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PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Beatrice A. Shirk
also known as
No.
To:
Register of Wills for the
Deceased. County of Cumberland in the
Social Security No. 201-18-1614 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 executor
in the last will of the above decedent, dated ,111n e 7.1
and codicil( s) dated
named
,19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
her
Decendent, then 74 years of age, died October 19 ~2001
at ~9rah Todd Memo~ia] Horq~
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
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:
101)()('), <XL
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
(testamentary; administration c. La.; administration d. b.n.c. La.)
theron.
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Craig Maurice Shirk
24 Marilvn Drive
CArlisle, FA 17013
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA l ss
COUNTY OF CUMBERLAND J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the est cor . g to law.
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11-18-11
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No. e..1- 6/-=lMD
Estate of
BeaGrice A. Shirk
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW November 1- ~ 200~ 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 23. 1999
described therein be admitted to probate and filed of record as the last will of
Beatrice A. Shirk
and Letters TeRtnmentnry
are hereby granted to Craig Maurice Shirk
(oOIDD
Probate, Letters, Etc. ......... $
Short Certificates( ).......... $J~. 00
RelHtnGiatloH . '~:-:~~j:)' .. $ l.o. 00
~$ 6.00
Filed . NoV.Z,.i8.b.t =. ~.~.~: .~.~
FEES
(Sup. Ct. I.D. No.)
Ronald E hnson, Esquire, 16453
~a W~~t P~fr~t Str~~t
ADDRESS
Carlisle, PA 17013
(717) 243 0123
PHONE
~T IN ATT\.f . ~TffoN~'f fll.E:-
0<; <:-(\<:; ":'''='\' 0!<:-r:..
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,
WARNING: It is illegal to duplicate this cop~ by photostat or photograph.
Fee for this certificate, $2.00
p
7714225
No.
me as
'g:-~. ~eu.~~
Local Registrar
OCT 2 3 2001
Date
Hl05.143 R.... 2117
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT 011 HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
liNT
STATE FIlE NUMIIER
SOCIAl. SECURllY 'lUM8ER
1.20] ]8 - ]6]4
DId
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he ill
Cumber land -.,Np7 17..0 :;:::-.:;::'"
MOTHER'S NAUE (f"...loId:Ie. ..._ Sol_I
" Katherine Shirk
INI'OAMANT'S MAIUNQ AOOAESS lSIr8lII. Cilylbon, .... Zip Codel
a.24 Ma~ilyn Drive Carlisle, Pa 17013
PUCE Cf' DlSPOSmOH. _ "'Cemetery. erem.""Y LOCATION .Cily(TOwn. SIal.. Zlp~
Of ou. PIKe
200] Curberland Valley r-en. GardeIl$ Car lis Ie, Pal 7013
ale. 21'. .
ENT
.Ifl(
NAME Cf' DECEDENT If,",. _. L_
1.
BEMI'RICE A, SHIRK
SEX
a. Female
AGE l\.UIllimaoyI
UNOER t YEAR
MMN 1 0.,.
UHllER , Dill'
_ ! M.......
IIlRTHPl.ACE (C'.Iy_
SlaIe Of Fer. ec..n.rYl
Carlisle, Pa
...
DECEOEHT'S USIJAl. oceUPRlOH
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l1L LPN 1111. State Hosp~tal
DECEDENT'S IIAIlIHG ADOAI!SS (SnIl. Ovfbwn. !!Ia. r.. Codel DECEOENT'S
113 Cottage Road ~~~
'ppensburg, Pa 17257 ~~
,..
fRltER.s HAAIE (FftI. loId:Ie. L"'i
" Elias e:taig
lNfOl;lMANT'S NAME (T Yl*f'rftI
Craig Shirk
....00 er_ 0 "-"""'SlateD
ou. (SpeciIyl
17.. SI...
1711.
WEntOO OF
LICEHSE NUUBfR
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DIJE 10 (CA AS A CONSEOVENCE Of):
weRE AtnOPSY FlNOINGS loIANNER Of OEATH
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COUPUmON OF CAUSE "fi('" 0
01' DeATH? Hat",a! _ide
-... 0 Penctmg k\vesUgat.ion 0
No 0 SuicIdoo 0 Could not be d...rm,t*:t 0
DATE OF INJURY
(Morllh. Day. lItlll
DATE Of DEATH.Menon. 0..,. '_,
.. Oct ]9, 2001
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SURVIVING SPOUSE
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NAWEAHOAOllRI!SSOFFACIUTV .
~ Funeral Hane 255 York Rd, Carlisle, Pa 17013
LICENSe NUMBER OR'E SIGHED
(MonII.(lav. -I
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PART H: 0Iher IiQniII<ulI CDoldtiono ~Ing II> dealh. IluI
..... --.oinlhe~_g;....in PART I.
TIME Of lNJUR'l'
INJURY AT WORK? DESCRIBE: tION INJtJRY OCCURRED.
a.
P\ACE Of IN.J\JAY . AI_. 181m. ""-. lKIllrI. .me.
bt-.g. etc. ISpeoI'<I
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.CEJITtFYlNG JlH'tSlClAtl (Ph_ cen/yW1g cause d.,..on _ """,h.. physc:.... haS pranoo.nce<l doom ana """""otod ""'" 231
Ta..._.....,~._occ_.....IO......u..(.I.ndm...n.,.. .""ed..,..................................................
'PlIIOMOUtlCIHQ AND CIIlTII'YING PHYSICIAN (Physicoan ""'" ;>0"""""""'9 dealll oncl cef1llVV'9 to cau.. Q/ <lelthl
To... beoet of fRY knowtedt_. fta... occuf"feod .t!he ame. d.... and ptece, and due to ,.... cauMta'aNt manner.. ~'.'H_.
'MEDlCAL EXAUINER/CORONER
On the b.... 0' ...,"In.Uon and/or Inv.allvelion. In my opinion. d..'" occurred It the 11m.. d.'., and place, attd due ta the C'U'.(I) .nd
S,.~.... O1ated.. .. . .. . . . . .. .. .. . . . . . . . . . .. .. .. .. . . .. .. . .. . .. .. . . .. . . . .. . . . . .. . . . .. .. . .. . .. .. . . . .. . . .. . . . .. . . . . ..
REGlSTAAIl'S SIGNATURE AND NU
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DONALD J. KOVACS. MD
o 32. i:-~~=~~~7007
DATE FILED (MOIlII1. Day, lItarl
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LAST WILL AND TEST AMENT
OF
BEATRICE A. SHIRK
I, BEATRICE A. SHIRK, of 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 all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give and bequeath the sum of $5,000.00 to the Bethel A.M.E.
Church, 131 East Pomfret Street, Carlisle, Pennsylvania.
THIRD: I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my nephew, CRAIG MAURICE SHIRK. Should my nephew,
CRAIG MAURICE SHIRK, predecease me or die on or before the thirtieth day following my
death, I give, devise and bequeath the residue of my estate, of every nature and wherever situate,
to his then living issue, per stripes.
FOURTH: 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.
FIFTH: I nominate, constitute and appoint, CRAIG MAURICE SHIRK,
Executor of this my Last Will and Testament. Should CRAIG MAURICE SHIRK, fail to
qualify or cease to act as Executor, I appoint ALTHEA SHIRK, Executrix of this my Last Will
and Testament.
SIXTH: I direct my Executor and his successors shall not be required to
give bond for the faithful performance of their duties in this or any other jurisdiction.
.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Te~~~ent, consisting of one (1) typewritten pages, each identified by my signature, this
A3 ~ day of June, 1999.
~~7!;~i t2.~
Beatrice~. Shirk
A.
(SEAL)
Signed, sealed, published and declared by the above-named Testatrix, Beatrice A. Shirk,
as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight
and presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
1LIJf!~
COMMONWEAL TH OF PENNSYL VANIA )
: SS.
COUNTY OF CUMBERLAND )
I, Beatrice A. Shirk, Testatrix, 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 and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
,... Sworn or affirmed to and acknowledged before me by Beatrice A. Shirk, the Testatrix,
this ;).3 f'e( day of June, 1999.
NOTARIAL SEAL
SHELLY SEXTON, NOTARY PUBLIC
CARLISLE BORO, CUMBERLAND COUNTY
MY COMMISSION EXPIRES APRil 26. 2003
Member, Pennsylvania Association of Notaries
A..z:",; a ~ ~A~
Beatrice A. S irk, Testatrix
(SEAL)
. .
AFFIDA VIT
COMMONWEAL TH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, RONALD E. JOHNSON and (Z \c.A-\A€..'V (y\ CU'TfJP , 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 Testatrix sign and execute the instrument
as her Last Will and Testament; that Beatrice A. Shirk, signed willingly and that she executed it
as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and
sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the
Testatrix was at 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 RONALD E.
and eJ\~eo (Y\~ , w. esses, this ~ro/~ f
(SEAL)
NOTARIAL Sr:~.1
SHELLY SEXTON, NO. fiRY PUBLIC
CARLISLE BORO. C'lr'~BERLANO COUNTY
MY COMMISSION EXr'IRES APRIL 26, 2003
Member, PennSYlv".~~\ciation of Notaries
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-
--
CERTIFICATION OF NOTICE UNDER RULES 5.6(a)
Name of Decedent:
Beatrice A. Shirk
Date of Death:
October 19,2001
Will No:
21-01-1 010
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 November 9,2001:
Craig Maurice Shirk
24 Marilyn Drive
Carlisle, PA 17013
Bethel A.M.E. Church
13 I East Pomfret Street
Carlisle, P A 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No exceptions.
Date: November 9,2001
Ronald E. Joh 0, squire
78 West Po r Street
Carlisle, P A 7013
Phone: 717-243-0123
Capacity: Counsel for personal representatives
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
JOHNSON RONALD E
78 WEST POMFRET STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 201-18-1614
FILE NUMBER: 2 1 - 200 1 - 1 0 1 0
DECEDENT NAME: SHIRK BEATRICE A
DATE OF PAYMENT: 01/18/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 10/19/2001
NO. CD 000771
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,750.00
I
I
I
I
I
I
I
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TOTAL AMOUNT PAID:
$4,750.00
REMARKS: CRAIG M SHIRK
C/O RONALD E JOHNSON ESQUIRE
CHECK#107
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE DEPT.
280601 HARRISBURG, PA 17128-0601
REV-1500 INHERITANCE
TAX RETURN RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Shirk, Beatrice A.
DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY)
10/19/2001 8/13/1927
(IF APPLICABLE) SURVIVING SPOUSE'S NAME
/1- /1'- II
OFFICIAL USE ONLY
FILE NUMBER
.2/ - ~/'" Itl(J
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COUNTY CODE
YEAR
NUMBER
SOCIAL SECURITY NUMBER
201-18-1614
THIS MUST BE FILED IN DUPLICATE
WITH THE REGISTER OF WILLS
SOCIAL SECURITY NUMBER
I
Xl 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return
:::J 4. Limited Estate 0 4a. Future interest Compromise 0 5. Fed. Est. Tax Return Req'd
:iJ 6. Decedent Died Testate 0 7. Decedent had Living Trust _0_8. Total number of SOB's
I 9. Lit'g'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax w/ Sec. 9113(A)
fMW$.gG.'t(QM~~lRgg(jjlRgb.tplR$.:&Ti~tl;rqtm~t$.#p~~&.ql1~j:@No.p'pljltjo.tffitm#t#.~f~Uf9.~M%.:T\Q.ij:*qtt:Kf:t::tt:Ht;t
NAME: COMPLETE MAILING ADDRESS:
Ronald E. Johnson, Esquire
FIRM NAME:
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Andrews & Johnson
TELEPHONE NUMBER
717 243-0123
Ronald E. Johnson, Esq.
Andrews & Johnson
78 W. pomt&t St. d
Carlisle, ~ 17013"..)
$0.00
$0.00
OFFICIAr:USE ONLY
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(1)
(2)
(3)
(4)
(5)
(6)
$0.00
$56,911.93
$0.00
(8) $56,911.93
$9,578.05
$4,481.42
(11) $14,059.47
(12) $42,852.46
$5,000.00
$37,852.46
x.0_
x.045
x.12
x.15
(15)
(16)
(17)
(18)
(19)
$0.00
$0.00
$0.00
$5,677.87
$5,677.87
1 . Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3.Closely Held Corporation, Partnership or Sole-Prop.
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Propate Prop.
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administration Costs (Sch H)
10. Debts of Decedent, Mortgage liabilities, & Liens
11. Total Deductions (total lines 9& 10)
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 (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(7)
(9)
(10)
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15. Amnt of Line 14 taxable at the spousal rate,
or transfers under Sec.9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line. 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
$0
$0
$37,852
tt:@m:fm:!IIltl::1@:titt@;i:~~M~.~m~p.M;fiiW&$.ti"N~u.~$.tm&Wp.jii~$.\$if$$.11mp.WANiiMijtQa~&t:M&t6M;::#:III:::ttttttlttlittt\
19. Tax Due
20 n CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
. Decedent's Complete Address:
STREET ADDRESS
113 Cottage Road
Shippensburg
Tax Payments and Credits:
1 Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
STATE ZIP
PA 17257
(1 ) $5,677.87
$4,750.00
$250.00
Total Credits (A+B+C) (2) $5,000.00
rlTY
" InteresUPenalty if applicable
D. Interest
E. Penalty
4
TotallnteresUPentally (D+E)
II Une 2 IS greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
'3
If line 1 + line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(3)
(4)
(5)
(5A)
(58)
$0.00
$677.87
$677.87
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: yes no
a. retain the use or income of the property transferred:
b. retain the right to designate who shall use the property transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary disignation?
-0
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El
El
El
El
El
El
El
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 return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete
DATE ~ ~'L...
DATE
," dates 01 death on or after July 1, 1994 and belor'; January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sutviving spouse is 3% [72P.S. Sec
9116(a)(1.1 )(1)).
I or 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 surviving spouse is 0% [72 P.S. Sec. 9116(a)(1.1)(ii))
fhE" statute does not exempt a transfer to a sUNMng 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 beheficiary
FIll dates of death on or after July 1, 2000.
Thf" tax rate imposed on the net value of transfers from a deseased 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. Sec. 9116(a)(1.2)].
The tax rate Imposed on the net value 01 transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1)
The tax rate imposed on the net value oftranslers to or for the use of the decedenfs siblin9s is 12% [72 P.S. Sec.9116(a)(1.3)). A sibling is defined, under Section 9102, as an
mdlvidual who has at least one parent in common with the decedent, whether by blood or adoption.
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LAST WILL AND TESTAMENT
OF
BEATRICE A. SHIRK
I, BEATRICE A. SHIRK, of 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 all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give and bequeath the swn of$5,000.00 to the Bethel A.M.E.
Church, 131 East Pomfret Street, Carlisle, Pennsylvania.
TIllRD: I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my nephew, CRAIG MAURICE SIllRK. Should my nephew,
CRAIG MAURICE SIllRK.. predecease me or die on or before the thirtieth day following my
death, I give, devise and bequeath the residue of my estate, of every nature and wherever situate,
to his then living issue, per stripes.
FOURTH: 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.
FIFTH: I nominate, constitute and appoint, CRAIG MAURICE SHIRK,
Executor of this my Last Will and Testament. Should CRAIG MAURICE SffiRK, fail to
qualify or cease to act as Executor, I appoint ALTHEA SIDRK, Executrix of this my Last Will
and Testament.
SIXTH: I direct my Executor and his successors shall not be required to
give bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Tes~ent, consisting of one (1) typewritten pages, each identified by my signature, this
....?3 ~ day of June, 1999.
g~ (2.~
Beatrice ~. Shirk
A.
(SEAL)
Signed, sealed, published and declared by the above-named Testatrix, Beatrice A. Shirk,
as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight
and presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
t-l J14 t?
COMMONWEALTH OF PENNSYL VANIA )
: SS.
COUNTY OF CUMBERLAND )
I, Beatrice A. Shirk, Testatrix, 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 and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by Beatrice A. Shirk, the Testatrix,
this ~ ,q day of June, 1999.
NOTARIAL SEAL
SHELLY SEXTON, NOTARY PUBLIC
CARLISLE BORO, CUMBERLAND COUNTY
MY COMMISSION EXPIRES APRIL 26, 2003
Member, Pennsylvania Association of Notaries
(SEAL)
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, RONALD E. JOHNSON and (Z \ c..AAe. ~ tY\ GU'TP P , 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 Testatrix sign and execute the instrument
as her Last Will and Testament; that Beatrice A. Shirk, signed willingly and that she executed it
as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and
sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the
Testatrix was at 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 RON.ALD E.
and \?A~ (Y\G{~ ,. esses, this ~rc1 A: f
(SEAL)
NOTARIAL S~~.L
SHEUY SEXTON, H(; ,riRY PUBLIC
CARLISLE BORO, C!f~A!3ERLAND COUNTY
MY COMMISSION WIRES APRil 26, 2003
Member, Pennsylr~ciation of Notaries
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Beatrice A. Shirk
2 1-0 1-1 0 1 0
(All property jointly-owned with Right of Survivorship must he disclosed on Schedule F)
ITEM DESCRIPTION
NUMBER
VALUE AT DATE
OF DEATH
Checking acct no: 43697313-Allfirst Bank (See letter attached)
$5()(}.81
2
Money market acct no: 980422718-Allfirst Bank (See letter attached)
$18,460.76
:1
Certificate of Deposit no: 8-000-000-1798720-Allfirst Bank (See letter attached)
$22,413.74
4
1999 Oldsmobile automobile - proceeds from sale
$13,000.00
5
Pennsylvania State Employees Retirement System-pension payment
$917.61
()
Pennsylvania State Employees Retirement System-pension payment
$917.61
7
People's Benefit Life Insurance Company-hospital insurance payment
$150.00
8
Cottages of Shippensburg-security deposit refund
$49.40
l)
Penn National Insurance Company-automoblie insurance refund
$88.00
10
Internal Revenue Service Center-income tax refund
$414.00
TOTAL (also on line 5, Recapitulation)
$56,911.93
iii allflrst
Mail Code 126-0101
P.O. Box 1596
Harrisburg, PA 17013
(717) 240-6702
March 26, 2002
Ronald E. Johnson
78 W. Pomfret Street
Carlisle, PA 17013
Dear Mr. Johnson,
Beatrice A. Shirk, deceased October 19, 2001, had three(3) accounts with
Allfirst at the time of her death. Her checking account #43697313, earning
.45% interest, had a balance of $500.81. The money market account #980422718
earning 1.83% interest had a balance of $18460.76. Finally, her certificate
of deposit, earning 5.73% interest, had a balance of $22413.74 on October
19, 2001. All of these accounts were titled "sole ownership". Please do not
hesitate to call me with any questions.
w~J~~s -e
Financial Service Representative
Carlisle Main
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
FILE NUMBER
Beatrice A. Shirk
2 I -0 I - 10 ] 0
(All property jointlv-owned with Right of Survivorship must he disclosed on Schedule F)
c.
. .
ITEM DESCRIPTION AMOUNT
NUMBER
Funcral EXllcnscs:
I Ronan Funeral Home-funeral expense $3,860. III
2 Cumberland Valley Memorial Gardens-monument restoration $350.00
Administrative Costs: -
I Personal Representive Commissions
Social Security Number of Personal Representative:
2 Attorney fees to Andrews & Johnson $2,800.00
3 Family Exemption
Claimant Relationship:
Address of Claimant at decedent's death:
Street:
City: State & Zip
4 Probate Fees to Register of Wills $83.00
Additional Probate fees to Register of Wills $55.00
Miscellaneous Expenses:
I Sprint-final telephone bill $1.04
2 Penn National Insurance Co-auto insurance premium $107.00
~ Pharmerica-prescription bill $19.70
.,
4 GM Repair Protection Plan-transfer of warranty on sale of automobile $55.00
5 Pennsylvania State Employees Retirement System - reimbursement
for overpayment of pension $1,402.21
(, Patricia A. Rosendale, CPA-preparation of income tax returns $80.00
7 Register of Wills-P A Inheritance Tax filing fee $15.00
8 Reserve for accounting fees for filing P A and Federal Fidicuary Income Returns $150.00
') Reserve for closing and accounting fees $600.00
10
II
TOTAL (also on line 9, Recapitulation) $9.578.05
A.
B.
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
Beatrice A Shirk
21-01-1 01 0
ITEM
NUMBER
DESCRIPTION
AMOUNT
Sarah Todd Memorial Home - outstanding nursing home bill
$2,273.86
2
Walmart - outstanding credit card bill
$1,244.75
3
GPU - outstanding electric bill
$14.11)
4
Carlisle Imaging - outstanding medical bill
$35.46
5
West Shore Emergency Medical Services-outstanding ambulance service bill
$832.12
6
Discover Card -account no: 6011 002853506095 - outstanding balance
$21.69
7
Sprint - outstanding telephone bill
$59.35
TOTAL (also on line 10, Recapitulation)
$4,481.42
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM
NUMBER
Beatrice A. Shirk
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
21-01- I 0 1 0
AMOUNT OR SHARE
OF ESTATE
I Craig Maurice Shirk
24 Marilyn Drive, Carlisle, PA 17013 Nephew residue less $5,000
charitable bequest
-
ITEM NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE
NUMBER OF ESTATE
B. Charitable and Governmental Bequests:
] BethaI A.M.E. Church, 131 East Pomfret Street, Carlisle, PA 17013 $5,000
TO TAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $5,000
/?-/R-//
\ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG1 PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
B QI)~NTY
ACN
06-04-2002
SHIRK
10-19-2001
21 01-1010
CUMBERLAND
101
'02
JurJ 1 0
RONALD E JOHNSON ESQ
ANDREWS & JOHNSON .
78 W POMFRET ST ~ .
CARLISLE PA 17013 LWr:i
*'
REY-1547 EX AFP Ul-02)
BEATRICE
A
Allount Rellitted
) CHANGED
(1)
(2)
(3)
(4)
(05)
(6)
(7)
.00
.00
.00
.00
56.911.93
.00
.00
(8)
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 ~
RE-Y=is"4j-ix--AFP--flff=ozr-Noi'Ici--oF-'rNHiiiiTAifci-i'-A)rjrpPRjrisii'-ENT~--ALi-owAifci-(fR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHIRK BEATRICE A FILE NO. 21 01-1010 ACN 101 DATE 06-04-2002
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)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
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
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:
IS. Allount of Line 14 at Spousal rate (IS)
16. Amount 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:
NOTE:
9,578.05
4.481.42
(11)
(12)
(13)
(14)
(9)
(10)
.00 X 00 =
.00 X 045 =
.00 X 12 =
37,852.00 X 15 =
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
56,911.93
14.059 47
42,852.46
5,000.00
37,852.46
(19)=
.00
.00
.00
5,677.87
5,677.87
. "'.. ...... . ".......... . II (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-18 2002 CDOO0771 250.00 4,750.00
04-09-2002 CDOOI045 .00 677.87
TOTAL TAX CREDIT 5,677.87
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.)
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
JOHNSON RONALD E
78 WEST POMFRET STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 201-18-1614
FILE NUMBER: 2101-1010
DECEDENT NAME: SHIRK BEATRICE A
DA TE OF PAYMENT: 04/09/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 10/19/2001
NO. CD 001045
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $677.87
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: CRAIG MAURICE SHIRK
C/O RONALD E JOHNSON ESQUIRE
CHECK# 110
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$677.87
MARY C. LEWIS
REGISTER OF WILLS
,.
()o~
-
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
dlfJd'lnu J4. ~~/yl
/O--l?/Oj
.z~6/" alll/tJ Admin. No.:
Date of Death:
Will 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. Stat~hether administration of the estate is complete:
YesA No 0
2. lfthe answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes _ No ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the person~resentative state an account informally to the parties
in interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report
Date: -rm/C~
ignature
,(};4NdZ, J;~#..l~
Name
7~ AJ '1(fTe1- d.
col'lL p;f- J7~1.!
Address
,7C{~ -ot2:-?
Telephone No.
Capacity: Q~ersanal Representative
~aunsel far personal representative