HomeMy WebLinkAbout03-0960Estate of
also known as
Register of Wills of CUMBERLAND COUNT~, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Catherine A. Luckenbauqh
Deceased
Social Security No. '~-f~ ~ -
(COMPLETE "a" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/a~ the executor named in the Last Will of the
Decedent, dated August 1, 2002 and codicil(s) dated N/A
State relevant circumslmlces, e.g.. ,enunciation, dealh ot executol, elc
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
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cu~mberland County, Pennsylvania, wi[h his/her last family or pr,nc~pal
residence at The Woods at Cedar Run, 824 Lisburn Road, Camp Hill, PA
Decedent, then 83 years of age, died November 11, 2Q03 ._, at above residence
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property .............................. $ 90 ~ 000 · 00
(If not domiciled in PA) Personal property in Pennsylvania ...................... $
(If not domiciled in PA) Personal property in County ..........................
Value of real estate in Pennsylvania ...............................................
Tota~ .............................................................. s 90,000.00
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
'~~ ~L, Typed or printed name and residence
- Harold A. Luckenbaugh, Jr.
Sigoature
115 Sholly Drive, Mechanicsburg, PA 17055
.W-7 /
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CU.~BERLAND
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 19th day of
Donna M. Otto, 1st Deputy Register of Wi ] 1 .~
DECREE OF REGISTER
Estate of Catherine A. Luckenbaugh Deceased No.
also known as
Social Security No: I c~ 'L, - -~,4_ /
-~,,"~-~3Date of Death: November 11, 1002
AND NOW, November 19th , 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 Harold A. Luckenbaugh, Jr.
in the above estate and that the instrument(s), if any, dated August 1:20f)2
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $ :200.00
Short Certificate(s) .... .4. ....
Renunciation.: ................
Affidavit ( ) .................
Extra Pages (:2) ............
Codicil ..........................
JCP Fee ........................
Inventory & Tax Forms...
Other ............................
$ 12.00
$ 10.00
TOTAL ................ $ 228.00
Rl~-7a
Mailed lettes to Attorney
11/19/2003
Register ot Wills
Donna M. Otto, 1st Deputy
At.torn, gy: Harry L. Bricker, Jr., Esq.
I. O'.l' N'o:' 0~049
Address: 407 North Front Street
Harrisburg, PA 17101
Telephone: (717) 233-2555
DATE FILED: Klr,~'cmh~:r lq~-h:
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph. ;t~ .
Fee for this certificate, $2.00
P 9852546
No.
Date
·LACK MK
COMMONWEALTH OF PENNSYLVANIA ° DEPARTMENT OF HEALTH o VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
I" Catherine A Luckenbaugh a. Female :. 192-34-6735 4. November 11, 2003
~ Cumberland I Lower Allen 824 Lisburn Road ~.~.,~ ~,, ~xte
~ ,,~oto Fznzsner I,,~. I,~. , . '
i ]824 ~i~ ,~ Hill, PA 17011
I,, ~nie P~ck
~s~ ]mil5 Sholly Dr., Mecn~csDurg,
~o[d ~. ~u~ep~h,
Occlusive Coronary Artery Disease
~ ~ ~ 0 ~ 0 ~~-~,~.~.~.~ IL~(~.~,~)
~~- ---- ~ ~-~' ~u~~ / Chief Deputy
3',, November 14~ 2003
't'~ C. Ec~'r~nro~,~m~.Dep. Coro
6375 Basehore Rd., Suite
Mechanicsburg, Pa. 17050
21-2003-960
LAST WILL AND TESTAMENT
OF
CATHERINE A. LUCKENBAUGH
I, CATHERINE A. LUCKENBAUGH, an adult individual, of the Township of
Lower Allen, County of Cumberland, and Commonwealth of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish and declare this to be
my Last Will and Testament, hereby revoking and making void any and all Wills or
testamentary writings by me at any time heretofore made.
FIRST: I direct that all my debts, funeral expenses and inheritance
taxes be paid by my personal representative, hereinafter named, as soon after my death
as may be practicable.
SECOND: I give and bequeath all the rest, residue and remainder of my
Estate, be it real, personal and mixed, of whatever nature and wheresoever the same may
be situate to my four (4) children in equal shares per stirpes and not per capita.
THIRD: I hereby nominate, constitute, and appoint my son, HAROLD A.
LUCKENBAUGH, JR., who presently resides at 115 Sholly Drive, Mechanicsburg,
Pennsylvania 17055, as Executor of this, my Last Will and Testament. Should the said,
HAROLD A. LUCKENBAUGH, JR., fail to qualify or cease to act as Executor, I hereby
nominate, constitute and appoint my daughter, SHARON K. WENTLING, who presently
resides at 58 Sussex Road, Camp Hill, Pennsylvania 17011, as Executrix of this my Last
Will and Testament. I further direct that the personal representative shall serve without
bond. Said personal representative shall have the power to discharge all the debts, liens
and encumbrances upon my Estate, as well as any taxes thereon, to pay for the cost of the
final disposition of my remains and final illness, if any, to receive any and all commissions
and other compensation for services rendered by me during my lifetime, and to perform
any and all fiduciary duties authorized by statute. Further, I direct my personal
representative to preserve my Estate and any instructions pertaining to the distribution of
the same from any attachment or anticipation while in the hands of my personal
representative, it being my express intent that all legacies shall be free from any
attachment or anticipation while in the hands of the accountant for my Estate.
FOURTH: I hereby direct that all taxes attributable to the passing of any
assets by means of this Will or otherwise, or that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from
the residuary of my estate as a part of the expense of the administration of my
estate.
IN WITNESS WHEREOF, I, CATHERINE A. LUCKENBAUGH, have signed, sealed,
published and declared this to be my Last Will and Testament, consisting of this and
two (2) additional pages in the margin of each of which I have also set my hand for
greater security and better identification this __!..,~ 'day of
2002.
CATHERINE A. LUCKENBAUGI-T'
(SEAL)
The preceding instrument, consisting of this and two (2) other typewritten
pages, each identified by the signature of the Testatrix, was on the day and date hereof
signed, sealed, published and declared by CATHERINE A. LUCKENBAUGH, Testatrix
herein 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 hereunto subscribed our names as
witnesses hereto. We further certify that at the time of the execution hereof, the said
CATHERINE A. LUCKENBAUGH was of sound and disposing mind, memory and
understanding.
of
2
II
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF DAUPHIN )
SS:
I, CATHERINE A. LUCKENBAUGH, Testatrix whose name is signed to the attached
or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and acknowledged before me by CATHERINE A.
LUCKENBAUGH, the Testatrix, this /~ day of C4.cc~'z.4~ ,2002.
Notar~ Publi~ / /~.
My c~mmission expires: G~/~?z" ~'
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
SS:
COUNTY OF DAUPHIN )
the witness~11:~'~es are signe'~.?e a~ed or foreg~C~g ,nstrum~nt, bei~g
duly qualifil~l according to law, do depos'e~and say that we were present and saw
CATHERINE A. LUCKENBAUGH, Testatrix, sign and execute the instrument as her Last
Will and Testament; that CATHERINE A. LUCKENBAUGH signed willingly, and that she
executed it as her free and voluntary act for the purposes therein expressed; that each of
us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the
best of our knowledge, the Testatrix was at that time 18 or more years of age, of sound
mind, and under no constraint or undue influence.
NO 'AR, .SEAL
AGNES G NICHiCI, NOTARY PUBLIC
]CITY OF' r~;~,RR(SBURG, DAUPHIN COUNTYJ
MY COMMISSION EXPIRES JUNE 19, 2006
Sworn to and subscribed before me
this ~ day of ~z.~T_~, 2002.
Not~jly Pu~li~.
My Commission expires: ~//?~"~
(SEAL)
i
I NOTARIAL SEAL
AGNES G. NICHICl, NOTARY PUBLIC
CITY OF HARRISBURG, DAUPHIN COUNTY!
MY COMMISSION EXRRES JUNE 19, 2006
3
LAST WILL AND TESTAMENT
OF
CATHERINE A. LUCKENBAUGH
ATTORNEY At LAW
407 NORTH FRONT STREET
~ &i~l~l 8 BYTRG ~
17lOI - 1296
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Catherine A. Luckenbaugh
Date of Death: November 11,2003
No. 21-03-0960
To the Register:
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 November 21, 2003:
Name
Harold A. Luckenbaugh, Jr.
Joyce C. George
Dwight L. Luckenbauqh
Sharon K. Wentling
Address
115 Sholly Drive, Mechanicsburg, PA 17055
75 S. 36th Street, Camp Hill, PA 17011
11 Higginson Court, Williamsburg, VA 23188
58 Sussex Road, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
No Exceptions
Date:
Harry L. B~., Esquire
407 Norttl'Front Street
Harrisburg, PA 17101
(717) 233-2555
Capacity:
Personal representative
X
Counsel for personal
representative
STATUS REPORT UNDER RULE 6.17
Name of Decedent: Catherine A. Luckenbauqh
Date of Death: November 11, 2003
No. 21-03-0960
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes~ No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: Hopefully within one year
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did 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: ', ~ -'"~*- t - c~.~ ~ "~
Harry L. Bricke'~r~_ r., Esquire '~
407 ~tOTth-Fi'b~t'Stfeet
~': Harrisburg, PA 17101
(717) 233-2555
Capacity:
Personal Representative
X
Counsel for Personal
Representative
HARRY L. BRICKER, JR.
ATTORNEY AT LAW
40? NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA
17101-1;~96
February 9, 2004
AREA CODE 717
Cumberland County Courthouse
Attn: Register of Wills
One Courthouse Square
Carlisle, PA 17013
Re:
Estate of Catherine A. Luckenbaugh, Deceased
Social Security No.: 192-34-6735
Date of Death: November 11, 2003
Estate No.: 21-03-0960
Gentlemen:
Enclosed is our Estate Account check payable to you in the amount of $13,350.00
on account of the Inheritance Tax Return.
You will note, this payment is being submitted within ninety (90) days from the date
of death and hence, a five percent (5%) discount applies.
HLB, Jr./bid
Enclosure
Very truly yours,
Nar .ry..L-~. B~I~'~'~:, 'Jr.'"' ~.
HLBLA W@ verizon, net ~
cc: Mr. Harold A. Luckenbaugh, Jr.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
q~UREAU OF INDIVIDUAL TAXES
DEPT.~.80601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
LUCKENBAU.GU HAROLD A JR
115 SHOLLY DRIVE
MECHANICSBURG, PA 17055
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003543
fold
ESTATE INFORMATION: SSN: 192-34-6735
FILE NUMBER: 2103-0960
DECEDENT NAME: LUCKENBAUGH CATHERINE A
DATE OF PAYMENT: 02/09/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 11/11/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $13,350.00
TOTAL AMOUNT PAID:
$.13,350.00
REMARKS: HAROLD LUCKENBAUGHJR
', i::~ CHECK//1002
INITIALS:
VZ
SEAL
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
HARRY L. BRICKER, JR.
ATTORNEY AT LAW
HARRISBURG, PEN-NSYLVANIA ~;i tis
17101-1~396
'04 FEB 27 P12:19
February 25, 2004
[~;~i:, . :~ :_ ~.;our[
AREA CODE 7~7
Cumberland County Courthouse
Attn: Register of Wills
One Courthouse Square
Carlisle, PA 17013
Re:
Estate of Catherine A. Luckenbaugh, Deceased
Social Security No.: 192-34-6735
Date of Death: November 11, 2003
Estate No.: 21-03-0960
Gentlemen:
Enclosed is an original and three (3) copies, all of which are siqned, of the
Pennsylvania Inheritance Tax Return concerning the above-captioned estat~ and four (4)
signed Inventories.
Also enclosed is an Estate Account check payable to you as Agent in the amount
of $720.31 for the balance of the inheritance tax which is due.
Please return all of the documents which you do not need, but we will appreciate
you marking them as filed and stamp them in before returning them to this office. We are
enclosing a self-addressed, stamped envelope for that purpose.
Thank you for your help.
Very truly yours,
HLB, Jr./bid
Enclosure
HLBLA W@verizon. net ~
cc: Mr. Harold A. Luckenbaugh, Jr.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
Rev-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
County Code Year Number
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z LUCKENBAUGH, CATHERINE a. 192-34-6735
r'~ DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
O 11-11-2003 ~06-16-1920 REGISTER OF WILLS
~ IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z
z
0
0
1. Original Return
4. Limited Estate
6. Decedent Died Testate (Attach copy of Will)
9. Litigation Proceeds Received
U 2. Supplemental Return ~_t35 Remainder
4a. Future Interest Compdse (date of death after 12-12-82) Federal Estate Tax Return Required
7. Decedent Maintained a Living Trust (Attsch a copy of Trust) 0 8. Total Number of Safe Deposit Boxes
10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) r'~ 11. Election to tax under Sec. 9113(A)
[.J (attach Sch O)
THIS SECTION MUST BE COMPLETED.
NAME
HARRY L. BRICKER, JR.
FIRM NAME (If Applicable)
TELEPHONE NUMBER
(717) 233-2555
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
lCOMPLETE MAILING ADDRESS
HARRY L. BRICKER, JR.
ATTORNEY AT LAW
407 NORTH FRONT STREET
HARRISBURG, PA 17101
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 & Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
~ Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
$0.00
'$o.oo
: $o.oo
$327;503.65
$0.00
OFFICIAL USE ONLY
(8)
$14,830.14
$0.00
(11)
(12)
(13)
$327,503.65
$14.830.14
$312,673.51
$0.00
$312,673.51
(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 (aX1.2)
16. Amount of line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20. ~
x (15)
$312,673.51 x .045 (16)
x .12 (17)
x .15 (18)
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
$0.00
$14,070.31
$o.oo
$14,070.31
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
D~(:eder~t's Complete Address:
STREET ADDRESS
CITY
CAMP H LL
824 LISBURN ROAD
STATE
PA
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
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 I 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 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
$14,070.31
$13.350.00
$0.00
$720.31
$720.31
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 revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
If death occurred after December 12, 1982, did decedent transfer property within on year of death
without receiving adequate consideration? ~
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ~-]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, i declare that 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 the information of which preparer has any knowledge.
115 SHOLLY DRIVE, MECHANICSBURG, PA 17055
DATE
~.GNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS ~'
407 NORTH F ET, HARRISBURG, PA 17101
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 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.
RE¥-1508 EX + (lr.9TX 1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF CATHERINE A. LUCKENBAUGH
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
10.
11.
12.
DESCRIPTION
WACHOVIA BANK - SAVINGS ACCOUNT NO. 3000022472736
WACHOVIA BANK - CHECKING ACCOUNT NO. 1000665227764
WAYPOINT BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. 2900001274
WAYPOINT BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. 605055897
WAYPOINT BANK - CHECKING ACCOUNT NO. 605004756
FULTON BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. 333-0037951
JNITED AMERICAN INSURANCE COMPANY - UNEARNED REFUND FROM PREMIUMS PAID -
POLICY NO. 574498676
AETLIFE - TOTAL CONTROL ACCOUNT NO. 4044552399
MELLON INVESTOR SERVICES - METLIFE STOCK INVESTOR ID NO. 806317213579
(57 SHARES AT $30.60)
FULTON BANK - INTEREST ON CERTIFICATE OF DEPOSIT
AMERICAN EXPRESS FUNDS:
1. MUTUAL FUNDS:
ACCOUNT NO. 01129101034 3 002 (8799.214 SHARES)
ACCOUNT NO. 01139101034 2 002 (5749.680 SHARES)
ACCOUNT NO. 01249101034 9 002 (9641.057 SHARES)
2. CERTIFICATES:
ACCOUNT NO. 00804308494 9 001
ACCOUNT NO. 00804308495 6 001
ACCOUNT NO. 00804344357 4 001
ACCOUNT NO. 00804373966 6 001
ACCOUNT NO. 00804396822 4 001
ACCOUNT NO. 00804424438 5 001
3. ANNUITIES - POST 1985:
ACCOUNT NO. 93006969147 3 004
PATRIOT NEWS - REFUND
AMOUNT OF CONTINUATION PAGE FOR SCHEDULE E
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
Of DEATH
$25,763.02
$1,506.42
$10,337.40
$42,051.59
$643.81
$5,018.57
$210.42
$8,008.79
$1,744.20
$66.09
$42,291.27
$5,750.85
$46,893.67
$6,250.00
$6,250.00
$12,846.08
$12,741.50
$25,410.89
$20,139.32
$50,058.41
$40.25
$3,481.10
$327,503.65
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
CONTINUATION PAGE
SCHEDULE E
ESTATE OF FILE NUMBER
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
THE WOODS AT CEDAR RUN - REFUND OF SECURITY DEPOSIT AND PARTIAL REFUND OF RENT FOR
NOVEMBER
TRAVELERS INSURANCE - APARTMENT OWNER'S REFUND
QUEST DIAGNOSTICS - MEDICAL REFUND
METLIFE - DIVIDEND FOR STOCK
$3,378.00
$87.00
$2.99
$13.11
TOTAL $3,481.10
RE¥-1511 EX-*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF CATHERINE A. LUCKENBAUGH
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Deb~ ofdecedentmustbe mpo~edon Schedulel.
~EM
NUMBER
FUNERAl. EXPENSES:
DESCRIPTION
2.
3.
4.
5.
FACKLER-WIEDEMAN FUNERAL HOME - FUNERAL
CHRISTIAN PUBLICATIONS - BULLETINS/CARDS FOR PASTOR/ORGANIST/JANITOR
THOMAS A. NOTESTINE - CHURCH ORC-:-:-:-~NIST
DAVID W. GUTHRIE - JANITOR
NANCY STONER - LUNCHEON FOLLOWING FUNERAL
5.
6.
7.
8.
9.
10.
11.
12.
COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Secudty Number(s) / EIN Number of Personal Representative(s) %~ ~-;.?? i; ::
Street Address 115 SHOLLY DRIVE ..... ':'~ :'
City MECHANICSBURG State PA Zip 17055
,^ROLOA.,UCKE"B^UGN, JR. i i
Year(s) Commission Paid: NONE
Attomey Fees HARRY L. BRICKER, JR., ESQ.
Family Exemption: (If decadent's address is not I~e same as claimant's, attach explanation)
Claimant
S~'eet Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY
Accountant's Fees
Tax Return Preparer's Fees
CLEANERS - ITEMS CLEANED PRIOR TO DONATING TO CHARITY
FIRST CHOICE REHAB SPEC - ELECTRIC STIMULATION THER
CUMBERLAND LAW JOURNAL - ADVERTISEMENT OF' ESTATE
THE SENTINEL - LEC-.-.-.-~L - ADVERTISEMENT OF ESTATE
REGISTER OF WILLS, CUMBERLAND COUNTY - 2 SHORT CERTIFICATES
VERIZON - TELEPHONE SERVICE
TOTAL (Also ei~{~ on line 9, Recepitu!al~on
AMOUNT
$4,O37.90
$27.91
$125.00
$50.00
$225.70
$228.00
$25.47
$24.00
$75.00
$102.11
$6.00
$3.05
$14,830.14
(Ifmorespaceis needed, insert additionalshee~ of~esame s~e)
REV-1513, EX .~. (9-00))
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF CATHERINE A. LUCKENBAUGH FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I.
II.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
HAROLD A. LUCKENBAUGH, JR.
115 SHOLLY DRIVE
MECHANICSBURG, PA 17055
JOYCE C. GEORGE
75 SOUTH 36TM STREET
CAMP HILL, PA 17011
DWIGHT L. LUCKENBAUGH
11 HIGGINSON COURT
WILLIAMSBURG, VA 23188
SHARON K. WENTLING
58 SUSSEX ROAD
CAMP HILL, PA 17011
SON
DAUGHTER
SON
DAUGHTER
1/4 OF ENTIRE ESTATE
1/4 OF ENTIRE ESTATE
1/4 OF ENTIRE ESTATE
1/4 OF ENTIRE ESTATE
TOTAL OF PART II - 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)
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
XCHOV
Deposit Account Close Confirmation
Date
12/[9/2003
ACCOUNT NUMBER:
3000022472736
CustomerName(s)and ~dmss
CATHERINE A LUCKENBAUGH
HAROLD LUCKENBAUGH JR POA
824 LISBURN RD
APT 610
CAMPHILL PA 17011
TaxpayerlDNumber
S192346735
Available Balance : $25,750
+ Accrued Int : $12
- Fed W/Hd Due : $0
- Admin Fee : $0
- Outstandina Db : $0
- Closina Fee : $0
Paid To Customer :
64
38
00
00
00
00
$25.763.02
0000 537523 (50/pkg Rev 01)
Thank you for having chosen Wachovia Bank, N. A. for
this account. If we can help you with other banking needs,
please let us know.
CUSTOMER COPY
-, ~ WACHOVIA
BANk, P~.A,
Deposit Account Close Confirmation
Date
12/19/2003
ACCOUNT NUMBER:
1000665227764
CustomerName(s)andAddmss
CATHERINE O LUCKENBAUGH
HAROLD LUCKENBAUGH JR POA
824 LISBURN RD
APT 610
CAMPHILL PA 17011
TaxpayerlDNumber
S192346735
Available Balance :
+ Accrued Int :
- Fed W/Hd Due :
- Admin Fee :
- Outstandina Db :
- Closina Fee :
Paid To Customer :
$1,506.31
$0.11
$0.00
$0.00
$0.00
$0.00
$1,506.42
0000 537523 (50/pkg Rev 01)
Thank you for having chosen Wachovia Bank, N. A. for
this account. If we can help you with other banking needs,
please let us know.
CUSTOMER COPY
Wau Better Banking OnlLI from Waupoint Bank
Receipt - Rcct. ~:
TLR ~:0927 Miscellaneous Debit
TR ~: 7 TR AMT: 10337.40
Date: 12/26/2003 Time: 13:51
Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain
deposits are subject to delays in availability according to Bank policy,
TEL-010(0~Y2) Thank You F:or Banking At Waupoint ~rFo,c
Wau Better Banking onlu from Waupoint Bank
Receipt - Acct, ~:
TLR ¢:0927 Miscellaneous DebLt
TR ~: &O TR AMT: 42051.59
Date: 12/2G/2003 Time: i3:52
Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain
deposits are subject to delays in availability according to Bank policy.
TEL-010(08/02) Thank You For Banking At Waupoint MemberFDIC
Wag Better Banking onlg from Wagpoint Bank
ReceiPt -Rcct, #: 0605004756
TLR ¢:0927 DDA Closeout
TR ~: 5 TR RMT: G43.81
Date: 12/26/2003 Time: 13:50
Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain
deposits are subject to delays in availability according to Bank policy.
TEL-010(08/02) Thank You For Banking At Waupoint ~rm,c
PLEASE RETAIN THIS VOUCHER FOR YOUR RECORDS
12/26/2003
137255220
$53,032.80
THE ESTATE OF CATHERINE A LUCKENBAUGH
DECEASED
Iii.
PAY
TO
THE
ORDER
OF
CASHIER'S
CHECK
CAPITAL DMSION · LANCASTER/CHESTER DIVISION
DROVERS BANK DIVISION · GREAT VALLEY DIVISION
DATE DECEMBER ~8,
,FULTO.N
$ [ 5,018.57
8 7 '7' '7 5 8
60-142
313
2003
~o~REDEEMED CD #333-0037951
PURCHASER
ESTATE OF CATHERINE A. LUCKENBAUGH
,"8777q~"" ,:O:,I, 3DI, L, 88~: OOq OOO Oq~
TOTAL CONTROL ACCOUNT
C/O PFPC INC.
P.O. BOX 8908
WILMINGTON, DE 19899
HAROLD A LUCKENBAUGH Jr EXEC
EST OF CATHERINE A LUCKENBAUGH DECD
C/O HARRY L BRICKER JR ATTORNEY
407 NORTH FRONT ST
HARRISBURG, PA 17101-1296
DEC 31, 2003
Page 1 of 1
Fund Number: 01
Dealer Address:
CENTRAL PENN FI GP
4550 LENA DR S-101
MECHANICSBURG
MetL|fd Family of Companies
Account Number: 4044552399
PA 17055
Dealer/Branch: 00001/56L
Rep Name: HAYES lAN
TOTAL CONTROL ACCOUNT
WITHDRAWAL CHECK
ACCOUNT NUMBER
0000058 4044552399
PAY TO THE ORDER OF:
HAROLD A LUCKENBAUGH dR EXEC
EST OF CATHERINE A LUCKENBAUGH DECD
CIO HARRY L BRICKER JR ATTORNEY
407 NORTH'FRONT ST
HARRISBURG, PA 17101'1296
DATE
DECEMBER 31, 2003
;PNC Bank, National Association
i Philadelphia, PA
310
- 538632
AMOUNT'
$ ............ 8,O08.Tg':J
VOID AFTER 180 DAYS
,'5~8Gq, i?,' ~:Ot, 3,:iOI, R,i??,: I, OO8:~?:~,5q,·
USER02 02/24/2004 10:03
Page
Symbol MET i Frequency D
Use Page UD, Page Down, 1, I
Date 11/11/03
Date
11/11/2003
11/10/2003
11/07/2003
11/06/2003
11/05/2003
11/04/2003
11/03/2003
10/31/2003
10/30/2003
10/29/2003
10/28/2003
10/27/2003
10/24/2003
10/23/2003
10/22/2003
10/21/2003
10/20/2003
10/17/2003
10/16/2003
10/15/2003
Close
30.600
30.780
30.900
31.220
31 070
31 020
31 510
31 400
30 800
30 780
30 930
30.400
30.420
30.460
30.200
31.010
30.580
30.980
30.660
30.450
METLIFE INC
High
30.780
31.000
31.550
31.220
31.080
31.250
31.820
31.490
30.940
30.810
30.930
30 450
30 420
30 690
31 010
31 090
30 950
31.270
30.760
30.450
LOW
30.490
30.300
30.890
30.850
30.530
30.250
31.210
30.290
30.500
30.40O
30.180
30.200
30.110
29.950
30.140
30.240
30.290
30.720
30.262
30.010
(Daily)
Volume
1,822,600
1,804,000
1,527,500
1,346,200
2,034,200
3,521,154
1,865,400
1,562,000
1 423,800
i 152,400
2 051,800
i 450,400
1 326,100
1771,200
25~6,800
2 682,900
2 024,200
2,744,200
1,671,600
2,718,800
To:
cc:
Subject:
. J Thon
Stacy
12/30/2003 12:19 PM
Susan H FulginitJ/Field/WH/AEFA{~AMEX
Re: Catherine Luckenbaugh, Deceased # 194251849001 ~
IDS UFE INSURANCE COMPANY
A~ERICAN EXPRESS FUNDS
AMERICAN EXPRESS CERTIFICATE COMPANY
AMERICAN EXPRESS BROKERAGE
70100 AXP Financial Canter
Minneapolis, MN 55474
December 30, 2003
SUSAN HORN-ER FULGIN1TI
5521 CARLISLE PI3LE
MECHA_NICSBURG, PA 17050-2419
Dear SUSAN HORNER FULGINITI:
Thank you for your recent inquiry regarding CATHERINE LUCKENBAUGH's accounts. These are the values of
the accounts as of I 1/11/2003.
Mutual Funds
AccountNumber TotsiValue # ofshares Asset Value Per Share
01129101034 3 002 $42291.27 8799.214 4.800
01139101034 2 002 $5750.85 5749.680 1.000
01249101034 9 002 $46893.67 9641.057 4.860
Certificates
AccountNun~ber Total Va~e
008043084949001 $6250.00
00804308495 6001 $6250.00
00804344357 4001 $12846.08
00804373966 6001 $12741,5
00804396822 4001 $25410,89
00804424438 5001 $20139.32
# of shar~s A~sct Valuc Per Sha~
Annuities - Post 1985
Account Number Total Value # of shares Asset Value Per Share
93006969147 3 004 $50058.41
Thc date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be
subject to market fluctuation aa governed by each product. Please note that the values indicated for any Life
Insurance product(s) reflect the gross death benefit at date of death, not thc cash vaiue.
We appreciate the opportunity to be of service to you. Please contact us if you have any questions.
Sincerely,
Stacy Thon
Death Settlements Processing Team
70100 AXP Financial Center
Miuneapolia, MN 55474
888-723-8476, option 1, 3, 1
November 12, 2003 Fulton Bank. - Interest on CD $ 66.09
November 20, 2003 Patriot News.- Refund
40.25
December 1, 2003
.December 5, 2003
December 8, 2003
December 15, 2003
The ~oods At Cedar Run 3,378.00
~ Securfty DepOsit - Partial
Return of rent for November
Travelers Insurance-- Apartment 87.00
Owner' s Refund
eUeSt Diagnostics.- Medical 2.99
fund
MetLife- Dioidend for Stock 13.11
TOTAL $3,587.44
Register of Wills
CUMBERLAND
INVENTORY
County,
Pennsylvania
Estateof CATHERINE A. LUCKENBAUGH
also known as
, Deceased
No.
Date of Death NOVEMBER 11, 2003
Social Security No. lg2-34-6735
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets
wherever situate end all of the real estate in the Commonwealth of Pennsylvania of said, Decedent that the valuation placed opposite each item
of said Inventory represents its fair value as of the date of the Decedent's death, and th Decedent owned no real estate outside of the Commonwealth
of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this inventory
are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to
unsworn falsification to authorities.
HARRY L. BRICKER, JR., ESQ.
07049
407 NORTH FRONT STREET
HARRISBURG, PA 17101
Attorney
I.D. No.:
Address
Telephone: (717) 233-2555
Description
1. WACHOVIA BANK - SAVINGS ACCOUNT NO. - 3000022472736
2. WACHOVIA BANK - CHECKING ACCOUNT NO. - 1000665227764
3. WAYPOINT BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. - 2900001274
4. WAYPOINT BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. - 605055897
5. WAYPOINT BANK - CHECKING ACCOUNT NO. - 605004756
6. FULTON BANK - CERTIFICATE OF DEPOSIT - ACCOUNT NO. - 333-0037951
7. UNITED AMERICAN INSURANCE COMPANY - UNEARNED REFUND FROM PREMIUMS PAID
POLICY NO. 574498676
8. METLIFE - TOTAL CONTROL ACCOUNT NO. - 4044552399
9. MELLON INVESTOR SERVICES - METLIFE STOCK INVESTOR ID NO. - 806317213579
(57 SHARES AT $30.60)
10. FULTON BANK - INTEREST ON CERTIFICATE OF DEPOSIT
11. AMERICAN EXPRESS FUNDS:
1. MUTUAL FUNDS:
ACCOUNT NO. 01129101034 3 002 (8799.214 SHARES)
ACCOUNT NO. 01139101034 2 002 (5749.680 SHARES)
ACCOUNT NO. 01249101034 9 002 (9641.057 SHARES) 6 L' ~L,-J
Total from Continuation Page(s)
(Attach additional sheets if necessary)
Total:
Value
$25,763.02
$1,506.42
$10,337.40
$42,051.59
$643.81
$5,018.57
$210.42
$8,OO8.79
$1,744.20
$66.09
$42,291.27
$5,750.85
$46,893.67
$137,217.55
$327,5O3.65
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal representative, include the value of
each item, but such figures should not be extended into the total of the Inventory.
Register of Wills CUMBERLAN County, Pennsylvania
INVENTORY CONTINUATION PAGE
Estate of CATHERINE A. LUCKENBAUGH No.
Description Value
2. CERTIFICATES:
ACCOUNT NO. 00804308494 9 001
ACCOUNT NO. 00804308495 6 001
ACCOUNT NO. 00804344357 4 001
ACCOUNT NO. 00804373966 6 001
ACCOUNT NO. 00804396822 4 001
ACCOUNT NO. 00804424438 5 001
3. ANNUITIES - POST 1985:
ACCOUNT NO. 93006969147 3 004
12. PATRIOT NEWS - REFUND
13. THE WOODS AT CEDAR RUN - REFUND OF SECURITY DEPOSIT AND PARTIAL REFUND OF RENT FOR
NOVEMBER
14. TRAVELERS INSURANCE - APARTMENT OWNER'S REFUND
15. QUEST DIAGNOSTICS - MEDICAL REFUND
16. METLIFE - DIVIDEND FOR STOCK
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal re
each item, but such figures should not be extended into the total of the Inventory.
$6,250.00
$6,250.00
$12,846.08
$12,741.50
$25,410.89
$20,139.32
$50,058.41
$4O.25
$3,378.00
$87.00
$2.99
$13.11
Total: $137,217,55
~resentative, include the value of
COMMONWEALTH OF PENNSYLVANIA
DEPART~IENT OF REVENUE
B~IREAU 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 003609
BRICKER HARRY L JR
407 NORTH FRONT STREET
HARRISBURG, PA 17101
........ fold
ESTATE INFORMATION: SSN: 192-34-6735
FILE NUMBER: 2103- 0960
DECEDENT NAME: LUCKENBAUGH CATHERINE A
DATE OF PAYMENT: 02/27/2004
POSTMARK DATE: 02/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 11/11/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $720.31
'REMARKS:
CHECK# 1011
SEAL
TOTAL AMOUNT PAID:
$720.31
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~J~ESTATE OF CATHERINE A. LUCKENBAUGH 3-50/310
HAROLD LUCKENBAUGH JR. - EXECUTOR ~l~~
C/O HARRY L BRICKER JR.
407 NORTH FRONT ST.
BUREAU OF ZNDZVZDUAL TAXES
INHERITANCE TAX DIVISZON
BEPT. 2&0601
HARRISBURG, PA 171Z8-0601
COHHONNEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
REV-I$~i? EX AFP C01-03)
HARRY L BRZCKER JR ATTY
q07 N FRONT ST
Hag
'04 fiP : 26
DATE Oq-Z6-ZO0~
ESTATE OF LUCKENBAUGH
DATE OF DEATH 11-11-2003
FILE NUHBER 21 03-0960
*q~OUNTY CUHBERLAND
ACN 101
I Amount Reai*~ad
CATHERINE A
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGTSTER OF NTLLS
CUHBERLAND CO COURT HOUSE
CARLZSLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF LUCKENBAUGH CATHERTNE AFZLE NO. 21 03-0960 ACN 101 DATE OR-Z6-ZOOR
TAX RETURN #AS: ( X} ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: 0RZGZNAL RETURN
1. Real Es~a~e (Schedule A} (1)
2. S~ocks end Bonds (Schedule B) (2)
$. Closely Held S~ock/Par*nership Zn~eres~ (Schedule C) ($)
4. Not,gages/No,es Reca/vabla (Schedule D) (4)
5. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) ($)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To~el Asse~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Ada. Cos~s/H/sc. Expenses (Schedule H) (9)
10. Deb~s/Hor~gage L/ab/lib/es/Liens (Schedule Z) (10)
11. To~al Deduc~/ons
12. Ne~ Value of Tax Re~urn
15.
14.
Char/~able/Governmen~al Bequests; Non-elec~ed 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Sub5ec~ ~o Tax
327/503.65
.00
.00 NOTE: To insure proper
.00 credi~ ~o your account,
.00 suba/~ ~he upper por~ion
.00 of ~his form w/~h your
~ax payaen~.
.0O
(8)
lq,B30.lq
.00
NOTE:
327,503.65
(11) l~ .B:~§. l(t
(~z) 312,673.51
(15) . O0
(14) 312,673.51
Z~ an assessment ~as issued previously, lines 1~, 15 and/er ;6, 17,
reflect figures that include the total of ALL returns assessed to date.
18 and 19
13,350.00
720.31
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
( IF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
1R,772.9R
702.63CR
.00
70Z.65CR
AHOUNT PAID
ASSESSHENT OF TAX:
15. Aaoun~ of L~ne 14 a~ Spousal ra~e
16. Aaoun~ of L/ne 14 ~axable a~ Lineal/Class A ra~e
17. Amoun~ of Line 14 e~ S/bling ra~e
18. Aaoun~ of L/ne 14 ~exable a~ Collateral/Class B ra~e
19. Pr/nc/pa! Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT
DATE NUMBER INTEREST/PEN PAID (-)
02-09-Z00~ CDOO35q3 702.63
0Z-Z6-ZO0~ CD003609 .00
(~$) .00 x O0 = .00
(16) 312,673.51 x Oq5 = lq,070.$1
(~7) .00 x 1Z = .00
(18) .00 x 15 = .00
(~e)= lq,070.31
RESERVATION:
PURPOSE OF
NOT[CE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 19BI -- [f any future interest in the estate Es transferred
in possess[on or mnSoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
Life or for years, the Coemonaealth 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 Il40 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S.
Sect[on 9140).
Detach the top portion of this Notice and submit aith your payment to the Rag[star of Hills printed an the reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, ahich was 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 Off[ca
of the Register of HElls, any of tho 23 Revenue District Offices, or by calling the special Z4-haur
ansuering service for forms ordering: 1-800-36Z-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, a11omance, or disalloaanca of deductions, or assessment
of tax (including discount or interest) as sheen on this Not[ca must object mi[bin sixty (60) days of race[pt of
this Notice by:
--mritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZBiOZ1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. 280601, Harrisburg, PA 171lB-060!
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-ISO1) for an explanation of administratively correctable errors.
If any tax due [s paid within three (3) calendar months after the decedent's death, a five percent (SX) discount of
the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty [s appealable in the s-aaa manner and [n the the same time period as you mould appeal the tax and interest
that has been assessed as indicated on this not[ce.
Interest [s charged beginning eith 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
slx (6Z) percent per annum calculated at a dally rate of .000164. ALi taxes which became delinquent on and after
January 1, 1982 ail1 bear interest at a rate ah[ch w[11 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Tn[eras[ Daily Interest Daily
Year Rate Factor Year Rate Factor Year
198Z lOX .ooosqa ~'~- 1991 11z .000301 ~
1983 162 .000~38 1992 92 .000247 Zooz
1984 llZ .000501 1993-199q 72 .00019Z 2003
1985 132 .000356 1995-1998 9Z .000247 ZO0~
1986 102 .000274 1999 7Z .00019Z
1987 IOZ .000Z74 ZOO0 7Z .000192
--Interest is calculated as follows=
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY ZNTEREST FACTOR
Interest Daily
Rate Factor
9Z .O00Z~7
6Z .000164
5Z .000137
~X .000110
--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 sheen on the
Notice, additional interest must bo calculated.
STATUS REPORT UNDER RULE 6.17
Name of Decedent: Catherine A. Luckenbau,qh
Date of Death: November 11, 2003
No. 21-03-0960
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
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
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 X 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:~ -~ ~ - c:~ ~f
Harry L.~,dcker~J r.,~sq uire
407 N6rth Front Street
Harrisburg, PA 17101
(717) 233-2555
Capacity:
Personal Representative
X
Counsel for Personal
Representative
BUREAU OF TNDZVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COHNONNEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
RE¥-1607 EX AFP (01-OS)
HARRY L BRICKER JR ATTY
q07 N FRONT ST
HBG PA 17101
DATE 05-17-200~
ESTATE OF LUCKENBAUGH
DATE OF DEATH 11-11-200:5
FZLE NUHBER 21 0:5-0960
COUNTY CUHBERLAND
ACN 101
Amount Remi.~ed
CATHERZNE A
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF NTLLS
CUHBERLAND C0 COURT HOUSE
CARLTSLE, PA 1701:5
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG TH'rS LZNE ~ RETAZN LONER PORT'rON FOR YOUR RECORDS *-~
REV-1607 EX AFP (01-03)
ESTATE OF LUCKENBAUGH
~ ZNHERZTANCE TAX STATEHENT OF ACCOUNT
CATHERZNE A FZLE NO. Z1 0:5-0960 ACN 101 DATE 05-17-200~
THZS STATEHENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACH ZN THE NAHED ESTATE. SHONN BELO#
ZS A SUHNARY 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~-19-200~
PRINCIPAL TAX DUE: ..........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
1fi,070.:51
PAYHENT RECEXPT DXSCOUNT (+) AHOUNT PAID
DATE NUHBER 1NTEREST/PEN PAXD (-)
702.6:5
02-09-200~
02-26-200~
0~-29-200~
CD0055~$
CD005609
REFUND
.00
.00
IF PAZD AFTER TH/S DATE, SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL /NTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT 1S REQU/RED.
ZF TOTAL DUE IS REFLECTED AS A "CREDZT" (CR),
YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORN FOR INSTRUCTZONS. )
1:5,:550.00
720.$1
702.6:5-
TOTAL TAX CREDZT 1~,070.:51
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
PAYMENT:
Detach the top portion of this Notice and submit mith your payment made payable to the name and address
printed on the reverse side.
-- If RES/DENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT.
-- If NON-RES[DENT DECEDENT make check or money order payable to: COMNON#EALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-Z313). Applications are available at
the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's lq-hour
answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-BO0-qq7-3OgO (TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes) ATTN: Post Assessment Review Unit, Dept. ZBOBO1, Harrisburg) PA 171ZB-0601, phone
(717) 787-650S.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death) a five percent (SZ) discount
of the tax paid is allo~ed.
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 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 ahich became deIinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. A11 taxes ~hich became delinquent on and after
January 1, 198Z ail1 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 198Z through ZOOq are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
m
1982 ZOZ .000548 1988-1991 1XZ .000501 2001
1983 16X .O00q~8 199Z 9Z .000Z47 ZOOZ
1984 11Z .000301 1993-1994 7Z .00019Z ZOO3
1985 X3Z .000356 1995-1998 9~ .000247 200~
1986 IOZ .000274 1999 7~ .000192
1987 91 .000247 ZOO0 81 .000Z19
Interest Daily
Rate Factor
.000247
.000164
.O00Z~7
.000110
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUIJBER OF DAYS DELINQUENT 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
Notice, additional interest must be calculated.