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Home My WebLink About04-0427 PETITION FOR PROBATE and GRANT OF LETTERS I al~q known as To: ~X/~.EI r [ P. .... ·~Pt ..... ~e.[_ - ~4 G~ Ox/t Register of W_ills for the , Deceased. County of ~,/_~I09 JOE P {OL/ri the Social Security No. ! 7~ ' ~- "' dc ip 5~P Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ir' I, ~,. named in the last willof the above decedent, dated j,'~E. E e. rw ~C~ ~' ' ';;;~.t7 , 19 g. E) and codicil(s) dated jr-} 0 ~ ~- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in O, LIVYI~O~-,f' IA ~('~ .County, Pennsylvania, with h e'~ ~ last family or.~rinci~al residenc~-at -~ ~ ~ ~ ~ [~ (list street, number and muncipality) Decendent. then ~,~ years of age, d~ ~ ~~ ~ ,~~ at ~~ ~~ ~~ ~ ~ (~'~(e. ~ ~70 I_~ . Except as ~ollows, de~dent did not marry, was not divorced and did not have a child born or adopted after execution of tt)e 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 ,request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -~e~4-0. (testamentary; adn~inistration c.t.a.; administration d.b.n.c.t.a.) theron. ~.= O~ OF PERSONAL REPRESENTATIVE COMMONWEALTHo ~OF PENNSYLVANIA COUNTY OF 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. Sworn to or affirmed and subscribed before me this~ ~t~ ~day°f ~ ~D~ ~ 2~[/~~~' ...... No. o21-~4- ~-~ Estate Of ~('~e.~0_~ ~ ~f)0 ~J c~,-. ~/-}~_ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW /~.~f ,~ ~,~C~,-~ ~2 , in consideration of the petition on the reverse side hereof, satih"actory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admitted to probate and filed of r.ecord as the last will of and Letters ~~-k-c~ ~ are hereby granted to ~Ct~_~~ ~C)0 Register of Wills ( Probate, Letters, Etc .......... $ [ ~O~,D Short Certificates( ) .......... $ [~ C~C) ATTORNEY (SUP. Ct. I.D. No.) ~ $ [ ~. c~ ADD.SS TOTAL $ ~ ~ Filed ~. ~ ~.-, ~.= ~.~ ............... PHONE Thi~, is. to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Loc,fl Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by Photostat or photograph. Local Registrar P !032 30 8! No. '~ Date r~~ .. I H10S.143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS ,~..T CERTIFICATE OF DEATH. 2. F 3. 178 -- 38 --4656 I,- 5. 5 9/13/1908 rlisle, P~ '~,., ~ t~.,,.,, D ~o~ ~ (If I ~L ~ker .b. Her ~ ~ . ~3. (0.,2) 1 (~.s.) .. Wi~d ~s. - 442 Wa~ut ~tt~ ~d RES,D~CE ,~..n, ~. ~rlisle t PA 17013 ~ ~h.,,~e) ~. cou.~ ~rl~d ~p~ ~*d. ~ ~' ~'~ "~ ~,,~ ~u., ~ of ~rlisle ~. ,.m~rs ~.E (T~P~,) ". Flor~ Kine~ '"~O%~Sr~'U~G;DgRESS [S~.,. C~, St.t.. ~p ~rl~e M. S~rr 20~. bzb ~r~[~ a~.; ~ Hill, PA 17011 2,.. ~(s~) ~12'b. 4/2/2004 2~.Wes~ster ~,tu~e~ 12,d. ~rlisle, PA 17013 2z~~ ~~~ 22b ~ 012633 L 22~g B~thers ~eral H~, Ins ~rlisl PA ~ ~ 24-26 ~lt ~ ~.,~ by TI~E OF D~H { , integral ~ no, msumng ~ the und~ Muse g~. ~ P~T I. ~". E~ UNDERLYING [ ~ : - ~ ~ ' ' ~ent Pad.gin.stOlon ~ Yes ~ No D Y"D NO~ yesS N~ ~e S C~ffino,~ ..... ined O ,30'. 3Ob. M. '0,. ~ED~ ~ffiE~COEONE8 ~M[~ ~DR[~ ~PERSON W~ ~PLETED ~8E O~D~TH ~l~ll~lx~lnl~a~lnv~tl~tl~ In~oplnl~,dll~cu~tlme date indplacl anddulto~ecaullll and t.~zt//~Pnnt ~-&.~ I, MARIE I. Mo(DY, a legal resident of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and ur~erstandi~g, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid frc~a the assets of my estate as soon as practicable after my decease. S~XI~D: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid frc~ my residuary estate as a part of the expense of the administration of my estate. ~IRD: I devise and bequeath the residue of my estate, of Should my daughter, MA~TRNE McCOY STARR, predecease me, I devise and bequeath the residue of my estate e~a]ly to my grandchildren who sbmll have survived me. MARTRNE McCOY STARR, Executrix of this, my Last Will a~d,'Test~ent. the event of the renunciation, death, resignation or inability to act_ for any reason whatsoever of the said MAPIRNE McOOY STARR, I ~inatei constitute and appoint my grandson, JAMES E. STARR, JR., ~tor of this, my Ta-~t Will and Testament. I hereby relieve my Executri%x or her sucoessor from the necessity of posting security in connection_with their duties as such in any jurisdiction in which they may be t~alled upon to act, insofar as I am able by law so to do. /N ~ ~R~DF, I have hereunto set my hand and seal to this, my Ta~t Will and Testament, consisting of one typewritten page, which bears my signature, this ~~ day of ~c~~,~, 199d~ . Signed, sealed, published and declared by the above-named Testatrix, MARIE I. McCOY, as and for her Ta~t Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our CC~9~a~3%LTH OF P~qNSYLVANIA ) : SS. COUNTY OF O3MR~ ) I, MARIE I. McOOY, Testatrix whose name is signed to the attached or foregoing instrument, having been duly ~,aq ified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntazy act for the purposes therein expressed. Sworn or affirmed add acknowledged before me by MARIE I. McCOY, the Testatrix, this ~p ~ day of ~)~~~ , 199 ~. T~sta~ix Marie I. McCo~ Notary ~lic- I NOTARIAL'SEAL , AF~'Vi"~ SHIRLEY W A~LERS, NOTARY PUBLIC : OF ) We, ~ L. ~o~ ~ · , ~e wi~~ ~ ~ ~ si~ ~ ~e a~~ or fo~o~ ~~t, ~ ~y ~ifi~ a~~ ~ law, ~ de~ ~ ~y ~t we w~ prat ~ ~w ~~ si~ ~ ~~ ~e ~~t ~ h~ Tarot Will; ~t ~ie I. ~ si~ will~ly ~ ~t ~e ~~ it ~ h~ f~ ~ vol~ a~ for ~e ~ ~~ ~~; ~t ~ of ~ ~ ~e h~ ~ si~t of ~ ~~ si~ ~e Will ~ wi~~; ~ ~t ~ ~e ~t of ~ ~l~ge ~e ~~ ~ at ~t t~ ei~ or ~ y~ of age, of ~ ~ ~ ~ ~ ~~t or ~e ~lu~. , 199~ . MY ~OMM<~.~ON ~XFIR~S JULY 14, 1~3 Cumberland County - Register Of wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 08/02/2004 STARR MARLENE MCCOY 626 GRANDVIEW AVENUE CAMP HILL, PA 17011 RE: Estate of MCCOY MARIE I File Number: 2004-00427 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 08/13/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FAR_NER STRASBAUGH Clerk of the Orphans' Court cc: File Counsel Judge CERTIFICATION OF NOTICE UNDER RULE 5.6(a} ~ ~e Register: I ce~O ~ no~ce of ~nefl~ in~t) ~ required by Rule S.O(a) of ~e ~h~s' Cou~ Rules was served on or m~led to the following benefici~ies of ~e above-captioned estate on : A~ress Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Name ,~. _ V-['('_ lq ~'. Address '- 7/7 70g ~1 7~ u:~ ,u, ~ %lephone ( ) - ~° o ~ ~.~ Capacity: ~ersonal Representative ~.Counsel for personal representative REV-1162 EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVlDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004817 STARR MARLENE MCCOY 626 GRANDVlEW AVENUE CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ foJd 101 ~904.52 ESTATE INFORMATION: SSN: 178-38-4656 :ILL NUMBER: 2104-0427 DECEDENT NAME: MCCOY MARIE I DATE OF PAYMENT: 01/10/2005 ~OSTMARK DATE: 01/10/2005 COUNTY: CUMBERLAND DATE OF DEATH: 03/30/2004 TOTAL AMOUNT PAID' t~904.52 REMARKS: MM STARR CHECK//4985 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS R E V- 1 5 0 0 o~,c,,, USE ONLY ~ PENNSYLVANIA .~32~~:~ DEPARTMENT OF REVENUE r~~ DEPT. 280601 INHERITANCE TAX RETURN ~HARRISBURG, PA17128-0601 RESIDENT DECEDENT cou.~co~ ~ -- .u~ -- -- DECEDENTS NAME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER DATE OF DEATH (MM-DD-Y~R) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ -~O --~O~y O~ -- [~ --/~O~ REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER ~ 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13~2) ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of death a.er 12-12-82) ~ 5. Federal Estate Tax Return Required ~ 6. De,dent Died Tes~te (A~ch ~py of Will) ~ 7. Decedent Maintained a Living T~st (A~ch ~py of Trust) ~ 8. Total Number of Safe Deposit Boxes ~ 9. Litigation Proceeds Re~ived ~ 10. Spousal Pove~ Credit (date of death ~een 12-31-91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A)(A~ch Sch O) FIRM NAME (If~pli~ble) TELEPHONE NUMBER 7/7 - 7~- 1. Real Es~te ($~uleA) (1) ~ O OFFICIAL ~SE ONLY 2. StoCks ~nU ~onUs (S~hedu~e B) (2) ~ /. 7 7 3' ~ ~ 3. Closely Held Corporation, Paflnemhip or Sole-Propfietomhip (3) ~ 4. Mo~gages & Notes R~eivable (Schedule D) (4) ~ 5. Cash, Bank Deposits & Miscellaneous Pemonal Prope~ (5) ~ O, m 3 /. ~ 7 I (Schedule E) 6. Jointly ~ned Pro~ (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfem & Mis~llaneous Non-Probate Prope~ (7) ~ (Schedule G or L) 8. Toal Gross ~se~ (to~l Lines 1-7) (8) ' 9. Funeral Ex,rises & Administrative Costs (Schedule H) (9) ~/~ ~ ? ~, ~ I0. Debts of Decedent, Uo~gage Liabilities, & Liens (Schedule I) (10) [ ~ ~, ~ ? 11. To~I Uedu~ions (total Lines 9 & 10) (11) iz Ne~ Vam~ of Emte (Une 8 m~nus Line l~) 02) 13. Charitable and Govemmental Bequests/Sec 9113 T~sts for which an ele~ion to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE ~TES 15. Amount of Line 14 ~xable at the spousal tax rate, or transfem under Sec. 9116 (a)(1.2) x .0 ~ (15) 16. ~ount of Line14 taxable at lineal rate ~.~ /~' ~ x .0~5 {16) 17. Amount of Line 14 ~xable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20. ~ Decedent's Complete Address: LCITY ~_~.~/~- Tax Payments and Credits: (1) 5 ~'~'~. :,2__ 1. Tax Due (Page 1 Line 19) 2. Credits/Payments _ A. Spousal Poverty Credit B. Pdor Payments C. Discount ~ Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest ~ /'' ~ ~ E. Penalty Total Interest/Penalty ( D + E 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. if Line l + Line 3 is greater than Line 2, enter the difference. This is the TAX OUE' (5) ~ ~ 47~' ,,~, (5A) A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: 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; ............................................ [] '~ ¢. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] '~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death [] [] without receiving adequate consideration? .............................................................................................................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which [] [] contains a beneficiary designation? ........................................................................................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perju~/, I declare that t have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all inforrnation of which preparer has any knowledge. ,,""7 DATE ADDRESS , - .--, ,'q .... / / DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute ~ a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. "~ SCHEDULE B CO~MONW~,TH 0F PE.~S~'V^~,^ I STOCKS & BONDS All prope~ ~in~-o~ed ~h fight of su~ivomhip must ~ disclos~ on Sch~ule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 2, Recapitulation) $ // 7 ~'.~.' ~ d~ (If more space is needed, insert additional sheets of the same size) '~" I SCHEDULE E I COMMONW~LTHOfPENNSYLV^N~^ / CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN / ~.~ ......... ESTATE OF _ ~ FILE NUMBER Include ~e pm~s of I~afio, and ~e date ~e p~s were mmived by ~e ~te. All pro~ ~i~ ~h ~e ~ght of su~ivomhip must be disclos~ on ~h~ule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF D~TH TOTAL (Also enter on line5, Recapitulation) $/~:~,, 0 ~/',. ~. ~' (If more space is needed, insert additional sheets of the same size) REV,-1511 F_,,X+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF Debts of decedent must be reposed on Schedule [. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State ~ Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulatior: $//~" "~ 3 . ~ ,~' (If more space is needed, insert additional sheets of the same size) , , RE~;15!3 EX + (1-97) ~~ '~' / SCHEDULE J COMMONW~'T~ OF PENNS~LVAN,A / BENEFICIARIES INHERITANCE TAX RETURN | FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBEI: NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE [. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART I!. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET i $ (If more space is needed, insert additional sheets of the same size) IAST W'F~2', AND ~ OF MAI~ I. 1~ I, MARIE I. McCOY, a legal resident of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my fa~t Will and Testament, hereby revoking all other wills "..and codicils heretofore made by me. F/lqST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. S~CC~D: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ~I~D: wh I devis? and bequeath the residue of my estate, of every nature and erever situate, to my daughter, MARfRNE McCOY STARR. Should my daughter, MARTA~E McCOY STARR, predecease me, I devise and bequeath the residue of my estate equally to my grandchildren who shall have survived me. FC[~I~{: I nominate, constitute and appoint my daughter, MARTRNE McOOY STARR, Executrix of this, my Ta~t Will and Testament. In the event of the renunciation, death, .resignation or inability to act for any reason whatsoever of the said MAPT~E McCOY STARR, I nominate, constitute and appoint my grandson, JAMES E. STARR, JR., Executor of this, my Last Will and Testament. I hereby relieve my Executrix or her successor frc~ the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called upon to act, insofar as I am able by law so to do. IN Wi~/qESS WH~OF, I have hereunto set my hand and seal to this, my Ta~t Will and Testament, consisting of one typewritten page, which bears my signature, this ~2~Y day of 199~ . -- ' ' Marie I. McCoy Signed, sealed, published and declared by the above-named Testatrix, MARIE I. McCOY, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our OSMMONWEALTH OF PENNSYLVAN/A ) : SS. COUNTY OF CUMBEP/AND ) I, MARIE I. McCOY, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affi~_r~edr~ acknowledged before me by MARIE I. McOOY, the Testatrix, this ~~ day of ~~--~_-~-~ , 199~. T~sta%~ix Marie I. McCo~ // Notary P~ lc ) We, ~ L. ~o~ ~~-.[~~'.--~--~ V~ ~e wi~~ ~ ~ ~ si~ ~ ~e at~ or for~o~ ~~t, ~y ~ifi~ a~~ ~ law, do de~ ~ ~y ~t we w~e prat ~ ~w ~~ si~ ~ ~~ ~e ~~t ~ h~ ~t Will; ~t ~ie I. ~ si~ will~ly ~ ~t ~e ~t~ it ~ h~ fr~ vol~ a~ for ~e ~ ~e~ ~r~; ~t ~ of ~ ~ ~e h~ ~ si~t of ~e T~~ si~ ~e Will ~ wi~~; ~t ~ ~e ~t of o~ ~l~ge ~e T~~ ~s at ~t t~ eigh~ or ~re y~ of age, of ~ ~ ~ ~ no ~~t or ~ue ~flu~. r ffi ~~~~~f~ ~ ~~ to ~fore ~ ~ ~ L. S~o~p , wi~~, ~is ~~y of~~~, 199~. 8Ht~ W ~.tII. ER~, ~U~RY PUBUC .~ EXFIH~ES JULY 14, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX *' REY-lS47 EX AFP (03-05) MARLENE M STARR 626 GRANDVIEW AVE CAMP HILL PA 17011 DATE ESTATE OF DA TE OF DEATH FILE NUMBER COUNTY ACN 03-28-2005 MCCOY 03-30-2004 21 04-0427 CUMBERLAND 101 MARIE I Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 11f!.-.t!l:,.Y!.m.m!'U!1.wtJtm.W.!fMtAW4M.'r.m.lmlmMMf~.'rI:t'fJV4MM.~Yr.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCOY MARIE I FILE NO. 21 04-0427 ACN 101 DATE 03-28-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (S) (6) (7) .00 1. 793.00 .00 .00 20.031. 27 .00 .00 (8) NOTE: To insure proper credit to your account. submit the upper portion of this forll with your tax paYllent. 21.824.27 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax (9) (10) 1.573.32 150.47 (11) (12) (13) (14) 1 .123 79 20.100.48 .00 20.100.48 (Schedule J) I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: lS. Amount of Line 14 at Spousal rate (lS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CR DITS: NOTE: .00 X 20.100.48 X .00 X .00 X 01:1"? = o 4~'~) ,~ 12 ~= (, 15..;::", - ....1 (19)=-/ 1'"':> ,''':'':'J .00"":' -""'" ;,,"", 904 .5~> ;::; .nt) I ....01:1.< -- 904.52 i DATE 01-10-2005 NUttBER CD004817 INTEREST/PEN PAID (-) .00 AHOUNT PAID 904.52 \"1 (...) (Ji BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-11-2005 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 904.52 .00 1.34 1.34 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~, Q.i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STARR MARLENE MCCOY 626 GRANDVIEW AVENUE CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: 178-38-4656 FILE NUMBER: 2104-0427 DECEDENT NAME: MCCOY MARIE I DATE OF PAYMENT: 04/05/2005 POSTMARK DATE: 04/05/2005 COUNTY: CUMBERLAND DATE OF DEATH: 03/30/2004 NO. CD 005160 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1.34 I I I I I I I I TOTAL AMOUNT PAID: $1.34 REMARKS: MARLENE STARR CHECK# 5069 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS In i'"O'"'llII oZc IC ~...ili::o :... ....o:::am U))(M)to I> !N~C I.... ~t~o :0 n 0- 3: "'''''''II IZ '"00 > N > >...~... :0 3: 0- ::0 !:::i x i!5 :... -0 r- (j) m ... 1::1... 1% :::E: ::0 Z N '"'< 1M '" <... I-t > m , E~ len 0 r- Z '" I r- t:l 3: 0 ij!: '.... < ... 1M IZ I-t II) t I", m... ~> I ::0 m I CIl I >::0 I < I m I I -0 " > ..... I ..... I I Cl ::;0 ..... I", ..... I... )00 :> "D O"D n 1M "'11::0 0 IZ )00 0... 3: .... mCll t13: 0 ~~! ",0 ~ m... "Z '" ...Z... >~ ......n :;0 i" m :;0'" ...> " CIl)ooO 3:.... 0 "''''11 ",'" :;0 ~i'" Z% ... o)oo~ "'0 M 0 3: >n'llt1 "'t1 ~ilim 0'11 Z > nOM> en> CIlm... 'II" ~ ZC....... ...... m ... 'II '" Z"''''>''' CIlO)oo :;0'" 0 nn ::0 ... ... ~::Oili ",Z :;0 >c::m n <zo'" mom <Z , ::03:(j) % C'II ~tt-l ",en ,< '" 3: 0 z< '0 r-I:I'I-t n t11t1'11 )00)00 C.... I-tmll) o,..x :C 11)::0... ~ "'''' "'II'" ",< ':;0 :;0> ~! > , r-r-m J ... Z ':;0 m>::o % M '", .. Z < Xiii > in t:lC -0 'TI > ..... n N Cl 3: Cl m '0 >n tII Cl c:: ..... (J.I n (J.I 1:;0 .... it1 C ~ ..... 3: , n I I-t '" 1:1' Cl (J.I C N len ..... n r- m .1:\ Cl < Oil , > I ..... C r- ::0 , I , I Cl c:: II) Z r- Cl N N I ..... ::0 t1 >.1:\ Cl Cl I;' (J.I ... :;0 ZN Cl Cl t:l..... .1:\ UI I :::E: '" I C 3: I c:: M I ... I II) :0 I m '" J < I I I 3: ... I < ... , > ... , 3: ::0 .." , '" I-t '" I Z m x I ... I ~ I ... I , 0 .... , .. 0 '" , , I I-t 0 I ~ STATUS REPORT UNDER RULE 6.12 NameofDecedent--hIG ~ ~~{')V _'3. /30 /;zOO J. I I I o J-f - at{ ~ 7 Date of Death: Will No.: 21 Admin. No.: 'Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether ailministration of the estate is complete: Yes g] No 0 2. lithe 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 W 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 S No' 0 Date: #OS c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. 1naJr~ln. ~ Signature _Ma.rr~h6 M. s+~ V' '( Name C:.') 102& GY'tlhdVtew Ave l2ampHil! FA Address' ' 17011 ilt-103-x l1(') Telephone No. Capacity: ~ Personal Representative o Counsel for personal representative ) BUREAU OF INDIVIDU~t:r~i~~=D ::::Fii,t INHERITANCE TAX DIVISION "'-,--- -:~ ' \' r: PO BOX 28D6Dl~',_<_', '; HARRISBURG PA 17128-0601' ' . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE :INHER:ITANCE TAX STATEMENT OF ACCOUNT *' REV-16D7 EX AFP (03-05 2005 Nti Y I G PH 2: It I DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-09-2005 MCCOY 03-30-2004 21 04-0427 CUMBERLAND 101 Aooount R_itt.d MARIE I CLERK OF ORPHAN'S COI 'RT MARLENE ~~:rIl'W'; Ci 1 pt, 626 GRANDVIEW AVE CAMP HILL PA 7011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi to your account 1 sub.it the upper portion of this form with your tax pay.ent. CUT ALONG THIS LINE .~ RETAIN LOWER PORTION FOR YOUR RECORDS ... ................................ ............................................................................... REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF MCCOY I ARIE I FILE NO. 21 04-0427 ACN 101 DATE 05-09-2005 THIS STATEHENT IS PROVIDED TO AD\ SE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHONH BELOW IS A SUHHARY OF THE PRINCIPAL TA) DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 03-28-2005 PRINCIPAL TAX DUE: 904.52 PAYMENTS (TAX CREDITS): PAYMENT DATE 01-10-2005 04-05-2005 RECEIPT NUMBER CD004817 CD005161 DISCOUNT (+) INTEREST/PEN PAID (-) .00 1.34- AMOUNT PAID 904.52 1.34 TOTAL TAX CREDIT 904.52 .00 .00 .00 ~ BALANCE OF TAX DUE . IF PAID AFTER THIS DATE, SE REVERSE SIDE FOR CALCULATION OF ADD TIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN , , NO PAYHEHT IS REQUIRED. INTEREST AND PEN. TOTAL DUE IF TOTAL DUE IS REFLECTED A A .'CREDIT" (CR)" YOU KAY BE DUE A REFUND. SE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )