Loading...
HomeMy WebLinkAbout09-16-111505610143 REV-1500 Ex(°'-'°, PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes ~EEIIRTMENTOFREVENUE County Code Year File Number PO 60X280601 INHERITANCE TAX RETURN 21 11 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 0205 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 209 20 5342 04 02 2010 11 25 1920 Decedent's Last Name Suffix Decedent's First Name BRANTHAFER MI GRACE A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffi;c Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return ~ 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ qa Future Interest Compromise ^ (date of death after 12-1232) 5. Federal Estate Tax Return Required g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 0 (Attacn copy or will> (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 1 p Spousal PovertY Credit (date of death between 12-31-91 and T-1-95) ~ 11.Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T Name SUSANN B MORRISON Daytime Telephone Number 717 249 6333 REGISTER OF WILLS USE ONLY First line of address , ~_ 354 ALEXANDER SPRING RO ~~ ~ -~~ - , , ,;.- Second line of address ; _, , C7 °~ - - .' -? _ , City or Post Office ~ ` ~'>> State ZIP Code DATE-F1~Di - ' __ CARLISLE PA -,~ `- }°= ~ , : r- `7 Correspondent's a-mail address: smorrison@salzmannhughes.com Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FCC FILI TURN UUU/C`J/~ DATE 4DDRESS Ronald J BatZel ~, ~ ~--_ I~ win Kun Road Fa etteville PA 17 OF PREPARER OTHF~f THA RE SENTATIVE Susann B Morrison TE ADDRESS 354 Alexander Spring Road, Carlisle, PA L Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX °e°ede"''S "ame Branthafer, Grace A Decedent's Social Security Number - RECAPITULATION --- 209 20 5342 - 1. Real Estate (Schedule A) .......................... ....................................................... ...... 1. 2. Stocks and Bonds (Schedule B) ...................... ............................ . ................... ...... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Sc:hedule C).... ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........... ................... . .................. ..... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .......... ..... 5. 36,823.27 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ........ 7. Inter-Vivos Transfers ~ Miscellaneous ~-Probate Property (Schedule G) .... g, Separate Billing Requested......... ... 7. 8. Total Gross Assets (total Lines 1-7) ............................................ . ----- .................. --- Funeral Expenses & Administrative Costs (Schedule H) ... .... s. - 3 6 , 82 3.2 7 - ................................. ... g. 7,153.32 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... 11. Total Deductions (total Lines 9 & 10) ................... ... 10. 1,053.51 ............................................. 12. Net Value of Estate (Line 8 minus Line 11) .................... ... 11. 8 , 206.83 ................................... 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .. 12 2 8 , 616.4 4 an election to tax has not been made (Schedule J) ...... ............. 13 14. Net Value Subject to Tax (Line 12 minus Line 13) ............. ............ _ _ .................... TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE R .. 1a. 28, 616.44 ATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 16. Amount of Line 14 taxable 15. 0 ' 00 at lineal rate X .045 28 , 616.44 17. Amount of Line 14 taxable 16. 1 , 2 8 7 - 7 4 at sibling rate X .12 0 . 0 0 17 18. Amount of Line 14 taxable . 0 • 0 0 at collateral rate X .15 0 . 0 0 18 . 0.00 19. Tax Due ..................... ............................................................................................. 19. 1, 287.74 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ' 1505610243 Side 2 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S tinnnG File Number 21-11-0205 Branthafer, Grace A STREETADDRESS 216 East Orange Street CITY Shippensbu STATE ~ ZIP PA ~ 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 0.00 (1) 1,287.7 Total Credits (A + g) (2) 0.0~ 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5> 1,287.74 Make Check Payable to REGISTER OF WILLS, AGENT. .. a . }~ ~.r, -. . s . s PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIA . TE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred :............... Yes No ................... b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................. d. receive the promise for life of either payments, benefits or care?......... ~~~~~. .. ............ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................ .................................................................. ~ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ^ contains a beneficiary designation? .............. HE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF HE RETURN. For dates of death on or after July 1 1994 and before Jan. 1, 1995,,the tax rate imposed on the net value of spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. transfers to or for the use of the surviving 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 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute 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 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 21 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 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)). . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1508 EX+ (6.98) COMMON WEALTH OF PENNSYLVANIA INHERITANCE 7AX RETURN RESIDENT DECEDENT C C.T~ T vv ~ /, I G L/r• Branthafer, Grace A FILE NUMBER SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ~ "~ -7 7 -U105 Include the proceeds of litigation and the data the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 Social Security Check -dated 4/2/2010 OF DEATH 2 Orrstown Bank Certificate of Deposit No. 5030061465 866.0 865.7 Accrued income on Item 2 through date of death 3 Orrstown Bank Certificate of Deposit No. 5030067540 -Irrevocable Burial Account 2.9- 720.2= Accrued income on Item 3 through date of death 4 Household goods at net proceeds of sale 2.5`. 5 Household goods and sentimental dolls 365.70 6 Nationwide Insurance, Survival Action Claim 500.00 -see attached 33, 500.00 TOTAL (Also enter on Line 5, Recapitulation) I 36,823.27 Copyright (c) 2002 form software only The (LacknerpGroupn Inced, additional pages of the same size) Form Pq_1500 Schedule E (Rev. 6-98) REV-1151 EX+(10-06) COM INO ERITANCE~ AX RETURN ANIA RESIDENTT DECEDENT ESTATE OF Branthafer, Grace A SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ITEM N MBER A. FUNERAL EXPENSES: Debts of decedent must be reported on Schedule I. DESCRIPTIC)N ~_ AMOUNT See continuation schedule(s) attached 1, 594.2 B• ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Ronald J Batzel Street Address 7821 Stump Run Road city Fayetteville State PA Zio 17222 Year(s) Commission oaid 2. Attorney's Fees Salzmann Hughes, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zlp Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~~ Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 1, 840.00 2,460.00 102.50 1,156.61 „~~ ~~ FILE NUMBER 71 _~ i _n7ne Copyright (c) 2009 form software only The Lackner Group, Inc. vv v` Form Pq-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Branthafer, Grace A (FILE NUMBER 21-11-0205 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exnensec 1 Fogelsanger-Bricker Funeral Home Inc. -funeral services 870. 2 Fogelsanger-Bricker Funeral Home Inc. -funeral services 723.E H-A 1,594.2 Other Administra iv ~ostc 3 Register of Wills -filing fees and expenses 90.0 4 Salzmann Hughes, P.C. -Closing costs for fiduciary income tax returns preparation, filing 800.Or and advertisement of possible formal accounting, postage and miscellaneous contingencies 5 Salzmann Hughes, P.C. -reimbursement for payment to Cumberland Law Journal for legal 75.OC advertising 6 Salzmann Hughes, P.C. -reimbursement for payment to The Sentinel for legal advertising 191.61 H-B7 1,156.61 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Branthafer, Grace A FILE NUMBER 21-11-0205 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DAT: 1 Bruce 8< Julie Beam -final payment for water, sewer and refuse OF DEATH 270. = 2 Orrstown Bank, Personal Credit Line Account No. 200395E -payoff loan 783. TOTAL (Also enter on Line 10, Recapitulation) I 1 053.51 Copyright (c) 2009 form software only The (LacknerpGroupn Inced, additional pages of the same size) r Form PA-1500 Schedule I (Rev. 12-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) 'ESTATE OF: Grace A Branthafer 04/02/2010 209-20-5342 Item Name and Address of Person(s) Number Receiving Property Relations 1 Cindy Poole Daughter 63 Amsley Drive Chambersburg, PA 17202 2 Gary Lee Batzel, Sr. Son 26B North Spring Street Shippensburg, PA 17257 3 Thomas R. Batzel aka Son Tommy R. Batzel 14019 Rt. 322 Brookville, PA 15825 4 Ronald J. Batzel Son 7821 Stump Run Road Fayetteville, PA 17222 5 Mary Anne Gutshall (predeceased the Daughter testatrix) 6 Kitina A. Nester (lineal issue of Mary Granddaughter Anne Gutshall) 620 East Broad Street, Apt. 1 Quakertown, PA 18951 Share of Estate I Amount of (Words) ($$$) 1/5th residue 5, 1/5th residue 5 1/5th residue 5 7 1/5th residue 5 7 1/5th residue 5 7= Total g 69 1 LAST WILL AND TESTA>v1ENT I, GRACE A. BRAN I'HA.~ER, of 216 East Orange Street, Borough of Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give and bequeath those certain items of fiirnishings, household appliances, a doll collection (each doll containing a number from 1 - 89 thereon) and other items ofpersonal property that I may own on my passing to those persons named on a certain six-page listing of personal property dated Apri128, 2000, and signed by me, which is to be found with or attached to this my Last Will and Testament. TI-TIRO. I give and bequeath any doll given to me which is not mentioned in paragraph two of this my Last Will and Testament to the person who gave me any such doll or dolls. FOURTH. I direct that any dolls that I may have purchased which are not mentioned in paragraph two of this my Last Will and Testament become a part of the rest and residue of my estate and disposed of in accordance with the provisions of paragraph fifth of this my Last Will and Testament. FIFTH. I give, devise and bequeath all the rest and residue of my estate, real, personal and mixed, whatsoever and wheresoever situate to my children and grandchildren, namely: CINDY POOLE, GARY LEE BATZEL, SR., THOMAS R. BATZEL, RONALD J. BATZEL, and MARY ANNE GUTSHALL, on a per stirpes distribution basis. My hereinafter named Co-Executors shall determine in their sole ;end absolute discretion whether to distribute items which comprise the rest and residue of my estate in kind or to liquidate all or a part of the rest and residue of my estate through private or public sale or sales. It is my specific intent and direction that any items which make up the rest and residue of my estate which are to be sold not be sold to auctioneers, dealers or other persons who will re-sell or who are likely to re-sell said items for profit. SIXTH. In the event that any beneficiary of this my Last Will and Testament is under the age of eighteen (18) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise my son, er_ w~THOMAS~. BATZEL, of Box 341, R. D. 1, Brookville, Pennsylvania 15825, AS v :~ ~-- ~t '"a Q~ ~, ~ ~ ~ L-~'/ ~~ /,~_'r.-t2--v-~`~f~ /,~ .->~ (SEAL) - ~,-` v~ ~- '~~ ~E ! ~. i W ui .:, J _ ,j C_~r^ ' i..i_ ___ U ~'-- l GUARDIAN, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the aQe of eighteen (18) years, with the following powers in addition to those presently given by law: A. The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; B. The power to expend the principal, within the discretion of the said Trustee, if the income is insufficient.. towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; C. The power to sell any and all real estate, within the discretion of the said Guardian; D. The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of eighteen (18) years, without the necessity of a formal adjudication of the Guardian's Account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; E. The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; and r. in the event the above-,~ieniioned persor. is unable to accept the position of Guardian I then name, constitute and appoint my grandson, GARY LEE BATZEL, JR., of 1717 Orchard Road, Chambersburg, Pennsylvania, as Guardian, with the same powers hereinbefore stated. SEVENTH. I nominate, constitute and appoint my grandson, GARY LEE BATZEL, JR., of 1717 Orchard Road, Chamlbersburg. Pennsylvania, and my grandson, TIMOTHY L. M. BATZEL, of 97 Parsonage Street, New-ville, Pennsylvania 17241, or the survivor thereof, to be the Co-Executors of this my Last Will and Testament. _, ~. + , t. /. ~2- _ . _ t,.? 1 ~r-i t _ T << . ~~~) (SEAL) EIGHTH. I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of nr,~ estate. NINTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, GRACE A BRANTHAFER, have hereunto set my hand and seal to this my Last Will and---"~estament, writte~~ ~ three pages, the first two pages signed for identification only, this L'~~~~~ day of C_,~-~~~~~~_ , 2000. ,. ~ ~ ,; , . _ ,. ~ ; ~"", ,- ~ _~ r (SEAL) ~~~ ..~.~.~~_, ~r_ ~- This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. 1 j r. r~ •_I C~C_ ^>l ~:'Y)l~' ' r ~ ~ ` j / ~ r COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, GRACE A. BRANTHAFER, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. i - t , Sworn or affirmed to and acknowledged . before me by GRACE A. ~RANTHA~.I?ER, the Testatrix. -• -'dais "Z'~ ,day of ~~ v~''v ,~ ~~ ~'~J7 ?000. .• ^ // r c \ ~: i ~ f • ttiOTAR!AL .ritAL Jerry A. ~1Jeig!e, Notary Public Shiooensb~.~rc~, f°:1 C+_::r•her!snd County COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND ., ~ ; . ,- We, ~~_ r r-~_~ ~~_ ,~~1 ~ ~m-~ and ~ ~~' ~ ~~/ , the witnesses ~~~hose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw GRACE A. BRANTHAFER, the Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. .` _,` I lr ,% Sworn or affirmed to and subscribed before r}1e by -~', ~ ~ ~ r_~=- ~ / c~~> ~' a-~zd-._ l C ~.,( .~- :~~,~ ~ ~/ ter- /~~ .~'~~.: wi •~sses, this "Z`~ ~,~'day of ~;A,,u~• ~ ` , 2000. / ~ / (~1 i ~ 1 PiOTARIAL SEAL i Jerry A_ Weigh,, Notary Public Shippenst;~_~!g, F'A C;~~~?~i~eriand Coitrity Rf•; Cr,,ir,mi;~i,;n [ ___tr' (lr.ii)~iCr 07. 2(i0'? LIST OF PERSONAL PROPERTY BEQUEST REFERRED TO IN MY LAST WILL AND TESTAMENT DATED APRIL 28, 2000 1. To my son, RONALD J. BATZEL: Doll #6 -Prairie doll with black hair, dressed in plaid & flowers Doll #41 -Doll with blonde hair dressed in light pink pantsuit Small china closet 2. To my daughter, MARY ANNE GUTSHALL: Doll # 18 -Doll with blonde hair dressed in red Christmas dress with ruffles on sleeves and skirt with a veil Doll #29 -Doll with short brown hair dressed in red velvet with white fur Doll #36 -Doll with blonde hair dressed in blue and green velvet with flower apron Five-shelf bookcase in living room Microwave stand 3. To my son, GARY LEE BATZEL, SR.: Doll #23 -Twin dolls dressed in green & red plaid -one tooth - on a stand Doll #23 -Eagle in a case Booher wedding picture Sewing machine with stool Stereo Knickknack stand with four shelves Entertainment center Talking stuffed Santa Claus 4. To my grandson, GARY L. BATZEL, JR.: Doll #2 -Rose colored doll -looks like Fawn with. a hair bow Doll #30 -Tall doll with blonde hair -rust light color -with umbrella at her side Doll #46 -Tall skinny clown with red pantsuit with feathers around neck Doll #51 -Gift gallery fantastic (hanging) All Avon except dolls in living room Ceramic cats in spare room Grace and Jim's wedding picture - 10 x 13 in size Small curio cabinet ~, (SEAL) 5. To my great granddaughter, JESSICA A. BATZEL: Doll #26 -Doll with blonde hair dressed inold-fashioned royal blue with glasses Doll #58 -Musical. doll with blonde hair dressed in red velvet (sitting/gift gallery) Doll #75 -Small bride doll in bell case Tiger picture in spare room 6. To my great granddaughter, FAWN E. BATZEL: Doll #33 -Pink and green clown Doll #53 -Doll with brunette hair holding umbrella up - nightlight Doll #64 -Indian doll with white dress Framed picture of kittens (11 x 13 in size) 7. To my great grandson, SEAN T. BATZEL: Doll #40 -Victorian gardner doll named Beth dressed in red satin Doll #62 -Doll with short blonde curly hair dressed with a hat with a rose on top (laughing) School desk Small rocking chair Desk with drawers Computer chair Iron claddsadle horse & wagon Five-drawer dresser in hall All toys including stuffed toys One of the painted kitten pictures in spare room One of the German Shepard pictures in spare room Toddler bed 8. To my great grandson, COLTON R. BATZEL: Doll #47 -Native American doll with blonde hair dressed in gray fur with jewels Doll #71 - Poncathos doll dressed in brown outfit Doll #83 -Doll with blonde hair with pink ribbon in her hair dressed in pink dress with flowers One of the German Shepherd pictures in spare room One of the painted kitten pictures in spare room ~, -~ l=' 1,~~~ti2'T/~~ ~1. (SEAL) ~ti p, c,e w 9. To my son, THOMAS R. BATZEL: Doll #27 -Doll with black hair dressed in a red dress with white apron and red Hat Blue recliner Hutch cupboard Large ceramic Mr. and Mrs. Santa Claus Ceramic Dutch boy and girl (little knickknacks) 10. To my granddaughter, THERESA BATZEL: Doll #4 -Doll with blonde hair dressed in plaid dress with red trim and white lace with a hat Doll #49 -Doll with blonde hair dressed in blue velvet with white fur/gold trim Doll #68 -Japanese doll 11. To my granddaughter, PATSI J. MCLINEY: Doll # 16 -Doll with brown hair dressed in blue party dress with puffy sleeves Doll #52 -Flexible porcelain pierrot doll Doll #72 -Old fashioned prairie doll with red hair 12. To my granddaughter, MISSY BATZEL: Doll #10 -Doll with blonde hair dressed in a dress with holly on it with a red velvet hat Doll #50 -Doll with short blonde hair dressed with a fancy ruffle with matching hat Doll #70 -Clown doll dressed in red and blue 13. To my daughter, CINDY POOLE: Doll #19 -Angel doll with brown and gold wings Doll #20 -Small musical doll on high chair dressed in green & white Doll #38 -Doll with blonde hair and a gray, green, purple & blue stripped back pack Shell hanging ornament Muffin ceramics for jelly Grandfather's Clock Table & Chairs ,~~t--~'--'~ C.1~ ~~1irt-~'/^~-{''1' ___ (SEAL) 14. To my grandson, RONALD A. POOLE: Doll #1 -Angelina doll with black hair dressed in red Christmas dress with white fur and bells Doll #48 -Doll with long blonde hair dressed in simple flower dress Doll #69 -Clown doll dressed in purple and yellow 15. To my great grandson, JAMES D. POOLF,: Doll #2~ -Doll with brown hair dressed in a purple ballerina outfit with a flower headband Doll #55 -Santa Claus doll with presents Doll #74 -Doll with dark hair dressed in a white dress with ruffle on top 16. To my great granddaughter, KAYLEE R. POOLE: Doll #39 -Doll with black hair dressed in a light blue polka dot outfit with lace and dark satin Doll #61 -Prairie doll with blonde hair dressed in blue and white Doll #79 -Doll with dark hair dressed in pink dress with bow in front wearing glasses with flowers 17. To my grandson, CHRISTOPHER J. C. BATZEL: Doll #3 -Doll with blonde hair with white fur & mitt -burgundy shawl Doll #5 -Doll bride with brown hair named Fran Doll #9 -Doll with red hair dressed in Angelina green velvet with white ruffle Doll #17 -Doll with. brown hair dressed in red dress with white front & hat of a teardrop Doll #34 -Doll with blonde hair dressed in peach outfit with fluffy hat Doll #37 -German doll Blue & white glaze two-handle vase with flowers on it 18. To my great granddaughter, KAYLA BATZEL: Doll #32 -Purple clown doll Doll #60 -Angel doll with blonde hair with wings, halo and star wand Doll #77 -Doll with blonde hair dressed in mauve outfit with flowers ~?~,~-.cam'-t,-~~C 1, (SEAL) 19. To my great granddaughter, SARAH BATZEL: Doll #43 -Doll with blonde hair dressed in mint green party dress Doll #6~ -Doll with brown hair dressed in pale pvik dress Doll #81 -Doll with dark hair dressed in a layered dress with a straw hat 20. To my grandson, TIMOTHY L. M. BATZEL: Doll #8 -Doll with brown hair dressed in pink silk party dress with pearl buttons Doll #11 -Black dolls dressed in blue dress with straw hat and spring flowers Doll #12 -Doll with blonde hair dressed in pink dress with straw hat and spring Flowers Doll #13 -Doll with blonde hair dressed in cowgirl suit with red hat Doll #14 -Christmas doll with dirty blonde hair dressed in green/rose dress with a burgundy hat Doll #15 -Black skater doll with burgundy hat Doll #21 -Boxed musical doll with blonde hair with red ribbon and pig tails Doll #54 -Skater doll with brown hair, dressed in blue velvet Doll #85 -Black doll with china tea set Doll #86 -Doll with blonde hair with spring tea set Five-piece bedroom suite (bed, dresser with mirror, 2 chest of drawers, night stand) 21. To my great grandson, Timothy L. M. Batzel, II: Doll #28 -Twin dolls dressed in blue plaid and black velvet Doll #59 -Doll with red hair dressed in green velvet with plaid and a hat Doll #76 -Doll with strawberry blonde hair dressed in a spring dress 22. To my great grandson, TAY"LOR D. BATZEL: Doll #42 -Crawling doll with red hair dressed in red velvet with hearts Doll #63 -Doll with blonde hair dressed in pink dress with lace Doll #80 -Ballerina doll with silver tutu 23. To my granddaughter, GRACE L. POOLE: Doll #31 -Victorian plastic doll dressed in red dress and high society hat Doll #35 -Doll with black hair dressed in pink frilly dress with lace ruffle veil down the front Doll #57 -Doll with brown hair dressed in pink satin dress with hair bow „; fez--~,~~~~'i. (SEAL) 24. To my great granddaughter, DESTINY D. POOLE: Doll #44 -Doll with blonde hair dressed in peach outfit with straw hat Doll #66 -Doll with red hair dressed in pink dress with flowers in her hair Doll #82 -Doll with dark hair dressecl in red velvet dress with a bow and lace across the front 25. To my granddaughter, TABITHA K. POOLE: Doll #22 -Twin dolls dressed in pink velvet with a small rocker Doll #73 -Doll with blonde hair dressed in red velvet dress with lace trim with a straw hat Doll #78 -Doll with blonde hair and pale fact dressed in a rust/brown dress 26. To my great grandson, BRYCE D. NEIV"ES: Doll #7 -Ballerina doll with brown hair dressed in a pink dress Doll #45 -Doll with red hair dressed in blue & purple and a hat with a feather Doll #67 -Bride doll with black hair 27. To my granddaughter, CRISTINIA L. REXROTH: Doll #56 -Doll with blonde hair with blue fur shawl 28. To WILLIAM J. WOLFE (friend of the family): Doll #84 -Doll with blonde hair dressed in red velvet & white with key in her left Hand with white fur head wrap & bow ~1~~ ~~%~-~'L'~.--c..~-~~-t'~~E'Y.. (SEAL) ,~ ~ IN THE COURT OF (:OMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA In Re: Estate of Grace A. Branthafer ORPHANS' COURT DIVISION NO. Z1-11-0205 RE: Petition for Approval of Settlement of Survival Action Pursuant to Section 3323 of the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, 20 Pa.C.S.A. §3323. ORDER APPROVING SETTLEMENT AND DISTRIBUTION OF PROCEEDS tl, pn AND NOW, this 3Q day of _ r\qc~ 2011, IT IS HEREBY ORDERED that the settlement and proposed distribution of the settlement proceeds set forth in the attached Petition are approved, and the proceeds from such settlement shall be paid as follows: 1. The sum of $50,000 shall be paid by Nationwide Insurance to the ESTATE OF GRACE A. BRANTHAFEI~, Deceased, in the survival action claim brought as a result of the death of Grace A. Branthafer. 2. From the settlement amount, the sum of $16,500 shall be paid to Salzmann Hughes, P.C. as attorney fees. A y-RUE COPY FROM RECORD !n Testimony ~herof, f hereunto set my hand ancf the sal of said r,;auri At Carlacla, P!~ ~ r. v ~r'14 U/~''+ ~~~ ~ ft~8,f~'i'9`Uri BY "fHE COURT: -~ n r-~ ; c ~ ~ n~r ~ n ~ ^ ` _ `-~ ' (T~ .. ~r~ r ~= ~O-T, ~ - rJC ~T _ 7 T~ N _' ~- rn c~ ^,1 a r 0 % 11 04;1 np Beth 717-249-9990 p,1 .~ HERSHEY A~c~rro~r 5.~~ ~, DICE, 1~L~ ¢' ~ I~~ SS ~ , i ^ ~- 790 West HYgh Street ~l ~ ~ t ~ ll ~~' ~,~ ~~~ (~~,~Ci~'~1 Carlisle, PA ~ 7013 ., (717) 532-'464 7 Steve Ege 717-385-5438 Cell ~ Chris Bream 71.7-226-1920 Cell SELLERS NA11fIE 'c , - ~ Q~;~I~ DATE Z ADDRESS_ 2I1, ~~ s ~ o ~~.,~,.~ S ~ ~~i ~1`'Fvts,~,: ~,~ PHONE 3 ~~-!y y: ,~ - OTHER~V'4 s ~ !mac e AUCTIONEER e/n ~C~ AUCTIO~t DATE/LOCATION ~~ ( ~_~~,~~ ~~ ~~__ CLERK pia 1 Corrzmission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Ivierchandise to be sold as is & grouped as necessary to ofatain bids. I certify that I am the owner or authorized representa- tive of the merchandise, goods and(or propert}~ and have good title and the right to sell and that they are free Lom all ircurnbrances. I agree to accept all responsibility for providing merchantable title and for delivery of title to the purchaser. I agree to hold 'Harmless the Auctioneers agai st any claims of the nature referred to in thi$, a ' eerraer~t. Trash fe appl_ed if applicable. /~ 1 ._ ~ -~ ~C SIGNATURE ((~'`~~((~~ SE RS SIG1VAfi'URE Total Sales (Clerking Tickets Attached) $ ll"~` ~~ Le~ss~~S~ale Expense: ~_-._ °/a Commission Auctioneer S ~ r ,1 • ~~"' °/a Commission Clerks $ OTHER: TOTAL SALE EXPENSE DEDUCTED $ SELLERS NET $ ~~ t~ L'J ~v~. d: AUCTION SIGN RE ~u.~~C:,NIPTIO-N rQF MERCEIANDISE c try ~ ~' {~ti~~ ~ ~~~-~`~ S ~a, !c~t~S~s OP-RSTOWN saNx A Tradition. of Excellence April 15, 2011 Re: Estate of Grace A Branthafer Social Security Number 209-20-5342 Date of Death 4!2/10 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE FOLLOWING ACCOUNTS WITH ORRSTOVVIV BANK: Tamera S. Siegrist, Estate Paralegal Salzmann Hughes, P.C. 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 Fax: 249-73 34 CERTIFICATES OF DEPOSIT Account No.- 503006.1465 Account Type- 120 Month Growth CD Date Opened- 11/14/00 Joint Account (name/date)- None ~,, Balance- $865.79 Accrued Interest- $2.94 Account No.- 5030067540 Irrevocable Burial Account Account Type- 120 Month. Growth CD Date Opened- 7/02/01 Joint Account (name/date}- Norie Balance- $720.25 Accrued Interest- $2.59 . ~ , '. M ~~ 2695 Philadelph Chambersburg, ' 1.888.OR LOfIN Account No.- Account Type- Joint Account (name/date)- Total Payoff (as of 4/1 S/11)- 200395E Personal Credit Line None $775.88 Enclosed you will find a breakdown of the amount due. Best Regards, R C,{.lC~ ill R. Worthin on ~~ Deposit Processing Clerk Enclosures 4/15/11 Loan Payoff Inauir 3race A Branthafer Messages *****~*~**~***********~***************** Shadow Bad Address 10:12: Loan## 200395 Type: Personal Credit Eff. Dt: _4115_L1l PerDiem: .11 Sns PerDiem: Description Amounts Rebates Payof Current Balance 745.88 74 Capitalized Fees 51.2E; 74 Accrued Interest 2,50 74 Late Charges 27.50 77 Total Payoff 77' Bo: F3=Exit F6=Messages F7=Escrow/Insurance F8=Set P/O Pending F12=Previo1_ F14=Fee Inq. F15=Calculate DP F16=Calculate Penalty F20=Generate P/O Lei