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Home My WebLink About03-0820PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Sarah E. Smith No. also known as To: Social Security No. Register of Wills for the Deceased. County of Cumberland in the 181-01-9208 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(~), who is/ma~l 8 years of age or older, applies . for letters of administration on the estate of (d.b.n.; pendenle lile; durante absentia; durante minorilate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 103 South Fayette ,Streets Borough of Sh.__~.ppensburg, (list street, number, Twp. or Boro.) Decedent, then 85 years of age, died August 8 .,XI~K 2003, at 103 South Fayette Street, Shippensburg, PA. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $,. 3~000 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 70 ~000 situated as follows: 103 South Fayette Street, Borough of Shippensburg, Cumberland County Petitioner__ after a proper search ha s the following spouse (if any) and heirs: Name ascertained that decedent left no will and was survived by Relationship Residence Michael T. Smith Son 103 South Fayette Street Shippensburg, PA 17257 THEREFORE, petitioner(s) respectfully request(s) appropriate form to the ~undersigned. Micfiael T./ Smith the grant of letters of administration in the 103 South Fayette Street Shippensburg, PA 17257 OATH OF PERSONAL REPRF~ENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss ~?:'- COUNTY OF C~B~.aLA~D -~ -;: 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 representative(s) of the above decedent petitioner(s) will well and ~ truly administer the estate according to law. ~~~~- ~--, _~__ .~ ~ Sworn to or afl' med and subscribed f ~~~;c;~,~-~~ beforetime this ~,~'/ __ . ~a_y of~ / ~Michael T. Smith No. Estate of Sarah E. Smith , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW 19 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, Michael T. Smith IT IS DECREED that is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Michael T. Smith in the estate of Sarah E. Smith FEES Letters of Administration ..... $'//~" ~ Short Certificates( ) .......... $ ~' ~ Renunciation ................ $ $ Fil~///~.../~ .......... A.D. Thomas L. Bright, Esquire ATTORNEY (Sup. C~. I.D. No.) WEIGLE & ASSOCIATES, P.C. 126 East King Street ADDRESS Shippensburg, PA 17257 (717) 532-7388 PHONE #30066 WEIGLE & ASSOCIATES, P.C. * ATTORNEYS AT LAW 126 EAST KING STREET, SmI'I'ENSl~URG, PA 17257-1397 * TELEX'HONE: (717) 532-7388 FAX: (717) 532-6552 IN RE: ESTATE OF SARAH E. SMITH, late of the Borough of Shippensburg, Cumberland County, Pennsylvania, deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA : ORPHANS' COURT DIVISION : ESTATE NUMBER 21-03-0820 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Sarah E. Smith Date of Death: August 8, 2003 Administration No. 21-03-0820 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 beneficiary of the above- captioned .estate on October 21, 2003 i Michael T. Smith 103 South Fayette Street Shippensburg, PA 17257 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE. October 21, 2003 SNign~..ture~~L' ~Brigh~Xt, Esquire Address: Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 Telephone: (717) 532-7388 Capacity: Personal Representative X Counsel for Personal Representative WEIGLE & ASSOCIATES, RC. -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO3199 BRIGHT THOMAS L ESQUIRE 126 E KING STREET SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN: 181-01-9208 FILE NUMBER: 2103-0820 DECEDENT NAME: SMITH SARAH E DATE OF PAYMENT: 11/04/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/08/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,900.00 TOTAL AMOUNT PAID: $1,900.00 REMARKS: MICHAEL T SMITH C/O THOMAS L BRIGHT ESQUIRE SEAL CHECK# 105 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 INHERITANCE TAX RETURN z 0 o COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPTI 2~01 RESIDENT DECEDENT HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Smith, Sarah E. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 08/08/2003 12/03/1917 IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) [] 1. Original Return [] 2. Supplemental Return [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (dateof death between 12-31-91 and 1-1-95) lAME Thomas L. Bright FIRM NAME (If applicable) Weigle&Associates, P.C. tELEPHONE NUMBER 717/532-7388 FILE NUMBER 21 03 0820 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 181-01-9208 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 3. Remainder Return (date ef death prior to 12-13~82) [] 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 126 East King Street Shippensburg, PA 17257 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which a n election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 51,545.00~ None 26,175.64 None None 2,657.78 None None 13,343.67 14,683.47 (8) (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (i5) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate x ,045 (16) 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. Tax Due (19) 54,202.78 28,027.14 26,175.64 26,175.64 1,177.90 1,177.90 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-O0) REGISTER OF WILLS, CUM]~ERI2uND COUNTY STATUS REPORT UNDER RULE 6. 12 Name of Decedent: Sarah E. Smith Date of Death: August 8, 2003 Will No. Admin. No. 21-03-0820 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally tO the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be .filed with the Cerk'of the Orphans' Court and may be attached to this report. Date: 8/1 04 Thomas L. Britt, Esquire Name (Pleas~ type or print) WEIGLE & ASSOCIATES, _P.C. 126 East King Street Address Shippensburg, PA ( 717 ) 532-7388 17257 Tel. No. Capacity: Personal Representative X Counsel for personal representative (MAH: rmf/AM3) fiecedent's Complete Address: IiTREET ADDRESS 1TY Shippensburg ST~E- PA ~Y17257 103 South Fayette Street Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 1,900.0~ 58.90 (1) Total Credits (A + B + C) (2) 1,177.90 1,958.90 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 the OVERPAYMENT. (4) 7 8 ]. 0 0 Check box on Page 1 Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE 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 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 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, correcl and complete. Declaration of preparer other than the personal rep.~sentative is based on all information of which preparer has any knowledge. SlG. NATURE OF P.ERSON RESP,OJqSIBLE FOR ~rlLING RET~ ADDRESS M~'~ "¢/~"--~-"~-- // ~ C~ ~ ~ ) 10~ Sout~ Faye~e Street ~~~~~~-'~ Shlppensburg, PA 17257 SI~A~RE OF PERSON RESPONSIBL~R FILING RETURN ADDRESS DATE DATE ST~-'q~ATURE OF PREPT[REI~ER THAN REPRE~ENTATI'v~E ADDRESS Thomas L. Bright ~ r"---~~ \ /'x L ~.~ 126 East King Street ~ . : -- ~ Shippensburg, PA 17257 q~o~c~-0 surviving spouse is 3 Yo [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116 1.2) [72 P.S. {}9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Smith, Sara.hE. FILE NUMBER 21-03-0820 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willingbuyer anda willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION Residence at 103 South Fayette Street, Borough of Shippensburg, Cumberland County, PA TOTAL (Also enter on Line l, Recapitulation) VALUE AT DATE OF DEATH 51,545.00 51,545.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Smith, Sarah E. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 03 - 0820 Include the .proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F, ITEM NUMBER 2 DESCRIPTION M & T Bank Checking Account #97526207 Accrued interest to date of death M & T Bank Savings Account #1217050 Accrrued interest to date of death M & T Bank Savings Account #1217828 Accrued interest to date of death TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 755.84 0.00 1,092.61 0.31 808.79 0.23 2,657.78 COMMONV~.ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Smith, Sarah E. SCHEDULE H FUNERAL EXPENSES & ADMIN~TIVE COSTS FILE NUMBER 21 - 03 - 0820 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION Fogelsanger-Bricker Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Weigle & Associates, P.C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Michael T. Smith Street Address 103 South Fayette Street City Shippensburg State PA Zip 17257 Relationship of Claimant to Decedent Son Probate Fees Register of Wills, Cumberland County - Letters of Administration and Short Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Register of Wills, Cumberland County - filing PA Inheritance Tax Return Reguster of Wills, Cumberland County ~ filing Family Settlement Agreement Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 6,883.00 2,500.00 3,500.00 134.00 15.00 100.00 211.67 13,343.67 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Schedule H Funeral Expemes & Adminislmlive Costs conlinued 4 5 6 Smith, Sarah E. I FILE NUMBER 21 - 03 - 0820 News Chronicle - advertising Letters of Administration Cumberland Law Journal - advertising Letters of Administration Postmaster - certified mailing to Department of Public Welfare Recorder of Deeds, Cumberland County - recording deed 92.75 75.00 4.42 39.50 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Smith, Sarah E. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 03 - 0820 Include unreimbursed medical expenses. ITEM NUMBER Bank - installment loan DESCRIPTION 2 3 4 5 6 7 Borough of Shippensburg - 10/31/03 billing Lisa L. Helm, Tax Collector- 08/01/03 school taxes Ohio Casualty Group - homeowner's premium Timmons Oil, Inc. Repairs to real estate Allstate Insurance - homeowner's premium TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 12,375.56 167.03 517.90 384.00 447.98 4OO.0O 391.00 14,683.47 RE~-1513EX+ ~-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT ESTATE OF Smith, Sarah E. SCHEDULE J BENEFICIARIES FILE NUMBER 21 - 03 - O82O NUMBER I. II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Michael T. Smith 103 South Fayette Street Shippensburg, PA 17257 RELATIONSHIP TO DECEDENT _ Do Not List Trust~e(s) Son --nter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee NON-TAXABLE DISTRIBUTIONS: I A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEiT AMOUNT OR SHARE OF ESTATE 100% DistrictNo 34 Parcel_ID 34-34-2415-054. MapSuffix HouseNo 103 Direction S Street FAYETTE STREET Ownerl SMITH, MICHAEL T Owner2 PropType R PropDesc LivArea 1392 CurLandVal 9220 CurImpVal 39870 CurTotVal 49090 CurPrefVal Acreage .18 CIGrnStat TaxEx 1 Sa leA m t 1 SaleMo 12 SaleDa 18 SaleCe 20 SaleYr 03 DeedBkPage 00260-04431 YearBlt 1900 HF_File_Date HF_Approval_Status ~'~t.~. ~ Page loll Detailed Results for Parcel 34-34-2415-054. in the 2000 Tax Assessment Database Weigle & Associates, P.C. Attorneys At Law 126 East King Street Shippensburg, Pennsylvania 17257-1397 Phone (gRS) 502-a349 I:ax (302) o34-2955 March I l, 2004 Re .' Estate of: Sara. h~_I1,_:~;mith a/k/a ,gadie £. ,5'm/th ,goo/al ,gecurity: / 81-01-9208 Dear Ms. Linde Klein: Per your inquiry received M,~ch 11, 2004. please be '.advised thai at the time of death, the above-named decedent had on deposit with this bank thc tbllowing: Tv[x: of /k~'ount 'h ' (. ¢cl~t~g Accour~l · 4ccount Number 97526207 Ownership (Na~v t~ ,gad/e ~: ~mith ()penis, Dale 01/28/80 Balance on Dt~te of ~alh $755.84 ~ ccrued lnlemvt $ 0.00 7brai "$755.'84 .... 7~lx: of ,,lccount A'~tvings ,'lccottnt Number 02/000001217050 Owne. rship (Name., o.1) ,gadie I~ Smith ()laming Otlte 04/2,~75 Bt:dance: on Dale t~'~ath $1,092. 6/ ~ccrued inter~q $ 0 3 I ~at.t "~)i~3.62 ............................ Re: ~3'tate of: ,Sarah E. ,S'mith_~a/k/a S'adie_E. Smith' '1~1~ Account Number Ownership (Nam~w o~ Opening Datt~ Rtdtmc'e on Date Accrued Interest 7~ltd l)pe of ,'lccount A¢¢tm~t Nuraber (.IwnershiR (Names oJ) Opening Date Balan¢o on Date of Death Current &dunce ,Yavinl4~' Acco~atlt 02100000121782 8 Sadie E. ,~tnith 11/02/89 $R08. 79 $ O. 23 s,¥o~.'b~ ...... ln,~tallme, nl Loan 10000192266880001 3'odle E, Stnilh, 13orrov~-,.r Micl~tel T Rtnith, ~:c~.Borrower 04/03/01 $12,375.56 $12, OOZ 07 Please be advised there was no safe deposit box found for the above decedent. For further account information, closures and/or reimbursement of funds please call the King Street Offico # 7~7~32.4132. Sincerely, Nancy Ch,gott Recorcls Management BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280&01 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT[CE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR D[SALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX THOMAS L BRIGHT WEIGLE & ASSOCS 126 E KING ST SHIPPENSBURG PA 17257 DATE 06-21-2004 ESTATE OF SMITH DATE OF DEATH 08-08-2005 FILE NUHBER 21 05-0820 COUNTY CUMBERLAND ACN 101 Amount Remitted SARAH E 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 ~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH SARAH E FILE NO. 21 03-0820 ACN I01 DATE 06-21-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate CSchedule A) (1) 51?545,0O 2. Stocks and Bonds CSchedule B} 5. Closely Held Stock/Partnership Interest CSchedule 4. Mortgages/Notes Receivable (Schedule D} 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E} C5} 2~657.78 &. Jointly Owned Property CSchedule F} 7. Transfers CSchedule G} 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9) 10. Debts/Mortgage Liabilities/Liens (Schedule 11. Total Deductions Cll} 12. Net Value of Tax Return C12) 13,343.67 15. 14. NOTE: NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 54,202.78 28.027.14 26,175.64 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TAX CREDITS: PAYMENT I RECEIP~ DATE NUMBER 11-04-2003 CD003199 58.90 . O0 x O0 __ . O0 26,175...4,~ x 04.~ I 177.90 i'oo x l~e ' .oo O0 x 15 _ . O0 ci~)'= 1,177.90 AMOUNT PAID 1,900.00 TOTAL TAX CREDIT {: 1,958.90 BALANCE OF TAX DUEIi 781.00CR INTEREST AND PEN.il .o0 TOTAL DUE I 781.00CR C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR}, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.} DISCOUNT C+} INTEREST/PEN PAID (-) reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rate C15} 16. Amount of L/ne 14 taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate (17} 18. Amount of L/ne Iq taxable at Collateral/Class S rate C18} 19. Pr/nc/pal Tax Due Charitable/Governmental Bequests; Non-elected 9115 Trusts CSchedule J} C15} .00 Net Value of Estate Sub3ect to Tax Clq} 26,175.64 If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wtll RESERVATION= Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possess/on 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: PAYNENT= REFUND OBJECTIONS= ADHIN- ISTRATIVE CORRECTIONS= DISCOUNT= PENALTY= INTEREST= To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). 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= REGISTER OF #ILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering= 1-800-$62-2050; services for taxpayers with special hearing and / or speaking needs= 1-800~447-5020 CTT onlY). Any party in interest net satisfied w/th the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must obSect within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans" Court. Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "'Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (5~) d/scount of the tax paid is allowed. The 15~ 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 is charged beginning with first day of delinquency, or nine ¢9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6~) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January I, 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 ~ 20~ .000548 1988-1991 11~ .000501 ~ 9~ .000247 1983 16~ .0004~8 1992 9~ .000247 2002 6~ .000164 1984 11~ .000501 1995-1994 7X .000192 2003 5~ .000157 1985 15~ .000556 1995-1998 9~ .000247 2004 c~. .000110 1986 10~ .000274 1999 7X .000192 1987 10~ °000274 2000 7~ .000192 --Interest ls calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUtIBER OF DAYS DELINQUENT X DAILY 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. ESTATE OF SARAH E. SMITH File No. 21-03-0820 FAMILY SETTLEMENT AGREEMENT Tt IlS AGREEMENT made this ay of 'Nhd ,2004, BETWEEN: MICHAEL T. SMITH, being the heir-at-I/a0 of Sarah E. Smith, late of the Borough of Shippensburg, Cumberland County, Pennsylvania, AND MICHAEL T. SMITH, Administrator of thc Estatc of Sarah E. Smith, deceased. WHEREAS, Sarah E. Smith died August 8, 2003, intestate; and WHEREAS, Letters of Administration were granted to Michael T. Smith on October 10, 2003, by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, all assets of the late Sarah E. Smith have been liquidated or distributed and all her debts paid in full, and further the period of four months having been terminated since the first advertisement of the issuance of Letters to the said Administrator, the said party hereto desires to ;vaive the duty of the Administrator to file a First and Final Account with Proposed Schedule of Distribution fbr purposes of contirmation by the Court of Common Pleas of Cumberland County, Orphan's Court Division, AND FURTHER desires that a Family Settlement Agrccment be executed, which Family Settlement will be duly recorded mnong the deed records in and for Cumberland County. NOW, THEREFORE, WITNESSETH, that the party hereto, in consideration of the premises above stated, and of the Accounting and Proposed Schedule of Distribution attachcd hereto and made a part hereof, and the receipt of his distributive share as therein shown, does bind himself to the said Distribution and Accounting as set tbrth and further rcleascs Michael T. Smith, Administrator, t¥om all claims and dcmands xvhatsoever arising out of settlement of the Estate of Sarah E. Smith. The party hereto does further agree that should any liability come due to the estate of the said decedent after the signing of this agreement, he does hereby covenant and agree with the aforesaid personal representative that he xvill contribute pro rata his share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the atbresaid personal representative after thc signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, the party has hereunto set his hand and seal the day and year first above written. WITNESS: (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this, thc ~.,:.~-¢tday of ",. ,,_...~ A ,,. .~_~:t~. ~ , 2004. betbre me, the undersigned officer, personally appeared MICHAEL T SMITH, known to me (or satisfactorily proveu) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) ADMINISTRATOR'S ACCOUNT FIRST AND FINAL ACCOUNT OF MICHAEL T. SMITH, ADMINISTRATOR FOR ESTATE OF SARAH E. SMITH, DECEASED Date of Death: Date of Administrator's Appointment: Dates of Advertisement of Letters: News Chronicle Cumberland Law Journal Accounting for the Period: August 8, 2003 October 10, 2003 October 24, 31, November 7, 2003 October 31, Novembcr 7, 14, 2003 October I0, 2003, to August 12, 2004 Purpose of Account: Michael T. Smith, Administrator, offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Thomas L. Bright, Esquire Weigle & Associates. P.C. 126 East King Street Shippensburg, PA 17257 717-532-7388 SUMMARY OF ACCOUNT Estate of Sarah E. Smith For the period of Au.qust 8, 2003 through Au.qust t2, 2004 Pa~e PRINCIPAL Receipts: This Account Net Gain (or Loss) on Sales or Other Dispositions Less Disbursements: Debts of Decedent 2 Funeral Expenses 2 Administration Expenses 2 Federal and State Taxes 3 Commissions Fees 3 Family Exemption 3 Balance Before Distributions Transfer from (to) Income Distributions to Beneficiaries 4 Principal Balance on Hand For Information: Investments Made Changes in Investment Holdings INCOME Receipts: This Account Net Gain (or Loss) on Sales or Other Dispositions Less Disbursements Balance Before Distributions Transfer from (to) Principal Distributions to Beneficiaries Income Balance on Hand For Information: Investments Made Changes in Investment Holdings COMBINED BALANCE ON HAND Current Value 14,683.47 6,883.00 460.67 1,900.00 0.00 2,500.00 3,500.00 Fiduciary Acquisition Value 84,910.92 0.00 84,910.92 29,927.14 54,983.78 54,983.78 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 08/08/2003 0810812003 08~08~2003 08/08/2003 08/08/2003 08108/2003 08~08~2003 0811012004 t 0~28~2003 11/28/2003 04~27~2004 SCHEDULE A RECEIPTS OF PRINCIPAL Cash M & T Bank Checking Account #97526207 Accrued income on above item through date of death M & T Bank Savings Account #'1217050 Accrued income on above item through date of death M & T Bank Savings Account #1217828 Accrued income on above item through date of death 755.84 0.00 1,092.61 0.31 808.79 0.23 Real Estate in PA Residence - at 103 South Fayette Street, Borough of Shippensburg, Cumberland County, PA 51,545.00 Subsequent Principal Receipts Commonwealth of PA - refund of PA Inheritance Tax Contribution from Michael Smith - for payment of administrative expenses Contribution from Michael T. Smith - for payment of funera! and debts of decedent Final Contribution from Michael Smith -for payment of administrative costs, fees and taxes 781.00 334.00 21,566.47 8,026.67 Total Receipts of Principal Fiduciary Acquisition Value 2,657.78 51,545.00 30,708.14 84,910.92 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Debts of Decedent 1011612003 Oil 6/2003 10116/2003 10/16/2003 10/16/2003 11/16/2003 12/15/2003 Allstate Insurance - homeo~vner's premium Lisa L. Helm, Tax Collector - 08/01/03 school taxes Ohio Casualty Group o homeowner's premium Repairs to real estate Timmons, Inc. Borough of Shippensburg - 10/31/03 billing AIIfirst Bank - installment loan Funeral Expenses 391.00 5t7.90 384.00 400.00 447.98 167.03 12,375.56 14,683.47 10116/2003 Fogelsanger-Bricker Funeral Home Miscellaneous Administration Expenses 6,883.00 6,883.00 012012003 0/2212003 0/28/2003 1/0812003 12/0812003 12/18/2003 0510312004 Cumberland Law Journal - advertising Letters of Administration Postmaster - certified mailing to Department of Public Welfare Register of Wills, Cumberland County - Letters of Administration and Short Certificates Register - of Wills, Cumberland County - filing PA Inheritance Tax Return News Chronicle - advertising Letters of Administration Recorder of Deeds, Cumberland County - recording deed Weigle & Associates - reserve for filing Family Settlement Agreement with Register of Wills, Franklin County 75.00 4.42 134.00 15.00 92.75 39.50 100.00 460.67 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Taxes 11/04/2003 Register of Wills, Cumberland County - PA Inheritance Tax payment at discount Fees 1,900.00 1,900.00 05~03~2004 Weigle & Associates TOTAL FEES Family Exemption 2,500.00 2,500.00 05/03/2004 Michael T. Smith TOTAL FAMILY EXEMPTION TOTAL DISBURSEMENTS OF PRINCIPAL 3,500.00 3,500.00 29,927.14 SCHEDULE D DISTRIBUTIONS OF PRINCIPAL Michael T. Smith t 0/10/2003 10/'I0/2003 10/10/2003 10/10/2003 10/1012003 12/15/2003 08/10/2004 M & T Bank Checking Account #97526207 755.84 M & T Bank Savings Account #1217050 1,092.61 Accrued income on above item through date of 0.31 death M & T Bank Savings Account #1217828 808.79 Accrued income on above item through date of 0.23 death Residence 5'1,545.00 Commonwealth of PA - refund of PA Inheritance 781.00 Tax 54,983.78 TOTAL DISTRIBUTIONS TO BENEFICIARIES 54,983.78 4 Michael T. Smith, Administrator of the Estate of Sarah E. Smith, deceased, hereby declares under oath (penalties of perjury) that he has iXdly and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due l¥om the estate have been paid. Michael T. Smith Administrator Subscribed and sworn to by MICI1AEL T SMIT ,H,,, before me this 2004. UO BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COHHONgEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATEMENT OF: ACCOUNT REV-i~D7 EX AFP C01-05) THOHAS L BRIGHT HEIGLE & ASSOCS 126 E KING ST SHIPPENSSURG PA 17257 DATE 08-02-Z00~ ESTATE OF SHITH DATE OF DEATH 08-08-2005 FILE NUHBER 21 05-0820 COUNTY CUHSERLAND ACN 101 Amount SARAH E HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To Ansure proper credit to your account, submit the upper portLon of this form with your tax payment. CUT ALONG TH'rS LINE ~- RETA'rN LONER PORTION FOR YOUR RECORDS ~1 REV-1607 EX AFP (01-03) x~ INHERITANCE TAX STATENENT OF ACCOUNT -~ ESTATE OF SHTTH SARAH E FILE NO. 21 0:~-0820 ACN 101 DATE 08-02-200~ THIS STATENENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELON ZSA SUNHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 06-21-200~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 1,177.90 PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID DATE NURSER INTEREST/PEN PAID (-) 58.90 ll-O~-ZO0$ 07-12-200~ CD005199 REFUND .00 1,900.00 781.00- TOTAL TAX CREDIT IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. 1,177.90 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. IF TOTAL DUE 1S REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.