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Home My WebLink About04-0702PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as , Deceased. Social Security No.& ~l I~[(~ a~ ~-{.5~.5''- No. To: Register of Wills for the County of C_~-c,~-~0rt~_~t6 in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl xe · for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in (~. ~,~..r ~ e.~- £ ,6~' .5~County, Pennsylvania, with h-~ e- last family or principal residence at ~c.~ ~/ M/t At o n eff,~ ~.~ ,-~ ~ ,~ (list street, number and municipality) Decendent, then ~ years of age, died ~ '~7- ;2 ,.'7. , ~l c~ ~ , Decendent at death owned property with estimated values as folllows: (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: Petitioner after a proper search ha the following spouse (if any) and heirs: Name ascertained that decedent left no will and was survived by Relationship Residence THEREFORE, petitioner(s) respectfully request(s) the grant of letters of ~inistration in~[h~ appropriate form to the undersigned. ~,' ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~- ss COUNTY or 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 representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affir~ng~_c~nd subscribed r- ~( ]~-~~ before lng this ~d.~'-~ ,/ day of ] _ Estate ,Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW ~'(xl ~_ c>~t~ ~r_2Oq 1~ in consideration of the p~ition on the reverse side hereof, s~$facto~ proof having been presented before me, IT IS DEC~ED that ~~ ~ ~a~4 is/are entitled to Letters of Ad~nistration, ~d in accord Mth such finding, Letters of Ad~nistration ~e hereby granted to ~ ~ ~e ~ ~ ~ ~t c_ ~ in the estate of~~ ~ ~C~ FEES Letters of Administration ..... $ ~. Short Certificates( ) .......... $ Renunciation ................ $ TOTAI,~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 10589301 Fee for this certificate, $2.00 ~ No. ~ Date JUL 2 3 200 CERTIFICATE OF DEATH COU~ OF D~TH .. I~tor ,,~. ~tal Mfg. 837 West ~ St. I~ ~lisle, PA 17013 PA Bertha Richwtne 837 West North St., Carlisle Pa 17013 xo*.~ Westminster ,~tmo*eo~sso~r~c~uw Hoffman-Roth Funeral Home CERTIFICATION OF NOTICE UNDER RULE 5.6 (c) Name of Deeedem: Pauline M. Barrick Date of Death: July 22, 2004 Will No.: 21-04-7502 To the Register: I certify that notice of (beneficial interest) estate administrntion 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: August 4, 2004. Nanle Kenneth E. Barrick Kenneth J. Barrick Frank L. Barrick Address 837 WestNorth Street, Carlisle, PA 17013 12 Irene Court, Carlisle, PA 17013 340 Dorwood Drive, Carlisle, PA 17013 Notice has now been given to ail persons emitled thereto under Rule 5.6(a) except: None. Capacity:__ Gtorge F. DoUglas, III, Esqu'n~ Duncan, Hartman & Douglas, P.C. One.Irvine Row Carhsle, Pennsylvania 1701~ Telephone (717)249-7780 Personal Representati~ X __ Counsel for Personal ~senta~ve ESTATE OF PAULiNE M. BARRICK, DECEASED BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA NO 21-04-702 DECREE AND ORDER OF THE REGISTER OF WILLS AND NOW, this 1 lth day of August, 2004, Letters of Administration in the Estate of the above-named decedent having been granted on July 28th, 2004 to Kenneth E. Barrick in the Estate of the above-named Decedent, and the instrument dated August 8, 1977, having been admitted to probate as the last Will of the above-named Decedent, it is hereby ordered that the Letters of Administration which were granted July 28th, 2004, to the aforementioned, are hereby revoked. Fees previously paid for the Letters of Administration will be credited to the fees for issuance of Letters Testamentary. Date Glenda Farner Strasb'augh Register of Wills PETITION FOR PROBAI'E and ~RANI OF LETTERS Estate of PA UL1NE M. BARR]CK also known as N/A, Deceased. Social Security No.: 201 -I 8-0455 No. 21 -04- To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner who is 18 years of age or older and the Executor named in the last will of the above decedent, dated August 8, 1977, and codicil dated (NONE). Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 837 West North Street, Carlisle, Pennsylvania (Borough of Carlisle). Decedent, then 79 years of age, died July 22, 2004, at Thomwald Home, Carlisle, Pennsylvania. 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: no exceptions. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner respectfully requests the probate of the last will and codicil presented herewith and the grant of letters Testamentary thereon. ~---'7: -. -~-- Kenneth E. Ba~rick, Exe~utor 837 West North Street Carlisle, PA 17013 OATH OF PERSONAL REPRESENTATIVE , COMMONWEALTH OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative(s) of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this \:x-~th day of Kenneth E. Barrick Signature(s) Estate of PAULINE M. BARRICK, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW (~( ;~,.~ oc~k ~:){- j ..~)~ ~ 2004, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, 1T IS DECREED that the instrument(s) dated August 8, 1977, described therein be admitted to probate and filed of record as the last will of Pauline M. Barrick and Letters Testamentary are hereby granted to Kenneth E. Barrick. ~ Register of Wills ' ^' FEES Probate, Letters, Etc ......... $ Short Certificates ( ) ......... $ Renunciation .............. $ $ TOTAL __ $. Filed ..~.. [¼..C?.i.[ .................... George F. Douglas, Ill, Esquire (61886) One lrvine Row Carlisle, PA 17013 (717) 249-7780 UL 2, 3 200~, Pauline M. Barrick Bb Oz~ber land ... Inspector 837 West North St. Carlisle, Pa 17013 CERTIFICATE OF DEATH z Female 201 - Frank Adam~ Xenneth E. Barrick ~,~, July 26, 2004 Bertha Richwine 837 West North St., Carlisle, Pa 17013 Jnt~ 014351 h n=.219 N. Hanover St., Carlisle, PA 17015 Also kno~n as __ OATH OF NON.SUBSCRIBING WITNESS ', __,Deceased (e, agk)-a subscriber heretO,.(-eaet'rYbeing duly qual¢ied according to law, depose(s) and say(s) that (one of the subscribing wimesses to) the signature on the codiCil/will is in the hand,axiting of to the best of ~ knowledge and belief. Sworn to or affirmed and subscribed · . ~ ~_'o, day pf Bogare me tins ~ (Name) - uJ UJ LM COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENI'S NAME {LAST, FIRST, AND MIDOLE INITIAL Oarrick, Pauline M. DATE OF DEATH (MM-DD-Year) 07/22/2004 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 11/02/1924 OFFICIAL USE ONLY FILE NUMBER 2 I -0 4 SOCIAL SECURITY NUMBER 2 0 1-1 8-0 4 5 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDOLE INITIAL) SOCIAL SECURITY NUMBER Barrick, KennethE. 1 8 4- 1 2- 2 3 6 3 [] 1. Original ,etum [] 2. Supplemental Re~um [] 3. Remainder Retem (d~of,~a~ pd~rto12-13-82) [] 4. Limited Estate [] 4a. F~ture Interest Compromise (~ e~ a~rlZ-l~L~ [] 5. Federal Est~e Tax Retum Rsquirad [] 6. Decedent Dled Testate (~c~yof~ [] 7. BousdentMaintainedaLivingT~ust(~t~chcopr~m,~s~ 0__ 8. TotaINumbarofSateDeppsitBoxes [] 9. LifigalJon Proceeds Received [] 10. SpousalPove~/Credit(aw~f~ea~:,.en12-31-9~a~l.l.~5) [] 11,ElectiontotaxunderSeo. 9113(A)~achscho) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS George F. Douglas, III, Esquire NAME ,geor,qe F. Douglas, Iff, Esquire FIRM NAME (ffApplicable) Duncan, Hartman & Dou,qlas, P.C. TELEPHONE NUMBER (717) 249-7780 One Irvine Row Carlisle PA 17013 1. Real Estate (Schedule A) (1) 2. Stod(s and Bonds (Schedule B) (2) 3. Cleeaty He~d Co~oraflon, Parlnership or Sole-Propdeto~ship (3) 4. Modgages & Notes Reoeivabte (Sshedule D) (4) 5, Cash, Bank Deposits & Miscellaneous Pemonal Properiy (5) (Schedule E) 8. Jointly Ow,ed Proder~ (S~edule F) (6) ] Sepa rata Billle§ R~luested 7. Inter-Vivus Transte~ & Miscellaneous Non-Probate Pro~ (7) (Schedule G or L) 8. Total areas Assg~s (total Lines 1-7) g, Funeral Expenses & Adminislm~i~e Costs (Schedule H) (g) 10. Debts of Decedent, Mortgage Liabili~s, & Liens (Schedule I) (10) 11. Total DedeoBoea (total Lines g & 10) 12. Net Velea of Estate (Line 8 minus Line 11) 13. Chadteble and Govemmeotel Boqueats/Sec 9113 Trusts for whish an election to tax has not been mede (Sshedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 191:670.27 O.oo (8) 15,318.35 (11) (12) (13) (14) 1 g~670.27 15T318.35 4~351.92 4~351.92 SEE INSTRUCTIONS ON REVERSE BIDE FOR APPLICABLE RATES 15. Amount of Une 14 taxable at the spousal tax rate, or ~nsfe~s under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rote 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x 0.00 (15) 4,351.92 x .045 (16) X .12 (17) x .15 (18) (19~ 195.84 195.84 Decedent's Complete Address: 837 West North Street Carlisle Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount I STATE PA I ZIP 17013 (1) 195.84 3. Interest/Penalty if appflcable Tetal Credits ( A + B + C ) (2) D. Interest E. Penalty Total Infemat/Panalty ( D + E ) (3) 4. If Line 2 is greeter than Line 1 + Une 3, enfer the difference. This is the OVERPAYMENT. Check box on Page I Line 20to request a refund (4) 5. If Une 1 + Une 3 is greater than Line 2, anter the difference. This is the TAX DUE, (5) A. Enter the interest o~ the tax due. (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: ~EGIS)'E/~ OF WILL~, AGENT 9.79 186.05 186.05 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 incoma of the properly transfen-ed; ........................................................................... [] [] b. retain the dght to designate who shalr use the property transferred or its income; ........................................ [] [] c. retain a mvemianary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefltsor.care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer properly within one year of death without receiving adequate consideration?. .............................................................................................. [] [] 3. Did decedent own an 'in trust for' or payable upon death bank account or secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Relirernent Account, aonuity, or other non.probata property which contains a beneflciar/designation? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTION8 I$ YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Ag'g,A,-SS Keni~e~h E. Barrick, Administrator 837 West North Street~ Carlisle S,GNATURE OF~ER~ ADORESS 'George F. ~)ouglas, III, Esquire One Irvine Row, Carlisle DATE / PA 17013 DATE PA 17O13 For dates of death on er after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or f~' 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 no{ exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return am 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 stepperont of the child is 0% [72 P.S. §9116(a)(I.2)]. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Barrick. Paulin~ M, Include the ITEM NUMBER 1. SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY FILE NUMBER 21 04 7002 ~roceeds of Ii,gabon and the date the proceeds were received by the estate. All property jointly-owned with the right of smvivomhi ~ must be di.¢u,~ _~_ on Schedule F. VALUE AT DATE DESCRIPTION OF DEATH Waypoint Bank certificate no. 8000020227. Principal - $1,224.27 Interest- $1.15 Waypoint Bank certificate no. 8000048653. Principal - $1,200.51 Interest- $ .92 Waypoint Financial Center, Glenbrook Life fixed annuity, account # GA0839630 SEE ATTACHMENTS FOR THE ABOVE TOTAL (Also enter on line 5, Recapitulation) $ 1,225.42 1,201.43 17,243.42 19,670.2/ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRA?IVECOSTS ESTATEOF Ba~ick. Pauline M, Debts of decedent must be repmted on Schedule I. FILE NUMBER 21 04 7Q02 ITEM NUMBER 2. 3. 4. 5. 6. 7. DESCRIPTION FUNERAL EXPENSES: Hoffman-Roth Funeral Home Westminster Cemetery, grave opening Carlisle Memodal Serivce, Inc., headstone Installation of headstone Funeral luncheon: food-$285/cooks-$100 Clergy Honorarium Hairdresser ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pemesal Representative (s) Social Security Number(s) / EIN Numbe~ of Pers~qal Representative(s) Street Address C~y state Year(s) Commission Paid: AttomeyFees Duncan, HaRman & Douglas, P.C. Family Exemp~no: (if decddenfs address b not the same as claimant's attach explanation) Caimant Kenneth E. Rarrick StrnotAddresa 837 West North Street Zip c~.Carlisle stme PA Zip 17013 Re~a~nship of Claimant to Decedent Spouse Probate Fees Costs to Date - $56.00 In Reserve - $100.00 Accountant's Fees Tax Return Preparers Fees Cumberland Law Journal, advertise Letters The Sentinel, advertise Letters TOTAL (Aisc enter on line 9, Recapitulation) $ AMOUNT 7,205.00 995.00 1,973.00 176.40 385.00 50.00 50.00 800.00 3,500.00 75.00 108.95 15,318.35 REV-1513 EX + COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ba~ick. l'aulineM. NUMBER I. 1. SCHEDULE J BENEFICIARIES FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTrONS [indudeout~ight spousaldistfibutJons and transfers under Sec. 9116(a) (1.2)] Kenneth E. Barrick 837 West North Street Carlisle, PA 17013 Do Not List 21 04 700~ RELATIONSHIPTO DECEDENT AMOUNT ORSHARE OF ESTATE Spouse 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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 $ I, Ps ...... 1' ~- ~",. ..... h~-u~rick, of Carlisle, Penns,~lvania~ ~llaks this nF wi].L and ret-nks all wilL~ aud codicils to wills made b~ ~e. 'L Z 'c~.~e m~ dj amond ~in~; 'to bhe first daughter born to ~)ither .... , _e~ .,bh ,.. Ba~z~ck or Frank L~ Barrick if she ts at the tinge of ~,~), c.e~tth. The receint of her father' for the z-:i_ng bca -'H)fJ [o.ter)~- release of my executors. 2~ [[ '~v~ ls~ ~lJ.!lk stole to m? daughte~ in law~ Jacqneline T. Ds.r'~'ick, [J '=~e ~s li~ing at the time of my death. '~. ][ .i. ve~ devise, and hequ. eath the ramainder el' gv estate 'uy chlld:~,en~ i~nn~'bb J. ?]arr-[ck and Frank L. Darrick~ in equal shares ~,.. 71: Declare that the expenses o.f m~,' burial shall be corns I '~a" ha~e which are u~aJ.d at the time of my death. 5. 1 a'~ol.r,'b Farmers Trust Company of Carlisle, Pennsylvania ~guard[an of an',' )roper'b~ which passes, either under this will done so~ Such %[z~:d'i, sn shall have the power to use principal ed~'catlon (i~]c!udinf college education, undergraduate and graduate) ~¢/thout re!~az.d to his or her parent's ability 'bo provide executor~ to settle ~ly estate. My executors shall serve without fili~ Carlisle, Pennsylvania, be used in the settlement of my estate. Phdline ~.. BarricH~ St'ace, ~ublished, and declared by Pauline M. Barrick, as he~- last will ia the presence 0£ us, who, at her request, in her precence and the uresencs of each other, have subscribed our Waup i.n t 8/10/2004 DUNCAN HARTMAN & DOUGLAS PC 1 IRVINE ROW CARLISLE PA 17013 The information which you requested on the account(s) of PAULINE M BARRICK (Social Security Number 201-18-0455) is/are as follows: 8000020227 8000048653 CERTIFICATE CERTIFICATE Account Number Class of Account Date Opened Principal Balance Accrued Interest 123095 1224.27 1.15 Balance at Date of 1225.42 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 123095 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established 022699 1200.51 .92 1201.43 SOLE 022699 Additional Information Reque~ed ~-tac~erel,2~ .-.~ I t "ERIN E WATTS SENIOR SERVICES REP. RO. Box 171 I, HARRISBURG. PGNNSYLVANIA 17105-1711 Waypoint FINANCIAL CENTER 2500 Kingston Road York PA 17402 717.840.8412 August 12, 2004 George F. Douglas, HI, Esquire One Irvine Row Carlisle, Pa. 17013 RE: Pauline M. Barrick As per your request, I am furnishing the following information concerning a fixed annuity, which Pauline Barrick had purchased through Waypoint Financial Center: 1. Type of Account- Fixed Annuity 2. Account Number= GA0839630 3. Company Name- Glenbrook Life 4. Date originally purchased- March 6, 2001 5. Current Account Value as of August 8, 2004- $17,243.42 This contract has a named beneficiary, which is Kenneth E. Barcick to whom the funds would be paid. Mr. Barfick needs to contact the branch and make arrangements to claim the funds. l~specffully, /Financial Consultant Securities are offered through Essex National Securities, Inc., member NASD.SIPC. Insurance products are offered through Waypoint Brokerage Services, Inc. May Go Down In Value Nor Insured By Any Federal Govern m eno Agency COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1718B 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD O04395 DOUGLAS GEORGE F III ESQ 1 IRVINE ROW CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 201-18-0455 FILE NUMBER: 2104-0702 DECEDENT NAME: BARRICK PAULINE M DATE OF PAYMENT: 09/17/2004 POSTMARK DATE: 09/1 7/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 07/22/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $186.05 REMARKS: TOTAL AMOUNT PAID: $186.05 SEAL CHECK# 1582 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INH£RITAHCE TAX DIVISION PO BOX ~280601 HARRTSBURG, PA 171Z8-0601 CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1547 EX AFP (09-0~) GEORGE F DOUGLAS III ESQ Z6 W HIGH STREET CARLISLE PA 17015 DATE 11-Z9-ZOOq ESTATE OF BARRICK DATE OF DEATH 07-ZZ-ZOOq FILE NUNBER 21 O~-070Z ..~qUNTY CUMBERLAND :'ACH: 101 Amount Remitted PAULINE M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~,~ REV-15~7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF BARRICK PAULINE H FILE NO. 21 0~-0702 ACN 101 DATE 11-29-200~ TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) $. Closely Held Stock/Partnarshlp Interest (Schedule C) ($) q. Mortgages/Notes Receivable (Schedule D) (q) E. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 19z670.27 .00 .00 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion of this form with your tax payment. (S) 19,670.Z7 APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/Nisc. Expenses (Schedule H) 10. Dabts/Hortgage Liabilities/Liens (Schedule Z) 11. 12. 15. lq. NOTE: 15,318.35 (9) (z0) .00 Total Deductions (11) Net Value of Tax Return (12) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J] (15) Net Value of Estate Sub~ect to Tax (lq) ASSESSNENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of Line lq taxable at Lineal/Class A rate 17. Amount of Line lq at Sibling rate 18. Amount of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DATE NUMBER 09-17-200q COOOq395 If an assessment was issued previously, lines 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. (~s). q,$51.92 x O0 = (16). .00 X Oq5= (17) .00 x 12 = (la) .00 x 15 = (19)= D/SCOUNT INTEREST/PEN PAID (-) .00 ANOUNT PAID 186.05 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 15.318.35 q,$51.92 .00 q,$51.9Z 18 and 19 will .00 .00 .00 .00 .00 TOTAL TAX CREDIT I 186.05 BALANCE OF TAX DUEl 186.05CR INTEREST AND PEN. .00 TOTAL DUE 186.05CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DU~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.)~L/~ . RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying an or before December 12, 19BZ -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho decadent after the expiration of any estate for life or for years, the Comsonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S. Sect[an 9140). Detach the top portion of this Notice and submit with your payment to the Register of Rills printed an the reverse side. --Hake check or money order payable to: REGISTER OF N/LLS, AGENT A refund of a tax credit, Nh[ch ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications ars available online at wae.revenus.stata.oa.us~ any Register of Nills or Revenue District Office, or from the Department's Z4-heur ensnaring service for forms orders: 1-800-562-2050; services for taxpayers ~ith special hearing and/or speaking needs: 1-800-447-5020 (TT only). Any party in interest not satisfied eith the appraiseant, allowance or disalloeanca of deductions or assessment of tax (including discount or interest) as shown on this Notice may object eithin 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at wew.boardofappaals.stata.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Board of Appeals wabsita. You amy also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box ZBlOZ1, Harrisburg, PA 17128-1021. Petitions may not be foxed. D) Election to have the matter determined at the audit of the account of the parsonat representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in ar[ting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, P.O. Box 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid eithin three (5) calendar months after the decadant's death, a five percent (BI) discount of the tax paid is a11oeed. The 15X 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 sams tiaa period as you would appeal the tax and interest that has been assessed as indicated on this netice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes Nhich became delinquent before January l, 1982 bear interest at the rate af six (6Z) percent per annum calculated at a daily rate of .000164. All taxes eh[ch became delinquent on and after January 1, 198Z mill bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for [982 through 2004 ars: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~'6-1991 Ill .000501 ~ 9Z .O00Z~7 1985 16Z .000q58 1992 92 .000247 ZOOZ 62 .00016~ 198~ llZ .000501 1995-1994 7Z .O0019Z 2005 52 .000137 1985 152 .000556 1995-1998 9Z .O00Z~7 ZO0~ ~Z .000110 1986 lOX .O0027~ 1999 7Z .O0019Z 1987 102 .O00Z7~ ZOO0 72 .O0019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Not[ca issued after the tax becomes delinquent wilt reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Tf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (6-88) ~ INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME FILE NUMBER Pauline M. Barrick 2104-0702 REVIEWED BY ACH ANITA MCCULLY 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES As per will, the spouse is the beneficiary of this estate and therefore taxable at 0%. ROW Page 1 U c) L~~ h~ ~~:.~ ~, \)'-- STATUS REPORT UNDER RULE 6.12 Name of Decedent: Pauline M. Barrick Date of Death: July 22, 2004 Will No. 21-04-0702 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration of the above-captioned estate: :.C Date: C"::! ,L" " ! L:",' L__' r.c ( " c:s I.Ll ex:: 1. State whether administration of the estate is complete: Yes IllI 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 fmal account with the Court? Yes 0 No IllI 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 IllI No 0 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. o N ,..,. N ,~ trl=~1.{ I 0) ES?':: O~'I: (L.:'.': o-~, U ~c.~~ ~ deorge F. Douglas, III, Esquire 26 West High Street Carlisle, Pennsylvania 17013 (717) 243-6222 ;1:: .-,.r:C: , 1~<"':) C':"., = c-J Capacity: _ Personal Representative X Counsel for Personal Representative BUREAU OF INOIVIllUAL.TAXES . INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 11128-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT GEORGL.FDOUGLAS 26 W HIGH STREET CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN III ESQ PA 17013 *' D IlEl~lU7 EX AF' U2-D4) 01-03-2005 BARRICK 07-22-2004 21 04-0702 CUMBERLAND 101 Allount R..illed PAULINE M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub..it the upper portion of this for.. with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... IlW:f~t1.,.!r.m".rar..lm...........YAMM!nlI~r"fll.r.~tA~fI\'H'f.b'I!'.lI.!:'l!6OW......................... ... ESTATE OF BARRICK PAULINE M FILE NO. 21 04-0702 ACN 101 DATE 01-03-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHEO ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 11-22-2004 PRINCIPAL TAX DUE:. PAYMENTS (TAX CREDITS): .00 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-17-2004 CD004395 .00 186.05 12-17-2004 REFUND .00 186.05- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J ~ OV\