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HomeMy WebLinkAbout02-0374PETITION FOR PROBATE & GRANT OF LETTERS Estate of WOODROW W. BRETZ also known as Social Security No. 177-16-0111 deceased. NO. 21-02- .~t~1~1'~ TO: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who is 18 years of age or older and the Executor named in the Last Will of the above decedent dated June 12, 1990, and codicils dated none ,19 . The Executrix named Mary E. Bretz died January 9, 1997 . Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 770 Poplar Church Road, Camp Hill, East Pennsboro Township Decedent, then 84 years of age, died West Shore Health & Rehab Center February 16 ,2002, at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $1,000.00 (If not domiciled in PA) Personal property in PA $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania, situated as follows: $90,000.00 1926 Chatham Drive, Camp Hill, Lower Allen Township, Cumberland County WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): Renold E. Bretz 210 Mtn. View Road Shermansdale, PA 17090 717-582-4621 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · SS The Petitioner(s) above named swear(s) or afffirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 11th day of Renold E. Bretz No. 21-02- ~q~6t Estate of WOODROW W. BRETZ, deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, April '11 , 2002, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 12, 1990 described therein be admitted to probate and filed of record as the Last Will of Woodrow W. Bretz ; and Letters Testamentary are hereby granted to Renold E. Bretz FEES Probate, Letters, Etc ........ $ 200.00 Short Certificates(~1- ) .... $ 3.00 Renunciation(s) ........... $ JCP .................... $ 5.00 Other Will Pages (-3-) .... $9.00 TOTAL: .... $ 217.00 Filed...4.-.1.1.-.50.02 ................ called atty on 4-11-02 -~T,~WZm; g' o s IRWIN McKNtGHT &,,HUGHES ...,-'V~..(,,~__~ ~. ~_c-~.__ Roger B.,,IrWin, Esquire (06282) ATTORN(E?/(Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE LAST WILL AND TESTAMENT OF WOODROW W. BRKTZ I, WOODROW W. BRETZ, of the Township of Lower Allen, County of Cumberland and State of Pennsyvlania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and whereso- ever the same may be situate, to my wife, NARY E. BRETZ, absolutely and unconditionally. Be In the event that my wife, MARY E. BRETZ, should predecease me, or should she die at about the same time as I do, such as in an accident common to both of us, then in either such event, I direct the settlement and distribution of my estate to be made in the following manner, to wit: -1- (a) I give and bequeath my Piano and the Stool thereto to my daughter, DARLENE F. FORBES. (b) I give and bequeath my Glider Rocker and my Bathroom Lamp to my daughter, KATHI g. ~INCHMOFF. (c) I give, dE.vise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever the same may be situate, to my three (3) children, to wit, my son, P,~NOLD E. BRETZ, my daughter, DAKLENE F. FORBES, and my daughter, KATHI g. MINCHHOFF, share and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my wife, MARY E. BRETZ, Executrix of this, my Last Will and Testament, and in the event that my said wife should predecease me, or should she be unable or un- willing to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my son, P, ENOLD E. BRETZ, Executor of this, my Last Will and Testament, in her place and stead. IN WITN~SS WMERgOF, I have hereunto set my hand and seal this 12th day of June, A. D. 1990. .... k~6odrow W. Bretz ~ (SEAL) -2- Signed, sealed, published and declared by the above-named WOODROW W. BRgTM, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as wit- messes. -3- COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, WOODROW W. BP. ETZ , the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed; for the purposes therein contained. Sworn and affirmed to and acknowledged before me by WOODROW W. BP. ETZ , the testat or , this 12th day of June , A. D. 1990. COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. NOTARIAL SEAL MARY S, ROBINSON, NOTARY PUBLIC MECHANICSBURG BO~O. CUMBERLAND CO. My C~mmisslon Expires Sept. 21, 1991 We, the undersigned, J. ROBERT STAUFFER and JOEEN N. EAICIN , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat or , WOODROW W. BRETZ , sign and exe- cute the instrument as his~hV~ Last Will and Testament; that the said testat or , WOODROW W. BI~ETZ , executed it as his/h~mx free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testat or , signed the Will as witnesses; and that to the best of our knowledge, the testat or was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence· Sworn and subscribed to before me this 12th day of JUne , 1990 NOTARIAL SEAL MARY S. RtBINSON, NOTARY PUBLIC MECHANICSBUR$ BORO, CUMBERLAND CO. C~mmtssion Expires SeMt. 21, 1991 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) WOODROW W. BRETZ Name of Decedent: Date of Death: Estate No.: FEBRUARY 16, 2002 21-02-0374 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 26, 2002 . Name Renold E. Bretz Darlene F. Forbes Kathi E. Minchhoff Address 210 Mm. View Road, Shermans Dale, PA 17090 509 South 9th Street, Berthoud, CO 80513 814 Greenwood Drive, Berthoud, CO 805113 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none. Date: 04/26/02 Signature IRWIN, McKNIGHT & HUGHES Capacity: Name Roger B. Irwin, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Telephone (717) 249-2353 X Personal Representative Counsel for Personal Representative REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21- 02 - 0374 COUNTYCODE YEAR NUMBER D E C E D E N T cAPB HpRL EpIO CRAC KOTK ES R 5. E C A 6. P I T U 7. L A T 8. I O 9. N 10. 11. 12. 13. 14. C O M mu" T I O N DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Bretz Woodrow W. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 02/16/2002 06/04/1917 (IF APPLICABLE) SURVIV NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 177-16-0111 THIS RETURN MUST BE RLED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ 1. Original Return ~ 2~4~.. Supplemental Return M 4. Limited Estate . Future Interest Compromise (date of death after 12-12-82) 5. Decedent Died Testate Decedent Maintained a Living Trust 0 (Attach copy of Will) (Attach copy of Trust) ~ 9. L,tigation Proceeds Received r--] 10. spousal Poverty Credit r-~ (date of death between 12-31 ~91 and 1 - 1-95) (date of death 3. Remainder Return prJorto 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Roger B. Irwin Esq. FIRM NAME (If Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 717/249-23~3 COMPLETE MAILING ADDRESS 60 West Pomfret Street 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship Mortgages & Notes Receivable (Schedule D) (4) Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11 ) West Pomfret Professional Bldg. Carlisle, PA 17013 80,600.00 None None None 1,755.85 None None 19,190.91 104,709.86 OFFICIAL USE ONLY (8) .~ 82,355.85 (11) 123,900.77 (12) (41,544.92) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) X .0 0 16. Amount of Line 14 taxable at lineal rate (41,544.92) X .0 45 (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) (41,544.92) 0.00 0.00 0.00 0.00 0.00 Copyright (c) ZO00 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 1926 Chatham Drive CITY Camp Hill STATE ?A ZIP 170.13. Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) O. O0 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest ;. Penalty Total Interest/Penalty ( D + E ) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer andi Yes No a. retain the use or income of the proper~y transferred; ......................... ~ ~ b. retain the right 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 care? ................... 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Renold E. Bretz DATE i- 6Db- .................... r/o SIGNATUREOF PREPAREROTHER THAN R ESENTATIVE IRWIN Mc~IC~ & ~CHES DATE ~ ~ ~ 60 West Pomfret Street ~ ~ For date~~r after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the vivi.g i /o P.s. (i)]. For dates of d~atfi on or after Janua~ 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 statuto~ requim~nts for disclosure of assets and filing a tax return are still applicable even if t~ surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The ~x rate imposed on the net value of transfers from a deceased child twang-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 dece~ent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 91 ~ S(a)( ~ )]. 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 com~n with the decedent, whether by blood or adoption. Copyright (c) gO00 form software on~ The Lackner Group. Inc. Form R~V-1~00 EX (Rev. REV- 150Z EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Woodrow W. Bretz SS# 177-16-0111 SCHEDULE A REAL ESTATE 02/16/2002 FILENUMBER 21-02-0374 All real property owned solely or aa a tenant in common must be reported st fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowled~]e of the relevant facts. Real property which is jointly-owned with right of survivorship must be disck?_ed on Schedule F. ITEM NUMBER DESCRIPTION 1926 Chatham Drive, Lower Allen Township, Camp Hill County (settlement sheet attached) Cumberland TOTAL (Also enter on line 1, Recapitulation) , (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. VALUE AT DATE OF DEATH 80,600. O0 $ 80,600.00 Form REV-1502 EX (Rev. 1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Woodrow W. Bretz SS# 177-16-0111 02/16/2002 21-02-0374 Include the .proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION M&T Bank, checking account TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. VALUE AT DATE OF DEATH 1,755.85 $ 1,755.85 Form REV-1508 EX (Rev. 1-97) R£V-~S. ~+(~-97) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF Woodrow W. Bretz SS~; 177-16-0111 02/16/2002 FILE NUMBER 21 - 02 - 0374 Debts of decedent must be reported on Schedule I. ITEM NUMBER Ao 2 3 4 DESCRIPTION FUNERAL EXPENSES: Parthemore Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Renold F. Bretz Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 210 Htn. View Road C~y Shermans Dale State PA Year(s) Commission Paid: ~ Attorney's Fees IRWIN McK~IG['D' & h~dC[-LES Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant zipl7090 Street Address c~ Relationship of Claima~ ~ Decede~ Pmbata Res Register of Wills Accountant's Fees ~x R~urn Preparer's Res Other Administrative Co~s Charges on sale of real Cumberland Law Journal Register of Wills The Sentinel - Legal State Zip estate - estate notice publication filing fee estate notice publication TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 3.00 4,100.00 4,100.00 217.00 10,582.08 75.00 20.00 93.83 $ 19,190.91 Copyright (c) 1996 form software only CPSysterr=, Inc. Form REV-1511 EX (Rev. 1-97) REV-151Z EX + (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, AND LIENS ESTATE OF Woodrow W. Bretz SS~/ 177-16-0111 02/16/2002 FILE NUMBER 21-02-0374 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Commonwealth of PA, DPW; restitution TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 104,709.86 $ 104,709.86 Copyright (c) 1996 form software only CPSystems. Inc. Form REV- 1512 EX (Rev. !-97) 'REV-IS13 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT E$¥ATE OF Woodrow W. Bretz SS~; 177-16-0111 SCHEDULE J BENEFICIARIES 02/16/2002 NUMBER I. 3 I1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DI:5/HiBUTIONS [fnclude outright spousal distributions, and tra~fem under S~. 911~a~1.2)] Renold E. Bretz 210 Mt. View Road Shermans Dale, PA 17090 Darlene F. Forbes 509 South 9th Street Berthoud, CO 80513 Kathi E. Mtnchhoff 814 Greenwood Drive Berthoud, CO 80513 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Daughter Daughter FILE NUMBER 21- 02- 0374 AMOUNT OR SHARE OF ESTATE 1/3 remainder 1/3 remainder 1/3 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS $ 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If mom space is needed, insert additional sheets of the same size) copyrlg ht (c) 2000 form software only The Lackner Group, Inc, Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT OF ~OODRO~ ~. BRETZ I, WOODROW W. BRETZ, of the Township of Lower Allen, County of Cumberland and State of Pennsyvlania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and whereso- ever the same may be situate, to my wife, MARy E. BRETz, absolutely and unconditionally. In the event that my wife, NARy E. BRETZ, should predecease me, or should she die at about the same time as I do, such as in an accident common to both of us, then in either such event, I direct the settlement and distribution of my estate to be made in the following manner, to wit: -1- (a) I give and bequeath my Piano and the Stool thereto to my daughter, DARLENE F. FORBES. (b) I give and bequeath my Glider Rocker and my Bathroom Lamp to my daughter, ~,ATMI g. MINCMMOFF. (c) I give, devise and bequezth all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever tte same may be situate, to ~y three (3) children, to wit, my son, RENOI~ E. BRETZ, my daughter, DARLENE F. FORBES, and my daughter, ~ATMI E. MINC~MOFF, share and share alike, per stirpes. I~TLy, I nominate, constitute and appoint my wife, MARY E. BRETZ, Executrix of this, my Last Will and Testament, and in the event that my said wife should predecease me, or should she be unable or un- willing to serve in such capacity.for any reason, then in such event, I nominate, constitute and appoint my son, RENOLD E. BRETZ, Executor of this, my Last Will and Testament, in her place and stead. IN WITNESS W~EREOF, I have hereunto set my hand and seal this 12th day of June, A. D. 1990. -2- Signed, sealed, published and declared by the above-named WOODROW W. BRETZ, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as wit- messes. -3- COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. I, WOODROW W. BRETZ , the testat or whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed~ for the purposes therein contained. Sworn and affirmed to and acknowledged before me by WOODROW W. BRETZ , the testat or , this 12th day of June , A. D. 1990. " COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) I NOTARIAL SEAL MARY S, ROBINSON, NOTARY PUBLIC MECHANICSBURG BO~O. CUMBERLAND CO, ~y Commission Expires Sept. 21, 109i SS. We, the undersigned, J. ROBERT STAUFFER and JOHN M. EA~IN , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat or , WOODROW W. BRETZ sign and exe- cute the instrument as hisj~F~r Last Will and Testament; that the said testat or , WOODROW W. BRETZ , executed it as his/h~xfree and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testat or , signed the Will as witnesses; and that to the best of our knowledge, the testat or was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subscribed to before me this i2th day of Jdhe , 1990 MaY S. Re$INSO,. NOTARY ~'t~BtIC ~tsston Expires ae~t · . OMB NO. 2502-0265 ,,~'~ U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT SETTLEMENT STATEMENT B. TYPE OF LOAN: 1.[~FHA 2.DFmHA 3. DCONV. UNINS, 4.l--]VA 5. E]CONV. INS FILE NUMBER: 7. LOAN NUMBER: GRAFF 30-002316 8. MORTGAGE INS CASE NUMBER: 441-6957231 C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown, Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1 0 3198 (Graft pfd/GRAFFI24) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: JENNIFER L. GRAAF CARDINAL FINANCIAL COMPANY G. PROPERTY LOCATION: 1926 CHATHAM DRIVE CAMP HILL, PA 17011 CUMBERLAnd County, Pennsylvania RENOLD E. BRETZ, Executor of the Estate of Woodrow W. Bretz H. SETTLEMENT AGENT: 23-2402316 PURITY ABSTRACT COMPANY PLACE OF SETTLEMENT 3329 Market Street Camp Hill, PA 17011 I. SETTLEMENT DATE: July 30, 2002 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 101. Contract Sales Price 102. Personal Property 103. Settlement Charges to Borrower (Line 1400) 104. 2002-03 SCHOOL TAX to BONNIE MILLER, TREASU 105. Adjustments For Items Paid By Seller in advance 106. County/Twp Taxes 07/30/02 to 01/01/03 80,600.00 107. City Tax to 108. School Tax to 109. :410. :111. J112. 4,532.22 907.45 K. SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract Sales Price 402. Personal Property 403. 404. 405. Adjustments For Items Paid By Seller in advance '406. County/TwpTaxes 07/30/02 to 01/01/03 407. City Tax to 408. School Tax to 409. 41U. 411. 80,600 00 127.79 412. 120. GROSSAMOUNTDUEFROMBORROWER 86,167.46 420. GROSSAMOUNTDUE TO SELLER 80,727 79 2,000.00 79,967.00 2,500.00 1,821.73 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 201. Deposit or earnest money 202. Principal Amount of New Loan(s) 203. Existing loan(B) taken subject to 204. GIFT CHECK '2'~--5. 206. 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 501. Excess Deposit (See Instructions) 502. Settlement Charges to Seller (Line 1400) 503. Existing loan(s) taken subject to 504. Payoff of first Mortgage 505. Payoti' ot second Mortgage 506. 507. (Deposit disb. as proceeds) 8,68825' 207. 208. 209. CLOSING COST/PREPAIDS CREDIT Adjustments For Items Unpaid By Seller 508. 509. CLOSING COST/PREPAIDS CREDIT 1,821 73 Adjustments For Items Unpaid By Sefler L. SETTLEMENT CHARGES ...... 700. TOTAL COMMISSION Based on Price $ 80,600.00 @ 6.0000 % 4,836.00 PAID FROM PAID FROM L)IVISIOn O! E;ommlsslon (line /OD) as l-o/lows: BORROWER'S SELLER'S /U1. $ 2,44;~.UU tO ICH AGbNr._;y/GMA(J Mb. FUNDSAT FUNDSAT /82. ~ 2,:5b~U.UU tO UI::N I UI~Y 21 I-'IUL.;IUNI-NI I~t:AL I Y, lNG. SETTLEMENT SETTLEMENt 7U3. L;ornmiss~on Pa~d al :Settlement 4,836.d'0' /U4. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN .,, 801. Loan Origination Fee 1.0000 % to CONSUMER MCR I GAGE SERVICES, INC. 787.86 ..... 802. Loan Discount 1.3800 % to CARDINAL FINANCIAL COMPANY 1,099.55 uu~. Appraisal I-ee to -- !uu4, tJrea]t h~eport to 1805. Lender's Inspection l-ee to ; 80{5 Flood Cert Fee to BO/. AUUtGNMEN I bb..b_ SZb tO I-'L) ICY LENL)bR I UU8. AL)MINI:5 t kAI lYE bbb to CARDINAL PINANCIAL COMPANYI 499 8L)Y. ICR(DKbR L)ISUOUNI HLZN I tO CONUUMbh~ MOM t (5AMP_ SERVICES. INC. ~/q OO !~ z'9$Z O0 g/~ IN3~±V3W± AH3991± ~ ~J39HO318 o1 wawnsvBw± 'WB]91V~ 31NNO8 ol dlHSNMO_L N3]]¥ ~JBAAO] o) '3NI '.l. 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To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: WOODROW W BRETZ 2/16/2002 Account Account Number Account Title Opening Branch D.O.D. Accrued Interest Type Balances (Includes Accr. Int.) CHK 1290924 WOODROW W BRETZ 4320 $1755.85 $.00 OPENED 5/96 C/O RENOLD BRETZ 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 Authorize~t~]gnamre o" DATE: q "~ ~ '"- 0 ~ Manufacturers and Traders Trust Company · 1100 Wehrle Drive, RO. Box 767, Buffalo, NY 14240-0767 IRWIN MCKNIGHT & HUGHES MARK D SCHWARTZ ESQUIRE WEST POMFRET PROF BLDG 60 WEST POMFRET ST CARLISLE PA 17013-3222 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 April 02, 2002 IRWIN, Re: WOODROW BRETZ CIS #: 250146492 SSN: 177-16-0111 Date of Death: 02/16/2002 Dear Mr. Schwartz: Please be advised that the Department of Public Welfare maintains a claim in the amount of $104,709.86 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 $22,841.03, 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 $81,868.83, is to be entered as a priority Class 6 claim a~ainst 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, Susan E. Naylor TPL Program Investigator 717-772-6265 717-772-6553 FAX Enclosure BUREAU OF ZNDZVZDUAL TAXES ZNHERTTAHCE TAX DTVZSTDN DEPT. Z80601 HARRTSBURG, PA 17116-0601 ROGER B IRWIN ESQ IRWIN ETAL 60 W POHFRET ST CARLISLE COHMONWEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l;4? EX AFP ¢D1-02) PA 170151~ DATE 10-22-2002 ESTATE OF BRETZ WOODROW DATE OF DEATH 02-16-2002 FZLE NUMBER 21 02-037fi i:: ~UNTY CUMBERLAND ACN 101 Amount Remitted HAKE CHECK PAYABLE AND RENZT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 W CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02} NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF BRETZ WOODROW WFZLE NO. 21 02-037~ ACN 101 DATE 10-12-2002 TAX RETURN NAS: (X) ACCEPTED AS F/LED { } CHANGED RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estete (Schedule A) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) r~. Nortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adc. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Nortgege Liabilities/Liens (Schedule T) (10) 11. Tote1 Deductions 12. Net Value of Tax Return 80~600.00 .00 .00 .O0 1~755.85 .00 .00 (8) 19,190.91 10~,709.86 (11) (12) CharitabXe/Governmental Bequests; Non-elected 911:3 Trusts (Schedule J) (15) Net VeXue of Estate Sub.~ect to Tax (1~) X'F an assessment was issued previously, 11nes 1~,, 15 and/or 16, 17, 1:5. 1~. NOTE: reflect figures that include the total of ALL returns assessed to date. NOTE: To insure proper credlt to your account, submit the upper portion of this for. with your tax payment. 82,355.85 ASSESSHENT OF TAX: 15. Amount of Line 1~ mt Spousal rate 16. Amount of Line 1~ taxabXe mt LineeX/CXass A rate 17. Amount of Line 1~ mt Sibling rate 18. Amount of Line 1~ taxabXe at Collateral/Class B rate 19. PrincZpaX Tax Due TAX CREDITS: PAYmeNT RECEIPT DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT[ON OF ADD/TZONAL INTEREST. ]2~.90o.77 q1,5qq.92- .00 R1,54R.9Z- 18 and 19 will ( XF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) TOTAL TAX CREDIT I BALANCE OF TAX DUE] INTEREST AND PEN. I TOTAL DUE ] .00 .00 .00 .00 ANOUNT PAID (15) .00 x O0 = .00 (26) .00 x 0~5= .00 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= . O0 STATUS REPORT UNDER RULE 6.! 9. Name of Decedent: WOODROW W. BRETZ Date of Death: FEBRUARY 16, 2002 No. 21-02-0374 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: X Yes No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? ~ Yes X No 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? X Yes No Date: 12/31/02 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. IRWIN, ~GHT & HUGHES Roger B. Irwin, Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle, PA 17013 .... City, State, Zip :~ (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative