HomeMy WebLinkAbout03-0570
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of //e/V ~ ~ ~"" r;- A /.$ - ~v"'-~d.r No. r::ll- 03- ~7c)
also known as To:
Register of Wills for the
, Deceased. County of CL<.,.,.....hL_/_~ in the
Social Security No. /9~ /~ 3 If ~1j Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut ~ ~ named
in the last will of the above decedent, dated .se:t?TIi""I?~n .;z,"7 l2.. , 19 ~?
and codicil(s) dated -
(state relevant circumstances. e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in eel ?>-I h ~.&. J - f" County, Pennsylvania, with
h c.r last family or principal residence at .:1../7 A/, ,;:J...s-rt S,..
t'" ......A,.., I"? /-1 r" "r ~4 / "7 0 1'/
(list street, number and muncipality)
Decendent, then ..r", L Y ,-r9''Y' '" "3 ,
at k 17 ()
Except as follows, decedent did ot marry, was not divorced an 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: -.
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ U)?&..,>t.........-f-r.c'
(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: :;;2../'7 ~, .:z.. .=>13 S~
r ~ "--' ~ /,t. I ~ I. . I;? ~b (POOl dO
r
WHEREFORE, p'etitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
(testamentary; administration c. La.; administration d. b.n.c. La.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I
COUNTY OF J SS
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Swom to 0' affirmed aod subscribed { .d.~J C. / /I~ en
bef~ this ::;78 d~ ,/ () c)Q'
::s
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,(k. ~ ./A /pL ~~r:; ~
~ /:lL-' /~;/ Register ~
//- I~-I- /y
No. ~/- oS - ~7C)
Estate of /'./~,A/ /C. /i~ rI ~ A, /V (/ A./ /( OE , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW /0"-- 902C03, in consideration of the petition on
the ,evem side he, of. sausfactory pwof having ~esented befo,e me.
IT IS DECREED that the instrument(s) dated' ~?~ 07 /999
described thmi~ be ~a~ ~~s ~~e last will of
and Letters (P/'bh J '
are he,eby g<anted to - ~- .-b. ~ = '. - - - - - .:
{JO~//) r7/~ /.0/> ~aLy
Regist~ ~ ~
FEES
Probate, Letters, Etc. ......... $~qiL5:' L!L')
Sxhort~. r. tificates( ).......... $ I ~ 0 D AITORNEY (Sup. Ct. 1.D. No.)
- r;A...L;~
., .00
RenunclatI n ................ $ Cj.
~~ $0~ ~~
TOTAL _ $~7.;J.... 00
Filed .M' /.-6--:" . .4P~ . . . . PHONE
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p 9268027 JUL 0 8 2003
No. Date
j Rey. 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH' VITAL RECOROS
CERTIFICATE OF DEATH
STATE FIl.E NUMBEA
NAME OF DECEDENT (FlrSI. Mlddle. lasrl SEX SOCIAL SECURITY NUMBER
1- Henrietta B. Munroe ..female ..196 -14
AGE (LaS! Birthday) UNDER 1 YEAR UNDER 1 DAY BlRTHPLACE ,c.ry iIond PlACE OF DEATH (C"eck only Qfle 'ie8 InslrucllOfli on other Sldel
Mooth. ! De,.. Hou.. ! Minut.. 3tale Of FCfe19n Counlry) HOSPITAL
80 Yrs. ,Ohio InPliIIent~ ERlOutpallenl 0 DOAo ~=dyio
5. ...
. COUNTY OF DEATH FACILITY NAME (It not InsN\Jllon. gIVe S1reel and numb8fl RACE. Amencanlndlan, Blae-k. White. etc.
(Specdy)
. Dauphin Co. Harrisburg .... Harrisburg Hospital 1.. white
Ib, ...
DECEDENT'S USUAL OCCUpqlON KINO OF BUSINESs/INDUSTRY DECEDENT'S EDUCATION MARITAL STATUS - Married SURVIVING SPOuSE
(<::;~,,~:o~~~:)' S I onl hi h radecom 81 N.y.r Manied, W~. (II NIle. giVe rnaldan namel
er.menlatyls.condiloty Co_ Divorc~ (Specify)
registered nurse medical ,.J 2 (0-12) 6 (1.4Of 5-+-1 ,.never married
.. 11.. 11b,
DECEDENT'S MAILING ADDRESS (Sir.. CitylTown. State. lip Codel DECEDENT'S Vanla 17..0 Yao,_liwdin
. ACTUAL OK! ""',
217 N. 25th Street RESIDENCE _no
{See Il'1SftUCIIOnS Cwnberland live an. ~ No,__ Camp Hill
Camp Hill, PA 17011 onOlher Sldel township?
11. 17b.Cou t7d. will'UnKtualltmltSot citylbon:l.
FATHER'S NAME (Firs!. Middle. LaSl) H.D. Munroe MaTHEA'S NAME ,Fits!. Middle, Malden SUfOame)
Mary Brown
11. ...
INFORMANT'S NAME (T ypelPrint) Robert J. Trace INFf3iANT'S MAiJNO ADDAESS tScreet. QtylTown, Stele. Zip Code)
200. ~. N. 8th st., Camp Hill,PA 17011
METHOO OF DISPOSITION PLACE OF DISPOSITION. N.me 01 Cemetery, Cremalofy LOCATION. CitylTown, Slate. Zip coo.
. Burial 0 Cremation)s1... R~oval from SI.le 0 Of Olher Place
DonelionD Other (Specify Con-o-Lite Crematory ersb:w1,PA 17008
. 21e. 2tc. 2td.
S1GNAT NAMe AND AOORESS OF FACILITY
L FH & CS,324 H.mrellwe., H\17043
LICENse NUMBER
.... 23... 7,.. ? 2.00 ::.
TIME OF DEATH WA.S CASE REFERRED 10 MEDIC"L
8 " 30 A.M <J U. VI' zoo:' Yo.:xI NaB'
'4. '5. . ...
27. PART I; Enletthe di$easea, injurieSQf com~ications which caused the dealh. 00 nolenter Ihe mode of dying, such as cardiac or respiratory arrest. shock Of" hear1lailure I Approximate PART II:
list only one cause on each Wne. : inletval belween
I onset and dulh
FD 0 2~A~ M 4..1 G."'''' NT Pc..;t:;'URI\\.. C;FF~~
e. E'Nc STAG-e C.O !
DUE TO (OR AS A CONSEOUENCE Of). , M A-1..-t'J i.ln<'ITIOAJ
$equenliaJIy- lill c:onditions F ,
if any. leading 10 immediale DUE TO lOR AS A CONSEOUENCE Of)~ 0
cau... Ent. UNOERLYIHQ I
CAUSE (Disease or Il'1lUrV I
Ihallf'Wated events DUE TO (OA AS A CONSEOUENCE 0Fj, I
'esuIbng 10 d8a1h) LAST I
..
WAS AN AUTOPSY WERE AlJlOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT \YORK? OESCRIBE HOYt' INJURY OCCURRED.
PERFORMED? AVAILABlE PRIOR TO (Monlh. Day. Year)
COMPLETION OF CAUSE !;8. D
OF DEATH? Nalurat Homicide NoD
D 0 Y.. 0
AcCident Pending InveSligalion
Yo. 15( No 0 Ye.o No 81 0 o ~CE OF INJURY - AI home. far;,O:;ee,. 'iIoClOly, otfk:e M. ...,
Suicide Could not be delennined LOCATION {Slr8el. Cllyffown. Statel
bu~ding. elc. ,Specll."l
_. ..... 2.. 3...
CER1IFIER fCheck oniy onel
"CERTIFYING PHYSICIAN (Phys.c"",ncerlifY'fl9 cause 01 death when anOln8f" pnySIC,an has prOOOllnced dealh ana COO'lpleled !t~n 23l
To the beat of my knowledve, d..th occurred du. to the cause(a) and mannera..tated. ..... ..............................,...
"PRONOUNCING AND CERTIFYING PHYSICIAN (PhYSICian bolh O)ronouncmg aealh aod certdYlng 10 cause 01 dealhl
To the best of my knowledge, dealh occurr.-d at the lime, date, .nd place. and due 10 the cau.e(s) and manner iIS .Iated. ..... _ ..............
"MEDICAL EXAMINER/CORONER
On the b.... of eJl:aminatlon andlorlnvesUgilotion, in my opinion. death occurred al the time, date, and place. and due to the c:ause(s) and 0
31..manne'8..tated...,....,........,.................................................."...,.......,....,.......". .
REGIST22SIGNATURE AND NUMBER i?/tP?1(1
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LAST WILL AND TESTAMENT c:21-03- 676
I , HENRIETTA B. MUNROE, of the Borough of Camp HIll,
County of Cumberland,State of Pennsylvania, bei.ng of sound
mind, memory and understanding, do make, publi sh and declare
this as and for my Last Will and Testament, hereby revoking
and making null and void all wills and Testaments, or writings
in the nature thereof by me at any time heretofore made.
direct my Executor, hereinafter named, to arrange r
FIRST: I
with the Musselman Funeral Home for the cremation of my
remains with graveside services conducted by the Camp Hill
Methodist Church and burial in Rolling Green Cemetery, Camp
.
.
Hill, Pa. and a bronze plaque with vase for flowers shall
also be provided.
SECOND: I give, devise and bequeath my entire estate
to my nieces, Mary J. Chorney of Liverpool, New York and
patricia L. Jones of Binghamton, New York, share and share
alike.
THIRD: In the event that Patricia L. Jones should
predecease Mary J. Chorney, her share shall vest in 1101al-}.:J.
Chorney, her heirs and assigns.
FOURTH: In the event that Mary J. Chorney should pre-
decease patricia L. Jones, her share shall vest in Nicole A.
Chorney and Jennifer L. Chorney, their heirs and assigns,
share and share alike.
.
.
..
'.'
. ,
------~
.
.
FIFTH: In the event that both Mary J. Chorney and patricia L.
Jones predecease me, I then give, devise and bequeath all of
my property real, personal and/or mixed of whatsoever nature
and wheresoever situate to my two grand-nieces, Nicole A.
Chorney and Jennifer L. Chorney, their heirs and assigns,
share and share alike.
SIXTH: I direct that all inheritance or succession taxes
that may be assessed in consequence of my death shall be paid
by my estate as part of the cost of administration.
SEVENTH: I appoint Robert J. Trace to be the Executor of this
my Last will and Testament and if he is unable to serve, I then
.
appoint PNC Bank to be the Executor of this my Last Will and
Testament
( a) 1 I authorize and empower my Executor, for the
payments of debts ro for any purpose of administration or
distribution, at any time within two years from the date of
my death, to sell all or any of my real estate, at public or
private sale, for such prices and upon such terms as to cash
and credit as it may deem best, and to execute deeds of
conveyance thereof, without liability on the part of the
purchaser to see to the application of the purchase moneys.
This power shall not be construed to work a conversion of
my real estate, unless and until the power is actually
exercised, nor shall this power be construed to extend the
lien of debts.
(b) I authorize my Executor to retain all stocks,
-2- .
, ,
.
.
bonds and other investments made by me for distribution in
kind, or in its discretion to sell and transfer the same,
either in person or by attorney, without liability on the
part of the purchaser to see to the application of the
purchase moneys.
IN WITNESS WHEREOF, I have hereunto set my hand
and seal this ~775 day of .Yt./..h.-In,y , 1999.
Signed, sealed, published and
declared by the Testatrix above
named as and for her Last Will
and Testament, in the presence of
us, who have hereunto, at her
request, subscribed our names ip
her presence and in the presence
of e~her as witnesses hereto.
()~
f~ /, ,.-,- J..--'
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Henrietta B. Munroe
.
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-
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COMMONWEALTH OF PENNSYLVANIA .
.
:
COUNTY OF CUMBERLAND .
.
WE, HENRIETTA B.. MUNROE , ANN.. J . LONG , and
~_..- SUSAN T. NEWTON The Testat ~ and the witnesses,
,
respectively, whose names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned authority that
the Testat rix signed and executed the instrument as her Last Will and
Teatamnet and that ~he had signed willingly (or willingly direc~ed
'another to sign for her) and that ~ he executed it as her free and
voluntary act for the purposes therein expressed, and that each of the
. . witnesses, in the presence and hearing of the Testat rix signed the Will
as a witness and that to the best of his or her knowledge, the Testat .I:.1x
was at that eighteen (18) years of age or older, of sound mind and under
no constraint or undue influence , and I, the said Testat rix do hereby
acknowledge that I signed and executed the instrument as my Last Will and
Testament, that I signed it willingly, and that I signed it as my free
and voluntary act for the purposes therein expressed.
~~u/jI~ ~ k/ UA1>f~
Testat !,ix .,-
S~Ul'L ;J,.Iu-u-fn-, -
Witness
~ (2, ~,?,-~f
Witness' / I
Subscribed, sworn to and
'acknowledged before me by
Henrietta.B. Munroe
the Testat rix and subscribed
and sworn to before me by
Ann J. Long and
Su.san 'I'. Newton
w;lnes~es, this :l7..r( day of NOTARIAl ~
t.1- J-r,;;. 6, .".. l,\"', A. D. MARGARET T. FOSlE ,Notaa'oPUbltc
, , Camp Hili, PA Cumber1and unty
.~~~ '\'". ~ My Commission Expires Aug. 7, 2000
lory l'ublic
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COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
OEPARTMENT OF REVENUE
BUREAU OF INOIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003089
TRACE ROBERT J ESQUIRE
331 N 28TH STREET
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold ----~----- --------
101 I $10,000.00
ESTATE INFORMATION: SSN: 196-14-3988 I
FILE NUMBER: 2103-0570 I
DECEDENT NAME: MUNROE HENRIETTA B I
DATE OF PAYMENT: 10/06/2003 I
POSTMARK DATE: 00/00/0000 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 07/07/2003 I
I
TOTAL AMOUNT PAID: $10,000.00
REMARKS: ROBERT T TRACE ESQUIRE
CHECK# 1024
INITIALS: AC
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: HENn..I'~TrA 13, 1"1 VN'R.oe
Date of Death: ::r ~ 1-'-1 1~ 200 ,
Will No. 7..t...O~-O!)'/O A9lRin. Na.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
~rved on or mailed to the following beneficiaries of the above-captioned estate on Tv ... 'Y 1<1/ ~OD~
Name Address
M A- A. '-/ J. C-/" (J fl,.tJ E "t l,v i'~ c.E-)
('ATY,I(.AA t.... :rOrJE~ l.Njr=t.~) q'~' fhd; t, If j) v'f, I ~r(b II.tJ.>~;tJ c.; t-Y, ,,-/, y /3710
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except No tJ ~
Date: N D " ~""'^' It (,v ~ ~1Ol13
Signature
Name ~b€"^ f -;;;;c ~
Address 331 #, ;2 ~ /~ S j..
C4H t? I-I/I-L. I ~ /71) II
,
(' '-,.I Telephone (1/1) I J1- 9:f~1
c-
Capacity: ----X- Personal Representative
_Counsel for personal representative
,
~~.."" * ---.----.------
REV-1500 OFFICI;l U,;E ONt y
.
COMMONWEALTH F PENNSYLVANIA INHERITANCE TAX RETURN
DEPARTMENT OF REVENUE
DEPT. 280601 RESIDENT DECEDENT
HARRISBURG PA 1 128-0601
DECEDENTS N.AAlE (lAST, FIRST, AND MIDDLEINI1'\Al1use ablank~ ~~ ~~ '. .
.... M .ll N ' R....P}3 ....H...E N
z
W SOC~SECURITYNUMBER
0
W I
0
w
0 REGISTER OF WILLS
-
w ~ 1. Original Return o 2. Supplemental Retum o 3. Remainder Return (dal8 of death priortD 12.1~21
...,
lI:~CIl o 4. Limited Estate o 4a. Future Interest Compromise (dalB of death aller 12.12-82) o 5. Federal Estate Tax Return Required
oa:lI:
wQ.o
J:oo o 6. Decedent Died Testate (Allach copy ofWoII) o 7. Decedent Maintained a Living Trust (AlIach copy of Trust) _ 8. Total Number of Safe Deposit Boxes
oa:.J
Q.lD
Q. o 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (dal8 of death between 12.31.9111ld 1.1.95) o 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
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I- TH!$,$E~lPNMQ$]!8E.(;OM.~f.:.I;TEP~\A.~;(;O~$~O~PENC;I::'NI)1;C;08f:lQENll.f.:.J'~!INIrOR.~TIONs;SH09I..D8E'PIRECTEDTO:/ .......
z NAME COMPLETE MAILING ADDRESS
w
Q i?o8tE.~r .:r; ?//,,4C/E' IV", ~'1' II" .:l fl 7'f? 57
z '331
0
Q. FIRM NAME (If Applicable) f>A /701/
CIl W,MP HIJ..~I
w
a:
a:
0 -t:l S ii/
0
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) :n
:'D
0
3. Closely Held Corporation,Partnership or Sole-Proprietorship (3) 'J
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
Z (Schedule E)
0 6, Jointly Owned Property (Schedule F) (6)
S
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
;:) (Schedule G or L)
!::: 8, Total Gross Assets (total Lines 1~7)
D.
< 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
0
W
~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) -
made (Schedule J) , .;1; , .
14. Net Value Subject to Tax (Line 12 minus Line 13)
15, Amount of line 14 taxable
Z at the spousal tax rate ,
0 See instructions on reverse side for applicabl~ perce~tag~
j::::; 16. Amount of line 14 taxable ..
~~ at 6% rate X .06 (16)
....::) 17. Amount of line 14 taxable 97,2.72.2..8
Q. ,i-f x .15 (17)
~ at 15% rate
0
0 18. Tax Due (18) 71,tJ'l () .~ Y.f-
.,',,, ,: < '" ,',,', ; ,><._, -,.~, " _'_, ,_ -x., ,"" .'.'.'.' - " " <. ." .
19.
";r:'<.?;''''.~)f~;,;i~~l't~~i{ee(SUR,e~IO(AN$WeR,IAt..:.li.tQQ.eS;JlIPNS~~aleRSe~S..DeAND:ReCH.ECKMAt....:;til;~!;~K!f;>,>...";',,iA.;.......'i";
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules nl statements, and to the best of my knowledge and belief, it is tnJe, correct nl complete. Declaration of preparer other
than the 118rsonal reoresentative is based on all information of which Dreoarer has any knowledae,
SIGNA~PERSON R SP SIBLE FOR FILING RETURN ADDRESS DATE
- '331. /1.~~i!..J;( ~ A/-tv A ~ft-9-
/ /\.,.4(..2~ /7" //
SIGNATURE OF PREPAR OTHER THAN REPRESENTATIVE ADDRESS DATE
,.
Decedent's Complete Address:
STREET ADDRESS :J. #0 I( rH :z s T.a 5)( I
17
. i
CITY CAMP fllu/ . I STATJ:?A I ZIP I
171!J /(
Tax Payments and Credits:
1. Tax Due (Page 1 Line 18) (1) 73 "9tJ. S"+
2. Credits/Payments
A Spousal Poverty Credit -.
8. Prior Payments /~ o "C), t!) C)
C. Discount 5".:1 O. .:It?
Total Credits ( A + B + C ) (2) /tJ 5t/t:I.tJO
3. Interest/Penalty if applicable
D. Interest -
E. Penalty -
TotallnterestlPenalty ( D + E) (3) .-,
4. If line 2 is greater than line 1 + line 3, enter the difference. This Is, the OVERPAYMENT.
Check box on Page 1 Line 19 to request a refund (4) -
5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) t~ S'f". '?if
A Enter the interest on the tax due. (5A) -
B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) t:A b"q".itj
Make Check Parable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "XU IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ............................................................. 0 ~
b. retain the right to designate who shall use the property transferred or its income; ................ 0 [i1
c. retain a reversionary interest; or............................................................................................. 0 ~
d. receive the promise for life of either payments, benefits or care? .........................................0 ~
2. If death occurred on or before December 12. 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12,1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................,............ 0 r&l
3. Did decedent own an "in trust for" or payable upon death bank account or security
at his or her death? ......................................................................................................................0 ~
4. Did decedent own an individual retirement account, annuity, or other non-probate property?.... 0 fRl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 P.S. ~9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P.S. ~9116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving
spouse from 3% to 0% for dates of death on or after January 1, 1995. 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 JANUARY 1.1995 - Please answer the following question by placing an "x. in the
appropriate space.
Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire
lifetime? Yes 0 No lil
If you answered yes to the above question. the tax on the trust or similar arrangement is postponed until the death of the second
spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(ies). Enter the value of the trust on
Schedule J, Part II, in order to remove it from the calculation ofthe tax due in this estate. You may wish to file Schedule 0 in order to
make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate,
and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or
similar arrangement between the surviving spouse an~ the remainder beneficiafy(ies).
II
~.v.,~. SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA . REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HENRIETTA B. MUNROE 2. I - 0.3 - Q S '10
All real property owned solely or as a tenant in common 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 facts. Real property which is jointly-owned with right of
survivorshiD must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
All those two certain lots of land in the Borol11gh
of Camp Hill, County of Cumberland and state of
Pennsylvania, together bounded and described
as follows:
ON the North by Lot# 54 Section E on. the Plan
hereinafter mention~~ ; on the east by St. John's
alley; onfthe Sbuth~by bpt: .fHr ::)1'1 saia Plan; and
on the west by North 25th Scre~t(formerly Locust
Avenue) ; Containing:,.:forty (40) feet in front on
North 25th Street (formerly Locust Avenue);and
extending back an even width to St. John's Alley.
BEING Lots Nos. 55 and 56, in Section E on Plan of
Lots laid out by Arthur R. Rupley and Caleb S.
Brinton and known as Plan No. 2 First Addition,
Borough of Camp Hill, recorded in Plan Book 1 , Page
5. Said lots being improved by a one story brick
and frame dwelling , known as and numbered~217
.
North 25th Street, Camp Hill, Penna.
Being the same premises which Mary Brown Munroe,
Widow, by her deed dated June 20th, 1966 granted and
coveyed unto Henrietta B. MUnroe, Single woman,
which deed is recorded in the Office of the
Recorder of Deeds in and for Cumberland County in
Deed Book '.AH , Vol. 22 , Page ~.
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
~
"
81 UNIFORM RESIDENTIAL APPRAISAL REPORT FileNo. 03-557
ESTIMATED SITE VALUE "..... . ..... .......... ..... ........ :. == $ Comments on Cost Approach (suchas~ source of cost estimate, site value,
ESTIMATED REPRODUCTION COST-NEW-OF IMPROVEMENTS: square foot calculation and for HUD, VA and FmHA, the estimated remaining
Dwelling 1,704 Sq. Ft. @$ =$ . economic I~e of the property): The Cost A ' roach enerall will result
899 Sq. Ft. @$ = in an excellent estimate to value if the buildin is new or
= reasonabl new and the im rovements reflect the hi hest and
= best use of the land. However when items of h sical
...........= $ deterioration and obsolescence must be estimated an area of
Functional Extemal 'ud ement is involved which is sub'ect to error. The Cost
I =$ A roach was not utilized due to the a e of the sub'ect ro ert
---..-..-. .... ... =$ and the amount of deferred maintenance.
..--.--..-- .-- ... =$
-_......- ..-_.--_.. ..-.-..-
COMPARABLE NO.2 COMPARABLE NO.3
3122 Yale Avenue 504 Haldeman Avenue
Cam Hill PA New Cumberland PA
0.62 miles 2.23 miles
100.74 rjJ 99.68 rjJ
MLS, Ext. Inspection, Agent MLS; Agent
Court House Records Court House Records
DESCRIPTION : + - $ Ad ust. DESCRIPTION + - $ Must. DESCRIPTION : + - $ Must.
Conventional , Conventional Conventional
None Costs -1 000 None
5-28-03 I 4 DOM 6-9-03 I 300M 2-25-03 I 300M
Avera e Avera e Avera e
Fee Sim Ie Fee Sim Ie Fee Sim Ie
.21 Acre .15 Acre : . 17 Acre
Avera e , Avera e
, Avera e
2 Sto , 2 Sto 2 Sto
:
t",: Brick Aluminum Brick
: :
62 Years 71 Years 65 Years
Su erior -7 500 Su erior -7500 Su erior -10 000
Baths Total : Bdrms: Baths : T alai : Bdrms: Baths : Total : Bdrms Baths :
8 : 4 1.5 : 6 : 3 : 1 +1,500 7 :3 1,5
I
1 748 S . Ft. : 0 1360S.Ft.: +5200 1560S.Ft.: +2 20C
Equal Equal Equal
Unfinished Unfinished Unfinished
Avera e Avera e Avera e
Steam - None H. W. - None FHA - None
Avera e : Avera e Avera e
Gara e/ x 1 +1 000 Off Street +3 000 Gara e/ x 1 +100(
Porches/Balcony +500 Porch/Stoop +500 Patio +1.00(
2 Fire laces -1 500 Fire lace FP/Dutch Oven -50(
2 Window AC Uni : +100 Fence W/D/2 Window A
Ref/2 Window AC : -500
. ~ 7400 + 1200 6301
138 200 14920
SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
None None None None
NA NA NA NA
- - - . . . - . . . . . ..-- .-_... ...... ...... $ 138,01
~
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[8J Did Did Not
Inspect Property
State PA State PA
State State
. Fannie Mae Form 1004 ,6-!
III
__w~.. . SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HT:iit...J R...IGTT/1- f3, M vN ~ or :2..1- 03- 0570
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 'loBo ShYJ ["'M/.UN Srock' fARMMfR c.. r"tK (8ANk) ca>.~3 111. G. 4-0 . 00
I .
2. HH l3oN1J5 ~o @ 1000.00 2,0 000,00
,
3. H~ 130fV DS 3e. '5'uo ,00 1,5"00.00
.
TOTAL (Also enter on line 2, Recapitulation) $ 111f, IIf (), () 0 ,
(If more space i/; needed, insert additional sheets of the same size)
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II
.
.
~'b~'''''... SCHEDULE E
CASH; BANK DEPOSITS, & MISC.
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HEI\I'RI/=TT~ 13. M l./ "..N! ., ,: 2., - e 3 - tlJS, 0
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. ('Nt '3 ~ N 1< (C f-l E C K' :v r: /.l C.COVI'J"") ~ 5"1-4 00 +_ !) 3 t i- t q, t I :3.!>8
2, (> JJ C. (;11. N K _ c... 1> W=- 3l oooo~f~'1.,q ~l-.3~.~O
r",TSR,cSi To 7)AT~ O~ :!)eATI-/ ,qo
3. P;.J c..... '3,Hv/( - c.:]) $t 3 1 8 "0"2 I 4 g II I " 5"0, S7
r ,.,r~~IiST 1'.. ])1\1"'/L OF ~AT(~ .75
4. f'rtc. ~ANI< ~ c1' f:t314o 00 5""\'.!)'?. 5" la '" 31,'2.0
Tf\JT{iItr.ST "-/1 J:>4Ta o~ 'f).:,ATt4 .q 0
5'. HOoJ5c.HO~D F'LJ~~;7v~,=- G-nc (5,n...~ ~r ~VC"TI'ON) 2." 3t. 2.S-
t.. i5o'<-1< 5r WAC"foJ (.qt:j.-f"'"R C.,v~) (KEL.t.y I3L'Ji; 6oe>~) l(,05.00
1. p I'oIC t;1I"'/C- PNC. .JNI/E5TME1oJTS Ll-lp.L.14RV IHI:!) L oN 5 7'Yl<') ( 7 'L" 4' q.. 07
TOTAL (Also enteron line 5. Recapitulation) $ :?o7 ^ 3~. 7:4
(If more space is needed, insert additional sheets of the same size)
~
<~,
. .
Estate of HENRIETTA B. MUNROE Date of Death: JulY 7, 2003
SS# 196-14-3988
Checking Accounts:
1 2 3
Number 2l:l0bLl5.3 I ~
Da te opened \~' J \ Or, ~
Balance at Dat.e of Death =- \'i. \ \~,5~' ~
Int. to Date of Death
Joint owner, if any N/A
.
Savings Accounts:
1 2 3
Number /><Z
Date opened ~ -
Balance at Date of Death
Int. to Date of Death
Joint owner, if any '.
certificates of Deposit:
1 2 3
Number <51cx>oo53 01'7'1 3/ <i t!>6!J) 0"/ / I 31 i/ CX205t./~"3S
Date ~ (4 '"lei, ~ "!tD . .
Value at Date of Death ~ 1,050,9;7 &, ~.3 q , .;L~
Int. to Date of Death
Joint owner, if any 11/1~,!f; ~ ~/,1q(~
Maturity Date =- :;..!,:).fJ / C> Y =- = ~ ~
Interest Rate . &It:>
Interest paid QuarterlY,
Semi-Annually, etc.
united states Treasury
Notes:
United states Savings
Bonds:
Individual Retirement
Accounts
Debts: others:
'-..- ~
" rD (2..
.
Association of Bank or
rklt, Official
.
..
. .
. .
/-, . ----.-
Kelley Bl~e Book Used Car Values -----
Page 10f2 ,
.
. .
KeUq Blue Book Blue Book Marlad Walt!;;'
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My Car's Value
Used Car Retail
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Moton:ycles AutoLoQns_frQm_~_.990{Q APB, bep
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Homel Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects.
The paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. In states where rust is a
problem, this should be very minimal, and a deduction should be
made to correct it. The tires match and have substantial tread wear
left. A clean title h.istQ!Y. A "good" vehicle will need some
reconditioning to be sold at retail; however major reconditioning
should be deducted from'the value. Most recent model cars owned by
consumers fall into this category. \
Private Party Value $1,605 ,
~eSI
Private Party value represents 'i'{hat you might expect to pay for a
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the value you might expect to receive when selling your own used
car to another private party.
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1
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RLv 1511EX+ff.lI7) '*
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
He.N P..IE,I,A 1::5 . M lJf\J RoE .:2/- 03-- O~-70
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. M v!> 5iL-""Atv F...JI"'C~t.... l-f<l'MI:
If" '7 /, ; P
(aJ adJ t.-nt.1 tJ..f<..Y1ft. /)<1 I3I?"tV~e.. j\{A~/(Ii" c?.:..o C7
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) l?.c boo t- :T 'l' P.4 cE ~7 0' 1{. t:1 CJ
/
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address ~ "1; Ai. '-~ ~ S'J~': 61
City ('AM f' /.../ / /.. I- Sta,,, - _.~
Year(s) Commission Paid: ).,,004
2. Attomey Fees
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address VON e..
City State Zip
Relationship of Claimant to Decedent
271.., 00
4. Probate Fees
5. Accountanfs Fees Slit), iJ(/
6. Tax Retum Preparer's Fees :3 S-t'.. t'P
7. C.U)vJ b t.O'I"", J 1.A~ J t)()1I.IJAj. - A ']) V ell. TI S"J C tS T ~ T f' 75". d (J
~ Tnt. $eNTI,JH _ A]> VI? (n 51 '" c. E:sr.+.e- 1<1,/7
~r M cHtl-ett 5A~~ ('d _ D~IL..l..lI'''t; SA-fl!: 1)c..Pt'S~T ~i:X J(J(},otJ
J 0;' L/ Mr-t ~AH4,<J cxxc>r.J _CNG./J€ Re.{I~iRS -c.I~o."\');"'1-13~ t:,.-k... r",w,;'c. 11), L3
M 0 /'J TO c.: ,t 0' '- C" - OH.. s.....ppL.Y' ?29. o-c
j I I
il. u.~ -TQE:A~Vn...y - ,:?d611C( """ 1.01;:1;2... (AX' ;J..t 'l.t" I
S'u J, Iv".4/.. '.33'1-5'1- 01 k\
TOTAL (Also enter on line 9, Recapitulation) $ 5if /6/. 1Iif
(If more space is needed, insert additionai sheets of the same size)
'jC/-I.EDUL..E H (CaNT I tv iJ€.b)
1~e:Nn., ETrA 16 ,H(hJ~DE ~I- 03- 05"7()
VE ~ l'Z-orV P h ~ 'nt Bdf
R- , 13(,\(~:YI'( dc.U 33,02
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COM CA 51' r" - "" Or-JiIH..." ~, 1.-1.- 31. "If
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LAST WILL AND TESTAMENT
I , HENRIETTA B. MUNROE, of the Borough of Camp HIll,
County of Cumberland,State of Pennsylvania, being of sound
mind, memory and understanding, do make, publish and declare
this as and for my Last Will and Testament, hereby revoking
and making null and void all Wills and Testaments, or writings
in the nature thereof by me at any time heretofore made.
FIRST: I direct my Executor, hereinafter named, to arrange
with the Musselman Funeral Home for the cremation of my
remains with graveside services conducted by the Camp Hill
Meth6dist Church and burial in Rolling Green Cemetery, Camp
.
Hill, Pa. and a bronze plaque with vase for flowers shall
also be provided.
SECOND: I give, devise and bequeath my entire estate
to my nieces, Mary J. Chorney of Liverpool, New York and
patricia L. Jones of Binghamton, New York, share and share
alike.
THIRD: In the event that patricia L. Jones should
predecease Mary J. Chorney, her share shall vest in MaryJ.
Chorney, her heirs and assigns.
FOURTH: In the event that Mary J. Chorney should pre-
decease patricia L. Jones, her share shall vest in Nicole A.
Chorney and Jennifer L. Chorney, their heirs and assigns,
share and share alike.
,. ..
, .
. ,
.
FIFTH: In the event that both Mary J. Chorney and patricia L.
Jones predecease me, I then give, devise and bequeath all of
my property real, personal and/or mixed of whatsoever nature
and wheresoever situate to my two grand-nieces, Nicole A.
Chorney and Jennifer L. Chorney, their heirs and assigns,
share and share alike.
SIXTH: I direct that all inheritance or succession taxes
that may be assessed in consequence of my death shall be paid
by my estate as part of the cost of administration.
SEVENTH: I appoint Robert J. Trace to be the Executor of this
my Last will and Testament and if he is unable to serve, I then
.
appoint PNC Bank to be the Executor of this my Last Will and
Testament
( a ) , I authorize and empower my Executor, for the
payments of debts ro for any purpose of administration or
distribution, at any time within two years from the date of
my death, to sell all or any of my real estate, at public or
private sale, for such prices and upon such terms as to cash
and credit as it may deem best, and to execute deeds of
conveyance thereof, without liability on the part of the
purchaser to see to the application of the purchase moneys.
This power shall not be construed to work a conversion of
my real estate, unless and until the power is actually
exercised, nor shall this power be construed to extend the
lien of debts.
(b) I authorize my Executor to retain all stocks,
-2- . ,
, ,
"
-
.
bonds and other investments made by me for distribution in
kind, or in its discretion to sell and transfer the same,
either in person or by attorney, without liability on the
part of the purchaser to see to the application of the
purchase moneys.
IN WITNESS WHEREOF, I have hereunto set my hand
and seal this :l. '1 ~ day of S.e.fJfl:l"U<'FT(, 1999.
Signed, sealed, published and
declared by the Testatrix above
named as and for her Last Will
and Testament, in the presence of
us, who have hereunto, at her
request, subscribed our names ip
her presence and in the presence
of each other as witnesses hereto.
5/ AIv~ 3'. Lc '" C
/
~ SVS4"r T. I'" E w'" N 51 IJ EN~ It: r,,II B. 1'1 vlif#?ol"'i (Seal)
Henrietta B. Munroe
. ,
, , -3-
1
COMMONWEALTH OF PENNSYLVANIA 'l
55:
COUNTY OF CUMBERLAND J
Ro136'~T :r 'l' itA cE
being duly S liVo R. N according to law, deposes and says that he l.;s E;<Ec:w-rL'JR
of the Estate of /-le-NRI ~TTA (~. Mv,vRO{:
late of _J3-'2_~~_(U=__f.'fLMPn H~~~ - ----..- , Cumberland County, Pa., deceased and that the
hL' 1=)( ';'cor<J ~
within is an inventory made by Y)-'1 -~-- , the said of the entire estate of said decedent, consisting of all the personal propt!rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
<;WOI1. N 10 and subscribed before me, l :2~/~
~ l., -rl~ :;, 00 1- En u. r .. AGMiAidrat9r
,
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.,"'\.'-,'-.:.i-\'" Pub!;' Address
~ '-~''''.'
: 27. '~C,;;'
,_"~
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,~ 01 o{, :2-003
Date of Death
Day Month Y..r
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA REV.1 162 EX(1 1-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003784
TRACE ROBERT K
331 N 28TH STREET
CAMP HILL, PA 17011
ACN
ASSESSM ENT AMOUNT
CONTROL
NUMBER
_n_____ fold ---------- --------
101 I $62,590.84
~ '~': r~'
ESTATE INFORMATION: SSN: 196-14-3988 I
FILE NUMBER: 2103-0570 I
DECEDENT NAME: MUNROE HENRIETTA B I
DATE OF PAYMENT: 04/07/2004 I
POSTMARK DATE: 00/00/0000 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 07/07/2003 I
I
~_..... . TOTAL AMOUNT PAID: $62,590.84
.......,._-
RiEMARKS: ROBERT J TRACE ESQ
...,....-.
._"~"
) CHECK#1074
>......... INITIALS: VZ
...- SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA *'
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
R",,,-,(JF DEDUCTIONS AND ASSESSMENT OF TAX REY-Im EX AFP <Dl-03l
,1-,.."""
DATE 05-17-2004
ESTATE OF MUNROE HENRIETTA B
"'~. '-,' 1.. '--. DATE OF DEATH 07-07-2003
U~i ,,: ,-'.- FILE NUMBER 21 03-0570
COUNTY CUMBERLAND
ROBERT J TRACE ACN 101
331 N 28TH 5T I .._t ._Ht.. I
CAMP HILL PA 17011
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=is4j-E'3CAFP-foY:oiY-NOYicE--OF-YNHEiiiTANCE-YA'X-APPRAisEi..-ENT-,-Ai::rOWANCE-cfi------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MUNROE HENRIETTA B FILE NO. 21 03-0570 ACN 101 DATE 05-17-2004
TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) U) 138,000.00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) 194,140.00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subnit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forn with your
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 209,233.72 tax paynent.
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 541,373.72
APPROVED DEDUCTIONS AND EXEMPT~ONS: 54,101.44
9. Funeral Expenses/Adn. CostS/M1SC. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions Ull 54.101 44
12. Net Value of Tax Return (2) 487,272.28
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (4) 487,272.28
NOTE: If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
lS. Anount of Line 14 at Spousal rate US) .00 X 00 = .00
16. Allount of Line 14 taxable at Lineal/Class A rate (6) .00 X 045 = .00
17. Allount of Line 14 at Sibling rate (7) .00 X 12 = .00
18. Allount of Line 14 taxable at Collateral/Class B rate (8) 487,272.28 X 15 = 73,090.84
19. Principal Tax Due (9)= 73,090.84
TAX CREDITS:
II (+)
DATE NUMBER INTEREST/PEN PAID (_) AMOUNT PAID
10-06-2003 CD003089 526.32 10,000.00
04-07-2004 CD003784 .00 62,590.84
TOTAL TAX CREDIT 73,117.16
BALANCE OF TAX DUE 26.32CR
INTEREST AND PEN. .00
TOTAL DUE 26.32CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. 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 Df decedents dying Dn Dr befDre December 12, 1982 -- if any future interest in the estate is transferred
in pDssessiDn Dr enjDyment tD Class B (cDllateral) beneficiaries Df the decedent after the expiratiDn Df any estate fDr
life Dr fDr years, the CDmmDnwealth hereby expresslY reserves the right tD appraise and assess transfer Inheritance Taxes
at the lawful Class B (cDllateral) rate Dn any such future interest.
PURPOSE OF
NOTICE: TD fulfill the requirements Df SectiDn 2140 Df the Inheritance and Estate Tax Act, Act 23 Df 2000. (72 P.S.
SectiDn 9140).
PAYMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment tD the Register Df Wills printed Dn the reverse side.
--Make check Dr mDney Drder payable tD: REGISTER OF HILLS, AGENT
REFUND (CR): A refund Df a tax credit, which was nDt requested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn
fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-1313). ApplicatiDns are available at the Office
Df the Register Df Wills, any Df the 23 Revenue District Offices, Dr by calling the special 24-hDur
answering service fDr fDrms Drdering: 1-800-362-2050; services fDr taxpayers with special hearing and I Dr
speaking needs: 1-800-447-3020 (TT Dnly).
OBJECTIONS: Any party in interest nDt satisfied with the appraisement, allDwance, Dr disallDwance Df deductiDns, Dr assessment
Df tax (including discDunt Dr interest) as shDwn Dn this NDtice must Dbject within sixty (60) days Df receipt Df
this NDtice by:
--written prDtest tD the PA Department Df Revenue, BDard Df Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--electiDn tD have the matter determined at audit Df the accDunt Df the persDnal representative, OR
--appeal tD the Orphans' CDurt.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errDrs discDvered Dn this assessment shDuld be addressed in writing tD: PA Department Df Revenue,
Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
PhDne (717) 787-6505. See page 5 Df the bDDklet "InstructiDns fDr Inheritance Tax Return fDr a Resident
Decedent" (REV-1501) fDr an explanatiDn Df administratively cDrrectable errDrs.
DISCOUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (570) discDunt Df
the tax paid is allDwed.
PENALTY: The 1570 tax amnesty nDn-participatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt
paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. This nDn-participatiDn
penalty is appealable in the same manner and in the the same time periDd as YDU wDuld appeal the tax and interest
that has been assessed as indicated Dn this nDtice.
INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDm the date Df
death, tD the date Df payment. Taxes which became delinquent befDre January 1, 1982 bear interest at the rate Df
six (670) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after
January 1, 1982 will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate
annDunced by the PA Department Df Revenue. The applicable interest rates fDr 1982 thrDugh 2004 are:
Interest Daily Interest Daily Interest Daily
Year Rate FactDr Year Rate FactDr Year Rate FactDr
~ ~ ~ Im-1991 ~ ~ Z1i1I1 --w-- . iiliDFiT"
1983 1670 .000438 1992 970 .000247 2002 670 .000164
1984 1170 .000301 1993-1994 n .000192 2003 570 .000137
1985 1370 .000356 1995-1998 970 .000247 2004 470 .000110
1986 lOX .000274 1999 n .000192
1987 lOX .000274 2000 n .000192
--Interest is calculated as fDIIDws:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NDtice issued after the tax beCDmes delinquent will reflect an interest calculatiDn tD fifteen (15) days
beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the
NDtice, additiDnal interest must be calculated.
A-z-
..._---,
COMMONWEALTH OF PENNSYLVANIA '*
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Z80601 INHERITANCE TAX
HARRISBURG, PA 171Z8-0601 STATEMENT OF ACCOUNT
REY-1607 EX iFP [01-05)
DATE 06-28-2004
ESTATE OF MUNROE HENRIETTA B
DATE OF DEATH 07-07-2003
FILE NUMBER 21 03-0570
COUNTY CUMBERLAND
ROBERT J TRACE ACN 101
331 N 28TH ST I Allount Rellitted I
CAMP HILL PA 17011
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV =i6"ifj-Ex-AFP--foY:03Y------...-iNifERITANCE--TA3f-siXfEME-N'T-oF'-Accouiff--.-..---------------- -- ---
ESTATE OF MUNROE HENRIETTA B FILE NO.21 03-0570 ACN 101 DATE 06-28-2004
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-10-2004
PR I NC I PAL T AX DUE: ........................................................................................................................................................................................................................... 73,090.84
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT ~~
DATE NUMBER INTEREST/PEN PAID (-)
- (!"\
10-06-2003 CD003089 526.32 10,01Bl;;oo
04-07-2004 CD003784 .00 62,5~~84
06-14-2004 REFUND .00 ~:6. 32- :J:::>
ffi
c::' I
\Q
-0
~
(.j
-J
TOTAL TAX CREDIT 73,090.84
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
lIE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, ~Y-
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J
I....UllLUc;Ll.d.llU L;UUIlCY - Keglscer UI W1LLS
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 6/06/2005
TRACE ROBERT K
331 N 28TH STREET
CAMP HILL, PA 17011
RE: Estate of MUNROE HENRIETTA B
File Number: 2003-00570
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: 7/07/2005
Your prompt attention to this matter will be appreciated.
Thank You.
r~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
cd
~
' . Register of Wills of Cumberland County
:- ';.
. .
STATUS REPORT UNDER RULE 6.12
Name of Decedent: hlEN'(>'Err.,4 a. JvJ/////?o~
Date of Death: I." 'I 7/ YOtJ.3
. ~~
Estate No.: Q.~ tJ3 - 05'70
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 whether administration of the estate is complete:
Yes 00 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. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No G-
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes J8l No 0
c. Copies of receipts, releases, joinders and approval offormal or informal
accounts may be filed with the Clerkof the Orphans' Court and may be
attached to this report.
Date: /,.jl,;J-/I)5"' '~~./~
/
Signature
;7<, ~ ty x' J; /;tA c:!f
Name
J 3/ ,41. ~i )! f)i (',//HI' Jlli; ~
Address
(7 J7 ) 73'7 -15({/
Telephone No.
Capacity: ~onal Representative
o Counsel for personal representative cd