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HomeMy WebLinkAbout02-0030PETITION FOR PROBATE and GRANT OF LETTERS Estate of' also known ~. Deceased. Social Security No. ) b 6 ,3 O 14 ~_ f~ ('~ No. 21-02-30 To: Register of Wills for the County of Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or ol~qer an the execut.~ · in the last will of the above decedent, dated ~ ~ ¢ ~ ~ and in the codicil(s) dated named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C. t~r~ b ~ c la rx t~ County, Pennsylvania, with h e c- last family or principal residence at I 0 o ~ 0 ~_~ ~ ~ ~ ".,~ (list street, number and muncipality) DecendenV,-[h~- /¢7~ years of age, died 3 ~ e. C ,. ~ 2 0 0 ] , at - ~- , ' Except as follows, dec~3t did not marry, was not divorced and did not have a child born or adopted after execution ofithe~ifl ~ffered for probate; was not the victim of a killing and was never adjudicated incompetent: , -; r-~ ... Decendent at de~ath%.~e~d_-:-property with estimated values as follows: (If domiciled in P~t:)~.' ~ Z' All personal property $ ~-; I_n 8"2. (If not domicile_d iff-Pti:')' Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal.'property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. reqggst(s) the probate of the last will and codicil(s) (testamentary; administranon c.t.a.; administrauon d.b.n.c.t.a.) /~//C//~£/q.5- C, ./~/,~'/7-~'/~ OATH OF' PERSONAL REPRESENTATIVE ' COMMONWEALTH OF PENNSYLVANIA ~ :ss COUNTY Q~,,.__,,_... CUMBERLAND · . J ' · .--'.-i' :.~ .'7/'",,. ' . . , ' , .: The petitioner(g)fibove-na~ed swear(s) or affirm(s) that the statements In the foregoing pet~Uon are true and-cqr~e~{~to the i~'es{~'f"Lhe knowledge and belief of petitioner(s) and that as personal repreSen- tative(s) of the/above,dece&e, fii~Oetitioner(s) will well an~Ftr.Uly administer, the estate according to law. , , ,: . _ Sworn io 'or affirmed an~d :subscribed 'r · c~ before m~e this llth '~ day of [ ....... ~ { JANUARY , .' , :iR 2002 J ' . ~ ' '7- /' ~._..- '/ ' R-e~isterd[ ' - ~ /'2- ,~ ~- -/..~ No.~ 21-02-30 Estate Of THEODORA K WOOD' , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 1 i 1~_2002 , in consideration of ',:he petition on the reverse side hereof, satisfactory proof having beer~ presented before me, IT IS DECREED,that the instrument(s) dated AUGUST 1, 2001 described therein be admitted to probate and filed of record as the last will of THEODORA K WOOD ; and Letters TESTAMENTARY are hereby granted to NICHOLAS C KIRITSIS FEES Probate, Letters, Etc .......... $ 40 o 00 Short Certificates( ) .......... $ 15.00 Renunciation ................ $ JCP $ 5. O0 TOTAL __ $. 60.'00 Filed . JANUA1LY..11 ,. 2002 ......... i ..... ATTORNEY (Sup. C:. I.D. No.) ADDRESS PHONE © 105.805 REV 9/86 photo ~IAME AND ADORESS OF PERSON WHO COMPLETE° CAUe~: OF 0EATH ~,-.~ ~.,. .., ,.::... 21-02-30 LAST WILL AND TESTAMENT OF THEODORA KIRITSIS WOOD Being of sound mind and body I herewith write my Last Will and Testament. This Will supercedes any other contract, Will, that I have written. I hereby leave all my personal belongings and worldly possessiOns, house, car, any monies such as bank,, checking, savings and trust accounts, certificates of deposit, insurances~ jewelry and monies owed to me or any inheritance given or left to me, go to my four sons, Peter A. Wood, 41 Tudor Drive, Patterson, New Jersey, Christopher A. Chekouras, 297 Kalorama Road, PO Box 454, Sykesville, Maryland 21784, Constantine (Dean) A. Wood, RR#2, Box 97, Brush Mountain Road, Hollidaysburg, PA 16648, Jonathan A..Wood, c/o 119 Philmar Avenue, Cherry Hill, New Jersey 08003, to be divided equally and with dignity all of my estate. If for any reason oneofmy sons is in dire need of more help, then the remaining sons should act accordingly with a clear and helpful conscience to help that brother. To Andrew P. Wood, 2933 Croyden Road, Harrisburg, PA 17104, my true desire for him to seek professional help and to have good health and forever to remain happy and very close with our four sons. That he promise to be there for our sons always. My prayers and my love are with them all always, here and in the hereafter. I name as my Executor of my Will, my brother Nicholas C. Kiritsis, 100 Howard Street, Enola, PA 17025: In the event ofhi's death at my time of death, I name my eldest son Peter A. Wood, address given above as my Executor. THEODORA K. WOOD WITNESS: (~_t~ce_. 7~,-~~ DATE: ' Address:/~F ~~  m' befor~ me this day of ,2oo . , I ' NOTAR~L S~L / ' ~ ~ I ~RENC.~HT, N~.~ic.~ ': . . · ., - I, ~of~ Dau~n~/~ ~ . ' I '~~s~n ~ires'Ju~ 1~, ~/I ' ~_,~/~, "'.., DATE: 21-02-30 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of testat__ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19.__ Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF Ctt~BERLmD COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscri.ber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of THEODORA K WOOD , testat rix of (one of the subscribing witnesses to) the will presented herewith and that they believes the signature on the will is in the handwriting of tJJ/~HEODOROA K WOOD to the best'of.~ tb.,e't'r ~-~. ?nDwledge and behef. .//, . · Sworn t0 or,a~firm~ and'subScribed before me this - llth .~ : -'= day of (Name) (~am0 2~7~ ~ Sck~o}ko~se ~A~ress~ x,If~OD Sq~IIM ~0 · xoq s!qi u! ff+dlZ pu~ 'sse~ppe 'a~ueu Jno~ ]u!Jd aS~@ld uepues o ~OIA~S qvisqd s~ivi, s a~±lNn W!~oel:l wn3el:l o?,sewoc] L00~ qoJl~ ' J. J.J~J~ wJO:l Scl .~eqwnN elO!].J¥ '8 sea [] eesseJppv [] ~ue§v [] ~elO ,lu!,~d eS~eld) ,~q pe^!eoebt '¥ fueA!leO ~o eleo 'El · si!wJed eoeds j! luoA[ eql uo Jo 'eoe!dfi~w eql jo ~o~q eql o; pJ~o sN1 qo~l~V · · no/~ ol pJeo Gq1 uJnleJ u~o eM ~,e41 OS esJe^eJ eql uo sseJpp~ pue eweu Jno~ lU!Jd · · peJ!sep s!/ue^!leC] pejo!J1seld j! ff eleldWOO OSl¥ '~ pue '~ ' L swej! e~eldwoo · ~etulsod JRD/June30,1992/17858 1 6 InRe: Estate of Theodora K. Wo}o:dJ Late of Estate No.: 21- 2002-00030 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE PersonalRepresentative: Nicholas C. Kiritsis Counsel for Personal Representative: Date of Grant of Original Letters: January 11, 2002 Date of Delinquency Notice: Apri ] 21, 2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on 4-2 ~, 20 02 , and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: May q5, 2002 Distribution: . lMa~ C. Lewis, Registe~r of Wills I/ d' Personal RePresentative Counsel for Personal Representative Estate File Ahearingis scheduled for ' 8/d~,/d'~9~ at ¢',~)/J, fi/ffl_n Courtroom No. 3. Ifthe Certification of Notice is filed prior to the hearing date, the hearing will automatically be cancelled. ~ George CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: '~0 J'r'(~ / ~Q/D'05 Date of Death: ' LC'~ .9., ff-O~ ] Will No. 2 002- 0 00~.~ D Admin. No. 2 t - 0 Z-- ~) O, .~ ~ To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Omhans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on / 2/~/(3 / Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature Name Address Capacity:__ Telephone (q/D) l~Personal Representative Counsel for personal representative t ~-'v. tsoo EX (6-0o)  '. LL'-.~ - COMMONWEALTH OF ~ .PENN$~LVANI .A .... DEPARTMENT OF REVENUE : ._ DEPT. 280601. .. INHERITANcE YAXRETURNIi"'="u""=" . ., .. .: 'iRESIDENT DECEDENT. ......... Zl""- DECEDE~T'S ~//0 ~ [)! NAME (LAST,.~.~ ~ 0 L~ 01~. ,,~ FIRST, AND MIDDLE INITIAL) K', Iii - DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) ~ '- "' 12/o /o,I ' Itl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) UJ I-. Z UJ Z O LU O SOCIAL SECURITY NUMBER .... /6,0 - .30 - ~YS~O THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ' SOCIAL SECURITY NUMBER 1. Original Return F-J4. Limited Estate. r'-~ 6. Decedent Died Testate (A~ch c~py of Will) [~9. Litigation Proceeds Received F-I. Supplemental Return .... I'll 4a. Future Interes~ ComprOmise (date of death after 12-12..82) i~l 7. Decedent Maintained; Living Trust (Atiac~ c(~y of Trust) i'~l 10. Spousal Poverty Credit {date of death between 12-31-91 and 1.1.95) FIRM NAME (If Applicable) TELEPHONE NUMBER i--I 3. Remainder Re~um idate o~ death pr[or tO 1243-82) ... i---1 5. Federal Estate Tax Return Required ~ .- . 8. Total Number of Safe Deposit Boxes ' I-'-I 11. Election to tax under Sec. 9113(A) (A,ach Sch O) COMPLETE MAILING ADDRESS 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 Rec;ivable (Schedule O) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ~(~ ~,Z,. ~ ~ (Schedule E) 6. Jointly Owned Property (Schedule F) (6) O, O ~ ~ Separate Billing Requested - 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) L~! I~ ~'~. ~;~ (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ~'.~ ~ ~, O O 10. Debts of Deced~ent, Mortgage Liabilities, & Liens (Schedule I) (10) ~ ~. 7~ 11. Total Deductions (t(~tal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) , *' ', , ' "'" o, ap o'?._ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 0,00 O. Ob .~... ,OFFICIAL:I;I_.SE ONLY' (8) 5'/] 5~'2. Z~ · (11) ' ~.~ 72..5,'~Y ...... ':~. (.12i'" '""' "- (13) .' O,O O.' * SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Lin_e 14 taxable at collateral rate 19. Tax Due x .o_ (15) ~ .o'U" (16) x .12 (17) " .. x .15 ..... (18) ......... ~. ., (19) I'1~t~ 5ff '- Tax' Payments and Credits: 1. 2. 4.. Tax Due (Page 1 Line 19) Credits/Payments . . ....... . .... A. SpouSa! Poverty .Credit; ..... B, Prior Payments. · ..... C. Discount (1) /q/f, 5;9 IriterestJPe~alty if applicable · D. Interest E. Penalty Total InteresqPenalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the diffei'ence. This is the OVERPA'~;MENT. Total Credits (A + B + C ) (2) Check box on Page 1 Line 20 to'request a refund If Line 1 + Lin~ 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 + SA. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) ~, O0. Make Check Payable to: REGISTER OF WILLS, AGENT ·· PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE 1. Did decedent make a transfer and: Yes 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 ......................... ~ .......................... [ ...................................................... : ....... :...;..' [] 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 a~ .in tn]st 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? ........ ' .......................... : .............................. - ............................ ; ......... ~ ................ [] BLOCKS No 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 line, correct and complete. Declaration of preparer other than the personal repmsenta§ve is based on all information of which preparer has any knowledge. · ,' SIGNAT~ FOR FILING RETURN . DATE, ADDRESS ' - .... 81GNATURE 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%. For dates of death on or after Jahuary 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 trafisfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return'are still applicable e,v.en if the surv!ving 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 ad6ptive pa.~rent, or a stepparent of the child is 0% [72 RS. {9116(a)(1.2)}.. ' · ....... ~ . ,. ..~ ' Tt~e tax rate imposed on the net value of transfers to or for the use of the decedent's hneal beneficiaries ~s 4.5 %, except as noted ~n '/2 P.S. {}9116(1.2) [72 P.S. §911~ The tax rate imposed on the net value'of transfers to or fof the"use df the'decedent's Siblin{]s 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 de'dent, whether by blood or adoption.. ".:' ' :.- -' . . .. -.:.; .' '. '" ' · '; ' ' REV.15i)8 EX * (1-97) '~ coMMo.w~J, oF ~N.S~W,~ CASH, BANK DEPOSITS, & MISC. INHE~T~CE T~ ~TU~ PERSONAL PROPERTY RESIDENT DE.DENT ESTATE OF FILE NUMBER ! Include the proceeds of litigation and the date the proceeds were received hy the estate. All property jointly-owned with the fight o! survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM NUMBER DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) OF DEATH COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT INTER-VIVOS TRANSFERS & MISC. NON-PROBATE pRoPERTY ESTATE OF RLE NU~ER This schedule mu~ be ~mp~t~ and fil~ ~ the an~r to any ~ ~ions I through 4 on ~e re~ s~ ~ the R~-I~ ~R 8H~ b r~. DESCRIPTION OF PROPERTY % OF DECD S ITEM ~c~u~e.~eo~-e~a,~,~-e~.e.~mo.s~,mr~'~ax~,~e'~e ~- ~u~s~e~. DATE OF D~TH INTEREST ~CLUSION T~LE V~UE NUMBER V~UE OF A88~ ~ ~m~ (If more space is needed, insert additional sheets of t~e same size) , REV-1511 EX+ (12-99~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FUNERAL ExPENSi~s & '1 ' " "' ADMINISTRATIVE COSTS I ' ' ' ' ESTATE OF /~0-- ,:30-/-/?2 o FILE NUMBER Debts of decedent must be reported on Schedule ]. DESCRIPTION AMOUNT ? ~'2'-/.,7~..¢o ITEM NUMBER 5. 6, 7. FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Street Address City State__Zip Relationship of Claimant to Decedent Probate Fees Accountanrs Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) R~V-~5~2 ~X * ¢-9h ~"~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 'DEBTS OF DECEDENT, I ' MORTGAGE LIABILITIES, & LIENS I , ' ESTATE OF Include unreimbu~ed medical e×pense$. FILE NUMBER ITEM NUMBER DESCRIPTION TOTAL (Also enter on line 10, Recapitulation) AMOUNT L~$, 5'2. 2-,5'0, O0 (If more space is needed, insert additional sheets of the same size) · REV-1513 E~* (1-97) SCHEDULE J ~MMOm~LT. OF PENNSYLVANIA B E N E F IC IA RI E S INHE~TANCE T~ RETURN RESIDENT DECEDENT ESTATE OF NUMBER II. /4", /e O- 30- ,4g o NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outn~ght spousal distributions) HoL. C,o~rSSt,~c,-/ PA FILE NUMBER RELATIONSHIP TO DECEDENT Do NotListTmstee(s) AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE 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 ON REV 1500 COVER SHEET (If more space is needed, insert additionar'sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001467 KIRITSIS NICHOLAS C 100 HOWARD STREET ENOLA, PA 17125 ........ fold ESTATE INFORMATION: SSN: 160-30;4820 FILE NUMBER: 2102-0030 DECEDENT NAME: WOOD THEODORA K DATE OF PAYMENT: 08/01/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/03/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,919.54 TOTAL AMOUNT PAID: $1,919.54 REMARKS: SEAL CHECK# 1 534 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVZS/OH DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 ' COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF ZNNERZTANCE TAX APPRAISEMENT, ALLO#AN~E OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX. R. .~- ~ ~ ~.'t .+.~..~. R~?:?: ~,~' ~" '''' '~ ~ iq~'.] DATE 09-16-2002 . ~' ESTATE OF H00B , DATE OF DEATH 12-03-2001 FILE. NUH]~ER 21 02-0030 COUNTY CUH]~ERLAND ACN 101 I Aaoun~ Rem/~{ad '02 ~Fo 23 CHRISTOPHER A CHEKOURAS PO BOX SVKESVILLE .D .. RE¥-I~? EX &FP (01-02) THEODORA K ,- HAKE CHECK PAYA~tLE AND REHZT PAYHENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-15~7 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEHENT~ ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF gOOD THEODORA K FILE NO. 21 02-0030 ACN 101 DATE 09-16-2002 TAX RETURN NAS: { X} ACCEPTED AS FILED ( } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN 1. Rea! Es~a~a (Schedula A) (1) 2. S~ocks and.Bonds (Schedule B) (2) $. Closely Held S~ocklPar~narship Zn~ares~ (Schedule C) ($) ~. Nor~gagas/No~as Receivabla (Schedule D) (q) 5. Cash/Bank Daposi~s/N. isc. Personal Proper~y (Schedule E) ($) 6. Jointly Owned Proper~y (Schedula F) (6) 7. Transfers (Schadula G) (7) 8. To~al. Asse~s APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funera! Expansas/Ada. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Deb~s/Nor~gaga Liabilities/Liens (Schedule Z) (10) 11. To'aX Deductions 12. .Na~'Valua of Tax Ra~urn 6~682.~0 .00 .00 NOTE: To insura proper .00 credi~ to your account, .00 subai~ ~ha upper portion .00 of ~his form wi~h your ~ax payment. · qqt699.88 ~8) 8,331.00 39~.7~ 13. lq. NOTE: 51,382.28 (11) fl.725.7~ (1~) qZ,656.Sq Charitable/Governmental Bequests; Non-alac4:ed 9115 Trus4:s (Schedule J) (15) Na~ Value of Es~a~a Subjec~ ~o Tax (lq) :Cf an assessment ~as issued previously, llnes 1~, 15 and/or 16, 17, reflect figures that include the total, of ALL returns assessed to date. .00 qZ,656.5q 18 and 19 will TOTAL TAX CREDIT J 1,919.5q I BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYflENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR INSTRUCTIONS.) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. ASSESSHENT OF TAX: 15. Amoun~ of Line lq a~ Spousal ra~a 16. Amoun~ of Line lq ~caxable a~ Lineal/Class A ra~a 17. Aaoun~ of Line lq a~ Sibling ra~a 18. Aaoun~ of Line lfi ~axable a* Collateral/Class B rata 19. Princlpal TaX Oue TAX CRED]:TS: ' PAYMENT RECEIPT' DISCOUNT DATE NUMBER INTEREST/PEN pATD (-) 08-01-2002 CD001~67 . 1,919.5q ANOUNT PAID (Is), .00 x O0 = .00 (16). qZ,656.5q x Oq5 = 1,919 (17), .00 x 12 = .00 (~8), .00 x 15 = .00 (19)= 1,919.5q RESERVATION: PURPOSE OF NOTICE: PAYMENT: · REFUND (CR): OBJECTIONS:' ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: iNTEREST: Estates of decedents dying on o~ before'December 11, 1981 -- if any future interest in the estate~is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate far *' life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer'Inheritance Taxes at the lamful Class B (collateral) rate on any such future interest. TO fulfill the requirements of'Section 21~0 of. the Inheritance and Estate Tax Act, Act Z$.of 2000. (71 P.S. Section 91~0). Detach the tap portion of this Notice and submit with'your payment to the Register' of Hills printed on the reverse side; --Make check or money order payable to: REGISTER OF NZLLSj AGENT . A r~fund of a ta~ credit, ~hich mas not ~equested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Hills,' any of the Z3 Revenue Oist~ict Offices,.or by calling the special Zq-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with'Special hearing and / or' speaking needs: 1-800-qq7-30Z0 (TT only). *.. Any pa~ty in interest not satisfied ~ith the appraisement~ a11ow~nce', Or disallowance of deductions,"o~ assessment of tax Cincluding discount or interest) as shown on this Notice must object within sixty (60)-days of receipt, of this Notice by: --~ritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17118-1011, 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: PADepartment.of Revenue~. .- . Bureau of ~ndividual Taxes~ ATTN:'Post Assessment Revie~ Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601~ Phone ¢717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return ;or a Re'sideht Decedent" (REV-IS01) for an explanation of administratively correctable errors. .. ' ~ .1. If any tax due is paid ~ithin three (3) calendar months efte~ the decedbnt's' death, a five percent (SX) discount of the tax paid is allowed. .. ' The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before JBnuary 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. I~terest is charged beginning ~ith first' day of delinquency, or nine (9) months and one (13 day from the date of death, to the date of payment. Taxes ~hich became delinquent before January 1, 1981 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016q. All taxes ~hich became delinquentOn and after Janbary 1, 1981 ~ill ~ear interest at a rate which will vary from calendar year to calendar year. with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOOZ are: year ~Intarest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZOX .0005~8 199Z 91 ' .0002~7 1983 162 .000q38 ,- - 1993-199~ 72 .000192 198~ llZ .000301 1995-1998 92 : .O00Zq7 1985 13Z .000356 1999 72 .000191 1986 lOZ .00027~ : ZOOO 82 .O00Z19 1987 92 .0002~7 ZOO1 92 .OOOZq7 1988-1991 llZ .000~01 2001 62 .00016q -~Interest is calculated as follo~s: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELI'NQUENT X DAZLY TNTEREST FACTOR --Any Notice issued meter the tax becomes delinquent uill 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: Date of D'eath: STATUS REPORT UNDER RULE~6.12 Will No.: 200Z- 0003 0 Admin: No.: 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: State whether adrninlstration 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: ao bo Did the Personal representative file a final account With the Court? Yes _ No [~ 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 1--]' 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 P,4 ]?oz..5' Address Capacity: ViT- 752-702. I Telephone No. ~] Personal Representative [-'] Counsel for personal representative