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Home My WebLink About03-0534 PETITION FOR PROBATE and GRANT OF LETTERS Estate of RUTN A. SEIFER? No. I-0 5- 5 .3 also known as To: · Deceased. Social Security No. 193-12-8561 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executor in the last will of the above decedent, dated November 11~ 1982 and codicil(s) dated NONE Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 801 N. Nanover $treet~ Boroullh of Carlisle~ Cumberland County~ Pennsylvania (list street, number and municipality) Decedent, then 81 years of age, died 6122103 at Church of God HomeI 801 N. Hanover Street~ Carlisle~ PA 17013 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 ajudicated incompetent: NONE Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 0.00 NONE WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Te~tiinenl:iar~ thereon, f · (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Mechanicsburfl PA 17055 ..~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND 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 estgte according to law. Sworn to or affirmed and subscribed r-,before me this __27th day of .... [ ' ' , - // [, h, ,June ....~ 6h.,', / /.,,;z,,~ zuu.s j Donna ~. Otto, lst 17._lZ/9._q ]NO. 21-2003-534 Estate of RUTH A. SEIFERT , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW July 1st, 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 '1'11'11182 described therein be admitted to probate and filed of record as the last will of RUTH A. SEIFERT and Letters TESTAMENTARY are hereby granted to KENNETH L. SEIFERT FEES Probate, Letters, Etc ......... $ 235.00 Short Certificates (4 ) ...... $ 12 o 00 ~. x-/~age~ ( 1 )... $ 3.00 10.00 JCP $ TOTAL__ $ 260.00 Filed.. July. 1st, 2003 ............ PUT LETI~RS IN PROTHONOTARY'S OFFICE A2TORNEY" S WALTERS FILE. Register of Wills Donna M. Otto, 1st Deputy Murrel R. Walter~ III, £squire 24849 ATTORNEY (Sup. Ct. I.D. No.) 54 East Main Street MechanicsburR PA 17055 ADDRESS 717-697-4650 PHONE REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS (each) a su~ibing witness to the will Xp~esented herewith, (OW~.) being duly qualified according to law, depose(s) ~(s) that NNNX % present and saw, the testat____, ~ig~he same and that XX x, Xx signed asa witness at the reque~esence of each oth'~(in the presence of the °ther sub~x~ng witness(es)% ~ ~ Swor~nd subscrf,{,d before NX NN me thii ~ ~y of ~ (Name) % ~_ 'XXN~ 19D~ \(Address) ' .~, qD ~ Register _ __ ~i~ >i ~ .~--~ Xx ~ (Name) (Address) 21-2003-534 REG4SUTER OF WILLS OF C~nberland COUNTY OATIt OF NON-SUBSCRIBING WITNESS Kenneth L. Seifert 0~%11~~~) being duly qualified according to law, depose(s) and say(s) that He is familiar with the signature of Ruth A. Seifert ., codicil testatrix of ~ '' ' the ~'~ presented herewith and codicil that He Ruth A. Seifert to the best of H±s knowledge and belief.'& Sworn to or affirmed and subscribed before me this 27th day of Donna M. Otto, ls~ Deputy Re~ister~~-~ believes the signature on the ~s in the handwriting of (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OE~CRIBING WITNESS the testat ,'~the same and that %_ ~'~. signed as a witness at the request of testat ~ presence and (in%esence of each oth~ (in the presence of the °ther subscribing witness(es)~x'~ Sworn to or affirmed and subscribed'~fore me this ................ -19day~ Register 21-2003-534 (Name) (Address) i~GI~R OF WILLS OF CL~berland COUNTY ~TH OF NON-SUBSCRIBING WITNESS ...... being duly qualified according to law, depose(s) and say(s) that She is familiar with the signature of Ruth A. So~i four4- , codicil testatr~ of '' ' ) the ~ presented herewith and that She believes the signature on the ~s in the handwriting of Ruth A. Seifert to the best of Her knowledge and belief. Sworn to or affirmed and subscribed before me this 30th day of Oune ,-~ ~ 2003 Donna M. Otto,ls% ~u%y ~ilt~~~. (Address) (Name) (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 8448815 JUN24 2003 No. ~ Date 2_.1 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ,. Ru~h A. SeZfert ~Fema£e ,.193 --12 --8561 .June 22,2003 Cumberland Cartrsle Church 0g God Home ~ ~.~ ~ ...... 801N. Hanover St. ,,.Car£Zs£e, PA 17013 ,,.Carrie She££hammer ~$9 Edgewood Dr. Mechanicsbur,,q~ PA 17055 J=,,M~. P£easant Cemeterq Iz,,. ~££s§urq, Pa 17019 F~THER'S NAME (FYi. M~. ,,. Bruce Di££er ~ Kenneth L. Seifert 21-2003-534 9~:~cl LZ Nfl? fO. 0 0 0 LAST WILL AND TESTAMENT OF RUTH A. SEIFERT I, RUTH A. SEIFERT, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. o I give and bequeath my set of stoneware to my daughter, Barbara Scott. I give and bequeath my set of dishes, service for eight, "Wheat Pattern" to my daughter-in-law, Ann Seifert, wife of Kenneth L. Seifert. o I give and bequeath my sewing machine to my daughter-in- law, Cindy Seifert, wife of Steven G. Seifert. Ail the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my husband, Lawrence G· Seifert, absolutely and in fee simple., -1- o In the event my husband, Lawrence G. Seifert, pre- deceases me, I give, devise and bequeath my entire estate, real, personal and mixed, to my children, in equal shares. o I nominate, constitute and appoint my husband, Lawrence G. Seifert, Executor of this my Last Will and Testament, and in the event he should be unwilling or unable for any reason to act as such, I nominate, constitute and appoint my son, Kenneth L. Seifert, to be the Executor of this my Last Will and Testament in his place and stead. IN WITNESS ~IHE~J~OF, I have hereunto set my hand and seal this //~day of ~~ , 1982. _.Phth A. ei ert (SEA Signed, sealed, published and deClared by the above named, Ruth A. Seifert, as and for her Last Will and Testament, in the presence of us who have subScribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. -2- LAST WILL AND TESTAMENT OF RUTH A. SEIFERT EAKIN & EAKIN ATTRRNEY5 AT LAW MARK~r 51~IUARE BUILDING MECHANICSBURG, PA. '1'7rl55 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: RUTHA. SEIFERT Date of Death: June 22, 2003 Will No. 2003-00534 Admin. No. 21-03-0534 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(4 of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 8, 2003. Name Address Kenneth L. Seifert 39 Edgewood Drive, Mechanicsburg, PA 17055 Craig E. Seifert 3668 McIntosh Lane, Carleton, MI 48117 Steven G. Seifert P.O. Box 875, Sierra Vista, AZ 85636 Barbara Scott 911 Wakefield Avenue, Mechanicsburg, PA 170~5 Notice has now been given to all persons entitled thereto~der Ruls,5.6(a) ex/c~t( Date: July 8, 2003 MurreI R. Walters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: Personal Representative __X__ Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003038 WALTERS MURREL R III ESQUIRE 54 E MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 193-12-8561 FILE NUMBER: 2103-0534 DECEDENT NAME: SEIFERT RUTH A DATE OF PAYMENT: 09/19/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,000.00 REMARKS: TOTAL AMOUNT PAID: MURREL R WALTERS III ESQUIRE $5,000.00 SEAL CHECK# 14964 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) I-- Z iii Z o Q. U.I n, o Z COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 JINHERITANCE RETURN RESIDENT DECEDENT DECEDENTS NAME (~ST, FIRST, AND MIDDLE INITIAL) SEIFERT~ RUTH A. DATE OF D~TH {MM-DD-Year) J DATE OF BIRTH (MM-DD-Year) O6/2~2OO3 O2/~ S/1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME {~ST, FIRST, AND MIDDLE INITIAL) FILE NUMBER OFFICIAL USE ONLY I 9 3-1 2-8 5 6 I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~'Jl. Original Return ['~J 4. Limited Estate [~6. Decedent Died Testate (Attach copy of Will) r~9. Litigation Proceeds Received [~]2. Supplemental Return r~4a. Future Interest Compromise (date of death after 12.12-82) --']7. Decedent Maintained a Living Trust (Attach copy of Trust) F'"] 10. Spousal Poverty Credit (date of death belween 12.31.91 and 1.1.95) F'~3. Remainder Return (date of death prior (o 12-13-82) ~---] 5. Federal Estate Tax Return Required I 8. Total Number of Safe Deposit Boxes J~111. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III ESQ FIRM NAME (If Applicable) TELEPHONE NUMBER 717/697-4650 1. Real Estate (Schedule A) (1) 54 EAST MAIN STREET MECHANICSBURG PA 17055 ONLY 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r~ 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) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 36~905~ 40;046.76 (8) (11) (12) (13) 7;980.20 3;707.04 96~287.91 11;687.24 84~600.67 (14) 84;600.6x 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. x (15) 84~6OO.67 X .O45 (16) X .12 (17) X .15 (18) (19) BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH 3;807.03 3;807.03 2 3 -0 3 0 5 3 4 '='~TY"~'~ YEAR NUMBER SOCIAL SECURITY NUMBER Decedent's Complete Address: IsS~'REET ADDRESS 01 NORTH HANOVER ST I (~iTY CARLISLE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 5~000.0n 250.0n STATE PA (1) 17013 3. Interest/Penalty if applicable Total Credits ( A + B + C ) (2) D. Interest E. Penalty Total InterestJPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 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. (SA) 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 1. Did decedent make a transfer and: 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 h s 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 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than ~e personal representative is based on all information of which preparer has any kno~edge. 3~807.03 5~250.0n 1~442.97 0.0n 0.00 SIGNATURE OF PE~O RESPONSIBLE FOR FILING RE. TURN ADDRESS KENNE,~ L. SEI~ERT /J' I 39 I~DJ;j~'E WO,,~O,,/D~['I V Ed~/I,E'C H A N I C S B U RG S GNA TURE OF PR~Z~ ~/~SENTA TIVE ADDRESS MURREL{R, WALTERS III ESQ DATE PA 17055 DATE 54 EAST MAIN STREET~ MECHANICSBURG PA 17055 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs 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. REV-1503 EX + (1-97) ESTATE OF SEIFERT, RUTH A. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM FILE NUMBER 22 03 O534 NUMBER DESCRIPTION VALUE AT DATE 1. U.S. SAVINGS BONDS OF DEATH 2 REDEMPTION VALUE PRUDENTIAL STOCK 24SHARES NET SALE PRICE 18,452.60 882.80 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 19~335.4,, REV-1508 EX * (1-97) j ~ I SCHEDULE E J · COM~E"~'"[~OFT~ER~uS~L"vANA I CASH~,~B~A~N,~K~,.D,EP~O~S~IT..S.,~&...MISC, I ESTATE OF FILE NUMBER SEIFERT, RUTH A. 22 03 0534 Include the )roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. CHURCH OF GOD HOME, CARLISLE OF DEATH 5,927.83 REFUND OF PARTIAL MONTH CARE AND RETURN OF DEPOSIT 2 4 5 7 HIGHMARK REFUND PREPAID INSURANCE PREMIUM CITIZENS BANK CHECKING CITIZENS BANK SAVINGS PSERS RETIREMENT BETHLEHEM STEEL RETIREMENT SMITH BARNEY IRA BENEFICIARY KENNETH L. SEIFERT TOTAL (Also enter on line 5, Recapitulation) $ 73.52 13,674.21 7,941.45 161.91 120.90 9,005.93 (If more space is needed, insert additional sheets of the same size) 36~905.7= REV-1509 EX + (1-97) ~ [ I ' I SCHEDULE F r · COM NO'N " c' OFPTJ"N " Su AN'A / JOINTLY'OWNED PROPERTY I ESTATE OF SEIFERT. RUTH A. FILE NUMBER 22 03 0534 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. KENNETH L SEli-i=K¥ B CRAIG E. SEIFERT C STEVEN G. SEIFERT ADDRESS 39 EDGEWOOD DR MECHANICSBURG, PA 17055 3668 MCINTOSH LANE CARLETON MI 48117 P.O.BOX 875 SIERRA VISTA, AZ 85636 RE~TIONSHIP TO DFCEOENT SON SON SON JOINTLY-OWNED PROPERTY: LEi i~-I~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identiyng number. Attach DATE OF DEATH NUMBER TENANT JOINT deed for jointly-held real estate. DECD'S VALUE OF VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 1. A. 4/7/t990 ClTi,,:,-NS BANK CD 20,023.38 50. ~ 10,011.6~ 2 B 4/7/1990 CITIZENS BANK CD 20,023.38 50. 10,011.69 3 C 4/7/1990 CITIZENS BANK CD 20,023.38 50. 10,011.69 4 D 4/7/1990 CITIZENS BANK CD 20,023.38 50. 10,011.69 TOTAL (Also enter on line 6, Recapitulation) $ (If more sDace is n~.Rd~d inq~rf :~lclifinn,~l Dk~^fn ~$~.k .......... 407046.7~, S of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent SEIFERT, RUTH A. 22 03 Paqe 1 Schedule F-1 - Jointly Owned Property O534 SURVIVINGJOINTTENANT(S)NAME D. BARBARA SCOTT ADDRESS 911 WAKEFIELD AVE MECHANICSBURG, PA 17055 RELATIONSHIP TO DECEDENT DAUGHTER REV-~512~+(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF SEIFERT. RUTH A. Include unreimbursed medical expenses. FILE NUMBER 22 03 0534 ITEM NUMBER DESCRIPTION AMOUNT 1. 56.45 2 BROCKIE PHARMATECH MEDICAL PSERS REIMBURSE PARTIAL MONTH RETIREMENT CHURCH OF GOD HOME RESIDENTIAL CARE JUNE 2003 KENNETH L. SEIFERT JR OUTSTANDING BIRTHDAY CHECK TOTAL (Also enter on line 10, Recapitulation) $ 43.23 3,582.36 25.00 3;707.0~ (if more space is needed, insert additional sheets of the same size) EV-1511EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF SEIFERT. RUTH A, Debts of decedent must be reported on Schedule I. FILE NUMBER 22 0:~ 0~4 ITEM NUMBER DESCRIPTION AMOUNT PREPAID FUNERAL EXPENSES: FUNERAL HOLLINGER FUNERAL HOME FUNERAL LUNCHEON ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) KENNETH L. SEIFERT Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 39 EDGEWOOD DRIVE 196387635 City MECHANICSBURG State PA__ Year(s) Commission Paid: 2003 Attorney Fees MURREL R. WALTERS III ESQ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip 17055 Street Address City Relationship of Claimant to Decedent Probate Fees REGISTER OF WILLS Accountant's Fees Tax Return Preparer's Fees State CUMBERLAND COUNTY Zip TOTAL (Also enter on line 9, Recapitulation) $ 110.20 4,350.00 3,220.00 300.00 7;980.20 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-nm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF SEIFER'I. RUTH A. NUMBER I. 1. 2 3 4 1. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] KENNETH L, SEIFERT 39 EDGEWOOD DRIVE MECNANICSBURG, PA '17055 CI~ItlG E, SEIFERT 3668 MClNTOSH LANE CARLETON, MI 48117 STEVEN G. SEIFERT P.O.BOX 875 SIERRA VISTA, AZ 85636 BARBARA SCOTT 91 '1 WAKEFIELD AVE MECHANICSBURG, PA 17055 SON SON SON FILE NUMBER 22 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER 25% 25% 25% 25% AMOUNT ORSHARE OF ESTATE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE TOTAL OF PART ]! - 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) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET BUREAU OF TNDIV/DUAL TAXES INHERITANCE TAX DTVTS~ON DEPT. Z80601 HARRISBURG, PA 17128-0601 HURREL R WALTERS 5q E HAIN ST NECHANICSBURG COHNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-15§7 EX AFP {01-05) '04 APR 14 PA ~ DATE Oq-12-Z00~ :. ESTATE OF SEIFERT DATE OF DEATH 06-22-2005 FILE NUHBER 21 05-053~ ~? :~0 COUNTY CUMBERLAND ACN 101 : I Amoun~ Remi~ad I RUTH A HAKE 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-1547 EX AFP (01-03) NOTZCE OF ZNHER/TANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SETFERT RUTH AFZLE NO. 21 05-053~ ACN 101 DATE O~-lZ-ZOOq TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE /NTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return .00 19~335.~0 .00 .00 36~905.75 ~0~0~6.76 .00 (8) NOTE: To insure proper credit to your account, submit ~he upper portion of this form with your tax payment. 96,287.91 7,980 .ZO 3t707.0q (11) (12) 11.687.2~ 8q,600.67 13. lq. NOTE: Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Nat Value of Estate Subject to Tax Z'P an assessment was issued previously, 1/nas 14, 15 and/or 16, 17, AMOUNT PAID 5,000.00 reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata (15) . O0 X O0 = 16. Amount of Line lq taxable at Lineal/Class A rata (16) 8q,600.67 X 0q5 = 17. Amount of Line lq at Sibling rate (17). . O0 X 12 = 18. Amount of Line lq taxable at Collateral/Class B rate (18). . O0 X 15 = 19. Principal Tax Due (19)= TAX CREDITS: PAYMENT RECETpT DT$COUNT DATE NUMBER INTEREST/PEN PAID (-) 09-19-2003 CD003038 190. .00 8q,600.67 18 and 19 will .00 3,807.03 .00 .00 3,807.03 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,190.35 1,383.3ZCR .00 1,383.32CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REgUIRED. IF TOTAL DUE KS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for Ilfe or for years, the Coaaonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). Detach the top 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 NILES, AGENT A refund of a 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 are available at the Office of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special [4-hour answering service for forms ordering: 1-800-562-Z050; services for taxpayers #ith special hearing and / or speaking needs: 1-800-447-5020 iTT only). Any party in interest not satisfied eith 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 of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (2) calendar months after the decedant's death, a five percent (52) discount of the tax paid is allowed. 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. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 1982 will bear interest et 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 Z004 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~'~ lOX .OOOSq8 ~'~-1991 11Z .OO0301 1982 167. . 000q58 1992 92 . 000247 1984 llZ .000301 1995-1994 72 .000192 1985 15Z .000556 1995-1998 92 .0002~,7 1986 102 . 000274 1999 72 . 000192 1987 lOX · 000274 ZOOO 77. . 000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~ 97. .OOOZ~7 ZOOZ 62 .000164 2002 52 .000157 2004 47. .000110 X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calcuZated. BUREAU OF TNDZVTDUAL TAXES TNHERTTANCE TAX DTVTSLON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANTA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-i&07 EX AFP C01-03) MURREL R WALTERS 5~ E MAIN ST MECHANICSBURG PA 17055 DATE 05-17-Z00~ ESTATE OF SEIFERT DATE OF DEATH 06-ZZ-2005 FILE NUHBER Z1 05-055~ COUNTY CUMBERLAND ACN 101 Amoun~c Remi'l:'l:ed RUTH A MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi:t :to your accoun:t, submi:t :the upper pot:t/on of :this fore wi~h your CUT ALONG THIS LINE ~-' RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP C01-03) ESTATE OF SEIFERT ~x INHERITANCE TAX STATEMENT OF ACCOUNT RUTH A FILE NO. Z1 05-055~ ACN 101 DATE 05-17-200~ THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH ZN THE NAHED ESTATE. SHONN BELOW ZSA SUMMARY 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: 0~-05-Z00~ PRINCIPAL TAX DUE: .......................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 5,807.05 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-19-2005 0~-Z6-200~ CD005058 REFUND 190.55 .00 IF PA/D AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCT/ONS. } 5,000.00 1,583.32- TOTAL TAX CREDIT 5,807.05 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 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: REGTSTER OF #ILLS, AGENT. -- Tf NON-RESIDENT DECEDENT make check or money order payable to: COMNONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which wes not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-lB15). Applications are available at the Office of the Register of Hills, any of the Z5 Revenue District Offices or from the Department's Zq-hour answering service for forms ordering: 1-&OO-56Z-ZOSO~ services for taxpayers with special hearing and / or speaking needs: 1-BOO-qq7-5OZO (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 Review Unit, Dept. Zg0601, Harrisburg, PA 171zg-0601, phone (717) 787-6SOS. DISCOUNT: [f any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ) 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 not paid before January 16, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, ar nine (9) months and Dna (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January l, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by tho PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year 198Z ZOX .0005¢8 1988-1991 llX .000501 ZOO1 1983 I6X .000q58 199Z 9Z .O00gq7 ZOOZ 19gq IiX .000501 1995-199q 72 .O0019Z 2005 1985 152 .000556 1995-1998 92 .O00gq7 200q 1986 IOZ .O00Z7~ 1999 72 .O0019Z 1987 9Z ,O00Z~7 ZOOO BZ .000219 Interest Daily Rate Factor .O00Z~7 .000164 .000157 .000110 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DATL¥ INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is mede after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/18/2005 WALTERS MURREL RIll 54 E MAIN STREET MECHANICSBURG, PA 17055 RE: Estate of SEIFERT RUTH A File Number: 2003-00534 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.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~AU_~~~~J GLENDA FARNER S;~~G~ REGISTER OF WILLS cc: File Personal Representative(s) Judge uJ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: RUTH A. SEIFERT 6/22/03 Estate No.: 2003-00534 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes_X_ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete (date) 3. 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_X_ B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) c. Did the personal representative state an account informally to the parties in interest: Yes _X No D. Copies of receipts, releases, joinders and approvals of formal ovinformal accounts may be filed with the Clerk of the Orphans' Court,A/a may be attached to this report. ;' rf / 111- ..::r Date: ,May ~, 200q_ co c": ',',J MURREL R. WALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, PA 17055 717-697-4650 Capacity: Personal Representative _X_ Counsel for Personal Representative uA