HomeMy WebLinkAbout07-24-08IN RE:
IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS, :
DECEASED : ORPHANS' COURT DIVISION
927 YEAR 2007
FAMILY SETTLEMENT AGREEMENT
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THIS AGREEMENT, dated this ~ a~ day of July 2008, ,;, f.
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I. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas ("the Decedent"), a widow, died testate on October 7,
2007, a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell submitted for probate to the Cumberland County
Register of Wills the Decedent's Last Will and Testament dated October 30, 2006 (the
"Will"). On October 15, 2007, Joanne Campbell duly qualified as Executrix of the
Decedent's probate estate. A copy of the Decedent's Will is attached hereto as Exhibit
"A," and is incorporated herein by reference.
3. The Executrix advertised her appointment in the Cumberland Law
Journal and the Sentinel. Copies of the Proofs of Publications are attached hereto as
Exhibit "B," and are incorporated herein by reference.
4. The Executrix notified the Commonwealth of Pennsylvania, Department
of Welfare, Estate Recovery Program ("DPW") of the Decedent's death. DPW
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informed the Executrix that it would not seek recovery from the Decedent's Estate. A
copy of DPW's response is attached hereto as Exhibit "C," and is incorporated herein
by reference.
5. The Decedent made various cash gifts under Item Third of her Will,
totaling $191,000. The Executrix has paid all such cash gifts. Copies of the various
Receipts, Releases and Refunding Agreements Concerning Cash Bequests are
attached hereto as Exhibit "D," and are incorporated herein by reference.
6. The Decedent bequeathed the residue of her estate equally to RIEGEL
HAAS and JOANNE CAMPBELL (collectively, and individually, the "Beneficiaries")
under Item Fourth of her Will.
7. The Executrix filed the Decedent's Federal and Pennsylvania Individual
Income Tax Returns for calendar year 2007.
8. The Executrix filed the Pennsylvania Inheritance Tax Return, which has
been accepted as filed. The Executor anticipates receiving the requested $309.34 tax
refund for the overpayment of inheritance tax in the next few weeks.
9. In May 2008, the Executrix distributed 800 shares of Exxon Mobil stock to
the residual Beneficiaries (each beneficiary received 400 shares of stock). A copy of
the Receipt, Release and Refunding Agreement Concerning Interim Residual
Distribution is attached hereto as Exhibit "E," and is incorporated herein by reference.
10. A First and Final Account of the Executrix's administration of the
Decedent's Estate (the "Account") is attached hereto as Exhibit "F," and is incorporated
herein by reference.
11. The Executrix claimed $16,000 of Personal Representative's
Commissions as a deduction on the Pennsylvania Inheritance Tax Return. The
Executrix paid herself $8,500 of commissions, and is owed an additional $7,500. The
amount of commissions still owing is set forth as a reserve on page 5 of the Account.
12. The Executrix claimed $11,000 of attorney fees as a deduction on the
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Pennsylvania Inheritance Tax Return. To date the Executrix has paid $6,356 of legal
fees to Keefer Wood Allen & Rahal, LLP ("KWAR"). KWAR is owed an additional
$3,300 of legal fees and $115.32 of disbursements, which are set for as reserves on
page 5 of the Account.
13. The Beneficiaries would like the Executrix to pay the above described
remaining estate administration expenses (i.e. Personal Representative's
Commissions, legal fees and miscellaneous disbursements), and to terminate the
estate administration by distributing the balance of Decedent's Estate to them as set
forth in the Schedule of Proposed Final Distributions (which is attached hereto as
Exhibit "G", and incorporated herein by reference). Moreover, the Beneficiaries wish to
forever settle and compromise any and all claims and rights which they may possess,
now or hereafter, in the Decedent's Estate, without the cost and delay of a court
adjudication and confirmation of the Account.
14. The Executrix is willing to pay the above described administration
expenses and so distribute the balance of the Decedent's Estate provided the
Beneficiaries give the Executrix satisfactory release, refunding and indemnification
protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiaries, for themselves, their heirs, personal
representatives, successors, and assigns, hereby do as follows, to wit:
A. Represent, warrant and agree that they:
(i) Have read and understand this Agreement and confirm the facts set
forth above are true, correct and complete to the best of their knowledge,
information and belief, and hereby approve the same for all purposes.
(ii) Acknowledge that they have sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Have entered into this Agreement of their own free will and choice
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without any compulsion, duress or undue influence from anyone.
B. Declare that they have had the opportunity to examine the Account
(Exhibit "F," hereto), and based upon such examination (or their decision
not to make such an examination), they are satisfied they have sufficient
information to make an informed waiver of their right to a formal court
accounting and do hereby waive the filing and audit of the same.
C. Acknowledge receipt of the Exxon Mobil Corporation Stock in partial
satisfaction of the bequest under Item Fourth of the Decedent's Will.
D. Acknowledge receipt of the Estate's remaining cash as set forth
Schedule of Proposed Final Distributions in full satisfaction of the
balance of the bequest under Item Fourth of the Decedent's Will.
E. Agree to refund on demand, all or any part of the above described
distributions, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
F. To the extent of the above described interim distribution of stock and the
distributions set forth in the Schedule of Proposed Final Distributions
(Exhibit "G" hereto), absolutely, unconditionally and irrevocably release,
remises and forever discharge Joanne Campbell, individually, and in her
fiduciary capacity as Executrix of the Estate of Barbara Haas, from any
and all manner of actions, causes of action, suits, liens, accounts,
reckonings, controversies, agreements, promises, claims, demands,
losses and expenses whatsoever, in any way arising from or concerning
the distributions under Item IV of the Decedent's Estate.
G. To the extent of the above described interim distribution of stock and the
Schedule of Proposed Final Distribution, agree to indemnify and hold
harmless Joanne Campbell, individually, and in the fiduciary capacity set
forth above, with respect to any and all matters or liabilities which she
may be subjected by reason of joining in this Agreement, and in carrying
out the provision hereof.
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H. Agree this Agreement is intended to compromise and settle disputed
claims, including, without limitations, claims and defenses asserted in
connection with the creation, administration and distribution of the
Decedent's probate estate.
Agree that this Agreement constitutes the entire understanding between
the Executrix and the Beneficiaries (individually and collectively, the
"Parties") concerning the subject matter hereof, and supersedes any and
all prior written agreements and any and all prior or contemporaneous
oral agreements or understanding relating to the subject matter hereof.
J. Agree that this Agreement may not be amended, modified, superseded,
canceled, renewed or extended, nor may any term or condition hereof be
waived, except by a written instrument or document signed by all the
parties hereto or, in the case of a waiver, signed by the party sought to
be charged therewith. No waiver by any party of the breach of any
provision hereof shall be deemed to constitute a waiver of any continuing
or subsequent breach of such provision or any other provision hereof.
Except as otherwise provided herein, the rights and remedies expressly
granted hereunder shall be cumulative with respect to, and shall not be
deemed to exclude, any other rights and remedies to which any party
shall be entitled at law or in equity.
K. Agree that this Agreement shall be binding upon and inure to the benefit
of the Parties and their respective heirs, successors, assigns, personal
representatives, and those who may hereafter claim through any of the
Parties.
L. Pursuant to 20 Pa.C.S. §3504, in the event of any litigation concerning
this Agreement, the Court shall be requested to waive appointment of a
guardian and/or trustee ad litem to represent the interest of any minor,
unborn or unascertained beneficiaries.
M. Agree that this Agreement shall be governed by and construed in
accordance with the laws of the Commonwealth of Pennsylvania, without
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regard to choice-of-law provisions. The Court shall have exclusive
jurisdiction over any action to enforce or interpret the terms of this
Agreement. The Executrix and Beneficiaries hereby consent to the Court
exercising personal jurisdiction over each of them in any action or suit
arising out of the enforcement of this Agreement.
N. Agree that any references to person or things shall be deemed to refer to
such persons or things in the singular or plural and in the masculine,
feminine or neuter gender as the context shall require.
O. Agree that this Agreement shall be deemed to be severable, so that if
any provision hereof shall be determined by a court of competent
jurisdiction to be invalid or unenforceable, the remaining provisions
hereof shall continue to remain valid and enforceable in accordance with
their terms.
P. Agree that this Agreement may be executed in multiple counterparts,
each of which may contain the signatures of one or more of the Parties,
all of which, taken together, shall constitute one and the same document.
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IN WITNESS WHEREOF, the Parties have placed their hands and seals on the
attached Consents to Family Settlement Agreement, with the same to be effective for
all purposes as the date first above written.
WITNESS:
RIEGEL HAAS
WITNESS:
By:
JOANNE CAMPBELL, individually, and
as Executrix of the Estate of Barbara
Haas, Deceased
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ON THIS, they`'` day of July, 2008, before me the undersigned officer,
personally appeared RIEGEL HAAS, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that he
executed the same as his free and voluntary act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
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Nota Public
~~.tMUNWE.ALIH Uf F'tNNSYLVANIA
NOTARIAL SEAL
CYNTHIA J. RUCLEP
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ON THIS, the rday of July, 2008, before me the undersigned officer,
personally appeared JOANNE CAMPBELL, known to me (or satisfactorily proven) to
be the person whose name is subscribed to the within instrument, and acknowledged
that she executed the same, in the capacities indicated, as her free and voluntary act
for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
Not ry Public
~OMMONVrEALTH OF PENNSYLVANIA
NOTARIAL SEAS
CYNTHIA J• R C`u Nbe~ ~~
lemon E~~~ F 3, 2012
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REGISTER OF WILLS Certificate of Grant of Letters
CUMBERLAND COUNTY, PENNSYLVANIA
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No. 21-07-927
ESTATE OF Barbara Haas
a/k/a: Helen Barbara Sloane Haas, H. Barbara Haas, Barbara
Sloane Haas H. Sloane Haas Helen Haas, Helen B. Haas,
Helen Barbara Haas Helen Sloane Haas, and H. Barbara
Sloane Haas.
Late Of: Lower Allen Township, Cumberland Count~,r,
Deceased
Social Security No. 184-26-4326
WHEREAS, on the 15 day of October, 2007_instrument(s) dated
10!30/2006 was (were) admitted to probate as the last will of Barbara Haas (a/lo'a Helen
Barbara Sloane Haas, H. Barbara Haas, Barbara Sloane Haas, H. Sloane Haas, I-leien
Haas, Helen B. Haas, Helen Barbara Haas, Helen Sloane Haas, and H. Barbara Sloane
Haas.) late of Lower Allen Township, who died on the 7 day of October, 2007, and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, Glenda Farner Strasbaugh, Register of Wills in and for the
County of Cumberland, in the Commonwealth of Pennsylvania, hereby certify that I have
this day granted Letters Testamentary to Joanne Campbell, who has duly dualified as
executrix
and has agreed to administer the estate according to law, all of which fully appears of
record in nay Office at Cumberland County Courthouse, Carlisle, Pennsylvania.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of
my Office the 15 day of October, 2007.
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Register of Wills ` gyp„ -~
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LAST WILL AND TESTAMENT OF
BARBARA HAAS
I, BARBARA HAAS, of Cumberland County, Pennsylvania, do hereby make this my
Last Will and Testament, revoking any former Wills and Codicils made by me.
FIRST: I am widowed. I have two stepchildren: 30ANNE CAMPBELL and RIEGEL
HAAS. These persons and any children born to or adopted by them are described in this Will as
"my issue." Provided, however, no adopted person shall benefit hereunder unless the order or
decree of adoption is entered before such adopted person attains the age of twenty-one (21)
years.
SECOND: I give my tangible personal property and all casualty insurance that I am
carrying on said tangible personal property in accordance with a Memorandum dated ~0~3a D~
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and given by me to JOANNE CAMPBELL ear ~ I have complete confidence
that JOANNE CAMPBELL or my Executor will honor any such written instructions that I may
leave with regard to said tangible personal property. Any such property not so distributed shall
be sold, and the proceeds added to my residuary estate to pass as hereafter described.
THIRD: I give and bequeath the following specific bequests:
A. I give and bequeath the sum of TWENTY THOUSAND DOLLARS
($20,000.00) to CALVARY UNITED METHODIST CHURCH, or its
successors, of 4700 Locust Lane, Harrisburg, Pennsylvania, to be used at
its discretion.
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B. I give and bequeath the sum of TWENTY THOUSAND DOLLARS
($20,000.00) to my niece, HEIDI STUM.
C. I give and bequeath the sum of TWENTY THOUSAND DOLLARS
($20,000.00) to my niece, TRACY DERK.
D. I give and bequeath the suin of FIFTEEN THOUSAND DOLLARS
($15,000.00) to my stepgranddaughter, SANDI HURLEY, or her issue if
she predeceases me, per stirpes.
E. I give and bequeath the suin of TWO THOUSAND DOLLARS
($2,000.00) to my stepgranddaughter, JANICE MACUT, or her issue if
she predeceases me, per stirpes.
F. I give and bequeath the sum of TWO THOUSAND DOLLARS
($2,000.00) to my stepgrandson, ERIC HAAS, or his issue if he
predeceases me, per stirpes.
G. I give and bequeath the sum of THREE THOUSAND DOLLARS
($3,000.00) to my stepgreatgranddaughter, LAURA HURLEY.
H. 1 give and bequeath the sum of THREE THOUSAND DOLLARS
($3,000.00) to my stepgreatgrandson, PATRICK HURLEY.
I. I give and bequeath the sum of THREE THOUSAND DOLLARS
($3,000.00) to my stepgreatgrandson, SEAN HURLEY.
J. I give and bequeath the sum of ONE THOUSAND DOLLARS
($1,000.00) to my stepgreatgranddaughter, CARLEY HAAS.
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K. I give and bequeath the suin of ONE THOUSAND DOLLARS
($1,000.00) to my stepgreatgrandson, WILLIE JOE KETNER.
L. I give and bequeath-the sum of ONE THOUSAND DOLLARS
($1,000.00) to my stepgreatgranddaughter, SHELLEY MAE KETNER.
M. I give and bequeath the sum of FIFTY THOUSAND DOLLARS
($50,000) to my stepdaughter, JOANN CAMPBELL, of Dauphin
County, Pennsylvania and if she predeceases me to her issue, per stirpes.
N. I give and bequeath the sum of FIFTY THOUSAND DOLLARS
($50,000) to my stepson, RIEGEL HAAS, of Dauphin County,
Pennsylvania and if he predeceases me to his issue, per stirpes.
To the extent that the assets of my estate are not sufficient to fulfill these specific
bequests listed above in this Article THIRD, each gift shall be funded by the available funds on a
pro rata basis so that no gift shall lapse due to failure of insufficient funds to pay all the specific
bequests.
FOURTH: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my stepdaughter,
JOANNE CAMPBELL, of Dauphin County, Pennsylvania, and to my stepson, RIEGEL
HAAS, of Dauphin County, Pennsylvania.
In the event that JOANNE CAMPBELL predeceases me or fails to survive me by thirty
(30) days, I give, devise and bequeath her share to my step granddaughter, SANDI HURLEY, of
Cleveland, Ohio. It is my hope that SANDI HURLEY uses the funds to help provide for her
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father, LEE CAMPBELL, but the use of the funds are SANDI HURLEY's sole discretion. In
the event that SANDI HURLEY predeceases me or fails to survive me my thirty (30) days, I
give, devise and bequeath said share to her husband, MICHAEL HURLEY, of Cleveland Ohio.
It is my hope that MICHAEL HURLEY uses these funds to help provide for LEE
CAMPBELL, but the use of the funds are MICHAEL HURLEY's sole discretion. In the event
he predeceases ine, then to his issue, per stirpes.
In the event that RIEGEL HAAS predeceases me or fails to survive me by thirty (30)
days, I give, devise and bequeath his share to his wife, KAY HAAS, of Dauphin County,
Pennsylvania. In the event that KAY HAAS predeceases me or fails to survive me by thirty (30)
days, I give, devise and bequeath said share IN EQUAL SHARES to HEIDI STUM, TRACY
DERK, JANICE MACUT, ERIC HAAS, and SANDI HURLEY, per capita.
FIFTH: If any person under the age of twenty-one (21) years shall become entitled to
any share hereunder, then such share shall immediately vest in such beneficiary, but
notwithstanding the provisions herein, my Executor may distribute such beneficiary's share to
any adult person standing in loco parentis, or to a legal guardian of such beneficiary, or to a
custodian (to be selected by my Executor) under the applicable Uniform Transfers to Minors
Act, without requiring bond of such adult person, guardian or custodian. The receipt of such
adult person, guardian or custodian shall constitute a full release of my Executor for any property
so distributed.
SIXTH: No person shall benefit hereunder unless such beneficiary shall survive me by
thirty (30) days.
SEVENTH: (1) I name my stepdaughter, JOANNE CAMPBELL, as my Executor. If
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she is unable or unwilling to serve, I name my stepson, RIEGEL HAAS, as my Executor. I
direct that my executor, herein referred to as my Executor regardless of number or gender, serve
without bond in any jurisdiction in which called upon to act.
(2) Except as otherwise provided herein, if all of the above persons should fail
to qualify as my Executor hereunder, or for any reason should cease to act in such capacity, the
successor or substitute Executor shall be some attorney or bank or trust company with trust
.powers, which successor or substitute Executor shall be designated in a written instrument filed
with the court having jurisdiction over the probate of my estate and signed by JOANNE
CAMPBELL or if she fails to act, signed by or on behalf of RIEGLE HAAS, or if he fails to act,
by the court having jurisdiction over the probate of my estate.
(3) My Executor shall receive reasonable compensation for services rendered.
EIGHTH: (1) I give to any Executor named in this Will or any Codicil hereto or to any
successor or substitute Executor all of the powers enumerated in this Will and all of the powers
applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through
the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date
of my death, during the administration and until the completion of the distribution of my estate.
I direct that all such powers shall be construed in the broadest possible manner and shall be
exercisable without court authorization.
(2) My Executor is authorized and empowered to acquire and to retain, either
permanently or for such period of time as my Executor may determine, any assets, including the
capital stock of any closely held corporation, whether such assets are or are not of the character
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approved or authorized by law for investment by fiduciaries and whether such assets do or do not
represent an over concentration in one investment.
(3) My Executor is authorized and empowered to disclaim any interest, in whole
or in part, of which I, or my Executor, may be the beneficiary, devisee, or legatee, by executing
an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of
1986, as amended, or such similar section as may then be in effect).
(4) My Executor is authorized and empowered to sell at public or private sale, or
exchange, and to encumber or lease, for any period of time, any real or personal property and to
give options to buy or lease any such property. Additionally, my Executor is authorized and
empowered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and
to pledge property as security therefor, to make loans to and to buy property from anyone
(including a fiduciary or beneficiary hereunder); provided that any such loans shall be
adequately secured and at a fair interest rate.
(5) My Executor is authorized and empowered to allocate property, charges on
property, receipts and income among and between principal or income, or partly to each, without
regard to any law defining principal and income.
NINTH: All debts, funeral or burial expenses, and all estate, inheritance, succession and
other death taxes imposed or payable by reason of my death and interest and penalties thereon
with respect to all property comprising my gross estate for death tax purposes, whether or not
such property passes under this Will, shall be paid out of the residue of my estate, as if such
debts or taxes were expenses of administration, without apportionment or right of
reimbursement. I authorize my Executor to pay all such taxes at such time or times as deemed
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advisable.
IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and
Testament this ~D ~ay of ~ , 2006.
',~~,-~-~~.,.~c~. ,~~-~~ (SEAL)
BARBARA HAAS
SIGNED, SEALED, PUBLISHED, and
:DECLARED by BARBARA HAAS,
.as and for her Last Will and
'Testament, on the day and year
:last above written, in the
presence of us, who, at her
request, in her presence, and
in the presence of each other,
all being present at the same
rime, have hereunto subscribed
our names as witnesses:
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SELF-PROVING AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
,, / SS.
COUNTY OF C,U~~~ ~Q/IO~
WE, BARBARA HAAS and SfI-R A J~ lV i ~ n~ f~~'/ . J /
~ ~ d~f'rf~r~) ~ ~~y jC ,and l~~i-S /~• (,~ ~ ~T~/ ,the Testatrix and the
witnesses, respectively, whose names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will and that she had signed willingly, and that she executed
it as her free and voluntary act for the puzposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or
her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind,
and under no constraint or undue influence.
D z.
BARBARA HAAS, Testatrix
Subscribed, sworn to, and acknowledged before me by BARBARA HAAS, the Testatrix`, and
subscribed and sworn to before me by ~ rQ ~ 1 ~ !Q C~ n ~~ 11. - ~7 ~-
and ~1~15 A~ ~lt)+ i T' \ ,witnesses, this ?,0~ day of ~ rG~'p-1~ , 2006.
Notary~Pulilic
~uY ~. emu, r~oan- PubMc
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Witness '~
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tammy Shoemaker, Classified Advertising_Manager, of The Sentinel, of the
County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL,
a newspaper of general circulation in the Borough of Carlisle, County and State
aforesaid, was established December 13,1881, since which date THE SENTINEL
has been regularly issued in said County, and that the printed notice or publication
attached hereto is exactly the same as was printed and published in the regular
editions and issues of THE SENTINEL on the following day(s)
November 02, 09, 16, 2007
COPY OF NOTICE OF PUBLICATION
ESTATE NOTICE
Estate of BARBARA HAAS• ~1lSL~li@18a1~~a a
Sloane ~ ~ ~rbara Haas:$~8[li Sloane
Haas, ~1. Sloane l~t@II . ~ ~
Barbara Shane ~, peceased. The Decedent
died testate on October 7, 2007, late of Lower ANen
Township, Cumberland County, Pennsylvania.
Letters Testamentary have been granted to the
undersigned.
All persons indebted to the Decedenf are requested to
make immediate payment, and those having claims
should present the them for settlement, without
delay to:
Joanna Campbell, Executrix
c!o Stephanie Kleinfelter, Esquire
Keefer Wood Aflen 8 Rahal LLP
635 North 12ttr Street, Suite 400
Lemoyne PA 17043
Affiant further deposes that he/she is not
interested in the subject matter of the
aforesaid notice or advertisement, and that
all allegations in the foregoing statement
as to time, place and character of
pu Jblic~at~i/oyn~ are true. ~~ /~.
Sworn to and subscribed before me this
19th. day of November, 2007.
~~
Notary Pub
My commission expires: % / ~ /~
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Christina L. Wolfe, Notary Public
Carlisle Born, Curt>b County
MY Commission Expires Sept 1,2008
Member. Pennsylvania Association Of Notaries
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
October 26, November 2, and November 9, 2007
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
Marie Coyne, >~ditor
SWOI~''f0 AND SUBSCRIBED before me this
Haas, Barbara a/k/a Helen Barbara 9 day of November, 2007
Sloane Haas a/k/a H. Barbara
Haas aJk/a Barbara Sloane Haas '
a/k/a H. Sloane Haas a/k/a L~
Helen Haas a/k/a Helen B. Haas
a/k/a Helen Barbara Haas a/k/a Notary
Helen Sloane Haas a/k/a H.
Barbara Sloane Haas, deed.
Late of Lower Allen Township.
Executrix: Joanne Campbell c/o
Stephanie Kleinfelter, Esquire, ~~
Keefer Wood Allen 8a Rahal, LLP, NOTARIAL SEAL
635 N. 12th Street, Suite 400, DEBORAH A COLUNS
Lemoyne, PA 17043. Notary Public
Attorneys: Stephanie Kleinfelter, CARLISLE BORO, CUMBERLAND COUNTY
Esquire, Keefer Wood Allen 8a My Commission Expires Apr 28, 2010
Rahal, LLP, 635 N. 12th Street,
Suite 400, Lemoyne, PA 17043.
R
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 8486
HARRISBURG, PA 17105-8486
October 19, 2007
KE;EFER WOOD ALLEN RAHAL
S'T'EPHANIE KLEINFELTER
A`T'TORNEYS AT LAW
635 NORTH 12TH STREET SUITE 400
LE:YMOYNE PA 17043
Re: BARBARA HASS
SSN: 184-26-4326
Dear Attorney Kleinfelter:
Pursuant to your letter dated October 17, 2007, the Department of Public
Welfare (DPW), Estate Recovery Program, has reviewed the information you
provided regarding the above-referenced individual.
It has been determined that this individual did not receive any type of
assistance during the questioned period.
Therefore, according to the information you provided, the Department's
Estate Recovery Program will not seek any recovery from this estate. If your
c:Lient applied for Medical Assistance and had an application and/or hearing
p~=_nding at the time of death, please advise us and provide any additional
information that may affect a recovery by our Department.
If you have any questions, please feel free to contact me.
Sincerely,
.~ ,~
~~
Carole A. Procope
Recovery Section Manager
(717)772-6604
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DlV1SlON
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERN/NG CASH BEQUEST
THIS AGREEMENT, dated this 17`h day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`Y~he Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph A of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Twenty
Thousand Dollars ($20,000.00) to Calvary United Methodist Church (located at 4700
Locust Lane, I-iarrisburg, Pennsylvania) (the "Beneficiary") to be used at its discretion.
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
-1-
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for itself, and its successor and assigns, hereby
does as follows, to °,vit:
A. Represents, warrants and agrees that it:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of its knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that it has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of its own free will and choice without
any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Twenty Thousand Dollars
($20,000.00), in full satisfaction of the cash bequest under Paragraph A of
Article Third of the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
-2-
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
arising from or concerning the Decedent's bequest of Twenty Thousand
Dollars ($20,000.00) to the Beneficiary under Paragraph A of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over it
ir: any S;.lit or 3Ctlur: 2r~c;nrJ. ~111t of the enforce,^~ent of tl'::s Agreenent.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS:
_„ Jy ~ .!
._~
CALVARY UNITED METHODIST CHURCH
~ .:
c,
By ~ /
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ON THIS, the ~~ day of January, 2008, before me the undersigned officer,
personally appeared S' ~-'-~-! '~-°~'~-~ ,who acknowledged himself/herself to
be ~~~~~~ of CALVARY UNITED METHODIST CHURCH (located at
~ttiu Locust Lane, ,-iarrisburg, rennsyivania), and that helshe, as such officer being
authorized so to do, executed the foregoing instrument for the purposes therein
contained by signing the name of the church by himself/herself as such officer.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
,. __
__
~_ ;- __~
N ~ ~ ,,_ d
-3-
Magisterial District Judge Joseph S. t+ndsey
Coucsty of Dauphin
Mag~stenai District 12-1-06
5201 Jonestown Road
41zrr~sburg, PA 111.12
My CommissiorrExperes.l-,2-2012
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17t" day of January 2008,
WITNESSETH:
1„ THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph B of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Twenty
T housand Dollars ($20,000.00) to Heidi Stum (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
-1-
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NCVV THEREF®RE, in consideration of the foregoing, and intending to be
legally uoun:; hereby, the Qe^ef~csu ;; does, for herself, her hers, Nersona•.
representatives, successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Twenty Thousand Dollars
($20.000.00), in full satisfaction of the cash bequest under Paragraph B of
Article Third of the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
-2-
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
arising from or concerning the Decedent's bequest of Twenty Thousand
Dollars ($20,000.00) to the Beneficiary under Paragraph B of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland C~!.lnty, Pennsy'I`./unia, ere'ciSin(~ personal j~.+risd'Cti:?n Cvpr
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS:
By:
HEIDI STUM
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ' br1,
~d
ON THIS, the ~~~ day of January, 2008, before me the undersigned officer,
personally appeared HEIDI STUM, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she
executed the same as her free and voluntary act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
ry
Notary Public
R.;OTARIAL SEAL public
Ghristtno A. NSiIIP.r, Notary
Lower Swat~ra Township, C3auphin County
tvly Commi~sipn moire°, July 2'~, 2Q10
-3-
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17~`' day of January 2008,
WITNESSETH:
l.. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas ("the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph C of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Twenty
Thousand Dollars ($20,000.00) to Tracy Derk (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
rBU~rai cli"iCi 1='2riii~jitvdnicl ir'1Cii'vlduai iii~t~fTi~ 1 cix RCtuiii5 fvr C;aieii~iai jCdi 2'~^v7 isoi'
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for herself, her heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Twenty Thousand Dollars
($20,000.00), in full satisfaction of the cash bequest under Paragraph C of
Article Third of the Decedent's Will.
C. Agrees to refund on demand, G!! or any pert of the ubo~>e described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Twenty Thousand
Dollars ($20,000.00) to the Beneficiary under Paragraph C of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
~areement or. the date first abo~~re written.
WITNESS:
By: S ~.
Y ERK
t:OMMONWEALTH OF PENNSYLVANIA
COUNTY OF ____JJI~~~'' "J
ON THIS, the 22-U`~'`~day of January, 2008, before me the undersigned officer,
personally appeared TRACY DERK, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she
executed the same as her free and voluntary act for the purposes expressed therein.
!N N1ITNESS ~NHERFOF, !have hereunto . , .y hand and nffici ~-~,aa[.
. ./~
Notary Public
Nown~ ~,~-
MIRICIA MC'OVIE
Notary ruONC
MARRIfWRfi C111~ D/1t1-HIN C011N11f
My Commtaaio~ Exp4ra: Ocl 1i, X010
-3-
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17~`' day of January 2008,
W-TNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph D of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Fifteen
Thousand Dollars ($15,000.00) to Sandi Hurley (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for herself, her heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Fifteen Thousand Dollars
($15,000.00), in full satisfaction of the cash bequest under Paragraph D of
Article Third of the Decedent's Will.
v. ~:t,~. rEsCS ttl ~ '~,'fl:n~.7 vn uCt I~ia! Eu, a'I ur as :ji pay i of ti,c ab~ Ve i1c^s:rCi ibcd Cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Fifteen Thousand
Dollars ($15,000.00) to the Beneficiary under Paragraph D of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS:
~ ~ .~
By: ~..~~(.-
SANDI HURLEY
STATE OF OHIO
COUNTY OF ~...~- :
ON THIS, the ~3~ day of January, 2008, before me the undersigned officer,
personally appeared SANDI HURLEY, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she
executed the same as her free and voluntary act for the purposes expressed therein.
;nv I ~i=c~c ~nlu~=r-'.EOF ;' ~,,,: I-,e ;^to sc:.t Iry `° ~" ~ ~' "fic~a~ seal.
!N TIC. _.~.. , , --, ~ ~~.~~, rep _, ~ ,; ~ ~Gnv un„ o~ ,
~„~ Cam-- .
Notary Public
MARY LOU TREPES
Notary Public, State of Ohio, Ctry. Gty.
MY commission expires July 23, 2011
-3-
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
: 927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
-THIS AGREEMENT, dated this 17~`' day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 20D7,
a domiciliary of Cumberland County, .Penn-Sylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph E of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Two
Tt~o~.;sand Collars ~~2,OC~0.00) tr 'P,~aIGE ~~IAC! ~T ra/k/a ,Janis Macut) (the
"Beneficiary")
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
-1-
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
nnheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for herself, her heirs, personal representatives,
successors, and assigns, Hereby does as follows, to ~vit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with are
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Two Thousand Dollars ($2,000.00), in
foil satisfaction of ti:e cash bequest i,nder Paragraph E of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
-2-
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
arising from or concerning the Decedent's bequest of Two Thousand
Dollars ($2,000.00) to the Beneficiary under Paragraph E of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her i;:~ any sut tar a%tit3li arising vut Gi the enft)rr~emcrt of this Ageer;ient.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS:
r .-~
~ ~ ~` - _
`i . rk_.~.,~-~:~' - '~~- ~ ~:v'v^~~,~~.~~ By. 1. ~`r ~ ~' '~ ~ ~(.( ,~~
_y
ANICE MACUT, a/k/a Janis Macut
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
ON THIS, the ~ .~ day of January, 2008, before me the undersigned officer,
personally appeared JANICE MACUT (a/k/a Janis Macut), known to me (or
satisfaut:,ril~f proven) ±c b.A the p;rscra :~~!-~ose Warne is subscribed to the within
instrument, and acknovvledged that she executed the same as tier free and voluntary
act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
i
1
otary Public
COMMLINWEALTH QF PENNSYIV~i~iA
DON~tA M~1~R~lA~I~~ tsry Public
Sus~uahanne Twp., Daupitiin Counq+
My CoRxnission Expires July 28, 2003
-3-
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
: 927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17`~ day of January 2UOt3,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testafe on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph F of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Two
Thousand Dollars ($2,000.00) to Eric Haas (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for himself, his heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
Dn~rrr~antc i1L,~rr;a:ttc arty? a Jrec,c that che:
.. _,
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Two Thousand Dollars ($2,000.00), in
full satisfaction of the cash bequest under Paragraph F of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Two Thousand
Dollars ($2,000.00) to the Beneficiary under Paragraph F of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
him in any suit or action arising out of the enforcement of this Agreement.
!~ 1!l~ITNESS WHEREOF; the F3enefici~!y has hereunto set its sea! to this
Agreement on the date first above written.
WITNESS:
;!
ERIC HAAS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ;, ~~~--~
~~'~cr.~-c.~-
ON THIS, the ~~c, day of may, 2~8, before me the undersigned officer,
personally appeared ERIC HAAS, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that he
executed the same as his free and voluntary act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
I?Yot Public
COAAMONWEAL7'H ~~ rciviw~~rt_v~ilvlA
Notarial Seal
Yvonne R Durharrt, Notary Pudic
City Of Harristxug, Dauphin county
My Canm~sion Expires Aug. 20, Zoos
Member, Pennsylvania Association of Notaries
-3-
IN RE:
IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17~`' day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph G of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Three
Thousand Dollars ($3,000.00) to Laura Hurley (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
Negally bound hereby, the Beneficiary, for herself, her heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Three Thousand Dollars ($3,000.00),
in full satisfaction of the cash bequest under Paragraph G of Article Third
of the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Three Thousand
Dollars ($3,000.00) to the Beneficiary under Paragraph G of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS:
~~~~~ ~.
! rt ~
By: ~~
LAURA HURLEY
STATE OF OHIO
J
COUNTY OF ~
;~, _
ON THIS, the da of J~~
~ y ae'e~, 2008, before me the undersigned officer,
personally appeared LAURA HURLEY, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she
executed the same as her free and voluntary act for the purposes expressed therein.
IN V\IiTNES:~ WHEREOF, i have hereunto set my hand and official seal.
,:: -} ~ ~"
Notary Public `
T A. ~!~
1~ls~try P'~1ic, Sty of Ohio
C o~tasion F~piras August 2~, zo Y u
~~ ~
-3-
IN RE: : IN THE COURT OF COMMON PLEAS
:CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 12t" day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up fo the execution of this Agreement are as
follows:
1. Barbara Haas (`Y~he Decedent', a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph H of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Three
Thousand Dollars ($3,000.00) to Patrick Hurley (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for himself, his heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Kepresents, warrants and agrees that she:
(i} Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Three Thousand Dollars ($3,000.00),
in full satisfaction of the cash bequest under Paragraph H of Article Third
of the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Three Thousand
Dollars ($3,000.00) to the Beneficiary under Paragraph H of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
him in any suit or action arising out of the enforcement of this Agreement.
IN ViliTivESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
W TNESS:
By:
PATRICK HURLEY
STATE OF NEW JERSEY
COUNTY OF M ~ dd I~S~!
ON THIS, the aq~ day of January, 2008, before me the undersigned officer,
personally appeared PATRICK HURLEY, known to me (or satisfactorily proven) to be
the person whose name is subscribed to the within instrument, and acknowledged that
he executed the same as his free and voluntary act for the purposes expressed therein.
IIV UViTNESS 'vii-HERtt~F, I nave hereunto -et my hand and official scai.
N tary Public
1-iEATHER LEIGH DUNHAM
Notary Public of New Jersey
Commission Expires 10/18/2011
-3-
IN RE:
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS, :
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17~`' day of January 2008,
W-TNESSETH;
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph I of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Three
Thousand Dollars ($3,000.00) to Sean Hurley (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
(provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for himself, his heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Three Thousand Dollars ($3,000.00),
in full satisfaction of the cash bequest under Paragraph I of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Three Thousand
Dollars ($3,000.00) to the Beneficiary under Paragraph I of Article Third of
the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
him in any suit or action arising out of the enforcement of this Agreement.
itv 'v"JITNESS ~~iVHEKCvF, the Beneficiary has hereunto sei its seal io this
Agreement on the date first above written.
WITNESS:
r~ ~;
.-
l By.
STATE OF CONNECTICUT
COUNTY OF ~ ~~ ~~~°'~"~
,~ ~ `~.=~
ON THIS, the ~,=day of January, 2008, before me the undersigned officer,
personally appeared SEAN HURLEY, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that he
executed the same as his free and voluntary act for the purposes expressed therein.
IN Wi-i"NESS WHEREOF, i have hereunto set my hand., offi `alseal.
f
Notary Public
~ ~~~ ,.
-3-
IN RE:
: IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVAN/A
ESTATE OF BARBARA HAAS, :
,DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS ~e,~EEMEN?; dated this 12th day of January 200,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph J of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of One
Thousand Dollars ($1,000.00) to Carley Haas (a/k/a Carly Haas) (the "Beneficiary").
4. Carley Haas, a minor, is the daughter of Eric Haas, the Decedent's step-
grandson.
5. Pursuant to Article Fifth of the Will, if a person under the age of twenty-
one (21) years of age is entitled to property from the Decedent's probate estate, the
property immediately vests in such person, but the Executrix may distribute property to
a custodian (selected by the Executrix) under the applicable Uniform Transfers to
Minors Act, without requiring bond of such custodian. The receipt of such custodian
shall constitute a full release of the Executor for the property so distributed.
-1-
6. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. Eric Hass, the parent and natural guardian of the Beneficiary, desires the
above described cash bequest be paid prior to the filing of the uecedent's individual
Income Tax Returns and the Pennsylvania Inheritance Tax Return. Thus, prior to the
receipt of the AppraisementlAssessment of Pennsylvania Inheritance Tax. The
;Executrix is willing to do so if Eric Haas, as the selected Custodian for the Beneficiary
under Pennsylvania Uniform Transfers to Minors Act, provides the Executrix with
satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Eric Haas, as the selected Custodian for the Beneficiary
under Pennsylvania Uniform Transfers to Minors Act, for the Beneficiary, her heirs,
personal representatives, successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that he:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
in`ormation and belief, and hereb~~ aoprc~ves the same for all purposes.
(ii) Acknowledges that he has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
-2-
B. Acknowledges receipt of the sum of One Thousand Dollars ($1,000.00), in
full satisfaction of the cash bequest under Paragraph J of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
arising from or concerning the Decedent's bequest of One Thousand
Dollars ($1,000.00) to the Beneficiary under Paragraph J of Article Third
of the W ill.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Eric Haas, as the natural guardian of the
Beneficiary, has hereunto set its seal to this Agreement on the date first above written.
WITNESS:
.~`' '~'~
By
~~~
ERIC HAAS, CUSTODIAN FOR
CARLEY HAAS, a/k/a CARLY HAAS,
UNDER THE PENNSYLVANIA
UNIFORM TRANSFERS TO MINORS
ACT
-3-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~ f~ ~'~' ~~
}./,~r~~ Ld zt
ON THIS, the _ day of d~~+, 2~8, before me the undersigned officer,
personally appeared ERIC HAAS, CUSTODIAN FOR CARLEY HAAS (a!k,'a CARLY
HAAS), UNDER THE PENNSYLVANIA UNIFORM TRANSFERS TO MINOR ACT,
known to me (or satisfactorily proven j to be the person whose name is subscribed to
the within instrument, and acknowledged that he executed the same in the fiduciary
rapacity set forth above, for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
f~1o ary Public
f~
COMMONWEAt:~i-s ~N i'~tvNSYLVANIA
Notarial Seal
Yvonne R. Durham, Notary Public
City Of Harrisburg, Dauphin Courtly
My Commission Expires Aug. 20, 2009
Member; Pennsyl~rania Associat{on of Notaries
-4-
IN RE; ; IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 17"' day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`1he Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph K of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of One
Thousand Dollars ($1,000.00) to Willie Joe Ketner (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
'the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for himself, his heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of One Thousand Dollars ($1,000.00), in
full satisfaction of the cash bequest under Paragraph K of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of One Thousand
Dollars ($1,000.00) to the Beneficiary under Paragraph K of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
him in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the tBeneficiary has hereunto set its seal to this
,Agreement on the date first above written.
'WITNESS:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~~~~~`-~'`
WI - JOE KETNER
ON THIS, the ~, ~ st day of January, 2008, before me the undersigned officer,
personally appeared WILLIE JOE KETNER, known to me (or satisfactorily proven) to
be the person whose name is subscribed to the within instrument, and acknowledged
that he executed the same as his free and voluntary act for the purposes expressed
therein.
IN WITNESS WHEREOF, I have hereunto set my hand
Public
COMMONWEALTH OF PENNSYLVA14lA
NOTARIAL SEAL
CHARLES FRANK CLASS. III, Notary Public
Lower Paxton Twp , Qauphin County
My Commission Expires Apnl 30, 2011
-3-
IN RE: : 1N THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUND/NG AGREEMENT
CONCERNING CASI.1 BFQt..~EST
THIS AGREEMENT, dated this 17~h day of January 2008,
WITNESSETH:
1. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Paragraph L of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of One
Thousand Dollars ($1,000.00) to Shelley Mae Ketner (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
Inheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
'legally bound hereby, the Beneficiary, for herself, her heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of her knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of her own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of One Thousand Dollars ($1,000.00), in
full satisfaction of the cash bequest under Paragraph L of Article Third of
the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of One Thousand
Dollars ($1,000.00) to the Beneficiary under Paragraph L of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
her in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
WITNESS: ,~
~~ f ~ r
l s
SHEL M "E KEENER
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~~~~ ~„~
ON THIS, the _~~ day of January, 2008, before me the undersigned officer,
personally appeared SHELLEY MAE KETNER, known to me (or satisfactorily proven)
to be the person whose name is subscribed to the within instrument, and acknowledged
that she executed the same as her free and voluntary act for the purposes expressed
therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
Id'otary Public
COMI~II~~;~~`~~i Ts-i 0~ ~'~9`~'~`ti^ ~'3 ~`61~~~;
SllS~~n;t.c"k~??~ E&iJ~'),, ti;~~ v).i:E `. slut's'.," ,
Nly ~i~rrm~ssi~n ~s;pires ~~ay t?, r~~l~~
-3-
IN RE: ; 1N THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS, :
DECEASED :ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUND/NG AGREEMENT
CONCERNING CASH BEQUEST
THIS AGREEMENT, dated this 12th day of January 2008,
WITNESSETH:
I. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas (`the Decedent'), a widow, died testate on October 7, 2007,
a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estafe on October 15, 2007.
3. Pursuant to Paragraph N of Article Third of her Last Will and Testament
dated October 30, 2006 (the "Will"), the Decedent bequeathed the sum of Fifty
Thousand Dollars ($50,000.00) to Riegel Haas (the "Beneficiary").
4. At present, the Executrix has neither prepared and filed the Decedent's
Federal and Pennsylvania Individual Income Tax Returns for calendar year 2007 nor
has she prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. However, the Executrix has made a significant prepayment of
Pennsylvania Inheritance Tax. The Executrix believes that the Estate has sufficient
assets in order to satisfy all debts of the Decedent, the Decedent's funeral expenses,
the estate administration expenses and the Pennsylvania Inheritance Tax.
5. The Beneficiary desires the above described cash bequest be paid prior
to the filing of the Decedent's Individual Income Tax Returns and the Pennsylvania
-1-
6nheritance Tax Return. Thus, prior to the receipt of the Appraisement/Assessment of
Pennsylvania Inheritance Tax. The Executrix is willing to do so if the Beneficiary
provides the Executrix with satisfactory release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiary, for himself, his heirs, personal representatives,
successors, and assigns, hereby does as follows, to wit:
A. Represents, warrants and agrees that she:
(i) Has read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of his knowledge,
information and belief, and hereby approves the same for all purposes.
(ii) Acknowledges that she has sought advice of an attorney, prior to
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of his own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledges receipt of the sum of Fifty Thousand Dollars ($50,000.00),
in full satisfaction of the cash bequest under Paragraph N of Article Third
of the Decedent's Will.
C. Agrees to refund on demand, all or any part of the above described cash
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described cash distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
of the Estate of Barbara Haas, from any and all manner of actions, causes
of action, suits, liens, accounts, reckonings, controversies, agreements,
promises, claims, demands, losses and expenses whatsoever, in any way
-2-
arising from or concerning the Decedent's bequest of Fifty Thousand
Dollars ($50,000.00) to the Beneficiary under Paragraph N of Article Third
of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas of
Cumberland County, Pennsylvania, exercising personal jurisdiction over
him in any suit or action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiary has hereunto set its seal to this
Agreement on the date first above written.
~JVITNESS: '
~.--- ~ `~
~~ ~
,r ~... e~,,..,.~
y
~~~ RIEGEL HAAS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF D(~+~~~1
ON THIS, the ~~ day of January, 2008, before me the undersigned officer,
(personally appeared RIEGEL HAAS, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that he
executed the same as his free and voluntary act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
Notary Public
r COMMONWEALTH OF PENNSY VANIA
NOTARIAL SEAL
TAMICA C. GOODSON, Notary Public
Susquehanna Twp., Dauphin County
My Commission Expires Oct. 6, 2010
-3-
IN RE: : 1N THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF BARBARA HAAS,
DECEASED : ORPHANS' COURT DIVISION
927 YEAR 2007
RECEIPT, RELEASE AND REFUNDING AGREEMENT
CONCERNING INTERIM RESIDUAL DISTRIBUTION
THIS AGREEMENT, dated this 12"' day of May 2008,
WITNESSETH:
I. THE CIRCUMSTANCES leading up to the execution of this Agreement are as
follows:
1. Barbara Haas ("the Decedent"), a widow, died testate on October 7,
2007, a domiciliary of Cumberland County, Pennsylvania.
2. Joanne Campbell, duly qualified as Executrix of the Decedent's probate
estate on October 15, 2007.
3. Pursuant to Article Fourth of her Last Will and Testament dated October
30, 2006 (the "Will"), the Decedent bequeathed the residue of her estate equally to
RIEGEL HAAS and JOANNE CAMPBELL (the "Beneficiaries").
4. The Executrix has prepared and filed the Decedent's Federal and
Pennsylvania Individual Income Tax Returns for calendar year 2007. The Executrix
has also prepared and filed the Pennsylvania Inheritance Tax Return for the Estate of
Barbara Haas. At present, the Executrix has not received the Commonwealth of
Pennsylvania's Notice of Appraisement and Assessment of Inheritance Tax or the
requested refund of overpayment of tax. The Executrix believes the Estate has
sufficient cash in order to satisfy all remaining estate administration expenses.
5. The Beneficiaries desire the Executrix to distribute the Estate's Exxon
Mobil Corporation stock prior to receiving the Commonwealth's Appraisement/
-1-
Assessment of Pennsylvania Inheritance Tax, leaving approximately $148,000 to pay
the remaining estate administration expenses and final residual distributions. RIEGEL
F-IAAS and JOANNE CAMPBELL each will receive 400 shares of Exxon Mobil Stock
with a basis of $36,327. The Executrix is willing to so distribute the Estate's Exxon
Mobil Corporation stock if the Beneficiaries provide the Executrix with satisfactory
release and refunding protections.
NOW THEREFORE, in consideration of the foregoing, and intending to be
legally bound hereby, the Beneficiaries, for themselves, their heirs, personal
representatives, successors, and assigns, hereby do as follows, to wit:
A. Represent, warrant and agree that they:
(i) Have read and understands this Agreement and confirm the facts set
forth above are true, correct and complete to the best of their knowledge,
information and belief, and hereby approve the same for all purposes.
(ii) AcknowledgE that t"ey has sought Guvice of an attorney, prior tc
executing this Agreement or has voluntarily chosen not to consult with an
attorney; and,
(iii) Has entered into this Agreement of their own free will and choice
without any compulsion, duress or undue influence from anyone.
B. Acknowledge receipt of one-half of the Estate's Exxon Mobil Corporation
Stock in partial satisfaction of the bequest under Article Fourth of the
Decedent's Will.
C. Agree to refund on demand, all or any part of the above described stock
distribution, which the Executrix or any court of competent jurisdiction
determines to have been improperly made.
D. To the extent of the above described stock distribution, absolutely,
unconditionally and irrevocably releases, remises and forever discharges
Joanne Campbell, individually, and in her fiduciary capacity as Executrix
-2-
of the Estate of Barbara Haas, from any and all manner of actions,
causes of action, suits, liens, accounts, reckonings, controversies,
agreements, promises, claims, demands, losses and expenses
whatsoever, in any way arising from or concerning the distribution of the
Estate's Exxon Mobil Corporation stock to the Beneficiary pursuant to
Article Fourth of the Will.
E. Consents to the Orphans' Court Division of the Court of Common pleas
of Cumberland County, Pennsylvania, exercising personal jurisdiction
over him in any suit or action arising out of the enforcement of this
Agreement.
IN WITNESS WHEREOF, the Beneficiaries have hereunto set their seal to this
,Agreement on the date first above written.
WITNESS:
_-U",
By:
RIEGE HAAS
WITNESS:
By:
~,
,,
1`, ~ , ;~ v
-3-
JOANNE CAMPBELL
COMMONWEALTH OF PENNSYLVANIA
t~ O U N TY O F ~,~~.~..r-~-~...~....~....c~.,~.,~s~~
ON THIS, the ~g-f~-- day of May, 2008, before me the undersigned officer,
personally appeared RIEGEL HAAS, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that he
Executed the same as his free and voluntary act for the purposes expressed therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~~~~.~
Notary Public
co~oNwar-~n+oF ~~sr~v~a~
NOTARIAL SEAL
GYNYfMIA J. RW.E, Notary PCubli~c
Coma Expros F 3, Zb12
-4-
COMMONWEALTH OF PENNSYLVANIA
1
COUNTY OF ~--~
ON THIS, the~~'~'+--° day of May, 2008, before me the undersigned officer,
personally appeared JOANNE CAMPBELL, known to me (or satisfactorily proven) to
k~e the person whose name is subscribed to the within instrument, and acknowledged
that she executed the same as her free and voluntary act for the purposes expressed
therein.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
I ~ 1y'f' `
Notar`,r Public
GOMMONWEALTMOF PENNSYLVANIA
NOTARIAL SEAL
CYNTHUI J. RULE, Notary PubNc
Lemoyne Horo., Cum ~ land C 3u~!~ 12
CorrNr~isaton Za
-5-
SUMMARY OF ACCOUNT
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
Page
Proposed Distributions to Beneficiaries 14
Principal
Receipts 1-3
Net Gain (or Loss) on Sales or Other Dispositions 4
Other Receipts
Less Disbursements
Income Taxes Payable 5 $ 40.00
Administration Expenses (Prin) 5 908.37
Fees and Commissions (Prin) 5 26,041.00
Funeral Expenses (Prin) 6 9,829.93
Other Expenses (Prin) 6 24,081.50
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
For Information:
Changes in Investment Holdings
7-9
10
11-12
Income
Receipts
Less Cisbursements
Balance before Distributions
Distributions to Beneficiaries
Income Balance on Hand
Combined Balance on Hand
13
Fiduciary
Acquisition
Value
$ 137,613.65
$ 460,014.29
(1,690.48)
0.00
$ 458,323.81
60,900.80
$ 397,423.01
263,654.00
~ I JJ, 1 V.7. V 1
$ 3,844.64
0.00
$ 3,844.64
0.00
$ 3,844.64
$ 137,613.65
RECEIPTS OF PRINCIPAL
Estate of Barbara Haas
As of 06/30/2008
Assets Listed in Inventory
(Valued as of date of death)
Checking Accounts
PPJC Bank
Df:cedent's Checking Account No. 5001845219
Savings Accounts
Pennsylvania State Employees Credit Union
Ac:count 8339XXXXXX
Regular Share Account
:63.89 Accrued Interest
Comrnon Stocks
Exxon Mobil Corp
'I ,216 Units
Federal Notes and Bonds
U.~S. Savings Bonds Series I
Issue Date 12/2001; Interest Rate 4.44%
6 Units $9,096.00 Accrued Interest
Certificates of Deposit
PNC Bank Ready Access Certificate of Deposit
PNC Bank Fixed Certificate of Deposit
Pennsylvania State Employees Credit Union
Account 8339XXXXXX
9 Month Certificate of Deposit; 5.25% Interest
$101.97 Accrued Interest
Pennsylvania State Employees Credit Union
Account 8339XXXXXX
18 Month Certificate of Deposit; 5.31 % Interest; Opened
October 4, 2007
$42.57 Accrued interest
$ 21,361.30
$ 53,221.33
$ 110,228.27
$ 100,042.57
Page 1
Fiduciary
Acquisition
Value
$ 10,196.17
$ 14,331.68
$ 110,434.08
$ 39,096.00
$ 284,853.47
Refunds
Erie Insurance Group -
Refund Of Unsed Premium Of Homeowner's !Renter's
RECEIPTS OF PRINCIPAL
Estate of Barbara Haas
As of 06/30(2008
Assets Listed in Inventory
(Valued as of date of death)
Insurance
Policy No. Q57 1513315 H $ 107.00
U.S. Treasury
-1007 U.S. Individual Income Tax Refund $ 64.00
AAA Mld-Atlantic Insurance Group -Refund Of Unused
Premium $ 7.75
Marsh Affinity -Refund Check $ 19.80
Page 2
Fiduciary
Acquisition
Value
$ 198.55
TOTAL INVENTORY $ 459,109.95
RECEIPTS OF PRINCIPAL
Estate of Barbara Haas
As of 06/30/2008
Receipts Subsequent to Inventory
(Valued when received)
06114/2008 U.S. Treasury -Economic Stimulus Check
06/30/2008 Commonwealth of Pennsylvania
Refund Of Overpayment Of Inheritance Tax
TOTAL RECEIPTS SUBSEQUENT TO INVENTORY
SUMMARY
Total Inventory
Total Receipts Subsequent To Inventory
TOTAL RECEIPTS OF PRINCIPAL
$ 595.00
309.34
Page 3
$ 904.34
$ 459,109.95
904.34
$ 460,014.29
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
Estate of Barbara Haas
For Period 10(7/2007 Through 06/30/2008
10/22/2007 Redeemed Six $5,000 U.S. Savings Bonds Series I
6 Units
Net Proceeds $ 30,000.00
Fiduciary Acquisition Value ~n nnn nn
Net Gain
11/13/2007 Sold 216 Shares of Exxon Mobil Corp.
216 Units
Net Proceeds $
Fiduciary Acquisition Value
Net Loss
11/14/2007 Sold 200 Shares Exxon Mobil Corp
200 Units
Net Proceeds $
Fiduciary Acquisition Value
Net Loss
Net Loss
18, 522.37
19,616.58
17,567.23
18,163.50
Gain
$ 0.00
Page 4
Loss
$ 1,094.21
~iAR 77
$ 1,690.48
DISBURSEMENTS OF PRINCIPAL
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
Income Taxes Payable
PA Department of Revenue - 2007 PA40
3/27/2008 Pennsylvania Department of Revnue - 2007 Individual
Income Tax
Administration Expenses (Prin)
11/15/2007 Cumberland Law Journal -Legal Advertisment $ 75.00
11/15/2007 Cumberland County Register ofWills -Probate Fees 360.00
11/15/2007 Cumberland County Register of Wills -Miscellaneous
Charges
Will $15.00
Short Certificates $24.00
JCP Fee $10.00
Automation Fee $ 5.00 54.00
11/15/2007 Keefer Wood Allen & Rahal, LLP
Miscellaneous Disbursments
Postage and Photocopies 17.36
04/14/2008 Keefer Wood Allen & Rahal, LLP
- Miscellaneous Disbursemetns (i.e., Copies, Postage,
Filing Fees, Messenger Services, Legal Advertisement) 286.69
06/30/2008 Keefer Wood Allen & Rahal, LLP
Reserve For Miscellaneous Disbursements
(i.e. Filing Fees, Postage, Copies, Telephone, Etc.) 115.32
Page 5
$ 40.00
908.37
Fees and Commissions (Prin)
12/20/2007 Joanne Campbell -Executor's Commissions $ 8,500.00
04/14/2008 Keefer Wood Allen & Rahal, LLP
- Legal Fees 6,356.00
5/8/2008 BMC -Accountant's Fees
Preparation Of The Decedent's Final Indiviudal Income
Tax Returns 385.00
06/30/2008 Joanne Campbell
Reserve For Executor's Commissions 7,500.00
06/30/2008 Keefer Wood Allen & Rahal, LLP
Reserve For Legal Fees 3,300.00
26,041.00
DISBURSEMENTS OF PRINCIPAL
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
Funeral Expenses (Prin)
11/15/2007 Hetrick Funeral Home, Inc. -Funeral Services
11/15/2007 Gilligan's Bar and Grill Too -Funeral Reception
06/ 30/2008 Brackendorf Memorials
Reserve For Memorial
Other Expenses (Prin}
10/09/2007 Millennium Pharmacy -Medical Expense
Debt Of Decedent
10/09/2007 Periodontal Associates -Medical Expense
Debt Of Decedent
10/12/2007 East Pennsboro Ambulance Services, Inc.
Medical Expense
Debt Of Decedent
11/15/2007 Millennium PharmacySystems, Inc.
Medical Expense
Debt Of Decedent
12/12/2007 Bethany Village -Medical Expense
Debt Of Decedent
12/26/2007 Register Of Wills, Agent -Prepayment of Pennsylvania
Inheritance Tax
12/2~B/2007 Bethany Village -Medical Expense
Debt Of Decedent
1(11/2008 Bethany Village -Medical Expense
3/4/2008 Bethany Village
Skilled Nursing Services 10/01/07-10/07/07
- Debt Of Decedent
$ 8,697.42
322.51
810.00
$ 25.20
115.00
44.00
56.14
119.00
21,340.00
735.16
1,098.00
549.00
Page 6
$ 9,829.93
~a nR~ ~n
TOTAL DISBURSEMENTS OF PRINCIPAL ~ 60,900.80
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Page 7
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
To: Joanne Campbell
C<3sh Bequest Under Article Third Of Will
01/17/2008 Cash $ 50,000.00
To: Joanne Campbell
Interim Residual Distribution
05/29/2008 Exxon Mobil Corp 36,327.00
400 Units
Total for Joanne Campbell $86,327,00
To: Riegel Haas
Cash Bequest Under Article Third Of Will
0'1/17/2008 Cash 50,000.00
To: RiE;gel Haas
interim Residual Distribution
05!29/2008 Exxon Mobil Corp 36,327.00
400 Units
Total for Riegel Haas 86,327.00
To: Heiidi Stum
Cash Bequest Under Article Third Of W ill
01/1712008 Cash 20,000.00
To: Tracy Derk
Cash Bequest Under Article Third Of Will
01/17/2008 Cash 20,000.00
To: Sandi Hurley
Cash Bequest Under Article Third Of Will
01,17/2008 Cash 15,000.00
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Page 8
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
To: Janice Macut
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash $ 2,000.00
To: Eric Haas
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 2,000.00
To: Laura Hurley
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 3,000.00
To: Patrick Hurley
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 3,000.00
To: Sears Hurley
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 3,000.00
To: Carley Hass, a Minor
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 1,000.00
To: Willie Joe Ketner
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 1,000.00
To: Shelley Mae Ketner
Cash Bequest Under Article Third Of Will
01/'17/2008 Cash 1,000.00
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Page 9
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
To: Calvary United Methodist Church
Cash Bequest Under Article Third Of Will
01/17/2008 Cash
20,000.00
TOTAL DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES $ 263,654.00
PRINCIPAL BALANCE ON HAND
Estate of Barbara Haas
As of 06/30/2008
Money Market Accounts
Estate's Wachovia Securities Money Market Account
Refunds
Commonwealth of Pennsylvania
Refund Of Overpayment Of Inheritance Tax
Less: Income balance on hand
PRINCIPAL BALANCE ON HAND
Current
Value
$137,304.31
309.34
$137,613.65
3,844.64
$133,769.01
Page 10
Carrying
Value
$137,304.31
309.34
$137,613.65
3,844.64
$133,769.01
INFORMATION SCHEDULES
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
Change's in Investment Holdings
Exxon Mobii Corp $ 37,780.08
1'1/13/2007 Sold 216 Shares of Exxon Mobil Corp.
216 Units (19,616.58)
11/14/2007 Sold 200 Shares Exxon Mobil Corp
200 Units (18,163.50)
U.S. Savings Bonds Series I $ 39,096.00
10/22/2007 Deposited Interest On U.S. Savings Bonds Series I (9,096.00)
10/22/2007 Redeemed Six $5,000 U.S. Savings Bonds Series I
6 Units (30,000.00)
PNC Bank Ready Access Certificate of Deposit $ 21,361.30
10/17/2007 Closed PNC Bank Ready Access Certificate of Deposit (21,361.30)
PNC Bank Fixed Certificate of Deposit $ 53,221.33
10/17/2007 Closed PNC Fixed Certificate Of Deposit (53,221.33)
PSECU Account 8339XXXXXX CD1 $ 110,228.27
10/17/2007 Interest (101.97}
10/17/2007 Closed PSECU Certificate Of Deposit Account (110,126.30)
Pennsylvania State Employees Credit Union CD2 $ 100,042.57
10/17/2007 Interest (42.57}
10,117/2007 Closed PSECU Certificate Of Deposit (100,000.00)
Page 11
0.00
0.00
0.00
0.00
0.00
0.00
INFORMATION SCHEDULES
Estate of Barbara Haas
For Period 10/7(2007 Through 06/30/2008
Erie insurance Group -Homeowner's /Renter's Insurance
1"1/08/2007 Deposited Erie Insurance Refund Check
U.S. Treasury - 2007 Form 1040 Refund
05/30/2008 Deposited Individual Income Tax Refund Check
$ 107.00
$ 64.00
Page 12
0.00
0.00
U.S. Treasury -Economic Stimulus Check
OE~/14/2008 Received And Deposited Economic Stimulus Check From
The U.S. Treasury
$ 595.00
0.00
AAA Mld-Atlantic Insurance Group
12/19/2007 Deposited Refund Check From AAA
Marsh Affinity -Refund Check
11/25/2007 Deposited Refund Check From March Affinity
$ 7.75
(7.75)
$ 19.80
0.00
0.00
PA Department of Revenue - 2007 PA40
3127/2008 Pennsylvania Department of Revnue - 2007 Individual
Income Tax
$ 40.00
(40.00)
0.00
RECEIPTS OF INCOME
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
Dividends
Exxon Mobil Corp
12/'10/2007 Dividends
03/'10/2008 Dividends
06/'10/2008 Dividends
Total Dividends
Interest
PSEC;U -Regular Share Account
10/'17/2007 Interest
Estate's Wachovia Securities Money Market Account
10/31/2007 Interest
11/30/2007 Interest
12/31 /2007 Interest
01 /:31 /2008 Interest
02/29/2008 Interest
03/:51/2008 Interest
04/30/2008 Interest
05/30/2008 Interest
06/30/2008 Interest
PSEC:U Account 8339XXXXXX CD1
10/17/2007 Interest
Pennsylvania State Employees Credit Union CD2
10/17/2007 Interest
Total Interest
TOTAL RECEIPTS OF INCOME
425.60
280.00
~~n nn
1,025.60
5.56
310.12
752.42
786.13
507.15
57.33
37.74
25.39
25.18
~a a~
2,525.88
145.68
141.92
Page 13
$ 1,025.60
~R~ana
3,844.64
PROPOSED DISTRIBUTIONS TO BENEFICIARIES Page 14
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
To: Joanne Campbell
Final Residual Distribution
06/30/2008 The beneficiary will receive a 50% interest in the
estate's residue, representing a portion of the
following assets:
Cash $ 68,652.15
PA Inheritance Tax Refund 154.67
Current balance $309.34
~fotal $ 68,806.82
To: Riegel Haas
Final Residual Distribution
06/30/2008 The beneficiary will receive a 50% interest in the
estate's residue, representing a portion of the
following assets:
Cash 68,652.16
PA Inheritance Tax Refund 154.67
Current balance $309.34
Total $ 68,806.83
TOTP~L PROPOSED DISTRIBUTIONS TO BENEFICIARIES $ 1~7 R1~ R.r,
PROPOSED DISTRIBUTIONS TO BENEFICIARIES Page 14
Estate of Barbara Haas
For Period 10/7/2007 Through 06/30/2008
To: Joanne Campbell
Final Residual Distribution
06/30/2008 The beneficiary will receive a 50% interest in the
estate's residue, representing a portion of the
following assets:
Cash $ 68,652.15
PA Inheritance Tax Refund 154.67
Current balance $309.34
Total $ 68,806.82
To: Riegel Haas
Final Residual Distribution
06/30/2008 The beneficiary will receive a 50% interest in the
estate's residue, representing a portion of the
following assets:
Cash 68,652.16
PA Inheritance Tax Refund 154.67
Current balance $309.34
Total $ 68,806.83
TOTAf_ PROPOSED DISTRIBUTIONS TO BENEFICIARIES $ 137,613.65