HomeMy WebLinkAbout03-0335PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Gloria L. Burns No. ~-
To:
Social Security No. 209-12-9982 Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner, who is 18 years of age or older and the executor named in the last will of the above
decedent, dated May 7, 1982 as result of the death of the named executor, Michael J. Burns, on June 27, 2002.
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal
residence at 624 State Street, Lemoyne Borough.
(list street, number and municipality)
Decedent, then 76 years of age, died March 11, 2003, at Lemoyne, Pennsylvania.
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:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: 624 State Street, Lemoyne, Cumberland County
$ not estimated
$. not estimated
WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the grant
of letters testmentary thereon.
Signature(s) and Residence(s) of Petitioner(s) /~ ~r__~)~~
OUG~S E. BURN~
530-B Florida Avenue
Portsmouth, VA 23707
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA :
: SS
COUNTY OF CUMBERLAND :
The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the
best of the knowledge and belief of petitioner and that as perso~,representative of the above decedent petitioner will
well
and
truly administer the estate according to law.
_ _, 2003 .
~~~ Signature(s)
/'2-
Estate Of
DECREE OF PROBATE AND GRANT OF LETTERS
, Deceased
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated_ /'~u '3. I o ~',:~.
described therein be admitted to probate and filed of record as the last will of
and Letters - 1~:,3T~,
are hereby granted to
~4~'~..~, in consideration of the petition on
FEES
.obate, Letters, Etc ~
Short Certificates( ) .......... $ )~'
Renunciation ................ $.
TOTAL
Filed . .~',./... t/~,. ~,~.~. ~.. ..........
R~gister of
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of No.
also known as To:
Register of Wills for the
, Deceased. County of
Social Security No. 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 execut_
in the la.st will of the above decedent, dated _
and codicil(s) dated
in the
named
_, 19
relevant circumstances, e.g. renunciation, death of executo
Decendent was domicile~at death in
h. last family or pril~ipal residence at
(list street, number and muncipality)
Decendent, then __ :ars of age, died
at__
Except as follows, decedent ot marry, was not divorcee
after execution of the will offered probate; was not the vi
Pennsylvania, with
incompetent:
Decendent at death owned property
(If domiciled in Pa.) All
(If not domiciled in Pa.)
(If not domiciled in Pa.)
Value of real estate in Pennsylvania
situated as follows:
did not have a child born or adopted
m of a killing and was never adjudicated
th estimated as follows:
property $
~roperty in vania $
~roperty $
$_
WHEREFORE, petitioner(s) respectful
presented herewith and the grant of letters
theron.
.-quest(s) the probate of the last will and codicil(s)
(lestamentary; administration c.t.a.; administration d.b.n.c.t.a.)
\ E
O~TH OF PERSONAL REPRESENTATIV
COMMONWEA/LTH OF PENNSYLVANIA
COUNTY OF /~f ~ re
itioner above-named swear(s) or affirm(s) that the statements in the foregoing petition a
The pet .r/! .a~b~o ..... r.h~ t~nowledoe and belief of petitioner(s) and that as person,a.l repre, sen
rrec to tilt: t/Cbt ,o~ ttt,,. ~ m -
true a,n? c? _ :)t.to u_~ ........ ;. .... t~ will well and truly administer the estate accormng to law.
tativets) oI tn?aBove oec~ucnt
Sworn to /r affirmed and subscribed c ~'
before me this _ day o ~
Register [
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9 0 9 312 8 i zoo3
No.
Local R~gistrar ..... ~
Date
,5,144 R~v. 1191 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH ' VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
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~ 76 v,..I ~~r.21,1926l~ Hill PA
~.. Cumberland Lemoyne I 624 State Street I~,..~,~ ....
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................... ~..~a .... ~e~.~.~ .... ~ ............... ~ ~. [a~e.~arch 11, 2003
qAME AND ~SS OF PER~ ~ C~EO CAU~ ~ ~a
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~echantcsburg. Pa. 17050
LAST WILL AND TESTAMENT
OF
GLORIA L. BURNS
I, GLORIA L. BURNS, a domiciliary of Cumberland County,
Commonwealth of Pennsylvania, being of sound and disposing
mind and memory, do hereby make, publish and declare this
instrument to be my LAST WILL AND TESTAMENT. I hereby
revoke any and all wills and codicils by me heretofore made.
I
IDENTIFICATIONS AND DEFINITIONS
A. I am married to MICHAEL J. BURNS, hereinafter
referred to as "my Spouse." We have one (1) child, DOUGLAS
E. BURNS. References in this Will to "my Children" include
this one (1) child and any other lawful children born to or
adopted by me.
B. The following definitions obtain in.any use of the
terms in this Will:
"Descendants" means the immediate and remote
lawful, lineal descendants of the person
referred to, and it means those descendants in
being at the time they must be ascertained in
order to give effect to the reference to them,
whether they are born before or after my death
or of any other person. The persons who take
under this Will as Descendants shall take by
right of representation, in accordance with the
rule of per stirpes distribution and not in
accordance with the rule of per capita
distribution. Persons legally adopted when
under the age of fourteen years shall not be
differentiated from blood descendants for any
purpose.
"Survive me" is to be construed to mean that the
person referred to must survive me by thirty
days. If the person referred to dies within
thirty days of my death, the reference to him
shall be construed as if he had failed to
survive me.
As used in this Will, the words "Executor,"
"he," "him," "his," and the like shall be taken
as generic and applicable to a natural person of
either sex or a corporate person or other legal
entity.
Page 1 of 4 Pages
II
PAYMENT OF DEBTS AND TAXES
I direct my Executor to pay the following as soon after
my death as may be practicable:
All of my just debts and the expenses of my last
illness, funeral and of the administration of my
estate; but my Executor need not accelerate and
pay those unmatured obligations which, in his
opinion, it might be proper and more
advantageous to retain or renew and pay as they
become due and payable.
Ail inheritance, transfer, estate and similar
taxes (including interest and penalties)
assessed or payable by reason of my death, on
any property or interest in my estate for the
purpose of computing taxes. My Executor shall
not require any beneficiary under this will to
reimburse my estate for taxes paid on property
passing under the terms of this Will.
III
RESIDUARY ESTATE
A. I define "my Residuary Estate" as all of my property
after the payment of debts and taxes under Article II,
including real and personal property, whenever acquired by
me, property as to which effective disposition is not
otherwise made in this Will, and property as to which I have
an option to purchase or a reversionary interest.
B. I give my Residuary Estate
survives me.
to my Spouse if he
C. If my Spouse does not survive me, I direct my
Executor to divide my Residuary Estate into equal shares and
to distribute those shares as follows:
1. one share to each of my Children who survive me;
if any of my Children fail to survive me, then
his or her share shall be distributed among his
or her descendants who survive me;
if any of my Children fail to survive me and
leave no descendants who survive me, then his or
her share shall be divided equally among such of
my Children who survive me, or their descendants
who survive me, as set forth in subparagraphs 1
and 2 above.
D. If my Spouse does not survive me and none of my
Children nor their descendants survive me, I direct my
Executor to divide my Residuary Estate into seven (7) equal
shares and to distribute the shares as follows:
Page 2 of 4 Pages
one share to my sister SANDRA KANE, or her
descendants.
one share to my sister's son PATRICK KANE,
or his descendants.
one share to my sister's son DENNIS KANE,
or his descendants·
one share to my sister's son KEVIN KANE, or
his descendants.
one share to my sister's daughter MEGHAN
KANE, or her descendants.
one share to my sister's grandchild
COURTNEY RICHARDSON of Camp Hill,
Pennsylvania, or her descendants.
one share to my sister's grandchild LINDSEY
RICHARDSON of Camp Hill, Pennsylvania, or
her descendants.
IV
APPOINTMENT AND POWERS OF EXECUTOR
I nominate and appoint my Spouse, MICHAEL J. BURNS, as
Executor of this my LAST WILL AND TESTAMENT. If MICHAEL J.
BURNS.is unable or unwilling to serve in this capacity, I
appoint DOUGLAS E. BURNS to serve instead. I request that
my Executor be permitted to serve without bond or surety
thereon. I authorize my Executor to do any and all things
which in his opinion are necessary to complete the
administration and settlement of my estate, including full
right, power and authority, without, the order of any court
and upon such terms and under such conditions as my Executor
shall deem best for the proper settlement of my estate; to
bargain, sell at public or private sale, .convey, transfer,
deed, mortgage, lease, exchange, pledge, manage and deal
with any and all property belonging to my estate; to
compromise, settle, adjust, release and discharge any and
all obligations or claims in favor of or against my estate;
and to borrow money for the payment of inheritance and
estate taxes or for any other purpose. Without in any way
limiting the scope of the powers enumerated herein of my
Executor, I hereby specifically give to him full power to
retain any and all securities or property owned by me at the
time of my decease whenever, in his absolute and
uncontrolled discretion, such a course shall seem to him to
be best, without liability for depreciation or loss, and
free from investment restrictions incident to executorship,
whether imposed by common law or statute. In the execution
of his duties and powers as Executor he shall have the power
to comply with all legal requirements as to the execution
and delivery of deeds and all other writings, documents or
formalities without the order of any court; and he shall
furnish a statement of receipts and disbursements at least
annually to each person then entitled to receive income or
property from my estate.
Page 3 of 4 Pages
IN WITNESS WHEREOF, I have at Carlisle Barracks,
Pennsylvania, this ~ day of /?~i/ , 1982, set my hand
and seal to this my LAST WILL AND TESTAMENT consisting of
four (4) typewritten pages.
Testator
Signed, sealed, published and declared by the Testator,
GLORIA L. BURNS, as and for her LAST WILL AND TESTAMENT, in
the presence of us, who, at her request, in her presence and
in the presence of each other, have hereunto subscribed our
names as witnesses.
NAME
ADDRESS
!
Page 4 of 4 Pages
Acknowledgment
COMMONWEALTH OF PENNSYLVANIA)ss:
COUNTY OF CUMBERLAND )
I, GLORIA L. BURNS, Testator, 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; that I signed it
willingly; and that I signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by GLORIA
L. BURNS, the Testator, this 7 day of ~/17 , 1982.
(SEAL)
GLORIA L. BURNS
Testator
No~a~ry~ub 1 i c
Affidavit
COMMONWEALTH OF PENNSYLVANIA)ss:
COUNTY OF CUMBERLAND
and .~K~MM_~¢i~V , the w~tnesses whose names are
signed tO the a~t~ched or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testator sign and execute the instrument as her
Last Will; that GLORIA L. BURNS, signed willingly and that she
executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight of
the Testator signed the will as witnesses; and that to the best
of our knowledge the Testator was at that time 18 or more years
of age, of sound mind and under no constraint or undue
influence.
(SEAL)
Sworn or affirmed to and subscribed to before me by (~/,~'~/~
d, Oxm, ba/~ , Mfl~l~g da~c~ ~5. rr~ , and ~-~
fl~ y , witnesses, this 7 day of ~a~
/
WITNESS
Notary Public
~--~T. 28, 1995
f~emb~r. Pennsylvarfia A~socia~ion of No~rie~
, 1982.
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.:
Gloria L. Bums
March 11, 2003
2003-00335
To the Register:
Administration No.:
21-03-0335
I certify that notice of beneficial interest 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 the
21 st day of April, 2003:
NalTle
Douglas E. Bums
Address
530-B Florida Avenue, Portsmouth, VA 23707
Notice has now been given to all persons entitled thereto under Rule 5.6(a).
ROBERT P. KLINE, ESQUIRE
Attorney ID# 58798
714 Bridge Street
Post Office Box 461
New Cumberland, PA 17070-0461
(717) 770-2540
Counsel for Personal Representative
IN RE: ESTATE OF FLORENCE H. WILKES
a/k/a F. H. WILKES and FLORENCE H.
SHUPNIK WILKES
Late of the Borough of Lemoyne
Cumberland County, Pennsylvania,
Deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-02-335
CERTIFICATE OF SERVICE
And now this '2. [~ day of May 2003, the undersigned does hereby certify that he did on this date serve a
copy of the foregoing Citation and attached Petition for citation to show cause why the Executor should not be removed
upon Lawrence T. Wilkes by causing same to be deposited in the United States Mail, first class postage pre-paid,
certified return receipt requested, and regular mail at Lemoyne, Pennsylvania addressed as follows: Lawrence T.
Wilkes, 224 Bosler Avenue, Lemoyne, Pennsylvania 17043, and also addressed to Lawrence T. Wilkes, 322 Allegheny
Drive, York, Pennsylvania 17403.
JOHNSON, DUFFIE, STEWART & WEIDNER
Date:
By:
Edmund G. Myers
Attomey I.D. No. 20558
301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
:213989
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DTVTSZON
DEPT. 1806D1
HARRISBURG, PA 17128-0601
DOUGLAS E BURNS
550 FLORIDA AVE
PORTSHOUTH
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
VA~; Z~707
DATE OR-ZG-ZO04
ESTATE OF BURNS
DATE OF DEATH 03-11-Z005
PILE NUNBER 21 03-0335
COUNTY CUHBERLAND
SSN/DC 209-11-9982
ACN 03119429
Amoun~ Remi~ed
REV-I;4a EX AFP (Ol-n5)
GLORIA
HAKE CHECK PAYABLE AND REHIT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV'1548 EX AFP (01'03)
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 0~-26-2004
ESTATE OF BURNS
GLORIA L DATE OF DEATH 03-11-Z003 COUNTY CUHBERLAND
FILE NO. Z1 03-0335 S.S/D.C. NO. Z09-11-9981 ACH 03119~29
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORNATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 10026~654
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 09-05-2002
Account Balance 1,610.69
Percent Taxable X 1.000
Amount Subject to Tax 1,610.69
Debts and Deductions - .00
Taxable Amount 1,610.69
Tax Rate X .15
Tax Due 241.60
TAX CREDZTS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 05-01-200~
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
241.60
3.98
245.58
PURPOSE OF
NOTICE:
To ~ulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z5 of ZOOO. (72 P.S.
Section 91¢0).
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF RILLS, AGENT.
A refund of a tax credit, ahich was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13153. Applications are available at the Office of
the Register of Rills, any of the Z3 Revenue District Offices or by calling the special Zq-hour ansaering service
for forms ordering: 1-800-$6Z-Z050; services for taxpayers with special hearing and or speaking needs:
1-800-~q7-30ZO (TT only3.
Any party in interest nat satisfied aith the appraisement, allaaance, or disalloaance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object aithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZglOZ1, Harrisburg, PA 171Zg-IOZ1, OR
--electing to have the matter determined at the 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, DEPT. Z80601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedant's death, a five percent (SZ)
discount of the tax paid is a11oaed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the date of payment. Taxes ehich became delinquent before January I, 198Z
bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .00016q.
Ail taxes which became delinquent on or after January I, I98Z mill bear interest at a rate ahich wi1! vary from
calendar year to calendar year with that rate announced by the PA
Department of Revenue.
The applicable
interest rates for Iggz through 200q are:
Interest Daily Interest Daily Interest Dally
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000548 198'~-8-1991 11Z .000301 ZOO'~'"~ 9Z .OODZq7
1985 16Z .000q38 199Z 9Z .O00Z~7 ZOOZ 6Z .OOOZl9
198~ llZ .000301 1993-199q 72 .00019Z 2005 5Z .000137
1985 152 .000356 1995-1998 92 .O00Z~7 200~ qZ .000110
1986 IOZ .O00ZTq 1999 7Z .O0019Z
1987 9Z .OOOZ~7 ZOOO 8Z .000Z19
--Interest is calculated as follows:
/NTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELIN{IUENT X DATLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will 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.
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Gloria L. Burns,
Deceased
No. 2003-00335
Date of Death: March 11, 2003
Social Security No. 209-12-9982
Personal Representative, Douglas E. Bums, Executor of the above Estate of Gloria L. Burns,
deceased, verifies that the items appearing in the following Inventory include all of the personal
assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said
Decedent, that the valuation placed opposite each item of said Inventory represents its fair value
as of the date of the Decedent's death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I verify that the statements made in this Inventory are true and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating
to unswom falsification to authorities.
Att°rn~ Klein~ ~~E. Burns~~~
I.D. No.: 58798
Address: 714 Bridge Street
Post Office Box 461
New Cumberland, PA 17070
Telephone: (717) 770-2540
Dated:
/g /%. y
Description
624 State Street, Lemoyn¢ Borough
Cumberland County, Pennsylvania
Tax Parcel No. 12-21-267-340
2. Miscellaneous Personal Property
Total:
Val~e:
'YU,UoO.UU
884,'70
90,884.70
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD O04O56
KLINE ROBERT P
714 BRIDGE STREET
P.O. 461
NEW CUMBERLAND, PA
17070
........ fold
ESTATE INFORMATION: SSN: 209-12-9982
FILE NUMBER: 2103-0335
DECEDENT NAME: BURNS GLORIA L
DATE OF PAYMENT: 06/1 6/2004
POSTMARK DATE: 06/1 5/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/1 1/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,854.01-
REMARKS:
ROBERT P KLINE ESQ
TOTAL AMOUNT PAID:
$3,854.01
SEAL
CHECK#2566
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Far
Glenda Farner-Strausbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Gloria L. Burns,
No. 21-03-335
Deceased
Date of Death: March rlt, 2003
Social Security No. 209-12-9982
FAMILY SETTLEMENT AND FINAL RELEASE
ESTATE OF GLORIA L. BURNS, DECEASED
KNOWALL MEN BY THESE PRESENTS, that GLORIA L. BURNS, late of Lemoyne
Borough, Cumberland County, Pennsylvania, deceased, died testate on March 11, 2003, having first
made her Last Will and Testament, which was duly executed on May 7, 1982 and probated in the
Office of the Register of Wills of Cumberland County on April 16, 2003.
WHEREAS, the decedent's husband, Michael J. Burns, departed this life on June 27, 2002,
and therefore predeceased the said decedent;
WHEREAS, the said Gloria L. Burns, by the aforesaid Last Will and Testament, named her
son, Douglas E. Burns, as Executor of said Last Will and Testament upon the death of her husband,
Michael J. Bums;
WHEREAS, Letters Testamentary on the Estate of the said decedent were duly issued by
the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, hereinafter called
personal representative;
WHEREAS, the personal representative has gathered the assets of the Estate of the said
decedent and the assets consist of personal and real property with the total value of $90,884.70, as
set forth in the Inventory filed of record with the Register of Wills of Cumberland County,
Pennsylvania, on June 1, 2004;
WHERAS, Douglas E. Bums is the sole and only heir pursuant to the terms of the Last Will
and Testament of the said decedent; and
WHEREAS, Douglas E. Bums hereby acknowledges that he is in receipt of a copy of the
decedent's Will, the Inventory filed of record with the Register of Wills of Cumberland County, the
Pennsylvania Inheritance Tax Remm filed and approved by him in his capacity as personal
representative, and a proposed Schedule of Distribution of the remaining assets of the estate of
decedent.
NOW, THEREFORE, Douglas E. Bums, being the sole and only heir under the Last Will
and Testament of the said decedent, and being the only person entitled to inherit under said Last
Will and Testament, does hereby acknowledge that he has this day received, in full satisfaction and
payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed
to him by the said Last Will and Testament, the amounts due to him under said Last Will and
Testament, which amounts have been received this day or prior to this day; and, does hereby
stipulate that in order to avoid the expense and time involved in the filing of a formal account and
schedule of distribution, he agrees that no account is necessary and he does hereby agree that he
consents 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 Common Pleas of Cumberland County, Pennsylvania.
THEREFORE, I do hereby authorize myself, in my capacity as personal representative, to
reserve from the funds available for distribution, the amount reflected on the proposed Schedule of
Distribution. Following his receipt of the Inheritance Tax Closing Letter and any estate tax
deficiency that may be assessed, and any other proper expenses or liabilities of the Estate of which
the Executor shall have received notice by that time, or which may otherwise be payable, including
any remaining attorneys fees due to Kline Law Office, the Executor shall distribute to the
beneficiaries, without further accounting, the balance then remaining. Such distribution will also
include any funds received by the Executor subsequent to the date to which the attached Schedule
of Distribution is stated. If any proper liabilities of the Estate, whether for taxes or otherwise, arise
or come to the attention of the Executor or any of the other parties thereafter, the beneficiary agrees
to be liable therefor consistent with the terms of this Agreement.
THEREFORE, I do hereby covenant and agree that should any liability come due to the
Estate of the said decedent after the signing of this Agreement, I do hereby covenant and agree that
I will contribute to 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 representative after
the signing, sealing and delivery of this Family Settlement Agreement and Final Release.
IN I, VITNESS }FHEREOF, I have hereunto set my hand and seal the day and year noted
below.
Date
Date OUG~AS E. BURNS, as Executor of the Last Will
and Testament of Gloria L. Bums, Deceased
~ Comm~ss'm ~ h~st 31, ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 03 00335
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Burns, Gloria L 209-12-9982
DATE Of DEATH (MM-DD-YEAR) DATE Of BIRTH (MM-DD-YEAR)
03/11/2003 O~1~ I I Iq7-~
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 1. Original Return
[] 4. Limited Estate
[] 6. Decedent Died Testate (Attach copy
of Will)
[] 9. Litigation Proceeds Received
12-31-91 and 1-1-95)
AME
tRobert P. Kline
IRM NAME (If applicable)
TELEPHONE NUMBER
~ 717/770-2540
] 2. Supplemental Return [] 3. Remainder Retum (date of ~leath prior to 12-13-82)
[] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required
12-12-82)
[] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes
copy of Trust) --
[] 10. Spousal Poverty Credit (date of death between [] 1 1. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
714 Bridge Street
P.O. Box 461
New Cumberland, PA 17070
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
90,000.00
None
None
None
3,835.92
8,007.31
8,007.31
23,719.54
2,302.09
OFFICIAL USE ONLY
(8)
109,850.54
(11)
26,021.63
83,828.91
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
83,828.91
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00
or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate 83,828.91 x ,045
(15)
(16)
3,772.30
17.Amount of Line 14 taxable at sibling rate
x ,12 (17)
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due (19) 3,772.30
20. []
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
' . Dec,dent's Complete Address:
ISTREET ADDRESS
CITY
624 State Street
Lemoyne
STATE PA ZIP 17043
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
3,854.01
81.71
(1)
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page I Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
3,772.30
3,854.01
81.71
0.00
0.00
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 properly transferred or its income; ....................................
c. retain a reversionary interest; or ..................................................................................................................
d. receive the promise for life of either payments, benefits or care? ..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of
preparer other than the pe,/~i~al representative is based on all infom3ation of which preparer has any knowledge.
SIGNATURE OF PERS(~N R~SPONSIBLE FOR FILING.,~ETURN ADDRESS
~/~ ~,/(~ ~ Newport News, VA 2_3001
SIGNATURE OF PERSON R~PONSIBLE FOR/FILING RETURN ADDRESS
DATE
Oq
DATE
DATE
ADDRESS 714 Bridge Street
P.O. Box 2~61
New Cumberland, PA 17070
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the 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 an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Bums, Gloria L
SCHEDULE A
REAL ESTATE
FILE NUMBER
21 - 03- 00335
All real property owned solely or as a tenant in comm. on must be reported at fair market value. Fair mar. ket value is defined as the price
at which property would be excnanged between a willing ouyer and a willing seller, neither being compelled to ouy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM
NUMBER
DESCRIPTION
624 State Street, Lemoyne Borough, Cumberland Co. Tax Parcel # 12-21-267-340, (copy of appraisal
attached)
TOTAL (Also enter on Line 1, Recapitulation)
VALUE AT DATE OF
DEATH
90,000.00
90,000.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Bums, Gloria L 21 - 03 - 00335
Include the .proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
Misc. personal property, sold by Haars, Inc., auctioneers
Misc. personal property, sold by Chuck E. Bricker, auctioneer
Members 1st F.C.U. Savings account #220001
TOTAL (Also enter on Line 5, Recapitulation)
563.95
320.75
2,951.22
3,835.92
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Burns, Gloria L
21 -03- 00335
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A Douglas E. Burns Son
624 State Street
Lemoyne, PA 17043
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY
% OF DATE OF DEATH
LE'VrER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF
NUMBERITEM FORTENANTJOINT JOINTMADE estate.°r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 06/27/2002 Waypoint Bank Account #5500029748 11,853.62 50% 5,926.81
2 A 06/27/2002 Waypoint Bank Account #100264654 1,610.66 50% 805.33
3 A 06/27/2002 Commerce Bank Account #062664158 2,550.34 50°A 1,275.17
TOTAL (Also enter on line 6, Recapitulation) 8,007.31
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Burns, Gloria L
FILE NUMBER
21 -03- 00335
This schedule must be completed and filed if the answer to any of questions 1 througt 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF
NUMBER include the name of the Attachtransferee'a copytheirof relationshiPthe deed fort°realdecedentestate, and the date of transfer. VALUE OF ASSET DECD'S (IFEXCLUSAPPLICABLE)IONTAXABLE VALUE
INTEREST
1 Waypoint Bank #5500029748 11,853.62 50% 5,926.81
2 Waypoint Bank #100264654 1,610.66 50% 805.33
3 Commerce Bank #062664158 2,550.34 50% 1,275.17
TOTAL (Also enter on line 7, Recapitulation) 8,007.31
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Bums, Gloria L FILE NUMBER
21 - 03- 00335
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
Ao
Bo
FUNERAL EXPENSES:
Musselman Funeral Home, 324 Hummel Ave., Lemoyne, PA 17043
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees Kline Law Office -- Robert P. Kline
Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Cumberland Law Journal
The Sentinel
Accountant's Fees
State Zip
Tax Return Preparer's Fees
Other Administrative Costs
P. Scott Archibald, real estate appraisal
Haars, Inc., auctioneer, 185 Logan Rd., Dillsburg, PA 17019
5,229.10
2,650.00
279.00
75.00
78.17
275.00
225.58
Total of Continuation Schedule(s) 14,907.69
TOTAL (Also enter on line 9, Recapitulation) 23,719.54
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
8cheduleH
Funeral Expenses &
Adminbtmtive Costs conlinued
ESTATE OF Burns, Gloria L FILE NUMBER
21 03-00335
3 Chuck E. Bricker, auctioneer, 93 Texaco Rd., Mechanicsburg, PA 17050 105.75
Robert Martinez, 6007 Hummingbird Drive, Mechanicsburg, PA 17050 (clean-up and junk
removal form 624 State Street property)
Closing costs, sale of 624 State Street, Lemoyne, (copy of settlement sheet attached)
1,300.00
13,501.94
Page 2 of Schedule H
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bums, Gloria L
21 - 03 - 00335
Include unreimbumed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
The Bon Ton, account #064161615
PPL Electric Utilities, #77060-76009
Pennsylvania American Water Co., 24-0630732-8
UGI Utilities, #216-545 6488-14
Verizon, #717-761-1420-859-77-Y
AT&T, #717-761-1420
Comcast, #09547-1791-10-01-4
TOTAL (Also enter on Line 10, Recapitulation)
60.00
482.97
225.21
976.78
214.74
265.82
76.57
2,302.09
REV-lg13 EX+ (9~00,) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Bums, Gloria L
21 - 03 - 00335
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
[. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Douglas E. Bums Son all 83,828.9 l
527-2A Randolph Road
Newpoert News, VA 23601-4424
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
LAST ~ILL AND TESTAMENT
OF
GLORIA L. BURNS
I, GLORIA L. BURNS, a domiciliary of Cumberland County,
Commonwealth of Pennsylvania, being of sound and disposing
mind and memory, do hereby make, publish and declare this
instrument to be my LAST ~ILL AND TESTAMENT. I hereby
revoke any and all wills and codicils by me heretofore made.
I
IDENTIFICATIONS AND DEFINITIONS
A. I am married to MICHAEL J. BURNS, hereinafter
referred to as "my Spouse." ~e have one (1) child, DOUGLAS
E. BURNS. References in this ~ill to "my Children" include
this one (1) Child and any other lawful children born to or
adopted by me.
B. The following definitions obtain in .any use of the
terms in this ~ill:
"Descendants" means the immediate and remote
lawful, lineal descendants of the person
referred to, and it means those descendants in
being at the time they must be ascertained in
order to give effect to the reference to them,
whether they are born before or after my death
or of any other person. The persons who take
under this ~ill as Descendants shall take by
right of representation, in accordance with the
rule of per stirpes distribution and not in
accordance with the rule of per capita
distribution. Persons legally adopted when
under the age of fourteen years shall not be
differentiated from blood descendants for any
purpose.
"Survive me" is' to be construed to mean that the
person referred to must survive me by thirty
days. If the person referred to dies within
thirty days of my death, the reference to him
shall be construed as if he had failed to
survive me.
As used in this ~ill, the words "Executor,"
"he," "him," "his," and the like shall be taken
as generic and applicable to a natural person of
either sex or a corporate person or other legal
entity.
Page 1 o£ 4 Pages
II
PAYMENT OF DEBTS AND TAXES
I direct my Executor to pay the following as soon after
my death as may be practicable:
1. All of my just debts and the expenses of my last
illness, funeral and of the administration of my
estate; but my Executor need not accelerate and
pay those unmatured obligations which, in his
opinion, it might be. proper and more
advantageous to retain or renew and pay as they
become due and payable.
Ail inheritance, transfer, estate and similar
taxes {including interest and penalties)
assessed or payable by reason of my death, on
any property or interest in my estate for the
purpose of computing taxes. My Executor shall
not require any beneficiary under this will to
reimburse my estate for taxes paid on property
passing under the terms of this Will.
III
RESIDUARY ESTATE
A. I define "my Residuary Estate" as all of my property
after the payment of debts and taxes under Article II,
including real and personal property, whenever acquired by
me, property as to which effective disposition is not
otherwise made in this Will', and property as to which I have
an option to purchase or a reversionary interest.
B. I give my Residuary Estate to my Spouse if he
survives me.
C. If my Spouse does not survive me, I direct my
Executor to divide my Residuary Estate into equal shares and
to distribute those shares as follows:
1. one share to each of my Children who survive me;
if any of my Children fail to survive me, then
his or her share shall be distributed among his
or her descendants who survive me;
if any of my Children fail to survive me and
leave no descendants who survive me, then his or
her share shall be divided equally among such of
my Children who survive me, or their descendants
who survive me, as set forth in subparagraphs 1
and Z above.
D. If my Spouse does not survive me and none of my
Children nor their descendants survive me, I direct my
Executor to divide my Residuary Estate into seven (7) equal
shares and to distribute the shares as follows:
Page 2 of 4 Pages
one share to my sister SANDRA KANE, or her
descendants.
one share to my sister's son PATRICK KANE,
or his descendants,
one share to my sister's son DENNIS KANE,
or his descendants.
one share to my sister's son KEVIN KANE, or
his descendants.
one share to my sister's daughter MEGHAN
KANE, or her descendants.
one share to my sister's grandchild
COURTNEY RICHARDSON of Camp Hill,
Pennsylvania, or her descendants.
one share to my sister's grandchild LINDSEY
RICHARDSON of Camp Hill, Pennsylvania, or
her descendants.
IV
APPOINTMENT AND POWERS OF EXECUTOR
I nominate and appoint my Spouse, MICHAEL J. BURNS, as
Executor of this my LAST WILL AND TESTAMENT. If MICHAEL J.
BURNS~is unable or unwilling to serve in this capacity, I
appoint DOUGLAS E. BURNS to. serve instead. I request that
my Executor be permitted to serve without bond or surety
thereon. I authorize my Executor to do any and all things
which in his opinion are necessary to complete the
administration and settlement of my estate, including full
right, power and authority, without the order of any court
and upon such terms and under such c~nditions as my Executor
shall deem best for the proper settlement of my estate; to
bargain, sell at public or private'sale, .convey, transfer,
deed, mortgage, lease, exchange, pledge, manage and deal
with any and all property belonging to my estate; to
compromise, settle, adjust, release and discharge any and
all obligations or claims in favor of or against my estate;
and to borrow money for the payment of inheritance and
estate taxes or for any other purpose. Without in any way
limiting the scope of the powers enumerated herein of my
Executor, I hereby specifically give to him full power to
retain any and all securities or property owned by me at the
time of my decease whenever, in his absolute and
uncontrolled discretion, such a course shall seem to him to
be best, without liability for depreciation or loss, and
free from investment restrictions incident to executorship,
whether imposed by common law or statute. In the execution
of his duties and powers as Executor he shall have the power
to comply with all legal requirements as to the execution
and delivery of'deeds and all other writings, documents or
formalities without the order of any court; and he shall
furnish a statement of receipts and disbursements at least
annually to each person then entitled to receive income or
property from my estate.
Page 3 of 4 Pages
IN WITNESS WHEREOF, I have at Carlisle Barracks,
Pennsylvania, this ~ day of //~/ , 1982, set my hand
and seal to this my LAST WILL AND TESTAMENT consisting of
four {4) typewritten pages.
GLORIA L. BURNS
Testator
Signed, sealed, published and declared by the Testator,
GLORIA L. BURNS, as and for her LAST WILL AND TESTAMENT, in
the presence of us, who, at her request, in her presence and
in the presence of each other, have hereunto subscribed our
names as witnesses.
NAMF.
ADDRESS
'~ ~ ~
Page 4 of 4 Pages
Acknowledgment
COMMONWEALTH OF PENNSYLVANIA)ss:
COUNTY OF CUMBERLAND
I, GLORIA L. BURNS, Testator, 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; that I signed it
willingly; and that I signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by GLORIA
L. BURNS, the Testator, this ~_ day of ~/;y , 1982.
(SEAL)
GLORIA L. BURNS
Testator
ROSA A. L%I~TIZ, NOTARY PUSLi(~
CARLISLE BOI~0, CUI~BERLAND COUNH
Affidavit MY COMUISS{0fl E~I~ES OCT. 2~. 19~5
CO~ONW~ALTH OF PENNSYLVANIA) ss:
COUNTY OF CUMBerLAND )
the w~tnesses whose names ~re
and ~A~AI~ ~l~t? V . ,
signed t0 the a~f~che~ or toregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testator sign and execute the instrument as her
Last Will; that GLORIA L. BURNS, signed willingly and that she
executed it as her free and voluntary act for the purposes
therein expressed; that each of us' in the h~aring and sight of
the Testator signed th~ will as witnesses; and that to the best
of our knowledge the Testator was at that time 18 or more years
of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and subscribed to before me by ~A~,~
~, ~b~ , ~R~ ~ww¢ &~r~ , and OA~ivAt
~l~ ~ , witnesses, t~is 7 day of ~ , 1982.
/
~IT~E8S
Notary Public ~
ROS~ ~. 0811l, ~OIAR~ PUBLIC
CA~LISLE B0~, ~UMBE~L~ND COUNTy
~T C0~MISSIO~ EXPIRES OCT, 2~, 1985
~ember. Penfl~ylvania RS$oc/ation of NOtarie~
~91~'T--V~arrant~ De~---~hort Fo~Act 1909-~Dou~le Sheet
~ Her~ry ~, Inc., Indian,% Ps.
of our Lo~'d one thousand nine hundred
October
si×ty~our (1964)
CCAC /Y?g
in the year
BETWEEN WIEL. IAM H. SNOOK, III, and DVELYN E. SNOOK, his wife, of
the Township of Lower Allen, County of Cumberland and State
Pennsylvania, parties of the first part,
a~ MICHAEL JAMES BURNS and GLORIA L. BURNS, his wife,~~
Borough of L. emoTne~ Count7 of Cumberland and
Grantee
WITNESSETH, that in oonsideration of Eight Thousand Five Hundred ($8,500.00)
in hand paid, the receipt whereof is hereby acknowledged, the said grantors do
and convey to the said grantee s,
Dollars,
hereby grant
ALL That certain lot of land situated in the Borough of Lemoyne,
County of Cumberland and State of Pennsylvania, bounded and described
as follows:
BEGINNING at a point on the southern line of State Street at the
dividing line between Eots Nos. 93 and 94 on the hereinafter mentioned
Plan of Lots; thence along said line south 49 degrees II minutes east
one hundred forty-five and sixty;one-hundredths (145.60) feet to a
point on a 20 feet wide alley; thence along said 20 feet wide alley
south 40 degrees 49 minutes west thirty-five (35) feet to a point, the
dividing line between Lots 92 and 93 on said Plan; thence along said
line north 49 degrees 11 minutes west one hundred forty-five and sixty
one-hundredths (145.60) feet to a point on the southern line of State
Street; thence along the southern line of State Street north 40 degrees
49 minutes east thirty-five (35) feet to the point or place of Beginning.
BEING Lot No. 93 in a plan of lots known-as ~lan No. 3, North
Riverton~ said Plan being recorded in the office for recording of deeds
in and for Cumberland County in Deed Book "J'~, Vol. 4~ Page 40.
Having thereon erected a single 2½ story frame dwelling house known
as Noo 624 State Street, Lemoyne, Pennsylvania.
BEING the same premises which Lemoyne Trust Company, ~xeoutor
~he Las~ Will and Testamen~ of Pearl g. Ifuh~, deceased~ by deed da~ed
July 18, 1963, recorded in %he Cumberland County Recorder's Office
Deed Book X~ Vol. 20~ Page 473~ g~an~ed and conveyed unto ~illiam H.
Snook III and Evelyn E. Snook~ his wife~ Grantors herein.
ScheQI ¢isf( Cumb. g~. Pa.
1% Rani Estate Transfer Tax Borough If ~,~ ~ ~ ~ -
C~b. Ce. r~.
Date~Amt.~ 1% Real Estate Transfer Tax
~ Cdmb. Ce. ~. ,.g~'
· AND the said grantors, do hereby covenant that they will WARRANT
general~ly the property hereby conveyed.
IN WITNESS WHEREOF, said grantor s have hereunto set
the day and year first above written.
t h e i rhan~, s and seal s
I hereby certify that the
precise residence of the within
named Grantee is 624/~tate St.,
State of Pennsylvania ~
88.
County of Cumberland
On this, the ~ ~ day of October
the u~r~ned o~cer, perso~lly a~eared
William H. Snook~ III and Evelyn E. Snook~
, 19 64, before me,
his wife
kn~y~n to me (or satisfactorily proven) to be the persons whose name s a r e subscribed to the
. ~ . ~....~..~ment, and acknowledged that t he y executed Same f~r the purposes therein
':. # IN '~z'ITN'ESS WHEREOF, I hereunto set my hand and o~eial seal
State of i
County of
On,his, the day of
the undersigned oB~cer, personally appeared
· 19 , before me,
known to me (or satisfactorily proven) to be the person whose name subscribed to the
within i~trument, and acknowledged that executed s~me for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and o~al seal.
Title of 01~eer.
~,...~ ~,~ ~,..
w~ith do hereby certify that thq precise residene~ and complete p~s~ office
address
COMMONWF~LTH OF PENNSYLVANIa4
County of .~~. ...........
SS.
A. D. 19__.~..._~, in the Recorder's office of the said County, in Deed Book
Vol .......... --~-..l ...... , Page ..... 2.-~.-~ ......
ARCHIBALD REAL ESTATE APPRAISALS
UNIFORM RESIDENTIAL APPRAISAL REPORT p.. No. 1403
Property Address 624 STATE ST. City LEMOYNE state PA. Zip Code 17043
Legal Description AS FOUND IN RECORD BOOK 21K. PAGE 256 County CUMBERLAND
Assessor's Parcel No. 12-21-267-340 Tax Year 2003 R.E. Taxes $ 029.02 Special Assessments $ N/A
Borrower Current Owner
Leasehold HOA$
Neighborhood or Project Name BOROUGH OF LEMOYNE Map Reference 12-21-267-340 Census Tract 42-43-106
Sale Pdce $ N/A Date of SaleN/A Description and $ amount of loan charges/concessions to be paid by seller N/A
Lender/Client KLINE LAW OFFICE Address 714 BRIDGE ST. NEW CUMBERLAND PA 17070
Address
Locafion Predominant Single family housing
Built up L~J over 75% 125-75% ~J Under 25%
occupancy
PRICE
AGE
$(0oo)(yr,,)
Growth rate [~ Rapid [ X~ Stable []Slow [~Owner 50 Low 20
Property values [] increasing [ X~ Stable [~ Declining[~T .... t 120 High 80
Demand/supply [~Shortage [] In bal .... [] Over supply {~Vacant (0-5%)
Note: race and the racial composition of the neighborhood are not appraisal factors.
Present land use % Land use change
One family 60 [] Not likely [] Likely
2-4 family 5 [] In process
Multi-fatuity 5 To:
Commercial 30
Neighborhood boundaries and characteristics: I HAVE CONSIDERED THE NEIGHBORHOOD TO CONSIST OF A 4 BLOCK RADIUS
AROUND THE SUBJECT PROPERTY.
Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc.):
THE SUBJECT PROPERTY IS LOCATED IN THE BOROUGH OF LEMOYNE CUMBERLAND COUNTY. MOST
AMENITIES ARE LOCATED WITHIN A REASONABLE COMMUTING DISTANCE OF THE NEIGHBORHOOD. THE
COMMERCIAL LAND USES WITHIN THE SUBJECT NEIGHBORHOOD CONSIST OF VARIOUS SHOPS STORES AND
OFFICES. IN MY OPINION THESE COMMERCIAL AND MULTI-FAMILY USES DO NOT ADVERSELY AFFECT THE
PRESENT MARKET VALUE OR THE FUTURE MARKETABILITY OF THE SUBJECT PROPERTY.
Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of Ixoperty values, demand/supply, and marketing time
-- such as data on competitive properties for sale in the neighborhood, des~ipfion of the prevalence of sales and financing concessions, etc.):
THERE ARE NO FORSEEABLE ECONOMIC FACTORS THAT MAY ADVERSELY AFFECT THE PRESENT MARKET
VALUE OR THE FUTURE MARKETABILITY OF THE SUBJECT PROPERTY.
Project Information for PUDs (If applicable) - is the developer/builder in control of the Home Owner's Association (HCA)? b_._J Yes ~j No
Approximate total number of units in the subject project N/A Approximate total number of units for sale in the subject project
Describe common elements and recreationa[ facilities: N/A
N/A
Dimensions 145.6 X 35 Topography
Sitearea 0.12ACRES CornerLot [~Yes r~No Size
Specific zoning classification and description C - COMMERCIAL Shape
Zoning compli .... [] Legal [] Legal ..... forming (Grandfathered use) [] Illegal [] No Zoning Drainage
Highes~ & best use as improved: ~ Present use ~ Other use (explain) View
Utilities Public Other ! Off-site improvements Type Public Private Landscaping
Electricity [] t Street ASPHALT ~ ~[~ Driveway Surface
Gas [] Curb/gutter CONCRETE [] Apparent easements
Water [] Sidewalk CONCRETE [] []
Sanitary sewer [] Street lights FLOURESCENT [] []
Storm sewer [~ Alley ASPHALT [] ~}
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.):
;ITE APPEARS TO BE TYPICAL OF THE NEIGHBORHOOD.
MODERATE SLOPE
AVERAGE FOR AREA
RECTANGULAR
APPEARS ADEQUATE
RESIDENTIAL
AVERAGE FOR AREA
CONC/BRICK
TYPICAL
FEMA Special Flood Hazard Area []Yes []No
FEMAZone ZONE C Map Date 12/4/79
FEMA Map No. 420361
THE SUBJECT
IGENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT INSULATION
No. of Units~1 Foundation STON~E Slab _ NONCE Area Sq. Ft. 741 Roof []
No. of Stories ~2 Exterior Walls ALUMINUM Crawl Space 23% % Finished N~E Ceiling -- []
Type (Dat./Att.) DETACHD RoofSur~ce COMP SH Basement _ 77% Ceiling N/A Wa,s []
Design (Style) TRADITN GUtters& DwnSPts. ALUMINUMSump Pump ~ Walls ~ Floor []
Exisfing/Proposed ~ WindowType DBL HUNG Dampness - NoN~N~s. Floor CONC. None -- []
Age (Yrs.) ~ S,ornVS .... ~ Se.len~nt - ~ Outs,de Entry ~- Unknown~VG []
m'~ ROOMSI Foyer Living Dining Kitchen Den amily Rm Rec. Rm. IBedrooms # Baths Laundry C her Area Sq Ft
I~i sa .... ti I ~ 741
BLevei I I1 1 I 1/1 I / / 1.00 I I I 968
~ Finished area above ~rade contains: 7 Rooms 3 Bedroom(s/; 2 00 E ath(s/' 1 596 ScI~ are Feet of Gross Living Area
t=INTERIOR Mater~als/Condition I HEATING KITCHEN EQUIP. I ATTIC~ AM 'ENITIES ' CAR STORAGE --
lin FI .... CARPET/AVG ~] Type HWBB Refrigerator ~]I None [] Fireplace(s)# [] None []
Ii-Ii Walls PLAS/AVG I Fuel GAS Range/Oven [~1 Stairs [] Paito -- [] garage 1 #ofcars
· Trim/Finish WOOD/AVG / Condition~-- Disposal [] Drop Stair [] Deck -- [] Attached
· Bath Floor LINO/AVG .~ COOLING Dishwasher []1 Scu.e [] Porch~ [] Detached
· ,sthW.,.-o,~F oe.tra, NONE Fen~Hood [~1 Floor[] F .... [] Suiit-,.
· D .... PANEL/AVG / Other NONE Mi ....... []1 Heatad [] poo, [] C.~ort
· ~I Cond~on- N--~ WasherlDr'/erl~I Finished ~] ~] Drivewa),
IAdditional features (special energy efficient items, etc.): 20 X 14 DETACHED GARAGE
ICondition of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, remodeiing/addibo~s, etc.: T U E
SUBJECT PROPERTY APPEARS TO BE TYPICAL FOR THE NEIGHBORHOOD. THE SUBJECT PROPERTY~-S
BEEN MAINTAINED IN AVERAGE CONDITION.
Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the
immedistevicinityofthesubjectproperty.: THE SUBJECT PROPERTY WAS CONSTRUCTED BEFORE 1980 AND COULD
CONTAIN LEAD-BASED PAINT, WHICH COULD ADVERSELY AFFliCT ITS MARKETAI~ILITY.
Freddie Mac Form 76 6-93
ClickFORMS Rear Estate Appraisal Software by BradfOrd Technologies {80O) 622-s727
Fannie Mae Form 1004 (6-93)
Valuation Section
ARCHIBALD REAL ESTATE APPRAISALS
UNIFORM RESIDENTIAL APPRAISAL REPORT F.eNo. 4110341403
ESTIMATED SITE VALUE ............ ~ $
ESTIMATED REPRODUCTION COST-NEW-OF IMPROVEMENTS:
Drilling 1,596 Sq. Ft. @ $ 56.45 = $ 90,094
Bsmt 741 Sq. Ft. @ $ 10.12 = 7,499
RANGE COV POR 1,800
GarageJCarport 280 Sq. Ft.@$ 10.12 2,834
Total Estimated Cost New,-- - = $ 102,227
Less Physical 30 ' ~FUnCtional'
External
Depreciation 30,668 | = $
Depreciated Value of Improvemer~ts = $
· As is" Value of Site Improvements ................ = $
INDICATED VALUE BY COST APPROACH $
ITEM I SUBJECT COMPARABLE NO. 1
624 STATE ST. 211 BOSLER AVE.
Address LEMOYNE LEMOYNE
4 BLOCKS EAST
Sales Price N/A
Price/Gross Ltv. Area 0.00 61.70
Data and/or INSPECTION CENTRAL-PENN MLS
Verification Source
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION
Sales or Financing CONVENTIONL
Concessions NONE KNOWN
Date of Sale/Time 2/2003
Location SUBURB/AVG SUBURB/AVG
Leasehold/Fee Simple
Site 0.12 ACRES 0.07 ACRES
View RESIDENTIAl
Qualit~ AVG/FRAME
Age 93 YEARS
Condition AVERAG
Above Grade
Room Count
Gross Living Area
Basement & Finished 77% BASEMENT FULL BSMT.
Rooms Below Grade UNFINISHED UNFINISHED
AVERAGE
HWBB/NONE
Energy Efficient Items NONE
NONE
Porch, Patio, Deck, COV PORCH COV PORCH
Fence, Pool, etc.
RANGE RANGE
Adjusted Sales Price
of Comparable
18,00¢
30,668
71,559
1,200
+ (-)$ Adjustment
Comments on Cost A,oproach (such as, source of cost estimate,
site value, square foot calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the property):
WITHIN THE COST APPROACH ESTIMATED COSTS
HAVE BEEN OBTAINED THROUGH THE
MARSHAL-SWIFT VALUATION BOOK AND ARE
BASED UPON LOCAL BUILDING COSTS.
Est Rem Econ Lifo: 40
COMPARABLE NO. 2 COMPARABLE NO. 3
725 BOSLER AVE. 92 HUMMEL AVE.
LEMOYNE LEMOYNE
2 BLOCKS SOUTH 6 BLOCKS EAST
63.33
CENTRAL-PENN MLS CENTRAL-PENN MLS
DESCRIPTION DESCRIPTION
CONVENTIONL
NONE
3/2003 4/2002
FEE SIMPLE
0.10 ACRES 0.13 ACRES
FULL BSMT.
UNFINISHED
133 YEARS
+960
77% BASEMEN
AVERAGE
+(-)$ Adjustment
NONE NONE
COY PORCH COY PORCH
FIREPLACE SCR PORCF
RANGE RANGE
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc.): I HAVE CONSIDERED ALL OF THE
THE MOST PROBABLE SALES PRICE OF THE SUI
ITEM SUBJECT COMPARABLE NO. 1 COMPARABLE NO. 2 COMPARABLE NO. 3
Date, Price and Data NONE PAST 3 NONE KNOWN NONE KNOWN NONE KNOWN
Source, for prior sales Y E A R S
Arralysis of any current agreernen of sale. opfic~, or listing of the subject property and ahab/sis of any prior sa~es of subject and comparables within one year of t~e date of appraisal
~OWN
INDICATED VALUE BY SALES COMPARISON APPROACH
INDICATED VALUE BY INCOME APPROACH IIf Applicable/ Estimated Market Rent $ N/A /Mo.x Gross Rent Multiplier N/A =$ -- Nh
This appraisal is made b~J "as is" ~J subject to the repairs, alterations, inspections or conditions listed below LJ subject to completion per plans and specifications.
Conditions of Appraisal: N O N E
Final Reconciliation: I HAVE FAVORED THE SALES COMPARISON ANALYSIS IN ESTIMATING THE MOST PROBABLE
PRICE OF THE SUBJECT PROPERTY.
The purpose of this appraisal is to estimate the market value of the real property thai is subject to this repod, based on the above conditions and the certi§~stion, contingent
and limiting conditions, and market value definition that are stated in the attached Freddie Mac Form 439/Fannie Mae Form 1004B (Revised 6-93 ).
I(WE) ESTIMATE THE MARKET VALUE, AS DEF,NED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF TH,S REPORT, AS OF 4/1 4/2003
(WHICH IS THE DATE OF INSp.17'(~/1ON.A~ND THE EFFECTIVE DATE OF THiS REPORT) TO BE$
APPRAISER: ~/~__/__--~--/_ ~ 90,000
SUPERVISORY APPRAISER (ONLY IF REQUIRED):
Signature J--~"-~ Signature [] Did [] Did Not
Name P. SCOTT~A~CHIBALD Name Inspect Property
Date Report Signed APRIL 20 2003 Date Report Signed
State Certification # RL-000060-L state PA state Certification # state
Or state License # State Or State License # State
Freddie Mac Form 70 6-93
C~ckFORMS Real Estate Appraisal Soltware by Bradford Technologies (800) 622-8727 Fannie Mae Form 1004 (s-g.'
EXTRA COMPARABLES 4-5-6 File No. 4110341403
Borrower BURNS, MICHAEL
Property Address 624 STATE ST.
city LEMOYNE County CUMBERLAND State PA. ZipCode17043
Lender/ClientKLINE LAW OFFICE Addrees714 BRIDGE ST. NEW CUMBERLAND PA 17070
These recent sales of properties are most similar and proximate to subject and have been c~r~id~ed in the market ar~alysis. The description includes a dollar adjustment, reflecting
market reaction to those items of significant variation between the subject and comparable properties. If a significant item in the comparable property is superior to, or more favorable
than, the subject propelty, a minus (~) adjustment is made, thus reducing the indicated value of su~ect; if a significant Rem in the comparable is inferior to, or less favorable than, the
ITEM SUBJECT COMPARABLE NO, 4 COMPARABLE NO. 5 COMPARABLE NO, 6
624 STATE ST. 348 BOSLER AVE. 727 STATE ST.
Address LEMOYNE LEMOYNE LEMOYNE
3 BLOCKS EAST SAME BLOCK
Sales Price N/A
Price/Gross Liv. Area 0.00 67.84 44.32
Data and/or INSPECTION CENTRAL-PENN MLS CENTRAL-PENN MLS
Verification Source
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION DESCRIPTION
Sales or Financing CONVENTIONL CONVENTIONL
Concessions NONE KNOWN NONE KNOWN
Date of Sale/time 10/2001 12/2001
Location SUBURB/AVG SUBURB/AVG
DESCRIPTION
FEE SIMPLE FEE SIMPLE FEE SIMPLE
site 0.12 ACRES 0.10 ACRES 0.12 ACRES
View RESIDENTIAL RESIDENTIAL RESIDENTIAL
2 2 STORY/AVG
AVG/FRAME AVG/FRAME AVG/FR/BRK
Age 100+ YEARS 83 YEARS 75 YEARS
Condition AVERAGE AVERAGE AVERAGE
Above Grade
Room Count
Living Area
Basement & Finished 77% FULL BSMT. FULL BSMT.
Rooms Below Grade UNFINISHED UNFINISHED UNFINISHED
AVERAGE AVERAGE AVERAGE
HWBB/NONE FWA/NONE HWBB/NONE
NONE NONE NONE
1 CAR DET 2 CAR DET NONE
COV PORCH COV PORCH COV PORCH
FIREPLACE
Pomh, Patio, Deck,
etc,
Fence, Pool, etc.
RANGE
:Ii. (total)
Adjusted Sales Pdce
Comments on Comparables:
APPLIANCES APPLIANCES
$ 0
ITEM
Date, Price and Data
Source, for pdor sales
within year of appraisa.
SUBJECT COMPARABLE NO. 4 COMPARABLE NO. 5 COMPARABLE NO. 6
NONE KNOWN NONE KNOWN
NONE PAST 3
YEARS
ClickFORM$ Real Estate Appraisal Sofl~var e by Bradford Technologies (800) 622-8727
SKETCH ADDENDUM File No. 4110341403
Borrower BURNS MICHAEL
Property Address 624 STATE ST.
city LEMOYNE County CUMBERLAND state PA. ZipCode17043
Lender/Client KLINE LAW OFFICE Address 714 BRIDGE ST. NEW CUMBERLAND PA 17070
21'
D/A
BATH
46' DEN
LIVING ROOM
KITCHEN
DINING ROOIV
46'
21'
BEDROOM
BEDROOM
30':
BATH
BEDROOM
30'
21' 21'
SKETCH CALCULATIONS
A1: 21.0 x 46.0 = 966.0
First Floor 966.0
A2: 21.0 x 30.0 = 630.0
^2
Second Floor 630.0
Total Living Area 1596.0
Clicld=ORMS Real Estate Appraisal Soft. ar e by Brad~rd Technologies (800) 622-8727
PLAT MAP ADDENDUM F~e No. 4110341403
Borrower BURNS MICHAEL
Property Address 624 STATE ST.
city LEMOYNE County CUMBERLAND State PA. Zipcode17043
Lender/Client KLINE LAW OFFICE Address 714 BRIDGE ST. NEW CUMBERLAND, PA 17070
PARCEL # 340
Cl~cld:OR MS Real Estate ^ppraisaJ Soft'~a r e by Bradford Technologies (800) 622-8727
LOCATION MAP ADDENDUM File No. 4110341403
BURNS. MICHAEL
Property Ad~ress 624 STATE ST.
city LEMOYNE county CUMBERLAND State PA. ZJpCode17043
Lender/C~nt KLINE LAW OFFICE Address 714 BRIDGE ST., NEW CUMBERLAND, PA 17070
SUBJECT PHOTO ADDENDUM File No. 4110341403
t~'owerBURNS,~ICHAEL
Prope~ Address 624 STATE ST.
city LEMOYNE counh, CUMBERLAND state PA. zip Code17043
Lender/Client KLINE LAW OFFICE Address 714 BRIDGE ST., NEW CUMBERLAND, PA 17070
FRONT OF
SUBJECT PROPERTY
Address
624 STATE ST.
LEMOYNE
REAR OF
SUBJECT PROPERTY
STREET SCENE
COMPARABLES 1-2-3 PHOTO ADDENDUM
~,~, BURNS; MICHAEL
F~No. 4110341403
624 STATE ST.
c~ LEMOYNE co~.~y CUMBERLAND st=,~ PA.
~ KLINE LAW OFFICE
z~ C~de 17043
714 BRIDGE ST., NEW CUMBERLAND, PA 17070
COMPARABLE SALE
211 BOSLER AVE.
LEMOYNE
COMPARABLE SALE
725 BOSLER AVE.
LEMOYNE
COMPARABLE SALE
Address
92 HUMMEL AVE.
LEMOYNE
COMPARABLES 4-5.6 PHOTO ADDENDUM
~ ..... . BURNS,'MICHAEL
File No. 4110341403
624 STATE ST.
~ LEMOYNE
~,~c~,~.t KLINE LAW OFFICE
Cou.t~ CUMBERLAND s,-te PA. =pco~ 17043
~ 714 BRIDGE ST.. NEW CUMBERLAND, PA 17070
COMPARABLE SALE fiR.
348 BOSLER AVE.
LEMOYNE
COMPARABLE SALE
Address
727 STATE ST.
LEMOYNE
COMPARABLE SALE ~6
Address
DI~FINITION OF MARKET VALUE:The most probable price which a property should bring in a competitive and
open market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and
assuming the price is not affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a
specified date and the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are typically
motivated; (2) both parties are well informed or welt advised, and each acting in what he considers his own best interest;
(3) a reasonable time is allowed for exposure in the open market; (4) payment is made in terms of cash in U. S. dollars
or in terms of financial arrangements comparable thereto; and (5) the price represents the normal consideration for the
property sold unaffected by special or creative financing or sales concessions* granted by anyone associated with the sale.
*Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments
are necessary for those costs which are normally paid by sellers as a result of tradition or law in a market; these costs
are readily identifiable since the seller pays these costs in virtually all sales transactions. Special or creative financing
adjustments can be made to the comparable property by comparisons to financing terms offered by a third party
institutional lender that is not already involved in the property or transaction. Any adjustment should not be calculated
on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should
approximate the market's reaction to the financing or concessions based on the appraiser's judgment.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS:The appraiser's certification that appears in the appraisal report is
subject to the following conditions:
1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or
the title to it. The appraiser assumes that the title is good and marketable and, therefore, will not render any opinions
about the tire. The property is appraised on the basis of it being under responsible ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements
and the sketch is included only to assist the reader of the report in visualizing the property and understanding the
appraiser's determination of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency
(or other data soumes) and has noted in the appraisal report whether the subject site is located in an identified Special
Flood Hazard Area. Because the appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding
this determination.
4. The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in question,
unless specific arrangements to do so have been made beforehand.
5. The appraiser has estimated the value of the land in the cost approach at its highest and best use and the improvements
at their contributory value. These separate valuations of the land and improvements must not be used in conjunction with
any other appraisal and are invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence
of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property or that he or she became
aware of during the normal reseamh involved in performing the appraisal. Unless otherwise stated in the appraisal report,
the appraiser has no knowledge of any hidden or unapparent conditions of the property or adverse environmental conditions
(including the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable,
and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied, regarding
the condition of the property. The appraiser will not be responsible for any such conditions that do exist or for any
engineering or testing that might be required to discover whether such conditions exist. Because the appraiser is not an expert
in the field of environmental hazards, the appraisal report must not be considered as an environmental assessment of
the property.
7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from soumes
that he or she considem to be reliable and believes them to be true and correct. The appraiser does not assume responsibility
for the accuracy of such items that were furnished by other parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of
Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory
completion, repairs, or alterations on the assumption that completion of the improvements will be performed in a
workmanlike manner.
10. The appraiser must provide his or her prior wdtten consent before the lender/client specified in the appraisal report
can distribute the appraisal report (including conclusions about the property value, the appraiser's identity and professional
designations, and references to any professional appraisal organizations or the firm with which the appraiser is associated)
to anyone other than the borrower; the mortgagee or its successors and assigns; the mortgage insurer; consultants;
professional appraisal organizations; any state or federally approved financial institution; or any department, agency,
or instrumentality of the United States or any state or the District of Columbia; except that the lender/client may distribute
the property description section of the report only to data collection or reporting service(s) without having to obtain the
appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before the appraisal
can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
Freddie Mac Form 43~ (6-93)Clic~FORMS Real Estate Apprai~l Software by Bradford Technologies (800) 622-8727 Fannie Mae ForrT1 1004B (6-93)
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar
and proximate to the subject property for consideration in the sales comparison analysis and have made a dollar adjustment
when appropnate to reflect the market reaction to those items of significant variation. If a significant item in a comparable
property is superior to, or more favorable than, the subject property, I have made a negative adjustment to reduce the
adjusted sales price of the comparable and, if a significant item in a comparable property is inferior to, or less favorable
than the subject property, I have made a positive adjustment to increase the adjusted sales price of the comparable.
2. I have taken into consideration the factors that have an impact on value in my development of the estimate cf market
value in the appraisal report. I have not knowingly withheld any significant information from the appraisal report and I
be eve, to the best of my knowledge, that all statements and information in the appraisal report are true and correct.
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions,
which are subject only to the contingent and limiting conditions specified in this form.
4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or
prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or
completely, my analysis and/or the estimate of market value in the appraisal report on the race, color, religion, sex,
handicap, familial status, or national odgin of either the prospective owners or occupants of the subject property or of the
present owners or occupants of the properties in the vicinity of the subject property.
5. I have no present or contemplated future interest in the subject property, and neither my current or future employment
nor my compensation for performing this appraisal is contingent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any
related party, the amount of the value estimate, the attainment of a specific result, or the occurrence cf a subsequent event
in order to receive my compensation and/or employment for performing the appraisal. I did not base the appraisal report
on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan.
7. I performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice that were
adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the
effective date of this appraisal, with the exception of the departure provision of those Standards, which does not apply.
I acknowledge that an estimate of a reasonable time for exposure in the open market is a condition in the definition of
market value and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this
report, unless I have otherwise stated in the reconciliation section.
8. I have personally inspected the intedor and exterior areas of the subject property and the exterior of all properties
listed as comparabies in the appraisal report. I further certify that I have noted any apparent or known adverse conditions
in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of
which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the
extent that I had market evidence to support them. I have also commented about the effect of the adverse conditions on
the marketability of the subject property.
9. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I
relied on significant professional assistance from any individual or individuals in the performance of the appraisal or the
preparation of the appraisal report, I have named such individual(s) and disclosed the specific tasks performed by them
in the reconciliation section of this appraisal report. I certify that any individual so named is qualified to perform the tasks.
I have not authorized anyone to make a change to any item in the report; therefore, if an unauthorized change is made to the
appraisal report, I will take no responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she
certifies and agrees that: I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal
report, agree with the statements and conclusions of the appraiser, agree to be bound by the appraiser's certifications
numbered 4 through 7 above, and am taking full responsibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED:
624 STATE ST. LEMOYNE PA. 17043
APPRAISER~
Signature:
Name: P. SCOTT ARCHIBALD
Date Signed: APRIL 20 2003
State Certification ~ RL-O00060-L
or State License #:
State: PA
Expiration Date of Certification or License: 6/30/03
SUPERVISORY APPRAISER
Signature:
(only if required)
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
[] Did [] Did Not Inspect Property
Freddie Mac Fo~'m 439 6-93 CIIcld=ORMS Real Estate Apprai~l Soft.care by Bradford Technologies (800) 622-8727 Fannie Mae Form 1004B 6-93
OMB NO, 2502-0~'65 ~
B. TYPE OF LOAN:
U.S. DEPARTMENT OF'HOUSING & URBAN DEVELOPMENT 1.~-]FHA 2.F-'~FmHA 3.[~CONV. UNINS. 4. r~VA 5.[-]CONV. INS.
6. FILE NUMBER: I 7. LOAN NUMBER:
SETTLEMENT STATEMENT BOLDOSSER.E2 310001703
8. MORTGAGE INS CASE NUMBER:
441-7469277-703
"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.
Items marked "[POC]" were paid outside the clo~ing; they are shown here for informational purposes and are not included in the totals.
1.0 3~8 (BOLDOSSER.F.2.PFD/BOLDOSSER. E2/21 )
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
ERiC M. BOLDOSSER DOUGLAS E. BURNS, EXECUTOR CARDINAL FINANCIAL CO. LTD
PARTNERSHIP
G. PROPERTY LOCATtON: H. SETTLEMENT AGENT: 23-2402316
624 STATE STREET I. SETTLEMENT DATE
LEMOYNE, PA 17043 PURITY ABSTRACT COMPANY
CUMBERLAND Coun[y, Pennsylvania PLACE OF SEttLEMENT March 26, 2004
3329 Market StJ'eet
Camp Hill, PA 17011
~ J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100, ~ 400. GROSS A~
~ce ~ 401. Contract alesPdce 94,~
102. Persona Property 402. Personal roperty
103~ to Borrow re Line 1400)~ ~ -~.
104. 2004 to AITHA. NI LA, 322.4~' -~ --
A justments or terns aid ySelerinadvence 405'
-- djustments For tems Pai By ellerin advance
106. County/Twp axes to 406. ounty wp Taxes to
~ to ~ to
~ 03~26 04 to 07 01 04 20~.85 ~ax 03/2~ 202,85
109. 1 R, RA 03 26/04 to 04/01 04 ~ 409,1 T TR. TRA H 03 26 04 to 04/01/04
~ 411.
412.
120. GROSS AMOUNT DUE FROM BORROWER 101,338.62 420. GROSS AMOUNT DUE TO SELLER 94,705.09
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SFI ~ ER:
202. P~ncipa1201' Deposit OrAmountearneStofmOneYNew can s __ ~1'000'00 501 · Excess Deposit See nstruc~ons
~ ~ 9,378.90
~ 503~oan(s taken subjectto
~ 504. Payo o rstMortgage
~ --__ . ayo o secon o gage
506.
~ 507. Deposit dis .as proceeds)
508.
209. LO N C T EDI ~ 509. CLO IN C T REDI7 3,~
~s or Items Unpai y eller Adjustments or Items Unpaid By eller
210. Co~ 01/01 04 to 03/26/04---- 7----4.88 510. County/TwpTaxes 01/01/04 to 03/26/04 74.88
211. Gib'Tax to 511. CityTax to
212. School Tax to ~ax
~ to
~ --~ 514__2.
~ 515.
~ 516.
~ ---- 517. FINA EWER BILL to LEM YNE BOROUGH
219. 518. FINAL TRASH BILL to LEMOYNE BOROUGH 145.76
519.
220. TOTAL PAID BY/FOR BO~ROWER 98,688.38 520. TOTA~L. REDUCTION AMOUNT DUE SELLER 13,707.03
30. : 6 . :
301~t Due From Borrower Line120 ~ ~ 601~ntDue o el er (Line 420)
302~Paid By or Borrower ine 220 ~ 94,70~.09
~ 602- ess e uctions ue eer (Line 520) -
303. CASH ( X FROM) ( TO) BORROWER 2,650.24 603. CASH ( X TO) ( FROM) SELLER 80,998.06
The undersigned hereby acknowledge receipt of a comcleled c~nv nf n~n~ '~_o ~.~ ~,~ ~, ..... o
~ement & any attachments referred to herein.
~'RIc M. BOLDOSSER
*CLOSING COST CREDIT, TOTAL $4,600.00
Page
L. St: i ~ LEMENT CHARGES
700. TOTAL (~OM~llS{ION Basad on Price $ 94,500.00 @ 7.0000 % 6,615.00 PAID FROM PAID FROM
Division Ot L;omml~sion [line ZOO) as f-o/lows: eORROWER'S
701. ~ 6,615.00 to ~EN [U~Y 21 PISCIONERI HEAL] y, INC. SELLER'S
70~, ~ tO FUNDS AT FUNDS AT
S00. ITEMS ~ o , .
-AD IN TRATIV F E to CAR AL IN N IAL . LTD PARTNE SHIP
~ so9.00
901.Interest From 03~6/04 to 04/01/04 ~ $ 16.700000/day ( 6 days %) 100.20
~surance 3.000 monks ~ $ 33.75 per mon~
~ 101.25
0.000 monks 38.29 per mon~
2.000 monks 26,87 per mon~ 53.74
~ per mon~
~ax 10.000 ~n s ~ 62.51 per mon~ 625.~
~ ~ per ~
~ mont~ per month
1008. A REGATE S R ADJ. mon~ per ~
~ -2~6.~
1101. E-Mail Document Re~eval to PURI~ ABST~CT COMPANY
1102..bs~act orIeSearc to ~ 35.00
~amination to ,
1104. Insur losing Le~er to irst ~eri~n i~e Insurance ~.
~ ~o
~ to ~ ~.~
~ mcu esaore I emhum ers:
~ance to PU ~ AB TRACTC MPAN T
inclu esabove item numbers:
.enes overage ~
· hers overage
. vermg eepacage ~
1201. Re~rding Fees: Deed $ 39.50; Mo~gage $ 52.50; Releases $
· ~ oun a amps:ee 92.00
1203~S~s~ Revenue S~mps ~
~ge
~ RECOR~ 945.00
RE ORDE O DEED
1301. Su~ey to
1303. T Al PAY F & H E INSPECTION 310.~
~ to MBER AN OUN~ C~IM BUREAU ~~ 873.40
l~on Jand502, Se~on ' 6 311.09
Certified to be a true copy.
Se eme., Age.t/
( BOLDOSSER.E2 / BOLDOSSER~E2 / 22 )
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
,HARRISBURG, PA 17128-0601
CONNONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-I;47 EX 4FP (01-03)
ROBERT P K'L~NEAUG 17 P 1:14
KLINE LAW OFFTCE
NEt,/ CUMBI[lJ~? = PA ~:1,707p:::
DATE 08-16-200~
ESTATE OF BURNS
DATE OF DEATH 05-11-2005
FILE NUMBER 21 05-0535
COUNTY CUHBERLAND
ACN 101
I Amoun~ Remitted
GLORIA L
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAHO CO COURT HOUSE
CARLISLE, PA I7013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS '~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BURNS GLORIA L FILE NO. 21 03-0335 ACM 101 DATE 08-16-200~
TAX RETURN NAS: ( ) ACCEPTED AS F/LED ( X} CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Tnterest (Schedule C) ($)
4. Hortgages/No~es Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funeral Expenses/Adm. Costs/HAsc. Expanses (Schedule H) (9)
10. Deb~s/Nortgage LAabilAties/LAens (Schedule I) (10)
11. Total Deduct ions
12. Nat Value of Tax Return
90~000.00
O0
O0
O0
3~835.92
8;007 31
5z007 31
(BI
23,719.5~
NOTE: To insure proper
credAt to your account,
submAt ~he upper portion
15.
14.
NOTE:
ASSESSNENT OF TAX: 15. Amount of LAne 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of LAne 14 at SAblAng rata
18. Amount of LAne 14 taxable a~ Collateral/Class B re'ce
19. PrAncA >al Tax Due
TAX CREDITS
PAYMENT RECEI'pT DISCOUNT (+}
DATE NUHBER INTEREST/PEN pAID (-)
06-15-200~ CD00~056
of this form wi~h your
*ax payment.
106,850.5~
2~302.09
(11) 26.02].63
(12) 80,828.91
(15) . O0
(14) 80,828.91
16, 17, 18 and 19 ~111
Charitable/governmental Bequests; Non-elected 911:5 Trusts (Schedule J)
Nat Value of Estate SubSec* to Tax
If an assessment ~as lssued previously, lines 14, 15 and/or
reflect flgures that include the total of ALL returns assessed to date.
(is) .00 x O0 = .00
(16) 80,828.91 x Oq5= 5,657.30
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= 3,637.30
AHOUNT PAID
3,85~. O1
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
76.78-
TOTAL TAX CREDIT I 3,777.23
BALANCE OF TAX DUEl 139.93CR
INTEREST AND PEN. .00
TOTAL DUE 139.93CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTZCE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possassion or enjoyment to Class B (collateral) benaficiarias of the decedent altar the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the la~ful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, ahich Has not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritanca end Estate Tax" (REV-1313). Applications ara available at the Office
of tha Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-BO0-36Z-Z050; sarvicas for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object mJthin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZOl0Z1, Harrisburg, PA 17iZ8-10Z1, 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 bo addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviaa Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (7173 787-6SOS. Soo page S of tho booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacadent's death, a five percent (SZ) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning .ith first day of delinquency, or nina (9) months and one (1) day from the date of
death, to the date of payment. Taxes ehioh became delinquent balers January l, 19az bear interest at the rate of
six (6g) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rata which Hill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ lOX .000548 ~)T~-1991 11z .OOOSO1 ~ 9Z .000247
1983 162 .000438 1992 92 .000247 ZOOZ 6Z .000164
1964 11Z .000301 1993-1994 72 .000192 2003 iX .000137
1985 132 .000356 1995-1998 92 .000Z47 2004 4Z .000110
1986 10Z .000274 1999 7Z .000192
1987 10Z .000Z74 ZOO0 72 .00019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUNBER OF DAYS DELZNQUEN? X DALLY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will 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.
REV-1470 EX (6-88)
INHERITANCE TAX
COMMONVVEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME FILE NUMBER
Gloria L Burns 2103-0335
REVIEWED BY ACN
Sandra J Eslinger 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
G I The $3,000 exclusion has been applied to the value of this item. Section 9107 (c) (3) of the
1995 Act provides that a transfer made within one (1) year of the death of the transferor is
subject to tax only to the extent that the value of the transfer exceeds $3,000 during any
calendar year.
ROW Page 1
- DUK"A~ OF TND/VTDUAL TAXES
INHERIT.%NCE TAX DIVISION
· ~EPT. Z80601
HARRISBURG, PA 171Z8-0601
DOUGLAS E BURNS
550 FLORIDA AVE
PORTSMOUT~
CUT ALONG THIS LINE
25707
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
08-15-200q
BURNS
05-11-Z005
gl 05-0555
CUMBERLAND
209-12-9982
03119qZ9
Amoun'l: Ree[~4:ed
REV-I&B¢ EX AFP (01-05)
GLORIA L
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
RETAIN LONER PORTION FOR YOUR RECORDS
REV-1604 EX AFP (01-03)
#~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE 08-13-200q
ESTATE OF BURNS
GLORIA L DATE OF DEATH 03-11-2003 COUNTY
CUMBERLAND
FILE NO. 21 03-0335 S.S/D.C. NO. 209-12-9982 ACN 05119qZ9
ADJUSTHENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: NAYPOINT BANK ACCOUNT NO.
10026q65~
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 09-05-2002
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions -
Taxable Amount
Tax Rate X
Tax Due
.00 NOTE:
1.000
.00
.00
.00
.15
.00
TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE NITH YOUR TAX
PAYHENT TO THE REGISTER OF NZLLS
AT THE ADDRESS SHONN ABOVE.
HAKE CHECK OR HONEY ORDER PAYABLE
TO: "REGISTER OF NZLLS, AGENT."
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID C-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DuEI
INTEREST AND PEN.
TOTAL DUE
IF PA/D AFTER THIS DATE, SEE REVERSE FOR CALCULAT/ON OF ADD/T/ONAL INTEREST.
IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE XS REFLECTED AS A "CREDXT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
.00
.00
.00
.O0
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.
-- Hake check or money order payable to: REGISTER OF NILLS, AGENT.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may bo requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at
the Dffice of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's Iq-hour
ensnaring service for fores ordering: 1-800-362-Z050~ services for taxpayers with special hearing
and / or speaking needs: 1-800-¢q7-3020 [TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue) Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601, Phone
(717) 787-6SOS.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's dmath, a five percent (SZ) discount
of the tax paid is alIowed.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed an 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.
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, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .00016¢. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The appIicabIe interest rates for 198Z through ZOO3 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea.__.r Rate Factor Yea..__r Rate Factor
1982 ZOZ .0005¢8 1987 9Z .O00Z~7 1999 7Z .O0019Z
1983 16Z .000¢38 1988-1991 llZ .000301 ZOO0 8Z -000219
198¢ 11Z .000301 199Z 9Z .000Z¢7 ZOO1 9Z .0002¢7
1985 13Z .000356 1993-199¢ 7Z .O0019Z ZOOZ 6Z .00016¢
1986 IOg .O00Z?¢ 1995-1998 9Z .000247 2003 5Z .000137
--Xntmrest is calculated as folloes:
INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will 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
Not/ce, additional interest must be calculated.
REV-1470 EX (6-88)
' ~ INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDEN'FS NAME FILE NUMBER
GLORIA BURNS 2103-0335
REVIEWED BY ACN
Phyllis Hoch 03119429
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
ADJUSTED ABOVE ACN TO ZERO. REPORTED ON PROBATE RETURN.
ROW Pa.~e 1
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death: O3
Will 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:
State whether administration of the estate is complete:
Yes ~C No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes__ No ~
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.
Signature
Name (Please type or print)
Address
Te 1. No.
(MAH:rmf/AM3)
Capacity:
__Personal Representative
~ Counsel for personal
representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRTSBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVAN/A
DEPARTNENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-i&D? EX AFP (01-05)
ROBERT P KLINE
KLINE LAW OFF[CE
PO BOX 461
NEW CUMBERLAND
PA 17070
DATE 09-07-Z004
ESTATE OF BURNS
DATE OF DEATH 03-11-Z005
FILE NUMBER 21 03-0335
COUNTY CUMBERLAND
ACN 101
Amount Rmm'~ tted
GLORIA L
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper port/on of this form w/th your tax payment.
CUT ALONG TH'rS L'rNE ~ RETAIN LOWER PORT'rON FOR YOUR RECORDS ~
REV-1607 EX AFP (01-03)
~ 'rNHERZTANCE TAX STATEMENT OF ACCOUNT #m(
ESTATE OF BURNS GLORIA L F'rLE NO. 21 03-0335 ACN 101 DATE 09-07-Z004
THIS STATEHENT TS PROVIDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAMED ESTATE. SHONN BELON
TS A SUHHARY OF THE pR'rNCTpAL TAX DUE,, APPLICATION OF ALL PAYMENTS,, THE CURRENT BALANCE,, AND, TF APPLI'CABLE,,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-09-2004
PRINCIPAL TAX DUE: ..........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
3,637.30
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID ¢-)
76.78-
06-15-Z004
08-18-2004
CD004056
REFUND
.00
IF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
3,854.01
TOTAL TAX CRED/T 3,637.30
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR INSTRUCTIONS.