 14 tallabl. at 6% rol. (Includ. valulI 'rom Schedul. K or Sch.dule M.) 17. Amounl 0' lIn. 14 tOllobl. 01 15% rol. (Includ. value, from Sch.dul. K or Schedule M.) 18. Prlndpallax due (Add 10. from line. 15, 16 and 17.1 19. Cr. dill Spoulol Poverty Cr.dil Prior Poym.ntl III (2) n (31 0 (4)- .2... (512&71.:.~1 161 13,234.48 (7) 0 (9) (10) 6.931. 72 o (e) 15,106.39 6,931. 72 (111 1l;l74.67 (12) (131 0 (1. R 174 (,7 )(,-- n )( ,06. 490.48 )( ,15. n (1 e) 490.48 (19) 0 (20) 0 490.48 (21) 0 (21A) (21B) 490.48 + (15) (16) (17) 8.174.67 Discount Interllt + 20. "lIn. 1911 9r.oler Ihan lIn. 18. enler Ih. diH,renu on lIn. 20. Thll h Ih. OVERPAYMENT. aD 21. If lIn. 18 II greol.r Ihon lIn. 19. en 1ft Ih. diff,renc. on lIn. 21. Thill.lh. TAX DUE. A, Enter Ih. Inler.1I on Ih. bolanu due on Lin. 21 A. 8, Enler Ih.lolol 0' lIn. 21 and 21A on lln. 21B. Thll I. Ih. BALANCE DUE. Malle Ch.cle Payabl. tal R.gl.t.r of Will., Ag.nt I ' . BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH'": :(.),; .s;:t,:.-;:;'" .n" Und.r p.nolli.. 0' perlury, I d.c1or. that I hay. uomin.d thil relurn, including occompanying IChedul.. and Ilol.m.nll. and to Ih. b.st 0' my kno.....l.dg. Gnd b.li.f It it tru., correct and campi. I., I d.c1ore Ihol 011 real eUol. hal been r.porl.er ot Iru. morbi volu.. D.c1oralion 0' preporer oth.r thon Ih. p.nonol repreulnlatlv. I; baled on allln'ormatlon of .....hlch preporer hOI any ~nowl.dg., :IoIGN'" Of 'I~ON U:lo'ON$t,u 'OR flllN .(tUIN I "PPIIU D"n . .' I ':J l-" le,~ "L 59 OI\K I-1.AT ROAD. NEWVJLLE. PA 17241-9467 3/8/96 'u I Of 'U,,,RUOTHIR r N IU'IUINtAf."'1 "POilU DAn Q, 3464 TRINDLE ROAD. CN-lP II1LL, PA 17011 3/8/96 Check hete If you 0'0 requesling -a ,efund of your ovc'poymcnl p ~ _. . \. 11'1 ltot II. IU'I ,f~ COMMONWfAlTH OF P(NNSYlVAHIA INHIIIIAHCI TAX .nU'N 'ISIDIN' DICIDIN' ESTATE OF RAY S. BERRY SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY (All prop"'Y lolntlv~own.d wllh ,h. Righi .f Survlvo,.hlp mutt b. dl,d...d an Schedule '1 DESCRIPTION ITEM NUMBER 1. REFUND- LEllDER NURS1NG AND REIllll3l1,1 TAT 1 VE CENTER REFUND- BLUE CROSS/BLUE SlIlEW 2. (Attach addltlonol eVIl' M 11" .hulll' ma,. IpacII. no,d.d,) TOTAL Aho enter on line S, RICO PieD.. Print or l' e FILE NUMBER 21-95-00458 VALUE AT DATE OF DEATH $ 1,312.71 559.20 $ 1 871.91 I' .;i.';j,l.;',. . ' 11\(1~1"11J'''1 . COMMONWfAltH 0' PlNN5YLVANIA INHUITANCf TAX JlUURH "UIDENJ DECEDENT SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OF RAY;:- BERRY I FILE.!~~fJ'!!6045B Jolnl 10nont(.I. --~.-~---_._----~~ ._..,._.~. ADDRESS RELATIONSHIP TO DECEDENT ---_._---~--_. ..-------.--.-------- A, NAME GAlL R. MCCORD 159 OAK FLAT ROAD NEWVlLLE, PA 17241 STEP-DAUGHTER B. C. Jolnlly-ownod proporty. ITEM LmER DATE NUMBER FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF JOINT OF ASSET % INT. DECEDENT'S INTEREST TEN ANT JOINT 1. A 12/4/90 MER lOAN BANK $26.46B.96 50 $13.234.4B OHECKING ACCT. #29362B5B DATE OPENED - 12/4/90 DATE OF DEA'Ili BALJ\NCE= $26.431. 29 ACCRUED INTEREST = $37.67 TOTAL (Also onlor on line 6. Recopltulollon) S 13.234.4B (II more space is needed inserl addilional she,'s of some sill) , UY.11lI r.. r,...11 ITEM NUMBER A. B. A. C. 1. 2. 3, A, 5. 6. 7. 8. -t.~ COMMONWU~TH 0' 'INNULVANIA INHUltANC( TAk _nURN allICIN1DIC(OINT SCHEDULE H FUNERAL EXPENSES. ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES RAY S. BERRY Pleale Print or Type R 21-95-00458 DESCRIPTION AMOUNT 1. Funeral EJCpen.elt EWiNG BRO'IllERS FUNERAL HGlE - FUNERAL SERViCE 5,826.00 1. Admlnlltratlve COltll Personal Representative Cammlnlans Saclal Security Number of Persanal Representative: Year Cammlnlans paid 2, Attarney Fees _ LAW OFFiCES OF CRA1G A. DiEHL 903.00 3. Family Exemptlan Claimant Addren af Claimant at decodent's death Slreet Addren City State Zip Cade Relatlanshlp Prabate Fees REGiSTER OF WiLLS, CLMBERLAND aJUNl'Y 77.00 Mlleellaneou. Expenl'" WE SENT1NEL - ESTATE ADVERTiSEMENT WE CU>lBERLAND LAW JOORNAL - ESTATE ADVERTiSEMENT 75.72 40.00 REG1STER OF WiLlS, CUolBERLAND COUNTY - FiLiNG FEE FOR PA iNHERiTANCE TAX RETURN 10.00 TOTAL (Alsa onlor an IIno 9, Recapltulatlan) (If more Ipaee II needed, Inlert addltlonallheell af lame II...) S 6,931.72 . . .I~ Ul) fit 11-171 L "~:';'\~l\ -Si!J~ to"''''ONWUI'" 01 "~h1,,,\""1& ''''"1I11ANU 'AX InUIN .nlOINIOIUO'NI SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 95-00458 RAY S. BERRY ITEM NUMBER AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 1. A. Toxobl. Bequ.".: GAIL R. MCCORD 159 OAK FLAT ROAD, NEWVILLE. PA 17241 ALPHRETI'A HIGHLANDS 2520 SPRING ROAD. CARLISLE, PA 17013 JOON STEEL 807 PETERSBURG ROAD, CARLISLE, PA 17013 STEPSON 1,000.00 STEPDAUGHTER $1,000.00 PLUS RESIDUE 2. STEPDAUGHTER 1,000.00 3. ITEM NUMBER AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY e. Charitable and Go....rnm.ntal B.qulittl 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI.o enllr on line 13, RecophulDIIDn) (If more spac. II n..d.d, In..rt addltlonol ,hull of lam. lite) o S .\ . LAW O'~lct. MARTlON "riD DHCLDAKtA -~ l.AST WIl.L AND TgSTAMENT I, RAY S. BERRY, of the Borough of Carlisle, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my Last Will and Testament. 1. I give, devise and bequeath all of my estate, both real and personal property, unto my wife, GAIL g. n~RRY, absolutely, and I hereby appoint my said wife as Executrix of my estate. 2. In the event my said wife shall predecease or fail to survive me, then I give, devise and bequeath all of my estate, in the following manner: A. I give the sum of One Thousand ($1,000.00) Dollars unto each of my wife's children, GAIL McCORD, ALPIIRETTA HIGHLANDS and JOHN STEEL, absolutely. B. All the rest, residue and remainder of my estate, after the payment of my debts, funeral and testamentary expenses and the above legacies, I give to GAIL McCORD, absolutely. 3. I hereby appoint the said GAIL McCORD as Executrix of my estate under the Second Paragraph of my Last Will and Testament. IN WITNESS WHEREOF I have hereunto set my hand and seal this ,-,~,:J),{day of February, 1974. ft." I y ~ ~;() 4?,'!..1 ~( /.' l "'~.:.!o~ (S~AL) {/ R'lIy'S. UCltp' SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testator, RAY S. BERRY, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of said Testator and of each ot.! er. , (.~/~, I ~1' ./ f / . nt/Il{ .-:\ ,/~. l. ,(." Iy (J" --- ~. ....-,., .... -.. . -'-- -. - --- .-~ -- -- -- -- ~-- -- -- -" ..~-- - ...._- -.-..-. -..... - .+.-.- --...- .---.. -"-, ,.-.,. . ~ -^- -- --- ,.-- g;~'11ISiig5':~:r2[':?i~f~~W. ACN I F OM e'I ASSESSMENT '!' AMOUNT RECE VED R I II CONTROL iii NUMBER 101 .....lfv.5-tB GAIL MCCORD 1:59 OAK FLAT RD NEWVILLE, PA 17241-9467 ESTATE INfORMATION. m fiLE NUMBER (,1 21-199:5-04:58 m NAME Of DECEDENT ILAST) ;II BERRY RAY S II DATE Of PAY~ENT m POSTMARK DATE COUNTY SSN 174-05-0048 IFIRST) IMII CUMDERLAND DATE OF DEATH m TOTAL AMOUNT PAID $490.48 VZ REMARKS GAIL R MCCORD SEAL CHECKIl :31E! RECEIVED BY ftI0NAJUU-- REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS '"- -- - - - -- -- -- -- -- - -~ --' .-- -- -----:- -~_... -.- - -..,- --' --- -- -. --- - -. -- -- -- -- - .._-' -~ 'J: ~-._____'~"'~_. _ _,r-r-.T .,..: , '. ":