HomeMy WebLinkAbout03-0731Estate of
also known as
Register of Wills of Dauphin County,
PETITION FOR GRANT OF
, Deceased
Pennsylvania
LETTERS
Social Security No. I ?/'7/-zo'~z~z/
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut,~F,
[~ Decedent, dated AuGc~$1' Icl) Z~'z~ and codicil(s) dated
named in the Last Will of the
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name
Relationship Residence
I~:OMPLETE IN ALL CASES:) Attach additional~ heetsif necessary.
Decedent was domicil.e.4::l at death in C/.2/,~ .~g~..z..fi~.,Z:) County, Pennsylvania, with his/her last family or pnnc~pal
residence at ~ ('~B~ ~b L'~ H~, ~R 17Ol1
Decedent, then 7 7 years of age, died ~U~ ~: r Z S , 20~, at ~/4.o. ¢~..,/ ~ ~c
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 .......................... ~
~r / ~/ - -
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters ~n ~he
appropriate form to the undersigned:
[ ~~ ' Signature Typed orprinted nameand residence ~
RW-7
/ -/6R
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Dauphin
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
before me this 5th
Septamber
day of
2O03
Donna M. Otto,lst Deputy
DECREE OF REGISTER
Estate of VI ~:~L, f~ /Z~, C/'/)~/'?/~ Deceased No. 21-2003-731
also known as
Social Security No: I 7¥ - 2.0 - Z8q
Date of Death:
AND NOW, September 5th , 2003 , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary [] of Administration
are hereby granted to Thomas C. Noll
in the above estate and that the instrument(s), if any, dated Auqust 14, 2003
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $235.00
Short Certificate(s)....5. .....
Renunciation ..................
Affidavit ( ) .................
Extra Pages ( 4 ) ............
Codicil ..........................
JCP Fee ........................
Inventory & Tax Forms...
Other ............................
15.00
Donna ~."°'~)w,~{~t Deputy
$ 10.00 Attorney: ~/~)'~J J, /k~/~(;~j .j
TOTAL ................ $272.00
Wil~w_~ck up letters on Monday,
September 8th, 2003
I.D. NO:
Address:
Telephone: 7t
DATE FILED:
his is to certify that the information here given is correctly copied from an original certificate of death drily filed with me as
Local ,Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No. ~ -k- ~ eDate -
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
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21-2003-731
Last Will
of
VIOLA A. CHAPPIE
I, VIOLA A. CHAPPIE, of Camp Hill, Cumberland County, Pennsylvania, make
this Will and revoke all of my prior wills and codicils.
Article One
My Family
I am not now married.
The names and birth dates of my children are:
LINDA L. CHAPPIE, bom January 23, 1948
Article Two
Distribution of My Property
Section 1. Pour-Over to My Irrevocable Trust
All of my property of whatever nature and kind, wherever situated, shall be
distributed to my Irrevocable Trust. The name of my trust is:
VIOLA A. CHAPPIE IRREVOCABLE SUPPLEMENTAL NEEDS
TRUST, dated AUGUST 14, 2003, and any amendments thereto.
Page 1
Section 2. Alternate Disposition
If my Irrevocable Trust is not in effect at my death for any reason whatsoever,
then all of my property shall be disposed of under the terms of my irrevocable
trust as if it were in full force and effect on the date of my death.
Article Three
Guardian of Person
I nominate, constitute and appoint Fay N. Ditmer as Guardian of my daughter.
Should Fay N. Ditmer be unable or unwilling to serve as Guardian, I then appoint
Nancy K. Shutt as Guardian of my daughter.
Article Four
Powers of My Personal Representative
My personal representative shall have the power to perform all acts reasonably
necessary to administer my estate, as well as any powers set forth in the statutes in
the State of Pennsylvania relating to the powers of fiduciaries.
Article Five
Payment of Expenses and Taxes
and Tax Elections
Section 1. Cooperating with the Trustee of My Irrevocable Trust
I direct my personal representative to consult with the Trustee of my Irrevocable
Trust to determine whether any expense or tax shall be paid from my trust or from
my probate estate.
Page 2
Section 2. Tax Elections
My personal representative, in its sole and absolute discretion, may exercise any
available elections with regard to any state or federal tax laws.
My personal representative shall not be liable to any person for decisions made in
good faith under this Section.
Section 3. Apportionment
All expenses and claims and all estate, inheritance, and death taxes, excluding any
generation-skipping transfer tax, resulting from my death and which are incurred
as a result of property passing under the terms of my revocable living trust or
through my probate estate shall be paid without apportionment and without
reimbursement from any person. However, expenses and claims, and all estate,
inheritance, and death taxes assessed with regard to property passing outside of
my revocable living trust or outside of my probate estate, but included in my
gross estate for federal estate tax purposes, shall be chargeable against the persons
receiving such property.
Article Six
Appointment of My Personal Representative
I appoint the following to be my personal representatives:
THOMAS C. NOLL, or if THOMAS C. NOLL is unwilling or unable to serve, I
appoint M&T BANK.
I direct that my personal representatives not be required to furnish bond, surety, or
other security.
Page 3
I have initialed all of the pages of this Will, and have signed it on August 14,
2003.
VIOLA A. CHAPPIE
The foregoing Will was, on the day and year written above, published and
declared by VIOLA A. CHAPPIE in our presence to be her Will. We, in her
presence and at her request, and in the presence of each other, have attested the
same and have signed our names as attesting witnesses and have initialed each
page.
We declare that at the time of our attestation of this Will, VIOLA A. CHAPPIE
was, according to our best knowledge and belief, of sound mind and memory and
under no undue duress or constraint.
wi _Ess _ - '
Page 4
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We~ VIOLA A. CHAPP1E, S'4eO[A~iq. ~'[c]4etbe~e;-,} ~' and
-7 2o , x'C_ /VoLA , th~ Testatrix and the-wimesses,
respectively, whose'names ~e signed to the foregoing Will, having been sworn,
declared to the undersigned officer that the Testatrix, in the presence of the
witnesses, signed the instrument as her last Will, that she signed, and that each of
the wimesses, in the presence of the Testatrix and in the presence of each other,
signed the Will as a witness.
VIOLA A. CHAPPIE
WIT SS
Subscribed and sworn before me by VIOLA A. CHAPPIE, the Testatrix, and
~'4e?l,,~,;~ ~,',t,~l b~.-~e& and '-f~.j~ora 05' ~ N~ b.,v
the wimesses, on August 14, 2003.
NOTARIAL SEAL I
THOMAS J. AHREN$, NOTARY PUBLIC I
MIrCHANICSBURG, CUMBERLAND CTY,]
I MY COMMISSION EXP'RE$ FEB' '2' 2007 I
Page 5
BUREAU OF 1~ND'rV'rDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA *171Z8-0601
THOMAS J AHRENS
AHRENS LAN OFFICES
55Z1 CARLISLE PIKE
HECHANICSBURG
CUT ALONG THIS LXNE
CONHONNEALTH OF PENNSYLVANXA
DEPARTNENT OF REVENUE
NOTZCE OF /NHER/TANCE TAX
APPRAISEHENT, ALLONANCE OR D/SALLO#ANCE
OF DEDUCT/OHS AND ASSESSHENT OF TAX
03-08-200~
CHAPPIE
08-28-2003
Z1 03-0731
CUMBERLAND
101
Amoun'l:
REV-I~;¢i7 EX
VIOL
PA 17055~tlmb6i~:i~ -'-- ~
HAKE CHECK PAYABLE AND RENZT PAYNE
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~-* RETAZN LONER PORTZON FOR YOUR RECORDS ~ ............
Ahrens Law Offices, P.C.
5521 Carlisle Pike
Mechanicsburg, PA 17050
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
I?013+3323 02
I,,,lll,,,lll,,,,,,li,,ll,,,ll,,,Ih,,hi,,Ihl,h,l,l,,I
Namc of Dcccdcnu_~L_~ ~
To thc Rcgistcr:
Estate
I certify Ulat notice of estate administration required by Rule 5.600 of tile O~ldums, Court Rulcs wa>
sera'ed on or mailed lo the following beneficiaries of the above-captioned estate oq ~/- ~'-- O~
Notice bas now been given lo ali persons thrilled thereto under Rule
Cal~acily:
l'crsumd l{ci}rcscntafive
Counsel fur Personal
Rel)resentalive
Nam~ (l'rinO
Address
_ ~c~ ,c~u~6., ?~ /705
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128~601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
USE ONi.~
FILE NUMBER
21 03 0731
COUNTY CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Chappie, Viola A
DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
08/28/2003 04/26/1926
F APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
[] 1. Original Retum [] 2. Supplemental Retu~urn-
[] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after
12-12-82)
[] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach
of Will) copy of Trust)
[] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between
SOCIAL SECURITY NUMBER
174-20-8284
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
] 3. Remainder Return (date of death prior to '~2-13-82)
[] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[] 11 .Election to tax under Sec. 9113(A) (Attach Sch O)
NAME
Thomas J. Ahrens
:IRM NAME (If applicable)
Ahrens Law Offices, P.C.
YELEPHONE NUMBER
7 ] 7/697- ] 800
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
COMPLETE MAILING ADDRESS
5521 Carlisle Pike
Mechanicsburg, PA 17055
(1) 126,730.00
(2) None-
-- -
(3) None
(4) None
(5) 27,248.94
(6) None
(7)
(9)
(10)
429,237.71
16,425.17
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
15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2)
(8) 583,216.65
(11) 16,425.17
(12) 566,791.48
(13) 566,791.48
(14) 0.00
x .00 (15)
16.Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19, Tax Due
20.
x .045 (16)
x .12 (17)
x .15 (18)
(19)
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
ISTREETADDRESS 47 Central Blvd
CITY Camp Hill
STATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
ZIP 17011
(1)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00
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 his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pedury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of
preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER. SON RESPONSIBLE FOR FILING RETURN ADDRESS
DATE
P.O. Box 205 / /
[-_? _~',~-~.o~- c--~ ,,~"~-)..~" Highspire, PA 17034
Thomas J. Ahrlt'ns 5521 Carlisle Pike
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 decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEAJ. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Chappie, Viola A
SCHEDULE A
REAL ESTATE
FILE NUMBER
21 - 03 - 0731
All real prope .r~y owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which properti/would be exchanged between a w ng 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 disclosedon
schedule F.
ITEM
NUMBER
DESCRIPTION
47 Central Blvd, Camp Hill, PA
TOTAL (Also enter on Line 1, Recapitulation)
VALUE At DATE OF
DEATH
126,730.00
126,730.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Chappie, Viola A
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 - 03 - 0731
Include the ~oroceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivomh~p must be disclosed on schedule F.
ITEM
NUMBER
l
DESCRIPTION VALUE AT DATE OF
DEATH
M & T checking account # 22356495 27,248.94
TOTAL (Also enter on Line 5, Recapitulation)
27,248.94
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Chappie, Viola A
FILE NUMBER
21 - 03 - 0731
ITEM
NUMBER
1
2
3
4
5
This schedule must be completed and filed if the answer to~an_y~o~uestions 1 throu~l
DESCRIPTION OF PROPERTY
IncJude the name of the transferee, their relationship to decedent and the date of transfer. DATE OF DEATH % OF
Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S
Variable annuity # 2453 094610
Variable annuity # 2453 139430
Fixed annuity # 20 51379526
Fixed annuity # 20 52201530
IRA #35004201728142 at M & T Bank
INTEREST
11,319.00 100%
20,293.0~3 100%
104,301.00 100%
274,109.00 100%
19,215.71 100%
TOTAL (Also enter on line 7, Recapitulation)
4 on page 2 is yes.
EXCLUSION TAXABLE VALUE
(IF APPLICABLE)
11,319.00
20,293.00
104,301.00
274,109.00
19,215.71
429,237.71
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ,
Chappie, Viola A FILE NUMBER
21 - 03 - 0731
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: ---
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Thomas C. Nol]
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address P.O. Box 205
City Highspire State PA Zip 17034
Year(s) Commission paid
Attorney's Fees Ahrens Law Offices, P.C.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State -- Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
The Sentinel - Estate Notice
Cumberland Law Journal
TOTAL (Also enter on line 9, Recapitulation)
5,000.00
272.00
78.17
75.00
16,425.17
11,000.00
REV-1513 EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Chappie, Viola A
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 - 03 - 0731
NUMBER
Il.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
RELATIONSHIP TO
DECEDENT
--__D~NotJJst~mstea(s)~_
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee
NON-TAXABLE DIS"I ~IBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
). CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
THE CHAPPIE IRREVOCABLE SUPPLEMENTAL NEEDS TRUST, dated August 14, 2003
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
AMOUNT ORSHARE
OF ESTATE
566,791.48
566,791.48
REV-1647 EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE M
FUTURE INTEREST COMPROMfl
(Check Box 4a on Rev-1500 Cover
leet)
ESTATE OF
Chappie, Viola A
This schedule is appropriate only for Estates of decedents dying after December 12, 1982.
I FILE NUMBER
21 - 03 - 0731
I1.
III.
IV.
NAME OF BENEFICIARY i RELATIONSHIP
1. Linda L. Chappie Daughter
This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and
enjoyment cannot be established with certainty.
Indicate below the type of instrument which created the future interest and attach a copy to the tax return
[]Will []Trust [] Other
Beneficiaries
~DATE OF BIRTH
01/23/1948
AGE TO
NEAREST BIRTHD.t ,Y
56
For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9
months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse
exercises such withdrawal rig.~.t.
[] Unlimited right of withdrawal [] Limited right of withdrawal
Explanation of Compromise Offer:
Summary of Compromise Offer:
1. Amount of Future Interest:
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet)
3. Value of Line 1 passing to spouse at appropriate tax rate Check One [] 6% [] 3*/. [] 0%
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line I taxable at lineal rate
[] 6°/, [] 4.5%
(also include as part of total shown on Line 16 of Cover Sheet)
5. Value of Line 1 taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of Cover Sheet)
6. Value of Line 1 taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet)
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1)
566,791.48
0.00
0.00
0.00
0.00
566,791.48
566,791.48
Schedule M
Estate of Viola A. Chappie
Explanation of Compromise Offer
Decedent bequeathed the residue of her estate to the trustee of the Viola A.
Chappie Irrevocable Supplemental Needs Trust, dated August 14, 2003, in trust.
The Trustee is authorized to invade principal for the supplemental needs of
Decedent's surviving daughter, Linda L. Chappie, (age 55 at decedent's death) for
life. The payment from the income and principal is to supplement and not supplant
any Federal, State, Local or other public benefits. The life estate is taxable at
4.5%; the remainder, if any, is taxable at 0%.
The Trustee believes that it is unlikely that the principal will be invaded
during the lifetime of the life tenant. The life tenant is a special needs individual
currently living at Keystone Services, 111 Silver Spring Road, Mechanicsburg,
and has been approved for Medicaid. It is unlikely that the life tenant will ever live
independently and therefore she will continue to qualify for Medicaid. The Trustee
of the Viola A. Chappie Irrevocable Supplemental Needs Trust, dated August 14,
2003 is directed to pay only for the health, education, maintenance and support of
the life tenant that is not paid by Federal, State, Local or any other assistance
benefits under the Federal Income Maintenance Program.
The Trustee has estimated the life tenant's average monthly expenses not
covered by Medicaid at $200 per month, including clothing. Her average annual
expenses would therefore be approximately $2,400.
The Trustee anticipates the following income from the Trust:
Interest and Dividends from the assets of the trust $15,000
Therefore, it is believed that the income from the trust will cover any of the
supplemental needs ofLinda. L. Chappie during her lifetime, with no invasion of
the principal. Upon the death of Linda L. Chappie, the trustee is to distribute the
Trust assets to the Enola First Church of God, Enola, Pennsylvania.
For the above reasons, the executor believes it is unlikely that the principal
of the trust will be invaded during the lifetime of Linda L. Chappie. Therefore, he
proposes that the entire fund from which income is payable be taxed at 0%
C'OMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
OO367O
AHRENS THOMAS J ESQUIRE
5521 CARLISLE PIKE
MECHANICSBURG, PA 17050
........ fold
ESTATE INFORMATION: SSN: 174-20-8284
FILE NUMBER: 2103-0731
DECEDENT NAME: CHAPPIE VIOLA A
DATE OF PAYMENT: 03/12/2004
POSTMARK DATE: 03/1 1/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 08/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,721.25
~REMARKS:
SEAL
CHECK//1025
TOTAL AMOUNT PAID:
$1,721.25
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REGISTER OF WILLS OF CUMBERLAND COUNTY
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF Viola A Chappie
* NO. 2003-0731
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.: 2003-0731
Viola A. Chappie
August 28, 2003
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: Yes X No __
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes No X
The separate Orphans' Court No. (if any) for the personal representative's
account is:
Did the personal representative state an account informally to the parties in
interest? Yes X No
do
Date:
Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Signature ~
Thomas J. Ahrens, J.D.
Name (Please type or print)
5521 Carlisle Pike
Mechanicsburg, PA 17050
Address
pt/: EH ZE ~]d~/ ~0. (717) 697-1800
Telephone No.
Capacity: __
Personal Representative
Counsel for Personal
Representative
BUREAU OF ZNDZVZDUAL TAXES
ZNHERI'TANCE TAX DTVTSTON
DEPT. 280601
HARRTSBUR(;, PA 17128-0601
COHHONt./EALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
ZNHERZTANCE TAX
STATEMENT OF ACCOUNT
REV-i$O? EX AFP (01-OS)
THOHAS J AHRENS '04 APR 26
AHRENS LAN OFFZCES
5521 CARLZSLE PZKE L~:'
HECHANZCSBURG PA 17055' ....
DATE 04-12-200~
ESTATE OF CHAPPZE
DATE OF DEATH 08-28-200:3
FZLE NUHDER 21 0:3-07:31
~NTY CUHBERLAHD
ACN 101
VZOLA A
Amoun~
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGTSTER OF 141'LLS
CUH]~ERLAND CO COURT HOUSE
CARLTSLE, PA 1701:3
NOTE: To insure proper credi~c ~:o your account, submi~ ~:he upper portion of ~:his fore wl~h your ~:ax paymen~c.
CUT ALONG THzS LZNE ~ RETAZN LO#ER PORT'rON FOR YOUR RECORDS ~.~
ESTATE OF CHAPP]:E VZOLA A FZLE NO. 21 0:3-07:31 ACN 101 DATE 04-12-2004
THZS STATEHENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHOI./N BELOI./
ZS A SUHHARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE,
A PROJECTED ZNTEREST FZGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 0:3-08-2004
PRZNCZPAL TAX DUE: ..........................................................................................................................................................................................................................
PAYHENTS (TAX CREDZTS):
1,721.25
PAYHENT RECEZPT DZSCOUNT (+)
DATE NUNBER [NTEREST/PEN PAZD (-) AHOUNT PAZD
0:3-11-2004 CD00:3670 .00 1,721.25
ZF PAZD AFTER THZS DATE, SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT ZS REQUZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" {CR),
TOTAL TAX CRED'rT
1,721.25
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.
PAYMENT:
Detach the top portion of this Notice and submit ~ith your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF NTLLS, AGENT.
-- If NON-RES/DENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANTA.
REFUND (CA): A refund of a tax credit, ~hich ~as not requested on the Tax Return, may be requested by completing an
'"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at
the Office of the Register of #ills, any of the g$ Revenue District Offices or from the Department's lq-hour
answering service for farms ordering: 1-800-36Z-ZOSO~ services for taxpayers ~ith special hearing and / or
speaking needs: 1-800-qqT-30ZO (TT only).
REPLY TO:
guestions regarding errors contained on this notice should be addrsssed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171ZS-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) 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 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 .00016q. All taxes which became delinquent on and after
January 1, 198Z ~ill bear interest at a rate which ~ill vary fram calendar year to calendar year with that rate
announced by the PA Department of Revenue.
The applicable interest rates for 198Z through ZOOq are:
Interest Dally Interest Daily
Year Rate Factor Year Rate Factor Year
198Z 2OZ .000548 1988-1991 IZZ .OOO3O! ZOO1
1983 16Z .000~38 1992 9Z .0002~7 ZOOZ
198q llZ .OOO~O1 1995-199q 7Z .000192 ZOO3
1985 132 .000356 1995-1998 92 .0002q7 20Oq
1986 lOZ .00027~ 1999 72 .O0019Z
1987 9Z .0002q7 ZOO0 8Z .OOOZ19
Interest Daily
Rate Factor
9Z .0002q7
62 .00016q
5Z .OOOX~7
qZ .O00llO
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPA'rD X NUNBER OF DAYS DELXNI;IUENT g DAXLY XNTEREST 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.
BURE/~U OF TI~DIVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 28060!
HARRXSBURG, PA X7128-0601
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR D/SALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1647 EX 4FP (01-03)
THOHAS J AHRENS '(~ MAR-5 P3:45
AHRENS LAN OFFICES
5521 CARLISLE PIKE(~;2i~.-.' '
MECHANICSBURG P~..,t~'~r~5i~- : ~ ,'-'~
DATE
ESTATE OF
DATE OF DEATH
FXLE NUHBER
COUNTY
ACN
03-08-200q
CHAPPXE
08-28-2005
21 03-0751
CUMBERLAND
101
Amoun.I. Ram i.l:.l, ed
VIOLA A
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~
REV-1547 EX AFP (01-03) NOTICE OF XNHERXTANCE TAX APPRAXSEHENT, ALLONANCE OR
DXSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CHAPPZE VIOLA A FXLE NO. 21 05-0751 ACM 101 DATE 05-08-200q
TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNXNG FUTURE XNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON:
1. Real Estate (Schedule A)
2.
3.
5.
6.
7.
8.
ORIGINAL RETURN
(1)
S~ocks and Bonds (Schedule B) (2)
CXoseXy HaXd S*ock/Par*nership Interes~ (Schedule C) (3)
Mortgages/Notes Receivable (Schedule D) (rt),
Cash/Bank Deposits~Misc. Personal Property (Schedule E) (5)
Jointly Owned Propar~y (Schedule F) (6)
Transfers (Schedule G) (7)
To~al Assats
APPROVED DEDUCTIONS AND EXENPT/ONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage LiabAXitAes/Lians (Schedule T)
11. Total Deduct ions
12. Ne~ Value of Tax Return
13.
Irt.
(9)
(10)
Charitable/governmental Bequests; Non-eXacted 9115 Trusts (Schedule J}
Net Value of Estate Subject ~o Tax
126/730.00
.00
.00
.00
2712~8.9~
.00
~29/257.71
(8)
16,~25.17
.00
(11)
(12)
NOTE
Z~ an assessment Nas issued previously, 11nes 14, 15 and/or 16, 17,
re~lect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
16. Amount of Line lrt at Spousal ra~e
16. Amoun~ of L/ne lrt taxabla at Lineal/CXass A rate
17. Amount of L'Jne lrt at Sibling rate
18. Amount of L~ne lrt ~axab~o at Co].].atara]./C].ass B ra~ce
19. Pr~nc~pa~ Tax Due
TAX CREDITS:
PAYMENT RECETpT
DATE NUMBER
DXSCOUNT (+)
INTEREST/PEN PAXD (-)
NOTE: To ~nsure proper
credit to your account,
submit the upper portion
of th~s form ~h your
~ex payment.
583,216.65
PAYMENT MUST BE MADE BY 05-Z8-Z00q.~.
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
1&.~25.17
566,791.q8
S28,Sql.q8
38,250.00
18 and 19 #ill
(].~) .00 x O0 = .00
(26) :38,250.00 x Oq5= 1,721.25
(~7) .00 x 12 = .00
(].8) .00 x 15 = .00
(~9)= 1,721.25
AMOUNT pATD
.00
1,721.25
.00
1,721.25
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
( IF TOTAL DUE XS LESS THAN $1) NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTZONS:
ADNIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laaful Class B (collateral) rata on any such future interest.
To fulfill the requirements of Section ZI~D of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S.
Section 91~0),
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: ReGISTeR OF #XLLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Apptication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office
of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special Z~-hour
answering service for fores ordering: 1-800-$BZ-ZOS0; services for taxpayers with special hearing and / or
speaking needs: 1-800-~7-$0Z0 (TT only).
Any party in interest net satisfied aith 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 171ZB-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appaaI 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. lB0601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) far an explanation of administrativeLy correctable errors.
If any tax due is paid within three (5} calendar months after the dmcedant's death, a five percent (SI) discount of
the tax paid is aIlowad.
The 15X tax amnesty non-participation penaIty is computed on the total of the tax and interest assessed, and not
paid before January 18, Z996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner end in the the same time period as you would appeaL the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months 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 (BI) percent par annum calculated at a daiIy rate of .00016~. Al! taxes which became delinquent on and after
January l, 198Z wil! bear interest at a rate which wil! vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO5 are:
Interest Dally Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 lOX . 0005~,8 1987 9Z . O00Z~7 1999 7Z . 000192
1982 16Z .O00~,BB 1988-1991 llZ .000501 ZOO0 8Z .000Z19
198~, 112 . 000201 1992 9Z . O00 Z~,7 2001 9Z · 000Z~,7
1985 132 . 000356 1995= 199r+ 77. · 00019Z ZOOZ 67. .00016~,
1986 107. .00027~, 1992-1996 97. . O00Z~,7 2:003 57. .000127
--Interest is calculated as follo~s:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELZN{IUENT X DAILY 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
Notica, additional interest must be calculated.
PROBATE [] JBA [] DATE:2/27104
~tEV-1470 EX (6-88)
EXPLANATION
COMMONVVEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF '.D~WDUA' T~ES
DEPT. 280601
HARRISBURG~ PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Viola A. Chappie 2103-0731
ACN
101
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
M The value of the life tenant's interest can be determined by calculating the present value
of an annuity which distributes $2,400 per year for the balance of her lifetime.
TAX EXAMINER: Shawn E. Young PAGE
FACTORS FOR A LIFE OR LIVES
Interest Rate:
3.2 %
Age:
56
Payment Frequency:
Monthly
Life Estate Factor:
0.50266
Remainder Factor:
0.49734
Annuity Factor:
15.7082
Adjustment Factor:
1.0146
Adjusted Annuity: 15.9375