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HomeMy WebLinkAbout97-00683 PETITION FOR PRODAn: IInd GRANT OF LETn~RS ___2 L.~LT~kX.:L-~~'--- Rcgistcr of Wills for the County of Cumberland in the (:onuuonwealth of I'ennsylvania IIstate (!f m~RTR'JDE M. D\lRKl\Ol,l)l<~R No cllw klloll'/I Cl.~ To' _.~-"-~..~,....._.,-~----_.__.<_.._'_.-_.._-_. -", ..__-.-.--,..-----,..J )ec(!(,sed. .'toclal Secllrlty No. 174_05-1767 The petition of the undersigned respectfully rcprcsents Ihat: Your petitioner. who is III yellfS of age or older is thc Exccutrix named in the I."'. will of the above decedent, dated June 10, '99' and codicil(s) dated \none\. John Burkholder. the co_Executor nl\l1led in said Will died June 10, 19%, Decedent was domiciled al death 111 cumberland County, Pennsylvl\llia, wilh her last family or principal residence at 80' North Hllnoyer Street, Carlls'e, North Middleton Township Decedent. then 88 yellfS of age, died July 19, '997. at 80' North lIanover Street, Carlisle, Fennrylvanla, ExccptllS followS, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will olTered for probate; was not the victim of a killing l\IId Wl\S never adjudicated incompetent: Decedent at death owned property with estimated values l\S follows: (If domiciled in Pa,) All personal property (\fnot domiciled in Pa,) Personal property in Pennsylvania (If not domiciled in I'a,) Personal property in County Value of real estate in Pennsylvania situated l\S follows: 1547 Spring Road, Carlisle. North Middleton Township $ unestimated $ $ fune;,timated WHEREFORE. petitioner respectfully requests the probate of the ll\St will and codicil(s) presented herewith and the grant of letters testamentary thereon, (' / ~);: /, / (;/0 1_ (/!, /) l !) ';71 'j) d~,,' {'; , L.!"'"'' 0" .N, "Cd <,h"p,," ,,';:fl" fh~j, J?~'- _ ct,.. \",.+, 1\"" \,.,UJ,~' <4\.Wliz-;beth Ann Burkholder Nicholson 4111 West Sixth Street Waynesboro, PA 172611 (717) 762-7312 ===============================~======~=======~===~~================= OATH OF FERSONAL REPRESENTATIVE COMMONWEAL I'll OFFENNSYL VANIA ) : SS. COUNTY OF CUMBERLAND ) The petitioner ab(lvc-named swears or alTlrms II1a\ the statements in the foregoing petition are true and CClTre<'\ In tlo~ b~st of 'the knowledge and belief of petitioner l\IId that l\S personal representative of the above d"cedent, petitioner will well and truly administer the estate according \0 ytw, . ' , ' ) , /"/f"'/I:1'/ (,ii''') /' Vi ,I<'/"'(.~~';r .' 'w,", . rn olli""" "" ..",,;'od L\.'-'" . I- ""d; <J', (,,, ' <<"I, ;k',cl !}<d&J4, ,~ before l\Ie this ._...ut.l:L day of (\ ,\,u\.F, ,,\\<'\" Elil,abeth Ann Burkholder Nicholson _f>.l~at--.-" \9, 7 fY)IlJU~ (,-, . ~f' ') :' '':I-- Re 'Ister\' J,5- - ;q ') :..C{ Thb b \0 ('rnth' t1lttllh(' il\I~"1l1,lti(l1l1li.'IT gi\"'ll i" ,,)lll'\I1\ '_'IPII'd 11'111\ ,III !111l',l!Ld (1.'lllIil,lll' (II dc,nll lltlly IiIi'd Wilhilll' ,1\ locd R~'gi'ILH"Th(' origiI1alll'l'liflc,lll' will he rlllW,lIdll! III Ill, \1,111' \'\I.d Fl'l/II\L {HIli 1,111\ 11l'lllI.l1\I'1l1 fililq~, WARNING: 1\ Is IIlcllalto duplicate this copy by pholO!llill or pholo"raph. No, 21-97-683 ":'i"."..i~~~'l~'Oi"f.'l~. '~.'" ,'l~.' -'.iJ'J,., !!'OS! "". "~. ( '~.'. ;.~ ~i ,fl'';; ,\. "'. I . * \..' - ,.~; _, ," ./.l \\ "". . '.' . .">" '.-~'-. - ~.'.' . '1ft !\.... 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'~'1 ' -.\ , or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservat.ion of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partit.ion of same; to compromise any claims or demands of my estate against others or of others against my estat.e; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS <R~ #1 day of WHEREOF I have hereunto set my hand and seal this o twIt.... , 1991. )' ." II l!.J.'/'cl'l)k/; Ij' I~I, l/I )()jLC}JEAL) Gertrude M. Burkholder SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. - ~/~' . . ~ ~ .L't~___ I'~ / ,:,.<&~~" L '7J; X//~_ Page 3 of 4 Pages I I!! il~ II ~' COMMONWEALTH OF PI;NNSYlVANIA DEMRTMI!NT OF REVENUE OI!Pl. 280801 lIARRIUeURO, PA 17120.0001 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) BURKHOLDER, GERTRUDE M, SOCIAL SECURITY NUMOER ,DATE OF DEATH 174.05.2767 0712'1/97 (If Applicable) SUfvlvlng Spoute'. N.mfl (I.st, FII'~1 'Anrt Middle Inllllll) ~~"I ______.... FILE NUIYIB~K 21 97 COUNTY CODe YEAR 'DECEDENT'S COMPLETE ADDRESS SO I Norlh Hannver Stl'<'el 'DATE 01' BIRTH Carlisle, I'A 170D 0511S/OI) COUNTY ('lIlllhcrlnnd SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INsmUCTIONSI (TO BE FILED IN DUPtJCAlC \MT1-I REGIS1ER OF WILLS) !: 4a. Future Interest Compromise (for dates of death altar 12.12.82) r.', 6, Decedent Died Tostate 7. Deoedent Mal~telned a Living Trust 0 8, (Attach copy of Will) (Attach copy of Trust) ALL CORRESPONOENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILiNO ADDRESS STEPHEN L. BLOOM, ESQUIRE MARTSON, DEARDORFF, WILLIAMS & O'ITO TELEPHONE NUMaER 10 East High Street (717 ) 243-3341 Carlisle, "A 17013 I,: 1. Original Raturn 2. Supplemental Return 6S~ NUMBER 3, Remainder Return (for dateA of doath prior to 12.13.82 5. Federal Estale Tax Return Required Tolal Number of Safe Deposit Boxes : , (1) (2) (3) (4) (5) (6) (7) ~2,551.79 1. Real Estate (Schedule A) 2, Stocks end Bonds (Schedule B) 3, Closely Held Stock/Partnership Interest (Schedule C) 4, Mortgages end Notes Receivable (Schedule 0) 5. CeshhBank Deposits & Miscellaneous Personal Property (Sc edule E) 6, Jointly Owned Propartv (Schedule F) 7, Transfers (Schedule G) (Schedule L) 8, Total Gross Assets (total Lines 1.7) 9, Funerel EXp'enses, Administrative Costs, Miscellaneous Expenses (Schedule H) 10, Debts, Mortgage Liabilities, Liens (Schedule I) 11, Total Oeductlons (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Government Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Spousal Transiers (for dates of death after 6.30.94) (Include values from Schedula K or Schedule M) 10, Amount of Line 14 taxable at 6% rate (Include velues from Schedule K or Schedule M) 17. Amount of Line 14 texeble et 15% rate (Include values from Schedule K or Schedule M) 18, Principal \ex due (Add tax from Lines 15, 16, and 17) 19, Credits Spousal Poverty Credits Prior Payments Discount Interest + + 17,89 (19) 20, If Line 191s greater than Line 18, enter the difference onLine 20. This Is the OVERPAYMENT (20) A. 0 Chick hlrl If you Irl rlqulstlng I rlfund of your oVlrplymlnt. 21, If Line 18 Is greater than Line 19, enter the difference on Line 2'1. This Is the TAX OUE. A. Enter the Interest on the balance due on line 21A, B. Enter the total of Line 21 and 21A on Line 21B. This Is the BALANCE DUE. Mlkl Chick PlYlble to: Rlglstlr of Willi, Aglnt "SE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE ANO TO RECHECK MATH" Under penalUaa of perjury, I declara thlt I haye a..mlned thla ratum, Including ecccmpanylng .ohedulas and .tatemenla, and to the besl of my knowledge and bellaf, It latrua, correcland complate. I daclaralhsl ell real I.late haa been reportad al true markal yalue, DeclaruUon of prDplr.r olha, Ihanlhe peraonal repreaenlaUye Is based on slllnformaUon ofwhloh preparar has any knowledge, ~URE OF PERSON RJ!PO~E F<}R F~INQ RETURN ADORESS DAJF. / ~). ~.. ,.~/..&'lI,/~)/~..J 418 W, Sixth Street, Wsynesboro, I'A 17268 I (" c~'I 17 10 ikEO~~I9fOTHe AN Rf.PRESENTA1IVE AODRliSS DATE. ..---;:rC.......-;Z i'-->:~.~ 10 E. High Street, Carllslo, P A 17013 I oj:)7 /,n 4. Limited Estate ~ i a: ~ I a 1,632.66 34,184.45 (9) (10) 28,219.82 5,964,63 5,964,63 (15) (16) (17) 357,88 357,88 17,89 (21) (21A) (21B) 339,99 $339,99 .', DATil 0I/'1J1197 ' '.aII.... """"t'.Cll' .'"'' ',,'\.~-"'C J'A - -'" ~H~ '- - ~ -' ,'l ", . . Cll' PUlL! .. ;.--);J', ITATIIlIIIT 0' CLAIM . IINlI "HOLDER. GUI~1 10 9Z01S4899 ENllMLD DRUG 110111 2300 IlOlITN '"'lID IIRIII KARR IIIURO . PA 17110 DATI 0' PAVlIEIIT ORIGIKAL ADJUSTED USUAL MCUlIT URVICI DATI CllN CRN cllARGII ~,,'., ._C'; ,.-:! 01/02197 . DI/Ia,/W 01/20191 7005104087101 OOQOOODDOO/oo 49.01 \9.20 DIAGNOIII 1. PROCIOUllI . 01/02/97 . 01/02191 ' 01/20191 70031041S1/01 ?0ooooo000/00 11.20 O.~ DIAGNOIII \I PROCIOURI . 01/21/97 . 01121/97 OZI2~197 70517\12510/01 OOQOOOOOOO/oo 49.01 \9.20 DIAClIIOIII \I ....OURI . 01/11191 . 01151/97 OJ/f13197 1OSI1II1204/01 ooooooooon/oo 61.26 0.24 DIAClIIOIII' 1. , t., ....DURI I " t., ",'" 02/24191 . la/24/97 OJ/24197 10597D2104/01 DOD(lIlOOOOO/oo 49.01 19.20 DIAGIlOIII I. PlOCIIUI I '(-, f13/f13/97 . OJ/f13197 lIS/1Il97 lO667116I26101 uuOQOOOOOOlOO 19.41 0.24 " DIAGllOIII I I PllOCOUlI . f13/03197 . lIS/OSI97 lIS/31197 '/Il661116655101 uuOQOOOOOO/oo 61.26 0.24 DIAIlIlOIII 1, PRQCIDURI I OS/24/97 . OS/Z4191 04/21197 7\194104479/01 OQOOOOOOOO/oo 49.01 19.20 01 AIlIlOI \I \I PI\OCBURI . 05151197 . OJI5I/97 04/21/97 7\194104130/01 ?0ooooo000100 61.26 0..24 o I AIlIlOI II II PllOCEOUlII . 04/01/91 . .04/01/91 04121/97 7\194705102/01 ?o?ooooooo/00 79.41 0.24 DIAIlIlOIII I. PMCIDUIII I i-j' Ii'" - .. ~~:" j\"'" .J \':.,'j I . ,j.... .. "'l,.' DATI. Dl/1IIt7 ~l~l!f.'i ", .JIIlIl.. " IfAT.MT D' CLAIM -- IIMl NtCNOl.DU. ae.TIUDI 10 9Z01J4899 I..ULD 01lLlG 1T0001.WILLOlI ZJoo N TNIIlD ITRIIf 1WI.ISIURO . PA 17110 DATI Of PAYIl'iNT OIllfllNAL ADJUITIO UIUAL l .T I HRVICI DA11 C1tM cn ClIARGI' APHOYID . ..'....., 04/22/97 . 04/22197 11J/26197 71221114655101 ?o?ooooooo/00 49.07 '..01 01_"1 PIlDCIDUIII, 04130197 . 04130197 11J/26197 l1ZZ71l3176101 ?o?ooooooo/00 61.26 .0.26 DIAGlIOI" , HOCIDUIIII 05/21197 . 11J/2'197 06/16197 11431ll1Z51101 ?o?ooooooo/00 49.07 ".01 D 1_". PIlDCIDUIII , I1J/YJI97 . I1JIJIJI97 061J1J197 115771l11'5IOl ?o?ooooooo/00 61.26 0.26 DI_II', PIlDCIDUIII! I 05130197 . I1JIJIJI97 06130197 715771l'" 1101 00lI00000001OO 79.41 0.24 DIAGlIOI"1 PIlDCIDUIII, 06/20197 . 06120197 071lA/97 111471ZJZ6/01 00lI0000000/00 49.07 ".01 DI_", PIlDCIDUIIt I 06/YJ19' . 061J1J197 07/'21197 111471 11 71/01 ?o?ooooooo/00 61.26 D.2' DI_". PROCIDUIII, 06130197 . 06IJJJ197 07/21197 1114711790/01 00lI0000000/00 79;41 0.24 DIAGNOIII. 1'IlDCIDUl1. 01101197 . 01101197 07/lA/97 111471 1794/01 ?o?ooooooo100 9.36 0.24 DI_", PROCIDUIIE. 07/11197 . 07/11197 08111197 11997U0279/01 ?o?ooooooo/00 6.29 0.72 DIAlIlIOI", HOCIDUIIE. ,oil .' ,... ....... -'( . LAST WILL AND TESTAMEN~ I, GERTRUDE M. 8URJO{OLDER, of North Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do here~y make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall b~ paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 2. I give, devise and bequeath all of my estate, both real and personal property, in equal shares unto my son, JOHN E. BURlOiOLDBR, and my granddaughter, ELIZABETH ANN BURltHOLDER NICHOLSON, absolutely. Should my son, JOHN E. BURKHOLDER, predecease or fail to survive me, then I give, devise and bequeath his share to my said gr~nddaughter, ELIZABETH ANN BURKHOLDER, and should the said ( \ . ..) .- 1:0 G.M.B. page 1 of 4 pages i.I, " ELIZABETH ANN BURXHOLDER fail to survive, I qive, devi.. and bequeath her share to her issue, per stirpe.. 3, I nominate, constitute and appoint the said JOHN BURKHOLDER and ELIZABETH ANN BURKHOLDER as Executors of my estate, In tho event both of th~m shall be unable or unwilling to serve in such capacity, then I ~ppoint FARMERS TRUST COMPANY, Carlisle, Pennsylvania, to act ~n such capacity. 4. I nominate, constitute and appoint FARMERS TRUST COMPANY, Carlisle, Pennsylvania, as the guardian of the estate of any minor beneficiaries under this my Will. In addition to all powers qranted by law or listed herein, I authorize my Guardian to expend any part or all of said guardian estate ~or the care, maintenance, support, education or general welfare of any minor beneficiaries or for any illness or emergency which may befall them. 5. I direct that my Executors shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 6 . I authorize and empower my personal representatives and guardian, in their lole and absolute discretion, to purchase or otherwi.e acquire and retain any investments of Wllich I die seized .j U -' H f) G.M.B.. Page 2 of 4 Pages ,. or any real or personal property of any nature, to .ell, lea.., pledge, mort9age, tran.f.r, exchange, di.po.e of or 9rant option. in r.9ard to any or all property of any kind forming a part of my e.tate for .uch terms and .uch prices as they may deem advi.able, to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or per.onal property forming a part of my estate or to join in or .ecure the partition of .ame; to compromise any claims or demands of my e.tate again.t others or of others against my estate; to make di.tribution in kind and to cau.e any share to be compo.ed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver .uch instrument. as may be nece.aary to carry out any of these power.. IN WITNESS tl/4#J day of WHEREOF I have hereunto set my hand and seal this ..June... , 1991. ,,1 k:.' tlJ."i: ll' H, /1. "Gertrude M. Burk 0 SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of u., who at her request, have hereunto subscribed our names as witne.... thereto, in the presence of the said Testatrix and of each other. __ -r-- .~~~ . ~7 /' '--~c. ~ ... L 1/ X:.I/,;..V Page 3 of 4 Pages Ir:\flIUI.'\I,^TAlrl(.l\\lI.~t"Tll.'\NmICI\,nllt CERTIFICATION OF NOTICE. UNDER RULE 5.~(a) Name 01' Deccdent: GERTRUDE M, BURKHOLDER Date of Death: July 29,1997 FileNo, 21-97-683 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 on or about October 28,1997: Elizabeth Ann Nicholson, 418 West Sixth Street, Waynesbol'o, PA 17268 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/ A Date: October 28, 1997 Signature Name ~:-';J" /--r ~: .~-_.- ;;;~~- .._-'. -~,- . ~. Blo~m,-ESq~~~----'----------'---- MARTSON, DEARDORFF, WILLIAMS & OTTO Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Personal R~presentative J'Jflt1q IUREAU OF INDIVIDUAL T~MES IMHEmAltCE UM DIYIII~ DE.PT. 210601 H."Alt1~aJ PA 17121-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE C~ *' _1.'lm.."'."-'" GERTRUDE M l MAKE CHECK PAYABLE AND REMIT PAY HINT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLC, PA 17013 CUT ALONG THIS LINE .. RITAIN LOWER PORTION FOR YOUR RECOItDS ~ iiV': lili; -iie""A,p-i i'i9 :,rnii'iTi6r-6,- INHiiiiT Ailci-TAx - APPRA-iiii..-iiir; -An-6iiANci -oli-...... ..-. - - - - -. DISALLOWANCI OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATI OF BURKHOLDER GERTRUDE M FILE NO. 21 97-0683 ACN 101 DATI 01-27-98 If an ..111.III.nt wa. i..uad previou.ly. 11n.. 14. 11 .nd/or 16. 17 .nd 11 will r.flect figur.1 that includl thl total of ~ return. .1....ld to d.tl. ASSESSMINT OF TAXI 11, ~aount of Lln. l~ .t Spoul.l r.t. li, ~..unt of Llno l~ t..obl. .t Lln..l/Cl.11 ~ r.t. 17. ~MOUI1t of Llno l~ t..obl. .t Coll.t.r.l/Cl.11 I r.t. 1.. prlnolp.l T.. Duo TAX CRlDnSI PAVHENT DATE -28-97 NOTICE OF INNERITANCE T~X AppRAIIENENT, AlLON~NCE OR OISALLON~NCE OF DEDUCTIONI ~NO ~ISE'S"ENT OF TAX STEPHEN L BLOOH ESQ HARTSON ET AL 10 E HIGH ST CARLISLE PA 17013 DATI ESTATI OF DATI OF DIA TH FILl NUMBER COUNTY ACN 01-27-98 BURKHOLDER 07-29-97 21 97-0683 CUMBERLAND 101 ~.oun~ R..ltt.d [ TAX RETURN N~S I I X) ACCEPTED ~S FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSI APPRAlSID VALUE OF RETURN BAIID ONI ORIGINAL RE1'URN 1, Ro.1 Eltot. ISoh.dul. ~I 2. Stookl end londl ISoh.dol. II S. Clol.l~ Klld Itook/p.rtn.rlhlp Int.r,"t eSoh.dul. CI ~. Hort,.,oI/Not.. R.o.lY.bl. ISoh.dulo OJ 5. C..h/lank O.pollt,/H1Ic. Perlonal Proparty (Schedule E) i. Jolntl~ awn.d prop.rt~ ISoh.dol. FI 7. Tronlf.r. ISoh.dol. 01 I. Tot.l A...h I I CHANGED III (2) 151 I~I 15) IiI 171 3'2,551.79 .00 .00 ,DO 1.632.66 .00 .00 III APPROVID DEDUCTIONS AND EXEMPTIONS I 9. Funeral EMPen..,/Ad.. Coatl/Hile. E~p.n... (Schedule H) 10. D.btI/Hort.... LI.bllltl.I/LI.n. ISoh.dul. II 11 . Tot.l Deduotiona 12. N.t V.lu, of T.. R.turn 15, Ch.rlt.bl./Gov.rnoont.l I.qu.ltlj Non-.I.ot.d '115 Trultl l~. N.t V.lu. of Elt.t. Subj.ot to T.. 7,957.00 1'1 1I01 20.2&2.82 1111 1I21 liS! 1I~1 Iloh.dol. J I NOTIl IUI_ lIi. 1I71 .00 X .00. 5,964.63 K ,06. .00 M .15. 1111 RECU pT _IU AAZ 2398-' ,-- DISCOUNT 1+ I INTEREIT/pEN PAID I') 17.89 339,99 AHOUNT PAID TOTAL TAX CRIDn BALANCE OF TAX DUE INTEREIT AND PEN. TOTAL DUI NOTE I To inaura proper oredit to ~our aooount, .ub.1t thtl upp.r porUon of thll for. with your t.x p.y.ent. 34,184,45 'A.'19 &2 5,964,63 .00 5,964,63 .00 357.88 .00 357,88 357,88 ,00 ,00 .00 . IF pAID AFTER DATE INDICATED, SE! REVERIE FQR CALCULATION OF ADOITION~L INTEREST, IF TOT~L DUE II LESI THAN fl, NO pAVHENT II REQUIRED, IF TOTAL DUE II REFLECTED AS A "CRIQU" ICRI. VDU H~Y IE DUE A REFUND, SEE REVERIE IIDE OF THIS FORK FOR INITRUCTIONS.I A\!IERY~T1,,"1 1'IJlI'OII! Of MOnef.! PAVMENT, REFUND (eA) I OIJECTIONSI ~D'UM IITRmYE COftRECTIONSI DI"DUllTI PlIlALTYI IMTEA\!ITI ht".. o' deCleRn" dylM1 on or blfor. ala"" 12, 1912 .... if Itny future int.r..t In the ..tit. 11 ,,_f.red In po,.._.lon or enjav..nt to Cl.,. . (eoI1a"r.1) banI'I.J"I,. of thl deG.~t aft" the IMplr.tlon of '"' ..t... tit l1f. or for y.~r', the C~.lth hereby IMpr.,.lv r...ry., thl right to ippr.'.. and ...... trtn.f.r l~lt.not ,.... It t~ lawful Cl... I (ooJlet.rel) r.t. on InY luch future lnt.r..t. to fulfUl thl rtqulrlHntl of SICtlon 2llfO of the Inheritance end Est... TIM Act, Act 21 of 1'''. (12 ".S. SIO' Ion 9140), Detlch the tOP portion of .hl. Hotlcl end .~lt with your ply..nt to 'hi R"II'" of WillI printed on ~ r.~.r" .~.. "~"ak' ch.ck or .aneY order pIYlbl. tal REOISTER OF MILLS, AOENT A r.fund of . tlM cr.dlt, Mhleh ~.. not r.que.tld on 'hl TaM R.turn, .ay bl rlqul.tld by OO.,lltlnt en "lpplloltlOft for Rlfund of Plnn.ylvanil InharitancI Ind E.tltl TIM" (REV-ISl]). Applloltlon. era aVlllabla .t thl Offlc' of thl Ra,i.t.r of WIll., any of the 2] R.venu' DI.trlet Offlo." or by 0.111"1 thl .paolal Z4-hQur en'Mlrlnt ..rvlu nlJllb.r. fur for.' ord.rlngl In P.nnsYlvanla l-eGo-16Z-1.DSO, ouulcs. p.MlYlvlnla and NUhin 10081 HerrlsbUr, .r.. (717) 7I7-.109oft, l1DOI (17) 772-2ZSZ (H..rlno lIP' Ired OnlY). Any p.rty In Int.r..t not ,.tl,fl.d Mlth the appr.l....nt, allowenc. or dl.allowane. of deduction., or ......IInt of t.1t (Including discount or' Inter..t) II .hONn on thlt HoUc. llIU,t obj.ct ..UMn .lMty (60) d.y. of r.c.lpt of thit Notic. bYI ~-Nrltt.n protl.t to the PA D.p.rt..nt of RIVlnue, lo.rd of 'p~I.I., Dept, Z11021, Herrl.bUrl, PI 17121-1021, OR ~-.leoUon to have thl ..tt.r d.tlr.lned .t audU of the "oount of the PIr.on.t reprll."t.Uv., OR --apPlII to the orphan.' Court. Flctu.1 error. dl.oov.r.d on thl. ........nt lhould b. .ddr....d In NrltlAl tOI PI Oapart,,"t of R.v.nue, lur'fU of Indlvldull TIM'" ATTHl Post A.......nt Revl'N Unit, D.pt. Z10601, H.rrl.bur" PA 17121-0601 Phone (717) 7.7-6S0S. Sa. p'" S of the bookl.t "In.truotl~' for lnh.rltanc' T'M Raturn for. RI.ldent Daoectant" (REV-lSOlJ for an 'Mplan.tlon of adIIlnhtnUv.h corr.ctabl. arror', If any t'M due 1. p.ld Nithtn thra. (I) c.landlr .unth' .ft.r thl dac.dant'. death, I flv. par cent (IX) dlsoount of thl t'M plld 1. .llowed, Tht llX tlM .-na.ty non-plrtlclPltlon p.n.lty I. COlPutad on the tot.1 of thl t'M and Int.r..t ......ed, and not plld bafor' Janu.ry II, 199', thl f1r.t dlY Iftlr thl .nd of tha t'M .ana.ty per1od. Thl. non-plrtlolpatlon panaltv it app..llbl. In thl .... .eMlr and In tha thl .... U.. par 10d .. you NOUld ."..1 thl tlX Ilnd Int.r..t thlt hi' bltn .......d .. indlc.tld on thi. notl~', lnt.rl.t II charged b.,lnnlnt with flr.t d.y of dlllnquancy, or nlnt C') .onth. and one (1) dlv frOl thl dat. of dtl\h, to thl dlt. of p.y..nt. 'IM.I which beo... dellnqu.nt b.fora January 1, 1.12 bllt Int.r..t at thl rltl of .IM (6Xl p.r~'"t par annul calculltad .t . d.lly rlt. af .0001.oft. All t.MI. ~Ich bac", del1nquent on and Iftlr January 1, 1'12 Nl11 bllr Intar..t It I rat. which Mill Vlry fro' callndlr yaar tn clland.r y..r Nlth th.t r.t. ~unotd by thl PI DIPlrt.."t of ".v.ou., Th. appllclbl. Int.ra.t rltl' for 1..2 through I'" .r'l US! Int.rut JIIta Dlllw Int.r..t FactBr !!!!' !!!l.r..t "It. O.lh Int.r..t FtCtor 1912 20X .0001".1 ,," .X .oaoz" 1"] IlX .OOOUI 1'11-1'" 11:< .\'00101 191. m ,0OasOl 1"2 'X .0\02" 1911 11% .ooon' l.n~I"lt 7X .oo.at! 1911 10:< .00027"- l'U-1"' .X .000241 ulnt.rll' II Clloulltad .. follOMII INTERUT . IALAMCE OF TAK UNPAID X MUNIER OF DAY' DELINQUENT K DAILY INTEREST FACTDR ."~nv Hotlc. ltl\llld IU.r the t.1t b.OOM' dll~nqulOt w111 r.Uaot an Int.rut cllt.ul.t1on to flft..n OS) d.~. beyond thl dat. of th.,.......-nt. If ply..nt tl I~ aft.r thl Int.ra.t coaput.tlon date lhewn on the "'~Io', addltlonl. Int.r..t llIU.t be o.lculltMt, ";.;' ;".,.. ...,. ."W no.. ~,- . '. ..,~... P R I NC I P AJ."..&1KlllfIS Installmcnt Salcs Agrccmcnt datcd Dcccmbcr 7, 1992, for promiscs at 1547 Spring Road, Carli sIc, PA~ principal balancc duc (32,350.03) plus accrued intcrcst (201.76) Ellis Kuhn, rcccipts of principlll on Inslullment Sulcs Agrccmcnt, August, 1997 through March. 1998 Financial Trust Company. chccking uccount Church of God Homc, pcrsonal account TOTAL RECEIPTS OF PRINCIPAL: PRINCIPAL DISBlJRSEMENIS. Ellis Kuhn, Installment Salcs Agreement, reduction of Ilrlncipal, August, 1997 through March, 1998 Vemon Kruger, reimbursement for allomey-in-fuct expenses Hoffman-Roth Funeral Home, balance due on funeral Register of Wills, Pennsylvania Inheritance Tax (paid at discount) MARTSON, DEARDORFF, WILLIAMS & OTTO, partial attorney's fee MARTSON, DEARDORFF, WILLIAMS & OTTO, disbursements: Probate fee 90.00 Advertising Letters Testamentary 133.68 Filing fee 15.00 RmW: MARTSON, DEARDORFF, WILLIAMS & OTTO, balunce attomey's fee Reserved for additional filing fees and expenses Commonwealth of Pennsylvania, Department of Public Welfare, claim TOTAL DISBURSEMENTS: INCOME RECEIPTS Financial Trust Company, checking account. interest through closing Church of God Home, interest on personal fund through closing Ellis Kuhn, Installment Sales Agreement, balance of August, 1997 interest Ellis Kuhn, interest on Installment Sales Agreement, September, 1997 through March, 1998 TOTAL INCOME RECEIPTS: 32,551.79 .1,364,34 \,021.66 6\1 ,00 . 35,548,79 1,364'\\4 367.40 849,16 339,99 1,700,00 238,68 1,000,00 175,00 19.895.42 25,929,99 1.57 \,32 \3,91 ),478,12 1,494,95 f 1t'II,mi\IJAlAt'IU\\I!Sl AnHiIM4n,!J'W lUll, ~. -' . , ESTATE OF GERTRUDE M, BURKHOLDER CUMBERLAND COUNTY FILE NO, 1997-0683 RELEASE KNOW ALL MEN BY THESE PRESENTS that the COMMONWEALTH OF PENNSYLV ANIA, DEPARTMENT OF PUBLIC WELFARE, docs hereby ucknowledge re\;eipt of and from ELIZABETH A, NICHOLSON, Executrix under the Last Will und Testament of the suid Gertmde M, Burkholdcr, ofpaymcnt ill the total amount of$19,895.42. in filII satisfaction and payment of its claim aguinst the within cstate duted August 29, 1997, a copy of which is uttuched hereto, AND, THEREFORE, the said COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFARE, docs hy these presents remise, release, quit,claim, ancl forever discharge the said ELIZABETH A, NICHOLSON, Executrix uforesaid, her heirs, executors and administrators, of and from the aforesaid claim, and of and from all actions. suits. payments, accounts, reckonings, claims and demands whatevcr. from the beginning of the world to the day of the date of these presents, AND the said COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFLARE, hereby consents and agrees that the Orphans' Court of Cumberland County may discharge the said Executrix upon application, without further noticc to it, IN WITNESS WHEREOF, the undersigned has hereunto caused this instrument to he executed this i-\ day of l-.\OI.:k!i'1'\ ).QWJ 99 , Witness: COMMONWEALTH OF PENNSYLV ANIA DEPARTMENT.O c' BIo~ ~.~"RE~) cB1, /~~/..;<<+ ~ &~ ,/ ./ -, J ()/>EUf,.I;J'? i(! " .. ' COMMONWEALTH OF PENNSYLV ANIA COUNTY OF'-'1:) (\'I.., I"\' ,W ) : SS, ) On this the ~ day of .~\ r, '.:k'((' \.)"1<.. , 1999, before me the undersigned officer, personally appeared '~\..\c:\'\\~i'=- C/",'..',.'I . who acknowledged that.tle is the . (;., I A. Suy~. LJ 1"_L:.s",__.~_____~_, ofthe Conllllonwealth of Pennsylvania, Department of Pub lie Welfare, and that as such, being authorized so to do. executed the foregoing instrument for the purposes therein contained, L' IN WITNESS WHEREOF I hereunto set my hand and official seul the day and ycur uforesaid, ;r , ." , / .J /1 ~i I. 01' (fZ..." ,/)(' (Ie 11: (;, !\ ~)' ,I,: :i '-) (~ NOT"IlIM $1M NICOL! L f"RlY, Ho4G<v """'" Ho"""'" DIu..... c:-.ly. PI. My <<=-_1....... Wt, It, 200lI