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HomeMy WebLinkAbout95-0227This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. Tr M SU1d(N( AUG 16_.2001' Date Fran eropoli, ct Division of Vital Records P.O. Box 1528 New Castle, PA 16103 N1O3.'~ A"'' bn COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~+T CERTIFlCATE OF DEATH /'} ~~-- PEAIANfNT WIME OF OEf~ocYra:~..ur_~~ ~ ~v , Y r ti - - 10i12i95 11:35 hI,RREL WALTERS ESQ. P. 02 L>lET •ILL ~ TSA'1'AIRRIIT l ~/ ~~ SS IT RENBMBERSb THAT i, BENJAMIN L. GOQDMAN, a resident of Cumberland County, Pennsylvania, being of avund and disposing mind, memory ar~d understanding, do malts, publish and dealers this to be my LAST WILL and TESTAMENT, hereby revoking any and all wills and Codicils previously made by me. ~~~ I I direst that all my just debts and funeral expenses shall be paid from my residuary estate as soon as praaticabia after my decease. II I direct that all taxes that may be asses9ed in consequence of my death, of whatever nature and by wh+~taver jurisdiction imposed, shall be paid from Toy residuary estate a: n part of the expense of the adminiettration v! my estate. sII i give and bequeath the sus of one Thousand Dollars (51,000.00) to each aP the following individuals, par capita, neighbors who have bean helpful to me during my lilatime: JosEPezNE suRxE SLAIR Is8ltHERG PETER GALLACHER AUDREY YOUNQ VI All the rent, residue and remainder of my property, whether real or personei, wherever situate, including any property over which I stay have a power of appointment, I give, devise, and bequeath as follows: Tw$HTY PERCS'!IT (a0t) to TRESSLER LUTHBEtAH SERVICES of Camp lull, Pennaylvanin; FIVE PERCI4NT (5~j to FREY VILLAdE, Middlat~rn, Pennsylvania; FIVE PERCENT (5~j to NATIONAL PSORIA8I8 FOCJNDATION, Portland, Oregon; FIVE PERCENT (St) to CHANNELS, 331 Bridge street, Nsw Cumberland, Pennsylvania; '~ 10~:.2~5 11:35 hNJRREL WW..TER$ ESO. P. 03 SIXTY-FIVE PERCENT (65~j to WILLIAI~t F. SMITH, or if he does not survive me, to his wire, JOBEPHiNB gMITH, par stirpes. v It is my desire that I ba cremated. I have made arrangements for this purpose with the Cremation Socisty of Pennsylvania, a1O0 Jonestown Road, Harrisburg, Penn~pylvania 17109. VI I nominate, constitute and appoint WILLIAM t~. SMITii as Sxeoutor of this LAST WIx+I,, to serve without bond. IN WITNS8SS WHEREOF, I, BENJAMIN L. GOODMAN, have eat my hand to this LAST WILL this ~ ~ day of i~'-L'tti4a~~C.,.~ ~_ 1995. d" '~- 6ignad, sealed, published and dealarsd by the above-named 8en~amin L. Goodman, ae And far his Last Will and Testament, in the presence of qs, who, at his request and in his presence, and in the preaenae of eech other, have hereunto subscribed our names as witnesses. Z '~~^2i95 P. 04 11:37 MURREL WALTERS ESQ. AC1TIfONLbDEi COMMONi9EAI,TN OF PENNSYLVANIA COUNTY OF CUMHETtLAND 9s. I, SENJA[dIN L. c3gODMAN, Testator, whose name is signed to the attached ar 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 ae my free and voluntary act Eor the purposes therein expressed. ~~ 1.e2.4f..re .... _ /' .~~ ~ a r y3 TJ L. _G T ''yy'P Sworn or affirmed to and acknowledged before ne by Benjamin L. ooodatan, Testator, thin ;?I,St day of ~ re?.~/`cc~.~~ , 1998. N cry b c Nciafa' Seat Dleno M, Snalh, Nobly f~uWo Medurt~.+n~rp 8r,+o Ckr-~6plaHlbi 7ll~IDAVIT COLIIKONNBALTN of PENNSYLVANIA , COUNTY OF CUMggRLANp ss. we, ~l;ti//,i.7~n F, ~.~,~i~/t, , and /!k[/'PO/ Jl~~ l[~-/~GPrs, ,~Z' the witnesaos Nhose names era signed to the attached or foregoing instru~aent being duly qualified according to law, do depose and say that wa were present and saw Testator sign and execute the instrument as hie LAST PILL, that Benjamin L. tTOOQatan ei ned willingly and that ha sxeouted it as hie free and voluntary act for the purposes therein axpreseed; that each of us in the hearing and sight of the Teetatpr eigntad the wail Ns witnesset9; and that to the b4st of our knowledge, the Testator NAs at the tine 18 years of age or More, of sound mind and under no constraint or undue influence, ,^ . sworn or affirmed to and acknowledged before me this o2 / aT flay of ~p,,(~~,c,tu /'t~ V , 1995. ca.~e., ~'Y ,.,.c,,. No cry Fu c ~A l~N,y~i,NMmYPUt)b ~st,~ S~n,'•l+rtwt~'J ~~iMhw9airr E:,;yg~,~na:r), 1~ ~ ,~ (~ INHERITANCE lA~( K~r u~crv ~• •° ~• ~•°~• POVERTY CREDIT FS CLAIMED U ' ` ~ RESIDENT DECEDENT FILE NUMBER CbMMONWEAITH OF PEP NSYIVANiA PTO BE FILED IN DUPLICATE DEPARTMENT OF RE'/F.NUE 60 E WITH REGISTER OF WILLS? 21 95 0227 HARRIS U RG, PA 128.0601 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIIFIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS ~ GoodmanL Ben'amin L. 700 Barbara Street W Soc1Al SECURITY NUMF!ER DATE OF DEATH DATE OF BIRiH Ne~T Cumberland r PA 17 0 7 0 e 280-01-5:317 3/10/95 5/11/03 co~~l Cumberland p (IF APPLICA+IEI SURVIVING SPOUSE'S NA/IE RAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED 1SEE INSTRUCTIONSI W ®f. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return Y a Y (for dates of death prior fo 12-13-82) ~~ca ^ d. Limited Estate ^ do. Future Interest Compromise ^ 5. federal Estate Tax Return Required ~ ~ -°+ (for dotes of death after 12-12-82) ~ O0 ~ 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 1- 8. Total Number o~ SaFe Deposit 9oxes (Attach copy of Will) (Attach copy of Trust) 1 t, . .... ,„ n~ W ~ E CO ET Murrel R. Walters III Es 54 East P~Iain Streit v~ iELEPF20NENUMBER 717 697-4650 Mechanicsburg, PA 17055 z i= s a a W a= z 0 Q H d 0 a 1. Real Estate (Schedule A) (1) 51, 5 9 3.6 4 2. Sfocks and Bonds (Schedule B) (2) _ - 0 - 3. Closely Held Stock/Partnership Interest (Schedule C) (3) - O- d. Mortgages and Notes Receivable (Schedule D) (d) - O - 5. Cash, Bank Deposits $ Miscellaneous Personal Property (5) 9 0 , Z~19 _ 9 2 (Schedule E) b. )oinlly Owned Property (Schedule F) (6) - O 7. Transfers (Schedule G) (Schedule L) (7) -O- 8. Total Gross Assets (total Lines 1.7) 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) 7 , 519.71 Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule i) (10) 299.22 11. Total Deductions (IOtal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line I1) ~ 3. Charitable and Governmental Bequests (Schedule 1) Id: Ne} Value Subject to Tax (Line 12 minus Line 13) I5. Spousal Transfers (for dates of death after 6-30-9d) See Instructions for Applicable Percentage on Reverse (15) Side. (Include- values from Schedule K or Schedule M.) I6. Amount of Line 1 d taxable a1 6°i6 rate (16) (Include values From Schedule K or Schedule M.) x, __ x .Ob = 17. Amount of line 1 d taxable at 15% tale (17) ~ 8 . 7~J~'~_ x .15 = 13 ; 317 . ~ 8 (Include values from Schedule K or Schedule M.) 18. Principal tax due (Add tax from Lines 15, 16 and 17.) (18) ~ ~ , 317 ~ 38 19. Credits Spousal Poverty Credit Prior Payments Discount Interest ~ 12.500.00 666.57 _ ~t9) 13,166.57 20. If line 19 is greater than line j8, enter the difference on line 20. Tltii ii Ihe,OV~RF'AYAiIENT. (20) _. ..: ®^ ~ ~ ~ ~ ~ 150; 81 21. If line 18 is greater than Line 19, enter the difference on Line 21. This (i the T/1X DUE. (21) A. Enter the interest on the balance due on Lina 21A. (21A) B. Enter the total of line 21 and 21A on Line 218. This is the BALANCE DUE. (21 B) 15 O + 81 Make Chsck Payable to: Reglsfer of Wills, Agent nder penalties of perjury, I declare that I have examined this return, including accompan is Irue, correct and complete. I declare that all real estate has been reported at true ma ssed on all information of ch re e s an knowled e. / AVVKCJJ William F. Smith ~,. ~~' ~, ft ~. ,~, (B) _142,303,56 7,818.93 (12) _ 134,484.63 (13) 45, 702.10 Ild- 88.782.53 Murrel R. Walters statementi, and to the best of my knowledge and belief, ion of preparer other than the personal represenfdtive ii 14 / b Bran t Ave . DATE hew Cumberland, _-PA 17070 6- 27 - ct 5~~ DATE III, Esq. ~ Z~'4S` 54 E. Main Street Mechanicsburg, PA 17055 for the reduction of the f~ax rates imposed en the nit value of ttnnsters 40 or for Act #48 of 1994 p~ovidea reacribed by th@ statute will b the use of the spouse. The rates as p licabls for estates of deced~nta dying on or after 7/1/94 and before 111/9 i ~% ~.03) will be app a licable for estates of decedents dying on or after 111 /96 and before 1 rl /97 Ii 2% ~.02) will be PP .. licab)e for estates of deeedentf dying on or aftet 1/1/97 and before 1/~~98 • ~ "lo x.011 will be app i S ousel transfers occurring on or after 1/1198 will be exempt from inheritance tax. P PLEASE ANSWER THE FOL~ HE APR PR ATE BLOCKS. BY PLACING A CHECK MARK (/) I . Did decedent make a transfer and: ...................... .......................:...:... a. retain the use or income of the property transferre , .. retain the right to designate who shall use the property Transferred or its income, ............... b. .................. ............................ • interest; or ......... .. ........... c. retain a reversionary .............................. d, receive the promise for life of either payments, benefits or care$ . • • • • •"' two ear3 preceding did decedeni w~i in y 2. if death occurred on or before becember 12, 1982, eivin adequate consideraiioh$ If deaThvi+~o ~ ~eceivin4 death ,transfer .property without rec 9 within one year of death 2 did decedeni transfer ro eN ...,..•••••••••• P P Y ......... December 12, 198 ,~ •••••••••••• adequate consideraiion$ ............................................................. ..... 'in trust for' bank account at his or het death$.........•••••••••••••••••""' 3. Did decedent own an ER TO ANY OF TIDE I~-BOVE QUESTIONS ~ THE R~TUR~: IF THE ANSW T COMPLETE SCHEDULE G AND FILE ~T ~-S Pl~-~T OF ~O~ MUS r COMMONWEALTH OF. PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Goodman,. Benjamin L. 21-95-227 (All property loinfly-owned with the Right of Survivorship musf be disclosed on Schedule F) ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH 1. Pennsylvania property tax rebate 146.08 2. Farmers Trust - CD X104664 3. Farmers Trust - CD ~~104722 4. Mellon Bank - checking ~~262-106-9984 5. Mellon Bank - savings X260-008599 6. Mellon Bank - CD X12998 7. Mellon Bank - CD X104879 8. Mellon Bank - CD ~~26-A36241-C 9. Mellon Bank - CD ~~260-001083-C 10. Mellon Bank - CD ~~260-001084-C 11. National Gardening - refund 12. 1991 Oldsmobile Cutlas Supreme automobile - per sale price March 27, 1995 13. Wall Street Journal - refund 14. Blue Cross/Blue Shield - refund 15. State Farm - automobile insurance refund 16. Homeowners insurance - refund 17. Penn Dot - auto tag refund 14,598.41 13,644.35 1,343.56 6,982.97 10,210.93 5,019.34 10,150.43 10,'057.64 10,057.64 28.00 8,000.00 64.66 186.40 166.51 29.00 24.00 TOTAL (Also enter on line 5, Recapitulation) I $ 90, 709.92 (Attach additional BYi" x 11" sheets if more space is needed.) FAR~v~ ER~S TRUST One West Nigh Street P.Q Box Z20 Carlisle, Peivisylvarlia 1701.3 June 8, 1995 Date Murrel R. Walters, III 54 E. Main Street Mechanicsburg, PA 17055-3851 Re: Estate of~ _ Benjamin L. Goodman Date of Death 3-10-95 Mr. Walters Dear In aruwer to your request concerning accounts owned, either ~spsrately or jointly, by the above referenced decedent and the balance in each account as of the date of death, we have checked our records and are submitting the following information in duplicate. We suggest that you file one of these letters attached to the Pennsylvanis Inven- tory forms (RCC) to substantiate the balance you report. Note that we have shown the correct registration for each account. Also, interest tcentbd to the date of death, if any, is listed as a separate figure. Very truly yours, Denise L. Sanno CD/IRA Dept. Certificate 104664 was opened 4/25/94. The value as of 3/10/95 was $14,598.41. Certificate 104722 was opened 10/21/94. The value as of 3/10/95 was $13,644.35. Both certificates are registered to Benjamin L. Goodman, alone. oarornron t-, • ~~d~H ~~~II ~ o~ o~ ~ ~~ Zi N I fD I (D ,b I I I I 1 G o o w E„g taro~ron ti o o rn H 0 0 ~ f~A Ual M t'1 f~D 0o OD ~+ ~Mk wa m rn n ~ w 1 u0i o° cdo a a ~ ~ ~ y ~ O N ~ n~nu~ n~ ~•a N•~w N C rt cD rt ~ ~• n ~' oo ao ~, ro F'• W N H N W N ~ ~ W fr ~O tp ~ fD O O lD ~ y fT H H H ~ ro H V1 G1 f7 f7 C1 f1 ~~~'~ naa :~ '~ O I I 1 y! 1 H V1 (,] k3 ~t r{ ro n a O ~ N ~ ',7' Fr ~ F' ~ ~• n p ~ 0 0 0 co rtm o 0 o Cropnn ~ n~~n~ o° c ~ ~Ca~ro ~• a N• CP~~7 yyy H H N• H O O O ~~y ID (7 ~ ~} t'S N fD fD N rr G1 H H ~ ~ G7 .'~ VI Vl ~ ~ J c C H n ~ ~ ~ o N 1 ~ ~ W I I 1~ O H ~ ~ ~~ y ~' 9' ~" a c» K {3 H O Si' ~ E cep rOr o m h N. c ~ ~ ~ d is n sr is cn ~' ~+ n ~ ~ w ,~~ w n pi ~ ~ n a c x• rr w a a u rr ~ n m n ~yq ~q w ~ ~ Q O M H y 0 0 0 ~ ~y y rn ~ ,p WWW ~j ~ pd E•1 ~ w w Cd ty0 O H roro~ro~ ' ~ , ('7 f/1 d C] bD 0 bd W O Cn O fD V1 F+ W N !!yy H O fD fD O pI O {~ ~-' Cf ly 0 9 N u• O rt u. --~ fD O~ p1 N tD O~ ~ O~ kI N (D 1 u• I (n] ~ f'! I I I I I ~~ ''c W N O N~ I..i ~ a a m~ ti ~~ x w~ o v N• ap+ ~ rn rn rn H cD p oo O p I w m m r'n n ~ r ~ r ~ ~, 'M~ . N O b p W fn ,o ~ s o m a is u,~'ro~~ ° ° ~ ° o rt o N o o ~ C rt m ~ s a• ~~ w ~ ~ a ~ ~• N f.. 1..1 ~ ~ ~"' O ~"~ N ~ ~ N od ~ W Ct ~ M O~ F+ w Qp \ fD ~ t0 ~ ~P ~ ~P tOp ~ fn rt ro l-+ 1'n c~ ~ ~ ~ ~ ro ~n~nn ~ n y ~ ~ o H ,~ aa I I I ~ ~ H 1 H f/1 ,('1 n ro a o H O f1' ~ ~ c~D ~ ~ ~ N'• lD ~ V~ O p~ ~ F, ~ ~ ~ fD f f' fD w ~ O O ~ ~ o ~ ~ w w H ~~ ~ a M N O O I ~ H ~d~ro . F i. H N ~ O~ rt `Q a c ~ D r + ~ ~ m rn G1 H H ~, .~. ~ Y ' ~, ~ \ 3, O 3', ~ F-~ N ('' ~ n~~ tC O w ~ I C W ~ to I ~ w w ° j bd O I I 1 ~ ~ ~ ~ ~ ~ ~ ~ a ~ ~ ~ a" ~~°' anoyr ~ N O ~ r r ~~ a o ~ ~~ ~ ~~a cn rn c O fD ri W N ~ O N ~ ~ W H yyd Ct c D ~Q "C w PI' m ~ O N 'a' w H ('~ C~~1 !~ a ~ a ~ w ~ I ~ O hl X rt w ~ ~ f~ w rn n m n x . N ~ ~ ~ H ~ 1-+ w ~ {!) H ~P W Qp I O O H O ~'+f ~~, ~~ ~ ~ 9 ~s_ ~ ~ yS_ C9'~„~ ,.~ Cam`'°'~~ _ ~~-~,~ SIN lG31uN s~T'7m~ ,~ ~~~ ~~ `~~ ti~y~ ~~2K ~~S~P N~ ~~ Gvm t3e,oc /ay Ply i~7o 70 ~. SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT _ __ ___ _ ESTATE OF FILE NUMBER Goodman, Benjamin L. 21-95-227 (Properfy iointiy-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value (tf more space is needed, insert additional sheets of same size.) A. Settlement 8~a~ement U.S. Department of Nousing end Urban Development 8. type of Loan i.[~ FIIA 2.~ FmIIA 3.~ Conv. Unins. F e N r oan 4.~ vA 5.~ l:onv. ins. GOODMAN OHg No. 2502-0265 8. Nortaeae Ins. C. this form is furnished as a statement of actual settlement costs. Amounts paid to and by the settlement agent are shoNn. items marked (p.o.e) were paid outside the closing; they are shown for informational purposes end are not included in totals. D. Name e A teas o Borrower E. Name e A rasa o Se er F. ame a A teas o Le er PETER GALLACIJER WILLIAM F. SMITH, KATHLEEN GALLACHER Executor of the Estate of Benjamin L. Goodman c. rroperty ~ocetton 700 BARBARA STREET NEW CUMBERLAND, PA 17070 vtaee or settlement 54 E. MAIN STt2EE'1` MECHANICSBURG; PA X7055 +u'~yC 04/13/95 '~ ~.gpRp~Rt~ .: .T .:.#5lr~d.~.x<..~/.,r~;~ ~...« : ' v ,x R.,, ~ t UC;~.Ni11i;: ' ~ +~r~ ?[t1111 < 101. Contract sales price 52,000.00 4 1. Contract sales price 52,000.00 102. Personal property S 402. Personal property 103. Settlement charges to borrower line 1400) 533.00 403. 104. 404. 105. 405. Adjustments for Items paid by seller in advance AdJustmm~ta for items paid by seller in advance 106. City/town taxes to 406. C1ty/town taxes to 107. County taxes to 407. County taxes to 108. Assessments 04/13/95 to 06/30/95 232.40 408. 1lsaesanKnta 04/13/95 to 06/30/95 232.40 109. 409. 110. 410. 111. 411. 112 412 ;;{~d GRb~~ ~1(f~Y, UUE FRdi(.<6tl~Aq,,,, :Y . ~ ,; Ii200 .h..:..,_? .p. tn.l: Y OR ;1N;.~ ,tp.,tlF....Qi~ .' 201. Deposit or earnest money 52,765.40 ..., ~.~<......, g 4~ x.'G,fl4S$. p , ,sE ~R sa :. ..::5~ ~''....... 1...:a.. ......1',d.:.p. R..k . . a:.~::`~~ 501. Exceas deposit see instructions) 52,232.40 .. , 202. Principal amount of new hen(s) 502. Settlement charges to aeller(Une 1600) 523.00 203. Existing loan(s) taken subject to 503. Existing laan(a) taken subject to 204. 504. Payoff of first mortgage loan 205. 505. payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes 01/01/95 to 04/13/95 109.24 511. County taxes 01/01/95 to 04/13/95 109.24 212. Asaessmenta to 512. Asseaements to 213. SELIER/REFUSE 4/1-4/13/95 6.52 513. SEVER/REFUSE 4/1-4/13/95 6.52 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. Lx0 ifiiAl:;h~iD ~Yj,iOR 6plROlIER: , 115.76 576 10t~1~ A@611C~1ON I~Ht~t DU(.'sr:i.l@k ~3d.7~ ,0. CA N ..t .s .t ,.~~NT fit ,ITU R :..1! ~ n: ,~.,. .;~ -. ..._, ~ tw:.:,..:N.:.~S~ ,t E 1 TD/Fk 3@. !E 301. Orosa amount due Tram borrower line 120) 52,765.40 601. Gross amotatt due to seller(line 420) 52,232.40 302. Less amount paid by/for borrower line 220) ( 115.76 ) 602. leas redUetion emou~t dve seller(line 520) ( 638.76 } 303 EASa.(;~] lRtl~ij[~ t0) ~DiZ~~JER ;~ 52,64964 ;:d`03. C~SNC~X tOJ,(~,~PRON) Sj:Lt~k_ ~ - §jy§93.dd the infornbtion contained (n Blocks E, 0, N ertd fend on line 401(or, li line 401 is asterisked lines 403 end 404) Is (nportant tax infornmtion and is being furnished to the internal Revenue Service. If you ere required to file b return d negligence penalty or other sanction will be Imposed on you if this item is required to be reported end the IRS determ{nes that it has not been reported. iR1D-1A SETiLEHENT STATEMENT ~ E) Computer Services end ConsUltenta i-7oi-665-0600 RED-1311 E%+ (7~BBI COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Goodman, Benjamin L. ITEM NUMBER A. Funeral Expenses: 1. bESCRIPTION Please Print or ILE NUMBER 21-95-227 AMOUNT B• Administrative Coats: 1. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees Murrel R. Walters, III, Esq. 6,695.00 3. Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code 4. Probate Fees 45 ~ . 0 0 C. Miscellaneous Expenses: ~• Cumberland I~aW Journal - estate notice publication 40.00 2• Sentinel - estate notice publication 62.71 3• Mark Hilbert & Associates - real estate appraisal 250.00 ~' Death Certificates 22.00 5. 6. 7. 8. TOTAL (Also enter on tine 9, Recapitulation) $ 7 , 519.71 (If more space is needed, insert additional sheets of same size.) COMMONWEAUH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Please Print or Tvne ESTATE OF FILE NUMBER Goodman, Benjamin L. 21-95-227 I ~. ~ .. (If more space is needed, insert additional sheets of same size.) _. _ _ -_ _. T _ _. I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION FIRST AND FINA ACCOUNT OF WILL oAM THES BOROUGH EOFTNEW CUMBERLANDE OF BENJAMIN L GOODMAN, LATE CUMBERLAND CO TY, PENNSYLVANIA; DECEASED DATE OF DEATH:i March 10, 1995 DATE OF ISSU CE OF LETTERS TESTAMENTARY: March 21, 1995 DATE OF ADVER ISEMENT OF LETTERS TESTAMENTARY: The Patr of-News: March 28; April 4, April 11, 1995 Cumberla d Law Journal: March 31, April 7, April 14; 1995 PRINCIPAL ACCOUNT Accountant ch the decedent' Real estate s New Cumberl Pennsylvania Farmers Trust Farmers Trust Mellon Bank - Mellon Bank - Mellon Bank - Mellon Bank - Mellon Bank RECEIPTS ges himself with the following items which comprise total estate; to wit: ituate at 700 Barbara street, and, PA property tax rebate - CD #104664 - CD #104722 checking #262-106-9984 savings #260-008599 CD #12998 CD #104879 • CD #26-A36241-C $ 51;593.64 146.08 14,598.41 13,644.35 1,343.56 6,982.97 10;210.93 5,019.34 10,150.43 First and Fin 1 Account - Estate of Benjamin L. Goodman Page 2 Receipts (con 'd.) Mellon Bank - CD #260-001083-C $ 10,057.64 Mellon Bank - CD #260-001084-C 10,057.64 National Gard ning - refund 28.00 1991 Oldsmobil e Cutlass Supreme automobile 8,000.00 per sale pr li ce March 27, 1995 Wall Street J urnal - refund 64.66 Blue Cross/B1 a Shield - refund 186.40 State Farm - utomobile insurance refund 166.51 Homeowner's i surance - refund 29.00 Penn Dot - au o tag refund 24.00 Refund of rea estate tax 30.80 Interest earn d 2,088.75 $ 144,423.11 GROSS ESTATE SSETS Accountant Murrel R. Wa Register of Cumberland L Carlisle sen Mark Hilbert Vital Record New Cumberla DIBHIIRSEMENTS credit for the following monies paid out: ters, III - Attorney's Fee ills - Filing Fee w Journal - Estate Notice Publication inel - Estate Notice Publication & Assoc. - real estate appraisal - death certificates d/Cumberland County personal tax $ 6,695.00 450.00 40.00 62.71 250.00 22.00 9.80 First and Final Account - Estate of Benjamin L. Goodman Page 3 Disbursements (cont'd.) AT&T - telephone rental Bell Atlantic - telephone U.G.I. - natu al gas PP&L - electr'c PAWL - water Pennsylvania nheritance Tax TOTAL DI RECAPITULATION GROSS ESTATE LESS: DISBU BALANCg IN FOR DISTRI SSETS EMENTS OF ACCOUNTANT 9.37 21.71 187.83 43.36 27.15 12,650.81 $20;469.74 $144,423.11 20,469.74 $12;953.37 COMMONWEALTH F PENNSYLVANIA ss. COUNTY OF CUM ERLAND Personal y appeared before me, the undersigned officer, a Notary Public, in and for said Commonwealth and County-latelof the Smith, Execut r of the ESTATE OF BENJAMIN L. GOODMANpennsylvania, Borough of ew Cumberland, Cumberland County, deceased, who being duly sworn according to law, deposes and says that he was th Accountant in the annexed Account and that the said Account is t ue and correct to the best of his knowledge, information a d belief, and that there are no unpaid creditors to be notified o ,tmationlhasobeenlgiven totalldpersonsywho haveoany decree of con it interest in t e estate as beneficiaries. WILL F' • IT Sworn to and ubs~cribed hef or me t i 7 day of ~~~, , 1995. Notary Public... Notarial Seal Diane M, Smittr, Notary Public og ~~m ~a~' ~~Y IN THE COURT ~F COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA, ORPHANS' COUR DIVISION. IN RE: ESTAT OF BENJAMIN L. GOODMAN, LATE OF THE BOROUGH OF NEW CUMBERLAND, C BERLAND COUNTY, PENNSYLVANIA SCHEDIILE OF PROPOSED DISTRIBOTION Suggestion is ~ ade that the balance in the hands of the Account for distribution, to wit: the sum of $123,953.37 in cash, be distributed a follows: Tressler ~Lutheran Services $ 23,990.67 Frey Vil age 5,997.67 National Psoriasis Foundation 5,997.67 Channels 5,997.67 Josephin Burke 1,000.00 Blair Is nberg 1,000.00 Peter Ga lacher 1,000.00 Audrey Y ung 1,000.00 William Smith 77,969.69 Respectfully submitted, ILLIAM F. SMITH COMMONWEALTH O~ PENNSYLVANIA ss. COUNTY OF CUMB RLAND Personall appeared before me, the undersigned officer, a Notary Public in and for said Commonwealth and County-lateLof New SMITH, Execut r of the ESTATE OF BENJAMIN L. GOODMAN, Cumberland Bor ugh, Cumberland County, Pennsylvania, deceased, who teing duly s orn according to law, deposes and says that the foregoing Sch dole of Proposed Distribution is a true and correct distribution f the net assets of the ESTATE OF BENJAMIN L. GOODMAN, dece sed, and is made with the provisions and laws of the Commonwealth f Pennsylvania applicable thereto. W LLI F. MITH Sworn to and ~ubs ibed before me thi `'1 ~`~' day of /92C,SYLtSf"~, 1995. ~l]J Lgtc-'~-~ Arn~-arv Pub11C l~lana M,, 5~in~, IVo~ry Public M~ Coms~on ~resJm~2~2,1~996~ _ _ COMMONWEALTH OF PENNSYLVANIA ' ss COUNTY OF CUMBERLAND orT _ i n 19.-.~.5 ~, Mary C. Lewis, Register for Probate of Wills and granting Letters of Administration for the county of ~u oeriana, m one wuunvi,woai~i= .,~ r~====~y=.a=•=a, u~ =•~=mow ~~• ••~ "'~ ""tea^--a -- -- true and accurate copi s of the FIRST AND FIN L ACCOUNT OF WILLIAM F SMITH EX C BENJAMIN L GO ODMAN, LATE OF NEW CUMBERLAND BOROUGH. .TIMRRRT.AN1~ rnrTp PENNSYLVANIA, DECEASED as the same were passed and advertised and remain on file and of record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal the date above. 4 Mary C. Le s, Register of Wills NOW TO WIT, OCT. 1(995 ,came into CourtWILLIAM F. SMITH, EXECUTOR and presented an account and statement of pro osed distrubution, p L 3 , 9 5 3. 3 7 f $ 1 h d which were examined, s o an assed, approved, and confirmed with a balance in his and the accountant was directed to distribute said balance in accordance with the statement of distributi n filed. ary ewis, Clerk of a Orphans Court COMMONWEALTH rJF PENNSYLVANIA ) COUNTY OF CUM ERLAND )} ss ' rt in and for said Count do hereb certify I, Mary C. Lewis, Clerk of the Orphans Cou Y, Y the foregoing to be a tr _ e copy of the account and statement of proposed distribution of WILLIAM F SMI H EXECUTOR as full and entire as the same remain on file and record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal at Carlisle, this 10th day of OCTOBER lg 9 5 r Mary .Lewis, Cler the Orphans Court .F TY, l ~ ~ o O Ei ~ H '~ ~ z Z U x~ ~ H p; z w x w ~ C7H az ° ~ a O Q -- ~ ~ ~~, o aw ~ ~ a~ d ¢ w l ~ w h 3N~ ~ ~° x ~ Q x ca ~ ~ W~ Z ~ '~ ~ N W I Z o ~ a H H O A A ,~j rn E~ ~ aLLa c H ZU) ~ ~H ~Q .ti l a a V~~ ~c Ua H ~-.~ w x Q a a a --1 ax ~ z ao l O ~ ~ ~ r -vo a Q w Ww ~, W (1. ao z w a~ LL al u m y Ca ~ z ~ ~ w O H ~ ~ U a w ~ Q ~¢" ~ x ~ Y ~ w ~ ~ v o H H a h U w l a „ a x ~ ~ a a 3 ~ Z A w fs, -_~ --~-~ ~ ®y1 It8 .'yllMe~ay uo!lnq!~islP Jo a n 'Pe4~8 pesodo~d yl!~ aouep~aa~e ul p~etu~!;uo'3 lunooayl,-ls~ip-; p-~u-~~,~ia<;+iosgr3. -~ qJ I (~'- ~. ", }, W W Q Q ~ U a W ~ ~H C, p H ~ ~ z0.' O ~ ¢ z ~ D x W ~ ~ ~Z ~ .~ a ~ s ~~ M••i O ~ N ~, ~ V ~ ~ a rd, Q ~ ~ ° ~ W h ~av ~ ~ ~ «o H ('~ ~.. ~ ~ Ca ~ ~ W W A mo t!') ~ '~ W J Q a LL d O .~ • ~ H +" H ~ ~ ~ ~" E" Q ~e~ . d N 01 [ E"' ~ V~~ ,, ~ C >+ o c z w ~ a~ ~ . ~ ~ c ~w ~ v,, A ~ W W w ~ N a W a ~~ ~ LL ~a ~o ai A z~ w H ~ ~, f1. W z ~ ` ~~ Y ~ ~ y ~ ~ E..~ 0 ~ U ~ ~ La rT. .-~ ~ ~ w ~ v a ~ a z ~ C~ ~ .a W x O a ~ 3 w ~ Z A -.~ ~~. / r M 8 .'yilN-e~ey uo!ingl~;slp ao e!n P eyoe pesodo~d U3lnn aSUePJnaae u~ P uo13nRljise. ~wallua3lunoaoy SP Pus Rie~~plosq~ ~. ~". 9~-~ ~.~ REV-1547 EX AFP (12-94) COMMONNEALTN OF PENNSYLVANIA DEPARTt~NT OF REVENUE NOTICE OF INHERITANCE TAX ACN 101 BUREAU OF INDrv1auAL TAxes APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPT. 280601 HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 10-23-95 LLI\J MI'll 1\ ~ FILE N0. 21 9 -0 DATE OF DEATH 03-10-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT T0: MURREL R WALTERS III ESp 54 E MAIN ST MECHANICSBURG PA 17055 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Amount Reeitted CUT ALONG THIS LINE - RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP'.C1~-943 NOTICE OF INHERITAFiCE TAX AFwRAISEMEFii, ALL0-1.iNCc OFc DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GOODMAN BENJAMIN L FILE NO. 21 95-0227 ACN 101 DATE 10-23-95 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED PION FUTURE INTEREST - APPRAISED VALUE pF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate ~, (Schedule A) (i) 51 .593.64 2. Stocks and Bonds (Schedule B) (2) .00 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) .00 5. Cesh/bank Deposits/Misc. Personal Property (Schedule E) (5) 9 0,709.92 6. Jointly OMned Property (Schedule F) (6) .00 7. Transfisrs (Schedule G) (7) .00 8. Total Assets i (g) 142, 303.56 APPROVED DEDUCTrONS AND EXEMPTIONS: 9. Funeral Expenses/Ado. Costs/Misc. Expenses (Schedule H) (9) 7,519.71 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 299.22 11. Total Deductions (11) 7 .B1 S _ 9~ 12. Nst Value of Tax Return (12) 134,484.63 13. Charitable/Governmental Bequests (Schedule J) (13) 45, 702.10 14. Net Value of Estate Subject to Tax (14) 88,782.53 NOTE: If an as'Bessment was issued previously, 11nes 14, 15 andior i6, li and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TA7C: 15. Aeount of Lids 14 at Spousal rate (15) .00 X . 00_ . 00 16. Aeount of L e 14 taxable at Lineal/Class A rate (16) . 00 X . 06. . 00 ~ 17. Aeount of L • 14 taxable at Collateral/Glees B rate (17) 88,782.53 X .15. 13,317.38 18. Principal Tax Due (lg) 13,.317.38 TAX CREDITS: PAYMENT ~ RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) AMOUNT PAID 06-09-95 !AA047860 657.89 12 500 00 06-30-95 AA047951 .00 , . 150.81 PAYMENT MUST BE ~NADE BY 12-i1-95*. * IF PAID AFTER DARE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. i TOTAL TAX CREDIT 13,308.70 BALANCE OF TAX DUE g,68 INTEREST .00 TOTAL DUE g,68 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ••CREDIT^ (CR), YOU MAY BE DUE A REFUND_ SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) No./~1~ 08226 COMMONWEALTH OF PENNSYGVANlA j DEPARTMENT OF REVENUE ~ :. r REV-Ilb2 E%Id•9d) OFJ~(C~A~ ~E~~IT, • pEidNSyLVANIA 1NHERITANCf ANU ESTATE TAX FOLD HER RECEIVED FROM: I I WALTER51 MURREL R III 54 E MAN STREET i • MECHANI~SHURG, PA 17055 ESTATE INFORMATION: © FILE NUMBER 21-1 95-0227 S5N 280-01-5317 © NAME OF DECEDENT (I,~ST) (FIRST) (MI) GOODMAN ~ENJAMIN L DATE OF PAYMENT © POSTMARK DATE I \1 COUNTY CUMAERLAND DATE OF DEATH ACN ASSESSMENT CONTROL AMOUNT NUMBER 1 FOLD HFR KtMARKS MURREL ~ R WALTERS i I I ESQ . SEAL CHECK# i 10230 1~ TAXPAYER TOTAL AMOUNT PAID `~8. 68 PB RECEIVED BY i SIGNAT E MARY C. LE IS 2~ REGISTER OF WILLS __ No.~t~ ~4~95.~ ! COMMONWEALTH OF PENNSYLVANIA: a i DEPARTMENT QF REVENUE REVaia~ fx la.val OfFIC~AL RECEIPT ~ PENNSYLVANIA IN41POtTeNt^t n win tcTwTr ~... FOLD HfR RECEIVED FROM: ACN ASSESSMENT CONTROL NUMBER AMOUNT X01 ~ 1503 fOLO HER WALTERS M RREL R III 54 E MAIM STREET MECt-IAN I CS p3URG PA 17055 ESTATE INFORMATION: © FILE NUMBER 21-199' -0227 SSN 280-01-531? © NAME Of DECEDENT (LAST) (FIRST) (MI) ODMAN H NJAMIN L DATE OF PAYMENT © POSTMAR E COUNTY CUMBERLAND DATE OF DEATH -~ r~s ~ R~m~arcRa WILLIAM F SMITH C/U P'IURREL WALTERS ESQ,III SEAL CHEG}~# 143 TAXPAYER TOTAL AMOUNT PAID $150.81 D RECEIVED BY NATURE MARY C. LEW REGISTER OF WILLS REV-1607 EX AFP (12-9~i) COMMONNEALTH QF PENNSYLVANIA DEPARTMENT DF REVENUE BUREAU OF INDIVIDUAL TAXES APT. 280601 HARRISBURG, PA 17128-0601 DATE OF DEATH NOTE: TO INSURE PROPER PAYMENT TO THE A' MURREL R WA TERS III ESQ REGISTER OF WILLS 54 E MAIN S CUMBERLAND CO COURT HOUSE MECHANICSBU G PA 17055 CARLISLE, PA 17013 Anowt R~witt~d CUT ALONG THIS LINE -- ----_ RETAIN LOWER PORTION FOR YOUR FILES __~ ___ -------------- -------------------------------------------- REV-1607 EX AFP (12-9i ) ~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~ "------"--""--"- ESTATE OF GOODMAN BENJAMIN L FILE N0. 21 95-0227 ACN 101 DATE 12-04-95 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A RY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, F APPLICABLE, A PROJECTED INTEREST FIGURE DATE OF LAST ASSESSME T PRINCIPAL TAX DUE:. PAYMENTS CTAX CREDITS): 13,317.38 PAYMENT DATE REC NU IPT BER DISCOUNT C+) INTEREST C-) AMOUNT PAID 06-09-95 AA 47860 657.89 12,500.00 06-30-95 AA 47951 .00 150.81 10-26-95 AA 82263 .00 8.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST * IF PAID AFTER THIS DA~E, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION F ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS 7~HAN Sl, NO PAYMENT IS REQUZREi. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), you MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ACN 101 INHERITANCE TAX STATEMENT OF ACCOUNT DATE 12-04-95 -I- BENJAMIN L FILE N0. 21 95-0227 COUNTY CUMBERLAND TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX SHOWN. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: , OR RECORD ADJUSTMENT: 10-16-95 13,317.38 .00 .00 .00 0 0 x © ~ © © m y m m z! ~ _rn m G1 ~ ~ ,..,.,C v U1 W -I m O m E r r N m D r n f m r n r n ~ n 3 S `ry N 3 N ",~ m D z tJ~ a 0 D D 3 O c z -~ D v Oi +.~ n1 y/ry V~ r~ L ~~y V _Q ~~ A REV-1607 EX AFP (12-94~) ACN 101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES DEPT. 280601 STATEMENT OF ACCOUNT DATE 11-13-95 HARRISBURG, PA 17128-0601 ESTATE OF GOODMAN BENJAMIN DATE OF DEATH 03-10-~5 NOTE: TO INSURE PROPER PAYMENT TO THE A'. MURREL R WAL 54 E MAIN ST MECHANICSBUR CUT ALONG THIS LINE -------------- REV-1607 EX AFP (12 FILE N0. 21 95-0227 COUNTY CUMBERLAND T TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX SHOWN. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: , .RS III ESQ REGISTER OF WILLS CUMBERLAND CO COURT HOUSE PA 17055 CARLISLE, PA 17013 A^ount R~witt~d _~ RETAIN LOWER PORTION FOR YOUR FILES __~ -------------------------------------- **~ INHERITANCE TAX STATEMENT -0F ACCOUNT x~~ ------~---'-----'-'- ESTATE OF GOODMAN ~ BENJAMIN L FILE NO 21 95-0227 ACN 101 ESTATE.~~SHOWN BELOWuISLA ~TUMMARYIOF THETPRINCIPALTTAXADUE,OAPPLICATION OF~ALLNPAYMENTSED THE CURRENT BALANCE AND F APPLICABLE A PROJECTED INTEREST FIGURE. DATE 11-13-95 DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-16-95 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDIT ): PAYMENT REC IPT DATE NU BER 06-09-95 AA 47860 06-30-95 AA 47951 10-26-95 AA 82263 DISCOUNT (+) INTEREST (-) 657.89 .00 .00 AMOUNT PAID 12,500.00 150.81 8.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION ¢F ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS ~HAN S1, NO PAYMENT IS REQUIRE. IF TOTAL DUE IS REFLECTED AS A ''CREDIT'' (CR), vnu Mev ac nuF a RFCUwn_ sEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. 13,317.38 13,317.38 .00 .00 .00 PETI~'ION FOR PROBATE and GRANT OF LETTERS Estate of B also known as gamin L. Goodman No. To: Register of W' Is fppr th Deceased. County of ~umbereland in the Social Security No. - - ~ Commonwealth of Pennsylvania The petition oft a undersigned respectfully represents that: Your petitioner ;who is/~c18 years of age or older an the executor in the last will oft a above decedent, dated Fahrttar~r ~ 1 named and codicil(s) dat none , 19 95 (state relevant circumstances, e.g. renunciation, death oPexecutor, etc.) Decendent was d miciled at death in Cumberland County, Pennsylvania, with h ~ s last f 'ly or princip 1 res~ience at Borou ha of New um er an ew um er an (list street, number and muncipality) Decendent, then 91 years of age, died March 10 ~ 19 95 at 0 Barba a St New C berg d Except as follow ,decedent did not marry, was not divorced and did not have a child born or adopted after execution oft a will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at dent owned property with estimated values as follows: (If domiciled in P .) All personal property $ 8 0 , 0 0 0. 0 0 (If not domiciled i Pa.) Personal property in Pennsylvania $ (If not domiciled i Pa.) Personal property in County $ Value of real estat in Pe sylvani situated as follow : 7$(~ Bar~ara St. New Cumberland $ 60 000 00 WHEREFORE, petitioner(aj respectfully request(s) the probate of the last will it~xc~~~j presented herewith and the grant of letterst e s t amen t a Y theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) h u 4 v b .-. ... (n a`3 ~ C i iam x °' mi t ~._ _'° 7 Bran ~ t Avenue Via, ~TeW tmhcrl nd, PA 1707(1 go a eo in ATH OF PERSONAL REPRESENTATIVE COMMONWE LTH OF PENNSYLVANIA l COUNTY OF ~ CUMBERLAND }- ss The petitioner(~labove-named swear(s) or affirm(s) thatJthe statements in the foregoin etition are true and correct to the best of the knowledge and belief of petitioner(lt~ and that as personal represen- tatives) of the ab~IIve decedent petitioner(3~ will well and truly administer the estate according to law. Sworn to or atlfirmed and subscribed before me this ~ day of William F Smith o0 i 19 a Register y CERTIFICATION OF NOTICE UNDER RULE 5.6(a Name of Decedent: Benjamin L. Goodman Date of Death: March 10, 1995 Will No.: Admin. No.: 1995-00227 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 17, 1995. Name Address Josephine Burke 1481 Brandt Ave. New Cumberland, PA 17070 Blair Isenberg 1485 Brandt Ave. New Cumberland, PA 17070 Peter Gallacher 3527 Country Side Lane Camp Hill, PA 17011 Andrew Young 704 Barbara Street New Cumberland, PA 17070 Tressler Lutheran Services 960 Century Drive Mechanicsburg, PA 17055 Frey Village Retirement 1020 N. Union St. Center Middletown, PA 17057 National Psoriasis 6600 S.W. 92nd, Suite 300 Foundation Portland, Oregon 97223 Channels 331 Bridge Street New Cumberland, PA 17070 William F. Smith 1476 Brandt Ave. New Cumberland, PA 17070 Notice has now been given to all perso s ; entitle, ~he eto .under Rule 5.6(a) except: none `/ l J/ J ~ // ~ J' ~,..., . Date: 4/17/95 !!!rr/" 1 Murrel R. Walters, III, Esq. 54 E. Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: Personal Representative x Counsel for Personal Representative REV-1607 EX AFP (12-94) CDMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX STATEMENT OF ACCOUNT ACN 101 DATE 12-04-95 ESTATE OF GOODMAN BENJAMIN L FILE N0. 21 95-0227 DATE OF DEATH 03-10-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE ADDRESS SHOWN. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: , MURREL R WALTERS III ESQ REGISTER OF WILLS 54 E MAIN ST CUMBERLAND CO COURT HOUSE MECHANICSBURG PA 17055 CARLISLE, PA 17013 Anount Rsnitt~d CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR FILES t _____________________ ------------------------------------------------------------------------------------------- REV-1607 EX AFP (12-941 *~* INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF GOODMAN BENJAMIN L FILE N0. 21 95-0227 ACN 101 DATE 12-04-95 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE AND IF APPLICABLE A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-16-95 PRINCIPAL TAX DUE :..............................._._.._.._._..............._. _. .... 13,317.38 PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) AMOUNT PAID 06-09-95 AA047860 657.89 12,500.00 06-30-95 AA047951 .00 150.81 10-26-95 AA082263 .00 8.68 ' TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), 13,317.38 .00 .00 .00