HomeMy WebLinkAbout02-0146Estate of
PETITION FOR PROBATE and GRANT OF LETTERS
.*~TLE I. BAKER No. 21-Oa -!
also known as
Deceased.
Social Security No. 1
To:
Register of Wills for the
County of Cumberland
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_Q~_.s
in the last will of the above decedent, dated February 12, 2001.
and codicil(s) dated
in the
named
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Curaberland County, Pennsylvania, with
her last family or prin'cinal resid.ence at 20~ South ~ashington St.,
~eehaniesbur~, PK 17055 ~2~c~_~~-~-~ /~,"~-~t~r~/c-
(list street, number and muncipality)
Decendent, then 96 _years of age, died January 28, 2002 ,~1~ ,
at Holy Splri~-Hospital, Camp ttill, PA 17011
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned 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: House and Lot of Ground situate
High St. Mechanicsburg, PA
$ 7%,000o00
$
$ 7~,000.00
at 20~ South
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
request(s) the probate of the last will and codicil(s)
Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
~0
,//~-jane~:-A. Baker
Charles St.
Mechanicsburg: PA 170,~_~
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF CUMBERLAND
J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
nd subscribed
Sworn to or affirmed..a ~'
before me this '/tl~ __ day of
Februar~ '7 ~z~ 2002. ~
~,~ L.. ~/~ r .... i~ Register ~.~2~dgr/
21-2002-146
Estate Of ]~,fk'RTLE I. BAKER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
February 8th
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated February 12, 2002
described therein be admitted to probate and filed of record as the last will of
Myrtle I. Baker
Testamentary
and Letters
............. ~_~00& in consideration
are hereby granted to Russell L, Baker and Janet Ao Baker
FEES
Probate, Letters, Etc ..........
Short Certificates(3) .......... $ 9.0 0
Renunciation ................ $
x-Pages (3) $ 9.00
JCP 5.00
TOTAL __ $
Filed P..E.b..r .u.a..r.y...8..t .h.: .2.0. .0.9...$.2..~.~.: 9.O..
Register of Wills Mary C. Lewis
J. Robert 8tm]f?ev
44-WORNEY
Market oquare tB!dg'°'
SumEt. L
No.)
Mechanicsburg, PA 17055
06356 )
ADDRESS
717 -766-9673
PHONE
MAILED LETTERS TO ATTORNEY
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 7913956
No.
JAN 3 0 2002
Date
'. MYRTLE I. BAKER
Cumbertc~nd
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Iz FEMALE [~. 186 -- lO -'4466
1~-"7~.1 ~, I ~:~ [~~ ....... ~,
I I I ' ' ' I --"" I~ I~
I-.. .,.o ,. 1~,~ ~ ~/~/ ~~ ' I,~
PA 17055
O_vA-
44.
21-2002-146
LAST WILL AND TESTAMENT
OF
MYRTLE L BAKER
I, MYRTLE I. BAKER, of the Borough of Mechanicsburg, County of
Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this my Last Will and Testament, hereby
revoking and making void any and all former Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my
decease as the same can be conveniently done.
2.
I give and bequeath fifty (50%) per cent of my estate to to my daughter-in-law,
MARIE S. BAKER, my granddaughter, LINDA C. SENTS, and to my greatgrandson,
JEFFREY ALAN GUCKELBERGER, share and share alike, with the stipulation
however, that in the event my daughter-in-law, MARIE S. BAKER, should predecease
-1-
me, then in such event, I give and bequeath her share in my estate to my granddaughter,
LINDA C. SENTS.
In the event that my greatgrandson, JEFFREY ALAN GUCKELBERGER, has
not attained the age of twenty (20) years at the time of my decease, I direct that his share
in my estate be deposited or invested in an interest bearing account or certificate where
the same shall remain until such time as he attains the age of twenty (20) years, at which
time the same shall be paid over to him in its entirety, absolutely and unconditionally,
free and clear of all further restrictions.
3.
I give and bequeath the remaining fifty (50%) per cent of my estate to my son,
RUSSELL L. BAKER, absolutely and unconditionally.
4.
For the purpose of facilitating the settlement and distribution of my estate, I hereby
authorize and empower my Executors hereinafter named, to sell any and all real estate
which I may own at the time of my decease, at either public or private sale or sales.
LASTLY, I nominate, constitute and appoint my son, RUSSELL L. BAKER, and
his wife, JANET A. BAKER, Co-Executors of this my Last Will and Testament and in
the event that both the said RUSSELL L. BAKER and JANET A. BAKER, his wife,
should predecease me, or should neither of them be able to serve in such capacity for any
-2-
reason, then in such event, I nominate, constitute and appoint my grandson, KIRK W.
BAKER, Executor of this my Last Will and Testament, in their place and stead, and in
all instances, I direct that my said personal representatives be excused from posting bond
or other security for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
of February, A. D. 2001.
Myrtle I. Baker
Z-/day
(SE )
Signed, sealed, published and declared by the above-named, MYRTLE I.
BAKER, as and for her Last Will and Testament, in the presence of us, who, at her
request and in her presence, and in the presence of each other, have hereunto subscribed
our names as witnesses.
-3-
COMMONWEALTH OF PENNSYLVANIA )
· SS
COUNTY OF CUMBERLAND )
I, MYRTLE I. BAKER, the testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the same instrument as my Last Will and
Testament; that I signed it willingly, and that I signed it as my free and voluntary act and
deed, for the purposes therein expressed.
Sworn and subscribed to before
me this / ~ ,Z-day of February, 2001.
Notary Public
Myi'tle I. Baker
COMMONWEALTH OF PENNSYLVANIA )
· SS
COUNTY OF CUMBERLAND )
(SEAL)
We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY, the
witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the testatrix,
MYRTLE I. BAKER, sign and execute the instrument as her Last Will and Testament;
that the said testatrix executed it as her free and voluntary act for the purposes therein
expressed; that each of us, in the hearing and sight of the testatrix, signed the Will as
witnesses; and that, to the best of our knowledge, the testatrix was, at the time, eighteen
(18) or more years of age, of sound mind, and under no constraint, duress or undue
influence.
Sworn and subscribed to before
meth~is /2 'FdayofF_e.bruary;,2001.
NotarfPublic
Notaxial Seal
Mafilyn E. WiUiams. Notary Pul~ti¢
V!,echan csburg Boro, Cumberland County
My Commission Expires Nov. 6.2001
Mem,~e,t. penn,qvlvanta A~.~ociatino of Nntafies
-4-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
~,%rRTLE I. BAtqER
Date of Death: Januar7 28, 2002
Will No. 2002-0011_[6 Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on February 21., 2002 :
Name Address
RUSSELL L. BAi~ER-708 Charles St.; Meehaniesburg; PA
MARIE S. BAIr~.R'296 South George St., Mechanicsburg,
LINDA C. SEh~S-510 West Main St., Mechanicsburg, PA
17o .
JEFFREY A. GUCKELBERGE~-R. D. 2, Box 119, Smethport, PA 167~9
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: February 21, 2002 ~ature 7 -- ~
Name J. Robert Stauffer
cz~ Address
'~:~ g) ,: .:r:: Market Square Bldg,
Mechanicsburg, PA 170~
:
~" wa Telephone {Il3 - 766-9673
~ ~ Capacity~ ~ Personal Representative
X Counsel for personal representative
i..-~ t....~
®~ o
o o
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 171.28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD 000994
REV 1500 EX (6 00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
r'H r'lr'!^! I1",1~: ~ttl ','
. \'--t
FILE NUMBER
2 1 -~ 0 O1
COUN~ CODE YEAR NUMBER
I-
Z
U.I
,,-,
Z
o
Q.
u~
u.i
o
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
BAKER, Mifrtle I.
DATE OF DEATH (MM-DD-YEAR) 1 DATE OF BIRTH (MM-DD-YEAR)
January 28, 2002J June 29, 1905
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/^
SOCIAL SECURITY NUMBER
186 - 10 - hJ_l-66
46_
[~1. Original Return
[~4. Limited Estate
[~6. Decedent Died Testate (Altach copy of Will)
[~]9. Litigation Proceeds Received
~]2. Supplemental Return
[~42. Future Interest Cotnpromise (date ol death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy o{ Trust)
]I0. Spousal Povedy Credit (dale ct death between 12-31-91 acd 1-1-95)
[~] 3. Remainder Return (date of death prior to 12-13-82)
[~5. Federal Estate Tax Return Required
_Q_ 8. Total Number of Safe Deposit Boxes
[~11. Election to tax under Sec. 9113(A) (A~ch Sch O)
NAME
J. Robert Stauffer
FIRM NAME (If Applicable)
Same
TELEPHONE NUMBER
14.
717-766-9673
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Padnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Properly (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.
COMPLETE MAILI.~G ADDRESS
Market ~quare Bld. g
I West Main St.
Mechanicsburg, PA 17055
80,000, O0
0.00
0.00
0.00
102,397 · 27
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
O.OO
O.OO
OFFICIAL USE ONLY
(8)
182,397.27
32,331.23
O,OO
(11)
(12)
(13)
32,331.23
15o,o66.04
0.00
(14)
150,066.04
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amounl of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
O. OD x .o __
1-L50,066. O[~- x.O__
O. OD x .12
O. OD x .15
(15)
(16)
(17)
(18)
(19)
0.00
6,752.97
0.00
0.00
6,752.97
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
Decedent's Complete Address:
STREET ADDRESS
20~ South Washington St.
CITY
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
4:~00.00
225.oo
Interest/Penalty if applicable
D. Interest O o OO
E. Penalty O. O0
ISTATE
PA J ziP
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penally ( D + E ) (3)
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)
6,752.97
4~725.00
OoOO
0o00
2,027.97
0.0o
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 2,027 · 97
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
AS PART OF THE RETURN.
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
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 properly 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
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.
S..~ RE OF PERSON RES_PON~IBLE FOR FILING RET,U~tN .~ ~ DATE
ADDRESS ,.// -' '
~ 708 Charles St., ~hanicsburg, PA 17055
~ss - / S 'r~d ~
Hamke~ qua g,, Hechanicsbum~, PA 170~g
For dates of death on or after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sullying spouse is 3%
F2 aS. ~9~6 (a)(~.~)(i)l.
For dates of dealh on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]
The statute does not exempt a transfer to a sullying spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax return are still applicable even i~
the su~iving spouse is the only beneficial.
For dates of death on or a~er July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child Menty-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)(12)].
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 lransfers 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 ar
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV I~2EX + (197) '~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE A
REAL ESTATE
M-y-RrT, r,l:;,, ]: T~i~i~ FILENUMBER 21-02-0]]~6
2oo2-oo1.4.6
All real prope~ o~ed some~ or a~ a tenant in common must be repoded a( fair market value. Fair manet value is defined as the pdce at which prope~ would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real properly which is jointly-owned with right r
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
.& LL
the
an(]
VALUE AT DATE
DESCRIPTION OF DEATH
'P~IA'? CE]{TAII'.,T house arid lot of Gro~md slbuate in
Borough of I.~echanicsb~.~rg, County of Cumberland
State of Pe~'~nsy].van:i.a, presently known
numbered as 20~ So~th WashLn~ton Street, ~echanicsb~
Pennsylvania. Sold to tIichae]. L. Stor~e for
~;~)0, 000. 00. Setl;!emo~]t Statement ~.s
herewi, th.
80,000.0~
TOTAL (Also enter on line 1, Recapitulation $
80,000.0(
(If more space is needed, insert additional sheets of the same size)
COMMONWEA[HI OF PENNSYLVAHIA
INtlFRIIAi',JCF lAX RFII_IRN
RESIDEN l DECEDEN )'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
~FfRTLL I. BAtLE~R
FiL~ ~UMBER-- 2 .L - 02- 01~ 1.6
2002-00146
Include Ihe
II-EM
NUMBER
10.
m~cee(I.'~ of lili.g.qfio, .q,(f the dn e fhe pmcemls were mc~lved hy Ilm e~l.qlp. All pmp,.~ly jol,l¥ow, ed with file right of survlvo~shl ~ taus! be disclosed ~n Schedule F.
DESCRIPI ION
P}~C Bank, N. A., Checking Account No. ~0-0102-1367.
PNC Bank, N. A., Savings Account No. ~0-03!~3-40~2.
It. B. Mclure, refund for heating oil.
Comcast, TV cable refund.
Housemaster, refund.
Farmers Mutual Insurance Co., claim for paint Splash.
Proceeds from Chuck Bricker Auctioneer, from sale of
b. ous e hoid furnishings.
I, ititz Mutual Insurance Co., refund for unexpired
homeowners t'nsurance.
Michael L. Stone, refund of Coun~ and Borough Taxes
from 8/~0/02 to 12/31/02.
Michael L. Stone, refun~ of School Taxes from 8/30/02
to 6/30/03.
TOTAL (Also enter on line 5, Recapilulation)
VALUE AT DATE
OF DEATH
$ 12,950.77
84 , 227.79
~75.24
12.78
~o.oo
2,~FF.5o
1,120.00
276.00
103.91
825.28
$ 102,397.27
EV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER 21_02_01].i.6
'l'~]l.[lkl., I. BAh ... ~nn~_nn-~/.~.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBEF DESCRIPTION AMOUNT
A.
1.
10.
11.
FUNERAL EXPENSES:
IIoll:Lnger Funeral I{ome, Mt.
vania, £uneral e×penses.
}{o].].y S. ' .. Pennsyl
~. prlngs, -
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) JD.t~o t A o ~aker
Social Security Number(s)/EIN Number of Personal Representative(s/
Street Address 708 Charles Street
City I'¢echanicsburg, ..... Slate PA Zip 170~
Year(s) Commission Paid: 2002
Attorney Fees J. Robert S'bauf.fer, Esq., attorney fee.
Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation)
Claimant
Russell L. Baker - 181-22-7662 - 208-24-176~
Street Address
City
Relationship of Claimant to Decedent
State___ Zip
Probate Fees Register of Wills of Cumberland County',
Pennsylvania, Letters Testamentary.
Accountant's Fees
Tax Return Preparer's Fees
Cumberland Law Journal, Estabe Notice.
Verizon, January 2002 telephone.
United Water Pennsylvania, ~uary 2002 water.
PPL Electric Utilities, January 2002 electric.
Verizon, February 2002 telephone.
PPL Electric Utilities, February electric.
United Water Pennsylvania, February 2002 water.
The Sentinel, Estate Notice.
Howard Cohen, M. D., Medicare deduction.
PPL Electric Utilities, March 2002 electric.
TOTAL (Aisc enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
.$ 6,307.00
3,500. O0
3,5oo. 00
6,000.00
258. oo
75 · O0
18.12
5a.14
35.77
18.42
19.43
6.61
77.63
25.00
17.87
$ CARRIED FORWAR
ITEM
NUMBER
SCHEDULE tt
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND'
MISCELLANEOUS EXPENSES
DESCRIPIION
Please Print or Type
~J.~ NUMBER
21-02-0146
2002-00146
AMOUNT
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41 ·
42 ·
43.
48.
Verizon, March 2002 telephone.
Borough of Mechanicsburg, 2nd. Quarter Sewer and
refuse charges.
Barry Heckard, Sr., Tax Collector, 2002 County and
Borough Taxes.
United Water Pennsylvania, March 2002 water.
Penns'ylvania State Retirement, refund of overpa'yment.
Verizon, April 2002 telephone.
PPL Electric Utilities, April 2002 electric.
Un:ired Water Peomsylvauia, &pril 2002 water.
Lititz Mutual Insurance Co., homeowners insurance.
Verizon, May 2002 telephoue.
United Water Pennsylvania, May 2002 water.
PPL Electric Utilities, May 2002 electric.
Borough of Mechanicsburg, 3rd Quarter Sewer and
refuse charges.
Verizon, June 2002 telephone.
PPL Electric Utilities, J~ue 2002 utilities.
United Water Pennsylvania,. June 2002 water.
PPL Electric Utilities, July 2002 electric.
United Water Pennsylvania, July 2002 water.
Barry IIeckard, Sr., Tax Collector, 2002-2001 School
Verizon, July 2002 telephone, final bill.
Remax, real estate sales commission.
Remax, Notary fees.
Penn Attorneys, Buyers Title Insurance premium.
Recorder of Deeds, real estate transfer tax.
Commonwealth of Pennsylvania, real estate transfer tax.
Remax, transaction fee.
Penn Pest Control, termite treatment.
Allfi~s$ Bank, towards Buyer's Settlement'costs.
PPL Electric Utilities, final bill.
United Water Pennsylvania, final bill.
Register of Wills, filing Inventory and Pennsylvania
Inheritance Tax Return.
Register of Wills, reserved to filing First and
Final'Account.
TOTAL..... , .$
$ i8. ii
60.40
303.81
6.61
21.84
18.20
16.02
6.71
3~6 O0
18:17
6.71
17.87
60.40
18.14
15.84
6.71
17.09
6.71
4,800.00
4.00
677.00
8OO.OO
8OO.OO
125.oo
710.20
2,400.00'
24.28
ll. O0
25. O0
~ Zl3. qo
32,331.23
Page - 2
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
~,~fRTI,E I. BAKE~-~
SCHEDULE J
BENEFICIARIES
FILE NUMBER
aoog-oo 4s
NUMBER
e
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
MARIE S. BAKER
296 South George St.
Mechanicsburg, PA 17055
LINDA C. SENTS
510 West Main St.
Mechanicsburg, PA 17055
JEFFREY A. GUCKELBERGER
R. D. ~, Box 119
Smethport, PA 16749
RUSSELL L. BAKJ~
708 Charles Street
Mechanicsburg, PA 170~
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Unremarried
Daughter-in-law.
Granddaughter
Greatgrandson
So~
AMOUNT OR SHARE
OF ESTATE
One-sixth share
of Estate.
One-sixth share
of Estate.
One-sixth share
of Estate.
0ne-half (50%0)
share of Estate.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
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)
Z
'61,61 jo t~¥ sep.!::,npH 'Al eI:3!HV eeS
Atlee4 .~o All.~,os.~ed ot s. petl~ette ecI A.m steetls i.uo!t!pp¥
'Hess. I.UO!l!pp. jo ,(.,e^o:~s!p jo sX.p At.~!q1, u!tu!.~ pel!j ecI tsnt,u ,(.mtu.,,,u! luemelddns ¥
'e/,H..lueseJdeJ liUOs.ed jo Suetu~lu!odd. ,etj. sqtuotu ee.qt U~tlH,~ pel!J ecI jsntu X.ofue^u! u¥
SNOI I.::)IltI.I. SNI
~tU°l'q AeC]
~00~ L,z~m-~ .................... q~-~
/Va: ~:~,:[~q~oT~z~qo~N ~,~,:[9, D ~e'l:,z~q~)
'em e.~ojaq paclHosqns pue
~eqo~oo
:ss
(INV'liFlal~ln3 dO A/NIIOD
VINVAIASNN~Id dO HI'IVHMNOININO::)
LZ
O0
6L
LL
oo
9Lz
poseaoap
L~tSIV~ ' I
jo olelsa leUOS~Od pue leal atll lo A~olua^ul
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 001 724
J ROBERT STAUFFER ESQUIRE
MARKET SQUARE BUILDING
MECHANICSBURG, PA 17055
........ fold
ESTATE INFORMATION: SSN: 186-10-4466
FILE NUMBER: 2102-01 46
DECEDENT NAME: BAKER MYRTLE I
DATE OF PAYMENT: 10/15/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/28/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,027.97
REMARKS:
TOTAL AMOUNT PAID'
J ROBERT STAUFFER ESQUIRE
$2,027.97
SEAL
CHECK# 311
INITIALS: JA
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF TNDTVTDUAL TAXES
.~NHERITANCE TAX DTVTSION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMNONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
J ROBERT STAUFFER
MARKET SQUARE BLDG
I N MAIN ST
MECHANICSBURG
PA 17'055
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
COUNTY
ACN
RE¥-IE4? EX AFP (01-12)
12-02-2002
BAKER MYRTLE I
01-28-2002
21 02-01q6
CUMBERLAND
101
Amount Rem/fred
HAKE CHECK PAYABLE AND REMZT PAYHENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE ~ RETATN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP ¢01-02) NOTTCE OF TNHERTTANCE TAX APPRAXSEMENT, ALLONANCE OR
DTSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF BAKER MYRTLE I FTLE NO. 21 OZ-01q6 ACN 101 DATE 12-02-2002
TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED
RESERVATZON CONCERNTNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks end Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership [nterest (Schedule C) ($)
q. Mortgages/Notes Reca/vabla (Schedule D) (q)
$. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Expenses/Ada. Costs/Misc. Expanses (Schedule H) (9)
10. Debts/Mortgage Liab/1/t/as/L/ans (Schedule I) (10)
11. Tote1 Deductions
1~. Nat Value of Tax Return
80zO00.O0
.00
.00
.00
102~97.27
.00
.00
(8)
$2,$31.2~
.00
NOTE: To /nsure proper
credit to your account,
subeit the upper port/on
of th/s fora w/th your
~ax pay,ent.
13.
NOTE:
182,:597.27
(11) 32.3~1.23
(12) 150,066.
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
Nat Value of Estate Subject to Tax (lq) 150,066. Oq
Zf an assessaent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w111
reflect figures that include the total of ALL returns assessed to date.
(~5) .00 x O0 = .00
(16) 150,066.0q x Oq5= 6,752.97
(~7) .00 x 12 = .00
(~a) .00 x 15 = .00
(~9)= 6,752.97
AMOUNT PAID
ASSESSMENT OF TAX:
15. Amount of Line lq et Spousal rata
16. Amount of L/ne lq taxable at Lineal~Class A rata
17. Amount of Line lq et S/bl/ng rata
18. Amount of L/ne lq taxable at Collateral/Class B rata
19. Princ/pal Tax Due
TAX CRED:;TS:
PAYMENT RECEIP] DTSCOUNT I.+)
BATE NUMBER TNTEREST/PEN PATD (-
O$-ZZ-ZOOZ CDOOO99q Z~6.Bq
10-15-Z002 CDOOIT2~ . O0
ZF PAZD AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATZON OF ADDZTIONAL INTEREST.
q,500.00
2,027.97
TOTAL TAX CREDZT I 6,76fi.81
BALANCE OF TAX DUEI 11.8qCR
ZNTEREST AND PEN. J .00
TOTAL DUE I 11.8qCR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UTRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR}, YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)
RESERVATION:
PURPOSE OF
NOTICE:
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 possession or enjoyment to Class B (collateral) beneficiaries of the decadent 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 laaful Class B (coltatarat) rate on any such future interest.
To fulfil! the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of 2000. (TI P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side.
--Hake check or money order payabZa to: REGISTER OF giLLS, AGENT
A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office
of the Register of gills, any of the Z3 Revenue District Offices, or by calling the special Iq-hour
answering service for forms ordering: 1-800-$6Z-ZOSO; services for taxpayers aith special hearing and / or
speaking needs: 1-800-~47-$0Z0 (TT only).
Any party in interest not satisfied eith the appralsaaent, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice oust object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-10Z1, 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 be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Oept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decadent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (3) calendar months after the dacedant's death, a five percent CSX) 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 mould 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 which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent per annue calculated at a daily rate of .00016~. All taxss ahich bscaaa delinquent an and after
January 1, 198Z wit1 bear interest at a rate which will vary from calendar year to calendar year with that rata
announced by the PA Department of Revenue. The applicable interest rates for 198Z through gOOg era:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198Z ZOX .0005~8 1992 9Z .O00Zq7
1983 16Z .000q$8 1993-199q 7Z .O0019Z
198q llZ .000301 1995-1998 9X .000Z~7
1985 13Z .000356 1999 72 .OO019Z
1986 XOZ .O0027~ ZOOO 8Z .O00ZX9
1987 9Z .O00Zq7 ZOOl 9Z .O00Z~7
1988-1991 IIZ .OOO30l ZOOZ 6Z .00016q
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER 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
Notice, additional interest must be calculated.
II',! ']'F[E (,01RT OF OOfl/IO~..I PLEAS OF CUI.IBEIiI,A~,~D COUNTY, PE?INS.~U.,VAI. IIA.
N0 2002-001116 0RPItANS' COURT DIVISIOII.
FIRST ,~]',TD FI?{AL ACCOUHT OF RUSSELL L. BAKER AIID JAI,EET A. BAKER,
EXECUTORS 0F THE LAST WILL Ah,rD TESTA?IEI'~T OF MYRTLE I. BAKER, LATE
OF T~-EE BORO17GH 0F NEC~I&I'~ICSBURG, COUNTY OF CUMBERLAI,FD A?.TD STATE
OF PEI'~NSYLVA}TIA~ DECEASED.
Date of Death: January 28, 2002.
Dates of Advertisement of Letters Testamentary:
In the Cumberland Law Journal: February 22 and March I and 8, 2002.
In The Sentinel: February 18 and 25 and March 4, 2002.
PRINCIPAL ACCOUNT
Debits
Accountants charge themselves with the following receipts
and assets of decedent's estate, consisting of real
estate and personalty as follows, to wit:
20O2
1/28
1/28
3/22
3/22
5/2
5/30
6/12
7/lO
9/3
9/lO
9/20
9/20
9/20
Checking Account No. ~0-0102-1367. $
-Performance Money Market AccOunt No. 50-0353-48~2.
H. B. McClure, Heating 0il, refund.
Comcast, TV Cable refund.
Harry Cupp, garage rental.
House Master, refund.
Farmers Nut,al Insurance, paint splash on house.
Harry Cupp, garage rent.
Michael L. Stone, proceeds from purchase of house.
Chuck Bricker, proceeds from sale of furnishings.
Lititz Mutual, Insura.nce, refund.
Michael L. Stone, refund on unexpired 2002 County
and Borot~gh Taxes.
Michael L. Stone, refund on unexpired 2002-2003
School Taxes.
GROSS PRINCIPAL ~'
AooE]?S AND REC[~ZPTS ..... . ............. ..
12,950.77
84,227.79
375
100.00
50.00
2,455.50
100.00
80,000.00
1,120.00
276.00
lO3.91
82 .28
-1-
PRINCI PAL ACCOUNT
Credits
Accountants ask Credit for the following items paid
out of Principal in the Settlement and Administration
of decedent's estate.
20O2
2/7
2/14
2/18
2/18
2/18
2/18
3/1
3/13
3/16
3/22
3/22
3/22
4/lO
4/lo
t/lO
4/10
4/22
4/27
~/i~
~/i~
~/27
6/~
6/ii
~/ii
7/i0
7/lO
7/10
8/5
~/12
8/i2
8/27
8/27
8/30
Register of Wills, Letters Testamentary.
Cumberland Law Journal, Estate Notice.
Verizon, January 2002 telephone.
Hollinger Funeral Home & Crematory, Inc.,
funeral expenses.
United Water Pennsylvania, January 2002 water.
PPL Electric Utilities, January 2002 electric·
Verizon, February 2002 telephone.
PPL Electric Utilities, February 2002 electric.
United Water Pennsylvania, February 2002 water.
Register of Wills, on account of Pennsylvania
Inheritance Tax.
The Sentinel, ]Estate Notice.
Howard Roy Cohen, M. D. doctor bill.
PPL Electric Utilities, March 2002 electric.
Verizon, March 2002 telephone.
Borough of Mechanicsburg, 2nd O~arter Sewer
and Refuse charges.
Barry Heckard, Sr., 2002 County and Borough
Taxes.
United Water Pennsylvania, March 2002 water.
State h~uployes' Retirement System, ret~rn of
overpayment.
Verizon, April 2002 telephone.
PPL Electric Utilities, April 2002 electric.
United Water Pennsylvania, April 2002 water.
Lititz Mutual Insurance Co., Home Owners policy.
Verizon, May 2002 telephone.
United Water Pennsylvania, May 2002 water.
PPL Electric Utilities, May 2002 electric.
Borough of ~iechanicsburg, 3rd Quarter Sewer
a~d Refuse charges.
Verizon, June 2002 telephone.
PPL Electric Utilities, June 2002 electric.
Ynited Water Pennsylvania, June 2002 water.
PPL Electric Utilities, July 2002 electric.
United Water Pennsylvania, July 2002 water.
Barry Heckard, Sr., T~ Collector, 2002-2003
School Tax.
Verizon, July 2002 telephone.
Remax, real estate sales commission.
2%8.oo
75.oo
18.12
6,307.00
52.i4
i8.42
i~.43
6.61
4,500.00
77.63
25.00
.ll
60.4o
303. 81
6.61
21. 815
18.20
16.02
6.71
346.00
18.17
6.71
17.87
60.4O
i8.i4
if.$4
6.71
17.09
6.71
98~.40
· 02
4,800.00
-2-
PRINCI PAL ACCOUI.1T
Credits
2OO2
8/3o
8/30
8/30
8/3o
8/30
8/30
8/30
9/12
9/12
lO/8
lo/8
Rema~, Notary Fees.
Penn Attorneys, B~er's Title Insurance premium.
Recorder of Deeds, Real Estate Transfer tax.
Recorder of Deeds, Real Estate Transfer tax.
Remax, transaction fee.
Penn Pest Control, termite treatment.
Allfirst Bank, Buyer's sett]..ement costs.
PPL Electric Utilities, final bill.
United Water Pennsylva~ia, final bill.
Register of Wills, filing Pennsylvania In-
heritance Tax Return with Inventory.
Register of Wills, Agent, balance due on
Pennsylvania Inheritance Tax.
Cash, reserved to filing Fiduciary Tax Return
and contingencies.
Register of Wills, filing Account.
Russell L. Baker, Executor's Commission.
Janet A. Baker, Executrix's Commission.
J. Robert Stauffer, Attorney fee.
TOTAL PRINCIPAL FD(PENDITURES ............................ $
4.00
677.00
80O.0O
800.00
125.oo
710.20
2,400.00
24.28
11.00
25.00
2,027.97
5CO.00
113.00
3,500.00
3,500.00
6,000.00
39,384.20
-3-
T ~'T~
IBC0. ~ .....~CCOUNT
Debits
Accountants charge themselves vrith the following items
of Income received, to wit:
2002
2/1[~ Checking Account No.
2/14 Money Market Account
3/14 Estate Checking Account
4/12 Estate Checking Account No.
5/11¥ Estate Checking Account lfo.
6/13 Estate Checking Account
7/1~ Estate Checking Account No.
8/115 Estate Checking Account No.
8/14 }{oney PIarket Account No
9/13 Estate Checking Account
9/1~ Money Market Account
10/16 Estate Checking Account
10/16 ~4oney i~'~arket Account Fo
5o-0102-1367.
No. ~o-o353-49~2/
5o-o312-oo51.
5o-o312-oo51.
5o-o312-oo51.
5o-o312-oo~.
5o-o312-oo51.
5o-o312-oo~1.
· 50-0391-8557.
No. 50-0312-0051.
· 5o-03~l-$557.
~o. 5o-o312-oo51.
· 50-0391-8557.
GR0 FC0;~E ~'
9.58
22.54
18.22
17.38
18.73
17
1.51
171.06
1.28
.78
*tT ~g
Credits
Accountants ask ~red_t for the following items
charged against Income, to wit:
2002
]~.T one a-.
.? 0. O0
TOTAL I~CO~'I.~ DISBYRS~:.,~,.~:~},:To AND C~:~A~G.~S ................ ,?
0.00
Principal Account
Debits $ 182,~96.87
Credits ,39, 3814.20
Debits ~,oA ~-2
Credits 0.00
212.67
1L3,7.>9 a5
°"',-"-'e~ io~ th. st the baqance i.n hanes of Accountants
for 3istribut:;..o~, to ~¢it, the suT.a of ?143,739.25, be made in Cash
under item 2. a~d 3. of my Last Ui!! and Testament arid therefore
Distribution is I0roposed as fol!ov~s:
..! .... Cash, to ]i.~A~IlE S BAKER
~" to LZL.~A S SE~fTS
7_n oash, .
7n Cash, to JE~'~¥ A. LA?~ GV~C~(ELBS~2GEU'I, to
be placed in an interest bearing
account until he atta;..~s the age
of t',¢e~ty (20) ,Tears.
Cash, to RUSSELL L ?' ~ '
.... oA!f%R.
950.
23,956.~4
~7:!,,!!69.62
1~3,739....2~
-5-
Personal..,) appeared before me, the undersigned officer,
a '. .... o~a.~ .Public, in an{] for said CoN~n. onv~ea!~h aed County, ~oooELL
L. l'~li~ER and JAii'ET A. BAiLiff, Executors of the Last Will and
Testament of }%[RTLE i~ I~AI%~R, late of the Borou.g'a of ilechaniosburg,
CoYnty of Cumberland and State of Pennsylvania, deceased, who being
duly sv~orn accoPdin~.'.,o to !at?, deposes and states, that they are
the Accountants in the annexed Account and that said Account is
· 'cru. e and correct to the best of their know!edse, inforr~ttatLon and
bel~.ef, and that there are no unpai~) cPeditors to be notitied
of this Account and the day of proposed decree of confirmation
has been given to all parties who have an interest i.n the
estate as beneficiaries aud deponents fvP'bher aver that the
foregoing Schedule of Proposed Distribution of 'the net assets
of the estate of ~.~n ~..~ ,~,-.~.~ -:~, ~.~,
and is made in accordance ~?ith the Nrovisl. ons of said. decedent's
Last WLI! and Testament and the laws of the Cot:;z~.onwea!th of
Pennsylvania, app!-}.cable there'bo.
Russell L. Baker
..... ell ~'A-. /laker
Sworn and subscribe/~.~before me
Member, Pennsy~ania ~s~a~on ~ No~
-6-
,~ ~ I I I II I i . I II] I I
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ~CERTLE I. BAKER
Date of Death: January 28, 2002
Will No. 2002-001~6 Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes x No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes x No~
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: April ~0, 2003
~.~gna6ure
Llr~OO S ~, !~: ; ~ ~]~'~
6~..ld 1-,I,~1 fO.
$iI?A _lo .... .~
(MAH:rmf/AM3)
J. Robert Stauffer
Name (Please type or print)
Market Square Bldg.
~eohanicsburg~ PA 1705~
Address
( 71~ 766-9673
Tel. No.
Capacity:
Personal Representative
x Counsel for personal
representative