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HomeMy WebLinkAbout04-0089 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Vincent Bernabe, Jr. No. also known as ( , Deceased Social Security: No. 155-42-0668 , 1'1~llljOIl!:l(lIl. who is/me 1 fj yea,s 01 aye or olde'. app/y(ies) 101 (COMPLETE "A" OR "S" SELOW:) Q A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut_ named In the Last Will of the Decedent, dated c1nd codicil(sl dated State relevant circumstances, e.g., 'enunciation, death 01 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,La_. d.bn,c.I .8.: pendente 1It1~: dll1811le lIhSt!rltlfl, d,u/lnll' 1IIIIIWI1I1I(:) 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 c:<-r i <...- Dau hter 57 Leeds Rd. , Newville, PA l. Jo ce M. Bernabe '11 .'. : 2. Michelle L. McNult Dau hter 268 Redwood Ln. , Carlisle, PA - 17013 318 Walnut Ln. , Carlisle, PA 17013 Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/H last family or principal residence at 57 Leeds Rd. , NeWVll.l.e, J:>A 1/241 (IiSI Sllcel, 1111l11lwr 111111 l'luniclpillily] Decedent, then ~ years of age!;died . 6/30/2003 , bexXXat Carlisle Regional Medical Center (11ll;il1l01l1 Decedent at death ow.ned property with estimated values as follows: (If domiciled in PAl ''->.11 personal property ... . .. .. . ..... .. . ... .. . . . . . $ S,OOO 00 (If not domiciled in PAl ,Personal property In Pennsylvania. . . . . . . . . . . . . . . $ (If not domiciled in PAl 'Personal property in County. . . . . . . . . . . . . . . . . . . . . . . , . . $ Value of real estate in Pennsylvania . ........ .. ..... ..... . ..... .. . . . . . .. . . .. ... $ ~O,OOO.OO Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000.00 Real Estate situated as follows: 57 Leeds Road, Newville, PA 17241 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: Typed or printed name and residence _--1:_,,-_1J /A-A. h-IL.. Joyce aY-.,e Leeds M. Bernabe, 57 Road () Newville, PA 17241 RW-7 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, Pet;t;one'(s) w;1I well and truly adm;n;ste, the eS:10'dm~' Sworn to and aff;'med and subscdbed x 7~ ~ ~ t~ before me this d. g day of ~ooLj. ;J(t_ DECREE OF REGISTER Estate of Vincent Bernabe, Jr. Deceased . No. ~- also known as Social Security No: 155-42-0668 Date of Death: 6/30/2003 AND NOW, ~ 1.. ,... " . c-L q I .() 00+ , ~_, in consideration of the Petition on the reverse side h on, satisfabtory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary IX] of Administration 'C.I.Il.; I.Llu,-,; 1 ; IWlIdlmte Ille, IJtJliIIlle ;ltJ~l"I\iil, ,h'li1nlt: llHlIlIlllall:j are hereby granted to Joyce M. Bernahe in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES . , Letters.......................... . $.;J<X) . DC:> J:Jb" J 0 , 8n n ,,"'- ~'-" \ '" 1'-'1>' ^ ~ ~ Short Certificate(s).......... $ '4c:n Register of Wills Renunciation................. . $ _ S . (')(') Affidavit ( )................. $ Extra Pages ( )............ $ Cod i c i I. . . . . . . . . . . . . . .. .. .. . .. .. . $ JCP Fee........................ $ \t> \~ Attorney: Harry,~. . Br icker , Jr. , Esquire Inventory & Tax Forms... $ 1.0. No: 07049 Other....................... ..... $ Address: 407 North Front Street Harrisburg,PA 17101 TOT AL................ $ 6La..~ . at:> Telephone: (717) 233-2555 ~~~ DATE FILED: J - c;2J~ - .;u:, 04- RW-7a \ -...:2.<1 -~OO+ Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of Vincent Bernabe, Jr. No. ~,-~ also known as , Deceased The undersigned, Michelle L. McNulty and Melinda A Leese, daughters of the above Decedent, hereby renounce the right to administer the estate and respectfully request that Letters of Administration be issued to Joyce M. Bem~~ . A- \. "~ " r Witness hand this B day of \\ (? D\ '\ \ J;x , AD., 2003. ~ce( J 1:ti.~~tJ- ' (Sig ature) 268 Redwood Lane. Carlisle. Pennsylvania 17013 zess) t" ,/ Ii . '11 . If;1UJ!''f ";x/U--- '-1 :. (Signature) 318 Walnut Lane. Carlisle. Pennsylvania 17013 (Address) Sworn to or affirmed and subscribed day of , AD, 2003 (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. -- H105. ,43 Rev. 2117 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH tiNT SlATE "'l.E NUMHIll ENT NAME OF DECEDENT (fitSI'. MIlSlSe. L_I SEX SOCIAL SECURITY NUMBER NK t. Vincent - Bernabe, Jr. 2. M 3.155 - 42 AGEll.. ~ UNDER 1 YEAR UHOEA 1 CIf:t BlATHPlACE (Cty and -1 Doyo ~! MInut.. 54 'os. ="'0 . COUNTY OF OERH RACE. ""*'can 1ndiM. 8IKk. White. etC. -, ~l . Cumberland Ie. Carlisle Bora. ...Carlisle Regional Medical Center ,i. White DECEDENT'S USUAL OCCUPATION KINO OF BUStNESSilHDU$TRY 'H\S DECEDENT EVER IN OECEDENT'S EDUCATION SUAVMHQ SPOuSE l~"=:_~~::~=r u.s. ARMED FORCEs? (11....... ~ INCMn 1'Wne) ....0 ...aJ. . 1t Engineer 1t 13. - OECEDENT'S MM.IHG ADDRESS (SIrMl CiIyf1O.wn. sa...lipCodel DECEDENT'S PA . ACTUAL 17L SIaM ....' 57 Leeds Road AESfOENCE -............. ,.. Newville, PA 17241 an__ Cumberland 11ill =-'-==01 1710. - F.G'HEA'S NAME tF"nI. M~.l.astJ MOTHeR'S NAME tF_.. Middle. Ma.den Sur,.,..., 11. Vincent - Bernabe, Sr. ... Vir inia - Rosas -ORMAHTS....WE(T_ir<l IHFOAMANT'S MAIUHO ADOAESS (~_ CitvI'fown. Slate. rIP Code) Jo ce M. Bernabe _ 57 Leeds Road; Newville, PA 17241 METHClO OF IllSI'OSITIOH PlACE OF DlSPO$IT1ON. H...... otc.m.tlfy. CrematoIy LOCATlON. Cify(Town. St.... ~Code . _0 c.-~ 01'0.,* ~ ""*- ;,: Harrisburg, PA 17109 . 17013 OfJt.j.a ...0 ... II. ... 2O. 27. NIIT I: Ene... rM (iM..... intuttn 01' complicato. which ceUNd Ihit dI.-th. 00 not ent... IN rnodII of I ,\pproJ:imat. Lilt onfy OM cauM on nch ft. '-- : onMI and..,. I .. : , F . I : LIt.t.~~ : DATE OF INJURY TIME OF INJURY INJURY Iff WORK? DESCRIBE HOlt' CNJUAY OCCURRED. \i( l~.o.y,...,) - Homieide 0 ....0 - 0 0 ...0 ~1nvMl:1ga11on ...0 0 o PlACE OF INJURY. AI hO,,-. farm. SCfNl. Ik'toIy. omc. ... - Coutd not be dIItermltled - .... ... buidInQ. etc. ISpecIM -. Clll'TIFIER IChctl Ol"lly ~ -caRTIFYWQ PHYSICIAN (PhyllColltl Cf!FtIttIng caused dedi oW\ert ~ DhvIcoan Ns pronounced Malh ana canplefe(J nem 23. To....,..... ""ltnowledge. ..1hOCCurrMfIue..hcauu<.landm.nner.............................................................. .~NO ANO CEltTIJrYJNQ PHYSICIAN IPhvscaan bOIh pronounc'"9 aeeth ~ cef1lfylng IOQUM Of aeath~ Ooy._' ,...... beet of my knowfe4g., death OCCurNCla1 1he time, dIIte. and "ee.. and due to .... nuM(.) ancl manne,.. sla'H.. . . . . . . . . . . . . . . . . . . . . . . . . t.J -MEDICAL O:AMINEAlCOAONER On the baal. or.umlnatlon andJM InveaUg.tion.ln my opinion, death occunec:l at IN lime, date, and pllce, and due to Ih. cauS.(a) and J1.~.,.....ted................................................................................................. . I 013 REGISTRAR'SSIGNATURELt:: ~. ~~~ iaJ, I~ 1101 34. 30 I a&03. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Vincent Bernabe. Jr. Date of Death: June 30.2003 No. 2004-00089 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 February 4, 2004: Name Address Jovce M. Bernabe 57 Leeds Road. Newville. PA 17241 Michelle L. McNulty 268 Redwood Lane. Carlisle. PA 17013 Melinda A. Leese 318 Walnut Lane. Carlisle. PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No Exceptions ~ -2;: Date: <- - '\- - 0 +-- --"-- s: Harry L. B . ., Esquire 407 No h Front Street Harrisburg, PA 17101 '" '" (717) 233-2555 Capacity: Personal representative X Counsel for personal representative c,/ oK STATUS REPORT UNDER RULE 6.12 Name of Decedent: Vincent Bernabe. Jr. Date of Death: June 30.2003 No. 2004-00089 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: Hopefully within one year 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 the Orphans' Court and may be attached to this report. ~ -'~ ~"'- Date: -z.. - l:\- -o~. (;'.:::? ....,,- "C:::..~~ --':':":::-::" '- Harry~-ke r., Esquire 407 North Front Street Harrisburg, PA 17101 (717) 233-2555 Capacity: Personal Representative _..~"- X Counsel for Personal Representative -'"^ ---., . - - / ,-, __~...-' :.._",V " . '- DATE: Marcn'30,2005 ESTATE NO.: 21-04-89 DATE OF DEA TH: Junc;~O, 2003 IN THE ESTATE OF VINCENT BERNABE, JR. CLAIM AGAINST DECEDENT'S ESTATE The Claimant certifies that there is due and owing by Vincent Bernabe, Jr., deceased, the sum of $1,260.00 together with attorney's fees. On behalf of the claimant, I do declare and affirm under the penalties of perjury that the :::::::: :~:en~tions made herein ~e ~d knowledge, HCR ManorCare, Inc. ~ c/o O'Brien, Baric & Scherer David A. Baric, Esquire 19 West South Street for Claimant, Carlisle, Pennsylvania 17013 O'Brien, Baric & Scherer (717) 249-6873 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 CERTIFICATE OF SERVICE I hereby certify that on March 30, 2005, I, David A. Baric, Esquire of O'Brien, Baric & Scherer, did serve a copy of the Claim Against Decedent's Estate, by first class U.S. mail, postage prepaid, to the party listed below, as follows: Harry L. Bricker, Jr., Esquire 407 North Front Street Harrisburg, Pennsylvania 17101 ~pJ c:: A David A. Baric, Esquire \J , , Rev-1500 OFFiCiAL. USE. <JNLY REV-1500 EX (6-00) FILE THiS RETURN WITH: COMMONWEALTH OF . *' PENNSYLVANIA INHERITANCE TAX RETURN FILE NUMBER DEPARTMENT OF REVENUE Ql - ('1--1 00 'f'1 DEPT. 280601 RESIDENT DECEDENT COUNTY CODE YEAR NUMBER HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- BERNABE, JR.. VINCENT 155-42-0668 z w DATE OF DEATH (MM~DD-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE Q w 06-30-2003 02-14-1949 REGISTER OF WILLS " w Q (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w ~ 1. Original Return 2. Supplemental Return 3. Remainder Relurn(d<<eofd_p<",to12_13-a2) ~ - r- :.::!UJ 4. limited Estate 4a. Future Interest Comprise (data of death after 12-12-82) 5. Federal Estate Tax Return Required ,,<<" f- '- w"" ~oo 6 Decedent Died Testate (Attach copy of Wilt) o 8. Total Number of Safe Deposit Boxes ,,<<~ 7. Decedent Maintained a living Trust (Attach a copy of Trust) ..<XI - .. r-- 10. Spousal Poverty Credit (dala of death between 12-31.91 and 1.1-95) 011. Election to tax under Sec. 9113(A) ~ 9. litigation Proceeds Received - _ \_501>0) .... THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z COMPLETE MAILING ADDRESS w NAME 0 z HARRY L. BRICKER, JR. HARRY L. BRICKER, JR. 0 "- FIRM NAME (If Applicable) ATTORNEY AT LAW '" w 407 NORTH FRONT STREET !l: !l: TELEPHONE NUMBER HARRISBURG, PA 17101 0 0 (717) 233-2555 1. Real Estate (Schedule A) (1) $94.489.37 i OFFICIAL USE ONLY ;"! 2. Stocks and Bonds (Schedule B) (2) $0.00 ~ (" , , , $0.001 0 (--: ) 3. Closely Held Corporation, Partnership or Sole-ProprietorshiP (3) _.-"J 4. Mortgages & Notes Receivable (Schedule D) (4) $0.00: 1 z $44,436.691 I , 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) 0 -". j:: 6. Jointly Owned Property (Schedule F) (6) $129.96 ~ < D Separate Billing Requested ...J :;) . ~ 7. Inter-Vivos Transfers & Misc. Non-Probate Property (7) $0.00 ...................... ....\.,..~....,. .................... 0: (Schedule G or l) < () 8. Total Grass Assets (total Lines 1-7) (8) $139,056.02 W ~ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) $91,088.95 10. Debts of Decedent, Mortgage Liabilities & liens (Schedule I) (10) $0.00 11. Total Deductions (total Lines 9 & 10) (11) $91 ORR 95 12. Net Value of Estate (line 8 minus line 11) (12) $47,967.07 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been (13) $onn made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Une 13) (14) $47,967,07 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES w 15. Amount of line 14 taxable at the spousal tax '"' rate, or transfers under Sec. 9116 (a){1.2) x (15) $0.00 wz - "Q 16. Amount of line 14 taxable at Jineal rate $47,967.07 x .045 (16) $2,158.52 ".... ":,, - w::> 17_ Amount of line 14 taxable at sibling rate x .12 (17) $0.00 ,,"- ",. ,,0 18. Amount of line 14 taxable at collateral rate x ,15 (18) $000 ,,0 0<;)( 19. Tax Due \::" (19) $2,158.52 0<; 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < '\;' , , Decedent's Complete Address: STREET ADDRESS 57 LEEDS ROAD CITY I~TATE I~IP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) $2,158.52 2, Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + 8 + C) (2) $0 00 3. Interest/Penalty jf applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) (3) $0,00 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) $2,158.52 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) $2,158.52 Make Check Payable to: REGfSTER OF WfLLS, 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 property transferred; ~ m b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary 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 on year of death without receiving adequate consideration? B E8 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? r=J CO 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 pe~ury, I declare thaI I have examined this return, including accompanying schedules and statements, aod lethe best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all the information of which preparer has any knowledge. SIGN TURE OF PERSON RESP SIBLE FOR FILING RETURN DATE /Yl v-JL h--o.- (}(P ADD S 46 BUTTONWOOD LANE, CARLISLE, PA 17013 SIGNAT E OF fREPA~R :H~R THAN REPRESENTATIVE DATE --~~ ~ "t.....~Cl.Y..-- ADDRESS 407 NO't"" FRONT STREET, HARRISBURG, PA 17101 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (01 (1.1)(I)J. 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 sUf\llvlng spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a tral"'lSfer 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 adopti\le parent, or a stepparent of the child is 0% (72 P.S. 99116(a) (1.2)]. ;(3'5 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. ~ Du e. c,Q 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. 39116(a)(1.3)). A sibling is defir 'PC\ 6l.oo,uu who has at least one parent in common with the decedent. whether by blood or adoption. Arb 3 '5 ill :r~ =I=l=.3q~ REV-1502EX.(6-98) , .. SCHEDULE A COMMONWEALTH OF PENNSYLVANiA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VINCENT BERNABE, JR. FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property 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 propert'y' which is jointly-owned with right of survivorship must be disclosed on Schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. REAL ESTATE - KNOWN AND NUMBERED AS 57 lEEDS ROAD, NEWVillE. PA 17241 $94.489.37 TOTAL (Also enter on line 1, Recapitulation) $94.489.37 (If more space IS needed. insert additional sheets of the same size) REV,1500,=X"j6-9B) , * SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF VINCENT BERNABE, JR. FILE NUMBER 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. PNC BANK ACCOUNTS: CHECKING ACCOUNT - ACCOUNT NO. - 5080133462 $2,106.54 SAVINGS ACCOUNT - ACCOUNT NO. - 5080347321 $13,089.51 2. 1999 VOLKSWAGEN JETTA TOI SEDAN (NOT IN RUNNING CONDITION) $6,000.00 3. 1974 SUZUKI 185 CCI MOTORCYCLE $125.00 4. FUNDS HElD IN ESCROW RE: REAL ESTATE $8,460.00 5. FUNDS HELD BY WIENKEN & ASSOCIATES: A. WASHINGTON MUTUAL INVESTORS FUND-A $4,505.18 B. THE INCOME FUND OF AMERICA-A $4,937.32 C. NEW PERSPECTIVE FUND-A $5,213.14 TOTAL (Also enter on line 5, Recapitulation) $44,436.69 (If more space is needed. insert additional sheets of the same size) REV-1S09,EX + 16-98) . SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLy..oWNED PROPERTY lNHERlT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VINCENT BERNABE, JR. FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. JOYCE BERNABE 192 BIRCH LANE WIFE CARLISLE, PA 17013 B. JOYCE BERNABE 192 BIRCH LANE WIFE CARLISLE, PA 17013 C. JOINTLY-OWNED PROPERTY: ITEM LETTER DATE DESCRIPTION OF PROPERTY DATE OF DEATH %OF DATE OF DEATH FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. DECO'S VAlUE OF NUMBER TENANT JOINT Atlach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 2/1973 UNITED STATES SERIES E SAVINGS BOND - $25.00 FACE VALUE $129.89 50.0% $64.95 2, B. 911974 UNITED STATES SERIES E SAVINGS BOND - $25.00 FACE VALUE $130.02 50.0% $65.01 TOTAL (Also enter on line 6, Recapitulation) $129.96 (If more space IS needed, insert additional sheets of the same size) REV_1511;EX+(12_99\ .. SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & lNHERITA.NCE TA.X RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF VINCENT BERNABE, JR. FILE NUMB Debts of decedent must be reported on Schedule t. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME - FUNERAL $2,640.00 STEVEN EWING, FUNERAL DIRECTOR B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) JOYCE M, BERNABE $6,953.00 Social Security Number(s} I EIN Number of Personal Representative(s) 161-60-6870 Street Address 57 LEEDS ROAD City NEWVILLE State PA Zip 17241 - Year(s) Commission Paid: NONE 2. Attorney Fees HARRY L. BRICKER, JR., ESQ, $6,953.00 3. Family Exemption: (If decedent's address is not the sarne as claimant's, attach explanation) Claimant JOYCE M. BERNABE $3.500.00 Street Address 57 LEEDS ROAD City NEWVILLE State P A Zip 17241 - Relationship of Claimant to Decedent DAUGHTER 4. Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY $224.00 5. Accountant's Fees 6, Tax Return Preparer's Fees 7. THE CARLISLE SENTINEL - ADVERTISE ESTATE $129.47 8. CUMBERLANO LAW JOURNAL - ADVERTISE ESTATE $75,00 9, lONNI ABSTRACT COMPANY - PRESENT OWNER SEARCH $40.00 10. ROBERT ENSMINGER APPRAISERS - APPRAISAL OF REAL ESTATE AND PERSONAL PROPERTY $300.00 11. MANOR CARE HEALTH $1,260,00 12. CABELA'S VISA CENTER - CREDIT CARD $722.37 ACCOUNT NO. 30024406 177 13. KEMPER - AUTOMOBILE INSURANCE $1,210.00 14, MABLE G. STITT - TAX COLLECTOR $1,236.29 AMOUNT OF CONTINUATION PAGE FOR SCHEDULE H $65,845.82 TOTAL (Also enter on line 9, Recapitulation) $91,088.95 (If more space is needed, insert additional sheets of the same size) .. CONTINUATION PAGE COMMONWEALTH OF PENNSYLVANIA SCHEDULE H INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PROGRESSIVE. MOTORCYCLE INSURANCE $86,00 2, PP&L UTILITIES $563.27 3. TRASH REMOVAL $1.263.14 4. SHIPPLEY OIL $130.51 5. REGISTER OF WILLSNEHICLE TRAN. $8.00 6. SOLLENBERGERS . CAR TRAN. $8,00 7. CLOSING COSTS RE: REAL ESTATE: $58.180.67 8, LINE OF CREDIT PAYMENTS TO AND INCLUDING DATE OF SALE OF REAL ESTATE $5.264.23 9. PA DEPARTMENT OF REVENUE. 2004 INCOME TAX DUE $12.00 10, SELIGMAN. FRIEDMAN & COMPANY. P.C" PREPARATION OF 2004 INCOME TAX RETURNS $300,00 11. REGISTER OF WILLS. CUMBERLAND COUNTY. FILING FEE FOR INHERITANCE TAX RETURN AND INVENTORY $30.00 TOTAL $65.845.82 REV-151i3 EX + (9-00)) . SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERIT MICE TM RETURN RESIDENT DECEDENT ESTATE OF VINCENT BERNABE, JR. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND AODRESS OF PERSON(S) RECEIVING PROPERTY Do Not list TrlJstee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under See, 9116 (a) (1.2)] ,. JOYCE M. BERNABE DAUGHTER ONE-THIRD (1/3) OF 46 BUnONWOOD LANE ENTIRE ESTATE CARLISLE. PA 17013 2 MICHELLE L. MCNUL TV DAUGHTER ONE-THIRD (113) OF 268 REDWOOD LANE ENTIRE ESTATE CARLISLE. PA 17013 3, MELINDA A. LEESE DAUGHTER ONE-THIRD (1/3) OF 318 WALNUT LANE ENTIRE ESTATE CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $0.00 (If more space is needed, insert additional sheets of the same size) A. S.ttl.m.nf StaNm.nt U,S. D.p.rtm.nt of Housing OMB Approval No. 2502.Q265 and Urban D.".lop~t B. Type or Loan 1.! I FHA2.1 ] FmHA3. ( J Conv.unlns'I,B ') 6. FUe Number: r~ 7. Loan Number; l~J 8. Mortgaga Insurance Cue Number: 4,[ jVA Sf jConv.lns. x ----,-' "'00402~87-cB . 92800031535 C. NOTE: THIS NOTE IS FURNISHED TO GNE YOU A STATEMENT OF ACTUAL SETTLEMENT COSTS. AMOUNTS PAID TO AND BY THE SETTLEMENT AGENT ARE SHOWN. ITEMS MARKED "(P.O.C." WERE PAID OUTSIDE 'THE CLOSING; THEv ARE SHOWN HERE FOR INFORMATIONAL PURPOSES AND NOT INCLUDED IN THE TOTALS. D. Nam. 'nd Addr... of Borrowe, [r~ 1 E, N.m. .nd Addreu of 1.1.., l~ f. N.m. and Addr... of Lender EARL P. GARMAN ]I( JOYCE MARIE BERNABE, ]I( FREMONT INVESlMENT & lOAN -"", AOMINISlRATOR OF VINCENT 555 TAXTER ROAD, S1E 220 610 NORTH MIDDLETON ROAD BERNABE, JR. ESTATE ELMSFORD, NY 10523 CARLISLE, PA 17013 .PA G. PROPERTY lOCATION H. S.ttl.m.nt Ag.nt 57 LEEDS ROAD, SECURED LAND TRANSFERS. MECHANICSBURG NEWVILLE, PA 17241 a'-U P1ac. of S.ttMm.nt o I. S.w.m.nt COUNTY: CUMBERLAND o 1068 HARRrSeURG PIKE D'NJ PARCElID: 31.32.2313-036 _ _ CARLISLE, PA DI.burs.....nt D." TOWNSHIP: PENN TOWNSHIP 2141200510:00:00 AM/2W2005 J. SUMMARY Of BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS 100, Groas Amount Du. From Borrower 400. Oro.. Amounl Du. To S.lIer 101. Purchase Price $94,000.00 401. Purchase Prica $904,000.00 102. Peraonal Property 402. Pertornll Property 103. S.ItJ.m.nl Ctulrg.. to Borrower $5,460.34 403. 104. ,1>1, 105. 405. AdJu.tmenta Fo, llath. Paid By Seller In Adv.nc:e ~tms-nta For Item. P.ld By S.lIer In Actv.nce 106. CltylTown Taxe. 408. CltylTown Taxa. 101. County Taxas 407. County Taxes 1011.AsseS9menls 408. Asse'sments 109. School Taxas1215.10001yr for 02104/05lhru $489.37 409. School Tsxes 1215.10001yr for 02/04105 thru $0469.37 07.'01105 07101105 110. 410. "' 411. 112. 412. 120. Gro.. Amount Du. From Borrower I $99,949.71 420. Gro.. Amount Du. To S.ller I $94,489.37 200. Amounw Paid By Or In Beh.1f Of Borraw.r 500. R.ducUon.ln Amount Du. To S.lItir 201. EamestMoney $1,000.00 50 1. Exce.s deposit 202, Principal rrom Fremont Investment & loan $94,000.00 502, S.W.m.nt Chng., To S.lIer (lln. 1400) $21,576.58 ./ 203. El\lst\ng loan{s) \$ken a\Jtljecllo S03. Elllstlng loen(a)18ken Subject To ..c~ 204. 504. Net Payoff to PNC Bank /" 5<<,941.72 205. 505. Payoff of Second Mortgage Loan 206. 506, 207. S07. '06. S08. 209. SO,. AdJuatm.nta for IIeIllS Unpaid By Sell., AdJu.tm.nta For "'ma Unpaid By Sell.r 210. CltyfTownTaxe. 510. CityfTown Taxes 211. County Tones 240AOOOlyr tor 01/01/051hru $22,39 511. County Taxas240.40oolyr for 01/01ros thru $22.39 ~ 02/04105 02I1l41O!5 212. Anessments 512. AS1l8ssments 213. 513. / 214. Window repair erredlt $100.00 514. WindoW repair cmtdll $100.00 215. 515. 216. 516. 217. 517. 216. 518. 219. 519. 220. Total Paid BylFor Borrower $95,122.39 520. Totaf RHucUon Amount Du. S.'I.r $66,640.67 300. Cash At S.ItJ.m.nt Frorn!To Borrower 800, Ca.h At l.ltJemenl ToIFrom S'II.r 301. Gro'l AmOunt Due From 8or'rowet (Une 120) $99,949.71 601. Grou hnow\t Due To Seller lIme "'20) $94,489.37 302, Lasl Amounts Paid BylFor Borrower (Una 220) $95,122.39 602. letls OeducUon. In AmI. Due To Seller (line $6&,640.67 520) 303. C..h I X J From ( J To Borrow.r $4,827.32 .~ j,..\ " ',., 103. Cash I X J TG ( J From S.II.r \. \0-.$21).8.70 (ill': 'C;\\\'lNDO'V~' Tcnl"'m'ln....~.')Ofntemcl%20Files\nT X'?5~\'P".fI('Irf hl111 2/4105 400402487 - CB p...' L. S.Wem.nt Statemant 700. Total Sal.. Commla.lon 1-4000.00 CD 7 %. e580.oo Dlvialon 01 CommIsalon (line 700) As Follows: Paid From Paid FrQmSeller's 701. $6580.00 10 ERA-NRT, Inc. Borrower's Funds AI Funds Al Settlement SelUemenl 702. Selling Agenl CommIssion 703. Commlulon peId al MUIemenI $6,580.00 706. T~ Fee to ERA-NRT, Inc. $'25.00 707. TnmaactJon Fee to ERA.-NRT,lnc. $125.00 1OD,u.ms Payab" an ConMctIon With Loan 801. Orlglnauon Fee % to Fremont Inv..tmllnt & Loan $4119.00 802. loan Discount 803. Appraisal Fee to Tumslone Mortgage Company (POC 275.001 $100.00 804. Credit Report 805. lel1der'.lnspectlon Fee 808. Un<ierwrltlng Fee Co Fremont lnvestmenl" loan $405.00 810. TalC; Servlce 10 lfinUAmerlc8 Tax and Flood Services $80.00 811. Flood Cert. Fee w landAmeflc8 Tax and FJooc;t SeNlcel $9.50 8'''. Brolc....F_1O TUlMlone MortplIge Company ~70.00 819. Yield 5pIead Premium 10 Turnlltone Mortgege Company (POC $9010.00 by Fremont Inveslment &. Loa") 900. Item. Rsqulrwd By Lender To Be 'aid In J.dvanc. 901. Inlarest from 02104105 to 03101105 021.25 f day $531.25 902. Mortgage Insurance pramium for 903. Huard In. Premium We.lfIek1 Group (POC 834.00) 1000. R...rve. D1poaU.d WIar lAndii' 1001. Hazard 1m; ReaeMt ...??OO mo CD 52.84 I mo 10 Fremont InWlllmant & Loan $211.36 1002. MortQege Iml.lranca 1003. CJIyPropertyTaxas 1004. CounlyTIIll ReMl'Vl13.0000 mo 020.041 mo to Frwnonllnvntment & l.cMln $280.52 1008. SchoollalC; 9.0000mo G 99.2-4' mo 10 Fremont lrlVeatmenl & Loan $893.16 1009. Aggregate ActounUng AdJultment from Fremont Inveatn'lenC" Loan ....50.20 1100. TIU. Chargs. 1101. Settlernanlor Clolll1g Fee 1102. Abstract otTIlie Search 1103. nile Examination 1106. Nalary Feel 10 Callh $10.00 1107. Allomey'. Feel 1108. Title /Munm(:e to Secured Land Trwn,fers . Mechanlcaburg $822.75 11otl. lender's Coverage $901000.00 ($) 1110. OWner'1 coverage $9<1000.00 ($82:2.75) 1111. Endol'llement100130019001710to Secured Land Trenafen. MechanlcsDut'g $200.00 1113. Insured Closing Protection lelter to First American TlUe IttIUf'8tlC$ Company $35.00 1114. Ovemlght Delivery & Proceaall1ij Fee to SecullJdUilM Tf'INlsOO . Mechanlc.burg $15.00 $15.00 1116. Wire Fee to Secured Land Trensfers - M'echaft~ $20.00 1120. Doc Plintto Secured land Transfers. MechBnk:5burg $50.00 1122. Set Fee to Secured land TrBnaf8rs - MeclwlJcsburg $35.00 1200. Government RKOrdlnG And T,..""", CbMgs. 1201. Recortflng Feu: Deed $ 38.50; Mortgage $ 74.50 $113.00 1202. CitylCoUflty TwStBl7lPS 940..00 . $940.00 1203. Slate Deed Tax $ 940.00 $940.00 1205. 1300. J.ddJtiona' Sattlemanl Chsrg.. 1302. Peat In.pectlon to Inspect Tech $50.00 1303. Home Warranty to AON Home Warranty $409.00 13004. Deed Prep and attendanCfl at 2l8tl1ement. to Harry l. Sr'icker, Jr. $1,000.00 1305. septic to Peck'a Septic ServICe $100.00 $585.00 1306. Peat Treatment to Termlnbl $1,335.60 1307. Peat contract 10 Terminbl $360.00 /- 1308. Escrow for InMrftanoe Tal{ CO Secured land Tl8Illferl - MechanlClburg $8,460.00 1309.2004 OeUnquenl Texealo CWnbefIanct County Tali: Claim $1,826.96- 1310. Notary Faelo Calny McKenzie $5.00 13' ,. EKfDW 101 Window to Securecll8nd Tra",fen - Mec.henk:abUrg $100.00 1400. Total ..........nl Ct..folllenta, On Un..10:S, SscUon J And 502. 5IGUon KJ $5.480.301\ $21,576.56 t have camully reviewed the HUI).1 8ell1ement tllnent and to the beat mylu1owledQ8and belief It II I d IIccursle ...tement of all receiptl and dlsbursernenl:& mads on my ~ or by "..l1llhls 1tanI8OIIOn, I fl.u~r certify 1tI8t 1 heye recelvlld a f the HUD-1 Settlement """".. BUYER~ I .1f~.4 Earl P. Garman The HUO-' Settlement Statement whic/'ll hailS prepared Is 81ru~ a di.lwn;ed In accordance with this Itatement. So.I.mO"2n~ ~ Dolo ,~_/! / d::,- fi (e:IIC: I WlNDOWSIT emporary%20Inlemel%20FilesIOLK3253\Report.htm 2/4105 ---~-"..-._' ~'~~_T_ .....'-'. ,-'-' . ",-,~_.,,,,, ,-- ,~'~ ~,' -'-~' . . '-- I L-..... '-''-' '-'-''-'~ ~ "'-...,-' - 0PNCBAN< February 7, 2005 Hany L Briclcec, Jr. SClP/,4'- Attomey at Law 407 North Front St. Harrisburg, P A 17101-1296 RE: Estate ofVinceII1 Bernabe, Jr. (Deceased) SSN: 155-42.(1668 DOD: 06-30-2003 Dear Mr, Bricker: In response to your reque&t for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5080133462 Establiahed 12-31-1993 VINCENT BERNABE 1R DOD balance: $2,106.44 + S0.10 accrued interest Savings Account A.ccaunt#5080347321 Establish<<! 12-31-1993 VINCENT BERNABE JR DOD balance: $13,088.65 + $0.86 accrued interest For information regardingtbe ReA line of credit account #4003048109537861,please call 1-888-762-2265 option 1,3 and 0 please remain on the line to .peek to a loan service representative. The decedent did not maintain any safe deposit box at PNC Bank. Page I of2 / ...... ~ Please note that this office ouIy provides d;lte of dead! "".."..,u for deposit accounts (IRAs. CDs, Checking and Savings llCCXllJllQ). We do DOt proeeu any fiDalleW transactiOlll or provide statemeDta. If you need assistance with any of tbtse items. please call 1-888-PNC-BANK (1-888-762-2265) or atop by your loc:a1 PNC Bank bl'lllWh office. Sincere1y. ~:;?~ Erica L Schlegel 1.800-762-1775 P7 -PFSC-04-F 500 First Ave. Pitubursh PA U219 Menber POIC Page 2 ot2 TnTAI p,~ ROBERT ENSMINGER APPRAISERS REAL ESTATE and PERSONAL PROPERTY 3557 ELMERTON A VENUE HARRISBURG, PA 17109-1132 PHONE 7[7-652-4111 FAX 717-541-9444 May 17,2004 E.MAIL: threecomps(4!cotncaSLt\e\ Harry L. Bricker, Jr., Esquire 407 N. Front St. Harrisburg, PA 17101 RE: Estate of Vincent Bernabe, Jr. Dear Mr. Bricker: In accordance with your request, I have appraised the listed personal property of Vincent Bernabe, Jr., Deceased. The property is located at 57 Leeds Road, Newville, PA 17241. The values shown have been arrived at after a careful study of the property. I believe it to reflect a true measure of its market value as of April 23, 2004. Market value is defined as being the most reasonable or probable price in terms of money that real or personal property will bring in an open and competitive market under all conditions requisite to a fair sale, the buyer and seller each acting prudently and knowledgeably, and assuming the price is not affected by undue stimulus. The items appraised include a 1999 Volkswagen Jetta TDI sedan, true mileage unknown due to dead battery, 60,000 miles estimated, expired inspection, average condition, $6,000. 1974 Suzuki 185 eel motorcycle, 7,900 miles, $125.00. General household items consist of upholstered fumiture, an old freezeer, miscellaeneous dishes, glassware, pots and pans. These items have no value. Taking into account these factors, it is the opinion of the undersigned that the fair market value of the personal property is Six Thousand One Hundred Dollars ($6,100.00.) Employment in and compensation for making this appraisal are in no manner contingent upon the value reported and I certify that I have no financial interest in the property appraised, present or contemplated. Very truly yours, K,4/I!~~ Robert A. Ensminger "- . ne right ch.Qi~ fo{ the. f:i... "",,,,,,(,,,,,.~..,, ,- :<\-.t'\<\:";':}~;;~ . . -,:,.", .' ~'T'i"'~"~" ~. .~...'''''1: . - n1i~< ".. Your_dol_ VINCENT BERNABE JR MML INVESTORS SERVICES, INC. 46 BUTTONWOOD LN C/O W SHORE OFFICE CTR CARLISLE PA 17013-7803 214 SENATE AVE STE 303 CAMP HILL PA 17011-2336 1",111...1""....""11.1...11"1,11.,,,,",,1..1,",,",,,1 Reo name LANGAN -- - - --.- ...'.WASHINGTOifNiUTUAi:-lNVESTORS.FUND=A..........,............................................................,.............'.......... Fund number 01 Accountnumber 926421517 Dividends \reinvest) and capital gains (reinvest) Sh"" thi, .!:.~~~.~~.!~.............E!~.'!!!!!.~.?..........................................._................,.............~~~~!~.!~~~~~..,......~~~!.~!..~~!......_............._..........:!.~.~.!~~.~~!!.........._............._.~~~.~~~!~~~ BEGINNING SHARE BALANCE 146.986 02/07/05 TELEPHONE REDEMPTION .14.505.18 130.85 -148.988 .000 ----.--'" A check is attached to this statement For more account information .....-....-......-....................................................................................-...................... .....................................-.-...................,...............,............................................... . y......, Ie...,Ib. m..,wn into.", .flb. AlHtie.n Fund. within . Cd your financi.l.dviser 110 ".,. wiIfIlNlf".,.... u/u .".. If. ~_.r, Y"" led..m." . 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INC. 46 BUTTONWOOO LN C/O W SHORE OFFICE CTR CARLISLE PA 17013-7803 214 SENATE AVE STE 303 CAMP HILL PA 1701'-2336 1."111,,.111......11,,11.1...11,,1,11, ""11,,1,,1.11,,11,,.1 Rep name LANGAN Transactions ..ffiEli'icoME'FUNi)"oF'AMERICA:;iC...........................................................,..................,.............................................................................. Fund number 06 Account number 938844075 Dividends (reinvest) end cepital gains (reinve.t) Sh ~' IrSS (illS rfld. d.rl O.uription DoJI" 'mount Shlr' price t,,"s.etian Sh.,. b,"nc8 ........................................................................................ .......m..... .......m...... .............................................................. ...... .m....... ......................... ......................................... BEGINNING SHARE 8ALANCE 266.519 02/01105 TELEPHONE REDEMPTION .$4,918.38 $18.45 .266.579 .000 02/07/05 INCOME DIVIDEND $18.94 .000 A check is attached to this st"t.......nt For more account information .....-......................................................-...................-..-......-...............................-... ................................................................................................................................. YIIU..y IWinratllW IWduption i11to.., 0'. AiIN1iuR Fund, within . Cell your finencill.dv.er so d.,. wiIIJout payin,. 0.. .".. II. 60_." you IWd..""d . 24-hour eutomelld imum.lion .nd ..rvich $5./1tJD", ~.... tIIIII.n4 ''1- within 1M fll'VloUl JD d.,., you American FundsLina~ 1 800325-3590 ..yMlIWIIIVISl$S.Dt1tl",__lhattlllll.nd.",,"unt. Fwd.teil6 . . . IIIIlHJt'putclJua 61tn:1t polit:y.p/a...... the fumr, pnnp.ctus. 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'.'- K,- . . .. -.{.,.,..,:\..;/.~}.::y:t'::;.;,'\.,::~;,'.::;~1.,,'i;.;::;;\:~~"" "~, ~' . ..:~m'\~"- ..':.i,;:,~,>~,::.;i".;.:'.:\;">:--:'-'; ~.__..... POec.zao '/Y';.;~':,:,,;,'~~j-~:11'-1i~f'~~ i,~ i :;; , :.," "',.iU~21C1 '_U.-J-- "..,"..\,....,',:tf,.,j\q \"""'"'~.""";;:..;\".!... 4-Mi. l "".'. ',_.. '''., .. ~ -. .;;,'-::~\::.<-",;:;,v~';j:;:S':f\~",ti4 .y:i~;'" .." . .', - .. .' '. ..'..... .......'''.'..,'..''',...:..'''''',...".'''''f>).! .." .."...... Ieee.......... Qeok...... '. ~;.>:.-'-"., ~'f~' ~'-"-"!::'-~(,j- ",;" .~~4.,i"G:.;;~]~\i~ii~~~~~;1:(1; .". 83884487& 42,..,21 ~::"~i~~,~.,;,__~;:...;;.';~5h:~>" ~,"j~ ":t '>7::!~"(:: p,ylPdw"" VlM:ENT8EIlNABEJR,,:.~i~~~;J.i'."" ,,~Y0#2 F*-y 7, 2110li 7,f '..'; , -, ',j'-:::;{{ti~:,;:!?;~~~~~;~~({:,-:,r:'~:~~~i,};:,~~st?;"}1 "RlUlllllOUSANDNlNEHUNllIlEDlHIRlYSEVENAN031I100DOUARS'i " '. ". '" . ".937.32 =~;:; --- ---------=-:..-~-_. ... .... : :!;.';~::;~S<:;,;;:;~;'/,:i;-n::;:"Vi.;,:(. "01, i! IoB& 10 i!B... .: 10 i! loooot~a.:II!'~EiOOO?E." Sq.. , 1-;~ "".. ',.) . ,.;;.... .. ,. j'. - 'h), Your fimlOcJ.a1 adviser VINCENT BERNABE JR MML INVESTORS SERVICES. INC. 46 BUTTONWOOO LN C/O W SHORE OFFICE CTR CARLISLE PA 17013-7B03 214 SENATE AVE STE 303 CAMP HILL PA 17011-2336 1...11I...11I......11..".1..."..1.",...."..1..1,"..11...1 Rep name LANGAN Transactions ....'..N'EViiPERSPECTiVifFUND:A......................................................,......................................................................................... Fund number 07 Account number 941391257 Dividends Ireinvest) and capitol gains (reinvest) Sh.rBS this .!!.~.~!.~~.~!...........,..~~~!!!!.~~~..............................................................................~~~~~~.~~~~~~.........~~.~!.'!.~~~..............................!!.~.~.~~~~!?~,.........................~~~~.~~~~~~~ BEGINNING SHARE BALANCE 192.154 02/07/05 TELEPHONE REDEMPTION .*5,219.14 f27.13 .192.154 .000 3O-dey purchoso/oxcheng. hold. You have redeemod or exchanged $5.000 or more lrom this lund. As a result, and as described in the lund's prospectus, you cannot purchasa or exchange $5,000 or more into this fund and .CCDunt lor 30 calendar days. You will egoin be able to purch..e shores in this lund .nd account alter 03/ll9l1l5. We regret any inconvenience this mey couse. A check is attached to this stavment For more account information ....-...........................................................-...........,.................................................. ......-............................................................................................................................ You..y "ilwen"" "t/.mption.. any "fth. Amorit:8n FuntI. within - Call your lin.nei.. ,"';oer lID d..,. withtntt 1M';'" ",,,,.,,,. If, ""we.." Y/HI 18t/..m.d _ 24-11our eutom.tod infom.tion .nd lelYie.. 15.I1DIl"'''!f8""",.ftMId'''''!1''OIIIItwithin",."...-.30d.p, f"u American Fundsline<!> 1800325-3590 _y "'" I8/IWen $SJ1I1I1 lIT"'" _",., funt/,nd ,,,,,ount. Fo1 dmit. . . . OII_pm-cIJeo. 6Iedcpoliq,pto...... IN fun4'. "..,.-. Amencon Funds Web srte www.omenconlunds.eom . . . ... . .. _ Person,' ,""istenee - 88m. to 8 pm. Elltom time M - F SherehDlder SeNices 1 800421-0180 ._--------------------~- @ Am~?canF~~~y.. .._.....~~..~~~~~CTlVEFUIlI1.A ..__.._....._._..... ~~ :::rD501.mo': -;-~-<' ~'\ ~ _ .'~',~':~~~.:~::>'-~ "~,:f~-' < : 11.2411'" AMnat....... .' .. . QIoIl.... 141381267'<' 4211121. I'r( to 11II <<dot qf ~t<<:ENT BERNABE ::.~_.._._.__.._........... FWnry 7. 2UOi . AVE THOUSANOlWll HUNDRED THIRTEEN AND 14/\00 OOUJJlS' _i.213." =i:.-:: - ------------------------=~- 4f=--- 'iC,! ;~;<~:, "010 i! ~8b i! ioOu' I: io i! ~OOO i!1081:''~~l:IOO 71:.10 Squ' COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 005398 BRICKER HARRY L JR 407 NORTH FRONT STREET HARRISBURG, PA 17101 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold nn_n___ __u'n_ 101 I $2,158.52 ESTATE INFORMATION: SSN; 155-42,0668 I FILE NUMBER: 2104-0089 I DECEDENT NAME: BERNABE VINCENT JR I DATE OF PAYMENT: 06/06/2005 I POSTMARK DATE: 06/03/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 06/30/2003 I I TOTAL AMOUNT PAID: $2,158.52 REMARKS: CHECK#1008 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Marjorie A. Wevodau Glenda Farner Strasbaugh First Deputy Register of Wills and Kirk S. Sohonage, Esq Clerk of Orphans' Court Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 I INVOICE I Bill To: InvoiceNo: 393 Invoice Date: 6/8/2005 HARRY L. BRICKER, JR., ESQ. Estate of: VINCENT BERNABE. TR. 407 NORTH FRONT STREET Estate No: 21-04-0089 JA HARRISBURG, PA 17101 Qty Fee Description Fee Total 1 Additional Probate 35.00 $35.00 Total: $35.00 Checks should be made payable to the Register of Wills. Tenus: Net 30. Please return one copy of this invoice with your payment. Thank you. Marjorie A. Wevodau Glenda Farner Strasbaugh First Deputy Register of Wills and Kirk S. Sohonage, Esq Clerk of Orphans' Court Solicitor Register of Wills and Clerk of the Orph ns' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: 393 Invoice Date: 6/8/2005 HARRY L. BRICKER, ]R, ESQ. Estate of: VINCENT BERNABE. TR 407 NOR1H FRONT S1REET Estate No: 21-04-0089 JA HARRISBURG, PA 17101 Fee Descri tion Fee Total 1 Additional Probate 35.00 $35.00 Total: -PC\ J *- I CX51 I $35.00 -" .- ~" ....,... Checks should be made payable to the Register of Wills. erms: Net 30. Please return one copy of this invoice with your payment. Thank you. ,f Register of Wills CUMBERLAND County, Pennsylvania INVENTORY Estate of VINCENT BERNABE, JR. No, ~I -D'f -?q also known as Date of Death JUNE 20, 2003 , Deceased Social Security No. 155-42-0668 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 end 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 th Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Attorney HARRY L. BRICKER, JR., ESQ. ~fo fY). ~~ 1.0, No.: 07049 Address 407 NORTH FRONT STREET Dated ()U/od-/6-'::'- { , HARRISBURG, PA 17101 Telephone: (717) 233-2555 Description Value 1. REAL ESTATE - KNOWN AND NUMBERED AS 57 LEEDS ROAD, NEWVILLE, PA 17241 $94,489,37 2, PNC BANK ACCOUNTS: CHECKING ACCOUNT NO, - 5080133462 $2,106.54 SAVINGS ACCOUNT NO. - 5080347321 $13,089.51 3. 1999 VOLKSWAGEN JETTA TDI SEDAN (NOT IN RUNNING CONDITION) $6,000.00 4. 1974 SUZUKI 185 CCI MOTORCYCLE $125,00 5. FUNDS HELD IN ESCROW RE: REAL ESTATE $8,460.00 6. FUNDS HELD BY WIENKEN & ASSOCIATES: A. WASHINGTON MUTUAL INVESTORS FUND-A ",",..) $4,505.18 C-:":'J ~'.:"',) 0 C,,;'.) 1 B. THE INCOME FUND OF AMERICA-A -:;!J (-- ~;9~7.32 C. NEW PERSPECTIVE FUND-A (-- $5.:213.14 c~ ~ - - .. ..,.. 1.0 Total from Continuation Page(s) $0.00 (Attach additional sheets if necessary) Total: $138,926.06 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of personal representative, include the value of each item. but such figures should not be extended into the total of the Inventory. HARRY L. BRICKER, JR. ATTORNEY AT LAW 407 NORTH FRONT STREET HARRISBURG,PENNSYLVANIA AREA CODE 7!7 17101-1296 233-2555 E-MAIL: HLBLAW@VERIZON.NET - FAX 233-8555 June 2, 2005 "', (') C~:':l Register of Wills Office ~o c;:, :::;:J c....'1 ~j '-',l Cumberland County Courthouse :'::-:0 <- rr'l C-'.) "q-o-, S C"") (~) One Courthouse Square u;;=; :::~n Carlisle, PA 17013 Re: Estate of Vincent Bernabe, Jr., Deceased Social Security No. - 155-42-0668 Date of Death - June 30, 2003 ~- \..C Estate No. 2004-00089 Tax 1.0. No. - 84-6376609 Gentlemen: Enclosed are six (6) Inventories as well as six (6) Pennsylvania Inheritance Tax Returns concerning the above-captioned estate. Also enclosed is an Estate Account check payable to you as Agent in the amount of $2,158.52 for the inheritance tax which is due. We are also enclosing a check payable to you in the amount of $30.00 which is, as we understand, the filing fee. Please stamp all of these documents in and return all of the documents which you do not need to this office using the enclosed self-addressed, stamped envelope. With best wishes. Harry L.:. Bricker, Jr. HLB, Jr./bld Enclosures cc: Ms. Joyce M. Bemabe '>.. \.1 k ~ )> 5\ ~ ~; -.. )lo (J)o ':II ~ ~... o?3 :PZ:;'~ 90 '~ OOc;1D GlO ~~.::g,. .;;~~: Q) ~ '3 ~ -", ~ ~ r ....r;-qo t ~oi~ ~~m~ ;}~~ C' - 0....... :I)~_ ~s.~9. ~~?~ -0 ~ <::-\s;;rn - , /) )lo~c.:: ~~~:;O .. ~~~1ii ~i!i\ ~ > x;- - \P 010$0 ::!':!\. Y1D ~~.:t:l g - ~ : ,:~ c;o~ i> a g 'i'; lE.~ $ -: Q ~~ ~ a .... ID ~ f ':r ~ = ~ i= ~\ '& == =- .. -- ::.- t.Q ~ ::.- O'\\f OE~ ~ -~2 '0' ~ _ :D"'1J ~- {,o) N. ~ "'. -v ~ ~<:j. :0 0 08-22-2005 BERNABE JR 06-30-2003 21 04-0089 CUMBERLAND 101 APPEAL DATE: 10-21-2005 ( See reverse side under Objections) AIlDUnt Rem:i:t1:ed I I KAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS - REY:is4;-Ex-AFp-co3:osi-NorlcE-oF-INHERlrANcE-rAx-APPRAIsEMENr:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX VINCENT FILE NO. 21 04-0089 ACN 101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDlvlOU~GQffiED OFFICE OF APPRAIS:~~~~ ~~L:~~~T:C~I~:~LOWANCE ~~~T~~D~AX nl~ISlllt\)r-r;r:r:"',:- ('.... :,~"" i (' OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG PA 17128-0601 . - ~ 2005 f:l'r; 30 Pi; '!: 24 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN HARRY 407 N HBG C:_t':::< C'= (jCW' ','t.,"c' v;, LCIIRICKER JR FRONT ST "-',~ PA 17101 ESTATE OF BERNABE JR *' REV-15~7 EX AFP (06-05) VINCENT TAX RETURN WAS: I X) ACCEPTED AS FILED ) CHANGED DATE 08-22-2005 I~ an assessmen1: was issued previously. lines 14. IS and/or 16. 17. 18 and re~lec1: ~igures 1:ha1: include 1:he 1:o1:al oi' ALL re1:urns assessed 1:0 da1:e. ASSESSMENT OF TAX: 15. AItount of Line 14 at Spousal rat. (IS) 16. ~ount of Line 14 taxable at Lineal/Class A rat. (16) 17. ~ount of Line 14 .t Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.al Est.t. (Schedule Al 2. Stocks and Bonds ISchlldule B) 3. Closely Held stock/Partnership Inierest (Schedule C) , 4. HortpgIIs/Notes Receivable (Schedule D) S. Cash/B'" l)eposits/Misc. Personal Properiy (Schedule E) 6. Jointly Owned property ISchedule F) 7. T.....,sfe...s (Schedule G) 8. Tot.l Assets (1) (2) (3) (4) (5) Ii) (7) 94,489.37 .00 .00 .00 44.436.69 129.96 .00 IB) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Hortgage Llabilities/Liens (Schedule I) 11. Total Oaductions 12. Net V.I.... of Tax Return 13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 91,088.95 .00 Ill) (12) (13) (14) NOTE: .00 X 47,967.07 X .00 X .00 X + INTEREST/PEN PAID 1-) .00 A/1OUNT PAID 2,158.52 NUIIBER CD005398 DATE 06-03-2005 BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-04-2005 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ~ 00 = 045 = 12 = 15 = (19)= NOTE: To lnsure proper credl t to your account I subait the upper portion of this forll with your tax pay...,t. 139,056.02 en .ORR 91; 47,967.07 .00 47,967.07 19 will .00 2,158.52 .00 .00 2,158.52 2,158.52 .00 111. 07 111. 07 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FDR YNSTRUnTllN>:: _ 1 'r ~ ~ 0.. & ~ ~ 15& O'i to:) ~~~~ OS&O d)Od)t- ::. .." :) <('" ..... - 0 ct ~~~o. ~ to ''::t ~ 0_-,& ""....O"ii) CD "0 ..... ~-&"C '&%e~ ~OO ~ ~ ct 0.- ~ ft ':) f!; $ l-'\ ~ 4- -:t \!'I ~ 0.. W \fl -r-\ N ~ '~ I;~ 'J, A.,J \ Cf> ~ \'I ~ ~ ~ ~ . r- ,:.. ~ ~ ~ ~,~ ~ Z I!} 'ti'\ --' r- Z ~ o ~ z \lo\ _ ..... - ~ Q;,.:. t ~ 'r "- . 0 ~1t~~ . 0 0 ? ~ I- Z ~ '4. '0 1Jl ~ ~~ ~ ~ ~ ~ -::. ~ - :. -:. -::::. :. -::. - -:. - -:. - -:. - -:. ::::: -::. - - -:. i',\ ~y\ \t~~\ " .' .~. ,.} ....1 '''I \." Y'" :1..1 . e..-~ \,j -lU . . '-(-.:1\..1. ' 'i'! ,-\ If \ J 'u \ ,,a ,- ..~".,! \\0-..\..;, ...; '," \ ,I'""\, t \-'.J".... -'"r~\,j,J\J \J.-l' "j......I....\ _. , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRA:ISfl.'!~i~ "L-:L~"U OR DISALLOWANCE Of DEDUCTIGNS'ANDASSESSHENT OF TAX BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 171Z8-0601 REV-IS 7 EX AFP (06-05) 08-22-2005 BERNABE JR 06-30-2003 21 04-0089 CUMBERLAND 101 \ APPEAL DATE: 10-21-2005 ( See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PA MENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS UNE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REY:is4,-ix-AFp.io3:0si-NOrici.OF-iNHERiTANCi-TAX.APPRiisEHENT:-ALLOWANCi-oi---- ---------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX VINCENT FILE NO. 21 04-0089 ACN 101 """""I '.....If.' - ~. ((.. DATE r: i: i'~'EmTE OF DATE OF DEATH FILE NUMBER -COUNTY ACN V NCENT HARRY L BRICKER JR 407 N FRONT ST HBG PA 17101 ESTATE OF BERNABE JR DATE 8-22-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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. Closaly Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (,. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2J (3) (4) (5J ((,) (7) 94.489.37 .00 .00 .00 44.436.69 129.96 .00 (8) NOTE: T insure proper credit your account. ~it e upper portion of this for. with your tax pay nt. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Hisc. Expenses (Schedule HJ (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 12. Net Value of Tax Raturn (2) 13. Charitable/Gover~ental Bequastsj Non-elected 9113 Trusts (Schedule JJ (13) 14. Net Value of Estat. Subject to Tax (4) 4 .967.07 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a~d 19 will re~lect ~igures that include the tota1 o~ ~ returns assessed to date.l ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousel rate US) .00 X 00 = 16. AIIount of Line 14 taxable at LineallCbss A rate (1(,) 47.967.07 X 045 = 17. AIIount of Line 14 at Sibling rata (17) .00 X 12 = 18. AIIount of Line 14 taxable at CollaterallClass B rata (18) .00 X 15 = 19. Principal Tax Due (19J= C 91. 088.95 .00 .158.52 .00 .00 .158.52 DATE 06-03-2005 NUttBER CD005398 INTEREST/PEN PAID (-J .00 AHOUNT PAID 2.158.52 BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-04-2005 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2. 58.52 .00 ~11. 07 111.07 ....... IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQ~RED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR). Y HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INST TIONS.J ~f\ RESERYATION: PURPOSE OF NOTICE : PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIYE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estat.. of dac.dent. dying on o~ befo~ D.c.-be~ 12, 1982 -- If any futu~. Int.~..t In the ..tete Is t~en.f.~~.d In posn.sion o~ enjoYllWlt to CI.ss . tcoll.t.~.l) b.llllflcla~I.. of the decedent afte~ the .lCpl~tlon of eny ..tet. fo~ Ilf. o~ fo~ y..~., the.Co_on....lth h.~IIbY tIlCP~...ly ~nrv.s the ~Ight to IIPP~.ln and .s.... t~ensf.~ Inhe~ltenc. TalC.. at the lawful CI..s B tcollat.~.I) ~t. on eny such futu~. Int.~.st. To fulfill the ~.qul~...nt. of Section 2140 of the'Inh.~ltenc. .nd Estat. T.lC Act, Act 23 of 2000. (72 P.S. s.ct~on 9140). IllItech the top po~tlon of this Notlc. end subIIlt with YOu~ pay.ant to the R.glst.~ of Wills p~lnted on the ~.v.~n sid.. --Mak. check o~ 80IllIY o~de~ payabl. to: REGISTJ:ROr~,AGENT.", " Fellu~. to pay the tell, Int.~.st, end pelllllty due..y ~sult In th.' fJUng of . lllll1 of ~co~ in the eppropd.te -ty, o~ the Issuanc. of en O~phen'. Cou~t cltatlli'"' ' A ~.fund of . tllX c~dlt, which wa. not ~.qUtl.ted on the T.lC R.tum, .ay be ~eqUtl.ted by COIIPI.tlng WI "Application fo~ R.fund of Penn.ylvanl. Inhe~ltance end Estat. TalC" (REY-1313). Appllc.tlon. .~ .vallabl. online .t www.~evenue.stat..oa.u., any Regl.t.~ of Will. o~ R.venue DI.t~lct Offlc., o~ f~ae the DlIPa~teent's 24-hour ensw.~lng ..rvlc. fo~ fore. o~de~.: 1-800-362-2050; n~vlc.. fo~ tellp.y.~s with specl.1 "".~Ing end/or speeking I\IHId.: 1-100~"7-302o (TT only). ' Any pe~ty In Inte~.t not ntlsfled with the IIPP~aln..nt, allow.nc. o~ dl..llowenc. of deduction. O~ ......ent of tell Clncludlng discount or lnte~.t) .. shown on this Notice _y object within 60 deys of the d.t. of ~ecelpt of this notice by filing 0IIII of the 'following: A) Prot.stto the PA IllIptI~~t of Revenu., Boa~ of Appe.ls. You 88Y object by flUng . p~ot..t onllllll at ww.boa~dofeoo.als.state.oa.us on o~ b.fo~. the tIlCPI~.tlon of the sillty-day IIPPWI ptI~lod. In orde~ fo~ en el.ctronic p~ote.t to b. valld, yOU .u.t ~caiv. . confl~_tlon nUllb.~ end proc.snd date f~. the Boa~d of App.al. wab.lt.. You ..y also .end a w~lttan p~ot..t to PA Depa~teent of R.v.nu., Bc.~ of Appeals P.O. BOlC 211021, H.~~lsbu~g, PA 17121-1021. Petition. ..y net be fllXed. B) Election to have the ..tt.~ deterelned .t the .udlt of the .ccount of the personal ~ap~..."tatlv.. C) Appe.1 to the O~phen.' Cou~t. Factual .~~o~s discove~lHl on this ass...lII1t should b. add~.snd In w~ltlng to: PA Depa~telll1t of R.vlll1U8, Bu~.au of Individual TalC.., ATTN: Po.t A.......nt Review Unit, P.O. BOlC 210601, H.~~lsbu~g, PA 17128-0601 Phone (717) 717-6505. See page 3 of the bookl.t "Inst~uctlons fo~ Inhe~ltence TalC Retu~n fo~ . R..ldant DeclHllll1t" (REY-15ol) fo~ 1111 .lCpl.natlon of ed.lnl.tnetlvely co~rectabl. .~~o~.. If any tIIX due Is paid within th..... (3) calende~ --.th. .ft.~ the decedlll1t's death, a fly. ptI~lII1t (5::0 discount of the tell p.ld I. .llow.d. The lSZ talC san..ty non-pa~ticlp.tlon penalty Is co.puted on tha totel of the t8lC and Int.~..t .s...nd, end not paid befone Janua~y 11, 1996, the fl~.t day aft.~ the end of the telC aane.ty p.~lod. Thl. non-p.~tlclpatlon plll1al ty Is appea1abl. In the .... .1II11111~ III1d In the the .... tI.. p.dod a. you would appeal the telC end Intere.t thet ha. belll1 ..nssad .s Indlc.t.d on this notlca. Int.~..t Is che~lHl beginning with fl~st day of d.llnqulll1cy, o~ nine (9) aonths end 0l1li (I) d.y f~o. the dete of death, to the d.t. of p~t. TlIXa. which bee_. dellnquent b.fo~. JanuII~y I, 1912 be.~ Int.~a.t at the ~.t. of .ill (6%) pe~ent per _ c.lcul.ted at . dally net. of .000164. All tIIX.s ....Ich be_ d.Unqulll1t on and .ft.r .January I, '1982 wlll bear int.~..t at . ~.ta ....ich wlll v.~y f~ae call1l1da~ Y..~ to cal.nd.r y..~ with thet rete announced by tha PA Dap.~~t of RevllnUll. 'The appllcabl. Int.ne.t net.. fo~ 1912 th~ugh 2005 .re: Int.~.st Dally Int.~..t D.Ily Int.~st Rat. F.cto~ Y.a~ Rat. Facto~ V.a~ Rat. -ar-:1nIlIM 'AD-1991 -,n- ";111!rr an -.r- 16% .00043a 1992 9% .000247 2002 6% 11% .000301 1993-1994 7% .000192 2003 SZ 13% .000356 1995-1998 9% .000247 2004 4% 10% .000274 1999 7% .000192 2005 SZ 9% .0002U 2000 1% .000219 V..r An 1983 1984 1985 1986 1987 Dally Facto~ .-mm- .0001M .000137 .000110 .000137 --Inte~e.t Is calculated a. follow.: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlc. Issued .fte~ the tIIX bacaee. delinquent will ~eflect an Inte~.st calculation to flft..n (IS) day. beyond the date of the .........,t. If p.y.ant is .ad. afte~ the Int.~.st co.putaUon date shown on the Notlc., additional interest .u.t be c.lculated. " , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 'Ell 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BRICKER HARRY L 407 N FRONT STREET HARRISBURG, PA 17101 ___n___ fold ESTATE INFORMATION: SSN: 155-42-0668 FILE NUMBER: 2104-0089 DECEDENT NAME: BERNABE VINCENT JR DA TE OF PAYMENT: 09/22/2005 POSTMARK DATE: 09/21/2005 COUNTY: CUMBERLAND DATE OF DEATH: 06/30/2003 , I I NO. CD 005~27 i I I I i ACN ASSESSMENT CONTROL NUMBER I I I AMOU~T I I 101 I $111.C 7 I I I I I I I I I i i I $111 "17 I TOTAL AMOUNT PAID: REMARKS: CHECK#1010 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBA GH REGISTER OF WILLS BUREAU OF INDIVIDU.AL,T~ES-, INHERITANCE TAX DIVISIQiI-: :' " " PO BOX 280601 . HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) n""~"- '-:-I'~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-11-2005 BERNABE JR 06-30-2003 21 04-0089 CUMBERLAND 101 VINCENT HARRY L BRicKER JR 407 N FRONT ST HBG PA 17101 Amount Remitted 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 +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~.. ESTATE OF BERNABE JR VINCENT FILE NO.21 04-0089 ACN 101 DATE 10-11-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-22-2005 PRINCIPAL TAX DUE: 2,158.52 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-03-2005 CD005398 .00 2,158.52 09-21-2005 CD005827 111.07- 111. 07 TOTAL TAX CREDIT 2,158.52 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J 0JtI" II -'I I INRE: ESTATE OF VINCENT BERNABE, JR. TO THE REGISTER OF WILLS: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION ESTATE NO. 2004-00089 PRAECIPE TO SATISFY having been satisfied. Kindly mark the estate claim filed by HCR ManorCare, Inc. in above-captioned estate as Date: /1/7/o~ f / da b.dir/manorcare/berna be/satisfy. pra Respectfully submitted, ~ mEN, BARIC ~~ David A. Baric, Esquire I.D. # 44853 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 r....J- {:-:."} :.;.:--' :":_"1 I \.f) -' (-,~) G,) _J - , ~:;~ - (:_~) r.n II CERTIFICA TE OF SERVICE I hereby certify that on November 9, 2005, I, David A. Baric, Esquire of O'Brien, Baric & Scherer, did serve a copy of the Praecipe To Satisfy, by first class U.S. mail, postage prepaid, to the party listed below, as follows: Harry L. Bricker, Jr., Esquire 407 North Front Street Harrisburg, Pennsylvania 17101 David A. Baric, Esquire - , , \8; L HARRY L. BRICKER, JR. ATTORNEY AT LAW 407 NORTH FRONT STREET HARRISBURG. PENNSYLVANIA 17101-1296 E-MAIL.HLBLAW@VERIZON.NET AREA CODE 717 233-2555 FAX 233-8555 November 8, 2005 HCR ManorCare, Inc. c/o O'Brien, Baric & Scherer Attn: David A. Baric, Esq. 19 West South Street Carlisle, PA 17013 Re: Estate of Vincent Bernabe, Jr., Deceased Social Security No. - 155-42-0668 Date of Death - June 30, 2003 Estate No. 2004-00089 Tax I.D. No. - 84-6376609 Gentlemen: Enclosed is an Estate Account check concerning the above-captioned estate; you will note it is payable to your client in the amount of $1,260.00. We will appreciate it if you will mark the Claim Against Decedent's Estate filed with the Register of Wills satisfied in order that we may proceed with this matter. Very truly yours, Harry L. Bricker, Jr. HLB, Jr./bld Enclosure - ~, cc: Ms. Joyce M. Bernabe ./ Register of Wills Office, ../' Cumberland County ~ ---., ~-~-:~ ("~) (..iJ l?'-- ..','{ < ,) C) >..J ;,>] ~/:l r"i ! -it HARRY L. BRICKER. JR. ATTORNEY AT LAW 407 NORTH FRONT STREET HARRISBURG. PENNSYLVANIA 17101-1296 E-MAil: HlBlAW@VERIZON.NET AREA CODE 717 23342555 FAX 233-8555 December 12,2005 Cumberland County Courthouse Attn: Register of Wills One Courthouse Square Carlisle, PA 17013 S~ '~O .:j ~1! _i::'" t........') (-~ .~l C~J ,cnl C) Re: Estate of Vincent Bernabe, Jr., Deceased Social Security No. - 155-42-0668 Date of Death - June 30, 2003 Estate No. - 2004-00089 Tax I.D. No. - 84-6376609 i'-:' ~I Gentlemen: We enclose for filing a Status Report Under Rule 6.12 concerning the above- captioned estate. With kindest regards. Very truly yours, c.... Harry L. Bricker, Jr. HLB, Jr./bld Enclosure cc: Ms. Joyce M. Bernabe - STATUS REPORT UNDER RULE 6.12 Name of Decedent: Vincent Bernabe. Jr. Date of Death: June 30. 2003 No. 2004-00089 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 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 the Orphans' Court and may be attached to this report. N ("\1 Har , Esquire 407 orth Front Street Harrisburg, PA 17101 (717) 233-2555 Date: 12/12/05 " -.- Capacity: Personal Representative ~ --"- ( ,'- L-'_i -- d~=c; I cc CJ X Counsel for Personal Representative c) L:,J CJ V1;