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HomeMy WebLinkAbout04-0137Register of Wills of Cumberland County, Pennsylvania Estate of PETITION FOR GRANT OF LETTERS JOANNE L. MYERS No. Deceased Social Security No. 136-26-9482 '04 FEB 11 73:19 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) ~..,.:~ :.~ .. :. ;t A. Probate and Grant of l:~-'n~'{/er ~{tia~ Petitioner is the executrix named in the Last Will of the Decedent, dated November 3, 1998 Appointed Co-Executor, Philip N. Myers, Jr., renounced State relevant circumstances, e.g. renunciation, death of Executor, etc. and codicil(s) dated 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 to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) 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 Cumberland County, Pennsylvania, with his last family or principal residence at 1918 High Street, Borough of Camp Hill (List street, number and municipality) Decedent, then 66 years of age, died Auqust 12, 2003 at (Location) 1918 HiRh Street, Camp Hill, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ..................................................................... $ (If not domiciled in PA) Personal property in Pennsylvania ..................................... $ (If not domiciled in PA) Personal property in County .................................................... $ Value of real estate in Pennsylvania ...................................................................................................................... $ Total ......................................................................................................... $ 7,000.00 -0- 7,000.00 Real Estate situated as follows: Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Roger W. Smith 601 State St., Apt. #2, Enola, PA 17025 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND 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 accordin(g_to law. Sworn to and affirmed and subscribed ~ R ER W. SM~H ~ Before me this \~-W~ day of ¢ Estate of JOANNE L. MYERS , Deceased. Social Security No: 136-26-9482 Date of Death: 8/12/2003 ,_.,4. AND NOW, ,~. ~ ,2004, in consideration of the Petition on the reverse side hereon, satisfa'-ctory proof l~ving been presented before me, IT IS DECREED that Letters Testamentary d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate are hereby granted to ROGER W. SMITH in the above estate and that the instrument(s) dated November 3, 1998 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. FEES Letters ........................... $ i'-I[ b .I;~) Short Certificate(s) Renunciation .............. Affidavit ( ) .................. Extra Pages ( ) ....... Codicil ............................ JCP Fee ....................... Inventory ...................... Other .............................. $ 5.0o $ t,-, ,o0 $ L ~R~gister ~f-~ills - ~ --' L~ ~ $ t c~ .c:>(_.~ Attorney: Edmund G. Myers $ I.D. No: 20558 Address: Johnson, Duffle, Stewart & Weidner, 301 Market Street, P.O. Box 109, Lemoyne, PA 17043- TOTAL ......... $ "-] L¢ .OO Telephone: 717-761-4540 RENUNCIATION IN RE: ESTATE OF JOANNE L. MYERS, deceased. To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned appointed Co-Executor of the above-decedent, hereby renounces the right to administer the estate and respectfully asks that Letters Testamentary be issued to Roger W. Smith Sworn to and Subscribed before me this day of February, 2004. Notary Public Philip' N. . 2213 Spruce Shadows Lane P. O. Box 99811 Raleigh, NC 27624 6L:£d IL 83J ~'0. ;05.905 This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. 3059721 No. Charles Hardester State Registrar JAN 02 200 Date 66 Joanne L Myers UNDER 1 YEAR UNDER 1 DAY Holm Mm 20,1937 Russell Johnson Roger W. Smith Cumberland Camp Hill Records ~ I1~.' Stat~ of PA 1918 High Street I~cru^t Camp Hill, PA 17011 ~'~ ,. Female ,.136-26-9482 qew Jersey1~,..~.., [] E,x~.,~ [] ,o~ [] ~ [] 1918 High Street ~1 v,, [] ,~,,.,~,~e~. ~.August 12, 2003 on -O-Lite Crematory ~,i:~i'KI~ , lat~. 10:20 ?. 2003 v.. '~{l ~[-] ~t~. ~~ ~. ~ ~,~ ~ ~ m~.~ ............ . ~~ .. Undete~ined ---- ---~, ---------.i--~.~ ..................................................... ~ I,b -- Coroner STATE OffiCl-37-O00, I~1, November 21, 2003 ~Z~T~ Michael L. Norris, Coroner 6375 Basehore Road, Suite ~1 Mechantcsburg, Pa. 17050 ,. JAN 0 2 ZOO4 LAST WILL AND TESTAMENT OF JOANNE L. MYERS I, JOANNE L. MYERS, a widow, of the Borough of Camp Hill, 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 any of the personal ornaments which had belonged to my deceased husband, Philip, which are in my possession at my death to his two children, Philip N. Myers, Jr., and Adam L. Myers, in equal shares, per capita. I here mention that I have bequeathed no other assets to Philip and Adam not because of any lack of affection or respect for these two fine men but simply because I believe they will be receiving assets from their father's family. Further, in this regard, and during my lifetime, I have delivered most of the personal ornaments which had belonged to my husband, Philip, to his two children herein mentioned. THIRD: I give, devise 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 son, Roger W. Smith, who presently resides in Camp Hill, Pennsylvania, providing he is living at my death. FOURTH: Should my son, Roger W. Smith, predecease me or not be living at my death, I give, devise and bequeath all the rest, residue and remainder of my estate, be it real, personal or mixed of whatever nature and wheresoever the same may be situate to his son, Roger W. Smith, who presently resides in Altamonte, Florida. FIFTH: I hereby nominate, constitute and appoint Roger W. Smith of 1918 High Street, Camp Hill, Pennsylvania, and Philip N. Myers, Jr. of 6123 Farrington Road, Apartment C9, Chapel Hill, North Carolina, to serve as co-Executors of this, my Last Will and Testament. Should either Roger W. Smith or Philip N. Myers, Jr. fail to qualify or cease to act as co-Executor, I hereby nominate, constitute and appoint my sister, Lois R. Cole of 5208 Third Park Avenue, Sacramento, California, as co-Executor. I further direct that my personal representatives shall serve without bond. Said personal representatives 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. IN WITNESS WHEREOF, I, JOANNE L. MYERS, 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 '-Z/~ day of x','~~ ,1998. ~.~-"Joanne L. Myers"" U 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 JOANNE L. MYERS, 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 JOANNE L. MYERS was of sound and disposing mind, memory and understanding. 2 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF DAUPHIN ) SS: I, JOANNE L. MYERS, 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 ackr)owledged before me by JOANNE L. MYERS, the Testatrix, this --.¢ ~ day of ~>Z--~:¢-~~/ , 1998. Not?~)~ Public" My commission expires: (Seal) AG~ES,:,. m N~HIOt, ~ota~ Fub~ic Hardsbt~r0, Da~jphin My Com~aissi~n ~pires ~une i9, 2002 ~mber, PennsyNanle ~o~n ~f Nota~es COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF DAUPHIN ) SS: the witnesses ',I~1~'~~s are signed'¥°~-I~e att~hed or~oregoTng instrument, being duly qualified according to law, do depose 'and say that we were present and saw JOANNE L. MYERS, Testatrix, sign and execute the instrument as her Last Will and Testament; that JOANNE L. MYERS 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. Sworn to aRd subscribe~before me ~ thi.~ ,.¢~.~ day of ~~~ ,1998. No~lry Public / / My~commiSsion expires: ~/~ 7/ ~-~ (Seal) / AG~ES g~. M~Cf, Nota~ F~b~c ~ Harrisb;~r~, ~up~in Coun~ ~ Commission ~pires June 19, 200~ Member, Pennsy~nia ~s~iation of Notades It~tltRY 1~. I~RICli~I~R~ dR. ATTORNEY AT LAW 40? NORTH FRONT STREET 17101-1296 .v:? .... , .... REV-1500 COMMONWE^LT~OEPENNSY'VAN,A INHERITANCE TAX RETURN DEPARTMENT OF REVENUE OE~T. 28o60, RESIDENT DECEDENT HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) MYERS, JOANNE L. ~ DATE OF DEAT~ ~MM-DD-YEAR) TD-,~¥E OVBIRTH (MM:DD-YEAR) ,?, 08/12/2003 05/20/1937 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) - OFFICIAl.. USE ONLY FILE NUMBER 21 04 00137 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 136-26-9482 --~HIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER O0 - [] 1. Original Return [] 2. Supplemental Return BI 3. Remainder Return (date of death priorto 12-13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required 12-12-82} [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) 12-31-91 and 1-1-95) NAME COMPLETE MAILING ADDRESS EDMUND G. MYERS FIRM NAME (If applicable) ~ JOHNSON, DUFFIE, STEWART & WEIDNER TELEP.0~ NUM~ 717/761-4540 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (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) [] 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) 301 Market St. Lemoyne, PA 17043-0109 None None~' None,:" None 7,484.70 None None OFFiCiAl. USE ONLY (8) 11. Total Deductions (total Lines 9 & 10) 7,518.70 7,484.70 (11) 7,518.70 12. Net Value of Estate (Line 8 minus Line 11 ) (12) insolvent 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 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate x .045 (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) 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) D~cedent's Complete Address: STREET ADDR~ESS 1918 HIGH STREET CITY , STATE ZIP CAMP HILL 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) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestJPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 0 o 00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ............................................................................. I I ~[~ 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 death2 ....... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?. ............................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that 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 preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE~E'~ FILING RETURN .4 ADDRESS ROGER~. SMITH . \ I ~ I1 SIGNATURE OF PE-"P,~N RESPdN~-IBLE FOR FILING RE~URN ADDRESS 601 STATE ST., APT. #2 ENOLA, PA 17025 DATE 'DfTE'/ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE ~:!)~J3~2 G. MyffR~S//I; 301 Market St. ~,~J ~ . Lemoyne, PA 17043-0109 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 statutedoes not exempta 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MYERS, JOANNE L. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 04- 00137 Include the proceeds of litigation and the date the proceeds were received by the estate~dl property jointly-owned with the right of survivorsh,p must be disclosed on schedule F. ITEM NUMBER l DESCRIPTION -199~ Cadillac DeVille Sedan 4D- 134,000 miles. Date of death value 1991 Chevrolet 1500 Pickup Long Bed Date of death value 1985 Cadillac Eldorado Coupe 2D Date of death value Pennsylvania State Employees Credit Union Account No. 8402924834 Regular Share Account - date of death balance Pennsylvania State Employees Credit Union Account No. 8402924834 Checking Shares - date of death balance M&T Bank - Checking Account No. 98240404 Date of death balance Household Goods - sold at Auction - net proceeds. TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 740.00 1,265.00 325.00 41.80 798.24 114.66 4,200.00 7,484.70 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPEN,.~S & ADMNSTRATIVE COSTS ESTATE OF MYERS, JOANNE L. I FILE NUMBER 21 - 04 - 00137 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: Musselman Funeral Home - funeral expenses Gingrich Memorials - Marker ADMINISTRATIVE COSTS: Personal Representative's Commissions ROGER W. SMITH iN Number of Personal Representative(s): ' treet Address T TE ST., APT. #2 City ENOLA State PA Zip 17025 Year(s) Commission paid Attorney's Fees Johnson, Duffle, Stewart & Weidner Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Roger W. Smith Street Address 1918 HIGH STREET City CAMP HILL State PA Relationship of Claimant to Decedent Son Probate Fees Register of Wills - Cumberland County Zip 17011 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Register of Wills - File Inventory & Inheritance Tax Retum Reserve for close-out costs TOTAL (Also enter on line 9, Recapitulation) 2,815.70 400.00 370.00 275.00 3,500.00 55.00 28.00 75.00 7,518.70 REV-I,513 EX; (9-00) ~ SCHEDULE J COMMONWEALTH OF PENNSYLVAN~^ BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MYERS, JOANNE L. NUMBER 1. 1 RELATIONSHIP TO NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ DECEDENT i Do Not List Irusteels) TAXABLE DISTRIBUTIONS (include outright spousal distributions) Roger W. Smith Son 601 State Street, Apt. #2 Enola, PA 17025 i FILE NUMBER 21-04-00137 AMOUNT OR SHARE OF ESTATE Residue Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she( II. i NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEErr Register of Wills of Cumberland County, Pennsylvania Estate of MYERS, JOANNE L. also known as INVENTORY , Deceased No. 21 - 04- 00137 Date of Death 8/12/2003 Social Security No. 136-26-9482 ROGER W. SMITH The Personal Representative(s) of the above Estate, deCeased, verifythat the item~'appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located 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 that the 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. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: I.D. No.: Personal Representati.~ ~ EDMUND G. MYERS Signature: ~[--~~ tx.,,,) ROoER W. ITH 20558 Signature: Signature: Address: Telephone: 301 Market St. Lemoyne, PA 17043-0109 717/761-4540 Personal Property Address: 601 STATE ST., APT. #2 ENOLA, PA 17025 Telephone: (717) 732-07!6 I/ 1992 Cadillac DeVille Sedan 4D - 134,000 miles. Date of death value 1991 Chevrolet 1500 Pickup Long Bed Date of death value 1985 Cadillac Eldorado Coupe 2D Date of death value Pennsylvania State Employees Credit Union Account No. 8402924834 Regular Share Account - date of death balance 740.00 00 '; 325.00 41.80 Pennsylvania State Employees Credit Union Account No. 8402924834 Checking Shares - date of death balance 798.24 M&T Bank - Checking Account No. 98240404 Date of death balance 114.66 (Attach additional sheets if necessary) Total Personal Property and Real Estate $7,484.70 Register of Wills of Cumberland County, INVENTORY Estate of MYERS, JOANNE L. also known as continued , Deceased Household Goods - sold at Auction - net proceeds. Pennsylvania No. 21-04-00137 Date of Death 8/12/2003 Social Security No. 136-26-9482 4,200.00 Total Personal Property $7,484.70 2 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JOANNE L. MYERS Date of Death: August 12, 2003 Will No.: 2004-00137 Admin. No.: To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 11,2004. Name Address Roger W. Smith, Beneficiary & Executor 601 State St., Apt. #2 Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: Signature Capacity: X Name Edmund G. Myers, Attorney Johnson, Duffie, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Personal Representative Counsel for personal representative BUREAU OF TNDZVZDUAL TAXES THHERZTANCE TAX D/VXSZON DEPT. Z8060! HARRXSBURG, PA 171Z8-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1~47 EX AFP (01-05) EDHUND G HYERS JOHNSON ETAL 301HARKET ST LEHOYNE PA 170~$ DATE 06-1~-200~ ESTATE OF HYERS DATE OF DEATH 08-12-2005 FILE NUNBER 21 0~-0157 COUNTY CUNBERLAND ACH 101 Amount Remitted JOANNE L HAKE CHECK PAYABLE AND RENZT PAYHENT TO.' REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LTNE ~ RETAIN LONER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF TNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLOk/ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HYERS JOANNE L FILE NO. 21 0q-0157 ACH 101 DATE TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATTON CONCERNTNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Hold Stock/Partnership /nterest (Schedule C) ($) ~. Hortgages/Notes Receivable (Schedule D) (~) E. Cash/Bank Deposits~Misc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule g) (7) 8. Total Assets 7zR8~.70 O0 00 NOTE: To insure proper O0 credit to your account, O0 subeit the upper portion O0 of this fora with your tax payeant. O0 (8) 7,~8~.70 APPROVED DEDUCTTONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs~Misc. Expanses (Schedule H) 10. Debts/Mortgage L/abilitias/Lians (Schedule T) 11. 12. 1:5. 1~. NOTE 7,518.70 (9) (10) .00 Total Deduct/ons (11) Net Value of Tax Return (12) Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) Net Value of Estate Subject to Tax (lq) Xf an assessment was issued previously, lines 14, 15 and/or 16, 17, reflect flgures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Aeount of L/ne 1~ at Spousal rata (15). 16. Aeount of L/ne lq taxable at L/heal/Class A rata (16). 17. Amount of Line 1~ at Sibling rata (17). 16. Aeount of Line 1~, taxable at Collateral/Class B rata (18). 19. Pr/nc/=al Tax Due ~ TAX CREDITS: PAYflENT DATE RECEIPT / D/SCOUNT NUNBER I ZNTEREST/PEN PAID (-) · O0 x O0 = · O0 x OR5 = · O0 x 12 = . O0 x 15 = (19)= IF PAID AFTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ANOUNT PAID 7.518.70 $~.00- .00 5~.00- 18 and 19 will .00 .00 TOTAL TAX CREDIT .00 BALANCE OF TAX DUEI .00 ZNTEREST AND PEN. . O0 TOTAL DUE . O0 ( TF TOTAL DUE IS LESS THAN $1, NO PAYNENT TS REOUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR)., YOU NAY BE DU~.~ A REFUND. SEE REVERSE STDE OF THTS FOR. FOR TNSTRUCTTONS., ~/~. .00 .00 .00 RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECT[OHS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- tf any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate far life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Sect[on 91q0). 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: REGISTER OF NILLS, AGENT 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-ISIS). Applications ara available at the Office of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-B00-362-2050; services for taxpayers aith special hearing and / or speaking needs: 1-8D0-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 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 Review Unit, Dept. 280601, Harrisburg, PA 1712B-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (52) discount of the tax paid is allowed. 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 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 notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (SI) percent par annum calculated at a daily rate of .000164. All taxes ahich 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 Z004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z .000548 ~'~-1991 1II .goos01 ~ 9Z .000247 1963 162 .O004SB 1992 9Z .D00247 2002 62 .000164 1984 llZ .000301 1993-1994 72 .000192 ZOOS 52 .00D137 1985 1SI .000S56 1995-1998 92 .000247 2004 42 .000110 1986 102 .000274 1999 7Z .000192 1987 IOZ .000274 ZOO0 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of tho assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOANNE L. MYERS Date of Death: AUGUST 12, 2003 Will No.: 21-04-00137 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is yes, state the following: 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 X Executor was the sole beneficiary - Estate was Insolvent. 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. Capacity: Edmund G. Myers Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne, PA 17043-0109 Address (717) 761-4540 Telephone No. Personal Representative X Counsel for Personal Representative