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Home My WebLink About04-0838PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as Deceased. Social Security No. / q ~- ,~ ~ - ~. ~_ ! _~ No. To: Register of Wills for the County of ~, :~.~_~;. I O~ Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in ~, V ~ ~'x ] ~b,) D , ,County, Pennsylvania, with h~_t"- last family or principal residence at !'~E5' ~x/. ~~?~ ~- AA~ ~. O ~0~ ~~ t~ ~( C~ (]ist st~et~ number and municipality) ~-'~. ' '~ ~ ~"- ~'~ ~. x~ · ~ ~ , ~ -- Decendent, then ~ years of age, aieo ~ ., 19_ ~ , at ~,,~m. - ' Decendent at death owned property with estimated va~4s as folllows: (If domiciled in Pa.) All personal property $ ~ [,2 0 0 ~. ~ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ V~ue of real estate in Pennsylvania $ situated as follows: Petitioner the following spouse (if any) and heirs: Name after a proper search ha ascertained that decedent left no will and was survived by Relationship AA ~ O"De, Residence THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF .~ ~_~,~r~~ 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 representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before r~ this . / ~ day of ! v . No. Estate of .'~~_-~, _//~.~_ ~/~. '~, ~K# , Deceased GRANT OF L~TTERS OF ADMINISTRATION AND NOW d~c~O~ /,7~tt~'- 19,.~aV ( in consideration of the petition on the reverse side h~ereof, s/atis.~f~tg}ry proof having i~een, present, ed before me, IT IS DECREED that is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to in the estate of FEES Letters of Administration ..... $ Short Certificates(q $. Renunciation ...... ~:~¥3"' ' $ O ~ TOTAL $. A.D. Filed ~L~t.~..-../..3j./~... ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from ;_tn 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 COl)l/blt photostat or photograph. Fee for this certificate, $2.00 P -'1-0867279 No. Judith 54 Cumberland COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RE~RDS CERTIFICATE OF DEATH >'~ ---' (Coroner) Hechanlcsburg Webb Female 196-38-1318 ,. September 7, 2004 130 West Portland Street ealth Care 13o ~lest Portland Street larenc Webb orence Webb .... * .... PA Cumberland 9-9-2004 White ~'~'"~'""~"~ MeChanicsburg e Hoin Webb sot B1 echa icsb~ )55 ;on-O-Lite Crematory chaefferstown PA East Ma Septembdr 7, 2004 Coroner September 8,2004 lchael E~ Norris, Coroner 6375 Basehore Road, Suite #1 Mechantcsburg, Pa. 17050 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004707 WEBB FLORENCE 5237 WINDSOR BOULEVARD MECHANICSBURG, PA 17055 ESTATE INFORMATION: SSN: 196-38~1318 FILE NUMBER: 2104-0838 DECEDENT NAME: WEBB JUDITH ANN DATE OF PAYMENT: 12/07/2004 POSTMARK DATE: 12/06/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/07/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,543.00 REMARKS: TOTAL AMOUNT PAID: $2,543.00 SEAL CHECK# 7837 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 12/06/2004 WEBB FLORENCE 5237 WINDSOR BOULEVARD MECHANICSBURG, PA 17055 RE: Estate of WEBB JUDITH ANN File Number: 2004-00838 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS, COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 12/23/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court REV-15Og. F..X (~00) I REV-1500 INHERITANCE RETURN F,[E.UMBBR 21-0 -09 5 RESIDENT DECEDENT 3ECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~OCIAL SECURITY NUMBER Judith A Webb 196-38-1318 3ATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR} 9/7/2004 2/21/1950 REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) iOCIAL SECURITY NUMBER z NAME Mm. Florence Webb FIRM NAME (If Applicable) TELEPHONE NUMBER 717-766-0187 COMPLETE MAILING ADDRESS 5237 Windsor Blvd. Mechanicsburg, PA 17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Mtscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) I (6) --'lSeparate Billing Requested 7. Inter-Vivos Transfer & MIsceJlaneous Non-Probats Proper~y (Schedule G or L) (7) 8. TOTAL GROSS ASSETS (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (ScheduJe H) (9) 10. Debts of Decedent, Mo~lgage Liabilities, & Liens (Schedule I) (10) 11. TOTAL DEDUCTIONS (total IJnes 9 & 10) 12. NET VALUE OF ESTATE (LIi3e 8 minus Li~e 11 ) 13, Char[table and Governmental Seduests/Sec 9113 Trusts for which an election to tax has not been n3ade (Schedu~ J) 14, Net Value Subject to Tax (Line 12 minus Line 13) 661809 0 (8) (11) (12) (13) (14) 51116 21199 66~809 71315 591494 0 59~494 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousaJ tax rate ,or transfem under Sec.9116 (aX1.2) x .0 (15) 16. AmountofLIne14tsxabieatlinealrats 59,494 x .045 (16) 17. Amount of Line 14 taxable at sibling rate X .12 (17} 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0 2~677 0 21677 217 Decedent's Complete Address: STREET ADDRESS 130 W. Portland Street Unit # 7 ICITY JMechanicsbur,q Judith A Webb 196-38-1318 STATE ZIP PA 17055 Tax Payments and Credits: 1. Tax Due (Page I Line 19} 2. Credits~Paymente A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2~677 134 Totel Credits (A + B + C ) (2) 134 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0 4. If Uno 2 is greater than Line I + Uno 3, enter the d~ffemnce. This Is the OVERPAYMENT. Check box on Page I Une 20 to request a refund (4) 0 5. ' Iflino 1 +line31sgreata~'thanllno2, enterthedlfference. This is the TAX DUE. (5) 2~,543 A, Enter the Interest on the tax due. (5A) B. Enter the total of Uno 5 + 5A. TNS is the BALANCE DUE. (SB) 2~543 Make Check Pa~able to: REGISTER OF WILl_.q_, AGENT '1 I I I I '"' I'1 ~_ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or Income of the property transferred; ........................ [] [] h. retain the right to designate who shall use the property transferred or its income; ............. [] [] c. retein a reversionary interest; or ................................ [] [] d. recelve the promise for life of eithor peyments, benefits or care? ................... [] [] 2. If death occurred after December 12,1982,diri pecedent transfor property within one y~ar of peath ~thout receiving adequate consideration? .................. ........... [] [] 3. Did decpoent own an "In t/ust for' or peyable 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 contelns a peneticJaty pesig nation? ................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS 18 YES, YOU BUST COMPLETE SCREDULE G AND FILE IT AS PART OF THE RETURN. Under penalties ~f penury, I declare Ihat I have examln~l thl~ return, including accompanying schadulm and statements, end to the best of my knowledge and belief, it is tree, SIGNATURE OF.PEI~:~I~RESPONSIBLE FOR FILING RETURN DATE 5237,~/indsor Blvd. Mechanicsbu ,rf:l~ PA 17055 SIGI~.I_ I~E _O5 ~P~REJ~OT,~ER TNAN~REPRESENTATIVE Ai~DRESS ' ~ ~ ~' ~' - ~' B & L Tax and AccountinQ Services 1071 Countn/Hill Drive Harrisbur.~, PA 17111 DATE [72 P.S. ~ection 9116 (a)(1.1 REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHER~ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Judith A Webb SCHEDULE A REAL ESTATE FILE NUMBER 21-04-0838 ITEM NUMBER All rea{ ~,[,,~,13. owned ~lolely or a~ & ~,~,,[ in common must be reported at fair market value. Fair market value Is defined as the price at which property DESCRIPTION VALUE AT DATE OF DEATH 0 TOTAL (Also enter on line I r Recapitulation) 0 (If more space is needed. Insert additional sheets of the same size) 217 REV-1503 EX+ (6-98) ESTATE OF Judith A Webb SCHEDULE B STOCKS & BONDS FILE NUMBER 21-04-0838 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0 TOTAL (Also enter on line 2, Recapitulation1 ~; 0 (If more space is needed, insert additional sheets of the same size) REV-1504 EX+ (6-98) AT COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Judith A Webb ISCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP FILE NUMBER 21-04-0838 Schedule C-1 or C-2 (Including all supporting information) must be attached for each cloealy-held corporation/partnemhip interest of the decedenl other than a sole-pmprletomhip. See instructions for the supporting information to be submitted for sole-pmprietomhips. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0 TOTAL (Also enter on line 3, Recapitulation). 0 (If more space Is needed, insert additional sheets of the same size) '217 REV-1507 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Judith A Webb SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21-04-0838 ITEM NUMBER All propertyJointl~.owned with right of survivomhlp must be disclosed on Schedule F. VALUE AT DATE DESCRIPTION OF DEATH None 0 TOTAL (Also enter on line 4, Recapitulation) $ 0 (If more space is needed, insert additional sheets of the same size) 217 REV-1508 EX* (6-98) ESTATE OF Judith A Webb SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-04-0838 ITEM NUMBER Include the proceeds of lit~gation and the date the proceeds were received by the estate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION Members First Certificate Of Deposit ( Certificate # 13703-41) 717-697-1161 Members First Savings Account ( Account # 13703-6) 717-697-1161 Social Secudty Disability Check Not Deposited Toyota Camry 2001 LE VALUE AT DATE OF DEATH 55,273 814 722 10,000 TOTAL (Also enter on line 5, Recapitulation) $ 66,809 (If more soace is needed, insert additional sheets of the same size) OFFICE USE ~,:IN~ ,: , Please Print MEMBER NAME: ADDRESS: HOME PHONE NUMBER: 6000 LOUISE DRIVE, R O. BOX 40 MECHANICSBURG, PA 17055 TELEPHONE NUMBER: 717-795.,6049 LONG DISTANCE: 1...800,237-7258 HEARING IMPAIRED: 717-697-5312 ]st z~P COBE: /V MEMBERS 1" CERTIFICATE WITHDRAWAL REQUEST ~!~ , jL)~, '~ .UMBER: ~ 7~-~ STA~: WORK NUMBER: Office Use Only DATECt:Ri~P~CATE ~.=~i;r~CATENO.: CERTiFiCATE CERTIFICATE CODE ~ Amountof ISSUED: RATE TYPE Penalty WITHDRAWAL DATE MATURITY DATE CER¥iI-iCATE BALANCE Amount Dlsbumed HEREBY APPLY TO REDEEM MY CERTIFICATE AND: CHOOSE ONE: ACCOUNT NUMBER - DEPOSIT TO SAVINGS ACCOUNT - - DEPOSIT TO CHECKING ACCOUNT - - DEPOSIT TO INVESTMENT SAVINGS ACCOUNT/MMA - - DEPOSIT TO SUPPLEMENTAL SAVINGS ACCOUNT - - DEPOSIT TO ADD-ON CERTIFICATE. - APPLY TO LOAN ACCOUNT - - RECEIVE A CHECK - MEMBER'S S,G.ATU.E, ?_ DATE: 91, A penalty will be Imposed for early withdrawal; for further received when you purchased the certificate, details refer to the certificate disclosure you MBRS 1: 58-21 Bev. 05/03 AUTOMOTIVE GROUP [] TELEPHONE [] SHOWROOM CIT~, STATE, ZIP - WORK PHONE HOME PHONE CELL PHONE F~ STOCK NO. ~ MAK~ MODEL TYPE COLOR ~']-~--MA.NUAL I I Tranmussion ~ PAYOFF GOOD MONTHLY PAYMENT MAKE MODEL TYPE MILES L~c ~ ~ A/C C'/apTILT ~'pw J pL ~'CC ~'/ ~o ~,Ir .. s~f t9 ~o~o,~~ ~l ~.,~,, ,~. LIBN HOLDER TITLED TO: ACCOUNT NO. / SSN. MONTHS GREY MARKEr / B ~R~RqDED TITLE Is ai~ag operable? Was e.a' ~ught n~O I~t major service / / e~z 217 REV-1509 EX+ (6-98) ESTATE OF Judith A Webb SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-04-0838 If an asset was made joint within one year of the dscedent°s date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. JOINTLY-OWNED PROPERTY: L= ~ ~ =r~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH 1. A. None TOTAL (Also enter on line 6~ Recapitulation (If mom space is needed, insert additional sheets of the same size) 21~ REV-1510 EX+ (6-98) ESTATE OF Judith A Webb SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FiLE NUMBER 21-04-0838 This scheduJe must be completed and flied if the answer to any of questions 1 throu ~ 4 on the reverse side of the REV-1500 COVER SHEET i= DESCRIPTION OF PROPERTY I ITEM ~-U~H~"X~O~'r~.~=~.THaR~O~SH~TO~Ce~.~N~We~T~O~ CATE OF DEATH % OF DECD'SI EXCLUSION TAXABLE NUMBER T~NSFER. ATTAC~I A CO~Y OF 1~ DEEO FOR RE~ E~TA'i'~. VALUE OF ASSET INTEREST I~' ~,~u~) VALUE 1, ~lone TOTAL (Also enter on line 7 Recapitulation) (If more space is needed, insert additional sheets of the same size) 217 REV-1511 EX + (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FiLE NUMBER ESTATE OF Judith A Webb 21-04-0838 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 1. 2. 3. 5. 6. 7. 8. FUNERAL EXPENSES: Rolling Green Cemetery -Preneed Counselor Ck. 7772 ~lyers Funeral Home, Inc. Ck. 7782 :~olling Green Cemetary -Marker - Ck. 7777 ~DMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative ($) Soc,[al Secudty NumbeRs) I EJN Number of Personal Representative(s) Street Address City State Zip Year(a) Commission Paid: Attorney Fees Family Exemption: (If becedent's address is not the same as claimants, attach explanaUon) Claimant Street Address city ~,dvertising - The Sential - Public Notice Advertising - The Patriot News - Public Notice state Zip AMOUNT 235 2,213 2,076 137 235 95 125 TOTAL (Also enter on line 9, Recapitulation) 5,116 (If more space is needed, insert additional sheets of the same size) Z U.J rw ,- TH~ AGREEMENT PROVIDES FOP. ENDOWMENT CARE CEM~TERY~ INTERMENT RIGHTS~ MERCHANDISE AND SERVICES PURCHASE/SECURITY AGREEMENT The undersigned, referred to as "Purchaser" hereby agrees to purchase the Interment Rights, Merchandise and Serv ecs described herein, subject to acceptance and approval o(the above named eemete~, hereinafter referred to as Seller'. Description o f Interment Rights: .'~ !, t~ Issue Certificate of Interment Rights to: Address INTERMENT RIGHTS MERCHANDISE AND SERVICES Interment Rights (including Endowment Care of S ) ....................................................... $ . lntermentrees ............................................................................................................................................................. /' -9/'; , ~'f~ Memoflthflon~e - _ · ~c~a~m~ ............................................................................................................................ (- -~ (49 ................................................................ s< afi~, ~:~ ............................................................................................. iO. ~. ~ TERMS -- CASH SALE The Totnl Cnsb Price is due and payable as of the date of this Agreement. A delinquency charge of percent will be assessed monthly on any ba ante u0t paid within 30 dnys of the date of this Agreement. if less than full ~ received, Seller shall deduct the accrued de nqueney charge from the amount received tad credit the remainder of.ese payment received to the Unpaid Balance SECURITY INTEREST: Seller (or its assigns) will have a security interest fa the Interment R gms and Merchandise being purchased as described above. Se ler wi I retain title to said Interment Rights and Merchandise until the Total Cash Price, together with any de nqueney charges thereon have been paid by Purchaser to Seller. Purchaser agrees that all rights conveyed under this Agreement are subject to, and Purchaser agrees to at all times comply with, the present (and us may be hereafter adopted amended or altered) Rules Re ula for examination in Seller's office. , g aloes and Bylaws of Seller, which are available NOTICE: BY SIGNING IHIS AGREEMENT, PURCHASER IS AGREEING THAT ANY CLAIM PURCHASER MAY HAVE AGAINST THE SELLER SHALL BE COURT OR RESOLVED BY ARBITRATION AND PURCHASER IS GIVING UP HIS/HER RIGHT TO A JURy TRIAL AS WELL AS HIS/HER RIGHT OF APPEAL, ~'\~--~,~ ,20 o' ~,o~.m~ . ..~,.~..~,, Accepted by: / NOTICE: SEE OTHER SIDE FOR ADDITIONAL TERMS AND CONDITIONS WHICH ARE PART OF THIS AGREEMENT (717) 766-3421 Myers Funeral Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main S~eet ~ !~: Mechanicsburg, Pennsylvania 17055 Fax(717) 795-7291 A standard of excellence in Central Pennsylvania since 1910 Wednesday, September 22, 2004 Mrs. Florence Webb 5237 Windsor Blvd. Mechanicsburg, Pa. 17055 Dear Mrs. Webb, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met you'Fneeds and those of your family and friends. The following is a summary of the service charges as~pr~'vi~sly explained and provided in written form on the services for: Judith Ann Webb SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED LESS: Credits granted LESS: Total Payments CURRENT BALANCE Credits Granted: $1,070.0 Package Price Discount ~ $3,283.00 1,070.00 0.00 $2,213.00 Interest at the rate of 1.5 % per month ( 18 % per annum) will he ad--days. If there are any questions or cOncerns that remain unanswered, please call me. (7171 766-3421 Myers Funeral Home, Inc. nord L. Myers Jr,, Supervisor 37 East Main Street Mechanicsbur~, Pennsylvania 17055 Fax t7171 795.7291 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges areonly for those items that you selectcd or that are required. Ifweare re uiredb laworb acemete orcremato ' ' explain in writing below. If you selected a funeral that may require embalming su~C~ asa ~neral will'view rig, 7ou may have tr~ot~a~S~oraneYm~lmmSin;.e x~&lul do not have to pay for embalming you did not approve if you selected arrangements such as d reet cremation or immediate burial. If we charge you for an embalming, we will explain why below. : ~ ~ For Services of ............... Judith Ann W_e_bb~ ....... D_ate Of Death September 7, 2004 D~'~ ~f Contract September 8, 2004 Charge to Florence Webb 5237 Windsor Blvd. Mechanicsburg, Pa. 17055 A. CHARGE FOR SERVICES SELECTED: 1. PROFESSIONAL SERVICES Services of Funeral Director and Staff $ 1795.00 Embalming ................... $_ Casketing, dressing, cosmetology_ ......... $ .............. Other Preparation of bod_y ................. $ .... _9.5_.0~0 Hairdresser / Barber $ Auto sy Remains $ $ SUB-TOTAL PROFESSIONAL SERVICES Al $_.__.1_,89~:0__0 2. USE OF FACILITIES AND SERVICES For visitation / wake service $ For funeral ceremony $ For memorial service _ $__ ......... Equipment & services tbr graveside service $ §UB:ybiAL'~-C-[Zi~i~S AND EQUIPMENT A2 $ 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home $ 350.00 Hearse (Casket Coach) $ Flower Car / Floral Distribution $ Family Car $ Lead Car / Clergy Car $ Utility Car $ Out of town transportation $ $ SUB-TOTAL AUTOMOTIVE EQUIPMENT A3 $ 350.00 TOTAL SERVICES, FACILITIES, AUTOMOBILE A $ 2,240.00 B. CHARGES FOR MERCHANDISE SELECTED Casket $ Other Receptacle_ C~_d__boat~_d..~m_9_ti_on___ __ $ Outer Burial Container $ Register Book .................. $ ..... 9~55.0_~ Memorial Folders $ Preyer Cards $ Temporary Grave Marke~ ............. Burial Clothin~ ................... $ Other Clothing ................. Cremation ur~ ..................... $ ._~350~_0_0. Temporary $ [ecl TOT,~L MER~H-A~-I~I~'I~-SELECTED B $ - 520.00 C. SPECIAL CHARGES Forwarding Remains to other Funeral Home $ Receiving Remains form other Funeral Home $ Immediate Burial $ Direct Cremation ~ ........ SUB-TOTAL OF SPECIAL CHARGES C $ D. CASH ADVANCED Opening G rave/Cry[~.t_ $ Newspaper_ Patriot $~-'-' 10~0-~ Newspaper ..................... $ ........... Clergy / Mass Offering $ 100.00 Certified Copies of Death Certificme 10 $ 20 Family Flowers $ 53.00 Coroner's Authorization Fee $ 25.00 Crematory_Charge $ 225.0(~ SUB-TOTAL OF CASH ADVANCED We charge you for our services in obtaining the following: NONE D $ 523.00 SUMMARY OF CHARGES TOTAL ABOVE ITEMS (A,B.C.DI $ 3,283.00 Sales Tax (if App) ~ % $ 0.00 TOTAL OF ALL SECTIONS $ 3,283.00 LESS: Payment Made $ LESS: Credits Pending $ LESS: Credits granted Package Price Discount $ 1,070.00 BALANCE DUE Oct 8, 2004 $ 2,213.00 UIRED SERVICES OR MERCHAN~SE/~' , / 7 /~1 REASON FOR REQ DISCLAIMER OF WARRANTIES Our funeral home makes no representations or warranties regard ng caskets or outer burial containers, The only warranties, expressed or implied, granted in connection with goods sold with the funeral service are the express written warranties, ii any, extended by the manufacturer thereof No other warranties including the implied warranties of memhantabiiity or fitness for particular purpose are extended by the seller. I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I have requested. I acknowledge receipt of a copy of this Statement of Funeral Goods and Sen/ices Selected represent that I have sufficient funds available for payment of the cash price for the goods and sen/ices celected. I also agree to make payment of $ 2213.00 within 30 days I agree to be ointly and severall !i~abl~e ~with ~a.n~one ?!s? .wh.o .s.!g.n.s celow;~A ~L.ATE C. H_,~RGE of, 1.5% per.month (18~per annum) wil(b_e, a~ed to the unpaid ba ance beglnning 30 days aft~Yr tne sate m m~s contract, i Will alSO pay tne ~'unera u rector a I reasonanle costs paleb~t the Funeral Director to collect amounts I owe under this agreement. Those costs mayinclude attorney fees and court costs. Any items requested after the date of this agreement will be considered part of this agreement and will be reflected on the final bill. ISeal) (Seal) 1071 Count~ Hill Drive Harrisburg, PA 17111 Telephone: 717-657-5340 Fax: 717-541-5402 December 1, 2004 Estate of Judith A. Webb CIO Florence Webb 5237 Windsor Blvd. Mechanicsburg, PA 17055 INVOICE FOR THE FOLLOWING SERVICES: Preparation of REV- 1500 TOTAL DUE $ $ 235.00 235.00 ALL INVOICES ARE PAYABLE WHEN RECEIVED. THANK YOU FOR YOUR BUSINESS. B&L TAX AND ACCOUNTING SERVICES IS A MEMBER OF THE HARRISBURG REGIONAL CHAMBER. 7i7-763-498;~ KESSLER'S INC. 853 PO:) NOU 16 '04 21:47 P.O. BOX 130~, CARLISLEr ~A 17013 FLORENCE WEBB 273580 10 PUBLIC N.OTICES 28 10/13/04 2~ * 2 NOTICE NOTICE IS HEREBY GIVEN THAT 09/25/04 10/09/04 3 THE SENTINEL - LEGAL ,3 LGL 88.92 TOTAL AD CHARGE 88.92 3 PROOF OF PUBLICATION 01PRF 6.35 PREVIOUSLY PAID -95.27 Est .ofJ.Webb PAY THIS AMOUNT .oo , oo* · AFTER 11/1~104 ME&SAGE: Thank you for advertising with The Sentinel. D~adlines for.in-colunm legal advertlsements~ Monday is Frida at 1~ a.~.; Tuesaay is Friday at 4 p.m.~ Wednesday is Honda at ~2 Noon; Thursaay is Tuesday at 12 Noon~ Friday Is Wednesday at 1~ Noon~ Sunday is Thursday at 12 Noon. - If you have any questions regarding your Legal bill please call Tammy Shoealaker 243-2611, ext 203. ' Fax your legals to 243-3754, attention. Tammy Shoemaker You can also EMAIL your legal to Classified ads: classified@cumberlink.com Please send a cover letter including your name and address as an attachment DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT THE SENTINEl LEGAL ),0. BOX leO. ~A~fiSLI-F~'%}%~ Est. o:EJ, Wabb 273580 PUBLIC NOTICES 09/25/04 10/09/04 NOTICR NOTICE IS HEREBY GIVEN THAT 10/13/04 717-766-0187 GROSS AMOUNT OF .00 DUE AFTER 11/12/04 FLORENCE WEBB 5237 WINDSOR BLVD. MECHANICSBURG, PA I.,llL,,lll,,.I,l,,I,h.J,II 17055 EOEOOOOOOOE73SGOOOOOOOOOOOOOOOOOOO0000000000007 717-?~J-4982 KESSLER'S INC. 853 ~03 NOU 16 '~ 21:47 pROOF OF PUBLICATION Stat~ of Pennsylvania, County of Cumberland Tammy Shoen'mker. Customer Care/Sales Mal'~_eer, of The Senltnel, of the County and State aforesaid, beLng duly sworn, deposes and says that THE SENTINEL, a newspaper ~ general ciro~tion in the Boroush of Carlisle, County and State doresaid, was established December 13% 1881, sh~ce which date THE SENTINEL has been rel~hrly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published ha the regular edilior~ and issues of THE SENTINEL on the follow~g date(s) ~¢ptember 25. October 02. 09, 2004 COPY OF NOTICE OF PUBLICATION Affiant hu. ther deposes that he/she is not int~est~d in the subject matter of the afot'e~aid notice or advertisement, and that all allegations in the foregoing statement as to time, plac~ and character of ere /, . 5worn to and subscribed before me tlxi$ day of October. 2004 No.fy 1~ My conunission expires: ~/[/~'~ COM~ONWeA~.T~ ~, L Wa~, Naw/Ra~c REV-1512 EX+ (12-03) 217 COMMONWEALTH OF PENNSYLVANIA INHERrFANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Judith A Webb SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-04-0838 Report debts incurred by the decedent prior to death which remained unpaid ec of the date of death, including unrelmbursed medical expenees, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. 5. 6. Visa Account # 4121440018137038 Ck. 7775 Holy Spidt Hospital Ck. 7788 PA Gastroentarology Consultants Ck. 7787 PP&L -3 bills -Ck. 7784, 7819 and 7822 Water bills - Ck. 7810 and 7825 A.T&T - Ck. 7785 1,070 9O7 62 120 12 28 TOTAL (Aisc enter on line 10, Recapitulation) $i 2,199 (If more space is needed, insert additional sheets of the same size) HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL, PA 17011-2288 IIl lll lllllllllll lll liilll llllIIllll lllillll ll Patient Name: JUDITH A WERR Account Number: ~ -- Patient ~- ~~ ~'~ Responsibility: k~,~~ ~, I,,,lll,,,lll,,,,I,l,,I,l,l,,,I,l,,I,,,ll,,I,IIl,,,I,,,I,,,lll 2392 0 AT 0.292 JUDITH A W£BB 130 W PORTLAND ST Tn00008 APT 7 MECHANICSBURG, PA 17055.7412 Dear Patient/Guarantor: Thank you for your monthly payment agreement. SEP 08 2004 Date of Service: 03~09~04 Your scheduled monthly payment in the amount of $50.00 is due on or before 09/23/04. If we do not receive your scheduled monthly payment, this agreement will be considered broken and we will require payment in full. If you should have any questions in reference to this agreement, please contact our office at (Toll Free) 1-877-254-9239. Sincerely, Patient Financial Services If you,hav, e multiple accounts, please indic, at;the account numbers and the amount applied to each on your eneeic, i-'ayments received without an account number may be applied to the oldest account. ................ If_Pa _~,n2e~_t _H_as _Al_rea_dy. _Been _Made Ple_~e Disregard This Letter PLEASE RETURN THIS PORTION WITH YOUR PAYMENT ................ DATS VZDD~ =",'ae== ==- ~Z.G BALANCE 03/06/04 LPL 564.5 99254 [INPATIENT CONSULT 150.00 27.35 03/07/~ LPL 5~.5 99232 SUBSEQUENT HOSPITAL CARE 75 03/~/0~ LPL 562.1C A5~1 FLEXI SZGMO~D NITH BIOPS 3~0.00 13.43 0~/09/~ LPL 562.1C ~/07/0~ HGS ABMINISTRATORS AOJ ~98.93 09/07/0~ HGS ADMINISTRATORS PATEN Acco~ ~ej ~FER TO 862.22 ~o~ 5973 JUDITH A WEBB (717)763-0430 PENNSYLVANIA GASTROENTEROLOGY CONSULTANTS STATemeNT DATE 09/13/2004 PENNSYLVANIA GASTROENTEROLOGY CONSU ~,A~a,r~ Do= B~ 899 POPLAR CHURCH ROAD 10/03/2004 CAMP HILL, PA 17011-2206 I~ gllJflll~lll BII~ Bllllgl11111llE IUI I Qaestions about this bill? Please contact usby Oct 4 at 1-800-34~-5775 or 484-634-4900 or write to: CustomerServiee 827 Hausman Rd: Allentown PA 18104-9392 www.pplweb.com Electric Use This gmpb shows your electric use over the last 13 months, ~vT 6pcs of ter Readings: Actual l Estimated ~ Customer ['~ Page 1 74300-71030 ] Summary Page Balance as of Sep 13, 2004 $ 0.00 Charges: ~ TotaYPPL ELEL'IRIC UTILI'll ~ES Charges $ 71.78 Total Charges $ 71.78 Account Balance $ 71.78 KWH - Average Per Day Meter Reading Infornmtion 54 IMeter #87482015 45 ISep 13 Actual I Aug12 Actual 36 132 ~)avs ~ Average - Sep 2003 27 Temperature 73F KWH Per Day 23 18 Yearly Use: Total Use 9 Oct 9~02. Sep 2003 9178 0 Oct 2003 - Sep 2004 9056 SONDJ FMAMJ JAS 2003 Mooths 2004 10878 2004 71F 26 Average Monthly 765 755 Other important information on back '-~ AT&T Wireless JUDITH WEBB 130 W PORTLAND ST APT 7 MECHANICSBURG PA 17055-7412 Questions? · attwireles~.c, om · 1-800-888-7600 + 611 from your wireless phone TrY users- 1 866 4-AWS-TTY SUMMARY OF MONTHLY CHARGES FOR ACCOUNT 2201342884 Wireless Number 717-215-6256 Date of Invoice: 09110104 2.t0 .00 .02 .00 2.!2 25.68 Your billing cycle began on 08109 and ended on 09/08. Current MOnthly Charges 27.80 Monthly Service Chames Home Alrtime Charges Home Long Distance Charges Messaging, Content, Application & WI-FI Roaming Charges Other Charges and Credits Taxes, Surcharges & Regulatory Fees .00 .00 .00 .00 .00 4.67 DUE UPON RECEIPT Total Current Monthly Charges TOTAL AMOUNT DUE Your Wireless Account I$ Currently In Canceled statue You can now pay your invoice online ~ www,attwimleea.com/oce AT&T WIRELESS APPRECIATES YOUR BUSINESS 25.68 27.80 NOte: => We Print on Front and Back 217 REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMEER Judith A Webb 21-04-0838 NUMEER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, end Mother transfem under Sec. 9116 (a) (1.2)] Florence Webb 5237 Windsor Blvd. Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Do Not List AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18~ AS APPROPRIATE~ ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRISUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 100% TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE estate of WEBB JUDITH ANN a/k/a WEBB JUDY I, GLENDA FARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAlVD County, do hereby certify that on the 13th day of September, Two Thousand and Four, Letters of ADMINISTRA~ON in common form were granted by the Register of said County, on the , late of MECHAN/CSBURG BOROUGH in said county, deceased, to WEBBFLORENCE and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 13th day of September Two Thousand and Four. File No. PA File No. Date of Death s.s.# 2004-00838 21-04-0838 9/07/2004 196-38-1318 NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2004- 00838 Estate Of: WEBB JUDITH ANN a/k/a : WEBB JUDY Late Of: MECHANICSBURG BOROUGH PA No. 21-04-0838 Deceased Social Security No: 186-38-1318 WHEREAS, WEBB JUDITH ANN a/k/a WEBB JUDY late of MECHANICSBURG BOROUGH C[~fBERLAND COUNTY died on the 7th day of September 2004 and, WHEREAS, the grant of Letters of Administration is required for the administration of the estate. THEREFORE, I, GLENDA FARNER~STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: WEBB FL ORENCE who has duly qualified as ADMINISTRATOR(RIX) of the estate of the above named decedent and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYI VAN/A. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 13th day of September 2004. egis er of W#l$ ~ **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l.oca? Registrar. The original certificate will be forwarded to the State Vital Records Office for permanen[ filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee tbr this certificate, $2.00 P 10667275 No. Date Judith A COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) Webb e~le ,. 196-38-1318 , September 7, 2004 ,,,.~-, PA Cumberland 10:00 A. . September 7, 2004 ~ ,..[~ ~.~.~ Mechanicsburg e Horn Webb PA 17055 ;chaefferstown PA September 8,2004 Norris, Coroner 6375 Basehore Road, Suite ~l Mechanicsburg, Pa. 17050 Name of Decedent: Date of Death: win No.: To the Register: CERTIFCATION OF NOTICE UNDER RULE 5.6(A) mdmin No.: ~, ~ ~OOM-O() B38 I certify that notice of (benetlcial interest) estate administration requ red 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 Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ~gnature Name Telephone - Capacity: ~ Personal Representative [] Counsel for personal representative Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 WEBB FLORENCE 5237 WINDSOR BOULEVARD MECHANICSBURG, PA 17055 RE: Estate of WEBB JUDITH ANN File Number: 2004-00838 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/07/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ,., " ," C/, I .~~J;&u/~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ,. --.. ... Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 /7 A' Name of Decedent: cl~ /7~ Date of Death: 1- 7- <:l H Estate No.: :!. tJ JIJ/ t!J 0 f 3 ~ ~~p 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 [0' No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or infonnal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~ - /;J- 0' Signature Name <tf7~w~ Address rPJJ 1 ~/5~ d5~ ~~. )?cd("- Telephone No. (7/7) 7" ~ - 0 /? 7 @ Personal Representative o Counsel for personal representative 6 0 : I lId S I %uz Capacity: c