HomeMy WebLinkAbout03-0952PETITION FOR PROBATE and GRANT OF LETTERS
Estate of John
also known as
William Bennett No. ~
To:
Register of Wills for the
Deceased. County of Cumberland
Social Security No. 1 ~i 1 - ~t zl - 13 ~ q q Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or
in the last will of the above decedent, dated November 7
and codicil(s) dated
in the
named
,xl~x~20_03
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h±$ .. last family or principal residence at 2902 Chesterbrook Court: Apt- _ ?.136,
Camp }{ill /.Lmwo_r Allon Tmwn_qhip)~ PA 17011
(list street, number and muncipality)
Decendent, then 58 years of age, died Nc~v~ml~=r I ?. XIXOX--20-03,
at_~q_pirit Ho.qpi ta 1 . Caren 14i 1 I . Cnmhorl and C~unty, PA ...
Except as follows, decedent did not ~narry, ~as 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: N/A
Decendent 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: None
$ 15:000.00
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters to_~qtamo_nt-a ry
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
~rg~ ~homas Bennett, .Jr
2~8 Smith Road
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 a~ording to law.
Sworn to or affirmed and subscribed ~- _ . , - ..... - - ~-
before me this ~-I "er~ --day°f [ /~ '~ ~r'~ ~~ ~
~- ~k~ ' Register I. ¥...~__\_~__~ - \\
No. ,,21- o~ -q.~, 2_
Estate 0f ._--~-o~, ~,~,\~.,~,~ t~'~_~,cxe.~k_ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated tt-~ o Zoos
described therein be admitted to probate and filed of record as the last will of
and Letters
are hereby granted to
tO '
, in consideration of the petition on
FEES
Probate, Letters, Etc .......... $~
Short Certificates( ) .......... $ .~0. ~
TOTAL $ qU.~
Filed ~:.~.z ~.e~ ......................
ADDRESS
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
P 9852428
No.
L~TRegistrar
Date
HI05 t43 Rev 2187
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ' VITAL RECORDS
CERTIFICATE OF DEATH
Yrs. ~ OTHER
I ~ I C L,' ~. (H..~ h,, _.. g ...... t ~d num.) IWAS DECEDENT OF HISP~IC ORiGiN?
~ i. deem)
· UNDERL¥~IG
~. H4rr
ZfZ -/._
:eme~. Cremato~/
23b.
23c.
I£DICA
PART U:
.bur
nM re~ulling in ~le tin.hying c4u~e g/~lll in pA~ T i.
Y~)
LAST WILL AND TESTAMENT
OF
JOHN WILLIAM BENNETT
I, John William Bennett, of 2902 Chesterbrook Court, Camp Hill, Pennsylvania,
being of sound mind, do declare this to be my last Will, hereby revoking any and all
Wills and Codicils by me at any time heretofore made.
ITEM I. APPOINTMENT OF PERSONAL REPRESENTATIVE. I name,
constitute, and appoint my brother, George Thomas Bennett, Jr., as Executor of this my
last Will. In the event that George Thomas Bennett, Jr., is unwilling or unable to serve as
Executor, I then appoint my nephew, Matthew Theodore Bennett, as Executor. My
Executor shall hereinafter be referred to as my "Personal Representative."
ITEM II. PAYMENT OF DEBTS AND FUNERAL EXPENSES. I order and
direct my Personal Representative to pay my debts and funeral expenses as soon after my
decease as may be convenient.
ITEM III. DISPOSITION OF ESTATE. I give, devise and bequeath all of my
estate, both real and personal, absolutely, unto my brother, George Thomas Bennett, Jr.,
and my nephew, Matthew Theodore Bennett, in equal shares. However, in the event that
either George Thomas Bennett, Jr. or Matthew Theodore Bennett predeceases me, I give,
devise and bequeath my entire estate, both real and personal, to the one that survives me.
ITEM IV. ALTERNATE DISTRIBUTION. In the event that both George
Thomas Bennett, Jr. and Matthew Theodore Bennett predecease me, I give, devise and
bequeath my entire estate, both real and personal, to Judith May Bennett.
ITEM V. POWERS OF PERSONAL REPRESENTATIVE. My Personal
Representative shall have, in addition to and not in limitation of the powers given by law
or by other provisions of this Will, the power to invest the estate or trust assets in stocks,
shares and obligations of corporations, of unincorporated associations or trusts and of
investment companies or in any other kind of personal or real property, notwithstanding
the fact that any or all of the investments made are of a character or size which but for
this expressed authority would not be considered proper.
ITEM VI. PAYMENT OF DEATH TAXES. I direct that all estate, inheritance
and other taxes in the nature thereof, together with any interest or penalties thereon
becoming payable because of my death, with respect to the property constituting my
gross estate for death tax purposes, whether or not such property passes under this Will,
shall be paid from the residue of my estate; and no legatee or devisee or any person
having a beneficial interest in such property, whether under this Will or any Codicil
thereto or otherwise, shall at any time be required to refund any part of such taxes. Taxes
on future interests may be prepaid.
ITEM VII. WAIVER OF BOND. I direct that none of the fiduciaries appointed
under this instrument be required to give bond.
ITEM VIII. SAVINGS PROVISION. If any provision of this Will or any
Codicil thereto is held to be inoperative, invalid or illegal, it is my intention that all of the
remaining provisions thereof shall continue to be fully operative and effective so far as
possible and reasonable.
day of
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
]q~_ d¢,n_~(F' ,2003.
J/~41:,,iarrl Be:ett ~'~
(SEAL)
THIS INSTRUMENT, consisting of 2 typewritten pages, was by the above-
named Testator, on the date hereof, signed, sealed, published and declared to be his last
Will and Testament, in the presence of the undersigned, who, at his request, in his
presence and in the presence of each other, have hereunto subscribed their names as
witnesses.
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF CUMBERLAND ·
SS:
We,/3~ohn William Bennett, (~Jx~a~ ~ ,and
~A~//~.,~ ~2~,,_~z~L ,4~ne ~i'estat~)r and the witnesses, respectively, whose
names are signed to th~attached or foregoing instrument, being first duly affirmed, do
hereby declare to the undersigned authority, a Notary Public, that the Testator signed and
executed the instrument as his last will and that he had signed willingly, and that he
executed it 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 witness
and that to the best of his or her knowledge the Testator was at that time eighteen (18)
years of age or older, of sound mind and under no constraint or undue influence.
Testator
Witness
Subscribed, affirmed to and acknowledged before me, a Notary Public, by John William
Bennett, the Testator, and subscribed and affirmed bef~e me
by ~ ~j~ ~ and X~2-~Z x~_~c~.q~-j
witnesses, this' y~>Z day of , 2003. (J '
Notary Public
l.... ~.. _ Noladai Seal
,.,_?_ta...C,: _A_r~tea_d, N.o~jy Public
~ump Mill b~om, GumDeffand Countv
My Commission Expires Apr. 18,
M~ifiL~,r. Pen~svlv~ni~ a~:~oci~tionof Notaries
LA~,/OFFICE
OF
PHILIP C. BRIGANTI
74 West Pomfret St.
Carlisle, PA 17013
Phone: (717) 960-0005
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: John William Bennett
Date of Death: November 12~ 2003
Will No. 21-03-0952 Admin. No.
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to
the following beneficiaries of the above-captioned estate on
November 19~ 2003 :
Name Address
George Thomas Bennett, Jr. 248 Smith Rd., Shippensburg, PA 17257
Matthew Theodore Bennett 857 W. Louther St., Carlisle, PA 17013
Judith May Bennett
248 Smith Rd., Shippensburg, PA 17257
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date:
Name Philip C'. Briganti, Esq.
Address 74 W. Pomfret Street
Carlisle, PA 17013
Telephone(71~ 960-0005
Capacity: Personal Representative
... X Counsel for personal
representative
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 004192
BENNETT GEORGE THOMAS JR
248 SMITH ROAD
SHIPPENSBURG, PA 17257
fold
ESTATE INFORMATION: SSN: 161-34-0699
FILE NUMBER: 2103-0952
DECEDENT NAME: BENNETT JOHN WILLIAM
DATE OF PAYMENT: 07/23/2004
POSTMARK DATE: 07/23/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 11 / 12/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,518.57
TOTAL AMOUNT PAID:
$2,518.57
REMARKS: G THOMAS BENNETT
SEAL
CHECK//155
INITIALS: CP
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~ COMMONWEALTH OF
· ~ PENNSYLVANIA
.e~7~l. DEPARTMENT OF REVENUE
,P',~"~, :,~T~¢~ ka~"~ DEPT. 280601
~HARRISBURG, PA 17128-0601
INHERITANcER E V- 1 5 00TAX RETURN
I 21 _ 03 00952
RESIDENT DECEDENT
Z
LU
0
DECEDENFS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Bennett, John W.
DATE OF DEATH (MM-BD-YEAR)
11/12/2003
DATE OF BIRfl]-I (MM-DD-YEAR
05/07/1945
SOCIAL SECURI'rf NUMBER
161-34-0699
THIS RETURN MUST BE FILED IN DUPLICATE WIT~ T-I~
REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
1~4. Limited Estete
~19. Ltligatlon Pmceeds Received
[] 2. Supplemental Re~um
]4a. Future Interest Compromise (~ate ~ death after 12-12-82)
El7. Decedent Maintained a Living Trust (A~,n copy ~fzn~
E~I 0. Spousal Poverty Credit (~ab ~ de~h ~,n 12-31-91 and
El5. Federal Estete Tax Return Requi~d
__ 8. Total Number of Saf~ Depc~it Boxes
E]11. Bec§on to tax under Sec. 9113(A) (A,ach Sch O)
NAME
Philip C. Bdganti, Esq,
FIRM NAME
Law Office of Philip C, Bdganti .
TELEPHONE NUMBER
(717) 960-0005
COMPLETE MAILING ADDRESS
Law Office of Philip C. Briganti
74 W. Pomfret St.
Carlisle, PA 17013
1 Real Estate (Schedule A) (1) none
2. Stocks and Bonds (Schedule B) (2) 3 6 7.0 9
3. Closely Held Corporation, Partnership or Sole-Pmpdetership (3) notre
4, Mo~ages & Notes Receivable (Schedule D) (4) none
5. Cash, Bank Deposits & Miscellaneous Personal Proper[./ (5) 3 1 ~ 7 7 0.3 1
(Schedule E)
none
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7, inter-Vivos Transfem & Miscellaneous Non-Probate Property
(Schedule G a' L) *not
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses &Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Chedtable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
[20,988.11~'ptease b~
U) separately]*
included in total here
(~) 32,1
(9) 7_~468.91
(10) 28,307.20
- see Schedule G
37.40
(11) 35,7:76.11
¢2) 0.00
(13) none
(14) 0. O0
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rata, or transfem under Sec. 9118 (a)(1.2)
x .0 0g)
16. Amount ct Line 14 taxable at lineal rate
17. Amount of Une 14 taxable at sibling rate
18. Amount of Uno 14 taxable at collateral rate
19. Tax Due
x .o __. (16)
0o00
.......................... x .12 (17)
0.00
............................. x .15 (18)
(t9)
0.00
0.00
0.00
· Decedent's Complete Address:
ISTREETADDRESS
2902 C~h_e~terb~rook Court
Apartment 206
ClTYcamp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable Total Credits ( A + B + C )
D· Interest
E. Penalty
Total Interest/Penalty ( D + E )
4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
5· If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(1) o.oo
(2)
(3)
(4)
(5) O. O O
(5A)
(59) 0. O 0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
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 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 properly within one year of death
w thout rece v ng adequa e cons dera on? .............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon dea h bank acooun or secu ty at his or her death? .............. [, []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probete properly which
contains a beneficiary 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.
Under p~,',ait~ of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belie;, it is true, correct and complete.
Dedaraknn of pmperm' other than the personal representative Is based m all Information of which preparer has any knowledge.
248 Smith Road, Shippensburg, PA 17257
SIG~ATUR~-~F~PREP.~RER O,~THER T~ REPRESENTA~VE 6AT~
Law Office of Philip C. Bdganti, 7'4 W. Pomfret Street, Carlisle, PA 17013
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) (ii)].
The statute does not exemDt a transfor to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
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) 172 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. §9116(a)(f.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
LAST WILL AND TESTAMENT
OF
JOHN WILLIAM BENNETT
I, John William Bennett, of 2902 Chesterbrook Court, Camp Hill, Petmsylvania,
being of sound mind, do declare this to be my last Will, hereby revoking any and all
Wills and Codicils by me at any time heretofore made. [
ITEM I. APPOINTMENT OF PERSONAL REPRESENTATIVE. I name,
constitute, and appoint my brother, George Thomas Bennett, Jr., as Executor df this my
last Will. In the event that George Thomas Bennett, Jr., is unwilling or unable' to serve as
Executor, I then appoint my nephew, Matthew Theodore Bennett, as Executor. My
Executor shall hereinafter be referred to as my "Personal Representative."
ITEM II. PAYMENT OF DEBTS AND FUNERAL EXPENSER. I order and
direct my Personal Representative to pay my debts and funeral expenses as soon after my
decease as may be convenient.
ITEM III. DISPOSITION OF ESTATE. I give, devise and bequea,,~ all of my
estate, both real an[l personal, absolutely, unto my brother, George Thomas Bennett, Jr.,
and my nephew, Matthew Theodore Bennett, in equal shares. However, in theI event that
either George Thomas Bennett, Jr. or Matthew Theodore Bennett predeceases ~ne, I give,
devise and bequeath my entire estate, both real and personal, to the one that survives me.
ITEM IV. ALTERNATE DISTRIBUTION. In the event that both George
Thomas Bennett, Jr. and Matthew Theodore Bennett predecease me, I give, devise and
bequeath my entire estate, both real and personal, to Judith May Bennett.
ITEM V. POWERS OF PERSONAL REPRESENTATIVE. My Pc
Representative shall have, in addition to and not in limitation of the powers gi~
or by other provisions of this Will, the power to invest the estate or trust assets
shares and obligations of corporations, of unincorporated associations or trusts
rsonal
:n by law
in stocks,
and of
investment companies or in any other kind of personal or real property, notwitt standing
the fact that any or all of the investments made are of a character or size which but for
this expressed authority would not be considered proper.
ITEM VI. PAYMENT OF DEATH TAXES. I direct that all estate, inheritance
,and o~er taxes,~,n ?e nature thereof, together with any interest or penalties thereon
oecommg payame oecanse of my death, with respect to the property constituting my
gross estate for death tax proposes, whether or not such property passes under t~is Will,
shall be paid from the residue of my estate; and no legatee or devisee or any person
having a beneficial interest in such property, whether under this Will or any Codicil
thereto or otherwise, shall at any time be required to refund any part of such es. Taxes
on future interests may be prepaid, ta~
ITEM VII. WAIVER OF BOND. I direct that none of the fiduciaries appointed
under this instrument be required to give bond.
ITEM VIII. SAVINGS PROVISION. If any provision of this Wall orlany
Codicil thereto is held to be inoperative, invalid or illegal, it is my intention that all of the
remaining provisions thereof shall continue to be fully operative and effective jo far as
possible and reasonable.
IN YqITNESS WHEREOF, I have hereunto set my hand and seal this I '7'~
dayof .~ltlt_l~,t~qO.~F ,2003.
THIS INSTRUMENT, consisting of 2__ typewritten pages, was by the a hove-
named Testator, on the date hereof, signed, sealed, published and declared to b ~ his last
Will and Testament, in the presence of the undersigned, who, at his request, in his
presence and in the presence of each other, have hereunto subscribed their nam es as
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
~.~ .~,z/..~: ~_ ~the Testator and the witnesses, respectively, whose
names are mgned to the 5ttached or foregoing instnunent, being first duly affi~ reed, do
hereby declare to the undersigned authority, a Notary Public, that the Testator signed and
executed the instrument as his last will and that he had signed willingly, and tl .at he
executed it as his free and voluntary act for the purposes therein expressed, an that each
of the witnesses, in the presence and hearing of the Testator, signed the Will a witness
and that to the best of his or her knowledge the Testator was at that time eight~ en (I 8)
years of age or older, of sound mind and under no constraint or undue influence.
J/~ ~~'~ Testator
.. ~..4~. Witness
/
Subscribed, affirmed to and acknowledged before me, a Notary Public, by Joh~ William
Benng~t, t~e Tj¢stator, and subscribed and affirmed before me 1
by.. .- and / .
w~messes, this ~ day of. ,~t~ ", 2003. c/ - /
Notary Public
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEOENT
ESTATE OF
John William Bennett
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-03-0cj52
All property Jointly.owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
$25.00 Series E U.S. Savings Bond (issued 9/1976)
$25.00 Series E U,S. Savings Bond (issued 4/1975)
$25.00 Sedes E U.S. Savings Bond (issued 1/1976)
VALUE AT DATE
OF DEATH
121,05
123.98
122.06
TOTAL (Also enter on line 2, Recapitulation) $ 367.09
(If more space is needed, insert additional sheets of the same size)
Redemption Date:
U.S. Savings Bond Transaction
Customer Copy
11/26/2003
Issue Redemption Backup
Series Denomination Date Value Interest Withholding
i E $25.00 Se / 1976 $121.05 $102.30 $0.00
2 E $25.00 Apr/ 1975 $123.98 $105.23 $0.00
3 E $25.00 3an / 1976 $122.06 $103.31 $0.00
Total: 3 Bond(s) $367.08 $310.84 $0.00
The interest earned on Series EE bonds issued on or after January
1990 may be wholly or partially exempt from Federal income tax
under the provisions of the U.S. Savings Bond Education Benefit
Program. For further information concerning the benefits and
restrictions that apply, please contact the internal Revenue
Service.
REV~1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John William Bennett
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-03-0952
Include the proceeds of litigation and Ihe date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
cash
checking account at Commerce Bank (#536051881)
checking account at M&T Bank (#15030091)
2002 Jaguar X-Type
miscellaneous personal property/household goods
wages/commissions from NB Liebman
return of security deposit from Society Hill Apts.
refund from Comcast
refund from Patriot-News
refund from AT&T
refund from Jaguar
refund of insurance premiums from Donegal Insurance Co.
refund from Highmark
VALUE AT DATE
OF DEATH
28.00
3,569.36
760.52
22.000.00
1,500.00
3,282.18
189.00
14.56
28.80
6.85
9.44
360.00
21.60
31 ,770.3t
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert addiliona~ sheels of the same size)
JOHN W BENNETT
2902 CHESTERBROOK CT APT 206
CAMP HILL PA 17011
11/24/03
0536051881
10 CYCLE-007
*** CHECKING *** 50 PLUS CLUB BEGINNING RATE 0.15000
ACCOUNT NI3MBER 0536051881
PREVIOUS STATEMENT BAI2~NCE AS OF 10/27/03 ........................ 7,515.29
PLUS 1 DEPOSITS AND OTHER CREDITS .................... 55
LESS 10 CHECKS AND OTHER DEBITS ...................... 6,261.53
CURRENT STATEMF/gT BALANCE AS OF 11/24/03 ......................... 1,254.31
NUMBER OF DAYS IN THIS STATEMENT PERIOD 28
*** CHECK TRANSACTIONS ***
SERIAL DATE A]4OUNT SERIAL DATE AMOUNT
102 11/12 2,403.74 107 11/14 470.00
103 11/10 500.00 108 11/24 14.38
104 11/14 1,000.00 109 11/18 1.00
105 11/10 1,000.00 110 11/17 15.22
106 11/12 42.19 111 11/18 815.00
*** CHECKING ACCOUNT TP~SACTIONS ***
DATE DESCRIPTION DEBITS CREDITS
11/24 INTEREST PAYMENT .55
*** BD~LANCE BY DATE ***
10/27 7,515.29 11/10 6,015.29 11/12
11/17 2,084.14 11/18 1,268.14 11/24
PAYER FEDERAL ID NUMBER
INTEREST PAID YEAR TO DATE
1,254.31
23-2324730 11.58
*** INTEREST EILRNED THIS STATEMENT PERIOD ***
DAYS IN PERIOD ......................... 28
INTEREST E/LRNED ......................... 55
A~AL PERCENTAGE YIELD EARNED (APY) .... 0.15%
PLEASE NOTE, STARTING DECEMBER 1, 2003
SAVINGS ACCOUNTS WILL REQUIRE A $100 MINIMUM
BAL~/gCE TO AVOID A $2 SERVICE CHARGE.
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Mr. G. Thomas Bennett, Jr., Executor
Estate of John William Bennett
248 Smith Road
Shippensburg, PA. 17257
Phone (888) 502-4349
Fax (302) 934-2955
March 9; 2004
Re: Estate of John W. Bennett
Social Security: 161-34-0699
Date of Death: November 12, 2003
Dear Mr. Bennett:
Per your inquiry dated March 8, 2004, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1. Type of Account Checking Account
Account Number 15030091
Ownership (Names oJ~
Opening Date
Balance on Date of Death
Accrued Interest
Total
John W Bennett
George T Bennett Jr, POA
02/28/82
$760.52
$ 0.00
$760.52
Please be advised there was no safe deposit box found for the above decedent.
For further account information, closures and/or reimbumement of funds please call the Camp Hill Office
# 717-255-2279.
Sincerely,
Records Management
Effective Immediately
Please Send all
Attorney Letters
M&T Bank
Records Management
DE-MB-12
Millsboro, DE 19966
Phone: (888) 502-4349
Fax: (302) 934-2955
6391 Carlisle Pike ,, Mechanicsburg ~. PA * 17050. (717) 766-8400 ,, 1-800-JAGUAR45
WILLIAM H EVERET'r 8, ~001
BEVERLY A EVERE1T
t 518 TERRACE AVE
~..
Edwad, Jones
1 :25 PM
N'B'UEBMAN
Carlisle Pike. i~l~chonlcsl~urg, PA 4705,5 · (717) 76~1.4550
March 11, '~004
To Whom It M,,y Concern:
Pica.sc find below a breakdown list of monies paid out to John Bennett from
November 2003 through the current month.
..Ck # Ch.,Ir _f}n_!e Net Pt.
12/12/03 .-~619.34
48738/.- 12/19/03 ~-P742.22
12/26/03 ---//-619.34
~763 ~- 1/2/04 ~=82.55
48805.4- 1/23/04 "/-81.24
1/30/04 ~P-43,88
Total:
3811.79
If you have any further questions or concerns, please do not hesitate contact me at
717-761-4550 ext 110,
Sincerely,
Nancy O'r
Accounting Assistant
REV-1510 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John William Bennett
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21-03-0952
This schedule musl be completed and filed if the answer to any of questions I through 4 on the revarse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE31~ENA~OFT~E3~SF~E, TFEIRREL~TIO~NSKIpTODECEDENTAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE
NUMBER I~E DATE Of TRANSFER. A3T,~H A COPy OF THE DEED t:OR REAL EBTA3E. VALUE OF ASSET INTEREST liF APPLIC4~LE) VALUE
1. NB Liebman 401k plan through Manulife, received by beneficiary (decedent's 41,976.22 50 20,988.1
brother, George Thomas Bennett, Jr.) upon decedent's death **
* Decedent could only borrow 50% of
the amount in his plan
** The inheritance taxes owed bY Geor~ e Thoma~ Bennelt, Jr.
[$20,988.11 X ,12 = $2,518.57] are being paid witll the f! l~ng
of this return. ~
TOTAL (Also enter on line 7 Recapitulation) $ 20,988.11
(If mom space is needed, insert additional sheets of the same size)
Page 1 of 3
Philip C. Briflanti
From:
To:
Sent:
Subject:
"Plan Advisors, Inc." <planadvisors@verizon.net>
<pbriganti@pa. net>
Tuesday, July 20, 2004 10:42 AM
Fw: Fw: vague of John William Bennett's 401(k) Plan
Email from Manulife. Loan he then would have been permitted is 1/2 of
$41,976.22 which is $20,988.11.
Plan Advisors, Inc.
610-667-8383
Confidentiality Note: This e-mail is intended only for the
person or entity to which it is addressed and may contain
information that is privileged, confidential or otherwise
protected from disclosure. Dissemination, distribution
or copying of this e-mail or the information herein by
anyone other than the intended recipient, or an employee
or agent responsible for delivering the message to the
intended recipient, is prohibited. If you have received
this e-mail in error, please contact the sender and destroy
the original message and all copies.
..... Original Message .....
From: <~Chris_Kussnlas~manulife.com>
To: "Plan Advisors, Inc." <planadvisors~verizon.ne?
Sent: Tuesday, July 20, 2004 9:51 AM
Subject: Re: Fw: value of John William Bennett's 401(k) Plan
Hi Chris,
Thanks
As of Nov/12/2003 John Bennets account balance was $41,976.22
7/20/2004
FAVORABLE TAX TREATMENT ARE VERY COMPLEX. YOU SHOULD CONSULT
WITH QUALIFIED TAX COUNSEL BEFORE MAKING A CHOICE.
ARTICLE IX
HOURS OF SERVICE
What is an Hour of Service?
An Hour of Service is:
(a) each hour for which you are directly or indirectly compensated by the Employer
for the performance of duties during the Plan Year;
(b) each hour for which you are directly or indirectly compensated by the Employer
for reasons other than the performance of duties (such as vacation, holidays, sickness,
disability, lay-off, military duty, jury duty or leave of absence during the Plan Year); and
(c) each hour for back pay awarded or agreed to by the Employer.
You will not be credited for the same Hours of Service both under (a) or (b), as the case
may be, and under (c).
How are Hours of Service credited?
You will be credited with your actual Hours of Service.
May I borrow money from the Plan?
Yes. You may request a participant loan using an application form provided by the
Administrator. Your ability to obtain a participant loan depends on several factors. The
Administrator will determine whether you satisfy these factors.
What are the loan rules and requirements?
There are various rules and requirements that apply for any loan, which are outlined in
this question. In addition, we have established a written loan program that explains these
requirements in more detail. You can request a copy of the loan program from the Administrator.
Generally, the rules for loans include the following:
· Loans are available to participants on a reasonably equivalent basis. Loans will be
made to participants who are creditworthy. The Administrator may request that you
provide additional information, such as financial statements, tax returns, and credit
reports to make this determination.
· All loans must be adequately secured. You must sign a promissory note along with a
loan pledge. Generally, you must use your vested account balance as security for the
16
loan, provided the outstanding balance of all your loans does not exceed 50% of your
vested account balance. In certain cases, the Administrator may require you to provide
additional collateral to receive a loan.
· You will be charged a reasonable rate of interest for any loan received from the Plan.
The Administrator will determine a reasonable rate of interest by reviewing the interest
rates charged for similar types of loans by other lenders.
· If approved, your loan will provide for level amortization with payments to be made
not less frequently than quarterly. Generally, the term of your loan may not exceed five
(5) years. However, if the loan is for the purchase of your principal residence, the
Administrator may permit a longer repayment term. Unless approved by the
Administrator, you must repay your loan through payroll deduction. If you have an
unpaid leave of absence or go on military leave while you have an outstanding loan,
please contact the Administrator to find out your repayment options.
· The amount the Plan may loan to you is limited by rules under the Internal Revenue
Code. All loans, when added to the outstanding balance of all other loans from the Plan,
will be limited to the lesser of:
(a) $50,000 reduced by the excess, if any, of your highest outstanding balance
of loans from the Plan during the one-year period prior to the date of the loan over
~5our~:u.'?ent outstandingbalal!ce~&of loans; or
~ 1/2 of your vested account b~-
· No loan in an amount less than $1,000 will be made.
· The maximum number of loans that you may have outstanding at any one time is one.
· If you fail to make payments when they are due under the terms of the loan, you will
be considered to be "in default." The Administrator will consider your loan to be in
default if any scheduled loan repayment is not made by the end of the calendar quarter
following the calendar quarter in which the missed payment was due. The Plan would
then have authority to take all reasonable actions to collect the balance owing on the loan.
This could include filing a lawsuit or foreclosing on the security for the loan. Under
certain circumstances, a loan that is in default may be considered a distribution fi.om the
Plan, and could result in taxable income to you. In any event, your failure to repay a loan
will reduce the benefit you would otherwise be entitled to from the Plan.
· If you become entitled to a distribution fi.om the Plan (except in the case of an
in-service distribution), your loan becomes due and payable in full immediately. You
may repay the entire outstanding balance of the loan (including any accrued interest). If
you do not repay the entire outstanding loan balance, your vested account balance will be
reduced by the remaining outstanding balance of the loan. In some cases, you may
request a direct rollover of the loan note to another qualified retirement plan.
The Administrator may periodically revise the Plan's loan policy. If you have any
questions on participant loans or the current loan policy, please contact the Administrator.
17
EV-1511 EX+ (12-g9)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John William Bennett
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
I
FILE NUMBER
21-03-0952
Debts of decedent muet be reported on Schedule
iTEM
NUMBER
2.
3.
4.
5.
6.
5.
6.
8.
9.
10.
DESCRIPTION
FUNERAL EXPENSES:
Neill Funeral Home funerakrelated services
Rev. Kathryn Z. Johnston funeral service
Paxton Presbyterian Chumh opening of grave
Holly Gainor organist
Gingdch Memorials grave marker
Rev. John Green - opening of grave
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Nameof PersonalRepresentative(s) George Thomas Bennett, Jr.
social Securtty Number(s)/EIN Number of Personal Representative(s) 188-32-3665
StmetAddress 248 Smith Rd.
City Shippensburg State PA Zip 17257
Year(s) Commission Paid: N /A
90-603239(
Testate)
Attorney Fees
Family Exemption: (If decedents address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State . Zip
Relationship of Claimant ta Decedent
Probate Fees
Accountant's Fees
Cohick & Assoc.- final tax returns
Tax Return Preparer's Fees
Cumberland Law Journal - advertising letters
The Sentinel - advertising letters
Ziegler's Storage - cleaning out/transferring items from decedent's apartment
LB Smith Ford - tires for decedent's car so it
could be sold
AMOUNT
2,866~70
200.00
150.00
75.00
580.00
100.00
0.00
2,250.00
96.00
165.00
75.00
88.43
577.62
245.1 6
7,468.9t
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John William Bennett
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABIUTIES, & LIENS
FILE NUMBER
21-03-0952
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
2.
3,
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
22.
23,
24.
25.
DESCRIPTION
Donegal Mutual Insurance Co. - insurance premiums
AT&T Wireless - cell phone bill
Bonnie Miller, Treasurer - personal taxes
PPL - electric bill
Patriot-News - newspaper subscription
CAMCO - settJement of credit card accounts
Discover Platinum Card - credit card
Bank of Amedca - credit card
Bank One - credit card
USA Telephone - phone bill
Ameritas Life Insurance Co.
The Sentinel - newspaper subscdption
Jaguar Credit - pay off on vehicle
Physician's Rehabilitation - medical expense
Associated Cardiologists - medical expense
T-Mobile - cell phone bills
Holy Spirit Hospital - medical bill
- insurance premium
~Qciety Hill Apts. - rent
Lenscrafters - optometry expense
Lower Allen EMS - paramedic services
US Treasury - federal income taxes
PA Dept. of Revenue - state income taxes
West Shore Tax Bureau - personal taxes
Weltman, Weinberg & Reis - settlement of Bank One account
Philip C. Briganti, Esq. - legal services rendered before death
TOTAL (Also enter on line 10, Recapitulation) $
{If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
337.00
134.60
77.00
79,57
18.00
8,588'.22
29.63
40.42
159.00
14.28
T4,38
21.99
14,686.01
73.40
20.00
58.99
25.44
70.00
389.00
491.00
20.00
263.27
1,500.00
580.00
28,30'7.20
Register for "My Jaguar, today and enjoy exclusive owner benefits:
-Track vehicle's mileage and maintenance records
-Receive insider notice about special events
-Access account status and morel
Visit www.jaguarusa.com
Click on "My Jaguar" under the heading "Services" to register,
"JAGUAR. Bom to pertorm."
Account Number Vehicl, DeeCqption VI. Stateelent Date [ P~yoff ~ood Through'"%l
00000028342390 2002 JAG X TYPE SAJEA51D22XC08204 11/16/2003 ~2/06/20035 14,641.28
For address changes or other communication, feel free to contact us.
CREDIT
Customer Serv ce Center
Website Address
TRANSACTIONS SINCE LAST,STATEMENT
Date DesCription Amount
11/03/2003 Payment ReCeived
Payments received after statement date are not reflected.
$ 978.88
AMOUNT(S) DUE
1-800-945-7000 Mon-Fri 7 am - 7 pm CST
www.jaguarcredit.com
If you disagree with the amount
~6cessary to payoff your account,
send all communications regarding
your disputed payoff and relaled
.paymants~o:
Jaguar Credit
c/o Correspondence
P.O. Box 681811
Franklin, TN 37068-1811
Data Deecription Amount
12/06/2003 P~/ment Due $ 470.24
Payments receiv~ ob._wee~er~s pr heliday ~ ~!! ~ qred~ited tp you~ acccupt pn thenext businessday,
Payments received at a kx;ation other thant the remittance address shown below may delay crediting
your account, unless otherwise ~ovided by state law.
All other payments should be
mailed to:
Jaguar Credit
Looking for a convenient payment alternative? Arrange for your payments to be automatically transferred from your
checking account. Call our toll-free Customer Service Center number listed above to enroll in AUTO CHECK todayl
Your F nencial Sen/cas Partner Now end in the Future...
As required by laW. in some states, you are hereby notified that a negative credit repoil reflecting your credit record may be submitted to s
credit repo~ling agency il you lail to fulfill the terms of your credit obligations.
Fo~ Texas only, we are attempting to collect a debt and any information obtained will be used for that purpose.
DETACH AND RETURN REMITTANCE COUPON ~ELOW FOR EACH ACCOUNT PAID 11 :,
P.O. Box 5247, Rockford, IL 61125-0087
RETURN SERVICE REQUESTED
Febmaty5, 2004
C JvlCo
11418568
BENNETT, JOHN W.
248 Smith Rd
In Cr Of Tm
Shippensburg, PA 17257-9626
h,.lll..h,hhhhh.lhh,,Ih,,,hhll,,,h,ll.,h,,Ihl
ORIGINAL CREDITOR ACCOUNT NUMBER
53290019991 ~[672~ ~
MBNA
RE: YOUR ACCOUNT WITH CAPITAL ACQUISITION AND MANAGEMENT COMPANY
CURRENT BALANCE
$10,838.57
This letter is to notify you that your MBNA account which was formerly held by MIDLAND RECEIVABLES CORP. has been purchased
by Capital AcqmSilions and Management Company.
As of the date of this letter, you owe $10,838.57. Because of interest charges that may vary fi-om day-to-day, the amount due on the day you
pay may be greater. Hence, if you pay the amount shown above, 0a adjustment may be necessary after we receive your payment, ia which
event we will reform you before depositing your payment. For luther reformation, call the undersigned at (877) 298-0845 Ex: 1123.
Federal law gives you thirty (30) days al~er you receive this letter to dispute the validity of the debt or any part of it. If you don't dispute it
within that period, we will assume that it is valid. If you do dispute it - by notifying us ia writing to that effect - we will, as requn~'d by the
law, obtain and marl to you proof of the debt. And if within the same period you request m the writing the name and address of your origreal
creditor, we will fiunish you with that reformation tee. The law does not require us to wait until the end of 30-day period that begins with
your receipt o f this letter, the law requires us to suspand our efforts to collect the debt until we mail the requested information to you.
To discuss, call Stacy Larson at (877) 298-0845 Ex: 1123 between 8:00 AM and 8:00 PM (CDT) Monday through Friday.
THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
THIS IS A COMMUNICATION FROM A DEBT COLLECTOR.
Please detach the bottom form of this letter and remm it with your payment. An envelope has bean enclosed for your convenience.
[] Payment by check enclosed
To pay by credit card: For your convenience, you may pay by
Visa, Mastercard or AMEX. Please indicate your credit card preference,
provide the account ia forma~ian, and sign below.
Account No.
Expiration Date
Signature
Paint Name
Please pmvida your credit card billing address at the back of thru foma.
BENNETT, JOHN W. 2/5/04
248 Smith Rd
In Cr Of Tm
Shippeasburg, PA 17257-9626 11418568
TOTAL DUE:
$10,838.57
CAPITAL ACQUISITIONS and MANAGEMENT COMPANY
P.O Box 5087
Rockford, IL 61125-0087
CAM0001
Statement for account number: 4266 8510 1200~'~
New Balance Payment Due Date Past Due Amount Minimum Payment
$8,933.33 11/24/03 $350.00 $528.00
BANK ONE.
426685101200990500052800008933334
CARDMEMBER SERVICE
P.O. SOX 15153
WILMINGTON DE 19886-5153
I..lll,h,l.l,h,l,,Ih.hh.,Ihl,h.ll.,I,h.lh,ll,,I
JACK W BENNETT
2902 CHESTERBROOK CT
APT 206
CAMP HILL PA 17011-8115
h.lll.,llh.,,,Ih.llh,l,,.Ih.,Ihl,l.l,h,lh,,I,,ll
t: SO00 & r~O 2P,~: 20 I~ &O & 200 c~ c~o S
BANK ONE.
VISA ACCOUNT SUMMARY
Previmla Ealance $8,821.42
Payments, Orodlt~ - $0.00
Purohaces, Cash, Debif; + $35.00
Finance Charges + $76.91
New Balance ~8,833.33
Statement Date: 10/04/03 - 11/04/03 CUSTOMER SERVICE
PayrnentDceDate: 1t/24)03 thU.8. 1-800-436-7927
Mll~lmumPaymentD~e: ~28.00 Espahol 1-B68-446-330B
/ ~ TOD 1-800-955-8060
~ ~ 1-302-5~-8200
Total Or.it ~ne $15~0~ ACCOUNT INQUIRIES
Awlleble for Cash $3,120 PAYMENT ADDRESS
VISIT US AT:
TRANSACTIONS
Trane Amount
Date Reference Number Merchant Name or 'l'ransaotion Description Credit Debit
11/04 LATE FEE $35.00
11/04 *FINANCE CHARGE* 76.91
FINANCE CHARGES
AVOID LOSING THE CONVENIENCE OF YOUR CREDIT
CARD ACOOUNTI YOU MAY QUALIFY FOR ONE OF OUR
PAYMENT PROGRAMS. CALL 1-800-955-8030(OOLLEOT
1-302-594-8200) TODAY.
PERIODIC RATE(S) AND APR(S) MAY VARY
Daily Corresponding Finance Charge
Periodic Rate APR Average Daily Balance Due To Transaofiolr FINANCE
Category 32day~ in cycle Previous Cycle Current Cycle Periodic Rate Fees CHARGES
Pumheses 02713% 9.900~ $0.00 $8,858.61 $76.91 $76.91
Cash advances .06477% 19.99% $0.00
Total finance charges $76.91
Effective Annual Pe~entage Rate (APR): 8.90%
Grace Period Type: A (Please see ba=k of statement for the Grace Period explanation.)
The Oorrexponding APR la the rate of Interest you paywher~ you carry a balance on purchases or o~sh advances.
The Effective APR reprecent~ your total finance charges - including transaction fees euoh as o~h advance and balance trausfer
fees - expressed aB a percentage.
IMPORTANT NEWS
***TAKE $10 OFF AL~S FAMILY FARMS FLORIDA OITRUSI***
A 30% DISCOUNT ON 2~ LES NAVEL ORANGES, GRAPEFRUIT OR MIXED.
FIRST TIME SUYERS ONLY-S22.95 PLUS S/H, OFFER ENDS 01/16.
CALL TO ORDER: 1-898-231-2314 DEPT. 06X ENJOYOITRUS.OOM
REV-1513 EX+ (~00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John William Bennett
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-03-0952
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and ~ransfers under
Sec. 9116 (a) (1.2)]
George Thomas Bennett, Jr., 248 Smith Rd., Shippensburg, PA 17257
Matthew Theodore Bennett, 857 W. Louther St., Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OB SHARE
OF ESTATE
brother
nephew
50%
5O%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTION8 SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
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
(If more space is needed, insert additional sheets of the same size)
0.00
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DIVISION
DEPT. 280601
HARRISBURG;, PA 1712:8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-16ii8 EX AFP COl-OS)
GEORGE T BENNETT JR
248 SMITH RD
SHIPPENSBURG PA 17257
CUT ALONG THIS LINE
DATE 09-20-2004
ESTATE OF BENNETT JOHN
DATE OF DEATH 11-12-200:3
FILE NUMBER 21 05-0952
COUNTY CUMBERLAND
SSN/DC 161-:34-0699
ACN 04000585
Amoun~c Rem'i ~:'~ed
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF
CUHBERLAND C~.._, CDURT ~OUSE
CARLISLE, PA ~::'1701:3 :.
1'~
REV-IS48 EX AFP (01-03)
W
~m~ RETAIN LOWER PORTION FOR YOUR RECORDS
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ~$SETS
DATE t4)9-20-2004
ESTATE OF BENNETT
JOHN
DATE OF DEATH 11-12-200:3 COUNTY CUHBERLAND
FILE NO. 21 0:3-0952 S.S/D.C. NO. 161-:34-0699 ACN 04000585
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: HANULIFE-4OIK ACCOUNT NO. 00000
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST ( ) TINE CERTIFICATE
DATE ESTABLISHED 05-15-1995
Account Balance 41,976.22
Percent Taxable X 0.500
Amount Subject to Tax 20,988.11
Debts and Deduct/ohs - .00
Taxable Amount 20,988.11
Tax Rate X .12
Tax Due 2,518.57
TAX CREDITS=
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
07-2:3-2004 CD004192 .00 2,518.57
TOTAL TAX CREDIT I
BALANCE OF TAX DUEl
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE TS LESS THAN $1, NO PAYHENT IS REi)UIRED.
IF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU NAY DE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
2,518.57
.00
.00
.00
PURPOSE OF
NOTICE:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act) Act 25 of ZOO0. (72 P.S.
Section 91q0).
PAYNENT:
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Nmke check or money order payable to: REGISTER OF NILLS) AGENT.
REFUND (CR): A refund of a tax credit) which Nas not requested on the tax return, may be requested by completing an "Application
far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office of
the Register of Nills, any of the Z5 Revenue District Offices or by calling the special Zq-hour answering service
for forms ordering: 1-aOO-36Z-ZO50; services for taxpayers with special hearing and or speaking needs:
1-800-~7-30Z0 (TT only).
OBJECT/ONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions ar assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. zaIoz1, Harrisburg, PA 171Z8-1021) OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADHZN-
ISTRATIVE
CORRECTZONS:
DZSCOUNT:
PENALTY:
iNTEREST:
Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue)
Bureau of [ndividual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z60601) Harrisburg) PA 171Z8-060!
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death) a five percent (5Z)
discount of the tax paid is allowed.
The 1SZ 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 end 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 with first day of delinquency) or nine (9) months and one (1) day
frae the date of death) to the date of payment. Taxes which became delinquent before January 1) 198Z
bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .00016~.
Al! taxes which became delinquent on or after January 1) 19aZ 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 200q are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198"~ ZOZ .0005~8 198'~8-1991 1XZ .000501 ZO0'~ 9Z .O00gq7
1985 16X .000~56 199Z 92 .O00Zq7 ZOO2 62 .000Z19
198q llZ .000501 1995-199q 72 .00019Z 2003 5Z .000137
1985 15Z .000556 1995-1995 92 .O00Z~7 ZOO~ qZ .000110
1986 IOZ .O00Z7q 1999 7Z .00019Z
1987 9Z .000Z47 ZOO0 8Z .000Z19
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPATD X NUHBER OF DAYS DELZNQUENT X DAILY TNTEREST 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 data shown on the
Notice) additional interest must be caIculated.
JA~ES A. BALOGH - MN
GARY W. BECKER - DC, FL, IL, MN, WI*
*C~EDITOR~S RIGHTS SPECIALIST
A~ERJCAN BOARD OF CERTIFICATION
CHELSEA A. WHITLEY - MN, WJ
ANGEL& M. HORN - MN
MICHAEL D. JOHNSON - MN
MARY ELLEN WEEMAN - KS, MN, MO
THERSIA O. LEE - MN
CHAD J. BOUNSKE - MN
STEV~N M. TOMS - MN
MICHAEL L. MCCAIN -- MN
WILLIAM B. HOPKINS - MN, WI
JOHN E. OLCHEFSKE- MN
JASON R. FOSTER - MN
MEAGAN M. PROBST - MN
MICHAEL J. DOUGHERTY - MN
BALOGH BECKER, LTD.
A~-I'ORNEYS AT LAW
SEND ALL WRITTEN REPLIES TO:
4150 OLBON MEMORIAl. HIGHWAY, SUITE 200
MINNEAPOLIS, MINNESOTA 55422-4811
TELEPHONE 763-852-8440
FAX 763-852-8499
TOLL-FREE 877-768-4492
REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE, #102
CARLISLE, PA 17013
ARIZONA OFFICE:
64 E. BROADWAY ROAD
BUTTE 175
TEMPE, AZ 85282
DIANA THEOS - AZ, CO
SANDRA TANG - AZ, CA
OE COUNSEL:
LITOW LAW OFFICES, P.C.
(IOWA)
LUSTIG, GLASER & WILSON, P.C.
(MASSACHUSb-TTS)
09129104
Re: In the Estate of
Probate Case No.
Social Security No:
Last known residence:
Our Client:
Account Number:
Amount of Debt:
Dear Sir or Madam:
JACK W BENNETT
212003-952
161340699
SH1PPENSBURG, PA 17257
BANK OF AMERICA
4427100023005684
$ 2196.92
Enclosed please find a Creditor's claim to be filed in the record-Cvith the ab0v~-ref~renced Estate.
Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you
for your assistance. If you have any questions or if this is a duplicate claim, please call our fh-m toll free at 1-
877-768-4492
Cordially,
Balogh Becker, Ltd.
Attorneys at Law
Enclosures
A check for $5.00 for the filing fee.
cc: Attorney for Estate
Personal Representative
This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This
letter is from a debt collector.
COMMONWEALTH OF PENNSYLVANTA
NO TICE OF CLAIM
COURT OF COMMON PLEAS
OF CUMBERLAND ,COUNTY
ORPHANS' COURT DZVZSTON
Tn Re: The Estate of:
Court File No: 212003-952
JACK WBENNETT
Deceased
TO: THE CLERK OF THE ORPHANS' COURT DTVTSZON:
Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Erobate,
Estates, and Fiduciaries Code, 20 PA.C.S.A. §3532(b)(2).
BANK OF AMERICA
1) Claimant's name:
c/o BALOGH BECKER, LTD 4150 OLSON MEMORIAL
2) Claimant's address: HWY STE 200
MINNEAPOLIS, MN 55422
877-768-4492
3)
Creditor listed below is the owner and holder of a claim in the amount of
$ 2196.92
4)
The facts upon which this claim is based:
This claim is based on an account for credit evidenced by the attached
Affidavit of Account Stated.
5) Decedent's address: ShlIPPENSBURG, PA 17257
6) Date of Death: 11/12/o3
7) That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by
On behalf of the claimant, ! do solemnly declare and affirm under the penalties of
perjury that they Information and representations made herein are true and correct
to the best of my knowledge, information and belief.
Dated: ~ ~ 0 ~r~n,,:[ ~
Chelsea A. Whitley/Angela M. Horn/Mary EIl~We~-~an/Chad ~inske/Thersia Lee, Attorney
Written notice of claim was given to Personal Representative and/or his/her counsel
as stated below:
GEORGE THOMAS BENNET
Name
248 SMITH RD
Address
SHIPPENSBURG, PA 17257
City/State/~ip / ,
i nh/ /
Date n6ti-c~ 'm~ailed
IN RE ESTATE OF: JACK W BENNETT
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit.
Your Affiant has reviewed the account records of the Claimant with respect to the
decedent. Your Affiant is familiar with these records and accounts and reviews them as a
regular part of his/her duties.
3. The Decedent purchased merchandise in the amount of $ 2196.92 evidenced by
account number 4427100023005684
The unpaid balance does not include any post-death late payment charges, accrued
interest, collection costs or attorney's fees.
Further your affiant sayeth not
BALOGH BECKER, LTD.
By:
One of its attorneys:
Chelsea A. Whitley__ Angela M. Horn
Michael D. Johnson __ Mary Ellen Weeman __
Thersia O. Lee Chad J. Bolinske
4150 Olson Memorial Highway, Suite 200
Minneapolis, MN 55422-4811
Subscribed and sworn before me
This ,qt9 dayof '(~2 _d~ ,2004.
122221
BUREAU OF ZNDZVZDUAL TAXES
TNHER'LTANCE TAX DZVTSXON
DEPT. Z80601
HARRZSBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTZCE OF INHERITANCE TAX
APPRA/SEMENT~ ALLONANCE OR DZSALLO#ANCE
OF DEDUCT/ONS AND ASSESSMENT OF TAX
PHILIP C BRIGANTI
7q W POMFRET ST
CARLISLE PA 17013
REV-I$4? EX AFP (Ol-O$)
DATE 08-Z3-ZOOq
ESTATE OF BENNETT JOHN
DATE OF DEATH 11-12-2003
FZLE NUMBER 21 03-0952
COUNTY CUMBERLAND
ACM 101
Aeoun~ Raei~ed
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF BENNETT JOHN W FZLE NO. 21 03-0952 ACM 101 DATE
TAX RETURN NAS: ( ) ACCEPTED AS F/LED (X) CHANGED SEE ATTACHED NOT]CE
RESERVATZON CONCERNING FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~:a~e (Schedule A) ¢1)
2. S~ocks and Bonds (Schedule B)
3. Closely Held S:~ook/Par~:narship Tn~ares~ {Schedule C) (3)
q. Mortgages/No,es Receivable (Schedule D)
E. Cash/Bank Depos/~s/Misc. Personal Proper~y (Schedule E) (5)
6. Jo/n~ly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~cs
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Expenses/Ada. Cos~cs/M/sc. Expenses (Schedule H) (9)
10. Dab,s/Mortgage L/abil/~:/es/L/ens (Schedule T) (10)
11. To,al Daduc~/ons
12. Ne~ Value of Tax Re~urn
367.09
31~770.31
.00
.00 NOTE: To insure proper
cred/~ ~o your account)
.CO sube/~ ~he upper portion
.00 of ~h/s fore w/~h your
{ax payment.
.00
32,137.q0
15.
lq.
NOTE:
ASSESSMENT OF TAX: 15. Aeoun~ of L/ne lq a~ Spousal ra~a
16. Amoun~ of L/ne lq ~axable a~ Lineal~Class A ra~e
17. A.oun~ of L/ne lq a~ Sibl/ng ra~e
18. Amoun~ of L/ne lq ~axable a~ Collateral/Class B ra~e
19. Pr/nc/pal Tax Due
(8)
7,q68.91
28~307.20
(1~) 35.776. ]]
(~2) 3,638.71-
TAX CREDITS:
PAYMENT
DATE
Char/~able/Governeen~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
Ne~: Value of Es~:a~e Sub~ec~: ~o Tax (lq) 3,638.71-
:If an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill
reflect figures that lnclude the total of ALL returns assessed to date.
RECEIPT
NUMBER
DISCOUNT (+J
ZNTEREST/PEN PAZD (-)
(z5) .00 x O0 : .00
(~6) .00 x Oq5= .00
(17) . O0 x 12 = . O0
(].8) .00 x 15 = .00
(19)= . O0
AMOUNT PAZD
.O0
.00
.00
.00
:IF TOTAL DUE 1S LESS THAN $1) NO PAYMENT ]~S REQUZRED.
IF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR)) YOU MAY BE DUE
REFUND. SEE REVERSE STDE OF THZS FORM FOR INSTRUCTZONS.)
TOTAL TAX CREDZT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
TF PATD AF~e;~'OATE ]~i~TCATE~)~EE REVERSE
FOR CALCU~t~N OF AI~OTTIOH~NTEREST.
RESERVATION:
PURPOSE OF
NOTZCE=
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT:
PENALTY=
INTEREST=
Estates of decedents dying on or before December 1Z, [982 -- 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 lawfut Class B (collaterat) rate an any such future interest.
To fulfill the requirements of Section 21¢0 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 91¢0).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF #ILLS, AGENT
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-1313). Applications are available at the Office
of the Register of Nills, any of the ZS Revenue District Offices, or by calling the special lC-hour
answering service for fores ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-¢¢7-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shcwn on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, 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.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxas~ ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z&-060l
Phone (717) 787-6505. See page 5 of the bookIet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of
the tax paid is allomad.
The 152 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 end 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 been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of
doeth, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rata of
six (62) percent per annum calculated at a daily rate of .00016¢. All taxes which became delinquent on and after
January l, 1982 wil! 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 2004 are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor
~ 202 . 0005q. 8 ~"~)'~'8 - 1991 llZ .O0030X
].983 Z6Z .000438 1992 9Z . O002¢7
1984 Ill .000301 1993-199¢ 7Z .000192
1985 132 .000356 1995-1998 92 .0002¢7
19B6 lOX .000274 1999 72 .000192
19BT 1aZ .000274 2000 72 .000192
--Interest is calculated as follows=
INTEREST = BALANCE OF TAX UNPAZD
Interest Daily
Year Rate Factor
~ 92 .0002¢7
ZOOZ 62 .000164
2003 5X .000137
2004 4Z .O001lfl
X NUNBBR OF DAYS DELZNQUENT X DAILY ZNTEREST FACTOR
--Any Notice issued after tho 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.
{EV-1 ~?0 EX ((~8~)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME FILE NUMBER
Bennett, John W, 2103-0952
REVIEWED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
G I To be billed directly by the Department.
Row Page 1
FAMILY SETTLEMENT AND FINAL RELEASE
1N
ESTATE OF JOHN WILLIAM BENNETT, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, John William
Bennett, late of Lower Allen Township, Cumberland County, Pennsylvania, deceased,
died testate on November 12, 2003, having first made his last will and testament, which
was duly executed on November 7, 2003, and is duly recorded in Cumberland County,
Pennsylvania at File No. 2003-00952.
WHEREAS, the said John William Bennett, by the aforesaid last will and
testament, named George Thomas Bennett, Jr., as Executor of said last will and
testament;
WHEREAS, letters testamentary on the estate of the said decedent were duly
issued by the Register of Wills of Cumberland County, Pennsylvania, to the said
Executor, hereinafter called personal representative;
WHEREAS, the said personal representative has gathered the assets of
of the said decedent and the assets consist of personal property, to a total value of~
$50,365.02, as set forth in Exhibit A, which is a statement of account of the said p~C~
representative, and which is attached hereto and made a part hereof, and marked
A;
WHEREAS, the debts and deductions, including the payment of inheritanc6Vtax
in the said estate, amount to $38,247.50, leaving a balance for distribution of $12,117.52,
also as set forth in the statement of the said personal representative, which is attached
hereto and marked Exhibit A;
WHEREAS, the balance for distribution as shown in the said statement marked
Exhibit A has been distributed as herein indicated in accordance with the terms of the last
will and testament of the said decedent;
NOW, THEREFORE, we, George Thomas Bennett Jr., the brother of the said
decedent, and Matthew Theodore Bennett, the nephew of the said decedent, both of us
being heirs under the last will and testament of the said decedent, and being those persons
entitled to inherit under said last will and testament, do hereby, each of us, acknowledge
that we have this day had and received from the aforesaid personal representative, in full
satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as
are given, devised and bequeathed to each of us respectively by the said last will and
testament, the amounts due us under said last will and testament, which amounts we have
received this day, and which amounts are in the amount set opposite our respective names
in the schedule of distribution in said statement attached hereto and marked Exhibit A;
AND, each of us does hereby stipulate that in order to avoid the expense and time
involved in the filing of a formal account and schedule of distribution, we each agree that
no account is necessary and we do hereby agree that we do consent to distribution being
made without the filing of an account and schedule of distribution, the same to be with
the same force and effect as if they had been filed and confirmed by the Orphans' Court
Division of the Court of Common Pleas of Cumberland County, Pennsylvania.
THEREFORE, we and each of us do hereby remise, release, quitclaim and
forever discharge the said personal representative, George Thomas Bennett, Jr., and his
heirs, executors, administrators and assigns, of and from the said estate and from all
actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by
reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the
estate of the said decedent, and each of us do further hereby covenant and agree that
should any liability come due to the estate of the said decedent after the signing of this
agreement, we and each of us do hereby covenant and agree with each other and the
aforesaid personal representative that we will contribute pro rata our share of the estate to
satisfy any and all claims, demands, suits, or causes of action which may be successfully
prosecuted against the said estate or the aforesaid personal representative after the
signing, sealing and delivery of this family settlement agreement and final release. 2/d:~-~
IN WITNESS WHEREOF, we have hereunto set our hands and seals this
day of January, 2005.
~eeorge Tt~mas ~3ennett,
Matthew Theodore Bennett
STATE OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
On this, the 5[ day of , 2005, before me, a Notary
Public, the undersigned officer, personally appearelfl-~George Thomas Bennett, Jr. and
Matthew Theodore Bennett, 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.
Notary Publi~
EXHIBIT A
STATEMENT OF ACCOUNT OF PERSONAL REPRESENTATIVE
AND SCHEDULE OF DISTRIBUTION
ASSETS
Miscellaneous personal effects (distributed to heirs)
Paychecks/commissions from N.B. Liebman
Commerce Bank checking account
M&T Bank checking account
Proceeds from sale of 2002 Jaguar
Proceeds from redemption of savings bonds
Refunds of deposits/overpayments/premiums
Proceeds from MetLife insurance policy
Federal income tax refund
Cash
Attorney's escrow account
VALUE ($)
1,500.00
6,390.40
1,254.31
723.81
22,000.00
367.09
630.25
16,488.74
982.00
25.00
3.42
DEBTS/DEDUCTIONS
Funeral expenses
Payment/settlement of debts
Inheritance taxes
Administrative costs
Attorney's fees
TOTAL ASSETS
$ 50,365.02
3,971.70
27,656.60
2,518.57
1,250.63
2,850.00
TOTAL DEBTS/DEDUCTIONS $ 38,247.50
DISTRIBUTION OF ESTATE
Balance for distribution $ 12,117.52
Value of personal effects distributed to
George Thomas Bennett, Jr. 750.00
Value of personal effects distributed to
Matthew Theodore Bennett 750.00
Cash distributed to George Thomas Bennett, Jr. 5,308.76
Cash distributed to Matthew Theodore Bennett 5,308.76
BALANCE $ 0.00
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/11/2005
BRIGANTI PHILIP CHARLES
74 W POMFRET STREET
CARLISLE, PA 17013
RE: Estate of BENNETT JOHN WILLIAM
File Number: 2003-00952
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
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: 11/12/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
I.-lr-
Cumberland County - Register or WlLLS
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/11/2005
BENNETT GEORGE THOMAS JR
248 SMITH ROAD
SHIPPENSBURG, PA 17257
RE: Estate of BENNETT JOHN WILLIAM
File Number: 2003-00952
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
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 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: 11/12/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
L..- G-
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
John William Bennett
Date of Death:
11/12/2003
2003-00952
Estate 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 ~ No 0
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 0 No EJ
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 Gl No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
Date: I /~ ~ _ oa;oo to this report. &r I ~
. Signature
Philip C. Briga ti, Esq.
Name
74 W. Pomfret st.
Carlisle, PA 17013
Address
(717) 960-0005
Telephone No.
I...)
I j :21 :;d 6-
, ro '7
1", il!
. ...J "1,)1,.;
Capacity: 0 Personal Representative
~ Counsel for personal representative
j
";''Jr, J:r)IJ.ln U"'-"UriJ('\rD',
- Jv,.J-,v :.J-..;\.J\).J(;
"
~)
Vf:;
..
IN THE CIRCUIT COURT IN AND FOR
CUMBERLAND COUNTY PROBATE DIVISION
INRE:
JACK W BENNETT
Our Client:
BANK OF AMERICA, N.A.
Account No:
4427100023005684
Court File No:
212003-952
SATISFACTION AND RELEASE OF CLAIM
The above named Claimant has received the sum of $1651.00 in settlement payment of the claim
made against the Estate. This Satisfaction and Release of Claim is executed to acknowledge
payment and discharge of claim and to release the Estate and personal representative from all
further liability with respect thereto.
Executed this L day of M;) v(iMb(r , 20 f) 5.
::O//lMl/;: JJt
One of its Attorneys-in-Fact:
Chelsea A. Whitley _ Angela M. Horn _
Michael D. Johnson Mary Ellen Weeman_
Thersia O. Lee _ ~Chad J. Bolinske _
Matthew R. Eichenlaub
Attorney-in-Fact for CI imant
4150 Olson Memorial Highway, Suite 200
Minneapolis, Minnesota 55422-4811
877 -768-4492
~-.)
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