HomeMy WebLinkAbout10-26-07 (2)
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15056051058
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
21 07
0405
Date of Birth
208-12-9422
04/15/2007
07/28/1921
Decedent's Last Name
Suffix
Decedent's First Name
MI
Birbeck
John
G
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Birbeck
Ruth
v
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
C.) 1. Original Return
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4. Limited Estate C.,
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
o
8. Total Number of Safe Deposit Boxes
i.e: 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
_:J
Michael A. Scherer, Esq
Firm Name (If Applicable)
O'Brien Baric & Scherer
(717) 249-6873)
~)
REGISTER OF WILtS USE
, ,
First line of address
l_ \
19 West South Street
i I
Second line of address
. )
City or Post Office
State
ZIP Code
DATE FILED
p.)
C>
Carlisle
PA
17013
Correspondent's e-mail address:mscherer@obslaw.com
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
ISLE FOR 1'1 NG URN DATE
I~ ... 1.. r-d'f
ESS
South Pitt Street, Carlisle, PA
SIGNATURE~EP~it^~R THAN REPRESENTATIVE
ADDRESS ~
19 West South Street, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
DATE
10 -1.5'".07
Side 1
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15056051058
15056051058
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15056052059
REV-1500 EX
Decedent's Social Security Number
Decedent's Name:
John
G Birbeck
208-12-9422
RECAPITULATION
1. Real estate (Schedule A). .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
493,678.65
6. Jointly Owned Property (Schedule F) Separate Billing Requested. . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
493,678.65
39,995.85
271.30
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10).... ....... ....................... . 11.
40,267.15
453,411.50
10,987.50
442,424.00
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ..... . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ 118,348.42
16. Amount of Line 14 taxable
at lineal rate X.O _ 324,075.58
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
0.00
16.
14,583.40
17.
18.
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
14,583.40
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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15056052059
Side 2
15056052059
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
John G Birbeck
STREET ADDRESS
26 Pine Tree Drive
DECEDENT'S SOCIAL SECURITY NUMBER
208-12-9422
CITY
Mechanicsburg
STATE
PA
liP
17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
14,583.40
23,000.00
729.17
Total Credits ( A + 8 + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
23,729.17
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in avalon Page 2, Line 20 to request a refund. (4)
9,145.77
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
A. Enter the interest on the tax due.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [iJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. ~ 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)( 1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-15G8 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF John G. w. Birbeck
FILE NUMBER
21-07-0405
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Janney Montgomery Scott, Account number 1576-7796 Gross value of account $697,387.37
493,678.65
Penn Mutual Diversified Annuity was an investment within the Janney Montgomery Scott account,
Penn Mutual Diversified Annuity d.o.d. value $185,708.72 was paid directly to the surviving spouse
pursuant to the annuity contract
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
493,678.65
REV-1511 EX+ (12-99)*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
John GW. Birbeck
FILE NUMBER
21-07-0405
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Jonathan R. Birbeck
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 149 S. Pitt Street
23,921.00
City Carlisle
Year(s) Commission Paid: 2007
. State PA
Zip 17013
2.
Attorney Fees
15,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. The Sentinel
8. Cumberland Law Journal
462.00
350.00
187.85
75.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
39,995.85
REV-1512 EX+ (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John G.W. Birbeck
FILE NUMBER
21-07-0405
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Quantum Imaging
243.00
2.
Dr. Inners
28.30
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
271.30
REV-1513 EX+ (9-00) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
John GW. Birbeck
FILE NUMBER
21-07 -0405
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. John GW. Birbeck Trust c/o Jonathan R. Birbeck 100% residue
149 South Pitt Street, Carlisle, PA 17013
Remainder interest of $15,000.00 to Camp Hili United Methodist Church
and the balance to decedent's son, Jonathan Birbeck.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Remainder interest in trust of $15,000.00 to Camp Hill United Methodist Church
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
"
(If more space is needed, Insert addllional sheets of the same size)
REV-1514 EX+ (12-03)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on REV-1500 Cover Sheet
ESTATE OF
John GW. Birbeck
FILE NUMBER
21-07-0405
This schedule is to ~e used for all ~ingle.life, joint o.r successive life .estate and term certain calculations. For dates of death prior to 5-1-89,
actuanal factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99
and in Aleph Volume for dates of death from 5-1-99 and thereafter. '
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
IE Will 0 Intervivos Deed of Trust 0 Other
Ruth V. Birbeck
07/19/1922
85
I!I Life or o Term of Years
o Life or o Term of Years
o Life or o Term of Years
o Life or o Term of Years
o Life or o Term of Years
1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
2. Actuarial factor per appropriate table .................................................
Interest table rate - 031/2% 06% 0 10% iii Variable Rate 5.6 %
3. Value of life estate (Line 1 multiplied by Line 2) ......................................$
442,424.00
0.26750
118,348.42
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
2. Check appropriate block below and enter corresponding (number) .. . . . . . . . . . . . . . . . . . . . . . . . .
Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) 0 Monthly (12)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( )
3. Amount of payout per period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
4. Aggregate annual payment, Line 2 multiplied by Line 3 ...................................
5. Annuity Factor (see instructions)
Interest table rate - 0 3 1/2% 0 6% 0 10% il Variable Rate 5.6 %
6. Adjustment Factor (see instructions) ..................................................
7. Value of annuity - If using 31/2%, 6%, 10%, or if variable rate and period
payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . .$
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 ..................................................$
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through
G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18.
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TEST~~ENT
en... n... ~,
. ...... ,". .
.~ I ..
... ...,J:-:.. .".,..;!r !:,.
'(,;c. .... ,~ tt1
....... II .
OF
JOHN G. W. BIRBECK
I, JOHN G. W. BIRBECK, now of Upper Allen Township,Cumberland
County I Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all other Wills and
Codicils previously made by me.
ITEM I:
I direct that payment of all my just debts,
expenses of my last illness, funeral expenses, and the costs of
administering my estate from my estate as soon after my death as
conveniently may be done.
ITEM II:
I give and bequeath, absolutely and ir:. fee
simple, to my spouse, RUTH V. BIRBECK, all my household furni~ure
and furnishing81 books, pictures, jewelry, silverware, automobiles,
wearing apparel and all other articles of household or personal use
or adornment, provided that if my spouse dies before the thir~ie~h
day following the day of my death, this gift shall lapse or be
divested and I make said bequest to my son, JONATHAN R. BIRBECK.
ITEM III:
If RUTH V. BIRBECK, my wife, survies me ~hen
all the rest, residue and remainder of my property to go "Co
JONATHAN R. BIRBECK, my son, to be held in trust with the income to
1
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go to RUTH V. BIRBECK, my wife, if then living, during her lifetime
with payments ~o be made to her at least bi-monthly and upon her
death the corpus of the trust to go as follows:
"A. $15,000.00 to Camp Hill United Me~hodist Church! 4:!.7
South 21st Street, Camp Hill, Pennsylvania, to be used by ~P-e
Higher Education Committee for the use of Endowment Fund for
college education of worthy children; and
B. Residue to go to JONATHAN R. BIRBECK, absolutely, if then
living and if he is not then living then to his then living
children share and share alike.
ITEM IV: If RUTH V. BIRBECK, my wife, does no~ survive
me then all the rest, residue and remainder of my property ~o go as
follows:
A. $15,000.00 to Camp Hill united Methodist Church, 417
South 21st Street, Camp Hill, Pennsylvania, to be used by the
Higher Education Committee for the use of Endowmen~ Fund for
college education of worthy children; and
B. Residue to go to JONATHAN R. BIRBECK, absolutely, if then
living and if he is not then living then to his then living
children share and share alike.
ITEM V:
In the event the said JONATHAN R. BIRBECK
refuses or is unable to act as ~rustee as above or at any ~ime
rasigns from being trustee then PNC Bank to be trustee for said
trust.
ITEM VI:
I direct that any and all taxes that may be
2
'63
assessed in consequence of my death, including all inheritance,
estate and transfer taxes imposed upon my estate passing under my
Will or otherwise, shall be paid om:: of the principal of my
residuary estate as a part of the expense of the administration of
my estate.
ITEM VII: I authorize and empower my personal
representative to compromise, adjust, release and discharge in such
manner as my personal representative may deem proper , all debts and
claims owed by or to me or my Esta~ei to sell, lease or exchange at
public or priva~e sale or in such manner, at such prices, and upon
such terms of credit or otherwise, as my personal represen~ative
may deem proper, all or any part of my property, real or personali
to exec ute, acknowledge and deliver instruments of conveyance,
including deeds in fee simple; to borrow money for the purpose of
paying estate, inheritance or other taxes which are required to be
paid and to secure any such loans by pledge or mortgage of all or
any part of my property and to execute the necessary ins~ruments to
carry out such powers; to distribute my estate in kind or partly in
money or partly in kind, and to determine the fair value at which
any property so distributed in kind shall be received by the
distributees; to conduct any business in which I have an interest
at the time of my death, for such period as my personal
representative may deem proper, power to borrow money and pledge
~ssets of the business and the power to do all other acts that I,
in my lifetime, could have done, to delegate such power to any
3
~
partner, manager or employee wi thou't. liability for any loss
occurring therein and to organize a corpora't.ion to carry on said
business as capital to such corporation and accept s't.ock in the
corporation in lieu thereof and hold such stock for the uses OI
this my Will, and to vote said stock or sell the same as to my
personal representative may seem best; to re-cain all stocks,
assets, bonds and investments owned by me wi-chout being confined to
what is known as legal investments; to execute any options 't.O
purchase, to apply for stocks, bonds or other investmer..ts, to
p~rchase or otherwise acquire real estate and to execute 't.he same
powers thereover as hereinbefore provided, to retain indefinitely
any part of my assets, real or personal, which is or may become
unproductive or to make sale thereof; to pay carrying charges and
expenses of the property out of other principal or income of my
estate; to invest and reinvest in all forms of proper't.y wi't.hout
restriction to investments authorized for Pennsylvania fiduciaries I
as my personal representative deems proper! without regard to the
principle of diversification or riSK; to exercise any law-given
option to treat administrative expenses either as income 't.ax or as
estate deductions , without regard to whether the expenses were paid
from principal or income. The powers herein conferred shall be to
my named personal representative and all successors thereto and
shall be in addition and not in limi ta't.ion of other powers
conferred on said fiduciary.
Any and all payment or payments of any sum or sums, whether in
4:
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cash or in kind and whether for ?rincipal or income payable to any
b?neficiary shall be made upon the sole receipt of the respective
beneficiary to whom the payment is made and free from anticipation,
alienation, assignment, attachment, and pledge and free from
control by the creditors of any such beneficiary.
ITEM VIII:
All shares of principal and income hereby
given shall be free from anticipation, assignment, pledge or
o~ligation of the beneficiaries and any of ~hem and shall not be
subject to any execution or attac~~ent, levy or sequestration or
other claims of the creditors of said beneficiaries or any of them.
ITEM IX:
I nominate, constitute and appoint my son,
JONATHAN R. BIRBECK, as the sole Execu~or of this my Last will and
Testament, to serve without bond.
In the event of the
renunciation, death, resignation, refusal or inability to act for
any reason whatsoever of the said JONATHAN R. BIRBECK, I nominate,
constitute and appoint PNC BANK as the Executor of this my Last
will and Testament, to serve without bond.
IN WITNESS WHEREOF, I, JOHN G. W. BIRBECK, have, ~o this my
Last will and Testament, set my hand ~his
Ltr~t day OI
~ M 1A..l\.~i
, 20 d~
~~ ~.LJ.~~~
JO G. W. BIRBECK
(SEAL)
Signed,
the above
'" A.tU'^'~~
sealed, published and declared by JOHN G. W. BIRBECK,
named Testator on the Jl7 H. day CI
,20o~ ,as for his Last Will and Testament,
5
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in the presence of us, who, in
of each other, have, at his
witnesses hereto.
his presence, and in the presence
request, subscribed our names as
~
Name ~
,ed --J. ~"JL~
Name
residing
at 7D;~ ~
/)u,.l D~,..
~~-~
a~~ ~ ~ \ P ~S-
residing
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~ SS
WE, the undersigned, the Testator and the witnesses,
respectively, whose names are signed to the foregoing instrument,
being first duly sworn and qualified according to law, do hereby
declare to the undersigned authority that we were present and saw
the Testator sign and execute the instrument as his Will, and 1:hai::
he had signed willingly and that he executed it as his free and
voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the Testator, signed
the Will as witnesses and that 1:0 the best of their knowledge, 1:he
Testator was at that time eighteen years of age or older, of sound
mind and under no constrain or undue influence, and I, the said
Testator, do hereby acknowledge that I signed and executed the
instrument as my Last Will and Testament, that I signed it:.
willingly, and that I signed it as my free and voluntary act for
the purposes therein expressed.
~~ ~,W, <b~~
estator JOHN G. W. BIRBECK
~~
Wltness
Oa\2,-~. ~~~
Witness
Sworn to and subscribed be~e
me this I/~ day of '- ~'
20~:;J.- .
Nota~~
My Commission
JJ!.-u ~rJ
~
0-
Expires:
NOTARIAL SEAL
MARY D. VER HAGE, Notary Publk:
FairvieWTwp.. York County
~ ~v C?mmissioB Expires May 7, 20<12
6
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~
~
CODICIL TO MY LAST WILL AND TEST AMENT
I, John G. W. Birbeck, of Cumberland County, Pennsylvania, being of
sound and disposing mind, memory, and understanding, do hereby make, publish,
and declare this codicil to my Last Will and Testament, hereby amending and
revising only ITEM IX of my Last Will and Testament dated January 11,2002.
Amended ITEM IX:
I nominate, constitute and appoint my son JONATHAN R. BIRBECK,
ESQ. as the sole Executor of this my Last Will and Testament as previously
drafted and executed July 11,2002, to serve without bond. In the event of the
death, or inability to act for any reason whatsoever of the said JONATHAN R.
BIRBECK, ESQ., I nominate MARTIN CHRONISTER my stockbroker and
friend (presently at 717- 731- 4400), as the Executor of this my Last Will and
Testament, to serve without commission or bond. In the event of the death or
inability to act for any reason whatsoever of the said MARTIN CHRONISTER, I
appoint PNC Bank as Executor of this my Last Will and Testament, to serve
without commission. "
In witness whereof, I, John G.W. irbeck signed this J$I-- day of~,
2006. ~ -J,..J. \>- ~~
stator John G. W. Birbeck
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, John G. W. Birbeck, Testator 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 instrument as a Codicil to my Last
Will and Testament in the presence of witnesses; that I signed it willingly and that
I signed it as my voluntary act.
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Sworn or affirmed and ac~wledged before me by John G. W. Birbeck, the
Testator, this l&day of ~~ 2006 as a codicil to my LAST WILL AND
TESTAMENT.~ ~ ,L' < ~
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NOTARIAL SEAL
SONIA E STMR
Notary Public
CARlISLE BOROUGH. CUMBERLAND COUNtY
Uv C'nmmlsslon EXDlres Jul 31 . 2008
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AFFIDAVIT
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COMMONWEALTH OF PENNSYLVANIA
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COUNTY OF CUMBERLAND
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Before me, the undersigned officer, personally appeared
Jonathan R. Birbeck, who being duly sworn according to law,
deposes and says that he drafted a Codicil to the original
John G.W. Birbeck Last Will and Testament, the original being
dated January 11, 2002. Said Codicil was executed November 1,
2006, and amended Item IX. In drafting said Codicil, Attorney
Birbeck referred to the January 11, 2002 Will as the July 11,
2002 Will. There is no July 11, 2002 Will. The January 11, 2002
will is the Will referenced in said Codicil. The date of July
11, 2002 was a typographical error. The original will dated
January 11, 2002, was filed at the Cumberland County Register of
Wills Office on April 26, 2007.
~
Subscribed and sworn to before me
NOTARIAL SEAL
SONIA E STIVER
Notary Public
CARLISLE BOROUGH, CUMBERLAND COUNTY
My Commission Expires Jul 31 , 2008
aEney
Janney Montgomery Scott LLC
May 4, 2007
O'Brien, Baric & Scherer
Attn: Michael Scherer, Esq.
19 W South St
Carlisle PA 17013
RE: Estate of John G. W. Birbeck
Mr. Schert:r:
I have received your request for a date of death valuation for the above referenced estate as of
April 15, 2007.
Enclosed is a summary of the assets held by Janney Montgomery Scott on behalf ofMr. Birbeck
at the time of his death. JMS also served as custodian on his IRA, which was depleted and closed
on April 9, 2007. Of the remaining two accounts, one is held in the names of John and Ruth
Birbeck as jo.int tenants with rights of survivorship. The balance of this account will
automatically be transferred to Ruth as survivor. The other account was maintained in John's
individual name. These assets must be transferred to an account established in the name ofthe
Estate, and then may be disbursed according to the terms of the will. Both accounts were
originally established over ten years ago, and no changes to the registration of either account have
occurred. Mr. Birbeck also owned an annuity, which appears on the summary. The guaranteed
death benefit of this contract may be more or less than what appears as its value on our records at
the time of death. Original paperwork to handle the death claim on this investment must be filed
directly with the annuity carrier. I have contacted the carrier to confirm that the annui is free of
all surrender charges, and Ruth is the eneficial1" With the exception of this annuity contract,
there are no additional benefits payable beyond the assets indicated on the enclosed summary. To
redeem the entire account, appropriate commission charges will be assessed on many ofthe
securities held; please contact Mr. Chronister for more information or with questions related to
the redemption of any investments.
When Jonathan is ready to proceed with the establishment of the estate account, please contact
me at 1-800-622-7200, and I will prepare the necessary paperwork for him to do so.
Should you4ave any questions or concerns, please do not hesitate to contact me.
cereJ~'+>-o .~~-};\M~
Kris J. Lehman~artson .
Registered Sales Assistant
:?(l Frford Ro,HI. Suite ~\F). IellW\llt'. P.-\ J70.t:\-11O~) . 717.7:\1..J-lOO . Et,: 717.7~~1..J-IJ I . \\\\\\..jimoll
\klll),n :\e\\' York Stock E'chan~l', JllC and o[her principall',chall~es
\!ember Securities Illn'S[nr Prot<,nion Corporation
Estate of John G. W. Birbeck
Value as of April 15, 2007
John G. trv. Birbeck Acct# 1576-7796
Market
Quantitv Description Price Value
584.459 Alliance Bernstein Large Cap Growth A $ 21.22 $ 12,402.21
1,847 Blackrock Enhanced Dividend $ 14.98 $ 27,668.06
2,347 Eaton Vance Tax Global Buy Write $ 20.01 $ 46,963.47
3,307 Eaton Vance Insd Municipal Bond Fund $ 15.85 $ 52,415.95
1,172.191 Franklin Growth Fund A $ 43.15 $ 50,580.04
17,265.059 Lord Abbett PA Tax Free Fund $ 5.21 $ 89,950.95
1,388 Pimco Municipal Income Fund II $ 15.50 $ 21,514.00
25,000 BOAMS 04-31A1 5.5 % Due 4-25-34 $ 2,271.16
25,000 GNMA 06-38WA 5.75 % Due 1-20-36 $ 17,961.36
15,000 Goodyear 7.857 % Due 8-15-11 $ 15,675.00
29,000 FHLMC 2864DB 5.0 % Due 9-15-34 $ 18,602.67
35,000 FHLMC 2975BK 5.25 % Due 1-15-35 $ 10,038.68
25,000 FHLMC 3013AP 5.5 % Due 8-15-35 $ 18,065.94
25,000 FNMA 06-15BH 5.75 % Due 2-25-35 $ 13,710.26
25,000 FNMA 06-34BN 6.00 % Due 12-25-35 $ 11,579.64
20,000 FHLMC 3257HA 5.5 % Due 6-15-36 $ 19,086.59
62 Nuveen Insured Unit Trust PA 269 Monthly $ 102.09 $ 6,329.58
130 Nuveen Tax Ex Fr Insured PA 271 Monthly $ 102.71 $ 13,352.30
50 Nuveen PA Insd 281 Monthly $ 102.25 $ 5,112.50
25 Penn Insd Municiapllnc Tr 150 $ 209.02 $ 5,225.50
3,337.111 Eaton Vance Pa Municipal A $ 10.12 $ 33,771.56 !<,v17f-
40,516.710 Penn Mutual Diversifier Annuity $ 185,708.72 -1t-
42.47 JMS Money Market Fund $ 1.00 $ 42.47
1,358.76 Accrued Interest and Dividend Balance $ 1.00 $ 1,358.76
Total: $ 679,387.37
John G. trv. Birbeck & Ruth V. Birbeck Jtwros. Acct # 1576-8100
Quantity Description
12989.253 Franklin Income Fund A
508.30 JMS Money Market Fund
Market
Price Value
$ 2.74 $ 35,590.55
$ 1.00 $ 508.30
Total: $ 36,098.85
PLEASE NOTE: This information ;s not the official record of the above account and ;s subject to changes. errors and omissions and cannot be guaranteed as to its
accuracy or compleleness. The printed confirmalions and periodic account s/alements constitute the official account record. This information ;s not a
substitule for olher irnporlanl information that JMS sends. The above may not be used for tax reporling purposes. JMS will send official tax
documentatio regarding this account via mail.
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AAA Member-Years'
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EV/
Rewarding Your Years of AM MembershipTM
Monday, May 14, 2007
Michael A. Scherer
19 West South Street
Carlisle, PA 17013
Regarding: AAA Member -Years Insurance Plans
Policy Number: ADD-ll079
Estate of John G. W. Birbeck
Dear Mr. Scherer:
Thank you for contacting our office to notify us of the death of John G. W. Birbeck. We
were saddened to hear of his death. Please extend our deepest sympathy to his family.
We have closed our files for Mr. Birbeck as of May 1, 2007 and coverage was never placed
in force.
Because Mr. Birbeck passed away before coverage had been placed in force, I have
enclosed our check, in the amount of $49.00, which is a full refund of the premium originally
submitted with the enrollment form.
If you have a question, Mr. Scherer, or if we may be of further service to you, please call
me.
Very truly yours,
!kan~
Senior Account Administrator
AE:nsl
Enclosure
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Insurance Administration Office . The Princeton Corporation. 600 Princeton Parkway. Kentland, Indiana 47951 . Telephone 1-866-345-6938.1-866-363-6304