HomeMy WebLinkAbout02-1040PETITION F(~R PROBATE
_ ~Uz
Estate of ~-ac~+z.~ ~.~. ~T~c'~r~`'~-~
also known as
Deceased.
Social Security No. r -' ~ ~ ' S~`7~ ~°
Register of Wills for the
County of ~ ~~~~"""~ in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an thg,exe ~ ~t 'r' ~ 19named
in the last will of the above de~e,~lent, dated ~~%'~"~ `l
and codicil(s) dated ~(V #'s
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cy ''`"SO'~`~ County Pennsylvania, with
h~ last family or principal residence at l~:i ~ ~ o~ '~r>.~
C'o,'r l ~~ ~-~ 1'~ c ~3 t c~tvsuv~
(list street, number andm~uncipality)
Decendent, then -6--t~- years of age, died '~ ``ti"~"`'-~- t ~' ~ `°~ 2e'`~
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned praperty with estimated values as fallows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: 1 ~ ~" ' C~ k ~'' ~~
~ .s ~ lac 13
WHEREFORE, petitioner(s) respectfully reggest(s th~ro ate y the last will and codicil(s)
presented herewith and the grant of letters -tom
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
N
~ 1 JN
~ N
~ ~ ~ ~ ~ w-
b o t1us~: v ~ ~~~ Q/~- ~7 2~~
~~
ha
v ~..
~ o
C
b0
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~'~'"~~'JZ~~O""`~
83
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to tine best of the krtowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above d~cedent p~;titioner(s) will well and truly administer the estate according to law.
Sworn to or affirm d subscribed
before me this _ X20}'^ day of
NOVEA~IBER -}9 ~~~
(l,~~Q Register
njd~l ~.Qt.~~,v-
and GRANT OF LETTERS
No. 2~-~oL- I~yo
To:
aa-t,~~i.2_, rl .1 v~
---~ A
i;
~o
t ~ _ i~ ~_ ~
No. ~1-O a.• 10~-~C7
,~<
Estate of E-~z ~ k~ ~` `~~~°"~- ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW NOVEMBER 21 , 2 0 0 2 ~9'~t?GZ.r in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~u`i°-- ~ + 1~1~s
described therein be admitted to p~R~~te and filed of record as the last will of
~~ ~A ~ct~~~~~ x r ~~ ;
and Letters ~ -mss ,~.~- ~ P.
are hereby granted to ~ ~ ~~
FEES
Probate, Letters, Etc.......... $ 2 7 0 .0 0
Short Certificates $ 21.0 0
~~rlirY~i#t~tx extra pag a s$ 66 ~. ~0 ~0
~ cp $~IIIJ
TOTAL $ 307.00
Filed , 11-21-2002
'r'al'Ied' 'at'ty' 'll'=2'I=20172' '
Register of Wills , , „ Q , ~
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
t~1~)s It t:> ~ rifi° that tip IsIL~;,rmation here gi~cl~ is correctly copies; ro;l~ 'tT
i.oL =1 fief; t)ar. The oti~,ln~:i certificate will b~ fi>I-~n~arded to the ~t,ttc Viral RecorislOftlicf for pru~rru~~r~(~i1irl~l• ~ ti~ir!' )~)e as
WARNING: It is illegal to duplicate this copy by photostat or photograph.
i"c~ fvr thi.; ~Lrt~tictte, k.2.U0 ~. j
- /I,I~~p1.SH Of PFD, ,~ ~=..~o~.~¢ ~. ~~;~a.~C,~ .
/,,,,o~~ y~~. -_
~~, x ~~~`' _ as
------P_- 8 7 0 3 7 8 5 ~~.~q~ ~~~:
--~._, ~f~~'' ` _~ V _l 1 2002
~:~.It
N f os.,u RaY. ve7
COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
NT CERTIFICATE OF DEATH
-NT NAME OF DECEDENT IF Vi. Malge, Lath -"'-------~--...--._
IK ' Ethel -- STATE aKE NLNABER
K . Erickson SEX SOCIAL SECURITY NVMBER
AGE (Lm BvmOay) UNDER, YEAR UNDER 1 DA' , e m a 1 e 19 9 - 3 2 - 5 782 DATE OF DEATH iMpim. ~'~-~
Morana Day. Ayrl
8 0 Dana /faAa I MMnAN !MOnmT~n~Q (7.y~N $I.N a FP aa~E~IJ~CM~anrytl~7 PLACE OF pEdN ICI~I, I., O V e m b @ T 1 0, 2 002
O Yv. Dec ..L V191 11``11, NDSPIULQ vw Me-,M,rpl,u<Yimaon anerabsl
~- I Manada i DEC D~
COUNTY OF DEATN ' •. T. Penna . InOat""' EaDw.lyM
I - CRY BORO. TWP OF DEATH FACK.ITY NAME IO ^er xunnxron, ~ N0^1e Readence ^ DIIMr
Cumberland Carlisl@ SneSUe«andna,,,a„ SP•~ayl^
• " Thornwald Home "~ CEDENT OF HISPANK; ORIGIN7 RACE-A
DECEDENT'S USUAL DCCVPATgN « man moan. B4gr. Wnee, stc,
W. ~ YYe ~ 0 ye., Cutyn ISpecly
IGwyli«d of vrdM ~Ory ~!!~rrroi KIND OF SUSINESSANDUSTRY NNg DECEDENT EVER IN •Pliry Rlr;an,aMp.~~ ' Wh t
edJ U.S.ARMEDF S7
«~~'~~~~ 'eor DECEDENT'S EDUCATION ' MµIULSTATU3- f0. 1 e
- „Music teac~ier Wes ~~~° ~choLpn,ls
e 5 e r U n 1 v e T 1 t'y ~~ Ey"yn'a'~"g't"^Gry ~colNy; "~ Mar'"d• suRVIYK+G SPOUSE
°ECE°E'^tt M"k"{A~E$sl5n.«.D '_• ,~. ~'~ 6+ o-.us.l Dlwro.a lspec.Y1 IK•a. oa. m.ur, rym«
13 wes aKwoo~"'.zgD°°" DECEDENT'S Widow _
rive ACTUAL „a•gray ennsy vanla "•
Carlisle, Penna• 17013 ~:~.~„ "-
~. ,Ta. Y....~...,,,ea.. ou 1 e on
'• onoeyraafe, Cumberland "'
FATItEH'$ NAME IF.i, M~dtDe. Lail 17D, top.
1piM^~T W, dace0are aaed
f0. L~J 170. uIIflMt attyi
wFDRMANT S NAME (1 O1S e S H • K e 11 e r MOTHER'S NAME IFv aaNn Surname ~~ w
~~~ian Bashore ""'°°°'
,,,• Louise K. Frantz "•
INFORMANT'~{""' ~sIStreelGy Road Newville Pc
METNDDOF DISPDSIT ,,,.13 ^Cst~aKwoo ~+°r°p°°"'
::°ori1on~ ~p„n,,,q„^ DATEDFOISrosInoN _ ~Tlve, Carlisle, Pq, 1 13
Rerrygt Man Slue ^ IMaKn, aY. y«I or OIMrE DMx M'. Crem«py
~ November 14 2002 ~ ~a~rp nn ~Dir'p e":~""•aPD°0e
SIGaJRURE UNEgAL SERVICE LICENSEE oR Rsan E,M. T M em a r 1 a ~ ~a T R
':p"'~"~S'~N ~'e' ~umber~and County, Penna
MYaerti °iMY.rtyn andyirg Tom. d LCY i'14(~°i~'`p L. fl`4"rs s~3 o~tJ1t an ov r @
aYaaaMle at «rIe «Gam y my anw~am ocwrree a IM 1xry, ane and a r 11 S J. e P
~r adeam. aroTia~ wx.ialed. @nnS lVan1Q@1 Ol
1 •,~ ~~ ~~~ LICENSE NUMBER
M«na TA•a0 mu,t W mmpala0 OY ~' DATE SIGNED
• ~~~Dronolareeade«n. EOFpEATN YlM. ~Na a5 L ~ i~v'~ to aao
DATE PRONOU ~ pEAD (MOnm. aY. ~«)
t7. PART 1: EmMIM M V ~~ t"dS CASE REFERRED TO MEDICAL EXAMINE(LCOgONEgT
diYaeea, "Murya a corrpMCatrory vrnich L'' n'
Li4 oMy ens cruse on eaM ary. oases IM Gam. Do nv eva IM moG of dttinO, auto u cardix 70. Ne ^
reapeatory ane«. sfwcs a neon saws. NO
iIYEgATE CAUSE (Fvyl r Approapnate
deeesvtvpapn ~(.(Gt'C ~// ~iM«vY G«waan PART N: OIMra'WfOCaM OprlgCVy
res„«gnownl-~ i~•f~/~ Iertaet ane G.m "°Ir'«wirw^m.IwG,yM,y~nrw~P,«,I°°w^PAar~l.
a DUE Ip AC WENCE OF): r
e m e. ~~/7ttLv
G~1AF ~UNDEIILTFNO DUE TOpJRA ACONSEOUENCE OF): i /,
_ __ aawy ~ L,~ y
rat~'gn IdwrL.AST o DUE OR><al ASACON$EOVENCE OF); I
I
d.
~~~SY WERE AUTOPSY FINDNa03 MANNER OF I
Aa1KABLE PRK7R 7D DEA7N // r
COMPLETK)N pF CAUSE ~ DATE OF IWURY TIME OFINJURY
OF DERN7 N«vY ~~ a lMOnm. Day. lpyl IWURYQ WpgKy pESCRIBE NOW INJURY OCCURRED.
N• ^ Na ALtaaery ~ Paryinp bneadgation
Yea ^ No ^ Suicide ~ qe ^ lao ^
Cauy np Ma Gtsrmuyd ~ ~' TOM.
~' tMe ~ E OF IWURY - Al fbme, farm, irNl, yQVy, ofnce M ~• ~Otl
cERTrIE1t Ien.rJ, a+r un« _'• +oMw. «~. Ispe~aYl LocAraN (stew. eayYroen,
70•.
'CERT,PYI„O PHYYSICIAN IPnyycyn ten S
TO ire aMrq rau3ed seam wfr«+anoM« OnvsKNn Ma avqurce0 Gam anO C ~' )
Heel W rnY MnOleledge, G.M eoourced dtN b me ewee(s) and m omp«eo Ilan Y31 SNiNAT
• annex as a1«ed ............ . . URE AN TI LE OF RTIFIER
'PRONOVNGN6 AND CERTIFVINO PHYSICIAN IPTyycon nam~ .•.• .•.•.•.••........ •. •. •••. •.....•. ~ ilM. ~~v
.. Teme Meat of mY 4rwwNdye, Gam xewne«tM Yoriouncug seam and<Md IIGEN /
' Ume, Gte, ary Ixe, and dw to the +uae(a) and m+Gnaner ae ««ed.......... MBER /J~ DATE SKJ
:. ///D NY !/,~~.. L NED IMmn. Dav. t-sr,
'MEDICAL E7IAMINER/COgONER P """'~~~~•~~-~ ^ afe. y
On LM Deaif ofeaaminatlon and/a invesllgation, Inm O NAME ANO ADDRES$pF PERSON Jf6 ~~ ~/ ~Z~
manner as atatw........... ptem 27) 7YPe v P IM WNO COMPLETED CAUSE DEAT
~L. Y pinio de«II occurred at Me Ilma, dal., and place, and tlue to Me ea x
........... .S'rtUC SS
................:............ u (al and ~ ?/N~ v ~SYtA'Aei.1 Cy
REGISTRAR'S SKiNATUR ••~•~•~~~ " " '• " " " " ~•~•~•~-.....,
UMBER /~ ~R • • ~ ~ ~ • ... .
v. ~'1• ~~1..U(~ u. ~/O G/ M~ Tsl7rq ~' C j G4Y~G~lI( T
,~, t _ r ^I DATE FILEDIMOnm. pay. yaan ~` r~ /td/J
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
LAW OFFICES
WILLOUGHBY.EVANS
ACCRED ff HOLLAND
P. 0. BOX 790
VlI LLCO%, ARIZONA 8$643
LAST WILL AND TESTAMENT
OF
ETHEL KELLER ERICKSON
~~- oa-- log-Icy
****** **********
KNOW ALL MEN BY THESE PRESENTS:
That I, ETHEL KELLER ERICKSON, of the County of Cochise, State of Arizona,
being over the age of eighteen years, and of sound and disposing mind and memory,
and not acting under duress, menace, fraud or undue influence of any person
whomsoever, do hereby make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me at any time heretofore
made.
FIRST
I declare that at the time of the execution of this Will, I am a widow;
that I have no children either natural born or adopted.
SECOND
I hereby direct the payment of all my just, unsecured debts, including,
but not limited to, funeral expenses and expenses of last illness, if any,
as soon after my decease as to my personal representative hereinbelow named
may seem proper.
THIRD
I hereby give and devise all of the property of whatsoever nature and
wheresoever situate which I may own or otherwise have the right to dispose of by
Will at the time of my death to FREDERICK S. FRANTZ and LOUISE K. FRANTZ, pres-
ently residing at 325 McClellan Drive, Pittsburg, Pennsylvania 15236, share and
share alike.
PAGE ONE
1
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
2
FOURTH
I hereby nominate and designate my sister LOUISE K. FRANTZ to be the
personal representative of my estate and direct that no bond be required of her
as such personal representative. Should she be unable or unqualified for any
reason to act as personal representative of my estate, then, and in that event,
I hereby nominate and designate FREDERICK S. FRANTZ to be the personal represen-
tative of my estate and direct that no bond be required of him as such personal
representative.
IN WITNESS WHEREOF, I, ETHEL KELLER ERICKSON, have hereunto set my hand
this _day of '~~
,,,, Wit, 1983.
~, //'' /~~ ~~ )
`ETHEL KELLER ERICKSON Testatrix
The foregoing instrument, consisting of three pages, the next included,
was on the day and date thereof signed by ETHEL KELLER ERICKSON, the above
named testatrix, in our presence and declared by her to us to be her Last Will
and Testament, and the execution thereof to be her free act and deed, and we
thereupon, at her request and in her presence and in the presence of each other,
signed our names thereto as witnesses to the said Will, and we hereby declare
that we believe the said ETHEL KELLER ERICKSON, at the time of the signing,
executing and acknowledging of the said Will, to be of sound mind and memory
and that the same was her free act and deed.
Dated this day of 1983.
r
residing at Arizona;
'~ ,
.t.,.~ residing at~l.c ~~~ Arizona;
25 .....
26 .....
LAW OFFICES
WILLOUGHBY.EVANS
ACCRED & HOLLAND
P. 0. BOX 790
WILLCOX, ARIZONA 65643
PAGE TWO
lI
2
3
~I
4~
5
6
7
8,
9
10
11
12
13'
14
15
16
17
18
19
20
21
22
23
24
25
2E
LAW OFFICES
WILLOUGHBY. EVAN
ACCRED & HOLLANI
p, O. BOX 790
W ILLCOX. ARIZONA 8$64
STATE OF ARIZONA )
ss.
County of Cochise )
We, ETHEL KELLER ERICKSON, Lucie I. Mills and Marye Ann Thompson ,
the Testatrix and the witnesses, respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn, do hereby declare to
the undersigned authority that the Testatrix signed and executed the instrument
as her Last Will and Testament and that she had signed willingly, and that
she executed it as her free and voluntary act for the purposes therein expressed
and that each of the witnesses, in the presence of the Testatrix, signed the
Will as witnesses and that to the best of their knowledge the Testatrix was
at the time 18 or more years of age, of sound mind and was under no constraint
or undue influence.
~ ~ ~'~
~ ~~~~
WITNESS
SUBSCRIBED, SWORN TO and acknowledged before me by ETHEL KELLER ERICKSON,
the Testatrix, and subscribed and sworn to before me by Lucie z. Mills and
Marye Ann Thompson , witnesses, this 9th day of June 1983.
,~
Notary Public
My Commission Expires:
6/2/86
'II PAGE THREE
CEl RTIFICATION OF NOTICE UNDER RULE 5 6(al
Name of Decedent: ~` ~1~ \ ~~~~Q S` C ~ ~c~ Sd~.~
Date of Death: '' lliV ~O 2~%v ~
Will No. Admin. No. Z- ~ "" b ~ ~ v ~ ~ `~ ~
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~l1~rV ~- i ~ Zr~o Z
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
ll
Date: ~ 13 I `~ ~ `i---~`.J~~
Signature
Name ~c, b~ ~ ~--_ ~ ~~~~.
Address ~--~ c . 1 c- . -~-c~ C~--
C~-~~s~~ ~ ~ ~~~ ,
Telephone ( ) Z~~ ~i _~~~ ~
Capacity: Personal Representative
_~Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
O'BRIEN ROBERT L
17 W. SOUTH STREET
CARLISLE, PA 17013
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: ~ 99-32-5782
FILE NUMBER: 2102-1040
DECEDENT NAME: ERICKSON ETHEL KELLER
DATE OF PAYMENT: 08/08/2003
POSTMARK DATE: 00/00/0000
couNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 10/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 ~ 540,000.00
TOTAL AMOUNT PAID:
REMARKS: ROBERT O'BRIEN ESQUIRE
CHECK# 3474
SEAL
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
540,000.00
DEPUTY REGISTER OF WILLS
REV-1162 EX(11-961
NO. CD 002880
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601 INHERITANCE TAX
HARRISBURG, PA I7IZS-o6ol STATEMENT O F ACCOUNT
REY-1607 E% AFP (O1-OS)
'~_; f,. ~ 4 =. ~ i.
ROBERT L OBRIEN ESQ
OBRIEN ETAL
17 W SOUTH ST -
CARLISLE ~'q'17013
DATE 03-15-2004
ESTATE OF ERICKSON ETHEL K
DATE OF DEATH 11-10-2002
FILE NUMBER 21 02-1040
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _____________________
----------------------------------------------------
---------------------------------------
REV-1607 EX AFP (01-03) *~* INHERITANCE TAX STATEMENT OF ACCO ***
ESTATE OF ERICKSON ETHEL K FILE N0. 21 02-1040 ACN 101 DATE 03-15-2004
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-16-2004
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
33,591.44
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-08-2003 CD002880 .00 40,000.00
02-27-2004 REFUND .00 6,408.56-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
TOTAL DUE
33,591.44
.00
.00
.00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
SETTLEMENT AND FINAL RELEASE
IN
ESTATE OF ETHEL K. ERICKSON
..,11-C~-IG~4c~
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Ethel K.
Erickson, late of Carlisle, Pennsylvania, deceased, died testate
on November 10, 2002, having first made her last will and
testament, which was duly executed on June 9, 1983, and is duly
recorded in Cumberland County Register of Wills Estate No. 21-02-
1040;
WHEREAS, the said, Ethel K. Erickson, by the aforesaid last
will and testament, named Louise K. Frantz, as Executrix of said
last will and testament;
WHEREAS, letters testamentary on the estate of the said
decedent were duly issued on November 21, 2002 by the Register of
Wills of Cumberland, County, Pennsylvania, to the said Executrix,
hereinafter called personal representative.
WHEREAS, the personal representative has gathered the assets
of the estate of the said decedent and the assets consist of real
and personal property, to a total gross value of $316,527.53, as
set forth in Exhibit A, which is a statement of account, in the
form of the inheritance tax return, of the said personal
representatives, and which is attached hereto and made a part
hereof, and marked Exhibit A;
WHEREAS, the debts and deductions, including the payment of
inheritance tax in the said estate, amount to $70,190.23, leaving
a balance for distribution of $246,337.30.
WHEREAS, the balance for distribution as shown in the said
statement marked Exhibit A has been reduced to cash and has been
,~
or will be distributed as herein indicated in accordance with the
terms of the last will and testament of the said decedent;
NOW, THEREFORE, We, individually by the execution of this
Settlement and Final Release, as heirs under the last will and
testament, do hereby each of us, acknowledge that we have or will
receive upon delivery of this Settlement and Final Release, from
the aforesaid personal representative, in full satisfaction and
payment of all sum or sums of money, legacies, bequests, and
devises as are given, devised and bequeathed to each of us
respectively by the said last will and testament.
AND, each of us does hereby stipulate that in order to avoid
the expense and time involved in the filing of a formal account
and schedule of distribution, we each agree that no account is
necessary and we do hereby agree that we do consent to
distribution being made without the filing of an account and
schedule of distribution, the same to be with the same force and
effect as if they had been filed and confirmed by the Orphans'
Court Division of the Court of Pennsylvania, Cumberland County
Branch.
THEREFORE, we and each of us, do hereby remise, release
quitclaim and forever discharge the said personal representative,
heirs, executors, and administrators and assigns of and from the
said estate and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever for or by reason
thereof, or for any other use, matter, cause or thing whatsoever,
touching upon the estate of the said decedent, and each of us do
further hereby covenant and agree that should any liability come
due to the estate of the said decedent after the signing of this
agreement, we and each of us do hereby covenant and agree with
each other and the aforesaid personal representative, that we
will contribute pro-rata, our 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
personal representatives after the signing, sealing and delivery
of this family settlement agreement and final release.
IN WITNESS WHEREOF, we have hereunto set our hands and
seals, by individual execution of copies of this Settlement and
Release this, day of Q 2004.
WITNESS:
~'~~;.c~i_e-C ~~,c.~ J~~-x~,<7 =Jj~ ''~ l _ ~,t ~~ ( SEAL )
Frederick S. Frantz
~a.t.~f.L.~, ~.~-~~~ ~~ ~ ~~u~v' , ' ( SEAL )
~T
Louise K. Frantz
::\.I:~c oX ;i..,,,,
/7-10;;-5
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
C/
OFFIC:::,\,- :_;St: (\\~';
.~ COMMONWEALTH OF
- . PENNSYLVANIA
, 'lii8i' . DEPARTMENT OF REVENUE
'. DEPT 280601
. HARRISBURG, PA 17128-0601
~,
w
"'
x::$cn
"",,,,
w""
",00
,,"'''''
..",
..
..
FilE NUMBER
..2.L-..Q...2.. ~Q.....LrL_
COUl<l'{ COCE 'f't.lR ~L'\18ER
I-
Z
W
C
W
U
w
C
DECEDENT'S NAME (LAST FIRST AND MIDDLE INITIAL)
Erickson, Ethel K.
DATE OF DEATH (MM-DD-YEAR)
11 - 10 - 2002
SOCIA, SECURITY NUMBER
199 -
32 - 5782
DATE OF BIRTH (MM-OD-YEAR)
12 - 18 - 1913
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST FIRST AND MIDDLE INITIAL)
[X] 1. Orlgif\al Retum
o 4. Limited Estate
o 6. Decedent Died Testate iMa:n copy 01 \'r :'
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4'21. Future Interest Compromise (date of ceatM after 12-12-821
n 7. Decedent Maintained a Living Trust (AltaCl1 copy of Trust)
~
o 10. Spousal Poverty Credit {date of death betvoeen 12.3;-91 anc: 1.95,
o 3. Remainder Return :date o/deatn prior to 12-13-821
o 5 Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
Election to lax under Sec. 9113(A) IA:tacll Scr C'
"'
Z
W
o
Z
o
..
V>
W
'"
'"
o
"
THIS SECTION MUST BE COMPLETED_ ALL CORRESPQJIlDllNCl: AND CONFlbi;",
NAME nobert L. O'Br'en, Esqu're COMPLETE MAILING AODRESS
'" L L R<j>bert L. O'BrienL Esquire
o Brien, Baric & :::>cherer
17 West South Street
Carlisle, Pennsylvania 17013-3432
:noN SHOULD BE DIRECtED TO:
FIRM NAME {I/Applicable)
O'BRIEN, BARIC & SCHERER
TELEPHONE NUMBER
(717) 249-6873
1, Real Estate (Schedule A)
2, Slocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
170.449.80
229.80
.-'-:;jF'F-lC:\AL..USE"O~~ y
3. Closely Held Corporation, Partnership or Sole-Proprietorship
z
o
~
...J
~
!:::
a..
<(
U
w
D::
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. lotal Gross Assets (Iolallines '-7)
(B)
316,527.53
i
145,847.93
(6)
(7)
i
1____.____._
(9)
(10)
25,147.65
11,451.14
9. Funeral Expenses & Administrative Costs (Schedule Hl
10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & to)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election \0 tax has nol been
made (Schedule J)
(11)
(12)
(13)
36.598.79
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
279,928.74
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-'
~
a..
:i
o
u
><
~
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See, 9116 (a)(1.2)
x.O_ (15)
x.O_ (16)
x ,12 (17) 33,591.44
x .15 (18)
(19) 33,591.44
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
279,928.74
lB. Amount of Une 14 taxable at collateral rate
1~~iJe
CHE';K HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
20.1XJ
>,; BE SU'10ANS\YER~I,LQQl:~TJO.'
Decedent's Complete Address:
STREET ADDRESS 1 3 w t Oakwood Dr'
es ~ve
CITY
Carlisle
I STATE
PA
I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
33.591.44
Total Credits ( A + B + C ) (2)
40,000.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnleresUPenally ( 0 + E ) (3)
4. If line 2 is grealer than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
33,591.44
6,408.56
5. 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.
(5)
(SA)
B. Enter the tolal of line 5 + SA. ThIS is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
,. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ................"..... ................ ........ !Xl D
b. retain the right to designate who shall use the property transferred or its income; ... ....................................... 0 IX]
c. retain a reversionary interest; or.. ................................... ........................ ............................... ...... D IK]
d. receive the promise for life of either payments, benefits or care? .................... ........................ ...................... D IRl
2. If death occurred after December 12, 1982, did decedentlransfer property within one year of death
without receiving adequate consideration? .......................... .. .................. ........................ .. ............ [X] 0
3. Did decedenl own an "in trust fo( or payable upon death bank account or security at his or her death?.. .......... 0 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .........Life...lnsur.ance. .......................... [X] 0
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 pe~ury, I declare that I have examined this return, including accompanying schedules and statemer,ts, arid to lI1e best of my krlowledge arid belief, it is true, correct
and complete
Declaration of preparer other than the persorlal represerltative is based on all information 01 which pre parer has any knowledge
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
ADDRESS
N REPRESENTATiVE
--v-
DATE
(7-
\l
~ ~\,,,>\z. YA 'I.'()\"~
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 survivin9 spouse is 0% [72 P.S. ~9116 (a) (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
the surviving spouse is the only beneficiary.
For dates of death on or after July " 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 paren
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings Is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined. under Section 9102, as a
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV.1502 EX+ 112.85j
'*
SCHEDULE A
REAL ESTATE
ESTATE OF
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DeCEDENT
FILE NUMBER
Ethel K. Erickson
21 - 02 - 1040
(Property jointly-owned with Right of Survivorship must be di.closed on Schedule F) All real e.tate should b. reported at fair market value
which I. defined as the price at which property would be exchang.d betw.en a willing buyer and 0 wilting ,en.r, neith.r being comp.lI.d
to buy or ..11, both having reasonClbl. knowl.dge of the relevant facts.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
1 3 West Oakwood Drive
Carlisle, Pennsylvania 17013
170,449.80
"
TOTAL (Also enter on line 1, Recapitulation)
S 170,449.80
....~"'.I''".
COMMONWEAlTH OF PENNSYlVAN~
INHERITANCE TAX RETURN
RESlOENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
Ethel K. Erickson
21 - 02 - 1040
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Echo Bay Mines Ltd.
229.80
TOTAL (Also enteron line 2, Recapitulation) $
llf more space is needed, insert additionai sheels of the same size)
229.80
REV-1508 EX. (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Ethel K. Erickson
FILE NUMBER
21 - 02 - 1040
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
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Currency - silver coins circulated
Rare coins
3,050.00
24,000.00
CD orrstown Bank #5060069477
12,146.05
CD Farmers National Bank of Kittanning #17696
12,218.42
9,073.30
CD Ephrata National Bank #740923
Apollo Trust Company CEl #60435
M&T #31003910179596
M&T #1152130
14,829.72
9,578.14
4,044.58
Cash
135.00
Auction proceeds from home furnishings
7,883.00
Furnishings taken by Mrs. Frantz
1,933.00
American Century
36,956.72
Steinway piano
10,000.00
TOTAL (Also enler on line 5, Recapilulation) $ 145,847.93
(If more space is needed, insert additional sheets of the same size)
'*'
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
,COMMONWEA1.TH Of PENNSYLV~lA
INHERITANCE TAX RETURN
SIDE CE NT
ESTATE OF
Ethel K. Erickson
FILE NUMBER
21 - 02 - 1040
This schedule must be oompleted and filed W the aJ1SWeIlD any of questions 11hlOll'lh 4 on the........ side of the REV-I500 COVER SHEET is yes,
DESCRIPTION Of PROPERTY '!.OF
ITEM INCl.tA:lEMJrIAolEClMTlWGFEAEE.netltEl.A~TQOlCElEKfUOM Il#ITiC#''l'RNISnR. DATE Of DEATH DECO'S EXCLUSION TAXABLE VALU
N"IMBER ATtA04Aeorr c# nc 0fED FOR llfJC. ESTAr&:. VALUE Of ASSET INTEREST
1. Jewelry and miscellaneous i terns of personal
property were given to Mr. and Mrs. Frantz
and Rachel Jones, their daughter, for equal
division among the three nieces and one 18,000.00 100% 18,000,0 0
nephew of Mrs. Erickson. Total value not
more than $12,000.00. Mr. and Mrs. Frantz
received i terns of personal property with a
total value of less than $6,000.00.
Iterns given October 31, 2002.
Mrs. Erickson also gave $1,050.00 to 1,050.00 100% 1,050.0 0
registered charities on Noven'her 7, 2002.
Mrs. Erickson had established charitable
annuities between 1980 and 1998. See 34,000.00 0% 34,OOO.Ol 0
attached list.
Northwestern Mutual Life Insurance policy
purchased May 31, 1988 and payable to Louise
K. Frantz, decedent's sister.
TOTAl (Also enteron line 7. Recapitulation) I $ 53.050.00
<If more space is needed, insert additional sheets of the same size)
~'~"~'l"n '*
~TH OF PENNSYlVANlA
INHERITANCE TAX RETURN
RE IDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Ethel K. Erickson
FILE NUMBER
21 - 02 - 1040
Debts of decedent must be reportad on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Floral arrangements 143.10
Ewing Brothers 7,380.00
Centerville Memorial Park 900.00
Eby Granite Works 873.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of PllISOllal Representative (s) Louise Frant7 6,000.00
-
Social Seanily Numbe~s) I EIN Number of Personal Representative(s
Street Address Lebanon Valley Home, 550 East Main street
City Annvi 11 p State PI>. Zip 1700,
Y..~s) Commission Paid: 2003
2. Ailomey Fees O'Brien, Baric & Scherer 8,163.94
3. Family Exemption: (If decedenfs address is nolllle same as c1aimanrs, attach explanation)
Claimant
Sttllet Address
City State Zip
Relationship of ClaimantlD Decedent
4. Probate Fees Register of Wills ($326) Advertising ($211.61) 537.61
5. Aa:ountanfs Fees
6. Tax Retum Prepare~s Fees Stott & stott 150.00
7. Reserve for additional probate, attorney and accountant fees. 1,000.00
TOT At (Also enter on line 9, Recapitulation) $ 25,147.65
(If more space is needed, insert additional sheets of the same size)
RfV.l51z,fX+ {7.891
&ti
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABLlTIES AND LIENS
Please Print ar Type
I FI~E NUMBER
.. 21 - 02 - 1040
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RErURN
IU:S1DENT DECEDENT
ESTATE OF
Ethel K. Erickson
ITEM
NUMBER
DESCRIPTION
AMOUNT
1. See attached list
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of same size.)
S 11,451.14
Date Payee Amount
11/25/02 Home Instead Senior Care $ 95.70
11/25/02 West Shore EMS $ 42.00
11/25/02 West Shore EMS $ 64.00
12124102 Rowe's Antiques $ 85.00
12/24/02 PharMerica $ 144.05
12/24/02 Charlotte Frantz - packing, shipping, organizing $ 989.57
12/24/02 United Church of Christ Homes $ 2,309.88
1/14/03 Wolfe & Shearer $ 250.00
1/29/03 RBC Ministries Trust $ 175.00
2/6/03 Fry's Carpentry $ 30.00
2/6/03 Home Instead Senior Care $ 334.95
2/20/03 Andrew Failor - snow removal $ 60.00
3/4/03 KA Mullen's - snow removal $ 65.00
4115103 Carolyn McQuellen - real estate taxes $ 386.02
5/28/03 Greentree Insurance Company $ 62.00
6/19/03 James Line Jewelers $ 50.00
7/24/03 Orrstown Bank $ 8.00
7/24/03 Lloyd's Home Inspection $ 175.00
8/7/03 Eichelberger's Inc. - make well water potable $ 858.60
914/03 Andrew Failor - snow removal $ 60.00
9/9/03 Paul Stone - roof repairs $ 125.00
9/30/03 Charlotte Frantz - prepare for public sale and reimburse for carpet $ 1,246.64
installation
10/15/03 DEW Septic Service $ 155.00
1 0/22/03 HOP warranty $ 425.00
10/23/03 Paul Stone - roof repairs $ 150.00
12/11/03 Cumberland/Goodwill $ 26.27
MetEd - Electric service from date of death to sale of residence $ 871.93
Culligan Water $ 34.32
Sprint - Phone service from date of death to sale of residence $ 433.10
Integrated Aiarm - Security system from date of death to sale of residence $ 716.00
Landscape Creations - lawn care from date of death to sale of residence $ 975.20
12/16/03 Register of Wills - Short Certificate $ 3.00
12/17/03 Carlisle Regional Medical Center $ 44.91
Total $ 11,451.14
rloIEstatesIErlctl:sonllnnerltancetax..attacnment
REV,'513EX~('-9T)
'*
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
I.
COMMONWEALTH OF PENNSYLVANIA
1NHERlT ANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 - 02 - 1040
Ethel K. Erickson
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OFEST ATE
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
Sister
Louise K. Frantz
550 East Main Street
Annville, Pennsylvania 17003
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)
North\W~tern
Mutual Lite'
LIFE INSURANCE ANNUAL POLICY STATEMENT
072
ETHEL K ERICKSON
13 W OAKWOOD DR
CARLISLE PA 17013
Insured Name:
Ethel K Erickson
Direct Beneficiary:
Louise K Frantz
All Information as of May 31, 1997
,..-..........-....-......-....................,...............-......-.-......-,...-...-...-.......-.-,-"-...-..........,....-.-,........-,..........-....,-.....,-..-,.,.,.---.,.....-...,.;."'''.;.'
'''.,'''''.
......rlJ\N;~y~~~~~~J~,J:NEfll~......... .................. ..........,
......,.........-...,-.-.-.....,',...,-.
.,.,..-.........,....-,...,...,...
.;-.._-_.;,;-.-;.,.;.".'''....,;,.,;,-.-",.;".,,;.;....
...-.-....,..........-.....,......;_._.
...--.....---.--....-...................
..........,........................,....
.,....,.,......,....-.-'.............,.
...........-....."". .,......
...--,...................,.....-,.......".....,......
.....,......,............".... -'
-.-----...-...-,-....-.......-....
.'..-.--.'....,..............,..,
.........,...,......'......,........
...-................."..--..---, .
--...-.................,.,...,...,.,..,...,."..
.......-.....-.-.......-......................
.!:..:l:\.;;.::!i:.:l;!!;.l:l;::!:~l!~!:~'
.......""...."----..,,
..--........................
................-.........
'--'''-'''''''.''-..
.....--.................
....................,..
''''''''','._.--,,''
.........-.....,....
'.."'"'~''''''''' .'.'.C"
.:.:: :'. :.: :::i__. ji~:!:~j!~:!i~!i~ili~rf~!~~~~l
!;H:;gglii;[\g;~;n;::gj::~[~y:!:;;;:g;~
Policy Number:
Plan:
Total Death Benefit:
10704126
Paid Up Life
$85,020.00
Policy Date:
Additional Benefits:
May 31, 1988
No Optional Benefits Included
Total Cash Value:
Dividend Used to:
Paid by check.
$61,683.71 Past Year's Cash Value Increase:
1997 Dividend:
$1,481.05
$1,953.76
For more information, contact:
Rulh H Kovich
307 Burley Ridge Rd
Manslield, PA 16933
(717) 662-2716
,'..,.,.,---------..._--..-,----...-.....,................
,.-,.-----..---..---------.,--..----......-...........,............""...
....~::e~~~~~~~o~:'h..
.. 'lor policyowners. Catl your a9,!,nl.;..
.. ;today for m<>re. info!i11Atio.n.;' . .. ..... ....
Turner Agency
Sle 200
100 Pine SI
Harrisburg PA 17101
(717)257-4100
.-_..--......-..,.....--",-,
....-.......,..--_...-.................-.......,
...........................-.......--..,.
. "".-."'.'
REFERTOTHE BACK OF THIS STATEMENT
FOR AN EXPLANATION OF TERMS
Get more information on how to plan tor your financial future at
httpJlwww.northwesternmutual.com/planning
Date Prepared: 0511 0/97
HlID -1 V'lFOR\l SETTLE.\IE"T ST A TBIE"T
OMB Approval No. 2502-0265
~f' US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT ST A TEMENT
TYPE OF LOAN 6. File Number: 7. Loan Number:
I. FHA 2. FmHA 356916 03-6120 065934357 8
3. Conv, Unins. 4. VA 5 Conv.lns. 8. Mortgage insurance Case Number
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. hems marked "(p_o.c.)"
v.ere paid outside [he closing; they are shown here for informational purposes and are not included in the totals
NOTE: TlN "" Taxna...er's rdentificatin" Number
D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS "'''D TIN OF SELLER: F. NAME AND ADDRESS OF LENDER
Steven L, Turner Estate of Ethel K, Erickson Washington Mutual Bank, FA
Lisa J. Turner by Louise Frantz, Executor 2000 Oxford Drive
813 N. Pitt Street 13 W, Oakwood Drive Bethel Park, PA 15102
Carlisle, PA 17013 Carlisle, PA 17013
.
G. PROPERTY LOCATION' H. SETTLEMENT AGENT NAME, ADDRESS AND TIN
13 W, Oakwood Drive PA RealEstate Settlement Service
Carlisle. PA 17013 10 West Pomfret Street Carlic::le PA 17013
I Parcel PLACE OF SETTLEMENT l. SETTLEMENT DATE
#08-10-0630-056 10 West Pomfret Street 10/15/2003
Carlisle PA 17013
J, SUMMARY OF BORROWER'S TR~NSACTION K. SUMMARY Of SELLER'S TR~NSACTIOi'i
100, GROSS AMOUNT DUE fROM BORROWER, 400. GROSS AMOUNT DUE TO SELLER:
, 101 , Contract sal~s nrice 185 000.00 40 I. Contract sales '"'rice 185 000,00
102 Personal Drooem 402. Personal orooertv
103. Sdtlement charlles to borrower (Une 1400 7 215.92 403.
104 404.
105. 405.
Ad' ustments for items aid b seller in advance Ad'uslments for item~id b~seller in advance
106. City/town taxes 406. Citvltown taxes
107. County taxes 10/15/2003 12/31/2003 81.90 407. County taxes 10/15/2003-12/31/2003 81.90
108. Assessments 408. Assessments
109. School Taxes 10 15 to 6 30 4 1 528.10 409. School Taxes 10 15 to 6/30T 1 528.10
110. 410.
III 411.
112. 412. .
120 GROSS AMOUNT DUE FROM BORROWER 193 825.92 420. GROSS AMOUNT DUE TO SELLER 186 610,00
200, AMOUNTS PAID BY OR IN BEHALf OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. De sit or earnest monev 1 000,00 501 Excess denosit
202 Princioal amountofn~w [oan(s 160 200,00 502. Settlement charoes to seller Line 1400' 15 120,20
20J Ex\stinll loan<s' taken subiect \0 503 Existin210anfs taken subj';;ct to
204. 504. Payoff of first morte:a e loan
205. 505. Pavoff of second mort2age loan
206 506.
207. 507.
208. Credi t for Dishwasher 300,00 508. Credit to Di hwasher 300.00
209 Credit for Radon 740.00 509. Credit for Radon 740,00
Adjustments for items un aid b seller Adjustments for items un'"'aid bv seller
210. Citv/to\-vll taxes 510. City/town taxes
2[ I County taxes 511. Coun'N taxes
212. Assessments 512. Assessments
213. 513
214 514.
215 515.
216. 516.
2[7. 517.
2[8. 518.
219 519
220. TOTAL PAID BYIFOR BORROWER 162 240.00 520. TOT AI. REDUCTION AMOUNT DUE SELLER 16 160.20
300, CASH AT SETTLEMENT FROMITO BORROWER
301 ross3mountduefrQmborrower Line 120
302 Less amount aid b /for borrower Line 220
303. CASH FROM BORROWER
193 825,92
162 240,00
31 585.92
600. CASH AT SETTLEMENT FROMrrO SELLER
601. Gross amounl' due to seller Line 420
602. Less reduction in amount due seller Line 520
603. CASH TO SELLER
186 610.00
16 160,20
170 449,80
SELLER'S STATEMENT
The information contained in Blocks E, G. H. and 1 and on line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being furnished to the
Internal Revenue Service (see Seller Certifica.tion). If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required
to be reported and the lRS determines that it has not been reported. You are required to provide the Senlement Agent with your correct taxpayer identification number. If you
do nol provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of
perjury, I certity that the number shown on this statement is my correct tax.payer identitication number.
(Seller's Signature)
Estate of Ethel K. Erickson
(Seller's Signature)
by Louise Frantz, Executor
C EASY SOFT, Inc 200! Previous editions are obsolete
Page I
form HUD.! (3/86) ref Handbook 4305.2
L. SETTLEMENT CHARGES
JH(SALESIBROKER',COMMISSIONbasedonnd" S 185000,00 . 6.000%
Division of Commission f1ine 700\ as follows'.
~575.00 to Wolfe and Shearer
;.~S 525.00 to Re/Max sterlincr Associates
J3. Commission naid at Settlement
10.
SOO.ITEMS PAy..BLE IN CONNECTION WITH LOAN
80 I Loan Oriszination Fee
802. Loan Discount 5
803 Annraisal Fee 10 Wa~hin(Jto'" MUT-ual Bank F'A
804 Credit renort to
805 Lender's Insneclion Fee
806. Denosit from Borrower
S07. pavrnent Process inn Fee t.o Washin(Jton Mutual
808 Fundinn and Review Fee to washinrrton Mutual
809. Tax Procurement ITrackinfT Fee to Transamerica
810 Tax Research-/Pa'~ent Service Fee to Washino Mutual FA
811 Flood Determination to Lereta Corn.
812. Wire Transfer Fee to Washinnton Mutual FA
Sl).
900. ITEMS REOlllRED BY LENDER TO BE PAID IN ADVANCE
901 Int~rest from 10/15/2003-10/3f"/2003 (a 528.200 ner da\J
902. Mortgage Insurance Premium for
903. I-Iazard insurance Premium for
904.
905
1000. RESERVES DEPOSITED WITH LENDER
lOOt Hazardinsuraf\ce 3 month s\ @ ~39.42 ner month
1002.Mort einsuranceS month's' ta ~32.17 Der month
1003. Cirv Prooertv Taxes
[004. Count\' Pronertv Taxes
1005. Annual assessments
1006. School Taxes 9 month's) Id $176.42 oer month
1007.
t008, Al1areaate Accountin.., Adjustment
1100. TITLE CHARGES
110 I. Settlemenl or c1osi~<i fee to
1102. Abstract or fIle search to
1103. Title Examination to
\ 104, Title insurance binder to
1105. Documenl renaration to
l t06. Notarv fees to Ann B. Sensenich
1107 Attornev'sfeestoO'Brien Baric and Scherer (POC)
(includes line numbers: 1101 1105
1108. Title Insurance to CTIC/PA Real Est.ate Settlement Services
(includes line numbers: 1101-1105
Lender's coveraae $ 160200. 00
Owner's covera"e S 185000.00
Endorsements: 100 300. 8.1
Conestoaa Title In urance Comoanv for CPL
PAID FROM
BORROWER'S
FUNDS AT
SETTLEMENT
PAID FROM
SELLER'S
FUNDS AT
SETTLEMENT
11 100.00
1 802.25
285.00
FA
FA
-295.00
200.00
330.00
50.00
31. 00
13 .00
35.00
479.40
118.26
160.85
1 587.78
-1 347.87
10.00
.' '''.-, '
1 283.75 l
. .'". .
10.00
Il09.
llIO.
llll.
1112.
III)
1200. GOVERNMENT RECORDING AND TRANSFER CHARr.[S
120 I. RecordiOll fees: Deed S 38 . 50 Mortllal2e .$
\202. Citv/cntv taxlslamns: r1eed $ 1 8 50.00 Mortll31?e S
1203. Slate taxlstamns: Deed $ 1 850. 00 Mortlil:al1e $
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
130 I. Survev to
1302. Pest insnection 10 Homechek
130). Carolvn Mc uillen - Tax C llector School Taxes at Face Value
1304 Homecheck for Water and Whole House Insnection
l3US Wire Transfer Fee to PA R~al Estate Settlement Services
1306.0verni ht Fee +"0 PA Real J:'.state Settlement Services
I-lOO. TOTAL SETTLEMENT CHARGES 'enter on lines 103 Section J and 502 Section K\
150.00
35.00
6 .50
Releasee
107.00
1 850.00
1 850.00
40.00
2 160.20
270.00
5.00
15.50
7 215.92 15 120.20
Seller
a J. Turner
ursed by the undersigned as part of the settlement of
Sdkr by Louise Frantz Bo owe
The HUD-l Settlement Statement which I have prepared is a true and accurate account ofthe funds disbursed or to
this transaction.
'-Pvt;~ '-7P ~-..-./
Selt[emef\t Agenl PA Rea lEs ta te Set t lernent Services Date
WARNING: It is a crime to knowingly make false statements 10 the United States on this or any other similar form.
imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
'0 EASY SOFT, Inc. 200[ Previous editions are obsolete Page 2
10/1512003
Penalties upon conviction can include a fine and
form HUD-I (3/86) ref Handbook 4305.2
Ethel Erickson
1) P.C. Friends of Israel Attn: Alison Gracely
P.O. Box 908
Bellmawr, NJ 08099 $5,000.00 4/24/98
2) American Bible Society
Patricia Samartano
1865 Broadway
New York, NY 10023-9980 $2,000.00 12/31/80
3) Prison Fellowship Ministries
1856 Old Reston Avenue
Reston, VA 20190-3321 $5,000.00 2/1/86
4) AMG International
6815 Shallowford Road
Chattanooga, TN 37421 $8,000.00 6/2/97
5) Radio Bible Class
Box 2222
Grand Rapids, MI 49555-0001 $5,000.00 7/26/83
6) Evangelical Ministries Inc. #841 $2,000.00 7/15/84
1716 Spruce Street #1027 2,000.00 7/15/84
Philadelphia, PA 19103 #1025 3,000.00 7/12/81
7) The Back to God Hour #80236-5
6555 West College Drive
Palos Heights, IL 60463 $2,000.00 12/1/80
rlo\Estates\Erickson\i nheritancetax.doc
Dec 19/2003 O'BRIEN, BARIC & SCHERER Page 1
Client Ledger
--~. ALL DATES
Date Received From/Paid To Chel General B1d Trust
Entry# Explanation Rcpt# Rcpts Disbs Fees Invlt Acc Rcpts Disbs Balance
2809 Erickson, Ethel
2809 Estate RLO - Rebert L. O'Brien
Oct 31/2002 Lawyer: RLO 2.50 Hrs X 125.00 312.50 10263
73239 Arrange for transport of Ethel to her
home so she can assist us with locating
items and transfering items to Rachael
who is visiting from Georgia.
Nov 1/2002 Ethel Erickson 01864 10263 1 2000.00 2000.00
72298 deposit
Nov 1/2002 Integrated Alarm Services 3031 10263 1 24.00 1976.00
72300 E Erickson
Nov 1/2002 Sprint 3032 10263 1 73.00 1903.00
72302 E Erickson
Nov 1/2002 Met Ed 3033 10263 1 55.99 1847.01
72304 E Erickson
Nov 5/2002 Lawyer: RLO 0.70 Hrs X 125.00 87.50 10263
73240 Meet appraiser at home to develope
value of home.
Nov 6/2002 Lawyer: RLO 2.25 Hr. X 125.00 281.25 10263
73237 Begin process of copying and moving
coin collection to sfe deposit box.
Nov 7/2002 RBe Ministries 3043 10263 1 50.00 1797.01
72694 donation
Nov 7/2002 African Enterprise 3044 10263 1 50.00 1747.01
72696 donation
Noy 7/2002 AMG International 3045 10263 1 50.00 1697.01
72698 donation
Nov 7/2002 Baptist Haiti Mission 3046 10263 1 50.00 1647.01
72700 donation
Nov 7/2002 American Bible Society 3047 10263 1 50.00 1597.01
72702 donation
Nov 7/2002 Bethesda Mission 3048 10263 1 50.00 1547.01
72704 donation
Nov 1/2002 Bible League 3049 10263 1 50.00 1497.01
72106 donation
Nov 7/2002 Friends Of The Alliance 3050 10263 1 50.00 1447.01
72708 donation
NoY 7/2002 Friends Of The Hour 3051 10263 1 50.00 1397.01
72710 donation
Nov 7/2002 The Friends Of Israel 3052 10263 1 50.00 1347.01
72712 donation
Nov 7/2002 Insight For Living 3053 10263 1 50.00 1297.01
72714 donation
Noy 7/2002 International Bible Society 3054 10263 1 50.00 1247.01
72716 donation
Noy 7/2002 The Jesus Film project 3055 10263 1 50.00 1197.01
72718 donation
Nov 7/2002 Jews For Jesus 3056 10263 1 50.00 1147.01
72720 donation
Nov 7/2002 Pacific Garden Mission 3057 10263 1 50.00 1097.01
72722 donation
Nov 7/2002 Prison Fellowship Ministries 3058 10263 1 50.00 1047.01
72124 donation
Nov 7/2002 Thru The Bible Radio 3059 10263 1 50.00 997.01
72726 donation
Nov 7/2002 Trans World Radio 3060 10263 50.00 947.01
72728 donation
Nov 7/2002 World Help 3061 10263 50.00 897.01
72730 donation
Nov 712002 RZIM 3062 10263 1 50.00 847.01
72732 donation
Nov 7/2002 Southwest Radio Church Ministries 3063 10263 1 50.00 797.01
72734 donation
Nov 7/2002 Lawyer: RLQ 1.00 Hrs X 125.00 125.00 10263
73238 Meet Mr. and Mrs. Frantz at Ethel's
home to continue copying and moving
coins to safe deposit box.
Nov 1312002 Expense Recovery 00316 4.44 10263
72735 postage
NoY 20/2002 Register of Wills 3068 10263 1 307.00 490.01
73037 filing fee
Nov 20/2002 Lawyer: RLO 2.00 Hrs X 125.00 250.00 10263
73241 Meeting at Ethel1s home to review
property and follow up with visit to
Register of wills to probate the estate.
Nov 22/2002 Lawyer: RLO 1.40 Hrs X 125.00 175.00 10263
73230 Meet with Charlotte and Mr. and Mrs.
D~; ROWE:~~~~~t
DOB . AU 2276L
R. D. 4, Box 353 · Carlisle, P A
249-2677 249-1978
Auction Is Action Call "ROWE"For Satisfaction
November 23, 2002
TO: Robert O'Brien
Attorney
17 West South Street
Carlisle, Pa. 17013
FR: Benny E. Rowe
Auctioneer/Appraiser
2505 Ritner Highway
Carlisle, Pa. 17013
RE: Ethel Erickson Estate, 13 Oakwood, Carlisle, Pa.
Personal property Appraisal at current Auction market
value.
"'I ~1
,:,,'..~~.~""\1"),."''''''''
.j . ~ '"..' ",
[j j,- /;1,- r;'-;;:"j
-
..
PAGE 2
Mahogany Music Cabinet
Indian Art Pottery Open Handle Dish
Black
Minature Oriental tea pot
Carved/Painted Pheasant
porcelian Lady Figurine
West Clock Travel Clock
Book- Birds- Readers Digest
Prince William Limited Edition Doll
Partial Set Martin Limoges China
Book- Wild Flowers of America
Red Transfer Plate, Richard Jordan
Residence N J
Lapel Pin- American Flag
Print, Birds/Water Sn. Windberg
Serving Tray, Black Laquered
Cut Glass Pedestal Candy Dish
Butter Churn, 1 qt. Daisy
Hand Bell- Brass
Book, Wonder of Birds
Book, The Singing Wilderness
Covered Cake Dish
Print, Rufous Sided
2 Table Covers, Linen
Clock, Alarm, Seth Thomas
(4) Crochet Needles
Clock, Carriage, Seth thomas
Bird Nest
Bowl, Black, Indian Art Pottery, Sgnd
(2) Coiled Rye Straw Baskets
10" Silverplate Plate
Busch & Lomb Binoculars
90 Pieces Sterling Flatware Set (Gorham)
Partial set China, Sweetheart Rose
Kitchen Aid Mixer/Processor
Cassette, Bird Calls
Hummingbird Feeder
Lane Cedar Jewelry chest
Book, Gift of Birds
Tasco Binoculars
Lapel Pin, Indian
Clear View Bird House
3 Quil ts- 1 Top
Minature Doll Furniture
,
$ 160.00
55.00
2.00
5.00
4.00
1 .00
8.00
12.00
25 .00
10.00
55.00
N/V
10.00
2.00
35.00
60.00
40.00
8.00
2.00
2.00
6.00
4.00
1.00
1.00
10.00
N/V
135.00
80.00
1. 00
12.00
540.00
10.00
35.00
N/V
1.00
8.00
6.00
10.00
1.00
1. 00
320.00
8.00
, -
PAGE 3
l
China doll
Pocket Knives, Etc.
Rock Samples
Benrus Ladies Wrist Watch-Crown Missing
Print, Trogan-Elegans
Print, Musical
Painting, Oil on Board
Step Stool, Folding
Lamp Stand, Oval
(4) Plank Bottom Chairs, Repaint
Opern Glasses
$ 15.00
18.00
N/
5.00
12.00
5.00
25.00
3.00
20.00
120.00
20.00
TOTAL $1933.00
~
Benny E. Rowe
BUREAU OF TNDZVZDUAL TAXES
THHERZTANCE TAX DZVTSTON
DEPT. 280601
HARRISBURG, PA 1711B-0601
COHHONNEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOT/CE OF 1NHER/TANCE TAX
APPRAZSENENT, ALLONANCE OR D/SALLOHANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
ROBERT L OBRIEN ESQ
OBRIEN ETAL
17 N SOUTH ST
CARLISLE
...... ~'_?i: DATE 02-16-2004
2} ~iiiS ESTATE OF ERICKSON
DATE OF DEATH 11-10-2002
FILE NUHBER 21 02-1040
FEB 13 P3:28 COUNTY CUHBERLAND
ACN 101
CUT ALONG THIS LINE ~
Amoun~c RemJ~ed
ETHEL K
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
RETAIN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRA]:SEHENT~ ALLONANCE OR D/SALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF ERICKSON ETHEL K FILE NO. 21 02-1040 ACN 101 DATE 02-16-2004
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATTON CONCERN]:NG FUTURE ]:NTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN
1. Reel Es*a~e (Schedule A) (1}
E. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~narshlp /n~eres~ (Schedule C) (3)
~. Nor~geges/No~es Receivable (Schedule D)
$. Cash/Bank Deposits~Misc. Personal Proper~y (Schedule E) (5)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Dab~s/Mor~gege Liabilities/Liens (Schedule Z) (10)
11. To~el Deductions
12. Ne~ Value of Tax Ra~urn
170/449.80
229.80
.0O
.0O
145/847.95
.00
.00
(8)
25,147.65
11,451.14
(11)
(12)
13.
1~.
NOTE:
Chari*able/Governmen~al Beques~cs; Non-elected 9113 Trus*s (Schedule J) (13)
Ne~ Value of Es~a~a Sub.~ec~ ~o Tax (lq)
Tf an assessment ~as issued previously, 11nas 1~, 15 and/or 16, 17,
re~lect ~igures that lnclude the total o~ ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Aeoun~ of Line lq a~ Spousal ra~e
16. Amoun~ of Line 1~ ~axable a~ Lineal/Class A ra~e
17. Amoun~ of Line 1~ a~ Sibling ra~e
18. Amoun~ of L~ne 1~ ~exeble a~ Collateral/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYHENT R~C~IPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PA/D (-)
08-08-2005 CD002880 .00
NOTE: To insure proper
credi~ ~o your eccoun*,
submi~ ~he upper portion
of *hAs form ~i~h your
~ax payment.
:316,527
279,928.74
IF PAID AFTER DATE ZND/CATED, SEE REVERSE
FOR CALCULAT/ON OF ADD/TZONAL INTEREST.
.00
279,928.74
18 and 19 wlll
(~;) .00 x O0 = .00
(16) .00 x 045 = .00
(17) 179,928.74 x 12 = 33,591.44
(18) .00 x 15 = .00
(1~)= 33,591.44
AHOUNT PAID
40,000.00
TOTAL TAX CREDIT
· ALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
40,000.00
6,408.56CR
.00
6,408.56CR
( ZF TOTAL DUE 1S LESS THAN $1, NO PAYHENT 1S REI~U/RED.
[F TOTAL DUE TS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE .~
A REFUND. SEE REVERSE SIDE OF TH/S FOR, FOR ]:NSTRUCTZONS.) '~\ l
/
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
OISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 11, 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 Comeonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class 8 (collateral) rate on any such future interest.
To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 13 of 2000. (71 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.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of #i118, any of the 23 Revenue District Offices, or by calling the special Z4-hour
anseering service for forms ordering: 1-800-361-1050; services for taxpayers with special hearing end / or
speaking needs: 1-800-447-3010 (TT only).
Any party in interest not satisfied aith the appraisement, allommnca, 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 should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. Z80601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-ISa1) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is alloeed.
The 151 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 end of the tax amnesty period. This non-participation
penaIty is appealable in the same manner and in the the same time period es you would appeaZ 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, 1981 will bear interest at a rate which wi1! vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1981 ZOZ .000548 1987 91 .000147 1999 71 .000191
1983 161 .000438 1988-1991 111 .000301 2000 81 .000219
1984 11Z .000301 1991 91 .000247 ZOO1 91 .000147
1985 13Z .000356 1993-1994 7Z .000191 2002 61 .000164
1986 10Z .000274 1995-1998 9Z .000147 2003 51 .000137
--Interest is calculated as follows:
/NTEREST = BALANCE OF TAX UNPAID
X NUNBER OF DAYS DELI'NI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent wilX reflect an interest calculation to fifteen (15) 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.
BUREAU OF TNBZVTDUAL TAXES
TNHERTTANCE TAX DZVZSTON
DEPT. Z8060]*
HARRTSBURG, PA 171Z8-0601
ROBERT L OBRIEN ESQ
OBRIEN ETAL
17 N SOUTH ST ~ ~
CARLISLE ~I~i01~
COHHONNEALTH OF PENNSYLVAN'rA
DEPARTNENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
DATE
ESTATE OF
DATE OF DEATH
FZLE NUNBER
COUNTY
ACN
REV-160? EX AFP COl-OS)
05-15-2004
ERICKSON ETHEL K
11-10-200Z
21 02-1040
CUHBERLAND
101
Amoun~ Remi~ed [
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
NOTE: To insur® proper' cr`ed:[~ ~:o your' eccoun~:, subat1~: ~:he upper por~1on of ~:his form wASh your' ~ex paylmn~:.
CUT ALONG THXS LXNE ~.~ RETA'rN LONER PORTXON FOR YOUR RECORDS -'~
REV-1607 EX AFP (01-03) ~ 'rNHER'rTANCE TAX STATEHENT OF ACCOUNT
ESTATE OF ERICKSON ETHEL K FZLE NO. 21 0Z-1040 ACN 101 DATE 05-15-:;'004
TH/S STATEHENT TS PROV'rDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NANED ESTATE. SRO#N BELON
TS A SUHHARY OF THE PR/NC/PAL TAX DUE, APPL/CATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, 'rF APPL/CABLE)
A PROJECTED ]:NTEREST F/GURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: OZ-16-ZO04
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
$3,591.44
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
.00
08-08-Z005
02-27-2004
CD002880
REFUND
.00
40,000.00
6,408.56-
TOTAL TAX CREDZT $$,591.44
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
IF PA/D AFTER TH/S DATE, SEE REVERSE
S/DE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
( ZF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQU/RED.
IF TOTAL DUE 1S REFLECTED AS A "CREDZT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR XNSTRUCTZONS.
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF NILLS) AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTN OF PENNSYLVANTA.
REFUND (CR): A refund of a tax credit, which Has not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l~15). Applications ara available at
the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Z4-hour
answering service for forms ordering: 1-800-56Z-ZO50) services for taxpayers with specie! hearing and / or
speaking needs: Z-800-q~7-$OZO (TT only).
REPLY TO:
guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individua! Taxes) ATTN: Post Assessment Review Unit) Dept. Z&0601, Harrisburg, PA 17128-0601) phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (5) calendar months after the decedent's death) a five percent (SZ) discount
of the tax paid is allowed.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed on the tote! of the tax and interest assessed) and not
paid before January 18, 1996) the first day after the end of the tax amnesty period.
INTEREST:
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) 1982 bear interest at the rate of
six CSX) percent par annum calculated at a daily rate of .O00iSq. A11 taxes ~hich became delinquent on and after
January 1, 198Z will bear interest at a rate which ~ill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue.
The applicable interest rates for 1982 through ZOOq are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
198Z ZOX .0005¢8 1988-1991 llZ .000~01 2001
1983 16Z .000~58 199Z 9Z .000Zq7 ZOOZ
1986 1XX .000~01 199~-199q 7Z .O00lgZ ZOO~
1985 ISZ .000~56 1995-199B 9Z .O00Z~7 ZOOq
1986 IOZ .O00Z7~ 1999 7Z .000192
1987 9Z .000247 2000 8Z .000Z19
Interest Daily
Rate Factor
9Z .000Z47
6Z .00016~
5Z .000137
qZ .000110
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELTN~IUENT X DAZLY 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 shown on the
Notice, additional interest must be calculated.
SETTLEMENT AND FINAL RELEASE
I__N
ESTATE OF ETHEL K. ERICKSON
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Ethel K.
Erickson, late of Carlisle, Pennsylvania, deceased, died testate
on November 10, 2002, having first made her last ~ill an'd
testament which was duly executed on June 9 1983 antis duly
recorded in Cumberland County Register of Wills Estate~o. 21-02-
1040;
WHEREAS, the said, Ethel K. Erickson, by the aforesaid last
will and testament, named Louise K. Frantz, as Executrix of said
last will and testament;
WHEREAS, letters testamentary on the estate of the said
decedent were duly issued on November 21, 2002 by the Register of
Wills of Cumberland, County, Pennsylvania, to the said Executrix,
hereinafter called personal representative.
WHEREAS, the personal representative has gathered the assets
of the estate of the said decedent and the assets consist of real
and personal property, to a total gross value of $316,527.53, as
set forth in Exhibit A, which is a statement of account, in the
form of the inheritance tax return, of the said personal
representatives, and which is attached hereto and made a part
hereof, and marked Exhibit A;
WHEREAS, the debts and deductions, including the payment of
inheritance tax in the said estate, amount to $70,190.23, leaving
a balance for distribution of $246,337.30.
WHEREAS, the balance for distribution as shown in the said
statement marked Exhibit A has been reduced to cash and has been
or will be distributed as herein indicated in accordance with the
terms of the last will and testament of the said decedent;
NOW, THEREFORE, We, individually by the execution of this
Settlement and Final Release, as heirs under the last will and
testament, do hereby each of us, acknowledge that we have or will
receive upon delivery of this Settlement and Final Release, from
the aforesaid personal representative, in full satisfaction and
payment of all sum or sums of money, legacies, bequests, and
devises as are given, devised and bequeathed to each of us
respectively by the said last will and testament.
AND, each of us does hereby stipulate that in order to avoid
the expense and time involved in the filing of a formal account
and schedule of distribution, we each agree that no account is
necessary and we do hereby agree that we do consent to
distribution being made without the filing of an account and
schedule of distribution, the same to be with the same force and
effect as if they had been filed and confirmed by the Orphans'
Court Division of the Court of Pennsylvania, Cumberland County
Branch.
THEREFORE, we and each of us, do hereby remise, release
quitclaim and forever discharge the said personal representative,
heirs, executors, and administrators and assigns of and from the
said estate and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever for or by reason
thereof, or for any other use, matter, cause or thing whatsoever,
touching upon the estate of the said decedent, and each of us do
further hereby covenant and agree that should any liability come
due to the estate of the said decedent after the signing of this
agreement, we and each of us do hereby covenant and agree with
each other and the aforesaid personal representative, that we
will contribute pro-rata, our 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
personal representatives after the signing, sealing and delivery
of this family settlement agreement and final release.
IN WITNESS WHEREOF, we have hereunto set our hands and
seals, by individual execution of copies of this Settlement and
Release this~ ~ day of ~ , 2004.
/
WITNESS:
Frederick S. Frantz
Louise K. Frantz
(SEAL)
(SEAL)
Hanover and High Street
Carlisle, PA 17013
Phone:(717) 240-6345
Date: 9/24/2004
O'BRIEN ROBERT L
19 W. SOUTH STREET
CARLISLE, PA 17013
RE: Estate of ERICKSON ETHEL KELLER
File Number: 2002-01040
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 11/10/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc:
File
Personal Representative(s)
Judge
STATUS REPORT UNDER RULE 6.17
Name of Decedent:
Date of Death: _ Il J t'O/~ "'&.
Will No.:
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 w~ether administration of the estate is complete:
Yes 11I 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:
Did the personal representative file a final account with the Court?
Yes _ No 1-~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal r_~resentative state an account infor~i~ to tli~ parti~ ~;:'
in interest? Yes ~ No [--] ? .
c. Copies of receipts, releases, joinders and approval o£formaluar
informal accounts may be filed with the Clerk of the Oi-13hans~_Court'
and may be attached to this report, o,~..~0,,.I -~'[q'~.3 ~]!!"2~[O~'
Signature
Name
Capacity:
Telephone No.
Personal Representative
~[.Counsel for personal representative