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Home My WebLink About01-0569 PETITION FOR PROBATE and GRANT OF LETTERS Estate of HL(thl vi, !3/JRf?6Ur<. No. ~Z- I-~ 01 - 569 also known as ^/ / V1- To: , " Register of ~lls for the , ~eceafrd. County of G-t1M~/1L.11tJO in the Social Security No. /71.{-- OS'" ?~vL.f Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who Klare 18 years of age 9'tJ2~J,a~ thDex~qt D~ 5 in the last will of the abov<;. decedent, dated lVi t:: ~ 1 '. c^. I ) and codicil(s) dated tyOtle Dr?d ,19 . ,~ ZOOI, I ~ () 15 Except as follows, decedent did not marry, was not divorced and did not ave 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: N() r:iCiPf/()d!; Oecendent 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 Pennsylv.ania ", situated as follows: 056 lAl 1. ::ll/t;/'ltl('::' G"t.l/,,'I..-(::(;L.- II/ 1)/) r /I" I $-.1L1V (!>1'll1IAl'ej) $ $ ~$ ,11 of the last wi1\ and codicil(s) WHEREFORE, petitioner(s) respectfully r pre<;ented herewith and the grant of letters theron. -.lOw I<NOroJtv' ~ G-tErap. ~ f1,cftG#L€1 fJ)(,{) f(ftJ N).J ~.u-k.-!:f. ~~r ~I t:. t...I:::N Or-r , :Ji<€:rlllc ~ fl . (rtfl> 7'-(/" N.f11f1Rt<',:r 5"- ,.;1 ,{O! flufCIIlf;YICSr?wR& I Flll-lo r;.;;: -1r/-0C1(- --1t17.;7. I 4~;~~~,,~ f/flt)LlN(!' [;;. n>fiL 5t!Z- nILC/O} I?;LV 12 tI OR"IH /J/)~ (' P, 5 L/- z. 81 q Lf/ - 7-Lf!> - 'f q OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss CO U NTY 0 F C /,1 HI r;:>t: I.?!}J N I) J '" '" u C '" ~--;; "'- '" ... 0::'" c -00 c':: cu'::: ~'" ~o.. "'.... ;:; 0 ;;; c 00 Vi (testamentary; administration c.t.a.; administration d.b.n.c.La.) 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) wilI weIl and truly administer the estate according to law. ~6~-'~ ~~ L-rHZ F~ tiC L t; 1~ I '36 1 ~M A L- 1?r;.f1cr/l.l:;;[ ilo t, . 1'1 ff (/ , I d~'l- ~ s:: ~ c:;- C- h.u:tJJ/ No. Z {... 1>8-- 5fiq Estate of G-L.eN~{ w. ~f1f<(?Ou.. (<. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS {vf tf,; AND NOW L- 18, 1-9 -z.w" in consideration of the petition on the reverse side hereof, satisfactory proof having b:9n ~resented before me,,, IT IS DECREED that the instrument(s) dated tJ../JVeM6ef( -Z I) ;too / described therein be admitted to probate and filed of record as the last will of GL.{!rltl W, (J;14R/J.;O{). t< and Letters -[ ( 51 AnI e rI l' pr I=< 1.1 are !1ereby granted to C L;t)~ ,;;-,/C ~ ~. /311f(tJ;Ou.R GL ell f)/t tiell)r!a F: (J.t;lc.l-li-t~/. }({!.Jllt:. ~. :S",x($;.I.J,fIL,~ FEES Probate, Letters, Etc. ......... $ ? nn nn Short Certificates( 4) . . . . . . . . .. $---1.?-.-OO- Renunciation ................ $ X-Pages $ 3.00 JCP 5 O~ ,/ TOTAL _ $ . v Filed... .~.~4!~~.. .1?. .). Zr?(J, P.~~:?~. 4r(~(J /'i~, ~Jl!&i11.0 fYI' 12' t't:" 't'f'i<//5 Cf2 f2,0~,t~o!( ()b1-b-J 3?:> :;, II Allole-I? 5~( Cfl;<U;.,LA! rAff~1..ESS ~/()13 --1/"'1-- ~Z(.f'~- '~~'II'/ PHONE Called attorney on 6-18-01 :'lw is to certifY that the information here given is correctly copied from an original certificate of death du!~ flied with I <lc:;d Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent tIlmg. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. No. 1"tI",'IINN"~ "",'I'~~\.i" OF PEi:----_~ ,l~7~4'''A~ /,f~~-.. - ~.~~ ~ ~I . c\l.!::' \-P ~ ~~'- .- I~~ ~ QI - :0:--1' - ::b~ ~c-) '~'.d I ~ ~ *\" .. .~, :.,/*~ ~ a.\'~_. /~d " ~~ /~ I" "'". ;srp~ //.~'r ,I' ......__;'iMENf~~ ~""," "'''''''NUFlJ/IJIJI'' '5l:.- (:\. \-'~&.-t"~ Local Regisrrar fee for this certificate, $1,00 P 7402234 JUN 4 2001 Date Hl05.i4.3Ah.2117 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH iT v". UNDER 1 OJ<< Hour8 ! MirltIt.. SEX STAll F'LE lIIUMBER SOCIAL SECURITY NUMBER H . NAME OF OECEOENT IF'rst MIdaIe. l'., 1. Gle.nn W. BMboUlt AGE{la.a.rtNJay) UNOER 1 YEAR Montha Days ..Male. 2. 174 - 05 .. COUNTY OF DERH 88 BIRTHPLACE (Cry.Ad PlACE OF DEATH iCP\eck 0f\Iy I:ll"e "" IflSl'uct.ons: on ort'ef SWJet State Ol' Fcre.gn COUMy) HOSPITAL; IncMllJenctJ EAIOur&)alillm [J ... FACilITY NAME (II nol InsllfUllOn. QI\4$1reet and numberl ~,O Q\ ..... Cumbvdand Ie. DECEDENT'S USUAL OCCUPATION tc:r:ww .;:':O~:::zt~ "L Se.C.UIti..ty ".. Manu6ac.tulti..n DECEDENT'S WAILING ADORESS (Sl'Mt CiIyITown, s... ZlpCode) DECEDENT'S ACTUAl RESIDENCE (See1nlll'Uc:11OnI on~et'IIde) MARITAL STATUS. Married SURVIVING SPOUSE N....... W.n~. W~, (II """e. gr4 maoo.lol\llmel -(5_'" ,.. wi..dowe.d 1050 Wayne. Ave.. ,I. CaIt.ii..l.lle., PA 17013 17a.&ate PIl 1'1 1'l6!f e...an ia Cumbe.ltland ... - .....in. _1 17C.IJEl....dllC~nu....d'" N. M-iddleton ...... 1111. -.. FATHER'S NAME IFirt(. MoOc:Je, last) II. INFORMANT'SHAWE (TypeiPrinr) ZOo, Clalte.nc.e. Eu e.ne. BaltboUlt METHOO OF DISPOSITION ......XJ C,..".....O _.........0 ""'"'- ((V)!""" c;', !-, f 0Uf 10 (OR AS A CONSEOVEN<;:E OF): ~~.~,,,-- vk ('UcJ DUE 10(00 AS A CONSEOuENCE OF): t.~oo~ACrl1EN~<MCf <.J. :.- ~tA_--- DATE S ED lM_.!loy._, ;) ~I .2.. 2>c.J.l \ \.C, I .. "*'S CASE REFERRED TO UEOfCAl EXAMINERlCOAONER? 'rd ~.O ~~ H. I Approximale PART N: Other Significant c:oncMicIN c:oncributtng 10 dealh, buI : int.,.,..~" not rnuh"'V in 1M undertying ~UM 0i\1ln in PlVrr l. I onset end deatl'l ! 6 VJ (~ l : WERE AUTOPSY FINOtNGS A'AtlA8LE PRtQA 10 COMPlEllON 01 CAUSE OF CE.<rH1 e, \.I~ MANNER OF DEATH v.. 0 ~O ....... - SuicicM g o DATE OF INJURY ''''''''''.lloy._l TIME OF INJURY INJURY AT 'NOAK1 DESCRIBE HOlt INJURY OCCURRED. Homicide D o o PlACE OF INJURY. At home, far,"~;e.t.lactory. otftce M. building. etc.l$peotv) _. .... 0 NoD Pencfino Inwesllgalion ~ Coutd not 1M det.rmlned 2ee. 2ab. Cl:RTlFtERlO1eck only ~I -CDlITIF'YIHG PHYSICIAN tPtlysocl8n c~ cauw d ~alh wfIen anoln8l' ptlVSOC<ar\ has ptQn()l.jnced deal" 011/'10 completee lIem 23) Tou..be-alormylu"Io....'-dge.de.tttoccuned due 10 Ih. c.use(s)sndmsn"e's.st.ted.""""...,... 20. .'ROHOUNCINQ AND CERTIFYING ~HYSICIAN (PhySICian bolh O)IO/"ouoc.nglJeath and Cer1tlylI'lQ 10 cause 01 deaThl To lhe blest 01 '"., kno....ecIgfl. dest" occurrM at ~ time. dsle, and pIK.. sncl due 10 tI'le csuse(slsnd ,"snt1.' s. stsled.. , , .. -"EDtCAL EXAMINER/CORONER On the b..i. of e..mln.1Ion and/or invealigalion,ln my opinion, duth occurred althe lime. d.le. and place. and du.to the cause(aland "'.nner a. sl.ted.. . , . , . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . :Jh. REGISTRAFI'S SIGNATURE AND N o ~.~~~ 1d..1 I ~ \ 101 22. OATE FILED (Montl1. Day. vean. t 24. CJ\.J.x\e +1 ,9.()<.J\ '. LAST WILL AND TESTAMENT OF GLENN W. BARBOUR I, GLENN W. BARBOUR, of 1050 Wayne Avenue, Carlisle, North Middleton Township, ClllIlberland County, Pennsylvania, declare this to be my Last Will and Testament, and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts, funeral expenses and ad- ministration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares, to my three (3) children, namely Clarence E. Barbour, Glenda F. Brenneman and Pauline E. Gutshall, or their issue, per stirpes. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM IV: I appoint my three (3) children, Clarence E. Barbour, Glenda F. Brenneman and Pauline E. Gutshall (or the survivor[s] of them), Co- Executors of this, my Last Will. ITEM V: I direct that my Executors shall not be required to gIve bond for the faithful performance of their duties in any jurisdiction. t./tf- day of . tN WITNESS lfIERmF, I have hereunto set my hand this 1l0v eJvt 6e~ , 1986. AL 11,-; tf? a..'1/t:--r_- Glenn W. Barbour (SEAL) The preceding instnnnent was, on the day and date thereof, signed, pub- lished and declared by Glenn W. Barbour, the Testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses. LA W (lFr]CES LANDIS, BLACK, JOHNSON & SCHORPP CARLISLE. PENNSYLVAN]A ]7(l] 1 '..... '" ..... CO~NWEAL1H OF PENNSYLVANIA) 55. COUNTY OF CUMBERLAND ) . We, GLENN W. BARBOUR ~d~~ ly, whose names are signed to the ROBERT R. BLACK , and , the Testator and the witnesses, respectiVe] attached or foregoing instrument, being first duly sworn, .do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will, and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness, and that to the best of his knowledge the Testator was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. g Testator LA W OFfiCES I.^NDIS, BL^CK, JOIINSON & SCHonrp CAllllSLE. PENNSYlVANIA 170ll Subscribed, sworn to and acknowledged before me by GLENN W. BARBOUR , Testator, and subscribed and sworn to be:5~Ore me by / ;/r:f ROBERT R. BLACK u- and ~ . ~ witnesses, this.:2/ day of/u--ihu.--, 19 6. lZL Not Public MARY m COR:!..' :1, r;:t:rj Public Carli:.Ic, Cum!:sr!i:~. CJ., r' J. My COr.1mi: :v~ E};;:l:r~: :.';Jt. 19, 1987 , ---- CERTIFICA TION OF NOTICE UNDER RULE 5.6 (c) Name of Decedent: Glenn W. Barbour Date of Death: June 2,2001 Will No.: 21-01-0569 Admin. No. To the Register: I certify that notice of estate administration 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 : Name Clarence E. Barbour Glenda F. Beachley Pauline E. Gutshall Address 40 West Allen Street, Mechanicsburg, PA 17055 26 North Market Street, Apt. 101, Mechanicsburg, P A 17055 5112 Palena Blvd, North Port, FL 34287 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: 71/3/0/ , (27 / 7 tJ- L.~t/ 11/31tU/'L Robert R. Black, Esq. 36 South Hanover Street Carlisle, Pennsylvania 17013 Telephone (717) 243-3727 Capacity:_ Personal Representative ---1L. Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B060 1 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BLACK ROBERT R 36 S HANOVER STREET CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 174-05-3324 FILE NUMBER: 21-2001- 0569 DECEDENT NAME: BARBOUR GLENN W DATE OF PAYMENT: 08/30/2001 POSTMARK DATE: 08/30/2001 COUNTY: CUMBERLAND DATE OF DEATH: 06/02/2001 NO. CD 000218 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,000.00 I I I I I I I I TOTAL AMOUNT PAID: $2,000.00 REMARKS: CLARENCE E BARBOUR ET AL C/O ROBERT BLACK ESQUIRE CHECK# 110 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS REV-1520~' '1~-oOi COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY C/ w '"' :lC.~cn U ."" w"u ",00 U"... ..Ill .. '" /~ -~ 7- .J.. FILE NUMBER 2 1 _ 0 1 INHERITANCE TAX RETURN RESIDENT DECEDENT YEAR NUMBER o 5 6 9 COUNTY CODE I- Z W C W (,,) W C DECEDENTS NAME (LAST, fiRST, AND MIDDLE INITIAL) Barbour, Glenn W. DATE Of DEATH (MM-DD-YEAR) June 2, 2001 SOCIAL SECURITY NUMBER 174 05 3324 DATE Of BIRTH (MM-DD-YEAR) July 6, 1912 THIS RETURN MUST BE fiLED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (If APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, fiRST, AND MIDDLE INITIAL) N/A lXJ 1. Original Return o 4. Um'lled Estale 06. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (daleo/death after 12-12-82) o 7, Decedent Maintained a living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1~1.95) o 3. Remainder Return (date of dealh prior 10 12-13-82) o 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attactl Sc/1 0] >-- Z W C Z o .. '" w " " o u NAME Robert R. Black, Esq. ~~t!trJ I'&,,'g'l:hck TELEPHONE NUMBER 717-243-3727 COMPLETE MAI,ING ADDRESS 36 South Hanover Street Carlisle, PA 17013 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 58,312.00 0.00 0.00 0.00 2,557.00 OFFICIAL USE ONLY z o !C( .J ::::) l- ii: <l: (,,) w a:: 3, Closely Held Corporation, Partnersh'lp or Sole-Propr'lelorship 4. Mortgages & Notes 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 Gtoss Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) 6,788.00 (12) 54,081. 00 (13) 0.00 (14) 54,081. 00 (6) 0.00 (7) 0.00 (8) 60,869.00 (9) (1Q) 6,457.00 331,00 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' ::::) D. ::E o (,,) ~ 15. Amount of line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a)(1,2) x.o_ (15) x .0 45 (16) x .12 (17) x .15 (18) (19) 2,434.00 16. Amount of Line 14 taxable at lineal rate 54,081 2,434.00 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 1050 Wayne Avenue CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due Ipage 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 11) 2,434.00 2,000.00 105.00 Total Credits (A f 8 f C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty 0.00 TotallnreresVPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 f Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 2,105.00 5. If Line 1 f Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5) 329.00 A. Enter the interest on the tax due. (SA) 8. Enter the total of Une 5 f SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 329.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.................................................... ....................... 0 b. retain the right to designate who shall use the property transferred or its income; ....... ......... 0 t. retain a reversionary interest; or ................"........................... ......................................................... 0 d. receive the promise for life of either payments, benefits or care? ....... .............................................................. 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..................... .......................................... ............................... 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which contains a beneficiary designation? ................................... ......................................................... 0 No IKJ ~ IX] o [] IX] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SlGN~~E ~ P5YS~ES~SIBLEJ:QR FILING RETURN ~ 'f. ~ C arenee 't':;~ Glenda F. Beachle ADDRESS 40 W. Allen PA 26 N. Market St.. Mechanicsburg, SIGNATURE OF Robert R. Black, Esq. ADDRESS 36 South Hanover Street, Carlisle, 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 or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. 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 01 the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (II)]. The statute does not exemot a transfer to a survivin9 spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dales 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% 172 P.S. ~9116(a)ll.2)J. The tax rate imposed on the net value oftranslers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value 01 transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent In oommon with the decedent, whether by blood or adoption. SCHEDULE A REAL ESTATE Estate of File Number Barbour, Glenn W. 21-01-569 AD I'eIII property owned lIOIeIy or... tenant In common must be ftported.atfalrtnal"btvahle. Fair market value is defined as the price at which property would be exchanged between a wining buyer and a willing seller, neither being compelled to buy or selL both having reasonable knowledge of the relevant facts. ReoI properly whkh Is joIntIy-oomed with rIcJd or survivorship must he diK_ 011 Schedule F. Item Number Description Value at Date of Death 1. Real estate situate at 1050 Wayne Avenue, Carlisle, Pennsylvania, as recorded in Cumberland County Deed Book "Z", Volume 20, Page 330. See settlement sheet attached hereto. Net proceeds. $58,312.00 TOTAL (Also enter on line I, Recapitulation) $58,312.00 SCHEDULE E CASH, BANK DEPOSITS & MISe. PERSONAL PROPERTY Estate of File Number Barbour, Glenn W. 21-01-569 Include to proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with Right of Survivorship must be disclosed on Schedule F. Item Number Description Value at Date of Death 7. State Farm Insurance, property iosurance refund. $750.00 $500.00 $24.00 $1.00 $1,253.00 $20.00 $9.00 I. M&T Bank, checking account 2679042503. See attached letter. 2. Commonwealth of Pennsylvania, property tax rebate. 3. State Farm Mutual, automobile insurance refund. 4. Comeast, TV cable refund. 5. Potteiger Auction Service, net proceeds sale of personal property and realty. 6. York Waste Disposal, refund. TOTAL (also enter on line 5, Recapitulation) $2,557.00 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Estate or Barbour, Glenn W. File Number 21-01-569 Debts of decedent must be reported on Schedule 1. ITEM NUMBE R DESCRIPTION AMOUNT A. Funeral Expenses: 1. 2. 3. B. 2. Gibson-Hollinger Funeral Home, balance $1,042.00 Administrative Costs: 1. Personal Representative Commissions Social Security Number of Personal Representative: NONE Year Commissions paid Attorney Fees - Landis & Black, estimated $5,000.00 3. Family Exemption Claimant N/S Address of Claimant at decedent's death Street Address: City: State: Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees $0.00 $50.00 $50.00 $9.00 $3.00 $3.00 $300.00 $6,457.00 7. Christopher R. Mason, set-up at Public Sale 8. Scott P. BeacWey, set-up at Public Sale. 9. PP&L, invoice. 10. Sprint, invoice. II. PP&L, invoice. 12. Reserve for closing and filing Releases. TOTAL (Also enter on line 9, Recapitulation) SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS Estate of Barbour, Glenn W. File Number 21.01-569 Include unreimbursed medical expenses. Item Number Description I. Carlisle Surburban Authority, water and sewer invoice 2. Sprint, invoice 3. York Waste Disposal, invoice 4. PP&L, invoice Amount $147.00 $98.00 $27.00 $59.00 TOTAL (Also enter on line 10, Recapitulation) $331.00 SCHEDULE J BENEFICIARIES Estate of Barbour, Glenn W. File Number 21-01-569 Number Nome _ Address of Person(s) Receiving Property Relationship to Decedent Do Not List Trustee(s) Amount or Share of Emt. I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Clarence E. Barbour 40 West Allen Street Mechanicsburg, PA 17055 SSN: 208-24-2299 Glenda F. Beachley 26 North Market Street, Apartment 101 Mechanicsburg, PA 17055 SSN: 171-30-5983 Son One-third (1/3) 2. Daughter One-third (1/3) 3. Pauline E. Gutshall 6576 Kipa Court North Port, FL 34287 SSN: 172-38-1441 Daughter One-third (1/3) 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 Govemmental Distributions 1. TOTAL OF PART II - Enter Total Non-Taxable Distributions on Line 13 of REV 1500 Cover Sheet $0.00 LAW ()FFI{:ES LANDIS, BLACK, JOHNSON & SCHOHPf' CARLISLE, rENNSY1.VANIA li,111 LAST WILL AND TFSTAMENl' OF GLENN W. BARBOUR I, GLENN W. BARBOlffi., of 1050 Wayne Avenue, Carlisle, North Middleton Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts, funeral expenses and ad- ministration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares, to my three (3) children, namely Clarence E. Barbour, Glenda F. Brenneman and Pauline E. Gutshall, or their issue, per stirpes. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM IV: I appoint my three (3) children, Clarence E. Barbour, Glenda F. Brenneman and Pauline E. Gutshall (or the survivor[sJ of them), Co- Executors of this, my Last Will. ITEM V: I direct that my Executors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. '2-1 Jf.- day of . IN WITNESS JWERmF, I have hereunto set my hand this fiO\lU1l16BR , 1986. ./U..-. It/ {I{ tNvI~ Glenn W. Barbour (SEAL) The preceding instrument was, on the day and date thereof, signed, pub- lished and declared by Glenn W. Barbour, the Testator therein named, as and for his Last Will, in the presence of us, WIO, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses. (2ftM-/f7jj~ ~ LAW OI'I:ICE.... I.ANDlS. llI.J\CK, JOIINSON & SCHOIf.PI) CAllLISLl!. rENNSYLVANIA 1101) CCM<IONWEAI;rn OF PENNSYLVANIA ) SS. COUNTI OF CUMBERLAND ) . We, GLENN W. BARBOUR ~/ dU~ ROBERT R. BLACK , and , the Testator and the witnesses, respective ly, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will, and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness, and that to the. best of his knowledge the Testator was at the time eighteen years of age or older, of s.ound mind and under no constraint or undue influence. AL- 74- ;lJrM//~ Testator M~::Jir ~~ -Witness ~ Subscribed, sworn to and acknowledged before me by GLENN W. BARBOUR , Testator, and subscribed and sworn to before ~ by / ;/ r6! ROBERT R. BLACK if and t~~. ~M witnesses, this.:2/ day Of/J4-.it.F~~, 19 6. L Public MARY ~N CORtA"}], ti8t.~ry Public Carti~lc, Cumbedc,>~' CQ., r~. My Cor.Hni~';,,:1 b:~:r~': S~[Jt, 19, 1937 RfV.d83fX+{1.Q21 11'<.". I~t .",-;j9}~ SAFE DEPOSIT BOX INVENTORY COMMONWEALTH OF PENNSYLVANIA DEPARTMeNT Of ReveNUE INHERITANCE TAX DIVISION DEPT,280bOl HARRISBURG. PA 17128.0601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAfE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER 21 174-05-3324 DECEDENT'S NAME (LAST, FIRST, MIDDlE) BARBOUR, GLENN W. ADDRESS OF DECEDENT (STREET) (CITY) 1050 WAYNE AVENUE CARLISLE NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX INAMj(TIORNEY ROBERT R. BLACK f./-tI D f i(ESiE,.tr- OA TE OF DEATH 6/2/01 (STATE) PA (STREET ADDRESS) 36 sourn HANOVER STREET /ClTY} CARLISLE (STATE) (ZIP CODE) PA 17013 NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSONIS) PRESENT AT THE BOX OPENING a. (NAMEl (RELATIONSHIP) Ct..A{I.~r{c~ ~. r?ft1'<.6DL.(~ .5C5t1 (STREET ADDRESS) 1./-0 vi. !-1 L-1...6N 5", b. (NAME) &t.-&NM Y. fJ.;€flQfU~ (STREET ADDRESS) :-Ir 2f.> II, J41!4f<'1.'e,P<[' c. (NAME) //tt<./,/;VG iF. &t<rSi-/14L t.. ISTREET.;?!tR':z.1 !J UN. 13l. Vi;;> ,r,:IClTYI fbr<r NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) M&TBANK (STATE) ft, JCITY) !vi Q;1fi4 N I C5, f.}l.d< G- (RELATlONSHIPI f}fJt..f Grf ('e.R (CITY) Iv/. ec.itlirll c.Sf34.I R r;.- (RELATIONSHIP) MtUiHft;!<? ~TE) I'll-. (ZIP CODE) 17013 (ZIP CODE) 170';:;5 MAE.J (ZIP CODE/ tJ:r ,'10<;:5 (STREET ADDRESS) 1 WEST HIGH STREET (CITY) CARLISLE (STATE! PA I NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY ./ G-t..6.NN "" ~K'iScu. 1- 0 I - <1:4-5 DATE OF CONTRACTTO RENT BOX NUMBER OF BOX TITLE UNDER WHICH BOX IS REGISTERED 1/ 1. ICj'i(-V- 3<fZ7 GLeNN w f3Af!f'>bUk? NAME AND ADDRESS OF PERSONIS) HAVING ACCESS TO BOX a. (NAME) b. (NAME) ~. (fLG.NN yJ'r?r:!;z,r30ul'Z N(Hf~ (STREET ADDRESS) {STREET ADDRESS} io5o IN(1rtjrfG .4vc (CITY) (STATE) (ZIP CODE) (CITY) (STATE) CA~/...l<;U:: (1013 NAME AND TITLE OF EMPLOY TAKING THE INVENTORY r<IJ &: Rf f<. rX.r4L.K r; sq. WAS A Will IN THE BOX? eYES ~o If yes, o. Oat. of will: b. Name and oddress of personal r.presentative, if named in the will (NAME) - ti/4 (STREET ADDRESS) <<Or')~ fl.l c. Nom. and address of attornev. jf any (NAME) 3(" 5. ffft1.JOVe.fC S"I f (CITY) (STATE) fl, r?tric-~ I f:Sf( CIt!?f.,i '> t..-6 I fr+, /7tJ/3 (STREET ADDRESS) (CITY) {STATE} (ZIP CODE! 17013 (ZIP CODE) (ZIP CODE) (ZIP CODE) Page of SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered and Iype of ownership, i.e., iointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, ete: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List end describe as fully as possible. (8) All other contents. ITEM NO. ITEM DESCRIPTION I t. 3. I./: (kED 1""6 c../...G>,.JtJw.tNlh!II,?_&. /J bIAR-ulrt//4(P3- "Z,,-z.S5i IO~()WMI'I~.4w? -f11L..~- itf'11 (16lJnftC 4tlfo - VIr/-U'f,:,tiW4P/agO!<'1, OiEO.- pl-r' HOu.4~~rr.l&S Ce,11e-r~/i?,' .aSS-O. 1.Jl"- 'iS1J.4 POl) ell - fr<u..fJerJn fl./.. ~N 5: C() Q~. tttl1e'R - &.1ft.ou~G- G-'-€tltJW' ~Rf'54o.te (~- 3i.WJr.1 A ,,^ - C-6S0"-H"'-'-ltJ&~ r::tI\rJ~ 1-111>1/;; -1.fJC. I'~IJ.IC"- fr<U.fJ6.I-f", It/... - -tf '55'f' ~3 I'f-f ~ -("rJslA.r<eo 'GuN,.; MRt30lLR 5. . I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON REC.~VING COPY OF / CORRECT AND 'OMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOS" BOX INVENTORY, SIGNATUPyf /J " U-1A _ /l A 0_ SIGNATURE C .-"L '1J1/"fA../ f vrJ(~/W · ~ l.. W PRINT N.o' /) .12.. PRlt''i.il~ ~i&}\'~~kRIA)7~~ '~'it (;MSllilU- II' 6 M(?'T'" 1<.. - /-)tA'\'-IL.. G-l&AlPiI r. (>,€I\CMI-etq PRINT HTlE CHECK APPROPRIATE BOX: A1 f 0 t\rJe u ~ Executor(lrix) DAdministrotor(trix) -- -, 0 Estate Representative 0 Joint owner of safe deposit box NOTE: Attach additional 81f2"" x 11"" sheet (s) if necessary or use duplicates of this page of form. - .. OMS NO. 2S02..(J265 --'"p A. 6. TYPE OF LOAN: U.S. OEPAATMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2-DFmKA. 3.0CONV. UNINS. 4.0VA 5.0CONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT 2351.1 8. MORTGAGE INS CASE NUMBER: C. NOTE: Thill fom! Is tlJmlshed 10 glvo you 8 sla/amen' of ae/ual Mtl/emtml oosIlI. Am<:IUnls paid to and by the settlement agen/af9 shown. Ilems marked iPOCr we" paid outside the closing; Ih(lY aID shown oon(J for Informs/lemal purposes and are no/ indud8d in /119 Io/a/s. '" - 12:15t.!M!;ALS.PFOI2:1.S11121 O. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: ToddE.MeaLs Es\a\e 01 Glenn W. Barbour 1022 H(lrrlsburg Pike 1050 Wayne Avenue Carlisle,PA 11013 Caflisle.PA 11013 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1736654 I, SETTlEMENT DATE: 1050 WSyml Avenue Law Office of Michael J. HlInft Cafllsle, PA 17013 AuUus129,2001 Cumberland COlIIlly, Penns)'lvania PlACE OF SETTLEMENT 19 Brool<wood AV$1ue, Sulle 106 Carlisle,PA 17013-9142 J. SUMMARY OF BUYER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION "". GROSS AMOUNT DUE FROM BUYER; 400, GROSS AMOUNT DUe TO SELLER: 101. ConlraelS,,18sPriee 59,000,00 401. COCIlractSale$P,ice 59,000.00 102. Personal Pro erl 402. PersonalPIO e 103. SeWement Char 8S to Bu . Line 1400 1,174.50 403. 104. "". 105. 405. Aduslmrmls For Iloms Paid B Stlllerln advance Aduslmenls For /iams Paid B Sellerinedver>ca "". Co," Ta~es 06129101 " 12131101 58,19 406. Count Ta~es 06129/01 .. 12131101 58.19 '" School Ta~es 00129101 " """'., 509.92 407. Sel1oolTa~es 00/29101 lo08J30102 509.92 lOB. Assessments " 40B,Au9ssmenls " 109. 409. 110. 410. 111. 4". '" 412. 120. GROSS AMOUNT DUE FROM BUYER 60,142,61 420'. GROSS AMOUNT DUE TO SELLER 59.568.11 '''''. AMOUNTS PAID BY OR IN BEHAlF OF BUYER; 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201, Do slloreamestmo 5,900.00 501. E~ce$S De osit See Jnstruclk:ms ,., ,""" I Amoon\ of Htffl Loan s 502. SelllementCha esLOSeller Line140C 1.255.98 'OJ histin lo.anstal<OIlSubeetto 503. Exislin loans lal<en sub eel 10 "". 504. p" II of Rrsl Morlga e "5 505.0 o secondMorl a" '" 506. 207, 507. 0' ildisb.as ~"', 208. 50<1. ",. 509. Ad'usJmenlsForllemsU" /lidB Seller Ad uslmenls For l/elll$ Un aid B Se/ltlr 210. C~" Ta~es " 510. CQtJnl T~, " 211. School Taxes " 511. School Taxes " 212. Assessments " 512.A$sessments " 213. 513. 214. 514. 215. 515. 216. 516. 217. M7. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BUYER 5.900.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1.255.98 300. CASH AT SETTLEMENT FROMrtO BuYER: 60<1. CASH AT SETTLEMENT TOIfROM Sf:lLER: 301. Gron Amount Due From Bu rLlne120 60.742.61 601. Gross Amoonl OueTo SeUer Llne420 5951'>IU1 "". less Amount Pald B orBu rLlne220 ( 5.900.00) 602. Less Reduclions Due Seller Line 520) ( 1.25598 30J CASH ( X FROM) ( TO) BUYER T 54,842.61 6QJ. CASH ( X TO)( FROM) SELLER r 58.312.13 ..... I pages 1&2 oflhis statemenl&anyallaehmenlsrelerred 10 herein. Buyer Seller EslateofGlennW.6arbour BY: ./IAj. C~, 1 ~..L- ~~ Todd E.Melill, - L. SETTLEMENT CHARGES % 700. TOTAL COMMISSION Based on PrIce OMslonofCommission Ii".. 700 asF<;>/kIws' 01. to 702. \0 703. Commission P~id al Seltlemenl 704. to SOD. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. LOilnOri InalionFee % to 8D2.LoonDlscounl % 10 603. Appra!salFee to 804. CredilReport to 605. Lender'slnspeclionFee 10 806. Mort a elns.A .Fee to 807. Assump~on Fee to ." ''''. '" 811- 900. ITEMS REQUIRED BY lENDER TO BE PAID IN ADVANCE 901.lnlereslFrom to S 902. Mort 1rn>lJfance?"~mlumf01 monl'ns 10 90J. Hazardlrlsurance Premlumror 1.0 ars 10 '" ,0> fOOD. RESERVES DEPOSITED WITH LENDER 1001,Hazardlnsur;mce l00Z.Mo lnswa<\OO 1003. Count w Ta.es 1004. SchoolTa."s 1005. Assessments "'''' 1007. 1008. A ale Alfuslment 1100. TITLE CHARGES 1101. Abstracl or Tille Search 1102. SelUemenlor Closin Fee 1103. Docum nlP,e ralion 1104. Allome sFell 1105. Nola Fee 110B. DRS Lllln Searches 1107. TiUe Binder Fee includ9sabov9il9mnumb9rs: '108, TU\e\ ll1"am:e /nclud6Sabolf9i/6mnumoors. 1109.Ll!nder'sCoverage 11 10. Owner's Covera e 1111 1112. \113. 1200. GOVERNMENT RECOROING ANO TRANSFER CHARGES 1201. Recording Fees: Deed S 2B,50:Mortgage $ 1202. Ci iCoun T"i<J \am S~ eed 1203. Stale Tai<JSlam s: Revenue Slam s 1204. 1205 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302.Pesllnseclion 1303. Final Waler/Sewer 1304. 2001-02 School Taxes 1305. 1'00. TOTAL SErrLEMENT CtlARGES Enter on llnll$103, Secllon J end 502, Section K B,.ignir>gpagej",,,,..,,.,,,,,...,,I..,..Ig..,,,,,..,,,,~"~""'oIpt"'a,,,,,,,pl.ledcopyol_2"'IIM'Mo>_"""""''"A I. -I . -prn'11; $ $ $ $ @ $ , @ , , t, to 10 Landis & Black " 10 NOla Public " " I CTIC/lawOm or Mkhael J. Hanfl 59,000.00 'S90.00.Morta 590,00:Morl a a " " 10 CartlSloSubu'banAulho,il 10 Robin t<. SottenlJer er,TaxCottec!or Cerlirredl.obeatrue\lOP~. /da~ "" " " '" , "" " '" ., Releases S %1 /1'04002210 LIIW Olfi1e df Michael J. Hanft Y SeltlemenlAgenl PAIOF~OI.O BUVE~'S fUNDS AT SETTlE""""T '00 ~ PAIDf~O'" snlE~'s FIJNDSAT SETI"lEMEN' '00 553.00 26.50 590.00 590.00 69.90 596.06 1,174.50 1.255,96 (1$\,11131.\.111) m~~Bank RE: Estate Search The Estate of: Date of Death (D.O.D.) Glenn W. Barbour 6/2/2001 To Whom It May Concern: Identified below is the account information requested. I. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title Opening Branch D. O.D. Accrued Interest Balances (Includes Accr. Int.) $749.98 $.00 Checkings 2679042503 Opened 9/1/67 Glenn W. Barbour 4319 2. Loans. Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed Account Description No Safe Deposit Box titled in the Decedent's name existed at our office. If you have any questions about the information provided, please contact our Records Department at (716) 635-40 I 0 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK. CORPORATION BY: ~J)1/Yltio. ~ Authonzed SIgnature DATE: 1I?:O/()1 Manufacturers and Traders Trust Company' 1100 Wehrle Drive, p.o. Box 7OT, Buffalo, NY 14240-0767 \, /6-~.37~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ROBERT R BLACK ESQ LANDIS S BLACK 36 S HANOVER ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-05-2001 BARBOUR 06-02-2001 21 01-0569 CUMBERLAND 101 '* REY-1547 EX AFP <12-001 GLENN W Allount Rellitted 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=i5'4j-E3f-AFP--fi1f=ooY-NOTicE-OF-YNHER-iTAifcE-TAX-APPRA-isEMENT~--A[ioWAirCE-C'-R------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BARBOUR GLENN W FILE NO. 21 01-0569 ACN 101 DATE 11-05-2001 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 54,081.00 X 045 = 2,434.00 .00 X 12 = .00 .00 X 15 = .00 ll9)= 2,434.00 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) (7) 58.312.00 .00 .00 .00 2.557.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage 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) 6,457.00 331. 00 (11) ll2) ll3) ll4) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 60,869.00 6.788 00 54,081.00 .00 54,081.00 PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 08-30-2001 CDOO0218 105.26 2,000.00 PAYMENT MUST BE MADE BY 03-02-2002*. TOTAL TAX CREDIT 2,105.26 BALANCE OF TAX DUE 328.74 INTEREST AND PEN. .00 TOTAL DUE 328.74 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: l-800-36Z-Z050; services for taxpayers with special hearing and I or speaking needs: l-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z8l0Zl, Harrisburg, PA l7lZ8-l0Zl, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z8060l, Harrisburg, PA l7lZ8-060l Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150l) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. The l5Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOl are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZOZ .000548 199Z 9Z .000Z47 1983 l6Z .000438 1993-1994 7Z .00019Z 1984 llZ .000301 1995-1998 9Z .000Z47 1985 13Z .000356 1999 7Z .00019Z 1986 10Z .000Z74 ZOOO 8Z .000Z19 1987 9Z .000Z47 ZOOl 9Z .000Z47 1988-1991 llZ .000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BLACK ROBERT R 36 S HANOVER STREET CARLISLE, PA 17013 __n____ fold ESTATE INFORMATION: SSN: 174-05-3324 FILE NUMBER: 21-2001- 0569 DECEDENT NAME: BARBOUR GLENN W DATE OF PAYMENT: 12/18/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/02/2001 NO. CD 000654 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $328.74 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CLARENCE E BARBOUR CHECK#123 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $328.74 MARY C. LEWIS REGISTER OF WILLS ! t- d 37 -- d. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* ~l BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 REV-UD1 EX AFP <12-001 ReGC'i Re~ji: T ROBERT R BLACK ESQ lANDIS 8 BLACK 36 S HANOVER ST CARLISLE '02 JAN 25 P2 :04 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-22-2002 BARBOUR 06-02-2001 21 01-0569 CUMBERLAND 101 GLENN w Clerk PA 1 flll-Sbb ld 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 =i6o-j-E3f-AFP--fi'2-:ooY------...--iNifiRITANCE--TA3f-s;:lrfEMENT-cfF'-Ac-couiff--.-i.--------------------- ESTATE OF BARBOUR GLENN W FILE NO.21 01-0569 ACN 101 DATE 01-22-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF lAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 2,434.00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-30-2001 CDOO0218 105.26 2,000.00 12-18-2001 CDOO0654 .00 328.74 TOTAL TAX CREDIT 2,434.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J PAVMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment made payable tD the name and address printed Dn the reverse side. If RESIDENT DECEDENT make check Dr mDney Drder payable tD: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check Dr mDney Drder payable tD: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund Df a tax credit, which was nDt requested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-13l3). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the Z3 Revenue District Offices Dr frDm the Department's Z4-hDur answering service fDr fDrms Drdering: l-800-36Z-Z050, services fDr taxpayers with special hearing and I Dr speaking needs: l-800-447-30Z0 (TT Dnly). REPLV TO: QuestiDns regarding errDrs cDntained Dn this nDtice ShDUld be addressed tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. Z8060l, Harrisburg, PA l7lZ8-060l, phDne (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5%) discDunt Df the tax paid is allDwed. PENALTV: The 15% tax amnesty nDn-participatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDm the date Df death, tD the date Df payment. Taxes which became delinquent befDre January 1, 198Z bear interest at the rate Df six (6%) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after January 1, 198Z will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department Df Revenue. The applicable interest rates fDr 198Z thrDugh ZOOZ are: Vear Interest Rate Daily Interest FactDr Vear Interest Rate Daily Interest FactDr 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 n .00019Z 1984 11% .000301 1995-1998 9% .000Z47 1985 13% .000356 1999 n .00019Z 1986 10% .000Z74 ZOOO 8% .000Z19 1987 9% .000Z47 ZOOl 9Z .000Z47 1988-1991 11% .000301 ZOOZ 6% .000164 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax becDmes delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. CI, o (", STATUS REPORT UNDER RULE 6.12 Name of Decedent: Glenn W. Barbour Date of Death: June 2, 2001 Will No. 21-01-569 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 181 No 0 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 fmal account with the Court? Yes 0 No 181 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 181 No 0 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. .. ....,.) ..- ~ .. {Z#t3 /Y!;1L~~~ Robert R. Black, Esq. 36 South Hanover Street Carlisle, Pennsylvania 17013 (717) 243-3727 Date: f"-J :May ~v: 2003 N N >- cc '-=-= '..,.,", (-:. ,. w ~l.1 (j) CC cc (T"\ p '.) ..0 =>= .;,'d ::: G6 Capacity: _ Personal Representative X Counsel for Personal Representative . Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 . Date: 5/07/2003 BARBOUR CLARENCE E 40 WEST ALLEN STREET MECHANICSBURG, PA 17055 RE: Estate of BARBOUR GLENN W File Number: 2001-00569 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 6/02/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: 'File Counsel Judge