HomeMy WebLinkAbout03-0972 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~/V~t~ ~ /tY,,qtgl;'tlS No.
also known as To:
Register of Wills for the
County of C~m~A~ in the
Social SecuriLv No. t?~- ~ 7- d& $~ceased.
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Yotlr petitioner(sL who is/are 18 years of age or older an the execut~;x named
in the last will of the above decedent, dated ~ ~ 1~
and codicil(s) dated ~ '
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendem was domiciled at death in ~btrl~ . County, Pennsylvania, with
h;~ last family o[ pr~cipal residence at ~q~? ~r
(list street, number and muncipality)
Dece~dent, then ~ years of age, died ffP~ / ~ ~ , ~2~ ,
ExCept as follo'ws, decedent did not marry, was ffot ' ' " t . - ·
d~vorced and d~d not have a child born or ad~pted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at d6ath 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: ~qff~ ~ ~/~ ff~/t
0"~ ~ I~ ~.~., ~ %~~ ~" -
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~/4P/~5~ff-~ff~f ss
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-
tativets) of the abov¢ decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or aff'rm~lc[_and subscribed 9< .-~{~
before me this ~ 0~ day of [ ~,~~.
eglster
No. ~9.1 o O~ -q'~ ~_
Estate Of BRENARD H PAULUS , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW NOVEMBER 24, 2003 ){9 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 5- 22-1995
described therein be admitted to probate and filed of record as the last will of
BRENARD H PAULUS ;
and Letters TESTAMENTARY
are herebygrantedto LARAINE K HOLLEY F/K/A LARAINE K CAMPBELL
Probate, Letters, Etc .......... $
'Short Certificates( ) ..........
Filed /I-~ g-~OQ~ 7/7. %&~-oZo~
.......... - .................... PHONE
REGISTER OF WILLS OF O~a_rn tS~ COUNTY
OATH OF SUBSCRIBING WITNESS
_
~ a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that ~ff ~5 present and saw
the testat,~ , sign the same and that ~ signed as a witness at the
request of testa~ in h'~5 presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this ~0~
day of
(Address)
(Name~
(Address)
REGISTER OF WILLS OF COUNTY
OATH.QF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified a~ing to law, depose(s) and say(s) thal
~-~ familiar with the signatOlre ot~,,, ,
J cod,-'
testat___ e -- _ ' o) the will~esented herewith and
t~e wi~l~C°%he~;~ handwriting of
that
to the~t/of ~__ _ knowledge and~~
Sworrt to or affirmed and subscribed before
me this _ _ day of
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
(each) a subscribing witness to the ~...p. resemed h'~~e~c,)being du~qualified according to
law, depose(s) and say(s) that '~'.~ ~"~-.~N,, ~ present and saw
the testat ., sign the same and that ~ signed as a witness at th~
request o~ ~~ ~nce and (in the presenc~ of e~er)(in the presence of the
other subsc~.~itness(es)). ~~- ....... ~x
Sworn to or affirmed and subs~ib~efor~ ' '~.~, ~
me this ~~~ ~~.~ ..~~~
~ ~ (Name}
(Address)
REGISTER OF WILLS OF Czzs;~~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
-(.each) a subscriber hereto, (t-ach') being duly qualified according to law, deposes) and say(s) that
~ ~ familiar with the signature of
testator of ~ .... c .~ .... ~--_:~: ..... :
...................... ~ ........... to) the will presented herewith and
codicil
that ~ff~ believes the signature on the will is in the handwriting of
to the best of ~ knowledge and belief.
me this ~0~ day of
(Name)
fAddress)
105.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00 ~ ~
~ ~-~cal Registrar
P 7 5 0 4 5 4
No. ~ Date
HI05.~44 Rev. 1/9~ COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
'FJ~RtNT
CERTIFICATE OF DEATH
MANENT (Coroner)
INK
'E FILE NUMBER
Brenard H. Paulus
Male 195 - 07 - 2666
~u~. o.v. ~,~ s~.., F.,~.'c~.,,yl 2 0 0 3
86 12/5/1916 ~rl~d
-~0 Perry S.W. Madison RT 233, 5 miles south of th ~,~c~..
White
H~ ~il~r v.,~ ~ 8 (o-m
3499 Ri~er Hi~y ,~,.s, .... PA -
-- ~ ,~*.~ ~.~,~,, West P~
N~ille, PA 17241 ~,~ ~rl~d ,~ ,~
Paulus Flor~ S~ne
P.O. ~x 588; N~ PA 17068
/2003 ~ ,~Wes~ster ~rlisle, PA
FD 012633 L Brot~rs ~eral H~, ~rlisle, PA 17013
/03
~ Hu[t~p[e S~u[[ E~ac~u~es ,
~~ ~. _.._~[_~t ~o~ce ~auma
· .~m~.~.. - ' ....................... u ~~,~.~ I,,,. 11/14/~3
~1l ......................... ' ' P , ~ due to the cmu.(I) i~ M~chael J. Shalon~
~~ ............................................ ~ ~.0 Trout Lane, Marysville, PA
LAST WILl. AND TESTAMENT OF BRENARD II. PAULUS
I, BRENARD H. PAULUS, of the West Pennsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and making void any and all prior
Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath to my beloved wife, MIRIAM A. PAULUS, to
her own use and benefit absolutely.
3.
In the event, however, that my said wife should predecease me, or should die at about the
same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said
estate unto my son, TERRY B. PAULUS. In the event that my son should predecease me, I give,
devise and bequeath my said Estate in equal shares unto his own issue of his body, to wit:
PAULA ANN THOMAS, LARAINE K. CAMPBELL, TAMMY SMILEY and MICHELLE
PAULUS.
4.
I nominate, constitute and appoint my wife, MIRIAM A. PAULUS, to be the Executrix of
this my Last Will and Testament. In the event that she should predecease me or for any reason be
unwilling or unable to act as such Executrix, I nominate, constitute and appoint my son, TERRY
B. PAULUS, to be Executor in her place and stead. In the event that he should predecease me or
for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoim
my granddaughter, LARAINE K. CAMPBELL, to be Executrix in his place and stead. I further
direct that they shall not be required to file bond or other security in the Office of the Register of
Wills for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2,-2. day of
'~'~ &~ , A.D. 1995.
BRENARD H. PAULUS
Signed, sealed, published and declared by the above-named BRENARD H. PAULUS as
and for his Last Will and Testament, in the presence of us, who at his request and in his presence,
and in the presence of each other, have hereunto subscribed our names as wimesses.
LAST WILL AND TESTAMENT (]F
BRENARD H. PAUI33S
CHARLES E. SHIELDS III
ATTORNEY-AT-LAW
MELLON BANK BUILDING
2 W. MAIN STREET
MECHANICSBURG, PA 17055
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Brenard H. Paulus
Date of Death: November 13, 2003
Will No. Admin. No. 21-03-0972
TO THE REGISTER:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
December 8, 2003:
Name Address
Paula Ann Kiner, f/k/a. 120 Ann Street, Duncannon, PA 17020
Paula Ann Thomas
Laraine K. Holley, f/Fda P.O. Box 588, New Bloomfield, PA 17068
Laraine K. Campbell
Tammy Myers, f/k/a 64 Paradise Road, Duncannon, PA 17020
Tammy Smiley
Michelle Sundy, f/k/a 349 E. Louther Street, Carlisle, PA 17013
Michelle Paulus
Beverly J. Paulus c/o Marlin R. McCaleb, Esquire, P.O. Box 230,
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: December 9, 2003
CHARLES E. SHIELDS, III
6 Clouser Road
~:::~ . Mechanicsburg, PA 17055
Telephone: (717) 766-0209
Counsel for Personal Representative
REV 1162 EX(11 96)
COMMONWEALTH OF PENNSYLVAN]A
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEpT 28060~
HARRISBURG, PA 17128 0601 PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO. CD 004280
HOLLEY LARAINE K F/K/A
PO BOX 588
NEW BLOOMFIELD, PA 17068
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 $8,775.82
ESTATE INFORMATION: SSN: 195-07-2666
:ILE NUMBER: 2103-0972
)ECEDENT NAME: PAULUS BRENARD H
DATE OF PAYMENT: 08/17/2004
,OSTMARK DATE: 08/1 712004
OUNTY: CUMBERLAND
DATE OF DEATH: 11 / 13/2003
TOTAL AMOUNT PAID: $8,775.82
REMARKS: LKHOLLEY
CHECK//501
INITIALS: VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
DOMMONWEA'TNOP REV' 1500
~;~.,,. ~ PENNSYLVANIA
,~~.~ DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECUR~ NUMBER
TH S RETURN MUST BE FILED IN DUPLICATE WiTH THE
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
//-/3 - ~ /~ -~ --/~/~ REGISTER OF WILLS
(IF APPLICABLE) SURVfVING SPOUSE'S NAME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER
~ 2 Supplemental Return ~ 3. Remainder Return (date of 8eath prior te ~2-13-82~
Odgina~
Return
~ ~ 4a. Future [nterest Compromise (date of death ~er 12 12 82) ~ 5. Federal Estate Tax Return Required
I Estate
~ 6 Deceden D~edTestate A~tachcop~ofW~lf~ ~ 7. Decedent Man aned a LvingTrust.A~achcopyofT~st)
/
8 Total Number of Safe Deposit Boxes
~ 9 Litigation Proceeds Received ~ 10 Spousal Pove~ Credit (date of death be~een ~2-31 91 and 1 I 95} ~ 11 EFection to tax under Sec 9 3(A) fAUac Sc O.
~i~ sE~io~ ~ST BE COMPLETED. ALL CORRESPONDENCE ~D ~ONFibEN~AEY~iNF~R~ATi~N~sH~E~ BE DIREu, eU TO:
COMPLETE MAILING ADDRESS
TELEPHONE NUMBER
OFFICIAL
-
2 Stocks and Bonds (Schedule B) (2) ~
3. Closely Held Corporation. Pa~nership or Sole-Proprieto~hip (3) ~
4 Modgages & Notes Receivable (Schedule D) (4) ~. ~ ~
5. Cash. Bank Deposits & Miscellaneous Personal Prope~ (5) ¢~ b3~ ~
(SchCuJe E)
6 Jointly Owned Prope~ (Schedule F) (6)
~ Separate Billing Requested
7. Inter-Vivos Transfers & Mis~llaneous Non-Probate Prope~ (7)
(Schedule G or L)
8 Toil Gross Asse~ (totai Lines 1-7) ~ (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) ~ ~
10 Debts of De.dent. Me,gage Liabillties. & Liens (Schedule I) (10) P /~ ~' ~
11 Total Deductions (total L~nes 9 & 10) (11)
12. Net Value of Estate (Line 8 mious Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been {13)
14 Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE BATES
15. Amount of Line 14 taxable at the spousal tax ~
rate ortransfersunderSec. 91~6(a)(l 2) ~/~ ~/~. /~ x 00¢~ (15)(16~
16 Amount of Lie 14 taxable at I~neal rate x __
17 Amount of Line 14 taxable at s~bling rate x
18. Amount of Line 14 taxabte at collateral rate x 15 08)
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
Tax Payments and Credits: ¢)
1. Tax Due (Page 1 Line 19)
2. Credits/Payments ~:~
A. Spousal Poverty Credit
B. Prior Payments
C. Discount ~:~ Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penagy ~:) Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page t Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) "~',~/
A. Enter the interest on the tax due. tEA)
B. Enter the total of Line 5 + EA. This is the BALANCE DUE. (ED)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
1. Did decedent make a transfer and: - ansferred [] []
retain the use or income of the property : .................................................................................
a. ' I~ use the roe~ transferred or its ncome'
b. retain the right to designate who sna p p n:y .............................................
c. retain a reversionary interest; or ......................................................................................................................
d. receive the promise for life of either payments, benefits or care? ............................................................. []
if death occurred after December 12, 1982, did decedent transfer property within one year of death
2. , n'~ []
w hou receving adeq, uate considerate
3. Did decedent own an 'in trust for or payable upon death bank account or secur ty at h s or her dec h? ........... ~ []
4. Did decedent own an individual Retirement Account, annuity, or other nomprobate property which [] []
contains a beneficiary designation? .....................................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS tS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
SIGNATURE ~F PERSON RESPONSIBLE FOR,FILING RETURN
AD D R E S S ~. ,AC ,~,,~¢/,///,~"' I(.'HmZ~_~y
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS ~'4i,~/~--~-~' ,~- ~ffL_--'~.~...~ _Z~--~., ~. /o/f/7¢,5".~'
Far dates of death on or alter July 1, ~994 and before January 1, t995, the tax rate imposed on the net value of transfers to or for the use of the survMng spouse is 3%
[72 P.S §9116 (a)(t.1)
For dates of death on or s~er January I 1995, the ~ax rate imposed on the net value of transfers to or for the use of the surv~wng spouse is 0% [72 P.S §9t16 la/ (,1.1] (ii)]
The sratute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse s he 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. §gl lG(a](1.2)]
· ~ 7 ' ~' §9116(12) [72 PS §9116(a)(1)]
The tex rate imposed on the net vaiue of transfers to or for the use of the deceden s ned, bene ~c~e es ~s 4,5 Y,~, except as note
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. §9116(a)(t,3)]. A sibling is defined, under Section 9102, as ar
individual who has at Least one parent in common with the decedent, whether by blood or adoption,
SCHEDULE A
COMMONWEALTH OFPENNS LV^N REAL ESTATE
RESIDENT DECEDENT
ESTATE OF
All real prope~ o~ed solely or as a tenant in common must be reposed at fair market value. Fair manet value is defined as ~e pd~ at which prope~ would be exchanged
be~een a willing buyer and a wilfin9 seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fa~s Real prope~ ~ich is jointly-o~ed ~h right of
suwivo~hip must be disclosed on Schedule F.
ITEM
NUMBER DESCRrPTION VALUE AT DATE
1 OF DEATH
TOTAL(Also enteron lice?, Recap[ulation) $ 1/7 ~"-'00' aa
(If more space is needed, insert additional sheets of the same size)
SCHEDULE B
CO~ONWEALTHOFPEBNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
'~/~t U/..~ .~, ~~ ~ FlEE NUMBER
All prope~ jei~tly-o~ed ~th right of suffivo~hip must be disclosed on Schedule F.
ITEM
VALUE AT DATE
N~MBE~ OESC~[PTION O~ D~TH
TOTAL (Also enter on line 2, Recapitulation) $ ~)
(If more space is needed, insert additional sheets of lhe same size)
SCHEDULE D
COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES
INHERITANCE TAX RETURN
RESidENT OECEOENT RECEIVABLE
ESTATEOF P~"~/--~5~, '-~/*~/'/~-~.,~) ¢/-/. FILENUMBER
All prope~ jointly-o~ed ~h the right of su~ivo~hip must be disclosed on Schedule F.
iTEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 4, Recapitulation) $ ~ (2/ 5 ~' ~,, 47
(If more space is needed, iRsert additional sheets of the same size)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
iNHERiTANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF
Include ~e ~ro~eds of litigation and the date ~e pro~eds ware re~ived by ~e es~te Ali prope~ jointty~ed ~h the right of suffivomhi ) must be disclosed on Schedule F.
ITEM
VAL~E AT DATE
NUMBER DESCRIPTION OF D~TH
AgOg. I~ ~ ~.~.~. ~ /~ i
3q. ~z
~d~
~7. m~
TOTAL (Also enter on line 5, Recapitulation) $ ~ ~, 6 31, S3
(If more s~ace is needed, [nse~ additional sheets of the same s~ze)
FARMERS NATIONAL BANK
December 12, 2003
Charles E. Shields, III, Esquire
6 Clouser Road
Mechanicsburg, PA 17055
RE: Estate of Brenard H. Paulus
Dear Mr. Shields:
Mr. Paulus had a savings account in this bank in his name alone.
The account was opened December 10, 2001, and bad a balance as of November
13, 2003, of $918.63 plus 30¢ accrued interest.
Mr. Paulus also had a safe deposit box in this bank.
Sincerely yours,
~' Carolyn FF. Kough
Executive Vice President
I~O. Box 156, Ncxvvillc PA I 2 i I · (717) 7'-6-53 2
hOOK FOR US. ~V~'hh G~T YOU TH~R~.
12/16/2003
CHARLES E SHIELDS, III
6 CLOUSER RD
MECHANICSBURG PA 17055
The information ~vhich you requested on the account(s) of BRENARD H PAULUS AKA B IA PAULUS
(Social Security Number 195-07-2666) is/are as follows:
Account Number 1900005153 1900028753
Class of Account CERTIFICATE CHECKING
Date Opened 091698 052199
Principal Balance 15000.00 302.71
Accrued Interest 34.52
Balance at Date of 15034.52 302.71
Death
Account Ownership SOLE SOLE
Name of Joint
Owner, if any
Date Ownership 091698 052199
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
Additional Si,ncerely~,
information
Requested
ERIN WATTS
SENIOR SERVICES REP.
F~O. Box 1711. HARRISBURG, PENNSYLVANIA 17105-1711
Toll Fr~e I-a66-WAYPOINT (1-866-9;=~1-76~,6). IN YORK ARC~, 717/815-4500 · www. wa~lpointbank.com
Estate of Brenard H. Paulus, deceased Cumberland County, Pennsylvania
PETITIONER
VS
04 -&% ~ I Civil Term
Beverly Paulus, Executrix of the
Estate of Terry Paulus, deceased
Petition for Approval of Compromise
Order of Court
AND NOW, this d_5~ - day of May, 2004, in consideration of the attached
petition, the proposed settlement of One Hundred Thousand Dollars
($100,000.00) for the death of Brenard H. Paulus is approved, and the following
distribution is directed:
Larraine K. Holley, in her capacity as $66,666.66
Executrix of the Estate of Brenard H.
Paulus, deceased
Douglas Law Office and $33,333.33
Charles E. Shields, III, Esq.
By the Court,
~/ Y 11 ~ I.
William P. Douglas, Esq.
Supreme Ct. ID # 37926
Douglas, Douglas & Douglas
27W. High St.
PO.B. 261
Carlisle, PA 17013-0261
Telephone 717 243-1790
Estate of Brenard H. Paulus, deceased Cumberland County, Pennsylvania
PETITIONER
VS
04 - Civil Term
Beverly Paulus, Executrix of the
Estate of Terry Paulus, deceased
Petition for Approval of Compromise
RESPONDENT Settlement and Distribution
Petition for Approval of
Compromise Settlement and Distribution
TO THE HONORABLE, THE JUDGES OF SAID COURT:
1. The petitioner, Larraine K. Holley, was appointed Executrix of the Estate
of Brenard H. Paulus, deceased, by the Register of Wills of Cumberland
County,, Permsylvania, is an adult individual residing in Perry County,
Pennsylvania.
2. The respondent, is Beverly Paulus, Executr/x of the Estate of Terry Paulus,
deceased, c/o Marlin McCaleb, Esq., attorney for the Estate of Terry
Paulus, 219 East Main Street, Mechanicsburg, Cumberland County,
Pennsylvania.
3. The decedent, Brenard H. Paulus, was the Grandfather of Larraine K.
Holley.
4. At the time of his death Brenard H. Paulus was 86 years of age.
5. On or about November 11, 2003, Brenard H. Paulus died as the result of
the injuries he received in the motor vehicle accident that occurred on the
same date, while he was a passenger in a vehicle being operated by Terry
Paulus, deceased.
6. Brenard H. Paulus died testate and had one son, Terry Paulus, who was
operating the motor vehicle involved in the accident and was killed in the
same collision.
7. Brenard H. Paulus died instantly as result of his injuries.
8. The petitioner, and her sibling named in the will of Brenard H. Paulus, are
the sole surviving heirs of the decedent.
9. At the time of the accident, Terry Paulus, was insured by Harleysville
Insurance Company. The policy provided liability coverage in the amount
of $100,000.00.
10. At the time of the accident, Brenard H. Paulus, had a $35,000.00
underinsured motorist insurance policy with Ohio Casualty Group.
11. At the time of Brenard H. Paulus' death there were no dependent heirs
who would be entitled to bring a wrongful death action.
12. To settle the survival action on behalf of the Estate of Brenard H. Paulus,
the petitioner, in txer capacity as executrix, is agreeable to accepting One
Hundred Thousand Dollars ($100,000.00) in full and final settlement for
the death of Brenard H. Paulus. Harleysville is to pay $65,000.00 and Ohio
Casualty is to pay $35,000.00.
13. The petitioner has agreed to a contingent fee of 33-1/3% of any recovery
in this matter as well as reimbursement of any costs advanced by Douglas
Law Office.
14. The petitioner, Larraine K. Holley, requests that the following distribution
be made for the wrongful death of her grandfather:
Larraine K. Hotley, in her capacity as $66,666.66
Executrix of the Estate of Brenard H.
Paulus, deceased
Douglas Law Office and $33,333.33
Charles E. Shields, III, Esq.
15. Due to the fact that all the proceeds are being allocated to the Survival
Action, review of the allocation for inheritance taxation purposes by the
Pennsylvania Department of Revenue is not necessary.
WHEREFORE, it is prayed that the aforesaid settlement of $100,000.00 for the
death of Brenard H. Paulus, and the proposed distribution, be approved.
DOUGLAS LAW OFFICE
William P. Douglas, Esq.~ \,,'
Attorney for the PetitioneKq,
May ~,c5 ,2004
Affidavit
I HEREBY SWEAR OR AFFIRM THAT THE FOREGOING IS TRUE gAND
CORRECT TO THE BEST OF MY KNOWLEDGE AND/OR INFORMATION
AND BELIEF.
THIS IS IVlADE SUBJECT TO THE PENALTIES OF 18 PA.C.S.§ 4904 RELATING
TO UNSWORN FALSIFICATION TO AUTHORITIES.
Larraine K. Holley ,:~'
May ~ , 2004
SCHEDULE G
COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS &
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
P~-~,L~XS, &,~,~-~j) H. FILENU~BER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reveme side of the REV-1500 COVER SHEET ~s yes
DESCRIPTION OF PROPER~
ITEM INCLUDE TH~ ~ME OF THE T~N~FEREE THEJR EE~TIONSHJP TO OECEDENT AND THE DATE OF T~SFER 0/0 OF
NUMBER A~ACH A COPY OF THE DEED FOR REAL ESTATE DATE OF DEATH DECD'S EXCLUSION TA~BLE VALUF
VALUE OF ASSET ~NTEREST HF A~PUCA~E}
EV-1511 E×= (12-99)
SCHEDULE H
COM'vIONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
Bebls of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTfON AMOUNT
A. FUNERAL EXPENSES:
B ADMINISTRATIVE COSTS:
1 Personal Representative's Commissrons
Name of Personal Representative(s)
SocJal Security Numbeds)/EIN Number of Personal Reoresentative(s) /,~ ¢- ~ ~¢/
Year(s) Commission Paid:
2 Attorney Fees ~H~L ~5
3 Family Exemption: (If decedent's address is not the same as claimant's at;acb explanation)
Claimant
Street Address
City State _~ Zip
Relationship of Claimant to Decedent
4 ProbateFees ~ ~/~/~ /~
5 Accountant's Fees
6. Tax Return Preparers Fees --
TOTAL (Also entel on line g. Recapitulation)
Cf more space is needed insert additional sheets of the same sizel
SCHEDULE G
COMMONWEALTH OF PENNSYLVANIAINTER-VIVOS TRANSFERS&
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATEOFP/fuLUS, H,FILENUMBER
3.1 -o.~- OD
This schedule must be completed and flied Jf ~e answer to any of questions 1 through 4 on the mveme side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPER~ % OF
ITEM 'NCL'JDETHEN~EOFTHET~SFEREETHEIRRE~TIONSHrPTOD~CEDENT~DTHEOATEOFT~SFE~ DATE OF DEATH DECD'S EXCLUSION TA~LE VALUE
N UMBER ATTACH A COPY OF THE DEED FOR ~ ESTATE
VALUE OF ASSET INTEREST ;rFAp~ICABLE)
I
TOTAL (Also enter on line 7, Recapitulation) $ ~ ~ Z~
{If more space is n~ded, inse~ additionaJ sheets of the same sJze)
~ SCHEDULE I
CO~,~O,'^,E~:H O: ~N~SYUV^~,,~ DEBTS OF DECEDENT,
~ES,::~EC:,: MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Include unreimbursed medical expenses.
ITEM
NUMBER DESCR]PTIO~ ~MOUNT
TOTAL(Also en ~, o: ,,~e 0r Recapitulation) $ /~ ~ ,,,~
,:If more space s needed, insert additional sheets of the same size)
SCHEDULE J
COMMONW LrH OFPENNS LV^N,^ BENEFICIARIES
INHERITANC£ TAX RETURN
RESIDENT DEC~DENT
ESTATE OF I _
FILE NUMBER
Paulus, Brenard H. 21-03-972
RELAT}ONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
[. TAXABLE DISTRIBUTIONS (include outdght spousal distrfbu[ions)
Paula Arm Thomas Granddaughter
~ now known as Paula Ann Kiner 1/4
124 North Market Street
Duncannon, PA 17020
2. Laraine K. Campbell Granddaughter 1/4
now known as Laraine K. Holley
RR.4, Box 4142
Duncannon, PA 17020
3. Tammy Smiley Granddaughter 1/4
now known as Tammy Myers
64 Paradise Road
Duncannon, PA 17020
4. ~fichelle Paulus Granddaughter 1/4
now known as Michelle Sundy
71 Regency South
Carlisle, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1,
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART [[ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S
(if more space is needed, insert additional sheets of the same size)
Tax Parcel # 46-10-0620-005
THIS INDENTURE
MADE THE o~e,C~ day of____~_t~4___~.. ,in the year of our Lord txvo tlmusand
and four (2004).
BETWEEN LARAINE K. HOLLEY, formerly known as LARAINE K.
CAMPBELL,Executrix of the Estate of BRENARD H. PAULUS, Deceased, late
of the Township of West Pennsboro, Cumberland County, Pennsylvania, Grantor
AND
DAREN W. HOCKENBERRY, single man, and DAVID R. HOCKENBERRY II,
single man, both of West Pennsboro Township, Cumberland County,Pennsylvania,
Grantees, to hold as joint tenants with right of survivorship and not as tenants in
common.
WHEREAS, the said BRENARD H. PAULUS, was vested in his lifetime with title to the premises
hereinafter described in the Township of West Pennsboro, Cumberland County, Commonwealth of
Pennsylvania; and
WHEREAS, the said BRENARD H. PAULUS died, testate, on the 13th day of November, 2003,
and Letters Testamentary were duly issnedto the said Laraine K. Holley, formerly known as
Laraine K. Campbell, as Executrix, by the Register of Wills of said Cumberland County, docketed
to No. 21-03-0972; and
WHEREAS, the lands herein-mentioned were not specifically devised.
NOW, THEREFORE, THIS INDENTURE WlTNESSETH, that the said Laraine K. Holley,
formerly known as, Laraine K. Campbell, Executrix, as aforesaid, for and in consideration of
the sum of ONE HUNDRED SEVENTEEN THOUSAND FB:E HUNDRED and No/100
($117,500.00) DOLLARS and other good and valuable considerations, to her in hand paid by the
said Hockenberrys, at and before the ensealing and delivery hereof, the receipt whereof is hereby
acknowledged, has granted and conveyed, bargained, sold, aliened, released, and confirmed, and by
these presents, by virtue of the power and authority vested in her, does grant and convey, bargain,
sell, alien, release, and confirm unto the said Grantees, to hold as joint tenants with right of
sm~eivorship and not as tenants in common, their heirs and assigns,
All that cmXain lot or parcel of ground situate, lying and being in West Pennsboro Township,
Cumberland County, Pennsylvania together with the dwelling house erected thereon, bounded and
described as follows:
BEGINNING at an existing railroad spike in the centerline of U.S. Traffic Route 11 (Legislative
Route 890) at corner of lands now or formerly of William G Miller; thence along line of lands now
or formerly of William G Miller, North thirty-two (32) degrees fifty-two (52) minutes ten (10)
seconds West, one hundred sixty-nine and forty hundredths (169.40) feet to an existing iron pin;
thence continuing by same, North fifty-four (54) degrees five (05) minutes thirty-four (34) seconds
East, ninety-nine and eighty hundredths (99.80) feet to an existing iron pin at a post; thence
continuing by same, South thirty-seven (37) degrees two (02) minutes five (05) seconds East, one
hundred sixty-five and ten hundredths (165.10) feet to an existing nail in the centerline of the
aforesaid public road U.S. Traffic Route 11; thence along the centerline of the aforesaid public road
U.S. Traffic Route 11, South fifty-two (52) degrees zero (00) minutes zero (00) seconds West, one
hundred twelve and ten hundredths (112.10) feet the point and place of BEGINNING.
CONTAINING a total area of 17~,694 square feet.
The foregoing description prepared in accordance with survey entitled "Land Survey for Annie E.
Gilbert", dated November 3, 1980, prepared by Carl D. Bert, Registered Surveyor.
UNDER AND SUBJECT to existing rights-of-way for highway and utility purposes as is shown on
said Plan and on record.
Known as 3499 Ritner Highway, Newville, PA 17241.
BEING THE SAME PREMISES which Annie E. Gilbert, widow, by her Deed dated November 7,
1980, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Deed Book "E," volume 29, page 759, granted and conveyed to Brenard H. Paulus
and Miriam A. Paulus, his wife The said Miriam A. Paulus departed this earthly life on July 12, 2002
~vhereupon full and absolute title vested in the said Brenard H. Paulus by virtue of the laws of this
Commonwealth incident to tenancies by entireties. The estate of the said Brenard H. Paulus is the
grantor herein.
TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and
premises hereby granted and released, or mentioned and intended so to be, with the appurtenances
unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said
Grantees, their heirs and assigns, forever.
AND THE SAID GRANTOR, Executrix as aforesaid, her heirs, executors and administrators, do
covenant, promise and agree to and with the said Grantees, their heirs and assigns, by these presents,
that the Grantor has not done, committed any act, matter or thing whatsoever whereby the premises
hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in
title, or otherwise howsoever.
IN WITNESS WHEREOF, the said Executrix of the Estate of Brenard H. Paulus, deceased, Grantor
herein, has hereunto set her hand and seal the day and year first above written.
WITNESS:
l~/;?c.~'e/,~ ,~' ~,,~c (,',~ (SEAL)
LARAINE K. HOLLEY, ~'
Executrix of the Estate of BRENARD W. PAULUS,
Deceased
formerly known as LARAINE K. CAMPBELL
COMMONWEALTH OF PENNSYLVANIA :
:SS
COUNTY OF CUMBERLAND :
On this, the ,~5'~ _ dayof e/~t'"~'~Y~' s, the un~r , A.D. 2004, before me, a Notary
Public, in and for said County and Stat igned officer, personally appeared LARAINE K.
HOLLEY, formerly known as, LARAINE K. CAMPBELL, known to me (or satisfactorily proven) to
be the person described in the foregoing instrument, and acknowledged, that she executed the same in
the capacity therein stated and for the purposes thcrein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public ~
My Commission expires: ~ NOTARIAL SEAL -
I BONNIE L COYLE, NOTARY PUBUC
ItORO OF CARLISLE, ClJ~BERLANCI CO, PA
CERTIFICATE OF RESIDENCE
[ do hereby certify that the precise and exact post office address of the within Grantee is:
Attorney ~e
A. Settlement Statement u.s, Departmentof Housing '1["
and Urban Development OMB No 2502 i)265 (Page l)
B. T2, pe of I~oan
[ VIi\ 2 FmHA 3 Conx Unins 6 File Numbcl 7 loan Nmnbcl 8 Mortgage h~smm~ce Case Nulnbe~
120. Gross Amount l)ue From Borrower 122,967.12 420. Gross Amount Due To Seller 117,972.97
200. kmounts Paid By Or in Behalf Of Borrower 500. Reductions in Amount Due To Seller
201 I)cpos~ts or carncst money 1,000.00 501. Excess deposit (see instructions)
202 P~incil3alamountofncx~loan(s) 101,60000 5(t2. Scttlement charges to seller (line l400) 1,374.68
2(~3 Exis0ng Ioan(M taken subject to 503 Existing loan(s) taken subject to
204 504 Payoff of first mortgage loan
2i;5 505. Payoff of second mortgage loan
2Uil 506.
2U7 507.
2~. 508.
21)9 509.
Mljuslments for items unpaid hy seller Adjustments for items unpaid by seller
2[0 CJI) toxin taxes to 510 Cits'/town taxes to
21 I (. oumx taxes to 51 [ ( OUltty taxes to
212 A.~cssmcnrs to 512. AsscsslnCnts to
2iF 8dlool Tax 16) 513. School qax to
214 814
213 515.
216. 516.
217 517.
21', 518
219 519
220. lotal Paid By/For Borrower 102,600.00 520. Total Reduction Amount Due Seller 1,374.68
300. Cash At Settlement From/To Borrov~er 600. Cash At Settlement To/From Seller
~01 Gross, Amount due tlom ho~o~cl (line 120) 122,967 12 6(11 Gross Allloutlt due to seller (line 420) i 17,972.97
302 i c,s amounts paid by fl)r borrower (line 220) ( 102,600 00 602. Less reductions in amt due seller (line 520) ( 1,374.68)
303. Cash X From To Borrower $ 20,367.12 ~. Cash X To From Seller $ 116,598.29
IH'D 139/ ~?C'Z&~Z RFSPA. HB43052
L. Scl:!_mcnt Charges Page 2
700. I'otal Sales/Broker's Commission based on $ ~): %= Paid From Paid From
Dix ision t~f Commission (linc 700) as fbllo,as: Borrowers Sellers
70] $ to Funds at Funds at
Sculemenl Settlement
702 $ to
703 COllllllisSJOll paid at Se~demcnt
704 -
800. Items Payable in Connection V*'i~h Loan
801 IoanOriginationFee 1.5 % CORNERSTONE FEDERAL CREDIT UNION 1,524.00
901 Interest from 022504 to 022904 (¢ $ 15.88 ,'da5, 7940
I i i I.Dale F Shughart, Jr Penn Attorneys, Endorsements 00, 30) and 8 1 ~ 5000
IIUD-I 391 RESPA lib 43052
CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG, PA 17055
GEORGEM. HOUCK TELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
October 18, 2004
Register of Wills
Cumberland County Court House -~ ~ .~
1 Courthouse Square ~" · '
Carlisle, PA 17013 :: ~
Re: Estate of Brenard H. Paulus ~
No. 21-03-0972 ~
Dear Register of Wills:
Please find enclosed my check number 1320 in the amount of $3.86 for additional interest
and penalty on the inheritance tax for the above estate.
Thank you for your kind attention to this matter.
Very truly yours,
Charles E. Shields, III
CES:slk
Enclosure
COMMONWEALTH OF PENNSYLVANIA REV 1162 EX(11-96)
DEPARTMENT OF REVGNUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17~ 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004537
SHIELDS CHARLES E III
6 CLOUSER ROAD
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $3.86
ESTATE INFORMATION: SSN: 195-07-2666
FILE NUMBER: 2103-0972
DECEDENT NAME: PAULUS BRENARD H
DATE OF PAYMENT: 10/22/2004
POSTMARK DATE: 10/22/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 11/13/2003
TOTAL AMOUNT PAID: $3.86
REMARKS:
CHECK# 1320
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COHNONWEALTH OF PENNSYLVANIA ~l~.~
SUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLDNANCE OR DZSALLOMANCE
OF DEDUCTIDNS AND ASSESSHENT OF TAX
~. DATE 10-11-200q
ESTATE OF PAULUS BRENARD H
DATE OF DEATH 11-15-2005
FILE NUMBER 21 05-0972
COUNTY CUMBERLAND
CHARLES E SHIELDS III '0~ ~J~*t' 22 P~ 101
6 CLOUSER RD
MECHANZCSBURS PA 17055 Amoun~ Ramified
HAKE CHECK PAYABLE AND REMIT PAYMENT TO=
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PAULUS BRENARD H FILE NO. 21 03-0972 ACN 101 DATE 10-11-200q
TAX RETURN NAS: ( X ) ACCEPTED AS FILED ( } CHANDED
~cKdATZON CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN DASED ON: ORIGINAL RETURN
1. Real Es~e (Schedule A) (1) 117~500.00 NOTE: To insure proper
2. S~ocks and Bonds (Schedul~ B) (2]. .00 credt~ ~o your acooun*,
$. Closely Neld S~ock/Per*nership Zn~eres~ (Schedule C) ($) .00 sub.1~ *he upper por~ton
~. Hor*g=gms/No~s R~cmivable (Schedule D) (q) 20/558.57 of ~hls form ~t*h your
5. Cash/Bank Deposi*s/Mtsc. Personal Proper~y (Schedule E) (5) 8qz6Sl.5S ~sx pey.en~.
6. Jointly Owned Propar~y (Schedule F) (6} . O0
7. Transfers (Schedule G) (7) .00
8. To'al Asse~s (8) 222,690.10
APPROVED BEDUCTZONS AND EXEMPTIONS:
27,507.68
9. Funeral Exp~ses/Adm. Costs~Misc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gag~ Liabilities/Liens (Schedul. I) (10) ~.S0
11. To*al Deduc*ions (11) 27. ~7]. ga
12. Ne~ Vml~m of Tax Re~urn (12) 195,018.12
15. Chart~ebla/5overnmen~alBeques~s; Non-elected 9115 Trusts (Sch~du1~ J) (15) .00
1fi. Nm~ Vmlum of Es~m~o Sub~e=~ ~o Tax (1fi) 195,018.12
NOTE: Z~ an assessment was issued prsviousZy, lines 1~, 15 and/or 16, 17, 18 and 19 will
re,elect ~tgurss that include the total o~ ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amoun~ of Line 1~ a~ Spouse1 ra~e (15) .00 X O0 = .00
16. Amoun~ of L~ne lq ~mxablm a* Lineal~Class A rico (l&) 195,018.12 X Oq5 = 8,775.82
17. Amoun~ of Line lq a* Sibling ra~e (17) .00 X 12 .00
18. /moun~ of L/nm 1~ ~axabla a~ Colla~eral/C1ass B ra~e (18) .00 X 15 .00
19. PrAncipal Tmx Due (19)= 8,775.82
rAX CRED;TSI
DATE NU~ER INTEREST/PEN PAID (-) AMOUNT PAID
08-17-200q CDO0~ZBO .00 8,775.82
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-18-200q TOTAL TAX CREDZT I 8,775.82
DALANCE OF TAX DUEI .00
INTEREST AND PEN. 3.86
TOTAL DUE $. 86
~ IF pATD AFTER DATE ZNDTCATED, SEE REVERSE ( TF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REOUIRED.
FOR CALCULATTON OF ADDTTZOMAL INTEREST. TF TOTAL DUE IS REFLECTED AS A "CREDTT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
RESERVATION: Estates of decedents dying on or before December 12, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S.
Section
PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
REFUND (CR): A rmfund of a tax credit, ahich ams not requested on the Tax Return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritancm and Estate Tax" (REV-1515). Applications ara available mt the Office
of the Register of #i118, any of the 13 Revenue D/strict Offices, or by calling the special Z4-haur
answering service for forms ordering: 1-800-562-Z05D~ services for taxpayers with special hearing and ! or
speaking needs: 1-800-447-5010 (TT only).
aBJECTIONS: Any party in interest not satisfied with the appraisammnt, allowance, ar dis~llowancm of deductions, or assessment
of tax [including discount or interest) as sheen on this Notice must object aithin sixty [60) days of receipt of
this Notice by=
--written protest to ~he PA Department of Revenue, Board of Appeals) Dept. 281011, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS= Factual errors discovered on this assessment should be addressed in writing to: PA Oapart~amnt of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Revima Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid aithin three (3) calendar months after the dmcadent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY= The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January la, 1996, the first day after the and of the tax amnesty period. Thi~ non-participation
penalty is appealable in the same manner and in the the same time period as you mould ~paal the tax and interest
that has been assessed as indicated on this notice.
INTEREST= Interest is charged beginning with first day of delinquency, or nine (9) months and one [1) day from the date of
death, to the date of payment. Taxes which became delinquent before January
six (6Z) percent per annum calculated at a daily rata of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rata
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1'~ 20Z .000548 ~'~-1991 111 .O003Ol ~ 91 .000247
1983 162 .000438 1992 91 .000147 ZOOZ 61 .000164
1984 111 .000301 1993-1994 71 .000192 2003 5X .000137
1985 131 .000356 1995-1998 9Z .000247 2004 4Z .000110
1986 101 .000274 1999 7Z .000192
1987 IOZ .000174 ZOO0 71 .000191
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen [15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
CONNONNEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTNENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l$47EX&FP(Bl-O$)
F~, ,. DATE 10-11-200~
-~7~ ESTATE OF PAULUS BRENARD H
DATE OF DEATH 11-15-2005
FILE NUNBER 21 05-0972
CHARLES E SHZELD~I~i;'~ 13 /'i~ :06 COUNTY CUHBERLAND
ACN 101
6 CLOUSER RD Amount Remltted
HECHANICSBURG L:,::PA 17055
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF HILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-15~7 EX AFP (01-03} NOTICE OF INHERITANCE TAX APPRAZSENENT~ ALLONANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF PAULUS BRENARD H FILE NO. 21 05-0972 ACN 101 DATE 10-11-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED { } CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 117z500.00 NOTE: To insure proper
2. Stocks end Bonds (Schedule B) (2) .00 credit to your account,
$. CloseZy Held Stock/Partnership Znterest (Schedule C) ($) .00 submit the upper portion
~. Nortgages/Notes Receivable (Schedule D) (~) 201558.57 of this for. with your
S. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) ($) 8~16~.5~ tax payment.
6, Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 222,690.10
APPROVED DEDUCTIONS AND EXENPTZONS: 27,507.68
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 16~.~0
11. Total Deductions (11) 27.~71.98
12. Net Value of Tax Return (12) 195,018.12
15. Charitable/Governeental Bequests; Non-elected 9115 Trusts (Schedule J) (15) ,00
1~. Net Value of Estate Subject to Tax (1~) 195,018.12
NOTE: ~ an assessment ~as issued previously, lines l&, 15 and/er 16, 17, 18 and 19
reflect flgures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of Line 1~ at Spousal rate (15) .00 X O0 = .00
16. Amount of Line 1~ ~axeble at Lineal/Class A rate (16) 195,018.12 x 0~5 = 8,775.82
17. Aeount of L/ne 1~ et S/bllng ra*e (17) .00 X 12 = .00
18. Aeount of L/ne 1~ taxable at Collateral/Class B rate (18) .00 X 15 = ,00
19. Principal Tax Due (19)= 8,775.82
TAX CREDITS:
PAYHENI RECEIPT I D/SCOUNT ~+) AHOUNT PA/D
DATE NUNBER INTEREST/PEN PAID (-)
08-17-Z00~ CDO0~Z80 I .00 8,775.82
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-18-200~ TOTAL TAX CREDIT I 8,775.82
BALANCE OF TAX DUEI .00
INTEREST AND PEN. $.86
' TOTAL DUE $.86
~ ZF PAID AFTER DATE /NDICATED, SEE REVERSE ( ZF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
FOR CALCULAT/ON OF ADDZTZONAL INTEREST. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF TH/S FORH FOR INSTRUCTIONS.)~*
RESERVATION: Estates of decedents dying on or before December II, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to Class D (collateral) beneficiaries of the decadent after the expiration of any estate for
life or for years, the Coemoneaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laafu! Class B (collatmral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section Z14O of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (7Z P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit eith your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
REFUND (CR): A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1515). Applications are available at the Office
of the Register of Hills, any of the Z5 Revenue District Offices) or by calling the special Z4-hour
answering service for forms ordering: 1-800-561-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3010 (TT only).
OBJECTIONS: Any party in intmrest not satisfied aith the appraisement, allowance, or dlselloaance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object aithin 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.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 1711&-0601
Phone (717) 787-650S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-ISO1) far an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid aithin three (5) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The leg tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January let 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 mould appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning eith first day of delinquency, er nine (9) months and one (1) day free the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January l, 1981 wi1! bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~"~ ~ .000548 ~'~'8-1991 11Z .000501 ~ 91 .000147
1983 162 .000458 1991 92 .O00Zq7 ZOOZ 61 .000L64
1984 Ill .000301 1995-1994 71 .000192 Z003 52 .000157
1985 132 .000556 1995-1998 9Z .000247 Z004 42 .O00XlO
1986 102 .000174 1999 71 .O00XeZ
1987 log .OOOZTq ZOO0 7Z .O0019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
FIRST AND FINAL ACCOUNT
INCLUDING
PROPOSED DISTRIBUTION OF LARAINE K. HOLLEY, formerly known as
LARAINE K. CAMPBELL, EXECUTRIX
OF THE
ESTATE OF BRENARD H. PAULUS
LATE OF WEST PENNSBORO TOWNSHIP
CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED
Date of Death November 13, 2003
Letters Granted November 24, 2003
Dates of Publishing Notices Cumberland Law Journal Dec. 18 & 26, 2003, January 2, 2004
Dates of Publishing Notices Patriot News December I6, 23 & 30, 2003
Covering the Period Nov. 13, 2003 to Nov. 30, 2004
Purpose of the Account: Laraine K. Holley, formerly known as Laraine K. Campbell,
Executrix offers this account to acquaint interested parties with the transactions that have occurred
during her administration. The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for additional information or
questions or objections can be discussed with Laraine K. Holley, formerly known as Laraine K.
Campbell, Executrix, c/o Charles E. Shields, III, 6 Clouser Road, Mechanicsburg, PA 17055.
SUMMARY OF ACCOUNT
TABLE OF CONTENTS
Page # Amount
Proposed Schedule of Distribution 6 $111,989.30
PRINCIPAL
Receipts 3-4
Real Estate 3 $I 17,500.00
Mortgages and Notes Receivable 4 $20,558.57
Cash and Miscellaneous 3 $84,631.53
TOTAL RECEIPTS OF PRINCIPAL 4 $222,690.10
Disbursements 4-6
Funeral Expenses 4 $7,100.00
Administrative Expenses 4-5 $2,974.98
Inheritance Taxes 5 $8,775.82
Debts of Decedent 5 $164.30
Reserves for Fees and Commissions 5 $17,920.70
Advances and Advance Distributions 6 $74,497.50
TOTAL DISBURSEMENT OF PRINCIPAL 6 $111,433.30
Receipts of Income 6 $732.50
RECEIPTS OF PRINCIPAL
Real property located at 3499 Ritncr Hwy. Newville $117,500.00 $117,500.00
(West Pennsboro Twp.), Cumberland County, sold to
Daren W. Hockenberry, single man and David R.
Hockenberry II, single man, by deed of conveyance
dated February 25, 2004
Stocks and Bonds 0
Cash and Miscellaneous
1. Tangible Personalty Located within decedent's $360.50
Home (see list attached hereto as Exhibit A)
2. Waypoint Bank Certificate #1900005153 $15,000.00
3. Accrued interest to d.o.d, on above certificate $34.52
4. Waypoint Bank Checking account #052199 $302.71
5. Farmers Nat. Bank of Newville savings account $918.63
6. Accrued interest to d.o.d, on above account $.30
7. Sale of 1985 Buick to Greg A. Campbell $400.00
8. Refund on Capital Blue Cross $99.66
9. Refund on trash collection $60.08
10. Refund - Sprint (telephone) $7.] 1
1 I. Prorations on above referenced sale of Real
Estate: city/township taxes 169.13
assessments/school taxes 303.84
12. Refund on car insurance, Ohio Casualty $69.35
13. Refund on homeowners insur.,Lititz Mutual $227.00
14. Refund from PPL $12.04
15. Net settlement of litigation per order of Hon. $66,666.66 $84,631.53
George E. Hoffer, P.J., Cumb. Co. Dkt. 04-2361,
Civil term
3
Mortgages and Notes Receivable - This figure of $20,558.57
$20,558.57 represents thc balance remaining on the
joint obligation of Terry B. Paulus and Beverly J.
Paulus, his wife to repay a loan made by decedent in
the original amount of $25,658.57. The said Terry
B. Paulus predeceased the said Beverly J. Paulus, his
wife, whereupon she became the sole surviving obligor
on the loan. Because bankruptcy proceedings were in
the process of being instituted and are currently being
carried on by thc said Beverly J. Paulus, now an
unremarried widow, it is impossible to tel1 exactly how
much per dollar of the claim will be paid to the estate.
In view of the present uncertainty, this item is listed
as part of the account (as per rules of the Penna.
Dept. of Revenue requiring its listing on the
Inheritance Tax Return). It will be excepted out from
the proposed distribution until the amount can be
more fully ascertained. It is the current intention of
thc beneficiaries, who are sisters, and the
grandchildren of the decedent, to divide whatever
amount is eventually received equally among
themselvers ~vithout the expense and delay of another
formal accounting and confirmation.
TOTAL RECEIPTS OF PRINCIPAL $222,690.10
DISBURSEMENT OF PRINCIPAL
Funeral Expense:
1. Ewing Brothers Funeral Home of Carlisle $7,010.00
2. Shull-Koontz, Cemetery Mem. Headstone $90.00 $7,100.00
Administrative Expenses:
1. Reimbursement ot Charles E. Shields, III for:
a.) original probate fees $68.00
b.) cost of title search re: potential boundary line $113.00
encroachment
c.) additional short certificate $6.00
d.) advertisement Metro-West $93.85
e.) advertisement Cumb. L. Journal $75.00
4
fi) reimbursement for photo copies, postage, etc. $21.70
2. Lititz Mutual homeowners $160.00
3. PPL Electric $12.70
4. Kough's Oil Service $111.25
5. PPL $14.33
6. Filing fee for Inheritance Tax Return $15.00
7. Additonal probate Fee $230.00
8. Peck's Septic Repair $405.00
9. Settlement related charges on sale of Real Est.
Realty transfer tax $1,175.00
Deborah Piper, Tax Collector $199.68
10. Larry Foote - real estate appraisal $250.00
11. PPL $12.04
12. PPL $12.43 $2,974.98
Inheritance Taxes:
Paid 8,775.82 $8,775.82
Debts of Decedent:
1. Sprint Telephone $28.55
2. Kough's Oil Service $89.64
3. PPL $22.66
4. Sprint Telephone $23.45 $164.30
For fees and commissions:
1. Executrix's fees to Laraine K. Holley $9,680.70
2. Attorney's fees to Charles E. Shields, III $7,240.00
3. Accountant/tax prep fees to Janet Brackbill for $650.00
income tax prep and prep. of estate income tax
For miscellaneous costs and reimbursements such as $350.00 $17,920.70
filing account, additional certified mailings, etc.
Advances and Advance Distributions:
1. By agreement of the Parties, the personalty has $360.50
been distributed amongst them
2. By agreement of the Parties, a suitable $2,137.00
gravemarker was obtained for Terry B. Paulus, the
father of the beneficiaries, with estate funds
3. Advance partial distribution to the beneficiaries as
follows:
Laraine K. Holley $18,000.00
Tammy J. Myers $18,000.00
Michele Sundy $18,000.00
Paula S. Kiner $I 8,000.00 $74,497.50
TOTAL DISBURSEMENTS OF PRINCIPAL $111,433.30
Receipts of Income:
Estimated from two shifted bank accounts $732.50
Disbursements of Income 0
Income Balance on Hand 0
RECAPITULATION
Total Principal Receipts $222,690.10
Total Principal Disbursements $111,433.30
Total Income Receipts $732.50
Total Income Disbursements 0
Balance on Hand for Distribution $111,989.30
PROPOSED SCHEDULE OF DISTRIBUTION
As per paragraph 3 of the last will and testament (see attached as Exhibit B) there are to be
four (4) equal shares of distribution among the grandchildren of decedent, who are now currently
known under the following names, to wit:
Paula A. Kiner; Laraine K. Holley; Tammy Myers; and Michelle Sundy.
Before distribution calculations are made for the purpose of the decree awarding
distribution, an adjustment must be made for the amount currently due on a promissory
note now part of a bankruptcy proceeding as has been more fully set forth hereinabove,
6
to wit $20,558.57
Thus leaving an actual available balance for equal distribution of $91,430.73
Said amount is to be further reduced by the amount of $1,205.00 to be paid
as part of a settlement to Marlin McCaleb, Esquire as attorney for the Estate
of Terry B. Paulus, deceased as per that certain SETTLEMENT AND RELEASE
(attached hereto as Exhibit C). By agreement amongst themselves, the said four
beneficiaries shall make the appropriate set-offs against the appropriate shares
of each for their respective shares of the said amount. $1,205.00
Final Net Available for Distribution $90,225.73
Paula A. Kiner $22,556.43
Laraine K. Holley $22,556.43
Tammy Myers $22,556.43
Michelle Sundy $22,556.44
(*The share of Michelle Sundy is partially subject to pledge for the payment of medical expense
billings which are to be paid forthwith upon the making of said distribution)
7
LARAINE K. HOLLEY, Executrix of the Estate of BRENARD H. PAULUS, deceased, hereby
declares under oath that she has fully and faithfully discharged the duties of her office, that foregoing
First and Final Account is true and correct and fully discloses all the significant transactions occurring
during the accounting period; that all claims now outstanding against the Estate; and that all taxes
presently due from the Estate have been paid. ~ ~
~'AI~AINE K. HOLLEY, Exe~duirix
Sworn and subscribed to before me this .~'/~ day of ~
A.D.201~
Notary Public
COMMONWEALTH OF PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA
,~,~, .'-~... ,~ .
Meml~er, pennsylvania Association Of Notafles -~' '"" A~latlon Of N~adea
8
I, BRENARD II. PAULUS, of the West Pennsboro Township, Cumberland County,
Pennsylvania, bein~ of sou,--~ --~ .....
o ,,,~ ,~uu a~sposmg mina, memory and understanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and m~king void any and all prior
Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and faucial expenses as soon afiur my decease
the same can conveniently be done. as
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath to my beloved wife, MIRIAM A. PAULUS, to
her own use and benefit absolutely.
3.
In the event, however, tha£ my said wife should predecease me, or should die at about the
same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said
estate unto my son, TERRY B. PAULUS. In thc event that my son should predecease me, I give,
devise and bequeath my said Estate in equal shares unto his own issue of his body, to wit:
PAULA ANN THOMAS, LARAiNE K.
PAULUS. CAMPBELL, TAMMY SMU.~y and MICHELLE
I nominate, constitute and appoint my wife, MIRIAM A. PAULUS, to be the Executrix of
this my Last Will and Testament. In the event that she should predecease me or for any reason be
unwilling or unable to act as such · ·
Execumx, I normnate, constitute and appoint my son, TERRY
B. PAULUS, to be Executor in her place and stead. In the event that he should predecease me or
for any reason be unwilling or unable to act as such Executor, I nominate, constitute
my granddaughter, LARA1NE K CAMPBELL, to and appoint
be Executrix in his place and stead. I further
direct that they shall not be required to file bond or other security in the Office of the Register of
Wills for the purpose of administering my Estate.
EXHIBIT B
SETTLEHENT AND RELEASE
THIS AGREEMENT made and entered into this J~day of
~-~3-¢~-~v~_~-~ , 2004, by and between: BEVERLY PAULUS,
also known as BEVERLY J. PAULUS, individually and as Executrix
under the Last Will and Testament of TERRY PAULUS, also known
as TERRY B. PAULUS, Deceased, party of the first part; and
LAIIAINE K. HOLLEY, PAULA ANN KINER, TAMMY MYERS and MICHELLE
SUNDY, natural children of the said TERRY PAULUS, Deceased,
parties of the second part; and LARAINE K. HOLLEY, f/n/a
LAR3tINE K. CAMPBELL, Executrix under the Last Will and
Testament of BRENARD H. PAULUS, also known as B. H. PAULUS,
Deceased, party of the third part;
WITNESSES THAT:
WHEREAS, TERRY PAULUS and his father, BRENARD H. PAULUS,
died on November 13, 2004, as the result of an automobile
collision with a fallen tree in South West Madison Township,
Perry County, Pennsylvania; and
WHEREAS, the said TERRY PAULUS was survived by his wife,
party of the first part herein, and by his natural children,
parties of the second part herein; and
WHEREAS, Letters Testamentary under the Last Will and
Testament of TERRY PAULUS were issued to the party of the first
part by the Register of Wills cf Perry County, Pennsylvania, on
,^WOFF,CES December 17, 2003, to Estate No. 5003-0193, which Letters
remain in full force and effect; and
EXHIBIT C
WHEREAS, Letters Testamentary under the Last Will and
Testament of BRENARD H. PAULUS were issued to party of the
third part by the Register of Wills of Cumberland County,
Pennsylvania, on November 24, 2003, to Estate No. 21-03-0972,
which Letters remain in full force and effect; and
WHEREAS, in September, 1995, the said TERRY B. PAULUS and
BEVERLY J. PAULUS executed and entered into a certain Loan
Agreement dated August 21, 1995, promising to pay to the said
B. H. PAULUS and MIRIAM A. PAULUS, his wife, the principal sum
of $25,658.57, with interest; and
WHEREAS, the said MIRIAM A. PAULUS died on July 12, 2002,
survived by her husband, the said B. H. PAULUS, in whom title
to the said Loan Agreement vested absolutely by operation of
law as the surviving tenant by the entireties; and
W~EREAS, party of the first part has filed for bankruptcy
under Chapter 7 in the United States Bankruptcy Court for the
Middle District of Pennsylvania, to Case No. 1-04-01511,
listing therein third party as an unsecured creditor for the
unpaid balance of the said Loan Agreement dated August 21,
1995, and third party has filed a Proof of Claim in said
bankruptcy case for the unpaid balance of the said Loan
Agreement dated August 21, 1995; and
WHEREAS, parties of the second part, or some of them, are
in possession of certain items of personal property belonging
to the said TERRY PAULUS at the time of his death, more
LAW OFFICES
MARLIN R. McCALE8
particularly itemized as follows:
Computer and Equipment: $ 800.00
H.P. Printer 100.00
.12 Gauge Shotgun 125.00
.22 Cal. Pistol 100.00
.22 Cal. Rifle 75.00
.38 Cal. Pistol 5.00
Total: $ 1,205.00
for which a claim has been made against them by party of the
first part; and
WHEREAS, parties of the second part have requested that
party of the first part pay or contribute to the payment of
certain funeral expenses for their father, including the cost
of the minister, the cost of the cemetery lot and the cost of a
gravemarker; and
WHEREAS, the parties hereto have come to an agreement as
to the settlement and resolution of their various claims
against each other and they desire to hereby document the terms
and conditions of such settlement and resolution.
NOW, THEREFORE, in consideration of the foregoing and in
further consideration of the covenants, terms and conditions
set forth and agreed to hereafter, the parties hereto covenant
and agree as follows:
1. Parties of the second part agree to pay to party
of the first part, upon confirmation of party of the third
part's First and Final Account, the sum of $1,205.00 in cash,
and parties of the second part further represent and warrant to
~^womcEs party of the first part that neither they nor any of them
MARLIN R. McCALEB
-3-
are/is in possession of any other item or items of personal
property owned by and belonging to the said TERRY PAULUS at the
time of his death, nor have they or any of them had possession
of any such other items at any time since his death. Upon
receipt of said sum of $1,205.00, party of the first part
hereby remises, releases, quit-claims and forever discharges
the said parties of the second part, and each of them, their
heirs, executors, administrators and assigns of and from any
and all actions, suits, payments, accounts, reckonings, claims
and demands whatsoever, for or by reason of any act, matter,
cause or thing whatsoever, from the beginning of the world to
the day and date of these presents, except for any obligations
arising under this Settlement and Release.
2. Party of the third part hereby remises,
releases, quit-claims and forever discharges party of the first
part, her heirs, executors, administrators, assigns and
successors in office and assigns of and from any and all
actions, suits, payments, accounts, reckonings, claims and
demands whatsoever, by reason of any act, matter, cause or
thing whatsoever, from the beginning of the world to the day
and date of these presents, except for any obligation arising
under this Settlement and Release, and further, except only to
the extent that party of the third part's Proof of Claim as
aforesaid is accepted by the Bankruptcy Trustee and is paid
from party of the first part's bankruptcy estate.
LAW OFFICES
MARLIN R. McCALEB
-4-
3. Parties of the second part hereby remise,
release, quit-claim and forever discharge party of the first
part, her heirs, executors, administrators, assigns and
successors in office of and from any and all actions, suits,
payments, accounts, reckonings, claims and demands whatsoever
by reason of any act, matter, cause or thing whatsoever, from
the beginning of the world to the day and date of these
presents, except for any obligation arising under this
Settlement and Release.
4. Party of the first part hereby remises,
releases, quit-claims and forever discharges party of the third
part, her heirs, executors, administrators, assigns and
successors in office of and from any and all actions, suits,
payments, accounts, reckonings, claims and demands whatsoever
by reason of any act, matter, cause or thing whatsoever, from
the beginning of the world to the day and date of these
presents, except for any obligation arising under this
Settlement and Release.
IN WITNESS WHEREOF, we have hereunto set our hands and
seals the day and year first above written intending to be
legally bound hereby.
~cz~j (SEAL)
Beverl~ Paulus
Individually and as Executrix
under the Last Will and Testament
of Terry Paulus
MARLIN R. McCALE8
Paula Ann Kiner
Tammy ~v~ers'
~ ~ichelle Sundy ~
~.Y /-Laraln¥ K.'~ol~ey~f/n/a
Individually and as Executrix
under the Last Will and
Testament of Brenard H. Paulus
COMMONWEALTH OF PENNSYLVANIA)
: SS.
COUNTY OF CUMBERLAND)
On the
day of , 2004,
before me, a Notary Public, in and for ~aid State and County,
the undersigned officer, personally appeared BEVERLY PAULUS,
individually and as Executrix as aforesaid, known to me (or
satisfactorily proven) to be the person whose name is
subscribed to the within instrument and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
(SEAL) Notary Public
Madin R. McC~b, ~tary Publ~
M~han~ ~m, CurrCDedan¢l Cou~
My Commi~ E~ms E~. 14, 2006
MARLIN R. McCALEB
COMMONWEALTH OF PENNSYLVANIA)
: SS
COUNTY OF )
On this, the ~ day of ~/~_0.e-~z~c~.~ 2004,
before me, a Notary Public in and for said State a~d County,
the undersigned officer, personally appeared LARAINE K. HOLLEY,
f/n/a LARAINE K. CAMPBELL, individually and as Executrix as
aforesaid, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument and
acknowledged that she executed the same for the purposes
therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
CON~MON3NEALTH OF P~qSYLVANIA No.fry Public
I Notarial Scsi
[ Robin j. Reeve, Notary Public ]
( SEAL ) ! Silver Spring Twp., Cumberland County
F. xpir~s
Aug.
Member, Perm A~ia~oo of Notates
COMMONWEALTH OF PENNSYLVANIA)
: SS
COUNTY OF )
On this, the ~ day of ~o~_~_~ , 2004,
before me, a Notary Public in and for said State and County,
the undersigned officer, personally appeared PAULA ANN KINER,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS W~EREOF, I hereunto set my hand and official
seal.
COMMONWEALTH OF PENNSYLVANIA Notary PuSlic
Notarial Seal
Robert J. ~eeg{~. Notary Public
( SEA]', ) Silver Spring Twp,, Cumb~:rland County
My Commission Expires Aug, 10, 2008
Member, PennsHv~n~ ASsociation of Notaries
LAW OFFICES
MARLIN R. McCALEB
_'7_
COMMONWEALTH OF PENNSYLVANIA)
: SS
COUNTY OF )
On this, the ~ day of ~~-~c~-. , 2004,
before me, a Notary Public in and for said State and County,
the undersigned officer, personally appeared TAM_MY MYERS, known
to me (or satisfactorily proven) to be the person whose name is
subscribed to the within instrument and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
Notary P'ub 11 c
COMMONWEALTH OF PENNSYLVANIA
INotarial Seal
(SEAL) Robert J, Re~se, Nota~ ~ublic
Silver Spring Twp. Cumberland Count~
My Conmaission Expires Aug. 10, 2008
Member, Pennsylvania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA)
: SS
COUNTY OF CUMBERLAND)
On this, the ~ day of ~~_~
2004,
before me, a Notary Public in a-d--for~d--f~ said State and' County,
the undersigned officer, personally appeared MICHELLE SUNDY,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
N0m..ia~ Sero I ~ - /~o~a~y/ P~blic
( SEAL ) Member, Pennsylvania Assocm~l, of Nota~'le~
BUREAU OF INDIVIDUAL TAXES
.Ft.,~ ;~P.~RTM~NT~;~ 8 06 01
H~SE~R:G, P.~ 17128-0601
Telephone
(717) 787-3930
August6, 2004 '04 /~U6 17 P1:14 FAX (717) 772-0412
Charles E. Shields III
Attorney At Law Ct~mb~ ~i
6 Clouser Road
Mechanicsburg, PA 17055
Re: Estate of Brenard H Paulus
File Number 2103-0972
Dear Sir/Madam:
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before 01/28/05. Because Section 2136
(d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be
granted that would exceed the maximum time permitted.
Sincerely,
Claudia Maffei, Supervisor
Document Processing Unit
Inheritance Tax Division
CONNONNEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE
BUREAU OF .rND'rV*rDUAL TAXES ZNHERZTANCE TAX
INHERITANCE TAX DIV/S/ON
.OBOXZSO60Z STATEHENT OF ACCOUNT
HARRISBURG, PA 171Z8-0601 REV-1;.Z EX AFP
DATE 1Z-O6-Z00~
ESTATE OF PAULUS BRENARD H
DATE OF DEATH 11-15-Z005
FZLE NUNBER Z1 05-0972
COUNTY CUHBERLAND
CHARLES E SHIELDS III ACN 101
6 C_I.I.I.I~USER RD Amoun~ Remi~md
.E.C ..IcsBu PA 17055
~_ ~_ ,~: u~Or~, HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
~ ~*~< REGISTER OF WILLS
~ ~ ~ CUH~ERLAND C0 COURT HOUSE
0~9 ~ ~ CARLISLE, PA 17015
E: T~nsure~r credit to your account, submit {he uppee pot{ion of ~hJs form wi~h your ~ax payment.
CUT ALONG~HZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS
ESTATE OF PAULUS IiRENARD H FTLE NO. 21 05-0972 ACN 101 DATE 1Z-06-200~
TH'rS STATEHENT TS PROV'rDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHO#N BELO#
*rs A SUHHARY OF THE pR'rNCTpAL TAX DUE, APPL.rCATTON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, TF APpLTCABLE,
A PROJECTED 'rNTEREST F'rGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: lO-11-200R
PRINCIPAL TAX DUE: ................................................................................... 8,775.82
PAYHENTS CTAX CREDITS):
PAYHENT RECEIPT DISCOUNT
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
08-17-Z00~ CDOO~ZSO .00 8,775.82
lO-ZZ-ZO0~ CD00~557 $.86- ~.86
TOTAL TAX CREDZT 8,775.82
BALANCE OF TAX DUE .
ZNTEREST AND PEN. . O0
ZF pA'rD AFTER THZS DATE, SEE REVERSE TOTAL DUE . O0
SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
ZF TOTAL DUE *rS LESS THAN $1,
NO PAYHENT ZS REi~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT'
YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCT'rONS.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Brenard H. Paulus
Date of Death: 11-13-2003
Will No. Admin. No. 21-03-0972
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a.
account with the
Did the per~nal representative
Court? Yes~ No .
file a final
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No X
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
~c~y
Signature
Date: 1-1l--05
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Charles E. Shields, III, Esquire
Name (Please type or print)
6 Clouser Road, Mechanicsburq, PA 17055
Address
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Te l. No.
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Personal Representative
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