HomeMy WebLinkAbout04-0138PETITION FOR PROBATE & GRANT OF LETTERS
Estate of JANE F. CABANA
also known as
Social Security No. 418-16-7280
, deceased.
No. 21-04-/,~ ~
To: Register of Wills for the
County of Cumber/and
Common wealth of Pennsylvania
The Petition of the undersigned respectfully represents that:
Your Petitioners, who is 18 years of age or older and the Executrix named in the Last Will of the above
decedent dated May 27, 1994 , and codicils dated none The Executor named none
~ died Renunciations for MaryIyn Ray Lapeyrouse is attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal
residence at 801 North Hanover Street, North Middleton Township
Decedent, then 84 years of age, died
Carlisle, Pennsylvania
January 15 ,2004, at
Chumh of God Home,
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in PA
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania, situated as follows:
$60,000.00
$.
WHEREFORE,
herewith and the grant of letters testamentary thereon.
Signature(s) and Residence(s) of Petitioner(s):
Jo Ann Zea
117 Pine Tree Drive
Newville, PA 17241
717-486-4495
Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA :
:
COUNTY OF CUMBERLAND :
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 representative of
the above decedent, petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this//
day of
February ,2004.
~.~,?~ . ,~ ( ~ ~ Register
d/Jo Ann Zea ~
RENUNCIATION
In regard to the Estate of
To the Register of Wills of
JANEF. CABANA
Cumberland
., deceased.
County, Pennsylvania.
The undersigned daughter
renounce(s) the right to administer the estate and respectfully ask(s) that Letters
be issued to Jo Ann Zea
WITNESS our hands this ~3 ~ day of
of the above decedent hereby
Testamentary
January ,2004.
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9990493
No.
Local Registrar
JAN 1
· Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
,. JANE F. CABANA ,. Female 3. 418 _ ]6 _ 7280ia. January 15, 2004
84 v,~ i : 10/28/1919 Georgia ,.~,..E] ~.~u~.O ~[~
Cumberland North Middleton ~ ~.~
~ ~. ~.Church of God Home I'~'~'~' I'~ ~ite
I
,,% Homemaker ,1,. Homemaking R,~ i ~-a~5+L
,z ~ ...... ] ...... ] ,,. Widowed
801 N. Hanover Street ~u~ ,..m,, Pennsylvania · ,~..~.~ North Middleton
Carlisle, Pa 17013 ~
'L 1~.~ Cumberland ~? ,TaO
,,. Edward Blount Fields I,.. Lura R[sh
~ m. ~ea 1~117 Pine Tree Drive ~e~tlle. Pa 17241
~ ~ ~1 ....... I I ~ bong Ave unox ~/
~'~ - I~ Jan lY, ZUU~ I~.Comforter Funeral Home Port St J
~_~~-~,,~e~ ................. - · . ...... . · ~,,,. . oe, FL 32456
~:~~ I~y~.-' ~. ~ ~ ~ ~ ..... .. ~.~ .===
~,~.:~ I~.~,, ~~:.:.~ _ .,. ~v a,,a~ ~ t,. /-~-~q
i
OF
JANE F. CABANA
I, JANE F. CABANA, resident of Jefferson County, Florida, and a citizen of the
United States of America, whose social security number is 418-16-7280, revoke all prior
wills and publish the following as my- last will and testament.
ARTICLE I
Personal Representative. I appoint my daughter, Marylyn Ray Lapeyrouse, as
personal representative of my estate, but if she fails or ceases to serve, I appoint my
daughter, Jo Ann Zea, as personal representative. I direct that my personal representative
not be required to post bond or other security.
A. Powers. I authorize my personal representative (which term included any
ancillary and successor personal representatives) to sell or convey all or any part of any
real or personal property in my estate at private or public sale without notice and without
obtaining authority or confirmation from any court, for whatever prices, terms and
conditions my personal representative deems best, m-~d to execute and deliver all
appropriate instnn~ents. Purchasers will not be bound to inquire into my personal
representative's authority or application of the purchase money. My personal
representative will have full authority and discretion to do all things necessary for the
administration of my estate, just as I could do myself if living. My personal representative
Page 1 of Five
may distribute the assets of my estate in any convenient manner, in kind or in case, in non-
prorata shares or otherwise, and without regard to the income tax basis of those assets.
This enumeration of powers does not limit the authority of my personal representative and
in addition to these powers, my personal representative has all other lawful powers not
inconsistent with these powers.
B. Ancillary_ Personal Representative. If any ancillary estate is required, I
appoint my domiciliary personal representative to serve as ancillary personal representative
or to select and appoint an ancillary personal representative. The ancillary personal
representative is to serve with all the powers, discretion, and immunities given to my
domiciliary personal representative and without bond.
ARTICLE II
Payment of Debts, Expenses and Taxes. My legally enforceable debts, the expenses
of my last illness and funeral, all administration expenses of my estate, and all estate,
inheritance, and other death taxes assessed or imposed with respect to the property
comprising my gross estate for federal estate tax purposes, whether or not passing under
this will, together with any related interest and penalties, are to be paid as provided by
statute.
ARTICLE III
Gifts of Tangible Personal Property. I direct the following distribution of my
tangible personal property, including, but not limited to household furniture, furnishings,
utensils and supplies, silver, china, rugs, linens, books, paintings, pictures, objects of art,
hobby equipment, collections, wearing apparel, personal effects, jewelry, and motor
Page 2 of Five /~f~C--~-~
vehicles (together with any insurance on those items).
A. Separate Writing. All items of tangible personal property that are designated
in the most recently dated separate writing in existence at my death, which is signed by
me and describes the items given with reasonable certainty, I give to the persons specified
in the writing. It is to be conclusively presumed that I have left no separate writing if one
has not been found by or delivered to my personal representative within sixty (60) days
after this will is admitted to probate.
ARTICLE IV
The remainder of my estate, both real and personal, of whatever nature and
wherever situate, including, without limitation, all property acquired by me after the
execution of this Will, all property over which I may have a power of appointment, and all
lapsed legacies and bequests, ! devise and appoint equally to my daughters, Marylyn Ray
Lapeyrouse and Jo Ann Zea, per stirpes.
!N TESTIMONY WHEREOF, I, the said JANE F. CABANA, have unto this, my
Last Will and Testament, hereunto set my hand and seal at Monticello, Florida, on the _
~___ day May, 1994.
of
On the day and year first above writteh, the foregoing instrument consisting of five
(5) pages, each page bearing the initials of the Testatrix, was subscribed, published, and
declared by the Testatrix to be her Last Will and Testament, in our presence, and we, in
Page 3 of Five
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Estate No.:
JANE F. CABANA
JANUARY 15, 2004
21-04-0138
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on March 9, 2004 .
Name
JoAnn L. Zea
M. Ray Lapeyrouse
Address
117 Pine Tree Drive, Newville, PA 17241
8236 Bridgewater Trail, Tallahasseee, FL 32312
Notice has now been given to all persons entitled thereto under ule 5.6(a) e ept none .
Date: 03/09'04 ~'~ Si~ / - ~
~.._RWIN & McKNIGHT ~
Name M~~ht III, E~I/
Address 60 West Pomfret Street
Carlisle, PA 17013
Telephone (717) 249-2353
Capacity:
X
__ Personal Representative
__ Counsel for Personal Representative
his presence and at her request, and in the presence of each other, have hereunto
subscribed our names as witnesses.
[SIGNATURE OF WITNESgJ
ADDRESS
Print or Type Name of Witness
[SIGNATURE OF WITNESS]
ADDRESS
Print or Type Name of Wil~less
We, JASU r. CaUl& md
~ ~ u dC,'~fg ~ ~ ,'~ h . me Testa~ ~d ~messes respeefivdy, whose nines
~e si~ed to ~e auaehed or forego~g ~~ent, ha~g been sworn, decl~ed to ~e
~demi~ed o~cer ~at ~e Testa~ ~ ~e presence of ~ese ~messes si~ed ~e
~stment as her Last W~ ~d Testment ~d ~at she si~ed vol~t~y, ~d ~at each
of ~e Mtnesses, ~ ~e presence of ~e Testa~ ~d ~ ~e presence of each o~er, si~ed
~s Last W~ ~d Test~ent as a ~mess.
[SIGNATU= OF ~TNESd
~t or ~ H~e of Wim~
Page 4 of Five ~jF~~C ~
[SIGNATURE ~ WITNESS]
Print or Type Name of Witness ~
The foregoing will was subscribed and sworn before me this ~-~ ~/'t-'0f May, 1994,
by JANE F. CABANA, and by ~'~---,~q ~/~ ~'-- 7///Oc.-~/'~d ~ , and
~ '"~ c~k; ,~/~ ~'-'~; rc ,~ (names of wimesses) ( ~who is/r~)personally
known to me or ( ) who has/have produced as
identification and who ~ (did not) take an oath.
My Commission Expires:
No'-ta~ Sign.ature
Crype or Print Notary Name)
Notary Public, Stare of Florida at Large
Serial No. ~/4ff~g~c~
Page S of Five
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Estate No.:
JANE F. CABANA
JANUARY 15, 2004
21-04-0138
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on March 9, 2004 .
Name Address
JoAnn L. Zea
M. Ray Lapeyrouse
117 Pine Tree Drive, Newville, PA 17241
8236 Bridgewater Trail, Tallahasseee, FL 32312
Notice has now been given to all persons entitled thereto under~ule 5.6(a) e~)~ep~, none.
Date: 03/09/04 ~" Si~'~
\
Name Mar~za~,g~~ht III, Esq~l/
Address 60 West Pomfret Street
Carlisle, PA 17013
Telephone (717) 249-2353
Capacity:
X
__ Personal Representative
__ Counsel for Personal Representative
REV- 1500 EX * (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
NHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-04-138
COUNTYCODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Cabana Jane F.
E
D
E
N
T I ~ 1. Original Return
C A P B 4. Limited Estate
HpRL
E P I O 6. Decedent Died Testate
CRAc
TK
KOEs
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
01/15/2004 } 10/28/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FI RST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
418-16- 7280
THIS RETURN MUST BE FILED IN DUPLICATEWITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~247! Supplemental Return
· Future Interest Compromise (date of death after 12-12-82)
Decedent Maintained a Living Trust
(Attach copy of Will) /Attach copy of Trust)
[~9. Litigation Proceeds Received U 10. Spousal Poverty Credit
(date of death between 12-31-91 and 1 - 1-95)
NAME
Marcus A. McKni~ht Esq.
FIRM NAM E (If Applicable)
IRWIN & McKNIGHT
(date of death .A,
3. Remainder Return prior to 1Z-13-u=)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
TELEPHONE NUMBER
717,/249- 2353
1. Real Estate (Schedule A) (1)
2, Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole -Proprietorship
4, Mortgages & Notes Receivable (Schedule D) (4)
5· Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6, Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8, Total Gross Assets (total Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H) (9)
18, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12, Net Value of Estate (Line 8 minus Line 11 )
13.
[~ Election to tax under Sec. 9113(A)
1
1,
(Attach Sch O)
COMPLETE MAILING ADDRESS
R
E
C
A
P
I
T
U
L
A
T
I
O
N
C
O
M
T
O
14.
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
.~e
~None
:None
62,376.52
NQne
None
4,169.97
716.72
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
OFFIC_~IA, [~SE ONLY
~J
(8) 62,376.52
(11)
(12)
(13)
(14)
4,886.69
57,489.83
57,489.83
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00
57,489.83
0.00
0.00
X .0 0
X .0 45
X .12
X .15
(15)
(16)
(17)
(18)
(19)
0.00
2,587.04
0.00
0.00
2,587.04
opyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
· --'* COI~MONWEALTH 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
REV-1162 EX(11-96)
OO3786
MCKNIGHT MARCUS A III
60 W POMFRET STREET
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 418-16-7280
FILE NUMBER: 2104-01 38
DECEDENT NAME: CABANA JANE F
DATE OF PAYMENT: 04/07/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 15/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,457.69
REMARKS:
.... SEAL
CHECK//021058
TOTAL AMOUNT PAID:
~2,457.69
INITIALS' JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Decedent's Complete Address:
STREET ADDRESS
801 North Hanover Street
CITY
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
129.35
ISTATE
PA
(1)
ZIP
17013
Total Credits ( A + B + C ) (2)
2,587.04
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 * SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... ~ ~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care?~ . ..................
Z. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~] .r-~-]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. ~ ~']
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [~ '~'~]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
129.35
0.00
0.0~
2,457.69
0.00
2,457.69
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN JoAnn L. Zea DATE
,/~_/~ . ~ ,~;7__ 117 Pine Tree Dr. _./~ //
~u~~~ ~ [7~ ~.s. ~ l~
For dates of dea r Jan , 199,5, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0°Yo
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%. except as noted i~ 72 P,S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1~00 EX (Rev. 6-00)
REV- 1508 EX + (1-97)
COMMONWEALTHOFPENNSYLVANIA
INHERITANCETAXRETURN
RESlDENTDECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Jane F. Cabana SS# 418-16-7280 01/15/2004 21-04-138
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
Church of God Home - refund
American Home Bank - #110434
PNC Bank - checking account
3,056.73
56,691.56
2,628.23
TOTAL (Also enter on line 5, Recapitulation) $ 62,3 76.52
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
REV- 1511 EX * (1-97)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCETAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jane F. Cabana SS# 418-16-7280 01/15/2004 21-04-138
Debts of decedent must be reported on Schedule h
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
FUNERAL EXPENSES:
Gulf Sands Rest.
Pastor Harry Martinez
Ronan Funeral Home
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney's Fees IRWIN & McKNIGHT
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
city
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Register of Wills filing fee
State Zip
481.00
400.00
165.97
2,900.00
151.00
47.00
25.00
TOTAL (Also enter on line 9, Recapitulation) $ 4,169.97
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV- 151Z EX + (1-97)
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES~AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jane F. Cabana SS# 418-16-7280 01/15/2004 21-04-138
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
Brockie Pharmatech
Church of God Home - nursing
Lehigh Valley Respiratory Care
517.85
145.92
52.95
TOTAL (Also enter on line 10, Recapitulation) $ 716.72
(if more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-151Z EX (Rev. 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Jane F. Cabana SS~ 418-16-7280
SCHEDULE J
BENEFICIARIES
01/15/2004
FILE NUMBER
21-04-138
NUMBER
II,
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISIHIBUTIONS [include outright spousal distributions, and
transfers u~er Sec. 911~1.Z)]
Marylyn Ray Lapeyrouse
8236 Birdgewater Trail
Tallahassee, FL 32312
JoAnn L. Zea
117 Pine Tree Drive
Newville, PA 17241
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Daughter
AMOUNT OR SHARE
OF ESTATE
1/2 remainder
1/2 remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
Bo CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
OF
JANE F. CABANA
[, JANE F. CABANA, resident of Jefferson County, Florida, and a citizen of the
United States of America, whose social security number is 418-16-7280, revoke all prior
wills and publish ~'--
mc follov/mg as my last will and testament.
ARTICLE I
Personal Representative. I appoint my daughter, Marylyn Ray Lapeyrouse, as
personal representative of my estate, but if she fails or ceases to serve, i appoint my
daughter, Jo Ann Zea, as personal representative. I direct that my personal representative
not be required to post bond or Other security.
A. Powers. I authorize my personal representative (which term included any
ancillary and successor personal representatives) to sell or convey all or any part of any
real or personal property in my estate at private or public sale without notice and without
obtaining aur~hority or confirmation from any court, for whatever prices, terms and
concmon~ my personal representative deems best, mhd to execute mad deLiver all
approprlate Lnstmrnents. Purchasers MI! not be bound to inquh'e into my personal
representative's authority or application of the purchase money. My personal
representative will have full authority and discretion to do all things necessary for the
administration of my estate, just as I could do myself if living. My personal representative
Page 1 of Five
may distn'bute the assets of my estate in any convenient manner, in kind or in case, in non-
prorata shares or otherwise, and without regard to the income tax basis of those assets.
This enumeration of powers does not limit the authority of my personal representative and
in addition to these powers, my personal representative has all other lawful powers not
inconsistent w~.'th these powers.
B. Ancilla_ry Personal Representative. If any ancillary estate is required,
appoint my domiciliary personal representative to serve as ancillary personal representative
or to select and appoint an ancillary personal representative. The ancillary personal
representative is to serve with all the powers, discretion, and immunities given to my
dornic~iap? personal representative and without bond.
ARTICLE
Payment of Debts, Expenses and Taxes. My legally'enforceable debts, the expenses
of my last illness and funeral, all administration expenses of my estate, and all estate,
imheritance, and other death taxes assessed or imposed with respect to the property
comprising my gross estate for federal estate tax purposes, whether or not passing under
this w~, together with any related interest and penalties, are to be paid as provided by
statute.
ARTICLE
G~Ls of Tangible Personal Property. [ direct the following distribution of my
tang~'b~e personal property, including, but not Limited to household furniture, furnishings,
utensils and supplies, silver, china, rugs, linens, books, paintings, pictures, objects of art,
hobby equipment, collections, wearing apparel, personal effects, jewelry, and motor
Page 2 of Five
/
vehic!es (together with any insurance on those items).
A. Ser)arate Writing. Al/items of tangible personal property that are designated
in the most recently dated separate writing in existence at my death, which is signed by
me and desc~bes the items given with reasonable certainty, [ give to the persons specified
in the wrJ.'t~ng. It is to be conclusively presumed that [ have left no separate writing ff one
has not been found by or delivered to my personal representative within sixty (60) days
after this wi5 is admitted to probate.
ARTICLE IV
The remainder of my estate, both real and personal, of whatever nature and
wherever situate, including, without limitation, all property acquired by me after the
execution of this Will, all property over which I may have a power of appointment, and all
lapsed 'legacies and bequests, [ devise and appoint equally to my daughters, Marylyn Ray
Lapeyrouse and Jo Ann Zea, per stirpes.
rN TESTIMONY WHEREOF, I, the said JANE F. CABANA, have unto this, my
Last Will and Testament, hereunto set my hand and seal at Monticello, Florida, on the
~day of May, 1994.
On the day and year first above writt , the foregoing instrument consisting of five
(5) pages, each page bearing the initials of the Testatrix, was subscribed, published, and
declared by the Testatrix to be her Last Will and Testament, in our presence, and we, in
Page 3 of Five
h~s presence and at her request, and in the presence of each other, have hereunto
subscpibed our names as witnesses.
~ ~/~/~ of
[S~GNATUR_E OF W~TNESg~
ADDRESS
Print or Type Name of Witness
[S.fGNATURE OF WITNESS]
of
ADDRESS
Print or Type Name of Witl~ess
We, JANE F. CABANA, ,.~ ~:~_.~ L~ ~./, c _l(, ~'~ ~d
~ u c~, ~ ~ n ~ ~ ~ ff~ , ~e Testat~ ~d ~tnesses respectively, whose n~es
~e s~ed to ~e attached or forego~g ~tment, ha~g been sworn, decl~ed to ~e
~dersi~ed o~cer ~at the Testat~ ~ ~e presence of ~ese ~messes si~ed ~e
~stpment as her Last Wi~ ~d Testament ~d that she si~ed vol~t~y, ~d that each
of the ~tnesses, ~ the presence of ~e Testa~ ~d ~ ~e presence of each other, si~ed
~s Last W~t! and Testament as a ~mess.
[SIGNATU~ OF ~SNES~
P~t or T~ Name of Wimps
Page 4 of Five ,/[ aFC ~
[SIGNATUKE t~F WITNESS]
Print or Type Name of Witness ~'
Tke foregoing will was subscribed and sworn before me this ~4 / -'of May, 1994,
by JANE F. CABA~NA, and by ~.-. ~',4~ L. ~ /Z'-. ..: or~,~.,'~ ~ , and
.... "~T '-~,?~'~ch_;,d~ ]~,¢,'~'-~; rc~ (names of wimesses) ( -'3~who is/(~r~personally
known to me or ( ) who has/have produced
as
identification and who ',(~5W (did not) take an oath.
My Commission Expires:
· (Type or Print Notary Name)
Notary Public, State of Florida at Large
Serial No..~,.c>
Page 5 of Five
MAR"-08-2004 23:24 PNCBANK 412 ?68 3458 P.01701
PN CBAN<
March 9, 2004
Marcus A. McKnlght III.
West Pomfret Professional Building
60 West Porn_fret Slreet
Carlisle, PA 17013-3222 ,
Estate of Jane F. Cabana, deceased
SSN: 418-16-7280
DOD: 1/15/2004
Dear Mr. McKnight:
In response to your request for Date of Death balances for.the customer noted above, our
records show the following:
Checking Account
Account #5004221313
JANE F CABANA
DOD balance: $2,628,23 (non-interest bearing)
Established 07/08/2003
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
1-800-762-1775
PT-PFSC-04-F
500 first Ave.
Piasburgb PA 152 i9
M~nb~r FDIC
TOTAL P.O1
AMERICAN
HOME BANK . .
We help build your future.TM
LAW OFFICES
IRWIN & McKNIGHT
WEST POMFRET PROFESSIONAL BUILDING
60 WEST POMFRET STREET
CARLISLE, PA 17013
February 2, 2004
RE: Estate of Jane F. Cabana
Account # 110434
Dear Mr. McKnight:
As you requested, the exact title of the account is Jane F Cabana. The account
was opened on July 9, 2003. The balance at date of death was $56,691.56. The
statement was showing 56,706.91 due to the statement date of January 20, 2004. We
subtracted $15.35 for 5 days interest from the 15th to the 20th.
This was the only account she had with us with no changes made to the title of the
account.
Should you have any questions, please feel free to call me a{ 717-218-6635.
Sincerely,
Laraine K Holley
Financial Service Representative
52 East High Street,/Cartisle, PA 17013-2922 * Phone 717/218-6630 * w,,,,w, bankahb.com
COMMONWEALTH (YF PENNSYLVANIA
COUNTY OF CUMBERLAND
JoAnn L. Zea
being duly sworn according to law, deposes and says that she is the personal
representative of the Estate of Jane F. Cabana
late of ---N*p~th__M-i~d!~tgn__.Tpwnsb~ip ----, Cumberland County, Pa., deceased and that the
within is an inventory made by JoAnn L. Zea , the said personalrepresent_atiye
of the entire estate of said decedent, consisting of all the personal property 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.
Sworn
and subscribed before me,
this a. day__of April, 2004
Marcus A. McKni§hUII, No.fy Pu~io
Cadisle Boro., Cum~dand Coun~
[ My Commission Expires ~t. 10, 2005
DaJe oJ Dea~~mber' Pennsylva~i~iation ~ Nomdes
JoAn L~ z~~a~'
--.%n~L~- ; Pe~s - al~Representative
· ll7'Pine Tree Drive
Newville, PA 17241
Address
O1 2004
Day Month Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thlrfy days of discovery of addlflonal assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
o
U
0
Inventory of the real and personal estate of
JANE F. CABANA
deceased
1. Church of God Home - Refund .........................
2. American Home Bank - #110434
3. PNC Bank - Checking Account .........................
TOTAL ..................
3,056
56,691
2,628
62,376
73
56
23
52
Estate Account-All Accounts
Class Report
12/1/94 Through 4/2/04
4/6/04
Page 1
Date Acct Num Description Memo Category Clr Amount
2/19/04 ESTATE ... DEP BC/BS JANE F. CABANA EST... PREM REFUND/CABA... R 219.43
2/19/04 ESTATE ... DEP PNC BANK JANE F. CABANA EST... CLOSED BK ACCT/C... R 2,628.23
2/19/04 ESTATE ... DEP AMERICAN HOME BANK JANE F. CABANA EST... CLOSED BK ACCT/C... R 56,792.81
2/20/04 ESTATE ...20812 BROCKIE PHARMATEC... JANE F. CABANA EST... PRES/CABANA J R -517.85
2/20/04 ESTATE ...20813 RONAN FUNERAL HOM... JANE F. CABANA EST... FUN/CABANA J -165.97
2/23/04 ESTATE ...20822 MARCUS A. McKNIGHT I... JANE F. CABANA EST... PROBATE/CABANA J R -151.00
2/27/04 ESTATE ...DEP CHURCH OF GOD HOME JANE F. CABANA EST... REF OVER/CABANA J 3,056.73
3/8/04 ESTATE ...20895 JOANN L. ZEA ............ ...JANE F. CABANA EST.,. REIMBURSE/CABANA J -1,914.78
3/8/04 ESTATE ...20896 M. RAY LAPEYROUSE**... JANE F. CABANA EST... REIMBURSE/CABANA J -21.00
3/8/04 ESTATE ...20897 SHEILA ZEA .............. ...JANE F. CABANA EST... REIMBURSE/CABANA J -323.90
3/8/04 ESTATE ... 20898 PERRY KEMP ............ ...JANE F. CABANA EST... REIMBURSE/CABANA J -90.00
3/8/04 ESTATE ... 20899 SELENA SICKLER ....... ...JANE F. CABANA EST... REIMBURSE/CABANA J -20.00
3/18/04 ESTATE ... 20952 LEHIGH VALLEY RESPI... JANE F. CABANA EST... MEDICAL/CABANA J -52.95
3/18/04 ESTATE ... 20953 CHURCH OF GOD HOM,.. JANE F. CABANA EST... NURSING/CABANA J -145.92
3/26/04 ESTATE ... 21024 PATRICIA A. ROSENDA... JANE F. CABANA EST... TAX PREP/CABANA J -47.00
TOTAL 12/1/94 -4/2/04
59,246.83
TOTAL INFLOWS
TOTAL OUTFLOWS
62,697.20
-3,450.37
NET TOTAL 59,246.83
DUREAU OF ZNDZVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
HARCUS A MCKNIGHT ESQ
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE
COMHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
'04 i't!i¥ 24.
z '7015.4
PA
DATE 05-24-Z00~
ESTATE OF CABANA
DATE OF DEATH 01-15-200~
FILE NUMBER 21 0q-0158
~UNTY CUMBERLAND
ACN 101
I Amount Remitted
RE¥-ISgi7 EX AFP C01-03)
JANE F
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THTS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRATSEHENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CABANA JANE F F/LE NO. 21 0~-0158 ACN 101 DATE 05-Z~-ZOOR
TAX RETURN NAS: (X) ACCEPTED AS F/LED { ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds {Schodula B)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
~. Nortgagos/Notes Receivable (Schedule D) (~)
S. Cash/Bank Daposits/Nisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expansas/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. Dobts/Hortgaga Liabilities/Lions (Schedule 1) (10)
11. Total Deductions
12. Nat Value of Tax Return
0O
O0
O0
O0
62/376 52
00
00
(8)
~,169.97
716.72
NOTE: To insure proper
credit to your account,
submit tho upper portion
of this fore with your
tax payment.
15.
1~.
NOTE:
62,$76.52
(11) ~ .88~. 69
(12) 57,489.85
Charitable/Governmental Bequests; Non-eXacted 9115 Trusts (Schedule J) (15)
Nat Value of Estate Subject to Tax
Zf an assessment Nas issued previously, 11nos 14, 15 and/or 16, 17,
re~lect ~igures that include the ~otal o~ ALL returns assessed to date.
.00
57,~89.85
18 and 19 ~ill
(15) .00 x O0 = .00
(16) 57,489.85 x 0~5= 2,587.0~
(17) .00 x 12 = .00
(18) .00 x 15 : .00
(19)= 2,587.04
ASSESSHENT OF TAX:
15. Amount of Line 1~ at Spousal ra~o
16. Amount of L1na 1~ ~axabXa at Lineal/Class A rate
17. Amount of Line lq at Sibling rata
18. Amount of Line 1~ taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYH~NT RECEXPT
DATE NUHBER
=AYMENT MUST BE MADE BY 10-15-2004~.
IF PAID AFTER DATE IND/CATED, SEE REVERSE
FOR CALCULATION OF ADDXTXONAL XNTEREST.
DX$COUNT
XNTEREST/PEN PAID (-)
AHOUNT PAID
TOTAL TAX CREDIT I .00
~ALANCE OF TAX DUEl 2,587.0~
INTEREST AND PEN. .00
TOTAL DUE 2,587. O~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CRED/T" (CR)~ YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 1982 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Caaeonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class 8 (collateral) rate on any such future interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
Detach the tap portion of this Notice and submit with your payment to the Register of Nills printed on tho reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office
of the Register of Mills, any of the 23 Revenue District Offices, ar by ceiling the special Z4-hour
answering service for fores ordering: 1-800-362-Z050~ services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 iTT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax iincluding discount or interest) as shown on this Notice must object within sixty i60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 28lOg1, 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 assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17II&-0601
Phone (717) 787-6505. Sea page 5 of tho 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 throe (5] calendar months after the dacedant's death, a five percent iSZ) discount of
the tax paid is allowed.
The 152 tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
interest is charged beginning 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 l, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rata of .O0016q. All taxes which became delinquent on and after
January 1, 1982 mill 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 Z004 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ lOX .000548 1988-1991 iIZ .OOO3Ol 2001 9Z .000247
1985 16X .000458 199E 92 .000247 ZOOZ 62 .000164
1984 IIX .000301 1993-1994 72 .O0019Z 2003 SZ .000137
1985 132 .000356 1995-199B 92 .000247 ZOO4 42 .000110
1986 lOX .000274 1999 72 .000192
1987 lOX .000274 2000 72 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUHBER OF DAYS DELINQUENT X DAILY TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen ilS) days
beyond the date of the assessment. Xf payment is made after the interest computation date sheen an the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
JANE F. CABANA
Date of Death: JANUARY 15, 2004
No. 21-04-0138
Pursuant to Rule 6.12 of the Supreme Coui-~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: X Yes __ No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X No
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? X Yes No
d. Copies of receipts, releases, joinders and approvals of formal or informal
Date: 06/04/2004
Clerk
accounts may be filed with the . of Orphgn's Court and may be
attached to this report~~
IRWIN & McKNIGHT
Marcus A. McKnight, III, Esquire
Name (please type or print)
60 West Pomfret Street
Address
Carlisle, PA 17013
City, State, Zip
(717) 249-2353
Telephone Number
Capacity:
X
Personal Representative
Counsel for Personal Representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DTVTS/ON
DEPT. ZBO6D1
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX AFP Cff1-05)
MARCUS A MCKNIGHT ESQ
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE PA 17015
DATE 05-24-2004
ESTATE OF CABANA
DATE OF DEATH 01-15-2004
FILE NUMBER 21 04-0158
~NTY.,~ CUMBERLAND 101
Amoun'l:
JANE F
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper cred/~ ~o your eccoun*, submi~ ~he upper por~:/on of ~his fore wi~h your ~ax payment.
CUT ALONG TH/S LINE ~ RETAIN LOWER PORT'rON FOR YOUR RECORDS
(01-03)
REV-1607 EX AFP ~## 'rNHERZTANCE TAX STATEMENT OF ACCOUNT
ESTATE OF CABANA JANE F F'rLE NO. 21 04-0158 ACN 101 DATE 05-Z4-ZO04
THTS STATEMENT TS PROVTDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHO#N BELO#
TS A SUMMARY OF THE PRINCIPAL TAX DUE.. APPL/CAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, TF APPLICABLE,
A PROJECTED TNTEREST F/GURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-Z4-Z004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
2,587.04
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-07-2004 CD005786 129.55 2,457.69
TOTAL TAX CREDIT 2,587.04
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
ZF PA/D AFTER TH/S DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDIT/ONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT 1S REQU/RED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS.
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check ar money order payable to: CONHON#EALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by compZating an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at
the Office of tho Register of Hills, any of the Z3 Revenue District Offices or frei the Department's Z4-hour
answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / ar
speaking needs: 1-800-447-30Z0 (TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601) Harrisburg, PA 171Z8-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the dacedent's death, a Five percent (51) discount
of the tax paid is allowed.
PENALTY:
The 151 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 amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent per annum calculated at a daily rate cf .00016~. 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 applicabZe interest rates far 198Z through 2004 are:
Interest Daily Interest Daily Interest
Year Rate Factor Year Rate Factor Year Rate
198Z ZOZ .000548 1988-1991 llZ .gO03Ol 2001 9Z
1983 16Z .000438 199Z 9Z .OOOZ47 ZOOZ 6Z
1984 XiZ .000301 1993-1994 7Z .O0019Z 2003 3Z
1985 13Z .000356 1995-1998 92 .000Z47 ZOO4 4Z
1986 IOZ .000Z74 1999 7Z .O0019Z
1987 9Z .000Z¢7 ZOO0 8Z .000Z19
Daily
Factor
.OOOZ~7
.000164
.000137
.000110
--Interest is calculated as follows:
XNTEREST= BALANCE OF TAX UNPA'rD X NUNBER 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 assessment. Xf payment is made after the interest computation date shamn on the
Notice, additional interest must be calculated.