HomeMy WebLinkAbout02-0023PETITIO'N FOR PROBATE and GRANT OF LETTERS
Estate of ' .~./u ~> v~.,, ~ ~. /~4/~.c. No.
also known as To:
Deceased.
Social Security No. / '4 7 - ~ S ~' .5 ~ 't q
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last will of the above decedent, dated
and codicil(s) dated
21-02-23
Register of Wills for the
County of CUMBERLAND
Commonwealth of Pennsylvania
in the
named
/ ,d~ ~cmo
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~.omJ~-~et_4w o County, Pennsylvania, with
h) ~ last family or principal residence at
(list street, number and muncipality)
Decendent, then -'9- 9 7 years of age, died
Except as follo~s,'dece~ent d~d not marry, w~s not divorced and did not have a child born or adopted
after execution ~f the ~fli:~ffered for probate; was not the victim of a killing and was never adjudicated
incompetent: - ~ 0 N ~E ...
Decendent at deaLk o~ne~:property with estimated values as follows:
(If domicile~i~Pa~).~:~ All personal property $ .~ o oO. oo
(If not domiciled'in'Pa0' Personal property in Pennsylvania $
(If not do~icile~,ih,P~.) Personal property in County $
Value of real est~[e in Pennsylvania $
situated as follows: tVO~ ~.
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
request(s) the probate of the last will and codicil(s)
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
~o
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA '1 ~
COUNTY OF ,,~t~tBERLAI, m j* ss
· ,.,:. ,;,..:~ ~;;~ .
:",' ',~-~ .J4 ' /- ' · ....
The petitioffer(s~:~bov~-n~mSd-.swear(s) or affirm(s) that the statements in the foregoing petition are.
true and co~r~gt~t6~the best b~ t.h~Sknowledge and belief of petitioner(s) and that as personal represen-
tative(s) of th6/~bdve dece~e~[ ,~t~ioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed &fi~-subscribed 'r ~ '~- ~
~ror~ m~t~is ~h : ~ar or / ' ~'
I J~UARY . ' - . ~2002 J ~
: : ~ ' Register/t ~
No.
21-02-23
Estate Of
ANDREW D MEHALL
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JANUARY 10 ~x~_2002 , in consideration of 'Q:e petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED~that the instrument(s) dated M~Y 1, 2000
described therein be admitted to probate and filed of record as the last will of
-ANDREW D MEHALL ;
and Letters TESTAMENTARY
are hereby granted to SUSANNE M LESNY
FEES
Probate, Letters, Etc .......... 5 80.00
Short Certificates( ) .......... 5 1 S.O0
~l~-~a~es . 6.00
u~cmnon ................ 5.
JCP 5. 5.00
TOTAL __ 5 106.00
Filed .. ~IAI~.UARY. 9 o. 2,Q01 ...............
ADDRESS
PHONE
:
O'
=-_- ¢0
21-02-23
'REGISTER OF WILLS OF ~bLb~]~/~("/~N~ COUNTY
OATH OF SUBSCRIBING WITNESS
(each) a subscribing witness to th resented herewith, (each) being duly qualified according to
law, depose(s) and say(s), that V~ ~ N ~'~I~ present and saw
. b. ,
the testat 0 [Tx , sign the same and that V~/~ signed as a witness at the
request of testat 0]7`` i.n h I -% presence and (in the presence of each other) (in the presence of the
other subscribih'g v~ithes~(4s.))..
Sworn to: or, affirmed-'~nd-:s~s~_ribed before
me this- · 9th . c.~ = day of
" ' ~--:~ 1~2002
f , '~ w ~% ,,'" Register
REGISTER OF WILLS OF
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, being duly qualified
filiar with the si:
testat.__ of (one of the subscribin
that
of
to law, depose(s) and say(s) that
codicil
to) the will presented herewith and
codicil
signature on the will is in the handwriting of
to the best of
Sworn to or affirmed an
me this
k and belief.
before
day of
19__
Register
(Address)
(Name)
(Address)
JTestament,
LAST WILL AND TESTAMENT
OF
ANDREW D. MEHALL
I, ANDREW D. MEHALL, of Carlisle, Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last
Will and Testament, hereby revoking all other Wills and Codicils
heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, in equal shares, to
my daughter, JANET M. MITCHELL, my daughter, ELAINE SWARTZ-LAIRD
and my daughter, SUSANNE M. LESNY, provided that should any of my
daughters predecease me, I giVe-and bequeath such daughter's
share unto her issue per stirpes by representation, and if there
be a failure of same, then I give and bequeath such deceased
daughter's share to my Surviving daughters as provided herein.
SECOND: No provision is made in this, my Last Will and
for my son, A. DAVID MEHALL, not necessarily because
of any lack of affection for him, but because he is already well
provided for. .
THIRD: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to. give
legally sufficient instruments for transfer of the property and
'%.
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
'"~'any other rights which they may have under the plan, in whatever
manner they consider advisable.
FOURTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not'with respect
2
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
FIFT~: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SIX?W: I nominate and appoint SUSANNE M. LESNY,
Executrix of this, my Last Will and Testament. In the event of
the death, resignation or inability to serve for any reason
whatsoever of the said SUSANNE M. LESNY, I nominate and appoint
ELAINE SWARTZ-LAIRD, Executrix of this, my Last Will and Testa-
ment. I direct that my Executrix or Executor, as the case may
be, and their successors, shall not be required to post security
or a bond for the performance of their dutieS in any jurisdic-
tion.
seaI
IN WITNESS WHEREOF, I have hereunto set my hand and
to this, my Last Will and Testament, this f~ day of
2000.
Signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his request, in his presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
Address
(
,F
to ;~o!i~0 .per~Jo-6oEI
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Date of Death: ~D~g. ~._~ , ~d) O I
Will No. ~ Or; Z ~ O(?&P aZ~ Admin. No.
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 ~. E. 12.~, .~oo'f :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ~ o ~o ~'"
Date:
Signature
Address Oql~ ~ / ~"-[~ ~.-~.
Telephone
Capacity: X Personal Representative
__Counsel for personal representative
'02 JUL 23
~ AMOUNT
0000 °
U.S. POSTAGE
PAID
CAMP HILL.PA
170ll
JUL 17.'02
00096736-09
17]28
REV- 1~00 EX (6-00) ·
~ cOMMONWEALTH OF
C~ ' PENNSYLVANIA
,i~;~~~::i~ DEPARTMENT OF REVENUE
r~.~-~ DEPT· 280601
~HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
,P. I -O,p..,
COUNTYCODE YEAR NUMBER
LU
LU
LLI
I-
Z
Z
0
UJ
n~
0
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YEAR) . J DATE OF BIRTH (MM-DD-YEAR)
12. -
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
/¢7 - -
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[~] 1. Original Return
~"'] 4. Limited Estate
~] 6. Decedent Died Testate (Att~ch copy of Will)
---]9. Litigation Proceeds Received
E~2. Supplemental Return
~14a. Future Interest Compromise (date of deeth after 12-12.82)
F--J7. Decedent Maintained a Living Trust {^ttach'copy d Trust)
~]10. Spousal Poverty Credit (date ofdeath between 12-31-91 and 1-1-95)
[~3. Remainder Return (date of death prior to 12-13-82)
'-'-]5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
E~] 11. Election to tax under Sec. 9113(A)(Attach Sch O)
E.~HIS SEC~ION~MUS~/BE..COMI~E.u_~ i=u; "..A.'EE, CORRESEONDENC~ND CONEIDEN~E~iNFORMATiON.~SHOUi~D~i~iEi''
.................. . .............................................................. ............ ---: ............. ' ~ ..... i.~... ~LREC~E.D~,T.O.:~
NAME S O.5.,aldfd~ Jlq. LE¢,'u y
FIRM NAME (If Applicable) '
TELEPHONF,,,.NUMBER
(7/'79
COMPLETE MAILING ADDRESS ~
~18 N. 1 '7-'¢ 5'~r~
C4mP )~t/--~,,__P-'.'/ /'70 Ii
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)~
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Properly (5~'
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
E~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) ,
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
LO 0~)
OFFICI~L~SE ONLY
L
r--
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13).
15.
16.
17.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
Amount of Lin~ 1~, ta~able at lineal rate ~ 1'11'~ ~ '7 ~ ~t.' L~
Amount Df Line 14 taxable at sibling rate
x .0 (15)
x.0 ~r5 (16)
x .12 (1'7)
18. Amount of Line 14 taxable at collateral rate x .15 ' (18)
X
~=~ 19,TaxDue. (19) '75
~ '?,~.~'.~-. ,,4;~'~'. ~:¢~'~.":~.~r~.~'~'~2~f~ 'x~ v ~ . ,. ~- , ....... ,. ..... . ........... ~ ....
Decedertt's Complete Address:
STREET ADDRESS
CITY
Tax Payrnent$ and Credits:
1. Tax Due (Page~
Line
19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments ·
C. Discount
IsTATE P A
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. '
Total Credits ( A + B + C ) (2)
(3)
(4)
Total Interest/Penalty ( D + E,)
(5)
(5A)
(59)
34_6
'7.5
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
& retain a reversionary interest; or ...................... : ....... i .............. []
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? ............................................... :.. ............................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................
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 this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
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 surviving spouse is 3%
[72 P.S. §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 0% [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 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 decedeni's lineal beneficiaries is 4.5%, 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 decedenrs siblings is 12% [72 P.S. §9116(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.
I~Ev4sI2 EX - (1-97) ~
COMiVlONWEAITH OF: PENNSYLVANi^
INHERITANCE TAX RETURN
RESIDENT OECEDENT
· SCHEDLJLi=I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
FILE NUMBER
Include unreimbursed medical expenses,
ITEM
NUMBER
3.
DESCRIPTION
'" AMOUNT
6o..0o
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, inser~ additional sheets of the same size)
EV-1511 EX+ (12-99) ~ .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
ITEM
NUMBER
SCHEDULE' N ·
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of d?cedent must be reported on Schedule [.
DESCRIPTION
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) _q;L,)~,qAJ.~: ~,.
Social Security Number(s)/EIN.Number of Personal Representative(s)
Street Address ~ i~ N. ~ ~ ''')'~
City ('~ ~;3 ~.-~ It~ [ State
Year(s) Commission Paid: ~ OO
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Stree{ Address .- .... · ' -: '
AMOUNT
City.. State Zip -~ . ...............
~OG,. oo
s r.,, .,4,'5
!
5.
6.
7.
Probate Fees '{~:~,1.~'['~'~' 0~' V'Jt~L.-~ - , ....
Accountant's Fees
TOTAL (Also enter on line 9, Recapitulation)
Tax Return Preparer's Fees
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX~- (9-00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
NUMBER
!
1.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
5u5~,.~ in. c~5n~y
ToT^ I.
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
'"'i:::". ~ '~'-i.~'i'~'~":;'::?'~;"!'~'!;::: -'" " '.~' ' ...... :.~'""'- · - :~"':?:-~:::" ':~::'~:~:'~:~:~:'- -~ ~- ~ , '- '-,'.--" ' '~- '~
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART [I - 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)
COMMONWEALTN OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Ahlor E o ['hE. HALL
Indude the proceeds of I~a~n and ~e date ~e p~s were ~N~ by ~e ~a~. All pmpe~ ~inW~ed ~ ~e right of su~ivomhip must be disclos~ on ~hedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF D~TH .
1.
Acc '~ 3 °1 ~ ~ '7 2 ?o u
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
9-
FILE NUMBER
All property jointly-owned v~th right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8060!
HARRXSBURG, PA 17116-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHEHT, ALLOHANCE OR DISALLOHANCE
OF DEDUCTIONSAND ASSESSHENT OF TAX
REV-15~i? EX &FP (01-02)
SUSANNE M LESNY
218 N 17TH ST
CAMP HILL
'02 SE? 16 ~8:18
DATE 09-10-2002
ESTATE OF MEHALL
DATE OF DEATH 11-28-2001
FILE NUMBER 21 02-0025
\
COUNTY CUMBERLAND
ACN 101
Amount Remltted
ANDREW D
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
.CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-02) NOTICE OF INHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MEHALL ANDREW. D FILE NO. 21 02-0015 ACN 101 DATE 09-10-2002.
TAX'RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es*ate (Schedule A) (1)
2. Stocks amd'Bonds (Schedule B) (2)
$. Closely HeZd S~ock/Partnership Interest (Schedule C) ($)
q. Nortgagas/Notes Receivable (Schedule D) (q)
$.*Cash/Bank Deposits/Hisc. Personal Proper*y (Schedule E) (5)
6. Join*ly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assa*s
APPROVED DEDUCTIONS AND EXEMPTIONS=
9. Funeral Expensas/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. Debts/Hortgaga Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12; Nat Value of Tax Ra~urn
qqz8$8.Zq · O0
13z2:50.q1
.00
.00 NOTE: To insure proper
credit to your account,
submit the upper portion
.00 of this form with your
tax payment.
.00
(8)
6,~$7.~5
15.
lq.
NOTE:
ASSESSMENT OF TAX:
15. Amount of L/nB lq at Spousal rata
16. Amount of Line lq taxable at Lineal/Class A ra*e
17. Amount of Line lfi at Sibling rata
18. Amount of Line 1~ taxable at Collateral/Class D ra~®
19. Principal Tax Due
TAX CREDITS:
PAYNENT RECETpT DISCOUNT
DATE NUMBER INTEREST/PEN PAID
07-2:~-2002 CDOOlqqO
qa905.51'
(11)
(12)
Charitable/Governmental Beques*s; Non-elected 911:5 Trusts (Schedula J) (1:5)
Nat Value of Esta*e Subject to Tax (1~)
If an assessment ~as lssued previously, lines 1~, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
58,068.65
ll .5~0.9~
q6,727.69
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
q6,727.69
18 and 19 will
(is) .00 x 00 = .00
(16) q6,727..69 X 0q5 = 2,102.75
(17) .... 00x 12 = .00
(18) .00 x 15 = .00
(19)= 2,102.75
AHOUNT PAID
2,102.75
TOTAL TAX CREDZT 2,102.75
BALANCE OF TAX DUEI .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REDUZRED.
IF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRAT[VE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying-on or.before December 1Z, 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 and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To .fulfill the requirements o~ Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOOO.'(7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit aith your payment to the Register Of Hills printed on the reverse side.
--Hake check ar money order payable to: REG/STER 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-IS15). Applications are available at the Office
of. the Register of Hills, any of the Z5 Revenue District Offices, or by. calling the special Z4-hour
ensmering service for forms ordering: 1-BOO-56Z-Z050; services for taxpayers with special hearing and / or
.speaking needs: 1-800-447-50Z0 (TT only).
Any party in interest not satisfied mith the appraisement, allowance, or disalloaance of deductions, or assessment
of tax (including discount or .~nterast) as shown on this Notice must object within sixty (60) days of Feceipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810ZI, Harrisburg, PA 17128-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the O~phans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. lB0601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6~05. 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 mithin~three (5) calenda~ months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
1982 207. .000548 1992
1985 167. .000458 1995-1994
1984 117. '*. 000501 1995-1998
1985 137. .000556 1999
1986 lOZ .000274 ZOO0
1987 92 .000247 ZOO1
1988-1991 1,17. .000501 ZOOZ
'--Interest is calculated as fo/lams:
INTEREST = BALANCE OF TAX UNPATD
The 15Z 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 mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning eith*rfirst'day ;f delinquency, or nine (9) months and one (1) day ~rom the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the ra~& of
six (6Z) 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 ah/ch will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through 200Z are:
Year Interest ~ate Daily Interest Factor Year Interest Rate Daily Interest Factor
9Z
7Z
92
7Z
8Z
9Z
6Z
.000247
.00019Z
.000247
.O0019Z
.000Z19
.000247
.00016~
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Not'ce-issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the lntarest computation date shown on the
Notice, additional interest must be calculated.
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes [~] No [-]
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:
Did the personal representative file a final account with the Court? '..
Yes _ No []
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes [--] No [--]
Co
Date:
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.
Signature
Name
-D
Capacity:
Address
Telephone No.
[-~ Personal Representative
[--] Counsel for personal representative
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