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HomeMy WebLinkAbout03-0009PETITION FOR PROBATE and GRANT OF LETTERS Estate of BERTHA P. MOFFITT No. also known as To: Social Security No. Deceased. 204-01-630g ,a l O - o ct Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older ~lt the execut rices in the last will of the above decedent, dated March 5 and codicil(s) dated None in the named ,19.90 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 1036 Trindle Road, South Middleton Township, (Carlisle, 17013) (list street, number and muncipality) Decendent, then 8/4 years of age, died December 21 ,:~9. 2002 at Church of God Home, North Middleton Township, Cumberland County, Pg_ 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 adjudicated incompetent: None Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ Unestimated (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ Unestimated situated as follows: 1036 Trindle Road, South Middleton Township, Cumberland County, Pennsylvania WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. - - l~art~ara M. Crtlln 0artiste, ~-~ ~acq~Xl~ine ~7 ~l~r f9~--200 Easy Road. Carlisle, PA 17013 OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ,~ ~-~t'~,~~~'~. C___~,~'---- ~ before me this ..... 6th day o!'~.l~ .-- v Barbara M. Crum ~' ~-~ January , ,q ~ 200~DI ' Do a . otto,.l.s. ,mpnty] ' 'ter [. F ~ JJc-q~e~ineCS. Miller ~. t 1NO. 21-2003-09 Estate Of BERTHA P. MOFFITT , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 6th 1~ 200~n consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 5~ 1990 described therein be admitted to probate and filed of record as the last will of Bertha P. Moffitt ; and Letters Testamentary are hereby granted to Barbara M. Crum and Jacqueline S. Miller FEES Probate, Letters, Etc .......... $ Short Certificates(3) .......... $ Renunciation ................ $ x-Pages 0 $ JCP TOTAL __ $ Filed 115.00 By ~ 44 West ~mln Street Mechanicsburg, PA 17055-0318 -0- 10.00 J~nuam~..6tk, 2003 .... S. 134.0B. ADDRESS (717) 697-8528 PHONE ,.? Mailed Letters to Attorney Snelbaker on January 6th, 2003. REGISTER OF WILLS OF C~nberland COUN/I~Y OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (e'~h) being duly qualified according to law, depose(s) and say(s) that,, -./'' present and saw the testat, sign the same and that signed as a witness at the request of testat__ in h__ presence an4,'(in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed he~re me this day of (Name) 19 (Address) Register (Name) (Address) 21-2003-09 REGISTER OF WILLS OF CU~ERL~D COUNTY OATH OF NON-SUBSCRIBING WITNESS Barbara M. Crum and Jacqueline S. Miller , (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that each is familiar with the signature of Bertha P. Moffitt , testat trix of (lIKtiXl~~ the will presented herewith and that each believes the signature on the will is in the handwriting of Bertha P. Moffitt, the testatrix to the best of their__ knowledge and belief. Sworn to or affirmed and subscribed before me this 6th day of ~ Barbara M. Crum (Name) z~ January .^ ~ 2003 1861 Spring Road, Carlisle, PA 17013 ....... //(//- Donna M. Otto, 1st Deputy Regist~J~ ~/~/_'~/_~- 3a~elin~a~e?iller 200 Easy Road, Carlisle, PA 17013 (Address) his is to certify that the information here given is correctly' copied fi'om an o!'iginal cet[ificate off dc:ida duh' filed with me as Ix)cai Registrar. The original certificate will be. forwarded to the State Vital Records Office for t)crmanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8869635 No. i COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH ,. Bertha P. Moffxtt [,. Female 13. 204-- O1- 6306 14. Dec. 21, 2002 84 v~ ] i I t ] NOV.8,1918 [ Wilmington,DE ] .... S ~o~.,,.~ [] ~ [~l~] '. I : I ; I', I'. I'"- I m Cumberland ]~North Mlddleton ~ Church of God Home ],.~-~ .... [,,.Whzte .M,.,,~.~..:~,,o,,..~,.,,,.,:,~ I I ~,r-I .o~--I I m,~,,n,*,vt.~-.~,,Y J c~ I I~,~,~c,~o~,,~l I ,,~ Co-Owner I,,t Restau. rant ],,. ~ ~ I,:. ~'a8 I , ...... ],,. Widowed Carlxsle, PA 17013 ~' --mrl - ~-~? m '"".~'=~'"~ ,.. James B. Beletos ~. Grigoria Doukas ~o~W~rr's ~ f;~ t~O~t~Nr s MA~U~,.,~ ,AOCmESS I.~w. C~'vno,m. s~e. Zip ~ ~Jacquel~ne S. Miller 1~.00 Ea~-~. Rd,, Carlisle. Pa 17013 ~o~ Westminster [ ~[q ~e~,~.S .... ~m.,.S SI2,, Dec. 24, 2002 [2,=.Memorial Gardens }2Id. Carlisle, PA 17013 O~FUNEI~.$~R U SEE RSOe4ACTINGA~ LICENSENUMS~R NAME.~NOAOORE~O~FACILITY Hozzman-Rocn ~%lnerat Nome ~--~~~ '~-'r~--~~.~O~'7-/~ I,,,. 013244 L ]~.19 N. Hanover St., Carlisle, Pa 17013 ~--.~.,,~o,~.~ ~.~t~ . ~_.,,,,. ....... ,., . ~/-'~--a~-'"'" "'"~'~" sz ~----, --'<-- ..,,-~-~,¢..,_d~. 4. : I ~-,,. ,0--.- .,,-, I. /~--'7 c'ou c,.-, , I I [] [] n .~r-:,f I ~ ~ I n n 1301. 131m. u. I:/0=~ IX~, IqK3NOUNC~N(2 D~RTIFY~PHYS~CIAN(Pt~r~c~l:x3~np~onQunc~ngdeama..x:lce,rIHy,.e,gmc,~m~am~ ~ ~ ~ ~ "L~,.~ 1~ ~ ~lP ~ I · ..0..~...,.,.,~o.o... :q~._ s~ ,-,,,-," F.e. ,,." ........ '" .................................................................................................. [],,. $o~. ,o ~t4h,,,~,--- ,,. ' h. I,~. t ,a, ~_ ,ol .. "'~r... az,, 21-2003-09 LAST WILL AND TESTAmeNT I, BERTHA P. MOFFITT, of South Middleton Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my last will and testament, hereby revoking and making void all former wills by me at any time heretofore made. FIRST. I direct all my just debts and funeral expenses be fully paid and satisfied out of my estate by my personal representative(s) hereinafter named as soon as conveniently may be after my decease. SECOb~. Ail the rest, residue and remainder of my estate I give, devise and bequeath to my two daughters, Barbara M. Crum and Jacqueline S. Miller, in equal shares or their issue. LASTLY, I nominate, constitute and appoint my said two daughters, Barbara M. Crum and Jacqueline S. Miller, Executrices, or the survivor, Executrix, if living, otherwise Kimberly L. Crum and Matthew J. Crum, Executors, or the survivor, Executrix or Executor, of this my last will and testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of , 1990. (SEAL) Signed, sealed, published and declared by the above named Testatrix, BERTHA P. MOFFITT, as and for her last will and testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. HENRY L. STUA~RT CARLISLE. PA 17OI3 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: No. 2003-00009 BERTHA P. MOFFITT, Deceased December 21, 2002 PA No,.,gl41,ldlon~...% To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on or about January 10, 2003: Name Address Barbara M. Cram 1861 Spring Road Carlisle, PA 17013 Jacqueline S. Miller 200 Easy Road Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: January 10, 2003 Snelbaker, Esquire 44 West Main Street Mechanicsburg, PA 17055-0318 (717) 697-8528 REV-tS0O EX,(6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 COUNTY COCE -- 2003 0009 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Moffitt, Bertha P 204-01-6306 UJ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) Tt-~S RETURN MUST BE FILED IN DUPLICATE WITH THE UJ 12/21/2002 11/8/18 REGISTER OF WILLS ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER L~J 1 Original Return ~ 2 Supplemental Return E~4. Limited Estate F-~ 4a Future Interest Compromise (date of death after 12-12-82) E~ 6, Decedent Died Testate (Attach copy of'Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) ~'~ 9. Litigation Proceeds Received E~ 10. Spousal Poverty Credit (date of d.ath be~een U-31-9, and ,4-95) ~ 11. Election to tax under Sec. 9113(A)(Atta~ S~h O) r'~] 3, Remainder Return (date of death pdor to 12-13-82) [---~ 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes 44 West Main Street Mechanicsburg, PA 17055 NAME COMPLETE MAILING ADDRESS Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker, Brenneman & Spare, P.C. TELEPHONE NUMBER (717) 697-8528 OFFICIAL US F-~NLY CD 119,113.15 21,324.03 97,789.12 0.00 97,789.12 1. Real Estate (Schedule A) (1) 108,000. ~ C 2. Stocks and Bonds (Schedule B) (2) I r 4 4 4. ~ ~ 3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) 0 · 610 4. Mortgages & Notes Receivable (Schedule D) (4) 0. 00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 9,668.32 6, Jointly Owned Property (Schedule F) (6) 0,00 E~ Separate Billing Requested i.]~. 7~ Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0 · 0 0 (Schedule G or L) 8 Total Gross Assets (total Lines 1 J) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 15,661.37 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) 5, 6 62. 6 6 11. Total Deductions (total Lin es 9 & 10) (11 ) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 14. Net Value Subject to Tax (Lin e 12 minus Line 13) (14) x .0© x .045 x .12 (15) (16) (17) (18) (19) 0.00 4,400.51 0.00 0.00 4,400.51 Z z O I-- o o x I-- SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.0 0 16. Amount of Line 14 taxable at lineal rate 97,789. 12 17. Amount of Line 14 taxable at sibling rate 0 · 00 18. Amount of Line 14 taxable at collateral rate 0, 00 x .15 19. Tax Due 2W4645 1000 REV-1 ~O'2EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REALESTATE ESTATE OF FILE NUMBER Moffitt, Bertha P 21-2003-0009 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts Real property which is jointly-owned with right o~ survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 108,000.00 Propemt~ known and numbered as 1036 Trindle Road, South Middleton Township, Cumberland County, PA 17013, sale value (copy of settlement sheet attached) TOTAL (Also enter on line 1, Recapitulation) $ 108,000.00 2W4695 2.000 (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Moffitt, Bertha P FILENUMBER 21-2003-0009 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER MetLife, ~SCRIPTION 51 shares of common stock valued at $28.33 per share TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 1,444.83 1,444.83 2W4696 3.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Moffitt, Bertha P 21-2003-0009 Include the )roceeds of litigation and the date the proceeds were received bythe estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBEF DESCRIPTION M&T Bank, checking account #840858 State Farm, return of unused premium on ho~owners policy Express Scripts, return of copay from health insurance policy Church of God Home, refund on resident care TOTAL(Also enter on line 5. Recapitulation) VALUE AT DATE OF DEATH 3,676.98 26.79 17.03 5,947.52 $ 9,668.32 2W46AD 2.000 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Moffitt, Bertha P 21-2003-0009 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. Tot. DESCRIPTION FUNERAL EXPENSES: Hoffman-Roth Funeral Home, funeral services Jacqueline S. Miller, reimbursement for grave opening and clergy services ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Name: Snelbaker, Brennem~n & Spare Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Zip __ Accountant's Fees Tax Return Preparer's Fees Settlement charges associated with the sale of real estate located at 1036 Trindle Raod, Carlisle: a. ERA-NRT, Inc., commission on sale $3,150.00 b. Notary Fees and tax certification $ 12.00 c. Transfer Tax $1,080.00 d. Final Sewer/refuse adjustment $ 88.00 TOTAL $4,330.00 Register of Wills Cumberland County, filing fee for Inheritance Tax Return 1 from cont±nuatlon pages .... TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 6,930.00 1,000.00 0.00 2,500.00 0.00 134.00 0.00 0.00 4,330.00 15.00 752.37 15,661.37 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Estate of: Moffitt, Bertha P Schedule H, Part B -- Administrative Costs Item Description Page 2 21-2003-0009 Amount 10 11 Greenawalt & Company, P.C., preparation of final Individual Income Tax Returns The Sentinel, advertising Executrices notice Cumberland Law Journal, advertising Executrices notice 65.00 112.37 75.00 12 Reserve for filing fees, accounting costs and other miscellaneous fees associated with the administration of Decedent's Estate 500.00 TOTAL. (Carry forward to main schedule) ...... 752.37 REV-15Y2 EX + (1-97) SCHEDULEI DEBTS OF DECEDENT, MORTGAGEL~BILITIES,& LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Moffitt, Bertha P 21-2003-0009 Include unreimbursed medical expenses. ITEM NUMBER 1 3 4 5 6 0ESCRIPTION PPL, electric service, account payable South Middleton Township Municipal Authority, sewer/refuse service, account payable Brockie Pharmatech, medical expenses, account payable Shipley Energy, heating oil, account payable Church of God Ho~, resident care, account payable Garry & Connie Kuykendal, sidewalk repairs at Trindle Road property, account payable TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 11.54 99.00 5.85 232.35 4,613.92 700.00 5,662.66 2W46AH 2,000 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANC~ TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Moffitt, Bertha P NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[includeoutrights~usaldistributions, andtran~er underSec. 9116(a)(1.2)] Crum, Barbara M 1861 Spring Road Carlisle, PA 17013 Miller, Jacqueline S 200 Easy Road Carlisle, PA 17013 FILENUMBER 21-2003-000! RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Daughter AMOUNT OR SHARE Of ESTATE 48,894.56 48,894.56 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET I1. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT I, BERTHA P. MOFFITT~ of South Middleton Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as a~d for-~my last will and testament, hereby revoking and making void all former wills by men, at any time heretofore made. FIRST.. I direct allgmy.~ju~st deB~s~an~d ~unera! expenses be fully paid and satisfied out of my estate by my personal' representative(s) hereinafter named as soon as conveniently may be ..a~ter my.:..decease.. SECOND.: Al% the rest, r'e'~'id~ and' remain'der '~f my estate I give, devise and bequeath to my two daughters,~B~"rb~ral 'M. ~Cr~um' ~and~!J~cqueline S. Miller, in equal shares or their .issue. LASTLY, I nominate, constitute and appoint my said two daughters, Barbara M. Crum and Jacqueline S. Miller, Executrices, or the survivor, Executrix, if living, otherwise Kimberly L. Crum and Matthew J. Crum, Executors, or the survivor, Executrix or Executor, of this my last will and testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this _N,.~i_,L~_ , 1990. __day of (SEAL) Signed, sealed, published mnd declared by the above named Testatrix, BERTHA P. MOFFITT, as and f~r her last will and testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O02712 SNELBAKER RICHARD C ESQUIRE 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 204-01-6306. FILE NUMBER: 2103-0009 DECEDENT NAME: MOFFITT BERTHA P DATE OF PAYMENT: 06/20/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/21/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,400.51 TOTAL AMOUNT PAID: $4,400.51 REMARKS: JACQUELINESMILLER&BARBARA M CRUM C/O RICHARD C SNELBAKER SEAL CHECK# 0104 INITIALS: .JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DZVTSZON DEPT. Z80601 HARR/SBURG, PA 1?liB-n601 RICHARD C SNELBAKER SNELBAKER ETAL qq W HAIN ST NECHANICSBURG PA 17055 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX *03 JUL 28 DATE 07-28-Z003 ESTATE OF MOFFITT DATE OF DEATH 1Z-ZI-ZOOZ i~,F~I/Lr~qNUMBER 21 03-0009 ~OUl~'ry CUMBERLAND ACN 101 I Amoun~ Remi~ed REV-1S¢7 EX AFP (01-n5) BERTHA P MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA I7013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTTONS AND ASSESSMENT OF TAX ESTATE OF MOFFITT BERTHA P FILE NO. 21 03-0009 ACN 101 DATE 07-Z8-2003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE IN.=KEST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~e~e (Schedule A) (1} 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) q. Hortgages/Notes Receivable (Schedule D) (q) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F} {6} 7. Transfers (Schedule G) (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses~Adc. Costs/Misc. Expenses (Schedule H) (9) 10. DBbts/Mortgage Liabilities/Liens (Schedule I) (lO) 11. Total Deductions 12. Net Value of Tax Return 108/000.00 1/qqq.83 .00 .00 9/668.3Z .00 .O0 (8) 15,661.37 NOTE: To insure proper credit to your account, sub. it the upper portion of this fore with your tax payment. 1:5. lq. NOTE: ASSESSMENT OF TAX: 15. Amount of Line lq at Spouse1 rate 16. Amount of Line lq taxable et Lineal/Class A rate 17. Amount of Line 1~ at Sibling rate 18. Amoun~ of L/ne 1~ ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUHBER INTEREST/PEN PAID (- 06-Z0-Z00~ CD00Z71Z .00 119,113.15 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (l~), .00 x O0 = .00 (16) 97,789.12 x Oq5 = q,qO0.51 (17) . O0 x 12 = .00 (18) .00 X 15 = .00 (19)= q,qO0.51 AMOUNT PAID q,q00.51 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) reflect flgures that include the total of ALL returns assessed to date. q,q00.51.00.00.00 I Char/table/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (13) .00 Net: Value of Estate Subject to Tax (lq) 97,789.12 If an assessment ~as lssued prev/ously, lines 1~, 15 and/or 16, 17, 18 and 19 ,ill 5~66Z.66 (11) 2] .:~2~. §~ (la) 97,789.12 RESERVATION: Estates of decedents dying on or before Deceabar 1Z, 19az -- if any futura interest in tha 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 resarves the right to appraise and assess transfer Inheritance Taxes at the laeful Class B (collateral) rate on any such future in[eras[. PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF #ZEES, AGENT A refund of a tax credit, which ams not requested on the Tax Return, say be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara aveilabla at the Office of the Register of Hills, any of [ha Z3 Revenue District Officas, or by calling the special Z~-hour ansaering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied aith the appraisement, alloaenca, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must ob[act within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Za-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --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: Post Assessment Ravia. Unit, Dept. Za0601, Harrisburg, PA XT1Za-0601 Phone (717) 787-6505. Sam page S of the bookLet "Instructions for Inheritanca Tax Return for a Resident Decedent" (REV-1501) for an explanation of adeinistrativaly correctable errors. Xf any tax due is paid within three (3) calendar months after the dacedant's death, a five percent ESI) discount of the tax paid is elloeed. Tho 15Z tax amnesty non-participation penalty is computed on the total of the tax and interast assessed, and not paid before January 18, 1996, the first day after the end of the tax aanesty period. This non-participation penalty is appealable in the same manner and in the [ha same time period as you mould appeal the tax and interest that has been assessed as indicated on this no[ica. Xnterast is charged beginning with first day of delinquency, or nine (9) months and one (X) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q. Al1 taxes ,hich became delinquent on and after January X, 1982 wiX1 bear interest at a rate which .ill vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO3 are: Interest Daily Interest Daily Interest Daily Rate Factor Year Rate Factor Year Rate Factor Yea__r 1982 20Z .000548 1987 9Z .000247 1999 7Z .O0019Z 1983 16Z .000438 1988-1991 llZ .000301 ZOO0 8Z .000Z19 1984 XIZ .O0030X 199Z 9Z .OOOZq7 ZOO1 9Z .000Z47 1985 13X .0003S6 1993-1994 7X .flOO19Z ZOOZ 6Z .000164 1986 lOX .O00Z7q 1995-1998 9Z .O00Zq7 ZOO3 5Z .000137 --Interest is calculated as folloas: TNTEREST = BALANCE OF TAX UNPAXD X NUHBER OF DAYS DEL/NQUENT X DATLY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is mede after the interest computation date sheen an the Notice, additional interest must be calculated. LAW OFFICES SNELBAKER BRENNEMAN & SPARE RECEIPT AND RELEASE WHEREAS, Bertha P. Moffitt, late of South Middleton Township, County of Cumberland and Commonwealth of Pennsylvania, died on December 21, 2002, having first made her Last Will and Testament in writing probated before the Register of Wills of said Cumberland County on January 6, 2003, and Letters Testamentary were issued on the same date to Barbara M. Crum and Jacqueline S. Miller, the Executrices named in the Last Will and Testament of said Decedent; and WHEREAS, said Executrices has entered upon and completed their administration of said Decedent's Estate as set forth in their First and Final Account attached hereto, and intends to distribute the net balance of the assets of said Estate to the persons named in the Statement of Proposed Distribution also attached hereto, both of said documents being incorporated herein by reference thereto; and NOW KNOW ALL MEN BY THESE PRESENTS, that we, Barbara M. Crum and Jacqueline S. Miller, being the principal legatees and distributees named in the Will of said Decedent and the persons entitled to share in the residuary distribution of the Estate of said Decedent, do hereby declare and say that we, and each of us, have examined the attached Account and Statement of Proposed LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Distribution, and find the same to be true and correct, and in strict accordance with the terms and provisions of said Will, and we do hereby acknowledge that we, and each of us, this day have, had and received of and from Barbara M. Crum and Jacqueline S. Miller, Executrices of the Estate of Bertha P. Moffitt, the cash, personalty and/or real estate set opposite our names in the above Statement of Proposed Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purports and dividends which were due, owing and payable and belonging to us, and each of us, by any means whatsoever, for or on account of our full share, part or dividend of the Estate of Bertha P. Moffitt, Deceased. NOW, THEREFORE, we, and each of us, the said Barbara M. Crum and Jacqueline S. Miller, do by these presents, remise, release, quit-claim and forever discharge the said Barbara M. Crum and Jacqueline S. Miller, their heirs, executors and administrators, of and from our said shares or dividends of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents. AND, desiring to avoid the delay and expense of the settlement of said Estate by filing the foregoing Account of said administration in the Office of the Register of Wills of said Cumberland County and by having the balance in the hands of the LAW OFFICES SNELBAKER, BRENNEMAN ~ SPARE Executrices, as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, we, and each of us, do hereby agree that the foregoing Account and Statement concerning the matter of settlement may be recorded with the same effect upon us, and each of us, as if the same had been reported upon by said Court, in a decree of distribution made on such proposed Statement of Distribution by the said Court of Common Pleas - Orphans' Court Division. A_ND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that we, and each of us, the said Barbara M. Crum and Jacqueline S. Miller, do hereby agree that if any debts or demands other than those included in the above referenced First and Final Account, as hereinbefore set forth, shall be hereafter recovered against the Estate of said Decedent and be legally payable out of the same, that we, and each of us, will return to the said Executrices such amounts thereof as may be necessary to pay such debts or demands. IN WITNESS WHEREOF, we have hereunto set our hands and seals this 1'14~ day of ~C~1~O_~ WITNESSED BY: 2003. Barbara-M-. Cl~Jm  Jcq ~uel~ine S. ~iiler ( SEAL ) (SEAL) LAW OFFICES SNELBAKER BRENNEMAN ~: SPARE COMMONWEALTH OF PENNSYLVANIA) : SS. :OUNTY OF CUMBERLAND) On this the I~]~1 day of (~¢~~ 2003, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Barbara M. Crum and Jacqueline S. Killer, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. JC[/~ ,~M~ ? j~L]O~o Notary Public COMMONWEALTH OF PENNSYLVANIA Member, Pennsylvania Association Of Notaries LAW OFFICES SNELBAKER. BRENNEMAN '~ SPARE ESTATE NO. 21-03-0009 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY BARBARA M. CRUM AND JACQUELINE S. MILLER, EXECUTRICES OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF BERTHA P. MOFFITT, DECEASED, LATE OF SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA ~arbara M. Crum and Jacqueline S. Miller, Executrices as aforesaid and Accountants herein, avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: December 21, 2002 January 6, 2003 DATES EXECUTOR NOTICE ADVERTISED: Cumberland Law Journal The Sentinel January 24, 31, February 7, 2003 January 15, 22, & 29, 2003 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT DEBITS The Accountants charge themselves with the receipt of the following items of Decedent's Personalty valued as of the date of Decedent's death: 1. MetLife, 51 shares of common stock valued at $28.33 per share 2. M&T Bank, checking account #840858 3. State Farm, return of unused premium on homeowners policy 4. Express Scripts, return of copay from health insurance policy 5. Church of God Home, refund on resident care 6. MetLife, proceeds from life insurance policy 7. PA State Employees Retirement System, final retirement benefit 8. Barbara Crum & Jacqueline Miller, deposit into M&T Bank account to cover overdraft TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: PERSONALTY - PRINCIPAL ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from Decedent's Personalty Account: 1. Brockie Pharmatech, perscriptions 2. Hoffman-Roth Funeral Home, funeral services 3. Jacqueline S. Miller, reimburse for grave opening & clergy 4. Register of Wills, additional probate fee 5. Register of Wills, Agent, Inheritance Tax 6. Register of Wills, filing fee for Inheritance Tax return 7. Loss on sale of MetLife stock 8. Church of God Home, resident care 9. Greenawalt & Company, P.C., preparation of Final Individual Tax Returns 10. Snelbaker, Brenneman & Spare, P.C., attorney services 11. Snelbaker, Brenneman & Spare, P.C., costs advanced: a. Cumberland Law Journal, adverising Executor's notice 75.00 Page 1 1,444.83 3,676.98 26.79 17.03 5,947.52 3,328.26 92.37 1,000.00 5,533.78 5.85 6,930.00 1,000.00 120.00 4,400.51 15.00 529.99 4,613.92 65.00 2,500.00 321.37 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE b. The Sentinel, advertising Executor's notice c. Register of Wills, probate fees 12. Reserve for filing fees, accounting fees and other costs associated with the administration of Decedent's Estate TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: PERSONALTY - INCOME ACCOUNT DEBITS ]'he Accountants charge themselves with the receipt of the following income from the investment of Personalty Principal: TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: PERSONALTY - INCOME ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from the Personalty Principal Account: TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountants charge themselves with the receipt of Decedent's Real Estate as follows: 1. Adjustments at settlement for County and School taxes TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: REAL ESTATE - PRINCIPAL ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from Real Estate Principal Account: 1. PPL, electric service 2. South Middleton Twp. Municipal Authority, sewer/refuse 3. Shipley, heating fuel 4. Garry & Connie Kuykendal, sidewalk repairs and return of earnest money following cancellation of sales agreement 5. Settlement charges associated with the sale of real estate a. ERA-NRT, Inc., commission on sale b. Notary fees and tax certification c. Transfer taxes d. Final sewer/refuse adjustment e. County and Township taxes TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: REAL ESTATE - INCOME ACCOUNT DEBITS The Accountants charge themselves with the receipt of the income from the investment of Real Estate Principal Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: Page 2 112.37 134.00 3,150.00 12.00 1,080.00 88.00 206.70 500.00 21,001.64 NONE NONE NONE NONE 08,000.00 451.79 108,451.79 41.21 99.00 232.35 1,700.00 4,536.70 NONE NONE $ 6,609.26 LAW OFFICES SNELBAKER. BRENNEMAN ~ SPARE REAL ESTATE - INCOME ACCOUNT CREDITS 'he Accountants claim credit for the payment of the following items from the Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: Page 3 NONE NONE LAW OFFICES SNELBAKER. BRENNEMAN & SPARE ~ERSONALTY; PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL PERSONALTY PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL REAL ESTATE: TOTAL FOR DISTRIBUTION; RECAPITULATION Page 4 15,533.78 21,001.64 NONE NONE 108,451.79 6,609.26 NONE NONE (5,467.86) NONE 101,842.53 NONE (5,467.86) 101,842.53 96,374.67 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE STATEMENT OF PROPOSED DISTRIBUTION Barbara M. Crum and Jacqueline S. Miller, Executrices and Accountants herein, proposes to distribute the balance of the Estate of Bertha P. Moffitt, Deceased, to wit: $96,374.67 in accordance with the Last Will and Testament of said Decedent as follows: Barbara M. Crum 50% of residue as per Item Second of Will Jacqueline S. Miller 50% of residue as per Item Second of Will TOTAL FOR DISTRIBUTION: Page 5 48,187.34 48,187.33 96,374.67 LAW OFFICES SNELBAKER BRENNEMAN & SPARE COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Barbara M. Crum and Jacqueline S. Miller, being duly sworn according to law deposes and says: that they are the Executrices of the Estate and under the Last Will and Testament of Bertha P. Moffitt, Deceased, and the Accountants herein; that there are no unpaid creditors or claimants of said Estate; that there are no persons interested in the distribution of said Estate other than as stated in the foregoing Statement of Proposed Distribution; and that the facts set forth in the foreqoing First and Final Account and Statement of Proposed Distribution are true and correct to the best of their knowledge, information and belief. Barbara M. Crum Executrice and Accountant ~/ Jacqueline S. Miller Executrice and Accountant Sworn to and subscribed before me Notary Public ~ -- COMMONWEALTH OF PENNSYLVANIA My ~ Expires Nov. 22, 2007 Member, Pennsylvania Association Of Notaries Page 6 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Barbara M. Crum and Jacqueline S. Miller being duly sworn according to law, deposes and says that try are the Executrices of the Estate of Bertha P. Moffitt late of South Middleton Township ., Cumberland County, Pa., deceased and that the Barbara M. _r___u~_ _ Executrices within is an inventory made by Rnr~ Jacque~ n,:, ~. Mi-l-l-er- .., the said of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, Date of Death COMMONWEALTH OF PENNSYLVANIA Executor - Admln;strator Barbara M. Crum Jacqueline S. Miller 1861 Sprinq Road 200 Easy Road Carlisle, PA 17013 Carlisle, PA 17013 No~ Se~ Sandm ~ Showem, No~y Parc M~ha~zm~g Bom, Ca~be~d C~un~ ~~ E~"m ~. ~. 2007D~ icembe r Memb~%~enn~ytvania Assocml,on Of Noiaries Month Address 2002 INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed wlth;n thlrfy days of discovery of additional assets. 3. Additional sheets may be a'rfached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. O'% 0 0 0 I 0 I Inventory of the real and personal estate of BERTHA P. MOFFITT, Deceased PERSONALTY: 1 MetLife, 51 shares of common stock valued at $28.33 per share 2 M&T Bank, checking account #840858 3 State Farm, return of unused premium on homeowners policy 4 Express Scripts, return of copay from health insurance policy 5 Church of God Home, refund on resident care TOTAL PERSONALTY: REAL ESTATE: I Property known and numbered as 1036 Trindle Road, South Middleton Township, Cumberland County, PA, sale value TOTAL PERSONALTY AND REAL ESTATE: 1,444.83 3,676.98 26.79 17.03 5,947.52 11,113.15 108,000.00 119,113.15 Page 1 Name of Decedent: STATUS REPORT UNDER RULE 6.12 Bertha P. Moffitt Date of Death: December 21, 2 002 Will No.: 21-03-0009 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: 1. State whether administration of the estate is complete: Yes 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a.Did the personal representative file a final account with the Court? Yes _ No b. The separate Orphans' Court No. (if any) for the personal representative's accoUnt is: c. Did the personal representative state an account informally to the parties in interest? Yes [] No ["] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed xSit-h.~e Clerk of the Orphans' Court and may be attached to this r~l~°?.~/}_.~../~-'~-/f Date: 12~ }'710B Capacity: Name Richard C. Snelbaker 44 West Main Street Mechanicsburg, PA 17055 Address (717) 697-8528 Telephone No. [-~ Personal Representative [k--I Counsel for personal representative