HomeMy WebLinkAbout03-0718 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of' /l, No. , 1-o /
also known as To:
Register of Wills for the
Deceased. County of C~berlancl
Social Security No. / q '7- /Z - 4,6 ~. 7z Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), wh~are 18 years of age or older an the execut.o,-
in the last will of the above decedent, dated ~Y~ ~,e_ 2_6z
and codicil(s) dated
in the
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C"~,~..,, ..4 to.~/~,, ,./ County, Pennsylvania, with
h ~'r last family o[~principal residence at /~o 2dz /~o c 1~/~' ~-/~' /D,-,'~ 3
(list street, number and muncipality)
Decendent, then ,J~cS~ years of age, died .-"~"~- · 'Tt 5-- ~ 2 co..c,
at C~:~ /, ? /e r('~'_~; ~ .... / ~7,~ ~-~,',-~ er ~",~.~ '/~"..- '
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent 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
situated as follows:
WHEREFORE, petitioner(s) respectfully refluest{~) the probate of the last will and codicil(s)
presented herewith and the grant of letters 'Tz~'~z-C-,~e~,~/-~,7,~
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
bg.f. ore me this 03 day of [ _
~nna . 'Otto, Is~ ~pEty R~i~~ /~
/ 7-1~. 1
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3,
COUNTY OF C~be~]and
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
NO. 21-2003-718
Estate Of DEI',LA SERAS DEACON , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW b'-epl:ember 3rd ~ 2003, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated June 24th, 2003
described therein be admitted to probate and filed of record as the last will of
Della Seras Deacon ;
and Letters
are hereby granted to
Testanentary
W~]]i~n P. Seras
FEES
Probate, Letters, Etc .......... $ 115.00
Shorx Certificates(5) .......... $ 1.5 - OO
Renunciation ~.1~ ............ $ 5.00
x-Pages (3) $ 9.00
10.00
JCP TOTAL ~ S--
Filed .S.eD t. .em. .~. . r. . .3 .~. . ,. . .2 p.0. 3. . .$. . ]:. 5. 4. .. .~. . .
Mailed Letters to Attorney on
09/03/2003.
Donna M. O~'~s:~-rs°~ Wl~puty ~°';tx~'"~'--/~'7
A~ORNEY (Sup. Ct. I.D. No.)
~ ~ ~//q/ ADDRESS ~ / --~//
PHONE
Estate of
also known as
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
DELLA SERAS DEACON No. 21-2003-718
,Deceased
The undersigned, Husband and Executor of
(Relationship) (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s)
that Letters Testamentary_ be issued to William P. Seras
Witness
hand
this
day of '~,, ~ ,200 ~_ .
) k H. Deacon, Sr
(Address~ ' '
(Signature)
(Address)
(Signature)
Sworn to or affirmed and subscribed
before me this /c./~_~ day of
,
200
My Commission Expires:
(Address)
21-2003-718
LAST WILL AND TESTAMENT
OF
DELLA SERAS DEA CON
I, DELLA SERAS DEACON, of 1038 Rockledge Drive, Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament, hereby revoking all prior Wills and
Codicils.
FIRST: I direct that my Executor or Executrix pay all my debts and funeral expenses
as soon after my death as may be practicable. I further direct that all state, inheritance, transfer,
legacy, or succession taxes which may be assessed to my estate, or any part of my estate, whether
passing under my will, shall be paid out of my residuary estate as an expense of administration and
without apportionment.
SECOND:
I hereby give, devise and bequeath specifically as follows:
To my nephew, WILLIAM P. SERAS, of Mt. Holly Springs, Pennsylvania,
I give my entire portfolio with Paine Webber.
THIRD: All the rest, remainder and residue of my estate, I hereby give, devise and
bequeath to my nephew, WILLIAM P. SERAS.
FOURTH: Without limiting the powers conferred by statute or by general rules of law,
my Executor is specifically authorized and empowered:
(a) To invest any funds of my estate in any corporate shares, bonds, notes,
or other securities or property, real or personal, including any common or commingled funds
maintained by my Executor. This is to reflect my intention to give the broadest investment powers
and discretion to my Executor;
(b) To sell or otherwise dispose of any property, real or personal, at any
time forming a part of my estate, for cash or upon credit, in such a way and on such terms as my
Executor may deem best;
(c) To manage, operate, repair, improve, mortgage, and lease for any term
any real estate at any time held;
(d) To make distribution in cash or in kind upon any division of my estate;
and
(e) In general, to exercise all powers in the management of my estate
which any individual could exercise in the management of similar property in his own right, and to
do all acts which my Executor deems necessary or proper to carry out the purposes of this will.
FIFTH: I hereby constitute and appoint my husband, JACK H. DEACON, SR.,
Executor of this my Last Will and Testament. In the event my husband does not survive me, or in
the event my husband will not or cannot serve as my Executor, I appoint WILLIAM P. SERAS to
2 of 4
serve as Executor of this Will. No Executor acting hereunder shall be required to post bond or enter
surety in any jurisdiction.
IN WITNESS WHEREOF,
v,..~<__ ,2003.
I have hereunto set my hand this
DELLA SERAS DEAC~)N
day of
(SEAL)
SIGNED, SEALED, PUBLISHED and DECLARED by the above, DELLA SERAS
DEACON, as and for her Last Will and Testament, 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:
3 of 4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
I, DELLA SERAS DEACON, Testatrix, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I have signed
and executed the instrument of 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.
~worn to and ac~a~owledged before me by DELLA SERAS DEACON, the Testatrix,
this ,~7c/' - day of ~ 2003.
Notary Pt~lic -
Notary Public
COMMONWEALTH OF PENNS
SS:
COUNTY OF CUMBERLAND
We, ~%_~ (-~6(~ and ~o.Sx°}qlatr:¢ll~OOll6qf he
witnesses whose names are signed to the attached instrument, being duly qualified according to' law,
do depose and say that we were present and saw the Testatrix, DELLA SERAS DEACON, sign
and execute the instrument of her Last Will and Testament; that she signed it willingly and that she
executed it as her free and voluntary act for the purposes therein expressed; that each of us in the
hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge
the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or
undue influence.
_Sworn to and subscribed to before me by (~tSP. ~ oGW-- and
~l~rC..~r~l~d¢ ~(~z~ , witnesses, this day of 2003.
XS~riinfiss
oNOTARI^L~ SEAL i
Cindy S. Burrell, ~ ~otary Public
Lower Allen Twp, County of Cumberland
n Expires Mar. 20, 2004
4 of 4
KOLLAS AND KENNEDY
ATTO R N EYS-AT-LAW
1104 FERNWOOD AVENUE
CAMP HILL~ PENNSYLVANIA 17Oll-6912
(717) 731-1600
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Della Seras Deacon
Date of Death: August 5, 2003
Will No. 2003-0071 8 Admin. No. 21 -03-071 8
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 December 1 7 t 2003 :
Name Address
William P. Se~as 7 Rockwell Court, Carlisle, PA 17013
Notice has now been given, to all persons entitled thereto under Rule 5.6(a) except N /A
Name James W. Kollas
Address 1104 Fernwood Avenue, Ste. 104
Camp Hill, PA 17011
Telephone (71 '~ 7 31 - 1 6 0 0
Capacity: ' Personal Representative
Counsel for personal representative
R E V- 1 5 0 0
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARPJSBURG, PA 17128-0601
LU
UJ
IINHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENI'$ NAME (LAST, FIP, ST, AND MIDDLE INITIAL)
Deacon, Della, S
DATE OF DEATH (MM-DD-Y~R)
08/05/2003
DATE OF BIRTH (MM.OD-YEAR)
03115/1923
(IF APPLICABLE) SURVNBIG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Deacon, Jack H.
[] ,ot l-12. scpp . t. ,et.r.
OFFICIAL USE ONLY
FILE NUMBER
21 _ 03
COUNTYCOOE YEAR
SOCIAL SECURR~ NUMBER
199-12.4627
00718
THIS RETURN MUST BE FEED IN DUPUCATE WITH THE
REGISTER OF WILLS
U 3. Remainder Return
j-'-J 4. Um~ Estate ~ ~. Fumm In~t ~ro~se {a~ ~d~m ~ lm~ ~ 5. F~ml ~am T~ ~ R~ui~
~ 6.~tD~T~(~~ ~ 7.~entM~aLb~T~{~~) ~ 8. T~Num~e~
~ 9.~P~~ ~ 10. S~ Pove~C~{~a~,=~,.~} ~ 11. B~n~d~S~9113~o)
;'.T~ISSEC~ON MUSTBE;COMP~'~ =O?~EECORRESPONDENCE=~NDCONFiDE~E~T~iNFO~ATiON :SHOULD;' BEDIRECTEDTO~
~E [ C~ ~ING
James W. Kollas
F~ ~E~[~) ~ James W. Kollas, Esquire
Kollas and Kennedy Kollas and Kennedy
~PH~E NUM8~ 11~ Femwood Ave
Camp Hill, PA 17011 ~
(717) 731-1600
1, Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Parlne~'ship a' Sole-Proprietorship(3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Propen'y (5)
(Schedule E)
6. J~.~Uy Owneq Propew (Schedule F) (e)
L~ Separate B~ing Requested
7. Inter-Vh/os Transfem & Miscellaneous No~-Probale Property (7)
(Schedule G or L)
8. ?etal Gro~ A~eete (Iotsl Lines 1-7)
9. Funeral Expenses & Adminisffa~e Costs (schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (schedule 1) (10)
11. 'real I:)educ~ (total Unes 9 & 10)
12. Net VaGue of Estate (Une 8 minus Line 11)
0.00 . OFFICIAL. 'U;SE ONLY
I
c~
o.0o j ,.,:
0.00
0.00 -
0.00
108,385.23
0.00
13. Charitable and Govemn~ntal Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Une 12 minus Line 13)
(8) 108,385.23
11,485.95
707.44
(11) 12,193.39
(12) 96,191.84
(13) 0.00
(14) 96,191.84
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
1~. Amount of Line 14 taxable at the spousal lax
rate, a' transfers under Se~ 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rats
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collat~qd rate
19. Tax Due
0.00 x .0 _0. (15) 0.00
0.00 x .o 0 (le) 0.00
0.00 x .12 (17) 0.00
96,191.84 x .15 (16) ,,, 14,428.78
(19) 14,428.78
Decedent's Complete Address:
crrYCarlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2.- Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Intemsf/Panalty if applicable
D. Interest
E. Penalty
0.00
0.00
0.00
0.00
0.00
IfUrm 2 is greater ~an Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Une 20 to request a refund
If Una 1 + Une 3 is greater than Line 2, anter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(1)
Totel Cradiis (A + B + C) (2)
Total hteresf/panalty ( D + E )
(3)
(4)
(5)
14,428.78
B. Enter the total of Una 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a lransfer and:
Yes No
a. rataln the use or income of the pmparty transfened; .......................................
b. re.fa~.' the right to designate who shall use the pmparty transferred or its income; ......................... [] []
c. reran a reversionary interest; or ....................................... " ................ [] []
d. receive the prondse fer life of either paymanls, banefits or care? .................................................................. [] []
2. If death occurred alter December 12, 1982, ~ decedent Iransfer properly within one year of death
wi t ..................................................................................................... [] []
3. Did decedent own an in trust for' or payable upon death bank account or sectutty at his or her death? .............. [] []
4. Did decedent own an Individual RatJrement Account, annuity, or other non-probate property which
c~teins a baner~lery designaUon? ..................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE ITAS PART OF THE RETURN.
Oedandice °l' IxePm'm' olher Ihan h Pe'~onal ' '"' ............ ~, ~u ~° me ~em m my Imowledge and belk~ i b line, correct and complete.
represenla~ve b based m al infonnalim d which ixepamr has any kmwledge.
ADDRESS -~ --. .' _ - ~ ~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
0.00
0.00
14,428.78
0.00
14~428.78
For dates of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on Ihe net value of transfera to or for the use of the surviving spouse is 3%
F2 P.S. §9116 (a) (1.1) (i)].
For dates of dealh on or after January 1, 1995, the tax rate imposed on the nat value of transfers to or for the use of the surviving spouse is 0% [72 RS. §9116 (a) (1.1) (',')].
The statute ~ a transfer to a surviving spouse from tax, and the statutory requimmants for disd(~ure of assets and fling a tax relum ere slill applicable even if
the surviving spouse is b"m only beneficiary.
For dates of death on or after July 1, 2000:
The lax rate imposed on the net value of Iransfers from a deceased child Iwan[y-one years of age or younger at dealh to or for the use of a natural parent, an adoplive parent,
or a stepparant of the ~'id is 0% F2 P.S. §9116(aX1.2)].
The lax rate imposed on the net valua of Iran,. fers to or for the use of the decedenrs lineal beneficisdas ia 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 lransfers to or for the use of the dececlent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A s~ling is defined, under Sec~on 9102, as an
individual who has at least one perent in common with the decedanl, whether by blood or adop~on.
REV-1502 EX* (6-98)
co.~.vv~_~.o~p~..s¥~v~ I REAL ESTATE
. ,..E~^.CE ~ R~U.. I ·
ESTATE OF
Della Seras Deacon FILE NUMBER
· A~rea~p'-~p~wned--~e~y~ra~tenantln~mr~'~nmuetber~F~`~dat~alrr~-ketva~ue~Fa~rr~etva~uei~ 212003-718
· xcha~g~l between a willing buy~ and a wUllng ,1~. ,~h~ I~i,,,, ,,,,,-~.~ ,^ ~, ............. da..~n,~, a~ ~e. r~oe at wt~ ~ wo~ld be
ReM properly which i$ jointly-owned wilh right of eurvlvor~hip must be d!;c!o~ed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. N/A
........ ......... ........... ........"~ "~" ..............':'*' * ....."~ '" ........... ' ..........'" ......... "* ............. ~*" ' ': ~,,:'~'~'F~-i ~'? '/,;:'L'~ ~ ,;::. i-..i~, ~,,.~:::, .L*:.~
.................. it,: ,:~:,,~;~,:r;~:-t,,~:,:.¥~:~.:~%L:,~i~i
VALUE AT DATE
OF DEATH
:,
(If mom space Is needed, Ineed addllionaJ sheets of bSe .ame size)
REV-1503 EX+ (6-98) I ;
CO~ONWE~T, OF,E. NSY,VA.~ I STOCKs ~- e~k,ne
. INHERITANCE TAX RETURN / ~ laVi~li,/,,~ J '
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
All property jolnlJy.owned with right of ~urvivomhip mu~t bt dl~clo~d on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION VALUE AT DATE
see schedule E OF DEATH
TOTAL (AJso enter on line 2, Recapitulali
O.OOi
ESTATE OF
della Seres Deacon FILE NUMBER
~u~e c-~ or c.2 (ind~ding a~l sop~ ~,Tl~UOn) 212003-718
must be aitached for each closely, held corpom~/pm'tnemMp InMre~t of Itm decedent, ob*~' Itmn a
ITEM NUMBER
NUMBER
1.
sole-proprietorship, See instructions for the supporting Information to be submflled for sole-pmpdetomhips.
~ DES. CRIPTION
N/A
VALUE AT DATE
TOTAL (Also enter on line 3, Recapitulation)
0.00 ~
(If mom e~ac~ b needed, insert addi6onal sheets of the ~wne ~.e)
REV-1507 EX+ (6-g~) !
cou~o.w~m or PE..sv,vAN~ ~ MORI'GAGES & NOTES
.INHERITANCE TAX RETURN I I~,,A ~,: ~.
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
NIp~pe.dyJoinfly. owned ~ dghtofIurvivo~hlpmust~ dli¢!~edonScheduleF.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
. · OF DEATH
TOTN.' (NSO enter on line 4, Recapitulation) $
0.00 !'
(If rnore space is needed, Insert ~ddl~io~al sheets d ~e same size)
REV-1508 EX+ (6-98) ~ I
CO~.O.N~.,W~.~;OH PE..S~.V^.~ JCASH, BANK DEPOSITS, & NILS(:.
RESIDEI~rl' DECEDENT ~,-m~I~U~M. rKUi"l=KI T
ESTATE OF
Della Seres deacon FILE NUMBER
212003-718
I~__~ the I~ of l~.;,~,a{;on and the date the proceeds were received by the e~tete.
Ail property jolntly..owned with right of survivorship must be d!_-c!o_-ed on Schedule F.
ITEM'
NUMBER .
1
2
3
4
DESCRIPTION .
M&T Bank account # 15004200067880 balance August 5, 2003
M&T Bank account # 0001261916 balance August 5, 2003
Wilder Richman Historic Properties II, L. P.
UBS Financial Services, Inc. account # FN 38155 KS
4 shares Agere Systems Inc CIA @ 2.81 11.24
105 shares Agere Sys(erns Inc New Q B @ 2.65 278,25
93 shams AT&TCorpNew @2126 1977.18
149 shares AT&T Wireless Inc @ 8.53 1270.97
150 shares ComcastCorpNewCLA @30.48 4572.00
400 shares Lucent Techndogies Ino @ 1.75 700.00
300 shares Rite Aid Corp @ 4,73 1419.00
1662 shares Insured Muni Income Fund @ 14.00 23268.00
700 shares Pioneer Muni High Income Trust @ 15,00 10500,00
1 sham RMA Tax Free Fund Inc @ 14063.58 14063.58
20000 shares DC Tobacco Settle Fin @ 86.789 17359.20
1021.863 shs delaware Delchester Class A @ 3.00 3065.58
total 78485.00
TOTAL (Nso enter on line 5, Recapitulal]on) $
(If more space is needed, Insa~t additlonal shsate of the same size)
VALUE AT DATE
OF DEATH
3,202.52
17,497.71
9,200.00
78,485.00
108,385.23
REV-1509 EX* (6-98)
E~I'ATE OF
Della Seras Deacon FILE NUMBER
212003-718
If an auet was made Joint within oM year._.._._~of the decedents dat~ of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. N/A
B.N/A :: ..,:'-.' ::. ::.: :::::1 ':::::: ·
JOINTLY-OWNED PROPERTY:
ITEM MADE
NUMBER
DESCRIPTION OF PROP~.~i ¥
INCLUDE NAME OF fiNANCIAL INSTITUTION AND SANK ACCOUNT NUMBER OR
TOTAL (AJSO enter on line 6. Recapitulation)
(If more space Is needed, Insert addiUonal ~s oi, ihe same size)
REV-1510 EX+ (6-98) . I
.co~o~~,~.~_~j~,~ I ~m~-v~'oSmANS~E~S & I '
ESTATE OF
Della SerBs Deacon RLE NUMBER
212003-718
~schedu~mu~ ~compieteda~ fledlflheansw~'~y~quesllonslthrough4~ ~emversed~of~eREV.1500COVERSHEE'r~y~,
NUMBE~.
1.
DESCRIPTION OF PROPERTY
DATE OF DEATH OF DECD'$ EXCLUSION TAXABLE
(If more space is needed, inae~t addiliona] ~'~eets of t~e ~ size)
TOTAL (AL~o enter on line 7 RecapiMa0on) $
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'ESTATE OF
Della Seras Deacon
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
212003-718
Debt~ of decedent must be reported on Schedule Ir.
NUMBEF
1.
DESCRIPTION
FUNERAL EXPENSES:
Wes~inister ~ete~ inte~enF~t~bm~t au~iza~ & ind~nifica~on
:G~d~ Galle~ memorial ~i~ ff~ picture
Holy Trini~ Gr~k ~ox Ca~dral r~igi~s buri~ ~i~
ADMINIS~E COSTS:
P~I ~p~ena~e's
~ ~fi~ Num~s~N N~ of Pe~ R~a~s)
.~ ...... ; .............................................................. ============================== ':::'.: .: :::":: :. .....................................................................
~ ...................................................................................... ~ A ~p ~7013
Y~r(s) ~m~n P~d: ~ N/A
~mey ~
C~nt ~
Pm~
~nt's F~
T~ Ream ~ar~'s Fe~
AMOUNT
5,906.57 ~
1,48~.00 !
171.72:
I 554.00 ':
ooo!
o.oo
399.23 i:'
~ 0.00 ~
~.'r 0.00 !~
~ 51.41 ;!
TOTAL (Also enter on line g, Recapit,lntinn $~ 11,485.95 ;:!
(If more space is needed, insert additionaJ sheets of the same size)
REV-l$12 EX+ (12-03)
COMMONWEALTH OF PENNSY1.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon
SCHEDULE I'
DEBTS OF DECEDENT,
MORTGAGE LIABIUTIES, & UENS
FILE NUMBER
212003-718
ITEM
NUMBER DESCRIPTION VALUE AT DATE
Lehigh Anesthesia DEATH
- 11.69
Leon Sweer, MD - -
34.48
Stoken OpthameJogy ' :' ·. i . . ~...
Belveder Medical Group
Myshin Prothedontis
Carlisle Pathology
C,~a~ P~n Medi~ %U,
Andera Radiology
Philip Carey, MD
Apda Healthcare
3.47
39.06
·
110.00
13.79
c..~, P.~. uedi~ ~o.p .... 5.60
Belvedere Medical Group
26.28
Keams ~d ~hly
~ 212.~
B~ ~afi~ ' ....... ' ............................................. ~' ~'"'~ ...... ~ ....... ' -'~,- '~
. ., ,... 28.~
103.82 ,:
26.48 ;'
....... : ..... . ...... . .... ;: .,,,,.. ,. ~...,.: .............
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
TOTAL (Also enter on line 10, Recapitu;a~u.) $
(ff more ~,~_n-3,~e_ _ is needed, insmt addJlJona/sheets of Be same size)
707.44
,R ,L~-1513 EX+ (900)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon
NUMBER
I
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal dis[~ibutions, and trar, sfe~s under
Sec. 9116 (a)
William Peter Seras
RELATIONSHIP TO DECEDENT
Do Not Ust
Nephew
FILE NUMBER
212003-718
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER S,'"IEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX iS NOT BEING MADE
N/A
8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
N/A
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If mom space is needed, insert additional sheets of the same size)
AMOUNT OR SHARE
OF ESTATE
100.00
0.00
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 003898
SERAS WILLIAM P
7 ROCKWELL COURT
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 199-12-4627
FILE NUMBER: 2103-071 8
DECEDENT NAME: DEACON DELLA SERAS
DATE OF PAYMENT: 05/04/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 08/05/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $14,428.78
REMARKS:
W P SERAS
TOTAL AMOUNT PAID:
$14,428.78
SEAL
CHECK# 143
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF Fk'NNSYLVANIA '~.
COUNTY OF CUMBERLAND
William P. Seras
be;ng duly sworn accord;ng to law, deposes end says that he is the. Executor
of the E~tate of Della Seres Deacon
late of __S.o.u.t...h_M_.idd. l_.e_t_o_n..Township ., Cumberland County, Pa., deceased and that the
wlfh/n is an ;nvento~ mede by .~~ P. Se. fas , the sa;d Executor
of the ant;re es'F~fe of sa;d decedent, cons;st|ng of ell the persona/ prop,Hy end reel estate, except reel estate outs;de
the Commonwealth of Pennsylvania, end thef the f;gures oppos;te each item af the Inventory represent it's fe;r value
as of the d~,to of decedent's death.
end subscribed before me,
~l~_ 2004
William P. Seras
7 Rockwell Court
Carlisle, PA 17013
Date of Death 05 August 2003
D.y -- k4~nth Y,,ae
INSTRUCTIONS
I. An ;nventory must be flied with;n three months after eppo;ntment of personal representative.
2. ^ supplement ;nventory must be filed within th;try days of d;s¢overy of additional assets.
3. Add~t;onal sheets may be attached es ~ personalty or realty
4. See Article IV, Fiduc;ar;es Act of 1949. ~-.
O ~ ~
~ z
Inventory of the real ~nd personal estate of
Della Seras Deacon
deceased
Real Estate
1. None
Bonds
2. None
Stocks
3. None
Bank Deposits, Cash, and Miscellaneous Personal Property
4. Cash
Total
0
0
08,385
08,385
00
00
00
23
23
FAMILY SETTLEMENT AND FINAL RELEASE
IN
ESTATE OF DELLA SERAS DEACON, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, DELLA SERAS
DEACON, late of 1038 Rockledge Drive, Carlisle, Cumberland County, Pennsylvania, deceased,
died testate on August 5, 2003, having made her last will and testament, which was duly
executed on June 24, 2003;
WHEREAS, letters testamentary for the estate of the said decedent were duly issued on
September 3, 2003, by the Register of Wills of Cumberland County, Pennsylvania, to WILLIAM
P. SERAS, Executor, hereinafter called personal representative, for the Estate of DELLA SERAS
DEACON, Number 2003-00718;
WHEREAS, the said personal representative has gathered the assets of the estate of the
said decedent and the assets consist of personal property, to a total value of $108,385.23, as set
forth in Exhibit A, which is the estate tax return prepared by the said personal representative, and
which is attached hereto and made a part hereof, and marked Exhibit A;
WHEREAS, the debts and deductions, including the payment of inheritance tax in the
said estate, amount to $26,622.17, leaving a balance for distribution of $81,763.06, which
schedule of distribution is set forth in Exhibit A;
WHEREAS, the balance for distribution as shown in said Exhibit ~ has been reduced to
c._
cash and has been distributed as herein indicated in accordance with the last will an~'testament of
the said decedent;
NOW, THEREFORE, KNOW YE, that, WILLIAM P. SERAS, being the sole
testamentary heir of the said decedent, and being the person entitled to inherit under said last will
and testament, does hereby, acknowledge that he has this day had and received from the aforesaid
personal representative, in full satisfaction and payment of all sum or sums of money,
$81,763.06, the amount due him under said last will and testament, which amount he has
received this day, and which amount is set opposite his name in the table and schedule of
distribution in said statement attached hereto and marked Exhibit A, unless modified herein;
AND, he does hereby stipulate that in order to avoid the expense and time involved in the
filing of a formal account and schedule of distribution, he agrees that no account is necessary and
he does hereby agree that he consents to distribution being made without the filing of an account
and schedule of distribution, the same to be with the same force and effect as if they had been
filed and confirmed by the Orphans Court Division of the Court of Common Pleas, Cumberland
County Branch.
THEREFORE, he does hereby remise, release, quitclaim and forever discharge the said
personal representatives, their heirs, executors, and administrators and assigns, of and from the
said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands
whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever
touching upon the estate of the said decedent, and he does further hereby covenant and agree that
should any liability come due to the estate of the said decedent after the signing of this
agreement, he does hereby covenant and agree that he will contribute his share of the estate to
satisfy any and all claims, demands, suits, or causes of action which may be successfully
prosecuted against the said estate or the aforesaid personal representative after the signing,
sealing and delivery of this family settlement agreement and final release.
IN WITNESS WHEREOF, WILLIAM P. SERAS has hereunto set his hand and seal this
2~'~ ~/ 2004-.
day of ,
WITNESS:
WILLIAM P. SERAS
(SEAL)
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
On this, the 2'-fI~ day of ~'}Q~ ,200___~:, before me, a Notary Public,
the undersigned officer, personally appeared WI~LLIAM P. SERAS, known to me to be the
person whose name is subscribed to the within instrument, and acknowledged that she executed
the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
CAROLE A I"~OSE I '
Notary Public
TWSP OF LOWER AjL~ I Notary Public
CUMBERLAND COU I My Commission Expires: ~.)C'~
My Comm.~-~e-~n ExpIr®s ~ 21, ~7 1 '
EXHIBIT "A"
REV-I.~O EX (64M
.. *' ~ COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE r',,~,
FILE NUMBER
___21___ 03 00718
DE¢~[~_NT'S NAME (LAST, FIRST, AND MIDDLE INmN.)
Deacon, Delia, S
DATE OF DEATH (MM-DD-YEAR) I DATE OF RIRTH (IvlM-DD-YEAR)
08/05/2003 103/15/1923
(~F ~PLgAI~.E) SURV~ING SPOUSES NAME CAST. F,~, AND MDDLE INffL~.)
Deacon, Jack H.
SOCIAL SECURITY NUMBER
199-12-4627
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF VVlLL~
SOCIAL SECURITY NUMBER
195-16-4868
I'~ 1. O,iginel Return [] 2. Supptomental Return r-'] 3. Remainder Return (d~e d~,~t= ~2.134z/
[--"] 4. Umited Estate E::] 4a. Future Interest CenlixomJse (dale ~dea. alta' 12-12~2) E:] 5. Federal Estate Tax Rel:u~ Required
I'~ 6. Decedent Died Testate (/W~cbcop,/dWW) l-'-] 7. Decedenl Maintained a Living Trust (Atta~hc~,/d~.n~) 8. Total Numberof Safe Deposit Boxes
i"THIS SECTION MUST' BE:COMPL,-! ~'D?A~CORRESPONDENCE~MdD CONFiDENTiAE..TAX/NFORMATION SHOULD BE DIRECii::D TOi~
NAME
James W. Kollas I COMPLETE M~UNG ~DRESS
aRM NAME ~,~,) ~ James W. Kollas, Esquire
Kollas a~cl Kennedy I Kollas and Kennedy
J 1 ~ 04 Femwoed Ave
TEL."PHONE NUMBER J Camp Hill, PA 17011
,(717) 73%1500
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely fleU Coq~omtton, Partnership or Sofe-Propriatorship (3)
4. Mmlgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Proper~y (5)
(Schedule E)
6. ?..~Uy Owned Property (Schedule F} (5)
I I Separate Billing Requested
7. Infer-Vivos Transfers & MisceJlaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Grose Assets (total Lines 1-7)
9. Funeral Expenses & Adminislralfve Costs (Schedule H) (9)
10. Debts of Decedeat, Modgage Liabaitfes, & ~ (Schedule I) (10)
11. Total I:)m:luclions (total Lines 9& 10)
12. Nat Value of Esta~ (Line 8 minus Lbe 11)
13. Cha~ and Govemmen~ Baquests/sec 9113 Trusts for which an etoclien to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Une 13)
0.00
0.00
0.00
0.00
108,385.23
0.00
0.00
(8) 108,386.23
11,485.95
707.44
(11) 12,193.39
(12) 96,191.84
(13) 0.00
(14) 96,191.84
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or lmnsfms under Sec. 9116 (a)(1.2)
16. Amount of Line 14 laxable at ~ rate
17. Amount of Line 14 taxable at aibrag rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00 x .0 0 (15) 0.00
0.00 x .o 0 tis) 0.00
0.00 x .12 (17) 0.00
96,191.84 x .15 (18)- 14,428.78
(~9) 14,428.78
Decedent;s Complete Address:
STREET ADDRESS
1038 Rod<ledge Driye
C~YCarlisle
I STATEpA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. -credits/Payments
A. Spousal Povedy Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
0.O0
O.00
O. O0
O.00
0.O0
(1)
Total Credits (A + B + C ) (2)
Tote ~nterest/Pena~ ( D + E ) (3)
If Una 2 is greater than line 1 + I. Jne 3, enter Ihe difference. This ts the OVERPAYMENT.
Check box on Page 1 Une 20 to request · refund (4)
If Una 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE, (5)
A. Enter the interes~ on the tax due. (SA)
B. Enter the total of Une 5 + SA. This is the BALANCE DUE. ($B)
Make Check Payable to: REGISTER OF WILLS, AGENT
I ziP17013
14,428.78
0.00
0.00
O.00
14,428.78
O.O0
14~428.78
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a b'ansfer and: Yes No
a. reteJn the use or income of the property lraneferred; ........................................................................................ [] []
b. retain the dght to designate who shall use the property transferred or its income; ............................................ [] []
c. rein a reversionary interest; or ........................................................................................................................ [] []
d. receive the promise for life of eilher payments, benefits or cam? ............................................................. [] []
Z if death occurred after December 12, 1982, did decedent Irensfer property wiif~n one year of death
without receiving adequate consideration? ...................................................................................................... [] []
3. Did decedent own an 'in Imst for' or payable upon death bank account or security at his or her death? .............. [] []
4. Bid decedent own an Individual RetirementAccount' 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,
Declare[on d prepare' o1~' ~han the personal mpmsenbllve b based on al infom~lion d which ~ ~ ~ k~_
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of Imnsfers to or for the use of the sun~iving spouse is 3%
[72 P.S. §9118 (e) (1.1) (i)].
For dates of desth on or after January 1, 1995, the fax rote imposed on the net value of transfers to or for the use of the surviving spouse is 0% ['/2 RS. ~9116 (a) (1.1) (ii)].
The statute does not exempt a Imnsfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are sfill applicable even if
the surviving spouse is lhe only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of lmnsfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an aduplive parent,
or a stsppamnt of the child is 0% [72 P.S. §9116(a)(12)],
The lax rate Imposed on the net value of lmnsfers to or for the use of the ducadent's lineal benermiaries is 4.5%, except as noted in 72 P.S. §g116(1.2) [72 RS. §9116(a)(1)].
The tax rate imposed on the net value of transfers te or for the use of the decedent's siblings is 12% [72 P.S. §gl16(a)(1.3)]. A s~ling is defined, under Secfion 9102, as an
individual who has at least one parent in common with the decedent, whether by blood er adoption.
REV,:1502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'~STATE OF '
Della Seres Deacon FILE NUMBER
212003-718
NI real properly owned ~ole/y or as a tenant in common must be reported at fair market value. Fair market vaiue is de,'ted as the price at which property would be
exchanged between a willing buyer and a willing seller, nelthe~ being compelled to buy or sell. both having reasonable knowie~ ~e of the relevant facts.
Real property which Is Jointly.owned with right of eurvlvor~hip must be disclosed on Schedule F
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. N/A
TOTAL (Nso enter on line 1, Recapitulation)
(If i'~ space is needed. Insert additional she~s of the same size)
0.00
REVelS03 EX+ (6-98) ~ I ' .
~.~-~.'~ oF,E..s¥,v~ / STOCKS & BONDS I
· INHERITANCE TAX RETURN I ~" ~"
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
All property jo;n~y-o~ with right of survivorship mu~t be ,JL-c!~_-ed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
see schedule E
TOTAL (Nso enter on line 2, Recapitulatio~
(If more space is needed, inse~t additional ~eets of the same size)
VALUE AT DATE
OF DEATH
REV-1504 EX+ (6-98)
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
della Seras Deacon RLE NUMBER
212003-718
.~,~,,,a,,,.. C-1 or C-2 (' _u~._.,_,~ al/ ...... '
......... supp<xting ,,,fom,ul/o~) must be attactmd for each close/y4m/d ~orpomtJorVpartnemhip interest of ~e dec~ent, olh~ than a .
sole-propdetorship. See inslruclio~s for the supporting inf~"mation to be submitted for ~ole-proprieto~hil~.
ITEM NUMBEF
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
N/A
TOTAL (Nso enter on line 3, R_ncapi_~j!n_tjon) $
(If more ipac~ is needed, ~,~ie,~ i,~;~;~,ml sheets of the same size)
0.00
REV-.1507 EX+ (6-98) _ I
co~o.w~T, oF PEN.S'~.W~ J NIORTGAGE$ & NOTES J '
·INHERITANCE TAX RETURN J DE~'I~/'A I~ I ~'
ESTATE OF . .
Della Seras Deacon FILE NUMBER
212003-718
Ail Property joinfly..owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
N/A
DESCRIPTION
VALUE AT DATE
OF DEATH
TOTAL (Nso enter on line 4, Recapitulation) $
(If more -_..,;~:~ is needed, Insert a,,~.~o~al sheets of the same size)
0.00
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'~ESTATE OF
Della Seres deacon
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
212003-718
ITEM
NUMBER
1
2
3
4
Inc~da the p,-~ of ;~*~a~on and ~he date Itm proceeds were received by Ihe estate.
All property jointly.owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
M&T Bank account # 15004200067880 balance August 5, 2003
M&T Bank account # 0001261916 balance August 5, 2003
Wilder Richman Historic Properties II, L. P.
UBS Financial Services, Inc. account # FN 38155 KS
4 shares Agare Systems Inc CIA @ 2.81 1124
105 shares Agere Systems Inc New CI B @ 2.65 278.25
93 shares AT&T Corp New @ 21.26 1977.18
149 shares AT&T Wireless Inc @ 8.53 1270,97
150 shares Comcast Cap New CL A @ 30,48 4572.00
400 shares Lucent TechnologieSlnc" @ i.75 700,00
300 shares Rite Nd Corp @ 4.73 1419.00
1662 shares Insured Muni Income Fund @ 14.00 23268.00
700 shares Pioneer Muni High Income Trust @ 15.00 10500.00
1 share RMA Tax Free Fund Inc @ 14063.58 14063.58
20000 shares DC Tobacco Settle Fin @ 86.789 17359.20
1021.863 shs delaware Delchester Class A @ 3.00 3065.58
total 78485.00
VALUE AT DATE
OF DEATH
3,202.52
17,497.71
9,200.00
78,485.00
TOTAL (Nso enter on line 5, Recapltulalion) $
(If mom space is needed, Insmt additional sheets of ~he ~arne size)
108,385.23
REV;150g EX+ (6-g8) ~ I '
· COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
If an a~t was made joint w/thin one yea~ of the decedent'e date of death, it must be reported on Schedule G.
A. N/A
JOINTLY-OWNED PROPERTY:
SURVIVING JOINT TENANT(S) NAME
ADDRESS RELATIONSHIP TO DECEDENT
ITEM
MADE
DESCRIPTION OF PROPERTY
INCl.[JOE NAUE OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DATE OF DEATH
ESTATE. VALUE
N/A INTEREST
TOTAL (Nso enter on line 6, RecapitulatJo~ $ 0.00
(If more space is needed, Irul~'t additional sheets ofb~e same size)
REV~151~) EX* (6-98)
COMUONWEN..TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
RLE NUMBER
212003-718
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the
....... ~ ...... ,.,~ .~,~,~ ,,~uG w ul~ ~cv- IovV ~,UVI:::I~ ,b/ll'l: I IS yes,
iTEM DESCRIPTION OF PROPERTY %
NUMBEI; ~NC~UDE THE ~ME O~ mE m.~SFEP~, mE~ aEL~nONS~p TO ~CEDE~T,~U DATE OF DEATF OF DECD'S EXCLUSION TAXABLE
THE DATE OF TRANSFER. ATTACHACOPYOFTHEDEEDFORREAJ. ESTATE. VALUE OFASSET INTEREST (IFAPP~E VALUE
1, N/A
TOTAL (Also enter on Pine 7 Recapitulation) $ 0.00
needed, insert addiiJonal sheets of the same size)
R 1511 EX+ (12 99
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA I FUNERAL EXPENSES
. INHERITANCE TAX RETURN I J~Ulkll~'l'l~ A'~'nt~- ~,~,-,~,,~,,,
RESIDENT DECEDENT r-u.-,Tum'~m,a I ~dr~l I V g ~,l,,JO
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
Oabbi of d~.nt must be reported on Schedule L
NUMi DESCRIPTION
~- FUNERAL EXPENSES: AMOUNT
1.
5.
6.
7.
Ewing Bros. Funeral Home funeral services
Westminister Cemetery interment/entombment authorization & indemnification
James R. Gingrich Memorials cemetery inscription
Jack H. Deacon post burial gathering meal receplJon.
Garden Gallery :' : ..... :
memorial service framed picture
Holy Trinity Greek Orthodox Catherdral religious burial services
ADMINISTRATIVE COSTS:
Personal ReprasefltatJve's Commissiona
Name of Personal Representative(s) William Peter, seras
Social Seeudty Number(s)/EIN Numbe~ of Personal Representative(s) 209'36-0254
StreetAddre~ 7 Rockwell Court
ci~ Carlisle
Year(s) Commission Paid: N/A
209'36-0254
.sate PA z¥ 17013
Attorney Fees
Family Exemp§on: (If decadenrs address is not t~e same as claimant's, attach explanalton)
Claimant
Street Address
City State
Relationship of Claimant to Becedent
Pmbal~ Fees
Accountant's Fees
Tax Return Preparer's Fees
Copier and Postage Expense
5,906.57
1,485.00
90.00
1,828.02
171172
1,554.00
0.00
0.00
0.00
399.23
0.00
0.00
51.41
TOTAL (Also enter on line g,
(If more ~ace is needed, insert additio~ sheets of Ihe same size)
$ 11,485.95
REV-1512 EX+ (12-03) .. I I '
: f SCHEDULE, j
cc~Mo~,~.~ o¢ P~v~ I DEBTS OF DECEDENT, I '
. INH~ff~E T~ ~ M
ESTATE OF
Della Seras Deacon FILE NUMBER
212003-718
Re~rt ~,e~i Incurred by Itm dec;~; p-for to ~a~'i which remained unpaid as of the dale of ,~._-',,.., Inci~ing unrelmbursed m,~z,,,J ~__%_nen~. as.
ITEM
I. Lehigh Anesthesia
2 Leon Sweer, MD
3 West Shore - EMS
4 Stoken Opthamalogy
5 Belveder Medical Group
6 Myshin Prolhodontis
7 Carlisle Pathology
8 Central Penn MedicaJ Group
9 Andora Radiology
10 Central Penn Medical Group
11 Belvedere Medical Group
12 Keams and Ashly
13 Baker Association
14 Belveda' Medical Group
15 Philip Carey, MD
16 Apda Healthcare
DESCRIPTION
VALUE AT DATE
OF DEATH
11.69
35.38
34.48
3.47
39.06
110.00
13.79
20.78
5.60
5.83
26.28
212.00
30.69
28.09
1 O3. 82
26.48
TOTAL (AJso enter on line 10, Recapitulation) $
(if mae space is needed, insert addiUoaal sheets of the same size)
707.44
REV-.1513 EX+ (g-O0)
COUtJO~VEN.'rH OF PENNS~I.VN~I~
INHERITN~CE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Della Seras Deacon
NUMBER
SCHEDULE J
BENEFICIARIES
NNVlE AND ADDRESS OF PERSON(S) RECENING PROPERTY
TAXABLE DISTRIBUTIONS [i~,_,de oubJght spousal ~b&utions, and transfers under
sec. 9116
William Peter Serae
RELATIONSHIP TO DECEDENT
Do Not Ua
Nephew
FILE NUMBER
212003-718
AMOUNT OR SHARE
OF ESTATE
100.00
ENTER DOU. ARAMOUNT8 FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECT ON 9113 FOR WHICH AN ELECT ON TO TAX IS NOT BEING MADE
N/A
B. CHARITABLE AND GOVERNMENTN. DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAX,~BLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(if more space is needed, insert addidonaJ sheets of ttm same size)
0.00
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280&01
HARRISBURG, PA 17128-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
JAMES W KOLLAS
KOLLAS & KENNEDY
1104 FERNNOOD AVE
CAMP HILL
CUT ALONG THIS LINE
PA 17011
DATE 06-21-2004
ESTATE OF DEACON DELLA
DATE OF DEATH 08-05-2005
FILE NUMBER 21 05-0718
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
RETAIN LONER PORTION FOR YOUR RECORDS ~
S
DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DEACON DELLA S FILE NO. 21 05-0718 ACN 101 DATE 06-21-2004
TAX RETURN WAS: C X} ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1 Real Estate (Schedule A)
2 Stocks and Bonds CSchedule B~
$ Closely Held Stock/Partnership Interest CSchedule C)
Mortgages/Notes Receivable (Schedule D)
5 Cash/Bank Deposits/M/sc. Personal Property (Schedule E)
Jointly Owned Property CSchedule F)
7 Transfers CSchedule G)
8 Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9 Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H~
10 Debts/Mortgage Liabilities/Liens (Schedule I)
ll Total Deductions
12 Net Value of Tax Return
c1)
108r585.25
.00
.00 NOTE: To insure proper
.00 credit to your account,
.00 submit the upper portion
· 00 of this form with your
tax payment.
108,585.25
11,485.95
707.44
12.19R.39
96,191.84
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
15
NOTE:
ASSESSMENT OF TAX:
15. Amount of L/ne 14 at Spousal rate ClS)
16. Amount of Line 1~ taxable at Lineal/Class A rate C16)
17. Amount of L/ne 14 at Sibling rate C17)
18. Amount of L/ne 14 taxable at Collateral/Class B rate C18>
19. Principal Tax Due
TAX CREDITS
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID
05- 04 -2004 CD005898 . O0
reflect flgures that include the iota! of ALL returns assessed to date.
· O0 x O0
~QOx 045
~0 x 1~=
9~, 191i84 x
AMOUNT PAID
14,428.78
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J} C15) .00
Net Value of Estate Sub3ect to Tax CI4) 96,191.84
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
.00
.00
.00
14,428.78
14,428.78
14,428.78
.00
.00
.00
c IF TOTAL DUE IS LESS THAN ~1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU HAY BE DU~-~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
.00
RESERVATION=
PURPOSE OF
NOTICE=
PAYMENT=
REFUND CCR):
OBJECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALLY:
INTEREST=
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral1 rate on any such future interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. C72 P.S.
Section 91401.
Detach the top portion of this Notice and submit with your payment to the Register of Hills 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 are available at the Office
of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering= 1-800-$62-2050; services for taxpayers with special hearing and / or
speaking needs= 1-800-447-$020 (TT
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must obSect within sixty C&0) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone C7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" CREV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three C$) calendar months after the decedent's death, a five percent CSX) discount of
the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the sase manner and in the the sase 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 (91 months and one C1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six C&X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 ~ill 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 2004 are=
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20X .000548 ~'~-1991 IIX .000501 2001 9X .000247
1985 I&X .000~38 1992 9X .000247 2002 &Y. .000164
1984 llX .000501 1995-1994 7X .000192 2003 5~ .000157
1985 13X .00035& 1995-1998 9X .000247 2004 4~ .000110
198& 10X .000274 1999 7X .000192
1987 10X .000274 2000 7X .000192
--Interest is calculated as follows=
INTEREST = BALANCE OF TAX UNPAID
X NUNBER OF DAYS DELXNQUENT X DALLY XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (151 days
beyond the date of the assessment. If payment is made after the interest computation date 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: Della Seras Deacon
Date of Death: Auqust 5, 2003
Estate No.:
2003-00718
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: N / A
(dale)
3. If the answer to No. I is yes, state the following:
A.
B.
Did the personal representative file a final account with the court?
Yes No x
The separate Orphans' Court No. (if any) for the personal representative's
account is: N / A (Not Applicable in Dauphin County)
Did the personal representative state an account informally to the parties in
interest? Yes X No
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. ,'7? ~;', -;' ,
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James W. Kollas
Name (Please type or print)
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1104 Fernwood Avenue,
Address ~amp Hill, PA 17011
(MAH:nntl AM3)
717-731-1600
Telephone No.
Capacity:
Personal Representative
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Counsel for Personal Representative
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R.W. - 58
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/13 /2005
SERAS WILLIAM P
7 ROCKWELL COURT
CARLISLE, PA 17013
RE: Estate of DEACON DELLA SERAS
File Number: 2003-00718
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
8/05/2005
Your prompt attention to this matter will be appreciated.
Thank You.
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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