HomeMy WebLinkAbout04-0032 Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of NANCY G. FAGER No. ~-~/--O'~-~'
Deceased Social Security No. 178-22-8485
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of
the Decedent, dated September 10, 1999 and codicil(s) dated
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at
2708 Walnut Street, Borough of Camp Hill
(List street, number and municipality)
Decedent, then 75 years of age, died December 29, 2003 at Hospice of Central PA
Residence- 1701 Linqlestown Road, Harrisburq, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ..................................................................... $ 1,000,000.00
(If not domiciled in PA) Personal property in Pennsylvania ..................................... $
(If not domiciled in PA) Personal property in County .................................................... $.
Value of real estate in Pennsylvania ...................................................................................................................... $
Total ......................................................................................................... $ 1,000,000.00
Real Estate situated as follows:
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature Typed or printed name and residence
Hummel C. Fager
'/~.//.~~.~ .~',/~ 2708 Walnut Street
~'~" ~ Camp Hill, PA 17011
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA · -~
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are
true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s)
of the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed /~.,z~...~ ~ ~__.~ ~--/- F~'~
hUMMEl:. C. FAGER
Before me this /.-~__f-// day of
No. ~ 1-~:~::) ~,~- ~'~,~
Estate of NANCY G. FAC. ER , Deceased
Social Security No: 175-22-$455 Date of Death: December 29, 2003
AND NOW,~i~_~.~_~.,.~,,~. /'.~. ,2003, in consideration of the Petition on the reverse side
hereon, sati~ory proem'having been presented before me,
IT IS DECREED that Letters Testamentary
d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate
are hereby granted to HUMMEL C. FAGER in the
above estate and that the instrument(s) dated September 10, 1999
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
FEES
Letters ........................... $ ~::::'~ ~.~_~ ,'T'<:~o
("' R--~gis-ter of V~II~ ' '-~
Short Certificate(s) $ / L,~'7'. <:::::~_~
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages ( ) ....... $
Codicil ............................ $
JCP Fee ....................... $ /4D .~,o Attorney: Richard W. Stewart
Inventory ...................... $ I.D. No: 18039
Other .............................. $ Address: Johnson, Duffie, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-
TOTAL ......... $ 4:~/,/,. ~ Telephone: 717-761-4540
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 ~ ~ ::..> .':,/--"'~
~1[ ~ Local Registrar
P 9812795 a 0 200
No. '~ Date
2/87 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
]Nanc~ G. Fager ,.Female ,. 178 -- 22 -- 8485 l,.December 29, 2003
~ ~auph~n ~. qu ha na Twp[,Cen~a~ Pennsglvanra Res~dene~ J~-~.~- ' [ h,~;~
2708 Waln~ S~ee~ ~ ,,.~ PennsyluanZa ~ ,,..~ ~~.
,tCamP Hill, PA 17011
,~. Ivan P. Gerber ,t Florence
~ Hu~el C. Fmr~ [~ 08 W~nut S~reet, Camp Hi~l, PA 17011
Im 4100 Jones~own Road, H~risb~
10:20 A ~. ~. D~e~er 29, 2003 I ~ ~
I~.~l: E~.~~~~h ~.~ ........... ' . ~
~*~ t r -- -x.~q ,~ (,o~L~,,~t~ 0 ~ 'Ft,~ (~ ~
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011810-O0001/9.7.99/RWS/DCP/125530.2
·ast lil( ¢stamCat
OF
NANCY G. FAGER
I, Nancy G. Fager, of the Borough of Camp Hill, County of Cumberland, and Commonwealth of
Pennsylvania, declare this to be my last Will and revoke any Will previously made by me.
ITEM I. I devise and bequeath all of my automobiles, household and personal
effects and other tangible personalty of like nature (not including cash or securities) together with any
existing insurance thereon, to my husband, HUMMEL C. FAGER, provided he survives me by thirty
(30) days. Should my husband, HUMMEL C. FAGER, not be living on the thirty-first (31st) day after
my death, I bequeath such tangible personalty and insurance thereon to such of my children as are living
on the thirty-first (31st) day after my death, to be divided among them by my Executor with due regard for
their personal preferences in as nearly equal shares as practical.
ITEM II. If my husband, HUMMEL C. FAGER, survives me by thirty (30) days, and if
the federal estate tax due because of my death will be reduced by making this gift for his benefit, I devise
and bequeath to my husband, ltUMMEL C. FAGER, absolutely, an amount equal to the least amount
(based upon values as finally determined for federal estate tax purposes) as shall be needed for the federal
estate tax unlimited marital deduction to reduce the federal estate tax to the lowest possible figure after
full use of ail other deductions and credits allowable in calculating the federal estate tax, except that such
amount shall be calculated without regard to the augmenting of my taxable estate by reason of generation-
skipping transfers and without regard for any credit for state death taxes that would not otherwise be
payable. Accordingly, I direct that:
A. If the marital deduction, or any similar benefit, is allowable with respect to any
property, including property, including property held by entireties, which my husband has received prior
to my death or at my death will receive otherwise than pursuant to this Item II, the value of such property
shall be taken into consideration in calculating the size of the gift under this Item II.
011810-O0001/9.7.99/RWS/DCP/125530.2
B. No property ineligible for the marital deduction, or any similar benefit, shall be
distributed to this gift for my husband, HUMMEL C. FAGER, pursuant to this Item II.
C. Either cash or investments or both may be allocated to the gift under this Item II.
D. Any property allocated under this Item II in kind shall be valued at the value at
which it is finally included in my gross estate for federal estate tax purposes, provided that the aggregate
market value thereof on the date of allocation (plus the value as finally determined for federal estate tax
purposes of all other property qualifying for the marital deduction) is at least equal to the dollar value of
the marital deduction as finally determined for federal estate tax purposes.
E. If any provisions of this Item II shall result in depriving my estate of the marital
deduction for federal estate tax purposes, such provision is hereby revoked and this Item II shall be read
as if any portion thereof inconsistent with allowance of the marital deduction for federal estate tax
purposes is null and void.
ITEM III. If my husband, HUMMEL C. FAGER, survives me by thirty (30) days, I devise
and bequeath the residue of my estate, of every nature and wherever situate, to the Trustee hereinafter
named, IN TRUST, for the following uses and purposes:
A. To pay the net income therefrom to my husband, HUMMEL C. FAGER, for and
during his lifetime in such periodic installments as the Trustee shall find convenient, but at least as often as
quarter annually.
B. To pay as much of the principal of this Trust as the Trustee, in its sole discretion,
may, from time to time, think advisable during illness or emergency for the benefit of my husband, or for
the support of my husband to maintain him in the station of life to which he is accustomed at my death, shall
be either paid to him or else applied directly for his benefit by the Trustee after taking into account his other
readily available assets and sources of income.
011810-0000119.7. 991RWSlDCPI125530.2
C. The Trustee may apply the net income of this Trust for the support of my husband,
HUMMEL C. FAGER, should he by reason of age, illness or any other cause, in the opinion of the
Trustee, be incapable of disbursing it.
D. In addition to the above provision, my husband shall have the power to direct the
Trustee to pay him or to apply out of principal in each year, including the year of my death, an amount not
in excess of the greater of Five Thousand ($5,000.00) Dollars or five (5%) percent of the then aggregate
value of the Trust principal. This power is non-cumulative and can be exercised only by an instrument in
writing signed by my husband, and delivered to the Trustee.
E. Upon the death of my husband, HUMMEL C. FAGER, or upon my death should
my husband predecease me, the Trustee shall distribute the balance of the principal and any accumulated
and undistributed income pursuant to the provisions of Item IV herein.
ITEM IV. Upon the death of my husband, HUMMEL C. FAGER, or upon my death
should my husband predecease, I devise and bequeath the residue of my estate, of every nature and
wherever situate, including any remaining principal and accumulated or undistributed income then held to
the Trustee, hereinafter named, IN TRUST, for the following uses and purposes:
A. To pay ~the net incon~e .therefrom in equal shares to my children, JANET
GUISBERT, DOROTHY FAGER-I~I~P and THOMAS FAGER. Should any of my children not be
living the income from that child's share shall be distributed to that child's then living issue, per stirpes, and
in default of such issue that child's share shall be distributed to my then living issue, per stirpes.
B. The Trustee may apply the net income which any beneficiary is entitled to receive
for the support of the beneficiary should the beneficiary be incapable of disbursing by reason of age, illness
or any other cause.
C. The Trust shall terminate twent~y-one (21) ~(ears after the death of the survivor of
150~..l~-~.rnt'~- - Nc--t::
my children, JANET GUISBERT, DOROTHY FAGER~ ~d THOMAS FAGER and the then
011810-00001/9.7.99/RWS/DCP/125530.2
remaining principal and any accumulated or undistributed income shall be distributed to my then living
issue, per stirpes.
ITEM V: Should any person entitled to distribution from a trust be, in the opinion of the
Trustee, incapable of disbursing it because of age, illness or other cause, and should it be impossible or
inadvisable, in the opinion of the Trustee, for such share to be awarded to such person or distributed to
another for such person's benefit, the share of such person shall be held, IN FURTHER TRUST, and
Trustee shall accumulate the income and shall apply, from time to time, such portions of income,
accumulated income and principal as it thinks proper for that person's support and education (including
education in college, trade school or graduate school) without regard to his or her parent's ability to provide
for such support and education, or to make payment for these purposes without further responsibility to the
beneficiary or the beneficiary's parent, or to any person taking care of the beneficiary. Any principal or
income not so applied shall be distributed to the beneficiary when he or she becomes of age or competent, or
the personal representative of the beneficiary's estate in case of death during minority or before becoming
competent.
ITEM VI: The interests of the beneficiaries hereunder shall not be subject to anticipation or to
voluntary or involuntary alienation.
ITEM VII. My Executors and Trustee shall have the following powers, in addition to those
vested in them by law, and by other provisions of my Will, applicable to all property, whether principal or
income, including property held for minors, exercisable without court approval, and effective until actual
distribution of all property:
A. To retain any or all of the assets of my estate, real or personal, including any shares of stock or
other securities I may own of the corporate fiduciary or its successors, or of a holding company controlling
the corporate fiduciary or its successor, without restriction to investments authorized for Pennsylvania
fiduciaries, as they deem proper, without regard to any principle of diversification.
B. To invest in all forms of property (including stock or other securities of the corporate fiduciary
or its successor, or of a holding company controlling the corporate fiduciary or its successor, and common
trust funds and mortgage investment funds whether maintained by my corporate fiduciary or its successors
011810-O0001/9.7.99/RWS/DCP/125530.2
or others), without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper,
without regard to any principle of diversification.
C. To sell at public or private sale, to exchange, or to lease for any period of time, any real or
personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or
conditions as they deem proper.
D. To allocate receipts and expenses to principal or income or partly to each as they from time to
time think proper.
E. To borrow from, or sell to, the trustee under the trust mentioned above, even though such trustee
may be my executor.
F. To compromise any claim or controversy.
G. To join with my husband, HUMMEL C. FAGER, or his personal representative in filing a
joint income tax return without requiring him or his estate to indemnify my estate against liability for the tax
attributable to his income and to consent to any gifts made by my husband during my lifetime being treated
as having been made one-half by me for purposes of the federal gift tax law.
ITEM VIII. I appoint FIRST NATIONAL BANK OF MIFFLINTOWN, P.O. Box 96,
Miffiintown, PA 17059, Trustee of any Trusts created by this my last will.
ITEM IX. 1 tbrgive any indebtedness in any form from my daughter, DOROTHY FAGER-
regard to her purchase of land from me in Fairview Township, yOrk County, Pennsylvania.
ITEM X. I appoint my husband, HUMMEL C. FAGER, Executor of this my last Will.
Should my husband, HUMMEL C. FAGER, fail to qualify or cease to act ,as Executor, I appoint my
children, JANET GUISBERT and DOROTHY FAGER--~~rY, ~Exe-~uNtriSe~s of this my last Will.
ITEM XI. I direct that my Executors and Trustees shall not be required to give bond for the
faithful performance of their duties in any jurisdiction.
011810-00001/9.7.99/RWS/DCP/125530.2
ITEM XII. My Corporate Trustee shall receive compensation for the performance of its
functions hereunder in accordance with its standard schedule of fees in effect fi:om time to time for the
period over which its services are performed.
ITEM XIII. The persons or a majority of sui juris persons then entitled to receive income may
revoke the appointment of the then acting Corporate Trustee and substitute a new Corporate Trustee. Said
action shall be accomplished by a writing signed by the person or persons so acting, which writing shall be
filed with the court then having jurisdiction over the Trust.
ITEM XIV. Trustee shall at any time after my death and the death of my husband, Hummel C.
Fager, merge any separate trust created under this Last Will and Testament with any other separate trust
held by the Trustee, if the terms of the trust are substantially similar and held for the benefits of the same
persons, in the same proportions and the Trustee determines there are no material adverse income, indenture
or estate tax consequences associated with the merge.
IN WITNESS WHEREOF, I have hereunto set my hand this /tY7-~. day of
~e?5,-,, t,,.- ,1999.
011810-O0001/9.7.991RWSlDCPI125530.2
SIGNED, SEALED, PUBLISHED AND DECLARED, by Nancy G. Fager, the Testatrix above
named, as and for her Last Will and Testament and in the presence of us, who, at her request, in her
presence and in the presence of each other, have subscribed our names as wimesses.
wim' ss - ^ fdres /
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
:ss:
COUNTY OF :
I, Nancy G. Fager, Testatrix, whose name is signed to the foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last
Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Swom to or affwrned and acknowledged before me, by Nancy G. Fager, the Testatrix, this
day of ~)~'13~(' ,1999.
Dada C. pa~r, N~ ~. [ Not~ ~blic
uv ~ml~ ~ ~¢' ~' '~' (SE~)
My co~ission expkes:
011810-00001/9.7.99/RWS/DCP/125530.2
AFFIDA~
COMMONWEALTH OF PENNSYLVANIA :
r ,_ \~, ~ :SS:
COUNTY OF k~'~O~¥~ :
l,\,"~'cc, ~ 5'~< the witnesses
whose names are signed to the foregoing ~nslrument, being duly qualified according to law, do depose and
say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will
and Testament; that she signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as
witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of
sound mind and under no constraint or undue influence.
,o, Sworn to_or af£n-med and subscribed to before me by '~{(.%(c~ .x~, ..)~%;llqC~ and
' ~-~C0. ~. ~,Xi~ , wimesses, this ]~.~cx day of ,,~c~y~,~-~ ,1999.
JOHNSON, DUFFIE, STEWART
& WEIDNER
ATTORNEYS AT LAW
LEMOYNE, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: NANCY G. FAGER
Date of Death: DECEMBER 29, 2003
Will No.: 21-04-00032 Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
APRIL 6, 2004.
Name Address
DOROTHY FAGER BORDLEMAY 1050 SILVER LAKE ROAD
LEWISBERRY, PA 17339
THOMAS FAGER 828 ALLENVIEW DRIVE
MECHANICSBURG, PA 17055
JANET FAGER GUISBERT R.R. #2, BOX 899, MIFFLINTOWN, PA 17059
JODY GRAYBILL, TRUST OFFICER 2 NORTH MAIN STREET, P. O. BOX 96
FIRST NATIONAL BANK OF MIFFLINTOWN MIFFLINTOWN, PA 17059
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Signature
Name Richard W. Stewart, Attorney
Johnson, Duffle, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
~_,., .. ~J~
; ',~:~ Capacity: Personal Representative
X Counsel for personal representative
ll:~.~ L-~V ~.
TO Register of Wills Office FROM
Cumberland County Courthouse JOHNSON, DUFFIE, STEWART & WEIDNER
1 Courthouse Square Attorneys at Law
Carlisle, PA 17013-3387 P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
SUBJECT: Estate of Nancy G. Fager DATE: May 4, 2004
No. 21-04-00032 .!"~ ~: ~
Enclosed for filing in the above-captioned Estate are the followin~'~ ~
1. Original Inventory. ,J~
2. Original and copy of Inheritance Tax Return - no tax due. :,;~;
3. Copy of Form 706 - Federal Estate Tax Return. ~..~
4. Check in the amount of $20.00, filing charges. . ~
5. Envelope to forward the receipts to this office. '~
Thank you.
SIGNED: Cindy Hubler, Estate Legal Assistant
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of FAGER, NANCY G. No. 21 - 04 - 00032
also known as Date of Death 12/29/2003
, Deceased Social Security No. 178-22-8485
HUMMEL C. FAGER
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Personal Representative
Attorney: RICHARD W. STEWART Signature: ~/~,z,->-/~ C ~TZ~-~
HLTMI~E'L'C~ F,~GER~
I.D. No.: 18039 Signature:
Signature:
Address: Address: 2708 WALNUT STREET
301 Market St. CAMP HILL, PA 17011
Lemoyne, PA 17043-0109
Telephone: 717/761-4540 Telephone: (717) 761-0179
Dated:
Personal Property
The Vanguard Group 1,23 l, 119.29
Vanguard Investment Account No. 9885594253
Date of death value.
Waypoint Bank 4,034.37
Checking Account No. 2222035857 --- '-~
Date of death balance.
1988 Chevrolet Station Wagon ~: '-~
~ 650.00
Date of death value. --<
1992 Chevrolet Caprice ~ .... , 2,065.00
Date of death value.
Total Personal Property $1,237,868.66
(Attach additional sheets if necessary) Total Personal Property and Real Estate $1,237,868.66
COMMO.WEAL~. Or.ENNSYLVA.,A IN H ERITAN C E TAX RETURN F"E NUMBE"
OEPARTMENT OF REVENUE ! 2 ! 04 00032
OE.T. 28o604 RESIDENT DECEDENT
HARRISBURG. PA 17128-0801 ! COUNTY CODE YEAR NUMBER
i DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
! FAGER, NANCY G. 17 8-22-8485
~ DATE Of DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
~ [ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~ 12/29/2003 i 05/23/1928 ' REGISTER OF WILLS
Ltl
Cl i(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) Y NUMBER
. FAGER, HUMMEL C.
[] 1. Original Retum [] 2. Supplemental Return 12-13-82)
(~ E '~ ~:u) [] 4. Limited Estate [] 4a. 12-12-82)Future Interest Compromise (date of death after [] 5. Federal Estate Tax Retum Required
~oo
a: ~ [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes
m m of Will) copy of Trust)
~ [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11.ElectiontotaxunderSec. 9113(A)(AttachSchO)
____ 12-31-91 and 14-95)
qAME COMPLETE MAILING ADDRESS
,~ ~ RICHARD W. STEWART
~ ~ :IRM NAME (If applicable)
$ ~ JOHNSON, DUFFIE, STEWART & WEIDNER I 301 Market St.
tOm
tELEPHONE NUMBER Lemoyne, PA 17043-0~:':
717/761-4540 -~.
1. Real Estate (Schedule A) (1) None' ~ OFFICIAE'USE:ONLY
2. Stocks and Bonds (Schedule B) (2) Non~. I
tJ't
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) Non~.::
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 1,23 7,8 68.6~
(Schedule E)
6. Jointly Owned Property (Schedule F) . (6) None
~ [] Separate Billing Requested
<~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) . 87,802.13
~ (Schedule G or L)
~- 8. Total Gross Assets (total Lines 1-7) (8) l', 3 2 5,67 0.79
,,' 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 14, ] 3 7.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,100.00
11. Total Deductions(total Lines 9 & 10) ,~ (11) 16,237.00
12. Net Value of Estate(Line 8 minus Line 11) ., (12) ! ,3 09,433.79
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) ], 0 00,0 0 0.0 0
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line .13) (14) 309,433.79
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, 309,433.79 x .00 (15) 0.00
or transfers under Sec. 9116(a)(1.2)
~. 16.Amount of Line 14 taxable at lineal rate
(16)
X
~ 17.Amount of Line 14 taxable at sibling rate x ,12 (17)
o
.~ 18. Amount of Line 14 taxable at collateral rate (18)
,- x .15
19. Tax Due (19) 0.00
20. []
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
2708 WALNUT STREET
CITY CAMPHILL :STATE PA 1Z1P 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is th~OVERPAYMENT. (4)
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 0.0 0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ............................................................................. [] []
b. retain the right to designate who shall use the property transferred or its income; ................................
c. retain a reversionary interest; or. ...........................................................................................................
d. receive the promise for life of either payments, benefits or care? ...........................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?. ................................................................................................................ [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ....... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?. ............................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration
preparer other than the personal representative is based o0 all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
HUMMEL C. FAGER
/~Z~..~.~j~¢ ~,~~ 2708 WALNUT STREET ¢ ~A?E
CAMP HILL, PA 17011
SIGNATUI~E"~o~L~i~E~PQN"'~'"~L~ FOR FILIN~I~I~ ADDRESS
SIGNATURE OF pREpARE~ OTHER THAN REPRESENTATIVE ADDREss ~ t v I~ATE
~ll~lll~[7 a~' ~"~- ~ 301 Market St.
_ · "~-/~r~,.-~./-~"~J" /~~ LemoTne.!.?A 17043-0109
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116
1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the 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 E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
FAGER, NANCY G.
21 - 04 - 00032
Include the proceeds of litigation and the date the proceeds were received by the estate~,ll property jointly-owned with the right of
survivorsh,p must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 The Vanguard Group 1,231,119.29
Vanguard Investment Account No. 9885594253
Date of death value.
2 Waypoint Bank 4,034.37
Checking Account No. 2222035857
Date of death balance.
3 1988 Chevrolet Station Wagon 650.00
Date of death value.
4 1992 Chevrolet Caprice 2,065.00
Date of death value.
TOTAL (Also enter on Line 5, Recapitulation) 1,237,868.66
,..~ SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC. NON'PROBATE PROPERTY
RESIDENT DECEDENT ,
ESTATE OF :FILE NUMBER
FAGER, NANCY G. 21 - 04 - 00032
This schedule must be completed and filed if the answer _to any of questio~ns 1 through 4 on page,2 is yes.
DESCRIPTION OF PROPERTY % OF
ITEM Include the name of the transferee, their relationship to decedent and the date of transfer i DATE OF DEATH EXCLUSION
NUMBER Attach a copy of the deed for real estate, iVALUE OF ASSETi DECD'S TAXABLE VALUE
' INTEREST (IF APPLICABLE)
1 ]The Vanguard Group 87,802.13 87,802.13
Individual Retirement Account - No. 9885594253
Beneficiary: Hummel C. Fager, Husband
Date of death value.
TOTAL (Also enter on line 7, Recapitulation)
SCHEDULE H
~ FUNEI~ EXPEN,.~$ &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN : ADMINISTRATNE COSTS
RESIDENT DECEDENT
ESTATE OF FAGER, NANCY G. i FILE NUMBER
21 - 04 - 00032
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 Cremation Society of Pennsylvania 1,339.40
2 Chestnut Hill Cemetery - internment charges 185.00
3 Chestnut Hill Cemetery - burial lot 200.00
4 Gingrich Memorials - marker inscription 285.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Johnson, Duffle, Stewart & Wei~lner 7,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Hummel C. Fager
Street Address 2708 Walnut St.
City Camp Hill State PA Zip 17011
Relationship of Claimant to Decedent Spouse
4. Probate Fees Register of Wills ~ Cumberland County 911.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Cumberland Law Journal - Legal Advertisement 75.00
2 The Patriot-News - Legal Advertisement 121.60
Total of Continuation Schedule(s) 20.00
TOTAL (Also enter on line 9, Recapitulation) 14,137.00
Schedule H
COMMONWEALTH OF PENNSYLVANIA FuneralExpenses&
INHERITANCE TAX RETURN .N:~inislrativeCOsls conlinued
RESIDENT DECEDENT
ESTATE OF FAGER, NANCY G. FILE NUMBER
21 04-00032
3 Register of Wills - File Inventory & Inheritance Tax Return 20.00
Page 2 of Schedule H
..~ SCHEDULE I
DEBTS OF DECEDENT. MORTGAGE
COMMO,WEALT. OF,E,NS¥.V^N,A LIABILITIES, & LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FAGER, NANCY G. FILE NUMBER
21 - 04 - 00032
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
] HospJc¢ o£ Ccntra! Pe~s~]va~Ja - account balance 2,]00.00
TOTAL (Also enter on Line 10, Recapitulation) 2,100.00
REV-1513 EX+. (9-00) ~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
FAGER, NANCY G. 21 - 04 - 00032
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
JDJ:~i~ot List 'rrustee(s)
t TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Hummel C. Fager Husband Tangible Personalty;
2708 Walnut Street Automobiles; Residue
Camp Hill, PA 17011
:Enter dollar amounts for distributions shown above on lines 15 through 18, as appropri2te, on Rev 1500 cover shee{'
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
IBEING MADE I
1 Trust under Item III of the Will of Nancy G. Fager f/b/o Hummel C. Fager, Husband 1,000,000.00
First National Bank of Miffiintown, Trustee.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 1,000~000.00
CONMONNEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
~RRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE 06-21-2004
ESTATE OF FAGER NANCY G
DATE OF DEATH 12-29-2003
FILE NUMBER 21 04-0032
COUNTY CUMBERLAND
RICHARD N STENART ACN 101
JOHNSON ETAL
301 MARKET ST Amount Remitted
LEMOYNE PA 17043
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORT[ON FOR YOUR RECORDS
REV-1547 EX AFP C01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FAGER NANCY G FILE NO. 21 04-0032 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) C1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
$. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) C4) .00 of this form w/th your
5. Cash/Bank Depostts/Hisc. Personal Property (Schedule E) (5) lt237t868.66 tax payment.
&. Jointly Owned Property (Schedule F) C6)
7. Transfers (Schedule G) C7) 87~802.13
8. Total Assets C8) 1,325,670.79
APPROVED DEDUCTIONS AND EXEMPTIONS:
14,137.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
lO. Debts/Mortgage Liabilities/Liens (Schedule I) CIO) 21100.00
11. Total Deductions C1L)
12. Net Value of Tax Return C12) 1,309,453.79
15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (IS) [~000~000.00
l~. Net Value of Estate Sub3ect to Tax C14) 309,433.79
NOTE: If an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 1G at Spousal rate C15) 309,433~79 x 0~? = .00
16. Amount of L/ne 14 taxable at Lineal/Class A rate C16) ;,00 X 0~ = .00
17. Amount of Line 14 at Sibling rate (17) .00 X 1~ = .00
18. Amount of L/ne 14 taxable at Collateral/Class B rate C18) .00 X [~i = .00
19. Principal Tax Due ~__~)=
TAX CREDITS=
PAYMENT RECEIP~ DISCOUNT (+)
I
TOTAL TAX CREDIT I .00
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE ¢ IF TOTAL DUE ~S LESS THAN 91, NO PAYMENT IS REQUIRED.
FOR
CALCULATION
OF
ADDITIONAL
INTEREST.
IF
TOTAL
DUE
IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION= 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 (collateral) rate on any such future interest.
PURPOSE OF
NOTICE= To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to= REGISTER OF NZLLS) AGENT
REFUND (CR)= 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" CREV-I$1$). Applications are available at the Office
of the Register of Hills, any of the 23 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-$020 CTT only).
OBJECTIONS= Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax Cincluding discount or interest) as shown on this Notice must object within sixty CEO) days of receipt of
this Notice by=
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative° OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-&505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: [f any tax due is paid within three ($) calendar months after the decedent's death, a five percent CSX) discount of
the tax paid is allowed.
PENALTY: 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 same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
IMTEREST= Interest is charged beginning with first day of delinquency, or nine C9) 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 CEX) percent per annum calculated at a daily rate of .0001&4. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are=
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 201 .000548 ~'~'~-1991 IIX .000501 ~ 91 .000247
1983 I&X .000458 1992 91 .000247 2002 EX .0001~4
1984 IIX .000501 1995-1994 71 .000192 2003 51 .000157
1985 I$X .000556 1995-1998 9X .000247 2004 4X .000110
1986 10X .000274 1999 71 .000192
1987 lO~ .000274 2000 71 .000192
--Interest is calculated as follows:
XNTERF..ST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXNqUBNT X DAXLY XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
COMNONNEALTH OF PENNSYLVANZA ~k.~
BUREAU OF /NDZV/DUAL TAXES DEPARTNENT OF REVENUE
ZNHERZTANCE TAX DZVZSION
DEPT. Z8060! NOTZCE OF DETERMZNATZON AND
HARRISBURG, PA 17128-0601 ASSESSMENT OF PENNSYLVANZA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN REV-~SSEX&FP(O~-03)
DATE 06-21-200q
ESTATE OF FAGER NANCY G
DATE OF DEATH 12-29-2005
FZLE NUMBER 21 0q-00$Z
· _. COUNTY CUMBERLAND
RICHARD N STENART ACN 201
JOHNSON ETAL Amoun~ Remi~ed
$01 MARKET ST
LEMOYNE PA 170q3
MAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGTSTER OF NTLLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 17013
NOTE: To /nsure proper credi* ~o your accoun*, submt~ ~he upper portion of ~his fore wi*h your ~ax payment.
CUT ALONG THTS LZNE ~ RETAZN LONER PORTTON FOR YOUR FZLES ~
REV-483 EX AFP (01-03) NN NOTZCE OF DETERNZNATZON AND ASSESSNENT
OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN #~
ESTATE OF FASER NANCY G FZLE NO.Z1 0~,-0032 ACN 201 DATE 06-21-200q
ESTATE TAX DETERMZNATZON
1. Credit For State Death Taxes as Verified .00
2. Pennsylvania Znher/tance Tax Assessed .00
(Exclud/ng O/scount and/or Znterest)
3. Znher/tance Tax Assessed by Other States .00
or Terr/tor/es of the Un/ted States
(Exclud/ng D/scount and/or [nterest)
q. Tote! [nher/tance Tax Assessed ,00
5. Pennsylvan/a Estate Tax Due .00
TAX CREDZTS:
PAYMENT RECEIPT D[SCOUNT (+) AMOUNT PAZD
DATE NUMBER [NTEREST/PEN PA[D (-)
TOTAL TAX CREDZT .00
BALANCE OF TAX DUEI .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
~ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE (ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED
FOR CALCULATI*ON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR)., YOU MAY BE
DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTZONS.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 (b) of the Inheritance and Estate Tax Act, Act Z$ of ZOO0.
(TI P.S. Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
REFUND (CR): A refund of a tax credit amy 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 Hills,
any of the Z5 Revenue Oistrict Offices or from the Department's Z4-hour anseering service for forms ordering:
1-800-56Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BOO-447-50ZO (TT only).
OBJECT[OHS: Any party in interest not satisfied aith the assessment of tax as sheen on this notice may object within
sixty (60) days of receipt of this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17lIB-lOll, OR
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTR: Post Assessment Revise Unit, Dept. Z80601, Harrisburg, PA 17126-0601,
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-ISO1) for an explanation of administratively correctable errors.
PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: For dates of death on or after 10-5-91, Pennsylvania Estate Tax based on the Federal Estate Tax
return becomes delinquent at the expiration of nine (09) months from the date of death.
For dates of death prior to 10-5-91, Pennsylvania Estate Tax based on the Federal Estate Tax return
becomes delinquent at the expiration of eighteen (18) months from the date of death.
Taxes ahich became delinquent before January l, 198Z bear interest at the rata of six (BI) percent per annum
calculated at a daily rate of .000164. All taxes which became delinquent on ar after January l, 19BI will bear
interest at a rate which mill vary from calendar year to calendar year aith that rate announced by the PA
Department of Revenue. The applicable interest rates for 1982 through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Yea~ Rate Factor Year Rate Factor Yea.~._r Rate Factor
198Z ZOZ .O00S4B 1988-1991 1IX .OO030l ZOO1 9Z .000Z47
1985 X6Z .00045B 1992 9Z .000Z47 ZOOZ 62 .000164
1984 llZ .000501 1993-1994 72 .O0019Z 2005 52 .000157
1965 15Z .000556 1995-1998 92 .000Z47 ZOO4 4Z .OO0ll0
1986 ZOZ .000Z74 1999 7Z .00019Z
1986 IOZ .000Z74 ZOO0 8Z .000Z19
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
COMMONWEALTH OF PENNSYLVANZA
BUREAU OF INDZVZDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Ze060! NOTZCE OF DETERHZNATZON AND
,ARNIS~UR~,P^I?lZB-"6"I ASSESSMENT OF PENNSYLVANZA
ESTATE TAX BASED ON FEDERAL REV-7$~EXAFP(OI-DZ)
CLOSZNG LETTER
DATE 10-11-200fi
,~i~ ESTATE OF FAGER NANCY G
~[i DATE OF DEATH 1Z-Z9-2005
FZLE NUMBER 21
~NTY CUMBERLAND
RICHARD N STEWART '04 !}~ ~} ;~$' 202
JOHNSON ETAL I Amoun~ Remi~ed
50! MARKET ST
LEMOYNE PA 170q$
{~:~.~i~ MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account) submi~ ~he upper portion of ~his fore wi~h your ~ax payment.
CUT ALONG THZS LZNE ~ RETAZN LOWER PORT!ON FOR YOUR FZLES
REV-736 EX AFP (01-0~) #~ NOT!CE OF DETERMZNATZON AND ASSESSMENT
OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL CLOSZNG LETTER
ESTATE OF FAGER NANCY G FZLE NO.!! 0q-0052 ACN 202 DATE 10-11-200q
ESTATE TAX DETERMZNATZON
1.Cred/~ For Sta~e Death Taxes as Verlf/ed .00
2. Pennsylvania Znheritance Tax Assessed .00
(Excluding Discount and/or Znterest)
$. !nheritance Tax Assessed by Other Sta~es .00
or Territorles of the UnA~ed States
(Excluding Discount and/or Znterest)
q. Total Znheritance Tax Assessed .00
5. PennsyZvanAa Estate Tax Due .00
6. Amount of Pennsylvan/a Estate Tax Previously Assessed
Based on Federal Es~a~e Tax Return .00
7. Additional Pennsylvan/a Estate Tax Due .00
TAX CREDZTS:
PAYMENT RECEZPT DZSCOUNT (+) AMOUNT PA!D
DATE NUMBER INTEREST/PEN PAZD (-)
TOTAL TAX CREDZT I .00
BALANCE OF TAX DUEl .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
TOTAL DUE TS LESS THAN '1, NO PAYMENT TS REI~UTRED
t~TF
pATD
AFTER
THTS
DATE~
SEE
REVERSE
STDE
CTF
FOR CALCULATTON OF ADDTTIONAL TNTEREST. IF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR)~ YOU MAY BE
DUE A REFUND. SEE REVERSE STDE OF TATS FORM FOR TNSTRUCTTONS.
PURPOSE OF
NOTTCE: To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 9140).
PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Hake check or money order payable to: RESISTER OF HXLLS, AGENT.
REFUND (CR}: A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania
Tnheritanca and Estate Tax" (REV-1313}. Applications ara avmilabia at the Office of the Register of Nills,
any of the 23 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering:
1-800-362-Z050; services for taxpayers with special hearing and/or speaking needs: 1-800-q47-3020 (TT only}.
OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within
sixty (60] days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81OZ1, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court
ADMZN-
TSTRATTVE
CORRECTTOHS: 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 (717) 787-6S05. See page S of the booklet "Tnstructions for Tnheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
PENALTY: The 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate Tax closing
letter becomes delinquent at the expiration of one (1) month from the date the final notice of the increase
in Federal Estate Tax is received.
Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67.) percent per annum
calculated at a daily rate of .00016q. All taxes which became delinquent on or after January 1, 19BI will bear
interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA
Department of Revenue. The applicable interest rates for 1982 through 2004 ara:
Interest Daily Interest Daily Interest Daily
Yea.~r Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .0005~B 1988-1991 117. .000301 Z001 92 .0002~7
1983 162 .000'q$8 1992 92 .000247 ZOOZ 62 .000164
198q 112 .000301 1993-1994 72 . O0019Z 2003 52 .000137
1985 132 .000356 1995-1998 92 .0002~7 200q qZ .000110
1986 10Z . O00Z7fi 1999 77. .000192
1987 92 .0002~,7 2000 82 .000219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must 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: NANCY G. FAGER
Date of Death: DECEMBER 29, 2003
Will No.: 21-04-00032 Admin No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a final account with the Court?
Yes No X
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:.
C. Did the personal representative state an account informally to the
parties in interest? Yes X No
D. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
Date: /"~'2/..~//1~¢ "'~~'~"~'--/
Signature
Richard W. StewaA, Attorney
Johnson, Duffle, Stewa~ & Weidner
301 Market Street, P.O. Box 109
Lemoyne, PA 17043-0109
Address
(717) 761-4540
Telephone No.
~ .(~ b,~'~ ~ Capacity: Personal Representative
~' ~0 ~ ~ Counsel for Personal Representative