HomeMy WebLinkAbout04-0058Register of Wills of
Estate of Ruth M. Burkey
also known as
Larry E. Burkey
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
.o.
, Deceased Social Security No. 179- 30 - 2529
(COMPLETE 'A' or 'B' BELOW:)
[] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut
the Decedent, dated and codicil(s) dated
named in the last Will of
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 incompetent:
B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship Residence
Larry E. Burkey
Richard E. Burkey
Russell H. Burkey
Son
Son
Son
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
or principal residence at 133 E. Dauphin Street,
Decedent, then 65 years of age, died 09/14/2003
IHarrisburs, PA
Mechanicsburs,
Enola, PA
PA
County, Pennsylvania with his/her last family
East Pennsboro Township
(liststreet, number, and municipality)
at Enola, PA
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: 133 E. Dauphin Street, East Pennsboro Township,
(Location)
70,000.~00
Cumberland County, PA
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:
Si. gma~ure T~/ped or printed name and residence
~ ~ / >'~--~ 231 Resent Road, I~arrisbur~, PA 17112
Prepared by the Pennsylvania Bar Association ....
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
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 representative(s) of
the Decedent, Petitioner(s)will well and truly administer the, estatx~cording to.,~., la~ ~
Sworn to or affirmed and subscribed
Larry ~.7 ~
before me this I t~.~t~day Of
No.
Estate of Ruth M. Burkey
Social Security No: 179-30-2529
Deceased
Date of Death: 09/14/2003
AND NOW,
, .. , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before
IT IS DECREED that Letters L'---J Testamentary ~ Of Administration
(c.ta.; d.b.n.c.t.a.; pendente lite; durante absenfia; durante minoritate)
are hereby granted to
Larry E. Burkey
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $ 115.00
Short Certificate(s) ..... $ 3.00
Renunciation ........ $ 10. O0
Affidavits ( ) .... $
Extra Pages ( ) .... $
Codicil ........... $
JCP Fee .......... $
Inventory .......... $
Other ........... $
TOTAL ......... $
Prepared by the Pennsylvania Bar Association
Register of Will
Attorney: Edward P. Seeber, Esquire
I.D. No: 76084
JAMES, SMITH, DIE1TERICK & CON..
Address: 134 Sipe Avenue
Hummelst own, PA 17036
Telephone: 717/533-3280
' ~-~%, ~ooq
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
Register of Wills of Cumberland County, Pennsylvania
Estate of Ruth M. Burkey
also known as
RENUNCIATION
, Deceased
The undersigned, . U~.,~f ~ ~ ,%~
(Relationshj~ (Capa~i~) ~
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to
of
(Signature)
(Address)
(Signature)
(Address)
(Signature)
Sworn to or affirmed and subscribed
before me this 2. '~day
of /)£e , ~.~
f -
M.y Comm,sslon Expires: /~/~//0~
(Signature and seal of Nota~ or other official
qualified to administer oaths. Show date of
expiration of Notary's commission.)
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
(Address)
NOTE: Renunciations executed outside the Office of Register of Wills
In some counties are required to be notarized.
Form #RW-4 (1991)
Register of Wills of Cumberland
Estate of Ruth M. Burke.y_
also known as
RENUNCIATION
County, Pennsylvania
.o. 2m-oH-5~
, Deceased
The undersigned, ' ~
(Relationship) (Capa~
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to
day of
of
(Signature)
(Address)
(Signature)
Sworn to or affirmed and subscribed
before me this
MN;tacr~° mP'rr~l~o n Expires:
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission.)
Prepared by the Pennsylvania Bar Association
Copyright lc) 1996 form software only CPSystems, Inc.
(Address)
Stephm~e L. eaffey, Notaw Pub~
NOTE: Renunciations executed outside the Office of Register of Wills
~n some counties are required to be notarized.
Form #RW-4 (1991)
his is to certi~/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 photogral~.
Fee for this certificate, $2.00 Mary T. Gray
o- ~ Deputy Registra
" 4308 BerMey St.
Harrlsburo, ~A. i 7 i 09
Local tXegfstrar
P 9702268
No.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
,,P~m,T CERTIFICATE OF DEATH
"~"~"~ ;)9- I l 0 (Coroner)
BLACK INK
65
Cumberland
Date
E FIrE NUMAR
Female )7~' ,~- ,~'~
29,2003 ~r C~i~v;~,,o, i~. ,~,~, ~ ~,0~
East Pennsboro Enola Dr. At East Dauphin St
September 14, 2003
September 14, 2003
· . .~_t._z_e. ffraumatic Injuries
~X~TO(C~~
,. M_o~:_o_? Vehicle Crash
[] ~ [] Aprx.
~ .-~,w~ 0 apt 14, 2003 8:20 A
~ [] ~ operator pulled from stop
vehicle.
)la, PA
Chief Deputy
2003
ueptCoroner
6375 Basehore Rd., Suite ~!
Mechanicsburg, Pa. 17050
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.
To the Register:
RUTH M. BURKEY
September 14, 2003
Adm. No. 2004-00058
I certify that notice of estate administration required by Rule 5.6(a) of the Orphan's Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
January 27, 2004.
.Name
.Address
LinTy E. Burkey
Russell H. Burkey, III
231 Regent Road
Harrisburg, PA 17112
133 E. Dauphin Street
Enola, PA 17025
Richard E. Burkey
17 Robin Court
Mechanicsburg, PA 17055
Notice has now been given to all personal entitled thereto under Rule 5.6(a) except
Date:
Signature f /~ ~.........--~/
Name ~d/a~rd P. Seeber, Esquire
Address 134 Sipe Avenue
Hummelstown, PA 17036
Telephone ( 717 ) 533-3280
Capacity:
Personal Representative
X
Counsel for Personal
Representative
June 16,2004
Law Offices
The Estate Security Formula
P.O. BOX 650
Hershey PA 17033
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
(717) 787-3930
FAX (717) 772-0412
Dear Sir/Madam:
Re:
Estate of Ruth M. Burkey
File Number 2104-0058
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before 12/14/04. Because Section 2136
(d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be
granted that would exceed the maximum time permitted.
/ ,¢ ?" .'.;~ ,4' ./ /
,~.-~,.~.~ / ' _...-: ~-
Claudia Maff~i',' 8Upe~ieor:
Document Processing unit
Inheritance Tax Division ~,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG. PA 17128.()801
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
JAMES SMITH DIETTERfCK ET AL
POBOX 650
HERSHEY, PA 17033
----fold
ESTATE INFORMATION: SSN: 179-30-2529
FILE NUMBER: , 2104-0058
DECEDENT NAME: BURKEY RUTH M
DATE OF PAYMENT: 08/10/2005
POSTMARK DATE: 08/10/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/14/2003
REV-1 162 EXf1 1-96}
,
NO. <to 005674
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
I ~------
1
101 I '$1,811.04
I
I I
I
I
I
I
I 1
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JAMES SMITH DIETTERICK &
CONNELLY LLP
CHECK# 6358
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WIllS
1$1,811.04
GLENDA FARNER STFSBAUGH
REGISTER OF WILLS
./,.h I
. "
I
I
.1
r'--~','_.-
..v.1IM ill. <<-I
.
" .""?' ;i~, '.;
REY-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMIU
OFFICIAL USE ONLY
!Z
.
~
COMMONWEAlTH OF
PENNSYLVANIA
DEPAR'nmfT OF REVENUE
DEPT. 280801
HARRlSBURG. PA 1712I-0I01
DECEDl!N'r8 NAME (lAST, FIRST, AND MlODl.E INITIALI
Burkey, Ruth M.
MTE OF DlfAnt <--DIl-YEAR)
DOO sg
NUMIIER
FILED IN IlUPI.lCATE WITH lHE
REGIS ER OF WILLS
IOCII\l SECURITY HER
I!!
II!
[!J 1. 0rigIn8I Relool
o 4. LlmilIId Estate
o 8. De*ent Died T...... c-
CCllI' d WIll
o 8. l.ItIgMIon PftlCI8d8 ReceIved
o 2. Supplemental Return
O 4.. F..... -COrnpfomIoe (_d__
12.12-82)
o 7. o-dent Maintained . I.Mng Trust (Ana
capy'alTNoI)
o 10. ~~redIt(_d_"""
03. _Retun(
o 5. Feder8I Eal8te T
o 8. TOl8l Number of
o 11. EIeclIon 10 tax u
d _ prior to 12.13-821
. FFICIAL atE ONLY.
c:::::>
'",0 c.n
"-C:o :1:>00
i.-' -0 c::
"IO (i")
'::;~F;i
.-"".:0 0
7G0^
(") 0 .."
) 0 -n ....
c)c .....
~ r::?
MTE DF BIRTH (MM-OIl-YEAR)
09-14-2003 08-29-1938
(IF APPLICAIIlE) 8URVMNG SPOUSE'I NAME ( lAST, FIRST AND MIDDLE 1N1T1I\l1
I
NAME
Edward P. Seeber
FIRM NAME (f....-..)
James, Smith, DleUerlck & Connelly, LLP
TELEPHONE NUMBER
717/533-3280
1. Real &tate (Schedule A)
2. St0ck8 and Bondi (Schedule B)
3. CIDIeIy Held Corporation, Partnership or Sole-Proprietorahlp
4. MorigIIgea & NOte. Reoaivlble (Schedule 0)
5. Caah, Bank Depoaila & MlaceH8neoua P8I'Ional Property
(Schedule E)
6. ~ Owned Property (Schedule F)
o Separate BIllIng Requested
7.Inter-VIvoa Tnlnlrera& MlsceIIaneoua ~ Property
(Schedule G or L) 0 Separate BIIIinO ReqUHled
8. Total Grou ABMla (totalLineI 1-7)
9. Funeral Expenses & Admlnlstratlve Costs (Schedule H)
(11)
(12)
(13)
(14) I
i
I
x.OO (15) I
x ~ (16) 1
- I
x .12 (17) I
x .15 (18) I
I
(19) ~
,
134 Slpe Avenue
Hummel.town, PA
(1) 60,000.00
(2) None
(3) None
(4) None
(5) 1,500.00
(6) None
(7) None
(9)
22,121.19
o
(8) 61,500.00
22,121.19
39,378.81
0.00
39,378.81
0.00
1,772.05
0.00
0.00
1,772.05
I
L
t1
&!-
10. Debts of Decedent, Mortgage LiabHltlea, & LIena (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Eatata (Line 8 minus Line 11)
13. CharitIbIe and GoveI1llllentaI BequelllslSec 9113 TruI" for which an election to tax hal
not been made (Schedule J)
14.NetVaJue Subject to Tax (Line 12 m11lU1 Line 13)
SEE INSTRUcnONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable aJ the spousal tax rate, 0.00
ortransfera underSec. 9116(a)(1.2)
~
~
:::I
L
8
s
18. Amount of Une 14 taxable at lineal rate
17. Amount of Une 14 taxable at Ilbllng rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
I
COPr\'llhl_..... __ .&~ onty n. Lackner GrouP. Inc.
39,378.81
0.00
0.00
~
Decedent'. Complete Add.....:
STREET ADDRESS
133 E. Dauphin Str..t
CITY Enola
ISTATE PA
/ZIP 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. ClIldilslPayments
A Spousal Poverty CredlI
B. Prior Payments
C. Discount
,
I
0.00
~1)
I
I
I
I
I
Total ClIldlts (A + B + C) (2)
i
I
1,772.05
3. InlelestlPenalty if ItIlPIIcable
D. Intarut
E. Penalty
0.00
38.99
TotaIlntareallPenally (0 + E) 3)
4. If Line 2 ia greater than Une 1 + Line 3, enter the dIfI'wenc:e. ThIs IIIhIDVERPA VMENT. 4)
ChecIc box on Page 1 une 20 to requtst .'NIfund
5. If Line 1 + line 311 greater than Line 2, enter the dlIrer8nce. Thll ia th4l'AX DUE 5)
A. Enter the interest on the tax due.
B. Enter the total of Une 5 + SA. This II theBALANCE DUE
Make Check Payable to: REGISTER OF WILLS, AGENT
38.99
1,811.04
1,811.04
PLEASE AN8WE:R THE FOLLOWING QUesTIONS BV PlACING AN "X. IN THE APPRQP TE BLOCKS
1. Did decedent make a tranlferand: 'I v.. No
a. retain the UN or income of the property tran.fiIrred:........................................................................+.. ~ ;
~ ::: ~~":::::::~~~~~.~.~.~.~~.~~~~..~.~.~:..............................:::::::::::::t... =
d. receive the promise for life of either payments, benelita or care?...................................................... ... x
2. If death occulTlld alter December 12, 1982, did decedent transfer property within one year of death with III
receiving lIdequate COnaideration?..........................................................._.................................................. 0
3. Did decedent own an "in tru.t for" or payable upon death bank account or security at his or her death?........ 0
4. Did decedent own an individual Retlrement Account, annuity, or other non-probate property which
contains a benelic:lary dealgnation?.............................-............................................................................... 0 [!]
IF THE ANSWER TO ANY OF THE ABOVE QUESnONa ~ YEs, YOU MUST CClMPUTE SCHEDULE G AND I'Ll! IT AS PAR OF THE RETURN.
~""'~~.I--_I_~Ihlo-. inc:Ildlg_.+-~__...--. ...1O"'_dmy'"-'edge'" .llo"""._...
d -"''''Io_'''''__d_ 11M .
~TURE PERSON RE8PONSI8LE FOR FI.ING RETURH ADDRESS
Bu
[!]
[!]
DATE
231 Regent Road
Harrisburg, PA 17112
ADDRESS
134 Slpe Avenue
Hummeietown, PA 17036
DATE
SS
For dates of death on or alter July 1, 19M and befant January 1. 1995, the tax rate imposed on the net value of transfe to or for the use of the
surviving spouse 113% [72 P.S. 59116 (a) (1.1) (I)).
For dates of death on or alter January 1, 1995, the tax rate Imposed on the net value of tranafera to or for the use of the urviving spouse Is 0%
[72 P.S. 59116 (a) (1.1) (11)). The atall- noIl1X8fl11l1a tranafar to a .urviving IflOUH from tax, and the statutory raq lren1ents for dlacloaul1l
of assets and filing 1 tax I1Itum ... t\ln applicable even If the .urviving spouse Is the only benefielary.
For dates of death on or after July 1, 2000: I
The tax rate Imposed on the net value oflranlfers from a de.,....d child twenty-one years of age or younger at death to lor for the use of a
natural pal1lnt, an adoptive parant, or a stepparent of the child Is 0% [72 P.S. 59116 (a) (1.2)). I
The tax rate Imposed on the net value of tran.tars to or for the USlI of the decedent'. lineal beneficiaries is 4.5%, except r noted in 72 P.S.
59116 1.2) [72 P.S. 59116 (a)(1)]. I
The tax rate imposed on the net value oftrensfera to or for the use of the decedent'. .ibling. is 12% [72 P.S. 59116(1) ( .3)]. A.1bIing Is
defined under SectIon 9102, a. an individual who has at Iea.t one parant in common with the decedent, whether by or adoption.
.. ~ ?t'~ - ......-;. ....,_"'..,,~;:.;~
_t_ 0+ (_,
'*
SCHEDULE A
REAL ESTATE
-.,..1l.....tH" flBM'YLV.......
__TAlCMlIM
--
ESTATE OF
Burkey, Ruth M.
FILE NU
R
All.... ___-......, -. ._..._ _ be ~alfIIlr__ F__ vaIua Ie _ u.. prtoall
--- .... m.,.ond. wiling _. _balng......,-tDbuy or.... boIh Iltlwfng _~ "'..
-____IaJalnlly__IIghl"''''-''_be_ on_ F.
VALUE AT DATE
OF DEATH
ITEM
NUMBER DESCRIPTION
1 Real Estate situate at 133 East Dauphin St....t, East Pennsboro Township, Enola,
Pennsylvania - valued per sales price
60.000.00
TOTAL (Also enter on Line 1, RecapItulation)
60.000.00
(If more .... . 1lINldad, IddllIoneI P8Qea of lha _ Ilze)
Copyright (c) 2002 fonn soflwal8 only The Lackner Group, Inc.
Form PA01t ScheduleA (Rev. 6-98)
I
I
'1 /,,~ ""q".':1.;J-
_ ,. EX. (S4)
.
*' SCHEDULE E
CASH, BANK DEPOSits, & MISC.
PERSONAL PROPERTY ,
,
~1'H~~VANfA
__TAllM1UllN !
--
ESTATE OF FILE NU!EER
Burkey, Ruth M.
--...~"'......-..._...~--IlI'..._.
AlI~~--"'IIght"'~_"_on_F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1990 Chevrolet Beretta - valued per Insul'8nce proceeds received 1.500.00
,
I
I
!
TOTAL (Also enter on Une 5, RecapItUlation) 1.500.00
(If IIlOI1I ~ Is needed, acldltionaI plIgelI of lIMI_lize)
Copyright (e) 2002 form software only The Lackner Group, Inc. Form PA-1li4 o Schedule E (Rev. 6-98)
""'" ~,~ """",-" ''''!"'-~" '",."
lIEV.tilt IX. (t_,
*'
SCHEDULE ..H
FUNERAL EXPENSEs &
ADMINISTRATIVE COSTS
~TH,~~ANIA
~~
ESTATE OF
Burkey, Ruth M.
Debts of decedent mu.t be reported on Schedule I. .
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation achedule(a) attached 9,622.00
I
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Cornml8slons
. .
SociII Security Number(s) I EIN Number Of Personal Reprnentallve(s):
. .. . . ..
StrwI Addreas
City State Zip
-
Year(a) Commluion paid
I
2. Attorney's Fees James, Smith, Dletterlck & Connelly, LLP 5,000.00
3. F8IIl1Iy Exemption: (If decedent's addreas Is not the same as cIalmlnt's, attach explanation) 3,500.00
Claimant Ru....1 H. Burkey III
Street Address 133 E. Dauphin Sthtet
City Enol. State PA Zip 17025
Relationship of Claimant to Decedent Son
4. Probate Fees 148.00
5. Accountant's Fees
8. Tax Return Prepare!'s F_
7. Other AdminIatratlve Costa I 3,851.19
I
See continuation achedule(a) attached I
I
I
TOTAL (A111O enter on line 9, Recapitulation) 22,121.19
CopyrIght (e) 2002 form sOftware only The Lackner GrouP. Inc. Form PA-15C D ScheduleH (Rev. 8-98)
f'"'.' ~ ..~ ~.~
. .
_1102 Ell..-l
.
'* SCHEDULE H-A
FUNERAL EXPENSES
continued
~THOJIl"""""'VNrM
-_ TAl( IIE1UIlN i
--
ESTATE OF FILE Nuf.1BER
Burkey, Ruth M. I
ITEM DESCRIPTION I AMOUNT
NUMBER I
I
1 Funeral luncheon 600.00
2 Gingrich Memorials. grave marker 1.400.40
3 Grave opening 850.00
4 Ne'" Funeral Home . funeral .ervlces I 6,771.60
!
I
.
Subtota 9,822.00
Copyright (c) 2002 fonn IOftwanl only The Lackner Group, 100.
Fonn PA-1500 ~Ule H-A (Rev. $.98)
I
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'0 ".".'i~'\<' '.i'
l'~'.,~ .~
, , . ..
-.1102 EX. I_,
'*
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
-~~.ISJU.TH OF P'ENNnLVMIIA
_..... TAllIll!'lUllN
--
ESTATE OF
FILE NU
Burkey, Ruth M.
ITEM
NUMBER DESCRIPTION
1 CUlllberland Law Journal - Eetate notice
2 Eat Pennsboro Township Authority - 8ewer charges for residence
3 James, Smith, Dletterlck & Connelly, LLP - reimbursement of out-of-pocket
expen...
4 James, Smith, Dletterlck & Connelly, LLP - reservation for estate admlnl8tratlon
closing costs
5 Keystone 011 - 011 delivery
6 NOtary fees .....1 estate settlement
7 Patriot News - estate notice advertisement fee
8 Recorder of Deeds, Cumberland County - realty transfer tax
9 Register of Wills, Cumberland County - filing fee for Return and Inventory
10 Sadler 011 - 011 delivery
11 Whltco Home Furnishings - carpet for residence
Subtota
CopyrIght (e) 2002 fonn software only The Lackner Group, Inc.
Form PA.11OO
AMOUNT
75.00
896.00
29.00
150.00
250.00
4.00
127.75
276.39
30.00
213.05
1.800.00
3.851.19
ule H-B7 (Rev. 6-98)
-"'''''''''.~'","
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. f ... .
~ 1113 EX+ tHO)
*'
.
SCHEDULE ..
COMMofnWALTH OF PENNSYlVANIA BENEFICIARIES
~~E~ :
ESTATE OF FILE N~MBER
Burkey, Ruth M. ,
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATI AMOUNT OF ESTATE
DECEDENT
NUMBER PERSON(S) RECEMNG PROPERTY Do Not LIol ~.I (Wolds) ($$S)
I. TAXABlE DISTRIBUTIONS !!,nclude outright I=::I
co.tributions lInd nsters I
under See. 9116(.)(1.2))
1 RUSHII H Burkey III Son 1/3 of Residue 39,378.81
133 Eat Dauphin St....t
Enola, PA 17025
2 Larry E Butitey Son 1/3 of Residue 39,378.81
231 Regent Road
Harrisburg, PA 17112
3 Richard E Burkey Son 1/3 of Residue 39,378.81
17 Robin Court
Mechanlcsburg, PA 170n
.
.
.
Total 118,136043
Enter doll... 8l1IOUIIta for distrlbullonllhown above on Ilnes 5 through 18, .. , on Rev 1500 COW sheet
u. NON-TAXABlE DISTRIBUTIONS:
A. Sf>OUSAL DISTFUBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PAfU II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF AEv-1500 COVER SHEI! 0.00
Copyright (e) 2002 fonn 1Of\we,. only The l.ecknetOnlup, Inc. Form PA-111 l) ScheduleJ (Rev. 6-98)
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Register of Wills, Cumberland' Qounty , Pennsylvan!ia
INVENTORY
Estate of
also known as
Ruth M. Burkey
. Deceased
No.
2004-00058
Date of Death 09/1412003
Social Security No. 171-30-2529
Larry E. Burkey
The Penonal R.....ntlltIve(.) of the above , cleceaHCI, ve that "'Items appearing In the Ilowlng Inventory
Include all of the peraonal...... wherever situate and an of the rHI..... located In the Comm of Pennsylvania
of aaId Dec.-nt, that .... valuation placed oppoalte each Item of said Inventory reprennta Ite fair v us.. of the date of
the DKedent'. death, end that the Decedent owned no rHlestate outside of the Commonwealth of enneylvanla except
that which appea18 In a memOl8ndum at the end of thl. Inventory. lIWe verify that the atetamentll m de In this Inventory
are tnle and correct IJWe undel8tend that fa... atetamenta herein are made subject to the penalties f 1 a Pa. C. S.
Section 4904 relating to Un8WOITI faI.lflcatlon to authorities.
Attomey:
Edward P. Seeber
SIgnature:
1.0. No.: 76084
Signature:
Jam.., Smith, Dletterlck & Conn.IIy,
Ann: LLP
Signature:
Address: 134 Slpe Av.nue
Hummelstown, PA 17036
TelephOlJ8: 717/633-3280
Address: 231 R.g.nt Road
H.rrlsburg, PA 17112
Telephone: 717/640-4231
Dated:
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Ca.h...............................................................................................
Miscellaneous Property.._.............................................................
StocksILlsted.._.............................................................................
StockalClosety H.Id......................................................................
Bonc:l8..............................................................................................
P.rtn.rshlps .nd Sole Proprl8torahlps .....................................
Mortg.g.. .nd Notes Rec.lv.ble...............................................
Total P.....on.1 Property.........................................
Total Real Property................................................
Total P.rsonal .nd Real Property.........................
Total Out-of-State Real Prop.rty..........................
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Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of
8Iso known as
Ruth M. Burkey
No.
12004-00058
,
. Deceased
Dole" Oealh ~911412l103
Social Security No. 179-30-2629
Person,_ PrODertv
1990 Chevrolet Beretta - valued per Inaurlnc. proCH. rec.lved
1.500.00
Total P.ntonal Properiy
1.500.00
~e.'Ea." I
Real Estate sltuat. at 133 Eaat Dauphin Street, Eaet Pennaboro Townahlp,
EnOla, P.nnsylvanla - valued per aales price
80.000.00
Total Real Estate
80.000.00
Total '....anal Property .ndRaaI Eetate
61.500.00
August 9,2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland. County Courthouse
I Courthouse Square
Carlisle, PA 17013-3387
Re: Estate ofRuthM. Burkey, deceased
No. 2004--00058
Dear Ms. Strasbaugh:
Enclosed are the following documents to be filed for the above referenced Estate:
1. An original and two (2) copies of the Pennsylvania Inheritance Tax ReF'
2. An original and two (2) copies of the Inventory. i
3. Check payable to the "Register of Wills, Agent" in the amount of One I
Thousand Eight Hundred Eleven and 04/100 Dollars ($1,811.04) repreJenting
the Pennsylvania Inheritance Tax due. -1
4. Check payable to the "Register of Wills, Cumberland" in the amount JThirty
Dollars ($30.00) representing the filing fee for the Return and Invento~.
Please time-stamp the additional copies of the Return and Inventory and return them t+ me in
the enclosed self-addressed, stamped envelope. I
I
If you have any questions, please feel free to give me a call. i
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Certified Paralegal
Enclosures
cc:
Larry E. Burkey, Administrator
[
Cheryl L. aaker. CP
Certified Paralegal
clb@jsdc.com
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MAILING ADDRESS
P.O. BOX 650
HERSHEY, PA 17033
TOU. FREE 1.800.942_3660
TEL 717.533_3280
FAX 717.533.7771
www.jsdc.com
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (71 7) 240 - 6345
Date: 8/15/2005
SEEBER EDWARD P
134 SIPE AVENUE
HUMMELSTOWN, PA 17036
RE: Estate of BURKEY RUTH M
File Number: 2004-00058
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/14/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~-~~
-' t
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
cP
In the Court of Common Pleas of
Cumberland
County, Pennsylvania
IN RE:
ORPHANS' COURT DIVISION
Estate of
Ruth M. Burkev
NO. 2004-00058
Status Report Under Rule 6.12
Name of Decedent: Ruth M. Burkey
Date of Death: 9/14/2003
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 No X
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete. 09/14/2006
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 Clerk of Orphans' Court and may be attached to this report.
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Name:
Address:
Edward P. Seeber
134 Sipe Avenue
Hummelstown, PA 17036
717/533-3280
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
,. . APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
10-18-2005
BURKEY
09-14-2003
21 04-0058
CUMBERLAND
101
APPEAL DATE: 12-17-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9~!_~~9~~_!~!~-~!~~______~___~~!~!~_~9~~~_~9~!!9~_f9~_!9~~_~~~9~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
RUTH M FILE NO. 21 04-0058 ACN 101
BUREAU OF INDIVIDUAl'-t~)(ES"''''
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
(-', "'.'-!;'~""-'-
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
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EDWARD P'SEEBER
JAMES ETAL
134 SIPE AVE
HUMMElSTOWN
PA 17036
ESTATE OF
BURKEY
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
60,000.00
.00
.00
.00
1.500.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
+
INTEREST/PEN PAID (-)
38.99-
DATE
08-10-2005
NUHBER
CD005674
22,121.19
.00
(11)
(12)
(13)
(14)
(9)
nO)
REV-1547 EX AFP [06-05)
RUTH
M
DATE 10-18-2005
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
61,500.00
22.121 19
39,378.81
.00
39,378.81
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
39,378.81 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
AHOUNT PAID
1,811.04
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-11-2005 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
1,772.05
.00
.00
1,772.05
1,772.05
.00
53.89
53.89
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. JnJl
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DU,<./"
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
REGISTER OF WILLS
Cumberland County, Pennsylvania
Supreme Court Orphans' Court Rule 6.12
Status Report by Personal Representative
Name of Decedent:
Ruth M. Burkey
Date of Death:
09/14/2003
Will Number:
2004-00058
dministration Number:
2004-00058
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 No X
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 X No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may
be filed with the Clerk of Orphans' Court and may be attached to this report.
Date:
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134 Sipe Avenue
Hummelstown, PA 17036
Telephone: 717/533-3280
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X Counsel for Personal Representative
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
EDWARD P SEEBER
JAMES ET AL
134 SIPE AVE
HUMMELSTOWN
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-14 -2005
BURKEY
09-14-2003
21 04-0058
CUMBERLAND
101
RUTH
M
Amount Remitted
PA 17036
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-.
RETAIN LOWER PORTION FOR YOUR RECORDS
4-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF BURKEY
RUTH
M FILE NO. 21 04-0058
ACN 101
DATE 11-14-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-18-2005
PRINCIPAL TAX DUE: 1,772.05
PAYMENTS (TAX CREDITS):
PAYMENT
DATE
08-10-2005
10-20-2005
RECEIPT
NUMBER
CD005674
CD005924
DISCOUNT (+)
INTEREST/PEN PAID (-)
38.99-
53.89-
AMOUNT PAID
1,811.04
53.89
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TOTAL TAX CREDIT
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BALANCE OF TAX DUE
.00
INTEREST AND PEN.
.00
* IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL DUE
.00
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
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October 20, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
Re: Estate of Ruth M. Burkey, deceased
No. 2004-00058
Cheryl L. Baker, CP
Certified Paralegal
c1b@jsdc.com
Dear Ms. Strasbaugh:
Enclosed is a check in the amount of Fifty-three and 89/100 Dollars ($53.89) representing the
additional Pennsylvania Inheritance Tax due for the above-referenced Estate.
If you have any questions, please feel free to give me a call.
Very truly yours,
Enclosure
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1 4 SIPE AVENUE
HUM ELSTOWN, PA 17036
M ILlNG ADDRESS
PO BOX 650
H RSHEY, PA 17033
TOLL FREE 1800942.3660
TEL 717.533.3280
FAX 717.533.7771
www.jsdc.com
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
]1
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SEEBER EDWARD P
134 SIPE AVENUE
HUMMELSTOWN, PA 17036
__~n___ fold
ESTATE INFORMATION: SSN: 179-30-2529
FILE NUMBER: 2104-0058
DECEDENT NAME: BURKEY RUTH M
DATE OF PAYMENT: 10/21/2005
POSTMARK DATE: 10/20/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/14/2003
NO. CD 005924
ACN
ASSESSMENT
CONTROL
NUMBER
I
AMOU~T
----~---
101 I $53.8~
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TOTAL AMOUNT PAID:
$53.$9
REMARKS:
CHECK# 6412
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
I
GLENDA FARNER STRASB,AJUGH
I
REGISTER OF WILLS