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HomeMy WebLinkAbout01-0607 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of R!';rnpr M~p- T.~y also known as No. To: ~l-O\- CtJ01 Register of Wills for the County of Cumber 1 and in the Commonwealth of Pennsylvania Deceased. Social Security No. 1 q 2- 3 2-14 6 3 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl y for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in h 8r last family or principal residence at Cumber land County, Pennsylvania, with 31 Mountain View Terrace. Upper Frankford Newv i 11 e (list street, number and municipalitY)Twp . Decendent. then 57 years of age, died ~ Carlisle Hospital March 17, 2001 ,~ Decendent at death owned property with estimated values as folllows: (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 situated as follows: N/A 25.000.00 $ $ $ $ Petitioner--5- after a proper search ha--Y.e. ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Dau hter Son Newville,PA ensburg, PA e Canaveral, lisle, PA THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ '" 'i:l u c '" -o~ .- '" "'~ "'.... cq;! -00 c''::: ~.= ~~ '<1,- 50 (;j c 00 Vi L1H1 f t1 ilM?~ee-.- Bever. y A. Hamilton c:2 ~ 7).,t:d/~~~ Donald . Ctlestnut ~ E:. ~~ Keith E. Chestnut James E. Chestnut, Jr. ,lo - ~ O~ - ) 3 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF C'nMRERL~T\1D } 58 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ~i~~~v .T)nn;;l 1 r'l T. ('np~t-nllt- No. ames E. cnestnut, Jr. ~JiL (i~-=--_ Keith E. Chestnut 21 - 01 - 607 ;-' t.....~ Estate of , Dec~ed F.sther Mae Lay __ _J GRANT OF LETTERS OF ADMINISTRATION - '" '-' ~ ... = .... ell = tlI) 00 AND NOW JUNE 28, 1~2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that HF"TPrl y 'A._ Hrlmi It-nn, nnnrllc'l T._ r.h~!';tnnt-, .Trlm~s E. Chestnut, is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration Jr. and Keith E. are hereby granted to Beverly A. Hamilton, Donald L. Chestnut, Chestnut .rames~Chestnut,~..~~th.. E. Chestnut in the estate of Esther Mae T.ay Lrf{Alc.J€~~ a,&~ MARY CLEWIS FEES Letters of Administration Short Certificates( 5) . . . . . . . . . . Renunciation ................ JCP $ 60.00 $ 15 00 $ $ 5 00 TOTAL _ $ 80.00 Filed.. .~V~.E. .~e........... A.D. >q:9~ JamQS K. JGnoc, Ecquiro 39031 ATTORNEY (Sup. Ct. 1.0. No.) 7 T rv; n p 'R n~.7. ('::l r 1 ; s 1 E'. PAl 7013 ADDRESS 240-0296 PHONE OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ('TlM'PE"RLnl\TD } 88 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according t~ ~tfr" I ,,\ OUm.. '" Sworn to or affirmed and. iJI~f~~~"cr' (/~ before me this MAY 08 200E'.-j) flay C$f...\ v '^~~'TPl"l y 'A Hrlm; 1 t-nn -. ;)19) . . ~"'. ~~ '~?)l<'.. :.~ I~~ L '. . . ': d'il< , par F. ~/ Y5.~92.c.o ':, ~e.gister L~'- ames . 0 C es nu I rO. ScoU 1::.1115, clerk 4S TV~€5 ..~ Brevard County, J=lorida C l/"z:STI\;\..I:;" .:S]e, ,-. '" '-' u ... ::I .... III c: co Cii No. ()/J,,'1 Keith E. 21 - 01 - 607 Chestnut Estate of Esther Mae Lay , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW JUNE 28, xj9 2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that Rp'TPrl y :no.. Hrlm; 1 t-nn. Dnnr.ll d To _ r.hestnnt- I .Tr.lmes E. Chestnui is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration Jr. and Keith E. Chestnut areherebygrantedto Beverly A. Hamilton. Donald L. Chestnut, -ilam.e..s~-Che.s.:t~_il.L....an.d-Ke.ith..E. Chestnut in the estate of Esther Mae J,r.lY lmo8. ri.~~~1t{)&91. MARY CLEWIS FEES Letters of Administration $ Short Certificates( ).......... $ Renunciation ................ $ $ TOTAL _ $ Filed ..................... A.D. 19_ J.mQS K. Jonoo, Eoquiro -39031 ATTORNEY (Sup. Ct. 1.0. No.) 7 Trv;np 'Rn~J, (';::n-lislp, PA 17013 ADDRESS 240-0296 PHONE PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of F.!":+npr Mne Tony also known as No. To: ,;)\- O\-(oCL- Deceased. Social Security No. 1 q 2-32-1463 Register of Wills for the County of ~erl and in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl y for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante m;norilate) the above decedent. Decendent was domiciled at death in Cumber land County, Pennsylvania, with h er last family or principal residence at 31 Mountain View Terrace, Upper Frankford N EWV ILL E {list street, number and municipalitY)Twp . Decendent, then 57 years of age, died ~ Carlisle Hospital March 17, ?99J., ",~ Decendent at death owned property with estimated values as folllows: (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 situated as follows: N/A 25.000.00 $ $ $ $ Petitioner-E- after a proper search ha~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Dau hter Son Newville;P ensburg, P e Canavera lisle, PA THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration 111 the appropriate form to the undersigned. ~ '" '-" <l) u t: <l) ~~ Beverly A. Hamilton C'.~ -g.g ~''::: 3d: ~ C5 't?~--".t7. (":/.~-<< ' ~ James E. Chestnut, Jr. Vi Donald L. Chestnut Keith E. Chestnut REV-1500:X (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY <:!., ~ -- t5lM- /(3 FILE NUMBER 2 1 -0 1 0 0 6 0 7 -- -- ----- COUNTY CODE YEAR NUMBER I- Z W C W o W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) LAY, ESTHER M. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) March 17 2001 Januar 26 1944 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- It:!Ul utt:lt wl1.U :1:00 utt:..J l1.111 l1. c( IKJ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95) SOCIAL SECURITY NUMBER 192 - 32 - 1463 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date 01 death pnorto 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I- Z W C Z o l1. Ul w tt: tt: o U NAME James K. Jones FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 240-0296 COMPLETE MAILING ADDRESS 7 Irvine Row Carlisle, PA 17013 k ~ OFFICIAL USE ONLY (1) (2) (3) (4) (5) 18.932.96 (6) 2,171.72 (7) (8) 21,104.68 (9) 3.040.30 (10) 1,025.08 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (11) 4 . () h S 1 R (12) (13) (14) 1 7 , 039 . 30 766.77 766.77 z o ~ ..J ::;) l- e: <C o w 0::: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ~ ::;) D. ::E o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 17.039.30 x.O_ (15) x .0 45 (16) x .12 (17) x .15 (18) (19) 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 31 Houn CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ZIP 1 7 241 Total Credits ( A + B + C ) (2) 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. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 a. retain 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 interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust fo~' or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....... .............. ..... ....... ... ..................... ........ ........... ............................................ 0 No o [] [] [] o [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. DATE A. Hamilton Adminstratrix ( PA 17241 James K. Jones Carlisle, PA 17013-3019 L_JlIWL 1111I11 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 3% [72 P.S. 99116 (a) (1.1) (i)]. 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 0% [72 P.S. 99116 (a) (1.1) (ii)]. 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 0% [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 4.5%, 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 12% [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-l506 EX ;(1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ESTHER M. LAY FILE NUMBER 21-01-00607 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 1999 Pontiac Grand Am 2. Mobile Home VALUE AT DATE OF DEATH 9,200.00 8,500.00 1,232.96 3. Misc. personal property TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-15OiEX + (1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ESTHER M. LAY FILE NUMBER 21-01-00607 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT ~ 1 '1 Bever y A. Ham1 ton 724 Shippensburg Road Newville, PA 17241 Daughter B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. ~ Members 1st FCU, checking, savings 4,343.43 50% $2,171.72 and CD TOTAL (Also enter on line 6, Recapitulation) $ 2,171.72 (If more space is needed, insert additional sheets of the same size) REV~1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ESTHER M. LAY FILE NUMBER 21-01-00607 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. Eggers Funeral Home 2. Funeral Flowers DESCRIPTION AMOUNT 1,175.00 52.95 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees - Law Office of James K. Jones 950.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 80.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Mountain View Terrace-Lot rent 720.00 8. Roy D. Gottshall-property appraisal 45.00 9. Yard sale costs 17.35 TOTAL (Also enter on line 9, Recapitulation) $ 3 , 040 . 30 (If more space is needed, insert additional sheets of the same size) . REV-1512EX-[1-971 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ESTHER M. LAY FILE NUMBER 21-01-00607 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 456.76 1. West Shore EMS - ambulance service 2. Newville Community Ambulance - ambulance service 391.00 3. Adams Electric - electric service 129.42 4 . Waste Systems, Inc. - trash removal 47.90 TOTAL (Also enter on line 10, Recapitulation) $ 1. 025.08 (If more space is needed, insert additional sheets of the same size) .. "8;-151 "X. (9~O. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF ESTHER M. LAY FILE NUMBER 21-01-00607 NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] AMOUNT OR SHARE OF ESTATE 1. Beverly A. Hamilton 724 Shippensburg Road Newville, PA 17241 daughter 25% 2. Donald L. Chestnut 5239 Heisy Road Shippensburg, PA 17257 son 25% 3. James E. Chestnut, Jr. 79 Oak Manor Drive Cape Canaveral, FL 32920 son 25% 4. Keith E. Chestnut 121 E. South Street Carlisle, PA 17013 son 25% 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 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 additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE !BUREAU OF INDIVIOUAL TAXES DEP~ 280601 ... HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT JONES JAMES K 7 IRVINE ROW CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 192-32-1463 FILE NUMBER: 21-2001- 0607 DECEDENT NAME: LA Y ESTHER MAE DATE OF PAYMENT: 10/02/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/17/2001 NO. CD 000340 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $766.77 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JAMES K JONES ESQUIRE CHECK#1036 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS THIS RECEIPT' IS REPLACING CD 338 $766.77 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 .~ HARRISBURG, PA 17128-0601 RECEIVED FROM: JONES JAMES K 7 IRVINE ROW CARLISLE, PA 17013 ___nn_ fold ESTATE INFORMATION: SSN: FILE NUMBER: 21-2001- 0607 LAY ESTHER MAE DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: REMARKS: JAMES K JONES ESQUIRE CHECK# 1036 SEAL PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 000338 ACN ASSESSMENT CONTROL NUMBER 101 192-32-1463 TOTAL AMOUNT PAID: INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS THIS RECEIPT IS BEING REPLACED WITH RECEIPT CD 340 AMOUNT $466.77 $466.77 CLAIM FORM ESTATE OF ORPfI..ANS' COURT DIVISION O~ COURT OF COMMON PLEAs OF t!M/YI f3F I2L .,tI-/fI P COUNTY P '-I _NO. 2/-t7/-~1 E:'7"7//e/? L fly 7#E BCJ},; /~,./ in the amount of S /c:?/~ ?'~ Notice of claim by f~8d pursuant to s8c~ion JJB4, Prabata, Estates and TO THE~ OF THE ORPHANS' COURT D:rvl:SION: '~Rc gOA/' rct/ (Cla~ant and Address) 4f/~, ~~ /VEW y /LI-~ ". ?A-- (Address) Fiduciaries Code Laws of 1972, Ac~ No. 104 effe~ive July 1, 1972 as amended. /O////~/ , , . 9441 LBJ FREEWAY LOCK, Box 30 Dallas~ TX 75243 Date .;;...; Enter the claim of in the amount of S against the above entitled Estate. The decedent who resided at died on -g~ ~C /' (Date) Written notice of said claim wasrnailedto , see attacned (Personal Representative or Counsel) at (Address) The basis of aforesaid cla~ is as tollows: on (Date) (Itemi:e fully to enable personal representative to make proper investigation). (Name) 441lBJ FREEWAY Lock Box 30 Dallas. TX 75243 (Address) 972-644-6360 Claimant's Counsel (Address) PROBATE COURT CUmberland Colli1ty, State of Pennsylvania Esther Lay, Deceased Case #21-01-607 Proof of Mailinq I mailed the creditors claim to the fiduciary (and attorney, if applicable) as follows: I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am employed in the COlli1ty where the mailing occurred. The envelope (s) was/were addressed and mailed as follows: Ms. Beverly Hamilton c/o James K. Jones, Esq. 7 Irvine Row Carlisle, PA 17013 Date of Mailing: lo)~k County of Mailing: Dallas, Texas foregoing is t:rue and correct. for The Bon Ton P.O. Box 741026 Dallas, TX 75374 . PACk ~AGE: 32 BTS-C024051F-001 RUN ON: 6/ 1/2001 01:37:44 NAME + ADDRESS ADDRESS CITY STATE SPOUSE EMPLOYER ADDRESS CITY STATE PHONE: COMMENTS: PREV-BAL 1212.74 1191.65 CUR PRV ... RONALD E LAY HOME PHONE DATE OPEN 724 SHIPPENSBURG RD OTHER ACCT NEWVILLE PA17241 REQ PAYMENT ESTHER LAY EXT: A/R BAL CURR PAY MEMO PUR MEMO CR HOL-BON TOTAL PURCHASE .00 .00 PAY/RET .00 .00 FIN-CHRG 21.09 21.09 THE BON-TON NRA - LOP ACCT# 062-743-711 F 717/776-5407 04/92 0000??oo 1233 o o o 1233 NEW BAL 1233.83 1212.74 LIMIT AD'" CODE AD'" ANT IN/COLL STATUS CYCLE MPI HIMPITY HIMPILY HIMPIMO PAST /0:. ct .1 r:: ~ CERTIFCATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Esther Mae Lay Date of Death: 3/17/01 Will No.: Admin No.: 2001-00607 To the Register: I certify that notice of (beneficial interest) estate administration 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 November 2, 2001 : Name Address Beverly A. Hamilton, 724 Shippensburq Road, Newville, PA Donald L. Chestnut, 5239 Heisey Road, Shippensburg, PA Keith E. Chestnut. 121 E. South Street. Carlisle. PA James E. Chestnut. 79 Oak Manor Drive, Cape Canaveral, FL Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: 11-2-01 ~v- ture James K. Jones Name 7 Irvine Row, Carlisle, PA Address 240-0296 Telephone Capacity: D Personal Representative [}9 Counsel for personal representative /6~c::439-M COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-12-2001 LAY 03-17-2001 21 01-0607 CUMBERLAND 101 Recorc2cl Rec;' c','."d ..it.jl.'t:~~; <;I' of ~/.j!lls JAMES K JONES J K JONES LAW 7 IRVINE ROW CARLISLE om NaV 16 A1l :51 OFFICE Clerk- PA 1 ~ber!anc ,..~O., PA '* REV-1547 EX AFP 112-001 ESTHER M Allount R_i Hed CHANGED U) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 18.932.96 2.171.72 .00 (8) MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is'4j-EX-AFP--ri'2-:JJOY-NOTicE--OF-YtiHEifiTAN-CE-TAX-'A-PPRirisEiofENT-:--ALi-oWANCE-cfi------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LAY ESTHER M FILE NO. 21 01-0607 ACN 101 DATE 11-12-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due I P T DATE 10-02-2001 NOTE: . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (9) UO) 3,040.30 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 21,104.68 4.065 38 17,039.30 .00 17,039.30 00 = 045 = 12 = 15 = .00 766.77 .00 .00 766.77 1.025.08 UlJ (12) (13) (14) .00 X 17,039.30 X .00 X .00 X AHOUNT PAID 766.77 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE (19)= 766.77 .00 .00 .00 IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERYATION: Estates Df decedents dying Dn Dr befDre DeceBber lZ, 198Z -- if any future interest in tha estata is transferred in pDssessiDn Dr enjDYBent tD Class 8 (cDllaterel) beneficiaries Df the decedent after the expiratiDn Df any estate fDr lifa Dr fDr years, the CDBBDnweelth hereby expressly reserves the right tD appraise and assess transfer Inheritance Taxes at the lawful Class B (cDllateral) rate Dn any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIYE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: TD fulfill the requireBents Df sectiDn Zl40 Df the Inheritance and Estate Tax Act, Act Z3 Df ZOOO. (7Z P.S. SectiDn 9140). Detach the tDP pDrtiDn Df this NDtice and submit with YDur paYBent tD the Register Df Wills printed Dn the reverse side. --Make check Dr BDney Drder payable tD: REGISTER OF KILLS, AGENT A refund Df a tax credit, which was nDt requested Dn the Tax Return, Bay be requested by cDBpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REY-1313). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the Z3 Revenue District Offices, Dr by calling the special Z4-hDur answering service fDr fDrBs Drdering: 1-800-36Z-Z050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-30Z0 (TT Dnly). Any party in interest nDt satisfied with the appraiseBent, allDwance, Dr disallDwance Df deductiDns, Dr assessBent Df tax (including discDunt Dr interest) as shDwn Dn this NDtice Bust Dbject within sixty (60) days Df receipt Df this NDtice by: --written prDtest tD the PA Oeparteent Df Revenue, BDard Df Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-10Z1, OR --electiDn tD have the Batter deterBined at audit Df the accDunt Df the persDnal representative, OR --appeal tD the Orphans' CDurt. Factual errDrs discDvered Dn this assessBent shDUld be addressed in writing tD: PA DepartBent Df Revenue, Bureau Df Individual Taxes, ATTN: PDst Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 PhDne (717) 787-6505. See page 5 Df the bDDklet "InstructiDns fDr Inheritance Tax Return fDr a Resident Decedent" (REY-1501) fDr an explanatiDn Df adBinistratively cDrrectable errDrs. If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5%) discDunt Df the tax peid is allDwed. The 15% tax aenesty nDn-participatiDn penalty is cDBputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax aBnesty periDd. This nDn-participatiDn penalty is appealable in the saBe Banner and in the the saBe time periDd as YDU wDuld appeal the tax and interest that has been assessed as indicated Dn this nDtice. Interest is charged beginning with first day Df delinquency, Dr nine (9) BDnths and Dne (1) day frDm the date Df deeth, tD the date Df paYBent. Taxes which becaBe delinquent befDre January 1, 198Z bear interest at the rate Df six (6%) percent per annUB calculated at a daily rate Df .000164. All taxes which becaBe delinquent Dn and after January 1, 198Z will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOI are: Year Interest Rate Daily Interest FactDr Vear Interest Rate Daily Interest Factor 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 n .00019Z 1984 11% .0003Dl 1995-1998 9% .000Z47 1985 13% .000356 1999 n .00019Z 1986 10% .000Z74 ZOOO 8% .000Z19 1987 9% .000Z47 ZOOI 9% .000Z47 1988-1991 11% .000301 --Interest is calculated as fDllows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becoBes delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date of the assessBent. If paYBent is made after the interest cOBputation date shown on the NDtice, additiDnal interest Bust be calculated. INRE: ESTATE OF b-.s 1-1...,. L_J IN THE COURT OF (}'i"/'.~ :.s (-'4./'+ C w,," t 4/ /-../ C. NO. ;1./-0/-(.0 7 WITHDRAWAL OF CLAIM TO: THE CLERK OF OI'I'/."'~ (..01A.;- 1/ C ~m te..r/o..,..1 CD. The claim of T /, -c... 13 ~,.. r:, '" was filed in the within Estate in error. Please remove the claim previously entered. ::TA~ ~ Larry E. Albertson Estate Claims Service 9441 LBJ Freeway Lock Box 30 Dallas, TX 75243 Dated: /I~/"~/ ;/ all STATUS REPORT UNDER RULE 6.12 Name of Decedent: ESTHER MAE LAY Date of Death: 3/17/01 Will No. Admin. No. 2001-00607 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 :::::o:O:~:/~~Phans' Court and may b~~rt. Sig ure JAMES K. JONES, ESQUIRE Name (Please type or print) 7 Irvine Row, Carlisle, PA 17013 Address (717) 240-0296 Tel. No. Capacity: Personal Representative (MAH:rmf/AM3) X Counsel for personal representative ,-.J 15056041114 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year ;2 ( ~OOI File Number o {pO '7 Date of Birth 192-32-1463 03172001 01161944 Decedent's Last Name Suffix Decedent's First Name MI LAY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix ESTHER M 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 CJ 1. Original Return m 2. Supplemental Return CJ 3. Remainder Return (date of death prior to 12-13-82) CJ 4. Limited Estate CJ 4a. Future Interest Compromise (date of CJ 5. Federal Estate Tax Return Required death after 12-12-82) CJ 6. Decedent Died Testate CJ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) CJ 9. Litigation Proceeds Received CJ 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 STEPHEN D TILEY Firm Name (If Applicable) 717-243-5838 FREY & TILEY REGISTER OF WILLS USE ONLY, .-- 0 20, ,"(J "--"J First line of address -.1 (") 5 SOUTH HANOVER STREET --.-/ .. r. - Second line of address c) -,-~ City or Post Office State liP Code . ,oj ~TlihLED (_0 CARLISLE PA 17013 - .f:'- . 6-I~ b~ !1-de. .3IIIJ?P~Wa13UR8 ROA.D, NEWVILLE, DATE O? PA 17241 -o~ D. TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 15056041114 --.J vflt ~~ ~ .~ ~ ~~ ~~ @ "- .'''~~ ~~.~~ \t {~l ,--.J, 15056042115 REV-1500 EX Decedent's Name: EST HER M LAY RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . 192-32-1463 Decedent's Social Security Number 1. 2. NONE 3. NONE 4. NONE 5. NONE 6. NONE 7. NONE 8. 9. NONE 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). ..... .. . . . . . . . 10. NONE 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 Subjectto 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 L 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 15400.00 17. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042115 15. 16. 18. 15056042115 15400.00 15400.00 0.00 15400.00 0.00 15400.00 0.00 0.00 1848.00 0.00 1848.00 D ---I .' REV~1500 EX ~age 3 192-32-1463 Deceaent's 'Complete Address: File Number 21-01-00607 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER ESTHER M LAY 192-32-1463 STREET ADDRESS 31 MOUNTAIN VIEW TERRACE CITY II STATE I,ZIP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 1848.00 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 0 + 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) 1848.00 A. Enter the interest on the tax due. (5A) 2471.11 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 623.11 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain 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 interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 o o 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 [R] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No [R] [R] [R] [R] [R] [R] 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 .5. ~9116 (a) (1.1) (i)]. 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. ~9116 (a) (1.1) (ii)]. 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 .5. ~9116(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. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 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. 217 RE'v-1502 EX~ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER LAY, ESTHER M. 21-01-00607 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH One-Half Interest: 36 Vine Street, Newville, PA 17241 15,400 Decedent acquired a one-half interest by virture of a deed from Harriet A. North dated January 23, 1999, and recorded January 25, 1999, in Cumberland County Deed Book 193, Page 142, see copy attached. Property is Cumberland County Tax Assessment Parcel number 28-20-1754-040, currently assessed in the amount of $47,200. The Common Level Ratio Factor for Cumbo Cty. is 1.14 resulting in an implied fair market value of $53,808 for a 100% intere However, the property is not worth the assessed amount. The property is in need of interior renovation. The property has been sold by Janet Hoover to Mr. Lester E. North (see deeds), for the consideration of $40,000 (100% interest). Mr. North is related to Ms. Hoover, however, the consideration reflects the true value of the property. The true value of the property is less than the assessment due to the condition of the property. This property was not included with the original Return as the Administrators did not know that the decedant had an interest in this property. At the time of the death of Esther M. Lay, the property was assssed at $30,800. Cumberland County undertook a reassessment in year 2000, first effective for taxes in year 2001. The predetermined ratio from the year 2000 countywide reassessment was 100%. Therefore, the Common Level Ratio Factor for year 2001 was 1.00% The assessment has been used as the date of death value. One half of the assessment is $15,400, the amount shown above. TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 15,400 . .' 2~7 REV<.1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Esther M. Lav 21- - 4 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Janet Hoover, 635 North Hanover Street, Carlisle, PA 17013 Sister 100% of Real Estate See Exhibit "A" to deed from the Ester Lay estate to Janet Hoover which is attached hereto. 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 IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ '. 0 32 1 63 (If more space is needed, insert additional sheets of the same size) .", t.1 ,':CJivlr'/1cr",J\:VEA'_Ti-1 DF ?ENhJSYLVAN!/~ :":-'cYhRHii::NT Of~ REVENUE ~ \.. -"'F 1~IDI\jIDiJi\l T !I,XES ~>::r~T _ 220bC ~ -IL.Ri1ISt3UHi-.l, PA 17123-0601 REV-1162 EX(11-96) f-;i~CEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT FREY AND TILEY 5 S HANOVER STREET CARLISLE, PA 17013 - - l'1lrt : :'5TATE INFORMATION: SSN: 192..32-1463 - F:l_E NUMBER: 2101-0607 DECEDENT NAME: LA Y ESTHER MAE I.. DATE OF PAYMENT: 10/10/2007 .. PSSTMARK DATE: 10/1 0/2007 C,jiJNTY CUMBERLAND .-.-..... ,DATE OF DEATH: 03/17/2001 ---~ NO. CD 008797 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,471.11 I " I I I I I I I TOTAL AMOUNT PAID: $2,471.11 REMARKS: RECEIPT TO A TTY CHECK# 8441 INITIALS: WZ SEAL RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ( r t)-H~"u...n __1.1.:j;11I'1;:f~ IIIII:.I:I! ~1!I;:f ...I.'.~:I :;C,I,! [lJo/.,.. :I::f'.{.... ~'A~:l... ::J;:t:al;IJ liII:.' I [tot :1'1:.1: II~II !II:;eJ .;{t] =f.};::'j; .. FREY AND TILEY, TTEE IOLTA ACCOUNT 5 S. HANOVER STREET CARLISLE, PA 17013 (717) 243-5838 '6~1q1 o~ BANK CAR~AsLE, 8441 60-15031313 10/9/07 PAY TO THE ORDER OF REGISTER OF WILLS, AGENT $ ****2,471.11 6 Two thousand, four hundred seventy-one and 11/100*********************************** DOLLARS MEMO ~7J ",' I r '-7 ~~~ ~'JJ(:- 6'0'?' ('~ '-,->~ f", -c,1-6, -::,9;-'<-' ~l'o'-,'<.C .&; L HOOVER TO NORTH Jm...... .1.I~tI.'d =l~~ 11fa\"l~i t" I~I-."" :1:1,,, ilIII~i;1~f.,.'iJl~I.:8I.:'I~~ (_111.,: 1Il_I:iI ;;.l:l ;:$-."i-....:I :::t:l ~:l ::til.I,' ntj * .1f..."'f.1:J ::.l;f.1:l-___'dll~:.: I ::r., II- 0 0 8 L. L. . II- I: 0 31 . 31 . 50 31 b I: .0 B .. 2 L. .011- # BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE P~CORD[f)..lltiJ-ANCE TAX P:(;~J~TE"r:Jln: OF ACCOUNT t 'l-T' ~~.~, V I l.o" ....." . \ ....:1.-"'-, *' REV-1607 EX AFP (03-05) JAMES K JONES J K JONES LAW 7 IRVINE ROW CARLISLE CLERK OF ORPHAN'S COURT CU.,iCC:OJ r,tr\ rtj Rl^ )"i',........_1 ~',j".. \~';..J "'-""~'f /"\ I: 34DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11- 05-2007 LAY 03-17-2001 21 01-0607 CUMBERLAND 101 ESTHER M Z007 NOV 16 PM OFFICE Amount Remitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF LAY ESTHER M FILE NO. 21 01-0607 ACN 101 DATE 11- 05-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001 PRINCIPAL TAX DUE: 766.77 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-02-2001 CDOO0340 .00 766.77 10-10-2007 CD008797 .00 2,471.11 TOTAL TAX CREDIT 3,237.88 BALANCE OF TAX DUE 2,471.11CR . INTEREST AND PEN. .00 " IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 2,471.11CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ~ PAYMENT, Detach the top portion of this Notice and submit with your pay.ent made payable to the name and address printed on the reverse side. If pay.ent if for a RESIDENT DECEDENT, make check or money order payable to: Register of Wills, Agent If pay.ent if for a NON-RESIDENT DECEDENT, make check or .oney order payable to, Commonwealth of Pennsylvania Failure to pay the tax, interest, and penalty due .ay result in the filing of a lien of record in the appropriate county, or the issuance of an Orphan's Court citation. REFUND (CR): A refund of a tax credit. which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313)' Applications are available online at www.revenue.state.pa.us. any Register of Wills or Revenue District Office, or from the Department's 24-hour answering service for for.s orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, 8ureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. 80x 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar .onths after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996. the first day after the end of the tax amnesty period. INTEREST, Interest is charged beginning with first day of delinquency, or nine (9) .onths and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which beca.e delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Rates for years 1982 through 1999 can be found in the Pennsylvania Resident Instruction Booklet, (REV-1501), the Pennsylvania Non-resident Instruction Booklet(REV-1736) or on the Pennsylvania Dept. of Revenue web site www.revenue.state.pa.us. The applicable interest rates for 2000 through 2007 are: Year Interest Rate DailY Factor Year Interest Rate Daily Factor Year Interest Rate Daily Factor 2000 2003 2006 8% 5% 7% .000219 .000137 .000192 2001 2004 2007 9% 4% 8% .000247 .000110 .000219 2002 2005 6% 5% .000164 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax beco.es delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~~ >= BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE "-(<'\,~,,-;-"~r, (-;-".-NOT.ICE OF INHERITANCE TAX "',~. .,' ,.APPRAiSEMENT, ALLOWANCE OR DISALLOWANCE OF DI'DUCJIONS AND ASSESSMENT OF TAX * REV-1547 EX AFP (06-05) DATE 12-31-2007 ESTATE OF LAY ESTHER M DATE OF DEATH 03-17-2001 FILE NUMBER 21 01-0607 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 02-29-2008 ( See reverse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LAY ESTHER M FILE NO. 21 01-0607 ACN 101 DATE 12-31-2007 20nn I,'~' , i.t; 1(\1''ll-4 d~, vf". ~ Pr112: 34 ''''LCD'/ fV :""'i"'\ O"'~' '" .'~ hi-';-;,'\\,.! STEPHEN D TILEY FREY & TILEY 5 SOUTH HANOVER CARLISLE C.!' ,- ST PA 17013 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 15,400.00 .00 .00 .00 .00 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15,400.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) .00 .00 (11) (12) (13) (14) nn 15,400.00 .00 32,439.30 NOTE: If an assess.ent was issued previouSly, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of Abh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due (15) .00 X 00 .00 (16) 17,039.30 X 045 = 766.77 (17) 15,400.00 X 12 1,848.00 (18) .00 X 15 .00 (19)= 2,614.7l TAX' CRl=nITS: PAYM I::. NT RECEIPT UISt,;OUNI l+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-02-2001 CDOo0340 .00 766.77 10-10-2007 CDo08797 620.27- 2,471.11 TOTAL TAX CREDIT 2,617.61 BALANCE OF TAX DUE 2.84CR INTEREST AND PEN. .00 TOTAL DUE 2.84CR * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~J IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE Du;D A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)