HomeMy WebLinkAbout03-0440PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Henrietta P. Bolknap
also known as
Deceased.
Social Security No. 162-22-0078
No. "~"J- 03" e./te~t'O
To:
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(~), who is/a~e 18 years of age or older an the execut rix
in the last will of the above decedent, dated Octol~r 3:2001
and codicil(s) dated N/A
in the
named
,:~
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Monroe Township
Decel~dent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 91 5 Park Place, Monroe Township,
Mechanicsburq, PA 1 7055
(list street, number and muncipality)
Decerj{dent, then 84 years of age, died May 14, ,
at Holy Spirit_ Hospital: W~qt Ponnsboro Twp: Cumberland County: PA
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: no mxmo_p~ions
Decel~dent 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: 915 Park Place: Monroe
p~_nnsylvania
$ Undetermined
$ N/A
$ N/A
$ Undetermined
TownshiD, Cumberland County,
WHEREFORE, petitioner(t0 respectfully request(s) the probate of the last will mir ootRI:4810
presented herewith and the grant of letters Testamen~-y
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
'~016 Blue Ridqe Road
Harrisburq, PA 17110
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
Thc pctitioner{~) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
truc and correct to the best of the knowledge and belief of petitioner(x) and that as personal represen-
tative00 of the above decedent petitioner(~} will well and trldfir administer the~tatc according to law.
befpr~,,l~.eSw°rn to this°r :~_ .,~:>7.,~affirrmed and subscribedday of
~/,4~/.c~t--- ,_" ~ 2003 J '
..... ¥' - RegfstdrO
No. 21-03-440
Estate Of Honrietta P. Bolknap
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW M_AY 29th 2003 ~.__., 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 Octobor 3, 2001
described therein be admitted to probate and filed of record as the last will of
Henrietta P. Belknap ;
and Letters Testamentary
are hereby granted to Michelle B, Hoqan
FEES
Probate, Letters, Etc .......... $ 200.00
Short Certificates( 2 ) .......... $ 6.00
~tlcqa~;J~:iatia:z~. e~t]:a, pages. 2 $ 6.0'0
JCP $. 10.00
TOTAL __ $. 222.00
Filed I~IA.Y..29,..2003 .....................
MAILED TO ATTORNEY MAY 29, 2003
ATTORNEY (Sup. Ct. I.D. No.)
39 West Main Street
Mechanicsburg, PA 17055-6230
ADDRESS
(717) 766-9622
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death d~ly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9154824
No.
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Belknap Female I" 162 -- 22 -- 0078
Henrietta P.
Secretar,
915 Park Place
Mechanicsburg, PA 1 7055
17..~.,4. Pennsylvania ~ ,,,.~9 ~.~...~.. Monroe
,~. o.w (~,mh~_r] an,,'] ~'~' ,,,O ~ --~.~ ~.~_.
Michael P~
Michelle B. Hogan
May 16, 2003
{t,,~"~NUt~%, 4889
Day. 'mm)
,,. Helen Mihalcik
~.1UI b Blue Ri~ R~a ~rzs~g, PA 1 71 / 0
{,,.~cs~g C~te~ [,,~Mechanicsb~g, PA 17055
UCENS~ NUMBER IDA]rE SIGNED
I
21-03-440
LAST WILL AND TESTAMENT
21-03-440
I, HENRIETTA P. BELKNAP, widow, of the Township of Monroe, County of
Cumberland and State of Pennsylvania, being of sound mind, memory and understanding, do make,
publish and declare this to be my Last Will and Testament, hereby revoking and making void all
former wills, codicils and other testamentary dispositions by me at any time heretofore made.
1.
I direct my Executrix, hereinafter named, to pay as soon as practicable after my decease
all my legally enforceable debts and the expenses of my last illness and burial.
2.
I give and bequeath all of my estate, whatsoever and wheresoever situate, unto my
daughter, Michelle B. Hogan, absolutely.
3.
Should my said daughter predecease me, then and in that event, I give and bequeath all
of my said estate unto my sister, my brothers and my sister-in-law, Margaret P. Gallop, George L.
Pancoe, Charles J. Pancoe, Clyde L. Pancoe, Richard T. Pancoe and Eleanor A. Pancoe, equally,
share and share alike.
4.
Should my said sister or any of my brothers predecease me, then and in that event, I
give and bequeath the share of my estate to which my deceased sister or brother would have been
entitled had she or he survived me unto her or his surviving spouse. Should my said deceased sister or
deceased brother leave no spouse surviving her or him, then and in that event, I give and bequeath the
said share of my estate unto my surviving sister, brothers and spouses of my deceased sister and/or
deceased brothers in equal shares.
5.
Should my sister-in-law, Eleanor A. Pancoe, predecease me, then and in that event, I
give and bequeath the share of my estate to which she would have been entitled had she survived me
unto my surviving sister, brothers and spouses of my deceased sister and/or deceased brothers in equal
shares.
o
I hereby nominate, constitute and appoint my said daughter, Michelle B. Hogan,
Executrix of this my Last Will and Testament. Should my said daughter fail to qualify or cease to act
as Executrix, I hereby appoint my sister-in-law, Eleanor A. Pancoe, Executrix of this my Last Will.
IN WITNESS WHEREOF, I, HENRIETTA P. BELKNAP, the Testatrix, have
hereunto set my hand and seal to this my Last Will and Testament on this 3~~'~ day of
~7"~'Lqd ,2001.
HEN15dETT~ P. t~ELKNA~P /
Signed, sealed, published and declared by the above named HENRIETTA P.
BELKNAP, as and for her Last Will and Testament in the presence of us, who at her request and in
her presence and in the presence of each other, have hereunto subscribed our names as witnesses
thereto.
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
I, HENRIETTA P. BELKNAP, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will, that I signed it willingly, and that I signed it as my
free and voluntary act for the purposes therein expressed.
,~. ~wom to gro~lracknowl, edge,d before me by HENRIETTA P. BELKNAP, the Testatrix,
thi ~s~~ day of C~-~,~_ ~ j ,2001.
/.~~, ~~2.,~AL)
' r-Notary Pt~i~//
[ '3~o~'~1Sea~
! Cbar~yn ¥. ~mero, Notary PoOlic 1
[ Meehanicsburg 8oro. Cumberland Coua~
L My Commission ~xpires May '/8, 2002
M~m~r, ~nnsylvania Association oI Notaries
COMMONWEALTH OF PENNSYLVANIA ·
· SS.
COUNTY OF CUMBERLAND ·
the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw the Testatrix, HENRIETTA P.
BELKNAP, sign and execute the instrument as her Last Will, that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed, that each of us in the
hearing and sight of the Testatrix, signed the Will as witnesses, and that to the best of our knowledge
the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue
influence.
Sworn to and subscribed before me by
and
, witnesses, this,,._ .~_.~¢'//day
,2001.
Witness /
I /' N~a~ Sea,
[ Ch~rl¥.n Y...~uerriero, Notary Public
! Mechanics-D-urg Boro, Cumberland County
My Commission Expires May 18, 2002
M~rnoor, I~ennsylvania Association of Notaries
90:£,5 '87_, },~l~J ~0.
LAST WILL AND TESTAMENT
OF
HENRIETTA P. BELKNAP
~ttorne~s -at-~a~
39 West M~n S~eet
Mechanicsburg, PA 17055
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
REV-1162 EX(11-96)
NO. CD 002875
SUNDAY WILLIAM L ESQUIRE
39 W MAIN STREET
MECHANICSBURG, PA 17055
........ fold
ESTATE INFORMATION: SSN: 162-22-0078
FILE NUMBER: 2103-0440
DECEDENT NAME: BELKNAP HENRIETTA P
DATE OF PAYMENT: 08/06/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 05/14/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 94,531.50
TOTAL AMOUNT PAID:
94,531.50
REMARKS: MICHELLE B HOGAN C/O
WILLIAM L SUNDAY ESQUIRE
SEAL
CHECK# 4961
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
RE~-1500 EX ($-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
_2 0 4 4
COUNTY CODE YEAR NUMBER
Z
UJ
UJ
UJ
UJ
Z
m,
Z
0
0
UJ
X
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Belknap Henrietta P
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
05/1 4/2003 01/27/1 91 9
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
SOCIAL SECURITY NUMBER
162 - 22 -- 0078
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
- N/A-
~] 1. Original Return I---] 2. Supplemental Retum
I--j4. Limited Estate F--] 4a. Future Interest Compromise (date o~deam after 12-12-82)
[~]6. Decedent Died Testate (Amc. copy of Will) [] 7. Decedent Maintained a Living Trust (^~ch copy of Trust)
[~]9. Litigation Proceeds Received [---I 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
NAME
William L. Sunday
FIRM NAME
TELEPHONE NUMBER
(717) 766-9622
~---~ 3. Remainder Return (date of death prior to 12.13-82)
['"~ 5. Federal Estate Tax Return Required
1 8. Totat Number of Safe Deposit Boxes
--]11. Election to tax under Sec. 9113(A) I^~ach Sch O)
COMPLETE MAILING ADDRESS
39 Nest Maln Street
F'~cha~lcsbu~g, :PA 17055-6230
1. Real Estate (Schedule A) (1) 1 1 9900. O0
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnemhip or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Piper%, (5) 381 6.78 iii:
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 2414.87 ?'
U Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Unes 1-7)
9. Funeral Expenses & AdministraUve 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)
OFFICIAL USE ONLY
(8)
23961.36
1452.46
126131.65
13.
14.
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (al(1.2)
16. Amount of Line 14 taxable at lineal rate 1 0071 7.83
(11)
25413.82
100717.83
0.00
(12)
(13)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
(14)
100717.83
x.0
x .0 45
x .12
x .15
(15)
(16)
(17)
(18)
(19)
4532.30
19. TaxDue 4532.30
Decedent's Complete Address:
ISTREET ADDRESS 915 Park Place
CITY Mechanicsburg
Tax Payments and Credits:
tSTATE PA
tzIP
17055
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit 0. O0
B. Pdor Payments 4531.50
C. Discount 238.50
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
0.00
0.00
Total interest/Penalty ( D + E ) (3)
If Line 2 is greater than Line 1 + Line 3, enter the di.fference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
4532.30
4770.00
0.00
237.70
5. 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 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
* Except as an incident of joint
1. Did decedent make a transfer and: ownership Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []*
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []*
c. retain a reversionary interest; or .......................................................................................................................... [] []*
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Unaer penalties of perjury, i cteciare rna! I have examined tins return, inciucimg accompanying schedules and statements, an~ to the pest of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all tnformation of which preparer has any knowledge.
SIGNATURE OF PERSON RESP(;NSIBLE FOR FIL~ETURN
ADDRESS (-/'
1016 Blue Ridge Road, Harrisburg, PA
SIGNATURE O~R OTH~I'HAN~PRESENTATIVE
ADDRESS Wes; Main
39 Stree/t, Mechanicsburg~
DATE
~--//-- 2004
17110
PA 17055-6230
2004
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 RS. §9~t6 (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 RS. §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 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as
individual who has at least one parent in common with the decedent, whether by blood or adoption.
R EV*~502EX · (1-97) .~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Hen~iett~ P. Belkr~ap 21-03-0440
All real prope~]/owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pdce at which 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
VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ALL that certain house and lot of ground together with the
improvements therein erected situate in the Township of Monroe,
in the County of Cumberland and State of Pennsylvania, more particularly
bounded and described as follows, to wit:
BEGINNING at an iron pin in the southern dedicated right-of-way
line of Old Williams Grove Road, now known as Park Place, at the
eastern line of land conveyed by Henrietta P. Belknap, widow, to
Robert L. Gross and Mary L. Gross, his wife, by Deed dated
January 11, 1977 and recorded in the Deed Book "Z", Vol. 26,
Page 94; thence by the southern dedicated right-of-way line of said
Old Williams Grove Road, now known as Park Place, north 80 degrees
east 137.16 feet to a point; thence by a curve to the right having a radius
of 42.00 feet an arc distance of 69.89 feet to a point on the western legal
right-of-way line of Williams Grove Road, L.R. 21017; thence by said
legal right-of-way line south 04 degrees 39 minutes 40 seconds east 29.22
feet to a point; thence by lands now or late of Kenneth Miller and lands
now or late of Harry Hale south 03 degrees 10 minutes 50 seconds west
120.77 feet to an iron pin; thence by said lands conveyed to Robert L.
Gross and Mary L. Gross, his wife, north 86 degrees 49 minutes 10
seconds west 175.00 feet to a pin; thence further by same north 01
degrees 55 minutes 30 seconds west 154.21 feet to an iron pin at
the point and place of BEGINNING.
BEING Lot No. 1 on Final Subdivision Plan for Henrietta P. Belknap,
which said Plan is recorded in the Recorder's Office in and for said
Cumberland County in Plan Book 29, Page 39.
Tax Parcel No 22-31-2156-015
Assessed Value $ 104410.00
Valued ~Sale Price $119900.00 119900.00
119900.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1507 EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Henrietta P. Belknap
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21-03-0440
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
Note from Michelle R. Belknap dated November 28, 1979 in face
amount of $1250. (Changed to $700 on June 10, 1986) with no
interest stated.
Said note was paid in full form proceeds of redemption of U.S.
Government Bonds owned by Michelle R. Belknap prior to Death
Henrietta P. Belknap
TOTAL (Also enter on line 4, Recapitulation) $
VALUE AT DATE
OF DEATH
0.00
paid as set
forth prior
to death
0.00
(If more space is needed, insert additional sheets of the same size)
' REV-I,~8 EX · (1-97) .~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Hen~iet~.a P. t~lk_n_ap 21-03-0440
NUMBER
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
DESCRIPTION OF DEATH
1. Coins and Stamps
One (1) United States Liberty - Half Dollar Proof 1986 27.50
One (1) Coin" 100 Celebrating Sears New Century" 1886-1986 5.00
One (1) Bicentennial - July 4, 1976 - Mechanicsburg,
Upper Allen Twp, Monroe Twp - "Jubilee Coin" 5.00
One (1) Sheet of 50 John Fitzgerald Kennedy Stamps 20.00
Two (2) envelopes "First Day Issue Inaugarating the
United States Postal Service" 7/1/71 5.00
One (1) Multi-Diamond Engagement Ring @ appraisal 1200.00
One (1) Lady's Wrist Watch @ appraisal 125.00
1977 Plymouth Volare 300.00
Household Goods, Furniture and Contents ~ Public Sale prices 1269.25
Household Goods, Furniture and Contents not sold ~ apprasied value:
2 draw file $ 10.00
Refrigerator 100.00
Microwave 10.00
(1) Lamp 10.00
Kidney table 10.00
Cedar Chest 60.00
Stand 10.00
Auto Washer 50.00
Auto Dryer 10.00
Tnmk 20.00
Dresser 60.00
Total Retained 350.00
Commonwealth of Pennsylvania - Property Tax Rebate
350.00
510.03
TOTAL (Also enter on line 5, Recapitulation) $ 3816.78
(If more space is needed, insert additional sheets of the same size)
r
COMMONWEALTH OF PENNS~ ~.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Henrietta P. Belknap FILE NUMBER
SCHEDULE F I
21-03-0440
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
Michelle B. Hogan
1016 Blue Ridge Road
Harrisburg, PA 17110
Daughter
JOINTLY-OWNED PROPERTY:
LEI I ~.a,DATE DESCRIPTION OF PRCPERTY % OF DATE OF DEATH
ITEM FCR JOINT MADE Include name of financial institution and bank account number or similar identifying numt~er. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held reaJ estate. VALUE OF ASSET INTEREST DFC~--nENT'S INTERES;
7/11/01 Checking Account # 5070076847
in PNC Bank, N.A.
Principal $4819.47
Accrued Interest .25
4819.72 4819.72 50% 2409.86
2. A. :11/17/98 Savings Account # 5001970685
in PNC Bank, N.A.
Principal $10.02
Accrued Interest 0.00
10.02 10.02 50% 5.01
3. A. 9/15/95 Certificate of Deposit # 21001026009
issued by PNC Bank on Sept. 15, 1995
in joint names of Henrietta P. Belknap and
Michelle B. Laskoski (now Michelle B. Hogan)
in face amount of $7000.00 maturing in 3 years.
Redeemed March 17, 2003 and deposited in
Checking Account # 5070076847 on 3/17/03
( item 1 above) See attached letter 0 50% 0
redeemed
3/17/03
TOTAl. (Also enter on line 6, R~capitulation) $ 2414.87
(If more space ~s needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RE$1OENT OECEOENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
He_n_~ietf. a P. ~elN~ap FILE NUMBER 21-03-0440
Deb~ of decedent must be reposed on Schedule I.
ITEM
NUMBER DESCRIPTION
Ao
5.
6.
7.
8.
10.
11.
12.
FUNERAL EXPENSES
Malpezzi Funeral Home - Funeral Expense
ADMINSTRATIVE COSTS
Personal Representative's Commissions
Name of Personal Representative (s):
Social Security No. (s) / EIN Number of Personal Representative
Street Address:
City: State: Zip:
Year(s) Commission Paid:
Attorney Fees
Family
Exemption (if decedent's address is not the same as claimant's,
attach explanation)
Claimant:
Street Address:
City: State:
Relationship of Claimant to Decedent:
Zip:
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Register of Wills - (2) Short Certificates
William L. Sunday - Reimbursement for Costs Advanced
Cumberland Law Journal - Executors Notice 75.00
The Sentinel - Executors Notice 98.69
Postmaster- Notices ( Rule of Court) 8.89
Central Penn Appraisers - Appraisal of Real Estate
Chuck Brickers Auctioneer - Appraisal Household Goods and Furniture
Henderson & Company, Jewelers, Inc- Appraisal of Jewelry
Chuck Bricker Auctioneer - Commission on Public Sale
carried forward
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$ 7317.00
4950.00
216.00
6.00
182.58
275.00
60.00
75.00
424.25
13505.83
RL~V-1511EX * (1-97) ~
COMMONWEALTH CF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Henrietta P.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
~elk~ap
FILE NUMBER
21-03-0440
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
13.
14.
15.
16.
17.
18.
19.
20.
DESCRIPTION
Mark Heckman Real Estate Apprasier - Appraisal
Verizon - Phone
Register of Wills - Additional Probate Fee
Register of Wills -
Filing PA Inheritance Tax Return
Inventory
balanceforward
$15.00
13.00
Gail Minnich - Notary Fees
Recorder of Deeds - Realty Transfer Fee
ReMax - Commission on sale of Real Estate
Reserved for Filing Account, Recording Releases, etc.
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
13505.83
600.00
40.53
35.00
28.00
10.00
1199.00
8393.00
150.00
23961.36
SCHEDULEI
DEBTS OFDECEDENT,
MORTGAGELIABILITIES,&LIENS
REV-:EI2 EX - {1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Henrietta P. Belknap FILE NUMBER 21-03-0440
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
2.
3.
4.
5.
6.
Check # 7512 dated 5/26/03 to Verizon (717) 766-6997
Check # 7514 dated 5/26/03 to Verizon (717)545-8688
Check # 7515 dated 5/26/03 to Messiah Village
Villa Teresa - Account Payable
Physicians Rehab - Account Payable
Met Ed - Balance due on Budget plan
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
20.10
21.55
56.00
850.00
26.81
478.00
1452.46
COMMONWEALTH OF PENNSYLVANIA
INHERJTANCE TAX RETURN
RESIDENT DECEDENT
E$¥ATE OF
Henrietta
SCHEDULE J
BENEFICIARIES
P. Belknap FILE NUMBER
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS (include outdght spousal distributions)
21-03-0440
II.
Michelle B. Hogan
1016 Blue Ridge Road
Hamsburg, PA 17110
Daughter
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART I-I'. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
AMOUNTORSHARE
OF ESTATE
Joint Property and
entire Probate Estate
ON REV 1500 COVER SHEET
None
None
$ None
Inventory of the real and personal estate of
HENRIETTA P. BELKNAP
(continued)
deceased
balanceforward
Commonwealth of Pennsylvania - Property Tax Rebate
Death Benefit - Life Insurance Policy No. 396264 issued by
Ohio National Financial Services payable to
Estate of Henrietta P. Belknap
TOTAL PERSONAL PROPERTY
TOTAL PROBATE ESTATE
Real Estate
Personal Property
Total Probate Estate
$119900. O0
5205.06
$ 125105.06
3306. 75
510. 03
1388. 28
Inventory of the real and personal estate of
HENRIETTA P. BELKNAP
deceased
REAL ESTATE
ALL that certain house and lot of ground together with the improvements thereon
erected know as 915 Park Place in the Township of Monroe, County of Cumberland
and State of Pennsylvania,
BEING lot # 1 on Final Subdivision Plan for Henrietta P. Belknap, which said plan
is recorded in the Recorder's Office in and for said Cumberland County in
Plan Book 29, page 39.
Tax Parcel No. 22-31-2156-015
Valued @ Sale Price
TOTAL REAL ESTATE
PERSONAL PROPERTY
1. Coins and Stamps
One (1) United States Liberty - Half Dollar Proof 1986
One (1) Coin" 100 Celebrating Sears New Century" 1886-1986
One (1) Bicentennial - July 4, 1976 - Mechanicsburg,
Upper Allen Twp, Monroe Twp - "Jubilee Coin"
One (1) Sheet of 50 John Fitzgerald Kennedy Stamps
Two (2) envelopes "First Day Issue Inaugarating the
United States Postal Service" 7/1/71
One (1) Multi-Diamond Engagement Ring ~ appraisal
One (1) Lady's Wrist Watch ~ appraisal
1977 Plymouth Volare
Household Goods, Furniture and Contents ~ Public Sale prices
Household Goods, Furniture and Contents not sold ~ apprasied value:
2 draw file $ 10.00
Refrigerator 100.00
Microwave 10.00
(1) Lamp 10.00
Kidney table 10.00
Cedar Chest 60.00
Stand 10.00
Auto Washer 50.00
Auto Dryer 10.00
Trunk 20.00
Dresser 60.00
Total Retained 350.00
carried forward
$119900.00
00
27. 50
5.00
5 00
20 00
5.00
1200. 00
125.00
300.00
1269 25
350. )0
3306. 75
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Michelle B. Hoqan
being duly swor~ according fo law, deposes and says fhaf ~he is Executrix
of the Estate of Henrietta P. Belknap
late of Monroe Township ...... Cumberland County, Pa., deceased end fhaf fha
within is an inventory made by her , the said ]~ecu~rix
of fha enHre estate of said decedent, consisflng of all fha personal property and real estate, except real estate oufslde
the Commonwealth of Pennsylvania, and fhaf the figures opposlfe each item of fha Inventory represent it's fair value
as of the date of decedenf's death.
February
I ] Gail P. Mipnich, Nora%, Public
~ Mechanicsbu, rp ~:i:,'o, Cumbr~rland Coun~
I My ~mn ~s~-ic'~ Exp~'~.s D~. 9, 2006
Mem~r, Pennsyfv¢~3 AsL':3d2t~on O¢ No. des
and subscribed before me,
' ' Executor =~h~s~. Michelle B. Hogan
1016 Blue Ridge Road
Harrisburg, PA 1 711 0
Date of Death 14 May 2003
Day K4onfh Year
Address
INSTRUCTIONS
I. An inventory must be filed within three months after appolnfment of personal represenfaflve.
2. A supplement inventory must be filed wlfhln fhlrfy days of discovery of additional assets.
3. Additional sheets may be attached as fo personalty or realty
4. See Arflcle IV, Fiduciaries Act of 1949.
Z
,,,
>.
7 0 r~
,,,
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Henrietta P. Belknap
Date of Death:
May 14; ~flClq
Will No. 2003-00440 Admin. No.
To the Register:
I certify that notice of (l~,nt, fit, i~i~) estate administration 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 Auqust 4, 2003 :
Name Address
Michelle B. Hogan, 1016 Blue Ridge Road, Harrisburg, PA 17110
Margaret P. Gallop, 3646 Rocky River Drive, Apt 211B Cleveland, OH 44111
George L. Pancoe, 701 S. 22nd Ave, Bellwood, Ill, 60104
Charles J. Pancoe, 6870 Rt. 356 Leechburg, PA 15656
~!~de L. Pancoe, 202 Lowell St. Vandergrift, PA 15690
Richard T. Pancoe, c/o Clyde L. Pancoe, 202 Lowell St. Vandergrift,PA 15690
Eleanor A. Pancoe, 1'124 Roup,Ave. Brackenridge, PA 15014
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: Auqust ~/ 2003
Name William L.
Address 39 West Main Street
Mechanicsburg, PA 17055-6230
Telephone (717) 766-9622
Capacity: __
X Counsel for personal representative
BUREAU OF ZNDZVTDUAL TAXES
INHERITANCE TAX DIVISTON
DEPT. 280601
HARRISBURn, PA, 171Z8-060!
WILLIAM L SUNDAY
$9 W MAIN ST
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
~'}:;'-': DATE Oq-ZZ-ZOOq
?:~, ji :* ESTATE OF BELKNAP
DATE OF DEATH 05-1q-2005
'04 APR 14 /~ c :~0 FILE NUMBER 21
.~ COUNTY CUMBERLAND
ACN 10 Z
Amount Remitted
REV-],Sici? EX AFP
HENRIETTA p
HAKE CHECK PAYADLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LO
.............................. WER PORTION FOR YOUR RECORDS ~ ·
REV-1547 EX AFP (01-03~-~-~'~-~'~-~-~-~-~-~-~-~.~ ......
D~SALLOWANCE ENT, ~-~ ......................
ESTATE OF BELKNAP OF DEDUCTIONS AND ASSESSMENT OF TAX E OR
HENRIETTA p FILE NO. 21 03-OqqO ACN 101 DATE Oq-lg-gOOq
TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED
.R_E_S_ERVA~CERNI'NG FUTURE ZNTEREST- SEE REVERSE
APPRAZSED VALUE ~' RETURN aASED ~.~
1. Real Estate (Schedule A)
ORIGINAL RETURN
2. Stocks and Bonds (Schedule B) (1).
(2)
3. Closely Held Stock/Partnership ]:nterest (Schedule C) (3)
q- Mortgages/Notes Receivable (Schedule D)
(~)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (6)_
8. Total Assets (7)
APPROVED DEDUCTTONS AND EXEMPTIONS:
9. FuneraZ Expenses/Adm. Costs/Misc. Expenses (ScheduZe H) (9)
10. Debts/Mortgage LiabiZities/Liens (ScheduZe Z)
11. Total Deductions (10)..
12. Net Value of Tax Return
SEE ATTACHED NOTICE
119/900.00
.00
.00
.00
3/816.78_
2/qlq.87
.00
30,961.36
1,q52.q6
(11)
(12)
13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Net Value of Estate Subject to Tax
NOTE: To insure proper
credit to your account,
submit tho upper portion
of th~s form with your
tax Payment.
126,131.65
32
93,717.83-
.O0
q,7q2.37 ]
525.07CR~
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED,
~F TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU MAY BE DUE
REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
ZF PA~D AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(2~) 93,717.8~5
NOTE: Z'F an assessment was issued previously, lines la, 15 and/ar 16, 17, 18 and 19 will
reflect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
1.6. Amount of Line Zfi at Spouse/ rate
(25) .00 x O0 = .00
16. Amount of Line lr, taxable at Lineal/Class A rate (16)_ 93,717.83 X Oq5 = q,217.30
17. Amount of Line Ir, at Sibling rate
(27) .00 x 12 = .00
18. Amount of Line lq taxable at Collateral/Class B rata (18)_ O0 x 15
19. Principa! Tax Due ' = · O0
TAX C_REDZTS: (19)=_
08-06-~]~1~ ZNTEREST/PEN PAZD (-) AHOUNT PAZD
INTEREST AND PEN.
TOTAL DUE
RESERVATION: Estates of ~ecsdents dying on or before December 12, 1982 -- if any future interest in the as~atm is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life ar for years, the Commoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the la.ful Class B (coIlateral) rate on any such future interest.
Tax Act, Act 23 of ZOO0. (7Z P.S.
PURPOSE OF
NOTICE: To fulfill the requirements of Section ZI~O of the Inheritance and Estate
Section ;l~O).
pAYHENT: Detach the top portion of this Notice and submit .ith your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS~ AGENT
REFUND (CR): A refund of a tax credit, .hich #as not requested on the Tax Return, may be requested by completing an -Application
for Refund of Pennsylvania inheritance and Estate Tax" [REV-1515). Applications are available at the office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z~-hour
ans.aring service for forms ordering: 1-BOO-56Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-800-~7-50Z0 (TT onlY}.
OBJECT[OHS: Any party in interest not satisfied .ith the appraisement, alio.ance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object .ithin sixty (60} days of receipt of
this Hotice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZl, Harrisburg, PA 17IZB-IOZ1, OR
--election to have the matter determined at audit of the account of the personal representative, ON
--appeal to the Orphans' Court.
ADHIN- to: PA Department of Revenue,
[STRATIVE
CORRECT[OHS: Factual errors discovered on this assessment should be addressed in ,riling
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. lB0601, Harrisburg, PA 17liB-060!
Phone (7[7) 787-6505. See page 5 of the booklet -instructions for Inheritance Tax Return for a Resident
Decedent" (REV-J501) for an explanation of administratively correctable errors.
DISCOUNT: [f any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (EX) discount of
the tax paid is allowed.
pENALTY: The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and ;~ot
paid before January [8, 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 would appeal the tax and interest
that has been assessed as indicated on this notice.
date of
the rata of
INTEREST: Interest is chargad beginning with first day of delinquency, or nine (9) months and one (1} day from the
death, ta the date of payment. Texas which became delinquent befare January It 198Z bear interest eton and after
.ith that rata
six (6X} percent per annum calculated at a daily rata of .08816~. Ail taxes which became delinquent
January l, 198Z will bear interest at a rate which .ill vary from calendar year to calendar Yearare:
Interest Daily
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~
Daily Interest Daily Factor
Factor Year Rate
Interest .~'~-
Year Rate Factor Year Rate ~
I985 16Z .O00~SB I99Z 92 .0002~7 2002 62 .00016~
1986 lOX .O0027~ 1999 7X .000192
19B7 lOX .O00Z?~ ZooO 7z .oool9z
--Interest is calculated as folio.s: OF DAYS DELINQUENT X DALLY INTEREST FACTOR
INTEREST = BALANCE OF TAX UNPAID X NUNBER will reflect an interest calculation to fifteen (IS) days
--Any Notice issued after the tax becomes delinquent
beyond the date of the assessment- If payment is made after the interest computation data sho.n on the
Notice, additional interest must be calculated.
REV-1470 EX (6-88)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
~RRISBURG PA 17128-0601
DECEDEN'FS NA~
Henrietta p Belknap
Deborah Washington
SCHEDULI
INHERITANCE TAX
EXPLANATION
OF CHANGES
EXPLANATION OFCHANGES
lol
H
Accepted additional expense
ROW
Page 1
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZVTSTON
DEPT. 180601
HARRTSBURG, PA, 17118-0601
WILLIAH L SUNDAY
HAIN ST
HECHANICSBURG
COMHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FZLE NUHBER
COUNTY
ACN
Oq-lZ-ZOOq
BELKNAP
05-1q-2005
21 05-0~0
CUHBERLAND
101
Aaoun~ ReaLiZed
REV-Z54? EX AFP (01-03)
HENRIETTA P
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-lSd7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF BELKNAP HENRIETTA P FILE NO. 21 05-OqqO ACN 101 DATE OR-12-ZO0~
TAX RETURN NAS: ( } ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Es~a~e (Schedule A) (1)
2. S~ocks end Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership Tn~eres~ (Schedule C) ($)
q. Mortgages/No,es Receivable (Schedule D) (~)
5. Cash/Bank Deposi:ks/Nisc. Personal Proper~y (Schedule E) ($)
6. Jointly O~ned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Ada. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule 1} (10}
11. To,al Deductions
12. Ne~ Value of Tax Re~urn
119;900.00
O0
O0
O0
5~816 78
Z~qlq 87
O§
(8)
50,961
NOTE: To insure proper
credi~ ~o your account,
subai~ ~ha upper portion
of ~his fora wi~h your
~ax payment.
15.
lq..
NOTE:
ASSESSMENT OF TAX:
15. Aaoun~ of Line 1~ a~ Spousal ra~a
16. Aaoun~ of L[na lq ~axable e~ Lineal/Class A ra~e
17. Aaoun~ of Line 1~ a~ Sibling ra~e
18. Aaoun~ of Line lq ~axable a~ Collateral/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEZP1 DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-)
08-06-2005 CD002875 210.87
126,151.65
1,~52.~6
(11) 32.~13.82
(12) 95,717.85
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13)
Ne~ Value of Es~:a~:e Sub~ec~ ~o Tax (lq)
T~ an assessment was issued previously, Zines 14, 15 and/er 16, 17,
reflect f/gures that lnclude the total of ALL returns assessed to date.
.00
95,717.85
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
18 and 19 #ill
q'7q2'~CR525.
525.07CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
q,531.50
AMOUNT PAZD
(15) .00 x O0 = .00
(16) 93,717.85 x Oq5= q.,217.50
(17) .00 x 12 = .00
(18) . O0 x 15 = . O0
(19)= q,217.50
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
[STRATIVE
CORRECTZONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of ~ecmdants dying on or before December II, 1981 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class S (collateral) rate on any such future interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S.
Section 9140).
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGZSTER OF HILLS, AGENT
A refund of a tax credit, ahich was not requested on the Tax Return, may bm raquastmd by completing an "Application
for Refund of Pennsylvania Znhmritance and Estate Tax" (REV-I$X3). Applications ars available at the Office
of the Register of Rills, any of the 23 Rmvenua District Officms, or by calling the special 24-hour
ansmaring servicm for forms ordering= 1-800-362-2050; smrvicas for taxpayers with spmcial hearin9 and / or
speaking needs: 1-800-447-3020 iTT
Any party in intmrest not satisfied with tho appraisement, allowance, or disallowance of deductions, or assassmmnt
of tax (inciudin9 discount ar interest) ms shown on this Notice must object mithin sixty (60) days of receipt of
this Notice by:
--aritten protsst to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have thm mattmr datmrained at audit of the account of the personal representative,
--appeal to the Orphans' Court.
Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individue! Taxes, ATTN: Post Assessment Revise Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident
Decedent" (REV-1SOX) for an explanation of administratively correctable errors.
If any tax duo is paid within three (3) calendar months after the decadsnt's death, a five percent (51) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on thm total of the tax and interest assessed, and r~ot
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 ties period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the data of payment. Taxes which became delinquent before January i, 1981 bear interest at the rate of
six (61) percent par annum calculated at a daily rate of .000164. AXX taxes which became delinquent on and after
January l, 1982 mill bear interest at a rate ahich ail! vary from calendar year to calendar year mith that rate
announced by the PA Depart;ant of Revenue. The applicable interest rates for 1982 through 2004 are:
Interest Daily Xntersst Daily
Year Rate Factor Year Rate Factor
1'~ ZOZ .000548 1988-1991 XXZ .00030l
1983 X6Z .0004':q8 1992 92 .000247
1984 117. .000301 1993-1994 72 .000192
1985 Z3Z .000356 1995-1998 91 . O00147
1986 lOZ .000274 1999 77. .000191
1987 IOZ .000174 ZOO0 77. .000192
--Interest is calculated as folloas:
ZNTEREST= BALANCE OF TAX UNPAID
Interest Daily
Year Rets Factor
ZOOX 97. .OOOZ4?
ZOOZ 62 .000164
2003 52 .000137
Z004 47. .000110
X NUHBER OF DAYS DELZNQUENT X DAZLY ZNTEREST 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.
;~EV-1470 EX (6-88)
INHERITANCE TAX
COI~IMONWEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 28O6O1
HARRISBURG~ PA 17128-0601
3ECEDEN3~S NAME FILE NUMBER
Henrietta P Belknap 2103-0440
~EVIEWED BY ACN
Deborah Washington 101
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
H B-21 Accepted additional expense
ROW Page 1
21-03-0440
FAMILY SETTLEMENT AGREEMENT
THE FIRST AND FINAL ACCOUNT OF MICHELLE B. HOGAN,
EXECUTRIX UNDER THE LAST WILL AND TESTAMENT OF
HENRIETTA P. BELKNAP, LATE OF THE TOWNSHIP OF MONROE,
COUNTY OF CUMBERLAND, AND STATE OF PENNSYLVANIA,
DECEASED, AND RELEASE OF THE DISTRIBUTEE UNDER THE
WILL OF SAID DECEDENT HERETO ATTACHED.
Date of Death: May 14, 2003
Dates Letters Advertised:
Cumberland Law Journal - June 20 and 27 and July 4, 2003
The Sentinel - June 12, 19 and 26, 2003
PERSONALTY
PRINCIPAL ACCOUNT
DEBITS
Accountant charges herself with the Personal Property
set forth in the Inventory filed in the Office of Register of
Wills in and for Cumberland County in the amount of:
$ 5205.06
Accountant also charges herself with the following:
2003
Advances from joint account by Michelle B. Hogan
by paying debts, taxes and administrative costs between
5/26/03 and 4/8/04
1033.44
Aug 5
Advancement by Michelle B. Hogan by
paying PA Inheritance Tax from her separate
account
4531.50
CARRIED FORWARD 10770.00
.2004
Jan 21
Feb 11
Jun 2
Jun 16
PERSONALTY
PRINCIPAL ACCOUNT
DEBITS (Continued)
BROUGHT FORWARD
Gain on Sale of Household Goods Sold 1/17/04
Gross Proceeds 685.00
Less: Costs of Sale 225.00
Net Proceeds 460.00
Less: Inventory Basis 0
Gain on Sale 460.00
Advancement by Michelle B. Hogan by
paying one-half (1/2) of Attorney's Fees
Directly to William L. Sunday
Verizon - Refund
Cormmonwealth of Pennsylvania Refund
(PA Inheritance Tax)
TOTAL
$10770.00
460.00
2475.00
13.46
525.07
$14243.53
PERSONALTY
PRINCIPAL ACCOUNT
CREDITS
Accountant asks credit for the following:
Payments of debts, taxes and administration expenses made by Michelle B.
Hogan, surviving joint owner, from joint account in PNC Bank.
2003
May 26
26
26
Sep 3
2
26
Nov 13
12
Verizon (717) 766-6997 - Account Payable
Verizon - (717) 545-8688 - Account Payable
Messiah Village - Account Payable
Physicians Rehab - Account Payable
Verizon Phone
William L. Sunday - Reimbursement For:
Probate 216.00
(2) Short Certificates 6.00
Notice - CLJ 75.00
Notice Sentinel 98.69
Postage - Rule - 5.6 8.89
Chuck Bficker-Appraisal(Household Goods)
Vedzon - Phone
Villa Teresa- Account Payable(On Account)
Vefizon Phone
20.10
21.55
56.00
26.81
40.53
404.58
60.00
40.91
150.00
40.84
CARRIED FORWARD $ 861.32
PERSONALTY
PRINCIPAL ACCOUNT
CREDITS (Continued)
2004
Feb 11
11
11
Mar 5
Apr 8
2003
Aug 5
2OO4
Feb 11
Mar 23
23
Jul 31
31
BROUGHT FORWARD
Register of Wills Additional Probate Fee
Register of Wills FilingFees
Gail Minnich Notary Fees
Verizon Phone
Verizon Final Phone
Sub-total (Paid From Joint Account)
Register of Wills, Agent - PA Inheritance Tax
Tax 4770.00
Less Discount 238.50
William L. Sunday - Partial Attorney's Fee
Malpezzi Funeral Home
Villa Teresa - Balance Account Payable
William L. Sunday Balance Attorney's Fee
Register of Wills - Filing Family Settlement
Agreement
Sub-Total of Payments
$ 861.32
35.00
28.00
10.00
61.56
$ 37.56
$1033.44
$ 4531.50
$ 2475.00
7317.00
700.00
2475.00
17.00
18548.94
CARRIED FORWARD 18548.94
2004
Jan 9
Mar 22
BROUGHT FORWARD
Accountant also asks credit for the following:
Loss on Sale of Household Goods and Furniture
Basis of Property Sold 1/7/04 $1269.25
Less: Gross Proceeds 1269.25
Costs of Sale 424.25
Proceeds Received 845.00 845.00
Loss on Sale 424.25
Loss on Appliances Sold as Part of Real Estate
Proceeds Received 0
Inventory Values
Refrigerator 100.00
Microwave 10.00
Washer 50.00
Dryer 10.00
Basis 170.00
Less: Proceeds Received 0
Loss on Appliances 170.00
$18548.94
424.25
170.00
TOTAL PERSONALTY PRINCIPAL ACCOUNT CREDITS $19143.19
2003
Sep 5
PERSONALTY
INCOME
RECEIPTS
Accountant charges herself with the following:
Ohio National Financial Services Interest
$ 13.35
TOTAL PERSONALTY INCOME ACCOUNT RECEIPTS $13.35
REAL ESTATE
PRINCIPAL ACCOUNT
DEBITS
Accountant charges herself with the proceeds
from the sale of the real estate described in the Inventory
filed in the Register of Wills Office aforesaid in the amount of
Accountant also charges herself with the following:
Advancements from joint account by Michelle B.
Hogan by paying debts, expenses and administrative costs
between 7/3/03 and 4/9/04
$119900.00
3387.44
2004
Mar22
Apr 26
Douglas A. Black - Property Tax Adjustments
on Date of Sale
464.74
Ohio National Insurance Co. Return Premium $ 106.00
TOTAL REAL ESTATE PRINCIPAL ACCOUNT DEBITS $123858.18
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS
Accountant asks credit for the following:
Payment of debts, taxes and administration expenses
by Michelle B. Hogan surviving joint owner of joint account
in PNC Bank.
2003
July 3
Aug 28
28
Sep 29
25
Nov 12
14
Dec 19
2004
Jan 26
30
Feb 2
Apr 9
Mark Heckman Real Estate Appraisal
(Commercial)
Hutters Insurance - Home Owners Premium
Met Ed - Account Payable
Central Penn Appraisals
Met Ed Electric
Calaman - Lawn Care
Culligan - Water Softener Purchased
Met Ed - Electric
Calaman - Lawn Care
Met Ed - Electric
Met Ed - Electric
Heckman - Appraisal (Balance)
Calaman - Snow Removal
Met Ed - Final Electric
Sub-total (Paid From Joint Account)
CARRIED FORWARD
$ 600.00
326.00
478.88
275.00
302.25
25.20
265.00
300.19
89.04
130.00
136.00
200.00
100.00
159.88
$ 3387.44
3387.44
2003
Dec 16
2004
Jan 25
Mar 22
Mar 22
23
23
Apr 5
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS (Continued)
BROUGHT FORWARD
Mary Murray, Tax Collector - 2003-2004
School Taxes
1 st Call Remodelers - Repairs
Settlement Charges Due From Seller as Follows:
Remax - Commission $8393.00
Remax Transaction Fee 125.00
Loan Origination Fee 1139.00
Loan Discount 1139.00
Tax Service Fee 75.00
Underwriting Fee 400.00
Flood Certification 18.00
Title Insurance 826.00
Realty Transfer Tax 1199.00
Tax Certification 2.00
Mary Murray, Tax Collector 261.13
First Call Remodelers 1226.78
Termite Inspection 232.00
Total Settlement Charges
by Seller 15035.91
Gregory R. Reed, Esq. - Escrow Agent for
Repairs to Sewer System and Installation and
Connection to Public Sewer System
Mark Heckman - Balance Due for Commercial
Appraisal
Calaman - Snow Removal
Michelle B. Hogan Reimburse Joint Account
CARRIED FORWARD
$ 3387.44
1055.25
300.00
15035.91
7000.00
400.00
165.26
197.44
$ 27541.30
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS (Continued)
BROUGHT FORWARD
$ 27541.30
Apr 5
Michelle B. Hogan Reimbursement
for:
PA Inheritance Tax Payment 4531.00
Storage Garage 455.00
Attomey's Fee 2500.00
7486.00
TOTAL REAL ESTATE PRINCIPAL ACCOUNT CREDITS $ 35027.30
Michelle B. Hogan
ADVANCEMENTS
Coins and Stamps
(1) Multi-diamond Engagement Ring
(1) Lady's Wrist Watch
1977 Plymouth Volare
Household Goods and Furniture ~ Appraised Value
TOTAL ADVANCEMENTS
$ 62.50
1200.00
125.00
300.00
180.00
1867.50
PERSONALTY:
REAL ESTATE:
RECAPITULATION
Principal Account
Debits
Credits
Balance
Income Account
Receipts $13.35
Expenditures 0
Balance 13.35
Principal Account
Debits
Credits
Balance
Total Distributable Estate
Less: Advancements
$123858.18
35027.30
Balance in Hands of Accountant for Distribution
Thc said Balance for Distribution consists of the following:
Cash PNC Bank, N.A.
$14243.53
19143.19
(4899.66)
13.35
88830.88
$83944.57
1867.50
$ 82077.03
$ 82077.07
SCHEDULE OF DISTRIBUTION
The balance for distribution in the hands of Michelle B. Hogan, Executrix under
the Last Will and Testament of Henrietta P. Belknap, deceased, as appears by the
Family Settlement Agreement is: $ 82~077.07.
DISTRIBUTION AND AWARD
TO:
MichelleB. Hogan Entire Estate
Cash
PNC Bank, N.A.
TOTAL
$ 82077.07
$ 82077.07
RELEASE
WHEREAS, Henrietta P. Belknap, died on May 14,2003, leaving her Last
Will and Testament dated October 3, 2001, where in and ;vhereby she gave,
devised and bequeathed all the rest, residue, and remainder of her Estate after the
payment of her just debts and funeral expenses unto her daughter, Michelle B.
Hogan; and
WHEREAS, she further provided that in the event her daughter
predeceased her, she gave, devised and bequeathed the residue of her Estate to the
individuals named in Item 3 of her Will; and
WHEREAS, her daughter, Michelle B. Hogan, survived the Testatrix, the
residue of the Estate is distributable to her surviving daughter, Michelle B.
Hogan.
NOW KNOW ALL PERSONS BY THESE PRESENTS, that I,
Michelle B. Hogan, sole legatee, devisee and distributee of the Estate of said
decedent, and the only person entitled to share in the distribution of said Estate,
do hereby declare and say that I have examined the foregoing Account and
Schedule of Distribution and find the same to be tree and correct and in strict
accordance ;vith the terms and provisions of said Will, and do hereby
acknowledge that I, this day have had and received of, and from Michelle B.
Hogan, Executrix of the Estate of Henrietta P. Belknap the cash set opposite my
name in the above stated Schedule of Distribution, in full satisfaction, payment
and discharge of all such sum or sums of money, legacies and bequests, share or
shares, purparts and dividends which were due, owing payable and belonging me,
by any means whatsoever, for or on account of my full share, part or dividend of
the Estate of the said decedent and all interest accrued thereon.
NO~V THEREFORE, I, Michelle B. Hogm~, thc sole legatee, dcvi~¢ and
distributee of the Estate of Henrietta P. Belknap, deceased, do by these presents
remise, release, quit-claim and forever discharge the said Michelle B. Hogan,
Executrix, her heirs, executors and administrators, of and from said shares or
dividends of said Estate aforesaid, and of and from all actions, suits, payments,
accounts, reckonings, claims and demands whatsoever, for or by reason thereof,
or of any other act, matter, cause or thing whatsoever, from the beginning of the
world to the day and date of these said presents.
AND, desiring to avoid the delaying and expense of the settlement of the
said Estate by filing the foregoing Account of said administration in the Office of
the Clerk of the Orphans' Court of the Court of Common Pleas of Cumberland
County, Pennsylvania, and by having the balance in the hands of the Executrix, as
shown by said Account, distributed by an auditor appointed by the Orphans Court
Division of the Court of Common Pleas of Cumberland County, I do hereby agree
that the foregoing statement concerning the manner of settlement may be recorded
with the same effect upon me as if the same had been reported by the said Court
of Common Pleas, Orphans' Court Division.
AND, in consideration of the aforesaid settlement being made without the
aid of said Court of Common Pleas, Orphans' Court Division, that I, Michelle B.
Hogan, do hereby agree that if any debts or demands other than those included
within The First and Final Account of the said Michelle B. Hogan, Executrix of
the Estate of Henrietta P. Belknap, deceased, as hereinbefore set forth, shall be
hereal2er recovered against the Estate of said decedent and be legally payable out
of the same, that I, Michelle B. Hogan, shall return to said Executrix such ratable
amounts thereof as may be necessary to pay such legally enforceable debts or
demands.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
/ 5' ~ day of ,42~,c~'~7' ,2004.
'/~"d~' <"~'~ (SEAL)
l~Iichelle B. Hogan
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
Before me, the subscriber, a Notary Public in and for said State and
County, personally appeared, Michelle B. Hogan, and in due form of law
acknowledged the foregoing Release to be her act and deed and desired that the
same might be recorded as such.
ITNESS my hand and notarial seal this day of
qSP ,2004.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Henrietta p. Belkg~p
Date of Death: May 14, 2003
Will'No. 21-03-0440
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 X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: N/A
If the answer to. No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes__ No × .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did ~he personal representative state an
account informally to the parties in interest? Yes x No
d. Copies of receipts, releases, Joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: October/~ 2004
Signature
William L. Sunday
Name (Please type or print)
39 West Main Street
M~h~ni~hl~rg~ PA 17055-6?30
Address
(717) 766-9622
Tel. No.
Capacity:
__Personal Representative
( MAH :rmf/AM3 )
X
__Counsel for personal
representative
21-03-0440
FAMILY SETTLEMENT AGREEMENT
THE FIRST AND FINAL ACCOUNT OF MICHELLE B. HOGAN,
EXECUTRIX UNDER THE LAST WILL AND TESTAMENT OF
HENRIETTA P. BELKNAP, LATE OF THE TOWNSHIP OF MONROE,
COUNTY OF CUMBERLAND, AND STATE OF PENNSYLVANIA,
DECEASED, AND RELEASE OF THE DISTRIBUTEE UNDER THE
WILL OF SAID DECEDENT HERETO ATTACHED.
Date of Death: May 14, 2003
Dates Letters Advertised:
Cumberland Law Journal - June 20 and 27 and July 4, 2003
The Sentinel - June 12, 19 and 26, 2003
PERSONALTY
PRINCIPAL ACCOUNT
DEBITS
Accountant charges herself with the Personal Property
set forth in the Inventory filed in the Office of Register of
Wills in and for Cumberland County in the amount of:
$ 5205.06
Accountant also charges herself with the following:
2003
Advances from joint account by Michelle B. Hogan
by paying debts, taxes and administrative costs between
5/26/03 and 4/8/04
Aug 5
Advancement by Michelle B. Hogan by
paying PA Inheritance Tax from her separate
account
1033.44
4531.50
CARRIED FORWARD 10770.00
2004
Jan 21
Feb 11
Jun 2
Jun 16
PERSONALTY
PRINCIPAL ACCOUNT
DEBITS (Continued)
BROUGHTFORWARD
Gain on Sale of Household Goods Sold 1/17/04
Gross Proceeds
Less: Costs of Sale
Net Proceeds 460.00
Less: Inventory Basis 0
Gain on Sale 460.00
685.00
225.00
Advancement by Michelle B. Hogan by
paying one-half (1/2) of Attomey's Fees
Directly to William L. Sunday
Verizon - Refund
Commonwealth of Pennsylvania - Refund
(PA Inheritance Tax)
TOTAL
$10770.00
460.00
2475.00
13.46
525.07
$14243.53
PERSONALTY
PRINCIPAL ACCOUNT
CREDITS
Accountant asks credit for the following:
Payments of debts, taxes and administration expenses made by Michelle B.
Hogan, surviving joint owner, fi:om joint account in PNC Bank.
2003
May 26
26
26
Sep 3
2
26
Nov 13
12
Verizon- (717) 766-6997 - Account Payable $ 20.10
Verizon - (717) 545-8688 - Account Payable 21.55
Messiah Village - Account Payable 56.00
Physicians Rehab - Account Payable 26.81
Verizon - Phone 40.53
William L. Sunday- Reimbursement For:
Probate 216.00
(2) Short Certificates 6.00
Notice - CLJ 75.00
Notice - Sentinel 98.69
Postage - Rule - 5.6 8.89
Chuck Bricker - Appraisal (Household Goods)
Verizon - Phone
Villa Teresa - Account Payable (On Account)
Verizon - Phone
404.58
60.00
40.91
150.00
40.84
CARRIED FORWARD $ 861.32
2004
Feb 11
11
11
Mar 5
Apr 8
2003
Aug 5
2004
Feb 11
Mar 23
23
Jul 31
31
PERSONALTY
PRINCIPAL ACCOUNT
CREDITS (Continued)
BROUGHTFORWARD
Register of Wills - Additional Probate Fee
Register of Wills - Filing Fees
Gail Minnich - Notary Fees
Verizon - Phone
Verizon - Final Phone
Sub-total (Paid From Joint Account)
Register of Wills, Agent - PA Inheritance Tax
Tax 4770.00
Less Discount 238.50
William L. Sunday - Partial Attorney's Fee
Malpezzi Funeral Home
Villa Teresa - Balance Account Payable
William L. Sunday- Balance Attorney's Fee
Register of Wills - Filing Family Settlement
Agreement
Sub-Total of Payments
$ 861.32
35.00
28.00
10.00
61.56
$ 37.56
$1033.44
$ 4531.50
$ 2475.00
7317.00
700.00
2475.0O
17.00
18548.94
CARRIED FORWARD 18548.94
2004
Jan 9
Mar 22
BROUGHT FORWARD
Accountant also asks credit for the following:
$18548.94
Loss on Sale of Household Goods and Furniture
Basis of Property Sold 1/7/04
Less: Gross Proceeds 1269.25
Costs of Sale 424.25
Proceeds Received 845.00
Loss on Sale
$1269.25
845.00
424.25
Loss on Appliances Sold as Part of Real Estate
Proceeds Received 0
Inventory Values
Refrigerator 100.00
Microwave 10.00
Washer 50.00
Dryer 10.00
Basis 170.00
Less: Proceeds Received 0
Loss on Appliances
424.25
170.00 170.00
TOTAL PERSONALTY PRINCIPAL ACCOUNT CREDITS $19143.19
PERSONALTY
INCOME
RECEIPTS
Accountant charges herself with the following:
2003
Sep 5
Ohio National Financial Services - Interest
$ 13.35
TOTAL PERSONALTY INCOME ACCOUNT RECEIPTS $13.35
REAL ESTATE
PRINCIPAL ACCOUNT
DEBITS
Accountant charges herself with the proceeds
from the sale of the real estate described in the Inventory
filed in the Register of Wills Office aforesaid in the amount of
Accountant also charges herself with the following:
Advancements from joint account by Michelle B.
Hogan by paying debts, expenses and administrative costs
between 7/3/03 and 4/9/04
$119900.00
3387.44
2004
Mar22
Apr 26
Douglas A. Black - Property Tax Adjustments
on Date of Sale
Ohio National Insurance Co. - Return Premium
464.74
$ 106.00
TOTAL REAL ESTATE PRINCIPAL ACCOUNT DEBITS $123858.18
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS
Accountant asks credit for the following:
Payment of debts, taxes and administration expenses
by Michelle B. Hogan surviving joint owner of joint account
in PNC Bank.
20O3
July 3
6
Aug 28
28
Sep 29
25
Nov 12
14
Dec 19
2004
Jan 26
3O
Feb 2
Apr 9
Mark Heckman - Real Estate Appraisal
(Commercial)
Hutters Insurance - Home Owners Premium
Met Ed - Account Payable
Central Penn Appraisals
Met Ed - Electric
Calaman - Lawn Care
Culligan - Water Softener Purchased
Met Ed - Electric
Calaman - Lawn Care
Met Ed - Electric
Met Ed - Electric
Heckman - Appraisal (Balance)
Calaman - Snow Removal
Met Ed - Final Electric
Sub-total (Paid From Joint Account)
CARRIED FORWARD
$ 600.00
326.00
478.88
275.00
302.25
25.20
265.00
300.19
89.04
130.00
136.00
200.00
100.00
159.88
$ 3387.44
3387.44
2003
Dec 16
2004
Jan 25
Mar 22
Mar 22
23
23
Apr 5
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS (Continued)
BROUGHTFORWARD
Mary Murray, Tax Collector - 2003-2004
School Taxes
1st Call Remodelers - Repairs
Settlement Charges Due From Seller as Follows:
Remax - Commission
Remax Transaction Fee
Loan Origination Fee
Loan Discount
Tax Service Fee
Underwriting Fee
Flood Certification
Title Insurance
Realty Transfer Tax
Tax Certification
Mary Murray, Tax Collector
First Call Remodelers
Termite Inspection
Total Settlement Charges
by Seller
$8393.00
125.00
1139.00
1139.00
75.00
400.00
18.00
826.00
1199.00
2.00
261.13
1226.78
232.00
15035.91
Gregory R. Reed, Esq. - Escrow Agent for
Repairs to Sewer System and Installation and
Connection to Public Sewer System
Mark Heckman - Balance Due for Commercial
Appraisal
Calaman - Snow Removal
Michelle B. Hogan - Reimburse Joint Account
CARRIED FORWARD
$ 3387.44
1055.25
300.00
15035.91
7000.00
400.00
165.26
197.44
$ 27541.30
REAL ESTATE
PRINCIPAL ACCOUNT
CREDITS (Continued)
BROUGHT FORWARD
$ 27541.30
Apr 5
Michelle B. Hogan - Reimbursement
for:
PA Inheritance Tax Payment
Storage Garage
Attorney's Fee
4531.00
455.00
2500.00
TOTAL REAL ESTATE PRINCIPAL ACCOUNT CREDITS
7486.00
$ 35027.30
Michelle B. Hogan
ADVANCEMENTS
Coins and Stamps
(1) Multi-diamond Engagement Ring
(1) Lady' s Wrist Watch
1977 Plymouth Volare
Household Goods and Furniture ~ Appraised Value
TOTAL ADVANCEMENTS
PERSONALTY:
REAL ESTATE:
$ 62.50
1200.00
125.00
300.00
180.00
Balance in Hands of Accountant for Distribution
The said Balance for Distribution consists of the following:
Cash - PNC Bank, N.A.
1867.50
RECAPITULATION
Principal Account
Debits $14243.53
Credits 19143.19
Balance (4899.66)
Income Account
Receipts $13.35
Expenditures 0
Balance 13.35 13.35
Principal Account
Debits $123858.18
Credits 35027.30
Balance 88830.88
Total Distributable Estate $83944.57
Less: Advancements 1867.50
$ 82077.03
$ 82077.07
SCHEDULE OF DISTRIRUTION
The balance for distribution in the hands of Michelle B. Hogan, Executrix under
the Last Will and Testament of Henrietta P. Belknap, deceased, as appears by the
Family Settlement Agreement is: .$ 82,077.07.
TO:
DISTRIBUTION AND AWARD
Michelle B. Hogan - Entire Estate
Cash
PNC Bank, N.A.
$ 82077.07
TOTAL $ 82077.07
RELEASE
WHEREAS, Henrietta P. Belknap, died on May 14,2003, leaving her Last
Will and Testament dated October 3, 2001, where in and whereby she gave,
devised and bequeathed all the rest, residue, and remainder of her Estate after the
payment of her just debts and fimeral expenses unto her daughter, Michelle B.
Hogan; and
WHEREAS, she further provided that in the event her daughter
predeceased her, she gave, devised and bequeathed the residue of her Estate to the
individuals named in Item 3 of her Will; and
WHEREAS, her daughter, Michelle B. Hogan, survived the Testatrix, the
residue of the Estate is distributable to her surviving daughter, M~chelle B.
Hogan.
NOW KNOW ALL PERSONS BY THESE PRESENTS, that I,
Michelle B. Hogan, sole legatee, devisee and distributee of the Estate of said
decedent, and the only person entitled to share in the distribution of said Estate,
do hereby declare and say that I have examined the foregoing Account and
Schedule of Distribution and find the same to be true and correct and in strict
accordance with the terms and provisions of said Will, and do hereby
acknowledge that I, this day have had and received of, and from Michelle B.
Hogan, Executrix of the Estate of Henrietta P. Belknap the cash set opposite my
name in the above stated Schedule of Distribution, in full satisfaction, payment
and discharge of all such sum or sums of money, legacies and bequests, share or
shares, purparts and dividends which were due, owing payable and belonging me,
by any means whatsoever, for or on account of my full share, part or dividend of
the Estate of the said decedent and all interest accrued thereon.
NOW THEREFORE, I, Michelle B. Hogan, the sole legatee, devisee and
distributce of the Estate of Henrietta P. Bclknap, deceased, do by these presents
rcmise, release, quit-claim and forever discharge thc said Michcllc B. Hogan,
Executrix, her heirs, executors and administrators, of and fi:om said shares or
dividends of said Estate aforesaid, and of and fi:om all actions, suits, payments,
accounts, reckonings, claims and demands whatsoever, for or by mason thereof,
or of any other act, matter, cause or thing whatsoever, fi:om the beginning of thc
world to the day and date of these said presents.
AND, desiring to avoid the delaying and expense of the settlement of the
said Estate by filing the foregoing Account of said administration in the Office of
the Clerk of the Orphans' Court of the Court of Common Pleas of Cumberland
County, Pennsylvania, and by having the balance in the hands of the Executrix, as
shown by said Account, distributed by an auditor appointed by the Orphans Court
Division of the Court of Common Pleas of Cumberland County, I do hereby agree
that the foregoing statement concerning the manner of settlement may be recorded
with the same effect upon me as if the same had been reported by the said Court
of Common Pleas, Orphans' Court Division.
AND, in consideration of the aforesaid settlement being made without the
aid of said Court of CommOn Pleas, Orphans' Court Division, that I, Michelle B.
Hogan, do hereby agree that if any debts or demands other than those included
within The First and Final Account of the said Michelle B. Hogan, Executrix of
the Estate of Henrietta P. Belknap, deceased, as hereinbefore set forth, shall be
hereafter recovered against the Estate of said decedent and be legally payable out
of the same, that I, Michelle B. Hogan, shall return to said Executrix such ratable
amounts thereof as may be necessary to pay such legally enforceable debts or
demands.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
f¥ ~''~ day of ,,4,'~asZ' ,2004.
Michelle B. Hoga~
STATE OF PENNSYLVANIA ·
· SS·
COUNTY OF CUMBERLAND ·
Before me, the subscriber, a Notary Public in and for said State and
County, personally appeared, Michelle B. Hogan, and in due form of law
acknowledged the foregoing Release to be her act and deed and desired that the
same might be recorded as such.
WITNESS my hand and notarial seal this //~ day of
t~r~t,~qjp ,2004.
N~tary Pubhc
Member, Pennsylvania Associ3'hon Of Notates
BUREAU OF ZNDZVZDUAL TAXES
INHERITANCE TAX DIVZSTON
DEPT. 280601
HARRISBURG, PA 171Z8-0601
WILLIAM L SUNDAY
$9 W MAIN ST
MECHANICSBURG
PA 17055
COMMONWEALTH OF PENNSYLVANTA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-I$07 EX AFP
DATE 05-17-Z00~
ESTATE OF BELKNAP
DATE OF DEATH 05-1~-Z005
FILE NUMBER 21 O$-O~qO
COUNTY CUMBERLAND
ACN 101
Amount Rem'i t'l:ed
HENRIETTA P
HAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To Ansure proper credit to your account, submit the upper portion of thAs fore with your tax payeent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *"~
ESTATE OF BELKNAP HENRIETTA P FILE NO. 21 05-0~0 ACN 101 DATE 05-17-Z00~
THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAHED ESTATE. SHO#N BELOW
TS A SUHHARY OF THE PRINCIPAL TAX DUE., APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: OR-O5-ZO0~
PRINCIPAL TAX DUE: ..........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
~,Z17.50
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID ¢-)
210.87
08-06-2005
0~-Z6-Z00~
CD002875
REFUND
.00
q,531.50
525.07-
TOTAL TAX CREDIT
q,217.$0
.00
BALANCE OF TAX DUE
INTEREST AND PEN. .00
TOTAL DUE .00
ZF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULATION OF ADDITIONAL /NTEREST.
ZF TOTAL DUE 1S LESS THAN $1,
NO PAYMENT 1S REQU/RED.
IF TOTAL DUE 1S REFLECTED AS A 'CREDIT'
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.
PAYMENT:
Detach the top portion of this Notice and submit aith your payment made payable to the name and address
printed on the reverse side.
-- Zf RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT.
-- zf NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTN OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit) ehich Nas not requested on the Tax Return) may bo requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-ISIS). Applications ara available at
the Office of the Register of Nit[s) any of the Z3 Revenue District Offices or from the Department's Iq-hour
ansmering service for forms ordering: 1-800-36Z-ZO50) services for taxpayers ~ith special hearing and / or
speaking needs: [-BOO-qqT-3OZO (TT on[y).
REPLY TO:
questions regarding errors contained on this notice should be addressed to: PA Department of Revenue) Bureau
of Individual Taxes) ATTN: Post Assessment Revie~ Unit, Dept. ge0601, Harrisburg) PA [7[gB-O60[) phone
(717) 787-6S05.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death) a five percent (SI) discount
of the tax paid is allowed.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed) and net
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. A11 taxes ~hich became delinquent on and after
January 1, 198Z 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 1982 through 2004 are:
Interest Dally Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20Z .0005q8 [988-1991 112 .000301 2OOl 9Z .000247
1983 16g .000q38 1992 9g .O00gq7 ZOO2 62 .O0016q
xgBq [IX .000301 1993-199q 7Z .O00Xez ZOO3 SZ .D00137
1985 132 .0D0356 1995-1998 9Z .000247 2004 ~Z .O00XlO
1986 lOX .O00Z7q 1999 72 .000192
1987 9Z .O00Z~7 ZOO0 8Z ,O00219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent Hill 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 caXculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/07/2005
SUNDAY WILLIAM L
39 W MAIN STREET
MECHANICSBURG, PA 17055
RE: Estate of BELKNAP HENRIETTA P
File Number: 2003-00440
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
5/14/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s}
Judge
cI
.,'"
<: .
e 0
Register of Wills of Cumberland County
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
#~~F"77''''' .r:' 4?#,e-'-y~
~/y- Z~~~
Date of Death:
Estate No.:
Z.,po~ -
~ ~PC>
( ;71 - IH- 0 crl/O)
7
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration ofthe estate is complete:
Yes Sd1 No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration wi11 be complete:
3. Ifthe answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes tlf No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes g' No 0
c. 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.
Dale:
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SIgnature
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Name
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Address
Capacity:
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Telephone No.
~ersonal Representative / /L./ ~ _
o Counsel for personal representatiM' -7 uJ
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