HomeMy WebLinkAbout04-0238 BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Estate of Kathryn R Wilbert Uo.~./'-4~ '~- ~..~
also known as
Kathryn R Wilbert , Deceased Social Security No. 189091030
Etalena F Bard
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ,rix named in the Last Will of the
[ Decedent,
dated 4/17/2003 and codicil(s) dated
State relevant circui~siances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
[] B
. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendei~e lite, durante absent,a; durante minor,tare)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I Name Relationship Residence
(COMPLETE IN ALL CASES:) Affach additional sheets if necessary,
Decedent was domiciled at death in Cumberland County, Pennsylvania,.~ith his/he.~ast family or principal
residence at 1700 Market Street, Camp Hill Borou~]h . ~_~ ,.;...:;,
(list street, number and municipality) t.O
Decedent, then 86 years of age, died March 2 ,2004 , at Manor Care Nursing Home
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ......................................... $ 250,000.00
(if not domiciled in PA) Personal property in Pennsylvania .................... $
(If not domiciled in PA) Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total
..................................................................................................................... $ 250,000.00
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signature Typed or printed name and residence I
Etalena F Bard
506 Thomas Road
Camp Hill PA 17011
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and 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 accor~g to law. ~/)
Sworn to and affirmed and subscribed .;~
Etalena F Bard
before me this /~7,,'/ day of
March, 2004.
-
DECREE OF REGISTER
Estate of Kathryn R Wilbert Deceased No. c~,'/-~
also known as
Social Security No: 189091030 Date of Death: 3~2004
AND NOW, 1'2"2'-'~""~¢ /// ,~ in consideration of-~e Petition
r / ' '
on the everse rode hereon, sat sfactory proof having been presented before me,
IT IS DECREED that Letters I~ Testamentary I~ of Administration '-o
(c.t.a., d.b.n.c.t; pendente lit~;;d~Jiante ab;tia duran~ mi~odtate)
are hereby granted to Etalena F Bard
in the above estate and that the instrument(s), if any, dated April 17, 2003
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .................................... $ 270.00
J.~L~3 ~ / ' Register oiCVVil, ~ -~.,~ ~"-~__~
Short Certificate(s) ............... $ 12.00
Renunciation .......................... $
Extra Pages (4@$3) .............. $ 12.00
Attorney
Codicil ................................. $
JCP Fee ................................. $ 10.00 Attorney: Jan L Brown
Inventory & Tax Forms ............. $ I.D. No: 67993
Other ...................................... $ Address: 845 Sir Thomas Court Suite 12
Harrisburg PA 17109
TOTAL ............................. $ 304.00 Telephone: 717-541-5550
DATE FILED: 3/10/2004
H105.805 REV 9/86
This is to certi~ that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9964534
No. '~ Date
)5.143 Rev. ~87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH c:
N~E OF DECEDENT ~F~sI M~d~ ~.~ ~ STATE~:~E~UM~R ~ ~ ' ~
AGE (Last Bi~ay) 2. uemale ~ t~9 -- 09 ,~. 1030 ' ' a =~
B'~*'''~'~,~ .. ~. "~ . ~. ~.~ =~o~,.~. ~~.~.,~ .....~~2. 200~
~ ~ ] Days I H~inutes I (M~,Day, Year) / st=t=~=~=~&'~) ~o=~&: ~ ~ ~ ' ~' .ct Z._
C TION
{ ~ ~ of~ ~ du~ most R IN DECEDENTS EDUCATION ~ ~IT~ STA~S Ma~ '
~, Secretary I Hamilton ..... / v..~ .o~ I ~'~-- co,~.. I o~(i~'~' I (.w,,...
' ]1 lb. O~tl~ (~) (14 ~
~6~c~.~.~,~,.~.o~.~<~.., ~,~o~. ~,.. ~,,~,,~ I,~. I''.~2 I I,. ~vo=~a
~ I ACT~"rs ,,.. s,a,.__PA ' ~0., 1'c. ~ Yes, de~en, lived ~ J ~p
~ 1700 Harke~ S~ree~ ~EmD~CE .
C a~ Hi (S~ ins~ns ~ve ~ a
~ 1701[ ~,.r.~.) ,,~.coun~ Cumberland ,o~n,~ ,,~ ~ ~o.~.~n,,~v~ ......
~ ~lHk~ N~E (F~st, Mid~, L~I) ...... ~ wi~ln a~ual limits of ~[~lii citgo.
MOTHER'S NAME (F~st, Middle, Ma~e~ S~a~)
~a. ~ilson ~. ~ilber~ ~. Esther Susan Bixler
METHOD OF OISPOSITION , 12Ob. as Noah, Camp ~Ill, P~ 17011
DATE OF DISPOSITION P~CE OF DISPOS T ON- Name of ~
~o.~D ~u.., DCr~.~o. ~ .... ~,~ D I~ ........... , Io~o~r., .......m~'.~?"~
SI NA 1b O~ 2~c PA Crematory Har
22~.
C~te ~te~ 23a~ only ~ ~ 1 09
7
ge~ 24-26 must ~ ~plet~ by Tl~ - .
...... · u *. , ~rox~mate PART Il: Other s~nirmant ~di~s ~tdbuti~ ~ dea~, ~t
IMMED~TE CAUSE (Final , inlewal be~r not resulgng in ~e unde~y~g ~use gNen ~ PART L
msul~ng iff ~am)~ a. ~
~ any, ~ading ~o ~te{ DUE TO (OR AS A }ONSE~NCE~):
~use. Enter UNDERLYING
=AUSE (Dissase ~ ~ju~ c.
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~AUSE ~Natura, ~ Homi~de
- /'*'.., m Pendinglnvest~ationmi /
28a J28b. I** ~I~CE~FiNJURY-AIhome fa~ strut facio~ office ILOCATi~ ;~:~7~
NAmE AND ~rEs~o ~r~ON W~ COMP~TED CAUSE OF
.~s~r.s ~.atu.~ anu .u~.~r ~. ~/~ ~
DATE FILED {M~. Day. Year)
LAST WILL AND TESTAMENT
OF
KATHRYN R. WILBERT
I, KATHRYN R. WILBERT, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
inclUding any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment.
Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 days of
the probate of my will. Gifts may only be to persons who survive me or to organizations which exist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
I give the sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) to my good friend,
ETALENA F. BARD, of Cumberland County, Pennsylvania, in recognition of many instances
of her kindness and assistance over the past several years. If, however, my friend, ETALENA F.
BARD, fails to survive me, this gift to her shall lapse and become part of my residuary estate.
Article V
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN EQUAL SHARES to: my brother-in-law, E. RAY
GOTTSHALL, of Pompano Beach, Florida, and my nieces: JANET E. BLOMGREN,
KATHRYN E. COLLMAN, LORI E. GOTTSHALL, SUSAN J. WELLNER, and NANCY J.
WILLIAMSON. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days,
I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or
she has no issue, the share(s) arc to be added equally to the other shares.
Article VI
I nominate, constitute, and appoint my friend, ETALENA F. BARD as Executrix of my
Last Will and Testament. In the event of the renunciation, death, or inability to act, for any
reason whatsoever of my Executrix, I nominate, constitute and appoint my attorney, JAN L.
BROWN of JAN L. BROWN & ASSOCIATES, or its successors, or an attorney of Jan L.
Brown & Associates, or its successors, currently of 845 Sir Thomas Court, Suite 12,
Harrisburg, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my
Executrix or successor Executor be permitted to serve without bond and in addition to those
powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike
shares and to file any qualified disclaimer I could have filed if living. My Executrix or successor
Executor shall receive reasonable compensation for services rendered to my estate.
Article VII
In addition to the powers conferred by law, I authorize my Executrix and successor Executor,
in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising fi.om the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
-3-
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
IN WITNESS WHEREOF, I, KATI-IRYN R. WILBERT, hereby set my hand to this my
Last Will and Testament, on '~ 'I~L IqI ~ 003 2003, at Harrisburg, Pennsylvania.
KATI-IRY0~I R. WILBERT
In our presence, the above-named KATHRYN R. WILBERT signed this and declared this
to be her Last Will and Testament and now at her request, in her presence, and in the presence of
each other, we sign as witnesses.
Name Address
-4-
I, KATI-IRYN R, WILBERT, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my Will,
and that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
KATHRYN R. W1LBERT, the Testatrix
on q- ]-7 2003.
KATI-IRYI~I R. WILBERT
i, flq:o~ Public '
'x I ' NOTARIAL SEAL
~ I .II~A.#OLLAND, NOTARYPUBLI~ J
co...'
t ,,.' 20. i
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
and i/~ox~//~ ~). /9-rch, Wi-thes~ ......
witnesses, on q-./7 ,2003.
I[SSICA A. H0U. AN0, N01ARY PUBlIC
'~'~ i NOTARIAL SEAL ' ,
CITY OF HARRISBURG. DAUPHIN COUNTY
MY COMMISSION EXPIRES MARCH 4, 2_0? _1
BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Kathrvn R Wilbert
Date of Death: 3/2/2004
Will No. 2004-00238 Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 3/19/2004 ·
Name Address
Etalena F Bard 506 Thomas Road
Camp Hill PA 17011
E Ray Gottshall 2217 Cypress Island Drive Apt 204
Pompano Beach FL 33069
Janet Blomgren 2500 NW 8th Ave
Fort L{~ud~rdale FL 33311
Kathryn E Collman 2334 Cypress Bend Drive Apt 712
Pompano Beach FL 33069
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:.
Sig L Brown Esquire
Name: Jan L Brown & Associate~
Address: 845 SirTh0mas Covrt Suite 12
Harrisburg PA 1710~)
~ i,'~:'), Telephone(717) 541- 5550
Z~: ~ (:J Z~ ~JV~ ~70. Capacity: Personal Representative
~( Counsel for Personal
~ .... Representative
Continuation of Certification of Notice Under Rule 5.6(a)
Kathryn R Wilbert 3/2/2004
Page 1
Names and addresses
Name Address ~ - -
Lori E Gottshall 2311 S Cypress Bend Apt 317
Pompano Beach FL 33069
Susan J Wellner 172 Union Road
Wales MA 01081
Nancy J Williamson 628 8th St N Apt 5
Naples F L 34102
JAN L. BROWN & ASSOCIATES
ATTORNEY AND COUNSELOR AT LAW
Ow~ E~u~ G~
845 SI. THOMAS COURT
SUITE 12
HA~SSU~, PA 17109
Email: jlbassoc@verizon.net
TELEPHO. E (717) 541-5550
Jan L. Brown, Esquire* FACSiMiLE (717) 541-9223 Brenda F. Kephart, LegaiAssistant
Jacqueline A. Kelly, Esquire Paula K. White, Legal Assis~nt
· ~urrTED a PA ^.D ~ST.~CT OF COtUUBa Judith A. Ebersole, Administrative Assistant
May 18, 2004
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Kathryn R. Wilbert
Social Security No. 189-09-1030
File No. 2004-00238
PA File No. 21-04-0238
Gentlemen or Ladies:
Enclosed please find the following items for filing with the Register of Wills:
1. Inventory.
2. Inheritance Tax Return in duplicate.
3. Estate Check 104 in the amount of $25 for the filing fee.
4. Estate Check 105 in the amount of $34,281.24 in payment of the tax shown to be due.
Please time stamp and return our file copies of these documents. A return envelope is
provided.
If you have any questions, feel free to contact this office.
Sincerely,
Brenda F. Kephart
Legal Assistant
bfk
Enclosure
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-11 62 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003960
BROWN JAN L
845 SIR THOMAS COURT
SUITE 12
HARRISBURG, PA 17109
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $34,281.24
ESTATE INFORMATION: SSN: 189-09-1030
FILE NUMBER: 2104-0238
DECEDENT NAME: WlLBERT KATHRYN R
DATE OF PAYMENT: 05/20/2004
POSTMARK DATE: 05/19/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/02/2004
TOTAL AMOUNT PAID: $34,281.24
REMARKS:
CHECK//105
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Wilbert Kathryn R No. 2004 00238
also known as Date of Death 3/2/2004
Kathryn R Wilbert , Deceased Social Security No 189091030
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 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 Decedent owned no
real estate outside 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 made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: Jan L Brown Esquire Etalena F Bard
I.D. No.: 67993
Address: 845 Sir Thomas Court Suite 12 Dated 5/18/04
Harrisburg] PA 17109
Telephone: 717-541-5550
Description :~lue
Wachovia Bank; Checking Account 1100001270518 ~ 22,783.55
Wachovia Bank; Money Market 1010084089861 ;..:. 234,791.48
Wachovia Bank; IRA 257410060272189 19,993.23
Estate of Kathryn R Wilbert, beneficiary
United States Treasury; Social Security benefit check 1,183.00
HCR Manor Care; personal care account refund 341.63
Verizon; refund 4.81
Total
281,097.70
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory,
RW-4
Continuation of Inventory
Wilbert Kathryn R 2004 00238
Pa,qe 1
Description of Inventory
Description Value
Prudential Financial; group life insurance death benefit 2,000.00
Estate of Kathryn R Wilbert, beneficiary
Subtotal $ 2,000.00
Grand Total $ 281,097.70
REV-1500 EX + (6-00)
COMMONWEALTH OF REV-1500 o~,c,^~u.~o.,~
OEPARTME.T OF REVENUE INHERITANCE TAX RETURN F,LE.U.BER
DEPT. 280601
HARR'SBUR . PA17128-0601 RESlDENT DECEDENT 2 1-0 4 0 2 3 8
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
z Wilbert Kathryn R
w 1 8 9-0 9- 1 0 3 0
t'"t DATE OF DEATH (UU-DD-Year) I DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
I
O 03/02/2004 08/30/1917 REGISTER OF WILLS
U.J (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
t'~ SOCIAL SECURITY NUMBER
~-"' [] 1. Original Retum E~ 2. Supplemental Retum [--] 3. Remainder Retum (date ofdeathpdorto 12-13-82)
,,, O,=,~ ~- G [] 4. Limited Estate E~ 4a. Future Interest Compromise (date of death after 12-12-82) E~ 5. Federal Estate Tax Retum Required
~:= ~.~' m ~ [] 6. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Aftach copy of Trust} ~ 8. Total Number of Safe Deposit Boxes
'~ E~ 9. Litigation Proceeds Received r~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1.95) E~ 11. Election to tax under Sec. 9113(A) (Attach Sch O)
~_ THIS SECTION MUST BE COMPL~t=D, ALL CORRESPONDENCE AND CONFIDEN'I'IAL TAX INFORMATION SHOULD BE DIRECTED TO:
z NAME
"' COMPLETE MAILING ADDRESS
z Jan L Brown Esquire
o
~- FIRM NAME (If Applicable)
LI.I
~- Jan L Brown & Associates 845 Sir Thomas Court Suite 12
o TELEPHONE NUMBER
717-541-5550 Harrisburq PA 17109
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) =~ .;
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) I ~r:
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 279,097.70
Z (Schedule E)
_O 6. Jointly Owned Property (Schedule F) (6)
~ J'~ Separate Billing Requested ~'~J
~) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
I'-- (Schedule G or L)
,,~ 8. Total Gross Assets (total Lines 1-7) (8) 279,097.70
L,U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 28~826.56
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,923.16
11. Total Deductions (total Lines 9 & 10) (11) 30~ 749.72
12. Net Value of Estate (Line 8 minus Line 11) (12) 248~347.98
13. Charitable end 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) 248,347.98
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
,~ rate, or transfers underSec. 9116 (a)(1.2) 0.00 X __ (15) 0.00
16. Amount of Line14 taxable at lineal rate 0.00 X __ (16) 0.00
17. Amount of Line 14 taxable at sibling rate 38~891.33 X .12 (17) 4,666.96
~O 18. Amount of Line14 taxable at collateral rate 209,456.65 x .15 (18) 31,418.50
19. Tax Due (19) 36,085.46
20.
> > BE:SURE TO ANSWER ALL QUESTIONS ON R~MERSE SIDE AND RECHE~ <
Decedent's Complete Address:
STREET ADDRESS
1700 Market Street
Camp Hill Borough
CITY
Camp Hill I STATE PA I Z~P 17011
Tax Payments and Credits:
1. Tax Due(Page 1 Line 19)
2. Credits/Payments (1) 36~085.46
A. Spousal Poverty Credit
B. Prior Payments
C. Discount 1,804.22
3. Interest/Penalty if applicable Total Credits ( A + B + C ) (2) 1,804.22
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
4.If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 34,281.24
A. Enter the interest on the tax due. (EA)
B. Enter the total of Line 5 + EA. This is the BALANCE DUE. (ED) 34~281.24
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... [] []
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 property which
contains a beneficiary designation? ...~s.ta.te...i.~...b.e~£...~ f....I/{~ ..................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER~.N RESPONSIBLE FOR FILING PZVTURN
ADDRESS 506 Thomas Road / /
Camp ~
SIGNATURE OF PREPAR,~R~ ~ PA 17011
DATE
..¢-/?-0¥
ADDRESS 845 ~{~'l~.omas Court Suite 12
Harris'bt~,~,
PA 17109
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {}9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 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 ecedent s I neal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX + (6-98)
~ SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONALPROPERTY
ESTATE OF FILE NUMBER
Wilbert Kathryn R ;~1 04 0238
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Wachovia Bank; Checking Account 1100001270518 22,783.55
2 Wachovia Bank; Money Market 1010084089861 234,791.48
3 Wachovia Bank; IRA 257410060272189 19,993.23
Estate of Kathryn R Wilbert, beneficiary
4 United States Treasury; Social Security benefit check 1,183.00
5 HCR Manor Care; personal care account refund 341.63
6 Verizon; refund 4.81
TOTAL (Also enter on line 5, Recapitulation) $ 279,097.70
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & J
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF ~
FILE NUMBER
Wilbert Kathryn R 21 04 0238
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES: AMOUNT
1. Cremation Society of PA
25.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Etalena F Bard 11,373.00
Social Secudty Number(s)/EIN Number of Personal Representative(s)
Street Address 506 Thomas Road
City .Camp Hill s~.~, PA Zip 17011
Year(s) Commission Paid: 2004 & 2005 (50%)
2. Attorney Fees Jan L Brown & Associates 16,746.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State .. Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills, Cumberland County 346.00
5. Accountant's Fees
6. Tax Return Preparer's Fees H&R Block; 2003 income tax return 45.00
7. Cumberland Law Journal; legal advertising
8 The Patriot-News; legal advertising 75.00
9 Postmaster 211.81
4.75
TOTAL (Also enter on line 9, Recapitulation) $ 28~826.56
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
~ SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA DEBTS OFDECEDENT,
INHERITANCE TAX RETURN
RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Wilbert Kathryn R 21 04 0238
Include unreimbursed medical expenses,
ITEM
VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Mobile X Ray 20.15
2 Hal S Fineburg MD 23.60
3 HCR Manor Care 1,109.62
4 NeighborCare Pharmacy 745.19
5 Verizon 24.60
TOTAL (Also enter on line 10, Recapitulation) $ 1,923. lIS
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-nn~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wilbert K~thryn R ;~1 04 0238
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Bo Not List Trustee(s) OF ESTATE
}'. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a)(1.2)]
1. Etalena F Bard, friend Collateral 15,000.00
506 Thomas Rd, Camp Hill, PA 17011
2 E Ray Gottshall, brother-in-law Sibling 38,891.33
2217 Cypress Island Dr #204, Pompano Beach, FL 33069 1/6 residue
3 Janet G Blomgren, niece Collateral 38,891.33
2500 NW 8 Ave, Ft Lauderdale, FL 33311 1/6 residue
4 Kathryn Collman, niece Collateral 38,891.33
2334 Cypress Bend Dr #712, Pompano Beach, FL 33069 1/6 residue
5 Lori Gottshall, niece Collateral 38,891.33
2311 S Cypress Bend Dr #317, Pompano Beach, FL 33069 1/6 residue
6 Susan Jayne Wellner, niece Collateral 38,891.33
172 Union Rd, Wales, MA 01081 1/6 residue
7 Nancy J Williamson, niece Collateral 38,891.33
628 8th St N Apt 5, Naples, FL 34102 1/6 residue
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Wilbert Kathryn R No. 2004 00238
also known as Date of Death 3~2~2004
Kathryn R Wilbert , Deceased Social Security No. 189091030
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 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 Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory, lANe
verify that the statements made in this inventory are true and correct, lANe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: Jan L Brown Esquire Etalena F Bard
LB. No.: 67993
Address: 845 Sir Thomas Court Suite 12 Dated 5/18/04
Harrisburq PA 17109
Telephone: 717-541-5550
Description ::r~lue
Wachovia Bank; Checking Account 1100001270518 r.,) 22,783.55
Wachovia Bank; Money Market 1010084089861 ~. 234,791.48
Wachovia Bank; IRA 257410060272189 19,993.23
Estate of Kathryn R Wilbert, beneficiary
United States Treasury; Social Security benefit check 1,183.00
HCR Manor Care; personal care account refund 341.63
Verizon; refund 4.81
Total
281,097.70
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
Wilbert Kathryn R 2004 00238
Page 1
Description of Inventory
Description Value
Prudential Financial; group life insurance death benefit 2,000.00
Estate of Kathryn R Wilbert, beneficiary
Subtotal $ 2,000.00
Grand Total $ 281,097.70
LAST WILL AND TESTAMENT
OF
KATHRYN R. WILBERT
I, KATHRYN R. WILBERT, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement fi'om any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of ~anY property over which I have the power
of appointment. ':'"
Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 days of
the probate of my will. Gifts may only be to persons who survive me or to organizations which exist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
I give the sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) to my good friend,
ETALENA F. BARD, of Cumberland County, Pennsylvania, in recognition of many instances
of her kindness and assistance over the past several years. If, however, my friend, ETALENA F.
BARD, fails to survive me, this gift to her shall lapse and become part of my residuary estate.
Article V
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN EQUAL SHARES to: my brother-in-law, E. RAY
GOTTSHALL, of Pompano Beach, Florida, and my nieces: JANET E. BLOMGREN,
KATHRYN E. COLLMAN, LORI E. GOTTSHALL, SUSAN J. WELLNER, and NANCY J.
WILLIAMSON. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days,
I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or
she has no issue, the share(s) are to be added equally to the other shares.
Article VI
I nominate, constitute, and appoint my fi-lend, ETA_LENA F. BARD as Executrix of my
Last Will and Testament. In the event of the renunciation, death, or inability to act, for any
reason whatsoever of my Executrix, I nominate, constitute and appoint my attorney, JAN L.
BROWN of JAN L. BROWN & ASSOCIATES, or its successors, or an attorney of Jan L.
Brown & Associates, or its successors, currently of 845 Sir Thomas Court, Suite 12,
Harrisburg, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my
Executrix or successor Executor be permitted to serve without bond and in addition to those
powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike
shares and to file any qualified disclaimer I could have filed if living. My Executrix or successor
Executor shall receive reasonable compensation for services rendered to my estate.
Article VII
In addition to the powers conferred by law, I authorize my Executrix and successor Executor,
in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
-3-
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
IN WITNESS WHEREOF, I, KATHRYN R. WILBERT, hereby set my hand to this my
Last Will and Testament, on ~ ~.,~\~- ~1~ ~ ~JO~ 2003, at Harrisburg, Pennsylvania.
KATHRY~ R. WILBERT
In our presence, the above-named KATHRYN R. WILBERT signed this and declared this
to be her Last Will and Testament and now at her request, in her presence, and in the presence of
each other, we sign as witnesses.
Name Address
-4-
I, KATHRYN R. WILBERT, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my Will,
and that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
KATHRYN R. WlLBERT, the Testatrix
on L/- / 7 2003.
KATHRY~ R. WILBERT
/"lqroXt~ Ph~lic '
! M~ COMMISSION EXPIR~ MARCH 4, 2006
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
and -/:~o.~/,2 2{'). /O-rc/~, Wi-t~es-s--' .....
witnesses, on ~'/'-/7 ,2003. "~/-~C/2." ~J, ~
~ ~-4~,~0~2 . Witness
-5-
II'lillililll'ili[ "
& ASSOCIATES
UNSELORS AT LAW
.ISH GAP
;OURT, SUITE 12
,~A 17109
}urthouse
COHNONNEALTH OF PENNSYLVANIA ~.. ~k ,~
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISIOH
DEPT. ZBO601 NOTICE OF INHERITANCE TAX
HARRISBURG, PA 171Z&-O601
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX REV-I;47EXAFP(01-O$)
DATE 07-05-200q
ESTATE OF NZLBERT KATHRYN R
DATE OF DEATH 05-02-200q
FILE NUHBER 21 0~-0Z$8
*i~.~ ,~!_ _~ ~.. COUNTY CUHBERLAND
JAN L BRONN ESQ ACM 101
J L BRO~N & ASSOCS Aeoun~ Roei~od ]
8~5 SIR THOHAS CT 1~ '
I
HBG PA ~?!09
MAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOgA~-~-~-~ ................. DZSALLOgANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF NILBERT KATHRYN R FILE NO. 21 0~-0258 ACN 101 DATE 07-05-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A] (1) .00 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2) .OiO crodi~ ~o your account,
$. Closely Hold S~ock/Par~nership In~eros~ (Schedule C) ($) .OiO subei~ ~he upper portion
q. Mortgages/No'as Receivable (Schedule D) (q) .00 of ~his form wi~h your
5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (E) 279;097.7,0 ~ax payment.
6. Jointly Owned Propor~y (Schedule F) (6) .OiO
7. Transfers (Schedule G) (7} .00
8. To,al Asso~s (8) 279,097.70
APPROVED DEDUCTZONS AND EXENPTZONS: Z8,826.56
9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Dobbs/Mortgage Liabili~ies/Lions (Schedule I) (10) 1,9Z$.L6
11. To,al Deductions (11) S0.7q9.72
12. Ne~ Value of Tax Re~urn (12} Zq8,$~7.98
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
lq. No~ Value of Es(a(o Sub~ec~ ~o Tax (=lq) Zq8,$q7.98
NOTE: Z~ an assessment was issued previously, 11nos 14, 15 and/or 16, 17, 18 and 19 w111
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amoun~ of Line lq a~ Spousal ra~o (15) .00 X O0 = .00
16. Amoun~ of Line lq ~axablo a~ Lineal/Class A ra~a (16) . O0 X 0~5 = . O0
17. Amount of Line lq a~ Sibling rata (17) 38,891.53 x 12 = q,666.96
18. Aeoun~ of Line lq taxable at Collateral/Class B ra~o (18) 209,q56.65 x 15 = $1,q18.50
19. Princi ~al Tax Duo (19)= $6,085. q6
TAX CREDITS
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
O5-19-ZOOq CD005960 1,80~.27 Sq,Z81.2q
TOTAL TAX CREDIT I 36,085.51
BALANCE OF TAX DUEl .05CA
INTEREST AND PEN. . O0
TOTAL DUE .05CA
IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UZRED.
FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CA), YOU NAY BE DUE
SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.)~F41~
A
REFUND.
RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coeaenmaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laaful Class D (collateral) rate on any such future interest,
PURPOSE OF
NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S.
Section 91q0).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS~ AGENT
REFUND (CR): A refund of a tax credit, ehich ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office
of the Register of Rills, any of the Z3 Revenue District Offices, or by calling the special Iq-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-~7-30Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shomn on this Notice must object eithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZB1021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CDRRECTIONS: Factual errors discovered on this assessment should be addressed in ~riting to: PA Department of Revenue,
Bureau of Individual Texas, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA 17128-0601
Phone (717} ?87-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501} for an axplanatlon of administratively correctable errors.
DISCOUNT: If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 15Z 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 non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent per annum calculated at a daily rate of .00016~. AIl taxes mhich became delinquent on and after
January 1, 1982 mill bear interest at a rate which mill vary free calendar year to calendar year eith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rata Factor Year Rate Factor
~ 20Z .O005qB 1988-1991 11Z .000301 ~ 9Z .O00Z~7
1963 16Z .000q38 1992 gZ .O00Zq7 ZOOZ 6Z .00016q
198q 112 .000301 1993-199q 7Z .00019Z ZOO3 52 .000137
1985 152 .000356 1995-1998 9X .O00Zq7 ZOOq q2 .000110
1986 lOX .O00ZTq 1999 7Z .O0019Z
1987 lOX .O00ZTq ZOOO 7Z .00019Z
--Interest is calculatad as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on tho
Notice, additional interest must be calculated.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF KATHRYN R. WILBERT, DECEASED
FILE NO. 2004-00238
FAMILY AGREEMENT AND FINAL RELEASE
THIS AGREEMENT by and between ETALENA F. BARD, as Executrix of the Estate
of KATHRYN R. WILBERT, Deceased, and ETALENA F. BARD, E. RAY GOTTSHALL,
JANET G. BLOMGREN~ KATHRYN COLLMAN, LORI GOTTSHALL, SUSAN JAYNE
WELLNER and NANCY J. WILLIAMSON, individually.
WHEREAS, KATHRYN R. WILBERT, late of Camp Hill Borough, Cumberland
County, Pennsylvania, died testate on March 2, 2004, having first made her Last Will and
Testament dated April 17, 2003, which instrument was admitted to probate and is recorded in
Cumberland County Courthouse, Register of Wills, File No. 2004-00238;
WHEREAS, ETALENA F. BARD has been duly appointed as Executrix of the Estate of
Kathryn R. Wilbert, Deceased; and
WHEREAS, the parties in interest under the Last Will and Testament of Kathryn R.
Wilbert, Deceased, are:
1. Etalena F. Bard, friend;
2. E. Ray Gottshall, brother-in-law;
3. Janet G. Blomgren, niece; .
4. Kathryn Collman, niece;
5. Loft Gottshall, niece;
6. Susan Jayne Wellner, niece; and
7. Nancy J. Williamson, niece.
Page I ofl0
WHEREAS, ETALENA F. BARD is entitled to a specific bequest of FIFTEEN
THOUSAND DOLLARS ($15,000);
WHEREAS, E. RAY GOTTSHALL, JANET G. BLOMGREN, KATHRYN
COLLMAN, LORI GOTTSHALL, SUSAN JAYNE WELLNER and NANCY J.
WILLIAMSON are each entitled to one-sixth (1/6) of the residuary estate;
WHEREAS, each of the parties to this Agreement have been furnished with a complete
listing of the estate assets, receipts and disbursements as set forth on the Statement of Account as
attached hereto and marked as Exhibit A;
WHEREAS, it is the desire of the parties to this Agreement that final distribution of this
estate be accomplished without a formal accounting to the Orphans' Court Division of the Court
of Common Pleas of Cumberland County, it being the desire of the parties to avoid the expense,
delay and publicity of a formal accounting;
WHEREAS, the parties to this Agreement each acknowledge to have received a proposed
Schedule of Distribution attached hereto and marked as Exhibit A.
NOW, THEREFORE, WITNESSETH, in consideration of the mutual promises,
covenants and agreements recited herein, the parties do agree as follows:
1. Each of the parties to this Agreement does hereby release and forever discharge
the said Executrix, ETALENA F. BARD, her heirs, executors, administrators and assigns,
JAN L. BROWN & ASSOCIATES, attorneys at law, and JAN L. BROWN, ESQUIRE from
any and all liability which may from time to time arise in connection with their service as
Executrix and Attorneys of the Estate ofKathryn R. Wilbert, Deceased. The parties do further
Page 2 of 10
agree to indemnify and hold them harmless from any and all liability which may arise against the
estate from creditors or claimants.
2. Each of the parties does hereby acknowledge receipt of the assets described on the
Schedule of Distribution attached hereto.
3. Each of the parties acknowledges that this Agreement shaI1 be indexed and
recorded in the estate proceedings and that the terms hereof shall be binding upon their respective
heirs, successors, administrators and assigns.
4. Each of the parties do further agree with each other and the aforesaid Executrix
that should any liability come due to the estate of the said decedent after the signing of this
Agreement, each will contribute pro rata his/her share of the estate to satisfy any and all claims,
demands, suits or causes of action which may be successfully prosecuted against the said estate
or the aforesaid Executrix after the signing, sealing and delivery of this Agreement.
5. This Agreement shall be governed by the laws of the Commonwealth of
Pennsylvania.
Page 3 of 10
1N WITNESS WHEREOF, I have hereunto set my hand and seal this ~__~ day of
k/ZTZ~,-~' ,2004.
WITNESS:
ETA~-ENA F. BA~, Executrix and Beneficia~
COMMONWEALTH OF PENNSYLVANIA :
SS:
COUNTY OF DA-I3P~~~~i
On this the ~ day of ,,.~z:-- z>~ ,2004 before me, a Notary
Public, the undersigned officer, personally appeared ETALENA F. BARD, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknoxvledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
ta~y'Pul~lic , ' ,
-- ~, : ' ~-;:Eh ho!ayPubc [
Page 4 of 10
IN V~ ITNESS WHEREOF, I have hereunto set my hand and seal this ~ daF' of
~ L y ,2004,
/
WITNESS:
E. RAY ~,GOT2'SH-ALL, BerJeficiary
STATE OF FLORIDA
SS:
COUNTY OF ,<z5:'~-¢
On this the ~4~.] day of _.~ ~-?' ,2004 before me, a Notary-
Public, the undersigned officer, personally appeared E. RAY GOTTSHALL, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purposes therein contained.
1N WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
Page 5 of' l 0
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,~7-~ _ day of
.4 ' ,2004.
WITNESS:
J~'4ET G. BLOMGREN, B~eficiary
STATE OF FLORIDA
SS:
COUNTY OF ~ ~-~
On this the /r?2 < day of ,-_5 ' '-/ ,2004 before me, a Notary
Public, the undersigned officer, personally appeared JANET G. BLOMGREN, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
iN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
Page 6 of I 0
IN WITNESS WHEREOF, I have hereunto set my hand and seal this "'~
.-~ ~ day of
.... ~ '/ ,2004.
WITNESS:
~THR~COLLMAN, Beneficia~
STATE OF FLORIDA
SS:
COUNTY OF
On this the ~-.'~< day of ,~v ~ ' ~ , 2004 before me, a Notary
Public, the undersigned officer, personally appeared KATHRYN COLLMAN, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
iN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
r- ~ - STANLEY S. ~'~'IS'hlEWSK[
Page 7 of 10
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~z · day of
WITNESS:
(~ /~ LORI GOTTSHALL, Beneficiary
STATE OF FLORIDA
. _~ SS:
COUNTY OF i~.t_~-4 e~
On this the .2' / day of ,2004 before me, a Notary
Public, the undersigned officer, personally appeared LORI GOTTSHALL, known?~o~_e or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Page 8 of 10
,~ t"~
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ ~ day of
~30 ~ x/ 2004.
WITNESS: / -
^
/ SUSAN J ~A/~ W'~LLNER, Beneficiary
STATE OF'FLORIDA~ tBhG%dC qk6c?~ % :
: SS:
COUNTY OF gC )c~h3 ~' ?_7%~ :
On this the ~'2 '~'- day of '-}U ~ "/ ,2004 before me, a Notary
Public, the undersigned officer, personally appeared SUSAN JAYNE WELLNER, known to me
or satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Page 9 of 10
1N WITNESS WHEREOF, I have hereunto set my hand and seal this ,'2._fl R(~ day of
~ ~ , 2004.
WITNESS:
~ ~v ........ N~2qCY J.~VILL[~kMSON, Beneficiary
STATE OF DI~h~A
SS:
COUNTY OF/'~A/eOC~/
Onthisthe ,_7P'd dayof ~a~7~,£/' , 2004 before me, aNotary
Public, the undersigned officer, personally appeared NANCY J. WILLIAMSON, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
1N WITNESS WHEREOF, I hereunto set my hand and official seal.
ROBERT B. HOLLISTER
Notary Public, State of
:~erpelual Commission ORC 147.03
Page 10 of 10
STATEMENT OF ACCOUNT
OF THE ESTATE OF KATHRYN R. WILBERT
Personal Property
Wachovia Bank Checking 1100001270518 $22,783.55
Wachovia Bank Money Market 1010084089861 $234,791.48
Wachovia Bank IRA 257410060272189 $19,993.23
US Treasury; Social Security benefit check $1,183.00
Prudential Financial; life insurance death benefit $2,000.00
Reimbursements/refunds $371.81
Total Probate Property $281,123.07
Income earned since date of death
Interest income as of 7/22/04 $850.61
Total Income $850.61
Expenses
Funeral -$25.00
Legal fee; Jan L Brown -$16,746.00
Administrative costs -$12,055.56
Debts of decedent -$1,923.16
Inheritance Tax -$34,281.24
Reserve for income tax and additional obligations -$1,542.72
Total Expenses -$66,573.68
Net Available for Distribution $215,400.00
8/17/2004 Exhibit A, Page 1
DISTRIBUTION TO BENEFICIARIES
ACCORDING TO TERMS OF WILL*
Etalena F. Bard, friend
Specific bequest; cash distribution $15,000.00
E. Ray Gottshall, brother-in-law, 1/6 residue
Cash distribution $33,400.00
Janet G. Blomgren, niece, 1/6 residue
Cash distribution $33,400.00
Kathryn Collman, niece, 1/6 residue
Cash distribution $33,400.00
Lori Gottshall, niece, 1/6 residue
Cash distribution $33,400.00
Susan Jayne Wellner, niece, 1/6 residue
Cash distribution $33,400.00
Nancy J. Williamson, niece, 1/6 residue
Cash distribution $33,400.00
Total Distribution $215,400.00
*Actual cash distribution may be increased or decreased based on interest accrued, market value of assets,
presentation of an obligation and/or payment of additional charges. Reserve will be distributed equally
between the residuary heirs after final payment of all obligations. After final distribution is made, the
beneficiaries agree to reimburse the personal representative if called upon to pay further liabilities of the
decedent in the future.
8/17/2004 Exhibit A, Page 2
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Wilbert Kathryn R
Date of Death: 3/2/2004
Will No. 2004-00238
Admin. No.
Pursuant to Rule 6. 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate :
1 . State 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.
account with the Court?
Did the personal representative file a final
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 informal accounts may be filed with the
Clerk of the Orphans' Court and may be attached to this report.
Date: 3/17/2005
Signarureft:.g ~
Jan L Brown Esauire
Name (Please type or print)
845 Sir Thomas Court Suite 12
Harrisbura PA 17109
Address
(717 ) 541- 5550
Tel. No .
Capacity :
Personal Representative
X
Counsel for personal
representative
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