HomeMy WebLinkAbout04-0132Estate of
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
FREEDA A. ROGERS No. C~//- ~)Z/,/'_ /~,~
Deceased Social Security No. 208-42-3908
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE "A" OR "B' BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of
the Decedent, dated
July 30, 1987
and codicil(s) dated
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at
113 November Drive, Apt. 3, Borough of.Camp Hill
(List street, number and municipality)
Decedent, then 94 years of age, died
Januaw 15,2004
at 113 November Drive, Camp Hill, PA
(Location)
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 Pennsylvania ..................................... $
(If not domiciled in PA) Personal property in County .................................................... $.
Value of real estate in Pennsylvania ...................................................................................................................... $
Total ......................................................................................................... $
68,000.00
-0-
68,000.00
Real Estate situated as follows:
None
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature
Typed or printed name and residence
Alverta Hubbard
10 Cornell Dr., Camp Hill, PA 17011
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND '
The Petitioner(s) above-named swear(s) and 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(s)
of the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
Before me this /(,~7"/-/ day of
ALVERTA HUBBARD
No. Oz/'.
Estate of FREEDA A. ROGERS
, Deceased
Social Security No: 208-42-3908
Date of Death:
Januaw 15,2004
AND NOW, I~t ~ ~qr<~/ 11 ,2004, in consideration of the Petition on the reverse side
hereon, satisfactory proof/having been presented before me,
IT IS DECREED that Letters Testamentary ..b...c.t.a.; pendente lite; durante absentia; durante minoritate
are hereby granted to Alberta Hubbard in the above estate and that
the instrument(s) dated July 30, 1987
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
FEES
Letters ...........................
Short Certificate(s) $
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages ( ) .......$
Codicil ............................ $
JCP Fee ....................... $
Inventory ...................... $
Other .............................. $
TOTAL .........$
Attorney: Edmund G. Myers
I.D. No: 20558
Address: Johnson, Duffle, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-
Telephone: 717-761-4540
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, $2.00
P 9961439
No.
Local Registrar
Emz ..... JANDate2 2004
NAME OF DECEDENT {First Middle, La~)
AGE (Lar~ ~y)
94
,~.ousewife
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMEER
,Highspire,PA ~,~ ~,,, U ~ .-- D .~
,o. ~ite
DATE OF ~IRTH
1,1909
DEC EDE NT'$ MAILING ADDflE SS (S~ee% C~/To~n. StYe. Z'k~ Code} OECEDENT'S Pe~sylv~ia ~7=.~ ~.~,~
113 ~V~ Dr., Apt. 3 ,~s,~
C,ematkm [] Removal Irom ~lale []
SUCH
Yam)
Jan.20,2004
t163-L
~.~s%l~H~'~S,324 Htmw'lel Ave.,Lemoyne,PA
LICENSE NUMBER DATE SIGNED
~ CASE REFERREDTO MEDICAL EXAMINER/COflONER?yos [] No
NEflE AU'~=SY FINDINGS
PERFORMED?,d~KILABLE pRIOR ~D
COMPLETION OF CAUSE
OF DEATH?
DUE TO (OR AS A CONSEQUENCE 04=):
DUE TO (Off AS A CONSEOUE NCE 04):
DUE TO (OR AS A CONSEQUENCE OF):
MANNER Of= DEATH
Natural
DATE OF INJURY TiME OF INJURY
JPLACE OF INJURY - Al home. tarm. street, factoo~, office
'MEDICAL EXAMINER/CORONER
On the belie Of examination and/re' Inveatlgation. iff my opinion, death occurred nt the time, data, and place, and due to the cause(e) and
manner aa stated ................................................................................................. []
LAST WILL AND TESTAMENT
OF
FREEDA A. ROGERS
I, FREEDA A. ROGERS, of the Borough of Camp Hill, County of Cumberland,
Commonwealth of Pennsylvania, do make, publish and declare this to be my Last
Will and Testament, hereby revoking any and all other Wills by me at any time
heretofore made.
1. The expenses of my last illness, my funeral and the administration of
my estate, wherever s~tuated, shall be paid as soon after my death as may be
convenient to my Executrix, and shall be charged against the principal of my
residuary estate without apportionment or proration.
2. Ail federal, state and other death taxes payable because of my death
on property passing under this, my Last Will and Testament, shall be paid out
of and charged against the principal of my residuary estate without apportionment
or proration. However, any federal, state or other death taxes assessed on property
passing other than under this, my Last Will and Testament, shall be paid by each
such beneficiary.
3. I give my diamond ring to Kara Keefer. In the event that Kara Keefer
is a minor at the time of my death, my Executrix may distribute said ring to
her, to her guardian for her use, or to any person with whom she is residing
without further responsibility, and the distributee's receipt shall be sufficient
discharge to my Executrix.
4. I give all my personal and household effects not otherwise effectively
disposed of, such as jewelry, clothing, furniture, furnishings, silver, books
and pictures, including policies of insurance thereon, to Alverta Hubbard, Dollie
Mae Keefer, Bernard M. Rogers, Larry L. Rogers, Janice E. Ritts, and Bonnie Lou
Koser to be divided as they agree or, if they fail to agree within six months
after my death as my Executrix determines. Any personal effects which the above
named individuals do not desire I give to Goodwill Industries of Central Pennsylvania,
Inc.
5. All the rest, residue and remainder of my estate wherever situate, I give
devise and bequeath in equal shares to Alverta Hubbard, Dollie Mae Keefer, Bernard
M. Rogers, Larry L. Rogers, Janice E. Ritts, and Bonnie Lou Koser.
6. I nominate constitute and appoint my daughter, Alverta Hubbard, Executrix
of this my Last Will and Testament. I direct that my Executrix shall not be
required to give bond for the faithful performance of her duties in any jurisdiction.
IN WITNESS WHEREOF, I have herunto set my hand this 30%~ay of July , 1987.
,.~f'/z~.~/~ ~. ~.7~./g~ (SEAL)
FRt~EDA A. ROGEt(S fz
The preceding instrument, consisting of this and one other typewritten page,
each identified by the signature of the testatrix, was on the date thereof, signed,
published and declared by Freeda A. Rogers the testatrix therein named, as and
for her Last Will in the presence of us, who, at her request, in her presence,
and in the presence of each other, have subscribed our names as witnesses hereto.
Witness
Witness
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND:
I, Freeda A. Rogers, testatrix whose name is signed to the attached or foregoing
instrument, haveing 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.
FRE~DA .i.- ROGERS
(SEAL)
this
Sworn or affirmed to and acknowledged before me, by Freeda A. Rogers the testator,
30%h day of July , 1987. ~..//'--~/<?
(seal) Notary~u~zic
~.~ .~ .... ~.i.l WOLFE, JR., NOTARY PUBLIC
My CoSiness:on Expires Nol,.~ I1~, 1~
Lemoyne, Ps. C~nt~rl~ld ~
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND:
We, Dorothy J. Kirkessner and
Rita A. Butler , 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 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 eighteen or more years
of age, of sound mind and under no constraint or undue influence.
dWi~ness
Sworn or affirmed to and subscribed to before me by witness, this
day of
30%h
July , 1987. .....
( Notary Pu~iez
?~oRMAN' WOLFE, JRt, NOTARY ~UBL~C
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: FREEDA A. ROGERS
Date of Death: January 15, 2004
Will No.: 21-04-00132
Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
February 26, 2004
Name
Address
10 Cornell Dr., Camp Hill, PA 17011
636 San Pedro Dr., Lady Lake, FL 32159
ALVERTA J. HUBBARD
DOLLIE M. KEEFER
BERNARD M. ROGERS 15415 Michigan Ave., Woodbridge, VA 22191
LARRY L. ROGERS
JANICE E. RITTS
BONNIE L. KOSER
KARA KEEFER CHOPAK
2707 Woodbine St., P. O. Box 61
Grantham, PA 17027
R. D. #2, Box 240
Landisbur9, PA 17040
7 Sheffield Dr., Dillsburg, PA 17019
3095 Lewisberry Rd., York Haven, PA 17370
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date:
9 [: ZM LZ 83-3
Signature
Name Edmund G. Myers, Esq.
Johnson, Duffle, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
X Counsel for personal representative
#224904
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 003793
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 208-42-3908
FILE NUMBER: 2104-01 32
DECEDENT NAME: ROGERS FREEDA A
DATE OF PAYMENT: 04/12/2004
POSTMARK DATE: 04/08/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 01/15/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,300.00
REMARKS'
..... SEAL
CHECK#O096
TOTAL AMOUNT PAID:
$2,300.00
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
TO Register of Wills Office R~:';: ': I FROM-.
Cumberland County Courthouse ] 3OHNSON, DUFFIE, STEWART & WEIDNER
1 Courthouse Square .- ~ Attorneys at Law
Carlisle, PA 17013-3387 04 ttPRll2 ~2:2,4 P.O. Box 109
Lemoyne, PA 17043
~ ~ ~ (717) 761~540
SUB.CT: Estate of Freeda A. Rog~ Fax: (717) 761-3015
~~ ~~ DATE: April 8, 2004
No. 21-04-00132
Enclosed is a check in the amount of $2,300.00 as a payment on account of Inheritance
Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% disCount.
SIGNED: Edmund G. Myers, Attorney
J~~H ' LAW OFFICES
NSON, DUFFLE, STEWART 8 WEIDNER
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-O109 R~C,; F~ , ~ ii,i~I
'04 !~PR 12 7!7:24
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
X
Register of Wills Office
Cumberland County Courthouse
I Courthouse Square
Carlisle, PA 17013-3387
SUBJECT: Estate of Freeda A. Rogers
FROM
3OHNSON, DUFFS[E, STEWART & WE:[DNER
Attorneys at Law
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: April 21, 2004
Enclosed for filing in the above-captioned Estate are the following:
1. Original Inventory.
2. Original and copy of Inheritance Tax Return.
3. Check in the amount of $28.00, filing charges.
4. Check in the amount of $573.39, Inheritance Tax balance.
5. Envelope to send filing receipt and tax receipt to me.
6.
Firm check in the amount of $3.00 - please send one (1) short certificate
for this Estate with the receipts in the envelope provided.
Thank you.
SIGNED: Cindy Hubler, Estate Legal Assistant
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 O03864
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
fold
ESTATE INFORMATION: SSN: 208-42-3908
FILE NUMBER: 2104-0132
DECEDENT NAME: ROGERS FREEDA A
DATE OF PAYMENT: 04/23/2004
POSTMARK DATE: 04/23/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 01/15/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $573.39
TOTAL AMOUNT PAID:
$573.39
REMARKS:
SEAL
CHECK# 0098
INITIALS: JA
RECEIVED BY'
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
First Class Mail
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
Register of Wills of Cumberland County, Pennsylvania
Estate of ROGERS, FREEDA A.
also known as
INVENTORY
No. 21 - 04- 00132
Date of Death 1/15/2004
, Deceased Social Security No. 208-42-3908
ALVERTA HUBBARD
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney: EDMUND G. MYERS
I.D. No.: 20558
Personal Representative
Signature: ~,~~
ALVERTA HUBBARD
Signature:
Signature:
Address:
Telephone:
301 Market St.
Lemoyne, PA 17043-0109
717/761-4540
Address: 10 CORNELL DRIVE
CAMP HILL, PA 17011
Telephone: (717) 737-7921
Dated:
Personal Property
400 Shares ExxonMobile ~ $40.28 per/share
M&T Bank - Certificate of Deposit
No. 031003914382210 - Date of death balance, plus accrued interest.
M&T Bank - Certificate of Deposit - No. 031003914506240
Date of death balance, plus accrued interest.
M&T Bank- Certificate of Deposit No. 03100391453362
Date of death balance, plus accrued interest.
32,596.83
10,931.46
M&T Bank - Checking Account No. 72435631
Date of death balance, plus accrued interest.
1,695.51
M&T Bank - Checking Account No. 98276735
Date of death balance, plus accrued interest.
7,227.07
Concast Cable - refund
49.91
(Attach additional sheets if necessary) Total Personal Property and Real Estate $78,218.32
Register of Wills of Cumberland County, Pennsylvania
Estate of ROGERS, FREEDA A.
also known as
INVENTORY
continued
, Deceased
No. 21 - 04- 00132
Date of Death 1/15/2004
Social Security No. 208-42-3908
Blue Cross/Blue Shield - premium refund
Household Goods - date of death value
Diamond Ring - appraised value
(Specific Bequest to Kara Keefer - Paragraph 3 of the Will)
PA Department of Revenue - PA 1000 - Property Tax or Rent Rebate Claim.
Rent Rebate due decedent for 2003.
UGI - refund - gas useage charges overpaid.
98.58
795.O0
120.00
500.00
79.94
Total Personal Property
$78,218.32
2
BUREAU OF INDIVIDUAL TAXES
[NHERITANCE TAX D/VTSIOH
DEPT. 28060!
HARRTSBURG, PA 17128-0601
COHHONNEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
REV-15~7 EX AFP (01-05)
EDHUND G HYERS
JOHNSON ETAL
301HARKET ST
LEHOYNE
PA 170~3
DATE 06-1~-200~
ESTATE OF ROGERS
DATE OF DEATH 01-15-200~
FILE NUHBER 21 04-0132
COUNTY CUHBER LAND
ACN 101
I kmoun~ Ram/~:ad
FREEDA A
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF ROGERS FREEDA AFZLE NO. 21 04-0132 ACN 101 DATE 06-1~-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
~. Nortgages/Notes Reca/vable (Schedule D) (~)
5. Cash/Bank Deposits/H/sc. Personal Property (Schedule E)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expanses/Ada. Costs/H/sc. Expanses (Schedule H) (9)
10. Debts/Hor~gaga L/abilities/L/aris (Schedule Z) (10)
11. Total Deductions
12. Nat Value of Tax Return
O0
16~112.00
00
00
62~106.32
O0
O0
(8)
11,~54.23
220.97
(11)
(12)
15.
1~.
NOTE:
Charitable/Governmental Bequests; Non-alac~ad 9113 Trusts (Schedule J) (15)
Net Value of Estate Subject to Tax
Zf an assessment ~as Sssued prev$ously, ZSnes Z~, 25 and/or 26, ~7,
reflect f~gures that Snclude the totaZ of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of L/ne 1~ at Spousal rate (15)
16. Amoun~ of L/ne 1~ taxable at Lineal/Class A rata (16)
17. Amoun~ of Line lq at Sibling rate (17)
18. Amount of L/no l~t taxable at Collateral/Class B~ ~ata (18)
Tax Due
R[C[IPT I DISCOUNT (+J
NUHBER I ~NTEREST/PEN ~A~D (-)
:.: i. ' i21 . 05
CD003793 !.::, ..... ~
CD00386~ .00
19. Pr/nci
TAX CRED]:TS
PAYHENT
DATE
04-08-200~
0~-23-200R
NOTE: To insure proper
credit ~o your account,
submit the upper portion
of ~his fora with your
tax payment.
78,218.32
11.675.2§
66,543.12
.00
66,543.12
18 and 19 will
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
· O0 x O0 : . O0
66,543.12 x 045= 2,99R.4q
. O0 x 12 : . O0
. O0 x 15 = . O0
(19)= 2,99~.44
AHOUNT PAID
2,300.00
573.39
TOTAL TAX CREDZT I 2,99~.RR
BALANCE OF TAX DUEl .00
ZNTEREST AND PEN. . O0
TOTAL DUE . O0
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DU~I~(
A REFUND. SEE REVERSE SIDE OF THZS FORN FOR ZNSTRUCTZONS.) V
RESERVATION:
Estates of decedents dying on or before December 1Z) 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (coXIatara1) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Comeoneaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at tho laaful Class D (collatara1) rate on any such futura interest.
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIYE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act) Act 23 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, ~hich mas nat requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office
of the Register of Nills) any of the 23 Revenue District Offices) or by calling the special Z4-hour
mnsaering service for fores ordering: 1-BOO-36Z-ZOSO; services for taxpayers aith special hearing and / or
speaking needs: 1-800-447-30Z0 iTT only).
Any party in interest not smtisfiod aith tho appraisement) a11oaancs) or disalloaance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--eritten protest to the PA Department of Revenue, Board of Appeals) Dept. Z810Z1) Harrisburg, PA 171ZD-lOZ1) 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 Raviaa Unit, Dept. ZOO601) Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent CSX) discount of
tho tax paid is allomed.
The lex tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not
paid before January 18) 1996) the first day after the and of the tax amnesty period. This nan-participation
penalty is appealable in the same manner and in the the same tiao period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death) to the date of payment. Taxes which became delinquent before January 1) 198Z bear interest at the rate of
six (6X) percent par annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by tho PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Dally Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20Z .0005q8 ~'8-1991 11Z .OO03Ol ~ 9Z .OOOZ47
1983 16Z .000438 1992 9Z .000Z47 EOOZ 6Z .000164
1984 llZ .000301 1993-1994 7Z .000192 2003 5Z .000137
1985 132 .000356 1995-1998 92 .000247 2004 42 .000110
1986 ZOZ .000Z74 1999 7Z .O00lgZ
1987 XOX .000274 ZOO0 7Z .O0019Z
--[ntarost is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID
X NUHBER OF DAYS DELINQUENT X DALLY 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. If payment is made after tho interest computation date sheen on the
Notice, additional interest must bm calculated.
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: FREEDA A. ROGERS
Date of Death: JANURY 157 2004
Will No.: 21-04-00132 Admin No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X 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?
Date: ~'f~'//~ ~/'
Yes No X
The separate Orphans' Court No. (if any) for the personal
representative's account is:.
Did the personal representative state an account informally to the
parties in interest? Yes X No
Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
Signature ~
Edmund G. Myers, Attorney
Johnson, Duffle, Stewart & Weidner
301 Market Street, P.Q. Box 109
Lemoyne, PA 17043-0109
Address
(717) 761-4540
Telephone No.
Capacity: Personal Representative
X Counsel for Personal Representative