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HomeMy WebLinkAbout02-0532PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~ r fl'(tCL T g e~ ea- also known as Deceased. Social Security No. ! 5'9- / 8- 6 7 88 No. ai~a -saw To: Register of Wills for the County of Cu•nb ~r (aHCL. in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s~, who is/.are-18 years of age or older an the executr i r named in the last will of the above decedent, dated rn ~ 7 19__yZ_ ^a ^^a~^~'(-) -'-~ a Y-la.or;y; (~,Le~~'x ~;e.) o,~ ~~,~t..c.cv 3. I`i`t`l. ncA (state relevant ciratms[ances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C~c m b pr/a n eL County, Pennsylvania, with h P~ last family or principal residence at Z 8 .N1 ognt«i.~ 'h1.F/e (Iv Sn r 'n s (list street, number and muncipality) ~~ Decendent, thFn g 3 years of age, died o2 fg.2oo,Z at ~uMB r/4 rs ('rDS I`~ Except as follows, decedent did not mar ,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: no-+.e_ Decendent at death owned property with estimated values as fallows: (If domiciled in Pa.) All personal property $ tout p~;~*j (If no[ domiciled in Pa.) Personal property in Pennsylvania $ ([f not domiciled in PaJ Personal property in County $ Value of real estate in Pennsylvania $~,; r ~~,V, situated as follows: WHEREFORE, petitionerfgf respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters +cs fc m e~tat<-v (testamentary; administration c.t.a.; administration d. b. n.c. [.a.) [heron. a~ zv 1-F~ele "9G'rGulde a_o c /DQ niuflPr St• v ~. ~ o m c m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF Ctuttberland ~ S' The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ ~~~~~[/~~~ f/ ~ `-`- me this o'o a e ~7 / / / rtrgtsrer ~ ~ /~-/ /_/7 No 21-2002-532 Estate of GREPTA T. FOYER ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS Jt>ne 3rd l~ 2002 in consideration of the petition on AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) date, March 7th 1997 described therein be admitted to probate and filed of record as the last will of Gretta T. Boyer , and Let[ers Testaments are hereby granted to Helen Gulden FEES Probate, Letters, Etc.......... $ 270.00 Short Certificates(~0) ~ ~ ~ • ~ ~ ~ ~ ~ • $ 30.00 Renunciation ................ $ x-Pages (2) $ 6.00 JCP TOTAL $31 0~ Filed .June,3rc~,_.2002_„,,,,,,,,,,,,,, Register of Wills Mary C. Lewis nhn H_ Rrouios. Esq. 1I06268 ATTORNEY (Sup. CL LD. No.) 4 N Hanover St Carlisle,PA 17013 ADDRESS 717-243-4574 PHONE r'r ~ 1. CALL ATPORNEY JOHN B120UJOS ON 6/3/02 LV 9/ql phis is ro certi v slat c4e information here given is correctly copied Moro an original certificate of death duly }fled with me as Local Registrar 'fhe original certificate will be forwarded ('1 the State Vital Records Office for permanent filing. 1NARNING: It is illegal to duplicate this copy by photostat or photograph. Pee for this cerci6catc, $2.011 a. Fem. Locil xegistral~~~~~ V - P 8'~1 977 Nu. 11 p-K. ~ ~ ~-`~-4~,I~'~1F. X+ps.. u Rn. yaT COMMON W EALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH VITAL RECORDS .NT CERTIFICATE OF DEATH EML NAME DF OELEDf Ni If vY.Mb]e, Easl SIMF MIEN 4K n..-ii_ ~ .. $EV w~.~a~.~............ nue lLw $wgeYl DXOER+rE:w uNDERIDM "r emRX DM NDF 9IRTX egETNFLAf{ILNMM 9 - ik - 7hkk 63 o-. r D.Y. XeM. , Mewlw Dw YMI sul.o- Eo-Xp,eX,mn queEa DEMN¢I.ec. o-y,„p--xe~mev/mmdnn A•1 r„ i 6/19/1918 Marty3vtk2e, PA IK)sPILLL: • OTHER a' : r F ^WIM^ ERpMpalnnU ppi^ ~ 99 CWx1Y OF CEMX Lf1Y. piq. }yap LF DEMM F.CIVIY NAME OI rp ipnpp~ M. '1j Cumbert~Qand ~PW1 Ar"1in0iX"n0°r' w/AS DF<FDENr DF XUry,NCDF O[ S. Mddd.Ze#on Tw N,~ „•^q~~~~ 'E. ,~ p. Cumbert2and Crtohain a Re`~• DE<E CEM'8 V$VAL OCLVFMENI F.. 9 #irtemen# M..Yp.FUne Rlu .«<. KINDLFBVLNESbINWSiRV a. IGMem YpeCyy pvvp yMa DECECENi EVERW OECECENiyEWCMlp1 d Yja~aMEN;mruwraMll V. s.ARMEDFOgLEbI MARlGL9TMUS~MMMa La001LCH Ne.M M•nYa. YRm..a. InMQRU6aC#LLrtin n.^ MR7 EYmenlero sttwlM'ar nil Dno-welsp.a.R oeLEDENr'a uAxING ADOrEE%IVr.w.crngMn. aYeY.mCCbl DE<EDENra aE ". 12 ae. widowed ' 2& Mountain St. ~~„~ +Y.. wY Pennhy vania pY a,e.^w.pMMp.NfwY M#. Ho££y Sprting~, PA 17065 ~W~ p.e.eMe Cumbe22and ~.* rq w.e.e.aXfE..a M Ho FMXEA'ENAME IFiyAMWAIaq IA.Ceun +TLIy rreMeMUaIlYn4Y Emi.ii, h n MOTNER'SNAME1F.d Mgna. uedmsunamel W{M,MMf's aUMERYWFr.'l) IF. He.Qen Gulden INFCgMANY, MAKYp %I$e.Y. .s... zpc,p., uEENW DFasroslTKXa Tle. aWl.•J Lremalbn^ DME Cf 018PO$ITKIH %ACEOF p$POSIFKIN.MMneq CwMMry. Gremnpy L Mlm+^ dnw6oacm R•mwYFOm4ne^ ^ ILMn. M.'M pl+w %aF ' • aa• E+E May 29,2002 !M#. HDT2y Sprting3 Cem. .M#, I EIDNM CFiVNEML RVK LKENEEEMPEP$DX A<ilnp A$911CM LICENSE NVMBEP NAMEANLACOgE%OF FALKrtV dryYeYnYga.aW L4~M IxyaIM w bNabntlmYYNrr4pEM1npngpnala„Mllme. gMUMdaa RMp. ~'~ + ' yyR4~Metlpenp SryMnne MMi L N%NVMBER e.e.luemm eevrornwq nMF OF ATn ~µ' ~ fe. F•rbn.lu dpvwe4baN, OMF FRgVWHCED DF/.p IMmT,Dry RVI VN$LA$E REFERREDTOMEpC.LLEMAY ~n. FARr I: EM.rm.m......MMr»av.amwa+la..~n~...aln. a..mm~I.m.~In.,3~m.ImA 2~a o-100L n.^ LueMYw e.won wn~ln.. o mmY,.u<no..,a.aor r.w~r.rm.rr.Y..noa.r n..n la„r.. a. -C~// -„''~L, ' wr..ImM. FART n: YYlDI1Tl GUal lFwl io W^Ybn••n '~9ndeN1~Y e C~/ ~~ I satll W E 101CR AS A Cd6F W E NCE O fl: F•^KMM. YebpYX ' r u~EM~1I110fAVN1O WETOIU113ACCN$EWENCE Df): r Glq[IOrrv+Yry c. I I • r~~'9•YMe'IWT WETO(piMACCaSEWENCE Cif: • e. I VMSAX/rlllppsY WyPE.LVIGP$r Nqq YµNER CF LEMX .!A<ORMED, MKABLETgR 1D DMEOFIWVflY TIME Cf IWVRY COMPLETICH (Y f,AygE ~ S Iumn. DaY. Merl IWVRrM VrCRYi LEat K Cf.QXI WIwY Nen~ •y ^ '~~•'a ^ FanMglnwaryalbn ^ tea ^ W ^ Yei ^ X•~ .a. ^ W ^ s+rn ^ Lo-+e~le.en..nwn ^ PucFraF lXnrY._...J_ ~_ _..... _ M' a xp. _.__...._...,,...... ~,m w~nrwxnll.~m _.___..._~ .. .. rerFR , :em.wewbwe.rr..m.Ib menrM. ee.Inw.......... ............................ ............... mn. •FgDWVNLINGYA`Np CIRTIFTIMGIMY$N:IAMIRryv ntrM dneurcipawd ygcenaryrq to FauydCeaml LICENSE NVMBEq .Map•. aaMnee.wreaat evmr.a. eala.aM glwa. arMauabma eauvlMana ^ d7J~-tZ~ mannannn•a .................. _... _. Te. 'M[OIC.EL F%1MINER/CORONER NAME ANOAOMESSCF ~[RSON yaNOCC OnIM OeW OM.amlMllan.rq/a lnwall (Item lT Typ•aPrlm U$y,/~~ Mnnxuat.t•Y .................... 9aabn.In mY Oplnlon~acelX MCUn•d eltM llme, E.l a,aM Iece~eM Jw 1a 1K•nuu(a)aM ,/'Y .. ..............................................p............................ ^ 3p3` Y,t/. REGI$TPAq'$SIGNMURE AHDN Ep -"F A•~~ ~~~ DMEFKEGIMmInDaYYUI N 4 2002 Date CJ geNie L7 QNr 15FCMl^ ~y^N+ ~.MrX.n Mtl.N,EYMr, yp .. whi#¢ v~J "~"~_ 3 -- ©a-- irY 21-2002-532 ~ Gretta T. Boyer of Mt. Holly Springs, Cumberland County, Pennsylvania, declaze this to be my last will and revoke any will previously made by me. ,item ®tte: I direct that all my debts and funeral expenses including my gravemazker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ~tetn ~tUO: I give, devise, and bequeath my entire estate as follows: A. 1/2 of my entire estate to my sister Ruth Shopp, per stirpes, B. 1/2 of my entire estate to my sister Helen Gulden, per stirpes. $tem ~fjr2e: I appoint my sister Ruth Shopp Executrix of this my last will. Should she fail to qualify or cease to act as Executrix, I appoint my sister Helen Gulden to act as Executrix with the same rights, powers, and duties. .~tettt 1FouC: I appoint my niece Judith E. Mazshall, Guazdian of any property which passes to any person under the age of 21 years and with respect to which I am authorized to appoint a guazdian and have not otherwise specifically done so. Guardian shall have the power to use income from time to time for the beneficiary's education, support, and welfaze without regard to his or her parent's ability to provide for such education (including vocational and trade schools), support, or welfare, or to make payment for these purposes, without further responsibility, to the beneficiary or to the beneficiary's parents or to any person taking caze of '~ the beneficiary. Guazdian shall administer the separate and equal share of each beneficiary „ ~ until he or she becomes 21 yeazs of age, at which time the shaze of each beneficiary ~~ remaining in the guazdianship account shad be paid to said'oeneficiary in full. In the event of Z the death of any beneficiary after my decease and prior to reaching the age of 21 yeazs, his or ~~ her shaze shall be distributed equally to my surviving children or child to be administered in accordance with this guazdianship provision. Should she fail or cease to act as Guardian, I ~~ appoint my niece Joyce L. Wallace to act as Guardian with the same rights, powers, and duties. item ~fibe: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. 1 of 3 .$tem fix: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. .$tem ~ebett: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this will, I give to my Executrix during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property, and to give options for leases. E. To make distribution in kind. F. To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of Mazch, 1997. ~igneD~ ,~2z:z~ ~i ~ Gretta T. Boyer The preceding instrument, consisting of this and two other typewritten pages each identified by the signature of the Testatrix was on the day and date thereof signed, published and declared by the Testatrix therein named as and for her last will, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names. 2 of 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We John H. Broujos and ~~~ 7 pw,J G;,p~~,~ witnesses whose names aze signed to the attached or foregoing instmment being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her last will; that she signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more yeazs of age, of sound mind and under no Sworn and subscribed to before me this 7th day of Mazch, 1997. ~. ' s~ ~~. c~ ~ Y .~~ Ia~`7 tary Public Notarial Seal Sherri L. Murphy, Notary Public Carlisle Boro, Cumberland County My Commission Expires Jan. 4, 7 999 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND (~ I Gretta T. Boyer whose name is signed to the attached document, 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 as my free and voluntary act for the purposes therein expressed. Sworn and affirmed to and acknowledged before me this 7th day of Mazch, 1997. 1TVOtary~Public Gretta T. Boyer Notarial Seal Sherri L. Murphy, Notary PuWlc Carlisle Boro, Cumberland County My Commission Expires Jan. 4, 1999 3 of 3 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Date of Death: Will No.: To the Register: Gretta T. Boyer May 26, 2002 Admin. No.: 21-02-00532 I certify that notice of 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 July 23, 2002: Name Address Helen Gulden 109 Butler Street, Mt. Holly Springs, PA 17065 Terry A. Shopp 139 Cold Springs Road, Carlisle, PA 17013 Sherry Shopp Rehr 5010 Alki Drive, Everett, WA 98203 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: 7.23.02 ign ture John H. Broujos, Esquire #06268 4 North Hanover Street Carlisle, PA 17013 (717)243-4574 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNRVLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1)128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001562 BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 1eIE ESTATE INFORMATION: ssN: t5s-to-sass FILE NUMBER: 2102-0532 DECEDENT NAME: BOYER GRETTA T DATE OF PAYMENT: 08/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/26/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 534,000.00 REV-1162 EXI11-961 TOTAL AMOUNT PAID: REMARKS: JOHN BROUJOS ESQUIRE CHECK# 23 INITIALS: AC SEAL RECEIVED BY: 534,000.00 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS /? . REV-H;,{lOE~+(6-00) '* COMMONWEALTH OF PENNSYLVANIA , OEPARTMENT OF REVENUE DEPT,280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl) \\-VI-\~ REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W U W C BOYER GRETTA T- DATE OF DEATH (MM-DD-Yea<) QA1E OF BIR1H (MM-OO-Year) OFFICIAL USE ONLY FILE NUMBER 21 -0 2 00532 "'COUNrvCODE ---ye~ - - NUi:lBER-- SOCIAL SECURITY NUMBER 1 59- 1 8 - 6 7 8 8 THIS RET\lRII MUST BE FILED IN OUPllCAlE WITH THE REGISTER OF WILL.S SOCIAL SECURITY NUMBER w ... :!Il:::!cn 0"''' wo.o ",00 0"'--' 0.", 0. '" OS/26/2002 06/19/1918 (If APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 00 1. Original Return o 4, Umited Estate 00 6, Decedent Died Testate (Attach copy of Will} o 9. Litigation Proceeds Received D 2, Supplemental Return o 4a. Future interest Compromise \datt: of dell\tlm12-12-82) o 7. Decedent Maintained a Living Trust {Attach copyolTrust} o 10. Spousal Poverty Credit (date of death bet\lt'een 12-31-91 and 1-1-95) o 3. Remainder Return (dale 01 death pricll'to 12-13-82) D 5, Federal Estate Tax Return Required 00 8, Total Number of Safe Deposit Boxes D 11. Election to tax under See, 9113(A) _" SC" 01 THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS JOHN H, BROUJOS ESQUIRE 4 NORTH HANOVER STREET FIRM NAME (11 Applicable) BROUJOS & GILROY P,C, TELEPHONE NUMBER 717-243-4574 CARLISLE PA 17013 >- z w o z o 0. ~ '" 8 z o i= ~ :::l l- ii: <C U w ~ 1. Real Estate (Schedule A) (1) 2, Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4, Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6, Jointly OWned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-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. TotaIDeductions(totaiLines9& 10) 12, Net Value of Estate (Line 8 minus Line 11) 13, Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) 90,550.26 OFFICIAL liSE ONL''''-- I I \ 70,167,24 14, Net Value Subjectlo lax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <C I- :::l 0. :.Ii! o u >< <C I- 15, Amount of Line 14 taxable atthe spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16, Amount of Line 14 taxable at lineal rate 119,685,86 (8) 280,403,36 17. Amount of Line 14 taxable at sibling rate 128,671,21 128,671.21 14,163,00 8,897,94 (11) (12) (13) 23,060,94 257,342.42 18. Amount of Line 14 taxable at collateral rate 19, Tax Due (14) 257,342.42 X _(15) X _(16) X ,12 (17) 15,440,55 X ,15 (18) 19,300,68 (19) 34,741,23 20. [8] CHECK HERE IF YOU ARE REOUESTlNG A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 28 Mountain Street -, . CITY Mt. Holly Springs Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount I STATE PA I ZIP 17065 (1) 34,741.23 34 000.00 1 700.00 Total Credits (A + 8 +C) (2) 35,700.00 3. InteresUPenalty if applicable D. Interest E. Penalty T otallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 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) A. Enter the interest on the tax due. (SA) 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 958.77 0.00 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 IKI b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IKI c. retain a reversionary interest; or ...................................................................................................... D lKl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IKI 2. If death occurred after December 12,1982, did decedent transfer property within on~ year of death without receiving adequate consideration?........................ ................... ............................ ........................ 0 IKI 3. Did decedent own an "in trust fo~ or payable upon death bank account or security at his or her death? ................. 0 IKI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... IKI 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. PA 17065 DATE ;( - ~ G,-03 PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to orforthe use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)). For dates of death on or after January I, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. The statute does not exemDt 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 rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)). The tax rate imposed on the net value of transfers to orforthe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(I.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 'REV'W2Ex<\,.,nw COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN I T SCHEDULE A REAL ESTATE ESTATE OF FilE NUMBER BOYER GRETTA T 21 02 00532 All real property owned solely or as a tenant in common must be reported at 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 knowledge of the relevant facts. Real property which is jointly-owned with right of survivorshiD must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 28 Mountain Street, Mt. Holly Springs, PA 17065 3 BR ranch house, 1144 sq.ft.; 1-car garage; full basement; .3 acre (HUD-1 attached) VALUE AT DATE OF DEATH 90,550.26 TOTAL (Also enteron line 1, Recapitulation) $ (II more space is needed, insert additional sheets 01 the same size) 90 550.26 OMS NO. 25 ~5 ",. A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1./RIFHA 2-D FmHA 3. DcoNV. UNINS. 4-OVA 5.DcONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT A102-205 WOLF 0048930838 8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER: 441-6973779 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 ~{pOCr were paid outside the closing; they are shown here for informa/ional purposes and are not included in the to/als. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: GARY L. WOLF HELEN T. GULDEN. EXECUTRIX OF WASHINGTON MUTUAL BANK 28 MOUNTAIN STREET THE ESTATE OF GRETlA M. BOYER AGENT FOR PNC BANK MOUNT HOLLY SPRINGS. PA 17065 P.O. BOX 25064 SANTA ANA, CA 92709 G. PROPERTY lOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE: 28 MOUNTAIN STREET A-1 Abstract Associates. Inc. MOUNT HOLLY SPRINGS, PA 17065 Augus129,2002 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 1600 linglestown Rd, Ste 102 Harrisburg, PA 17110.3355 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 97.000.00 401. Conlract Sales Price 97,000.00 102. Personal Pro e 402. Personal Prooerlv 103. Settlement Char es to Borrower (Line 1400) 2 238.57 403. 104. 404. 105. 405. Ad'ustments For Items Paid B Seller in advance Adiustments For lIems Paid Bv Seller in advance 106. Citvfrown Taxes to 406. Cit frown Taxes to 107. Counlv Taxes 08/30/02 to 01/01/03 129.36 407. Count Taxes 08/30102 10 01/01/03 129.36 108. Schoof Tax 08/30/02 to 07/01/03 751.75 408. School Tax 08/30/02 to 07/01/03 751.75 109. 409. 110. 410. 111. 411. 112. 412. 120 GROSS AMOUNT DUE FROM BORROWER 100,119.68 420. GROSS AMOUNT DUE TO SELLER 97,881.11 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest mone 500.00 501. Excess Oeoosit See Instructions) 202. Principal Amount of New Loan(s 95,501.00 502. Settlement Char es 10 Seller Une 1400\ 6,449.20 203. Existino loan(s) taken subject to 503. Existino loan/s) taken sub'ect to 204. CredlVCPL d bv lender 35.00 504. Payoff of first Mortgage 205. PNC Grant 1,QOO.00 505. Pa off of second Mort a e 206. Grant Funds/Redev Auth of CC 3 000.00 506. 207. 507. (Deposit disb. as roceeds 208. 508. 209. 509. Ad;ustments For Items Un aid B Seller Adiustments For Items Unnaid Bv Seller 210. Citvfrown Taxes to 510. Cit fTown Taxes 10 211. Counlv Taxes to 511. Count Taxes to 212. School Tax to 512. School Tax to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 2002 School Tax to Mable R. Satteson Tax Colleato 881.65 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 100.036.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 7,330.85 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower (Une 12m 100,119.68 601. Gross Amount Due To Seller Une 420) 97,881.11 302. Less Amount Paid By/For Borrower (Une 220) ( 100,036.00) 602. Less Reductions Due Seller (Une 520) ( 7.33085 303. CASH ( X FROM) ( TO) BORROWER 83.68 603. CASH ( X TO)( FROM) SELLER 90,550.26 "m ~ The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Bo,,"we' -1f~ -i. Lw{i GARY L. WOLF Seifer c.,-fl/{J!'k_ r.1 i/~i{:tlt~'-/ HELEN T. GULDEN, EXECUTRIX OF THE ESTATE OF GRETTA M. BOYER L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ ((j) % 3,000,00 PAID FROM PAlorROM Division of Commission line 700las Follows: BORROWER'S SELLER'S 701. $ 3,000.00 10 Re/Max Sterling Associates I'UNDSAT FUNoslr 702. $ 10 SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 3,000.00 704. Transaction Fee 10 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. loan Oriaination Fee % 10 802. Loan Discount % 10 803. Appraisal Fee paid by Lender 10 S.W. Barrett Real Estate POC $325,00 804. Credit Report 10 CBA Information Services POC $53.00 805. Lender's Inspection Fee 10 806. Mort ana Ins. Ann, Fee 10 807. Assumption Fee 10 808. Tax Service Fee 10 First American Real Estate Tax Service POC $23.76 809. Flood Certification Fee 10 WASHINGTON MUTUAL BANK AGENT FOR PNC BANK POC $13.00 810 Wire Transfer Fee 10 WASHINGTON MUTUAL BANK AGENT FOR PNC BA~ Seller credit 35,00 811, FHA Premium to US Dept of HUD 1,411.35 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 08/29/02 10 09/01/02 @ $ 17,010000/day ( 3 days %) POC $51.03 902. Mort a e Insurance Premiumfor months to 903 Hazard Insurance Premium for 1.0~ars toMA Insurance Aoencv POC $245.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3,000 months Ii;) $ 20.42 ner month ... Seller credit 61.26 1002. Mortnane Insurance months ((j) $ er month 1003. Citvrfown Taxes ,110nths ((j) $ oer month 1004. Countv Taxes 3,000 _months Ii;) $ 28.27 ner month ... Seller credit 84,81 1005. School Tax 3,000 110nths @ $ 73.47 per month ... Seller credit 220,41 1006, months cID $ er month 1007. -months @ ,$ er month 1008. A re ate Ad'ustment -months cID $ er month -0,01 1100. TITLE CHARGES 1101. Settlement or Closioo Fee 10 E;,ou'oS & Gilrov, PC, Attornevs at Law I 450.00 1102. Abstract or Title Search 10 J~, 1 Abstract Associates, Inc. '''Spllt credit/Sell 64.48 30.52 1103. Title Examination 10 1104. Title Insurance Binder 10 ~'onna L. Godfrev, Esquire 185.00 1105. Document Preoaration 10 1106. Notarv Fees 10 ASH ... Seller 22.50 1107. Attorney's Fees 10 :_'oona L. Godfrey, Esquire ."Seller credit 403.00 includes above item numbers: ) 1108. Title Insurance 10 ,-\-1 Abstract Associates Inc. Polic # 342.75 (includes above item numbers: 1109. Lender's Coverage $ 95,501,00 1110. Owner's Coverage $ 97,000,00 1111. Endorsements 100.300.8.1 10 A-1 Abstract Associates, Inc. 150.00 1112. Closing Protection Letter 10 First American Title Insurance Co. see credit/line 204 35.00 1113. Overnight (Payoffs/Package) A.1 Abstract Associates, Inc. 1114, Tax Receipts A-' Abstract Associates, Inc. 1115. Notary Fee 10 Brujos & Gilroy, PC 350 1116. 1117 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 28,50; Mortgage $ 99.00; Releases $ "'Seller crecdit 127,50 1202. Cit /Count Tax/Starn s:Deed 970.00' Mort a e 970,00 1203. State Tax/Starn s: Revenue Stamns 970.00; Mort a e ".Seller credit 970.00 1204. 1205 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survev 10 1302. Pest Ins ection 10 HOMECHEK 10#6090 50.00 1303. Administrative Fees 10 Donna L. GOOfre ,Es uire ".Seller credit 45.00 1304, Final Water/Sewer No Usa e 1305. Trash Collection/10 wks to Mount Holly Springs Borough 25.70 1400. TOTAL SETTLEMENT CHARGES fEnter on Lines 103, Section J and 502, Section K) 2,238,57 6,449.20 ,",,,,p,' By Signing page 1 of th,s stalemenl. lt1e S'QI1atories acknowledge receipt of a complelad copy of page 2 of thiS two page stalemenl ~:, / A-1 Abstract Associ~tes, \nc. Settlement Ag~t 7 J -I-~ ( -.1-':( '''''';00''''''971. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BOYER GRETTA T. FILE NUMBER 21 02 00532 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, 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION PNC Bank checking acct # 5140397399 VALUE AT DATE OF OEA TH 14,152.68 American Express Mutual Funds 6633.746 shares @4.840 acct # 01245284563 4 002 32,107.33 PNC Brokerage Corp. - Blackrock Bal Port B; CBIBX A; 1,496.63100 shares@$13.00 19,456.20 1988 Ford Tempo. VIN: 1FAPP37X9JK234437 1,500.00 Household items, net from sale at Haar's Auction (bill of sale attached) 1,333.45 IDS Life Insurance Company - refund of premium on long-term care policy 62.50 Refund from Hollinger Funeral Home, Ml. Holly Springs 256.41 Cash on hand 1,040.10 Refund of Erie homeowners insurance premium 42.00 Blue Cross Blue Shield reimbursement of medical expenses 112.50 Miscellaneous deposit 104.07 TOTAL (Also enter on line 5, Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) 70167,24 ----------....". .....- 1p;f. .~~i_Cn --- 11-:2. NO"'" ""^'" ~~ -~ -- ;).0 <51 Lf.) ~ s\,aa\ 01 RIO 101ALSALE -~-~ C- 7/~OO ~- C - " - "" _ ~U~-:J---- -~ DOLLARS CE.t'-lTS iA~ CHARGE \ '~ eft (~) 0 <...c r} ') 0 \/ I J..2 o~ ~. ((/ KAAR'S ~UC1'ON D\LLSlURG, p", 432-38\5 . 432-30\\ ~uct\ON EVER" 1\JESO"''' 81 fRtD"''' iVE. - 6:30 pM (:k2 \iE.M -- '--.0J\.hy '-- ("'''' -:.:' u\./ ('0 ,/'_ -- n :f\-:'!,fvv--x.- --- /11 -- ----- --- - _' t. I ,< 0 N / . -Prf __ J 6 f\f'..0N ' j " ::r5 (. r: ~ y (.;t- .- Vi d" -- ! , " (y} ~ - ~ -- rS.()'_JJ /1\ \ ~ Sf ...-- ""'''''','',971. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BOYER GRETTA T. SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY FILE NUMBER 21 02 00532 Th'lS schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR I'lELATION$HIP TO DECEDENT AND THE DA TEOfTAANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY OF THE OEEO FOR REAl ESTATE VALUE OF ASSET INTEREST (lfAPI'L1CABLE) 1. American Express Annuities Post 1985 40,587.40 100. 40,587.40 acct # 93003320861 0004; transferred 9/02 to sister Helen Gulden (50%), nephew Terry A. Shopp (25%), and niece Sherry Shopp Rehr (25%) 2, PNC Brokerage Corp. - Glenbrook Annuity Contract 27,327.22 100. 27,327.22 # GA280831 ; transferred 8/02 to sister Helen Gulden 3, PNC Brokerage Corp. - MetLife Annuity Contract 51,771.24 100. 51,771.24 # A2068667; transferred 8102 to sister Helen Gulden TOTAL (Also enter on line 7, Recapitulation) $ 119685.86 " (If more space IS needed, Insert additional sheets of the same size) "",15"""''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDEN1 DECEDEN1 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF BOYER GRETTA T FILE NUMBER 21 02 00532 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1- Pre-paid B. ADMINISTRATIVE COSTS: 1- Personal Representative's Commissions Name of Personal Representative (5) Helen Gulden 4,000.00 Social Security Numbe<<s) I EIN Number of PelSonal Represenlative{s) Street Address 109 Butler Street City Ml. HoIIV Springs Slate PA Zip 17065 Yea~s) Commission Paid: 2003 2. Attorney Fees Broujos & Gilroy, P.C.; EIN 23-2267691 9,500.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) 0.00 Claimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 311.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees Patrick L. Donley 35.00 7. Register of Wills - Inventory filing fee 10.00 8. Register of Wills - Inheritance Tax Return filing fee 15.00 9. Register of Wills - Family Settlement Statement 17.00 10. George L. Ebener & Associates - appraisal of real property 275.00 TOTAL (Also enter on line 9, Recapitulation) $ 14163.00 (If more space is needed, insert additional sheets of the same size) - .~. """""''''9''~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21 02 ESTATE OF BOYER. GRETTA T 00532 Include un reimbursed medical expenses. ITEM NUMBER AMOUNT DESCRIPTION 1. Sprint - phone 55.58 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Borough of Mt. Holly - water and sewer 59.60 The Patriot News - newspaper 23.55 The Sentinel - newspaper 55.00 Alert Pharmacy - medication 328.29 Cumberland Crossing - nursing care 3,725.15 Met Ed - electricity 79.77 Erie Insurance - homeowners insurance 71.00 Jay and Joan McBride - services to clean house and prepare for sale 1,250.00 Judith Marshall - services to clean house and prepare for sale 1,000.00 Joyce Wallace - services to clean house and prepare for sale 1,250.00 Barry McCoy - services to clean house and prepare for sale 250.00 Kelly L. Cluck - services to clean house and prepare for sale 250.00 Roxanne Wallace - services to clean house and prepare for sale 250.00 Kraig Wallace - services to clean house and prepare for sale 250.00 TOTAL (Also enter online 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8897.94 'EV.15m;.,,"". COMMONWEALTH OF PENNSYLVAN'A INHERITANCE TAX RETURN RESIDENT DECEDEN1 SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER ,T 21 07 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME ANO ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (Include outright spousal distributions) 1. Helen T. Gulden sister 1/2 109 Butler Street, Mt. Holly Springs, PA 17065 2. Ruth T Shopp (predeceased the death of decedent) a. Terry A. Shopp nephew 1/4 139 Cold Springs Road, Carlisle, PA 17013 2. b. Sherry Shopp Rehr niece 1/4 5010 Alki Drive, Everett, WA 98203 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1- B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. none 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) V ~ ~-6~- ~~ BUREE'J OF INDIVIDUAL TAXES INHERITANCE TA% DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JOHN H BROUJOS ESQ BROUJOS 8 GILROY 4 N HANOVER ST CARLISLE PA 17013 EEY-l56) EM IFV (Y1-Ob DATE 04-14-2003 ESTATE OF BOYER GRETTA T DATE OF DEATH 05-26-2002 FILE NUMBER 21 02-0532 COUNTY CUMBERLAND ACN 101 Amount Remitted 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 t REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOYER GRETTA T FILE N0. 21 02-0532 ACN 101 DATE 04-14-2003 TAX RETURN HAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate [Schedule A) (1) 9D ,550 .26 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable f5chedule D] (4) .00 of this fiorn with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 70 ,167 .24 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) [7) 119 ,685.86 B. Total Assets fig) 280,403.36 APPROVED DEDUCTIONS AND EXEMPTIONS: 14,163 .00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) [9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (30) 8,897.94 11. Total Deductions Q1) 23.060.94 12. Net Value of Tax Return (12] 257,342.42 13. Charitable/Governmental Bequests) Non-elected 9113 Trusts (Schedule J] (13) .00 14. Net Value of Estate Sub]ect to Tax X14) 257,342.42 NOTE: If an assessment was issued previously, sines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the totes of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Lina 14 at Spousal rate (15) •OD X OD __ .00 Ib. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 . .00 17. Amount of Line 14 at Sibling rate X17) 168,220.44 X 12 20,186.45 18. Amount of Line 14 taxable at Collateral/Class B rata (18) 89,121.98 g 15 - 13,368.29 19. Principal Tax Due (19). 33,554.74 TAY CRFMTTRe DATE NUMBER F INTEREST/PEN PAID [-) AMOUNT PAID 08-26-2002 CD001562 1,677.74 34,000.00 ^ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 35,677. 74 BALANCE OF TAX DUE 2,123. 000R INTEREST AND PEN. . 00 TOTAL DUE 2,123. 000R [ IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REVUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ti ~~- ~, y BUREAU OF INDIVIDUAL TAXES INHERITANCE TpX 0IVI8ION DEPT. 280601 NARRISBURG• PA 17128-0601 JOHN H BROUJOS ESp BROUJOS 8 GILROY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT PEY-1 W] EM iFP [OI-n) Tl ('i(~.~ir "f ~~~~ .I^ ~.. .,4 '03 MAY 16 A1D :44 4 N HANOUER ST 1.:i4(k CARLISLE pA ~, Inlbc. ~;~n ,' ~ 1 DATE 04-28-2003 ESTATE OF BOYER GRETTA T DATE OF DEATH OS-26-2002 FILE NUMBER 21 02-0532 COUNTY CUMBERLAND ACN 101 Anount Renittad MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subnit the upper portion of this Porn with your tax paynent. CUT ALONG THIS LINE --__ RE_TAIN LOWER PORTION FOR YOUR RECORDS ~ -------------- ---------- REV-1607 EX AFP (01-03) d[3E3[ INHERiTANeF-TAY-eTnteu-rum ::~---------- ESTATE OF BOYER GRETTA T FILE NO. 21 02-0532 ACN 101 DATE D4-28-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOMN BELOM IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-07-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 33,554.74 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID OB-26-2002 CD001562 1,677.74 34,000 00 04-08-2003 REFUND .00 . 2,123.00- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. n IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A '•CREDIT•• (CRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ] 33,554.74 .OD .00 .00 INVENTORY OF THE REAL AND PERSONAL ESTATE OF GRETTA T. BOYER, deceased File No.: 21-02-00532 Date of Death: May 26, 2002 Probate Assets 1. Proceeds from sale of 3-BR Ranch house at 28 Mountain Street, Mt. Holly Springs, PA $ 90,550.26 2. PNC Bank checking acct # 5140397399 3. PNC Brokerage Corp. - Blackrock Bal Port B; CBIBX A; 14,152.68 19 456 20 1,496.63100 shares @ $13.00 , . 4. 1988 Ford Tempo. VIN: 1FAPP37X9JK234437 1 500 00 5. Household items, net from sale at Haar's Auction , . 1 333 45 6. IDS Life Insurance Co. -refund of premium on long-term care policy , . 62 50 7. Refund from Hollinger Funeral Home, Mt. Holly Springs . 256 41 8. Cash on hand . 9. Refund of Erie homeowners insurance premium 1,040.10 10. Blue Cross Blue Shield reimbursement of medical expenses 42.00 11. Miscellaneous deposit 112.50 104.07 Total Probate Assets 128,610.17 Non-Probate Pronertv (Schedule G). 100% was decedent's interest. Transferred after death. 1. American Express Mutual Funds, acct # 01245284563 4 002 32,107.33 6633.746 shares @ 4.840 2. American Express Annuities Post 1985 acct # 930033260861 0 004 $ 40,587.40 3. PNC Brokerage Corp - Glenbrook Annuity Contract # GA280831 27,327,22 4. PNC Brokerage Corp - MetLife Annuity Contract # A2068667 51.771.24 ~-r TotaYNgn-Prate Property $ 151,793.19 ~~ TOTAL ASSN'S $ 280,403.36 ~; .:= -., Heiieii'C,ulde>~Exectiotr-ix of the Estate of Gretta T. Boyer, late of Mt. Holly Springs, Cumberland County, Pennsylvarir~@as made an inventory of the entire estate of decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent its fair value as of the date of decedent's death. Date: April 30, 2003 .Jr'/~z,,~ ~ ~ Helen Gulden, Executrix Family Settlement Agreement File No. 21-02-0532 THIS is an agreement entered into this ~ day of ~ 2003, by and between Helen Gulden, Executrix and Beneficiary under the Estate of Gr tta T. Boyer, of 109 Butler Street, Mt. Holly Springs, PA 17065 (Executrix), Terry A. Shopp, 139 Cold Springs Road, Carlisle, PA 17013, and Sherry Shopp Rehr, 5010 Alki Drive, Everett, WA 98203, Beneficiaries, whose names are set forth as signatories at the end of this Agreement. WHEREAS: A. Gretta T. Boyer, of 28 Mountain Street, Mt. Holly Springs, PA 17065, died on May 26, 2002. B. On June 3, 2002, Letters Testamentary were granted to Helen Gulden at File No. 21-02- 0532 in the Register of Wills Office for Cumberland County, Pennsylvania. C. Executrix has administered the estate up until the present time and has paid all debts of the estate, including lnheritance Tax owed. D. Gretta T. Boyer died testate, thereby vesting all rights and interest in her personal and real property to Helen Gulden and Ruth Shopp (per stirpes to Terry Shopp and Sherry Shopp Rehr). E. The probate assets of the estate are set forth in Exhibit A attached #~Xeto and made a dart hereof. The non-probate assets of the estate are set forth in Exhibit D atta~h~tl her~0 and ~ta~"e a part hereof. ,,. ,- F. Executrix has paid the debts of the estate as set forth in Exhibit B attached hereto and made a part hereof. N G. There remains to be distributed to the beneficiaries the assets set forth in t}3e Sched'u'le:of Distribution in Exhibit C attached hereto and made a part hereof. A H. Executrix and Beneficiaries desire to forego a formal accounting and schedule of distribution and desire to conclude the estate by virtue of the filing of this document. NOW, THEREFORE, Executrix and Beneficiaries intending to be legally bound, state as follows: 1. The Executrix and Beneficiaries agree that the Executrix of the Estate of Gretta T. Boyer need not file a formal accounting or schedule of distribution. Executrix states that all costs of the estate are paid. 3. The parties agree to distribution of the assets in accordance with Schedule C. 4. The parties acknowledge that any distribution made by Executrix pursuant to this Agreement is an "at risk" distribution pursuant to 20 P.S. 3532. Beneficiaries hereby release Executrix with respect to acts or omissions in the administration and distribution of the estate and hereby agree to return such funds as were distributed under the administration of the estate as may be required for the payment of any proper claims not discharged prior to this distribution. 5. The parties designate this statement as a "satisfaction of award" and hereby authorize and direct the Clerk of Orphans' Court to make satisfied of record any award which may subsequently be made by the Court with respect to the distribution made to the distributees in this Agreement. 6. The parties agree that this Family Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the Estate of Gretta T. Boyer, subject to the provisions hereof. IN WITNESS WHEREOF, Helen Gulden, Executrix, and Beneficiaries, intending to be legally bound hereby set their hands and seals the day and year first above written. WI E S: ~~ 1 ([~~ Helen Gulden, Executrix and BenefTiciary Terry A. Shopp, Beneficiary Sherry Shopp Rehr, Beneficiary COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND On this, the ~ day of 2003, before me, the undersigned officer, personally appeared Helen Gulden, known o e or satisfactorily proven to be the executrix whose name is subscribed to the within document, and acknowledged that she executed the same for the purpose therein contained. fN WITNESS WHEREOF, I have hereunto set my hand d notarial seal. /' ~-/ C~/G~.~/~ N TARY UBLIC Notarial Seal Bridget qnn Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires lone 10, 2006 Member, Pennsylyyttlaga,~pojyrygtaNOharies 4. The parties acknowledge that any distribution made by Executrix pursuant to this Agreement is an "at risk" distribution pursuant to 20 P.S. 3532. Beneficiaries hereby release Executrix with respect to acts or omissions in the administration and distribution of the estate and hereby agree to return such funds as were distributed under the administration of the estate as may be required for the payment of any proper claims not dischazged prior to this distribution. 5. The parties designate this statement as a "satisfaction of awazd" and hereby authorize and direct the Clerk of Orphans' Court to make satisfied of record any awazd which may subsequently be made by the Court with respect to the distribution made to the distributees in this Agreement. 6. The parties agree that this Family Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the Estate of Gretta T. Boyer, subject to the provisions hereof. IN WITNESS WHEREOF, Helen Gulden, Executrix, and Beneficiaries, intending to be legally bound hereby set their hands and seals the day and year first above written. ~LL~?Qo~,., ~ ~C, O~lo~; Helen Gulden, Executrix and Beneficiary Terry A. Shopp en iciary /v/7T~- Sherry Shopp Rehr, Beneficiary COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this, the ~ day of 2003, before me, the undersigned officer, personally appeazed Helen Gulden, known o e or satisfactorily proven to be the executrix whose name is subscribed to the within document, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand d notarial seal. /~' ,~ (~CQ/Gc~. N TARY UBLIC Notarial Seal Bridget Ann Corcoran, Notary public Carlisle Boro, Cumberland County My Comndssion Expires June l0, 2006 Member, PBnnsylvaniaA4Spdietionof Notaries 4. The parties acknowledge that any distribution made by Executrix pursuant to this Agreement is an "at risk" distribution pursuant to 20 P.S. 3532. Beneficiaries hereby release Executrix with respect to acts or omissions in the administration and distribution of the estate and hereby agree to return such funds as were distributed under the administration of the estate as may be required for the payment of any proper claims not dischazged prior to this distribution. 5. The parties designate this statement as a "satisfaction of awazd" and hereby authorize and direct the Clerk of Orphans' Court to make satisfied of record any awazd which may subsequently be made by the Court with respect to the distribution made to the distributees in this Agreement. 6. The parties agree that this Family Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the Estate of Gretta T. Boyer, subject to the provisions hereof. IN WITNESS WHEREOF, Helen Gulden, Executrix, and Beneficiaries, intending to be legally bound hereby set their hands and seals the day and year first above written. WI E ~, (~ fk9~o~ ~ <SluC i~l a Helen Gulden, Executrix and Benefcli ary ~ ~~~~~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this, the ~ day of 2003, before me, the undersigned officer, personally appeazed Helen Gulden, known o e or satisfactorily proven to be the executrix whose name is subscribed to the within document, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand d notarial seal. N TARY UBLIC ~CF%Ct,c~_ Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Ezpves lone 10, 2006 Member, PennsyryanlaASSOCiatior101Nelades I. PROBATE EXHIBIT A -ASSETS ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 3 BR ranch house, 28 Mountain Street, Mt. Holly Springs, PA $ 90,550.26 2. PNC Bank checking acct #5140397399 14,152.68 3. PNC Brokerage Corp. -Blackrock Bal Port B; CBIBX A; 1,496.63100 shares @ $13.00 19,456.20 4. 1988 Ford Tempo. VIN: 1FAPP37X9JK234437 1,500.00 5. Household items, net from sale at Haar's Auction 1,333.45 6. IDS Life Insurance Co. -refund of premium on long-term care policy 62.50 7. Refund from Hollinger Funeral Home, Mt. Holly Springs 256.41 8. Refund of Erie homeowners insurance premium 42.00 9. Blue Cross Blue Shield -reimbursement of medical expenses 112.50 10. Cash on hand 1,040.10 11. Miscellaneous deposit 104.07 TOTAL ASSETS $ 128,610.17 LOSS 1. PNC Brokerage Corp. -Blackrock Bal Port B; CBIBX A; 1,496.63100 shares; decrease in value from date of death to 8.29.02 when deposited into estate checking account - 1.219 30 NET ASSETS $127,390.87 EXHIBIT B -DEBTS AND DEDUCTIONS ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES -prepaid B. ADMINISTRATIVE COSTS 1. Personal Representative Commissions -Helen Gulden 2. Attorney Fees - Broujos & Gilroy, P.C.; EIN 23-2267691 4,000.00 3. Register of Wills -Probate Fees 9,500.00 311.00 C. MISCELLANEOUS EXPENSES 1. Register of Wills -Inventory 2. Register of Wills -Inheritance Tax Return 10.00 3. Register of Wills -Final Settlement Statement 15.00 4. George L. Ebener & Associates -appraisal of real ro ert P P 17.00 Y 275.00 D. MISCELLANEOUS DEBTS 1. Sprint -phone 2. Borough of Mt. Holl _ d sewer 55.58 3. The Patriot News - newspaper 59.60 4. The Sentinel -newspaper 23.55 5. Met Ed -electricity 55.00 79.77 6. Erie Insurance -homeowners insurance 7. Cumberland Crossin 9 -nursing care 71.00 8. Alert Pharmac y -medication 3,725.15 9. 10. Jay and Joan McBride-services to clean house and prepare for sale Judith Marshall -services to clean h 328 29 1,250.00 ouse and prepare for sale 1,000.00 11. 12. Joyce Wallace -services to clean house and prepare for sale Barry McCoy -services to clean ho 1,250.00 13. use and prepare for sale Kelly L. Cluck -services to clean house and prepare for sale 250.00 14. 15. Roxanne Showers -services to clean house and prepare for sale Kraig Wallace -services to clean hou 250.00 se and prepare for sale 250.00 16. Patrick Donley -final 1040 tax return preparation 17. Jack Nace -final 1041 fiduciary return preparation 35.00 18. Value of '88 Ford Tempo to Kraig Wallace in accordance with 300.00 decedent's wish for services performed for decedent 1.500.00 TOTAL 24, 860.94 Inheritance Tax (33,554.74 less 1,677.74 discount) 31.877.00 TOTAL DEBTS AND DEDUCTIONS $ 56,737.94 EXHIBIT C -DISTRIBUTION Assets Loss in Assets (Mutual Fund) $ 128,610.17 Net Assets - 1.219 30 127,390.87 Expenditures _- 56.737 94 Balance $ 70,652.93 Advance Distribution on 12-13 02 Helen Gulden Terry A. Shopp $ 33,000.00 Sherry Shopp Rehr 16,500.00 16.500.00 Balance .....+. - 66.000.00 $ 4,652.93 Checkbook Balance (on 4.30.03) $ 9,778.93 Refund of inheritance tax + 2,123.00 Final Bills: Register of Wills -filing fee for Inventory Register of Wills -filing fee for Family Settlement Agreement $ 10.00 Helen Gulden -personal representative com i i 17.00 m ss on Broujos & Gilroy, P.C. -legal fees 4,000.00 Broujos & Gilroy, P.C. -reimbursement for inheritance tax filing fee 2 0105 00 Jack Nace -final fiduciary return preparation . Total Final Bills 300.00 - 6.342 00 Cash balance for final distribution 5,559.93 Final Distribution Helen Gulden Terry Shopp $2,779.97 Sherry Shopp Rehr 1,389.98 1.389.98 - 5.559.93 -0- EXHIBIT D II. NON-PROBATE ASSETS Subject to Inheritance Tax Distribution of Annuities & Mutual Fund (from Schedule G of Inheritance Tax Return) Per Capita: 1. PNC Brokerage Corp. Glenbrook Annuity Contract # GA280831 2. PNC Brokerage Corp. MetLife Annuity Contract # A2068667 Per Stirpes: 3. American Express Annuities Post 1985, acct #93003320861 0 004 DOD value Beneficiary 27,327.22 Helen Gulden 51,771.24 Helen Gulden 40,587.40 Helen Gulden +/ Terry Shopp /, Sherry Shopp Rehr '/, (from Schedule E, Item 2, of Inheritance Tax Return) 4. American Express Mutual Funds 6633.746 shares @ 4.840 acct #01245284563 4 002 32.107.33 Helen Gulden '/2 Terry Shopp /, Sherry Shopp Rehr '/, TOTAL NON-PROBATE ASSETS 151,793.19 VJ~ STATUS REPORT UNDER RULE 6 12 Name of Decedent: Gretta T. Bo er Date of Death: 5.26.02 Will N Admin. No. 21-02-0532 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 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. 1 is Yes, state the following: a. Did the personal representative file a final account/statement 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? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: - •uui~ ' %i; l ~~: ! d L L ~Jt+W b0. Capacity: < ~~ I n ~~~~~~~~ -~e~Le~ ~ Signature Helen Gulden 109 Butler Street Mt. Holly Springs, PA 17065 717-486-3825 Personal Representative