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HomeMy WebLinkAbout04-0018 PETITION FOR PROBATE and GRANT OF LETTERS Estateof LI//tC_ /'1-7- .~r'- No also known as To' Register of WAlls f~r thee · Deceased County of ( e. ~oe,.,/~.r ~ in the Soctal Secunty No ~ 0'~ c5-$z / SL CL~~-- Commonwealth of Pennsylvania The petttion of the undersigned respectfully represents that Your petitioner(s), who is/are 18 years of age or older an the execut. ~ r- named in the last will of the above decedent, dated ,19___ and codicd(s) dated ~e?/_ :2d. ,, / q ~ (state relevant c~rcumstances, o g renuncmtmn, death of executor, etc ) Decendent was domiciled at death in ('~cs ,.n ~ etlon c~ County, Penns~tlvama, with ~ last family, or principal residence at d (hst street, number and muncipahty) Decendent, then ~),~¢ years of age, died ,'7'~,¢. Except as follows, decedent did not r~ry~ was not chvorced 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 ~ ~. .~ .~-~ ..~,~ /~. ~ ., _-g-'t5' ./- Decendent at deatli owned ~Sroperty with estimated values as follows: (If domiciled in Pa ) - ' c o All personal property $ (If not domiciled in Pa ) Personal property in Pennsylvania $ (If not domlcded in Pa ) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters 7%.- ff"~ (testamentary, adn~mxstratmn c t a, adm~mstrauon d b n c t a ) theron ,1/-4 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ s~ COVNT The petltl6n~e~)'~aboyey-~am~d swear(s)or affirm(s)that the statements in the foregoing petit,on are true and co{r(ct tb the best of the knowledge and behef of petmoner(s) ~d that ~ person~ represen- tauve(s) of the' aboEe decedent petmoner(s) will well a~t~ly administer the estate according to law. Sworn to or affirmed and subscribed ~ ~ ~, ~~ ~ ~fore me th~s ~ day of [ ~/ - ~ No. Estate of .--~,Ya /('-/)~ /'~v~ , Deceased DEC OF PROBATE AND GRANT OF LETTERS the reverse side ~of, sausfact~-y proof having been~resented before me, . IT IS DECREED that the instrument(s) dated ~. ~~ described there~n be admitted to probat~and ~d of record as the last will of ,~ ~>;~ ~ ~. ~~ - ~e hereby g~ted t~C ~; FEES Probate, Letters, Etc Short Certificates( ) $ ,-,___~. enunciation $. q TOTAL $ ~. &TTORNEY (Sup Ct I D No) ~DDILESS PHONE ~0 ttV L- NVF' his ~s to certify that the ~nformauon here g~ven ~s correctly cop~ed from an original ceruficate of death duly filed with me as Local R,eg~strar The original cernficate wdl be forwarded to the State V~tal Records Or'ce for permanent 'fihng WARNING. It is illegal to duphcate this copy by photostat or photograph. Fee for this certlflcate, $2 00 ~ [{~ ~'Local Reglstrar No Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH .... o~., ............. Ldhe M F,sher ;~' Female [~'~""'~ _ 1425 ~ ~- ~i~ ~" u~~. ~ 93 , May2 1910 an ennsyNama .~ CumbeHand ~echanmsbur9 Se~dle Memonal Hosp~l ~ ~ '~'~ White I I,, I,,, 120 South Filbert Street i~[~- .. m~. - -.. --.- ,~ O ~ ~ Mechanlcsburg, Pennsylvan,a 1705 ~ ~ ~ Cumberland ~" ~ Mechamcsburg ~"~ JohnM Hutchinson ~'~a~n~s~ 17013 [] 0 ~'oo~ LAST WILL AND TESTAMENT OF LILLIE M. FISHER I, LILLIE M. FISHER, of 5 South High Street, Mechamcsburg Borough, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made FIRST: DIRECTIVE FOR BURIAL - I direct that I be buried in the Westmimster Cemetery, Carlisle, Pennsylvania, at Location 197D, Lots 3 and 4 SECOND: PAYMENT OF EXPENSES - I direct that all my just debts and funeral expenses, including my headstone and engraving and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate ~ RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder of my estate, be it real, personal, or mixed, of whatsoever kind and wheresoever situate, unto my husband, FRANCIS J FISHER, provided he shall survive me by thirty (30) days In the event my husband falls to survive me by thirty (30) days, I then give, devise and bequeath all the rest, residue and remainder unto my children, MYRTLE CALAMAN, JOHN HUTCHISON and JAMES HUTCHISON However, if a child does not survive me and leaves children who so survive me, such children shall receive, per stirpes (by representation), the share my child would have received had he or she so survived me PAGE ONE OFFOUR FOURTI~: TAXES RESULTING FROM MY DEATH - All federal, estate and other death taxes that may be assessed as a consequence of my death, whether or not the assets pass under this Will, shall be prod from the residuary estate of my probate estate just as ~f they were my debts, and none of those taxes shall be charged agatnst any beneficiary or jotnt owner FIFTH: EXECUTOR - I appmnt my son, JOHN HUTCHISON, Executor of my W~II In the event that he predeceases me or is unwdhng or unable to serve as Executor, I then appoint my son, JAMES HUTCHISON and my daughter, MYRTLE CALAMAN, Co-Executors of my Neither my Executor nor any successor shall be reqmred to gtve bond for the performance of their duties I grant to my Executor and successors the power to compromise clmms w~thout court approval and w~thout the 'consent of any beneficiary SIXTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary or to h~s or her account, no ~nterest in income or pnnc~pal shall be assignable by a benefictary or available to anyone having a claim agatnst a beneficiary IN WITNESS WHEREOF, I hereunto have s~gned my name to th~s, my Last Wall and Testament, consisting of a total of FOUR (4) typewritten pages, th~s -~fY~day of .~/¥t'z-, ~,-- , 1999 LILLIE M FISHERt; Testatrix PAGE TWO OF FOUR In our presence, the above-named Testatrix signed th~s and declared it to be her Will, and now, at her request and in her presence and In the presence of each other, we sign as witnesses STATE OF PENNSYLVANIA : · SS COUNTY OF CUMBERLAND : I, LILLIE M FISHER, having been duly qualified according to law, acknowledge that I signed the foregoing ~nstrument as my Will and that I s~gned ~t as my free and voluntary act for the purposes therein expressed LII LiI M ISi E , Testatrix PAGE THREE OF FOUR We, having been duly c~uahfied according to law, depose and say that we were present and saw LILLIE M FISHER s~gn the foregoing instrument as her Will, that she stgned ~t as her free and voluntary act for the purposes therein expressed, that each of us in her sight and bearing and at her request s~gned the Will as witnesses, and that to the best of our knowledge she was at the t~me 18 or more years of age, of sound mind and under no constrmnt or undue influence Subscribed, sworn to or affirmed, and acknowledged before me by the above-named Testatrix and by the witnesses whose names appear opposite on this ) ~ $~- day of ~:~_ t~--- ]~-~-~ ,1999 f, Nota~ Public NOTARIAL SEAL IIICHARD L WEBBER, JR, NOTARY PUBLIC ItEWVILLE BORO, CUMBERLAND COUN1Y MY COMMISSION EXPIRES MAY 6. 2002 PAGE FOUR OF FOUR ' ~. COMMONWEALTH OF ~ PENNSYLVANIA ~J~'~m. DEPARTMENT OF REVENUE ~ ~1~,~,~,~'~ DEPT 280601 ~HARRISBURG, PA 17128-0601 I-- Z UJ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ILl DATE OF DEATH (MM-OD-yEAR) CATE OF BIRTH {MM-DO-YEAR) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST, FIRST, AND MilLE INITIAL) OFFICIAL USE ONLY FILE NUMBER COUN~ CODE YEAR NUMBER SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER uJ [] 10r,g[nal Retum [] 2 Supplemental Retum [] 3 Remainder Return (date olde,~Ui prior to 12 ~I~ [] 4 Limited Estate [] 4a Future Interest Compromise (date of deam aider 121282) [] 5 Federal Estate Tax Return Required o:z: O~ ~ [] 6 Decedent D~ed Testate (Arach copy of Will) [] 7 Decedent Maintained a L~vLng Trust (Attach copy olTrust) __ 8 Total Number of Safe Deposit Boxes ~' [] 11 Elechon to tax under Sec 9113(A) I^~am s~ o) < [] 9 Llhgat~on Proceeds Received [] 10 Spousal Poverb/Credit (date c~ death ~e~een ~231 Sl ar~ 1 1 95) :-- THIS SECTION MUST BE COMPLETED ALL CORRESPONDENCE AND CONFIDENTIAL~'TAX INFORMATIOI~I SHOUI~Dt'BE~DII~EC~ED~TO~ FIRM NAME (If Appl,c~ble) 14.1 n~ TELEPHONE NUMBER ?fT- ~q-P'- 3;z9/. ,', 1 Real Estate (Schedule A) (1) 2 Stocks and Bonds (Schedule B) (2) 3 Closely Held Corporahon, Partnership or Sole-Pmpnetorshlp (3) 4 Mortgages & Notes Recewable (Schedule D) (4) 5 Cash, Bank Deposits & Miscellaneous Personal Propor[y (5) (Schedule E) 6 Jointly Owned Property (Schedule F) (6) [~ Separate B~lhng Requested 7 Inter-V~vos Transfers & M~scellaneous Non-Probate Property (7) (Schedule G or L) 8 Total Gross Assets (total bnes %7) 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 10 Debts of Decedent, Mortgage Llablld~es, & bens (Schedule I) (10) 11 Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 m~nus Line 11) 13 COMPLETE MAILING ADDRESS 14 Chardable and Govemmental Bequests/Sec 9113 Trusts for which an elechon to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 m~nus Line 13) 15 OFFICIAL USE ONLY (12) (t3) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amount of Line 14 taxable aHhe 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 L~ne 14 taxable at collateral rate 19 Tax Due 2O x 0_ (15) x 0_ (16) x 12 (17) x 15 (18) (19) · > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SID~ AND RECHECk~I~I~,TI:I~'5~?{~,,~ ~I;~II~{lI Decedent's Complete Address: STREETADDRESS CITY Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2 Credits/Payments A Spousal Poverty Cradlt B Pnor Payments C Discount 3 Interest/Penalty ifapphcable D Interest E Penalty [ z,P/ (1) Total Credits (A+ B + C ) (2) Total Interest/Penalty ( D + E ) (3) If bne 2 ~s greater than Line 1 + Line 3, enter the ddferance Th~s ~s the OVERPAYMENT Check box on Page 1 Line 20 to request a refund (4) 5 If bne 1 + L~ne 3 ~s greater than L~ne 2, enter the d~fference Th~s ~s the TAX DUE (5) A Enter the ~nterest on the tax due (5A) B Enter the total of bne 5 + 5A Th~s ~s the BALANCE DUE . (5B) · Mak~ Check Payable to REGISTER OF WILL. S, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 D~d decedent make a transfer and Yes No a retain the use or income of the property transferred, [] [] b retain the right to designate who shall use the property transferred or Its ~ncome, [] [] c retain a reversionary ~nterast, or [] [] d receive the promise for life of e~ther payments, benefits or care'7 [] [] 2 If death occurred after December 12, 1982, d~d decedent transfer property wdhm one year of death without receiving adequate consideration? [] [] 3 Did decedent own an "~n trust for" or payable upon death bank account or security at h~s or her death'~ [] [] 4 D~d decedent own an Ind~wdual Retaement Account, annuity, or other non-probate property which contains a beneficiary deslgnahon? [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN Under penalties of perjury, I declare that I have examined th~s return, including accompanying schedules and statements and to the best of my knowledge and behef, ~t ~s true correct and complete Dedarabon of preparer other than the personal representative ~s based on all ~nformahon of which preparer has any knowledge S,C.ATUREda;. oF PERSON, /-'/" .ESPONS,SLE ¢c4 ,.'c-.FOR E,.,NC RETURN ADDRESS ~'/ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 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 surv~vlng spouse ts 3% [72 PS §9116 (a)(1 1) For dates of death on or after January 1, 1995, the tax rate ~mposed on the net value of transfers to or for the use of the survlwn9 spouse is 0% [72 PS §9116 (a) (1 1) The statute does not exemet a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fihng a tax retum are sh[I apphseble even if the sur',dwng spouse ~s the only benefictary For dates of death on or after July 1, 2000 The tax rate tmposed 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 adophve parent, or a stepparent of the chdd is 0% [72 P s §9116(a)(1 2)] The tax rate imposed on the net value of transfers to or for the use of the decedent's hneal beneflclanes is 4 5%, except as noted in 72 P S §9116(1 2) [72 P S §9116(a)(1)] The tax rate ~mposed on the net value of transfers to or for the use of the decedent's s~b~ngs ~s 12% [72 PS §9116(a)(1 3}] A s~blmg ~s de~ned, under Secbon 9102, as an ~nd~wdual who has at least one parent ~n common w~th the decedent, whether by blood or adoption COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONALPROPERTY ESTATE OF FILE NUMBER Include ~e p~s of I~a~on and ~e date ~e pm~s were r~ved by ~e ~ All pm~ ~in~ed ~ ~e right of su~lvo~hip must be disclosed on Schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF D~TH 1 ,/Ccc. TOTAL (Also enter on hne 5, Recapitulation) $ / ~ ,~',~,-O / (If more space ~s needed, ~nsert addlhonal sheets of the same s~ze) R~V-1513 EX+ (9-00~ COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMSER 1 11 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [~nclude outright spousal dmtr~bubons, and transfers under Sec 9116 (a) (1 2)] FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(e) AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 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) BUREAU OF INDZVZDU/,L TAXES COHNONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLORANCE OF DEDUCTIONS AND ASSESSNENT OF TAR Recorded Off:ce of DATE 05-08-2006 Regi~er of Writs ESTATE OF FISHER LILLIE N DATE OF DEATH 12-15-2005 FZLE NUMBER 21 06-0018 '04 HAR -5 P3:45COUNTY CUNBERLAND JOHN H HUTCHISON ACN 101 6 STRANBERRY DR Amount Remitted CARLISLE PA 17~rk-Orr;b~2 S Cumberland Co, PA HAKE CHECK PAYABLE AND RENIT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 1701~ CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-lSd7 EX AFF (01-03) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOgANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF FISHER LILLIE NFILE NO. 21 06-0018 ACN 101 DATE 05-08-2006 TAX RETURN NAS ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re~l Estate (Schedule A) 2. Stocks end Bonds (Schedule B) $. Closely Held Stock/Partnership Interest (Schedule C) q. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7 Transfers (Schedule B) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Expenses/Adm Costs/Hist Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deduct tons Nat Value of Tax Return (1) .00 (2) .00 ($) .00 (4) O0 (S) 1~662 O1 (6) .00 (7) O0 (8) NOTE: To insure proper credit to your account, submit the upper port,on of thls form with your lq. NOTE: 1,662.01 TAX CREDITS: 19 Principal Tax Due (19)= 76 79 ASSESSMENT OF TAX-' IS Amount of Line lq at Spousal rate 16. Amount of Line lfi taxable at Lineal/Class A rate 17. Amount of Line lq at S~bltng rata 18 Aaount of Llna lq taxable at Collateral/Class B rate (15) O0 X O0 O0 (16) 1,662 O1 x 065= 76.79 (17) O0 x 12 .00 (18) O0 x 15 = O0 NUHBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 09-1S-2006~ ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE[ INTEREST AND FEN. TOTAL DUE .00 76.79 .00 76.79 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RERUZRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS ) Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) 115) . O0 Nat Value of Estate SubBect to Tax (lq) 1,662 01 If an assessment Nas ~ssued p~ev~ously, l~nes 1~, 15 and/o~ 1~, 17, 18 and lP wi~1 ~e~le~-t fiDu~es that ~n¢lude the tota:l of ALL ~etu~ns assessed to date. .00 (9) (10) . O0 (i1) . O0 (12) 1,662 O1 J RESERVATZON PURPOSE OF NOTZCE PAYRENT REFUND (ER) OBJECTIONS DXSCOUNT. PENALTY INTEREST INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANtA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT 28O6O1 HARRISBURG, PA 17128-0601 DECEDENTS NAME FILE NUMBER LILLIE M FISHER 2104-0018 REVIEVVED BY ACN John Kealy 101 ITEM SCHEDULE NO EXPLANATION OF CHANGES J Lineal heirs are taxable at the rate of 4.5% for dates of death on or after 07-01-2000. ROW Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES R~CEIVED FROM rr ~ i HUTCHINSON JOHN F_' 4 STRAWBERRY DRIVE ~- CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003653 _ESTATE INFORMATION SSN 203-54-1425 ~i.LE NUMBER 2104-001 8 DECEDENT NAME FISHER LILLIE M DATE OF PAYMENT 03/09/2004 POSTMARK DATE 00/00/0000 COUNTY CUMBERLAND DATE OF DEATH 12/13/2003 JOHN M HUTCHISON CHECK# 103 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 .~74.79 TOTAL AMOUNT PAID: $74 79 INITIALS AC RECEIVED BY GLENDA FARNER STRASBAUGH REGISTER OF WIL[~S REGISTER OF WILLS BUREAU OF ZNDZVZDUAL TAXES COMHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOMANCE OR DZSALLOMANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Recoroad Off cs o! Register of W~lis '04 ~R-9 ~0'34 JOHN N HUTCHISON ~, STRAWBERRY DR t~ CARLISLE (~lerk pA: 17013 ,'~A ~kllnberlana bo, r~ DATE 03-08-200q ESTATE OF FISHER DATE OF DEATH 12-13-2003 FILE NUMBER 21 0q-0018 COUNTY CUMBERLAND ACN 101 Amount Remitted LILLIE N MAKE CHECK PAYADLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS LZNE ~'~ RETAZN LOWER PORTION FOR YOUR RECORDS ~¥: ~ ~¥ - ~- -~ ~- - ~ 6~:-~ ~3- -~ ~-~ ~- -~ - ¥~ ~-f ~-~ - ~ - ~¥~ ~-~ ~k-g~ ~3- '~ C~ ~- ~ ................. DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF FISHER LILLIE MFILE NO. 21 0~-0018 ACN 101 DATE TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN DASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) $ Closely Held S~ock/Par~nershlp Zn~erest (Schedule C) q Mortgages/Notes Receivable (Schedule D) .6. Cash/Bank Deposlts/Nisc. Personal Proper~y (Schedule E) 6. Jolntly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Total Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Ada Costs/Hisc. Expanses (Schedule FI) 10. Debts/Mortgage L~abili~1es/Llens (Schedule Z) 11 Total Deductions 12. Nat Value of Tax Return (1) O0 (2) .00 (3) .00 (,~) .00 (5) 1 ~,662 01 (6) O0 (7) O0 (8) .00 (lO) O0 NOTE: ASSESSMENt' OF TAX: NOTE' To Insure proper 1,662 01 1,662 01 .00 IF PAID AFTER DATE TNDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. PAYMENT MUST BE MADE BY 09-13-Z00q~ .00 x 00 : .00 1,662.01 x 0qB= 7q.79 00 x 12 = .00 .00 x 15 = 00 (~9)= 7~.79 TOTAL TAX CREDZT .00 JALANCE OF TAX DUE 7q.79 INTEREST AND PEN. .00 TOTAL DUE 7q.79 ( EF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY DE DUE A REFUND. SEE REVERSE SIDE OF THZS FORM FOR ZNSTRUCTZONS) 15. Amoun~ of Line lq a~ Spousal rata 16. Amount of L/ne lq ~axable at Lineal/Class A ra*a (16). 17 Amoun~ of L~ne lq a~ S~bl~ng ra~e (17). 18 Amoun~ of Line lq ~axable at Collateral/Class B ra~e (18). 19 Principal Tax Due rAX CREDITS: PAYMENT RECEIPT DISCOUNT (+J AMOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) Charltable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Estate Subject to Tax (lq) 1,662.01 If an assessment ~as issued previously, 11nes lq, 15 and/er 16, 17, 18 and 19 ~111 reflect figures that include the total of ALL returns assessed to date. REFUND (CR) OBJECTIONS. DISCOUNT PENALTY the tax paid is allowed. ZNTERSST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DSLZNQUEHT X DAZLY ZHTERRST FACTOR I~~a~~-- INHERITANCE TAX EXPLANATION ~, COMMONWEALT~ OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG~ PA 17128-0601 DECEDEN3'S NAME FILE NUMBER LILLIE M FISHER 2104-0018 REVIEWED BY ~,CN John Kealy 101 ITEM SCHEDULE NO EXPLANATION OF CHANGES J Lineal he~rs are taxable at the rate of 4.5% for dates of death on or after 07-01-2000. ORIGINAL Page 1 STATUS REPORT UNDER RULE 6.12 Date Will No.: Pursuant to Rule 6.12 of the Supreme Court ,0r~hans' Court Rules, I report the following with respect to completion of the adminis '~;n of the above-captioned estate' ~ i~L _.- , · ' 1. State whether administration of the estate is complete: 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the anuwer to No. 1 is Yes, state the following: 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 au account informally to the parties in interest? Yes [~ No [-] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. S NalTiC Address Capacity: Telephone No. [~ersonal Representative [~] Counsel for personal representative Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: Will No. To the Register: [~t ;I r~2 . . I ceffify ~at notice of (~nefiei~ ~t) ~ administration required by Rule 5.6(a) of ~e O~h~s' Court Rules w~ served on or mailed to ~e following beneficimes of the above-captioned estate on : Nme Addres~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date:. Signature Address Telephone ( ) ?/7-~q~-3-2~ I Capacity: ~Personal Re re ' - p sentanve Counsel for personal representative BUREAU OF ZNDZV'rDUAL TAXES ZNHERTTANCE TAX DTV'rSZON DEPT. 280601 HARRI*SBURG,, PA 17128-0601 JOHN M HUTCHISON ~ STRANBERRY DR CARLISLE COHHONNEALTH OF PENNSYLVAN'rA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT *04 2O PA DATE 0~-05-200q ESTATE OF FISHER DATE OF DEATH 12-13-2003 FILE NUMBER 21 0~-0018 :35COUNTY CUMBERLAND ACN 101 Amoun'l: Rmm'i 'lc'l:md REV-1G07 EX AFP C01-05) LILLIE M HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF NILLS CUH]IERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper crmd/~: ~o your account, submL~ ~hm uppor portion of ~his form wi~h your ~ax payment. CUT ALONG TH'rS L'rNE ~'~ RETATN LONER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-03) ""# TNHER'rTANCE TAX STATEHENT OF ACCOUNT ESTATE OF FISHER LILLIE Fl F1'LE NO. 21 0~-0018 ACN 101 DATE OR-O5-ZOO~t THTS STATEHENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAHED ESTATE. SHONN BELON ZSA SUNHARY OF THE PRINCIPAL TAX DUE, APPLZCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPL/CABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 05-08-200q PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT NUMBER CD005653 05-09-200~ DZSCOUNT (+) INTEREST/PEN PAID (-: 3.7r~ AHOUNT PAID 7~.79 TOTAL TAX CREDIT 78.53 7~.79 BALANCE OF TAX DUE ZF PAID AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 3.74CR INTEREST AND PEN. .00 TOTAL DUE 3.7~CR PAYMENT: Detach the top portion of this Notice and submit mith your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. 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-1315). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's Iq-hour ansaaring service for forms ordering: 1-B00-36Z-Z050; services for taxpayers eith special hearing and / or speaking needs: Z-&OO-q47-30ZO (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individua! Taxes, ATTN: Post Assessment Review Unit, Dept. 2BOSOL, Harrisburg, PA 171ZB-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed, PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid bmfora January LB, 1996, thm first day after the end of the tax amnesty period. INTEREST: 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 L, 1982 bear interest at the rate of six (6g) percent per annum calculated at a daiIy rate of .000164. Ali taxes which became delinquent on and after January 1, 1982 wil! bear interest at a rate which will vary from calendar year to caIendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2004 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZO2 .gOOS4& 198B-199! IIZ .00030I ZOO! 9Z .000247 1983 16g .000458 1992 92 .000247 ZOOZ 6X .000164 198q llX .000301 1993-1994 7X .O00lgz 2003 SX .000137 1985 13X .000356 1995-L998 92 .000247 2004 4~ .O00llO 1986 1DX ,000Z74 1999 72 .O0019Z 1967 9X .000247 ZOO0 8X .O00Z19 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT 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.