HomeMy WebLinkAbout02-0497
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Estate of C. Russell Hackenberry No. ~/- G "2. - CJ 9' 7
also known as
, Deceased
Social Security No 177-10-2178
Pelilioner(s), who is/are 18 years of age or older, apply)ies) for:
(COMPLETE "A" OR "B" BELOW:)
GJ
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or
Decedent, dated 5/5/99 and codicil(s) dated
named in the Last Will of the
Slate relevant circumstances, 8.g., renunciation, death of executor, elc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
o
B. Grant of Letters of Administration
(c.ta., d,b,n.c.t.a.: pendente lite, durante absentia; durante minorilate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at Messiah Villa(]e, 100 Mt. Allen Drive, Mechanicsbur(], PA 17055 (Upper Allen Township)
(list street, number and municipality)
Decedent, then 89 years of age, died j'v1av 15 ,2002 ,at Messiah Villa(]e
(Location)
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 ......................................................................
Total ........................................... ......................................
$
$
$
$
$
120,000.00
120,000.00
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
I
Signature
Typed or printed name and residence
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() II Lv<.. t
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James D. Camobell Jr.
222 Willow Avenue
Camo Hili PA 17011
RW-1!7 ',: 5- 8
,j''-.,'''-,t:fll /, - ,:.:.. I..~ - L: . :..1,
Oath of Personal Representative
Commonwealth of Pennsylvania
County of
The Petitioner(s) above-named swear(s) and 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 personai representative(s) of the
Decedent, Petitioner(s) will well and truly administer the esta~ according to law. J-
Sworn to and affirmed a~ subscribed (j 11 ~ '
before me this dJ,(J day of
~.l~ c2/i1A
W," I "J4t;; .; ~
~(1)J'!I II, d//JUJ,iJh I.tl.. /~J.JlPj
Estate of C. Russell Hackenberrv
DECREE OF REGISTER
No.
also known as
Deceased
21-02-0497
Social Security No: 177-10-2178
Date of Death: 5/15/02
AND NOW, MAY 21, 2002 , in consideration of the Petition on the
reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that letters Il\I Testamentary 0 of Administration
are hereby granted to James D. Campbell, Jr.
({c.La d,bn,c,l., pendente lite; durante absentia; durante minoriale)
in the above estate and that the instrument(s), if any, dated MAY 5th, 1999
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
letters .................................
Short Certificates(s) ........6......
Renunciation
Extra Pages ( 4 ) ...............
I.T.R.......................................
JCP Fee .................................
Inventory
Other
$ 235.00
'-FY}]Pt/,t, )/"hr~ tJh {lJ,I ~4(,tZ.dZ"..A-I; /J.1r'h~-
IT Regi~te, of \lVills
$ 18.00
$
$ 12.00
$
$
$ 5.00
$
$
Signature
Attorney: James D. Campbell, Jr., Esquire
I.D. No: 07051
Address: 3631 North Front Street
Harrisburq
Telephone: (717) 232-7661
DATE FilED: MAY 21, 2002
PA 17110
TOTAL
......................$ 270.00
MAILED LETTERS TO ATTORNEY MAY 21, 2002
'.'1:\
This is to cerrifv that the information here given L~ cnn (Ih \'UpiCi! i"j"(l I! I :1]] onginal ccrrificate of death duly filed with me as
Local Registrar..' The original certifIcate will 'he f()r\V:11-\_k,d i 1 \ he ')1:11:.: Viul Records Office for permanent tIling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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I.ocal Registrar
P 8207356
MAY 1 7 ZOOZ
Dare
21-02-497
JRe.2187
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
SI"'E<'l.E~UMeER
~.AME OFD€CE~NT(f;~~-M~-a~- c.'--~:~;l ~~~:~nJ~~~=-~~_------- - :~K-:~;_,~-r~~CURITYNU:8~R-=--~~ 78
AGE (lalla.-Jt"IclaYI UNDER1'fEAR UNOER10/Jtt~ATeOF8IRTH] BlRTHPLAce'C.,.A<1 PLO.CiC*OE...TH,n,,,,,",,".,.,,, """""".:".'."""""" ,,,"'.
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COUNTY OF oe..<rH CITY. 9000--:- TWP OF OE;"~ FACilITY NAME III """ "'''''IUI'~'~ ~."e ;"....I..M "u,nOO"
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FRHEJl'SN"'ME(Full.M<1<lI"_laSl)
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DATE-Oi:-OEAi;;~,i:iZr.;;;'o..--;. -W;I-~-~
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2002
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OJrnber land
DECEDENT'S USUAL OCCUMION
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11". Foreman I1b. Steel Indust
OECEDENT.S r.tAIUNG ADOAESS fSI'Ml. c,..,no...., sw..l'll Cooel DECEDENT'S
100 Mt. Allen Drive ~i~~E
Mechanicsburg, PA 17055 ~~~'~~
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AACE - ...m....::an 1...0.". Black. W1l~.. eI<:
(Speo:;oJy)
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SUfWl\IlNG SPOUSE
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INFOflMANT'SN.o.ME(TVpslP"ncl
Charles Hackenberry
James D. Campbell
....
CompIet"~.ms23e-<:""I. nce"otying
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5-25-02
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DlUe Of DISPOSITION
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Carrie Getz
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'N'~~~'1TIT~""'~e':-: '~p'"1li'fl"': PA 17011
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SIGNATURE Of' FUNERAL
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I.IETHOOOFOlSPOSlTION
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c'.ITI.I._D R__Sla,.O
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N"'~RESSOFFACllITY
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UCENSENUMSER
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w.,S CASE REFERRED TO MEDICAL EXAMINERlCORONER1
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lOC,(lIONjSo_Cotyf!ooon_Slataj
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....EDICAL EX......INER/CORONER
On 'h" ba.is 01 "umlna'ion andlG< inveslig.lia". '" m~ api'"on. d.alh acc..".d.' the lim.. da'". ."d plac.. ."d due t.. th" causei"j."d
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REG'S
SSIGNATU~N~
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SIGN"'TURE. AND T1TL~ Cj:RIIFiER
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NAME ANO"'DORESSC* PERSON WHO COMPlETEOCAUSE Of DEATH
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21-02-497
LAST WILL AND TESTAMENT
OF
C. RUSSELL HACKENBERRY
I, C. RUSSELL HACKENBERRY, presently of Lewistown, Mifflin
County,
Pennsylvania,
memory
and
being
of
mindt
sound
understanding, do make and publish this my Last Will and Testament,
hereby revoking and making void all former Wills by me at any time
heretofore made.
ITEM I.
I direct that all my just debts,
funeral expenses and inheritance taxes which may become due as a
result of my death be fully paid and satisfied as soon as
conveniently may be after my decease.
ITEM II.
All
residue and
the rest,
remainder of my property and estate, both real and personal, of
whatsoever kind and wheresoever situated, which I may own at the
time of my death, I give, devise and bequeath unto my Wife, IVA V.
HACKENBERRY, if she survives me by thirty (30) days.
11
ITEM III.
In the event that my wife shall
not survive me by thirty (30) days, I then give, devise and
bequeath all of the rest, residue and remainder of my property
and estate unto my granddaughter, LYNN MARIE VERMILYA, of Powder
Springs, Georgia, my stepdaughter, SHIRLEY A. CAMPBELL, of Camp
Hill, pennsylvania, and my stepdaughter, KATHY R. STETLER, of
Scotch Plains, New Jersey, in equal portions, share and share
alike, per stirpes.
ITEM IV.
I hereby nominate, constitute
and appoint JAMES D. CAMPBELL, JR., to be the Executor of my
estate, with the power to sell all real and personal property at
private or public sale.
I direct that my Executor shall not be
required to give a bond for the performance of his duties in this
or any other jurisdiction.
IN WITNESS WHEREOF, I, C. RUSSELL HACKENBERRY, the Testator,
have to this my Last will and Testament, written on one side only
2
'-
I'
of three (3) sheets of paper, set my hand and seal this
C;f1..
day of
1'1"7
, 1999.
Cfi})AJ~1Q %.~ _
C. RUSSELL HACKENBERR
The preceding instrument, consisting of this and two other
typewritten pages, was on the date thereof signed, published and
declared by C. RUSSELL HACKENBERRY, the Testator therein named, as
and for his Last Will, in the presence of us, who at his request,
in his presence and in the presence of each other, have subscribed
our names as witnesses hereto.
C" .' <<
:h p /1:/f~ , "/,
5~ . x:I <.eX
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oS- 6i, 3(l!-g
Residing at
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Residing at
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF iJ+
SS:
I, C. RUSSELL HACKENBERRY, 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; that I signed it willingly and that
I signed it as my free and voluntary act for the purposes therein
expressed.
IN WITNESS WHEREOF, I, C. RUSSELL HACKENBERRY, have hereunto
set my hand and seal this
,.-J1
) '" day of
, 1999.
M'J
() &/AA"C?<, ~p~~
C. RUSSELL HACKENBERRY
SWORN TO and subscribed
before me this ~ day
of ,ff}A'(' , 1999.
~~~.
No ry Publlc
NOTARIAL SEAL
NANCY L. BRESKI, Notary Public
Harrisburg, Dauphin County
My Commission ~!PireS March 16, 2000
4
II
COMMONWEALTH OF PENNSYLVANIA
In/"" />1:
COUNTY OF t.:J~~
SS:
We,
C hUll
/ld-; .4 S'k,<-,c
;1
!;.~"r I" and
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testator sign and execute the
instrument as his Last Will; that he signed willingly and that he
executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testator
signed the will as witnesses; and that to the best of our
knowledge, the Testator was at the time eighteen (18) or more years
of age, of sound mind and under no constraint or undue influence.
SWORN TO and subscribed
before me this ~~ day
of ~//y , 1999.
H/lAMd.j. X~'
. Notlj!ry Public
:dl002-1
NOTARIAL SEAL
NANCY L. BRESKI, Notary Public
Harrisburg, Dauphin County
My Commission Expires March 16, 2000
5
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
G--..r<
CERTIFICATION OF NOTICE UNDER RULE 5.61a)
Name of Decedent: C. Russell Hackenberrv
Date of Death: 5/15/02
Will No. 2002-00497
Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration 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
Name Address
Lyn Vermilya 5066 Stratford Way
Powder Sorinos GA 30127
Shirley A. Campbell 222 Willow Avenue
Camo Hill PA 17011
Kathy R Stetler 623 Westfield Road
Scotch Plains NJ 07023
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date: 6/3/02
Signature
James D. Campbell, Jr
~I/ "-<2
3 31 North Front Street
Name:
Address:
Harrisburo
PA 17110
Telephone(717) 232- 7661
S:=5
Capacity:
x
Personal Representative
Counsel for Personal
Representative
c
CALDWELL & KEARNS
A PROFESSIONAL. CORPORATION
CARL G. WASS
..JAMES R. CLIPPINGER
CHARLES J. DEHART. III
..JAMES O. CAMPBELL. .JR.
JAMES L. GOLDSMITH
STANLEY J. A. LASKOWSKI
JEFFREY T. McGUIRE-
DOUGL.AS K. MARSICO
BRETT M. WOODBURN
DOUGL.AS E. HERMAN
RAY J. MICHALOWSKI
-ALSO A MEMBER OF N.) BAR
ATTORNEYS AT LAW
OF COUNSEL
RICHARO L. KEARNS
3631 NORTH FRONT STREET
HARRISBURG. PENNSYLVANIA 17110-1533
THOMAS D. CALDWELL. .JR.
(l928-2001l
August 12, 2002
717-232-7661
FAX, 717-232-2766
thefirm@caldwellkearns.com
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of C. Russell Hackenberry
No. 2002-00497
PA No. 21-02-0497
Dear Sir/Madam:
Please find enclosed herewith a check in the sum of $4,500.00 as a
payment on account of Pennsylvania inheritance tax in the above-
captioned estate.
Sincerely,
Q/J0-!
Jl-imes D.
CALDWELL
Campbell,
& KEARNS
Jr.
JDCJr/nb
/Enclosure
02-126/43941-1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
JAMES D CAMPBELL JR ESQUIRE
3631 N FRONT STREET
HARRISBURG, PA 17110
-------- fold
ESTATE INFORMATION: SSN: 177-10-2178
FILE NUMBER: 2102-0497
DECEDENT NAME: HACKENBERRY C RUSSELL
DATE OF PAYMENT: 08/12/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/15/2002
NO. CD 001512
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,500.00
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TOTAL AMOUNT PAID:
REMARKS: JAMES D CAMPBELL JR ESQUIRE
CHECK#108
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$4,500.00
MARY C. LEWIS
REGISTER OF WILLS
REV-1500EX + (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
Hackenber C, Russell
DATE OF DEATH (MM-DD-YeCl")
DATE OF BIRTH (MM-DD-Year)
OFFICiAl USE ONLY
(j
05/15/2002 08/11/1912
(IF APPLICABLE) SURVrvlNG SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
~ 1.0riginalRetum
D 4, limited Estate
00 6. Decedent Died Testate (AttachcopyofVVi~)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date 01 dealh after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trusl]
D 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1.95)
/ 7 ~~5--
FILE NUMBER
21 -0 2 497
"coUNh""C05E ---YEA~ - - NUMBER--
SOCIAL SECURITY NUMBER
1 77- 1 0 - 2 1 7 8
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Retum (date oldeath priortD 12-13-B2)
D 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Elecion to tax under Sec. 9113(AIi_hS<hol
THIS SECTION MUST BE COMPLETlED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTlED TO:
NAME COMPLETE MAILING ADDRESS
James D. Cam bell Jr. Es 3631 North Front Street
FIRM NAME (If Applicable)
CALDWELL & KEARNS
TELEPHONE NUMBER
717 232-7661 Harrisbur PA 17110
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1. Real Estale (Schedule A)
(1)
(2)
(3)
(4)
(5)
2. Stocl<s and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7.lnler-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8, Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent Mortgage liabilities, & liens (Schedule I) (10)
11. Total Deductions (Iotal lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for whieh an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Une 14 taxable at the spousal lax
rate, or transfers under Sec. 9116 (a)(1.2)
X _(15)
110,984.36 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of line 14 taxable at ~bling rate
18. Amount of line 14 taxable at collateral rale
19. Tax Duo
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
41,087.62
81,449.65
(8)
122,537.27
9,385.77
2,167.14
(11)
(12)
(13)
11,552.91
110,984.36
(14)
110,984.36
4,994.30
4,994.30
Decedent's Complete Address:
STREET ADDRESS
100 Mt. Allen Drive
,
CITY I STATE I ZIP
Mechanicsburg PA 17055 I
Tax Payments and Credits: I
1. Tax Due (Page 1 Line 19) (1) 4,994.30
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 4.500.00
C. Discount 236.84
Total Credits I A + B + C) (2) 4,736.84
3. InteresUPenalty if applicable
D. Interest
E. Penalty
T otallnteresUPenalty I 0 + E ) (3)
4. If Line 2 is greaterthan Line 1 + Line 3, enter tile difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 257.46
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 257.46
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'X" IN THE APPROPRIATE BLOCKS
I. Did decedent make a transfer and: Yes No
a. retain the use or income of tile property transferred: ...........................................................................0 ~
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 ~
c. retain a reversionary interest; or ..........................._.......................................................................... 0 ~
d. receive the promise for Iile of either payments, benefits or care? ............................................................. 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................. _. _............................................. 0 IZl
3. Old decedent own an "in trust fo~ or payable upon death bank account or security at his or her death? ................. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 lEl
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 at perjury, I decln thall have examined this return. including accompanying schedules and statements, lIld to the besl of my knowledge and be~ef, it is true, correclcm
complete.
Declaration of prepcwer other than the personal representative is based 0fI all jnformation of which preparer has any knowledge.
SIGNATURE OF PERSO RESPONSIBLE FOR FILING RjRN DATE
~O.C~, 11../1'.,/.7-
ADDRESS 363V lJorth Front Street
HarrisburQ PA 17110
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
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 tile surviving spouse is 3%
[72 PS ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on tile net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) Iii)].
The statule does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rale 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. 99116Ia)(1.2)].
The tax rate imposed on Ihe 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 forthe 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 leasl one parent in common with the decodert, whether by blood or adoption.
REV-1507 EX. (1-91)
'*'
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hackenberrv C Russell
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
FilE NUMBER
21 02
497
ITEM
NUMBER
1.
DESCRIPTION
Note and Mortgage from William J. Goodman and A. Phyllis Goodman dated May 2,2002
Principal Balance at date of death - $41,000.00
Accrued Interest at date of death 87.62
($6.74 per diem x 13 days) $41,087.62
(Copy of Note Attached)
VALUE AT DATE
OF DEATH
41,087.62
TOTAL (Also enter on line 4, Recapitulation) $
Ilf more space is needed, insert additional sheets of tI1e same size)
41 087.62
MORTGAGE NOTE
$41,000.00
Camp Hill, Pennsylvania
May 2, 2002
For Value Received,
WILLIAM J. GOODMAN and A. PHYLLIS GOODMAN, his wife, of Mifflin County, Pennsylvania
(hereinafter called "the Undersigned"), promise to pay to the order of
c. RUSSELL HACKENBERRY, his heirs, successors or assigns, of 222 Willow Avenue, Camp
Hill, Cumberland County, Pennsylvania, or at such other place as the holder hereof
may designate in writing, in lawful money of the United States of America, the sum
of Forty-One Thousand Dollars ($41,000.00) and any additional moneys loaned or
advanced by any holder hereof as hereinafter provided, as follows, to wit:
On June 1, 2002, principal payments in the sum of Three Hundred Fifty Dollars
($350.00) shall commence and be payable on the same day of each succeeding month
thereafter, plus monthly payments of interest on the unpaid principal balance at the
rate of Six (6%) percent per annum, such payments being applied first to interest
due and then to the unpaid principal balance hereof.
This note shall mature, and the entire unpaid balance of the principal sum and all
accrued and unpaid interest thereon shall be due and payable on May 1, 2005; and in
addition thereto, in the event any payment provided for herein shall become overdue,
for more than ten (10) days, the Undersigned agrees to pay a late charge in an
amount not exceeding four per cent (4%) of any such overdue payment as compensation
for the additional service resulting from the default;
This Note shall evidence and the Mortgage given to secure its payment shall
cover and be security for any future loans or advances that may be made to or on
behalf of the Undersigned by any holder hereof at any time or times hereafter and
intended by the Undersigned and the then holder to be so evidenced and secured, as
well as any sums paid by any holder hereof pursuant to the terms of said Mortgage,
and any such loans, advances or payments shall be added to and shall bear interest
at the same rate as the principal debt.
In case default be made for the space of thirty (30) days in the payment of
any installment of principal or interest, or in the performance by the Undersigned
of any of the other obligations of this Note or said Mortgage, the entire unpaid
balance of the principal debt, additional loans or advances and all other sums paid
by any holder hereof to or on behalf of the Undersigned pursuant to the terms of
this Note or said Mortgage, together with unpaid interest thereon, shall at the
option of the holder and without notice become immediately due and payable, and one
or more executions may forthwith issue on any judgment or judgments obtained by
virtue hereof; and no failure on the part of any holder hereof to exercise any of
the rights hereunder shall be deemed a waiver of any such rights or of any default
hereunder.
The Undersigned hereby empowers any attorney of any court of record within the
United States of America or elsewhere to appear for the Undersigned and, with or
without complaint filed, confess judgment, or a series of judgments, against the
Undersigned in favor of any holder hereof, as of any term, for the unpaid balance
of the principal debt, additional loans or advances and all other sums paid by the
holder hereof to or on behalf of the Undersigned pursuant to the terms of this Note
\
or said Mortgage, together with unpaid interest thereon, costs of suit and an
attorney's commission for collection of ten per cent {lO%} of the total
indebtedness but not less than $500 on which judgment or judgments one or more
executions may issue forthwith upon failure to comply with any of the terms and
conditions of this Note or said Mortgage. The Undersigned hereby forever waives and
releases all errors in said proceedings, waives stay of execution, the right of
inquisition and extension of time of payment, agrees to condemnation of any property
levied upon by virtue of any such execution, and waives all exemptions from levy and
sale of any property that now is or hereafter may be exempted by law.
This obligation shall bind the Undersigned and the Undersigned1s heirs, executors,
administrators and assigns, and the benefits hereof shall inure to the payee hereof
and its successors and assigns. If this Note is executed by more than one person,
the undertakings and liability of each shall be joint and several.
This note is secured by a Mortgage of even date herewith upon real estate
described therein.
WITNESS the due execution hereof the day and year first above written.
Witnessed
91
by,
~I
c. t; I.. n.
~*2~ (SEAL)
A~Hy~~~L)
38811
"",..":',." '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Hackenberrv C Russell
FILE NUMBER
21 02
497
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 Schedute F.
ITEM
NUMBER
1.
DESCRIPTION
Pennsylvania Employees Benefit Trust Fund - Refund of premium overpayment
VALUE AT DATE
OF DEATH
1,103.88
2.
Pennsylvania State Bank Ace!. #26014282
70,863.42
3.
Standard Steel Pension Check
378.76
4.
Juniata Valley Bank CD #43-925167-9
1,271.14
5.
Juniata Valley Bank DDA #57-935-364-0
250.20
6.
Furniture, furnishings
1,925.00
7.
Jewelry (Appraisal attached)
4,805.00
8.
Miscellaneous additional and other personal property sold at auction (Proceeds
statement attached)
852.25
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
81 449.65
June 1,2002
James D Campbell, Jr
Caldwell & Kearns
3631 North Front St
Harrisburg, PA 17110
Re: C Russell Hackenbeny
Attorney Campbell,
The date of death balance for C Russell Hackenbeny is $70,863.42. This is the only
opened account he has with us. Please let us know if there is anything else we can do to
help with this matter.
Sincerely,
~-d\p') 1u~
Heather Williams
Senior Banking Specialist
1148 Market Street P.O. Box 487 Camp Hill, PA 17001-0487 717.731.7171 fax 717.731.7176 pastatebonk.com
THE JUNIA TA VALLEY BANK
MIFFLlNTOWN PA 17059
Phom~: (717) 436.8211 Fax: (717) 436-8889
Decedent: C , RUS3e. \ \ \-\Of' KQn~rry
Date of Death: - 1- DS)
SSN: I
ACCOUNT #:
BALANCE 000:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTD:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
ACCOUNT #: J.i -
BALANCE 000:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTO:
OPENING DATE:
MATURITY DATE: 01 I {) - 0
OWNERSHIP: C. U.5.3 L/ 0 I
y' , 0-
~I:S Fe.... WltCl5
ACCOUNT #: -..3.5 ..3 L, - D
BALANCE 000: . ~
ACCRUED INTEREST: I.
000 VALUE: D. ~O
INTEREST PAID YTD:
OPENING DATE:
MA TUR/TY DATE:
OWNERSHIP: us>s e..1
bUl'-<{ or I-vC\ V.
bl("' f\ISWI
ACCOUNT :
BALANCE 000:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTD:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
ACCOUNT #:
BALANCE 000:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTO:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
D.te:
L -[Jr;-(j'd..
Prep.red by: *. it. F<)p~
Phon.: / '7 -:JJ./ d - '6 I
Fex: rJ / r; - :;;))-/ ?: - q.L/ q /
ACCOUNT #:
BALANCE 000:
ACCRUED INTEREST:
DOD VALUE:
INTEREST PAID YTD:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
ACCOUNT #:
BALANCE 000:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTD:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
ACCOUNT #:
BALANCE DOO:
ACCRUED INTEREST:
000 VALUE:
INTEREST PAID YTO:
OPENING DATE:
MATURITY DATE:
OWNERSHIP:
S I:Dc.)< {l\[ 0
So-Fe.. dlp bolt No
.N1Q~
Trust Your Special Moments To Mountz.
Sepnonber17,2002
James D. Campbell, Jr.
222 Willow Avenue
Camp Hill, PA 17011
Dear James Campbell.
At your request I examined the jewelry you submitted for valuation and have provided an opinion of the
Fair Market Value for the estate ofC. Russell Hackenberry
This report is valid only in its entirety and the final figure excludes any applicable taxes. You may wish to
take this into consideration when using the report. The value conclusions are subject to limiting conditions
that are set forth in the body of the report. To the best of my knowledge and experience. I estimate the
jewelry has a total Fair Market Value ofS4,80S.00.
Photographs are included with the original report for your reference. I suggest that you keep your copy of
this report in a safe place.
This report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice
(USPAP).
If) can be ofany further assistance, please call.
,,~6d(~ It}?hJA'''
Certified Gemologist Appraiser. AGS
Enclosures
?IOII",
(A'2."l )
..,,~~,-
"""OI~'.J-
Page 1 ofl
3780 Trindle Road. Camp Hill, PA 17011 · (717) 763-1199
www.mountzjewelers.com
'iii"
ROLE X
Table of Contents
. Letter of Transmittal
. Table ofCootents
. Purpose
. Intended Use
. Definition of Fair Market Value
. Approach to Value
. Market
. Limiting Conditions
. Subscriptions Retained for Value Consulting
. Metal Markets
. Certification
. List of Laboratory Instruments
. Item Descriptions
. Photograph(s)
. Biographica1Information
This report is valid only in its entirety and for its stated purpose and intended use and was prepared in
accordance with the Uollonn Standards of Professional Appraisa1 Practice (USP AP).
Statements and Limiting Conditions
Purpose
The purpose of this report is to descnlle and document the quality of the jewelry listed and to estimate it's
Fair Market Value.
Intended Use
The intended use of this report is for pro\'.iding an estate appraisal listing the Fair Market Value for use in
the resolution of the C. Russell Haclcenberry.
Valuation Date:
Definition of Fair Market Value
The fair market value is the price at which the property would change hands between a willing buyer and
willing seller, neither being under any compulsion to buy or sell and both having reasonable knowledge of
relevant filets. The fair market value of a particular item of property... is not to be determined by a forced
sale price. Nor is the fair market value of an item of property to be determined by the sale price of the item
in a market other than that in which such item is most commonly sold to the public, taking into account
location of the item wherever apl'ml'.iate. Taken from Treasury Regulation 20.2031-1 (b)
Approacb to Value
There are three traditional approaches to value that are as follows:
Income approach: Applies to income producing properties and is used only if an income situation or rental
property can be identified.
Market Data approach: Compares the qualities of the subject item to an article with similar or identical
qualities, and researches and records current verifiable sales of such merchandise.
Cost approach: Establishes the total value of an item by considering the value of its component parts
(precious metal content, gemstone weights and qualities, labor, and any other fees) together with the
appropriate retail markup according to the norms of the jewelers in the locale, supply and demand, and the
current state of the marketplace.
Page 2 of2
Fair Market Value is estimated using tbe market data approacb. Nei1her the income approacb nor the cost
approacb apply in establishing Fair MlIIket Value. However, tbe cost approacb to value was used to cbeck
on the reasonableness or market values found.
Market
To value an item a market (and market level) must be recognized. The most appropriate market for jewelry
can vary depending upon the article's age, condition, quality, intrinsic content, aesthetic appeal,
provenance, current fashion trends, artistic ink. I'",bdioo, period of manufacture among others.
The type of retail outlet that most commonly carries the items being appraised is considered to be the most
appropriate marlcet However, the auction market was also considered as another ""l"ul',iate market in
establishing Fair market Value for this type of jewelry.
Limiting Conditions
The jewelry described within bas been analyzed and graded in accordance with prescribed grading
standards using "state of the art" methods and precision laboratory equipment.
Jewelry constructed solely ot; or in combination witb, precious metals (Le. platinum, palladium, yellow or
white gold and/or silver) is tested, analyzed and described for its type and content of such metal. Unless
otherwise stated, all gemstone weights, grades and measurements are approximate and stones have not been
removed from tbeir mountings.
Diamonds are graded with tbe prescnbed grading nomenclature of tbe Gemological Institute of America
(GIA) and tbe use of pre-graded permanent master diamond color comparison stones.
Colored stones are color graded according to the GIA color grading system. Unless otberwise stated, all
colored stones listed on this appraisal report have probably been subjected to various treatments to improve
tbeir appearance. Treatments are considered usual and customary practices when properly disclosed and
when done witbout intent to defraud the consumer. Tbe treatments are mostly stable and do not require
special care. When a treatment is detected and considered unusual it will be so noted by this appraiser.
Some treatments are reversible and re-treatable. It may be beyond tbe scope of an appraisal to determine
exact treatment methods or tbe amount of treatment present Some treatments require sophisticated
equipment not found in a standard gemological laboratory. Prevailing market values are based on tbese
universaIly practiced and accepted processes by the gems and jewelry trade.
Sources are assumed to be reliable and the appraiser does not assume responsibility for tbeir information.
The appraiser assumes tbe ownership oftbe subject property is true 115 stated by tbe client.
The fees paid for tbis appraisaI do not include the services of the appraiser for any otber matter. In
particular, fees paid to date do not include any of the appraiser's time or services in connection with any
statement, testimony or otber matters before an insurance company, its agents, employees or any court or
otber body in connection witb tbe property berein described.
If the appraiser is required to testify or to make any oWG_ to a third party concerning the descnbed
property and/or appraisal, tbe applicant sbaII pay the appraiser for all of such time and services so rendered.
This document is limited to its stated intended use and is invalid if all items listed in tbe Table of Contents
are not present
Unless expressly stated, tbe items appraised are in good condition. Any serious deficiencies and repairs are
noted. Ordinary wear and tear is not noted.
The information in this report is confidential.
Page 3 of3
This appraisal process does not discover liens, encumbrances, or fractional interests but, ifknown, they are
noted.
The limited owner of this appraisal is the party for whom the work was performed.
Possession of this report does not provide title to the items appraised.
Possession of this report, any portion of this report, or any copy thereof; does not include the right of
publication without the appraiseI's written consent
Use of the information contained in the appraisal is invalid ifall items listed in the Table of Contents are
not present
Each item descn"bed in this report bas been photographed and file copies of the photograph(s) as well as a
copy of the report are maintained in the appraiseI's files for at least five years after the report date.
Third parties may rely on the information in this report for the defined purpose and intended use only.
Third parties requiring further information than what is in the report must obtain the written permission of
the owner of the appraisal before the appraiser will discus the report
No changes may be made to this report by anyone other than the appraiser. The appraiser cannot be
responsible for unauthorized alterations.
The professional relationship between the appraiser and the client ends with the delivery of this report
SUbseriptioDI RetaiDed for Value CODlDltiDg
Drucker, Richard - The Guide. Northbrook, IL
Rapaport, Martin - Ranaoort Diamond Reoort. New York, NY
Metal Market
Gold
Silver
Platinum
09/1712002
$323.80
$5.05
$530.60
List of Laboratory IDStnJments
Binocular microscope
Electronic scale
Touchstone and acids
Spectrascope
Polariscope
Refractometer .
Heavy liquids
Diamond light and graded master comparison diamonds
Leveridge gauge
Thermal conductivity diamond tester
Ultraviolet light unit
Proportionscope
Dichroscope
Chelsea color filter
Page 4 of4
Certification
. I hereby certifY that, to !be best of my knowledge and belief
. The SC8IemeDlS offilct contained in this report are 1Iue and COII'eCl.
. The reported aoa1yses, opinions, and cooclusioos are limited only by !be reported lLWIIIIptions and 1imiting
conditions, and are my lIIIbiased protessionallllllliysis, opinions, and cooclusions.
. I bave no present or prospective ioIerest in !be property tbaI is die subject of this report and I bave no penona1
ioIerest or bias with respect to the parties involved.
. My compensation is not cootiogent upoo the development or reporting of a JlI..ddt.wined wille or directioo
in value tbaI mvor.;!be cause ofmy client, !be amount of the wille .".J:....te, die ....mm.... oCa stipuIaled
result, or the occurrence of a subsequent event.
. I bave made a penona1 inspectioo of!be property tbaI is !be subject of this report.
. No ooe provided significant protessional ~ssistanre to the person sigJrlng this report.
. My aoa1yses, opinions, and cooclusioos were developed, and this report bas been prepared. in confonnily
with the Uniform S1andards ofProfi:ssiona1 Appraisal PracIice.
(~ I;/;:;;J/~~
L./Linda L. Cunningham G.G.
Certified Gemologist Appraiser, 11. S
09/1712002
Page 5 of5
Prepared For:
James D. Campbell Jr.
222 Willow Avenue
Camp Hill, P A 17011
Date: 09/1712002
Item I
Diamond Engagement Ring
One 18K yellow gold solitaire englIgement ring with one, approximately .85 carat, oval brilliant cut
diamond set in a six prong, 14K wbite gold head. The ring has a pinehed shank that tapers from 2.5 mm at
the shoulders to 1.3 mmatthe bottom of the ring. The ring is stamped "F.89 18K," is finger size 7112, and
weighs 2.5 grams.
Diamond Grading Report
Shape and Cut:
Measurements:
Weight:
Depth:
Girdle:
Culet:
Finish
Polish:
Symmetry:
Clarity:
Color:
Fluorescence:
Oval
726 x 5.30 x 3.50 mm (approximate)
0.85 Cts. (estimated)
66.00%
Extremely thin to slightly thick, fiIceted
Medium
Good
Fair
SI-I
H
None (Iw)
Total Approximate Estate Value Excluding Tax
$2,310.00
Item:!
Diamond Wedding Band
One 14K yellow gold band style ring with five, approximately .17 - .21 carat, round brilliant cut diamond
set in a row across the top. The diamonds are all set in 14K white gold, four prong heads. The shank is flat
and tapers from 1.8 - 1.75 Mm. The ring is stamped "14Ko. (Stuller), is finger size 7 112, and weighs 3.5
grams (2.3 DWT).
Diamond Melee Attributes
Shape and cut
Weight.
Number of diamonds:
Total Weight:
Clarity:
Color:
Round full cut
0.17 to 0.21 cts. each
5
.95 cls. (estimated)
SI-2 - 1-1
I-J
Total Approximate Estate Value Excluding Tax
$421.00
Page 6 of6
Item 3
Diamond Stnd Earrings
One pair of diamond stud earrings. Each earring has one, approximately .46 - .48 carat, round brilliant cut
diamond set in a four prong head. The eanings have threaded posts and screw backs. The backs are
stamped "14K." The eanings weigh 1.5 grams (1.0 OWl').
Diamond Gnding Report
Shape and Cut:
Measurements:
Weight:
Deptb:
Girdle:
Finish
Polish:
Symmetry:
Clarity:
Color:
Round brilliant
4.93 x 4.86 x 3.10 mm(approximate)
0.48 Ct!. (estimated)
63.30"/0
Very thick, frosted
Fair
Fair
1-2
1
DIamond Gnding Report
Shape and Cut:
Measurements:
Weight:
Deptb:
Girdle:
Finish
Polish:
Symmetry:
Clarity:
Color:
Round brilliant
4.90 x 4.83 x 3.00 mm (approximate)
0.46 Cts. (estimated)
61.60"10
Very thick, frosted
Fair
Fair
1-2
1
Total Approximate Estate Value Excluding Tax
$600.00
Item 4
Lady's Watch
One 14K yellow gold and diamond, lady's wristwateh. The watch case and band are 14K yellow gold The
watch has a 6 jewel, quartz movement (#976001). The case is hexagonal, is stamped "14K GOLD" on the
outside and "14K GOLD B&A 297M" on the inside. The diamond is hexagonal, gold with baton hour
marlc:ers and black hands. The bracelet tapers from 725 - 7.05 mm, has cobra link, and a box clasp. The
watch has a white gold bezel with five, approximately .0075 carat each, single cut diamonds head set on the
two longer sides. The watch is marked "GENEVE" on the dial and weighs 17.2 grams (11.0 OWl').
DIamond Melee Attributes
Shape and cut
Measurements:
Number of diamonds:
Total Weight
Clarity:
Color:
Round single cut
1.2mm
10
.08 cts. (estimated)
SI
G-H
Page 7 of7
Total Approximate Estate Value Excluding Tax
$115.00
Item 5
Diamond Earring Jackets
One pair of 18K yellow gold eaningjackets. Each jacket bas ten, approximately .015 carat each, round
brilliant cut diamonds set with three prong each. The diamonds are set in a circle around the outer edged of
eachjacket. The jackets are 9.2 mIi1 round. They are stamped "18K JABEL" and weigh 1.5 grams (1.0
OWT).
Diamond Melee Attributes
Shape and cut
Measurements:
Number of diamonds:
Total Weight:
Clarity:
Color:
Round full cut
1.Smm
20
.30 cts. (estimated)
VS-2 - SI-1
G-H
Total Approximate Estate Value Excluding Tax
$245.00
Item 6
Platlnnm Diamond Ring
One platinum li1igree, lady's ring set with one, approximately .34 carat, old European cut diamond. The
diamond is flush set in an octagon in the center of the ring. The top and shoulders of the ring are pierced
filigree. The ring measures 9.6 rom wide at the top and tapers to 1.65 rom at the bottom. The shank is
knife-edge style. The ring is stamped "PLATINUM P A TO," is finger size 5, and weighs 2.5 grams .1.6
OWT). Condition: Poor.
Diamond Attributes
Shape and cut:
Measurements:
Weight:
Clarity:
Color:
Old European
4.80 x 4.80 x 2.30 rom (approximate)
0.34 CIs. (estimated)
SI-I
H
Total Approximate Estate Value Excluding Tax
$400.00
Item 7
Gold Lion's Head Necklace
One 14K yellow gold, lion's head pendant and cbain. The pendant is 1 1/4" long x 1 1/8" wide, pressed
high relieflion's head. The lion bas diamond eyes (approximately .04 carat each, round brilliant cut
diamonds) and an, approximately. 10 carat, round ruby in its mouth. The pendant bas a hidden loop bail on
the back, is stamped "141(," bas an illegible trademark, and weighs 7.4 grams (4.8 OWT). The pendant
hangs from a 191/2" long, 3.3 rom wide, oval curb link chain. The chain bas a barrel clasp, figure eight
safety, is mmked "141(," and weighs 16.8 grams (10.8 OWT).
Page 8 of8
Diamond Melee Attributes
Shape and cut
Measurements:
Number of diamonds:
Total Weight
Clarity:
Color:
Round full cut
2.2mm
2
.08 cts. (estimated)
1-1
I
Total Approximate Estate Value Excluding Tax
$145.00
Item 8
Lion's Head Ring
One 14K yellow gold lion's head ring with three diamonds. The ring measures 20.7 mm wide at the top.
The top of the ring has a lion's head and mane in relief. The lion has diamond eyes (approximately .025
carat each, single cut diamonds) and has a diamond in its mouth. The ring is cast. The shank is slightly
domed and tapers from 6.7 - 5.1 mm. The ring has no metal stampings ortrademaric, is tingersize 9, and
weighs 13.6 grams (8.7 OWT).
Diamond Melee Attributes
Shape and cut
Measurements:
Number of diamonds:
Total Weight:
Clarity:
Color:
Round single cut
1.8mm
3
.08 cts. (estimated)
VS-2 - SI-1
H
Total Approximate Estate Value Excluding Tax
$99.00
Item 9
Gold Coin Pendant
One South African Krugerand set in a pendant frame with a box chain. The Krugerand is dated 1982 and is
in good condition, but shows minor wear. The coin is in a screw-closed, 14Kyellow gold, bezel with a 4.1
mm rope chain trim soldered to the outside of the coin bezel. The pendant has no metal stampings or
bade'D1uXs. The chain is 22" long, 1.65 mm wide, box link with a lobster clasp. The chain is atamped
"14K SO," and weighs 10.7 grams (6.9 OWT). The coin and frame weigh 39.7 grams (25.5 OWT).
Total Approximate Estate Value Excluding Tax
$395.00
Item 10
Poo:ket Watch and Chain
One gold filled Elgin pocket watch. The watch is 16 size, Elgin National, with a 20 year guaranteed heavy
gold plated hunting case. The case number is 6825298 and has a guilloche and floral design. The case is in
good condition with minor scratches and one tiny dent The watch has a 15 jewel mechanical movement
#9,278,707. The dial is white with black roman numerals and hands and a sunken second hand dial.
Approximate production date: 190 I. The watch has a gold plated figure pocket watch chain.
Total Approximate Estate Value Excluding Tax
$75.00
Page 9 of9
Total Approximate Estate Value for All Items - Excluding Tax:
$4,805.00
Four thousand eight hundred five dollars and no ceDtll
Signature of Appraiser:
, ~t.-
Linda L. .G.
Certified Gemologist Appraiser, AG
Page 10 of 10
Biographical Background and Qualifications
Appraiser's Name
Linda L. Cunningham G.G.
Education: Bachelor of Arts, the University of Missouri, 1981.
Graduate Gemologist, Gemologica11nstitute of America, 1992.
Registered Jeweler, American Gem Society, 1998.
Certified Gemologist, American Gem Society, 1999.
Certified Gemologist Appraiser, American Gem Society, 2001.
Business: In the jewelry ttade since 1995.
Page II of II
\
Estate of C. Russe" Hackenberry
september 2002
Estate of
C. Russell Hackenberry
September 2002
c. Russell Hackenberry Estate
September 2002
1\
. RusseU Hackenberrv Estate
september 2002
--.- -'.."
. -"S~'\\~~:":~~-&,;.i:::j.-._~'
BODNAR'S AUCTION SALES
PO BOX 1132
NEW BRUNSWICK, N.J. 08903-1132
PHONE: 732-951-2100
10/12/02
- - CONSIGNOR STATEMENT - ~
,-.
<,
PAGE I
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CONSIGNOR NOOER: 259 lU:TICJI DATE : 18/18/1!2
NAl'f
KATHY STErcE;:;
023 WESTFlEU :1D.
SCOTCH IUHS. NJ 07075
(9lllll 889-7148
PROD ITM IN~ lljIT
CODE NO. ------ lID DESCRIPTION ----- NO. CTY PRICE
TDTIL
PRICE
-----------------------------------------------------------------------
87 LENOX LOT
aa BOX LOT FIGS
89 GlOL LOT
50 BOX LOT FIGS
91 BOX LOT RDSENTl'.hL DISHES
'l2 BOX LOT 0 JAPIlN FIGS
93 Bel LOT ~ PLml:JES 0 JAAAN
94 BOX LOT COVEilED BOX ETa DISii:S
95 BOX LOT COVERED BOX & CIWSUG
96 BOX leT GREEN Sl.AS3
& PORe VASE LOT
97 WIlL:. HANGERS LOT
sa MILK a.qSS LOT
99 BOX LOT DEPR :ilIlSS
100 BOX LOT GRN GLASS
101 BOX LOT RL'BY GLASS
1112 BOX LOT p,.W:R GLASS
103 BOX LOT CRANBERRY GLASS
124 BOX LOT :\l1BER
:05 LIl,'1PS LOT & CIlR LOU FIGS
105 CAR LOT
m OWl. LOT
108 BOX LOT GLASS
109 BOX LOT ELEGI\NT GLASS ClBlR
110 BOX cOT CODDLERS ETa
III BOX LOT FLDIlER OR l:Ill,"LE
HOLDC:RS
112 BOX LeT S P~TE
I:;:; BOX LOT SU;SS CLEM
114 Box lOT rL~nS Ere
11::; roRe JOlL
115 BOX LDT CL~R
Iii BOX LOT CCEIlR .ITri IRISH & H
118 BOX cOT ,IlSES & BIReS
119 BOX LOT LEllCX & CUPS
12~ BOX ;'GT ~rriUC~'LAm PU~~5
:21 BOX :"CT ClilS Ai~;) SAUCERS
I
1
I
I
I
I
1
I
I
I
I
I
15.00
15.88
15.00
70.00
30.08
311.00
30.00
40.00
Jll.0lI
15,00
25.00
10.88
211.00
5.00
28.88
5.~0
5.0lI
5.80
18.00
1ll0.0lI
18.08
15.80
15.00
25.08
15.08 '
1
1
1
I
1
1
1
I
I
1
I
I
I
1
I
,
"
10.80
5.00
5.00
5.00
18.00
15.00
5.0Il
40.00
15.30
40.30
I
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15. 80 Jll~
15.80 ~
15. 80 ~
78.80~
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Jll.80~
Jll.80~
4Ul~
Jll.88~
15..~
25.0lI~
11l.80~
2Il.80~,
5.80 ~
21!.08 ~
5.88 ~
" 5.88 ~
5.80 ~
18.88~
18Il.80~
18.88 ~
15.88 ~
15.88 ~ '
25.88~
15. 88 ~
18.80 ~
5.80 ~
5.88 ~
5.80 ~
10.88 ~
15.80~
5.08 ~
40.80~
15.80 Jllj
40.80 ~
ClJIIIIISSICJI sa.LER' S RESERVE
IlIUlJNT IV RIlCOO AI<<lOO BIDDER I
4.58
4.58
4.58
21.80
9.80
9.08
. 9.08
12.88
9.88
4.58
7.58
3.08
6.80
1.50
6.08
. 1.58
1.58
1.50
3.08
311.80
3.88
4.58
.4.58
7.58
4.58
3.00
1.58
1.58
1.58
3.00
4.50
1.50
12.08
4.50
12.00
10.50
10.50
10.50
49.00
21.00
21.00
21.00
28.00
21.00
18.50
17.50
7.00
14.00
3.50
14.00
3.50
3.50
3.50
7.00
70.00
7.00
10.50
Ill. 50
17.50
18.50
7.00
3.50
3.50
3.50
7.00
10.50
3.50
28.00
10.50
28.08
.08 153
.1I\l 235
.011 238
.00 237
.011 101
.88 178
.88 241
.011 190
.88 23S
.00 132
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BODNAR'S AUCTION SALES
PO BOX 1132
NEW BRUNSWICK, N.J. 08903-1132
PHONE: 732-951-2100
IU12/02
- - CGNSIGNOR STAIDIENT ~ -
PAGE 3
CONSIGNOR :o:JlER :
IWIE
0<0
"",,j
ILCTIlIl DATE : 10/10/02
KllTllY STE7.Eil
623 OIESrr;ELD lID.
SCOTCH PL:l::IS, NJ ~7076
{S3Bl B89-71';8
PlIDD rrn
CODE N(J.
INV
----- I~ !)ES:R:PTIGN ---- NO.
GTY
!}lIT
PRICE
TOTIll
PRICE
COIIlISSIlll
lmm
SELLER'S RESERVE
NET RQJl,'T liWlT BIDDER'
1123 HlJi:PHI\EY FlSF
1
7.50
7.51 301.
2.25
5.25
.00 1115
TOT;'/' GRCSS SIU..E. IlI:llUNT
ICoUiIl. SIlLES TOTi:!..
LESS CCMMISSIOIl
1,217.58
1,217.51
365.25
c;c:t.PLETEl) ': YES NO
TCT~L NET PROCEEDS
TOTAL lIDS: 72
TOTAL DUE TO SELLER
852.25
.
852.25
NOTE: t.rXi AUC7:ON NOVEMBER ~4 ~T THE E.B. ELKS!
\
REV.1511EX"(1.g1J~_
,.~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FilE NUMBER
Hac:kenherry C Russell
21
02
497
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Myers Harner Funeral Home, Camp Hill 7,587.00
2. Organist 40.00
3. Sl. Mark's Cemetery 400.00
4. Funeral Luncheon 204.58
B. ADMINISTRATIVE COSTS'
1. Personal Representative's Commissions
Name of Personal Representative (s) Waived
Social Security Number{s) f EIN Number of Personal Represenlative(s}
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorne) Fees Caldwell & Kearns 250.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 295.00
5. Accountanfs Fees
6. Tax Return Preparers Fees
7. Cumberland Law Journal (Legal advertising) 75.00
8. Carlisle Sentinel (Legal advertising) 64.67
9. Mountz Jewelers (Appraisal) 290.00
10. Copies, Postage, UPS. Packing 163.52
11. Recorder of Deeds (Mortgage assignment) 16.00
TOTAL (Also enter on line 9, Recapitulation) $ 9385.77
(If more space is needed, insert additional sheets of the same size)
REV-1512EX"(1.s7J_~_
..~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
Hackenberrv C. Russell
FILE NUMBER
21
02
497
Include un reimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1,973.55
1. Messiah Village - final bill
2. Penelec
3. Verizon
4. Pharmerica
5. Senior Eye Care
6. Municipal Authority
29.31
4.44
132.33
15.00
12.51
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needee, insert additional sheets of the same size)
2167.14
REV.:51',EX.I*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
r ?1 n? 497
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY Do Not List Trustee{s} OF ESTATE
I. TAXABLE DISTRIBUTIONS ~nclude out~ht spousal d.tributions, and transf", under
See, 9116 (a (1,211
1, Shirley A Campbell Daughter 1/3
222 Willow Avenue
Camp Hill, PA 17011
2, Kathy R Steller Daughter 1/3
623 Westfield Road
Scotch Plains, NJ 07076
3. Lyn Vermilya Granddaughter 1/3
5066 Stratford Way
Powder Springs, GA 30127
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON.T AXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART II - ENTER TOTAL NON. TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
, .
LAST WILL AND TESTAMENT
OF
C. RUSSELL HACKBNBERRY
I, C. RUSSELL HACKENBERRY, presently of Lewistown, Mifflin
County, Pennsylvania, being of sound mind, memory and
understanding, do make and publish this my Last Will and Testament,
hereby revoking and making void all former Wills by me at any time
heretofore made.
ITEM I.
I direct that all my just debts,
funeral expenses and inheritance taxes which may become due as a
result of my death be fully paid and satisfied as soon as
conveniently may be after my decease.
ITEM II.
All the rest,
residue and
remainder of my property and estate, both real and personal, of
whatsoever kind and wheresoever situated, which I may own at the
time of my death, I give, devise and bequeath unto my Wife, IVA V.
HACKENBERRY, if she survives me by thirty (30) days.
. .
ITEM III. In the event that my wife shall
not survive me by thirty (30) days, I then give, devise and
bequeath all of the rest, residue and remainder of my property
and estate unto my granddaughter, LYNN MARIE VERMILYA, of Powder
Springs, Georgia, my stepdaughter, SHIRLEY A. CAMPBELL, of Camp
Hill, Pennsylvania, and my stepdaughter, KATHY R. STETLER, of
Scotch Plains, New Jersey, in equal portions, share and share
alike, per stirpes.
ITEM IV.
I hereby nominate, constitute
and appoint JAMES D. CAMPBELL, JR., to be the Executor of my
estate, with the power to sell all real and personal property at
private or public sale. I direct that my Executor shall not be
required to give a bond for the performance of his duties in this
or any other jurisdiction.
IN WITNESS WHEREOF, I, C. RUSSELL HACKENBERRY, the Testator,
have to this my Last Will and Testament, written on one side only
2
.
. .
, .
of three (3) sheets of paper, set my hand and seal this
t;'h
day of
1'1/
, 1999.
C~~;~~~~ -
The preceding instrument, consisting of this and two other
typewritten pages, was on the date thereof signed, published and
declared by C. RUSSELL HACKENBERRY, the Testator therein named, as
and for his Last Will, in the presence of us, who at his request,
in his presence and in the presence of each other, have subscribed
our names as witnesses ereto.
Residing at
/7/tJ
Residing at
'.3S- c5. 3fl!--S?
/)1)1/
3
. I I"
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF lJ+
SS:
I, C. RUSSELL HACKENBERRY, 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; that I signed it willingly and that
I signed it as my free and voluntary act for the purposes therein
expressed.
IN WITNESS WHEREOF, I, C. RUSSELL HACKENBERRY, have hereunto
set my hand and seal this )-/1.. day of Md ' 1999.
/}/&"'dOCt<, ~I'~~
C. RUSSELL HACKENBERRY
SWORN TO and subscribed
before me this ~ day
of f11 A '(' , 1999.
J1b~ 4. ~
No ry Public
NOTARiAl SEAl
NANCY l. BRESKI. Nolary Public
Harrisburg. Dauphin COunty
My Commission expires March 16, 2000
4
.
. ,I . .
COMMONWEALTH OF PENNSYLVANIA
Ill....... AI":
COUNTY OF /.Y~
SS:
We,
C ky I ;l
5"....... f?. and
/J~K A !: Ic-.....r
,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testator sign and execute the
instrument as his Last Will; that he signed willingly and that he
executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testator
signed the Will as witnesses; and that to the best of our
knowledge, the Testator was at the time eighteen (18) or more years
of age, of sound mind and under no constraint or undue
SWORN TO and subscribed
before me this .!Jf/. day
of A",y , 1999.
J11~~ .:I'~'
. No ry Public
111002-1
NOTARIAL SEAL
NANCY L. BRESKI. Notary Public
Harrisburg. Dauphin County
My Commission Expires March 16. 2000
5
. ----...
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of C. Russell Hackenberry
No.21
2002
497
also known as
, Deceased
Date of Death 5/15/02
Social Security No. 177-10-2178
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe
verify that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: James D. Campbell, Jr., Esquire
I.D. No.: 07051
James D. Campbell, Jr., Esquire
r- (/ ~, 1-
( /
Dated I "2... i] /0 L.
Address: 3631 North Front Street
HarrisburQ
PA 17110
Telephone: (717) 232-7661
Description
1. Note and Mortgage from William J. Goodman and A. Phyllis Goodman
dated May 2, 2002
Value
41,087.62
2. Pennsylvania Employees Benefit Trust Fund - Refund of premium
overpayment
1,103.88
3. Pennsylvania State Bank Accl. #26014282
70,863.42
4. Standard Steel Pension check
378.76
5. Juniata Valley Bank CD #43-925167-9
1,271.14
6. Juniata Valley Bank DDA #57-935-364-0
250.20
Total
(Attach Additional Sheets if necessary)
122,537.27
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
C. Russell Hackenberry
21
2002
497
PaQe 1
Description of Inventory
Description
Value
7. Furniture, furnishings
1,925.00
8. Jewelry
4,805.00
9. Miscellaneous additional and other personal property sold at auction
852.25
Subtotal $
Grand Total $
7,582.25
122,537.27
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(' '.96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CAMPBELL JAMES 0 JR ESQ
3631 N FRONT ST
HARRISBURG, PA 17110
uuu--lold
ESTATE INFORMATION: SSN, 177-10-2178
FILE NUMBER: 2102-0497
DECEDENT NAME: HACKENBERRY C RUSSELL
DATE OF PAYMENT: 12/13/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/15/2002
NO. CD 001946
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $257.46
I
I
I
I
I
I
,
I
TOTAL AMOUNT PAID:
REMARKS: JAMES 0 CAMPBELL JR ESQUIRE
CHECK# 116
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$257.46
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
/?-b,s-P
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
JAMES D CAMPBELL
CALDWELL ETAL
3631 N FRONT ST
HARRISBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-10-2003
HACKENBERRY
05-15-2002
21 02-0497
CUMBERLAND
101
JR ESQ
-
REV-1547EXAFPC01_D31
C
R
Allount Rallifted
PA 1711 0-4802
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
riEV=i54-j-EiCAj:i.--ciiFii3Y-Nii"-icE--OF-i:-NiiEifiiA~jcrTAX-A-PPRAisEHENT~--ALioWAiicE-cfR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HACKENBERRY C R FILE NO. 21 02-0497 ACN 101 DATE 02-10-2003
TAX RETURN WAS: I X) ACCEPTED AS FILED
) CHANGED
NOTE: If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18J
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
11 0,984.36 X 045 = 4,994.30
.00 X 12 = .00
.00 X 15 = .00
(19)= 4,994.30
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule AJ
2. Stocks and Bonds (Schedule BJ
3. Closely Held stock/Partnership Interest (Schedule CJ
4. Hortgages/Notes Receivable (Schedule OJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ
6. 40intly Owned Property (Schedule FJ
7. Transfers (Schedule GJ
8. Total Assets
(lJ
(2)
(3)
(4)
IS)
(6)
(7)
.00
.00
.00
41, 087 . 62
81, 449.65
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ
10. Debts/Hortgage Liabilities/Liens (Schedule IJ
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule 4J
14. Net Value of Estate Subject to Tax
(9)
(10)
9,385.77
2.167.14
Ill)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
122,537.27
11.~~:> 91
110,984.36
.00
110,984.36
DATE 'jiUHBER -'~+ ) AHDUNT PAID
INTEREST/PEN PAID 1-)
08-12-2002 CDOO1512 236.84 4,500.00
12-13-2002 CDOO1946 .00 257.46
TOTAL TAX CREDIT 4,994.30
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN 01, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
STATUS REPORT UNDER RULE 6.12
Name of Decedent: C. Russell Hackenberrv
Date of Death: 5/15/02
Will No. 2002-00497
Admin. No.
Pursuant to Rule 6. 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
I . State whether administration of the estate IS complete:
Yes X No
2 . If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3 . If the answer to No. I is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No X
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 X No
d . Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans' Court and may be attached to this report.
Date: 7/14/03
O/{A?!
SignrUre
James D. Campbell. Jr.. Esquire
Name (Please type or print)
3631 North Front Street
Harrisburq PA 17110
Address
( 717 ) - 2327661
Tel. No.
..'
Capacity:
X
Personal Representative
~.;Z l!'r [0.
Counsel for personal
representative
tYuly
IN RE: ESTATE OF C. RUSSELL
HACKENBERRY, DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO: 2002-00497
RECEIPT AND RELEASE
The undersigned, LYN VERMILYA, intending to be legally bound
hereby, does hereby acknowledge that she has this day had and
received of and from James D. Campbell, Jr., Executor of che Estace
of C. Russell Hackenberry, deceased, the sum of Nine Thousand Eight
Hundred Thirty-Four Dollars Thirty-Four Cents ($9,834.34) Dollars,
in final distribution, on account of the undersigned's share of the
residuary Estate of C. Russell Hackenberry;
AND THEREFORE, the said Lyn Vermilya does by these presents
remise, release, quit-claim and forever discharge the said James D.
Campbell, Jr., his heirs, successors and assigns, of and from any
and all actions, liabilities, claims and demands relating in any
way to this final distribution of the said Estate of C. Russell
Hackenberry.
The undersigned verifies that the statements made in the
foregoing document are true and correct.
I understand that false
statements herein are made subject to the penalties of 18 Pa. C.S.
~4909 relating to unsworn falsification to authorities.
"Zit
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r Vermllya
Dated:~~., ~~ c;a--h
,
02-126/52771-1
IN RE: ESTATE OF C. RUSSELL
HACKENBERRY, DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO: 2002-00497
RECEIPT AND RELEASE
The undersigned, SHIRLEY A. CAMPBELL, intending to be legally
bound hereby, does hereby acknowledge that she has this day had and
received of and from James D. Campbell, Jr., Executor of the Estate
of C. Russell Hackenberry, deceased, the sum of Nine Thousand Three
Hundred Twenty-Two Dollars Thirty-Three Cents ($9,322.33) Dollars,
in final distribution, on account of the undersigned's share of the
residuary Estate of C. Russell Hackenberry;
AND THEREFORE, the said Shirley A. Campbell does by these
presents remise, release, quit-claim and forever discharge the said
James D. Campbell, Jr., his heirs, successors and assigns, of and
from any and all actions, liabilities, claims and demands relating
in any way to this final distribution of the said Estate of C.
Russell Hackenberry.
The undersigned verifies that the statements made in the
foregoing document are true and correct.
I understand that false
statements herein are made subject to the penalties of 18 Pa. C.S.
~4909 relating to unsworn falsification to authorities.
WITNESS:
9/0-
~C:~
. Shi l,ex A. Campbell
Med, -:/~. J '/ ?--i3
02-126/52769-1
IN RE: ESTATE OF C. RUSSELL
HACKENBERRY, DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO: 2002-00497
RECEIPT AND RELEASE
The undersigned, KATHY R. STETLER, intending to be legally
bound hereby, does hereby acknowledge that she has this day had and
received of and from James D. Campbell, Jr., Executor of the Estate
of C. Russell Hackenberry, deceased, the sum of Seven Thousand Two
Hundred Forty-Three Dollars Thirty-Three Cents ($7,243.33) Dollars,
in final distribution, on account of the undersigned's share of the
residuary Estate of C. Russell Hackenberry;
AND THEREFORE, the said Kathy R. Stetler does by these
presents remise, release, quit-claim and forever discharge the said
James D. Campbell, Jr., his heirs, successors and assigns, of and
from any and all actions, liabilities, claims and demands relating
in any way to this final distribution of the said Estate of C.
Russell Hackenberry.
The undersigned verifies that the statements made in the
foregoing document are true and correct.
I understand that false
statements herein are made subject to the penalties of 18 Pa. C.S.
~4909 relating to unsworn falsification to authorities.
WITNESS:
1/ I
h UH1.JG- ~I
f
!J
0.) O--ly{ ')
-1;;', r E c~~J
~hY R. Stetler
d .Jill!' ~ c::.. '7 u' 3
Date: V\rGf'~ oJ '-- ()
02-126/52770-1