HomeMy WebLinkAbout03-0055Estate of
also known as
NANCY F. JUMPER
PETITION FOR PROBATE and GRANT OF LETTERS
To:
,Deceased.
Social Security No. 052-26-2687
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older and the executor
in the last will of he above decedent, dated June 25~
and codicils(s) dated No Codicils
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
named
20 02
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania,
with her (3-~z~-'°a'~ _ . ~last[eI f~.n~_ .',1E(/~x 42.tgto]or principal residence ..... at 15 Rockaway Drive, Camp Hill, PA 17011
' ~list street, number and municipality)
Decedent, then 69 years of age, died January 6 ,20 03
at
Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: No exceptions
Decedent at death owned property with estimated vales 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
situated as follows:
TOTAL $39,000.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Testamentary thereon.
rAMES R. J JMPER
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ] ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s)
of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
bg,fore me this 21st day of
[] Janualx . ~ /3 20 03
Donna N. Otto, 1st Depu'tyffegi~c~r
No. 21-2003-55
Estate of NANCY F. JUMPER , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW January 21st 20 03 , in consideration of the petition on the reverse
side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated June 25, 2002
described therein be admitted to probate and filed of record as the last will of Nancy F. Jumper
and Letters Testamentary
are hereby granted to James R. Jumper
FEES
Probate, Letters, Etc .......... $ 70.00
Short Certificates (?) ......... $ 21.00
Renunciation ............... $
x-Pages ( 3 ) 9.00
JCP $ 10.00
TOTAL $ 110.00
Filed Jar~ary. 21st., 21503 ................
- ' Regist~i~°f Wills"
Donna M. Otto, 1st Deputy
Herbem G. Rupp, Jr., - 01597
A'ITORNEY (Sup. Ct. I.D. No.)
355 N. 21st St., Suite 205, Camp Hill, PA 17011
ADDRESS
717-761-3459
PHONE
Mailed Letters to Attorney on January 21, 2003.
his is to certify that the information here given is correctly copied fi'om an original certificate of death duls' 61o. t wit!-, m,. as
Local Rqgistrar. The original certificate will be fbrwarded to thc State Vital l{ccords Office i'ot pc'rmane',~t tlhm,~.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8778092
No.
l.ocal R%istrar ~
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
z'e ~1 : I I / ~/ ..... / ... /,~ E~
. I I _ I~
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21-2003-55
LAST WILL AND TESTAMENT
OF
NANCY F. JUMPER
I, NANCY F. JUMPER, of 15 Rockaway Drive, Camp Hill,.Pennsylvania, 1 7011,
being of sound and disposing mind and memory, do hereby make, publish and declare
this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils
by me at any time heretofore made.
ITEM I - I am a widow and I have four children: DAVID LEE JUMPER, JOYCE EILEEN
KREUTER, AMY CAROL ZULLO and JAMES RICHARD JUMPER, and they are described in
this Will collectively as "my children" and individually as "my son" or "my daughter".
ITEM II - I give my tangible personal property and all insurances thereon to my
children who survive me by thirty (30) days.. I have complete confidence that my
children will carry out my wishes on a list or memorandum which refers to this Will. If
no such list is found within thirty (30) days of my death, it shall be presumed that no
such list exists.
RUPP and MEIKLE, 355 NORTH 21sT STREET, SUITE 205, CAMP HILL, PENNSYLVANIA 17011
Page 1of 3
Initials~/
ITEM III - All the rest, residue and remainder of my Estate, real, personal and mixed
I give, devise and bequeath to whoever is my Trustee of Nancy F. Jumper Irrevocable
Trust Agreement signed by me dated June 7, 2002, to be held and distributed under the
terms of said Agreement of Trust.
ITEM IV- Until distribution, no gift or beneficial
anticipation or to voluntary or involuntary alienation.
interest shall
be subject to
ITEM V - All death taxes (and interest and penalties thereon in) imposed as a result
of my death upon any property passing under my Will or the said Trust Agreement but
not otherwise, shall be paid out of my residuary estate.
ITEM VI - (1) I give to my Executor named in this Will or any Codicil hereto or to
any substitute Executor the power to sell real estate and all of the powers now
applicable by lawto fiduciaries in the Commonwealth of Pennsylvania and in particular
to the Pennsylvania Probate Estates and Fiduciaries Code as effective and in effect on
the date hereof during the administration and until the completion of the distribution
of my Estate.
(2) If there be any property located outside the Commonwealth of
Pennsylvania, in which I may have an interest at the time of my death, which cannot be
Page 2of 3
n~t~a s~
conveniently administered as provided herein, then I authorize, but do not require, my
Executor to appoint a Bank or Trust Company with trust powers, to administer such
property according to the terms of this Will.
ITEM VII - I appoint my son, JAMES R. JUMPER, to be the Executor of this my Last Will
and Testament. In the event my son predeceases me or refuses to serve, I appoint my
daughter, JOYCE EILEEN KREUTER, to be the successor Executrix of this my Last Will and
Testament.
ITEM Vlll -
jurisdiction.
My Executor/Executrix shall not be required to post
security in any
of
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
~ (~. D~_~_, ,2002.
day
I<iA~,I CY ,1~.' JUMP~R''
residing
Page 3of 3
Initials~]/
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C(_imbC~£JCLI~C~
WE, NANCY F. JUMPER,
:
· SS.
I~L(~ ~L ~ pp , and
the Testatrix and the witnesses, respectively,
whose names are signed to the attached or foregoing will, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed the
instrument as her Last Will and Testament and that she had signed willingly (or willingly
directed another to sign for her), and that she executed it as her free and voluntary act
for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testatrix, signed the Will as witness and to the best of his or her
knowledge the Testatrix was at the time eighteen (18) year of age or older, of sound
mind, and under no constraint or undue influence.
Witness
Witness
Subscribed, sworn to, and acknowledged befor~ me by NANCY F. JUMPER, the Testatrix,
and subscribed and sworn to before me by ~i(~ t'~Jr~d i~ ~r~ , and
~'! r~Ck~._~/ I I~¢~ ) , witnesse~, this ~) 'd~y of June, 2002·
Notary Public u (SEAL)
NOTARIAL SEAL J
BARBARA J. KOCHER, Notary Public J
Camp Hill Boro, Cumberland County J
My Commission Expires Oct. 22, 2005 J
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Nancy F. Jumper
Date of Death: January 6, 2003
Will No.
Admin. No. 2003-00055
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 March 10, 2003:
Name Address
David Lee Jumper, 15 Rockaway Drive, Camp Hill, PA 17011
Joyce Eileen Kreuter, 519 McBath Street, State College, PA 16801
Amy Carol Zullo, 614 Hummel Avenue, Lemoyne, PA 17043
James Richard Jumper, 226 First Street, Lemoyne, PA 17043
James Richard Jumper, Trustee of the Nancy F. Jumper Irrevocable Trust
Aqreement dated June 7, 2002, 226 First Street, Lemoyne, PA 17043
Notice has now been given to all persons entitled thereto under Rule 5.6(a)
except None
Date: March 10, 2003
Capacity:
Name
Address
X
Signature
~H~rb~rt G. Rupp, Jr., Esquire
~'~N. 21st St., Suite 205
Camp Hill, PA 17011
Telephone (717) 761-3459
Personal Representative
Counsel for Personal
Representative
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 002396
JUMPER JAMES R
226 FIRST STREET
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 052-26-2687
FILE NUMBER: 2103-0055
DECEDENT NAME: JUMPER NANCY F
DATE OF PAYMENT: 04/04/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 01/06/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $15,950.00
REMARKS: JAMES R JUMPER
CHECK# 610
SEAL
TOTAL AMOUNT PAID'
$15,950.00
INITIALS' DO
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Register of Wills
Courthouse
are
HERBERT G. RUPP, JR.
RICHARD C. RUPP
ANN MEIKLE ERIKSSON (1954-82)
LAW OFFICES
RUPP AND MEIKLE
A PROFESSIONAL CORPORATION
355 NORTH 21ST STREET, SUITE 205
CAMP HILL, PA 17011
(717) 761-3459
E-MAIL: RUPPLAW1OAOL.COM
September 16, 2003
MAILING ADDRESS
P.O. BOX 395
CAMP HILL, PA 17001-0395
TELEFAX: (717) 730-0214
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE:
Estate of Nancy F. Jumper, deceased
No. 2003-00055
Our File No.: J-3712.02
Dear Madam:
Enclosed are the following items:
· Original and photocopy of 1500 Return for the Estate
· Inventory
· Our check payable to your order in the amount of $28.00
Please file the Inventory and 1500 Returns and send your receipt fo~,~~
filing to me. '~ ~
Thank you. ~~ ~/,/~_~
Very truly yours,
HGR/lin
~Jr.
Enclosures (4)
500 ~(X6-O0)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
Rev-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONlY (.~/j
FILE NUMBER
21 03 0055
County Code Year Number
Z
Z
0
o
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
NANCY F. JUMPER
DATE OF DEATH (MM-DD-YEAR) IDATE OF BIRTH (MM-DD-YEAR)
i
January 6, 2003 IMaY 4, 1933
IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1~. Original Return
4. Limited Estate
Decedent Died Testate (Attach copy of Will)
Litigation Proceeds Received
SOCIAL SECURITY NUMBER
052-26-2687
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
2. Supplemental Return ]_._~3. Remainder
4a. Future Interest Comprise (date of death afl[a' 12-12-82) US. Federal Estate Tax Return Required
7. Decedent Maintained a Living Trust (^fl[~h a copy of Trust) 8. Total Number of Safe Deposit Boxes
10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) r~ 11. Election to tax under Sec. 9113(A)
NAME
Herbert G. Rupp, Jr,, EsqUire
FIRM NAME (if Applicable)
RuPp and Meikle
TELEPHONE NUMBER
'.717~76i-3459
ICOMPLETE MAILING ADDRESS
1355 N. 21" St., Ste. 205
Icamp Hill, PA 17011
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Misc. 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 (Schedule I) (10)
11. 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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
~0~00,
$0.00
$o.0o
$o.oo
$47,037.77
$0.00
$332,437.61
OFFICIAL USE ONLY
(8)
$7,984.O5
$3,359.19
(11)
(12)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (aX1.2)
16. Amount of line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20. ~
$379,475.38
$11.343.24
$368,132.14
$0.00
$368,132.14
$368,132.14
x
x .045
x .12
x .15
(15)
(16)
(17)
(18)
(19)
$0.00
$16,565.95
$0.00
$0.00
$16,565.95
Decedent's Complete Address:
ISTREET ADDRESS
15 R°Ckaway Drive
TM
Camp Hill
ISTATE IZIP
PA 117011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E)
(3)
If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income;
c. retain a revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
$16~565.95
$16.565.95
$0.00
$o.oo
$0.00
$0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS
1. Yes No
If death occurred after December 12, 1982, did decedent transfer property within on year of death
without receiving adequate consideration? ~ ~
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
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 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.
Declaration of preparer other than the personal representative is based on all the information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
ADD'SS ~ ?~'
226 First Street, Lemoyne, PA ¥~043
DATE.
SIGNATURE OF PREPARER OTHER THAnE.REPRESENTATIVE
355 N-21't St., Ste. 205, Camp Hill, PA :17011
DATE
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. §9116 (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.
§9t 16 (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. §9116(a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72
P.S. §9116(a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
RUPP AND MEIKLE
A PROFESSIONAL CORPORATION
355 NORTH 21~'I'"'~"~T, SUITE 205
CAMP HILL, PA 17011
LAST WILL AND TESTAMENT
OF
NANCY F. JUMPER
I, NANCY F. JUMPER, of 15 Rockaway Drive, Camp Hill, Pennsylvania, 17011,
being of sound and disposing mind and memory, do hereby make, publish and declare
this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils
by me at any time heretofore made.
ITEM I - I am a widow and I have four children: DAVID LEE JUMPER, JOYCE EILEEN
KREUTER, AMY CAROL ZULLO and JAMES RICHARD JUMPER, and they are described in
this Will collectively as "my children" and individually as "my son" or "my daughter".
ITEM II - I give my tangible personal property and all insurances thereon to my
children who survive me by thirty (30) days.. I have complete confidence that my
children will carry out my wishes on a list or memorandum which refers to this Will. If
no such list is found within thirty (30) days of my death, it shall be presumed that no
such list exists.
RUPP and MEIKLE, 355 NORTH 21s; STREET, SUITE 205, CAMP HILL, PENNSYLVANIA 17011
Page 1of 3
· ·
Initials
ITEM III - All the rest, residue and remainder of my Estate, real, personal and mixed
I give, devise and bequeath to whoever is my Trustee of Nancy F. Jumper Irrevocable
Trust Agreement signed by me dated June 7, 2002, to be held and distributed under the
terms of said Agreement of Trust.
ITEM IV- Until distribution, no gift or beneficial
anticipation or to voluntary or involuntary alienation.
interest shall be subject to
ITEM V - All death taxes (and interest and penalties thereon in) imposed as a result
of my death upon any property passing under my Will or the said Trust Agreement but
not otherwise, shall be paid out of my residuary estate.
ITEM VI - (1) I give to my Executor named in this Will or any Codicil hereto or to
any substitute Executor the power to sell real estate and all of the powers now
applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular
to the Pennsylvania Probate Estates and Fiduciaries Code as effective and in effect on
the date hereof during the administration and until the completion of the distribution
of my Estate.
(2) If there be any property located outside the Commonwealth of
Pennsylvania, in which I may have an interest at the time of my death, which cannot be
Page 2of 3
Initials.~;~,?,'~
conveniently administered as provided herein, then I authorize, but do not require, my
Executor to appoint a Bank or Trust Company with trust powers, to administer such
property according to the terms of this Will.
ITEM VII - I appoint my son, JAMES R. JUMPER, to be the Executor of this my Last Will
and Testament. In the event my son predeceases me or refuses to serve, I appoint my
daughter, JOYCE EILEEN KREUTER, to be the successor Executrix of this my Last Will and
Testament.
ITEM Vlll -
jurisdiction.
My Executor/Executrix shall
not be
required to post
security in any
of
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
~j (_c f')~-~_~ ,2002.
day
/i~[ -~ !') 27, '~.(_.-L--(SEAL)
NANCY ~ JUMPER" '"
residing at:?)-r'l_ _ 'Hill
Page 3of 3
Initials ~ ~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CCi ~ ~ICLI~
: SS.
:
WE, NANCY F. JUMPER,
Lino v i..Mail
/
)'Y~I(C~ aL ~L 1[')l_'9 , and
the Testatrix and the witnesses, respectively,
whose names are signed to the attached or foregoing will, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed the
instrument as her Last Will and Testament and that she had signed willingly (or willingly
directed another to sign for her), and that she executed it as her free and voluntary act
for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testatrix, signed the Will as witness and to the best of his or her
knowledge the Testatrix was at the time eighteen (18) year of age or older, of sound
mind, and under no constraint or undue influence.
Witness / ~
Witness
Subscribed, sworn to, and acknowledged before me by NANCY F. JUMPER, the Testatrix,
and subscribed and sworn to before me by ~i0 I'-Y'tKC] A( ~ ,~.,D , and
~'! r~dL<-~a_~ I tk. lo~ ) , witnesse~, this ~% - day of June, 2002.
Notary Public (SEAL)
NOTARIAL SEAL
BARBARA J. KOCHER, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires Oct. 22, 2005
REV-1508 EX + (1-97X1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF NANCY F. JUMPER
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER 2103-0055
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. $15,079.60
Legacy Bank Certificate of Deposit - No. 100078856 - Valuation letter attached
Susquehanna Valley Federal Credit Union - Valuation letter attached
Shara Account No. 90300
Share Account No. 356300
PNC Bank Checking Account No. 5140032592 - Valuation letter attached
Massachusetts Mutual Benefit Management Account No. 820088498 - Account Statement Attached
1999 Chevrolet Lumina -Appraisal attached
-Iousehold property - List attached
TOTAL (Also enter on line 5, Recapitulation)
$490.57
$5,157.89
$3,932.13
$14,139.83
$6,999.00
$1,238.75
$47,037.77
(If more space is needed, insert additional sheets of the same size)
2600 Commerce Drive
PO Box 60947
Harrisburg, PA 17106-0947
Phone 717-441-3400
Fax 717-441-3410
T011 Free 1-800-436-2124
xvxvw, thelegacybank.com
February 12, 2003
James R. Jumper
226 First Street
Lemoyne, PA 17043
Subject: Certificate of Deposit # !00078856
Dear Jim:
This xvill confirm the balance in the above referenced account as of
January 6, 2003:
Principal Balance - $15,072.76
Accrued Interest - $6.84
The account xvas held in the name of Nancy F. Jumper. Please let me
knoxv if you need anything else. Thank you.
Sinc%e. ly,
/// .// /.- .
Linda Smith
Director of Branch Admnistrafion
SUSQUEHANNA
FEDERAL CREDIT UNION
February 12, 2003
Nancy F. Jumper Estate
c/o James R. Jumper, Executor
226 First Street
Lemoyne, PA 17043
Dear Mr. Jumper:
Please accept our condolences on the recent passing of your mother. We
also will remember her fondly.
The information you will need for the Inheritance Tax return is as follows:
1. Share account 903.00 had a date of death balance of $490.49 plus
$0.08 accrued interest for a total value of $490.57.
2. Share account 3563-00 had a date of death balance of $5157.03 plus
$0.86 accrued interest for a total value of $5157.89.
Neither of the above accounts had a joint owner.
As per your request, we have closed both accounts. The checks are
enclosed.
There is a life insurance benefit associated with account 903-00. This
benefit is based on the age of the member when various deposits have
been made. I estimate the insurance to be $487. Please provide us with a
death certificate so that we may file the claim. The Estate will be the
beneficiary.
If there are any questions, feel free to call.
Sincerely,
Larry L. Stoner
President/CEO
3850 HARTZDALE DRIVE · CAMP HILL, PA 17011-7809
LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589
PNC Bank, N.A.
3549 Capital Civ' Mall Drive
Camp Hill, PA 17011
717 761 0897 Tel
717 731 8145 Fax
March 21, 2003
PNCBANK
James Jumper
226 1st Street
Lemoyne PA 17043
RE: Nancy F. Jumper//5140032592
Date of Death: 01/06/2003
James,
The balance in your mother's checking account on the date of death was $3931.45. The amount
of accrued interest on the date of death was 68 cents.
If you have any further questions regarding your mother's account please feel free to contact me.
Regards,
Mary A{ice Bitner
Branch Service Manager
87/89/2883 13:85 7L773878-35
Mass Mutual Life Ins. Co.
1295 Stame Street
SLamlom Hi60
SprLngfie!d, Iv~ 01111
NAlqCY E JUMPER
15 ROC~AWAY DRIVE
C_~MP HILL
PA 17011
h,,llh,,llh,,,,,Ih,,lll,,,Ihl,,,,Ih,,,ll,,,Ihhl,,I,,ll
ASS UTUAI,
BENEFIT
MANAGEMENT
ACCOUNT
Page 1
PRIMARY STATE~4ENT
ACCOUNT NLH~BER CLOSING DATE
TAX ID NO: 052-26-2687
BENEFIT MANAGEMENT ACCOUNT NO.
LAST STATEMENT . TOTAL AMOUNT ] NO. I TOTAL AMOUNT
14,153.87 1.55 ......... J-'"~
ACCOUNT ~%%NS~CTZONS
DAT~ ........... AMOUNT ............. BALANCE... DESCRIPTION
0~/06 1.55 14,15~.42 CREDIT-INTEREST
06/06 14,155.42- 0.00
RATE HISTORY
DATE ............ RATE
05/21 0.250%
820088498
BALANCE
THIS STATE~4ENT
WITHDRAWAL-CLOSING-CHECK
CLOSEOUT-TREA~ CK
DATE ............ RATE
****** CURRENT INTEREST RATE
****** INTEREST CREDITED YEAR-TO-DATE
0.250% ******
16.17 ******
MINIMIIMBALANCE REMINDER
IF YOUR ACCOUNT FALLS BELOW $1,000, IT WILL CLOSE AUTOMATICALLY.
BALANCE + INTEREST WILL BE SENT TO YOU IMMEDIATELY AFTER THE
20TH DAY OF THE FOLLOWING MONT~.
********** END OF STATEMENT **********
NOTICH: See reverse sl~e fcr reconciliation of thls saatem~n= and Xm~ortant information. 789-~2
3400 Hartzdale Drive at Capital City Mall Drive · Camp Hill, PA 17011 · Phone (717) 761-0600
NANCY F. JUMPER ESTATE
RECAP OF INVENTORY OF PERSONAL PROPERTY
S SENTIMENTAL VALUE ONLY
N NORMAL
O OLD, NOT ANTIQUE
A ALMOST NEW
V VARIES
B BROKEN, POOR CONDITION
QTY DECSRIPTION
CODE
ESTIMATE
OF VALUE
40
20
2
12
8
2
24
2
15
2
3
2
9
PLASTIC CHRISTMAS TREE
WAFFLE IRON
WOODEN CHILDREN'S DESK AND CHAIR SET
DESK LAMP
PORTABLE FAN
HEAVY DUTY PLASTIC 3 SHELF SHELVING
MISC BOOKS
MISC. CHRISTMAS DECORATION
VAPORIZER
FOOD PROCESSOR
VINYL LUNCH BOXES
MISC. CHILDREN'S BOOKS
CURTAINS, SETS
STANDING FLOOR LAMP
JIGSAW PUZZLES
BOARD GAMES
PURSE - CROCHETED
"BELT" PURSE
WALL PICTURES & FRAMES
FAMILY MEMORABILIA, MISC. "KNICK KNACKS"
PILLOWS
IMITATION LEATHER "BRIEFCASE"
SUITCASE, CLOTH
WICKER BASKET
ELECTRIC HAIR DRYER
SEWING MACHINE
FOLD-UP CARD TABLE
CALLER ID BOX
CHEAP PLASTIC DESK PHONE
BATTERIES, ASST SIZES (POSSIBLY DEAD)
"CROSS" PENS (DIFFERENT MANUFACTURER)
METAL FOLDING CHAIRS
APPROX. 3' x 3' WOODEN COFFEE TABLE
13" SHARP COLOR TELEVISON
ONEIDA SILVERWARE SET
DECORATIVE ALUMINUM HOTPLATE
METAL LAPTOP TV TRAY
13" MIKASA CHRISTMAS CAKE SERVER (GLASS)
BASIC FIRST AID KITS
PLASTIC HAIRBRUSHES AND COMBS
N
O
O
N
N
A
V
V
N
N
N
N
N
N
N
N
N
N
N
S
N
N
O
N
O
O,B
O
N
N
N,B
A
O
N
N
O
N
O
N
N
N
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
1.00
5.00
5.00
3.00
3.00
20.00
10.00
2.50
3.00
10.00
2.00
2.00
10.00
5.00
0.50
1.00
0.50
0.50
1.00
2.00
2.00
2.00
0.50
2.00
5.00
0.25
1.00
5.00
15.00
2.00
20.00
5.00
5.00
0.50
5.00
1.00
0.25
12
2
10
2
24
18
12
9
24
6
3
6
4
2O
5
2
12
14
2
60
24
8
24
TOOTHBRUSHES, UNOPENED IN BOX
TOOTHPASTE TUBES, UNUSED
RUBBER ICE BAG
BATH SPONGE
MISC. FIRST AID, GAUZE, BANDAGES,ADHES. TAPE
SCENTED DECORATIVE CANDLE, UNUSED
CLOTH PLACEMATS (SETS OF 6 AND 4)
HAND MIRRORS
CLOTH WASHCLOTHES
BATH TOWELS
HAND TOWELS
CLOTH DISH TOWELS
PAPER PLACEMATS
TABLECLOTHS
BEDSHEETS
PILLOWCASES
HANDMADE AFGHAN
60 WATT LIGHT BULBS
STYROFOAM BOWLS & CHINETTE PLATES
PLASTIC BOWLS
ROOM DEODIRIZERS
WAX CANDLES
14" x 7" TUPPERWARE CONTAINER
BOX OF FACIAL TISSUES
BOXES OF PLASTIC STORAGE BAGS
CURTAIN RODS, 2 PIECES FOR I WINDOW
CHEESECLOTH "DUSTER", 2 FT WOODEN HANDLE
JACK STRAWS GAMES/BLOCKS
POSSIBLE ANTIQUE, BUT PICES ARE BROKEN
AND MISSING
POTHOLDERS
MISC. PAPER ART SUPPLIES
METAL SERVING PLATTER
ASST. PAPER & PLASTIC PICNIC SUPPLIES
METAL COOKIE CUTTERS, CLOSE TO BEING "ANTIQUE
CERAMIC PLATES
SMALL CERAMIC CROCK
SMALL GLASS CANDY JAR
SMALL METAL BOOKCASE, 3 SHELF
MISC. HARD AND SOFCOVER BOOKS
HANGERS
ROLLS CHRISTMAS WRAP, 2 UNUSED
ELDON JUMPER'S RETIREMENT PLAQUE
ELDON JUMPER'S FRAMED B.S. DEGREE
US STATE QUARTERS AND MISC. COINS
STEREO EQUIPMENT (PARTS?)
CLOCK RADIO
50' COAXIAL TV CABLE
MICROSONICS BIRD CALL PHONOGRAPH SET
PAPER NOVELTY BEVERAGE NAPKINS
FAMILY PHOTOS
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
O
N
O
N
O
N
O
N
N
N
O
N
N
N
S
S
N
B
O,B
A
N
N
S
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
1.00
2.00
0.50
1.00
0.50
3.00
1.00
1.00
5.00
2.00
1.50
0.25
3.00
5.00
2.00
5.00
4.00
1.00
2.00
1.00
2.00
1.00
0.25
3.00
0.25
0.25
1.00
1.00
5.00
3.00
20.00
2.00
0.50
1.00
5.00
5.00
0.25
1.00
19.50
5.00
0.50
100
200
3
100
2
20
48
ASST. MEMORABILIA(LIGHTER, COIN BANK,
NOVELTY ITEMS)
WOODEN ROCKING CHAIR
2 DRAWER METAL FILING CABINET
CASIO FA2650A ADDING MACHINE
3 PIECE WOODEN DESK UNIT
WHITE ENVELOPES
JASON MODEL 26F BINOCULARS
4 ROLLS ADDING MACHINE TAPE
RADIO SHACK EC3027 ADDING MACHINE
ZENITH RADIO
LOW POWER FIELD/OPERA GLASSES
ASSORTED HARDCOVER ATLASES
NOTEBOOK PAPER AND GRAPH PAPER
CLIPBOARD
3 DOZEN 1.5 VOLT WATCH BATTERIES
HI-Q "HEXED" GAME
RADIO SHACK OUTDOOR THERMOMETER
BOSTON ELECTRIC PENCIL SHARPENER
LINT BRUSH
65 YR OLD BIBLE PICTURE CARDS
SWISS ARMY KNIFE
METAL JOHN WEITZ BRAND MEN'S WATCHBAND
WEBSTER'S DICTIONARY
PORTABLE ALARM CLOCK/RADIO
COLORED MEAD FILE FOLDERS
SMALL PRINTS OF PAINTINGS
APRIL 2002 SPRINT PHONEBOOK
FRAMED "MUTSS" COMIC STRIP
BLOOD PRESSURE MONITOR
UNOPENED "PILOT" PEN
SELF-UPDATING ELECTRONIC CLOCK
s $
o $ 5.oo
O $ 4.00
O $ 1.00
O $ 25.00
N $ 2.00
N $ 5.00
N $ 1.00
O $ 1.00
O.B $ -
O $ -
O,B $ 2.0O
N $ 0.50
0 $ 0.25
N $ 2.00
O $ 0.25
N $ 1.50
O $ O.25
N $ 0.25
B $ 3.00
A $ 10.00
N $ 1.00
O $ 2.OO
O $ O.5O
a $ 3.00
O $ O.25
N $
N $ 0.25
N $ 10.00
N $ 0.50
N $ 5.00
BOXED FOOD
ASST CLEANING SUPPLIES, SPRAY CONTAINERS ETC...
KITCHEN UTENSILS -
MICROWAVE OVEN
IRON
$ -
$ 40.00
4 CUPS,2 TEAPOT, 2 GRAVYBOAT, 2SMALL PLATTER, 3 WICKER BASKET,
3 PLASTIC BOWL,PIE PLATE, GRINDER, OJ SQUEEZER, SIFTER, NUT
CHOPPER, METAL GRATER, JAR OPENER, 4 PIE PAN, 30 COOKIE CUTTER,
THERMOS, 4 PLASTIC PITCHER, 2 CERAMIC PITCHER, SERVING BOWL,
TOOTHPICKS, ROLLING PIN, 10 CANDLE(USED), METAL PAIL, 8 POTHOLDER
KNIVES, FORKS, SPOONS, 12 POTS, 6 MIXING BOWLS, 3 CASSEROLE
DISH, 2 MUFFIN PAN, 2 STRAINER, 2 FRYING PAN, PAPER TOWEL HOLDER,
50 STORAGE CONTAINER, 3 DISH HOLDER, 2 DEVILED EGG HOLDER,
FRYING PAN, 3 PLATTER, 24 BOWL, 19 CUP, 30 PLATE, BUTTERDISH,
SUGAR AND CREAM CONTAINERS, ELECTRIC CAN OPENER, BLENDER,
COOKIE SHEET, 10 COOKING KNIFE, 6 SPOONS AND SPATULAS, 3 HAND
CAN OPENER, ASST HAND UTENSILS, 10 BAKING PAN, 2 COOKIE RACK
10 MEASURING CUP, 20 COOKING PAMPHLET, 4 GLASS COASTER
N $ 7.00
N $ 3.00
6
2O
2
MIXERS N $ 3.O0
WOODEN TABLE AND CHAIRS, ALMOST ANTIQUE O $ 75.00
WOODEN DESK O $ 20.00
BATTERY POWERED WALL CLOCK N $ 1.00
LIGHTBULBS AND MATCHES $
MARBLES, PUZZLE BOOKS, JIGSAW PUZZLE, N $ 1.00
WOODEN STEP STOOL O $ 1.00
TELEPHONE N $ 4.00
PLAYING CARDS AND DICE N $ 1.00
ASST. OFFICE SUPPLIES- PENS, TAPE, NOTECARDS, PENCIL N $ 2.00
3 SCISSORS
SHOELACES, BATTERIES, NAIL CLIPPERS O, B $
DUST BUSTER N $ 2.00
TOASTER N $ 2.00
17 NYLONS, 2 WASHBAG, STRING, BRAS, GIRDLES, SOCKS $
15 HEAVY BLANKET, 5 SHEET, 4 PILLOWCASES,3 HOMEMADE N $ 18.50
3 LIGHT BLANKET
PANASONIC PHONE N $ 7.00
ELECTRIC BLANKET N $ 1.00
US FLAG N $ 5.00
CLOTH SUIT CARRIER N $ 1.50
11 DRESSER COVER, 6 TABLECLOTH, 6 CROCHETED RESTS, N $ 8.50
6 DRESSER MAT, CHAIR BACK COVERS
DRESS, 21 SWEATER, CROCHETED SHAWL, 14 LONGSLEEVE N $ 35.00
JACKET, 26 T-SHIRT, 4 LIGHT PANTS, CAMISOLE, 7 HOUSECOAT, 9 PAJAMA
SLIP, SLIPPERS, 20 BELT, 10 SCARF, 2 NEW GLOVES, 3 OLD GLOVES, 3
SWEATSHIRT, 6 PANTS, 50 BLOUSES, DRESSES & SHIRTS
ASST BABY CLOTHES N $ 2.00
CEDAR CHESTS (CLOSE TO BEING ANTIQUE) O $ 40.00
LAMP N $ 11.00
STUFFED CAT A $ 5.00
4 APRON, 11 HANKERCHIEF, LEG WARMERS, 3 BABY BIB, N $ 4.00
SAFETY PINS, 2 TINS, BUTTONS, SMALL WICKER BASKET, SE N $ 4.50
AND SUPPLIES, BACKSCRATCHER, SHOEHORN,7 COMBS AND BRUSHES,
NAIL KIT,7 PURSE, 2 COIN PURSE
MEDALLION, DIPLOMA AND PHOTO, PLATES PAINTED BY CHI S $
ASST COSTUME JEWELRY, CAMEO, 3 PINS N $ 8.00
TRAVEL ALARM N $ 1.00
PILLOW N $ 2.00
MIRROR O $ 2.00
HIGHBOY DRESSER O $ 40.00
PLASTIC COOLER N $ 1.00
NECKTIE O $ 0.50
VACUUM CLEANER N $ 10.00
"BROWNIE" CAMERA O $ 11.00
BOY SCOUT MEMORABILIA, OLD BOWLING SHOES S $
5 BASKET, MUG, HANGERS, HAT, SHOESHINE KIT, WRAPPING N $ 3.00
PAPER CUPS AND PLATES,2 WOOD BOX, DOG STATUE, JAR, FABRIC
MILKCAN O $ 1.00
SUITCASE SET N $ 3.00
MISC.MEDICINE CABINET ITEMS - OINTMENT, LOTION, ETC... $
2
13
24
40
2
PLASTIC TRASH CAN $ 0.25
MISC. BATHROOM CLEANING SUPPLIES $
ENCLOSED CAT LITTERBOX $ 5.00
SOAP, SHAMPOO $ _
3 WOMEN SUNHAT, LONDON FOG JACKET LINER, 5 SWEATER, 2 RAIN JACK $ 15.00
8 WINTER COAT, 6 SPRING JACKET, 2 PAIR WOMEN'S BOOTS, 1 PAIR MEN'S
BOOTS, 10 WINTER SCARF, 6 WINTER HAT, 16 PAIR GLOVE AND MITTEN,
STADIUM CUSHION AND COVER N $ 0.25
MOUNTED US FLAG, SMALL US FLAG O $ 1.00
LAWN CHAIR N $ 1.00
MINI UMBRELLA N $ 4.00
WOODEN TOY CHEST O $ 5.00
SIDEWALK CHALK $
PLASTIC PLANT POT N $ 1.50
ALUMINUM EXTENSION LADDER O $ 3.00
ALUMINUM STEP LADDER N $ 3.00
2HP ELECTRIC EDGER N $ 10.00
ELECTRIC HEDGE TRIMMER N $ 10.00
PAINT & PAINTING SUPPLIES N $ 5.00
2 GARDEN RAKE,PRUNING CLIPPERS, AXE,2 BROOM, 2 SNO O,N $ 3.00
3 METAL TRASH CAN, 1 HEAVY PLASTIC TRASH CAN N $ 3.00
BIRD FEEDER N $ 5.00
50' ELECTRIC EXTENSION CORD N $ 3.00
SNAPPER LAWN MOWER N $ 25.00
SPREADER N $ 10.00
1 SET PVC LAWN FURNITURE N $ 25.00
GARDEN HOSE N $ 1.00
METAL GAS CAN N $ 0.25
PLASTIC BUCKET N $ 0.25
MISC. STORAGE CONTAINERS N $ 1.00
METAL TOOL CABINET O,B $ 1.00
ASSORTED HAND TOOLS N $ 3.00
ASST. HOUSE CLEANING SUPPLIES $
MAILBOX O $ 0.50
CARD TABLE O $ 0.25
ASST. MEMORABILIA, KNICK-KNACKS, BOOKS, CHURCH BULL S $
WALL PICTURE AND FRAME O $ 1.00
WOODEN ROCKING CHAIR, CLOSE TO ANTIQUE O $ 5.00
METAL TV TRAY W/FOLDING LEGS O $ 1.00
LA-Z-BOY RECLINER O $ 10.00
PLASTIC MILK CRATE N $ 1.00
SOFA - FOLD OUT BED N $ 25.00
CROCHETED MORSE COAT OF ARMS S $
SMOKE ALARM N $ 1.00
DECORATIVE DESK LAMP O $ 10.00
SMALL WOODEN TABLE O $ 2.00
2 SHELF WOODEN BOOKSHELF O $ 3.00
ASST. BOOKS, BIBLES O,S $ 5.00
PURSE N $ 0.50
LAUNDRY BASKET N $ 0.25
COFFE TABLE - CERAMIC TOP O $ 3.00
2
3
250
18 TAPE VIDEO TAPE HOLDERS
10 ORIGINAL VIDEOCASSETTES, 30 "RECORDED" VIDEO CAS
FLASHLIGHTS
RECORD CABINET
RECORDS - EST. 150 OUT OF PRINT IN GOOD CONDITION
25" RCA COLOR TV WITH REMOTE
QUARTZ LADIES WRISTWATCH
OLD REFRIGERATOR
OLD WASHER AND DRYER
N
N
N
N
O,N
N
N
$
$
$
$
$
$
$
$
$
$
2.00
10.00
3.00
5.00
75.00
50.00
5.00
25.00
100.00
1,238.75
REV~1510 EX + (1-97X1}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF NANCY F. JUMPER
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER 2103-0055
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF DECD'S
TAXABLE
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH INTEREST EXCLUSION VALUE
NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET (IF APPLICABLE}
1. James R. Jumper, Trustee of Nancy F. Jumper Irrevocable Trust dated June
~7, 2002 - Real estate - 15 Rockaway Drive, Lower Allen Township,
iCumberland County, Pennsylvania - transferred by deed dated June 7, 2002 $104,500.00 100.0% $3,000.00 $101,500.00
2. Nancy F. Jumper Irrevocable Trust dated June 7, 2002 - cash transferred on
June 14, 2002 $230,937.61 100.0% $230,937.61
TOTAL (Also enter on line 7, Recapitulation) $332,437.61
(If more space is needed, insert additional sheets of the same size)
EV-1511 EX + (1-97Xl)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF NANCY F. JUMPER
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER 2103-0055
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
5.
6
7.
8.
9,
FUNERAL EXPENSES:
James R. Jumper - reimbursement for dinner after funeral
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) James R. Jumper
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address 226 First Street
168-56-6422
City Lemoyne State PA Zip 17043
Year(sl Commission Paid:
Attorney Fees - Rupp and Meikle (estimated)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Register of Wills, Probate, Letters, Short Certificates
Tax Return Preparer's Fees
Patriot News - Advertising Estate
Cumberland Law Journal - Advertising Estate
Register of Wills o Filing Inventory and 1500 Return
Notary Fees
Appraisal Solutions - real estate appraisal
Zip
- Samuel Barbush - 2002 1040 and PA 40
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$179.00
$2,345.00
$4,400.00
$110.00
$375.00
$182.05
$75.00
$28.00
$15.00
$275.00
$7,984.05
NANCY F. JUMPER
1500 INHERITANCE TAX RETURN
SCHEDULE H
ITEM 2 - ATTORNEY'S FEES
EXPLANATION
A substantial part of the legal fees were incurred in working out a
Family Settlement Agreement by and among the children of the Testatrix
REV-1512 EX + (1-97Xl)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF NANCY F, JUMPER
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIESr & LIENS
FILE NUMBER 2103-0055
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
2.
3,
4.
5.
6.
7.
8.
9.
National City Bank - credit card balance
Eye Care Plus - eye exam
UGI Utilities - gas services
Pa. American Water Co. - water services
Verizon - telephone services
PPL - electric services
Comcast Cable - cable tv services
David Jumper - caretaker fee for residence
Cleve Frederickson Ubmry - balance of pledge
Bonnie Miller, Treasurer - 2003 real estate taxes - local and county
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$123.16
$10.00
$96.37
$43.67
$181.28
$190.67
$113.49
$200.00
$2,000.00
$400.55
$3,359.19
REV-1513 EX + (9-00))
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF NANCY F. JUMPER
FILE NUMBER 2103-0055
NUMBER
L
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
David Lee Jumper
15 Rockaway Drive
Camp Hill, PA 17011
Joyce Eileen Kreuter
519 McBath Street
State College, PA 16801
Amy Carol Zullo
814 Hummel Avenue
Lemoyne, PA 17043
By Will
By Irrevocable Living Trust
By Will
By Irrevocable Living Trust
By Will
By Irrevocable Living Trust
James Richard Jumper By Will
226 First Street By Irrevocable Living Trust
Lemoyne, PA 17043
~opy of dlspositive pages and signature page of Nancy F. Jumper In'evocable
Living Trust attached.
Son
D~ughter
Daughter
~on
1/4 personal property
1/4 residue of trust
1/4 personal property
1/4 residue of trust
1/4 personal property
1/4 residue of trust
1/4 personal property
1/4 residue of trust
:NTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$0.00
(If more space is needed, insert additional sheets of the same size)
NANCY F. JUMPER
IRREVOCABLE TRUST AGREEMENT
THIS TRUST AGREEMENT is entered into on the date set forth on the signature
page hereof, by and between NANCY F. JUMPER of 15 Rockaway Drive, Camp Hill,
PA 17011, as Settlor, and JAMES R. JUMPER of 226 First Street, Lemoyne, PA 17043,
as Trustee.
ARTICLE I TRUST PROPERTY
The Settlor has heretofore transferred and delivered or will transfer and deliver
to the Trustee, without consideration, the property described in Schedule A attached
hereto. Additional property, real or personal, or any interest therein, acceptable to
the Trustee, may be transferred to this trust by the Settlor or any other person. The
Trustee agrees to hold, manage, and distribute the property described in Schedule A
and all other property hereafter received (the "Trust Estate"), in trust, as hereinafter
provided. This Trust shall be known as the NANCY F. JUMPER IRREVOCABLE TRUST.
A. During the Settlor's Lifetime. The income of this Trust shall be paid to the
Settlor for and during her life, at such times as elected by her, but she shall elect to
take the Trust income or not to take the Trust income, at least annually.
B. Prohibition Against Distributions of Corpus to Settlor. Notwithstanding anything
contained in this instrument to the contrary, and without exception of any kind or
nature, Settlor hereby renounces all interests, either vested or contingent, including
reversionary interests and possibilities of reverter, which Settlor might at any time
otherwise be held to have in the corpus of any trust hereunder and, except as
otherwise provided herein, Trustee is not authorized to make distributions of the
corpus of this Trust to Settlor, directly or indirectly.
C. Division of Trust Into Separate Shares Upon Death of Settlor. Upon the death of
the Settlor, the Trustee shull divide the balance of the trust estate (and any additions
thereto from any source) into separate equal shares as follows:, one (1) such equal
share shall be paid to each child of Settlor then living and one (1) such equal share
shall be set aside for each group composed of the living issue of a deceased child of
Settlor on the principle of representation.
D. Each share for the children of a predeceased child of the Settlor shall be held in
separate and discrete Trusts for his or her maintenance, education, health and
welfare. Such part or parts of the income and/or corpus of the Trust may be paid to
or for the benefit of each such child and such part or parts of the income which are
not so paid shall be accumulated and made a part of the corpus of the Trust.
At the time each child attains the age of 22 years, he or she shall receive one-half of
the balance of his or her Trust corpus and at the time such child attains the age of 26
years he or she shall receive the balance of his Trust corpus together with any
accumulated and undistributed income, at which time his or her Trust shall
terminate.
ARTICLE II DISTRIBUTIONS OF CORPUS
The Trustee shall have the discretion to distribute corpus to or for the benefit
of the children of the Settlor for support, health, education and maintenance, taking
into consideration the value of the Trust estate, the relative needs of each
Beneficiary, and any other factors the Trustee believes to be relevant.
The Trustee may make distributions to any one or more of the Beneficiaries.
No Beneficiary shall have any ascertainable right, title or interest to any portion of
the Trust estate, whether determined actuarily or otherwise and the Trustee shall
have the discretion to completely withhold distributions from any one Beneficiary.
Any distributions made shall be charged to the Trust estate as a whole and shall not
affect the amount distributed to any Beneficiary upon termination of the Trust.
A Trustee - Beneficiary may not make distributions to himself / herself for any
reason without the approval of all of the other then living Beneficiaries and if there
are no other then living Beneficiaries, without the approval of a Trust Officer of a
bank in the Harrisburg, PA area.
ARTICLE III CERTAIN DISTRIBUTIONS AND MANAGEMENT OF CERTAIN ASSETS
A. Instruction About Qualified S Corporation Trust. The purpose of this instruction
is to be sure that if any trust the Trustee creates under this document holds stock in
one or more S Corporations, that trust will qualify as a Subchapter S Trust under
Code Section 1361 as it then exists or is amended.
Therefore, if any trust under this document becomes the owner of any stock in
an S Corporation, the Trustee of that trust shall follow the provisions of that trust to
the extent those provisions are not inconsistent with this instruction; and regardless
of any other provisions of that trust, the trustee shall follow these instructions to
preserve the trust's qualification and to prevent the corporation from losing its S
status:
There shall be only one income beneficiary of that trust.
All income of that trust (within the meaning of Code Section 643(b))
shall be distributed to the beneficiary thereof at least annually.
The Trustee's distribution, if any, of the trust's principal shall be to only
the income beneficiary during that beneficiary's lifetime.
2
TRUSTEES' SIGNATURE
IN WITNESS WHEREOF, the parties hereto have execUted and delivered this Trust in
Camp Hill, Cumberland County, Pennsylvania.
Trustee
SETTLOR'S SIGNATURE
The undersigned Settlor certifies that she has read the foregoing Agreement and
Declaration of Trust, and that it correctly states the terms and conditions under which
the Trust Estate is to be held, managed and disposed of by the Trustee. The
undersigned Settlor approves of this Trust in all particulars and requests the Trustee
to execute it.
At Camp Hill, Cumberland County, Pennsylvania.
Nancy F. Jumpe~,~Settlor
WITNESSES
The above Instrument was executed in our presence by the Trustee and the Settlor.
~. l
Witness
Date:?)
Witness
16
Register of Wills
Cumberland
INVENTORY
County,
Pennsylvania
Estate of Nancy F. Jumper No. 2103-0055
also known as Date of Death JanuarY6, 2003
, Deceased Social Secudty No.: 052,26-2687
Personal Representative(s) of the above Estate, deceased, vedfy that the items appearing in the following inventory include all of the personal assets
wherever situate end all of the real estate 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 th 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 vedfy 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.
I.D. No.: 01597 J,-, R. JUMPER, TOR
Address 355 N 21't St., Ste. 205 Dated
camp Hill, PA 17011
717~761,3459
Telephone:
Legacy Bank Certificate of Deposit - No. 100078856
Susquehanna Valley Federal Credit Union
Sharo Account No. 90300
Share Account No. 356300
Description
PNC Bank Checking Account No. 5140032502
Massachusetts Mutual Benefit Management Account No. 820088498
1999 Chevrolet Lumina
Household Property
Susquehanna Valley Credit Union Insurance Death Benefit
Total from Continuation Page(s)
(Attach additional sheets if necessary)
Total:
Value
$15,079.60
$490.57
$5,157.89
$3,932.13
$14,139.83
$6,999.00
$1,238.75
$490.47
$0.00
$47,528.24
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal representative, include the value of
each item, but such figures should not be extended into the total of the Inventory.
BUREAU OF TNDZVZDUAL TAXES
INHERITANCE TAX DZVZSTON
DEPT. 280601
HARRISBURG, PA 17118-0601
CONHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT~ ALLO#ANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-1647 EX AFP (gl-B6)
HERBERT G RUPP JR ESQ
RUPP & HEIKLE
$55 N 21ST ST STE 205
CANP HILL
PA 1701"1
DATE 10-27-2005
ESTATE OF JUHPER
DATE OF DEATH 01-06-2005
...~FILE NUNBER 21 05-0055
'~]COUNTY CUHBERLAND
ACN 101
I Amount Rem/fred
CUT ALONG THIS LINE
NANCY
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAHD CO COURT HOUSE
CARLISLE; PA I70I$
RETAIN LOWER PORTION FOR YOUR RECORDS 4
REV-1547 EX AFP (01-03) NOT/CE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF JUHPER NANCY F FILE NO. 21 03-0055 ACN 101 DATE 10-27-2003
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rea1 Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (5)
4. Hortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expanses/Adm. Costs/Hisc. Expanses (Schedule H) (9)
10. Debts/Nortgage LiabLlities/Liens (Schedule I) (10)
11. Total Deductions
12. Nat Value of Tax Return
~7~037.77
.00
.00 NOTE: To insure proper
.00 credit to your account,
.00 submit the upper port,on
.00 of this form ~ith your
tax payment.
7,98~.05
3.359.19
(ll) 11 .~.Z~
(12) 368,132.
ASSESSNENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rata
17. Amount of Line 14 at Sibling rata
18. Amount of Line 14 taxable at Collateral/Class B rata
19. PrLncipel Tax Due
TAX CREDITS:
PAYHENT RECE/PT DISCOUNT (+J
DATE NUHBER ~NTEREST/PEN PAID (-)
0~-0~-2003 CD002396 828.30
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDIT/ONAL INTEREST.
15.
14.
NOTE:
reflect figures that include the total of ALL returns assessed to date.
(is) .00 x O0 = .00
(16) 368,13Z.lq x OqS= 16,565.95
(17) . O0 x 12 = .00
(18) .00 x 15 = .00
(19)= 16,565.95
AHOUNT PAID
15,950.00
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J} (13) . O0
Nat Value of Estate Subject to Tax (14) 368,131. lq
Zf an assessment was issued prev/ously, lines 1~, 15 and/er 16, 17, 18 and 19 w111
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
16,778.30
212.35CR
.00
212.35CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR ZNSTRUCTZONS.)
332~R37.61
(8) 379,R75.38
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December ZZ, 1981 -- if any future interest in the estate Js transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rata on any such future interest.
To fulfill the requirements of Section 110,0 of the Inheritance and Estate Tax Act, Act Z$ of Z000. (71 P.S.
Section 910,0).
Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available et the Office
of the Register of Hills, any of the Z$ Revenue District Offices, or by calling the special g0,-hour
ansaaring service far forms ordering: 1-800-:561-1050; services for taxpayers eith special hearing end / or
speaking needs: 1-800-q0,7-:5010 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disalloeance cf deductions, ar assessment
of tax (including discount or interest) as shown on this Notice must object aithin sixty [60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17128-1011,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of IndividuaI Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1SO1) for an explanation of administratively correctable errors.
If any tax due is paid within three (:5) calendar months after the decadent's death, a five percent (5Z) discount of
the tax paid is alloeed.
The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you advid 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, 1981 bear interest at the rate of
six (6X) percent per annum calculated at a daily rate of .000160,. Ali taxes which became delinquent on and after
January 1, 1981 mill bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through 200`5 ere:
Interest Daily Interest Daily Tnterast Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 207' . 00050`8 1987 97, . 00020,7 1999 71 · 000192
198:5 16Z .0000,38 1988-1991 llZ .goo`sOl 2000 8Z .000219
1980, 117, .000:501 1991 9Z .00020`7 ZOO1 97, .00020`7
1985 1:51 .000:556 199:5-1990, 72 .000192 ZOOZ 61 .000160`
1986 101 .000270` 1995-1998 9X .00020`7 200:5 5Z .0001'57
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY ZNTBREST 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 the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TNHERTTANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX AFP (0]-05~
HERBERT G RUPP JR ESQ
RUPP & HEIKLE
555 N 21ST ST STE 205
CAMP HILL PA 17011
DATE 12-01-2005
ESTATE OF JUMPER
DATE OF DEATH 01-06-2005
FILE NUHBER 21 05-0055
COUNTY CUHBERLAND
ACM 101
Amount Remitted
NANCY
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, submit the upper port/on of this form w/th your tax payment.
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1607 EX AFP C01-05)
INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF JUHPER NANCY F FILE NO. 21 05-0055 ACN 101 DATE 12-01-2005
THIS STATENENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-27-2005
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
16,565.95
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
~ 828.50
04-04-2005
11-12-2005
CD002596
REFUND
.00
IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CE},
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR [NSTRUCTIONS.
15,950.00
212.35-
TOTAL TAX CREDIT 16,565.95
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
HERBERT G. RUPP, JR.
RICHARD C. RUPP
ANN MEIKLE ERIKSSON (1954-82)
LAW OFFICES
RUPP AND MEIKLE
A PROFESSIONAL CORPORATION
355 NORTH 21ST STREET, SUITE 205
tAMP HILL, PA 17011
(717) 761-3459
E-MAIL: RUPPLAW I~AOL.COM
April 14, 2004
MAILING ADDRESS
P.O. BOX 395
CAMP HILL, PA 17001-0395
TELEFAX: (717) 730-0214
Ms. Glenda F. Strausbaug
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re:
Dear Ms. Strausbaug
Please find enclosed original and copy of Status Report Under Rule
6.12 for the above-referenced Estate.
Please file the original and return the time-stamped copy to me in the
enclosed self-addressed stamped envelope.
Thank you.
HGR/lin
Enclosures (3)
Yours sincerely,
~upp, Jr.
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
Nancy F. Jumper
Date of Death
Will No.:
Admin. No.:
21-03-0055
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:
State whether administration of the estate is complete:
Yes X No
If the answer is No, state when the personal representative reasonably believes the administration
will be complete:
3. If the answer to No. 1 is Yes, state the following:
ao
Did the personal representative file a final account with the Court?
Yes No X
bo
Co
The separate Orphans' Court No. (if any) for the personal representative is:
Did the personal representative state an account informally to the parties in interest9
Yes ~ No - '
do
Copies of receipts, releases,joinders and approvals of form or informal accounts maybe filed
with the Clerk of the Orphans' Court and may be attached to this report.
Previously filed on
Date:
4/14/04
Herbert G. Rupp, Jr., Esquire
Name (Please type or print)
355 N 21st St., Ste. 205, Camp Hill, PA 17011
Address
170. 717-761-3459
Telephone Number
-~¢E
Capacity:
Personal Representative
X Counsel for personal representative
EXHIBIT D
Savings Bond Calculator Page 1 of 3
'12/2002
Bond
Series
Denomination
t4soo
Serial Number
# Bonds To~! Price To~l Interest
31 $9,600.00 $25,871.04
Issue
Serial Number Issue Date Series Denom Price
57262407 01/1989 EE $500 $250.00
57262406 01/1989 EE 500 250.00
57262405 01/1989 EE 500 250.00
57262404 01/1989 EE 500 250.00
57262403 01/1989 EE 500 250.00
57262402 01/1989 EE 500 250.00
57262401 01/1989 EE 500 250.00
57262400 01/1989 EE 500 250.00
57262399 01/1989 EE 500 250.00
57262398 01/1989 EE 500 250.00
57262397 01/1989 EE 500 250.00
57262396 01/1989 EE 500 250.00
75408773 01/1989 EE 1,000 500.00
75408772 01/1989 EE 1,000 500.00
75408771 01/1989 EE 1,000 500.00
75408770 01/1989 EE 1,000 500.00
75408769 01/1989 EE 1,000 500.00
75408768 01/1989 EE 1,000 500.00
Issue Date
Interest Value
$289.40 $539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
289.40 539.40
578.80 1,078.80
578.80 1,078.80
578.80 1,078.80
578.80 1,078.80
578.80 1,078.80
578.80 1,078.80
Total Value YTD Interest
$35,471.04 $1,379.52
Interest Next Final
Rate Accrual Maturity Note
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
4.00% 01/2003 01/2019
file://H:\Glant,%20Ira\Savings%20Bond%20Calculator%20Glant.htm 2/24/2003
Savings Bond Calculator Page 2 of 3
214675294 03/1976 E
214675293 03/1976 E
214675292 03/1976 E
214675291 03/1976 E
214675290 03/1976 E
214675289 03/1976 E
214675288 03/1976 E
214675287 03/1976 E
214675286 03/1976 E
212397296 03/1976 E
212397295 03/1976 E
213519366 03/1976 E
213519365 03/1976 E
l [ Viewing Bonds 1-31
200 150.00
200 150.00
200 150.00
200 150.00
200 150.00
200 150.00
200 150.00
200 150.00
200 150.00
500 375.00
500 375.00
1,000 750.00
1,000 750.00
788.56
788.56
788.56
788.56
788.56
788.56
788.56
788.56
788.56
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
938.56 4.00% 03/2003 03/2006
1,971.40 2,346.40 4.00% 03/2003 03/2006
1,971.40 2,346.40 4.00% 03/2003 03/2006
3,942.80 4,692.80 4.00% 03/2003 03/2006
3,942.80 4,692.80 4.00% 03/2003 03/2006
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for
MN Matured (Not Exchangeable for HH)
Please rate this service.
(Please print and/or save this page before submitting your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator ~ C C C'
file://H:\Glant,%20Ira\Savings%20Bond%20Calculator%20Glant.htm 2/24/2003
EXHIBIT E
Joseph James Jewelers
TO WHOM IT MAY CONCERN:
This is to certify that we are engaged in the jewelry busin~es, appraising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day carefully
examined the following listed and described articles, the property of:
NAME: Ira Giant
ADDRESS: 2398 Famham Creek Road Warsau VA 22572
we estimate the value as listed for insurance or other purposes at the current retail value, excluding Federal and other taxes. In making this Appraisal we DO NOT agree to purchase or replace
the ~rticl~.
DESCRIPTION
One United States $3.00 gold piece. The coin is dated 1878 and is in very f'me condition.
The reverse of the coin has lead contamination and a clasp.
Value: $100.00
JAME~,~. I~AVIS P.G.
March 10,2003
The foregoing Appraisal is ma~ ~.~ t~ unders/eaglding thg the Apl~raiser ~sumes go liability ~vith respecl, t0,,ang, ac.4ila~Lmay btxtal~n.~a thg,h,asis o.f..this. ABPraisal.
du-~ast Ma~n btreet * rvlecnamcsDurg, ~ 't /UDD ' t/'~/J/~b-~E~z~
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of [RA B. GLANT
also known as
, Deceased
No. 21-03-0056
Date of Death 12/28/2002
Social Security No. 717 - 10- 6703
IRA B GLANT, Jr.,
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 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 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.
Name of
Attorney: Edmund G. Myers
I.D. No.: 20558
Address: P. O. Box 109
Lemoyne, PA 17043-0109
Telephone: 717/761-4540
Signature: ~ ,(~"~ ~ ~~. ~_
Signature: IRA B GLANT, Jr. ~
Address: 2398 Farnham Creek Road
Warsaw, VA 22572
Telephone: 804/394- 2337
Dated:
Description
(See continuation page(s) attached)
Value
(Attach additional sheets if necessary) Total: ~':~ 265,868.59
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (199Z)
Estate of:
Date of Death:
County:
IRA B. GLANT
12/28/2oo2
Cumberland
INVENTORY
CASH:
ARK Money Market Account held
for the benefit of the IRA
GLANT Trust
C.P. Medical Group - Refund
due to overpayment
Prudential Financial Life
Insurance Policy M06372627
PERSONAL PROPERTY:
One United States $3.00 Gold
Piece dated 1878. Appraised
by Joseph James Jewelers.
STOCKS/LISTED:
2.000 shares American Financial
Group, Inc. Ohio
2,377.580 shares ARK Funds - Value
Equity Instl.
2,540.650 shares ARK Funds INTER FIX
INST
2,548.420 shares ARK Funds Short Term Bd
Ins
6,014.67
23.82
5,644.75
100.00
45.76
17,285.01
26,422.76
25,458.72
11,683.24
100.00
2,572.016 shares ARK Funds US
Government Bonds Ins.
1,336.898 shares ARK FDS - Blue Chip
Inst.
2,159.309 shares ARK Funds Equity Inc.
Ins
2,432.432 shares ARK Funds Eq. Index
Instl
111.919 shares ARK Funds Small Cap.
Instl.
232.739 shares ARK Funds - Mid Capital
Instl.
2,500.000 shares ARK Funds - Income PTFL
159.642 shares Harbor Fund Intl Fd
Instl
126.000 shares Penn Treaty American
Corp.
51.000 shares Wachovia Corporation
2nd New
.26,054.52
16,417.11
17,382.44
17 927.02
1,369.89
2,325.06
26 175.00
4,351.84
220.82
1,866.86
BONDS:
United States Savings Bonds
Series E and Series EE
35,471.04
183,302.81
35,471.04
REAL ESTATE/PA:
9.45 Acres of Real Estate
located on Dark Hollow Road,
Wheatfield Township, Perry
County, Pennsylvania. Deed
dated January 6, 1961 and
recorded in Volume 166 Page
54. Tax Parcel Number:
290,116.00-102~000.
35,311.50
TOTAL RECEIPTS OF PRINCIPAL ...............
35,311.50
265,868.59
-3-
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 003052
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
DUPLICATE
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
........ fold
101 82,328.57
ESTATE INFORMATION: SSN: 717-10-6703
FILE NUMBER: 2103-0056
DECEDENT NAME: GLANT IRA B
DATE OF PAYMENT: 09/24/2003
POSTMARK DATE: 09/23/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 12/28/2002
REMARKS:
TOTAL AMOUNT PAID:
IRA B GLANT JR (EXECUTOR)
C/O EDMUND G MYERS ESQ
82,328.57
SEAL
CHECK# 1009
INITIALS' JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
?-//
BUREAU OF INDTVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z&0601
HARRISBURG, PA 17128-0601
CONHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
EDHUND G MYERS
JOHNSON ETAL
PO BOX 109 ~
LEMOYNE PA 170~
DATE 11-10-2005
ESTATE OF GLANT
DATE OF DEATH 1Z-Z8-ZOOZ
FILE NUMBER 21 05-0056
COUNTY CUMBERLAND
ACN 101
Amount Rea/~ed
REV-1Sgi7 EX AFP C01-03)
IRA B
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THXS L/NE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GLANT IRA B FILE NO. 21 03-0056 ACN 101 DATE 11-10-2003
TAX RETURN NAS: { X} ACCEPTED AS FILED ( } CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~a (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
3. Closely Held S~ock/Par~nership Interest (Schedule C)
~'. Nor~geges/No~es ReceJ. vable (Schedule D)
5. Cash/Bank Deposi~s/Nisc. Personal Proper4:y (Schedule E) (S)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To4:aZ Asse~s
APPROVED DEDUCT]:ONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Cosmos/Misc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gage Llabili'cies/L/ens (Schedule I) (10)
11. To,al Deductions
12. Na~ Value of Tax Re~urn
35/311.50
218,773.85
.00
.00
6,158.q9
.00
NOTE: To insure proper
cred/~ ~o your account,
subm/~ ~he upper portion
of ~h~s fore w/~h your
~ax pay.en~.
5,722.11
1~q19.58
(11) 7.141
(12) 276,691.76
15.
lq.
NOTE:
ASSESSHENT OF TAX:
15. A.oun'l: of L/ne 1~ a~ Spousal ra~a
16. A.oun~ of Line le ~axabZe a~ Lineal/Class A ra~e
17. A.oun~ of L/ne lq a* Sibling ra*a
18. A.oun~ of L/ne lq ~axabla a~ Collateral/Class B ra~a
19. Pr/ncJ )al Tax Due
TAX CREDZTS
PAYtlENT KECEZPT UT$COUNT
DATE NUMBER INTEREST/PEN PA/D (-)
05-28-2005 CD002565 500.00
09-25-2005 CD005052 . O0
INTEREST IS CHARGED THROUGH 11-25-2005
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
(1.;) .00 X O0 = .00
(16) 276,691.76 x 0~5= 12,~51.15
(17) .00 x 12 = .00
(lB) .00 X 15 = .00
(19)= 12,~51.1S
AHOUNT PATD
9,500.00
2,328.57
Char/~able/Govarn.en~al Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0
Ne~ Value of Es~a4:e Sub,ac4: 4:o Tax (lq) 276,691.76
Z~ an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 wlll
reflect figures that include the total of ALL returns assessed to date.
12,328.57
122.56
.97
125.5S
( IF TOTAL DUE 1S LESS THAN $1, NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
25/609.61
(S) 285,855.~5
RESERVATION:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of Z000. (TI P.S.
Section 9140).
PAYHENT=
REFUND (CR):
OBJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which ems not requested on the Tax Return, say ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications are available at the Office
of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour
answering service for fores ordering: 1-800-S6Z-ZOSO; services for taxpayers with special hearing and / ar
speaking needs: 1-800-447-50Z0 (TT only).
Any party in interest not satisfied with the appraisement, elloeanca, or disallowance of deductions, or assessment
of tax (including discount or interest) as sheen on this Notice must object .ithin sixty (60) days of receipt of
this Notice by:
--arittan protest to the PA Department of Revenue, Board of Appeals, Dept. ZalOZl, Harrisburg, PA 171Za-IOZ1, 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 ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Raviea Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone [717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the dacedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax end interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rata of
six (6Z) percent per annum calculated at e daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 mill bear interest et a rate which mill vary from calendar year to calendar year with that rate
announced by the PA Department cf Revenue. The applicable interest rates for 198Z through 2005 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rata Factor Year Rate Factor
198Z ZOZ .000548 1987 9Z .000Z47 1999 7Z .00019Z
1985 16Z .000458 1988-1991 Ill .000~01 2000 8Z .000219
1984 llZ .000501 199Z 9Z .000247 ZOOX 9Z .O00Z47
1985 15Z .000556 1995-1994 72 .O0019Z ZOOZ 6Z .000164
1986 lOX .000274 1995-1998 9Z .000247 ZOO5 5Z .000157
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER 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 shown on the
Notice, additional interest must bo calculated.
LAW OFFICES
JOHNSON, DUFFIE, STEWART g WEIDNER
301 MARKET STREET
P. O. BOX 100
LEMOYNE, PENNSYLVANIA 17043-0109
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
ATTN: CHERYL
,70 i 3+390 i 02 I,,,llh,,lll,,,,,,ll,,Ih,,Ih,,li,ll,,,,,
JERRY R. DUFFIE
RICHARD W. STEWART
C. ROY WEIDNER, JR.
EDMUND G. MYERS
DAVID W. DELUCE
RALPH H. WRIGHT, JR.
DAVID J. LANZA
MARK C. DUFFIE
MELISSA PEEL GREEVY
MICHAEL J. CASSIDY
ROBERT M. WALKER
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
ATTN: CHERYL
Dear Register:
LAW OFFICES
JOHNSON, DUFFLE, STEWART & WEIDNER
i Professional Corporation
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
WEBSITE: www.jdsw, com
TELEPHONE 717-761-4540
FACSIMILE 717-761-3015
E-MAIL mail@jdsw, com
November 21, 2003
Re~
HORACE A. JOHNSON
COUNSEL TO THE FIRM
E-MAIL dlw@jdsw.com
Estate of Ira B. Giant
SSN: 717-10-6703
Date of Death: December 28, 2002
Your File No. 21-03-0056
Enclosed please find Estate Check No. 1014 in the amount of $123.53. This payment represents
additional tax due including interest. Please provide a receipt along with the enclosed copy of this
correspondence, time stamped and returned in the enclosed self-addressed stamped envelope.
Should you have any questions, please do not hesitate to contact our office. Thank you for you
assistance in this matter.
Very truly yours,
/JONSON, ~UFFIE, STEWART & WEIDNER
Legal Assistant
cc: Ira B. Glant, Jr., Executor
:221270
BUREAU OF ZNDZVZDUAL TAXES
INHERXTANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
EDHUND G NYERS
JOHNSON ETAL
PO BOX 109
LENOYNE
PA 170~$
CONNONNEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FZLE NUNBER
COUNTY
ACN
1~-1o-~oo~
GLANT
12-28-2002
21 03-0056
CUMBERLAND
101
REV-l;47 EX AFP C01-03)
IRA
/,~ Amoun* Remi**ed
HAKE CHECK PAYABLE AND REHIT PAYNENT TO:
RESISTER OF WILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17013
RETAZN LOWER PORTZON FOR YOUR RECORDS *~
CUT ALONG THZS LZNE I~*
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 003270
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
fold
ESTATE INFORMATION: SSN: 717-10-6703
FILE NUMBER: 21 03-0056
DECEDENT NAME: GLANT IRA B
DATE OF PAYMENT: 11/24/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 12/28/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $123.53
TOTAL AMOUNT PAID:
$123.53
REMARKS: RECEVIED OF IRA BGLANTIN CO
EDMUND G MYERS, ESQ.
SEAL
CHECK//1014
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Name of Decedent:
Date of Death:
STATUS REPORT UNDER RULE 6.12
IRA B. GLANT
December 28, 2002
Will No. 2003-0056 Admin No.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the Estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
If the answer to NO. 1 is Yes, state the following:
ao
Yes
b.
Did the personal representative file a final account with the Court?
No X
The separate Orphans' Court No. (if any) for the personal
representative's Account is:
parties of interest?
Did the personal representative state an account informally to the
Yes X No
d. Copies of receipts, releases, j oinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Date:
December 10, 2003
Signature
EDMUND G. MYERS
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Capacity: __Personal Representative
(x) Counsel for Personal
Representative
BUREAU OF ZNDTVZDUAL TAXES
TNHERTTANCE TAX DZYZSZON
DEPT. Z80601
HARRTSBURg, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX AFP (01-03)
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
PA 170q3
DATE 1Z-ZZ-200$
ESTATE OF GLANT
DATE OF DEATH 1z-ze-zo02
FILE NUMBER Z1 05-0056
COUNTY CUMBERLAND
ACN 101
Amoun'k Rem ~.'l:'l:ed I
IRA B
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper crmd/~ ~o your account, subm/~ ~he upper por~ion of ~hJs form wi~h your ~ax payment.
CUT ALONG THIS L'rNE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS *~
REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT NN~
ESTATE OF GLANT IRA B F'rLE NO. 21 05-0056 ACN 101 DATE 1Z-II-ZOOS
THTS STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHOWN BELOW
TS A SUMMARY OF THE PRTNCTpAL TAX DUE, APPLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLTCABLE,
A PROJECTED TNTEREST FTGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-10-2005
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
12,q51.15
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
05-28-2005
09-25-2005
11-2q-2005
CD002563
CDOO305Z
CDOO3Z70
500.00
.00
.96-
9,500.00
2,328.57
123.53
ZF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE ZS LESS THAN $1,
NO PAYMENT IS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT"
TOTAL TAX CREDIT
1Z,q51.1q
.O1CR
BALANCE OF TAX DUE
INTEREST AND PEN. .00
TOTAL DUE .01CR
YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS.
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- Zf RESIDENT DECEDENT make check or money order payable to: REGTSTER OF #TLLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMON~/EALTH OF PENNSYLVANTA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). AppZications are available mt
the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Zq-hour
answering service for fores ordering: 1-800-36Z-1050; services for taxpayers with speciaI hearing and / or
speaking needs: 1-800-qq7-5010 (TT only3.
REPLY TD:
questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17126-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (51) discount
of the tax paid is allowed.
PENALTY:
The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, 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 (6Z) percent per annum calculated at a daily rate of .000164. AIl taxes which became delinquent on and after
January 1, 1961 ~ill bear interest at a rate ~hich ~il1 vary from calendar year to calendar year ~ith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z003 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1981 20Z .000548 1987 91 .000247 1999 71 .OOOlgZ
1983 161 .000438 1988-1991 llZ .000301 2000 81 .000219
1984 llZ .000301 1991 92 .000247 ZOO1 92 .000147
1985 132 .000356 1993-1994 72 .O0019Z ZOOZ 62 .000164
1986 101 .000274 1995-1998 92 .000147 ZOO3 52 .000137
--Interest is calculated ms follows:
I'NTEREST = BALANCE OF TAX UNPAI'D X NUMBER OF DAYS DBLI'NQUBNT X DATLY TNTEREST 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 the interest computation date shown on the
Notice, additional interest must be calculated.