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Home My WebLink About01-0600 PETITION FOR PROBATE and GRANT OF LETTERS ;(/-OI-='OLL Estate of JOHN R. McCLA IN No. also known as To: Lower Allen Twp., Register of Wills for the Cumberland County Deceased. County of Cumberland Social Security No. 194-09-1352 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated Mardi 5, and codicil(s) dated in the named , l~...l.- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent, then 82 years of age, died June 15, 2001 at his home (1800 Letchworth Drive, Camp Hill, PA 17011) Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: n/a Decendent 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 situated as follows: ~ $ IOIOoJ. $ $ $ --- WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. - l,71~rl :// /&,c (Jt~ ~~ . are H. McC aln -00 c';:: <<S.= E~ ..'- 50 o;j c 00 en 1800 Letchworth Drive Camp Hill, PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } S8 COUNTY OF Cumberland 1ft; -;}..3q - b 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed . # ~ 'C'.l before me this 26th day of ~. l::l - l:: il1 ~ . No; --.- 21-2001-.60.0 Estate of JOHN R. McCLAIN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW June 26th )@2001 ,in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 5, 1991 described therein be admitted to probate and f1led of record as the last will of __ JOHN R. McCL~IN and Letters Testamentary are hereby granted to Margaret H. McClain FEES Probate, Letters, Etc. ......... $ 40.00 Short Certificates( T. .10 . . . . .. $ 30 . 00 Renunciation ................ $ x-Pages (6) $18.00 JCP TOTAL _ $ .5.00 Filed . .J:\P)~. .4Qt:tlJ.4QQ~...... :;;.~~:PP.... Mary C. Lewis ~gister of Wills Luther Milspaw, Attny. I.D. #19226 ATIORNEY (Sup. Ct. LD. No.) 130 State Street, P.O. Box 946 Harrisourq, PA 17108-0946 ADDRESS (717)236-0781 FAX: (717) 236-0791 PHONE MAILED LE'ITERS 'ID AT'IDRNEY LUTHER Mlr.SPAW. H10'i.SO'" ','; \' \!I:~() This is to certify that the information here given is correctly copied fran: an original certificate of death dul~ filed with me as I,(leal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fillllg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ar/l'./ ~ ~-~}vt--- Local Registrar d Fee for this certificate, $2.00 p 7430266 JUN 1 8 109, Date 21-2001-600 ~ R." 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH NAME (y DECEDENT (Fwlt MJddIe. l_t .. John R. Mc C1ain .x I. Male S_E'".E~ SOCIAL MCUMY NUMBER a. 194 - 09 1352 ORE 0# DEATH.-. 00-,. ....1 .. 6/15/01 -(I."-Yl UHIleR' YEAR - !lop ~(CIv- sa... Of fcre-gn CaunlrY>> A1toona, PA Y. LIlY_I1I......--.ll""...__. ,-0 E~O ='1'10 82 Y... COUNTY 0# DEATH Cumberland - .;.:::..~"::'=~:r .. Technician t OE<:EDlNT'SMAIUNG_lIlS1r"'~,_lIp~ 1800 Letchworth Dr. ... Camp Hill, PA 17011 FRHER'SNAME (1'"... _.lJtI) _STRUS._ _.....Iocl._ ~(SpocIy) white IIURVMNB SPOUSE ..---- H. Endler A 11 ~n 'I't.l:p ..... to. ."'.01:___.. T.nw~r .l'tI. Cumberland "..0 :"'-:::::.. _1I.s_iF.... _. _s.._1 II. Julia Ruth Cant U<fOIIIMNT'IIotMJHO-..\Shol. ~ _. z;pc-. 1800 Letchworth Dr. Camp Hill, 0# ._..c....y.c~ l ",0lM0_ Rolling Green Mem. Park . . ... INfClIlMANTlNAME{TypoIl"inl) Robert Irvin Mc C1ain Margaret H. _ __IIOf MCIlJTY ufarthemore FH&CS,Inc.New LICENSE NUMIlER PA __SIoI.O 17070 :=_''''__110-'-''' by OREPACltlOUNCEDDEADC_.lloy. -I ~~~,~~ . 5:00 a 6/15/01 _-'-'"" tr.-Mjjf.: i:rut the....... ...... or compIicaIiDnI wbiCh'GaUHd'1he death, 00 not......... mode 01 dying,1UdI.. cardiac or '...aaorv ..r.... Ihodl or hHIt..... LiII onIf one CAUM on Mdt line. _I CAUII iFinII oe-or concMion _'-*'11'" 0IiIIh)-"'" . .5 MdR e.Jj 1V4 DUE 10 lOR AS A CONSEOUE!"CE Of): ~~ I Appfuirnal. '-- :_and.... ! J ~MJ,.... _I: ~........_.........IO_. ... _---.In....~__lnl'lUlTl. DUE IOCCA AS A CONSEOUENCE Of): .:......-..- ~=:~ ;;_too-OI""", -=.. inlIiIIm... ;;_.._lAIT =Wii'iNAUloPSY ~PEJIFCINED? lO. c. d OUIIOCCA AS A CONSEOUENCE Of): WERE AUltlPIY FiNDINGS -..eLE_1O CC*PlET1ON Of CAU&E DEATH? loIAMER Of DERH ORE Of INJURY _.Day. -I TIUE Of INJURY INJURY R WORK? DESCRIBE HOW INJURY OCCURMD. ... 0 No ....0 NoD - o o Ponding-.-- o o o PUi:EOflNJURy...._...rm._._._ ... ......... _,_I :100. .... 0 NoD -.. -.. - Could naI be dt&efmIned ._1 Of -- _. CUT_cO>ock _0lI01 .CBt~ PHY..caAN (Ph~c.llf'tW'9 QUM d"..... IIlltItf'M'IOINf pt'lYIlCIM Me pronounced deeIr'l ana ta'I'lIMed him 23) .......................... ..occ................IheC8UMC...........nner.............................................................. ... · 'PIIONOUHCING AND CUlTWYINQ PtfYSICIAN ~ both pr~ oealh.-.d cer1ltY'"Q IOCauM 01 c>>athl To Iht..... of.., kno........"'OCCUfrM ........... data. ....,.... and due to thecauM(a. and maIIMf...I8Ied.......................... '- .. _IlL EllAMlNaIl/COllONlII OIl... _ of......_1on _......IIt_.1n my opinion. de.", occ_'" .1.... _. d.I., _ plac., _ c1u.lo.... ...."(ol- ......................................................-....... ................................................... ('.RE~~~ Ir,l./~.I( I 133. ~ /) ~,tU::'l/ ".I . ' c2/-01-. ,()O 1JIagt )liII anh QItgtaumtf OF JOHN R. McCLAIN I, JOHN R. McCLAIN, residing at 1800 Letchworth Drive, Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make this to be my Last Will and Testament, hereby revoking any and all Wills and testaments at any time heretofore made" and disposing of all my estate: FIRST: I direct that the expenses of my last illness and funeral be paid out of my estate as soon as may be convenient after my death. SECOND: I give my household goods and furnishings to my wife, Margaret H. McClain, if she survives me for a period of thirty (30) days. If she does not so survive me, I give said goods and furnishings to my children, Patrick M. McClain and Michele Ann Morrison, in such shares as they may determine, or all to whichever of them survives us both. THIRD: All the rest, residue and remainder of my estate I give to my wife, Margaret H. McClain, if she survives me for a period of thirty (30) days. FOURTH: If my wife, Margaret H. McClain, does not survive me by a period of thirty (30) days, I give, devise and bequeath as follows: A. To my four grandchildren, namely Sean Michael McClain, Kelly John Robert McClain, Autumn Lyn Morrison and Kyle George Morrison, in equal shares, per stirpes, one-third of the assets enumerated as follows: cash, funds deposited in all ftfjf!' banks, savings and loan institutions, or brokerage houses; certificates of deposit, bonds, annuities, shares of stock, and other similar assets. B. The rest, residue and remainder of my estate I give in equal shares to my children, Patrick M. McClain and Michele Ann Morrison, the share of any child who predeceases either my husband or me to go to his or her issue who survive us both per stirpes or, if he or she has none, to be added equally to the shares of the others. FIFTH: I appoint my wife, Margaret H. McClain, Executrix of this my Will, In case of her inability or unwillingness to act or to continue as my Executor, I appoint my children, Patrick M. McClain and Michele Ann Morrison, co-Executors. In case of their inability or unwillingness to act or to continue as my Executors, I appoint Luther E. Milspaw, Jr., Esquire, Executor. I give to my said Executors, in addition to the authority conferred by law, the power to sell any or all of my property, real or personal, at public or private sale, at such time and for such price and upon such terms and conditions as he or they might see fit, or in his or their discretion to retain the same for distribution in kind, and the power, but not the duty, to invest any cash without being limited to "legal" investments. No bond shall be required of any fiduciary hereunder in any jurisdiction, and no individual fiduciary shall be entitled to compensation. No fiduciary hereunder shall have any liability for any mistake or error of judgment made in good faith. I specifically authorize my Executor or Executors to file a joint income tax return with my wife for any period (-R1r{ during which such a return is permitted, without requiring her to sign an indemnification agreement. SIXTH: I realize that executors and trustees are given discretion by law to make various elections which affect the income and estate taxes payable by estates, trusts and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income tax purposes, selecting options for the payment of employee death benefits, electing to take qualified terminable interests as part of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift tax returns, and redeeming corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon and not subject to question by any affected persons. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions, including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. They are specifically authorized to file a joint income tax return with my wife for any period during which such a return is permitted, without requiring her to sign an indemnification agreement. SEVENTH: I appoint the natural parent of the minor as guardian of the estate of any minor receiving any sums of money, real property or other intangible personal property free of trust by reason of my death, if such property is in excess of the amount which may be paid to the natural guardian; and I authorize said guardian, in his sole discretion and without order of court, to retain such property in kind or to sell the FII1Il same, giving good title to any real estate, to invest and reinvest without being limited to "legal" investment, and to use both income and principal for the minor's welfare, comfortable support, and education, including college expenses. When the minor reaches the age of eighteen (18) years, the guardianship and trust created hereunder is to be terminated, and the sums of money, real property, and other intangible property is to be devised to the minor, free of trust or other claim. For purposes of this paragraph, a minor is considered to be any child under the age of eighteen (18) years. EIGHTH: I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest and penalties thereon, becoming payable because of my death with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from the principal of my residuary estate, and no person receiving or having a beneficial interest in any such property, whether under this Will or otherwise, shall at any time be required to contribute to or refund any part thereof; PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised, or on any qualified terminable interest, or to any generation-skipping transfer taxes. IN WITNESS WHEREOF, I, JOHN R. McCLAIN, have hereunto set my hand and seal to this, my Last Will and Testament, consisting of six (6) typewritten pages, including f~~e the attestation clause and signatures of witnesses, this day of (r,~~"lr"1l , 1991. ~ 2)'( ~ 5/.,4.';'./(SEALl ~o n R. McCla n Signed, sealed, published and declared by the above named Testator, JOHN R. McCLAIN, as his last Will and Testament in the presence of us, who at his request, in his presence and in the presence of each other have hereunto subscribed our names as witnesses. ~~I~~ W ness ~~V~ Residence I 'Z31/ t~ 1;;'4.-1 Residence ::'-1 , ;:~f//S~ /1l1 / lYe) , COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF DAUPHIN . . We, V6/JN // #tI/}JE"t:s c" A~I/ /J6-.L!ot/r?r , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and acknowledged before me by \\JC;/JJ.....I I). #1//l)F~ {'("I ~I/ 1/ Grt!I.JUer , witnesses, -' this 5th day of March, 1991. ~~.~~c,-^ wi ness illi f! -4 . Witness I ...-~ / ~~~~~~ Notary 1 ...----. NOTARIAL SEAL MARTHA L. SZCZYPT A. NOTARY PUBLIC DILLS8URG BOROUGH, YORK COUNTY MY COMMISSION EXPIRES APRIL 12, 1993 . Member, Pennsylvania Association 01 Notaries ... jl; /JJC " . " COMMONWEALTH OF PENNSYLVANIA : : : SS COUNTY OF DAUPHIN Personally appeared before me, the undersigned notary public, JOHN R. McCLAIN, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, did hereby acknowledge that he signed and executed the instrument as his Last Will, that he signed it willingly, and that he signed it as his free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by JOHN R. McCLAIN, Testator, this 5th day of March, 1991. 7J;4f'l/ar!f ~ Notary Public ' NOTARIAL SEAL MARTHA L SZCZYPT A, NOTARY PUBLIC OiLLSBURG BOROUGH, YORK COUNTY MY COMMISSION EXPIRES APRIL 1~: 1993 Member, Pennsylvania Association 01 Notaries plJtC - ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: John R. McClain Date of Death: June 15.2001 Will No. 21-01-0600 Admin. No. To the Register: I certify that notice of 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 June 28, 2001 Name Address Patrick M. McClain 1800 Letchworth Drive. Camo Hill. PA. 17011 1800 Letchworth Drive. Camp Hill. PA. 17011 404 Cabin Hollow Road. Apt. #1. Dillsburg. PA 17019 Margaret H. McClain Michele Ann Morrison Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Name: Luther E. Mils Address: 130 State Street. P.O. B x 946 Harrisburg. PA 17108-0946 Telephone (717) 236-0781 Capacity: _ Personal Representative _X_ Counsel for personal Representative NONE Date: June 28, 2001 ~ _t.tlllMll COMMONWEAlTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 /6 -dS9'~ 6 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ('FFICIAl U:E om.': FILE NUMBER 21- 0 1 060 0 -- -- ----- COlMYCODE YEAR NUIIBER DECEDENTS NAME (lAST, ARST, AND MIDDLE INI1lAl.) ~ MCCLAIN, JOHN R. ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ June 15, 2001 August 12, 1918 W (IF APPlICABLE) SURVIVING SPOUSE'S NAME (lAST. ARST,AND MIDDLE INI1lAl.) C McClain, Margaret H. r: ~~r.! :dL8 x~... ULID D- C l!I 1. 0riginaJ Return o 4. Umited Estate og 6. Decedenl Died Testate (AIIdl alpf 01 WI) o 9. UtigatIon Proceeds Received Jt .. SOCIAl.. SECURITY NUMBER 194 - 09 - 1352 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAl. SECURITY NUMBER o 2. Supplemental Return o 4a. Future InIeresI Compromise (dolo 01 dIIIIt * 13-12.ez) o 7. Decedenl Maintained a LMng Trust (AIIdlalpfolTIUIl) 010. Spousal Poverty Credil (datil 01_ beIwIen 12-31-91...1.1-95) ,~~~ COMPLETE MAILING ADDRESS o 3. Remainder ReIIm (dIIooldlllltprlarlD1Z.1M2t o 5. Federal Estate Tax Return RequIred .l.... 8. Total Number of Safe Deposit Boxes o ", Eleclion to lax under See. 9113(A) (AIIdl Sell 0) NAME Luther ARM NAME (~AppIIcIIlIII TELEPHONE NUMBER 717 236 0781 1. Real Estate (Sc:hedule A) 2. SlDcks and Bonds (Schedule B) 3. Closely Held Colporalion, Partnership or Sde-ProprielDrship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscelaneous Personal Property (Schedule E) 6. Jointly <Mned Property (Schedule F) o Separale Billing Requested 7. inter-VIVOS Transfers & Miscellaneous Non-PnJbate Property (7) (Schedule G or L) 8. Total GIllIS Assets (lDtaI lines 1-7) 9. Funeral Expenses & AdninIsIratlve Costs (SchecIuIe H) (9) 10. Debts of Decedent, Mortgage Uabi&ties, & liens (Schedule ~ (10) 11. Total Deductions (total lines 9 & 10) 12. Net Value of Estall (LIne 8 minus Lite 11) 13. ChaIIIabIe and GovemmentaJ 8equesIsfSec 9113 Trusts for which an e1ecl1on to lax has not been made (Schedule J) z o 5 :) ... ii: -c u w ~ ('!I ;(~]Y~~~~ 130 State Street P.O. Box 946 HarriSburg, PA 17108-0946 (1) (2) (3) (4) (5) 0.00 50.00 0.00 0.00 2,450.00 ~Ir-r-I(' 1-",[ us!:: O!'!U' (6) 0.00 I I I I I ...... 0.00 (8) 0.00 0.00 (11) (12) (13) 2,500.00 0.00 2,500.00, 0.00 14. Net Value Subject to Tax (Line 12 minus Lile 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 2,500.00 z o ~ ... :) ~ :E o CJ ~ 15. Amount of Une 141axab/e at the spousal lax 2, CiOo.OO 0 0.00 rale, or transfers under Sec. 9116 (a)(1.2) x .0 _ (15) 18. Amount of Une 14 taxable at IneaI rale 0.00 x.O_ (16) 0.00 17. Amounl of Une 14 taxable al silIing rate 0.00 x .12 (17) 0.00 18. Amount of Une 14 taxable al coIateraI rate 0.00 x .15 (18) 0.00 19. Tax Due (19) 0.00 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT . Decedenfs Complete Address: STREET ADORESS 1800 Letchworth Drive CITY STATE P A ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. CreditslPaymenls A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 0.00 0.00 0.00 3. Inler8stlPenalty if applicable D. Interest E. Penalty Total Cred"Jts (A + B + C ) (2) 0.00 TotallnteresUPenalty ( 0 + E ) (3) 4. If line 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 0.00 0.00 5. If Line 1 + line 3 is greater than lile 2, enter the difference. ms is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 0.00 0.00 -- ""r ,-- ,- ~ T"' - _ _ _ _ _ _ ___ _ , ~ "'" ~ ~... .t'!. ~ "'" , ~ ~ '" ~ ~ '" 1 '.... "- ~.... ..... ~, >, , ""'->. _'- _~ ,~ _ 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 transferTed;.......................................................................................... 0 n b. retain the right to designate who shaH use the property transferred or its income; ............................................ 0 n c. retain a reversionary interest; or.......................................................................................................................... 0 n d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 n 2. If death occurred after December 12, 1982, d'1d decedent transfer properly within one year of death without receiving adequate consideration? .............................................................................................................. 0 U 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 U 4. Did decedent own an Individual Retirement Account, annuity, or other non-probaIe property which contains a beneficiary designation? ........................................................................................................................ ~ C f THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS DATE (;,-{)! Hi 11, PA 1 70 11 130 State 946, Harrisbur , PA 17108-0946 H~_.~.........._""~:~{;::~ ~ 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 suMving spouse is 3% (72 P.S. 59116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.8. 59116 (a) (1.1) [a)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for d'lSdosure of assets and filing a tax relum are sbll applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The lax 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 nalural parent, an adoptive parent, or a stepparent of the child is 0% (72 P.S. 59116(a)(1.2)). The lax rate imposed on the net value of transfers to or for the use of the decedenfs 6neal beneficiaries is 4.5%, except as noted in 72 P.S. 59116(1.2) (72 P.S. 59116(a)(1)). The lax rate imposed on the net value of transfers 10 or for the use of the decedenrs siblings is 12% [72 P.S. 59116(a)(1.3)~ A sibling is defined, under SecIIon 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. '\ii' _ . , REV- 1503 EX. (1-971 ESTATE OF SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT McCLAIN, JOHN R. FILE NUMBER 21-01-0600 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Series EE United States Savings Bond, L511662886EE VALUE AT DATE OF DEATH 50.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 50.00 REV.iscie EX '(1-97) (I) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McCLAIN, JOHN R. FILE NUMBER 21-01-0600 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 1992 Mercury Grand Marquis Sedan VIN2MECM75W9f,ix703871, as per Kelley Blue Book Value, appraisal attached VAlUE AT DATE OF DEATH 2,450.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,450.00 REV-1510 EX. (1-97) SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McCLAIN, JOHN R. FILE NUMBER 21-01-0600 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLICABLE) NUMBER 1. Federal Employees Group Life Ins. claim #20010800723; Group #0017000 3,793.15 0% 3,793.15 0.00 2. Baltimore Life Insurance #103209047 762.00 0% 762.00 0.00 3. Prudential claim #655468 454.53 00,.6 454.33 0.00 4. John Hancock Mutual Insurance #06078956 4,849.46 0% f4,849.46 0.00 THE ABOVE IS BEING LISTE~ FOR INFORMATION PURPOSES ONLY. IT IS ALL LIFE INSURANCE AND THEREFORE NOT TAXABLE. TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) KeJley Blue Book Used Car Values . . http://www.kbb.comlkb/ki.dll/kw.kc.ur?kb...Mercury; ] 992%20Grand%20Marquis& I O;ME;E8& .~gu== New CaT Pricing Build a Car Incentives My Car's Value USed Car Retail Buy Ii New Car Buy a Used Car Sell YOUT Car Motorcydes Financing Insurance Lemon Check Warranties Accessories car R,,~s Car PrllYiews Decision Guidf!s Advice About kbb Horn" lof2 ~ The easiest way to find the right vehicle. Click on the image above to visit this advertiser Blue Book Trade-In Report 1992 Mercury Grand Marquis LS Sedan 40 Buy a New Car Buy a Used Car List Your Car For Sale Online Financing Quote Insurance Quote Warrantv Quote Payment Calculator Engine: V8 4.6 Liter Trans: Automatic Drive: Rear Wheel Drive Mileage: 70,000 Equipment Air Conditioning Power Steering Power Windows Tilt Wheel AM/FM Stereo Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Trade-In Value $2,450 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Get a Private Party Value Get Invoice & MSRP on New Cars 10/18/01 9:57 AM . . .. MO '.FAA -.. ~..to< liVe wllh. 00_._ lhlln)Olll< _J:I1IICl<.one III _ _ 'llObIoOk Is _. _ ....bot _as '_In CllmmlIn. A 0 JoInIT__llti#ofSU~{""doIIlI>c1"",,_..li1Ie_ 10 Il1& """'_ ownor) B 0 Tenantaln Ccmtnon (OIl _ of 0Il0 ~.lntere.. 01_ Owner _ 10 hIo or.hor heirs or _le~ SIGNAlUAE OF PERSONAllMlNIStE OATH _ ... ,'i. .. ..~~ f . -,I \.'. l,... .. I. \ " LIEN DATE f NAME STREET CITY swe LEN DATE: =.,~-~re:~=:~:': ~ ~ ~~o.:: whK:i'J mSa'ibed SECOND UENHOlOEA~ NAME SIGNATURE Of APPlICANT AUTHO ER SlGN.<IVRE OF CO-AI'PI.JCAm /TIn.e Of AllrtlORlZEO !llGNER STREET CITY Sl;\TE . . IF NO LIEN CHECK BOX ZIP IF NO LIEN CHECK BOX ZIP o o COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 55: MARGARET H. McCLAIN being duly Swo r n according to law, deposes and says that s he is the Executrix of the Estate of John R. McClain Camp Hill late of --------------------- , Cumberland County, Pa., deceased and that the 'th'. . t d b her th 'd Executrix WI In IS an mven ory ma e y ., e sal of the entire estate of said decedent, consisting of all the personal propcnty and real estate, except real estate outside the Commonwealth of Pennsylvania. and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. ~ ~ ~ c?1CJtJ and subscribed before me, ~711dA{/JV&~ 01.71Jc ~ (/ .fl\ecutor . Administrator Date OfOC"'i~h ,---- NotariGI Seal Elizabeth M, Gable. Notary Public Harrisburg. Dauphin County My Com''T1ISSii)fl Expires Oct. 20, 2003 Member. 8v:vanw AssociatlonofNolarles Day Margaret H. McClain, Executrix 1800 Letchworth Drive Camp Hill, PA 17011 Addre" June Month 2001 Y.ar INSTRUCTIONS ,. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ..... .c rn >- C "'0 lo-! :z: ); III .... W H 0 ... IJ 0 << .... III 0 ~ w < t<l:; E-< lD .. ~ Q. ... H u ., ); 0 V) () C GI 0 0 w w C VI ro ~ << U Q) 'II . I I- :I: Q. ~ Q. p~ C LL ...-t ...... Z .... ..J III rn ~ 0 -I < 0 ...-t Q. 0 LL ...-t ~ I W 0 < w r<t: >. > ~ 0:; ..... < ...... Z ... ~ N Z 0 lo-! c C :z: Q) :I 0 V) Z ::c ); 0 << 0 J:Ll Z w < 0 0 4Ito Q. IJ H "'0 c lo-! III Q) - 0: 0 lD .c .D "'0 oW .j..) III E ;:3 ... ..! 0 III :I 0 H ..J 0 u: all lnventory of the real and personal estate of JOHN R. McCLAIN deceased 1. Serries EE United States Savings Bond, #L511662886EE 50 00 2. 1992 Mercury Grano Marquis Sedan, VIN2MECM75W9NX703871, per Kellyel Blue Book value, appraisal attached 2,450 00 TOTAL 2,500 00 \ /6-a2~~d, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP 112-001 RecorcwG Registe ~} , of Wills DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-10-2001 MCCLAIN 06-15-2001 21 01-0600 CUMBERLAND 101 JOHN R LUTHER E MILSPAW JR '01 MILSPAW & BESHORE PO BOX 946 HBG Ole 17 P12:03 A.ount R_iUed Clerk.. P N"'...........,. ,. .-"., "",,,,.I.fIPPI iL1;! .v PA 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 ~ R'EV=is4-j-E3f-AFP-n'2-:00Y-NoYicE--OF-YNHEifiTAifci-YA'x-APPRjrisEi'-ENT~--Ai:.i-oWAifci-c'-R-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCLAIN JOHN R FILE NO. 21 01-0600 ACN 101 DATE 12-10-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED 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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 50.00 .00 .00 2.450.00 .00 .00 (8) NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax pay.ent. 2,500.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Gover~ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 (11) (12) (13) (14) nn 2,500.00 .00 2,500.00 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. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due CR ITS: AYM DATE NOTE: 2,500.00 X .00 X .00 X .00 X 00 = 045 = 12 = 15 = T (19)= .00 .00 .00 .00 .00 CEIPT NUMBER (-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .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. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise end assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of section Zl40 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT 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 at the Office of the Register of Wills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. 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. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar yeer to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOI are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 77- .00019Z 1984 11% .000301 1995-1998 9% .000Z47 1985 13% .000356 1999 77- .00019Z 1986 10% .000Z74 ZOOO 8% .000Z19 1987 9i( .000Z47 ZOOI 9i( .000Z47 1988-1991 lli( .000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes 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. Name of Decedent: JOHN R. McCLAIN Date of Death: June 15. 2001 Will No. STATUS REPORT UNDER ORPHANS' COURT RULE 6.12 51 c S.S.N.: 194-09-1352 Admin. No. 21-01-0600 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 0 th Orpha s' ourt nd may be attached to this report. Date: ".,,,~ '-0 ~ N a: 0\ - '1'\ '. t..:l .I:~~' .;>~, 25 !..... ,:,::'~~;"' \:J .io"..,.,l ~~ P 0:: Signature Luther E. Mils aw Jr. Name 130 State Street, P.O. Box 946 Harrisburg. PA 17108-0946 Address (717) 236-0781 Telephone Number 1:' :i~ \'0 ,.0 ;6 E \1)- G6 Capacity: X Personal Representative Counsel for Personal Representative