HomeMy WebLinkAbout02-0048PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of' ~~ ~va-~ NO.
also known as To:
21-02-48-
Register of Wills for the
Deceased. County of ~UI~ERLAND in ,the
Social Security No. /~_6--0 '7 -A//~ ?~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or.older, appl / 6 5
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the aiSove decedent. '.
Decendent was domiciled at death in C/72z~t J/,~t~t~t .~_ ' County, Pennsylvania, with
h ~ last family or principal residence at-~
(list street, n~nber' and municipality)
Deqon~ent, the. tn 9/ ~ge,_died ~2e~L~ ~z,~,e/t_~ -. ,~, 7~t'~ , ~9 ~7~ /
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal. property in Pennsylvania $
(If not'~lb~_miciled in Pa.) PersOnal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner.__
the following spouse (if any) and heirs:
after a proper search ha ascertained that decedent left no will and was survived by
N me
hip
THEREFORE, ';15etitioner(s) respectfully request(s) the grant of letters of. administration in the
approprmte form tO t-he:undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1. ss
COUNTY OF CUMBERLAND
The petitiofier(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) 'of the above decedent petitioner(s) will well and
truly administer "the-es'tale.according to law.
Sworn to or affirmed, a~ subscribed
before me this . llt'~-.~ dayof
~- / '/ ._./-. ~- -~-..~
No. 21.--02-48
Es~te of~ ~_ FLORENCE ~XTTXNCTON , Oecease~]
,;;~<~" ~.~ ~ G~NT OF LETTERS OF AOMINIST~TION
m ~D NOW ...~, J~U~Y 16 ~[2002 , in consideration of the petit on on
~evers~de h~ satisfactory proof having been presented before me,
~S DE~EED~ ~CY ~ GIBBO~S ~D JE~ ~ GROSS
is/are entitled to Letters of Admiffistration, and in accord with such finding, Letters of Admmmtrat~on
"are herebygranted to ~CY ~ GIBBO~S A~D JE~ ~ GROSS
in the estate of FLORENCE ~ITTINGTON .:~
FEES
Letters of Administration ..... $ · 18.00
Short Certificates( ) .......... $ 3.00
Renunciation ..... ; .......... $
JCP $ 5.00
TOTAL __ $ 26.00
Filed .... 1.-.1,6-. ......,... '.. A.D.
/ / ~.R~gi~ fer.; f :.W/'ills'
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
105.805 REV 9/86
DECEDEN'I~S USUAL OCCUPY*ION <
-:x?/f ,~; .~f:/, x , "U.S. ~MED FORCES?
~., ;~,~;-;, :'
......... Y P , ccurred at thellme dale and lace anddue o he
STATUS REPORT UNDER RULE 6.12
Name of Decedent: >~~~
Date of Death: /2~n~l
Will No. ~/-0~-00~ Admin. No.
Pursuant to Rule 6.12 of the SuPreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State wh~ther administration of the estate is complete:
Yes .~/ No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes v No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative stat~' an
account informally to the parties in interest? Yes v No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: i//~/~DO~
S~natu~re
Name (Please type or print)
Ad~ E~s s
Capacity:
__Personal Representative
__Counsel for personal
representative
(MAH:rmf/AM3)
IN TIlE BJ~TTER OF
Sara }~. Whittinqton
~m I ncompet'.ent:
IN THE COURT OF COB3~ON PLFo%$
CUBBERLA~D COl~'rY, PENNSYLVANIA
ORPHAI{S' COURT DIVISION
No. 507 Orpl)a~s 1978
and after
}{earing in open Court and after Proof of service upon the
]ncompetent and off Notice to the I~competenE.'s ne×t-of-kin, it is
ORDERED and DECREED that Bonita J. Stahl, Guardian of {she Estate
of Sara M. Whittington shall change the beneficiary on all {she
life insurance policies of Sara 14. Whittington to "Estate of Sara
M. Whittington" snd to change the following policies.ii0 rec~uced
pa~d-up policies: 1.--Policy number 00W0749355, 2.--policy number
0078266624, and 3.--policy number 0079366340.
BY ~HE C?URT:
A TRUE COPY FROM R'ECORD
In T(4.':imony whareof, I hereunto set. my h~nd
and the ,,.~eal of :;.~id Cc, urt at C~riisle, PA.
'"""2:~' "':'::'""?"'"' "-" ' "ih"s ..... / ~ ~ "' ~' ";-r~ .-- 199 a
:.
::,.:....:..:..,.. ......... :.... ,: .. ~:<:~_~-:
~---:-..._.:......'..'__..: ..... ... ...... ,~..,, ~-'
Cure'and
~unW
COMMONWEALTH OF PENNSYLVANZA
NO TICE OF CLAI/~
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
ORPHANS' COURT DIVI:SION
Re: The Estate of:
Court File No: 21-02-48
FLORENCE WHITTINGTON
Deceased
TO: THE CLERK OF THE ORPHANS' COURT DlVZSZOl~otice of claim by
creditor, Pursuant to Section 353:2(b)(2) of the Probate, Estates, and Fiduciaries
Code, 20 PA.C.S.A. §3532(b)(2).
1) Claimant's name: SEARS, ROEBUCKAND CO.
2)
Claimant's address: C/O BALOGH BECKER LTD, 4150 OLSON MEMORIAL 11200
MINNEAPOLIS MN 55422
8887629997
3)
Credito~ listed below is the owner and holder of a claim in the amount of
$, 610.24
4)
The facts upon which this claim is based is an account for credit evidenced by the
attached Affidavit of Account Stated.
5)
6)
7)
Decedent's address: 500 FRONT ST ENOLA PA 17025
Date of Death: / /
That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by.
On behalf of the claimant, ! do solemnly declare and affirm under the Penalties of
per-jury that they Information and representations made herein are true and correct
to the best of my knowledge, information and belief.
Dated: .Z/'-~Z/~--~-~'~ _//~__~ ~,
Claimant Angela ~. Ho~, Roebuck and Co.
Written notice of claim was given to Personal Representative and/or his~her counsel
as stated below:
NANCY GIBBONS
Name
500 FRONT ST
Address
WEST FAIRVlEW PA 17025
City/State/Zip
se~ a ,e~da_vt4.
Date notice mailed
IN RE ESTATE OF: FLORENCE WHITTINGTON
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
o
Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit.
Your Affiant has reviewed the account records of the (~laimant with respect to the
decedent. Your Affiant is familiar with these records and accounts and reviews them as a
regular part of her duties.
The Decedent purchased merchandise in the amount of $610.24 evidenced by account
number 5484126609693.
The unpaid balance does not include any late payment charges, accrued interest,
collection costs or attorney's fees.'
Further your affiant sayeth not
Gary W. Becker__
Michael C. Conn
Chelsea A. Jagusch
Angela M. Horn ~
Balogh Becker, Ltd.
4150 Olson Memorial Highway., Suite 200
Minneapolis, MN 55422-4804
(763) 852-8440
Subscribed and sworn l~efore~ me
This ['O'l~l day of~, 2002.
717:td 9t ~]d~ Z0,
LAW FIRM.-.
BAL0 'H BEcKER,
.lAMES A. BALOGH - MN
GARY W. BECKER - DC, FL, IL, MN, WI
MICHAEL C. CONN - MN
CHELSEA A. JAGUSCH - MN, WI
ANGELA M. HORN - MN
4150 OLSON MEM6RIAL HIGHWAY, ~OITE 200
MINNEAPOLIS, MINNESOTA 55422--4804
TELEPHONE 763-852-8440
FAX 763-852-8499
TOLL-FREE 888-762-9997
04/03/02
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE, #102
CARLISLE, PA 17013
OF COuNsEL:
LIIOW LAW OFFICES, P.O.
(IOWA)
LUSTIG, GLASER & WILSON, P.C.
(MASSACHUSETTS)
Re:
In the Estate of
Probate Case No.
Social Security No:
Last known residence:
Our Client:
Account Number:
Amount of Debt:
FLORENCE WHITTINGTON
21-02-48
195074673
500 FRONT ST ENOLA PA 17025
SEARS, ROEBUCK AND CO.
5484126609693
610.24
Dear Sir or Madam:
Enclosed please find a Creditor's claim to be filed in the record with the above-referenced Estate.
Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you
for your as:Sista~ce.' If you Mve any questions or concerns, please call our firm toll free at 1-888-762-9997.
Sincerely,
/s/Chelsea Jagusch
Balogh Becker, LTD
Attomey for Claimant
PCRTCOV
Enclosures
Ifapphcable, a check for the filing fee
cc: Attorney for Estate
personal Representative. ' ' '~ '
This communication is fxom a debt collector.
.' '"~' .~ t.c ~ ' '. . ,"': t ~ ' ~' .:',.-',"~ ~-?. ',:~
Name of Decedent:
Date of Death:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Will No. Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of thq Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on //.~//~OO~ ·
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Address
Telephone (711) 73~
Capacity: ~Personal Representative
__Counsel for personal representative
IMPORTANT NOTICE ·
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be deter-
mined wholly or partly by the decedent's will. If the decedent
died without a will, whether you will receive any money or prop-
erty will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, C.OUNTY OF CUMBERLAND, CARLISLE, PA
In re Estate of ~;~ ~,~_9 , deceased,
Estate No.
(Name and Address)
TO:
Please take notice of the death of decedent and the grant 0f letters to the personal representative(s) named below.
The Decedent ~.~-t.~ 'ZA~~ ,
dayof 'A(~~-t.~'.~' ,,,2t~O! ,at ~~ '~.County,
Pennsylvania.
, died on the ~,~t9 ~
The Decedent died testate (with a Will); or
The Decedent died intestate (without a WilD.
The personal representative of the Decedent is
(name, address and telephone number).
If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1
Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the
Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa.' 17013. Phone No. 717-240-6345
A copy of the Will or Petition may be obtained by contacting the Register of Wil!s and paying the charges for duplication.
Date: !//at J,,Ttg~,4 Signature: _~_tg~.z~3~ ~. j~~.~
Name (Print) 3//~'t' ~/ /2/. ~, J,~4//.-~
Address .6-ff-~ /~'4~A/~' x~
Telephone (~'/7) t~.3'~2- ~ q/
Capacity: 4ffersonal Representative
Counsel for per;sonal representative
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: c~57q'r~,q//'~ .,,- _ ~ ~. '. J-67~_._~
Date of Death: /~.7./.4e /2 ,/,~dT ~ /
WiliNo. _ ,7~-~- ~>0~ W~-~--'/TZ~ Admin. No. r~rt;~- '~
To the Register:
I certify that notice of (beneficial interes0 estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on :
Name Address
Notice has now been given to all personS entitled thereto under Rule 5.6(a) except
Date:
Name
Address
Telephone
Capacity: ~ Personal Representative
__Counsel for personal representative
Address ,g)~t~ /c'-~.tr/qZ ~-
Capacity: JPersonal Representative
__Counsel for personal representative
JRD/June 30, 1992/17858
~IAY 1 6
In Re: Estate of Florence Whittington
Late of
Estate No.: 21-02-00048
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Jean W. Gross
Counsel for Personal Representative:
Date of Grant of Original Letters: January 16, 2002
Date of Delinquency Notice: April 26, 2002
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named .counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 4-26, 2002, and that the ten (10)
day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the
Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a
hearing to determine whether sanctions should be imposed upon the delinquent personal
representative or counsel for the delinquent personal representative.
Date: May 15, 2002
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A heating is scheduled for ~6,,~ ~d,7~ at ~73d ~,~,In Courtroom No. 3. If the
Certification of Notice is filed prior to the hearing date, the hearing will automatically be
cancelled. Geor~--
JRD/June 30, 1992/17858
UAY 1 6 2002
InRe: Estate of Florence
Late of
Estate No.:21- 02 - 00048
Whittington
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), suPREME COURT
ORPHANS' COURT RULE
Personal Representative: Nancy W. Gibbons
Counsel for Personal Representative:
Date of Grant of Original Letters: danuary 16, 2002
Date of Delinquency Notice: April 26, 2002
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the' personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 4-26,20 02 , and that the ten
(10) day notice to file the certification has expired. Accordingly, 'in accordance with Rule 5.6(e)
the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: May 15, 2002
Personal Representative
Distribution:
(Ma~ C. LewiS, Register 0f Wills ' - (/ d
Counsel for Personal Representative
Estate File '
A hearing is scheduled for O~7-d''~' ~' ~ at ?.,'~¢~,,~,,~/In CourtroOm No. 3. If the
Certification of Notice is filed prior to the hearing date, the h~be
cancelled.
George E~. I~.ffer, P.J.
R~'~ ~0 EX
;'(' ' ~'~ COMMONWEALTH OF
PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA, 17128-0601
I--
Z
U.I
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ·
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND.MIDDLE INITIAL)
OFFICIAL. USE ONLY
FILE NUMBER
;).t
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER oF WILLS
SOCIAL SECURITY NUMBER
~/'~. Original Return
[~4. Limited Estate ·
r---~ 6. Decedent Died Testate (Attach copy of Will)
E~9. Litigation Proceeds Received
[~2. Supplemental-Return -
E~4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Aaach copy of Trust)
[~] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
r---i 3.. Remai'nde'f Return (date of death pdor to 12-13-82)
E~]5. Federal Estate Tax Return Required ,
~ 8.'Total Number of Safe Deposit.Boxes
---]11. Election to.tax under Sec. 9113(A) (Attach Sch O)
1. Real Estate (Schedule Ai
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4: Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
i~1 Separate Billing Requested
7. Intar-Vivos Transfers & Miscellaneous Non-Probata Property
(Schedule G or L)
9.
(1)
(2)
(3)
14.
(4)
(5) .
(6)
(7)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liab!lities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 6 minus Line 11)
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has.not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0.__
16. Amount of Line 14 taxable at lineal rate ~---~.-~4°~'3 '4~") 7 x.0 __
17. Amount of Une 14 taxable at sibling rate '. '~.~'~"3 Z~-~~- 7 x.12
18. Amount of Line14 taxable at collateral rate / 2/'~5"~1"f') 7 x.15
19. Tax Due
(15)
(16)
(17)
(18)
(19)
Decedent's Complete Address:
STREET ADDRESS
Tax Payments and'Credits:
.1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A.' Spousal Poverty Credit
B. Prior Payments
C. ·Discount
ISTATE
Interest/Penalty if applicable
D. Interest . . ·
E. Penalty
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
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
(3)
(4)
If Line-1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5).
A, Enter the interest on the tax due. " (5A)
B. Enter the total of Line 5 ~- 5A. This is the BALANCE BUE. (5B)
· -' Make Check Payable to: REGISTER OF WlLLS~ AGENT
-PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X','. IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retainthe use or income of the property transferredi .......................................................................................... []
b. retain the right to designate who shall use the property transferred or its income; .......... i .......... : ...................... []
c. retain a reversionary interest; or ....................................................................................................................... ;.. [~-
· d. receive the promise for life of either payments, benefits 0r care? ...................................................................... []
2. · If death occurred after December' 12, :1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. []
3. Did decadent own an "in trust for" Or payable Upon death bank account or security at his or her death? .............. []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ' ' ' []
-IF THEANSWERTO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT
AS PART OFTHERETURN.
Under penalties of periury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete.
Declaration of preparer other than the personal representative is b~sed on all informatioh of.which preparer nas any knowledge· :
SIGNATURE OF PERSON RESPONSBLE F. OR FILING RET, URN ..
ADDR'ES~,S .. ~,.. / -.~ - / , ·
SIGNATURE OF PREPARER O~ER THAN REPRESENTATIVE
DATE
ADDRESS
· For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) (i)].
~ For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116.(a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory.requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use'of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) !72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of. transfers to or for the use of the decedent's siblings is-i'2% [72 P.S. §9116(a)(1-.3)]. A sibling is defined, under Section 9102,~ as an
individual who has at. least'one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX * (1-97} ~ ~ ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF ,..~~ ~ FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All propeAy jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER ' DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 5, Recapitulation) $. "~,-~.
(If more space is needed, insert additional sheets of the saroe size)
REV-1511 EX+ (12-99) ~'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
on Schedule 1.
~-~ ~ decedent must be reported
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State__Zip
Year(s) Commission Paid:
Attorney Fees
.Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State__Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
TOTAL (Aisc enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX *
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
· ESTATE OF
Include unreimbursed medical expenses.
FILE NUMBER
ITEM
NUMBER DESCRIPTION AMOUNT
1.
.. TOTAL (Also enter on line 10, Recapitulation) $ ~1~::7,0"~
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (1-97} ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
FILE NUMBER
RELATIONSHIPTO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART ]]. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additiona!;-sheets of the same size)
,7.~R ,:oc, o'¢d ea- ' ;:
':'," Ft,~gister ~-,
6.1
,:.:"02 jIIN-6 p3:,:tO
kT UNDER RULE 6.12
I
Admin. No. ~- OOO
;
i2 of the Court
Supreme
Orphans'
lowing with respect to completion of
'~e-captioned estate:
tdministration of the estate is complete:
~!s' No, state when the personal
iieves that the administration will be~
!!o No. 1 is Yes, state the following:
i?rs o~a 1 representative
.... ':~'! ¢' No__.
;lII~l'i/. s account is:
'~-~'" _=rsonal representative stat~/~n
~'~,'~-.'.-:-.-T-~r.]~_ ?rties in interest? Yes ~' No
a'c'c'ou'n~-----r,---~,'~-,,,~-~-~-3--~
file a final
(if any) for
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
N~ (/Please type or print)
Address
Te'l. No'.
Capacity: ~_ Personal Representative
__Counsel for personal
representative
'(MAH:rmf/AM3)
BUREAU OF INDIVIDUAL TAXES
INHERTTANCE TAX D/VISTnN
DEPT. 180601
HARRISBURG, PA 17118-0601
NANCY W GIBBONS
500 FRONT ST
WEST FAIRVIEW
CONNONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR D/SALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
~ ~,:~:., L?; Ci: ~' 'i, ii? ESTATE OF
DATE OF DEATH
FILE NUHBER
'02 BEC 20 R2:02 C0UNT¥
ACN
PA17025' '" ...... " ....
1Z-Z3-ZOOZ
WHITTINGTON
1Z-ZO-ZO01
21 02-00q8
CUHBERLAND
101
Amoun'l: Remi*~ed
REV-1547 EX AFP (01-02)
FLORENCE
HAKE CHECK PAYABLE AND RENIT PAYHENT TO=
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"~
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF WHITTINGTON FLORENCE FILE NO. 21 02-00q8 ACN 101· DATE 12-23-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL. RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
5. Closely Held S~ock/Par~narship In~eres~ (Schedule C) ($)
~. Not,gages/No,es Receivable (Schedule D) (fi)
5. Cash/Bank Deposits/Misc. Personal Propar~y (Schedule E) (E)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exponsas~Adm. Cos~s/Misc. Expenses (Schedule H) (9)
10. Dab,s/Mortgage Liabili~1as/L1ens (Schedule I) (10)
11. To,al Daduc~ions
12. Ne~ Value of Tax Re~urn
.00 NOTE: To insure proper
~ .00 credi~ ~o your account,
.00 submi~ ~he upper portion
.00 of ~his for= wi~h your
700.00 *ax payment.
.00
.00
(8)
3,583.00
600.00
700.00
15.
1~.
NOTE:
(11) ~. 18S. oo
(12) 3,~83.00-
Charitable/Governmental Beques*s; Non-elec~ed 9115 Trusts '(Schedule J) (15)
Ne4: Value of Es~a~e Sub~ec~ ~o Tax (1~)
If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
.00
3,q83.00-
18 and 19 will
ASSESSHENT OF TAX:
15. Amoun~ of Line 1~ a~ Spousal ra~e
16. Amoun~ of Line 1~ ~axable a~ Lineal/Class A ra~a
17. Amoun~ of L/ne lq a~ Sibling ra~a
18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~a
19. Princi)al Tax Due
TAX CREDITS
PAYMENT RECEZPT
DATE NUHBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
(15), .00 x O0 = O0
(16). .00 x 0~5= .00
(17) .00 x 1Z = .00
(18) .00 x 15 = .00
(19)= . O0
AHOUNT PAiD
TOTAL TAX CREDZT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
.00
( IF TOTAL DUE ZS LESS THAN ~1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on 'or before December 1Z, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collatmral) beneficiaries of the decedent after, the'expiration of any estate for
life or for years~ the Cenmonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laeful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 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 ems net requested on the Tax Return, may be requested by completing an ~Application '
for Refunder Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office '.
of the Register of Hills) any of the Z3 Revenue District. Offices) or by calling the special Z4-hour
a~swaring service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-D00-447-30Z0 (TT only), '.
Any party in interest not satisfied with the appraisement, ~11omance, or disalloaance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by: (
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021)'Harrisburg) PA 17118T1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphaqs' Court.
Factual errors discovered on this assessme~t should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes) ATTN: Post Assessment Review Unit, Dept. 180601) Harrisburg, PA 17128-8601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-ZEN1) for an explanation of administratively correctable errors. ..
If any tax due is paid within three'(3) calendar months after the dece~ent's death) a five percent (5z) discount of
the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the totml of the tax and interest assessed, and not
paid before January 18) 1996, the first dpy 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 (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 (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after -
January 1) 1981 will bear interest at a rate which will vary from calendar year to calendar year mith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOOZ are:
Year Interest Rate Daily Interest Factor
m
1982 20Z . 000548
1983 161 .000438
1984 117. .000~01
1985 131 .000356
19D6 101 .000Z74
1987 9Z .000147
1986-1991 i17. .000301
--Interest is calculated as'follows:
/NTEREST = BALANCE OF TAX UNPAZD
Year Interest Rate Daily Interest Factor
m
1992 97. .ooo147 .,,
I993-I994 77. ;oooI92
I995-1998 97.
I999 7~
2000 8Z .000219
ZOOl 9Z : .000Z47
ZOOZ 67. .000164
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
-. beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must b~ calculated.