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HomeMy WebLinkAbout03-0545 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: BERNICE R. HORST Date of Death: June 16, 2003 Will No. 200 ~-00545 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July ll, 2003 : Name Address JOAN Y. T}:UJ?DU~, 105 Lamb' s Gap Road, Marysville, PA 17053. !?£~FFORD T. EBE~T, 11425 Westside Ave., Honesdale, PA 18431. ..... ~,,. BR0~qN, 210 West Maplewood Ave., Mechanicsburg, PA 17055. IRVIN A. HORST, JR., 6331 Brandy Lane Trailer Village., Lot 9, Mechanicsburg, PA 17055. Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None '~nature // Name J. Robert Stauffer Address Market Square Bldg. Mecha~icsburg~ PA 170J~ Telephone~lT~TS6_gfi73 Capacity: ~ Personal Representative X Counsel for personal representative ,EV-,~00EX(6~) OFFICIAL USE ONLY REV-1500 PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28060 INHERITANCE TAX RETURN F,LE.UM.E. _S_ !__--___03__ 00 5--g-- 5-- HARRISBURG. PA 11128-0601 RESIDENT DECEDENT cou. COOE DEOEDENT'S NAME I ST. F RST. AND M DBLE ..mALl SOC,AL SECUR, NUMBER Z ~ORST, Bernice tl. 2Ol1~ - 0.3 - 9200 C:~ DATE OF DEATH (MM-DB-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH'THE uJ June 16, 2003 July 8, 191.3 REGISTER OF WILLS UJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER }';'/A _ _ ,- ~] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of dea,h ~or to 1~-13-~2, O~ [] 4. Limited Estate [] 4a. Future lnterest Compromise (date of death a,e12-1~-~2) [] 5. Federal Estate Tax Return Required o ~. ~ [] 6. Decedent Died Testate (Attach copy of W~) [] 7. Decedent Maintained a Living Trust (^each copy of Trust) O 8. Total Number of Safe Deposit Boxes < [--] 9. Litigation Proceeds Received [--] 10. Spousal Poverty Credit (date of death belwe, ~2-3~-9~ a,d 1-~-~) ~ 11. Eleclion to tax under Sec. 9113(A)I^r~ch s~ o) I--. z "' NAME c~ COMPLETE MAILING ADDRESS oZ ,I. ]-{obert Stauff'er, Atty. ]'4afl{et Square ]31dg. ~' FIRM NAME (If Applicable) "' S a~,]e ~J'echani csburg, PA "" TELEPHONE NUMBER o o 717-766-9673 1. Real Estate (Schedule A) (1) l_~_'r') ,, 000. OO OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) l. Jr ~2 o ~.0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0. O0 4. Mortgages & Notes Receivable (Schedule D) (4) 0. O0 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ,OF ~, ~ 8 9 (Schedule E) i 6. Jointly Owned Property (Schedule F) (6) 000 U Separate Billing Requested ' ::~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) O o O0 I'- (Schedule G or L) ' ' ~ 8. Total Gross Assets (total Lines 1-7) (8) Ill 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 18, g52 93 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) O. OO 11. Total Deductions (total Lines 9 & 10) (11) 18 .~ 45,O * 93 12. Net Value of Estate (Line 8 minus Line 11) (12) 5 6., ~.l¢'] 8 · 93 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) O ° O0 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 56, [I.18.93 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES  15. Amount of Line 14 taxable at the spousal tax ~ rate, or transfers under Sec. 9116 (a)(1.2) O x .000 (15) 0 o O0 .~ 16. Amount of Line 14 taxable at lineal rate 56~t-18.93 x .0 ~,..~_. (16) O~ 17. Amount of Line 14 taxable at sibling rate O x .12~ (17) O ,, OO (..) 18. Amount of Line 14 taxable at collateral rate O x .150 (18) O o OO  19. Tax Due 2,538.85 (19) 20.~-1 si el 3 I:',, · .w e~ ~ :, Decedent's Complete Address: STREET ADDRESS Bernice R..Horst 211-213 !:.rest Simpson St. [STATE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2,538 . 85 2. Credits/Payments A. Spousal Poverty Credit O, O 0 B. Prior Payments O. ©O C. Discount O, 00 Total Credits ( A + B + C ) (2) 3. InterestJPenalty if applicable D. Interest 0.0 0 E. Penalty 0.0 0 Total Interest~Penalty ( D + E ) (3) O o OO 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) O, OO 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2.,~.~ A. Enter the interest on the tax due. (SA) O, OO B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 2. 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; ............................................ [] ~. 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? ........................................................................................................................ [] [] ' 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 tatum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is Irue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. OF PERSON RESPONSIBLE FOR FILING RETURN DATE SIGNATURE · ,~0~ L~mb~s Gap Road, Marysville, PA 17053 ' SIGNATURE oF~PA~~ ~AN~.PR~TATIVE~I ' DAlE ADDRESS / ///~ . 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 ,se of the surviving spouse is 0% [72 RS. §9116 (a) (1.1) (ii)] The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for dis, !, 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 RS. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as ar individual who has at least one parent in common with the decedent, whether by blood or adoption. OMB NO. 2502-0265 '1~ A. J B. TYPE OF LOAN: 1 1.[-'1FHA 2. E]FmHA 3. E~CONV. UNINS. 4. E]VA 5. F-lCONV. INS. U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT I 6. FILE NUMBER: J 7. LOAN NUMBER: SETTLEMENT STATEMENT J 2003110088 J CASH J8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is fumished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 12003110088. PFD/2003110088/201 D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: ' F. NAME AND ADDRESS OF LENDER: Mitzi Valentine 54 West Locust Joan L. Thumma, ExeCutrix for Estate of Mechanicsburg, PA 17055 Bernice R. Horst SSN: 173-38-7266 105 Lambs Gap Rd Manjsville, PA 17053-9506 G. PROPERTY LOCATION: H. SETI'LEMENT AGENT: I. SE'I-I'LEMENT DATE: 211 and 213 West Simpson Street Chelsea Settlement Services Mechanicsburg, PA 17055 December 19, 2003 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 3800 Market Street Camp Hill, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 401. Contract Sales Price I 49,000.0C 102. Personal Property I 402. Personal Property 103. Settlement Charges to Borrower (Line 1400) I 403. 104. Payoff Mort~a_cle I 404. 105. Payoff Mort.qa~le I 405. Adjustments For Items Paid By Seller in advance Paid By Seller in advance 106. Co/TwpTaxes 12/19/03 to 01/01/04 i 5.90 406. Co/TwpTaxes 12/19/03 to 01/01/04 107. County Taxes to j 407. County Taxes to 108. School Taxes 12/19/03 to 07/01/04 I 295.46 408. School Taxes 12/19/03 to 07/01/04 295.4~ 109. Sewer 12/19/03 to 01/01/04 I 9.83 409. Sewer 12/19/03 to 01/01/04 9.83 110. Trash 12/19/03 to 01/01/04 I 5.45 410. Trash 12/19/03 to 01/01/04 5.4.~ 111. I 411. 112. I 412. 120. GROSS AMOUNT DUE FROM BORROWER 50,637.89 420. GROSS AMOUNT DUE TO SELLER 49,316.64 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: $00. REDUCTIONS IN AMOUNT DUE TO SI~LLFR: 201. Deposit or earnest money J 501. Excess Deposit (See Instructions) 202. Principal Amount of New Loan(s) I 502. Settlement Charges to Seller (Line 1400) 27575.00 203. Existing loan(s) taken subject to ; 503. Existing loan(s) taken subject to 204. )rt~la~le 205. I Mortgage 206. [ 506. 207. I as proceeds) 208. J 508. 209. I 509. Adjustments For Items Unpaid By Seller Adjustments For Items Unpaid By Seller 210. Co/Twp Taxes to I 510. Co/Twp Taxes to 211. County Taxes to 511. County Taxes to 212. School Taxes to 512. School Taxes to 213. I 513. 214. I 514. 215. 515. 216. 516. 217. I 517. 218. I 518. 219. J 519. 220. TOTAL PAID BY/FOR BORROWER 520. TOTAL REDUCTION AMOUNT DUE SELLER 2,575.00 ~00. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) t 601. Gross Amount Due To Seller (Line 420) I 49,316.64 302. Less Amount Paid By/For Borrower ILine 2201 i( 602. Less Reductions Due Seller (Line 5201 I( 2,575.00 1303. CASH( X FROM)( TO)BORROWER 49,637.89 603. CASH( X'TO)( FROM) SELLER 46,741.64 The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Borrower ~ {~'~./~ ' ~~./~/*~I,~ ~1~ Seller Estate of Rernice R. Horst Joan Y. Thumma. Executrix Page L. SETTLEMENT CHARGES ,OTAL COMMISSION Based on Price $ 49,000.00 ~ 4.0000 % 1~960.00 I PAIDFROM I PAIDFROM Division of Commission (line 700) as Follows: I BORROWER'S I- SELLER'S .01. $ 1,960.00 to Re/Max Realty Associates, Inc. FUNDSAT ~ FUNDSAT r 702. $ to SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 1 ,960.0( 704. Processing Service Fee to Re/Max Realty Associates, Inc. 175.00J| 125.0( 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % to 802. Loan Discount % to 803.. to 804.. to 805.. to 806.. to 807.. to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to ~} $ /da)/ ( days %) 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Piei~iium for 1.0 years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance ~ $ per 1002. Mortgage Insurance ~, $ per 1003. Co/l'wp Taxes ~ $ per 1004. CountyTaxes ~, $ per 1005. SchoolTaxes ~ $ per 1006. ~ $ per 1007. ~ $ per 1008. Aa(;re;lata Adjustment ~, ~ per 1100. i i i LE CHARGES 101. Transportation Fee to Chelsea Settlement Services 102. Service Rendered Fee to Chelsea Settlement Services After 6:00 PM 1103. Title Examination to 104. Title Insurance Binder to 1105. Document Preparation to Chelsea Settlement Services Deed Prep. 1106. Notary Fees to 1107. Attorney's Fees to (includes above item numbers: 1108. Title Insurance to Chelsea Settlement Servi(;es ,552.7~ (includes above item numbers: 1109. Lender's Coverage $ 1110. Owner's Coverage $ 49,000.00 Policy #382754 1111. ALTA Endorsements 1112. 1113. 1114. Express Overnight Fee Chelsea Settlement Services 1115. 1116. 1117. 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mort~la~e $ ; Releases $ ~ 38.50J 1202. City/County Tax/Stamps: Deed 490.00; Mortgage Conveyance Feel 245'001i 245.00 1203. State Tax/Stamps: Revenue Stamps 490.00; Mo~ge,ne 245.00 245.00 1204. Assianment Recording Fee Che sea Recordina A_n~__urlt 1205. Recording Service Fee to Chelsea Settlement Services 10.00J t300. ADDITIONAL $~-! ! LEMENT CHARGES 1301. Survey to I 1302. Pest Inspection to Home Paramont 55.00 r 1303. Pest Treatment to Tri-County Pest Control POC $749.0C 13O4. 1305. 1400. TOTAL S,- ~ ~ LEMENT CHARGES {Enter on Lines 103r Section J an(t 502r Section K) // 1~321.251 2,575.00 Chelsea"S,l~ttlement Services ...................... Settlem~lt Agent REV.15~,. EX * (1-97) . SCHEDULE A COMMONVVEA TH OF PEN.S LV^N,A REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BE~IN.ICE It. HO~ST 2 -o3-o5k5 All real prope~ o~ed solely or as a tenant in common must ~ repealed at fair market value. Fair manet value is defined as ~e p~ at which pro~ would ~ ex~a~ed be~een a willing buyer and a willing seller, nei~er being mm~lled to buy or sell, ~ having reasonable knowledge of the relevant fa~. Real pmpe~ ~ich is jolntly-o~ed suwivomhip must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. AT~L that certai~ House ~ut~bered 211 a~d 213 ~fest S:~.~'r~pson Street, I,~echanicsbur~, Penns~flvan~a, bounSed a~d 5escribed as follov~s: BEGIkr?.~'[NG at an iron pin on the Buf~lding Line of t'~fest Simpson Street and Cedar Alle]r; thence east~arS].;f' a]_on~ said bt~ild:[n,?~ l~ne of t'fest S'[.mpson Stroet, ~0.9~ feet to a point; thence southvrardly alot~ the ].i~e of property no>z or formerly of John L. Stine amd Kabhryn E.. StOne, h~s >~ife, ~2.6 feet to a point; thence ~estwardly along the line of propert;f novr or formerl]r of ~'J. rs. Joh~ Yfa~ner, 2~.~. feet to an irot~ pin on the East side of Cedar Alley, thence northvmrdly along said Alley, feet to an iron pin on the building li~e of West Simpso~ Street, aforesaid, the ~lace of BEGINNING. Sol~] to PIitz[ 1]. Valentine for f~;49,000.00. A copy of the settlement statement is attached hereto. [~ 49,000.00 TOTAL (Also enter on line 1, Recapitulation) $ 4(::) , 000 o O0 (If more space is needed, insert additional sheets of the same size) · Market Plaza Way · Mechanicsburg, PA 17055 Michael J. Malpezzi Phone: 697.4696 FO N ERAL HOME November 30, 2003 Mrs. Joan Thumma 105 Lambs Gap Road Marysville, PA 17053 To Whom It May Concern: The family of Bernice Horst has tried unsuccessfully to sell crypts at Woodlawn Memorial Gardens that are owned by the deceased. As the cemetery will not purchase back the crypts and they have no cash value on the open market, it is my professional opinion that the crypts have no value for estate purposes. If you have any further questions regarding this matter, do not hesitate to contact me. Sincerely, Clearing Th?Jgh FINANCIAL NETNORK Jelsey Cily, New Jersey 01399 INVESTMENT CORPORATION ;?780 SKYPARK DRIVE SUITE $00 TORRANCE CA 90505-556[ TEL: (510)526-$[00 CONFIRMATION HAIL TO: PAGE I FOR TIlE ACCOUNT OF : ACCOUNT NUMBER: qN2-179693 ACCOUNT TYPE: 1 ESTATE OF BERNICE R HORST ESTATE OF BERN[CE R HORST JOAN Y. THUrlHA EXECUTRIX JOAN y. THUMMA EXECUTRIX 105 LAHBS GAP RD [os LAMBS GAP RD YOUR ACCOUNT EXECUTIVE: HARYSVILLE PA 17055-9506 MARYSVILLE PA 17055-9506 A.E. HUMBER: 5F7 YOU SOLD: TRADE DATE: 10-07-05 PROCESS DATE: 10-07-05 PRUDENTIAL F[NL INC SETTLEMENT DATE: 10-10-05 COH CUSIP NUMBER: 766520-10-2 SYMBOL: PRU WE CONFIRM THE BELOW TRADE(S), SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE. m,mm TRADE 0UANTITY PR[CE PR[NC[PAL INTEREST/ COMMISSION SERVICE .C. NET AHOUNT HKT/ ~UNBERI STATE TAXI CHARGE [ CPTY m,mm... M8TRZJ 15 57.60 686.20 60.00 6.00 .05 662.17 5/1 .=.,,,,,,m A PERSHING CO IS SPCLST ON EXCH & MAY HAVE ACTED AS PRIM UNSOLICITED. ..i THIS CONFIRMATION IS AN ADVICE NO[ AN INVOICE. REMIITANCE OR SECURITIES ARE DUE ON OR BEFORE SEI-rLEMENT DATE. FOR THE ACCOUNT OF: ACCOUNT NUMBER: ~N2-I79695 YOU SOLD: PRU ACCOUNT TYPE: ESTATE OF BERNICE R HORST PRUDENT[AL F[NL IHt JOAN Y. THUNMA EXECUTRIX COM 105 LAMBS GAP RD MARYSV[LLE PA 17055-9506 YOUR ACCOUNT EXECUTIVE: A.E. HUMBER: 5F7 SETTLEMENT DATE: 10-10-05 CUSIP NUMBER: 764520-10-2 SEE REVERSE SIDE FOR TERMS AND CONDI11ONS AND EXPLANATION OF CODED SYMBOLS RELAIING TO 1'1115; CONFIRMATION. THEON OTHERAMi)iiNTTHAN~tF SHc. HRO[INBr~IFFFn~N rlALLOTS tIORMALLYwll I IOOFiF FSHARESRN S ?FFIIF UPoND F APPEARSRFOUEsTABOVE AN ODU-LOT DIFFERENTIAL HAS BEEN CHARGED IN CONNECTION WITH THIS TRANSACTION. COMUO.WE^.., Or PE.~.~¥~V^.,^ STOC KS & BONDS RESlDENI DE,EDEN[ ESTATE OF FILE NUMBER 2003-005~ BERNICE R. HORST 21_03_0545 All p~opedy Jolnlly-o~ed with right of survivorship musl be disclosed on Schedule F. iTEM VALUE AT DATE NUMBER L)ESCRIP110H OF DEATtl ~' 13 ~:es o~ ~de~i~ ~ci~, [~c.~ com~o~ s~oc~, TOTAL (Also enter on line 2, Recapitulation) $ [.J.80 o 20 Iit' rnr,r~ ~nnc~ I~ .~.HeH i~sell ~ddilional sheets o! the seine size) ,: 02 018 060803 .,._ o~o ~_,-,,No~_,,~,., L?.o^,.- 11337597 "=----- ,'"FIRS UNION.NATZONAE:,BANK ;: _" PHIL DELPHIA,: PA: '; .; - - VERIFICATION AVAILABLE~ "PoSJi~I?E! i i .:i:;; i": : , . "" - PAY,-'",,~-=[~Fi~O~ · ~ :... ;. ~ · '::,'"':; i .. ..... ~,,..:,,,~' :...: D^~E'.",, :.. ..~''"~' ,. . ' . ' . · ; ;.l 1. l: ,>' '!;,.: '": ' ~ :" '] .,'/. :,. ,, =--'~ ; TO TIlE ORDER OF ';" " "~ ""' '"'""" ~ .....'~" ....... ' " ' " ' ~ ' ' !;' ~' '~ ' : ' ~ VOID AFTER 180 DAYS , ,, ~ ~ ! ,' . .,. ' ~ *****~*****'360 $ ;'09 i;_,' = BERNICE R HORST '- .. ~' ~- . DLN 0270001~1~0~ REV REBATE ~ ~IECHANI¢SBURG PA 17055-6~1~ . ~ . · · ,If,l,l,,I ' · ~ :~;;....:i .~.,...... ?~ :: ::... ..:.. ::; ~, ... ~ ,.. .: : ;; ~.! .....,;. ,:...,. % ~..... .. ~. ~;. Commerce  Banl¢ .? 5032 SIMPSON FERRY RD MECHANICSBURG, PA 17055 EST OF 8ERNlrCER HORST TO THE ORDER OF ~ ':: RE: ::} .~ Commerce  Banl¢ Signer acknowledges receipt in full from The First National Bank of Marysville of the amount shown on BALANCE TO CLOSE box below. ^ccount .' ~: S S 80,,, 8000~: - CERTIFICATE OF DEPOSIT FIRST NATIONAL BANK OF MARYSVILLE NON TRANSFERABLE 101 LINCOLN ST., BOX B, MARYSVILLE, PA 17053 · ss~ 204-03-9200 3 0 6 2 3 5 0 PAYEE(S}: INTEREST PAYMENT OPTION Bernice R Horst S MONTHLY "Under penallles of perjuw, I cefli~ (1) that the number shown on ~UARTERLY this form Is my correct taxpayer Identification number, and (2) that I am not subject to backup w hholding, eilher because I have nol ~ SEMI*ANNUALLY been no f ed 1~11 am subject 1o backup wllhholdlng as a resull of a ~ AT MATURITY failure lo repod all Interesl or dividends or the Inlernal Revenue Se~lce has notified me that I am no longer subject to backup ~ 2~3 ~ ~O~ ~ ~APITALIZE withholding. I also cedRy hat instructions regarding res~nse to this ~~ ~[]~ P~ ~ 7~ R~ ~ DEPOSIT TO ced f cation have been provided and explained to me." O CITY, STATE ~ ZIP - -- - ~ MAIL CHECK SUBSTANTIAL PENALTY FOR EARLY WITHDRAWAL , ~=u, u~ ~mb MA/UHITY DATE. INTERESTWILL BE PAID AS AGREED. CUSTOMER MUST SELECT EITHER OPTION BELOW: ][~ AUTOMATICALLY RENEWABLE. THIS CERTIFICATE W LL BE RENEWABLE AUT M AN ADDITIONAL PERIOD OR PERIODS EQUAL Tn T.~ ~n,¢ _. O ATICALLY FOR ~ SINGLE MATURITY. THIS CERTIFICATE MATURES ON THE MATURI~ DATE ......... o~&L TERM OF THE CERTIFICATE BELOW AND WILL N~BE AUTOMATICALLY RENEWED. (NO INTEREST WILL AND AT THE INTEREST RATE IN EFFECT ON THE RENEWAL BATE UNLESS PRESENTED FOR BE PAiD FOR ANY ~:¢~R ~T~.,~ PAYMENT WIfHIN TEN (10) DAYS OF THE MATURI~ DATE. 7-Z8-02 2.76 .~ 7-[8-03 [2 ' ' ~ ~ - '~ATURITY DAT~ months ~ ~~ CERTIFI'C, ATE OF 6EPOSIT NON TRANSFERABLE FIRST NATIONAL BANK OF MARYSVILLE 101 LINCOLN ST., SOX B, MARYSVILLE, PA 17053 ss# 204-03-9200 PAYEE(S): INTEREST PAYMENT OPTION 3 0 5 ? 9 9 3 ~T'n'i ~ R Hn'r-c:;~ ~ONTHLY 'Under penalties o~ perJu~, I cedl~ (1) that the number sh~n on ~QUARTERLY this form Is my corre~ t~payer Identl~atlon number, and (2) Ihat am not subJe~ 1o backup ~thholdtng, either because I have not ~ SEMI-ANNUALLY been notified that I am subj~ to backup withholding as a result of a 2~3 S~pson St ~ AT MATURI~ failure to repod all Interest or dividends, or fha Internal Revenue ~c~..has. n?lfled me lhatl am .o long .... bj~ to backup ~chan~osbu~q~ 2a. ~ 7 0 5 ~ ~ CAPITALIZE mno,amg. I also ce~l~ that Instru~lons regarding res~nse Io this cedlfl~tlon have been provided and explained lo me.' ~ DEPOSIT TO CITY, STATE ZiP ~ MAIL CHECK ISSUE AMOUNT ~'., ~, ~' ~ ~ ~ ~ '{ J-~ ~; I'~ :f ~;" ~'~ ~ ,'.,~ ~ PAYABLE TO THE NAMED PAYEE(S) UPON PRE .... ~ ~ ~ ~ SENTATION OF THIS CERTIFICATE PROPERLY ENDORRFn ................. _DOLORS $ SUBSTANTIAL PENALTY FOR EARLY WITHDRAWAL ........ , ul~/~E MA/UHI [ y DATE. INTEREST,~ILL BE PAID AS AGREED. CUSTOMER MUST SELECT EITHER OPTION BELOW: ~TOMATICALLY RENEWABLE. THIS CERTIF CATE WILL BE RENEWED AUTOMATICALLY FOR ~SINGLE MATURITY, THIS CERTIFICATE MATURES ON THE MATURITY DATE AN ADDITIONAL PERIOD OR PERIODS EQUAL TO THE ORIGINAL TERM OF THE CERTIFICATE BELOW AND WILL NOT BE AUTOMATICALLY RENEWED. (NO INTEREST WILL AND AT THE INTEREST RATE IN EFFECT ON THE RENEWAL DATE UNLESS PRESENTED FOR BE PAID FOR ANY PERIOp AFTER MATURI~,) PAYMENT WITHIN TEN (10, DAYS OF THE MATURiTY DATE. '0 ~ 9~ ~8 '~ 4-3-96 5.07 ,,___, - - .,, 2 days CERTIFICATE OF DEPOSIT FIRST NATIONAL BANK OF MARYSVILLE NON TRANSFERABLE 10t LINCOLN ST., BOX B, MARYSVILLE, PA 17053 ss~ 204-03-9200 3 0 6 2 2 8 2 PAYEE(S): INTEREST PAYMENT OPTION Bernice R Horst [] MONTHLY "Under penalties of perjury, I cedlfy (1) that the number shown on X~ QUARTERLY this form Is my correcl taxpayer identification number, and (2) that am not subject to backup withholding, either because I have not [] SEMI-ANNUALLY been notified that I am subject Io backup withholding as a result of a failure to report all interest or dividends or Ihe Internal Revenue [] AT MATURITY Service has notified me that I am no longer subject to backup 213 W Simpson St Z~CAPITALIZE withholding, l also cedify lhat instrucfions regarding response to this Mechan±csburq PA 17055-631 9 [] DEPOSIT TO cerlificafion have been provided and explained to me.' CITY, STATE ZIP [] MAIL CHECK J&3/. ~/ I O0Is OD t ORIGINAL t~'" ~'~ ~' ~"'~ ' ~ 0['~ ' REDEEMED VALUE ISSUE AMOUNT 0 S DOLLARS $ l/000.0'0 PAYABLE TO THE NAME[) PAYEE(S) UPON PRESENTATION OF THIS CERTIFICATE, PROPERLY ENDORSED ON THE MATURITY DATE. INTEREST WILL BE PAID AS AGREED. SUBSTANTIAL PENALTY FOR EARLY WITHDRAWAL ' CUSTOMER MUST SELECT EITHER OPTION BELOW: X~AUTOMATICALLY RENEWABLE. THIS CERTIFICATE WILL BE RENEWABLE AUTOMATICALLY FOR [] SINGLE MATURITY. THIS CERTIFICATE MATURES ONZHE MA~IRITY DATE AN ADDITIONAL PERIOD OR PERIODS EQUAL TO THE ORIGINAL TERM OF THE CERTIFICATE BELOW AND WILL NOT.BE A~/OMATICALLY RENEW ..(NO ]'ERNST W LL AND AT THE INTEREST RATE ~N EFFECT ON THE RENEWAL DATE UNLESS PRESENTED FOR BE PAID FOR ANY PEF~OD.~FTER MATURI~'Y.) ~ i~? PAYMENT WITHIN TEN (10) DAYSOFTHE MATURITY DATE. ~,,-/,~ .... / - / /j ( / /. - 5-1-02 2.76 ~ 5-1-03 12 months ~/'/~-~"/ /~ st MEMBERS 1't FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 71158 -00 Date Account Established 04/12/1973 Principal Balance at Date of Death $367.78 Accrued Interest to Date of Death $.23 Total Principal and Accrued Interest $368.01 Name of Joint Owner None INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix 71158 -05 Date Account Established 04/24/1989 Principal Balance at Date of Death $8,252.75 Accrued Interest to Date of Death $5.05 Total Principal and Accrued Interest $8,257.80 Name of Joint Owner None BERS 1sT ?~-'RA~CREDIT UNION Insurance Supervisor July 23, 2003 Estate of: BERNICE R. HORST '~, Date of Death: 06116~2003 Social Security Number: 204-03-9200 5000 Louise Drive, P.O. Box 40, Mechanicsburg, PA 17055 www.memberslst.org . ,~, ~ . .1~ I.'. ,::,,,:::,,,,:,, :,,,,,,, ,,,:,,::,,,.,,,,u (.;A!_;II, I.I^NI~ I~1'!1'(.)!;11 !;, & MILL;. II,IIllHI.~I,., ,,, I:,llllll, 'I{I{SL ' ' 'EI{IY ~ :l = .. li[{;llJl Ill Ill: I l'l Ill I ~llAl l li~l B~NICE R. HORST r,.[llUMllEll '2003-00545 IlIM V~l. lJ~ ~l ~l~ IllJ~lll~H I'l "., I~ll'll, ,Il ' O~ ~. Members lStlFederal Credit Union, Savings Account No. 7n58-00. $ 367.78 Interest accrued to 6/16/03. .23 2. Members 1st1Federal Credit Union, Investment Savings Accost No. 71158-05. 8,252.75 Interest accrued to 6/16/03. 15.05 3. First National Bank of Marysville, Christmas Club Accost No. 2107570. 742.81 ~. First National Bank of Marysville, CertiFicate of Deposit No. 3062350. 1,027.36 5. First National Bank of Marysvtlle, Certificate of Deposit No. 3057993. 3,417.77 6. First National Bank of Marysville, Certificate of Deposit No. 3062282. 1,031.~ 7. Commerce Bank, Checking Accost No. 08-032078057. 2,759.96 8. Co~erce Bank, Savings Account No. 08-480001152. 5,025.11 9. Co~onwealth of Pennsylvania, property t~ rebate. 360.09 10. Household furnishings sold. A copy of sales is attached hereto. 1,903.00 ll. Two crypts located in Woodlawn Memorial Gardens, Harrisb~g, Pennsylvania. See a copy of attached letter of Malpezzi F~e~al Home. These crypts were advertised for sale in local newspapers to no avail. 0.00 12. Highmark Blue Shield, ref~d. 179.67 13. Mitzi R. Valentine, ref~ds as follows: County and Borough Tax~s, 12/19/03 to 12/31/03. 5.90 School T~es, 12/19/03 to .7/1/0~. 295.~6 Sewer, 12/19/03 to 1/01~04. 9.~3 Refuse, 12/19/03 to 1/01/Oh. 5.45 SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FlEE NUMBER 2003_ OO ~4.,~ ....... ,,,., 21_O3_O545 Debts of decedent must be reposed on Schedule I. ITEM NUM13ER DESCRIPTION AMOUNT A. FUNNEL EXPENSES: 1. ~,lalpezzi Funeral ];omo, ~ ]'~arket Plaza Way, ~..Iechanics- burg, PA, Funeral .~x!~enses. $ 6,19~.80 2. r:~echanicsburg Comotery, oDoning and closing 13. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) JoaT1 ~[. ?['lU.]:rli"r].8. 3,~OOoOO Social Security Number(s)/EIN Number of Personal Representative(s) Street Address ].O~ ]],al'i']~,) t S G~]D ]~'~oad city '[iarys ville State PA Zip 170~3 Year(s) Commission Paid; 2. Attorney Fees , J. 1~.obort Stauffer, atto'cl~ey £oo. 2,~.OO.OO 3. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant 7.T/A Street Address City State __ Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of W'ills, Letters 'res t ament ary. 146. OO 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Cumberland Law Journal, Estate Notice. 7~.00 8. UGI Utilities, gas to 6/17/03. 20.11 9. Borough of Mechanicsburg, Sewer and Refuste to 9/30/0 117.22 10. Verizon, telephone to 7/18/0~. 26~6 11. PPL Electric Utilities, electric to 7/1/03. 3~ 12. United Water Pennsylvania, water to 7/7/03. 19.72 13. The Patriot News, advertising cr~pts for sale. 18.00 14. AT & T, long distance telephone to 7/14/03. 3.27 1~. UGI Utilities, gas 7/16/03. 18.~9 16. Verizon, telephone, to 8/18/03. 28.76 17. PPL Electric Utilities, electric to 7/30/03. 41.24 18. i Barry I[eckard, Tax Collector, School taxes to (}/30/04 ~4.~ TOTAL (Also enter on line 9, Recapitulation) $ CARRIED FORWA (If more space is needed, insert additional sheets of the same size) page - I REV-IS11 EX4. (;'-88) m~. SCHEDULE H · FUNERAL EXPENSES, CO~ONW~^LT, oF P~NNSYLV^N~^ ADMINISTRATIVE COSTS AND ' · INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES Please Print or Type RESIDENT DECEDENT ~r ESTATE OF FILE NUMBER 2003-00545 BERNICE fi. HORST ~ ITEM I 2i-03'00545 NUMBER DESCRIPTION AMOUNT 19. The Sentinel, Estate Notice. ~ 85.01 20. United Water Pennsylvauia, water to 8/6/03. ll.07 21. UGI Utilities, gas to 8/13/03.' 16.73 22. Verizon, telephone to 9/18/03. 26.25 23. PPL Electric Utilities, electric to 8/29/03. 31.28 ~541 The Paxton Herald, advertising crypts for sal~. 2.00 The Patriot News, advertising crypts for sale. 21.4© 26. United Water Pennsylvania, water to 9/4/03. 11.07 27. UGI Utilities, gas to 9/13/03. 17.68 ' 28. J.J. Skelton, renewal of service agreement. 199.95' 29. Borough of Mechanicsburg, Sewer and Refuse to 12/31/03. 117.22 30. PPL Electric Utilities, electric to ~9/30/03. 26.80 31. Verizon, telephone to 10/18/03. 28.12 32. Pershing-Financial Network, costs of sale of 13 shares of Prudential Financial, Inc. 44.03 33. United Water Pennsylvania, water to 10/3/03. 11.07 33541 Channel 27 TV, advertising crypts for sale. 5.00 UGI Utilities, gas %o 10/15/03. 15.84 36. Verizon, telephone to 11/18/03. 2~.94 37. PPL Electric Utilities, electric to 10/29/03. I .60 38. J.J. Skelton, heating fuel. 69.42 39. United Water Pennsylvania, water to 11/04/03. 6.75 4©· Tri County Pest Control, termite treatment. 749.00 41. UGI Utilities, gas to ll/12/03. 15.8~4· 42. Verizon, telephone to 12/18/03.~ 30.~2 PPL. Electric Utilities, electric to 11/26~03. 11.74 44~ Unmted Water Pennsylvania, water to 12/0~03. ' ll.07 . Re/Max Realty Associates, sales commission. 1,960.00 46~ Re/Max Realty Associat~es, processing fee. 175.00 47. CUmberland County Recorde~ of Deeds, ~eal estate transfer tax. 490.00 48· PPL Electric Utilities, final bill. 7.04. 5409 United Water Pennsylvania, final bill. 3.6'0 ~ UGI Utilities, final bill. 22.33 51. Register of Wills, filing.Inventory and Pennsylvania Inheritance Tax Return. 25:00 52. Register of Wills, filing Account. ll~..00 Tota~ ....... . ..... .$ 18,458 :.9~ PAGE ~ 2 COM ONWEALTN Or PENNSYLVAN,A BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENI- ESTATE OF BERNICE R. ItORST FILENUMBER ~003-00~ RE~TIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPER~Y Do Not List Truslee(s) OF ESTATE !. TA~BLE DIS] RIBU'I IONS (include outrighl spousal distributions) 10~ Lamb's Gat} l:~oad of Estate. Mar~sville, I~A 170~3 Daughter 2. LYNFOR]) T. EBF. RT One-fourth sh~ ]J_~2~ ~;lestsf. de Ave. of Estate. IIonesdale, PA 18~31 Son ~. EDITH M. BI~O~.IN One-fourth shar~ 210 West Haplewood Ave. of Estate. Mechanicsburg, PA 1'[0~ [~. IRVIN A. HORST, JR. One-fourth shar~ 6~1 Brandy Lane Trailer Court of Estate. Lot 9 Mechanicsburg, FA 170~0 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINEI 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET ]]. 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 Il - 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) COMMONWEALlll OF PENNSYLVANIA COUNTY OF CUMI1ERLANU ...... Joan ¥. Thumma bei,,g duly .......... .S3'~o. iN~ ........ occordi,,g to law, deposes a,,d says ti, at She iS the Executrix ............... of fha Estate of Bernice R. Horst lefe of ..... ~eoha~io~b~rgs ............. Cumberland County, Pa., deceased end fh~f wilhln is a. ;nye.tory made by Joan ~Z. Tb.u~a of the enfire esfefe of smd decade.f, co,,sisthm of nil the perso. M properly e.d reel esfafe, excepf real esfefe outside the Commonwenlfh of Pa..sylvania, e.d lhef Jim figures opposHe eecl, Her. of fhe Invenfory represenf if's fair value es of fhe date of decede.f's deefh. _rZl:_gp 7s y.%}_l~ PA 17 0~3 Addres~ Date of Death 16 Jono 200~ Day Mo.th Year INSTRUCTIONS I. An inventory mus~ bo filed wifhin three months after ~ppo;ntment of personal represenfat;ve. 2. A suppleme.f ;nvenfory must be filed within thirty days of discovery of additlonal 3. Additional sheets may be attached as lo personally or really 4. See Arilcle IV, Fiduciaries Act oF 1949. IHVOHto~y of the ~oal arid i)olsoHal oslale of deceased (1) Members 1st Federal Credit Umion, Savings Account No. 71158-00. 367 78 Interest Accrued to 6/16/03. 23 (2) Members ].st Federal Credit Uniom, Investment Savings Account No. 71158-05. 8,252 75 Interest Accrued to 6/16/03. 5 05 (3) First National Bank of Marysville, Christmas Club Account ~.~o. 2107~70. 742 81 (~.) First National Bank of fiarysvil!e, Certificate of Deposit No. 30623~0. 1,027 36 (~) First National ];~au~ of ;.~arysville, Certificate of Deposit I,To. 3057993. 3,417 77 (6) First National Bank of i'(arysville, Certificate of Deposit No. 3062282. 1,031 [~$ (7) Commerce Bank, Checking Account Nc. 08-032070057. 2,759 96 (8) Commerce Bank, Savings Account ~o. 0(~-4.80001152. 5,025 ll (9) Commonwealth of Pennsylvania, property ta;~ rebate. 36( 09 (10) Household furnishings, sale price. 1,90] 00 (ll) Highmark Blue Shield, refund. 17~ 67 rota ........ $ a ,0 3 0a PETITION FOIl PROBATE and GRANT OF LETTERS /z~ta~e of B~IGE ~_t___I~ORST No. ~l--~-~ also known as ............................... To: ................................................... Register of Wills for the ................................ Deceaaed. Coumy of ~~_ in ll~e So¢ial S¢¢utt/v No 20 ~ ~' ' ~"'" ...... ~.0~9_~O~ ........ Comnlonwealth of Pennsylvania The petition of the undersigued respectfully represents Ihal: Your petitioner(s), who is/are 18 years of age or older an the execut P~x named in the last will of Ihe above decedent, daled February ~ - ~ 1998 and codicil(s) dated ' (state relevanl circmnstances, e.g. ;enunciation, death of execulor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h_e~ last family or principal residence at 213 West Simpson St,, Mechanicsbu~g, PA ~_05~ .......... (list street, number and muncipality) Deceudcn/, then ~9 _ years of age, died ..... J~P_ ~}6__t , = 2003 , at 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 nol the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) Ail personal property $ 2~ ~ 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 $ ~6 ~ 000. O0 situated as follows: House and Log of OPound sSg~go ag 213 ~ss¢ 85mp$on Street, Mechan~csbu~g,' P&_~ WHEREFORE, petitioner(s) respectfully re_quest(s) the probate of the last will and codicil(s) presented herewith and the grant of letters. Testamentary theron. (testamentary; administration cA.a.; administration d.b.n.c.t.a.) e JoaneY. Thuma 105 L~bs Gap Road Mavysvtlle, PA__lT0~3 OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA q COUNTY OF CUMBERLANDf ss The petitione~(s) above-n~med swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to thc best oi ~l~e knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decc~en! petitioner(s) will well and trnly administer the estate according to law. Sworn to or affkmcd and subscribed ~- J? Lf. ~~wr~ before me this . a?m,~ . __ dav of I ~ ~' No. Estate of __ BERNICE R. HORST , Deceased DECREE OF PROBATE AND GRANI OF LEI~TERS AND NOW _ July____._~ :lm.__2_003in consideration of the petition on the reverse side hereof, satisfactory p,'oof having been presented before me, lq' IS DECREED that thc instrument(s) dated ...... __F~.r_~ary __17, lC)~98 described therein be adtnit[ed to probate and filed of record as the last will of Bernice R. Horst __; and Letters_ Testamentary~ are hereby granted to __ Joan ~. Thumma FEES Probate, Letters, Etc .......... $~l,..q. OO _ J. Robert Stauffer-No. 06356 Short Certificates( ) $ /,5'-Oc'~ ATTORNEY (Sup. Ct. I.D. No.) .......... Market Square Bldg. R~a~adm~.~ .... $ &.oo Mechanicsburg, PA 17095 . .J0...io $ /o. cO .ADDRESS TOTAL .__ $~ 717_766_9673 Filed . .~7..5 .~. :-..d?._B. .................... PHONE [!li~tot/~i~i~?~2reTt~ljar~aew~l ~,2~eFo ~r~vS a~v°d~v~Ctr~ copied from an original certificate of death duly filed with me as 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 ~ · [~ Local Registrar P 9330949 No. ~ ~ - r Date mo~ :4a Rev .~a7 COMMONWEALTN OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS ~,~,.,.~ CERTIFICATE OF DEATH ,'~ ~a. ~nicsb~g ,,. ~w H, ~ ~*~"?~'""~'~ ~'~' ~'s~c~v,;4 ,,. Vlolette M. ~ee ~ms~ I~,~ J,~./u~ .mm~ ~p R~ M~sville, PA 17053 :~ ~ ~ ~ ,,. J~ 19, 2003 I,,=.W~la~ ~rial ~rde~J,,, H~risb~g, PA 17109 ~ i<- a ........... r~I I I'n'~/ ~ Q ~ ~ ~ ~ I~ ~ ~----.~.m~ FJI~;-: ...... -- i~. ~. i~. _ OF BERNICE R. HORST I, BERNICE R. HORST, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be sltuate to my four (4) children, to wit, LYNFORD T. EBERT, EDITH M. BROWN, IRVIN A. HORST, JR. and JOAN Y. THUMMA, share and share alike, per stirpes. 4. LASTLY, I nominate, constitute and appoint my daughter, JOAN Y. THUMMA, Executrix of this my Last Will and Testament and direct that.she be excused from posting any bond or other - 1 - security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~7 day of February, a. D. 1998. Bernice R. Horst Signed, sealed, published and declared by the above named, BERNICE R. HORST, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. - 2 - COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND) I, BER~ICE R. ~{ORST, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by BER~ICE R. }{ORST, the testatrix, this /~ day of February, 1998. otar~ Public COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND) We, the undersigned, j. ROBERT STAUFFER and SUSAN A. McCOY, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix, BERNICE R. ~{ORST, sign and execute the instrument as her Last Will and Testament; that the said testatrix, BERNICE R. ~{ORST, executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix, signed the Will as witnesses; and that to the best of our knowledge, the testatrix was, at the time, eighteen (18) or~-more years of age, of sound mind and under no , constraint, undue influence. Sworn and subscribed to before me this /?Ttday of ,February, 1998. Notary Public J Notarial Seal ! Marilyn E. Williams, Notary Public IMechanicsburg Boro Cumberland County [ My Commission Expires Nov. 6, 2001 Member Pennsylva[lia Association of Notaries -- 3 -- J. ROBERT STAUFI-'ER AT'TORNli¥ A'T LAW ~/~ARKE~ SQUAP~ BUXLDINC MECHANICSBURG, PA. 17055 I I IN THE COURT OF C0~.~E.~0N PLEAS OF CU~-IBERLAND COUNTY, PENNSYLVANIA NO. 200~ ORPHANS, COURT DIVISION· ' FZRST AND FINAL ACCOU~£ OF JOAN Y. Tt-KUM~A, EYSECUTRIX OF THE LAST WZLL A~D TESTAME~.~ OF BERNICE R. HORST, LATE OF THE BOROUGH OF MECHANTCSBURG, COU~TT OF CU~E~RLAND AND STATE OF PENNSYLVANIA, DECEASED. Date of Death: June 16, 2003. Dates of Advertisement of Letters Testamentary: In the Cumberland Law JoLLrnal: July 25 and August 1 and 8, 2003. In The Sentinel: July 23 and 30 and August 6, 2003. PRINCIPAL ACCOUNT Debits Accountant charges herself with the following receipts and assets of decedent,s estate, consisting of real estate and personalty as follows, to wit: 6/16 Commerce Bank, Account No. 032078057. ~ 2,759~96 6/16 Commerce Bank, Account No. 480001152. 5,025,i1 6/16 Members let Federal Credit Union, Account · Nos. 71158_5 and 71158-0. 8,633.75 6/16 First National Bank of Marysville Christmas Club Account No. 2107570. ' 6/16 First National Bank Of~Marysville, Certificate 742.81 of Deposit No. 3062350. 6/16 First National Bank of Marysville, Certificate 1,027.36 of Deposit No. 3057993. 6~16 First National Bank of Marysville, Certificate 3,417.77 o£ Deposit No. 3062282· 1,031.44 6/16 Commonwealth of Pennsylvania, property tax rebate. 7/31 Proceeds from sale of twin beds 360.09 · 20.00 8/7 Fairy Godmother, proceeds from sale of clothing. 100.00 8/26 Salt & Pepper Man, proceeds from sale of collection· 10/15 Prudential Financial, Inc. net proceeds from 1,100.O0 sale of stock. ' 10/15 Proceeds from sale of dishes. ~5~17 00 ll/3 High_mark Blue Shield, refund of premium. 179.67 -1- PRINCIPAL ACCOUNT ~ebits_ 2oo3 12/17 Elmer and Joan Thumma, proceeds from sale of washer, dryer and furniture. $ 535.00 12/19 Mitzi R. Valentine, refund on 2003 County and Borough taxes. 12/19 Mitzi R. Valentine, refund on 2003-2004 School ~ .5.90 t~o 295. 6 12/19 Mitzi R. Valentine, refund on Sewer rental. ~ 9.03 12/19 Mitzi R. Valentine, refund on Refuse collection 5.45 12/19 Mitzi R. Valentine, proceeds from sale of real estate located at 211 and 213 West Simpson Street, Mechanicsburg, PA. 49,000.00 12/24 Proceeds from sale of Card Table. 12/24 Verizon, refund. 95.00 12.40 2/9 J.J. Skelton, refund on service agreement. _ 149.94 GROSS PRINCIPAL ASSETS A~ RECEIPTS .................... $ 75,002.11 PRINCIPAL ACCOU~ Credits Accountant asks Credit fo~ the following amounts paid out of Principal in the Settlement and Admin- istration of decedent,s estate, to wit: 7/11 Cumberland Law Journal, Estate Notice. $ 75.00 7/ll UGI Utilities, gas to 6/17/03. 20.11 7/ll Borough of Mechanicsburg, 3rd quarter Sewer and Refuse. 117.22 7/11 Malpezzi Funeral Home, funeral expenses. 6,195.80 7/ll Verizon, telephone to 7/18/03. 7/21 PPL Electric Utilities, electric to 7/1/2003. 35.56 7/21 United Water Pennsylvania, water to 7/7/03. 19.72 7/21 Joan Y. Thumma, reimbursement for payment of costs of opening and closing grave. 850 00 7/21 Joan Y. Thumma, reimbursement for cost of ' Letters Testamentary paid to Register of 146 O0 7/23 The Patriot News~ advertising crypts for sale. 18~00 7/23 A.T. & T., service to 7/14/03. 3.27 -2- PRINCIPAL ACCOUNT ~Credits  /23 UGI Utilities, gas to ?/1~6/03 /4 Verfzon, telephone to 8/1~/03~ $ 18.59 28.76 8/4 PPL Electric Utilities, electric to 7/30/03. 41.24 8/7 Barry Heckard, Sr., 2003_2004 School tax. 8/14 The Sentinel, Estate Notice 554.55 · , 85.01 8/20 United Water Pennsylvania, water to 8/6/03. 8/29 UGI Utilities, gas to 8/13/03. 11.07 8/29 Verizon, teleph.one to 9/18/03. 16.73 26.25 9/8 PPL Electric Utmlities, electric to 8/29/03. ' 31.28 9/9 Paxton Herald, advertising crypts for sale. 2.00 9/9 The Patriot News, advertising crypts for sale· 21.40 9/18 United Water Pennsylvania, water to 9/4/03. 9/29 UGI Utilities, gas to 9/13/03 11 ~ ' , 17~ 10/3 J- J. Skelton, maintenance agreement· '~ 199.95 10/6 Borough of Mechanicsburg, 4th quarter Sewer and Refuse collection. 10/6 PPL Electric Utilities, electric to 9/30/03· 117'22' 10/6 Verizon, telephone to 10/18/03. 26·80 Iz 10/15 United Water Pennsylvania, water to 10/3/03. 11.07 10/15 TV Channel 27, advertising crypts for sale. 10/24 UGI Utilities, gas to 10/15/03. 5 00 10/28 V ' ' ermzon, telephone to 11/18/03. 15.84 24- ?4 11/3 PPL Electric Utilities, electric to 10/29/03 16.60 ll/ll J. J. Skelton, heating fuel. ' 11/17 United Water Pennsylvania, water to 11/4/03. 69.42 11/21 Tri County Pest Control, termite treatment. .6.75 11/24 UGI Utilities, gas to 11/12/03. 749.00 12/1 Vertzon, telephone 'to 12/18/03. 15.84 12/6 PPL Electric Utiliti~es, electric to 11/26/03. 30.82 11.74 12/15 United Water Pennsylvania, water to 12/3/03. 11.07 12/19 Re/Max Realty Associates, Inc., sales commission. 1,960.00 12/19 Re/Max Realty Associates, Inc., processing fee. 125.00 12/19 Recorder of Deeds, real estate transfer tax. 245.00 12/19 Commonwealth of Pennsylvania, real estate trane fer tax. - 245. oo 12/29 PPL Electric Utilities, final electric bill. 7.04 12/29 United Water Pennsylvania, final water bill. 12/29 UGI Utilities final gas bill. 3.60 20~ ' 22.33 1/13 Register of Wills, filing Inventory and Pennsyl- vania Inheritance Tax Return. , 25.00 1/13 Register of Wills Agent, Pennsylvania Inheritance Tax. 2,538.85 PRINCI PAL ACCOUNT --Credits 004 Joan ¥. Thumma, Executrix,s commission. $ 3,500.00 J. Robert Stauffer, Esq., attorney fee. 2,400.00 Cash, reserved to preparation of final Fiduciary Tax Return and contingencies. ,5oo.oo Register of Wills, filing Final Account. . ll~.00 TOTAL PRINCIPAL EXPENDITURES · INCOME ACCOUNT Debits Accountant charges himself with the following items of Income reveived, to wit: 8/4 1st National Bank of Marysville, interest. $ 8.10 9/1 1st National Bank of Marysville, interest. 7.09 10/16 1st National Bank of Marysville, interest. 9.20 ll/3 1st National Bank o£ Marysville, interest. 7-34 12/1 1st National Bank of Marysville, interest 20~ ' .7.43 1/5 1st National Bank of Marysville, interest. 25.21 2/2 1st National Bank of Marysville, interest. 35.37 3/1 1st National Bank of'Marysville, interest. ., 34.71 GROSS INCOI~ -- INCOME ACCOUNT Credits Accountant asks Credit for the following items charged against Income, to wit: None o_qi4 $ o.oo None 0.00 -4- $ o.oo SUMMARY Principal Account Debits ~ 75,002.11 Credits 21,397.75 $ 53,604.36 Income Account Debits 134.45 ~ ~ Credit 0.0___~0 ~ BALANCE IN ~NDS OF ACCOUNTANT FOR DISTRIBUTION .... $ ~ SCHEDULE OF PROPOSED DISTRIBUTION Suggestion is made, that the balance in hands of Accountan~ for Distribution, to wit, the sum of $53,738.81, be made in Cash under item "2." of decedent,s Last Will and Testament, to her four (4) children and therefore Distribution is proposed as follows: In CASH, to LYNFORD T. EBERT. $ 13,434.70 In CASH, to EDITH M. BROWN. 13,~34.71' In CASH, to IRVIN A. HORST, JR. 13,434.70 In CASH, to JOAN Y. 'THU~.~A ~ -5- C0~q4ONWEALTH OF PENNSYLVANIA.) )ss: COUI~Y OF CU~.~ERLAND ) Personally appeared before me, the undersigned officer, a Notary Public, in and for said Commonwealth and County, JOAN Y. THU~A, Executrix of the Last Will and Testament of BERNICE R. HORST, late of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, deceased, who being duly sworn , according to law, deposes and states, that she is the Accountant' in the annexed Account and that said Account is true and correct to the best of her knowledge, information and belief and that there are no unpaid creditors to be notified of this Account ' and the day of proposed decree of confirmation has been given to all parties who have an interest in the estate as beneficiaries and deponent further avers that the Schedule of Proposed Distribution o£ the net assets of the estate of BERNICE R. HORST, deceased, is true and correct, and is made in accordance with the Pr6~sions of said decedent.s Last Will and Testament and the laws of the Commonwealth of Pennsylvania, applicable thereto. Sworn and subscribed before me this ~,. day of March, A. D., 2004. ! ~ o ~ Notary Public COMMONWE~.,L.'I-H OF PENNSLVANIA -6- i hereby certify that written notice of the filing of flu: ',ii'; liE: TIL~ FIRST 1713 F!!!AL theOou~torconllm~lk~andollhek~tdeylot#e . .. wr#len oblecllons to ~id 81ateme~ of Proposed ACCOUN? OP JO:i?.}' Y, ?HUN'.X ~ Dlelrttii, llk~, haabeengi~lmtoeveryunpeidclelma~ L,.,, .. ...... ~ ~ ......... uo :,~.~.~,{.i ~ COLJ!iTif OF A ~ of ~ ~nt ~ i~t~ w~h the i hereby certify that written notice of the filing ~': this Account, and of the date, time and place when the same wilt be preeented to the Court for com~rrna~ a~d of the le~t day to ~e writte~ ~bjectio~s to said ACOOU~, ha~ been given to every unpaid ctaknent aed to ov~y othe~ pers¢ paajoeP u°!lnq!J[~!P pUB ~lotnl°sqe known to the accour~lm to have or claim an i~m~,,uoO ~unc~v ..... interest in the eetate a~ creditor, benefmiary, j. ROBERT STAUFFER ATTOP, bT~Y AT LAW M~T S~u~ MF. CH^NICSBURG, PA. STATUS REPORT UNDER RULE 6.12 Name of Decedent: BERNICE R. HORST Date of Death: June 16~ 2003 Will No. 2003-00~4~ 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. Did the personal representative file a final account with the Court? Yes x No 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 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. /,~igna~re ~" ~ ~ ~bert ~tauff N~e (Please type~ or print) '[echsn-~csbuPg, ~:~ !']:~r~'~,:,p . :~ ,UC [,~0 Address iSfiOO S,NVHd~O (?'17 ) '}'6~,-9673 Tel. No. ~0 :~ ~ ~}~I~Z capacity: Personal Representative ~T~ .... ~:~-~-~ x Counsel for personal fl0~j.~; -.: , z, representative (~H: rmf/~3) ~0-' ' ~