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HomeMy WebLinkAbout01-0218 (f) Estate of Ralph L. Shenk also known as Ralph Shenk PETITION FOR PROBATE and GRANT OF LETTERS No. ~- CJ 1- :l./~ To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 174-05-0781 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner~, who is~ 18 years of age or older at~xecutor in the last will of the above decedent, dated and codicil(s) dated Renunciation dated February 15, 2001 April 26 named , 19~ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h; R last family or principal residence at Thornwald Home Borough of Carlisle L..4? TJ,qJnll!" Rn!"!"nm Rif, r.,qrlic:lp, PA 17013 (list street, number and muncipality) Decendent, then __.-.9~ years of age, died at Thornwald Home Except as follo~'s, decedent did not marry, was not divorced and did not have a child born or adopted after execlltion- of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: February 14 , P9 2001 $ 36,474. $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.La.; administration d.b.n.c.La.) '" -- Q) u C Q) ~3 Q)... ~Q) c .,,0 c';:::: roo;:::: 3~ v,- ;:;0 ~ c 00 Vi :t~.u cL~ Lawrence L. Shenk 304 Glendale Street r.,qrl;Rlp, PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF _ CUMBERLAND ) 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 d truly administer the e~te acc rding to law. {iJ'~ ." 4~ V:l c)Q' :::s l:l ~ ~ J~~ ~ No. 21-01-218 Estate of RALPH L. SHENK A/K/A RALPH SHENK , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 26th ~ 2001, 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 APRIL 26. 1996 described therein be admitted to probate and filed of record as the last will of RALPH L. SHENK A/K/A RALPH SHENK and Letters TESTAMENTARY are hereby granted to LAWRENCE LEE SHENK ~tJ. ~LAyJ ru. t?d/~~~~dj Regist Wills ATTORNEY (Sup. Ct. .0. No,) . Broujos, Esquire #6268 anover Street, Carlisle 17013 ADDRESS FEES Probate, Letters, Etc. ......... $ Short Certificates("i) . . . . . . . . .. $ Renunciation ................ $ .Tep $ ') . 00 TOTAL _ $ 92.00 Filed . :F.EaRlJARY. Z.6.~ . ZO.Ql . . . . . . . . . . . . . 70.00 12.00 5.00 717-243-4574 PHONE ATTORNEY CALLED FEBRUARY 26, 2001 ,'~ n, Hl05.805 REV 9/86 This is to certifY that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. """"1''''''0"",,,,, \\\\\1"~~\.1\\ OF PEi:----__ \l~~.', ...... . ~~\. $~_lliI.a.c.~" ~~I - ,_~._ .- ?~ ~ :e(,~ _ - \;Z!:~ ~ ~-- :-D~:: _ /i::~ ~*~.. ,.....>*~ \~'~co.. ~l """'* . ~/ -.,....~, '-?lltfENT \l~ ~~'IIII\\ """""N,nUJII111",1 2i.- ~~Q~::;';~~ Fee for this certificate. $2.00 P 6948281 FEB 1 5 2001 Date / H'OS.i43AfN.2/87 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH "IN" v". UNDER 1 DAY HourI ! '-tlnul. SEX .. Male SWE FIlE NUMeEA SOCIAL SECUAITV NUMBER 174 - 05 CATE OF OEATH iMcrnn. De~. .",.,) ..February 14, 2001 ,ENT INK NAME Of DECEDENT {F1fsr. Middle, la!al 1. Ralph L. Shenk AGE llast Binhday) UNOER 1 YEAR __ Do,. 98 BIRTHPLACE p,_ H . ,... '" ~'!'2' CcuN'Y! lCKO"y,-OWO PA =",,0 .. COUNTY OF OE.fJ'H ..~rland Ie. Carlisle DECeoeNT's USUAL OCCUPRION (~wortI~~~~:::ir:r ".. Ca nter ".. Lumber Yard DECEDENT'S "''''UNO ADDRESS (SIr". CiIyITown, sw.. Z'IpCoclt) DECEDENT'S 442 Walnut Bottom Road ~~NCE Carlisle PA 17013 ~orI'I~1OI"II 1l. FMHER'S NAME (F"~. Middle. I..nl 11. Har Shenk INFOAMAHT'S NAME (TYP6'PrintJ RACE. Amencan lnellan, SItIctl, Whit.. etc. I_I White SURVfVING SPOuSE ," WIf.. 0fYI!J /n8ll:Wl name) d( 17., State 170. 0lcI - ...... -. ""'. Carlisle Cify/bclro. PART II: Other signiftcanl condItionI contl'ibUtin; 10 death. baA noIl1t8UtlingintM~cauMgMoninPAml ~~~'D out TO tOR AS A CONSEQUENCE OF): {b, e. d. WERE AUlOPSY FINDINGS JUULASLE PRJOA 10 COMPlETlON OF CAUSE Of DE.<rH? DUE TO (OR AS A CONSEOUENCE OF): DUE"1\) lOA AS ^ CONSEOUENCE Ofj, .....0 MANNER OF DEATH N_ "kb Homicide 0 - 0 "__Ion 0 - 0 Could nor tit det.rmined 0 DATE OF INJURY I""""'. Day. _, TIME OF INJURY INJURY n WORK? OESCRlBE HeM' INJURY OCCURRED. ..... 0 HoD 2aII. _. CERTIFIER (CtItctl; only one) ~CEllTIFY1NG PttYSlCtAM (Pt\ysoen~ eauM at dn1h when anolher physi(:iln Ns ptor'lOllnced death ana ccrnpleled"am 23) Tothe-..ot"'YIuIowfedOe, ..thOCC\N'l'Mduetolhe~a)and""nneraaatat_............ ,.....,.,........,.',...,.,'...". ... Db ". PlACE OF INJURY. AI horne, farm, sf,.., I~, oIftce _. ....tsooc.,l >Go. NoD .MEOICAL EXAMINER/CORONEA On the blal. of eumlnatlon and/or InvuUgation, in my OJ)lnion, death oecurred at the time, date, ."d pllce, and due to the cau..(.} and mannera. stated....,........,....,..."....,...".,.....".,."",...,.,...,.......".,..,...........,."......., :11,. REGISTR,A.P:S SIGNATURE AN .R (:\. ~eu...~ ~\ ..?J\ 01 p~ .~HG AND CERTIFYING PHYSICIAN (Physician boItI ptQnOllncmg cJea1h and Cetlilylng to cause d dealhl To "'- blMt of tny kno~, dhtft OCCUfTM at tfte um., date, and place, and due 10 the cauM(s) and manner.. .taled.. . . . . . . . .. . . .... . . . . . .. . . c:\wp51 \wills\shenk.wil 21-01-218 1Ea6t lIlIill anb Qrtstatntttl OF RALPH SHENK I, RALPH SHENK, of 341 "A" Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, I hereby give, devise and bequeath to my sons, EDWARD SHENK, of 500 Franklin Street, Carlisle, Pennsylvania; LAWRENCE LEE SHENK, of 304 Belvedere Street, Carlisle, Pennsylvania; and FRANK T. SHENK, of 15 Briarwood Court, Mechanicsburg, Pennsylvania, in equal shares, per stirpes. c:\wp51 \wills\shenk.wil LASTLY: I nominate, constitute and appoint my sons, EDWARD SHENK, LAWRENCE LEE SHENK and FRANK T. SHENK, to be the Executors of this my Last Will and Testament. In the event that any of my said sons shall predecease me or shall be unable to serve as Executor any reason, I appoint, my surviving sons as Executors. No Executor shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this (:) b'.Jt day of r11 . , 1996. j p' /~ /' 7 tJ-/;'L E!../'VL. //;/ / SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ~~ 2 c:\wp51 \wills\shenk.wil COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, RALPH SHENK, 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. Sworn or a~)Nved to a.np acknowledged before me, by , the Testator, this ~~..1r.. day of ~~ul ,1996. ~ NOTARIAL SEAl MERLENE MARHEVKA, Notary Plblic carisle. Cumberiand County, PI. My Commission E~res 618198 3 c:lwp51Iwillslsbenk.wil COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, Thomas E. Flower and James D. Flower, Jr., the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by Thomas E. Flowe and James D. flower, Jr. this d.(Q~ day of~1.. 1996. C}~~ Witness M~'i:E:!L~~ary Ptbl~ My Comm. " nd ~Ullly, Pa. ISSI01l Expns 6IllI'98 4 RENUNCIATION 21-01-218 In Re Estate of Ralph L. Shenk deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned children of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Lawrence L. Shenk WITNESS our handSthis ~ /' day of February , J:~200 1 . 2~:?,C~ Edward Shenk (Signature) 500 Franklin Street Carlisle, PA 17013 (Address) ~c-iL ~ ~ (Signature) Frank T. Shenk 609 Copper Circle Carlisle, PA 17013 (Address) (Signature) (Address) E ----- CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Ralph L. Shenk Date of Death: February 14,2001 Will No.: Admin. No.: 21-01-0'31 f To the Register: 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 February 23,2001: Name Address Edward Shenk Lawrence L. Shenk Frank T. Shenk 500 Franklin Street, Carlisle, P A 17013 304 Glendale Street, Carlisle, P A 17013 609 Copper Circle, Carlisle, P A 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: February 23,2001 Signature: ~.~ ;( AJz Lawrence L. Shenk Personal Representative Capacity: i'- "- I John H. Broujos, Esquire #06268 4 North Hanover Street Carlisle, P A 17013 (717) 243-4574 Capacity: Counsel for Personal Representative lN3V11Altd~3^0 Nit ;0 aNn;3~ It !.lNI1S3n03~ 3~1t nOA;1 3~3H )l:J3H:) ~ (6,) ana X'el '6~ (B,) S, , alE!) 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Shenk, deceased File J] C I Ol..t- of - 00 '-I "? Date of Death: February 14,2001 1. Waypoint Bank Checking Acct. # 1700031777 $ 380.54 2. Waypoint Bank Savings Acct. # 1705004134 6,093.76 3. Waypoint Bank Certificate of Deposit #1700015175 30,000.00 4. Interest on CD through DOD 140.61 5. Refund from Hoffman-Roth Funeral Home 422.45 6. Refund from Sprint - telephone 25.00 r;:? "I::;t a.. ...J I >"< ,~ Q a:: 1""\ I :z o:::r::: ....., TOTAL $ 37,062.36 ~ \J) ,.0 '':: j:;: ID= Gu Lawrence L. Shenk, being duly sworn according to law, deposes and says that he, the Executor of the Estate of Ralph L. Shenk, late of Carlisle, Cumberland County, Pennsylvania, deceased, and that the within is an inventory made by Lawrence L. Shenk, the Executor 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. ~x~~ Lawrence L. Shenk, Executor 16 -c:) J ;3 -~ 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 Rec>)' Re: DATE ESTATE OF DATE OF DEATH ...fILE NUMBER :5 COUNTY ACN 02-18-2002 SHENK 02-14-2001 21 01-0218 CUMBERLAND 101 ~) JOHN H BROUJOS ESQ BROUJOS 8 GILROY 4 N HANOVER ST CARLISLE '02 FEB 25 (111. Mil '* REY-1547 EX AFP IlZ-DDI RALPH L Allount Rellitted G: E;;! 1<. PA 1701~l\1nt1c 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 ~ REV=is4j-EX-AFP-fi'2=oOY-NOYiCE--OF-YNHERiTAifCE-YAX-APPRAisEMENy-,--AL1-owAiicE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHENK RALPH L FILE NO. 21 01-0218 ACN 101 DATE 02-18-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 34,203.79 X 045 = 1,539.17 .00 X 12 = .00 .00 X 15 = .00 ll9)= 1.539.17 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 ll) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 37,062.36 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) llO) 1,359.00 1.499.57 (11) ll2) ll3) ll4) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 37,062.36 2.81jR 1j7 34,203.79 .00 34,203.79 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-14-2001 AA496591 76.96 1,500.00 02-11-2002 REFUND .00 37.79- TOTAL TAX CREDIT 1,539.17 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .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.) \/ - Jb-.c:2I.3 . ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '*' REY-1Ul EX AFP 101-82) '02 FlPH-1 JOHN H BROUJOS ESQ BROUJOS & GILROY 4 N HANOVER ST C: '; CARLISLE f{AUlll'jt)H. :49 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-25-2002 SHENK 02-14-2001 21 01-0218 CUMBERLAND 101 RALPH L Allount Rellitted 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, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i&'ifj-ixAFP-((jr=02Y------...-iNHERii'ANc'E--;:A3f-STATEM'E1i;:-ifF'-AC-COUNT--...------------------ --- ESTATE OF SHENK RALPH L FILE NO. 21 01-0218 ACN 101 DATE 02-25-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW 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: 02-18-2002 PR I NCI PAL TAX DUE: ..........................._................................................................................................................................................................................... 1,539.17 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-14-2001 AA496591 76.96 1,500.00 02-11-2002 REFUND .00 37.79- I I TOTAL TAX CREDIT 1,539.17 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 IE SIDE 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), vn.. MAV D" nil" ... DI'I'IINn. So!::!:: R!::V!::RSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) Family Settlement Agreement THIS is an agreement entered into this 19th day of April, 2002, by and between Lawrence Lee Shenk, Executor and Beneficiary under the estate of Ralph L. Shenk, of 304 Glendale Street, Carlisle, P A 17013, and R. Edward Shenk, 500 Franklin Street, Carlisle, P A 17013, Beneficiary, and Frank T. Shenk, 609 Copper Circle, Carlisle, P A 17013, Beneficiary, whose names are set forth as signatories at the end of this agreement. WHEREAS: A. Ralph L. Shenk, of Thomwald Home, 442 Walnut Bottom Road, Carlisle, PA 17013, died on February 14, 2001. B. On February 26,2001, Letters Testamentary were granted to Lawrence Lee Shenk at File No. 21-01-0218 in the Register of Wills Office for Cumberland County, Pennsylvania. C. Executor has administered the Estate of Ralph L. Shenk up until the present time and has paid all debts of the estate, including Inheritance Tax owed. D. Ralph L. Shenk died testate, thereby vesting all rights and interest in his personal and real property to Lawrence Lee Shenk, Edward Shenk, and Frank T. Shenk. E. The assets of the estate are set forth in Exhibit A attached hereto and made a part hereof. F. Executor has paid all debts ofthe estate as set forth in Exhibit B attached hereto and made a part hereof. G. There remains for distribution the sum of $32,903.11. H. Executor 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, Executor and Beneficiaries intending to be legally bound, state as follows: 1. The Executor and Beneficiaries agree that the Executor of the Estate of Ralph L. Shenk need not file a formal accounting or schedule of distribution. 2. Executor states that all costs of the estate are paid. 3. Beneficiaries agree that the final distribution of all estate assets remaining after payment of debts and expenses shall be made to the Beneficiaries in accordance with Exhibit C. 4. The parties acknowledge that any distribution made by Executor pursuant to this Agreement is an "at risk" distribution pursuant to 20 P .S. 3532. Beneficiaries hereby release Executor 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 Agreement shall be filed with the Clerk of Orphans' Court in final settlement ofthe estate of Ralph L. Shenk, subject to the provisions hereof. IN WITNESS WHEREOF, Lawrence Lee Shenk, Executor, and Beneficiaries, intending to be legally bound hereby set their hands and seals the day and year first above written. Mrn~ ,,~W-'W-<= XcL,kJ Lawrence Lee Shenk, Executor and Beneficiary /Z. ~~~~ R. Edward S enk, Beneficiary d':.-e... <3=~ Frank T. Shenk, Beneficiary COMMONWEALTH OF PENNSYL VANIA : SS COUNTY OF CUMBERLAND On this, the 19th day of April, 2002, before me, the undersigned officer, personally appeared Lawrence Lee Shenk, R. Edward Shenk, and Frank T. Shenk, known to me or satisfactorily proven to be the persons whose names are subscribed to the within document, and acknowledged that they executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. ~R~riLI~ &~ Notarial Seal Bridget Ann Corcoran, Notary Public I Carlisle Bora, Cumberland County My Commission Expires June 10, 2002 l EXHIBIT A ASSETS & INCOME ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ASSETS 1. Waypoint Checking Acct. # 1700031777 $ 380.54 2. Waypoint Savings Acct. # 1705004134 6,093.76 3. Waypoint Bank Certificate of Deposit #1700015175 30,000.00 4. Interest on CD through 000 140.61 TOTAL ASSETS $ 36,614.91 INCOME 5. Refund from Hoffman-Roth Funeral Home 422.45 6. Refund from Sprint - telephone 25.00 7. Interest from estate checking account 585.06 TOTAL INCOME $ 1,032.51 TOTAL ASSETS & INCOME $ 37,647.42 EXHIBIT B EXPENSES & DEBTS ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES 1. Ed Shenk - reimbursement for payments to minister, organist, soloist $ 225.00 B. ADMINISTRATIVE COSTS 1. Personal Representative Commission 2. Attorney Fees - Broujos & Gilroy, P.C. 3. Register of Wills - Probate Fees - 0 - 1,000.00 92.00 C. MISCELLANEOUS EXPENSES 1. Register of Wills - Inventory 2. Register of Wills - Inheritance Tax Return 3. Register of Wills - Family Settlement Agreement 10.00 15.00 17.00 D. DEBTS 1. PharMerica - medications 185.55 2. Thornwald Home - nursing care 3. Sprint - telephone 1,081.50 30.54 4. Darlene Moyer - 2001 personal tax 9.90 5. RWC Corp - hospital exam 12.45 6. Carlisle Hospital 35.12 7. Cumberland Goodwill Ambulance 144.51 8. Dept. of Revenue - 2001 state income tax 17.00 9. Raymond Keller - 2001 income tax preparation 75.00 TOTAL EXPENSES & DEBT $ 2,950.57 Assets and Income Expenses and Debts Balance Inheritance Tax Paid Adjustment Balance for Distribution Bank Balance for Distribution R. Edward Shenk Lawrence Lee Shenk Frank T. Shenk EXHIBIT C DISTRIBUTION $ 37,647.42 - 2,950.57 $ 34,696.85 - 1,462.21 - 331.53 $ 32,903.11 $ 32,903.11 $ 10,967.70 10,967.71 10,967.70 " [/1/ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ralph L. Shenk Date of Death: February 14,2001 Will No. Admin. No. 21-01-0218 Pursuant to Rule 6.12 ofthe 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 ofthe estate is complete: Yes X No 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe 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? Y es ~ 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. ~"~J ohn H. Broujos 4 N. Hanover St., Carlisle, P A 17013 717-243-4574 ,..,....... .....'.._l Date: 4-19.-02 r-J .--.....1 P >= - -' " "'\ ( ~... --' '-" Capacity: Personal Representative ~ Counsel for Personal Representative