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Home My WebLink About02-0098PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of N. JANE SLONAKER No. 21-02-98 also known as To: Deceased. Social Security No. 209-] 2-6997 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, applies 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 Cumbe r land County, Pennsylvania, with h er last family or principalresidence at 70~ q Ca?i'i s] 0 Pike ~. Carlisle_. (~,~; ~' ) ;% c-- (bt street,,numb~_and muni, cipality~//Q~- Decendent, then 77 years of age, died January 19~ 62002 u ',~ at Holy Spirit Hospital, Camp Hill, PA 17011 ' Decendent at death owned property with estimated values as folllows: (lf 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 $ situated as follows: None 10,000.00 17013 Petitioner after a proper search h~q ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Mary Lou Rider Sister h12 West Simpson St Mechanicsburg, PA 170~ THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ' -/~ar~Lou Rider ~/~12 West Simpson St. Mechanicsburg, PA 170~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ¢OMBE74LAND The petitioner(s) above-named swear(s) or affirm(s)that the statements in the foregoing petition are true and correct to the best z 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 subscribed before me this 28th _ day of l ~ ~AN~A~¥ ~1~ 2002 J / / ~// Register No. 21~-02-98 Estate of N. JANE S,~0NALER ,, Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW JANUARY 29 ~l~ 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Mary Lou Rider is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Mary T,ou Rider in the estate of N. Jane Slonaker r of Wills Filed 40.00 15.00 FEES Letters of Administration ..... $ Short Certificates( ) .......... S- Renunciation ................ $ JCP $. 5. O0 TOTAL__ $ 60.00 ·..0.1.-:-.2.8.~ ........... A.D. lSjti2002 J. Robert Stauffer (NO, 067~6) A,~WTORNEY (S,~$h C~t. I.D. No.) Market ~quare ~zmg. Meahan~a.~b~g~ P-~' 170%~ ADDRESS 7].7-766-9673 PHONE l05.805 RJ~V 9/86 This is to certify that the information here given is correcdy copied from an original certificate of death duly filed with me as Local. Kegistrar. The original certificate will be forwarded to the State 'Vital Records Office for permanent ~filing. WAFINU~IG: it is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8010619 No. 21-02-98 Local Registrar Date 77 '~,,. Cumberland COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH N Jane Slonaker I:EXFemale · 1. 1. 209 -- 12 -- 6997 ],. January 19. 2002 : I Jan 14 1925 I NewKinflstown I~ ~.~ East Pennsboro I- .o,, Spirit Hospital I'~' ~- ~' I'=' White ,,.. Clerk .b. Federal Government ~. [] ,,,~ I ~ ~ ,2. [,3. ~'~ 12 ,4~s+~ ,4. Never Married ACTU~ ,7..~. Pennsylvania ,~c.~ ~.~. Silvsr Rnrinn TnwnRhJn 7043 Carlisle Pike ~s~ ~ , - · Carlisle, 17013 rennsy~vama ~) ~. ~ ,.. ,~.~ Cumberland ~ ~,.~ ,~rs~e,~ ~ ~ m' ~lonaKer ,~. Merian Sadler ~m~s~ '~ ......... .... , ~]~' 412 West Simpson Street Mechanicsburfl, Pa 17055 ~--~~ ~[~,, .Jan 22 2002 L.~ Conolite Cremato~ _ Schaefferstown Pa 17088 ~1o~ I Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) N. JANE SLONAKER Date of Death: January 19, 2002 Will No. 2002-00098 Adnfin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 None : Name Address Mary Lou Rider-412 West Simpson St., Mechanicsburg, PA 1705~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except No.~ e Nalne J. Robert Stauffer Address Market Square Bldg. Mechanicsburg, PA 17055 Telephone (71 ~' - 76 6- 96 7 3 Capacity! __ Personal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001084 STAUFFER J ROBERT MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 209-12-6997 FILE NUMBER: 2102-0098 DECEDENT NAME: SLONAKER N JANE DATE OF PAYMENT: 04/18/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/19/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02116987 $47.94 TOTAL AMOUNT PAID: $47.94 REMARKS: MARYLOUSRIDER C/O ROBERT S STOUFFER ESQUIRE CHECK# 5633 SEAL INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO1O85 STAUFFER J ROBERT MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 209-12-6997 FILE NUMBER: 2102-0098 DECEDENT NAME: SLONAKER N JANE DATE OF PAYMENT: 04/18/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/19/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02116992 $46.49 TOTAL AMOUNT PAID: $46.49 REMARKS: MARY LOU S RIDER C/O ROBERT S STAUFFER ESQUIRE SEAL CHECK# 5664 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF /NDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-060! REV-I~i3 EX AFP COg-OO) '02 APR 18 MARY L RIDER 412 W SIMPSON ST "EC"A"ICSBUR6 ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE / ?-3 FILE NO. 21 02-0098 ~// ACN 02116987 DATE 04-08-2002 "lC :(i9 TYPE OF ACCOUNT BS?. OF N J SLONAKER [] SAVINGS S.S. NO. 209-12-6997 [] CHECKING DATB OF DBATH 01-19-Z002 [] TRUST COUNTY CUMBERLAND []CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 HENBERS 1ST FCU has provided the Department aith tho information listed below which has been used in calculating the potential tax due. Their records indicate that et the death of the above decedent, you were a joint owner/beneficiary of this account. Zf you feel this information is incorrect, please obtain Nrittan correction from the financial lnstitutlon, attach a copy to this form and return it to the above address. This account is taxable in accordance N~th the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be ansusrsd by calling (7Z7) 787-83Z7. COMPLETE PART ! BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. $917-00 Data 08-14-1956 To insure proper credit to your account, too Established (Z) copies of this notice must accompany your Account Balance 840.94 payment to tho Register of #ills. Hake check payable to: "Register of Hills, Agent". Percent Taxable X 50.000 Amount Subject to Tax 420.47 NOTE: If tax payments are made N]thin three (5) months of the decsdent's date of death, Tax Rate X .12 you may deduct a AZ discount of the tax due. Any inheritance tax due ~ill become delinquent Potential Tax Due 50.46 nine (9) month~ after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LINE A. ~The above information and tax due is correct. 1. You may choose to remit payment to the Register of NitIs ~ith two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of NilZs and an official assessment ail1 be issued by the PA Department of Revenue. B. ~The above asset has been or Nil1 be reported and tax paid ~ith the Pennsylvania Inheritance Tax return to be filed by the dacedant's representative. C. ~The above information is incorrect and/or debts and deductions Here paid by you. You must complete PART ~ and/or PART ~belaw. If you indicate a different tax rate) please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Established 1 2. Account Balance 2. ~. Percent Taxable $ ~ ~. Amount SubSact to Tax ~ S. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIM;~ PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I dmclara that the facts I have reported above are true) correct and complete to the bast of my know/edge and belief. TAXPAY~/,,,,~IGNATURE WORK ( ) TELEPHONE NUMBER GENERAL ZNFORHATZON 1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death. 3. A joint account is taxable even though the decadent's name oas added as a matter of convenience. 4. Accounts (including those held betaeen husband and wife) which the decedent put in joint names aithin one year prior to death are fully taxable as transfers. S. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING iNSTRUCTiONS - PART [ - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign tad copies and submit them with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Hills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt 180601, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions ars being claimed, check block "C" and complete Parts 2 and according to the instructions below. Sign two copies and submit them aith your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART Z - TAX COHPUTATTON LINE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/1Z/81: Accounts which the decedent put in joint names aithin one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (mx) appears before your first name in the address portion of this notice, the S$,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDEB BY TOTAL NUHBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE JOINT OHNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 5 (JOINT O~ERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7X (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decedsnt's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OHNERS OR TRUST BENEFTCIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = SOZ (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (1ina 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined bsloa. Da~e of Dea{h Spouse Lineal Sibling Cella{era1 07/01/94 ~o 12/$1/94 3X 6X 01/01/95 ~o 06/30/00 OX 61 07/01/00 ~o presen~ OX wTha tax rate imposed on thl net value of tram from a .;,~,c ~ounger at death to or far the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ. The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendants, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" ars defined as individuals who have et least one parent in common aith the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTTONS - PART $ - DEIITS AND DEDUCTIONS CLAIMED Allowable debts and deductions ars determined as follows: A. You legalIy are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 1/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. CONHONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRZSDURG, PA 17128-0601 REV-1;liS EX AFP (09-on) 'O7_ APR 18 MARY L RIDER q12 W SIMPSON ST ~,~ MECHANICSBURG PA 1 LiD,. ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 02-0098 ACN 02116992 DATE 0q-08-2002 TYPE OF ACCOUNT EST. OF N J SLOANAKER []SAVIN$S S.S. NO. 209-12-6997 []CHECKING DATE OF DEATH 01-19-2002 E~TRUST COUNTY CUMBERLAND [] CERTIF. RENIT PAYHENT AND FORHS TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 HENBERS 1ST FCU has provided the Department Hlth tho information listed beloH Hhich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you Hera a joint oHner/beneficiary of this account. If you Feel this information is incorrect, please obtain Hrittan correction from the financial institution, attach a copy to this Form and return it to the above address. This account is taxable in accordance Hith the Inheritance Tax LaHs of the CoaeonHaalth cf Psnn=ylv&n'.'a. Qua;tiGris may be answered by calling ;717) 787 8527. COMPLETE PART 1 BELO# ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS PART Account No. $917-11 Date 12-$1-1979 Established Account Balance 815.56 Percent Taxable X 50. 0 0 0 Amount Subject to Tax ~07.78 Tax Rate X .12 Potential Tax Due ~8.9~ TAXPAYER RESPONSE To insure proper credit to your account, tho (Z) copies of this notice must accompany your payment to the Register of Wills. Hake check payable to: "Register of Wills, Agent". NOTE: If tax payments ara mede within three (3) months of the decadsnt's date of death, you amy deduct a SZ discount of the tax due. Any inheritance tax due Hill become delinquent nine (9) months a~tsr the dote of death. PART TAX LINE A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Nills with tho copies of this notics to obtain CHECK -~ a discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK ] B. [] The above asset has been or Hill be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacadent's representative. C. ~The above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] beloH. If you indicate a different tax rata, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Established I 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount Subject to Tax q 5. Debts and Deduct/oDs 5 6. Amount Taxable 6 7. Tax Rata 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUC¥ZONS CLAZMEt~ PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne $ of Tax Computation) $ Under panalt/as of perjury, T declare that the facts I have reported above are true, correct and comp/ate to the bast of ay knowledge and belief. HOME ( ~/7) ~/~ ~- TAXPAYER'SI~U~r-~E/ - - ' ) TELEPHONE NUMBER GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT ~N AN OFFiCiAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decadent's date of death. 5. A joint account ts taxable even though the dacedent's name aaa added as a matter of convenience. q. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check ~or the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15q8 EX) upon receipt of the return from the Register of Nills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the dscedant's representative, place an "X" in bZock "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt Ia0601, Harrisburg, PA 171Z8-0601 in the envelope provided. $. BLOCK C - [f the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and according to the instructions below. Sign two copies and submit thee with your check for the amount cf tax payable to the Register of Nills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1S48 EX) upon receipt of the return from the Register of Nills. TAX RETURN - PART g - TAX COMPUTATION LINE l. Enter the date the account originally wes established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1g/1Z/BZ: Accounts which the decedent put in joint names within one Il) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (mx) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the dacedant's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OMNERS SURVIVING JOINT OMNERS Example: A joint asset registered in the name of the decedent and two other parsons. 1 DIVIDED BY 3 (JOTNT ONNERS) DIVIDED BY Z (SURVTVORS) TM .167 .X 100 = 16.7Z (TAXABLE FOR EACH SURVTVOR) B.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVTVING JOINT X lO0 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name cf the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X lOO = 50X (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (1ina 4). 7. Enter the appropriate tax rate (line 7) as determined below. Da~e of Death Spouse L/nee1 S/blinD Collateral 07/01/9q ~o 12/$1/9q 01/01/95 ~o 06/$0/00 OX 6X 07/01/00 ~o presen~ OX q.JX~ 12Z wThe tax rate imposed on thc net value of tran ;4 :y years .Jounger at death to or ~or the use of a natural parent, an adoptive parent, or a steppsrent of the child is OX. The lineal class of heirs includes grandparents, parents, children) and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes a11 children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class cf heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decadent end can furnish proof of payment. C. Debts being claimed must bm itemized fully in Part 3. If additional space is needed, usa plain paper B l/Z" x 11". Proof of payment may be requested by the PA Department cf Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(I 1-96) CD 001291 J ROBERT STAUFFER ESQUIRE MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 209-12-6997 FILE NUMBER: 2102-0098 DECEDENT NAME: SLONAKER N JANE DATE OF PAYMENT: 06/13/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/19/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $598.61 REMARKS: TOTAL AMOUNT PAID' MARY LOU RIDER C/O J ROBERT STAUFFER ESQUIRE CHECK//120 INITIALS' SK SEAL RECEIVED BY: $598.61 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV 1500 EX (6'00)~ ' ~ ~'COMMONWEALTH OF ~3~',,~'~ PENNSYLVANIA ,j~T/~~, DEPARTMENT OF REVENUE r .tlF~_~/,~'l'~ ~ DEPT. 280601 .,' ,.,~F'~,~.::,[,].~l.r:l-;'~.~'~ HARRISBURG, PA 17128-0601 I.- z UJ Q UJ IJJ LU REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT F- Z U.I Z O. DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) gammr':y* 1~), 2002 J'a.rmar,~, 11.1., (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A nr FIr~'IAI liRE FILE NUMBER 2 1-02 O0098 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 209 -- 12 -- 6997 [~1. Original Return ---]4. Limited Estate --]6. Decedent Died Testate (Albch copy of Will) [~9. Litigation Proceeds Received NAME J. ~obert FIRM NAME {If Applicable) Same THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [~]5, Federal Estate Tax Return Required _0_O 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (Attach Sch O) [~2. Supplemental Return [-] 3. Remainder Return (date of death pdo,-lo 12-13-82) [~4a, Future Interest Compromise (date o1 death after 12-1242) [~7, Decedent Maintained a Living Trust (Attach copy of Trust) ~10. Spousal Poverty Credit (date of death between 12-31 91 and 1-1~95) ALL CORRESPONDENCE AND ~ON[:iD~NflAL,i?A~, INl~OEp_qlONiH~~--~-.~..-~, I~ COMPLETE MAILING ADDRESS ]iarket Square t-~].dg. 1 West ~[ai~ St. TELEPHONE NUMBER 717-76(~-9673 l~lecha.~icsbu~g, PA 170~[] 1. Real Estate (Schedule A) (I) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r-]separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probale 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 Beductions (total Lines 9 & 10) 12. 13. 14. Net Value of Estate (Line 8 minus Line 11) Charitable and Governmenlal Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) 0.00 0.00 o. do 15,291.19 0.00 O. O0 OFFICIAL USE ONLY ¢) 349.87 (11) 10,302.79 (12) 4,988.40 (13) 0. O0 (14) 4,988.40 15,291.19 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amounl of Line 14 taxable at collateral rate 19. Tax Due 0.00 x.O__ O, O0 x O__ 1-I-, 9I~8' 4-0 x.12 O. O0 x .15 (15) O. OO (16) O. OO (17) 598 · 61 (18) 0 o OO (19) ~98.61 Decedent's Complete Address: STREET ADDRESS 70!.1.3 Car!isle .,ot . o9 Is'^TE m IzIP l' ol3 CIIY Carlisle ~ PA . Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount O. O0 O,00 0, OO Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, A. Enter the interest on the tax due, (1) 598.61 0o00 (3) 0. O0 (4) 0,0 0 (5) 598.6:]. (5A) O. OO (5B) 998.61 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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; ............................................ [] [] b. 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 properly 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 properly 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 exarnined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, il is true, correct and complete. Declaration of preparer other than the personal representative is based on all ini'ormation of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADbI~E§S- -/ - - ~ ~,~e~t Simpson St., Mechan.~.csb]~rg, ]?A ].70~ ~E ~EP~REa OTH~MAN REPB~ENTATIVE ~ ~ATE 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 decedenrs 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 R~URN RESIDENT DECEDENT ESTATE OF N JANE ~ "-' · oLONAL. I~,R SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21- 02 - 0098 2002-00098 Include the proceeds of litigation and the date the proceeds were received by the estate, All property Jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. ~h~rdential Utility Fund (Prudential Financial, Accounts as fol].ows: Class B, Fund No. 04500034982. $ 180.07 Class A, Fund LTo. 04500034982. 4,186.04 Class A. Fund No. 0390019~1..961. 81.3~ 2. Brickers Auction, 93 Texaco Road, Mechanicsburg, PA, gross proceeds from sale of c(mtents of Mobile Home. 2,246.75 3. Patrick A. Duck, proceeds from sale of 14' X 60', 1986 Zimmer Mobile Home. 8,000.00 ~b. Janet Rosner, proceeds from sale of 1986 Dodge, sedan Automobile. 200.00 ~. United States Treasury, refund, on 2001 [Income Tax. 397.00 TOTAL (Also enter on line 5, Recapitulation) $ 15,291.19 (If more space is needed, insert additional sheets of the same size) ¢ REV-15~I1 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF N. JAN J; ¢ .... oLO FILE NUMBER 21-02-0098 2002-00098 ITEM NUMBEF 10. 11. 12. 15o 16. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: P Nyers Funeral Ih)me, 37 Last Ha:tn Pennsylvania, funeral expenses. ~t,s He chanic sburg, ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) ~'J On e Social Security Number(s)/EIN Number of Personal Representative(sl Street Address City ....................................... State ...... Zip Year(s) Commission Paid: Attorney Fees J. Robert Stauffer, Attorney fee. Family Exemption: (if decedent's address is not the same as claimanl's, attach explanation) Claimant N/A Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Reg:ister of Wills Penns.ylvania, Letters Accountant's Fees of Cumberland County, of Administration. Tax Return Preparer's Fees Cmnberland Law Journal, Estate Notice. Drain Doctor, commode repair. Leiby's Trailer Court, March 2002 Lot Rent. Verizon, March te].ephone. The Senti.nel, Estate Notice. PPL Electric UtilitY. es, March electric. Nembers 1st FCU, Checkbook charge. Verizon, April telephone Register of Wills, I Short Certificate. Debra B. Weist, 2002 County and. Township Taxes. TOTAL (Aisc enter on line 9, Recapitulation) AMOUNT $ 2,897.00 55o.oo 60.00 oo. 5o.oo 272.00 17.16 90.28 7.22 0.08 3.oo 39.76 CARR:[EI) t;I()RWAR[ $ (If more space is needed, insert additional sheets of the same size) PAGE-1 R~VISII EX~ 17 Irtlq) COMMOIIWEALTll OF PEIqNSYtVANIA INII[RIIAt,ICE TAX RETURN RESIDEr,II DECEDEN[ ESIATE OF N. JANE oL( NAI'd,R NUMBER J ........................... SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND' MISCELLANEOUS EXPENSES DESCRIPIION Please Print or Type ~iL~'NUMBER 21-02-0098 2002-00098 AMOUNT 17. Chuck Bricker, Brickers Auct:J_on, 93 Texaco Road, Mechanicsburg, PA 17050, Auctioneer, s servi, ces. 18. PPL Electric Ut:[lities, Apr.~.l electric. 19. PPL Electric Utilities, FJ. nal Bill. 20. Register of Wills, Filing Inventory and Pennsylvania Inheritance Tax Return. $ 741.75 32.50 4.82 2S.oo Total ...... . .... $ 4,952.92 PAGE - 2 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESlDEN! DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS N. JANE SLONAKER FILE NUMBER 21-02-0098 2002-00098 Include unrehnbursed medical expenses. ITEM NUMBER 10. 11. 12. 14 · DESCRIP~IOH Members 1st Federal Credit Union, loan account due. Blair, Inc., balance d. ue on account. Wal-Hart, Inc., paid on account of charge account. Citi Bank, paid on account of charge account. Ligts Figis, due on CanSy account. Reader Service Center, charge account due. Wal-Mart, Inc., paid on account of charge account. East Pennsboro Ambulance Assoc., ambulance services. Citi Bank, balance due on account. Wal-Mart, Inc., balance due on account. Figis, fuel account. Great Gifts, charge account. First USA Bank, balance due on account. Visa Account, balance due on account. : TOTAL (Also enter on line 10, Recapitulation) AMOUNT 2,056.16 0.00 9.89 14.36 40.00 38.98 214.69 389.23 69.89 31.71 1,324. 78 760.45 5,349.87 (If more space is needed, inserl addil, ional sheels of the same size) COMMONWEALTH OF PENNSYLVANIA INHERllANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-02-0098 7~!. JA. Ii'F;; SLO!!A][ER 2002-00096 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) II. Mary Lou 'Rider West Simpson St. Mechanicsburg, PA ].70~ olster Entire Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART lI. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (if more space is needed, insert additional sheets of the same size) Inventory of the real and personal estate of deceased (~) (2) (3) (Il_) Prudent-iai Utility Fund (Prud. ent;ial ,~' " , t.~.nanc~al) Accounts as follows: Class B, Fund No. 0~l.50003Ji982 180 Class A, F~md No. 01tJ0003~.1.9~2 4,186 Class A, Fund No. 039001911.961 81 Brickers Auction, Gross proceeds from s~l~ of F~.rnish:[ngs and contant;s o'~ !'{obi.]e IIo~ne. _P,2~6 Patr~.ck A. ])~.clc, ppoceeds, frem sale of "Ztm.nep' ~ !'!obile !Iome. 1986 l'!odel, MI_' x 60'. 8,000 Janet Rosner, proceeds from sale of 1986 Dodge Aires automobile 200 ,o? 04 33 O0 19 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss: being duly sworn according fo law, deposes and says fhafShe iS Adm. inistratrix of the Estate of N. Jato Slo~sker late of ---~[1]ve, r Opr:[n~ rJ~o~-ms~i.? Cumberland County, Pa., deceased and that fha wlfhin is en inventory m~de by_ .~ar'~ %ou_]~[c~r .......... ~he snld Ad~i~istratrix of the enHre esf~fe of seld decedent, consisfln~ of ~11 the persen~l property end re~l estate, except real esfnfe outside the Commonwealth of Pennsylvania, end fhef the figures opposite e~ch Hem of the Inventory represent it's fear value es of ~he date of decedenf's death. S~or~ end subscribed before me, J ~~~ ~~ / ~~ ~ 2002 -~ ~,.~- Admin;strat~r )1 12 ~fes'[, OLmpsor~ St l"Iechar~icsburg, 1'~& l'[O-r:~-~ Address Date of Death 19 J ar~u a r ,~ff' 2O02 -- Day Monfh Year INSTRUCTIONS I. An inventory must be filed wifhin three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Addit;onaJ sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. z >. z Z 0 ~ U t- O r- BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 17128-0601 MARY L RIDER qlZ W SIMPSON ST NECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT. ALLOHANCE OR DISALLOHANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS PA 17055 FILE NUMBER COUNTY SSN/DC ACN REV-16q8 EX AFP {01-02) DATE 06-10-2002 ESTATE OF SLONAKER N DATE OF DEATH 01-19-2002 21 02-0098 CUHBERLAND 209-12-6997 02116992 Amoun~ R~mi~ed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV-1548 EX AFP (01-02) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 06-10-~2002 ESTATE OF SLONAKER J DATE OF DEATH 01-19-2002 COUNTY CUHBERLAND FILE NO. 21 02-0098 S.S/D.C. NO. 209-12-6997 ACN 02116992 TAX RETURN WAS: eX) ACCEPTED AS FILED ¢ ) CHANGED dOZNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 3917-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-31-1979 Account Balance 815.56 Percent Taxable X 0.500 Amount Subject to Tax q07.78 Debts and Deduct/ohs - .00 Taxable Amount ~07.78 Tax Rate X .12 Tax Due q8.93 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYNENT DATE 0~-18-2002 RECEIPT NUMBER CD001085 DISCOUNT C+) INTEREST/PEN PAID ¢- 2.q5 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) AMOUNT PAID q6.q9 TOTAL TAX CREDIT BALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE q8.9q .01CR .00 .01CR PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S. Section 9140), PAYHENT: Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF NILLS, AGENT. REFUND (CR): A refund of a tax credit, mhich 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 are available at the Office of the Register of NJlls, any of the Z5 Revenue District Offices or by calling the special Z~-hour answering service for forms ordering: 1-800-56Z-lOS0; services for taxpayers with special hearing and or speaking needs: 1-800-~47-50Z0 (TT only). OBJECTIONS: 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 may object within sixty (60) days of receipt of this Notice by: OR --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ZD-10Z1, --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to tho Orphans' Court ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Factual errors discovered on this assess;ant should be addressed in writing tm: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ID0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-650S. See page S of tho booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent 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 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in tho 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 fl) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. A11 taxes which became delinquent on or after January 1, 1982 will bear interest et a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rotes for 1982 through 200Z are= Year Interest Rate Daily Interest Factor Yea_~.r Interest Rate Daily Interest Factor 1982 20X .000548 1992 9Z .O00Z~? 1985 16Z .000458 1993-1994 72 .O0019Z 1984 llZ .000501 1995-1998 9Z .O00Zq7 1985 1SI .000356 1999 72 .O0019Z 1986 XOZ .O0027~ ZOO0 8Z .000Z19 1967 9X .000247 2001 9Z .000247 1988-1991 1XZ .000501 2002 6X .000164 --Interest is calcu/ated as follows: TNTBRBST = BALANCE OF TAX UNPAXD X NUHBER OF DAYS DELTNQUENT X DA/LY TNTEREST 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. BUREAU OF INDZVTDUAL TAXES INHERITANCE TAX D]*VTS*rON DEPT. 280601 HARR]'SBURG,, PA 171P'8-0601 NARY L RIDER fi12 W SIMPSON ST HECHANICSBURG PA 17055 COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRATSENENT. ALLO#ANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-10-2002 ESTATE OF SLONAKER DATE OF DEATH 01-19-2002 FILE NUHBER 21 02-0098 ~ -, COUNTY CUHBERLAND i" SSN/DC 209-12-6997 ACN 02116987 Amoun'l: RemZ't ted REV-15¢8 EX &FP N HAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV-IS48 EX AFP (Ol-OE) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-10-2002 ESTATE OF SLONAKER N J DATE OF DEATH 01-19-2002 COUNTY CUHBERLAND FILE NO. 21 02-0098 S.S/D.C. NO. 209-12-6997 ACH 02116987 TAX RETURN WAS: (X) ACCEPTED AS FILED ¢ ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: NEHBERS ZST FCU ACCOUNT NO. 5917-00 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 08-1q-1956 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 8q0.9~ X 0.500 RZO.~7 - .00 ~ZO.q7 X .12 50.~6 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYNENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: **REGISTER OF WILLS, AGENT.** PAYHENT DATE 0~-18-2002 RECEIPT NUMBER CDOOIO8q I DISCOUNT C+) INTEREST/PEN PAID (-) AHOUNT PAID 2.52 IF PAID AFTER TH/S DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS RE~U/RED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) q7.9q TOTAL TAX CREDIT BALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE 50.q6 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 9140). Detach the top portion of this Notice and submit mith your payment to the Register of Mills printed on the reverse side. -- Make check or money order payable to: REGISTER OF MILLS, 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-Z3[3). Applications are available at the Office of the Register of #ills, any of the Z3 Revenue District Offices or by calling the special Z4-hour ansmaring service for fores ordering: 1-BOO-36Z-ZOSO; services for taxpayers with special hearing and or speaking needs: 1-800-4qT-30ZO (TT only). Any party in interest not satisfied mith the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZB-lOZ1, OR --electing to have the matter determined at the 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 DepartJ. ent of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ZB060I) Harrisburg, PA IT1ZB-0601 Phone (717) 787-650S. See page S 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 decedent's death, a five percent discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same aann&r 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 (II day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on or after January 1, 19BZ 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 19S2 through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20Z .000548 1992 92 .000247 1983 16Z .000438 1993-1994 72 .O0019Z 1984 112 .000301 1995-1998 92 .000247 1985 13Z .000356 1999 72 .OOO19Z 1986 lOX .000Z74 ZOO0 8Z .000219 1987 9Z .000Z47 2001 9Z .000247 1988-1991 112 .000301 2002 62 .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY 'rNTEREST 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 ba calculated. BUREAU OF ZNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX J ROBERT STAUFFER'~fl? HARKET SQUARE BLDG I W MAIN ST ~. MECHANICSBURG I'~17055 DATE 07-22-2002 ESTATE OF SLONAKER DATE OF DEATH 01-19-2002 FILE NUHBER 21 02-0098 COUNTY CUMBERLAND ACN IO1 I Amount Rem/fred REV-154? EX &FP COl-OZ) N J HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE l~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF SLONAKER N J FILE NO. 21 02-0098 ACN 101 DATE 07-22-2002 TAX RETURN NAS: (X) ACCEPTED AS FZLED { ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSK, APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) ($) q. Nortgages/Notes Race/vabZe (Schedule D) (~) 5. Cash/Bank Depos/ts/N/sc. Personal Property (Schedule E) (5) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/H/sc. Expenses (Schedule H) (9) 10. Debts/Nortgage L/ab/1/t/es/L/ens (Schedule Z) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 15/291.19 .00 .00 NOTE: To insure proper .00 cred/t to your account, .00 subeit the upper portion .00 of th/s form w/th your tax payment. .00 (8) ~,952.92 13. NOTE: 15,291.19 (15) .00 x O0 = .00 (x6). .00 x ORS= .00 (17) Q,988.~0 x 12 = 598.61 (18) .00 x 15 = . O0 (19)= 598.61 ANOUNT PAID ZF PA/D AFTER DATE /ND/CATED, SEE REVERSE FOR CALCULAT/ON OF ADDZT/ONAL INTEREST. 598.61 ASSESSMENT OF TAX: 15. Amount of LLne 1~ at Spousal rate 16. Amount of L/ne lfi taxable et L/neal/Class A rate 17. Amount of L/ne 1~ at Sibling rate 18. Amount of L/ne lfi taxable at Collateral/Class B rate 19. Pr/nc/pal Tax Due TAX CREDITS: PAYMENT I KECE/PT D/SCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 06-15-2001 CD001291 .00 re.Floor .F/gures that include the tote! o.F ALL returns assessed to date. TOTAL TAX CREDIT J 598.61 BALANCE OF TAX DUEI .00 INTEREST AND PEN. I .00 TOTAL DUE J .00 ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT 1S REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE ~ A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) Char/table/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0 Not Value of Estate Subject to Tax (1fi) ~,988.~0 Z'F an assessment Nas Lssued prev/ously, 1/nas 1~, lS and/or 16, 17, 18 and 19 will 5~$~9.87 (11) 10.~D2,79 (1~') ~,988.~0 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1g, 1982 -- if 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 for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B [collateral) rate on any such future interest. To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (TZ P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, 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-1315). Applications ara available at the Office of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special gq-hour answering service for forms ordering: 1-BO0-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-~q7-5020 [TT only). Any party in interest not satisfied with the appraisement) allowance, or disallowance of deductions, ar assessment of tax Cincluding 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. g81021, Harrisburg, PA 17128-10Z1, 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. ge0601, Harrisburg, PA 17128-0601 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 (5) calendar months after the decedent's death, a five percent (SI) 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 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you mould 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, 198Z bear interest at the rate of six (61) percent per annum calculated at a daily rate of ,00016~. All taxes which became delinquent on and after January 1, 198Z 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 appllcable interest rates for 1982 through gOOg are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 2OZ .0005~8 1992 9Z .O00Zq7 1985 16Z .000~58 1993-1994 7Z .O00XYZ 198~ llZ .000~01 1995-1998 9Z .O00Z~7 1985 13Z .000356 1999 7Z .000192 1986 log .00027~ 2000 8Z .000219 1987 9Z .O00Zq7 ZOO1 9Z .O00Zq7 1988-1991 11Z .000501 ZOOZ 6Z .00016q --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 the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must bm calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: N. JANE SLONAKER Date of Death: January 19~ 2002 Will No. 2002-00098 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: 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 x No d. Copies of receipts, releases, Joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may~ttached to this report. Date: April 30~ ~ 0 ~j gnature · Robert Stauf Name (Please type or print) Vd 'o00~aq~l~ Market Square Bldg. ..... ~ ~ ~,3~O ~{echanicsburg, PA t70~5 Address j.o ( 71% 766-9673 Tel. No. Capacity: __Personal Representative (MAH:rmf/AM3) x Counsel for personal representative