HomeMy WebLinkAbout01-0543Estate of 14ELEN p. HOLLINGER
also known as
Deceased.
Social Security No. 5'02-1 fl-8561 °
The petition of the undersigned respectfully represents that:
Your petitioner(gL who is74ff:~ 18 years of age or older an the execut~Or
in the last will of the above decedent, dated Fnhrunry 21~ 200].
and codicil(s) dated
PETITION FOR PROBATE and GRANT OF LETTERS
To:
Register of Wills for the
County of ~ in the
Commonwealth of Pennsylvania
_ named
,19
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h-e~-~ last famil~.o~,t~rinci~alresideqgeat 1/, I,c~nc, vi~w Drtv6,. M~t-h~nJesbttr~. PA
....~ ./~.~/.. (list street, number and muncioality)
Decendent, then _. ~179~/,..years of age, died May 26, 2001 ,19
at l& T,n~Evlew DrJ~ve:~:Mechhnicsburg, PA
Except a~ follows, deceden{ did~hot marry, was not divorced and did not have a child born or adopted
after execution of the v)ill of(e~ed~for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at dea. th owned p. roperty with estimated values as fotlows:
(If domiciled in Pa!)~ :.,~" All personal property
(If not domiciled in Pti.} Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: 14 T,nngv~ew Drive. Mechanicsbur~. PA
$ I00,000.00
$ 115,000.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '-[~-/-'~ ~Y% ~ r'/~ ~._"~
theron.
Gary L. Hollinger
260 Rich Valley Roaa
Mechanicsburg,.PA 17055
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Ct~4~P. LAN9
The petitioner, s) ab3ve-named swear(s) or affirm(s) ~tthe statements in the foregoing petition are
true and correct to thCbest of the knowledge and b~f petitioner(s)~d that ~ person~ represen-
tative(s) of the above-decedent petitioner(s) will we~d truly ad~n~tdr the estate according to law.
Swor
b~re me this ~ ~T~ day of [~rv
-Z35 -5
LAST WILL AND TESTAMENT OF
HELEN P. HOLLINGER
I, HELEN P. HOLL1NGER, of Cumberland County, Pennsylvania, declare this to be my last will
and revoke any will previously made by me.
ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall be
paid fi.om my residuary estate as soon as practicable aRer my decease as a part of the expense of the
administration of my estate.
ITEM TWO: I give, devise and bequeath my entire estate to my children, GARY L.
HOLL1NGER and JOYCE E. HALEY, share and share alike per stirpes.
ITEM THREE: I appoint GARY L. HOLLINGER, Executor of this my last will. Should he fail
to qualify or cease to act as Executor, I appoint JOYCE E. HALEY to act as Executrix with the
same rights, powers and duties.
ITEM FOUR: All estate, inheritance, succession and other taxes, imposed or payable by reason of
my death, and interest and penalties thereon, with respect to all property comprising my gross estate
for tax purposes, whether or not such property passes under this will, shall be paid out of the
principal of my residuary estate, without apportionment or right of reimbursement.
ITEM FIVE: I direct that my personal representative or guardian shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
ITEM SIX: In addition to the rights and powers given to the fiduciaries by law or elsewhere in
this will, I give to my Executor during the full time necessary and for the administration of my
estate the following rights and powers to be exercised in his sole discretion.
A. To retain any real or personal property which may at any time form a part of my estate so
long as he or she deems it advisable.
B. To invest in any real or personal property without restrictions to legal investments.
C. To repair, alter, improve or lease for any period of time any real or personal property and to
give options for leases.
Helen P. Hollinger ~
PAGE ONE OF THREE PAGES
D. To sell at public or private sale, for cash or credit, with or without security, to exchange or
to partition real or personal property, and to give options for leases.
To make distribution in kind.
To compromise claims.
IN ~[I~NESS WHEREOF, I have hereunto
_, 2001.
set my hand this o2
day of
siONED
HELEN P. HOLL1NGER
The preceding instrument, consisting of this and two other typewritten pages each identified by the
signature of the Testatrix was on the day and date thereof signed, published and declared by the
Testatrix therein named as and for her last will, in the presence of us, who at her request, in her
presence and in the presence of each other have subscribed our names.
COMMONWEALTH OF PENNSYLVANIA :
~ SS
COUNTY OF CUMBERLAND :
We /~'/t~(-.)t-q~- ~ &'~ ~' and .~a*. ~qo~4do~.
witnesses whose names are signed to the attached or foregoing instrument being duly qualified
according toAaw, do depose and say~.thst we were present and saw the Testatrix sign and execute
the instrument as her last will; that she signed willingly and executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the heating and sight of the Testatrix signed
the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more
years of age, of sound mind and under no constraint or undue influence.
PAGE TWO OF THREE PAGES
Swom and subscribed to
before me this~t~y
of ~ ,2001.
Notarly Public
' Notarial Seal
Bridget Ann Corcoran, Notary Public
I Cadisle Bore, CumberlandCounty
My Commission Expires June 10, 2002
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, Helen P. Hollinger, whose name is signed to the attached 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 it as my fi~ee and voluntary act for the purposes therein expressed.
Helen P. Hollinger (/
Sw~n/~nd affirmed to and acknowledged before me this c~.lgl'day
~~l~.dl , 2001.
Notary P~blilc
Notarial Seal
Bridget Ann Corcoran, Notary Public
Carlisle Bore, CumberlandCounty
My Commissh~n Expires June 10, 2002
of
PAGE THREE OF THREE PAGES
n
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JOHN H. BROUJOS
HUBERT X. GILROY
BROUJOS & GILROY, P.c.
ATTORNEYS AT LAW
4 NORTH HANOVER STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-4574
FACSIMILE: (717) 243-8227
INTERN£T:b rgilroypc@aoLcom
NON-TOLL FOR HARRISBURG AREA
717-766-1690
July 31, 2001
Mary C. Lewis
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Helen P. Hollinger/No. 21-01-0543
Dear Mary:
Enclosed is a check in the amount of $9,000.00 as preliminary payment of inheritance tax
in the above referenced Estate.
Sincerely yours,
Hubert X. Gilroy
dca
Enclosure
cc: Gary L.iHollinger
OC:;:Z~ L- QgV [0.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
BUREAU OFINDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 000100
BROUJOS & GILROY PC
4 N HANOVER STREET
CARLISLE, PA 17013
ESTATE INFORMATION: SSN: 203-10-8561
FILE NUMBER: 21 -2001 - 0543
DECEDENT NAME: HOLLINGER HELEN P
DATE OF PAYMENT: 08/01/2001
POSTMARK DATE: 07/31/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 05/26/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,000.00
TOTAL AMOUNT PAID:
$9,000.00
REMARKS: BROUJOS&GILROYPC
SEAL
CHECK# 7636
INITIALS: PB
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
BROUJOS & GILROY, P.c.
ATTORNEYS AT LAW
4 NORTH HANOVER STREET
CARLISLE, PENNSYLVANIA 17013
August 31, 2001
TELEPHONE: (717) 2434574
FACSIMILE: (717) 243-8227
INTERNET:brgilroypc@aoL corn
NON-TOLL FOR HARRISBURG AREA
717-766-1690
Mary C. Lewis
Register of Wills
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Helen P. Hollinger/File No. 2001 - 00543
Dear Mary:
Please accept this letter as Certification of Notice under Rule 5.6(a).
The Decedent is Helen P. Hollinger. The date of Death is May 26, 2001. The Estate
Number is 21-01-00543
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 August 31, 2001:
Gary L. Hollinger
260 Rich Valley Road
Mechanicsburg, PA 17055
Joyce E. Haley
109 Park Road
Waynesburg, PA 15370
Notice has now been given to ali persons entitled thereto under Rule 5.6(a).
If you have any questions, please feel free to contact me.
Sincerely yours,
Hubert X. Gilroy '
Attorney for Estate of Helen P. Hollinger
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF IN DIVtDUAI. TAXES
DEPT. 280601
HARRISSURG, PA 1 ? 128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 000563
GILROY HUBERT X
4 N HANOVER STREET
CARLISLE, PA 17013
........ reid
ESTATE INFORMATION: SSN: 203-10-8561
FILE NUMBER: 21 -2001 - 0543
DECEDENT NAME: HOLLINGER HELEN P
DATE OF PAYMENT: 11/28/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/26/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $692.73
TOTAL AMOUNT PAID:
$692.73
REMARKS: GARYLHOLLINGER
C/O HUBERT X GILROY
SEAL
CHECK# 125
INITIALS: AC
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT, 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl
HOLLINGER~ HELEN P.
DATE OF DEATH (MM-DD-Year)
05/26/2001
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 -0 1 0 5 4 3
S~IAL SECU~TY NUMBER
203-10-8561
CATE OF BIRTH (MM-O[~Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
02/14/1922
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1.OdginalRetum [] 2. SupplementaIRetam [] 3. RemainderReturn (dateofdeathpr~rto12-13-821
[] 4. Limited Estate ~L_J 4a. Futam Interest Compromise (d~ or
5.
Federal
Estate
Tax
Return
Required
[] 6. Decedent Died Testate (A~ach copy of win) [] 7. Decedent Maintained a Living Trust I^=,ch copy of Trust) 8. Total Number of Safe Deposit
Boxes
[] 9. Litigation Prceeods Received [] 10. Spousal p,over~ Credit (date of de~l be~ 12-31-91 acd 1-1-95) [] 11. Election to tax under Sec. 9113(A)I,~h S<h O)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO;
NAME COMPLETE MAILING ADDRESS
HUBERT X. GILROY 4 NORTH HANOVER STREET
Z
X
,<
FIRM NAME )If Applicable)
BROUJOS & GILROY~ P.C.
TELEPHONE NUMBER
717-243-4574
CARLISLE, PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnemhip or Sole-Proprietorship {3)
4. Mo~ages & Notes ReCeivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Prober'b/(Schedule F) (6)
] Separate Billing
Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probata Prope~ (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Adminisb-ative Costs (Schedule H) (9)
10. Debts ol Decedent, Modgage Liabilities, & Liens (Schedule I) {10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estaie (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
5~651.26
1~451.92
(11)
(12)
7,103.18
215~394.04
215,394.04
(13)
(14)
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
16. Amount ol Line 14 taxable at lineal rate
X __ (15)
215,394.04 X .045 (16)
9,692.73
17. Amount of Line 14 taxable at sibling rate X .12 (17}
18~ Amount of Line 14 taxable at celtateral rate X A5 (18)
19. Tax Due (19)
9,692.73
· · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
R~IOENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
HOLLINGER. HELEN P. 31 01 O~4~
All real prope~ly owned solely or as a tenant in common must be repo~ted at fair marke~ value. Fair market value is defined as {he pdce al which properly would be exchanged
between a willing buyer and a willing seller, nei{her being compelled to buy or sell, beth having reasonable knowledge of the relevant facts, Real property which is jointly-owned v~th right of
survivorship must be disclosed on Schedule F,
ITEM
NUMBER
VALUE AT CATE
DESCRIPTION OF DEATH
107,820.73
Sale of 14 Longview Drive, Mechanicsburg, PA
;ee attached Hud-l)
TOTAL (Also enter on line 1, Recapitulation) '
$ 107=820.73
(If more space is needed, insert additional sheets of the same size)
OMB NO. 2502-0265 C
A. . B. TYPE OF LOAN:
I.J.S. D~PARTMENT OF HOUSING & URBAN DEVELOPMENT 1.E]FHA 2.[~FmHA 3.~lcoNv UNINS. 4. FIVA 5. E]CONV. INS.
6. FILE NUMBER: I 7. LOAN NUMBER:
Pd19061 .... ' ' -
I
SETTLEMENT STATEMENT 8. MORTGAGE INS CASE NUMBER:
C. NOTE: This fon'n is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown,
Items marked '?POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals
D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F NAME AND ADDRESS OF LENDER:
Craig M McEwen Estate of Helen P. Hollinger Centu~/21 (R) Mortgage(SM)
400 Kings Highway 2001 Bishops Gate Blvd
Marysville, PA 17053 Mount Laurel, NJ 08054
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2267691 I. SE"CI'LEMENT DATE:
14 Longview Drive Broujos & Gilroy, PC
Mechanicsburg, PA 17050 July 30, 2001
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
4 North Hanover Street
Carlisle, PA 17013
J. SUMMARY OF BUYER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 118,000.00 401. Contract Sales Price 118,000.00
102. Personal Propert*~ 402. Personal Property
103. Settlement Charges to Buyer fLine t400) 6,725.26 403.
104. 404.
105. 405.
Adjustments For Items Paid Bv Seller in advan6¢ Adjustments For Items Paid Bv Seller in advance
106. City,Town Taxes to 406. City/Town Taxes to
107. County Taxes 07/31/01 to 01/01/02 ~ 105.51 407. Count}, Taxes 07/31/01 to 01/01/02 i 105.51
108. Assessments 07/31/01 to 07/01/02 812.95 408 Assessments 07/31/01 to 07/01/02 812.95
109.I' 409.
110. I 410
111. !411.
112. 412.
120 GROSS AMOUNT DUE FROM BUYER 125,643.72 420. GROSS AMOUNT DUE TO SELLER 118,918.46
200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest money 501. Excess Deposit (See Instructions)
202. Principal Amount of New Loan(s) r 120,350,00 502, Settlement Charges to Seller (Line 1400) 11,097.73
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204 504. Payoff of first Mortgage
205. 505, Payoff of second Mortgage
206. 506
207. Credit of Points 350.00 507.
208. 508
209, 509.
Adiustmenls For Items Unpaid By Seller Adiustments For Items Unpaid By Seller
210. City/Town Taxes to 510. City/Town Taxes to
211. Count), Taxes to 511. County Taxes to
212. Assessments to : 512. Assessments to
213. 513.
214. 514
215. 515.
216. i 516.
217 ~ 517.
218. ; 518.
219. 519.
220 TOTAL PAID BY/FOR BUYER i 120,700.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 11,097.73
300. CASH AT SETfLEMENT FROM/TO BUYER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Buyer (Line 120) 125,643.72 601. Gross Amount Due To Seller (Line 420) 118,918.46
302. Less Amount Paid By/For Buyer (Line 220) ( 120,700.00) 602. Less Reductions~Due Seller (Line 520) ( 11,097.731
303. CASH ( X FROM) ( TO) BUYER 4,943.72 603. CASH ( X TO~f/~ FROM) SE~LLE~ 107,820.73
The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & attachment re ed to herein.
HUD-1 (3-86) RESPA, H~4305 2
COMMONWEALTH O~c PENNSYLVANIA
INHER~TANCE TAX RETURN
R£SIDENT DECEDENT
SCHEDULE E
CASH, BANK Di PosiT , MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
HOL, LINGER. HELEN P. 21 Q1 {~45
include the proceeds of litigation and the date the proceeds were received by the estate. All property joint¥owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2
3
4
5
6
7
8
9
t0
12
13
14
15
Savings Acct with Members 1st
Acct # 2252-04
Investment Savings with Members 1st
Acct # 2252-05
18 month certificate with Members 1st
Acct # 2252-40
18 month certificate with Members 1st
Acct # 2252-41
Life Insurance Proceeds from Share Acct (Minnesota Life Group)
Fulton Bank 30 month Certificate
Acct # 025-0123999
Fulton Bank Interest check on 30 month Certificate
Acct # 025-0123999
2001 Buick Sold to Turner Buick
First Union Certificate # 247412061157413
First Union Certificate #247412061145877
Mellon Bank
Checking Acct # 142-103-4966
Verizon - Telephone bill refund
Erie Insurance - refund 8/14/01
Erie Insumce -refund 8/21/01
Patriot News
5,713.48
15,621.48
10,029.37
21,061.68
1,795.55
10,000.00
24.15
16,000.00
20,030.48
20,057.20
6,039.81
18.45
232.00
24.00
28.84
TOTAL (Also enter on line 5, Recapitulation) $ 126,676.49
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHEPJTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
HOLLINGER, HELEN P, ,21 ~1 0543
This schedule must be completed and flied if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET i~ yes.
DESCRIPTION OF PROPERTY % OF
ITEM iNCLUDE T~E NA~E OF THE TP-~NSFEREE. THEIR RELATIONSHIP TO DECEDENT ^ND THE DATE DE TP'ANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATT~H A COFf OF THE DEED CDR R~fl' ESTATE VALUE OF ASSET INTEREST (IF APPLIC~B-E}
1. Gary Hollinger, Son 8,000.00 3,000.00 -3,000.00
2 Joyce Haley, Daughter 8,000.00 3,000.00 -3,000.00
3 Frank Haley, brother-in-law 7,000.00 3,000.00 -3,000.00
4 Chris Reese, daughter-in-law 7,000.00 3,000.00 -3,000.0C
TOTAL (Also enter on line 7, Recapitulation) $ -12,000.0£
(If more space is needed, inset1 additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX P,~'TURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
HOLLINGER. HELEN p,
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 01 0543
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
Melpezzi Funeral Home
Dr. Terry Zebulske
Pastor David Allen
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Repmseetative (s) Gary L Hollinger
Social Security Number(s) / EIN Number of Personal Representative(s)
StreetAddress 260 Rich Valley Road
C~y Mechanicsburg State PA
Year(s) Commission Paid:
AttomeyFees Broujos & Gilroy, P.C.
Family Exemption: (If decedent's address i~ not the same as claimant's, attach explanation)
Claimant
17055
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparers Fees
Register of Wills - Filing Fee
Family Settlement Agreement
Inheritance Tax Return
State . Zip
TOTAL {Also enter on fine 9, Recapitulation
3,558.26
150.00
100.00
1,500.00
311.00
17,00
15.00
5~651.2R
more space is needed, inse~t additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
HOLLINGER, HELEN P.
Include unreimbursed medical expenses.
FILE NUMBER
21 01 0543
ITEM
NUMBER DESCRIPTION AMOUNT
2
3
4
5
6
7
8
9
10
12
13
14
15
Verizon Telephone - June
Jnited Water Company - June/July
'ork Waste Disposal -
Lowe's (painting of bedroom 14 Longview Drive)
Gary Hollinger - reimbursement for plumbing material for 14 Longview Drive
Verizon Telephone - July
Silver Spring Township Authority
ComCast Cable Company
Olive Garden - Gift Cetificate for neighbors Dale and NancyHench and Jerry & Pat Sheel
Olive Garden - Gift Certificate for Fred Maderia for singing at funeral services
Advantage Receivable to pay off GM Master Card
Castle Clean - carpet cleaning at 14 Longview Drive
Zimmerman Plumbing & Heating (removal of old boiler)
PP&L - electric
MCI World Corn
20.39
27.46
29.34
36.39
47.44
53,27
80.75
64.02
60.00
30.00
129.37
136.74
230,00
157.98
71.04
TOTAL (Also enter on line 10, Recapilulation) $ 1 ~451.92
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
HOLLINGER, HELEN P. 21 01
Pa,qe 1
Schedule I - Debts or Decedent, Mortgage Liabilities, & Liens
0543
ITEM
NUMBER DESCRIPTION AMOUNT
16
17
18
United Water Company
Ken Diltz / Appraiser
Phillips Office Supply - supplies for handling estate
14.46
150.00
113.27
SUBTOTAL SCHEDULE I 277.73
GRAND TOTAL SCHEDULE I $ 1,451.92
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
HOLLIN( iER. HELEN P.
NUMBER
1.
2
I[,
1.
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Gary L Hollinger
260 Rich Valley Road
Mechanicsburg, PA 17055
Joyce E. Haley
109 Park Road
Waynesburg, PA 15370
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES
FILE NUMBER
21 01
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daugh~r
THROUGH 17, AS APPROPRIATE
0543
AMOUNT OR SHARE
OF ESTATE
5O%
50%
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 ILl - 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)
LAST WILL AND TESTAMENT OF
HELEN P. HOLLINGER
I, HELEN P. HOLLINGER, of Cumberland County, Pennsylvania, declare this to be my last will
and revoke any will previously made by me.
ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall be
paid from my residuary estate as soon as practicable after my decease as a part of the expense of the
administration of my estate.-
ITEM TWO: I give, devise and bequeath my entire estate to my children, GARY L.
HOLLINGER and JOYCE E. HALEY, share and share alike per stirpes.
ITEM THREE: I appoint GARY L. HOLLINGER, Executor of this my last will. Should he fail
to qualify or cease to act as Executor, I appoint JOYCE E. HALEY to act as Executrix with the
same rights, powers and duties.
ITEM FOUR: All estate, inheritance, succession and other taxes, imposed or payable by reason of
my death, and interest and penalties thereon, with respect to all property comprising my gross estate
for tax purposes, whether or not such property passes under this will, shall be paid out of the
principal of my residuary estate, without apportionment or right of reimbursement.
ITEM FIVE: 1 direct that my personal representative or guardian shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
ITEM SIX: In addition to the rights and powers given to the fiduciaries by law or elsewhere in
this will, I give to my Executor during the full time necessary and for the administration of my
estate the following rights and powers to be exercised in his sole discretion.
A. To retain any real or personal property xvhich may at any time form a part of my estate so
long as he or she deems it advisable.
B. To invest in any real or personal property without restrictions to legal investments.
C. To repair, alter, improve or lease for any period of time any real or personal property and to
give options for leases.
Helen P. Hollinger ~-
PAGE ONE OF THREE PAGES
D. To sell at public or private sale, for cash or credit, with or withoui security, to exchange or
to partition real or personal property, and to give'options for leases.
E. To make distribution in kind.
F. To compromise claims.
IN ~_I2NESS WHEREOF, I have hereunto set my hand this c,~ [ ~'~'-
day of
,2001.
HELEN P. HOLLINGER ~'
The preceding instrument, consisting of this and two other typewritten pages each identified by the
signature of the Testatrix was on the day and date thereof signed, published and declared by the
Testatrix therein named as and for her last will, in the presence of us, who at her request, in her
presence and in the presence of each other have subscribed our names.
COMMONWEALTH OF PENNSYLVANIA :
~ SS
COUNTY OF CUMBERLAND :
witnesses whose names are signed to the attached or foregoing instrument being duly qualified
according to law, do depose and say that we were present and saw the Testatrix sign and execute
the instrument as her last will; that she signed willingly'and executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed
the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more
years of age, of sound mind and under no constraint or undue influence.
./
PAGE TWO OF THREE PAGES
Sworn and subscribed to
before me this~fC<J~y
of ~ ,2001.
Nota~ Public
Notarial Seal
Bridget Ann Comoran. Notaq/Public
,Carlisle Doro, C6mberland County
~'.4~ Commission Expires June 10, 2002
COMMONWEALTH OF PENNSYLVANIA :
~ SS
COUNTY OF CUMBERLAND :
I, Helen P. Hollinger, whose name is signed to the attached 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 it as my free and voluntary act for the purposes therein expressed.
tfelen P. Hollinger (/
S,~m/~nd affirmed to and acknowledged before me this c ]CXday of
~IA,~.~, 2001.
Notarial Seal
Bridget Ann Corcoran. Notaq/Public
Carlisle Boro, CumberlandCounty
My Commissi,.,n Ex~ircs June 10,2002
PAGE THREE OF THREE PAGES
Monongalia Emergency Medical Services
~.~ Business: Billing:
801 I.D. Anderson Drive 1000 J.D. Anderson Drive
Morgantown, WV 26505 Morgantown, WV 26505
(304) 295-2715 (304) 59g-1940
Emergency: 911
c-~ ......-c~,~ ..... ~' ...........................
f~:P-~OOF I~F CLA.[M:~- AGAINST DECEDEITT'S ESTATE
~Iq:,the matter 6~e
ate o~-Iele ,r~, ~t. olhnger
Pending before
REGISTER OF W~LLS, Commissioner
Of Deceased Accounts,
Cumberland County, PA
The undersigned, being first duly sworn, says: That he/she is a creditor (that he/she
is a duly authorized agent of a creditor) of the estate of the above named decedent;
that the character of his/her claim is medical, that the amount thereof is
$ 80~,.83 until paid. That a proper voucher relating to said claim is hereto
attached; that the said claim is just and true and that the said creditor, or any prior
owner of the claim, if any there was, hath not received any of the money stated to
be due, or any security or satisf~ctiori for the same except that which is credited.
I~lary ~n Tokarz, Affidavit ._.)
Taken, sworn to, and subscribed to rhe this 6th day of February, 2002.
rvly commission expires: May 10, 2010.
~-~.~A service of Monongalia Health System
Monongalia Emergency
Medical Services
1000 J.D. Anderson Drive
Morgantown, West Virginia 26505
304-598-1560
FEDERAL i.D. # 550725494
MONOi'~IG~IA COONTY'EMERGENC¥
SERV'ICE IS A P~IV~TE~'NOT FOE
~PROF'ZTORGANZZA~['ON'
~NSUPPORTED'~Y'AN¥ MUNiCIPAl
OR"CODNIY TAX; ~R'~8['L[T¥
TO PROVIDE EMERGENCY 'SERVICE
ACCOUNT NUMBER PADENT NAME I S DEPENDENT' ON" YO[~R' ~PA'¥ME NT,
56~]'8--5 HO[f.[NGER~' HELEN P
'ROL~INGER~ H~P
MECR~NICSBORG~ 'P'~ -[T055'
DATE ADU~ED DATE D~SCHA~GED PAGE NUMBER
~Z~O~ O0~
DATE BATCH CHARGE SE~IC~ DESCRIPTION QUANTI~ PRIDE
NUMBER , NUMBER
' [O~USTMENIS
?/[0/200'I 8Z005 ~709700 ' ~A'T~I'DE PRO~ 'COMP "A'B 1'-- I'85.8Z--
~ SOBTOT~C o* I~ I85;:8Z--
~AYM ENT5 003
7/'[0/'200I '8Z~E t97'ZO['g )AYMENT' NAT[ONNIDE PRO 1'- '33I;3'Z~
9~28/'200~ 85000 ~9[~03I' 'aYfl~T-' aC' FED'ERAC EMP
~'MB~ ~N~ E SERVICE ~OO
5~0~00I '03008 :Z0007'7 ~L5' '~ NE'MER HOS'P TO R'ES'AO~'Z6HR 't' 'Z60~'O0
5/20/2001 '03008 iZ05555" ~LS MILEA'GE A0'390
~ S'OBTOTAL ** Z~7 T~O~'80
~R'~N~ TOTALS
~' ~A~' TWO C~RGE~S
'A~U STMENT S ' 'I 85.8Z-
'TO~ A[ BaC ANC'E
FORM - 0802 11/93
Monongalia Emergency Medical Services
Business: Billing:
801 J.D. Anderson Drive 1000 J.D. Anderson Drive
Morgantown, WV 26505 Morgantown, WV 26505
(304) 285-2715 (304) 598-1940
Emergency: 911
RELEASE OF CLAIM - AGAINST DECEDENTS ESTATE
In the matter of the estate of
Helen R. Hollinqer
Deceased,
Pending before
Commissioner of Accounts,
Cumberland County, PA
The undersigned, being first duly sworn, says: That he/she is a creditor (that he is a duly
authorized agent of a creditor) of the estate of the above named decedent; that the character
of his claim is and
Account # 5694385
that the amount thereof is $
Mononoalia Emeraencv Medical Services
804.83 is paid in full.
$804.83
Affiant ._~
Taken, sworn to and subscribed before me this the
4th day of March, 2002.
- ~ Notary Public-
My commission expires May 10, 2010
~"~.~ A service of Monongalia Health System
BUREA~ OF ZND/VIDUAL'TAXES
INHERITANCE TAX DIVISION
.DEPT. 180601
HUBERT X GILROY
BROUJOS & 6ILROY
~ N HANOVER ST
CARLISLE
COHHONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF TNHERTTANCE TAX
APPRAISEHENT, ALLONANCE OR nTSALLONANCE
OF UEDUCTTONS AND ASSESSHENT OF TAX
*02 HAY -3 ~]]:19
p/~LI*qO-I:3~-A, 3A, 8J, ,, %'
DATE 0~-29-2002
ESTATE OF HOLLINGER
DATE OF DEATH 05-26-2001
FZLE NUHDER 21 01-05~$
COUNTY CUHBERLAND
ACN 101
Amount Ramified
HELEN P
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF HOLLINGER HELEN P FILE NO. 21 01-05~$ ACN 101 DATE 0~-29-2002
TAX RETURN NAS: ( ) ACCEPTED AS FTLED (X) CHANGED SEE ATTACHED NO~ICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. S~ocks and Bonds (Schedule B)
$. CZosely Held Stock/Par~nership [nteras~ (Schedule C)
q. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Proper~y {Schedule F]
7. Transfers (Schedule G}
8. To,al Assets
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expansas/Adm. Cos*s/Hlsc. Expenses (Schedule H)
10. Debts/Not,gage Liabil~ias/L~ens (Schedule 1)
11. To,al Deductions
12. Ne~ Value of Tax Ra~urn
(1) 107z8ZO.75
(2) . O0
(5) . O0
(q) . O0
(.6) 1Z6,r676.q9
(6) .00
NOTE: To insure proper
cred~ to your account)
submi~ ~he upper port~on
of ~h~s form ~h your
tax payment.
(9) 5,651.26
(10) 1,~51.92
(11) 7. ] 03. ]8
(12) 2~5,39q.0~
15.
NOTE:
ASSESSHENT OF TAX:
15. Amount of L/ne 1~ a~ Spousal ra~a
16. Amount of L/ne 1~ ~axabla a~ Lineal/Class A rate
17. Amount= of Line 1~ a~ S:ibling ra~e
18. Amoun~c of Line 1~ taxable at Collateral/Cless B rate
19. Principal Tax Due
TAX CREDITS:
PAYNEN1 RECEIPT
DATE NUHDER
07-31-2001 COO00100
11-28-2001 CD00056:5
INTEREST 1S CHARGED THROUGH 05-1~-Z001
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
DISCOUNT
INTEREST/PEN PAID (-)
~,7~.68
.00
(1~) .00 X O0 = .00
(16) 2ql,59~'.Oq X 0~5= 10,862.7~
(17) .00 X 12 .00
(1s) ~,000.00 x 15 600.00
(19)= 11,~62.7~,
AHOUNT PAID
9,000.00
692.75
TOTAL TAX CREDIT
TOTAL DUE
10,166.ql
BALANCE OF TAX DUE 1,296.$$
INTEREST AND PEN. 16.37
1,312.70
( IF TOTAL DUE ZS LESS TNAN $1, NO PAYHENT ZS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A 'CREDIT" (CR}~ YOU HAY BE DUE
A REFUND. SEE REVERSE B/DE OF THIS FORH FOR INSTRUCTIONS.)
Chari~abla/Governman~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0
Na~: Value of Es~a~a Sub.~ec~ ~o Tax (lq) 2q5, ~9~.. O~
I~ an assessment Nas ~asued p~eviously, l~nsa 1~,, 15 and/o~ 16, 17, 18 and 1~ Ni1:l
reflect fi§urea that ~n¢lude the tota! of AL_~_L returns asaessed to date.
ZF PAID AFTER DATE ZND/CATED~ SEE REVERSE
FOR CALCULATION OF ADDITIONAL ZNTEREST.
(7) 18;000.00
(8) 252,~97.ZZ
~EV-1470 EX (%88) ' ,~ '*
EXPLANATi~':~I'r
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
~}ECEDENT'S NAME FiLE NUMBER
Hollinger, Helen P. 2101-0543
ACN
REVIEWED BY Daniel Heck
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
These transfers have been adjusted to show the taxable amount for each transfer.
G 1,2,3, Transfers I and 2 are taxable at $5,000.00 to the daughter and the son. Transfers 3 and 4
4
are taxable at $4,000.00 to the daughter-in-law and brother-n-law.
G 3 Changed tax rate from 4.5 percent to 15 percent since a brother-in-law is a collateral
beneficiary.
ROW Page 1
,'llll Monongalia Emergency Medical Services
,..t...JI7 Business: Billing:
801 J.o. Anderson Drive 1 000 J.o. Anderson Drive
Morgantown, WV 26505 Morgantown, WV 26505
(304) 285-2715 (304) 598-1940
Emergency: 911
o
r~''''1
------------------------------------------------------------------------------------------------------
.',
" (-.,,<
PROOF OF CLAIM - AGAINST DECEDENTS ESTATE
----------o~-------------------------------------------------------------------------------------------
I
CO
t.J.J
w..
:l~,;the matter Q~ ~e
,[;Emate ot:fielereP5Hollinger
L_ ,,'~
'....~ "-'"
Pending before
REGISTER OF WILLS, Commissioner
Of Deceased Accounts,
Cumberland County, PA
0.2/-0/- 0-<<3
The undersigned, being first duly sworn, says: That he/she is a creditor (that he/she
is a duly authorized agent of a creditor) of the estate of the above named decedent;
that the character of his/her claim is medical, that the amount thereof is
$_804.83_ until paid. That a proper voucher relating to said claim is hereto
attached; that the said claim is just and true and that the said creditor, or any prior
owner of the claim, if any there was, hath not received any of the money stated to
be due, or any security or satisfaction for the same except that which is credited.
Taken, sworn to, and subscribed to me this 6th day of February, 2002.
My commission expires:
May 10. 2010.
F;.). A service of Monongalia Health System
Lr-C" AI,
"/O'longa'ia -=:mergency
~, : I:~ J eaical Services j." ~ ." ..
" '.
FEDERAL I D, # 550725494
MONUNGALIA COUNTY EMERGE~CY
SERVICE IS A PRIVATE., :'\lOT FOR
PROfIT ORGANI LA TION
tJNSUPPGRTEOSY ANY MUNI CIPAt.
OR COUNTY fAX. OUR ABILITY
TO PROY IOEE~ERGENC 'f SERVICE
lIS DEPENDENT ON YOUR PAYMENT.
~
i
I
I
o lC ,J D t\lrJers:'r; 0 :VI'
11< IW:U,tUViIl '.tv.? 3t Vir Jlnia 26505
: D k,i8'l., EifiC
~AC( ~,.~ 1 NUtv~'~~~I===~~=' PATlENTNAME
i 56q438-5 HOl.t.INGER. HECEfif P
HC::.t.INGER. HELEN P
i<t l.(;N'GVIEW QRIVE
MECflANICSBORG~ PA 11055
,
i ;
17/10/2001 8Z005 912019
19128/?001! 85000 ,912031
i i
~OJUSTMENTS
~ATIO'NWI1JE PROF COMP AD
i
I
fA. Y. ME,N T,S
AYMENT- NA TIONWIOE PRO
AYMENT- BC FEDERAL E~P
tfi4BULANCE SERVICE
lS 1 NEMER HOSP TO RESA0426HR
lS MILEAGE A0390
~ SUBTOTAL **
**
I DATE DISCHARG~E N~M!ER ~..
j5/'20/0l ---r-- 1
I ~~~RICE____~=
aoz . r _ I 1 85 . 82-
SU6TOT.t.. ~* 1- I UJ5.8l-
003 i
1- !
1'- i
!
l-
DATE ADMITTED
PHONE: I
2/1)5/2002
r-=~-! 'ft T . = l =~~~~~R L.....&tj~~~~
i
I I
171lC1/2001 62005 k709100
517.01'0 t
SERVICE DESCRIPTION
**
SUBTOTAL **
331.32-
82.83-
414.15-
~oo
IS/2C/2001 03008 4200077
,51'20/2001 03008 ~Z055'55
1
216
211
260.00
1144.80
1404.80
'RANS TOT ",-S
I wlO aAL FWO CHARGES
i At).Jt1STfIIIIENT S
I PA'YMENTS
1
: 1 i
.._."_..__._~---~
1.404.80
t 85.8 2-
4-l4.15-
TOTAt. BALANCE : 804..83 r
..L_~____L____~..__._._..__;
FORM.0802 1193
..
r"1 ,_' <<--,( / ~.
~ / I '~~7--~'
~rl'-~ Monongalia Emergency Medical Services
~ .
~.-~7 Business: Billing:
801 J.D. Anderson Drive 1 000 J.D. Anderson Drive
Morgantown, WV 26505 Morgantown, WV 26505
(304) 285-2715 (304) 598-1940
Emergency: 911
RELEASE OF CLAIM - AGAINST DECEDENTS ESTATE
In the matter of the estate of
Helen R. Hollinger
Deceased,
Pending before
Commissioner of Accounts,
Cumberland County, PA
The undersigned, being first duly sworn, says: That he/she is a creditor (that he is a duly
authorized agent of a creditor) of the estate of the above named decedent; that the character
of his claim is and
Account # 5694385
that the amount thereof is $
Monongalia Emergencv Medical Services
804.83 is paid in full.
$804.83
./YY\u.,~~
\ Affiant
Taken, sworn to and subscribed before me this the
:;;~,;C'c;:;-<-::::::' _."..:~
. '.,~ ~
4th day of March, 2002.
\.:~:;~-~-,-.
('
II
'.',
(~ ~"
\ .
r~,;j , . .. , ., L;';;,~~"
.- -" .-,
""=.....c'J1o:o-~-.4!b ,-~ ~- ;<:~~~"::,,:l:>>.i.......
'~};''';';C.I/'''''''''''''''''-,J'--''''''''i' ---- -
.' j:.~ 'l
" nlAJ. Ii ~ dzA
- J Notary Pub Ie
My commission expires
May 10, 2010
I";;) A service of Monongalia Health System
/ c<'-,23"s~- 5
\ BUREAV OF INDIVIDUAL TAXES
,.,. INl ~!~ITANCE TAX DIVISION
l3Ei~.. 280601
4f 'HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
'0;:
!i!\Y
..,
- --j
" : 1(.'
HUBERT X GILROY
BROUJOS & GILROY
4 N HANOVER ST
CARLISLE
\J
'"
PA ,ll?013-4348
04-29-2002
HOLLINGER
05-26-2001
21 01-0543
CUMBERLAND
101
'*
REV-lS47 EX AFP (0I-02l
HELEN
P
Allount Rellitted
NOTE: To insure proper
credit to your account.
subllit the upper portion
of this forll with your
tax paYllent.
(8)
252.497.22
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 ~
REV=is'4j-E3f-i,FP--foY=02Y-NOTicE--OF-YNHEififAifcE-TAX-jrppRAYsEi..-ENi':--i,irowAifcE-'(fli------------ - - ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOLLINGER HELEN P FILE NO. 21 01-0543 ACN 101 DATE 04-29-2002
TAX RETURN WAS: ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
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)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/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 (Schedule J)
14. Net Value of Estate Subject to Tax
(1)
(2)
(3)
(4)
(5)
(6)
(7)
107,820.73
.00
.00
.00
126,676.49
.00
18.000.00
7.103 18
245,394.04
.00
245.394.04
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount 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 Due
TAX CREDITS:
.00 X 00 = .00
241.394.04 X 045 = 10.862.74
.00 X 12 = .00
4,000.00 X 15 = 600.00
(19)= 11.462.74
(9)
(10)
5.651.26
K~\.~.LI"I (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-31-2001 CDOOOI00 473.68 9.000.00
11-28-2001 CDOO0563 .00 692.73
INTEREST IS CHARGED THROUGH 05-14-2002 TOTAL TAX CREDIT 10.166.41
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 1.296.33
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 16.37
TOTAL DUE 1.312.70
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
1. 451. 92
(11)
(12)
(13)
(14)
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoy.ent to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Co..onwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the require.ents of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and sub.it with your payment to the Register of Wills printed on the reverse side.
--Make 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 "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraise.ent, allowance, or disallowance of deductions, or assess.ent
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of AppealS, Dept. 281021, Harrisburg, PA 17128-1021, 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 assess.ent should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for 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 decedent's death, a five percent (5%) discount of
the tax paid is allowed.
The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax a.nesty period. This non-participation
penalty is appealable in the same manner and in the the sa.e time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 20% .000548 1992 9% .000247
1983 16% .000438 1993-1994 n .000192
1984 11% .000301 1995-1998 9% .000247
1985 13% .000356 1999 n .000192
1986 10% .000274 2000 8% .000219
1987 9% .000247 2001 9% .000247
1988-1991 11% .000301 2002 6% .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assess.ent. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
REV-1470 fV 16-~r'
~ l.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
FILE NUMBER
REVIEWED BY
ACN
2101-0543
101
Hollinger, Helen P.
Daniel Heck
ITEM
SCHEDULE NO.
G 1,2,3,
4
EXPLANATION OF CHANGES
These transfers have been adjusted to show the taxable amount for each transfer.
Transfers 1 and 2 are taxable at $5,000.00 to the daughter and the son. Transfers 3 and 4
are taxable at $4,000.00 to the daughter-in-law and brother-n-Iaw.
G 3
Changed tax rate from 4.5 percent to 15 percent since a brother-in-law is a collateral
beneficiary .
ROW
Page 1
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. CD 001156
GILROY HUBERT X
4 N HANOVER STREET
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 203-10-8561
FILE NUMBER: 2101-0543
DECEDENT NAME: HOLLINGER HELEN P
DATE OF PAYMENT: 05/09/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/26/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,312.70
TOTAL AMOUNT PAID:
$1,312.70
REMARKS: GARYHOLLINGER
C/O HUBERT X GILROY ESQUIRE
SEAL
CHECK# 131
INITIALS: VZ
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZVZSZDN
HUBERT X GILROY
BROUJOS & GILROY
4 N HANOVER ST
CARLISLE
CONMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
R6gisier ot
'02 JUNIO / 8:06
PA'
DATE 06-05-2002
ESTATE OF HOLLZNGER
CATE OF CEATH 05-26-200!
FILE NUN~ER 2I 01-0545
COUNTY CUMBERLAND
ACN 10!
Amount Remt~ed
HELEN P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 17013
NOTE: To tnsure proper credit to your account,,submit tho upper por~ton of ~his form w~h your tax paymen~c.
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV 1607 EX AFP (OI 02) l;~# INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF HOLLTNGER HELEN P FILE NO. 21 01-05q3 ACN 101 DATE 06-03-2002
THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHOMN BELO#
ZSA SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE;
A PROJECTED INTEREST FTSURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-29-2002
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
lltq62.7q
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
07-31-200Z
11-28-2001
05-09-2002
CDO00100
CD000565
CD001156
475.68
.00
15.31-
9,000.00
692.73
1,312.70
ZF PAID AFTER THIS DATE; SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1, HO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT*' (CR);
TOTAL TAX CREDIT 11,q63.80
BALANCE OF TAX DUE 1.06CR
INTEREST AND PEN. .00
TOTAL DUE 1.06CR
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: EVELYN M. WAGNER
Date of Death:
June 1, 2002
No. 2002-0543
Admin. No. 21-02-543
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 fo]lowing beneficiaries of the above-captioned
estate on June 19, 2002.
Name Address
Marcia A. Laganosky
86 Hoover Road, Carlisle, PA 17013
Donna J. Johnson 2712 Lisburn Road, Camp Hill, PA 1701~
Barry L. Wagner 895 Emily Drive, Mechanicsburg,=~, PA/~$5!PA. ~)55
Linda K. Markel 46 Warrington Road, Dillsburg, PA,/~019
gll persons entitled th~et,, und, e~ le 5.~a)/' except:
Notice has now been given to
None
Date: July 19, 2002
Murrel R. Waiters, III, Esquire
54 East Main Street
Mechanicsburg, PA 17055
(717) 697-4650
Capacity: __ Personal Representative
X Counsel for personal representative
Estate of Helen P. Hollinger
Estate Settlement Agreement
THIS AGREEMENT made this ]~ day of ~ , 2002, between Gary
L. Hollinger, in his capacity has Executor of the Est~e of Helen P. Hollinger (Executor)
and Gary L. Hollinger and Joyce E. Haley, in their capacity as beneficiaries of the Estate
of Helen P. Hollinger (Beneficiaries).
WITNESSETH
WHEREAS, Helen P. Hollinger (Decedent) died on May 26, 2001; and
WHEREAS, pursuant to the Will of the Decedent dated February 21, 2001, Gary L.
Hollinger was appointed Executor of the Decedent's Estate by the Cumberland County
Register of Wills by appropriate action by the Register of Wills at Docket Number 21-01-
0543; and
WHEREAS, the Executor has truly and appropriately administered the Estate of the
Decedent; and
WHEREAS, the Executor has filed a Pennsylvania Inheritance Tax Return with the
Pennsylvania Department of Revenue and has also filed all necessary Income Tax
Returns; and
WHEREAS, the Executor has accomplished payment of all inheritance taxes owing on the
Estate of the Decedent and has accomplished the payment of all obligations owing on the
Decedent's Estate; and
WHEREAS, the Executor has provided to all beneficiaries the opportunity to examine all
records of the Decedent in possession of the Executor and to examine ali records of the
Estate; and
WHEREAS, the Executor is prepared to achieve the final distribution of the Decedent's
Estate; and
WHEREAS, the Executor and the Beneficiaries desire that the administration of the
Estate of Helen P. Hollinger be terminated without the expense and delay of a court
accounting and the parties are willing to enter into this Estate Settlement Agreement in
order to expedite the conclusion of the Estate.
NOW THEREFORE, the parties in consideration of their mutual covenants herein
expressed and intending to be legally bound hereby agree as follows:
1
The parties to this Agreement hereby waive the filing of a formal accounting and schedule
of distribution in the Estate of Helen P. Hollinger.
2
The parties acknowledge that they have been provided an opportunity to examine all
paperwork and accounting of all expenses and revenue with respect to the Estate of Helen
P. Hollinger.
3
The parties acknowledge that ali bills of the Estate of Helen P. Hollinger have been paid
and further acknowledge that they have satisfactorily distributed or will distribute the
remaining assets of the Estate between the two named beneficiaries Gary L. Hollinger and
Joyce E. Haley, in equal shares.
4
The parties hereby forever release, compromise, settle and discharge any and all claims
which any of them may have against any party hereto or against the Estate of Helen P.
Hollinger.
5
In the event there are any further claims filed against the Estate, the parties agree to
equally refund to the Estate such sums that are necessary in order to pay said claims.
6
The two named Beneficiaries release the Executor Gary L. Hollinger from any and all
claims, by reason of any matter growing out of or relating to his action as Executor of the
Estate.
7
The parties acknowledge that they have been afforded the opportunity to present this
Agreement to their own private legal counsel for legal advice if such party desired such
individual legal advice.
8
The parties agree that this document should be binding upon themselves, their successors,
assigns, and personal representatives.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the date
and year first above written.
WITNESS
ESTATE OF HELEN P. HOLLINGER
BENEFICIARIES
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
Date of Death:
wiuNo.: :::)oo l - ooz'
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:
I. State w~her 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 re~entative file a final account with the Court?
Yes _ No ~___1 '
b. The separate Orphans' Court No. (if any) for the personal representative's
accomit is:
c. Did the personal rep~entative state an account informally to the parties
in interest? Yes ~ No []
Datd!'
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 attached to this~r~~
Signature ~
Name
Xddre
Telepk
HUBERT X. GILROY
ATTORNEY AT LAW
4 NORTH HANOVER STREET
CARLISLE, PA 17013
LAW OFFICE 717-243-4574 I
BROUJOS & GILROY, P.C. 717-766-1690~
-- hgiiroy@broujosgilroy, com FAX 717-243-822'7
www.brouj osgl[roy.com
Capacity: [] Personal Representative
[~2Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/09/2003
HOLLINGER GARY L
260 RICH VALLEY ROAD
MECHANICSBURG, PA 17055
RE: Estate of HOLLINGER HELEN P
File Number: 2001-00543
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 will become delinquent on: 5/26/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: ~-Fil~
Counsel
Judge