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COMMONWEALTH OF PENNSYLVANIA.. DEPARTMENT OF HEALTH. VITAL AECORDS
CERTIFICATE OF DEATH
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not qualify, or not accept the p05ition of Executor, then I
hereby nominate, constitute and appoint STANLEY BEDNARCHIK as
Executor in her place.
v.
My Executor shall have the following powers in addition
to those conferred by law until all property i5 di5tributed:
(a) To retain any real or personal property
in the form received and to sell it at public or private
sale.
(b) To manage real estate.
(c) To purchase all forms of property without
being confined to so-called legal investments and
without regard for the principle of diversification.
(d) To exercise any option or rights arising
from ownership of investments.
(e) To compromise claims without order of
court or consent of any legatee.
(f) To distribute in cash or in kind.
(g) To employ accountants, agents, investment
counsel, brokers, bank or trust company to perform
services for and at the expense of my estate and to
carry or register investments in the name of the nominee
of such agent, broker, bank or trust company. The
expenses and charges for such services shall be charged
against principal or income or partly against each as my
Executor may determine. My executor is expressly
relieved of any liability or responsibility whatsoever
for any act or failure to act by, or for following the
advice of, such accountants, agents, investment counsel,
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brokers, bank or trust company, so long as my Executor
exercises due care in their selection. The fact that an
Executor may be a member, shareholder or employee of any
accounting, investment or brokerage firm, agent, or bank
or trust company so employed shall not be deemed a
conflict of interest. Any compensation paid pursuant to
this subparagraph shall not affect in any manner the
amount of or the right of my Executor to receive
commissions as a fiduciary.
VI.
I direct that my Executor shall not be required to post
bond for the faithful performance of his duties in any
jurisdiction.
VII.
I direct my Executor to pay all inheritance, estate,
succession and legacy taxes of whatsoever nature and kind, to
which my Estate or the transfer of any property passing hereunder
or otherwise passing by reason of my demise, may be subject and
to charge such taxes against my residuary estate, it being my
intention that none of the aforesaid taxes, either federal or
state, or any property required to be included in my gross
estate, under the provisions of any state or federal law now in
force or hereafter enacted, shall be prorated among the persons
interested in my Estate to whom such property is or may be
transferred or to whom any benefit accrues.
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du~EAU OF INDIVIDUAL TAKES
lNtl[RUANC[ 'AI( DIVISION
DEP'. :aObOI
IlARRISBUAG, PA 11I;'I"QbOI
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COMHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(y
NOTICE OF INItERITANCE TAK
APPRAISEHENT. ALLOWANC[ OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAK
"'-lhl" ", Ill-h.
JOANNE M MCGREEVY
137 S WEST ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
02-03-97
BEDNARCHIK
09-16-96
21 96-0941
CUMBERLAND
101
ALBERTA
z
A.,ount Re"itt.d
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifiY:is'4i"EX-"Fji-n'Fij&Y-NOTicEnOF-YNHEiiii'AN-CE-TA'i("'A-ppiiiiisEHENT-,--"Ll-owAiicE-iili---n-------m--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BEDNARCHIK ALBERTA Z FILE NO. 21 96-0941 ACN 101 DATE 02-03-97
TAK RETURN WAS, I X 1 ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
L Real Estate ISchedule A) Cl)
2. Stocks and Bonds CSchedule 8) (2)
3. Closely Held stock/Partnership Interest CSchedule C) (3)
4. Hortg.ges/Notes Receivable (Schedule D) (4)
~. Cash/Bank Oeposits/Hisc. Personal Property CSchedule E) (5)
6. Jointly Owned Property CSchedule fJ 1&1
7. Transfers ISchedul. G) (7)
8. Total Assets
) CItANGED
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this form with your
tax paynent.
.00
.00
.00
.00
.00
23 .118.49
.00
181
23,118.49
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn, Casts/Misc. Expenses (Schedule H) (9)
10, Debts/Mortgage liabilities/Liens (Schedule I) (10)
11. Total Deductions
12, Net Value of Tax Return
13. Charitable/Governmental Bequests CSchedule J)
14. Net Value of Estate Subject to Tax
7,364.82
3.329.81
1111
112)
1131
1141
10.694 63
12,423.86
.00
12,423.86
If an assessment was issued previouslY, lines 14. 15 and/or 16, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. A"ount of Lin. 14 at Spousal rat. 115)
16. Anount of line 14 taxable at lineal/Class A r.t. (16)
17. Anount of Lin. 14 taxable at Collateral/Class Brat. 117)
18. Principal Tax Due
NOTE:
.00 K .00=
12.423.86 K .06=
.00K.15=
1181
.00
745.43
.00
745.43
TAX CREDITS:
PAYHENT
DATE
11-21-96
DISCOUNT 1+1
INTEREST I-I
37.27
RECEIPT
NUHBER
AA146967
AHOUNT PAID
708.26
TOTAL TAX CREDIT
BALANCE OF TAX DUEl
INTEREST AND PEN.
TOTAL DUE
745.53
.10CR
.00
.10CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS TitAN $1, NO PAYH[NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TItIS FORH FOR INSTRUCTIONS. I
RESERVAtION:
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E.tat.. of d.c.d.nt. dying on or before D.c..ber 12, 1982 -- If any future Inter..t In the est~te I. tr~f.rred
In pass..slan or enjay.ent to Clas. I (collateral I beneflclarle. of thl dlCldlnt after the e{Plretlan o~iny e.tate
I1fe or far year., the Ca..onwealth hereby e.pre..ay nurvII the right to 8ppralu and a""' tr8n.fer Inhlrltl!lllce
at the lawful CII.' I (call.terall r.t. on any such future Interlst,
on :n
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PURPOSE OF
HOnCE:
to fulfill the rlqulr.eents of Slctlan 2140 of the Inhlrlt.nc. and (statl ,.. Act, Act 22 of 1991, 12 P.S.
S.ctlon 2140.
PAVHENT I
O.tach the tap portion of this Natlc. and sub.it with your pay.ent to the R.gl.t.r of Will. prlntld on thl r.ver.. .Id.,
..H.ke chick or .oney order payabl. to: REGISTER OF' HILLS, ACENT
All pay..nt. rlc.ived shall flr.t b. .ppll.d to any Intere.t which ..y b. due with any reealnder appll.d to the ta..
REFUND eCR)1 A refund of a ta. cr.dlt, which was not rlqu.stld an the ta. Return, .ay b. requI.ted by ca,pleting an "Application
far R.fund of p.nn.vlvanl. Inherltanc. and [.tate ta." (REV-1515), Applications ar. .vallabl. at thl Offlc.
of the Regl.ter of Will., any of the 23 R.venue District Office., or by calling the ,plclal 2~.haur
an.werlng ..rvlc. nu.blr. for far.. ordering: In P.nn,Ylv.nla 1-800-562-20S0, out.ld. P.nn,Ylvanla and
within 10c.1 HarriSburg ar.a (111) '1'-809~, TOOl (717) 712-2252 (H.arlng I.palr.d Onlv),
OBJECtIONS: Anv party In Intlr..t not .atlsfl.d with the .ppraisl.ent, allowanc. or dl.allowanc. of d.ductlon., or ........nt
of ta. (Including di.count or Inter..tl as .hown on thl. Natlc. .ust obj.ct within .I.ty (60) day. of r.celPt of
this Notice by:
.-wrlthn prate.t to the PA D.part.lnt of R'Vllnu., laard of App.als, D.pt, 21ID21, Harrisburg, PA 17121-1021, OR
".I.cllon to h..". the .athr d.t.r.ln'd at audit of the .ccount of the p.r.ona1 repn.entallv., OR
--applel to the Orphan.' Court.
ADHIN
IStRAnVE
CORRECTIONS:
Factual .rrars dl.cov.r.d on thl. ........nt should b. addr,s'ld In writing to: PA D.part.lnt of Rev.nu..
Bur.au of Individual Ta..., AttN: Post A.......nt R.vl.w Unit, D.pt_ 280601. HarriSburg, PA 17121-0601
Phon. (111) 117-6S0S. SI' page S of the bookl.t "In.tructlon. for Inh.rltance T.. R.turn for a Rlsldlnt
Dlced.nt" (REV-1S01) far an e.plenatlon of ad.lnl.tratlvely corr.ctabll .rror.,
DISCOUNTs
If any taM due Is paid within three (3) callndar lonths afhr thl dlcldent's de.th, a flv. plrclnt es:o discount of
thl ta. paid I. allow.d.
PENAL TV:
the IS~ ta. a.ne.ty non-participation p.nalty I. co.put.d an thl total of the taM and Int.r..t ....s..d, and not
paid b.for. Januarv II, 1996, thl first day aftlr the Ind of the taM ..n.sty plrlOd. this nan-participation
p.naltv I. apPlalabl1 In the sa.1 _ann.r and In the the sa.. tl.. periOd a. you would appeal the taM and Intlr..t
that has bll.n a......d a. Indlcat.d on thl. notlcl,
INtERESt I
Intlrl.t Is charg.d beginning with flr.t day of del1nqullncy. or nln. (9) .onth. and one C1) day Iro. the date of
d..th, to the data of p.y..nt. ta... which beca'l dlllnquent b.for. J.nuary 1, 191Z b..r Intlre.t at the rate of
.1. (6~) plrcllnt per annul calculated at a dally rata of ,OOOI6~, All ta.I' which b.ca.. d.llnqu.nt on and after
January 1, 1982 will b.ar Interll.t .t a rat. which will vary fro. cal.ndar Ylar to c.lendar year with that rat.
announc.d by thl PA Dlpart..nt of Rlvlnue, fh. applicable Int.re.t rates for 198Z through 1991 arl:
'!!!! Intlre.t RIIte Dally Intarest ractar !!!! Intll,e.t Aat. Dally Int.re.t rllctor
1912' 20:< .000541 1911 .% ,000241
1911 16:< .ooo~sa 1911-1991 IlX ,000301
1914 I1X .000501 1992 .% ,OOOl47
1915 U~ .0005S6 1991. JlJ94 1i!: .000192
1986 10~ .00027~ 199~-1991 .% .000241
"Int.r..t Is calculatld .. follow'l
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlcl I,.uld .ft.r the te. bllCo." d.llnquant will r.flect an Int.re.t calculation to flfteln (IS) days
beyond thl dati of the a.'I.,..nt. If paY.lnt I, .ad. .fter the Intlre,t co.putatlan date shown on thl
Natlc., additional Inter..t .u.t be calcul.tld.
CERTIFICATION OF NOTICE UNDEH HUI,E 5.6 ( a)
6tOAlAfLc/tlj<:.
Admin. No. Pit AJl) ..1.1 1100 -0 '(0.(/
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
3/. J If?
Name
Address
Lnl),CI tJ+~j
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AI, Hui..t -'7" !t-V'f.rJl, HOtl..J.tIt1A-PJ-.N'7!tI''f1
W~lLlf..,lv~""',.) /-0; PI' d"IJ~ 1"4-17 o/f
111t1L/ t 4/:> ~ IC/C
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Notice has now been given to all
Rule 5.6(a) except "HI!: Ptltd"oJlfi..
persons entitled thereto under
IL, 'ILL~Wr+n'" .+r <-1,".$1.
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Name Jal9^,N~ n,../C-,,v,, x'"lS-lLu"7
Address 11? .I. wCLJ r sr.t..u.r
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Date:~,~
Telephone (117) 1-,/ 1 . ... '1'....
Capacity:
Personal Representative
,/
Counsel for personal
representative
JOANNE MARINO Me URI:EVY, ESC).
IJ7 S. WEST STREET
CARLISLE, PENNSYLVANIA 1701J
717-24J-(01)2
SUPREME COURT 1147612
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FAMIL Y SETTLEMENT AND F[NAL RELEASE
[N
ESTATE OF ALBERTA Z. BEDNARCH[K
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS,
ALBERTA Z. BEDNARCH[K, late of5[6 N. Bedford Street, Carlisle,
Cumberland County, Pennsylvania, died testate on 9/16/96, having first made
her Last WiIl and Testament, which was duly executed on December 5, 1989;
and
WHEREAS, the said Alberta Bednarchik, by the aforesaid Last WiIl and
Testament, named Eugenia Bednarchik as Executrix of said Last WiIl and
Testament; and
WHEREAS, Letters Testamentary on the estate of the said decedent were
duly issued by the Register ofWiIls ofCumbedalld County, Pennsylvania, to
the said Executrix, on November 22, 1996; and
WHEREAS, the said Executrix, hereinafter called personal representative,
has gathered the assets of the estate of the said decedent and the assets
consist of joint personal property with right of survivorship, with decedent's
probated share amounting to 23.118.49, as set forth in Exhibit A, which is a
statement of the account of the said personal representative, and which is
attached hereto and made a part hereof, and marked Exhibit "A;" and
WHEREAS, the debts and deductions, including the payment of
inheritance tax in the said estate amount to $11402.89 leaving a balance for
distribution to the surviving owner of joint accounts with right of sUlvivorship
of$11.715. 60, also as set forth in the statement of account of the said
personal representative, which is attached hereto and marked Exhibit "A;"
and
WHEREAS, the balance for distribution to the joint owner with right of
survivorship as shown in the said statement marked Exhibit "A" has been
reduced to cash or its equivalent and has been distributed as herein indicated
.
in accordance with the tenns of the account agreements and the Last Will and
Testament of the said decedent and in the Schedule of Distribution as shown
in the said schedule, attached hereto and made a part hereof, and marked
Exhibit "B;" and
NOW THEREFORE, KNOW YE, that we, Marie Novick, Alberta
Winieski, Eugenia Bednarchik and Louise Bates, being all of the children of
the said decedent, and heirs under the Last Will and Testament of said
decedent, and being those persons entitled to inherit under said Last Will and
Testament, do hereby, each of us, acknowledge that we have this day had
and received from the aforesaid personal representative, a full accounting of
the sum or sums of money, legacies, bequests, and devises as are given,
devised and bequeathed to each of us respectively by the said Last Will and
Testament the amounts due us under said Last Will and Testament, which
amOlmts, "Q" dollars, we acknowledge as set opposite our respective names
in the table and Schedule of Distribution in said statement attached hereto and
marked Exhibit B;
AND each of us does hereby stipulate that in order to avoid the expense
and time involved in the filing of a fonnal account and schedule of
distribution, we each agree that no account is necessary and we do hereby
agree that we do consent to distribution being made without the filing of an
account and schedule of distribution, the same to be the same force and effect
as if they had been filed and confinned by the Court of Common Pleas of
Cumberland County.
THEREFORE, we, each of us, do hereby remise, release, quitclaim and
forever discharge said personal representative, Eugenia Bednarchik, her heirs,
executors administrators and assigns, of and from the said estate and from all
actions, suits, payments, accounts, reckonings, claims and demands
whatsoever for or by reason thereof, or for any other use, matter, cause or
thing whatsoever, touching upon the estate of the said decedent, and each of
us do further hereby covenant and agree that should any liability come due to
the estate of the said decedent after the si/,'11ing of this agreement, we and
each of us do hereby covenant and a/,rree with each other and the aforesaid
personal representative, that we will contribute pro rata, our share of the said
estate, which share amounts to ~ dollars, to satisfY any and all claims,
demands, suits or causes of action which may be successfully prosecuted
against the said estate of the aforesaid personal representative after the
signing, sealing and delivering of this Family Settlement agreement and final
release.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this
/.,,('1: oJ It..,t, day of ,i.{N'h"'V' , 1997.
Witness:
")J!r<i,U /.1 )(;I.~t'L (SEAL)
MARIE NOVICK
l!f /JJJnl-:!X;11 flu A1i~{ft:~:;;~"/.
(la.dtUv.u&' (ltVJU';<"'~L' ~_ a z:;.., ui-
~ ~) . LOUISE BATES ! .
~ tu..Aou 11 >fr J'VLu:b:1 '.' ....~." '.L. J.t:../.:
/ I ' . EUGE IA BEDNARCHIK
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND : SS
(l,/..UiiMrl.[.0l (IevJM
(SEAL)
(SEAL)
(SEAL)
On this, the 10th day of n",. , 1997, before
me, a Notary Public, the undersigned officer, personally appeared Eugenia
Bednarchik and Alberta Winieski, ( known to me or satisfactorily proved to
be) the person(s) whose names are subscribed to the within instrument, and
acknowledged that they have executed the same for the purposes herein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
JiliJ\cl~ S O'0t.=>
NOTARY P LIC \~endy S. Ciuffo
My commission expires ~q
My office is in Cumberland Coun~y Carlisle PA
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'OR DATlSO' DIATH AnlR 12/31/91 CHICK HIRI
If A 5POU5AL
POVIRTT CRlDIT 15 CLAIMID I ]
Fill NUMBlR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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Federal EUale To. Relurn Required
j 010 fUlure IntCHlnt Campramiul
(for dolln 01 deolh aher 12.12.82)
Decedenl Died Tlnfote : 7 Deco dent Mainloined 0 living Trust
IAlloch (Opy 01 Will) {Alloc" copy 01 Trull}
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTEO TO,
'jAM( ~... '.0 ~PIITl MAIUNGAODAt~~
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13. Chari lab Ie and Goyernmental 8equesh ISchedule JI
14. Net Value Subiectlo To. (line 12 minu!_l~~..!._.~_________. _._._________~_.__._
IS. Spou,ol Transfers Ifor dale' 01 dealh after 6.30.94)
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See InstrUClions far Ar,plicoble Percenlage on ReYllIIIl (15) r;;:or;;,. I." ~,... 'II:J_
Side. (Include values rom Schedule K or Schedule MI
16. Amount of line 14 to. able at 6% rote
(Include values from Schedule K or Schedule M.I
17. Amount of line 14 to.able at 15% role
Ilnclude volues from Schedule K or Schedule M.)
18 Principal 10. due (Add laJ. from linel 15. 16 and 17.J
19, Credits Spoulol Poverty Credil Prior Payments
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4. Mortgage, and Nolel Receiyable ISchedule OJ
5. Cosh, 8an~ Oepasih & Mi"ellanfloul Pellonol Properly
IS,h.dul. E)
6. Jointly Owned Property (Schedule FI
7. Transfers (Schedule GI (Schedule L)
8. Total Gran Aneh (total lines 1.7J
9. Funeral E.penles, Adminiltraliyo Calh. MilCellaMous
E-penses (Schedule H)
10. DeblS. Morlgoge liabilities, lien, (Schedule IJ
11. T 0101 Deductions ltotalline, Q & 10)
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>- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~
'Jnder penaltiel 01 perjury. I declare lhot I haye eJ.amined lhil return, including accompanying schedules and stalemenll, and to Ihe bell of my ~nowledge cnd belief,
I i, true, correct and (omplete. I declare thaI 011 real eltotfl has been reporled 01 true mor~et value. Decloralion of preporer olher than the personal representotiye is
'losed on 011 informal ion of which preparer has ony ~nowledge
~IGN"'IUlt 0' '[I!lor~ IlSoPON!ollLI '01 fILINe. AtlUil-t~A-6D-R-i~!;-~-------~~~- ...-----._----~-----.--- --~--~~ OATE-------
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20. If line 19 is greater than line 18, enter Ihe difference on line 20. Thil is Ihe OVERPAYMENT,
DID
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Check here if you are requesting a refund of your overpayment.
21. If line 18 is greater than line 19, entflr Ihe difference on line 21 Thil i, Ihe TAX DUE.
A. Enter the inlerell on the bolance due on line 21A.
B. Enter the lotol of line 21 and 21A on line 218. This is the BALANCE DUE,
Mak. Check Poyobl. to: Reglst., ~f Will" A_gent
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LAST WILL AND TESTAMENT
OF
ALBERTA Z. BEDNARCHIK
I, ALBERTA Z. BEDNARCHIK, Borough of Carlisle, County of
Cumberland and State of pennsylvania, being of sound mind, memory
and understanding, do hereby make, publish and declare this as
and for my Last Will and Testament hereby revoking and making
void any and all other wills by me at any time heretofore made.
I.
I direct that my Executor hereinafter named shall pay
.
all my just debts and funeral expenses as soon as conveniently
may be done after my decease and that I be interred in my lot in
St. Joseph Cemetery, Beaverdale, Pennsylvania.
II.
All the rest, residue and remainder of my estate,
whether real, personal or mixed, and wheresoever situate, I
I
s~arel
hereby give, devise and bequeath in equal shares, share and
alike, per stirpes, to my four step-daughters, named as
follows: MARIE NOVICK, EUGENIA BEDNARCHIK, LOUISE BATES and
ALBERTA WINIESKI.
III.
The word "Executor" when used herein shall include both
I genders
and the singular or plural as the context may require.
IV.
I hereby nominate, constitute and appoint my step-
daughter, EUGENIA BEDNARCHIK, as Executor of this my Last Will
and Testament. If my said step-daughter should predecease me,
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not qualify, or not accept the position of Executor, then I
hereby nominate, constitute and appoint STANLE~ BEDNARCHIK as
Executor in her place.
v.
My Executor shall have the following powers in addition
to those conferred by law until all property is distributed:
(a) To retain any real or personal property
in the form received and to sell it at public or private
sale.
(b) To manage real estate.
(c) To purchase all forms of property without
being confined to so-called legal investments and .
without regard for the principle of diversification.
(d) To exercise any option or rights arising
from ownership of investments.
(e) To compromise claims without order of
court or consent of any legatee.
(f) To distribute in cash or in kind. I
I
(g) To employ accountants, agents, investment
counsel, brokers, bank or trust company to perform
services for and at the expense of my estate and to
carry or register investments in the name of the nominee
of such agent, broker, bank or trust company. The
expenses and charges for such services shall be charged
against principal or income or partly against each as my
Executor may determine. My executor is expressly
relieved of any liability or responsibility whatsoever
for any act or failure to act by, or for following the
advice of, such accountants, agents, investment counsel,
-2-
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brokers, bank or trust company, so long as my Executor
exercises due care in their selection. The fact that an
Executor may be a member, shareholder or employee of any
accounting, investment or brokerage firm, agent, or bank
or trust company so employed shall not be deemed a
conflict of interest. Any compensation paid pursuant to
this subparagraph shall not affect in any manner the
amount of or the right of my Executor to receive
commissions as a fiduciary.
VI.
I direct that my Executor shall not be required to post
bond for the faithful performance of his duties in any
jurisdiction.
VII.
I direct my Executor to pay all inheritance, estate,
succession and legacy taxes of whatsoever nature and kind, to
which my Estate or the transfer of any property passing hereunder
or otherwise passing by reason of my demise, may be subject and
to charge such taxes against my residuary estate, it being my
intention that none of the aforesaid taxes, either federal or
state, or any property required to be included i~ my gross
estate, under the provisions of any state or federal law now in
force or hereafter enacted, shall be prorated among the persons
interested in my Estate to whom such property is or may be
transferred or to whom any benefit accrues.
-3-
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
5S:
-
We, ,JoJ./,v /1. WIN,,;S,", and
D.S I 11 [ "",,,71 ' , the
witnesses whose names are signed to the foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix sign and execute the instrument as
her Last Will; that ALBERTA Z. BEDNARCHIK signed willingly and
that s/he executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the h~aring ,and
sight of the Testatrix signed the will as witnesses;. and that to
the best of our knowledge the Testatrix was at the time 18 or
more years of age, of sound mind and under no constraint or undue I
influence.
Ctldu~
Witness
(/
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Witness
Sworn or affirmed. to and subscribed to before me by
Jl/lIIJ ,^,1^,E'~/q
and b;j. Mf;II<.v,"Tf
, witnesses,
this
) II+- day of
l)E'r;,.,gF/7
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NOTARIAL SEAL
RAYMOND J. RESTAGNO. NOTARY PUBLIC
HAMPOEN TWP. CUHBERL~ND COuNTY
MY CCJlHmlOIl rx.:RES .I'M 27. 1991
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COMMONWI;.UH Of '(N~4~YIVAUIA
INHUnANCI tAll: III1UIIN
IIUIDINt DfCIDINt
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
A- ... (S LtL 1"'" -Z-A-1f_r,.,K_~~("/J 40' C j.J. L f;:;,
Jolnllonanll.I,
FILE NUMBER
NAME
A. ~v't'" 14 ... Stt7,A141C.C'H' K..
AODRESS RELATIONSHIP TO OECEDENT
__~______.._...._. .__....._.^.__~~__.._.._.. __n._.._._.._.__ ___
511. !oJ. B€..pFolC.'p PAV.'l1rvr
C/f-(l.. LI J"'~ ,..., 1'0 JJ
B.
C.
Jolnlly.ownod proporty:
ITEM LmER OATE
FOR TOTAL VALUE OECO'S DOllAR VALUE OF
NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. A 7/,1/17 c:l+ul<'...... 4c.c.'r
'1F / 'fS"~" ~ /P a
OA...,Pff, ,.J Olf'",:.,r 'f7r'J..~ " $'0 .;1,,3 7'-. 'It?
,
:l. A 7/51 hi ~/H!l.19 ..... l< J "",..... prt J...J
O.,(1a)/ r ''',.;1,$'(.,1/ l >~ e, ' ;l.. ,y, J... J
t=f:: of' ll~ .., .... ;I '/1.
g . A '11....Jrd D 1++ (f./f-IJ S-tu/....c.) 7, " Go " ..r:
-t:b- 17 0" 00' r).,j Ict)3j3. as' S'o
'i. Ir )~Jol'il f-M..e. re , 1 c.odi: I S, J-'1 '1.r7 5'0 ~, '11./7. J-
17 )~ ). ,.....,..,1
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TOTAL (Aho enter on line 6, Recopitulolion) $_ ~ 3 .-lJ.L _
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(II more space is needed insert additional sheets 01 some size)
'7
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SCHEDULE H
~~ ~~,~ FUNERAL EXPENSES,
COMMO"W"'''' Of "'''''''VA'''' ADMINISTRATIVE COSTS AND ,
''''m::~i\~'o\~~~::~''' MISCELLANEOUS EXPENSES I.... . -"Io~.! Prln!. or Type
ESTATE OF ' FILE NUMBER
-A.J-tJ to,c..: r:A. '7...Af?! t:-<._.lSf.P~I!~_c. H Ll<" .w.__ _J
ITEM
NUMBER DESCRIPTION
1.
A. Funoral Expon....
r-= Ihv (""If- ..
H-a ""1 ( FL......... L-n.> P,,,,,,, c.A.
I ,
1.
B. Admlnl.tratlve Co.t..
2.
Personal Representative Commissions
Social Security Number of Pe..onol Reprelentalive, -P.!I,)... - t 4- - 9/.), .1
Year Commi..ions paid
('1J~
Attorney Fees
3. Family exemplion
Claimant
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
Relationship
Addre.. of Claimant at decedent's death
Street Addre..
City
Stale __ Zip Code
Probate Fees
Miscellaneous Expen.e..
,.J a or' G4 I' H-a-rn c...o f" I 2..1
,
f': I 1-/,,</ ,;..
TOTAL IAlso enler on line 9, Recapitulotian)
(If more space I. n..dod, In.ort additional .hoet. of .ome size.)
AMOUNT
!>~ 1'3.l.f9
1/ .s' SO. '1 oJ..
</-S'/:J.01O
9 ~, Q 0
" r. if I
I $". 0 ..
S 7116 IJ
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: IJ I ,...; 'I\'r/; .-,
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.-
Date of Death: : /, (.
Ii,
Will No. .) }- I rr Ii!' :'. I .../ I
,
f)} ('Iv' 11'~ , ..." V
Admin. No. ..," ..J ..~~ Ie, ,.H , .
.
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. State whether administration of the estate is complete:
Yes ,/ No
2. If the answer is No, state when the personal
representative reasonably beiieves that the administration will be
complete: -
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No ,// .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is: .-
c. Did the personal representative state an
account informally to the parties in interest? Yes ,..... No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
lil
Da te :~.J.f.,f
s'i~~a t~~~)"" . ~ )n (j/, , , . 'J
}.--",,1""': 11~'A',,,..j 11f6-r...~~"Y
Name (Please type or print)
1,5..} c; t...;f 11 j 1-,
Address
{....,:!L,l'-C tA 11','''s
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( I,') .)'-13 "'''f ~
Tel. No.
Capacity:
Personal Representative
t~Counsel for personal
representative
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(HAH:rmf/AM3)
.
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JRD/June 30, 1992/17858
REGISTER OF WILLS
Cumberland County Courthouse
Onc CourthollSc Squarc
Carlisle, PA 17013
NOTICE pURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: PClSDnal Representative
Counsel: .l()l.lI!IIlR tool Mrr.1>m.'\N =r\
.-
RE: E'slllte of ALBEHTA Z BEDNARCHIK , Deceased, Late of
CARLISLE OOROOGl:!
E'slllte ND.: 21-1996-0941
Date of Decedent's Death: 9-16-96
Pursuant to Rule 6.12, the above named personal representative or the above named attorney, if
applicable, within two (2) years of the decedent's death, and annually thereafter until administration is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6.12. in
substantially the prescribed form. showing the date by which the personal rcpresentative. or attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice is to advise
you that unless the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
is required to IlDtify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to detelTDine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent perfn~1 9wpresentative's counsel, if any.
AccoIdingly, if the requisite Status Report is not filed by -. , 19_, you are hereby
advised that a request will be submitted to e Court in accordance with Rule 6.12.
10.22-96
Date:
Distribution to Estate File