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Home My WebLink About95-00659 . , ':~ ~}~!~;'l' ' ~!;j\, ;;:',..:;, ., ...:.<:(..~~\.<.:,: .' .,'.... " . ,;jF "~:;~i:':."'/"; "f)j ,'" ,'.'- ,,, " ,:-' .'. ," ;";<." , '. .' f';'"",:,", ,: C' ;'''':;. .i"'" ": ~"; . "'/-'f.' j': :;,..,> : ':;:~; .,~. ,:. ,:' . 'i;__:';. > ...., , J;' ;"'j'. "j .~...~e 'f'.i.. ,;\:: .' /- ... ...<.;;...... . j" '."U'~h . ';,..~.:~:.){ .'. ~}\~1;- '.:'ii'<':;3 ....,.:.,:f.;, '. :! ;',i'" .C' :.~ ~l~tt': <(; .'. ,,,;!: i..,,r,.;.;.,; : ;,::' ;?~h; ~f:i,. ,: .) r:':~' ;y,,; ,. ". . ;'.' ;'., .,~:i,'!::i>:L..y.;. ':~. ,ic: ~;.~ ~i 'J " '.';~--";"'.' '.: ' .'.., .... ';--: ;" '. , ; )':..' ;"~" . - -~:~fM:~; ;:: . '~', ~~ ~.~ .;~\~i~l.. !~~:; ,-x(c~it "')c-~,,, t'-'_,;:_~ -...~ \~~i;:':';"-('''ii;> _"" ~1,. ,'1 '- -',' _~ f_ 1 "';,-:7; :.M,. 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County of Cumborland In the Social Security No, 208-24-4973 Commonwealth of Pennsylvania The pethlon of the undersigned respectfully represents that: Your pethloner(s), who Is/arc 18 years of age or older an the executrix in the last will of the above decedent, dated ,111M" 7 and codlell(s) dated N/ A Estate of DIANE GOODALl. 8ERT also known as named , 19...21.- (.IBle relevant clrcllmSlanc:cs, C.I. rcnuncladon. death or eXI:CUlor, etc.) Decendent was domiciled at death in Cumberland County. Pennsylvania, with "er last family or principal residence at 503 Srw"nth Str""t. New Cllmhprlnnrl. Cnmhnrlnnn Cnnnt.y. P,..nnRylvllnin (1111 "'etl. number and muncipalllY) Decendent, then~.l-- years of age, died AUQust 22 ,19 95 at 503 Seventh St. ,.J!mt Cumberland. PA . Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted arter execution of the wlll offered for probate: was not the victim of a killing and was never adjudicated Incompelent: _ N/A ' Decendent at death owncd property whh estimated values as follows: (H domiciled In Pa.) All personal property (If nOI domiciled in Pa.) Personal properlY In Pennsylvania (If nOI d()mlclled In Pa.) Personal property in County Value of real estate In Pennsylvania situated 11.' follows: 503 7th St.. New Cumberland. PA $ 10.000.00 $ $ $100.000.00 WHEREFORE, petltloner(s) respeclfull)' reQuest(s) the probate of the last will and codlcll(s) presented herewhh and the grant of lellers testamentary , (lc5lomenlaryj admlniS1ration C.t.D.: adminismnion d.b,n.c.I.II.) theron. j .,,- 'il ~ "'~ -g.g ..'- -:;;-~ 1l'~ 50' lO C .. Vi ~~SlAr-' 117 RnRomnnt: AV('lonl1('lo New Cumberland. PA 17070 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } sa COUNTY OF CUl~DF.!lLAND The pelhllJllcr(s) above-narr.ed .wear(s) or affirm(s) that the statements In the foregoing pethlon arc Irue anel correct to the best of :he knowledge and bel of pethloner(s) and that as personal represen. ulllve(l) of the above decedent perhloner(s) wlll wel a truly adml~r the estate according to law. Sworn 10 or affirmed and sul:scrlbed ~' ..L- '" before me this _--2!.'!t___. day of Anno Slm i' ~J..~u, al . _ J9 ?5 ~ ":)/I'ik ..it',n";,, 11... .IXUx-- t ~ /5-5'3-7 / /Jr.';! c. I,.,wl'fi Register {/ 'I' / ~ t-' ;';' ~': -~...-..... No. 21-95-659 Estate of , Deceased DIANE GOODALL BERT DECREE OF PRODA TE AND GRANT OF LETIERS AND NOW September Is t 19~, In consideration of the petition on the reverse side hereof. satisfactory proof having been presented before me, IT IS DECREED that the Instrument(s) dattd June 7, 1995 described therein be admitted to probate and flied of record as the last will of Diane Goodall Bert and Letters Testamentarv are hereby granted to Anne Sim ~l1.J4.L./;.J.LJ4/ f/~.1-(174t4tJ, o R'll!l1c." ..f Wllb ." :I1tI1vr.. Mary C. Lewis . :- r '0 FEES Probate, Letters, Etc. ......... S Short Certlficatesl ~ . .. . . .. ... S Renunciation ................ S x-'pages ( 6), JCP Gerald~. Shcklets~i i40486 235.00 1~_no ......iORNhY ,""Po Ct. 1.1l. 1010.) 414 BridlJil..~t,., "'oM C';Il:Il:lerland, PA 17070 ^t:DI~ (717) 774-7435 18.00 5. 00 S TOTAL _ S Filed . .~~.J?~~~~.~:..~: .~~?~.... ~.~~...~O PHONE Letters and order put in Attorney's Fi1e on 9-5-95. 21-95-659 ~ ~ ' ;. .p\vl11.\bert.dg\I..5 LAST WILL AND TESTAMENT OF DIANE GOODALL BERT I, DIANE GOODALL BERT, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I hereby give and bequeath the sum of Twenty Thousand ($20,000.00) Dollars unto my daughter, ANNE SIM. ITEM II: I hereby give and bequeath the sum of Two Thousand ($2,000.00) Dollars unto ROSS E. GAHAGAN, who is and has been like a son to me. ITEM III: I hereby give and bequeath my 1993 Chevrolet Lumina unto my daughter, ANNE SIM. ITEM IV: I bequeath my tangible personal property not herein otherwise specifically bequeathed in equal shares to my then living children and step-son, BRADLEY BERT, to be divided among them by my Executrix, in her sole and absolute discretion, in as nearly equal portions as may be practical having due regard to the personal prefer- ences of my then living children and step-son, BRADLEY BERT. ITEM V: I direct my Executrix to sell all my real property situate at 503 Seventh Street, New Cumberland, Cumberland County, Pennsylvania, with the net proceeds of such sale to be added to the residue of my estate and distributed under Item VI of this my Last will and Testament. Page 1 of 7 ITEM VI: I devise and bequeath the residue of my estate of whatever nature and wherever situate as follows: A. Twenty Thousand ($20,000.00) Dollars to be held IN TRUST by my daughter, ANNE SIM, as Trustee for the following uses and purposes: 1. To pay the net income of said trust to or for the benefit of my son, THOMAS SIM, for his life in such periodic install- ments as my Trustee shall find convenient, but at least as often as annually. 2. To distribute to or for the benefit of my son, THOMAS SIM so much principal as my Trustee shall deem advisable for the health, maintenance and support of my son, THOMAS SIM. 3. If my son, THOMAS SIM, should not survive long enoagh to exhaust the funds held in trust, or should my son, THOMAS SIM, be committed to a federal or state penal institution, the balance then held in further trust shall be distributed to the issue of my son, THOMAS SIM, then surviving, per stirpes. If my son, THOMAS SIM, should not have any surviving issue, the balance then held in further trust shall be divided equally among my then surviving children and my step-son, BRADLEY BERT. B. The balance of the residue of my estate shall be divided and distributed as follows to the Trustee hereinafter named to be held IN TRUST for the benefit of my following named grandchildren: one- seventh (1/7) to DANIELLE BERT, one-seventh (1/7) to BECKI BERT, one- seventh (1/7) to GREGORY SIM, one-seventh (1/7) to CHRISTINE SIM, one- Page 2 of 7 . . seventh (1/7) to KELSEY SIM, one-seventh (1/7) to COURTNEY SIM, one- fourteenth (1/14) to ROSE BERT and one-fourteenth (1/14) to THEA BERT. The trusts herein created in this Item VI.B. shall be used for the following purposes: 1. To expend and apply so much of the net income and principal of the trust as the Trustee shall, in the Trustee's sole discretion, deem advisable for the beneficiaries' education (including college education, trade school and graduate school). 2. When the child reaches the age of twenty-five (25) years, he or she may, upon written demand to the Trustee, withdraw the entire remaining balance of the trust principal and accumulated and undistributed income. J. Should a child die before receiving the entire balance of the trust, the trust shall terminate and the principal and accumulated income shall be paid to the then living issue of said child, per stirpes. Should the child die leaving no issue, the principal and accumulated income shall be paid to the parents of such child, if living, and in default thereof shall be distributed in equal shares to the then living children of mine and my step-son, BRADLEY BERT. ITEM VII: Subject to my desires set forth in Item VIII bel~w, I appoint the parents of any minor child who may take a share under this will guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, Page J of 7 provided that this appointment of a guardian shall not eupersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time solely for the minor's education (inclUding college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes. ITEM VIII: I appoint the parents of any beneficiary as Co- Trustees of any trust created under this Last Will and Testament for such beneficiary provided, however, that BRADLEY BERT and MARTHA BERT shall act as Co-Trustees for any trusts created under this my Last Will and Testament for the benefit of R05E BERT. ITEM IX: The interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM X: I appoint my daughter, ANNE 5IM, Executrix of this my last will. 5hould my daughter, ANNE 5IM, fail to qualify or cease to act as Executrix, I appoint my son, MICHAEL 5IM, Executor of this my last will. ITEM XI: For purposes of this my Last Will and Testament, my children shall include ANNE 5IM, THOMAS 5IM, PATRICK SIM and MICHAEL 5IM. I have made no provision in this my Last Will and Testament for my step-son, CHRI5TIAN BERT, as I have provided adequately for him during my lifetime. Page 4 of 7 . . . ITEM XIII No fiduciary acting hereunder shall bs required to post bond or enter security for the faithful psrformance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, hand and seal this '7 W . I, DIANE GOODALL BERT, have hereunto set my day of :luA'" . , 1995. ,dtlllP ~ .zt~r- DIANE G ODALL BERT SIGNED, SEALED, PUBLISHED and DECLARED by DIANE GOODALL BERT, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. ~&~ ~~~t.e. :f ' ~ hO ~~ t:.-w4-~ j A-, Address ' . ~"~j.f7, ~JUAJf~, ~. A dress . . Page 5 of 7 ~..,-,__._",_z_,-;":,:i--.-",,,~,<'=':'\.~fW'\ii.~ COMMONWEALTH OF PENNSYLVANIA I ISSI COUNTY OF CUMBERLAND I I, DIANE GOODALL BERT, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qua~ified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. 44<<PJ tl~//,{'I A.u:b' DIANE GO ALL BERT Sworn to or affirmed to and acknowledged before me by DIANE GOODALL BERT, the Testatrix, this '7 ~ day of -Y-'-"A "_ ' 1995. !7J , ~L~Y/ t Notary PUb~~ NOTARIAL SEAL r.ON~TMjC[ l. 1<P,nU, tlomry Public I hI'! C\Jdlbcil.1n~, I'A Cumborlallll Co, My COllilulsslcll Diplros April 13, 1000 COMMONWEALTH OF PENNSYLVANIA I ISS: COUNTY OF CUMBERLAND we,4fl~ and the witn~sses wh~ names are signed to ~d~ LA?:f-. ~ J,lJ.' th attach~ or fo going , instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as Page 6 of 7 \ . ":-' " CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Diane Goodall Bert Date of Death: August 22, 1995 will No. 2195-0659 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 September 21, 1995. Anne Sim 117 Rosemont Avenue New Cumberland, PA 17070 Mr. Ross E. Gahagan 602 Lavina Drive Mechanicsburg, PA 17070 Mr. Bradley Bert 422 Poplar Avenue New Cumberland, PA 17070 00 c:- :.J~ " r: Mr. Thomas Sim P.O. Box 2000 Whitedeer, PA 17887 Mr. Patrick Sim 13944 Rock Creek Road paway, CA 92064 Mr. Michael Sim 110 North 20th Street Camp Hill, PA 17011 Anne Sim ITF Mr. Thomas Sim 117 Rosemont Avenue New Cumberland, PA 17070 ~ \ ~"- j , "LIe., )~ ~':. ~ :0 ;:0", n,' () i',' _H ,., 'p n n .1, ...... I -l:>o ;:i ~_:<. .-. ~1(1l \....1 lo'i <> .~ U1 \" . Mr. and Mrs Bradley Bert ITF Danielle Bert ITF Becki Bert ITF Rose Bert ITF Thea Bert 422 Poplar Avenue New Cumberland, PA 17070 Mr. and Mrs. Michael Sim ITF Gregory Sim ITF Christine Sim 110 North 20th Street Camp Hill, PA 17011 New CUmberland, PA 17070 Mr. and Mrs. Patrick Sim ITF Kelsey Sim ITF Courtney Sim 13944 Rock Creek Road Paway, CA '92064 "Notice has now been given rule 5.6(a). 9~/ /9J" , . Date: to all persons entitled thereto under ~/?~ cGerald J.~ekletski, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative x Counsel for Personal Representative . .~ p .. IN REI ESTATE OF DIANE GOODALL BERT LATE OF NEW CUMBERLAND BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA . . ORPHANS' COURT DIVISION I NO. 21-95-0659 RECEIPT. RELEASE AND WAIVER 01" ACCOUNTING KHON ALL MEN BY THESE PRESENTS, that we, Michael Sim and Maryann Sim, being the trustees designated for Gregory sim and Christine Sim, minor children named as beneficiaries under the will of DIANE GOODALL BERT, do hereby acknowledge that we have recsived all sums of money and property due the aforesaid minor children by virtue of the death of DIANE GOODALL BERT, in full satisfaction and settlement of all of rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Diatribution in any Court of Common pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, Michael Sim and Maryann sim, do by these presents, remise, release, quitclaim and forever discharge the Execut- rix, her heirs, successors and aseigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, We have hereunto set our hands and seals the J 1/- day O~~7' L , 1996. ~~Anu~. fJ~~;/{ ) itness C?1; qi~~,au witne s ~~~ lchael SiriI ~.d~;W?S~ ry n SinI COMMONWEALTH OF PENNSYLVANIA: : 5S: COUNTY OF . . On this, the ,~L~J day of 4,:1" L , 1996, before me a Notary Public, the undersigned officer, personally appeared Michael S1m and Maryann Sim, known to me (or satisfactorily proven) to be the persons whose name are eubscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~~j~,;,; L~NO a Pu lic No\nridl Sonl Carmola JOl:c~h CI~lJdio, Notary Public Lowor Swal~'rn Twp., Dauphin Counlv My Comml3Slon e'plrol Feb,16, 1998 "r_' fljjj;' ':~-r.;_c '- -f;- - ~i>--- ~~;i:'i, ,...- ~~~':: If/;'-'- ~~-. ~~' ij'\, :~:/, - ), Rer.orc.:.rf elf ::" 01 Re!J\'.~rl!i 0; Willu '96 MAY 21 1\9:08 Clerr;.., ." ,,')urt Cumbenal1l.1 Co., PA ,..- " .;!-' '-", , -',> -'--;." :i- H ' ':::\ . . . . '~ \ -.- ~ .---,--....-..-.- ..i'_ , ~ IN RE I ESTATE OF DIANE GOODALL BERT LATE OF NEW CUMBERLAND BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA I IN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA I I ORPHANS' COURT DIVISION I NO. 21-95-0659 RECBIPT. RELEASE AND WAIVER OF ACCOUNTING KHON ALL MEN BY THBSB PRESBNTS, that I, ANNE 5IM, being the trustee designated for Thomas sim, an adult individual named as a beneficiary under the will of DIANE GOODALL BERT, do hereby acknowl- edge that I have received all sums of money and property due the aforesaid Thomas sim by virtue of the death of DIANE GOODALL BERT, in full satisfaction and settlement of all rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. " . ., ' . l ,. , ' i AND THBREFORE, I, ANNE SIM, do by these presents, remise, re- lease, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. "L- IH WITNESS WHBREOF, I have hereunto set my hand and seal the ~~ day offlpn I , 1996. ~ --~^- ne Sim COMMONWEALTH OF PENNSYLVANIA: : 55: COUNTY OF . . On this, the :J..S day of {1f/J~ , 1996, before me a Notary Public, the undersigned officer, personally appeared Anne Sim, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IH WITNBSS WHEREOF, I have hereunto set my hand and seal the day and year first above written. _ISoaJ Jac:quelneUA'"t( NaatvPt.tllc East PemsbolO T\I'~~ ~'JIT(,-"'1tld c~ MyCommisSlon':>.PJC!>.It>.1,2.1997 r, PemsyN'an6:l" of Recorec lJ (,111:0 of ROlji:ll.H of Wills -.",.., '"""J' '96 MAY 21 A9 :08 ., ~ '. ,', , , <- .-- , ~'''--'' Cler,.Q-:';"I;'s Court ,. CUmb"i,i,n" Co,. PA . . "- -1 ~ I' IN RE: ESTATE OF DIANE GOODALL BERT LATE OF NEW CUMBERLAND BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA : IN THE COURT OF COMMON PLEAS OF . . CUMBERLAND COUNTY, PENNSYLVANIA . . : ORPHANS' COURT DIVISION : NO. 21-95-0659 RECEIPT. RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, ANNE 8IM, being one of the beneficiaries under the will of DIANE GOODALL BERT, do hereby ac- knowledge that I have received all sums of money and property due me by virtue of the death of DIANE GOODALL BERT, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby w~ive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, ANNE SIM, do by these presents, remise, re- lease, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as ,;\c. '. IN REI ESTATE OF DIANE GOODALL BERT LATE OF NEW CUMBERLAND BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 21-95-0659 RECEIPT. RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, Bradley Bert and Martha Bert, being the trustees designated for Danielle Bert, Becki Bert, Rose Bert, and Thea Bert, minor children named as beneficiaries under the will of DIANE GOODALL BERT, do hereby acknowledge that we have received all sums of monsy and property due the aforesaid minor children by virtue of the death of DIANE GOODALL BERT, in full satis- faction and settlement of all of rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, Bradley Bert and Martha Bert, do by these presents, remise, release, quitclaim and forever discharge the Execut- rix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executrix. IN WI~HESS WHEREOF, We have hereunto set our hands and seals the 3f\-t( day of ~ ' 1996. - ~r~~ ~ 1:;t~B~;t ~ --- Witness Witness COMMONWEALTH OF PENNSYLVANIA: COUNTY OF ~ : On this, the ~ ':J tv{ day of -y)~ SS: , 1996, before me a Notary Public, the undersigned officer, personally appeared Bradley Bert and Martha Bert, known to me (or satisfactorily proven) to be the persons whose name are subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~-', ';j K.~. Notary Public NOTARIAL SEAL CONSTIIIICE L. KAI1U. Notary Public Now Cumhullon~, rA Cumbcllaml Co. M/ Commi5Slon &111105 flp11l13, 1099 - ,- ~ " ~. , ,,' ! . I '1 , . , IN REI ESTATE OF DIANE GOODALL BERT LATE OF NEW CUMBERLAND BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA . . ORPHANS' COURT DIVISION NO. 21-95-0659 RECEIPT. RELEASE AND WAIVER OF ACCOUNTING KNOW ALL HEN BY THESE PRESENTS, that we, Patrick Sim and Dee Sim, being the trustees designated for Kelsey sim and Courtney S1m, minor children named as beneficiaries under the will of DIANE GOODALL BERT, do hereby acknowledge that we have received all sums of money and property due the aforesaid minor children by virtue of the death of DIANE GOODALL BERT, in full satisfaction and settlement of all of rights and claims under her estate. We further declare, intending to be legally bound, th~t we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, Patrick sim and Dee 8im, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her , . ) . heirs, successors and assigns, from the acts of the Executrix as - aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, We have hereunto set our hands and seals the _ c; day of171a.r ' 1996. 4k~- Prick Sim &~ Dee 8im 9t~/l~fl/ witness State OF CALIFORNIA . . : SS: ~OUNTY OF SAN DIEGO . . On this, the 5th day of MAY , 1996, before me a Notary Public, the undersigned officer, personally appeared ~atrick aim and Dee sim, knoWlI to me (or ~atisfactorily proven) to be the persons whose name are subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. Shamara Velasco 3: Comm. '1034060 ..g NOTARY PUBLIC CALlFORN SAN DIEGO COUNTY Comm e_Pito'Ju1y3t.1008 ~ ,J/"ld/>r?oAA., v'efMO-U Notary Public ~ j . Recorar;'d (;1['(.(1 of Reul~t';r 01 Willa " ,~ 1\9 :08 '96 HAY 21 < - ~ ~ , .J~ , Clur/\.I:, ::.'.i;~'I; Court CUmbe1i<lflU Co.. PA "~, . .," , AfY.1.500 U + 17.9'" . /5 -(.)::) - r INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) NUME l!! . :5" "",.. Ill...... :C',.:. YE~ '" co 5 ~ :II 8 :: ... 'OR DAnS 0' DIATH AmR 12/31/91 CHICKHII I' A SPOUSAL 0 POVIRTY CRIDIT 15 CLAIMID flU NUMBIR 21 ... ifi lil III co COMMONWIAlTH 0' 'fNNSYlVANIA Of'AUMfNT 0' AfVfNUf onT. U0601 HAIUI:ISlURO.'A 1712'.0601 OIC OIH' HAMlllA$. rIIST. AND MIDDLllNllIAll BERT, Diane Goodall SOCIAL SlCUlIlfY HUMIU DATI O'IIITH 11-13-33 COUNTY CODE o CfOINf'S COM'll f ADDUSS 503 Seventh St. New Cumberland, PA 17070 COU", Cumberland AMOUNT AlCIIVED Isn INSTIlUCTIONI) 95 YEAR 0659 DAlf Of DUIH 208-24-4973 08-22-95 111 """,C"'UltUIVIYIHQ lPOUlI'1 N.u,. fI."". "utAND ""DDIIINIIIAl' :!lffi "'co "'''' 8le (ill. Original R.lurn 0 2. Suppl.m.nlal R.turn o A. Umlt.d E.tat. 0 Aa. Fulur. Inler.I' Comproml.. ('or dolo. 0' doolh okor 12.12.82) (i] 6. D.c.d.nt DI.d T.I'ol. 0 7. D.ced.nl Malntaln.d a Uvlng Trull (Attach copy 0' Will) (Attach copy 0' Trull) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAnON SHOUlD BE-DIRECTED TO. N~MI COMPUlf MAIUNG ADDIUS Gerald J. Shekletski, Esquire Stone LaFaver & Stone P.O. Box E o 3. R.malnd.r R.lurn ('or dOlO' 0' doa.h prlor.o 12.13.E o 5. F.d.ral Eliot. TaJII Relurn R.quir.o _ 8. Total Number of 50ft D.pasit Bou '" 51 S ! '" 1. Rool E.,o.o (Schodulo A) II ) 2. Slack. and 8and. (Schodulo 81 ( 2 ) 3. C1o.oly Hold Slock/Partno"hlp Inloroll (Schodulo q ( 3 I A. Mortgogo. and No.o. Rocolvoblo (Schodulo DI ( A ) .5. Colh. Ban~ D'POIIII & Mlscellon,oul P.nonal Property {5 } (Schodulo EI 6. Jolnlly Ownod Proporty (S,hodulo F) 7. Tran.'o" (Schodulo 0) (Schodulo l) 8. Tolal Gro.. A..o', (Io.olllno. 1.7) 9. Funeral bp.n..., Admlnblratlv. Coif" Mlle.llan.aul e.pon.o. (Schodulo H) 10. Dobl., Mortgogo Uoblllllo., Uon. (Schodulo I) 11. T 0'01 Doductlon. (10101 Uno. 9 & 10) 12, Nol Voluo of ellolo (lIno 8 mlnu.lIno 11) 13. Charitabl. and Governm.ntal B.qult" (Schedul. J) IA. No. Valuo Subloct.o To'llIno 12 mlnu.lIno 13) IS. Spau.al Tran.lora (lor dolo. of doolh akor 6.30.9A) 5.. 'nurudlanl for Ar.pllcabl. Percenlag. on R.v.n. (15) Sldo. (Indud. valuo. ram Sthodulo K or Schodulo M,) 16. Amount of lIn, fA fOJllobl. at 6% ral. (Includo voluo./rom Schodulo K or Schodulo M,) 17. Amount of lIn. fA laJllabl. 01 15% ral. (Indud. valu.. from Sch.dul. K or sch.dul. M.I 18. Principal 10' duo (Add '0. 'rom lIno. IS. 16 and 17.) 19. C,.dill Spoulal POYlrty Cr.dl' Prior Paymlnl. + $5,000.00 + 20. If Uno 191. groolor Ihan Uno 18, onlor .h. dlno,onc. on lIno 20. Thla I"ho OVERPAYMINT. 110 21. If Un. 181. groalor .han lIno 19. on.or tho dlno,onc. on lIno 21. Thl.I. Iho TAX DUE. A. Enter the Inl.,lIt on the balance due on Un. 21 A- 8. enlor Iho 10101 of lIno 21 and 21A an lIno 218. Thl.I. Iho BALANCE DUE. Male. Chicle Payabl. tOI R.gl.'er of Will., Ag.n' (111 30,530.32 (12) 113.573.41 (13) .00 (1A) 113,573.41 )C._- x .06 .. 6.694.41 X .15 .. 300.00 118) 6,994.41 1191 5,000.00 120) {211 1,994.41 (21A) .00 (2181 1.994.41 121.900.00 7.000.00 8,138.99 5,064.74 (6) (71 (8) $144.103.73 19) 21.232.92 9,297.40 (10) (16) 111,573.41 (17) 2,000.00 Dlacounl In,.,.1I Check hem If you mc rC'quC'slinq n refund 0' your OVNpovmenl. ~ BI SURE TO ANSWER ALL QUESnONS ON REVERSE SIDE' AND TO RECHECK MATH nd., p.naUI.. of perjury, I d.da,. thai I ha.... IJllamln.d thll r.furn. including accompanying Ich.dul.. and lIol.mlnll, and to th. bltl of my knowl.dg. and b.lI.f. Iltru., correct and compl.t.. I d.clare thai all real "10" hat b..n rlport.d 01 true markel valu.. D.c1aratlon of prepar., olher than 'h. plnonal repre..nrativ. il al.d 0 allln'ormallon 0' which pr.parer hal any ~nawl.dg.. o A U 0' PUSON IIfS~11L1 'Olt fiLING ItUUIIN ADDIlUS DAti ,,- ~ <o-.>//t.-- 117 Ro~eml)nt Ave.. New Cumberland, PA 17070 /,)//I/~;) ONAIU Itr'Altr IH N r NJAllyr ADCltru OAIl I /c"- I'..J./II /7:7 Act #48 of 1994 p~ovld.. for tho r.ductlon of tho tax rat..lmpo..d on tho n.t valu. of trand.,. to or for tho u.. of tho .pou... Th. rat.. a. pr..crlb.d bv tho datut. will b.1 · 3% (.G3) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 711/94 and b.for. 111/96 · 2% (.11) will be appllcabl. for ..tat.. of doc.d.nt. dyIng on or aft.r 111/96 and b.for. 111/97 · 1% (.111) will b. appllcabl. for ..tat.. of d.c.d.nt. dyIng on or aft.r 111/97 and b.for. 111/98 · 5"..... tran.f.r. occurring on or aft.r 111/98 will b. .xempt from Inh.rltanc. tax. PLEASE ANSWER THE FOLLOWING QUESTIONS IY PLACING A CHECK MARK (,...) IN THE APPROPRIATE BLOCKS. YES 0 1. Old decedent make a transfer and: a. retain the use or lncome of the property transferred, ....................................................... x b. retaIn the right to desIgnate who sholl use the property transferred or its Income, ............... x c. r.tain a reversionary intere.t; or ............................................................11..................... x d. receIve the promIse for life of eIther payments, benefits or care' ....................................... 2. If delllh occurred on or before December 12, 1982, dId decedent withIn two yea,. precedIng death Iransfer property without receiving adequate consideratIon' If de,ath occurred after December 12, 1982, did decedent transfer property withIn one year of death without receIving adequate consideration'................ of...... 00..... to... .1........ to.............. ... 00............ .... to.... 00 00.. .... x x 3. Old decedent own an 'In trust far' bank account ot hIs or her deatU...................................... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. .) ..~: -j' I" ' ',.. ' I ".. 1l!Y,1S0J ElC. 112'''1 , ~~ COMMONWfAlTH 01 PfNNIYlYANIA INHUI1'ANCf fAX ll!tUIN f1UIDtNT DECEDENT SCHEDULE A REAL ESTATE J ESTAilop FILE NUMBER Diane Goodall Bart 2195-0659 (P,op.rty lolnlly.own.d with RI,ht of Survlvorlhlp mUll b. dlldol.d on Sch.dul. FI AU ..01.1101. Ihould b. ..port.d at fair morhlvolu. which II d.fln.d 01 tho prlco at which prop.rty would b. oxchon,.d b.lw"n 0 wlllln, buy.. and a willing 1.11... n.lth.. b.ln, comp.lI.d to buy or ",U, both hovlnll ..aIGnabl. knowl.dg. of tho ..I.vanl fodl. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. All that certain piece or parcel of land situate in the Borough of New Cumberland, Cumberlend County, PA being the same premises which Clinton W. Hammond, widower, by his deed dated August 26, 1987 and recorded in Cumberland County Deed Book X, Vol. 32, Page 937, granted and conveyed unto Silas E. Bert and Diane G. Bert, his wife. The ssid Silas E. Bert having died February 15, 1993 whereupon title vested in Diane G. Bert, the decedent herain. The said property was sold to Joseph D. Holston, Jr. and Brenda F. Holston, his wife, on November 29, 1995. $123,900.00 .,,,uO'...I1.I7I SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploo.o Print Dr l' 0 . FILE NUMBER 2195-0659 ~ COMMONWfALTH O. 'INNSYLVANIA INHIIIlANCI TAX lININ IUIDINT DICIDINT ESTATE OF Diane Goodall Bert CAli p_fIy lolnllv--n.d wllh Ih. RI,hl ., S.nllvonhlp 10..1 h. dlscl...d .n Sch.d.l. ') VALUE AT DATE OF DEATH ITEM NUMBER DESCRIPTION 1. 1993 Chevrolet Lumina at blue book value $6,000.00 2. Miscellaneous personal property 1,000.00 S 7,000.00 tAHach additional''''" M 11" 0"""If ..... .poco 10 n....ocI.) 1IV.1JOflhI11.", , . COMMONWfAUH 0' PENNSYLVANIA INHUITANCf TAX RETURN kUIDfNT DfCfDINT SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE Of Diane Goodall Bert Join' l,nonl(ll. FILE NUMBER 2195-0659 NAME A. Ann E.' Sim ADDRESS 117 Rosemont Ave. New Cumberland, PA 17070 RELATIONSHIP TO DECEDENT daughter B. C. " JOlnlly-own,d properly. ITEM LmER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBE, JOINT MADE DESCRIPTION Of PROPERTY OF ASSET 'II> INT. DECEDENT'S INTEREST TENANT JOINT 1. A 3-23-9 Members First Federal Credit Union-Share Savings Acct. # 83418-00, Prine. $522.29, Interest $1. 22 $ 523.51 50% $ 261.76 2. A 3-23-9 Members First Federal Credit Union-Checking Acct. #83418-1 324.94 50% 162.47 3. A 3-23-9 Members First Federal Credit Union-Investment Savings Acct #83418-05, Prine. $15,382.30, Interest $47.22 15.429.52 50% 7,714.76 TOTAL (AI.o ,nlor on IIn, 6, RlCopllulollonl S 8,138.99 (II more 'pan i, n..d.d In,.rt additianal ,hula 01 ,am. tin) 'r ~~, ::;:; --5- i!i ~" ~ \i' -.t' ',,: ~~ ~, ",' ii SHARE SAVINGS ACCOUNT: Account NUIIlbu/Sutt.lx Date Opened Principal Balance at Date of Death Accrued Interoat to Date of Death Name of Joint Owner, if any Date Joint Ownerehip Created CHECKING ACCOUNTI Account Number/Suffix Data Opened PrinCipal Balance at Date of Death Accrued Interest to Date of Desth Name ot Joint Owner, ;f.[ any Data Joint Ownereh1p Creeted INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Det. Opened Principal Balance at Date of Death Accrued lntereat to Oats of Dosth Na=a of Joint Owner, if any Date Joint Ownerahip Created INDIVIDUAL RETIREMENT ACCOUNT; Accnunt Number/Suffix Dat" Op'lD~d PrinCipal Balance at Dato of Death Accrued Intoroet to Date of Daath Name of Benefic1ary KIltat. of --plANK G. BERT Data of DaaLh R-22-9S Soc1al Security No. 208-24-4973 Members~) FEDERAL CREDIT UNION 1 83418 -DO S-13-87 $S22.29 $1.22 An" E 81m 3-23-93 2 N/A 83418 -11 NIA 5-13-87 $324.94 $.00 APn E 81m 3-23-93 83418 -OS N/A 3-23-93 S15.382.30 $47.22 Ann I! S1m 3-23-93 83418 -10 MIA 4-27-93 $11. aa $.02 Ann E. 81m 11-1-9S In.. Cla1me Adm1nietrator DAte Title ~275 East Trlndlc Road e P.O. Box 40 . Mechanlc:sburg, I'cnnsylvanla 17055 · (717) 697-1161 i I. I- --~.__ ~~...".... .'.,"-';-.""'''.....-.<-~'_..'''''I....''''''''',...,''"~'''',.'':H,.''._'.''"_ 40-"- "..' --- uY.IIIO IX+ 17"1J . COMIffl~~fT~w.!IO/.Jlw:lw,rANIA IIlIDIHT DICIDIHT SCHEDULE "G" TRANSFERS UTATI O' Diane Goodall Bert PILI NUMBIR 2195-0659 THIIICHIDULI MUST BI COM'LITID AND "LID IPTHI ANIWIR TO ANY O'THI aUISTIONI ON THI RIVIDIIIDI O.THI COVII IHIIT II" IRM TOTAL VALUE DECD, DOLLAR VALUE D!!CRlPnON or 'RO'ERTY EXCLUSION I~ or DECEDENT'S NUMBER or ASSET INTER!!T 1. Members First Federal Credit Union-IRA Acct. 183418-10, Principal $11.88, Int. $.02 0 11.90 100% $ 11.90 2. Members First Federal Credit Union-IRA Cert. 183418-15 $5,052.84 5,052.84 $5.052.84 .' , TOTAL (Alto on'" on II.. 7. RocopItulatlonJ 5 5,064.74 III",.". 'p_ i. noedod In_ oddilionol.- 01._ sln,j IfY.Ul1 lh ('''1) B. A. C. 1. 2. 3. A. 5. 6. 7. 8. 9. -!i& COMMONWfALTH 0' P!NNSYlYANIA INHUITANCf TAX IUTUJtN lI!SIDfNT DfC!O!NT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI. a.. Print or Typ. B R 2195-065 DESCRIPTION Fun.rol Exp.n.... 1. Parthemore Funeral Home, Inc.-funeral expenses Food for funeral dinner Clothing for decedent Diane Goodall Bert ITEM NUMBER A. 2. 3. 1. Admlnl.tratlv. CO.t" Panonal Repre..ntatlvo Cammlulan. Nt A Social Security Numb.r of Penonal Repre.entatlve: Year Comml..lon. paid 2. Attorney Fee. Stone LsFaver & Stone 3. family Exemptlon Claimant N I A Relatlon.hlp Addre.. of Claimant at decedent'. death Street Addre.. City . Stale Zip Code Probate Fee. Letters Testamentary & short cert. ($273.00), filing Inheritance Tax Return & Inventory ($25.00) MI.c.llan.ou. Exp.n...: Cumberland Law Journal-adv. grant of letters The Patriot News Co.-adv. grant of letters Ann Sim-Reimb. on postage and for sale sign and misc. items Bowers Pest Control-services rendered at property U-Haul-moving expenses at property Settlement charges on property ($4.651.66 less reimb. on taxes and trash & sewer $941.07) PP&L-electric services at property PAWC-water services at property Bell Atlantic-telephone servicea at property TOTAL (AI.o enter on line 9, Recapltulatlon) (If mar. .pac. I. n..ded, In..rt additional .h..t. of .am. .1...) AMOUNT $ 8.217.40 335.18 156.48 7.055.00 298.00 40.00 66.34 75.77 35.00 55.14 3,710.59 531.13 106.05 250.84 S . 21,232.92 A. U,S. DEPARTMENT OF "OUSING AND unBAN DEVELOPMENt ~."":lhl.tt,,,w...~ T-Vjl,UllOII, l.uAH ";'~I~~.f..l,J._~t\ot,.", "t" - I- -- rllA J. ntllA I. __CONV. liNIN>. <. VA So X CONY, INS. . Robert E. Myers, Esquire ^. rill" Nllmt1f'r 11. l.nln Hum"', 271\14 II, MOIl,." Int, e." Nn. SETTLEMENT STATEMENT C. NOTE: 77111 ""m " /lImlJh,d In all" )YJII n "nl,mtnl "I ar,,,nl ""t,nrt", ram, Ammml.t mid III mltl '" "" ""',m",, n"nl tt" .hnll'n. '""" mn,*,J .(f.O.C.}-w,,, PtJld ",mid, th, clodn,: Ihty a" ,fu",.,. h,,, Inr Ittfl"mmlmrnl I''''PO"' and II" tlnll"r/,,,I,,II,, ,h, 111,,,11. D. NAME AND ADDRESS OF sonnOWEn: Joseph D. 110 I s ton, Jr., UremIa, t. 110 I s ton 1216 Capital Street, Harrisburg PA 17102 E. NAME. AODnESS AND TIN OF SELLEn: Anne Slm, Executrix of the Estate 117 RDsemont Avenue, New Cumberland PA 17070 F. NAME AND ADDRESS OF LENDER: HARRIS SAVINGS RANK Second and Pine Streets Harrisburg, PA 17101 G, PROPERlY LOCATION: 503 7th Street New Cumber'l and PA 17070 D p,,,,,,,rty Of Bontk:o. Roc""-'"d Robert Eo Myers, Esqu I re H, SEmEMENT ADENT: PLACE OF SETTLEMENT: 100 Old York Road New Cumberland, PA 17070 L SEnLEMENT DATE: 11-29-95 ~UMMARY10P;Dil ~S' ANS,l.C110Ni;lt'.~\l'. '1,' I\j~1tsUMM^IlY,'. o~ SBI.IJlR'S,:TRANSACTION~' l,iJit:,",;i.'" ' 100. GROSS AMOUNT DUB FROM nORR01VER: 4011. GROSS A"OUNT DUE TO SF.U.F.R: lOt. Cnnll"lCl lalel prke 171 onn;oo 401. Contract .alu flllee li!J,9UU.OU 102. Pmoo.1 r,oreny ~02. refsnnal prn(1tfl)' 103. Settlement chlrles In horrower(Unt UOII) 4.696.51 401. 104. 4111. 103. 40'. Acf/uJrmtll" for Iltm,- tJiJld "11t1l,,1,. odl'dnu Adj,urmtnll/tJr /tlnu pnld "1 "II" In Ddl'tlnn 106. Clly/lown lues 10 406. CII)'/lnwn IlIle. 10 107. Count)' Inel 11~29-9:! 10 UI-Ul-96 47.98 401. Counly IIIU 11-29-951001-01-96 47.98 108. Auusmenll 10 "08. ^I'tnmenll 10 109, TAX TO /-UI-96 Illll.111 409. lAX TO 7-01-96 882.14 110. 410. III. Trash: 11-29-95 to 01-01-96 lU.95 411. I rash: 11-29-95 to 01-01-96 lU.9:! 112. 412. 113. 413. 114. 414. 113. 413. 116, 416. 120. GROSS AMOUNT DUB FROM BORROWER .537.58 420. GROSS A~IOIJNT DUE ro SEUER .U7 ~ " Q, ,'l!YI!1RaHiBEllAlF"jQF.I!QRIlC?~lMW""" I Ii :.':gnl\H'iJ,'l 30(). "BEQUC170NSllIN:AAloum, D.UE: tp,SEUIi ~'\~,: , . ~.. q 201. DCf'Osh or eamell money 3, .00 301. Rltnl dc('(nllCIl' Im"u""""J Ul. '0 202. rrlnclo.1 omouol 01 new 10'0(') 99.100.00 ~02. ~clllemcnl el'lflel tn selJer(f/nt 14(0) 1.IlJ' .19 203. 1l001lIo,looo(.) I.ken .ublecl 10 303. 1l0l,11o,lo,o(l) I.keo .ubJecl 10 204. ~. ..... . IYV' ---480lMl14- SM. rlyurr nr nr.t mnl1..ae lOin 203. '0'. r.yorr (lr aecnnd nlOlll'la lOin 206. '06. Radon ReolOdlallon rcc I Ann nn \ ./ 207. '01. 208. '08. 209. 309. Atljl/'lm..1I lor Iltnu I/nJXI/d 61 "lItr Mjl/Jlm'nll lor Iltnu I/nJXIld 61 "II" 210. Clly/lown I.... 10 . '10. Clly/lown IIUS 10 ~Couoly I.... 10 , II. Cnunl)' lues In 212. AlleJlnlCnlJ 10 '11. Alltl'lmentl 10 213. m. 214. :leWer: - - to 11-t:9-!l:! 17.117 314. :.ewer :1U-1-95 to 11-29-95 1/.47 213. 313. 216. 316. 217. 317. 11'. JIB. 219. 319. roTAt rAm BY/FOR TOTAl. REOUcnON AMOUNT 220. BORROWER 102.617.47 320. DUB SELUR 12,351.66 I" ,\.,!olJ~~: ,JOO, :CASII'Ar..Stm't.1!MENT~VRO/olIl'O' ,1I0RRO"3~N ~,'i'f'.t.;,WJ"~, CCSII.:AT,.tETIUH . TO 0101. , I )~~'':'l'" 301. Ornll Imnunt due rrnm hormwe,(I/1I1 Un) 1: . (.,oI.O,nu ."'nullt due III aelle,ru", 410) . 30:Z. Le.. Imnunl. "skt bylfnr horrower(U", 220) 102.617.117 f'l(U. tell retlllcdnn. In amount due .ellerrllnt "0) ---rz . . , JOJ. CAS" ( X 26,920.11 6IIJ. cc.m ( X TO) ( FROMI SEIJ.F.R FROMI ( ro) BORROWER 112,489.41 TAXrAYr!J 'p!HT1rk"....,fON "IIMII'" KOUarATIONIII!U.r.. 'M"''''''''''' ....."""" Icftft ft. ":.r:' ,=,wh. t:i mmt "1:'" ....IIka..'......tort. It,...... "",We ',",1 ft. "'''''. r.... .kIl......""ttC1I1....", ...IAntlM......'.,....,..N+d.d..n ,..,.h "",,","'''' _. 1~""'.I--<<.)....."......ta.ldr...lfk......MMhnfl)h.,.".....hrlllll--.""'.........hrd.d...rr.Ir'nfWJ',1 UMrr ,.,-"'" rlf'"""'.1 CfltlfJ'..............,........ tN, 'LlMMftIII. IlIJ m'l'Il ''''''Jff .....'nn.IM........... -< ThI Wlll'__~"'''''' ft.O.II.I.""'" <<u I. ""'"'....'n War""......... h tor.... ,.."01,,.,.. tnlht 1..,M1"~ ~"k,. If,... It, ''''''''....1'''. ft"",... !'It,1I1"'1"' f'tN1tJ,. .."', lMtl.lCllll.m be ~ I'll "" If.Nt I..", h """".. '" N ,""""........,.. IU &....,.11... 111I1 It .... M ","II ,,,,,,,"d. Sill' .. . 'Di Ali SAUlSIDIlOkllR'S;o,COMMISSIONJa ' . >..;..;~,u 'j/~~;r::r..t.IJvi~1(:' ~ ....~ rM) I'ROM r^1/I "nOM 1/ rnlen S lit "w IU)RnOWI!R'S SI!I.I,ER'S ar Com,"luln" (line 700) II rnJlnwl: "llNIlS AT I'IJNIlS ^T In Sllnl.I!MIlN'r SRITI.I!MIlNT In ..llIlnn r.kl .. 5eulrmenl Bf)():,mtMS,~"AY-1But,>tN.(:ONl{tCl10N <IVml WAN M;'<.~I' ~1!' !. ,'..':U>'<~','4 ',,\f.!~~J."/r,.:'! ~h.!t"f~LVl<1J:f~1!iJ1 ~-~:~:1~'~ .tt~':,~::A~";~'. fl. .' , -'- 1..01" Orlllolllon Pre " I, l..nln IlIsc:olln' " dl, Arrlll,,1 r.. In 1M, Cndll R.pnn In 10', 1.0...,,', In......llon Pre In 106, Mon.... Insllrlnte Arrllc:,llnn (fee 10 I I 107, Allumlllon Pee 10 101. :ierv Ice Charge to IlARRIS SAVI~G~ OAN~ m~:~~E 1.982.00 109. 11001 Icatlon Fee to HARRIS SAVINGS 07\ K , 110, III. m. 113. 114, ~~9/lO.1mtM~IllED"IlI',~roS6'r"AID'^, ..wVANCS~~I~~~ ' , dJ:q:'~lil'~~" , ..~ ~lh.:.t",L;7'Wki\"'!""'~"" . . ~ . I' - , ' " .~ t, ...J 901. In"'''1 rrom . ~In 12- .950 S .27 Id.y (2 . d.y.) .511 901. Mnnllle Insunnce rremlum (or months In 903. nlUN Inlunnee rRmlum tnr I vur 10 IlST YEARI 904. ~ ; 1/1011J, tJl :.i'./JSf'Mtrtl1., LEMlER 1.,)'I~.'lI,il,li:\ ;l.!./.i!:';',' r~J,:,~\'j,',t." '';;:;U;:,~.''-l}jli' "". ,,~,:,~~'~,k; ,:r:.,' 1001. limn! Insuflne. months 4>> S ~r monlh 1002. Mnn.,.. Insurance mnnlhs " S per monlh 1003. CIIy r..reny I.... nlonlhl fit S oer month 1004. Cnun.y p'.....My I.... monlhs 0 S 'PO. mon.h 100.5. AMUII .,sellmenll monlh. 0 S ---.,er n1nnlh 1006. nlnnlhl 0 S -r;, month 1007. mon.h. ~ S rer nlonlh Wreg;tIO EscrcW Soloock-ooo allncinIlnlllal oscrOll' nc,;-I. . 695.71 sbnl. " . 'HODl; 't1tARC1/1S, ',' ' ,..,\,' .. ,e '. ,.~'\ ..'~ !1l'.i'J""::llI.J.ul"'" .,. . "I,~,.I~}'''''J';''~i..t-l'-:;\. 1!1l~Ilt.L'':'\ 'l.h.I;~,- 1101. Sentemenl or closlnl ree to 1102. AhslrlCI or tllle lurch I. 1103. Till. .umlnlllon I. 1104. Till. ,",uflne. hlnd.r I. 110'. Documenl n""lItlon I. 3:;:QQ: 1106. NolllV r.. In (;ASH 6.00 1107. AllOmey', r.. 10 Slone Lafavor & Slone (rocl (tndudtl abovt lunu numb,,,: } 1108, Tltl. In.ullne. I. ROOERT Eo HYERS. ESlJ. 655.20 (lncludtl Dbol" tlrnu numbtn: I 1109. Lender', cnvenlO S 99:1nn.nn 1110. Owner', cover-lie S 123 900.00 1111. DI:iBUK:iEMENT FEE to ROBERT E. MYERS. ESO. . I 1112. TI tIe Insurance Endorsements to Robert E. Hvers. ESQufre 5U.UU 1113. ~~JJj,"~rl'(I' 1~~jiiI1OD'~' IIEN1'j~MI:ORJJIN(J ,AND. 77t4NSfER . CI/ARGES :;;JjiiMl; ',ill! [Jl:,~<~;:':,~t.:; .,"',,;,'lJ.~,:"" '! , "~ ' ~, ~. '..' i 1201. R..onlln. 1m, De.d S 12.00 , Mort.... S TII. 00 : Rclcue S . 1202. CI'Y'COUnIY 1..,.I,nlnll Deed S 1239.00 : MoM,", S 1.239.00 1203. SlI" 1..,.I,mot D..d S 1239.00 : Mort.... S I.. . n04. '. no,. I' 1;':.!rJi~i\l.!l.~~_' ~I" ~WlO/' 0' ,CIIARGES!l'i~ " .~,~( ; 't . ..,t :~ " 1301. Trash Oct..Noy..Dec.) to 8orough 0 New um er an . 1302. . JUI '.AulI..:ieDt.T to 8oroufh of New Cumberland . 1303. Schoo tax (Penalty) to Rob' n-r.asrierlttl 1.64 . 1304. (;ount '/BoroulIh tax (Pena ltvl to Roh n Gasp'erlt t 1 . 130'. ermlte lnSDectfon to Rowers Pest Contro . 1306. Root/ChImneY reDafrs to Ralnh Fenstermac er 225.01 1307. Innerl tance tax Dayment to Real s ter of W lIs 5.000.00 1301. /4110, roTAI. SFT7lF.A/ENT CIIARGES (,,,,,r "" II"" InJ. Stet/nit J .,,,If '01. .f",I",. KI 11.696.51 8.834.19 1~''''''''''''lIIm'l ......... _ ............,......_...... ......,..,...._... _... ....- ...11'....... ..........._... __ M...__ ...._..... I .... I "~"' dwt f.... ,,"I'"' . 'j' '" lIunl If"~ !ltItf--... , . J1 D I ~ fit -- -', ~ , I, .:.~nn; ~.~' :~~e~ ..'uo, ....~ ";'" lIoTiTp, r;-=:: &,.dt' r.n ~' . lI.to ."--- Oil". , ;~~1Il~, . III~' ~... ."ll t .. C"f1*t. I, IlnIt ............. IIrtftlIIl '" 1M r-h _"'. _ft. I'n"~ .M ..... ,,"It .. _In... ",....... ..,.... _,"...... ",..1 ...,hI"" ~1 ~" -- ''Jf..../J - - ., RD"l'~.r,r.;/' "yorl, .!.''1,,!ofro WAIt~INOI I II' n_ .., ....1Ilt" eN" .... 1""'_'" '" ""' ......1P4 ~I~'" .... ,WI ,. .'" ",,,," elMIIM ,....., r.,.1l1t1 "'"' ,_In''''' ".. ....htdr . n", ..... 1......1'.-.... ,.. *..111 1ft: Tld. II 11.1. C~ lWtkwll 1001 ..... !WI,"" InlO. 1I\l.11I2Ih('.1I1 t!~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L1ABLlTIES AND LIENS PI.a.. Print ar T p. FILE NUMBER 2195-0659 COMMONWIALIH 01 PlNNInY4NIA INHllIIANCIU.IUl\,1IN IUIDINIOIClOIHI ESTATE OF Diane Goodall Bert ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. DESCRIPTION AMOUNT AMOCO-credit card 0476-721-890-4 $ 192.47 344.44 QVC-Q Card 005-4039-838260-2 Montgomery Ward-credit card #12408910477 1,163.11 GE C1assis Visa Card 05441-3100-0162-1613 1,875.63 JC Penny-credit card 0087-122-131-3 103.05 Services Corp.-ambulance service 220.00 American Express-credit card 03720-494682-81008 621.07 533.17 Lane Bryant-credit card Ford CitiBank-credit csrd 3,216.06 1,028.40 Bon Ton-credit card e TOTAL (Allo onto, on IIno 10, Rocopitulotlon) (If more space is n..ded, in,.rt addiliona/,h..tI 01 sam. sin.) $ 9,297.40 'I~ lSlJU.IU7J ~ COMMONWIAUH 0' ,fNN"lYANIA INHII""NCI '''XlIJUIN InlDINT DICIDIN' SCHEDULE J BENEFICIARIES ESTATE OF Diane Goodall Bert FILE NUMBER 2195-0659 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxabl. B'l.JU."11 1, Ross E. Gahagan ssU 169-44-5495 602 Lavina Drive, Mechanicsburg, PA 17055 friend $2,000.00 2. Anne Sim SSU591-01-2512 117 Rosemont Ave., New Cumberland, PA 17070 daughter $20,000.00, car valued at $6,000 1/5 of pers. pro' 3. Thomas Sim SSU 205-50-2100 P.O. Box 2000, Unit 3A, Whitedeer, PA 17887 son 1/5 of pers. prol & $20,000.00 ITF by Anne Sim 4. Patrick Sim SSU 182-52-6109 13944 Rock Creek Rd., Paway, CA 92064 son 5. Michael Sim SSU 207-44-5877 110 North 20th Street, Camp Hill, PA 17011 son 6. Bradley Bert 422 Poplar Ave., New Cumberland, PA 17070 step-son 1/5 pers. prop. 1/5 pers. prop. 1/5 pers. prop. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charllobl. and Governm.ntal B.quIIIs: 1. N/A TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AIID enler Dn IIn. 13, RocDpllulallDn) S (If more .pac. f, n..d.d, Inllrt additional ,b..t, of .am. ,II.) SCHEDULE "J" CONT BENEFICIARIES ESTATE OF Diane Goodall Bert ITEM NUMBER NAME & ADDRESS OF BENEFICIARY FILE NO. 2195-0659 AMOUNT OR RELATIONSHIP SHARE OF EST 7. 8. 9. 10. Mr. and Mrs. Bradley Bert 422 Poplar Ave., New Cumberland, ITF Danielle Bert ITF Becki Bert ITF Rose Bert ITF Thea Bert PA 17070 granddaughter II If II II II II 11. 12. Mr. and Mrs. Michael Sim 110 North 20th Street, Camp Hill, PA 17011 ITF Gregory Sim SS#178-64-5485 grandson ITF Christine Sim granddaughter SS# 203-66-5327 13. 14. Mr. and Mrs. Patrick Sim 13944 Rock Creek Road, paway, CA 92064 ITF,Kelsey Sim SS#179-70-1613 granddaughter ITF Courtney Sim "" SS# 197-72-6873 1/7 res. 1/7 res. 1/14 res 1/14 res 1/7 res. 1/7 res. 1/7 res. 1/7 res. AT ronNt.y~ At i..(,W LAST WILL AND TESTAMENT OF DIANE GOODALL BERT I, DIANE GOODALL BERT, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I hereby give and bequeath the sum of Twenty Thousand ($20,000.00) Dollars unto my daughter, ANNE SIM. ITEM II: I hereby give and bequeath the sum of Two Thousand ($2,000.00) Dollars unto ROSS E. GAHAGAN, who is and has been like a son to me. ITEM IIII I hereby give and bequeath my 1993 Chevrolet Lumina unto my daughter, ANNE SIM. ITEM IVI I bequeath my tangible personal property not hers in otherwise specifically bequeathed in equal shares to my then living children and step-son, BRADLEY BERT, to be divided among them by my Executrix, in her sole and absolute discretion, in as nearly equal portions as may be practical having due regard to the porsonal prefer- ences of my then living children and step-son, BRADLEY BERT. ITEM V: I direct my Executrix to sell all my real property situate at 503 Seventh Street, New Cumberland, Cumberland County, Pennsylvania, with the net proceeds of such sale to be added to ths residue of my estate and distributed under Item VI of this my Last Will and Testament. Page 1 of 7 . ITEM VI: I devise and bequeath the residue of my estate of whatever nature and wherever situate as follows: A. Twenty Thousand ($20,000.00) Dollars to be held IN TRUST by my daughter, ANNE SIM, as Trustee for the following uses and purposes: 1. To pay the net income of said trust to or for the benefit of my son, THOMAS SIM, for his life in such periodic install- ments as my Trustee shall find convenient, but at least as often as annually. 2. To distribute to or for the benefit of my son, THOMAS SIM so much principal as my Trustee shall deem advisable for the health, maintenance and support of my son, THOMAS SIM. 3. If my son, THOMAS SIM, should not survive long enough to exhaust the funds held in trust, or should my son, THOMAS SIM, be committed to a federal or state penal institution, the balance then held in further trust shall be distributed to the issue of my son, THOMAS SIM, then surviving, per stirpes. If my son, THOMAS SIM, should not have any surviving issue, the balance then held in further trust shall be divided equally among my then surviving children and my step-son, BRADLEY BERT. B. The balance of the residue of my estate shall be divided and distributed as follows to the Trustee hereinafter named to be held IN TRUST for the benefit of my following named grandchildren: one- seventh (1/7) to DANIELLE BERT, one-seventh (1/7) to BECKI BERT, one- seventh (1/7) to GREGORY SIM, one-seventh (1/7) to CHRISTINE SIM, one- Page 2 of 7 seventh (1/7) to KELSEY SIM, one-seventh (1/7) to COURTNEY SIM, one- fourteenth (1/14) to ROSE BERT and one-fourteenth (1/14) to THEA BERT. The trusts herein created in this Item VI.B. shall be used for the following purposes: 1. To expend and apply so much of the net income and principal of the trust as the Trustee shall, in the Trustee's sole discretion, deem advisable for the beneficiaries' education (including college education, trade school and graduate school). 2. When the child reaches the age of twenty-five (25) years, he or she may, upon written demand to the Trustee, withdraw the entire remaining balance of the trust principal and accumulated and undistributed income. 3. Should a child die before receiving the entire balance of the trust, the trust shall terminate and the principal and accumulated income shall be paid to the then living issue of said child, per stirpes. Should the child die leaving no issue, the principal and accumulated income shall be paid to the parents of such child, if living, and in default thereof shall be distributed in equal shares to the then living children of mine and my step-son, BRADLEY BERT. ITEM VII: Subject to my desires set forth in Item VIII below, I appoint the parents of any minor child who may take a share under this will guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, Page 3 of 7 provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time solely for the minor's education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes. ITEM VIII: I appoint the parents of any beneficiary as Co- Trustees of any trust created under this Last will and Testament for such beneficiary provided, however, that BRADLEY BERT and MARTHA BERT shall act as Co-Trustees for any trusts created under this my Last will and Testament for the benefit of ROSE BERT. ITEM IX: The interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM X: I appoint my daughter, ANNE SIM, Executrix of this my last will. Should my daughter, ANNE SIM, fail to qualify or cease to act as Executrix, I appoint my son, MICHAEL SIM, Executor of this my last will. ITEM XI: For purposes of this my Last Will and Testament, my children shall include ANNE SIM, THOMAS SIM, PATRICK SIM and MICHAEL SIM. I have made no provision in this my Last Will and Testament for my step-son, CHRISTIAN BERT, as I have provided adequately for him during my lifetime. Page 4 of 7 ITEM XII: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. III WITNESS WHEREOF, i .""...~ hand and seal th e L I, DIANE GOODALL BERT, have hereunto set my day of (lu" " . , , 1995. ;i / ,;' r ,,! , . " ('; . J', ,'" , ~.."t:/.' I v:::!..-_ DIANE GOODALL BERT SIGHED, SEALED, PUBLISHED and DECLARED by DIANE GOODALL BERT, the Testatrix above named, as and for her Last will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. ..a;o ~.{/?l(a~p Witness [/ ~:,v {~r;~4r-/ /iL Address \-d:/' (v1 ( at ~', wl;tn ss , " I ~, '.' h"'f // ( .. v , l' 'Y..,JI.k J, / tt. 4(~~ . :.t. /) \'.1 ," ....:; .~." / .. I .. " Address , 'oJ "... " ,,.. . I Page 5 of 7 COMMONWEALTH OF PENNSYLVANIA: :55: COUNTY OF CUMBERLAND I, DIANE GOODALL BERT, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I siglled it as my free and voluntary act for the purposes therein contained. "ei' /2 /, "-t.- '-t..1..'Lf' ,~,~ A II ( f A L.L " DIANE GOODALL BERT Sworn to or affirmed to and acknowledged before me by DIANE '7 ~ day of ~,,_ ~L- >f~f, Notary Public , GOODALL BERT, the Testatrix, this 1995. NOTARIAL SEAL r.O'i'.'" 'C l l"nLI ",. r, II . . ,Ir-' ;..1,.; . v', . .,owry U I r.: Ih,'1 l., 1..,~cfidnJ.I'A CUit1~CIl~IIIII;I:-' My Cun.ii.i~sloll explro. ~jJrll13. 1009 COMMONWEALTH OF PENNSYLVANIA : :55: COUNTY OF CUMBERLAND we,.~~'fl'~dtz~ and the witnesses whOse names are signed to ;(:.. ,,' ~A/') _1,:-, . ; ~ Co d ,'/ . I /j. the. attached or for,ego1ng , instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as Page 6 of 7 -- -,.- --~. '., -.... ~------------------------------------------------ '*' RECEIVED FROM, f3 ACN ASSESSMENT P:' CONTROL I:iI NUMBER AMOUNT SHEKLETSKI, GERALD J., ESQ. STONE, LAFAVER & STONE P. O. BOX E NEW CUMBERLAND, PA 17070 Iv1 .1,..,..,....&+1 '~DHr" ESTATE INfORMATION. !'I fiLE NUMBER ~ 21-19915-06159 I!:'I NAME Of DECEDENT ILASTI ~ BERT DIANE GOODALL II DATE Of PAYMENT m POSTMAR E COUNTY SSN 20S-e4-4973 IflRSTI (Mil NO DATE Of DEATH REGISTER OF WILLS m TOTAL AMOUNT PAID .1 .994 .41 VZ RECEIVED ByC}rl,(l~1t ~ . /~U'U'1 IJM./ . \ "GHtlhi I. " J; MARY C. LEWIS Ill$-o-vj)r 'J- REGISTER OF WILLS q REMARKS ANNE SIM SEAL CHECK" 14 ;.~~<~,~._--:,-:-_.-;'""--:,____.__-___~-:""'~~._~._________ -------T";---X------ ~. .J;. ~ . .f .....-- -.' .._-" ~.- ~ - ...~ .....~. I I , 1 " --;.- r .. ..-~ ,} /..; - (5:> - f? R!V-1547 EX AFP (12-95* to""OHWUL 1H OF PENNSYLVANIA DEPAAfHEHr OF R(V[NIJ( ftUREAU OF IHDIVIDUAL TAMES D[PT. 210601 HARRISBURG, PA 17UI-OUl '\ \,/ ACN 101 NOTICE Of INNERITANCE TAK APPRAISEHENT. ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AND ASSESSHENT Of TAK DATE 04-15-96 FILE NO. DATE 08-22-95 COUNTY CUMBERLAND HOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT THE UPPER PORTION Of THIS fORH WITH YOUR TAK PAYHEHT TO THE REOISTER Of WillS. HAKE CHECK PAYABLE TO "REOISTER Of WILLS. AGENT" REMIT PAYMENT TO: GERALD J SHEKlETSKI ESQ STONE ETAL PO BOX E NEW CUMBERLAND PA 17070 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 Aaaunt R..Ht.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ riEV:isW-Eif-AFP--n2':9!;"j-iiii'ficE--ciF""{NHEiiii'iiiici-TAX-iipPR'AisEHEii'i'-;-AL'LOWANci-b-Iiou-------- - ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BERT DIANE G FILE NO. 21 95-0659 ACN 101 DATE 04-15-96 TAK RETURN WAS. I X) ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.d Eotot. CSch.dule A) Il) 2. Stock. and Bond a ISchedule B) (2) 5. Clos.ly Held Stock/Pertnerahlp Int.r..t (Schedule C) (5) ~. Hcrto_a/Hot.a R"".lvllble (Schedul. D) I~) S. C.ahl8~ Oapoltta'Hllc. par.on.l Property (Sch.dule EJ (5) 6. Jolnt1~ Owned Prcp.rt~ ISchedu1. f) (6) 7. Tranlfarl (Schedul. Q) (7) ... Tat.l A...t. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Exp.n.D./A~. Coata/Hila. Expens.. (Sch.dul. HJ 10. o.bt./~rtD.V. Llabl11tl../Llana (Schadul. I) 11. Tot.l Deduotlon. 12. Net Value of r.. Return 15. Cheritabl./Govern.ent.l Beque.t. ISchedul. J) 1~. Hat Value of Eat.t. Subjact to T.. NOTEI 11 an a..a....nt was 1..u.d pr.v1ou.ly, 11n.. ra11.ct 11gur.. that include the total 01 ALL ASSESSMENT OF TAXI 15. A.aunt of Lin. 14 .t Spou..l rat. 115) 16. Aaount of Lin. 14 t.xabl. .t Line.1/Cl... A r.t. (16) 17. Aaount of Lin. 14 t.xabl. .t Coll.t.ral/CI... B r.t. (17) 18. Prinaip.l re. au. TAX CREDITS: PAYHEHT DATE 11-30-95 12-21-95 (9) UOI RECEIPT HUHBER AA082359 AA082432 DISCOUNT I') INTEREST (-) .00 .00 ) CHANGED 123.900.00 .00 .00 .00 7.000.00 8.138.99 5.064.74 IB) 144.103.73 21.232.92 9.297.40 Ill) (2) US) U~) 14, 15 and/or 16, 17 and 18 will return. a..e..ed to date. 30.1;30 3? 113,573.41 .00 113,573.41 .00 K .00_ 111.573.41 K .06_ 2.000.00 K .15. UB) .00 6.694.41 300.00 6.994.41 AHOUHT PAID 5,000.00 1,994.41 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE . If PAID AfTER DATE INDICATED. SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. 6,994.41 .00 .00 .00 If TOTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS.) g~ ~ :1]~ 3 ";'. ,~ 0 0" .~'- ~I! I') ;a '.'.. () t: .. '1.' l'tl .' ... it. L:;"'i -- 00 N _0.- ;l \,," .";",,' f"l ~J ;f.l ~ro :Ug 0 iff a 1'" )>;::. "" RESERVATION I hb... 0' dM:Henh Iblng on Dr bafor. DHHb.,. 11, .'11 -- If MY future lnt.r..t In .t. ..tat. h tn"".rr" In po.....lon or enJov-.nt to CI,.. . (call",ral) beneflclarl.. of the dec~t .'t,r t~ ..p.ta'lon of MY 'Itat. for Uf. or for ya.r., the C~lth htI,...,,, IICPt...b r...rv.. the rIght to 1aPP"'''' Md ...... 'r.",flr Inheritance h... at the l.wful Cia,. . (collat.r,l) r.t. on MY .uch future 1"I.r..t. PIJRPCIU Ill' NOTICE I To ,uHUl the r...lr....t. of Section 2140 of the Inher1t-.M:I WId ht,t_ TI. Act, Act Z2 of 1991. 7l P.I. SeclUon 214D. PAYHEHTI DetKh tM top portion of thl, Hath:. Md .UbIIlt with Your PlY"'" to the A",ht.,. 0' Wllh pr!nhtd on tM rav.r,. .Ide. u",*, check 0,. ....y orde,. pa".tIle tal REGISTER OF MILLS, AGENT All p.,..,.. recallfed shlill ,Int b. epplJ'" to MY lnt.,...t whIch Ny M dull with ..,y ,....,.,. -..l1K to the t... Rf:~D (CR). A nflnt of a tax crlldlt, which .,.. nat requ..t~ on the Ta. R.turn, .ay be r.....tMt by cOllPlaUng In "Appl1caUan far A.hrId of P.....ylv.nl. Inharltanca and Eltat. Tall" (REV-UU). Application. .r. avail_I. at the Offlca of the Aaglst.r of Willi, any of the 23 R.v~ Ol.trlat Offlc.., or by cllllna the spaol.l 24-haur an....rlng .arvlc. nuaber. 'or 'or.. ord.rlngl In Penn.ylvanl. 1-8aO-36Z-Z050, aut.ld. P~.ylvlnla and within local Harrl.burg .r.. (717) 787-8094, TOOl (717) 772-225Z (H.arlng lap.lr~ Onlyl. OIJECTlONS. Any p.rb' In Int.r..t not ..thf1ad .,Ith the appr....-nt, aUowanca or dl..llONanca of Ehtduatlonl. or ...........t of t.x (Including dl.count or Int.r..t) .. .hown on thl. Hatlc. au.t obJ.ct within .I.ty (60) d.y. of recalpt of thh Notlc. bYI AOft!N IITAATlVE COAA(CTJOHS. --wrlttan prat..t to the PA O.p.rt..nt of A.venu., Board 0' A~ah, Dept. Z110Zl, H.rr!lburg, PA l7UI-IOl1, OR u.htctlan to have the ..tt.r d.t.r.lnlKt at audit af the .ccount of the p.r.on.1 rapr....,t.tiv., OR .........1 to the Or,..,.' Caurt. INTEREST. 'Htu.l arrar. dhcov.red on thh ........"t .hould b. addr...ad In .,rltlng tal PA D.,.rt.~t a' A.venua, Iura.. af Indlvldu.l Ta..., ATTNI Pa.t A.......,t A.vl... Unit, Dept. Zl06D1, H.rr..burg, PA 17Ua-0601 PhoN (717) 787-6505. S.. peo- 1 af the book..t "In.tructlon. 'or Inherltanc. TIM Aaturn far. A..ld.,..t Decadent" (REY-ISOI) lar an .Ilpl~tlon 01 .dalnl.tr.tlv.ly carr.ct.bla .rror.. If eny hx dUe II paid within thr.a UJ calend.r aonth. aft.r the d.cadent'. d..th, . flv. p.rcent (5~O dllcount 01 the taJl p.ld Is .llowed. Int.r..t ia charged baalnnlng .,Ith Ilr.t d.y of dallnquency, or nlns (9) ~th. and ~ II) d.y fr~ the data of de8th, to the d.ta of p.YHnt. Tan. which bee... cMUnquent bafar. JanullrY 1, 1912 ba.r Int.r.at at the r.t. of .ix (6XI pa:rc....t pa:r ........... calculated at a d.Uy rat. of ,000164, All tall.. which bec... dellnquant an end .ftar Janu.ry 1, 1912 .,111 bear Int.r..t .t . r.t. which will vary fra c.lendar y..r to c.Jandar y..r with that nt. announced by the PA Dap.rt-.nt of R.venue. Th. appllc~l. Int.r..t r.t.. far 1911 through 1996 .r., DISCOlItTl !!!! Int.r." R.te Dally Intar..t F.ctor !!!r Int.r..t Aa" a.11v Int.r..t Feotar 1912 'U .OODM8 1917 .. ,000247 I9IS lOX .000411 J'14-1991 lIX .DOasOI 1'" lIX .000sal 199. 'X .000247 1915 UX .000S56 1995-1994 ]X .ODOI9Z 1986 lU .000274 1995-1996 'X ,ODDZ47 --Int.r..t I. c.lcul.ted .. follow.. IIlTEREBT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINqUEHT X DAILY IIlTEREST FACTOR --Any NoUc. Issued .fhr the hJl bee... dallnquent will r.flect an Int.r..t ulcul.Uan to flft.." liS) day. b.Vond t~ data of tha .......ant. If p.v-.nt I. aad. aft.r the Intar..t coaputatlon date .hawn on tha NoUe., additional Int.r..t .,.t be ulcul.tad. .... ~. .... -".' ..~, . " - , ~--------------_._-------------------------------- '! ~1i~~~~~~~9!;;:A~MM!'r:..~~~Mt.~:YLVANIA l;'~li~i;,,;:;;,.':;;;: i iO~F1C'AL RECEIPI' · P~NNSYLVANIA INHERITANCE AND ESTATE TAX *' j' r!, . RECEIVED FROM, & ACN ASSESSMENT Il' CONTROL Il:I NUMBER AMOUNT SHEKLETSKI GERALD J ESQUIRE STONE LAFAVER & STONE 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 101 .~.ooo.oo ~'OCOH'" 'OlOHII, SSN e09-e4-4973 (fiRST) (Mil REMARKS JERRY SHEKLETSKI ESQUIRE m TOTAL AMOUNT PAID -e,ooo.oo VZ RECEIVED BY JJIII'I..." (, cX;< ".,;.y , ' . IJ (./ SIGNAJURI: '. ,_ /. MARY C. LEWIS ...! 1".".I"/,)/ REGISTER OF WILLS SEAL CHECK" eoee REGISTER OF WILLS -_......_---------------------------------------~----- ....- ,. )....-.... --..- - --.-;-- ," . , . , " " -t' ..;: , " I ~. . , " -, ~ \' ~, t 'f "-- , r.....".,...-... to. - " .-,..':- ...-.--...1 r . , .. r ' \. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I, I , u: Ann(! Him bolng duly ~orn according 10 low, doposos and says Ihots he ~a .he "Ye~""~~v__ 0' tho Estate 0' Diane Goodall Bert 1010 0' _BoIoug!1_of l-!e_w_ f!1mberl,and,,_ _______ , Cumberland County, Po., decoosed and thot the within Is on invontory modo by Anne Sim " the soid Executrix 0' Ihe entir. eslote 0' soid docedenl, consisting 0' all tho persona' prop.rly and rool estate, except rool estoto ouhlde the Commonwoolth 0' Ponnsylvonio, and that the figuros opposite each Itom 0' the Inventory reprosont it's fair value os 0' tho do to 0' docedonl's death. 19 ., ). {(,~- S:;:~, Anne 8im EucutDflo . AMH~"", rix Sworn and subscrlbod be'ore me, 117 Rosemont Ave. New Cumberland. PA 17070 Add,... Dole of Ooolh 22 DB 1995 O.Y Month Vu, INSTRUCTIONS J. An Invenlory must be flied wilhln three months after oppolnlment of personel reprosentotlve. 2. A supplemont Inventory musl be filed within thirty deys of discovery of additlonol assets. 3. Additlonal sheets may be attached os to personally or realty 4. See Article IV, Fiduciaries Act of J 949. "tl " I1l .... " 011 .,; ~ w il D " ~ ~ ~ u .. '" w " 0. :t u '" 0 1%1 " D '" 0 C '" >- c W IX W j .. D I .... J: 0. ;::j .; 0. c ... ...J Ll. ~ '" Z 0 '" Ll. ..J ~ 0 III 0. ~ .... W 0 < 'tl ,;. N > Z '" 0 - c Z 0 0 GI " .; - VI Z <.:>' 0 Z I IX < 011' U ... W 0. ~ "1 -a c ..... .. i '" - 0: 0 " ..0 ... :i " e - 0 ~ " 0 U lZl . I ./ : Inventory of the real and personal estate of '. Diane Goodall Bert doceased PERSONAl. PROPERTY 1. 1993 Chevrolet Lumina at blue book value $6.000 00 2. Miscellaneous personal property 1,000 00 TOTAL PERSONAL PROPERTY $7,000 00 REAL PROPERTY All thst certain piece or parcel of land situate in the Borough of New Cumberland. Cumberland County. PA being the same premises which Clinton W. Hammond, widower, b hie deed dated August 26, 1987 and recorded in Cumberland County Deed Book X. Vol. 32. Page 937, granted and conveyed unto Silas E. Bert and Diane G. Bert, his wife. The said Silas E. Bert having died February 15. 1993 whereupon title vested in Diane G. Bert, the decedent herein. The said property was sold to Joseph D. Holston, Jr. and Brenda F. Holston. his wife, on November 29, 1995 123.900 00 TOTAL PERSONAL PROPERTY $ 7,000.00 TOTAL REAL PROPERTY 123,900.00 TOTAL $130,900.00 \/t [ unD '10 02:: () \, l z~r:J (:0;. -".1 fj -U I r' STATUS REPORT UNDER RULE 6.12 Name of Decedent: Dianne Goodall Bert Date of Death: August 22, 1995 Will No. 21-95-0659 To the Register: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. Yes -X-- State whether administration of the estate is complete: No_ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes _ No X (b) The separate Orphans' Court No. (if any) for the personal representative's account is: N/A (c) Did the personal representative state an account informally to the parties in interest? Yes --X- No - (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court a~d may e attached to this report. .r/.;/If~ . .' , Vd "08 Q\:"iJi)qlun~ Gerald S ekletsk , Esq. \.lnorj ", :IJal~ 414 Br ge Street . New Cumberland, PA 17070 717-774-7435 Date: 80: 6V IZ AVl-I 96, Capacity: s\l!l'~ ie, liminal:! )0 n:>I;:', ;'1"OJ009l:! X Personal Representative Counsel for Personal Representative ~~~..~ ~N-'""'-'_:t-..,;/O~,,~;l"''''.';''_~''"'''-''''_;i;,~'''''''~i''j;l,~---'~-''~'.".. . '\ ' V e