HomeMy WebLinkAbout02-0010 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of' l ._04L.~X[ ~. %,3~,~& No. 21-02-10
To:
a;so .- Y
~b ~ ~ ~ ~ ~ ~ ~ ~ t_ ~ Deceased.
Social Security No. ~ ~t ~ _ ~ ~ ~ ~ Q ~ ~
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut~ ~
in the last will of the above decedent, dated ~~ X ~ i~ ~ ~
and codicil(s) dated ~ D ] ~ ~ / 7 ~- ~ i- 7 ~ } -~
Register of Wills for the . '
County of('~.t~e~,~ r~.~eO~in the
Commonwealth of Pennsylvania
named
,19__
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at'death in~'(~a tN'-x--~-O ~'~ [A-0~/~ Cou-ty Pennsylv nia with
h t~ -last fa. mily or principal rgsidence at ~ o
t.,,,w-.,,. ~il~.,o. t~_::.~--u- .VAA_~-_o.._U_,a..,,, -
:2
'¥- '~ , '?&/. (list street, number and muncipality)
Degendent, then :' ~,50~- ~years of age,,&ed '.~_ e.
ExcePt as ~ollows, d~cedefit~'[~!not marry, was not divorcedan-"d did not have a child born or adohr'ed .
after execution of the will ofi'e.-red~for probate; was not the victim of a killing and was never adjudicated
incompetent: / ' ~.--'
Decendent at death owned'property with estimated values as follows:
(If domiciled in Pa.) - - All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the. last will and codicil(s)
presented herewith and the grant of letters -~-~'~--~ ."C~ ~ ~ tORy'S' ~,N~:
(testamentary; administration/c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
The petitioner(s3 .ab6ve=named s.wfia~(s) or affirm(s) that the statements in the foregoing petition are
true and correct to'the)est o? the knb~ledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petiti6n~r(s) will well ~d truly administer t~ ~tate acco~ng to law.
Sworn to or affirmed and subSCriBed ~ ~0~~ ~ ~
before me this ~ 4th d~y of [ ~~[~ ~- ~O~ ~
NO. 21-02-10
Estate Of
LEROY M BURD, aka'LEROY BURD
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
JANUARY
AND NOW
the reverse side hereof, satisfactory,prOof ha~'ing been presented bef~r.e.nie;
IT IS DECREED that the instrument(s) dated Mar. 1. 1965~'
described therein be admitted to probate and filed of record as the last will of
LEROY M BURD, aka LEROY BUILD
and Letters TESTAMENTARY
t~2002 , in consideration 0,5' ',:i:e petitiort on
26.. 1Q76_ .TAN 10:1992
are hereby granted to: , · DENNIS L BURD-
Filed
FEES
Probate, Letters, Etc .......... $ 200.00
Short Certificates( ) .......... $ 18.00
~e-Da~e& 9.00
nhn~at]on ................ $
CODICIL $ 21.00
3CP 5.00
TOTAL__$
.... JAN...4,.2B02 .................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
i
!
21-02-10
REGISTER OF WILLS OF
OATH OF SUBSCRIBING WITNESS
oq, codicil b.
(each) a witness to the will presented herewith, (each) b
law, say(s) that
the testat , sign same and that
request of testat in __ presence and (in the
.other subscribing witness(es)).
Sworn to or affirmed and subscribed
me this day o
duly qualified according to
present and saw
signed as a witness at the
ice of each other) (in the presence of the
(Name)
Register
(Address)
(Name)
COUNTY
q~)C~TH OF NON-SUBSCRIBING WITNESS
.~ach) a subscriber hereto, (each) being duly qualified according to law, depose(s) and._~.ay(s) thah
Ck_rw~x~ familiar'with the signature of ~--~~
~., codicil ,
testat t¢)lD'-
that
to the best of "-~,~iS'?,fi~ledge and belief.
Sworn ~oAor affirmed an~sli~sc~bed before
this ~/'~,".~', .:: .... ~ day of (Name)
me
/~ // ~/J- - '. // · Register
?
of (one of the subscribing witnesses to) the will presented herewith and
· .~) -codicil
~D.~. believes the signature on t'~ will is in the handwriting of
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING
21-02-10
codicil e it~h,(ea '
(each) a subscribing witness to the will presented h ch) being duly qualified according to
law, depose(s) and say(s) that /'/ present and saw
the same and~h~ signed as a witness at the
the
testat
sign
request of testat in h__/esence and (in the presence of each other) (in the presence of the
other subscribing witness(e~;~
Sworn to or affirmed a~subscribed before_
me this /' day of (Name)
/ (Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
CONNIE L DRAWBAUGH
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and _say(s)_xxtll~at
she i~ familiar with the signature of
codicil
testat ~ of (one of the subscribing witnesses to) the Q~will presented herewith and
[~_ believes the signature on the~ ~ill is in the handwriting of
that
to the best of ?--< L~) /1: R~owledge and befieL ~
(NamO
(Address)
21-02-10
I, LEROY BURD, and I, BERTHA BURD, of Munson, Clearfield
County, Pennsylvania, and each of us and both of us being of sound.
mind and memory and realizing the uncertainty of life, and the cert-
ainty of death, and wishing to direct how our property Shall be
distributed upon the death of each of us or both of us, do hereby
make, publish and declare this to be our Last Will and Testament,~
hereby revoking all former Wills by us or either of us heretofore
made.
FIRST: It is the will of each of us and both of us that all
of our just debts and funeral expenses be paid by our Executor, here-
inafter named, as soon as conveniently may be after our decease.
SECOND:
It is the will and'desire of each of us and the mutual
wish and desire of both of us that on the death of either of us, all
of the property of the deceased party, whether real, personal, or
mixed, shall descend, to and become the sole and separate property of
the surviving party.
THIRD: In the event that both of us should die simultaneously
or in a common disaster, or upon the death of the survivor of us,
then all of the property, whether real, personal or mixed, shall go
to our children, Dennis Burd, Larr~ Burd, and Rosalie Burd, share and
share alike.
FOURTH: We hereby appoint William W. Litke, Esq., of Litke &
Gettig, Bellefonte, Pennsylvania, to be the Executor of this our
Last Will and Testament with full powers to act in the premises.
FIFTH: This instrument is made in conformity with a contract
heretofore entered into between us, the aforesaid~ LeRoy Burd and
Bertha Burd, by the terms of which each of us contracted with the
other to execute this Will in consideration of the promise of such
other to execute this Will; and by the further terms of which we,
each of us, contracted that we would not revoke this Will in whole
or in part~ nor make any attempt to do so.
this
IN WITNESS WHEREOF, we have hereunto set our hands and seals
~~~, ~Se al)
Seal )
ATTESTATION CLAUSE
Signed, sealed, published and declared by the above-named
Testators as and for their Last Will and Testament in our presence,
who, in their presence and at their request, and in the presence of
each other, have hereunto set our hands in witness to such execution
by said Testators of this their Last Will and Testament.
-2-
CODICIL
AND NOW~..~/,~'~-..~ , 1'976, we, LEROY M. BURD and BER-
THABURD, now of 608 Park Hills Drivet.Mechanicsburg, Pennsylvania
17055, do hereby delete paragraph FOURTH of our Last Will and Testa-
ment, dated March I, 1965, and in its stead do hereby substitute the
following paragraph:
FOURTH: -We hereby designate and appoint our son, DENNIS
[~--~BURD, of Mechanlcsburg, Pennsylvania, to be our. Executor of this
our Last'Will and Testament,.with full powers to .act in the premises.
In .all other respects, we do hereby republish and confirm
the provisions of our said Last'Will and Testament of March~.l, 1965.
WITNESS,. our hands and seals th is
1976.
Witness
(SEAL)
.(SEAL)
CODICIL
AND NOW, this /O day of January; 1992, we, LEROY M. BURD
and BERTHA BURD, of Mechanicsburg, Pennsylvania, being of sound
mind and memory, do hereby make and publish this second Codicil
to our Last Will and Testament, dated March 1, 1965, as follows:
FIRST: Livinq Will
(1) While competent to govern ourselves and manage our
affairs, each of us intend to exercise such legal rights as we
may have to participate in decisions relating to our physical
care and treatment or to make decisions to refuse care and
treatment.
(2) If either of us become incompetent to govern ourselves
and manage our affairs or become unable to make or communicate
decisions relating to our medical care and treatment, then this
directive shall stand as our final expression of such legal
-rights as either of us may have, to refuse medical or surgical
treatment and to accept the consequences of such refusal, subject
only to such limitations as may be imposed upon our exercise of
these rights by the legislature or courts of the jurisdiction in
which either of us is being cared~for from time to time.
(3) If either of us should suffe~ an incurable injury,
disease, or illness certified by two physicians (one of whom may
be our attending physician) to be such as has resulted in perma-
nent loss of consciousness or to be such that the application of
life-sustaining procedures would serve only to postpone our death
and where our attending physician determines that Our death is
fairly predictable within what he or she considers to be a
relatively short time as a consequence of such condition or
related complications whether or not life-sustaining procedures
are utilized; each of us direct that such procedures be withheld
or withdrawn, and that we be permitted to die naturally. By way
of example and not by way of limitation, such procedures may
include repeated cardiac resuscitation and mechanical
respiration.
(4) For purposes of our own care and treatment, each of us
direct that our treatment be limited to measures to keep us com-
fortable and to relieve pain, including any pain that might occur
by withholding or withdrawing treatment.
(5) Each of us recognize that a time may occur that we can-
not participate in our medical care decisions, and accordingly,
we appoint the survivor Of us and the persons named below to make
such medical decisions with respect to our care and treatment;
namely, our daughter, ROSALIE ANN BURD, and our two sons, DENNIS
BURD and LARRY BURD.
(6) Each of us and both of us further authorize the persons
above named by us to plan and arrange all medical care and
related care and treatment on our behalf, and their decisions
shall be binding in all respect upon all those'involved in our
care.
SECOND: In all other respects, we hereby confirm and ratify
the provisions of our Last Will and Testament dated March 5,
--2--
1965, and first Codicil dated December 25, 1976.
(SEAS)
(SEAL)
Signed, sealed and declared by the above-named Testators as
and for the second Codicil to their Last Will and Testament in
our presence, who, in their presence and at their request, and in
the presence of each other, stand as witnesses to this Codicil to
their Last Will and Testament.
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Leroy M. Burd
Date of Death: December 12, 2002
Will No. Admin. No. 21-02-0010
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 April 12, 2002:
Name Address
Dennis L. Burd, 5120 Ravenwood Drive, Mechanicsburq, PA 17055
The Reverend Larry E. Burd, 3659 Michiqan Ct., Bethlehem, PA 18017
Rosalie Ann Burd, 197 Squires, Apt. , Kelloqq Rd., Courtland, NY 13045
Notice has now been given to
except None
Date: April 12, 2002
,.~ '~ -- o- "~C~pacity:
[1.
S~ig atu e
Name Ric~-C. R~ ~
Address 355 N. 21st St., Suite 205
Camp Hill, PA 17011
Telephone (717) 761-3459
X
5.6(a)
Personal Representative
Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001610
RICHARD C RUPP ESQUIRE
355 N 21ST STREET
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 204-03-6702
FILE NUMBER: 2102-0010 "- ~'
DECEDENT NAME: BURD LEROY M
DATE OF PAYMENT: 09/12/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/12/2001
ACN
ASSESSMENT.
CONTROL
NUMBER
AMOUNT
101 $4,587.37
TOTAL AMOUNT PAID:
~4,587.37
REMARKS: DENNIS BURD
C/O RICHARD C RUPP ESQUIRE
SEAL
CHECK# 1032
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
FORM '16 REG. WILLS
of all real and personal estate of
deceased, late of
INVENTORY
(Number and street) (city)
~}~.~.}.~.}.}.~.}.}.~.}.}.~.~.}.~.~.}.~.~.}.~.~.}.~.}.}.~.~.}.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.}.~.~.?}.~.}.}.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.~.}.~.~.}.~.~.~.~.~.~.~.~.~. ,Cumberland County, Penns¥1¥ania, !i!ii!ii!!!~ii!ii!ii!i!ii!i!ii!ii!i!}i!i}i!}i!ii?!ii!ii!ii!i!ii!ii!!i!ii!ii!~
(Borough or Township) (Zip Code)
(date of death)
PERSONAL ESTATE SCHEDULE
Copyright 2000 David James Thorpe, Esq.
AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR
, deceased, that the foregoing schedules constitute a complete inventory
and appraisement of the real and personal estate of
deceased, except real estate outside the Commonwealth of Pennsylvania, that t? figures opposite each item of real and
personal estate in the foregoing schedules are determined and stated by the undersigned to be fair value of said items as
of the date of the decedent's death. "
Sworn and subsCribed before me
~ Camp Hill ~oro, Cumb'erland ~3 ty I
~ .~..I;t~y_C,0,,rnmission Expires Oct. 22, 20051 ADDITIONAL INSTRUCTIONS
1. The i.hv?;ntory shall be filed no later than the date the account is filed or the due date, including any extension, for the
filing iof the I~heritance Tax Return (9 months from the date of death) whichever comes first.
2. '/~, Sup~pl?~e~tal inventory must be filed within thirty days of discovery of additional
3. .An original;and two copies must be filed.
'. Additiohal sheets may be attached as to personalty'or
5. 'See Section 3301 et seq. 'Of the Probate Estates and Fiduciaries Code of 1972, as amended.
6. The inventory must be typed.
Copyright 2000 David James Thorpe, Esq.
Z
Z
0
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-O601
REV- 1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
................. '"" ........ :'"' ........ '"'"'"'"'"'"'"'"'"'"'"'"'"'":+ :+ ?'""+:':':':':'"'" '"'""" ................. :::: :::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
DATE OF DEATH . JDATE OF BIRTH ·
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH
THE
REGISTER OF VVII I -~
SOCIAL SECURITY NUMBER
1. Original Return
4. Limited Estate
6. Decedent Died Testate (Attach copy of w311)
9. Litigation Proceeds Received
THIS SECTION MUST BE COMPLy-t [-[~. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
I~i] 2. Supplemental Return * lii!iiiiiiiiiil 3. Remainder Return (d,,, of ream prior to 12.
4a. Future Interest Compdse (date of death after 12-12-82) ~5. Fede~l Es~te T~ Return R~uired
7. D~ent Uain~in~ a Living Trust ~..~ ~ .. d T~.) ~ 8. Total Number of Safe Deposit Boxes
~;~ 10 S~usal Pove~ Credit (aate of death ~ee. ~2-3~-e~ a~ ~ ~ ~ * ~ 11. Elation t~ ~ under Sec. 9113(A)
~ * ~*~ ~..~o) '
~.A..I~I..E ........ ICOMPLI= ! ,': MAILING ADDRESS
1. Real Estate.(Schedule A)
2. Stocks and BOnds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank De ~osits & Misc. P~rsonal Property (Schedule E)
~. Jointly Owned Property (Schedule F) ~ Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(lO)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
~ ~).oo
? $o.oo
: $0.00
$1'J'7,610':12
~ $0.0o
$0.0oi
OFFICIAL-.~USE ONLY
~ i~:~
(8)
$117,610.12
$13,333.00
$2,336.30
(11)
$15.669.3o
$101,940.82
$o.0o
(12)
(13)
(14)
$101,940.82
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable at collateral rate
19. Tax Due
x .12 (17)
x .15 (18)
(19)
$0.00
$4,587.34
$0.00
$000
$4,587.37
Copyright 2000 David James Thorpe, Esq.
Decedent's Complete Address:
tSTREET ADDRESS
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C)
"3. Interest/Penalty if applicable
Total Interest/Penalty (D + E)
4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
5. If line 1 + line 3 is greater than line 2, enter the differe, nce. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DuE.
(I) $4,587.37
(2)
$0.00
$0.00
$4,587.37
~(3)
(4)
(5)
(SA)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
............................................................................................................................................ ~=~<.~<~<<~;~:~:~=~?~:~[~=~=~=~:~Ji~[~!~i!~ii~[~[~[~[~[[[i[i[~[~i~[~[~[i[![ii
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS
Yes No
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the dght to designate who sh~ll use the property transferred or its income;
c. retain a revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1982, did decedent transfer property within one year of death without'
receiving adequate consideration?
3. Did decedent own an 'in trust for' or payable upon death bank account or secudty at his or her death?
4. Did decedent own an individual retirement account, annuity, or other non-probate property?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including ~=,.~u,~ ~panying ~-c~%~ules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.
DecJaration of preparer other then the personal representative is based on all the information of which preparer has any knowledge.
SI~ES~ETURN
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 3% [72 P.S. §9116 (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 0% [72 P.S.
{}9116 (a) (1.1) (ii)]. The statute does no exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a
tax retum 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 0% [72 P.S. §9116(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 4 5% except as noted in 72 P.S. {}9116(1.2) [72
P.S. §9116(a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(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.
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL pROPE.RTY
ESTATE OF LEROY M. BURD FILE NUMBER 21-02-0010
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on
Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
TOTAL (Also enter on line 51 Recapitulation
(If more space is needed, insert additional sheets of the same size)
$117,610.12
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF LEROY M. BURD .~ FILE NUMBER 21-02-0010
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION AMOUNT
TOTAL (Also enter on line 9, Recapitulation
$13,333
(If more space is needed, insert additional sheets of the same size)
Copyright 2000 David James Thorpe, Esq.
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIAB!LIT!ES~ & LIENS
ESTATE OF LEROY M. BURD FILE NUMBER 21-02-0010
Include unreimbursed medical expenses~
ITEM DESCRIPTION AMOUNT
NUMBER
TOTAL (Also enier on line 10, Recapitulation)
$2;366.30
(If more space is needed, insert additional sheets of the same size)
Copyrighl 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
BENEFICIARIES
ESTATE OF LEROY M. BURD FILE NUMBER 21-02-0010
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) Ol~ ESTATE
I1.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
JNON-TAXABLE DISTRIBUTIONS: .
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
;0.00
(If more space is needed, insert additional sheets of the same size)
Copyright 2000 David James Thorpe, Esq.
I', LEROY BURD, and I, BERTHA BURD, of 5lunson, Clearfield
County, Pennsylvania, and each of us and both of us being of sound
mind and memory 'and realizing the uncertainty of life, and' the .cert-
ainty of death, and wishing to direct how Our property shall be
distributed, uDon the death of each of us or both of us, do hereby
make, publish and declare .this to be our Last Will and Testament,
hereby revoking all former Wills by us or either of us heretofore
made.
~I'~ST: It is the will of each of us and both of us that all
· of our just debts and funeral expenses be paid by Our Executor~ here-
iinafter named, as soon as conveniently may be after our decease..
'SECOND: Il is the will and desire of each of us and the mutual
wish and desire of both of us that on the death of either of us, all
of the property of the deceased party, whether real, personal, or
mixed, sh~ll descend to and become the sole and separate property of
~he survivino party
T~{![:~I): In the event that bot.h of us should die simultaneously
or in a common disaster, or Upon the death of the survivor of us,
then all of the property, whether real, personal or mixed., shall go
.to our children, Dennis Burd, Larry Burd, and Posalie Burd, share and
share alike.
FOURTH: We hereby appoint William w. Litke, Esq., of Li%ke &
Oettig, Bellefonte, Pennsylvania, to be the E~cecutor of this Our
Last Will and Testament with full powers to act in the premises.
FIFTH: This instrument is made in confOrmity~vith a con%rac*.
heretofore entered into bet-~een us, the aforesaid, Lef~oy ~3ur¢! and
Bertha Burd, by'the terms of which each. of us contracted with thc
~other to execute this Will in consideration of the promise of such
other to execute this Will; and by the further terms of which
each of us~ contracted that we would not revoke this Will in whole
or in part, nor make any' attempt to do so.
'~thzs
I~,~' WITk~$S WHEREOF, we have hereunto set our
hands and seals
ATTESTATION CLAUSE
Signed, sealed, published and declared by the'above-named
iTestators as and for their Last Will and Testament in our presence,
~,~ho, in their presence and at their requost, and in the.presence of
!each other, have hereunto set our hands in witness to such execution
by s~.id Testa%ors of this ,their i~ast \Jill and Testament.
CODICIL
AND.NOW~-~a~.~/o"~ , 1'976, we, LEROYM. BURD and BER-
THABURD, now of 608 Park Hills Drive, Mechanicsburg, Pennsylvania
17055, do hereby delete paragraph FOURTH of our La'st Will and Testa-
ment, dated March I, 1965, and in its stead do hereby s~ubstltute the
following paragraph:
J~ BURD,
FOURTH:. We hereby designate and appoint our son, DENNIS
of Mechanlcsburg, Pennsylvania, to be our Executor of this
our Last Will and Testament, with full powers to act in the premises.
In all other respects, we do hereby republish and confirm
the provi'sions of our said Last Will and Testament of March I, 1965.
WITNESS our hands and seals this~(~/~/day o
1976.
Witness
',(SEAL]
(SEAL)
Financial
Advisors
IDS LIFE INSURANCE COMPANY
AMERICAN EXPRESS FUNDS
AMERICAN EXPRESS CERTIFICATE COMPANY
AMERICAN EXPRESS BROKERAGE
70100 AXP Financial Center '~
Minneapolis, MN 55474
December 24, 2001
JAMES S PECKHAM
STE 302 1200 CAMP HILL BYPASS
CAMP HILL, PA 17011-3700
Dear JAMES S PECKHAM:
Thank you for your recent inquiry regarding LEROY M BURD's accounts. These are the values of the
accounts as of 12/12/2001. At the end of this letter, you will fred a list of beneficiaries shown in our initial
review of the deceased's accounts.
Account Information
Mutual Funds
Account Number
01036495190 4 002
02122718519 2 002
02152718519 9 002
Annuities- Post1985
Account Number
93102316509 1 004
LTC Premium Return
Account Number
91003314927 9 004
Ownership
IRA - beneficiary designated
IRA - beneficiary designated
Individual: TOD
Ownership
IRA - beneficiary designated
Ownership
Individual
Mutual Funds
Account Number Total Value # of shares
01036495190 4 002 '$8779.07 467.718
02122718519 2 002 $13429.74 2795.716
02152718519 9 002 $43510.26 9955.175
Asset Value Per Share
18.770
4.790
4.360
Annuities - Post 1985
Account Number
93102316509 I 004
Total Value
$30752.05
Account Disposition
Account disposition is based on how an account is owned (the ownership ~ype). The follo~ving
information will help you understand the process that will be used to settle the accounts.
Insurance and annuities are issued by IDS Life Insurance Company. an American Express company.
Financial
Advisors
IDS LIFE INSURANCE COMPANY '
AMERICAN EXPRESS FUNDS
AMERICAN EXPRESS CERTIFICATE COMPANY
AMERICAN EXPRESS BROKERAGE
70100 AXP Financial Center
Minneapolis, MN 55474
Beneficiary Information
Wc have the following beneficiaries on record for thc dcceascd's accoUnts.
Account Number: 01036495190 4 002 '
Designation:
PRIMARY BENEFICIARy
DENNIS L BURD SON
LARRY E BURD SON
ROSALIE A BURD DAUGHTER
EQUALLY, THE SURVIVORSEQUALLY, OR THE SURVIVOR
Account Number: 02122718519 2 002
Designation:
PRIMARY BENEFICIARY
DENNIS L BURD SON
LARRY E BURD SON
ROSALIE A BURD DAUGHTER
EQUALLY, THE SURvIVoRS EQUALLY, OR THE SURVIVOR
Account Number: 02152718519 9 002
Designation:
PRIMARY BENEFICIARY
LIVING, LAWFUL CHILDREN IN EQUAL SHARES
100.00%
Account Number:
Designation:
No record on file.
91003314927 9 004
Account Number: 93102316509'1 004
Designation:
PRIMARY BENEFICIARY
LIVING, LAWFUE CHILDREN IN EQUAL SHARES
100.00%
Insurance and annuities are issued by IDS Life Insurance Company. an American Express company.
~EP-l~-2~2 21:21 PNCBRNK a12 768 34~8 P.01/01
PN C_BAN(
September 6, 2002
Rupp & Meikle
Attn: Richard Rupp
355 N 21~ St Suite 205
Camp Hill, PA 17011
Estate of Leroy M Burd (DeCeased)
$$N: 204-03-6702
DOD: 12.12-2001
Ia resl)ollse to your request for Date of Death balances for the customer noted above, our
records show the followia~.
Checking Aceount
Account~5070087941 Established 01-01 - [ 979
LEROY M BURl)
DOD balance:. $5,070.51 4. $0.04 accrued interest
Please note that this offic~ only provides date of death balances for deposit accounts
(IRAs, CDs, (2hooking and Savings accounts). We do not proc, ess any t~nzn¢ial
transaotions or provide statements. If you n~.xl ~sist,xnce with any of these item~, please
call 1-$8$-PNC-BANK (1-888-762-2265) o~ stop by your local PNC B,n~ branch offioe.
Sincerely,
Brim L Schlegel
PNC Doc~xleot Rcporfin~
Firstsido Ceniee
500 First Av~, 4~ Fl ClF
Pi~sburgh PA 1521%3128
! 400-762-~ 775
Member FDIC
TOTRL P.O1
· ' Kelley Blue. Book Used Car Values
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Blue Book Private Party Report
Pennsylvania · September 11, 2002
1998 Buick Park Avenue Sedan 4D
Engine: V6 3.8 Liter' ~
Trans: Automatic
Drive: Front Wheel Drive
Mileage: 35,000
Equipment
Air Conditioning
Power Steering
Power Windows
Power Door Locks
Tilt Wheel
Cruise Control
AM/FM Stereo
Cassette
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Financing Quote
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Warranty Quote
Print "For Sale" Sign
Payment Calculator
Dual Front Air Bags
ABS (4-Wheel)
Dual Power Seats
Alloy Wheels
Consumer Rated Condition:
Fair
"Fair" condition means that the vehicle probably has some mechanical or
cosmetic defects, but is still in safe running condition. The paint, body and/or
interior need work to be performed by a professional in order to be sold. The
tires need to be replaced. There may be some repairable.rust damage. The
value of cars in this category may vary widely. A clean title history is assumed.
Even after significant reconditioning this vehicle may not qualify for the Blue
Book Suggested Retail value.
Private Party Value $11,585
Private Party value represents what you might expect to pay for a used car
when purchasing from a private party. It may also represent the value you
might expect to receive when selling your own used car to another private
party.
Get a Used Car Trade-In Value Get Invoice & MSRP on New Car_
.../kw.kc.ur?kbb. PA;981353 ;PA041 & 17011 ;p&723;Buick; 1998%20Park%20Avenue&5;BU;N 9/11/02
I~-~.~1- ~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COHHONHEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1;q? EX AFP (61-02)
'02 140¥-'1 ?t :45
RICHARD C RUPP ESQ
RUPP & NEIKLE
355 N 21ST ST STE 20~'5¢i-:~'.: .~.: : ",;. ,:'.
CAHP HILL PA .f,~?ip~'l.~.,].i..!.;' ,;:.: (:, .....,,,,' : :...,';"
CUT ALONG THIS LINE ~
DATE 10-28-2002
ESTATE OF BURD
DATE OF DEATH 12-12-2001
FILE NUHBER 21 02-0010
COUNTY CUHBERLAND
ACN 101
Amount Remitted
LEROY
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF HILLS
CUH~ERLAND CO COURT HOUSE
CARLISLE, PA 17013
RETAIN LOHER PORTION FOR YOUR RECORDS ~
DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF SURD LEROY HFZLE NO. 21 02-0010 ACN 101 DATE 10-28-2002
TAX RETURN ~/AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1).
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
q. Mortgages/Notes Rece/vable (Schedule D) (q)
E. Cash/Bank Deposits/MAsc. Personal Property (Schedule E) (5)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule H) (9).
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
11. Total DeductAons.
12. Nar'Value of Tax Return
O0
O0
O0
.00
117z610.1Z
O0
O0
(8)
13,333.00
2,336.30
(11)
(12)
13.
1~.
NOTE:
NOTE: To Ansure proper
credAt to your account,
subm/t the upper port/on
of this form wAth your
tax payment.
117,610.12
101,9~0.82
Charitable/GoVernmental Bequests; Non-elected 9115 Trusts (Schedule J) (13)
Net Value of Estate Sub~ect to Tax (lq)
Zf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17,
re~:lect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amount of Line lq at Spousal'ra~e (15)
16. Amount of L/ne lq taxable at LAneal/Class A rate (16)
17. Amount of LAne lq at S/bl/ng rate (17)
18. Amount of L/ne lq taxable at Collateral/Class B rate (18)
19. PrAncApal Tax Due
RECEIPT
NUHBER
DISCOUNT
INTEREST/PEN PAID (-)
.00
· oo x °o :
101,9q0.82 x 0q5=
· 00 X 12 =
· O0 x 15 =
(19)=
AMOUNT PAID
TAX CREDITS:
PAYHENT
DATE
09-12-2002
.00
101,9q0.82
18 and 19 N111
.00
q,587.3q
.00
.00
q,587.37
q,587.37
CD001610
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT q, 587.37
BALANCE OF TAX DUEI .oo
INTEREST AND PEN. .00
· TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
puRposE OF
NOTICE:
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z) 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$.of ZOO0. (7Z P.S.
Section 91q0),
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications are available at the Office
of the Register of gills, any of the Z3 Revenue District Offices, mr by calling the special Iq-hour
answering service for forms ordering: 1-800-~6Z-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-qqT-~OZO (TT only}.
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest} as shown on this Notice must object within sixty [60} days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlO21, Harrisburg, PA 171ZS~lOZ1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZSO601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-15Ol) for an explanation of administratively correctable errors.
If any tax due is paid within three (3} calenda~ months after the decedent's death, a five percent (BI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed an the total of the t~x and' interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is cha~ged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent'per annum calculated.at a daily rate cf .000164. All taxes which became delinquent on and after
January 1, 19BI will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2002 are:
Year Interest Rate Daily Interest Factor
1982 ZOZ .0005~8
1983 162 .000438
1964 IIZ .000301
1985 152 .000356
1986 lOX ,000274
1987 92 .000247
198B-19~ ~lX .ooo~.l
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Year Interest Rate Daily Interest Factor
1992 9Z .000247
199~-1994 72 .OOOl9g
1995-1998 92 .000Z47
1999 72 .000192
ZOO0 8Z ,O00Zl9
ZOO1 9Z .000Z47
ZOOZ- 62 .000164
X NUHBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
C:~Program Files\Corel\WordPerfect Office 2002~Estates~Loeffier\612,6,17,2003.wpd
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
LEROY M. BURD
Date of Death:
Will No.:
December 12, 2002
Admin. No.:
21-02-0010
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:
State whether administration of the estate is complete:
Yes No X
o
If the answer is No, state when the personal representative reasonably believes the administration
will be complete: On or before June 15, 2003
3. If the answer to No. 1 is Yes, state the following:
ao
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 is:
Co
Did the personal representative state an account informally to the parties in interest?
Yes No
Date: 12/8/03
d°
Copies of receipts, releases, joinders and approvals of form or informal accounts may be filed
with the Clerk of the Orphans' Court and may be 's report.
Previously filed on (~._~
Signature
Richard C. Rupp, Esquire
Name (Please type or print)
355 N 21st St., Ste. 205, Camp Hill, PA 17011
Address
717-761-3459
Telephone Number
"~:- ~ ' ' :' ~¢~ Capacity:
Personal Representative
X Counsel for personal representative
JRD/June30, 1992/17858
JAN 1 2 20~
Estate No.: 21-02-0010
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
In Re: Estate of Leroy M. Burd
Late of Upper Allen Township
NO. 21-02-0010
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Dennis Burd
Counsel for Personal Representative: None
Date of Decedent's Death: 12/12/2001
Date of Delinquency Notice: 01/10/2005
The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance
with Rule 6.12, Supreme Court Orphans' Court Rules, hereby, notifies the Orphans' Court
Division, Court of Common Pleas of Cumberland County, that neither the above named personal
representative nor the above named counsel for the personal representative have filed with the
Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule
6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12,
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on
November 10, 2004, and that the ten (10) day notice to file the Status Report has expired.
Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and
the undersigned requests that a Court conduct a hearing to determine whether sanctions should
be imposed upon the delinquent personal representative or counsel for the delinquent personal
representative.
Date: 0111312005
~~A~7f!
Glenda Famer Strasbaugh
Clerk of the Orphans' Court
Distribution: Personal Representative
Estate File
~,+,~'lOOS 9:301\1-\
A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to
the hearing date, the hearing will automatically be cancelled.
u^
STATUS REPORT UNDER RULE 6.12
Name ofDecedent: Lt V'()\.f M. J3u rq
I
Date ofDeath: /:J. - /:)- 0 I
Will No.: JI- () J, - DO / '()
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Comi Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State ~ther administration of the estate is complete:
Yes ~ No 0
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 r~sentative file a final account with the Court?
Yes _ No U:::1
b. The separate Orphans' Comi No. (if any) for the personal representative's
accountis:~
c. Did the personal ::ryyesentative s. tate an account informally to the parties
in interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: UJ~ O,r- {l ~~1n ~ f (~
Signature
_fin r:l-s L. l3 u v-d
Name
05/ Pf~U'SMj- W ed. J-km()\i~oM')f/t
Address
00
(')
('0..1
"",,-
Cl...
M
"
bl
o
1{1. 5(,& ,.9S15
Telephone No.
Capacity: ~ersonal Representative
o Counsel for personal representative
vuf