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HomeMy WebLinkAbout03-0966 Stephanie E. Chertok, R.N., Esq. ATTORNEY AT LAW 61 West Louther Street (717) 249-1177 Carlisle, PA 17013-2936 FAX (717) 249-4514 November 24, 2003 Cumberland County Register of Wills 1 Courthouse Square Carlisle, PA 17013 RE: Estate of John F. Barrick, Jr. Dear Register: I hereby authorize you to change the Personal Representatives' names on the Petition for Probate and Grant of Letters in the above captioned Estate. The Personal Representatives' names should be changed to: KAREN SUE SWARTZ TERRI KEENEY Sincerely, John C. Porter, Esquire Before the Register of Wills of Cumberland County, Pennsylvania Name of Decedent: John F. Barrick, Jr. Date of Death: October 1, 2003 File No.: 2003-00966 Status Report under Rule 6.12 Pursuant to Pule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect completion of the administration of the above captioned estate: 1. State whether administration of the estate is complete: Yes: X No:~ 2. If the administration of the estate if not complete, state when the personal representative(s) reasonably believe(s) that the administration will be complete: 3. If the administration of the estate is complete, state the following: a. Did the personal representative(s) file a final account with the Court? Yes: No: X b. Did the personal representative(s) state an account informally to the parties in interest? Yes: X No: 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. 3mdrew H. Shaw Supreme Court I.D. No. 87371 :., 61 West Louther St. · Carlisle, PA 17013 717-249-1177 _ Capacity: Personal Representative ~ X Counsel for Representative Register of Wills of Cumberland County Petition for Probate and Grant of Letters Estate of JOHN F. BARRICK, JR. No. c~~] -0 3- q (t~9 Social Security No. 190-26-6624 Petitioners who are 18 years of age or older, apply for: ~-~ Probate and Grant of Letters Testamentary and aver that Petitioners are the Executrixes named in the last Will of the above Decedent dated March 26, 1992. Decedent was domiciled at death in the BOROUGH OF CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA, principal residence at 1860 AERONCA STREET, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA 17013. Decedent, then 75 years of age, died October 1, 2003, at HEALTH CARE SOUTH REHAB HOSPITAL, MECHANICSBURG, PENNSYLVANIA. Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $3,325.00 (If not domiciled in Pa.) Personal property in Pennsylvania $0.00 (If not domiciled in Pa.) Personal property in County $0.00 Value of real estate in Pennsylvania situated as follows: $130,000.00 TOTAL $133,325.00 WHEREFORE, Petitioners respectfully request the probate of the last Will presented herewith and the grant of letters testamentary thereon. 1850 AERONCA STREET 1010 CRANES GAP ROAD CARLISLE, PA 17013 ~ CARLISLE, PA 17013 OATH OF PERSONAL REPRESENTATIVES COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : The petitioners above-named swear that the statements in the foregoing petition are true and correct to the best of the knowledge of petitioners and that as co-personal representatives of the above decedent, petitioners will well and truly administer the estate according to law. Swom to and subscribed before me this 19tltlay of KAREN~oS~fieSWARTZ Nouember, 2003. , . .-~ ~/ ?-t'? °~-- ffRegister- Donna M. Otto, 1st Estate of JOHN F. BARRICK, JR., Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, November 26th; 2003, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated March 26, 1992, described therein, be admitted to probate and filed of record as the last will of JOHN F. BARRICK, JR. and Letters Testamentary are hereby granted to KAREN S. SWARTZ and TERRI ~. KEENEY. Register of Wills Donna tq. ott6, l~t FEES ~~ ~~ Probate, Letters, Etc. $ 235.00 Short Certificates 4 $~ Johfi C. Porter, Esq. Renunciation $ Stephanie E. Chertok, R.N., Esq. x-Pages ( 2 ) $ 6.00 61 West Louther Street JCP 16WrxM~ $ 10.00 Carlisle, PA 17013 Filed: November ~/~th, 20035263.00 Total 717-249-1177 Called Attorney on 11/2~/2003 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 9610091 OCT 2 2oo3 No. ~ Date mos.~3 R~, 2/a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS · .T CERTIFICATE OF DEATH · ~t.' %(% t~Cl CIL, ~ ~, "~le '.190 .... 26 -- 6624 4. ~to~r 1,"'2~3 Febma~ 2 75 ~. : ~,. 1928 '~ ~ ~ C~rl~d Mech~icsburg ,Health South Reh~ Hospital ~ ~,~.. ~'~'~ .... ,,~ Security ,,~Hospital h,. I,,. 6 I ,. Divorc~ ,,. 18~ Aeron~ St. ,~ ~rlisle PA 17013 ~' ,~.~ ~r~and ~' ,~,.~ ~.~ ,m. John ~r~c Sr. ~, Leona Patterson m. ~renoa na~en ~. 371 ~n R~d, ~rlisle PA 17013 ~ ~ 0 ~ot~r 3, 2~3 lWaggoners Unzt~ Meth~ist N. Middleton D-, PA ~~ ~ ~ ~~ ' 0131~ L I ~'~'~'~~.~.~ .... ~-~-~.,~ .................................... ........ . ............................................................. 21-2003-966 OF JOHN F. BARRICK, JR. I, JOHN F. BARRICK, JR., of 1860 Aeronca Street, Carlisle, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any and all wills and codicils heretofore made by me. ITEM I: My personal representative shall pay from the residue of my estate the expenses of my last illness, funeral and burial debts duly allowed against my estate, and estate taxes occasioned by my death and incurred with respect to property passing by this Will. It is my desire that I be cremated. ITEM II: I bequeath my automobiles personal effects, , household goods, and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, if any, as set forth in a separate memorandum which I shall place with my Will to the persons therein designated. If I shall leave no separate memorandum, or with regard to my automobiles, personal effects, household goods, and other tangible personalty of like nature (not including cash or securities) not referenced by such memorandum, I bequeath such property to my children, K~REN SUE SWARTZ, TERRI KEENEY, BRENDA HAREN, and NANNETTE STEWART, to be divided among them by my Executrices with due regard for their personal preferences in as nearly equal shares as practical. 2 ITEM III: I bequeath the sum of Five Hundred Dollars ($500.00) to each of my grandchildren. ITEM IV: I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares, with one (1) share for each of my children who survive me, and one (1) share for my friend, HELEN LAU, provided she survives me. ITEM ¥: I appoint my Daughters, KAREN SUE SWARTZ and TERRI KEENEY, as Co-Executrices of this my Last Will and Testament· Should either fail to qualify or cease to act as Co- Executrix, I appoint the other as Executrix of my estate. ITEM VI: I direct that my Co-Executrices and their successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I, JOHN F. BARRICK, JR., have hereunto set my hand and seal to this my Last Will and Testament, consisting of two (2) typewritten pages, each of which bears my signature, this ~ day of /~CH , 1992. · Barrick, Jr., Testator COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND ) WE, JOHN F. BARRICK, JR., TAYLOR P. ANDREWS, and ~f-~.{ Z, J~5~- , the Testator and witnesses, respectively, whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as and for his Last Will and Testament and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge the Testator was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. rrick, J~., Testator ~~or P. An~~/Witness Subscribed, sworn to and acknowledged before me by JOHN F. B~ICK, JR., the Testator, and subscribed to and sworn or af~$~ed to b~,re me by TAY~R P. ~DREWS and ~/~ ~ ~~ , witnesses, this ~ ~- day of ~~ ~ 1992 ~ta~ ~blic ~DA L. BREHM, NOTARY ~RUC MY ~MM~S~N ~RES ~N~RY 6, 3OHN F. BARRICK, JR. ANDREWS & JOHNSON ATTORNIEYS AT LAW TAYLOR P. ~d~IDR]EL'NVS RONALD E. JOHNSON IO SOUTH COURTHOUSE AVENUE CARLI{~LE, PENNSY~.V~NIA 17013 ~'~I..m'PHONE (717) 243-012.~ CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: JOHN F. BARRICK, JR. Date of Death: October 1, 2003 No. 2003-00966 PA No. 21-03-0966 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 this I~r~ day of December, 2003. Name Address MS. HELEN LAU 400 GANETT ST., HARRISBURG, PA 17112-3030 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: KAREN S. SWARTZ 1850 AERONCA ST., CARLISLE, PA 17013 TERRI L. KEENEY 1010 CRANES GAP RD., CARLISLE, PA 17013 BRENDA HARREN 371 CORNMAN RD., CARLISLE, PA 17013 NANETTE STEWART 28 WARWICK CIRCLE, MECHANICSBURG, PA Notice was not sent to Karen S. Swartz and Terd L. Keeney who are the decedent's daughters and executrices and who consequently are on Notice of the Grant of Letters and the Administration of the Estate. The decedent's other two daughters, named in the will, Brenda Harren and Nanette Stewart, attended the initial consultation with the Attorney for the Estate, and they, too are on Notice of the Grant of Letters and of the Administration of the Estate. These foui daughters are the only issue of the decedent and are the parents of the grandchildren named in the Will. In accord with PA Orphans' Court Rule 5.6(a)(4), and as stated above, the parents of the beneficiaries who are minor children, are on Notice of the Grant of Letters and the Administration of the Estate. ~ Signature: Signature: , -~ll K'~en S. ~w~tz d Terri L. Keeney J Jo~ C. Porter, E~q. Personal Representative Personal Representative CS-£ounsel for Personal Representative 1850 Aeronca Street 1010 Cranes Gap Road PA Sup. Ct. ID# 90152 Carlisle, PA 17013 Carlisle, PA 17013 61 W. Louther Street 717-245-0589 717-243-4601 Carlisle, PA 17013 : 717-249-1177 Date: l'~loI !0~::~  PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28060 INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESIDENT DECEDENT COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z John F. Barrick, Jr. 190 - 26 - 6624 IIII DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE UJ REGISTER OF WILLS O 10/01/03 02/02/28 III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I~1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) ,~, E: ~ [] 4. Limited Estate I~ 4a. Future Interest Compromise (date of death after 12-12-82) I'~ 5. Federal Estate Tax Return Required [-~ 6. Decedent Died Testate of ~:] 7. Decedent Maintained a Living Trust (Attach of Trust) 0 8. Total Number of Safe Deposit Boxes < [] 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-%95) I~ 11. Election to tax under Sec. 9113(A)(Attach Sch O) Z "' NAME COMPLETE MAILING ADDRESS z John C. Porter ~ Esq. o ~ 61 West Louther Street m FIRM NAME (If ADpiicable)~ ,,, ~gtepnan~e ~.Chertok, R b~ , Esq. ~ ' ' Carlisle, PA 17013 '"' TELEPHONE NUMBER o o (717) 249-1177 1. Real Estate (Schedule A) (1) $ I O 2, 900. O O 2. Stocks and Bonds (Schedule B) (2) O . 00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0. O 0.~ 4. Mortgages & Notes Receivable (Schedule D) (4) 0 , 0 0_. 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) $1 3 , O 2 9 . 6 i (Schedule E) f""J 6. Jointly Owned Property (Schedule F) (6) O. O O ~ [] Separate Billing Requested 22) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) $ 2 3,1 4 7.9 7 ~ (Schedule G or L) ._:. ,~ 8. Total Gross Assets (total Lines 1-7) (8) "~1 3 9,0 7 7. 5 8 LU 9. Funeral Expenses & Administrative Costs (Schedule H) (9) $1 4 ~ 1 81 . 5 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) $ $ i , 6 5 8. 9 2 11. Total Deductions (total Lines 9 & 10) (11) $1 5 , 7 97 · 4 7 12. Net Value of Estate (Line 8 minus Line 11) (12) $ i 2 3, 2 3 7 · 1 1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) O o 00 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $1 2 3,2 3 7.1 1 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES  15. Amount of Line 14 taxable at the tax ~ rate, or transfers underSec. 9116(a)(1.2)sp°usal O . OO x .0 __ (15) 0 . O0  16. Amount of Line 14 taxable at lineal rate $ 9 5, 2 8 9 . 2 8 x .0 4 5 (16) $ 4, 2 8 8. O 1 17. Amountof Line 14taxable at sibling rate O. OO x .12 (17) O. OO ~ 18. Amount of Line 14taxable at collateral rate $ 22 .. 947 . 83 x .15 (18) $ 3; 44'2 . I 7  19. Tax Due (19) $ 7,7 30. 1 8 Decedent's Complete Address: STREET ADDRESS 1860 Aeronca Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) $ 7 , 7 30. 1 8 2. Credits/Payments A. Spousal Poverty Credit O o O O B. Prior Payments 0.00 C. Discount O. O O Total Credits ( A + B + C ) (2) 0 ./00 3. Interest/Penalty if applicable D. Interest O. O O E. Penalty O. O 0 Total Interest/Penalty ( D + E ) (3) 0.0 0 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) $ 7,7 30. 1 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $ 7,7 3 0.1 8 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO AI~Y OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S~I"~URE OF PE'SONCESPO~IBLE FOR FILING RETURN' (~/~t DATE[ ADDRESS // -.. ,,.. ' 81GNATURE OF~[tEP~,RER O~EB-"I'HAN R~PREfS[=NTATIVE DATE ADDRESS 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) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a, individual who has at least one parent in common with the decedent, whether by blood or adoption. FacetWin Screen Print for assessO1, from "CAMA_LOgin" 6/18/04 2:34:05 PM CUMBERLAND COUNTY ASSESSMENT OFFICE NEIGHBORHOOD: 765 CONTROL # 29003042 DISTRICT: 29 - NORTH MIDDLETON TWP SD: 3 PARCEL: 29-17-1585-114. ISPEC ID: LOT: L-0001 , Tback: Short Name : BARRICK, JOHN F JR LAST NAME : BARRICK JR I I PROPERTY TYPE: R ] FIRST NAME : JOHN F C/O NAME : SALES ADDRESS1 : 1860 AERONCA STREET DEED BK/PG ..... 0032X-00307 ADDRESS2 : DATE Of SALE...09/02/1987 POST OFFICE: CARLISLE SELLING PRICE: 1 STATE & ZIP: PA 17013 Situs: 1860 AERONCA STREET CURRENT VALUES Prop Oescrip.: J Assessed Fair Market ~ LAND DESC: LOT 1 PB 39 PG 75 FMV - 102900 L - 231201 LAND USE TYPE: 101 C&G - B - 79780 | DEEDED ACRES: .42 approved? -> T - 1029001 Screen 1 Enter Selection > Record: 55019 Number -Switch Screens, x -Exit, J -Jump Mode, F -Forms, I -Image Down Arrow -Next Entry, Up Arrow -Previous Entry, ? -Screens, B -Browse REV-1502EX + (1-97) SCHEDULE A COMMONWEA'T. OFPE..SY.VA.,^REAL ESTATE ESTATE OF FILE NUMBER All mai pmpe~ o~ed sole~ or as a tenant in common must be m~Aed at ~ir market value, Fair maAet value is defined as the pd~ at which pmpe~ would ~ ex~anged ~n a willing buyer and a willing seller, neither being compelled to buy or sell, bo~ having reasonable knowledge of ~e relevant fa~. Real pm~ ~ich is jointly-o~ed ~h right of su~ivomhip must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Single Fam~l~ D~e11~g .42 Ac~es 1860 Aero.ca S~. Ca~11sle, ~A. 17013 Conveyed o~ 8/24/1987 by Ge~e~al ~a~a~y Deed f~om ~usba~d a~d ~fe ~o ~usba~d $102,900 TOTAL (Also enter on line 1, Recapitulation) $1 0 2,9 0 0 (If more space is needed, insert additional sheets of the same size) ,~.,=~.,~.,7, ~ SCHEDULE B COMMO,W~LTHOrPE,NS~'V^",A STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, Jr. '~t-- O~ --0~6~ All prope~ jointly-o~ed ~h ~ght of su~o~hip must ~ disclosed on Sch~ule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF D~TH 1. ~O~E TOTAL (Also enter on line 2, Recapitulation) $ 0 (If more space is needed, insert additional sheets of the same size) REV-1504 EX + (1o97) SCHEDULE C COMMONWEALTH~"Jk~='~OF PENNSYLVANIA CLOSELY-HELD CORPORATION, iNHERITANCE TAX RETURN PARTNERSHIP or SOLE-PROPRIETORSHIP RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, Jr. 7--~--O~--(~96~ Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corpomtJon/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE TOTAL (Also enter on line 3, Recapitulation) $ O (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (1-97) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, Jr. ~-I-O~--OC~06 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE TOTAL (Also enter on line 4, Recapitulation) $ 0 (If more space is needed, insert additional sheets of the same size) R~-I~ ~ + (1-9~ ~ SCHEDULE E COMMONWE^LTH~OF PENNSYLV^NIA CASH, BANK DEPOSITS, & MISC. INHERITANCE T~RETURN RES,0ENT DECEDENT PERSONAL PROPERTY EST~E OF FILE NUMBER John F. Barrick, Jr. zI-oB-o?66 Include the pm~s of litigation and the da~ the proceeds were m~ived by He es~. All pmpe~ ~int¥o~ed ~h the right of su~ivo~hip must be disclosed on Schedule F. ITEM ~LUE AT ~TE NUMBER DESCRIPTION OF D~TH 1. Waypoint Bank Account #1903007507 $5,765 47 2 Waypoint Bank Account #1900005843 $1,492 42 3 Cash on Hand $400 00 4 1994 Ford Tempo $800 00 5 1981 Chevrolet Scottsdale $375 O0 6 Gun Collection $1,200 O0 7 Couch $50 O0 8 Coffee and End Tables $25 O0 9 Recliner $50 O0 10 Bed $150 00 11 Dresser $100 00 12 Kitchen Table and Chairs $150 00 13 Lawn Mower $25 O0 14 Dishes and Flatware $50 O0 15 Tools $100 O0 16 Crossbow $100 O0 17 Television $50 O0 18 Wooden Rocking Chair $25 O0 19 Entertainment Center $20 00 20 China Cabinet $25 O0 21 Pictures $30 O0 22 Miscellaneous Household Items $173 O0 23 Rental Income $1,750 O0 24 Vehicle Insurance Refund (State Farm) $123 72 TOTAL (Also enter on line 5, Recapitulation) $1 3,0 2 9. 6 1 (If more space is needed, insert additional sheets of the same size) ,~v.,.~x.,~.,7, ~ SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWN ED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, ar. LI-oM-o966 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. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifi/ing number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES1 1. A. NONE TOTAL (Also enter on line 6, Recapitulation) $0. 0 0 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER John ¥. Barrick, Jr. This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM ~NCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST {~FAP"_~CASLE) 1. AIG Life Insurance Company Annuity $23,147.97 100 $23,147.9' Account #T002997560 TOTAL (Also enter on line 7, Recapitulation) $ 2 3, 1 4 7.9 7 (If more space is needed, insert additional sheets of the same size) REV-1511EX + (1-97) SCHEDULE H COMMONWEALTH~OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, Jr. Ct'e%-O966 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home Funeral & Burial Expenses $6,774.80 2. N.L. Minnich & Sons, Inc. Footer $100.00 3. Funeral Reception and Minister's Fee $64.00 4. Headstone $1,200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's CommissionsN O N E Name of Personal Representative (s) Social Secudty Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Stephanie E. Chertok, R.N. , Esq. 2. A~°meyFees 61 West Louther St., Carlisle, PA 17~13 $5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) N O ]~IE Claimant Street Address City State __ Zip Relationship of Claimant to Decedent File Inheritance Tax Return, Inventory,Family 4. Probate Fees Settlement Agreement, Probate, etc. $309.00 5. Accountant's Fees N O NE 6. Tax Return Preparer's FeesN O N E 7. Advertising for sale of Real Estate located at 1860 Aeronca Street, Carlisle, PA 17013 $140.00 8. Preparing home for sale Painting $47.75 Carpeting $503.00 9. Auctioneer's Commission on sale of Personal Property $43.00 TOTAL (Also enter on line 9, Recapitulation) $1 4,1 8 1.5 5 (If more space is needed, insert additional sheets of the same size) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER John F. Barrick, Jr. ~1--05-~9 ~6 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Department of Veterans Affairs $14 00 2 Comcast Cable $14 30 3 O'Brien, Baric, & Scherer $67 50 4 Sprint $31 31 5 York Waste $10 86 6 Duron Paints $42 09 7 PP&L $68 45 8 Health South $8 48 9 North Middleton Authority $84 10 10 Sprint $44 74 11 Aero Energy $177 01 12 Comcast $14 30 13 Aero Energy $36 03 14 North Middleton Authority $76 80 15 Aero Energy $155 87 16 Erie Insurance Group $289 50 17 North Middleton Authority $90 08 18 Erie Insurance Group $17 50 19 North Middleton Authority $79 90 20 2004 Real Estate Taxes $336 10 TOTAL (Also enter on line 10, Recapitulation) $1, 6 5 8. 9 2 (if more space is needed, insert additional sheets of the same size) SCHEDULE J COMMONWEALTH OFPENNSWV^N,A BENEFICIARIES INHERITANCE TM RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER John F. Barrick, Jr. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPER~ Do Nm LiN Trustee(s) OF ESTATE [. TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 1. Ms. Helen Lau Friend $22,947 83 2 Karen S. Swartz Daughter $23,822 32 3 Terri L. Keeney Daughter $23,822 32 4 Brenda Harren Daughter $23,822 32 5 Nanette Stewart Daughter $23,822 32 6 Heather Lottes Grandchild $500 O0 7. Colby Swartz Grandchild $500 O0 8. Courtney Nickel Grandchild $500 O0 9. Ryan Nickel Grandchild $500 O0 10 Camron Barrick Great-Grandchild $500 O0 11 Kyle Harren Grandchild $500 O0 12. Brody Harren Grandchild $500 O0 13. Mitchell Stewart Grandchild $500 00 14. Chandler Stewart Grandchild $500 O0 15. Hunter Stewart Grandchild $500 O0 *See attached sheet for addresses ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET [1. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. NONE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NObTE TOTAL OF PART I[ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE13 OF REV1500 COVER SHEET $123 , 237 . 11 (If more space is needed, insert additional sheets of the same size) Names and addresses of persons receiving property (Schedule J): 1. Helen Lau 400 Gannett Street Harrisburg, PA 17112-3030 2 Karen S. Swartz 1850 Aeronca Street Carlisle, PA 17013 3 Terri L. Keeney 1010 Cranes Gap Road Carlisle, PA 17013 4 Brenda Harren 371 Cornman Road Carlisle, PA 17013 5 Nanette Stewart 28 Warwick Circle Mechanicsburg, PA 17055 6 Heather Lottes 11709 Lord Phillip Ct. Germantown, MD 20876 7 Colby Swartz 624 N. West Street Carlisle, PA 17013 8 Courtney Nickel 6 West Louther Street Carlisle, PA 17013 9 Ryan Nickel Same as above 10. Camron Nickel Same as above 11. Kyle Harren 371 Cornman Road Carlisle, PA 17013 12. Brody Harren Same as above 13. Mitchell Stewart 27 Warwick Circle Mechanicsburg, PA 17055 14. Chandler Stewart Same as above 15. Hunter Stewart Same as above JOHN F. BARRICK, JR. ANDREVV~B & JOHNSON ATTORNL~YS AT l-AW TAYLOR P. WB~QDR~9/VS ROI',~a~LD E. JOHNSON I0 SOUTH COU~HOUSE A~NUE ~RLI~LE, PENN~V~IA ~) ~LEPHONE (717) 243~123 LAST WILL AND TESTAMENT OF JOHN F. BARRICK, JR. I, JOHN F. BARRICK, JR., of 1860 Aeronca Street, Carlisle, cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any and all wills and codicils ~eretofore made by me. ITEM I: My personal representative shall pay from the ~esidue of my estate the expenses of my last burial debts duly allowed against my estate, and estate taxes occasioned by my death and incurred with respect to property passing by this Will. It is my desire that I be cremated. ITEM II: I beql/eath my automobiles, personal effects, household goods, and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, if any, as set forth in a separate memorandum which i shall place with my Will to the persons therein designated. If I shall leave no separate memorandum, or with regard to my automobiles, personal effects, household goods, and other tangible personalty of like nature (not including caen or uecurities) not referenced by such memorandum, I bequeath such Property to my children, K~REN SUE ~TZ, TE~I KEENEY, BREND& H~N, and N~NN~ STEWART, to be divided among them by my 8xecutrices with due regard for their personal preferences in as nearly equal shares as practical. COMMONWEALTH OF PENNSYLV~NIA) : SS. COUNTY OF CTTMBERLAND ) WE, JOHI~ F. BARRICK, JR., TAYLOR P. ANDREWS, and /~r'~/~'/ ~. . 5~ , the Testator and witnesses, / respectively, whose names are signed to the foregoing or attached inst~ent, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instr~ent as and for his ~st Will and Testament and that he signed willingly and that he executed as his free and voluntary act for the pu~oses therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their ~owledge the Testator was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~ohn F. Barrick, Jr., Testator 'Tabor P. And~,~' Witness / / , Witness / / S~scribed, swo~ to and ac~owledged before me by JOHN F. B~ICK, ~., ~e Testator, and s~scribed to and sworn or aff$~ed t~ he.re me by TAY~R P. ~D~S and ~,~,/~/--. ~,,~:~, , witnesses, ~is ~ ~ day of Nota~ ~lic ~ L. ~M. ~T~ ~C ~S~ ~, CUMB~D ~ MY ~MM~N ~R~ ~ 6. 1~ ITEM III: I bequeath the sum of Five Hundred Dollars ($500.00) to each of my grandchildren. ITEM IV: I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares, with one (1) share for each of my children who survive me, and one (1) share for my friend, HELEN LAU, provided she survives me. ITEM V: I appoint my Daughters, KAREN SUE SWARTZ and TERRI KEENEY, as Co-Executrices of this my Last Will and Testament. Should either fail to qualify or cease to act as Co- Executrix, I appoint the other as Executrix of my estate. ITEM VI: I direct that my Co-Executrices and their successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I, JOHN F. BARRICK, JR., have hereunto set my hand and seal to this my Last Will and Testament, consisting of two (2) typewritten pages, each of which bears my signature, this ? ~' day of /f~ ~ c~- , 1992. ~'~~ohn F COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004101 PORTER JOHN C ESQUIRE 61 WEST LOUTHER STREET CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 87,730.18 ESTATE INFORMATION: SSN: 190-26-6624 FILE NUMBER: 2103-0966 DECEDENT NAME: BARRICK JOHN F JR DATE OF PAYMENT: 06/30/2004 POSTMARK DATE: 06/30/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/01/2003 TOTAL AMOUNT PAID. $7,730.18 REMARKS: CHECK# 1333 INITIALS: JA ' SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS In re: Estate of John F. Barrick, Jr., deceased Estate No. 2003 - 00966 : PANo. 21-03-0966 PRACEIPE TO ENTER APPEARANCE AND WITHDRAWAL TO THE PY~: 1. Kindly enter the appearance of Andrew H. Shaw, Esquire, and Stephanie E. Chert°k, R.N., Esquire as Counsel of Record for the Estate in the above matter. Please serve all papers to 61 West Louther Street, Carlisle, PA 17013. 2. Please withdraw the appearance of undersigned counsel on behalf of the Estate, John C. Porter. I, John C. Porter, Esquire, hereby withdraw my representation on the defendant in the above caption~!vnatter. ~i5 57-~O~ 'O / ~.'/2004 John C. Poj~e~, Esqu' /2004 BY: , ~'/~('A~-~_f Andrew H. Shaw, Esq. PA Sup. Ct. 1D0 87371 Stephanie E. Chertok, R.N., Esq PA Sup. Ct. ID# 52651 Attorney's for Estate 61 W. Louther St. Carlisle, PA 17013 717-249-1177 COMNONNEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE ~NHER'TANC~TAX D~V~S~ON DEPT. ~0£01 HARE 'RG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX R£V-IS47EXAFP(OI-OI) ~ri,~.~ ..... DATE 09-1q-ZOOq ESTATE OF BARRICK JR JOHN F DATE OF DEATH 10-01-2003 FZLE NUMBER 21 03-0966 COUNTY CUMBERLAND JOHN C PORTER ~ ~EP 1~ ,~ :~ ACH 101 61 N LOUTHER ST Amount Remitted CARLISLE [.:L,~;PA 17013 I HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT~ ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BARRICK JR JOHN F FILE NO. 21 03-0966 ACN 101 DATE 09-1~-200~ TAX RETURN NAS: ( ) ACCEPTED AS FILED { X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 102z900.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 cradlt to your account, $. Closely Held Stock/Partnarshlp Interest (Schedule C) ($) .00 submlt the upper portlon ~. Mortgages/Notes Receivable (Schedule D) (~) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 13;029.61 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) 23z1~7.97 8. Total Assets (8) 139,077.58 APPROVED DEDUCTIONS AND EXEHPTZONS: 1~,181.55 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Hortgage LAabillties/Liens (Schedule Z) (10) 1;658.92 11. Total Deductions (11) 15.8~§.~7 12. Net Value of Tax Return (12) 123,237.11 15. Charltabla/Govarnaantal Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 1~. Nat Value of Estate Sub~ac~ to Tax (1~) 123,237.11 NOTE: 1~ an assess;ant ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~111 reflect flgures that lnclude the total of ALL returns assessed to date. ASSESSHENT OF TAX: 16. Amount of L/ne lfi at Spousal rata (15) .00 X O0 = .00 16. Amoun~ of Line 1~ taxable at Lineal/Class A rata (16) 10~,96~.28 X 0~5 = 17. A;oun* of Line lq at Sibling rata (17) .00 X 12 = .00 18. Amoun~ of Line 1~ taxable at Collateral/Class B rate (18) 18,272.83 X 15 = 2,7~0.93 19. Principal Tax Due (19)= TAX CREDITS: PAYfl~NT RECEZP1 DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-30-200~ CDO0~101 .00 7,730.18 TOTAL TAX CREDIT I 7,730.18 BALANCE OF TAX DUEl 265.85CR INTEREST AND PEN. . O0 TOTAL DUE 265.85CR ZF PAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS REg~UIRED. FOR CALCULATION OF ADDITIONAL TNTEREST. TF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class D (collateral) rate on any such futura interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act ZS of 2000. (72 P.S. Section 9140). PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake chock or money order payable to: REGISTER OF NILLS~ AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any of tho Z$ Revenue District Offices, or by calling the special Z~-hour answering service for forms ordering: 1-800-56Z-Z050~ services for taxpayers eith special hearing and / or speaking needs: 1-800-447-~020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disalloHanca of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --mritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. lB0601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-15Ol) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SX) discount of the tax paid is allowed. PENALTY: The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has bean assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 19BZ bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will very from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 era: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rata Factor Year Rate Factor ~ lOX .O005~B ~'8-1991 Ill .000501 ~ 9X .OOOZ~7 1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6Z .000164 1984 llZ .000301 1995-199~ 7Z .000192 2003 5Z .000157 1985 152 .000356 1995-1998 92 .000247 2004 42 .000110 1986 lOZ .000Z74 1999 7Z .O0019Z 19B7 iOZ .000276 2000 7Z .O0019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (6-88) · ~ INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REV~NU~ OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENTS NAME FILE NUMBER Barrick, John F. Jr. 2103-0966 REVIEWED BY ~,CN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES G I Annuities are fully taxable with no exclusion. G 1 Named beneficiary assets and bequests are taxable outright to the beneficiary/ies before determining residue. Line 11 The value of the total deductions has been adjusted as the result of the correction of an error in arithmetic. ROW Page 1