HomeMy WebLinkAbout97-00718
PlnlTION .'OR GRANT 010' LETTERS 010' ADMINISTRATION
h.slale of L11~.I')_.h~~ .fi,' J.I~:c_____
also known QS ~_____________________
No, _~-.l=q_(l=__:1J_~_._.__
To:
Register of Wills for Ihe
County of _..__CUMIIliliLAND.__._ In the
Commonwealth of Pennsylvania
_.______""______.____..m__._._.. l)I"',,Q,led,
Social Se,'ur/ty No, K.tJll,,'_JJ___,:.2SI_,"".
The petltklll of the undersigned respectfully represents that:
Your petltloner(s), who Is/are 18 years of age or older. appLL~,J-~_ for lellers of administration
___.___._________,.___._______._________.._____._____ on the estate of
(d,h,n.; IlCndelllc lhe; dUrlilllC 8h~c:nllal durallte mllloriltllc)
the ahove decedent.
Deeendent was domiciled at death in C u "" 6 e' /... .L _ _ County. Pennsylvania. with
he V' last family or prlnclpa\r~slde~.cpl.~;L2..e--wN f z. ,- ; I', 1',(, J?!~ .',*(>..,
Nil /rJyct'.'N '/\Op (list street, numbtr and municipality)
h '--I .. f dl d If A r I / ,) , '16
Decen\l~nt. t ,e~ --n--- years 0 age, e _--'-'-'cc___~____. 19
at ~QIlJ\J #. I 1I.O-I.l.1'-t , _'.
Decendent at death owned property with estimated values as folllows:
(If domiciled In I'a,) All personal property
(If not domiciled in I'a,) Personal property in Pennsylvania
(If not domiciled In Pa.) Personal property In Couaty
Value of real estate In Pennsylvania
sltllated as follows:
$ S 6 ....
$
$
$
.--..
Petltloner_ after a proper search ha...2_. ascertained that decedent left no will and was survived by
the following Sl,ouse (If any) and heirs:
Name Relationship Residence
J;:i",,- " 7 .!,J;I 7 u t.....,,. 71. ~. Ilr ,.-<..-- ' 7',.,<, fi,..
tA:-C''1') b 1 '-. " I, (-
7...~:c. /Jlf. ,. (. r. f,
THEREFORE. petltloner(s) respectfully request(s) the grant of lellers of administration In the
appropriate form to the nndersigned.
L
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"3J..cr,>1<M.:.lh Ie f{, I )Oy~
Hl~112fUiV8'6lI
(FE[FOHHUA
CI!RfIFICAT( $2001
WARNING, IT IS IUEUAI. TO ^I 111\ IIIIS COpy Oli
TO nUPL.lCATE BY PHOTOS'I/,] Oil PIIO[[JOflAPH.
COMMONWtiAllH 0"" f1r:NN9YlVANIA
OEPARl'MENT or- HEAt.nl VITAL fUCOHOS
21-97~718
LOCAL REGISTRAR'S CERTIFICATION 01' DEATH
'/
CERT, NO, 2983581
~~(,;"- t'~
~_~'T~T,_.,._._~__~_.~L~_~.-.-.",__~_,,<<.
O~II! !II Iq~1I1l of t!li:l CB!llli~ft'l<lf\
N f D d t &'&;(.v C?Ce:.--'"
ame 0 ece en ~-~_. T;;;i""'-"" "'",.",,
-
S ~ S clal Se IrIty No ....,?q__l..Z.._..-.J. (, ~ .?.:J...?...1.....
ex _._u._._._......__..___ 0 Cl .
.. --...-_._...._&Lf~._c..____~__....,..______
I ~'1
'1"'-;)/_ ~r
.~_..__._____~.__E..__r_., ____..
Date of Death
Date of Birth ,__.____.,L' ....c__~7'_ Blrthplaco.. 4~.(j_?<!__ __ .._ _. ________~_____._______.
Place of Death&~4;.J~~~~...",p~f'~_J..___~~.&.Yk~-.f___p.eI}O~Ylvarllil.
r-=-~M,'111Y NnrllI' C"'I!,f.i!!---='~-:" r.,ty, Ih"'H',lh Of rO'",n-\h,p
Race ~f~_______ occupatio~~~~~-","",-~~ ________ Armed Forces? (Yo~r ~. _.._L__~_~____.___
Marital Status..Z2.l<!-'t~c:!. Mailing Address~c4___..~,,;~..t:c1i;~~?-!_ ..____&.L?:.~_4..;
N'I',\llt" Slt,Hd (;,1,' 'If Towr, Sl,l!"
Informant _ /~,., /1.J:!,r_~;r:~(A x__ Funeral Director ~4fIf"',t,,~~:,r/'tt{~/~,~..L_,_______
~~~e~a~~sta~1i:~s~~~t ..~{t.'.r.L",~ff ~-L~,e'~~..4t~,~~v~~._~~______
: I nleryal Between
Part I: Immediate Cause : Onset and Death
I
(a) y.~4.&c--.f..-&.c.~.y~~_6,&'("'''<.~_________L__________________
,
(b) ..cC...c"..;".6~ ~_~~'^-S:-:-~___________. ... .____~-m--_._____:-------___________
(c)~~C;:~h.G../~__"'4~Z:>~..[~&... ...------l---__..___________
,
Part II: Oth~~)Si~ ~:tlo~ -~~: ~7~~~~{i;-.;.:~~~<;-i;i&~y
,Lk~It(AJ'...u../ """:-/:..~~-~-"./-!;~..-":'"'.v~r'-~~~-11-~,Y
Manner of Death: Describe tlOW injury occurred:
Natural @
Accident 0
Suicide 0
HomiCide 0
Pending Investi[Jalion [J
Could not be Dotermined [.1
---, ---'-----._-'--~.-_.,-_..~._~~-.-.,.-_.
Name and Title of Certlfier__~....._...... .- ..~~L"f~4~t!I:~~....-'-----iM.D.-,D:O., Coroner,'MY)
Address~~,z.L .A!:_..l--~~t:..u~defT ,a. ~l'<<.r)n_uu ______________.__~
This Is to certify that the information here given is correctly copied flOm an original cerllficate of
death duly filed with me ail Local Ruglslrar. The 01 iginal curlificate will be forwardod to the Statu
Vital Records Office for permanent filing. ~ .. <:I?g~.~4;])yh,,{~-:'N ~
~I,,,(,,lll,...II,trlll,d'lil,\rfh..:..),H 1i;i"'LINlJ
____~~:f.~_ .. . J 4 A~-<40~~t--'::L?"t..J~~_,.:~_.....
Oil!/) flm;"II'/llll1v I.l,,:~! n~\li~lrrtl U':;I!I'<lI ^ilrI"i'h Clll, !torl)"I/ll. T('Wl1~l,.p
L~
1"""'''';'''' ~ /5-'-/1'
COMMON~YlV"'N!^
O(!/,ARTMl:NT Of ~r:Vr:NtJfi
oepr 21.10601
tlA"RI~8URG "A 171;!fl,0601
OECEOfiNT'S ~ llJ.liT. FIRS1, AND MIDDlE; l~l!T1Al) us. ~ ~ltr\lo; tihxk ~ller.w~!IlWlll'J5
14 Net Value Subject to Ta, (Line 12 minus Lln. 13)
15. Amount of line 14 Imble X
Z althespousaltax rate , ,0
0 See Instruc1ioos 00 reverse side lor applicable percenlaqe
1= 16. Amounl 01 line 14 taxable 2 S 9 4 9
~g al6%ratl!l " X 06
,
1-0.. 17. Amount 01 line 14 taxable X 15
Ii at 15% rate 2 ,0 0 0 . 0 0
0
(.) 16. Tax Due
19.
, " ' ., ,>'> > '.BE SURE'TO ANSWER'ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Under penaltllJ's 01 perjury, I declare !hat I have 81lamlned thIs relum, IncludinQ ACcompanYing schedules and stutefllClnls, ~nd to Iho oost of my knowledge and OOIIOf, II is true, COrf!~CI and complole, Doclaralion of prllpllfer olher
than \/'Ie personal rll(lfflsentativD Is based on all Information 01 which Dflloarer has MY knowlOOQI)
SI~NAT RE OF R RSON RESPONSIB;E FOR fll.l~G RETURN ADDRESS Mark T. Silliker, Esquire
-1~ --'I,.' 5922 Lin ,Icslnwn Road. I-Ial'risburq
SIGNATURE 0 ,O~ENTAT~VE ADDRESS Evelyn F. Zeiders
,~ ~ P. n, Box K8, Shermans Dale
/11,,(. 7- ~"It;I(-', E11.
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REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
l]fTli;IAI.U;lrONlY
fllF.NUM8F.R
~ I I)
7 () ()
7
H
(lllJNfYConf
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.
!Z Il 1 X L E R M ^ R Y L
W SOCIAl. SECURITY NUM8ER OAl~ Of' OI:A.lll
C
W 2 0 2 ~J 6 ~7 5 8 2 II ,I /2 I /1 I) l) ()
U
W (IF ,IJIPllCA8L~l SURVlV1NG SPOUSE'!> NAME (lAST, FIRS r, MID MIDDLE ItJlliAll ;jOl'I....lSf:Cl!A11'fNl!MHHl
C
(JA'fO!' IIIHTH
II S I () S II l) .1 l)
ItUS RE TlIHN MUr.r Ilf flU:O IN UUPlICAH: WITH nil:
REGISTER OF WILLS
12\1 I. DfiginelRetum
o 4.limiled Estate
o 6, Decedent Died Testate IAn.1(l~ C(}\IY of'NUl
o 9.llllgation Proceeds Received
, E T MUST BE COM LETED,
NAME
Mark T, Silliker, ESl lIire
FIRMN^ME (I' Applicable)
Silliker & Reinhold
TElepHQNE NUMBER
717 671-1500
o 2_ Supplomonlal Return
o 4a, FlIhJfe Intoresl Compromiso Id~le of </I},llh !III!}t 1?12,~2)
o 7, Decodent Maintaino(! i'l Li~in9 Trust (A""I<:~(,Q~yot TrlJ~ll
o 10, Spousal Poverty Credit (ddlftof de1M between 12.)1,9! ,wI '.1.951
LL CORRESPONDENCE AND CONPIDENTlAL TAX INFO
COMrLE TE MAlW1G ADDRESS
5C)22 LinglcsloWIl Road
o 3. Remalndor Return (d.ltl! ill d/l~lh p(k)f ~ 12.11012)
o 5, Fedmal Eslale Tax Return Roquired
!.!.. 8 T alai NlImbor of Sale ()epo~it 80.es
o 11. Election 10 la. under Sec. 9113(A) (.AnlCh 3.:h 0)
MAT ON 0 BE DIIIECTEDTO:
HlIrrishur'
"A 17112
1. R.sl ESlale (Schedule ^I
(1)
(2)
OFFICIAL USE: ONLY
2. Blocks end Bonds (Schedule B)
. ~ r
..r~'
r,
3, Co"ly Held Corporation. Partne"hlp or Sole,Propliel,"hlp (3)
z
o
5
::l
t::
D-
c(
U
W
~
4. Mortgages & Notes Receivable (Schedule D)
5, C..h, Bank Deposlla & Miscellaneous Pe"onal Property
ISchedule E)
6. Jolntiy Owned Property ISchedule F)
7.lnter,Vlvos Transle" & Miscellaneous Non,Probate Property
ISchedule G or LI
6. Tot,1 Gross Assela 1101,1 lines 1,71
IB)
..." -.
6 '2 5 0 0 0 0
, .'
(4)
15)
(6)
(7)
2 ,5
o
o ,0
o
6
J
2 9
8
o 5
9 funeral E,pense, I. AdminIStrative Cost" (Schedule H)
191
(101
-~
10. Debla of Decedenl. Mongagellebllitles, & liens (Schedule I)
11. Total Oeduc1lons (total lines 9 & 101 (11)
J 2 9 8 0 5
,. I
2 9 S 9 4 9
I
2 9 ~ 9 4 9
,-
12. Nel Value of Eslalelllne 8 minus line 111 (12)
13. Ch"llable end Govemmental Bequesla/Sec 9113 Trusls lor which an election 10 lax h.. nol been (131
msde (Schedule ,II
(14)
115)
(16)
117)
1181
5 5
7
'3 0 0 '0 0
9 5
7
P^
17112
DATE
1.:1 ' .1 :J " <1 ~
I'A
170l)()
DATE
/ .? / ?./ / 9-)>
,
Olcldlnt', Com letl Addrl..:
~TRF.E' AOORE~r.
4270 W~'tl.vlll~ Il,,"d
CllV ,
I\nolll
l ~'A1E I'A l~~025-
T.x P.ymlnt. .nd Crldlt.:
1. Tax Due (Pagel Une 181
2, Credlts/Paymenls
A, Spousal poveny Credll
8. Prior Payments
C, Discount
(I) 1,771.17
Total Credits (A + 8 + C I (2)
3. InleresVPenalty If applicable
O. Inlaresl
E. Penalty
TolallnleresUPenalty (D + E) (3)
4. If IIna 21s grealer Ihan line 1 + line :\, enler Ihe diffdrence. This is the OVERPAYMENT,
Check box on Page 1 Une 1910 requesl a refund (41
6. If Iina 1 + line 31s greater than line 2, enler Ihe difference This Is the TAX DUE, (6)
A. Enter the Interesl on the tax due. (5A)
B. Enter the lolal of Une 5 + 5A. This Is the BALANCE DUE, (5B)
Make Check parable /0,' REfSTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, DI~ decedent make a transfer end: Yes
e, reteln the use or Income of the property transferred; .........,..........,................,............,..,.....,..0
b. retain the right to designate who shall use the property transferred or Its Income; .................0
c. retain a reversionary Intarest: or ...................................................,..........................,...............0
d. receive the promlsa for IIfa of either payments, benefits or care? .....,...........,.....................,..,0
2. If death occurred on or before December 12, 1982, did decedent within two yeare
precedl"g death trensfer property without receiving adequate conslderaffon? If death occurred
after December 12,1982, did decedanttransfer property within one yeer of death without
r!lcelvlng edequate consideration? ...... ......"....."..... ..... ......., ,. ........... ......... ....',... ... ... ... ..............., 0
3, Old decedent own an "In trust for" or peyabte upon death bank account or security
at his or her death? ............."..............................,.......,...,...............,....,..........................,.... .,......0
4. Old decedent own an individual retirement account, annuity, or other non-probate property'! .....0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YEll.
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
1,771.17
1,771.17
No
1ZI
1ZI
~
1ZI
~
72 P,S. Gg116 (a) (1.1) (I) provided for the reduction of the tax rate Imposed on the net value of transfers to or for the use of the
.urvlvlng spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P .S. G9116 (a) (1.1) (II) provided for the reduction of the rate Imposed on the net value of transfors to or for the use of the surviving
spouse from 3% to 0% for dates of death on or efter January 1, 1995. The statute does not exempt a transfer to a surviving spouse
from tax, and the statutoryrequlraments for disclosure of essets and filing a tax return are stili applicable even If the surviving spouse
Is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please enswer the following question by placing an "x" In the
appropriate space.
Old tha d.c.d.nt cre.t. I trult or IlmUlr .rrsngement which II loley for the lurvlvlng .poule'. benefit for hll or her entire
IIf.llml? Yel 0 No 1ZI
If you answered yes to the above question, the tax on the trust or similar arrangement Is postponed until the death of the second
apouse, at which time It will be fully taxable at the rate(s) applicable to the remainder beneficlary(les), Enter the value of the trust on
Schedule J, Part II, In order to remove It from the calculation of the lax due In this estale. You may wish to file Schedule 0 In order to
make the election available under Section 9113, If the election Is made, the trust or similar arrangement Is texed in the eslete of the
first decedent apousa, the portion of the trust or slmller arrangement which baneflls the surviving spouse Is tsxed at the lero tax rate,
and the remainder Is taxed at tha rate(s) applicable to tha remainder beneficlery(les). If you choose to make the election, you must
atlach Schedule 0 to a timelv.filed tex return, along with Schedule(s) K and/or M In order to show Ihe apportionment of the trust or
similar arrangement betwean the surviving spouse and the remainder beneficlary(les).
,
~~V\"Jf~ 'I' ./)
ESTATE OF
NUMBER
I.
'*'
SCHEDULE J
BENEFICIARIES
FILE NUMBER
2 1 91-O.D.llR
RELATIONSHIP TO DECEDENT
Do Not L1.t Trult"(.)
Daughter
Daughter
Daughter
-
AMOUNT OR SHARE
OFESTATE
$2,636
$2,636
$2,636
4. Heather If.eiders Niece $1 ,000 .
1'.0. Box 88
Shermansdale, PA 17090
5. Tony Zeiders Nephew $1,000
1',0, Box 103
Shermansdale, PA 17090
COMMONWEAl.lIl OF P~MNSYI.VANIA
INH~Rr;ANCE TAX RETURN
Bixler, Mary E,
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (Include outnght spousal distributions)
1. Kim A. Despeaux
6280 Carlisle Pike, Lot 136
Mechanicsburg, PA 17055
2, Wendy M. Romberger
P.O. Box 106
Summerdale, PA ]7093
3, ~amje R. Klemz
4270 Wertzvil1e Road
Enola, PA 17025
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II, NON,TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART II. ENTER TOTAL NON,TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space Is needed, Insert addlllonal sheets of the same size)
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SKi\RLATOS & ZONARICII
Juhn R. l,ollurioh, E,<!,
Johnll. l.Ullllrloh, E'<J,
204 Slate Street
norri.bllrg, PA 17101
(717) 233 . 1000
AUomc)'M lhf PiJtitioltcr
EVELYN ZEIDERS, as the Administratrix of
of the ESTATE OF MARY E. BIXLER,
PlaillliO;
IN THE COURT OF COMMON PLEAS OF
DAUPHIN COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 3609.5-97
ALLSTATE INSURANCE COMPANY,
Defendant .
PETITION TO COMPROMISE ACTION: TO DESl9NATE PERSONS ENTITLED TQ
RECOVER DAMAGES: TO ALLOW DEDUCTION OF COUNSEL FEES AND EXPENSES
AND TO DIRECT PA VMENT OF BALANCE
To the Judges of Your Honorable Court:
This petition respectfully represents:
I, I, Evelyn Zeiders, am the Administratrix of the Estate of Mary E. Bixler in this action.
2. On August 9, 1993, Mary E. Bixler was involved in an nutomobile accident whereby she was
stopped and was struck from behind by a vehicle that was traveling at an estimated speed of over sixty
(60) miles per hour.
3, . After the accident. Mary E. Bixler, was treated under the care of her physicians .and
eventually passed away on April 21. 1996, intestate.
4, That on August 28,1997, Petitioner. was appointed Administratrix of the Estate of Mary E.
Bixler by Register of Wills of Cumberland County, Pennsylvania A copy of the Certificate of Grant of
Letters is attached as Exhibit "A".
5 That on September 17,1997, Petitioner engaged the services of John R. Zonarich. Esquire of
the Law Firm of Skarlatos & Zonarich to pursue litigation regarding the circumstances surrounding the
injuries and death of Mary E. Bixler.
6. In the pursuit of the litigation regarding the circumstances sllfl'Ounding the injuries and death
of Mary E. Bixler, Skarlatos &. Zonarich conducted a thol'Ough investigation. lengthy pre.suit settlement
negotiations. filed suit, conducted extensive discovery. engaged and worked with witnesses and experts
in preparation for depositions, reports and arbitration. selected arbitrators and generally prepared the
instant action for arbitration
7. Through the efforts of Skarlatos & Zonarich. pre-arbitration settlement discussions ensued
with Defendant and resulted in a tlnal offer of settlement in the amount of one hundred twenty tlve
thousand dollars ($125.000.00), which they recommend as being fair and reasonable
8. After consultation with counsel, Petitioner accepted Dcfendant's otTer of settlement in the
amount of one hundred twenty tive thousand dollars ($125,000.00)
9. Petitioner knows the uncertainties of litigation and believes that the pl'Oposed compromise is
in the best interests of the Estate.
1 o. Wher~as. the parties to this action are willing to enter into a compromise of the action upon
the following terms: In exchange for a lump sum settlement of one hundred and twenty five thousand
dollars ($125,000), Petitioner will execute a general release in favor of the Defendant and all others and
will have the instant action marked settled, satistjed and discontinued with prejudice.
II. There are no minors on whose behalf this action is brought.
12, Skarlatos &. Zonarich have been the attorneys in this action for the Petitioner and request a
counsel fee, per the executed fee agreement with Petitioner" of forty percent (40%) of the gross amount
recovered for their services. They desire the Court to approve the deduction from the share of the
damages to which the Estate is entitled of fifty thousand dollars ($50,000) tor their counsel fee,
13. Expenses detailed in Exhibit "B" attached hereto have been incurred on behalf of the
Plaintiff in connection with this action by Skarlatos &. Zonarich It is desired that the Court approve the
deduction from the share of the damages to which the Estate is entitled in the amount of eight hundred
eleven dollars and two cents ($811.02).
14. Mary E. Bixler was not married at the time of her death and was survived by her children,
Kim A Despeaux, Wendy J'vI. Vencak and Jamie R. Kiehn.
15, According to the rules of intestate succession, as contained in 20 Pa.C.SA *2103. the
entire estate if there is no surviving spouse, shall pass to the issue of the decedent.
>",. ,
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EXHIBIT C
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BURUU OF INDII/IDUAL TAKES
INHl.I'~E lAX DIYIIION
DEPl, """"
HARRIsau.o, PA 111288"01
COMMOMWEALTH OF PENNSVLVANIA
DEPARTNENT OF RIVENUE
'*
(J
NOTICE OF IMMERITANCE TAX
ArrRAISEHEMT, ALLOWANCE DR DISALLOWANCE
Of DEDUCTIONS AMD ASSESSHEMT OF TAK
uv.It"" U, 1"-"1
'i"
07-Z6-1999
BIXLER
04-21-1996
21 97-0718
CUMBERLAND
101
E- AIoQ~1 R..~ttedJ
MAKE CHECK PAVAILE AND REHIT PAVMINT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINI ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..
illv :ii;;;-iif-APji- I09:muNcificr-oP-i:"NiiiiiiiANci-;rAx-ji;PRAisiiiiNT-;-Ai.i."oWANCE-oli------------ m__
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARV E FILE NO. 21 97-0718 ACN 101 DATE 07-26-1999
TAK RETURN liAS. ( I ACCEPTED AS FIl.ED 1 XI CHAMGED SEE ATTACHED NOTICE
DATI
ESTATE OF
DATI OF DIATH
FILE NUMlER
COUNTY
ACN
MARV
MARK T SILLIKER ESQ
SILLIKER I REINHOLD
5922 LINGLESTOWN RD
HBG PA
1:7-112
ESTATE OF BIXLER
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN lASED ONI ORIGINAL RETURN
1. R..l Eat.l. ISchedul. AI
2, stock. end .ond. ISch<Htul. .1
5. C1Q..ly Held slock/r.rtner.hlp Int.r..t ISQhodul. CI
~. IIc>rt_./llc>t.. R....lvebl. ISchlldub 01
I. C..h/.... _.Ih/Hiec. P.r.M.l rrQperty (Schedul. EI
6. .lclinth OWned Pr_rty ISchedul. FI
7. Tren.f.r. ISchedul. GI
a. TQtol Au.h
NOTE I To inlur. proper
credit to your account,
.ub.U lho upp.r PQrUcm
of this for. with your
t.)( p.y.....t.
...M-
.00
.00
.00
62.500.00
. OJ,.
.00
(al
111
(2)
m
(~)
(II
(61
171
62,500.00
191
(10)
32,980.51
.00
1111
1121
1151
11~1
~'.QAn lit
29,519,49
,00
29,519.49
APPROVED DEDUCTIONS AND EXEMPTIONSI
9, Funer.l EMpen.../AdII. COlh/"hc. EMP."'.. ($oMdul. H)
10. Qebt./Hcrtgeoo Llobiliti../LI.n. (Sch.dul. II
11. T Qtal De_11M'
12. Het Value of Tax R.turn
15. Chorlt....l./Gc..rnooental a._.hi MQn-.l.ct.d 9115 Tru.h (Sch.dub JI
1~. Hel Value of Eot.t. SubjltOt tQ T.x
If .n ........nt w.. i..u.d previou.1Y, line. 14, 15 .nd/or 16, 17 end 18 will
rafl.ct fillur.. th.t includ. th. total of ill rnurn. .......d to d.t..
ASSESSMENT OF TAXI
11. A_I of Lina 1~ .t SPQu..l r.t. Ill)
16. A_I Qf Lina 1~ bx.bb .t Line.l/Cl... A r.ta (16)
17. Aeounl of Llna 1~ t.xebl. .1 Ccll.t.r.l/Cla.. . rct. 1171
la. rrincipal T.x Due
TAX CREDITS I
PAYIIENT
DATE
12~01-1998
12-23-1998
NOTE I
.00 K' 00.
21,519.49 x .06.
8,000.00 K .15.
(181
.00
1,291.17
1,200.00
2,491.17
RECEIrT
MUI1IIER
WRITEOFF
AA324442
DISCOUlIT I + I
IMTEREST/rEM PAID (-I
.00
.00
417.80
1,951.17
AIlDUIIT rAID
INTEREST IS CHARGED THROUGH 08-10-1999
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1,951.17
540.00
37.62
577.62
. IF rAID AFTER DATE IMDICATED, SEE REI/ERSE
FOR CALCULATIDII OF ADDITIOIIAL IMTEREST.
I IF TOTAL DUE IS LESS THAll .1, NO rAYHEMT IS REQUIRED.
IF TOTAL DUE IS REfLECTED AS A "CREDIT" ICRI, YDU HAY .E DUE
A REFUND. SEE REVERSE SIDE Of 'IHIS FOIlll fOR IMSTRUCTlONS.)
E
~
.
,
.,.'
REIERYATlOth E.tat.. of decedent. dviOl on or before OeQ..r12, 1962 -- if MY future In'.r..t in thft I.t.t. b trentf.rred
in pO.HIIlon or."jOY*M\t to el... . (coll.ter.1) beMf!oiari.. of thl deotder\t .ft,r thtl IMplraUon of ..~ IItata for
11f. or for y..r., ttMt C~.lth ~,'.by IlCpr...ly r...ry.. the right to appfaha Itnd ...... trent'.r Jnhel'ltlftCl ,axI.
.t the l'Mful Chu I (oollat.rlll rata on MY .uch futun lnt.r..t.
PIlRPOSE OF
MOTlCEI To 'uUlll the r...lr...nh of 5~tlon 21ftO of the 1nh.dtane. IKld Eltat. Till Aot, Aot 21 of 1995. (72 P.S.
Seotlon 9140),
PAvttEHTI Detach the top portion of this Hotlu and .ub.lt with your ply..nt to tI'M RIl1ls"f of NUh pcrlntld 00 tn. rlvar" .'de.
--teak. CMck o. ItOMY order plyabl. tOI REGISTER OF MlloL8, ADENT
REFUHD (eII)1 A r.fund of . tax credit, which "'.. not r'quI.tad on the Tll( Return, ..y be tlCfU'l.tad by ot'llPl1tlng ." "Appllc.Uon
for Rafund of PlIMlvlYMlia Inhlrltenca Mld E.tate lal(" (REY~1:S1S). AppUcaUon. ara .v.llabl. at tha Offlc.
of the Raght.r of MiUs, "Y of tha 230 AavenUB Distrlot Offic." or by c.lllnu thll speoi.l 24~hoUr
an.waring ..rvio. nuabar. fo( fora' ordering I In Penn.Ylvania 1-800~362pZ050, outsida PennsYlvania tnd
wlthin local tltirrhburl IIr.. (111) 7&7-8094, 1001 (711) 172-2252 (H..rina llP.ired OnlY),
OBJECTIONS I Any party In inter..t not ..tllfted with the ...r.he.~", .110"u,"c. 0'. ditall'**"C. of dedUCtion., or .....lRnt
of tal( (including discount or Inter..U a. .hown on thh Notice ltU.t Object within .1Ict~ (60) day. of receipt of
thh NoUc:a byf
--wr ittan prot..t to the PA o.plrtllllflt of R.vanue, loard of Appa.h, Dapt. 281021, Hflrr !Iburg, PA 1112a~1O~1, OR
--.l.ctlon to h.ve tha .atter datarained et audit of the account of the personal npraMntatlva, OR
---.pp..l to tha Orphan'- Court.
ADllIN
ISTRATIVE
CORRECTIONS 1
Faotual arror. dhcovar." on thh ........nt should be Itddre..ad in wrlUng tOl PA IMpartHOt of Revenue,
lurslU of Individull 'al(.', ATTNI po.t A.....-.nt Raview Unit, n.pt. 280601, HarrlsbUrl, PA 17128-0601
Phone (111) 187-6505. $a4I PIIiB 5 of tha bookl.t "In.tructlons for Inharltenu. 'al( ".turn for II R.sldent
o.cedant" <<REY-150!) for an .Mpltnatlon of ~lnl.trativ.1Y correctable arror..
If My tal( due II paid within thr.. (5) ca1.ndar eonths after tha decadent'. death, . flv. ptIrcant (5X) discount of
tM taM p.id 11 .llowed.
1M 15X talC ......ty non-partlclPlltlon p.nalty is cOIIPuted on the tot.l of the tal( ~ lnt.ra.t .......d, and not
p.id beforl JllnUary 11, 1996, thcl firat d.y .ttar the .nd of the talC .....ty p.riod. This non-partlclp.tion
penalty Is iippellllbl. in the .... unnoJr and in th8 the .... U... p.riod I' YOlI would appaal tha tal( and intere.t
that ha' bUn ......ad a. lndJ.CIItMl on ttlll noUce.
Inur..t 11 charged ballnnih8 MUh fir.t d.y of delinquency, or nllK\' (9) finth. end one (1) d.y frOll the date of
death, to tha data of PBYlMInt. ,.xe. ""ich b.c". delinquent bafor. JINll..ry 1. 198Z ....r Int.rest .t the rat. of
.b (6X) ptIrcllnt per annuB calculat.d .t . u.J lY rata of .000164, All tllll' which bee... delinquent on and flft.r
Jenuary 1, 1912 ,fill baBr interut at a rat. "h!ch "UI vary frOll calendar y..ar to c.land.r y.ar with that r.t.
announc" by the PA o.part..nt of A.vent'" The appllCflbl. lnter..t rata. for 198Z through 1'999 aral
't!!!: lnt.r..t Rlt. D.ily tnt.rast F~ ~ lnt.r..t R.t. D.Uy Int.r..t F~tor
1982 'OX .000548 1918-19'1 11:< .000501
1915 16X .000438 199' 9X .000247
1914 UX .000501 1995-1994 1:< .000192
1915 UX .000556 1995-199. 9:< .0002117
1916 lOX ,0002711 1999 7'1. .000192
19&7 9X .0002'"
~-Int.re.t I. calcul.tad a. follow' 1
llITERBlT . IALAMCE OF TAX UMPAID X MUIIIER OF DAYB DELIHQUENf X DAILY IMTERBlT FACTOR
--Any Notlc. IlIutd aftar the taM NCOM' delinquent wUI ren.ct IIn intar..t calculation to flft.."OS) dayS
beYond the data of the ..........t. If pay..nt it ..da .fter the lnt.r..t coaputaUon d.t. shoMn on the
MoticI, addltlonel int.r..t .ust be calcul.ted.
DISCOUNT 1
PENALTV,
IMTEMST I
I
,
I
,
,'i
!
, I
I
I
I
"
i/
\"\U";.,
'"''''"....,''' I"", .m",,, Of$4" '0 fro ,
'99., '''' do'Oof '''''PI Of,,,, /No,,,,,, of lil/.;,!: dol",,,,", do" 0 "22"99, to 12-0,.
'l\('WQ'
c~~ M/''''-TI1O/'p'!i!i'VLVANI04
I'AltTA4l!/oiT 0/' I!!VI!/oiU1!
11/" AU Oft 1NDlV1lIlJ",- TA~"
Of!PT, 21Oao,
INHERITANCE TAX
EXPLANA TION
OF CHANGES
I
i
,
/Ir .
~- MARY E e'XTER
~EVIEWEiiBY-____________
- "- "Ii_ _______________
'CH'OULE IT'M _____
No.
--~-
EJ(P'ANA rlON OF CHANoe.
E
1
E
1
Interest is etrective 12-02-1998,
ROW
FILE /lUMBeR
AC/I
2197.071.
~
101
---
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PAOF;I'AltTMF;NT OF RF,vtNuF;
nURF;AU OF COLLF;CTIONS
ANIl TAXI)A YF;R SF;IWICF;S
.Inn 10.2001
ESTATE OF; Mary E Bi'xlcr
DATE OF DEA T11: 4.21-\996
FILE NUMBER: 2197.0718
AeN: 101
PLBASE REMIT TOP PORTION WITH YOUR PAYMENT
C.\--
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IUtlIAU OF INDIVIDUAL TAKES
IH.n~E lAX DIVISION
DEPl. ....II
.-tslURO, PA 17128-0601
COMMONWIALTH OF PENNSVLVANIA
DEPARTMINT OF REVENUE
INHER%TANCE TAX
STATEMENT OF ACCOUNT
ct*
m-I." .. iff m.m
MARK T SlLLIKER ESQ
SILLIKER I REINHOLD
5922 LINaLESTOWN RD
Haa pi! 'l7112
DATI
ESTATE OF
DATI OF DIATH
FILE NUMIIR
COUNTY
ACN
03-05-2001
BIXLER
04-21-1996
21 97 - 0718
CUIIBERLAND
101
MARV
E
~un\ ~..Ittod
MAKE CHECK PAVABLE AND REMIT PAVMENT Tal
--'
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE. To In""r. pr_r cr.dil tQ yc>ur ..count. lubMiI tho uppar PQrUon of Ihh fQra dth y""r t.. p.y..nl.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ...
itlv:iiiol-iX"AP,-ri2:ooY _____ -.ilii-iitii'iiii TAiic'!-i'Ajf- sTA'fiMiNi'-OF -ACCOUNf -- ii..- ----- ---------- -- - --
ESTATE OF BIXLER MARV E FILE NO. 21 97-0718 ACN 101 DATI 03-05-2001
THIS STATEHEMT IS rROVIDED TO ADVISE Of THE CURREMT STATUS DF THE STATED ACM 1M THE HAHED ESTATE. sHDlIM IE LOW
IS A SUIllfARY OF THE rRIMCIrAL TAX DUE, ArPLICATIDH OF ALL rAYHEMTS. THE CUR.EMT IALAHCE. AMD, IF ArPLICAILE.
& rRDJECTEO IMTEREST fIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 09-08-2000
PRINCIPAL TAX DUE, 2.491.17
PAVMENTS (TAX CREDITS).
PAVMENT
DATE
12-01-1998
12-23-1998
01-26-2001
RECEIPT
NUMBER
WRITEOFF
AA324ft42
AA477992
DI SCOUNT (+) --:l
INTEREST/PEN PAID (-)
.00
.00
96.40-
AMOUNT PAID
417.80
1.951.17
636.40
BALANCE OF UNPAID ,INTEREST/PENALTV AS OF 01-27-0101
TOTAL TAX CREDn
IALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUI
2,491.17
.00
2.80
2.80
. IF rUD AftER THIS DATE. SEE ~EI/ERSE
SIDE fOR CALCULATIDH DF ADDITIDHAL IMTE~EST.
( IF TOTAL DUE IS LESS THAM n,
lID rUHEHT IS REquIRED.
IF TOTAL DUE IS REfLECTED AS A "CREDIT" ICR..
YDU HAY If DUE ^ REfUMD. SEE ~EVERSE SIDE OF THIS fDRH FD. IMST~UCTIDMS, )
PAM'WTl
...tll'1~ tl10 tot> po,tlon of t~l. Wotlo. Il1CI .....It .It~ ...., P.._t ..... p..obl. to tho n_ and add,'"
printed on the r.vlnt .Sde.
If RESIDENT DECEDENT .1Ik. check or MMY order ply8bl' tOI REGISTER OF WILLS, AIiIENT.
If NON.RESIDEN' DECEDEN' .... choCk or .0.... c,do, p..obl. to' cDllHOHllEALTH OF rENMSVWAMIA.
REFUMD lco). A rofund of . t" c,...It. .~Ic~ ... not ,..u..t.d on the 'IX II.tu,n. ... .. ro'I"".ted b. c.."l.tlno ...
"Appllc.tlon fo' R.fund 01 P......,v...I.'....rltono. and E.t.1I ,,," '.EY-Ul3l. Appllo.tlon. Ira ...l1ob1..t
the Olllc. of tho ...1111' of Will.. "'. of the Z> R...""" DI.td., Dfflc.' cr f,.. '110 Dep.,t..nt.. '4-ho\I'
.._rlno ..,.10. fo, fo,..orel.rlno' 1....-5.'.'..0' ..,.Ic.' for ,..p..." .It~ .p.cl., ....rlI1II ..... I 0'
.p.llk1ng ,...edtl 1~aOO-4~7.S020 (TT onlY).
REPLY TD. .....tlon. ,_,dll1ll .rrorl cont.lned on t~l. notl.. .~ou1d b. odd'....d '0' PA ...."t....t of R..""", .u'.'"
.f In,lIvl_' ,,,... ATTN' Po.t A.......nt ...1.. Unit. Dept. ....01. IIml.burt. PA ,112.....,.-
(717l 111-6505.
DISCQUH1.
If "'. t.. ..... 10 p.ld .lthln '~ro. '51 ..1."''' ..nt~. .ft., tho d.c....n'.. ....,~. . f1va p.,c.nt 'OXl .hc....t
of the tali( paid is .uowttd.
PENALTY 1
T~. lOX ,.. ....,. """'o"tlolp.tlon p.n.H. 10 ..."ut.. on tho 'ot.1 01 ,he '" and Int.'.., .....oed. and ""t
Plid btIfort JlI1UafY II, ~99b, the firlt day ,nar thl -.nd of the ta)( HMlsty periDd.
INn.ST I
In,.,..t II oho,..d b..lnnlno .It~ II'" d.. of ...lIn"""", 0' nine (., .ont~. .nd .... <Il d.. I,oe tho ...t. of
....,~. to tho ...,. of p....ot. T.'" ""I.~ b.c_ d.ll..""n' b.fo'. J"",... 1. 1..2 b." In,.,..t ., t~. rot. of
", "Xl p.""" p" """.. c.'cu1.,ed ., . d.11. n'. 01 .....'" , All ,.... ""Io~ ...- <lo11""""ot on .... .ft.,
J....... 1.'902 .111 ..., 10"'01' ., . ,.,. whlc~ .111 .". f," 0.11"''' .." to C.,."''' ..., .It~ ,~.t nt.
IlMOUflOlld bY thel PA D.part..nt of R.vlnue. Thl appUollbl. intsr..t ret.. for 1982 through ZOOl ara:
V.ar Inter's' A.t, Daily Jnhr..t faator '!I.ar Int.r..t R.t_ O.Uy lotere.t Feotor
--
198' 20:< .00054_ '''' 9X .000247
1915 l'X .0004J8 199]-1994 n ,0110192
1914 m .000301 1995-199_ 9X .000247
1985 nx .0OOlh6 1999 n .00019?
19" lOX .000274 2000 a~ .000219
1987 'X .000247 zoo 1 9~ .000247
1'''.'''' 11;: .000301
4-lnter.llt I. a.laut.ted .. follnN.1
IMTBllEBT . IALAHCE Of TAX UNPAID X MUKBER OF DAYS OELIMqUtMT X DAILY IMTEREST FACTOR
..An. Motlo. 1.._ .ft., t... ,., ..._. ...11_' .111 ,.u.ct .n Int....t .,'cu1.tloo '0 flft..n 001 ....
..._ tho ...,. of ,he ..........t, If p....nt 11 ._ .ft., t... In'.'''' c.....'.tlon ..,. ....... on 'ha
Motlce, IlddUlonal Interut .u.t be o.lcul.t.d.
'Tn"
\
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 estatel
\.
Name 0 f
Date of
Will No.
STATUS, REPORT UNDER RULE 6.12
"",odo'to iE~ rl E
Death 1 /, ,). 4 (,
(), \ .- {L7 - '7 l;{
61 'l-ltT
Admin. No.
1.
State whether administration of the estate is complete I
Yes___ NO-A__
2. If the answer is No, state when the personal
rlJpresentative reasonably believes that the administration will be
completel "'"' :'1' ~"" li- -... '{l. (
3. If the answer to No.1 is Yes, state the followingl
a. Did the personal representative file a final
account with the Court? Yes No___
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
\
\
\
i
I
c. Did the personal representative state an
account informally to the parties in interest? Yes 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.
~.---;~ ';t' .0#'
"..../ ......-7~....-":.:
e/" :;;//d'-~Z::-.~-_
S gn~t.ure'
Date:
OJL!
(l"p.-:
(1 ~:~:
I
I
I
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\.1 .
l'll ',l'
D (XI
o '~'))-
~~
rllf /rr
-
....
l()
N
Et
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JRDIJune 30, 1992/17858
REGISTER OF WIU.s
Cumberland County Courthouse
One Cllurtholl5e Square
CarUsle, PA 17013
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES '
To: ' pecsonal Representative.
CoullSel: Ml\.IlK sILLlKE.IL ESO. ,
ltB: Estateof MI\IlULL~:N BIXL\<;1l _,Deceased, LlIteof
HI\MP\<;N TWP
Estate No.: 21a1997.0718
Date of Decedent's Death: 4' 21..96
Pursuant to Rule 6.12, the above named personal representative or the above named attorney, if
applicable, within two (2) years of the decedent's death, and annually thereafter until administration Is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6.12, in
substantially tbe prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice Is to advise
you that umess the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this N?tice that the Register of Wills
Is required to ootlfy the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that saId Court conduct a hearing to detennine whether sanctions should be imposed upon the
delinquent penooal representative and the delinquent personal representative's counsel, If any.,
AecordiDgly. if the requisite Status Report Is not filed by 6. r 9t6.' i9 -' you are hereby
advised that a request will be submitted to the Court in accordance wit Ru e 6, 12,
DOO: 5.12.98 \..f~O::j/'Im:,~. pvJr~
Deputy egister of Wills
Distribution to Estate File
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Date of
Decedent I JDaL~,_,J:'_~nEil er
Death I J1puJ,aLIIqq{P
Admin. No.dl- q7 -DO?I?
Name of
Will No,
pursuant to Rule 6.17 of the supreme Court Orphans'
Court Rules, I report the [ollowing with respect to completion of
the administration of the ahove-captioned estatel
1.
Sta~whether administration of the estate is complete:
Yes No
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2. If t.he answel- is No, state when the personal
representative reasonabiy believes that the administration will be
complete 1____,__,___,
3. It the answer: t.o No. I is Yes, state the following I
a. Did the personal representat.ive file a final
account with t.he Court.? Yes __,)(- NO,____n_'
b. The sepal'ate Or'philns' Court. No. (if any) for
the personal representative's ilccount is:
c. Did \.he persona 1 represnntative sXe an
account., informally to the parties in interpst.? Yes No
d. Copies 0 f rece i pts, re leases, 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.
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Capacity: personal Representative
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