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HomeMy WebLinkAbout04-0021 CUMBERLAND Register of Wills of County, Pennsylvania PETITION FOR GRANT OF LETTERS; Estate of ELIZA C. ETTER also known as , Deceased Social Security No. 201 -1 8-4406 Petitioner(s) who islare 18 years of age or older apply(les) for: (COMPLETE "A" OR "B" BELOW:) [~ A~ Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute decedent, dated 1 1/3 9 / 1 9 9 6 and codicil(s) dated N/'A named in the last Will of the ( 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 the victim of a killing and was never adjudicated incompetent: [2~ B. Grant of Letters of Administration (d.b.h.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 or principal residence at 1 081 York Rd., Dillsburg, _ County, Pennsylvania. with his/her last family Monroe Twp., Cumberland .Co., PA Decedent, then (list street, number and municipality) 96 years of age, died De_c. 22 ,20 0_~_,at home address. Decedent at death owned property with estimated values as follows: (Loc. at on) (if domiciled in PA) All personal property $ 55,0 00.00 (If not domiciled in PA) Personal property in Pennsylvania $.. (If not domiciled in PA) Personal property in County $ .. Value of Real Estate in Pennsylvania $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: i .... Signature Typed or printed name and residence J Patricia I. Knecht 1081 York Rd., Dillsburg, PA 17019 snace/W31ts PetG rant Lt/2001 Oath of Personal Representative Commonwealth of Pennsylvania County of Ym~l~ Cumberland 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 or Petitioner(s) and that, as personal representative(s) of the Decedent, Petition(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this [z9~ day of '~%.xu~' _~.~z.~_- 20 ~J~ .. 'd Estate of No. Eliza C. Etter PATRICIA I. KL~ECHT Deceased 1-2/22/2003 ' Social Security No.: 2 0 1 I 8 4 4 0 6 Date of Death: AND NOW, ; ' 20 of the Petition on the~everse side hereon, satisfactory proof having been presented before me, , in consideration IT IS DECREED that Letters ]l~[Testamentary ~ Of Administration are hereby granted to PATRICIA I. KNECHT d.b.n.c.t.a.; pendente lite; durante absentia; durante mlnodtate in the above estate and that the instrument(s) dated Nov. 1 9, I 9 9 6 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ............ $ Short Certificate(s)...$ Renunciation ....... $ Affidavits ( ) ....... $. Extra Pages ( ) .... ..$ Codicil ............ $ JCP Fee ........... $ inventory ........... $ Automation Fee ..... $ Other .............. $ TOTAL ........ $ - ~_ ] , Regist¢' of ~¢ills (J - Attorne/J n/n~M, Wiley, Esquire i.D.N.~e''/06298 Address: Telephone: 130 W. Church St. Dillsburg, PA 17019 (717) 432-9666 snace/WilJsPetGrantLi/2001 OF ELIZA C. ETTER BE IT REMEMBERED, that I, ELIZA C. ETTER, of 1081 York Road, Dillsburg, York County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me, at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM Z: Ail the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my daughter, PATRICIA I. KNECHT, and my son-in-law, RAY A. KNECHT, in equal shares, per capita. ITEM 3: I direct my hereinafter named Executrix to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, and may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid ta×es, either federal or state, on any property required to be included in my gross estate, under the provisions of any state of federal law now QTNESS: ( SEAL ) in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 4: I appoint my daughter, PATRICIA I. KNECHT, as Executrix of this my Last Will and Testament. Should my daughter, PATRICIA I. KNECHT, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my son-in- law, RAY A. KNECHT, as Alternative Executor of this my Last Will and Testament. ITEM 5: I direct that my Executrix, or her successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~t~ day of '.~.~~ 1996. WI~. :NESS: × . ETTER (SEAL) -2- COI414OI~E~,LTH OF PENNSYLVi~NIA COUNTY OF YORK sB We, ELIZA C. ETTER, JAN M. WILEY, ESQUIRE, and JANICE E. YOCUM, the Testatrix and the witnesses respectively, whose names are signed to the attached or 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 Testament and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed this Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this /~ day of ~/~~/~ , 1996. MY COMMISSION EXPIRES: ELIZA C. ETTER JAN M. WILEY & ASSOCIATES ATTORNEYS AT Law 2 Barlo Circle Dillsburg, PA 17019 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Eliza C. Etter Date of Death: December 22, 2003 Estate Number:21-04-00021 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 January 12, 2004 Name Address Patricia I. Knecht Ray A. Knecht 1081 York Rd., Dillsburg, PA 17019 1081 York Rd., Dillsburg, PA 17019 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A. Date:January 12,2004 ~:~i-gnature Name: Jan M. Wiley, Esquire Address: 130 W. Church St. Dillsburg, PA 17019 Telephone: (717) 432-9666 Capacity: Counsel for personal Rep. Jan M. Wiley David J. Lenox Timothy J. Colgan Christopher J. Marzzacco March 18, 2004 THE VClLEY GROUP Attorneys at Law Wiley, kenox, Colgan 8, Marzzacco, P.C. Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 David E. Hershey Diana Woodside Bradley A. Winnick Jennifer L. Frechette In Re: Estate of Eliza C. Etter, deceased File Number 21-04-00021 Dear Register: Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status report with regard to the above captioned estate. Also enclosed is a check in the amount of $1,378.41 representing the tax due, and a check in the amount of $25.00 representing the filing fee. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. Sincerely, Dawn Gladfelter/A~istant /dg encl. 130 W. Church Street, Suite 100 · Dillsburg, PA 17019 · Phone: (717) 432-9666 · (800) 682-4250 · Fax: (717) 432-0426 Offices in Harrisburg · York · Carbondale www. wileygrou plaw. com COMMONWEALTH OF PENNSYLVANIA DEPA'~TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003708 WILEY JAN M 1 S BALTIMORE STREET DILLSBURG, PA 17019 ........ fold ESTATE INFORMATION: SSN: 201-18-4406 FILE NUMBER: 2104- 0021 DECEDENT NAME: ETTER ELIZA C DATE OF PAYMENT: 03/22/2004 POSTMARK DATE: 03/1 9/2004 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,378.41 REMARKS: ..... SEAL CHECK//1 732 TOTAL AMOUNT PAID: $1,378.41 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS CO.MONW~'LT. OE.E.NSYLW~ INHERITANCE TAX RETURN DEPARTMENT OF REVENUE ...~ ~0, RESIDENT DECEDENT HARRISBURG PA 17128 0601 I COUN_~ CODE YEAR NUMBER DECEDENT,~N~ME~LAsT~A~EMiD~LE~i~A~) ;z;; ~ ~: ~Z: . ~ . SOCIALSEcu~IWNuMBER Etter, ElizaC. ~ 201-18-4406 DATE OF DEATH (MM-DD-YEAR) DASE 0F BIRTh ~M-DD~Y~) ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 12/22/2003 ; 06/03/1907. ,.~ REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( ~ST, FIRST AND M~DDLE ~NITIAL) '~ SOCIAL SECURITY NUMBER [] 1. OriginalReturn [] 21 Supplemental Return [] 4. Limited Estate [] 4a. 12-12-82)Future Interest Compromise (date of death after [] 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 (date of death between 12-31-91 and 1-1-95) ?~is S~c~o~ ~;c NAME Jan M. Wiley, Esq. ~IRM NAME iif ;~plic~131;) The Wiley Group TELEPHONE NUMBER 717/432-9666 D ~' Remainder Re~um (date of dea{h prior ic ~-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 1 S. Baltimore St. Dillsburg, PA 17019 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (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) (1) None-~.iC (2) None (3) None (4) None (5) 37,205.30 9,396.89 None 14,358.59 ?FFiCiAi_ USE ,~,~.Y (8) 46,602.19 12. Net Value of Estate (Line 8 minus Line 11) (11) (12) (13) (14) (15) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 or transfers under Sec. 9116(a)(1.2) - 14,358.59 32,243.60 32,243.60 16. Amount of Line 14 taxable at lineal rate 32,243.60 x .045 (16) 1,450.96 17.Amount of Line 14 taxable at sibling rate ~8 Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [] x .12 x .15 (17) (18) (19) 1,450.96 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Dece~lent's Complete Address: STREET ADDRESS 1081 York Rd. cITY Dillsburg STATE PA 17019 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D Interest E. Penalty 72.55 Total Credits (A + B + C) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. 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 the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 1,450.96 (1) (2) 72.55 (3) 0.00 (4) (5) 1,378.41 (SA) (5B) 1,378.41 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, correct and complete Declaration of preparer other than the personal representative is based on all information of which preparer has any kr~owledge. DATE SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS tricia I. Knecht O[' ~"'~ PERSON RESP~G RETURN ADDRESS THAN ATIVE ADDRESS Wiley, Esq. 1081 York Road Dillsburg, PA 17019 1 S. Baltimore St. Dillsburg, PA 17019 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 survwing 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% [/2 P.S §9116 (a) (1.1) (i0j. The statute 0oes 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. t till. tti v tamvnt OF ELIZA C. ETTER BE IT REMEMBERED, that I, ELIZA C. ETTER, of 1081 York Road, Dillsburg, York County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments und. writings in the nature thereof by me, at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real~ personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my daughter, PATRICIA I. KNECHT, and my son-in-law, RAY A. KNECHT, in equal shares, per capita. ITEM 3: I direct my hereinafter named Executrix to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise' passing by reason of my demise, and may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state of federal law .now (SEAL) in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 4: I appoint my daughter, PATRICIA I. KNECHT, as Executrix of this my Last Will and Testament. Should my daughter,.PATRICIA I. KNECHT, predecease me, fail to qualify,. cease to act or renounce probate, I then appoint my son-in~ law, RAY A. KNECHT, as Alternative Executor of this my Last Will and Testament. ITEM 5: I direct that my Executrix, or her successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal (SEAL) -)_ COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK : ; ss : We, ELIZA C. ETTER, JAN M. WILEY, ESQUIRE, and JANICE E. YOCUM, the Testatrix and the witnesses respectively, whose names are signed to the attached or 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 Testament and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed this Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. / WITNESS' Sworn to and subscribed before me this /¢ ~ MY COMMISSION EXPIRES: COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Etter, Eliza C. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 04 - 00021 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 I DESCRIPTION Citizen~ Bank ~heCki~ A~c0unt 610070~)070: Citizens Bank Savings Account 6140210453: TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 4,396.22 32,809.08 37,205.30 CITIZENS BANK Account Number 6100700070 Account Title ELIZA C ETTER 6/6/66 Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD ACC0uut ~alauce;' as of DOD YTD Imerest to DOD Checking $4396.22 $4396,22 $ .00 CITIZENS BANK Account Number 6140210453 Ac¢oum Title -.. ,, P.I.!VA C ETTER _Date. Oper~d Acco.unt Typ~i Principal Balance as of DOD Iaterest from Last Posting to DOD Account Balance as of DOD YTD h~est to DOD 4/4/01 Savings $32784.85 $24.23 $32809,08 $271.I4 TOTAL F'.04 ~ ~ SCHEDULE F COMMONWEALTH OF PENNSYLVANIA I JOINTLY'OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT t_ _ ESTATE OF i FILE NUMBER Etter, Eliza C. 21 - 04 - 00021 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. A SURVIVING JOINT TENANT(S) NAME Patricia I. Knecht ADDRESS RELATIONSHIP TO DECEDENT 1081 York Road Daughter Dillsburg, PA 17019 ITEM NUMBER JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY ' i LETTER DATE Include name offinancial institution and bank account number DATE OF DEATH i D°i~cODF, s DA~./~,LOi~ED(~FATH FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real I VALUE OF ASSET iNTERESTi TENANT_ JOINT estate, j : .................... A 08/07/1980. Waypoint Bank Certificate 516010132 18,793.78i 50% 9,396.89 TOTAL (Also enter on line 6, Recapitulation) 9,396.89 w aup2 n LOOK FOR US. WE'LL GET YOU THERE. 1/12/2004 THE WILEY GROUP 130 W CHURCH ST STE 100 DILLSBURG PA 17019 The information which you requested on the account(s) of ELIZA C ETTER (Social Security Number 201-18-4406) is/are as follows: Account ~umber 5160 ! ¢132 Class of Account ~ERTIFICATE Date Opened 0{g0.780 Principal Balance 18689.77 Accrued Interest 104.01 Balance at Date of 18793.78 Death Account Ownership JTO Name of Joint PATRiCIA I Owner, if any KNECHT Date Ownership 080780 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ERIN WATTS SENIOR SERVICES REP. P.O. Box 171 i. HARRISBURG. PENNSYLVANIA 1710~-!711 Toll FP~ t-866-WAYPOINT (I-866-929-7646) · IN YORK ARC:A 717/~31~-4~00 · ,~.~w, wagpointbanLcom COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL~& ADIVlINISTRATIVE COSTS ESTATE OF Etter, Eliza C. FILE NUMBER 21 - 04 - 00021 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 1 FUNERAL EXPENSES: Rothenberger (engraving tombstone): DESCRIPTION Cocklin Funeral Home: Calvary United Methodist Church (memorial donation): AMOUNT 320.00 250.50 2,000.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Patricia I. Knecht Social Securitv Number(s) / EIN Number of Personal Representative(s): 1081 York Road City Dillsburg State PA Zip 17019 Year(s) Commission paid Attorney's Fees Jan M. Wiley, Esquire: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Patricia I. & Ray A. Knecht Street Address 1081 York Rd. City Dillsburg Relationship of Claimant to Decedent Probate Fees Register of Wills: State PA Zip daughter and son-in-law 17019 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Filing Fee: Cumberland Law Journal (advertise): 3,000.00 3,500.00 143.00 25.00 75.00 Total of Continuation Schedule(s) 5,045.09 TOTAL (Also enter on line 9, Recapitulation) 14,358.59 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN N~ SIDF ~! DECEDENT ESTATE OF Etter, Eliza C. The Sentinel (advertise): Schedule H Funeral Expenses & Adminislralive Cosls o:~nlinued I .E NUMBER 115.79 State Employees Retirement System (reimbursement): Heritage Medical Group: 48.30 4,881.00 Page 2 of Schedule H REV 1513~EX+ (9-00) ' SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN / RESIDENT DECEDENT ESTATE OF Etter, Eliza (2. FILE NUMBER 21 - 04 - 00021 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT Do Not List Trustee(s) t TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Patricia I. Knecht Idaughter one-half 1081 York Rd. Dillsburg, PA 17019 AMOUNT OR SHARE OF ESTATE Ray A. Knecht 1081 York Rd. Dillsburg, PA 17019 son-in-law one-half Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. i NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Etter, Eliza C. also known as , Deceased No. 21 - 04- 00021 Date of Death 12/22/2003 Social Security No. 201-18-4406 Patricia I. Knecht The Personal RePreSentatiVe(s) of the above Estate, deceased, verify th--at 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. lANe verify that the statements made in this Inventory are true and correct, lANe understand that fa[se statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: I.D. No.: Address: Jan M. Wiley, Esq. 06298 Personal Representative Patricia I. Knecht Signature: Signature: 1 S. Baltimore St. Dillsburg, PA 17019 Address: 1081 York Road Dillsburg, PA 17019 Telephone: 7!7/432-9666 Telephone: 717-732-8646 Dated: 3 "" / J~"O q . Personal Property Citizens Bank Checking Account 6100700070: Citizens Bank Savings Account 6140210453: 4,396.22 32,809.08 Total Personal Property $37,205.30 (Attach additional sheets if necessary) Total Personal Property and Real Estate $37,205.30 STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~'//2..g:~ ~-----. ~'L"".~C--.M~ Date of Death: ~ Will No. ,~/..~z/.. ~-.)~0,~1 Admin. No. Pursuant to Rule 6.1 2 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 ,."'" No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer to No. I is Yes, state' the following: a. Did the personal representative file a final account with the Court? Yes No ~ . 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 .v/' 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. Name (Please type 5'r print~ Address ~ i//~ ~¢ ~ /~ / ~ Tel. No. Capacity: Personal Representative Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVTSZON DEPT. 280601 HARRISBURG, PA 171Z8-0601 JAN H WILEY ESQ THE WILEY GROUP I S BALTIHORE ST DILLSBURG COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15~? EX &FP (QI-OS) '04 I~,'~¥'-? DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 05-10-200q ETTER 1Z-II-ZOOS 21 0q-0021 CUHBERLAND 101 Amoun~ Remitted ELIZA C HAKE CHECK PAYABLE AND REN/T PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOT/CE OF INHERITANCE TAX APPRATSENENT, ALLOWANCE OR DTSALLOWANCE OF DEDUCTTONS AND ASSESSMENT OF TAX ESTATE OF ETTER ELIZA CFZLE NO. 21 0R-0021 ACN 101 DATE 05-10-Z00~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: 1. Real Estate (Schedule A) 2. $. q. 5. 6. 7. B. ORIGINAL RETURN Stocks and Bonds (Schedule B) Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D} (q) Cash/Bank DeposLts/Misc. Personal Property (Schedule E) Jointly Owned Property (Schedule F) (6) Transfers (Schedule G) (7) Total Assets APPROVED DEDUCTIONS AND EXEHPT~ONS: 9. Funeral Expenses/Adm. Costs/Misc. Expanses {Schedule H} 10. Debts/Hortgege Liabilities/Liens (Schedule Z) 11. Total Deductions 12. Nat Value of Tax Return 15. 1~. (9) (10) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax $7~Z05.30 9~$96.89 .00 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion .00 of this fora ~ith your tax payment. (8) lq,358.59 .0O NOTE: q6,602.19 IF PAID AFTER DATE ZNDZCATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID (-) 05-19-200q CD005708 72.55 (is) .00 x O0 : .00 (~6) SI,Iq3.60 x Oq5= 1,q50.96 (17) .00 x 12 = .00 (la) .00 x 15 : .00 (19)= 1,q50.96 AMOUNT PAID 1,378.ql If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wlll TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,q50.96 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1~ NO PAYMENT IS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCT/ONS.) reflect figures that include the total of ALL returns assessed to date. (~;) $2,Zq$.60 (15) . O0 (~i) SZ, 2q$. 60 RESERVATION: Estates of decadents dying on or before De(amber 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for life or far years) the Coaaonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lamful Class B (collateral) rata on any such futura interest. Tax Act, Act Z3 of ZOO0. (72 P.S. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Section 9140). pAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. --Make check or money order payable to: REGISTER OF HZLLS~ AGENT REFUND (CR): A refund of a tax credit, ahich ams not requested on the Tax Return) amy be requested by completing an -Application for Refund of Pennsylvania Inheritance and Estate Tax'" (REV-IBIS). Applications are available at the Office of the Register of Nills) any of the Z3 Revenue District Offices, or by calling the special [4-hour ansaering service for fores ordering: l-BOO-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement) allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice oust object within sixty (60) days of receipt of this Notice by: OR --arittan protest to the PA Department of Revenue, Board of Appeals, Dept. ZSlOZ1, Harrisburg, PA 171ZB-lOZ1, --eta(lion to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADH[N- to: PA Department of Revenue, [STRATIVE CORRECTIONS: Factual errors discovered on this asseSsment should be addressed in writing Bureau cf Individual Taxes) ATTN: Post Assessment Raviaa Unit) Dept. gB060l) Harrisburg) PA 171Z8-060! _ e S of the book[et -Instructions for Inheritance Tax Return for a Resident Phone (717) 757 6505. Sea pad · ~ dainistrativaly correctable errors. Decedent" (REV-tS01) for an explanation ~- a If any tax due is paid aithin three (3) calendar months after the dacedant's death, a five percent (EX) discount of DISCOUNT: the tax paid is allowed. PENALTY: The tBg 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 and 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: Interest is charged beginning mith first day of delinquency) or nine (9) months and one (l) day free the date of death, ta the date of payment. Taxes ahich became delinquent before January [, IgBZ bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and 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 Dapar~ent of Revenue. The applicable interest rates for 19BI through gOOq ara: Interest Daily Interest Daily Interest Daily Factor Year Rate Factor Year Rate Factor Year Rate ~ .~OOZq7 tTE~ zox ~ IT~-I99l ~ =ooo~og ~ IgBS tax .ooo43B 199z 9x .oo0z47 zooz 6x .oo0164 19B4 112 .000301 1993-1994 72 .00019Z 2003 5Z .000137 I~BS 13X .0003S6 X99S-l~a 9X .000Z47 ZOO4 4X .O001tO lge6 lOX .000274 1999 72 .000192 1987 lOX .000274 ~000 72 .O0019g --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNP&/D X NURBER OF DAYS DEL/NI;~UENT X DAILY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond ihs date of the assessment- If payment is aada after the interest computation date shoan on the Notice, additional interest must be calculated.