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HomeMy WebLinkAbout96-00457 ~ . /0 ,z '0 CD a 1;; ~ j('" !' I'" 11'11111 IllldH'lll.d d',"ll\.dl .J! ,h.!dl (1111) '''1,111 \ It,d 1\1 ,"llh t 1111\\' 1"1 1-1'1 II 1.11 It III Ilbur llkd \\1111 I Ill' .1' I I I I "" "",..'" Till, I' III ul1d) 11,11 I It" 111"111111"'11 ]lIt L I 1 I." , I.lll," Hq~I'Ir.1I Till "11~:lll.d t l',"l 11 ,11(" \~ 111 1'1 1.11'.' 11':' ,I 1" !' WARNING: It Is IlIegol to dupllcah' Ihis copy by pholostot or photograph, rn' inl III;, It'IIt1Il,lIt.. S.l,PO 1~~.:~\~\,KQ1;,:t....( .~... ,.1'.. /: ,~, '"F ! ~I I '\;:,,\~ (~(, . \~ 1'-' - II. ' ,/'" \ a" ,...-~ · \~, ~:"" '.' ~~~ IPr"'E-H'l'n~ 'l-",;" u ..,.,t- .H'" '.r -.:? / -7>4: 1).lll' ~ l'll.t1lh'.c1...11.1( I" 1'''' ti~, ') G 'J ["" r: (1 v v J LJ J No. IOiIU"'"Jt17 CDIUfONWEALTH 0' PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH D'ClKl.OUt1,...-~ ,. James Crook. ~...~ \.IIClIJItIYUl'l - .... ... .. Hale '.1.........,. lOOAt..(Ulllf"I~ . 16S - 36 - 1618 ~~llIlRlt~_____""__ ............ - ,...,.....c..r.." GMIC1f'MT" -...- so ,~ -..... -,- I _Iil' .... ij Cumberland Pennsboro ...:;::::-.-::==: Com uter Pro ra=mer Feder 1 ~IIIoIr.UQACJClM..,....~""lllIC<CIIIII 98 16th Street ,.. New Cumberland. PA 17010 ,.......1W.-:rr-.YOM.It.M .--.......D o "" ..""" LQAX ...-. ...- ....-:.f~--......-_.......--- IIIIII.MtD'IO ...I!l~,l>, - ..0 I==- \--- "","Ii: 0IlW..-__.............. ...........-..._........-rL . . ...___._.._---..-c....-..-"..... -- .......--.-- H e..f a.oJ. ci. c. Oz " (Q).. QlA'IOIO'IASACt:MlOJlfCtCTJ ---- L Ct..-IOIO'IASAaNlOAfCttrl: C1A101OII A QlAOCl"" DoII'ICIf'~' ...- T...CIf'IK,Ut1" ...un" ~f OIIC1i1MiHOfl""","oc::c:uwoel -.ftrJIDlRN .......,...- -....-.. " ..... o o o I'\..ICtQIIIllol..Uff...__......~.- Y. --- ... Iii'! o o '1M 0,.0 - -- e.........___ - - - ...... ...0 ..0 .. - CIPII'tW'IM~__ ~.,...PM'l'UQAlIt",.,..,_......_".....__......_II_....______lJI "'...........,--.....--................--....... .,...,.., ....... ,.............. . : -NlO~"f'l'U:IM"..".......~....""'~._...... "'......."..,.............__....-.--......................-01.......-.-- "tIIIlICAL....-....eow-. 0lI...............................,....". ....,............. --' ............... -"'",......... ...~.I- tt..-_.............. .... .... ..... ,.............. .... ......... ...........,...,.... .................'........ a, GOII.UD,.......Dtt_. PA 17011 .1 I~?I?I?I?I """'. ...0........." v'-" .. t r 1 I I I I t,.... r , . - ~ - - .- - <,,'_. Cumberhmd. Pennsylvania, 17070 to Collette's mother, Mrs, Rulh R, Evans. I direct that any existing morlgage on said properly be paid in full from my residuary estale as sel forth in Item IV of this Will, Mrs. Evans shall then have the right to live in said property, renl free. until she dies or until she no longer desires 10 reside therein. During her occupancy, Mrs, Evans shall be responsible for paying all taxes, utilities and insurance on the property. Afler termination of her life interest, the property shall be devised to the beneficiaries set forth in Item IV of this will. I give, devise and bequeath to my son, JAMES MICHAEL CROOK, all my woodworking hand tools, all my wooden ship models. and if all legal requirements can be met, all my firearms, Disposal of the firearms will be at the discretion of the Execulrix. if legal requirements cannot be met. ITEM IV: All the rest. residue and remainder of my estate I leave to my special significant other, COLLETTE R, KELLY. In lhe event COLLETTE R, KELLY should predecease me or, in the evcnt she does not survive me by thirty (30) days. I devise and bequeath my est ale as follows: (a) Thirty percenl (30%) 10 COLLETTE R, KELLY's daughter, RAGIN KELLY; (b) Thirly percent (30%) to COLLETTE R. KELLY's son, HAYES KELLY: (c) Thirty percent (30%) to COLLETTE R, KELLY's daughter. ALICIA KELLY; and (d) Ten percent (10%) to my son, JAMES MICHAEL CROOK. 2 ~{v In Ihc cvcnl any bcncfieiary abovc predeeeascs mc, his or hcr sharc shall bc dividcd cqually bctwccn my surviving bcneficiarics, ITEM V: In lhc scttlcmcnt or my cstalc, my Excculrix shall posscss, among others, lhe following powcrs: (a) To rClain any invcstmcnls I may havc al my dcath, as long as lhc Exccutrix may dccm it advisablc to my cslalc to do so; (b) To sell eilhcr at privatc or public salc and upon such terms and conditions as the Excculrix may deem advantageous to the cstalc, any or all real or personal properly or inlerest therein owned by the cstatc; (c) To pay all costs, laxcs, expenses and charges in connection with the adminislralion of my estate; (d) To compromise controversies; and (e) To do all other acls in lhe Executrix's judgmenl deemed necessary or desirable for the proper and advantageous management, investment and distribulion of the eslale. ITEM VI: Any person who shall have died at the same time as I shall have, or in a common disasler with me, or under circumstance that the order of dealhs cannot be established by proof, or wilhin lhirty (30) days of my death, shall be deemed to have predeceased me. 3 ~ ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : SS, COUNTY OF CUMBERLAND I. JAMES FREDERICK CROOK, Testator, whosc namc is signcd 10 thc atlached or foregoing instrument, having becn duly qualificd according 10 law, do hercby acknowlcdge that I signed and cxecuted thc instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my frce and voluntary act for thc purposcs therein cxprcssed, j (SEAL) J NOTAR P LIC My Commission Expires: (SEAL) N01AAIAL St:AL Ilolbat. Sumpl..Sul~v.n, Not.ry PubliC _ Cumberland Bora, Cumberland Co, lIyCommlslion Esp".. Nov. 15.1999 ,\FFmA VIT COMMONWEALTH OF PENNSYLVANIA' : SS. COUNTY OF CUMBERLAND We, Thomas G, Emerick , and Dianna Stopinski , the Wilnesses whose names are signed to the attached or foregoing inslrumenl, being duly qualified according 10 law, do depose and say thaI we were presenl and saw Testator, JAMES FREDERICK CROOK, sign and execute lhe instrumenl as his Last Will and Testamenl; thaI Testator signed willingly and he execuled said Will as his free and volunlary act for the purposes therein expressed; that each of us in lhe hearing and sight of the Testator signed the Will as Wilnesses; and that to lhe best of our knowledge lhe Testator was at thaI time eighleen (I8) or more years of age, of sound mind and under no conslraint or undue influence, r;; d?~>J*W--A-' ITNESS NOTARY PUBLIC -_____ - My Commission Ex iilette,. s NO~ (SEAL) 1'/... cu,"~:,'"Plo'SUlti. fAL .\fy com rll1r,d 80' nn, No,~, p tn1oSSIOl) 1;;" o. CUmb., Y lIb"e -I)"os A, "and C "0. IS. ,gg; Recu,(,'"',, " of R~", I" . '/'1' 1.:1. .,I..,'! . ;1:) '96 .IUN -6 P 2 :20 Clej,' ' Cum'" " , ......... .'.t.. '. ['.;urt Cu., PA ~ '" '" ~ ci :.: Z l- I 1 0 < o 1 l- I g > ~ ~ u ::i :$ .J Z :.: :qj~ ~ u 1:1 Ul"';J H liIrt> r. t ~ u .Jliilll ~ rsl ii: D.",Z ~ .. '~ ~ Q 0 ::l!"z " w rsl ~ :Jii:D. r:: Ul" . 0 ~ CIl <~z ~ lI:"j ~ rsl < a: ~ <l: m w Ij II: m < :E m :l u ~ Z ~ ; " Register of Wills of CUMBERLAND Ellal. of also known u County, Pennsylvania PETITION FOR GRANT OF LElTERS No, 02l:.91a - 4-51 JAHES FREDERICK CROOK (' , ,( - J.._Cf'l _ .:,'1/))(' :., ;: , DocuulKl 5~1 50cunty Na165-36::.!&.!.L Ptttl::ll"lef1II.""O LL've 11 )..... 01 ~ Of o~~ .w-~("'I b: (COMPlfTE 'A' OR '8' BelOW,) ~ A. P/Obatl Ind Grant 01 lonlll T15tlmontary ard """/ hi P"lltr^'"~cl:I&ollrll tt>. ulClJ1.Li>>lamod., "" Ion Wil of "" Oecodon~ dollKl...'!.<!!1Ui:lZ:Y. .1..5-'. 1 996 IJ>d 00<Sa~.) doled a..,........ ~~.~ fWV'CICG\ 0wUI alaaeo..-a... Elcopl u tonow.. Oecodenl dd not m.rry,..... not di""n:ed, Ind dd nol ha.. I eM:' born or odoplod wr IJftCUcon ollho docunonll on"'d tor proba18; "'II nol tt>. ..etln 01 I lulling ond "'u no_ od,udcallld Wl"'mpeltnl: o B, Grant 01 tenors 01 Administration CGJl.IlL.lA.,~ "'-.II...,.."l. .......0.,.,.... tr1."OUW P.ll1>ono~.1 attar a propot .urch ha""a.. UtefUJnod thai Decadonllen no Willond "'u 'lJ'\1Yl1d by lho loIiowvlg .pau.. (d any) and hlira; Nan-. Retaconlhlll Resodence CCOMPLm IN AU CASES 1 At&ctl loala\&J .......tI d necna.wy~ Decedent "'u donllclled II deott> in _~l!ml:J.e_r la!1d 98 Sixteent;R-SJ:.r.e..U,-.Ne.lc.c.um.b.eliallii. PA t~lI.n<<.r.u.-n~"""fnl.I\Iap&lrrr1 Oeceden~ lhon _11-0_ y..... or age, dld.-. 5/27 . ,,__, '.96 ., Counry, Pennsylvania. WItt> hI""" lullalrily 17070 BoRtl 0 r~ NE~\J (wnE>, ex principII ...odenoe II Decedent_I doalh owned prcPOfl)'~;:h .,tmlll.od 'nJuu.. toaow. (II domoa1od., PAl AC pot'IorW prcPOrly (II not domICIled n PA) PO'floMJ proPfHt( In Punn.ytv....n. (II nol dam""",, WI PAl p""""oJ prtlPOrly In Counly Value of roal81latn., PUnnl}f'(MIoa Camp Hill, PA. llOo:..:..on1 S3,OOJ~.OO s $ $ IlhJor.dulocows_ -New Cumberland __ .. __.._ Whl"to,., Plltltloner(~ res~crtuny fUQ'UIUt(.) Che prcb.tII oletl., Iasl Wilt atld CodiCll(l) presGOted with Chi. PetItion and tit grant of .tt8l'1 n Ihe appt'Opriate form to tho undonignod S,gnolr..uo (?:" ;d7; uk) _, ;:Y':(1:j T yr--;c CI ptlr'!l"(J n.1f!"\O L"ICI rus'oonOll . "Co 11 !l.!: t.!l R..l.<gJJy Form .~w., Paoe 1 of 2 P'.p.&tld br fie P.M.ytn..... Bat ""001001'1 'WI I C,- tel - Cj "-..- ..--..- - 20, If Uno 191. groalor Ihan line 18, enlor Ihe diKerence an line 20, This l'lhe OVERPAYMENT, aD 21, If line 181. groaler Ih.n line 19, enlor Ihe diKe,ence an line 21. Thi. l'lhe TAX DUE, A. En'er ,hltnl,r..' on the balonet due on lint 21A. 8, Enlor Ihe 101.1 of line 21 and 211. an line 21B, This islhe BALANCE DUE. Make Check Payable la, Regl.ler 01 Will., Agent . .BE SURE TO,ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK,MAT Under ptnalU.. of perjury. I dedor. thot I ha"'l exomlned thl. "Iurn, Including accompanying schedule. and ,'al,menh, and 10 ,hi bill of my knoW'ltdgt and b,n,f, It I, tru., corrld and compltl.. I declor. tho I 011 '101111011 has bltn '.parl.er at true markt' value. Oeclaration of prepar., other thon ,h. penonal rlpr.unlotly. It bOlld on all tnformollon of whIch preper., has any .nowl,dg'. SIONAt~! O. PUSON .("OHSllll '011. 'lUNG _(TUIN ,t.DCltSS DAII I ..., . ) It t/i ~I AlI'-'(L,' (j (,1'J/,(/';"Wd" l.'4 r .'"'It) HA $p.... ~ UY.l$OO fh 17.9"1 w .... ..:5" llllE~ :z:oS u~.. .;,.... wiS OCc OCz 8f J'j -IC' 7-({ w FOR DATlS 0' DEATH A"IR 12/31/91 CHECK HERI If A SPOUSAL POVERTT CRlDIT IS CLAIMID 0 flU NUMIIR INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) / 9(il" VEAR L/:.){ NUMBER COMMONWEALTH Of PfNNSYlVANIA Df....UMfNT Of IEVfNUl Ofrl,210601 HAUISlUIO,'A 11121-0601 DICIOIHI'S! HAMII\,ASI. fiRSt. AND MIDD\(INlIIAlJ ,2.1 COUNTY CODE DlUDlNI'S COMPau ADDUSS .... is lil u w o 98 16th street New Cumberland,PA 17070 c"" hc.riano ,. N TinlVlb jU( INSUUCTlON51 50(11.\ $IeUR.I' HUMI . OAn Of III'H Kell Collette R. 208-42-6470 03. 05, x:K: 1. Original Return 0 2. Supplemental Return o A. limited ellot. 0 Aa. Future Inler.,' Compromise (fa, dale. of dealh ah" 12,12,B2) o 6. oecldent Di.d T"tall 0 7. Decedent Maintained Q living Trus' (Allach copy of Will) (Allach copy 01 T,u.11 ALL.,c:ORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. i~. NAM COMPlEIE MAILING .t.DDIUS Remainder R,turn (far dale. of dealh prior 10 12.13,82) Fed.ral ellal' Tax R,turn Required _8. Total Numb.r of Safe Deposit Bous _ :~~~~~!:t!~~~"~!~'~ C' 549 Bridge street New Cumberland, PA 17070 z o S ::> t: .. .. u w a: (1) - - - - :1')", ..; " (2) - .1 (3) - , J (4) - - - ~ ,'J (5) 2710 -' (6) -0- ,) (7) - , , (B I 771n nn 19) 47'11 _. "'I 1101 41l. li1 1. Real E.lale (Schedule AI 2, Slach and Band. (Schedule B) 3, Cla.ely Held SlackIPa"ne"hlp Inle"'I(Schedule C) A. Mortgog" and Nolu Receivable (Sch,dule OJ 5. Cash, Bank Deposits & Mis"lIaneous Penonal Property (Schedule E) 6, Jalnlly Owned P,apt<ly (Schedule FI 7, Trande" ISchedule GI(Schedule l) B. TOlal Gron AUI's (Iolal Lintl ,.7) 9. Fun.ral bpln..., Administrative COlts, Miscelloneous Expenlt. (Schedule HI 10. O,bt., Mortgag. liabilities, liens (Schedule II 11. Total Deductions (tolallinl,9 & 10) 12. NIt Value of Estall (lin. 8 minus line 111 13. Charitable and Governmentol a.quI'" (Schedule JI lA. NIt Value Subject to Tolt (lin. 12 minu.lin. 13) 15, Spau.al Tran.le" lIar d.l.. 01 dealh ahe, 6,30.941 S.. Instrudion. for Applicable Petunlog' on Reverse (15) Sid.. (Include valul' from Sch,dule K or Schedule M.) 16. Amount of line 14 taxabl, at 6% ralt (16) (Include value. from Schedule K or Schedule M.) 17, Amaunl of line 14 laxable 01 15% role 117) (Indude v.lue. from Schedule K a, Schedule M,) 18, Principal lax due (Add lax f,am lIn.. 15, 16 and 17,) 19. Credill Spousal Poverty Credit Prior Poymenll + 1111 112) IIJI 1141 4705.20 (1 '1'1" ::>0)_ NO T^X DflE K._= NO T,n.x OUI!: x .06 = )( .15 II z c ~ ~ :IE o u (leI Oiscount Int,rlll (l91 (20) + ~ .... Check' hero If you ora fcq"ucsling'Q.rcfund of your overpayment. --" .- (21) (21"') (218) ,~ - /J. - '17 .2--(2 - 7 '1~,lSall" lU.1 ~ COMMONWfAlTH OF ,rNNSnV.t.NIA INHUllANCf u.. IUU.N IUlorN' DlCfOfNf SCHEDULE B STOCKS AND BONDS ESTATE Of Crook, James F. fiLE NUMBER (All p,aplrt, 'alnll,-ownld with RighI 0' Survivorship mu.1 bl dl.c1o..d on Schldull f,) ITEM NUMBER I. DESCRIPTION VALUE AT DATE Of DEATH - 0 - :.,-.....,. TOTAL fAho Inter on linl 2, RICo itulatlan) (II more spac. ;, n..d.d, ;nl." ocldil;onol sh.." of sam. siz..) s ....< UVlllNI1.P'bl J \- SCHEDULE F JOINTLY _OWNED PROPERTY CO",,,"0'.1\II10"'" 01 flW''''V'''''''''' IWII.I'...hCl'....U1UUI U\IOINI PIClPIN' FILE NUMBER -.----- --------- ESTATE OF crook, James F. ---------.-------..---.. --- - ------------------ -----------.------ ---.----.----.-- -~_._-_.._---- Jolnl tononl(')1 A~__.._____. _ RELATIONSHI!,_ TO ~CEDENT___. 98 16th street Wife New Cumberland, PA 17070 A, NAME Collette R. Kelly B. C, ITEM LETTER DATE fOR TOTAL VALUE DECD'S DOLLAR VALUE Of NUMB'U JOINT MADE DESCRIPTION Of PROPERTY Of ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. A. 12/21/ 7 98 16th st. $80,000.00 TW - 0 - New cumberland as 2. A. 12/29/ 9 Members 1st Credit Union II 12184 14.82 TW -1)- RaS 3. A. 12/29/ 9 Members 1st Credit Union II 12184 48,651.10 TW RaS - 0 - 4. A. 12/29/ 9 Members 1st Credit 5,134.10 TW - 0 - Union II 1284 RaS CD -' ..-. Jolntly.ownod propooty: TOTAL (Also anlnr on Ii no 6, Recopilu!olion' l S ------- ---------------------- (If more space is needed inse,' addjtional sheels of same size) I.YUIII.. (1111 ITEM NUMBER -t'~ COMMONWUtfH Of PlNNSYlVANIA INHUIIANC( IA. IUJURN RUIDfNI D[CfDfNJ J Plla~1 P,I~!D!TYPI FILE NUMBER SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Crook, James F. ~--------~- DESCRIPTION AMOUNT A. Funeral Explnll.. B, 4. C, 1, 2. 3, 4. 5, 6, 7. 8, 1. Cremation Society of PA $1,110.00 1. Admlnlllrallvl Calli: Personal Rep,esenlotive Commissions Social Secu,ity Numbe, of Personal Rep,esentotive: Veo, CommissiDns paid 2. Allo,neyFees $412.48 + $358.81 + $93.96 + $34.34 + $500.0 = $2845.59 3. Family Exemption Claimant Add,ess of Claim anI at decedenl's death SI,eet Add,ess Relationship City Slale Zip Code P,obale Fees MllcellanlDul Explnlel: Car title transfer - Penna. Department of Motor Veh. $5.00 TOTAL (AlsD enle, on line 9, RecapilulotiDn) S 4291. 59 (If mDre Ipace II nllded, Inllrt addltlanallhelll Df lame IIzI.) ..v.ISIIU.II.'1I '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Plea.e Print or Tvpe fiLE NUMBER COMMoHwrAUH Of PlNNIYlVANIA INHUllAHCl tAl I(JUIN .UIOINI 01(101"'1 ESTATE Of Crook, James F. ITEM NUMBER DESCRIPTION AMOUNT 1. Oakwood Radiation $66.10 + $116.01 c$182.11 $182.11 2. Smith Radiology 3. Andrews & Patel $11.73 + $23.32 8.35 4. Polyclinic Medical Center 35.05 8.00 5. Holy Spirit Hospital 6. Apria Home Care 3.18 48.50 7. Thrift Drugs 127.97 TOTAL (Aho .nter on Iin. 10, Recopitulation) (I( more spac. is n.edod, inJlrl additional sh..ts 01 sam, size.) $413.16 , ~~'--~-'..~'._' ......IlUU.n.r) 9.,~,~ ~ CO..........ONW.All" 0' ,tNN\'lVANIA IH"IIII"NU fAl .nUIN InlDINT DleIDIN' SCHEDULE J BENEFICIARIES FILE NUMBER ESTATE OF crook, James F. ITEM NUMBER NAME AND ADORESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxoble Bequests: 100% 1. Collette R. Kelly Wife ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Go...ernmental Bequests: 1. 0, TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Alia enlO/ on line 13, Recapitulalion) S (II marl .poce II needed, In.ert oddltlonol.heetl 01 .ome 1110) IS-It 1.-(/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES IHIt[RIlAHC[ IAIl DIVISION DEPT. 18DbDl HARRISBURC, PA llUa-ObOI NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLDWANCE OF OEOUCTIOHS AND ASSESSHENT OF TAX BARBARA SUMPLESULLIVAN 549 BRIDGE ST NEW CUMBERLAND PA 17070 DATE ESTA TE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-28-97 CROOK 05-27-96 21 96-0457 CUMBERLAND 101 AhDunt Rell1 tt.d ( I, ~*, Ih.lh'lI ,n 111.'" JAMES F 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 .... ifEV:is4-j-EX--"FP-ni:F9:n--Noi''icn,,,--iNHEiiii'ANcrfAi(APPRAisEHENi'",--'\i,LOWANCE-OR----m------m- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CROOK JAMES F FILE NO.21 96-0457 ACN 101 DATE 04-28-97 TAX RETURN WAS: I X I ACCEPTED AS FILED I ) CHANGED If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 wiil reflect figurBs that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. AMount of Lina 14 at Spousal rat. lIS) 16. AMount of Lina 14 taxable at lin..l/CI... A rat. (16) 17. AIIDunt of Lina 14 taxable at Collateral/CI... 8 rat. (17) 1&. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rod Eatato ISchodulo A) (11 2. stocks and Bonda (Schedule 8) (2) 5. Cloa.ly Hald stock/Partnarship Inter..t (Schedul. C) (3) 4. Hortg.gas/Notl' Receivable (Schedule D) (4) S. C.sh/Bank Deposits/Hlsc. Personal Property ISchedul. E) IS) 6. Jointly Owned Property ISchedule F) (6) 7. Transfers ISchedule G) (7) 8. Tot.l Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Hisc. Expense. ISchedule H) (9) la, Dobta/Hortgago Liabllltloa/Liona (Schodulo II (101 11. Tot.l Deductions 12. Hat Value of Tex Return 13. Charltabla/Governnental Bequests ISchadule ~) 14. Hat Value of Estate Subject to Tax NOTE: TAX CREDITS: PAYHENT DUE RECEIPT NUHBER DISCDUNT 1'1 INTEREST/PEN PAID (-I ,00 ,00 ,00 ,00 2,710,00 ,00 ,00 (BI 4,291,59 413,61 1111 (12) (131 (14) ,00 X ,DO. ,00 X,06. ,00 X .15. llBI AI1DUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE HOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax pay.ent. 2,710.00 4,70~ :>0 1,995,20- .00 1,995,20- ,00 .00 .00 ,00 .00 .00 .00 ,00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, ( IF TDTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FDR INSTRUCTIONS.) ,-, ~ ,,,'J !""":-- '. .,- ~ :~l RESERVATION: Eltat., of dlcadant. dYing an or bafora Dlc..bar 12. 198Z .. If any future Int.r..t In the ..tat. I. transflrrad In POI.I.llon or anJoy..nt to Cl... B (collat.ral) bln.fle!arll. of thl dlCldant a,t.,. the Ixplratlon of any ..tat. for I1f. or for y..r., the Co..onw,.lth hareby Ixpressly rl.arv.. the rlaht to appraise and ...... tran".r Inheritance Tax.. at thl lawful CI... B (collat,ra.' rat. on any such future lnt.r..t. PIJRPOSE lll' HaTICE. To fulfill the requlta..ntl of Section 2140 of the Inheritance end Elta.. Tax Act. Act 21 of 1995. (7l P.S. Section 9140), PAvtEHTz aetech the top portion of thl, Hot lei and lubalt with your paY'.nt to the Rlglst,r of Will, printed on the tev.r.. .Ida. "HIlk. check or lonay ardar paYabl, to: REGISTER OF HILLS, AGENT REfUND (CR): A refund of a tax credit, which was not r.qu..t.d on the Tax R.turn, aay b. r.qua.t.d by cO~I.tlng an ~Appllcatlon for R.fund of Penn'Ylv.nla Inh.rltanc. and E.tat. Tax~ (REY-131]). Appllc.tlon. are avallabla .t tha Offlc. of the Ragl.t.r of Will., any of tha 2] Ravanue DI.trlct Offlc.., or by C.lllng tha 'pacl.1 Z~-hour an.waring .arvica nu.Ger. far far.. ordaring: In P.nn'Ylvani. l-aOO-]6Z-2050, out.ida P.nn'Ylvani. and within local Harri.burg .r.. (717) 737-8094, TOO' (717) 172-2252 (Haarlng I~alred Only). OIJECTIOHSI Any p.rty In Intar..t not .atl.flad with tha .ppr.I....nt, allowanca or dl,allowanc. of deduction., or .'.e".snt of tax (InclUding dl.count or Int.ra.t) a. .hown on thl. Notlc. .u.t obJ.ct within .Ixty (60) day. of r.c.lpt of thl. Notice by: _IN ISTAAfIVE CORRECfIONS: --written prota.t to the PA Dapart.ant of Revanue, Board of App.al., Dapt. 281021, Harrl.burg, PA --election to h.v. the .att.r d.t.ralned at audit of tha account of the par.onal repra.entatlv., --appeal to tha Orphan.' Court. OR 11128-1021, OR factuel .rror. dl'covarad on thl. a"....ant .hould ba .ddra..ad In writing to: PA Depart..nt of Rav~a, Buraeu of Indlvldu.l Taxa., ATTN: Po.t A..e....nt Ravlaw unit, D.Pt. Z80601, Harrl.burg, PA 17128-0601 Phona (717) 787-6505. Sae pag. 5 of the bookl.t ~In.tructlon. far Inharltanc. Tax R.turn for a Ra.ldent Daced."t~ (REY-1501l for an .xplanatlon of adelnlttr.Uveiy corractable arror.. DISCOIMT. I' any tax due I. P.ld wIthIn thr.a (3) cal.ndar eonth. aftar tha dacadant'. death, a flva percent (5~) dl.count of the tax paId I. allow.d. PENALTY: The 15~ t.x .~a.ty non-p.rtlclpatlon pen.lty I. coaput.d on tha total of the tax and Int.ra.t ...a..ad, and not p.ld bafor. January 13, 1996, the fir.t day aftar the and of the tax .ana.ty parlod. Th!. non-participation penalty I. app.alable In tha ...a aannar and In the the .a.a tl.a period a. YOU would .pp.al tha tax and Intere.t that ha. bean a..a..ed a. Indica tad on thl. notlca. INTEREST: Intar..t I. charg.d begInning with flr.t day of delinquency, or nine (9) aonth. and ana (I) day fro. the data of death, to the data of payaant. T.xa. ~Ich bee... dallnquent bafora January 1, 1982 b..r Intara.t at the rat. of .lx (6~) parcant par annua calculat.d at a dally rat. of .00016~. All tax.. which bac..a dallnquent on and aft.r January 1, 1982 wIll bear Intara.t at . rata ~Ich will vary fro. calandar year to calendar y.ar with that rat. ~ad by the PA Departaant of Revanu.. Tha appllcabla Int.ra.t rate. for 198Z through 1991 ar.: !!!! Intlra.t Rate O.11y Intarut Factor :!!!r Inter..t Rllta Dally Inhrut Factor 1982 20~ .000543 1981 .~ .000241 1983 I'~ .000it]3 1983-1991 II~ .000301 1984 II~ .000301 1992 .~ .000Z41 1985 13~ .000156 1991-19'" T.l .000192 1986 I.~ .000214 1995-1991 .~ .00az41 hIntara.t I. calculated .. foUow.: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR --Any Notiea i.,uad aftar the tax baeoa.. d.llnquent will r.fl.ct an Int.ra.t calculation to flftaan (15) day. beyond the d.t. of tha .......ent. If payaant I. .ade aft.r the Int.r..t COBPUtatlan data ~ on the Notlu, add I tlon.1 Interalt ault ba calculatad. ~,' STATUS REPORT UNDER RULE.6.l2 Name of Decedent: James F. Crook Date of Deathl r:../n/qF, Will No. Admin. No. 1996-00457 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 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, 1 is Yes, state the following: a, Did the personal representative file a final account with the Court? Yes No x b, The separate Orphans' Cuurt No. (if any) for the personal representative's account is: n/a c, Did t.he personal representative stale account informally to the parties in interest? yes)' Estate was insolvent. d, Copies of receipts, releases, approvals of formal or informal accounl~, Cerk of lhe Orphans' Court and may be att an No joinders and filed with the o this report. Date: II/Ii /t] / , Barbara Sumple-Sullivan, Esquire Name (Please type or print) 549 Bridge street Address New cumberland, PA 17070 (717 )774-1445 Tel. No, (HAH: rmfl AM3)