HomeMy WebLinkAbout04-0275
FAMILY SETTLEMENT AGREEMENT
ESTATE OF J. BART CASEY
A.K.A. JOSEPH B. CASEY
DATE OF DEATH: 03-14-2004
CASE NO. 21-04-275
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FAMILY SETTLEMENT AGREEMENT
AGREEMENT TO INDEMNIFY, RECEIPT, TRANSFER AND RELEASE
THIS AGREEMENT by and between MICHAEL JOHN CASEY, individually and as
Executor of the Estate of J. BART CASEY (A.K.A. JOSEPH B. CASEY), and, ROBERT CASEY,
son and beneficiary of the Estate of J. BART CASEY, and KATHLEEN ANN CASEY, daughter
and beneficiary of the Estate of J. BART CASEY.
WHEREAS, J. BART CASEY who resided at 1805 Dighton Street, Camp Hill, PA 17011
died on March 14, 2004, and:
WHEREAS, MICHAEL JOHN CASEY was duly appointed Executor of the Estate of J.
BART CASEY, deceased, at Estate No. 21-04-275;
WHEREAS, the parties in interest under the Last Will and Testament of J. BART CASEY,
deceased, are his three children, MICHAEL JOHN CASEY, ROBERT CASEY, and KATHLEEN
ANN CASEY and;
WHEREAS, with the exception of the house and land located at 1805 Dighton Street, Camp
Hill, Pennsylvania, which will be signed over to KATHLEEN ANN CASEY in her sole name, the
parties hereto are entitled to receive one-third (1/3) share ofthe decedent's remaining estate; and;
WHEREAS, it is the desire of the parties to this Agreement that final distribution of this
estate to be accomplished without a formal hearing or accounting to the Orphans' Court Division of
the Court of Common Pleas of Philadelphia County, it being the desire of the parties to avoid the
expense, delay and publicity of a formal accounting.
Page 1 of3
NOW THEREFORE, WITNESSETH, in consideration of the mutual promises, covenants
and agreements recited herein, the parties do agree as follows:
1. The Executor has now completed the execution of the Estate, including paying all the
known debts owed by the decedent as of his death and all the administration expenses incurred
during the course of the Estate; filing the required final Federal and Pennsylvania income tax returns
for J. BART CASEY and paying all income taxes, if any, owing thereon; and filing on behalf of the
Estate the Pennsylvania Inheritance Tax Return and paying all such taxes due by the Estate.
2. The Executor has caused to be prepared an Inventory which has been filed with the court,
a true copy of which is attached hereto as Exhibit "A". The Inventory sets forth all the property
owned by J. BART CASEY as of his death.
3. Michael John Casey hereby acknowledges distribution of the interest in the assets
contained in the attached Inventory which is incorporated herein by reference.
4. The above named Beneficiaries acknowledge that they are over the age of 18, are
mentally competent, and are capable of understanding and entering into a legally binding agreement.
5. The Beneficiaries agree that to the best of their knowledge, information and belief, the
statements of fact set forth in the preceding paragraphs are true and correct.
6. The Beneficiaries acknowledge that they have reviewed the attached Inventory and
thereby accepts it as a true, accurate, and complete Inventory by the Executor.
7. Each party to this Agreement acknowledges that this Agreement shall be indexed and
recorded in the estate proceedings and that the terms hereof shall be binding upon their respective
heirs, successors, administrators and assigns.
Page 2 of3
~ '. ~
8. The parties to this Agreement do hereby agree to indemnify and release and forever
discharge Michael John Casey, Executor, from any and all liability which may from time to time
arise in connection with his service as Executor of the Estate of J. BART CASEY, deceased. The
party forever discharges Anthony T. Floro, Esq., from any and all liability which may from time to
time arise in connection which his services as Attorney to the Estate of J . BART CASEY, deceased.
9. This Agreement shall be governed by the laws of the Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, the Beneficiaries to the Estate of J. BART CASEY have
affixed their signatures to the following pages.
Witness:
Date
\~>u),,-~D~ _
~/oj( of
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6'!c'f3!D5'
-N..w~~
fj(03!CJj
~'Le.LL-J if j ~)
I- Jr-vY
Page 3 of 3
/ Mv ~A/J11
ichael John asey, son, ~V
mdividually as Executor of the Estate
of J. BART CASEY
Kleen Ann Casey, ughter
~
AnthonyT. Flor , Esq.
"
"
PETITION FOR PROBATE and GRANT OF LETTERS
,a,e o: T' '4,4t" ddSx'y No
also known as ~fO~c~t ~' d~y To.
, Decea*ed
Soctal Security No /~/~ ~ /~ -/~
Register of Wdls for the
County of
Commonwealth of Pennsylvama
The petxt~on of the undersigned respectfully represents that
Your petmoner(s), who ~s/are 18 years of age or~ older an the ex.ecut
tn the last wd] of the above decedent, dated
and cod~cd(s) dated
~n the
namedt
,19 '~
h { ~ last famdy or pnncipal residence at/.o°oc' O/t~//'7~A/ ~'~! C%q~/~ ~/~[~
Except as follows, decedent d~d not marry, was not chvorced and d~d not have a chdd born or adopted
after executmn of the wdl offered for probate; was not the 'nct~m of a kdhng and was never adjudicated
i~n.~dmpetent ·
Do:endent at death owned property wRh estimated values as follows :
(If dom]cded ~n Pa.) All personal property $
(If not domiciled m Pa ) Personal property m Pennsylvama $
(If not dom~cded ~n Pa ) Personal property m County
Value of real estate m Pennsylvama $
muated as follows
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and cothcd(s)
presented herewith and the grant of letters
theron
(testamentary, adm~stratlon c t a, admlmstratlon d b n c t a )
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAlth O,V
COUNTY OF ULkPC~~ J
The peutioner(s) above-named swear(s) or affirm(s) that the statements m the foregoing petition are
true and corr~:t to the beat of the knowledge and belief of petitioner(s) and that as personal represen-
~ well and.truly admwaster the estate according to law
tatlve(s) of the a_,bove d cedent p?tloner(s) wtll
Sworn to or~.-~ffi~ued ~and
before me this
PETITION FOR PROBATE and GRANT OF LETTERS
Esta{e of No
To
also,own as
Register of Wills for the
~ , Deceased County of
Social Se~u{lty No _ Commonwealth
The petltlOnxof the undersigned respectfully represents that
Your petitioner(s), who is/are 18 years of age or older an the execut
the last will of X~e above decedent, dated
and codicil(s) dat~
the
named
,19
Decendent was domlcdedXat death ~n
h last family or prm~pal residence at
(hst street, number and
Decendent, then year, of age, d~ed
at
Except as follows, decedent did not'marry,
after execution of the will offered for probate,
incompetent'
Decendent at death owned property
(If domiciled in Pa ) All person~k
(If not domiciled In Pa ) Personal
(If not domiciled In Pa ) Personal
Value of real estate m Pennsylvania
situated as follows
ere )
', Pennsylvama, wxth
and d~d not have a child born or adopted
was ~ : the v~ctlm of a k~llmg and was never adjudicated
values as follows
$
In Pennsylvania $
In County $
$
theron
request(~xthe probate of the last will and codicil(s)
WHEREFORE,
presented herewith and the of letters '~
(testamenta~,xadmxmstrat~on c t a, adm~mstratxon d b n c t a
\
OATH OF PERSONAL REPRESENTATI' E
~EALTH OF PENNSYLVANIA
OF
~er(s) above-named swear(s)or affirm(s)that the statements la the foreg~mg petition are
.~ct to the best of the knowledge and belief of petitioner(s) and that as per~nal represen-
the above decedent petitioner(s) will well and truly administer the estate according to law
Sworn to or
before me this
affirmed and
subscribed
day of
19.__
Regtster
REGISTER OF WILLS OF "'"'x COUNTY
OF SUBSCRIBING~
codicil ~lf~l according to
(each) a ng wltness~ thatt° the will --(each) being duly q prese~
saw
~est of testat_ in . presence and On the presence of h other) (in the presence of the
~other ~bmg witness(es)) %
Sworn to or a~rmed and subscribed bef __ _
me th~s 'N,. day (Name)
(Address)
Regtster
(Name)
(Address)
REGISTER OF WILLS OF ~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
~x~ ~ famlhar with the signature of-~.'~i;~NC~''
codicil
testatOC' of (one of the subscribing w~tnesses to) the ~l~ presented herewith and
codlcd
that '~eXALk~ ~ believes the signature on the will is in the handwriting of
%
to the best of ~'-T~'uL'l sa. knowledge and belief
Sworn to or affl£med and subscribed before
me this . c./],~'.~r~ ~ day of
(Name)
(Address)
RENUNCIATION
In Re Estate of
To the Reg:ster of Wills of
deceased
/
C~. ~ L ~d County. Pennsylvania
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
he issued to
WITNESS hand this day of ., 20__
(Address)
(Stgnature)
(Address)
(Signature)
(Address)
V~ ' oo PLIelJgqulIiO
1Jno.o S u~cud. C -H~,%9
hru is to cemfy that the Lnformatmn here given ~s correctly cop~ed from an original cemficate of death duly filed w~th me as
Local Registrar The original cemficate wall be forwarded to the State Vital Records Office for permanent fihng
WARNING' It ~s illegal to duphcate th~s copy by photostat or photograph.
Fee for this certfficate. $2 00
P 10181146
No
CERTIFICATE OF DEATH
LAST
WILL AND TESTAMENT
OF
J. BART CASEY A/K/A/ JOSEPH B. CASEY
Ii ]. ~BAR~'CASEY A/K/A/~ JOSEPH B. C~SEY, of the
Commonwealth of Pennsylvania, being of sound m~nd, memory and
understanding do hereby make and declare th~s my last w~ll and
testament thereby revoknng all prior w~lls and codicils
heretofore made by me.
FIRST: I d~rect that my executor hereinafter named,
to pay and d~scharge all my legal debts and funeral expenses.
SECOND: I g:ve, devise and bequeath unto my beloved
wmfe, MARY PICHOLA CASEY, all the rest, residue and remainder
of my property, of every description, real, personal and mnxed,
of whatsoever k~nd, nature and description or wheresoever
s~tuate, of wh:ch I should d~e senzed or possessed, or to which
at the t~me of my death, I may be entitled.
THIRD: In the event that my w~fe, MARY PICHOLA CASEY,
should predecease me or d~e w~th~n thirty (30) days from the
date of my death, then and ~n that event, I g:ve, devise and
bequeath unto my beloved children, per st~rpes and not per
capita, all the rest, resmdue and remainder of my property,
of every description, real, personal and mnxed, of whatsoever
kmnd, nature and descr~pt:on or wheresoever s:tuate, of which
I should d~e seized or possessed, or to which at the t~me of
my death, I may be entitled. If any chnld of m~ne should
predecease me and leave no l:v~ng ~ssue, then and ~n that event,
hns or her share shall pass to my remaining chnldren, equally,
per st~rpes and not per capita.
Page 1 of 3
My Executor shall represent any m~nor child ~n any
d~v~s~on of such property and may delmver the share of any m~nor
child to the person having custody of such child, w~thout bond,
and accept the receipt of such person as full satisfaction.
Th~s property should be d~strmbuted among them as they
shall mutually agree, or nn the absence of such agreement, as
my Executor or gxecutrnx, as they case may be, ~n h~s or her
sole d~scret~on, shall deem advisable, making such d~str~but~on
· n as nearly equal shares as possible.
FOURTH: In addition to the powers conferred by law,
my Executor shall have the d~scret~onary power to retain for
d~str~butnon ~n k~nd, w~thout duty of d~vers~f~cat~on, all
property owned by me at my death, or to sell all or any part
of such property, upon such terms as my Executor shall deem
advisable; to hold any proceeds and other cash uninvested to
· nvest ~n all forms of property; to exchange or lease for any
per~od of t~me any real or personal property and to g~ve options
for sales, exchanges and leases; to exercise all r~ghts of
security holders; to compromise any claim or controversy w~thout
court approval; to borrow money from any source; to delegate
d~scret~onary powers; and to make d~str~but~on ~n cash or ~n
k~nd at current values, ~n undivided ~nterest or non-pro rata
shares.
FIFTH: I dmrect that all my legal debts, my funeral
expenses and the cost of administration of my estate, ~nher~tance
and succession taxes, ~nclud~ng nnterest and penalties, payable
w~th respect to all property ~ncluded ~n my gross estate shall
be pa~d from the principal of my residuary estate, at such t~me
and ~n such manner as my Executor shall deem advisable, w~thout
apportionment or r~ght of reimbursement.
SIXTH: I hereby name, constitute and appoint my sons,
MICHAEL CASEY and ROBERT CASEY, the Co-Executors of th~s my ,
Page 2 of 3
last w~ll and testament. My f~duc~ary shall not be required
to post bond ~n any our~sd~ct~on.
SEVENTH: If any provision of th~s w~ll or codicil
hereof ~s held to be ~noperat~ve, ~nval~d or ~llegal, ~t ~s
my antentmon that all of the remaining provisions shall continue
to be fully operative and effective so far as possible and
reasonable.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal thns ,~ day of ~-~-4~ , 1992.
~./Ba r t Casey !
S~gned, sealed, published and declared by the above
named Testator, J. Bart Casey a/k/a/ Joseph B. Casey, as hms
last w~ll and testament ~n the presence of us, who at h=s
request, ~n h~s presence and ~n the presence and hearing of
each other, have hereunto subscribed our names as w~tnesses.
Address
Address
Page 3 of 3
IN THE COURT
OF COMMON PLEAS OF ~ COUNTY,
PENNSYLVANIA
IN RE:
Estate of
ORP~B · COURT DIVISION
9..'7.S
CERT/FICATION OF NOTICE UNDFR RI.J'I'~E 5.6(a)
Name of Decedent:
Date of Death:
To the Register:
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
: (attached additional sheets, if
necessary).
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
610 Charles St.
Mechanicsburg, PA 17055
June 6,2004
Register of Will's & Clerk of Orphans Court
1 Courthouse Square
Carlisle, PA 17013
To whom it may concern:
Enclosed is a check in the amount of $34,000 payable to the Register of Wills,
Agent, representing a prepayment on the Estate of Casey J. Bart, EIN # 56-
6635514 and Social Security number 186-14-1522 (PA No. 21-04-0275). The
payment is the estimated total payment due less the 5% discount for filing within
3 months after the decedent's death.
If you have any questions on the payment, please contact Michael J. Casey, the
Executor at 717-766-1243
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OFINDIVIDUALTAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 004029
CASEY MICHAEL
610 CHARLES ST
MECHANICSBURG, PA
17055
........ fold
ESTATE INFORMATION: SSN: 186-14-1522
FILE NUMBER: 2104-0275
DECEDENT NAME: CASEY J. BART
DATE OF PAYMENT: 06/09/2004
POSTMARK DATE: 06/09/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/14/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $34,000.00
REMARKS:
TOTAL AMOUNT PAID:
834,000.00
SEAL
CHECK//1016
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
RB/-1500 EX (6~o)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
,J..L-_o_ '/ o
COUNTY CODE YEaR NUI~BER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I-- Casey, Bart, J 186-14-1522
Z
t-t DATE OF DEATH (MM-DD-YEAR) DATE OF 81RTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
LLI 03/14/2004 08/23/1922 REGISTER OF WILLS
Iii (IF APPLICABLE} SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ NA
uJ
~ 1. Original Return r'"'] 2. Supplemental Retum ~ 3. Remainder Return (date ofdaath p~or to 12-13-82)
[] 4. Limited Estate r~ 4a. Future Interest Compromise (date of death after 12-12-82)~ 5. Federal Estate Tax Return Required
~,,~ 6. Decedent Died Testate (Attach c.~oy of t~ll) [] 7. Decedent Maintained a Living Trust (Amc~ copy of Trust) 8. Tctal Number of Safe Deposit Boxes
~ 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date ordeath between 12-31-91 am 1-1-85) ~ 11. Election to tax under Sec. 9113(A)(At~ach Sch O)
NAME COMPLETE MAILING ADDRESS
Michael Casey 610 Charles St.
FIRM NAME (If,~oplica~e) Mechanicsburg, PA 17055
TELEPHONE NUMBER
(717) 766-1243
1. Real Estate (Schedula A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnemhip or Sole-Proprietomhip
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Pemonal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~_~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)(10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11)
9.
10.
11.
12.
(3) !;::
(4) ":
(5) 14,974.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject lo Tax (Line 12 minus Line 13)
(8)
13,179.00
848.00
(11)
(12)
¢3) .........
809,333.00
4,027.00
795,306.00
(14) ...................................................... .795,306.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfem under Sec. 9116 (a)(1.2) .............................................................. x .0 ........
16. Amount of Line 14 taxable at lineal rate 795,306.00 x .0 45
(16) 35,789.00
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 Due (19) 35,789.00
Decedent's Complete Address:
STREET ADDRESS
1805 Dighton Street
CFYcamp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments 34,000.00
C. Discount 1,789.00
Intarest/Penalty if applicable
D. Interest
E. Penalty
I STATEpA
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
(3)
(4)
(5)
(5A)
(5B)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
ZIP 17011
35,789.00
35,789.00
0.00
0.00
Make Check Payable to: 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 Imnsferred or ils income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust 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-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 panaittes of perju~J, I declare that I have examined ~s return, including au.~,,,pa,,ying schedules and st.,l=,.ents, and to the best of my knowledge and belief, it is true, correct and complete.
Dedara,lian of preparer other than the personal representative is based on all infa"ma~on of which preparer has any knov, tedge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING _RETURN ~, ,,-q ~ ~ DATE .,-. ,,~ ~' .
:::::
E OF PR H
For dates of death on or alter July 1, 1994 and before January 1, 1995, the lax 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 dealh 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a 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 stepparant of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the riel 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 decedenrs 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, wheiher by blood or adoption.
~ECEtVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE 'fAX
OFFICIAl., RECEIPT
NO.
CD 004029
CASEY MICHAEL
610 CHARLES ST
F-¢'"
M~,,.,HANICSB. URG, PA
1 '2'055
Eo'f..'rE INFORMATION: ss,,',J: 186.14-1522
FILE NUMa'.ER: 2. 104.-0275
DECEDENT NAME: CASEY J. BART
DA'rE OF PAYMENT: 06/'09/2004
POSTMARK DATE: 06: 09:2004
COUN'T'¥: CUM BERLAN D
DATE OF DEATH: 03/14/2004.
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 i - 834,000.00
]
TOTAL. AMOUNT PAID:
~34,000,00
~bMARKS:
CHECK//10i6
INITIALS: ,,iA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
REV-1502 EX+ (6-98~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
J Bart Casey EIN 56-6635514
All real property owi-,ed solely or as a tenant in ,.,,.,,,~'~ must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell. both having reasonable knowledge of the relevant fads.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
92,000.00
House and Land, 1805 Dighton St. Camp Hill, PA 17011
(see attached appraisal)
TOTAL (Also enter on line 1, Recapitulation)
$ 92,000.00
(If more space is needed, insert additional sheets of the same size)
June 1, 2004
Bob Casey
6310 Spring Lake Dr.
Burke VA 22015
PRUDENTIAL
THOMPSON
WOOD
717 761 256~
Prudential ThOml~en Wood Real E,'~ate
3815 Market Street
Camp Hill, PA 17011
Bus 717 751-8353 Fax 717 761-2563
info@prudentialthompsoflwood.com
www. pcudentialthomp$onwood.com
RE: 1805 Dighton St.
Camp Hill PA 17050
My Broker (Vi Thompson) and I previewed your father's home on May 26t~ 2004 for the
purpose of determiniag the eurteat market value,
The property is a 988 square foot ranoh style home in a good area of Camp Hill Borough.
The home has 3 bedrooms, 1 bath, gas heat and central air conditioning~ The lot is .2
acres and there is off street l~rking.
While the home is solid, it is in need of ulxiating and some deferred maintenance.
A number of similar properties have sold recently. One of note was 2014 Columbia Ave
which settled 1/9/2004. It is the same home except it has been updated and has a 1 car
garage. It sold for $104,900.
Another home at 2809 Columbia Ave closed on March 15, 2004. It too was quite similar
although somewhat larger. It did not have central air. It was also ia need of updating. It
sold for $91,000.
Based upon these and other homes that have recently settled, I believe that the current
market value is as follows:
two t~us~m~/do//,~s ($~,ooo).
sistance, please let me know,
Wood
P.01/01
~ An in~am~dm~v own~ md ou~ member ¢4 Tl:u Yru~.tial Ik'ul [sta~ ~ffili~tcs. ~.
TOTRL P.O~
REV-1503 EX+ (6-98~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
J Bart Casey EIN 56-6635514
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. See attached schedule
702,359.00
TOTAL (Also enter on line 2, Recapitulation) $ 702,359.00
(If more space is needed, insert additional sheets of the same size}
Estate of J Bart Casey
Estate ID # 56-6635514 _
Schedule B, Stocks and Bonds
Number MARKET'
Symbol Description of Shares VALUE
AGR B AGERE SYSTEMS INC CL B COMMON STOCK '~?? $715
AMX AMERICA MOVIL S A DE C V SPONSORED ADR REPSTG SE COMMON STOCK 30 $1,064
AMOV AMERICA MOVIL S A DE CV SPONSORED ADR REPSTG SEI COMMON STOCK 20 $708
AEP AMERICAN ELECTRIC POWER CO INC COMMON STOCI< 220 $7,36?.
APC ANADARKO PETROLEUM CORP COMMON STOCK 400 $20,4~-~.
AAUK ANGLO AMERICAN PLC ADR COMMON STOCK 356 $8,427
AT&T COMMON STOCK 242 $4,591
AWE AT&T WIRELESS SERVICES INC COMMON STOCK 389 $5,255
AV AVAYA INC COMMON STOCK 70 $1,1 ,32
BLS BELLSOUTH CORP COMMON STOCK 1128 $30,69,~
BMY BRISTOL MYERS SQUIBB CO COMMON STOCK 400 $10,204
BWS BROWN SHOE COMPANY COMMON STOCI~ 400 $15,086
BRT BRT REALTY TRUST SBI-NEW COMMON STOCK 300 $7,089
C ClTIGROUP INC COMMON STOC~ 195 $9,597
CMCSA Comcast COMMON STOCK 39' $11,4,31
DPH DELPHI CORP (FORMERLY DELPHI AUTOMOTIVE SYSTEM~ COMMON STOCK 139 $1,41
DTE DTE ENERGY CO COMMON STOCK 100 $4,1~.,t
DUK DUKE ENERGY CORP FORMERLY DUKE POWER CO COMMON STOCK 416 $8,96'~
DYN DYNEGY INC (HOLDING CO) CL A COMMON STOCK 400 $1,526
DD E I DU PONT DE NEMOURS & CO COMMON STOCK 180 $7,498
EDS ELECTRONIC DATA SYSTEMS CORP NEW COMMON STOCK 40 $76~
EXC EXELON CORP COMMON STOCK 1107 $74,152
FJC FEDDERS CORP NEW COMMON STOCK 395 $2,135
FE FIRSTENERGY CORP COMMON STOCK 200 $7,57,F,
F FORD MOTOR CO DEL PAR $0.01 COMMON STOCK 888 $11,682
GE GENERAL ELECTRIC CO COMMON STOCK 1920 $58,464
GM GENERAL MOTORS CORP COM COMMON STOCK 200 $9,036
GP GEORGIA PACIFIC CORP (GEORGIA PACIFIC GROUP) COMMON STOCK 200 $6,253
HPQ HEWLETT PACKARD CO COMMON STOCK 200 $4,407
JPM J P MORGAN CHASE & CO COMMON STOCK 966 $39,82~-
LU LUCENT TECHNOLOGIES INC COMMON STOCK ' 840 $3,276
NGG NATIONAL GRID TRANSCO PLC SPONSORED ADR COMMON STOCK 128 $4,891
NCR NCR CORP NEW COMMON STOCt~ 40' $1,696
NU NORTHEAST UTILITIES COMMON STOCK 342 $6,44
NST NSTAR COMMON STOCK 400 $20,19~;
PJC PIPER JAFFRAY COS COMMON STOC~ 4 $218
PCL PLUM CREEK TIMBER CO INC COM COMMON STOCK 137 $4,27(~
PPG PPG INDUSTRIES INC COMMON STOCK 800 $45,700
PPL PPL CORPORATION COMMON STOCK 420 $19,039
Q QWEST COMMUNICATIONS INTERNATIONAL INC COMMON STOCK 439 $1,982
RAD RITE AID CORP COMMON STOCK 1400 $7,504
SBC SBC COMMUNICATIONS INC COMMON STOCK 2085 $50,60;~
TMX TELEFONOS DE MEXICO SA DE CV-SPONS ADR REPSTG 2( COMMON STOCk 30 $1,027
T×N TEXAS INSTRUMENTS INC COMMON STOCk 200 $5,893
USB US BANCORP DEL COM NEW COMMON STOCK 428 $11,956
VZ VERIZON COMMUNICATIONS COMMON STOC~ 1228 $46,17~
VIA B VIACOM INC-CL B COMMON STOCK 513 $19,24~;
VC VISTEON CORP COMMON STOCK 66 $61b
VOD VODAFONE GROUP PLC NEW SPONSORED ADR COMMON STOCK 620 $14,8~0
WB WACHOVIA CORP 2ND NEW COM COMMON STOCK 1296 $62,0,'~-
ZMH Zimmer COMMON STOCK 40 $3,07~
Total Market Value --
$702.350
REV-1508 EX+ (6-98) ~'~'~
'~'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
J Bart Casey EIN 56-6635514
FILE NUMBER
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM Belco Community DESCRIPTION
I Credit Union Camp Hill, PA 17011 Acct. # 11730 Regular Savings
2 I Belco Community Credit Union, Camp Hill, PA 17011 Acct. # 11730 Checking
VALUE AT DATE
OF DEATH
NUMBER
3
4
5
6
7
8
9
10
11
12
Raymond James Financial Services, Harrisburg, PA 17112 Acct. # 47720514
1993 Ford Taurus, poor condition, bad motor mounts, donated to The Kidney Foundation (see attached)
Old boat, Lonestar, scrapped for metal value (see attached)
Wedding Ring, Gold
Living Room Furnilu re, Sofa, 2 chairs, and End Table
Master Bedroom Furniture, One Bee, Two Dressers, fair condition
Bedroom Furniture, One Bed, Two Dressers, poor condilion
Kitchen, One steel table and chairs, dishes glasses, and utensils
Appliances, Washer, Dryer, and Refrigerator
Eleclronics, 25" TV, 19" TV, One VCR, One DVD Raver
13,322.00
690.00
87.00
0.00
75.00
50, O0
100.00
150.00
100.00
75.00
150.00
175.00
I
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of lhe same size)
14,974.00
BELCO
DECEDENT ESTATE INFORMATION
1, Name(s) in whk'J; Il'se account was hekI:
M~!ry ~¥.,'.~.:?...e:.~. i.=s..thejoint owner
2. Accou:',t number: 1 I730
Balance as of date of deaih: 3~ 14~2004
[~.ala~:ce Accrued Dividends YTD Dividends
Re,gdlar Savings: $13,322.17 $5.1
Christmas Climb: $
VVha~,e: Clu~:
Checkir~g: $689.89 $0.00
Money Market: $ $
Cert~fic~tes: Bala r~ce
$26.54
$
$
$0, DO
$
Y'TD Dividends
$
Accrued Divider~ds
$ $
$
$ $
$
$
10/2071967
[)ale ihe account was Jnitia!¢:d:
Name(s) in wh}ch Safe Deposit Box was heM:
Ce:tiicate Number
Date the t;ox was initiaiiy rented
Branch address a~ wi~ich the box is located:
L.oar~ information' .Baia~:,-.,.e ,Accrued I~ierest
A. Unsecdred L.oans: $ $
B. SecLIf'ed
9. Mis(:ellar~eous;
C. Mo tclage Loans:
Per Oiem )nt
$
$ $ $
$ $
.$_ ........................... $ $
$ $
The
Kidney Foundation
of Central Pennsylvania
March ] 9, 2004
Mr, Michael Casey
610 Charles S[reet
Mechanicsbui.g, PA 17055
I)ear Mr, Casey:
Please acc~p.'t this letter as acknowledgement o.fyour donation of 1993 Ford 'Faun.ts GL
to the Kidney Foundation of Cemra[ Pennsylvania.
We thank you for your kind generosity.
Fi.mmc~a] data fi'om the auto auction, is enclosed.
Sincerely,
., ........... ".:!~.~'f ...9::'.,,.¢::::':';'? .:"
~..... ,~ .&?::. - ........ ,~,,.-~ .. ...-.:~. .
.,....~ ....-~.~. ~, -~,.<-. ....%~.~...-:. ~.,...
Steven M. Joule"
Executiv~;~[:q rector
Enclosures
Olde Libels,- Square, 48~3 Jonestown Roa,d, Suite 10'I, H;~rrisb~,~r.q.. PA 'I 7109
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
J Bart Casey EIN 56-6635514
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Deb[,, of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES AMOUNT
1.
5.
6.
7.
8
9
10
James Kelley Funera! Home, coaI TOWnshiP,' PA 17866: Traditional Funeral Service
Casket and Register Book
FUneral LUncheon, Church Services, Veteran Marker Base with InscriPtion
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal F~epresentative(s)
Street Address
City State
Year(s) Commission Paid:
Zip
A~orney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Kathleen Casey
Street Address 1805 Dighton St.
City Camp Hill State PA
Relationship of Claimant to Decedent Daughter
.Zip 17011
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Shod Cediflcales
Death Certificates
Inventory Fee
House Appraisal Fee (Prudential Thompson Wood Realtors)
J. E. Husic Co. Container Service, Dillsburg, PA 17019, house cleanup
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, ~nsert additional sheels of the same size)
2,560.00
1,000.00
3,500.00
200.00
600.00
550.00
210.00
90.00
200.00
375.00
497.00
13,179.00
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABIUTIES, & LIENS
J Bart Casey EIN 56-6635514
RE
ITEM
NUMBER
FILE NUMBER
~ort debts incurred by the decedenl prior to ~,e&{h which remained unpaid as of the date of death, including unreimbursed medical expenses.
1. Real Estate Tax, Camp Hill Borough
2 Visa, Belco Cmdi! Union
3 Comcast Cable
4 Pennsylvania Water Co,
5 UGI
6 PP&I
7
DESCRIPTION
VALUE AT DATE
OF DEATH
437.00
224.00
42. O0
29.00
68.00
48.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
848,00
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
J Bart Casey EIN 56-6635514
NUMBER I I
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) 11.2)~
Michael Casey, 610 Charles Slreet, Mechanicsburg, PA 17055
2
3
Kathleen Casey, 1805 Dighton Street, Camp Hill, PA 17011
Robed Casey, 6310 Spring Lake Drive, Burke VA 22015
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
Son
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
265,102.00
265,102.00
265,102.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX S NOT BE NG MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
0.00
Register of Wills
Cumberland County, Pennsylvania
Inventory
Estate of J. Bart Casey, 1805 Dighton Street, Camp Hill, PA 17011
EIN 56-6635514
Cash and Investments:
Belco Community Credit Union Savings
Belco Community Credit Union Checking
Raymond James Financial Services
Stocks (see attached detail)
Personal Property:
1993 Ford Taurus
Boat, Lonestar
Wedding Ring and watch
Living room; Sofa, 2 chairs, end table
Master bedroom; bed, two dressers
Bedroom two; bed, two dressers
Kitchen, steel table and chairs, dishes, glasses/cups, utensils
Appliances; washer, dryer, refrigerator
Electronics; 25" TV, 19" TV, VCR, DVD player
Clothing
Real Estate:
Home and land located at 1805 Dighton Street, Camp Hill, PA
Signed:
Michael-C
Estate of J Bart Casey
Estate ID # 56-6635514
Stocks
Symbol
Description
Number
of Shares
AGR B
AMX
AMOV
AEP
APC
AAUK
T
AWE
av
BLS
BMY
BWS
BRT
C
CMCSA
DPH
DTE
DUK
DYN
DD
EDS
EXC
FJC
FE
F
GE
GM
GP
HPQ
JPM
LU
NGG
NCR
NU
NST
PJC
PCL
PPG
PPL
Q
RAD
SBC
TMX
TXN
USB
VZ
VIA B
VC
VOD
WB
ZMH
AGERE SYSTEMS INC CL B COMMON STOCK
AMERICA MOVIL S A DE C V SPONSORED ADR REPSTG SER COMMON STOCK
AMERICA MOVIL S A DE CV SPONSORED ADR REPSTG SER ~ COMMON STOCK
AMERICAN ELECTRIC POWER CO INC COMMON STOCK
ANADARKO PETROLEUM CORP
ANGLO AMERICAN PLC ADR
AT&T
AT&T WIRELESS SERVICES INC
AVAYA INC
BELLSOUTH CORP
BRISTOL MYERS SQUIBB CO
BROWN SHOE COMPANY
BRT REALTY TRUST SBI-NEW
CITIGROUP INC
Comcast
DELPHI CORP (FORMERLY DELPHI AUTOMOTIVE SYSTEMS (
DTE ENERGY CO
DUKE ENERGY CORP FORMERLY DUKE POWER CO
DYNEGY INC (HOLDING CO) CL A
E I DU PONT DE NEMOURS & CO
ELECTRONIC DATA SYSTEMS CORP NEW
EXELON CORP
FEDDERS CORP NEW
FIRSTENERGY CORP
FORD MOTOR CO DEL PAR $0.01
GENERAL ELECTRIC CO
GENERAL MOTORS CORP COM
GEORGIA PACIFIC CORP (GEORGIA PACIFIC GROUP)
HEWLETT PACKARD CO
J P MORGAN CHASE & CO
LUCENT TECHNOLOGIES INC
NATIONAL GRID TRANSCO PLC SPONSORED ADR
NCR CORP NEW
NORTHEAST UTILITIES
NSTAR
PIPER JAFFRAY COS
PLUM CREEK TIMBER CO INC COM
PPG INDUSTRIES INC
PPL CORPORATION
QWEST COMMUNICATIONS INTERNATIONAL INC
RITE AID CORP
SBC COMMUNICATIONS INC
TELEFONOS DE MEXICO SA DE CV-SPONS ADR REPSTG 20 I
TEXAS INSTRUMENTS INC
US BANCORP DEL COM NEW
VERIZON COMMUNICATIONS
VIACOM INC-CL B
VISTEON CORP
VODAFONE GROUP PLC NEW SPONSORED ADR
WACHOVIA CORP 2ND NEW COM
Zimmer
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
COMMON STOCK
222
30
20
220
400
356
242
389
70
1128
400
400
300
195
391
139
100
416
4O0
180
4O
1107
395
200
888
1920
200
200
200
966
84O
128
4O
342
4OO
4
137
8OO
42O
439
1400
2085
30
200
428
1228
513
66
620
1296
40
BUREAU OF ZNDZVZDUAL TAXES
ZNHERTTANCE TAX DZVISZOH
PO BOX Z80601
HARRTSBURG, PA 17116-0601
COHHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
RE¥-15¢17 EX AFP
HICHAEL J CASEY
610 CHARLES ST
HECHANICSBURG
PA 17055
DATE 11-15-2004
ESTATE OF CASEY
DATE OF DEATH 05-14-2004
FZLE NUHBER 21 04-0275
COUNTY CUHBERLAND
ACN 101
L Amount Remitted
JOSEPH B
HAKE CHECK PAYABLE AND REHZT PAYHENT TO.'
REGTSTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARL/SLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
~ m m m m m m mmmmmm m mm mm mmmmmmmmmmmmmmmmmmmmmmmm mmm m mmmmmmmmmmmmmmmm mm m m mmmmmmmmmm m mmmmmmmNNNmNmNmmmmmm mm m mm m mm m m m m m m m
REV-1547 EX AFP (01-03) NOTZCE OF ZNHER]:TANCE TAX APPRA]:SEMENT, ALLOWANCE OR D]:SALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF CASEY JOSEPH B F]:LE NO. 21 04-0275 ACN 101 DATE 11-15-2004
TAX RETURN #AS: (X) ACCEPTED AS FTLED ( ) CHANGED
RESERVATTON CONCERNZNG FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
I Real Estate (Schedule A)
2 Stocks and Bonds (Schedule B)
$ Closely Held Stock/Partnership Interest (Schedule C)
Nortgages/Notes Receivable (Schedule D)
$ Cash/Bank Deposits/Nisc. Personal Property (Schedule E)
6 Jointly Owned Property (Schedule F)
7 Transfers (Schedule G)
8. Tote1 Assets
APPROVED DEDUCTZONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule H)
10. Debts/Nortgege Liabilities/Liens (Schedule [)
11. Tote1 Deductions
12. Net Value of Tax Return
92;000.00
702;:559.00
.00
(r,) .00
14;974.00
.00
(7) .00
(9)
(8)
1:5,179.00
(10) 848. O0
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
809,5:55.00
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0
Net Value of Estate Subject to Tax (lq) 795,:506.00
:;f an assesseent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
.O0
:55,789.00
.00
.00
19. Principal Tax Due
TAX CREDZTS:
PAYMENT R[CEZPT
DATE NUHBER
06-09-2004 CD004029
DISCOUNT (+)
INTEREST/PEN PAZD (-)
iF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
(19): $5,789. O0
1,789.45
AHOUNT PAZD
54,000.00
TOTAL TAX CREDZT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
55,789.45
.45CR
.00
.45CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT IS REeU/RED.
ZF TOTAL DUE 1S REFLECTED AS A 'CRED/T' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORN FOR [NSTRUCTZONS.)
15.
1~.
NOTE:
reflect figures that /nclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
1.6. Amount of Line 1~ at Spousal rats (1E) .00 X 00 =
16. Amount of Line 1~ taxable e~c Lineel/Cless A ra~e (16) 795,:506.00 X 045 =
17. Amount of Line lq at Sibling rate (17) . O0 X 12 =
18. Amount of Line lq taxable at Colla*eral/Class B rats (18) . O0 X 15 =
(11) 1~.027. O0
(12) 795,506. O0
RESERVATION:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the CommonaeaIth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the taaful Class S (cotlatera1) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
[NTEREST:
To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 25 of 2800. (7z P.S.
Section 91q0).
Detach the top portion of this Notice and submit Nith your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLSj AGENT
A refund of a tax credit, ahich Nas not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I313). Applications are available
online at NNN.ravenue.state.pa.us~ any Register of Hills or Revenue District Office, ar from the Department's
2q-hour ansaaring service for forms orders: 1-800-362-2080; services for taxpayers with special hearing and/or
speaking needs: 1-800-~q7-3020 iTT only).
Any party in interest not satisfied Nith the appraismsnt, alloNance or disallowance of deductions or assessment of tax
(including discount or interest) as sheen on this Notice may object aithin 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at
www.boardofappaals.stats.pa.us on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals eebsita. You may also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box ZBIOZ1, Harrisburg, PA 171ZB-lOZI. Petitions may not be faxed.
B) Election to have the matter determined at the audit cf the account of the personal representative.
C) 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 Raviea Unit, P.O. Box 280601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6S05. Sea page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed an the total of tho tax 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 mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning Nith 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, 198Z bear interest at the rate of
six (6X) percent par annum caIcuIatad at a daily rate of .00016q. All taxes which became delinquent on and after
January l, 198Z wiI1 bear interest at a rate Nhich mill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for I98Z through ZOOq ara:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20Z .O005qB 1988-1991 llX .000501 2001 9Z .0002q7
1983 162 .000q38 1992 9Z .O00Zq7 ZOOg 62 .000164
19Bq 11Z .000301 1993-199q 7Z .OOOXgZ 2003 5Z .000137
1985 13Z .000356 1995-1998 9Z .O00Zq7 ZOOq qZ .000110
1986 IOZ .O00Z7q 1999 72 .000192
1987 iOZ .aOOZ74 2000 7Z .00019Z
--Interest is calculated
as folloas:
TNTEREST = BALANCE OF TAX UNPA'rD X NUNBER OF DAYS DBLXNQUENT X DAXL¥ 'rNTERBST FACTOR
--Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen liS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be caXculated.
Cumberland County - Register Of
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Carlislej PA 17013
Phone: (717) 240-6345
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Date: 2/02/2006
CASEY MICHAEL
610 CHARLES ST
MECHANICSBURG, PA 17055
RE: Estate of CASEY J. BART
File Number: 2004-00275
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.1, for decedents dying on or after
July 1, 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:
3/14/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
iI~V. 4- ~L.._/J
lt31/'AC ~~fffk~J j$"~
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GLENDA FAP~ER STR~SBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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Re1:;iMer of'JVUI~ of C-ur"i1b.ei';and Cow"J.ty
STA11JS REPORTu""NTIERRli'LE 6.12
Name of Decedent Jc~@-h er~r-thoIOf\\el..d La6-tA-/
Date of Death: 3 J 14-) 0 4-
f f
(' S. i3.a r-t )
Estate No.:
d. OOLl -- OW 1S
.
Pursuant to Rule 6.12 ofllie 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 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. Did the persoIiai representative file a final account with'the COUrt7 .
Yes 0 No J2g
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
Date:
c. Did the personal representative state an account informally to the parties in
interest? Yes LID No 0 5 e e r-C:l (Y\'\ t"-) Se.--ttl ~ rY1 e Y0t ~ tc e. ry,'f ~~t
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
~1~ICk attached to this report. /7l.f~ I, ~d ..
Si~ture ./ .'
'!", .
{ fvl I c-hCLt { J. {b.cSeA...j
Name
1010 Crar/t's 9, mi!dlt:InICSbur'j
Address P4 I 7 OG~
III 71..7 f.,-, -10;.43
J.
Telephone No.
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