HomeMy WebLinkAbout04-0943
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of Paul Edward Barrick
also known as
No. ..:> \ - 04 _cp+ ~
To:
Deceased.
209-28-8194
Register of Wills for the
County of ~nnhA-rl gnd in the
Commonwealth of Pennsylvania
Social Security No.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are]8 years of age or older, apply
for letters of administration
on the estate of
(d.b.n.; pendcnle lilC; durante absentia; durante minoritil!c)
the above decedent.
Decedent was domiciled at death in N. Newton Twp. Cumberl~ni ;enn~i~nia, will!f:
his last family or principal residence at 16 Windv Hill Road. r.'1il.D18, PA 17PlJ'
llist street, number, Tm..... 0 or E!oF<J.1R n;;ll-\\
~,~--"'!
Decedent, then 67 years of age, died October 11 . ,N 1004
at 16 Windv Hill Road. Newville. PA 17241 a
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ ~~. nnn nn
situated as follows: tracts of real estate situate in North Newton Towoship.
Cumberland County. Pennsylvania. containillR 2.08 acres.
All assets will remain in the custody and control of John H. Barrick
OJ
10.000..00
v,
Petitioner~ after a proper search ha ve ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
John H. Barrick Son 1032 HarrisburO' Pike Car
MarUyn E. Barrick DauO'hter 16 Windv Hin Road Newv .
P. Steven Barrick Son 1005 Old Eastside Rd. Bu
lisle. PA
17013
l.lle. PA
17241
ms. TN 37029
THEREfORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
~
%
=
u
] ~ P. Steven Barrick
'" ~ 1005 Old Eastside Road
-g.g
i~ ~YW2~? -/
~o (~~-V
=
"
0;
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} 55
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
__.J of ,.,....... """"" ",_.J will "" "" ~
truly administer the estate according to law. ~ v
Sworn to or affirmed and subscribed J)< ~ ~
b~ me this ':;;O'c"C day of 'if
~~ ~2004 fj'~ B
,*,c ~~.;.tt -<~: t1 - - - J
No. .;J.\ - DL\-- q L\ 3
Estate of\=>~ '(6..h-O~~ "-PYJJVLA cl<
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ...PC!:h>'o 0 k 020 dccJ..i. j!f , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that P. Steven Barrick and John H. Barrick
isl are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to P. Steven Barrick and John H. Barrick
in the estate of Paul Edward Barrick
Resister of Wills ~
Richard L. Webber, Jr., Esq.
Weigle & Associates, P.C.
FEES
Letters of Administration ..... $\15. O\:)
Short Certificates( ).......... $ 15. L 'b
Renunciation ................ $ C;. 0\)
..'l<!..tO $ It"> . CO
TOTAL _ $ )LJ.5.c;0
Filed .ott. .01-.9. .~(,)~ A.D. ~_
ATIORNEY (Sup. Ct. I.D. No.)
126 East King St.
~~4FP9R~burg~ PA 172~7
ADDRESS
(717) ~1'-7~RR
PHONE
REY-1500 EX + (6-00)
*'
OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
il 04
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
I-
Z
W
C
W
U
W
C
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
Barrick, Paul E
DATE OF DEATH (MM-DD.YEAR) ~ DATE OF BIRTH (MM-DD.YEAR)
10-13-2004 I 12-07-1936
(IF APPLICABLE) SURVIVING SPOUSE'S NAME { LAST, FIRST AND MIDDLE INITIAl}
209-28-8394
0943
NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Limited Estate
D
D
D
D
4a. Future Interest Compromise (da'e of death after
12-12-.82)
7. Decedent Maintained a Liv;ng Trust (Attach
copy of Trust)
10 Spousal Poverty Credit (date of death between
. 12-31-91 and 1-1-95)
D 3. Remainder Return (date ofdealh prior 10 12-1J82)
D 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
w
...
.)(:$VI
"~,,
w~"
~oo
,,~J
~m
~
<(
0'
D4
D6
D9
Decedent Died Testate (Allach
copy of Will)
Litigation Proceeds Received
OFFICIAL USE ONLY
.....,
=
=
"'"
<-
c::
r-
c..>
Original Return
2. Supplemental Return
126 East King Street
Shippensburg, PA 17257
(1)
(2)
(3)
(4)
(5)
(6)
(7)
78,170.00
None
None
None
o
c::
;;:::
,-
,,,::go
TJ '1> r-
c: :z: m:o
~ -
_.",:(I)^
'=00
, 0..
:~ c::
:- ::lJ
_ -,
P(8)
-0
::l1:
r)
':-;.,
;~~~:
r"'l
...
z
w
o
z
o
~
"'
w
~
~
o
"
NAME
Richard L. Webber, Jr., Esquire
FIRM NAME (If applicable)
Weigle & Associates, P.C.
TELEPHONE NUMBER
717-532-7388
52,808.96
23,214.10
None
~54,193:06
9,724.59
144,468.47
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has (13) 0.00
not been made (Schedule J)
14, Net Value Subjectto Tax (Line 12 minus Line 13) (14) 144,468.47
------..-----.--.--- -.------- -...--.--.---...--.---------.-'--------
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
z
o
>=
'"
...J
::>
I-
0:
'"
u
w
'"
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Properly (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9)
(10)
8,664.75
1,059.84
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) 0.00
z or transfers under Sec. 9116(a)(1.2)
0
>= 16.Amount of Line 14 taxable at lineal rate 144,468.47 x .045 (16) 6,501.08
'"
I-
::>
0. 17.Amount of Line 14 taxable at sibling rate 0.00 .12 (17) 0.00
::;; x
0
u 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
~ x 0.00
I- 19. Tax Due
(19) 6,501.08
-------~-
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(11)
(12)
SEE INSTRUCTIONS CN REVERSE SIDE FOR APPLCABLE RATES
Copyright 2002 form software only The Lackner Group,Jnc.
-
Form REV-1500 EX (Rev. 6-00
Decedent's Complete Address:
STREET ADDRESS
16 Windy Hill Road, Newville, PA 17241
CITY Newville
ISTATE PA
IZIP 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6,501.08
0.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
0.00
TotallnteresVPenally (0 + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4)
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5)
A Enter the interest on the tax due. (SA)
8, Enter the total of Line 5 + SA, This is the8ALANCE DUE. (58)
Make Check Payabe to: REGISTER OF WILLS, AGENT
6,501.08
6,501.08
PLEASE ANSWER THE FQLOWlNG QUESTIONS BY PLACING AN "X" IN lHE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.....n.......................................................................... 0 0
b. retain the right to designate who shall use the property transferred or its income~................................... [J L!J
c. retain a reversionary interest; or.................................................................................................................. [J 0
d. receive the promise for life of either payments, benefits or care?............................................................ 0 0
2. If death Occurred after December 12,1982, did decedent transfer property within one year of death without
receiving adequate consideration?...... ............ ...... ....... ........................ .... ..... .............. ... ... ........... ......... .... ......... [J 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?. [J 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?...... ............ .............. .... ....... .......... ...... ............................. ........ ....... ....... 0 0
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 troe, correct and
complete. Declaration of prep~relOther than the personal repesenlalive Is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN - ADDRESS -._" - DATE
Sf~~~~-d:-aUR~/7 AODRess- ~~~~s~I~NE~~~~~eRoa~___?~o/uS- OATE--
Jo~~arriCllk
1032 Harrisburg Pike
Carlisle, PA 17013
SIGNAT EOFPREP .--- ERTHANREPRESE - E ADDRESS --n-------------.---------.-OATE---.-
Ric ard L. Webber, Jr. Esquire Esquire
126 East King Street
Shippensburg, PA 17257
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving Spouse is 3% [72 P.S. ~9116 (a) (1.1) 0)).
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. ~9116 (a) (1.1) (ii)J. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even jf 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 P.S. ~g116 (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.
~9116 1,2) [72 P,S, ~9116 (a) (1)J,
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. ~9116 (a) (1.3)}. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
---
Rev-1502 EX+(6-98)
.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
All real property owned solely or as a tenant In common must be reported at fair market valueair market value is defined as the price at which property would be
exchanged between a wiliing buyer and a willing seller, neither being::ompelled 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
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Real Estate, - together with improvements thereon, situate in North Newton
Township, Cumberland County, Pennsylvania, containing 2.08 acres more or less
78,170.00
TOTAL (Also enter on Line 1, Recapitulation)
78,170.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
-
Rev-1508 EX+ (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
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 schodule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEA~
1 2000 Ford Ranger Pickup Motor Vehicle - VIN # 6,000.00
2 2004 Federal Income Tax Refund 790.95
3 Cash 9,000.00
4 Contents of House 8,730.00
5 Farmers National Bank Checking Ace!. #138185 28,288.01
TOTAL (Also enter on Line 5, Recapitulation)
52,808.96
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev, 6-98)
Rev-1509 EX+ (6-98)
'*
SCHEDULE F
JOINTL V-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
If an asset was made Joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
A. P. Steven Barrick
ADDRESS
RELATIONSHIP TO DECEDENT
Son
1005 Old Eastside Road
Burns, TN 37029
B.
c.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DE CD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSE INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 112812002 Farmers National Bank. Savings 46,428.20 50.000% 23,214.10
Account
TOTAL (Also enter on Line 6, Recapitulation) 23,214.10
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
Rev-1502 EX+ (6-98)
'*
SCHEDULE H.A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
ITEM
NUMBER
DESCRIPTiON
AMOUNT
1
Auer Memorial Home and Cremation Services, Inc.
260.00
Su btotal
260.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H.A (Rev, 6-98)
REV.1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
Debts of decedent must be reported on Schedule I,
FILE NUMBER
21-04-0943
ITEM DESCRIPTION AMOUNT
NUMBER
A, FUNERAL EXPENSES:
See continuation schedule(s) attached 260.00
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Paul Steven Barrick
Social Security Number(s) I E1N Number of Personal Representative(s):
Street Address 1005 Old Eastside Road
City Burns State TN Zip 37029
-
Year(s) Commission paid 2005 5,500.00
See continuation schedule(s) attached
2, Attorney's Fees 2,500.00
See continuation schedule(s) attached
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 145.00
See continuation schedule(s) attached
5, Accountant's Fees
6. Tax Return Preparer's Fees
7, Other Administrative Costs 259.75
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 8,664.75
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev, 6-9B)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-81
PERSONAL REPRESENTATIVE'S
COMMISSIONS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
ITEM
NUMBER
1
Paul Steven Barrick
Burns, TN 37029
DESCRIPTION
159-68-7645 - 5 Old Eastside Road
AMOUNT
5,500.00
Subtotal
5,500.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B1 (Rev. 6-98)
Rev-1502 EX+(6-98)
*'
SCHEDULE H.B2
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTOECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21.04.0943
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Weigle & Associates, P.C. - Attorney Fees
2,500.00
Subtotal
2,500.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev, 6-98)
Rev-1502 EX+ (6-98)
'*
SCHEDULE H-B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills
145.00
.
Subtotal
145.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev. 6-98)
Rev-1502 EX+ (6.98)
*'
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENTOECEOENT
ESTATE OF
Barrick, Paul E
FILE NUMBER
21-04-0943
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Recorder of Deeds - Filing fees for Deeds
80.00
2
Cumberland County Register of Wills - Filing fee for inheritance tax return
15.00
3
Cumberland Law Journal - Legal Advertisement
75.00
4
Valley Times-Star - Legal Advertisement
89.75
Subtotal
259.75
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-9S)
Rev-1512 EX+ (6-98)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
COMMONWEALTH Of' PENNSYLVANIA
INHERITANCE TAXRETURN
RESIDENT DECEDENT
Barrick, Paul E
FILE NUMBER
21-04-0943
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Blue Mountain Anesthesia Assoc.
VALUE AT DATE
OF DEA Tl-I
57.94
2 Lancaster HMA Physicians Management Center of Pennsylvania
10.72
3 Newville Community Ambulance
480.94
4 PPL
262.24
5 Sprint
248.00
TOTAL (Also enter on Line 10, Recapitulation)
1,059.84
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev, 6-98)
R'EV-1513 EX+ (goOD)
.
SCHEDULE .J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Barrick, Paul E 21-04-0943
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
00 Not list Trustee;)
I. TAXABLE DISTRIBUTONS [include outright sr,ousal
C1istributionsg and ransfers
under See, 116(a)(1,2)J
1 John H Barrick Son One-Third 48,156.16
1032 Harrisburg Pike
Carlisle, PA 17013
2 Marilyn E Barrick Daughter One-Third 48,156.16
16 Windy Hill Road
Newville, PA 17241
3 P. Steven Barrick Son One-Third 48,156.15
1005 Old Eastside Road
Burns, TN 37029
Total 144,468.47
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTICNS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION {) TAX IS NOT
BEING MADE
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIG./S
TOTAL OF PART 11- ENTER TOTI'L NON-TAXABLE DISTRIBUTICNS ON LINE 13 OFREV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
.,
'~"''>
\It\\b ( ()\ '\1 Y ,\.\ III. \"'-.\\ 1\\ '\h. ,",
I\R\1I1(' "'-A III \:'-.AI I\A:'-. I-. ( \I :'-.1\\ \11 II
( 111(1--1'\(, ~TATF\lL'\i
Statement Date: 10/31/04
Account #: 138185
Page 1
801
PAUL E BARRICK
16 WINDY HILL ROAD
NEWVILLE PA 17241
***IMPORTANT NOTICE***
The check clearing Act for the 21st Century, also known as Check 21,
goes into effect nationwide on october 28. check 21 will improve our
nation's financial system by streamlining the check-clearing process.
A brochure regarding check 21 is included with this account statement.
BASIC CHECKING
Account #
138185
Account SummarY
Previous Statement Balance
+ Deposits and Other Credits
- Checks Paid or Other Debits
- Service Charges
+ Interest Paid
Ending Balance
Days in Statement Period
Beginning Balance
Activity Ending Balance
09/30/04
2
3
$26.331.73
1.956.28
28,288.01-
.00-
.00
$.00
31
Date
Account Detail
Deposits/Credits
CheckslDebits
Balance
26,331. 73
27,359.01
2 , 1i'8. 1
23,288.01
3,288.01
.00
.00
10-01
10-13
10-13
10-13
10-20
10-31
Activity Description
BEGINNING BALANCE
CUSTOMER DEPOSIT
US TREASURY 303 SOC SEC
CHECK # 882
CHECK # 883
CLOSING TRANSACTION
ENDING BALANCE
1,027.28
929.00
S ,000.00
20,000.00
3,288.01
Check #
Checks Paid ~. Indicates skin in check number
Date
Amount
Check #
Date
Amount
882 10-13
Total Number of Checks:
5,000.00
2
883 10-13
Total Amount of Checks:
20,000.00
S25,OOO.00
END OF STATEMENT
P( ) Bo:--. _-) 12l), (,('Hyshuq~. PA ,.... 52~ . HXHI.-)5'I-A< .NB (22(\,2)
\\.'\\ \\';l( 'nh.colll
,
~ FARMERS NATIONAL BANK
OF NEWVILLE ,IDiIJlJi(iila!~d' ihe/) ,'I:'\;,/i"I/(/!/3rlilk
October 22, 2004
Richard L. Webber Jr., Esquire
WEIGLE & ASSOCIATES, P.C.
126 East King Street
Shippensburg, PA 17257
RE: Estate of Paul Edward Barrick, Deceased
Dear Mr. Webber:
Mr. Barrick had a checking account with this bank in his name alone
which was opened Novembl'r"~6, 1984 and had a date of death balance of
$3,288.01.
He also had a savings account which was opened January 28, 2002 and
was joint with Paul S. Barrick. The October 13, 2004 balance was $46,302.79
with $125.41 accrued interest.
Sincerely yours,
.~~-g(H
Carolyn tl'. Kough '
Executive Vice President
po. Box 1
1! c'--'-'i\r)r-, fA lT~41 ,. orn I/(i.,':!:;d.7.
RENUNCIATION
In Re Estate of
Paul Edward Barrick
deceased.
To the Register of Wills of
Cumberland
County, Pennsylvania.
The undersigned
:) \- Ii',
Inhn n ~riek, son and Marilyn E.
Barrick c1", _ . L, t<- or
)
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
of Administration
be issued to
P. Steven Barrick
WITNESS
Ours
hand this
day of October
~ 200.4
J~
(Address)
0Y;~.!;JaMillfJ
Marilyn E. Barrick
16 Windy Hill Road
Newville, PA 17241
(A4<lI&ss)
:::-..1\
....:'j
C
,
g
Cl
r~"\
(Signature) -;
N
o
OJ
"(Address) .~
, 1111'i.~II" RFV l)/~(,
This is to ccrtify 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 Rccords Office for permanent filing,
I
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this celtificatc. $2,00
11111111""'##""'"''
"",'~~\.1" Of PEj,----'
....~~i1'.r."
$~ -- ~~
~~ '. . f"~~
~~ .,' '. ~~
~~~r.cc~ c':f,..,;;:!
'*~~.'*'
\a "--- ~~
~~ ~ . ~l'
'---}?',o,ffNT- ~\ ~"""""
""""'###'~Jfj/JlIJlll
P 10686135
No.
thn-- fJl tbw~
Local Registrar
OCT 1 5 2004
Date
~
,
d
"""
o
C"J
-1
N
o
!1~143Rev.2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
DATE OF DEATH (Moottl. OilY, Year)
...OCt'Og,!!T 13, 2004
MOTHER'S NAME iFII'SI. Mi<idIe. Maiden SurNlrmt)
1.. Geor 1a M. Houck
INFORMANT'S MAILING ADDRESS iSlfeel, CityfTown, Stile, Zip Code)
..., 1005 Old Eastside Road Burns TN 37029
PLACE OF DISPOSITION. Name 01 Ceme\ety. CrernalOI)' LOCATION. CilyfTown. Slate. Zop Code
orOtharPlaee Cremation Society
21c.of penns lvania Cremator 1d. Harri bur P 171
NAME AND ADDRESS OF FACIL1TY r ma
22c. Services, Inc.) Harrisburg) FA 17109
LICENSE NUMBER DATE SIGN D
(Monttl.Dily.Vellf)
23b. 6.' 23&.
WAS CASE REFERRED TO A MEDICAL EXAMINER ICOROOER?
2.. Yes KJ JL No 0
: Approldmate PART II; OlheJsiQlliflcantcondibon5-COf1tr\tlU1ingIOdeatl1.O\Jt
.,nteevlllbelwee not rll$uIIing,ntile uoder1Ylngcause given ,nPARl t
:oo5-etai\ddeall1
"
,n
2. Male
BlRTHPLACE(Cityaod P
Stale or Foreign CounII')') HO AL
Carlisle, PA tnp.....AlD
1. ..,
FACILITY NAME (II not inS@lIion,give5-treelandl\Umber)
'IT
"
NAME Of DECEDENT (Fnt, Middle, Lut)
1.
AGE (Las-tBo1\'ldily)
Paul Edward Barrick
67
Vn
.,
COUNTY OF DEATH
lb.
Cumberland
oeCEDeNT'S USUAL OCCUPATION
tOI...::.:~,,==::t
Ie. N. Newton Twp.
KINO OF BUSINESS IINDUSTRY
16 Windy Hill Road
AS DECEDENT EVER tN DECEDENT'S EDUCATION
US_ ARMED FORCES? (Spo on! ot" 00
IXI 0 t_olloryl ""oSIr/ .....~
Ye5- No (Q-t2) 12 (1-.4o<S-')
12, U.
17'.SlIIle Pennsylvania
11.. Welder 11b. Trans ortation
OECEDE MAILING ADDRESS iSlreel, CityfTown. State, Zip Code) DECEDENrS
16 Windy Hill Road ~~~~~NCE
Newville, PA 17241 ~~I~S
17b.Countv
Cumberland
D,;
decell8nt
HVflintl
township?
.
...
FATHER'S NAME (First, Midcle, Ltlst)
...
INFORMANT"S NAME (TypelPrint)
...,
ME HQOOFOI liON
Burial D Cremabon ~emovalff'omStale 0
Other(SptK;ify)
.
DATE OF OISPOSlTION
tt.lon1~.O.,. VU'l
October IS, 2004
LiCENSE NUMBER
",", FDI38202
John E. Barrick
Paul S. Barrick
DATE
<
M 21.
V.PARTI: ~__,~""'DI__.-..ftlch.....-""""', Do......_II\oI_."'.rlnt,.u...u..........or....,nl<>..,.rr..t,.~oc~"'h.""'.ilu...
l~onIy_.......Of\""_'
.
,oj
~alIy~llconditiOl'll II
"1ttt,l8edinglollnll'llJ(hta
C8U5-e. Entef UNOERlY1NO
CAUSE (OlMlIIe or iIlury \ '
lMIinilillWldeven\1
reWlingonQlalh) LAST d.
WAS AN AUTOPSV WERE AUTOPSY FINDINGS
PERFORMED? AVAILABlE PRIOR TO
COMPlETION OF CAUSE
OF DEATH?
"
"
o
MANNER OF DeATH
DATE Of INJURY
(lAonlh,o.,.V.ar)
o
o
o ~~CE OF INJUIW
boiIdrlQ,."'_I5!>.<il\'l
301.
IXI
o
o
N....
--
"""""
PeoQInglnve$ligatirnl
COI.Ildnot~determllll>d
"01[]
vesD NOIXl '1'8$0
Ua. 211I.
CERTIFIER (Check only one)
~l~~F=orn~~ls~~:\hc:~~Il-:tc:g.e:tJ'.:==~X:~a;:.r:~~.~.~~~~.~~.~.~~.~.I~.~?~)...
S"jc;de
n.
.PROMOUNCIHG AND CERTIFYING PHVSlCIAN {Physician bO\t1 prorlI;>UOdng deaIII end certilyiflg to cause Q/ deilthl
To ltl.bftI oImyknowtedue,duth occUlTed Itth. lime, date, and place, and due to Ihe Cllll ..(II and ntanner Illtlld,
'MEDtCAL EXAMlNERlCORONER
On Itle...... or eumlnMlon .nd/or tnvutIglllon, In my opinion, d.ath occurred It the time, date. ~ place, Ind dOlI to the callHa(I).nd
--,"uetlted...
~1..
REGISTRAR'S SlQ
RE AND N
JllhN'( I
/1.-j.?/.I.~.1P;~
l:
STAnFlLEt4IM8ER
SOCIAL SECURITY NUMBER
, 209 28 .~
. .
--
co
8394- .
E~on,D
~o
R_.[] :::'1\'10
AC _ArnericanlMian.BlllCI<. V\tlileel
iSpady)
0:=0
WAS DECEDENT OF HlSPANtC ORIGIN?
NoG1V..nllyel,sptdlyC~an.
MeM:., pua'nS'RlUln. e\C
...
White
MARITAL STATUS. Mamed.
Never Maffiell. WdDwed
Oivorcad(Specily)
14. Divorced
17c. 0 Ves.decedeI1t~vedin North
SURVIVING SPOUS€
(W..Io.\Jv.,..,<lenn......1
...
Newton
~o
17d.D ~ithi=a1nt~~:Q/
"'lV/bOro
on
TIME OF INJURV
INJURV AT 'y\()RK7 DESCRIBE HOW INJURY OCCURRED
"
RE: P AUL EDWARD BARRICK, LATE
OF TOWNSHIP OF N. NEWTON,
CUMBERLAND COUNTY, PENNSYLVANIA,
DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
ESTATE NUMBER 21-04-0943
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Paul Edward Barrick
Date of Death: October 13,2004
Will No.
21-04-0943
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 October 21, 2004:
P. Steven Barrick
1005 Old Eastside Road
Bums, TN 37029
John H. Barrick
1032 Harrisburg Pike
Carlisle, P A 17013
Marilyn E. Barrick
16 Windy Hill Road
*w.ville, PA 17241
=r d
"""
Notice has now been given to all persons entitled thereto under Ruld'S.6(a).
CJ
I ~
Date: I D ). ( Ie '-( -<
Signature
.L//{ _ //<
-
0/
:f:~
Name:
Richard L. Webber, Jr., Ew.~ire
"""
Weigle & Associates, P.C.
126 East King Street
Shippensburg, P A 17257
Address:
Telephone: (717) 532-7388
Capacity: Personal Representative
X Counsel for Personal
Representative
0--
WEIGLE & ASSOCIATES, P.c. .- ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1/128-0601
-
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BARRICK PAUL STEVEN
1005 OLD EASTSIDE ROAD
BURNS, TN 37029
-__Uu told
ESTATE INFORMATION: SSN: 209-28-8394
FILE NUMBER: 2104-0943
DECEDENT NAME: BARRICK PAUL EDWARD
DA TE OF PAYMENT: 07/13/2005
POSTMARK DATE: 07/13/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/13/2004
TOTAL AMOUNT PAID:
REMARKS:
CHECK#1389
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
NO. CD 005558
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $6,501.08
I
I
I
I
I
I
I
I
$6,501.08
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
10-03-2005
BARRICK
10-13-2004
21 04-0943
CUMBERLAND
101
APPEAL DATE: 12-02-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~~!_~~9~9_!~~~_~~~~______~___~~!~!~_~g~~~_~g~!!g~_~g~_yg~~-~~~g~~~--~--------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
PAUL E FILE NO. 21 04-0943 ACN 101
BUREAU OF INDIVIDUALC7D~'It!~r
INHERITANCE TAX DIVISION '.., ",.'."
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
'~'''PPRAISEHENT, ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSHENT Of TAX
,.., '" .... - r- '.', ~~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
..,
('~
RICHARD ~,WEBBER JR
WEIGLE 8 ASSOCS
126 EKING ST
SHIPPENSBURG
ESQ
PA 17257
ESTATE OF
BARRICK
REV-1547 EX AFP (06-05)
PAUL
E
TAX RETURN WAS: (X) ACCEPTED AS fILED
DATE 10-03-2005
1 CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule Bl
3. Closely Held Stock/Partnership Interest (Schedule Cl
4. Hortgages/Notes Receiveble (Schedule Dl
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers ISchedule Gl
8. Total Assets
III
(2)
(3)
(4)
(51
(61
(7)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule Hl
10. Debts/Hortgage Liabilities/Liens (Schedule I)
ll. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
l4. Net Value of Estate Subject to Tax
(9)
110)
78,170.00
.00
.00
.00
52.808.96
23.214.10
.00
(8)
8,664.75
NOTE: If an assessment was issued previously. lines 14. lS and/or 16. 17. 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
l7. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Cless B rate (18)
19. Principal Tax Due
.00 X 00 = .00
144,468.47 X 045 = 6,501. 08
.00 X 12 = .00
.00 X 15 = .00
119)= 6,501.08
1.059.84
(11)
112)
113)
114)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
154,193.06
9.7~4 1;9
144,468.47
.00
144,468.47
TAX CREDITS:
"'''T",:", "'".."...... I+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
07 13 2005 "'- CD005558 .00 6,501. 08
TOTAL TAX CREDIT 6,501. 08
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. If PAID AFTER OATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Rl
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 9/14/2006
WEBBER JR RICHARD L
WEIGLE & ASSOCIATES PC
126 E KING STREET
SHIPPENSBURG, PA 17257-1397
RE: Estate of BARRICK PAUL EDWARD
File Number: 2004-00943
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: 10/13/2006
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,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 9/14/2006
BARRICK PAUL STEVEN
1005 OLD EASTSIDE ROAD
BURNS, TN 37029
RE: Estate of BARRICK PAUL EDWARD
File Number: 2004-00943
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: 10/13/2006
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,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/14/2006
BARRICK JOHN H
1032 HARRISBURG PIKE
CARLISLE, PA 17013
RE: Estate of BARRICK PAUL EDWARD
File Number: 2004-00943
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: 10/13/2006
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,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
.'
....
~
"
o
Register of Wills of Cumberland County
_~ STATUS REPORT UNDER RULE 6J2 .42 . I /J
NarneofDecedent~~'.P7~ &~~ """"'~
Date of Death: 9 - ,/5 - r-J-o 6 .y
Estate No.: ~OO -',L-O() 9~3
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 00 No 0
2. Ifthe answer is No, state when the perso r.eprer--:-
the administration will be complete:./ ; ~ 1 I
3. If the answer to No.1 is Yes, state the~OWing:
a. Did the personal representative file a final account with the Court?
Yes @ 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. No EJ
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
/j", JI2..-.~ ,
Sigfiafure
G-
Ja.. t\. (
Name
~PI'4tlcu
Date:
~~x 0Ci.t
lD-g:;> ~ ~~~u c.G '41 \(f
Address
. ,,-y'"
\..i..1 "i" , '. __.:...' _. ,\1 IJ
v'": .--/\j.. \ ".\0
.01 'd~'I.-/ , ,oIU-'tJ
~ IJ ) ~ I
.L :. \ I~J~ \)i.X:\"" I(]
J\ li-"":'
;:y)~~~ , I
Telephone No.
10 : 11 H~ 92 d3S _acity:
o Personal Representative
o Counsel for personal representative
, -1 \
~) . , l' Ci~;!~,! ~\'~'IJ':j
...... ,('II . '+ \ 0-" J"jl 'v~
~;.J JJiJJ'0 -1\- '-. 'o....
~