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HomeMy WebLinkAbout02-0106 PETITION FOR PROBATE and GRANT OF LETTERS Estate of VIRGINIA R WEIDNER No. 7--1 - OZ--IOto also known as To: Register of Wills for the Social Security No. 162-22-770~ Deceased. County of _ CUYdgERL331D 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 executrixs in the last will of the above decedent, dated. APRIL 12 - named and codicil(s) dated -, ~9_ 2001 in the (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in YORK __ County, Pennsylvania, with er last family or principal residence at_ 4125 CARLISLE RD, GARDNERS, PA i 7324 (list street, number and muncipality) Decendent, then 76____ years of age, died JANUARY 25 , ~ 2002 at YORK HOSPITAl,. YORK. PA , 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: $ 5,000.00 WHEREFORE, petitioner(s) respectfully request(s) presented herewith and the grant of letters theron. 'rD 0 the probate of the last will and codicil(s) testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~-~'DAVID E WEIDNER CAROL A HENRY k~ ' 65 FUNT ROAD 1330 GOODYEAR ROAD . ASPERS, PA GARDNERS, PA OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CU~BERLAND 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 20~PH day of ] r~7 // ~IAR3(/C IS / R'egi~ter F/,.~-,'~.c,'J/"('4~'~'.~~ Iq-3 -- [NO. _ 21-02-106 - Estate Of CUMBERLAND __.____, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW _ the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated APRIL 12, 2001 described therein be admitted to probate and filed of record as the last will of VIR(gTNIA R WEIDNER and Letters TESTAMENTARY are hereby granted to _D~.I_D_F_~_?~J~",~D~IE, R & CAR(1T, A r-l~lqRV SgtlgUARY 30TH ............... ~ in consideration c/'.;'~e ve:itiot'., on R .e~ster of Wills FEES Probate, Letters, Etc .......... Short Certificates(6 ) .......... R~I~iC3O~X..EX.TRA · P.AG.E JCP TOTAL Filed .. 1. 7.3. .0.-. 0..2 ........................ mailed to executor ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE 105.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death- duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 7813875 No. Local Registrar JAN 2 6 2002 Date H10~.144 Rev. 1/~1 PRINT ~NENT K INK VIRGINIA R. WEIDNER 76 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) 162- 22 7704- (MOVah. Day, 1925 E, PA 4125 CARLISLE RD. GARDNERS, PA 17013 TAYLOR WEIDNER GOV ' T ~. E3 CUMBERLAND ELZIN R. ~IEIDNER SHOWERS E '9/2002 ;I1589L PA 17324-9027 11324 FUNERAL HOMEMT. HOLLY SPRINGS, PA De~ut~Coroner LAST WILL AND TESTAMENT 21-02-106 I, VIRGINIA R. WEIDNER, of 4125 Carlisle Road, Gardners, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time ~,~Le,- my death as seems expedient t° said represent~.tiv~. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: My d~amond -:-~ '~ ,,, ,u ,.,~ n;y ?.au~htcr, Carol A. Hcnry; ,?,md n~l. '~..-,, ,,. B. Rest, residue and remainder of my estate I give, devise and bequeath to my son, David E. Weidner, and my daughter, Carol A. Henry, share and share alike. 5. If my son, David E. Weidner, does not survive me, then the share of my estate given to him in paragraph four above, I give, devise and bequeath to my daughter, Carol A. Henry. 6. If my daughter, Carol A. Henry, does not survive me, then the share of my estate given to her in paragraph four and five above I give, devise and bequeath to her children, share and share alike. 7. If any of my beneficiaries are under the age of thirty (30) at my death, then said beneficiary's share of my estate shall be held in trust by my hereinafter named trustee according to the following terms and conditions: The trustee, as well as my representative, is hereby authorized to retain, unconverted, any property, real or personal, that I may own at my death and shall be under no duty to convert it into legal investments. The trustee shall have the power and authority to sell, transfer, convey, invest and reinvest and to pay over the net income of the trust property, to or for the use of such beneficiary, or to accumulate it in the sole discretion of the trustee. The trustee is also authorized and empowered to pay over to, or for the use and benefit of such beneficiary such portion of or all of the principal of the trust estate as in the trustee's sole discretion seems proper for such beneficiary's support, maintenance, education, or medical care. My pdmary object is to insure the support, maintenance, education and medicai care of such beneficiary until he or she reaches the age of thirty (30) years. When such beneficiary reaches the age of thirty (30) years, then whatever remains of income or principal of the trust estate shall be distributed to such beneficiary, the child or children of any deceased beneficiary taking the share their parent would have taken if living and subject to the same trust provisions. 8. I nominate and appoint David E. Weidner and Carol A. Henry to be the co- personal representatives of my estate, to serve without bond. 9. I nominate and appoint Orrstown Bank, Shippensburg, Pennsylvania, to be the trustee of any trust established under paragraph seven above. 10. I suggest that my personal representative retain the services of the Law Offices of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this of April, 2001. t~fday VI~IA R. W~II:INER Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ACKNOWLEDGMENT ANn _,4.FFIDA VIT WE, VIRGINIA R. WEIDNER, RHONDA S. IRWIN and HEATHER A. BARBOUR, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. I-i~_A'~HER A. BA:RBO-UR COMMONWEALTH OF PENNSYLVANIA : :SS: COUNTY OF CUMBERLAND - Subscribed, sworn to and acknowledged before me by VIRGINIA R. WEIDNER the testatrix herein, and subscribed and sworn to before me by RHONDA S. IRWIN and HEATHER A. BARBOUR, witnesses, this t~:~ day of/~./~/~.~//-.._.--, 2001. Notadal Seal Harold S. Irwin 111, Notary Public Carlisle Boro, Cumberland County My Commission Expires Sept. 23, 2002 Member, Pennsylvania Association of Notaries I~i~ta'~Public Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: Will No. Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) o[the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ,~ea .-~ ~ . ~::>~.._ · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Capacity: Signature Name ~ Address Telephone ( ) /N~ Personal Representative ' ;': Counsel for personal representative Name of Decedent: Date of Death: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Will No. ~ Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) o.f the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ,.~ ~O '~_CO'~_ · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature >~ Name xAddress Telephone ~ Capacity: __ Personal Representative Counsel for personal representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Ok/~6/OZ- Will No.: ~OD2.., -0010~ Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~, NoD 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: o 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 ["I b. The separate Orphans' Court No. (if any) for the personal representative's account is: ~ Date: c. Did the persona~resentative state an account informally to the parties in interest? Yes ~ No [--] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphan~' Court and may be attached to this repo~,~ Signatur~'~-q Name Address 17,3~5/ Capacity: Telephone No. ~,Personal Representative Counsel for personal representative 15D56D51D47 REV-1500 EX (os-45) OFFICIAL USE ONLY PA Department of Revenue Count Code Year File Number Bureau of Individual Taxes Y Po aox 2aosol INHERITANCE TAX RETURN _ Harrisburg, PA 17128.0601 RESIDENT DECEDENT ~ \ ~ ~ ~ , ~i ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 62 zz 7 7 0~ 1 a z52oo 2 007 1 425 Decedent's Last Name Suffix Decedent's First Name MI (If Appticable) Enter Surviving Spouse's Information Below Spouse's last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) d~ 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) C~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wili} (Attach Copy of Trust) O 9. litigation Proceeds Received O 10. Spousal Poverty Credit {date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORINATtON SHOULD BE DIRECTED TO: Name Daytime Telephone Number .G A V I D vJ E- ~ D lv ~- ~' Firm Name (lf Applicable) First line of address (;S ~U NT fZo~D Second line of address City or Post Office State ZIP Code z ~ REGiSTERr8FC12DILLS USE~LY ..O ' 'tom -i- r-~ ~, `~ A ~ P\> ' ~,- _^; ~~ < x~ _ DATE FILED R7 ~73o~f Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, ft is true, correct and complete. I)eclaretlon of preparer other the the personal representative is based on all Information of which preparer has any knowledge. DATE 3 -2 ~ -O ADDRESS / ~ ~V-1"~" ~ OCC~ ~, ~Qer('C 1 ~ ~ (W ~t' SIGNATURE(OF PREPARER OTHER THAN REPRESENTATIY DATE ADDRESS i PLEASE USE ORlGlNAL FORIYI ONLY Side 1 15D56D51D47 15D56D51047 ~~ J 15D56O52O48 REV-1500 EX cedent's Social Security Number De ' l ~ Z ~ Z ~ ~ 0 s Name: Decedent RECAPITULATION 1. Real estate (Schedule A) ...................... . .................... .. 1. • 2. Stocks and Bonds (Schedule B) ..................................... .. 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . , . .. 3. • 4. Mortgages 8~ Notes Receivable (Schedule D} ........................... .. 4. • 5. Cash, Bank Deposits 13< Miscellaneous Personal Property (Schedule E) ...... .. 5. 7.5 ' S ~ • ~ ~ 6. Jointly Owned Property (Schedule F} O Separate BiNing Requested ..... .. 6. • 7. Inter-~vos Transfers & Miscellaneous Non-Probate Property {Schedule G) G7 Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. ,2,,, S ~ S ~ .3 ~ 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. / ~ 5 7 (p . ~ ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 8~ 10) ..................... . ........... .. 11. ~ S 1 ~ .0 O 12. Net Value of Estate (Line 8 minus Line 11} ............................ .. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J} .......... . ........... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. Z, 0 S $ Z.. J ~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATE8 15. Amount of Line 14 taxatNe at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxatNe 2 ai lineal rate X .0 ~ z ~ S S Z.c3 ~ 16. ~ Z6 • Z ~ 17. Amount of line 14 taxable at sibling rate X .12 17. • 18. Amount of Line 14 taxable at collateral rate X .15 18. • 19 ~ Z ~v . ~ O 19. TAX DUE ...................................................... ... . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT t~ Side 2 15D56O52O48 15056052048 J REV-1500 EX Page 3 Decedent's Complete Address: Flle Number DECEDENTS NAME ~ ~~ra~n:a R. l.~ e ~ c re y~ _ _______________ STREET ADCIRESS `~ ~ 2 S ~a r ~ ~ s ~ R~ ---- - - -- CITY STATE ~ ~ ZIP ~ ~~ ~~ Tax Payments and Credits: ' 1. Tax Due (Page 2 Line 19) (1) 9,Z Cp Zd 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments _ _ C. Discount Total Credits (A + B + C) (2) 3. Interest(Penalty if applicable D. Interest E. Penalty Total Interest/Penalry (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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. {3) 3 ~s~, cp {4) t5) Z~ _ ZC~ (5A) c_j cj B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~ Z O ~ , ~5 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 Uansfer and: Yes No a. retain the use or income of the property transferred :................................................................................... ....... ^ b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ c. retain a 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. For dates oi' 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 three (3) percent [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 zero (0) percent [72 P.S. §9116 (a) (1.1} (ii}]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stilt applicable even if the surviving spouse is the only beneficiary. For dates oif 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 zero (0) percent 172 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 four and one-half (4.5) percent, 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 twelve (12) percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1511 EX+ (10.08} COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER V t ~ in ~ g ~ , ~ e c~ >tie Ir- Debts of decedent must be reported on Schedule L ITEM NUMEiER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ~o ~~~nc~etr ~v''~~~ ~ot~ I--E SSA • 00 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commissron Paid: 2. Aitomey Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Relationship of Claimant to Decedent 4. Probate Fees 5. Acxountant's Fees 6. Tax Retum Preparer's Fees 7. State Zip Zip l b ~~ TOTAL (Also enter on -ine 9, Recapitulation) (S ~ ~~ tp ~ d~ (tf more space is needed, insert additional sheets of the same size) REV-151 EX+ (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDI~LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF ~ - ^~~~ ~ FILE NUMBER U \ Y~°~`I~.CI, . V~J Indude the proceeds of litigation and the date the proceeds were received by the estate. Aq property jointly-0wned with right of survivorship must be disclosed on Schedule F. C 30 (If more space is needed, insert additional sheets of the same size) 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 IVO. CD 01 1035 WEIDNER DAVID E 65 FUNT RD ASPERS, PA 17304 -------- fold ESTATE INFORMATION: ssrv: ~s2-22-~~04 FILE NUMBER: 2102-0106 DECEDENT NAME: WEIDNER VIRGINIA R DATE OF PAYMENT: 03/24/2009 POSTMARK DATE; 03/24/2009 couNTY: CUMBERLAND DATE OF DEATH: 01 /25/2002 REMARKS: CHECK# 2235 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 51,280.85 TOTAL AMOUNT PAID: INITIALS: AJW REV-1162 EX111-96) 51,280.85 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION -. APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 2806D1 OF'-DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG PA 17128-0601 ~!'~'~ ~~€!u ~ ~ ~'j ~; ~JS DATE 08-17-2009 ESTATE OF WEIDNER VIRGINIA R r~ ~_~~; ~`,,,_ DATE OF DEATH 01-25-2002 CF 7 ~ ,i,r-,T FILE NUMBER 21 02-0106 is ~ ~ ~ ~~, ~ ~~; COUNTY CUMBERLAND DAVID WEIDNER C,. `, ~ _ ~ ~, ACN 101 65 FUNT RD APPEAL DATE: 10-16-2009 ASPERS PA 17304 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ---- -• RETAIN LOWER PORTION FOR YOUR RECORDS ~-- _ ___ -------------------- ----------------------- __________ REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEIDNER VIRGINIA R FILE N0. 21 02-0106 ACN 101 DATE 08-17-2009 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) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) of this form with your (4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 25,158.30 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 25, 158.30 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4,5 76.00 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 4. 76 OD 12. Net Value of Tax Return (12) 20,582.30 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 20,582.30 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. 16. 17. 18. 19. Amount of Amount of Amount of Amount of Principal Line 14 Line 14 Line 14 Line 14 Tax Due at Spousal taxable at at Sibling taxable at rate Lineal/Class A rate rate Collateral/Class B rate (15) (16) (17) (18) .00 20,582.30 .00 .00 X X X X DATE NUMBER INTEREST/PEN PAID C-) 03-24-2009 CD011035 354.65- 08-10-2009 SBADJUST .00 AMOUNT PAID 00 _ .00 045_ 926.20 12 _ .00 15 _ .00 c19)= 926.20 1,280.85 .O1 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 926.20 .00 .00 .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) DDD COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '. NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES APpRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 ~ _ _ _ ~ _ , HARRISBURG PA 17128-0601 REV-1547 EX AFP (01-09) w''~'? ~;';~ 2 ~ F'~~ ?~ 56 DATE os-17-2009 ESTATE OF WEIDNER VIRGINIA R CR~_ ~~~,_ ~ ~'~.^,~ ,nT DAVID WEIDNER C '~~~`' ~~'~~ ~'~, 65 FUNT RD ASPERS PA 17304 DATE OF DEATH 01-25-2002 FILE NUMBER 21 02-0106 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 10-16-2009 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE __-- -~ RETAIN LOWER PORTION FOR YOUR RECORDS F- -------------------- ---------------------------------------------------------------- REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEIDNER VIRGINIA R FILE N0. 21 02-0106 ACN 101 DATE 08-17-2009 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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: (1) .00 NOTE: To insure proper C2) .00 credit to your account, (3) .00 submit the upper portion of this form with your C4) .00 tax payment. c5)_ 25, 158.30 c6) .00 cn .00 cB) 25, 158.30 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) fig) 4,5 76.00 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00 11. Total Deductions (11) 4. ri76 - 00 12. Net Value of Tax Return I12) 20,582.30 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) .00 14. Net Value of Estate Subject to Tax (14) 20,582.30 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due reY rornrrc. c15) • 00 X 00 _ . 00 c16) 20,582.30 X 045. 926.20 c17) .00 X 12 _ .00 clB) • 00 X 15 _ . 00 (19) PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 03-24-2009 CD011035 354.65- 1,280.85 08-10-2009 SBADJUST .00 .O1 - 926.20 TOTAL TAX CREDIT 926.20 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. ~ ~n FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~/~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) DD