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02-0031
ADMINISTRATION PETITION FOR GRANT OF LETTERS c.T.A. Estate of Kathryn E. Stalter No. also known as , Deceased.: Gar)/D. Stalter ~ ' Socia! Security No. 162224875 Petitioner(s), who is/are 18 years of age or older, apply)les) for: (COMPLETE "A" OR "B" BELOW:). A. Pro'bate and Grant of Letters and aver that Petitioner(s) is/are the execut,. _ -. name. e.d-in the Last Will of the [Decedent, dated and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration c.t.a. (c.t.a., d.b.n.c.ta.: pendente lite, durante absentia; durante minodta~e) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survi~/ed by the following spouse (if any) and heirs: I Name Relationship Residence [ Ira ~i Stalter, Jr. Son 7327 Pleasant View Dr, Dallas, TX Son Gary D. Stalter 34 Sycamore Dr, Mechanicsburg, PA (COMPLETE IN ALL ,CASES:)~ Attach',additional sheets if necessary. Decedent was domiciled at ~J~ath in CumSerland County, Pennsylvania, with his/her lastfamily or principal residence at 327 Salt Road, Enola, East P~ennsboro Township, Cumberland County, Pennsylvania (list street, number and municipality) Decedent, then'73 years of age, died: December 1 ,2001 , at Holy Spirit Hospital, Camp Hill, PA (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA _. '- All personal property ......................................... $ 72,000 (if not domiciled !n PA "- Personal property in Pennsylvania .................... $ (if not domiciled in PA ." Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 78,000 Total ..................................................................................................................... $ Real Estate situated as follows: 327 Salt Road, Enola, PA Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Gary D. Staiter 34 Sycamore Drive Mechanicsbur~, PA 17050 ,- Oath of Personal Representative Commonwealth of' PennSylvania County of Cumberland The Petitioner(s) above-named swear(s) and afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowl~edge and belief of Petitioner(s) and that, as personal representative(s).of the Decedent, Petitioner(s) will well and truly administer the estate according to law..n SwOrn to and affirmed and subscribed . Gary-D. Stalter / before m'e this 2nd 'day of January 200'2 M /¢' , - I ! ary CCewis ' ,;~ -: ,. DECREE OF REGISTER Estate of Kathrvn E. Staltcr also known as OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA. - - Deceased Social Security No: 162224875 Date of Death: 12/1/01 AND NOW, January 't,4_,, 2002 __ , in cons~derabon of the petition on the reverse side hereon, satisfactory proof having been presented 'before me, IT IS DECREED that Letters O Testamentary I~ of Administration c.t.a. ~ - ((c.ta., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate) are hereby granted to Gary D. Stalter ~ in the above estate and that the instrument(s), if any, dated July 29, 1971 .~ described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. 235.00 12.00 '5.00 -0- 5.00 FEES ' Letters ..................... : .............. $ Short Certificates(s) .... .4. ......... $ RenUnciation ......... .1. ............ L. $ Extra Pages ( ) ...............$ I.T.R ....................................... $ JCP Fee ................................. $ Inventory ................................$ Other ...................................... $ TOTAL .... : ........... , ............ $ 257.00 DENISE WHEN LEThe, RS ARE FINISHED CALL Attorney: David'R. Getz, Esquire I.D. No: 34838 Address: Wix, W~nCer & Weidner/PO Box 845 Harrisbur~l. Telephone: (717) 234-4182 DATE FILED: 5anuary 14.,2002 PA 17108 21-2002-003i OATH OF' NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) beir~g duly qualified according to law, depose(s) and say(s) that she familiar with the signature of Kathryn E. Stalter , testat trix of(one of the subscribing witnesses to) the will presented herewith and that she believes the signature on the will is in the handwriting of Kathryn E. Stalter to/t/he best of her knowledge and belief. ,//. Sworn to or affirmed and sub- scribed before me this llth ~day of (Name) Oanua~ . 2002 . / (Add(ess)~ - // For the Register ~/1~ ~a~ ~.Lewis. - ,.' . '~ ' ,. ,,,"' ' ~ ' (Addres~5 ~ 17070 Sellt by: WIX' WENGER WEIDNER- 7172344224; 12/20/01 9:22AM;.JeI'F-aX #599;Page 2/2 RENUNCIATION Eslate ct Kathryn E. Stalter also known as Deceased No. 21-2002-0031 The undersigned, Ira A. Stalter, Jr., son and appointed con/i0~ent executor fR~l~tionship) the above Decedent. hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters of Administration c.t.a, be issued to Gay D. Stalter Witness hand this ~ day of._,~l~.CJ~T~ZC_/T 4. (S;gna[ura) Ira A. Stalter, Jr. 7327 Pleasant View, Dallas TX. 75231 (Address) CddreCs) (Signature) (Address) of /, Sworn to d~/ afl rmed'ano subscribed before me [his '~-[ day of My Commission Expires: ($1gnal.ure a~'~ ,~¢al oi' Notary or o(her otlic~al qualified to aclminlster (:~aths. Sho~ NOTE: Renunciations executed outside,the Office of Regisler of Wills are required in some ceunde5 f;o be notarized. RW.3 105.805 REV 9/86 ';'~ '~¢jThfsqs, to cern~that the'~tnf6~matton~:he~e' ' '7 Lo~EReg~strir. Th'e ong~fi~, eerufi~ate:?lll ' : a. ::-: ..: :W~NING: t 0 ¢:' k :" : · ";~ ,~;.,, - .... :~ [ALTH NIA~ DEPARTMENT OF HEALTH · ·VITAL >'"~' ~ ;:'.;!< -v f ~,,,CERTIEI~ATE:OF~DEA~H "~ (~J?-~,~}_~'~ ...... I.. "'~J3:;: '& ~?.-' U.S.'~MEOFO.CES? I ;"~'mm,~,~a~i~:.' ~?~1"~::' ~.ri~. .... , ~, ~. ,-< :: ~:~,~ ~*c~,~-,, , 'e,..s?i. *g, , .... -~( ~,~ '%~ ~ 24Z: 5:1,~:~a~. East Penniboro ,~ n a,, Pa. 7025;;. ~-~z ~ ,, .,,,,.~, _,_-,-,Cumberlan~,~, ,~ ~ z', -~- . ~ ,., · '--"~, .;~- · 5 ~ - Z,*. . ' __ 7.' .+~' f~' ~>~,~4. '~' e,. "/ ~V'. ~/2~ ~. MOTHER'SNA~iF~:M~.M~S~n~) '¢),~- ~Z' ~/~.7' ,,-5~ ~2 ..... ~'oonn ~one -.' ~ ,z/. 5~~ .,.~7~ .--~% ~2 · ~ .;5'-' ...~ '~:- ..f~.. ~, ~z' .... 5. · ..... ',<~' -%"-,~ ,>.. '-..~.e~ ~ . : .. ,. , .... ~. - . .. -~-,. ,.' z,~/ ~' ., ,~ . ~., . .>~ ~,...~. ,..~, ~ , ~: Kath~.v,n W~seman ~- ~ . = .~ . .., ..~.~ :~,.) . . . ~..~ ,. , % o '~- ~?q~o~ca~oneamu~.~. · ' ~ ~/2Z.~ .~%~'"""{. ~"C5~ -% 7'~&.~: C '.-' '.. .~ .<. ..~}. . 0~-/. ...4. .Zr--';T'?- ~ 5 5qp.~.f~- ~r~*,~~tr~to~ath. m: : . ~'~' ' ~":" ~ .~ '.l , ~.,%; ;~5:~.~ ~'~ ,:~.~: ~;.:~ ~,~' ~' ..:~ ~: z. ~ .~ ..~ .~. e:,g. ~ r,5~'. F: ~2~' ~.' ,~. ' ':.. ,~.-. ; z? ~. ~:?, ~L~'~.~'. ',~'~, .:, "~:E~:: .?'~ ~,:~ & '~' "..~'5: & ¢4 I~m~>, ,~ ~:,~. ~ ~ x- ., :.> % . . ~,. , .., ., ' ~ d.-"~ <t . ~ ~g' .~ ~.~ ~ ,~ '~ %. ~% . .* .<N'z ' ~: ~. ~ ~"~ ~", "'aS' ~ ~"':, ~ < ~ · ''-. .~' .}/ · l>~ ' 21'2002-0031 LAST WILL AND TESTA~iENT OF KATHRYN E. STALTER. I, Kathryn E. Stalter,..of East Pennsboro Township, Cumberland County, Pennsylvania, hereby declare this ito be my last Will and revoke all Wills which I have previously made. 1. I direct my Executor to pay the eXpenseS of my funeral and last illness as soon as convenient afte~ my death. All of the rest, residue and remainder of my estate I give, devise and bequeath to my husband, IraA.~ Stalter, absolutely and forever. 3. If my husband, Ira A. Stalter, should predecease me, or should we both die in a common accident, then'I ~order and direct my Executor hereinafter named to sell ~all the rest, residue and remainder of my real and personal prop- erty at either public or private sale and convert the same into cash; the net proceeds derived therefrom to be ·divided into two equal parts or shares:- .A. One part or share thereof I give and bequeath to my son, Ira A. SS.alter, ~.Jr?. B. Th'e remaining p~rt or share thereof, I give a~d bequeath to my · son, Gary D. Stalter. 4. I appoint my husband, 'Shou~ he, for any reason, fail to qualify, or cease to .act as such, I appoint my son, Ira A. Stalter, Jr., Executor of this Will. 'IN WITNESS WHEREOF, I have 'hereunto set my hand and seal this day of July, 1971.. sIGNED, SEALED, PUBLISHED AND DEOIARED by the above named Kathryn E Stalter, as and'for·her last Will and Testament, in the presence of us, who, at her request, in her presence and in the.presence of each other have hereunto subsCribed our names as witnesses. ; IN THE REGISTER OF WILLS OFFICE FOR CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF KATHRYN E. STALTER DATE OF DEATH: 12/1/2001 ESTATE NO. 2002-00031 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) TO THE REGISTER OF WILLS: 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 January 11,2002: Gary D. Stalter 34 Sycamore Drive Mechanicsburg, PA 17050 Ira A. Stalter, Jr. 7327 Pleasant View Drive Dallas, TX 75231 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Respectfully submitted, WIX, WENGER & WEIDNER David R. Getz, Esquire / Attorney ID No. 34838 508 North Second Street P.O. Box 845 Harrisburg, PA 17108-0845 (717) 234-4182 Counsel for Personal Representative Dated: January 23, 2002 IN THE REGISTER OF WILLS OFFICE FOR CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF KATHRYN E. STALTER DATE OF DEATH: 12/1/2001 ESTATE NO. 2002-00031 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) TO THE REGISTER OF WILLS: 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 January 11, 2002: Gary D. Stalter 34 Sycamore Drive Mechanicsburg, PA 17050 Ira A. Stalter, Jr. 7327 Pleasant View Drive Dallas, TX 75231 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Respectfully submitted, WIX, WENGER & WEIDNER ~. By: David R. Getz, Esquire Attorney ID No. 34838 508 North Second Street P.O. Box 845 Harrisburg, PA 17108-0845 (717) 234-4182 Counsel for Personal Representative Dated: January 23, 2002 RICHARD h. WiX THOMAS L. WENGER DEAN a. WEIDNER STEVEN C. WILDS THERESA L. SHADE WIX * DAVID R. GETZ STEPHEN J. DZURANIN STEVEN R. WILLIAMS SEAN P. DEI..ANEY Also Member Massachusetts Bar WIX, WENGER & WEIDNER A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 508 NORTH SECOND STREET POST OFFICE BOX 845 HARRISBURG, PENNSYLVANIA 17108-0845 (717) 234-4182 TELECOPIER (717) 234-4224 www.wwwpalaw.com 4705 DUKE STREET HARRtSBURG, PA 17109-3099 (717) 652-8455 TELECOPIER(717)652-6290 PLEASE REPLY TO DUKE STREET OFFICE( ) February 21,2002 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Kathryn E. Stalter Estate No. 2002-00031 Dear Ms. Lewis: We enclose our client's Check No. 101 in the amount of $5,700, made payable to "Register of Wills, Agent," representing the estimated inheritance taxes due on behalf of the above-captioned estate. Please process this payment at your earliest convenience and forward a receipt to me. Thank you for your assistance in this matter. If you have any questions regarding the above, please call me. Sincerely, /dbw ",,, Enclosure' cc: Mr. Gary D. Stalter WIX, WENGER & WEIDNER Denise B. Williamson Paralegal oO -n ".-'2& O ~.'.:. 7'¢ .C";,,,': . "'":; 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 N0. CD 000889 GETZ DAVID R 508 NORTH SECOND STREET HARRISBURG, PA 17101 -------- fold ESTATE INFORMATION: ssrv: ~s2-22-4s~5 FILE NUMBER: 2102-0031 DECEDENT NAME: STALTER KATHRYN E DATE OF PAYMENT: 02/25/2002 POSTMARK DATE: 02/21 /2002 CouNTY: CUMBERLAND DATE OF DEATH: 1 2/01 /2001 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 5, 700.00 TOTAL AMOUNT PAID: REMARKS: GARY D STATLER C/O DAVID R GETZ ESQUIRE CHECK#101 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS REV-1162 EX111-96) S 5, 700.00 REGISTER OF WILLS REGISTER OF WILLS ¢ RICHARD H. WiX THOMAS L. WENGER DEAN A. WEIDNER STEVEN C. WILDS THERESA L. SHADE WIX * DAVID R. GETZ STEPHEN J. DZURANIN STEVEN R. WILLIAMS SEAN P. DELANEY WIX, WENGER & WEIDNER A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 508 NORTH SECOND STREET POST OFFICE BOX 845 HARRISBURG, PENNSYLVANIA 17108-0845 (717) 234-4182 TELECOPIER (717) 234-4224 www.wwwpalaw.com April 16, 2002 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Kathryn E. Stalter, File No. 2002-0031 4705 DUKE STREET HARRISBURG, PA 17109-3099 (717) 652-8455 TELECOPIER (717) 652-6290 PLEASE REPLY TO DUKE STREET OFFICE ( ) Dear Ms. Lewis: We enclose the following documents for filing on behalf of the above-captioned estate: i. The original and two copies of the Pennsylvania Inheritance Tax Return; Our client's check in the amount of $1,020.07, made payable to "Register of Wills, Agent," representing the additional inheritance tax due; The original and one copy of an Inventory for filing on behalf of the estate; and Our check in the amount of $25.00 representing the filing fees for the above documents. Please process these documents at your earliest convenience and return time- stamped copies of the tax return and Inventory to our office. A self-addressed, stamped envelope is enclosed for your convenience. Thank you for your assistance in this matter. If you have any questions regarding the above, please call me. Sincerely, WiX, WF__~GER & WEIDNER Paralegal /dbw Enclosures cc: Gary D. Stalter, Executor Estate of Stalter, Kathr~n E. also known as INVENTORy , Deceased No. 21 02 0031 Date of Death 12/1/01 Social Security No. 162224875 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: I.D. No.: Address: David R. Getz, Esquire 34838 508 North Second Street Harrisburg PA 17108 Personal Representative: Gar7 D taltor, Administrator Dated ~///~//~ ~_ /' Telephone: (717) 234-4182 Cash on hand Description Ordinary household gq.ods and furnishings Ordinary wearing apparel 1988 Pontiac Grand Am Tax credits set forth on settlement statement House and lot known as 327 Salt Road, Enola, Cumberland County, Pennsylvania, being Tax Parcel No. 09-13-0999-018 (Attach Additional Sheets if necessary) Total Value 143.00 1,300.00 150.00 975.00 395.28 93,700.00 96,663.28 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 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 001083 DAVID R GETZ ESQUIRE 508 NORTH SECOND STREET P O BOX 845 HARRISBURG, PA 17108-0845 ........ fold ESTATE INFORMATION: SSN: 162-22-4875 FILE NUMBER: 2102-0031 DECEDENT NAME: STALTER KATHRYN E DATE OF PAYMENT: 04/1 8/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/01/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,020.07 TOTAL AMOUNT PAID: $1,020.07 REMARKS: GARY D STALTER C/O DAVID 'R GETZ ESQUIRE SEAL CHECK# 110 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS R;=Vo 15(~ EX * COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl. Stalter, Kathryn E. -REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-OD-Year) 12/01/2001- I 01/14/1928 (IF APPLICABLE) SURViViNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A OFFICIAL USE ONLY /q' 53. --' FILE NUMBER COUNTY COOE YEAR .1 SOCIAL SECURITY NUMBER 1 6 2-2 2-4 8 7 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r'x-'~ 1. Original Return --]2. Supplemental Return r---~ 3. RemainderRetum '(~lateofdeathprlort~12.13-821 ~] 4. Limited Estate [] 4a. Future Interest Compromise (date o,,aath aftsr 12-12-82) r--] 5. Federal Estate Tax Return Required ~ F'~ 7. Decedent Maintained a Living Trust (A~ch copy of Trust) __ 8. Total Number of Safe Deposit Boxes ~ 6. Decedent Died Testate (At,ch Ir-'] 9. Litigation Proceeds Received ~ 10. SpousalPovertyCredit(dat~ofdoamb,t~e~n12-31-91~ndl-l-gs) [] ll. Elec{]on to tax under Sec. 9113(A)(A~chsch,o) NAME ' ! COMPLETE MAILING ADDRESS David R. Getz, Esquire I 508 Rorth $ocond Stroot . · FIRM NAME (If ApPlicable) I WIX, WENGER & WEIDNER ' I P.O. Box 845 . ' ~ Harrisbur[i ?A 17108-0845 TELEPHONE NUMBER (717) 234-4182 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held'Corporation, Pad. nership or Sole-Proprietorship '(3) 4. Mortgages & Notes Receivable (Schedule D) (4)' 5. Cash, Bank Deposits & Miscellaneous Personal Propert7 {5) (Schedule E) 6. Jointly Owned Property (Schedule F) , (6) ~] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross AsseiS (total Unes 1-7)' 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedenl Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 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) 9~ OFFICIAL USE ONLY ,~Oo.oo ~ ' ' ~.~ O ;i 963 28 :: · 62,181.60! (8) 19,380.10 · 179,20 (11) (~2) (13) (14) 175,560.83 19,559.30 156,001.53 156,001.53 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 Line 14 taxable at collateral rate 19. Tax Due 20. X 156,001.53 X ~ (15) .045 (16) X .15 (17) (18) (t9) 7,020.07 7,020.07 X .12 Decedent's Complete Address: STREET ADDRESS 327 Salt Road CITY Enola .' I STATE'pA Tax Payments,and Cr 'dits: · 1, Tax Due (Page 1 Line 19) 2. Credits/payments A. Spousal Poverty Credit B. Prior Payments C, Discount 3. InterestJPenalty if applicable B. Interest, E. Penalty 5,700.00 300.00 (1) Total Credits ( A + B + C ) (2) (3)' If Une 2 is grea!er than L. ipe 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. - · (5) · A, Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT Total Interest/Penalty ( O + E ) '7,020.07 6,000.00 0.00 1,020.07 1,020.07 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; ........................................ [] [] c, 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 properly 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 accornlpanying schedules and statarnants, 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/nformafion of which preparer has any knowledge. . SIGNATURE {~F PERSON RESPONSIBLE FOR FILING RETURN ADDI~ES~' 3~ Sycamor~ brive . Mechanicsburg DATE PA 17050 SIGNATU RE~F~-.REPARER. OTHER...THAN 8EPRESENTATIVE ADDRESS '"-'"Wix, Wenger' & W~idr/er/P O. Box 845 Harrisburg DATE PA 17108-0845 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 o~"~fter 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)]. Yhe 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 dedeased 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 decedent'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 decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Sectio~ 9102, as an COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Stalter. Kathrvn E, _ All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. House and lot known as 327 Salt Road, Enola, Cumberland County, Pennsylvania, being Tax Parcel No. 09-13-0999-018 (valued per settlement statement attached hereto) TOTAL (Also enter on line 1, Recapitulation) 93,700.00 $ 93,700.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT D~(~EDENT SCHEDULE B STOCKS & BONDS ESTATE OF Stalter. Kathrvn E, All property jointly.owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1504 E~ * (1-97) · COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY. HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Stalter. KathrYl3 E~, Schedule C-1 or C-2 (Including all supporting information) must be a~ched for each closely-held corporation/partnership interest of the decedent, other than a sole.proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0.OO TOTAL (Also enter on line 3, Recapitulation) $ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER Stalter, K~thryn E. All prope~'y jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0.00 TOTAL (Also enter on line 4, Recapitulation) $ REV-1508 ~X + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 'SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Stalter. Kathryn E, Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. iTEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Cash on hand 143.00 Ordinary household goods and furnishings Ordinary wearing apparel 1988 Pontiac Grand Am (valued per Kelley Blue Book report attached) Tax credits set forth on attached settlement statement 1,300.00 150,00 975.00 395.28 TOTAL (Also enter on line 5, Recapitulation) $ 2,963.28 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER . Stalter. Kathrvn E. ~ If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Gary D. Stalter Son ' 34 Sycamore Drive Mechanicsburg, PA 17050 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF ~IUMBERTENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 1. A. 2/1970 PNC Bank Checking Acct # 5140110386 13,783.01 50. 6,891.54 DOD balance: $13,780.75; Accrued Int:.$2.26 (valued per attached statement) 2. A. 12/2000 Members 1st Fed Credit Union Savings Acct 200168-00 25.00 50. 12.5( (valued per attached statement) 3. A. 9/2001 Members 1st Fed Credit Union Checking Acct 200168-11 1,351.68 50. 675.8z (valued per attached statement) 4. A. 12/2000 Members 1st Fed Credit Union CD 200168-41 11,194.26 50. 5,597.1," (valued per attached statement) 5. A. !5/1992 First Union Certificate of Deposit No. 247412041975050 3,069.69 50. 1,534.8,' DOD balance: $3,000; Accrued Int.: $60.69 (valued per attached statement) 6. A. Various U.S. Government Savings Bonds held JWROS 4,008.24 50. 2,004.1; (inventory attached) TOTAL (Also enter on line 6, Recapitulation) $ 16,715.9~ (If more space is needed, insert additional sheets of the same size) I~'V-1510 ~X * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Stalter. Kathrvn E, 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 ~s les. DESCRIPTION OF PROPERTY % OF ITEM ~.~UOE THE NAME OF THE TRANSFEREE, THEIR RB. ATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ~UMBER ATrACHACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFN~PUCAI~LE) 1. American Investors IRA Annuity Policy No. 319681 20,702.20 100. 20,702.20 Beneficiaries: Gary D. Stalter and Ira (Alfred) Stalter (valued per attached statement) 2. American Investors Non-Qualified Annuity Policy No. 319682 13~723.19 100. 13,723.19 Beneficiaries: Gary D. Stalter and Ira (Alfred) Stalter (valued per attached statement) 3. Mass Mutual Annuity Contract No. 9822307 27,756.21 100. 27,756.21 Beneficiaries: Gary D. Stalter and Ira (Alfred) Stalter (valued per attached statement) TOTAL (Also enter on line 7, Recapitulation $ 62,181.6( COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Stalter. Kathryn E, Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION 1. 2. 3. 8. 9. 10. 12. 14. 15. 17. FUNERAL EXPENSES: Funeral Home .Reception costs Memorial Lettering (estimate) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Secur'~ Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attomey Fees Wix, Wenger & Weidner (estimated) Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Accountant's Fees Tax Return Preparer's Fees Cumberland County Law Journal (legal publication) The Sentinel (general publication) PP&L PAWC Phone TV/Cable Oil Garbage and Sewer Plumbing repairs Estate Checks Advertising for sale of personal items Closing costs incurred re: sale of real estate (see settlement sheet attached) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 5,000.00 100.00 80.00 2,600.00 257.00 75.00 97.07 128.98 48.71 38.54 10.14 145.38 87.75 67.60 19.90 7.25 10,566.78 $ 19,380.10 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Stalter, Kathryn E. Pa.qe 1 Schedule H - Funeral Expenses & Administrative Costs - B7 ITEM NUMBER DESCRIPTION 19. Wix, Wenger & Weidner (estimated out-of-pocket costs) SUBTOTAL SCHEDULE H-B7 AMOUNT 50.00 50.00 REV-1512 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN .RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS ESTATE OF Stalte~', Kathrgn E. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER Ambulance Service Office of Aging Visa Credit Card DESCRIPTION TOTAL (Also enter on line 10, Recapitulation) AMOUNT 25.00 18.00 136.20 179.20 (If more space is needed, insert additional sheets of the same size) REV-151~3 EX + (9-009 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Stalter, K NUMBER II. FILE NUMBER ~thry_ n E, RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Bo Not List Trustee(s) OF ESTATE Son Son TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] Gary D. Stalter 34 Sycamore Drive Mechanicsburg, PA 17050 Ira A. Stalter 7327 Pleasant View Dallas, TX 75231 1/2 Annuities set forth on Schedule G; 1/2 residue 1/2 Annuities set forth on Schedule G; 1/2 residue 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) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NoT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET LAST WILL AND TESTA~ OF I~TB~J E. STALTER. I, Kathry~ E. $talter, of East Pennsboro Township, Cumberland Co .unty, Pennsylvania, hereby declare this to be my last Will and revoke all Wills which I have previously made. 1. I direct my Executor to pay the expenses of my funeral and lzst illness as soon as convenient s~ter my death. 2. All of the rest, residue ~d remainder of my estate I give, devise and bequeath to my husbar~, Ira A. Stalter, absolutely and forever. $. If my husband, Ira A. Stalter, should predecease me, or should we' both die in a common accident, then I or,er an~ direct my Executor herai~ter ~ed to sell ~1 the rest, residue and remainder of my real and perso~l prop- erty at either public or private s~e a~ convert the s~e into cash; the net proceeds derived therefrom to be divided into two eQ~l parts or shares:- A. One part or's~re thereof I give and bequeath ~o my son, Ira A. starer, Jr. B. The remaining part or s~re thereof, I give and bequeath to my son, Gary D. Stalter. 4. I a~oiut my husband, i~r~SA'~?S~tte~,lE~ecutor of thi~ Will. Shoed he, for ~ reason, fail to q~ify, or cease to act as ~u~, I appoint my son, Ira A. Stalter, Jr., Executor of this Will. I~ ~T~SS ~OF, I have hero,to set my h~d and seal this ~ ~ ~y o~ J~Y, 19~1. / ~ ~~. ~S~L). · . ......~_~.D~ S~A~D, P~S~D AI'~ ~CIA~D by the above n~e~ Kathr~u ~ Stalter, as a~ for her last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other have hereunto -subscribed ou~ names as witnesses. o~/~8/~.0o~ 1~.'~3 F~ ?17 76.1.1 ~-~ , ~0o~ U.~. DEPAR~NT OF HOUSING & URBAN D~oPM;NTlo F L~ ~UMU=~; , ' I r'. LO~ NU~I~" ~ I. $~ ~'LEMENT DATE~ I~rch 28. 2002 ,, · - , '120.. ~RO,..W$ ~MOUN"r Du~ FROM BORRO'~~-a~~ 99,707.01 , I ~O~- Adjuo~oflt~ wor imma UflO81O ~y ~ell~;' · ~18, ' ~ ~ R~DUCTION AMOUNT DU~ ~E~ ~ t 0,~6.78 · ~0. TOTAL ~AIg BY. OR BOR~WER g~,~O 620. -~. L~= ~U~L~ Duo ~otler t&tne ~2o)' ', ~ 1o,~.~ '~e underMgnga hereby a~n~ledge m~lpt of ' · ob' 'F I - " go1, Inmre-~t Fn=m JGR-]~RA L,. SETTLEMENT 0 . y .. n iml i~ 04101102 I~ $ 12.050000/day ( 4 day~ per month i~o , ) P'OllOy ~,~;.Gu 100.Ou 1.UL 12U4. Ce~ficd to be s trua oopy. Ke ey Blue ,Book The Trusted .Resource New ~Car Pricing Build a Car Ince~tlves My Car'S Vatue llsed Car Retai[ Buy a New Car Buy a Used :Car Sell Your Car MOtOrCycleS Financing Insurance Lemon Check Warranties Accessories' Car Reviews Car Previews DeCision Guides Ad. ce About kbb lto. me I se.cu.ri.ty, (n): Click on the Image above to visit this advertiser \7. :.i~ _;,::. '.)...,.....-. .... . ::.. !:::~;..~. ~.~. , .?i;.~_., ,.: Pennsylvania. January 23, 2002 1988 Pontiac Grand Am Sedan 4D Engine: 4-Cyl. 2.5 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 100,000 Equipment Air Conditioning Power Steerlng B.~u.y..a.. New CAr Bu__.y a_ _U_se_.d_, C_a.r L.!s.t Yo.ur C~.r. _Fo._r..S.a. le Online F_.n._a_p ting .quote [ n s u_Ea_Q c_e_..q..u.o. ~;e Wa rr.a n t_.__y._C! u_ g.te. Payment Calculator AM/FM Stereo Consumer Rated Condition: Fair "Fair" condition means that the vehicle probably has some mechanical or cosmetic defects, but is still in safe running condition. The paint, body and/or interior need work to be performed by a professional in order to be sold. The tires need to be replaced. There may be some repairable rust damage, The value of cars in this category may vary widely. A clean t_i.tJ~, hi,s.t;.o_.ry~ Is assumed. Even after significant reconditioning this vehicle may not qualify for the Blue Book Suggested Retail value. Private Party Value $975 Private Party value represents what you might expect to pay for a used car when purchasing from a private party, it may also represent the value you might expect to receive when selling your own used car to another private party. G. eJ;.~.Used Ca__r_T_r_a_i~z.I_rl.Y. al~{ G~.t_lovoj.~¢.~.Jvj_S. RP on New Co.rs Copyright © 2002 by Kelley Blue Book Co., All Rights Reserved. 3an-Feb 2002 Edition. The information in this repod: was printed from the Kelley Blue Book Web site (www.kbb.com) and is intended for the personal use of the customer only and may not be sold or transmitted to another party. We assume no responsibility for errors or omissions.{v.02010) FEB-20-2002 $5:55 PNCB~NK ClF DEPARTMENT 4i2 ?05 8857 P.Oi/O1 i PNCBAhK Febma_~20,2002 /SCP Wix, Wengor & Woidner A Professional Corporation Attorneys At Law 508 North Seoond Street PO BOX 845 I-Iarrisb~g PA 17108-0845 Estate of Katb_rya E Stalter, Deceased SSN: 162-22-4875 DOD: 12101/2001 Dear Ms. Williamson: In response to your request for Date of De~th balances for the customer noted above, our records show the £ollowing.' C~ECKINO ACCOUNT #51401.10386 KATHKYN E STALTER GARY D STALTER DOD Balance: $13,780.75 + $2.26 accrued interest Please note that this office only provides date of death balances for deposit accoUnts (IRAs, CDs, Checking and 5avings accounts). We do not process any finaneiat transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BAaNK (1-888-762-2265) or stop by your local PNC branch office. Established 02/01/1970 Si~rely, o,. 1-800-762-1775 P7-PFSC-04-F 500 First Avenue Pittsburgh~ PA 15219 A member of Thc PNC Finaneia[ Services Group M.embersl FE DERAL CREDIT UNION ~NSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1'161 February 13, 2002 Denise B. Williamson Wix, Wenger & Weidner 508 N. Second Street PO Box 845 Harrisburg, PA 17108-0845 RE: Estate of Kathryn E. Stalter 'SSIN 162-22-4875 Dear MS. Williamson, ..; Enclosed is the information requested In your letter of January 23, 2002 regarding the accounts held with Members 1st by Kathryn Stalter. Please do not' hesitate to contact me at 795-5131 should you have any questions or require additional information. Insurance Products Supervisor Enclosure ,/ Reference ID: 241379 First Union National Bank Atto: Account Verifications P 0 Box 40028 Roanoke VA 24022-7313 March 8, 2002 WIX WENGEK & WEIDNEK P O BOX 845 HARRISBURG, PA 17108-0845 Verification / Confmnation of Account and Balance Information provided for: KATHRYN E STALTER (SSN# 162-22-4875) Date of Death: December 1, 2001 Account Type Deposit Account Information Account Date of Death Average Date M~turity Interest Number Balance Balance* Opened Date Rate CERTIFICATE OF DEPOSIT 247412041975050 LEGAL TITLE: KATHRYNE STALTEK GAKY D STALTER $3,000,00 5/21/1992 Accrued YTD Date Interest Interest Paid Closed $60.69 $91.44 2/21/2002 * Due to system limitations, we can only provide a twelve month average balance on depository accounts. * Date of death balance does not include accrued interest. * If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that. were made during that time period. Si~ature of Depository RepresentaU"'ve Date Brenda Allen Servicenter Associate (540)563-7323 Depository Representative Title Phone Number abs; at ,,,,,~.,~yaerUs Annuity Group Co. 555 South Kansas Ave Topeka, KS 66603 800/ANNUITY 888/ANNUITY (curroM~R S~RV~Cm DENISE B WILLIAMSON WIX WENGER & WEIDNER PO BOX 845 HARRISBURG PA 17108 0845 February 12, 2002 AMERus Annuity Group RE: 'Policy ~319681-319682 · Annditant: KathrynE. Stalter Dear Ms, Willkamson: We were sorry to learn of Kath~yn Stalter's death, and would appreciate your expressing our sincere sympathy to her family. Enclosed are the forms necessary to claim proceeds under the annuity contracts noted above. The Proofs of Death Claimant's Statements will need to be fully completed by each beneficiary, .NOTARIZED and returned to our office, along with the Notice of With~oldtng"Forms and Addendum to Claimant's Statements. We will also need one Certified Copy of.the Death Certificate and the original 'policy contract. If the original policy contract is not available, wa will need a"notat!on on Question #10 on the Proofs of Death Claimant's Statement indicating that the policy is lost. Our records indicate the beneficiaries are listed as Gary Stalter and Alfred Stalter, sons. The Death Benefit is equal to the accumulated value. Upon receipt of all claim information ~he Death Benefit will be paid 'in a lump sum distribution unless another Settlement Option is selected. We will be pleased to provide illustrations for alternative payout options upon request. .. The accumulated value as of February 11, 2002, is $20,890.62 for #319681 & $13,848.09 for ~319682. The date of death value for #319681 was $20,702.20 and $13,723.19 for #319682. Each contract is a. Single Premium'Deferred Annuity and enclosed for your review are activity statements for each '' contract; If you have any questions, please feel free to contact our office at 1-800-435-4884. Si ly., - - '. ." : ' : '.:."...' ' ..' ". :' .': ncere .. .: ..... · '"' '.': ~- .'; .'..' "....'. ,:.'. '" ':.,;.:''." .. '. '. ';'..:' :.'.2: " '; . '" '"--,- ......... · .~i:; ..' '" ;?';. · c '..'-..,.' ...... ':. : .... ." :' ' ' .... ;'" · ' .':; .... .;"..' :: ' ':"7.~.. '..' ...',.:....~ ..' .'"' ' ":'. i 2 .. Theresa'. Teter · .. Enclosures AMERICAN INVESTORS LIFE fClaims' Specialist . ' :.'.: .:" .: ".~. DELTA LlleE & ANNUITY FINANCIAL BENEFIT LIFE IL ANNUITY MassMutual FINANCIAL GROUP THE BLUE CHIP COMPANIES'~''-' DENISE B WILLIAMSON WIX WENGER & WEIDNER 508 N SECOND ST BOX 845 HARRISBURG PA 17108-0845 February 15, 2002 Dear Ms. Williamson: Re: Kathryn E_. Stalter -. Contract Number 9822307 .. ,. We were sorry to learn of the death ofKathryn E. Stalter. Please extend our sincere sympathy to the family ......... The death benefit of this variable annuity contract is payable in equal shares to Alfred and Gary Stalter, sons of the deceased. The actual mount payable is determined when all the claim documents are received. The beneficiaries should complete the enclosed Claimant's Statements entering their Social Security numbers and indicating whether or not federal income ta,,/is to be withheld from the death benefit. A certified copy of the death certificate will be required. The value of the contract as of December 1, 2001, the date of death, was $27,756.21. The value of the contract as of February 14, 2002 was $27,114.43. Please call me, at 1-800-767-1000, Ext. 47278, if there are any questions. Sincerely, Judith E. Tyburski Claim Examiner C065 MassachusetLs Mutual Life Insurance Company and affiliated companies * Springfield MA 01111-0001 · (413) 785-8411 Redemption Date: 12/2001 Inventory 1 Accrual Bonds Issue Serial Number Denom. Series Date Value Interest 'Q603907~360E $25 E 1/1976 $112.76 $94.01 Q6082406669E $25 E 4/1976 $112.76 $94.01 Q609!179841E $25 E 5/1976 $113.83 $95.08 Q6105208741E $25 E 7/1976 $111.83 $93.08 Q6112345344E $25 E 8/1976 $111.83 $93.08 Q6133009985E $25 E 11/1976 $112.92 $94.17 Q6142775610E $25 E 12/1976 $113.24 $94.49 Q6103768778E $25 E 1/1977 $109.94 $91.19 Q6161232198E $25 E 4/1977 $109.94 $91.19 Q6177596958E $25 E 6/1977 $111.26 $92.51 Q6140857868E $25 E 6/1977 $111.26 $92.51 Q6191287930E $25 E 8/1977 $108.00 $89.25 Q6210976154E $25 E 10/1977 $108.00 $89.25 Q6223930859E $25 E 1/1978 $96.43 $77.68 Q6223932611E $25 E 1/1978 $96.43 $77.68 Q6246558879E $25 E 4/1978 $87.00 $68.25 Q6263805217E $25 E 5/1978 $82.46 $63.71 Q6277297954E $25 E 7/1978 $81.06 $62.31 Q628423948E $25 E 9/1978 $81.06 $62.31 Q6292312889E $25 E 11/1978 $81.83 $63.08 · Q6311912160E $25 E 12/1978 $82.05 $63.30 Q6325925441E $25 E 2/1979 $80.46 $61.71 Q6348420290E $25 E 5/1979 $81.24 $62.49 Q6348473907E $25 E 7/1979 $79.83 $61.08 Q6369165661E $25 E 9/1979 $79.83 $61.08 Q6368168306E $25 E 10/1979 $79.83 $61.08 Q6388058712E $25 E 12/1979 $80.58 $61.83 L2198470046E $50 E 4/1980 $158.00 $120.50 L437795069EE $50 EE 3/1990 $49.34 $24.34 L411057178EE $50 EE 3/1989 $51.84 $26.84 L411057214EE $50 EE 4/1989 $51.84 $26.84 L411057237EE $50 EE 5/1989 $51.84 $26.84 L411057288EE $50 EE 6/1989 $51.84 $26.84 L411057310EE $50 EE 7/1989 $50.82 $25.82 L411057333EE $50 EE 8/1989 $50.82 $25.82 L413965333EE $50 EE 9/1989 $50.82 $25.82 L413965353EE $50 EE 10/1989 $50.82 $25.82 L413965391EE $50 EE 11/1989 $50.82 $25.82 L437794964EE $50 EE 12/1989 $50.82 $25.82 L437795018EE $50 EE 1/1990 $49.34 $24.34 L457132596EE $50 EE 4/1990 $49.34 $24.34 L458988787EE $50 EE 6/1990 $49.34 $24.34 L461148665EE $50 EE 6/1990 $49.34 $24.34 L473655817EE $50 EE 8/1990 $47.92 $22.92 L475016356EE $50 EE 7/1990 $47.92 $22.92. L476373302EE $50 EE 9/1990 $47.92 $22.92 L476485974EE $50 EE 11/1990 $47.92 $22.92 L475485972EE $50 EE 11/1990 $47.92 $22.92 L476485973EE $50 EE 11/1990 $47.92 $22.92 L477384432EE $50 EE 1/1991 $46.52 $21.52 C277099857EE $100 EE 1/1991 $93.04 $43.04 L472766230EE $50 EE 3/1991 $46.52 $21.52 Yield Next Final To Date Accrual Maturity 7.16% 7.16% 7.20% 7.27% 7.27% 7.31% 7.32% 7.35% 7.35% 7.40% 7.40% 7.43% 7.43% 7.09% 7.09% 6.64% 6.40% 6.47% 6 47% 6 51% 6 52% 6 58% 6 62% 6 69% 6 69% 6 69% 6.74% 6.80% 6.00% 5.92% 5.92% 5.92% 5.92% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 1/2002 1/2006 4/2002 4/2006 5/2002 5/2006 1/2002 7/2006 2/2002 8/2006 5/2002 11/2006 6/2002 12/2006 1/2002 1/2007 4/2002 4/2007 6/2002 6/2007 6/2002 6/2007 2/2002 8/2007 4/2002 10/2007 1/2002 1/2008 1/2002 1/2008 4/2002 4/2008 5/2002 5/2008 1/2002 7/2008 3/2002 9/2008 5/2002 11/2008 6/2002 12/2008 2/2002 2/2009 5/2002 5/2009 1/2002 7/2009 3/2002 9/2009 4/2002 10/2009 6/2002 12/2009 4/2002 4/2010 3/2002 3/2020 3/2002 3/2019 4/2002 4/2019 5/2002 5/2019 6/2002 6/2019 1/2002 7/2019 2/2002 8/2019 3/2002 9/2019 4/2002 10/2019 5/2002 11/2019 6/2002 12/2019 1/2002 1/2020 4/2002 4/2020 6/2002 6/2020 6{2002 6/2020 2/2002 8/2020 1/2002 7/2020 3/2002 9/2020 5/2002 11/2020 5/2002 11/2020 5/2002 11/2020 1/2002 1/2021 1/2002 1/2021 3/2002 3/2021 1 = Not eligible for payment (purchase price) 2 = Matured (exchangeable for HH) * = Possibly eligible for U.S. Savings Bond Education Benefit Program. See footnotes on Inventory Summary page. 3 = Matured (not exchangeable) Redemption Date: 12/2001 'Accrual Bonds Pre-January 1990 Issue Dates: January 1990 and Later Issue Dates: Current Income Bonds Inventory Totals inventorY t~ Invento~ Summa~ Number Inventory . Redemption of Bonds Value Value Interest 38 $3,287.94 $3,287.94 $2,494.19 14 $720.30 $720.30 $345.30 * 52 $4,008.24 $4,008.24 $2,839.49 0 $0.00 $0.00 $0.00 52 $4,008.24 $4,008.24 $2,839.49 Footnotes * Proceeds from Series EE & I Savings Bonds with issue dates beginning January 1990 may be eligible for special tax exemption when used for post-secondary education. For further information concerning the benefits and restrictions that apply, please contact the Internal Revenue Service. 1 These bonds are not eligible for payment within 6 months of their issue date. 2 These bonds have reached final maturity and will earn no additional interest. They can be exchanged for HH Bonds within a year of their final maturity date. 3 These bonds have reached final maturity and will earn no additional interest. They are not eligible for exchange for Series HH Bonds since they have been held over a year past their final maturity date. Z8f~-~t, OZ ~ Vd 'elS!lJeO eJenb$ esnoqlJno0 euo ~snoqpnoo &unoo PUelJaqLuno Sll!M jo J91sll~9~l '$!Ma-J '0/rtJeJ~ :OI ~80-~0IZ! VINVAT_JkSNN~d 'D~ID~tSpdXdVH ~8 XO~t ~[DI.4dO J~$O4 Z~LLS QNOD~[$ HJ.'8ON ~0S /AV~ ZV SX~NT~O.T-T V BUREAU OF ZN~TVZDUA~ TAXES ZNH£RZTANCE TAX DTVTSZON DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONNE~LTH. OI~' PENN~YLVAN]:A DEPARTMENT OF REVENUE NOT/CE OF ~/NHER~ZTA, NCE TAX APPRAISEMENT, ALI~ONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l;47 EX AFP DAVID R GETZ ESQ NIX ETAL PO BOX 8~5 HBG CUT ALONG THIS LINE ~ Re~u~a~'-,'~"""~... !,.,.,.~; ...... of DATE 05-27-Z002 R~!!st~' c~f ~uii~-* ESTATE OF STALTER DATE OF DEATH 12-01-2001 : FILE NUMBER Z1 02-0031 'OZ 10 COUNT CUMBERLAND ACN 101 Amoun~ Remi~ad KATHRYN MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAIN LO~ER PORTION FOR YOUR RECORDS ~ E REV-15~7 EX AFP [01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STALTER KATHRYN E FILE NO. 21 02-0031 ACN 101 DATE 05-27-Z002 TAX RETURN NAS: ( ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE'ZNTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Esta~ce (Schedule A) {1} 2. S~ocks and Bonds {Schedule B) $. 'Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Mortgages/No,es Receivable (Schedule D) (~) 5. Cash/Bank Deposi~s/Hisc. Personal Propar~y (Schedule E) ($) 6. Jointly Owned Proper~y (Schedule F)' (6) 7. Transfers (Schedule G) (7) B. To~al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONs: 9. Funeral Expenses/Adm. Cos~:s/M~sc. Expenses (Schedule H) (9) 10. Dab,s/Hot,gage Liabilities/Liens (Schedule Z) (10) 11. To,al Deduc~/ons 12. Ne~ Value of Tax Re~urn 93~700.00 .00 .00 .00 2~963.28 21~637.2~ 62~ 181.60 19,380.10 179.20 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. 180 ,~82.12 ]9.559.30 160,922.82 13. 1~. NOTE: ASSESSMENT OF TAX: 15. Amoun~ of L/ne 1~ a~ Spousal ra~e 16. A.oun~ of Line lq ~axabla a~ Lineal/Class A ra~a 17. Amoun~ of Line 1~ a~ Sibling ra~e 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~e )al Tax Due 19. Princi TAX CREDITS PAYHENT DATE Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (1:5) . O0 Ne~ Value of Es~a~e Sub,~ec~: ~o Tax (1~) 160,922.82 If an assessment ~as issued previously, llnes 1~, 15 and/or 16, 17, 18 and 19 ,~11 re~:lect flgures that include the total of ALL returns assessed to date. I RECETpT NUHBER 02-21-2002 CD000889 0~-18-200Z CDOO1083 PAYMENT MUST BE MADE BY 09-01-Z002~. (15). .00 X O0 = .00 (ZB) 160,922.82 X 0~5= 7,2R1.55 (~7). .00 X 12 = .00 (ZB] ..00 x 15 : .00 (19)= 7,2~1.53 INTEREST/PEN PAID (-) 300.00 .00 AMOUNT PAZD 5,700.00 1,020.07 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 7,020.07 221.~6 .00 221.~6 ZF PA/D AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZT/ONAL INTEREST. ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCT/ONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE RUREAU'OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION INHERITANCE TAX DEPT. 280601 HARRISBURG, PA 171ze-obol RECORD ADJUSTMENT REV-1593 E% ~FP [12-03) DATE 05-29-2002 ESTATE OF STALTER KATHRYN E DATE OF DEATH 12-01-2001 FILE NUMBER Z1 02-0031 u{_' -~`~ ~' COUNTY CUMBERLAND DAVID R GETZ ESQ ACN 101 WIX ETAL Amount Remitted PO BOX 845 HBG ~A~ -17108 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 ---------------------------------------------------------------------------------------------------------------- REV-1593 EX AFP (12-00) ~(* INHERITANCE TAX RECORD ADJUSTMENT ~(~( ESTATE OF STALTER KATHRYN E FILE N0. 21 02-0031 ACN 101 DATE 05-29-2002 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION VALUE OF ESTATE: 1. Real Estate (Schedule A) (1) 93 ,700.00 2. Stocks and Bonds (Schedule B) [2) .0 0 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) [4) .0 0 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) f5) 2 ,963.28 6. Jointly Owned Property (Schedule F) (6) 18 ,637.24 7. Transfers (Schedule G) [7) 62 , 181 .60 8. Total Assets (8) 177,482.12 DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) (9) 19,380.10 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 179.20 11. Total Deductions (11) 19,559.30 12. Net Value of Tax Return (12) 157,922.82 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax [14) 157,922.82 TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: 02-21-2002 I CD000889 04-18-2002 CD001083 PAYMENT MUST BE MADE BY 09-01-2002*. -iu i-~ 300.00 .00 [15) . 00 x 00 = . 00 ci67 157 , 922.82 X 045 = 7 ,106.53 [ln . 00 x 12 = . 00 (18) . 00 x 15 = . 00 (19) 7,106.52 AMOUNT PAID 5,700.00 1,020.07 TAX CREDIT 86.45 ~ INTEREST AND PEN. ~ .00 = TOTAL DUE 86.45 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT•' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) F'AYMtNI: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed an the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. REFUND CCRI: A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" CREV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT only). REPLY T0: questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and net paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency or nine C9) months and one C1) day from the date of death to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Oaily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beycnd the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR)~ OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST:.. Estates of decedents dylng on or before D~ceaber ii, 1982 -- if any future interest in the estate is trahsferred in passessi~.n or'enjoyment to Class S'(collateral) beneficiaries of the decadent 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 lawfuI Class B (colIateral)*rate on any such future interest. To ~ulfill the gequirements of Sectibn 2140 of the Inheri_tanca and Estate Tax Act, Act 23 of ZOOO. (71 P.S. Secti~p 9140). . . Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NZLLS; 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 o~:gills, any of the 23 Revenue District Offices, or by calling the special Z4-hour. answering service for forms ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with tho 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. 281021) Harrisburg, PA.17118-I021, 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. 280601, Harrisburg, PA 17128-0601 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 (52) discount of .the tax paid is allowed. The 152 tax amnesty nonLpapticipation penalty is computed on the total of the tax and interest assessed) and not paid bafore~January 18, 1996, the first day after the and of the tax amnesty period. This non-partic~pation 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 b&fore January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year mith that rate announced 'by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate 1982 ZOZ .000548 1992 9Z 1983 161 ".000438 ' ' 1993-1994 77. 1984 111 .000301 1995-1998 91 1985 151 . 000356 1999 7X 1986 107. . 000174 2000 82 1987 97. . 000147 Z001 91 1988-1991 111 .000301 ZOOZ 62 --Interest is calculated as follows.'. '' INTEREST = BALANCE OF TAX UNPAZD X NUHBER OF DAYS DELINQUENT Daily Interest Factor .000Z47 .000191 .000247 .000191 .000219 .000247 .000164 X DALLY 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 calculatmd. REV-1470 EX (6~8) '.,'" ' ' . ~ ~'~ '. ,.,:2', ?~'~'h':i' ~, ':" · EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 .' HARRISBURG, PA 17128-0601 DECEDENT'S NAME FILE NUMBER STALTER, KATHRYN 2102-0031 REVIEVVED BY ACN LARRY SZOLLOSY 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The $3,000 exclusion has been applied to the value of this item. Section 9107 (c) (3) of the F 3 1995 Act provides that a transfer made within one (1) year Of the death of the transferor is subject to tax only to the extent that the value of the transfer exceeds $3,000 during any calendar year. The Value of the account subject to tax has been adjusted to $$11,194.26 based on corrected F 4 information received from the financial institution. ROW Page 1 ~UREAU~OF INDIVIDUAL TAXES ~HERZTANCE TAX DzVTSTON DEPT. 180601 HARRISBURG, PA 17118-0601 DAVID R iETZ ESQ NIX ETAL PO BOX 845 HBG CONNOI~NEALTH oF PENNsYLVANTA DEPARTNENT OF REVENUE TNHERZTANCE TAX RECORD ADJUSTHENT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN REV-159S EX AFP (12-DO) 05-29-2002 STALTER KATHRYN E 11-01-2001 21 02-0051 CUHBERLAND 101 Amount Remitted I HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit to your account, subait the upper portion of this fora with your tax payaent. CUT ALONG THIS LINE I~ RETAIN LONER PORTION FOR YOUR RECORDS ~ ESTATE OF STALTER KATHRYN E FILE NO. 21 01-0051 ACN 101 DATE 05-29-2002 ADJUSTMENT BASED ON: ADHINISTRATIVE CORRECTION VALUE OF ESTATE: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 11. Total Deductions 12. Nat Value of Tax Return 95;700.00 .00 .00 .00 2~965.28 18~657 62~ 181.60 19,580 10 179.20 (11) (12) 177~48Z. 1Z 19~559.$0 157~922.82 13. TAX: 1~. 16. 17. 18. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Nat Value of Estate Sub~ect to Tax Amount of Line lq at Spousal rate Amount of Line lq taxable at Lineal/Class A rata (16) Amount of Line lq at Sibling rate (17) Amount of Line lq taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDZTS: PAYMENT RECF;TpT DATE NUMBER 02-21-2002 CD000889 04-18-2002 CD'00108~ INTEREST/PEN PAXD (-) 300.00 .00 .00 PAYHENT HUST BE HADE BY 09-01-2002~. (13) (lq) 157~922.8Z · 00 x 00 = .00 157~921.82 x 045= 7~106.55 .OOx 12 = .00 .OOx 15 = .00 (19) 7~106.52 AMOUNT PAID 5,700.00 1,020.07 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER DATE ZNDZCATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 7,020.07 86.45 .00 86.45 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF ~/ILLS, AGENT. REFUND (CR]: A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-1315).. Applications ars available at the Office of the Register of Nills~ any of the Z3 Revenue District Offices or from the Department's Iq-hour answerin~ service for forms ordering: 1-B00-362-Z050; services for taxpayers mith special hearing and / or speaking needs: 1-B00-~¢7-$020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 260601, Harrisburg, PA 1~128-060!, Phone (717) 787-6S05. DISCOUNT: PENALTY: INTEREST: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. ~ Interest is charged beginning with first day of delinquency or nine (9) months and one (1) day from the date of death to the date ~f payment. Taxes ahich became delinquent before January l, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent oR and after January l, 1982 mill bear interest a~ a rate which will vary from calendar year to calendar year .ith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 ar~: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 Z02 .0005¢8 X992 92 .O00Zq7 1985 162 .000¢38 1993-199~ 72 .000192 198¢ X1Z .000301 1995-1998 92 .000Z¢7 1985 1~2 .000~56 1999 72 .00019Z 1986 102 .00027~ ZOO0 82 .000219 1987 92 .O00Zq7 ZOOX 92 .0002~7 1988-1991 llZ .000301 ZODZ 62 .OOOl6~ --Interest is caZculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER 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 sheen on the Notice, additional interest must be calculated..... ~EV-1470 EX (6-88) ~ " ~ INHERITANCE .T, ~AX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF'INDIVIDUAL TAXES . DEPT. 280601 HARRISBURG~ PA 17128-0601 3ECEDENT'S NAME FILE NUMBER KATHRYN E STALTER 2102-0031 :{EVIEWED BY ACN SCOTT ELLISON 101 ITEM SCHEDULE NO, EXPLANATION OF CHANGES F 4 THEi.~3,000.00 EXCLUSION HAS BEEN APPLIED TO THIS ACCOUNT. Row Pa.qe 1 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 001290 WIX WENGER & WELDNER PC 508 N SECOND STREET HARRISBURG, PA 17101 ........ fold ESTATE INFORMATION: SSN: 162-22-4875 FILE NUMBER: 2102-0031 DECEDENT NAME: STALTER KATHRYN E DATE OF PAYMENT: 06/13/2002 POSTMARK DATE: 06/1 2/2002 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/01/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $86.45 . TOTAL AMOUNT PAID' $86.45 REMARKS: GARY D STALTER C/O WIX ETAL SEAL CHECK//1 1 2 INITIALS: DO RECEIVED BY: / MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS RICHARD H. WiX THOMAS L. WENGER DEAN A. WEIDNER STEVEN C. WILDS · THERESA L. SHADE WIX * DAVID R. GETZ STEPHEN J. DZURANIN STEVEN R. WILLIAMS SEAN P. DELANEY TRACY L. UPDIKE · Aisc Member Massachusetts Bar WIX, WENGER & WEIDNER A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 508 NORTH SECOND STREET POST OFFICE BOX 845 HARRISBURG, PENNSYLVANIA 17108-0845 (717) 234-4182 TELECOPIER (717) 234-4224 www.wwwpalaw.com 4705 DUKE STREET HARRISBURG, PA 17109-3099 (717) 652-8455 TELECOPIER (717) 652-6290 PLEASE REPLY TO DUKE STREET OFFICE ( June 12,2002 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Kathryn E. Stalter Date of Death: 12/1/2001 File No. 21 02-0031 Dear Ms. Lewis: We enclose our client's Check No. 112 in the amount of $86.45, made payable to "Register of Wills, Agent," representing the additional inheritance tax due on behalf of the above estate. Please process this payment at your earliest convenience. Thank you for your assistance in this matter. If you have any questions regarding the above, please call me. Sincerely; WIX, WENGER & WEIDNER Denise B. Williamson Paralegal . ' /dbw Enclosure. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Estate No.: KATHRYN E. STALTER 12/1/2001 21-02-0031 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 administration of the estate is complete: Yes X No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: N/A 3. If the answer to No. I is Yes, state the following: Did the personal representative file a final account with the Court? Yes No X The separate Orphans' Court No. (if any) for the personal representative's account is: N/A Did the personal representative state an account informally to the parties in interest? Yes X No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Respectfully submitted, WIX, WENGER & WEIDNER David R. Getz, Esquire /" Attorney ID No. 34838 508 North Second 'Street P.O. Box 845 Harrisburg, PA 17108-0845 (717) 234-4182 ~ Dated: September 6, 2002 Counsel for personal representative BUREAU OF TNDZVZDUAL TAXES TNHERTTANCE TAX DTVZSIOH DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 DAVID R GETZ ESQ NIX ETAL PO BOX 845 HBG COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT Reco"d~d ,'?i:,,,; of DATE 07-08-'2002 ESTATE OF STALTER DATE'OF DEATH 12-01-2001 FILE NUNBER 21 COUNTY CUHBERLAND ACN 101 REV-I~;O? EX &FP (01-02), KATHRYN E Amoun~ Remi'~'l'ed HAKE CHECK PAYABLE AND RENTT PAYNENT TO: REGISTER OF NILLS. CUHItERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To /nsure proper cred/~: ~:~ your 'account, submit: ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG TH'rS L'rNE I...* RETAIN LONER PORTTON FOR YOUR RECORDS *~ ' ESTATE OF STALTER ~ KATHRYN E F]:LE NO. 21 02-0031 ACN 101 DATE 07-08-2002 TH'rS STATEHENT TS PROVTDED TO ADVI'SE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHONN BELOI./ TS A SUHHARY OF THE PR/NC/PAL TAX* DUE, APPLTCAT'rON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, TF APPL'rCABLE.. - A PROJECTED 'rNTEREST F'rGURE. DATE OF LAST ASSESSHENT OR RECORD ADJU~THENT: 05-ZS-ZOOZ PRINCIPAL TAX DUE: ......................................................................................................... : .......................................................................................................... PAYHENTS (TAX CREDITS): 7,106.52 PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID OZ-Z1-ZOOZ 04-18-200Z 06-12-2002 CD000889 CD001083 CD001290 300.00 .00 .00 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULAT/ON OF ADDZT/ONAL /NTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT 1S REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), 5,700.00 1,020.07 86.45 TOTAL TAX CREDIT 7,106.52 BALANCE OF TAx DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORN FOR TNSTRUCTZONS. ) PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check ~r money order payable to: REGISTER OF NILLS~ AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COHHONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, ahich ~as not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at. . the Office of the Register of Hills, any of th~ 23 Revenue District Offices or from the Department's Z4-hour answsring service for forms ordering: i-800-362-Z050; services for taxpayers with.special hearing and / or speaking needs: 1-800~447-3020 (TT only). , REPLY TO: DISCOUNT: PENALTY: INTEREST: Questions regarding errors contained on this notice should b~ addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. ' If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (51) discount \ of the tax paid is allowed. ~ The 15X tax amnesty non-participa[ion penalty is Computed on the to'al of the tax and interest assessed, and not paid before January 16, 1996, the first day after the end of the tax'.amnasty period. 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 (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and!after January 1, 19~Z will bear interest at a rate which will vary from calendar yearlta calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates far 1982 through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .0005~8 1983 Z6Z .000438 1984 IXZ .000301 1985 13Z .000356 1986 lOZ .000Z74 1967 9Z .000247 1988-1991 111 .000301 1992 92 .000247 1993-199~ 72 .000~92 1995-1998 92 .000Z47 1999 72 .000191 ZOOO 8Z .000219 ZOOZ 9Z .000247 2OOZ 61 .000164 ' --Interest is calculated as follows: ZNTERr~-ST = BALANCE OF 1'AX UNPAID -X NUHBER OF DAYS DELINQUENT X DA'fLY 'rNTEREST F~CTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to ~iftaen (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.