HomeMy WebLinkAbout96-00386
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PETITION FOJ{ (;J{ANT OF I.ETTlmS OF ADI\IINISTI(ATlON
I::"'I/t' of __!l'l'H\flm W. G1U!EN
ul,\'O klloWIl liS
38&
No.
10:
21-96-
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Sociul S<'<'lItity 1....0. _ '~_I_O_:-__ .,. 0 r l"
Rcg;'.I'" "I Wilh '0' Ihe
C"lII1IY "I Cumberland __ ill Ihe
('lHllllhlll\\l'alth of Pl'lIl1'yh'illlia
The petition of till' ulllll'l'.i!!nl'd 1l'\pl'l'll'lIl1y Il'llIl'WIIl\ Ihill:
Your pelilioner(\), who blare IX Yl'ar~ of age 01 nlder. applies
_ for klter\ of mllllilli\tmlion
__~__u_.__~__ 011 the e\tnll.' of
hl.h.n.; rclllkllh.'lill.'; dlll,IIlIl.' alht'llli;l; dlll,lILl": 1111Ih1Ilt;ltl.'I
Ihe ahove deeedelll.
()ecendenl 'Vi" domidled OIl dealh ill__QlJlllb_crla_nd _ . m _ ('Ollllll". I'enn'ylvania. with
h is 101'1 family or prilldpal re,idc,,,"e ill _ .i!l.!!..\V_cst OldYor~_Road,J~arlisle, Pa. .
lit\! \111.'1.'1, 1l1ll11hl'r ,,"d 1II1111KIJlaljl~'
()ecendelll. Ihen 21 yea" 01 age. died ___ Muy.4, .. __________. 19J!6_.
OIl North Middleton TOWl!~!1iRJ_QUlIJ.Q.e_rllU}!tC:9untYJPa.
Dcccllllenl at ueath owncupropcrty with eMil1l;lIed valuc, <1\ folllo\\.,:
(If domiciled in POI.) All pe"onal properll"
(If nOI domidled in POI.) I'e"onal properll" in I'enn'yl,an;a
(If nol domidled in POI,) I'e"onal properll" in Counly
Value of real eSlate in Penn'ylvania
situated as follows:
s __uncstimatcd_
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PelitionerL.. ufler a proper ,earch ha__ a,cerlainedlh:u de~edenlleft no will and was survived by
Ihe following spouse (if any) and heirs:
Name Rclalioll\hip Rc,\iuclll.:c
D. WilIimlLG.re_cn______ __Eather____.
Linda ~G.r.e.l1n ___ _MotheL______
499_W..Dld...Yorklld.._Cactisle, Pa.
499-JV..Old...York.Rd...Carli.s1e, Pa.
THEREFORE. pelitioner(,) rc.'pcClfull)' leqlle'I(" Ihe gran I of lelle" of ",Iministralion ill Ihe
uppropri:ue form 10 Ihe unde"igned.
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D. William Green
499 W. Old York Rd.
CarlisleL~A 170ff---------
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OATH OF I)ERSONAL RElIRESENTATIVE
COMMONWEAl,TH 01" I)ENNSYl,V ANIA
COUNTY 01" CUMIlEHt.ANIl
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The petitioner(s) lIbove.named swellr(s) or affirm(s) that the
statements in the foregoing petition nre true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representalive(s) of the abovc decedent pctitioner(s) will well and
truly administer the cstatc according to law.
Sworn to or affirmed and subscribed J #: /;!U~et;_ /..t-a~
beforc me this 9TH day of ' /1<--/<<- C 2t!L<"-
a -, 19 6.,,-.
{. L'. iJ1 - 711\:'~ rr, t .
MARY C. LEWIS Register (L 1'J
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No. 21-96- 386
Estate of
Steven W. Grecn
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW MAY 10. 19~, in consideration of the petition on
the rcverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that D. William Green and Linda C. Green
is/are entitled to Lctlers of Administration, and in accord with such finding, Letlers of Administration
are hercby granted to D. William Green and Linda C. Green
in thc estatc of Steven W. Grecn.
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FEES
Letlers of Administration ..... S 50.00
Short Certificates(2 ) . . . . . . . . .. S h no
Renunciation................ S
JCP S S 00
TOTAL _ S 61.00
Filed.... M.~~ .J.Q,........ A.D. 19.22-
Called attorney on 5-13-96.
Frcy and Tiley
13y Robert M. Frcy #06274
A TIORNEY (Sup. Ct. 1.0. 1'10.)
5 S. Hanovcr St., Carlis1c, P A 17013
ADDRESS
717-243-5838
PHONE
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
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405 Fa1rway Drive
Mech:mic9hur , PA 17055
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Radio Shack Credit Card Plan
PO Box 7004
Sioux Falls, SD 57117
:June 21i, 1991i
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Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
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IN CIRCUIT COURT
SS#: 190-~i ~-...
File Numbe : 21-96-386~
County of Cumberland iu, COllrt
:N THE MATTt:H OF ThE ESTATE m""----------.
Steve Green, Deceased
Proof of Claim
State of Pennsylvania
STATE OF South Dakota
COUNTY OF Minnehaha
Kim Richardt, being duly sworn, deposes and says that the amount
of the annexed claim against the estate of Steve Green,
deceased, marked Exhibit "A", is justly due and owing to said
claimant, Radio Shack whose post office address is PO Box 7004,
Sioux Falls, SD 57117 that no payments have been made thereon which
are not credited upon said claim, and that there are no offsets or
counterclaims against the same to the knowledge of claimant or
affiant.
Acct# 7738-1559-0102-6
* See attached sheet
Balance $368.33
IALn. (~1l1IJ('-I'CU
before me this ,;;t:. P day OfY-u>tJ?) lift.
My Commission EXPires:7)(dI,.I../.~?,r;,;1a;/
Subscribed and sworn to
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(Nam Offlce) ,
The within claim was presented to me for allowance
19 and
,19 ,allowed by me for
of the Estate of
dollars.
Deceased.
Allowed and approved by me
19 ,at the sum of
Dollars.
Judge of the Circuit Court
Radio Shack credit card plan
PO Box 7004
Sioux Falls. SO 57117
June 26. 1996
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D. William Green
499 W. Old York Rd.
Carlisle, PA 17013
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proof of Claim
State of Pennsylvania
County of Cumberland
IN THE MATTER OF THE ESTATE OF
Steve Green, Deceased
C.i
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IN CIRCUIT COURT
SS#: 190-68-2965
File Number: 21-96-386
Judicial Court
STATE OF South Dakota
COUNTY OF Minnehaha
Kim Richardt, being duly sworn, deposes and says that the amount
of the annexed claim against the estate of Steve Green.
deceased. marked Exhibit "A". is justly due and owing to said
claimant. Radio Shack whose post office address is PO Box 7004,
Sioux Falls. SO 57117 that no payments have been made thereon which
are not credited upon said claim, and that there are no offsets or
counterclaims against the same to the knowledge of claimant or
affiant.
Acct# 7738-1559-0102-6 ~alance $368.33
. See attached sheet j/JI m EJI cnrlfCU
Subscribed and sworn to before me this .;JC:, ~ day of a/fit cJ 199C.
n~.J (J. -m t'::.'d;/. ~ My Commission Expires :m,1_'1?:L -P \~ .;100/
(N~meO'llooffiCe) , l (J '\' ~
The within claim was presented to me for allowance
dollars.
19_ and
. 19_, allowed by me for
of the Estate of
Deceased.
Allowed and approved by me
19 . at the sum of
Dollars.
Judge of the Circuit Court
PO lJOX 8367
GR/w'rN 3'/615'036'/
11/\010 SII/\CK
A1afl'e/llaelt.
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Sf'ORS"
P\nil5U wnd lop 1l01'l~n 01 s!alOmont with p.1yn"l1l11 III ollclo!ood onvolOPo
New Oalanel Account Numb.r Pl.... Wlit. amount
01 paymentenclo..d
Total Payment OUI PaI,OUI
thl.lt.lemenl Amount
Payment
OUIO.ll
$
;13.00 11.00 NOW DUE 368.33 7'/38 1559 0102 6
P.'lyrnonlS rocolved olltlo oolow ,",'Iling addloss 001010 1,00 P'" Will lxl Clll<tI!OO \0 yOlll accolln' as 01\110 dalo ollo<:olpl
P,lnl address and 1010phOoo numbel changes t>olow oW chock. bol
35
685 007
R,\Dro SI!t\CK
PO lJOX 182218
COLUMlJUS OH 43218-2218
STEVE GREEN
499 W OLD YORK RD
CAIlLISLE PA 17013.7503
DDD77381SS9D1D2bDD3b833DDDllDDDDD23DD
for InqUllicS regmding your billing stalemon!. call betwoon 9 am. 5 pm (M.F):
.
800 ~ 767.4, 556 Soo billing rights summary on reverSe side.
Account Number
l}ne 01 Credit
C,.dlt
Avail.blt
Cays In
Billing Cycl.
Statement
Closing Oal1
Payment
OUIOal1
Tolal paym.nt Out
this atat.m.nt
7738 1559 0102 6
NOW DUE
23.00
Activity Slnc.last Statem.nt
Amount
Sale
Oal.
Post
Dale
Ref.renc. Number
6.58
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0527 0527 00000527000127520 lJILLED 'FINANCE CHARGES'
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361.75 0.00 0.00
An a.mounlloUowod by a minus sIgn H 15 n crodlt 01 clc<1I1 balanco.
0.00
0.00
6.58
368.33
AMOUNT DUE INCLUDES A PAST DUE AMOUNT.
PLEASE PAY THE ~IT DUE NOW. IF PMT HAS
BEEN MADE PLEASE DISREGARD TillS REQUEST.
Send NollCO 01
biUlOg CflOIS 10:
PO BOX 8181. GRAY TN 37615-8181
2_ AverageDa.t~
Oa1anceOl
Cullen!
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Which"""
ANNUAL
PERCENTAGE
RATE
d
361.75
the Fina!lclII whoch is an
Charge It ANNUAL
delermoned b~ PERCENt AGE
~tJ,ng.,
n1Dnlhl~ p.lllod,e RATE
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10 Ihalp.,"
(llhell.,l.\nce
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62..03.1020.... 2,"Q.t
'Notlc.: Selllllll~erse side 101 impCIrl"lII tnlolm.1l.on
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fon'" 9~-'O. C. blVlSIOIl
IN THE COURT oP COMMON PLEM;
.., Of...
cumberland COUNTY, PENNSYL V ^NI^'
onrl-l^NS' counT DIVISION
IN nF.: f'$rNm
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Steven W. Green
Acct No. 4250_432-988-332
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In.1r)( oml ",olin "rollCI' .1Ilry ill linnI' "Ificilll fl'COfll~ 01 the dohn or..............................................
First.Card Services. Inc.
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Carlisle. PA 17013
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1\1..96
D. William Green
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w.illtn IIn'ifr of thi~ Chl;1I' \l'1I~ ~ivl'" ,".
499 W. Old Y~rk Rd. Carlisle. PA 17013
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Notarv PubliC. Stine 01 New York
01CL5012164
aU81iliod In ~ultolk Coun"tn
comml'iSion Ellpires June 16,'\'9'-
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4 50 432
l nRSTCARO~
968 332
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....-.nun New
0... Pllyn'"llll Due Blllllnce
6/03/96 100.00 4.807.0&
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4250 432 ~ 332
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STEVEH M GREEH
499 MOLD YORK RO
CARLISLE PA 17013-7503
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~2~D~3~988332000 48070&10000
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1037400172E02 ~AVKEHr - THAHK V~V FOR YOUR PAV;,EKi
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PROTECT VOURSFLF AGAIMST UHEK~LoY"E~ ... ACCIOEHT ... tLLHESS ...
FIRST CARD GUARC CAK llELP. EllROLL HOIl K. IH11 JAL:'1G THE TO,' PORTIO" OF
YOUR STATEKtHT. SEE EHLLOSEO I"~ERT fOR DET~!L~.
. . . .
LET US SEIIO YOU A"O~I:tP. C~RO FOR SC,KEU\lE IH VO:.1 HC\ISr.hI)L~',
JUST fl~L O~T THE EHrLOSEP fORK AHO ~E"~ Ir q~tK TODAY -- YOUR A:~ITI~AL CA~
MILL U~ OH THE NAVI
. . . .
HELP OUR 1996 OL VMPIC ATHLETES !i0 fllR THE GOLI':
SEE THE [HCLoSEo OLVMPIC IHSERT.
. . . .
DOH" q[ TaE ~~,: ViCTIM OF CREOiT CRIKE. PROTECT YOURSELF BY EHROLLIHO
IH CREblT Ct.RD . J.1fl JHEL. SEHTI"r.~ IIlLL PROTECT EVER" C:lEDIT. nEon. AHD
AT" CA~ YOU HA~t. TO EHROLL A~D RECEIVE A FREE GIFT. SEE [HlLOSED IHSERT.
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"'z
8~
J5-/LiI-"
,,~<~\Yro
.~5?..,...
COMMONW(AIHt Of PINH~YlVAWA
(J(rAIl:1MINl 01 RI\lWU(
OIPI 180Ml
ttARRI~8.UR,!! _PA "_l_~~ ~bOl. _
Ol<lt}ft.t~ UAMIIIA~l.II""T, .ulU ",,01111 INtllAlI
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
fOR OATIS Of DEAtH AnER 12/31191 CHECK HERE
If A SPOUSAL I '
POVERty CREDit IS CLAIMED I I
filE NUMBER
21-!lli-:!8li
COUNty COOL YlAR
GHHHN STHVHN W. 4!l!lW. Old York Hood
!>o(iiiMCullllj-;ru-M"li-~--'-'--- --~ -\IlATl 01 DIAl" ]IlA1I or ~1111l . - - Curlislc, P^ 17013
"I.gg~~~,:~~;?"~","", ,;o~."",,,-.,,~:~~ ,,?,~.} !l!lr'o("l~~<~~;' !,~~!.~~ 4 (~"] '~O:)~~'~~~~D~~' ~'\l'~~'~~: ____
lJICltllw",(U",rlllt AllO.I....
I 3
1]5
~8
Romainder Relurn
(far dale' 01 death prior 10 12.13.82)
Fodoral E'tate To.. Return Required
Ix 1
I I 2
Supple menIal rteturn
Total Number of Sole Depa'it Bo..e,
COM-PU1f MAlLltlG ADOIUS
5 S. Hanover Street
Carlisle, PA 17013
(11 _ ----~--------
(21 ___------
131
(41 ----------------
(51 _________13,790.74 ---
(61-----------------
(71---------------
(81-.--
13,790.74
[] 4. limiled Estale [] 40. Fulure Interost Compromise
Ifar doles of dealh alter 12.12.821
o 6 Decedenl Died Teslale r.-j 7. Decedent Maintained a living Trust
(Allach copy of Will) IAlla(h copy 01 Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO,
Original Return
tlA.M(
Frey and TIley
IIUPHOtH NUMIIR
717 1
243-5838
(91 _____!!1.,~tQ9--'-OlJ...
(101 _______________.
_____ .--!.Q.,309.~
. _' __J.!.,_5}_8~ 26)__
z
<>
;::
:5
:>
~
a:
'"
u
w
'"
1. Real Estate (Schedule A)
2 Stocks and Bonds (Schedule B)
3. Closely Held Stock/Parlnenhip Interest (Schedule C)
4. Mortgages and Nole' Receivable ISchedule 01
S. Cash, Bank Deposih & Miscellaneou, Perlonal Property
(Sch.d,l. E)
6. Joinlly Owned Property (Schedule F)
7. t,on,I." IS<h.d,l. GI(Sch.d,l. LI
8. Talal Gran Auet' (total line' 1-7)
Q. Funeral Expenses, Administrative Cast', Miscellaneau,
hpenses (Schedule H)
10. Debh, Mortgage liabllitie" lien, ISchedule I)
11. Total Deduction' (tolallines Q & 10)
12. Net Value of Estale (lino 8 minus line 11)
13. Charitable and Governmental Bequest' (Schedule JI
14. Net Value Subject to Ta..lline 12 minus line 131
15. Spousal Transfen (lor datu 01 dealh alter 6.30.Q4)
See In,tructions for Applicable Percenlage on Re....etse
Side, (Indude values 'rom Schedule K or Schedule M.I
16. Amount of line 14 laxable at 6% role
(Indude value, from Schedule K or Schedule M.I
17, Amounl of line 14 taxable at \5% rate
{Indude values from Schedule K or Schedult'l M.)
18. Principal tax due (Add tax from lines IS, 16 and 17,)
1 Q. Credits Spousal Poverly Credil Prior Paymenh
(111
(121
(131
(141
--.----.. ----- -------._-------~._---
(~,518~2_6)
z
"
;::
'"
~
:>
~
'"
"
u
'"
'"
~
_.__.~_._------- +
(151 _______ ____ _.__K.__.= --------------------
(161
K .06 =
--.-----.- .--. -.--,...-.- --.----
(171
_ __ X
15 =
(181
Oi"aunl
Inlere,1
+.-
(191
(201
20.
Utine lQ is greater than line 18, enler the difference on line 20. this is the OVERPAYMENT.
Ii! 0 _1iI:TT.I!'II il7a:I1aTI.l'. .1 f .. '_1.111." 1I11!....,Itrr:'r.l'=1.a.l.II'..lTl u ~.",I.ltl
21 If line 18 i, greater than line lQ, enter Ihe difference on line 2\. This is the TAX DUE.
A. Enter the inlercnt on Ihe balance due on line 21A
B Enler the tolal of line 21 and 21A on line 218. Th;s is the BALANCE DUE.
Malee Check Pavable to: Register of Wills, Agent
(21)
121AI
(21BI
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -;;c: -<-----
Under penaltil!' of perjury. I dedare thai I hove e..amined this relurn, including accompanying schedules and ,talemenh, and to the be,' 01 my knowledge and belie!.
il i, Irue, correct and (omplete. I dedare Ihol all real o\Iate has been reported at true mor~el value, Declaration 01 preparer olhe, Ihan Ihe personal rf'pre\enlalive is
based on alllnlormolion of which preparer has any knowledge
~lGUAiuilOTi'-{i~olT'lIlspomialt 1011 HtltlG--rrluirj----~-A."h[iRl..!l-- -- -- ---~- ._--,-~"--. - ----"' - - - _n_~"___.___ ,. --,-- -~..-.-- OA:fi. --- ..------ . ---.--"-
)( :. {/ I
_~_j~.._ L{-'.........._~.,____..:;~'-,_. . . _ 499 W._OId York_Rd., Carlisle, PAl 7013 Sepl'u8',1997
!tIC.tjA1URf 0' PllfPutl OlIHlIltIAt.lIlIFlf':iolr.1AII,'! A(1l)llt~.. DAll
__~~-<=hf. Yn9 5 S'n\lO~lover St.,Carlisle,I'A 17013 sept.l~1997n
IIV '~l' II. I' Itl
ESTATE OF
ITEM
NUMBER
"~i..i?},,
_:{/iU"
COMMONWfALHt or PfNNSYlVANIA.
INIt(lIII"NCE lAX A[tUIIN
IIfSIDfNI DfCfDfNI
STEVEN W. GREEN
1.
A. Funeral Expense..
B.
1.
2.
3.
4.
C.
1.
2,
3.
4.
S.
6.
7.
8.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
I Ploase Print or Typo
FilE NUMBER
DESCRIPTION
21-96-386
_--1_________,______ __.____..
I AMOUNT
Hoffman-Roth Funeral Home, funeral services
Westminster Cemetery, cemetery lot
Westminster Cemetery, grave marker
Carlisle Memorial Service, Inc., vases for grave
5,640.00
3,500.00
2,712.00
130.00
I
Admlnlstratlvo Cosll:
0.00
Personal Representative Commissions
Social Security Number of Personal Reprosontotive:
Year Commissions paid
Family Exemption
D \V'!l' d L' d Green
Claimant . I IB m an In a Relationship
Addross of Claimant at decedent's dooth
499 W. Old York Road
Allorney Foes
Street Address
City
Carlisle
Probate Fees
750.00
Parents
3,500.00
State Pa. Zip Code 17013
61. 00
Miscellaneous Expense..
Register of Wills, 2 short certificates
6.00
Register of Wills, filing Inheritance Tax Return
10.00
TOTAL (Also onter on lino 9, Recapitulation)
(II more space Is needed, Insert additional sheets 01 same size.)
5
16,309.00
I(v.UOIlh IU11
~.,~.~(\
~ff/}j,;
COMMONWEAlTH Of PfNNSYlVANIA
IHHIIITANCE 'AX IETUIN
IlSIDfN' DICIDINr
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plooso Prinl or Typ.
filE NUMBER
ESTATE Of
STEVEN W. GREEN
21-96-386
CAli prop.f1y lolnlly-own.d with th. RIght of Survlvorahlp mUlt b. dllClo..d on Sch.dul. F)
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
1
l
.1
"
ij
i
!
i
i
DESCRIPTION
VALUE AT
DATE OF DEATH
Deposit to passbook savings account on May 6, 1996
Bal. Farmers Trust Company account # 6-016577
Accrued interest to May 4, 1996
Balance Farmers Trust Comopny checking account #001161873
Deposit to checking account
ReCund or unused premium, Progressive
ReCund oC unearned premium, Consumers LiCe Insurance Co.
BeneCl ts, Consumers LiCe Insurance Co.
CoreStates Bank, proceeds liCe insurance
Cancellation oC insurance premium, Ford
ReCund
CoreStates Bank, proceeds life insurance
Tax reCund
Tax reCund
1992 Honda TRX, poor condition
100.00
325.00
.34
1,281.67
149.30
644.00
10.14
91. 99
8,408.24
202.79
11. 77
1,712.07
203.43
50.00
600.00
TOTAL (Also .nler on line 5, Reeo ilulotion) S
13 790.74
(Atlach additional BY!" )( 11" .heett if mo,e tpace h needed.1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
. ;!J k"'.{. 1/
. BUREAU OF IHOIVIDUAL TAXES
tHtll:RIUHC[ tAX DlvISIO..
OCP1. Z80b01
HARRISBURG, PA "1~8'Q'OI
HOT ICE OF IHHERITAHCE TAX
APPRAISEHEHT, ALLOWAHCE OR DISALLOWAHCE
OF OEDUCTIOtlS AHD ASSESSHEHT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-22-91
GREEN
05-04-96
21 96-0386
CUMBERLANO
101
FREY 8 TILEV
5 S HANOVER ST
CARLISLE
PA 17013
Anount Renltted
,,-
~5~.
.~.
, ':"'il.
w
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 ~
iiEV:iS4j-EiCAj:-p-[Oii:97Y-HOTiCE--OF-YNHE'RiiANCE-TAX-jiPiiiIAisEHEHT-;-ALLOWANCE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
STEVEN W FILE NO, 21 96-0386 ACN 101
ESTATE OF GREEN
I ACCEPTED AS FILED
TAX RETURH WAS' (
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. (Schedule A)
2. Stack. and Bonds (Schedule 8J
3. Closely Hald stock/partnership Int.r..t (Schedule C)
4. Hartgag../Hot.. Receivable (Schedule DJ
5. C..h/Bank Deposits/Hi.c. Parsonal Property (Schedule EJ
O. Jointly Owned Property (Schedule fJ
7. Transfars (Schedule G)
e. Total A...ts
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.ral Expanse./Adn. COlts/Hisc. Expans.' (Schedule H)
10. Debts/Hartg.g. Liabilities/Llans (Schedule 1)
11. Total D.ductions
12. H.t Va1u. of Ta_ R.turn
13. Charitab1./Goyarnn.ntal B.qu.sts; Hon-.1.ct.d 9113 Trusts
14. N.t Va1u. of Est.t. Subj.ct to Ta_
f1,.~h' It." ,:' "1
STEVEN
( X I CHAHGED
SEE ATTACHED
DATE
12-22-97
NOTICE
III
(21
(31
141
(51
1&1
(71
.00
.00
.00
.00
3,670.43
.00
.00
(81
HaTE: To insur. prop.r
cr.dit to your account,
subnit the upp.r portion
of this forn with your
h_ payn.nt.
3.670.43
16.~nq 00
12.638.57-
.00
12.638.57-
If an assessment was issued praviDuslY, linas 14, lS and/Dr 16, 17 and 1B will
raflact fi9ures that include the tDtal Df ALL returns assessed tD data,
ASSESSMENT OF TAX:
15. Anount of Lin. 14 at Spous.1 r.t. (15)
16. Anount of Lin. 14 t._.b1. .t Lin..1/C1a.s A rat. (16)
17. AMount of line 14 taxable at Co11.t.r.1/C1..s B r.t. (17)
18. Principal ta_ Du.
NOTE:
TAX CREDITS:
PAYHEHT
DATE
RECEIPT
HUH8ER
DISCOUHT (tl
IHTEREST/PEH PAID I-I
(91
1101
16.309.00
.00
(III
1121
1131
1141
.00
.00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER OATE IHOICATED. SEE REVERSE
FOR CALCULATIOH OF ADOITIOHAL IHTEREST.
IF TOTAL OUE IS LESS THAH $1. HO PAYHEHT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUHD. SEE REVERSE SIDE OF THIS FORH FOR IHSTRUCTIOHS.I
(Schodule JI
.00 X .00.
.00 X .06.
.00 X .15.
118)
AHOUHT PAlO
TOTAL TAX CREDIT
BALANCE OF TAX DUF.
INTEREST AND PEN.
TOTAL DUE
RESERVATION I E.tate. of d.cldent. dying on or before Clceaber 12, 198Z .. If any future Intere.t In the I.tate I. tran.farrld
In Po.....lon or enJoy..nt to Cia.. a (collatlral) blneflclarle. of the dlc.dent aft.r the I.plratlon of any I.tat. for
life or for yaars, the Co..onwealth hlreby ..pre..ly r..erve. the right to appraise and assess tran,f.r lnherltanc' Ta..s
at the lawful Class B (collataral) rat. on any such future Interest,
PURPOSE OF
NoIICE:
To fulfill the r.qulr..ents of S.ctlon 2140 of the Inhlrltanc. and Estat. Ta. Act, Act ZI of 1995, (12 P,S,
s.ctlon 91U).
D.tach the top portion of thl. Notice and sub.lt with your pay.ent to the Register of Wills prlnt.d on the revers. side,
.-"ak. chack or .oney order payable tal REGISTER OF MILLS, AGENT
PAYtU:NT:
REFUND [CR):
A r.fund of a taa cr.dlt, which was not requ..ted on the Tax R.turn, .ay b. requllt.d by co.pl.tlng an -Application
for R.fund of P.nnlylvanl. Inh.rltance and Elt.t. Tax- CREV.I]I]l. Appllcatlonl are avallabl. at the OffiCI
of the R.gllt.r of Wills, any of the 2] R.vlnu. District Offices, or by c.lllng the sPlclal 24.hour
anlw.rlng 'Irvlc. nu.b.rs for for.1 ord.rlngl In P.nnlylvanla 1.800-56Z.Z0S0. out.ld. Penn.ylvanla and
within 10c.1 HarrllbUrg ar.a (111) 181.a094, TOO' [1111 772.Z252 CHearlng I.palred Only).
Any plrty In Int.r.lt not I.tl,fled with the appralse.ent, allowanc. or dls.llowance of dlductlon., or a..es...nt
of taa [Including discount or Intere.t) al shown on this Hotlce au.t obJlct within II.ty (60) days of r.c.lpt of
this Notlca by:
..wrltt.n protelt to the PA D.part..nt of R.venue, Board of Appeall, D.pt. Zal021, Harrllburg, PA l11za.IOZI, OR
...Iectlon to have the .atter dlt.r.lned at audit of the account of the perlon.l r.pr...ntatlv., OR
..app.al to the Orphan" Court.
OBJECTIONS:
ADHIN
ISTRAT1vt:
CORRECTIONS!
Factual .rrorl dlscov.rld on thll ....s...nt should b. addr.ll.d In writing tal PA D.parta.nt of R.v.nu.,
Bur.au of Indlvld~al T...., ATTNI POlt A.s.....nt Revl.w Unit, Dept. 2a0601, HarrllbUrg, Pl 17128-0601
Phona (717) 7a7-6505, Sae page 5 of tha bookl.t -In.tructlons for Inh.rltanc. Tax R.turn for a Ralld.nt
Olcldent- IREV.150IJ for an eaplanatlon of .dalnlltratlvelY correctabl. .rror.,
If any t.x due II paid within thraa (]) calandar eonthl aftar the d.cadant'. death, a flv. par cent (5~) dl.count of
the ta. paid II allow.d.
The 15~ tax eana.ty non.plrtlclpatlon p.nalty I. co.puted on thl tot.1 of the ta. and Int.rl.t a......d, and not
paid be for. January la, 1996, tha flrlt day .ft.r tha .nd of the ta. aan..ty p.rlod, Thl. non.partlclpatlon
Plnalty II .pp.alable In the I..a .annlr and In the tha .... tll. period al you would appeal the ta. and Int.r..t
that has bl.n ..I.II.d a. Indlcat.d on thl. not Ie..
Int.relt II charg.d b.glnnlng with flr.t day of dlllnquency, or nlna (9) .onths and on. 11) dlY frol the data of
dlath, to the data of pay.ent. Taa.1 which blc... dellnqu.nt b.for. January I, 1982 blar Int.r..t at the rata of
II. C6~1 parclnt per annua caleulat.d at a dally rat. of .000164, All ta.11 which b.c.,. d.llnqulnt on and .ft.r
January I, 1982 will bear Int.r..t at a r.t. which will vary fro. cal.ndar y.ar to cal.ndar y.ar wlth that rat.
announc.d by the PA Depart..nt of Revenu., tha applicable Int.r..t rat.1 for Iqa2 through 1998 Irll
~ Intere.t Pitt. 01111'1 Int.r..t Flletor ~ Inter..t Pitta Dltllv In..re.t Fltctor
1982 zn ,OOOSc.8 1987 .~ ,OOD247
1985 16~ ,000418 198a.1991 II~ ,ooalDI
19a" UX ,OOOlDl 199Z .. ,000247
1985 U~ ,OO03S6 199]-lq94 ,. ,000192
1986 IO~ ,OOOZ74 1995.1998 .. ,000241
ulnter..t Is calculat.d .. followlt
DISCOUNT:
PENAL TV:
INTEREST I
INTEREST = BALANCE OF TA)( UNPAID )( NUNBER OF DAYS DELINQUENT )( DAILY INTEREST FACTOR
..Any Notlc. lllu.d aft.r the t.. baeo.el delinquent will r.flect an int.r..t calculation to flft.an CIS) day I
bayond the data of the a.s....ant. If pay.ant II .ade Ift.r the Int.r.lt co.putatlon data .hown on the
Notlca, additional Int.r..t IlUSt ba calculated,
ItrV.WO[XI&;"1
.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENTOFREVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT.28060'
HARRISBURG PA 1712A.or)(JI
OECEDENT'S NAME
Steven W. Green
FILE NUMBER
REVIEWED BY
Charles Wright
ACN
2196-0386
101
SCHEDULE ITEM
NO.
E
8and
11
EXPLANATION OF CHANGES
The proceeds of life Insurance policies on the life of the decedent are not subject to tax In
the decedent's estate.
ROW
Page 1
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Steven IV. Grccn
Date of Death:
May 4, 1996
Will No.
Admin. No.
21-96-386
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of th~ above-captioned estate:
1. State whether administration of the eatate is complete:
Yes X No
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. I is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X .
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 X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: June 11, 1998
co
o!I'J r;:;> '-'0:(
~3 D:
"J ,
c...
~
:s
, -,
'.;
'...J CJ ..c..
:J>Q; Q., r;;
Q; P' .ills
u(.)
;~ hr, /-,
Signature ~
Robert M. Frey
Name (Please type or print)
5 S. Hanover St., Carlisle, PA 17013
Address
( 717) 243-5838
Te I. No.
(HAH: rmf! AM3)
Capacity: Personal Representative
X Counsel for personal
representative