Loading...
HomeMy WebLinkAbout04-0315PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of ~;l~C ? !~,q~4/~- No. also known as To: '2.1-o,4 -3 I.._% Social Security No. / '-7 l'~"- % ~/- ~T Zf' ~ Register of Wills for the Deceased. County of C_c~,'~ ~e/~ ,-~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl! £ g (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. for letters of administration on the estate of Decendent was domiciled at death in (' ~.;u,,.4 ~&gt/-r~-~ ~ ~, ~ Cou~nty, Pennsylva~a, with last family or principal residence at ~0(~ (list street, number and municipality) Decendent, then ~ L~) years of age, died Decendent at death owned property with estimated values as folllows: (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 $ situated as follows: ) Petitioner after a proper search ha the following spouse (if any) and heirs: 0~4 y l/- ~ Name ascertained that decedent left no will and was survived by Relotionship Residence THEREFORE, petitioner(s) respectfully request(s) the grant of letters o~inist~tion appropriate form to the undersigned. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } COUNTY OF ~,~e&c~ 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(s) 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 No. c~ I- 0~-.~1~ Estate of ,Deceased GRANT OF LETTERS OF ADMINISTRATION ~~ ~ ,. ;2)~©qbM ~ in consideration of the petition on AND NOW ~ __, the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that~-'"~A~ ~ is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration areherebygrantedto'--~'~,\ox'c~x>~c,_ ~ [~_c~.rwckv- ~\<L'R~"~%'4, I!',5 ~/'~ in the estate of ~2:~x,~, e \ ~ ~3,x,.~o. c FEES Letters of Administration ..... $ ~_~, (2kb Short Certificates( ) .......... $ l o. c-xB Renunciation ................ $ ~ $ 1o. oO TOTAL __ * ~%~, O~ Filed ..~.:~.'.~) ..... A.D. 19 ~~~ q-a-o~ ATTORNEY(Sup. Ct.I.D. No.) ADDRESS PHONE 5.805 REX,' 9/86 This 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. 105.144 RRV. 1/91 Fee for this certificate, $2.00 Local Registrar 2 5 2_0O4. Date REcoRD~ COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL -'~ CERTIFICATE OF DEATH (Coroner) S~ATE FILE NUMBER (First Mi~e La~) ISEX I~IAL ~CURITY NUMBER ~M~th, ~y. , I L' , __ I ......... ,"o~ ~.,..,~c~.. Dauphzn , I ~rr~s~g I .~rzsDurg nosp~a~ I. .... ~.~.~. ~,o white hiefWarrant Officer J,Eederal Government J,, J,, (*) J 2 ( ) J,. ~rrted I,,~hyllts Uoll~ood (sir et% City/Town, Slat e. Zip Code) DECEDENT'S Pennsylvania ~Tc.n yes, decedent lived in ACTUAL ~Ta. State Did 306 W. Maple Avenue RESIOENCE decal "o, ~ ~d Shiremans t own Shiremanstown, PA 17011 ~h.~ t?b. Co..~ Cumberland James Peters ,e. Joyce Demczyszyn 306 W. Maple Avenue, Shiremanstown, PA 17011 D.E m D,S~SI,,ON ~,,~ ..~lZ~ JOL{ ,,~ Yorktowne Crematory ,,, York, PA 17404 · LICENSENUMBEa ' NAMEANDADDRE$SOFFACtLITY Parthe~ore FH & CS, Inc. ,~. FS 012 849 L I~E~P.O.BoX 431, New Cumberland, PA 17070-0431 o~. 12:25 p.t~ ,,. March 23,' 2004 J,.. ~l;~,q¢,:l~, .o[2 [Final Arteriosclerotic cardiovascular disease INFORMANT'S NAME (Type/Print} ,llis M. LaMar Mu~ C,amat~-~ P~novmfmmsiat.~] Danalidn[] ~r (S~I WERE Ab1DPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCUR~E.g. PERFORMED? IAVAILABLE PRIOR TOJ I(M°nth' Day' Year) I J Tothebe~tofmyknew~e,~eath~e~due~au~(J)a~mam~e~a~te~ ..................................................... u 31b. ~/' /~/$" J ~ ~' · LICENSE NUMBER ~./ · ~ IDATE Sid[NEl~onth, Day, Yea0 · PRONO~JNCB~lANDCERTlFYIN~PHYBlCl&N(PhySCianbothpmr~nClngdeaiham:lcert,yl~gl .... old. Ih) [] ,,.. J,,,. March 24, 2004 'MEDICAL EXAMINER/CORONER On the balli of examination lnd/M Inveltlgltlon, In my opinion, ~eath occurrnd l! the time, dRte, Rnd place, and duR to the cau~e(I) and (Item 27) Txpe or Print Graham S. Hetrick, Coroner 3,. 1271 S. 28th St., Harrisburg~ PA 17111 DATE FILED (Moolh, Day, Yea0 Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 LAM_AR PHILOMENA M A/K/A 306 W MAPLE AVE SHIREMANSTOWN, PA 17011-6523 RE: Estate of LAM_AR DANIEL P File Number: 2004-00315 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/12/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge Sincerely, GLENDA FARNER STP~ASBAUGH Clerk of the Orphans' Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 LAMAR PHYLLIS M RE: Estate of LAMAR DANIEL P File Number: 2004-00315 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/12/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel Judge Sincerely, Clerk of the Orphans' Court JRD/June 30, 1992/17858 .qEP O1 2004 ., In Re: Estate of Daniel P Lamar Late of Shiremanstown Borough Estate No.: 21-04-315 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2004-315 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: Philomeua M Lamar Counsel for Personal Representative: Date of Grant of Original Letters: 04-02-2004 Date of Delinquency Notice: 07-12-2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of the Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on July 12, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 09-01-2004 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for at in Cout~troom No. 3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically b~0~l~J. ~ / lit III1 Geo~e ~o f~r, KJ~ I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LAMAR PHILOMENA M A/K/A 306 W MAPLE AVE SHIREMANSTOWN, PA 17011-6523 u______ fold ESTATE INFORMATION: SSN: 176-44-7487 FILE NUMBER: 2104-0315 DECEDENT NAME: LAMAR DANIEL P DA TE OF PAYMENT: 11/17/2005 POSTMARK DATE: 11/15/2005 COUNTY: CUMBERLAND DATE OF DEATH: 03/23/2004 NO. CD 006006 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $644.26 I I I I I I I I TOTAL AMOUNT PAID: $644.26 REMARKS: CHARLES F SULLIVAN CPA CHECK# 265 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS l{) --.D ~ <.0 '" N -..J- cG .j-- co 0<; ; -..0 <t '" .J C 'J Cl ~ ~ ,'> ~\,) ?> ~ 1"::) ~.._- ~("":, c1\ M~ , "'.... ---~ -.. ..,...,. ",..,. ~ '"', ftj~ OJ I ~ f- 0'" <( <s> C Q,j y. ~ y C? C/ 0'> '" C"I p:::~~~ t-...... 'c t-.t-. r:~ ,....li< . P..p.., ~ . ,z ~ ~:c -...>- Z<o ~~t;:; ""s::z ~ <<f' 0....'" ,....l4(i:j ~3:E6 :r:",'T" P-. ?i tn !; '> -..:;1 \ ,~ ----. --~ ~--- I:',) L' ~ 'f ~ [~ n 0 '---=; ~ 1Il r.D n.J rn ... ['- ... \ I" co ... ru ~ .. 'j ~~lS \:"" -t b~~ ... ~S~~ oJ ~e~j n.J )<. ~~~~ n.J ~el~ . CO !ill! ~ ,,5Y) ...::;",:e ti rn ...- C) (.r ... 0<; w rn 02 -'I '""0 ru >-.0.> .. <>::r: 0..;... -- n i ... i' g tII ~(')~" J1ll3~cn g ~ C ~::I:~= 3~i:i ~~~.? -..l-'=n ~ ~ o. . -' =:I. ~ U1-,~~ ~ . ~ w n ;, :u --n ...-' :;;0 (/1 .-\ C"J r- y UJ (fl. t; "P cP~ !: ~ ~ Ftf!)< c-1'CJ f~' l/1 :: h %- I? :;J I' ?, Q p; ::? Voy .<JI >- ' ) 1} ;q RCV.1500 EX + (&-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -04 0 3 1 5 "'"CoU'NTvCoDE ---vEA~ - - N'Ui:4aER- - I- Z W o W () W o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) LaMar Daniel P. DATE OF DEATH (MM-DD.Year) DATE OF BIRTH (MM-DD-Vear) SOCIAL SECURITY NUMBER 1 76- 4 4 - 7 4 8 7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- lI::Sen oO::lI:: w 11.0 :I: 00 OO::J 1I.1lI II. < 03/23/2004 07/26/1953 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) LaMar Philomena M. [X] 1. Original Return o 4. Limited Eslate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received D 2. Supplemental Return o 4a Future Interest Compromise (dale of death after 12-12.82) o 7. Decedent Maintained a Living Trust (Attach copyofTru't) o 10. Spousal Poverty Credit (dale of death between 12-31.91 and 1-1-95) o 3. Remainder Return (dale of dealh prior 10 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ;.;.:.;.;.:.;.:-:. .....:.:.:...;...:..,;.;.;. ~:fBts:$e01J6N':Mij$tae6dMPtEtebiAtt:66~~E$PQNb~NcEANttCQM!1bENtiMJtAX1NfORMA't16N'sH60UbaebIRl!lbtli6t6i: NAME COMPLETE MAILING ADDRESS Charles F. Sullivan CPA CFP 352 Blacksmith Road FIRM NAME (If Appicabe) Same Camp Hill PA 1701 TELEPHONE NUMBER 717737-3339 I- Z W o z o II. en w 0:: 0:: o o 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Noles Receivable (Schedule D) (1) (2) (3) (4) (5) OFFICIAL USE ONLY 62,401.15 ) :-) r--;> (":";:-j. c.':') 10.':_1""1 :TJ [.--1 ,-") , ; ("'"J -, "-') .' '~i ~"~~~ ;, C.::J 15,995.00 ~) lD z o t= <( ...J ::> l- e:: <C () W ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) B. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule'l) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus line 11) (9) (10) )'1 5,649,50 (--:) ~- ',- r--l '-rl ~r~ (6) (7) ~ .~ ~""') \.0 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <C I- ::> CL :E o U X <C I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(12) 19. Tax Due 43,316.91 X ~ (15) 13,316.91 X .045 (16) 0.00 X .12 (17) 0.00 X 15 (18) (19) (8) 84,045.65 8,055.68 19,356.15 (11) (12) (13) 27,411.83 56,633.82 16. Amount of Line 14 taxable at lineal rale (14) 56,633.82 17. Amount of Line 14 taxable at siblrng rate 0.00 599.26 0.00 0.00 599.26 20. 0 "::~:>);::B:ESORE[OANSWERALtQ.oE$Tlb.N$~tjNREVER$E:SibEANbRECHec}(MATHg;;~:': 18. Amounl of Line 14 taxable at collateral rate CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Com lete Address: STREET ADDRESS M I 306 W. a eAve. CITY Shiremanstown STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 599.26 Total Credits (A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 4. Total Interest/Penalty ( D + E ) 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 (3) 0.00 5. If Line 1 -+- Line 3 is greater than Line 2, enter the difference. This is the TAX. DUE. (4) (5) (5A) (5B) to: REGISTER OF WILLS, AGENT 0.00 599.26 45.00 644.26 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check 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; ..... ....,.. ""'" ........... ......, ""'"'' .................... ....... 0 [ZJ b. retain the right to designate who shall use the property transferred or its income.;...................................... 0 [ZJ c. retain a reversionary interest; .or.......... .......... .......... ............................. ............ ......... .................. 0 [ZJ d. receive the promise for life of either payments, benefits or care?................................. ..... .................... 0 00 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?........ ..................... .................... ........ ""'''''' """'" ............. 0 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........... .. .. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?...... .... . . ............................ .................................... 0 00 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 pena~ies 01 pe~ury. I declare that I have examined this return. inclJding accompanying schedues and statements. and to the best of my knowedge and beiel. it is true, correct and compete. Declaration of preparer other than the personal representative is based on an information of which preparer has any knowedge. SIGNATU~OEPER~ON RES,PONSIBLE F~FILI~fGRETURN , L). 0 ~>-,-a. .X-e , ~\-'--/ ADDRESS 306 W. Maple Ave. Shiremanstown PARER OT DATE j 5 1\.)01.1, ~OO~ ADDRESS Charles F. S van CPA CFP 352 Blacksmith Road, Camp Hill PA 17011 For dates 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 surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)]. For 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. S9116 (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 the only 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 adoptive parent, or a stepparent of the child is 0% [72 P.S. s9116(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 in 72 P .S. !l9116(1.2) [72 P .S. !l9116(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. !l9116(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. REV-1503 EX + (6-98) .w SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EST ATE OF LaMar. Daniel P. FILE NUMBER 21 04 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0315 ITEM NUMBER 1. DESCRIPTION 331.193 Sh. Vanguard Long-Term Bond Index Fd. @12.09 CUSIP 921937-40-5 2 347.617 Sh. Vanguard Tot. Bond Market Index Fd. @10.52 CUSIP 921937-10-8 VALUE AT DATE OF DEATH 4,004.12 3,656.93 16,924.03 18,263.04 19,553.03 3 166.986 Sh. Vanguard 500 Index Fd. @101.35 CUSIP 922908-10-8 4 1103.507 Sh. Vanguard Int. Growth Fd. @16.55 CUSIP 921910-20-4 5 851.242 Sh. Vanguard Small Cap. Index Fd. CUSIP 922908-70-2 @22.97 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 62401.15 THMmguardGROUP" CHARLES SULLIVAN 1513 CEDAR CLIFF DR CAMP HILL PA 17011 March 30, 2005 Various Funds 09962978093 Dear Mr. Sullivan: Weare responding to your letter requesting a valuation of the above accounts for Daniel LaMar. We have provided the information below. As of March 23,2004, the number of shares, the price per share, the value of each fund, and the accrued dividends (if applicable) were as follows: Fund Shares Price Value Accrued Dividends Long-Term Bond Index 331.193 $12.09 $4,004.12 $12.89 500 Index Fund Inv 166.986 $101.35 $16,924.03 NA Small-Cap Index Fund Inv 851.242 $22.97 $19,553.03 NA International Growth Fund 1,103.507 $16.55 $18,263.04 NA Inv Total Bond Market Index 347.617 $10.52 $3,656.93 $9.83 Fund Inv Post Office Box 2600, Valley Forge, Pennsylvania 19482-2600 (610) 669-1000 . www.vanguard.com If you have any questions or need further assistance, please contact a member of our Transition Specialist Team at 1-888-237-9045. We are available Monday through Friday from 8 a.m. to 8 p.m. Eastern time. Sincerely, Client Service Department bsf 50532669 R,V-150",\' '6. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LaMar Daniel P. FILE NUMBER 21 04 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0315 ITEM NUMBER 1. DESCRIPTION 2001 Nissan Sentra Vin: 3NICB51 D21 L470060 Kelley Blue Book 2 2002 Hyundai Accent Sdn. Vin: KMHCG45C22U297511 Kelley Blue Book 3 Miscellaneous Personal Property VALUE AT DATE OF DEATH 8,295.00 6,850.00 850.00 TOT AL (Also enter on line 5, Recapitulation) $ (If more space is needed, inserl additional sheets of the same size) 15.995.00 \,;(lJ. ;:).I,;U111. .l\..CUCY DIUC DUUK us~u-\....ar VaJUeS .page 1 ot 'L Enter ZIP Code L'''''T'''_' .1 m(lIt~1 I.~" 't I-~ \~~'>:"':t=!iP;~I~''''>-,'C\~,t ("T1"::'~'i ""~..f.;ti",:,...~,.,r" '{ J"\~, ';;'~ ", t'''''{ r~_\ ~1'::' I~' ~"';'~"$! ~'o!~/(' .,.?,,:~w-,....,~ r'i"....~NI~,,' t~;;.~~--.,,-"'~ft Home , Buy I Sdl R<'<;(' arch : Shopprng Advlt~ Kelley Blue Book Used-Car Values J- ~", i . '" ~ ~. ...,.....,' .-, Next Step. Sell this Vehicle Search Online Classifieds Research this Vehicle [gl E-Mail Paae ~ Print paae 2001 Nissan Sentra GXE Sedan 40 ~ ~hana.s1.. Vehicle Supply basic Information to see values for this vehicle (required) Approximate Mileage, 1!?!Q9.Q,._J Engine: 4-Cyl. 1.8 Liter Tran.m15.lon: 1'-"lJ!()I11~~~~.. . Drive Type: Front Wheel Drive ..m.' Values provided by Kelley Blue Book ....................................................................................................... "- '. - ,",. ".,. '"," :': '-.... .<;-.:,- .J.:' ;., ... ":' ':. . . . . , . ..... ", '.. .,:>' .... . ,Iii Equipment that may affect vehicle values ............_...4.... ~....... .......~ 4............44.......... _.......... .............................. ...... Copyright @ 2005 by Kelley Blue Book Co" All Rights Reserved. Mar - Apr 2005 Edition. The information in this report is intended for the personal use of the customer only and may not be sold or transmitted to another party. Kelley Blue Book assumes no responsibility for errors or omissions. ( v.5032) Pi Air Conditioning Pi Power Steering I?i Power Windows [J Power Door locks [J 11lt Wheel I?i Cruise Control Pi AM/FM Stereo [J Cassette I?J Single Compact Disc [J Multi Compact Disc [J Premium Sound [J ABS (4-WheeI) [J leather [J Power Seat [J Dual Power Seats [J Rip-Up Roof [J Sliding Sun Roof [J Moon Roof C Rear Spoiler o Alloy Wheels [J Premium Wheels ....................................................................................................... Values listed for 17011 on 03/21/2006 Vehlde Condition, Retail yalue: Fair N/A Good Excellent $5,415 N1A $8,295 Home I Contact Us I Site Index f About cars.com I ~!QYment OpQortunlties I Become a cars.com Dealer .'~"~__M._..___.~.~______..__.__~___~____._~.__.____.....--._,__~....~,.__~~ $6,680 Private Party Value: View Trade-in Va'u~ $6,120 Kelley Blue Book does not provide retail values for vehicles in good or fair condition. Recalculate Values http://www.cars.com/go/kbb/kbbMain.jsp?year=200 l&mkid=36&mdid=33 9&kbbmdid=200 I... 3/21/05 ..vv.. ~~J uuu<u .n.."''''~ll~ - ~ ,U"'Jll~ - l"V~Or'l ~UtU;S MSN Home I My MSN I Hotmail I Shopping I Money I People &. Chat .l'age 1 or L !~~~jgh]~,~ Web Search: I", e" >..... Find a Car: @, New C Us~ l~a.~~.:.. 1~?9e.I:.. Find by Category: I,~~:._.._.,.,....... ~ Home ~ New Cars .... Used Cars - Used Car Ustings - Trade-In Values - Compare - Reliability Ratings - Decision Guide - Sell Your Car ~ Certified Pre-Owned ~ Future Cars ~ My Research ~ My Car ~ Finance ~ Insurance ~ News & Advice ~ Videos &. Photos ,-:; /y d )" 0; t'~:~ ~[ f)1S5':.~ Add Auto News Add Local Traffic DRWE TO A IIvuuuvv $1000 CASH E ," OR 2.0% APR ANA' SALes E'ilE.Nl Cl'let; !Fon' OFFER tlHMl,6 Home I Site Map I About MSN Al model research Kelley Blue Book Price Expert Rating Consumer Rating Reliability $6,400 - $7,775 Not Reviewed 8.3 out of 10 No data Used TherE 157:1 Iistin~ natiol Accer $500. l~!~,5 Acce "" To to "" All !Ii, Ac O'J '>>J All " Us CI, Coml 1l' All Me '-'1 Co Ye ,~ To An Ph Rece 111 20 Ac iii! 20 Ac '" 20 Ac ,., Ml ui Cars You a 'iI Th Gc Pa http://autos.msn.com/research/vip/pricing.aspx?modelid= 10132&trimid=-1&src=VIP&tab= 1~... 3/21/05 Overview Pricing Photos &. Video Ratings &. Reviews advertisement I Of )~c";;;:n1 ~i,: Autos L. wL...........iL.. L,~. Pricing Focus Your Research Filter the data below by trim. Pick a Trim: l~'_!!:!~,. What is a ? Help me General Pricing L GS GL $8,999 $10,249 $10,649 $8,610 $9,593 $9,967 \'Ifiodet Warranty The information shown below only applies to the original equipment manufacturer warranty. Basic (mo.) 60 Basic (mi.) 60,000 Powertrain (mo.) 120 RE.V.1509 EX. + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LaMar. Daniel P. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 04 0315 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Susan M. LaMar B c JOINTLY-OWNED PROPERTY: ADDRESS 306 W. Maple Ave. Shiremanstown PA 1701 RELATIONSHIP TO DECEDENT Daughter LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INQUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DEm'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL Y.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1. A. 10/9/03 2003 Hyundai Accent Sdn. 11,299.00 50. 5,649.50 Vin: KMHCG35C43U261749 TOTAL (Also enter on line 6, Recapitulation) $ 5 649.50 (If more space is needed, insert additional sheets of the same size) T _ _ _ _ --J -......-- ~ ....---......... ..... ""''''.1.1.15 - ,L'I'.l.U.l.' L"1.ULV13 f;{~ign 11'1'/ M..-.. ...J~ yage 1 or 1. MSN Home I My MSN I Hotmail I Shopping I Money I People &. Chat Web Search: L Find a Car: (i, New 0 Used l,.,~~~:_._, ..,... 1f'>1()(j.~I:. find by Category: I~~ry:. ..,.... ~ Home ~ New Cars ... Used Cars - Used Car Ustings - Trade-In Values - Compare - Reliability Ratings - Decision Guide - sell Your Car ~ Certified Pre-Owned ~ Future Cars ~ My Research ~ My Car ~ Rnance ~ Insurance ~ News & Advice ~ Videos & Photos tt:): Y:j~ 1} V~ sr{.l Add Auto News Add Local Traffic model research Home I Site Map I About MSN Al 2003 Hyundai Accent Kelley Blue Book Price Expert Rating Consumer Rating Reliability $7,300 - $8,775 Not Reviewed 8.9 out of 10 No data Pricing OVerview Pricing Features &. Specs Photos It Video Ratings &. Reviews advertisement 3-door GL 3-door GL 4-Door Focus Your Research Alter the data below by trim. Pick a Trim: l~.~,!!"~."... What is a ? Help me $9,999 $10,899 $11,299 Genera! f./ridng r~~{."d'eJVjfarranty $9,567 $10,201 $10,576 The Information shown below only applies to the original equipment manufacturer warranty . http://autos.msn.com/research/vi p/pricing.aspx?modelid= 1 0686&src=vip Basic (mo.) 60 Basic (mi.) 60,000 Powertrain (mo.) 120 Used TherE 157:J listin~ natiol Accer $500. 1~!~5 Acce '" To to ~; All '" Ac Ov rN All ~, Us Clc Coml :~ All Me ':~t Co Ye ~!}j To An Ph Rece tli 20 Ac III 20 Ac ~a M, U; Cars You a TI1 Gc Pa 3/21/05 REV-1511 EX + (12-99) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LaMar. Daniel P. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 0315 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Parthemore Funeral Home & Cremation Services, Inc. 1303 Bridge Street New Cumberland, PA 17070 6,720.68 B. ADMINISTRATIVE COSTS: 1. 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: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant 10 Decedent 4. Probate Fees Cumberland County Register of Wills 260.00 5. Accountant's Fees Steven W. Fahnestock CPA - Prep. of 2003 Income Tax Returns 200.00 6. T ax Return Preparer's Fees Charles F. Sullivan CPA - Prep. of Inheritance Tax Return 750.00 7. Steven W. Fahnestock CPA - Preparation of Fiduciary Tax Returns 125.00 TOTAL (Also enter on line 9, Recapitulation) $ 8 055.68 (If more space IS needed, insert additional sheets of the same size) REV-1512 EX" + (6-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LaMar. Daniel P. FILE NUMBER 21 04 0315 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Nissan Motor Acceptance Corp. P.O. Box 660360, Dallas TX 75266-0360 Loan on 2001 Nissan Sentra Vin: 3NICB51 021 L470060 2 Members 1st Federal Credit Union 5000 Louise Drive, Mechanicsburg, PA 17055 Loan on 2002 Hyundai Accent Vin: KMHCG45C22U297511 3 Keystone Health Plan Central Harrisburg PA 17177 Ambulance Service & Supplies 4 Keystone Health Plan Central Harrisburg PA 17177 ALS Services & Supplies 5 Cardiovascular Surgicallnst. 423 No. 21st Street, Camp Hill, PA 17011 Office Visit 2/16/04 6 Pinnacle Health Hospitals P.O. Box 2353, Harrisburg PA 17105 Visit 3/23/04 7 Members 1st Federal Credit Union 5000 Louise Drive, Mechanicsburg PA 17055 Loan on 2003 Hyundai Accent Sdn. Vin: KMHCG35C43U261749 - 50% interest VALUE AT DATE OF DEATH 7,295.26 5,392.17 985.50 100.00 25.00 46.92 5,511.30 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 19.356.15 ~ COUNTY ~' ::;yur~ /'~ R C. HAS E'" DATE OF CONTRACT e'ti16/01 CONTRACT NO, NISSAN MOTOR ACCEPTANCE CORPORATION SIMPLE INTEREST RETAIL INSTALLMENT CONTRACT. PENNSYLVANIA BUYER'S NAME DANIEL P LAMAR BUYER'S RESIDENCE OR PLACE OF BUSINESS 306 W MAPLE AVE SHIREMANTOWN p~ 17~11 CO-BUYER'S NAME AND ADDRESS ZIP CODE COUNTY ZIP CODE In this contract the words "we," "us" and 'our" refer to the creditor (Seller) named below and, after an assignment of this contract, will refer to the assignee of the contract. The words ''you'' and ''your'' refer to the buyer and co-buyer, if any, named herein, Seller sells you the vehicle described below on credit. The estimated credit pric~;is shown below as the "Total Sale Price." The "Cash Price" is also shown below, By signing this contract you choose to buy the "vehicle" on credit and agree to pay us the' Amount Financed and ()ther charges according to the terms and agreements shown on the face and back of this contract. If this contract is signed by a buyer and co-buyer, each is individually and together responsible for all agreements in the contract. YEAR NEW USED MAKE TRADE NAME MODEL ODOMETER READING 10 NUMBER $ N/A deductible collision Optional Coverages These coverages are optional and are not required by Seller, If obtained through Seller, the premium and term are as follows: Coverage Limits Term Premium ITEMIZATION OF THE AMOUNT FINANCED Liability: 15186 00 ....;n mas, $ N/I'\ 1. A, Cash Price 01 Motor Vehicle (Inc, Ace.) .$ , . ' (A) Bodily Injury .u..z:r t1 Property Damage tJH'I--. ~ dl/(;.0/ .-'ax.,........,.,....$ 851.16(8) GAP Coverage '11' '/""'. f?'I _ /......axes.................$ N/A(C) (See polley or certificate of in sur; /~.::S?Jl!:. (;./ ..:... d9..CJ f. - ~viceContract..",.,... ,$ N/A(D) ::- 'j<'>""/'. r,,c, ,ntena,nce Contract , , , , , . .$ N/A (E) TOTAL Vehicle Insurance (. f?l ~~..,....(J 6k;O f 'ire.;z. 9. ' Price (A+B+C+D+E) .. . . . . . . . . . . . . . . . . . . . . . . $ I~ ,;;;,,9/ ,yl ': &:;b/."1.l-~nt . ;Zoo,;).... D- ;:- ~50 J, "7..2J(Gross Value). . . . . . . . .$ ~()o3 I~ ,;;1..5/.6 I ionofTrade-in: ~.r:;;) <"'rOo /. 2' I;. p-6.43 ~g 1 " Make HYUNDRI c< or; 'f- o;.J ~ <K. -, , ~ EXCEL I ~.< /3,a~ berKMHVD12J4MUt 07424 ,r ?~ cr5:.J... Iff on trade-in STATEMENT OF INSURANCE You have the option to obtain the required coverages, and any optional coverages you desire, from a person of your choice and through any insurance company authorized to transact business in Pennsylvania, or through existing policies owned or controlled by you. VEHICLE INSURANCE Required Coverages You are required to maintain insurance on the vehicle for at least collision ($ N/Adeductible) and comprehensive ($ N/A deductible). or equivalent coverages, until you payoff this contract, ~t you elect to obtain the required coverages from Seller, the coverages are written by (name of company) and the premium and term are as follows: Coverage Term Premium $ N/A _mos. $ N/A deductible comprehensive _mos. $ N/A LIABILITY INSURAN( AND · PROPERTY' DAI INCLUDED INTHISC ARE SHOWN ABOVE. THE ABOVE VEHICLE VOLUNTARILY. ELECT THE AMOUNT FINANe CR' Credit Life Insurance a ~ required to obtain cred.3' I~.I ]) 04. e.. sign and agree to pay I ..", .;.-)...c.,. available from of company) of address) for the premium Type T Credit Life Joint Credit Life Credit Disability mos. $ $ fI,I/CI mos. '" .., ~ r'\ DISCLOSURES PURSUANT TO TRUTH-IN,LENDlNG ACT ANNUAL PERCENTAGE RATE 5.90 % (The cost of your credit as a yearly rate.) FINANCE CHARGE (The dollar amount the credit will $ 2377.94 cost you.) Amount Financed (The amount of credit provided to you $ 15130.66 or on your behalf.) Total of Payments (The amount you will have paid after $ 17508.60 you have made all payments as scheduled.) Total Sale Price (The total price of your purchase on $ credit, including your downpayment of $ 1000. 00.) 18508.60 Payment Schedule. Your payment schedule will be: NUMBER OF AMOUNT OF PAYMENTS ARE DUE PAYMENTS EACH PAYMENT One Payment of $ N/A On N/A 5g>ayments of $ 291. 81 Monthly, Beginning 05/16/01 One Final Payment of $ 291. 81 On 04/16/06 SECURITY INTEREST: You are ~iving a security interest in tbe vehicle being gurchased. LATE CH~RGE: II payment isla e, you will be charged two percent per mont on the amount 01 the ~i(Jment In arrears. EPAYMENT: II you ry off in lull early, you will not have to pay a penalty. See the rever~?oIfide 0 tliis contract 10rrl~~Ei!~~~~~:,~~~~\~~;,~~t~ut nonpayment, default, any required i6037~16(1) 1000. 00(A) . . . . .$ N!A(B) in allowance (A-B) ....$ 1000. 00(C) npayment at Closing. . . .$ N/A(D) Ite (if any) . ... .. .. . .$ N/A(E) ownpaymentOue. .. . . .$ N/A(F) \). I alai c.;ash Oownpayment (O+E+F). .$ N/A(G) Total Downpayment (C+G) ..... . . . . . . . ,$ 3, Unpaidcash price balance (1-2) .......,.. . . . . . . . . . . . . . . $ 1000. 0et2) I ~0.17. 1 E(3) A ^~~"ntn no,"/ tn lno,,"n~o rnc nn "nllr hoh,lf (,~ rlp~r.rihprl in St~tp.mp.nt nllnsurance): ,YIL.lllh...Jl-n...:> Il::)l Federal Credit Union ~JMPLE INTEREST PA. J {; P c, 77-;;) PErffl.JYLVANIA MOTO~ VEHICLE INSTALLMENT SALE CONTRACT, Dated AtfNUAL PERCENTAGE RATE The cost of your credit as a yea rly rate. Amount Financed The amount of credit provided to you or on your behalf. FINANCE CHARGE The dollar amount the credit will cost you. otal Sale Price The total cost of your purchase on credit, including your down payment of$ :S100..00 5.89 % $ 1625.08 10357.52 11982.60 $ 15082.60 $ $ Your Payment Schedule will be: No. of Payments Amount of Payments $ $ Security: You are giving a security interest in the motor vehicle being purchased. Prepayment: If you payoff early, you will not have to pay a penalty. When Payments Are Due Monthly, beginning Filing Fees: $ [) . 00 Late Charge: If a payment is late, you will be charged 2% of the portion of the payment which is late for each month, or part of a month greater than 10 days, that it remains unpaid. See below and any other Contract documents for any additional information about nonpayment, default, any required repayment in full before the scneduled date and prepayment refunds and penalties. e means estimate In this Contract we are the SELLER. IF YOU DO NOT MEET YOUR CONTRACT MECHAN' I CBURG, PA 170S,OBLlGATlONS, YOU MAY LOSE THE MOTOR \VEHICLE AND PROPERTY THAT YOU Zip Code . BOUGHT WITH THIS CONTRACT, AND/OR MONEY ON DEPOSIT WITH THE ASSIGNEE. This Contract is between Seller and Buyer. All disclosures have been made by Seller. Seller Zip Code(s) intends to assign this Contract to the Assignee. Itemization of Amount Financed Cash Price FREYSINGER PONTIAC INC 62S1 CARLISLE PIKE Name Address DANIEL P LAMAR 306 W.MAPI F AVF Na me(s) You are the BUYER(S). SHTRFMANSTOWN PA 17011 Add ress(es) If there is more than one Buyer, each promises, separately and together, to pay all sums due us and to perform all agreements in this Contract. TRADE-IN: You have tr.aded in the following vehicle: 1 CJ% nonr,r: rARl\llAN Year and Make Description If a balance is still owing on the vehicle you have traded in, the Seller will payoff this amount on your behalf. You warrant and represent to us that any trade.in is free from lien, claim, encumbrance or security interest, except as shown in the Itemization of Amount Financed as the "Lien Payoff." PROPERTY INSURANCE: You may choose the person throul Ind against liability arising out of use or ownership of the Vehicle. In this C / ., ~"...u:: ~ I CREDIT INSURANCE IS NOT REQUIRED: Credit Life Insural r Co. "'7 r<., d to obtain credit, and will not be provided unless you sign below and, / /0 o-..-r, / ., _,r /~~"'II __ /'.-. ;ED CREDIT INSURANCE on the reverse side. Your insurance certificate ./ , 7 (Yo( . ~ 77, /1 fJ;>", I insurance purchased will be for the term of the credit. " $ Cash Downpayment $ Trade-In Value of Trade.ln $ Lien Payoff to : ".,' $ Unpaid Cash Price Balance $ To Credit Insurance Company ~ $ 0- c:: To Public Officials for: B l!: License, Tags and Registration >- E $ ~ Lien Fee -;;; $ .c ~ To ~ $ g To .DOC FEE ~ $ 5 To PI\, TIRE :; $ ~ To PA ~AI F~ $ Amount Financed $ Finance Charge By signing, you select Single Credit Life Insurance, What is yot which costs $ N " ,^, age? _ 0<,0 0-2.. ./. "\...-;;;;' /9'7. 7/ ="/~~Q i your ~- ~~ .;{oo3 1ae.....J".71 :::-<~%Q=- Si.nature 0.1 Buyer to be insured tor Single Credit Lite Insurance ,., _ ~) Ci 0 ~urance 6 o<P tf)~. .:3 ~ /97/71 :- ..sr; 1,13 By signing, you both select Joint Whal _.'. Percentage Credit Life Insurance, which costs $ ~ / ,fl. your 5" "9.-J 17 to be - f~t;t/ S.~/:D..-c:... ~55o, ~3 :.;> '"'}, insured % 1. 2. Signatures of both Buyers to be insured for Joint Credit Life Insur; _% Insurer: VEHICLE: You have agreed to purchase, under the terms of this Contract, the following motor vehicle and its extra equipment, which is called the "Vehicle" in this Contract.- ML.J.! NEW Yw m Mill 2002HYUNDAI ~ ACCENT ~~ SON H2.. .en. l1:l&!Iill. ~ ~ ~ KMHCG45C22U297511 Equipped _ A.T. _ P.S. _ AM.FM Stereo _ 5 Spd. Other with _ A.C. _ p.w, _ AM.FM Tape Vinyl Top ASSIGNEE: We may assign this Contract and Security Agreement to a sales finance company which is the "Assignee." If the Assignee assigns the Contract to a subsequent assignee, the term also refers to such subsequent assignee. After the assignment, all rights and benefits of the Seller in this Contract and in the Security Agreement shall belong to and be enforceable by the Assignee. The Assignee will notify you when and if Seller makes an assignment. Payment Schedule. You agree to pay to us the Amount Financed plus interest in en R";"" 8f >"_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER I ::lM::lr C aniel P '1 04 0315 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS (include outright s~ousal distributions, and transfers under Sec. 9116 (a) (1. )] 1. Philomena M, LaMar Spousal 43,316.91 306 W, Maple Ave, Shiremanstown PA 1701 2 Susan M. LaMar Lineal 4,439.86 306 W. Maple Ave. Shiremanstown PA 17011 3 Danielle L. LaMar Lineal 4,439.86 306 W. Maple Ave. Shiremanstown PA 17011 4 Karen S. LaMar Lineal 4,437.19 306 W. Maple Ave. Shiremanstown PA 17011 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, Insert additional sheets of the same size) NArD ~.~ " t BUREAU OF INDIVIDUAL fAXES INHERITANCE TAX DIVISION ' PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 02-06-2006 LAMAR 03-23-2004 21 04-0315 CUMBERLAND 101 APPEAL DATE: 04-07-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REv:is4'-Ex-AFP-coi:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANcE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DANIEL P FILE NO. 21 04-0315 ACN 101 DATE 02-06-2006 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE ~ , . DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CHARLES F SULLIVAN 352 BLACKSMITH RD CAMP HILL PA 17011 ESTATE OF LAMAR REV-1547 EX AFP (06-05) DANIEL P APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate (15) 16. Anount of Line 14 taxable at Lineal/Class A rate (16) 17. Anount of Line 14 at Sibling rate (17) 18. Anount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS. RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ( 9) ClO) NOTE: Cl) (2) (3) (4) (5) (6) (7) .00 62.401.15 .00 .00 15.995.00 5.649.50 .00 (8) 8,055.68 19.356.15 CllJ (12) (13) Cl4) 40.492.16 X 16,141.66 X .00 X .00 X NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 84,045.65 27.411 83 56,633.82 .00 56,633.82 00 = 045 = 12 = 15 = .00 726.37 .00 .00 726.37 Cl9)= . n~_~.... (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-15-2005 CD006006 .00 644.26 INTEREST IS CHARGED THROUGH 02-21-2006 TOTAL TAX CREDIT 644.26 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 82.11 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 33.72 TOTAL DUE 115.83 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ," IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~-~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ... iEi-1470 EX (6-88) , INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 JECEDENrS NAME Daniel P. laMar FILE NUMBER ~EVIEWED BY Destiny S.R.Brown ACN 2104-0315 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES F 1 Jointly held assets are taxable outright to the beneficiary/ies before determining residue. ROW Page 1 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/17/2006 LAMAR PHILOMENA M A/K/A 306 W MAPLE AVE SHIREMANSTOWN, PA 17011-6523 RE: Estate of LAMAR DANIEL P File Number: 2004-00315 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1/ for decedents dying on or after July 1/ 1992/ the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/23/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel \~~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 LAMAR PHILOMENA M A/K/A 306 W MAPLE AVE SHIREMANSTOWN, PA 17011-6523 RE: Estate of LAMAR DANIEL P File Number: 2004-00315 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/23/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. ~lY ~j~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ','7) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT . ~r-,"""~ ~-i-.,-'"""lnr'v-f' r+'--i ~" .~ ~t".)-:;~;i-:..:~_~, ._,:~,,~. IJ~ BUREAU OF INDI,VlDUAL-'TAK'fS INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG P~dU~~V~O PM 2: 58 C~~~ 9f QT OR~~S\\I,) C99~ '101\ C! 1"1[- c',: ' ,-"),, \.,... . i I ~ -.' REV-1593 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CHARLES F SULLIVAN 352 BLACKSMITH RD CAMP HILL PA 17011 11-09-2006 LAMAR 03-23-2004 21 04-0315 CUMBERLAND 101 DANIEL P Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- --------------------------------------------------------------------------------------------------------------------------------------- REV-1593 EX AFP (03-05) ESTATE OF LAMAR DANIEL .. INHERITANCE TAX RECORD ADJUSTMENT .. 11-09-2006 P FILE NO. 21 04-0315 ADJUSTHENT BASED ON: VALUE OF ESTATE: PROTEST BOARD DECISION 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Hiscellaneous Expenses (Schedule H) Debts/Hortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Govern.ental Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax 10. 11. 12. 13. 14. TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (9) ClO) Cl5) Cl6) Cl7) Cl8) ACN 101 DATE Cl) (2) (3) (4) (5) (6) (7) .00 62,401.15 .00 .00 15.995.00 5.649.50 .00 (8) 84,045.65 8,055.68 19.356.15 (11) Cl2) Cl3) Cl4) 27.411.83 56.633.82 .00 56.633.82 (Schedule J) 43.247.81X 00 = 13.386.01X 045= .00 X 12 = .00 X 15 = Cl9) .00 602.37 .00 .00 602.37 .. ..-.. . ----. lTJ AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 11-15-2005 CD006006 26.86- 644.26 TOTAL TAX CREDIT 617.40 BALANCE OF TAX DUE 15.03CR INTEREST AND PEN. .00 TOTAL DUE 15.03CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ '~OARD ~F APPEALS DEPT. 281021 HARRISBURG, PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT 0F REVENUE CHARLES F SULLIVAN CPA 352 BLACKSMITH RD CAMP HILL PA 17011 IN RE ESTATE OF: LAMAR DANIEL P. DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0603154 Inheritance Protest 2104-0315 101 2/6/2006 2/13/2006 JEFFREY HOLLEN BUSH Direct Dial: (717) 783-7891 Fax: (717) 787-7270 Email:jhollenbus@state.pa.us November 3, 2006 On February 6, 2006, the Department issued an appraisement and assessment which increased the portion of the estate subject to tax at the 4.5% lineal rate from $13,316.91 to $16,141.66. Petitioner argues the Department failed to offset an outstanding automobile loan against the 2003 Hyundai Sedan which decedent jointly owned with his daughter. In the opinion of this Board, Petitioner has established decedent's $5,511.30 share of the automobile loan should be offset against his $5,649.50 one-half interest in the Hyundai. The net taxable value of that non-probate asset passing to decedent's daughter will, therefore, be $138.20 ($5,649.50 minus $5,511.30). With respect to the $56,495.62 probate estate, the first $30,000.00 plus one-half of the $26,495.62 remainder passes to decedent's wife under 20 Pa.C.S.A. 9 2102(2). The remaining $13,247.81 passes to decedent's daughter. The total estate taxable at the 4.5% rate is $13,386.01 ($13,247.81 plus $138.20). . LAMAR DANIEL P. BOARD DOCKET NO. 0603154 Page 2 of 2 Accordingly, it is hereby, Ordered that the protest is sustained. The Department is directed to issue an amended appraisement and assessment increasing the amount taxable at the 0% spousal rate to $43,247.81 and decreasing the amount taxable at the 4.5% lineal rate to $13,386.01. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). COMMONWEALTH OF PENNSYLVANIA PEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES r\',C\,\ {'f~\Ct. 9 INHERITANCE TAX INHERITANCE TAX DIVISION c~r;:.C(}\.)\.j' \ STATEMENT OF ACCOUNT PO BOX Z80601 ,. - HARRISBURG PA 171Z8-0601 '* ~'" \\ ~ '3'3 l~~b ~t.C \ S \ \~\Z Or 1" c....[. ,i" ('C'\\jB \ , on\-\f~ J u;:,(\ Vf\ CHARLES F SULLIVAN Or:'~,..~, . - 352 BLACKSMITH RD C~J\\!'" - - - CAMP HILL PA 17011 REV-1607 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-11-2006 LAMAR 03-23-2004 21 04-0315 CUMBERLAND 101 DANIEL P A.ount R..Uted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax pay.ant. CUT ALONG THIS LINE REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF LAMAR DANIEL P FILE NO.21 04-0315 ACN 101 DATE 12-11-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-08-2006 PRINCIPAL TAX DUE: 602.37 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-15-2005 CD006006 26.86- 644.26 11-27-2006 REFUND .00 15.03- TOTAL TAX CREDIT 602.37 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) %