HomeMy WebLinkAbout02-0677
MARY C. LEWIS, REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Estate of ELEANOR BULLOCK
No.21
02
\0"
also known as ELEANOR L. BULLOCK
, Deceased
Social Security No. 179-16-0911
PAUL G. CAZER AND FREDERICK D. CAZER
Petitioner(s), who is/are 18 years of age or older, apply)ies) for:
(COMPLETE "A" OR "B" BELOW:)
[J
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ORS named in the Last Will of the
Decedent, dated 3/26/02 and codicil(s) dated N/A
State relevant circumstances, e.g., renunciation, death of executor, elc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
o
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 the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal
residence at MESSIAH VILLAGE, 100 MT. ALLEN DR, UPPER ALLEN TWP., MECHANICSBURG, PA 17055
(list street, number and municipality)
Decedent, then 82 years of age, died JULY 13 ,2002 ,at MESSIAH VILLAGE, MECHANICSBURG, PA
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA All personal property.....
(if not domiciled in PA Personal property in Pennsylvania .. .
(if not domiciled in PA Personal property in County.. ................
Value of real estate in Pennsylvania . . ......................
Total. ... ............... ............... ...................
$CiaJ100(bo,,;
$
$
$
sCfo _-t;oo ?\IN
Real Estate situated as follows:
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:
Signature
Typed or printed name and residence
PAUL G. CAZER
43 S. CHEVANGO STREET GREENE NY 13778
FREDERICK D. CAZER
220 REESE ROAD EARLVILLE NY 13332
RW-1
n - fOY- 2
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, Petltioner(s) will well and truly administer t~s~tate~')8.:10 law.
Sworn to and affirmed and subscribed /r;-/ ~ ~L ;7.-e--<---
...AUL G. AZERO
before meJthisy 2 26TH. day of 7. f /( <.. (D A'~
~ ~CK D CAZER 'tJ
DECREE OF REGISTER
Estate of ELEANOR BULLOCK
also known as ELEANOR L BULLOCK
Social Security No: 179-16-0911 Date of Death:
Deceased
No.21
02
AND NOW, JULY 26. 2002 , in consideration of the Petition on the
reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters CJ Testamentary CJ of Administration TESTAMENTARY
((c.I.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate)
are hereby granted to
PAUL G CAZER AND FREDERICK D CAZER
in the above estate and that the instrument(s), if any, dated 3-26-2002
described in the Petition be admitted to probate and filed of record as the Last Will of ~~cEldenl.
FEES
Letters .......
Short Certificates(s) ...............
Renunciation ..........................
Extra Pages (
)...............
I.T.R...
JCP Fee ...........................
Inventory............................ ....
Other
$
200.00
$
$
$
$
$
$
$
$
15.00
fJjif' 0
6.00
~~z(_ ~~
r Signature
5.00
Attorney: GERALD J. BRINSER
I.D. No: 09655
Address: 6 E. MAIN STREET, P.O. BOX 323
PALMYRA PA 17078
226.00
Telephone: (717)838-6348
7-26-2002
TOTAL .............................$
mailed to atty 7-26-2002
DATE FILED:
.
WILL
OF
ELEANOR BULLOCK
Z,/-02-L,"l"l
I, ELEANOR BULLOCK, a/k/a ELEANOR L. BULLOCK, currently of Upper
Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and
Testament, hereby revoking any and all prior Wills and Codicils made by me.
I. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence of
my death, shall be paid out of the principal of my general estate to the same effect as if said
taxes were expenses of administration and all property includable in my taxable estate
whether or not passing under this Will shall be free and clear thereof.
III. I bequeath my 2000 Buick Century automobile and my Sun Life Assurance
Company Account #92-9200-007652, with a current approximate value of Twenty-two
Thousand Dollars ($22,000), unto Dawn Stanard. Ifshe predeceases me, this bequest shall
lapse and pass as part of my residuary estate below.
IV. I bequeath my Atlas American Series 20 Ltd #303620, with a current approximate
value of Forty Thousand Dollars ($40,000) unto my nephew, Ronald P. Bullock. If he
predeceases me, this bequest shall lapse and pass as part of my residuary estate below.
V. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and bequeath
unto my Trustee named in the Revocable Trust Agreement dated August 9, 1991, as
amended, TO HOLD IN TRUST on the terms and conditions specified in such Agreement
VI. I appoint my nephews, Paul G. Cazer and Frederick D. Cazer, Executors, or the
survivor of them as sole Executor, of this my Will.
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VII. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I, ELEANOR BULLOCK, herewith set my hand to this
my Last Will, typewritten on two (2) sheets of paper including the attestation clause and
signatures of witnesses, this..{ (,.,.... day of 1'1 '" ~ c tI , 2002.
c ,I! J
G.&.-L-Y<-M l~tO--t'f( (SEAL)
ELEANOR BULLOCK
Signed by ELEANOR BULLOCK, by her declared to be her Will in our presence,
who have hereunto subscribed our names as witnesses in her presence and at her request,
this ;1,,,,.,., day of /-1-1 ,e " H ,2002.
~ ~. a '/?~ 0
/ /( . 'A-<.P2-" residing at . ~ {c
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COMMONWEALTH OF PENNSYL VANIA
1)
COUNTYOF CU/1lJUL4,vJ)
WE, ELEANOR BULLOCK, (;f/!-1! iJJ :.J. tR ''''SEe and DD'rbfAy/fJ.Rr.<.!.<f4/1>1 '<-feJ-
, the testatrix and the witnesses, respectively, whose names are signed to the attachea
or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument as her Last Will and that she
signed willingly (or willingly directed another to sign for her), and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best
of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
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ELEANOR BULLOCK
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WITNESS F
,f; ~'{ IY,. It. if ~J2 ll; PJ.__
WITNESS
Subscri?ed, s~om or affirmed and acknowledged before me b?:.. ~LEAN?R ~ULLOC~,
the testatnx, C .cflJi ,j} x/3 /?11V5 ~ K andJ)oi' e11..y jl(, /'("1 ~~nr<('I~>"'Itnesses, thiS
;?,tJ day of iJ1(){ch. ,2002.
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Notary Public
(SEAL)
NolariaI Seal
VicI<y M. MlcUita, NoIaIy Public
Upper Allen lWp., CtJmboI1and County
My Ct...,....., Expius December 31. 2005
Memller. Ponns-,ivania Assodation Of NoIat!es
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LAW OFFICES
BRINSER, WAGNER & ZIMMERMAN
6 EAST MAIN STREET - SECOND FLOOR
P. 0 BOX 323
PALMYRA. PENNSYLVANiA 1,707B
(717) 638-6346
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MARY C. LEWIS, REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
~
CERTIFICATION OF NOTICE UNDER RULE 5.61a)
Name of Decedent: ELEANOR BULLOCK, A1K1A ELEANOR L. BULLOCK
Date of Death: 7/13/02
Estate No. 2002-00677
SSN: 179-16-0911
File No. 21-02-0677
Date Letters Granted: 7/26/02
Will or Administration No.
To the Register:
I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served
on or mailed to the following beneficiaries of the above-captioned estate on 8/20/02
Name Add ress
HAMLIN C. BULLOCK PO. BOX 104
WAYMART PA 18472
DAVID L. BULLOCK 2875 BONDLAKE ROAD
CONYERS GA 30012
DAWN STANARD 7 ALLIANCE DRIVE, APT 304
CARLISLE PA 17013
RONALD BULLOCK 36 VALLEY VIEW ESTATES
JERMYN PA 18433
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
PAUL G. CAZER AND FREDERICK D. CAZER, CO-EXECUTORS
Personal Representative
X Counsel for Personal
Representative
~~9.~/~
Signature
GERALD J. BRINSER, ESQUIRE
Name (Please type or print)
6 E. MAIN STREET
Address
P.O BOX 323
Date 8/20/02
Capacity:
PALMYRA
PA 17078
Telephone No. (717)838-6348
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1712B-0601
REV-1 162 EX{1 1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CAZER PAUL G
43 S CHEV ANGO ST
GREENE, NY 13778
-nn---fold
ESTATE INFORMATION: SSN: 179-16-0911
FILE NUMBER: 2102-0677
DECEDENT NAME: BULLOCK ELEANOR
DATE OF PAYMENT: 10/16/2002
POSTMARK DATE: 10/11/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 07/13/2002
NO. CD 001734
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $43,000.00
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TOTAL AMOUNT PAID:
$43,000.00
REMARKS: PAUL CAZER
CHECK# 527
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
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~ NANCY W, C^ZER 1
~ 43 S Chcnango St ~
. Greene, NY r3778 ~
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG, PA 17126-0601
DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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OFFICIAL USE ONLY
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FILE NUMBER
2 1 -0 2 0 6 7 7
"'Cl5iiNTYCODE --yw,- - - Q8ER--
SOCIAL SECURITY NUMBER
BULLOCK ELEANOR A1K/A ELEANOR L
DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year)
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1, Real Estate (Schedu", A)
2, Stocks and Bonds (Schedule B)
179-16-0911
THIS RETURN MUST BE FilED IN DUPUCATE WITH THE
REGISTER OF WILLS
07/13/2002 07/01/1920
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITiAl)
15. Amount of Une 14 taxable at the spousal tax
rate, ortransfe" under Sec. 9116 (a)(1,2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
SOCIAL SECURITY NUMBER
o 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy afTrust)
o 10. Spousal Poverty Credit (date ofdeath between 12-31-91 and 1.1.95)
D 3. Remainder Retum (date 01 death priorto 12-13-82)
o 5. Federal Estate Tax Return Required
Q.. 8, Total Number of Safe Depos. Boxes
o 11, Election to tax underSec, 9113(A)(A"'h Soh 0)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
OFFICIAl::i!fE ONLY
P. ::0 <tl
........ ('D (;:
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THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD 8E DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
GERALD J, BRINSER ESQUIRE 6 E, MAIN STREET
FIRM NAME (If Ap.icab.1
BRINSER WAGNER & ZIMMERMAN P,O, BOX 323
TELEPHONE NUMBER
717838-6348 PALMYRA PA 17078
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3. Closely Held Corporation. Partnership or Sole-Proprietorship
4, Mortgages & Notes Receivab", (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8, Total Gross Assets (total Lines 1-7)
9. Funeral Expenses &'Administrative Costs (Schedule H)
10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedu", J)
N/A
[Xl 1. Original Return
o 4. Limited Estate
[XI 6. Decedent Died Testate (AkhcopyofWiIl)
o 9. Litigation Proceeds Received
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162,664,431
301 ,393,00
18,637,89
2,591.28
(11)
(12)
(13)
21,229,17
280,163,83
2,589,80
14, Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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(14)
277,574,03
0,00
0,00
58,799,71
218,774,32
X ,OL(15)
X ,04,5 (16)
X ,12 (17) 7,055,97
X ,15 (16) 32,816,15
(19) 39,872,12
20. ~
CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER AlL QUESTIONS ON REVERSe SIDE AND RECHECK MATH < <
o d . C
ece ents omPlete Address:
STREET ADDRESS
MESSIAH VILLAGE
100 MT. ALLEN DRIVE
CITY MECHANICSBURG I STATE I ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
39,872.12
43.000.00
1.993.61
Total Credits (A + 8 +C)
(2)
44,993.61
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresuPenally (D + E) (3)
4. If Line 2 is greater than line 1 + line 3, enler 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 Ihe TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a Iransfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.................. .......................... ............. .............................. ....... 0 00
3. Did decedent own an 'in trust fo~ or payable upon death bank account or security at his or her death? ................. 00 0
4. Did decedent own an individual Retirement Acoount, annuity, or other non-probate property which
contains a beneficiary designation? ..................................................... .............. ............... ..................... 00 0
5,121.49
0.00
0.00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
this return, including accompanying schedules and statements, and to the best of my knowledge and bellef, it is true, correct and complete
"ve is on all information of which preparer has any knowledge.
FI G ETURN ATE
J... S~
"'-----"
NY 13332
DATE
ADDRESS
E. MAIN STREET, .0. BOX 323
PALMYRA
PA 17078
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (iJJ.
For dates of death on or after January 1,1995, the tax rate imposed on the net value oftransfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the stalulory requirements for disclosure of assets and filing a tax return are still applicabla even if
the surviving spouse is Ihe only beneficiary.
For dates of death on or after Juiy 1, 2000:
The tax rale imposed on 100 net value of transfers from a deceased child twenty",ne years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)1.
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. ~116(1.2) [72 P.S. ~9116(aJ(1)J.
The lax rate imposed on the net value oflJansfers to or for the use ofthe decedent's siblings Is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individuai who has at least one parent in common with the decedent, whether by blood or adoption.
Comoutation of Value Passing
to Brother (Taxed@ 12%)
$280,163.83
- 2.589.80
$277,574.03
- 162.664.43
$114,909.60
- 9.800.00
$105,109.60
4
$ 26,277.40
+ 32.522.31
$ 58.799.71
Net Value of Estate
Donor-Advised Account to
Charity
Non-Probate
Specific Bequest
Residuary Estate
Y. Residue Estate
y. Non-Probate Trust
TAXED AT 12%
~"~~:I'," .
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
BULLOCK ELEANOR AlKlA ELEANOR L
FILE NUMBER
21 02
0677
Include the proceeds of litigation and the date the proceeds we<e received by the estate. All property jolntly-owned with the right of IUlYlvorohip mUlt be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
MESSIAH VILLAGE - REFUND ON APARTMENT
VALUE AT DATE
OF DEATH
94,544.50
2.
COMMONWEALTH INVESTMENTS - MFS MONEY MARKET FUND #8188277557
32,669.37
3.
MISCELLANEOUS PERSONAL TV - APPRAISED VALUE
1,550.00
4.
2000 BUICK CENTURY - APPRAISED VALUE
9,800.00
5.
CAR INSURANCE-REFUND
164.70
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
138 728.57
Richard P. MUJTY
Auctioneer,Appraiser
608 Thrush Court
Mechanicaburg,PA 17060
717-691-9481
ESTATE APPRAISAL
Personal property of:
Eleanor S. Bullock
Apt# 881
Messiah Village
Mechanicsburg,PA 17055
July 26,2002
Date of death: July 13,2002
I.Kitchen table and chairs
2.0ak hutch
3.Mccoy vase
4.Lakeside ruby mug
5.9 collectors bone china cups and saucers
6.Small Bavarian dish
7.StainIess flatware
8.Partial set of dinner ware
9.Everyday dishware
10.Oven cart
II. Television set
12.VCR
13.Daniel Dakota clock
14. Cane seat chair
15.Upholstered chair
16.Recliner
I 7. Antique treadle sewing machine
18.Various pictures
19.Floor lamp
20.Pair pottery lamps
21.Lawn chairs
22.T. Y. tables
23.Upholstered couch
24.Daily Bread prayer picture
25.Gleaner picture
26.Large plate glass mirror
27.Contents of metal cabinet
28.Blankets
29.SectionaJ bookcase
100.00
130.00
45.00
15.00
45.00
10.00
15.00
20.00
20.00
15.00
100.00
10.00
25.00
20.00
30.00
40.00
140.00
25.00
N.Y.
30.00
5.00
10.00
20.00
5.00
5.00
30.00
20.00
5.00
140.00
. .
30.Theological books 20.00
31.Card table and chairs 10.00
32.(2) Lamps 5.00
33.Bookcase desk 55.00
34.Rocker 25.00
35.Book shelf 5.00
36.Single bed (old) N. V.
37.Misc. lot 5.00
38.Two drawer filing cabinet 10.00
39.Cat figurine 10.00
40.Four piece bedroom suite 140.00
41.Cedar chest 90.00
42.Book shelf 45.00
43.Electric fan and misc. lot 5.00
44.Television set 30.00
45.Jewelry box and contents of chest of drawers 15.00
46.Table lamp 5.00
47.2000 Model Buick Century automobile 37,000 miles 4 door automatic 9800.00
Upon observation of the aforementioned items,it is to the best of my knowledge and
belief that Eleven Thousand three hundred and fifty (11,350.00) Dollarsreprc;~ents a fair market
value. - -
:::",:~;L
t-........
REV."",,.,,.n.
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
ESTATE OF
BULLOCK ELEANOR NKlA ELEANOR L
FILE NUMBER
21 02
0677
Th~ schedule must be completed and filed n the answer to any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET ~ yes.
DESCRIPTION OF PROPERTY 'IIOF
ITEM INCLUOfTHfWJ.lEOFTHETRANSFEREE.THElAREL.ATl~SHtPTOOECEDENTANDTHEOATEOFTAANSFEA. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COP'l'Of'THE Deeo fOR REAL ESTATE VALUE OF ASSET INTEREST
(IFAPPUCABLE)
1. ATLAS AMERICAN SERIES 20 ITD #303620 - MADE JOINT 16,478.76 100. 3,000.00 13,478.76
WINEPHEW, RONALD P. BULLOCK, MARCH 14,2002.
2. PNC BANK.. CHECKING ACCOUNT, ADDED FREDERICK 5,812.51 10.0. . 5,812.51
AND PAUL CAZER ON 3/11/02 AS JOINT OWNERS.
3. U.S. CHARITABLE GIFT TRUST WICHARITY NAMED 2,589.80 100. 2,589.80
AS A BENEFICIARY
4. MFS SUNLlFE OF CANADA - IRA - #92-9200-007652 - 16,506.63 100. 16,506.63
VARIABLE ANNUITY - DAWN STANARD NAMED AS
BENEFICIARY
ELEANOR BULLOCK NKlA ELEANOR L BULLOCK
REVOCABLE TRUST AGREEMENP**
5. COMMONWEALTH INVESTMENT SERVICES- 105,902.68 100. 105,902.68
PERSHING ACCOUNT #4NP-35917
6. COMMONWEALTH INVESTMENT SERVICES - 13,862.32 100. 13,862.32
ATLAS PUBLIC #10
7. COMMONWEALTH INVESTMENT SERVICES- 10,324.24 100. 10,324.24
WELLS RE.IT
***TO BE DISTRIBUTED EQUALLY AMONG THE ,..
FOLLOWING INDIVIDUALS:
1. HAMLIN C. BULLOCK - BROTHER
2. FREDERICK D. CAZER - NEPHEW
3. PAUL G. CAZER - NEPHEW
4. DAVID L BULLOCK - NEPHEW
TOTAL (Also enter on line 7, Recapitulation) $ 162664.43
(If more space is needed, insert additional sheets of the same size)
" 02 03:251'
commonwealth Inve5~men~
{.L , --.J...)w
Eleanor L Bullock
881 Messiah Village
P.O. Box 2015
MechanlcsbulY. PI'. ~ 7055
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Quarterly Account Summary
Values as of: June 28, 2002
179-16-0911
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Atlas
Resources,lnc.
February 6, 2003
Estate of Eleanor L. Bullock
Eleanor Bullock and Ronald Bullock, Joint Tenants
p, O. Box 2015
Mechanicsburg, PAl 7055
Gentlemen:
Re: Atlas America Series 20 Ltd.
Value ofJoint Tenant Units as 00-13-02 - $16.478.76
The value of the one and six tenths (1.6) joint tenant units own~~or and Ronald Bullock in
the Atlas America Series 20 Ltd. partnership as of July 13, 2002 is S19,478,7<5" ,The per unit value as of
January I, 2002 is $12,438.92. Your 1.6 unit interest value is $19,902.27. Distributions between January I
and July I, 2002 have to be deducted to arrive at the value. There were distributions of $3,423.51 bringing
the value as of July 13, 2002 to $16,478.76. >
This estimate of value was derived from an internally generated Reserve Report. The production
projections were audited by Wright & Company and completed on November 28, 2001. This estimate of
value is used in determining the price at which units in the partnership would be repurchased by Atlas
Resources, Inc. as of January I, 2002. Our estimate of value does not take into account any discounts that
may be available to you by way of IRS Revenue Rulings or other announcements or ruling by any taxing
authority that may be used to determine fair market value.
It is important to note the economic assumptions used in this evaluation are to the Partnership's
interest and vary from Atlas' Reserve Report. The assumptions used are as follows:
I. Gas and Oil Prices. The average projected gas prices per current gas and/or oil
marketing agreements at fiscal year end September 30, 2001.
2. Expenses - Pumpers and Management fees per Prospectus. Third party Work on
Well cost average of most current preceding twelve (12) months.
3. No escalation of prices.
4. Present value of future cash flow was discounted at 10%.
Changes in these assumptions could have a dramatic effect on the projected income stream and
calculated value. These estimates do not include any accounting for tax savings, benefits or payments due
to the complex nature of each individual's tax requirements. This methodology for calculating the value of
remaining reserves is commonly accepted by the Society of Petroleum Engineers and American Association
of Petroleum Geologists.
Please contact me if you have any questions at 800-251-0171, extension 184 or bye-mail
wloncar(Q)atlasamerica.com. . . .h~~' ~
Smcerely, &""-
ATLAS RESOURCES, c., Managing General Partner
Winifred Loncar, Director, Investor Services
cc: Terry Evearitt
Evearitt/McCoy
311 Rouser Road. PO Box 611, Moon Township, PA 151 DB . tel: 412 262-2830 . fax: 412 262.2820
fY~ ~~ J
.
February 6, 2003
Estate of Eleanor L. Bullock
Eleanor Bullock Revocable Tr Ag 8/9/1991
Paul G. Cazer and Frederick Cazer, Sue, Trustees
p, 0, Box 2015
Mechanicsburg, PA 17055
Gentlemen:
Re: Atlas-America Public #10 Ltd.
Value as of 7-13-02 -- $13.862.32
The value of Eleanor Bullock Revocable Trust Agreement dated August 9. 1991 two
units in the Atlas America Public #10 partnership as of July 13, 2002 is (13,862.32) Since
the partnership had no estimated reserve valuations as of the date of death due to it being a
new partnership formed in December 3 I, 2001 and it takes about a year's worth of
production to detennine estimated reserves, we have used the initial investment of $20,000
times 70% (30% discount would be used to detennine buyback amounts) which equals
$14,000 and then deducted the.one distribution ($137,68) in the partnership, Thus $14,000
less $137,68 gives a value of$13,862}2>
Please contact me if you have any questions at 800-251-0171, extension 184 or by e-
mail \\,'Joncafi,(i'atlasiiillc:i-jCd,COi-J-l.
Sincerely,
ATLAS RESOURCES, INC.
Managing General Partner
~~~
Winifred Loncar
Director, Investor Services
cc: Terry Evearitt
Evearitt/McCoy
311 Rouser Road. PO Box 611. Moon Township. PA 15108 . tel: 412 262.2830 . fax: 412 262.2820
REVOCABLE TRUST AGREEMENT
,;iRIS REVOCA!i!LE TRUST AGREEMENT (the "Agreement") made this
a. - day of _~'-'" ,1991, by ELEANOR BULLOCK a/k/a ELEANOR
L. BULLOCK, single woman, of 5427 Autumn Drive, Harrisburg,
Dauphin County, Pennsylvania, (the "Settlor" and "Trustee).
WITNESSETH:
WHEREAS, Settlor desires to establish a revocable trust
under the terms and conditions hereinafter set forth; and
WHEREAS, Settlor desires to transfer assets to said trust at
this time.
NOW, THEREFORE, in consideration of the foregoing premises
and the covenants and promises herein contained, the parties
hereto, intending to be legally bound hereby, agree as follows:
1. TRUST PROPERTY. Settlor hereby constructively
transfers and delivers to Trustee the property listed on Schedule
"A" attached hereto, which, together with any additions thereto
as hereinafter provided, shall constitute the Trust Estate, and
shall be held, administered and distributed as provided in this
Agreement.
2. DISPOSITIVE PROVISIONS. Trustee shall invest and
reinvest the Trust Estate and shall distribute the net income
(the "Income") and principal thereof as follows:
A. During Settlor's lifetime, Trustee shall pay the
Income no less frequently than quarter-annually to her or for her
benefit and shall also pay to her such sums from principal as she
may direct in writing; PROVIDED, however that in the event of
Settlor's mental or physical incapacity, as certified to Trustee
by Settlor's personal physician, Trustee shall expend both Income
and principal to such extent and in such manner as he in his
discretion deems advisable for the welfare and comfortable
support of Settlor during such period of incapacity. Trustee is
specifically authorized, in the event of such incapacity, to
continue Settlor's pattern of making gifts to individuals and
organizations.
B. Upon Settlor's death, Trustee shall distribute
funds from the Trust Estate to the personal representative of
Settlor's estate for the payment of expenses of Settlor's estate,
including, without limitation, taxes, funeral expenses, and
administrative expenses.
C. Upon Settlor's death and upon payment of expenses
pursuant to Section 2.B of this Agreement, Trustee shall
distribute the balance of the Trust Estate in equal shares to
such of the following persons as survive Settlor's death for a
period of thirty (30) days:
"
(1) Settlor's sister, IRENE M. BENNETT;
(2) Settlor's nephew, FREDERICK CAZER;
(3 ) Settlor's nephew, PAUL G. CAZER;
(4) Settlor's nephew, DAVID L. BULLOCK; and
I
,
(5) Settlor's nephew, RONALD P. BULLOCK. I
D. Should the principal of the Trust Estate, in the
sole opinion of the Trustee, be or become too small to warrant
placing or continuing of such fund in trust or should its
administration be or become impractical for any other reason, my
Trustee, in the exercise of his sole discretion, may then pay
such principal absolutely to any beneficiary hereunder or may
place said principal in the name of any beneficiary hereunder in
an interest bearing account in any bank, bank and trust company
or national banking association of his choosing, payable to such
beneficiary.
E. The interest of any beneficiary hereunder,
including a remainderman, in Income or principal, shall not be
subject to assignment, alienation, pledge, attachment or claims
of creditors until after payment has actually been made by
Trustee as hereinbefore provided.
F. Corporate distributions received in shares of the
distributing corporation shall be allocated to principal,
regardless of the number of shares and however described or
designated by the distributing corporation.
3. POWERS OF TRUSTEE. Except as otherwise specifically
provided herein or as Settlor may direct during administration of
the Trust Estate, Trustee shall hold and manage all real and
personal property held by him, together with any additions
thereto as hereinafter provided, upon the following terms and
conditions with the following powers and authorities, all in
addition to and not in limitation of those granted by law:
A. To take, hold or retain all or any part of the
Trust Estate hereby created in the form acquired as long as he
deems advisable and to receive all the Income, increments, rents
and profits therefrom.
B. To sell, exchange, partition, lease, option or
otherwise dispose of any property or part thereof, real or
personal, which may at any time form part of this Trust Estate at
pUblic or private sale for such purposes and upon such terms,
including sales on credit with or without security, in such
manner and at such prices as he may determine, including the
right to lease real estate for periods in excess of five years
-2-
and for a term expiring after the termination of any trust. In
the event of a sale, exchange, partition or lease of any of the
property of this Trust Estate, there shall be no liability on the
part of the purchase or purchasers to see to the application of
the purchase money, but the same shall be held and disposed of by
such purchase or purchasers, free and clear of any of the
provisions of this Agreement.
C. To continue any investments which may form a part
of this Trust Estate or to invest or reinvest the same in any
property, real or personal, of any kind or nature, including
stocks, bonds, mortgages, other securities and common trust funds
of Trustee without being limited or restricted to investments as
now or may hereafter be prescribed for trustees by the laws of
the Commonwealth of Pennsylvania or any other state.
D. To cause securities which may from time to time
comprise any part of this Trust Estate to be registered in his
name as Trustee or in the name of any nominee or to take and keep
the same unregistered and retain them or any part thereof in such
condition that they will pass by delivery without disclosing the
fact that the property is held in a fiduciary capacity.
E. To make any loans, either secured or unsecured, in
such amounts, upon such terms and such rates of interest and to
such persons, firms, or corporations as he deems advisable, and
to pay over to the Executor or Administrator of Settlor's estate
such sums as may be required for the purpose of the payment of
taxes, debts and administration expenses.
F. To retain the principal or corpus or any part
thereof of this Trust Estate in the form of cash.
G. To borrow money for any purpose in connection with
the administration of this Trust Estate; execute promissory notes
or other obligations for the amounts so borrowed and secure the
payment of any amount so borrowed by mortgage or pledge of any
real or personal property which may at any time form a part of
this Trust Estate.
H. To vote, in respect to any securities which may at
any time form a part of this Trust Estate, upon any proposition
or election at any meeting and to grant proxies, discretionary or
otherwise; vote at any such meeting; to join in or become a part
of any reorganization, readjustment, merger, voting trust,
consolidation or exchange and to deposit any such securities with
any committee, depositary, trustee or otherwise and to payout of
this Trust Estate any fees, expenses and assessments incurred in
connection therewith and to charge the same to principal or
Income as he may see fit; to exercise conversion, subscription or
other rights, or to sell or abandon such rights and to receive
and hold any new securities issued as a result of such
-3-
reorganization, readjustment, merger, voting trust,
consolidation, exchange, or exercise of subscription, conversion
or other rights; and generally take all action in respect to any
such securities as he might or could do as absolute owner
thereof.
I. To retain or purchase policies of life insurance,
to pay premiums thereon from Income or principal and to exercise
all rights of ownership thereover.
J.
or Income or
which he may
In his discretion to allocate to either principal
between them any and all capital gains and taxes
be required to pay on behalf of this Trust Estate.
K. To divide or distribute, whenever it is required
or permitted, this Trust Estate; to make such division or
distribution in kind or in money, or partly in kind and partly in
money; and that for such purposes the judgment of Trustee as to
the value of the different items shall be conclusive and final
upon the beneficiaries.
L. To hold and administer the Trust Estate created
hereby in one or more consolidated funds in whole or in part in
which the separate Trust Estate shall have an undivided interest.
M. To determine, in connection with making
investments, whether to amortize premiums in whole or in part.
N. To engage attorneys, investment counsel,
accountants, agents and such other persons as he may deem
advisable in the administration of this Trust Estate and to make
such payments therefor as he may deem reasonable and to charge
the expenses thereof to Income or principal as he may determine
and to delegate to such persons any discretion which he may deem
proper. Trustee shall not be liable for any negligence, omission
or wrongdoing of such counselor agents, providing reasonable
care was exercised in their selection.
O. Should the principal or Income of the Trust Estate
be payable to any person as to whom Trustee has actual knowledge
of a court adjudication of incompetency, or who Trustee, in his
discretion, determines is unable to act effectively on his own
behalf in financial matters, to use such principal or Income for
the benefit of such beneficiary, including, but not limited to,
the right to pay premiums for life, health, accident and any
other insurance.
P. To effect direct deposit of any retirement
benefits, Social Security benefits, or other regular monthly
payments into accounts maintained for the benefit of Settlor.
-4-
4. TRUSTEE.
A. During Settlor's lifetime and so long as
Settlor is mentally and physically competent, Settlor shall act
as Trustee. In the event of Settlor's mental or physical
incapacity, as certified by Settlor's personal physician, Settlor
appoints her nephew, PAUL G. CAZER, to act as successor Trustee.
In the event that PAUL G. CASER is unable or unwilling to act as
successor Trustee, Settlor appoints her nephew, FREDERICK CAZER,
to act as successor Trustee. For the purpose of this Agreement,
any reference to Trustee shall be deemed to include any successor
Trustee, who without court order or act of transfer, shall have
all the title, power, and discretion granted to the original
Trustee.
B. The powers granted in section 3 of this
Agreement shall be in addition to those granted by law and may be
exercised even after termination of this trust until actual
distribution of the Trust Estate, but not beyond the period
permitted by any applicable rule of law relating to perpetuities.
C. To the extent that such requirements can
legally be waived, no Trustee hereunder shall ever be required to
give bond or security as Trustee, or to qualify before, be
appointed by, or account to any court, or to obtain the order or
approval of any court respecting the exercise of any power or
discretion granted in this Agreement.
P. Trustee's exercise or non-exercise of powers
and discretions in good faith shall be conclusive on all persons.
No person paying money or delivering property to any Trustee
hereunder shall be required or privileged to see to its
application. The certificate of Trustee that Trustee is acting
in compliance with this instrument shall fully protect all
persons dealing with Trustee.
S. COMPENSATION AND RESIGNATION OF TRUSTEE.
A. Trustee shall be entitled to receive
comP7nsation from time to time over the period during which his
serv~ces are performed, but not in excess of such compensation as
would be approved by a court of competent jurisdiction. During
Settlor's lifetime, such compensation shall be charged wholly
against Income, unless Settlor directs otherwise in writing.
B. Trustee may resign at any time by written
notice to Settlor or any other beneficiary of the trust.
-5-
6.
RIGHTS OF SETTLOR.
Estate,
cash or
A. Settlor or others may add to the Trust
by will, inter vivos transfer or beneficiary designation,
such property in kind as is acceptable to Trustee.
B. Settlor reserves the right to revoke this
Agreement at any time, in whole or in part, by written notice
delivered to Trustee during Settlor's lifetime.
C. Settlor further reserves the right to amend
this Agreement at any time by a proper instrument in writing,
executed by Settlor, delivered to Trustee during Settlor's
lifetime and accepted by Trustee.
D. If Settlor designates Trustee as beneficiary
of the proceeds of any policies of insurance on her life, the
duty and responsibility for the payment of premiums and other
charges on such policies during Settlor's lifetime shall rest
solely upon her, unless she shall expressly direct Trustee in
writing to pay the same from Income or principal; otherwise, the
only duty of Trustee shall be the safekeeping of such policies as
are deposited with him, and Trustee shall be under no duty to
notify Settlor that any such premium or other charge is due and
payable. All options, rights, privileges and benefits
exercisable by or accruing to Settlor during her lifetime by the
terms of the policies shall be for her sole benefit and shall not
be subject to this Agreement: Settlor agrees, however, not to
exercise any options whereby the proceeds would be payable to
Trustee other than in one sum. Upon the written request of
Settlor, Trustee shall execute and deliver such consents and
instruments as may be requisite to enable Settlor to exercise or
avail herself of any option, right, privilege or benefit granted
by any of the policies. Upon Settlor's death, or at such later
time as may be specified in the policies, the net proceeds of any
policies then payable to Trustee hereunder shall be collected by
Trustee; the receipt of Trustee for such proceeds shall release
the insurance companies from liability on the policies, and the
insurance companies shall be under no duty to see to the
application of such proceeds. Trustee may take all steps
necessary in his opinion to enforce payment of said policies and
shall be entitled to indemnify himself out of any property held
hereunder against all expenses incurred in taking such action.
E. Settlor may also designate Trustee as beneficiary
of certain employee death benefits. In such case, Trustee shall
collect the proceeds receivable therefrom upon Settlor's death
and hold them as part of the Trust Estate. The receipt of
Trustee for such proceeds shall be a full acquittance to the
administrators of such benefits, and said administrators shall
not be liable to see to the application of such proceeds. To the
extent that such proceeds are not included in Settlor's estate
-6-
for federal estate tax purposes, they shall not be used for the
payment of death taxes or any administration expenses of her
estate. Trustee may select any option available to him as to the
time and method of payment of such proceeds and may also exercise
any option with respect to the income or death taxes thereon as
he in his discretion deems advisable, and his decision in these
matters shall be binding upon, and shall not be subject to
question by, the beneficiaries.
7. INTERPRETATION. Wherein used in this Agreement the
masculine shall be deemed to refer to and include the feminine.
8. APPLICABLE LAW. This Agreement has been delivered to
and accepted by Trustee as hereinafter provided in the
Commonwealth of Pennsylvania and shall be governed in all
respects by the laws of the Commonwealth.
9. ACCEPTANCE BY TRUSTEE AND SUCCESSOR TRUSTEE. Trustee,
by joining in the execution of this Agreement, signifies his
acceptance of the Trust Estate created hereby and acknowledges
(unless otherwise noted in writing) that he has received this day
from Settlor the property listed on Schedule "A," attached hereto
and made a part hereof by reference. Trustee and successor
Trustee agree that they will use the Trust Estate and dispose of
the proceeds thereof upon and subject to all and singular the
trust, terms and provisions set forth in this Agreement.
IN WITNESS WHEREOF, Settlor and Trustee have hereunto set
their hands and seals the day and year first above written.
WITNESS:
SETTLOR AND TRUSTEE:
[~~
ELEANOR BULLOCK
'iL,-'^-""- ;;/- ~Wc.
ELEANOR L. BULLOCK
WITNESS:
SUCCESSOR TRUSTEES:
PAUL G. CAZER
FREDERICK CAZER
-7-
ACKNOWLEDGMENT
STATE OF PENNSYLVANIA
)
) ss:
)
COUNTY OF
On this, the day of , 1991, before me
a Notary Public, the undersigned officer, personally appeared
ELEANOR BULLOCK a/k/a ELEANOR L. BULLOCK, known to me, or
satisfactorily proven, to be the person whose name is subscribed
to the within instrument, and acknowledged that she executed the
same for the purpose therein contained.
IN,WITNESS WHEREOF, I hereunto set my hand and official
seal.
NOTARY PUBLIC
ACKNOWLEDGMENT
COUNTY OF
)
) ss:
)
STATE OF PENNSYLVANIA
On this, the
a Notary Public, the
PAUL G. CAZER, known
person whose name is
acknowledged that he
contained.
day of , 1991, before me
undersigned officer, personally appeared
to me, or satisfactorily proven, to be the
subscribed to the within instrument, and
executed the same for the purpose therein
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
NOTARY PUBLIC
-8-
ACKNOWLEDGMENT
STATE OF PENNSYLVANIA
)
) ss:
)
COUNTY OF
On this, the (ftL day of Uur;turf---- , 1991, before me
a Notary public, the undersigned officer, personally appeared
ELEANOR BULLOCK a/k/a ELEANOR L. BULLOCK, known to me, or
satisfactorily proven, to be the person whose name is subscribed
to the within instrument, and acknowledged that she executed the
same for the purpose therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and
seal. 1/ I
(fL/lLVo>>- ?
~~~:T,~~::,:~~
....:;': '.' '.' d';" '.' .' ;
. ", '- ~ ....- .., - '. ~:.::.5-..:.__ _...;.-~":':~.:
ACKNOWLEDGMENT' '
STATE OF PENNSYLVANIA
)
) ss:
)
COUNTY OF
On this, the day of , 1991, before me
a Notary Public, the undersigned officer, personally appeared
PAUL G. CAZER, known to me, or satisfactorily proven, to be the
person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purpose therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
NOTARY PUBLIC
-8-
ACKNOWLEDGMENT
STATE OF PENNSYLVANIA
)
) ss:
)
COUNTY OF
On this, the day of , 1991, before me
a Notary pUblic, the undersigned officer, personally appeared
FREDERICK CAZER, known to me, or satisfactorily proven, to be the
person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purpose therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
NOTARY PUBLIC
-9-
,co~~
SECOND AMENDMENT TO ELEANOR BULLOCK AfKJA ELEANOR L. BULLOCK
REVOCABLE TRUST AGREEMENT
THIS SECOND AMENDMENT TO ELEANOR BULLOCK AlKJA ELEANOR L.
BULLOCK REVOCABLE TRUST AGREEMENT (the "Amendment") made this dl2- day of
m~
, 1999, by ELEANOR BULLOCK AlKJA ELEANOR 1. BULLOCK, single
woman, of 5427 Autumn Drive, Harrisburg, Dauphin County, Pennsylvania (the "Settlor" and
"Trustee") .
WITNESSETH:
WHEREAS, Settlor established a revocable trust pursuant to a Revocable Trust
Agreement dated and executed August 9, 1991 (the "Agreement"); and
WHEREAS, Section 6.C. of the Agreement reserves unto Settlor the right to amend the
Agreement at any time by a proper instrument in writing, executed by Settlor, delivered to
Trustee during Settlor's lifetime and accepted by Trustee; and
WHEREAS, Settlor desires to amend the Agreement subject to the terms and conditions
hereof.
NOW, THEREFORE, in consideration of the foregoing premises and the covenants and
prolUlses herein contained, the parties hereto, intended to be legally bound hereby, agree as
follows:
1. Amendment. I hereby delete Section 2 of the Agreement, as amended on August
26, 199 I, and substitute therefor the following:
2. DISPOSITIVE PROVISIONS.
Trustee shall invest and reinvest the Trust Estate and shall distribute the net
income (the "Income") and principal thereof as follows:
A. During Settlor's lifetime, Trustee shall pay the income no less
frequently than quarterly to her or for her benefit and shall also pay to her such
sums from principal as she may direct in writing; PROVIDED, however, that in
the event of Settlor's mental or physical incapacity, as certified to Trustee by
Settlor's personal physician, Trustee shall expend both income and principal to
such extent and in such manner as Trustee, in his discretion, deems advisable for
the welfare and comfortable support of Settlor during such period of incapacity.
Trustee is specifically authorized, in the event of such incapacity, to continue
Settlor's pattern of making gifts to individuals and organizations.
B. Upon Settlor's death, Trustee shall distribute funds from the Trust
Estate to the personal representative of Settlor's estate for the payment of
expenses of Settlor's estate, including, without limitation, taxes, funeral expenses,
and administrative expenses.
C. Upon Settlor's death and upon payment of expenses pursuant to
Section 2.B of this Agreement, Trustee shall distribute the balance of the Trust
Estate as follows:
I. If my net trust estate exceeds $100,000, I give and bequeath
ten (10%) percent of my net trust estate to Chosen People Ministries,
Charlotte, North Carolina. If my net trust estate is $100,000 or less, I give
and bequeath five (5%) percent of my net trust estate to Chosen People
Ministries.
2. The rest, residue and remainder of my estate shall be
distributed in equal shares to such of the following persons as survive
Settlor's death for a period of thirty (30) days:
a. Settlor's nephew, FREDERlCK CAZER; v.
b. Settlor's nephew, PAUL G. CAZER;
c. Settlor's nephew, DAVID 1. BULLOCK; ,
d. Settlor's nephew, RONALD P. BULLOCK; "
e. Settlor's brother, HAMLIN C. BULLOCK; and ,.
f. Settlor's sister, LILLIAN CAZER.
D. Should the principal of the Trust Estate, in the sole opinion of the
Trustee, be or become too small to warrant placing or continuing of such fund in
trust, or should its administration be or become impractical for any other reason,
my Trustee, in the exercise of his sole discretion, may then pay such principal
absolutely to any beneficiary hereunder or may place said principal in the name of
any beneficiary hereunder in an interest bearing account in any bank, bank and
trust company, or national banking association of his choosing, payable to such
beneficiary.
E. The interest of any beneficiary hereunder, including a
remainderman, in income and principal, shall not be subject to assigning,
alienation, pledge, attachment or claims of creditors until after payment has
actually been made by trustee as hereinbefore provided.
F. Corporate distributions received in shares of the distributing
corporation shall be allocated to principal, regardless of the number of shares and
however described or designated by the distributing corporation.
2. Amendment. I hereby delete Section 4 of the Agreement and substitute therefor the
following:
4. TRUSTEE.
A. During Settlor's lifetime and so long as Settlor is mentally and physically
competent, Settlor shall act as Trustee. In the event of Settlor's mental or physical
incapacity, as certified by Settlor's personal physician, Settlor appoints her brother,
HAMLIN C. BULLOCK, and her nephew, PAUL G. CAZER, or the survivor of them, to
act as successor Co-Trustees. For the purpose of this Agreement, any reference to
Trustee shall be deemed to include any successor Trustee, who, without court order or act
of transfer, shall have all the title, power and discretion granted to the original Co-
Trustees.
B. The powers granted in Section 3 of this Agreement shall be in addition to
those granted by law and may be exercised even after termination of this trust until actual
distribution of the Trust Estate, but not beyond the period permitted by any applicable
rule of law relating to perpetuities.
C. To the extend that such requirements can legally be waived, no Trustee
hereunder shall ever be required to give bond or security as Trustee, or to qualify before,
be appointed by, or account to any court, or to obtain the order of approval of any court
respecting the exercise of any power or discretion granted in this Agreement.
D. Trustee's exercise or non-exercise of powers and discretions in good faith
shall be conclusive on all persons. No person paying money or delivering property to any
Trustee hereunder shall be required or privileged to see to its application. The certificate
of Trustee that Trustee is acting in compliance with this instrument shall fully protect all
persons dealing with Trustee.
2. Ratification. In all other respects I hereby confirm and ratify the remaining
provisions of this Agreement, reserving unto myself the right to amend further that Agreement
and this Amendment thereto.
IN WITNESS WHEREOF, Settlor has executed this Amendment the day and year fIrst
above written.
WITNESS:
SETTLOR:
&./.., ''L/~
ELEANOR BG1..LOCK
ZA~,,~~.~
ELEANORL.BULLOCK
The undersigned Trustee acknowledges receipt of and consents to the Amendment as of
the day and year fIrst above written.
TRUSTEE:
E.-e... "L~
ELEANOR BL1..LOCK
Zh---~X: ~'---
ELEANOR 1. BULLOCK
~(Q)~V
THIRD AMENDMENT TO ELEANOR BULLOCK
A/KlA ELEANOR L. BULLOCK REVOCABLE TRUST AGREEMENT
THIS THIRD AMENDMENT TO ELEANOR BULLOCK NKJA ELEANOR L.
BULLOCK REVOCABLE TRUST AGREEMENT (the "Amendment") made this
day of ,2002, by ELEANOR BULLOCK, aJkIaJ ELEANOR L. BULLOCK, (the
"Settlor" and "Trustee").
WITNESSETH:
WHEREAS, Settlor established a revocable trust pursuant to a Revocable Trust
Agreement dated and executed August 9, 1991 (the "Agreement"); and
WHEREAS, Section 6.C. of the Agreement reserves unto Settlor the right to amend
the Agreement at any time by a proper instrument in writing, executed by Settlor, delivered
to Trustee during Settlor's lifetime and accepted by Trustee; and
WHEREAS, Settlor desires to amend the Agreement subject to the terms and
conditions hereof.
NOW, THEREFORE, in consideration ofthe foregoing premises and the covenants
and promises herein contained, the parties hereto, intended to be legally bound hereby, agree
as follows:
1. Amendment. I hereby delete Paragraph I.2.C. of the SECOND
AMENDMENT TO ELEANOR BULLOCK NKJA ELEANOR L. BULLOCK
REVOCABLE TRUST AGREEMENT and substitute in lieu thereof the following:
C. Upon Settlor's death and upon payment of expenses pursuant to
Section 2.B. of said Trust Agreement as amended, my Trustee shall distribute
any remaining balance equally among the following persons who survive
Settlor for thirty (30) days:
1) My brother, Hamlin C. Bullock;
2) My nephew, Frederick D. Cazer,
3) My nephew, Paul G. Cazer;
4) My nephew, David L. Bullock.
2. Amendment. I hereby delete Paragraph 2.4.A. of the said SECOND
AMENDMENT TO ELEANOR BULLOCK AlKJA ELEANOR L. BULLOCK
REVOCABLE TRUST AGREEMENT and substitute in lieu thereof the following:
A. During Settlor's lifetime and so long as Settlor is mentally and
physically competent, Settlor shall act as Trustee. In the event of Settlor's
mental or physical incapacity, as certified by Settlor's personal physician,
Settlor appoints her nephews, Paul G. Cazer and Frederick D. Cazer, or the
survivor of them, to act as successor Co-Trustees. For the purpose of this
Agreement any reference to Trustee shall be deemed to include any successor
Trustee, who, without court order or act of transfer, shall have all the title,
power and discretion granted to the original Trustee.
3. Ratification. In all other respects, I hereby confirm and ratifY the remaining
provisions of the aforesaid TRUST AGREEMENT as amended reserving unto myself the
right to amend further that Agreement and this Amendment thereto.
IN WITNESS WHEREOF, Settlor has executed this Amendment the day and year
first above written.
WITNESS:
SETTLOR:
ELEANOR BULLOCK
ELEANOR L. BULLOCK
The undersigned Trustee acknowledges receipt of and consents to the Amendment as
of the day and year first above written.
WITNESS:
TRUSTEE:
ELEANOR BULLOCK
ELEANOR L. BULLOCK
REV..."",..".n.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
BULLOCK ELEANOR AlKlA ELEANOR L
FILE NUMBER
21 02
0677
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. BRENNAN AND BRENNAN FUNERAL HOME 5,445.00
2. REV. RITCHEY - FUNERAL SERVICE 125.00
3. MINISTER 50.00
4. FUNERAL MEAL 401.09
5. HEADSTONE 95.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) PAUL G.CAZER / FREDERICK D. CAZER 6,545.00
Social Security Numbe~s) I EIN Number of Personal Representative(s)
Street Address C/O 43 S. CHEVANGO STREET
City GREENE State NY Zip 13778
Year(s) Commission Paid:
2 AttomeyFees BRINSER, WAGNER & ZIMMERMAN 2,550.00
3. Family Exemption: (If decedenfs address is nollhe same as c1aimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant 10 Decedent
4. Probate Fees REGISTER OF WILLS 226.00
5. Accountants Fees
6. Tax Return Preparer's Fees
7. REGISTER OF WILLS - ADDITIONAL COST OF LETTERS 35.00
8. REGISTER OF WILLS -INHERITANCE TAX RETURN FILING FEE 15.00
9. REGISTER OF WILLS - INVENTORY FILING FEE 10.00
10. RICHARD MURRY - APPRAISAL OF VEHICLE AND MISC. PERSONAL TV 150.00
11. SMART MOVERS - HAULING/MOVING 1,12460
12. VERIZON - PHONE 41.38
13. P P & L - ELECTRIC 6.77
14. STORAGE DEPOT - TWO MONTHS OF STORAGE 220.48
15. EXECUTOR EXPENSES, INCLUDiNG TRAVEULODGING 743.90
16. CUMBERLAND LAW JOURNAL - LEGAL ADVERTISING 75.00
17. THE SENTINEL - LEGAL ADVERTISING 90.59
18. U-HAUL RENTAL 428.08
TOTAL (Also enter on line 9, Recapitulation) $ 18637.89
(If more space is needed, Insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
. BULLOCK, ELEANOR, A1K1A ELEANOR L.
21
02
0677
Paaa 1
Schedule H - Funeral Expenses & Administrative Costs - 87
ITEM
NUMBER
DESCRIPTION
AMOUNT
19.
C & R STORAGE
260.00
SUBTOTAL SCHEDULE H.B7
260.00
:REV.""~.".n.
COMMONWEAlTH OF PENNSYLVANIA
INHERJTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BULLOCK ELEANOR A1K1A ELEANOR L
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21 02
0677
Include unrelmbul1Ied medical expenses.
ITEM
NUMBER
OESCRIPTlON
AMOUNT
1.
.
P P & L - ELECTRIC
16.02
2.
TAX COLLECTOR - SCHOOL TAX
9.80
3.
ALLERT PHARMACY
183.53
4.
VERIZON - PHONE
40.02
5.
GM - CREDIT CARD
64.48
6.
MSHMC - PHYSICIANS GROUP
24.81
7.
MESSIAH VILLAGE - ASSISTED LIVING (BALANCE DUE)
1,960.70
8.
PINNACLE HEALTH HOSPITAL
18.92
9.
U.S. TREASURY - IRS - 2002 INCOME TAXES
201.00
10.
PA DEPT. OF REVENUE - 2002 INCOME TAXES
72.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2 591.28
,"""3~"..n.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
DIIII nr'''' <=1.
NUMBER
I.
1.
2.
3.
4.
5.
6.
Jj.JfI(/11 LI-...--I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
HAMLIN C. BULLOCK
P.O. BOX 104, WAYMART, PA 18472
FREDERICK D. CAZER
220 REESE ROAD, EARLVILLE, NY 13332
PAUL G. CAZER
43 S. CHEVANGO STREET, GREENE, NY 13778
DAVID L. BULLOCK
2875 BONDLAKE ROAD, CONYERS, GA 30012
DAWN STANARD
7 ALLISON DRIVE, APT. 304, CARLISLE, PA 17013
RONALD P. BULLOCK
36 VALLEY VIEW ESTATES, JERMYN, PA 18433
FILE NUMBER
71 n?
RELATIONSHIP TO DECEDENT
Do Nol L1llTrullee(l)
nt:.77
AMOUNT OR SHARE
OF ESTATE
BROTHER 1/4 Residue per terms
of Trust
NEPHEW 1/4 Residue per terms
of Trust
NEPHEW 1/4 Residue per terms
of Trust
NEPHEW 1/4 Residue per terms
of Trust
NONE Auto (Value $9800)
& Life Assurance Acct.
(Val.$16,506.63)
NEPHEW Atlas Amer. Series (Val.
$16,478.76)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON liNES 15 THROUGH 17, 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
1.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
(DONOR-ADVISED ACCOUNT UNDER TRUST)
2,589.80
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLEOISTRIBUTIONS ON liNE 13 OF REV 1500 COVER SHEET S
(If more space is needed, insert additional sheets of the same size)
2 589.80
.
,\
WILL
OF
ELEANOR BULLOCK
I, ELEANOR BULLOCK, a/kJa ELEANOR L. BULLOCK, currently of Upper
Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and
Testament, hereby revoking any and all prior Wills and Codicils made by me.
1. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence of
my death, shall be paid out of the principal of my general estate to the same effect as if said
taxes were expenses of administration and all property includable in my taxable estate
whether or not passing under this Will shall be free and clear thereof.
III. I bequeath my 2000 Buick Century automobile and my Sun Life Assurance
Company Account #92-9200-007652, with a current approximate value of Twenty-two
Thousand Dollars ($22,000), unto Dawn Stanard. Ifshe predeceases me, this bequest shall
lapse and pass as part of my residuary estate below.
IV. I bequeath my Atlas American Series 20 Ltd #303620, with a current approximate
value of Forty Thousand Dollars ($40,000) unto my nephew, Ronald P. Bullock. If he
predeceases me, this bequest shall lapse and pass as part of my residuary estate below.
V. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and bequeath
unto my Trustee named in the Revocable Trust Agreement dated August 9, 1991, as
amended, TO HOLD IN TRUST on the terms and conditions specified in such Agreement
VI. 1 appoint my nephews, Paul G. Cazer and Frederick D. Cazer, Executors, or the
survivor ofthem as sole Executor, of this my Will.
~
-1-
c..L<-;~ ~
1
r
"
d
VII. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I, ELEANOR BULLOCK, herewith set my hand to this
my Last Will, typewritten on two (2) sheets of paper including the attestation clause and
signatures of witnesses, this;? (,.,.., day of /14 ~ <= tl , 2002.
c ~
c:. .eL~ . (
ELEANOR BULLOCK
(SEAL)
Signed by ELEANOR BULLOCK, by her declared to be her Will in our presence,
who have hereunto subscribed our names as witnesses in her presence and at her request,
this ~/'1'1 day of H-f t<." H ,2002.
,~,( /1:1u~"A"--- residing at ~ I?
//
'fY~~ m. f? "~rjL,:o ~I residing at /r} 6'" (L..,~.'~.L\ 11-<.>2 ' Jl..
-2-
.
,
,
COMMONWEALTH OF PENNSYL V ANlA
1)
COUNTY OF CV/1 8flUAI..P
WE, ELEANOR BULLOCK, (;0.# /.lJ J. t.R""->E€ and Dort>fAyJf!.RI"<<.'!o./h1<z.'r'CJ
, the testatrix and the witnesses, respectively, whose names are signed to the attached"'
or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument as her Last Will and that she
signed willingly (or willingly directed another to sign for her), and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best
of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
fi.lJ'd ......,. <...0 ~
ELEANOR BULLOCK
~~(~
WITNESS ,;
4) ~'J Iv,. ~? ~f2_,,; PA__
WITNESS -\.
Subscri?ed, s~om or affirmed and acknowledged before me b~ ~LEAN?R ~ULLOC~,
the testatnx, C "':fl.1l '.D J:{!, ItIN.H.t: and..,LJor 0 lAy j1f, It, ~'~J>r<l.I~)'f1tnesses, thiS
J~tj day of !y/orc"- , 2002.
t~
)11. />1Af~
Notary Public
(SEAL)
NoCariaI Seal
VIcky M. MlcUita, NolaIy Public
~AIen nvp., CunbedandCounly
MyCo,....... Expires December 31,2005
Mentler, f'enns\MnIa Associallon Of NoIarie.s
-3-
--
t:.-
INVENTORY
Estate of ELEANOR BULLOCK
also known as ELEANOR L. BULLOCK
, Deceased
No. 21 02 0677
Date of Death 07/13/2002
Social Security No. 179-16-0911
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IM/e
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
PALMYRA
PA 17078
Name of
Attorney: GERALD J. BRINSER, ESQUIRE
I.D. No.: 09655
Address 6 E. MAIN STREET
Telephone: (717)838-6348
Description
Cash, Bank Deposits, & Misc. Personal Property
Value
MESSIAH VILLAGE - REFUND ON APARTMENT
94,544.50
COMMONWEALTH INVESTMENTS - MFS M.M. FUND #8188277557
32,669.37
MISCELLANEOUS PERSONALTY - APPRAISED VALUE
1,550.00
2000 BUICK CENTURY - APPRAISED VALUE
9,800.00
CAR INSURANCE-REFUND
164.70
Tolal
(Attach Additional Sheets if necessary)
138,728.57
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
/./) ~}/i
\..1 .
BUREAU Of INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE Of INHERITANCE TAX
APPRAISEMENT, ALLOWANCE DR DISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT Of TAX
Rer::,
R"
[DATE
. ESTATE OF
DATE OF DEATH
FILE NUMBER
All :'m!UNTY
ACN
06-03-2003
BUllOCK
07-13-2002
21 02-0677
CUMBERLAND
101
GERALD J BRINSER
6 E MAIN ST
PO BOX 323
PALMYRA
'OJ JUN-6
'*
REV-1547EX 'FF (Ql-Ul
ELEANOR
Amount Rellitted
GCl";
PA 1707lC\'mLlL
MAKE 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 ...
REV=is47-EX-AFP-foFoiY-NoricE--OF-i-NHERiTANCE-TAX-APPRAisEMENT:--AL.l.-OWAtiCE-OR"-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BULLOCK ELEANOR FILE NO. 21 02-0677 ACN 101 DATE 06-03-2003
TAX RETURN WAS: (X J ACCEPTED AS fILED
J CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks end Bonds (Schedule 8)
3. Closely Held stock/Partnership Interest (Schedule C)
~. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedule G)
8. Total Assets
llJ
12J
13J
(41
(SJ
I&J
In
.00
.00
.00
.00
138,728.57
.00
162.664.43
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule Hl
10. Debts/Mortgage Liabilities/Liens (Schedule 11
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
19J
110J
18,637.89
2.591.28
(l1J
112)
(131
(14)
NOTE: To insure proper
credit to your account)
submit the upper portion
of this for.. with your
tax paYllent.
301,393.00
71.<'29 17
280,163.83
2,589.80
277,574.03
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ abb
ASSESSMENT OF TAX:
15. Allount 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
.00 X 00 =
.00 X 045 =
58,799.71 X 12 =
218,774.32 X 15 =
119)=
.00
.00
7,055.97
32,816.15
39,872.12
"'AX CREDITS:
(+J AtIOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-J
10 11-2002 CDOO1734 1,993.61 43,000.00
TOTAL TAX CREDIT 44,993.61
BALANCE OF TAX DUE 5,121. 49CR
INTEREST AND PEN. .00
TOTAL DUE 5,121. 49CR
. IF PAID AfTER DATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REfUND. SEE REVERSE SIDE Of THIS fORM fOR INSTRUCTIONS.)
F}- ?:? - ;:)~
~ BUREAU OF INOIVIOUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171la-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
-
REV-liD1 EX AFP (Ol.03l
GERALD J BRINSER
6 E MAIN ST
PO BOX 323
PALMYRA
'03 JUL 11
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-16-2003
BUllOCK
07-13-2002
21 02-0677
CUMBERLAND
101
ELEANOR
iJJl :28
Allount Rellitted
L
PA 1 ~0I78,i;'
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, sub.it the upper portion of this for.. with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RW=i&OTix-AFji-ioY=ii3Y------...--iNHERI':ANcrTAiCs'i'A"fEHEN'T-oTAccouiif--ii...---------------------
ESTATE OF BUllOCK ELEANOR FILE NO.21 02-0677 ACN 101 DATE 06-16-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUHKARY 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: 05-27-2003
PRINCIPAL TAX DUE:_
39,872 .12
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-11-2002 CDOO 1734 1,993.61 43,000.00
05-29-2003 REFUND .00 5,121. 49-
TOTAL TAX CREDIT 39,872.12
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 PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CRI,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ELEANOR BULLOCK
Date of Death: 7/13/02
Will No. 2002-00677
Admin. No.
Pursuant to Rule 6. 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
I . 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. I is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
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 the Orphans' Court and may be attached to this report.
Date: 6/18/04
A~~.~J~
- I
Signature
GERALD J. BRINSER
Name (Please type or print)
6 E. MAIN STREET, PO BOX 323
PALMYRA PA 17078
Address
(717) 838-6348
Tel. No.
Capacity:
Personal Representative
X
Counsel for personal
representative
t.,