HomeMy WebLinkAbout04-0643 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of GLEN A. ERB
also known as ' To:
, Deceased.
Social Security No. 717-09-5652
The petition of the undersigned respectfully represents that:
Register of Wills for the
County of CUMBERLAND
Commonwealth of Pennsylvania
Your petitioner(s), who is/are 18 years of age or older an the executrix
in the last will of the above decedent, dated Aufuat 77 '199S
and codicil(s) dated NONE
in the
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with
h is last family or principal residence at MANOR CARE OF CAMP HILL~ '1700 MARKET STREET7
CAMP HILL7 CAMP HILL BORO7 PENNSYLVANIA
(list street, number and municipality)
Decedent, then 87. years of age, died 61'1'1104
at MANOR CARE OF CAMP HILL7 '1700 MARKET ST7 CAMP HILL7 CAMP HILL BORO7 PA
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never ajudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ 967000.00
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters TESTAMENTARY
there~n. . -~ I /- ~ / (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
-'/ / >~,~' . 440 WOODLAND DRIVE
~ ? ~.i~,/i./.l?~f.~D~. {~o xtJL,(LJt _ DILLSBURG PA t70'19
~ /.~N-~ L. F.~H'~NOUI~ ..... ---' -
)UDI'I:H L. BREWB,~KE~ --
6 EAST BEALE AVENI/E-*
ENOLA PA 17025
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUUBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as person__al represen-
tative(s) of the aboveldecedent petitioner(s) will well and~trujly ]tdminister th~ e~tate ac.c~,r~ng to law.
Swomtooraffirmedlandsubscribed .,. ,X ~/ ~'~ l { ~/ ~
before me this I 4;/~c~ day of / ,
Estate of GLEN A. ERB ~ Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
~
AND NOW i ~ \ ~L .. ~Qq-~ , in consideration of the petition on
the reverse side hereof~atisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 8/7/95
described therein be admitted to probate and filed of record as the last will of GLEN A. ERB
and Letters TESTAMENTARY
are hereby granted to
NANCY L. ESHENOUR and JUDITH L. BREWBAKER~ CO-EXECUTRIXES
FEES
Probate, Letters, Etc ......... $~L,~, ~
Short Certificates (.~) ...... $ Ot .~
~a~i~w_au~o~x..~ $ to.oo
TOTAL ~ $ ~
Filed...~.-. I.~-: .~.~..t~ ...........
MURREL R. WALTERS III, ESQUIRE
24849
ATTORNEY (Sup. Ct. I.D. No.)
54 EAST MAIN STREET
MECHANICSBURG PA 17055
ADDRESS
717-697-4650
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
- Local Registrar
dUN 1 5 2004
' - Date
· ::: ~2
C.2_
NAME OF DECEDENT (Fkst. MiddY, Last)
Glen A.
1.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS -~
CERTIFICATE OF DEATH
SOCIAL SECURITY NUMBER I DAlE OF DEATH (Month. Day. Year)
~. 717 -- .09 --5652 14. June II, 2004
AGE (Last Billhday) INDER I YEAR
8 7 Yrs
COUNTY OF DEATH
Cumb e r i and
DECEDENT'S USUAL OCCUPATION
J SEX
2. Male
DATE OF BIRTH BIRTHPLACE (City and PLACE OF DEATH (Check only 9nq~ - §~e in~truqhon~ 9q othej' ~id~)
(Month, Day, Year)Smta ~ Fme~n Counl~) I .OS .... I ......
7/24/1916 ~.McClure PA ......... ~ e~, ...... ~ oo~ .~,~ ~
I~". I ~
CI~, ~ORO, ~P OF D~TH FACILI~ NAME (If nol Jnslilution, give slr~l and numar} WAS DECEDENT OF HISP~IC ORIGIN?
INOffi Yes ~ If yes, ~ Cu~n,
Camp Hill Manor Care of Camp Hill I~ex~an, P.e~ri~n,e~c.
KIND OF BUSINESS / INDUSTRY DECEDENT EVER IN DECEDENT'S EDUCATION
~a. Trainman ~b. Conrail
DECEDENTS MAILING ADDRESS (Slreet, City/Town, State, Zip Code) I DECEDENTS
Manor Care of Cam,? H].ll ~CE[~UDaeLNcE
· k ia t KY . } I (See instructions
,'TK 17012/ I on other s~e)
RACE -Amedcan thdian, Black, WNte, et
(Speofy)
tMARITAl. STATUS - Maraud, I SURVIVING SPOUSE
U.S. ARMED FORCES? Never Man-iud, Widowed. I {if w,fe, gi~ m&~en name}
Yes r-1 Nol~ ElemenlarylSecondery College Divorced ~Sp~cJfy)
(of21 ( ....,.t Widowed
14. t5.
17a, State PA
lIbmCOUnt¥ Cumberland
Did
ITc. LJ Yes, decedent lived in
decedent
live in a
township? l?d.[~'] No, desedentlived Camp Hill
within actual limits of
FATHER'S NAME (First, Middle. Last) I MOTHER'S NAME (First, Middle, Maiden Surname)
~. Jay grb t~g' Bessie Morgan
INFORMANTS NAME (Type/Print) INFOI;IMANT'S MAILINI~ ADDRESS (Stt~t~I, City/Town. ~tate, Z~C,i~.
z0.. Judy Brewbaker I~0b. 6 g. Beale Ave. Enola, PA {/uz>
METHOD OF DISPOSITION DATE OF DISPOSITION I pLACE OF DiSPOSitiON- Name el Cemetery, Crematory {LOCATION - City/Town, state, Zip code
2ia. Othar [] 21b. June 16, 2004 21¢ Stone Chruch Cemetery 21d Silver Springs Twp. PA
SIGNATURE OF LICENSEE OR I L,CENsE NuMBer I NAME AND ADDREss OF FACILITY
22b. FD 012774-L 22¢.Richardson F. H. 29S. Enola Dr. Enola,PA17025
IDATE SIGNED
when ce~hng death occurred at the time, date and place slated. LICENSE NUMBER [(Month, Day, Year)
physician ls not available at time of death to (Signature and Title
p~rso~ltems 24-26who p~onouncesmust be compleleddeath, by TIME OF DEATH lEAD (Month, Day, Year) mi 26.WAS CASE REFERREDyes:TO []A MEDICAL EXAMINER ¥~}RON~No
27, PART I: ; Approxm'.ata PART #:Other significant condil~nS contritxltmg to death, b~t
IMMEDIATE CAUSE (Finaldisease oi' condition ~'*H F :: onset and death
DUE tO (OR AS .... EQUENCE OF): //,~ ~.~ ¥~
Sequentially list conditions
thatCAusEcause'i' any, leading to JmmediateinitiatedEnter(DiseaseeventsUNDERLYiNGor injury [ c. DuEOUE TO (OR AS a CONSEQUENCE OF): / ~L ' /(: (?TO (OR AS A CONSEQUENCE OF): ~'"? ~ ::
COMPLETION OF CAUSE I Nat.,a, [] Ho-.cide []1 I I I
Y-E:{ NDE{
[] [] [] [] I" [] · []IPLACEOF.DRY-A,h , ..... ..... 'LOC^T,O"(B.t.D, /T ....
LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, GLEN A. ERB, a resident of Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do
make, publish and declare this to be my LAST WILL and TESTAMENT,
hereby revoking any and all Wills and Codicils previously made by
me o
I
I declare that I am married to EDNA G. ERB, and that I have
two (2) children, NANCY L. ESHENOUR and JUDITH L. BREWBAKER.
II
I direct that all my just debts and funeral expenses shall be
paid from my residuary estate as soon as practicable after my
decease.
III
I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of
the administration of my estate.
IV
I give, devise and bequeath all my property, whether real or
personal, wherever situate, including any property over which I may
have a power of appointment to my wife, EDNA, provided that she
survives me by thirty (30) days.
V
If my wife, EDNA, shall predecease or fail to survive me by
thirty (30) days, I give and bequeath TEN PERCENT (10%) of my
estate to ZION LUTHERAN CHURCH, Enola, Pennsylvania.
VI
If my wife, EDNA, shall predecease or fail to.s.urvive me by
thirty (30) days, I give and bequeath the following:
ONE THOUSAND DOLLARS ($1,000.00) to my grandson, BRETT A.
ES~ENOUR, per stirpes;
ONE THOUSAND DOLLARS ($1,000 00) 'tO my g~anddaughter, HEIDI L.
ESHENOUR, per stirpes;
ONE THOUSAND DOLLARS ($1,000.00) to my grandson, MICHAEL
BREWBAKER, per stirpes;
ONE THOUSAND DOLLARS ($1,000.00) to my grandson, MATTHEW J.
BREWBAKER, per stirpes;
ONE THOUSAND DOLLARS ($1,000.00) to EMILY STAMBAUGH, per
stirpes.
VII
All the rest, residue and remainder of my property, whether
real or personal, wherever situate, including any property over
which I may have a power of appointment, I give, devise, and
bequeath to my daughters, NANCY and JUDITH, in equal shares, per
stirpes.
VIII
I nominate, constitute and appoint my wife, EDNA, as Executrix
of this LAST WILL, to serve without bond. If my wife is unable or
unwilling to act in that capacity, then I nominate, constitute and
appoint my daughters, NANCY and JUDITH, as Co-Executrices of this
LAST WILL, to serve without bond. If either is unable or unwilling
to act in that capacity, then the other may act alone as Executrix
of this LAST WILL, to serve without bond.
IN WITNESS WHEREOF, I, GLEN A. ERB, have set my hand to this
LAST WILL this ~ ~/~ day of ~.~ ~3'~- , 1995.
GLEN A. ERB
Signed, sealed, published and declared by the above-named GLEN
A. ERB, as and for his Last Will and Testament, in the presenc~f
us, who, at his request and in his presence, and in the prese~e of
each other, have hereunto subscribed our/names as w~nesse~/
Sworn or affirmed to and acknowledged before me by GLEN A. ERB,
Testator, this 7 ~/~ day of /~4~j~' , 1995.
-j
Notary Public
AFFIDAVIT
Notarial Seal
Diane M, Smith, Notary Public
Mechanicsburg Boro, Cumberlard County
My Corr~mission Expires June 22, 19?3
COMMONWEALTH OF PENNSYLVANIA :
ss.
COUNTY OF CUMBERLAND :
We, /w~7~£[~/ /~. ~Jd./~rJ, ~ and ~, ~ ,//~C~I' ,
the witnesses whose names are signed to the attached or foregoing
instrument being duly qualified according to law, do depose and say
that we were present and saw Testator sign and execute the
instrument as his LAST WILL; that GLEN A. ERB signed willingly and
that he executed it as his free and voluntary act for the purposes///~-
therein expressed; that each of us in.the hearing and sight of t~e
Testator signed the Will as witnesses, and that to the~est of/Our
knowledge, the Testator was at the time 18 y~ars of age/or morg~, of
sound mind and under no constraint or influe {.///
Sworn or affirmed to and acknowledged before me
this ~ day of ~S&~j/~ , 1995.
Notary Public
Notarial Seal
Diane M. Smith N,otai',/Public
Mechanicsburg Boro, Cumberland Cour~y
My C~ri'l;'r,,is~;~i~ E :i2',,?,s ,3u~e 22, 1996
I--
Z
LU
LU
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
UJ
DECEDERI'S NAME (LAST, FIRST, AND~ MIDDLE INITI,~
ERBI GLEN A.
DATE OF DEATH (MM-DD-Yea~)
06/1 t/2004
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DATE OF BIRTH (MM-DD-Year)
07/24/19t6
(IF APPLICABLE) SURVIVING SPOUSES NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ O 8 [] 4. Limited Estate
<J~m [] 8. Decedent Dtsd Testate (Atia~qoy~v~
r'-~ 9. Lifigalion Proceeds Received
[~]2, Supplemental Retom
[~4a. Future Interest Compro~se
1~]7. Decedect Maintained a m ivleg Trust (^r~c~ cop./oFTn~)
~] 10. Spousal Pover'b/Credit (da;e of dea~ ~ 12.31.91 an~ 1.1.S5}
FILE NUMBER
2 I -0 4 0 0 6 4 3
SOCIAL SECURITY NUMBER
7 I 7-0 9-5 6 5 2
THIS RETURN MUST BE FILED IN DUPUCATE WiTH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 3. Remainder Return (dal~ of dea~l pp~ ~o f 2.13~.)
~-]5, Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxec
~'111. ErasUon to lax ueder Sec. 9113(A) ~tta~ s~ o)
THIS SECTION MUST BE C~MPLETED; ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
MURREL R. WALTERS mr:ESQUiRE
FIRM NAME (IfAppiicabie)
TELEPHONE NUMBER
717-697..4650
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule S) (2)
3. Closely Held Coqx)m~on, Pa~erabip or Sete-Pmlxietership (3)
4. Mortgages A Notes Receivable (Sdr~lule D) (4)
5, Cash, Sank Deposits & Miecella~enus Persona Properly (5)
(Schedule E)
6. Join~ Owned Pmperby (SchedL~te F) (6)
] Separate B.;l~teg Requested
7, Intar-Vivos Transtem & Miecella-m~°us Non-Probate Pmpe~ (7)
(Schedule G or L)
8. Total Gmus Assets (total Unes 1-7)
9. Funeral Expenses & AdmintstratJve Costs (schedute H) (9)
10. Debts of Decedent, Mo;tgage Liabili~s, & Uens (Schedule I) (10)
11. Total Deductions (total Lines 9:& 10}
12. Net Value of Estata (Line 8 minus Line 11)
COMPLETE MAILING ADDRESS
54 EAST MAIN STREET
MECHANICSBURG
13. Chedteble end Govemrnental Bequaste/Sec 9113 Trusts for which an election to tax has net been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Une 13)
SEE INSTRUCTIONS ON ,REVERSE BIDE FOR APPLICABLE RATES
97~,~03,.8;
PA 17055
OFFICJAL USE ONLY
(8)
2t,715.00
4r277.29
(11)
(12)
(13)
{14)
97;103:R.
61992.29
90;11t.59
9;01t.16
15. Amount of Une 14 taxable at th~ spousal tax
rate, er tmnstem under Sec. 91.16 (a)(1.2)
16. Amount of Line 14 taxable at lin6al rate
17. Amount of Line 14 taxable at s~b~ing rate
18. Amount of Une 14 taxabte at collateral rote
19, Tax Due
20.
x (15)
8t~tOO.43 X .O45 (16)
X .12 (17)
X .15 (18) ,
(t6)
> > BE SURE TO ANSWER ALL. OUI=$TIONS ON REVERSE SIDE AND RECHECK MATH < <.
3~649.~2
3;649:~9
Dece'dent's Complete Address:
ADDRESS 1700 MARKET S'I~REET
;AMP HILL '*
STATE
PA I ZIP
17011
Tax Payments and Credits:
1. Ts( Due (Page 1 Line 19)
2. Cr ~its/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (2)
(1) 3~649:K_~
3. Int ~rest/Penalty if applicable
D. Intamst
E. Penalty
Total Intarost/Penalty ( D + E ) (3)
4.If I ina 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYUENT,
Check box on Page I Erie 20 to request a refund (4)
5. If I ina 1 + Line 3 is greater than Une 2, estar the dJfforence. This is the TAX DUE. (5)
A. Enter the interest on the tax due. i (5A) ....
B. Enter the total of IJne 5 + SA. 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 transfer and: Yes No
a. retain the use or income of the properly transferred; ........................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ........................................[] []
c. retain a reversiona~ interest;, or ...................................................................................................... [] []
d. receive the promise for life of either payments, benef~ or care? ............................................................. [] []
2. If death occurred afterOesember 12, 1982, did decedent transfer property within one year of death
without receiving adeq~ata consideration?. .............................................................................................. [] []
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. [] []
4. Did desedent own an Individual Retirement Account, annuity, or other nen.probata proparty which
contains a beneflc, iary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABovE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
SIG N.~.~RI~,~: ]P E R SO N RESPONS[BLFa~R FILII~ETURN '-' ......
! ...... Y L'~ESHENOU~I/. '"~- 440 WOODLAND DRIVE ~/,DILLSBURG. PA 1701~ / '
o AVE., ENOLA, .A 170a5
SIGNATH RE OF ;"~'~,R~%~TJ,~E~'TH~'~ ,~ EN TATIVE DATE ./
ADDRE'CS MIDOL L WALTERS I,1 ESQ. 54 EAST MAIN STREET ¢~/~
173.~
3?476.00
3~476.00
MECHANICSBURG
PA 17055
For date s of death on or after July 1, 1994 and before January 1, 1995, the tax rata 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 date s 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 s u wiving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)].
The stalute does not exeffl~t a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets end filing a tax return are still applicable even if
the surv ring spouse is the only panef~ary.
For date s of death on or after July 1, 2000:
The tax *ate impesed on the net value of t~ansfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural patent, an adoptive parent,
or a Stol,parent of the child is 0% [72 P.S.i§9116(a)(I .2)].
The tax ~ata imposed on the net value of t~'ansfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §gl 16(1.2) [72 P.S. §9116(a)(1 )].
~ !ax ,ata 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 an
tndtvidu~d who has at least one parent in common with the decedent, whether by blood or adoption.
SCHEDULE E
cO~O~L~O~.ERNSYLVAN~ I CASH, BANK DEPOSITS, & MISC. J
INHERITANCE TAX RETURN
__ '"" RSONAL PROPE'R Y ..... I
ESTATE OF
ERB. GLEN A, FiLE NUMBER
21 04 0064;~
In( lude the m:xmeds of,,uu~uu,, and the date 1~ proceeds were received by the estate. AJI prope~y JolntJy.owned with the right of sulvivor~h p must be d;o,-,^o,~ on $~h.a,,;. F
ITE ~
NUMI~ER
2.
3.
4.
5.
6
7
8
DESCRIPTION
CiTi,~I~NS BANK
CHECKING ACCOUNT
CITIZENS BAHI~
CHECKING ACCOUNT
CITIZENS BANK
SAVINGS ACCOUNT
CITIZENS BANK
TIME DEPOSIT
CITIZENS BANK
TIME DEPOSFr
GNMA FUND
EXPRES8 SCRIPTS
MEDICINE REIMBURSEMENT
!
RAILROAD RETIREMENT
DEATH SENEFIT
VALUE AT DATE
OF DEATH
2,129.70
50,075.83
t2,884.33
2t,048.32
8,942.61
873.8t
74.28
1,075.00
TOTAL (Also enter on line 5, Recapih~lnfinn) $ 97T'1 -n3:n n
(If mom space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ERB. GLEN ,~,
I)edts of decedent must be reported on Schedule I.
ITE ~1
NUMI~ER
1.
2
3
FUNERAL EXPENSES:
RICHARDSON FUNERAL HOME
GINGRICH MEMORIALS
ZION LUTHERAN CHURCH
ADMINISTRATIVE COSTS:
Pe~onal Repreeentative's Commissions
Name of Personal Repmeen~alive (s)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 04
DESCRIPTION
PREPAID
GRAVESTONE ENGRAVING
FUNERAL MEAL
RENOUNCED
5.
6.
7.
Sodal Security Number(s) I EIN Number of Personal Repreeenta~ve(s)
Sf~eet Addmss
CJi'/ State
Yee~s) Commission Paid:
A~meyFees MTJRREI. R. WALTERS III, ESQ.
Family Exemp~on: (If deeedent's address is not ~he same as claimant's, attach explaha~Jno)
Clail~
Stre~ Address
Ci[y
Relationship of Claimant to Decednot
Probete Feee REGISTER OF WILLS
CUMBERLAND COUNTY
Accountant's Fees
$~ate Zip
Tax Retom Prep&ePs Fees
TOTAL (Also eeter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
00643
AMOUNT
t00.00
260.00
2,100.00
255.00
ESTATE OF
ERB. GLEN
__Include unreimbureed medical expenses.
ITE~ I
NUME£R
1. MANOR CARE
RESIDENTIAL CARE
2 NEIGHBORCARE
MEDICINE
3 Ill/EST SHORE EMS
AMBULANCE
4 EAST PENNSBORO AMBULANCE
5 HOLY SPIRIT HO8PITAL
MEDICAL
6 KENNEI'H HARMS M.D.
MEDICAL
7 DLUE CR08S
MEDICAL
8 ZION LUTHERAN CHURCH
JUNE 6, 2004 MONTHLY CONTHIBUTION
FILE NUMBER
SCHEDULEI
DEBTS OF DECEDENT,
AMOUNT
2,116.80
465.46
1,t15.89
60.00
200.00
30.00
189.14
100.00
21 04 0064~
DESCRIPTION
TOTAL (Nso enter on line 1 O, R~-~.nlh,l~Son) $
(If mom space is needed, insert additional sheets of the same size) 4~277.29
CO ~IMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTA1 E OF
ERB. GL ;H A,
NUMBER
1
2.
3,
4.
5.
7.
1
1
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS ~nclude outfight spousal distributions and tra,,=l=~= under
Sec. 9116 (a) 1.2
NANCY L. ESHENOUR
440 WOODLAND DRIVE
DILLSBURG, PA 17019
JUDITH L. BREWBAKER
6 EAST BEALE AVENUE
ENOLA, PA 17025
BRETT A. ESHENOUR
106 E. SIDDONSSURG ROAD
DILLSBURG~ PA 17019
HEIDI L. ESHENOUR
56 CLEMENS DRIVE
DILLSBURG, PA 17019
MICHAEL BREWBAKER
105 WINDING WATERS DRIVE
INWOOD~ WV 25428
MATTHEW J. BREWI~AKER
320 W. BRENTON STREET
IOWA CITY, IA 52246
EMILY 9TAMEAUGH 469 STAR ROAD
WEST FAIRVIEW, PA 17025
FILE NUMBER
21 04
RELATIONSHIP TO DECEDENT
Do Not List
DAUGHTER
DAUGHTER
ISRANDSON
~'RANDDAUGHTER
GRANDSON
GRANDSON
GRANDDAUGHTER
00643
AMOUNTORSHARE
OF ESTATE
50%OF RESIDUE
50 %OF RESIDUE
;1000.
;1000.
;t000.
1000,
1000.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUT~NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
( TEN PERCENT )
B. CHARITABLEANDGOVERNMENTALDISTRIBUTIONS
ZION LUTHERAN CHURCH
265 NORTH ENOLADRIVE
ENOLA~PA 17025~
9,011.16
TOTAL OF PART ]] - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size) 9701 t,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVtDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 0O4330
WALTERS MURREL R III
54 E MAIN STREET
MECHANICSBURG, PA 17055
........ fold
-'STATE INFORMATION: SSN: 717-09-5652
FILE NUMBER: 2104-0643
DECEDENT NAME: ERB GLEN A
DATE OF PAYMENT: 09/01/2004
POSTMARK DATE: 09/01/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 06/11/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 83,476.00
TOTAL AMOUNT PAID:
$3,476.00
REMARKS:
· SEAL
CHECK//102
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DTVTS/ON
PO BOX Z80601
HARRTSBURG, PA 171Z8-0601
COHHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF INHERITANCE TAX
APPRAZSENENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-i~i? EX AFP Cgg-g4~
HURREL R WALTERS III ESQ
54 E HAIN ST
HECHANICSBURG PA 17055
DATE 11-15-2004
ESTATE OF ERa
DATE OF DEATH 06-11-2004
FZLE NUHBER Z1 04-0645
COUNTY CUHBERLAND
ACN 101
I Amount Ree/tted
GLEN A
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THTS LZNE ~ RETAZN LOWER PORTTON FOR YOUR RECORDS -~
m m m m m m m mm m mm m mm m mm m m m m m m m m m m m m mm m mm m m m m m m m m m mm m mm m m m m m m m m m mm m m m m m m m m m m m m m m m mm mm m m m m m m m m m m mm m m m m m m m m m mm mm m m m m m m m m
REV-154? EX AFP (01-03) NOTZCE OF TNHERITANCE TAX APPRATSEHENT, ALLOWANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF ERG GLEN A FZLE NO. 21 04-0645 ACN 101 DATE 11-15-2004
TAX RETURN NAS: { X) ACCEPTED AS FILED { } CHANGED
RESERVATION CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnersh/p Interest (Schedule C) ($)
~. Hortgages/Notes Receivable (Schedule D) (~)
S. Cash/Bank Deposits/N/sc. Personal Property (Schedule E]
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
.0O
97~105.88
.00
.00
.00 NOTE: To /nsure proper
.00 credit to your account,
.00 subm/t the upper port/on
of th/s form w/th your
tax payment.
(8) 97,103.88
APPROVED DEDUCTZONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H)
10. Debts/Hortgage Liabilit/es/Liens (Schedule Z)
11.
12.
15.
lq.
NOTE:
2,715.00
(9)
(10} 4,277.29
Total Deductions (11)
Net Value of Tax Return (12}
Char/teble/Governeental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Net Value of Estate Subject to Tax (lq)
Zf an assessment was issued previously, lines 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amount of Line 1~ et Spousal ra~o (15)
16. Aaount of L/ne lq taxable at L/neal/Cless A rate (16)
17. Amount of L/ne 1~ at S/bl/ng rata (17)
18. Amount of L/no 1~ taxable at Collateral/Class B rata (18)
19. Pr/nc/pal Tax Due
TAX CREDTTS:
PAYHENT
DATE
'?' RECEZPT
"=: NUHBER
DZSCOUNT (+)
INTEREST/PEN PAID (-)
182.48
09-01-Z004
6.992.29
90,111.59
9,011.16
81,100.43
18 and 19 w111
.00 x O0 = .00
81,100.43 x 045= 3,649.52
.00 x 12 = .00
.00 x 15 = .00
(19]= 3,649.52
AHOUNT PAID
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATZON OF ADDITIONAL INTEREST.
3,476.00
TOTAL TAX CREDZT 3,658.48
BALANCE OF TAX DUEI 8.96CR
INTEREST AND PEN. .00
TOTAL DUE 8.96CR
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' {CR}, YOU NAY BE DUE
REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laaful Class 8 (collateral) rata on any such futura interest.
To ~ulfi11 the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (7Z P.S.
Section 91~0).
Detach the top portion of this Notice and submit mith your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which aaa not requested on the Tax Return, say ba requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications ara available
online at was.revenue.state.pm.us, any Register of NiXls or Revenue District Office) or from the Department's
Z~-hour anseering service for forms orders: X-800-56Z-ZOSO~ services for taxpayers with special hearing and/or
speaking needs: 1-800-~7-~OZO (TT only).
Any party in interest not satisfied with the appraisaent, allowance or disallowance of deductions ar assessment of tax
(including discount or interest) as sheen on this Notice may object within 60 days of the date of race[pt of this notice
by filing one of the folloein9:
A) Protest to the PA Department of Revenue, Board of Appeals. You say object by filing a protest online at
www.boardofappeaIs.stata.pa.as on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to ba valid, you must race[va a confirmation number and processed date from the
Board of Appeals aabsita. You may also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box 281021, Harrisburg, PA 17128-10Zl. Petitions may not ba faxad.
8) EXaction to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court,
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Past Assessment Revise Unit, P.O. Box Z80601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Xnstructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
Xf any tax due is paid aithin three (5) calendar months after the decadent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith first day of delinquency, or nine (9) months and one (l) day from the date of
death, to the date of payment. Taxes ahich became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .00016fi. Al1 taxes ahich became delinquent on and after
January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200~ ara:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20Z .0005~8 1985-1991 1iX .000501 ~ 9Z .O00Zq7
1983 162 .000fi$8 199Z 9Z .O00Zq7 ZOOZ 62 .O0016q
198~ 112 .000301 1993-X996 72 .00019Z ZOO3 5Z .000137
1985 13Z .000356 1995-1998 92 .0002~7 ZO0~ ~Z .000110
1986 lOX .00027q 1999 7Z .00019Z
1957 lOX .O00Z7q 2000 7Z .O0019Z
--Xntarest is calculated
as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINI;~UENT X DAXLY 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 sheen on the
Notice, additional interest must be calculated.
BUREAU OF INOIVIDU~~!'iT) ()F~:r-:~ C,,)F
INHERITANCE TAX DIVISIOM:.~" ,~' - - --., ," ,,- . (
PO BOX 280601 ,..:!. " ; - ,.
HARRISBURG~ PA 17128-06011- " '
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-UD1 EX lFP 109-04)
2n:'l'~ l.~: '1 I 41
" t, ...J 'J ..J i . ~ -;
p~.,1 '7l: b,O
l;: '-'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-13-2004
ERB
06-11-2004
21 04-0643
CUMBERLAND
101
GLEN
A
CLEF-}( O~
(IDe.--1 f.,~\":'
i I' 11.;--".,1...'
MURREL R (WAlTERs II iESQ'
54 E MAIN ST
MECHANICSBURG PA 17055
Allount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~~:r&~,r.!5r.K~~..rG1~.6!,...........:rA~!~e1r"fl5r.~'~~~.b".l~1!60~...;;..........._..........
ESTATE OF ERB GLEN A FILE NO. 21 04-0643 ACN 101 DATE 12-13-2004
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHDWN BELDW
IS A SUMMARY DF 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: 11-15-2004
PRINCIPAL TAX DUE:,
......,~'.'.'M""...'M'N'.'.'n"."M'M'.'M'~".""'M'M'M'M'M'M""""M'M'.'.
3,649.52
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-01-2004 CD004330 182.48 .~ 3,476.00
11-29-2004 REFUND .00 8.96-
TOTAL TAX CREDIT 3,649.52
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO 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
s'\C
~
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
ST A TUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
GLEN A. ERB
6/11/2004
Estate No.:
2004-00643
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes__X___ No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete
( date)
3. If the answer to No.1 is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No_X_
B.
The separate Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C.
in interest:
Did the personal representative state an account informally to the parties
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. / /// //'
rAt-
MURREL R. WALTERS, III, ESQUIRE
54 East Main Street
Mechanicsburg, PA 17055
717-697-4650
Dq.t~: Aprff:25, 2006
\......_) I
L.....1--:
(::~)
(",j
Capacity:
Personal Representative
_X_ Counsel for Personal Representative
.-Q
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
WALTERS MURREL RIll
54 E MAIN STREET
MECHANICSBURG, PA 17055
RE: Estate of ERB GLEN A
File Number: 2004-00643
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/11/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
ESHENOUR NANCY L
440 WOODLAND DRIVE
DILLSBURG, PA 17019
RE: Estate of ERB GLEN A
File Number: 2004-00643
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/11/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregarc
this notice.
Sincerely,
~.dL~J~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
("'1'-"1,~~c::.l
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
BREWBAKER JUDITH L
6 EAST BEALE AVENUE
ENOLA, PA 17025
RE: Estate of ERB GLEN A
File Number: 2004-00643
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
~s per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
rhis filing is due by:
6/11/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
:::c: File
Counsel