HomeMy WebLinkAbout03-0074 PETiTiON FOR GRANT OF LETTERS
Estate of IVladin L. Bardck No. ~'
also known as
, Deceased Social Security No. 2.10265076
Pe~;;~,F, er(s), who is/are 18 yea~= of age or older, apply)ies) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executL named in the Last Will of the
[~ Decedent, dated 5/3/68 and codicil(s) dated
Slale relevanl circumsla~c~s, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not many, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
E B. Grant of Letters of Administration
(c.t.a., d.b.n.c.l.a.: pende~e lite, durante absentia; dumnte minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
, i
(COMPLETE DN ALL CASES:) Afech additional sheet~ if necessary.
Decedent was domiciled at death in CUmberland County, Pennsylvania, with his/her last family or principal
residence at 188 McAIlister Church Road~ Cadisle~ PA 17013
(list street, number and municipalily)
Decedent, then 69 years of age, died December 2 ,2002 , at Clinton County- in woods while huntin.q
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA All personal property ......................................... $
(if not domiciled in PA Personal property in Pennsylvania .................... $ j O O~ /.PO O, 0 ~
(if not domiciled in PA Personal property in County .............................. $,
Value of real estate in Pennsylvania $
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signature Typed or printed name and residence
,'?-//?- ?
STATUS REPORT UNDER RULE 6.12
Date of Death:
Will No.: 2- O O '~ ----- o o 9-1 ~g .. Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whe,0;}er admirfistrati0n of the estate is complete:
Yes,J~ No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal:~l~esentafive tile a fi.ual account with the Court?
Yes ~ No~
b. The separate Orphans' Court No. (if any) ~or the personal represeritat~ve s
account is: .
c. Did the personal representative state an account informally to the parties
in interest? Yes [] No ['-'1
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Name
~'~' '~ Address
Telephone No.
Capacity: ~___ Personal Represer,Xative
//,~Counsel for personal representative
Oa[h of Persorm
Commonwealth of Pen~sylvanJa
CouR[y Of CumbeHand
The Peffibner(s) abo~-named ~ear(s) and affix(s) that the ~atemen~ in the forgoing Per,ion am tree
and ~ffe~ to the be~ of the knowledge and bel~f of Pet~bner(s) and that, as pemonal mpresenta[~(s) of the
De,dent, PetA~ner(s) will well and truly admin~er the e~ate a~ing to law.
Swom to and affi~ and subscd~d
before me th~ 24th day of
~ Janua~ 200~
~nna H. Otto,lst ~puty
DECREE OF REGISTER
E~ete of Martin L. Ba~k Debased No. 21-2003-74
al~ kno~ as
~dal ~cur~y No: 210~5076 Date of Death: 1 ~02
AND NOW, J~u~ 27th , 200~ , in ~ns~emtion of the PetR~n on the
m~ s~e hereon, setbfa~ou proof ha~ng ~en presented before me,
~ IS DECREED that Le~em ~ Te~amentau ~ of Admin~mfion
((c.t.a., d.b.n.c.t.; ~nd~e I~e; dum~e a~ia; dum~e min~e)
am hereby granted to Dom~y R. Ba~ck
in the above estate and that the instrument(s), if any, dated May 3, 1968
described in the Petition be admitted to probate and filed of record as the Last Will of Decedent.
Letters .................................... $ 200.00 /~;.z,~,, .
· ' Regisle~ of Wills ~ '
Short Certificates(s) 10 $ 30.00 Donna M, Otto, 1st Deputy
............... ..
Renunciation .......................... $ ....
--//
E~raPages( i ) ............... $ 3.00
................................................ , - _ ¢,
LT.R ....................................... $
JCP Fee ................................. $ 10.00
Attorney: William P. Douglas
Invento,7 ................................ $ I.D. No: 37926
Other ...................................... $,. Address: 27 W. High St.
Cadisle PA 17013
TOTAL .............................. $ :. 243. O0 Telephone: 717-243-1790
DATE FILED: January 27th, 2003
Call Attorney at 243-1790 on 1-27-03
REGISTER-OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat. , sign the same and that signed as a witness at the
request of testat.__ in Ix__ presence and (in the' presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of.' (Name)
19
(Address)
~_.-, Register
(Name)
(Address)
21-2003-74
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose~) and say(s) that
-~~,~ familiar with the signature of
codicil
testat ~ of (one of the subscribing witnesses to) the will presented herewith and
codicil
that ~~ believes the signature on the will is in the handwriting of
to the best of ~.~ knowledge and belief.
Sworn to or affirmed and subscribed before ~~'. ~ , ~~
me this 24th day of (Name)' -
;J~u~ ~, A~ 2003
~nna M. Otto, 1st ~putv- /Regge~
0
~~ddress)
This is to certi~ that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be.fbrwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00 ~~
~,,~
= 8 7 0 419 6
' ~,~, ~,,,:~, 2002
No. ~
~.~4 R~,. ~ COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH* VITAL RECORDS
CERTIFICATE OF DEATH
,~,'m (Coroner)
INK
Marlin L. Barrick M 210 - 26 - 5076 12/2/2002
69 11/6/1933 Carlisle, PA ,.-,.~[]
'iS' Clinton Twp. woods while
LeRoy A. Barrick & White
Sons Roof' v. [] ~ []
12~m Rosetta
188 McAllister Church Rxi. ,?..~.,.. PA
_ v~ ,?~.~ -.,~.~,~ West Pennsboro
Carlisle, PA 17013 Cumberland
A. Barrick
- Brown
R. Barrick
~[] m.~ c~..~[] ,~.,,~.,.[] Church PA 17013
o,~mu~,~z_ _r-I .-
l~,n. Gardens Carlisle, PA 17013
FD 012633 L Funeral Hcrne, Carlisle, PA 17013
ua or~/or,~'~u,, ~ e.ch ,~,. ' ~'[~
¢~ OF):
21-2003-74
LAST WILL AND TESTAMENT OF MARLIN L. BARRICK
I, MARLIN L. BARRICK, of the Township of West Pennsboro,
Cumberland County, Pennsylvania, being of sound and disposing mind,
memory and understanding, do hereby make, publish and declare this
as and for my Last Will and Testament, hereby revoking and making
null and void any and all prior wills, or instruments in the nature
thereof, by me at any time heretofore made.
ITEM I - I give, devise and bequeath all of my estate,
of whatsoever nature and kind, and wheresoever situate, to my wife,
DOROTHY R. BARRICK, should she survive me.
ITEM 2 - In the event my said wife survives me, I name,
constitute and appoint her the Executrix of this my Last 'Will and
Testament.
ITEM 3 - In the event my said wife should predecease me,
or in the event we should die under such circumstances as renders
the order of our death uncertain (in which case it shall be conclu-
sively presumed that my said wife predeceased me), or if my said
wife should die from any cause within the space of thirty (30) days
after my death, I give, devise and bequeath all of my estate to the
FAM'~E~.-'$ TRUST COMPANY, of Carlisle, Pennsylvania, IN TRUST, NEVER-
THI~i~]SS, to invest the same, and from the income derived therefrom,
together with such portio~ of the corpus as my Trustee in its sole
discretion shall deem necessary, to provide for the support, cmre,
maintenance and education of my two children, JODY L. BARRICK and
JOHN L. BARRICK, and at such time as each of my said children shall
~ttain the age of twenty-one years, i direct his or her share, to-
gether with any income accumulat ed thereon, shall be paid over
absolutely to him or to her by my said Trustee, less the proper fee,
costs and charges that may then be due and owing to my said Trustee
for its services performed as such.
ITEM h - In the event that Item No. 3 of my will becomes
effective, I name, constitute and appoint as the Guardian of the per-
son of ~ two children, MRS. JO}H~ N. TOMCHECK, of 126 West C~rch
Avenue, Carlisle, Pennsylvania.
ITEM .~ - In the event that Item No. 3 becomes effective,
I name, constitute and appoint as the Executor of this ~y Last Will
and Testament, F~PMERS TRUST CO~ANY, of Carlisle, Pennsylvania.
IN WITNESS WHEREOF I have hereunto set ~y hand at Carlisle,
Pennsylvania, this -? ~ zl day of ~v/ z,~. ~3~, 1968.
Signed, sealed, published, pronounced and
declared by the said Testator as and for
his Last Will and Testament in our pre-
sence, who, at his request, and in his
presence, and in the presence of each
other, have hereunto set our names as
subscr ~ibing witnesses.
LAST WILL AND TESTA~ENT i.~ ,'~i ~'?
OF
MARLIN L. BARRICK
EDWIN J~. BLUMENTHAL
ATTORNEY AT LAW
CARLISLE~ PA,
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No. 2. OO 3 -- O O""} ~ Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 2..! ~' [~ ~ .
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except_
Signature
.
Name ~
Address DOUGLAS, DOUGLAS & DOUGLAS
P.O. BOX 261
CARLISLE, PA 17013 ~
Telephone C! c'} ->... ~.. a> _ I--I. ~1 ~
~ Capacity: _, Personal Representative
· sel for personal representative
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS,
COUNTY OF CUMBERLAND, PENNSYLVANIA
IN RE: ESTATE OF Marlin L. Barrick, DECEASED
TO: NO. 2003-0074
Mrs. Dorothy R. Barrick
188 McAllister Church Road
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of Marlin L. Barrick.
See attached copy of Will
Name of decedent: Marlin L. Barrick
Last known address of decedent: 188 McAllister Church Road, Carlisle, PA
17013
Date of Death: December 2, 2002
Place of Death: L,~ c_.~,. ~ ~q O_C~.
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy R. Barrick
188 McAllister Church Rd.
Carlisle, PA 17013
Name, address and phone number of counsel:
William P. Douglas, Esquire
27 WEST HIGH ST.
CARLISLE, PA 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
D°ug~as2 I~suglas
By..
William P. Douglas, Esquire ~ -
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: February 5, 2003
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS,
COUNTY OF CUMBERLAND, PENNSYLVANIA
IN RE: ESTATE OF Marlin L. Barrick, DECEASED
NO. 2003-0074
TO:
Mrs. Dorothy R. Barrick
188 McAllister Church Road
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of Marlin L. Barrick.
See attached copy of Will
Name of decedent: Marlin L. Barrick
Last known address of decedent: 188 McAllister Church Road, Carlisle, PA
17013
Date of Death: December 2, 2002
Place of Death: L,oc_,~-- !-4-~qO_~. ~.
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy R. Barrick
188 McAllister Church Rd.
Carlisle, PA 17013
Name, address and phone number of counsel:
William P. Douglas, Esquire
27 WEST HIGH ST.
CARLISLE, PA 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Douglas.? Dau$1as ~ l~'t~las/}
~villiam P. Douglas, Esquire ~
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: February 5, 2003
IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS
MARLIN L. BARRICK ' OF CUMBERLAND COUNTY,, PENNA.
ORPHANS' COURT DIVISION
· NO. 2003 0074
~DER
'3:1
AND NOW, this ~ day of l~[~a~, 2004, the
Petatlon to Settle this Estate is approved, and Dorothy R. Bamck is hereby discharged
from her duaes as Execumx of this Estate
IN RE' ESTATE OF . 1N THE COURT OF COMMON PLEAS
MARLIN L. BARRICK : OF CUMBERLAND COUNTY, PENNA
ORPHANS' COURT DIVISI?~q~.
· NO. 2003 0074 ~ ~~ra~o
PETITION FOR THE SETTLEMENT OF AN ESTATE.. ~_n
TO THE HONORABLE, THE JUDGES OF SAID COURT c~ ~ --o
DOROTHY R BARRICK, Executrix of the Estate of Marlin L. Ba~'hck, tl~ough
her attorneys, Douglas Law Office, respectfully represents
I Marlin L. Barnck, the husband of Dorothy R Barnck, who resided at 188
McAlhsters Church Road Carlisle, PA 17013, died testate on December 2, 2002
2 Letters Testamentary were granted to Petitioner on January 27, 2003.
3 The assets in the estate were as follows
I 2000 Ford Fl50 15,000.00
2 1999 Citation Trailer - 27 ' shdeout 10,500 00
3 Pioneer Investments - IRA 85,760 49
4 266 shares M&T stock @$82 21,812 00
5 M&T Securities IRA 19,642 82
6 American Funds, IRA 9,790 90
7 Waypoint Bank, IRA 13,106 86
Total $175,613 07
4. Expenditures as follows have been made on behalf of the smd Marlin L Bamck
Estate
Ewlng Brothers, funeral and headstone $10,102 00
William P Douglas, Esquire, attorney fee $ 1,000.00
Register of Wills, probate fee $ 243.00
Cumberland Law Joumal, adv $ 75 00
Sentinel, adv $ 80.00
Register of Wills, filing fees $ 75 00
Total expenses $11,575 00
5 No inheritance tax was due A copy of the Notice of Appraisement from the
Department of Revenue is attached hereto as Exhibit A
6. The smd Marlin L. Bamck left h~s enUre estate to his wife, Dorothy R Bamck ~n
Item I of his Last Will and Testament. A copy of said Will is attached hereto has Exhibit
B.
7 The Balance in the estate has been d~stnbuted to Dorothy R Barrlck
RECAPITULATION
Total Assets: $175,613.07
Total Credits $ 11,575.00
Balance distributed to
Dorothy R. Barrick $164,038.07
WHEREFORE, your Petltmner prays that Your Honorable Court approve the
distribution of this estate as set forth herein, and that the said Executrix, Dorothy R Bamck
be discharged from the duties of hers appointment.
Douglas Law Office
B Y ~or p;t~t~ n~'t?~)°~
Attorney o ~
Dated' March 2004
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Dorothy R Barrlck, Executrix betng duly sworn according to law, deposes and says
that the averments of the within Petition are true and correct to the best of affiant's
knowledge, information and behef
Dorothy R B~mck
Sworn to and subscribed before me
this ~ day of ~ , 2004.
Notary
Notarml Seal
Anne M Cox, Notary Pubhc
Carlisle Borough, Cumberland County
My Commission Expires July 14, 2005
7
LAST WILL AND TESTAMENT OF MARLIN L. BARRICK
I, MARLIN L. BARRICK, of the Township of West Pennsboro,
Cumberland County, Pennsylvania, being of sound snd disposing mind,
memory end understanding, do hereby make, publish and declare this
ss and for m~r Last Will and Testament, hereby revoking and making
null and void any and all prior wills, or instruments in the nature
thereof, by me at any time heretofore made.
IT~ 1 - I give, devise and bequeath all of ~y estate,
of whatsoever nature and kind, and wheresoever situate, to my wife,
DOROTHY R. BARRICK, should she survive me.
ITEM 2 - In the event my said wife survives me, I name,
constitute and appoint her the Executrix of this m~ Last Will and
Testament.
ITEM 3 - In the event m~ said wife should predecease me,
gether with any income accu~lat ed thereon, shall be paid over
absolutely to him or to her by my said Trustee, less the proper fee,
costs and charges that may then be due and owing to my said Trustee
for its serwces performed as such.
ITEM 4 - In the event that Item No. 3 of my will becomes
effective, I name, constitute and appoint as the Guardian of the per-
son of w~ t~o children, MRS. JOHN N. TOMCHECK, of 126 West C~rch
Avenue, Carlisle, Pennsylvania.
ITEM 5 - In the event that Item No. 3 becomes effective,
I name, constitute and appoint es the Executor of this my Last Will
snd Testament, FXRM1~S TRNST COMPANY, of Carlisle, Pennsylvania.
IN WITNESS WHEREOF I bare hereunto set my hand at Carlisle,
Signed, sealed, published, pronounced and
declared by the ssmd Teststor as and for
his Last Will and Testament in ~ur pr~- ~ _ ~
BUREAU OF ZNDZVZDUAL TAXES COMMON#EALTH OF PENNSYLVANZA
lrNf~-RZT&NC~ TAX .ZVZSTGN DEPARTMENT OF REVENUE
DEPT. ZSOGO]
HARRISBURG, PA 171Z8-0601 NOT/CE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE
OF DEDUCTZOf~ AND ASSESSMENT OF TAX
DATE 10-13-2003
ESTATE OF BARRTCK NARLTN R
DATE OF DEATH 12-01-2002
FiLE NUMBER 21 03-0074
WTLLXAM p DOUGLAS COUNTY CUMBERLAND
DOUGLAS LAW OFFTCE ACN 101
27 N HI'GH ST [ Amount Remitted
CARLTSLE PA 17013
HAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGZSTER OF WTLLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 17013
REV ].547 EX AFP (OX 03) NOTZCE OF ZNHERZTANCE TAX APl3~'Z'~Trk'~j~:-'j,i'~.'~i~,~l-~j~-~-~ .................
DZSALLOWANCE OF DEDUCTZONS AND ASSESSNF,,NT OF TAX
ESTATE OF BARRZCK NARLTN R FZLE NO. 21 05-0074 ACN 101 DATE 10-13-200,~
TAX RETURN #~.. (X) ACCi~r~u AS FTLED ( ) CIL4~I~ED
RESERVATXON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPEAXSED VALUE OF RETURN BASED ON: ORTGZNAL RETURN
1. Real Estlte (~hodulo A)
2. St~s u~,J Bm~d$ (~1o B) (1) . O0 NOTE: To inmzre pr~or
(2) . O0 crmdit to your
3. Clos01¥ Hold St~PIrtnord~lp Tnterest (~le C) (3) . O0 ~ubmtt ~ ~r
4. Ho~t~s/Notes Receivable (Schedule D) (4) .00 of ;chis form wl~h Your
s. Cesh/Be~ D~ostts/~isc. Por~m~ P~oport~ (Sch~dull E) (S) 47,$12.00 ~x pa~u~nt.
6. ~olfltly Omwcl P~oporty (Schedull F)
7. Tr~flsfors (Schedule D) (6) · 00
8. TotAl Assets (72 128;301.07
(8) _ 175,613.07
APPROVED DEDUCTZONS AND EXEMPTIONS:
9. FunormX Expenses/Ada. Costs/Hire. Expert, s (~hoduXe H) (9} 11,575.00
10. Ddzts/Hort~o Lla~blXittes/Llm~s (Schedule X) (102 t
11. Totll Dm:k~tlo~s
12. Not Vmltm of Tax Return (Il) 11 .~Tfi_Ofl
(12) 164,038.07
13. Charitmblo/~overflme~tmX b~msts; Non-oXo~tod 9113 Tr~zsts (SchoduXe J) (13) .00
14. Net Vllue of Emtlte Subject to Tax
(14) 164,038.07
NOTE: ~Y an assessaent uas issued Previously, :Ztnes 14, 1S and/or 16, 17, 18 and 19
~e~:Zect ~tgures thee include the total o~ ~LL returns assessed to deeo.
ASSESSMENT OF TAX**
1~. Am~nt of Line 14 mi Spou~X rite (1~)_ 164,038.07 X 00 = .00
16. Am~mt of Limo 14 taxable mi Llrmml/Clmsl A rite (16) . O0 X 045 = . O0
17. Amount of Line 14 it Sibling r~to (17)_. .00 X 12 = .00
18. Amount of Limo 14 taxmbll ii Co111torul/Cliss B rite (18) . O0 X 15 = . O0
19. Prir~tpll Tax
(19)? . O0
ZNTEREST/p~. ~AZD (-) AmUm FAn
· O~AL TAX CREDZT J .00
'BALANC~ OF TAX DUE/ .00
Z.~ AND P~. I .00
TOTAL DUE f .00
ZF PAZD AFTER DATE ZNOZCATED~ SEE REVERSE ( ZF TOTAL DU~ Z$ LESS THAN $1; NO PAYHENT Z$ REQUZRED,
FOR CALCULATZON OF ADDZTZO~AL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A ~CREDZT~ (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE $ZDE OF THZS FORff FOR ZNSTRUCTZO~S. )
~ PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FILENUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT cou c®
J-- DECEDENTS NAME (LAST, FLI;~ AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
UJ '
t't DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
UJ (IF APPLICABLEI SI Immm,~r: ~,',~ ~,-,~ ~,~ (LAST..~.~FIFIRST, AND MIDDLE INITIAL),.,,. ~ ,----.,~ SOCIAL SECURITY NUMBER
o~'~ r_.~l~ 4'~Estate j'---J 4a. Future Interest Compromise ,date of de~ after 12-12.82, j---J 5. Federal Estate Tax Return Required
3:~0 ~. Decedent Died Testate (Attac~ copy of Will)
O,, m~ ~ 7. Decedent Maintained a Living Trust (Attach moy of Trust) 8. Total Number of Safe Deposit Boxes
< j---J 9. Litigation Proceeds Received J~] 10. Spousal Poverty Credit (da,e of death between :2-3:-91 and ,4-95) J---J 11. Election to tax under Sec. 9113(A)(A~ch Sch O)
Z
,", COMPLETE MAILINt
o ' 27 ~. [-]':Lgh Sl:z'ee-I:
TELEPHONE
o
1. Real Estate (Schedule A) (1) ~. ~. OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2)
3. Closely lileld Corporation. Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) /'¥ *~ '~ J ~.... (,.~C)
(Schedule E) !
6. Jointly Owned Proper[y (Schedule F) (6)
J J Separate Billing Requested ;L'
:~) 7. Inter-VivosTmnsfem&MiscellaneousNon-ProbatePmperty (7) [,~ '~ (-,% j · ~
I-- (Schedule G or L)
~ 8. Total Gross Assets (t~tal Lines 1-7) (8) I -I ~", G l: 5, ~ '7
ILl 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ! ~i ~'~9, O O
10. Debts of Decedent, Mortgage Liabilities, & Lens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10) (11)
12. Net Value of L~tate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE I~TES
~ 15. Amount of Line14 taxable at the spousal tax /{::~/-1~ ~'~ .~'"7 x .0_
~.. rate, or transfers under Sec. 9116 (a)(1.2) (15) 4:~ ,/
3= 16. Amount of Line 14 taxable at lineal rate x .0 (16)
O~ 17. Amount of Line 14 taxable at sibling rote x .12 (17)
~ 18. Amount of Line 14 taxable at collateral rote x .15 (18)
19. Tax Due
(19)
J
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Pag. e 1 Line 19)o · .
. : , ~.~- . ... (1)..
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments . ' ·
C. Discount * '
, . Total Credits (A + B + C ).(2)
3. Interest/Penalty if applicable . .,.
D. Int~, st
E. Penalty ---
Total Interest/Penalty ( D + E )(3)
4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4)
5. If Une 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on lhe tax due. (5A)
B. Enter the total of Uue 5 + 5/L This is the' BALANCE DUE. ~'
Make. Check Payable to; R~G/STER OF WlLLSj AGENT "
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use o~ income of the property lranaferred; ..................................................................................... []
b. retain the right to designate who shall use the properly transferred or its income; ............ i ............................... r-'~.
c. retain a reversionary interest; or ....................................... ; ................................................... []
d. receive the promise for life ef either payments, benefits or care? ...................................................................... []
2. If death occurred after December 12,'1982, crKJ'de(Jedent fransfer property within one year of dealh
3. Did decedent own'an 'in Imst for" or payable upon death bank account or security at his or her death? .............. [] E~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ..:...: ........ :( ......... :: ....... ~ .................................................................................... [~ []
IF THE ANSWER TO ANY OF ,THE. ABOVE QUESTIONS IS YES, YOU MUST CoMpLETE SCHEDULE G AND FILE IT AS PAET OF THE RETURN.
SIG~TU_~O~ PERSON RE~I~I~ FOR I~L~G RETURN ' ' I/~ ~ --- - DATE ~ _ '
ADDRESS__ / '~ ' ~ __ . ~ · / / --
'SIGNATURE O PREI=AI~ OTHER THAN REPRESENTATNE DATE
ADDRESS .
For dates of death on or after July 1, 1994 and before January 1, 1995, lhe tax rate imposed on the net value of lransfers lo or for the use of the su~,iving spouse is 3%
[72 P.S. {9116 (a) (1.1) (i)]. ' '
For dates of death on or after January 1, 1995, the lax rote imposed on the net value of transfers to or for the use of the sun/lying spouse is 0% [72 RS. {9116 (a) {1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and lhe statutory requirements for' disdosum of assets and filing a tax retum are still applicable even if
For dates of death on or ~er July 1, 2000:
The tax rote imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for lhe use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rote imposed on Ihe net value of Iransfers to or for the use of the decedent's lineal .beneficiaries is 4.5%, except as noted in 72 RS. {9116(1.2) [72 P.S. {}9116(aX1)].
The.tax rote imposed on the net value of lransfers to or for the use of the decedent's siblings is 12% 172 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV~I~I EX * (1 -,97)
~ SCHEDULE E
COMMO.W~,TH~'"'""'"'~OF PE..SYLV~^ CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
~SIDENT DECEDENT PERSONAL PROPERTY
Include the ~oceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
· ~ ,2,.11
TOTAL (Also enter on line 5, Recapitulation) $ ~ '"D ''~ t '~_ O o
(If more space is needed, insert additional sheets of the same size) r
Oq4OO~ ~:'~
HARLIN L BARRICK ~
'L88 MCALLISTER CHURCH
ROAD
C,ARL[SLE PA 17013
eD
1 ST LIENHOLDER
~ ~ Of <~ tO 'd~ vehicle ~'flibed 2f~LIENI"~LDER
~ STREET
REV-1510 EX * (14)7)
~ SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NN~IE OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT N~D THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COPY OF THE DEED FOR RE~L ESTATE.
VALUE OF ASSET INTEREST
I
~, ~_~' .~_. P..:. D~ j 1000 g.-~~--0(~
TOTAL (Also enter on line 7, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
PIO ER Combined
lnve
3tments' Account Statement 6>Cull Us 1-800-225-5292 Page
September 30, 2002 Retirement Accounts Call 1-800- 622-0176 1 of 3
' ........ www. pioneerfunds.com
~ Your Rel)resentative
PIX IPA CU.~T FOR 1304 BISTLINE BARBARA 6565-5197-0004
XAELIN L B~M~EICK AMERICAN GENERAL SECURITIES INC
188 MCALLISTER CHURCH RD 8R PAO08 CARLISLE
CARLISLE, PA 17013-9411 301 SOUTH HANOVER ST
CARLISLE, PA 17013
~ .......... :'"':':"':':':'~ ~:~:~:~:i:::::.::.::i&:::::.:.::::i:i:::..::.ii!::::.:::!::!::!~ii:.i::.:::.:$:::!iiii. ' !.!.:..'i .......... :!~i::"':'""':::
Now is lhe time got going on year-end planning strategies -- be sure to talk to your financial advisor about deadlines for retirement plans and
moves Itmt could lower your tax burden for 2(X)2. And it's not too soon to make your annual IRA contribution. Take advantage of the new higher
IRA contribution limit of $3,000 for the 2002 tax year ($3,500 if you're age 50 or older). Don't forgot your employer-sponsored retirement plan.
Limits are on the rise for these types of plans too. For more information, talk to your advisor, or call Pioneer's Retirement Plans Account
Information line al 800-622-0176. PiOneer Funds Distributor, Inc., Underwriter of Pioneer Mutual Funds, 50 State St., Boston, MA 02109.
Please see page 6 of the enclosed issue of Pioneer News for information about account services, including an important change to FactFone.
................. · ................ .'-'.":':--'--'.:-:.:-:-:-'.-:..'-:.:. x.m ::: ........ ::. · :.:. :~. _ ../_.Y .~..~'.~1!: .'.:: :::.':;: -':'-'.-':!: :.-'.' :i: :.-'.'.-"..:::::: -'."-'.-'-':': ~ ~ ~: :~. ~ $ c-'.'-':~ ~ ~¢~:: :~ :~ :~.':':: .-..'
r-ami Name Nl~m°~r Be ilmia "-- _A~ditie_as WMIdrawals Ckmlge ia Yabe
U.S. Grow~E-. ~ ~e labia Ydae , Yea-to-Dale . Year-to-Dale
?y.,..~ER_?OV'~__H~ S[~d:IES-CLASSA 070-6201460626 I m k-~ ~ I ~ ..... ~i.:.:.:~
u, .wu, uno lacome -
i~ONEER EQUITY INCOME FUN(} CLASS A ·
Current Quarter Tatals
Allocation ~ j~ 46% U.S. 6mwtk
of your
Regular PIONEER GROWTH SHARES
Accounts ~ 54% 6row& md Income
· PIONEER EQUITY INCOME FUND
omo ~ ue lamb Value + Year-lo-Dm . Year-lo-Date + v.~_,.
PION ......... ', .......... ,,~,~ - Total Vidue
eeK~UNIJ-CtASSA 001 91 II I --- .......,.............................,................~
Currant Quarter Tatals 7u t a;o2- se ta~nber.M am2
PIO ER Combined
Investments' Account Statement
September 30, 2002 Page
3 of 3
PIONEER FUND-CLASS h - Overview
Account Inlormntiou Owner
Account No. 001-9100057911 I~IM IRA CUST FOR Earnings SUlllmar~ Paid Year-To-Date
Account Open Date 01/15/1991 MARLIN L BARRICK D~,-'.~,~- * $314.49
188 MCALLISTER CHURCH RD Short Term Capital Gains ~).00
CARLISLE, PA 17013-9411 Long Term CapitaFGains
Year-to-Date Transaction Activits_
scriplion . Dollar Share Number . Total Share-'r~s ~-T'~'etalAccount
Amount :- Price = of Shares Owned Value
PIONEER Combined
Investments' Account Statement
September 30, 2002 /~} ~ ^(~ q 2 of 3
of your PIO~ER ~NO -
Retirement
.................................................................................................................................................................................................................... ~::-:::' "'. .................. ::::::::: :i:: :;:::: :~::: ¢:::: :~: :~:~: :!:~:i:~:~:i:~:i:i:i:~:;:i:i:~:~:~ ! ~ ;i~;~ii~i ~i!! ~;.. ~'s~ ............ ~.}~.........~...i~i~ii::
PIONEER fiRO~H $HARE$-C~$S h - Owmiow
Account Inf~tion O~er EamJn~ ~ Pa~ Year-To-Data
Account No. 07~1~ M~LIN L BARfllCK DMden~
Accent Open Da~ ~1~1~7 1~ MC ~LISTER CHURCH RD ~Te~ ~p~l Ga~s ~.~
~flLIS~, PA 17013-~11 L~g Te~ ~p~l Gains
Year-to-Dnte Transaction Activity
Dollar Share Number Total Shares Total Account
Date Transaction Description Amount + Price = of Shams Owned Value
PIONEER EQUITY INCOME FUND-CLASS A - Overview
Account Information Owner Earnings Suntmaf~ Paid Year-To-Date
~.ccount No. 011-6201460635 MARLIN L BARRICK Dividends $329.42
Account Open Data 02/18/1997 188 MC CALISTER CHURCH RD ShortTerm Capital Gains $0.00
CARLISLE, PA 17013-9411 Long Term Capital Gains $0.00
Year-to-Date Transaction Activity
Dollar Share Number Total Shares Total Account
Data Transaction Descripdofl ~,,,v.,,.Amount ?:- Pric~
~)IAYI/g2 ,~-~:;.;.:;.~ E~:.:.;.a $ ~':7~ .... ,mud uwneo value
o3/25/o2 DMDEND REINVESTED I;0.10 I;88.60 $26.14
Quarterly Statement Page 1 of 1
American Funds' Jan a. 1- September 30, 2002
PO Box 2560
MARLIN L BARRICK
h,,llh,,llh.,,,Ih,lhhh,,h,h.lh.llh,hl,,hh,,ll
Online conve~ence
~en you access your accou~ online, you can sele~ options such as m Carl your financial adviser
elec~nic statemen~ and get ~e info~ation you need - ~en you g A~omated i~afion and sewices
need ~ See ~at ame~can~nds.com can do for you. Webshe - ame~canfuflds, corn
.. Ame~can FundsLine ® - 80~25-3590
~O~ f~ m Pemonal a~nce - 8 a.m. - 8 p.m. Eastern time M-F
Shareholder Sewices - 800/421-0180
A ~0 annual fee ~11 be deduced in December ~m ~dRional I~s, Ro~
I~,.SIMP~ I~s, ~b~ 4~s,'moneywurchase pla~, profd-s~adng
plans end ~ account, ffyou pmfer to pay by c~ec~ we m~t recede
~ ~ December
Somm~
Fund ~count T~e of Shares held Share pdce Account value
...................................................................................................... ~ ................... .~?~r ~,~ ,,o~ ,,o~ ,,o~
.~-to-~te ~viden~ ~d capi~ ga~
Fund Accou~ $hoa~e~ Long4e~
number number D~idends
- * *. ........... cap~algains cap~Mgains
· ~*nd~'~*;~*i i~;~*~'~' ....................................................... ~*~ .............. *~ .............................. ~i~'~*'*~* ............................. ~'*~ ...................................... '~--~*
T~sa~ons
Fundamental Investors - Cla~ A
Fund number 10
Account number ~978936
D~idends and cap,al gains reinvested
Shares this
Trade date PescdpOon Dollar amount Share p~ce ~ansacOon Share balance
' ~ ........... ~;~';*;i';~'";~*;;;'"~;i*;;;;* .........................................................................................................................................................................................
414.619
0~2 Income Dividend 0.10 ~1.46 $26.38 1.572 416.191
05/15~2 Income Dividend 0.10 ~1.62 $27.62 1.507 417.698
08/1~2 Income Dividen~ 0.10 ~1.77 $23.31 1.792 419.~
09~0~2 Ending share balance 419.~0
oooo0ooo
Member FDIC ·
December 6, 2002
RETIREMENT CERTIFICATE MATURITY NOTICE
MARLIN L BARRICK
188 MCALI.I.~'I'ER Cl~tJRCH RD
CARI,I,gLE PA 17013-9411 "
On 1/07/03 your Certificate will mature. The interest rate, APY and balance of your new
term have not yet been determined but will be available on 1/07/03 by calling Customer
Service at 1-866-929-7646 or your local branch. Please see the reverse side of this letter for
additional account terms and conditions.
We are dedicated to improving our products and services for the benefit of valued customers,
like yourself. One of these improvements is a change in the rate structure of our Certificates
of Deposits. By adding additional funds to your certificate, you may earn a higher rate.
You, may also contact a licensed member of your branch who will gladly discuss alternate
investment opportunities with.you.
To request additional information, please call Okstomer Service at 1-866-929-7646. In
York, PA, call (717) 8154:500. At Waypoint Bank we are dedicated to giving extraordinary
customer service. Thank you for allowing us to serve your financial needs.
Maturity Date: { 1/07/03
Issue Value: ~ 13,1_06_8_~6,~/
Current Interest Rate: ~
Interest Payment
Method: Capitalization
Q Quarterly Statement
· Jul 1, 2002 to Sep 30, 2002
Nationwide Life and Annuity
P O Box 182008
Columbus OH 43218-2008
24 Hr. Annuity Line: (800) 848-8258
Customer Service: (800) 321-9332
Hearing Impaixed: (800) 238-3035
MARLIN L BARRICK
188 MCAT .T JSTER CHURCH RD
CARLISLE PA 17013-9411
YOUR CONTRACT IS SERVICer.D BY:
i 'SHAWNEE E SMITH : '
M T SECLrRITIES . · '.
ONEM T PLAZA 3RD FLR '-
i BUFFALO NY 14203
Representative Nnmber; 070C00592115 Contract Issue Date-- 07/03/2002
Annuitant: MARLIN L BARRICK
Contract Number: 07-1102525
Nationwide will assume all transactions are accurate unless notified within 30 days.
Q uarter-To-Date Year-To-Date Inception-To-Date
Beginning Value $.00 $.00 $.00
Ptu~hase Payments $ i9,437.66 $19,437.66 $19,437.66
Withdrawala/Charges $.00 $.00 $.00
Earnings $205.16 $205.16 $205.16
Ending Value $19,642.82 $19,642.82 $19,642.82
Cttrrent Death Benefit Value $19,642.82
Year of Purchase Wilhdrawals Ending Credited Base Rate
Purchase Payment Since Purchase Value on Interest Rate Guaranteed
Payment Amount Payment 09/3012002 Through
2002 $19,43~.66 $. 00 $19,642.82 4.40% 07/02/2003
Fund Total ~~
RR~2Q II Fl 071102525
00000001000000aZ 000~56~ 000~0~3 Page I of 2
RE, V-1511 EX,+ (12-99)~
' SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVECOSTS
RESIDENT DECEDENT
Debts of decedent must be reported on Schedule ].
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
~Sto~ l 0 tO~ ~
/
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State __ Zip
Year(s) Commission Paid:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Olaimant
Street Address
City State __ Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7.
~ ~'0 .oo
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
REV-I$$3 EX + (1-97) . ~l~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN ~
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tm__,_,_,_,_,_,_,_,_~e~__,_~) OF ESTATE
]. TAXABLE DISTRIBUTIONS (include oub~ghl spousal disb-ibutions)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART H- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA '~ ss:
COUNTY OF CUMBERLAND
late of _~_~_.__~T~ .... P'~.___~_~'~_~___~.o~o "~'~/S , , Cumberland County, Pa., deceased and that the
within is an inventory made by ~ ., the said
of the entire este. te of said decedent, consisting of all the personal property and real .estate, excep~ real ~state outside
the Commonwealth o{ Pennsylvania, and that the figures oppos;te each item of the Inventory represent ;t's falr value
as of the date of decedent's death. .
~'~(~'~' -~ and subscrlbed before me,
J Notarial Seal Address
J Anne M. Cox, Notary Public
I Carlisle Borough, Cumberland County
_/ ~y Commission [v4~lres July 14, 2005
Day Month Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be affached as fo personalty or realty
4. See Article IV, Fiduciaries Act of 1949. , :!:. ~-~
Inventory of the real and personal estate of
~J~,~ L.,, ~J'~Aj,~..,. deceased
· I
CONNON#EALTH OF PENNSYLVANIA
BUREAU OF ZNDZVZDUAL TAXES DEPARTNENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. ZD0601
HARRISBURG, PA 17118-0&0! NOTICE OF ZNHERTTANCE TAX
APPRAZSENENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
REV-1$~7 EX
DATE 10-15-2003
ESTATE OF BARRZCK HARLIN R
DATE OF DEATH 12-02-2002
FZLE NUNBER Z! 03-0074
~*..' COUNTY CUHBERLAND
NILLIAH P DOUGLAS
DOUGLAS LAN OFFICE ACN 101
Z7 N HIGH ST ~. I Amount Rem/fred
CARLISLE PA lY~13
NAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LZNE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR
DZSALLO#ANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
ESTATE OF BARRICK HARLIN R FILE NO. 21 03-0074 ACN 101 DATE 10-13-200~
TAX RETURN gAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2). . O0 credit to your account,
$. CloseZy Held Stock/Partnership Interest (Schedule C) ($) .00 submit the upper port/on
q. Hortgages/Notes ReceLvable (Schedule D) (~) .00 of thLs form wLth your
$. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) ($) 47/31Z.00 tax payment.
6. Jointly O~ned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7)
8. Total Assets
(8) 175,613.07
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funeral Expenses/Ada. Costs/HLsc. Expenses (Schedule H) (9) 11,575.00
10. Debts/Nortgege LLebL11tLes/Liens (Schedule I) (10) .00
11. Tote1 DeductLons
(11) ]].576.00
12. Net Value of Tax Return (12) 164,038.07
15. Cheriteble/Governeentel Bequests; Non-elected 9115 Trusts (Schedule J) (13) .00
lq. Nat Velue of Estate Subject to Tax (1~) 164,038.07
NOTE: Z~ an assessment Has issued previously, lines 14, 15 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of Line lfi at Spousal rata (15) 164,038.07 X O0 = .00
16. Amount of LAne lq taxable at Lineal/Class A rata (l&) .00 X 045: .00
17. Amount of Line lfi at Sibling rata (17) .00 x 12 = .00
18. Amount of L/ne 1~ taxable at Collateral/Class B rata (18) .00 X 15 = .00
19. Principal Tax Due
£AX CREDITS: (19)= .00
PAYH~NT RECEIPT DISCOUNT (+)
DATE NUHBER TNTEREST/PEN PA/D (-) AHOUNT PATD
TOTAL TAX CREDZT
BALANCE OF TAX DUEl .00
ZNTEREST AND PEN. / .00
TOTAL DUE / .00
TF PAID AFTER DATE TNDZCATED~ SEE REVERSE ( ZF TOTAL DUE TS LESS THAN $1~ NO PAYNENT TS REI~UTRED.
FOR CALCULATTON OF ADD/TTONAL TNTEREST. TF TOTAL DUE 1S REFLECTED AS A 'CREDTT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORH FOR TNSTRUCTTONS.)
RESERVATZON: Estates of decadents dying on or before December 1Z, 198Z -- if any futura interest in tho estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 2~ of ZOOO. E7Z P.S.
Section 9140].
PAYNENT: Detach the top portion cf this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF #XLLS, AGENT
REFUND (CR): A refund of a tax credit, ~hich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l~13). Applications era available at the Office
of the Register of #ills, any of the Z$ Revenue District Offices, or by calling the specie1 Z4-hour
answering service for forms orderinG: 1-800-S61-Z050; services for taxpayers with special hearing end / or
speaking needs: 1-800-447-$010 (TT only].
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance cf deductions, or assessment
of tax (including discount or interest) es sho~n on this Notice must object within sixty (60) days cf receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17118-10A1, OR
--election to have the matter determined at audit of the account cf the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment sheuld ba addressed in wrlting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717] 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (~) calendar months after the dacadent's death, a five percent (51) discount of
the tax paid is a11oaad.
PENALTY: The 151 tax amnesty non-participation penalty is computed on the total of the tax end interest assessed, end not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This rice-participation
penalty is appealable in the same manner and in the the same tiaa period es you would appeal the tax end interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (9] months and one (1) day from the date cf
death, to the data of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six (6~) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1981 will bear interest et a rate which will very from calender year to calendar year with that rata
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea.~r Rata Factor Yea.~r Rate Factor
1981 ZOX .OOOS¢8 1987 91 .OOOZ~7 1999 71 .000191
1983 161 .O00~3B 1988-1991 X1Z .000301 2000 81 .000119
1964 111 .000501 1991 9Z .000247 2001 9Z .0002~7
1985 131 .000556 199~-1994 71 .00019~ ZOOZ 61 .000164
1986 IOZ .000274 1995-199B 9Z .O00Zq7 2005 51 .0001~7
--Interest is calculated as follo~s:
XNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXNQUENT X DAXLY /NTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. Xf payment is made after the interest computation date sheen on the
Notice, additional interest must be calculatad.
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/10/2004
DOUGLAS WILLIAM P
27 W HIGH STREET
CARLISLE, PA 17013
RE: Estate of BARRICK MARLIN L
File Number: 2003-00074
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncom~}leted administration.
This filing will become delinquent on: 12/02/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,(- ~ . ~
GLENDA FARNER STP_ASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge