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Home My WebLink About01-0119 Estate of Mervin R. Barrick also known as PETITION FOR PROBATE and GRANT OF LETTERS ~I-O'-D' 1'1 No. To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 174-05-2551 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 execut rix in the last will of the above decedent, dated June 13. and codicil(s) dated named ,19~ (state relevant eircllmstances. e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania... with ~___ last family or principal residence at 144 Cherry Street. Carlisle. Cumber.Land County. Pennsylvania. 17013 (list street, number and muncipality) Decendent. then ~L_~ years of age, died January 19. 2001 , 19 at __~!!::lsJ.e. Cu1!!!!erland County. Pennsylvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the \vill offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendellt at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (I I' not domiciled in Pa.) Personal property in Pennsylvania (11 not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 144 Cherry Street~ Carlisle~ C......herland $ $ 125.000.00 $ $ 7"1.000 00 Cgunty~ PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters----.t...estamentary , (testamentary; administration c.I.a.; administration d.b.n.c.l.a.) therOIl. ;:: :- ~:= ::...J :..... ::=:: ~ ~ U. c!'7L~ Ln. Bauder 2264 Ritner Highway Carlisle. PA 17013 ~:~ ::Jj :;. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLV ANIAi r 88 COL!'T\' OF ~mQ!ERLAND ~ j The petitioner(sl above-named swear(s) or affirm(s) that the statements in the foregoing petition are true aIld currecl 10 the beSt of the knowledge and. . of fltioner(s) and that as personal represen- talih'(',) of the above decedent petitioner(s) wjWwell 1y administ7~)1 cording to law. E. Bauder <>Q' ::: s:::, -.. l:: ~ 2 ~L. llo- JDLP- 5 No. Estate of MERVIN R. BARRICK , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 21 ,2001 19_. in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 13, 1996 described therein be admitted to probate and filed of record as the last will of MERVIN R. BARRICK and Letters TESTAMENTARY LUANN E. BOUDER are hereby granted to ~f'iAUC.'-AtttW V ~Register 0 Wills FEES Probate, Letters, Etc. ......... $ 2.'10. 00 Short Certificates(l2.) . . . . . . . . .. $ 3{g. 00 Rent1tlG~att9R '1-:-. pq~.. . . . . . .. $ to . 00 ..rcP $ 6.00 TOTAL _ $ 3/'1.00 Filed .. JPrN... 2&1.0./. . . . . . . . . . . . . . . . . . CAtU2t ATT'-I. ATTORNEYJ~l!P' Ct. J.D. No.) WILLIAM A. DUNCAN, ID I 22080 1 Irvine Row, Carlisle, PA 17013 ADDRESS 717-249-7780 PHONE ":j ;:::::J . ~ r~ ;10".80"i REV 91R6 This is to certify that the information here given is correctly copied fran: an original certificate of death dul~ filed with Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. No. 21.~~. ~~~~~ Local Registrar Fee for this certificate, $2.00 p 6947932 JAN 2 2 2001 Date H10S. iQ At'oI 2/87 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH \1"'1 'EHT INK NAME Of DECEDENT IFlrsI MdcIe.I.._1 .. Mervin R. Barrick !lEX .. Male STAlE FU !rrIUMBEA SOCIAL SECURIT"t NUMBER .. 174 05 DATE OF DEATH ,UCNtl. 0.). 'Ur) 19.2001 "I 91 UNOER 1 YEAR "...... 0..,. 1, FAClI.rrY NAME (H nt;1~. or.- SfJNt anCI numberl Carlisle Hospital BIRTHPLACE (Coty and N;~M~: ="",0 AGE (La.. Bit1I'Ic2ey) v.., .d.\ COUNTY OF DEATH Cumberland White ... ... ". DECEDENT'S USUAl OCCUPlUtON (~-=:.;w:o~::~:-r ,,,.Forklift Driver 110. SU OECEDENT'S MAtLING ADORESS (SIr.... Cityfbwn. SWI. Zip Codel Wl\S oeCEDEHT EVEA IN U.S. -'ArID FORCES? .....~ NoD 11. 3. SURYMNG SPOUSE (" WIle. ;we INIOen namel .,; 144 Cherry Street l~lisle, PA 17013 ''''''ER'S NAME {,.... """!ta'lnu e 1 W . 11. IHFOAMAHT'S NAME (T 'fPWPrinl) Lou Ann E. Bouder Cumberland l>d -.. ...... _1 -, 17..$b11t1 Carlisle ....-- .n.. Barrick METHOOOF OISPOSIT~ O -.'/oJ C'....l"'" 0 DonatiOn 0IMr ($i:leclfyl 21.. SlGNRURE DATE OF DISPOSITtON R~~ trom Slale 0 (Monltl. o.y. "-l o anuary 23.2001 21111. 21c. E OR P~RSON ACTING AS SUCH LICENSE ~~ 219- L .... :It. I Approximete '-- : onMt and dMIh I I No~ PART I: QlPler s;gnincan. COf'lCMiona coneribullng 110 de..",. bul: noI feSU"in9 in tM unditI'Iytng CIlUM gIwn in PART l. l : WEAE AU10PSY FINDINGS A\AILA8l.E PRIOR 10 COMPLETION 01' CAUSE 01' 0EA1H? DUE 10 lOR AS A CONSEOUENCE Of): DUE TO(OAAS ACQNSEOUENCE Clf'): MANNER Of DEATH DATE OF INJURY (Mon<h,llay. -, TI"e OF INJURY INJURY III 'M)RK? DESCRIBE HOW' INJURY OCCURRED. Suicide 7g o HomiCide Pendingl~lgallon _ 0 No~ _ 0 De. 2ft. URTIP1EPl IOttck only onel .CEJlTIn'ING PHYSICIAN (PhySIC,*" cer1If'yIng Gause d dfoath wMrl ~nolher phVSC..... has pronounced deattl at'Itl cornp6eted hern 23) Talhebes1ot"'YknOwledge, de.thoccu"," "....1ClIh.C.use(.Ianct manne, a. .tated.................... ................................. No@ Could not ba determined o o o PLACE OF INJURY. M hQfM, farm, "'....Iactory. omc. M. buIIlIng.MC.I~l _. _ 0 NoD N...... A<_ ~.~~~~ ~\ ~\Iq o ... '~IHG AND CERTIFYINQ HfYStCIAN (PhySIC-' bOth ptOl'lOuf"C"'9 dea'" and cemfyw1g locause of death! Tal.... M.tof"'yk~.. death occurred a. the u.n_, dill., and "Ke, and due to thacauHII) ancf manner...tated.. .................... 'MEDICAL EXAMINER/CORONER On the b..I. of eumin'flon andJorlnvesllgallon. in my opinion, death occurred at the time. data, and place, and due to the cau..(a) and ",.nne, a. stated.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318. REGISTRAR'S SIGNATURE AN o 17013 &~ , d-.cro \ . . tGnst lIIi11 nub westnmeut nf MERVIN R. BARRICK I, MERVIN R. BARRICK, of738 West North Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot located at Westminster Memorial Gardens. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my daughter, LuAnn E. Bouder, per stirpes. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my daughter, LuAnn E. Bouder, per stirpes. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my daughter, LuAnn E. Bouder, per stirpes. SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my daughter, LuAnn E. Bouder, as Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection with her duties, as such, in any jurisdiction in which she may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executrix and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this J 3 t ~ day of June, 1996. }lJl(1/}~ 11 /3~A/Ld MERVIN R. BARRICK Signed, sealed published and declared by the above named Testator MERVIN R. BARRICK as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. \AA5~{A.AAA/LCLVtt ~~. /f4~ COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, MERVIN R. BARRICK, 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. J11.p/l~/f R t2a~ MERVINR. BARRICK Sworn or affirmed to and acknowledged before me, by MERVIN R. BARRICK this/3fAday of June, 1996. ()Jlt1t4tz ~ Notary Public (SEAL) :~~.;~~'~~t~OTA~ALS8\i:- b VELDA M. Sf:ASE, Nm..'lIY Public , ShiP!".*J,:5bwg ['Of:;" ~;umbj)IIE'J, ld County, Pa. Myl."("\1HN'.5IoJ:) E:.q)!ms Apn116. 1998 ~~.t.IO<U<i.r_n.,._~ .. . . . COMMONWEALTH OF PENNSYLVANIA: ss. COUNTY OF CUMBERLAND We, MII/dm II. Vt/f!CJ,1 and L./t1rJ.sdf S, J1 t/JSer- 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 MERVIN R. BARRICK sign and execute the instrument as his Last Will; that (name) signed willingly and that MERVIN R. BARRICK executed as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight ofthe Testator signed the will as witnesses; and that to the best of our knowledge, the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. \}JWV~qA~ ~~~ Sworn or affirmed to and subscribed before me by (p; (I; tL1/k A-. f)~ and L ; ",.pi s ~ y S < )1-1.M r.s (!' r , witnesses, this /.3 f- L day of June, 1996. ()~~ Notary Public (SEAL) l.iWll~~~;' r~OTAr:;jilL ~8\L VELDA M. SEASE, Nct:lJY Public Shippensbwig tk::m, Cumb,~r!alld County, Pa. My Commission Expires Apri! 16. 1998 \., /b-at:/~-b COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN WILLIAM A DUNCAN DUNCAN & HARTMAN 1 IRVINE ROW CARLISLE PA 110~:~ 07-16-2001 BARRICK 01-19-2001 21 01-0119 CUMBERLAND 101 '* REY-1547 EX AFP <12-01> MERVIN R Amount Remitted (1) (2) (3) (4) (5) (6) (7) (9) (10) ) CHANGED 85.000.00 .00 .00 .00 111.374.73 34,546.78 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 20,389.70 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 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 ~ REY=is4j-EX-AFP-fi'2-:i)'oY-NOYiCE--OF-YNHEifiTANCE-YAX-XPPRXisEifENT~--AiLOWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BARRICK MERVIN R FILE NO. 21 01-0119 ACN 101 DATE 07-16-2001 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 230,921.51 Ul) (12) (13) (4) 20.389 70 210,531.81 .00 210,531.81 If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYMENT DATE 06-06-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets NOTE: (5) .00 X 00 = .00 (16) 210,531.81 X 045 = 9,473.93 (17) .00 X 12 = .00 (8) .00 X 15 = .00 (9)= 9,473.93 AMOUNT PAID 9,473.93 RECEIPT NUMBER AA496686 DI COUNT (+) INTEREST/PEN PAID (-) .00 9,473.93 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) s -- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: MERVIN R. BARRICK Date of Death: JANUARY 19, 2001 Will No. ,2/ -rd. -Pr9 , Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6{a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 2, 2001 : ~ Address LuAnn E. Bouder 2264 Ritner Highway, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6 ( a) except none Date: /' ~02 9-tf}! /j.(;!!~4C ('$~ ) ture ~ Name William A. Duncan Address 1 Irvine Row Carlisle, PA 17013 Telephone (717) 249-7180 Capacity: Personal Representative x Counsel for personal representative r- ) I r I I I I ) I I I ! I I I I f 1 r r [ I I i I f [ I I I I r I [ I I I r [ 1 I I [ I I ! I ! 1 I r fI) ... ." < ~ ~ z ~ ... -' en :E >- w <r CJ)w)( ;; ...3; <r ~::>~ co ..JO Q.. --, . 0 WZ..J cO ..Ja:: o..w< C\l u.>::l ;:::. ... .. oWe :li 3W LLI 0:_ :Cu.~ < 0 Z a.J ~oe 0.. a: z- CD <1-30 - lL. <r:> ~nJ~g~ Q ..... w un:: ..J ~~~ref8 > z.... a:: jjj :3 ~ ~<w,..:o: 0 Q-t U 0..0::0..0: W OW::lW< a: L c..>c III c:c w a: w :I: C ii! , co t '1' x w i?J :> w a: (0 <X) CD to 0) -.:t <( <( 0 z >< ~ I- w Q. .... - <c<C W -.... 0 zen <cw W >0 a: ...Iz ><C ..J enw <C Zo ffiz - 0 11.<C - .... LL it LL w 0 J: ~ I- Z ;:) o ~ < P') 0- o fI) ~ ~ D- . ... o ... " I- z W5a: z~a:W uenl-lXl <enz~ wo;:) ~uZ < --'-r-~-, c' I lI! w :I: ~ " ,\ , ......:..... ~ .,.: . f:. .; '" ~, ~i bJ ..J .- '" " a::.- '-' 0 lit ,.: . . .<( "'-' . .. a.: ..- " - ,r~. f:' \-,"10 11'-'1'(1 3. ..;>: ':; :;: · 0- ,t ,H' aJ u.. ..... ~ fill~ ...J ~ ~ ~ o W I- a: ,.'. .-. .~~ ~ ... an n 01 I n 0 I ~ ~ ~ 0:: ... ~ Z CD U) a:: z ..... ...-- 0- 1='> Z .... CJ)1Ie 0 ... ~r ... 8 0 .... i= 0 0 Z g <( I 0 <t :E ... I-:lt QI 0 ..J N a: 8 nJU 1-' , a: , 0 e..... Z.o wo LLf :cD- LL o:QI Wet ~o ~~ ~ I- ... ~ W I @<< >-, us' W 11I_ ~I ~..o ~o e... S ~l'U u. < ~u u. 0 ~ 0 Z W W Z W W ::e !;( ~ ::l !;( en -' < 0 W u: Z C 0.. c..> C Ld a:: .... ::J CJ m bI Z ~ U z 5 E <l .... -' ..J ..... :J en ~ a: < ~ w a: o ~ en -' -' ~ u. o a: w ~ ~ w a: ..0 ... .... . :It (J ~ U ...J < W en I I I -I I ... r'--== '" jl V' VI I 'I DV\ STATUS REPORT UNDER RULE 6.12 Name of Decedent: ffI el2.lJ IIJ K. J? G-{2QuJ F-~ Date of Death: / - / 9 -(!J / . Will No. 2/-0!- 601/9 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: 1. State;whether administration of the estate is complete: Yes~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal rep~sentative file a final account with the Court? Yes 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"/ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: I;)-/it,,();)., s~~ W/I!I#m /J. "2)u/7utJ Name (Please type or print) , -zK1I1 AJ-e ~j,...J CAe It j/~ /Ja 170 I ~ Address I , I (1/7l d~9-'i7fO Tel. No. (MAH:rmf/AM3) Capacity: Personal Representative ~counsel for personal representative REV_1500EX+(6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 /6-07LJ6~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAl. USE ONLY FILE NUMBER 21 -01 001 19 ""'Ci5Uifu""55i5E ----vEAR- - - 'NuMBER-- I- Z W C W o W C DECEDENt's NAME (LAST, FIRST, AND MIDDLE INITIAL) BARRICK MERVIN R. SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 174-05-2551 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 01/19/2001 08/05/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-Year) SOCIAL SECURITY NUMBER w .... ,,:$., 0"''' W&8 ""'-l O..m ~ !KIt Original Return o 4. limited Estate [&1 6. Decedent Died Testate (AltachCOl7fofWtR) o 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dale of de<th afIer 12-12-82) D 7. Decedent Maintained a living Trust (AltachCOPfofTrusl) o 10. Spousal Poverty Credit (daleofdealhbe\weef112-31-91 cn:f 1-1-95) 03. Remainder Return (d!teofdealhprbrto12-13-82) D 5. Federal Estate Tax Return Required Q.. 8. Total Number of Safe Deposit Boxes o 11. Eleclion 10 lax under Sec. 9113(Ali....""o} .... z w c l'i .. ., w ~ o THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS WILLIAM A. DUNCAN 1 IRVINE ROW FIRM NAME I" A"ie".} DUNCAN & HARTMAN PoCo TELEPHONE NUMBER 717-249-7780 CARLISLE PA 17013 z o ~ ...J :J l- ii: <C o w a:: z o ~ I- :J D.. :E o o ~ I- 1. Real Eslate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Noles Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (Iotal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) 11. Total Deductions (tolal Lines 9 & 10) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) OFFICIAL USE ONLY I (1) (2) (3) (4) (5) 85,000.00 I I I 111,374.731 34,546.781 0.001__ J (6) (7) (8) 230,921.51 (9) (10) 20.389.70 (11) (12) (13) 20,389.70 210.531.81 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 210,531.81 15. Amount of line 14 taxable at the spousal tax rate, or Iransfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due X _(15) 210,531.81 X .045 (16) X .12 (17) X .15 (18) (19) 9,473.93 9,473.93 20. 0 CHECK HERE IF YQU ARE REQUESTING A REFUND OF I'" ~ lEPRA YllEIH Decedent's Complete Address: STREET ADDRESS 1 Irvine Row , , CITY Carlisle I STATE I ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,473.93 Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty Totai InteresUPenalty ( 0 + 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 9,473.93 9,473.93 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 transfenred;........... ................. .................. .................. ..... 0 ~ b. retain the right to designate who shall use the property transfenred or its inca me;............ ................ ........ 0 ~ c. retain a reversionary interest.or. ............... ............... ................ .................................. ............ D ~ d. receive the promise for life of either payments, benefits or care?..... .................. ................ ................ 0 EiI 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?......... .................. ............... ................. ............... .......... 0 I[] 3. Did decedent own an "in trust fo~ or payable upon death bank account or security at his or her death?.............. 0 129 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?....................... ............... ................ ................ ................. . D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. /,/ \~. . RESS.. 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 the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute 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 II 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 oftrensfers 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 imoosed on the net value of transfers to or for the use of the decedent's siblinas is 12% rn P.S. &9116(a)(1.3\1. A siblina is defined. under Section 9102. as an REV-1502EX+{1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER BARRICK MERVIN R. 21 01 00119 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 survivorshlD must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 85,000.00 144 CHERRY STREET CARLISLE, PA. 17013 (see attached HUD) TOTAL IAlso enter on line 1. Recaoitulationl S QI:;. nnn nn REV-15OllEX+(1.fJ7) ESTATE OF BARRICK SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA JNHERJTANCE TAX RETURN RESIDENT DECEDENT MERVIN R FILE NUMBER 21 01 00119 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survlvolllhip must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. DESCRIPTION M & T BANK CHECKING ACCOUNT # 15004200896651 VALUE AT DATE OF DEATH 101,290.52 REFUND THE SENTINEL 43.62 1996 PLYMOUTH NEON SEDAN 4D 4,040.00 REFUND NATIONWIDE MUTUAL INSURANCE 14.20 PERSONAL PROPERTY (SEE LIST) 2,665.00 US SAVINGS BONDS (SEE LIST) 3,037.37 REFUND LOCAL REAL ESTATE TAX (pro-rated on HUD see attached) 207.62 REFUND SCHOOL REAL ESTATE TAX (pro-rated on HUD see attached) 76.20 TOTAL (Also enter on line 5, Recapitulation) $ 111,374.73 REV-1509EX+(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OF BARRICK MERVIN R. FILE NUMBER 21 01 00119 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELA TlONSHIP TO DECEDENT A. LUANN E. BOUDER 2264 RITNER HIGHWAY CARLISLE, PA 17013 DAUGHTER B c JOINTLY.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE IncWe name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed forjointty-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 06/98 M & T BANK CERT. DEP. # 3910142064 42,725.13 50. 21,362.57 2. A. 10/98 M & T BANK CERT. DEP. # 3910189842 24,258.34 50. 12,129.17 3. A. 09/99 M & T BANK CERT. DEP. # 3910440971 2,110.08 50. 1,055.04 TOTAL (Also enter on line 6, Recapitulation) $ 34,546.78 REV-1510EX+11-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF BARRICK MERVIN R FILE NUMBER 21 01 00119 This 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 It.CLUDE H-IE fIWo'E OF THE TRANSFEREE, THElRRB..ATIONSHPTO mNT AND TI-E IYITE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACHACCPI' OF TI-E DEED FORREAL ESTATE VALUE OF ASSET INTEREST 1''''''"''''''El 1. M & T BANK CERTIFICATE OF DEPOSIT TRANSFERRED 2,305.00 100, 2,305.00 0.00 2-23-00 TO LUANN BOUDER, DAUGHTER #3910707058 TOTAL (Also enler on line 7. Recaoilulationl $ n nn REV.1511EX+(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF BARRICK FILE NUMBER MERVIN R 21 01 00119 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME, INC. 4,836.00 2. REV. ALAN MATHNA 50.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) (EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees DUNCAN & HARTMAN, P.C. 11,589.51 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS 332.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 0.00 7. THE SENTINEL LEGAL AD 80.87 8. CUMBERLAND LAW JOURNAL 75.00 9. LINDEN HALL ANTIQUES 75.00 10. S.w. BARRETT REAL ESTATE & APPRAISAL SERVICE 250.00 11. M & T BANK ESTATE CHECKS 24.92 12. DARLENE L MOYER TAX COLLECTOR LOCAL TAX 362.71 13. CP02 (medical bill) 118.72 14. M & T BANK 19.92 15. UGI gas bill on house from 2-01 to 5-01-01 527.71 16. SPRINT phone bill from 2-01 to 5-01-01 126.85 17. Comcast Cable from 2-01 to 5-01 115.38 18. BORO CARLISLE WATER/SEWER 2-01 to 5-01-01 68.67 TOTAL (Also enter on line 9, Recapitulation) $ 20389.70 ilL ____ _____ ,_ ___.J_.J ,___..... _.J.J'~'___I _1..__>_ _L >1.._ ____ _,__\ Continuation of REV-1500 Inheritance Tax Return Resident Decedent BARRICK 'MERVIN R. 21 01 00119 PaQe 1 Schedule H - Funeral Expenses & Administrative Costs - B7 ITEM NUMBER DESCRIPTION AMOUNT 19. 20. 21. 22. 23. 24. PP & L ELECTRIC BILL from 02-01 Iii 5-01-01 1 % REALTY TRANSFER TAX (see attached HUD) FINAL WATER/SEWER 05-30-01 PA DEPT. REVENUE 2000 TAX IRS 2000 TAX 168.95 850.00 23.49 250.00 444.00 SUBTOTAL SCHEDULE H.B7 1,736.44 REV-1513EX+(1-1l7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER DAI ""Q\lIN Q ?1 01 001Hl RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PRDPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outnght spousal distnbutions) 1. LUANN E. BOUDER DAUGHTER 100 % 2264 RITNER HIGHWAY CARLISLE, PA 17013 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. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEE $ llf mnrp. ~n~p. i~ np.p.rlP.rl in~p.rl ;;v1rlitinn::l1 ~hAAt~ nf thp. ~j:lmA ~i7P.\ A: H.LJ.D~SETTLEMENT STATEMENT B.LOAN TYPE: I OUR FILE #: RE01 -97 LENDER: Mortgage America C~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 P.O.C. were paid outside closing. D. NAME OF BORROWER: E. NAME OF SELLER: Cynthia A. Delp Estate of Mervin R. Barrick G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE: 144 Cherry Street, Carlisle, PA 17013 DUNCAN & HARTMAN, P.C. Wednesday 30-May-01 1 IRVINE ROW Carlisle Borough, Cumberland County CARLISLE, PA. 17013 3:00 p.m. J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100 GROSS AMOUNT DUE FROM BORROWER .00 GROSS AMOUNT DUE TO SELLER 101 Contract Sales Price $85,000.00 .01 ContrAct sales price $85,000.00 102 Personal Property 0.00 .02 Personal Property 0.00 103 Settlement Charges (line 1400) 4237.03 .03 10. 0.00 .0. 105 Adjustments items prepaid by seller: Adjustments iteme prepaid by seller: .05 Local taxes to 31-D80-01 207.82 10. Local taxes to 31-080-01 207.82 .0. Assessments 107 Ass8ssments to .07 School taxes to 30-Jun-Ol 76.20 108 School taxes to 3Q-Jun-Ol 76.20 .08 10. '0. 120 GROSS DUE FROM BORROWER 89521.05 420 GROSS DUE TO SELLER 85284.02 200 AMOUNTS PAID BY OR FOR BORROWER 500 REDUCTIONS IN AMOUNT DUE TO SELLER 201 Deposit or Earnest Money 5000.00 501 Excess deposit 202 New Mortgage Amount: 65000.00 502 Settlement charges 873.49 203 Existing loans taken subject to 503 Existing loans taken 20. 50. Payoff 1st Mortgage 0.00 20S 505 20. 50. 207 507 Adjustments for items unpaid by seller 508 210 Local Taxes to 30-May-Ol 0.00 Adjustments for items unpaid by Seller 211 Assessments to 510 Local taxes 30-May-Ol 0.00 2" school Taxes to 30-May-Ol 0.00 511 Assessments to 215 5" School taxes to 30-May-Ol 0.00 21' 513 217 514 220 TOTAL PAID BY BORROWER 70000.00 520 TOTAL REDUCTIONS SELLER 873.49 300 CASH FROM/TO BORROWER .00 CASH TO/FROM SELLER 301 Gross amount due from borrower 89521.05 .01 Gross amount to seller 85284.02 302 Less amounts paid by/for borrower 70000.00 .02 Reductions to seller 873.49 i $19,521.05 160~ J;' .......... $84,410.53 I have carefully reviewed the HUD-l Settlement Statement and to the best of my knOWledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or on my behalf and I have received a copy Of..~jl- ~-l for my re.cPfds. ~LZ':J.:!!..U'~_C:;f~' Estate of Mervin R. Barrick / '-.. PAGE #2 HUD DISCLOSURE/SETTLEMENT STATEMENT PAID BY BORROWER PAID BY SELLER 700 TOTAL REAL TOR'S COMMISSION 0.00 701 Listing Agency: 702 Selling Agency: 703 Commission paid at settlement 0.00 600 ITEMS PAYABLE IN CONNECTION WITH LOAN 601 Origination Fee 1 .000% Mortgage America 650.00 602 Loan Discount 0.250% Mortgage America 162.50 603 Appraisal Fee Mortgage America 275.00 604 Credit Report Mortgage America 54.00 605 Underwriting Fee 606 Document Preparation Fee Mortgage America 292.00 607 Flood Certification Mortgage America 25.00 606 Tax Service Fee 809 Lender Administration fee: 610 Overnight Mail Charges: FedEx $23 23.00 0.00 900 ITEMS LENDER REQUIRES TO BE PAID IN ADVANCE 901 Interest @ $11.2647/day from 30-May-01 to 01 -Jun -01 22.57 902 Mortgage insurance 903 Hazard insurance 904 1000 RESERVES DEPOSITED WITH LENDER Escrows collected: # mos. due: X $ per mo.: 1001 Hazard insurance 3 22.25 66.75 1002 Mortgage insurance 0 0.00 0.00 1003 County/Local taxes 4 29.40 117.60 1004 School taxes 12 74.77 897.24 1005 Aggregate Adjustment -184.38 1100 TITLE CHARGES 1101 Settlement or closing fee: 1102 Abstract or title search: 1103 Transaction Fee: 0.00 0.00 1104 Title insurance binder: 1105 Document preparation: Duncan & Hartman, P.C. POC 1106 Notary fees: Notary 6.00 1107 Attorney's fees: 0.00 0.00 (includes above item numbers): 1108 Title Insurance: WILLIAM A. DUNCAN, AGENT FOR FIDELITY NATIONAL TITLE 888.75 (includes above item numbers):1101-1104 Endorsements 1003008.1 $150 1109 Owner's coverage $85,000.00 $738.75 1110 Lender's coverage $65,000.00 1111 Insured Closing Letter Fidelity National Title 0.00 1200 GOVERNMENT RECORDING AND TRANSFER CHARGES 0.00 1201 Deed 25.50 Mortgage 51.50 77.00 1202 Release/Satisfaction 0.00 Assignment/Stip 14.00 14.00 0.00 1202 County/Local transfer tax (1 %) 850.00 1203 Pa. State transfer tax (1 %) 850.00 1300 ADDITIONAL SETTLEMENT CHARGES 1301 Radon testing: 1302 Pest inspection: 0.00 0.00 1303 Water & Sewer Reading:#401 -2517 -01 Carlisle Borough 23.49 1304 Homeowners Association Fee la()!) >S ...iiii<. ii .ii. ii ... << < 4237.03 873.49 (also entered on line 103 for Borrower; line 502 for Seller) 1Jjnst mill nub wcstnmcut of MERVIN R. BARRICK I, MERVIN R. BARRICK, of738 West North Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot located at Westminster Memorial Gardens. THIRD. I authorize my personal representative to expend funds from. my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my daughter, LuAnn E. Bouder, per stirpes. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my daughter, LuAnn E. Bouder, per stirpes. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my daughter, LuAnn E. Bouder, per stirpes. SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my daughter, LuAnn E. Bouder, as Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection with her duties, as such, in any jurisdiction in which she may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executrix and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this J 3th day ofJune, 1996. .-v -1Y.2 tl 1J7[O/J.AYW1 II. /:2 c;<JVLLC..4::. MERVINR. BARRICK Signed, sealed published and declared by the above named Testator MERVIN R. BARRICK as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. \AA~~CL0t ~~.IfJt~ COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, MERVIN R. BARRICK, 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. )1].; A4/"7'1'l R. ta aA/'i.A<:X MERVIN R. BARRICK Sworn or affirmed to and acknowledged before me, by MERVIN R. BARRICK this/3ft.day of June, 1996. ()JI~'[:AAZ Notary Public (SEAL) ".:"".."'-......._..I!Il&r,.~""...-:""""''''''''''''''''''''',....,''"'''w_''''''-.... ~ H\FAmAL ~b\t b VF:1.fh\ M. l;if.~'\:,,,};', No~t'Y Public , Sol' 1:1'. r.~L' :::,tov,~l.. b If';;", ell{;';\'h)ll~n(' CO\) 'nt" Pa :. ", ,'" ,r, > M\' l~,.lM';"\'ii,J:l ~:,;;pjltfb J\pd; 16. 1996 '-"."""'-""~'-"-""'"'-"""--~'" . COMMONWEALTH OF PENNSYL VANIA: ss. COUNTY OF CUMBERLAND We, M/hdl'l1 ,1. Vi/fla,1 and l./rrdSdf S /-f t/JSer 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 MERVIN R. BARRICK sign and execute the instrument as his Last Will; that (name) signed willingly and that MERVIN R. BARRICK executed 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 that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. \v^v~~QA~ ~ f(/ ~~ Sworn or affirmed to and subscribed before me by w;ll;fI.1IIt ,,(. f)~ and J..: ",I s "- y s. )/)1-<< sSe'r , witnesses, this j-U-L day ofJune, 1996. ~~~4Z Notary Public (SEAL) "NOfAr';1/\1. SfAl VELDA M. fJEASE, NlJt-2rt Public Shippens.bmg r!.ore, C\Jiiih.nrh'iud Courfty, Po. My Commi..ion Expiws Apr~ 16. 1998 '''I\'; ~,,~ ','lev '1",% This is to certify that the information here given is correctly copi~d hon: an original ce~(ificate of death dul~ filed with Local Registrar. Tne original certificate will be forwarded to the State VItal Records Offrce for permanenr filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. ""'<~\'"~"'iif'Pl~--_,, ,,,,,~y ~\. "~(..~' :~( ~" '?~ 15'~~::'1, :~! \. *' ._' ..~, . ': -~) * i \. a.. ' ' '_' ' /~~"" '::,<r>> /~'\\ , -ift> -/.>&,"v" -'----~/IIfEN1~\ ~""," ~~"'~.,'~~~N"/#IIJJII'f 2i-~.~~~~ Local Registrar . Fee for this certificate, $2.00 P 6947933 JAN 2 2 2001 Date 11105,'.JA...., 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH mn ,"1-41 ". N..ME OF DECEOE"'T '",;.., M<Cdl<t, ~mj Mervin ,. Jo.GE"ILuISoMOay! R. Barrick '" t. Male $T..:tI'UHU...IA SOCI"~ SECUAITY "'Uld8EP: 91 UNQEfllYEAI'I M...,,,,, 0ayI0 UN~ -lM"'''''' J. 174 05 2551 O~lEO'ou.fH,M~:o;.-:;-;I-"- ..January 19.2001 '" .. f"CllfTYNAAlE~I"OI_IUloCIl>_O<""snHlanllnurn!ler, Carlisle Hospital lIlRTHF'1.Jl,a<IC....._ NefiM11'; 1'LlGE000I!:"'HIC~0Cl0""",a>oI-_oMl'","""",""__ I'IOSPIlAJ.,:. ,__$. g;:;<tyIO ~\ COUHT"'l'OFQE..ClH Cumberland White M tIE: OEl-C1'SUS\lM. IJPIiI\0t4 l~r:,.IcW::::O "=':::zl.:f u.,Forklift Driver lib OECEDENf.SIoWLINQAllORESS(Sl,....ColylTown.5tatoo.ZopCo<lo!I w,o.sOECEDENTEVEAIN U_S. ARrIO HlllCES7 ....~ ~O ... E_MaryI~""a'Y 8 ~'. .. IAARlTALSWUS.Ma"..d _ManiMl.~. rn=~ SUl'MYIHOSPOuSf l~'_.~"""""n....n 11..Sla~ e "" - ~.. -..., 11..D__Iiwood'" - 144 Cherry Street ,l:arlisle, PA 17013 flQ"HEA.sN..ME(F....M~amuel ... 1HI'00MAtoIT'S NAMf (TypilIPrrt) . Lou Ann E. Bauder aAETHOO OlSPOSIT~ . 0 8uIItl c~""'''''O A___~""Sl".O DotIM.,., Qtlw'(S . .. Cumberland HIl.___ 17'" __at MOTHEA'SN..MIE(F;,1ll M"""'. M_Sut-...) ... Martha E. Blaser INFOAMANT'SMA!I,l"IQADOAE"JSIt.Hl.Cil'/Ibon.~~ 2264 H~tner H~ghWay, carl~sle, PA 17013 l'UIClOFOlSPOSITlON._oIea-..,y.CNmalIlry LOC,lQ"lON.C~ ~""".f"l~ ....01....."""'. westminister Nortn ~lQCt....eton Twp. no. Memoria den :uCumber an County, Penna. Jr~~g;~ro~rsI6JO Sout anover ree LICENSENU~A S (MonrI.o.y._1 Carlisle '.- ,~. W. Barrick \lI,TEQFIlI:!lPOS\1lOK (M"""'.DlY._l o anuary 23.2001 21b. EOI'\~l\SOIt,>.CllNQ.l\SS\,I(;H LICENSEN~219_L .~. n... nc. _SC...s.EREHP:REOTOMEDlCALE:<..oldINERJCOAONEA? .0 ~1J H. M. 21. n. PIlItT t: En....the d....a.... injut;MoICornpliul........_ea""..:lIr..lMal~, Do ....,.....' I~. moo.ol ""';"11. """~u"'",ISiaC....'''''"'al ~..."",,_ea........,UCII""" -A-v,.;,~",[;+p'",,~ ~. ,- l~a:= , : PAATN, OI/Ie'Oi{lnillGanl~COI'Ilf11:IoJIlIO_"',bul .....lH<lllIc'IVinlM~_gMooinF'AAl"1 I: l. wEREAUlOPSVFIHOlHGS ........."""'''' COIoIPl.El'1ONOfCAVSE OFDEJJ"H7 OUETO/OAAS..CC>>ISEOIJENCEOF\: O\!E'IOlOR.l\S"CONSEOlJENCEOF!" ldANNEROF otATN OI<TeQFIMJUAY (lo6onln,o.y._1 fIMI1Ot'INJUR't' IklURVta"""""-~ 0i.~1eE \oIOHIKNWfOCC\lf\PED. 'I'M 0 No~ .... 0 2IIl. 211>. <:f:III"lIl'II.RlCh_."..,."""" 'CIE,"II'YINQlI'HYSICIAN(""_e8I1tyongeauY"'__~""''-pl1y$>C_'''''Il'O/''OUt"oCIKl''''.I~a''''c<>''''''''oclll''''?l! T.__.I",,_~,$a"',,"_d"".'~..a""('I,""rn.nn.ruat'll<l. . ~~ -- Jg o He...""'" o o .. DpI.ACIEOF'NJURy,,,,_,'arrn.,,,,,,,.,~,,,,,,_ D<-.g."",ISpooo.lol .... ..... 0 ,..,0 - Acc""'.... P.ndlngl......~."'" ~.~~~ ~,\ ~\rCl o C<><.oIdnolbl""'.",,jnH ~. '~ANtJCUlflFYINQlI'1iYSIClANII'h\'S'Clllnl>Ol~",O"ov'''''''>g<lNlha''''C'''''''''RQ'oea'''''''<:lN'''' T.,...._",..., k""wl*<l~', _"'QeD""'" al "'.11_. da... ano:l pi......... dll.'. '~.caUH(.) ."""'.nn.. ....aIM.. "MEO'CAL EXAMINER/COflONER On tile ba.l. oluamln~lona""'/H" In"..lIgatlon, In rn.,oplnlon, du'h OCcull.d all~e Urn., dat., and pia.., andduoto 'ho cau<<(.) al1d ll1.n"..u.ttall'd.....,..........,.......................................,........................."....."....... 31.. REOISTRAA'SSI(lNAJUREAN 17013 ~. Ol.ci. d-.cro \ Linden Hall Antiques 211 Old Stone House Road Carlisle, PA 17013 February 3, 2001 William A. Duncan, Attorney I Irvine Row Carlisle, PA 17013 Re: Estate of Mervin Barrick 114 Cherry St. Carlisle, PA 17013 This is to certifY that I, W. David Rowe, of the firms Linden Hall Antiques and Rowe's Auction Service (RH79L) have examined said items and their values are as follows: Maple Table and 4 Chairs G.E. Refrigerator Miscellaneous pots and pans Misc. small appliances G.E. Stove 2 Utility Cabinets 3 piece Bedroom Suite Misc. Pictures and Frames Costume Jewelry 5 Drawer Stand Electrolux Sweeper Mahogany End Table Pine Chest Seth Thomas Mantle Clock Sewing Machine Magazine Rack Hitchcock type Rocker 2 door Cabinet Marble Top Stand Upholstered Chair and Ottoman Air Guide Binoculars Wall Clock Set of Golf Clubs Small Oak Stand 2 piece Living Room Suite 2 old Recliners Console Stereo Glass Door Bookcase Misc. Lamps 50.00 90.00 15.00 15.00 25.00 40.00 40.00 20.00 15.00 15.00 30.00 15.00 25.00 50.00 no value 5.00 20.00 5.00 15.00 25.00 10.00 10.00 20.00 5.00 25.00 no value no value 5.00 10.00 , . Pair of End Stands Knee Hole Desk Mahogany DropleafStand Cedar Chest New Quilt Misc. Bedding Card Table and Chairs Fancy White Mirror Metal Wardrobe 16 gauge Winchester Model 1912 Remington 30 Pwnp Wall Stand Cedar Wardrobe Blanket Chest Wicker Chair Brass Floor Lamp Misc. Linens Misc. Christmas Items Jelly Cupboard Misc. Bench Tools Folding Table Western Flyer Wagon Mortised Bench Old Kelvinator Freezer Work Bench Bench Grinder Old Croquet Set Amana Washer 3 Crocks Misc. Pots and Pans Aluminum Double Ladder Misc. Lawn and Garden Tools Push Mower White's Riding Mower Front Tine Cultivator Old Cultivator Porch Glider Toro Snowblower Huskee Adjustable Rototiller T ota1: 5.00 10.00 40.00 50.00 25.00 15.00 10.00 20.00 5.00 350.00 175.00 25.00 50.00 125.00 35.00 5.00 25.00 10.00 200.00 40.00 10.00 10.00 25.00 10.00 10.00 10.00 10.00 50.00 10.00 10.00 20.00 30.00 15.00 250.00 50.00 10.00 15.00 150.00 150.00 $ 2665.00 tv II , IQ . j.t-- . v,_J W. avid Row Kelley !:Ilue !:look Used Car values -~~= ..... c. Vl!IIue$I N.. q.r PriC:!"'1 ~qd" ---.-,'''' ..{ .... a .... Qlr . _a.u..CIr ... VourClr ~ I.......... ~.~ WIltIi.... Car ...... C. "...... Declakw! ... ~ --.... "-tl rage 1 U1 ~ r~LX /"J Clid<onlhe~_\o_lIis _ Blue Book Trade-In Report Penl1ll'flvania . January 25. 2001 1996 Plymouth Neon Highline Sedan 40 Wavs to Buv a Used Car Wavs To Buy a New Car list Your Car For Sale Online Financino Ouote Insurance Ouote Warranty Ouote Parts &. Accessories pavment Calculator Engine: 4-Cyl. 2.0 Uter Trans: Automatic Drive: Front Wheel Drive Mileage: 25,000 equipment Air Conditioning Power Steering AM/FM Stereo Cassette Dual Air Bags Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Trade-In Value $4,040 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Copyright @ 2001 by Kelley Blue Book Co., All Rights Reserved. Jan-Feb 2001 Edition. The information in http://www.kbb.comlkblki.dlllkw.kc.ur?kbb;207392&;t&39&6;PL;B2& 01/2512001 MERVIN R BARRICK 174-05-2551 144 CHERRY STREET CARLISLE, PA 17013 Redemption Date: 02/01/2001 Transaction Number: 1458852 Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value Q2443532703 E $25 04/1970 $18.75 $118.61 $137.36 Q2526913851 E 25 10/1970 18.75 120.94 139.69 Q2421890679 E 25 06/1969 18.75 114.67 133.42 Q2433673482 E 25 09/1969 18.75 116.27 135.02 Q2458310882 E 25 11/1969 18.75 116.27 135.02 Q2459771342 E 25 01/1970 18.75 118.25 137.00 Q2481965493 E 25 04/1970 18.75 118.61 137.36 Q2494478411 E 25 06/1970 18.75 119.25 138.00 Q2501727099 E 25 08/1970 18.75 120.94 139.69 Q2622902598 E 25 01/1972 18.75 101. 45 120.20 Q5056726008 E 25 12/1972 18.75 99.03 117.78 Q5029734424 E 25 10/1972 18.75 101.12 119.87 Q5028790778 E 25 07/1972 18.75 100.86 119.61 ... Q5020016246 E 25 05/1972 18.75 99.38 118.13 Q2611451851 E 25 03/1972 18.75 101. 74 120.49 Q5111042624 E 25 06/1973 18.75 98.40 117.15 Q5075023602 E 25 02/1973 18.75 100.46 119.21 Q5124811200 E 25 09/1973 18.75 99.81 118.56 Q5131997625 E 25 11/1973 18.75 97.48 116.23 Q2539146191 E 25 01/1971 18.75 107.55 126.30 Q2559307095 E 25 03/1971 18.75 106.49 125.24 Q2571392792 E 25 06/1971 18.75 103.47 122.22 KEYSTONE FINANCIAL BANK NA WEST HIGH ONE WEST HIGH STREET CARLISLE, PA 17013 717-240-4536 n-............. 1 f""I+ ') MERVIN R BARRICK 174-05-2551 Redemption Date: 02/01/2001 Transaction Number: 1458852 Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value Q2 6048007 92 E $25 10/1971 $18.75 103.16 121. 91 Q2570983034 E 25 08/1971 18.75 103.16 121.91 Total Price Total Interest Total Value Total number of bonds redeemed: 24 KEYSTONE FINANCIAL BANK NA WEST HIGH ONE WEST HIGH STREET CARLISLE, PA 17013 717-240-4536 n.............. '1 ,,~ '1