HomeMy WebLinkAbout09-26-05
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JAN L: BROWN. ESQUIRE.
JACQUELINE A. KELLY. ESQUIRE
* ADMITTED IN PA AND DISTRICT OF COLUMBIA
JAN L. BROWN & ASSOCIATES
ATTORNEYS AND COUNSELORS AT LAW
OLOE ENGLISH GAP
845 SIR THOMAS COURT
SUITE 12
HARRISBURG, PA 17109
EMAIL: jlbassoc@verizon.net
TELEPHONE (717) 541-5550
FACSIMILE (717) 541-9223
BRENDA F. KEPHART. LEGAL AsslsTANT
PAULA K. WHITE. LEGALASSISTA/'IT
JUDITH A. EBERSOLE. ADMINIST~ATIVE ASSISTANT
September 23,2005
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013
Re: Estate of Shirley A. Fry
Estate No. 2005-00344
Executrix: Judy A. Fry
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To Whom It May Concern:
Enclosed for filing are an original and two copies of the Inheritance Tax Return and tm
original and one copy of the Inventory for the Estate of Shirley A. Fry. A check in the amo~nt of
$3,092.53 made payable to the Register of Wills, Agent, for payment of Pennsylvania
Inheritance Tax due, and a check in the amount of$30.00 made payable to the Register of Wills
for the filing fee have also been enclosed.
Please return a time-stamped copy of each document in the envelope provided. Als~,
Please forward the receipt of payment to my office.
Sincerely,
Jacqueline A. KellY,;: ~
Enclosures
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11
COMMONWEALTH OF PENNSYLVANIA REV-116~ EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA ,
[
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT CD 005842
NO.
KELL Y JACQUELINE A
845 SIR THOMAS COURT SUITE 12
HARRISBURG, PA 17109
ACN
ASSESSMENT AMOuNT
CONTROL
NUMBER
-------- fold ---------- --------
101 I $3,092~53
ESTATE INFORMATION: SSN: 184-26-5479 I
FILE NUMBER: 2105-0344 I
DECEDENT NAME: FRY SHIRLEY A I
DA TE OF PAYMENT: 09/26/2005 I
,
POSTMARK DATE: 09/23/2005 I
COUNTY: CUMBERLAND I
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DATE OF DEATH: 03/24/2005 I
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TOTAL AMOUNT PAID: $3,092)53
REMARKS:
CHECK# 1678
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAWGH
I
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX . (6-00)
'*
I
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)
DATE OF BIRTH (MM-DD-Year)
11
OFFICIAL USE ~NL V
FILE NUMBER
2 1 -0 5 0 3 4 4
____---1____
COUNTY CODe YEAR NUMBER
SOCIAL SECURITY NUMBER
1 8 4 - 2 6 - 5! 4 7 g
THIS RETURN MUST BE FILED Iii ,DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
D 3. Remainder Retum (Oate 01 death priorto 12-13-82)
D 5. Federal Estate Tax ~tum Required
_ 8. Total Number of Saf~ Deposit Boxes
D 11. Election to tax undet Sec. 9113(A) (Attach Soh 0)
03/24/2005 09/16/1935
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[Xl 1. Original Retum
o 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
D 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (AttachcopyolTrust)
D 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95)
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148,900.00 ·
5,633.02
PA 17109
OFFld~.L USE O/'-.JL y
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184,238.43
115,515.64
68,722.79
68,722.79
0.00
3,092.53
3,092.53
NAME
Jac ueline A. Kell
FIRM NAME (If Applicable)
Jan L. Brown & Associates
TELEPHONE NUMBER
717 -541-5550
COMPLETE MAILING ADDRESS
845 Sir Thomas Court
Suite 12
Harrisbur
(1)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
X _(15)
68,722.79 X .045 (16)
X .12 (17)
X .15 (18)
(19)
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
19. Tax Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
-,
0.00
15.753.88
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0.00 I
13.951.531__
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(8)
52,879.19
62,636.45
(11)
(12)
(13)
(14)
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ece en s omDI ete dress:
STREET ADDRESS
1 Sherwood Drive
CITY I STATE I ZIP .
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
3,092.53
Total Credits (A + 8 + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/Penalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
3,092.53
3,092.53
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes 1110
a. retain the use or income of the property transferred; ........................................................................... 0 IEl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IEl
c. retain a reversionary interest; or ...................................................................................................... 0 lEI
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IEl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............... .................... ......... .................................................. 00 []
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 l&J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 00 CJ
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 penallies of pe~ury, I declare that I have examined this return, includinQ accompanying schedules and statements, and to the best or my knowledge and belief, it is true, correct and complete. :
Declaration of preparer other than the personal representative is based on all mformation of which preparer has any knowledge.
PA 17055
DATE
PA 17109
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)l.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. $9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are slill 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 oftransfers to orfor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [~2 P.S. ~9116(a}(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 has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
'*
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Fry. Shirley A. 21 05 03441
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property woull:l be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real ro e which is 'ointl -owned with ri ht of survivors hi must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Real property located at 1 Sherwood Drive, Mechanicsburg, PA 17055.
See attached settlement sheet.
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11
ilVALUE AT DATE
OF DEATH
148,900.00
148900.00
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REV-1503 EX + (6-98) ,
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
n
ESTATE OF
Fry. Shirley A.
ITEM
NUMBER
1.
FILE NUMBER
21 05
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
Putnam Investments
Mutual Fund; account #A511184265479BBBJ
320.240 shares @ $17.59 share price as of date of death
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0344,
VALUE AT DATE
OF DEATH
5,633.02
5,633.02
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REV-1508 EX + (6-98) ,
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fry. Shirley A.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
6.
7.
8.
9.
10
11.
12.
13.
14.
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jOintly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
Members 1 st Savings Account
Account #40898-00
Members 1 st Checking Account
Account #40898-11
Members 1 st Money Management Account
Account #40898-05
Members 1 st Certificate of Deposit
Account #40898-40
Members 1 st Certificate of Deposit
Account #40898-43
2002 Coachmen Trailer
sold to Richard R. Gutshall
1995 Saturn--no salvage value; donated to fire company
title transferred before death
Household furnishings--proceeds from yard sale and yard sale values
Refund from Heritage Medical Group
Refund from Department of Revenue for individual income taxes
Refund from State Farm Mutual Automobile Insurance Company
Reimbursement for local taxes--1 Sherwood Drive, Mechanicsburg, PA
see settlement sheet
Cumberland Family Practice--refund for overpayment
Refund deposited into Members 1 st account #40898-00
Rebate deposited into Members 1 st account #40898-11
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0344
VALUE AT DATE
OF DEATH
655.85
350.23
483.42
2,589.33
2,472.02
8,000.00
0.00
669.80
13.92
154.00
55.97
265.75
41.11
2.28
0.20
15753.88
REV-1510 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fry. Shirley A.
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
11
FILE NUMBER
21 05
03441
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSIO~ TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICASLEli] VALUE
1. Members 1 st IRA Account 13,951.53 100. II' 13,951.53
Account #40898-10, beneficiaries are 3 children and 4
grandchildren equally
2. Ford F1-50--joint ownership established w/in 1 year of death 0.00 0.00
no net value after substracting vehicle loan
($16,155 - $16,574 = $0)
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TOTAL (Also enter on line 7 Recapitulation) $ 13,951.53
(If more space is needed, insert additional sheets of the same size)
~.. -
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fry. Shirley A.
REV-1511 EX + (12-99) .
.
ITEM
NUMBER
A.
1.
2.
B
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21
05
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
Malpezzi Funeral Home
Baughman Memorial Works--engraving of tombstone
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Judy A. Fry
Social Security Number(s)/EIN Number of Personal Representative(s) 173-54-0340
Street Address 1 Sherwood Drive
City Mechanicsburg State PA Zip 17055
Year(s) Commission Paid: 2005
Attorney Fees Jan L. Brown & Associates
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant Judy A. Fry
Street Address 1 Sherwood Drive
City Mechanicsburg State PA
Relationship of Claimant to Decedent daughter
Zip 17055
Probate Fees Register of Wills, Cumberland County
Accountanfs Fees
Tax Return Preparers Fees Parks & Company--estate tax returns
Cumberland Law Journal--advertising
The Sentinel--advertising
Citizens Bank--estate account charge
Settlement charges--1 Sherwood Dr., Mechanicsburg, PA
Cumberland County Register of Wills, satisfactions of claims
Cumberland County Register of Wills, FSA, Inventory and Inheritance tax filing fees
Jan L. Brown & Associates--reimburse for postage
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0344
11
AMOUNT
9,050.25
190.00
5,661.12
11,055.00
3,500.00
314.00
250.00
75.00
137.03
29.69
22,523.59
40.00
45.00
8.51
52879.19
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REV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21 05
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Lowe's c/o TSYS Total Debt Management Inc.--outstanding debt
account no. 7982222390967010
3. Hershey Kidney Specialists, Inc.--outstanding medical bills
4. The Bon-Ton--outstanding debt
account no. 113288039
5. Pinnacle Health Hospitals--outstanding medical bills
account no. 250067225
6. Pinnacle Health Hospitals c/o Accounts Recovery Bureau, Inc.--outstanding medical bills
account no. 01-050810124
7. Holy Spirit Hospital--outstanding medical bills
account nos. 25055716,25007592, 24479669
8. Bank One c/o Omnium Worldwide, Inc.--outstanding debt
account no. 110668769
9. HSBC Bank c/o Phillips and Cohen Associates, Ltd.--outstanding debt
account no. 3978647
10. Susquehanna Internal Medicine--outstanding medical bills
11 . VISA--outstanding debt
account no. 4121 440018408983
12. Nephrology Associates of Central Pennsylvania--outstanding medical bills
account no. 005117-00
13. Conner Rich Associates--outstanding medical bills
account no. 268278
14. Moffitt Heart & Vascular Group--outstanding medical bills
account no. 96994
15. Timothy A. Clark, MD LLC--outstanding medical bills
account no. 21552736-1
16. George K. Shahinian MD LLC--outstanding medical bills
account no. 32552736-1
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11
0344
43.14
296.41
753.35
1,122.74
152.50
5.143.95
3.105.58
249.81
4,812.67
226.92
142.39
144.55
157.92
288.80
62636.45
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Fry, Shirley A.
Decedent's Name
l'
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
21
Page 1
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
DESCRIPTION
AMOUNT
44.44
Philhaven--outstanding medical bills
account no. 1065698-541325
Beverly Enterprises, Inc. d/b/a Camp Hill Care Center--outstanding medical bills
account no. 68818-03959-91891
3,876.00
East Pennsboro Ambulance Services, Inc.--outstanding medical bills
103.00
Jan L. Brown & Associates--outstanding legal fees
account no. 704-05-001
100.00
County of Cumberland, Borough of Mechanicsburg--Iocal taxes for 2005
11.00
Associated CArdiologists--outstanding medical bills
10.62
Smith Radiology--outstanding medical bills
account no. 084533-00
4.64
Neurology Center PC--outstanding medical bills
24.87
Pinnacle Health Emergency--outstanding medical bills
account no. PHE 184265479
29.20
Quantum Imaging & Therapeutic--outstanding medical bills
account no. A65479A93
54.48
Vascular Associates--outstanding medical bills
18.60
Pinnacle Health Medical Services--outstanding medical bills
account no. 403409
11.55
MBNA America--outstanding debt
account no. 4264294228524155
5,344.95
Home equity loan; Members 1st FCU; account#40898-10; payments from March-Aug2005
1,779.56
Home equity loan; Members 1 st FCU; account#40898-10; payoff amount
see settlement sheet
16,752.45
SUBTOTAL SCHEDULE I
28,165.36
Fry, Shirley A.
Decedent's Name
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Page 2
21 (!)5 0344
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
DESCRIPTION
Shares Pledged loan; Members 1st FCU; account#40898-07; payments from March-Aug,
2005
Shares Pledged loan; Members 1st FCU; account#40898-07; payoff amount
Recreational Vehicle loan; Members 1 st FCU; account#40898-05; payments from March-
July, 2005
Recreational Vehicle loan; Members 1st FCU; account#40898-05; payoff amount
Signature loan; Members 1st FCU; account#40898-06; payments from March-Aug, 2005
Signature loan; Members 1st FCU; account#40898-06; payoff amount
AT&T--outstanding debt
Members 1st checking 40898-11
ACH withdrawal--Iife insurance premium payment
Members 1st checking 40898-11
check written pre-death and cashed post-death
Members 1st checking 40898-11
check written pre-death and cashed post-death
Members 1st checking 40898-11
check written pre-death and cashed post-death
Members 1st checking 40898-11
check written pre-death and cashed post-death
Members 1 st CD 40898-40
ACH withdrawal
SUBTOTAL SCHEDULE I
GRAND TOTAL SCHEDULE I
AMOUNT
478.38
3,411.98
421.54
6,639.65
428.50
3,726.08
4.56
26.01
76.03
36.49
59.38
50.10
1,004.16
$
16,362.86
62,636.45
't':"'-~___""""""""__~"<'"
"".,,,, "', '"* .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
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FILE NUMBER
Frv. Shirlev A 71 nfi 0341.
RELATIONSHIP TO DECEDENT A~OUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) i OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under 'i
Sec. 9116 (a) (1.2)] :\
1. Judy A. Fry daughter 20% Oftesidue;
1 Sherwood Drive joint pr perty
Mechanicsburg, PA 17055 II
2. Lori A. Trace daughter 20% of tesidue
20 W. Simpson Street 'i
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Mechanicsburg, PA 17055 I
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3. Christopher R. Trace, clo Judy A. Fry, Trustee grandson 10% of residue
20 W. Simpson Street 'I
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Mechanicsburg, PA 17055 'I
10% of tesidue
4. Matthew E. Trace, c/o Judy A. Fry, Trustee grandson
20 W. Simpson Street !!
Mechanicsburg, PA 17055 il
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5. Larry W. Biller son 20% of ~esidue
6317 Forrest Drive il
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Mechanicsburg, PA 17050 I
6. Regina B. Biller granddaughter 10% of ~esidue
441 Mumper Lane I
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DiIIsburg, PA 1701 9 i'
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7. Lindsay M. Biller granddaughter 10% of ~esidue
6317 Forrest Drive II
II
Mechanicsburg, PA 17050 'I
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ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-15001IcOVER SHEET
II. NON-TAXABLE DISTRIBUTIONS: Ii
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)
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LAST WILL AND TESTAMENT
OF
SHIRLEY A. FRY
I, SHIRLEY A. FRY, of 1 Sherwood Drive, Mechanicsbutg,
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(Borough of Mechanicsburg), Cumberland County, Pennsylvania, ma~(e,
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publish and declare this as and for 111Y Last Will and Testan1ent, here~y
revoking all other Wills and Codicils heretofore Inade by IHe.
FIRST: I direct that all inheritance, estate, transfer, succe~sion
and death taxes, as well as Iny just debts and funeral expenses, of anyl kind
,
whatsoever, which Inay be payable by reason of Iny death, shall be pa,d
\ ;~ ~~) of the principal of my estate as the same can conveniently be donf<
\I'" SECOND: I gIve, deVIse and bequeath all the rest, resIdui~
(.....~~ and reInainder of Iny estate of whatever nature and wherever situate, '
,,--) including any property over which I hold power of appointlnent and "
~ \~~~gether with any insurance policies thereon, as follows: ,
~ (a) Twenty percent (200/0) thereof unto Iny daughter, JUI!>Y
~~'
~, ;~:R;~;:~a::I~::~C;:~::'~l;::~~::::':~o::::: l::: :~e:~~:~~~~r~'
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and share alike, and if there be a failure of saUle, then I give and beqL~eath
"
,
her share unto Iny surviving children and grandchildren as naIned herdin,
share and share alike; and
(b) Twenty percent (20 %) thereof unto 1l1Y daughter, LOJ\U A.
"
TRACE, of Mechanicsburg, provided that should LORI A. TRACE '
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predecease Ine, I give and bequeath her share unto her children, CHROCS-
TOPHER R. TRACE and MATTHEW E. TRACE, share and share ~like;
and
(c) Twenty percent (200/0) thereof unto IHY son, LARRY W.
II
BILLER, provided that should LARRY W. BILLER predecease me,:I
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give and bequeath his share unto Iny grandchildren, REGINA B. BIL~ER
,
and LINDSAY M. BILLER, share and share alike; and
(d) Ten percent (10 0/0) thereof unto Iny granddaughter,
REGINA B. BILLER, of Dillsburg, Pennsylvania, provided that sholl~d
REGINA B. BILLER predecease Ine, I give and bequeath her share U~1tO
;\
her issue, share and share alike, and if there be a failure of saIne, theI1 I
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i ,)give and bequeath her share unto LINDSAY M. BILLER; and
(e) Ten percent (10 0/0) thereof unto IllY granddaughter,
LINDSAY M. BILLER, of Dillsburg, Pennsylvania, provided that shtuld
LINDSAY M. BILLER predecease ll1e, I give and bequeath her sharej
unto her issue, share and share alike, and if there be a failure of saInd
then I give and bequeath her share unto REGINA B. BILLER; and
(f) Ten percent (10 %) thereof unto Iny grandson, CHRI~TO-
PHER R. TRACE, of Mechanicsburg, Pennsylvania, provided that sh~llld
"'CHRISTOPHER R. TRACE predecease Ine, I give and bequeath hi$1
~ !
share unto his issue, share and share alike, and if there be a failure ofl
saIne, then I give and bequeath his share unto MATTHEW E. TRAdcE;
and
2
(g) Ten percent (10 0/0) thereof unto IllY grandson,
MATTHEW E. TRACE, of Mechanicsburg, Pennsylvania, provided tJ~lat
I
I
should MATTHEW E. TRACE predecease 111e, I give and bequeath lFs
'i
share unto his issue, share and share alike, and if there be a failure of
saIne, then I give and bequeath his share unto CHRISTOPHER R.
TRACE.
THIRD: Should any of 11lY grandchildren not have attaiqed
the age of eighteen (18) years at the tiIne for distribution to him or 11er, if
il
applicable, I give, devise and bequeath the share of each such grandcliild
ito Iny hereinafter nallled Trustee, IN SEPARATE TRUSTS, to hold, II
"
nage, invest and reinvest the shares so received, and to use and apply
fr01n tillle to titne such portion of inC01ne and principal for such grang~
child's education (including college, trade school or other silllilar train~ng
or education), support and welfare as 1l1Y Trustee, in her sole discretiqn,
\ ,
\3 \Jdeenls advisable. My Trustee lllay Inake the paYInents for the supporft and
.~ Inaintenance of ll1V grandchild directly to said grandchild or to such
'::':i grandchild's Guar~ian, as required, Any payments made by my Trustpe
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"\ pursuant hereto shall be lllade without further responsibility to the sa~d
\ ,
\grandchild, or to any person taking care of Iny grandchild. The Trust~e, in
exercising her discretionary authority with respect to the paytnent of :1
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income or principal of the within Trust to Iny grandchild, shall take ilito
,
consideration any inC01ne or other resources available to Iny grandchi~d
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fro111 sources outside this Trust. In addition, Iny hereinafter named
3
Trustee shall have the right, in her sole discretion, to purchase and pay for
out of the principal, as well as incOlne, such insurance policies as will
provide for the lllinor's Inedical care.
Any inCOlne or principal not so applied shall be distributed to ea~.h
grandchild when such grandchild attains the age of eighteen (18) year$.
FOURTH: In addition to all powers granted to thelll by l~w
I!
and bv other provisions of this Will, I give the fiduciaries acting hereuib.der
~ I:
the following powers, applicable to all property, exercisable without cQurt
approval and effective until actual distribution of all property:
(A) To sell at public or private sale, or to lease, for any p~riod
_ :--."of tilHe, any real or personal property and to give options for sales, ex~
\t \-~hanges or leases, for such prices and upon such terms (including cre4t,
vvith or without security) or conditions as are deelned proper. This
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\"j includes the power to give legally sufficient instnnnents for transfer of the
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property and to receive the proceeds of any disposition.
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(B) To partition, subdivide, or ilnprove real estate and to
enter into agreelnents concerning the partition, subdivision, ilnproven~ent,
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zoning or Inanagelnent of real estate and to ilnpose or extinguish restric-
tions on real estate.
(C) To cOlllprolllise any claim or controversy and to abal~tlon
any property which is of little or no value.
(D) To invest in all fonns of property, including stocks,
conunon trust funds and 1l10rtgage investlnent funds, without restrictlpn to
4
investlnents authorized for Pennsylvania fiduciaries, as are deel11ed 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 investlnents.
(F) To exercise any election or privilege given by the Fed4ral
Ii
and other tax laws, including, but not necessarily being lilnited to, pe~lsonal
incOlne, gift and estate or inheritance tax laws.
Ii
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(G) To Inake distributions to l11Y herein nalned beneficia*es
II
in cash or in kind or partly in each. 'I
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( (H) To borrow l1loney froln thelnselves or others in orde~ to
". ~ '\'jJay debts, taxes, or estate or trust adlninistration expenses, to protec~ or
~ I
\- ilnprove any property held under Iny will, and for investlnent purposel~.
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'~ (1) To select a l110de of paynlent under any qualified reti~~-
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"' j \.lnent plan (pension plan, profit sharing plan, elnployee stock ovvnersI1ip
~) " ) 1.1.
, ,~ ~
,,:~ plan, or any other type of qualified plan) to the extent provided for by the
~ plan or the law.
~}
FIFTH: I nOlninate and appoint my daughter, JUDY A. ~RY,
\ !
\ as Trustee, of any trust created for the benefit of the issue of LORl ~.
Ii
TRACE. I direct that Iny Trustee nalned herein shall serve without bbnd
and shall receive fair and reasonable cOlnpensation.
SIXTH: I nOlninate and appoint Iny daughter, JUDY A.
FRY, Executrix, of this, ll1V Last Will and Testalnent. In the event oR the
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death, resignation or inability to serve for any reason whatsoever of r(JDY
,
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A. FRY, I n0111inate and appoint LORI A. TRACE, Executrix, of this, my
Last Will and Testalnent. I direct that n1Y Executrix and her successor
shall not be required to post security or a bond for the perfonnance of
I
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set IllY hand and s~al to
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this, Iny Last Will and Testanlent, this - day of Septe111ber, 200l
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SHIRLEY A. FR-Y
C~\
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rt:-G1sEALI
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Signed, sealed, published and declared by the above-naIned Te9ta-
trL\: as and for her Last Will and Testalllent in our presence, who, at Her
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request, in her presence and in the presence of each other, have hereubto
subscribed our naInes as attesting witnesses.
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Address
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NaIne
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/f{'JJI41 'YllcZ;Jtt(/7~'g{ '1/] t/J{1/2~~ j:c.-;
I'l, / 7C-25~ / Nam.e c;
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Century 21 Piscioneri Fax:7177377129
Hug ~ L'UU:) 1 L' .1):)
r.11..)
!JIB NO. 2~02-0265 ,i
A B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2,0 FmHA 3. I!JCONV, UNINS, 40V , 5. OCONV, INS.
6. FILE NUMBER: 17, LOAN NUM6Ef :
SETTLEMENT STATEMENT 4497 1000225717
6 MORTGAGE INS CASE NUMBER
C. NOTE: This form is furnisNJd 10 give ~u B statement of actual s9/r/emM/ 00!ts. Amounts paid to and by Ih9 sai/lAment agenl ere ~bwn.
119m. marked "[POC]" were paid ou/side the cfosifJ!}. they are shown hors lor InlorfMlionaJ IlUr0000S and 8llI, ~ ~.;'ud::::;~~~~.~o::~)
0, NAME AND ADDRESS OJ: BORROWER: E. NAME AND ADDRESS OF SELLER: I F. NAME AND ADDREsf.; bF LENDER:
Reid fGae and The Est3te of Shh1ey A. Fry Merlla9" Mortgage Corp 'I
\lll9lnl. KI<:e. ~usbond end wife '9300 SW Gemini Drive, 1'I\e 100
[ Beevenan, OR 97008 'I
- I !! l. SETTLEMENT DATE:
G, PROPERlY LOCATION: H. SETTLEMENT AGENT: 46.0500033
1 Sherwood Drtvo LCD SettlemOnl. LLC I
Mec.hanlcsb"rg. PA 17055 I !llIu9uOl 5. 2005
C"mb9l1ond Coonty, Pennsylvonl3 PLACE OF SETTLEMENT I ~ I
660 Mdernen Dr FOSler Plaza 10 Suite 530 'I
Plnsburgh. PA 15220 :i
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J, SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRAlfi$ACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SE . LER:
101. Conlr.lcl Sale. Poce 146900,00 401, C2.ntract Seles Price I I 14690000
1 02. Pe~al ProOertv 402. Pe=nal ~ 'I
103. Settlement Choro.. to Bor""""r une 1400 10136,99 403 I ,
104 404. I!
lQ.q, 405. .~oo-
AdlUstm9llls For IIams Paid aI/SeRer in advanc9 Ad'uslmen/3 For Ilems Paid Bv Soller in ed --
106. Boro&Ub!~Tax... 01/01105 10 OBl05lO5 14503 406. Boro&l.ibnlrv T axe, 01/01105 to OS/OS - , 14503
107, Co.."wT~!" 01/01105 10 08105105 12072 407, CounIv T axe~ 01/01105 to 08105 I 120.72
-
108. School T oxe. to 408 School Taxes 10 'I
109. 409. !!
110, 410,
111. 411,
112. 412 I
120. GROSS AMOUNT DUE FROM BORROWER 169.302.74 420. GROSS AMOUNT DUE TO SELLER II 149.165,75
:l00. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: '00. REDUCTIONS IN AMOUNT DJ1E TO SELLER
201. DeoOsn or 8ames1 money 500.00 501. Exces'!.9J!J:>oSll {See InstruCllonsL
202. Ponci.a! Amount of New L""n s\ 1'9'2000 502. Set1lenvlnl Charoe. to Seller rUne 1400)_ , 1932?39
203. Exlsnno IoGns\ taken 'ubtect to 503, EXI.tino loanlo1 token wb ecllo
204. 504. P.voff Rr<:1 Mortlege 10 '-4embers 1., FeU I 18.752.45
205, 505. puvof( Second MOI1oaoe
206. Credit from 2nd 27 83602 506. Sewer and R8fu... I' 214.53
207. 507 D.oOB~ d.sb. es .roceeds) , ,
206 Seller Assbl - 8 93400 ~~lIer Asslsl .- II I --~
209 ~a ! ..-
~io Adi",,'manfs Fer koms Un~i<1 Bv Seller Adiu.,lrnems For Item, Unpaid By SellerT
Boro&Libr3rv Taxes 0110'105 to 081051\)5 510. Boro&Llbrorv Taxe. 10 'I
211 Coun\Y. T ..es to 511 COUT'\tv Taxes 10 . !! I
I 10 06105lll5' .--
212 School Texes 07101m~ 10 ""'05105 162.87 512 School T ox... 07101105 ,e267
213. 513 'I i
214. 514 'I
215. 515 ! I
2'6 .- 51.6
?17. 517
218 5'8.
'19. 519.
220. TOTAL PAID BY/FOR BORROWER 158.552.69 520. TOTAL REDUCTION AMOUNT DUE SELLER! I 45,386,04
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CIISH AT SETTLEMENT TO/FROM BElLER:
~Ol, Gross Amolml Due From Borro~r'(i,no 1201 159302.74 601, Gross M,ount Du~ To SoUer (line 4~Q) II I 141916$.75
302 LoO" M10unl Paid BvlFor Borrower line 220) Ie 158.552.69 802. Less RoduCllone Due Seller (Line 520'. I !( 45 386.04'
303, CASH ( X FROM) ( TO) BORROWER I 2.750.05 6n..1. CASH ( X TO) ( FROM) SELLER : 103.779.71
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The lJnde~lgnod hereby 8cknow"'dge receipt of a comoleted oooy of pages 1 &2 of the, SlaleOl.nt & 3ny altlchrnenlS r9forred 10 herein, :!
I HAVE CAREFULLY REVIEWED THE HUD-' SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BElIE~ tiT IS A TRUE AND
ACCURATE STATEMENT OFALL RECEIPTS AND DISBURSEMENTS MADE ON My ACCOUNT R BY ME IN THIS TRAN$ACTIl:l'tol. I FURTHER CERTIFY
THAT I HAVE RECEIVEJ.1 cOPY ~')"HE HUD-l SETTLEMENT STATEMENT.
-~~ ~? ~
Pl'eld Klse v~
'ULti OLn la )~ .
Virginia Kl~1
TO THE BEST OF MY KNOWLEDGE. THE HUD.' SETTLEMENT STATEMENT WHICH I HAVE PREPARED IS A TRUE AND ACC4Ri'\TE ACCOUNT OF
THE FUNDS WHICH ~E RECEIVG!-ED 0 HAV~EN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE ~.ETTLEMENT OF THIS
TRANSACTION. ~__~~ ,I
~~~e~~~~~~t - :i
WARNING: iT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS 1'0 THE UNITED STATES ON THIS OR ANY SIMILAR FbRM. PEN^L TIES
UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TI1'LE 16 US. CODE SECTION 1001 & S~CTION 10,0.
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Centur':J 21 Piscioneri Fax:7177377129 Aug 5 2005 12:0') ~lll
P~Q~
L. SETTLEMENT CHARGES
1!!.0:29TAL COMMISSION BQS8<I on Price $ 148.900.00 @ 7.0000 % 10,423.00 I PNOF '" P"'D FAO,..,
J """""" ;R'O s.l;.lI..~R'S
Divi8fon of Comm/~?:!jl/ne 700) 8S FollowS: .1 FUNDS r ~urlO{;"f
701. S 5961.00 \0 Exit Platinul!!.f!oally ,!'tn..
ND1a Line 701 Include. AdiuSlme11l of For NT SETTLEl\1E1\/T
'-
~lli..9Q.. \0 Centurv 21 PI.cloner; - 10.423.00
70' (';nrnm;B2illoEQj!lJ!1 ~.",Am~'
704. Tnmaac\xm FP.e Ie CentIJry 21 Plsdonerl & Ex;! Plgtinum 195.00 H15.00
BOO.ITEM8 PAYABLE IN CONNECTION WITH LO"N
801. loan O~"'n.non F~!!. 3.0000 .~ to Mottoaa& Landina Grouo 3573.60
602. Lo.n DIScount % to
003. Accral",,1 Fe~ 10 ~rl"'ge rvfMgoge Corp ,. --
604. Credit BMort 10 I --
60S. T"" SeM", Fee 10 Merl",qe M0I1!l9Qe Caro. , 73.00
~ml..streti"" Fee 10 Mefrtage Mortgage Co!)l - 11567.00
~:...Flood Cert Fee to Mer,laqe Mortgsoe COm. I 10.00
S08.
~:..._- . --
810 Proce68inQ Fee 10 Mortoeoe Le0d1ng GrollP 375.00
611.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. InlBrest From OBlO5105 10 08101105 ~ $ 26.940oo0Iday { -'ldlly1.l ....} I 107.76
~9!'~ Im:"",~ Pmm"'m for monrhsJo -
903. Hazard Insvrante Premium for 1.0 years to fanners Insurance 661.00
904. -
90S
1000. RESERVES DEPOSITED WITH LENDER I
1001. Hez m'Mh. {f,) ~ nor month -
1002. Morta"". In...nmce . nlOnth! (Ii) $ Dar mon<l1 '--
1003. Boro&Llbrtlry Tax"" months <<l> $ cor rnonlfl
..!QQ.4. County Taxes month~ l!ll $ per "'001" -
1005. SchoolT3xes month!, @ S per month -
.1!l9.L. "lll~Jho (iil $ p... month__
1007. months @J S Der menU'
1006. momhG c& S ner month
1100. TITlE CHARGES
1101. SAttlemenl or C',jo.ing F"" to LCD Setnemanl, LlC ' 17!?,PO 175.00
1102. Ab9lnlct or Title Seilrth to_ , -
1103. ~on to LCD SeWement, LlC 125.00
104. Hie Insurance B!nder (0 -
~_ Document Preoarallon to LCD SOln."'''''I, LLC , 75.00 7500
-
1106. NeWry Feea to LCD Setll."'o~LlC 15.00 15.00
~8)". F.a. Oeed Pre~ \0 Jan L. Brown & A.ssociates .. ,I - 110.00
Include. 300"" ~em numbe~ )
1.106 nle I"""",nee 10 I ;tnd Amencs18wver-. Tltl. ,9587
(includes above item numb",,:
1109 Lend..... ec,"""ge $ 120,00000 - ..
1110. Ownefs CoV<l",)le $
1111. Endo,.,.,ments 100130018.1 10 LCD Settlement. lLC 150.00
~~ 10 Land Americe Lawye", Tlue 35.00
1113. ,
1111. 2005 County T 8xe. te asny l. Heckard. Tax Collector 297.72
1115.2005 Towns"'pTex 10 asrry l. H~k.rd, Tox CotleClor 330.96
1116. library Ta~ 10 Barry L Heck2rd. Tax Collector 26.71
1117. 2005 School Taxes to Elerry L. Heckard. Tax Collector ~S6AOI
1116. Lie'; Lellerorrex Com to LCD Satllemen\, lLC 1000
1200. GOVERNMENT RECORDING AND TRANSFER CHAROES ,
~~~ ~aes: Deed $ 38.50 : MOr1Q311. $ 72.50: Rele.""" $ 111.00 74450
1202. ell (Coun:!y' T exlS1all1Ds: De<KI Mortaaae 7<14.50
1203. Slate Ta><lS",mos: Deed .1489.00: MOl1oallf' 74A50 74459
1204
1206.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Surv~ to
.~ 302. Pest. lnsDedlon 10 IntefSt.l!t@ Termite - - 35.00
1303 W're Fttes to lCD Settlement, lLC 20.00 20.00
1304 Courier Fee to LCD Sen'"!!,enl. Ll.C 3000 30.00.
1305 Inheri(gnce Ta-.: Eacrow to e~w account 6,000.00
1400. TOTAL SETTLEMENT CHAROE9 lEntOI' on Line. 103, Section J and 502 Section Kl 1 .13699 19.322.39
6)1' illlll\!ng ~e 1 of lnll' 1119lelTtem, !I'Ie ~1Q~ lK'MOwI6dQ. fetel", of lll'()mDk't9l1 COVf ~ l)~" 2 of 1111;. ""^ ollOC' ~UIIll:.'Tl.'"
Cot1ined It> be ~ IruO copy.
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lCD Seltlemenl. ~ . Senlem""llIgent
(.4~7i4-1Q7123)
? Regl~ter of Wills, Cumberland County
INVENTORY
Estate of Shirley A. Fry
also known as
Shirley A. Fry
, Deceased
No. 2005
0344
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of ttie
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuati$n
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent ownb~ no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INve
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are sUbj~dt to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. 'I
Name of
Attorney: Jacqueline A. Kelly
I.D. No.: 91973
PA 17109
Description
Real property located at 1 Sherwood Drive, Mechanicsburg, PA 17055
Putnam Investments
Mutual Fund; account #A5111842654 79BBBJ
320.240 shares @ $17.59 share price as of date of death
Members 1 st Savings Account
Account #40898-00
Members 1 st Checking Account
Account #40898-11
Members 1 st Money Management Account
Account #40898-05
Members 1st CD
Account #40898-40
(Attach Additional Sheets if necessary)
Date of Death 3/24/2005
Social Security No. 184-26-5479
Personal Representative:
Judy A. Fry
Dated
q -~d.-()5
148,900.00
:'.J
5;633.02
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1:"1':::1
i ;~-;350.23 <5
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483.42
2,589.33
170,286.90
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal represen~ative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Value
Total
..._-".._.".,P~"''''''''''-'.''~'~"-_._- ".,".,-'.....~....~.....--.-..~_',,"'"
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Continuation of Inventory
Shirley A. Fry
2005
0344
Paae 1
Description of Inventory
Description Value
Members 1st CD 2,472.02
Account #40898-43
2002 Coachman Trailer 8,00d.oo
I
1995 Saturn--no salvage value; donated to fire company d.oo
Household furnishings--proceeds from yard sale and yard sale values 66~l80
Refund from Heritage Medical Group 131.92
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Refund from Department of Revenue for individual income taxes 1541,00
"
Refund from State Farm Mutual Automobile Insurance Company 55197
Reimbursement for local taxes--1 Sherwood Drive, Mechanicsburg, PA 265175
Cumberland Family Practice--refund for overpayment 41111
Refund deposited into Members 1 st account #40898-00 2128
,
Rebate deposited into Members 1st account#40898-11 0120
Grand Total $
Subtotal $