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HomeMy WebLinkAbout02-0062PETITION FOR PROBATE and GRANT OF LETTERS Estate of' -~C~:~tT~' ~o~ ~o'r~ also known as NO. · To: Deceased. Social Security No. /~ --/¥ - 28; The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut in the last will of the above decedent, dated /~o*.~ and codicil(s) dated Register of Wil. ls for the County of Commonwealth of Pennsylvania in the named ,19. 5L~- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent, was ~o ,m, iciled at death in t/g/z n/~ea/8 p d County, Pennsylvania, with h , lastJ;fi~fi~i~'o~/principal residence at ./Ioo G~nolo~,'d4)~ 777e~,t~ni~l,u,~..~ · ' · % (list street, n6mber and muncipality) Decendent, then ~ a~ . 'years of age, died ~ ~ t.o o-,~ at /4o1~ q~,'a,'~ /-/'~.~;0; ~,¢ ] ~ (~,,,., ,~1,,,1! 3 /6, ,~ 09_. '. Except as f~lo~v~, dec~de~{ did not marry, was t~ot divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: A///q - Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal 'property $ ~ ~ OOO (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. reque,st(s) the probate of the last will and codicil(s) (testamentary; ~ministration c.t.a.; administration d.b.n.c.t.a.) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF C~ m/~'~/~ d · .. f The petitioner(s) above-named ~we~_r(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed .,- "~~ ~'~///~ r~ before me this .17~-h day of [ / . ~'~ · · ' ' ,'. E.. ZOo-A-o / 9' NO. 21-2002-0062 Estate Of '.~n M. w~-~nn , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 17t-h ~ 9002 in consideration of ~:i'~e pefitior~, on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED~that the instrument(s) dated Mai' 9th, 1995 described therein be admitted to probate and filed of record as the last will of Jean M. Watson ; and Letters Testamentary are hereby granted to Melvin E. Watson ~,,~,,~t~, ,, .,,,v'I, . . ~I.~. " FEES Probate, Letters, Etc .......... $.115.00 Short Certificates{6 ) .......... $ 18.00 Renunciation ................ x-Pacles (2) $. 6.00 JCP TOTAL __ $ 5.00 Filed '3anuary' l Tth; 20(~2 · · · $144;00 ' · ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE LETTERS WILL BE PICKED UP ON January 18th, © : O 105.805 REV 9/86 t~ie ~n f6 r mauon.,,/.,Eier e 5 t .Jearl Mae ~at$on --x-,.' ,"~: -~- ~/., ,~-/ · ,~- ,, .... ;,/':e .... ,'. ,,- .- <.-' ',.~ ................. ~.;:,;.~' . :?>,,,'i :,: ..... -, ,,. ,,,,.~//~,., ,~,, :5 zFema.1~ -:.-I~.' I,,8,6.. ,.,,-~, 14, '' ~ ' "~IOTHER ' ~ ~g ~" ' · ":'A ' ~'"': N : ~Cumbe~land ,?: ~;~ ' as,t;~Pennsboro '- -.'. -' ~.'-: Yz '., :"~5' .':' ~.~0~ : ~. ,.:,: "~,.. ;. - ' . . Meeh'ani'esbhrg,?Pg'' 1-7055" :" .... ~': . ' ~:::' ~','" ', ::,', '~. .~',':' . ' :'-.' '-: · ~ ;-~' -'~' ~->> "' -' - .... ~ng~.e '-f,<?>,:- ~.,,.. .:~e:.: . e,~:>?: 0......~¢-~ ~x.. ~-:~ ,~,/Beu'l:a;~May~,.Wzs'~.' ..... ~.:' ~>' ~:> ..,, ~>:.,:" ." . . ~o~m~,T,~-.~.o' :- ~f~ :...~. ~ 'c ~' I~p.~T~% %,. ~,,. ~, ~5;I~o,~U~.N~.C,,~ :.~,:iL~.C~.~.Z~~ .... ,. ,<:/> ~ .z~;~ ,~..x~ ' ~ 'Januarv~> 1 o,~:,) zuuz," , ~l~' ~-::=~-~ '~5'~ ~'" ~ '~ '~: ~ ~/~ 5/1~: ~xs: ,' · '~5 _ ~ ,; '" ' ' ' 2 ~...~ I:. E~t~ the al .... . iniu~es o~ c4.~-~-'-- ~,~_ ~ caused the ~ath. ~ ~ e~er ~., : s~k ~ ~a~ fa~e ,.~ .... ~,.~,.,. ..~ ,,~ ~ ..... .>~,.. ,-~.. SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA '21-2002-0062.. ...... ; LAST WILL AND TESTAMENT OF · .' " 'JEAN M. WATSON I, JEAN M. WATSON, of the Borough of Wormleysburg, Cumber- land County,.Pennsylvania, declare this to be my Last Will and Testament;',hereby revoking any will previously made by me. I. - I di'rect the payment of all my just debts and funeral, expenses out'of my estate as soon as may be practical after .my, death...~.. ....... ,:.~..,~ .. :~. - .. II - I devise and bequeath all of my estate of what- ever nature'and wherever situate unto my three children, Melvin E. Watson, Linda Ream and Suzanne Myers, in equal shares, the share of a deceased child to be paid to his or her issue per stirpes. III -'I appoint my.son, Melvin E. Watson, Executor of this, my Last Wili and Testament. Should my said son fail to qualify or cease to act as such, then I appoint my daughters, hinda Ream and Suzanne Myers, to act in this capacity. None of my Personal representatives shall be required to post bond in this or any jurisdiction. this, the IN WITNESS WHEREOF, I have hereunto set my hand and seal on ~___% 1995 ~ day of , . <SEAL>  -Jean M. Watson Page 1 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA Signed, sealed, published and declared by JEAN. M. WATSON, Testa- trix therein named, on this and one (1) other sheet of paper as and for.her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Name Name Address Page2 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market street Camp Hill, PA COMMONWEALTH OF PENNSYLVANIA) : COUNTY OF CUMBERLAND ) SS. WE, the undersigned, the testatrix and the witnesses,. respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authoLity that the testatrix signed and executed the instrument as her Last Will and Testament and that she .signed willingly ~(or wi.~lingly directed another to sign for her), and that~she executed it as her.free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind, and under no cOnstraint or undue influence. Testatrix Witness Subscrlbeo, sworn to and acKnow±edged before me-by.2the~, testatrix,, and subscribed and sworn~t~before me by both wit- nesses,, .t'his ~ day of ' t/~e~.- ~ , 1995. otary Public- NOTARIAL SEAL 'FHELMA $. McCAUSLIN, Notary Public Camp Hill, Cumberland County My Commission Expires ,.luly 3,1996 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601, RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001 O68 WATSON MELVIN E 2305 "B" NANTUCKET DRIVE HOUSTON, TX 77057 ........ fold ESTATE INFORMATION: SSN: 186-14-2811 FILE NUMBER: 2102-0062 DECEDENT NAME: WATSON JEAN M DATE OF PAYMENT: 04/15/2002 POSTMARK DATE: 04/11/2002 COUNTY: CUMBERLAND DATE OF DEATH: 01/1 6/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,247.05 TOTAL AMOUNT PAID: $4,247.05 REMARKS: MELVIN E WATSON SEAL CHECK# 117 INITIALS' SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS ~EV-1500 EX (6-90)  COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 R E V- 15 o o ." .... 'd6'- v -. I F~LE NumaEr ----~ -- NHERITANCE TAX RETURN I .,. .RESIDENT DECEDENT ' '['0~".~,~P~'~'~?- -~-'~ DECEDENTS NAME (LAST, FIR.ST, AND MIDDLE INITIAL) , .. (. '. /_/~¢'~o~ ~ ,j-~ ~,' DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 01- I(~- ~oo~ o~- o~- 'Z U.I 1:3 W (.3 UJ 1:3 W Z Ltl Z UJ 8. 10. 12. 13. 14. SOCIAL SECURITY NUMBER /,¢'~, - /'-/- - ~ ~'ti THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER []. 1. Odginal Return [~ 2. Supplemental Return E~ 3. remainde¢ Return (date of death prior to ,2-13-82) [] 4. Limited Estate E~ 4a. Future Interest Compromise (date of death after 12:12-82) [-~ 5. Federal Estate Tax Return Required ~-----]6. Decedent Died Testate (A~ch ~py of Will) ~ 7. Decedent Maintained a Living Trust (AUach copy ¢ T~st) 8. Total Number of Safe Deposit Boxes ,~ 9..t~igation Proceeds Received ~ 10. Spousal Pove~ Credit (date of dea~ belden 12-31-91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A)(AEach Sch O) 1. Real Estate'(ScheduleA) (1) ' ~ ~" ' 2. Stock. s. .and Bonds (Schedule B) (2) 3. Closely Held Corporation, Padnership or Some-Proprietorship (3) ~ ',.'.:~ ~: 4. Mortgages & Notes Receivable (Schedule D) (4) ~, 3"'. . .--, 5m Cash, Bank Deposits & Miscellaneous Personal Property (5) f'~ (Schedule E) ~- ,b" t'~..) JointlY Owned Property (Schedule F) (6) [~ Separate Billing Requested Inter-Vivos Transfem & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) (8) Funeral Expenses & Administrative Costs (Schedule H) (9) ' Debts of Decedent, Mortgage tial~ilities,~ & Liens (Schedule I) (10) Total Ded'ucti(~ns (total Lines 9 & 10) Net Value of Estate (L ne 8 m nus L ne11) " ' ' ' .... " ' ' Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) Amount of Line 14 taxable at lineal rate Amount of Line 14 taxable at sibling rate Amount of Line 14 taxable at collateral rate Tax Due '¢'3 ~4.37~', ?1 OFFICIAL USE ONLY ,tO O ,¢::: 0 (11) -(13) (14) x .0_ (15) x .0 /"~'~ (16) ¢ ~f'. ~7, O~ x .12 (17) x .15 (18) (19) Decedent's Complete Address: ISTREET ADDRESS Tax Payments and Credits: !. Tax Due,(Page 1 Line 1,9) ,:. - 2. Cr~dit~/Pa~,ments ' A. Spousal Poverty Credit B.' Prior Payments C. Discount ' Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + B + C') (2) Total Interest/Penalty ( D + E If Line 2 is g,reater than Line 1 + Line 3, enter the differeni;e. This is the OVERPAYMENT. CheCk box on Page 1 Line 20 to request a refund 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. (3) (4) (5) (5A) B. Enter the rot'il' ~(l'.ine:5.+ ~A': This'i§~the BALANCE DUE., ,, (SB) . ,' '- Make , "hedl tS yable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make.a trans,f~.cand: ,., [. Yes No a. retain the use or'incor~ ~f t~ p76~rtY t~:~nsferred; .......................................................................................... [] [] b. retain the ri~lht to designate who shall use the property transferred or its income; [] [] c. retain a reversionary interest; or ................................................................................................. : ........................ [] [] d. receive the pr~m, ise for,Ii:re of .e!ther tp.ayme.,nts,' benefits or care? ...................................................................... [] [] 2, If death occurred ~'~ter I~e~mber' 12~ 1982, di~l decedent transfer property within ohe Year of death' ' ' without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................... ' .................... : ............................................... [] [] IF THE ANSWER.TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. under p~nalties of [~erjury, I d~clare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete· Declaration of preparer other than he personal representative is b~sed on.all informati60 of which preparer has any knowledge ..... SIGNATURE OF PERSON RESPONSIBLE FO,R FILING RE'[UBN' ~' ,., ADDRESS ,, ~ /' ~ 77057 DATE SIGNATURE OF'PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS ;. f ":h' , , , '.;:!' ,:.- ~¥., 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) (iii. For dates, of dea%o.n.,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 statut~ does.,.n'ot exempt a transfer to a surviving sp&~'se from tax; and the'sta.{ut5ry 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 yeais 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)]. Th~'tax' r~t(~ i~npo~e'd on''the net value of transfers tb 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. REV-150~ EX + (1-97) ~ COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT STOCKS & BONDs'' ':' ' ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DEscRIPTION OF DEATH TOTAL (Also enter on fine 2, Recapitulation) $3. (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (I-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PA TOTAL (Also enter on Fine 5, Recapitulation) $ ~'1~ S'~2,. '73 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF z,7'~_.~ ~ ~ ~/0'~ '//".~'0 Y~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1. 5. 6. 7. FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State__Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State__. Zip Relationship of Claimant to Decedent Probate ~ees -~//~1/.. OO * ~/.-~. OO Accountant's Fees Tax Return Prepar. er's Fees TOTAL (Also enter on line 9, Recapitulation) '~ 7,z~. ,-P+ $ 7,,/8Oo (If more space is needed, insert additional sheets of the same size) / '03×08202 16:01 REGISTER OP WILLS + 917132964962 SCHEDULE I DEBTS OF DECEDENT,. MORTGAGE LIABILITIES, & LIENS N0.664 FILE NUMBER D01 Include unrelmbursed medical expenses, ITEM NUMBER DESCRIPTION &. 7. lC). Il.. TOTAL (AIs~ enter on line 10, Recapitulation AMOUNT $ R~ P qq. 7G REV-1513 EX + (1-67) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF ~.~7-e~';'7 ,/~0 /--~o?/Z.-¢O )'/ FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY BO Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) II. 1. 305. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additiona!i~sheets of the same size) STATUS REPORT UNDER RULE 6.12 Name of Decedent: --~m /~8~ Date of Death: ~m~ /&; Will No. ~t-O2- DD~ Admin. No. Pursuant to:,Rule 6.12 of the Supreme Court Orphans' Court Rules, I report ~the following with respect to completion of the administration of the above-captioned estate: 1. State W~hether administration of the estate is complete: __ Yes ~' No 2. If the answer .is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative' file a"final account with the Court? Yes ~/ No b. The separate" ~Phans' ~our~~ ...... N0'. '(~f' .... ' '-~"~'~ '"~'~;~'~: ~'"'":'any) for the personal representative's account is: c. Did the personal' representative state an account informally to the parties in interest? Yes / No d. Copies of receipts,.releases, joinder~ and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may'be attached to this report. Date ( MAH: rmf/AM~'~ Name (Please type or print) Address //v/~~ ~ 7~ 77o~7 Tel. No. ~'~Per'Sona~'Rep'~eSe~tiVe Counsel .for personal rbpre'sent~tive Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: ~7~g~ ta_~ I~,) Will No. o~. ! ,.. 0,2 .- OO~,.~ Admin. No. ~QQ2 "- 000~, ~ To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signatul Name Address ,.~ ~0 ~' i/'t[O ..r /o ~ . Telephone (?13) Capacity: /Personal Representative Counsel for personal representative United for Medical Excellence: From Outer Space to Inner Space BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRA/SEHENT, ALLO#ANCE OR.D/SALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '02 /tY 31 P1:51 MELVIN E WATSON 2305B NANTUCKET D~.r.i- HOUSTON DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-27-2002 WATSON 01-16-2002 21 02-0062 CUMBERLAND 101 REV-l$47 EX AFP (01-02) Amount Remitted JEAN MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 M CUT ALONG THIS ,LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WATSON JEAN MFZLE NO. 21 02-0062 ACM 101 DATE 05-27-2002 TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (S) q. Mortgages/Notes Receivable (Schedule D) (q) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Net Value of Tax Return 22/2fil .$8 .00 81/562.75 .00 .00 NOTE: To insure proper credit to your account, submit the upper portion .00 of this form with your tax payment. .00 (8) 7,150.qq 105,80q.ll 2~29q.76 (11) 9.425.20 (12) 9q,578.91 15. NOTE: ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lfi taxable at Collateral/Class B rata* 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUMBER /NTEREST/PEN pATD (-) 0q-11-2002 CD001068 212.35 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 Net Value of Estate Subject to Tax (lq) 9q,$78.91 If an assessaent was issued previously, ZSnes 14, lS and/or 16, 17, 18 and 19 wA[! reflect fSgures that Snclude the tote! of ALL returns assessed to date. (lS) .00 X O0 = .00 (16) 9q,578.91 x 0q5= q,Zq7.05 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= q,ZqT. 05 AMOUNT PAID q,Zq7.05 TOTAL TAX CREDIT [ q,q59.q0 BALANCE OF TAX DUEl 212.$5CR ~ INTEREST AND PEN. .00 TOTAL DUE 212.55CA IF PATD AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE 1S LESS THAN 91, NO PAYMENT 1S REQUTRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CA), YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT~ PENALTY: INTEREST: Estates of decadents dying on er before December 12, 198Z -- [f any future interest in the estate .is transferred in possession or enjoyment to Class B (collateral) beneficiaries'of the decedent after the expiration of any estate for life or for years, the Commbnwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To ~uXfilX the requirements of Section ZlqO of the Xnher[tance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section Detach the top portion of this Not[ce and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "APplicat[on for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at.the Office of the Register of Hills, any of the ES Revenue'District .Offices, or by .calling the special Z4-hour answering service for forms ordering: 1-800-56Z-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-~0Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance Of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sl'xty ~60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81OZl, Harrisburg, PA 171ZB-IOZi, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed [n writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three the tax paid .is allowed. The 1SZtax amnesty non-participation penaltY is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged.beginning mith first day of delinquency,.or nine (9) months and one (1) day frog. the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (BI) percent per annum calculated at a daily rate of .00016~. All taxes which became delinqoentton and after January 1, 198Z will bear interest at a rate which m[11 vary from. calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200E ~re: Year Interest Rate Daily Interest Factor Year Interest Rate 198Z 20Z .0~0548 199Z 92 1985 162 .000458 1993-199~ 72 198~ X1Z .000501 1995-1998 9Z 1985 1SI .000~56 1999 7Z 1986 lOX .O00Z7~ ZOO0 82 1987 9Z .O00Z~7 ZOO1 92 1988-1991 lie .000301 2002 6Z --Interest is calculatad as follows: Daily Interest Factor .000Z47 .O0019Z .O00Z~7 .O0019Z .O00Z19 .000247 .000164 INTEREST = BALANCE OF TAX UNPAID X; NUNBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent sill reflect an interest calculation to fifteen (15) days -- beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF ZNDZVTDUAL TAXES TNHERTTANCE TAX DZVTSZON DEPT. 280601 HARRISBURG, PA 1712&-060! COMHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,~. ZNHERZTANCE TAX STATEHENT OF AC~.0UNT '02 / UG 19 q9:42 MELVIN E WATSON ZS05B NANTUCKET DR~ .. .~ HOUSTON XX".7,7057 - .;, ,.,'~... t' DATE ESTATE OF DATE OF DEATH FILE NUMBER ; COUNTY ACH 07-29-2002 WATSON 01-16-2002 210Z-O06Z CUMBERLAND 101 Amoun'l: Remitted REV-1607 EX AFP {01-02) JEAN M HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper por~ion of ~his form wi~h your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP [01-02) INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF WATSON JEAN M FILE NO. Z1 02-0062 ACN 101 DATE 07-29-2002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THECURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELOW ZSA SUHHARY OF THE PR/NC/PAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 05-27-2002 PRINCIPAL TAX DUE: ................................................................................................................................................................................................................. ~,2~7.05 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE ' NUHBER INTEREST/PEN PAID (-) AMOUNT pAID 0~-11-2002 07-11-2002 CD001068 REFUND 212.35 .00 R,Z~7.05 212.35- ZF PA/D AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULAT/ON OF ADD/TZONAL /NTEREST. ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYHENT 1S REgUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ~,2~7.05 .00 .00 .00 YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORH FOR 'rNSTRUCTTONS. ) PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. *. -- If RESIDENT DECEDENT make check'or money order payable to: REG/STER OF WILLS, AGENT. -- If NON-RES/DENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania. Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or fromthe Department's Zfi-hour "ansaering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers mith special hearing and / or speaking needs: 1-800-qq7-$OZO (~T only). REPLY TO: DISCOUNT: PENALTY: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601j Harrisburg, PA 171ZS-060i, phone (717) 787-650S. If any tax due is paid ~ithtn three (3) calendar months after tho decedent's death, a five percent (5X) discount of the tax paid is allo~ed.. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18,'1996, the first day a~ter tho end of the tax amnesty period. INTEREST: Interest is charged beginning ~ith first day of delinquency, or nine (9) months and one (1) day from the date of death, to th~ date of payment. Taxes ~hich became delinquent before January 1j 198Z bear interest at the rate of six (6X) percent per annum calculated at e daily rate of .OO016q. A11 taxes which became delinquent on and after January 1, 198Z ~ill bear interest at a rate ~hich ~ill vary from calendar year to calendar year aith that 'rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ arm: Year Interest Rate Daily Interest Factor Year X98Z 20X .O00Sq6 1983 X6Z .000q38 198~ ZXX .000301 1985 13~ ~ .000356 1986 XOZ.'. .00027~ 1987 gX ',. .O00Zq~ Interest Rate Daily Interest Factor X99Z 9~ .O00Zq7 1993-199q 7~ .00019Z 1995-1998 92 .0002~7 1999 7~ .000192 2000 6~ .o00gl9 2001 9X .0002~7 200Z 6X .O0016q ' --Interest is calculated as follows: · . ZNTEREST = BALANCE OF TAX UNPATD X -NUHBER OF DAYS DELTNI~UENT. X DATLY I'NTEREST FACTOR --Any Notice issued after the tax becomes delinquent Nill reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated.