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:
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ELLEN R. OLBEHG NO.O< I - 04 -15,
also known as To:
Register of Wills for the
l67-LtO-19fi2 Deceased. County of Cumberland in the
Social Security No. Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execur nT'S named
in the last will of the above decedent, dated April 20 , 19-9.2.--
and codicil(s) dated
~A ;~::~2~..,1J 11,;- ,r-+ f. /?eI;; /~,,,'u,___.1
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cl1mber1and County, Pennsylvania, with
h AT' last family or principal residence at LLl? East Coover Street,
Mechanicsburg. PA 1?0~~
(list street, number and muncipality)
Decendent, then 93 years of age, died AU,Q:ust 31. , !OOLL ,
at
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows: ~OO,OOO.OO
(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 $ ??5,000 00
situated as flows: H s'd ~
Pa. 1 0 and Parcel ot 1 d . . n .
ms
County, pennsy1 VAn; a.
WHEREFORE, petitioner(s) respectfully re~est(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters es tamentary
(testamentary; administration c.1.a.; administration d.b.D.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } S8
COUNTY OF Cm.ffiERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
_. '" ~ .,~' ,.m."" { ,(~/~r ~~ '"
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before me this . day of "
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No. &ho'4 -'8"Si
Estate of M~iY ELLEN OLBERG , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW~r~ bo Ad..O '2004, 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 April 20. 1992
described therein be admitted to probate and filed of record as the last will of
Mary Ellen Olber" ;
and Letters Testamentary
are hereby granted to lJi1liam F. 01beri and Nary Ellen Barnin"er
FEES John H. Eakin
Probate, Letters, Etc. ......... $445.00 J. R"be~t Stallr~er No. 06<~6
Short Certificates( ).......... $ ~I. ()t:) ATj',ORNEY (Sup.. Ct.I.D. No.)
~g<l' $'-';;)..'00 Market 6quare Bldg.
Mechanicsburg. PA. 1 10;;
$ \0.0'0 (717) 766-311WSS
TOTAL s4-C\4-.W
Filed ... .3.: .~'? .-.~*.=. ........... (717) 766-9673
PHONE
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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. $2.00 ~^'LAA~ ~1h'~'M
Local gistrar
p 10667145 J,/ :I; .~ il.Jl i < "lAHJ:I
No.
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H,05143RIJV_2/111 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
TYPEiPfUNT CERTIFICATE OF DEATH IT,o,lE,IU!_1IER
'" NAME Of DECEOENT lFnI. MIclch, ~l 8OCIAl. SECURITY NUUEleR
PERMANENT Ellen R. Olberg DATE ~~g~~t 13r.1~2?5b4ean
E1LACK1NK .. . 16Z- 40 _ 1962 .
AGE (L.IIIlhhday) 9RTHPLACE(a~ancl
StaleOl'F~COUrlIrr) .....0
. I. 93 .. Princeton, MN R.M......O ~:;::'~I 0
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COUNTY 01' DEATH FACILITY NAME (l'OOllntl~won, r;ve_ancI~ RACE-Amllncanlnd'lII1. lllao<., V\Ih,le.el
. Camp Hill Camp Hill Care Center ($pa<o'fJ)
~. Cumberland k. " While
DECEDENf'S USUAL OCCUPATION K1NDOFIlUSINESSIINDUSTRV MARITALST,o,TUS.Matl1eO, SURVIVING SPOUSE
:ot~w;:~~~..;:iOi.:i;' tj~'i5[~~1S=)"'ol, i""..", ;"_""""'," ","~J
. ". Homemaker Own Home Widowed
1111. ..
CEDENrSMAlU I l)rfTown. ..Ip ) DECEDENTS 17c.Dv..,_iWloin
- 417 East Coover Street '''''AC 0.. "" -,
RESIDENCE -
11~echanicsburg, Pa. 17055 (S.lr1ltrucllorll ..... l1dJ8..~~~oI Meehan; csburq
0ll0llwr....) n.. -'" C,lyM><o
F,o,THER'Sw.ME(Fhl,MkIdle.t."I) !.IOTHER'S NAME (FIrat, Milich, M"" SI.IITla'I'la)
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fNFQRtolANTSNAME (T INFORMANT'S llIAlUHG ADOAESS (SlIMl, Cltyltown, Stat., ZIp Coda)
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OATEP OUNCEjOEADi""""",o.y,VM1 WM CASE AEFERAEO TO A MEDICAL EXAMINER /CORONER?
M. u. 24c't' H. VitO No. 0
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MANNEAOFOEAT DATEOFINJURV TIME OF INJURV INJURVAT';\(lflK? OESCRIBEHOWlNjURYOCCURRED
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No CoulO not be Oefermlned o PLACEOFlNjURV....._.Jann..-.~.ollItol LOCATlON(SU.IIl,QlylTown,S'ale)
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LAST WILL AND TESTAMENT OF ELLEN R. OLBERG
I, ELLEN R. OLBERG, of the Borough of Mechaniosburg,
County of Cumberland and State of 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.
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I direct the payment of all my just debts and f~eral
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expenses as soon atter my decease as the same can be.~onv$m;!.~ntly
.:Of ".."
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done.
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever and
wheresoever the same may be situate, to my husband, FRANK E.
OLBERG, absolutely and unconditionally.
3.
In the event that my husband, FRANK E. OLBERG, should
predecease me, or should he die within thirty (30) days from the
date of my death, then in either suoh event, I direct the settlement
and distribution of my estate to be made in the tollowing manner,
to wit:
-1-
(a) I give, devise and bequeath my personal residenoe,
oonsisting of a House and Lot of Ground looated at 417 East
Coover Street, Meohaniosburg, Pennsylvania, together with all
the contents thereof, such as, but not limited to my furnishings,
appliances and personal items such as clothing books, papers,
jewelry and other miscellaneous items, excluding however my tools,
to my daughter, MARY E. BARNINGER.
(b) I give and bequeath all automobiles which I may own
at the time of my decease to my daughter, MARY E. BARNINGER.
(c) I give and bequeath all my tools which are located
in the garage building at 417 East Coover Street, Mechanicsburg,
Pennsylvania, to my son, WILLIAM F. OLBERG.
(d) I give, devise and bequeath my real estate located
at Lake Meade, Adams County, Pennsylvania, and known and designated
as Lots Nos. 720 and 720~ in the Lake Meade Development, to my
son, WILLIAM F. OLBERG.
(e) I give and bequeath all the rest, residue and remainder
ot my estate, of whatsoever nature and wheresoever the same may
be situate, to my two (2) children, the atoresaid MARY E. BARN INGER
and WILLIAM F. OLBERG, share and share alike, per stirpes.
(f) In the event that my son, WILLIAM F. OLBERG, should
predecease me, I direct that his share in my estate be paid over
and distributed to my daughter, MARY E. BARNINGER.
-2-
LASTLY, I nominate, constitute and appoint my husband,
FRANK E. OLBERG, Executor of this my Last Will and Testament,
and in the event that my said husband should predecease me, or
should he be unable or unwilling to serve in such capacity for
any reason. then in such event. I nominate, constitute and
appoint my son. WILLIAM F. OLBERG, and my daughter, MARY ELLEN
BARNINGER. Co-Executors of this my Last Will and Testament. in
his place and stead, and in either event, I direct that my said
personal representatives be excused from posting bond or other
security for the faithtul performance of their duties.
IN WITNESS WHEREOF. I have hereunto set my hand and seal
this ~o day of April. A. D., 1992.
~e~ (SEAL)
Ellen R. 01berg
-3-
Signed, sealed, published and declared by the above
named, ELLEN R. OLBERG, as and for her Last Will and Testament,
in the presence of us, who have subscribed our names hereto as
witnesses, at the request of said testatrix, in her presence and
in the presence of each other.
\Jyf2U d,., ~/ ULW:L )
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COMMONWEALTH OF PENNSYLVANIA )
: SS.
,i, COUNTY OF CUMBERLAND )
I'
Ii I, ELLEN R. OLBERG the test at rix
, ' ,
I whose name is signed to the attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; ana that I signed it as my free and volun-
I tary act and deed, for the purposes therein contained.
,
,I
'i Sworn and affirmed to and acknowledged before me by
:i ELLEN R. OLBERG , the testa~ix ,this d tJ l"-
I
'I day of Ap:r>il , A. D. 1992
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!:j COMMONWEALTH OF PENNSYLVANIA ) fwiy Jrl"',G:;,cr ~~;;;,;.;;) !"\;';~ 6, 11i~~
I! : SS. Meniler,~~gft<<lll1lli8
I. ; ~OUNTY OF CUMBERLAND )
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n We, the undersigned, J. ROBERT STAUF~-~
I" and RUTH ANN FULWIDER the witnesses whose names are
I: ,
,!,i signed to the attached or foregoing instrument, being duly qualified
j: according to law, depose and say that we were present and saw the
I testatriX , ELLEN R. OLBERG , sign and exe-
I cute the instrument as ~her Last Will and Testament; that the
.'.1 said test at rix . ELIEN R. OLBERG , executed it as
. I
! ! ~her free and voluntary act for the purposes therein expressed;
I'; that each of us, in the hearing and sight of the testat~, 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,
I of sound mind, and under no constraint, duress or undue influence.
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Sworn and~b~ibed to before
me this 0 day of
April , 1992.
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I My J'nl"i~'::;.cr t:X1::;i\::.:3i-..;o'l, G. 1~~
W Member, Per.nsylwlnla~"llt<<lll1lli8
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CERTIFICATION OF NOTICE UNDER RULE 5.6Cal
Name of Decedent: ELLEN R. OLBERG
Date of Death: August 31, 2004
Will No. 200li-00es? Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration 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 September 21. 200li :
~ Address
William F. 01berg, 4640 South Clearview Drive, Camp Hill, PA 17011
Mary Ellen Barninger, 2 Kelly Court, Enola, PA 17025
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: SApt:AmhAT'::>II, ::>0011
Name J. Hobert Stautfer
Address Market Square Bldg.
Mechanicsburg. PA 17055
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~ TelephoneV17)-766-9673
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IV) Capacity: _ Personal Representative
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COMMONVv'EALTH OF PENNSy'_VA~JIA REV-1162 EX(11-96)
DEPARTMENT OF q~VENU::
aUR~AJ OF ,NOIVIDJAL TAXES
OE~~ 2EOGe1
HA'i.RISBURG, 0:\ ' 71 28-060 1
PENNSYLVANIA
RECEIVED FROM INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CO 004631
OlBERG WilLIAM F
4640 SOUTH ClEARVIEW DRIVE
CAMP Hill, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
nnn 1"ld _n_n___ n_n___
101 I $40,000.00
ESTATE INFORMATION: SSN. 167-40-1982 I
FILE NUMBER: 2104-0857 I
DECEDENT NAME: OlBERG EllEN R I
DATE OF PAYMENT: 11/16/2004 I
POSTMARK DATE: 11/16/2004 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 08/31/2004 I
I
TOTAL AMOUNT PAID: $40,000.00
REMARKS: W F OlBERG
CHECK#109
INITIALS: VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WillS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004797
OLBERG WILLIAM F
4640 SOUTH CLEARVIEW DRIVE
CAMP HILL, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold ---------- --------
101 I $2,077.94
ESTATE INFORMATION: SSN: 167-40-1982 I
FILE NUMBER: 2104-0857 I
DECEDENT NAME: OLBERG ELLEN R I
DA TE OF PAYMENT: 01/05/2005 I
POSTMARK DATE: 01/05/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 08/31/2004 I
I
TOTAL AMOUNT PAID: $2,077.94
REMARKS:
CHECK# 113
INITIALS: CCP
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
.....--" "
REV-1500 EX (6-00) REV-1500
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT. 280601
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT L ..L - ---D- --4.. ..0..... 1L -5- -1- -
COUNTY CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I- Olberg, Ellen R. -
Z , 167 - 40 1982
W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W August 31, 2004 April 17, 1911 REGISTER OF WILLS
U
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C - -
w 09 1. Original Return D 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82)
I-
lI::~en D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estale Tax Return Required
ua::lI::
wll.U
J:00 [!J 6. Decedent Died Testate (Attach copy of Will) D 7. Decedent Maintained a Living Trust (Attach ccpy of Trust) B. Total Number of Safe Deposit Boxes
ua::...J
ll.al -
11. D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date ofdealh between 12-31-91 and 1-1.95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
<(
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w NAME COMPLETE MAILING ADDRESS
c John M. Eakin & J
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11. FIRM NAME (If Applicable) Market Square Building
en
w
a:: Mechanicsburg, PA 17055
a:: TELEPHONE NUMBER
0 (717) 766-3172
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1. Real Estate (Schedule A) (1) 270,500.00
2. Stocks and Bonds (Schedule B) (2) 456,345.55
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ~
c::;3 ~~
0 c;>
(4) ~~~ c.n
4. Mortgages & Notes Receivable (Schedule D) <- Fi. C")
J,''l-'' G)O
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 266,772.38 :-0:: - - :::0
~!3~-.:J
Z (Schedule E) I r-j*'i r .,
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0 6. Jointly Owned Property (Schedule F) (6) 2,657.27 ::j)7' c:)C)
~ D Separate Billing Requested 0 "" -\"1 ~.'''r-l
-'11
--n ....;.......... ("5
-J (7) - rn
;:) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
!::: (Schedule G or L) W
Q. <..11
<( B. Total Gross Assets (total Lines 1-7) (B) 996,27').20
U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 16,030.31
W
n: (10) 735.02
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10) (11) 16,765.33
12. Net Value of Estate (Line B minus Line 11) (12) 979.509.87
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 979,509.87
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0
~ rate, or transfers under Sec. 9116 (a}(1.2) x.O_ (15)
979,509.87 x .0 45 (16) 44,077.94
I- 16. Amount of Line 14 taxable at lineal rate
;:)
Q. 17. Amount of Line 14 taxable at sibling rate x .12 (17)
::E
0 1 B. Amount of Line 14 taxable at collateral rale x .15 (1B)
U
~ 19. Tax Due (19)
Decedent's Complete Address:
STREET ADDRESS
417 E. Coover Street
CITY Mechanicsburg I STATE I ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 44.077.94
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 40.000.00
C. Discount 2.000.00
Total Credits (A + B + C ) (2) 42,000.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( 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 1 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) 2.077.94
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 2,077.94
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves No
a. retain the use or income of the property transferred; .......................................................................................... 0 OCJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 OCJ
c. retain a reversionary interest; or.......................................................................................................................... 0 OCJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 OCJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 OCJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 !XJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 IKJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under 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 FOR FILING RETURN
./
or
[72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (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 retum are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 PS. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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.
~,_w ._.__."'-_.~-
REV-1502 EX+ (6-9. SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Tract 1 - Cumberland County, House and Lot in Mechanicsbur
being Lot 9B book B of Plan of Lots of Blackburn Village
known as 417 E. Coover Street, Tax parcel 17-24-0789Q002
see attached appraisal $ 128,500.00
Tract 2 - Adams County, unimproved 11 Custer Drive, Lake
Meade, Reading Township, Tax parcel 01-37-010-0103-00
see attached appraisal $ 142,000.00
TOTAL (Also enter on line 1, Recapitulation) $ 270,500)00
(If more space is needed, insert additional sheets of the same size)
~--' \
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~f"'., ..., - n. ND.. CUBTI:JDUII P.
/ I . LAHD ApPRAISAl hEPtU.r
'f CUSTEItOR
8_ NlA. ESTATE OF elLEN R. OLBERG CensuI Tllet 0301.02 Map RsI_ 01-37-(ltO-Ol03
I'ropsrtJ Addrsss It CUSTER DRIVE
CWy EAST BERLIN County ADAMS SIalI PA lip Code 17318-9386
legllOescrfptlon DEED BOOI< 0319 PAGE 0558 READING TOWNSHIP BERMUDIAN SPRINGS SCHOOl DISTRICT
Sale Prtcl S DIle 01 SIll lOIn TIllIll l'IS. Property Rights AppraIsed fee o leasehold 001 MWm
I Aclua/ Rnl Estate TIllis S I, 113.75 (l'I' lOIn chlrges 10 be flIld by seifer S -==. Other sales concessions NONE
! lender/Cllenl WILLIAM F. OlBERG Address 4840 S. ClEARVIEW DRIVE. CAMP HILL PA 17011
Occupant VACANT lOT Appraiser JOHN S. BOSWEll InslrucBons 10 Apprllser ESTIMATE MARKET VAlUE
Location lhban Rorll Good ~. Fa p,
8u11tllp I8l Over 751 o Under 251 Employment Stablllly DOL
Growth Rate o Fully IllY. 0 Rapfd o Slow Convenlencelo EmpIoymenl Ol8l0L
I'rnpIlly Vlrues l8llnclelSlng o Declining COl1ven"ncllo S~ Ol8l0L
DemafH1lSuppIy o Shortage o Oversupply COl1venfencllo Schools Dl8lD[
f Marttellng TIme l8lllnder 3 Mos. [] 4-8 Mos. D Over 8 MOl. Adequacy 01 PublIc TlII1Iporlallon Dl8lD[
Presen1land Use ..J!Q.I' flmfty -.!11 2.4 Family -.!11 Apls. _01 Condo --11 Commercial Recreallonll Fac. l8lDO[
-.!11 1ncN1"'III~I Vlcanl -.!1" Adequacy oI_es O18l0[
: Change In Presenlland Use D Nllt likely o llllely (" I8l Taking Place (" I'ropsrtJ Compa- O18l0[
I lib'rDm VACANT LAND To SINGLE FAMILY ProIectlon !rom 0elrtnenlaI CondIlIons Ol8l0C
\ PredomInant Occupancy Owner 0 Tenanl --.J!LI Vacant Pob II1d FIrt ProIectlon Ol8l0C
I Single flmlIy PrIce Range S 75.000 10 S 400.000 PredomInant Value S 120.000 General Appeallnce at Pruperfa Ol8l8C
.,. Single FIIl1lIr Age --'l yrI. 10 ~ yrI. Predomlnanl Age 25l'1l. AppeaIIoMlIltil 0181 C
; '(~r;i~.,;
Comments including thoseflml. favorabll or untlYOIlIbIe. IlIacllng II1Irlletablllly (I.g. pubic plllle. schools, view, nolse): ThIs iuburben nelahborhood hn IllOII
bllc uUIIUes available relaO eas access 10 and servlces and Is 1I0ve with other n In '.es.
Most have "mllar amentlles. No unfavorable faclors wera observed which would advereelv effect markelebllttv. Merkeladlvllv 1ndIce1.
aver e or bailer acce lance In the market ce. lAKE MEADE lOT #1720. INITIATION FEE OF 3200 + ANNUAl DUES.
OImenslOl1s SEE LEGAl DESCRIPTION . 0.88 Sq. FI. or AcI.. CorneIlal
i i Zoning classlflealfon RESIDENTIAl Presenl knprovemenII /81 do 0 do nol moon 10 1ri1g reauIdcm
i Hlghesllnd besl use I8l Presenl USI
PuIJIc Oller lIJescrtbe)
I EIee. I8l
I GIS 0 NONE
Wiler I8l
I Sill. Sewer /81 I8lHoOy,
I8l Underg!ound EIecI. & Tel. SIdeWllk S""' Is \hi """*" roc.w In aU IdIntffIsd 8pICIsI FIood"-d""
Conwnenh (1riolabIe Of unInorlblelncblnt 111)' 1flII1I'" """,,e ,........... .......1Chmenls. Of oI1l1ldver.. eGIItIfone): SIIe has a~ .IIe Imlll1lV8nWlll. 8VeI'lIae
I landscaofna. and Iypfcal malnlenance. Thera are no aDDSrent adverse easement. encroachmenll. or other edverae condIIIona on,: 1Ite._ THE
WOOD DOCK AND LAKE WAll APPEAR TO BE IN AVERAGE CONDITION. THE LAKE WAS AT LEVEL UPON MY INSPECT .
I ILh_
-. ... " .
GOODIlAKEFRONT
0.88 ACRElEXCELl +2500
GATEDiHARDROAD
PUBLIC' PUBLIC
SLIGHT SLOPE
WOOD DOCK -10000
NONE
FF
I
-.
11J.2O. 2O-RL- Ioht
i DIid o lidlfal~~~ ':1
. RnInr
CInInII'Inn AppqIuIs, h:. 17m 737__ .
Form lNO - 'TOTAL lor WIndoM' ""*'.... br' Ii 1\iocIt, h:. -1_AI.NAooE . .
I .i"'~'i/'I
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.r- t;l""'J' '--"'<r~,,~.; ;;-; ~"~~'~'."~~~~, .i'l
""'~".,," '* SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Fidelity Investments, see attached $ 98,232.13
2 Edward Jones, acct. 270-03571-1-0, see attached $ 211,263.84
3 2958.979 Shares Janus Fund @ $22.19 $ 65,659.74
4 2133.908 Shares Janues 20 @ $38.01 $ 81,189.84
TOTAL (Also enter on line 2, Recapitulation) $ 456,345.55
(If more space is needed, insert additional sheets of the same size)
n !!!.t!IJliW
November 3,2004
William Olberg
4640 S. Clearview Dr.
Camp Hill PA 17011
Dear William Olberg:
We are responding to your request for information about Ellen Olberg's account with
Fidelity. The table below lists the account holdings and values as of 08/3112004.
Fidelity account 2BC-570281: ELLEN R OLBERG - INDIVIDUAL
Security Description CUSIP Quantity Unit Value Market Value
FIDELITY MAGELLAN 316184100 334.830 $96.01 $32,147.03
SPARTAN PA MUNICIPAL 316344209 1,777.370 $11.01 $19,568.84
INCOME
FIDELITY PUR IT AN 316345107 914.800 $18.63 $17,042.72
FIDELITY VALUE 316464106 454.558 $64.84 $29,473.54
Total Value $98,232.13
We hope this information is helpful. For questions concerning account holdings or
instructions on how to transfer the ownership of the accounts, please call our Inheritor
Services Group at 800-544-0003 between 9:00 A.M. and 5:30 P.M. Eastern time Monday
through Friday or visit our web site at www.fidelity.com.
Sincerely,
Fidelity Investments
Our file: W023207-290CT04
Brokerage Services provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC
Clearing, custody, and settlement services by National Financial Services LLC, Member NYSE, SIPC
P.O. Box 770001, Cincinnati, OH 45277-0034
-
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ELlj!~IJ n. OLBEHG
Date of Death: August 31, 200L~
Will No. 2(0)!-008'57 Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes 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. Did the personal representative file a final
account with the Court? Yes No x
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did t_he personal representative state an
account informally to the parties in interest? Yes x No
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.
e. Solo beneficIarIes .. also theCxec1J.tors
of' t1"lG Est<:ite.
Date: ,TuJ.:r S t 2005'
J. r10bert Jtal1ffer
Name (Please type or print)
11aloket Square Bldg.
I1echanLcsburg, PA 17055
Address
(717 ) 766-9671
Tel. No.
Capacity: Personal Representative
x Counsel for personal
repreSentative ~
(MAH:rmf/AM3)
. . C~1/loA- ~
.
3780 Trindle Road Peter B. Arnold
oL:.- ~
Camp Hill, PA 17011 Investment Representative
(717)731-1672
www.edwardjones.com
EdwardJones
October 14, 2004 j
William F. Olberg
4640 S. Clearview Drive
Camp Hill, PA 17011-4017
Dear Client:
Re: 270-03571-1-0 Ellen D. Olberg
Valuation Date: 08/31/2004
Per your request, I am writing to provide valuation for the attached list of securities belonging to the
Olberg account..
Oty Description Maturity Rate Total Value Accrued
Date Interest
10000 Pittsburg PA Wtr & Swr bond 09/01/16 4.0% $ 9908.00 $ 00.00
10000 Phila PA Airport Rev bond 06/15/25 6.1 % $ 10429.00 $ 429.00
5000 Federal Natl Mtg Assn REMIC 01/18/27 7.0% $ 4950.00 $ 00.00 '2.51 ~1. 00
Oty Description Value Per Item Total Value Accr Div
106 Agere B 1.225 129.85 00.00
4 Agere A 1.23 4.92 00.00
100 Cable & Wireless 5.845 584.50 00.00
404 Lucent 3.11 1256.44 00.00
152 Reynolds American 74.84 11375.68 00.00
505.5779 Sara Lee Corp 22.085 11165.68 00.00
3246 Waypoint Financial 27.435 89054.01 00.00
4831.388 Van Kampen High Yield 10.54 50922.829 00.00
21482.93 Money Market 1.0 21482.93 2.64
I as' "11 (,.8 t
The values were obtained from an outside historical pricing service and while we believe that they are
reliable, we do not guarantee their accuracy.
Re~'b;vP- 2(( 2(,3.84
J I
Peter B. Arnold
Investment Representative "
~,~"."., '* SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Members First Federal Credit Union, Acct. 5876-00, see attached $ 13,550.12
2 Members First Federal Credit Union, Acct. 5876-11, see attached $ 19,243.53
3 Members First Federal Credit Union, Acct. 5876-05, see attached $ 199,522.49
4 Members First Federal Credit Union, Acct. 5876-04, see attached $ 4,003.29
5 Waypoint Bank, Acct. 4100014894, see attached $ 25,012.54
6 Waypoint Bank, Acct. 100150671, see attached $ 513.91
7 1970 15 Foot Glastron boat with motor $ 450.00
8 1970 TeeKee Boat Trailer $ 50.00
9 Household Furnishings, see attached $ 835.50
10 1993 Cadillac, see attached $ 3,591.00
TOTAL (Also enter on line 5, Recapitulation) $ 266,772.38
(If more space is needed, insert additional sheets of the same size)
fvlm
MEMBERS 1st
FEDERAL CREDIT UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 5876 -00
Date Account Established 05/07/1962
Principal Balance at Date of Death $13,538.99
Accrued Interest to Date of Death $11.13
Total Principal and Accrued Interest $13,550.12
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 5876 -11
Date Account Established 08/27/1999
Principal Balance at Date of Death $19,239.51
Accrued Interest to Date of Death $4.02
Total Principal and Accrued Interest $19,243.53
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 5876 -05
Date Account Established 07/08/1987
Principal Balance at Date of Death $199,286.62
Accrued Interest to Date of Death $235.87
Total Principal and Accrued Interest $199,522.49
Name of Joint Owner None
LIFE SAVINGS ACCOUNT:
Account Number/Suffix 5876 -04
Date Account Established 02/01/2001 *
Principal Balance at Date of Death $4,000.00
Accrued Interest to Date of Death $3.29
Total Principal and Accrued Interest $4,003.29
Name of Joint Owner None
* Account opened with funds from 5876-00
'tJERS ~EF'~L CREDIT UNION
$/& - ~~
Denise A. Wolfe
Insurance Services Supervisor
October 1, 2004
Estate of: ELLEN R. OLBERG
Date of Death: 08/31/2004
Social Security Number: 167-40-1982
5000 Louise Drive. P.o. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org
.
~l WayR.qi!1J
9/28/2004
J ROBERT STAUFFER
1 W MAIN ST
MECHANICSBURG P A 17055
The information which you requested on the account(s) of ELLEN R OLBERG
(Social Security Number 167-40-1982) is/are as follows:
Account Number 100150671 4100014894
Class of Account CHECKING CHECKING
Date Opened 121100 121100
Principal Balance 513.91 24978.77
Accrued Interest .01 33.77
Balance at Date of 513.92 25012.54
Death
Account Ownership SOLE SOLE
Name of Joint
Owner, if any
Date Ownership 121100 1211 00
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 ~~dU
Information
Requested
E E W A TS
SENIOR SERVICES REP.
P.O. Box 1711. HARRISBURG. PENNSYlVANIA 17105-1711
Toll Free 1-866-WAYPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com
...
. .
HARDY'S AUCTION SERVICE
193 Orebank Rd
Dillsburg, P A 17019
717-432-3779
Mary Barninger
2 Kelly Court
Eno1a, P A 17025
November 15,2004
Mary,
Attached is the appraised value for the estate of Ellen Olberg. Fee for this
service is $25.00.
Sincerely,
t::. /; I /
'/&C~r" v~0f{.V{~/
Vickie Hardy
AU-L-2795-L
wwvv.hardysauctionservice.com
-
.
ITEM AMOUNT
SOFA 10.00
COFFEE & END TABLES 75.00
CABINET 10.00
TV 10.00
DRESSER 10.00
CHEST OF DRAWERS 10.00
REFRIGERATOR 10.00
GAS STOVE 5.00
OLD DISHWASHER 1.00
ORGAN 20.00
MODERN DRY SINK 25.00
RECORD CABINET W/RECORDS 12.00
SEWING MACHINE 5.00
GOVERNOR WINTHROP DESK 200.00
HUTCH 75.00
CORNER HUTCH 125.00
CHEST OF DRAWERS 10.00
CHEST OF DRAWERS 10.00
RECORD PLAYER 5.00
DESK 1.00
CABINET 2.00
STEREO CABINET 1.00
UPRIGHT FREEZER 25.00
OLD FREEZER 1.00
SINGLE BEDS 2 @ 3.00 EACH 6.00
OLD ROCKER 5.00
DRESSER W/MIRROR 10.00
GAME TABLE 5.00
EXERCISE BIKE 0.50
MILK CAN 5.00
WHITE CHAIR 2.00
BED LINEN, TOWELS, SHEETS 5.00
POTS, PANS, DISHES, HOUSEHOLD 15.00
ORGANIZERS - HAND & GARDEN TOOLS 35.00
LADDER 25.00
WHEELBARREL 2.00
ROTOTILLER 25.00
BOOKS 2.00
LAWN MOWER 35.00
TOTAL 835.50
USNN TRUE 1993 Cadillac
MARKET
1 . · VAWE .. Fleetwood 4 Dr STD
..... Sedan
Color: Light Blue ASKING PRICE
Mileage: 50,000 $1
Condition: Average
Edmunds TMv<B> Private Party Pricing: Contact Information:
Base Price $2,751 I
Optional Equipment
$107 ......
Color Adjustment $-:~ I
Regional Adjustment
Mileage Adjustment $1,274 I
Condition Adjustment $-481
Total: $3,591 I
TMv@> pricing represents estimated Prices as of: I..
market transaction values. 11/04
Standard Equipment: Optional Equipment:
. 15 Inch Wheels . 5.7L V8 OHV 16V FI . Heated Front Seats . Vinyl Roof
Engine . Leather Seats
. AM/FM/Cassette . Air Conditioning
Audio System
. Alarm System · Aluminum/Alloy
Wheels
. Antilock Brakes . Automatic 4-Speed
Transmission
. Automatic Climate . Automatic Load
Control Leveling
. Automatic On/Off . Cruise Control
Headlights
. Digital Clock . Digital Instrument
Panel
. Dual Front Airbag . Leather Steering
Restraints Wheel
. Lighted Entry System . Power Antenna
. Power Brakes . Power Door Locks
. Power Driver Seat . Power Heated
w/Memory Mirrors
. Power Passenger . Power Steering
Seat
. Power Windows . Premium Audio
System
. Rear Window . Remote Trunk
Defroster Release
. Split Front Bench . Tilt Steering Wheel
Seat
. Tinted Glass . Traction Control
REV.1509 EX+ (12.88) '*'
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
Joint tenant(s):
NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Mary E. Barninger 2 Kelly Court Daughter
Enola, PA 17025
B.
C.
Jointly-owned property:
LETTER DATE
ITEM FOR TOTAL VALUE DECO'S DOLLAR VALUE OF
NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. A ;)()C~, PNC BAnk Checking Account
50-7008-3027, see attachec 5,314.53 50 2,657.27
i
TOTAL (Also enter on line 6, Recapitulation) S 2.657.27
(If more space is needed insert additional sheets of same size)
-
~
. ~
Senior Checking Plan Account Statement
PNC Bank
Primary account number: 50-7008-3027
Page 1 of 2
For the period 08/18/2004 to 09/17/2004 Number of enclosures: 1
ELLEN OLBERG Q For 24-hour banking, customer service and
MARY E BARN INGER transaction or interest rate information,
1t sign-on to Account Link @ by Web on
C/O WILLIAM F OLBERG pncbank.com or call1-888-PNC-BANK
4640 S CLEARVIEW DR
CAMP HILL PA 17011-4017 Para servicio en espanol, 1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
I2!SI Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
e Visit us at pncbank.com
III TOO terminal: 1-800-531-1648
For hearing impaired clients only
Senior Checking Plan Ellen Olberg
Regular Checking Account Summary Mary E Baminger
Account number: 50-7008-3027
Balance Summary Please see the Activity Detail section for
Beginning Deposits and Checks and other Ending additional information.
balance other additions deductions batance
5,314.53 2,541.05 67.35 7,788.23
Average monthly Charges
balance and fees
6,675.42 .00
Transaction Summary
Checks paid! Check Card POS Check Card/Bankcard
withdrawals signed transactions POS PIN transactions
1 0 0
Total ATM PNC Bank Other Bank
transactions A TM transactions A TM transactions
0 0 0
Interest Summary As of 09/17, a total of $2.11 in interest was
Annual Percentage Number of days Average collected Interest Earned eamed this year.
Yield Eamed (APYE) in interest period balance for APYE this period
0.00% 0 .00 .00
Activity Detail
Deposits and Other Additions There was 1 Deposit or Other Addition
Dale Amount Description totaling $2,541.05
09/01 2,541.05 Direct Deposit - Civil Serv
US Treasury 312 F 2645599 W CSF I
Checks
Check Date Reference
number Amount paid number
132 67.35 09/03 025194550
There is 1 check listed totaling $67.35 .
-
REV-1511 EX+ (12-99) i' SCHEDULE H
~~
'm ~
". '.
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State _ Zip
Year(s) Commission Paid:
2. Attorney Fees $ 15,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State __ Zip
Relationship of Claimant to Decedent
4. Probate Fees $ 494.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Sentinel, Estate Notice $ 136.31
.
,
Cumberland Law journal, Estate' Notice $ 75.00
Central Penn Appraisals, real estate appriasals (2) $ 325.00
TOTAL (Also enter on line 9, Recapitulation) $ 1 h 010 11
(If more space is needed, insert additional sheets of the same size)
.
,
nF.V'~11 E.'f' fl !i' . R~ \
~~~l' )
I -t'ld;~ '\ SCffEOULE I
'~l;f,$l' ~~~).J
(;l)M~lll"Wr^, 11101 II "";')1 V^,,,^ VEUTS OF DECEUENT,
'''':II:'~:~~'''lilJ~^Lvi:Gl:',:i'"'' MOl{ rG^GE L1^U1L1f fES & LIENS
.. Esi^liror~'h~~--"'~~ -,--.---- - -------. ---~ -.___.____.m________ -.--_~~/.~~~~~h- r1i.E"r.;UMBEIt'- . - . . -_._________h_____
___~!.le?_~ _Olb_e_~g_____._____________ __.__ ______ _..___ ... _._________ 21-04-0857
Includo 111I1 r.llIlhlll !H!ll IIIr.dll:nl r.~ I'CIl!lr.!I.
___....___._._._ ..............._ . _ .....04._ .. .._.._....... _. .. --.. ... .. ....._._ _m .._____ _ .._.."___.._._u. ____ ____.___.__ .-.
ITEM
/lUMllf:H [11:Sr_'~"'II!)11 AMQUI/T
------.--- _ . __n..__'_"____~..._..__.._ _..____.._ _____ . _.. _...._____._ ...__._____." _0... . ________.___.__.____..____...__.________ ----
I. Lake Meade authority, water bill 3rd Quarter 04 $ 60.00
2 Beverly Healthcare - medical $ 290.25
3 Pharmerica, prescription Beverly Healthcare $ 96.23
4 J&J Lawn Service, lawn mowing $ 45.00
5 Window Replacement $ 243.54
:
.
i ".
If
,.
,
...
..
101 Al (Also ellter on line 10. Recapllulallon) S 735.02
-pilllol e-s-l~aceis,\l]e.:ioJ.llisella&jiiio,i8i9i1eel;;;ilile S31l1e- size)
.
. REV-1513 EX+ (9-00)
. SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen R. Olberg 21-04-0857
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. William F. Olberg Bequest of Personal &
son
4640 South Clearview Drive Real Property & one
Camp Hill, PA 17011 half of residue
Mary Ellen Barninger daughter Bequest of Personal &
2 Kelly Court Real Property & one
Enola, PA 17025 half of residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
1.
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)
Marjorie A. Wevodau First
Glenda Farner Strasbaugh Deputy
Register of Wills
and
Kirk S. Sohonage, Esq
Cierk of Orphans' Court Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
I INVOICE I
Bill To: InvoiceNo: 167
Invoice Date: 01/12/2005
JOHN M. EAKIN Estate of: Ellen R. Olberg
MARKET SQUARE BUILDING Estate No: 21-04-0857
cop
MECHANICSBURG, PA 17055
Qty Fee Description Fee Total
1 Additional Probate 35.00 $35.00
Total: $35.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
COMMONWEALTH OF PENNSYLVANIA '*
DEPARTMENT OF REVENUE
: '-, " ",'
BUREAU OF INDIVIoUAt-1'AXES. NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISIoN "- APPRAISEMENT, AllOWANCE OR DISAllOWANCE
PO BOX Z80601 OF DEDUCTIONS AND ASSESSMENT OF TAX
HARRISBURG PA 171Z8-0601 REV-1547 EX AFP 112-041
i8 Il. ,-- DATE 03-21-2005
II' 4b
ESTATE OF OLBERG ELLEN R
C: '('if DATE OF DEATH 08-31-2004
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......l.,.. H \ FILE NUMBER 21 04-0857
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'Ht'r1:-l,I\t ;;:; COUNTY CUMBERLAND
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JOHN M \EAltnr ACN 101
MARKET SQUARE BLDG I Allount Rellitted I
MECHANICSBURG PA 17055
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ......
RE-y=UW-EX--AFP--cOr:O!'r-Noi'-icE-OF-iNHErtiTlilcrTAX-APPRA-isE'iEN'~--A[towANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF OLBERG ELLEN R FILE NO. 21 04-0857 ACN 101 DATE 03-21-2005
TAX RETURN WAS: (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) 270.500.00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) 456.345.55 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subllit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forll with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 266,772.38 tax paYllent.
6. Jointly Owned Property (Schedule F) (6) 2,657.27
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 996,275.20
APPROVED DEDUCTIONS AND EXEMPTIONS: 16,030.31
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage liabilities/liens (Schedule I) (10) 735.02
11. Total Deductions (11) 16.765 33
12. Net Value of Tax Return (12) 979,509.87
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 979,509.87
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX: .00 X 00
15. Allount of line 14 at Spousal rate (15) = .00
16. Allount of line 14 taxable at lineal/Class A rate (16) 979,509.87 X 045 = 44,077.94
17. Allount of line 14 at Sibling rate (17) .00 X 12 = .00
18. Allount of line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 44,077.94
TAX CRI!.DITS:
... l+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-16-2004 CD004631 2,105.26 40,000.00
01-05-2005 CD004797 .00 2,077 .94
TOTAL TAX CREDIT 44,183.20
~ BALANCE OF TAX DUE 105.26CR
INTEREST AND PEN. .00
TOTAL DUE 105.26CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF D1DIVIDUAL TAlCESRECORDED OFFICE OF INHERITANCE TAX
IIHRITAIICE TAX DIVISIIlIl CFr.,S,.p ('I[ \,t.J!! ! ~TATEMENT OF ACCOUNT
PO lOX 280601 Il_.\....".... 1 L..~ I \_'1 . J,. 0...-..
_1_ PA 17128-1601
'*
REY-1607 EX AFP (03-05)
2005 JUL 22 P~l 2: 12
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-05-2005
OLBERS
08-31-2004
21 04-0857
CUMBERLAND
101
Qaunt R_l tted
ELLEN
R
CLERK OF
ORPHP,J-rS COURT
JOHN M EAKIN CUi,/~'" "r' r'r, PA,
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To In..... proper credit to your _t, subltit the _r portion of thb fo... with your to _to
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
.................~......................~~~........................................1......................
REV-1607 EX AFP (U3-05) ... INHERITANCE TAX STATEMENT OF ACCOUNT ...
ISTATE OF OLBERG ELLEN R FILE NO.21 04-0857 ACN 101 DATE 07-05-2005
THIS $TATEJtI!NT IS I'llOVIDED TO ADVISE OF THE CUltRENT STAtus OF THE STATED ACN IN THE IWtED ESTATE. SIlOlIN BELOW
IS A SUltllARY OF THE PRINCIPAL TAlC DUE, APPLICATION OF ALL PAYltENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PIlOJECTED INTEREST FIIlUIlE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-14-2005
PRINCIPAL TAX DUE: 44,077.94
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-16-2004 CD004631 2,105.26 40,000.00
01-05-2005 CD004797 .00 2,077.94
06-13-2005 REFUND .00 105.26-
TOTAL TAX CREDIT 44,077.94
BALANCE OF TAX DUE .00
INTEREST AND PIN. .00
. IF PAID AFTER THIS DATE, SEE R..-sE TOTAL DUE .00
t
SIDE FOR CALCULATIClII OF ADDITItlML INTEREST.
( IF TOTAL DUE IS LESS THAN .1,
NO PAYItENT IS RElIUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR),
YDU HAY BE DUE A REAMIl. SEE REVERSE SmE OF THIS FORlt FOR INSTRUCTIONS. )
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