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Home My WebLink About02-0042PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of ALI ~ ~'[-IADLr~- ~'fi/ktJ~EY~ No. 21-02-'42 also known as To: Register of Wills for the Deceased. County of C'&~ t¢£~ L/q¥O in ,the Commonwealth of Pennsylvania Social Security The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl-t r~ f~r letters of administration . on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) "./ ' the above decedent, i :, , . ..~, Decendent was domiciled at death in C u ~ ~ ~ ~ [_ ~ I~ .0 zT " ,' ' Cou'nty, Pennsylvania, with h CF last family or principal residence at"/l ( <~- 2 I~-'r ST') :C ~vvl~' l~ll_l (k.oa2~2AL£dto"FoJ~]~A. . . (list street,~?rhyr, and municipality) Decendent, then '~ g years of age, died I') e re (lq ~ ~ ~. ~. g)O~ ~ ~ 2_0 o { , Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property $ { ~t~t 060 (If not domiciled i'n Pa.) Personal. property in Pennsylvania $ (If not do~m~_i_ciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: ~tp~o<E ..Jol~o'tL~ Ot, OIJ~D LO,TI+ Petitioner after a proper search ha --% the following spouse (if any)'and heirs: Name ascertained that decedent left no will and was survived b~ Relationship Residence THER.EFORE, pet~t~.on~er~s) respectfully request(s) the grant of letters of administration in the appropriate form~to ,the'ufiderygned. OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ' The petitioner(s) above-named swear(s) or affirm(s).that the' statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) 0[ the _ab.ove decedent petitioner(s) will well and 'truly administffr the ~st~te hccording to law. . -_. L_~?3,~ ., Sworn to or affirmed: and: subscribed beforc~me this 10t~E __ day of 1 k ' J~U~Y. ~ ~z,~ No. 21-02-/.2 Estate, of ALICE SAHDLE-MAURER , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW JANUARY 15, 1~2002, in consideration of the petition on the reverse side hereof, satisfactory ·proof having been presented before me, IT IS DECREED that JOHN F MAURER is/are entitled to Letters of AdminiStration, and in accord with such finding, Letters of Administration are hereby granted to JOHN F MAURER in the estate of ALICE SHADLE-MAURER FEES Letters of Administration ..... $ 235.00 Short Certificates( ) .......... $ 9.00 Renunciation. ............... $ JCP $ 5. O0 T 0 T~T~L $ 249. O0 Filed ... J./~..u..A~. y...x. ET.. .... A.D. ~2002_ ATTORNEY.(Sup. Ct. I,D. No.) ADDRESS PHONE 105.805 REV 9/86 qlN( : Alice ,,,,-, .. ;,;,,, ;-, ,- ,--. ,~:~. Shadle,,,,~/Maurer ~:,, - ;>, .... ~emale .... ,, ...... ,., ..... . 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PA/~I,7011-..~' ~-~' zS:~:l(S-~ -<.t<,,~':~" ,,/g;3~f~, -F, f[-fJz~j, '<<',,,,~..,;,>;~S ~" '~','2 ';i, ~,'. -..~? 't,~Y ,;-'5;, - .... ' '~/- ~,- ' ' '~ ' ¢' "; "' '- ' '~': ' ':q~ ' 'k ~p;,~l ~'~ . ~, ~.1 ,.~, . ~ ~ ~ · ..z~<~ ~ ..> 5..: ~ ' > ' '1 : ' ' ~. ' "' .- '~','"~ ",-~: '~'~T' ,, ' · ',.; - .....~ ,,~4: ..... , ~. ' . ) ~':, '> ~ ' ~,,;. , ' ' -" , ' :' '. ' V,,. ~' ~:.~ ?.~.~~ ~r. ~ /,,.? ~ :. .. , ~ ...~,,~ ~.:, , ~ ~: I~ T ~.. ~ ~:' .Z~ ' ~, : - ... =.John :, ~: ..... u :.,,,:/,...,:,;~..Fg C:': ,:: ?' ': Naught:. iz :c,:, ~,l~'C+ Pc~.?}~t~tr~>~m~illi> PA:' 17011 -..:. :, / ~l ' ' ' '4/' ~ '~ " ' ' "'"' .... '~ ' ' ' /" ': '" ' ' ' ' ' "~ " · ': ..... ,.,-;:~,-. :. ..... ;..~ ....... :'..- ',..~:lA~:~mb.~O!J:~i2994':x<~?}i~9~'z~=b~St~' i.C. rematO~y:)<5 ;~-v. ~'~l~;~s~haefferst°~, PA 17088 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2806O1 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O0103O MARTHA MACTAVISH 405 GOUCHER STREET JOHNSTOWN, PA 15905 ........ fold ESTATE INFORMATION: SSN: 196-18-0762 FILE NUMBER: 2102-0042 DECEDENT NAME: SHADLE-MAURER ALICE DATE OF PAYMENT: 04/03/2002 POSTMARK DATE: 03/25/2002 COUNTY: CUMBERLAND DATE OF DEATH: 12/30/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $647.72 TOTAL AMOUNT PAID: $647.72 REMARKS: MARTHA MACTAVISH SEAL CHECK# 999 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZRDI¥IDUAL TAXES DEPT. ZB0601 HARRISBUR;, PA 171ze:D601 REV-16q5 EX AFP CDg-OO) ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 2102-OOqZ ACN 021115q5 DATE 05-18-2002 MARTHA MACTAVISH ~05 GOUCHER ST JOHNSTONN PA 15905 EST. OF ALICE SHADLEHAURER S.S. NO. 196-18-076Z DATE OF DEATN 12-$0-2001 COUNTY CUHBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKI'N*' [] TRUST [] CERTIF. REHZT PAYHENT AND FORHS TO: REGISTER OF RILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 .,. "~' HEHBERS 1ST FCU has provldad tha Department with tha information listed belom mhich has been used in calculating the potantial tax due. Their records indicata that at tha death of the above decedent, you were a joint owner/banaficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance mith the Inheritance Tax Laws of the Commonwealth of-Penn-s~'[v~la~--g~est'ibns'm~y-be 'a-bewared bY ballln~ (717)-787-83Z7:" ................. COMPLETE PART 1 BELON x x N SEE REVERSE SIDE FOR FILZNG AND PAY~,~;T INSTRUCTIONS Account No. 75q26-q1 Date 10-19-1999 To insure pro~r~radit t~your acEeu~'~.,, tNo Established (z) cop~es o;~ls notice must accompany your ' ' pa~ent to thei~Re~'ister ~ills. ['fla~ check Accoun~ Balance 1 1,5 6 5.5 0 Payable to Pe~cen~ Taxable X 50 . 000 Amoun~ SubSec~ ~o Tax 5,68~. 75 (3) months o; ~eJdeceden~ data ~d~, Tax Ra~e X .1~ you may deduct~'-SZ discount o~ ~e~a~)due. Any ~nher~tanc~:;tpx*~due ~ become~el~tnquent Po~en~ial Tax Due 68[ . 8[ nine (9) month~ after the~ta of de~th= TAXPAYER RESPONSE A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of CHECK -~ Hills and an official assessment mill be issued by the PA Department of Revenue. ONE BLOCK B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the decadant's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] halco. PA~D' DATE Under penalties of per3~ complete to the best of my kn ~~--~ ~7"--~~'''''n'--~-- ~''--~r-%''.'.'WORK TAXPAYER SIGNATURE 'above are true, Correct and DATE GENERAL ZNFORHATZON 1. FAILURE TO RESPOND NILL RESULT ZN AN OFFICIAL TAX ASSESSNENT mith appZicable interest based on information'~ ~:2'J ' '= submitted by the financial institution, Z.Inheritance tax becomes delinquent nine months after the decedent's date of death. 5.~ joint accaun~ is taxable oven though the decedent's name was added as a matter of convenience. 4.'Accounts (including th~se h~l~ betNee~ h~sband and wife) Nhich the, decedent put in joint names within one year prior to deatl~ ~re fully taxable as transfers. ""~. Accounts established jointl~ betaeen~husb~nd and wife mare'than one year prior to death are net taxable. 6.,Accounts held by a deced~;+?in t~s~ ~or')~oth~ o~. otl~er~,'are taxable fully. REPORTING ~NSTRUCTZONS - PART ! - TAXPAYER RESPONSE 1. BLOCK ~ ;:, If the i~form~tion' and ~mput~'ti~n in the notice are correct and deductions are not'b~in~ ~laiead~ place an ~X"- '. in block'~A; ~f'~a~t l' o~' ~h~';T~a~er'~e~anse" section. 'Sign tmo copies and submit them.aith your check fbr the amount of tax to the Register ~f NiCks'of ~he c~n~y' indicated. The PA Department of Revenue oil1 i~sOe an o~ficial assessment (Form REV-154B EX) upon receipt of the return fram the Register of NilZs. Z. BLOCK B - If the asset specified on this notice has been ar ail1 be reported and tax paid aith the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part i of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue~ Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 17128-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed,.check bIock "C" and complete Parts Z and $ according, to the instructions below. Sign tNo copies and submit them eith your check for the amount of tax payable to the Register of Nills of the county indicated. The PA Department of Revenue will issue an officiaL assessment (Form EEV-154B EX) upon receipt of the return from the Register of NiZZs. ; . .., TAX RETURN - PART Z TAX COHPUTATION LINE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/1Z/BZ: Accounts .hich the decedent put in joint names althin one (13 year o~ death are taxable fully as transfers. Hamever, there is an exclusion not to exceed $~,000 per transferee regardless of the value of the account ar the number of accounts held. If a double asterisk (x~) appears before your-first name in the address portion of this notice, the $5,000 exclusion already has been deducted 'free the account balance as reported by the financial institution. Z. Enter. the tot-at balance ef't~ account including interest accrued to the date of death. ~. The percent of. the account-,that isttaxable;fo~:each survivor is determined as follows: -- A. The percent..taxable .fm~ join%assets~estabZished more than one yeflr prio~ ~o.t~ d~t's death: -' ' . ! DIVIDED BY "TOTA~ "U"BER OF '"~IDED BY" TOTAL NURSER O~' ': PERCENT /....'-.:: .. .-:.'.--'~ .... 'JOINT..ONNERS ..... ....... -~ ..... SURVIV]NG~.JOINT O~NE~ ,.,~,-~l~0. =, ; . : TAXABLE ...... ..- ~ -~ _ . '.~ ~. "~ Exbmbie:"' A'..jqin.t 'a~set rebistered in the n~me bf.the :dededent and two bth~ person~.' .'. :~ ":; ' ;:'"" :',".' :" '' '.}" : ..:' 5 . - . , :: :. . ... , ..' .: . .: - . . .~,....: · :.. *.. .. !_ ~:;'~::'!::,:: .. ........ - ....... ! DIVIDED'BY' ~ (JOINf ONHERS~ DIVIDED BY Z'~'SURVI~R~) =' .167 X 100 -= ~6.7Z'(TAXABLE FOR EAC~SURVIVOR} B. ':The pe~behtr'~axab~e, fOP ~s~ets Cr~a{~it~n bna year of the d~c~dant's ~h o~ aeco'unts o~ned by'~h~ decedent but held in trust for' another"ihdividual(s) (trust beneficiaries): *' ~" ...... I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE · ORNERS OR TRUST BENEFICIARIES .... Example: Joint account registered in the name of the decedent'and twa other persons and established aithin one year of death by the decedent. : , 1'DIVIDED BY Z (SURVIVORS) = .50 X' 100 = 5OZ (TAXABLE FOR EACH s~RVZVDR) . q. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 5). 5. Enter the thtal of the debts and deductions listed in Part 5.. . 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (l~ne 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined belom. D&~e of-Dea~ ' ' SPoUse* *~ Lin~l - '* Sibling - Collateral 07/01/9q to 12/$1/91 SZ 6Z lSZ 15Z 01/01/95 ~o 06/50/00 OZ 6Z 15Z 15Z 07/01/00 to presen* OX q.SZa 12Z 1EX mThe tax rate imposed on the net value of transfers from a deceased child twenty-one years of age ar younge~ at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ. The lineal class of heirs includes grandparents, parents, children, end linealdescandants. "Children" incLudes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" incLudes all children of the natural parents and their descendants, uhethar or net they have been adopted by others, adopted descendents and their descendants and step-descendants· "SibLings" are defined as individuals who have at LeaSt one parent in=common with the decedent, mhetherby*blood Or adoption. The "Collateral"~lasS*of~heir~ includes a11 other, benefi~iaries.' * ;-.-.~-' ......................................... CLAINE~ DE~UCTIONS'~'PART '$:":'=':-:'~DEBTS"AND'DEDUCTIONS CLAIHE~ Allocable debts and deductions are determined as follows; ----.A..--You, legally ara-cesponsible-fo~.payment,-.or, the-estate.subject.~o administration, by a persohal representative..,is.ins~f, ficient ' to pay the deductible ~tems. ~ .... B'; -'Yo~ ~ctuaIIY'~aid'~th~d~bts~a'ft~*'dbat~'bf*'the~deoedent' and can-furnish-proof '~f payment; ......... .... C.. Debts, being.cLaimed must,~be.itemized_fully impart 5; ..If additional.space is.needed..usa~ plain paper 8 i/2" x lI"o! Proof of payment may be requested by the PA Department of Revenue. : .... , . CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned es:~,te on ~-~'~Pt~OAI~Y' ?~':o~'~,e2.. : Nam__e. _Address I ALL. P40~u~.~Y_To mt,I ~04 b~OT ITZ.~rp / Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature Address '"'/ I it $,. 2..t ~ Telephone q'l'() '-( ~ "(^ ~' 'Capacity: ~i~.mersonal Representative __.Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280~01 HARRISBURG, PA 17128-0~01 MARTHA .405 GOUCHER ST JOHNSTOWN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONSj AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS '02 HAY l0 ,410~5 MACTAVISH DATE 05-15-2002 ESTATE OF SHADLEMAURER DATE OF DEATH 12-50-2001 FILE NUHBER 21 02-0042 COUNTY CUHBERLAND SSN/DC 196-18-0762 ACN · 02111545 Amount Remitted REV-1548 EX AFP (01-02) ALICE MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~-: ~ ~- - ~ -~ ~-- ~ ~-~ ~3- .... : .............................................................................. NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-15-2002 ESTATE OF SHADLENAUR'ER ALICE DATE OF DEATH 12-50-2001 COUNTY CUMBERLAND FILE NO. 21 02:'0042 S.S/D.C. NO. 196-18-0762 ACN 02111545 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 75426-41 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING C ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 10-19-1999 Account Baiance Percent Taxabie' Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 11,363.50 X o .5oo · , 5,681.75 .00 5,681.75 .12 X 681.81 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE 'REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID PAYMENT MUST BE MADE BY 10-01-2002~. TOTAL TAX CREDIT i I BALANCE OF TAX DUE INTEREST AND pEN. TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT[ONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) .00 681.81 .00 681.81 PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000· (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your.payment to the Register of WiIls printed on the reverse side. -- Hake check or money order payable to: REGISTER OF WILLS, 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-ISiS). Applications are availab!? at the Office of the Register of Wills, any of the 25 Revenue D/strict Offices or by calling the special 2~-hour answering service for forms ordering: 1-800-$62-2050i services for taxpayers with special hearing and or speaking needs: 1-800-447-$020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty ¢60) days of receipt of this Notice by: '. --written protest to the PA Department ef Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-102L, OR --electing to have the matter det'er~ined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone C717) 787-&505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-]501} for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent C5%) discount of the tax paid is allowed. : The 15X tax amnesty non-participation penalty is computed on the total'of thb' ta~ and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you 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 (l) 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 C6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or 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 Daily interest Factor Year Interest Rate DaiLy Interest Factor 1982 20% 000548 1992 91 .000247 1983 16% .000438 1995-1994 7% .000192 1984 11% .000501 1995-1998 9% , .000247 ~ 1985 ' ISY. . O00~S& 1999 7% ,000192 1986 10Y. .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000501 2002 6% .000164 --Interest is calculated as follows: TNTEREeT = BALANCE OF TAX UNPATD X NURBER OF DAYS DELTNQUENT X ' DATL¥ TNTEREST 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 intermit must be calculated.: : ', J ~~.~,-.~,~~,,, °'~ COMMONWEALTH OF ~ PENNSYLVANIA ~ ` r -15 0 0 /`+rf Ir•+nr Il~r ,r r1 ti: ~" 3„3- ,~~-- D 'Z ~ Y ~ , O U 2- (~ U -{ Z ~~} DEPARTEPT280601VENUE INHERITANCE TAX RETURN FILE NUMBER ~~ ~ ~ HARRISBURG, PA 17128-0601 ~ ~ RESIDENT DECEDENT Z ~ -- _p `L <V CU _- ~N,Y co ~ - - M R Lk ~ ---- o DE YEAS N~ aE ~ DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) r I~ t ~ - r? ~ '~ ~ SOCIAL SECURITY NUMBER ..7 - 4 ' z _ _~ I_f i t ..c: _ M JL y > C-r? -a- ~ L ! C~_ _~ ` 1 L ~ Z ~ 1 ~ ! - W W U DATE OF DEATH (MM-DD-YEAR) ~---~-3 U ~ t _ ----- ----------- DATE OF BIRTH (PAM-DD-YEAR) __~ `7~3 _ - - - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS _ W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER F ~ 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return ida+e of dea+n prior +o tt-+a-ez) w a v ~ 4. Limited Estate ~ 4a. Future Interest Compromise {d,+e order+n seer 12-rz-az) ~ 5. Federal Estate Tax Return Required ~ a m ~ 6. Decedent Died Testate (Anacn copy or wap ~ 7. Decedent Maintained a living Trust (nnacn copy or rnsn 8. Total Number of Safe Deposit Boxes a a ~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit id~iP or Aoatn between +z-a+-s+ anti + +-ssJ - ~ 11. Election to tax under Sec. 9113(A) iA¢aon scn o) z THIS SEC~'ION MU$ ,, E COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIA4 TAX INFOR ATION SHOULD BE DIRECTED TO; c NAME `~ I ~ ~ t' ~~ ~ l J t- J ~ ~ ~ COMPLETE MAILING ADDRESS z ° - ? - ' a y FIRM NAME Of App~icab~e) -- 71 1 S - 5 ~ ~ ;~ t LL ~ I7 1 ~v j j ~ ~~ ~ ~ - r i ~ ~` o TELEPHONE NUMBER `T1 7 - 7 3-7 - ~ S5 L5 1. Real Estate (Schedule A) (1) _.,.__ vJ~ .. _.._._-_._-_--.. .._. _. ._.__. ..-.. .. --' OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) -~- _ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) "' -- 4. Mortgages 8 Notes Receivable (Schedule D) (4) '~"" ~•: f^,~,~~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ~ ~ j,~ _ ~-j 77• Z. ,~j~ Z (Schedule E) T --~~ 6. Jointly Owned Property (Schedule F) (6) S E ~ ~ T T f\~-E'~ED SC1 } C~ ) Q ~ Separate Billing Requested ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) `J ~~` r a. v W Z 0 Q I-- a O U X Fa- txneauie ~ or ~1 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus Line 11) 13 Charitable and Governmental BequestslSec 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) (11) --- (12) -~~~~__2 ~J (13) ~ r4) ~ ~ ~ , .5~ ~77. 2 S SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax ~ t~ t-~ 7 rate, or transfers under Sec. 9116 (a)(L2) ~--~-~!--7-1-1__Z ~ -_ x .0 __ (15) 16. Amount of Line 141axable at lineal rate ~ ___ _ x .0 __ (16) 17. Amount of Line 14 taxable at sibling rate _U x .12 (17) 18. Amount of Line 14 taxable at collateral rate Q___- x .15 (18) 19 Tax Due (19) 20. C~ • e rr • • U O G > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET DDRESS 7 ~ r s. z i sr s-r- CITY ~' ~ ~rn j-a ALL ~ ~ STATE ~~~ ZIP ~ ~ o t 1 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) y 2, Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) C7 3. InterestlPenalty if applicable D. Interest E. Penalty Total InteresUPenatty (D + E) (3) U 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) O 5. 1f Line 1 + Line 3 is greater than Line 2, enter the difference. This is the tAX DUE. (5) U A. Enter the interest on the tax due. (5A} O B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ Make Check Payable fo: REGISTER OF WILLS, AGENT _. ,, , .. , , , PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income :...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ '~ t. If death occurred after December 12, 19132, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................... 3. Did decedent own an "in trust tor" or payable upon death bank account or security al 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 penall+es of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is True, correct and complete. Declaration or preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P ON RESPONSIBLE FOR FILING RETURN ATE ADDRESS ~` ~~~ 5, zr5' S~r., ~~~~~ [~fi.~r f7~ t7~ri SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.t) (ii)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a !ax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5°!°, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(t)J. The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12°1° [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REJ~~~E%•f1~971 SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY' RESIDENT DECEDENT ESTATE OF FILE NUMBER St.~/~ f~l~ ~ Mn~2r/~ /~LICC 2v°2~` Ooo ~z- Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshiq must be disclosed on Schedule F. ~. ,' i pi more space is needed, insert addinonat sneers of the same slzel ~ REY•}SOC EX+ 114-881 /yam COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEOENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER 5" ~i~ (~ZE - MR U>2~~- , A LICE _ 2 C:UZ- G 6U ~Z Joint tenant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT A. M AQ~~I~a M~ cT~~ (5(-{ ~v~' Go~~i~ ~12'S~". S ~ S~r~12 ,~o,"~~s"r~w1J P~ ~5K~. B. c Jointly-owned property: ITEM NUMBE LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY TOTAL VALUE OF ASSET DECD'S fo INT. DOLLAR VALUE OF DECEDENT S INTEREST ~. q 14~to? tv~Em 3~~5 F~RS~z ~~~ IT V rJ i o~ ~A~PP f~ U~ J' ~ o ~ P!'t~.o~t S ~ {- F- s ~T~ .~ ~-(~ f K ~rJ+-1T>-lS .~ f~l 3C":~ -~ 1 f , 3~.,`2 , ~`~ ~ C it l~`f t ~'~C ~+ T~ ~= o,~. t r~ l= 0 QiY1 k7 + a ~ 0 tJ c-Y .. t31`~ s~~H ~~~~zY . .TOTAL (Also enter on line b, Recapitulation) ~ $ {If more space is needed insert additional sheets of same size) REV.1510 EYr+ ('<-87) 4.~ d' `l~ .,,,:~,r,.. COMMONWEALTH OF PENNSYlVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATI: OF FILE PLEASE PRCNT OR TYPE 2.002- c) DuC-~'Z THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET Ic vl:c ITEM NUMBER DESCRIPTION OF PROPERTY Indvde name o/ the Irons/eree, their relationship to decedent, dale ollrans/er. - EXCLUSION TOTAL VALUE OF ASSET DECD. % INT. DOLLAR VALUE OF DECEDENT'S INTEREST ~0~5 t v+~ b~1tTPa 3~r.i t; ~~T C5~ Z`1 I ~ ~ l Z- tJU~/ hlo~il~-1 (: n1K.N~~+~r~l ~-; ~ ~ ~~~>~Dx ~ ~ y ~~ . C F~ `T ~-~ ~ ~ I -~ C ~E ~~ d~!'J iL (~ S I S T~ p ~. -- M ~ ~T(--f ~ M ~ ~Tn Uc 5 r-I t l (~ ~,~vSE~f•~ 13~ACcL} ~ 13~c,Tt{-r`-V' !'-4V~ 1»CSSrS ~, q wq ti-4h~ iL ~~~ -, ~w~ ~~~~ ~e~ ~sQ ~~3 ~, 4U5 GavC1(Et? y1.~ ~Ct-~,vS7~~~~ ~~~ ~ t5 (G S D ~ I ~ CR~SLEuT ~ne~ ~ w'1..~~.~ t~W I ~ 3 U 5 t vii 1 ~ ~ ~P- tom! /'~T ~ ors Q ~1 LY ~ ~~z i t~~c R B Z~ TOTAL (Also enter on line 7, Recapitulation- ~ $ SCHEDULE G TRANSFERS (If more space is needed, insert additional sheets o/ same size.( LU I-- LU "ff Z 0 I-- Z L~ '~ 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 001207 MARTHA MACTAVISH 405 GOUCHER STREET JOHNSTOWN, PA 15905 ........ fold ESTATE INFORMATION: SSN: 196-18-0762 FILE NUMBER: 21 02-0042 DECEDENT NAME: SHADLE-MAURER ALICE DATE OF PAYMENT: 05/23/2002 POSTMARK DATE: 05/21/2002 COUNTY: CUMBERLAND DATE OF DEATH: 12/30/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $681.81 TOTAL AMOUNT PAID' $681.81 REMARKS:' MARTHA MACTAVICH SEAL CHECK# 1023 INITIALS: JA RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERXTANCE TAX DTVZSZON DEPT. Z80601 HARRISBURG, PA 17128-0601 COHHONWEALTH OF~"PENNSYLVANZA DEPARTHENT OF REVENUE zNHERz'I'ANCE TAX STATEHENT OF ACCOUNT ......... KENNETH N QUERRY 421 W HAIN ST DATE 05-28-2002 ESTATE OF QUERRY DATE OF DEATH 10-18-2001 FILE NUHBER 21 02-0044 COUNTY CUHBERLAND ACN 01155526 Amoun~ Remitted REV-16D? EX AFP ALAN S HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit to your account, submit the upper portion of thAs 'form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ESTATE OF QUERRY ALAN S FXLE N0.21 02-0044 ACN 01155526 BATE 05-28-2002. THXS STATEHENT XS PROVXDED TO ADVXSE OF THE CURRENT STATUS OF THE STATED ACN XN THE NAHED ESTATE. SHOWN BELOW XS A SUHHARY OF THE PRXNCXPAL TAX DUE, APPLXCATXON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, XF APPLXCABLE, A PROdECTED XNTEREST FXGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 04-29-2002 PRINCIPAL TAX DUE: ................................................................................................................................................................................................................... PAYNENTS (TAX CREDITS): .00 PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER- INTEREST/PEN PAID (-) AHOUNT PAID 01-14.-2002 05-15-2002 CD000754 REFUND .00 .00 12.60 12.60- ZF PAID AFTER TH/S DATE, SEE REVERSE S/DE FOR CALCULATION OF ADD/TZONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT 1S REQU/RED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR 'rNSTRUCT/ONS. ) PAYMENT: REFUND [CR): REPLY TO: DISCOUNT: PENALTY: INTEREST: 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 or money order payable to: REGTSTER OF t/TLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONgEALTH OF PENNSYLVANTA. A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register o~ gills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-362-ZOS0; services, for taxpayers aith_speci.al hearing and / or speaking needs: 1-800-447-3020 (TT only)~ regarding errors contained on this notlce should be addressed tm: PA Department of'~avenue, Bureau Questions of Individual Taxes, ATTN: Post Assessment Review*Unit, Dept. ZS06Ol,'Narrisburg, PA i7128-0601, phone (717) 787-6S05. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (S23 discount of the tax paid is allomed. The 152 tax amnesty nan-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'amnedty peridd.' Interest is charged beginning with first day o~ delinquency, or nine (9) months and one (1) day fram the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of i six (62) percent per annum calculated at a daily rate of .000164. Ali taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate mhich mill vary from calendar year to calendar year mith that rate announced by the PA Department of Revenue. Th~ applicable interest rates for 1982 through ZOOZ are: Year Interest Rate DaiIy Interest Factor · Year Interest Rate Daiiy Interest'Factor I 1982 Z02 1983 198¢ 112 1985 1986 102 1987 92 1988-1991 112 .000548 1992 ~2 · 000438 1993-1994 72 · 000301 1995-1998 92 · 000356 1999 72 .000274 ZOO0 82 · 000247 Z001 92 .000301 - ZOOZ 62 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPATD .000Z47 .000192 ..000247 .000192 .000219 .000247 .00016~ X NUIJBER OF DAYS DELINQUENT X DALLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) davs beyond the date of the assessment. If payment is made after the interest computation date shomn on the Notice, additional interest must be calculated. \ BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTyTSTON DEPT. Z80601 HARRISBURG; PA 17'lIB-D601 JOHN F HAURER 711S ZIST ST CAHP HILL COHHONWEALTH OF*PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT~ ALLO#ANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 06-2~-200Z ESTATE OF SHADLEHAURER DATE OF DEATH 12-$0-2001 FILE NUNBER 21 02-00~2 COUNTY CUHBERLAND ACN 101 I Amoun~ Remi~ed RE¥-1547 EX AFP ALICE HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA I70I$ CUT ALONG THIS LINE B~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRA~SENENT, ALLOWANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX. ESTATE OF SHADLEHAURER ALICE FILE NO. 21 02-00~2 ACN 101 DATE 06-2~-2002 TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE [NTEREST*- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 1. Real Es~e~e (Schedule A) 3. 4. $. 6. 7. 8. ORIGINAL RETURN (1) S*ocks end Bonds (Schedule B) (2) CZosely Held S~ock/Par*nershlp In~eres~ (Schedule C) ($) Hor~gages/No~es Receivable (Schedule D) (~) Cash/Bank Deposi~s/Hisc.'Personal Proper~y (Schedule E) ($) Jointly O~ned Proper~y (Schedule F) (6) Transfers (Schedule G) (7) To,al Asse~s APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos'cs/Hisc. Expenses (Schedule H) 10. Deb~s/Hor~gage Liabili~cies/Liens (Schedule Z) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn 1:3. (9) (10) Charitable/Governmental Bequests; Non-aZec~ed 911:3 Trusts (Schedule J) Ne~ Value of Es~a~e Subjec~ ~o Tax 8~577.Z5 .00 .00 NOTE: To-insure proper .00 credi~ ~o your account, .00 submi~ ~he upper portion .00 of ~hls form ~i~h your ~ax payment. .00 (8) .00 NOTE: 8q, 577.25 (11) . flO (12) 8~,577.Z5 (1:3) . O0 (14) 8~, 577.25 If an assessment ~as issued previously, 1&nas 14, 15 and/OrX6, 17, reflect figures that include the total of ALL returns assessed to date. 18 and 19..w111 ASSESSHENT OF TAX-- 15. Amoun~ of L/ne lq a~ Spousal ra~e 16. Amoun~ of L/ne lq ~axable a~ Lineal/Class A re~e 17. Amoun~ of L/ne lq a~ Sibltng ra~e 18. Amoun~ of L/ne 1~ ~axable a~ Colla~ceral/C1ass B ra~e 19. Principal Tax Due TAX CREDITS.' PAYHENT R~C[TpT DISCOUNT DATE NUHBER INTEREST/PEN PAID (-) 05-21-200Z CD001207 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. (15). 8~,577.Z5 x O0 = .00 (16) .00 x 0~5= .00 (17) . O0 x 12 = . O0 (18) . O0 x 15 = . O0 (19)= . O0 AHOUNT PAID 681.81 TOTAL TAX CREDIT 681.81 BALANCE OF TAX DUE[ 681.81CR INTEREST AND PEN. .00 TOTAL DUE 68Z.81CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- /STRATIVE CORRECTIONS: DISCOUNT: PENALTY: . INTEREST: Estates of decedents dying on or before December 12, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section Z140 of the ·Inheritance and Estate Tax Act, Act 25 of 2000. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund 'of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Appllcations are available at the Office of the. Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour . answering service for forms ordering: 1-800-36Z-ZO50; sarvices for taxpayers with special hearing and / or speaking needs: 1-807447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, ar disallowance of deductions, ~r assessment 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 171ZB-10Z1, 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 mriting to: PA Department of Revenue, Bureau of individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZEOS01, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "instructions for Inheritance Tax Return for a Resident .Decedent" (REV-IS01) for an explanation of administratively correctable errors. · If any tar due is paid within three (3)calendar months after the decedent's death, a five peFcent ~SZ) discount of :the tax paid is a11omed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This npn-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 is charged beginning with first day of delinquency, or nine (9) months and one (1) day from ~he date of death, to tho date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of si~ (SI) percent per annum calculated at a daily rate of .000164. All taxes which became, delinquent on and after January 1, 198Z will bear interest at a rate mhich mill 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 are= Year Interest Rate Daily Interest Factor Vaar Interest Rate 198Z ZOZ .000548 1992 9X 1983 16Z ' .000438 1993-1994 7Z 1984 I1Z .000301 1995-1998 9Z 1985 13Z .gD0356 1999 7Z 1986 XOZ .000Z74 ZOO0 8Z 1987 9Z .000247 2001 9Z 1988-1991 llZ .000301 ZOOZ 6Z --Interest is calculatad as*follows: INTEREST = BALANCE OF TAX UNPAID Daily Interest Factor .000247 .00019Z .000247 .00019Z .000219 .000247 .000164 X NUIIBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent w111 reflect an interest calculation to fifteen (15) days beyond the date of the assessment, l~ payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES. /NHERITANCE TAX DIVIS/ON DEPT. 280601 HARRISBURG,, PA 17128-0601 JOHN F MAURER 711S Z1ST ST CAMP HILL coMMoNWEALTH OF;)PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT..~O~i:iACCOUNT Reoome r..,., . ,,,,f '02 JUL -1 I- t0:06 REV-I$O? EX AFP (01-02) DATE 06-Zq-ZO02 ESTATE OF SHADLEMAURER DATE OF DEATH 1Z-SO-ZOO1 FILE NUMBER 21 02-00~2 COUNTY CUMBERLAND ACN 101 L Amoun~ Remi~ed ALICE HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER O'F WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ESTATE OF SHADLEMAURER ALICE F'rLE NO. 21 O2-OOqZ ACN 101 DATE 06-Z~-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN 'IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLXCATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE:. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 06-Z~-2002 PRINCIPAL TAX DUE= ................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): .00 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 05-21-2002 CD001207 .00 681.81 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 681.81 BALANCE OF TAX DUE 681.81CR INTEREST AND PEN. .00 TOTAL DUE 681.81CR YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. 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 cake check or money order payable 'to: REGISTER OF NILLS, AGENT. -- If NON-RES[DE~T DECEDENT make check or money order payable to: CONHONNEALTH OF PENNSYLVANIA. ' REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Off~ces or from the Department's Z4-hour answering service for forms ordering= 1-800-$61-Z0S0~ .services for taxpayers with special hearing and / or speaking needs= 1-D00-447-3010 (TT only). REPLY TO: guestions regarding errors contained on this notice should ba addressed to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Reviee Unit, De~t. 280601, Harrisburg, PA 17118-0601, phone (717) 787-6505. DISCOUNT: PENALTY: INTEREST: If any tax due is paid eithin three (3) calendar months after the decedent's death, a five percent (51) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is-computed on the total of th~. tax and interest'assessed, and not paid before January 18, 1996, the first day after the end of the tax a~nesty period. Interest is charged beginning eith 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 (61) percent per annum calculated at a daily rate of .000164. A11 taxes which became delinquent on and after January l, 1981 mill bear interest at a rate which eill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor . Year Interest Rate 1982 20Z .000548 1983 ~61 .000~38 1984 ZZZ .000301 1985 131 .00q356 1986 - IOZ .000274 1987 91 .000247 1988-1991 llZ '.000501 1991 91 1993-199q 71 1995-1998_ 91 , . 1999 71 ZOO0 81 ·ZOOX 91 2002 61 Daily Interest Factor .000247 .000192 .000147 .000192 .O00ZX9 .OOOZ~7 .000i6~ --Intoras*~ is calculated as,folloms:''" INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FAC, TOR --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 bo calculated. BUREAU OF TNDZVZDUAL TAXES ZNHERTTANCE TAX Dzv'rSTON DEPT. Z80601 HARRZSBURG, PA 171Z8-0601 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF .~.CCOUNT RE¥-].6D? EX AFP (01-02) JOHN F HAURER 711 S 21ST ST CAHP HZLL ...... :.'"'~m'~\){; gESTATE OF DATE OF DEATH F'rLE NUHIIER "02 JUL-9 t.~31~.D'-YJNTY ACN 07-01-2002 SHADLEHAURER 12-$0-Z001 21 0Z-00~Z CUHBERLAND 101 Aeount Ree/tted ALZCE HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGZSTER OF NILLS CUHBERLAND CO COURT HOUSE ' CARLZSLE, PA 17015 NOTE: To insure proper credit to your account, subeit the upper portion ~f this fore with your tax payeent. CUT ALONG THZS LZNE ~'* RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-02) ~ ZNHERZTANCE TAX STATEHENT OF ACCOUNT ~ ESTATE OF SHADLEHAURER ALZCE FZLE NO. Z10Z-OO~Z ACN 101 DATE 07-0].-Z00Z THZS STATENENT ZS PROVZDED TO ADVZSE OF THE CURRENT. STATUS OF THE STATED ACN TN THE NANED ESTATE. SHONN BELON ZS A SUNHARY OF THE pRI'NCZPAL TAX DUE, APPLZCATZON OF ALL PAYHENTS, THE CURRENT BALANCE,. AND, ZF APpLTCABLE, A PROJECTED ZNTEREST FZGURE. DATE OF LAST ASSESSHENT OR RECORD 'ADJUSTHENT: 06-Z~-ZOOZ PRINCZPAL TAX DUE: ............................... ............................................................................................................................................................................................ PAYHENTS CTAX CREDZTS): .0O PAYHENT RECEZPT DISCOUNT (+) AHOUNT PAZD DATE NUHBER ZNTEREST/PEN PAZD (-) ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), TOTAL TAX CREDZT .00 · ALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THTS FORN FOR ZNSTRUCTZONS. ) 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. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ZLLS, AGENT. -- If NON-RESIDENT ~ECEDENT make check or money'ordar payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance. and Estate T~x" (REV-1513). Applications are available at the Office of the Registe~ of Hills, any of the Z3 Revenue District Offices or from the Department"s gq-hour answering service.for forms ordering; 1-800-36Z-ZOSq; services for taxpayers with ~pecial hearing and / or speaking needs: 1-BOO-qfiT-3OZO (TT REPLY TO: DISCOUNT: PENALTY: 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 171Z8-0601, phone (717) 787-6505. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after'the end of the'tax amnesty period. INTEREST: Interest is ~ha~ged 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, I98Z bear interest at the rate of six (BZ) percent per annum calculated at a daily rate of .O0016q. Ali taxes which became delinquent on and after January I, 198Z wi1! bear interest at a rate ~hich wil! vary from calendar year. to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor ' Year Interest Rate 1982 20Z .O00Sq8 1983 162 .O00~3& - 198~ llZ . .000301 1985 132 .000356 1986 ' IOZ .00027q 1987 92 .0002q7 1988-i991 IXZ .000301 Daily Interest Factor 199Z 9Z ,O00Zq7 1993-199~ 72 .00019Z 1995-1998 9Z .OOOZ~7 1999 7Z .O0019g ZOO0 8Z .000219 2001 92 .O00Z~7 ZOOZ 6Z .00016~ --Tn~erest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXN~UENT X' DAXLY, 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. Xf payment is made after the interest computation date shown an the Notice, additional interest must ba calculated. BUREAU OF TND'rVI'DUAL TAXES INHERITANCE TAX DTVTSTON DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANi'A DEPARTMENT OF REVENUE *ZNHERZTANCE TAX STATEMENT* OF ACCOUNT KEV-li07 EX a'FP (01-02) DATE 06-17-2002 ESTATE OF SHADLEMAURER DATE OF DEATH 1Z-$0-2001 FILE NUMBER 21 02-00q2 'COUNTY CUMBERLAND ACN 021115q5 I Amoun~ Remi~ed ALICE HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o. your account, subm/~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG THIS LINE ~- RETAIN LOWER PORTTON FOR YOUR RECORDS '~ REV-1607 EX AFP (01-02) xxx ZNHERTTANCE TAX STATEMENT OF ACCOUNT xxx ESTATE OF SHADLEMAURER ALICE F'rLE NO. 21 02-00q2 ACN 021115~,5 DATE 06-17-2002 THTS STATEHENT 'rs PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACM 'rN THE NAHED ESTATE. SHO#N BELO# .rS A SUHHARY OF THE PR.rNC'rPAL TAX DUE, APPL'rCAT'rON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPL'rCABLE., A PROJECTED INTEREST F*rGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-15-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................ PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT NUMBER CDO010$O 05-25-2002 DISCOUNT (+) INTEREST/PEN PAID (-) Sq.. 09 'rF PA'rD AFTER THIS DATE, SEE REVERSE S'rDE FOR *CALCULATION OF ADD'rTIONAL INTEREST. ( ZF TOTAL DUE 'rS LESS THAN $1~ NO PAYHENT IS REQU/RED. 'rF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCT'rOMS. ) AMOUNT PAID 6q7.7Z 681.81 TOTAL TAX CREDIT 681.81 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check ar money order payable to: REGTSTER OF NTLLS, AGENT. -- If NON-RES/DENT DECEDENT make check or money order payable tm: COHHONNEALTH OF PENNSYLVANTA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for. Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513)~ Applications ara available at the Office of the Registe~ 6f NJlls, any of the Z$ Revenue District Offices er from the Department's Z4-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers aith s~acial hearing and / or · speaking needs: 1-800-447-30Z0 (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: PENALTY: If any tax due is paid within three (5) calendar months after the decedent's death, a flve percent (SZ) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the.tote! 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: Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1,'198Z bear interest at the rate of six [6Z) percent per annum calculated at a daily rate of .000164. A11 taxes which became delinquent on an~ after January 1, 198Z will bear interest at a rate which mill vary from calendar year to calendar year with that 'rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZOZ .000548 199Z 9Z .000247 1983 16Z .000438 : 1995-199~ 7Z .o0axg2 1984 11Z .000301 1995-1998 9Z .q00247 1985 132 .000356 1999 7Z .OOO19Z 1986- IOZ .000Z74 - 2000 8Z .000219 1987 9Z .000Z47 ZOO1 9Z .000Z47 '1988-1991 ' 11Z .000501 ZOOZ 6Z .000164 --Interest is calculated as follems: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELXN~IUENT X DAILY 'rNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF ZNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANZA DEPARTMENT 0F REVENUE ZNHERZTANCE TAX STATEHENT ' OF "*ACCOUN? R8co~'~;'.g',:~ ~":!';i~i~ ~; 2,,': DATE 07-15-2002 RE *Si;':' O', ,,.:.~i:~ ESTATE OF SHADLEMAURER DATE OF DEATH 12-~0-2001 FILE NUMBER gZ 02-00qg MACTAVZ~O~H ~UB 1 ~ ~8 :~ d COUNTY CUMBERLAND MARTHA ACN 02111~q5 q05 GOUCHER ST I REV-i&O? EX AFP (01-02) ALZCE MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMIIERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsure proper cred/~: ~o your account:, submit: ~he upper portion of ~his form wASh your ~:ex payment. CUT ALONG THZS L'rNE ~* RETAZN LOWER PORT'rON FOR YOUR RECORDS *~ REV-Z607 EX AFP (01-02) #~# INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF SHADLEMAURER ALICE FILE N0.21 02-00q2 ACN 021115q5 DATE 07-15-2002 TH/S STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH ZN THE NAMED ESTATE. SHO#N BELON 1S A SUMMARY OF THE PRINCIPAL TAX DUE, APPLZCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE~ AND, [F APPL/CABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-15-2002 PRINCIPAL TAX DUE: ....................................................................................................................................................................... PAYMENTS (TAX CREDITS): 681.81 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-25-2002 05-21-2002 06-26-2002 CD001050 CD001207 REFUND ~q.09 .00 .00 6q7.72 681.81 681.81- ZF PAID AFTER THIS DATE, SEE REVERSE S[DE FOR CALCULATION OF ADDZT/ONAL INTEREST. ( IF TOTAL DUE 1S LESS THAN $1, NO PAYMENT ZS REgUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CA), TOTAL TAX CREDZT 681.81 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 'TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR ZNSTRUCTTONS. ) PAYNENT: REFUND'(CR): REPLY TO: DISCOUNT: PENALTY: INTEREST: Detach the top portion of this Notice and submit ~ith your payment made payable to tho name and address printed on the reverse side. -- Zf RESIDENT DECEDENT make check or money order payable to: REGISTER OF gILLS, AGENT. -- zf NON-RESIDENT DECEDENT make check or money order Payable to: COHHON#EALTH OF PENNSYLVANIA. A refund of a tax credit) ~hich ~as not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131~). Applications are available at the Office of the Register of Nills, any of the Z$ Revenue District Offices or from the Departuent's Z4-hour answering service for forms ordering: 1-800-$6Z-Z050~ services for taxpayers oith special hearing and / or. speaking ne~ds: 1-800-447-30Z0 (TT only). Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revie~ Unit, Dept. 280601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. If any tax due is paid ~ithin three (~) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allo~ed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end*of the tax amnesty period. - Interest is charged beginning mith first day of delinquency, or nine (9) months, and one (1) day from the date of death, to the date of payment. Taxes ~hich became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes mhich became delinquent on and after January 1, 198Z ~111 bear interest at a rate ~hich oill vary from calendar year to calendar year oith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rote Daily Interest Factor 1982 ZOZ 1983 16X 1984 11X 1985 13X 1986 lOZ 1987 92 1988-1991 11Z .000548 .000438 .000301 .000356 .000274 .000Z47 .000501 199Z 92 .O00247 1993-1994 7Z .00019Z 1995-1998 92 .000247 1999 7Z .000192 2000 8Z .O00Z19 2001 9Z .000247 ZOO2 6Z .000164 --Interest is calculatad as fallo~s: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZEY ZNTEREST 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 sho~n on the Notice, additional interest must be calculatad. STATUS REPORT UNDER RULE"& 12 Na.me of Decedent: Date °fDeath: Will No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I.report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No 2. If'the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the/nswer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes_ No [~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an acc°unt.informally to the parties in interest? Yes [--] . No Copies of receipts, releases, joinders ~nd approval of formal or informal accounts may be filed with the Clerk of the. Orptians' Court and may be attached to this report. Si~natm:e Address Capacity: Te!ephone No. ' .... - ersonal Representative ($ P00 ~') ounsel for personal representative