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HomeMy WebLinkAbout04-0037Estate of also known as REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS JUANITA D. BEHRENS NO. (~/- , Deceased Social Security No. 211545143 Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ~'~ Decedent, dated 6/23/03 and codicil(s) dated N/A or named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., dbn.c,t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 521 Bedford Court, Hampden Township (list street, number and municipality) Decedent, then 78 years of age, died October 23 ,2003 , at Holy Spirit Hospital, Camp Hill, PA (Location) 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 ........................................................................................ $ Total ..................................................................................................................... $ Real Estate situated as follows: 425 Pear Avenue, Swatara Township, Dauphin County Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: 1,300.00 62,000.00 63,300.00 Signature Typed or printed name and residence RICHARD BEHRENS 521 BEDFORD COURT MECHANICSBURG, PA 17050 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s)will well and truly adminis,~.)th, e estate.acc°rdin..Tq?t° lay. Sworn to and affirmed and subscribed RICHARD BEHRENS before me this 12th day of January, 2004 · DECREE OF REGISTER Estate of JUANITA D. BEHRENS also known as OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Deceased No. (~/':~-~ Social Security No: 211545143 Date of Death: 10/23/03 AND NOW, January /,..~ , 2004 , in consideration ofthe Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary I-I of Administration ((c.t.a., d.b.n.c.t; pendente lite; durante absentia; durante minoriate) are hereby granted to RICHARD BEHRENS in the above estate and that the instrument(s), if any, dated 06/26/2003 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ Short Certificates(s) ............... $ Renunciation .......................... $ Extra Pages ( ) ............... $ I.T.R ....................................... $ JCP Fee ................................. $ Inventory ................................ $ Other ...................................... $ TOTAL ............................. $ z"z/'~ ¢--'~ Signature Attorney: CHARLES E. PETRIE I.D. No: 29029 Address: 3528 BRISBAN STREET HARRISBURG PA 17111 Telephone: 561-1939 DATE FILED: 1/12/04 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 ocr L: ,5 2.00:] No. Local Registrar Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH 78 ,~. J } aanuary 2, : ~ " : Cumberland C E Pennsborn ~l g . ~ '-. '. Z/ ...... . I=~ ~_'--~. I'~' .... ~L..,.s ~l~e r _ ,,,.. Domestic I,,. l,,12 ,~,z, "''"' {,, Married I r { ,m Cumberland ~? m ~ l~'s~ I"- Florence Rife ~m~T~+,.~ .e.rens ,~ ........... I~. 521 Bedford Court, MechanicsburK, PA 17050 ~ ~ m{,,,gctober 28, 2003 l,,~oodla~ Memorial Garden ILower Paxton ~p., PA 17109 ~ ~ ~.~ .... n--'~D~~'~Parthemore ~'H & CS, inc. lu~.~u u~z oqo ~ Ju~.P.O. Box 431, New Cumberland, PA 17070-0431 ~ ~7 J' ~ ~ J D~E P~NCE D DE~ (M~. Day. ~J J~ C~ REFEREO m UE~ E~I~ P~RFO~MED? ' {Y~JE ~ (~ AS A CONSEOI.~NCE O~: D~E TO {OR A,S A CO~SEOOE NCE O~: CAUS~ · - 0 .o~ mE] ~pf/ LAST WILL AND TESTAMENT I, JUANITA D. BEHRENS, of 521 Bedford Court, Mechanicsburg, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I give, devise, and bequeath all of my property, real, f~ersonal, and mixed, to my husband, RICHARD BEHRENS. THIRD, that if my husband has predeceased me, or has failed to survive me for a period of at least ninety {90) days, or if our deaths should occur in a such a manner that it cannot be determined of us has predeceased the other, then I give, devise, and bequeath all of my property, real, personal, and mixed, to my daughter, LINDA D. BEHRENS. FOURTH, that if my daughter LINDA D. BEHRENS has predeceased me, then her share of my estate shall pass to my daughter DOLORES J. SHELLENBERGER. FIFTH, that I hereby appoint my husband, RICHARD BEHRENS, as the Executor of my Estate. If he is~unable or unwilling to perform in this capacity, then I appoint my daughter, LINDA D. BEHRENS, as the Executrix. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 26th day of June, 2003. {JANITA D. BEHRENS WITNESS WITNESS ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, JUANITA D. BEHRENS, testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by JUNITA D. BEHRENS, the testatrix, this 26th day of June, 2003. JI ANITA D. BEHRENS Notarial Seal Member, Pennsylvania Association ot Notar~s AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and RICHARD BEHRENS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her LAST WILL AND TESTAMENT; that JUANITA D. BEHRENS 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 testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix 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 before me by CHARLES E. PETRIE and RICHARD BEHRENS, witnesses, this 26th day of June, 2003. WITNESS WITNESS ~,¢~TAI~'~ ~.JB L'I C Notarial Seat ~ ~mm~on ~ ~. Member, Pennsylvania Association ot Notafiee JRD/June 30, 1992/17858 HAY 0 6 2004 In Re: Estate ofJUANITA D BEHRENS Late of HAMPDEN TOWNSHIP Estate No.: 21-04-37 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2004-37 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: RICHARD BEHRENS Counsel for Personal Representative: CHARLES E PETRIE, ESQ. Date of Grant of Original Letters: 01-13-2004 Date of Delinquency Notice: 04-23-2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of the Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on APRIL 23, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a heating to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 05-06-2004 Distribution: Personal Representative Glen& Famer-Strasbaugh~-~ (q/C 0~ Clerk of the Orphans' Court ~- ~ Counsel for Personal Representative Estate File A heating is scheduled fo in Courtroom No. 3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically/~/~//~/,,~ Georg~E. ~ex~.~. ' CERTIFICATE OF NOTICE UNDER RULE NAME OF DECEDENT: JUANITA D. BEHRENS DATE OF DEATH: October 23, 2003 WILL NO.: ADMIN NO.: 2004-00037 TO THE REGISTER: 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 March 12, 2004: NAME RICHARD BEHRENS ADDRESS 521 Bedford Court, Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE DATE: 4/26/2004 ~ ~ SIGNATURE NAME CHARLES E. PETRIE ADDRESS 3528 Brisban Street Harrisburg, PA 171 1 1 TELEPHONE (717) 561-1939 CAPACITY,~- C~ X Personal Representative Counsel for Personal Representative PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 NAME OF DECEDENT: JUANITA D. BEHRENS DATE OF DEATH: October 23, 2003 WILL NO: ESTATE NO: 21 04 0037 Pursuant to Rule 6.12 of the Supreme Court Orphan's Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X_ No __ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) c. Did the personal representative state an account informally to the parties in interest? Yes X No__ DATE: d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. July l9, 2004 ~ cr'J-~---- SIGNATURE LI;':dV g2'lllP CAPACITY" ~ ~.ers~ ~esentative CHARLES E. PETRIE NAME {PLEASE TYPE OR PRINT) 3528 Brisban Street Harrisburg, PA 17111 ADDRESS (717) 561-1939 TELEPHONE NO. X Counsel for Personal Representative Z Z COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z O X I-- REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL JUANITA D. BEHRENS DATE OF DEATH (MM DD Year) DATE OF BIRTH (MM-OD-Year) 10/23/2003 02/25/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) OFFICIAL USE ONLY _od_ 3._!_ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 2 1 1 -5 4-5 1 4 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ] 1 OriginaIReturn El4 Limited Estate [~]6 Decedent Died Testate IA~ch copy of Will) [~9 Litigation Proceeds Received BI2. Supplemental Return E~] 4a. Future Interest Compromise (da~ of deat~ a~er 12-12 82) r~7 Decedent Maintained a Living Trust (A~ta¢ copy of Trust) ] 10. Spousal Povedy Credit (date oldeath between 12.31.91 and 1.1.95) r--] 3. RemainderReturn (dateofdeathpriorto12-13-82) E~]5. Federal Estate Tax Return Required 0.~ 8. Total Number of Safe Deposit Boxes E]11. Election to tax under Sec. 9113(A) (A~ch Sch O) NAME CHARLES E PETRIE FIRM NAME (If Applicable) TELEPHONENUMBER 561-1939 COMPLETE MAILING ADDRESS 3528 BRISBAN STREET HARRISBURG PA 17111 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 B) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (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) 12. Net Value of Estate (Line 8 minus Line 11) 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 fax (Line 12 minus Line 13) 0.00 I OFFICIAL USE ONLY (8) 2,092.'64 8,115.80 (11) 8,115.80 (12) (13) -6,023.16 (14) -6,023.16 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15~ Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec 9116 (a)(t2) X .0 (15) 16 Amount of Line 1,4 taxable at lineal rate X .0 (16) 17 Amount of Line 14 taxable atsibling rate X 12 (17) 18 Amount of Line 14 taxable at collateral rate X .15 (18) 19 Tax Due (19) Decedent's Complete Address: STREE~ADDRESS 521 BEDFORD COURT CITY MECHANICSBURG I STATE PA I ZIP 17050 Tax Payments and Credits: 1. Tax Due (Fage 1 Line 19) 2, Credits/Payments A. Spousal Poverty Credit 8, Prior Payments C. Discount (1) Total Credits ( A + B + C ) (2) 3, Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. 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 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 properly 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 n trust for or payable upon death bank accoun o secur y a h s o he 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 personal representative is based on all information of which preparer has any knowledge. DATE 7/19/04 ADDRESS 521 BEDFORD COURT MECHANICSBURG PA 71050 SIGNATURE OF PREPARER ~THER THAN R,~,~S.~TATIVE DATE ~'~;"~ 7/19/04 ADDRESS 3528 BRISBAN STREET HARRISBURG PA 17111 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% 172 P.S. §9116 (a) (11) (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)l. 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 SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROP£RTY ESTATE OF FILE NUMBER · )U,~NITA D. BEHRENS 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PERSONAL PROPERTY 500.00 TOTAL (Als° enter °n line 5, Recapitulati°n)I $ 500.00 (If more space is needed, insed additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OF JUANITA D. BEHRENS If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. RICHARD BEHRENS SPOUSE B C 521 BEDFORD COURT MECHANICSBURG, PA 17050 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH iTEM FOR JOINT MADE Include name of fnancial institution and bank account number or similar identifying number AUach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate VALUE OE ASSET INTEREST DECEDENT'S INTERE~ 1. A. 05/1955 425 PEARAVENUE 116.00 SWATARA TOWN S HIP TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insed additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF JUANITA D. BEHRENS Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT 5 6 7. FUNERAL EXPENSES: PARTHEMORE FUNERAL HOME ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Secudty Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees CHARLES E. PETRIE Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address city Relationship of Claimant to Decedent Probate Fees State Zip Accountantrs Fees Tax Return PrepareCs Fees 7,225.80 750.00 140.00 TOTAL (Also enter on line 9, Recapitulation) $ 8,115.8(~ more space is needed, insert additional sheets of the same size) COMMONWEALTHOFPENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEJ BENEFICIARIES ESTATE OF JUANI'I k D. BEHRENS NUMBER 1. 1. H. 1. 1, FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) RICHARD BEHRENS 521 BEDFORD COURT MECHANICSBURG, PA 17050 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SPOUSE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE 100% AMOUNT OR SHARE OF ESTATE ON REV 1500 COVER SHEET 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 [][ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT I, JUANITA D. BEHRENS, of 521 Bedford Court, Mechanicsbur§, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I §ive, devise, and bequeath all of my property, real, l)ersonal, and mixed, to my husband, RICHARD BEHRENS. THIRD, that if my husband has predeceased me, or has failed to survive me for a period of at least ninety (90) days, or if our deaths should occur in a such a manner that it cannot be determined of us has predeceased the other, then I give, devise, and bequeath all of my property, real, personal, and mixed, to my daughter, LINDA D. BEHRENS. FOURTH, that if my dau§hter LINDA D. BEHRENS has predeceased me, then her share of my estate shall pass to my daughter DOLORES J. SHELLENBERGER. FIFTH, that I hereby appoint my husband, RICHARD BEHRENS, as the Executor of my Estate. If he is ,unable or unwilling to perform in this capacity, then I appoint my daughter, LINDA D. BEHRENS, as the Executrix. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 26m day of June, 2003. WITNESS WITNESS COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, dUANITA D. BEHRENS, testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by dUNITA D. BEHRENS, the testatrix, this 26th day of June, 2003. JI~rANITA D. BEHRENS /~'T~.Ry/igUB Li ~ - AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and RICHARD BEHRENS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her LAST WILL AND TESTAMENT; that JUANITA D. BEHRENS 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 testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix 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 before me by CHARLES E. PETRIE and RICHARD BEHRENS, witnesses, this 26th day of June, 2003. WITNESS WITNESS ~C~TAR~ ~'~JB LI ~ I ~, Penns,/ban~a Assoclatton ot N~a~ REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of JUANITA D. BEHRENS also known as , Deceased No. 21 04 0037 Date of Death 10/23/2003 Social Security No. 211545143 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: I.D No: Address: CHARLES E. PETRIE 29029 3528 BRISBAN STREET HARRISBURG PA 17111 Personal Representative: RICHARD BEHRENS Dated 07/20/2004 Telephone: 561-1939 Description SALE OF PRUDENTIAL STOCK PERSONAL PROPERTY (Attach Additional Sheets if necessary) Value 1,592.64 500.00 Total 2,092.64 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW*4 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17118-0601 p~ CHARLES E P~RIE' ~= $518 BRISBA'N ST - HARRISBURG PA 17111 COHHONWEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 09-Z7-ZOOR ESTATE OF BEHRENS DATE OF DEATH IO-ZS-ZO0$ FILE NUNBER 21 0~-0057 COUNTY CUHBERLAND ACH 101 Amount Raei~ed REV-IS47 EX AFP (01-95) JUANITA D HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGTSTER OF WTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17015 CUT ALONG THIS LINE ~.- RETAIN LOWER PORTION FOR YOUR RECORDS -.~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BEHRENS JUANTTA D FILE NO. 21 0~-0057 ACN 101 DATE 09-27-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVAT:KON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN DASED ON: ORIGINAL RETURN 1. Real Es*a~a (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Par*nership In~eres~ (Schedule C) ($) ~. Not,gages/No,es Receivable (Schedule D) (~) $. Cash/Bank Daposi~s/Nisc. PersoneZ Proper~y (Schedule E) ($) 6. Jo/n~ly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Cos~s/N/sc. Expenses (Schedule H) (9) 10. Dab~s/Nor~gage Liabil/~/es/L/ens (Schedule I) (10) 11. To'al Deductions 12. Ne~ Value of Tax Re~urn 15. 1~. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Ne~ Value of Es~a~e Subjec~ ~o Tax .00 1;591.6~ .00 .00 500.00 .00 .00 (8) 8,115.80 .O0 (11) (12) (15) (1~) NOTE: Zf an assessment ~as issued prev/ously, 1/nes 14, 15 and/er 16, 17, reflect f/gures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 1.;. Amoun~ of L/ne 1~ a4: Spousal ra*e 16. A.oun~ of L/ne lq ~axable a~ L/heal/Class A ra~e 17. Aeoun~ of L/ne 1~+ a* S/bl/ng ra~e 18. Aeoun~ of L/ne lq ~axable a~ Collateral/Class B ra*e 19. Princ/pal Tax Due TAX CREDITS: PAYNENT RECEIPTr DT$COUNT (+) DATE NUHBER INTEREST/PEN PAID NOTE: To /nsure proper cred/~ ~o your account, subei~ ~he upper por~/on of ~h/s fore w/~h your ~ex payment. 2,092.6q ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 8.115.80 6,025.16- .00 6,025.16- 18 and 19 Nill (16) .00 X O0 = .00 (~6). .00 X 0~5= .00 (17) .00 X 12 = .00 (18) .00 x 15 = .00 (19)= . O0 ANOUNT PAID .00 .00 .00 .00 TOTAL TAX CREDIT I I · ALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REgUZRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 11, 1981 -- if any futura interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the taafut Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To RJlfi11 the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (71 P.S. Section Detach the tap portion of this Notice and submit aith your payment to tho Register of gi118 printed on tho reverse side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131~). Applications ara available at the Office of the Register of Wills, any of the Z~ Revenue District Offices, or by calling the special Zq-hour anseering service for farms ordering: 1-800-56Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-~q7-S020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assesseent of tax (including discount or interest) as sheen on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 171ZS-IOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTW: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the 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 decsdent's death, a five percent (5Z) discount of the tax paid is allowed. The /SI 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 mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of six (61) percent par annum calculated at a daily rate of .OOOl6~. A11 taxes which became delinquent on and after January 1, 1981 ail1 bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 201 .0005~8 ~J~6-1991 111 .000301 ~ 9X .0002q7 1983 161 .000~38 1992 9X .0002~7 2002 6Z .00016~ 198~ 112 .000301 1995-199~ 72 .000192 ZOOS 51 .000137 1985 152 .000356 1995-1998 92 .0002fi7 ZO0~ ~Z .000110 1986 IOZ .00027~ 1999 71 .000192 1987 101 .00017~ 2000 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY /NTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.