HomeMy WebLinkAbout04-0061PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Susan M. Carver No. 21-04-
also known as To:
Deceased.
Social Security No. 165-38-0500~
Register of Wills for the
County of Cumberland
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 ors
in the last will of the above decedent, dated Jo_nu~r'v 25.
and codicil(s) dated -
in the
named
,19 85
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland
_ County, Pennsylvania. with
h er last family or principal residence at 1196 Newville Road, C&rlisle, PA, 17013
at
(list street, number and muncipality)
Decendent, then 58 years of age, died. Octobor 25 , ~ 2003
Carlisle ~ional M~=dical Ce~nter ,
Except as follows, decedtnt did not marry, was not.divorced and did not have a child born or adopted
.after execution of the offered for probate; was not' the victim of a killing and was never adjudicated
~ncompetent: n/awill
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value or' real estate in ~P~;n~n_syJvania...
situated as follows: .1.196 Newvx±±e Road, Carlisle, PA, 17013
$84,373.00
$ 1,500.00
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theroll. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
Gary E. Carver
'~ ~ --~05 A North Walnut St
~.~ Mt. Holly Spring, PA
~'= (717) 486-4742
~ Sco. tt C. Carver
~ _l196_N~wvJl]~ Road
.~, Carlisle, PA 17013
~ (717) 249-6782
17065
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Ctmf3erland ~ 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.
Sworn to or affirmed and subscribed
this ~/~, day of
Gary E. Carver
Scott C. Carver
No.
21-o4- /
Estate of SUSAN M, ~
., Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~/~"~'/
the reverse side ~eof, satisfact~/Y proof having been Presented before me,
IT IS DECREED that the instrument(s) dated Jemuory 25, 1985
described therein be admitted to probate and filed of record as the last will of
Susan M. Carver
and Letters Testamentary
consideration of the petition on
are hereby granted to_ G E. C&rv~ and Scott ·
FEES
Probate, Letters, Etc .......... $'~ 0 {~. ~
Short Certificates(d) .......... $ ~' 0 L~
$
Renunciation ................
EYc ~ $to, oo
TOTAL $ ~.7..~'. OO
SALZMANN, HUGHES & FISHMAN, P. C
James-D! Hughe~ Esquire I.D. 58884
ATTORNEY (Sup. Ct. I.D. No.)
95 Alexander Spring Rd, Ste 3
Carlisle, PA 17013
ADDRESS
(717) 249-6333
PHONE
l0$,g0$ REV 9/g6
This is to ce~ti6/that the in£ormation here given is correctly copied From an original certificate o£ death duly 61ed wit~ 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 ~
~ Local Registrar
P 9749941 0gT g8 2003
No. '~ Date
'- Susan M. Carver
58 ~"'i
s.
~ Cumberland
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ° VITAL RECORDS
CERTIFICATE OF DEATH
,. Female [,. 165 -- 38 -- 0500 ,.~ ~S',,aoo,3
~rllsle ,,~rl[sle R~lonal Medcial Center ~ .... ~""".~, ,.. ~lte
Homemaker Own H.ome
1196 Newville Road ^CrUAL
Carlisle PA 17013 ~"~
~:lar C. Weidner
Scott Carver ~ 1196 Newville Road, Carlisle PA 17013
_ ~.,~i~ c~..~u N-.~..m.,U IMxm.°".~''l I~m I
,~U ~, F ~ O[,,b: ~r 29, 2~3 I=,.. Westminster Ce~te~ I,,, ~rlisle PA 17013
~ ,/.,- a/~v ~ . i 0148'- - z ___ - Den ~unera~ ~
~C~J~_~-- I:~. l~--b I~. 219 N. Hanover St., Carlisle PA 17013
/70//
LAST WILL AND TESTAMENT OF SUSAN M. CARVER
I, SUSAN M. CARVER, of North Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will
and Testament, in manner and form following:
1. I hereby expressly revoke all Wills and Codicils
heretofore made by me.
2. I hereby direct my Executors to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. I devise and bequeath the remainder of my estate to my
issue, per stirpes.
4. I nominate and appoint Farmers Trust Company, Carlisle,
Pennsylvania, Trustee of the share of any beneficiary who may be
under the age of twenty-one years. The income and/or principal
of said trust may be accumulated or expended for the maintenance,
education and support of such beneficiary as my Trustee in its
sole discretion may determine; and my Trustee, in the expenditure
of income and/or principal for such purposes, may, at its discre-
tion, apply the same directly without the intervention of a
guardian or pay the same to any person having the care or control
of said beneficiary or with whom the beneficiary resides, without
duty on the part of the Trustee to supervise or inquire into the
application of the funds by any person to whom any payment is so
made. The balance of such income and/or principal shall be paid
to such beneficiary upon reaching the age of twenty-one years or
to such beneficiary's estate in the event of death prior thereto.
5. I nominate and appoint my sons, Gary E. Carver and Scott
C. Carver (if he is twenty-one years of age), as Executors of
this my Last Will and Testament.
6. I direct that my Executors and Trustee, as well as their
successors, shall not be required to file bond or security in any
jurisdiction.
- 1 -
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 25th day of January, 1985.
Susan M. Carver
WITNESS:
(SEAL)
CO~{MONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
I, Susan M. Carver, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Susan
M. Carver, Testatrix, this 25th day of January, 1985.
Testatrix
My Con~.mission F.,xpir~ Jaaumy 2,7,
- 2 -
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
We, Tom H. Bietsch and Roger M. Morgenthal, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix, Susan N. Carver, sign and execute
the instrument as her Last Will; that she signed willingly and
that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the Will as witnesses; and that to
the best of our knowledge the Testatrix was at that time 18 or
more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and subscribed to before me by Tom H.
Bietsch and Roger M. Morgenthal, witnesses, this 25th day of
January, 1985.
Witness
- 3 -
OF
SUSAN M. CARVER
STATE OF PENNSYLVANIA
IN THE MATTER OF
ESTATE OF:
SUSAN CARVER
A/K/A SUSAN M. CARVER
'04 FEB 27 P12:17
IN THE ORPHAN'S COURT
OF CUMBERLAND COUNTY
ESTATE#: 21-04-61
DATE OF DEATH: '10/25/03
STAteMENT oF 9J~AIM
· ,'n - ~ ~'0 ~A
1. The creditor, American Express, certffie~ [l[a~f~ere ~s &e '~owing by SUS~ C~VER, deceased, the sm of
zwo .ous stay c ms (, 2,3 6.69).
2. The nature of the claim is a BLUE CARD account 371288871391001, which was established in 09/18/01.
3. The name and address of the claimant is: American Express, 200 Vesey Street, New York, NY 10285-3830.
4. The name and address of the claimant's agent is: Jennifer L. Strehlein, Estate Recoveries, Inc., P. O. Box 24566,
Baltimore, Maryland 21214.
5. This claim is not contingent and is not secured by any liens or judgments.
6. This claim is not based on any one instrument. Said balance has accrued since the account was established.
On behalf of American Express, creditor, I do solemnly declare and aft'mn under the penalties of perjury that the
information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made
diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to
the affiant have been allowed.
P.O. Box 24566
Baltimore, Maryland 21214
(410) 444-8022
County of Harford, Maryland:
IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this Feb~-iry 25, 2004:3
_
j.
My Commission Expires: November 24, 2007.
COMMONWEALTH OF PENNSYLVANIA
In Re: The Estate of:
SUSAN M CARVER
Deceased
NO TICE OF CLAIM
COURT OF COMMON PLEAS
OF-, CUMBERLAND
-COUNTY
ORPHANS' COURT DIVISION
Court File No: 21-04-61
TO: THE CLERK OF THE ORPHANS' COURT DIVISION Notice of claim by
creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries
Code, 20 PA.C.S.A. §3532(b)(2).
1)
2)
3)
4)
Claimant's name:
Claimant's address:
5)
6)
7)
BANK ONE
cio NCO Financial Systems, Inc
Probate Depa rtment,~f.450
1804 Washington Boulevard
Baltimore, MD 21230
(443)263-3300, ext 3304
Creditor listed below is the owner and holder of a claim in the amount of
$4,055.34
· ACCT#4417168592586261
The facts upon which this claim is based is a credit agreement between
Creditor and Decedent, identified as account number which is evidenced by
the attached affidavit of account stated.
Decedent's address: 1196 NEWVILLE ROAD, CARLISLE PA 17013
Date of Death: 10/25/03
That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by
On behalf of the claimant, I do solemnly declare and affirm under the penalti s of
perjury that they Information and representations ade h ein a~: rue an rrect
t° the best of mY knowledge, information and i~s.~i~. , n/~' ]~J e~
Dated:March 2, 2004 (df f~./ / /~/') /J/ [ /"7 ·
/.-¢ v-,,~// ~. t i.~'~__~ .AGENT
Claimant r L54520
Written notice of claim was given to Personal Representative and/or his/her counsel
as stated below:
GARY CARVER
'Name
~406A NORTH WALNUT STREET
Address
.MOUNT HOLLY SPRINGS, PA 17065
City/State/Zip
MARCH 2,2004
Date notice mailed
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Estate No.:
SUSAN M. CARVER
OCTOBER 23, 2003
21-04-0061
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 February_ 11, 2004 .
Name Address
Gary E. Carver
Scott C. Carver
406A North Walnut Street, Mt. Holly Springs, PA 17065
1196 Newville Road, Carlisle, PA 17013
Notice has now been given to all persons entitled th~5.6(a) except __
Date: 04~05~04r
~X,,._..~ame James D. Hughes, Esquire
none.
'
Capacity:
Address 95 Alexander Spring Road, Suite 3
Carlisle. PA 17013
Telephone (717) 249-2353
X
__ Personal Representative
__ Counsel for Personal Representative
IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF
SUSAN M CARVER
)
) Register's #
Deceased)
21-04-61
CLAIM
To the Clerk of the Orphans' Court Division :
Index and make proper entry in your official records of the
claim of CITIBANK (SOUTH DAKOTA) NA in the amount of
3,745.15 against the estate of the above-named decedent. This
claim is filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S.
ss. 3532 (b) (2) .
The said decedent, whose last known residence was at
1196 NEWVILLE RD CARLISLE, PA 17013
Written notice of this claim was given to GARY CARVER
406A N WALNUT ST MTHOLLY SPRNG, PA 17065
on March 9, 2004
(Claimant)
SHAWN HARMER,manager of Citicorp
Credit Services, Inc. USA under limited
power of attorney for CITIBANK (SOUTH
DAKOTA) NA
7930 NW 110T~ ST
KANSAS CITY, MO 64153
(Claimant's Address)
Account #(s) 5398570050315176
Y ur sa/Card Statement
October 14 - November 12, 2003
SUSAN M CARVER
Account 5398 5700 5031 5176
Calling Card 8631766240 + PIN
No Annual Fee/Platinum Card
Page 1 of 3
AT T
How To Reach Us
Account Online: www.universalcard.com
Customer Service: 1 800 423-4343 or write
Cardmember Services, PO Box 44167
Jacksonville, FL 32231-4167
Minimum Payment Due ......................................... $157.00
Due Datex ............................................. December 8, 2003
*Payment must bi raceivod by 1:n0 pm local time on the payment duo date.
Amount Past Due .................................................... $78.00
Credit Line .......................................................... $12,700.00
Available Credit .................................................... $8,874.00
Cash Advance Limit ............................................. $3,400.00
Available Cash Advance Limit ............................. $3,400.00
Previous Balance 3,754.15
Payments and Adiustments 0.00
Master Carcle) Activity 70.93
Total AT&T Services 0.00
New Balance $3,825.08
Note: Detailed activity starts on page 3.
The Annual Percentage Rate on your
account may increase due to one of the
following reasons stated in your Card
Agreement with us: if you fail to make a
payment to us or any other creditor when
due, you exceed your credit line or you
make a payment to us that is not honored
by your bank.
Your AT&T Universal MasterCard could
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November 1 through December 31, 2003.
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Payment Record Amount Paid: Date Paid: Check Number:
Please follow payment Instructions outlined in the "Important Instructions for Making Payments" section of the statement.
Y~r Acc~u.t Ntm~er
05398570050315176382508157005907
I 5398 5700 5031 5176
Pl#~e F.~er Ammmt of Pa~ [~1o~
SS HC OD A I AR7OSOSZ6
I,,.llh.,lll ...... I1,,11 .... IIl,,,I,,ll,l,l,,hl.,,ll .... I1,1 II1.,,I,,.I,I1.,11,,,,11,,I,.I,,,I,II1,.,I,,I,,,11,1
SUSAN M CARVER AT&T UNIVERSAL CARD
1196 NEWV1'LLE RD PO BOX8208
CARLZSLE PA 17013-1739 SOUTH HACKENSACK NJ 07606-8208
I1,1,1,,111,,111,1,1111,1,1,11,,111,,I,III1,1,11,1,111,,,I,III
SUSAN M CARVER
Account 5398 5700 5031 5176
October 14 - November 12, 2003
Page 3 of 3
Purchases ........................................................................................................................................................ 0.00
Cash Advances and Checks .......................................................................................................................... 0.00
Finance Charges ........................................................................................................................................... 35.93
Fees ................................................................................................................................................................ 35.00
Total MasterCard Activity ......................................................................................................................... $70.93
Total MasterCard Purchases ............................................. $0.00
Cash Advance Limit ............................. $3,400.00* *This represents a portion of your total credit line.
[~'mancc Charge Infomu~km ]
Days in Balance Periodic Transaction ANNUAL
Nominal Periodic x Billing x Subject to = FINANCE + Fee/FINANCE PERCENTAGE
APR Pete Period Finence Charcje GNAR~E ~,HAR~iE RATE
PURCHASES
Standa~ Purch 11.990% .03285%(D) x 29 x $3,771.47 = $35.93 + SQ00 11.990%
CASH ADVANCES
Standa~ Adv 19.990% .05477%(D) x 29 x $0.00 = $0.00 + $0.00 19.990%
Total FINANCE CHARGE = $3S.93
IStandard Purch
Trans Post Description Amount
lZ/12 LATE FEE - OCT PAYMENT PAST DUE 35.00
Total Fees $35.00
AT&T Universal Calling Card Calls ......................................................................................................... $0.00
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 004125
HUGHES JAMES D
95 ALEXANDER SPRING RD
SUITE 3
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 165-38-0500
FILE NUMBER: 2104-0061
DECEDENT NAME: CARVER SUSAN M
DATE OF PAYMENT: 07/07/2004
POSTMARK DATE: 07/07/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 10/25/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,102.00
REMARKS:
SALZMANN ET AL
TOTAL AMOUNT PAID:
$3,102.00
SEAL
CHECK# 3078
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 28O601
HARRISBURG, PA 17128-0601
REV-I$00
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 -- 04
COUNTY CODE YEAR
-0061
NUMBER
DECEDEN'FS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ Carver
Z Susan M 165-38-0500
"' DAm OF D~ (MM-DD-YEAR) I DAm OF B~R~ (MM-DD-Y~R)
~ ?HIS RETURN MUST BE FILED IN DUPLICATE ~TH THE
W 10/25/2003 I 6/1/1945
O REGISTER OF WILLS
U./ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I X J 1. Odginal Return I J 2. Supplemental Return
[] 4. Limited Estate r'~ 4a. Futura Interast Compromise (data of death after 12-12-82)
r~6. Decedent Died Testate (Attach copy of Will) r~ 7. Decedent Maintained a Living Trust (Attach copy of Trust)
]9. Litigation Proceeds Recei',ed
NAME
L~J3. Remainder Return (date of death prior to 12-13-82)
]5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
[~ 10. Spousal Poverty C~'edit (d,t, of delth between 12-31-gl and 1-1-95) r~ 11. Election to tax under Sec. 9113(A)(^,~ch s~h o)
u,J
James D. Hughes, Esquire
FIRM NAME (If Applicable)
SALZMANN, HUGHES & FISHMAN PC
TELEPHONE NUMBER
717-249-6333
COMPLETE MAILING ADDRESS
95 Alexander Spring Road, Suite 3
Carlisle, PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Coq3oration, Partnership or Sole-Propdetorahip (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Pemonal Property
(Schedule E) (5)
6. J~ Owned Property (Schedule F)
(6)
[~-.I Separate B~ling 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)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedu~e l) (10)
1 1. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
93,000
34
0
0
2,894
0
OFFICIAL USE ONLY
(8)
95,928
16,603
10,388
(11)
26,991
68,937
0
(12)
(13)
Z
uJ
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
68,937
15.
16.
17.
18.
19.
20.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (aX1.2) 0
Amount of Line 14 taxable at lineal rate 68,937
Amount of Line 14 taxable at sibling rate 0
Amount of Line 14 taxable at collateral rate 0
Tax Due
x.0 .0, (15)
x.0. 45 (16)
x .12 (17)
x .15 (18)
(19)
0
3,102
0
0
3,102
BE SURE TO ANSWER ~E QUESTIONS ON REVERSESIDE AND RECHECK MATH
3W4645 1.000
Decedent's Complete Address:
STREETADDRESS
1196 Newville Road
Cl~
Carlisle
ISTATE
~P
17013-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable D. Interest
E. Penalty
Total Credits (A + B + C)
Total Interest/Penalty (D + E)
(1)
(2)
(3)
3,102
0
0
0
3,102
4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(4)
5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3,102
Make Check Payable to: .~R~G~OFWlLLS, 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; ......... ~ r~
c. retain a reversionary interest; or ................................ ~ ~
d. receive the promise for life of either payments, benefits or care? ................. ~ ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................ ~ []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ................................ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I ha~e examined t[~isjmtum, including acscmpanying schedules and statements, and to ~e best of my knowledge and b~ief, it is true, co,rant and correlate.
Declaration of preparer other titan the personai represanta~ is based on all information of which prepa'm' has any knowledge.
SlGNATUI~OF PERSON RESPONS~LE FOR FILING~IbTURN DATE
ADDRE 1196 Newville Road ~ Carlisle. ~A 17013
Mt. Holly ~prings, PA 17065
406A North.W~lnut Street
~5 S_~I a~~nder Spring Road, Suite 3 Carlisle, PA 17013 ~ ~
For dFt'es of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the suwiving spouse is 3%
[7~/1~S. § 9916 (a) (1.1)(i)]. ,
~F'~r dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 ~ [72 P.S. § 9116 (a) (1.1) (ii)]
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is?e- o~ly beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adopt[va parent,
or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)].
The tax rate im posed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )].
The tax rate imposed on the net value of transfere to er 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 er adoption.
3w4646 1.000
REV-1502 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Susan M. Carver 21-04-0061
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 pdce at which properly would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both ha~,ing reasonable knowledge of the relevant facts.
Real properbj which is jointly-owned with right of survivorship must be disclosed on Schedule F
ITEM
NUMBER
1.
DESCRIPTION
Newville Road, Carlisle,
North Middleton Township,
C~mherland County (settlement
sheet attached)
TOTAL (Also enter on line 1, Recapitulation) $
VALUE AT DATE
OF DEATH
93,000
93,000
3W46951.000 (If more space is needed, insert additional sheets of the same size)
REV-,~503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Susan M. Carver
21-04-0061
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIP'RON
ITEM
NUMBER
1. US Savings Bond,
issued 07/1996 -
Series EE
$50.00
TOTAL (Also enter on line 2, Recapitulation)
VALUE AT DATE
OF DEATH
$ 34
34
3W4696 1.000 (If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Susan M. Carver 21-04-0061
Include f:he proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the Hght of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2
6
1981 American Motors, 65,633
miles
1988 Oldsmobile Cutlais
Supreme SL
F&M Trust, checking account
#34-25177
M&T Bank, checking account
#951050214
M&T Bank, checking accounting
#980048
Miscellaneous personal
property (appraisal attached)
TOTAL (Also enter on line 5, Recapitulation)
25O
1,000
336
166
42
1,100
2,894
3W46AD 1.000 (If more space is needed, insert additional sheets of the same size)
REV-,1511 EX + (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT i
ESTATE OF FILE NUMBER
Susan M. Carver 21-04-0061
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
2
5.
6.
7.
2
3
DESCRIFRON
FUNERAl. EXPENSES:
Hoffman-Roth Funeral
Westminster
Home Inc.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Scott C. Carver
Street Address 1196 NewVille Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent SON
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
C~mberland Law Journal
Register of Wills
The Sentinel - Legal
AMOUNT
6,904
945
4,800
3,500
225
75
25
129
TOTAL (Also enter on line 9, R~,~ap!tulation
$ 16,603
3W46AG t000 (If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Susan M. Carver 21-04-0061
Include unreimbursed medical expenses.
DESCRIPTION
ITEM
NUMBER
1.
2
3
4
5
6
7
8
American Express
Bank One
Belvedere Medical Corporation
Citibank
Pinker & Associates
PP&L
Sprint Telephone
York Waste Disposal
TOTAL (Also enter on line 10, Recapitulation
VALUE AT DATE
OF DEATH
2,417
4,055
4
3,745
2
54
35
76
10,388
3W46AH 1.000 (If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (~-00)
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Susan M. Carver
FILE NUMBER
21-04-0061
NUMBER
I
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfer~
under Sec. 9116 (a) (1.2)]
Gary E. Carver
406A N. Walnut Street
Mt. Holly Springs, PA 17065
Scott C. Carver
1196 Newville Road
Carlisle, PA 17013
Son
Son
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1 / 2 r~mainder
1/2 r~maJ~der
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE ON REV-1500 COVER SHEET
II
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0
3W46AI 1.000 (If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT OF SUSAN M. CARVER
I, SUSAN M. CARVER, of North Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will
and Testament, in manner and form following:
1. I hereby expressly revoke all Wills and Codicils
heretofore made by me.
2. I hereby direct my Executors to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. I devise and bequeath the remainder of my estate to my
issue, per stirpes.
4. I nominate and appoint Farmers Trust Company, Carlisle,
Pennsylvania, Trustee of the share of any beneficiary who may be
under the age of twenty-one years. The income and/or principal
of said trust may be accumulated or expended for the maintenance
education and support of such beneficiary as my Trustee in its
sole discretion may determine; and my Trustee, in the expenditure
of income and/or principal for such purposes, may, at its discre'-
tion, apply the same directly without the intervention of a
guardian or pay the same to any person havin~ the care or control
of said beneficiary or with whom the beneficiary resides, without
duty on the part of the Trustee to supervise or inquire into the
application of the funds by any person to whom any payment is so
made. The balance of such income and/or principal shall be paid
to such beneficiary upon reaching the age of twenty-one years or
to such beneficiary's estate in the event of death prior thereto.
5. I nominate and appoint my sons, Gary E. Carver and Scott
C. Carver (if he is twenty-one years of age), as Executors of
this my Last Will and Testament.
6. I direct that my Executors and Trustee, as well as their
successors, shall not be required to file bond or security in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 25th day of January, 1985.
WITNESS:
Susan M. Carver
(SEAL
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
I, Susan M. Carver, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
..executed the instrument as my Last Will; that I si~ned it
willingly; and that I signed it as my free and vol6ntary act for
the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Susan
M. Carver, Testatrix, this 25th day of January, 1985.
Testatrix
JAINICE ~, [~.'/'~TZL2R, I';OTARy ?UELIC
My Commission Expire~ January 27, 1987
- 2 -
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
We, Tom H. Bietsch and Roger M. Morgenthal, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix, Susan N. Carver, sign and execute
the instrument as her Last Will;~that she signed willingly and
that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the Will as witnesses; and that to
the best of our knowledge the Testatrix was at that time 18 or
more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and subscribed to before me by Tom H.
Bietsch and Roger M. Morgenthal, witnesses, this 25th day of
January, 1985.
Witness
- 3 -
OI~JB NO 2502.0
C NOTE
~ ~ ' ' totals.
NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER:
1196 NEWVILLE ROAD I
CARLISLE, PA 17013 I P.O. BOX 501910
O. PROPERTY LOCATION: H. SETTLE------------~NT AGENT: 25-1894310 ISAN DIEGO, CA 92150-1910
1196 NEWVILLE ROAD
L SETTLEMENT DATE:
CARLISLE. PA 17013 , Salzmann, Hughes & Fishman, P.C.
CUMBERLAND County Pennsylvania PLACE OF SETTLEMENT
95 Alexander Spring Road, Ste. 3
Carlisle PA 17013
100. GROSS AMOUNT~ROWER: --.-----.----- K. SUMMARY OF SELLER'S TRAN,~ ACTION
101. Contract Sales Price 1 400, GROSS AMOUNT DUE TO SFI I ~=R:
102. Personal Propert~ 93,000.00 401. Contract Sales Price .
402. Personal Property I 93,000.0u
103. Settlement Char~les to Borrower (Line 1400) 14,639.06 403.
104.
404.
105. [ 405.
Adjustments For Items Paid By Seller in advance Adjustments For Items Paid By Seller in advance
106. County/Twp. Taxes to I 406. County/Twp. Taxes to
107. School Taxes 06/09/04 to 07/01/04 I 60.4~ '407. School Taxes 06/09/04 to 07/01/04
108. Assessments to I I 6046
109. .408. Assessments to
110. 409,
111.
12. 411.
412.
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: ~ [500, REDUCTIONS IN AMOUNT DUE TO SELLER:
1201. Deposit or earnest money 18,600.00~ ~ ~01. Excess Deposit (See Instructionsl
202. Principal Amount of New Loan(s) 74,400.00~ L502. Settlement Charges to Seller (Line 1400)
203. Existing toan(sI taken subject to ~ L503. Existing loan(s) taken subject to 42.5u
204. /~TBANK 8,259.49
205. I a e
206, ' 18,500.00
207. I ' 507.
20g. t J ~
Adjustments For Items Unpaid B~/ Seller ~ L Adjustments For Items Unpaid By Seller
210. CountT/Twp. Taxes 01/01/04 to 06/09/04 125.49~ I 510. County/Twp. Taxes 01/01/04 to 06/09/04
212. Assessments to J ' 12. Assessments to
213. i ] 513.J_~.~
214. I L514. ~
215. /L515.
217.
218 I JJ. 517.
i · "518
219, J
220. TOTAL PAID BY/I=OR BORROWER I 93,125.49J[520. TOTAL REDUCTION AMOUNT DUE SELLER 27,027.48
.300. CASH AT SETTLEMENT FROM/TO BORROWER: ~l 6~'66~0' CASH AT SETTLEMENT TO/FROM SEII"R'
301. G ,o,, A m ou ,, D UeBFyr/; omr ~tr;r;;tr, l~i;t ~22~I
302. Less Amount Paid ( 1~:~,?~59. 1. Gross Amount Due To Seller (Line 420) - '
~9~j ! 93,060.,16
303. CASH ( X FROM) ( TO) BORROWER , , . 602 Less Reductions Due Seller (Line 520) I( 27,027.4~
14,574.03 603. CASH ( X TO) (FROM) SELLER i 66,03298
The undersigned hereby acknowledge receipt of a completed copy of pages 18,2 of this statement & any attachments referred to herein.
Borrower ~')~ C. ~ Seller ~,,~ ~
SCOTT C. CARVER --
SCOTT C. CARVER
Page 2
L. SEttLEMENT CHARGES ,.
BORROWER'S SELLER'S
'O0. TOTAL COMMISSION B~-$e~1 on Pric~ollOWS:._
· $ to SETTLEMENT SETTLEMENT
702. $ to --
Settlement
704. to
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
nation Fee % to
802. Loan Discount % to
to DIVERSIFIED APPRAISAL SERVICES
Credit Report
to COMMONWEALTH FUNDING
qDER SERVICE CHARGE
to ACCREDITED HOME LENDERS, INC.
8~m BROKER ORIGINATION FEE to COMMONWEALTH FUNDING
YLD SPREAD PREMUIM to COMMONWEALTH FUNDING POC $744.00b
808.
809.
810.
811.
ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
From 06/09/04 to 07/01/04 ~) $ 16.820000/day ( 21 days %)
275.00
19.00
876.00
I~657.00
e Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 years to
904.
353'221
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 months ~ $ 28.83 per month
months {~ $ per month
Taxes 5.000 months ~ $ 23.86 per month
1004. $chool Taxee 2.000 months ~ $ 83.82 per month
86.531
-t 00.39t
1005. Assessments months ~ $ per month
months ~ $
months ~, $
008· AGGREGATE ESCROW ADJUSTME months ~ $
1100. TITLE CHARGES
per month
per month
per month
1101. Settlement or Closin~l Fee
1102. Ab=ii act or Title Search to
03. Title Examination to
1104· Title Insurance Binder to
1105. Document Preparation to
' Fees to Salzmann, Hu~]hes & Fishman~ P.C.
1107. Attorney's Fees to Salzmann, Hughes & Fishman, P.C.
~umbers:
POC
1111. Endorsements 100/300/g00
112. Insured Closing Protection Ltr
to Stewart Title Guaranty Company/SHF, PC
(includes above item numbers: 1101-1105; 1107-1111 )
Lender's Coverage $ 74,400.00
10. Owner's Coverage $ 93,00Q00 816.75
to Stewart Title Guaranty Company/SHF, PC
to Stewart Title Guaranty Company/SHF, PC
816.75
150.0C
35.0C
1205.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 38.50; Mortgage $ 70.50; Releases $ $930.00
Deed 93000; Mortgage
State Tax/Stamps: Revenue Stamps 930.00; Mortgage $930.00[
SAT PIECE to CUMBERLAND County Recorder of Deeds
109'001 27.u~
1300. ADDITIONAL SETTLEMENT CHARGES
to
1302. Pest inspection to
Mail Fee to Salzmann, Hu~hes & Fishman, P,C,
1304. FINAL WTR/SWR to NORTH MIDDLETON AUTHORITY 14000145
1305. See addit'l disb. exhibit to
1400. TOTAL SETTLEMENT CHARGES {Enter on Lines 103, Section J and 602,,.Seet~ K) ,,~ /
By signing pnge 1 of thie statement, the signatories acknowledge receipt of a completed copy of page ,~ two page~
/
~'Ail.l/
,/ ,,~ ~e' z m a~[]/( ,~.,V ~l~gg e rhte'~'&'''F~hman,~P ' C ' --
Certified to be a true copy. ~ Age
51.50I
26.25[
9,987.24
14,639.061
15.5,
42.b
Borrower:
Seller:
Lender:
Settlement Agent:
Place of Settlement:
Settlement Date:
Property Location:
PAYEE/DESCRIPTION
SCOTT C. CARVER
THE ESTATE OF SUSAN M. CARVER
ACCREDITED HOME LENDERS, INC.
Salzmann, Hughes & Fishman, P.C.
(717)263-2121
95 Alexander Spring Road, Ste. 3
Carlisle, PA 17013
June 9, 2004
1196 NEWVILLE ROAD
CARLISLE, PA 17013
CUMBERLAND County, Pennsylvania
NOTE/REF NO
BORROWER
SELLER
COLLECTION OF AMERICA
CREDIT CARD PAYOFF
NCO FINANCIAL
CREDIT CARD PAYOFF
ROBIN SOLLENBERGER
2004 COUNTY TAXES
124821430204001010
5477365
6,701.00
3,000.00
286.28
Total Additional Disbursements shown on Line 1305 $
9,987.28 $ 0.00
(CA RVERS06-O4.PFD/CARVERS06.04/27)
TRUST
April 8, 2004
Salzmann, Hughes & Fishman
Law Office
95 Alexander Spring Road Suite 3
Carlisle, PA 17013
RE:
SUSAN M. CARVER
Gentlemen:
In reference to the above customer, our records show the
enclosed information to be accurate. Our researching fee for the
information we have provided is $ 0.00 Please send your
remittance to the following address:
Farmers and Merchants Trust Company
ATTN Stacey Stenger
20 South Main Street
Chambersburg, PA 17201-0819
If I may be of any further assistance, please contact me.
Sincerely,
Stacey ~]. Stenger ~
Data Operations Supervisor
P.O. Box 6010, CHAMBERSBURG, PA 17201-6010
Phone 717-264-6116 · Toll-Free 888-264-6116 · Fax 717-264-3415
RE: SUSAN M. CARVER
DATE OF DEATH 10-25-2003
ACCOUNT INFORMATION
X
CHECKING
SAFE DEPOSIT
SAVINGS CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED
ACCOUNT NUMBER 34-25177
ACCOUNT BALANCE AT DATE OF' DEATH
2-11-2003 DATE CLOSED STILL OPEN
$336.37
NON-INTEREST BEARING ACCOUNT
$336.37
SUSAN M CARVER
ACCRUED INTEREST
TOTAL ACCOUNT BALANCE
NAME ( S ) ON ACCOUNT
REGISTRATION OF ACCOUNT INDIVIDUAL ACCOUNT
ACCOUNT INFORMATION
CHECKING
SAFE DEPOSIT
SAVINGS CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED DATE CLOSED
ACCOUNT NUMBER
ACCOUNT BALANCE AT DATE OF DEATH
ACCRUED INTEREST
TOTAL ACCOUNT BALANCE
NAME(S) ON ACCOUNT
REGISTRATION OF ACCOUNT
Bonds:
o, i Series[Denoml Serial Number ] Date
Inventor, Totals:
!~'~nds~
Price
$25.00
Inventory Report
Active Inventory
Print Date: 04/05/2004
File Pricinq Date: 10/2003
,nterest I
Value ~Rate~_Yiel~l"extlnterest-IFinalMaturitylDate / Date Note,
$8.66t $33.66~ 2~_5_~-_ %~- 4.2~%~ 6;1~200~ [ 0-'~2026 * i
Price I Interest
Value $33~6(~!
........ ~Ci' bo~--w~a~hed In · EX- bond was EXchanged for an HH bond · ME- bond is Matured and Exchangeable for an HH bond
· MN - bond is Matured and Not exchangeable for an HH bond · NE - bond is Not yet Eligible for payment · NI - bond has Not yet been Issued
· P5 - bond is a Series I or EE, was i-sued in or after May 1997 and includes a 3-month-interest Penalty until the bond is 5 years old
· * bond is a Series I or EE, was issued in or after January 1990 and may be tax exempt if used for p~)st-secondary education
· 0 bond was Cashed In or EXchanged for an HH bond, but is being priced on a date prior to the cashed or exchanged date
Untitled 1
Page 1 of 1
APPRAISAL
Personal Property of ~)~.~j C~r_~L/~g-, /l:?d~ li/~/o':'/z~/~-A, c~. ~/../:~L~: ,/~ /7~,/~
Appraised by Chuck E. Bricker AU094-L Date
........ "'~"~ I - >< ¢: ~/--~ ' ~'
ITEM VALUE ITEM VALUE
~,~-:~, ~ ~z ~. /d,~,o
January 7, 2004
Salzmann, Hughes & Fishman, P.C.
95 Alexander Sprin§ Road, Suite 3
Carlisle, PA 17013
499 Mitchell Street, Millsboro, DE 19966
Estate of Susan Carver
Date of Death: October 25, 2003
Social Security Number: 165-38-0500
Dear Mr. Hughes:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
Account Type ........................... Checking Account
Account Number. ...................... 980048
Ownership (Names oJ) .............. Susan M. Carver
Opening Date ........................... 12/14/81
Balance on Date of Death_ ......... $41.67
Accrued Interest $ 0.00
Total. ...................................... $41.67
Account Type ........................... Checking Account
Account Number. ...................... 951050214
Ownership (Names ojD .............. Susan M. Carver
Opening Date ........................... 07/16/02
Balance on Date of Deattt ......... $165.60
Accrued Interest $ 0.00
Total. ...................................... $165.60
· Page 2 Januar7 7, 2004
Account ~jpe ........................... Installment Loan
Acco~mt Number. ...................... 1000018785180001
Ou~nership (Names oj') .............. Susan M. Carver
Opening Date ........................... 08/26/98
Balance on Date of Deatlz .........$8,672.57
Sincerely,
Charlene Warrington, Re~ords Management
(302) 934-2722
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Gary E. Carver and Scott C. Carver
being duly according to law, deposes and says that theY are the co-executors of the Estate of Susan M. Carver
late of N_..'__MJ:dd_le_t°n T°~wn_shiP , Cumberland County, Pa., deceased and +hat the
within is an inventory made by them , the said Co-Executors
of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedenf's death.
and subscribed before me,
Date of Death Member, Pe~SylvaniaAssaciationOfNaeal~e
Executor - Administrator
406A N. WaZnut Street
Mt. HolZy Spr±ng$, ?A 17065
1196 Newville Road
Carlisle, PA 17013
Address
October 2003
Day Month Year
INSTRUCTIONS
I. An inventory must be filed wifhln three months after appointment of personal representative.
2. A supplement inventory must be filed wlfhln thlrfy 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. ,
Inventory of the real and personal estate of
Susan M. Carver
deceased
1196 Newville Road, North Middleton Township, Carlisle
US Savings Bond
1981 American Motors
1988 Oldsmobile Cutlais Supreme
F&M Trust, checking
M&TBank, checking
M&T Bank, checking
Miscellaneous personal property
$93,000
34
25[
1,00(
336
166
42
1,100
395,928
O0
O0
O0
O0
O0
O0
O0
O0
O0
1N RE:
ESTATE OF:
SUSAN CARVER
ESTATE NO. 21-04-6!
DECEASED.
SATISFACTION AND RELEASE OF CLAIM
The undersigned, Kathy M. Peyton, Agent for AMERICAN EXPRESS, has received a
payment of $2,316.69 which satisfies the claim as filed for the date of death liability. This
Satisfaction and Release of Claim is executed to acknowledge discharge of the claim and to
release the estate and personal representative from all further liability with respect to the date of
death liability on account number 371288871391001.
Executed this July 1, 2004.
AMERICAN EXPRESS
Claima?/~, //~
Estate Recoveries, Inc.
P.O. Box 24566
Baltimore, MD 21214
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DIVISION
DEPT, 280601
HARRISBURG, PA 17128-0601
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
JANES D HUGHES ESQ
SALZNANN ETAL
95 ALEXANDER SPG RD 5
CARLISLE
PA 17015
REV-l;47 EX AFP
DATE 08-$0-200~
ESTATE OF CARVER SUSAN N
DATE OF DEATH 10-25-2005
FZLE NUNBER 21 0~-0061
COUNTY CU~,.,~LAND. ~:~
HAKE CHECK PAYABLE AND RENZT PAyNENT TO:
OF,WILLS '-~
REGISTER
CUMBERLAND CO,,~OURT-ROUSEiiiil,
CUT ALONG THIS LINE ~'~ RETAIN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRATSENENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
ESTATE OF CARVER SUSAN NFZLE NO. 21 0~-0061 ACN 101 DATE 08-$0-200~
TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CNANOED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS£
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. RaaZ Esta~a (Schedule A) (1)
2. S~ocks end Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership Zn~ares~ (Schedule C) (3) .00
~. Nor~gagas/No~es Receivable (Schadula D) (q) .00
S. Cash/Bank Oeposits/Hisc. Personal Property (Schedule E) (5) ~89~.00
6. Join~Zy Owned Proper~y (Schedule F) (6) .00
7. Transfers (ScheduZe G) (7) .00
8. Total Asse~s (8)
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expensas/Ade. Costs/Hisc. Expenses (Schadula H) (9)
10. Dabts/Hor~gaga Liabilities/Liens (Schedule Z) (10) ~0;~88.00
11. To~al Deductions (~1)
12. Net Value of Tax Re~urn (12)
95~000.00
Sq. O0
NOTE: To insure proper
cradi~ ~o your account,
submi~ the upper por~ion
of ~his form wi*h your
~ax payment.
95,928.00
16,605.00
2~.99].§0
68,957.00
15.
NOTE
ASSESSNENT OF TAX:
15. Amount of Line lq a~ Spousal ra~e
16. Aeoun~ of Line lq ~axable a~ Lineal/Class A ra~e
17. Amount of Line lq a~ Sibling rate
18. Amoun~ of Line 1~ taxable a~ Colla~aral/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYHENT RECEIPT DZSCOUNT (+)
DATE NUHBER ~NTEREST/PEN PAZD (-)
07-07-200~ CDO0~IZ5 .00
Charitable/Governmental Beques*s; Non-eZected 911:~ Trusts (Schadula J) (15) . O0
Net Value of Es~:a~a Sub.iec~: to Tax (1~) 68,9:37.00
Z~ an assessment Nas lssued previously, lines 1~, 15 and/or 16, 17, 18 and 19 w111
reflect flgures that include the total of ALL returns assessed to date.
(15) .00 X O0 = .00
(16) 68,957.00 X 0~5= $,10Z.00
(17) .00 x 1Z = .00
(18) . O0 x 15 = . O0
(19)= ~,102. O0
AHOUNT PAZD
$,10Z.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDZTZONAL INTEREST.
~,102.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUEif ?
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ ~
RESERVATZON:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coamoneealth hereby expressly reserves the right to appraise end assess transfer Inheritance Taxes
at the lawful Class 8 (collateral) rate on any such future interest,
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Znheritance and Estate Tax Act, Act Z2 of 2000. (72 P.S.
Section 9140),
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake chock or money order payable to: RBGZGTER OF N/LLS, AGENT
A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1213). Applications ere available at the Office
of the Register of Hills, any of the 22 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers with special hearing and / or
spaaklng needs: 1-800-447-2020 (TT only).
Any party in interest nat satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount er interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 261021, 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: Pest Assessment Revise Unit, Dept. Z80601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid mJthin three (3) calendar months after the decedent's death, a five percent [5Z) discount of
the tax paid is alloeed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
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 tiaa 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 data of payment. Taxes which became delinquent before January 1, 19DZ bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which ail1 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest DaiZy Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20Z .00054D 1988-1991 XIZ .000301 ZOO1 9X .000247
1982 16Z .000438 1992 9Z .000247 ZOOZ 6Z .000164
1984 llZ .000201 1993-1994 7Z .00019Z 2002 5Z .000127
1985 122 .000356 1995-1996 92 .000247 2004 42 .000110
1986 IOZ .000274 1999 7Z oO0019Z
1987 lOX .000274 ZOO0 7Z .O0019Z
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELTNQUENT X DA*rL¥ TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
SUSAN M. CARVER
Date of Death:
OCTOBER 25, 2003
No. 21-04-0061
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 _ 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
accounts may be filed with the Cler rphan's Court and may be
attached to this report.
Date:
2/25/05
!
(
6D :
d u ':,
X
Personal Representative
Counsel for Personal Representative
Capacity:
uA