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HomeMy WebLinkAbout96-0464~ ~~g~ ,o~-- ~r~,w~ITANCE TAX Pennsylvania ~ BUREAU OF INDIVIDUAL rnxES APPRAI~ EN"T`{ A;~.~~1~fkMCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF D~Crz.oN& A,wb~ `ASSESSMENT OF TAX DEPARTMENT OF REVENUE PO BOX 280601 REV-1547 EX AFP (12-10) HARRISBURG PA 17128-0601 ~~ ~ ` °`' `D~tTE 10-18-2011 ESTATE OF STONE JR CLARENCE T p tC~~~iK r1 DATE OF DEATH 11- 28 -1988 Cf1rR4 ~w``~ ~ f'(1,' '7T ~ ~Jv~~("ti FILE NUMBER 21 96-0464 ~~~~~ ~~~~ '~~°~~') '~l t , P~OUNTY CUMBERLAND FRANCIS A ZUI~LI ACN 109 LOCUST ST 501 APPEAL DATE: 12-17-2011 H BG PA 17101 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~-! RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ REV-1547 EX AFP C12~10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR -------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: STONE JR'' CLARENCE TFILE N0.:21 96-0464 ACN: 501 DATE: 10-18-2011 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF ~ETURN BASED ON: LITIGATION RETURN 1. Real Estate CSch~edule A) (1) .00 2. Stocks and Bonds (Schedule B) NOTE: To ensure proper C2) .00 credit to your account, 3. Closely Held Stork/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) of this form with your C4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 20,065.69 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers CSchedwle G) (7) .00 8. Total Assets APPROVED DEDUCTIONS ',AND EXEMPTIONS: ca) 20,065 69 9. Funeral ExpensesXAdm. Costs/Misc. Expenses (Schedule H) (q) 7.066 06 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions 12• Net Value of Tax'Return (11) 7,066.06 13. Charitable/Governmental Bequests; Non-elected 9113 Tr t ( 13) 1 2,999.63 14. Net Value of Estate Subject to Tax us s Schedule J) ( .00 (14) 12.999.63 NOTE: If an assesshent was issued previously, lines 14, 15 and/or 16 1 reflect figuhes that include the total of ALL , 7, returns o and 19 will ASSESSMENT OF TAX: assessed to d t 15. Amount of Line 14 at Spousal rate (15) 00 06 = 16. Amount of Line 14' taxable at Lineal/Class A rate C16) . x ~ ? 999 • 00 17. Amount of Line 14 at Sibling rate . 6; x 06 = 779.98 18. Amount of Line 14, taxable at Collateral/Class B ra C17) te (18) - nn x oo - 0 0 15 - .oo 19. Principal Tax Due . x - .00 TAX CREDITS: (19)= 779.98 DATE NUMBER INTEREST/PEN PAID ( ) AMOUNT PAID 14 2011 CDOli4586 .00 ~~ ~ IF PAID AFTER DATE INDI¢ATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX PAYMENT 779.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. COMMONWEALTH O~ PENNSYLVANIA DEPAR'f;';€NT1oF REVENUE '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 -'-,- ,. ~-.:- -, "'r'~'nNOrICE OF INHERITANCE TAX "--"'~Apehr'SEMENT, ALLOWANCE OR DISALLOWANCE .\ ,-O~ D.EDUtTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (06-05) DATE 01-02-2007 ESTATE OF STONE CLARENCE E DATE OF DEATH 11-28-1988 FILE NUMBER 21 96-0464 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 03-03-2007 ( See reverse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -. RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STONE CLARENCE E FILE NO. 21 96-0464 ACN 101 DATE 01-02-2007 Z007 JM~ -8 PI'l 2: 52 FRANCIS A ZULLI 109 LOCUST ST HBG CI L:R"/ L-L 1;\ QRn' \ ^, "" ~ ,-' J-"i ;.", 1\: "-.., I I ." I' \...- CU~'!" . Ii- PA 17101 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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 (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 .00 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. .00 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) (0) .00 .00 (1) (2) (3) (4) .on .00 .00 .00 NOTE: If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of !bb returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due AX TS: R P NUMBER OS) .00 X 06 .00 (6) .00 X 06 .00 (7) .00 X DO .00 (8) .00 X 15 .00 (9)= .00 AMOUNT PAID (-) * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 % ( 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.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE '* " . I ~ REV-1470 EX (6-68) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME INHERITANCE TAX EXPLANATION OF CHANGES Clarence Stone FILE NUMBER REVIEWED BY Joan M. Peters ACN 2196-0464 101 SCHEDULE ITEM NO. EXPLANATION OF CHANGES Efforts to obtain an Inheritance Tax return have been exhausted for the above referenced estate. Therefore, the filing requirements have been waived. The Department however, reserves the right to assess any assets that may be recovered at a future time. Paqe 1 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of CLARENCE T. STONE JR. also known as Deceased COUNTY, PENNSYLVANIA File Number 2 1- 1 9 9 6- 4 G 4 Social Security Number 162-22-5144 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated. and codicil(s) dated named in the Anna T. Stone s ouse and Executrix died Janua 6 1998 (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: d.b.n.c.t.a. B. Grant of Letters of Administration M ~ (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendentelite; duranteabsentia; duran~rOritate) `~ 'T'~ -~z Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spc~~~f any) anterrs ~, ~ ' Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ ~ ~ m ~ - Resid~~ ~ ~ ~ Name Relationshi ,, , ~ -CJ ,~ Will probated to 21-1996-464 r~ j ~ --~ See attached list of children of decedent and ~ --i ~. rn renunciations. - ~ -ri e- (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 119 Center Street Enola PA East Pennsboro T (List street address, town/city, township, county, state, zip code) 60 ears of a e died on November 28, 1988 at West Brown Township, Potter Co., PA Decedent, then Y g Decedent at death owned property with estimated values as follows: $ 1,000.00 (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania $ Personal property in County $ (1f not domiciled in PA) $ Value of real estate in Pennsylvania TOTAL $ 1,000.00 situated as follows: None Wherefore, Petitioner(s) respectful';y request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: I Claire S. Smith, 50 Dubbers Drive, Etters, PA 17319 Susan M. McCartney, 3 Beilman Court, Mechanicsburg, PA 17055 Form RW-Ol rev. /0.13.06 Page 1 of 2 ~~/ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the ~-. day of ~r ~ r1n~-r ~~ Fo he Register . ,~ y Signature of Personal Representatives (~ ~~~,-- Signature of Personal Representative Signature of Personal Representative File Number: Estate of CLARENCE T. STONE JR. •_ , , ~. ----~~ (~ T..__ Deceased Date of Death:November 28 1988 Social Security Number: 162-22-5144 I ~ D'~h ~~ Ce ~' ~ ~_ in consideration of the foregoing Petition, satisfactory proof AND NOW, having been presented before me, IT IS DE~~D that Letters are hereby granted to in the above estate and that the instrument(s) dated ~ ~ described in the Petition be admitted to probate and filed of rec ~ d as the last Will Viand CodiciA(s)) o~D~etcedent. FEES Letters ............... $ '~ $ , ~~ Attorney Signature: Short Certificate(s) ....... . Renunciation(s) .......... $ ~' Attorney Name: ... $ $ Supreme Court I.D. N ' ' $ Address: ... $ ... $ . $ ... $ $ Telephone: ... $ 0.00 TOTAL .............. $ ~ is A. Zulh, >Jsquu 316 109 Locust Street Harrisburg, PA 17101 717-232-1488 Page 2 of 2 Form RW-02 rev. 10.13.Oti ESTATE OF CLARENCE T. STONE JR. Name Claire S. Smith 50 Dubbers Drive Etters, PA 17319 Relationship Daughter Susan M. McCartney 3 Beilman Court Mechanicsburg, PA 17055 Carolyn J. Smith P.O. Box 223 Lemont, PA 16851 Deborah J. Pesce 128 Christopher Drive Camdenton, MO 65020 Donna J. Shepler 353 East Meadow Drive Mechanicsburg, PA 17055 Clarence E. Stone III 650 Lewisberry Road New Cumberland, PA 17070 Larry A. Stone 851 Magaro Road Enola, PA 17025 Drenda M. Cordeiro 505 Leeward Lane Enola, PA 17025 Lori A. Staub 119 Center Street Enola, PA 17025 Daughter Daughter Daughter Daughter Son Son Daughter Daughter 105.905 REV.(3I09) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. ~` ;`"~~'~ ""~:-,-t„~ ~ARNING: It is illegal to duplicate this copy by photostat or photograph. RE~~C~: ~ . ~ ~~~~ a ~. ~~%~ ~! ; ~ ,~ ~ ~~ Z 0 P f'l ~: I..F .~ Linda A. Caniglia State Registrar CLERK 0~ OR~'~,~~1'S C~O;aRr No. TYPERRMT ~ NAME OF PERMANENT tILAd(NIK t. 69 Y~ ~~ ~_ Cumberland - JAN 14 2011 Date CDMMONWEALTN OF P CERTIFICATE OF DEATHEAt.TH + VITAL RECORDS Anna T. Stone eniuw - iMOnn,ON.'4e0 SlwaFaagnCaaryl f ~ 11/6/28 Zemoyne,Pa ~ 0. T. arr,eoRO,rNPOFDEaLI ~a~~~"~1d0N~ si Carlisle ~ ~,,,~ a1, C,.,..~ .o,rAegnpM.:mmlueene<WI Co. Court ] ~~ Snack Bar „a SWBINGADORESS~,Ciylyorm.Siale.79Cade1 pECEDENT'9 20 Sherwood Circle ~ Enola, Pa 17025 ~adN ID'E"$""ME'~"'Md°°'`~ Fortunato Rizio rBNA~a'~ Susan McCartney I Doren^ °[~ pNmvYwemsm.^ ^ ae .. LetadyoneuueeaneeMfer. rECldaElFw ~~ C~ eaeilion Female ~,. 162 - 22 - 7172 002602 ~.~•~ ~[- EIVOupIMd ^ DOA ^ ItN~ L7 RaidN~Ce ^ (Sp6iY) ^ MMS DECEDENy OFFMSPANIC DRIGUR YMr4 B4ckN ~elv.b; I; In ~ ~oAl ,~C we ^ Mr..>Pe~iaeM. ,. Pee,nl6an.~. ,_ White Z ,3. ,h~,~ Pennsylvania ~, ,h.®~d~ti-- - deodMe r.ne ~-I Cumberland ~' iTeJJ ~~a- ,n. ....,ucu~s u.tE n-m Mfdw. Medan smromM ro .; Enola, Pa 17025 Jan 8, 1998 S,GEast ,~F O 1897-L ,canedrdr OnM, date and phce aunt. DIGE PROttOUNCEO DEAD pdaim. Dey, T+•n L fb rnr modeaarlne. aunt ae a'dee ,ap„anryuraaL Snx Cemetery ~ra Harrisburg, Pa an F H.,51 N. Enola Dr.,Enola,Pa LICENSE NUMBER DaE SIGHED pAMh,Oe,Lkrl / ~j `(~ ~. MMS CASE HEFERREDIO MEDICALEXAMIlRAICORDIER'I u .e. Q' F D NoJ wiw beleem aretaM eeeN i ~+"w'I1YCai0"0A` ° DuEm(aRASACONSEOtIENCEOFx lpmmdWe B ~ ~ UMDERLYBIG w.E e a ~~°~ DUE7DIDRASACONSEDUENCEOFl: 1 ~ MliiiMedeeerei ,e~/npndrN LAST d TBIE OFINAI . MANNER DF DEATH DIRE Of WJURY y WERE AU10p5YFWDWGS plant. D+Y.MnA CpONOFCAt1SE N neel ~ Flomidde ^ e ApddMe ^ Peed+9°^ ^ ld notb+dewmined ^ PLACE DF MLURY•NMme. Mn. aden.fuC ra' ^ C ~ ^ ~ ^ ~ fly a LJ l+idYK.+n.15Pedvl M ~• SM SIG QRTRIFA IChece Ody arl ddeMh vAen anatl~e<~,~ypen haspronouirsdd~nand cunpeNd eem 231 ............................. IFyING MIYSICUHIPAYSe+v'~e~MScauee -• ^ 3 CHR deMaewneawatM eaerl+l+ndrtwwraeMW ........................ lmorrMdOe a . n~/ TeNe Ma 2 .... •PRDNOUNCINO ANDII<RTIFYMNt PHYSICIAN IPhyecnn°ae~0~+'9~yd tt,plyngncaused deanl dNe: indP~+. and due totM eewM+Ird manmrge4tM ...................... drilM Wne i1' w ~ w . TeMe°WanYknowbd9+.dM°oeeum p° U p •IBEDN:AL OGMINERICORONER deeM aecurred et the Lime, dria, arM piece. end due to UIe caueelel ~ •. .............................. . ...... buh ri aaamllletlon andlor Imeetlgalioe, in my opinion. R ^ z u. ~ ... _ „ •...... • • • • • Ie . On IeMMMnp riatb .......................................... - G W Z Sta. HD / REGISTRAR'SSIGNATURE ~. ~ I ~ ^ Na ^ M. SeG ~s,~v os-gs~ ~ L GADDIESSDF PERSON WHOCOMP Type or Print 8 ~99~ al - Flo-~~4 ~~:'. _ ,,~,ic ~C ~ ,,_.~.~_1 RENUNCIATION I! t.~1~ GU ~~S J• ~L:J REGISTER OF WILLS ~~~~~{ n= CUMBERLAND COUNTY, PENNSYLVANIA CRpi-`Ati'c ~;1)Rl" 21-1996-464 Deceased Estate of CLARENCE C. STONE JR tiu` , in m ca acit /relationship as dau>?hter I, Carolyn J Smith Y P Y of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M McCartn~• (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills (Signature) arolyn J. Smith © r1 rive ~ • D . ~ X ~ oS3 (Street Address) Lemont PA 16851 (City. State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified tiiut he Or slle ~XeCLitc.ti the i~,riililCiatlvil flZr the purposes stated within on this~~--\ day of Nc~~ty ~~ _ ~~ ~~-~ !~ tart' Public y Commission Expires: (Signature and Seal of Notary or other official qualified to Administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 CAMMONWEALTH of PENris v ~ Seai Jamie M. Kreider, Notary Ribuc State CAMege Boro, Centre County Oct.7 2'014 ANOdNIon NotMN~ ~-q~-c~yc~y RENUNCIATION ',i j ~r ti,~ ~s'~~~ ~0 ~'~~~ 3~ ELF; REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA C~E~-{~, (1r o~p~~a~~~ c;~~~~~ ~ ~~ ~~?~ I ,' I~i~.~ t_,~ . , . 21-1996-464 r' ~( Estate of CLARENCE C. STONE JR. ,Deceased I, Deborah J. Pesce , in my capacity/relationship as daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M. McCartney (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this c~'~~' day of ~ ~,,,~._ bey -. ~ 1 u Deputy for Register of Wills (Signature) De rah J. Pesce J~~tN~1I ~~°~ ~~ ' _ ~- (Street Address) Camdenton MO 65020 (City. State, Zip) (/Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she execu*.ed the renunciation for the p oses stated within on this ~ ~~ day of .~v., -~ o /~ Notary Public My Commission Expires: ~ - g" da' ~ Y P"''~. (Signature and Seal of Notary or other official qu t0'VB~i~ Administer oaths. Show date of expiration of Notta*;'};'3~b'f~rns!r~n•) ~SEAI.,r - ~e ~ ~~ ~n pugust9,2012 Cart-den CoU~y p~ ~p84113C Form RW-06 rev. 10.13.06 RENUNCIATION °i /fir r ~~'+. ~ ~_,. i S ..{4d3 j6 t. ~J ~B;: ~. 1~Y vt REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA O~E~K OR~I~r1N'S L;~~~RT 21-1996-464 L,U"'.~":~+ ~' _~'~'.(~ ._ i~,~~ , ?H, ,Deceased Estate of CLARENCE C. STONE JR. I, Donna J Sheeler , in my capacity/relationship as daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M McCartne //_~d-moo/D (Date) (Signature) Donna J. Sheeler 353 E. Meadow Drive (Street Address) Executed in Register's Off ce Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 Mechanicsburg, PA 17055 (City. State, Zip) (~ Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he o: she executed the renunciation for the purposes s_tatgd within on this ~ day ~- Notary Public My Commission Expires: ,rt/pv ~6 ~' ~~ (Signature and Seal of Notary or other official qualified to Administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAT. gt~E R. FISHER, NOTARY PUBLIC CARLISLE BOROUQH, CUMBERLAND COUNTY MY COMMISSION EXPIRES NOVEMBER 26, 2012 `~l-~Lv ' N(Q~F ,, Rr ~ `~ r~' - '+.~~E 0~ ~,~,c RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA 21-1996-464 C~ER~', ~~ T O~PI~~~~ ~ E.,u;!~; Estate of CLARENCE C. STONE JR. ,Deceased I, Clarence C. Stone,_III , in my capacity/relationship as son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M. McCartney ~ ~ 12.2 ~o (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills Form RW-06 rev. 10.13.06 (Signature) Clarence E. Stone, III 650 Lewisberry Road (Street Address) New Cumberland PA 17070 (City. State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this 22'~'tl day of ~o~cem~er' Z.O ~ O otary Public ~) ~y Commission Expires: ~"2 ~ (Signature and Seal of Notary or other official qualified to Administer oaths. Show date of expiration of Notary's Commission.) COMMONWEANo~ ~ Se ENNSYLVANIA Bonnie J. RidgwaY~ Notary Public Silver Spr+r9 i"wp~, Cumberland County s ire_ March 26, 2013 l+1~;° fio"jl~rsl~,iot~ 1=xP ,'~- g„i ~~;rti ~ F1,S56CfG:t1Cn Of l~flt:e:rl@S RENUNCIATION ,., ?~ ~.; !~ ~~~?0 ffi~ ~:~ REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ~LE~K { R,,,~,c ,,,, ~~; 21-1996-464 ~~~~,' h `" ` "`' ,Deceased Estate of CLARENCE C. STONE JR. I, Larry A Stone , in my capacity/relationship as son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M McCartney 1/~~~ ~ ~~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 (signature) Larry A. Stone 851 Ma aro Road (Street Address) Enola PA 17025 (City. State, Zip) °~Executed out of Register's Off ce Before the undersigned personally appeared the party executing this renunciation and certified That he or she executed the renur~ciati~~ for the, purposes stated within on this ~3 day of Yl U J c-~ 1~-c ~ z_ o - 0 =- No Pu lic M Commission Expires: n ~ ~' s ~a ~ ~ {Signature and Seal of Notary or other official qualified to .Administer oaths. Show date of expiration of Notary's Commission.) AAMON .:. EAL~H ~ PENNSYL ' . ... No~irial Seal Tma M. Robertson, NotaiY PubNc !seat Penr~sbao twp., Gxnbeti~td Canty ~y Cotrwnlssion ex~es Nov, t5, 2011 ~~~ii4~A~SCua~-af ~j-~to-yam y ~~ ., >~,_~ , _ ~ ,_41 RENUNCIATION 1 i re) Drenda M. Cordeiro 505 Leeward Lane (Street Address) REGISTER OF WILLS ~~~ ~1 CUMBERLAND COUNTY, PENNSYLVANIA ORrC~~S~1'~ rJ~,URT 21 1996-464 r;UP,.~~~'-~~ =.r.,~ , ~'~"~ , PA. ,Deceased Estate of CLARENCE C. STONE JR in my capacity/relationship as _ dau titer I, Drenda M. Cordeiro , of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M. McCartney ~ ~/D (Date) Executed in Register's Off ce Sworn to or affirmed and_ sy~bscribde y before me this t7 ~/U of ' Depu fy ro Register of Wills Form RW-06 rev. 10.13.06 Enola PA 17025 (City. State, Zip) Executed out of Register's Office COMMONIMEALTH QF PENNSYLVANIA trohrlsl Seal -- Laura L. Kennedy, PWiary Public Newberty Twp., York County ~. / ~ My Conxnisslon Expires Ftlb. 18, 2013 Member, Pennsylvan(a Association of Notaries Before the undersigned personally appeared the party executing this renunciation and certified that he or she execated the reiranciati~r for the ~,.,f-~i ~__. purposes stated wi of _ ~~~~~ (Signature and Seal of Notary or other official qualified to Administer oaths. Show date of expiration of Notary's Commission.) My Commission tJxplres: ~ ~ ~ ~ ~ ~- ~ ~ gCv - y t~f ~~ - ~.~i ~ c RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA 21-1996-464 ~, , C! ERK G~??~N~1~N`S ~CUF~T Deceased Estate of CLARENCE C. STONE JR. I, Lori A. Staub , in my capacity/relationship as daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Clarie S Smith and Susan M McCartn~._. ll130 /D (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 (Signature) Lori A. Staub 119 Center Street (Street Address) Enola PA 17025 (City. State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciati~for the purposes stated within on this __ j~_~_ day of `(1 ~Je r ~~ V ~~(.tl ~ Not y Public My ommission Expires: n ° ~ ' s ~'' ~ (Signature and Seal of Notary or other official qualified to Administer oaths. Show date of expiration of Notary's Commission.) Notarial Seal Tina M Robertson, Natary Ptf~Ac bast Penrrsboro Twp., (Axrtberland Ootmty My Commission E>q~ires Nov. 'F5, 2841 MhitOfNWEALTH OF PENIuSYL . ponnsylvania Association of G ~T~~ ~ ~, ~ ; ~~-~~- ~ ~i~~~ ~ ~. ~//~DD~ ~i V l! r ~JO ~~~o ~~~.~~ Glenda Farner Strasbaugh Register of Wills & Clerk of the Orphans' Court Kirk S. Sohonage, Esquire Solicitor 1 Courthouse Square, Room 102 (arliclP PA 17013 OFFICES OF Marjorie A. Wevodau First Deputy Wanda S. Zeigler Second Deputy (717) 240-6345 FAX (717) 240-7797 1-888-697-0371 x 6345 ~e inter of ~irf$ att~ ~CYer~ of t~je ®r~~au~' ~tCourt g QGouutp of c~umberlnub January 7, 2011 Susan M. McCartney 3 Beilman Court Mechanicsburg, PA 17055 In Re: Estate of Clarence E. Stone, Jr. Docket No. 21-96-0464 Dear Ms. McCartney: Enclosed you will find your receipt for C ount of $106 50 tPleas oaccept my $86.50 as well as your Check No. 18581n the am re ets for any inconvenience thanks for sending the check in the correct amount and my gr the error may have caused. If you have any questions or concerns, please feel free to contact me at 717-240- 6345. Thank you for your assistance in this matter. Yours truly, Glenda Farner Strasbaugh of Orphans' Court ., . __ _.. _ r.zr,i_ o_ n~,._+- SUSAN M. MC CARTNEY 3 BEII,MAN COURT MECHANICSBURG, PA 17055 ff 3 0 ~1BELC0 ~ - ~2~c~c~..t~-~...:._. COMMUNITY CRFDR UNION //R ---___~--- _-----__--_ MEMO ~ _., r.. n~ n en1`_ua LA SA so-8oss/2313 18 5 8 ~ Z ~ ~ /U DATE J REV-100°`(07-t0) ~ 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsyNania county Code veer Flle Number Bureau of IndlVidUel Taxes osr~arr,Ear ov aeveaue PO Box.2sosol INHERITANCE TAX RETURN 21 9 6 0 4 6 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 162 22 5144 11 28 1988 07 05 1928 Decedent's Last Name Suffix Decedent's First Name MI STONE JR. CLARENCE E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name STONE Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW Suffer Spouse's First Name MI ANNA T THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 1. Original Retum ® 2. Supplemental Retum ^ 3. Remainder Retum (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest compromise ^ 5. Federal Estate Tax Retum Required (data or deatnaver t2-t2-82) ^ g. Decedent Died Testate ^ ~ Decedent Maintained a Living Trust e. Total Number of Safe De (Attach Copy of Wllq (Attach Copy of Trust) posit BOxes ^ 9. Litigation Proceeds Received ^ t p, spousal Poverty credit taste or aeath 11, Election to tax under Sec. 9113 A between 1231-81 and i-1-as) ^ ( ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number FRANCIS A ZULLI 717 232 1488 r.~ REGISTER GILLS USE (~..Y ~~ ~ n First line of address "`CUU~ C'> ~ ..ry 10 9 LOCUST STREET ~~~rr ~ _, Second Ilne of address C~J~~ ~,=.'; o ~ ~` ~ T' .... =_ ~ City or Post Office State DATE tV ZIP Code HARRISBURG PA 17101 ~' correspondenrse-mall address: wzs~mindspring.com Under penalties of perjury, I deGare That I have examined this return, including accomparrying schedules and statements, and to the best of my knowledge and belief, it is true, coned and complete. Dedaretlon of preparer other than the pertsonal representative fa based on all information of which preparer has any knowledge. x~~, ~ • `7n~~,-, Susan M. McCartney ~~3~~ ADDRESS 3 Bei an Court, Mechanicsbu , PA 17055 SIG PRE. RERO THA REP E ATIVE DATE Francis A Zulli ~ ~ ~j D 1 Locust Stree , arrisburg, PA 17101 Side 1 1505610143 1505610143 ~^6 ADDITIONAL Personal Representatives Stone, Clarence E. Jr. SS# 162-22-5144 11/28/1988 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. 2 Signature Name Address City, State, Zip Date 3 Signature Name Address City, State, Zip Date 4 Signature Name Address: City, State, Zlp Date 5 Signature Name Address: City, State, Zlp Date 16 Signature Name Address: Clarie S. Smith 50 Dubbers Drive Etters 6-ice-~i PA 17319 City, State, Zip Date J 1505610243 REV-1500 EX Decedent's Social Security Number oecaaerresNeme: STONE, CLARENCE E. JR. 162 22 5144 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits 8 Miscellaneous Personal Pro a P p rty (Schedule E) ................ 5. 2 0 0 6 5. 6 9 r 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... g, 2 0, 0 6 5. 6 9 9. Funeral Expenses & Adminlstrative Costs (Schedule H) ......................................... 9. 7 , 0 6 6 . 0 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11_ 7 , 0 6 6 . 0 6 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 12 , 9 9 9 . 6 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has nat been made (Schedule J) ................................................. 13, 14. Net Value 8ubJect to Tax (Line 12 minus Line 13) ................................................. 14. 12 , 9 9 9 . 6 3 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .os 12 , 9 9 9. 6 3 15• 7 7 9. 9 8 16. Amount of Line 14 taxable at lineal rate X .06 16. 17. Amount of Line 14 taxable at sibling rate X .15 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..................................................................................................................... 19. 7 7 9. 9 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 96 - 0464 Stone, Clarence E. Jr. STREET ADDRESS 119 Center Street CITY Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) 0.00 (4) (5) 779.98 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 properly transferred :.................................................................................. ~ x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ x c. retain a reversionary interest; or .................................................................................................................. ^ x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ ^x 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death?......... ~ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ ^x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (I)]. For dates of death on or after Januarryy 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The stafute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax reffum 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 vaiue of transfers from a deceased chiid 21 ears 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 percent p2 P.S. §9116 (a) (9.2)]. (1) 779.98 0.00 Total Credits (A + B) (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 percent, except as noted in 72 P.S. §8116 1.2) [72 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 percent p2 P.S. G9116 (a) (1.311. A sibling is defined under Section 9102, as an individual who has at least one parent in wmmon with the decedent, ether y blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. ""D""~uTMOFVE""mv""a PERSONAL PROPERTY INHERRANCE TAX RENRN REBDFM DECEDENT ESTATE OF Stone, Clarence E. Jr. FILE NUMBER 21 - 96 - 0464 Include the pproceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of aurvivorshtp must be disclosed on schedule F. ITEM ~ DESCRIPTION I VALUE AT DATE OF NUMBER DEATH 1 Celotex Asbestos Litigation Net Settlement Proceeds. Funds recieved April 6, 2011. See attached disbursement statement. 20, 065.69 TOTAL (Also enter on Line 5, Recapitulation) ~ 20,065.69 Sq-EDULE H FIA~LD~ENSES& coernoNwEaI.TN ov vENNSV~vnNw MHERITANCE TAx RETURN ArY11NaCTQA~ /~/1C'R~ RESIDENT DECEDENT r~r~~~ ~v ~ ~ v~ ~7 ~ ~7 FILE NUMBER ESTATE OF Stone, Clarence E. Jr. 21 - 96 - 0464 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Sillivan Funeral Home -Funeral Services 4,188.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Wion, Zulli and Seibert - Francis A Zulli 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Anna T. Stone (before 1995) Street Address 119 Center Street city Enola state PA zip 17025 Relationship of Claimant to Decedent SpOUSe 4. Probate Fees Register of Wills Register of Wills -Letters of Administration Register of Wills -filing fee 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7, Other Administrative Costs 1 Vital Records -Death Certificate 650.00 2,000.00 29.00 86.50 15.00 18.00 TOTAL (Also enter on line 9, Recapitulation) 7,066.06 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Sd~ckde H Funeral E & ~W~ ESTATE OF Stone, Clarence E. Jr. FILE NUMBER 21 - 96 - 0464 Clarie Smith -Travel expenses 79.56 Page 2 of Schedule H REV-0610 EXr (11-08) SCHEDULE J COMMNHERIraNCEOTnx RETURNANw BENEFICIARIES RESIDENT DECEDENT ESTATE OF Stone, Clarence E. Jr. I FILE NUMBER 21 - 96 - 0464 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not Llst Tnutae(s) SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) I, TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X118 (a) (1.2)] 1 Anna T. Stone Wife Entire Estate 119 Center Street Enola, PA 17025 Enter dollar amounts for distributlons shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. ~ NON-TAXABLE DISTRIBUTIONS: ~ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ O.OO r , )I'.. f" ..LJ '~_'..1 .. ,. r~ ~~ ~: ti. LAST WILL ANd TESTAMENT Ci=,~ ~', j~~' :~t~~,~ T I, CLARENCE 8. STONE, JR., of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby declare this to be my Last Will and Testament, hereby revoking any and all Willa or Codicils in the nature thereof by me at any time heretofore made, thus disposing of all my estates ITEM I: I order and dizect that my just debts and funeral expenses be paid as soon after my decease as may be convenient. ITEM Ixs I give, devise and bequeath all my estate, of whatsoever nature and wheresoever situate, both real and personal, unto my wife, ANNA T. STONB, if she shall be living at my death. ITEM III: In the event that my wife, ANNA T. STONE, does not survive ma, then I give and bequeath my estate in equal shares to my children. ITEM IVs I hereby nominate, constitute and appoint my wife, ANNA T. STONE, as Exeautrfx of this my Last Will and Testament. IN WITHE&3 WSEREOF, I have hereunto set my hand and seal to this my Last Will and Testament this 12th day of February, 1984. (SEAL} Claren E ton Jr. . ~., Witness: ~ , ~tc-<-~, ,~1" ~r~ Motle R:ice y ATTORNEYS AT LAW April OG, 2011 Clarie S Smith 50 Dubbers Dr. Etters, PA 17319 Re: Halliburton - Clarence E Stone Jr. (MRID: 029603.000) Dear Ms. Smith: Enclosed please find a check(s) which represents the net settlement in the above 11000IendonAve.,l4thfloor referenced case. Zhe enclosed disbursement statement indicates the breakdown of Los Angeles, CA 90024-3503 this settlement. If you have any specific questions regarding the distribution of the o. 310.500.3540 settlement, you should consult with your estate attorney. f. 310.824.2870 Please be advised that there is no guarantee that the amount listed in the Release was 2a Bridgeside Blvd. actually paid at the payment percentage indicated in the Release. The Trust has the Mt. Pleasant, SC 29464 authority to change the payment percentage at anp time prior to the Trust receiving a o. 843.216.9000 signed release. f. 843.216.9450 If you have any questions ox need additional information, you may call me at 321 South Main St. 843.216.9094 or send E-mail to kesmith@molleyrice.com. Providence, RI 02903 o. 401.457.7700 f 4 Sincerely yours, . 01.457.7708 ~rsten E. Smith One Corporate Center 20 Church St., 17th Floor Kristen E. Smith Hartford, CT 06103 Settlement Paralegal o. 860.882.1681 f. 860.882.1682 KES/pb ?75 Seventh Ave., 2nd Floor New York, NY 10001 o. 212.577.0040 f. 212.577.0054 320 Chestnut St. Morgantown, WV 26505 o. 304.413.0456 f. 304.413.0458 1000 Potomac St., Ste. 150 Washington, DC 20007 o. 202.232.5504 f. 202.232.5513 'Motley Rice LLP operates the Ca6farrua office. www.motleyrice.com .®r. 20091016T02P132 DISBURSEMENT STATEMENT Clarence E Stone Jr. SSN: 162-22~5144 MRID: 029803.000 MANUFACTURER'S SETTLEMENT Case: Clarence E Stone Jr., deceased Defendant: Halliburton Total Gross Settlement: 0.00% $0.00 0.00% $0.00 100.00% $30,504.50 0.00% $0.00 $30.504.50 Allocation of Settlement Proceeds LINng Consortlum Surv(val Wrongful Death Attorney's Fee 33.33% Total Attorney's Fees: $10,168.16 Total Expenses: $270.65 Total Fees and Expenses: 3 1 Less Lien(s): Interest Paid: $0.00 Net to Client(s): $20,065.69 Net: Clarence E Stone III 100.00°~ $20,065.69 Total Settlement Payout $20,065.69 I am the Representative of the Estate of Clarence E Stone Jr.. I understand that I am receiving these funds in my capacity as Representative, and that I am requ(red by law to distribute these funds in accordance with the laws which govern this estate. I understand that my attorneys may crontinue to attempt to secure other and further compensation for me from other partles who may prove to be responsible. However, I also understand that such additional compensation Is contingent upon settlement with other parries and is not included in this disbursement unless expressly stated above. I have read the above statement and am fully satisfied with the handling of my claim and the expenses incurred In the pursuit of this settlement. I assume responsibility for any liens not referenced above. Motley Rlce LLC does not practice taxation law and cannot advise you about the potential tax implications of these settlement proceeds, if any. We do however, recommend that you consult with your tax advisor with respect to your settlement proceeds. By cashing or depositing this check(s), I acknowledge my satisfaction with the handling of this claim and agree with the disbursement statement regarding this settlement. Date Generated: 04/05/2011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1 7 1 2 8-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 014586 SMITH CLARIE S 50 DUBBERS DRIVE ETTERS, PA 17319 role ESTATE INFORMATION: ssN: ~s2-22-5~aa FILE NUMBER: 2196-0464 DECEDENT NAME: STONE CLARENCE E JR DATE OF PAYMENT: 06/16/2011 POSTMARK DATE: 06/14/2011 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /28/ 1 988 REMARKS: RECEIPT TO ATTY SEAL CHECK# 502 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5779.98 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: 5779.98 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~,,npMM ./Y//J/{~LrA'W OFFICES ~i~f ~' V v ~ ~ ~""'~~ DgVID A. WIpN FRANQS A. ZULU P.O. Box 1121 HARRISBURG, PA 17108-1121 JEAN D. SEIBERT SHELLYJ.KUNKEL "------------------ 109 LOCUST STREET HAwGSeURG,PA17101 , (717) 236-9301 (717) 232-1488 FAx (717) 236-6100 EMAIL: WZS cr MINDSPRMG.COM Register of Wills Cumberland County Courthouse 1 Courthouse Square, Room 102 Carlisle, PA 17013 Dear Register of Wills: June 14, 2011 Re: Estate of Clarence E. Stone, Jr. No. 2196-0464 113 E. Mq~ STREET HUMMELSTOWN pA 17 (717)566-2501 Enclosed please find a Pennsylvania Inheritance tax return for the above me ' Also enclosed is a check made payable to your office for the filing fee in the and a check for the inheritance ~ in the nhoned estate: return in the envelope provided. ~O~t of $779.9g amount of $15.00 Kindly stamp our file copy and Thank you for your attention to this matter. FAZ/dm Enclosures V ~-~ m G _ ~? ~.'' cn -9 ~~~ ~ ~ - i~a n =~ ~ ~~ "P~ IR E r ~- ! ~+ ~~ ~ ~~_ P ~" ~= e ~~ y r , a°. S~3iJ. Mn .i ~, ,_ • ~.~v~ t~~~ i~~~~1 7n ~~71 .. ~ ~~~ Lr '~7il~ilNlt; .' I:tJ C1.ERt( OF ~~ F~ ~r~ ~,'~i~~ ~~ Q ,~ Pennsylvania ~- ~ ~•. ~~ DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL ~A•XE~ I ~ INHERITANCE TAX REV-1607 E:X AFP (12-10) INHERITANCE TAX DIVISION ~;f_.- '_:.~.5 TA T E M E N T O F A C C O U N T PO BOX 280601 -~-- ~ - HARRISBURG PA 17128-0601 ,~'.j_ :_~~} ~ ... ~. DATE 07-18-2011 ESTATE OF STONE JR CLARENCE T CL~`,f~ (J~ DATE OF DEATH 11 - 28 - 1988 ~~j~~~~~K~~S v~~RT FILE NUMBER 21 96-0464 FRANCIS A SAJ+L~L~RI_~R'~n ~'~" PA, COUNTY CUMBERLAND ACN 101 109 LOCUST ST Amount Remitted HARRISBURG PA 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP C12-10) *~* INHERITANCE TAX STATEMENT DF ACCOUNT ~** ESTATE OF:STONE JR CLARENCE T FILE NO.: 21 96-0464 ACN: 101 DATE: 07-18-2011 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-26-2006 PRINCIPAL TAX DUE: 00 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-14-2011 CD014586 ~ .00 TOTAL DUE 779.98 TOTAL TAX PAYMENT ~ 779.98 BALANCE OF TAX DUET 779.98CR INTEREST AND PEN. ~ .00 ~ IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION DF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 779.98CR - rs~y r ,...~- ( ~ Pennsylvania ~ . r~ , -. y- r} r. ~ DEPARTMENT OF REVENUE ~- t ~I~HE~RT~Tl1NdE TAX REY-1607 Ex AFP az-lo) BUREAU OF INDIVIDUAL TAXES STATEMENT OF ACCOUNT INHERITANCE TAX DIVISION PO BOX 280601 (~ ~ !`;C HARRISBURG PA 17128-0601 C~E~., U` ^~ n^+, r i T 10-11-2011 O~it'~ I!i~`a S ..0~•;~ i DATE -~"~~~, h~i'"? ~;ir; k.~ STONE JR CLARENCE T G~jP~~~~C,`~~ r~~~~~. _ ESTATE OF FRANCIS A ZULLI 109 LOCUST ST HBG PA 17101 DATE OF DEATH 11-28-1988 FILE NUMBER 21 96-0464 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 1701.3 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALON6_ THIS LINE ~_- RETAIN LOWER PORTION FOR YOUR RECORDS _ ~ _ _ ~EV X1607 EX AFP C12 10) ~~ ~ *** INHERI~'AF~CE TAX SfATTEMENT OF~ACCOUFIT ~***~~~~~ ~ ~~•••••^•• • ESTATE OF:STONE JR CLARENCE T FILE N0.:21 96-0464 ACN: 101 DATE: 10-11-2011 THIS STATEMENICATIONDOF ALLRPAYMENTS~,STHE CURRENTTBALANCEINANDE IFMAPPLICABLE,BALPROJECTED INTEREST FI6UREINCIPAL TAX DUE, A~~l DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-26-2006 .00 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX PAYMENT .00 .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. TOTAL DUE ~ .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~(~~~~~~~'~_' ~- d • _ ; ;r pennsylvarna ~ BUREAU OF INDIVIDUAL TAXES ~ ~ ~ANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION ~~'~~ ' '' ~ N ;• PO BOX 280601 `, s TAT E ~ 0 F ACC 0 U N T REV-1607 Ex AFP clz-lo) HARRISBURG PA 17128-0601 `F~~~~Li'~~f'7 ~~~~'~' 0~ DATE :LO-17-2011 ESTATE OF STONE JR CLARENCE T ~~'~'~'~ ~~~ DATE OF DEATH 11-28-1988 ~RPFI~~~'+~ l.l~~~~'j FILE NUMBER 21 96-0464 CUPdli~it: -+~ ~~'~'~~ ^t~ , P,q COUNTY [:UMBERLAND FRANCIS A ZULLI 109 LOCUST ST ACN 501 HBG PA 17101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE _ ~ RETAIN LOWER PORTION FOR YOUR RECORDS _ ~EV 1~a7 E;C AF~~ (12 l~a~ ~~~~~°** INHEFF{~AI~CE Ti~X S~A~EMEN~~O~~~A~COU~IT ~~ ~~~~~~""""•""•• ESTATE OF:STONE JR CLARENCE T FILE NO.: 21 96-0464 ACN: 501 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARAYTOF THE PRINC IPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-11-2011 PRINCIPAL TAX DUE: 779.98 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DATE NUMBER 06-14-2011 CD014586 DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID .00 779.98 TOTAL TAX PAYMENT 779.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.