HomeMy WebLinkAbout01-1117
PETITION FOR PROBATE and GRANT OF LETTERS
;tl-Ol -111 '1
No.
To:
Register of Wills for the
. Deceased. County of Cumberland in the
Social Security No. 195-07-2558 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or
in the last will of the above decedent, dated March 11
and codicil(s) dated
Estate of Beatrice K. Faust
also known as
named
, 19~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in r.llrnb~rl rlnd . County, Pennsylvania, with
her last family or principal residence at 4833 E. Trlndle Road, #563
Hampden Township, Mechanicsburq, PA 17055
(list street, number and muncipality)
Decendent, then 83
at Camp Hill, PA
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;
years of age, died
I>ecember 2
.~
2001
, .
$137,000.00
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters 'T'p!=:trlrnpntrlry
(testamentary; administration c.I.a.; administration d.b.n.c.t.a.)
theron.
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Stephen E. Faust
1158 Kings Row
Waterloo, NY 13165
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA "I ~~
?- S~
COUNTY OF CUMBERLAND J
The petitioner(s) above-named swear(~) 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 a uly minister es rding to law.
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Sworn to ~r.. affi'med and subscr;bed ~,'"
before me thiS 7th day ot
)~cem~e~ ~. ~
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Mary . Lewis /' Register
/ '7-c:2. (p - /
~o. 21-2001-1117
Estate of Beatrice K. Faust
, Deceased
DECREE OF PROBATE A~D GRA~T OF LETTERS
AND NOW December 10th l~x 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 March 11th, 1996
described therein be admitted to probate and filed of record as the last will of
and Letters
are hereby granted to
Testamentary
Stephen E. Faust
c. Lewis ~~
FEES
235.00
12.00
5.00
6.00
5.00
Andrew C. Sheely, Esquire
$
$
$
$
TOTAL _ $
Filed . ~GE;'!Jl~~:r;-. ~P.1;D:?OO} . . $. .:?f5;3...QQ .
Probate, Letters, Etc. .........
Short Certificates( 4) . . . . . . . . . .
Renunciation . LU . . . . . . . . . . .
x-Pages (2)
JCP
ATTORNEY (Sup. Ct. I.D. No.)
127 S. Market St., P.O.95,
MechanicsburgV)DRESS PA 17055
717-697-7050
PHONE
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Call Attorney Andrew Sheely
21-2001-1117
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LAST WILL AND TESTAMENT
21-2001-1117
OF
BEATRICE K. FAUST
I, BEATRICE K. FAUST, of 46 Center Drive, Camp Hill,
Lower Allen Township, Cumberland County, Pennsylvania, 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 inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
SECOND: I devise and bequeath all the rest, residue
and remainder of my estate of whatever nature and wherever
~ situate, including any property over which I hold power of
.~ appointment and together with any insurance policies thereon,
unto my husband, CYRIL E. FAUST, provided he survives me by
1./ sixty (60) days.
THIRD: Should my husband, CYRIL E. FAUST, predecease
me or die on or before the sixty-first (61st) day following my
death, I devise and bequeath all the rest, residue and remainder
~ of my estate of whatever nature and wherever situate, including
~ any property over which I hold power of appointment and together
~
\'i with any insurance policies thereon, in equal shares, to my
,
children, BARBARA M. LUCKHARDT, of McMurray, Pennsylvania, and
STEPHEN E. FAUST, of Seneca Falls, New York, provided that should
any of my children predecease me, I give and bequeath such
child's share unto his or her issue per stirpes by
representation, and if there be a failure of same, then I give
and bequeath such deceased child's share to my surviving children
as provided herein.
FOURTH: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
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retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
FIFTH: I nominate and appoint my husband, CYRIL E.
FAUST, Executor of this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said CYRIL E. FAUST, I nominate and
appoint BARBARA M. LUCKHARDT and STEPHEN E. FAUST, Co-Executors
of this, my Last Will and Testament. I direct that my Executor
or Co-Executors, as the case may be, and their successors, shall
not be required to post security or a bond for the performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this lick day of
1
'IJz(Vt-c.4--, 1996 .
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BEATRICE K. FAUST
(SEAL)
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
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Address
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acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(e) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
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21-2001-1117
REGISTER OF WILLS OF r.nM"RF.RT,ANn COUNTY
OATH OF SUBSCRIBING WITNESS
Andrew C. Sheely, Esquire
eodkil
~a subscribing witness to the will presented herewith, fefteht being duly qualified according to
law, depose(s) and say(s) that he wa s present and saw
Beatrice K. Faust
the testat r ix, sign the same and that he signed as a witness at the
request of testat.ri..x- in her presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this 10th day of
December 2001
7
Andrew C. Sheely, Esquire ~r~~..........
P.O. Box 95 (Name)
127 S. Market St. Mechanicsburg, PA 17055
(Address)
(Name)
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REGISjIm OF WILLS OF CUMBERLAND COUNTY
aRIH OF NON-SUBSCRIBING WITNESS
Stephen E. Faust
(eaeflt- a subscriber hereto, (.eaefl1 being duly qualified according to law, depose(s) and say(s) that
he is familiar with the signature of Beatrice K. Faust
eetiiett
will
presented herewith and
eeEHetl-
believes the signature on the will is in the handwriting of
testat r ix of (one of the subscribing witnesses to) the
that
he
Beatrice K. Faust
to the best of
his
knowledge and belief.
Stephen E. Faust_J~~
(Name)
Kings Row, Waterloo, NY 13165
Sworn to or affirmed and subscribed before
me this day of
December 2001 1158
757,CXu~~h/~
Mary- . Lewis '
. Reglste
(Address)
(Name)
(Address)
RENUNCIATION
21-2001-1117
In Re Estate of Beatrice K. Faust
deceased.
To the Register of Wills of
Cumberland
County, Pennsylvania.
The undersigned
Barbara M. Luckhardt, dauqhter
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
Testamentary
be issued to
Stephen E. Faust
WITNESS
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hand this
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day of Dpr'pmnpr ,20nl
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(Signature)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
NAME OF DECEDENT:
Beatrice K. Faust
Date of Death:
December 2, 2001
will No.
1117
Estate No. 21-01-01117
To the Register:
I hereby certify that Notice of Beneficial Interest required
by Rule 5.6(a) of the Orphans Court Rules was served or mailed to
the following beneficiaries of the above-captioned Estate on
December 13, 2001.
Barbara M. Luckhardt
Daughter
127 Highland Drive
McMurray, PA 15317
Stephen E. Faust
Son
1158 Kings Row
Waterloo, NY 13165
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except: NONE
Date: December 13, 2001
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Andrew C. Sheely, Esquire
PA ID NO 62469
P.O. Box 95
127 S. Market Street
Mechanicsburg, PA 17055
717-697-7050
Counsel for Personal Representative,
Stephen E. Faust, Executor
Estate of Beatrice K. Faust
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ANDREW C. SHEELY
ATTORNEY AT LAW
Telephone: (717) 697-7050
127 South Market Street
P.O. Box 95
Mechanicsburg, Pennsylvania 17055
Fax: (717) 697-7065
March 1, 2002
Register of wills
Cumberland County Courthouse
Carlisle, PA 17103
RE: The Estate of Beatrice K. Faust
No. 21-01-01117
Date of Death: December 2, 2001
Dear Register of wills:
I represent the Estate of Beatrice K. Faust. Enclosed is a
check made payable to the Register of wills in the amount of
$5,475.00 which constitutes a prepayment on account of
Pennsylvania inheritance taxes in the above-captioned estate.
Your time and consideration in this matter is greatly
appreciated. Please forward a receipt as in the normal course of
payments.
velJZcs~
ANDREW C. SHEELY
ACS/awm
Enclosure
c: Stephen E. Faust, Executor
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Hand Delivered
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INOIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHEELY ANDREW C ESQ
PO BOX 95
MECHANICSBURG, PA 17055
n___n_ fold
ESTATE INFORMATION: SSN: 195-07-2558
FILE NUMBER: 2101-1117
DECEDENT NAME: FAUST BEATRICE K
DATE OF PAYMENT: 03/01/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/02/2001
NO. CD 000907
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5,475.00
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TOTAL AMOUNT PAID:
$5,475.00
REMARKS: STEPHEN FAUST
C/O ANDREW SHEELY ESQUIRE
CHECK# 1071
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
REV-1~OO EX iii.ool
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
Faust, Beatrice K.
DATE OF DEATH (MM-DD-YEAR)
12-02-01
~/
REV-1500
OfFICIAL USE ONLY
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 _ 0 1-1 1 1 7
COUNTY CODE
YEAR
NUMBER
SOCIAL SECURITY NUMBER
195 _07 _2558
DATE OF BIRTH (MM-DD-YEAR)
06-06-18
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)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
o 2. Supplemental Return
o 4a. future Interest Compromise (date ofdealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Atlach copy 01 Trust)
o 10. Spousal Poverty Credit (date of death between 12-31.91 and 1.1-95)
NAME
Andrew C. Sheely, Esq.
FIRM NAMEIIfApP""b1l..ndrew C. Sheely,
TELEPHONE NUMBER 71 7 -697 -7050
o 3. Remainder Return (date 01 death priOl to 12.13.82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to lax under Sec. 9113(A) (Attach Sch 0)
COMPLETE MAILING ADDRESS
Andrew C. Sheely, Esquire
Attorneya Law 127 S. Market Street
P.O. Box 95-
Mechanicsburg, P~ 17055
OFFICIAL USE ONLY
(1)
(2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
40:- 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 Gross Assets (total Lines 1-7)
14. Net Value Subject to Tax (Line 12 minus Line 13)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(4)
(5)
$147,509.41
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[}g 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
(6)
(7)
(8) $147,509.41
(9)
(10)
$14,782.01
2,314.78
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(11)
(12)
(13)
$17,096.79
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SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14) $ 1 30 , 4 1 2 . 62
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at linea! rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
200
x.O_ (15)
x .042- (16) $ 5,868.57
x .12 (17)
x .15 (18)
(19) $ 5,868.57
$130,412.62
Decedent's Complete Address:
STREET ADDRESS
4833 East Trindle Road
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CITY
Mechanicsburg
I STATE
PA
I ZIP
17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments $ 5.475.00
C. Discount 288.15
(1)
$5,868.57
Total Credits (A + B + C ) (2)
5,763.15
3. InteresUPenalty if applicable
D.lnterest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is Ihe TAX DUE. (5)
B. Enter the tolal of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
A. Enter the interest on the tax due.
105.42
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;........................................... . ......................................... .. 0 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 Q9
c. retain a reversionary interest; or........... .............................................................. .................. ...... 0 \!]
d. receive the promise for life of either payments, benefits or care? ............................... ...................... ............... 0 Q9
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
withoul receiving adequate consideration? .................................. ......................................................... ................ 0 IXJ
3. Did decedent own an "in trust for" or payable upon death bank account or security al his or her death? .............. 0 Q9
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................... ......................... ....................................... 0 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.
/3/~s-:. 9W3
Andrew C. Sheely, Esq. DATE 8/19/02
127 S. Market St., P.O. Box 95
Mechanicsburg, PA 17055
-..- -.. .~,. . - . -. . .....- .~_.
For dates of death on or after July 1, 1 994 and before January 1, 1995, Ihe tax rate imposed on the net value of transfers to or for Ihe use o!the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of dealh on or after January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (al (1.1) (E)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to 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)1.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who hes at least one parent in common with the decedent, whether by blood or adoption.
stephen E. Faust, Executor D~E
1158 Kings Row, Waterloo, NY 13165
8/19/02
--~.~--,._----_._--"_..--,..~ -
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEP._ 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(l1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHEELY ANDREW C ESQ
PO BOX 95
MECHANICSBURG, PA 17055
_n_un fold
ESTATE INFORMATION: SSN: 195~O7~2558
FILE NUMBER: 2101-1117
DECEDENT NAME: FAUST BEATRICE K
DATE OF PAYMENT: 03/01/2002
. 00/00/0000
POSTMARK DATE:
COUNTY: CUMBERLAND
DATE OF DEATH: 12/02/2001
NO. CD 000907
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5,475.00
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TOTAL AMOUNT PAID:
REMARKS: STEPHEN FAUST
C/O ANDREW SHEELY ESQUIRE
CHECK# 1071
SEAL
INITIALS: VZ
RECEIVED BY:
TAXPAYER
$5,475.00
MARY C. lEWIS
REGISTER OF WillS
REV.l508EX.(HI7)_~
,.~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
RI'4TRICI' K I'411C;;T
FILE NUMBER
21-01-1117
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Country Meadows Refund Check
$ 1,829.25
2.
Citizens Bank
Account No. 262-109-1319
Date of Death Principal Balance
Accrued Interest
Date of Death Account Balance
$ 5,747.78
$ 0.16
$ 5,747.94
3.
Citizens Bank
Account No. 00355-075856
Date of Death Principal Balance
Accrued Interest
Date of Death Account Balance
$ 7,426.44
$ .30
$ 7,426.74
Beatrice K. Faust died on Sunday, December 2, 2001,
at Country Meadows. Values are listed as
the average ofthe mean between the high and low
on Friday, November 30, 2001 and Monday, December 3,
2001. Values based upon attached correspondence. Cyril E. Faust
died June 2, 2001.
4. Legg Mason
Account No. 363-00878-1-9
Date of Death Value
$ 29,089.50
5. Legg Mason
Account No. 363-00878-1-9
Date of Death Value
. $101,122.59
6. Union Central Direct Access Account
Account No. 72-0057873
$ 1,043.39
7. Personal Property
$ 1,250.00
TOTAL (Also enter on line 5, Recapitulation) 6147,509.41
(If more space is needed, insert additional sheets of the same size)
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.: CITIZENS BANK
Account
Number Account Title
-----~-~---~
._---_._---------------~._-------~--..._-
262-109-1319
Cyril E Faust
Beatrice K Faust
Date Opened: 09/29/1981
Principal Sal Int from Last
as of DOD Posting to DOD
$5,747.78 $0.16
Date Opened: 08/01/1984
302600-033
Cyril E Faust
Beatrice K Faust
Principal Sal Int from Last
as of DOD Posting to DOD
Thursday, December 27, 2001
Account Type: DO
Account Sal YTD Int to
as of DOD DOD
$5,747.94 $18.88
Account Type: LC
Account Sal YTD Int to
as of DOD DOD
00355-075856
Date Opened: 08/02/1999
Account Type: SA
Cyril E Faust Or
Beatrice K Faust
Principal Sal Int from Last
as of DOD Posting to DOD
$7,426.44 $0.30
Account Sal
as of DOD
$7,426.74
YTD Int to
DOD
$255.85
--.....-------------.--- -_.._-_._~~_.__..._----_._-----"_._..-
Page 2 of 2
LEGG
MASON
Legg Mason Wood Walker, Incorporated
274 Senate Avenue, 7th Floor, P.O. Box 8853, Camp Hil" PA 17007.8853
717.737.6500 800.433.8786 Fax: 717.737.0800
Member New YQrK Stock Exchange, Inc/Member SIPC
Andrew C. Sheely, Attorney At Law
127 South Market Street
Mechanicsburg, Pa. 17055
December 11,20021
Re: Estate of Beatrice K. Faust
Date of Death: December 2,2001
Dear Mr. Sheely:
The information you requested on the account of Beatrice K. Faust:
Name on Account - Beatrice K. Faust
Account # 363-07642-19 (Mrs. Faust had only one account at Legg Mason)
Date Opened - August 18, 1999
The Date of Death Values is as follows:
I.) 3,921 Shs. AT & T Cap Corp 8.125%, SRPublic Income NT, Due 12/15/28
(Book Entry)
Value on 11/30/01 - $101,279.43; I u/) /:2~. 51 ,'I'Ve.
Value on 12/03/01 - $100,965.75;
2.) 33,000 Bell Atlantic Penn Inc Debs, Due 12/01/2028,6.00%
Value on 11130/01 - $29,040.00 d q (j?q 50
Value on 12/03/01 - $29,139.00 ) .
The estate account has been established and everything in the retail account has been
transferred to the estate account. We will sell the 2 positions as soon as the estate account
is in good standing. The check will be made out to the Estate of Beatrice K. Faust and
mailed to your office address. If you have any questions please give me a call at 737-
6500.
Sin~erely~ jl '_
(--YlJ.-I-~ j 4dp-1''tJ7/U
~;~avom
Client Service Rep for
G. David Bias & Henry J. Pofi
The Union Central
Life Insurance Company
1876 Waycross Road
PO Box 40888
Cincinnati,OH 45240
(513) 595 2200
---'11
UlllOl1Cenbal
Group Benefits
December 27, 2001
ANDREW C SHEELY
ATTORNEY AT LAW
127 S MARKET ST
POBOX 95
MECHANICSBURGPA 17055
72,0057873
Beatrice Faust
Dear Mr. Sheely,
Please express our sincere sympathy to the members of the family of Beatrice Faust.
Enclosed please find our check for $1,043.39 representing the remaining proceeds, along with
interest earned, that were retained under the Direct Access Account.
If you have any questions, please contact me at 1,800,825,1551, extension 2759.
Best Regards,
(\~&-~c~~
Natalie Wright
Senior Approver
Group Claims Division
Enclosures:
Check for $1,043.39 payable to The Estate of Beatrice Faust.
NW
R"""''':''97'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
BEATRICE K. FAUST
FILE NUMBER
21-01-01117
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
11: MYERS FUNERAL HOME, INC. $8,229.00
2. JAMES GINGRICH MEMORIALS HEADSTONE 925.00
3. BIXLER'S FLOWERS AND GIFTS 157.94
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5) 9"'~91lIH.:r ~ ~:IliTTC!rn. :i"~("lI~QP
Social Security Number(s) I EIN Number of Personal Representative(s) 000-00-0000
1158 KINGS ROW $ .00
Street Address WA'J,'tau..uu NY 131b5
City Slate Zip
. Year(s) Commission Paid:
2. Attorney Fees ANDREW C. SHEELY, ESQUIRE, PER AGREEMENT $ 31125.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City Slate Zip
Relationship of Claimant to Decedent
4. Probate Fees COUNTY REGISTER OF
CUMBERLAND WILLS $ 263.00
LEGAL ADVERTISING: THE PATRIOT-NEWS 85.95
5. Accountanfs Fees CUMBERLAND COUNTY LAW JOURNAL 75.00
BOREMAN & BABB, CPA DECEDENT'S PERSONAL/FEDERAL
6. Tax Return Preparer's Fees INCOME TAX RETURN $ 140.00
M.F. ROCKEY MOVING COMPANY $ 20.00
7. REIMBURSEMENT TO STEPHEN E. FAUST FOR MEALS & LODGIN $ 915.46
REIMBURSEMENT TO BARBARA M. LUCKHARDT FOR MEALS & LO GING $ 311.26
FILING FEES FOR INHERITANCE TAX RETURNS 15.00
MISC. POSTAGE AND MAILINGS 19.38
Reserves to concl.ude administration of Estate, $ 500.00
Accounting Fces, taxc15, prcparation/mail.ing
and CODV charges of necessarv Fiduciarv Returns
TOTAL (Also enter on line 9, Recapitulation) $ $14,782.01
..
(If more space IS needed, Insert add,tlonal sheets of the same s,ze)
Myers Fu:ne.ralllome, Inc.
37 Eiiet Maill Str(lct
IlIlecMnicsllurg, Pa, 17055
B';)yd L ~'y.rs Jr, Supl~rvl~;or
(717) 766.3.,21
A STANDJIRD ()f eXCElU;NGE SINCE 1HO
Tuesday, Oecembl!l '.8, 2001
Mr. Andrew Shee,11
'27 S,)u!h Market :>':,,~et
Mech,micsburg, Pa 17055
Dear Mr Sheely,
Thank you tor seleoli"9 our funeral home 1<> pro\'id" sllrvic'~s fo,' your family during your beroavement.
I hope that you fOU1d our services 10 be of the hig! asf stardElrds, and that the,y met your needs and th0il8
(,fyour family ano "riands. Th,j following Is a surnn',ar!1 oft,e sew.ice, charge:; as previously explained ii.ne
,,,ovided in written form on the, services for:
!!!~;riClit .-u::-a~~
lWlMAflY,m' exl~~!~
TOTAL OF SERVICE REN[tE :IED
LESS: Cr~it. Ilrallle,j
LESS: TOlal Pay",enl.
CURRENT BALANCE
$8,229,00
1,385.00
0,00
$6,864.00
<:redit$ Grinted: $1 360:;,0 Paekag~~ Pri~e Disoount
Inle(E!S': .:It the rat~~ of 1 % per m~nth ( 1 ~ % per annum} will be addec! to balance efter 30 days.
If Ihe,,~ are any qUllI,,1 ons or concerns that remain unnnswe,,3d, please call me,
~>inoerely ,
Iloyd i_. Myers Jr,
cZllal 10. 81 J30
':0d 1>09
'3WOH ll;ld3in" ~3d3^W lc1>>:-99.!.-.!.1.!.
James Gingrich Memorials
InV:Qjc,e:
............'...."..... ....'..""......."..-.....
5243 SIMPSON FERRY ROAD
MECHANICSBURG
Date '"
12/1.2/2001
c6rli#
27638
PA
17050
MS. BEATRICE GAUST
COUNTRY MEADOWS
ROOM 563
4833 TRINDLE ROAD
MECHANICSBURG PA 17050
Item Description
Memorial for: FAUST
Qty.
Price Each
1,800.00
Total
1,800.00
-
-
-
TOTAL
1,800.00
\.;UllllllttIIUi.
- 1,800.00
Memorial installed on: 12/12/2001
Please call us with any questions at (717) 766-5622
Please Send This.s!ub;SQ YQll' paY!Ti~nt'.Can.BeprQP!l'lY.ReCQrdll~. .
900.00
cut along dotted line
27638
Please Send Payment to:
James Gingrich Memorials
Family Name,
FAUST
5243 SIMPSON FERRY ROAD
MECHANICSBURG PA
(717) 766-5622
MS. BEATRICE GAUST
COUNTRY MEADOWS
17050
Balance Due
900.00
Amount Enclosed $ qOD, OD
---- --~,-- ---"--'.- --
Wnte. of bla:tric.i!- ,mu.sr
5/qlhen t. Filu.5t eXecutor
12.7 South ,M(lAkeJn.$tfl'e+
,MIU.ha.rH'cs~ ,r'A 17055
PAY
TO THE
ORDER OF
-~'-I
~II--
"
'II Nine
-I'!
j~
I FOR
94
~12~
313 I
I
I
DATEJanlJ;::lry ?, ?O()? I
James G;n9rirh Mpmorial!'=: 1$ 900.00 I
I
Hundr ed Do 11 ar s - - - -- - -- - -- -- - ----- --- -- -- - -- - -_ _ __ _ __ _ __ _ --DOLLARS iii iE':1:"
@~~ I
Mel~~N.A I
Harrl,b~rg.PA
Headstone
~---......,.-1;;;?
James R. Gingrich Memorials
Ir;)M'O~"~"""
", 'I' ",,' " ~'" ""')1
"'[';',,,',,,,,,,,,;,., ,_",f,',' ,,\'(:':,1,
:"::""",J"",,,,,,,,'A\"""",,""1, """""J""
1";'~:"~[N!2~,~:;:iT>j;~J;L;BK{I'i~i~1:t,':!'",)
Date Cont #
568 N, UNION STREET
MIDDLETOWN PA
5/21/2002
116715
17057
ANDREW SHEELY
P,O, BOX 95
MECHANICSBURG PA 17055
Item
Description
ITEM SUMMARY
Qty.
Price Each
Total
Inscription work for: FAUST, BEATRICE
25,00
25,00
-
-
-
Total
25,00
Lettering was done on: 5/21/2002
',,,:,,,,,~",'.
25:00
Please call us with any questions at (717) 944-3441
cut along dotted line
~8,:::'i:~~~~,:i",~':-; :'":,\,,i,,: ',' :,:;'i:>t': :<~:',:;"'./~~;i,:j":;"'~UJ::"_:"',!i;:r ,:;'j
::,);":!'ii,~dii~:''':'i;:.a..IJIlc.iDUe':E1: 25.00"""1
");:~';;,j;,~d:~Mj((!;!:;;:''::::';:'}::;:/;::J::;:1!J-i~4xi,,, ,. "",,::.:;:',
-----------------------
'.i~1~~~~~,~~lrm~~~:~~~~I!~~~,,:~~~.rJ~i;ml~~~~f~~~~Y~;~:~e~~:~f#,;;. 116715
Please Send Payment to: Family Name: FAUST, BEATRICE
James R. Gingrich Memorials
ANDREW SHEELY
568 N, UNION STREET
MIDDLETOWN PA 17057
Balance Due 25.00
Amount Enclosed fd5,OO
~ ~~,I!~PN.-\
LL""i>bu,~. ~"
No, 1022
DATE
May 23, 2002
6~~~2126
PAY
TOTHE
ORDER OF
JAMES R. GINGRICH MEMORIALS
----.-.J $ 25.00
'T'WPN'T'Y_ FTV'F. nOLLA RS ----------------------------------------------- DO LLARS
FOR
Headstone Lettering
Invoice # 116715
ESTATE OF BEATRICE K_ FAUST
STEPHEN E, FAUST
lfl=,_
-----------------------------~
.
--------.,---~---'----_._-------'''------. -,---
11'0010 2 211' ':0, I ,008 2 "': ODD'" 2 b ~"'O g 2811'
BIXLER'S FLOWERS & GIFTS
829 State Street (Hoover Plaza)
LEMOYNE, PA 17043
(717) 731-0732
DELIVER TO
WIRE ASSOCIATION
[] IN DOUT
FLORIST
CODE NO
ADDRESS
~" ''Z.-
~ ,0
, 1.\.-7
PHONE NO
DELIVERY DATE
P..tk.- ' I~- -
S M T W T F S
A.M. P.M.
CALL TAKEN BY
PHONE NO
o CORSAGE 0 CUT FLOWERS
-"'_____"_____.__.____~m__ __ _ "n _._ _ __ _ ..".__
OCCASION
/,/,S"
CHAeG"OS* hoJ Fit-us, 53>9
'"A''' / I~l< Kln...s D0
WCLfw/o() 131{pS-
CREDIT CARD NO
E
o CASH
o CHARGE
PRODUCT 672
DC.a.D.
o NEW ACCOUNT
~ To Raorder:
800-225-6380 or nebs.com
o PLANT
,
,
:
,
, ,
60 b-o
__~ildV
sb-o
~'6~
ORDERED BY
DATE OF ORDER
PHONE NO.
EXP.DATE
~JL CY&UJ
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and High StreeE
Carlisle, PA 17013
FAUST BEATRICE K
File Number 2001-01117
Remarks SHEELY ANDREW C ESQ
SK
Receipt Date
Receipt Time
Receipt No.
12/10/2001
10:20:42
1027691
------------------------ Distribution Of Receipt ----____________________
Transaction Description
PETITION FOR PROBA
SHORT CERTIFICATE
RENUNCIATION EXECU
EXTRA PAGES
JCP FEE
Payment Amount
235.00
12.00
5.00
6.00
5.00
Check# 2922
Total Received.........
$263.00
$263.00
~
JJ ~\j
,'\
,~ :::1
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Payee Name
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
CLASSIFIED
ADVERTISING
INVOICE
eSlior,:i regarding this invoice call (717j255-8138
~......._.~---=
~t~t-Ndu~
BILLING DATE 101/0"/02 I
To Place your ad Call Classified (717) 255-8121
Tearsheet Aequestcall (717) 255-8417
INVOICE NO.
Ir c '; S 'j Jtd li~
CLASS START DATE
I B Ill/2S/01
STOP DATE
IID1/DBlO?
TIMES
IGI
/ fffj'
,%~
IIi
SIZE
1.30 IN
11$
AD AMOUNT
81.45
BOX CHARGE
4. !\!I~} Q ;,:'.J C", 5 ';t::L '(
A TT'l,'l"y H L'hl
121 $~UTH MA~K~T ST~EET
4fLrl~~lCS~U~G PA 1705S
AFFIDAVIT CHARGE
IHILD PRINT
ATTENTION GETTER
1.50
3.00
DEBIT MEMO
CREDIT MEMO
DISCOUNTS
DESCRIPTION OR TAG LINE
ACCOUNT NAME
jANO,(eW C. SHF~Lyl
leSTATt OF FAUST
ADVANCE PAYMENT
ACCOUNT NO.
I" '''7 ' ~ ,. ". c,
.., .' I l,I. i..J Ad.
~I$
RS.95
TERMS I DUE UPON RECEIPT
I
tsWe. cf frlotrice.IUnust-
, Stephen E. Iilus~ 6ecu.t!lr
I? 7 SOuth .Market ,Street
Mech()(lj~ I p"" 11 055
i ~€J~~ oedhe.. ~ ' NR.kJS
"I. 6(Jhh-~VL-PA.I\'Ll~ (.
U1@Mellon
Mellon Bank,N.A.
HarrJ.burll,PA
FO~S~ tv( -+ilL fSh}f'
II 0000 '18"' 1:0:1 ~ :1008 2 ~I:
98
oO-iJ2126 I
313 .
DAT.1anIi~ I ~/OO? I
I $ 85, Cl5 ,I
O--~d CfrK)<. -DOLLARS lfI"ii1::rl
,
I
!
I
...._______...__ ____~ I
I
000.., 2 b 1,"'0 '128"'
-
CUMBERLAND LAW JOURNAL
2 LIBERTY AVENUE
CARLISLE, P A 17013
JANUARY 4,2002.
Cumberland Law Journal is published every Friday by the Cumband County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
Andrew C. Sheely, ESQUIRE
RE:
Beatrice K. Faust, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
---------------------------------------------------------------------
---------------------------------------------------------------------
Advertisement inserted on following dates:
DECEMBER 21, 28, 2001
JMTUARY 4, 2002
Advertising Cost
$ 75.00
$ 0.00
$ 0.00
$ 75.00
-------------
Proof of Publication
Second Proof Request
Payment received
Total Amount Due
$
0.00
---------
---------
Payment received DECEMBER 18. 2001
by Beckv H. Morgenthal/Executive Director
r~
~~
Boreman & Babb
. .
CERTIFIED PUBLIC ACCOUNTANTS
BILL TO
Cyril & Beatrice Faust
4833 East Trindle Road
Mechanicsburg, P A 17050-3654
DESCRIPTION
200 I FEDERAL INCOME TAX RETURN
Schedule B - Interest and Dividends
P A 40 - PENNSYLVANIA ST ATE RETURN
P A Schedule NB - Interest and Dividends
QTY
710 Bridge Street
New Cumberland, P A 17070
Phone: (717) 774-8129
INVOICE
DATE INVOICE #
I
,
. 3/21/2002 20761
TERMS
Due on receipt
,
i
!
RATE
95.00
10.00
25.00
10.00
AMOUNT
95.00
10.00
25.00
10.00
Total
$140.00
~
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
BEATRICE K. FAUST
21-01-01117
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
2 .
3 .
4 .
5 .
6 .
7 .
8 .
9.
10.
11.
12.
13.
14.
15.
DESCRIPTION
AMOUNT
$ 6.80
$ 67.30
$ 4.95
$ 23.79
$ 14.57
$ 22.20
$ 4.18
$ 14.25
$ 14.42
$ 28.61
$ 25.00
$ 1,643.00
$ 69.71
$ 116.00
$ 260.00
The Patriot News - final bill
AT&T - final bill
The GM Card
Verizon - final bill
Jackson Gastroenterology Ltd.
Siegelbaum, Gunder and Lacey
Quantum Imaging & Therapeutic Associates, Inc.
West Shore Pathology
Associated Cardiologists
Pulmonary and Critical Care Medicine Associates, P.C.
Misc. Checks
Social Security Reclaim (December)
12/27/01 Reclaim of Social Security Payments
Comcast Cable - final bill
US Treasurer - Decedent's 2001 Income Tax
PA Department of Revenue
TOTAL (Also enter on line 10, Recapitulation) $ $ 2 4
,31 .78
(If more space is needed, insen additional sheets of the same Size)
.[lJe patriot-News
f',:) Box 1437
111rl sburg. PA 1 7105
'f)r~'cil drc@mail.patriot-news.com
Account Number I
006135933
I Amount Paid $
Carrier Tip $
",go
811100te
Due Upon Receipt
Newspapers In
Education
Donation
Subscription Notice
Total
Amount
Enclosed
$
$10.8'0
lU11/01
Make check payable to The Patriot-News. If you have any questions regarding
your notice or to pay by phone, call 255-8150 or 1..800.692.7207.
Payment Options
006135933
CYRIL FAUST
4833 E TRINOLE RO
,<lcCHANICSBURG PA
APT 563A
17050
BALA~CE PAST DUE
6.80
oe~JI~~' DDDDDDDDDDDDDDDD I"p"atla; Date
Signature
.---.....-------------------------------------------------------------------------.
~---j~
~ D.t,.ln thlc ",....,+1...." 'ft. u....... .....__.....0 ~
94
60-132126
313
DATEJ-::lVll:::ary 2,
2002
I $6.80
- and 80/XX
DOLLARS m~:.:~
@ Mellon
McllonBank,N.A.
Harrisburg,PA
Final Bill
-'~._--------.._-----_.~.._------------~---~----,,--,._----
I
:M'
-----1--
11'0000 "l1,1I' 1:0 j I. jo08 2 1.1: ODD..' 2 b 1,"'0 "l 2811'
Your A1 &1 Statement
Novenlber 26-Decembec 25, 2001
,BWNCJFM
#091~0145322Q19'
1822AB1Q.280Bl1A28977
IlllllIll.lIlIIIII,lllllIlI,IIIIII'IlLLullll.llll.IUlIII.1
MR CYRIL E FAUST
4833 E TRINDlE RD STE 563
MECHANICS BURG PA 17050-3652
SUlllluary of <-'haq.;('s
Previous balance .... ....................... ................5.99
Payments ................................... ................................................0.00
UNPAID BALANCE DUE UPON RECEIPT .........................$5.99
AT&T One Aatei@ Off-Peak Plan calls. ..............p 3 ..........51.67
Olhar charges and credits.... .......................p 4 ...4.02
Taxes and surcharges .............................. ..........p 4 ....... 5.62
Current charges due Jan 8, 2002.. m............................... $61.31
Total amount due
$67.30
..~-~_.,~~._-...-.-.---'.r-
No. 1005:
I
I
I
I PAY 4 ~
laTHE .. "'} T
ORDER OF' ....,..
,
@ ~~,I~~!\,_".
II."..,I,",,~ I',~
Siify-SOVUl Dollar<; ______
FOR (\.1(; 1 ~ 11$+ m.. ry'7-737-LJ7QJ
11-2./"-01- 12-25.0 I
;:~ I ~
~~~~,.. j ~AlTQt9'002
Customer 10 717 737~4791
Page 1 of 5
Customer Service: 1 800222-0300
Text Phone (TTY): 1 aDO 833-3232
Internet address; www.att.com
DATE :rnnlj[)Jj 31:ZOM -;;;"1
-___----.J $ 67% ,
fll1d 30/,,)( DOLLA$S
1lI=i--
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------.--------------.-----------.--1.-
ESTATE Of BEATRICE K. FAUST
STEPHEN E. FAUST
11'00000511' ':0,.,0082.,:
,
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------------------ ----- ---r
00011I 21;[,1110'1 2811.
-I
Detach and rt.'turn "dth paymcnt
Please write your account number on your check or money
order made payable to AT&T. Do nol send cash. Do nol staple
this portion to your payment. Thank you.
Total amount due
Date due
$67.30
January 8, 2002
Amount enclosed: $ ~ b7~ 30
111111111111111111111111,111111111111111111111111111.111111111
AT&T
PO BOX 8212
AURORA IL 60572-8212
-
AT&T
-
-
MR CYRIL E FAUST
Nov 26-Dec 25, 2001
Customer 10 717 737-4791
D
Moving? Check the box and
print new address on back.
09120145322010010100000006730000000613100000067306
-.-
= CUSIOffillr Center Payment Address
;;;;;;;;;;; 1800 947-1000 The GM Card
'=POBoxB0082 P.O. Box 80119
- Salinas, CA City of Industry, CA
-93912-0082 91716-0119
= Visit us al www.Qmcard com
visit g m ca rd. CO m 10 manage your A~CDunl onUne
11
Accounl Number
Statement Date
New Balance
Payment Requested By
Minimum Payment Due
Amount Past Cll"
uick.L.ook Account Sununa
5437 0002 0$43 0250 Total Credit Limit
12/27/01 Total Cash Advance limit
$495 Available Credit
1/16102 AvalJable Cash AclvanCII
$4.95 # Days This BIlling Cycle
$0.00 Page
$7,000
$7,000
$6,995
$6,995
30
10f 1
004918
01-01
004911/BM
BGAl
Transaction Dale
- 12/03
= 12/04
~ 12/13
= 12/20
Post Date
12105
12/05
12/14
12121
(ansa OdS:
Description
NATIONAl. WHOLESAlE CO 336-2485904
NATIONAL WHOLESALE CO 336-2485904
NATIONAL WHOLESALE CO 336-2485904
NATIONAL WHOLESALE CO 336-2485004
Ne
Ne
Ne
Ne
Amount
$38.95CR
$26,95
$13.47CR
$13,4BCR
Reference Number
MT013390030002OBOOO352 I
MTOl3J900JOOO2oeOOO1015
M TO 1348003200 I 290006764
MT013550033oo165ooo7709
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t?2.5{l
ESTATE OF BEATRICE K, FAUST
STEPHEN E. FAUST
--j
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~-~--------------- --~--------
Average Daily Daily Periodic Nominal Annual !UwIa Cash Advance W.\I.!l.
Balance RallO Perr..,nlanA AalA ~ Fees Perr..,nlan.,Rale
Purchases $0,00 00463% 16.90% $0.00 $0,00 0.00%
Cash Advances $0.00 0.0548% 19.99% $0.00 $0.00 0.00%
-._~-~---------_._- ~.-'-i.----
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Earni Sunm... Ea n . iration
PrevIous Earnings $203.26 New Earnings Tot..1 tJ201--:J2l Expired in December 2001 $0.00
Earnings Receiwd $1,94 ArlniVQrsaryDate 12/07/92 Ellpiring in January 2002 $6.47
Addilional Earnings $0,00 Arlniversary Y-T-D Earnings $134 Ellpinng in February 2002 $0.00
Earnings Adluslmenls $0.00 LifellmeEarnings RlKleemed $0,00 Ellpiring in March 2002 $0.00
Cyrrenl Period Earllln s ~1.94'
Wtum l,I'rfll'ljl.d W (8(feel11
r(jlNl C;8fr;l'Eal1li
10- tI-~ Ilf~e,.e.1I- eli 1"18 new GMurQf truck call us JlI1 800 947-11;100
(please detach and return bottom portion with payment and retain top portion for your records Do not staple or clip your cheCK to the form below.)
TheGMcard'
Mlka CIl.d:. PlYlbl. 10: The GM C:ilrd
Account Number
5437000206430250
PI....u w,,'" your iKCOum number on
yourcllecl<;dcnclundcuh
Plnu UOndyo..r p-"Ymtlm 7 dOly'
proor 10 lh. r.q....llId !>ydl.IO'lU;ur.
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- S..bmnon.cll.Cl<ormon.YOrdlrper
. l~'::r:ul'o~n mar. inklrmlolion
Amount $
Enclosed
1.J.q 5
Minimum Paymenl Dye
$4.95
What are you charging toward? ~M
S00491810Z345608oooo
1111.lllIlIullllllllllllullIllIlIllllIllllllIlIlll
CYRIL E FAUST
BEATRICE K. FAUST
4833 E TRINDLE RD
MECHANICSBURG PA 17055-3652
11111I111I1II11I1111111.IIIIIIJlIIIIIIIIIIIIII'IIIII.11..11I1,1
THE GH CARD
PO BOX 88000
BALTIMORE HD 21288-3000
0000495 0000495 5437000206430250 S
{/~2/02- No Oc(OUi7 -t h/();)(C!-
- Jiz.ulxrL
, " .
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veri70q
Page 1 of 12
717 737-4791-391 73Y
Please make Davment to V,arizon December 1, 2001
and return this e9ge with y~p-ayment
--
-
-
-
Due Date December 31, 2001
-
...........
$23.79
-
Fill in Amount Paid
MR CYRIL E FAUST
APT 563
4833 TRINDLE RD
MCHNCSBRG PA 17050-3652
1",111",1/1""1,1,11"",11"11,,,1,1,,,1,1/,1,,1,1",,11,1
$ W5J.[2]~
PO Box 28000
Lehigh Vly PA 18002-8000
10971707374791391202802159000006000000000000000002379600000
R21 028
@ Mellon
;\l"Il'lJ.lJ~JL..N A
PAY V~'~''''l'A
TOTHE /'Yon
;;;;;;fj~:;: 1
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FOR
No. 10 08
-
DATE JiiJll1f1~ 31, 2n'l( c~;;'I"
I $ 0l3'%x _
-- and 19/X,>< {)OLLAR~
m~"""""!
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Cynl Hl.JlsJ 7/1- 737- 47Q,
ESTATE OF BEATRICE K, FAUST
STEPHEN E. FAUST
- ---~ - ---- - ---- - - - -- -- --- --- -- - ----
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--_________u___!
11'001000811'1:0:\10 :\0082101: ODD... 21;1,"'0,,/2811'
------.------------------..----___.________.____._____________ M>;
-
STATEMENT
..J(:jCJ<.~:)UH U(I~::;'i'I;':OEHTEh:DL.UG\' L'rD
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Statement Date
U,c;,/U';}/(i),;'.:
Account Number
1 L~ :1. ":'(J' .I.
Account 10
1-'ll'J')i,-,,~
BILL TO:
Page Number
uf
F('IU~:::'I (:::/U ';;;j-jCi:::L.--( (IT"j' r'
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INDICATE ,J c-,
AMOUNT PAID $ L~7--,_--
NOTE: Payments made alter statement date will appear on your
next statement.
Dale Reference Descnp1l0n Amount Charged Payments Adjustmenls !nsuran~e Pending Your Balance
------------------------------------------------------~----------~-----------~-------~--------~~----------------------------
PLEASE RETURN THE TOP PORTION WITH YOUR REMITTANCE
:1.1/ ::;(,),/U1
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No. 1016
PAY
6~~~~ OF JACKSON GASTROENTEROLOGY LTD
DATE Apri1 11, 2002 O~~~21:!iJ
-----l $ 14.57
FOURTEEN DOLLARS ------------------------------------------AND 57/XX
DOLLARS
FOR BEATRICE K. FAUST
ESTATE OF BEATRICE K, FAUST
STEPHEN E. FAUST
m----
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1::.(-I-'(i"I::~I.I.1 I.;::: 1:::XPi:::C"j'CD..
PLEASE PAY
THIS AMOUNT
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JACK~~(J~I GA~::;I.RUE~Nl-ER()L(JGy L.t.])
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Siegelbaum, Gunder and Lacey Gastroenterology
The Rose Garden Building, Suite 3A
2626 North Third Street
Harrisburg, PA 17110-2034
717238-3111
1\l;<;0\l111 11I0",
~ \lDID,~',"
dteven P. Siegelbaum, M.D. F.A.C.G.
Scott A. Gunder, M.D.
Paul G. Lacey, M.D.
fall s b e--0 III
2 :;~ . :' ~1
Daatt'ice K FaUbt
4833 E Trindle Rd 563
01/~'~B/02
Amq\lIlU""lp"<l
$ A,;t , ;;LO
MecharlicsburgpPA 17055
Please remove and return this portion with your payment
Date
Ell
Procedure Code
Description
12/~)1/~) pg1.
99232
Sub Hospital Cat'S
shott call
Plan payment:04342
Adj,Medicare Write
2S
532.70
160.0{j
12/21/ib
12/21/0'
na.80..""
49.00..
@ ~~,I~~rN.A
IlJnisb'ug,I'A
No, 1019
DATE APRIL II, 2002
60-0::126
313
PAY
TO THE SIffiELBAUM, GUNDER AND LACEY GASTROENTEROLOGY $ 22 20
OO~R~ I .
, 20
iTWENTY-TWO DOLLARS--------------------------------_____________AND /X~OLLARS
. FOR BEATRICE K. FAUST ESTATE OF BEATRICE K, FAUST lfHi!ii,:::.
STEPHEN E. FAUST
ACCOUNT # fausbe-OO
M'
-._-------------- ..--------------.--------...--.-----------------..---
M'
11'00 ~O ~ 911' 1:0:l ~ :l008 2 ~I: 0001112 b 1,"'0 92811'
YO R OUTSTANDING BALANCE WITH THIS OFFI E IS NOW
FM . rout:, P,L,t.. ,,', ' I,', f',WMt:MT I FULL OR
CO '.' , , ' .,J,,",
'!.llef lid!; OfFICe I U iiii:",,~ SAliSFACTOR PAYMENT
AR GEMENTS.
Accoun( AnaJysis
To,,1
0.00
22 . 211~
Current
0.00
0. ,HJ
22.20
Patient Name: De a -t t~ .i. c e K Fa u s t
Insurance Balance
Patient Balance
~o .60
0.00
22.20
0.00
0.00
0.00
II!. ,J0
0.00
0.0'1!
PATIENT t
BALANCE
AMOUNT DUE
Account Balance
22.20 Balance past due, plea.. pay promptly I
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!;:~':;; 1 f~ ,., I Hi,,::n,"':~'E:UT:I: C ':.\E,S-iDe I/,TES_, IN\:;
r~"':. i X:'.JC [{FFICE 1~7::3 FDF:: ~:;EH\ilCES r{ENDEF~ED
(=RAI'~BE0RY HIGliWAV MXI MDBII_E (90 HSH)
l,.J/',i~::r:;-L:)i"i., I'),:::, o:.:::~) '} 1 -- ~'/OOQ 5 i :20 L,c';NCAEnEH E:TREET
b'~~'iJ ::!'}Cj 'f} ~rOFi ;-;!95 5:~,56 1.-lAF:F<ISBUnG P,6, 1711~:2
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PLEASE KEEP THIS PORTION FOR YOUR RECORDS.
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PA YMENTS RECEIVED AFTER BILLING DATE
WILL NOT APPEAR ON THIS STA TEMENT-
PATIENT BE~\TI~ 1 cr: rT)U~~-f
ACCOUNT NUMBER BILLING DATE BALANCE NOW DUE
1b891 ,c,C"13 02/04/0;;': 4. 18
1;;:U26!Ol
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*IF YOU ,c,r-:::: UNABLE rt.: 1",.-',,.. ti\i ""ULL. PLEA;'3E SEi\lD ;~ F',t:;RTIAL
P A Yi"lENT. '( -jf;Nh 'r' OU
AGED BALANCE
CURRENT OVER 30 DAYS OVER 60 DAYS
4.18
*;~PRIMARY
r-lEDICARE PAHT B
ID#: 16209873;;;:0
GRP:
i'-IC!NC:
1>1,/5
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02/04/02
@l Mellon
",LL.", U.u,-_ ~_A
H-I''''""'~, PA
No. 1020
PAY
~~~~~ OF OUAtm:N IMAGTlE & THRR1i.P1<UPTC A~c:n"'TATF.R. INC.
DATE APRIL 11, 2002
~'26
]13
FOUR IXlLIARS
----.-J $ 4.18
AND 18/XX
DOLLARS
FOR
BEATRICE K. FAUST
ESTATE OF BEATRICE K FAUST
STEPHEN E. FAUST
Q-.,..-
W=.....
ACCOUNT * 16891 A93
E-----------------
"'00 W 20'" ':0313008211: 000'" 2b~"'0'l28'"
--_.._-~~ ~----____J
-----------.-----.,-----..---.--------------.
-~
----_.._'-----._-----~---- ------------------------."
-----!<!
-
WEST SHORE PATHOLOGY
PO BOX 750
SCRANTON PA 18501
PATIENT NAME
, , ,
Return Service Requested
BEATRICE K FAUST
ACCOUNT NUMBER
STATEMENT CATE
Place of Service: HOLY SPIRIT HOSP IP
PHL4'26'17947136
26*17947136
ME>>5710DQC3NDODH~2.007a28
BEATRICE K FAUST
127 S MARKET ST
MECHANICSBURG PA 17055-6328
14.25
02/08/2002
$ f;O~~ATO J
AMOUNT DUE
1,.,111.,.111.,1,1.1,.1.1,.11.,1111,.,1,11..1,111.11.,.1.1,,11
WEST SHORE PATHOLOGY
PO BOX 750
SCRANTON PA 18501
- -
-
PLEASE DETACH AND RETURN TOP PORTION WITH PAYMENT
Date
Doctor
Code
88312
88305
1199
1100
Description
SPECIAL STAINS GROUP I
SURG PATH SINGLE COMP
MEDICARE CONTRACTUAL ADJUSTMENT
MEDICARE PAYMENT
Page 1 of
Amount
40.00
130.00
-98.77
-56.98
11/30/2001 ANJALI G BHATT,MD
11/30/2001 ANJALI G BHA TT,MD
12/26/2001
12/26/2001
@ Mellon
:'kl1"Hl:Itin~,N,A
,lJll i,b~llg, PA
No. 1 021
PAY _'
~~6~~OF WEST SHORE PATHOLOGY J $14,25
iFOURTEEN DOLLARS-------------------------___________________AND 25/XX
DOLLARS
DATE APRIL 11. 2002
60-~2126
:113
FOR BEATRICE K. FAUST
ACCOUNT #26*17947136
ESTATE OF BEATRICE K, FAUST
STEPHEN E. FAUST
",.-,.-...
I.!J~=""",,
...
-, --- ._----------_._.__._-._--------~---,--_._--
M'
11'00 l.D 2 ~II' 1:0 3 ~ 3008 2 ~I: 00011, 2 b ...."0 "l 2811'
ACCOUNT NUMBER
01111111:1 YUC;:)lIUII;:)f \..tdll. OUVJ'~O-";'U-Ict
DATE OF STATEMENT
26*17947136
02/08/2002
PAYMENTS AFTER THIS
DATE WILL APPEAR ON
YOUR NEXT STATEMENT
BALANCE
AMOUNT DUE
PATIENT NAME
14.25
BEATRICE K FAUST
INSURANCE PAID THEIR PORTION ON THIS ACCOUNT. YOU ARE
RESPONSIBLE FOR THE BALANCE. PLEASE MAIL PAYMENT IN FULL
TODAY.
BILLING HOURS ARE 10AM TO 4PM
Place of Service: HOLY SPIRIT HOSP IP
Referring Doctor: WILSON JACKSON
Diagnosis: 535.10
MAKE CHECKS PAYABLE TO:
WEST SHORE PATHOLOGY
PO BOX 750
SCRANTON PA 18501
800/238-3614
SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION
Pulmonary and Critical Care Medicine Associates, P.C.
1631 N. FRONT STREET
HARRISBURG, PA 17102
PHONE: (717) 234-2561
SEND PAYMENT TO,
ROBERT C. GILROY, M.D.
WILLIAM M. ANDERSON, III, M.D.
FRANKLIN J. MYERS, III, M.D.
RICHARD G. EVANS, D.O.
TIMOTHY A. CLARK, M.D.
PULMONARY AND CRITICAL CJ
MEDICINE ASSOCIATES, P.C
1631 N. FRONT STREET
HARRISBURG, PA 17102
PHONE: (717) 234-2561
STATEMENT DATE
STATEMENT DATE
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DATE DESCRIPTION CHARGE CREDIT
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DETACH THIS STUB ANI
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ASSOCIATED CARDIOLOGISTS
856 CENTURY DRIVE
'MECHANICSBURG, PA 17055
IF PAYING BY VISA OA MASTERCARD, FILL OUT BELOW
DVISA l y~J [" 1 MASTERCARD [:;J]
CARONUMBEA ~,
6KlNAlUAE EXP.OATE
STAnMENrDATE . PAY'rHIS :MlOUtlT ; ; ... ACCQUtlTtlll
05/03/02 $ 14.42 fausbe-02
CHARGES AND CREDITS MADE AfTER STATEMENT I SHOW AMOUNT $
DATE WILL APPEAR ON NEXT STATEMENT. PAID HERE
For Billing Questions Call: (717) 591-7122
For Toll FreeCall: 1-800-845~1742
Patient Name: Beatrice K Faust
Beatrice K Faust
4833 E. Trindle Road
Mechanicsburg,PA 17055
1..,111,..111".,1.1"1.1,1,,1.,1..111,,,.1,1..1,1.,11.,,1,,11
ASSOCIATED CARDIOLOGISTS
85b CENTURY DRIVE
MECHANICSBURG, PA 17055
o Please check box if above address is incorrect or insurance
information haschanged,andmdlcatechange(sj on reverse side
STATEMENT
PLEASE DETACH AND RETURN TOP PORTION WITH
YOUR PAYMENT IN ENCLOSED ENVELOPE
Dale Proeeduro Description Diagnosis Charge Crodil 8alanel
Code
.~
PREVIOUS EALANCE--> 14.
.
,
I
I
I
I
I
,
Total Current 31-60 Days 61-90 Days 91.120 Days Over 120 Days I Amount Due: I $ 14.42
Insurance Balance $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
ASSOCIATED CARDIOLOGISTS
Patient8a'anee $ 14.42 $ 0.00 $ 0.00 $ 0.00 $ 14.42 $ 0.00 856 CENTURY DRIVE
1---- MECHANICSBURG, PA 17055
Account Balance $ 14.42
1,.. BruceAlthouli8, M.O" FAce (1941-19aS)
Donald C. Durbeck, M.D., FACe
Jeffrey S. Fugate, 0.0" FACe
StU8l1 B. Pink, M.D., FACC, FSC!\I
KennethJ. May, Jr, M.D., FACe
RobertA. Skotnlck{. 0.0" FACC
David 1,.. Scher, M.D., FACF, FACe
JoyC..L.CottoniM,O., FAce
Ira Sackman, M.D.. FACe
Robert D. Aronoff, M.D., FACe
David C. Man, M.O" FACe
Edward C. Brennan, D.O., FACe
Andreas'U. Wall, M.D., FACe
Michael D. Bosak, M.D.. FACe
Lenke Erkl, M.D.
StephenS. Sloan. M.D.
Tracey Wuestkamp Sloan, MSN/CRNP
RajeshM. Dave, M.D.
All billing questions can be made between
the hours of 8;30 AM and 4:00 PM.
For Billing Questions Call: (717) 591.7122
For Tell Free Call: 1-800-845.1742
Patient Name: Beatrice K Faust
557
STATEMENT
SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION
-
@ Mellon
~Jdkt"UUl1k,;'L.\
II . ILmL,bu'g.I'A
No. 1013
~~~~~OF (It Yeflr b ~ ~ e>t(.,,,,-
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Bet/Iv,,, <- !t. h-.vJ I _________
DATE AI"'"! I t..Do2- b~;:"26
f
~ $ ;1.c:,O( 00
C/O/f)
,6:'Q_- DOLLARS
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-. _____ ..______ ____nu'________.________ ..___ l'oP
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No. 1012
Ibrri,l111lg. ~A
DATE Iltrl 7 ~ 2o(J7.-
60-d2126
313
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Cha.- t'~'1dred $( 'KJ4!/\ CM.d .::.---c
FOR l(p~ - Of! - ff7:J~!I'iJ~tJ7- Z-5~'i?____
2.00 I FOrm 'IO'jO _____
I $ IIb,Otl
00/
~fliL.__DOLLARS
ESTATE OF BEATRICE K. FAUST _
STE;PHEN. E. FAUST
m =roo'::."t
~
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,"00000 ~ ~ 1;00,"
11'00 ~o ~ 211' 1:0:1 ~ :1008 2 ~I: ODD'" 2 I; 1,"'0 "/2811'
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No. 1007
-5
DATE ,1o.nWUj 31, ZOoz- 6~;:2'26
'$M%
------ _ Ofl(i '7)1".,lC DOLLARS
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----- ~~~==~L~~-..
OS- OZ,l7t;7 t,81J i__________________,_________._ -------.. I
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II.m "bu I ,~, P'I.
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REV-1513EX~11-97)_~
,.,.~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BEATRICE K. FAUST
SCHEDULE J
BENEFICIARIES
FILE NUMBERz 1 _ 0 1 - III 7
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nol Lisl Truslee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. BARBARA M. LUCKHARDT DAUGHTER 50 % of
127 Highland Drive Rest, residue
McMurray, P A 15317 & remainder of
estate
STEPHEN E. FAUST SON 50% of
1158 Kings Row Rest, residue
Waterloo, New York 13165 & remainder of
estate
.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON liNES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTiONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DiSTRiBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON liNE 13 OF REV 1500 COVER SHEET $
(If more space is needed, Insert additional sheets of the same size)
".
till' . "
LAST WILL AND TESTAMENT
OF
BEATRICE K. FAUST
I, BEATRICE K. FAUST, of 46 Center Drive, Camp Hill,
Lower Allen Township, Cumberland County, Pennsylvania, 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 inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
SECOND: I devise and bequeath all the rest, residue
and remainder of my estate of whatever nature and wherever
~ situate, including any property over which I hold power of
~ appointment and together with any insurance policies thereon,
~ unto my husband, CYRIL E. FAUST, provided he survives me by
1 sixty (60) days.
:'-\ . THIRD: Should my husband, CYRIL E. FAUST, predecease
me or die on or before the sixty-first (6Ist) day following my
death, I devise and bequeath all the rest, residue and remainder
- ,
~
~
of my estate of whatever nature and wherever situate, including
any property over which I hold power of appointment and together
with any insurance policies thereon, in equal shares, to my
children, BARBARA M. LUCKHARDT, of McMurray, Pennsylvania, and
STEPHEN E. FAUST, of Seneca Falls, New York, provided that should
any of my children predecease me, I give and bequeath such
child's share unto his or her issue per stirpes by
representation, and if there be a failure of same, then I give
and bequeath such deceased child's share to my surviving children
as provided herein.
FOURTH: In addition
to all powers granted
this Will, I give the
to them by
law and by other provisions of
fiduciaries
#... . .
~
\'\
v
~
acting hereunder the following powers,
ty, exercisable without court approval
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed prOpeL". This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, SUbdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(e) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance pOlicies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
applicable to
and effective
all proper-
until actual
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(1) To select a mode of payment under any qualified
2
......
..,
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
FIFTH: I nominate and appoint my husband, CYRIL E.
FAUST, Executor of this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said CYRIL E. FAUST, I nominate and
appoint BARBARA M. LUCKHARDT and STEPHEN E. FAUST, Co-Executors
of this, my Last Will and Testament. I direct that my Executor
or Co-Executors, as the case may be, and their successors, shall
not be required to post security or a bond for the performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last will and Testament, this Ilc~ day of
'~7"itl~/'; , 1996.
jt. .VL-41,....-'
),L gl/ L
~tUCL_ ' \-/Juld
BEATRICE K. FAUST
(SEAL)
signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
#kJc. ~
/[., '. /) ~/')
( ;17J1;~,~ HZ 'I- i"_.Jd/,71tP1
:/
Address
Address
3
---
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
SHEELY ANDREW C ESQ
PO BOX 95
MECHANICSBURG, PA 17055
____un fold
ESTATE INFORMATION: SSN: 195-07-2558
FILE NUMBER: 2101-1117
DECEDENT NAME: FAUST BEATRICE K
DATE OF PAYMENT: 08/27/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/02/2001
NO. CD 001568
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $105.42
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$105.42
REMARKS: ANDREW SHEELY ESQUIRE
CHECK# 3206
SEAL
INITIALS: AC
RECEIVED BY:
TAXPAYER
MARY C. LEWIS
REGISTER OF WILLS
1?-c2b- /
'" BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIDN
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
-11
~ ~
DATE
ESTATE OF
DATE OF DEATH
,F1ILE NUMBER
COUNTY
ACN
10-07-2002
FAUST
12-12-2001
21 01-1117
CUMBERLAND
101
ANDREW C SHEELY
127 S MARKET ST
PO BOX 95
MECHANICSBURG
ESQ ATTY
*
REY-1547 EX AFP IDl-02l
BEATRICE
K
Amount Remitted
PA 1705's'
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 ~
rfEV = iS47-E3CAFP--foY=o'2Y-Ncii'-icE--oF-YNHEiiiTANcE-i"-A'jrAPPRAisEMENT-,--AiD5'WAifcE-oi-------------- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FAUST BEATRICE K FILE NO. 21 01-1117 ACN 101 DATE 10-07-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
130,412.62 X 045 = 5,868.57
.00 X 12 = .00
.00 X 15 = .00
1I9)= 5,868.57
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
1I)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
147,509.41
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
1I0)
14,782.01
2,314.78
(11)
1I2)
1I3)
1I4)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
147,509.41
17 .096 79
130,412.62
.00
130,412.62
,,~-~_. . l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-01-2002 CDOO0907 288 . 16 5,475.00
08-27-2002 CDOO1568 .00 105.42
TOTAL TAX CREDIT 5,868.58
BALANCE OF TAX DUE .0ICR
INTEREST AND PEN. .00
TOTAL DUE .0ICR
. 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.)
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:
To fulfill the requirements of Section Zl40 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S.
Section 9140).
PAYMENT:
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
REFUND (CR):
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-1313). 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: 1-800-36Z-Z050; services for taxpayers with special hearing and I or
speaking needs: 1-800-447-30Z0 (TT only).
OBJECTIONS:
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. Z810Z1, Harrisburg, PA 171Z8-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: 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. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT:
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.
PENALTY:
The 15Z 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:
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 ZOOZ are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198Z ZOZ .000548 199Z 9Z .000Z47
1983 16Z .000438 1993-1994 n .00019Z
1984 llZ .000301 1995-1998 9Z .000Z47
1985 13Z .000356 1999 n .00019Z
1986 10Z .000Z74 ZOOO 8Z .000Z19
1987 9Z .000Z47 ZOOI 9Z .000Z47
1988-1991 llZ .000301 ZOOZ 6Z .000164
--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 (15) 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.
(t ) l
L/-)D
c
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Beatrice K. Faust
Date of Death:
December 1, 2001
Will No.:
21-01-01117
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 IX] 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 final account with the Court?
Yes No ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes I!l No 0
Date:
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".. .~..../
November 26, 2003 il~c~
~gnature
Andrew C. Sheely, Esquire
Name
127 S. Market Street
P.O. Box 95
Mechanicsburg, PA 17055
Address
(717) 697-7050
Telephone No.
Capacity: 0 Personal Representative
Q9 Counsel for personal representative