HomeMy WebLinkAbout04-0282COMMONWEALTH OF PENNSYLVANrA
DEPARTMENTOFREVENUE
BUREAU OFINDIVIDUAL TAXES
DEPT 280601
HARRfSBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1162EX(11 96)
NO. CD 004735
RUPP HERBERT G JR ESQ
355 NORTH 21ST ST SUITE 205
CAMP HILL, PA 17Oll
ESTATE INFORMATION: SSN: 189-10-9017
FILE NUMBER: 2104-0282
DECEDENT NAME: PEGAN VIRGINIA I
DATE OF PAYMENT: 12/14/2004
POSTMARK DATE: 12/14/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/22/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,092.12
REMARKS:
TOTAL AMOUNT PAID:
$3,092.12
SEAL
CHECK//505
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF I I ...................... 6~1~i,~1~'1~ ~E' ~ .......................
ENNg LVAN,A REV ' 1500
BE.A.TMENTO. gEVENUE INHERITANCE TAX RETURN .....................................................
RESIDENT DECEDENT
Z
IDECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
PEGAN VIRGINIA I.
DATE OF DEATH DATE OF BIRTH
02~22-04 08!2~3/1
J(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
IN/A
ISOCIAL SECURITY NUMBER
189-10-9017
THiS RETURN MUST BE FILED IN DUPLICATE WtTH THE
REGISTER OF WILLS
ISOCIAL SECURIT~ NUMBER
1. Odgina~ Return
4. Limited Estate
6. Decedent Died Testate (Attach copy of Will)
9. Litigation Proceeds Received
N J 13 Remainder Return (aa · d d~th phc ~o 2
2. Supp!emental Return ~-s2) '
4a. Future Interest Comprise (d~te o~ death after 12-12~2) US' Federal Esiate Tax R~tum Required
N7. Decedent Maintained a Living Trust {Nt~ch a c~py~ T~us0 8. Total Number Of Safe Deposit Boxes
II J J(At-ch 8ch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
COMPLETE MAILING ADDRESS
NAME
RICHARD C. RUPP ESQ.
=)RM NAME (If Applicable)
TELEPHONE NUMBER
5
Z
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) - · (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship . (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5)
§. Jointly Owned Property (Schedule F) (6)
~] Separate SIIllng Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property (7)
(Schedule G or L)
9. Total Gross Assets (total Lines 1-7)
~). 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 Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Scheduta J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
$0.00 OFFICI~ISE ONLY
$0.00
(8)
$10,507.24
$0.00
(11)
(12)
(13)
(14)
$79,220.94
$10.507.24
$68,713,70
$6E 713 70
$0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (aX1.2) x (15)
16. Amount of line 14 taxable at lineal rate x .045 {16)
17. Amount of line 14 taxable at sibling rate x .12 (17)
18. Amount of line 14 taxable at collateral rate x .15 (18)
19. Tax DM®
~0. ~ 09)
$0.00
$68,713.70
$0.00
SO,O0
$3,092.12
Copyright 2000 David James Thorpe, Esq.
Dece~lent's Complete Address:
~ISTREET ADDRESS
CAMP HILL
Tax Payments and Credits:
Tax Due {Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C)
(1)
(2)
3. IntaresgPenalty 8 applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
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)
5. If line 1 + line 3 is greater than line 2, entar the difference. This is the TAX DUE. (5}
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
$3,092.12
$0.00
$0.00
$3,092.12
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 proper/y transferred or its income;
c. retain a revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
2. If death occurred on or before December t 2, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1 g82, did decedent transfer property within one year of death without
receiving adequate consideration? ~
3. Did decedent own an "in tr~st for" or payable upon death bank account or secudty at his or her death?
4. Did decedent own an individual retirement account, annuity, or other non-probata property?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe[~u~y, I declare that I have examined~ t~'~ur~t ' ~rn, m ' g accompanying schedules and statements, and to the best of my knowledge and belief, it is flue, con'ect, and complete.
Declaration of preparer other than the personal rapt esent~e is ba?.~j~ll the information of which preparer has any knowledge.
SIGNATURE PE S N RESPO -- G RETURN ATE
204 BEAV~F.I;~E MECNANICSBURG PA 17050
SIGN E PREP ~ AN REPRESENTATIVE
ADDRLS~S / ~'-
355 N 21s~ STREET SUITE 205 CAMP HILL PA 17011
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 statuta does no exempt atransfer to a surviving spouse fromtax, andthe statutory requirements for disclosure of assets and flling atax
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 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright 2000 David James Thorpe, Esq.
LAST
WILL AND TESTAMENT
OF
VIRGINIA L PEGAN
I, VIRGINIA I. PEGAN, of 47 Green Spring Drive, Mechanicsburg, Cumberland
County, Pennsylvania, 17055, being of sound and disposing mind and memory, do hereby make,
publish and declare this for and as my Last Will and Testament, hereby revoking any and all wills
by me at any time heretofore made.
ITEM I - I direct my Executor, hereinafter named, to pay all my just and lawful debts
and funeral expenses out of my personal estate as soon after my decease as is convenient.
ITEM II - All the rest, residue and remainder of my estate, real, personal and mixed,
wherever situate, I give, devise and bequeath to my beloved son, WILLIAM PEGAN, of
Cumberland County, Pennsylvania.
ITEM I~ - If my son BILL should predecease me, then I give, devise and bequeath
all the rest, residue and remainder of my Estate, real, personal and mixed, to my Trustee, IN
TRUST, for MARK LEITCH.
ITEM IV - I direct my Trustee, for the Trust for MARK LEITCH, to hold, invest, and
reinvest the rest, residue and remainder of my estate which is distributed into this Trust, and after
paying all the expenses necessary or incidental to the management of the Trust, to pay over or to
apply such part or parts of the income and/or principal as in my Tmstee's sole discretion, may
3_
be necessary or advisable for the maintenance, support, education, health and welfare, of MARK
LEITCH.
ITEM V - If Mark Leitch should predecease me or die during the term of his Trust,
then I give devise and bequeath the rest residue or remaider of my estate, real, personal and
mixed, wheresoever situate, or the balance of Mark's Trust, interest and principal to my neices
and nephews Colleen Viscusi, Richard Pegan, Jack Wright, Shirley Soper, Jmes Freyermuth,
Robert Freyermuth, Richard Freyermuth, Nbrma Knutson or the survivor or survivors of them,
in equal shares.
ITEM VI- All federal, state and other death taxes, payable because of my death, with
respect to the property forming my gross estate for tax purposes, whether or not passing under
this Will, including any interest or penalty imposed in connection with such tax, shall be
considered part of the expense of the administration of my estate and shall be paid from my estate
without apportionment or right of reimbursement. All such taxes on present or future interests
shall be paid at such time or times as my Executor may think proper, regardless of whether such
taxes are then due.
ITEM VII - My Executor or Successor-Executor shall have the following powers for the
administration of my estate except as limited hereinabove, in addition to those vested in him by
law and by other provisions of my Will:
A. To retain any or all assets of my estate, real or personal,
without regard to any principle of diversification, risk, or productivity.
B. To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without
restriction to investment authorized for Pennsylvania fiduciaries as
he deems proper, without regard to any principle of diversification,
risk, or productivity.
C. To sell at public or private sale, to exchange or to lease, for
any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms and conditions as he deems proper.
D. To borrow money from any person or institution including
my Executor and to mortgage or pledge any or all real or personal
property as my Executor, in his sole discretion shall choose,
without regard for the dispositive provisions of this instrument.
E. To compromise any claim or controversy.
F. To exercise any option, right or privilege granted in
insurance policies or in other investments.
ITEM VIII - I nominate and appoint my son, WILLIAM, to be the Executor of this, my
last Will and Testament. In the event that my son, WILLIAM, predeceases me or in the event
he fails to qualify as Executor, I nominate and appoim MARK LEITCIt, as the Successor-
Executor of this, my Last Will and Testament. All references to Executor herein shall also refer
to my Successor-Executor. I appoint and nominate Dauphin Depostit Bank and Trust Company
as my Trustee for this my Last Will and Testament.
ITEM IX - No bond or other security shall be required of any Executor or Trustee or
other fiduciary appointed in this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this (~e day of
~J~, 1997, at .(~//~tn/~' ~q~J , Pennsylvania.
COMMONWEALTH OF PENNSYLVANIA :
:
COUNTY OF fZLt/rl..t2.t4Jcl~n6(, :
I, VIRGINIA I. PEGAN, testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
this
Sworn or affu'med to and acknowledged before me by VIRGINIA I. PEGAN, testatrix,
(o44xdayof ~ ,19~/~
Notary Public
My Commission Expires:
(SEAL)
f'4OTA~AL ~AL
g. ATH~t'4 A. h~LU~, ~tc~ry Pubic
Camp ~ Gx~o, GumbG.-tand Co., PA
My Commld~ Expire Sept. 2~, ~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~/~/? ~L¢.~/~(~z~ '~-
SS.
We,~-~ CiaO. rd C._. ~ and WC~tcie .~-~Ro~le~b~ , ~e wimesses whose ~es
are signed to ~e a~ched or foregoing ~s~ent, berg duly qu~ified a~ord~g to law, do
depose ~d say ~t we were present ~d saw ~e ~s~ix, ~G~ I. PEG~, sign ~d
execute ~e ~ment as her Last Will; ~t she signed will~gly and ~at she executed it as her
~ee ~d vol~ act for ~e pu~oses ~ere~ e~ressed; ~t each of us in ~e hea~ ~d si~t
of ~e restock, ~G~A I. PEG~, signed ~e Will as wimesses; and ~t to ~e best of our
~owledge ~e tes~ix, ~G~A I. PEG~, was at ~e t~e 18 or. ore years of age, of
sound mind ~d under no cons~aint or undue i~e. ~ OJ~ ' - ~ ~
before me ~s G~ day 'x
of ~ ,1997. :' '-"
Notary Public
My Commission Expires:
(SEAL)
'%.
. NOTAI~AI..SI~L
C~r~p ~ ~,ro, ~,umi:.iv[cmd Co., PA
Cc~nmlntGn Ex,res ,~r4. 21, 1995
LAST
WILL AND TESTAMENT
OF
VIRGINIA L PEGAN
I, VIRGINIA I. PEGAN, of 47 Green Spring Drive, Mechanicsburg, Cumberland
County, Pennsylvania, 17055, being of sound and disposing mind and memory, do hereby make,
publish and declare this for and as my Last Will and Testament, hereby revoking any and all wills
by me at any time heretofore made.
ITEM I - I direct my Executor, hereinafter named, to pay all my just and lawful debts
and funeral expenses out of my personal estate as soon after my decease as is convenient.
ITEM II - All the rest, residue and remainder of my estate, real, personal and mixed,
wherever situate, I give, devise and bequeath to my beloved son, WILLIAM PEGAN, of
Cumberland County, Pennsylvania.
ITEM III - If my son BILL should predecease me, then I give, devise and bequeath
all the rest, residue and remainder of my Estate, real, personal and mixed, to my Trustee, IN
TRUST, for MARK LEITCH.
ITEM IV - I direct my Trustee, for the Trust for MARK LEITCH, to hold, invest, and
reinvest the rest, residue and remainder of my estate which is distributed into this Trust, and after
paying all the expenses necessary or incidental to the management of the Trust, to pay over or to
apply such part or parts of the income and/or principal as in my Trustee' s sole discretion, may
3_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF VIRGINIA L PEGAN FILE NUMBER 21-04-0282
Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must be disclosed on
Schedule F.
ITEM DESCRIPTION
NUMBER
3OMMERCE BANK
CERTIFICATE OF DEPOSIT #301595
OPENED 12/22/03
~OLARIS AIRCRAFTS INCOME
FUND Ill 20 UNITS @ $13/UNIT
BERKSHIRE INCOME REALTY
~,CCOUNT # 24218910901703-209 SHARES
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
$20,001.08
$260.00
$5,590.75
Copyright 2000 David James Thorpe, Esq.
C~MMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
CONTINUATION PAGE
SCHEDULE E
ESTATE OF VIRGINIA I, PEGAN FILE NUMBER 21-04-0282
ITEM
NUMBER
DESCRIPTION
3ANKER'S LIFE
:~EFUND OF PREMIUM
NTEREST
BANKER'SLJFE REFUND
BANKS OF NEw YoRK
PAYMENT
~ANOR CARE
REFUND
TOTAL
VALUE AT DATE
OF DEATH
$2,310.00
$1.20
$2,369.12
$4,157.00
$2,068.44
$36,757.59
Copyright 2000 David James Thorpe, Esq.
Commerce
Bank~
July 29, 2004
Rupp and Meikle
A Professional Corporation
P O Box 395
Camp Hill, PA 17001-0395
RE:
Estate of: Virginia Pegan
Social Security #: 189-10-9017
Date of Death: February 22, 2004
Dear Sir/Madam:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Checking
Account #: 032025447
Date Opened: 9/23/91
Primary Owner: Virginia Pegan
Secondary Owner: William Pegan
Date of Death Balance: $9,508.03
Accrued Interest: $.69
Principal Balance: $9,507.34
Type: Savings
Account #: 616138005
Date Opened: 9/21/00
Primary Owner: Virginia Pegan
Secondary Owner: William Pegan
Date of Death Balance: $37,767.40
Accrued Interest: $22.57
Principal Balance: $37,744.83
Commerce Bank / Harrisburg, N.A.
RO. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
Commerce
Bank
Type: Time Deposit
Account #: 301595
Date Opened: 12/22/03
Date Closed: 4/8/04
Primary Owner: Virginia Pegan
Date of Death Balance: $20,001.08
Accrued Interest: $1.08
Principal Balance: $20,000.00
If there are any questions or additional
is needed, please feel free to contact me at
ext. 3151.
Sincerely,
Wanda J. Morris
CIF Team Leader
information that
(717) 795-7118
Commerce Bank / Harrisburg, N,A,
FrO, Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
~UG-04-~O04 <ED 04:I$ ?H SE$OU~OE PHOEH!× F~X NO, 9997 P, 02
March 2004
~0LARIS AIRCRAFT INCOME FUND III
We have received you~ request for a~ market value for the limited ga,rtnership units you
own in Polari~ Aircraft Income Fund II! (the Partnership).
Polaris Aircraft In~ome Fund ill was designed as a long-term, non-liquid
orjgin0,1ty projected to last for a period oF approximately 8 to 12 years. Polasis neither
participate,~ in, nor monitors, secondary markets for these units. There is no formal secondary
market for limited partnership m~ts ~ there ]s for the buying and soiling of sto~ks and bonds.
Thus, Polaris has no rc~f~rence from which to quote a current mm'ket value for your t~mitcd
partnership units for ~y purpose, including estate valuation purposes.
In order to assist you, however, we have calculated the ~ for one uuit cf
Polaris Aircraft Income Fund III, as reflectgd in the titmncisl statements prepared as of
December 31, 2003, This value per unit is based upon the limited pruners' capital account
datcnnlneZ, in accordance with generally accepted accounting principles (GAAP) as of
December 31, 2003 and reflects an cstimat~ of asset values, which are assumed to be
dcl~rc, ciatcd using a straight-line method over the estimated economic htc of' the aircraft. The
Psctnctship periodically evaluates its estimates of the hook vaktes, residual values and thc
' 1
oconomlc lives of its aircraft and rcvisas its calculation et' depreciation expense according y.
Tho ne[ book vainc reflects certain ndjustmcuts For events that imvc occurr~ in the airline
industry, which cansed the values of the Parmcrship's aircraft to decline. (Please rcf~r to thc
partn~rship's 2003 Annual Rdpott for further discussion o£these events.) Listed below is thc
book ya]uo per unit for Polaris Aircrat~ Income Fund III: e.
· ~ Book Value Per
· $500 Unit as of
It is important to note that this computation does not purport to assign or represent the
mal'ket value for units of Polaris Aircraft Incom~ Ftmd III, and is not intended to, nor does it,
represent thc amomat th~t canbe realized in an arm's-l~ngth sale o£units.
* Tho net book value ~'n~y bo used to assist you wifl~ th~ r~'porttng requii'em~nts for
costodiam and trustees of qualifiad plans and IKAs. Please ~onsult your legal or
accounting advisor with respect to such repotting reqt~irements.
(~00) 6.52-1285
(41.5) 453-.5~i13
~U6-04-2004 ~ED 04:16 P~ RESOUROE PHOENi~ F~X NO, ~997 P, 03
TRANSFER CONFIRMATION
pOLARIS AIRCRAFT INCOME FUND III
p~evious Ti~~,lellOlder:
VIRGINIA I. I~F~GAN &
WILLIAM G. 9EGAN JTWROS
MEC~ANICSBURO, PA 17050-2501
Tax ID:
189-10-9017
Invmstor Subscription
,~,yp~'l Joinb Tenan~a
Current Titleholder:
WI~,LIAM PEGAN
· ~a~ BEAVER DRIVE
MEC~{ANICSBURG, ~A 17050
Units Transfer Dabe
20.0000 03/31/04
Tax ID:
170-42-2420
,~ nves~O3; Subscription
TyDe: Individual
Br0]¢er;
' ~I~CIA].~ S~CURITIES CORP.
~zN J ~cuso
Units S~ar~ Date
20.0000 04/01/04
~iS iZ a duplicaUe transier confirmation, if you have any
qu%stions.regarding ~his form or the information,. 9lease ¢onaact
Emile dm Vera in our Investor Relations Departmen= at (800) 652-1285.
VAN KA M P E N Confirmation Report
INVESTMENTS
Generations qf ExperienceTM
VIRGINIA I PEGAN
V/ILLIAM G PEGAN JT ~qROS
2O4 BEAVER DR
MECHANICSBURG PA 17050-2501
003243
February 26, 2004
~ Financial
Advisor
~ Access
Your Account
I~l~ On the Web
Page 1 of 2
VAN KAMPEN FUNDS
NO DEALER INFORMATION ON ACCOUNT
PLEASE PROVIDE FIRM NAME/ADDRESS
REGISTERED REP NAME/NUMBER
PENDING MO 64153
(800) 847-2424
vankampen.com
Expecting a tax refund? Talk to your financial advisor about additional investment opportunities
wxth an Kampen -- and don t forget to ask how you can have your refund deposited into your
account.
Did you misplace a tax form? Are you wondering which forms you need? Take a look at the helpful
tax form checklist in our 2003 Tax Guide. Simply go to vankampen.com and select Investor
Services/Tax Information Center.
Purchases and new accotmt applications should be sent to the addresses on their respective forms
when using USPS. If you need to send your purchase or new account application via overnight
courier, please ship to:
Van Kampen Investments
816 Wyandotte Station
Kansas City, MO 64105
Pennsylvania Tax Free Income Fund - A (VKMPX)
Fund/Account Number 58/5802148003
Account Owner V~RGINL~ I FEGAN
W/LLIAM G PEGANJT WROS
Dollar Sham SharesThis Total
Amount .'-- Price = Transaction Shares
Beginning Value as of 1/26/2004 $203.94
01/26/2004 U~t Series,f 104 Interest $13.50 $17.54
01/30/2004 Income Reinvest $0.65 $17.48
02/25/2003 Uit Series # 104 Interest $13.75 $17.33
04/30/2003 Increase Dividend Payment $0.01 $17.45
05/30/2003 Increase Dividend Payment $0.01 $17.74
07/31/2003 Increase Dividend Payment $0.01 $16.93
01/30/2004 Increase Dividend Payment $0.02 $17.48
Ending Value as of 2/26/2004 $234.59
0.770
0.037
0.793
0.001
0.001
0.001
0.001
11.627
12.397
12.434
13.227
13.228
13.229
13.230
13.231
13.231
Thank you for choosing Van Kampen Investments. Your satisfaction is important to us.
If you notice any inaccuracies on your statement, please contact us within 60 days of receiving this statement.
Confirmation of Transfer
'Berkshire Income Realty, Inc.
~USIP NUMBER
Attn: investor Services
P.O. Box 7090
Troy, MI 48007-7090
(800] 745-7094
24218910901703
084690205
002842
REG/STERED REPRESENTA TtVE
VIRGINIA PEGAN & WILLIAM G PEGAN, JTTEN
204 BEAVER DRIVE
MECHANICSBURG PA 17050
MARTIN J MANCUSO
FSC SECURITIES
3 GATEWAY CTR SUITE 1306
PITTSBURGH PA 15222-1004
Fund:
Type of Ownership:
Taxpayer I.D.:
Broker/Bank acct#:
Shares Before Transfer
Shares Transferred out
Shares Remainsng:
Transfer Effective Date:
Current Distribution Option:
Berkshire Income Realty, Inc.
JTWROS
189-10-9017
209.00000
209.00000
0.00000
02/29/2004
Cash
Registration Address: See
Please review the information printed on this confirmation. Should you have
any questions, please contact our Investor Communications Department
at (800) 745-7094.
03/03/2004
16
Confirmation of Transfer
'Berkshire Income Realty, Inc.
A ttn: Investor Services
P,O, Box 7090
Troy, MI 48007-7090
(800] 745~7094
~U$/P NU/~R EIR~KER/D~£R ~uMB~
14117042242081 084690205 002842
~EG/STE, gED REPRESENT/~ ~VE
WILLIAM G PEGAN
204 BEAVER DRIVE
MECHANICSBURG PA
17050
MARTIN J MANCUSO
FSC SECURITIES
3 GATEWAY CTR SUITE 1306
PITTSBURGH PA 15222-1004
Fund:
Type of Ownership:
Taxpayer I.D.:
Broker/Bank acct#:
Shares Before Transfer
Shares Transferred In:
Total Shares:
Transfer Effective Date:
Current Distribution Option:
Berkshire Income Realty, Inc.
Individual
170-42-2420
0.00000
209.00000
209.00000
03/01/2004
Cash
Registration Address: see
Please review the information printed on this confirmation. Should you have
any questions, please contact our Investor Communications Department
at (800) 745-7094.
03/03/2004 13
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF VIRGINIA I. PEGAN FILE NUMBER 21-04-0282
If an asset was made Joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.WILLIAM G. PEGAN SON
204 BEAVER DRIVE
MECHANICSBURG PA
JOINTLY-OWNED PROPERTY:
ITEM LETTER DATE DESCRIPTION OF PROPERTY DATE OF DEATH % OF DATE OF DEATH
NUMBER FOR JOINT MADE Includenameoffinancialins0tutionandbankaccourRnumbe¢orslmllaridentifyfngnumber. Attach VALUEOFASSET DECD'S VALUEOF
TENANT JOINT deed for jointly-hePJ real estate. INTEREST DECEDENT'S INTERES1
1. A. 9/23/91 COMMERCE BANK $9;508.03 50% $4~754.1{
CHECKING ACCOUNT#
032025447
2. A. 9/21/04 SAVINGS ACCOUNT NUMBER $37,767~40 50% $18, 883.3;
616138005
3. A. 4/01/04 VAN KAM PEN INVESTMENTS $219.83 N/A $219.8-~
FUND ACCOUNT#5815802148003
12.434 SHARES
TRANSFER INTO JOINT NAMES ON 4/01/04
A. 1995 TVA POWER BOND IN
NAME OF BROTHER
JANNEY MONTGOMERY SCOTT $37,212.00 50% $18,606.0(~
TOTAL (Also enter on line 6, Recapitulation $42,463.35
(If more space is needed, insert additional sheets of the same size)
Copyright 2000 David Sames Thorpe, Esq.
VAN KAMPEN
INVESTMENTS
~.1 {7131 438-4UD0
August 3, 2004
MR RICHARD C RUPP
RUPP AND M~JIiLE
FAXtt 1-717-730-0214
Refenmce: 00341112
Re: 58 / 5802148003
Virgiaia 1. Pegaa
William O. Pega~
Dear Mr. Rupp:
Thank you for your recent inquJxy regarding thc ~fl)ove referenced shareholders' Van
K~mpen aeeouat. In yom letter, you requested the value of the shareholders' a¢cotmt as
of the date oFM$. Pega~'s death, February 22, 2004. In addition, you requested thc date
the account was opeaed, the date the aecotm'c was made joint, and the name of the joint
owner of the ~eounL
The following is a $',mmez7 of the share balence and net asset value (NAV) J~ormation.
Since February 22, 2004, was not a business day, we have provided the account value as
of February 20, 2004, the business day prior to her death. The value of the aecotmt may
flucluat~ depending on market coadilions.
ACCOUNT # DATE SHARES NAV . ~
VALUE
58 / 5802148003 Z/20/04 12.434 $17,68 $219.83
Our mcotda indicata tI~ th~ account was established on January 17, 1989. Since thai
time, the a~count has been registexed as a joint tenant account for VirEinia I. Pegen end
Williem (L Pega~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF VIRGINIA I PEGAN
FILE NUMBER 21-04-0282
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
5.
6.
7.
DESCRIPTION
FUNERAL EXPENSES:
DICKSON'S FUNERAL HOME
MUSSELMAN'S FUNERAL HOME
FLOWERS
GROUND OPENING-COCHRAN CEMETARY
ST. MARK'S CHURCH*FUNERAL SERVICE
ST. MARK'S WOMEN'S GROUP-LUNCHEON
MINISTERS
~DMINISTRATIVE COSTS:
Pemonal Representative's Commissions
Name of Pemonal Representative(s) WIk~!~M, G. PEGAi~I
Social Secudty Number(s) / EIN Number of Personal Representative(s)
Street Address I
City State Zip
Year(s) Commission Paid:
Attorney Fees RUPP AND MEIKLE LAW OFFICES
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 Retum Preparer's Fees
PRESCRIPTION-NEIGHBORHOOD CARE RX
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
$4,880.00
$2168.00
$312.50
$295.00
$500.00
$200.00
$300.00
$4,500.00
$115.00
$236.74
$10,507.24
(If more space is needed, insert additional sheets of the same size)
Copyright 2000 David James Thorpe, Esq.
CO~IMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF VIRGINIA I. PEGAN FILE NUMBER 21-04-0282
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER Do Not List Trustee(s} OF ESTATE
I.
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
WILLIAM G. PEGAN
SON
~NTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 DOVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
100%
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LiNE 13 OF REV 1500 COVER SHEET $0.00
(If more space is needed, insert additional sheets of the same size)
FORM 16 REG.
WILLS
INVENTORY
of all real and personal estate of VIRGINIA L PEGAN
deceased, late of 1700 MARKET STREET CAMP HILL PA 17011
CAMP HILL BOROUGH
(Number and street)
who died
(Borough or Township)
02-22-04
(date of death)
(city)
,Allegheny County, Pennsylvania,
(Zip Code)
PERSONAL ESTATE SCHEDULE
SEE ATTACHED SCHEDULE
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA '~ ss:
COUNTY OF CUMBERLAND j
oeing amy ~ -- accoraing ~o taw, aeposes and says that he (~ ~
~~ o~ the ~+ate of ~/'~ '~ /~ ~ ~ ~
late of ~ ~ ~ ......... , ~umberland ~oun~, Pa., deceased and that the
within is an invento~ made by ~ ~ ~ ~ ~ ~ ~ , the said ~ ~ ~
of the entire estate of sa~d decedent, consisting of all the personal pr~y and real estate, except real ~s?te.outside
the ~ommonwealth of Pen~,sylvania, and that the figures opposite each item of the Inventory represent ~t sfatr value
as of the date of decedent s death.
.nd subscribed before me. X ~~ ~. ~~
~eeuf~r - Adm;ni~fr.fer
.19.
t Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be affached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
[
ESTATE OF VIRGINIA I. REGAN FiLE NUMBER 21-04-0282
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned w~th the right of survivorship must be disclosed on
Schedule F,
DESCRIPTION VALUE AT DATE
SCHEDUL[,
ITEM
NUMBER
3ERKSHIRE INCOME REALTY
~,CCO~NrF # 24218910901703~209 S HARES
OF DEAT~-
'(' ,$~o,OOl.O8
$260.00
$5,590.75
TOTAL (Aisc enter on line 5, Recapitulation)
(if more space is nee(leo, insert additional sheets of the same size)
Copyright 2000 David James Thorpe, Esq,
COMMONWEALTH OFPENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE
ESTATE OF VIRGINIA I. PEGAN
FILE NUMBER 21-04-0282
nclude the proceeds of litigation and the date the proceeas were received by the estate. All property jointly-owned with the right of survivorship must be disclosea on
Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
11703-209 SHARES
TOTAL (Also enter on line 5. Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Copyrigh 2000 Day d James Thorpe ~sq.
Estate of
also known as
Social Security No 189-10-9017
The petition of the undersigned respectfully represents that
Your petitioner(s), who ts/are 18 years of age or older and the executor
in the last will of he above decedent, dated June 6, 1997
and codmfls(s) dated NONE
PETITION FOR PROBATE and GRANT OF LETTERS
Virmma I. Pegan No. ~
To'
Register of Wills for the
, Deceased. County of~ m the
Commonwealth of Pennsylvania
(state relevant circumstances, e.g renunciation, death of executor, etc )
Decedent was donucfled at death in
h er last farmly or pnnclpal residence at
Camp T-I'lll PA 17011
Cumberland County, Pennsylvama, w~th
Manor Care Health Servaees, 1700 Market St
(list street, number and mumclpahty)
Decedent, then 87 years of age, died February 22
, at Manor Care Health Serwees. 1700 Market Street. Callm Hill. PA 17011
,2004_
Except as follows', decedent did not marry, was not divorced and did not have a child bom or adopted
after execution 6f the will-offered for probate; was not the rectum of a lalhng and was never adjudicated
incompetent No exceptions
Decedent at death owned property with estunated vales as follows.
If dormcfled in Pa.) All personal property
if not donucfled'ln Pa ) Personal property in Pennsylvania
If not donucfled in Pa ) Personal property in County
Value of real estate m Pennsylvama
situated as follows None
WHEREFORE, petatloner(s) respectfully request(s) the probate of the last will and co&cfi(s)
presented herewith and the grant of letters Testamentary
thereon.
dbncta)
WILLIAM PEGAN
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF O. to~,.~., ;.n.,.,z,L I ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
tree and correct to the best of the knowledge and behef of petitioner(s) and that as personal representative(s)
of the above decedent petitioner(s) will well and truly adrmmster the estate according to law
Swom to or affirmed and subscribed
before me this ~,'~,,~d day of
Register ~
Estate of VIRGINIA I. PEGAN , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW '~_~.~2.q 20Dqt , in conmderat~on of the petition on the reverse
side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated June 6, 1997
described therein be adnutted to probate and filed of reoord as the last will of Vlrgtma I Pegan
and Letters Testamentary
are hereby granted to William Pegan
FEES
Probate, Letters, Etc .. $
ShortCerhficates(6) . . $
... $ /,Coo
,7c D -~a~ $ IOoo
TOTAL $
~' ~ Register of Wills
Pochard C ATFORNEy (Sup Ct 1 D No
355 N 21st St., Ste. 205, Camp Hill, PA
17011
ADDRESS
717-761-3459
PHONE
" ' ' ~' ' / ' ' ' r~fi e f'eathdul filed with
This Is to ceru~y mat me inrormauon here given ts c/orrecuy copied from an ongmal ce t cat o a y me as
Local Registrar The ongznal cemficate will be forw?rded to the State Vttal Records Office for permanent fihng
WARNING: It ~s dlegal t duplicate this cop~/by photostat or photograph.
No Date
87
Cumberland
1700 Market St. ^CTU~
~sCamp Hill, Pa. 17011
Henry Freyermuth
William G. Pegan
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
,Female a 189 -lQ -9017 ~-22-04
Camp Hzll ~.~..~ ~}Whzte
~o.204 Beaver Dr. Mochanicsburq, Pa, 17010
~ (,~eB. 57, 2004 ~chranton Cemetery ~pchranton, Pa.
F.H. C.S Inc. 324 Humml
TIME OF DEATH
DATE PRONOUNCED DEAD (Month Day Year) WAS C~E REFERRED TO A MEDICAL EXAMINER/CORONER?
LAST
WILL AND
OF
VIRGINIA L PEGAN
TESTAMENT
I, VIRGINIA I. PEGAN, of 47 Green Sprmg Drive, Mechanicsburg, Cumberland
County, Pennsylvama, 17055, being of sound and d~sposing mind and memory, do hereby make,
publish and declare tins for and as my Last Will and Testament, hereby revoking any and all wills
by me at any tune heretofore made
ITEM I - I direct my Executor, hereinafter named, to pay all my just and lawful debts
and funeral expenses out of my personal estate as soon after my decease as is convement.
ITEM II - All the rest, residue and remamder of my estate, real, personal and m~xed,
wherever situate, I give, devise and bequeath to my beloved son, WILLIAM PEGAN, of
Cumberland County, Pennsylvama
ITEM III - If my son BILL should predecease me, then I g~ve, devise and bequeath
all the rest, residue and remainder of my Estate, real, personal and m~xed, to my Trustee, IN
TRUST, for MARK LEITCH
ITEM IV - I direct my Trustee, for the Trust for MARK LEITCH, to hold, invest, and
reinvest the rest, residue and remainder of my estate which is distributed into this Trust, and after
paying all the expenses necessary or mcldental to the management of the Trust, to pay over or to
apply such part or parts of the income and/or principal as in my Trustee's sole discretion, may
1
be necessary or adwsable for the mamtenance, support, education, health and welfare, of MARK
LEITCH
ITEM V - If Mark Leltch should predecease me or d~e during the term of his Trust,
then I give devtse and bequeath the rest residue or remalder of my estate, real, personal and
rmxed, wheresoever s~tuate, or the balance of Mark's Trust, interest and pnnc~pal to my neices
and nephews Colleen V~scusl, Richard Pegan, Jack Wright, Shirley Soper, James Freyermuth,
Robert Freyermuth, Richard Freyermuth, N6rma Knutson or the survivor or survivors of them,
tn equal shares
ITEM VI- All federal, state and other death taxes, payable because of my death, with
respect to the property forming my gross estate for tax purposes, whether or not passing under
this Will, ~ncluding any interest or penalty unposed m connection with such tax, shall be
considered part of the expense of the admimstratlon of my estate and shall be paid from my estate
without apportionment or right of reimbursement. All such taxes on present or future interests
shall be paid at such tune or tunes as my Executor may ttunk proper, regardless of whether such
taxes are then due
ITEM VII - My Executor or Successor-Executor shall have the following powers for the
admunstratlon of my estate except as hm~ted heremabove, m addition to those vested m hun by
law and by other provisions of my Will
2
A To retain any or all assets of my estate, real or personal,
w~thout regard to any pnnc~ple of diversification, rlsk, or productlv~ty
B To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without
restriction to investment authorized for Pennsylvania fiduciaries as
he deems proper, without regard to any principle of diversification,
risk, or productivity.
C To sell at public or private sale, to exchange or to lease, for
any period of tune, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms and conditions as he deems proper
D To borrow money from any person or institution including
my Executor and to mortgage or pledge any or all real or personal
property as my Executor, in his sole discretion shall choose,
without regard for the d~spos~tlve provisions of this instrument
E To compronuse any claun or controversy
F To exercise any option, right or privilege granted ~n
insurance policies or in other Investments.
ITEM VIII - I nominate and appoint my son, WILLIAM, to be the Executor of this, my
last Will and Testament In the event that my son, WILLIAM, predeceases me or in ~e event
3
he falls to qualify as Executor, I nominate and appoint MARK LEITCH, as the Successor-
Executor of flus, my Last Will and Testament All references to Executor herein shall also refer
to my Successor-Executor. I appomt and nominate Dauphin Deposnt Bank and Trust Company
as my Trustee for this my Last Will and Testament.
ITEM IX - No bond or other security shall he required of any Executor or Trustee or
other fiduciary appointed in th~s Will
IN WITNESS WHEREOF, I have hereunto set my hand and seal th~s (4, day of
~,~) ~, 1997, at (~,/~vtf//~' , Pennsylvania
4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~d. trLO-.t4dcLr~6~.
I, VIRGINIA I. PEGAN, testatrix, whose name zs s~gned to the attached or foregomg
instrument, having been duly qualified according to law, do hereby acknowledge that I s~gned and
executed the instrument as my Last Will, that I signed wflhngly, and that I signed it as my free
and voluntary act for the purposes thereto expressed
this
Sworn or affirmed to and acknowledged before me by VIRGINIA I. PEGAN, testatrix,
~44x day of ~ . 19~7./~ , ~('~ . .
Notary Pubhc ,, ......... "",,,
My Commission Expires'
(SEAL)
NOTARIAL ~
Camp H~ ~, Cu."n;~,'tancl Co., PA
My Gommhdon ~ $~pf. 21, 1998
5
COMMONWEALTH OF PENNSYLVANIA.
couNTY oF
SS
We,~-~ Cjx0.rd ~ ~o~ and WC~l~te _~ ~s0D~e_bq, , ae w~messes whose ~es
are s~gned to ~e attached or foregoing mst~ent, being duly quahfied according to law, do
depose and say ~at we were present ~d saw ~e tesmmx, V~G~IA I. PEG~, s~gn and
execute ~e ~ment as her ~st Will, ~at she s~gned wflhngly and ~at she executed ~t as her
~ee ~d volun~ act for ~e pu~oses ~erem expressed; ~t each of us m ~e hearing and s~ght
of ~e testate, ~G~A I. PEG~, s~gned ~e Will as w~tnesses, and ~at to ~e best of our
knowledge the testamx, VIRG~IA I. PEG~, was at the t~e 18 o~ore years of age, of
sound mxnd and under no comtraint or undue i~e ~ oJ ~ ~' · ~ ~
Sworn to and subscribed
before me this (~'[J6 day
of ,.J cc~e_~ ,1997
Notary Pubhc
My Commission Expires
(SEAL)
I'~OTA~IA t $E~L
Camp ~11 ~ro, Cumb~'~i Co, PA
My Comm~on Ex,ms ~i~. 21, 199~
--4
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Virqinia I. Peqan
Date of Death: February 22, 2004
Will No.
To the Register:
Admin. No. 21-04-0282
I certify that notice of beneficial interest 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 April 12, 2004:
Name Address
William Peqan, 204 Beaver Drive, Mech~nicsburg, PA 17050
Notice has now been given to all persons entitled thereto under Rule 5.6(a)
except None
Capacity:
Name
Address
X
Date: April 12, 2004
Rich~ard C. Rupp, Esquire
355 N. 21 st St., Suite 205
Camp Hill, PA 17011
17
Telephone (7~ 761-3459
·
Personal Repr nta ve ~.
Counsel for Pe~sona~
Representativ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INDIVIDUAL::f4)(ES~--
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT~ ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REY-1547 EX AFP 112-041
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-21-2005
PEGAN
02-22-2004
21 04-0282
CUMBERLAND
101
Allount Rellitted
VIRGINIA
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE~ PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rw=r!'l;,rE;C--AFP--Cfil-=6J'--Noi"ICE-OF-1NHErtI-flNCE-YAX-APPRA-isEMiN'~.ALtowlNCE-OR---.----_._-_. ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATIt OF PEGAN VIRGINIA I FILE NO. 21 04-0282 ACN 101 DATE 02-21-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Benk Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
36,757.59
42,463.35
.00
(8)
NOTE: To insure proper
credit to your account~
submit the upper portion
of this forll with your
tax paYl\8nt.
79~220.94
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts
14. Net Value of Estate Subject to Tax
(9)
llO)
10,507.24
.00
(11)
ll2)
(13)
ll4)
10.507 24
68,713.70
.00
68~ 713.70
(Schedule J)
I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax OUe
T X C TS:
NOTE:
.00 X
68~713.70 X
.00 X
.00 X
00 =
045 =
12 =
15 =
ll9)=
.00
3~092.12
.00
.00
3~092.12
DATE
12-14-2004
NUMBER
CD004735
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
3~092.12
~
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-15-2004 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
3,092.12
.00
7.48
7.48
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, 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.)
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
RUPP HERBERT G JR ESQ
355 NORTH 21ST ST SUITE 205
CAMP HILL, PA 17011
(old
ESTATE INFORMATION:
SSN: 189-10-9017
FILE NUMBER:
2104-0282
DECEDENT NAME:
PEGAN VIRGINIA I
DATE OF PAYMENT:
03/03/2005
POSTMARK DATE:
03/02/2005
COUNTY:
CUMBERLAND
DATE OF DEATH:
02/22/2004
REMARKS:
CHECK# 36988
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
REV -1162 EX(11-96)
NO. CD 005018
AMOUNT
101 $7.48
TOTAL AMOUNT PAID:
$7.48
INITIALS: JA
RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
•-) ;;'.1
BUREAU OF INDIVIDUAL. JAXES
INHERITANCE TAX DIVISION
PO BOX 280601 ...
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1607 EX AFP (03-05)
: ',.t
'...;
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-04-2005
PEGAN
02-22-2004
21 04-0282
CUMBERLAND
101
Allount Rellitted
VIRGINIA
I
,.-
RICHARlfc RUPP
RUPP & MEIKLE
355 N 21ST ST
CAMP HILL
ESQ
STE 205
PA l70ll
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................................................................................................................
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF PEGAN VIRGINIA I FILE NO.21 04-0282 ACN 101 DATE 04-04-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-21-2005
PRINCIPAL TAX DUE: 3,092.12
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-14-2004 CD004735 .00 3,092.12
03-02-2005 CD005018 7.48- 7.48
TOTAL TAX CREDIT 3,092.12
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
lIE IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
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STATUS REPORT Ul\il)ER RULE 6,12
Name of Decedent: V,'rl"/) "a:.- T Pl?r/1
Date of Death: C:;/e2 ;1.) ~o 0 ~
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Estate 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. St~h er administration of the estate is complete:
Yes No 0
\
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. .;:.~!J per:o~=tative file a final account with the COurt? .
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the per~esentative state 8.1"1 account informally to the pa.."iies in
interest? Y e~ No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
Date: Df J ''7--i;btOtbiSrepart. ~ t
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Name
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/13/2006
RUPP HERBERT G JR ESQ
355 NORTH 21ST ST SUITE 205
CAMP HILL, PA 17011
RE: Estate of PEGAN VIRGINIA I
File Number: 2004-00282
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
2/22/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~"~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
JUd.ge