HomeMy WebLinkAbout02-0337PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Helen R. Burger
also known as N/A, Deceased.
Social Security No.: 172-01-2747
No. 21 -02 - 337
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respeetfu!ly represents that:
Your petitioner who is 18 years of age or older and the Executor named in the last will of the above
decedent, dated December 15, 1997, and codicil(s) dated: None.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or
principal residence at ManorCare, 940 Walnut Bottom Road, Carlisle, PA 17013 (South Middleton
Township).
Decedent, then 89 years of age, died March 5, 2002, at ManorCare, 940 Walnut Bottom Road,
Carlisle, PA 17013 (South Middleton Township).
Except as follows, decedent did not marry, was not divorced and did not have a child bom or
adopted after execution of the will offered for probate; was not the victim of a killing and was never
adjudicated incompetent: No exceptions.
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 3,500.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented
herewith and the grant of letters Testamentary thereon.
Robert E. Burger
126 South Hanover Street
Carlisle, PA 17013
(717) 249-1240
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA )
) SS
COUNTY OF CUMBERLAND )
The petitioner above-named swears or affirms that the statements in the foregoing petition are true
and correct to the best of the knowledge and belief of petitioner and that as personal representative of the
above decedent petitioner will well. and truly administer the estate according to law.
Sworn to or affirmed and subscribed before me ~ ~ ~--~j //~ ~O~'z.~ff.~L.~
this 22nd day of Robert E.' Bhrger c7
MARCH ,2002.
· ?' ? -~/ Ma~y C. Lewis, Register ~/ Signature(s)
21-02-337
LAST WILL AND TESTAMENT
OF
HELEN R. BURGER
I, HELEN R. BURGER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and
codicils.
FUNERAL EXPENSES
FIRST: I direct the payment of my funeral expenses, including my gravemarker,
as soon as may be convenient after my death.
PAYMENT OF DEATH TAXES
SECOND: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of administration of my estate.
BEQUESTS
THIRD: I give the following items to the following individuals who survive me:
(a) To Glenda S. Liebrum, of Carlisle, Pennsylvania, my three-stoned diamond
ring.
(b) To Lisa Bonner, of Fredricksburg, Pennsylvania, my one-diamond diamond
ring.
If any beneficiary shall not survive me, then the gift to such beneficiary shall lapse
and be distributed as a part of my residuary estate.
initials
Helen R. Burger
Wimess
Witness
ACKNOWLEDGMENT and AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, Helen R. Burger, the testatrix in, and
, the witnesses to the last will, the
attached or foregoing instrument, who have signed the instrument, having been duly
qualified according to law do depose and say:
(a) that I, the testatrix, do hereby acknowledge that I signed and
executed the instrument as my last will, that I signed it willingly and as my free
and voluntary act for the purposes therein expressed; and
(b) that we, the wimesses, were present and saw the testatrix sign and
execute the instrument as her last will, that she signed it willingly and executed it
as her free and voluntary act for the purposes therein expressed; that each of us in
the heating and sight of the testatrix signed the will as a witness and that to the
best of our knowledge the testatrix was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
Helen R. Burger, Testatrix,
Wimess
Witness
Notary Public
CERTIFICATION OF NOTICE UNDER RULE 5.6 (c)
Name of Decedent: Helen R. Burger
Date of Death: March 5, 2002
Will No.: 21-02-0337
Admin. No.
To the Register:
I certify that notice of 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 ·
Name
Robert E. Burger
Address
126 South Hanover Street, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE
Date:
Robert R. Black, Esq.
36 South Hanover Street
Carlisle, Pennsylvania 17013
Telephone (717) 243-3727
Capacity:~ Personal Represemative
X Counsel for Personal Representative
REV-1500 EX (600)
COMMONWEALTH Of
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
q~~.~ HARRISBURG, PA 17128-0601
REV 1 500
INHERITANC TAX RETURN
OFFICIAL USE ONLY
FILE NUMBER
21 02
0337
NUMBER
RESIDENT DECEDENT COUN. 0ODE
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Burger, Helen R. 172 - 01 - 2747
t't DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
ILl 03-05-2002 02-24-1913 REGISTER OF WILLS
(,.)
LLI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ N/A - -
Z
LLI
Z
LLI
r~
(.3
r-~--11. Original Return
~-14. Limited Estate
[--'16, Decedent Died Testate (Attach copy of Wifl)
~19. Litigation Proceeds Received
[~]2. Supplemental Return
[-~ 4a. Future Interest Compromise (date of death after 12-12-82)
1~]7. Decedent Maintained a Living Trust (Attach copy of Trust)
----[10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
[~3. Remainder Return (date o1 death prior to 12-13-82)
~15. Federal Estate Tax Retu~ Required
0 8. Total Number of Safe Deposit Boxes
---]11. Election to tax under Sec. 9113(A) (Attach Sch O)
NAME
Robert R. Black, Esquire
FIRM ~~bl% Black
TELEPHONE NUMBER
(717- 243-3727
COMPLETEMAILINGADDRESS
Robert R. Black, Esq.
Landis & Black
36 South Hanover Street
Carlisle, PA 17013
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Padnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Pemonal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
0.00
0.00
0.00
0.00
5,074.50
o.oo
(8)
(9) 4,351.34
(10) 16,830.48
(11)
(12)
(13)
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
OFFICIAL USE ONLY
5,074.40
21,181.82
0.00
0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15)
16. Amount of Line 14 taxable at lineal rate x .0 __ (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
20. []
0.00
0.00
0.00
0.00
0.00
Decedent's Complete Address:
ISTREET ADDRESS ManorCare Carlisle ~'
940 Walnut Bottcm Road
IClTY STATE PA ZIP 17013
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 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 I 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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0, O0
Make Check Payable to: REGISTER OF WILLS, AGENT
'- -'~- III - ~] I'1~1 1~ ............. ~
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the dght to designate who shall use the property transferred or its income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or cam? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [] []
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.
SIGN/~RE~F PERSON RESPONSIBLE FOR FILING RETURN ~fl,.~.D~r~,~
~~~/. ~j~~ Robert 13. Burger, Executor
ADI~RESS
126 South Hanover Street, Carlisle, PA 17013
[]~ y~'~ Robert R. Black, Esquire __
ADDRESS
36 South Hanover Street, Carlisle, PA 17013
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) (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. {}9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child 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. {}9116(a)(1.2)].
The tax rate imposed on the net Value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116(1.2) [72 P.S. {}9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. {}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.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS PERSONAL
PROPERTY
Estate of
Helen R. Burger
Include the proceeds of litigation and the date the proceeds were received by the estate. All property joint-owned with the
right of survivorship must be disclosed on Schedule F.
Item Value at Date
Number Description of Death
1. M&T Bank, checking account #603023. See attached letter. $5,074.50
File Number
21-02-0337
TOTAL (also enter on line 5, Recapitulation) $5,074.50
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Estate of File Number
Helen R. Burger 21-02-0377
Debts of decedent must be reported on Schedule I.
ITEM
N-UMBER DESCRIPTION AMOUNT
A.
Bo
5.
6.
7.
8.
Funeral Expenses:
Hof~i-uan-Roth Funeral Home
Administrative Costs:
Personal Representative Commissions
Robert E. Burger
Social Security No.
126 South Hanover Street, Carlisle, PA 17013
Year Commissions paid: 2003
Attorney Fees - Landis & Black (estimated)
Family Exemption
Claimant: None
Probate Fees - Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Return unearned Social Security check to U.S. Treasury
Register of Wills, file account
$147.95
TOTAL (Also enter on line 9, Recapitulation) $4,351.34
$2,000.00
$215.39
$1,363.00
$125.00
$500.00
Estate of
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
Helen R. Burger
Include unreimbursed medical expenses.
Item
Number Description Amount
File Number
21-02-0377
ManorCare Carlisle, nursing home care.
Department of Public Welfare, estate recovery program
$541.92
$16,288.56
TOTAL (Also enter on line 10, Recapitulation) $16,830.48
LAST WILL AND TESTAMENT
OF
HELEN R. BURGER
I, HELEN R. BURGER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and
codicils.
FUNERAL EXPENSES
FIRST: I direct the payment of my funeral expenses, including my gravemarker,
as soon as may be convenient after my death.
PAYMENT OF DEATH TAXES
SECOND: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of administration of my estate.
BEQUESTS
THIRD: I give the following items to the following individuals who survive me:
(a) To Glenda S. Liebmm, of Carlisle, Pennsylvania, my three-stoned diamond
ring.
(b) To Lisa Bonner, of Fredricksburg, Pennsylvania, my one-diamond diamond
ring.
If any beneficiary shall not survive me, then the gift to such beneficiary shall lapse
and be distributed as a part of my residuary estate:
initials
DISTRIBUTION OF RESIDUE
FOURTH: I give the rest of my estate to my son, Robert E. Burger.
POWERS OF EXECUTOR/RIX
FIFTH: I confer upon my executor the right to sell or otherwise convert any real
or personal property at public or private sale, at such time or times, in such manner, and
for such price or prices, and upon such terms and conditions as my executor shall
determine, and to execute and deliver good and sufficient conveyances, assignments and
transfers thereof, without liability of any purchaser for the application of any
consideration; to borrow money and to secure its payment by mortgage of real or personal
property, pledge of investments or otherwise, without liability on the part of the lenders
to see to the application thereof; to retain any investments at discretion; to invest and
reinvest at discretion, without restriction to so-called "legal investments;" to make
distribution in cash or in kind; and to do all other acts and things necessary or appropriate
in the management, administration and distribution of my estate.
APPOINTMENT OF EXECUTOR/RIX
SIXTH: I appoint my son, Robert E. Burger, executor of my will. I direct that
my executor shall not be required to furnish security in any jurisdiction.
INTERCHANGEABILITY OF LANGUAGE
SEVENTH: Words used in the singular may be read to include the plural or the
plural may be read as the singular. Similarly, the masculine form may be read to include
the feminine and neuter; the feminine may be read to include the masculine and neuter;
and the neuter may be read to include the masculine and feminine.
HEADINGS
EIGHTH: The headings used on the various paragraphs of this will are included
for convenience only and shall have no legal significance.
initials
I have signed this will this of C¢]44t~/~ 1997.
Helen R. Burger
Wimess
Wimess
ACKNOWLEDGMENT and AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, Helen R. Burger, the testatrix in, and
)
, the witnesses to the last will, the
attached or foregoing instrument, who have signed the instrument, having been duly
qualified according to law do depose and say:
(a) that I, the testatrix, do hereby acknowledge that I signed and
executed the instrument as my last will, that I signed it willingly and as my free
and voluntary act for the purposes therein expressed; and
(b) that we, the wimesses, were present and saw the testatrix sign and
execute the instrument as her last will, that she signed it willingly and executed it
as her free and voluntary act for the purposes therein expressed; that each of us in
the heating and sight of the testatrix signed the will as a wimess and that to the
best of our knowledge the testatrix was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
Helen R. Burger, Testatrix,
Wimess
Wimess
Notary Public
IlmlERT It BL.qCK, I~OT, ARY Iq, mI, J~
~.,ARU,SI,,.E IIORO.. CUMBERL/IND CO., IIR,.
,. MY COMMISSION EXPIRES SEPt EOf 2001
May 30, 2002
Estate Search
The Estate of:
Date of Death (D.O.D.)
To Whom It May Concern:
HELEN R BURGER
3/5/2002
Identified below is the account information requested.
1. M&T Bank accounts in which the decedent's name appears:
Account Account Number Account Title
Type
CHK 603023
Opening Branch
MRS HELEN R BURGER 4319
D.O.D. Accrued Interest
Balances
(Includes Accr.
Int.)
$5074.50 $.00
2. Loans, Mortgages, or other obligations titled in the decedent's name
Account Number Amount Owed Account Description
No Safe Deposit Box titled in the Decedent's name existed at our office.
If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724-
2440 outside of the Buffalo, NY calling area. Thank you.
Sincerely,
M&T BANK CORPORATION
Authorized Signature
DATE: ">'--- 7~0- 0 2---
Manufacturers and Traders Trust Company · 1100 Wehrle Drive, RO. Box 767, Buffalo, NY 14240-0767
LANDIS & BLACK
ROBERT R BLACK ESQUIRE
36. SOUTH HANOVER ST
CARLISLE PA 17013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERA'RONS
ESTATE RECOVERY PRO~RAM
PO BOX ~48~
HARRISBURG, PA 17105-8486
April 24, 2002
Re: HELEN BURGER
CIS #: 310153282
SSN: 172-01-2747
Date of Death: 03/05/2002
Dear Attorney Black:
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $21,588.23 against the above-mentioned estate. This
claim is for restitution of medical assistance granted on behalf of the
decedent for which the Probate Estate is now responsible to reimburse the
Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as
amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's
itemized statement of claim.
A portion of this medical expense, namely $16,288.56, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $5,299.67, is
to be entered as a priority Class 6 claim against the estate.
Please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected. If the
estate accounting is complete, please provide a copy. If the estate contains
real estate, please provide copies of the deed, the latest tax assessment,
and a current appraisal, if available.
Sincerely,
Carl G. Rinkevich
TPL Program Investigator
717-772-6258
717-772-6553 FAX
Enclosure
BUREAU OF ZNDZVZDUAL TAXES
TNHERZTAHCE TAX DZVZSTON
DEPT. 180601
HARRZSBURG, PA 17118-0601
ROBERT R BLACK ESQ
56 S HANOVER ST
CARLISLE
COHHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
- '-~ DATE
Re~:~:~: i~. ESTATE OF
DATE OF DEATH
FZLE NUHBER
'03 JUN -6 All :4~OUNTY
ACN
170,~,~1 ~- . : .~
PA
I
06-05-2005
BURGER
05-05-2002
21 02-0557
CUHBERLAND
101
Amount
REV-15~i7 EX AFP (01-OS)
HELEN R
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGTSTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
CUT ALONG THzS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS -~
REV-15~7 EX AFP (01-03) NOTZCE OF ZNHER]:TANCE TAX APPRA]:SEHENT~ ALLONANCE OR D]:SALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF BURGER HELEN R FZLE NO. 21 02-0:5:57 ACN 101 DATE 06-0:5-200:5
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORI6INAL RETURN
I Real Estate (Schedule A)
2 Stocks and Bends {Schedule B)
$ Closely Held Stock/Partnarsh/p Interest (Schedule C)
Nortgagas/Notas Receivable (Schedule D)
Cash/Bank Dopes/ts/N/sc. Personal Proper~y (Schedule E)
6 Jo/ntly O~nad Property (Schedule F)
7 Transfers (Schedule O)
8 Total Assets
APPROVED DEDUCTZONS AND EXENPTZONS:
9 Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H)
10 Debts/Nortgage L/ab/1/t/es/L/ans (Schedule I)
11 To~al Deductions
Net Value of Tax Return
(1)
(2)
(3)
(~)
(;) 5/07r,.50
(e) .00
.00 NOTE: To insure proper
.00 credit to your account,
.00 subm/t the upper port/on
.00 of th/s form ~/th your
tax payment.
(7) .00
(8)
(9)
5,07~.50
ASSESSHENT OF TAX:
15. Amount of L/ne 1~ at Spousal rate
16. Amount of LAne lq taxable at Lineal/Class A rata
17. Amount of L/ne 1~ at Sibling rate
18. Amount of L/ne 1~ taxable at Collateral/Class B rata
19. Pr/nc/pal Tax Due
TAX CREDZTS:
PAYHENT RECEIPT' DISCOUNT
DATE NUHBER ~NTEREST/PEN PA~D (-)
ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULAT/ON OF ADDITIONAL INTEREST.
15
NOTE:
(15) .00 X O0 = .00
(16) .00 X 0~5= .00
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= . O0
reflect fLgures that lnclude the total of ALL returns assessed to date.
AHOUNT PAZD
TOTAL TAX CREDZT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
( ZF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) . O0
Net Value of Estata Sub,oct to Tax (lq) 16,107
Z~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
.00
.00
.00
.00
(lO)
16,830.~8
(11) 21.181.82
(12) 16,107.:52-
ESTATE OF HELEN R. BURGER,
Deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 0~- 0337
FIRST AND FINAL ACCOUNT OF
ROBERT E. BURGER, EXECUTOR OF THE
ESTATE OF HELEN R. BURGER,
LATE OF SOUTH MIDDLETON TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA
Date of Death:
Letters Testamentary Granted:
Letters Advertised:
Sentinel -
Cumberland Law Journal -
Account Stated as Final
March 5, 2002
April 3, 2002
May 10, 17 & 24, 2002
May 17, 24 & 31, 2002
SUMMARY & INDEX
PRINCIPAL
Receipts
Conversions (Gain) or (Loss)
Less Disbursements
Balance Before Distributions
Advancements to Beneficiaries
Principal Balance Remaining
PAGE
2 3,711.50
0.00
2 - 2,926.31
785.19
- 0.00
785.19
INCOME
Receipts
Less Disbursements
Income Balance Remaining
3 7.00
3 - 0.00
7.00
COMBINED BALANCE REMAINING $ 792.19
5/30/02
RECEIPTS OF PRINCIPAL
Close classic checking account #603023 at M&T Bank
$3,711.50
Total Receipts of Principal
$3,711.50
2002
9/9
2003
3/5
DISBURSEMENTS OF PRINCIPAL
ManorCare Carlisle, nursing home care
Landis & Black, attorney fees and costs advanced as follows:
Attorney fees, 9.8 hours ~ $130 per hour $1,274.00
Register of Wills, probate Will 42.00
Register of Wills, short certificate 3.00
Cumberland Law Journal, advertise Letters 75.00
Register of Wills, short certificates 6.00
The Sentinel, advertise Letters 74.39
Reserved:
Robert E. Burger, Executors fee
Landis & Black, attorney fees for preparation, execution and filing
First and Final Account, preparation of Notices, approval of Account
and final closing and distribution
Register of Wills, Final Account filing fee estimate
Total Disbursements of Principal
541.92
1,474.39
500.00
260.00
150.00
$ 2,926.31
2002
2003
RECEIPTS OF INCOME
Orrstown Bank
Orrstown Bank
Total Receipts of Income
5.30
1.70
$ 7.00
DISBURSEMENTS OF INCOME
None
Total Disbursements of Income
0.00
ESTATE OF HELEN R. BURGER, ·
Deceased ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 03 - 0337
SCHEDULE OF PROPOSED DISTRIBUTION
TO:
Combined Balance for Distribution Remaining as per
First and Final Account
Commonwealth of Pennsylvania, Department of Public
Welfare (Estate Recovery Program)
$ 792.19
$ 792.19
TOTAL BALANCE FOR DISTRIBUTION
$ 792.19
ROBERT E. BURGER, Executor under the Last Will and Testament of HELEN R.
BURGER, deceased, hereby declares under penalties of perjury that he has fully and faithfully
discharged the duties of his office; that the foregoing First and Final Account is true and correct
and fully discloses all significant transactions occurring during the accounting period; that all
known claims against the estate have been paid in full; that the first complete advertisement of the
grant of letters was more than four months from the date the account was filed; that, to his
knowledge, there are no claims now outstanding against the Estate; and that all taxes presently
due from the estate have been paid. He understands that false statements herein are made subject
to the penalties of 18 Pa. C.S.A. 4904 relating to unsworn falsification to authorities.
Robert E. Burger, Execut6~
LAST WILL AND TESTAMENT
OF
HELEN R. BURGER
I, HELEN R. BURGER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and
codicils.
FUNERAL EXPENSES
FIRST: I direct the payment of my funeral expenses, including my gravemarker,
as soon as may be convenient after my death.
PAYMENT OF DEATH TAXES
SECOND: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of administration of my estate.
BEQUESTS
THIRD: I give the following items to the following individuals who survive me:
(a) To Glenda S. Liebrum, of Carlisle, Pennsylvania, my three-stoned diamond
ring.
(b) To Lisa Bonner,' of Fredricksburg, Pennsylvania, my one-diamond diamond
ring.
If any beneficiary shall not survive me, then the gift to such beneficiary shall lapse
and be distributed as a part of my residuary estate:
initials
FOURTH:
DISTRIBUTION OF RESIDUE
I give the rest of my estate to my son, Robert E. Burger.
POWERS OF EXECUTOR/RIX
FIFTH: I confer upon my executor the right to sell or otherwise convert any real
or personal property at public or private sale, at such time or times, in such manner, and
for such price or prices, and upon such terms and conditions as my executor shall
determine, and to execute and deliver good and sufficient conveyances, assignments and
transfers thereof, without liability of any purchaser for the application of any
consideration; to borrow money and to secure its payment by mortgage of real or personal
property, pledge of investments or otherwise, without liability on the part of the lenders
to see to the application thereof; to retain any investments at discretion; to invest and
reinvest at discretion, without restriction to so-called "legal investments;" to make
distribution in cash or in kind; and to do all other acts and things necessary or appropriate
in the management, administration and distribution of my estate.
APPOINTMENT OF EXECUTOR/RIX
SIXTH: I appoint my son, Robert E. Burger, executor of my will. I direct that
my executor shall not be required to furnish security in any jurisdiction.
INTERCHANGEABILITY OF LANGUAGE
SEVENTH: Words used in the singular may be read to include the plural or the
plural may be read as the singular. Similarly, the masculine form may be read to include
the feminine and neuter; the feminine may be read to include the masculine and neuter;
and the neuter may be read to include the masculine and feminine.
HEADINGS
EIGHTH: The headings used on the various paragraphs of this will are included
for convenience only and shall have no legal significance.
initials
I have signed this will this of C~]44t~ ~ 1997.
Helen R. Burger
Wimess
Wimess
ACKNOWLEDGMENT and AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, Helen R. Burger, the testatrix in, and
)
, the wimesses to the last will, the
attached or foregoing instrument, who have signed the instrument, having been duly
qualified according to law do depose and say:
(a) that I, the testatrix, do hereby acknowledge that I signed and
executed the instrument as my last will, that I signed it willingly and as my free
and voluntary act for the purposes therein expressed; and
(b) that we, the wimesses, were present and saw the testatrix sign and
execute the instrument as her last will, that she signed it willingly and executed it
as her free and voluntary act for the purposes therein expressed; that each of us in
the hearing and sight of the testatrix signed the will as a wimess and that to the
best of our knowledge the testatrix was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
Helen R. Burger, Testatrix,
Wimess
Witness
Notary Public
CARUSI.( IIORO.. CUMBERL3VtD CO.,
,., MY COMMISSION EX~IR~$ SEPT. ]O~ 2OOl
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 2/02/2005
BLACK ROBERT R
36 S HANOVER STREET
CARLISLE, PA 17013
RE: Estate of BURGER HELEN R
File Number: 2002-00337
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within 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 will become delinquent on: 3/05/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~c
GLENDA~~~
REGISTER OF WILLS
cc: File
Personal Representative(s)
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Will No.:
STATUS REPORT UNDER RULE 6.12
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Admin. No.:
Name of Decedent:
Date of Death:
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:
I. State ~ether administration of the estate is complete:
Yes f}Q No 0
2. lfthe answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. lfthe answer to No. I is Yes, state the following:
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 0 No 0
c. Copies ofreceipts, 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 ^ Q
Date:3f1--/btf ~l1jRL(t ~~
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Telephone No.
Capacity:
Qlersonal Representative
~ounsel for personal representative
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
ANDREWS TAYLOR P
78 W POMFRET STREET
CARLISLE, PA 17013
RE: Estate of DOERWANG JOSEPH F
File Number: 2004-00363
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. I, for decedents dying on or after
July I, 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:
4/14/2006
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)
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