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HomeMy WebLinkAbout03-1073 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as To: Register of Wills for the Deceased. County of ~tr,~<~,~,b in the Social Security No. ~0 ~ -~6- qq ~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, applt~ for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in ~3~ ~-~ ~-~ County, Pennsylvania, with h ~ last family or principal residence at I0~ A~ ~0~?~- ~ ~ ~' (list street, number and municipality) 3E' ye~s of age, died : ~c~ i~9 ., ~ ~6~ , Decenden~ then Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal prope~y in Pennsylvania $ (If not dOmiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situated as follows: Petitioner.__ after a proper search ha 5 ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship R~s~denc4.' I THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~,~ PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28060 INHERITANCE TAX RETURN HARRISBURG, PA17128-0601 RESIDENT DECEDENT oou,, coDEI -- DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER III DATE OF DEATH iMM-DD-YEAR) (3 [ DATE OF BIRTH (MM-DD-YEAR THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U.I ~,7.. '~0- l.Oo3 I 0'3 [0~-~ ~"'tZ.~ REGISTER OF WILLS U.J (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I-~1. Original Return I'---] 2. Supplemental Return [~ 3. Remainder Return (data of death prior to 12-13-82) LLI ,Z, O:: '"' I~ 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required ,,~ ,', o I---] 6. Decedent Died Testate (Atiach copy of Will) [] 7. Decedent Maintained a Living Trust (At~ach copy of Trust) __ 8. Total Number of Safe Deposit Boxes C) ,-, Il. < [~ 9. Litigation Proceeds Received [] 10, Spousal Poverty Credit (date of death between12-31-91and1-1-95) [] 11. Election to tax under Sec. 9113(A)(AttachSchO) I- Z Z""LU NAME ~1.~'~$ ¢~,,t,.~_,,~,~ COMPLETE MAILING ADDRESS FIRM NAME (If Applicable) TELEPHONE NUMBER o 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) ~ I~).'-~-~  (Schedule E) .._, 6. Jointly Owned Property (Schedule F) (6) ~ ~-~ ~ ~ [] Separate Billing Requested ~) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) --~-- I-'" (Schedule G or L) ,~ 8. Total Gross Assets (total Lines 1-7) (8) UJ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) /J~'7. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) -"~.~'~ 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES  Amount of Line 14 taxable the 1 5. at spousal tax ~ rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15) ~ 16. Amount of Line 14 taxable at lineal rate x .0 __ (16) I~. 17. Amount of Line 14 taxable at sibling rate x .12 (17) O (.) 18. Amount of Line 14 taxable at collateral rate x .15 (18) X 19. Tax Due (19) Decedent's Complete Address: STREET ADDRESS Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) ..,~._._., A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable Total Credits ( A + B + C ) (2) D. Interest E. Penalty Total Interest/Penalty ( 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. (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 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 perjury, 1 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. S 6N^TURE OF PERSON RESPO,S B,E FOR F L N6 RE -URN ADDRESS ,U a. SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 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 RS. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 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-1511 EX+ (12-99) _ ~ SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE (::OSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: r~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) Nationwide "The Simple Digrtified Choice" 1-800-722-8200 12-11-2003 231393 JL-5 Mr. Charles E. Bartch 48 Butter Road Dover, PA 17315 Beverly J. Bartch - Deceased X Direct Cremation $995.00 Special 48 Hour Or Weekend Cremation Service Nationwide Guarantee Program Worldwide Travel Protection Program Private Family Viewing/Witnessing Cremation Cremation Container Medical Documents/Courier Fee X Meadow Green Marble Urn with Engraving $255.00 Urn Burial Vault Arrange For Burial Personal Delivery of Cremated Remains Arrange/Deliver Remains To A National Cemetery Scattering Charge Packaging And Forwarding Cremated Remains Express Mail X Certified Copies 5 @ $2.00 $10.00 Register Book Memorial Folders Thank You Cards # Memorial Service Package Flowers Newspapers X Harrisburg Patriot $112.85 X Cumberland County Coroner Cremation Approval Fe $25.00 DNA Preservation Other Other TOTAL $1,397.85 1-14-2004 PAID $1,285.00 BALANCE DUE $112.85 www.cremationsocietyofpa.com ~v.,~E×.<~.9,, ~ ,,,,ou SCHEDULE E BANK & MISC. COMMONWEALTH OF PENNSYLVANIA ~,on, INHERITANCE TAX RETURN RES,DENT DECEDENT PERSONAL PROPERTY FILE NUMBER Include the pro~eds of I~gaaon and ~e date ~e p~eds were re.ired by ~e es~te. All pmpe~ ]oint¥o~N ~ the ~ght of su~ivomhip ~ust be disclosed on ~hNule F. ITEM VALUE AT DATE NUEJBER DESCRIPTION OF DEATH TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 12--22-2003 Checking Account Inquiry Next display: ,0,5, 20-0700-4 11::05:11 Current Statement for: 100283472 DSPBR01818 Bal as of 11-30-03 466.47 BEVERLY J BARTCH +Dep/CR: 1 675.00 1065CALLENDALE RD MECHANICSBURG PA 17055-4464 -Chks/DR: 7 722.70 -Service charge: .00 +Interest paid: .00 Current balance: 418.77 Pst Dt Serial Number TC Description Amount Balance Str/Run/Bat/Seq# X Elf Dt 120103 1264 081 CHECK 37.55- 428.92 120103 1270 081 CHECK 20.15- 408.77 120303 018 US TREASURY 303 675.00 1083.77 120503 058 AARP HEALTH CAR 127.00- 956.77 120503 1268 081 CHECK 77.00- 879.77 120803 1273 081 CHECK 300.00- 579.77 120803 1271 081 CHECK 126.00- 453.77 121003 1272 081 CHECK 35.00- 418.77 Bottom F3=Exit F8=Recent trans F16=Print research stmt F11=Fold/unfold F13=Inquiry window F15=Restart F24=More keys OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF ~~ ss i/i~ ~-~-: 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 representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed., and subscribedf ~ 6-~-- befm:e me this ~t ~ 6~? day of I No. ~/-t~,.~o/~ 7~, Estate of ~v~ t,0 .~ I~g ~.~ .1~ , Deceased GRANT OF LETTERS OF ADMINISTRATION ANn NOW c', c~ ~ ~ ~ <? ~ ~ ~~, in consideration of the petition on the reverse side hereof, sat~factory proof havi~been presented before me, IT IS DEC~ED that (~L~ ~ ' ~T~ is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to in the estate of FEES Letters of Administrmion ..... $ Short Certificates( ) .......... $ ~. ~ A~ORNEY (Sup. Ct. I.D. No.) iation ................ $ TOTAL ~ $~ ADD.SS PHONE This 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. Local Registrar P 9 8 1 1 7 0 8 ~~~~ DEC i ,5 2003 No. ~ Date R~ ~a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (F~rs~. M i~,e, La~l) ISEx ISOCIAL SECURITY NUMBER E]~F ~H~ __' . ~. '~} ,. ~ *~. ~ ,,. I se ~ C~b~land ..E~ Pen~boro Igl~ ~065 Allend~e Road Apl. C,,~ ,t Mechanrcsb~g, PA 17055 · . · ,~.~ Cumberland ,,. Ch~les Wrl' f.(c~' H~k [,,. B~tha Elrzabeth' Shenk ~. Ch~les E. B~tch [~ 48 Butter Road, Dove, PA 17315 _ ~U ~,~ ~.~ P~.~,.~ I~ C~ema~ton ~oele~ o~ I ~~A ~~~' ~ J~. I~. 4100 Jonestown Road. H~r~b~O, 'PA 17109 ~ IT~ ~ _. ~ I ( ~. ay. ~) I~. ~(~y c. ~SY J~NER ~ ~ATH ]~URY TIME ~ ~URY J~URY~ ~? ]~ ~I~Y~D. ~ ,.~ c~ ~" I". I~. I 'MEDIAL ~AMINE~CORONER ~..~,.o, .... ,..,, .... ~o,, .... ,,..,,~.,..,o,,.,o.:,Tt,.UyyyF.~t,.,.~,.,~..,.,....~,, ..... ~,.~,.~y~y~).~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date ofDeath: ~. /iQ, ,~903 / Will No. q~ ~ - 0 ~.~- [ 6~'~ ~ Admin. No. To the Register: I cegify ~m notice of (~nefiei~ intent) es~te a~ffistration required by Rule 5.6(a) of the O~h~s' Cou~ Rules was served on or mailed to the following benefici~ies of the above-captioned estate on : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Name Address ~ /~[0 *o~t Telephone ( ) Capacity: ~( Personal Representative __Counsel for personal representative JRD/June 30, 1992/17858 t'l^Y 0 6 20114 ¢ In Re: Estate of BEVERLY J BARTCH · ORPHANS' COURT DIVISION Late of UPPER ALLEN TOWNSHIP · COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY Estate No.: 21-03-1073 · PENNSYLVANIA NO. 21-2003-1073 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: CHARLES E BARTCIt Counsel for Personal Representative: Date of Grant of Original Letters: 12-30-2003 Date of Delinquency Notice: 04-09-2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of the Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on APRIL 9, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 05-06-2004 _~l..a.~M~~ Glenda Farrier Strasbaugh-~S~C')~ Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A heating is scheduled fo at in Courtroom No. 3. If the Certification of Notice is filed prior to the hearing date, the hearing will autom~ Geot~ge ~. I-toWer, ~.J: ' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF IND~I~'1~~~~iCE OC INHERITANCE TAX ~QN:~..../L_--, .j. I . ;.... I PO BOX 280601 l'~:"f\:':' '~ (I HARRISBURG PA 171Z8~06iJ1i .'J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-17-2005 BARTCH 12-10-2003 21 03-1073 CUMBERLAND 101 ZuGS J!\H I II Pi: 3: 14 C E~)I( r\: L~I',i\ U, ~..R..'~'.' :.^'~'C',~ nl..i~.'.'T '"",I,...... ",.. n i CHAR,' .;'8 ~i;:fl,,'. 48 B 'fER RD DOVER PA 17315 *' REY-1547EKAFPI12-B4l BEVERLY J Allount Rellitted I CHANGED III 121 131 141 151 161 171 .00 .00 .00 .00 418.77 .00 .00 181 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Ri.V' :r~~-Ei<--AFP--Cil1":cl'!".NiiT"icE.oF.i:NiiER-ii'Al(cl.'''Ax.A.PPRiiiSEMitl':..ALLowANclf-o'R......----- -- -... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BARTCH BEVERLY J FILE NO. 21 03-1073 ACN 101 DATE 01-17-2005 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate {Schedule AJ 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable {Schedule DJ S. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. ~ointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ~ ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (IS) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 1,397.85 .00 1111 1121 1131 1141 191 1101 NOTE: To insure proper credit to your account I submit the upper portion of this form with your tax payment. 418.77 1 .397 8~ 979.08- .00 979.08- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = (19)= .00 .00 .00 .00 .00 .AX CREDITS: ~AY"EN~ "C~CH , 1+' AMOUNT PAID DATE NUMBER INTEREST/PEN PAID I-I TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED I SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAyMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAy BE DUE ~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIDNS.I ~~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/01/2005 BARTCH CHARLES E 48 BUTTER ROAD DOVER, PA 17315 RE: Estate of BARTCH BEVERLY J File Number: 2003-01073 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: 12/10/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge \Jb STATUS REPORT UNDER RULE 6.12 Name of Decedent: {)e.\J{"'~ ,J 6Clttd1 Date of Death: UL,~ \w- l\9 "le;Q?> Will No.: ~Go 3-0 \ 0/3 Admin. No.: ;,{ I- 03 -1073 , 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 M No 0 2. lithe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lithe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No B 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 0 No G c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. Date: /I-IF-OJ thtu.Lt~ 6udcA Signature (3ho.l 1M .~ (tr-tch Name '-1& t,-U.~ f~ - JIV{/ A 1731j'- Address (' L , ,-) 7/7 -z92-tJ/;!.7 Telephone No. Capacity: BPersonal Representative o Counsel for personal representative xlI+ :