HomeMy WebLinkAbout04-0254Estate of
also known as
Ronald M. Katzman
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Robert ~/. Harb is on No..~/- ~_~/~/~_ ~L~,,~
, Deceased Social Security No. 206-12 - 9241
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 09/22/3.992 and codicil(s) dated None
named in the last Will of
State relevant circuF,¥.~,nces, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, 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 incompetent:
-'-] B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name
Relationship / Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family
or principal residence at 5 Spruce Circle, Shiremanstown Boro, Shiremanstown, PA 17011
(list street, number, and municipality)
Decedent, then 79 years of age, died 02/12/2~04 at Holy Spirit Hospital, Camp Hill, PA
(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
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$ 900,(~00. O0
$
$
$
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 undersioned:
t. /1 Sic~nature T~,ped or printed name and residence
Ronald M. Katzman
320 Market Street, Harrisburg, PA 17101
PrepareO by* the Pennsylvania Bar Association
Copyrigi3t (c) 1996 form software only CPSystems. Inc. Form Ri-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before
me this J~_ day~ of
Ronal~ M. Katzman ~ '~
Estate of Robert ~. ~{arbison
Deceased
Social Security No: 206-12- 9241 Date of Death: 02/12/2004
AND NOW,
, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary L---] Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absenfia; durante rninoritate)
are hereby granted to Ronald M. Katzman
in the above estate and that the instrument(s) dated 09/22/1992
described in the Petition be admitted to probate and filed'of record as the last Will of Decedent.
FEES
...........
Letters
Short Certificate(s) ..... $
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... ~ -~'-~,
Codicil ...........
JCP Fee .......... $ J~.~,
inventory .......... $
Other .......... $
TOTAL .........
Prepared by the Pennsylvania Bar Association
Attorney:
I.D. No:
Address:
Telephone:
Copyright (c) 1996 form software only CPSysterns. inc.
Form RW-1 (1991~
his is to certify 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 forwarded to the State Vital Records Office for permanent ming.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9825953
No.
v - Local Registrar
-- b/ Date
79 *'
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ' VITAL RECORDS
CERTIFICATE OF DEATH
Male ~. 206-- 12 --9241
! Mar 18, 1924 Springdale, PA ~o,~,... [] ~x~O [] N...~ C] ~,w[]
East Pennsboro
Insurance
Pennsylvania
5 Spruce Circle
Robert L.
White
L~ST WILL AND TESTAMENT
OF
ROBERT W. I~ARBISON
I, ROBERT W. HARBISON, of Shiremanstown, Cumberland County,
Pennsylvania, being of sound and disposing mind, do hereby make,
publish, and declare this to be my Last Will and Testament, hereby
revoking and making null and void all prior Wills and Codicils made
by me at any time heretofore.
ITEM I. I direct that all my legally valid debts,
funeral and administrative expenses, and debts incurred or payable
because of my death, shall be paid by my Executor, hereinafter
named, from my residuary estate as soon after my death as
practicable. All death taxes, including federal, state, and other
death taxes, payable with respect to the property forming my gross
estate for tax purposes, whether or not passing under this Will,
including any interest or penalty imposed thereon, shall be
considered an expense of the administration of my estate, and shall
be paid out of the principal allocable to the residue without
apportionment or right of reimbursement. Taxes on future interests
may be prepaid.
ITEM II. I acknowledge that, as of this time, the home
in which I reside with my wife, NANCY M. HARBISON, now of
Shiremanstown, Pennsylvania (my "Wife"), is titled between us in a
tenancy by the entirety, so that it, and all personal property
therein not otherwise identified as owned solely by me, shall not
pass under this Will, but shall pass by operation of law in the
event that I predecease her.
ITEM III. I give and bequeath those items of tangible
personal property solely owned by me that are identified in any
separate writing, which is dated and is signed by me at the end
thereof, to those persons designated who survive me. If any item
of tangible personal property is identified in more than one
separate writing, I direct that only the separate writing bearing
the last date shall govern the disposition of such item.
ITEM IV. I give and bequeath all my household and
personal effects, jewelry, automobiles, and other tangible
personalty of like nature not effectively disposed of by any
separate writing referred to above, to my Wife, NANCY M. HARBISON,
if she survives me. If she does not so survive me, such property
shall be distributed to my son, WILLIAM L. HARBISON, now of Rhode
Island, or to his then-living issue per stirpes. Such property
shall be divided by said beneficiaries as they shall agree. As to
2
those items upon which they shall not agree, distribution shall be
determined by my Executor.
ITEM V. I give, devise and bequeath the sum of One
Hundred Forty Thousand Dollars ($140,000.00) to my son, WILLIAM L.
HARBISON, if living, or to his then-living issue, per stirpes.
ITEM VI. If my Wife, NANCY M. HARBISON, survives me (and
I direct that, for the purpose of this Item, she shall be deemed to
have survived me unless it appears unmistakably that she
predeceased me), I make the following bequests:
A. In such event that my Wife survives me, if the
federal estate tax due because of my death will be reduced by
making a bequest for her benefit, I then give, devise, and
bequeath to my Trustee, hereinafter named, IN TRUST,
NEVERTHELESS, the least amount (based upon values as finally
determined for federal estate tax purposes) as shall be needed
for the federal estate tax unlimited marital deduction to
reduce the federal estate tax payable by reason of my death to
the lowest possible figure after full use of all other
deductions and credits allowable in calculating the federal
estate tax, except that such amount shall be calculated
without regard to the augmenting of my taxable estate by
reason of generation-skipping transfers, and without regard
3
for any credit for state death taxes that would not otherwise
be payable. With respect to the bequest and the trust created
under this Item VI. A., which shall be known as the "Marital
Bequest", I hereby direct as follows:
1. If the marital deduction or any similar
benefit is allowable with respect to any property,
including property held by entireties, which my Wife has
received prior to my death, or at my dea%h will receive
otherwise than pursuant to this ITEM VI. A., the value of
such property shall be taken into consideration in
calculating the size of the Marital Bequest created under
this ITEM VI. A.
2. No property ineligible for the marital
deduction or any similar benefit shall be distributed to
the Marital Bequest for my Wife, pursuant to this ITEM
VI. A.
3. Either cash or investments or both may be
allocated to the Marital Bequest under this ITEM VI. A.
4. Any property allocated under this ITEM VI.
A. in kind shall be valued at the value at which it is
finally included in my gross estate for federal estate
4
tax purposes, provided that the aggregate market value
thereof on the date of allocation (plus the value as
finally determined for federal estate tax purposes of all
other property qualifying for the marital deduction) is
at least equal to the dollar value of the marital
deduction as finally determined for federal estate tax
purposes.
5. My Wife shall be paid the entire income
from the principal in such periodic installments as my
Trustee shall find convenient, but at least as often as
quarter-annually.
6. My Wife is hereby given a power to appoint
by will to her estate or to others, in such manner and
for such estates as she may appoint, exercisable only by
specific reference by her alone and in all events over
the principal of this trust.
7. As much of the principal of the trust as
my Trustee may, from time to time, think advisable for
the support of my Wife or for expenses during illness or
emergency shall either be paid to her or else applied
directly for her benefit by my Trustee.
5
8. In addition to the above provisions, my
Wife shall have the power to withdraw such amounts from
principal as she shall desire from time to time,
including the entire exhaustion of principal.
9. If my Wife shall fail, either wholly or in
part, to exercise effectively the power of appointment
created in the preceding subparagraph 8., the unappointed
principal shall be added to, and thereafter treated as
part of, the principal of my residuary estate passing
under ITEM VII. hereof; Provided, that my Trustee shall
first deduct and pay to the personal representative of my
Wife's estate an amount equal to the increase in federal
and state death taxes and any increased administration
expenses which her estate will have to pay because of the
inclusion of the principal of this trust in her estate
for tax or administrative purposes.
10. If any provision of my Will shall result
in depriving my estate of the marital deduction for
federal estate tax purposes, such provision is hereby
revoked and my Will shall be read as if any portion
thereof inconsistent with allowance of the marital
deduction for federal estate tax purposes is null and
void.
6
11. If my property is insufficient for payment
in full of all legacies and devises, I direct that this
Marital Bequest shall be preferred over all other
legacies and devises.
B. In such event that my Wife survives me, I give,
devise, and bequeath all of the residue of my estate, not
otherwise disposed of above, whether real, personal, or mixed,
and wherever situate, including any property subject to any
power of appointment which I may now have or hereafter
acquire, to my Trustee, hereinafter named, IN TRUST
NEVERTHELESS (such trust to be known as the "Bypass Trust"),
for the following uses and purposes:
1. My Trustee shall pay the net income to my
Wife, NANCY M. HARBISON, during her lifetime, in such
periodic installments as my Trustee shall find
convenient, but at least quarter annually.
2. If the income so payable to my Wife shall
at any time exceed the amount which my Trustee deems to
be in her best interests (considering her other income
and means of support known to my Trustee, including the
income from her other solely-owned assets, the
desirability of augmenting her separate estate, and any
7
other circumstances and factors deemed pertinent), my
Trustee may accumulate the same and add it to principal,
as my Trustee deems advisable.
e
principal of
necessary or
My Trustee may also pay as much of the
the Bypass Trust as my Trustee deems
advisable, from time to time, for the
support and maintenance of my Wife at such times as my
Trustee deems best, after considering her needs, her
other income and means of support known to my Trustee,
including the income from her other solely-owned assets,
the desirability of augmenting her separate estate, and
any other circumstances and factors deemed pertinent.
4. During illness or emergency, my Trustee
may either pay a distribution to my Wife or may make a
distribution for her benefit.
5. Upon the death of my Wife, the assets
remaining in the Bypass Trust shall be distributed by my
Trustee pursuant to Item VII. hereof.
ITEM VII. In the event that my Wife has predeceased me,
or upon the death of my Wife after funding of the Trusts created
under Item VI. above, my Executor or my Trustee, as appropriate,
8
shall distribute my entire Estate, or the remaining principal of my
Trusts:
A. To my son, WILLIAM L. HARBISON, now of Rhode
Island, if he survives me and my Wife by thirty (30) days;
provided, however, that if he does not so survive my Wife and me,
but leaves descendants who so survive both of us, such descendants
shall receive, per stirpes, the share my said son would have
received had he so survived my Wife and me.
B. In the event my said son fails to survive my
Wife and me by thirty (30) days, and there are no descendants
living on the 31st day after the death of my Wife and me, I then
give, devise, and bequeath all my household and personal effects,
jewelry, automobiles, and other tangible personalty of like nature
owned by me and not effectively disposed of in any other manner,
together with fifty percent (50%) of the rest, residue and
remainder of my estate, or of the remaining principal of my Trusts,
to my sister-in-law, LOIS M. RIMMEY, of Centre Hall, Pennsylvania,
if she is living on the 31st day after the last to die of my Wife,
my son, or his descendants. If she fails to so survive, then I
direct that said assets be paid over to my corporate Trustee,
hereinafter appointed, IN TRUST NEVERTHELESS, to pay the net income
to my brother-in-law, JOHN M. RIMMEY, JR., of Centre Hall,
Pennsylvania, during his lifetime, in such periodic installments as
9
my Trustee shall find convenient, but at least quarter-annually;
upon the death of my said brother-in-law, the assets of said Trust
shall be paid equally to the then living issue of my sister-in-law,
LOIS M. RIMMEY, and her husband, JOHN M. RIMMEY, JR., per stirpes.
C. I give, devise, and bequeath the remaining
fifty percent (50%) share of the rest, residue and remainder of my
estate to my cousins in the following shares:
1/7 to RICHARD M. RHEA of Clarion, Pennsylvania;
1/7 to JAMES L. WHYTE of Parker, Pennsylvania;
1/7 to SHIRLEY SLATER of Poland, Ohio;
1/7 to ELLEN JANE FREDERICK of Brooksville, Florida;
1/7 to ELEANOR BREAM of McLean, Virginia;
1/7 to BETTY WELCH of McLean, Virginia; and
1/7 to JOHN P. McINTYRE of Miami, Florida.
The share of any of the foregoing who shall not survive the
death of my Wife, my son, and any descendants of my son, by thirty
(30) days, shall be paid to the other legatees entitled hereunder
in proportion to their respective interests.
ITEM VIII. No interest of any beneficiary of my estate or
of a trust created herein, either in income or principal, shall be
subject to anticipation or to pledge, assignment, sale or transfer
10
in any manner, nor shall any such interest be liable on account of
the debts, contracts, torts, or other engagements of any
beneficiary.
ITEM IX. I hereby appoint RONALD M. KATZMAN, now of
Mechanicsburg, Pennsylvania, as the executor (the "Executor") of
this, my Last Will and Testament. In the event of his refusal or
inability to so serve, I then nominate and appoint NEIL HENDERSHOT,
now of Harrisburg, Pennsylvania, to serve in the capacity as
Executor.
ITEM X. I hereby appoint FULTON BANK, now of Harrisburg
and Lancaster, Pennsylvania (and its successors in interest), and
WILLIAM L. HARBISON, now of Rhode Island, or the survivor of them,
to serve together as the trustee (collectively, the "Trustee") of
the trusts created under this Will.
ITEM XI. I direct that my Executor and Trustee shall not
be required to give bond or post any other security for the
faithful performance of their duties in any jurisdiction; provided,
however, that I consent to the specific imposition by a Court of
competent jurisdiction of a requirement of bond or other security
upon my children who shall serve as an Executor or a Trustee
hereunder.
11
ITEM XII. In the event that my Wife and I die under such
circumstances that it cannot readily be determined which of us died
first, she shall be deemed to have survived me. If any beneficiary
hereunder should die within thirty (30) days after my death, or
within thirty (30) days after the death of any other beneficiary
upon the survival of whom an interest of that beneficiary depends,
then that beneficiary shall be deemed to have predeceased me or
such other beneficiary, as the case may be.
ITEM XIII. Any amounts which are payable to a minor
under this Will, at the discretion of my Executor or Trustee, as
appropriate, may be paid either to a parent or guardian of such
minor, to the person who had custody of such minor, directly to
such minor, or may be applied for the use or benefit of such minor.
ITEM XIV. My Executor and Trustee shall have the following
powers in addition to those invested in them by law and by other
provisions of my Will applicable to all property, whether principal
or income, exercisable without Court approval, and effective until
distribution of all property:
A. To retain all or any part of my property,
real or personal, in the form in which it may be at the
time of my decease, including any business owned or
controlled by me, as long as in the exercise of their
12
discretion it may be advisable so to do, notwithstanding
that said property may not be of a character authorized
by law.
B. To invest and reinvest any funds in my
estate or the trusts created in this will in any
property, real or personal, even though such property
would not be considered appropriate or legal for a
fiduciary apart from this provision, it being my
intention to give my fiduciaries the same power of
investment and reinvestment which I would possess if
present and acting.
C. To sell, convey, exchange, partition, give
options upon, or otherwise dispose of any property, real
or personal, at any time held by them, at public or
private sale or otherwise, for cash or other
consideration or on credit, and upon such terms and for
such price as they may determine.
D. To borrow money for any purpose in
connection with the administration of my estate or the
trusts created in this will, to execute promissory notes
or other obligations for amounts so borrowed, and to
secure the payments of such amount by mortgages or
13
pledges of any property which may be included in my
estate or the trusts created in this will.
E. To make loans, secured or unsecured, in
such amounts, upon such terms, at such rates of interest,
and to such persons, firms or corporations as they may
deem advisable.
F. To renew or extend the time for payment of
any obligation, secured or unsecured, payable to or by my
estate or the trusts, for as long a period or periods of
time, and on such terms, as they may determine, and to
adjust, settle and arbitrate claims or demands in favor
of or against my estate or the trusts created in this
will.
G. To hold, manage, and develop any real
estate which may be held by them at any time, to mortgage
any such property in such amounts and on such terms as
they may deem advisable, to lease any such property for
such term or terms, and upon such conditions and rentals
as may be advisable, irrespective of whether the term of
any such lease shall exceed the period permitted by law
or the probable period of retention under this will; to
make repairs, replacements and improvements, structural
14
or otherwise, in connection with any such property, to
abandon any such property which they may deem to be
worthless or not of sufficient value to warrant keeping
or protecting, and to permit any such property to be lost
by tax sale or other proceeding.
H. To employ such brokers, banks, custodians,
investment counsel, attorneys, and other agents, and to
delegate to them such duties, rights and powers as they
may determine, and for such periods as they think fit.
I. To register any securities at any time in
their own names, in their names as fiduciaries, or in the
names of nominees, with or without indicating the trust
character of the securities so registered.
J. With respect to any securities forming
part of my estate or the trusts created in this will, to
vote upon any proposition or election at any meeting of
the corporation issuing such securities, and to grant
proxies, discretionary or otherwise, to vote at any such
meeting; to join or become a party to any reorganization,
readjustment, merger, voting trust, consolidation or
exchange,
committee,
and to deposit any such securities with any
depository, trustee or otherwise, and
15
generally to take all action with respect to any such
securities as could be taken by the absolute owner
thereof.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament, consisting of sixteen (16)
pages, this ~ day of~~~~, 1992.
typewritten
/ ROBERT W. HARBISON
16
We, the undersigned, hereby certify that the foregoing Will
was signed, sealed, published and declared by the above-named
Testator, ROBERT W. HARBISON, as and for his Last Will and
Testament, in the presence of us, who at his request and in his
presence and in the presence of each other, have hereunto set our
hands and seals the day and year above written, and we certify that
at the time of the execution thereof, the said Testator was of
sound and disposing mind and memory.
residing at
residing at
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
: SS.:
_ We, ROBERT W. HARBISON, the Testator, and
'~'~Ct~ ~. }z'~T ~Q~\ , and ~¼~e~ L, ~f:~ , the
witnesses, respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the
instrument as his Last Will and that he had signed willingly, and
that he executed it as his free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the Testator, signed the Will as witness and that to
the best of his/her knowledge the Testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
~ ROBERT W~ ~BISON ~
17
Subscribed, sworn to and acknowledged before me by the Testator,
ROBERT W. HARBISON, and subscribed and sworn~ to before me by
~[~ ~L ~~ and ~J~t~u% %, ~~? , witnesses, this
~ day of _ ~~~f- , 1992.
[NEH:WIL#OlO:\witlO\harbi-hm.w[2]
~N~ a~y Public
(SEAL)
_~n~assosnnnn ,~,~.!,~,, I
18
IN RE: ESTATE OF
ROBERT W. HARBISON,
Deceased
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: No. 2004-00254
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Robert W. Harbison, deceased
Name of Decedent:
Date of Death:
Will No.
February_ 12, 2004
2004-00254 Admin. No.
To the Register:
I certify that notice of 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 March 17, 2004:
Nancy L. Harbison
5 Spruce Circle, Shiremanstown, PA
17011
William L. Harbison
288 Rolling Avenue, North East, MD
21901
Fulton Financial Advisors
Third Floor, Trust Offices, 200
North Third Street, Harrisburg, PA
17101
Notice has now been given to all persons entitled thereto under Rule
5.6(a).
Date
Signature
Name
Address
Harrisburg, PA 17108-1268
Telephone (717) 234-4161
Capacity:
X
Personal Representative
Counsel for personal
representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 28O601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003917
........ fold
KATZMAN RONALD M ESQ
320 MARKET ST
P O BOX 1268
HARRISBURG, PA 17108-1268
ESTATE INFORMATION: SSN: 206-12-9241
FILE NUMBER: 2104-0254
DECEDENT NAME: HARBISON ROBERT W
DATE OF PAYMENT: 05/07/2004
POSTMARK DATE: 05/06/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $27,000.00
REMARKS:
TOTAL AMOUNT PAID:
$27,000.00
SEAL
CHECK# 1424
INITIALS. JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
320 MARKET STREET · STRA~,'BERRY SQUARE
P.O. BOX 1268 ', HARRISBURG, PENNSYLVANIA
717.234.4161 ,, 717.234.6808 (FAx)
17108-1268
OF COUNSEL
E LEE SHIPMAN
COUNSEL
JOSHUA D. LOCK
ARNOLD B. KOGAN
GOLDBERG, KATZMAN
ATTORNEYS AT LAW
(50 SHIPMAN,
May 6, 2004
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle PA 17013-3387
Re~
Estate of Robert W. Harbison
No. 21-04-00254
Dear madam:
P. C.
ARTHUR L. GOLDBERG
(1951-2000)
HARRY B. GOLDBERG
(1961-1998)
RONALD M. KATZMAN
PAUL J. ESPOSITO
NEIL HENDERSHOT
J. JAY COOPER
THOMAS E. BRENNER
JOHN A. STATI, ER
APRIL L. STRANG-KUTAY
GUY H. BROOKS
JEFFERSON J. SHIPMAN
JERRY J. Russo
MICHAEL J. CROCENZI
THOMAS J. WEBER
STEVEN E. GRUBB
JOHN DELORENZO
JOHN R. NINOSKY
ROYCE L. MORRIS
DAVID M. STECKEL
HEATHER L. PATERNO
BENJAMIN a. ANDREOZZI
Enclosed please find our check number 1424 dated May 6, 2004, in the
amount of $27,000.00 payable to Register of Wills. This check is to prepay the
Inheritance Tax at a discount.
Please send us a receipt.
Encl.
Very truly yours,
Mark B. Hammond
Estate Paralegal
GOLDBERG, KATZMAN & SHIPMAN, P.C.
35849
Re:
00003 Harbison, Mr & Mrs
Robert W.
Estate of Robert W. Harbison
35894-003
PA Inheritance Tax
Estate of Robert W. Harbison
05/06/2004
1424
1424
$27,OOO.OO
~DELUXE BUSINESS FORMS 1+800-328-0304 www. deluxeforms.com
GOLDBERG, KATZMAN & SHIPMAN, P.C.
35849
Re:
00003 Harbison, Mr & Mrs
Robert W.
Estate of Robert W. Harbison
35894-003
PA Inheritance Tax
Estate of Robert W. Harbison
CHECK DATE CHECK NO.
05/06/2004 ]424
$27,000.00:1. 4 2 4
CHECK AMOUNT
'04 r'i~Y-7 f~1:24
320 MARKET STREET · STRAWBERRY SQUARE
P.O. Box 1268 · H^RrlSBUR(;, PENNSYLVANIA 17108-1268
GOLDBERG, KATZMAN ~ SHIPMAN, P.C.
ATTORNEYS AT LAW
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle PA 17013-3387
In Re:
ESTATE OF
ROBERT W. HARBISON,
deceased
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No. 21-04-00254
DISCLAIMER AND RENUNCIATION
OF INTEREST
Recitals
A. This "Disclaimer and Renunciation of Interest (the "Disclaimer") is executed on
-461N~ Z/ ,2004, by NANCY M. HARBISON (the "Disclaimant"), the undersigned, who is an
adult individual residing at 5 Spruce Circle, Shiremanstown, Pennsylvania 17011.
B. Robert W. Harbison (the "Decedent"), who was the spouse of the Disclaimant, died on
February 12, 2004, a resident of Cumberland County, Pennsylvania.
C. The Decedent's Last Will and Testament, dated September 22, 1992, (the "Will"), was
probated with the Office of the Register of Wills of Cumberland County, Pennsylvania (the "Register"),
and on Marchl 5, 2004, the Register issued Letters Testamentary to Ronald M. Katzman, as executor
(the "Executor") of the Estate of Robert W. Harbison, deceased (the "Estate").
D. The Disclaimant desires to disclaim, by way of this Disclaimer, any interest whatsoever,
now or in the future, regarding the following estate asset (the "Estate Assets") pursuant to the
Pennsylvania Probate, Estates and Fiduciary Code, 20 PA. C.S.A. Section 101 et. seq. (the "PEF Code")
and the Internal Revenue Code of 1986, as amended (the "IRC"):
The entire residue of the Estate of Robert W. Harbison under ITEM VI. of said Will, which has an
estimated value of m excess of $600,000· This disclaimer is to be effective as of February 12, 2004,
the date of Decedent's death. ' ' ~'
Provisions
1. Pursuant to Section 96201 of the PEF Code, the Disclaimant hereby renounces and
disclaims any and all right, rifle, or interest whatsoever that she may now have or may have had in
the Estate Assets forming the entire residue of said estate.
2. This Disclaimer is declared as irrevocable. This Disclaimer is intended to be a
"qualified disclaimer" for purposes of the PEF Code and the IRC, and the regulations thereunder.
3. The Disclaimant avers and confLrms that she, personally and individually, has not
accepted any interest, control, or benefit whatsoever regarding the Estate Assets prior to the date of
this Renunciation.
4. The Disclaimant believes and understands, and avers, that the Estate Assets will pass
to a person or entity other than the Disclaimant, specifically, the son of the Decedent, as a result of
her renunciation of her interest in the Estate Assets.
5. This Disclaimer shall relate back for all purposes to February 12, 2004, the date of
death of the Decedent. This Disclaimer shall be binding upon the Disclaimant and all persons
claiming through or under her.
6. This Disclaimer shall be recorded as evidence of the matters set forth herein.
7. This Disclaimer shall be delivered to the Executor for purposes of administration of
the Estate; and such parties may rely upon this Disclaimer for all purposes.
Execution
IN WITNESS WHEREOF, intending to be legally bound hereby, the Disclaimant has
executed this Renunciation for the purposes set forth herein, on this q~ day of
2004.
WITNESS:
NAN C¥--IvkTHARBISC~N
2
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~)~~K)
On this, the ~ day of (~ ~/~ , 2004, before me, a Notary Public, the
undersigned officer, personally appeare~ NANCY M. HARBISON, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instrument, who
acknowledged that she executed the foregoing "Disclaimer and Renunciation of Interest" for the
purposes set forth therein.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
108640.1
Notarial Seal
Jennifer L. Boltz, Notary Public
,My Commission Expires May 30, 2005
City of Harrisburg. Dauphin County
IV,~muer, Pennsylvania A~oe~o~ of Notarie~
3
z
; ., REV.1500
CO~O'~T"O~"E.N*YLVA.~, INHERITANCE TAX RETURN
"^""*"U"O,"A ~'~2'-000~RERIDENT DECEDENT
Harbison, Robert W.
~-ATE OF DEATH (MM-D[~YEAR) F BIRTH (M M-DO-YEaR)
02/12/2004 ~
{IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
Harbison, Nancy M.
~- 1. Odginal Return ~ 2. SupplementaIReturn
[] 4. Limited Estate [] 4a. FuturelnterestComprom[se(dateof0eathaRer
12-12-82)
[] 6. Decedent Died Testate (Attach copy [] 7. DecedentMaintainedaLivingTrusttAttach
of Will)
copy of Trust)
[] g. Litigation Proceeds Received [] 10, Spousal Poverty Credit (date of death between
Ronald M Katzman
Goldberg, Katzman, PC
717/234-416l
21 04 00254
206-12-9241
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~3. Re--Return (date of death prior to 12_13.82)
[] 5. Federal Estate Tax Return Required
~0 8. Total Number of Safe Deposit ~oxes
[] 11~ Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
320 Market Street
Harrisburg, PA 17108
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedure E)
6. Jointly Owned Properly (Schedule F)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Prope~'y
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funerar Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1) None
(2) 807,304.09
(3) None_
(4) None_
(5) 82,730.25
(6) 6,485.00
(7) 10,628.13
(9) 50,012.00
(10) 563.67
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFFIC AL [ SE ONLY
(8) &3~67~7,147 47
r~
(11) 50,575.67
(12) 856,571.80
(13)
(14) 856,571.80
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousa~ tax rate,
or transfers under Sec. 9116(a)(1.2) x .00 (15)
16.Amount of Line14 taxable at lineal rate 856,571.80 x .045 (16)
17.Amount of Line 14 taxable at sibling rate
x .12 07)
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
20. [] " · '' ' * ' ' ~ · · e .., (19)
38,545.73
38,545.73
opyrtght 2000 form software only The Lackner Group, Inc.
Form REV-t600 EX (Rev. 6-00)
SCHEDULE B
STOCKS & BONDS
COMMON--TH OF PEN N SYI. VAN~A
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Harbison, Robert W.
21 - 04 - 00254
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE O
NUMBER DESCRIPTION UNIT VALUE
DEATH
1 300 shares, Altria Group, Common 55.01 16,503.00
2 Dividend thereon, Declared 2/25/2004, Ex-Dividend date 3/11/2004, Record Date 204.00
3/15/2004, Payable date 4/12/2004
3 174 shares, American Telephone and Telegraph Co, Common 20.00 3,480.00
4 1,044 shares, BellSouth Corp., Common 30.18 31,507.92
5 400 shares, Bristol Myers Squibb Co., Common 30.09 12,036.00
6 281 shares, Comcast, Class A, Common 30.77 8,646.37
7 80 shares, Nuveen National Trust 165 Quarterly, per letter dated April 20, 2004 34.81 2,784.80
8 2,729.918 shares, Pepco Holdings, Inc., Common 20.82 56,836.89
9 1,263 shares, SBC Communications, Common 25.58 32,307.54
10 464 shares, Teco Energy, Common 15.03 6,973.92
11 1,250.364 shares, Dreyfus Premier Core Bond Fund - Class A 18,567.91
12 18,000 shares, General Electric, Common 32.95 593,100.00
13 Dividend thereon, record date 3/1/04, payable 4/26/04 3,600.00
14 464 shares, Verizon Communications 37.67 17,478.88
15 279 shares, AT&T Wireless 3,276.86
TOTAL (Also enter on line 2, Recapitulation) 807,304.09
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
C OMMON~c,~LTH OF PEN N SYI. VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
Include the,proceeds of litigation and the date the proceeds were received by the estate A property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
DEATH
1
2
3
4
5
6
7
MBNA Bank, NA, Money Market Fund
Scottrade Money Market Account
2002 Honda CHF Metropolitan, VIN #JH2AF60092K000938, value per Kelley Blue Book
PayPal Money Market Fund 01359771830060950915
AARP - United Health Care - reimbursement for medical expenses
Firearms - proceeds of sale to Classic Firearms
State Treasury - Bureau of Unclaimed Property
75,778.34
2,762.02
1,025.00
868.59
1,656.00
600.00
40.30
TOTAL (Also enter on Line $, Recapitulation) 82,730.25
Qecede.nt's Complete Address:
STREET ADDRESS
CITY 5 Spruce Circle
Shiremanstown I STATE PA IZIP 17011
Tax Payments and Credits:
1. Tax Due (Page I Line lg)
2. Credits/Payments
A. Spousal Poverty Credit
B, Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
27,000.00
1,421.05
(1)
Total Credits (A + B + C) (2)
(3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 1 Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5Al
B. EnterthetotalofLine5+5A. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
Total Interest/Penalty (D + E)
38,545.73
28,421.05
0.00
10,124.68
10,124.68
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transfarred; .................................................................................. ~ ~
b. retain the right to designate who shall use the property transferred or its income; ....................................
d. receive the promise for life of either payments, benefits or care? ..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................................................................... [] []
3. Diddecadentownan'intrustfor" or payable upon death bankaccountorsecurityathisorherdeath? ......... [] []
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 TIlE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pequ~y, I declare tha{ I have examined this return, including accompanying schedules and stefements, and to the bes~ of my knowledge and belief, it is true, CO~TeCt and complete Declaration of
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS 320 Market Street DATE
.o.,d M. P. 0. Box 1268
Harrisburg, PA 17108
SIGNATURE OF PERSON'RESPONSIBLE FOil' FILING~.~URN ADDRESS DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Ronald M Katzman
ADDRESS DATE
320 Market Street
Harrisburg, PA 17108
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. §9116 (al (1.1) (iii.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (al (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (al (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116
1.2) [72 P.S. §9116 (al (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (al (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.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNS~.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
All properbj jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE O
NUMBER DESCRIPTION UNIT VALUE
DEATH
I 300 shares, Altria Group, Common 55.01 16,503.00
2 Dividend thereon, Declared 2/25/2004, Ex-Dividend date 3/11/2004, Record Date 204.00
3/15/2004, Payable date 4/12/2004
3 174 shares, American Telephone and Telegraph Co, Common 20.00 3,480.00
4 1,044 shares, BellSouth Corp., Common 30.18 31,507.92
5 400 shares, Bristol Myers Squibb Co., Common 30.09 12,036.00
6 281 shares, Comcast, Class A, Common 30.77 8,646.37
7 80 shares, Nuveen National Trust I65 Quarterly, per letter dated April 20, 2004 34.81 2,784.80
8 2,729.918 shares, Pepco Holdings, Inc., Common 20.82 56,836.89
9 1,263 shares, SBC Communications, Common 25.58 32,307.54
10 464 shares, Teco Energy, Common 15.03 6,973.92
11 1,250.364 shares, Dreyfus Premier Core Bond Fund - Class A 18,567.91
12 18,000 shares, General Electric, Common 32.95 593,100.00
13 Dividend thereon, record date 3/1/04, payable 4/26/04 3,600.00
14 464 shares, Verizon Communications 37.67 17,478.88
15 279 shares, AT&T Wireless 3,276.86
TOTAL (Also enter on line 2, Recapitulation) 807,304.09
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RE.DENT OECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Har5ison, RoScrt W. 2] - 04 - 00254
Include the ,proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
MBNA Bank, NA, Money Market Fund
Scottrade Money Market Account
2002 Honda CHF Metropolitan, VIN #JH2AF60092K000938, value per Kelley Blue Book
PayPal Money Market Fund 01359771830060950915
AARP - United Health Care - reimbursement for medical expenses
Firearms - proceeds of sale to Classic Firearms
State Treasury - Bureau of Unclaimed Property
75,778.34
2,762.02
1,025.00
868.59
1,656.00
600.00
40.30
TOTAL (Also enter on Line 5, Recapitulation) 82,730.25
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
If an asset was made Joint within one year of the decedent'$ date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A William L. Harbison Son
288 Rolling Acres
North East MD 21901
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY
% OF DATE OF DEATH
ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF
NUMBER FOR JOINT MADE ~r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTERESt
TENANT JOINT estate.
I A 07/16/2003 2002 Honda CHF Metropolitan, VIN 1,025.00 100% 1,025.00
#JH2AF60052K003478, value per Kelley Blue Book
2 A 11/21/2002 1993 Ford F150 Short BedTruck, VIN 2,425.00 50°A 1,212.50
#2FTDFI5N3PCB 18458, value per Kelley Blue Book
3 A 11/15/2002 2002 Taylor Trailer, VIN #5H3CUI21888200381, 500.00 50°A 250.00
estimate
4 A 10/26/2001 1942 Ford Jeep, VIN #93612, per appraisal of 7,995.00 50% 3,997.50
William Smith, copy of appraisal attached to death tax
ret.
TOTAL (Also enter on line 6, Recapitulation) 6,485.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
This schedule must be completed and filed If the answer to an)' of questions I througl ~ 4 on page 2 is }'es.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF
Include the name of the transfeme, their relationship to decedent end the date of transfer. EXCLUSION
NUMBER Attachacopyofthedeedforrealestate VALUEOFASSET INTEREsTDECD'S (IFAPPLICABLE) TAXABLE VALUE
1 Dreyfus Premier Core Bond Fund Class A, Account 10,628.1-~ 10000% 10,628.13
#0031-0557026614, Individual Retirement Account,
715.699 shares with a net asset value of $10,628.13; no
beneficiary was named on this account
2 Vanguard Inter-Term Tax-Exempt Inv., Account 129,979.31 10000% 129,979.31 0.00
#09859577523, Individual Retirement Account, 9,391.569
shares with a net asset value of $129,979.31, beneficiary of
account is wife, Nancy M. Harbison, valued per letter from
Vanguard dated April 12, 2004
3 Vanguard Inter-Term Tax-Exempt Inv., Account 168.6; 10000% 168.6~ 0.00
#09859577523, Individual Retirement Account, accrued
dividend thereon per letter from Vanguard dated April 12,
2004
TOTAL (Also enter on line 7, Recapitulation) 10,628.13
COMMONWEALTH OF pENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
FUNERAL EXPENSES:
Myers Funeral Home
Osiris Holding of Pennsylvania, cemetery plot and memorial
ADMINISTRATIVE COSTS:
Pemonal Representative's Commissions
Social Secudty Number(s) / EIN Number of Personal Representative(s):
Street Address
City State __ Zip
Year(s) Commission paid
Attorney's Fees Goldberg, Katzman, PC
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Nancy M. Harbison
Street Address 5 Spruce Circle
City Shiremanstown State PA Zip
Relationship of Claimant to Decedent Spouse
Probate Fees Register of Wills, Probate Will and Short Certificates
Register of Wills, Short Certificates
17011
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Smith Barney, change registration of securities
Cumberland Law Journal, Legal Advertising, Estate Notice
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
9,669.00
2,645.00
33,000.00
3,500.00
556.00
30.00
180.00
75.00
357.00
50,012.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
Funeral Expenses &
Adn-~blmOve Costs con~nued
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
Patriot News, Legal Advertising, Estate Notice
William H. Smith, Appraisal of antique jeep
Register of Wills, record disclaimer
Register of Wills, file Inventory and Inheritance Tax Return
Goldberg Katzman, PC., filing fees and miscellaneous closing costs
97.00
125.00
10.00
25.00
100.00
Page 2 of Schedule H
COMMONWEAETH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RES[DENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
George K. Shahinian, M.D., LLC, medical services not covered by insurance
Internists of Central PA, medical services not covered by insurance
Quantum Imaging & Therapeutic, medical services not covered by insurance
Neurology Center, P.C., medical services not covered by insurance
Amesti Eye, final bill
Verizon Wireless, account due at date of death
AOL Online, account due at date of death
Dr. Janet Dardick, account due at date of death
Dr. McMillen, account due at date of death
PPL Electric, account due at date of death
Verizon, telephone service, account due at date of death
PA American Water Co., account due at date of death
United States Treasury, Internal Revenue Service, penalty and interest for late payment of 2002 income
taxes
Dreyfus, Annual Fee for Individual Retirement Plan, as shown on statement dated 4/6/04
39.68
20.01
10.92
81.58
11.70
16.66
16.40
16.40
9.76
60.78
51.47
10.50
207.81
10.00
TOTAL (Also enter on Line 10, Recapitulation) 563.67
COMMONWEALTH OF PE NHSYLV^NI^
}NHERITANC£ TAX RETURN
RESIDENT O£CEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Harbison, Robert W. 21 - 04 - 00254
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
lo TAXABLE DISTRIBUTIONS (include outdght spousal distributions)
I William L. Harbison, 288 Rolling Acres, Son Residue of Estate per
North East MD 21901 disclaimer of spouse
2 William L. Harbison, 288 Rolling Acres, Son $140,000 per Item V of
North East MD 21901 Will
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE'
Estate of Robert W. Harbison
Date of Death: 2/12/2004
B.
C.
D.
E.
F.
Index to Exhibits
Copy of Will and Letters Testamentary
Valuation of Securities
Bank Accounts
Valuation of Vehicles (joint assets)
Intervivos Transfers and Miscellaneous Non-Probate Property
Copy of Disclaimer
112358.1
LAST WILL A~D TEST~ww~T
OF
ROBERT W. F~ARBISON
I, ROBERT W. HARBISON, of Shiremanstown, Cumberland County,
Pennsylvania, being of sound and disposin~ mind, do hereby make,
publish, and declare this to be my Last Will and Testament, hereby
revoking and making null and void all prior Wills and Codicils made
by me at any time heretofore.
ITEM I. I direct that all my legally valid debts,
funeral and administrative expenses, and debts incurred or payable
because of my death, shall be paid by my Executor, hereinafter
named, from my residuary estate as soon after my death as
practicable. All death taxes, including federal, state, and other
death taxes, payable with respect to the property forming ~y gross
estate for tax purposes, whether or not passing under this Will,
including any interest or penalty imposed thereon, shall be
considered an expense of the administration of my estate, and shall
be paid out of the principal allocable to ~he residue without
apportionment or right of reimbursement. Taxes on future interests
may be prepaid.
ITEM II. I acknowledge that, as of this time, the home
in which I reside with my wife, NANCY M. HARBTSOM, now of
Shiremanstown, Pennsylvania (my "Wife") , is titled between us in a
tenancy by the entirety, so that it, and all personal property
therein not otherwise identified as owned solely by me, shall not
pass under this Will, but shall pass by 0peratio~ of law in the
event that i predecease her.
ITEI~ III.
personal property
separate writing,
! give and bequeath ~hose items of tangible
solely owned by me that are identified in any
which is dated and is signed by me at the end
thereof, to tho.se persons designated who survive me. If any item
of tangible personal property is identified in more than one
separate writing, I direct that only the separate writing bearing
the last date shall govern the disposition of such item.
ITEM IV. I give and bequeath all my household and
personal effects, jewelry, automobiles, and other tangible
personalty of like nature not effectively disposed of by any
separate writing referred to above, to my Wife, NANCY M. PLARBISON,
if she survives me. If she does not so survive me, such property
shall be distributed to my son, WILLIAi~ L. HARBISON, now of Rhode
island, or to his then-living issue ~. Such property
shall be divided by said beneficiaries as they shall agree. As to
those items upon which they shall not agree, distribution shall be
determined by my Executor.
ITEM V. I give, devise and bequeath the sum of One
Hundred Forty Thousand Dollars ($140,000.00) to my son, WILLIAM L.
HARBiSON, if living, or to his then-living issue, Der stirDes.
ITEM VI. If my Wife, ~ANCY M. HARBISON,..survives me (and
I direct that, for the purpose of this Item, she shall be deemed to
have survived me unless it appears unmistakably that she
predeceased me), I make the following bequests:
A. In such event that my Wife survives me, if the
federal estate tax due because of my death will be reduced by
making a bequest for her benefit, I then give, devise, and
bequeath to my Trustee, hereinafter named, IN TRUST,
NEVERTHELESS, the least amount (based upon values as finally
deterrained for federal estate tax purposes) as shall be needed
for the federal estate tax unlimited marital deduction to
reduce the federal estate tax payable by reason of my death to
the lowest possible figure after full use of all other
deductions and credits allowable in calculating the federal
estate tax, except that such amount shall be calculated
without regard to the augmenting of my taxable estate by
reason of generation-skipping transfers, and wi~hou~ regard
for any credit for state death taxes that would not otherwise
be payable. With respect to the bequest and the trust created
under this Item VI. A., which shall be knowl% as the "Marital
Bequest,,, I hereby direct as follows:
1. If the marital deduction or any similar
benefit is allowable with respect to any property,
including property held by entireties, which my Wife has
received prior to my death, or at my dea~h will receive
otherwise than pursuant to this ~TE~ VI. A. , the value of
such property shall be taken into consideration in
calculating the size of the Marital Bequest created under
this ITEM VI. A.
2. No property ineligible for the marital
deduction or any similar benefi~ shall be distributed to
the Earita! Bequest for my Wife, pursuant to this !TE~
VI. A.
3. Either cash or investments or both may be
allocated to the Marital Bequest under this ITEM VI. A.
4. Any property allocated under this iTEM VI.
A. in kind shall be valued at the value at which it is
finally included in my gross estate for federal estate
4
tax purposes, provided that the aqgregate market value
thereof on the date of allocation (plus the value as
finally determined for federal estate tax purposes of all
other property qualifying for the marital deduction) is
at least equal to the dollar value of the marital
deduction as finally determined for federal estate tax
purposes.
5. My Wife shall be paid the entire income
from the principal in such periodic installments as my
Trustee shall find convenient, but at least as often as
q~arter-annually.
by will to her estate or to others,
for such estates as she may appoint,
specific reference by her alone and
the principal of this trust.
My Wife is hereby given a power to appoint
in such manner and
exercisable only by
in all events over
7. As much of the principal of the trust as
my Trustee may, from time to time, think advisable for
the support of my Wife or for expenses during illness or
emergency shall either be paid to her or else applied
directly for her benefit by my Trustee.
8. In addition to the above provisions, my
Wife shall have the power to withdraw such amounts from
principal as she shall desire from time to time,
including the entire exhaustion of principal.
9. If my Wife shall fail, either wholly or in
part, to exercise effectively the power of appointment
created in the preceding subparagraph 8., the unappointed
principal shall be added to, and thereafter treated as
part of, the principal of my residuary estate passing
under ITEM VII. hereof; Provided, that my Trustee shall
first deduct and pay to the personal representative of my
Wife's estate an amount equal to the increase in federal
and state death taxes and any increased administration
expenses which her estate will have to pay because of the
inclusion of the principal of this trust in her estate
for tax or administrative purposes.
10. If any provision of my Will skall result
in depriving my estate of the marital deduction for
federal estate tax purposes, such provision is hereby
revoked and my Will shall be read as if any portion
thereof inconsistent with allowance of the marital
deduction for federal estate tax purposes is null and
void.
in full
Marital
legacies
11. If my property is insufficient for pa_~-ment
of all legacies and devises, I direct that this
Bequest shall be preferred over all other
and devises.
B. In such event that my Wife survives me, ! give,
devise, and bequeath all of the residue of my estate, not
otherwise disposed of above, whether real, personal, or mixed,
and wherever situate, including any property subject to any
power of appointment which I may now have or hereafter
acquire, to my Trustee, hereinafter na~ed, IN TRUST
NEVERTHELESS (such trust to be known as the "~Byl0ass T~-ust"),
for the following uses and purposes:
1. My Trustee shall pay the net income to my
Wife, NANCY M. HARBISON, during her lifetime, in such
periodic installments as my Trustee shall find
convenient, but at least quarter annually.
2. If the income so payable to my Wife shall
at any time exceed the amount which my Trustee deems to
be in her best interests (considering her other income
and means of support known to my Trustee, including the
income from her other solely-owned assets, the
desirability of auq~menting her separate estate, and any
7
other circumstances and factors deemed pertinent), my
Trustee may accumulate the same and add it to principal,
as my Trustee deems advisable.
3. My Trustee may also pay as much of the
principal of the Bypass Trust as my Trustee deems
necessary or advisable, from time to time, for the
support and maintenance of my Wife at such times as my
Trustee deems best, after considering her needs, her
other income and means of support known to my Trustee,
including the income from her other solely-owned assets,
the desirability of augmenting her separate estate, and
any other circumstances and factors deemed pertinent.
4. During illness or emergency, my Trustee
may either pay a distribution to my Wife or may make a
distribution for her benefit.
5. Upon the death of my Wife, the assets
remaining in the Bypass Trust shall be distributed by my
Trustee pursuant to Item VII. hereof.
ITEM VII. In the event that my Wife has predeceased me,
or upon the death of my Wife after funding of the Trusts created
under Item VI. above, my Executor or my Trustee, as appropriate,
@
shall distribute my entire Estate, or the remaining principal of my
Trusts:
A. To my son, WILLIAM L. PIARBISON, now of Rhode
Island, if he survives me and my Wife by thirty (30) days;
provided, however, that if he does not so survive my Wife and me,
but leaves descendants who so survive both of us, such descendants
shall receive, Der stirpes, the share my said son would have
received had he so survived my Wife and me.
B. In the event my said son fails to survive my
Wife and me by thirty (30) days, and there are no descendants
living on the 31st day after the death of my Wife and me, ! then
give, devise, and bequeath all my household and personal effects,
jewelry, automobiles, and other tanqible personalty of like nature
owned by me and not effectively disposed of in any other manner,
together with fifty percent (50~) Of the rest, residue and
remainder of my estate, or of the remaining principal of my Trusts,
to my sister-in-law, LOIS M. R/_WfMEY, of Centre Hall, Pennsylvania,
if she is living on the 31st day after the last to die of my Wife,
my son, or his descendants. If she fails to so survive, then I
direct that said assets be paid over to my corporate Trustee,
hereinafter appointed, IN TRUST NEVERTHELESS, to pay the net income
to my brother-in-law, JOHN M. RIPIMEY, JR., of Centre Hal!,
Pennsylvania, during his lifetime, in such periodic installments as
9
my Trustee shall find convenient, but at least quarter-annually;
upon the death of my said brother-in-law, the assets of said Trust
shall be paid equally to the then living issue of my sister-in-law,
LOiS M. RI/4~EY, and her husband, JOHN M. R!/~EY, JR., per stirpes.
C. I give, devise, and bequeath the remaining
fifty percent (50%) share of the rest, residue and remainder of my
estate to my cousins in the following shares:
1/7 to RICHARD M. RHEA of Clarion, Pennsylvania;
1/7 to JAMES L. WHYTE of Parker, ~ennsylvania;
1/7 to SHIRLEY SLATER of Poland, Ohio;
1/7 to ~LLRN JANE FREDE~iCK of Brooksville, Florida;
1/7 to ELEANOR BREAM of McLean, Virginia;
1/7 to BETTY WELCH of McLean, Virginia; and
1/7 to JOAq~ P. MciNTYRE of Miami, Florida.
The share of any of the foregoing who shall not survive the
death of my Wife, my son, and any descendants of my son, by thirty
(30) days, shall be paid to the other legatees entitled hereunder
in proportion to their respective interests.
ITEM VIII. No interest of any beneficiary of my estate or
cf a trust created herein, either in income or principal, shall be
subject to anticipation or to pledge, assignment, sale or transfer
10
in any manner, nor shall any such interest be liable on account of
the debts, contracts, torts, or other engagements of any
beneficiary.
ITEM IX. I hereby appoint RONALD M. KATZNuAN, now of
Mechanicsburg, Pennsylvania, as the executor (the "Executor.,) of
this, my Last Will and Testament. In the event of his refusal or
inability to so serve, i then nominate and appoint NEIL HENDERSHOT,
Pennsylvania, to serve in the capacity as
now of Harrisburg,
Executor.
ITEM X. I hereby appoint FULTON BANK, now of Harrisburg
and Lancaster, Pennsylvania (and its successors in interest), and
WILLIA/~ L. HARBISON, now of Rhode Island, or the survivor of them,
to serve together as the trtlstee (collectively, the "Trustee") of
the trusts created under this Will.
ITEM XI. I direct that my Executor and Trustee shall not
be required to give bond or post any other security for the
faithful performanc~ of their duties in any jurisdiction; provided,
however, that I consent to the specific imposition by a Court of
competent jurisdiction of a requirement of bond or other security
upon my children who shall serve as an Executor or a Trustee
hereunder.
11
ITEM XiI. In the event that my Wife and I die under such
circumstances that it cannot readily be determined which of us died
first, she shall be deemed to have survived me. if any beneficiary
hereunder should die within thirty (30) days after my death, or
within.thirty (30) days after the death of any other beneficiary
upon the survival of whom an interest of that beneficiary depends,
then that beneficiary shall be deemed to have predeceased me or
such other beneficiary, as the case may be.
ITEM XIII. Any amounts which are payable to a minor
under this Will, at the discretion of my Executor or Trustee, as
appropriate, may be paid either to a parent or guardian of such
minor, to the person who had custody of such minor, directly to
such minor, or may be applied for the use or benefit of such minor.
ITEM X!V. My Executor and Trustee shall have the following
powers in addition to those invested in them by law and by other
provisions of my Will applicable to ail property, whether principal
or income, exercisable without Court approval, and effective until
distribution of al~ property:
A. To retain all or any part of my property,
real or personal, in the form in which it may be at the
time of my decease, including any business owned or
controlled by me, as long as in the exercise of their
12
discretion it may be advisable so to do, notwithstanding
that said property may not be of a character authorized
by law.
B. To invest and reinvest any funds in my
estate or the trusts created in this will in any
property, real or personal, even though such property
would not be considered appropriate or legal for a
fiduciary apart from this provision, it being my
intention to give my fiduciaries the same power of
investment and reinvestment which'I would possess if
present and actinq.
options upon,
or personal,
To sell, convey, exchange, partition, give
or otherwise dispose of any property, real
at any time held by them, at public or
private sale or otherwise, for cash or other
consideration or on credit, and upon such terms and for
such price as they may determine.
D. To borrow money for any purpose in
connection with the administration of my estate or the
trusts created in this will, to execute promissory notes
or other obligations for amounts so borrowed, and to
secure the payments of such amount by mortgages or
!3
pledges of any property which may be included
estate or the trusts created in this will.
in my
E. To make loans, secured or unsecured, in
such amounts, upon such terms, at such rates of interest,
and to such persons, firms or corporations as they may
deem advisable.
F. To renew or extend the time for payment of
any obligation, secured or unsecured, payable to or by my
estate or the trusts, for as long a period or periods of
time, and on such terms, as they may determine, and to
adjust, settle and arbitrate claims or demands in favor
of or against my estate or the trusts created in this
will.
G. To hold, manage, and develop any real
estate which may be held by them at any time, to mortgage
any such property in such amounts and on such terms as
they may deem advisable, to lease any such property for
such term or terms, and upon such conditions and rentals
as may be advisable, irrespective of whether the term of
any such lease shall exceed the period pez-mitted by law
or the probable period cf retention under this will; to
make repairs, replacements and improvements, structural
14
or otherwise, in connection with any such property, to
abandon any such property which they may deem to be
worthless or not of sufficient value to warrant keeping
or protecting, and to permit any such property to be lost
by tax sale or other proceeding.
H. Toemploy such brokers, banks, custodians,
investment counsel, attorneys, and other agents, and to
delegate to them such duties, rights and powers as they
may determine, and for such periods as they.think fit.
I. To register any securities at any time in
their own names, in their names as fiduciaries, or in the
names of nominees, with or without indicating the trust
character of the securities so registered.
J. With respect to any securities forming
part of my estate or the trusts created in this will, to
vote upon any proposition or election~at any meeting of
the corporation.issuing such securities, and to grant
proxies, discretionary or otherwise, to vote at any such
meeting; to join or become a party to any reorganization,
readjustment, merger, voting trust, consolidation or
exchange, and to deposit any such securities with any
committee, depository, trustee or otherwise, and
15
generally to take all action with respect to any such
securities as could be taken by the absolute owner
thereof.
IN WITNESS W-~EREOF, I have hereunto set my hand and seal to
this my Last Will and Testament, consisting of sixteen (16)
typewritten pages, this ~?--r. day of
~ 'i/~-~*, ~,~-~,' 1992.
16
We, the undersigned, hereby certify that the foregoing Will
was signed, sealed, published and declared by the above-named
Testator, ROBERT W. HARBISON, as and for his Last Will and
Testament, in the presence of us, who at his request and in his
presence and in the presence of each other, have hereunto set our
hands and seals the day and year above written, and we certify that
at the time of the execution thereof, the said Testator was of
sound and disposing mind and memory.
~,. ~.<~..~'~ ~-~ ...... residing at
residing at
CO~0~W~ALTH OF PENNSYLVANIA :
: SS.:
COUNTY OF DAUPHIN :
Q We, ROBERT W. HARBISON, the Testator, and
witnesses, respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the
instrument as his Last Will and that he had signed willingly, and
that he executed it as his free and voluntary act for the pul-poses
therein expressed, and that each of the witnesses, in the presence.
and hearing of the Testator, signed the Will as witness and that to
the best of his/her knowledge the Testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence. . '"'?
~ ROBERT W. HARBIBON
,44itness
17
Subscribed, sworn to and acknowledged before me iD1; the Testator,
ROBERT~ W. HD2qBISON, and subscribed, and . sworn to before me by
~.-~i,~, ~ ,, ,., ,, ~11 ~'~,~7~7%~ ~ ~, and ~C.&?~ ~..~ ~'-~4~?-' , witnesses, this
~n3 day of ~~,~ 1992.
[NEH:~II~010:\willO\harbi-hm. w12]
N ,0ta~y, Public
(SEAL) '~'/
18
SMITH BARNEY_
ot groupT
April 6, 2004
Attn: Ronald M. Katzman, Esq.
Goldman, Katzman, and Shipman
P.O. Box 1268
Harrisburg, PA 17108-1268
Re: Date of death prices for stocks in the Robert W. Harbison estate
Dear Attorney Katzman:
The following is a list of the date of death prices (February 12, 2004) for the six
securities deposited into the estate account for Robert W. Harbison:
Security High Low Close VWAP
Verizon (VZ) $37.90 $37.43 $37.61 $37.65
General Electric (GE) $33.25 $32.65 $32.86 $32.96
Bristol Myers (BMY) $31.30 $28.90 $29.89 $30.09
SBC Comm. (SBC) $25.86 $25.38 $25.64 $25.58
BellSouth $30.51 $29.98 $30.09 $30.18
Pepco Holdings (POM) $20.89 $20.74 $20.85 $20.82
Please call us at 717-780-1735 if you have any questions.
Sincerely,
Bill Barton
Sales Assistant for
Marilynn R. Kanenson
Vice President - Investments
Financial Planning Specialist
THE INFORMATION HC..REIN HAS BEEN
C'BI'AIN£D FROM SOURCES WE EELIEVE
TO Bi: RELIABLE, BUT DO NOT GL,tARANTI~
ITS ACCURACY OR COMPLETENESS.
Citigrl>upGlobalMarketslnc. llNorth3rdStreet, 2ndF[oor Harrisburg. PA 17101 Te17177801700 Fax 717 233 2090 Toll-fi'cc8002371700
Awe: ~storlcal Prices tor Alal WII~Lb' ~VCS - Yahoo! Finance Page 1 of 3
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First J Prev J Next I Last
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SMITH BARNEY._
c t group -
April 20, 2004
Attn: Ronald M. Katzman, Esq.
Goldman, Katzman, and Shipman
P.O. Box 1268
Harrisburg, PA 17108-1268
Re: Date of death price for the Nuveen Tax Exempt Bond Fund
Series 165 for the Robert W. Harbison estate
Dear Attorney Katzman:
The following is the price information provided by Nuveen for the fund
indicated above:
Security High Low Close
Nuveen Tax Exempt
Bond Fund Series 165
$34.81 $34.81 $34.81
The total value of the 80 shares represented in certificate number 165-2375
would have been $2,784.80 as of the date of death on February 12, 2004.
Please contact us if you need any additional information at 717-780-1735.
Sincerely,
Bill Barton
Sales Assistant for
Marilynn R. Kanenson
Vice President - Investments
Financial Planning Specialist
THE INFOIIMATIO~ HERI~I¢ HAS ~EEN'
C~TAINED FROM SOURCES WE BELIE~
TO BE RELIABLE, ~ DO NOTGU~IANTEE
/TS ACCI.~ACY C~
Citigroup Global Markets lnc, 11 North 3rd Street, 2nd Floor Harrisburg, PA 17101 Tel 717 780 1700 Fax 717 233 2090 Toil-fYee 800 237 1700
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Feb-13-04 20.13 20.26 19.98 20.00 3,724,900 20.00
Feb-12-04 20.00 20.14 19.86 20.06 4,001,500 20.06
Feb-Il-04 19.94 20.07 19.80 19.97 5,789,500 19.97
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I of 2
4/23/2004 8:12 AM
April 6, 2004
Ronald M. Katzman, Esq.
Goldberg, Katzman & Shipman, P.C.
P.O. Box 1268
Harrisburg, PA 17108-1268
Subject: Estate of Robert W. Harbison
Dear Mr. Katzman:
We recently received your request to provide the date-of-death balance for the below-
referenced account(s). The information that you requested is as follows:
Account Type of Date-of-Death Accrued Account
Number Account Balance Interest Registration
February 12, Included in
2004 Date-of-Death
Balance
406409528 Certificate of $25,561.31 $32.24 Nancy M Harbison
Deposit Robert W. Harbison
574389953 Money Market $73,323.96 $82.77 NancyM. Harbison
Robert W. Harbison
571433952 Money Market $75,778.34 $85.54 Robert W. Harbison
Enclosed are statements containing the additional infomation you requested.
If you have any questions, please call 1-800-345-0397, Monday through Friday from 8 a.m.
Lo 8 p.m., or Saturday, 8 to 5 (Eastern time). If you prefer, you may write to P.O. Box
15103, Wilmington, DE 19850-5103. Our knowledgeable representatives are ready to assist
you.
Sincerely,
Nancy Ballach
Deposit Services department
Enclosures
850-801
William H. Smith
2083 Schoolhouse Rd.
Middletown, PA 17057
(717) 948-0935
Mr. Mark Hamond
Goldberg, Katzman, & Shipman, P.C.
PO Box 1268
Harrisburg, PA 17108
Re: 1942 Ford Jeep
Body: Army green with same interior
Vin No. 93612 (on glove box)
Qualifications
1979 & 1980 National
President of the Antique
Automobile Club of
America
National Judge with
more than 150 judging
credits
Executive Director of
Antique Automobile
Club of Ameriea for 17
years
AACA Library &
Research Center Board
of Directors and past
president
AACA Museum Board
Member and past
president
Member of SEMA and
ARMO
VEHICLE CONDITION: Good
This certifies that on this day, March 19, 2004, William H. Smith has hereunto appraised the
above-mentioned 1947 Dreyer Sprint Car in the amount of $7,995.00 (Seven thousand, nine
hundred ninety five dollars). The value of this vehicle is subject to change due to the fact of
deterioration, repeated use and any damage resulting f~om theft, effects of nature and/or damages
out of the control &the owner. This appraisal is made with the understanding that the appraiser
assumes no liability with resPect to any action that may be taken on the basis of this appraisal.
The appraisal of this vehicle is intended to remain valid until such time as on the above-
mentioned causes may effect the vehicle in any way. Upon such time, this appraisal is subject to
change. Wherefore, the appraisal made the day and year first above written is made to the best of
my knowledge and belief and is subject to change in accordance with the facets previously listed.
Date: 2~ -- /L--~ .-- ~/ Certified by: /(/,/~5~ ~ ~. ~.~2-~
William H. Smith
Name: Estate of Robert W. Harbison
Address: S. Spruce Circle
Shiremanstown, PA
Phone: Contact Mark Hamond
Re: 1942 Ford Jeep
· Color: Army Er~.en
· Interior Color Same (2 front seats, 1 rear)
· Vin No.: 93612 (on glove box)
· Plate No. 64MV Antique
· Miles: ....
· Engine: Willys Jeep
· Trunk: ~q/A
· Tires: 5 McCreary 600/16 Milita~
· Hub caps N/A
· Glass Good
· Trim: N/A
· Undercarriage: l~air
· Runningboards: .....
· Floor: Patched
· Bumper: Good
· Grill: Good
· Body: A lot of welding and patching
c/o: Mark Hamond
Goldberg, Katzman & Shipman
PO Box 1268
Harrisburg, PA 17108-1268
PH: 717.234.4161
Appraisal Amt. $7,995.00
~.euey roue t~ooK Usea Uar Values Page 1 of 2
Kelley Blue Book
Ith Insurance
~ompa~y
THE TRUSTED RESOURCE
BLUE BOOK TRADE-IN VALUE
Pennsylvania · May 3, 2004
1993 Ford F150 Short Bed
Engine: V8 5.0 Liter
Trans: Automatic
Drive: 2 Wheel Drive
Mileage: 50,000
See Local Listinqs of This Car
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Equipment
Air Conditioning
Power Steering
AM/FM Stereo
Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects.
The paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. In states where rust is a
problem, this should be very minimal, and a deduction should be
made to correct it. The tires match and have substantial tread wear
left. A clean title history is assumed. A "good" vehicle will need some
reconditioning to be sold at retail; however major reconditioning
should be deducted from the value. Most recent model cars owned by
consumers fall into this category.
Trade-In Value $2,450
Trade-in value represents what you might expect to receive from a
dealer for this consumer owned vehicle. Keep in mind that the dealer
must then absorb the cost of making the vehicle ready for sale,
advertising, saJes commissions, arranging financing and insurance
and standing behind the vehicle for any mechanical or safety
problems.
GAt_a_ Pr_iy_a_te~ _P~r~ty V~alu~
http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb. PA;4453 g4;PA043& 17101 ;+t&39;Ford; 1993%... 5/3/2004
'eyfus Family of Funds
P.O. Box 55552
Boston, MA 02205-8568
April 2, 2004
GOLDBERG KATZMAN & SHIPMAN PC
ATTORNEYS AT LAW
ATTN RONALD KATZMAN
PO BOX 1268
HARISBURG PA 17108-1268
REFERENCE: 02094495 - 20040402065925
DREYFUS PREMIER CORE BOND FUND CL A
FUND:0000031-ACCOUNT:00557026614
FUND:0000031-ACCOUNT:00012536934 (CLOSED)
ESTATE OF ROBERT W HARBISON
Dear Mr. Katzman:
We have received your request to for information on the
above referenced accounts.
As of February 12, 2004, account number 0031-0557026614 had
715.699 shares with a net asset value of $14.85 per share.
The total dollar balance on that date was $10,628.13.
As of February 12, 2004, account number 0031-0012536934 had
1,250.364 shares with a net asset value of $14.85 per
share. The total dollar balance on that date was
$18,567.91.
The balances were calculated by multiplying the total
number of shares by the price (net asset value) per share.
Please keep in mind that the balance may change daily
because of changing market and economic conditions. Also,
past performance is not a guarantee of future results.
Please be advised there is no beneficiary on account number
0031-0557026614, therefore, the beneficiary defaults to the
decedent's estate. The account may not be rolled over to
the spouse's IRA, since she is not the executor. In
addition to the submitted Letters Testamentary, listed
below are the items required to distribute the account.
Service C6rporation
x44 Glenn Curtiss Boulevard
Uniondale, New York H556-oi44
March 19, 2004
Mr. Mark Hammond
Goldberg, Katzman & Shifman
P.O. Box 1268
Harrisburg, PA 17108
Re: Roger W. Harbison
Dreyfus Premier Core Bond Fund, Class A
AdC No. 0031-0012536934
AJC No. 0031-0557026614
Re£No. 20040318110804
Dear Mr. Hammond:
As per your request, the following are summaries of the Date of Death balances for the referenced
accounts.
The balance of the Dreyfus Premier Core Bond Fund, Class A, A/C No. 0031-0012536934, as of
February 12, 2004 was $18,590.17. The accrued dividends for the month were $22.27, which is
included in the balance.
The balance of the Dreyfus Premier Core Bond Fund, Class A, A/C No. 0031-0557026614, as of
February 12, 2004 was $10,640.87. The accrued dividends for the month were $12.74, which is
included in the balance.
If you have any questions about this information, our service representatives are available for you,
Monday through Friday, 8 a.m. to 6 p.m., Eastern time, at our toll-free number, 1-800-645-6561.
Sincerely,,
Judith Siper /
P0hdent
Cortes ~'~
Call Toll Free 1-800-645-6561 · In NewYork City Call 1-718-895-1206 · On Long Island Call 516-794-5200
THEVall~ROUP,
RONALD M KATZMAN ESQ
PO BOX 1268
HARRISBURG PA 17108-1268
May ll, 2004
Inter-T~rm Tax-Exempt Inv
09859577523
Estate of Robert W. Harbison
Dear Mr. Katzman:
We are responding to your letter us of the death of Robert W. Harbison, and requesting a
valuation of the above account. As of February 12, 2004, the number of shares, the price per
share, the value of the fund, and the accrued dividends were as follows:
Fund Shares Price Value Accrued
Dividends
Inter-Term Tax-Exempt Fund 9,391.569 $13.84 $129,979.31 $168.67
Please note, this account was transferred as requested on May 10, 2004. Nancy M.
Harbison will receive confirmation of the transfer within five to seven business days.
If you have any questions or need further assistance, please contact a member of our
Transition Specialist Team at 1-888-237-9045. We are available Monday through Friday
fi.om 8 a.m. to 8 p.m. Eastern time.
Sincerely,
Client Services Department
are
50408662
ESTATE OF
ROBERT W. HARBISON,
deceased
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DMSION
No. 21-04-00254
DISCLAIMER AND RENUNCIATION
OF INTEREST
Recitals
A. This "Disclaimer and Renunciation of Interest (the "Disclaimer") is executed on
'4 ti ~q~ 5z ,2004, by NANCY M. HARBISON (the "Disclaimanf'), the undersigned, who is an
adult individual residing at 5 Spruce Circle, Shiremanstown, Pennsylvania 17011.
B. Robert W. Hathison (the "Decedent"), who was the spouse of the Disclaimant, died on
February 12, 2004, a resident of Cumberland County, Pennsylvania.
C. The Decedent's Last Will and Testament, dated September 22, 1992, (the "Will"), was
probated with the Office of the Register o fWills of Cumberland County, Pennsylvania (the "Reffister"),
and on MarchlS, 2004, the Register issued Letters Testamentary to Ronald M. Katzman, as executor
(the "gxecutor'~ of the Estate of Robert W. Harbison, deceased (the "Estate").
D. The Disclaimant desires to disclaim, by way oft. his Disclaimer, any interest whatsoever,
now or in the future, regarding the following estate asset (the "Estate Assets") pursuant to the
Pemasylvarfia Probate, Estates and Fiduciary Code, 20 PA. C.S.A. Section 101 et. seq. (the "PEF Code")
and the Intern,1 Revenue Code of 1986, as amended (the "IRC"):
The entire residue of the Estate of Robert W. Harbison under ITEM VI. of said W/Il, which has an
estimated value of in excess of $600,000. This disclaimer is to be effective as of February 12, 2004,
the date of Decedent's death.
Provisions
1. Pursuant to Section ~6201 of the PEF Code, the Disc!aimant hereby renounces and
disclaims any and all right, rifle, or interest whatsoever that she may now have or may have l~ad in
the Estate Assets forming the enrire residue of said estate.
2. This Disclamaer is declared as irrevocable. This Disclaimer is intended to be a
"qualified disclaimer" for purposes of the PEF Code and the IRC, and the regtflarions thereunder.
3. The Disclaimant avers and confirms that she, personally and individually, has not
accepted any interest, control, or benefit whatsoever regarding the Estate Assets p~or to the date o£
this Renunciation.
4. The Disclaimant believes and understands, and avers, that the Estate Assets will pass
to a person or entity other than the Disclaimant, specifically, the son of the Decedent, as a result of
her renunciation of her interest in the Estate Assets.
5. This Disclaimer shall relate back for all purposes to February 12, 2004, the date of
death of the Decedent. This Disclaimer shall be binding upon the Disdaimant and all persons
claiming through or under her.
6. This Disclaimer shall be recorded as evidence of the matters set forth herein.
7. This Disclaimer shall be delivered to the Executor for purposes of administration of
the Estate; and such parties may rely upon this Disclaimer for all purposes.
Execution
IN WITNESS WHEREOF, intending to be legally bound hereby, the Disclamaant has
executed this Renunc. Jarion for the purposes set forth herein, on this qz~ day of d/J~F~ ,
2004.
WITNESS:
NANC¥t~xTHARBISON
2
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Harbison, Robert W.
also known as
, Deceased
Ronald M. Katzman
No. 21 - 04- 00254
Date of Death 2/12/2004
Social Security No. 206-12-9241
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney: Ronald M Katzman
I.D. No.: 07198
Signature:
Signature:
Address:
Telephone:
320 Market Street
Harrisburg, PA 17108
717/234-4161
Address: 320 Market Street
P. O. Box 1268
Harrisburg, PA 17108
Telephone: 717/234-4161
Dated: "~ ' 2-g. D ~4
Personal Property
300 shares, Altria Group, Common
16,503.00
Dividend thereon, Declared 2/25/2004, Ex-Dividend date 3/11/2004, Record Date 3/l 5/2004,
Payable date 4/I 2/2004
204.00
174 shares, American Telephone and Telegraph Co, Common
3,480.00
1,044 shares, BellSouth Corp., Common 31,507.92
400 shares, Bristol Myers Squibb Co., Common ~ c!?_~ ~ 1~ ~6.00
281 shares, Comcast, Class A, Common ff ~__ .."8 6;¢6.37
80 shares, Nuveen National Trust 165 Quarterly, per letter dated April 20, 2004 c~. r,o
~ 2,7~4.80
2,729.9l 8 shares, Pepco Holdings, Inc., Common i. r,o ,
~ '/2.
1,263 shares, SBC Communications, Common 1:~ 32,307.54
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$890,034.34
Estate of
also known as
Register of Wills of Cumberland County, Pennsylvania
Harbison, Robert W.
INVENTORY
continued
, Deceased
464 shares, Teco Energy, Common
1,250.364 shares, Dreyfus Premier Core Bond Fund - Class A
18,000 shares, General Electric, Common
Dividend thereon, record date 3/1/04, payable 4/26/04
464 shares, Verizon Communications
279 shares, AT&T Wireless
MBNA Bank, NA, Money Market Fund
Scottrade Money Market Account
No. 21 - 04- 00254
Date of Death 2/12/2004
Social Security No. 206-12-9241
6,973.92
18,567.9i
593,100.00
3,600.00
17,478.88
3,276.86
75,778.34
2,762.02
2002 Honda CHF Metropolitan, V1N #JH2AF60092K000938, value per Kelley Blue Book
PayPal Money Market Fund 01359771830060950915
AARP - United Health Care - reimbursement for medical expenses
Firearms - proceeds of sale to Classic Firearms
State Treasury - Bureau of Unclaimed Property
1,025.00
868.59
1,656.00
600.00
40.30
Total Personal Property
$890,034.34
2
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD OO4213
KATZMAN RONALD M ESQ
320 MARKET ST
P O BOX 1268
HARRISBURG, PA 17108-1268
........ fold
ESTATE INFORMATION: SSN: 206-12-9241
FILE NUMBER: 2104-0254
DECEDENT NAME: HARBISON ROBERT W
DATE OF PAYMENT:
POSTMARK DATE:
07/29/2004
07/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $10,124.68
REMARKS:
TOTAL AMOUNT PAID:
~10,124.68
CHECK# 1538
INITIALS: JA
..... SEAL RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
320 MARKET STREET · STRAWBERRY SQUARE
P.O. BOX 1268 ° HARRISBURG, PENNSYLVANIA 17108-1268
717.234.4161 · 717.234.6808 (FAX)
GOLDBERG, KATZMAN
ATTORNEYS AT LAW
SHIPMAN, P.C.'[Nl JUL29 P2:24
July 28, 2004 U
OF COUNSEL
F. LEE SHIPMAN
COUNSEL
JOSHUA D. LOCk
ARNOLD B. KOGAN
ARTHUR L. GOLDBERG
(1951-2000)
HARRY B. GOLDBERO
(1961-1998)
RONALD M. KATZMAN
PAUL J. ESPOSITO
NElL HENDERSHOT
J. JAY COOPER
THOMAS E. BRENNER
JOHN A. STATLER
APRIL L. STRANG-KUTAY
GUY H. BaOOKS
JEFFERSON J. SHIPMAN
JERRY J. Russo
MICHAEL J. CROCENZI
THOMAS J. WEBER
STEVEN E. GRUBB
JOHN DELORENZO
JOHN R. NINOSKY
ROYCE L. MORRIS
DAVID M. STECKEL
HEATHER L. PATERNO
BENIAMIN D. ANDREOZZI
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle PA 17013-3387
Re: Estate of Robert W. Harbison
Madam:
Enclosed please find an original and two copies of the Pennsylvania
Inheritance Tax Return and our check in the amount of $10,124.68 payable to
Register of Wills Agent. Please file the original and one copy as required by law.
Timestamp and return one copy.
We are also enclosing an original and two copies of the Inventory, together
with our check in the amount of $25.00 as filing fees for both the Inheritance Tax
Return and Inventory. Please file the Inventory and return the unneeded copies to us.
Very truly yours,
Mark B. Hammond
Estate Paralegal
Encl.
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENTOFREVENUE
BUREAU OFINDIViDUAL TAXES
OEPT. 280601
HARRISBURG, PA 17128 0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004213
KATZMAN RONALD M ESQ
320 MARKET ST
P O BOX 1268
HARRISBURG, PA 17108-1268
........ fold
ESTATE INFORMATION: SSN: 206-12~9241
FILE NUMBER: 2104-0254
DECEDENT NAME: HARBISON ROBERT W
DATE OF PAYMENT: 07/29/2004
POSTMARK DATE: 07/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 910,124.68
REMARKS:
.... SEAL
CHECK#1538
TOTAL AMOUNT PAID:
910,124.68
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF TNDTVTDUAL TAXES
TNHER'TTANCE TAX DTVZSTON
DEPT. 280601
HARRTSBURG, PA 17128-0601
COHHON#EALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DISALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-15~7 EX AFP
RONALD M I~TZMAN
GOLDBER6 ~ZHAN pC
$20 MARKET ST
-
DATE 09-27-Z004
ESTATE OF HARBZSON
DATE OF DEATH 02-1Z-ZOOq
FiLE NUMBER 11 04-0254
COUNTY CUMBERLAND
ACN 101
I Amount Remitted
ROBERT
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THiS LiNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF iNHERiTANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HARBISON ROBERT WFZLE NO. 210q-O25q ACN 101 DATE 09-27-200q
TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE iNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORTGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Hold Stock/Partnership Zntarast (Schedule C) (3)
q. Mortgages/Notes Receivable (Schedule D) (q)
.6. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Adm. Costs/Misc. Expanses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10)
11. Total Deduct ions
12. Nat Value of Tax Return
807z304.09
.00
82~750.15
6zq85.00
140z776.11
(8)
50,012.00
563.67
.00 NOTE: To insure proper
credit to your account,
submit the upper portion
.00 of this form with your
tax payment.
13.
lq.
NOTE:
1,057,195.45
(11) 50.57~.67
(12) 986,719.78
Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (13)
Nat Value of Estate SubSact to Tax (lq) 986,719.78
Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill
.00
.00
38,545.75
.00
.00
$8,5q5.75
AMOUNT PAiD
reflect figures that /nclude the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of L/ne lq mt Spousal rata (15) 150,147.98 x O0 =
16. Amount of Line Xq taxable at LinaaX/Class A rata (16) 856,571.80 x 045 =
17. Amount of Line lq mt SibXing rata (17) .00 x 12 =
18. Amount of Line lq taxable at Collatarel/CXass B rata (18) . O0 X 15 =
19. Principal Tax Due (19)=
TAX CREDXTS:
PAYMENT RECEIPT DT$COUNT (+)
DATE NUMBER iNTEREST/PEN PAID (-)
05- 06-2004 CD005917 1,421.05
07-26-Z004 CD004215 . O0
IF PAiD AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDiTiONAL iNTEREST.
17,000.00
10,124.68
TOTAL TAX CREDXT $8,545.73
BALANCE OF TAX DUEI .00
XNTEREST AND PEN. . O0
TOTAL DUE . O0
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SiDE OF THiS FORM FOR iNSTRUCTiONS.
RESERVATION:
Estates of decadents dying on or bafora December 11, 1981 -- if any future intarest in the astata 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 tho lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 13 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISI3). Applications are available at the Office
of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-561-2050~ services for taxpayers eith special hearing and / or
speaking needs: 1-800-447-$020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment shouZd be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-060!
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacodent's death, a five percent (51) discount of
the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This nan-participation
penalty is appealable in tho same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with First day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year eith that rate
announced by the PA Department of Revenue. Tho applicable interest rates for 1982 through 2004 ars:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .000548 ~)'~'~-1991 11Z .000301 ~ 9Z .OOOgq7
1983 161 .0004~8 1992 91 .000147 ZOOZ 61 .000164
1984 112 .000~01 1993-1994 72 .O0019Z 2003 51 .000137
1985 131 .000356 1995-1998 92 .000247 2004 42 .000110
1986 lOX .000174 1999 71 .000191
1987 10Z .000174 ZOO0 71 .000191
--Interest is calculated as Follows:
ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELTNQUENT X DAZEY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
~EV-1470 EX (~-8'8)
(~ INHERITANCE TAX
EXPLANATION
COMMONVVEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG~ PA 17128-0601
;)ECEDENTS NAME FILE NUMBER
Harbison, Robert W. 2104-0254
~EVIEVVED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Assets passing from the decedent to the surviving spouse are reportable and taxable at
G 2,3 the zero tax rate.
ROW Page 1
Arlhur I. (;oklbcrg
I hlrry B. Goldbelg
Joshua 1). I,ock
\mold B. l(%an
Goldberg
Katzman
A full-service law firm.
December 16, 2004
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle PA 17013-3387
Re: Estate of Robert W. Harbison
Madam:
Enclosed please find an original and two copies of the Supplemental
Pennsylvania Inheritance Tax Return and our check in the amount of $1,079.12
payable to Register of Wills Agent. Please file the original and one copy as required
by law. Timestamp and return one copy.
We are also our check in the amount of $25.00 as filing fees for both the
Inheritance Tax Return.
Very truly yours,
Mark B. Hammond
Estate Paralegal
Encl.
116836.1
Markcl Street, Strawberry Square I I~O. Box 1268 I ttarrislmrg, PA 17108 1268 I 717-234-4161 I 717 234 6808 (filx)
wwn:goldbc~kalzman.co,t
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
21 04 00254
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Harbison, Robert W.
206-12-9241
DATE Of DEATH (M M-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
02/12/2004 03/18/1924
REGISTER OF WILLS
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( I~,S T, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
169-26-1202
z
z
Harbison, Nancy M.
[] 1. Original Return
[] 2. Supplemental Return
] 3. Remainder Return (date of dee h prior to 12-13~2)
] 4. Limited Estate [] 48, Futura tnterest Compromise (date of death after
12-1242)
[] 6. Decedent Died Testate (Attach copy [] 7, Decedent Maintained a Living Trust (A~tach
of W~tl) copy of Trust}
[] 9, Litigation Proceeds Received [] 10. SpousalPovertyCredit(dateofdeathPetween
[] 5, Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
[] 11.ElecgontotaxunderSec. 9113(A)(At~achSchO)
lAME
Ronald M Katzman
IRM NAME (If applicable)
Goldberg Katzman, PC
ELEPHONENUMBER
717/234-4161
COMPLETE MAILING ADDRESS
320 Market Street
Harrisburg, PA 17108
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Coq~oration, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(1) None
(2) 24,005.46
(3) None
(4) None
(5) None
(6) None
(7) None
(9) 25.00
(10)
(6) 24,005.46
(11) 25.00
12. Net Value of Estate (line 8 minus Line 11) (12) 23,980.46
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) 2 3,9 8 0.4 6
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2)
x .00 (15)
16.Amount of Line 14 taxable at lineal rate 23,980.46 x .045 (16)
17.Amount of Line 14 taxable at sibling rate x .12 (17)
18, Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
(19)
1,079.12
1,079.12
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
tTREET ADDRESS 5 Circle
Spruce
ITY Shiremanstown ISTATE PA IZIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments
C. Discount
3. Interest/Penaltyif applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
Total Interest/Penalty (D + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page t Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the toter of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1) 1,079.12
(2) 0.00
(3) 0.00
(4)
(5) 1,079.12
(SA)
1,079.12
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ..................................................................................
b. retain the right to designate who shall use the property transferred or its income .........
c. retain a reversionary interest; or .............................................................................................
d. receive the promise for life of either payments, benefits or care? .................................
2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ..................... . .................. []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non.probate preperty 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 PART OF THE RETURN.
Un,er penalties of pequry, I dec,are that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belie[ it is tree, correct and complete Decrara~ion Of
preparer other than the personal representative is based on all infomlation of which preparer has any knOwledge.
SIGNATURE OF PERSON_RES/~NSIBLE F(RESR NSIBLE FOR F~LING~G ~E~FURNETURN ADDRESS 320 Market Street
Ronald M. Katzma.~/, ^ ,~ ~ P.O. Box
1268
SIGNATURE OF PERSON'~E~/~'~,t"lC''----'-~ Harrisburg, PA 17108
IBLE FOR FILING RETU~,~ ADDRESS
DATE
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
Ronald M Ka~
320 Market Street
Harrisburg, PA 17108
For dates of death on or after July 1 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
survlwng spouse is 3% [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased ch d twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {;9116
1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings s 12% [72 P.S §9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE T~X RETURN
RESIDENT DECEDENT
ESTATE OF
Harbison, Robert W. FILE NUMBER
21 - 04 - 00254
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE O,
DEATH
I 1,153 shs, Pepco Holdings 20.82 24,005.46
TOTAL (Also enter on line 2, Recapitulation) 24,005.46
COMMONWEALTH OF PENNSYLVANIA
INHERJTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Harbison, Robert W. FILE NUMBER
21 - 04 - 00254
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State ~ Zip
Year(s) Commission paid
Attorney's Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
C~ty
Relationship of Claimant to Decedent
Probate Fees
State Zip
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Register of Wills, file Inventory and Inheritance Tax Return
TOTAL (Also enter on line 9, Recapitulation)
25.00
25.00
SCHEDULE J
BENEFICIARIES
ESTATE OF
Harbison, Robert W. I FILE NUMBER
21 - 04 - 00254
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT
~,, No~ Ll~ 'r~,,.~..~.~ OF ESTATE
I. TAXABLE D~STRIBUTIONS (include outright spousal distributions)
) 'W'
Il]am L. Harb son, 288 Ro lng Acres, Son Residue of Estate per
North East MD 21901 :lisclaimer of spouse
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
~l'I. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II ~ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV~1500 COVER SHEET
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1162 EX(11 96)
NO. CD 004749
KATZMAN RONALD M ESQ
320 MARKET ST
P O BOX 1268
HARRISBURG, PA 17108-1268
ESTATE INFORMATION: SSN: 206-12-9241
FILE NUMBER: 2104-0254
DECEDENT NAME: HARBISON ROBERT W
DATE OF PAYMENT: 12/17/2004
POSTMARK DATE: 12/16/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,079.12
TOTAL AMOUNT PAID:
$1,079.12
REMARKS:
SEAL
CHECK# 2471
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
ROBERT W. HARBISON
Date of Death:
FEBRUARY 12.2004
Will No.
Admin.
2004-00254
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 whether administration of the estate is complete:
Yes X 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 representative file a final account with the Court?
Yes No X
b.
The separate Orphans' Court No. (if any) for the personal
representative's account is:
c.
Did the personal representative state an account informally to the
parties in interest?
Yes X No
d.
Copies of receipts, releases, joinders and approvals of formal or
information accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
. /2~WA~ (;,1)
Signature
Date: /.;J./' o:{
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Telephone
Ronald M. Katzman. Esquire
Goldberg Katzman. P.C.
320 Market Street. P.O. Box 1268
Harrisburg. P A 17108-1268
(717) 234-4161
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Katzrnan
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A full-service law firm.
March I, 2005
r\".)
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Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
,')
P,'-..."1
O~',
Re:
Estate of Robert W. Harbison
File Number - 21-04-0254
Dear Register of Wills:
Please find enclosed our firm's check in the amount of $4.04 for the
outstanding Inheritance Tax due on the above mentioned estate.
Thank you for your assistance. If you have any questions, please do not
hesitate to contact me.
Sincerely,
~~~~
Elizabeth Lewis
Estate Paralegal
ledl
Enc!.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ~~oWANCEo~DI~A~.~NCE
OF DEDUCTIoNS'rND ASSESSMENl';'DF"TAX
DATE
EST.A Ta;; qF," '1 r
DATE bj:l'D!Mj1
FILE NUMBER
couNty
ACN
2005
uu.
02-21-2005
HARBISON
02-12-2004
21 04-0254
CUMBERLAND
101
RONALD M KATZMAN
GOLDBERG ETAL
320 MARKET ST
HBG
C
CUI
Amount R...l tt.d
T
.':'
PA 17108
'*'
REV-15~7 Ell AFP (12-D~)
ROBERT W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
ii.v =r.!ii'f.IY.&~p.rfil--.6J'..NOT.icE.OF.'i'iiHErtI.fAN.CE.TAX.A.PPRA.islJMtJ'~..A[l'b""QANc"l.OR......_....... ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HARBISON ROBERT W FILE NO. 21 04-0254 ACN 101 DATE 02-21-2005
TAX RETURN WAS: (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. R..l Est.t. (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held stock/Partnership Interest (Schedule C) (3)
~. Harigagss/Notes Receivable (Schedule Dl (4)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule f) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
.00
24,005.46
.00
.00
.00
.00
.00
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequestsi Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
25.00
.00
llll
1121
1131
(14)
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rat. (15)
16. Amount of line 14 taxable at Line.l/Class A rate (16)
17. ADOunt of Line 14 at Sibling rat. (17)
18. A.aunt of Line 14 taxable at Coll.teral/Class B rate (IS)
19. Principal Tax Due
NOTE: To insure proper
credit to your account,
submit the upper portion
of this for. with your
tax pay..ent.
24,005.46
;>1; nn
23,980.46
.00
1,010,700.24
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
130,147.98 X 00 =
880,552.26 X 045 =
.00X12=
.00x15=
1191=
AMDUNT PAID
27,000.00
10,124.68
1,079.12
DATE
05-06-2004
07-26-2004
12-16-2004
NUMBER
CD003917
CD004213
CD004749
INTEREST/PEN PAID (-)
1,421.05
.00
.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-17-2004 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION DF ADDITIONAL INTEREST.
.00
39,624.85
.00
.00
39,624.85
39,624.85
.00
4.04
4.04
IF TOTAL DUE IS LESS THAN $1, ND PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS.)
,,>-'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG, PA '17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KA TZMAN RONALD M ESQ
320 MARKET ST
POBOX 1268
HARRISBURG, PA 17108-1268
___non fold
ESTATE INFORMATION: SSN: 206~ 12~9241
FILE NUMBER: 2104-0254
DECEDENT NAME: HARBISON ROBERT W
DATE OF PAYMENT: 03/02/2005
POSTMARK DATE: 03/01/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
NO. CD 005012
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4.04
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$4.04
REMARKS:
CHECK# 2553
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
BUREAU OF INDIVIDbAW'fAXES
INHERITANCE TAX DIYISI0It_
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REY-1607 EX AFP (03-05)
}" t) ~ .
;' <:; ',j <--or
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-04-2005
HARBISON
02-12-2004
21 04-0254
CUMBERLAND
101
ROBERT
W
(-, ,-.-.
I,
RONALD--M KATZMAN
GOLDBERG ETAL
320 MARKET ST
HBG
Allount Rellitted
PA 17108
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................................................................................................................
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF HARBISON ROBERT W FILE NO.21 04-0254 ACN 101 DATE 04-04-2005
THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW
IS A SU""ARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAY"ENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-21-2005
PRINCIPAL TAX DUE: 39.624.85
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-06-2004 CD003917 1.421. 05 27.000.00
07-26-2004 CD004213 .00 10.124.68
12-16-2004 CD004749 .00 1.079.12
03-01-2005 CD005012 4.04- 4.04
TOTAL TAX CREDIT 39.624.85
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
lIE IF PAID AFTER THIS DATE. SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ.
YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. J
o~'L.