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Home My WebLink About01-1012 PETITION FOR GRANT OF LETTERS Estate of Mary E. Krow No. 21-01-1012 also known as , Deceased Social Security No. 193-12-9060 Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) CJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or Decedent, dated 12/7/1995 and codicil(s) dated n/a named in the Last Will of the 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 documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 325 Wesley Drive, Lower Allen Township(MechanicsburQ, PA 17055) . (list street, number and municipality) Decedent, then 84 years of age, died October 13, ,2001, at 325 Wesley Drive, MechanicsburQ, PA 17055 (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........ ..... ............................................................. .............. $ Total ..................................................................................................................... $ 245,000.00 245,000.00 Real Estate situated as follows: none Wherefore, Petitioner(s) respectfully 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: Typed or printed name and residence James A. Shoo 3904 Chestnut Street Carn Hill PA 17011 RW-1 /?-/R-/Y Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 admini e the estate c . g to law. Sworn to and affirmed and subscribed before me this 2nc. day of November. 2001 "7~/'~e'~'~<~<~ Estate of Marv E. Krow DECREE OF REGISTER OF WILLS OF CUMBERLAND COUNTY Deceased No. 21-01-1012 also known as Date of Death: 10/13/2001 Social Security No: 193-12-9060 AND NOW, NOVEMBER 5 2001 l"eVerSe side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration , in consideration of the Petition on the ((c.t.a.. d.b.n.c.t.; pendentEflib3; durante ~entia; durante minoriate) are hereby granted to James A. Shoop in the above estate and that the instrument(s), if any, dated December 7, 1995 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... Short Certificates(s) ............... Ren unciation .......................... Extra Pages ( ) ............... :. T. R.. . '" ..... . ... .... ... . .. . .. . ... . .... .. JCP Fee................................. Inventory ................................ Other ...................................... TOTAL........... ..... .............$ $ 270.00 7/~a~~1-~~4')~)f~.,7 Reglst of Wills $ 15.00 $ $ 6.00 $ $ $ 5.00 $ $ J:-1 tf7P~ / I Signature Attorney: Kent H. Patterson 1.0. No: 15307 Address: 221 Pine Street HarrisburQ PA 17101 296.00 Telephone: (717) 238-4100 DATE FILED: / /-6'L-/-"J / ~w~~ "0.<:':., ,:,"':::, r:.---:\" 0'-:-<:; This is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph, No. ~ .ft2~r Fee for this certificate, $2.00 Local Registrar p 7744088 OCT 1 7 2001 Date 21-01-1012 3 Rev. 2117 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT Of HEALTH · VITAL RECORDS CERTIFICATE Of DEATH NAME ~ DECEDENT (For.. ModeIe.lalll SEX $Wlfll.E_f11 SOCIAl SECURITY NUMBER DAlE ~ DEATH .MonlII. o.~ ..... Middletown 2. female 2. 193 - 12 9060 ~ ~ DEAI'H 1C/>eclI.........".. _ ......UCloOf'S on _ -. HOSP\lAL.: ......._ 0 ER/()uqIMienl 0 ~ 0 .. October 13. 2001 1. E. Krow UNDER 1 VIAA MonlIW Daya IIRTHPI..ACE (Coly and SlaIe Of FCleqo CClUfllIYI eo.. (1'.Of~+1 MAAI1Al. SWUS . ........ ~u.mM.~. ow-.d~ 14. IN 17..0 ....... dIIcedent..... III g::ilVIO Cumberland DECEOENrS USUALOCCUMnON (:-..:=:.:., ':: ':::.l::r .... office mana er 11 federal govermen 2- llECS)ENT'S UAIUNG AOONSS (SIr...~. SIMe. ~ Codel DECEDENT'S 3509 Walnut St. =r~~ Camp Hill, Pa. 17011 :-0::::'" Ie. Bethany Village V\N DECEDENT EVER IN U.S. ARMED FORCES? .... 0 No Ql white SUfMVING SPOUSE .. ...... gooe-""" 17L S18le Pa. Old decedenI ... in. --.' .... 17lJ. Cumberland ~. 17011 "-"- SlaI.D PAIIT .: Olhar 1igniIIcInl~-............ bill nail"""'" in... UIIlIIIlWlnlI-~ III fWn I. L E DUE 10 10ft AS" CONSEOUENCE Of): Wi'S AN AU10PSV WEllE AUlOPSY FINOIHGS MANNER OF DEATH DATE ~ lfUURY PERFOfIUEO? ~PAIORlO (MonlII. Day. ....1 COUPLETIOH OF CAUSE K ~ OERH' ...... HonIicide Acc*nl D Pending~ ...... 0 No ......0 NoD SuleId. 0 Could_be~ TIUE ~ INJURY INJUAV AI' WORK? DESCfIII8E t40W INJURY OCCUAAED. 'PRONOlINCINQ AND CERTIFYING PHYSICIAN ~ ball> "'~ _ _ ce<1IIyor1V 10 cause 01_1 TO........ol..'kMwIecIge......__..........lIe,..Mldptec.. ....._....caUM(.'Mldm.nn.r.....'............................. NoD .SWeI ... 2A. 21. c:un.... ~ only one! 'CERTIFYING PHYlIIClAN ""'yIlCOAftcertilytnQ_~_ _-...Ilh~_l\aslll__de"'" _~ _ 23) To......ol""lulowIecIge.daath_........eauee(.I__............................................................. . '1IEDICAL EXAIIINERlCORONEIl 011... bMIa of ..........~ andfor InvtI..\gaIlort,1n my opinion. ..'" occurred .. ....lIme. d.... .lId plac.. and du. '0 .he cauM(a' and :l1.~" ......... . . . . . . . . . . . . .. . . . . . . .. . .. . . . . . . .. . . .. . . . . . . . .. .. . . . . . . . . .. . .. . . . . . . .. . . . . . .. . .. . . . . .. . . . . .. .. . .. D """"""."'G~~ ~7"-- ,ol, I ~,I/ I 34. .u. Ie AOO I .- .... ... . f . r........ .'" ~ 21-01-1012 LAST WILL AND TESTAMENT OF MARY E: now I, MARY E. KROW, of 3509 Walnut Street, Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I I hereby direct my hereinafter named Personal Representative to pay all of my just debts, funeral expenses and estate and inheritance taxes as soon after my death as may be found convenient. I further direct that my Personal Representative pay all estate, inheritance and other death taxes as expenses of the administration of my estate with respect to property constituting my gross estate for death tax purposes, whether or not such property passes under this Will. ITEM II - I give and bequeath the sum of $1,000 to TRINITY EVANGELICAL LUTHERAN CHURCH, Camp Hill, Pennsylvania, and direct that it be used for the music program at the Church. ITEM III - I give and bequeath any automobiles owned by me at the time of my death to my sister, DOROTHY E. SNYDER. ITEM IV - I give and bequeath all jewelry owned by me at tt time of my death to my sister, RACHAEL A. YOUNG. ITEM V - I give, devise and bequeath all the rest, residue remainder of my estate, whether real, personal or mixed, whatsoever nature and kind and wheresoever situate, to my brat' .... , . . . ,.. " and sisters, DOROTHY E. SNYDER, of Yocumtown, PA; RACHAEL A. YOUNG,of Houston, TX; JAMES A. SHOOP, of Camp Hill, PA; and LESTER B. SHOOP, of Camp Hill, PA, who are living at the time of my death, in equal shares, provided, however, that if James A. Shoop should predecease me, then his share shall be distributed to his wife, Harriet D. Shoop, and if Lester B. Shoop should predecease me, then his share shall be distributed to his wife, Phyllis J. Shoop. ITEM VI - I appoint James A. Shoop as Executor of this, my Last Will and Testament, but if he should predecease me or otherwise be unable to serve, then I appoint Lester B. Shoop as Executor. ITEM VII - I direct that my Personal Representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7!!:- day of ~ ~ 1995. MAD:\v~ ~, ~~ Signed, sealed, published and declared by the above Testatrix, MARY E. KROW, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other, we, believing her to be of sound mind and memory, have hereunto subscribed our names as witnesses. ~ t-I;r~"l-- / I J ~J-- -r:: :::v '~~ of ?-- d- \ Pl/V-..f ~ ~'/{~(}. f?+ nJO J _?,s-/t> w~ A-L. (;~O WiLe f /0. ) 70 /J of -2- .. ~ '. COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF We, MARY E. KROW, Testatrix, 7}1?/7-CJ/ ~#e/5'0/7 and .:73>>;;e.s /( v /j1/)5-Z:,~;';~ , wi tnesses, respectively, whose names are J signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority, the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that, to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. m~. ~I 1V>-/atL MARY E. OW . --- - b r /Iq~vv~ / I c;)ft~ K -7/ '12:j~ Subscribed, sworn to and acknowledged before me by MARY E. subscribed and sworn to before me by and ~~~ , day of , 1995. My Commission Expires: Notary Public NOTARIAL SEAL ESPIRIRRION A. COLUNGA, Notary Public Middletown PA, Dauphin Co~nty My Commission Expires May 7, 1998 -3- REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6{a) Name of decedent Mary E. Krow Date of death October 13, 2001 Will No. Admin No. 2001-01012 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 21, 2002. Name Address James A. Shoop 3904 Chestnut Street, Camp Hill, PA 17011 Lester B. Shoop 700 Nailor Drive, Apt. 204, Camp Hill, PA 17011 Dorothy E. Snyder 1210 Yocumtown Road, Etters, FA 17319 Rachael A. Younq 8534 Hiqhcrest Drive, Houston, TX 77055 Trinity Evangelical Lutheran Church 2000 Chestnut Street, Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6{a). Date: ~-;)./ -OJ- ~17~ Signature -;:qUUl~) <p:'.) ;~) Name Kent H. Patterson Address 221 Pine Street 17[: Ot\! ZZ 83:1 lO. Harrisburq, PA 17101 Telephone (717) 238-4100 Capacity: Personal Representative x Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KENT H PATTERSON ESQUIRE 221 PINE STREET HARRISBURG, PA 17101 -------- fold ESTATE INFORMATION: SSN: 193-12-9060 FILE NUMBER: 2101-1012 DECEDENT NAME: KROW MARY E DA TE OF PAYMENT: 07/15/2002 POSTMARK DATE: 07/12/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/13/2001 NO. CD 001405 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $26,000.00 I I I I I I I I TOTAL AMOUNT PAID: $26,000.00 REMARKS: JAMES A SHOOP C/O KENT H PATTERSON ESQUIRE CHECK# 113 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS 6 KENT H. P ATfERSON ATTORNEY AT LAW 221 PINE STREET HARRISBURG, PENNSYLVANIA 17101 TELEPHONE (717)238-4100 TRANSMITTAL July 12, 2002 TO: Register of wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 FROM: Kent H. Patterson RE: Estate of Mary E. Krow No. 2001-01012 Enclosed is a check made payable to the Register of wills, Agent in the amount of $26,000 for payment on account of the inheritance tax for the estate referred to above. Would you also please send me four (4) short certificates of letters testamentary for this estate. Enclosed is a check for $12.00 and a self addressed, stamped envelope. Thank you. .~"""':, ,.;"'~.- ~: ~ KHP/cvf Enclosures ~......rt_ ({ ~! ".' ,.,' \ ... \ '. :, " \ - '- ~ :.2:: CL.. \'?- \<Y(, ~j"~ Z .-I 0 .-I 0 t-- .-I rn -< -.; ~ ~ z ~ E-o ~ J;:;1 8 ~ f:;1 ~ ~ p:: ~ ~ E-o rn ~ rn Z ~ J;:;1 Z ~ Z Z ~ p:: -.; ~ ~ 0 0.. ri E-o .-I p:: ~ 01 :J 8 01 ~ Z rn -.; ~ p:: p:: ~ -< :I1 '02 JUL 15 P -, : -: 1 G) to ::;j o ..c: .&J ~ ::;j G) o H CJ as to ~ 6. ~ r-i.&JtIlO r-i ~ t' .rf ::s G) M :3: 0 Ul CJ ::s tcC ~ 0 ~ orcs..c: r::.&J ... J.1 cd H G) G) r-i ::s r-i .&J H 0 tJ) Ul G) U .rf .~ ~ G) s:: G) ::J r:: cd !X:CJOCJ o (<., t:;') ,:-., (r' (':' (.:. ,+. ,..:. ..... 1St r", ..,.... JRD/June 30, 1992/17858 ,. NOV 0 5 2003 V Estate No.: 21-2001-1012 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA 21-2001-1012 In Re: Estate of Mary E. Krow Late of Lower Allen Township NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative Kent H. Patterson, Esquire Date of Decedent's Death 10-13-2001 Date of Delinquency Notice: 09-09-2003 The undersigned, Donna M. Otto, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 09-09-2003, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11-03-2003 Distribution: Personal Representative Counsel for Personal Representative Estate File I-a 9 -tJ i/ t?-. )t:) It III, A hearing is scheduled for at / in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancel .~~ ~ 4,'O~~ Geor [J"" ru' CJ CJ ru ...D c[] Ul Postage Certified Fee ...D CJ CJ CJ Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Postmark Here CJ ....=I Ul ru Sent r:J CJ CJ ["- ,/ ..... -. Court of Common Pleas of Cumberland County In Orphans' Court Division STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary E. Krow Date of Death: October 13, 2001 will No. Admin. No. 2001-1012 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 No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: July 2004 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 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 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Page 1 of 2 ~ -. Date: I - 7 ,)--C/C/~ ~h.f~ Signature / /. ~ Kent H. Patterson N~e (Please type or print) 221 pine Street Harrisburg, PA 17101 Address (717) 238-4100 Tel. No. Capacity:___ Personal representative ~ Counsel for personal representative Page 2 of 2 ...-J 15056041125 REV -1500 EX (06-05) PA Department of Revenue .. Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number "L..-\ D \ (? ~ OlL-- Date of Birth 193129060 1 0 132 001 o 1 0 1 1 9 1 7 Mar y MI E Decedent's Last Name K row Suffix Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW [gJ 1. Original Return o 4. Limited Estate [gJ o 2. Supplemental Return o o 1 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes Ken t H . Fat t e r son Firm Name (If Applicable) :-REGISTER OF WILLS-USEONLY-. i I 2 2 1 Fin e Street !h_,_'"J ~.~ - ) i::::.) --l First line of address =-~.... Second line of address r', ') City or Post Office State ZIP Code -.J L_..__~~TE:Fl!:.~~,", .. H a r r i s bur 9 FA 17101 I' r'J 0, RESS ames A. Shoop, SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE DATE ADDRESS 3904 Chestnut Street Camp Hill PLEASE USE ORIGINAL FORM ONLY FA 17011 Side 1 L 15056041125 15056041125 ~ ?J -.J 15056042126 REV-1500 EX Decedent's Name: Mary E. Krow RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) .................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous N~Probate Property (Schedule G) U Separate Billing Requested. . . . . ., 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 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.O _ 16. Amount of Line 14 taxable at lineal rate X .0 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 o . 0 0 15. o . 0 0 16. 254388.33 17. o . 0 0 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042126 Decedent's Social Security Number 193129060 2315400 202219.09 4 9 2 3 5. 8 8 2 7 4 6 0 8 9 7 1 8 8 5 8. 3 5 3 6 2 2 9 1 9 2 2 O. 6 4 2 5 5 3 8 8. 3 3 1 0 0 O. 0 0 2 5 4 3 8 8. 3 3 O. 0 0 O. 0 0 30526.60 O. 0 0 3 0 52 6.60 o 15056042126 ~ REV-1500 t:X Page 3 Decedent's Complete Address: DECEDENT'S NAME Mary E. Krow STREET ADDRESS 325 Wesley Drive File Number o o (Borough of Mechanicsbur_9'I ~~erland County) CITY Mechanicsburg I STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 30,526.60 26,000.00 Total Credits (A + B + C) (2) 26,000.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, line 20 to request a refund. (4) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,526.60 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 1,195.09 A. Enter the interest on the tax due. 5,721. 69 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 property transferred; ...................................................................... D !ZI b. retain the right to designate who shall use the property transferred or its income; ............................... D !ZI c. retain a reversionary interest; or ................................................................................................ D !ZI d. receive the promise for life of either payments, benefits or care? ....................................................... D !ZI 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... D !ZI 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... D !ZI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. !ZI D 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)l. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return 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 value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P .S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent. except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 'REV-1503i:X + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Mary E. Krow FILE NUMBER o 0 All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 2,714.80 220 shares of Waypoint stock at $12.34 per share 2. US Savings Bonds Series EE 20,439.20 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 23,154.00 ESTATE OF MARY KROW LIST OF SAVINGS BONDS Serial Number Value M20892443 $ 1,137.60 M20892444 $ 1,137.60 M26034248 $ 1,078.80 M26034249 $ 1,078.80 M28225690 $ 1,036.80 M35260410 $ 1,016.40 M35260411 $ 1,016.40 M35260387 $ 1,016.40 M35873471 $ 1,016.40 M35873486 $ 986.80 M42993446 $ 930.40 M43049750 $ 903.20 M43755792 $ 876.80 M48175686 $ 876.80 M43806297 $ 876.80 M49420174 $ 876.80 M52777956 $ 851.60 M45983692 $ 826.80 M59901969 $ 745.20 M61880533 $ 728.00 M61969630 $ 728.00 M65008878 $ 696.80 Total $20,439.20 . REV-150a'EX + (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary E. Krow FILE NUMBER o 0 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION VALUE AT DATE OF DEATH 6,359.87 ITEM NUMBER 1. Waypoint Bank Checking account 100351410 2. Waypoint Bank Checking account 4100041525 3. Waypoint Bank Certificate of Deposit 4. Mellon Bank Checking account 172-552-2567 5. Mellon Bank Savings account 003255-071098 6. Mellon Bank Certificate of Deposit 00405799 7. Mellon Bank Certificate of Deposit 01104897 8. Mellon Bank Certificate of Deposit 0-A03044-C 9. Mellon Bank Certificate of Deposit 0-B19843-C 10. Mellon Bank Certificate of Deposit 16-A331928-C 11. Asbury, Inc. refund 12. Blue shield refund 13. Federal insurance death benefit 14. PA Department of Revenue 2001 tax refund 15. IRS 2001 tax refund 16. Wachovia Bank Certificate of Deposit 247412091384797 23,206.82 40,072.79 4,310.50 24,689.02 22,120.69 18,198.94 3,597.03 11,721.43 11,981. 04 161. 26 63.77 572.74 198.00 2,281.00 32,684.19 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 202,219.09 . . REV-151.( EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Mary E. Krow ITEM NUMBER A. 1. 2. 3. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ll. 12. 13. FILE NUMBER o 0 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Neumyer Funeral Home Shoop's Cemetary Evan's Cemetary Memorials ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City Stale Zip Year(s) Commission Paid: AttomeyFees Kent H. Patterson Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal Patriot-News Register of Wills - short certificates Register of Wills - inventory and inheritance tax return Guy Accounting Services Padden, Guerrini & Associates, P.C. - accounting fees Reserve for costs and accounting fees TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 7,845.92 625.00 125.00 7,500.00 296.00 75.00 108.43 33.00 30.00 270.00 450.00 1,500.00 18,858.35 REV-1512 EX + (12-03) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER o 0 Mary E. Krow Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Andrews & Patel 150.00 medical expense 2. Lower Allen EMS 63.77 3. Lower Allen EMS 63.77 4. West Shore EMS 84.75 TOTAL (Also enter on line 10, Recapitulation) $ 362.29 (If more space is needed, insert additional sheets of the same size) . ,,,.,,,, ",. ". SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marv E. Krow NUMBER I. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Dorothy E. Snyder 1210 Yocumtown Road Etters, PA 17319 Rachel A. Young 8534 Highcrest Drive Houston, TX 77055 James A. Shoop 3904 Chestnut Street Camp Hill, PA 17011 Lester B. Shoop 700 Nailor Drive, Apt. 204 Camp Hill, PA 17011 FILE NUMBER o 0 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Sibling Sibling Sibling Sibling AMOUNT OR SHARE OF ESTATE 63,597.08 63,597.08 63,597.08 63,597.09 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX 1$ NOT BEING MADE 2. 3. 4. 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Trinity Lutheran Church TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) 1,000.00 $ 1,000.00 LAST WILL AND TESTAMENT OF MARY E. KROW I, MARY E. KROW, of 3509 Walnut Street, Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I I hereby direct my hereinafter named Personal Representative to pay all of my just debts, funeral expenses and estate and inheritance taxes as soon after my death as may be found convenient. I further direct that my Personal Representative pay all estate, inheritance and other death taxes as expenses of the administration of my estate with respect to property constituting my gross estate for death tax purposes, whether or not such property passes under this Will. ITEM II - I give and bequeath the sum of $1,000 to TRINITY EVANGELICAL LUTHERAN CHURCH, Camp Hill, Pennsylvania, and direct that it be used- for the music program at the Church. ITEM III - I give and bequeath any automobiles owned by me at the time of my death to my sister, OOROTHY E. SNYDER. ITEM IV - I give and bequeath all jewelry owned by me at the time of my death to my sister, RACHAEL -A. YOUNG. ITEM V - I give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed, of whatsoever nature and kind and wheresoever situate, to my brothers and sisters, DOROTHY E. SNYDER, of Yocumtown, PAi RACHAEL A. YOUNG,of Houston, TXi JAMES A. SHOOP, of Camp Hill, PAi and LESTER B. SHOOP, of Camp Hill, PA, who are living at the time of my death, in equal shares, provided, however, that if James A. Shoop should predecease me, then his share shall be distributed to his wife, Harriet D. Shoop, and if Lester B. Shoop should predecease me, then his share shall be distributed to his wife, Phyllis J. Shoop. ITEM VI - I appoint James A. Shoop as Executor of this, my Last Will and Testament, but if he should predecease me or otherwise be unable to serve, then I appoint Lester B. Shoop as Execu tor. . ITEM VII - I direct that my Personal Representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7 '[!::. day of ~~ 1995. ~~ [, K~ S'iqned, sealed, published and dec~ared by the above Testatrix, MARY E. KROW, as and for her Last Will and Testament, in our pre~ence, who, at her request, in her presence and in the presence of each other, we, believing her to be of sound mind and memory, have hereunto subscribed our names as witnesses. of ~~ \ PLAri ~ ~/f~. f?+ {I/OJ -~U.> W~V. O~ ~ t a.. ;/011 ~ r-1j/2~ t. I Y ~'J.- ~:J7'~~ of -2- COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF We, MARY E. KROW, Testatrix, 7j1?-"7-;f-f/ Me/5"0/7 and $mes K $) ,~q05--zf;;';t:) , witnesses, respectively, whose names are d signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority, the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of ,the witnesses, in the presence and hearing of the Testatri~, signed the Will as witnesses and that, to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~ m~ [. 1Vunif MARY E. 'W i:--. r /Ig~ / . ~~ k .-pJ@~ Subscribed, sworn to and acknowledged before me by MARY E. KROW, the witnesses, and subscribed and sworn to before me by and ~ , day of , 1995. My Commission Expires: Notary Public NOTARIAL SEAL ESPIRIRRION A. COlUNGA, Notary Public Middletown PAt Dauphin County My Commission Expires May 7, 1998 -3- .,., ~ INVENTORY Estate of Mary E. Krow No. 2001-01012 also known as Date of Death 10/13/01 Social Security No. 193-12-9060 , Deceased James A. Shoop Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedenfs death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: Kent H. Patterson 1.0. No.: 15307 F7~ 6tet:::vTTJ R. Dated Li/3 0 /O? Address: 221 Pine Street Harrisburg Telephone: (717) 238-4100 PA 17101 Description Waypoint Bank account #100351410 Value Waypoint Bank account #4100041525 Waypoint Bank Certificate of Deposit # 1866239296 C) S;o .-'::;::0 'l) I~~~ _Cr5X ~j~~ Mellon Bank account #172-552-2567 Mellon Bank account #003255-071098 ~,- --'..1 :::::; E Mellon Bank Certificate of Deposit #00405799 Total (Attach Additional Sheets if necessary) 6,359.87 23,206.82 4o.g72.79 <:::;:> (~ ~ :r,: .~, . ~10.$O /< "...,' co 2l689.h2 w w ~, 120.69 225,373.09 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 ) '. . Continuation of Inventory Mary E. Krow 2001-01012 Page 1 Description of Inventory Description Value Mellon Bank Certificate of Deposit #01104897 18,198.94 Mellon Bank Certificate of Deposit #0-A03044-C 3,597.03 Mellon Bank Certificate of Deposit #O-B 19843-C 11,721.43 Mellon Bank Certificate of Deposit #16-A331928-C 11,981.04 US Savings Bonds Series EE $1,000.00 denominations (see attached list) 20,439.20 Asbury, Inc. refund 161.26 Blue Shield refund 63.77 Federal Insurance death benefit 572.74 PA Department of Revenue 2001 tax refund 198.00 IRS 2001 tax refund 2,281.00 220 Shares of Waypoint Bank stock at $12.34 per share 2,714.80 Wachovia Bank Certificate of Deposit 247412091384797 32,684.19 Subtotal $ 104,613.40 225,373.09 Grand Total $ ~ ESTATE OF MARY mow LIST OF SAVINGS BONDS Serial Number Value M20892443 $ 1,137.60 M20892444 $ 1,137.60 M26034248 $ 1,078.80 M26034249 $ 1,078.80 M28225690 $ 1,036.80 105260410 $ 1,016.40 105260411 $ 1,016.40 105260387 $ 1,016.40 105873471 $ 1,016.40 105873486 $ 986.80 M42993446 $ 930.40 M43049750 $ 903.20 M43755792 $ 876.80 M48175686 $ 876.80 M43806297 $ 876.80 M49420174 $ 876.80 M52777956 $ 851.60 M45983692 $ 826.80 M59901969 $ 745.20 M61880533 $ 728.00 M61969630 $ 728.00 M65008878 $ 696.80 Total $20,439.20 COMMONWEiQ, M v~NNSYlVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SHOOP JAMES A 3904 CHESTNUT STREET CAMP HILL, PA 17011 _____n_ fold ESTATE INFORMATION: SSN: 193-12-9060 FILE NUMBER: 2101-1012 DECEDENT NAME: KROW MARY E DA TE OF PAYMENT: 04/27/2007 POSTMARK DATE: 04/27/2007 COUNTY: CUMBERLAND DA TE OF DEATH: 10/13/2001 NO. CD 008091 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $5,721.69 I I I I I I I I TOTAL AMOUNT PAID: $5,721.69 REMARKS: RECEIPT GIVEN TO ATTORNEY CHECK# 507 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS Court of Common Pleas of Cumberland County In Orphans' Court Division C) Co ':_-~::D .~~o ;~~~ ~"" 1:"':::':)- = --.I :;0.. C GJ N m STATUS REPORT UNDER RULE 6.12 (") CO) (--:J -"Tl ,)':6 _.~ i Name of Decedent: Mary E. Krow Date of Death: October 13, 2001 Will No. Admin. No. 2001-1012 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' 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 Clerk of the Orphans' Court and may be attached to this report. Attached to this report are copies of proofs of publication of legal advertisements in the Cumberland Law Journal and The Patriot News. Page 1 of 2 ~ 1...0 N j . . J The estate was settled by a Rece1pt, Release and Rerund1ng Agreement for Final Distribution executed by the executor and the heirs under the will. Date: ?/7-7/o7 Signature ~ /I. ~ J~ A. Shoop Name (Please type or print) 3904 Chestnut Street Camp Hill, PA 17011 Address (717) 761-7606 Tel. No. Capacity:~Personal representative ___Counsel for personal representative Page 2 of 2 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16,1929), P. L.I784 STATE OF PENNSYL VANIA : ss. COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, VlZ: MARCH 1, 8, 15,2002 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Krow, Mary E., dee'd. Late of Lower Allen Township. Executor: James A Shoop, 3904 Chestnut Street, Camp Hill. PA 17011. Attorney: Kent H. Patterson. Es- SWORN TO AND SUBSCRIBED before me this 15 day of MARCH. 2002 quire. 221 PIne Street. Harris- burg. PA 17101. NOTARIAL PublIc lOlSE.~~~~ CarIsIe Boro. \"rUlTIUVIIGIN 5 My CommI8alon Expir8s March · . THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16,1929 Commonwealth of Pennsylvania, County of Dauphin} ss Michael Morrow being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and..I!li! Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 26th day(s) of February and the 5th and 12th day(s) of March 2002. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COpy Notarlal Seal Terry L. Russtlll, Notary Public Harrisburg, Dauphin County My Comlllission Expires June 6,2002 NOT Y PUBLIC Member, PennsylVania Association 01 NotarieMy commission expires June 6, 2002 KENT H. PATTERSON ATTORNEY-AT-LAW 221 PINE STREET HARRISBURG, PA. 17101 Statement of Advertising Costs To THE PATRIOT-NEWS CO., Dr. For publishing the notice or publication attached hereto on the above stated dates $ Probating same Notary Fee(s) $ Total $ 106.68 1.75 108.43 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. By.................................................................... 08-06-2007 KROW 10-13-2001 21 01-1012 CUMBERLAND 101 APPEAL DATE: 10-05-2007 ( See reverse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 . BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX it;'~(~t:~)'AEl'lrr'~~-o\'l~NCE OR DISALLOWANCE lll':;.,I)ED,Il'eTf~KS'>'AND ASSESSMENT OF TAX i-;l~ ;,,:;, ~> i L. 2001 AUG I 0 DATE Mi II: I 'STATE OF DATE OF DEATH FILE NUMBER COUNTY ACN Pi\. KENT H PATTERSON 221 PINE ST HBG CLERK OF ORPH,!:.~\!'S C(iURT CUI,,/:~r 'f.r ~\ PA 17101 . REV-1547 EX AFP (06-05) MARY E TO: 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 KROW MARY E FILE NO. 21 01-1012 ACN 101 DATE 08-06-2007 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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 !bh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal ~ate 16. Amount of Line 14 taxable at Lineal/Class A ~ate 17. Amount of Line 14 at Sibling ~ate 18. Amount of Line 14 taxable at Collate~al/Class B ~ate 19. P~incipal Tax Due X R A N DATE 07-12-2002 04-27-2007 07-30-2007 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN .00 23.154.00 202,219.09 .00 .00 .00 49,235.88 (8) 1. Real Estate (Schedule A) 2. 3. 4. 5. 6. 7. 8. (1) (2) (3) (4) (5) (6) (7) Stocks and Bonds (Schedule B) Closely Held Stock/Pa~tne~ship Inte~est (Schedule C) Mo~tgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Misc. Pe~sonal P~ope~ty (Schedule E) Jointly Owned P~ope~ty (Schedule F) T~ansfe~s (Schedule G) Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fune~al Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mo~tgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Retu~n 13. Cha~itable/Gove~nmental Bequests; Non-elected 9113 T~usts (Schedule J) 14. Net Value of Estate Subject to Tax 18,858.35 (9) ClO) 362.29 (11) Cl2) Cl3) Cl4) NOTE: Cl5) Cl6) Cl7) Cl8) .00 .00 254,388.33 .00 X 00 X 045 = X 12 = X 15 = (+) PAID (-) .00 1,195.09- .00 C NUMBER CD001405 CD008091 SBADJUST AMOUNT PAID 26,000.00 5,721.69 .01 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insu~e p~ope~ c~edit to you~ account, submit the uppe~ po~tion of this fo~m with you~ tax payment. 274,608.97 19.~~D l;4 255,388.33 1,000.00 254,388.33 Cl9)= .00 .00 30,526.60 .00 30,526.60 30,526.60 .00 .00 .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. C:.IJ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)