HomeMy WebLinkAbout03-0050PETITION FOR PROBATE and GRANT OF LETTERS
also known as
No. /-- 03--,5--O
To:
· Deceased.
Social Security No. gtc,,'.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an,the execut.o~-
in the last will of the above decedent, dated
and codicil(s) dated
Register of Wills for tile
County of C~,.- 6-e r {,~ .~ ,fl
Commonwealth of Pennsylvania
in the
named
,19.__
[-/,~sdo,~J,. rs,'-- e~,ec,.,¥.. - de ce,~..,'e,.~
( t te relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C~ ,'-- ~e.- t"a ~ ~ County, pennsy~
with
h e ~ last family or principal residence at
Decendent, then ¢ ~ years of age, died ///~ / O O 19.
at ' "
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: g' O o G o (< ~ o e o~
$
$
$
WHEREFORE, petitioner(s) respectfully r.eques.t(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~1
COUNTY OF C~,-,.. 6 e .. f'.., ./p ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~ ~-~. ~ ~ ~
~ore me this i 7~ day of [ ~- ~ ~~ ~'
' Register '~ ~
NO. 21-03-50
Estate Of JACQUELINE H. MCINTYRE , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JANUARY 17 ~11~ 20_~_0~, 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 OCTOBER 29, 1981
described therein be admitted to probate and filed of record as the last will of
JAY M. MCINTYRE ;
and Letters TESTAMENTARY
JAY M. MCINTYRE
are hereby granted to
FEES
Probate, Letters, Etc .......... $ 270.00
Short Certificates(5 ) .......... $ 15.00
~ E.X..T.RA...P..A.G.E.S...3. $ 9.00
JCP $ 10.00
TOTAL ~ $ 304.00
Filed ...J.A~..U..A~..Y..1.7. ~..2.0.0.3 ..............
LISA MARIE COYNE, ESQUIRE
ATTORNEY(Sup. Ct.I.D. No.)
3901 MARKET STREET, CAMP HILL, PA 17011
ADDRESS
717-737-0464
PHONE
GAVE LETTERS TO EXECUTOR JANUARY 17, 2002
his is to certi~ that the information here given is correctly copied fi'om an original certificate of death duly filed with me as
Local Registrar. The original certificate will be fm~vardcd to thc State Vital P, ccotds Office for permanent fiJim,
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8911735
No.
Ix)cai Registrar (~
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
Jacqueline W. McIntyre l~male ]~c~,~ ~cu.,'~.u~,~. 5885
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Cumberland I S. Mlddleton I~annr P~ ~=~1~.]- ~E~"~-~'~'~
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~c,ooi 'reacne: ISc~ool ~lsE~ I ~O ~ I~~ I ~ 3,.,~~ ' I
i,,~ ' {,~ {,3 ' ' ,'-~'~ / -~c~ I
500 Gale Rd ~,u~ ,,,.~ Pa. ' ,,,.~ . · S. Hiddieton
Camp Hill, Pa. 17011
~ ,~.~ Cu~b~ianO ~ ~.~
~ow~.'~z.cyre I,F~a~ ~.,~~~,pa
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~,Z'~'..~ %:?-.--~,zuu~ I~ntown Gap Nat. Ceq.annvlll~teDanon Co.
~~~. [~ J~011248 L {~~~nerai Home &C.S Inc
I I'" '' I I I
21-03-50
21-03-50
LAST WILL
OF
JACQUELINE H. MCINTYRE
I, JACQUELINE H. MCINTYRE, of the Township of Hampden,
County of Cumberland, Commonwealth of Pennsylvania, declare
this to be my Last Will and revoke any will or codicil pre-
viously made by me.
ITEM 1: I devise and bequeath all of my estate of every
nature and wherever situate, together with all insurance thereon,
to my husband, JIM E. MCINTYRE, providing he shall survive me
by sixty (60) days.
ITEM 2: Should my husband, JIM E. MCINTYRE, predecease me
or die on or before the sixtieth (60th) day following my death,
I direct that my estate be distributed in the following manner:
(A) I bequeath my automobiles, household and personal
effects and other tangible personalty of like nature (not
including cash or securities), together with any existing
insurance thereon, in equal shares to such of my three (3)
children as survive me. Such property shall be divided
by selection of the children, provided all agree, and as
to any property about which there is no unanimous agreement,
I direct that my executor sell any such property at private
or public sale, and that the proceeds of any such sale be-
come part of my residuary estate.
(B) I devise and bequeath all the rest, residue and
remainder of my estate, of every nature and wherever situate,
together with all insurance thereon, in equal shares, to
my issue, per stirpes.
I~M 3: I direct that in the distribution of my estate, the
share of each of my issue shall be charged with an advancement in
an amount equal to the amount that that particular issue is
indebted to me under any loan agreement, whether verbal or
written.
ITEM 4: Should any of my issue entitled to a share of my
estate not have attained the age of twenty-two (22) years at the
time of distribution to him or her, I devise and bequeath the
share of each such issue to FULTON BANK of Harrisburg, Pennsyl-
vania, in separate trust, to hold, manage, invest and reinvest
the shares so received, and the accumulation of income thereon,
to use and apply the income and principal, or so much thereof,
as, in trustee's discretion, may be necessary or appropriate
for such issue's medical care, support and education (including
college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
support or education, or to make payment for these purposes,
without further responsibility to such issue or to such issue's
parents or to any person taking care of such issue. Any
principal or income not so applied shall be distributed to such
issue absolutely when he or she attains the age of twenty-
two (22) years. If he or she dies before attaining age twenty-
two (22), the trust shall terminate and such share shall be
distributed to his or her personal representative.
ITEM 5: All shares of principal and income hereby given
shall be free from anticipation, assignment, pledge or obliga-
tions of beneficiaries, and shall not be subject to any execu-
tion or attachment.
ITEM 6: I direct that all taxes that may be assessed in
consequence of my death of whatever nature and by whatever
jurisdiction imposed, shall be paid from my residuary estate as
a part of the expense of the administration of my estate.
ITEM 7: I appoint my husband, JIM E. MCINTYRE, executor
of this my Last Will. Should my-husband, JIM E. MCINTYRE,
fail to qualify or cease to act as executor, I appoint my son,
(2)
JAY M. MCINTYRE, executor of this my Last Will.
ITEM 8: I direct that my executor or his successors shall
not be required to give bond for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this ~g ~
day of ~-~- , 1981.
The preceding instrument, consisting of this and two (2)
other typewritten pages, each identified by the signature of
the Testatrix, JACQUELINE H. MCINTYRE, was on the day and date
thereof signed, published and declared by JACQUELINE H. MCINTYRE,
the Testatrix therein named, as and for her Last Will, in the
presence of us, who, at her request, in her presence, and in
the presence of each other have subscribed our names as
witnesses hereto.
COMMONWEALTH OF PENNSYLVANIA)
) ss:
COUAY~Y OF CUMBERLAND )
We, JACQUELINE H. MCINTYRE,
,J. /-IA , and
, the Testatrix and the witnesses
respectively, whose names are signed to the attached or fore-
going instrument, being frist duly sworn, do hereby declare to
the undersigned authority that the Testatrix signed and executed
the instrument as her Last Will and that she had signed willingly,
and that she executed it as her free and voluntary act for the
purpose therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the Will as
witness and that to the best of his or her knowledge, the
Testatrix was at the time eighteen (18) years of age or older,
of sound mind and under no constraint or undue influence.
Subscribed, sworn to and acknowledged before me,
~. COY~ , by JACQUELINE H. MCINTYRE, the
Testatrix, and subscribed and sworn to before me by
3 ' S~A~T~ and ~4~ ~. C0~ ,
witnesses, this ~9 ~ day of 0C~6~ , 1981.
Notary Publi~
EIZ~SN B. COtrf~:
NOTARY PUBLIC
3701 ;~aiket St. (Hampdc-n
CAMP HILL, PA. 1701]
%Y Commission Expires June 26.
JACQUELINE H. MCINTYRE
HENRY ~'. ~OYNE
ATTORNEY AT hAW
390i MARKET STREET
CAMP HILL, PENNA. 1'701
(717) 737-0464
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: JACQUELINE H. MCINTYRE
Date of Death:
January 14, 2003
Will No.: 21-03-00050
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 October 17,
2000:
Name: Address:
Jay M. Mclntyre
James Mclntyre
Jon Mclntyre
643 Springharbor Drive, Woodstock, GA 30188
2311 River Road, Middletown, PA 17057
500 Gale Road, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None
Date: -~, _ 2/~ 2r)o,.g
COYNE & COYNE, P.C. A
Bf ~isa Marie Coyne, ~squire
!\ ~,/¢901 Market Street~
~ Camp Hill, PA 170114227
(717) 737-0464
Pa. Supreme Ct. No. 53788
Counsel for Personal Representative
BUREAU OF ZNDZVZDUAL TAXES
INHERITANCE TAX DTVTSTON
DEPT. 28060].
HARRTSBURG, PA 171Z8-0601
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLORANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
JON
500 GALE RD
CAMP HILL
MCINTYRE
;,~ ~: ~*'!' J~::~ o~ATE 02-16-200q
~ii~i~' O~ V?i~is ESTATE OF MCINTYRE
DATE OF DEATH 01-1q-2005
FILE NUHBER 21 05-0050
;~UNTY
'04 FEB 13 P ~ :.S~tN/DC
ACN
CUMBERLAND
201-16-5885
05109q19
Amoun'~ Remitted
JACQUELIN H
PA 1701]C:i~r? ;~ , ~ i~rt
,.,Lcm~ ~ Co,, PA
MAKE CHECK PAYABLE AND REMIT PAYNENT TO:
REGISTER OF RILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
RETAIN LONER PORTION FOR YOUR RECORDS
REV-Z548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF
DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-16-200q
ESTATE OF MCINTYRE
JACQUELZN H DATE OF DEATH 01-1q-Z005 COUNTY CUMBERLAND
FILE NO. Z1 05-0050 S.S/D.C. NO. 201-16-5885 ACN 05109q19
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 107159-1!
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 01-02-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDZTS:
2,165.$9
X 0.500
1,081.70
- .00
1,081.70
X .~5
q8.68
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
NITH YOUR TAX PAYMENT TO THE
REGISTER OF RILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF RILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C- AMOUNT PAID
INTEREST IS CHARGED THROUGH O2-Zq-ZOOq TOTAL TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORM INTEREST AND PEN.
TOTAL DUE
;~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
.00
q8.68
.81
q9.q9
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act g3 of ZOO0. (7Z P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of Mills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, ahich was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara avaiZabla at the Office of
the Register of Nills, any of the Z3 Revenue District Offices or by calling the special gq-hour answering service
for forms ordering: 1-800-36Z-ZO50; services for taxpayers with specie! hearing and ar speaking needs:
1-egO-qqT-3OZO (TT on[y).
Any party in interest not satisfied with the appraisement, alloaance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ge-ICg1, OR
--electing to have the matter determined at the audit of tha account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should bo addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ge060[, Harrisburg, PA 17198-0601
Phone (7173 787-6505. Sea page S 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 (3) calendar months after the dacedent's death, a five percent
discount of the tax paid is allowed.
The 15X 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 and of the tax amnesty period. This nan-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months end one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, [982
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .OOOl6q.
All taxes which became delinquent on or after January 1, 198g will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA
Department of Revenue.
The applicabLe
interest rates for [982 through 2003 are:
Intarast Daily Interest Daily Interest Dally
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .O00Sq8 [987 9Z .O00gq7 [999 7Z .O0019g
1983 16Z .OOOq38 1988-1991 IXZ .000301 ZOOO 8Z .000Z19
198q 1iX .000301 1992 9Z .O00Zq7 ZOO[ 9Z .o00gq7
1985 13Z .000356 1993-199q 7Z .00019Z goog 6Z .00016q
1986 lOX .O00Z7q 1995-1998 9Z .o00gq7 ZOO3 5Z ,000137
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPA/D X NUMBER OF DAYS DELINQUENT X DAI'Ly TNTERBST FACTOR
--Any Notice issued altar the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond fha date of the assessment. If payment is made after tho interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF INDZVZDUAL TAXES
TNHER/TANCE TAX DTVZSZON
DEPT. 280601
HARRZSDURG, PA 17128-0601
dON
500 GALE RD
CAMP HILL
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
MCINTYRE
PA 1 ?~!~q,~'. .~ ;,S,~J~t
C~,,mb~fiana Go., PA
NOTICE OF INHERITANCE TAX
APPRAISENENT. ALLONANCE OR DISALLOHANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
~i~ !::i ..... i~ DATE 02-16-200~
~S~S~ ' + Wills ESTATE OF MCINTYRE
DATE OF DEATH 01-1q-2005
FILE NUMBER 21 05-0050
'0~ FE~ ~3 P3:3~ COUNTY CUMBERLAND
SSN/DC Z01-16-5885
ACN 05109~20
A~ount Remitted
RE¥-16~8 EX &FP (01-05)
JACDUELIN H
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
REV-1548 EX AFP [01-03)
RETAIN LOWER PORTION FOR YOUR RECORDS
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 02-16-200q
ESTATE OF NCINTYRE
JACQUELIN H DATE OF DEATH 01-1q-2005 COUNTY CUMBERLAND
FILE NO. 21 05-0050 S.S/D.C. NO. 201-16-5885 ACN 05109q20
TAX RETURN WAS: (X) ACCEPTED AS FILED [ ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 107159-05
TYPE OF ACCOUNT: (~ SAVINGS C ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-10-1989
Account BaZance 5,601.29
Percent Taxable X 0.500
Amount Subject to Tax 2,800.65
Debts and Deduct/ohs .00
Taxable Amoun~ 2,800.65
Tax Rate ~ .q5
Tax Due [26.05
NOTE=
TAX CRED'rTS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
INTEREST IS CHARGED THROUGH 02-2q-200q TOTAL TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORM INTEREST AND PEN.
TOTAL DUE
~ ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UZRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS. )
.00
126.05
2.11
128.1q
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (TZ P.S.
Section
PAYNENT:
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF #ILLS,
REFUND (CR): A refund of e tax credit, ahich ams not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS15). Applications ere available at the Office of
the Register of Nills, any of the Z3 Revenue District Offices or by calling the special Z4-hour answering service
for fores ordering: 1-800-36Z-ZOSO; services for taxpayers with speciaI hearing and or speaking needs:
1-DOO-447-30ZO (TT onIy).
OBJECTIONS: Any party in interest not satisfied aith the appraisement, allowance) or disalIowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice amy object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171Z8-IOZ1, OR
--electing to have the setter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Dureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 7&7-6505. See page 5 of the booktat "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-15Oi) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (5) calendar months after the decedent's death, a five percent (SZ)
discount of tho tax paid is aIIowad.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB) 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 Nould 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
free the date of death, to the date of payment. Taxes ahich became deIinquent before January 1, 19Bi
bear interest at the rate of six (6Z) percent par annum caIculated at a daily rate of .000164.
Ali taxes which became daIinquant on or after January I, I98Z wiI1 bear interest at a rate ~hich ~iII vary from
calendar year to calendar year ~ith that rata announced by the PA Department of Revenue. The applicable
interest rates for 198Z through ZOO5 ara:
Interest Da[Iv
Year Rate Factor Yea.~r
198Z ZOZ .000548 1987
1983 162 .000458 1988-1991
1984 1IX .000501 1992
1985 XSZ .000556 I995-1994
1986 lOX .000274 1995-1998
--Interest is calculated as follows:
lnterest Daily Xnterest Daily
Rate Factor Year Rate Factor
92 .000247 1999 72 .00019Z
XXZ .000501 ZOO0 8Z .000219
9Z .000247 ZOO1 9Z .000247
7Z .00019Z ZOOZ 6Z .000164
9Z .O00Zq7 2005 5Z .000157
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent ~JlI reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. Xf payment is made after the interest computation date shown on the
Notice, additional interest must be caXculatado
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 2806O1
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
MCINTYRE, JACQUELINE H. 201 - 16- 5885
~ DATE OF DEATH (MM-DD-YEAR) j DATE OF BIRTH (MM-DD-YEAR)
~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
o .01/14/2003 11/14/1924 REGISTER OF WILLS
LU
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1. Original Retum
[] 2. Supplemental Retum
[] [] 4a. Future Interest comprom se (date of death after
12-12-82)
[] [] 7. Decedent Maintained a Living Trust (Attach
copy of Trust)
[] [] 10. Spousal Poverty Credit (date of death between
12-31-91 and ~
qAME
4. Limited Estate
6. Decedent Died Testate (Attach copy
of Will)
9. Litigation Proceeds Received
Lisa M. Coyne, Esquire
"IRM NAME (If applicable) .
Coyne & Coyne, P.C.
'ELEPHONE NUMBER
717/737-0464
OFFIC!AL USE ONLY
o
ODE YEAR NUMBER
[] 3. Remainder Return (date of death prior to 12-13-82)
[] 5. Federal Estate Tax Retum Required
__ 8. Total Number of Safe Deposit Boxes
[] 11 ..Election to tax under Sec. 9113(A) (Attach Sch O)
3901 Market Street
Camp Hill, PA 17011-4227
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 & Miscellaneous Personal Property
(Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
1 ~1. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
181,950.00
None
None
None
60,603.16
3,964.82
None
37,864.98
1,550.00
13. Charitable and Govemmental 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)
~FIClAL
m
(8) 246,517.98
(11) 39,414.98
(12) 207,103.00
(13)
(14) 207,103.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
x .00 (15)
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
207,103.00
x .045 (16) 9,320.00
x .12 (17)
x .15 (18)
(19) 9,320.00
20. []
:opyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
500 Gale Road
CITY Calllp Hill STATE PA ZIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 9,400.00
C. Discount 466.00
9,320.00
Interest/Penalty if applicalSle 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 I Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
9,866.00
0.00
546.00
0.00
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes~ No
a. retain the use or income of the property transferred; ......................................................... ....................... ~ L~
b. retain the right to designate who shall use the property transferred or its income; .................................... H
c. retain a reversionary interest; or ............................................................................................................... H
d. receive the promise for life of either payments, benefits or care? ............................................................. L_I []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation'~ .......................................................................... [] []
· IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. De~.laration
prepare[ other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
Jay M. Mclntyr.~ - i ~
ADDRESS
643 Sprin~:harbor Drive
Wood~stoclq GA 30188
,* ///~ 0 / ~ Y
,~TUt:~E-OF'ISERSON~cESPONSIBLE FOR FILING RETURN
ADDRESS · DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
Lisa M. Coyne, Esquire 3901 Market Street
Camp Hill, PA 17011-4227
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. §9116 (a) (1.1) (ii)]. The statute does not exempta 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.
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MCINTYRE, JACQUELINE H.
SCHEDULE A
REAL ESTATE
FILE NUMBER
21 - 2003 - 0050
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM
NUMBER
l
DESCRIPTION
500 Gale Road, Camp Hill, PA 17011 -- See Attached Settlement Sheet
TOTAL (Also enter on Line l, Recapitulation)
VALUE AT DATE OF
DEATH
181,950.00
181,950.00
J A. U.S. DEPARTMENT OF HOUSING and URBAN DEVELOPMENT
OMB
No.
2502-0265
I
SETTLEMENT STATEMENT
TITLEPRO
SECURED LAND Laserprin,
TRANSFERS, INC.
B. TYPE OF LOAN
5006 East Trindle Road 1. [ ] FHA 2. [ ] FMHA 3. [ ] CONV. UNINS.
Suite 203 4. [~j VA 5. [ ] CONV. ~NS.
Mechanicsburg, PA 17055 6. FILE HUMBleR: J 7. LOAN NUMBER:
' 505719I 702027137
Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORLI~S. CASENO.:
101060575445
C. NOTE: This form is furnished Io give you a statement of actual settlement cos,el Amounts paid to and by the settlement agent are shown, Items marked
'(p.o.c.)' were paid outside the closing; they are shown here for informalional purposes and are not included in the totals.
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: E NAME AND ADDRESS OF LENDER:
Kenneth L. Hall Estate of Jacquellne H. USAA Federal Savings Bank
Megan Eve Mines-Hall McIntyre
10750 McDermott Freeway
San Antonio, TX 78288
G. PROPERTY LOCATION; H. SE]-rLEMENT AGENT: L SETTLEMENT DATE:
500 Gale Road Secured Land Transfers, Inc. 09/26/03
Hampden TOWNSHIP PLACE OF SETrLEMENT:
CUMBERLAND County 3915 Market St., Camp Hill, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
I00, GROSS AMOUNT DUE FROM BORROWER 4SO. GROSS AMOUNT DUE TO SEL, LER
lot. Contract sales price 181950 . 00 4o,.Contract sales price 1~1950.00
,02. Personal property 4o2.Personal property
lO3. Settlement charges to borrowe~ (line 1400) i 1 4 3 4 , 6 5 403.
lo4. 404..
los. 405.
Adjustments for items paid by seller in advance A. diustments for ilems paid by seller in advance
1o6. City/Town tax to 40s. Clty/Town tax to"
to?.. County tax . 09/26/03~o12/31/03 117.38 4oy.county,a~ . 09/26/031o12/31/03 11~7.38
108. Assessments to 408.Assessments to
,09. schooZ 09/26/03,006/30/04 1325.92 40s. echoo~ 09/26/03,006/30/04 1325.92
,,0. Swr/Rf:$.99.00/C~oend 9/3f 4.34 4,0. Swr/Rf:.$99.00/c~oend 9/3.0 4.34
12o, GROSS AMOUNT DUE FROM BORROWER 19 4 8 3 2. 2 9 420. GROSS AMOUNT DUE TO SELLER 18 3 3 9 7. 6 4
200. AMOUNTS PAID BY, OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER , , ,
2ot. Deposit or earnest money 3 0 0 0 . 0 0 6el. Excess deposit (see instructions) , ,
2o2. Principal'amount of new loan(s) 1 8 5 5 8 9. 0 0 so2.Settlement charges to seller (line 1400) . 1 4 7 4 3.1.3
203. Existing Ioan(s) laken subject to 803.Existing loan(s) talien subject.lo
204. s04.Payoff of First Mortgage Loan
NON~..
205. sos. Payoff of Second Mortgage Loan
Application Fee Credit 350.00
206. SO6.
207. 507,
208. 508.
209. 509.
Adjuslments for items unpaid by seller Adjustments for items unpaid by seller
210..city/Town lax to 610,City/Town tax to
21 I. County tax to 511. County tax
212. AssesSments to 512. Assessmenls to
213. School to 513. School to -
214. 514.
215. 515.
218. 518.
220. TOTAL PAID BY/FOR BOflROWER 188939 · 00 520.,TOTAL REDUCTION AMOUNT DUE SELLER 14'743.13
300. CASH AT SE'F~.LEMENT FR, OM eR TO I~ORI~OWI~R 8' 600. CASH AT SETTLEMENT TO OR FROM SELLER ·
3oI. Grossam'ount. due'"frbm.[:)oflower: ~" (fine. ..... 120) ~ 2.29 ' 6o,.Grossamount due!osell~'r{]i~'4:ED) " 'i'8'339,,7: 64,
302. Less amount paid by/for borrower (line 220) 1 8 8 9 3 9' ~ O,0 s0z. Less. reduction ,a~o%znt due .seller (Ii, ne 520) 1 47 4 3.1 3
303. CASH ([~[ FROM) ([ ] TO) BORROWER 5 8 9 3.2'9. 603.CASH ([ ZTO) ([ ] FROM) SELLER 1 6 8 6 5 4.5 1
Buyer or Borrew,~r's Sig0a, tdre , ".. '.
Seller's Signature
HUD-1 Rev. 5/86
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT OMB No. 250,2-0265
SETTLEMENT STATEMENT Pa~e
505719 'PAID'FROM I PAID FROM -
1 ......... ' BORROWER'S . SELLER'S
TOTAL SALE.~'BROKER'S COMMISSION based on price S -- - : ~.L ~ b ?.., ? U ~. ~. ?_ [ FUNDS AT '1 FUNDS AT
Division of Commission (line 700) as follows: '1'O ca_L: ¥ ]- U I ~1 ].'/ . U U I SETIrl I=U~=NT I SE~'FLEME~'
$ 5433.50 to ERA/NRT, Inc. "
$ 5483.50 to Re~ax Realtv'Associates
,aid al Seltlemen, ..... ''
'.?T, F-irst .Ames±can Title ZnsI 35;.00[
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
nation Fee
802. Loan Discount 1. 500 % 2783.84
USAA Federal Savings. Bank
~raisal Fee to USAA Federal... Savinqs Ban.k
804. Credit Report to USAA Fed. oral Savinqs Bank
805. Lenders Inspection Fee
,lication Fee to
2lion Fee
eeo. Flood Cert
USAA Federal Savinqs ~nk
Fee
8ti. VA FundFee
900, ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
USAA FSB(350.POC)
USAA Federa!. Savinqs Bank
Dept of VA
901. lnterestfrom 09/26/03 t~09/30'/03 @$
Insurance Premium for mo. lo
3 0,. 93/day
903. Hazard Insurance Premium for
904.
lyre.!o USAA(399.62. POC)
yrs. to
3o0.0o
12.00
10.00
485.00
3639.00
905.
000. RESERVES DEPOSITED WlfH LENDER FOR
lO0t. Hazard Insurance 3 mo. e S 3 3.3 0 /mo.
e Insurance mo. ~ $ /mo.
mo. ~ $ /mo.
,tax 9 mo.@$ 37.19 /mo.
Ioo5. Assessments mo. @ $ ~ - /mo.
mo~.School Tax 4 mo.e$ 145.47 /mo.
1007. mo. ~ $ /mo.
ate mo. ~ $ /mo.
i100. TITLE CHARGES
lot. Settlement or closing fee to
to2. Abstract or title search to
1103. Tide examination to
1104. Title insurance binder to
1105. Document prepa, ration to
fees Io
,'s ;ess to
99.9 0
,
334.?.1.,
-368.59~~~'
Coyne&Coyne(POC-S)
Cash
20.00
11o8. Title Insurance to Secured Land Transfers J... 1438.75 J
includes above items No.:),, END..S. :. 10 0 / 3 0 0 / 9 0 0 '
09. Lender's coverage $ 185~ 589 ....... '
110. Owner's coverage $ 1 8 ..... 1, 9 5 ~ '
~2.~aX Ce=~ Secu=ed ~a~d ~a~'s~e~s 3'~'00'
. ReHax ~eaZ~y. Assoc&a~es j. J [95.00:
1113. Trans Fee
t200. GOVERNMENT RECORDIN~ AND TRANSFER CHARGES
1203. State tax/stamps: Deeds 1819.50Mortga.qe $
1204.
,205. ' 03 School Kathrvn W.- .Fat.row, T/C.
1819.50
1300. ADDITIONAL SETTLEMENT CHARGES
1745.63
to
3ection to HomeSpec ( POC )
303. HmInsp/Rad HomeSpec ( POC )
304.
Cert ReMax Realty Associates 3.00~
1400. TOTAL SETTLEMENTCHARGES (enter on Ji,qes 103aBd 502, Sections J and K). 11434.65 14743.13
HUD CERTIFICATION OF BUYERS AND SELLERS
I have careJully reviewed the HUD-1 $etllement Slalemen[ and to Ihs besl el my ~owledge and belial, il Is a Irue and a~urate slateme~l el all receipls and disbursements
made on my~cgounl by ~e in this Iransaclion. I lurther cerli'~ that I have received a copy el Ihs HUD- 1 Selllemem Slalemeal.
.~ · ,~ , . ,
Buyer o~ B~ower's Slgnalure Selle~*~ 81gnalure
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MCINTYRE, JACQUELINE H. 21 - 2003 - 0050
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
NUMBER
2
DESCRIPTION
U.S. Savings Bonds-- See Attached Inventory
Personal Property-- Attached Inventory and Appraisal
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
53,036.00
7,567.00
60,603.00
Savings Bond Calculator Page 1 of 2
Savinc
Series
Denomination
$10,000 :v
Serial Number
# Bonds Total Price Total Interest
21 $28,800.00 $24,236.16
Serial Number Issue Date Series
X2183595EE 07/1992 EE
X2183596EE 07/1992 EE
X2183597EE 07/1992 EE
V2535119EE 12/1992 EE
V2535118EE 12/1992 EE
V234822GEE 07/1992 EE
M45958918EE * 12/1992 EE
M45958919EE * 12/1992 EE
M45958920EE ' 12/1992 EE
M45958921EE', 12/1992 EE
M45958922EE · 12/1992 EE
M45958923EE · 12/1992 EE
M45958924EE ' 12/1992 EE
M45958925EE - 12/1992 EE
M45958926EE ' 12/1992 EE
M45958927EE ' 12/1992 EE
M45724383EE ' 07/1992 EE
R894582999EE 12/1992 EE
R89458298EE 12/1992 EE
R82436431EE 07/1992 EE
Denom
$10,000
10,000
10,000
5;000
5,000
5,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
2O0
200
200
i:V?t~}ii0!{ i Viewing Bonds 1-21
Issue
Price
$5,000.00
5,000.00
5,000.00
2,500.00
2,500.00
2,500.00
500.00
500.00
500.00
500.00
500.00
500.00
500.00
500.00
500.00
500.00
50O.O0
500.00
100.00
100.00
100.00
Issue Date
u~ YTD Im
$53,036.16 $1,011
Next Final
Interest Value Rate Accrual Maturity
$4,304.00 $9,304.00 6.00% 07/2003 07/2022
4,304.00 9,304.00 6.00o/6 07/2003 07/2022
4,304.00 9,304.00 6.00% 07/2003 07/2022
2,016.00 4,516.00 6.00% 06/2003 12/2022
2,016.00 4,516.00 6.00% 06/2003 12/2022
2,152.00 4,652.00 6.00% 07/2003 07/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.~20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
403.20 903.20 6.00% 06/2003 12/2022
430.,40 930.40 ............ ' .......
430.40 930.40 6.00% 07/2003 07/2022
80.64 180.64 6.00% 06/2003 12/2022
80.64 180.64 6.00% 06/2003 12/2022
86.08 186.08 6.00% 07/2003 07/2022
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for I-IH)
MN Matured (Not Exchangeable for 1-15t)
Please rate this service.
http ://wwws.publicdebt.treas. gov/BC/SB CPrice 1/16/2003
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL,, PA 17011
717-761-2763
Appraisal for the Estate of Jacqueline H. McIntyre
500 Gale Road, Camp Hill, PA 17011
February 3, 2003
ENTRY
Misc. knick-knacks
Large jar with artificial flower
Stool
Wall mirror
LIVING ROOM
Mahogany card table
Pair of green chairs
End table - stained
19" Portable RCA television
2-Unit lighted curio cabinet
(2) Shirley Temple glasses
Cow creamer
Misc. glassware
Misc. ironstone
Bone dishes
Misc. pewter pieces
Pair of brass wall sconces with convex mirrors
George Steck spinet piano
Emperor grandfathers clock
Pair of round end tables and coffee table
Pair of Stangl bird figurines
A. Sargent oil paiming
Pair of table lamps
Sofa- wom
Wing back chair - worn
10.00
2.00
3.00
10.00
75.00
5.00
2.00
30.00
t00.00
50.00
20.00
10.00
20.00
2.00
10.00
30.00
200.00
350.00
85.00
30.00
30.00
2.00
5.00
2.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
.FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-761-2763
Mclntyre appraisal
Page 2 of 7
LIVING ROOM - continued
Stool
Stack tables
Mahogany knick-knack shelf
Misc. contents of knick-knack shelf
Tan colored table lamp
Misc. contents of living room
DINING ROOM
Green painted china cabinet
Tea set - some chips
Luncheon set
(5) Large and (6) small Bohemian stemmed glasses
Gorham sterling solver flatware - svc/6
Unmarked sterling silver flatware - sve/6
Misc. contents of green china cabinet
Telephone stand
Wall mounted, glass enclosed, curio cabinet
Misc. knick-knacks in cabinet
Remote telephone
9-Piece dining room suite
China closet:
Covered chicken
Haviland china - partial svc/12
Misc. crystal
Misc. Depression glass
Misc. glassware
Hummel - Chimney Sweep (12) 5 ¼" TM2
Hummel - Chimney Sweep (12) 5 ¼" TM1
Bowl & pitcher - cracked
Blue spittoon shaped 6" container
Electric coffee um- old
3.00
5.00
20.00
15.00
2.00
35.00
15.00
35.00
25.00
250.00
500.00
500.00
25.00
15.00
20.00
15.00
10.00
395.00
7.00
125.00
50.00
30.00
75.00
250.00
300.00
15.00
65.00
5.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-761-2763
MeIntyre appraisal
Page 3 of 7
DINING ROOM - continued
Large ironstone platter
Linens
Misc. glassware in buffet
Hibler-Munehen
Misc. contents of dining room
KITCHEN
J.C. Penny refrigerator - old
Sharp Carousel microwave
Toaster
Can opener
Coffee maker
Franciscan dinnenvare - partial sve/8
Corelle Ware dishes
Misc. glassware
Misc. cookware
Misc. souvenir plates (68)
Oak roll top table (rough condition) & 4 worn chairs
RCA 19" portable TV
Microwave stand
Trash can
Misc. contents of kitchen
LAUNDRY
Maytag washer & dryer
ENCLOSED PORCH
Plastic furniture
Microwave stand
50.00
20.00
15.00
25.00
25.00
10.00
30.00
1.00
1.00
2.00
65.00
20.00
25.00
15.00
25.00
150.00
30.00
2.00
1.00
20.00
400.00
75.00
2.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-761-2763
McIntyre appraisal
Page 4 of 7
OUTSIDE
Plastic table - 2 chairs
GARAGE
Misc. garden tools
Aluminum stepladder
FAMH,Y ROOM
Pair of glass top end tables
Sofa - worn
Coffee table
Pair of yellow colored table lamps
JVC TV
TV stand
Quasar VCR
Misc. stuffed bears - (40+)
Misc. books on wall shelves
Misc. ship figurines
Knee hole desk
Blue electric powered chair - worn
Cabinet - home made
Brass floor lamp
Recliner - worn
Pair of 3-section stackable Oak bookcases .
Misc. books in bookcases
Silk Oriental framed pictures
Hoover upright vacuum cleaner
Clocks
Barometer
Misc. contents of family room
5.00
5.00
' 10.00
10.00
2.00
1.00
2.00
60.00
5.00
20.00
80.00
65.00
25.00
45.00
1.00
1.00
5.00
1.00
600.00
100.00
50.00
10.00
3.00
3.00
50.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FA MIL Y 0 WNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-761-2763
Mclntyre appraisal
Page 5 of 7
BASEMENT
Foster & Co., player piano
Metal cabinet
Misc. coments of cabinet
Mirror
Mahogany table
Martha Washington sewing cabinet
Mahogany chifforobe
3 Army trunks
Misc. National Geographies
FRONT WEST BEDROOM
King size bed - worn
Pair of Oak Queen Anne style tables
Shaving mug
Lady's Victorian beaded handbags (one is tom)
Cedar chest
Misc. contents of cedar chest
Oriental style table lamp
Amtel 19" portable TV
Mahogany dresser with mirror
Trash can
Misc. contents of bedroom
HALL CLOSET
Tank vacuum cleaner
Bed linens
10.00
2.00
5.00
1.00
40.00
30.00
80.00
30.00
2.00
30.00
40.00
20.00
5O.OO
50.00
25.00
20.00
30.00
75.00
1.00
10.00
5.00
10.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
71 7-761 -2763
Melntyre appraisal
Page 6 of 7
REAR WEST BEDROOM
Trash can
Mahogany slant top secretary desk
Table lamp
78 RPM phonograph records
Record cabinet
Singer treadle sewing machine
Chair - worn
Stuffed bears
Doll house
Card table
Luggage
Misc. books
Misc. contents of bedroom
REAR MIDDLE BEDROOM
Projector
Trash can
Kirby vacuum cleaner
Pitcher-bowl & stand
Single bed
Floor lamp
Bookcase - poor condition
Framed arrow heads
Misc. contents of bedroom
REAR EAST BEDROOM
Chaise lounge - worn
Stand/floor lamp
Double bed
Jewelry chest
Costume jewelry
1.00
175.00
1.00
2.00
5.00
50.00
1.00
20.00
10.00
3.00
1.00
2.00
15.00
1.00
1.00
10.00
10.00
10.00
1.00
1.00
5.00
10.00
1.00
5.00
10.00
60.00
50.00
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET. CAMP HILL, PA 17011
717-761-2763
Mclntyre appraisal
Page 7 of 7
REAR EAST BEDROOM- continued
Bowman's Department Store mug
Misc. wooden boxes
Seth Thomas mantle clock
Desk
Desk chair
20.00
20.00
30.00
20.00
5.00
Clock lamp - new shade
Pair of Oriental figural lamps
Misc. watches - poor quality
Watch cabinet
1930's Vanity with triple mirror
60.00
20.00
t0.00
20.00
135.00
Globe
TV stand
Misc. contents of bedroom
2.00
1.00
20.00
MASTER BEDROOM
Table - broken
Coat/hat tree
Upholstered chair
Safe
Quilt
2.00
15.00
2.00
40.00
25.00
Carved Oriental chest
35.00
APPRAISAL TOTAL $ 7,567.00
This Fair Market Value appraisal is true and correct to the best of my ability as an
auctioneer and appraiser with 3 5 years experience.
Member: Certified Appraisers Guild of America
W. K. Dusty Chapman, CAGA
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
MCINTYRE, JACQUELINE H.
21 - 2003 - 0050
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 ADDRESS RELATIONSHIP TO DECEDENT
A. Jon Mclntyre a/k/a John Mclntyre Son
500 Gale Road
Camp Hill, PA 17011
JOINTLY OWNED PROPERTY'
DESCRIPTION OF PROPERTY % OF DATE OF DEATH
LETTER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF
NUMBERITEM FORTENANTJOINT JOINTMADE estate.er similar identi~ing number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTERES'I
1 A. 03/10/1989 Members lstFCU 164.94 50% 82.47
Savings Acct. No. 107139-00
2 A. 03/10/1989 Members lstFCU 5,601.29 50% 2,800.65
Inv. Savings Acct. No. 107139-05
3 A. 01/02/2001 Members lstFCU 2,163.39 50% 1,081.70
Checking Acct. No. 107139-01
TOTAL (Also enter on line 6, Recapitulation) 3,964.82
cmoersl
FEDERAL CREDIT UNION
INSURANCE DEPARTMENT
5000 Louise Drive
P. O. Box 40
Mechanicsburg, PA 17055
1-800-283-2328 or (717) 697-1161
RI=GUI AR gAVlN~g A~OUNT:
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Created
INVI::RTMFNT RAVIN~ ACC~IINT_'
Account Number/SuffiX
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Created
GHF~KIN~ A~OIJNT:
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Created
107139 -00
03/10/1989
$184.85
$.09
$164.94
John Mclntyre
12/20/2000
107139 -05
03/10/1989
$5,597.82
$3.47
$5,601.29
Jon Mclntyre
120/20/2000
107139 -11
01/02/2001
$2,161.88
$1.51
$2,163.39
Jon Mclntyre
01/02/2001
D~nise A.~And~r~----~
Insurance Products Supervisor
February 7, 2003
Estate of: JACQUELINE H. MCINTYRE
Date of Death: January 14, 2003
Social Security Number: 201-16-5885
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMIN~TIVE ~
ESTATE OF FILE NUMBER
MCINTYRE, JACQUELINE II. 21 - 2003 - 0050
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1.
2.
3.
4.
FUNERAL EXPENSES:
Musselman Funeral Home & Cremation Services, Inc., Lemoyne, PA
Flowers
Reception
IIonorarium
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees Coyne & Coyne, P.C.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Jori McIntyre
Street Address 500 Gale Road
City Camp Hill State
Relationship of Claimant to Decedent Son
Probate Fees Cumberland County Register of Wills
PA Zip 17011
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Postage
Legal Advertisement-- Cumberland Law Journal
5,585.00
200.00
500.00
100.00
5,000.00
3,500.00
334.00
74.00
75.00
Total of Continuation Schedule(s) 22,497.00
TOTAL (Also enter on line 9, Recapitulation) 37,864.98
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedu~H
Adrnin~ Costs conlinued
ESTATE OF FILE NUMBER
MCINTYRE, JACQUELINE H. 21 2003 - 0050
3 Legal Advertisement-- Patriot News 94.00
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Toll Calls-- Executor
R/T Travel-- Executor @$.36
Claude Wolfe & Associates-- Inventory & Appraisal
Deed Preparation
John Shillingford-- Income Tax Preparation
Income Taxes due and owing
Checks--Estate Checking Account
Real Estate Appraisals-- Kurt A. Eby
Realtor's Commission-- ERA/NRT, Inc
Closing Costs for sale of Real Estate
Reserves
Lodging and Board for Executor for Travel to and From Pennsylvania
Repairs and Radon Remediation Unit Required for Sale of Home
Filing Fee-- Inheritance Tax Return
100.00
1,908.00
245.00
100.00
100.00
1,000.00
10.00
300.00
10,917.00
3,826.00
1,000.00
1,060.00
1,822.00
15.00
Page 2 of Schedule H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
MCINTYRE, JACQUELINE H. 21 - 2003 - 0050
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
PP&L
Verizon
UGI
TOTAL (Also enter on Line 10, Recapitulation)
900.00
50.00
600.00
1,550.00
REV-1513 EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
Do Not List Trusteegs~
]. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Jon McIntyre Son 1/3 of Residual
500 Gale Rd., Camp Hill, PA 17011
2 Jay Mclntyre Son 1/3 of Residual
643 Springharbor Dr., Woodstock, GA 30188
3 James Mclntyre Son 1/3 of Residual
2311 River Rd., Middletown, PA 17057
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
ESTATE OF FILE NUMBER
MCINT~QLE, JACQLT~LINE H. 21 - 200: - 0050
Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
WHEREAS, on the 17th
~ted October 29th 1981
No. 2003-00050 PA No. 21-03-0050
ESTATE OF MCINTYRE JACQUELINE H
(LAs'±',
Late of HAMPDEN TOWNSHIP
CUM~EmL~LNO
Deceased
Social Security No. 201-16-5885
day of January
2003 an instrument
~s admitted to probate as the last will of MCINTYRE JACQUELINE H
~te of HAMPDEN TOWNSHIP , CUMBERLAND County, who died on the
14th day of January 2003 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, DONNA M. 'OTTO , Register of Wills in and for
Ne County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
hat I have this day granted Letters TESTAMENTARY
D MCINTYRE JAY M
ho has duly qualified as Executor(rix)
~d has agreed to admini.ster' the estate according to law, all of which fully
ppears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
%RLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
E my Office the 17th day of January 2003.
-~ ,
~egm~scer oz wm±±s
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
ii JACQUELIATE H. MCIAUfYP~E
i, I JACQO~LINE H. MCINTYRE, of the Township of Hampden,
i County of Cumberland, Commonwealth of Pennsylvania, declare
i! this to be my Last Will and revoke any will or codicil pre-
il viously made by me.
!i ITEM 1:' I devise and bequeath all of my estate of every
ii nature and wherever situate together with all insurance thereon,
i! to my husband, JIM E MCINTYPd3, providing he shall survive me
ITEM 2: Should my husband, JIM E. MCINTYRE, predecease me
{i or die on or before the sixtieth (60th) day following my death,
ii I direct that my estate be distributed in the following manner:
(A) 7 bequeath my automobiles, household and personal
effects ~nd other tangible personalty of like nature (not
including cash or securities), together with any existing
insurance thereon, in equal shares to such of my t~hree (3)
children as survive me. Such property shall be divided
by selection of the children, provided all agree, and as
to any property about which there is no unanimous agreement,
I direct that my executor sell any suCh property at private
or public sale, and that the proceeds of any. such sale be-
come part of my residuary estate.
(B) I devise and bequeath all the rest, residue and
remainder of my estate, of every nature and wherever situate,
~together' with all insurance thereon, in equal shares, to
my issue, per stirpes.
ITEM 3: i direct that in the distribution of my estate, the
share of each of my issue shall be charged with an advancement in
an amount equal to the amount that that particular issue is
indebted to me under any loan agreement, whether verbal or
written.
ITEM 4: Should any of my issue entitled to a share of my
estate not have attained the age of twenty-two (22) years at the
time of distribution to him or her, I devise and bequeath the
share of each such issue to FULTON BANK of Harrisburg, Pennsyl-
vania, in separate trust, to hold, manage, invest and reinvest
the shares, so received, and the accumulation of income thereon,
to use and apply the income and principal, or so much thereof,
as, in trustee's discretion, may be necessary or appropriate
for such issue's medical care, support and education (including
college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such
support or education, or to make payment for these purposes,
without further r.e. sponsibility to such issue or to such issue's
parents or to any person taking care of such issue. Any'
principal or income not so applied shall be distributed to such
issue absolutely when he or she attains the age of twenty-
two (22) years. If he or she dies before attaining age twenty-
two (22), the trust shall terminate and such share shall be
distributed to hiS.' or her personal representative.
ITEM 5: Ail shares of principal and income hereby given
shall be free from anticipation, assignment, pledge or oblige-
tions of beneficiaries, and shall not be subject to any execu-
tion or attachment.
ITEM 6: I direct that all taxes that may be assessed in
consequence of my death of whatever nature an~ by whatever
jurisdiction imposed, shall be paid from my residuary estate as
a part of the expense of the administration of my estate.
ITEM 7: I appoint my husband, JIM E. MCIBUfYRE, executor
of this my Last ~ill. Should my."husband, JIM E. MCIBVfYRE,
fail to qualify or cease to act as executor, I appoint my son,
(2)
JAY M. MCi~'fP~, executor of this my Last will.
ITEM 8: I direct that my executor or his successors shall
not be required to give bond for the faithful performance of
their duties in any jurisdiction. ~
IN WIT~-ESS W'I~R.EOF, I have hereunto set my hand this ..~.~
day of ~'""~ ., 1981.
~ JACQUELINE H. MCI~TYREJ
The preceding instrument, consisting of this and' two (2)
other typewr~itten pages, each identified by the signature of
the Testatrix, JACQUELIATE H. MCIAVEYRE, was on the day and date
thereof signed, published and declared by JACQUELIATE H. MCINTYRE,
the Testatrix therein named, as and for her Last Will, in the
)} presence of Us, who, at her request, in her PresenCe, and in
the presence of each other have subscribed our names as
witnesses hereto. .
CO[4MONWEALTII OF PEN~[SYLVANIA)
) ss:
COUNTY OF CUMBERLAlqD )
We, JACQLVELI~N-E H. MCINTYRE, ~NLX d - S ~IA[-~ , and
t~[~ F' CO~tk~E , the Testatrix and the witnesses
respectively, whose names are signed to the attached or fore-
going instrument, being frist duly sworn, do hereby declare to
the undersigned authority that the Testatrix signed and executed
the instrument as her Last Will and that she had signed willingly,
and that she executed it as her free and voluntary act for the
purpose therein expressed, and that ~ach of the witnesses, in
the presence ~p.d hearing of the Testatrix, signed the Will as
witness and that to the best of his or her knowledge, the
Testatrix was at the time eighteen (18) years of age or older,
of sound mind and under no constraint or undue influence.
Subscribed, sworn to and acknowledged before me,
r~. Co"/'NE , by JACQLr~T.TIq~ H. MCIIqTYPdg, the
Testatrix, and subscribed and sworn to before me by
3 ' ~A~ and 14~/Q~ ~"- CO~AJg ,
witnesses, this ~ Qt~ day of 0C~-~ 6~ , 1981.
Notary Publi~
EELEEN B. CO17~
NOTARY PUBLIC
3,c01 /Aurket Sr. (Hampden Twp4
C.AJ, AP HILL, PA. 17011
Commission Expires June 26.
Jay Mclntyre
643 Springharbor Drive
Woodstock, GA 30188
770-591-0260
April, 11, 2003
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
To Whom It May Concern,
Enclosed please find check #105 in the amount of $9,400.00 which represents payment
on account for Inheritance Taxes for the estate of Jacqueline H. Mclntyre of 500 Gale
Road, Camp Hill, PA 17033, who passed away on January 14, 2003.
Sincerely,
cc: Lisa Coyne, Esquire
Jay Mclntyre
643 Springharbor Drive
Woodstock, GA 30188
2030 00~3 808~
0000 17013
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
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 002437
MCINTYRE JAY M
643 SPRINGHARBOR DRIVE
WOODSTOCK, GA 30188
ESTATE INFORMATION: SSN: 201-16-5885
FILE NUMBER: 21 03-0050
DECEDENT NAME: MCINTYRE JACQUELINE H
DATE OF PAYMENT: 04/14/2003
POSTMARK DATE: 04/11/2003
COUNTY: CUM BERLAN D
DATE OF DEATH: 01/14/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $9,400.00
REMARKS:
JAY M MCINTYRE
TOTAL AMOUNT PAID:
$9,400.00
SEAL
CHECK#105
INITIALS: CW
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF ZNDTVTDUAL TAXES
/NHERTTANCE TAX DTVZSTDN
DEPT. Z8060!
HARRISBURG, PA 171Z8-0601
CONNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-Z547 EX *,FP (01-0,3)
LISA M COYNE ESQ
COYNE & COYNE
$901 MARKET ST
CAMP HILL
DATE Oq-lZ-ZOOq
ESTATE OF MCZNTYRE
DATE OF DEATH 01-1q-ZOOS
FILE NUMBER Z1 0:5-0050
COUNTY CUMBERLAND
ACN 101
Aeoun~ Ree*i t:'l:ed
JACQUELIN H
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MCINTYRE JACOUELIN H FILE NO. 21 0:5-0050 ACN 101 DATE Oq-lZ-ZOOq
TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
3. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) (3)
q. Mortgages~No,es Receivable (Schedule D) (q)
5. Cash/Bank Deposits~Misc. Personal Proper~y (Schedule E) ($)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad.. Cos~s/Misc. Expanses (Schedule N) (9)
10. Debts/Mortgage Liabili~ies/Liens (Schedule Z) (10)
11. To,al Deduc~/ons
12. Ne~ Value of Tax Re~urn
181~950.00
.00
.00
.0O
60~60:5.16
:5~96q.82
.00
(8}
:57,86q.98
NOTE: To insure proper
cred/* ~o your accoun*,
subei* *he upper portion
of ~his fore wi~h your
~ax payment.
15.
NOTE:
Zq6,517.98
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL /NTEREST.
ASSESSHENT OF TAX:
15. Aeoun~ of LLne lq a~ Spousal ra~e
16. Amount: of L/ne lq ~axable a~: LLneal/Class A ra~:e
17. Aeoun~ of L1ne lq a~ Sibling ra~e
18. Aeoun~ of Line lq ~axable a~ Collateral/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECETpT OT$COUNT
DATE NUMBER TNTEREST/PEN PAID (-
0q-11-200:5 CD00Zq:57 q66.00
(15) .00 X 00 = .00
(16) 207,10:5.00 X 0q5 = 9,:520.00
(17) .00 x 12 = .00
(18) .00 X 15 = .00
(19)= 9,520. O0
AHOUNT PAID
9,q00.00
reflect figures that lnclude the total of ALL returns assessed to date.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
9,866.00
5qG.00CR
.00
5qG.00CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Chari~:able/governeen~al Bequests; Non-elect:ed 911:5 Trus*s (Schedule J) (1:5) . O0
Ne~: Value of Es~:a~:e Sub,~ec~ ~:o Tax (1~') 207,10:5.00
Z.F an assessment was issued previously, 11nes 14, 15 and/er 16, 17, 18 and 19 wi11
1,550.00
(11)
(12) 207,10:5.00
RESERVATION:
PURPOSE OF
MOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to CIass B (colIateraI) beneficiaries of the decedent after the expiration of any estate for
lifo or for years, the Coamonmsalth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes
at the lamful Class B (collateral) rats on any such futura interest.
To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section
Detach the tap portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, Nhich Nas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available et the Office
of the Register of Hills, any of the Z$ Revenue District Offices, or by calling the special Iq-hour
ansaering service for forms ordering: 1-800-361-Z050; services for taxpayers Nith special hearing and / or
speaking needs: 1-800-4qT-$OZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--aIaction to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of [ndividual 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-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (51) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the torsi of the ta< and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tine 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, or nine (9) months and one (l) day from the date of
death, to the date of payment. Taxes ~hich became delinquent before January l, 1982 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after
January l, [982 ~ill bear interest at a rate uhich will vary free calendar year to calendar year eith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200~ are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20Z . 0005q8 1988-1991 llZ . 000301 ~ 97. · OOOZq7
1983 162 . 000~38 1992 91 . 0001~7 ZOOZ 6Z . 00016q
198~ 11X .000301 1993-199q 77. .000192 2003 SX .000137
1985 13Z .000356 1995-1998 91 .0002~7 ZOOq a,Z . O00llO
1986 IOZ .00027¢ 1999 7Z .000192
1987 102 .00027~ 2000 72 .000192
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA ~.71Z8-06~'1
JON
500 GALE RD
CANP HILL
CONNONHEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTHENT
JOINTLY HELD OR TRUST ASSETS
~*~ ~,,'~ ~: ~: : DATE
~;-, :, ESTATE OF
'O4
HCI NTYRE
PA 17011 C- ~.'
04-09-2004
HCINTYRE
DATE OF DEATH 01-14-2005
FILE NUNBER Z1 05-0050
COUNTY CUHBERLAND
ACN 05109419
Amoun~
REV-Z601 EX AFP [01-03)
JACQUELIN H
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
RETAIN LOgER PORTION FOR YOUR RECORDS
REV-1604 EX AFP (01-03)
~ INHERITANCE TAX RECORD ADJUSTNENT JOINTLY HELD OR TRUST ASSETS
DATE 04-09-2004
ESTATE OF HCINTYRE
JACQUELIN H DATE OF DEATH 01-14-2005 COUNTY
CUHBERLAND
FILE NO. Z1 05-0050
S.S/D.C. NO. Z01-16-5885
ACN 05109419
ADJUSTNENT BASED ON: ADHINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORNATZON
FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO.
107139-11
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 01-0Z-ZO01
Account Balance
Percen~ Taxable X.
Amount Sub~eci to Tax
Debts and Deductions -
Ta×able Amouni
Tax Ra~e ~
Tax Due
TAX CRED'rTS:
.00 NOTE:
0.500
.00
.00
.00
.00
TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBNIT THE UPPER PORTION
OF THIS NOTICE NITH YOUR TAX
PAYHENT TO THE REGISTER OF HILLS
AT THE ADDRESS SHONN ABOVE.
HAKE CHECK OR HONEY ORDER PAYABLE
TO: "REGISTER OF gILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
.00
.00
.00
BUREAU OF ZNDTVZDUAL TAXES
ZNHERTTANCE TAX DTVTSION
DEPT. 280601
HARRTSBURG, PA ~71ZS-O6n'l
JON HCINTYRE
500 GALE RD
CAHP HILL PA 17011
CONNONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTNENT
dOZNTLY HELD OR TRUST ASSETS
~'~- ' DATE : 04-09-2004
..... ESTATE OF HCINTYRE
DATE OF DEATH 01-14-2005
FILE NUNBER 21 05-0050
~I CUHBERLAND
'04 A ,'!~ :37 z01-1~-58~5
ACN 05109420
iL'_, ~. Amount Resilled
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV-I~04 EX IFP (nl-OS)
JACQUELIN H
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1604 EX AFP (01-03)
~ INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS
DATE 04-09-2004
ESTATE OF HCINTYRE JACQUELIN H DATE OF DEATH 01-14-2005 COUNTY CUHBERLAND
FILE NO. 21 05-0050 S.S/D.C. NO. 201-16-5885 ACN 05109420
ADJUSTHENT BASED ON= ADHINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORNATION
FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO.
107159-05
TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 05-10-1989
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions -
Taxable Amount
Tax Rate X.
Tax Due
TAX CREDITS=
.00 NOTE:
0.500
.00
.00
.00
.00
TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBHIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYHENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
HAKE CHECK OR HONEY ORDER PAYABLE
TO= ~REGISTER OF WILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PAID AFTER THTS DATE~ SEE REVERSE FOR CALCULATTON OF ADD/T~ONAL TNTEREST.
TF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REQUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT"
YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTTONS.)
.O0
.00
.00
,00
~EV-1470 EX (6-88)
' INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 28O6O1
HARRISBURG, PA 1712~0601
DECEDENTS NAME FILE NUMBER
JACQUELINE MCINTYRE 2103-0050
REVIEWED BY ACN
J U DY WATTS 03109419, 03109420
ITEM
SCHEDULE NO, EXP~.ANATION OF CHANGES
Above-referenced ACN(s) are being adjusted to reflect zero tax due since they have been
reported on the probate return.
ROW
Page 1
Name of Decedent: 0-~4 ¢ ~'u f-,//"/~- ff'
Date of Death: Ill q'
Will No.: ~:~/~ 0-5
STATUS REPORT UNDER RULE 6.12
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes ~] No [-]
If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes _ No [~
b. The separate Orphan~' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes ~ No [--[
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
ature
Name ~' c,
Capacity:
Address /v ~
7 7 o-J' ~/- o ;~ ~'o
Telephone No.
Personal Representative
Counsel for personal representative
BUREAU OF TNDIVTDUAL TAXES
THHERTTANCE TAX DTVTSTON
DEPT. zsn601
HARRTSBURG, PA 171Z8-0601
COMNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-i~O? EX AFP C01-D3)
LISA M COYNE ESQ
COYNE & COYNE
$901 MARKET ST
CAMP HILL
PA 17011
DATE 05-17-ZOOq
ESTATE OF MCINTYRE
DATE OF DEATH 01-1q-ZOOS
FILE NUMBER Z! 05-0050
COUNTY CUMBERLAND
ACN 101
Amoun~
JACQUELZN H
MAKE CMECK PAYABLE AND REMIT PAYMENT TO=
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LONER PORT'rON FOR YOUR RECORDS
REV-1607 EX AFP (01-03) aaa 'rNHERZTANCE TAX STATEMENT OF ACCOUNT
ESTATE OF MCINTYRE JAC~UELIN H F'rLE NO. 21 03-0050 ACN 101 DATE 05-17-Z00q
TH'rS STATEMENT IS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHONN BELO#
TS A SUMMARY OF THE PRTNCTpAL TAX DUE., APpLTCATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, 'rF APPLTCABLE,
A PROJECTED TNTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: Oq-OS-ZOOq
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
9,520.00
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
q66.00
0q-11-2005
Oq-Z6-2OOq
COOOZq$7
REFUND
.O0
9,q00.00
5q6.00-
TOTAL TAX CREDIT
9,520.00
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
ZF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE XS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE XS REFLECTED AS A "CREDIT" {CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
PAYMENT:
Detach the top portion oF this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #TLLS, AGENT.
-- IF NOR-RESIDENT DECEDENT make check or money order payable to: COHMON#EALTH OF PENNSYLVANTA.
REFUND (CA): A refund of a tax credit, ~hich mas not requested on the Tax Return, may be 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 Hills, any of the Z5 Revenue District Offices or From the Department's Z4-hour
ansmering service for forms ordering: 1-800-362-2050~ services for taxpayers aith special hearing and / or
speaking needs: 1-800-4qT-SOZO (TT only].
REPLY TO:
guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Ravie~ Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone
(717) 787-6505.
DISCOUNT:
IF any tax due is paid ~ithin three (33 calendar months after the decadant's death, a five percent (SZ] discount
of the tax paid is a11o~ed.
PENALTY:
The 15Z 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.
ZNTEREST:
Interest is charged beginning mith 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, 1982 bear interest at the rate of
six (gZ) percent per annum calculated at a daily rate of .00016q. All taxes Nhich became delinquent on and after
January 1, IOSZ aill bear interest at a rate ~hich ~il1 vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOq are:
Interest Daily Interest OaiIy Interest Daily
Year Rate Factor Year Rate Factor Year__ Rate Factor
1982 20Z .000548 198B-1991 llZ .O00SOI ZOO1 9Z .000247
1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6Z .000164
1984 llZ .000301 1993-1994 7Z .000192 ZOOS 5Z .000137
1985 132 .000356 1995-1998 92 .000247 2004 42 .000110
1986 IOZ .000Z74 1999 7Z .00019Z
1987 9Z .000247 2000 8Z .000219
--Interest is calculated as follows:
ZNTEREST = BALANCE OF TAX UNPAZD X NU~IBER OF DAYS DBLTNQUENT X DAZLY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.