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HomeMy WebLinkAbout03-0013PETITION FOR PROBATE and GRANT OF LETTERS Estate of IRENE ~'. DALTON also known as Deceased. Social Security No. 508-22-4079 NO. ~[-- O .~" /-~ TO: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania. The petition of the undersigned respectfully represents that: Your Petitioner is 18 years of age or older and the executrix named in the last will of the above decedent, dated 13 May 2002 and codicil(s) dated n/a. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 61 Kensington Drive, Camp Hill, Pennsylvania. Decedent, then 80 years of age, died on 21 November 2002 at Holy Spirit Hospital, Camp Hill, Cumberland County, Pennsylvania. 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: n/a Decedent at death owned property with estimated values as follows: (if domiciled in Pa.) All personal property (if not domiciled in Pa.) All personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania Situated as follows: 61 Kensington Drive, Camp Hill, PA $35,000.00 $ $125,000.00 WHEREFORE, Petitioner(s) respectfully request the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary. Signature and residences of Petitioner(s): Diane D. Byerly 1749 Olmstead Way Camp Hill, PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 6th day of January , 200 3 Do~a H. Otto, ]st Depu~_yRegi~'ter Diane D. Byerly 1749 Olmstead Way Camp Hill, PA 1701~ No. 21 -7003-0Ol ~ Estate of Irene ~. Dalton, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, January 8th, , 2003 , in consideration of the Petition for Probate and Grant of Letters, satisfactory proof having been presented to me, IT IS DECREED that the instrument d~ed 13 May 2002 described therein be admitted to probate and filed of record as the last will of IrenelAii. Dalton and Letters Testamentary are hereby granted to Diane D. Byerly. Register of Wills Donn~ _~I. O~ttoCC[¢t Deputy FEES Probate, Letters, Etc ............ $ 736.00 Short Certificates ( 5 ) ..........$ 15o00 Renunciation ....................... x-Pages (3) 9.00 JCP TOTAL $ 10.00 $269.00 FiledJanuaz7 8th.2003 Samuel L. Andes Attorney-at-Law (I.D. No. 17225) 525 North 1 2th Street Lemoyne, PA 17043 (717) 761-5361 Mailed Letters to Attorney Andes on 1-8-03. 21-2003-0013 WILL OF IRENE E. DALTON I, IRENE E. DALTON, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give, devise and bequeath all of my possessions and estate of every nature and wherever situate to such of my issue, per stirpes, as survive my death by sixty (60) days. ITEM III. If I leave no issue who survive my death by sixty (60) days, I give, devise and bequeath all my possessions and estate of every nature and wherever situate as follows: A. One-half thereof to my niece, CHERYL A. STRUBHAR, provided she survive my death by sixty (60) days and, if she does not so survive my death, to such of her issue, per stirpes, as survive my death by sixty (60) days; and B. One-half thereof to my nephew, JAMES M. CHICORA, provided he survive my death by sixty (60) days and, if he does not so survive my death, to such of his issue, per stirpes, as survive my death by sixty (60) days, and if he leaves no such issue who survive my death by sixty (60) days, then to my niece, CHERYL A. STRUBHAR, provided she survive my death by sixty (60) Pa~e 1 of 4 ITEM VI. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this i~ day of The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by IRENE E. DALTON, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. Amy H a(r,~ins Pa~e 3 of 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ) ( SS.: ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing 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. ~-'~IR[NE E. DALT~~~~-~ Sworn or affirmed to and acknowledged before me by the testatrix named above this !,~ ~ day of ,,7¢~ ,2002. Notary MY..... NO1ARIAI~ SI:AL LYiIW £HRENFELI), NOTARY PUBLIC LEktOYNE BORO., CUMBERLAND CO. COMMISSION EXPIRES AUG. ]7, 2o04j COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ) ( SS.: ) WE, SAMUEL L. ANDES and AMY HARKINS, 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 sign and execute the instrument as her last will; that she signed it 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 testator was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and acknowledged before me this I$~ day of /'~ ,2002. Amy Ha~ins Notary Public Page 4 of 4 days or, if she fails to survive my death by sixty (60) days, to such of her issue as survive my death by sixty (60) days. ITEM IV. I appoint my daughter, DIANE D. BYERLY, executrix of this my last will. Should my daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my grandson, CHRISTOPHER J. BYERLY, executor of this my last will. ITEM V. In addition to the other powers and authorities granted to m~/personal representative by Pennsylvania Law and by the other terms and provisions of this will, I hereby give to my personal representative the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representative may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representative deems proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representative deems proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. Page 2 of 4 ATTORNEY AT LAW 525 NOi~TH TWELFTH STREET P. O. BOX 168 LEMOYNE~ PENNSYLVANIA 1~043 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. 21-03-0013 To the Register: Irene E. Dalton 21 November 2002 Admin. No. I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 14 January 2003. Name Diane D. Byerly Address. 1749 Olmstead Way Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: Name: Samuel L. Andes Address: 525 North 12th Street Lemoyne, PA 17043 Telephone # 717 761-5361 Capacity: Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 '~ HARRISBURG, PA 17128-0601 I-.. Z I.U ILl UJ X REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Dalton, Irene E. DATE OF DEATH (MM-DB-YEAR) DATE OF BIRTH (MM-DD-YEAR) 11-21-2002 06-14-1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL) none FILE NUMBER 21 -03 0 0 0 C"~TY-~-~E '-'-~E~-~ NUUBER SOCIAL SECURITY NUMBER 508 - 22 - 4079 THIS RETURN MUST BE FILED IN DUPLICATE WITH T REGISTER OF WILLS SOCIAL SECURITY NUMBER [-~1. Original Return ~---~ 4. Limited Estate J---] 6, Decedent Died Testate (A.ach [---~ 9. Litigation Proceeds Received r---] 2, Supplemental Return r--~ 4a. Future Interest Compromise (date of death after 12-12-82) ~-t, 7. Decedent Maintained a Living Trust (A~ch copy of Tr~st) ~]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) F'-] 3. Remainder Return (date of beath prior to 12-13-82) ~--] 5. Federal Estate Tax Return Required 8, Total Number of Safe Deposit Boxes E~11. Election to tax under Sec. 9113(A) (Arac~ Sch ( NAME Samuel L. Andes FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 761-5361 COMPLETE MAILING ADDRESS 525 North 12th Street Lomoyne, P~,~I7043 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (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. 14. 124,000.00 7,577.69 42,897.42 14,231.86 28,730.74 36,031.41 220.31 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) (8) 217,437.71 (11) 36,251.72 OFFICIAL USE ONLY (12) 181,185.99 (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15) 181,185.99 16. Amount of Line 14 taxable at lineal rate x .0 ~. ~' (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19, Tax Due (19) 8,153.37 8,153.37 'Decedent's Complete Address: STREET ADDRESS 61 Kensington Drive CITY Camp Hill (Lower Allen Township) Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. ISTATE PA IzIP 17011 (1) 8,153.37 Total Credits (A + B + C) (2) 0.00 (3) (4) (5) (5A) (5B) Total Interest/Penalty ( D + E ) 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? ........................................................................................................................ J~ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, incJuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeclaraUon of preparer other than the personal representative is based on all information of which preparer has any knowredge. SIGNATURE QF PERSON RESPONSIBLE FOE FILING RETURN ADDRESS' - - ~' ' - 1749 Olmstead Wa~, Camp~Hill, PA 17011 ADDRESS- -- '%5 --~ - 525 North 12th Street, Lemoyne, PA 17043 DATE -,~1 DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 RS. §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 decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Irene E. Dalton SCHEDULE A REAL ESTATE FILE NUMBER 21-03-00013 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the 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 propeAy which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Single-family residence at 61 Kensington Drive, Camp Hill, Pennsylvania Property sold in August of 2003 (see copy of settlement sheet attached) $124,000.00 TOTAL (Also enter on line 1, Recapitulation) $ 124,000.00 (If more space is needed, insert additional sheets of the same size) B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.~]FHA 2.~-]FmHA 3.F-]CONV. UNINS. 4. ~]VA 5.r']CONV. INS. 6. FILE NUMBER: SETTLEMENT STATEMENT YANEZ I 7. LOAN NUMBER: 002001078697 8. MORTGAGE INS CASE NUMBER: 441-7317551703 C. NOTE: This f°rm is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 (YANET-PFD/YANEZ/19) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: BRYAN P. YANEZ DIANE D. BYERLY, EXECUTRIX " CITIMORTGAGE, INC. OF THE ESTATE OF IRENE E. DALTON G. PROPERTY LOCATION: H. S~- I ILEMENT AGENT: 23-2402316 61 KENSINGTON DRIVE I. SETTLEMENT DATE: CAMP HILL, PA 17011 PURITY ABSTRACT COMPANY CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT August 26, ..2003 3329 Market Street ~ Camp Hill, PA 17011 101. Contract alesPdce 400. GR~ ~ 124~ 401. ontract Sales Price 124,~ 103~esto orrower (Line 1400) ~ 403. 104. 105. 404. Adjustments For Items Paid By Seller in advance 405. Adjustments For Items Paid By Sefler in advance 106. County/TwpTaxes 08/26/03 to 01/01/04 143.96 406. County/TwpTaxes 08/26/03 to 01/01/04 107. City Tax to 143.96 407. City Tax to 108. School Tax 08/26/03 to 07/01/04 909.6i 408. School Tax 08/26/03 to 07/01/04 109. REFUSE ACCT CREDIT 909.6' 1i0. 65.80 409. REFUSE ACCT CREDIT 65.80 ~12. 120. GROSS AMOUNT DUE FROM BORROWER 127,511.1~ 420. GROSS AMOUNT DUE TO SELLER 125,119.3~ ~00. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,000.00 501. Excess Deposit (See ]i~s[,uCtions) 202. Principal Amount of New Loan(s) 122,084.00 502. Settlement Charges to Seller (Line 1400) '203. Existing loan(s) taken subject to 13,115.88 204. 503. Existing loan(s) taken subject to 205. 504. Payoff of first Mortgage 206. 505. Payoff ot second Mortgage ~07. 506. 50?. (Deposit dish. as proceeds) 208. '~08. 209. PREPAIDS CREDIT 722.83 "509. PREPAIDS CREDIT " Adjustments For Items Unpaid By Seller " 722.83 Adjustments For Items Unpaid By Seller 210. County/Twp Taxes to 510. County/Twp Taxes to 211. City Tax to 511. City Tax to ~i2. School Tax to '713. ~12. School Tax to 214. 513. 215. 514. 216. 615. 217. 516. 219. 518. 519. 220. TOTAL PAID BY/FOR BORROWER 123,806.83 520. TOTAL REDUCTION AMOUNT DUE SELLER 13,838.71 300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower(Line 120) 127,511.18 601. Gross Amount Due To Seller (Line 420) 125,119.37 302. Less Amount Paid By/For Borrower (Line 220) ( 123,806.83 602. Less Reductions Due Seller (Line 520) 13,838.71 303. CASH( X FROM) (TO) BORROWER 3,704.35 603. CASH( X TO) (FROM) SELLER 111,280.661 The undersigned hereby acknowledge receipt of a completed colby of n~n,~* l.~ ~¢ t~,~o ~*,, ..... o nent & any attachments referred to herein. Seller DIANE D. B'¥'ERLY, EXECUTRIX *CLOSING COST CREDIT, TOTAL $4,500.00 Page 2 L. SETTLEMENT CHARGES TOO. TOTAL COMMISSION Based on Price $ 11g,500.00 @ 6.0000 % 7,'170.00 P^~DFROM P^~DF~OM Division ot Commission (line ZOO) as Follows: BORROWER'S SELLER'S 701. $ 3,610.00 to ERA-NRT, INC. FUNDS AT FUNDS AT 702, $ 3,560.00 tO CEN I URY 21 PISCIONERI REAL I Y, INC. 703. Commission Paid at Settlement SE'C'i'LEMENT SETTLEMENT 7,170.00 704. I RANSAC1 ION FEE to CENTURY 21 PISCIONERI REALTY, INC. 195.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 80 . oan rig~nat~on ee ~ to ~unt 0,500--0'~o to ALLIED MORTGAGE CAPITAL C RP. --- 610.4; · en ers nspeclon ee ~ee to ~ · ocumen rep ee --~ '70700 900, ITEMS REQUIRED BY LEND~ANCE 901. Interest From 08/26/03 to 09/01/03 @ $ 17.560000/day ( 6 days %) 105.36I . o gage nsurance remlum or mon~ ~urance Premi~ years to . 1000, RESERVE~H LENDER ;1001, Hazard Insurance 3.000 months @ $ 33.91 per month 101.73 ~ 0.00~~- 50.49 per month  7.000 months @ 34.21 per month 239.47 mo n th s"~'~-~ per month ~ 3,000 ~ 89.49 per month 268.~- ~ m o n--'55[fl'~-~ per ~ ~ months ~ per month 1008. AGGRE A E ES R ADJ. mon~s---'~--'~ per month -136.~' 1100, TITLE CHARGES 101. Settlement or Closing Fee to ~h to 1~. Title Examination to 1104. Insure osing Letter to Firs~ ~5.00 ~eparatlon to SAM EL .A DES, SQ. ~ to ~ --~ 75.00 ~ InC £1esa ovei®rr~ hum ers: ~surance to P RI BS RA T COMPANY T- -- (inclu es above item numbers: -~overage ~ ~overage 1200. OOVE i_______ 1201. Recording Fees: Deed $ 38.50: Mortga9e $ 50.50; Releases $ I 89.00 · ~ oun a amps: ee ~gage ~mps: ~mps ~age __ '~,2-40700' ~ ~ 1,240.00 RECORDER OF DEEDS ~ON~ENT CHARO E-"~'~=*~ ' 1301· Survey to ~ EE to~ to ~ 736.70 '1304. 3RD QTR SEWER 24/QTR to L WER ALL N T WNSH P 100,00 1400.. ~. . on Lines 103, Section J and 502, Section K) 2,391.8~ 13,115.88 Certified to be a true copy. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATEOF Irene E. Dalton FILE NUMBER 21-03-00013 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 251 shares of John Hancock Financial Corporate valued at $30.19 per share (see letter from stockbroker attached) TOTAL (Also enter on line 2, Recapitulation $ $7,577.69 7,577.69 (If more space is needed, insert additional sheets of the same size) Frank R. Baker 146 Springhouse Lane Spring Grove, PA 17362 Phone: 717/225-5450 Fax: 717/225-0494 e-mail: frankr, baker~suscom.net January30,2003 Samuel L Andes Attomey At Law 525 North Twelfth Street P.O. Box 168 Lemoyne, PA 17043 Here is the information you requested concerning the values of the stocks owned by Irene E. Dalton as of November 21, 2002. Equities High Low Average John Hancock Fin'[ JHF 30.89 29.48 30.19 Shares 251 Total: Value 7,577.69 7,577.69 If you have any questions, please call me at 717-225-5450 Sincerely, Frank R. Baker SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY REV*150~ EX* (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF Irene E. Dalton FILENUMBER 21-03-00013 Include the proceeds of litigation and the date the proceeds were received by lhe estate, All property jointly-owned with the right of survivorship must be disclosed on Schedule ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking account No. 1000005925 with Waypoint Bank (see statement attached) Checking account No. 1003019709 with Waypoint Bank (see statement attached) 1991 Oldsmobile 4-door sedan with 73,150 miles (see appraisal letter attached). Miscellaneous items of household personal property and personal effects $10,097.57 $30,549.85 $1,250.00 $1,000.00 TOTAL (Also enter on line 5, Recapitulation) $ 42,897.42 (If more space is needed, insert additional sheets of the same size) LOOK FOR US. WE'LL GET YOU THERE. 01/23/2003 SAMUEL ANDES 525 N TWELFTH ST LEMOYNE PA 17043 The information which you requested on the account(s) of IRENE DALTON (Social Security Number 508-22-4079) is/are as follows: Account Number 1000005925 1003019709 7100030217 9500003674 Class of Account CHECKING CHECKING CERTIFICATE IRA Date Opened 06/19/92 11/04/99 06/17/02 03/25/02 Principal Balance 10097.57 30533.96 28424.46 28634.09 Accrued Interest 15.89 39.25 96.65 Balance at Date of 10097.57 30549.85 28463.71 28730.74 Death Account Ownership SOLE SOLE JTO Name of Joint DIANE Owner, if any Date Ownership Was Established 06/17/02 SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Accoum Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested Si,n.,gerely, . ! SENIOR SERVICES REP. P.O. Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-9;~9-7646) · IN YORK AREA 717/815-4500 · www. wagpointbank.com The Winning Combination of Sales and Service L.B. Smith Ford, Inc. 1100 Market Street · Lemoyne, Pennsylvania 17043 Phone: (717) 761-6700 or (800) 422-3673 · FAX: (717) 761-3951 E-mail: fords@ Ibsmith.com December 24, 2002 TO WHOM IT MAY CONCERN: The value for the 1991 Oldsmobile 4 Door Sedan with 73,151 miles is $1250.00. L.B. Smith Ford, Inc is not interested in purchasing this vehicle. 1991 Oldsmobile Sdn #2G3AJ54N3M2357326 was apprased for the Estate of Irene Dalton. Steve Souder, Salesperson SCHEDULE F JOINTLY-OWNED PROPERTY REV-1509 EX + (1-97~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Irene E. Dalton FILE NUMBER 21-03-00013 ff an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDE A. Diane D. Byerly 1749 Olmstead Way, Camp Hill, PA 17011 Daughter JOINTLY-OWNED PROPERTY: L~-/P-R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEAl ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointiy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTE June, Certificate of Deposit #7100030217 with 50% ~. A. 2002 $28,463.71 $14,231.8( Waypoint Bank (see attached) TOTAL (Also enter on line 6, Recapitulation) $ 14,231.86 (if more space ~s needed, insert additional sheets of the same size) LOOK F:OR UE;. WE'LL GET YOU THERE. 01/23/2003 SAMUEL ANDES 525 N TWELFTH ST LEMOYNE PA 17043 The information which you requested on the account(s) of IRENE DALTON (Social Security Number 508-22-4079) is/are as follows: Account Number 1000005925 1003019709 7100030217 9500003674 Class of Account CHECKING CHECKING CERTIFICATE IRA Date Opened 06/19/92 11/04/99 06/i7/02 03/25/02 Principal Balance 10097.57 30533.96 28424.46 28634.09 Accrued Interest 15.89 39.25 96.65 Balance at Date of 10097.57 30549.85 28463.71 28730.74 Death Account Ownership SOLE SOLE JTO Name of Joint DIANE Owner, if any ~d~O~q Date Ownership 06/17/02 Was Established SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested Si~.,gerely, . ! KATBZf ¥OUt SENIOR SERVICES REP. RO. Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-Ei66-9;=9-7646)· IN YORK AREA 717/Eil5-4500 . www. wa~jpointbank, com REV-1510 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Irene E. Dalton SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY 'FILE NUMBER 21-03-00013 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes, DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO OECEOENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VAL ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST 1. Individual retirement account #9500003674 with $28,730.74 100% none $28,730.7 Waypoint Bank (see attached). Decedent's daughter, Diane D. Byerly, was named as the beneficiary on this IRA and has received the funds from this asset. TOTAL (Also enter on line 7, Recapitulation) $ 28,730.74 (If more space is needed, insert additional sheets of the same size) LOOK FOR US. WELL GET YOU THERE. 01/23/2003 SAMUEL ANDES 525 N TWELFTH ST LEMOYNE PA 17043 The information which you requested on the account(s) of IRENE DALTON (Social Security Number 508-22-4079) is/are as follows: Account Number 1000005925 1003019709 7100030217 9500003674 Class of Account CHECKING CHECKING CERTIFICATE IRA Date Opened 06/19/92 11/04/99 06/i7/02 03/25/02 Principal Balance 10097.57 30533.96 28424.46 28634.09 Accrued Interest 15.89 39.25 96.65 Balance at Date of 10097.57 30549.85 28463.71 28730.74 Death Account Ownership SOLE SOLE JTO Name of Joint DIANE Owner, if any Date Ownership 06/17/02 Was Established SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested Si,n/gerely, , / KATI-~ YOI3Y~ SENIOR SERVICES REP. P.O. Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Fr~ 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/815-4500 · vvww. wagpointbank.com REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Irene E. Dalton FILE NUMBER 21-03-00013 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: Myers-Harner Funeral Home Harding's Restaurant (catering) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) None Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Samuel L. Andes Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant NONE Street Address City State ___ Zip Relationship of Claimant to Decedent Probate Fees Register of Wills (probate and filing fees) Accountant's Fees Tax Return Preparer's Fees The Sentinel (advertising) Cumberland Law Journal (advertising) Frank Baker (stock appraisal) Mark Heckman (real estate appraisal) Costs incurred to preserve and sell residence (see Schedule attached hereto) $4,411.00 $991.70 $10,000.00 $284.00 $81.59 $75.00 $50.00 $300.00 $19,838.12 TOTAL (Also enter on line 9, Recapitulation) $ 36,031.41 (if more space is needed, insert additional sheets of the same size) Estate of Irene E. Dalton 21 -O3-OOO 13 Costs Incurred to Preserve and Sell Residence: 1. Electric utility expense 2. UGI - heat utility 3. Sewer and trash fees 4. Water utility fees 5. Real estate taxes: (Minus proration reimbursement at sale) 6. School taxes: (Minus proration reimbursement at sale) 7. Painting, repairs and clean-up of residence 8. Real estate sales commission 9. Realty transfer tax 10. Realtor's transaction fee 11. Pest inspection and treatment charges 12. Fee to prepare deed 13. Purchaser's settlement costs (as shown on settlement sheet attached) $304.65 $820.78 9146.70 9109.40 9266.55 9164.32 94,204.02 97,170.00 91,240.00 9100.O0 9736.70 975.00 94,500.00 Total 919,838.12 CCMMONWE^LTH OF PENNSYLV^NIA iNHERiTANCE TAX RETURN R£SIDENT OECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS ESTATE OF Irene E. Dalton FILE NUMBEE 21-03-00013 Include unreimbursed medical expenses, ITEM NUMBER DESCRIPTION AMOUNT 1. Verizon phone bill Comcast Cable bill Auto insurance (after refund upon cancellation) Homeowners insurance (after refund upon cancellation) $56.72 $53.59 $32.00 $78.00 TOTAL (Also enter on lin~ 10, Recapitu!ation) $ 220.31 (If more space is needed~ inser[ additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF Irene E. Dalton NUMBER SCHEDULE J BENEFICIARIES FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Diane D. Byerly RELATIONSHIP TO DECEDENT Do Not List Daughter 21-03-00013 100% AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART [!. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) August20,2003 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES : DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Law Offices of Brown, Schultz, Sheridan & Fritz, CPA. P.O. Box 67865 Harrisburg, Pa. 17106-7865 Telephone (717) 787-3930 FAX (717) 772-0412 Dear Mr Abel: Re: Estate of Irene Dalton File Number 2103-0013 This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before February 21,2004. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, ~ ~ Claudia Maffei, Supe./K/~ Document Processir~lSk~ t inheritance Tax Divisio--n-- ., COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO3178 ANDES SAMUEL L 525 N 12TH ST LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 508-22-4079 FILE NUMBER: 2103-001 3 DECEDENT NAME: DALTON IRENE E DATE OF PAYMENT: 10/29/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/21/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,153.37 TOTAL AMOUNT PAID: $8,153.37 REMARKS: DIANE D DALTON EXECUTRIX C/O SAMUEL L ANDES ESQUIRE SEAL CHECK//2636 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-060I SAHUEL L ANDES 525 N 12TH ST LEHOYNE CUT ALONG THIS LINE COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT[CE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX PA 1704.:5. RETAIN LONER PORTION FOR YOUR RECORDS DATE 12-22-2005 ESTATE OF DALTON IRENE DATE OF DEATH 11-21-2002 FILE NUNBER 21 05-0015 COUNTY CUHBERLAND ACN 101 Amount Remitted HAKE CHECK PAYABLE AND REHIT PAYHENT REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 DISALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF DALTON IRENE E FILE NO. 21 05-0015 ACN 101 DATE 12-22-2005 TAX RETURN NAS: C X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) 2 Stocks and Bonds (Schedule B) $ Closely Held Stock/Partnership Interest (Schedule C) 4 Hortgages/Notes Receivable (Schedule D) 5 Cash/Bank Deposits/Nisc. Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9 Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule H) 10 Debts/Hortgage Liabilities/Liens (Schedule I) 11 Total Deductions 12 Net Value of Tax Return Cl) 124t 000. O0 c2) 7r577.69 cs) .00 .00 (5) 42~897.42 14~251.86 (7) 28~750.74 (8) 220.51 NOTE: To insure proper credit to your account, submit the upper port/on of this form w/th your tax payment. 1s NOTE: 217,457.71 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. reflect figures that Include the total of ALL returns assessed to date. · O0 x O0 = 181,185.99 x 045= · O0 x 12 = · O0 x 15 = c19)= TOTAL TAX CREDXT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ASSESSNENT OF TAX: 15. Amount of Line 14 at Spousa[ rate (15) 16. Amount of L/ne 14 taxable at Lineal/Class A rate 17. Amount of L/ne 14 at Sibllng rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS PAYNENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUNBER INTEREST/PEN PAID (-) 10-29-2005 CD00:5178 . O0 8,155.57 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-:50-2005 .00 .00 8,155.57 .00 .00 8,153.37 8,155.57 .00 77.07 77.07 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) C15) Net Value of Estate Sub3ect to Tax (14) 181, 185.99 If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will (11) ~.?GI .72 (12) 181,185.99 RESERVATION~ PURPOSE OF NOTICE= PAYMENT= REFUND OBJECTZONS= ADMIN- ISTRATIVE CORRECTIONS= DISCOUNT= PENALTY: INTEREST= Estates of decedents d~ing on or before December 12, 1982 -- if an~ 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 life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. C72 P.S. Section 91401. Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to= RBGZS~'~ (~ N~LLS) &~ A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an '~pplication for Refund of Pennsylvania Inheritance and Estate Tax" CREV-l$131. Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for fores orderings 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs= 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax Cincluding discount or interest) as sho~n on this Notice must object within sixty C&O~ days of receipt of this Notice by= --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone C7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-15011 for an explanation of administratively correctable errors. If any tax due is paid within three C$I calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allo~ed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the 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 not/ce. Interest is charged beginning with first day of delinquency, or nine (9) months and one C1) 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 CEX) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 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 2003 are= Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20~ .000548 1987 9~ .000247 1999 7X .000192 1983 l&~ .000438 1988-1991 11~ .000301 2000 BY. .000219 1984 ll~ .000301 1992 9~ .000247 2001 9X .000247 I985 13~ .00035& 1993-1994 7~ .000192 2002 &X .000164 1986 10~ .000274 1995-1998 9~ .000247 2005 5X .000137 --Interest is calculated as follows= ZNTBREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELXNQUENT X DAXLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (151 days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES DEPARTNENT OF REVENUE ]NHERZTANCE TAX DIV][S~[DN nEPT. 28060]. HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX SAHUEL L ANDES 525 N 12TH ST LEHOYNE PA 17043 DATE 12-22-2003 ESTATE OF DALTON IRENE DATE OF DEATH 11-21-2002 FILE NUHBER 21 03-0013 COUNTY CUHBERLAND ACH 101 Amount Remitted I HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF NZLLS CUNBERLAND CO COURT HOUSE CARLISLE, PA t7013 CUT ALONG THIS LINE ~' RETAIN LONER PORTION FOR YOUR RECORDS ~-~- ~--~-~=~--~ ..... ~ ............................................... THE BYERLYS 1749 Olmstead Way. Camp Hill, PA 1701 BUREAU OF TNDTVTDUAL TAXES TNHERTTANCE TAX DTVISTOH DEPT. 280601 HARRTSBURG, PA 171ZS-O60Z COHHONWEALTH OF PENNSYLVANTA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT REV-i&07 EX AFP (01-03) SAMUEL L ANDES 525 N 12TH ST LEHOYNE .~<; O~ DATE 02-Z$-200R il Wi~$ ESTATE OF DALTON DATE OF DEATH 11-Zl-ZOOZ FILE NUHBER 21 03-0013 '04 FEB 27 P 1 'n~COUNTY CUMBERLAND '--ACN 101 PA 170~$ , . I Amoun~ Remitted I Ctim~'~ Co., PA IRENE E NAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 NOTE: To insure proper credit to your account, subm/t the upper portion of this form with your tax paym.nt. CUT ALONG THIS L'rNE ~'- RETAIN LOWER PORT'rON FOR YOUR RECORDS *-~ REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF DALTON IRENE E FILE NO. 21 03-0013 ACN 101 DATE 02-23-200~ THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUMMARY OF THE PRINCIPAL TAX DUE., APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPLICABLE, A PROdECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-22-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 8,153.37 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID .00 10-29-2003 01-02-200~ CD003178 CD003~07 77.07- 8,153.37 77.07 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" TOTAL TAX CREDIT 8,153.37 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORH FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT. -- If NON-RES[DENT DECEDENT make check or money order payable to: CONMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's Zq-hour answering service for fores ordering: 1-BO0-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-B00-q47-3020 (TT only}. REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Xndividua! Taxes, ATTN: Past Assessment Review Unit, Dept. 28060[, Harrisburg, PA [7128-060l, phone (7173 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 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. 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, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rata of .000[64. All taxes which became delinquent on and after January l, 1982 wi[[ 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 IeBz through Z003 ara: Interest Oaity [nterest Daily Interest Year Rate Factor Year Rate Factor Year Rate Dally Factor 1982 Z02 .00054B 1987 92 .O00Zq7 1999 72 .000192 1983 162 .000438 1988-1991 112 .000301 ZOO0 82 .000219 1984 11Z .000301 1992 9Z .000247 2001 92 .000247 1985 132 .000356 1993-1994 72 .000192 2002 62 .000164 1986 102 .000274 1995-1998 9Z .000247 2003 52 .000137 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAXD X NUIIBER OF DAYS DEL/NQUENT X DA/LY XNTBREST 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 data shown on the Notice, additional interest must be catculatad. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003407 ANDES SAMUEL L 525 N 12TH ST LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 508-22-4079 FILE NUMBER: 2103-001 3 DECEDENT NAME: DALTON IRENE E DATE OF PAYMENT: 01/05/2004 POSTMARK DATE: 01 ~02~2004 COUNTY: CUM BERLAN D DATE OF DEATH: 11/21/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $77.07 REMARKS: TOTAL AMOUNT PAID' $77.07 SEAL CHECK# 8299 INITIALS' AC RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS STATUS REPORT UNDER RULE 6.12 Name of Decedent: Irene E. Dalton Date of Death: 21 November 2002 Will No. Admin. No. 21-03-OOO1' To the Register: 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 nf ,h. estate is comp!eto: yes 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: 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: C. Did the personal representative state an account informally to the parties in interest? Yes ~' No__ D. 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. Date: LO: L~ 9- 8d~ ~. Name: Samuel L. Andes Address: 525 N. 12th Street Lemoyne, PA 17043 Telephone # 717 761-5361 Capacity: Counsel for Personal Representative