HomeMy WebLinkAbout02-0418
PETITION FOR PROBATE and GRANT OF LETTERS
No.
To:
Register of Wills for the
, Deceased. County of LV"" &:"- '4N 1-> in the
Social Security No. Zl> 2...- 56 _ (p .,~ \" Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execuw n.- named
in the last will of the above decedent, dated v;i~AI'P,Y tF-, 19~
and codicil(s) dated
21-~418
Estate Ofc'4~DI"'-'< R ~ J4,~ L./)C~J
also known as
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in r U'h 6,.~ L ,-,.,J;> County, Pennsylvania, with
h .AJ7_ last family or principal residence at ./0 (/ ~..,. ALL~....J .!) /o? I ......-~
/VI Gc #A"-' I C"~ ~ ~ ~- u...pJl/i>-Sc- A ~ ~ ......; --r-A-!>. / 70...r- .1-
(list street, number and muncipality)
Decendent, then ----L5- years of age, died A?,e, L- ,7' ,-1-9 z.,,p~
at /'-1~ t;",AS+-! ~ l-' A- C G /"? ~ hi"......, I C S".iS <J ~ :0- . .
Except as follows, decedent did not marry, was hot 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: ,... ^f ,,4...:-.
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
;2 l' 2.... 0 tJ 0
,
$
$
$
$
2-92.... t!)dt)
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters -r-~~~+A 12/Y-
(testamentar~; administration c.La.; administration d.b.n.c.La.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF Cu m 13C:L ~ ~ J
The petitioner(s) above-named swcar(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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No. 21-Q;t-418
Estate of
GERALDINE R WILDEMAN
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIL 25 Ji~ 2002, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before ~ .
IT IS DECREED that the instrument(s) dated .J1 PI?,1 7 l' ~ ~ ~/ 1'/"7
described therein be admitted to probate and filed of record as the last will of
Ge~{D~rV.?- 12.... frle:-.tJ~
and Letters ~~A-/t?~.... 1-,.4 tt:i!. \.y-
are hereby granted to .r ~ /., c...~ / ~- BA-p-d v.r H
~)1//:I (? ;f;//.Lt2~,t2a<J,(IV ~&'7
Re . 1er of Wills
FEES
$ 270.00
$ 16 . 00
$ 12 . 00
$ 5.00
TOTAL _ $ 323.00
Filed ..... .APR.LL .25.,. .2002. . . . . . . . . . . . .
Probate, Letters, Etc. .........
Short Certificates( )..........
lfedUntfil~ion ..... ... ........
JCP FEE
ATTORNEY (Sup. Ct. 1.D. No.)
ADDRESS
PHONE
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REGISTER OF WILLS OF CvM I~c~ kJ-.J) COUNTY
OATH OF SUBSCRIBING WITNESS
{lAd/ill A 2t11~(.I.sh
codicil
(each) a subscribing witness to the ~ pr~ented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that ..i- A m present and saw
<::t:-;" --;--
the testat ft.. 1'1..... , sign the same and that ~ ___ signed as a witness at the
request of testat~ in h t V presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
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()1a:n, I'Amel?~.56
Sworn to or affirmed and subscribed before
me this 23rd day of
I APRIL ._ Hl~2
'>>:J'lfU~P !f/<L~ ~//)AJ/ 4~o/
," ',.'. Register
I r"'~i
r,
(Address)
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REGISTER OF WILLS OF C VIn 13G.~ /) COUNTY
OATH OF NON-SUBSCRIBING WITNESS
SAMUEL M BARBUSH
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
.:;:- ~ familiar with the signature of c: &~~/____.12 , hi { ~~
codicil
testat.Lk.:!!::.....- of (one of the subscribing witnesses to) the Gill> presented herewith and
codicil
that ~ believ~ the signature on the.@s in the handwriting of
C;C~~O A~../__ .?2 _ h-- . ? t) ~/
knowledge and belief.
,~~.;.-, /~
me this 23rd __ day of (Name)
APRIL ~ 2002 SA1-?u.et:.-,.". 8...4~6IJs/~
~ny 12 r<-,,",/h/J/ft ) ~L4 (Address)
. Register I / / () (,I' rea,..,- ~&J , J> /I v--<-
to the best of
MV
/
Sworn to or affirmed and subscribed before
(Name)
C~p /~// ?A.
(Address)
/70//
H
21-CQ..-418
LAST WILL AND TESTAMENT
OF
GERALDINE R. WILDEMAN
I, GERALDINE R. WILDEMAN, of 325 Wesley Drive, Mechanicsburg,
Cumberland County, Pennsylvania, being of sound mind, memory and
understanding, do make and publish this my Last Will and Testament,
hereby revoking and making void all former Wills by me at any time
heretofore made.
ITEM I.
I appoint Samuel M. Barbush,
CPA, to be the sole Executor of my estate and the sole Testamentary
Trustee of any trust herein created. In the event of renunciation,
death, resignation or inability to act for any reason whatsoever of
Samuel M. Barbush, CPA, I nominate, constitute and appoint Dauphin
Deposit Bank & Trust Company, of Harrisburg, Pennsylvania, to be
and act as Executor of my estate or Testamentary Trustee of any
trust herein created.
No Executor, Trustee or other fiduciary
herein appointed shall be required to post bond or provide any
security as fiduciary hereunder.
11
1
ITEM II.
I have maintained a list of
beneficiaries who are to receive several items of jewelry and other
tangible personal property within my personal papers.
I direct my
Executor to carry out my desire in this regard.
ITEM III.
I give all the rest, residue and
remainder of my estate equally among the following individuals, or
their living issue per stirpes:
A. My grandson, Peter Wildeman.
B. My daughter, Marydel W. Clark.
C. My daughter, Miriam W. Olsson.
ITEM IV.
Any income or principal payable
to any beneficiary who is a minor or to be a beneficiary who, in
the sole judgment of my personal representative, is mentally or
physically incapacitated, shall be held in trust by Samuel M.
Barbush, Trustee, during such minority or incapacity. Trustee is
authorized, in his exclusive discretion, to expend from income or
principal such sum or sums as may be necessary for the proper care,
2
11
II
maintenance and support of such minor or incapacitated beneficiary
directly, without the intervention of a guardian or committee; or
Trustee may pay the same to any person having care or control of
said beneficiary or with whom the beneficiary resides, without any
duty on the part of Trustee to supervise or inquire into the
application of the funds by any person to whom payment is so made.
Any income and principal not so expended by Trustee shall be
retained by Trustee and paid to the beneficiary upon termination of
the incapacity (including minority), or to the estate of the
beneficiary if he or she dies before reaching the age of majority
or while still incapacitated, as the case may be.
For purposes
herein contained, the age of majority shall be twenty-one (21)
years.
ITEM V.
In addition to the powers
conferred by law, I authorize my Executor or Trustee, in absolute
discretion:
3
11
A. To retain ln the form received and to sell either at
public or private sale any real or personal property.
B. To manage real estate.
C. To invest and reinvest only in forms of property defined
as legal investments according to the laws of the Commonwealth of
Pennsylvania.
D. To exercise any optional rights arising from ownership of
investments.
E. To compromise claims without court approval, and without
the consent of any beneficiary.
ITEM VI.
It is hereby directed that my
Executor, hereinafter named, shall pay all inheritance, state,
succession and legacy taxes to which my estate or the transfer of
any property hereunder may be subject and to charge such tax as
part of the administration, payable out of my residuary estate.
4
, .
"
> .
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
? dayof ~
7
, 199t.
~~/f~(SEAL)
GERALDINE R. WILDEMAN
The preceding instrument, consisting of this, and four other
typewritten pages, was on the date thereof signed, published and
declared by GERALDINE R. WILDEMAN, the Testatrix therein named, as
and for her Last Will, in the presence of us, who at her request,
in her presence and in the presence of each other, have subscribed
our names as witnesses hereto.
r;iLL1d~
5/() likm r1v-e.... J&u,. /J; 11j55
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Residing at
Residing at
20559-1
5
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BARBUSH & HOFFMAN
1104 FERNWOOD AVENUE
CAMP HILL, PA 17011
______u fold
ESTATE INFORMATION: SSN: 202-36-6505
FILE NUMBER: 2102-0418
DECEDENT NAME: WILDEMAN GERALDINE R
DATE OF PAYMENT: 07/01/2002
POSTMARK DATE: 06/28/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 04/09/2002
NO. CD 001356
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $25,399.93
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: BARBUSH & HOFFMAN
NO CHECK #
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$25,399.93
MARY C. LEWIS
REGISTER OF WILLS
~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: c;6eAt.~6
R. J'V/ ~.}jE"""~
Date of Death: t4}>,02., L
" 2-C)l) ~
Will No.
2- 60 2- - 0 0 ~ I ~
Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on J 11 Ij /2 I l(yJL :
liww< Address
M~YLJEL
C LA-AZ /c::.
.2. 44u I(f!~L /)t('j ".A.. /"'1 ~#A-/e ~ ,4,,e9. ~. /74~
H/~(~
o/.,,~oJ'
,2;J. 7 .1-- ~ p Y4- 4.
~g, 1"',",- W"Arr&';C..r,~ .,.,rc. ..:L? .$'70
,
.:p,-,-.12 4-- Yv I L.-J e-iI'Y?~
IlK
.
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
~. 5. 01.-
Signature ~~ ~
Name s;'''+ntLle--t-- M' ~n/g~SH
Address /10 s/ R;z~l-v71t-CO A If.:' ~
c~,. .Ih/I,
~.
r7lJ , "
Telephone ("'7)
76/'- 2-h I
~ j
Capacity: ,/"Personal Representative
_Counsel for personal representative
SAMUEL M. BARBUSH, CPA
DAVID B. HOFFMAN, CPA
BARBUSH AND HOFFMAN .
CERTIFIED PUBLIC ACCOUNTANTS
1104 FERNWOOD AVENUE, SUITE 204
CAMP HILL, PENNSYLVANIA 17011-6912
(717) 761-2801
FAX (717) 761-2923
e-mail: b_h_cpas@barbushandhoffman.com
MEMBERS OF:
PENNSYLVANIA INSTITUTE
AND
AMERICAN INSTITUE
OF
CERTIFIED PUBLIC ACCOUNTANTS
E.I.N. 2S-1697Sn
Estate of Geraldine R. Wildeman
Also known as
Geraldine R. Wildeman Deceased
(Died April 9, 2002)
Late of the Township of Upper Allen
Cumberland County P A
File No. 21-02-0418
INVENTORY
Commonwealth of Pennsylvania
SS: 202-36-6505
County of Cumberland
Samuel M. Barbush, CPA of Barbush and Hoffman, CPA's, Executor of the Estate of
Geraldine R. Wildeman deceased having been duly affirmed according to law did depose and
say that the items appearing in the following inventory are personal assets wherever situate
and real estate if any in the Commonwealth of Pennsylvania of said decedent that the valuation
place opposite each item of said inventory represents its fair value as of the date of the
decedent's death and that the decedent owned no real estate outside the Commonwealth of
Pennsylvania except that which appears in a memorandum at the end of this inventory.
Affirmed and subscribed by me
This jl{t^ day of ~2002
~~
/~~~
,
r TAr::"~ 0~~~~~1~ ~~~a~ Public
I Lowe( ;,k:,', CUiTlberland County
My ~:.:~~i~.::~_~~n Expi~s ~u!y 5, 2006
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX111-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BARBUSH SAMUEL M
1104 FERNWOOD AVENUE
CAMP HILL, PA 17011
__nun fold
ESTATE INFORMATION: SSN: 202-36-6505
FILE NUMBER: 2102-0418
DECEDENT NAME: WILDEMAN GERALDINE R
DATE OF PAYMENT: 11/26/2002
POSTMARK DATE: 11/25/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 04/09/2002
NO. CD 001886
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3.26
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: SAMUEL M BARBUSH
CHECK# 1004
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$3.26
MARY C. LEWIS
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent: qtraJdJnt. /f.. Wi Idcmar7
Date of Death: 4. q. J-OOl.--
Will No.: .200-< - C04j'l Admin. No.:
~t/
f))(
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion ofthe administration ofthe above~captioned estate:
1. State~ether administration of the estate is complete:
Yes~ No 0
2. lithe answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. lithe answer to No.1 is Yes, state the following:
a. Did the personal ~sentative file a final account with the Court?
Yes _ NOA
b. The sepaxat" ftbam,' Court No. (if any) for the personal representative's
account 1S:
c. ?i~ the person~sentative state an account informally to the parties
mmterest?Ye~ No 0 -
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
and may be attached to this report.
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Signature
o t1jYU1fj
Name
~
rr1 brbusJ? C{J~
Date: ~O+
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J/04- f:Crnwortl he I Suik JfJ4-
Address camp+{; 1/, {J fl /10" I
-1J 1 1j~/- JifJ/
Telephone No.
Capacity: Wersonal Representative
o Counsel for personal representative
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\v BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REY-I6D7 EX AFP (Ol-OS>
SAMUEL M BARBUSH
BARBUSH & HOFFMAN
1104 FERNWOOD AVE 204
CAMP HILL PA'17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-21-2003
WILDEMAN
04-09-2002
21 02-0418
CUMBERLAND
101
GERALDINE R
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV= i60-j-E"X-AFP-(' oY:oiY------...-iNHERiTANCE--fi,3Csi' A'TEME-Nf-OF-i,ccouiiT--...---------------- - - ---
ESTATE OF WILDEMAN GERALDINE R FILE NO.21 02-0418 ACN 101 DATE 01-21-2003
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: 01-20-2003
P R I NC I PAL TAX DUE: ...............................................................................................................................................................................
............................................
26,740.02
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-28-2002 CDo01356 1,336.84 25,399.93
11-25-2002 CDo01886 .00 3.26
TOTAL TAX CREDIT 26,740.03
BALANCE OF TAX DUE .0ICR
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .0ICR
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 1
/7~9- /.;;Y
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'\.i.
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-20-2003
WILDEMAN
04-09-2002
21 02-0418
CUMBERLAND
101
SAMUEL M BAR BUSH
BARBUSH S HOFFMAN
1104 FERNWOOD AVE 204
CAMP HILL PA ~7pll
'*
REY-1547 EX AFP (01-05)
GERALDINE R
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV =iS4j-EX-AFi'--foY=oiY-NOYicE--OF-YNHEifiTAifcE-TAiC-A-PPRA-isEi'-ENT~--ALiowAircE-cfR------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WILDEMAN GERALDINE R FILE NO. 21 02-0418 ACN 101 DATE 01-20-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS.
.00 X 00 = .00
594,222.64 X 045 = 26,740.02
.00 X 12 = .00
.00 X 15 = .00
(9)= 26,740.02
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
.00
234.648.88
.00
.00
44.560.38
.00
350.761.86
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO)
24,250.56
11.497.92
(11)
Cl2)
Cl3)
Cl4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
629,971.12
35.748 48
594,222.64
.00
594.222.64
.
"..........~ Ill+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-28 2002 CDOO1356 1,336.84 25,399.93
INTEREST IS CHARGED THROUGH 02-04-2003 TOTAL TAX CREDIT 26,736.77
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 3.25
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .01
TOTAL DUE 3.26
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
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./~ No 1-'1
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 r~.~ff,~sentative file a final account with the Court?
Yes _ No,/~
b. The separate Or~haus' Court No. (if any) for the personal representative's
account is: _~
c. Did the personal~sentafive state an account informally to the parties
in interest? Yes/l~J No [-] '
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: d'6OO p
~ignatm:e
Name
Telephone No.
Capacity:' ~'~_ersonal Representative
[~] Counsel for personal representative
~1~recll-a1:'."
..., COMMONWEALTli OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
. DEPT. 281J601
HARRISBURG, PA 17121l.{)6()1
::>FHC~:;:'l USE ON:,.';' V
"......LZ::.>m..~'l:...l~m......
FILE NUMBER
21 02 0418
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ro..NTY~ Y€.to.R
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DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAL)
WilDEMAN, GERALDINE R.
SCCIAL SECURITY NUMBER
202-36-6505
DATE OF DEATH IM~.DD.YEAR)
04109/02
DATE OF BIRTH (MM.DIl- \'EAR)
11/13/12
THIS RETURN MUST BE ALED IN DUPUCATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
~ f!] 1.OrigirlalRiKum 02SuppiemsI'1talRetum D3.RemainderReturn(<lBIetr.dFJalhprio"lolZ-IU21
~~ ~ 04. Limited Estate 0 4a. Furure Interest Compromise (CRo:dEllllhdfJ 12.12-a21 05. FeQemlEstate Tax Rerum Required
w"g
is f i 0 6. Oeced&nt Died Testate iA:tad> C:JIl'f o!"WlQ 0 7. Decec!ent Maintained a Living Tn:st (Attach CllPi IJfTII:5:) 8. Total Number of Safe Deposit Boxes
..
.. 0 9. Litigation Proceeds Recel'ffld 0 10. SpousafPovertyCreait(:lale;Jfcealhbe\weel'lIZ_31-91 arcll.1-iSj 0 H. Election tala)( under Sec. 9U3{A) (A7acIl5dlOi
.. 411'l$$$:~ilifll$t~~'~i.tC~~AII..i~Ittt#!l);1#ki~RItA~~m.lUj;bilill'lt:1lI'1l9tfj:i!tti)i'.
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w NAI>lE COMPLETE MAILING ADDRESS
i SAMUEL M. BARBUSH, EXECUTOR 1104 FERNWOOD AVENUE
g FIRM NAME l'_t SUITE 204
::! BARBUSH & HOFFMAN, CPA'S CAMP Hill, PA 17011
~ TELEPHONE NUMBER
u (717) 761-2801
I. Real Es.." (ScI1edule A) (1) 0.00
2. Stocks and Bonds (Schedula B) (2) 234,648.88
3. Closely HI!Id Corporation, Partnership or Soie-Proprietorship (3) 0.00
4. Mortgages & Notes Receivable (Schedule D) (4) 0.00
5. Cash. Bank Deposits & Miscellaneous Pel'S(]nal Property (5) 44,560.38
Z (Schedule E) -'
0 , 0.00
6. Jointly Owned Property (Schedule f) (6)
~ o Separate Billing Requesteci
j: 7. InterNivos TransfefS & Miscellaneous Non-ProtJate Property (7) 350.761.86
(Schedule G or l)
a:: a TobI Groll Allots (to~ Lines 1-7) (B)
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() 9. Funeral Expenses & Admjnistra~ve Costs (Schedule Hl (9) 24,250.56
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0:: 10, Debts of09C8dent Mortgage Liabi!ities, & Liens (Schedule I) (10) 11,497.92
11. Total Deductions (tolel Unes 9 & 10) (11)
12. Net Value 01 Estat. (line B mifWs Line 11) (121
13. Charitable and Governmental Bequests/See 9113 Trusts for which an eleCtion to tax has not been (13)
made (SchedUle J)
14. Net Value Subject 10 Tax (line 12 minus line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES
629,971.12
35,748.48
594,222.64
0.00
594,222.64
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15. Am:lUnl of Linll14 taxable at the spousal tax 0.00
"'''. or iIllnsfet> under Soc. 9116 (aU1.2) x.O_ (IS,
16. Amount of Line 14 taxable at lineal rate 594,222.64 x.o 45 (16)
17. Amount ot Line 14 taxable at Sibling rate 0.00 x .12 (17)
18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18)
19_ Tax Due (19)
26,740.02
26.740.02
200
%ttiFhhHnWS*Qlii,$jf{i;tQ'~~A4i4~tl4tl$~~~i;i$~~!tn!ii~&{IifAtf!*A
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Qltced~IM's Complete Address:
STREET ADDRESS
C/O~~AMIIEl M. BARBUSH
1104 FERNWOOD AVENUE, SUITE 204
CITY CAMP HILL I STATEpA I ZIP 17011
Tax Payments and Credits:
1. Tax Due (Pagel line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
26.740.02
25.399.93
1,336.83
Total Credits ( A+ 8 + C) (2)
26.736.76
3. InteresllPenally ~ applicable
a.lnlerest
E. Penally
0.00
0.00
TotellnteresVPenally ( 0 + E) (3)
4. If Line 2 is greater than line 1 + lina 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 10 request a refund (4)
5. If line 1 + Line 3 is great.r than Line 2, .nler the diff.rence. This is the TAX DUE.
3.26
A. Enter the inlerest on the tax du..
(5)
(SA)
8. Enter the total of Lin. 5 + SA. This is !he BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
3.26
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did deced.nt make a Iransf.r and: Yes
a. r.tain th. use or incorn. of th. property transf.rred;.......................................................................................... 0
b. r.tain the right to designate who shall use the property transferred or ils incom., ............................................ 0
c. retain a reversionary interest; Dr......"..............................................................."'...,............................................ 0
d. receive the promise for life of either paymenls. benefils or care? ...................................................................... 0
2. If death occurred after December 12.1982, did _nttransf.r property WIthin one year of death
without recei~ng adequate consideration? .............................................................................................................. 0
3. Did deced.nt own an "in Imst fo~ or payable upon death !lank account or securily at his or her d.ath? .............. 0
4. Did deced.nt own an Indi~dual Retirem.nt Account, annuily, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Undllrpenaltiel Dfpe~l.J'}', I d8c1;ntlat I hav. e:tarnned hI relLtn, induling aa::o~g scNciJIeI.d~, and to Ule bast of my knO'olltedge and belief, itis tNe. oorrad: lI'Id canple1ll.
o.dafaticrI rJ pnIpaNf ok 1hen fl. P<<SOhlIl representatYI is baed lll'I all infmnaton of wnen preparer n. any krnwledge.
SIGNATUR f PERSON RESPONSIBLE fOR RUNG RETURN OAT
".~~'-- /,.,.....-
ADDRESS '
1104 FERNWOOD AVENUE. SUITE 204, CAMP Hill, PA 17011
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
1104 FERNWOOD AVENUE. SUITE 204, CAMP Hill, PA 17011
DATE
,tW1mwf*!mtf$fiflf:fFmMttmH:tfwt!@!NMm@a1rHtt~@'&tm-itiM}m;%rf:tt{Mit.tBillMMmMnMtHMr.tRMtf:iM.~.%MNin;1!mttjj&@%H#Wt.mgDMt.Hmt.@HmfntJ.t.m
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
(72 P.S. ~9116 (al (1.1) (ii].
for dates of death on or after January 1, 1995, the lax rate imposed on !he nel value of Iransfers to or for the use of t,e SUIViVlng spouse is 0% (72 P.S. S9116 (a)(1.1) (ii)!.
The statute does not AXAmot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure of assets and filing a tal' retum Bre stll applicable even jf
the sulViving spouse is the only beneficiary.
For dates of death on or after July I. 2000:
The tax rate imposed on the net value of transfers from a deceased ohid twenty-one yea,s of age or younger at death to or for the use of e nalural parenl, an adoptive parenl,
or a stepparent of the o.~"d is 0% [72 P.S. 99116(a)(1.2)].
The1ax rate imposed on the nel value of Iransfers to or for the use of lI1e oacedent's lineal beneficiaries is 4.5%. excePt as noted in 72 P.S. 99116(1.2) (72 P.S. s9116(a)(I)].
The tax rate imposed on lhe net valu. of transfers 10 or for the use of the decedent's siblings is 12% (72 P.S. s9116(a)(1.3)]. A sibling is defined. under Section 9102, as an
individuai who has at least one parent in common ~ith the decedent. wtlether by biood or adoption.
,
REV.151lI'EX+ (S.98)
.
COMMONWEAI.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
GERALDINE R. WILDEMAN
FILE NUMBER
21-02-0418
All property jolntJr-owned with right 01 &UlYlvorshlp mut be dlsdos.d on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
ALLIED IRISH BANKS, PLC COMMON STOCK
CUSIP # 019288 40 2
981 SHARES
VALUE AT DATE
OF DEATH
23,131.98
PNC FINANCIAL SERVICES GROUP INC. COMMON STOCK
CUSIP #693475105
2668 SHARES
159,733.16
FIRST TRUST INSURED MUNICIPAL BOND SERIES 124
ACCOUNT # 12929293220
30 SHARES
3,119.70
NUVEEN INTERMEDIATE MUNICIPAL BOND CLASS R FUND 543
ACCOUNT # 1464375
4,463.41 SHARES
41,331.64
OPPENHEIMER LIMITED TERM GOVERNMENT FUND
ACCOUNT # 855 8551 231076
723.830 SHARES
7,332.40
TOTAL (Also enter on line 2, RecaplllJlauon) $
(If more space is needed, insert additional sheets of the same size)
234,648.88
f
REV-ldEX+ (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECeDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
GERALDINE R. WILDEMAN
FILE NUMBER
21-02-0418
lndude the proceeds of Iitigalion and the date the proceeds were received by the estate.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. PNC BANK CHECKING ACCOUNT
ACCOUNT # 5410068851
VALUE AT DATE
OF DEATH
41,200.14
2. CANADA LIFE ANNUITY - APRIL PAYMENT
684.25
3. FIRST TRUST SERIES 124 INTEREST INCOME
26.40
4. CAPITAL BLUE CROSS INSURANCE REFUND
167.05
5. CAPITAL BLUE CROSS PRESCRIPTION REFUND
201.90
6. PNC FINANCIAL SERVICES DIVIDEND CHECK
ACCOUNT # WILDEMAN-GER
1,280.64
7. FURNITURE AND PERSONAL ITEMS
FURNITURE WAS IN A ONE BEDROOM ASSISTED CARE ROOM AT
MESSIAH VILLAGE NURSING HOME:
CEDAR CHEST
SINGLE BED
WOODEN DRESSER
ROUND WHITE WICKER TABLE
WHITE WICKER CHAIRS
900.00
8. CASH ON HAND
100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
44,560.38
r REV-15m EX. (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
GERLADINE R. WILDEMA1'l
FILE NUMBER
21-02-0418
This schedule must be completed and filed if the answarto any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLLllEM tW.E OF TJoETlVMFEREE, T1-EIR RELATlONSHIPTOOECEOEHr Nt) DATE OF DEATH % OF DECD'S EXCLUSION TAXABUE
NUMBER nt?: DATE OF "TRANSFER ATTAO-I ACOPYOFMDEED FOR REAlESTATE_ VALUE OF ASSET INTEREST (IFAPPL'c.aaEl VAlUE
1. UNION CENTRAL LIFE INSURANCE CO. 101,316.62 100% 101,316.6
CONTRACT # C 6100 7774
TRANFEREE: ESTATE OF GERALDINE R. WILDEMAN
DATE OF TRANSFER: MAY 24,2002
PHOENIX LIFE INSURANCE CO. 249,445.24 100% 249,445.2
CONTRACT # Q 0006007625
TRANSFEREE:MARYDELCLARK,DAUGHTER
MIRIAM OLSSON, DAUGHTER
DATE OF TRANSFER: MAY 23,2002 & AUGUST 20,2002
TOTAL (Also enter on line 7 Recapitulation) S 350,761.86
2
4
(If more space is needed. insert additional sheets of the same size)
REV.1S"" EX. (12.991*
COMMON'W'EALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GERALDINE R. WILDEMAN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISlRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-02-0418
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
,.
MALPEZZI FUNERAL HOME 8,633.98
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal RepresentatiYe(s) BARBUSH AND HOFFMAN, CPA'S
Social Security Number(s}IEIN Number of Personal Represenlative(s)
Street Address 1104 FERNWOOD AVENUE, SUITE 104
City CAMP lDLL Sta PA Z' 17011
t8_lp
1001 5,000.00
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation)
Claimant
Street Address
City State_Zip
Relationship of CIslmant to Decedent
4. Probate Fees 313.00
5. Accountant's fees 10,000.00
6. Tax Return Preparer's Fees
7. EXECurOR'S NOTICE
PATRiOT NEWS 177.10
THE SENTINEL 116.48
TOTAL (Also enter on line 9, Recapitulation) I 14.150.56
(If more space is needed, insen additional sheets of the same size)
. F REV-15J2!.X+ (8-98)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEAl1l-l OF PENNSYlVANiA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GERALDINE R. WILDEMAi'l
FILE NUMBER
21-02-0418
Include unreimburnd medical expense5.
ITEM
NUMBER
1.
DESCRIPTION
VAlUEAT DATE
Of DEATH
403.81
ALERT PHARMACIES
HABITAT FOR HUMANITY
12.00
MESSIAH VilLAGE
6,914.05
STORAGE DEPOT SOUTH
116.60
PHARMERICA
219.23
HOLY SPIRIT HOSPITAL
25.44
ASSOCIATED CARDIOLOGISTS
25.00
VERIZON
12.79
FEDERAL TAXES - 1040 FEDERAL TAX RETURN
3,731.00
STATE TAXES - PA-40 PENNSYLVANIA STATE TAX RETURN
38.00
TOTAL (A~o enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11,497.92
. . REV:,;nEX'(9~~ .-
COItldONWEA1..TH OF PENNSVlVA.~1A
INiiERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
GERALDINE R. WILDEMAN
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-02-0418
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE
[ TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)1
MARYDEL CLARK 33.33333
2 LAUREL DRIVE DAUGHTER
MECHANICSBURG, PA 17055
MIRIAM OLSSON 33.33333
2722 ROYAL DRIVE DAUGHTER
WINTERVILLE, NC 28590
PETER WILDEMAN
118 DIKEMAN STREET 33.33333
HEMPSTEAD, NY 11550 GRANDSON
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 B. AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS;
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- 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)