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HomeMy WebLinkAbout02-0036ister of Wills of Cumberland PETITION FOR GRANT ~erine E. Culley Reg Estate of Cat] also known as Carol L. You] Petitioner(s), who is/a (COMPLETE 'A' or 'B' A. Prob the Decedent, dated none Except as follows, De, offered for probate; w none B. Gran Petitioner(s) after a pr, heirs: Decedent was dol re 18 years of age or older, apply(ies) for: BELOW:) OF County, Pennsylvania LETTERS Social Security No. 188- 32 -4094 , Deceased ate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut rix 1/13/2001 and codicil(s)dated None named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. :edent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents not the victim of a killing and was never adjudicated incompetent: ~ of Letters of Administration · (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) 3er search has/have ascertained that Dece~dent left no Will and was survived by the following spouse (if any) and Name Relationship Residence (COMPLETE IN ALL f ASES:) Attach additional sheets if necessary. niciled at death in Cumberland or principal residence at 11 Honeysuckle Drive, years of age, died '12/07/2001 County, Pennsylvania with his/her last family Boroush of Mechanicsburs, PA 17011 z~-~~ (list street, number, and municipality) ~~.~....~. at Seidel Hospital, PA ~ "t"u~'~ (Location) led property with estimated values as follows: :iled in PA) All personal property $ )miciled in PA) Personal property in Pennsylvania $ imiciled in PA) Personal property in County $ real estate in Pennsylvania $ Decedent, then 82 respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of ~,000.00 Typedorprintednameandresidence Carol L. Young 11 Honeysuckle Drive, Mechanicsburs, PA 17055 Decedent at death ow (If domi~ (If not d~ (If not d~ Value of situated as follows: Wherefore, Petitioner(.< letters in the appropna[ form to the undersic;Ined: Prepared by the Pennsylva ia Bar Association Copyright (c) 1996 form sol ware only CPSystems. Inc. Form RW-1 (1991) Commonwealth of Penn County of Cumbe The Petitioner(S) abo~ and correct to the best of the Decedent, Petitioner(s Sworn to or affirmed and ~ylvania rland before me this llthda January 2002 C~L~ewis For,,t ~[,~ "'; \ -' lhe, ~Regi"~e r,, ~', ~ ~~/~ , . .,~' Oath of Personal Representative e-named swear(s) or affirm(s) that the statements in the foregoing Petition are true Ihe knowledge and belief of Petitioner(s) and that, as personal representative(s) of will well and tr-lyladminister the est33~ according to law. ubscribed / ~ /'~~, ~ "-Carol L. You~ ~ of N( Estate of Cz Social Securi AND NOW, of the Petition on the rever.~ IT IS DECREED that Letters are hereby granted to in the aboye estate and that described in the Petition be F Letters ........... Short Certificate(s).( .4 ) . Renunciation ........ Affidavits ( ) .... Extra Pages ( 4 ) .... Codicil ........... JCP Fee .......... Inventory .......... Other ........... TOTAL ......... Prepared by the Pennsylvania Bar 21-2002-0036 therlne E. Culle¥ Deceased No: 188-32-4094 Date of Death: 12/07/2001 January 14th , 2002 in consideratio, n side hereon, satisfactory proof having been presented before me, [] Testamentary ~ Of Administration :-' (c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) Carol L. Youn~ Ihe instrument(s) dated ~dmitted to probate and filed of record as the last Will of Decedeq~: $115.00 ~"~,/~/ $ 12.00 // ' $ Attorney: James D. Flower, Jr. I.D. No: 27742 Saidis, Shuff, Flower & Lindsay 12.00 Address: 2109 Market Street Camp Hill, PA 17011 $ 5.00 Telephone: 717/737-3405 144.00 CALL ATTORNEY JAMES D FLOWER JR. ;sociation Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) EV 9~86 P'E~ NS YLVAI' ~.E..~PARI'M ENT 0 VITAL'R a ~T',7050' S A COI~O~JENCE ( Cumberla understan( hereby rev nature ther hereinafter and all Inh convenientl~ sell my mobi grandson, Agreement I have entere( principal balar mobile home LAST WILL AND TESTAMENT OF CA THERINE E. CULLEY 21-2002-0036 I, CATHERINE E. CULLEY, of 7073 Carlisle Pike, Lot 102, Carlisle, ,d County, Pennsylvania, being of sound and disposing mind, memory and ing, do make, publish and declare this as and for my Last Will and Testament, )king and making void any and all former Wills, Codicils, or writings in the ,~of, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, ~amed, to pay all my just debts, funeral expenses, testamentary expenses ~ritance, Estate, Transfer and Succession Taxes, as soon as may be done after my death, out of my residuary estate. SECOND: I am in the process of entering into an Agreement of Sale to. home located at 7073 Carlisle Pike, Lot 102, Carlisle, Pennsylvania, to my OMAS EDWARD CULLEY, JR. If I have not yet entered into such an Sale with him as of the date of my death, I give said mobile home to him. If into an Agreement of Sale With him to purchase said mobile.home, and if a is still due on said mobile home, I give to him all remaining equity in said such that it will pass to him with no requirement for further payment, following my d ath. remainde situate, in YOUNG, and JOE[ THOMAS CULLEY, devise and shares. YOUNG, to representativ THIRD: I give, devise and bequeath all the rest, reSidue and of my estate, be it real, personal or mixed, of whatsoever kind or wheresoever equal shares to my surviving children, GEORGE R. CULLEY, CAROL L. IIRGINIA L. ARMOLD, CREEDIN A. CULLEY, ROBERT H. CULLEY, JR. C. CULLEY, and one share to be divided by the issue of my deceased child, -'. CULLEY, who are JUEL MORRELL, MISTY WALKER and THOMAS E. R. In the event that any of my aforesaid heirs shall predecease me, I give, )equeath his or her share of my estate to his or her issue surviving in equal LASTLY: be the Executrix of this my Last Will and Testament. shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 'h day of ~ ~ ,L_Ojvv~L~ ,2001. SIGNED, SEAl ED, PUBLISHED and DECLARED in ~he presence of: I nominate, constitute and appoint my daughter, CAROL L. No personal v 2 COMMOr COUNTY IWEALTH OF PENNSYLVANIA 3F CUMBERLAND SS CULLEY, ti 2001. I, CATHERINE E. CULLEY, Testatrix, whose name is signed to the attached ol foregoing instrument, having been duly qualified according to law, do hereby acknowled~.le that I signed and executed the instrument as my Last Will; that I signed it willingly; arid that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by CATHERINE E. Testatrix, this /~~ day of ~'~(~.~.~_. , Catherine E. 'Cu'll~rix ~. NOTARIAL ~.AL ': ~ ERLENE J. ~ NOTARY PUBMC ' ' ~-;, ' c'mus~, ~o couurv, p^ '..~- COMMON COUNTY We, the witness duly qualifi Testatrix si( he of us in the best of our mind and WEALTH OF PENNSYLVANIA )F CUMBERLAND SS ~w-~ P. ~/~'O'LVg~ and James D. Flower, Jr. , es wf~'~;eCnames are sigr~ to the attached or foregoing instrument, being ~d according to laTM, do c~epose and say that we were present and saw n and execute the instrument as his Last Will; that he signed willingly and that it as his free and voluntary act for the purposes therein expressed; that each leanng andsight of the Testatrix signed the Will .as witnesses; and that to the ge the Testatrix was at that time 18 or more years of age, of sound der no constraint or undue influence. Swor and James ora~rmedto and subscribedto be~re me by O. Flower, Jr. this Gregory N. McVay day of , 2001. !MERLENE J- MA/~ NOTARY PUBUC I ': I~ C-AFItJ,~GUMBERLANDCOUNTY. PAI ,4, omc r- tn 'ri ~ 0 o ;~ rq I- > .< Nan ~EGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) e of Decedent: Catherine E. Culley of Death: December 7, 2001 Date Will No. 21-02-0036 Admin. No. To he Register: Or abo' ' Address L. Young Virf~inia L. Armold GeOrge R. Culley I certify that notice of Estate Administration required by Rule 5.6(a) of the :~ans' Court Rules was served _on,or mailed to the following beneficiaries of the re-captioned estate on January d[~'62002. Cms, din A. Culley Ro' ~ert H. Culley, Jr. 11 Honeysuckle Dr., Mechanicsburg, PA 17050 1 Gomer Road, Newville, PA 17241 2550 Old Trail Road, Lot 15 Amber Hill Park, York Haven, PA 17370 130 Mountain Road, Shermansdale, PA 17090 357 Long's Gap Road, Carlisle, PA 17013 Joe i C. Culley 40 Conley Lane, Etters, PA 17319 ThI mas E. Culley, Jr. 7073 Carlisle Pike, Lot 102, Carlisle, PA 17013 Juei.. Morrell 67 Dogwood Street, Etters, PA 17319 Milty Walker 3507 Chestnut Street, Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Da' aone es D. Flower, Jr., ES/lui~e / {/2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: ._ · ._Personal Representative Counsel for Personal "Representative COMMONWEALTH Of P. DEPARTMENT OF REVEl', BUREAU OF iNDIVIDUAL DEPT. 280601 HARRISBURG, PA 1712~ RECEIVED FROM: ........ fold FLOWER JA 2109 MARK CAMP HILL ESTATE INFORM, FILE NUMBER: DECEDENT NAM iNNSYLVANIA UE TAXES -0601 vIES D JR ET STREET PA 17011 ~TION: SSN: 188-32-4094 2102-0036 .: CULLEY CATHERINE E DATE OF PAYME~IT: 03/06/2002 POSTMARK DATI-': 03/05/2002 COUNTY: CUM BERLAN D DATE OF DEATH: 12/07/2001 REMARKS: J, SEAL PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TOTAL AMOUNT PAID: CHEC ~,MES D FLOWER JR ESQUIRE # 1335 INITIALS: AC RECEIVED BY' REGISTER OF WILLS REV-1162 EX(11-96) ACN ASSESSMENT CONTROL NUMBER NO. MARY C. LEWIS CD AMOUNT 000930 REGISTER OF WILLS 101 $2,000.00 $2,000.00 COMMONWEALTH OF Pi DEPARTMENT OF REVEi~ BUREAU OF INDIVIDUAL DEPT. 280601 HARRISBURG, PA 17128 RECEIVED FROM: FLOWER JA 26 WEST HI CARLISLE, ........ fold !NNSYLVANIA UE TAXES -0601 VIES D JR GH STREET 'A 17013 ESTATE INFORM,~TION: SSN: 188-32-4094 FILE NUMBER: 2102-0036 DECEDENT NAMI!: CULLEY CATHERINE E DATE OF PAYMENT: 05/30/2002 POSTMARK DAT--: 05/29/2002 COUNTY: CUMBERLAND DATE OF DEATH 12/07/2001 REMARKS: C C SEAL CHEC~ PENNSYLVANIA INHERITANCE AND ESTATE TAX. OFFICIAL RECEIPT 'TOTAL AMOUNT PAID: ~ROL L YOUNG /O J D FLOWER JR ESQUIRE REV-1162 EX(11-96) 338 INITIALS: VZ RECEIVED BY: ACN ASSESSMENT CONTROL NUMBER NO. REGISTER OF WILLS CD 001 232 MARY C. LEWIS AMOUNT REGISTER OF WILLS $658.63 101 $658.63 OFFICIAL USE ONLY , Ex +(6-00) REV-1500 ,MONWEA'T. OFPENNSYLVAN,A INHERITANCE TAX RETURN F LE"UmBER DEPARTM--NT OF REVENUE RESIDENT DECEDENT 21- 02- 0036 DE =T. 280601 HARRISBU :~G, PA 17128-0601 COUNTYCODE YEAR NUMBER DECEDEI' T'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Culley Catherine E. 188-32-4094 DATE OF [ )LATH (MM- DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPMCATE WITH THE 12/07 /2001I 07/18/1919 REGISTER OF WILLS (IF APPLI¢ABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER H (date of death X 1. o~iginal Return 2. Supplemental Return 3. Remainder Return prior to 12-13-82) 4. Linited Estate 4a. Future Interest Compromise (date of death after 12-17-8;~) 5. Federal Estate Tax Return Required X 6. D,~cedent Died Testate ?. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (A:tach copy of Will) (Attach copy of Trust) I I9. LiigationProceedsReceived ['-'"'~10. Spousal Poverty Credit [~ 11. Election to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch O) NAME COMPLETE MAILING ADDRESS James D. Flower, Jr. FIRM NA~ E (If Applicable) 2109 Market Street Saidis, Shuff, Flower & Lindsay Camp Hill, PA 17011 TELEPHO ~IE NUMBER ~ ~- 717/737-3405 ~ ¢'2 1. Real Estate (Schedule A) (1) ~6[:'~e OFFIC. I~D~.U~SE ONLY 2. Stoc!~s and Bonds (Schedule B) (2) None 3. Clos~:ly Held Corporation, Partnership or (3) ~orte , Sole -Proprietorship. . ' 4. Morti]ages & Notes Receivable (Schedule D) (4) None 5. CasF bank Deposits & Miscellaneous Personal Property (5) 12,93%. 16 c'~ ~,; ,.'3 (Sch ,~dule E) /' ~; ;- 6. Joint y Owned Property (Schedule F) I (6) 58,661.69 [~- Separate Billing Requested 7. Inter -Vivos Transfers & Miscellaneous Non-Probate Property (7) 7,000.00 (Sch ,~dule G or L) 8. Tota Gross Assets (total Lines 1-7) (8) 78,592.85 Q [~lln=r=l I:vn~neme ~ l~lminietr=tit~ Pn¢fc (~ha~l,,la W~m (Q~ ~ q '70.~ REV-1500 EX + D E C E D E N T cABP~ HP"~ EP.'cO CR~ 0 S I 1 L T I 0 of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) i ~434.28 Deductions (total Lines 9 & 10) of Estate (Line 8 minus Line 11 ) and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (Schedule J) Subject to Tax (Line 12 minus Line 13) (11) 17,173.18 (12) 61,419.67 (13). (14) 61,419.67 C O M T I 0 Copyright (c) ;~000 fort SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Jnt of Line 14 taxable at the spousal tax under Sec. 9116(a)(1.2) mt of Line 14 taxable at lineal rate mt of Line 14 taxable at sibling rate mt of Line 14 taxable at collateral rate )Me 61,419.67 X .0 0 (15) 0.00 X .0 45 (16) 2,763.89 X .12 (17) 0.00 X .lS (18). 0.00 (19) 2,763.89 software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Deced nt's Complete *Address: STREET ~DDRESS 11 H6neysuckle Drive CITY Mech~ Tax Pa 1. Tax [ 2. Credil A. B.I C. 3. Inter~ D.I E. 4. If Lin 5. If Lin, A. Er B. En PLEASE 1. Die a. b. C. d. 2. Ifc wit 3. Dic or 4. Dic wh Under penalties of peri ~nicsbur5 ,ments and Credits: L~e (Page 1 Line 19) s/Payments ipousal Poverty Credit ~rior Payments )iscount STATE ?A 2,000.00 105.26 (1) Total Credits ( A + B + C ) (2) ZIP 17055 2,763.89 st/Penalty if applicable nterest )enalty Total Interest/Penalty ( D + E ) (3) 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to request a refund (4) 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) er the interest on the tax due. (SA) Ier the total of Line 5 + SA. This is the BALANCE DUE, (SB) Make Check Payable to: REGISTER OF WILLS, AGENT ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS decedent make a transfer and: Yes No letain the use or income of the property transferred; ......................... ~ ~ 'retain the right to designate who shall use the property transferred or its income; ........... retain a reversionary interest; or .................................... receive the promise for life of either payments, benefits or care? ................... eath occurred after December 12, 1982, did decedent transfer property within one year of death lout receiving adequate consideration? ................................ ~ [--"] decedent own an "in trust for" or payable upon death bank account or security at his 1er death? .............................................. [--] ~ decedent own an Individual Retirement Account, annuity, or other non-probate property ch contains a beneficiary designation? ................................ r'~ ~'] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Jry, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, 2,105.26 0.00 0.00 658.63 0.00 658.63 and filing a tax retu For dates of death The tax rate impose parent, an adoptiw The tax rate impose [72 P.S. 9116(a)(1)' The tax rate impose Section 9102, as Copyright (c) ZOO0 fo 'n are still applicable even if the surviving spouse is the only beneficiary. ~n or after July 1, 2000: ~d 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, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)1. .d 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) d 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 individual who has at least one parent in common with the decedent, whether by blood or adoption. software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) correct and complete. [ )eclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SlGNATURE OF PERS )N RESPONSIBLE FOR FILING RETURN Carol '[,. Young DATE  ~ I~J~]~4~f 11 Honey. suckle Drive ',-I - - - - .................... ~ ~- SIGNATUREOFPREF~R~ROTHERTH~REPR~NTATIVE~ % Saidis, Shuff, Flower & Lindsay Q ~~~~n~oro janua~ ~, 1 ~, tho tax rato i~posod ~ tho ~t' vSl~o of t~a~S~O~s 'to' 0~ 'fO~' t'h~'~$~"0~'i~~ ........... ~rvivin~ spouso is13% [72 ~.~ ~ (a) (l~lj (i)]. For dates o~ death ~n or a~er Janua~ 1, 1 ~85, the tax rate imposed on the not valuo of transfers to or for tho uso of the survivin~ spouso is 0% [72 ~.S. ~115 (a) (~. 1 ) (ii)]. lhe statute does not exempt a transfer to a survivin~ spouse from tax, and the statuto~ r, quiremonts for disdosum o~ assots I~E'V- 1508 EX + (1-97) SCHEDULE E COMMONWEAI.TH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITA qCE TAX RETURN RES~D~ NT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Catherine ~.. Culley SS~; 188-32-4094 12/07/2001 21-02-0036 Include the pr 3ceeds 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 mo~ile home, value based on agreement of sale (attached) 8,200.00 2 Ve Eizon, refund 8.01 3 Ag~ay refund 95.84 4 Co:ncast, refund 34.68 5 M&F Bank, checking acct. no. 408735 4,592.63 TOTAL (Also enter on line 5, Recapitulation) $ 12,931.16 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 for ~ software only CPSystems. Inc. Form REV-1508 EX (Rev. 1-97) REV- 1509 EX + (1-97) COMMONWE~ INHERIT RESIC ESTATE OF Catherine If an asset wa SURVIVING J, A, Carol Co JOINTLY-OWl' LTH OF PENNSYLVANIA ~,NCE TAX RETURN ENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER ~.. Culley SS~/ 188-32-4094 12/07/2001 21-02-0036 made joint within one year of the decedent's date of death, it must be reported on Schedule G. )INT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT L. Young daughter 11 Honeysuckle Drive Mechanicsburg, PA 17055 ED PROPERTY: ITEM NUMBEF 4 5 DATE MADE JOINT 02/03/00 08/16/00 03/11/97 03/27/95 11/15/99 01/15/00 04/11/90 11/04/91 07/02/90 of Cont int DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. First Union National Bank CD 247412041041548 interest First Union National Bank CD 247412041306448 interest Members First FCU ~16101-40, 1 yr. CD 1embers First FCU ~161601, savings acct. ~&T Bank CD #31003910548543 accrued interest M&T Bank, CD #3100391064751 accrued interest M&T Bank, CD #3100391066346 accrued interest M&T Bank, CD #310039111558( accrued interest M&T Bank, CD #310039111558z accrued interest DATE OF DEATH VALUE OF ASSET 5,453.50 3.55 % OF DECD'S INTEREST 50.00% 50.00% 50.00% 50.00% ation Schedule(s) 7,956.48 17.29 2,577.03 200.87 10,000.00 226.99 50.00% 50.O0% 50.00: 50.00; 10,000.00 50 149.83 50 20,000.00 50 266.15 50 20,000.00 50 89.40 50 .00 .00~ .00: .00 .0O% .00% 20,000.00 53.47 50.00% 50.00~ TOTAL (Also enter on line 6, Recapitulation) DATE Of DEATH VALUE OF DECEDENT'S INTEREST 2,726.75 1.78 3,978.24 8.65 1,288.52 100.44 5,000.00 113.50 5,000.00 74.92 10,000.00 133.07 10,000.00 44.70 10,000.00 26.74 10,164.38 58,661.69 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 fol ly CPSystems, Inc. Form REV- 1509 EX (Rev. 1-97) Estate of: C~ E. Culley Soc Sec #: 11~8-32-4094 Date of Death 12/07/2001 Continuation of Schedule F (Jointly Owned Property) Item Ltr for Date Description of property # Jt Joint Total Val of Asset Decds Dollar Val of % Iht Decds Interest 10 A 11 A M&T Bank, CD #3100391116776 accrued interest )7/06/90 M&T Bank, CD #3100391115551 accrued interest 10,000.00 50.00% 5,000.00 166.29 50.00% 83.15 10,000.00 162.46 50.00% 5,000.00 50.00% 81.23 10,164.38 REV-lSlO EX+(1-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWE~ ,LTH OF PENNSYLVANIA INHERIT ~,NCETAXRETURN MISC, NON-PROBATE PROPERTY RESIC ENT DECEDENT ESTATE OF FILE NUMBER Catherine ,]. Culley SS~t 188-32-4094 12/07/2001 21-02-0036 This schedL le must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM IN(: LUDE THE NAME OF THE TRANSFEREE,THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIOqSHIP TO DECEDENT AND THE DATE OF TRANSFER, NUMBER AT ACH ACOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 M&~ money mkt #150041198310185 20 000.00 50 00% 3,000.00 7,000.00 ransferred to Carol L. Young from acct. owned jointly with Carol and her mother within onB year of date of death - total value $20,000 - decedent interest $10,000) TOTAL (Also enter on line 7, Recapitulation) $ 7,000.00 (If more space is needed, insert additional sheets of the same raze) Copyright (c) 1996 fo m software only CPSystems, Inc. Form REV-I$10 EX (Rev. 1-97) ~E~/-1511 EX +(1-97 SCHEDULEH COMMONWE/ .TH OF PENNSYLVANIA FUNERAL EXPENSES & INHERIT kNCE TAX RETURN ADMINISTRATIVE COSTS RESID ENT DECEDENT ESTATE OF FILE NUMBER Catherine . Culley SS~/ 188-32-4094 12/07/2001 21-02-0036 Debts of de,:edent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUI' IERAL EXPENSES: Ho !fman-Roth Funeral Home 6,747.50 We ;tminster Cemetery, grave opening 248.40 We '.tminster Cemetery, plot 815.00 Fellowship meal after funeral 55.32 Ca':lisle Memorials, marker 415.00 B. ADI 41NISTRATIVE COSTS: 1. P ;rsonal 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: 2. AAorney's Fees Saidis, Shuff, Flower & Lindsay 3,525.00 3. F~mily Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500. O0 Claimant Carol L. Youn8 Street Address 11 Honeysuckle Drive City Mechanicsbur~ State PA Zip 17055 Relationship of Claimant to Decedent- daughter 4. Frobate Fees Register of Wills 144.00 5. ~ccountant's Fees 6. 7 ~x Return Preparer's Fees 7. (:ther Administrative Costs Th~ Patriot News 131.47 Co nberland Law Journal 75.00 ccl~ts to transfer mobile home title 56.50 Bank checks 10.71 Register of Wills, filing fee 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 15,738.90 (If more space ~s needed, insert additional sheets of the same size) ~ software on y cPsystems, Inc. Form REV-1511 EX (Rev. 1-97) F~E~/- 151Z EX + (1-97) SCHEDULE I COMMONWE^,T ~ OF ~ENNSYLV^N~^ DEBTS OF DECEDENT, INHERITAN( :E TAX RETURN RESIDEN'DECEDENT MORTGAGE LIABILITIES, AND LIENS ESTATE OF FILE NUMBER Catherine ']. Culley SS# 188-32-4094 12/07/2001 21-02-0036 Include unr~.,imbursed medical expenses. , ITEM NUMBER DESCRIPTION AMOUNT 1 Se:.dle Hospital, medical costs-:. .... :~'*'~ '~ ''' ,.- ('"LFo ~ollocc)~ 2 Ho*.y Spirit Hospital, medical c6'sts -- 822.30 3 Ho.y Spirit Physicians, medical cost 15.09 4 PPi', utility bill 31.08 5 Mo~fitt Heart & Vascular, medical expenses 153.93 6 Qulntum Imaging, medical expense 35.34 7 He_~shey Kidney Specialists, medical expense 122.06 8 We;t Shore Pathology, medical expense 4.13 9 Pi:~nacle Health Hospice 100.00 10 In':ernists of Central PA 106.58 11 Qu. ~ntum Imaging 12.69 12 Pil]nacle Health Hospital 31.08 TOTAL (Also enter on line 10, Recapitulation) $ 1,434.28 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 fort ~ software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) SCHEDULE J COMMONWl ~LTH OF PENNSYLVANIA BENEFICIARIES INHERI' 'ANCE TAX RETURN RESII )ENT DECEDENT ESTATE OF FILE NUMBER Catherine ';. Culley SS~; 188-32-4094 12/07/2001 21-02-0036 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAb E AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXA ~LE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Ca~:ol L. Young daughter 1/7 of residue 11 Honeysuckle Dr. Me('.hanicsburg, PA 17055 2 Ge)rge R. Culley son 1/7 of residue 2550 Old Trail Rd., Lot 15 Aml)er Hill Park Yo:k Haven, PA 17090 3 Cr..~edin A. Culley son 1/7 of residue 13~) Mountain Road Sh~.~rmansdale, PA 17090 4 Ro]~ert H. Culley, Jr. son 1/7 of residue 351 Long's Gap Road Ca :lisle, PA 17013 5 Jo~=l C. Culley son 1/7 of residue 40 Conley La., Etters PA 17319 ENTEl DOLLAR AMIS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON .TAXABLE DISTRIBUTIONS: A. Si OUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CI ~ARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL O1" PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 2000 for ~ software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) Estate of: C~therine E. Culley Soc Sec #: 1~18-32-4094 Date of Death 12/07/2001 Item 6 7 8 9 Continuation of Schedule J, Part I (Taxable Bequests) Name Virgir 1 Gome Newvil aid Address of Beneficiary .a Armold ~Rd. .e, PA 17241 Relationship Amount or Share of Estate daughter 1/7 of residue Thomas Culley, Jr. 7073 C..rlisle Pike, Lot 102 Carlisle, PA 17013 Juel M,)rrell 67 Dog,~ood St. Etters, PA 17319 Misty l;alker 3507 C]lestnut St. Camp Hill, PA 17011 grandson granddaughter granddaughter 1/3 share of 1/7 residue 1/3 share of 1/7 residue 1/3 share of 1/7 residue AGREEMENT FOR SALE :OF MOBILE HOME f THIS AGREEMENT is entered between CATHERINE A. CULLEY, of ~mberland County, Pennsylvania, heceinafter referred to as "Seller", and THOMAS CULLEY, JR., of Cumberland County, Pennsylvania, hereinafter referred to "Purchaser". WI TN E S S E TH: 'SAIDIS . ,HUFF, FLOWER & LINDSAY 26 w. High Street Carlisle, PA 1. AGREEMENT OF SALE. Seller agrees to sell and convey to rchaser and Purchaser agrees' to purchase and accept one 14 foot by 71 foot ~user 1987 Mobile Home, Serial No. THPM365. 2. PURCHASE PRICE. Purchaser agrees to pay the sum of Eight ~ousand Two Hundred ($8,200.00) Dollars to Seller for the aforesaid mobile home. retest shall run on this obligation at the rate of six (6%) percent per annum, and the ~yments shall be amortized over a period of twenty (20) years from the date of this reement, each monthly payment to be made in the amount of Fifty-eight and 75/100 Dollars per month. Each installment payment shall be applied first to the Cment of interest due on the of the principal sum due. 3. PREPAYMENT. unpaid principal balance and the balance for the Purchaser shall have the privilege to prepay ~paid principal, in part or in full, at any time. 4. SETTLEMENT. Upon payment of the entire unpaid principal lance, Seller shall convey the title of the mobile home to Purchaser, and the parties ~all divide equally any costs of said title transfer. SAIDIS HUFF, FLOWER & LINDSAY A.'ITORNL~S*AT.LAW 26 W. High Street Carlisle, PA 5. . MUNICIPAL ASSESSMENTS, After the date of the execution this Agreement the cost of any municipal improvements or assessments shall be the sponsibility of Purchaser. In the event municipal improvements or assessments are paid by the Purchaser within Sixty (60) days after the due date and proof of Seller, such failure shall constitute a default on the part of ~yment provided to Jrchaser. 6. POSSESSION. home as of the date of the execution of this Agreement.'. 7. FIRE, CASUALTY AND LIABILITY INSURANCE. Purchaser' .all immediately upon taking possession, insure said mobile home for fire and other Purchaser shall receive possession of the maintain Purchaser agrees that the mobile home in a ~zards, including appropriate liability insurance. 8. MAINTENANCE AND REPAIRS.' ~rchaser, at Purchaser'S own expense, will .~ state of repair at all times. ALTERATIONS AND IMPROVEMENTS. No improvements or be made to the mobile home without the Prior written consent of shall 41er, which consent shall not be withheld unreasonably. 10. ASSIGNMENT OF AGREEMENT. The interest of the ~rchaser in this Agreement may be assignable, in whole or in part; without the prior itten consent of the Seller. 11. WARRANTY AS TO CONDITION. The premises are being Id in "as in" condition and it is understood that Purchaser has inspected the )perty or hereby waives the right to do so, and that Purchaser has .agreed to 2 SAIDIS HUFF, FLOWER & LINDSAY 26 W. High Street Carlisle, pA rchase the property as the result of Purchaser's inspection and not because of or in liance on any representation made by the Seller or Seller's Agent. 12. ENTIRE AGREEMENT. This 'Agreement Constitutes the entire ~derstanding between the parties and there are no covenants, conditions, )resentations or agreements, oral or written, of any nature whatsoever other than ~se contained herein. No modifications of this Agreement shall be binding unless same shall be in writing and duly approved by Seller. 13. TIME OF THE ESSENCE, ~reto that time shall be of the essence. .14. WAIVER. Failure of It is the agreement of the parties either party to insist upon strict forcement of any of. the provisions of this Agreement shall not constitute a waiver of right to enforcement of that provision or any other provision. 15. INSPECTION. Purchaser agrees that Seller or their ~thorized agent shall have the right with 48 hours notice at all reaSonable hours of day to enter the premises for the purpose of inspection to determine whether the rchaser is complying with the terms of this Agreement.. 16. DESCRIPTIVE HEADINGS. The descriptive headings used rein are for convenience only and are not intended to indicate all of the matter in the ,ctions that follow them. Accordingly, they have no effect whatsoever in determining e rights or obligations of the parties. ITNESS: 3 OCT 30 .'~ I1 0~: ~6PM 1_.1!~] I]Y ' !; MOt3 ] I..I{ HOMF:. .~¥ql_ L' .' /'- SERVICE ORDER" Lelby's Mobile Home Park & Sales 7073-75 Carlisle Pike CARLI.~L.F. PENNSYLVANIA 17013 .--,. Phone: /'1 7/697-1321 -- 7~0-9242 ' ' ' ,, ::,, ,_/ 4~_7~'~~i. i~;~x~ ..... -" L_- _'- CUSTOMERS ( ;i.[:AR HEC';J-:iPT ALI. REPLACED PARTS WILL BE DIS- CARDED UNLES~ OTHERWISE STRUCTEo. ~ ~AVE O DISCARD MATERIAL. f_ TI__ME.. 1'AX TOTAL 'ORIGINAL First U fion National Bank Atto: t ~ccount Verifications P O Bt,x 40028 Roano] ce VA 24022-7313 Febm; sAID 2109 CAM SUBJ Account Type CERTIFICATE OF DEPOSI' LEGAL TITLE: CATHERIh CAROL L. YOUNG X~ REISSUED FROM ACCT. CERTIFICATE OF DEPOSI LEGAL TITLE: CATHERII' CAROL L. YOUNG REISSUED FROM ACCT. * Da1 * I£d rna~ Signa Drem Depc SSS; al 001032 Reference ID: 232203 try 6, 2002 S, SHUFF, FLOWER & LINDSAY VlARKET STREET HILL, PA 17011 ,CT: Verification / Con£u-mation of Account and Balance Information provided for: CATHERINE E CULLEY (SSN# 188-324094) Date of Death: December 7, 2001 Deposit Account Information Account Date of Death Average Date Maturity Number Balance Balance* Opened Date 7 . 24741204'1041548 $5,453.50 2/3/2000 5/3/2002 E E. CULLEY 247412054059022 247412041306448 Interest Accrued YTD Date Rate Interest Interest Paid Closed $3.55 $7,956.48 8/16/2000 2/16/2002 $17.29 $203.78 $324.28 IE E. CULLEY 247412054090478 * Due to system limilations, we can only provide a twelve month average balance on depository accounts. of death balance does not include accrued interest. te of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were le during that time period. rare of Dep~)~itory Rel3r~tative a Rubinoff ;itory RepreSentative February 6, 2002 Date Servicenter Associate Title (540)563-7323 Phone Number M&T March 11, 2002 RE:' Estate The of: CATHERINE E CULLEY (D.O.D.). 12/7/2001 To Whom It May C, Identified below is account information requested. 1. accounts in which the decedent's name appears: ' Account Acc Number Account Title Type CHI( [' f~-~" 401 735 CD 31{ 3 CD si CD t~ [U.['~. 3.~( 155884 CD ,5~;~0 31C )3911167756 ' ic'i's'e 31C0391f155511 Opening Branch CATHERINE E CULLEY 4319 CAROL L YOUNG PO__.~A. CATHERINE E CULLEY 4319 OR CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG CATHERINE E CULLEY 4319 CAROL L YOUNG Account Number or other obligations titled in the decedent's name Amount Owed D.O.D. Balances (Includes Accr. Int.) $4592.63 $10,226.99 $10,149.83 $2O,266.15 $20,089.40 $20,053.47 $10,166.29 $10,162.46 Account Description Accrued Interest $.00 $226.99 $149.83 $266.15 $89.40 $53.47 $166.29 $162.46 NO Safe Deposit ox titled in the Decedent's name existed at our office. If you have any qt about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK BY: DATE: Signature Manufacturers and Traders Trust Company · 1100 Wehrle Drive, P.O. Box 767, Buffalo, NY 14240-0767 Membersl FEDERAL CREDIT UNION February 2, 2002 James D. Saidis, SI~ 2109 Mar Camp Hill RE: E S Dear Mr. :lower, Enclosed with Mere INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 Flower, Jr. uff, Flower & Lindsay (et Street PA 17011 ;tate of Catherine E. Culley SIN 188-32-4094 is the information requested in your letter of January 30, 2002 regarding the accounts held )ers 1st by Catherine Culley. Please d( informati~ n. ~ truly, you rs,~./?~ Denise A. Ander~'-~''''~ Insurance. Products Supervisor Enclosur( not hesitate to contact me at 795-5131 should you have any questions or require additional Me'mbersl FEDEP. AL CREDIT UNION REGULA SAVINGS ACCOUNT: Account umber/Suffix Date Acc unt Opened Principal ilalance at Date of Death . Accrued ] ~terest to Date of Death Total Prin :ipal and Accrued Interest Name of oint Owner Date Join Ownership Created CERTIFi CATE OF DEPOSIT: Account I ;lumber/Suffix Date of P~ ~rchase Principal Balance at Date of Death Accruei:l I~terest to Date of Death Total Priqcipal and Accrued Interest Name of {oint Owner Date Joint Ownership Created INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 161601 -00 03/13/1973 $200.80 $.07 $200.87 Carol L. Young 03/27/1995 161601 -40 1 YR 03/11/1997 $2,574.60 $2.43 $2,577.03 Carol L. Young' 03/11/1997 Estate ol Date of I Social SE / ~ERS 1s* I~D~REDIT UNION Insurance Products Supervisor February 22, 2002 : CATHERINE E. CULLEY }eath: 12/07/2001 curity Number: 188-32-4094 LAST WILL AND TESTAMENT OF, CA THERINE E. CULLEY I, CATHERINE E. CULLEY, of 7073 Carlisle Pike, Lot '102, .Carlisle, Cumber:and County, Pennsylvania, being of sound and disposing mind, memory and ~nding, do make, publish and declare this as and for my Last Will and Testament, g and making void. any and all former Wills, Codicils, or writings in the un~ hereby nature tllereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinal :er named, to pay all my just debts, funeral expenses~ testamentary.expenses and all nheritance, Estate, Transfer and Succession Taxes, as soon as may be SECOND: I am in the process of entering into an'Agreement of Sale to sell myhome located at 7073 Carlisle Pike, Lot 102, Carlisle, Pennsylvania., to my n, THOMAS EDWARD CULLEY, JR. If l have not yet entered into such an of Sale with him as of the date of my death, I give said mobile home to him. If I have into an Agreement of Sale with him to purchase said mobile home, and if a principa balance is still due on said mobile home, I give to him all remaining equity in said mobile such that it will pass to him with no requirement for further payment, followin¢ my death. conven .~ntly done after my death, out of my residuary estate. remain( situate, -YOUN6 and THOMA CULLE devise shares. YOUN( represe 'SIGNE DECLA THIRD: I give, devise and bequeath all the rest,~ residue and ;r of my estate,'be it real, personal or mixed, of whatsoever kind or wheresoever in equal shares to my surviving children, .GEORGE R.' CULLEY, CAROL L. VIRGINIA L. ARMOLD, CREEDIN A. CULLEY, ROBERT H. CULLEY, JR. :L C. CULLEY, and one share to be divided by the issue of my deceased child, E. CULLEY, who are JUEL MORRELL, MISTY WALKER and THOMAS E.' JR. In the event that any of my aforesaid heirs shall predecease me, I give, ~nd bequeath his or her share of my estate to his or her issue surviving in equal LASTLY: to be the ntative shall be Executrix of this my LaSt Will and Testament. I nominate, constitute and appoint my daughter, CAROL L. No personal required to file bond in this or any other jurisdiCtion. IN WITNESS WHEREOF; I have hereunto set my hand and seal this ~::;'~ day of ~"--"?/'""~ O'~_.LDJ~,..~::z~,~,.. 2001 [. ' . CathenlC/~"E'FO~ley ~' - , SEALED, PUBLISHED and :~ED in the presence of: COMM ~ COUN']' attachec acknowl willingly expres.. · CULLEf, 2001 )NWEALTH OF 'PENNSYLVANIA Y OF CUMBERLAND SS I, CATHERINE E. CULLEY, Testatrix, ' Whose name is signed, to the or foregoing instrument, having been duly qualified according to law, do hereby ~dge that I signed and executed the instrument as my Last Will; that I signed it and that l signed it as my free and voluntary act for the purposes'therein ~d. Sworn or affirmedto and acknowledged before me, by CATHERINE E. the Testatrix, this / ~ ~"~ day of ,,,, ~._..,.'}/"'-h~ 'i~/L~3.~ ' Catherine E. Cu~l'~est~rix'-~'" \- Notar~lic ' ' ~' : ~ 3 COMM( COUNT ~NWEALTH OF 'PENNSYLVANIA Y OF CUMBERLAND SS VCe, ~-,.-f,~:.¢.n ~). ¢'1 ~"~,/~ and James D. Flower, Jr. , the witr esses wi~se~'names are sigrt¢ to the attached or foregoing instrument, being duly qu)lified according to law, do c~epose and say that we were present and saw Testatrix< sign and execute the instrument as his Last Will; that he signed willingly and that he exequted it as his free and voluntary act for the purposes therein ex ressed' that e · . .. . . . . P , ach 0' us in Jthe hea, ~ng and s~ght of the Testatrix s~gned the W~!l as witnesses; and that to the best of Iour knowledge the Testatrix was at that time 18 or more years of age, of sound mind arid under no constraint or undue influence. and .j~ ;worn or affirmed to and subscribed to before me by ?.es D. Flower, Jr. this Gregor_v N. ;.'-~cVay /L'Z'~'~'L'j'''dayof ,2001. 4 BUREAU OF ZNDZVZDJAL TAXES XNHERZTANCE TAX DZVZI [ON DEPT. 2806D1 HARRISBURG, PA 17128*0601 JAMES I FLOWER JR SAIDIS ETAL 2109 M~RKET ST CAMP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHER/TANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 'OZ JUL -9 Alt :47 DATE 07-08-2002 ESTATE OF CULLEY DATE OF DEATH 12-07-2001 FILE NUMBER 21 02-0056 COUNTY CUMBERLAND ACN 101 I Amount Remitted REV-ii4? EX AFP (01-01) CATHERINE E HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH S LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-Z547 EX ~FP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF C LLEY CATHERINE E FILE NO. 21 02-00:56 ACN 101 DATE 07-08-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATZON ~ONCERNZNG FUTURE INTEREST.- SEE REVERSE APPRAISED OF RETURN BASED ON: ORIGINAL RETURN 1. Real E **tare (Schedule A) (1) 2. Stocks and Bonds (Schedule B)~ (2) $. Close1 Held Stock/Par~nershAp Interest (Schedule C) ($) q. Receivable (Schedule D) (q) 5. Deposits/Misc. Personal Proper~:y (Schedule E) (5) 6. JoAntl; O~ned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Tot ~1 Assets APPROVED DE] UCT/ONS AND EXEMPTIONS: 9. Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Deb' LAabAiAtAes/LAens (Schedule 1) (10) 11. To~al Deductions 12. Ne' Value of Tax Return 12~9:51.16 581661.69 7~000.00 (8) 15,7:58.90 .00 NOTE: To Ansure proper .00 credAt to your account, .00 submAt the upper portion .00 of this form with your tax payment. 78,592.85 l~q:sq.28 (11) 17.175.18 (12) 61,q19.67 15. Iq. NOTE: ASSESSMENT 16. 16. Amoun 17. Amoun 18. Amoun 19. TAX CREDIT! IF PAID Ar FOR CALCU; rAtable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) . O0 Ne' Value of Estate Subject to Tax (lq) 61,q19:67 Z~: ~n assessment was issued previously, lines 14, 15 and/er 16, 17, 18 and 19 w111 re~Lect ~igures that include the total of ALL returns assessed to date. )F TAX: of LAne lq at Spousal rate of Line lq ~axable a~ LAneal/Class A rata of LAne lq at SAblAng rate of Line lq taxable at Collateral/Class B rate Tax Due RECEZPI' NUMBER CD0009:50 CDO01252 DISCOUNT ZNTEREST/PEN PAID (-) 105.26 .00 £ER DATE INDICATED~ SEE REVERSE ATION OF ADD/TZONAL INTEREST. (15) .00 x O0 = .00 (16) 61,q19.67 x Oq5= 2,76:5.89 (17) .00 X 1Z : .00 (18) .00 x 15' = .00 .(].9): 2,76:5.89 AMOUNT PAID 2,000.00 658.6:5 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE Z,76:5.89 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UZRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 9 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS:' ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby, expressly reserves the right to appraise and aSSeSS transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of.the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment 'to the Register of Hills printed an the reverse side. --Hake check or money order payable to: REGISTER OF NILES, 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-1515). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special. Z4-hour answering service for forms ordering: 1-800-562-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 iTT only). Any party in interest not satisfied with the appraisement, al'lomance) or disallowance of deductions, or a[sessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --mritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, · 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 bm addressed in writing to: PA Department bf Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg) PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. ~. If any tax due is paid Hithin ~three (3) calendar months after the decedent's death, a five percent (SX) discdu~t of the tax paid is allomed. The 152 tax amnesty non~articipation penalty is computed on the total of the tax and interest assessed, and not' paid before January 16) 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest i~ charged beginning with first day of delinquency) or nine (9) months and one (1) day from the date of death) to the date of payment. Taxes which became delinquent before January 1) 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 1982 Nill bear interest at a rate which will vary from calendar year to.calendar year with that rate announced b~ the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate 1982 ZOZ . O00S48 1992 92 1983 16X .000458 ' 1995-1994 7X 1984 llZ .000501 1995-1998 ' 9Z 1985 I3Z .000556 1999 7Z 1986 IOZ .000274 ZOOO 82 1987 92 .000247 2001 92 1988-1991 llZ .000501 ZOOZ 62 --Interest is calculated as folloms: INTEREST = BALANCE OF TAX UNPAID Emily Interest Factor .000247 .000192 .D00247 .000192 . .000219 .000247 .000164 X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice i~sued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. IN Name Date Will Court the a( compl repre compl T} E COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 cf Decedent: Catherine E. Culley cf Death: December 7, 2001 o. 21-02-0036 Admin. NO. Pursuant to Rule 6.12 of the Supreme Court OrPhans' Rules, I report the following with respect to completion of [ministration of the above-captioned estate: 1. State whether administration of the estate is ~te: Yes' X ; No 2. If the answer is No, state when the personal ~entative reasonably believes that the administration will be ate: ac( 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final nt with the Court? Yes ; No X b. The separate Orphans' Court No. (if any) for the .ersonal representative's account is: c. Did the personal representative state an acco nt informally to the parties in interest? Yes X ; No d. Copies of receipts, releases, joinders and appr)vals of formal or informal accounts may be'filed with the Cler of the Orphans' Court and may be attached to this report. Date O~ ~~~ I N~me: qames7~~ Fio e~/, Jr., Esquire [ I~D. N6. 27742. ~'SAIDIS, SHUFF, FLOWER & LINDSAY Capacity: 26 West High Street Carlisle, PA 17013 (717) 243-6222 Personal Representative X Counsel for Personal Representative